Announcement

**pat3332** · 03-06-2011, 02:29 AM

Re: Newly diagnosed...A BIG thanks to all!!

Hi Sandy and Tiggy,

I work a 12 hour night shift and at the moment I'm not very busy and trying to stay awake, so I get to be the first to say welcome.

I've only used the Humulin N and Novolin N insulin, so I'll let someone more knowledgeable help with that. It does sound like they may have started Tiggy out a little high at first. I think the normal starting range is about 1/8 to 1/2 unit per pound and usually starting at the lower end and working up. At 4 units, that would be pretty close to 1/4 unit/pound. It sounds like you're at about 1/8 unit/pound now at 2 units. It's possible the 4 units was too much and caused the blood sugar to drop too low causing her to be lethargic. Since Tiggy seemed to act more normal after lowering the insulin though, It sounds like the 4 units may have been too much too soon.

You'll hear this a lot, but it's so true. Consistency is the key to getting regulated. Even very small changes in the amount of food given, the time between feedings and when the injections are given can cause big changes in the glucose levels. 4-6 pieces of kibble, more or less can have a fairly big impact on my 95 pound dog's levels over a 12 hour period.

Along with consistency in importance is home testing. I know Tiggy isn't crazy about the injections, so may be a bit of a problem to do home blood testing with, but if possible, I do recommend trying to get started. Since your mother had diabetes, I'm sure you're already aware of how important it is. It may be even more important with our pets since they can't talk to us and tell us how they feel, so we rely on the numbers to tell us that. It will also give you a better idea of not only how the changes in the amount of insulin are affecting Tiggy, but will also help you track what changes are affecting the levels, in what way they are affecting them and help you understand how she is acting at the different levels. It can be very difficult to get them regulated even if you are doing home testing, but not home testing makes getting regulated much more difficult. All dogs react differently and my Rottie Bailey doesn't always react much differently whether he's high or low, so I'd have a hard time telling what his levels are without testing him.

Reading between the lines a little, it sounds like you're feeding every 12 hours and giving the insulin right after feeding, which is usually recommended starting out. Just changing from chicken to lean hamburger and from the green beans to the broccoli could also affect the levels. Every time you change anything, try to change one thing at a time, then give it a day or two to see what that does to the levels. If you change 2-3 things at once and the levels change, you can't be sure which change caused it.

As you can tell, you're long post was more like a quick note compared to most of mine.

Please post as much information as you can think of and don't worry about the length because the more information you can give, the more help the knowledgeable folks here can be. Let us know when you have any curves or glucose levels at all to report.

This can all be pretty overwhelming at first, especially with all of the information that you're going to be getting, but it sounds like with your experience with human diabetes and your good attitude that you've got a good start on handling it.

Looking forward to hearing more from you

Pat

**CarolW** · 03-06-2011, 03:14 AM

Re: Newly diagnosed...A BIG thanks to all!!

Glad to see Pat's excellent welcome to you, Sandy and Tiggy! And I can be the second to welcome you, with my usual brief wee-hours stint.

I think Pat covered the situation very well, and at the moment, I don't have anything else to add, except the remark that I THINK the insulin you mention corresponds to the NPH insulins we have in the U.S. and Canada (where I am). What country are you in? Maybe you meant to type "NPH."

It does sound as though Tiggy was on too high a dose to begin with. Maybe they needed that much to bring Tiggy's BGs down at the start.

We do long posts here, in the interests of being at least somewhat complete, at any stage!

It takes from one to two weeks for a changed dose of insulin to stabilize fully in the dog's body, say my own vets, so you can't REALLY tell what the complete effect is from a changed dose for at least a week. I guess you can get some idea after about 3-5 days.

About the food, I think you're doing okay, but in effect, dogs don't "get tired of" food if you feed the same thing, and if the appetite changes, that probably suggests Tiggy's BGs are either high - or low - affecting the appetite. As Pat said, I'd hold the food type steady till you have BG curve information, and usually, with curve information, you'd change the insulin dose appropriately first, without changing the food. The principle for feeding diabetic dogs, I was taught, is to feed exactly the same food for both daily meals, 12 hours apart (and give insulin after feeding, as you are doing).

Anyway, without current BG information, we don't know what is affecting Tiggy's appetite.

When you're ready to tackle BG-testing, let us know, and we'll load you up with whatever help you would like to have! Assuming, of course, that you want to do it! You sound very capable!

And when you get curve results, could you post them, please? along with Tiggy's current weight, diet, and insulin-type and dose - and times of injections.

Ask anything, any time, and somebody will be along shortly to assist!

And a Big, Fat Welcome to you and Tiggy!

