Tony's Jessie earned her wings

[Margaret Boyle]

Re: New Member Jessie - Problem with shots

Thanks to everyone. As soon as get the curve results from the vet we will post it here. In the meantime, unless you tell us different, we will give Jessie her 5 units in the morning and then wait for the curve results. We gave her the last vetoryl on monday morning. We have been testing the urine for glucose but not for ketones (I have only just found out about this and am still tyring to get my head around it). The instruction leaflet was missing from the diastix box so we don't really know what we are doing. All I know is that initially, 3 weeks ago, after the 30 seconds, the colour was dark brown (the furthest shade of colour to the left). It is now on the third shade up which is browny/green and we thought that was a good sign. I will try and get some photos and post them tomorrow. She is very sore around her rear end/vulva and it is black/swollen and occasionally bleeding. She is scratching a lot tonight and very unsettled although she can still jump and off the settee. We don't know what to do for the best with her. She's so much part of the family and I don't want her to suffer. I'd prefer to ease her painful skin problems so that she has a relatively pain free time with us - even if she only has a short time left. My wife Pat has put some calomine lotion on her sore bits tonight, and we have a mild skin shampoo that we use. The only thing that seemed to work on her skin problems was something called 'Atopica' (quite pricey) which we used a couple of months ago, BUT it states in the information sheet not to use on diabetic dogs. Also don't know whether to ask the vet to refer Jessie to the Vet University Hospital in Glasgow, now, or wait until the new year. So many things to think about. And I know there are dogs worse off than Jessie so we must try and remain positive. cheers, Tony

Hi Tony,

Fantastic I told you there would be lots of people who would help with the skin issues and offer you some advice.

I am so glad I actually worried all night about the vets attitude towards Jessie.

You will make up your mind about internal specialists once you have done some probing

Keep up the good work.

Hugs

[CarolW]

Re: Problem with shots

Wow, Carol, your pages are really great. I follow a lot of threads here, just to learn more, and clicked to your injection pages. I had completely forgotten about injecting with the bevel side up. I knew that at one time, but it must have slipped back into my memory abyss.

I had just opened a pack of 10 tonight and used one on Mik. After seeing your site, I pulled the red cap off the remaining 9 needles and there is no pattern from one to the next. The bevel can be anywhere. I will mark barrel with black felt pen from now on.

[Actually, with good light, I went ahead and marked all 9 in advance]

I prep Mik's injection then put it carefully in a nearby dish. It's 3-4 IU Vetsulin and sits there at room temps for 20-40 minutes, while I prep meals and depending on Mik's mood to eat.

I figured that was enough "warm-up" and have never tried the arm pit. Might try that tomorrow.

thanks for great information!

bob

Noting that this is Tony and Jessie's thread, and Tony has ONE HECK OF A LOT OF STUFF on his mind right now, what with a possible false positive on Cushings disease, along with diabetes that hasn't yet been brought under control. Tony - I just dropped in quickly on the Cushings forum, and am delighted you seem to be getting excellent assistance there, including in finding a good vet in Glasgow.

Bob - I'm so glad you found the painless-injection pages helpful - lots of people do, or so they tell me. I write in such excruciating detail because I need that for MYSELF! So I figure, maybe some others can use it too.

It is SO EASY to forget one of those steps.

With Jessie, with skin problems, it might be difficult to "tent the skin" - that is, pull up a bit of skin to inject into. In that situation, I'd ask others here what they do in such situations. MAYBE it would be possible to inject without pulling skin up, but instead, if it were me, I would probably try to insert the needle almost parallel to the skin surface, so the needle doesn't go very deep, but slides under the skin with the needle-tip still fairly close to the surface.

The target area for injecting is, typically, the "fat layer just under the skin." There may not be much fat in some areas!

The other thing I'd consider is, for ANYONE - to remember why you are doing this - to feel, at the time you are preparing the syringe, the deep, deep pleasure in knowing that with EVERY injection, you are saving your dog's life. To enjoy that. And - to REMEMBER TO BREATHE!

Dogs really notice when we hold our breaths. Singing and crooning to your dog is a good way to make sure you are breathing when you do this job.

I hope others can help with the idea of how to inject if you're not going to "tent the skin."

And, Bob, thank you so much for letting me know those pages were helpful to you, too.

Oops - Bob - I forgot one thing. I prefer not to let a filled syringe sit for 20 to 40 minutes, as the insulin may settle a bit if you do that. That's why I fill the syringe only very shortly before injecting, and use the armpit-warming technique, instead of letting the insulin come to room temperature. Also, when I inject, I like to be able to feel, through the syringe-barrel, that the temperature feels "distinctly warm" to the fingers. That will be much more nearly at the dog's body-temperature than room-temperature is! Tony - that might make a useful difference to Jessie, as well.

Tony - I'm watching you and Jessie, and wishing you everything good.

