Brownie my Yorkie became an angel August 31, 2017

[Brownies Mom]

Brownie is a 12 lb. Yorkie and was well controlled on 5 units of NPN until she got a bladder infection. Now she is free of the infection but has Alpha Trak glucose curve readings in the 600 range after receiving 12 units of insulin twice daily.

Our vet has said that she is probably insulin resistant and we could try Vetsulin. I cannot afford the Vetsulin so I'm hoping for some advise on how to suppress the resistance. So far she isn't showing outward signs of ketoacidosis.

[jesse girl]

Re: Insulin Resistant After Bladder Infection

hi and welcome

12 units is allot for a small dog . Its possible raising the dose in response to resistance from the infection has led to a dose being to much

I might lower back down to at least 5 units i might even go lower just because that 5 units if given during the infection may have seen a bit of resistance and the 5 units may have been to much without the infection

higher numbers and big swings in sugar after seeing good regulation may point to a dose being to much or some other medical issue coming off fairly stable sugar previously

Home testing can help with determining whats going on but it going to take some work on your part just minimal testing at the vet wont accomplish much.

Now i have not seen much difference between nph and vetsulin on the forum as far as a response from dogs but sometimes a switch can give a reset to the process and once again i would start with a much lower dose

Many times our pull is to give more insulin when we see higher numbers and actually we might be going in the wrong direction especially since you have some history of adequate regulation with a much lower dose

[Brownies Mom]

Re: Insulin Resistant After Bladder Infection

Thanks Jesse girl,

Brownies reading were coming up as High while we were increasing her dosage. Never a lower number even though I was taking them before meals and 2 -3 readings during the day. When we reached 12 units I actually got a number instead of high, they were consistently 575 - 650.

My vet said she was resistant and that she might have something else going on. The vet would like to do ex-rays and an ultrasound and possibly more testing to rule out cancer or pancreatitis, I can't afford this.

Without seeing any low readings, it seems to me we could go up to 13 or 14 units and we would see lower numbers. What do you think?

If I can't regulate this I will eventually have to euthanize Brownie. Obviously this is not an option I want to make.

[MomofGus]

Re: Insulin Resistant After Bladder Infection

How long have the high readings been going on? What is your dog's diet and how often do you feed her? Does she get snacks? Could the food and when/what she eats be partial cause of higher numbers? Is the bladder infection cleared up?

The dose should not be more than the weight of the dog. So, I would not give increase. 12 units for 12 lb dog twice a day seems like an awful lot, but some dogs do require more.

I would certain look at all options before euthanizing. If you're using Alphatrak meter and strips, that can be very costly. I made the switch to Advocate Pettester and strips, which cut down the costs considerably. The meter starter kit was $9.95, and 50 strips are around $18 on Amazon. vs. $55 for alphatrak strips on Amazon.

[Brownies Mom]

Re: Insulin Resistant After Bladder Infection

Brownie was diagnosed in March 2016 and was well regulated on 5 units until the October spike. Brownies numbers have been between 384 and Hi (750+) since October 22nd. Most in the 580 - 680 range. She is 12.6 lbs. and her bladder infection is cleared up but her numbers have not. She eats Purina dog chow 1/2 c. twice a day with insulin injections right after eating. She gets treats very rarely. She gets a very small piece of dehydrated liver usually after a difficult glucose test or after nail clipping or hair cut which are stressful for her.

[CraigM]

Re: Insulin Resistant After Bladder Infection

Please don't take this the wrong way, but are you using real AlphaTrak test strips and verified the code number is set correctly?. Mistakes can happen like messing up the code number.

How is Brownie's urine? Accidents in the house, sticky looking? With true high numbers you are seeing I'd think he would be drinking water / peeing all the time.

Craig

[Brownies Mom]

Re: Insulin Resistant After Bladder Infection

Please don't take this the wrong way, but are you using real AlphaTrak test strips and verified the code number is set correctly?. Mistakes can happen like messing up the code number.

How is Brownie's urine? Accidents in the house, sticky looking? With true high numbers you are seeing I'd think he would be drinking water / peeing all the time.

Craig

No problem, I appreciate any response to help out. I am using the Alpha Trak and it's test strips and have verified the code number.

Brownie is drinking alot but is not having accidents unless we leave her alone for an extended period. She is let out multiple times during the day and at around 11 pm, once during the night and again between 7 and 9 am. (Kinda like my husband. lol) She barks to be let out, the dog not the husband.

[CraigM]

Re: Insulin Resistant After Bladder Infection

This is a tough one I don't think we've seen a pup that actually required more than one unit per pound. Hope someone will come up with some good ideas.

Craig

[Riliey and Mo]

Re: Insulin Resistant After Bladder Infection

this is just a thought but I have read posts on dogs getting sick from dehydrated liver treats especially the ones manufactured in Thailand and China. I would stop all treats , do a curve in a week to see if this is the problem.

worth a try

also changing the dog food might help

[Brownies Mom]

Re: Insulin Resistant After Bladder Infection

this is just a thought but I have read posts on dogs getting sick from dehydrated liver treats especially the ones manufactured in Thailand and China. I would stop all treats , do a curve in a week to see if this is the problem.

worth a try

also changing the dog food might help

Thank you. I made the liver treats myself with beef liver from my butcher. After cooking and dehydrating I have kept the treats in the freezer.

Please keep the ideas and comments coming something is going wrong with her glucose so any comments are welcome.