Sun, 6 Mar 2011 02:13:53 (PST)

**jesse girl** · 03-06-2011, 08:29 AM

Re: Newly diagnosed...A BIG thanks to all!!

hi and welcome theres already some great information going out to you and your buddy as they said for me and jesse home testing is a must I believe it should be strongly suggested and trained at the vets but believe they are behind the times and change can be difficult.

your mother should have a testing device and even though it is for humans most give pretty reliable numbers in the lower range (200 and lower) which is important do to hypoglycemia . I started out with a friends meter when jesse got sick and lethargic you cant always trust outward symptoms especially at the beginning many here can help you get started.

be careful about exercising without testing at home and not knowing where she is at can be dangerous it speeds up the metabolism and can make the insulin work faster

diabetes is a disease primarily managed at home as you know and you and your dog can have a long happy and healthy life together and it sounds like your off to a good start always have sugar around we use corn syrup rubbed on her lips gets in her system quick

**SandyL** · 03-06-2011, 10:14 AM

Re: Newly diagnosed...A BIG thanks to all!!

Good morning! Once again some great information!
Carol, you are correct, I meant to put NPH (brain wasn't functioning at it's max last night) I live in the states, California to be exact. I purchased my first vial at Walgreens and paid a whopping $68 for it and am currently looking for a more reasonable outlet to get it. I don't want to purchase it from Petmeds or someplace on line...afraid of the handleing of such sensitive liquid!
I thought I might get away without doing BG checks at home, wishful thinking on my part, but it really sounds like I HAVE to, even though the vet told me just to do her urine which is also nearly impossible with as low as she squats and stops peeing as soon as something is within a foot of her

If you could educate me on the BG process ie do I do it dailey? how many times? What time of day? and where on this needle Phobe baby do I prick her??

I have already discovered that she hates the scruff for her injections so I have moved to her sides which doesn't seem to bother her. But I am telling you, this girl doesn't tolerate anyone messing with her and is a squirmer! I really have to get the mindset that the BG's just need to be done and do it.

I have the Kayro syrup and maple skyrup within easy reach, and everyone in the house has been educated on when, why, and how to use it, so thanks Jesse girl for mentioning that important piece of info!

As for her food. She has ALWAYS been a very picky eater since a puppy and I admit we have spoiled her rotten and is the little princess in the house. Our Bensenji/Chow mix even lets Tiggy have her way! Tiggy has always received a variety of food, never the same thing nightly....I guess it's the mindset of humans getting something different daily. So should I stick with just one kind of meal and NEVER vary from it? What happens if she refuses to eat for a full day? I know she will be ok from one skipped dose of insulin but a whole day? Before her diagnosis my feelings if she wouldn't eat would be "oh well, she'll eat when she's really hungry" Should I keep that mindset?
Do you give your furry kids any kind of treats at all and if so what? Her routine with her grandpa out in his shop would be a mid morning snack of dried duck jerky and a milkbone and both of them seem to be going thru withdrawl from this bonding time. My hubby keeps asking can't I give her just one?

You're so very right Pat...this is all VERY overwhelming !!!!

Sandy and Tiggy

**CraigM** · 03-06-2011, 01:34 PM

Re: Newly diagnosed...A BIG thanks to all!!

Originally posted by tiggys grandma View Post

I purchased my first vial at Walgreens and paid a whopping $68 for it and am currently looking for a more reasonable outlet to get it.

Sandy & Tiggy,

Only have a minute to welcome you, but thought I'd mention Walmart as the place many of us get our insulin. Walmart sells their ReliOn branded Humulin-N for just under $25. The other supplies are pretty cheap there also.

Welcome and will be reading about your adventures with Tiggy!

**Patty** · 03-06-2011, 01:41 PM

Re: Newly diagnosed...A BIG thanks to all!!

Hi Sandy,
Welcome to you and Tiggy

You've gotten some great advice already. As far as a cheaper place to purchase insulin, Walmart/Sam's Club has contracted with the makers of Humulin NPH and sell it under their Relion name for about half the price. Just ask for their Relion Humulin N.

If you are up for home testing, it would be a huge benefit in helping to regulate Tiggy. There are some videos here on various places you can try to use for testing: http://www.k9diabetes.com/bgtestvideos.html I wouldn't worry about how often you need to test or anything else at this point. Just work on trying to get a reading and go from there. It took me several weeks and many strips later to find a place to get a sample on my dog.

I am a fan of the AccuChek Softclix lancets. I never could get a sample with the OneTouch ones. So you just have to find what works best for your dog. It may take trying a difference place, or a larger gauge lancet, etc to get it right. But take your time. You don't want to make it a stressful thing for either of you. You may even have to just start with handling the area and getting Tiggy used to that before even trying to get a sample.

