Gretel is now our angel

[CoolGram]

Hello Everyone,

I have an 8yr. old mini schnauzer, Gretel, who was diagnosed with diabetes one month ago. Presently she weighs 18.5 lbs., but normal for her is around 20 lbs. As of this writing, she is still not regulated, although the vet has done 4 curves plus a few spot checks, and she is up to 8 units of NPH insulin twice a day. Her lowest reading so far was 250 but most of them have been in the 3 and 400 range. Complicating things is the fact that she just had bladder stone surgery a week and a half ago. (This is her 3rd bladder surgery in less than 2 years.) Tomorrow she goes to get the stitches out and will stay for the day for another curve.

She has been on wd canned and dry dog food (I mix them), plus I add to her food Tricitrate syrup which is to keep her urine ph at an acceptable level to try to prevent stone formation. It's been a real balancing act with her, because the food/medicine that helps one condition isn't usually good for the other. She also was recently diagnosed with a disc problem in her neck that was causing her pain. She seems to have recovered from that, at least for now, but she was on meds for that as well.

Through all of this, Gretel has remained a cheerful and energetic little girl. She takes the injections quite well. I can tell she doesn't exactly want it, but she will come right to me when I call her, and as soon as I give it to her I praise her greatly and give her a small treat (which is compatible with the wd dog food.) She gets no other food or treats throughout the day.

I do have a question that may not seem all-important but I'm curious as to what feeding schedule works best for others. Since they must be 12 hours apart, at some point in time there may be a conflict with your own schedule, and I'm wondering how you handle those occasions. I've always tried to stay at exactly 12 hrs. apart (give or take 5 mins.), but is there any room for leeway - like maybe 20 mins. or even 1/2 hour? (Just on the rare occasion, obiously not all the time.) Right now I'm feed her at 6:30am and 6:30pm, with the insulin following immediately after she finished eating. I chose this schedule because I thought that if we had plans for the evening we wouldn't have to rush back at a certain time to feed her. However tonight I have a situation where I need to leave the house by 6:15, so over the last two days I have inched her feeding back by 6 or 7 mins. each so that by tonight she'll be due for her feeding and insulin by 6:15 (but I don't necessarily want to stay that early). Would love to hear how others handle this type of situation.

Again, I'm thrilled to have found this forum. I'm sure all of us wish we didn't have to be here, but it sure is nice to know you can help one another out with questions and just with support in general. Thanks to all who respond!

Carolyn

[k9diabetes]

Re: Feeding schedule question

Hi Carolyn,

Welcome to you and Gretel!

Life happens We all have had to adjust on occasion because of a scheduling conflict. A half an hour should not be a problem. We occasionally had an extreme circumstance that required us to delay longer and if that happens you can adjust things back to normal in 20 minute or 30 minute increments over a day or two to reduce how much difference there is.

So if I'm late an hour tonight, I could give it half hour later in the morning and then at the usual time that evening and be back on track.

Hope that makes sense - I'm feeling a little disjointed today!

Gretel has a lot going on! When things settle from the surgery and the neck, you may see better blood sugar. Pain and inflammation can both raise blood sugar levels.

Natalie

[CoolGram]

Re: Feeding schedule question

Thank you Natalie. I'm trying so hard to do everything "by the book". It's been a rough 2 yrs. with all her issues and I want so badly for her to feel well and to know that I'm doing everything I can to help her. I wouldn't want to do anything that might be detrimental to her. Again, thanks for your response, it did help.

Carolyn

[Patty]

Re: Feeding schedule question

Carolyn,
Just wanted to say welcome! Sorry to hear about Gretel's surgery. Glad she's on the mend. What a sweet picture
Take care,
Patty

[CarolW]

Re: Feeding schedule question

And so, we get to meet ANOTHER super-great Human Dog-Mum! Wow; Carolyn, you have REALLY had your hands full.

I just loved your question about scheduling meals. I'm so compulsive I go to the minute - pretty much, anyway. And because I use my computer an awful lot, and also, I'm wildly absent-minded, I put my computer to work to tell me what to do when. For me, this is a great blessing, because my computer won't shut up until I check off the task I'm supposed to be doing!

http://www.coherentdog.org/vek/calendarscope.php

I think it DOES make a difference to the dog - our bodies - and dogs' bodies - can be quite time-sensitive, in a biological sense. I'm so compulsive about it that I start changing times, a little at a time, two weeks before we go to Daylight (or Summer) time, and two weeks before we go back to Standard time. I change 15 minutes a day, for three days at a time, and set that all up on my CalendarScope program. Today is my first day of time-change. I'll actually be on Daylight time FIVE DAYS before it arrives!

