Winston - Odd numbers; need advice

[MikeMurphy]

Re: Winston's Thread

Concerning the low T4 at 0.7... it looks like your vet is very good. Phenobarbital can indeed throw the T4 out of wack.

With that said, and the T4 test alone not being completely sufficient, it still wouldn't be a bad idea to have a full thyroid profile done. Then you would know for sure. The last time I looked, Hemopet charges a little over $100. They're the best.

Does Winston experience any of the classic symptoms of hypothyroidism, such as thinning hair, darkening of skin on the belly or cold intolerance?

[Aggie]

Re: Winston's Thread

Mike: Winston has always had a very thin coat. Like, for the whole time we've had him (8 years). You can see his skin through it. It's very fine and very silky, and I've never seen anything like it.

Is it thinner lately? Maybe??? Not sure. Maybe on the topline???

As he has aged, his skin has picked up a bunch of age spots and freckles. His belly is more or less pink. He may have a little overall darkening kind of in the armpit and side flank areas.

He is not cold intolerant, which has always surprised me because he has so little fur. We put a coat on him below 40 degrees even though I'm not sure that is needed. I have never seen him shiver from cold, for example.

He's not particularly lethargic, although he does sleep a lot during the day like most dogs, he is pretty zippy in the morning and evening.

I don't know. Our vet is good and was not concerned. I was told the test would be $190 through the vet when I asked. He'd probably also need a triglyceride/cholesterol test to go along with it.

Raysaint, good to know about the Omega 3. I take krill oil myself. One problem with Winston is he won't eat a big pill like that, and if you break open the pill and put the oil on his food, he refuses to eat. If you have a solution (like, a really small pill) I'd be open to it.

[Raysaint]

Re: Winston's Thread

Here is a link to Nordic. There is a liquid you could drop on his food. I ordered the Softgels, but not sure how big they are. I'll let you know once I receive them.
Nordic is a top brand.

https://www.nordicnaturals.com/en/Ge...ogs_&_Cats/469

[Aggie]

Re: Winston's Thread

I wonder if the liquid smells at all fishy...'cause if it does, Winston will not eat it.

[Raysaint]

Re: Winston's Thread

This is from their site. Hopefully a few drops wouldn't be noticeable to him, mixed in his food.

Unsurpassed freshness equals great-tasting fish oil
The key objections to taking fish oils are taste and aftertaste. Nordic Naturals utilizes proprietary enzymatic and oxygen-free processing technologies to ensure no fishy smell, taste, or aftertaste.

[Aggie]

Odd numbers; need advice

Hi, I haven't been here for a while but I have a confusing situation. Winston was pretty well regulated in the summer, with most numbers in the 200s and 100s, rarely 300, and so I stopped doing curves after August because I thought I had found the right level. Kind of regretting that now. He had a fructosamine test last week which came in high. So I did a curve because I couldn't believe it was high. His weight is stable, his food is the same, his insulin (vetsulin) amount is the same.

The curve looked like this: 6AM 234, 8AM 175, 10AM 304, 12 noon 394, 2PM 409, 4PM 362, 5:30PM 388.

Well, that was overall too high and it almost looked like rebound. So for his night dose I decreased by 0.2 units (yeah, tiny decrease but I am afraid to tweak it much at one time) and this morning his fasting was 442. Which is awful because his fasting is normally in the 200s somewhere.

So after that reading, this morning I went back to the usual dose but tried a new bottle of insulin (but it has the same expiration as the old bottle so maybe same batch). This evening fasting is 433. Still not good.

Really I don't know what to do. Does his curve look like rebound or not? Should I raise insulin or lower it? I am trying to order (yet another) new bottle, hopefully a different batch, on the long shot that the whole batch is bad?

He has no real symptoms. Appetite great, not drinking excessive water, happy and playful. Winston has early cataracts 10 months since diagnosis and saw an eye doctor recently. He got the fructosamine test because he might need a dental. He is about 11 years old and a 23.5 pound poodle mix.

[k9diabetes]

Re: Winston - Odd numbers; need advice

Good detective work to try a new bottle of insulin. That's always a good start.

I wouldn't consider this a rebound.

Many things can change their need for insulin - even just the season with colder temperatures and potentially less activity. Age, other conditions such as allergies and inflammation, and no reason known.

Any changes in diet, supplements, etc.?

I would guess that 0.2 units wasn't enough of a change to make a difference - that reading in the morning wasn't much different from other readings.

Is the shape of the curve pretty typical of curves done in the past?

Your curve suggests that more insulin is needed in the morning but not at night. And you will have to be careful with a dose increase because of that low of 175.

I would try a small increase in the dose - half a unit maybe - with breakfast on a day when you can test and see how low that takes his blood sugar.

The low number is the one that determines how much insulin you can give, not the high. You don't want that 175 to drop 100 points.

So I would try that and see what you get with multiple readings - see how much half a unit affects all of his readings.

If that doesn't produce a better curve, you might need to consider a change in the composition of the food to better match the insulin. But try the dose change first.

[Raysaint]

Re: Winston - Odd numbers; need advice

If a dose increase doesn't give you the numbers and curve you want, you may have to consider changing to NPH. I think many have done that.

[Aggie]

Re: Winston - Odd numbers; need advice

His fasting this morning was 347. I am trying an increase of 0.4 units. I am home today and can keep an eye on him. Since he is starting out so high, though, I am skeptical that would drop him too low. But we will see.

When he got regulated in the summer, the shape of his curve switched from a bowl with a low around 1 PM, to a mountain with lows at fastings. Before a few days ago, I have not seen something like that quick early dip followed by a sharp rise before.

He is not on new supplements or food.

[Aggie]

Re: Winston - Odd numbers; need advice

So just tested 2 hours after an INCREASE of 0.4 units and got a reading of 496. How can that possibly be? Argh.

[Aggie]

Re: Winston - Odd numbers; need advice

Does anyone think a UTI is a possibility here?

[Raysaint]

Re: Winston - Odd numbers; need advice

2 hours after eating many dogs can be higher because the food is raising blood sugar before the insulin starts to pick up steam. That's typical of a bowl curve, and maybe your dog is going back to a bowl curve. If he had it before, it's possible.
And remember his body needs to adjust to a new dose, don't expect a correction right away.
I look back at my numbers and see identical morning fastings on some different days, same dose each day, but different nadirs. Some nadirs lower than fasting, some higher. Go figure.

[Suzanne123]

Re: Winston - Odd numbers; need advice

I sure hope you can get Winston regulated soon. He is adorable. What food is he on?

[Aggie]

Re: Winston - Odd numbers; need advice

Per meal, he gets 50 grams Wellness Core reduced fat kibble, 22 grams boiled chicken, and 3/4 a tub of Natural Balance Duck and Chicken.

He also gets chicken jerky for a reward for his shots.

[amydunn19]

Re: Winston - Odd numbers; need advice

I am wondering if your dog food company could have changed heir formula. I know this happens. I have a pet supply store and companies do their new launches of food in usually March and July to coincide with two very large trade shows. That is usually when they make changes. I don’t know but it might be worth looking into.

A UTI is always a possibility or perhaps a dental infection. If you can get his teeth cleaned, it might be a great idea.

If all things check out, you might want to roll with the increase and see if it helps.