Dear Champ crossed the bridge today

[Champ]

My name is Shawn, proud father of Champ an 8 year old St Bernard/Rottweiler mix (typically 140 punds). Back in November we noticed Champs belly to appear "swollen", and he was very sedate and inactive. On occasion he would wimper when getting up/down or moving. This lasted a couple days, so we took him in to have him looked at. At that time they found through xrays an enormous amount of fluid build up in his abdomen. So we were sent to an E-clinic for more tests, and a sono. That night, the attending vet at the E clinic essentially told us that she was certain it was a large cancerous mass and he likely had 30-60 days to live. Shocked and dismayed, we were able to take Champ home that night, but we had set an appointment to have his belly "tapped" 2 days later.

That Wednesday I took Champ in for his belly tap, and a follow up scan of his abdomen. While at work the vet calls me that afternoon to tell me that Champ was ready to be picked up and we could discuss the findings then. So I gladly skip out of work and go pick up my boy. As they bring him out there is a NOTICEABLE difference Champs size. He has clearly lost a significant amount of weight! The vet proceeds to tell me that she drained 12 POUNDS of fluid from his belly....that morning he was 146#'s, and picking him up he was 134#'s. WOW!

She goes on to tell me that after draining the fluid they don't see anything out of the ordinary and his prognosis looked good, with one exception! He "probably" is suffering from pancreatitis. This had to be verified with more tests. Which we did...and yep the diagnosis was confirmed. We promptly did our research and altered his diet to a very low fat regimen of dry kibble, boiled chicken, and white rice. He seemed to be doing much better. His energy was improving, he actually wanted to eat. We thought we were in the clear.

As time went along, I noticed that Champ was getting thinner....much thinner. This worried me, so I scheduled a check up in early January. At that point he was down another 15 pounds to a measly 119#'s. I was concerned, but the vet assured me that there was nothing to be concerned about at this point. We discussed the diet we were feeding and she was impressed at our initiative.

Another couple weeks go by and I notice that Champ is drinking incessantly...and this again concerns me. I take him in to the vet, and they run some tests. Ketones show up at +2 and glucose levels in the 800's. Guess what, your dog has diabetes! He needs to get to the Evet immediately to get the ketones flushed out. So off we go. 3 days in the Evet getting flushed and ketone free.

During those 3 days, my wife and I did extensive research looking for suitable food brands and pretty much anything else we could read about diabetes in dogs.

Upon picking him up, we get the consultation on injecting the Humulin N and the importance of ROUTINE and CONSISTENT feedings. We have no problem with that as our lives/schedules are pretty regulated to begin with.

So here we are...we now have a dog that at this moment weighs a PALTRY 107#'s, and should weigh 135+. Who has diagnosed pancreatitis, and diabetic to boot.
We are in the "curve" stage at the moment. Week 1 (last week) were giving a dose of 12 units. Took him in for his "curve" check and they called me after the second reading to come get him...his readings were still in the 600's and no point in keepin him there to continue the tests. So they bumped the dose up to 15units 2x's per day. We are to follow up next Wednesday for a new curve check.

So that is the abbreviated version. To follow are some questions I have, maybe those of you with more experience can help with.

1. Given the pancreatitis overrules the diabetes in terms of diet. I am at a loss on finding a good kibble to feed. He is severely underweight, and the RX foods are not suitable for his condition. At this point we are sticking with Canidae All Life Stages boosted with boiled chicken/broth. Any other recommendations?

2. I think I want to start home testing. I've watched the videos on this site (AWESOME), and read multiple threads. Is the Wal Mart brand tester suitable, or should I pony up the extra $ for the Alpha?

3. Treats....we have been using Dogwells chicken jerky for now, but they are $30 bag and really don't last long. (we have 2 very large dogs)

This site is awesome.

[Champ]

Re: New to diabetes...let alone in my Champ

I'm sorry, I left out a few critical items that I'm concerned about as well.

Our vet said to not give the insulin shot until roughly 1/2 hour after eating. Now, I understand this is to ensure that 1. the dog eats 2. the food stays down. I guess my question is this, in all the reading about diabetes I've found that in humans they are to take their insulin before their meal to allow it to aid in the digestion/absorption of food.

Is this half our post meal a critical element?

I don't know enough about canine digestive systems to make an educated assumption, but I suspect that after a half hour of feeding the food has already made pretty good progress through the digestive system? Are you guys waiting the half hour post meal time?

