Newbie needing help

[MomtoMax]

Re: Newbie needing help

I brought Max back to the vet again today for a recheck on his ulcerated cornea and it’s not improved. The vet talked about sending him to Tufts for a double appointment for the endocrinologist and etymologist, but when I picked his up to put him in the back of my SUV, I felt a lump between his breast bone. When I got home, I found it to be hard and the size of a walnut.
I lost my last Corgi to Lymphoma and my last German shepherd to Hemagio sarcoma…. I’m devastated now….
Donna and Max

[Riliey and Mo]

Re: Newbie needing help

riliey had a hard lump removed on his chest at 12 years.

it turned out to be fatty tissue.


best of the holidays to you Donna.

[jesse girl]

Re: Newbie needing help

hoping for a Christmas miracle and things can settle down . You have had a tough go at it trying to help your best buddy . I do understand how hard it can be . A prayer for some light at the end of the tunnel will come your way .

[MomtoMax]

Re: Newbie needing help

Max is completely blind now. We have an appointment at Tufts small animal vet school 0n 2/3.
For those that are seeking B12, try Wonderlabs B12with intrinsic factor as that absorbs the B12 into the system.
I has an EPI dog with low B12.
Donna

[k9diabetes]

Re: Newbie needing help

What have they been doing to treat the corneal ulceration?

There are several treatments involving scoring the area of the cornea, which helps it fill in the cells in multiple smaller spaces instead of one large one.

Our diabetic dog had chronic corneal ulcers that were very slow to heal and those procedures were required, along with wearing a cone so he absolutely couldn't scrape his cornea while it was healing, to resolving them.

Following is a copy of a post I wrote some time ago about these processes:

We had extensive experience with corneal ulcers that refused to heal with Chris. He got the first one I think before he was diagnosed with diabetes and had several while he was diabetic. So that was between 2004 and 2008.

Originally we worked with the GP vet, who kept debriding the ulcer - that's where they go over the cornea with a swab. That wasn't working so eventually they sent us to an ophthalmologist. Since that was our first experience with them, we didn't know any better. Now I wish they would have sent us to the ophthalmologist immediately after the ulcer didn't quickly heal.

Chris never had the plasma treatment - I think it may have become popular after his experiences. There's a PDF document here that describes the procedure:

His ophthalmologist was not a fan of debridement. His feeling was you try it once and it the ulcer doesn't heal up right away, more serious steps are needed.

What worked for Chris was keratotomies - his first one was a grid keratotomy and the rest were punctate - in both cases interrupting the surface of the cornea with either a grid of scratches or minute needle punctures helps the corneal cells cement better in dogs who have trouble healing an ulcer. Sounds like it would make it worse, not better huh?

These were done very quickly in-house with no general sedation or anesthesia, just anesthesia of the eye itself, in about 15 or 20 minutes during an office visit.

http://en.wikipedia.org/wiki/Corneal_ulcers_in_animals

There used to be a really great description of treatment of uncooperative ulcers available online. So far, I haven't been able to find it.

In Chris' case, one ulcer was very slow to heal. The cells would fill in but wouldn't be properly cemented so they would slough off easily. It wasn't until the ophthalmologist did a punctate keratotomy over pretty much the entire cornea that it healed up, and it healed up fast at that point. He had a condition where his corneal cells tended not to cement properly. Common in boxers, which may have been a part of his genetic grab bag.

Natalie

[MomtoMax]

Re: Newbie needing help

Sorry, I have not given any updates, but until yesterday, we didn’t have any. Yesterday we saw an Ophthalmologist and an Endocrinologist at Tufts University and we have a new treatment plan.
First, as you referred to Natalie, they did the scoring of the eye, as you referred to (they called it a Burr procedure) and then put a contact lens over it as well. He’s to go back in two weeks to get the lens removed and may have to have it done one more time, but it’s nice to at least have a plan! He’s on more Ofloxacin and they added a Ocular repair gel as well as putting him on Doxycyclin.
As for the Endocrinologist, she believed he could go to a much higher dose of the Vetsulin, before trying others. My primary vet was concerned at 8 units, he was at the top of what he could have, but the Endocrinologist said we were only midway into the dosage that he could have. She raised him to 9 units and wants to see a curve every 3 days.
We discussed his diet, of which I’ve been through so many over the last several months and she liked what I’m currently feeding him, The Honest Kitchen. Here’s the thing – I got my first box of chicken and he did really, really well on it! When I tried to reorder it, nobody had it!! Turned out to be one of the Covid food supply shortages… So, I bought the base mix and said, I’ll just cook more chicken (boneless, skinless chicken breast)! But his BGs went up on it?!?! She suggested that I add more meat than what the instructions as this is what I was basically doing before by adding additional chicken topper, so we’ve implemented that.
That’s where we are at for now.
Donna and Max the well loved nearly blind Corgi who got all the attention at Tufts yesterday and is happy wearing his pirate patch – Arhhh, Arhhh

[jesse girl]

Re: Newbie needing help

Well it seems like things are going in the right direction . I have heard of others doing good on honest chicken . Jesse was homemade so I have no knowledge personally . Not sure I understand exactly what you were suggesting saying you had good numbers with the chicken version .of honest chicken .What kind of numbers were you getting before it was out of stock ?

