Hello
First, I wanted to thank Natalie for providing such an amazing combination of information and support for owners of diabetic dogs. I have been reading here for quite a while and the information has been invaluable! I wanted to start a thread for Noodle and I'm going to pack it with info. My apologies if you fall asleep before you reach the end.
Noodle was diagnosed about a year ago. He is currently on 30 units of NPH (2x day) and also takes Thyroxine (2x day) for low thyroid. He doesn't suffer from any other known illnesses. We test his BG at home (the lip method) pre-meal, pre-walks or other activity & excitement (because they cause him to drop quite a bit), spot checks when needed, and curves. Our meter has been compared to the vets AlphaTRAK and the lab values and is within 15 points (tends to run lower). We initially had a heck of time regulating him, but things improved rapidly once his dose entered the 20's and the Thyroxine was added. He eats Newman's Own Organics Advanced. He also has a reverse curve, so his lowest numbers are always at meal time.
He's been well regulated for many months with BG numbers generally 90 to the upper 100s, with some short trips to the 200+ range when his meals kick in. Depends on the day, activity level, who knows...phase of the moon?
He was originally a little overweight, but his weight resolved itself with the necessary tighter meal routine and elimination of the types of treats he enjoyed prior to the diabetes. Now it's more of an issue maintaining his weight while trying to balance the amount of food to insulin. So of course I had to go and muck everything up by trying to increase his food slightly, and therefore his insulin as well.
We increased his food from his previous 1 1/2 cups each meal to 1 3/4 cups. This of course caused the anticipated giant leap in numbers, so we increased the insulin by 1 unit each injection. I really thought that was a reasonable amount considering he was already on 30U each injection. Initially his BG readings were good and we thought we were on the right track. But then he started to throw us a strange range of numbers. He would have a day or 2 where even his pre-meal readings were up in the 200 range and his later numbers would jump to the 300 & 400's. But then the next day or so we would be fighting lows much of the day, particularly in the few hours before meals.
He does not show any signs of illness or infection and his activity, playfulness, and appetite have consistently been normal. His water consumption goes up a bit when he is running high for long periods, but nothing extreme. We would have never known his BG was so screwy if it had not been for home testing. He had a few infections back before he was regulated (ear & bladder). From those experiences we know his BG goes up and stays there when he is ill and/or on antibiotics.
I decided to curve him and a typical curve with BG tests every 2 hours wasn't giving us enough information since the swings were so great from one day to the next. With the weird wide ranges we were seeing I was starting to suspect we had overshot the increase and he was repeatedly rebounding. So Noodle and I have been very sleepy the last several days as we test around the clock looking for precipitous drops/increases...and I think we found them. I have since pulled back to his original 30 units per shot while maintaining the increase in food. His highs have dropped but we are still seeing lows too far in advance of his meals. I'm hoping that resolves in the next few days.
Here are his latest curves:
Sat 2/6 (31 units)
6am - 257
8am - 260
10am - 222 (then food & insulin)
12pm - 309
2pm - 275
4pm - 377
5pm - 302 (walk after)
6pm - 276 (unusual for him - usually drops further with activity)
8pm - 154
10pm - 132 (then food & insulin)
12am - 267
2am - 347
Sun 2/7 (31 units)
4am - 392 (husband spot checked him when he was up)
8am - 114 (the big drop made me check him more before his meal)
8:30am - 99
9am - 58 (Yikes! Gave him glucose tab & biscuit)
9:15am - 104
9:30am - 114
10am - 119 (then food & insulin)
12pm - 155
3pm - 138
5pm - 135
7pm - 87 (Too low 3 hours before next meal - glucose tab & biscuit)
10pm - 93 (then food & insulin)
12am - 168
2am - 214
Mon 2/8 (31 units)
6am - 228
8am - 203
10am - 148 (then food & insulin)
12pm - 259
4:30pm - 461! (followed by walk)
5:30pm - 473! (NOT the norm - usually drops quite a bit after walk)
7pm - 344
10pm - 205 (then food & insulin)
12am - 421!