As far as a meter, we have people using all different types. I like the consistency of the OneTouch Ultra. The Freestyle Lite meters have shown good results with smaller dogs as well. Do you have a meter your mother used?

Glad you found a place she doesn't mind for injections

As for food, yes I would try to keep things as consistent as possible. The more consistency you have the easier it will be to regulate. That may include
incorporating her routine of being in the shop with grandpa each day.

I'm of the mindset you need to be as consistent as possible when it comes to food/snacks. There are some dogs that just can't have a snack midday without it affecting their bg (blood glucose) significantly. Others have found a snack that when given at the same time every day has been incorportated into their curve and creates a pattern they can work with.

Take a look at her dried duck jerky and see if it is simply dried meat or other additives. If it's simply meat, I'd keep her portion the same from day to day and add it to her routine. I think I'd skip the milkbone though until you know how her numbers are looking as it has more carb to it. I've gone to weighing my dog's food for accuracy as the smallest variation can really affect her blood sugar.

Then, when you have a curve done on your dog, you'll want to be sure to feed snacks/food the same as normal even if at the vet's office to see how it's affecting your dog.

I would also talk to your vet about what to do if she doesn't eat one day. A portion of the insulin goes to your dog's basic needs aside from food. Many dogs can have 1/4 of their usual dose without food to meet the body's basal needs. You could also try to entice her to eat by sprinkling a tiny bit of parmesan cheese on her food or adding a bit of warm water to release the great food smells. But you don't want to give a full dose of insulin on a day she doesn't eat as that could send her blood sugar too low.

Let us know as you have questions. There are a lot of great people here to help!
Take care,
Patty

**Patty** · 03-06-2011, 02:06 PM

Re: Newly diagnosed...A BIG thanks to all!!

Oh my goodness, I just had a look at Tiggy's picture on your profile page. Too cute

. You can also add her as your avatar by going to the User CP at the top left. Go down to Edit Avatar and upload the pic from your computer.

**pat3332** · 03-06-2011, 02:49 PM

Re: Newly diagnosed...A BIG thanks to all!!

Hi again grandma,

Like Patty said, if you're buying the duck jerky, check the ingredients. If you're dehydrating your own duck jerky just be sure you're not adding anything like garlic salt or other condiments that might affect the glucose levels. Duck is a pretty fatty critter, so I like to get a lean roast that I slice up and dehydrate with no additives. My dog's don't care what kind it is, or how dried out it is as long as it's meat. I've also dehydrated chicken breast, but can't tell any difference in the glucose levels when I make it into jerky, or just cook and dice it. I've also dehydrated sweet potatoes.

Some of us also like the AlphaTrak glucometer made for pets, but it and the test strips are a lot more expensive and probably not really necessary except for some of the OCD folks among us.

Any of the human meters Patty mentioned are good and you mainly want to know if the levels are going up or down. Jesse girl had a great idea about using your mothers old meter if you still have it.

Whatever you get, you need to take it to the vet with you when you take Tiggy back and using the same blood sample they use, compare your reading with theirs. It probably won't be that close, but you can apply the difference to your readings to get an idea of what your levels are. Also, the readings of a lot of meters seem to get farther apart from the vet's readings as the levels get higher and closer together as they get lower which is nice since the low hypoglycemic readings are the most dangerous and that's when you want the closer accuracy. It will help if you are able to compare both high and low readings against your vet's results when you have the opportunity.

One more time, consistency is extremely important in everything, from what food you use to the amount you give, how carefully it's measured, what snacks you give and when, how much exercise she gets and when and the timing of everything you do. Bailey's 95 pounds and just 4-5 pieces of kibble more or less can make his levels go up or down over a 12 hour period. I weigh each feeding and then I can leave the insulin where it's at and control a lot of those highs and lows by just slightly adjusting the amount of food he gets instead of trying to adjust the insulin up and down.

We tend to get excited about new members and start throwing a lot of information at you which I know doesn't help you become any less overwhelmed, but trust me, after a while, it will become routine. I started out trying to process everything at once which made it worse and it helped me to do one thing until I was comfortable with it and had a routine down for it, then I moved on to the next challenge. Try to make everything you do with Tiggy upbeat and fun with a lot of petting, love and reassurance. They can tell when you're nervous and unsure.

Just keep asking questions and don't worry about repeating, or how long the post is. I know telling you to relax right now is a waste of time, but just take a deep breath, you'll get there.

**k9diabetes** · 03-06-2011, 03:06 PM

Re: Newly diagnosed...A BIG thanks to all!!

Hi Sandy,

Welcome to you and Tiggy!

You've gotten lots of great information already so I won't add much more.

