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-   -   Newly Diagnosed, having issues (http://k9diabetes.com/forum/showthread.php?t=8138)

Neirracul 03-31-2020 03:26 PM

Newly Diagnosed, having issues
 
Hi everyone,

My pooch, Maura, is an 8 year old Siberian Husky who was recently diagnosed (2 weeks ago). She was in dka when we figured out what was happening and she had a hospital stay, and they released her when her blood sugar came down some. They gave her an initial prescription of 20 units of Vetsulin and we’ve been following all the rules, two meals a day 12 hours apart, insulin directly after. She seemed to be getting more lethargic and our alphatrak 2 came in and I decided to do a blood glucose curve to see what was happening since the spot reading I did was around 400. Her bg only went up from there during the day (I can post the full curve if needed) and came back down into the 400s later in the day. Called the vet with my worries and he was irritated that I’d done a home curve because they don’t recommend owners doing their own curves at home (???). Either way, his solution was to increase her dose to 22 units and see how that works out. Today I did a spot check 8.5 hours after her morning dose and her bg was 655. I am extremely frustrated and not sure what to do at this point. I know it’s early on but the readings I’m getting just keep getting higher, not lower.
Anyone have any ideas? I was doing a lot of reading about insulin resistance and somogyi overswings/ rebound but the vet just brushed me off when I asked about possibilities.

Edited to add:
Maura is 62 lbs
Eating 2.5 cups of Ketona salmon per day



Cheers,

Erin and Maura

Raysaint 04-01-2020 05:42 AM

Re: Newly Diagnosed, having issues
 
vets try to maintain control, and some don't like owners doing things themselves. Home testing is crucial, doing your own curve is quite ok.

This whole process of regulation takes a lot of time, don't expect changes right away. Increasing insulin willy nilly is not the way.
Starting dose is 0.5 units per kg (2.2 lbs).
Stick with that for a week, do a curve, and increase insulin a unit at a time each week.
The body is going thru lots of changes so it takes time to adjust to changes, and things will sometimes be opposite of your expectations. Stay the course.

Don't get too focused on numbers right now, get the routine down and be consistent.
Patience is your best friend.

MikeMurphy 04-01-2020 01:32 PM

Re: Newly Diagnosed, having issues
 
Hi and welcome to the forum.

I agree with Raysaint. The starting dose of 20 units is way to high for a 62 lb dog. The normal starting dose should have been 12 to 14 units, twice daily. Then adjust insulin in .5 to 1 unit increments, based on the results of weekly 12 hour curves.
Going beyond the correct dose can cause Somogyi Rebound.

Neirracul 04-01-2020 03:56 PM

Re: Newly Diagnosed, having issues
 
Thank you guys for your responses! I feel a lot better that my suspicions are being confirmed. I went onto the Vetsulin webpage about dosing and did some math last night about the recommended starting doses and decided to use their starting dose of .5 units per kg once daily and a 25% reduction of that twice daily and started her with 10 units that we will move up from. Its a bit lower than you said but honestly, she seems to be doing better already. Her 330 PM spot check was ~550 today which is way better than the 650 bg we got yesterday at the same time. As long as she is feeling better itll be easy to stay the course and be patient. I expect some bumps in the road but this is reassuring. Thank you!

Riliey and Mo 04-01-2020 04:00 PM

Re: Newly Diagnosed, having issues
 
hi
thats good news

just wanted to mention the amound of food twice a day is important
it goes by weight also
i would check the mfgs website or the dog food bag to see how many cups per day then divide by 2
looks like 3.5 cups

jesse girl 04-01-2020 05:37 PM

Re: Newly Diagnosed, having issues
 
I just want add to all the good advice you received has your dog been spayed ?

Section1 04-02-2020 05:16 PM

Re: Newly Diagnosed, having issues
 
Hope Maura keeps doing better. I'm in a similar position as you and don't have any advice to offer but please post updates on your dog's progress.

Riliey and Mo 04-02-2020 05:59 PM

Re: Newly Diagnosed, having issues
 
this journey gets easier its just getting it all together at first thats hard but its doable and well worth it

Raysaint 04-03-2020 10:54 AM

Re: Newly Diagnosed, having issues
 
This is a good read for basic education. Combine that with advice from the good people on here and you'll do well.

https://www.aaha.org/globalassets/02...ines_final.pdf

Believe it or not, I've learned that there are lots of vets out there with little diabetes experience. And we can usually tell based on the initial advice, dose, etc. that they give.

Seems odd that info we can get right on websites from insulin makers, etc., they don't seem to have read it.

And one key thing to remember, one my vet reminded me of the other day, it's how the dog is doing clinically that matters, not just his specific numbers each day. That's something us human diabetics focus on, and it delayed my dog's regulation.

Neirracul 04-10-2020 09:21 AM

Re: Newly Diagnosed, having issues
 
Hi everyone, thank you! I think we are in a much better place now with a dose of 10 units twice daily. Shes fully transitioned to Ketona salmon, 3.25 cups per day for a 60 pound dog with treats of either frozen broccoli cubes or small apple slices when we have to give her eye medicine. Shes had pannus since age 4 and has been on and off Optimmune 2-4 times daily (currently on). Tear production has improved slightly. I was worried about giving her a steroid but three separate vets have claimed that the medication is nonsystemic and stays primarily in the eyes. She gets two walks per day, one right after her morning meal and one either right after her evening meal or within 2 hours of it. Shes a lot perkier now and the excess lethargy has seemed to go away. Clinically, it appears she is doing fine. No accidents or excess urination. She drinks a good bit more but I think that is more the result of switching to a kibble from a hydrated food. We are going to start measuring her water intake so we can stay on top of things.

Our spot checks have been in the 400s since lowering her dose. We had one reading of 311 after a long midday walk but that was a special event. We are going to do another glucose curve tomorrow and see how shes doing. Will most likely be moving up to 11 units on Sunday.

Ive been doing a lot of reading about different insulins and financially we are having difficulty affording the Vetsulin (its 75 bucks a vial from our vet). I was considering switching to the Walmart branded Relion (Novolin N?) since it seems like a lot of dogs do well on it. Any tips here? I just bought a months worth of Vetsulin so we are good for a little while and can focus more immediately on finding her ideal dose.

P.S. Maura is spayed!


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