*Decided to drop him back to the original 30 units but maintain the food increase (1 3/4 cups each meal). *
Tues 2/9 (30 units)
4am - 465!
6am - 157 (308 point drop in 2 hours!)
7am - 122
8am - 92
9am - 104
10am - 82 (then food & insulin)
11am - 161
12pm - 243
3pm - 238
6pm - 68 (UGH! Glucose tab & biscuit)
6:30pm - 114
7pm - 120
8pm - 102
9pm - 103
10pm - 72 (Another glucose tab to stop the drop, then food & insulin)
11pm - 127
12am - 239
2am - 236
Today, Wed 2/10 (30 units)
4am - 236
6am - 118
7am - 85 (too low 3 hours before meal - glucose tab & biscuit)
8am - 98
9am - 83 (glucose tab to stop the drop)
10am - 101 (then food & insulin)
12pm - 204
2pm - 241
5pm - 267
So that's where we are so far. Since the drop back to 30 units we have not seen the extreme highs, but we are still fighting the lows and his afternoon numbers today are still higher than his previous norm. Do the extreme variances of highs and lows from one day to the next, and/or the very rapid drops, look like Somogyi rebound...all from a one unit per injection increase?
I'm encouraged that his upper numbers have come down and I'm hoping the lows will come up as the increase leaves his body. In the past he has taken about 3 days to settle into a new dose and this is day 2.
On a side note: I know the amount of testing looks extreme. This is absolutely not the norm, but the lows made me feel like I had to monitor him very closely. He never has symptoms when he runs low, so the only way to catch it is to test. The lip testing doesn't bother Noodle a bit - he can literally sleep through it when he's tired. When he's awake, he comes right over and lays his head in my lap with his nose pointed up. He is the most easy going diabetic dog...we are very fortunate.
Did anyone make it to the end of this post without a break for a nap?
First, I wanted to thank Natalie for providing such an amazing combination of information and support for owners of diabetic dogs. I have been reading here for quite a while and the information has been invaluable! I wanted to start a thread for Noodle and I'm going to pack it with info. My apologies if you fall asleep before you reach the end.
Noodle was diagnosed about a year ago. He is currently on 30 units of NPH (2x day) and also takes Thyroxine (2x day) for low thyroid. He doesn't suffer from any other known illnesses. We test his BG at home (the lip method) pre-meal, pre-walks or other activity & excitement (because they cause him to drop quite a bit), spot checks when needed, and curves. Our meter has been compared to the vets AlphaTRAK and the lab values and is within 15 points (tends to run lower). We initially had a heck of time regulating him, but things improved rapidly once his dose entered the 20's and the Thyroxine was added. He eats Newman's Own Organics Advanced. He also has a reverse curve, so his lowest numbers are always at meal time.
He's been well regulated for many months with BG numbers generally 90 to the upper 100s, with some short trips to the 200+ range when his meals kick in. Depends on the day, activity level, who knows...phase of the moon?
He was originally a little overweight, but his weight resolved itself with the necessary tighter meal routine and elimination of the types of treats he enjoyed prior to the diabetes. Now it's more of an issue maintaining his weight while trying to balance the amount of food to insulin. So of course I had to go and muck everything up by trying to increase his food slightly, and therefore his insulin as well.
We increased his food from his previous 1 1/2 cups each meal to 1 3/4 cups. This of course caused the anticipated giant leap in numbers, so we increased the insulin by 1 unit each injection. I really thought that was a reasonable amount considering he was already on 30U each injection. Initially his BG readings were good and we thought we were on the right track. But then he started to throw us a strange range of numbers. He would have a day or 2 where even his pre-meal readings were up in the 200 range and his later numbers would jump to the 300 & 400's. But then the next day or so we would be fighting lows much of the day, particularly in the few hours before meals.
