Bailey got his wings... June 26, 2014

[Rubytuesday]

Re: Geoff: A question about meter problem

I am assuming this a different trend then he was showing before, but then he had crazy different curves at the vet. Do you have enough of your home testing to compare to to see that there is definitely a change in trend.
What I see now with the limited numbers is a need for more insulin, but I am not familiar with how he usually runs.
Can you tell us when he ate in relation to those numbers. Not all dog's get a food rise, but my Ruby can go up as much as 300 points.

[Geoff]

Re: Geoff: A question about meter problem

He is never normally that high. His diet is the same across all curves. He at 1/2 cup dried dog food 1/4 tin wet food. Same morning and night

[Geoff]

Re: Geoff: A question about meter problem

OK, I did give him a slither of pasta tonight, 2 inches long at best, uncooked. Surely not? I did not give him some the other day when he was high so no. Very weird though

[Geoff]

Re: Geoff: A question about meter problem

OK, all curves:

mm/ol mg/l
10-Jun-12 8:29am 23.1 Fasting 415.8
10-Jun-12 9:41am 27.4 493.2
10-Jun-12 12:06pm 22.8 410.4
10-Jun-12 2:09pm 16.3 293.4
10-Jun-12 4:00pm 13.7 246.6
10-Jun-12 6:05pm 18.4 331.2

17-Jun-12 8:30am 16.6 Fasting 298.8
17-Jun-12 10:48am 22.4 403.2
17-Jun-12 1:00pm 24.8 446.4
17-Jun-12 4:18pm 19.3 347.4
17-Jun-12 5:26pm 20.3 365.4

24-Jun 8:35am 13 Fasting 234
24-Jun 11:29am 20.5 369
24-Jun 1:43pm 18.8 338.4
24-Jun 3:23pm 16.2 291.6
24-Jun 4:56pm 19.8 356.4
24-Jun 7.52pm 13.6 244.8
24-Jun 9:40pm 22.5 405

Done at Vets
27-Jun 8:29am 27.6 496.8
27-Jun 10:39am 6.4 115.2
27-Jun 12:46pm 5.3 95.4
27-Jun 2:41pm 3.5 63
27-Jun 3:55pm 5.3 95.4
27-Jun 5:42pm 6 108

1-Jul 8:37am 20.3 365.4
1-Jul 1:04pm 19 342
1-Jul 2:47pm 12.9 232.2
1-Jul 4:13pm 11.1 199.8
1-Jul 7:04pm 19.4 349.2

8-Jul 9:11am 17.4 313.2
8-Jul 12:17pm 16.8 302.4
8-Jul 2:25pm 9.9 178.2
8-Jul 4:32pm 16 288
8-Jul 7:37pm 20.8 374.4

13-Jul 7:49pm Over 33.3 Over 599
13-Jul 11:01pm 31.2 561.6

14-Jul 8:25am 14.9 268.2
14-Jul 1:04pm 21.4 385.2
14-Jul 5:25pm 19.1 343.8

15-Jul 9:19am Over 33.3 Over 599
15-Jul 12:31pm 24.4 439.2
15-Jul 2:31pm 15 270
15-Jul 4:37pm 18.4 331.2
15-Jul 9:56pm 28 504

17-Jul 7:20pm 15.2 273.6
17-Jul 10:08pm 23.3 419.4

18-Jul 8:13am 17.5 315
18-Jul 8:17pm Over 33.3 Over 599
18-Jul 10:30pm 30 540

[jgr789]

Re: Geoff: A question about meter problem

Boy maybe it's something in the air! Sadie's numbers have gone from being relatively stable between 150 and 250 to high 300's the past few days!

I'll be watching your thread with interest to see if anyone has any ideas about why and what to do about it.

[Geoff]

Re: Geoff: A question about meter problem

Cheers! Yeah weird stuff. I might test him now (results below) No reason for it, he doesn't snack on dodgy food or treats, he is pretty regimented.

[Geoff]

Re: Geoff: A question about meter problem

So, 33.3 ish last night, then at 10:30pm it was 30 and this morning 14.8 or so. Really weird. Not sure where to go from here, do I wait a few days or take him to the vet or???!

[Rubytuesday]

Re: Geoff: A question about meter problem

Well, I think wether or not to go to the vet depends on your comfort level.
I have been in a similar situation and took Ruby to the vet's had them do a urinalysis that came up clear. What they ended up talking to me about was wether or not she had become resistant to the type of insulin she was on. I think sometimes it is even hard for the docs to know. I took matters into my own hands and have worked with dosing changes, different insulins, different time frames, you name it!