Also, I just went out and purchased a Relion Prime test meter/strips and lancet today. Going to begin the testing process immediately.

Is there anyone else using the Prime meter that can shed some light on the +/- difference between it and the Alpha meter? I know our vet uses the Alphatrak so I just want to try and get an apples for apples comparison.

TIA

[Talulah]

Re: New to diabetes...let alone in my Champ

Welcome Shawn and Champ. Your big boy has been through a lot. This is a great forum with very helpful people. I really can't give much advice as I am quite new to diabetes as well. My dog, Talulah, was diagnosed in November.

I can tell you what I have experienced with the Prime meter vs. AlphaTrak2 as I use both (mainly the Prime due to cost of test strips). When BG is in the higher numbers the Prime reads quite a bit lower than the Alpha, but much more accurate with lower numbers.
For example, 310 on my Prime was 459 on the Alpha, 159 Prime was 203 Alpha, 63 Prime was 112 Alpha, Talulah has had a few reading in the 40s, a few times these numbers were exact on the Alpha while other time they are a bit higher on they Alpha (between 60 and 80). Talulah has never had hypo symptoms with her low numbers but I always intervene with honey and food (while having an OMG breakdown). These numbers are just to give you an idea of the differences and others may have different experiences/information.
What I have learned from my vet, and more so from the people on this forum, is the importance of home testing. So whichever meter you use, you will have a much better understanding of how Champ is doing.

I have no experience with pancreatitis. Talulah was not crazy about RX foods available at our vet's so we put her on a homemade diet. As far as giving shots after food, I usually do it immediately after eating. If Talulah has a low fasting number then I wait a bit after eating before injecting.

Again, welcome! And I am sure others with more knowledge and information will be here soon to help you.
Pam and Talulah

[Cebe]

Re: New to diabetes...let alone in my Champ

I disagree a bit with your vet on waiting 30 minutes, but i understand why he gave that advice. My advice is to know your dog. If vomiting is an issue then wait. If he doesn't vomit a lot, then don't wait. And the reason is that he needs his insulin to help with the food and you don't want one operating without the other. But there is reason behind what your vet said. And, no, we don't give the shot before. It's given with food or just after food is eaten.

[Patty]

Re: New to diabetes...let alone in my Champ

Hi and welcome to you! Sounds like you both have been through quite a bit recently.

So glad the routine and consistency were emphasized. That will help tremendously with regulation.

As far as the weight loss, it is pretty common with newly diagnosed dogs (though heartbreaking to see). A good way to understand the process: Think of insulin as the key that unlocks the gate into the body's cells for nutrition. When there isn't enough insulin the glucose remains in the blood stream and is flushed through the kidneys. The body isn't able to adequately use the nutrition given - no matter how much is being fed.

It is a patient process though. Dogs are often started out at about 1/4 unit per pound of dog and gradually increased based on blood sugar curves (where bg - blood glucose - is measured before food/insulin then every 2 hours after until next shot time). Then the dose is raised based on the lowest level. The dosing is raised slowly because over time, the amount of insulin that overlaps and is working in the background increases. Going too fast can mean taking 2 or more steps backward. Curving also allows you to see how well the food and insulin are balanced http://www.k9diabetes.com/insulinfood.html.

I think it's great you are considering home testing. Human meters will often test a dog's blood sugar lower than actual due to the difference in size/shape of a dog's red blood cell. And that range is often wider at higher levels. The Prime is a decent meter for just starting out as the test strips are cheaper. My personal favorite was the OneTouch Ultra2. Test strips for this meter are cheaper on ebay (just watch for factory sealed boxes and good expiration dates). A lot of us have a collection of meters at this point

As far as lancets, depending on where you lance larger lancets may help (such as the elbow, base of tail or carpal pad). Many like the 25-26 guage lancets for this. I like the AccuChek Softclix for the lip area since its thinner skin.

I'm not a fan of the fact the vet's office had you pick up Champ after just 2 readings last time. Though they may have felt they knew his trend and that he typically stays flat. I don't know. But I am glad they are curving every week.

Some dogs can actually have large swings in blood sugar, whether from stress at the vet office or an imbalance between food/insulin, etc. A dog can have readings in the 600s and then drop into the 100s, for example. Another reason to test at home!

As far as your questions:
1. I started out feeding Wellness Reduced Fat CORE, though they have changed their formula since I fed it (we eventually switch to a raw diet due to allergies). Holli used this with Decker though with good results.
Blue Buffalo Healthy Weight (for the reduced fat and higher fiber component) is another that people have liked.
A third idea that many are using is Honest Kitchen Zeal. It is a dehydrated raw diet if that interests you. Then a carb can be added to balance the insulin.