But I can do that, because I'm long-retired, and always at home. I don't recommend my method to anybody. Some ultra-compulsive people who are always home might like it.

Dogs can easily adjust, say 15 minutes, 20 minutes, even half an hour - the main concern would be whether insulin doses might overlap, or fail to cover, say 13 hours, rather than the 12 they're designed for.

About regulation, that does often take time, and with all Gretel has been through, it may still take a little more time. I think you're getting very good numbers for the situation.

Kumbi says, Hi Gretel! and he adds licks and wags.

Mon, 1 Mar 2010 13:13:37 (PST)

[BestBuddy]

Re: Feeding schedule question

Hi Carolyn,

I used the 6am and 6pm schedule for Buddy because like you we were up early and if we wanted or needed to go out in the evening it didn't mess anything up. There were occasions when I was an hour late or early with the injection and in the grand scheme of thing it didn't make much of a difference to BG's. If you know early enough you can make those small 10-15 minutes up in the days before.

Jenny

[CoolGram]

Re: Feeding schedule question

Hello again,

I’m writing with an update on Gretel’s curve yesterday. Unfortunately, her numbers still haven’t come down. The lowest reading was 330 at 8:30am (2 hrs. after feeding and insulin). At noon she was at 383 and by 3:00pm she was up to 441. Needless to say, I am very discouraged.

Since the very beginning, I have been very suspicious that maybe the Tricitrate solution I give her for her urine ph might be a culprit in elevating her blood sugar. I questioned the pharmacist as to whether this was a sugar based liquid because it does come in either sugar based or sugar free formulas. He assured me that what I had was sugar free although the bottle does not say sugar free. Also, the liquid forms a sort of granulation around the opening of the bottle which made me really suspicious that there was sugar in it. The pharmacist said that even if it was sugar based, there’s only a small amount of sugar added to those types of solution, and he also said that if the high readings were coming from that, he would expect to see the sugar level elevate shortly after I gave it to her, but then the levels should drop rather quickly. Since her numbers go up and stay up he doesn’t think that would be causing it. So, neither he nor the vet think it could be a factor. As I told the vet, I’m just grasping at straws, trying to think of anything that might be keeping her numbers up. I am even questioning myself as to whether I’m doing something wrong when I give her the injection. I really don’t think so; I tent the skin and inject at a slightly downward angle and I know it’s not coming out the other side because I always feel the hair around the injection site to make sure I don’t feel anything wet and I never have. I honestly do believe that everything is being done that can be done, but since I’m a novice at this, it’s kind of hard not to worry that it’s something I’m doing wrong.

The vet assured me that this difficulty in getting the numbers down is not uncommon and that we will eventually get there, but it needs to be done slowly because she is a small dog and we can’t take a chance on taking her too low. She’s now up to 9 units twice daily and the vet wants to do a spot check next week. On the bright side, she gained several more ounces since her surgery a week and a half ago (she’s now 18.8 lbs., up from a low of 17.5 when she was diagnosed a little more than month ago), so the vet said that shows things are going in the right direction.

On another note, thanks to all who responded to my question about feeding. It’s really nice to “meet” all of you. It’s just great to have that support and I really do appreciate it.

Carolyn

[k9diabetes]

Re: Feeding schedule question

Mini Schnauzers are infamous for a couple of contributors to high blood sugar, one of which is high triglycerides. So I wondered if those have ever been checked.

I am with the vet on this right now - with so much that Gretel's been through recently, I think it's just going to take some time for everything to get healed up and uninflamed.

Also, she may have built up some temporary insulin resistance that comes from having high blood sugar for a while. If that's true, then that will break after she's had these higher doses of insulin and then she will become more sensitive to the insulin and get even better levels from the same dose.

If the insulin wasn't working for her, you would not see blood sugar down into the 300s. So it's working and even seems to be providing a pretty nice, flat response, which is what you want in order to get the best regulation possible.

So I know it's really hard not to worry - I remember many sleepless nights early in Chris' diagnosis and regulation - but I agree with the vet that things are moving in the right direction.

Natalie

[CoolGram]

Re: Feeding schedule question

I have never heard the vet mention anything about Gretel's triglycerides, I didn't even realize that could be a factor in high blood sugar. She just had bloodwork done prior to her surgery and since she was known to be diabetic maybe her triglyceride level was included in that. I will ask the vet next time I speak to her.

Thanks for the suggestion.

Carolyn

[k9diabetes]

Re: Feeding schedule question

Just thought I'd copy this here for handy reference.

