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**jesse girl** · 10-19-2014, 08:30 AM

Re: Hello, from Chuck and his Mom

hi and welcome

glad your home testing . you may want to get your big boy use to the sounds and routine of testing like the clicks and sounds of it without physically testing. just breaking things down like just getting use to the clicking sound and the meter beep with treats and praise can be helpful . smaller steps with practice

this all will become a new normal . can take up to 6 month to get to a good place which is quite normal sometimes longeror shorter but i consider that the middle of the road for everyone to get to a pretty good place

the more time you put into it the more helpful it can be . you may have to be the detective on what works and doesn't . the vet has an important place but they just dont have the time to put into this . i believe the regulation process is when you want to test more and as a dog becomes regulated then you can tapper down the testing just my opinion

as long as you follow simple protocols on dosing , feeding and exercise a pup can lead a normal life with some limitations and you should be able to keep him safe

as far as changing up the protein source some have had to do that to keep there pup motivated to eat but during this regulation process you really want to stay consistent until you can figure out what dose of insulin will be given for the long haul . after that there can be some flexibility and home testing will help with that

your off to a good start

**JoJo's mom** · 10-19-2014, 08:31 AM

Re: Hello, from Chuck and his Mom

Hi and welcome to you and Chuck
I can address some of your issues:

I NEVER shake the bottle of insulin, I just roll it enough times between may hands to mix.
I use the alphatrak and yes I use them with the freestyle lite strips. Just make sure you change the code on the meter to 6 for the FL strips.

I always injuect JoJo in the scruff. I do alternate from side to side.
I am not sure about the human meters but I know on the alphatrak you can shut off the beep. Others that use the human meters will know about them.
also you might want to considerer the Novolin-N insulin from Walmart for $25.00.
Since Chuck is a big boy and you will be using a lot of insulin. You can discuss that with your Vet.

Sounds like you are on top of things.

Mary

**amydunn19** · 10-19-2014, 08:44 AM

Re: Hello, from Chuck and his Mom

Welcome to you and Chuck! You are headed in the right direction. I had a few thoughts reading your post and I will try to answer your questions.

First, the vet started Chuck very conservatively. A starting dose is 1/5 unit per pound, which would put him at 24 units as a start BUT, there may be a reason. Do you have any blood glucose numbers from his diagnosis or any since? Have they done any curves? I understand caution and we preach caution and patience but I wonder why the dose was started at 15 units. It is good they have moved him up some. Some dogs need less than that starting dose based on weight but that is a big difference.

Waiting to test for regulation is something we commonly hear as vet's advice but honestly, testing needs to be done now more than ever. It will help with the process and keep him safe.

I can't address vetsulin since I have never used it.

The scruff is used for injections but many have found the absorption in that area is not great. I have never injected there because my dog seems to be more painful there. I get better results on the sides.

I do alternate the flavors but I do it a bag at a time and you should test to see if the flavors change those numbers. You might wait until he is settled on a dose to really start switching, though. It is easier to feed the same thing,every day, at the same time in the beginning.

**k9diabetes** · 10-19-2014, 04:26 PM

Re: Hello, from Chuck and his Mom

Welcome to you and Chuck! He IS a big boy!! I can imagine it can be hard to convince a guy that big to do something he doesn't want to do!

But it's great that he has elbow callouses as those are good places to test.

Will answer some of your questions first.

As far as shaking Vetsulin vigorously, that is a new recommendation that came when Vetsulin was reintroduced into the market a year or two ago.

And I think most of us are not really comfortable with doing that because of insulin being considered fragile for such a long time. The recommendation for all other insulins has been NOT to shake it vigorously.

So the answer to your question is... up to you. It is in fact what the manufacturer now recommends, and it is probably related to the reasons why they took it off the market in the U.S. for a couple of years.

Once you're testing at home, you can see if it seems to make a difference in Chuck's numbers and decide that way.

Also re Vetsulin, it's likely to get pretty expensive for a dog Chuck's size. The much less expensive alternative is NPH from Walmart, sold as Relion N for $25 for a bottle that contains 1,000 units of insulin. NPH is a U100 insulin - 100 units per ml - while Vetsulin is a U40 insulin - only 40 units per ml.

Not sure what his blood sugar is currently but there's a good possibility he will need quite a bit more than 19 units per injection.

What was his blood sugar reading at the vet's office?

In terms of varying dog food versions, you may see some differences in how the various foods are digested but probably not much. You probably can get by with that unless Chuck turns out to be very sensitive to small differences in diet and insulin. I'd say keep everything the same for now and see how it goes. If he's not regulating well, you could consider changing it then.

Injecting in the scruff is another one of the Every Dog Is Different things. Some dogs don't get get absorption there and/or develop scar tissue readily, which definitely can cause absorption problems. Other dogs do fine there and/or only are comfortable with it there.

I think this is another thing where you can wait and see how it goes. If Chuck regulates quickly and easily on his current routine, no need to change it. If not, then we can look at what makes sense to change - and it's important to make just one change at a time so you can evaluate it.

