hind leg weakness

[jesse girl]

Re: Latest curve not what I expected

Same battle with jesse for almost 8 years . raising the dose to higher sugar may helped briefly and then deteriorate

for me jesse body is not accepting the higher dose . It appears to me reactionary . Why we can only speculate . Its possible you could be giving to much insulin

Now its possible you maybe able to overwhelm whats happening with more insulin

jesse fluctuates and thats her reality she has periods that she needs more insulin and other times she needs less

you could do a substantial reduction say to 5 units and hold for a week and see if things become more stable but if the dose has been to much it may take weeks for the body to settle and numbers could stay elevated for a period of time and might be hard to stay at that lower dose and have no guarantee it will work .

jesses second vet told me jesse may have been misdiagnosed and to go off insulin and for a couple weeks for the body to settle . We lasted a couple days and her symptoms came back so i felt she was diabetic and she is . no doubt there . No sense going down that road again

Another theory i had with jesse is she might be reacting to this as a foreign substance and the body is not completely accepting it . So the more i give the more the reaction could be . Now this is just speculation on my part

you maybe able to give a short or fast acting insulin . maybe not a day in day out routine but as a correction but it can muddy the waters but we have used it and it has some benefits for jesse

you have done this for a while and maybe you need to change things up a bit .I understand thats hard to do depending how well regulation is going . The reason we went to one meal with jesse is nothing else worked and her regulation was poor at best . fortunate that worked for her .

[Riliey and Mo]

Re: Latest curve not what I expected

it might be time to feed less food. the recommended amount of food for a 25 lb dog is 3\4 to 1 cup a day. based on your bowl curves seems food is raising his blood sugar then its not good to keep increasing the insulin.

I had to cut back on Riles food intake at 1/2 cup a day to meet up with 5 units of mph.

25 lbs x .2 = 5

if cutting back doesn't work changing food would be a good idea. some foods don't work with insulin.

mo

[Raysaint]

Re: Latest curve not what I expected

Going to do a curve today, before the vet visit tomorrow. If the pattern is the same, then my theory is that he's metabolizing the insulin too fast. Hence his good sugar during the morning and than a big spike by 1:00.
I'll see if today's curve is still like that.

I read a lot about fast insulin metabolizing, but nothing really said why it happens.

[jesse girl]

Re: Latest curve not what I expected

Thats the big problem for most in regulation . Large spikes in sugar raises it to a level where it can take all day for those numbers to come down to an adequate range .

All the theory's and speculations in the world doesnt matter if you cant slow and limit the size of a spike .

If its consistent day in day out there are things to address it like a fast or short acting insulin . Possibly a carby snack before the spike takes hold ( timing can be important ) . Always on the table is a dose reduction . We cant forget an undiscovered medical condition

I am not in the camp of insulin metabolizing to fast and running out . Insulin is either being overwhelmed by food or the bodies sugar or the body is negating injected insulin . From jesses one meal i have discovered with jesse she gets 18 hours out of N insulin but many times that is clouded by spikes in sugar

A friend of mine is a type 2 diabetic and he is struggling with higher numbers . He is getting spikes into the 400s and takes all day for those numbers to come back down into an adequate range . Now i dont treat a human diabetic just a dog but i told him if you cant identify the timing , the length and the consistency of the spike you dont know how to address it . Since it appears you have that you have half the battle taken care of

Now i have seen solving one problem can create a problem in another area so something to keep in mind . Good luck with your vet visit

[Raysaint]

Re: Latest curve not what I expected

Well, here's the curve so far. I'm posting it before completion because it already worries me.

Fasting, 7:15 a.m. : 12.3 (220)
Insulin : 8.5 units @ 7:45
9:30 a.m. : 13.3 (240)
10:40 a.m. : 13.1 (235)
11:45 a.m. : 15.1 (270)
1:00 p.m. : 19.1 (340)

So my theory of fast insulin metabolism seems less likely. Seems he processed some insulin, as there's no big rise after eating (he used to rise 4 - 5 points after meals).
Insulin is starting to peak at 1:00, but does nothing for his sugars.

Is this curve a sign of insulin resistance? I guess maybe a higher dose can bring the numbers down relatively, but I want to know if there's an underlying condition. A higher dose sounds too simple.

[jesse girl]

Re: Latest curve not what I expected

its possible the 220 fasting could be a continuation of an earlier spike in the morning and it continues to overwhelm injected insulin till late morning . At first glance most would think its a food rise but you cant be sure of that .

I do not think your dealing with resistance . Injected insulin is working .

curious to see if there is a drop off for the rest of the day and see if fasting is much lower which is a common with a pattern like this

i would think if you dont see a drop off towards fasting your vet will recommend raising the dose with just looking at this specific curve

now remember this is not bad my jesse spiked off her 220 fasting yesterday evening and 2 hours latter she was at 313 . Its a bit frustrating but thats just how it is but its not a crisis

[Raysaint]

Re: Latest curve not what I expected

jesse, it's not the 220 fasting that bothered me. It's the late morning, as insulin gets stronger, why no drop, as in the past. And no real post prandial rise, as in the past.

[jesse girl]

Re: Latest curve not what I expected

like i suggested it could be a continuation of a rise from earlier in the morning . could be a hormonal component to it and yes you may have it correct in one aspect that if insulin is being overwhelmed by the body then that could be called temporary resistance .

it gives almost the impression like you never gave the shot . Its not uncommon or unusual for people that test there dogs blood sugar at home to see a pattern like this. I see it maybe 50 percent of the time . Sugar may not spike up as much where it just stays relatively flat maybe in the 200s all day but last evening it spiked into the 300s which is less common

[Raysaint]

Re: Latest curve not what I expected

So here is the full curve from yesterday.