He does not show any signs of illness or infection and his activity, playfulness, and appetite have consistently been normal. His water consumption goes up a bit when he is running high for long periods, but nothing extreme. We would have never known his BG was so screwy if it had not been for home testing. He had a few infections back before he was regulated (ear & bladder). From those experiences we know his BG goes up and stays there when he is ill and/or on antibiotics.
I decided to curve him and a typical curve with BG tests every 2 hours wasn't giving us enough information since the swings were so great from one day to the next. With the weird wide ranges we were seeing I was starting to suspect we had overshot the increase and he was repeatedly rebounding. So Noodle and I have been very sleepy the last several days as we test around the clock looking for precipitous drops/increases...and I think we found them. I have since pulled back to his original 30 units per shot while maintaining the increase in food. His highs have dropped but we are still seeing lows too far in advance of his meals. I'm hoping that resolves in the next few days.
Here are his latest curves:
Sat 2/6 (31 units)
6am - 257
8am - 260
10am - 222 (then food & insulin)
12pm - 309
2pm - 275
4pm - 377
5pm - 302 (walk after)
6pm - 276 (unusual for him - usually drops further with activity)
8pm - 154
10pm - 132 (then food & insulin)
12am - 267
2am - 347
Sun 2/7 (31 units)
4am - 392 (husband spot checked him when he was up)
8am - 114 (the big drop made me check him more before his meal)
8:30am - 99
9am - 58 (Yikes! Gave him glucose tab & biscuit)
9:15am - 104
9:30am - 114
10am - 119 (then food & insulin)
12pm - 155
3pm - 138
5pm - 135
7pm - 87 (Too low 3 hours before next meal - glucose tab & biscuit)
10pm - 93 (then food & insulin)
12am - 168
2am - 214
Mon 2/8 (31 units)
6am - 228
8am - 203
10am - 148 (then food & insulin)
12pm - 259
4:30pm - 461! (followed by walk)
5:30pm - 473! (NOT the norm - usually drops quite a bit after walk)
7pm - 344
10pm - 205 (then food & insulin)
12am - 421!
*Decided to drop him back to the original 30 units but maintain the food increase (1 3/4 cups each meal). *
Tues 2/9 (30 units)
4am - 465!
6am - 157 (308 point drop in 2 hours!)
7am - 122
8am - 92
9am - 104
10am - 82 (then food & insulin)
11am - 161
12pm - 243
3pm - 238
6pm - 68 (UGH! Glucose tab & biscuit)
6:30pm - 114
7pm - 120
8pm - 102
9pm - 103
10pm - 72 (Another glucose tab to stop the drop, then food & insulin)
11pm - 127
12am - 239
2am - 236
Today, Wed 2/10 (30 units)
4am - 236
6am - 118
7am - 85 (too low 3 hours before meal - glucose tab & biscuit)
8am - 98
9am - 83 (glucose tab to stop the drop)
10am - 101 (then food & insulin)
12pm - 204
2pm - 241
5pm - 267
So that's where we are so far. Since the drop back to 30 units we have not seen the extreme highs, but we are still fighting the lows and his afternoon numbers today are still higher than his previous norm. Do the extreme variances of highs and lows from one day to the next, and/or the very rapid drops, look like Somogyi rebound...all from a one unit per injection increase?
I'm encouraged that his upper numbers have come down and I'm hoping the lows will come up as the increase leaves his body. In the past he has taken about 3 days to settle into a new dose and this is day 2.
On a side note: I know the amount of testing looks extreme. This is absolutely not the norm, but the lows made me feel like I had to monitor him very closely. He never has symptoms when he runs low, so the only way to catch it is to test. The lip testing doesn't bother Noodle a bit - he can literally sleep through it when he's tired. When he's awake, he comes right over and lays his head in my lap with his nose pointed up. He is the most easy going diabetic dog...we are very fortunate.
Did anyone make it to the end of this post without a break for a nap?
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