[MomtoMax]

Re: Newbie needing help

I thought I’d give and update: Things are finally going in the right direction!!!!
I brought him back to Tufts for an ophthalmology appointment and his cornea is healed! At the first appointment, they said they may have to do the procedure again, but did not have to. They prescribed him Ketorlac Tromthamine Opthalmic Solution for both eyes once a day and a recheck in 6 months.
Endocrinology put another Libre sensor on him that stopped reading after just three days! I’m done with them as they are just way too expensive and wonky. It’s still stuck on him, but doesn’t read anymore. I haven’t done a true curve on him since it stopped reading, but check it a couple of times a day with the Alphatrak and it’s been really good! At 9 units of Vetsulin, he’s averaging around 150 a day (I take it at various times, so not always the same time of day)! The highest I’ve seen is 240 and the lowest 100. Much different than the 500’s to the 50’s!!!!
I wonder if his body just finally “accepted” the insulin instead of flat out “rejecting” it? I’ve no idea, but I’ll take it!!!
Oh, and I had to purchase him a stroller as while he does beautifully around the house (except for predicting where his housemate may be laying down), in strange places, he’s frightened to move not being able to see. It took a bit, and lots of treats, but he’s now comfortable being wheeled around in it. My grown children swear I’ve lost my ever loving mind in doing this, but I guess getting older does have its advantages in that you do get a pass on some things… LOL Why they cannot understand I cannot carry around a 30 pound, oddly configured dog is beyond me as well!!! LOL
Donna and Max the blind, diabetic, but still quite happy Corgi

[jesse girl]

Re: Newbie needing help

My Jesse used my grandkids stroller . We went camping and strolled her in the redwood forest . She was more of an attraction than the trees . It's not unusual to strole a dog . My Jesse had doggie dementia and could only walk in circles .

Some can't see . That's just the way it is . You do what's best for your situation and it doesn't matter what others think. You do what you do out of love

Great that regulation has been achieved . I stopped doing complete curves over time just doing checks at her 3 injection times and she was well regulated

Her last year I barely tested her at all as she kind of protested during that end part of her life . That was more of an acceptance on my part that time was short

I am glad I got to be with her for this extended time . She taught me more than anything and appreciate all she did for me . Appreciate your time and like I said it doesn't matter what others think .

[MomtoMax]

Re: Newbie needing help

I did a curve today and here are my numbers at 9 units of Vetsulin:

Breakfast and Insulin
5:30
Unknown
BG test
8:30
94
BG test
10:30
160
BG test
1:30
68
BG test
3:00
Er3
BG test
4:00
123
Dinner and Insulin
5:30
Unknown
BG test
6:30
215
Am I in the right place?

[jesse girl]

Re: Newbie needing help

Looking good and a job well done . Keep up the good work and congrats .

[MomtoMax]

Re: Newbie needing help

While I felt I had his diabetes under control, I did a curve today and this is the results:
5-Apr
Breakfast and Insuline
5:30
Unknown
BG Test
8:00
180
BG Test
10:00
55 (Karo Given)**
BG Test
11:30
67 (Karo Given)**
BG Test
1:00
40 (Karo Given)**
BG Test
3:30
235
5:30
Dinner and Insulin
Unknown
BG Test
6:00
545
Is the Alpha Track II the best meter? All of those lows, in which I gave Karo, he showed zero signs of being Hypo.I gave it based on the meter readings and now I'm sorry I did...
Donna

[Riliey and Mo]

Re: Newbie needing help

you brought his blood sugar up and saved a hypo incident. retest when u get a low. the alphatrack is good Nothing to be sorry about

40 is low and warrants at least a 1/2 unit reduction.

yes it would help to get a fasting number.

you can prevent a hypo by testing after you feed him!!!

inject only when the blood sugar is over 200, wait till it is, if not not over 200 start reducing by half .5 a unit

[MomtoMax]

Re: Newbie needing help

Forgive my ignorance, but I'm having a hard time understanding. Today he was totally normal!
Why is this happening?
BG was 180 this morning, and 320 before dinner. Yesterday was a total fluke! Why???

Donna

[jesse girl]

Re: Newbie needing help

My Jesse never showed any problems at lower levels. Dogs maybe more resilient to the affects of low sugar . There tolerance for pain is high from what I see . You do have to consider those numbers low . Whether your dogs body would have naturally responded to lower levels is hard to say . It seems rare to see a true hypo event in a dog that's not heavily overdosed . If you have to worry about low sugar events it maybe worth cutting the dose as mo suggested . It's just not worth the risk keeping numbers at that level .