Hershey

[Raysaint]

Re: Hershey

When you say never got to the 400's, do you mean from a higher number?
If she stayed higher than 400, not sure an insulin decrease would be needed.

Why did the vet suspect somogyi? That indicates her numbers were too low.

[Phyllis Diot]

Re: Hershey

No her numbers ran:
383 before breakfast and insulin 815am
430 after breakfast/insulin and walk 1125am
340 at 220pm
334 before meal and insulin 6pm
393 at bedtime 10pm
I think perhaps it is for several possible reasons. If you look at the original vet curve numbers I posted it seemed everytime he increased dosage, the glucose increased. Perhaps the other reason is the need to get up almost consistently around 230-3 am for water and pee. Not sure of his reasoning as he did not explain why only what it was (which I knew) and what to decrease it to.

[jesse girl]

Re: Hershey

this is the perplexing thing to regulation and i have seen it also where raising the dose sees a deterioration in the numbers driving them higher without any low numbers seen . As you raise the dose the numbers just goes higher and resistance strengthens . This is not text book rebound

So what is occurring . My thought its the bodies reaction to a foreign substance . It may not be fully accepting of injected insulin and as the dose is raised the body reaction increases

Now here is the conundrum . You lower the dose and the resistance is reduced but the numbers remain higher than you like .

This is where a diabetic dog may benefit from a fast or short acting insulin . The curve is fairly flat but you cant break resistance lower . The logic is if you could break the resistance with say an insulin like R into a lower level say in the 200s to begin with and say your dog is on nph so the hope the N insulin would keep that level stable through that 12 hour period

So if you cant break through the resistance either with a higher or lower dose this maybe an option . The advantage with the curve you are seeing is there is no big swings you can identify . You may want to get some tests late at night to make sure there has not been any lower numbers that could cause rebound

just a thought

[MikeMurphy]

Re: Hershey

I totally agree with jesse girl’s analysis.

In addition, I can see why your vet wants to drop her insulin to 15 units. The vet was correct in starting Hershey on 17 units because that’s the standard conservative starting dose for an 86 lb dog. (86 x .20) = 17.2. Because her BG has gone up with every methodical increase in insulin, It just may be that Hershey requires less than the normal starting dose. As they say, every dog reacts differently to injected insulin.

[Phyllis Diot]

Re: Hershey

But she is on vetsulin. I will try and get a test done on her early morning run timeframe and see what it shows, but with the recent change from 20units down to 15 just started last night may be hard to tell anything at this point.

[jesse girl]

Re: Hershey

But she is on vetsulin. I will try and get a test done on her early morning run timeframe and see what it shows, but with the recent change from 20units down to 15 just started last night may be hard to tell anything at this point.

Thats another choice you may have if you do not get the results you look for to move to another insulin like NPH

Its going to take a week for the dose to settle and get a true result of the adjustment lower

Now if you see any diabetic symptoms returning or degrading it may point to the dose not being enough and rethink your options

[Phyllis Diot]

Re: Hershey

Okay, will be back I am sure. fingers and paws crossed.

[Phyllis Diot]

Re: Hershey

OK, not been a week yet but did a good curve and want thoughts. Vet dropped her to 15 units on Tues. so first lower dose was not until Tues night. So been Tues night, and Wed thru today. Here is what I got:
yesterday :
536pm 332 before food and insulin
700pm 2c dry and chicken cubes and green beans
720pm insulin 15units
1102pm 512
early morning:
150am 536
900am 342
905am food (over slept) same food
910am insulin 15 units
940am walk 1.5 miles
1125am 503
130pm 466
330pm 406
530pm 415
655pm food (same)
705PM insulin 15 units
1020pm 494
So I think we can rule out the somogyi effect. But after having a curve with all numbers in the 300 range except one this makes me nervous. Vet wants to keep it at 15 units for the two weeks and said not to adjust dose without his approval. And always closed over the weekend. Will spot check again to insure it doesn't get worse.

[jesse girl]

Re: Hershey

Usually i dont like to comment on something until the prescribed time has been exercised . I can understand the desire to see how things are going but a dose needs time to settle to get a true understanding of how it will work . We have seen some dogs need 2 weeks for a dose to see its true colors

Now this curve will be helpful for a comparison after the week is completed and that curve is done . You maybe able to draw a better conclusion between the 2 when its completed .

If diabetic symptoms return than you may want to do an increase sooner but if all is normal steady she goes with the program

[Phyllis Diot]

Re: Hershey

Thank you. I was planning on waiting unless I see things get worse as far as numbers climbing.

[Phyllis Diot]

Re: Hershey

It's been a while since I have posted. Since Nov. Hershey has been on vetsulin anywhere from 17 units up to 23 back to 17, down to 15 and back to 17. Still not regulated. Vet took her record to a specialist to consult with him. Wed morning we changed to 8 units NPH. I am to take two curves within two weeks and call them in. Now I know it has only been 4.5 days thus far but her glucose has gone up with all varying spot checks. Lowest in mid 400 range and highs in low 600 range. Never a good thing. I think I will be giving him a call tomorrow. Any thoughts?

[Lolo]

Re: Hershey

Since you just changed insulin from Vetsulin to NPH it may take some time to get to the right dosage. 8u is probably the starting dosage for your pup’s weight. You may have to just do a slow and steady increase of no more than 1u or .5u every week based on a curve after being at that same dose for a week. I know it’s a frustratingly slow process and it’s torture seeing high numbers, but there’s no easy answer to finding the right dosage. My vet raised my dog’s dosage WAY too fast taking big jumps in the first month and it totally set everything back.

[Riliey and Mo]

Re: Hershey

I switched from to nph also. its recommended to start nph a at a lower dose because its more concentrated. dropping back to 8 units is to low. recommended starting dose for a 67 lb dog is 13 units

I.d o up to at least 11 units wait 5 days tdo a curve with spot checks during the day

[amydunn19]

Re: Hershey

It is tough to do but maybe a reset will be good to get on the right track. I know we probably asked before, but what are you currently feeding?

You might want to get some of those ketone urine test strips if the numbers get too high. If ketones are present, action would need to be taken.

I know you are frustrated but keep in mind that many dogs have had higher range blood sugar and still lead normal lives. You do the best you can.

Have they ever checked for possible resistance issues like thyroid function? Just a thought.

[Phyllis Diot]

Re: Hershey

Thanks everyone. Yes I was thinking too low of dose as well because my pre calculation came out to about 12 units, but will call vet in morning and see if we should make a move up to say 9 units for a week. She is eating Beneful healthy weight with sometimes a little beneful grain free mixed in. Also try to toss in a little chicken tender a couple times a week.