You will love the savings you get at Walmart. The same bottle of insulin that cost you $68 should be about $25 and the syringes and test strips are much less expensive there as well. We get all of our prescription meds for our pets there. Back when Chris was on a half a dozen very expensive meds, we wouldn't have survived the cost without the big price break there.

If you have a chance, once you've gotten the insulin at Walmart, you might let your vet know about it. That kind of direct communication would probably be the best way for them to find out that Walmart now sells Humulin N and what a great savings it is for their clients. They could then pass on the tip in the future.

I'll second Patty's recommendation of the Softclix lancing device - it was the only one I ever used. I tried all of the others and it was by far the quietest plus has decent sized needles on the lancets so you can get a reliable blood sample.

Your willingness to research and learn is probably the very best trait someone with a diabetic dog can have so Tiggy is in good hands.

Natalie

**eileen** · 03-06-2011, 03:11 PM

Re: Newly diagnosed...A BIG thanks to all!!

Originally posted by pat3332 View Post

Some of us also like the AlphaTrak glucometer made for pets, but it and the test strips are a lot more expensive and probably not really necessary except for some of the OCD folks among us.

Hey, hey, hey ;-), I have used several varieties of meters over the years and do much prefer my Alpha Trak since going to it almost 2 years ago.

The savings can come by using Freestyle Lite test strips with our Alpha Trak meters with more reliable readings than when using a human meter.

But, I must say that for 4 1/2 years I used human meters and was able to successfully monitor Mildred so I think the main point is that monitoring by blood, whether it is with a human meter or an animal validated meter and watching trends is what matters most.

**pat3332** · 03-06-2011, 05:31 PM

Re: Newly diagnosed...A BIG thanks to all!!

Just thought I'd mention that if you have a Sam's Club close, their pharmacy has the same pricing and I almost never see more than 2 other people there and the wait for a prescription is much shorter. I hate crowds.

Eileen, so far I still haven't been able to make the detail oriented side of me accept the "close to AlphaTrak" Free Style Lite strips, but you and Craig are making me think about it more. I think Craig and I have found what you already knew, that the readings get a lot closer as they get lower.

Natalie was right about communicating with your vet. Mine not only didn't realize the price difference, he was shocked that it was a lot less than what his supplier charges him. He said he was going to start sending his other patients out to Wal-Mart. We were also his first patients that insisted on doing the home testing and he got me the AlphaTrak at his cost and now he thinks it's great and recommends home testing to all of his diabetes patients. I don't think it's really cost him much money in office visits and he doesn't have those panicky phone calls day and night like he did. (He gives his patients his cell number). I can't wait to show him my new auto injector.

Pat

**SandyL** · 03-06-2011, 05:44 PM

Re: Newly diagnosed...A BIG thanks to all!!

Wonderful suggestions from all and once again I'm in my information overload! You're right Pat, I am trying to process everything at once...Type A person who wants things done right YESTERDAY! I have to slow down and be a little more mythotical about this new life we're leading!

Patty..I have the One Touch Ultra Mini monitor. I will take it with me when we go to the vet to get the curve done so that they can help me regulate it. At least that's a step in the right direction! I checked her duck and it is JUST DUCK, so her and Grandpa will be happy once again!!!!

Natalie..I should have checked the thread first! When I get a new perscription, as the original was a 1 time only with no refills (I guess they wanted to make sure we'd be back) I will DEFINATELY be headed to Walmart! Wow what a difference!

Please keep all the info rolling in...every little bit helps and I will be checking out the web site on obtaining the BG, but if anyone wants to stick my baby for me...have at it LOL Will keep you informed on our progress!!

Thanks Everyone of you!
Sandy and Tiggy

**CraigM** · 03-06-2011, 05:51 PM

Re: Newly diagnosed...A BIG thanks to all!!

I believe most States do NOT require a prescription for insulin. Might want to check at your local Walmart.

**Patty** · 03-06-2011, 05:58 PM

Re: Newly diagnosed...A BIG thanks to all!!

Patty..I have the One Touch Ultra Mini monitor. I will take it with me when we go to the vet to get the curve done so that they can help me regulate it. At least that's a step in the right direction!

Sandy,
When you compare your meter at the vet, I think the most accurate way is to have them draw blood to run on their lab machine then you'd test Tiggy's bg the way you normally would at home just before or after their blood draw.

Maybe they can help you find the best place for testing Tiggy since I know you're not there yet but it's a future goal.

Definitely take a look at the videos and see if they can help.

Meters measure capillary blood so that's why I suggest using a sample the way you would test at home instead of their venous sample in the meter. I've done both and there's a bit of a difference.

Don't rush it though. You have time to learn and don't have to compare at your first curve.

Patty

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