Wed, 23 Dec 2009 08:15:33 (PST)

[Margaret Boyle]

Re: Problem with shots

Noting that this is Tony and Jessie's thread, and Tony has ONE HECK OF A LOT OF STUFF on his mind right now, what with a possible false positive on Cushings disease, along with diabetes that hasn't yet been brought under control. Tony - I just dropped in quickly on the Cushings forum, and am delighted you seem to be getting excellent assistance there, including in finding a good vet in Glasgow.

Bob - I'm so glad you found the painless-injection pages helpful - lots of people do, or so they tell me. I write in such excruciating detail because I need that for MYSELF! So I figure, maybe some others can use it too.

It is SO EASY to forget one of those steps.

With Jessie, with skin problems, it might be difficult to "tent the skin" - that is, pull up a bit of skin to inject into. In that situation, I'd ask others here what they do in such situations. MAYBE it would be possible to inject without pulling skin up, but instead, if it were me, I would probably try to insert the needle almost parallel to the skin surface, so the needle doesn't go very deep, but slides under the skin with the needle-tip still fairly close to the surface.

The target area for injecting is, typically, the "fat layer just under the skin." There may not be much fat in some areas!

The other thing I'd consider is, for ANYONE - to remember why you are doing this - to feel, at the time you are preparing the syringe, the deep, deep pleasure in knowing that with EVERY injection, you are saving your dog's life. To enjoy that. And - to REMEMBER TO BREATHE!

Dogs really notice when we hold our breaths. Singing and crooning to your dog is a good way to make sure you are breathing when you do this job.

I hope others can help with the idea of how to inject if you're not going to "tent the skin."

And, Bob, thank you so much for letting me know those pages were helpful to you, too.

Oops - Bob - I forgot one thing. I prefer not to let a filled syringe sit for 20 to 40 minutes, as the insulin may settle a bit if you do that. That's why I fill the syringe only very shortly before injecting, and use the armpit-warming technique, instead of letting the insulin come to room temperature. Also, when I inject, I like to be able to feel, through the syringe-barrel, that the temperature feels "distinctly warm" to the fingers. That will be much more nearly at the dog's body-temperature than room-temperature is! Tony - that might make a useful difference to Jessie, as well.

Tony - I'm watching you and Jessie, and wishing you everything good.

Wed, 23 Dec 2009 08:15:33 (PST)

Carol sorry for butting in here but quite a few have came in with tips about not tenting the skin and I had said to Tony about placing the needle parallel to the skin, Lucy does not like tenting and this is what I do.

You must have missed the post where we were talking about this.

Hugs Margaret

[CarolW]

Re: Problem with shots

Carol sorry for butting in here but quite a few have came in with tips about not tenting the skin and I had said to Tony about placing the needle parallel to the skin, Lucy does not like tenting and this is what I do.

You must have missed the post where we were talking about this.

Hugs Margaret

I did miss it, Margaret - thanks so very, very much for pointing it out to me! So that placing the needle parallel to the skin does seem to be the way to go! I'm really glad to know that.

THANKS!

Wed, 23 Dec 2009 09:47:02 (PST)

[robertpri]

Re: Problem with shots

Oddly enough, Mik does not mind the tenting. [he does not like much of anything these days, but the tenting does not bother him]

But I "pinch" a tent in one spot, let it go, pinch another one, let it go, and he kind of gets used to it. Then when the skin\flesh looks just right and Mik is calm, I use the syringe which has been at the ready in my right hand.

I then pinch another tent, and another one, so a total of maybe 10 times. Somewhere in the middle, he gets the shot. Mostly, he is unaware of when he got the shot. Over the year, he has slightly moaned about three times. I must have been off a bit.

I had not thought of the insulin 'settling' in 20-40 minutes while it warms up. I will try the armpit method tonight.

[CarolW]

Re: Problem with shots

Bob - I LOVE your multiple-tents idea! Fabulous! Wouldn't probably work so well with Jessie, with her skin problems, but for a dog who is comfortable with tenting, it's IDEAL!

Some people warm the contents of the syringe in their mouths - I don't like to get saliva on the syringe barrel, so I don't do that; haha! I warm in my armpit, from 15 to 30 seconds.

Wed, 23 Dec 2009 10:14:08 (PST)

[robertpri]

Re: Problem with shots

Bob - I LOVE your multiple-tents idea! Fabulous! Wouldn't probably work so well with Jessie, with her skin problems, but for a dog who is comfortable with tenting, it's IDEAL!

Some people warm the contents of the syringe in their mouths - I don't like to get saliva on the syringe barrel, so I don't do that; haha! I warm in my armpit, from 15 to 30 seconds.

Wed, 23 Dec 2009 10:14:08 (PST)

I read [here?] about the mouth idea. Somebody said they put the barrel 'sideways', or sort of 'across' their mouth, just between the lips. [in front of their teeth]

I tried this on an empty syringe for practise, and it did not seem all that awkward. How effective to warm, I don't know.

