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Hi,
On March 5, 2010, our nearly-9-yr-old Maltese dog, Gigi, was diagnosed with diabetes and mitral insufficiency. She was exhaustively tested for Cushings -- negative. However, she is on heart meds: Fortikor and furosemide.
We live in Europe, vets in Europe use Caninsulin (Vetinsulin) almost exclusively (widely available here, no warning issued). The vets I have contacted (6 of them) have little or no experience with Humulin formulations.
Gigi weighs 9 pounds. She was started on 5 units of Caninsulin once daily. Within a few days it became apparent that she was rapidly metabolizing this insulin and the effect was gone after about 6 hours. The vet then reduced the dose and began twice daily injections, one every 12 hours with a meal.
At first the curve looked promising but once again, after a few days we saw wild swings in the space of 6-7 hrs: from 120 to 400+. After 4pm (7 hrs after injection), her BG value was/is always over 350 until the next injection takes effect.
We decided to try Humulin N. Our vet agreed to try it but admitted that he has never had experience treating a dog with human insulin.
After a week of 'start low, go slow' we again reached 4 IU twice daily = 8 units of insulin for a 9-pound dog. It's a lot! But alas, same problem. From about 4pm until the second injection takes effect around 11pm, her BG values are in the 300 - 400s. IOW, she quickly metabolizes whatever insulin she receives, and the effect is gone. We are unable to extend the duration.
We tried increasing the dosage - at first with Caninsulin, later with Humulin. Both times we got the Somogyi effect. Her BG went down to 40 then shot up about 100 mg/DL per hour until it leveled off above 500.
The vet tells me he has never had a dog as difficult to regulate as ours. The dog has now been in and out of the vet hospital for over 10 days trying to find a smooth curve but so far no luck.
We've two questions:
1) Has anyone else had a similarly difficult experience in regulating their dog, and if so, what worked? Should I try a mixture of N and L? I read that L is not very effective for dogs.
2) Although we have a glucometer, we have let the vet do the glucose curves because we are only able to draw blood from Gigi's upper lip. To get 7 readings in a day we have to prick her lip(s) an average of 10 times during the day. We tried unsuccessfully to draw blood from the pinna of her ear but only once we got enough blood for a reading. Even warming the ear with hot water and rubbing it doesn't work. The vein is tiny, collapses and it clearly hurts her when lanced. So we've given up on the ear. I read that some people draw blood from the base of the tail. Our vet told me not to do this for fear of infection.
What have people with very small dogs found to be an effective technique to get enough blood for a glucometer?
Any experiences you have to share in regulating an insulin resistent dog and / or successfully drawing blood from elsewhere than the lip will be greatly appreciated.
Carole
On March 5, 2010, our nearly-9-yr-old Maltese dog, Gigi, was diagnosed with diabetes and mitral insufficiency. She was exhaustively tested for Cushings -- negative. However, she is on heart meds: Fortikor and furosemide.
We live in Europe, vets in Europe use Caninsulin (Vetinsulin) almost exclusively (widely available here, no warning issued). The vets I have contacted (6 of them) have little or no experience with Humulin formulations.
Gigi weighs 9 pounds. She was started on 5 units of Caninsulin once daily. Within a few days it became apparent that she was rapidly metabolizing this insulin and the effect was gone after about 6 hours. The vet then reduced the dose and began twice daily injections, one every 12 hours with a meal.
At first the curve looked promising but once again, after a few days we saw wild swings in the space of 6-7 hrs: from 120 to 400+. After 4pm (7 hrs after injection), her BG value was/is always over 350 until the next injection takes effect.
We decided to try Humulin N. Our vet agreed to try it but admitted that he has never had experience treating a dog with human insulin.
After a week of 'start low, go slow' we again reached 4 IU twice daily = 8 units of insulin for a 9-pound dog. It's a lot! But alas, same problem. From about 4pm until the second injection takes effect around 11pm, her BG values are in the 300 - 400s. IOW, she quickly metabolizes whatever insulin she receives, and the effect is gone. We are unable to extend the duration.
We tried increasing the dosage - at first with Caninsulin, later with Humulin. Both times we got the Somogyi effect. Her BG went down to 40 then shot up about 100 mg/DL per hour until it leveled off above 500.
The vet tells me he has never had a dog as difficult to regulate as ours. The dog has now been in and out of the vet hospital for over 10 days trying to find a smooth curve but so far no luck.
We've two questions:
1) Has anyone else had a similarly difficult experience in regulating their dog, and if so, what worked? Should I try a mixture of N and L? I read that L is not very effective for dogs.
2) Although we have a glucometer, we have let the vet do the glucose curves because we are only able to draw blood from Gigi's upper lip. To get 7 readings in a day we have to prick her lip(s) an average of 10 times during the day. We tried unsuccessfully to draw blood from the pinna of her ear but only once we got enough blood for a reading. Even warming the ear with hot water and rubbing it doesn't work. The vein is tiny, collapses and it clearly hurts her when lanced. So we've given up on the ear. I read that some people draw blood from the base of the tail. Our vet told me not to do this for fear of infection.
What have people with very small dogs found to be an effective technique to get enough blood for a glucometer?
Any experiences you have to share in regulating an insulin resistent dog and / or successfully drawing blood from elsewhere than the lip will be greatly appreciated.
Carole
. 
Do you have a prior curve from one of the days where food/insulin were matched?
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