Because they all kind of do their own thing, there isn't one "book" that explains your dog's diabetes and tells you what works and what doesn't. The thing to do is to read Chuck's book and work from that.

Natalie

Originally posted by chucksmom View Post

A little about Chuck-
Chuck turned 8 on Nov.15, 2014. Last weigh in at the vets, he weighed 124.

After dx, vet started him on 15 units of Vetsulin 2x a day. Then upped it to 17u 2x a day, and we are now at 19u 2x daily.
Now I have some questions, are you surprised? lol

1. He is on Vetsulin. Vet said gently shake/roll the bottle to mix. I go to the Vetsulin site, and they say to shake it vigorously the first time to mix properly. Then gently shake each time after to make sure it is still mixed. So who do I believe? The vet or the people who make the insulin?

2. I feed Nulo Large Breed turkey and peas, & Merrick Grain Free 96%.
He gets 1 1/3 cup of the dry and 1/2 cup of the wet. I vary the protein of the wet, Pork, Chicken, Tripe ect.
Again, I asked the vet if the varied proteins were OK or should I keep to one flavor. It is the same brand and seems the only thing different is the main protein. The calorie count stays under 400 cal, per 13.2 ounce can, but it does vary. She said sure you can change the flavors.
Is the changing the proteins ok or should I pick one flavor and stay with it?

3. Scruff of the neck injecting? OK or shouldn't be done. That's where the vet told me to inject, so I did for a while, then started reading that may not be the best place to inject. I do change the injection site from side to side.

**chucksmom** · 10-19-2014, 10:03 PM

Re: Hello, from Chuck and his Mom

Hi again, and thanks for the welcome and advice!
From what I'm reading, I should stick to one protein, until he is regulated. I kind of felt that way, but I didn't want him to quit eating again, so I changed it up.
Chuck has never been a very active dog, we have a couple of acres fenced, he will walk around, and maybe chase a squirrel occasionally. He also has hip problems, so that has slowed him down even more.
I did tell my vet that if Chuck had to have a much larger dose of insulin it would have to be the Novolin-N from Walmart. Because at the moment he is going through 3 1/2 to 4 vials of Vetsulin a month. That is putting a strain on our budget, especially since we have two Boxers as well as Chuck. Yeah, I'm a little crazy

I do remember his BG was 589 when he was dx. She kept him for a few hours because of his sodium and potassium levels were off. So he got a dose of insulin and was put on an IV for that time.
He had three more spot tests, no curves. I can't find his records right now, so no numbers to give.
He was also tested for addisons-neg. He did have pancreatitis, this was all at the time of dx of diabetes.
I also know that on Aug.1, 2014, his BG was 136 at fasting. So we did catch the diabetes early.

I did manage to do a full 12 hour curve today..yeah me, lol
here are the numbers for that:
8:00 am fasting: 425
8:30 am fed & 19 units of Vetsulin
10:00 am 454
12:00 pm 365
2:00 pm 440
4:00 pm 393
6:00 pm 398
8:00 pm 376
8:30 pm fed & 19 units of Vetsulin

All these tests were done with the Relion Micro, so they could be as much as 50 points higher than an AlphaTrax.

I think I messed up because after the 12:00 pm test, I gave him a half of a rice cake, I think that caused the rise in the 2:00 test.
I also think the 376 reading at 8:00 pm was due excitement, my daughter and her pup showed up about 10 minutes before that blood test and he always gets excited when she comes over. I'm guessing that would cause the lower reading, when it should be going up 12 hours post injection.
If I am off base on any of my guesses here please set me straight.

So what do you all think of these numbers? I see an insulin increase in his future, so I am thinking the Novolin N is where we are headed. I just opened a vial of Vetsulin Thursday evening, and I have one more, my vet got me an order of three vials for $98, so I got three at one time. I guess when those are gone, I'll be switching.
I hope I'm doing things right, because I feel like we caught this early, maybe my boy can avoid some of the worse side affects of this disease.
again, thanks for reading and advising. I am here to learn.
kim

**Riliey and Mo** · 10-19-2014, 10:16 PM

Re: Hello, from Chuck and his Mom

Hi Chucksmom

this curve is has relatively flat numbers close together

i'd send this report off to the vet .

A one unit increase looks good.
to save some $. I,d suggest switching insulin from vetinsulin to novolin nph. I get mine for $ 25.

more to read for me will post again in a few minutes

mo

**Riliey and Mo** · 10-19-2014, 10:37 PM

Re: Hello, from Chuck and his Mom

Congratulations on doing your first curve

An increase of 1 unit, sticking to this 7 days, then doing another curve is feasable. Also comparing your meter, calibrating, to your vets meter gives your more reliable data.

your vet has been conservative starting on a low dose.