2. I saw you posted about purchasing the Relion Prime. Great that you are ready to dive in! Craig has done a number of comparisons that can give you an idea of difference if you want to do a search. But do note that each meter even of the same brand can vary. I'd recommend once you are able to test, taking your meter into the vet's office and comparing your numbers. It would be great if you could do this at various ranges. I used to take my meter in whenever my dog was getting blood drawn so I had an idea of how consistent it was. It's also good to know how close the vet's Alphatrak is to the lab analyzer. Some Alphatrak's can have slight variations as well.

3. I'm pretty leary at this point of any commercial chicken jerky. I recommend making your own. It'd help with savings as well! Here's a great link that talks about this http://www.k9diabetes.com/forum/showthread.php?p=65684

Our vet said to not give the insulin shot until roughly 1/2 hour after eating. Now, I understand this is to ensure that 1. the dog eats 2. the food stays down. I guess my question is this, in all the reading about diabetes I've found that in humans they are to take their insulin before their meal to allow it to aid in the digestion/absorption of food.
Is this half our post meal a critical element? I don't know enough about canine digestive systems to make an educated assumption, but I suspect that after a half hour of feeding the food has already made pretty good progress through the digestive system? Are you guys waiting the half hour post meal time?

This is often standard advice to be sure a dog eats and keeps his food down, as you said. Many inject right after the dog eats if they know their dog doesn't usually vomit.

When humans take their insulin ahead of food, it is the bolus dose to cover their meal...And they know they will eat. You may not know if your dog is having an off day and will turn his nose up at a meal, so it's better not to have a full dose in before food. You'd wind up really in danger trying to get enough glucose into your dog to prevent lows. Short answer - Dogs don't typically need the basal/bolus type dosing that humans do. Often 1 insulin will cover both.

Glad to have you here!
Take care,
Patty

[amydunn19]

Re: New to diabetes...let alone in my Champ

Hi - you are sounding quite overwhelmed and I know how you feel. My dog went through severe pancreatitis many years ago after a snake bite and she was diagnosed diabetic 5 years ago. She had a pretty bad pancreatitis attack a few years back. Take a breath - it is survivable.

I looked up the Canidae on dog food advisor - it is a four star food with above average carbs. I noticed it has white rice, potatoes and peas. I would look at a food without that white rice for sure. He needs a carb source- something a little more complex - brown rice is ok. There are so many diabetic suitable foods out there. The biggest thing is something that he eats willingly, and is good for the pancreatitis. I have used Blue Buffalo Weight Management, Nutrisca and Merrick Grain Free in the past and it didn't upset her pancreatitis. I know you are worried about his weight loss though. The weight will gradually come back some with more control of his blood sugar.

Injection wise, I was advised to wait thirty minutes after her meal because she was inclined to vomit after meals. Once she recovered from her last flare up, she stopped the throwing up so I now inject her as soon as she finishes. Does he keep down what he eats usually? As high as he is(in the 600's), you could probably still inject without much worry even if he got sick. I think it is ideal to inject with the meal - it seems to give better results. This will be much easier to decide when you are testing him because you will know his blood sugar.

I use the One Touch Ultra and I take it to the vet with me and compare it to his Alphatrack and his lab results. Human meters won't be exact but I have always been comfortable with my meter as it is always really close to the vets. My vet even purchased a One Touch Ultra to check his diabetic patients to see how reliable it was and he is pretty satisfied with the results. I know nothing about the Relion but I would take it with you and compare with the same blood draw. Then, you will know how to adjust your numbers. The meters are usually further apart on the higher range than in the low range.

Also, I would choose another treat- those Dogswell jerky treats are made in China plus probably not good for the pancreatitis or diabetes. I wouldn't give any treats until you get his numbers down. We all have a go to treat or two in our bag of tricks so eventually you will be able to do treats.

This is a great place with lots of knowledge and support. I haven't been around here very long so I am still new here on this forum but I have been through a lot with this diabetic journey. You sound like you have really got the determination to learn all you can and that is all you need. There will be ups and downs but hopefully it will be all up from here.

Amy D

[CraigM]

Re: New to diabetes...let alone in my Champ

I also use both the ReliOn Prime and AlphaTrak2 meters for the same reason as Talulah. A rough conversion would be to divide the Prime reading by 0.75 to get a reading that is close to what the aalphaTrak2 would indicate. If you can afford the AlphaTrak2, I'd recommend you do your own comparisons.