I like the idea of marking syringes. I tried black, but it was too confusing with the black lines on the barrel, so I use Red, and mark them in advance.

[ajtony]

Re: New Member Jessie - Problem with shots

Hi Margaret/Guys, 24 hours is such a long time with a sick doggy isn't it. After the despair of Tuesday, today we all feel a lot better. We revisited the vet Practice and saw the vet who first saw Jessie a week ago and he was just fine. I think we must have met his Dr Jekyll partner yesterday. Anyway, the Mr Hyde (or have i got that the wrong way around?) vet said he would be happy to refer us to an IMS, even Glasgow University Vet Hospital but he suggested we wait until the New Year as he wants to get Jessie regulated first. The Cushings can wait until then. We were happy with that. The new 29G needles arrived and it was much easier giving Jessie her injection tonight! And a book arrived from Annette with tips about blind dogs (Thanks Annette) so we are readin up on that. I will post the curve results next. Thanks again, Tony. PS I have posted some photos of Jessie and her skin.ear infection.

[ajtony]

Re: New Member Jessie - Problem with shots

Hi Jenny, just posted some photos of Jessie's sore vulva area. The rest of her coat isn't that bad at present - its mainly her ear infections and vulva. cheers, Tony

[ajtony]

Re: Problem with shots

Hi Carol, excellent tips on your site thanks. We used a 29G needle tonight and it was much easier. Jessie still flinches/struggles when we make any sort of tent in the skin but I think we bored her to tears in the end with our rendition of, 'How much is that doggy in the window'. Ha, Ha. Thanks again, Tony

[ajtony]

Re: New Member Jessie - Problem with shots

Hi Nathalie, Right, here are the figures from the curve done yesterday. Jessie was given her shot about 5 minutes before they did the first test and she was quite stressed due to the vet giving the shot very roughly. She was fed about 40 minutes before that.

0900 hrs 24.6 (x 18 for US (is that right? = 442.8)

11.20 hrs 17.6 (316.8)

1220 hrs 18.4 (331.2)

1530 hrs 16.2 (291.6)

1700 hrs 17.6 (316.8)

As far as we know she wasn't fed anything during this time. the vet said go onto 7 units of caninsulin twice a day (she has been on 5 units ) but tonight we just went up to 6 units. What do you think? She is booked to go back in for anothet curve in 10 days.

We are presntly feeding her half her food at about 8am and then the rest 11/12 hours later. She gets a dental chew in the evening and home made treats/green beans when getting her shot.
Cheers, Tony

[robertpri]

Re: New Member Jessie - Problem with shots

Others are this forum are the experts, but in my opinion, you are increasing the insulin exactly right by going from 5 to 6, then 6 to 7.

A jump directly from 5 units to 7 is a 40% increase. Unless the BG readings are really high, I think that's too much an increase at one time.

I increased Mik +.5 units a day for 1-2 days, then another +.5, etc.

My opinion only....

[k9diabetes]

Re: New Member Jessie - Problem with shots

The curve looks pretty good Tony, especially given all the stress poor Jessie has been under. You will have to tell Dr. Jekyl that Mr. Hyde is no longer allowed to have any contact with her though!

I would never ever do a 2 unit increase for a dog getting 5 units, even her blood sugar had been a LOT higher than it was. So I'm glad you went up just 1 unit. If you see her urine tests go negative, I would cut back to 5.5 units and leave it there for a while. It can take a few days for things to settle in.

The particularly nice thing about the curve is how flat her blood sugar levels stayed. If it stays that way when her BG gets into lower numbers, she will regulate beautifully.

Very nice!

Hope you have a lovely holiday. Should be a lot easier to do now...

Natalie

[k9diabetes]

Re: New Member Jessie - Problem with shots

I've just looked at Jessie's photos... has this crud she has ever been diagnosed as anything?

Has she ever been put on antibiotics or fungal or mite treatment?

Whatever else she might have, I would think antibiotics would be needed as anytime the skin is moist and inflamed bacteria are likely to grow as well.

What does the new vet say about this?

Natalie

[k9diabetes]

Re: New Member Jessie - Problem with shots

So Jessie did well on cyclosporine (Atopica)... there is a fairly extensive site on the maker's page here:

http://www.us.atopica.com/vIndexVet.shtml

http://www.atopica.com/about_ad/en/index.shtml

I looked at the product label

http://www.us.atopica.com/pdf/04-08-product_label.pdf

and it did not include diabetes as a contraindication, only dogs with is a history of neoplasia.

I know of at least one diabetic dog some years ago who received cyclosporine for her auto-immune disease.

This is an immune-system suppressing drug, which probably is just what Jessie needs. They might want to clear up any infectious agents before putting her back on it but it looks like she perhaps could go back on Atopica.

I also know of a Westie whose allergies were so bad that he had to have steroids his entire life. Which made managing his diabetes a lot more difficult - he needed a high dose of insulin - but it was that or he would bleed to death from stomach ulcers. So he got steroids and insulin and they made it work.