[Judi]

Re: Insulin Resistant After Bladder Infection

how are her teeth and ears? any other infections
The kidney infection sure could have set something else off
Even though insulin resistance is defined as a unit per pound, I guess I wouldn't have a problem with trying 13 for a week and see what happens.

while we were figuring out if my dog had cushings, which she did, she was getting 7 units at 8 pounds. it took what it took

how is her cholesterol or thyroid?

Barb's sweet dog Abby was sneaking out to her bird feeders and eating all the dropped bird seed, resulting in higher blood sugar. any possibility of something weird like that going on?

what does your gut say?

this is hard. Judi

[MomofGus]

Re: Insulin Resistant After Bladder Infection

I would certainly look at changing the food. Not sure Purina dog chow is that good for controlling diabetes. And, you might try adding a tblsp of pure canned pumpking (not pumpkin pie mix), but 100% pumpkin. That helps controls spikes in BG. I added it to my dog's diet, and it has helped a lot. I mix it with his canned food and he loves it. I even freeze dollops and give asa treat. Frozen green beans are good too and won't raise sugar.

Is the high number at certain time of day?

And, another thought - where are you injecting the insulin on the body? Sometimes location of the injection makes a difference in absorption, and as well as getting the needle under the skin just right.

Just thoughts for you.

[Brownies Mom]

Re: Insulin Resistant After Bladder Infection

how are her teeth and ears? any other infections
The kidney infection sure could have set something else off
Even though insulin resistance is defined as a unit per pound, I guess I wouldn't have a problem with trying 13 for a week and see what happens.

while we were figuring out if my dog had cushings, which she did, she was getting 7 units at 8 pounds. it took what it took

how is her cholesterol or thyroid?

Barb's sweet dog Abby was sneaking out to her bird feeders and eating all the dropped bird seed, resulting in higher blood sugar. any possibility of something weird like that going on?

what does your gut say?

this is hard. Judi

My gut says that I'm heartbroken that I can't get all the veterinary tests that would give me more information to work with.

Her ears are clean, no sign of infection or scratching. In March her teeth were level 2 out of 4 although since then she lost a front tooth and loosened 3 others shortly after getting cataracts so vet upped that number to 3. I think the loose teeth were due to bumping into things and jumping down from chairs and crash landing. She has conquered these issues and teeth are now solid.

Cholesterol is 225 mid-normal range. Not sure what her thyroid is. what would I look for on the blood work-up?

She had been known to take down morning doves and came in with feathers in her mouth yesterday but I don't know how she could kill one with the cataracts she now has. Other than this anomaly there are no other food sources for her.

My gut says that the symptoms of cushings is so close to the high glucose symptoms it's got me scared.

Is there any way to treat cushings without the diagnosis? I've heard that the treatment is inexpensive but the diagnosis is not.

[Brownies Mom]

Re: Insulin Resistant After Bladder Infection

I would certainly look at changing the food. Not sure Purina dog chow is that good for controlling diabetes. And, you might try adding a tblsp of pure canned pumpking (not pumpkin pie mix), but 100% pumpkin. That helps controls spikes in BG. I added it to my dog's diet, and it has helped a lot. I mix it with his canned food and he loves it. I even freeze dollops and give asa treat. Frozen green beans are good too and won't raise sugar.

Is the high number at certain time of day?

And, another thought - where are you injecting the insulin on the body? Sometimes location of the injection makes a difference in absorption, and as well as getting the needle under the skin just right.

Just thoughts for you.

I have some 100% pumpkin in the cupboard that I will start adding to her diet tonight, she'll love it. What food would you recommend? Please keep in mind that my budget is taxed due to the vet bills.

Her numbers are pretty consistent through out the day. I did her most recent curve November 21st 3 days after she started on 12 units of NPH. 8 am High before 12 units insulin and 1/2 c. food, 10 am High, 12 noon 543, 2 pm 651, 4 pm 575, 6 pm 493, 8 pm 501 before 12 units insulin and 1/2 c. food, 10 pm 665, 3 am 600, all readings since these closely mimic time and reading.

As far as injection sight both my husband and I do her shots and we lift the skin between an area from lower neck to shoulder blades, with thumb and middle fingers we make a small dent in skin with index finger then inject in the dent injecting under skin not into it.

[MikeMurphy]

Re: Insulin Resistant After Bladder Infection

My gut says that I'm heartbroken that I can't get all the veterinary tests that would give me more information to work with.

Her ears are clean, no sign of infection or scratching. In March her teeth were level 2 out of 4 although since then she lost a front tooth and loosened 3 others shortly after getting cataracts so vet upped that number to 3. I think the loose teeth were due to bumping into things and jumping down from chairs and crash landing. She has conquered these issues and teeth are now solid.

Cholesterol is 225 mid-normal range. Not sure what her thyroid is. what would I look for on the blood work-up?

She had been known to take down morning doves and came in with feathers in her mouth yesterday but I don't know how she could kill one with the cataracts she now has. Other than this anomaly there are no other food sources for her.

My gut says that the symptoms of cushings is so close to the high glucose symptoms it's got me scared.

Is there any way to treat cushings without the diagnosis? I've heard that the treatment is inexpensive but the diagnosis is not.

Look for the results of the T4 thyroid test on her blood work. Low thyroid or hypothyroidism can cause insulin resistance in dogs. However, sometimes the T4 test can be inconclusive and a full thyroid panel may be needed. This article by Dr. Jean Dodds is very good, but is very technical ... http://www.hemopet.org/clients/14145...and_Dosing.pdf

The T4 ranges are discussed starting on page 8 or 9.