One recommendation before you get too far into using Humulin-N ($70-85?) is to switch to ReliOn Novolin-N ($25). These insulins are similar, but there might be a small difference in response.

I believe most of us, who have dogs that eat without problems, inject right after, or even as they are eating. In fact, I've been injecting just prior to meals, but Annie will eat at anytime!

Welcome, and I'll be reading about you and Champ's adventure!

Craig

[SandyL]

Re: New to diabetes...let alone in my Champ

Welcome!!!
You've done some great research so far and you're well ahead Og the game!!
So happy you want to test at home. It will give such peace of mind and enable you to get Champ regulated much faster.

As far as meters go, I use the One Touch Ultra. Craig is the resident expert on meters.... I think he has about 6 in his collection so far I want to say he uses the Prime for everyday use and the Alpha for his curves. Any meter will work so that you can get a close approximation of his BG. Just take it to the vet with you and compare the reading of yours with there's All meters are pretty much the same.... Difference of about 20-30 pts in the lower BG ranges under 100

As far as food goes, feed him whatever you wish and you can work with that. We have a lot of different kinds of diets that people work with

Humans can inject first.... They KNOW they then have to eat.... Dogs don't! There might be days Champ just doesn't feel we'll and he may not eat, you DON'T want to give insulin and then not be able to get food in him . Or he may only eat 1/2 his meal and then you would want to adjust his insulin accordingly by only giving 1/2 dose. Lots of variables here. I give Tiggy her shot as soon as she finishes eating. If she has a really low fasting number , 100 or less, I'll wait about 1/2 hour to make sure she rises before I give her the injection. The food and insulin will work together as long as you maintain the consistency with the diet

Sandy

[stylynjm]

Re: New to diabetes...let alone in my Champ

Hi shawn and champ, I have the prime and the alphatrak. I use the prime most of the time realizing it runs lower than alphatrak. If I get a low # or want to be sure of sissys levels at bedtime,or if I am going to be gone,I use alphatrak. U found the right place for knowledge and experience with all kinds of problems. I have another dog with bad pancreatituS,but he does not have diabetes,so sorry,no help with diet. Go slow and keep a notebook of everything champ does. It can be invaluable. Numbers before food,food & amount,insulin amount,type etc. Anything that could effect,exercise,how long,test before and after walking,they can go low. Forum members advise always carry Karo or something for lows if applies. Good luck and test!!

[Champ]

Thank you all for the warm welcome, and encouragement.

Just did my first reading with the Prime meter. It read 531! This was 1/2 hour after meal/injection. Looks like we have a ways to go.

[CraigM]

Re: New to diabetes...let alone in my Champ

Thank you all for the warm welcome, and encouragement.

Just did my first reading with the Prime meter. It read 531! This was 1/2 hour after meal/injection. Looks like we have a ways to go.

The great thing about the Prime is the low cost strips (18 cents/strip). The AlphaTrak2 cost over $1/strip.

[stylynjm]

Re: New to diabetes...let alone in my Champ

Lol,don't be discouraged,this is a slow process.At least that gives u a starting point for ur meter.

[Champ]

Re: New to diabetes...let alone in my Champ

Lol,don't be discouraged,this is a slow process.At least that gives u a starting point for ur meter.

However, if Craig's formula is "relatively close" then that puts him in the 700's...not good.

[Rubytuesday]

Re: New to diabetes...let alone in my Champ

If he has been at the new dose for 5 days you could probably do your own curve and call the numbers in to the vet. That way you wouldn't need to wait till Wed. to evaluate another increase. Not sure if the recommendations of the group would change for possible 500s or more, but we usually recommend small increases, 1 unit for a dog Champs size. This becomes very important as you get closer to ideal numbers. Then you want to do 1 unit or less and let the dose settle for at least 5 days.

My only complaint about the Prime meter was that early on it was hard for me to get enough blood sucked up by the strip and the meter wouldn't always give me an error msg. What I do now is make sure I have a nice fat drop of blood and just set the strip on the top of it at an angle. I try not to let the strip touch the skin underneath the blood thinking that might hinder the uptake of blood. For instance, if in the near future you get a lower number you might want to retest until you get a feel for Champs trends.

Tara

[stylynjm]

Re: New to diabetes...let alone in my Champ

He is definnately high,but it gives u a reference point for meter.hopefully next test is lower.