its possible around 23 units is more feasible for your dogs weight

glad you found us

Mo

**chucksmom** · 10-19-2014, 11:47 PM

Re: Hello, from Chuck and his Mom

Thanks Mo! I was pretty impressed with our curve, Chuck and I both calmed down after about check #3, lol
He has a vet appointment tomorrow for a frucosamine (sp) tomorrow. And I will be informing the vet that we will be changing to Novolin, as soon as we finish using the Vetsulin we have now. I will bring the results of my curve so she can look it over, but the Novolin N is a done deal as far as I'm concerned.
I'm pretty sure she will also suggest an increase in insulin. So, I'll wait and see, and then tell her what I"m going to do, lol.
When I first got my Relion Micro, I did order the control solution, and ran the test, it was within the acceptable range. Then I took it with me to the vet and there was a 50 point difference in the readings.
AlphaTrax from vet 319, my Relion Micro 270. So mine read 49 points lower. I didnt add those in to the readings above, I was just concerned with the curve, my readings would be +50, compared to an AlphaTrax, but they showed the rise and falling BG.
I did order an AlphaTrax and it should be in by the end of next week. Once I change the insulin, I'll do another curve. Hopefully with lower numbers

**RockyNFrankie** · 10-20-2014, 10:30 AM

Re: Hello, from Chuck and his Mom

Welcome. I am completely new to this as well and I really don't have much advice I just wanted to reiterate that you should definitely look into the Novolin-N. My Rocky was diagnosed in Sept too. Rocky is 114lbs and we are already up to 29units of Vetsulin 2xdaily. Its making us go broke! I have no experience with Novolin-N, but from what I have learned on here I am planning on switching as soon as things settle down at my house. It seems to work well for most dogs and you get more than 2x as much for less than 1/2 the cost of Vetsulin. Good luck and everyone here is super knowledgable and friendly!

**chucksmom** · 10-21-2014, 10:18 PM

Re: Hello, from Chuck and his Mom

Hello again
Well, Monday morning I woke up to a very large puddle in the middle of the carpet. I automatically suspected Chuck, even though we have two other dogs. It's been years since Chuck has had an accident, but I've heard diabetes makes UTI's common.
Got to the vets for the check and testing. Chuck had lost 2 more pounds since his last weigh in on the 8th of this month. He now weighs 122.
I told her about the accident and she checked for a UTI. Yep, he has one. So she put him on a 14 day run of antibiotics.
She took a spot BG check, it was 443, this was about 45 minutes after his morning food and injection. She also looked at my curve results and said based on her check and my curve we should increase to 20 units,(up 1) 2x a day. She also said there was no point in doing the Fructosamine test while he had an infection. After the course of antibiotics wait 5 days then run the test.
Also, once I've finished with the Vetsulin that I already have, we'll be switching over to Novolin N. She is going to figure the dosage and switch out the syringes, I already have for the ones I'll need for the Novolin.
So it will sort of be like starting all over again, I guess I shouldn't be too impatient, since it seems that 6 months is the average for getting a pup regulated. I just want my boy to feel better, he seems so down, just lays around most of the time, even more than he used too. He never brings me his ball any more to play fetch. I miss that, a lot.

Thanks for letting me share these things and giving me advice. If any of this sounds off or hurtful to my boy, please let me know. I am learning there is not a quick solution to this and it's driving me nuts!

**k9diabetes** · 10-22-2014, 01:37 AM

Re: Hello, from Chuck and his Mom

Sounds like the vet is being very helpful and flexible.

**amydunn19** · 10-22-2014, 03:44 AM

Re: Hello, from Chuck and his Mom

I like your vet - willingness to work with you is very important.

You will get there - very few dogs just regulate very quickly. If they do, there is an element of luck involved.

**momofdecker** · 10-22-2014, 04:14 AM

Re: Hello, from Chuck and his Mom

Sorry to hear that Chuck has a UTI. Good instincts on your part to take him in. It does sound like you have a vet who is pretty on top of things.

Throwing this out there but more of an FYI. Given that Chuck was overweight and that he is lethargic, has your vet ever looked into testing him for hypothyroidism? My guess is that his current UTI is making him not feel well and likely the cause of him not wanting to play. I only mention it because low thyroid levels can also cause dogs to slow down and untreated hypothyroidism can wreak havoc on trying to regulate diabetes in dogs. Blood work of a hypothyroid dog might show low white blood cell count, low red blood cell count (anemic), low platelet count, high cholesterol value (diabetes can also cause high cholesterol). Here is a link to a full range of symptoms hypothyroidism can cause:
http://siriusdog.com/hypothyroid-dog-signs.htm

Has Chuck recovered from the pancreatitis? Did the vet give him any pain meds to help with recovery?

Hope Chuck starts feeling better soon. Kudos to you for jumping in and taking charge of his care!

**Monsters Momma** · 10-22-2014, 04:48 AM

Re: Hello, from Chuck and his Mom

Hi there!! I just wanted to add my belated welcome! Looks like you've really taken charge of Chuck's diagnosis and have become a great advocate for him. 😃

I sincerely do understand the issues with a big dog like Chuck. We had a blockhead lab that was 130 lbs when we got him! When he didn't or did a at to do something, that was it! LOL. I'm sure you'll do great! You have found a great place!!

Mel and Vinny

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