So what you can look at is how he is acting, voiding and deficating. If all of those seem normal I would try an increase. This is based on a few things:
* My dog will often throw a higher fasting. It may not be as high as what you are seeing now, but you still have wiggle room on the lowest number (other then the low reading from the vets). So in theory if you drop the nadir then the highs will come down too and then it wouldn't look all that different then when Ruby throws a high fasting.
* As you haven't settled on a dose yet, I would say that even before the 500s that there was room for improvement.
* If this is all the numbers that you have so far I wouldn't be surprised if this is going to be his trend, similar to Ruby's when on the NPH. It may have just taken this long to present itself.
* Are you sure he isn't picking up crumbs from the kids. That could explain it.
* It is possible that this is what you are seeing:

http://diabetesindogs.wikia.com/wiki/Glycogenolysis

Good job hanging in there with the testing. I know it was hard for you in the beginning.

[Geoff]

Re: Geoff: A question about meter problem

Hello, well I did speak to the vet about resistance, and he said given he goes so low at the vets that that doesn't look like resistance as its doing its job. Not sure really. At the vets he is active, at home, less active (he digs allllll day at the vets in his cage ha-ha)

But when at home yes, his curves need improving. It WAS going ok for a week or so until it bounced up to 33.3+. His urine sample was clean from infection so that leaves what?? Either

a) an infection elsewhere (but he appears fine to me and my wife)
b) not enough dosage but he has never gone that high (for ages since he was first diagnosed.
c) not sure !!

[jim maceri]

Re: Geoff: A question about meter problem

So, 33.3 ish last night, then at 10:30pm it was 30 and this morning 14.8 or so. Really weird. Not sure where to go from here, do I wait a few days or take him to the vet or???!

Geoff, For what it's worth....Spirit about every 3 weeks starts throwing me some really strange numbers. New lows and new highs. He goes from a bowl curve to a hill curve and back again over maybe 2 or three days....I just "hold on" and keep the routine the same and every time he comes back into what I consider his "normal" range.

Why does this happen? Don't know and I've racked my brain to figure out what might be different. Yesterday was a good example of a day where everything was the same including the time and distance of his walks and after the first walk I got a reading of 59 (food and karo introduced here)......today, again same, same and the reading after the walk was 99. This happens on the opposite end too. Fasting numbers are usually between 220-240....then the bugger throws me a few days of 300+

How long has it been for you that the numbers seem higher? These cycles for us can last 2-3 days.

[Geoff]

Re: Geoff: A question about meter problem

Hello Jim, last Friday it all went weird. He did a poo in the lounge-room and I tested his blood on Fri night and it was high. Since then, like you, same food same routine but high spikes. V Weird. His eye is sore tonight too, cataracts, nasty. The whole thing is very stressful for me

[momofdecker]

Re: Geoff: A question about meter problem

Geoff -
From looking at the curve numbers I would say it looks like the insulin is working - just not lowering to where you may feel more comfortable. Not sure why the numbers may be so much lower at the vets other than a big variance between their meter and yours. Sounds like you've compared them though and that not much difference was noted. One question on the comparison - was it done as you normally would test - with a lancet? There is a difference between capillary blood vs. venous blood. Not sure how much that may impact meter readings.

My other thought - I experienced a lot of variation with Decker. He would lower for a day or two then shoot right back up. Went on for eight months. Vet honestly felt it was a matter of him simply needing more insulin and that the day or two he lowered the dose had settled to the point where he needed more.

He was lethargic and had on/off leg weakness. Both could be explained by his extended elevated bg. Other than that and the fluctuating bg he did not display a lot of symptoms that would lead one to believe something else may be going on. Finally pushed to have him tested for other concurrent diseases. Turned out he had pancreatitis, high triglycerides and hypothyroidism. All three can cause insulin resistance. And knowing that helps me better understand why we would see such fluctuations in his bg. A good day here and there but it never held steady. Not that we ever want our babies to have additional illnesses but after four weeks on his thyroid meds his spunk has started to return. He will be retested in about four weeks to make sure his levels are good and to make sure his pancreatitis has cleared and triglycerides have hopefully returned to normal levels.

May be worth a discussion with your vet to see if additional testing is something to consider. It was a bit costly - around $500.00 when all was said and done. That does not include the thyroid meds or the upcoming follow up costs.

May want to talk to the vet about the cataracts too - if there is some pain associated with them the pain could be driving his bg up. Wishing you the best in figuring this mystery out.

Holli

[CraigM]

Re: Geoff: A question about meter problem

May want to talk to the vet about the cataracts too - if there is some pain associated with them the pain could be driving his bg up. Wishing you the best in figuring this mystery out.

Holli

This is what I was wondering about. Started any new eye drops, or other meds this past week?

[Geoff]

Re: Geoff: A question about meter problem

Hello, he has been on prednef forte for 3-4 months or so now so nothing new there. Twice a day. His blood was 20 last night at bed time, a great improvement over 33.3.

[CraigM]

Re: Geoff: A question about meter problem

Good morning!
Have you done a full curve recently, or just spot checks? Would be interesting to see how low he goes during a 12 hour period?