Dog's Name: Gretel
Sex: Female
Breed: Miniature Schnauzer
Age: 8
Current weight: 18.8 lbs.
Weight when diagnosed: 17.5 lbs.
Average weight: 20 lbs.
Diagnosed with diabetes 1/21/10

Insulin: NPH - currently at 9 units twice a day

Food: w/d canned and dry mixed
1/2 can and 2/3 cup dry at 6:30am and 6:30pm

Treats: Hill's Veterinary Treat (compatible with w/d dog food)
She gets one small treat after her morning and evening injection

Still working on getting regulated. Not yet doing home testing.

[CoolGram]

Trouble brewing at injection time

Hello everyone!

It has been about 6 weeks since Gretel (my 8 yr. old mini schnauzer) was diagnosed. Up until a few days ago, she was taking the injections like a champ. The first week I gave them to her she came to me after eating without me even needing to call her to me. Then she gradually decided maybe she really didn't want to come, but when I called her she came without hesitation. This past week she has gotten more and more hesitant to come, she has jerked several times and yelped once when the needle went it. Of course this isn't helping me, because it makes me more nervous to give it, which I know isn't good. We seem to be doing things in just the reverse of everyone else. Most people start out rocky, but eventually things improve. We started out better than expected but now we're going downhill. I would really like to nip this in the bud before it gets worse. Oh, in case anyone is wondering, I do give her a treat following the injection, so she knows she has that to look forward to.

I have been injecting into the scruff of her neck because it seems that's where the most loose skin is on her. I had been instructed to inject anywhere from the scruff down to an area above the shoulder blades, sort of in a triangular area. But the lower I go, the less excess skin there is and it becomes harder to inject there.

I'm wondering if she's simply getting sore in the scruff area? I do move the site from left side, then middle, then right side. But every third injection I'm back at the same site again.

I've also read in this forum that the beveled edge of the needle should be down when the injection is given. Could this be the problem, that the needle isn't turned in the right direction? I really couldn't even tell which side was which until I got a magnifying glass out. Does anyone know whether the beveled edge is always on the same side of the syringe barrel or do you need to look at each one to see where it is?

As always, thank you to all who respond. I really appreciate your help.

Carolyn

[Dakotapix]

Re: Trouble brewing at injection time

My own schnauzer, Wolfie, had an excess of fatty growth around his scruff so my vet advised us to inject insulin below the scruff. I tried to vary the injection point from both sides of his back and along both flanks to avoid overly sensitizing any one area of his body. I also kept a bag of his favorite treats in his vision to distract him while giving the shot. I think Natalie and most forum members will suggest that you vary the injection point. Somewhere on the forum there's an illustration that diagrams good injection points on a dog.

[catusgirl66]

Re: Trouble brewing at injection time

Hi i'm new at this too lol. My dogs name is Boober we have been having a heck of a time with her... at least she is eating some now. I too have been having some problems with the shots, so you are not alone. But see I was told not to give in the neck area but to imagine a saddleback like whats on beagles and to do it only in that area and to switch sides each injections. Boober she is the same way, she yelps or jerks whats bad is one night she didn't even get all meds had to stick twice, because I put it in and she jerks on me urggggg. I hope like you this gets easier .

Kelly

[CoolGram]

Re: Trouble brewing at injection time

Yes, I did see the instructions on different sites to inject. I have just been doing what I was instructed to do by my vet, but I plan on mentioning this to her to see if she has any particular objection to me finding a different site. I do vary the site as much as I can, given the small area I have to work with, but she just doesn't have much loose skin anywhere but on her scruff. I think I will try to set the treat container in front of her while I inject her, so maybe that will help her refocus on that, rather than what I'm doing to her! Thanks for your suggestions!

[ozzi]

Re: Trouble brewing at injection time

I've also read in this forum that the beveled edge of the needle should be down when the injection is given.
Carolyn

Hi Carolyn,

Actually, the bevel should be UP when giving the injection. This is for purposes of comfort for the dog. You do have to look for the bevel every time because the needles are not in the exact same position on the barrel of the syringe each and every time. If the bevel is down, it will still be effective, so that is not the worry...it's about comfort when injecting. Gretel might be having pain because the bevel is down. I'm not sure if you're warming the insulin prior to injection, but I take it out of the frig, draw it up, and put it under my armpit for 5 minutes. I think if you warm it and try injecting with the bevel up every time, Gretel will find it more comfortable.

Regarding locations, I have read that absorption is less effective in the scruff because of limited vascularization, and that the armpit and flank are more effective, however my vet did instruct me to inject in the UPPER half of the body and showed me how to do it in the neck, and I have been doing that as well.

Kevin