Fasting, 7:15 a.m. : 12.3 (220)
Insulin : 8.5 units @ 7:45
9:30 a.m. : 13.3 (240)
10:40 a.m. : 13.1 (235)
11:45 a.m. : 15.1 (270)
1:00 p.m. : 19.1 (340)
3:30 p.m. : 10.4 (190)
4:00 p.m. : a 20 minute walk
5:00 p.m. : 3.9 (70) (gave him 3 little biscuits)
5:25 p.m. : 8.3

Didn't check after that as the food alters curve pattern.

Wow, wasn't expecting that, and don't even know what to make of it. Such extreme differences from high to low.
Saw the vet today and she admitted it's wonky.

My questions to her were:

If that pattern continues, how does one dose bring morning sugar down without bottoming out late afternoon (maybe a late treat might be needed.)
I'll spot check late afternoon to see if it continues.
She said let's look for obvious things that could be affecting it and treat it if something shows, i.e. his thyroid changed and he needs a higher dose of thyroid med.
He's gained a bit of weight also.

If nothing obvious shows, then we have to start experimenting and fishing.

[jesse girl]

Re: Latest curve not what I expected

Its the hard drops that probably cause the spikes . Its not a bad curve . Watch that walk late in the day if numbers are dropping

A late carby snack may help but timing is everything on that

The body will find a way to balance injected insulin and try to keep itself safe and will do it by any means necessary . Thats why you dont see allot of hypo events

Now we would like to see a more stable and flatter blood sugar but maybe the insulin we use just makes that difficult to do so we just have to accept some of the inconsistencies . Now that doesnt mean we give up and say this is the best we can do . To this day 8 years in experiment to try to improve things and try to understand this disease . Like your vet said go fishing a bit

glad things went well with the vet

[Raysaint]

Re: Latest curve not what I expected

So the full blood panel results came back yesterday, except the thyroid test, which takes an extra day or 2.

Everything was normal, including pancreas enzymes. The only thing high was triglycerides, but it wasn't a fasting test. (he gets 1/2 tsp of omega 3 every morning).

Vet said that if the thyroid comes back low (he's on the minimum thyroid dose right now) that may explain some of the wonky blood sugar and strange pattern, and also can contribute to the triglycerides. So that would be an easy fix.

If not, then I have to deal with the strange curve pattern. The strategy, based on the curve, will be to maintain the dose to help keep morning numbers flat, accept the big midday spike, and give a carb treat later in the afternoon if his morning fasting is below 12. I don't want to lower the dose if morning fasting is low, just to protect the late afternoon potential crash. But I have to spot check a few days at around 4:00 on days his morning fasting is good, like today, morning bg was 10.4

[jesse girl]

Re: Latest curve not what I expected

sounds like a good plan

[amydunn19]

Re: Latest curve not what I expected

I didn’t think the numbers were bad - pretty tight until you get the afternoon drop. The walk came at a bad time and may have dropped him quite a bit. I would do the walk earlier when he is higher and maybe do a carby snack before or after. Have you ever given a small snack in the afternoon? I know if you aren’t available to do all of this with work or obligations, then these suggestions may be of no value,

[Raysaint]

Re: Latest curve not what I expected

Well, now I wonder if the curve (in lower part of this thread) from Feb. 13 was a one-off unreliable reflection of his metabolism. He seems to consistently have the big spike around 1:00 p.m., but after that it's a crap shoot.
Did some spot checks and here's what I saw. Same food, same dose, same exercise.
(I didn't spot check mornings because it was late afternoon that had possible danger)


Feb 13 Fasting, 7:15 a.m.=12.3 (220) 3:30 p.m. = 10.4 (190) 5:00 p.m. = 3.9 (72) 6:30 p.m. = didn't check as food was given

Feb 14 Fasting, 7:15 a.m.=14.1 (255) 3:30 p.m. = no check 5:00 p.m. = 11.7 (210)

Feb 15 Fasting, 7:15 a.m.=14.9 (270) 3:30 p.m. = no check 5:00 p.m. = no check 6:30 p.m. = 15.3 (275)

Feb 16 Fasting, 7:15 a.m.=10.6 (190) 3:30 p.m. = 18.8 (340) 5:00 p.m. = 17.1 (306) 6:30 p.m. = no check

Feb 17 Fasting, 7:15 a.m.= 14.5 (260)


Compare those with the curve from Feb. 13 lower in the thread.
Once again, such differences in how he seems to metabolize insulin. So my strategy from my last post, seems no good now. Which pattern is it going to be?
I can't have a strategy on single dosage with such wide possibilities.
If I increase to bring down afternoon numbers, can low morning fastings and morning numbers be safe.

I actually hope his thyroid comes back low and after treating it with higher med dose, that maybe fixes this situation. All I want is a consistent pattern so I can figure a dose.

[jesse girl]

Re: Latest curve not what I expected

What would be helpful is to figure if you have some consistency at times except for the 13th it appears you do

My jesse is usually ruled by her fasting number . If higher she would have a tendency to be lower at the next fasting . If she is lower she has a tendency to be higher at her next fasting . To me that makes sense as being higher the body is allowing insulin to clear excess sugar while at a lower range there maybe not enough wiggle room with a full dose of insulin so it spikes

With the thyroid problem and you dont know where your at on that its going to be difficult to draw conclusions . The good thing from your numbers your no where near to a problem at these levels