Taylor - Road to Regulation

[Taylor]

Taylor, 10 yr old, male, neutered, yellow lab, adopted at age 4, mellow disposition. Diagnosed 11/12/09. Was 100 lbs, now down to 80 or less? 1 1/2 cans W/D and 1/2 cup science diet lite dry at 6am and 5pm (he starts fussing at 4 and I can only hold him off till 5). Vetsulin 27u am and 23u pm. Green beans, broccoli and cauliflower for treats. Was still doing stairs at diagnosis but quickly went downhill to the point where he could not stand up on his own and had ear and eye infections. At this point he is able to stand up and walk for short distances. I am using a Bayer Contour Meter as of 12/11/09, and thanks to this forum the shots and testing are easy. Also have the urine strips. I wish I had started on nph but the theory now is to get him stable and healthier on the vetsulin before making the switch. The vet is not in favor of the switch at all. I am increasing dose without consulting vet and a little faster than I would like because I have some time off over the holidays and can closely monitor him. Meter has not been compared to lab values, and I am assuming it reads low, but here are yesterday's readings:

6am 190 - food and (26u for past three days)
9am 387
11am 398
1pm 364
3pm 293
5pm 280 - food and (23u for past six days)
8pm 352

Today: 6am 201 - food and (increase to 27u)
9am 390

I had lower numbers on 3 cans per day of W/D alone, but was also getting very high after meal spikes, and did not think this was enough calories to gain back any weight. Adding the science diet light seems to have flattened the curve but raised the need for insulin. One question I have is why the morning fasting reading is lower than the evening fasting reading, while the evening dose is less than the morning dose? I am assuming he is getting a late peak of insulin activity, so that the morning dose is still working at the time I give the evening dose, holding down the numbers somewhat and allowing the morning reading to be lower. But I still don't have a handle on this curve interpretation stuff. Without the existance of this forum, which gave me the confidence to take a more hands on approach, I don't think we would have made it this far. Any input and advice is welcome. Pat

[CarolW]

Re: Taylor - Road to Regulation

Pat - welcome to you and Taylor; I'm glad you joined us.

I have a few thoughts; none to be LEANED on - just to think about.

First, I personally want a vet who will be my TEAMMATE! - who also has at least considerable knowledge and experience with canine diabetes. Maybe a look at Dr. Nancy Kay's work would assist you; her book _Speaking for Spot_ is worth reading.

(I have links to her sites on the Coherent Dog links page; see my signature.)

Will your vet discuss things with you? Give you reasons? Does he (she?) have a reason not to change Taylor over to NPH insulin?

My gut feeling about this is, if Taylor were my dog, I wouldn't ATTEMPT to regulate him on Vetsulin any longer, but go ahead and make the change to the NPH insulin. It could take months to achieve something like regulation, especially if one vial of Vetsulin is differing from another.

So many dogs do so well on NPH insuiln that if it were me, I would change now.

HOWEVER! You do need to be able to monitor closely for several weeks while changing.

My vet refuses to change a dose without a full curve. Looks as though you are also doing full curves before changing a dose.

I believe I read somewhere that the Bayer Contour isn't all that accurate. You don't NEED great accuracy, either, as long as you can see trends, from one curve to another.

I believe, though, you could get a free (Lifescan) OneTouch Ultra2 meter - there are rebates that permit this, I think - you could inquire with your pharmacist. Where I am, in Canada, to get the rebate for a free meter, all we have to do is buy 100 test strips at once. I have an Ultra2, but can always use another, and so, the other day, I made the big financial stretch to buy 100 test strips at once - but they were out of stock on the meters! haha! (I'll pick one up next week.)

I like the OneTouch BECAUSE it seems to be highly rated for consistency. This abstract might interest you:

http://k9diabetes.com/forum/showpost...7&postcount=18

Whatever you decide to do, I'm sure you'll find lots of support and assistance here. I'll be watching, and wishing you and Taylor well.

Sat, 2 Jan 2010 09:50:41 (PST)

[Soaphie & Sydney's Mom]

Re: Taylor - Road to Regulation

Welcome! You have come to the right place - lots and lots of knowledge and experiences here - everyone willing to share!

Best,

Tami & Soaphie

[Margaret Boyle]

Re: Taylor - Road to Regulation

Taylor, 10 yr old, male, neutered, yellow lab, adopted at age 4, mellow disposition. Diagnosed 11/12/09. Was 100 lbs, now down to 80 or less? 1 1/2 cans W/D and 1/2 cup science diet lite dry at 6am and 5pm (he starts fussing at 4 and I can only hold him off till 5). Vetsulin 27u am and 23u pm. Green beans, broccoli and cauliflower for treats. Was still doing stairs at diagnosis but quickly went downhill to the point where he could not stand up on his own and had ear and eye infections. At this point he is able to stand up and walk for short distances. I am using a Bayer Contour Meter as of 12/11/09, and thanks to this forum the shots and testing are easy. Also have the urine strips. I wish I had started on nph but the theory now is to get him stable and healthier on the vetsulin before making the switch. The vet is not in favor of the switch at all. I am increasing dose without consulting vet and a little faster than I would like because I have some time off over the holidays and can closely monitor him. Meter has not been compared to lab values, and I am assuming it reads low, but here are yesterday's readings:

6am 190 - food and (26u for past three days)
9am 387
11am 398
1pm 364
3pm 293
5pm 280 - food and (23u for past six days)
8pm 352

Today: 6am 201 - food and (increase to 27u)
9am 390

I had lower numbers on 3 cans per day of W/D alone, but was also getting very high after meal spikes, and did not think this was enough calories to gain back any weight. Adding the science diet light seems to have flattened the curve but raised the need for insulin. One question I have is why the morning fasting reading is lower than the evening fasting reading, while the evening dose is less than the morning dose? I am assuming he is getting a late peak of insulin activity, so that the morning dose is still working at the time I give the evening dose, holding down the numbers somewhat and allowing the morning reading to be lower. But I still don't have a handle on this curve interpretation stuff. Without the existance of this forum, which gave me the confidence to take a more hands on approach, I don't think we would have made it this far. Any input and advice is welcome. Pat

Hi Pat,

Just to say welcome to you and Taylor, I will follow your thread you will get plenty of support.

Hugs

[Taylor]

Re: Taylor - Road to Regulation

Carol, Thanks for all your advice and the link to your website. Will spend lots of time there. I just read one of the chapter's in Dr Kay's book and found it helpful. I live in a remote area with limited vet choices. A specialist or emergency vet clinic would be hundreds of miles away. I have not given up on convincing my vet to change to nph. She is young and new to the area and willing to work with me. To her credit, she is the one who convinced me we could get the diabetes under control. I also consulted a friend who is a large animal vet and lives a couple of hours away. She consulted with the small animal vets in her practice and also advised me to stick with the vetsulin at this point. I actually bought the nph and syringes at Wal-mart and have it ready for when I feel confidant enough to make the change. I am living and breathing diabetes at this point and probably obsessed with testing, so I would like to wait until I have educated myself more thoroughly and calmed down. I am on the lookout for a deal on the one touch meter, but so far haven't found one. Thanks for your help and support. Pat

[Soaphie & Sydney's Mom]

Re: Taylor - Road to Regulation

Hi Pat & Taylor!

If you think you might stick with Vetsulin....I would start hoarding it .

Right now we have 14 bottles in our fridge - that will last about 35 weeks - I will be getting 5 more so it will last a year (of course, watching expiration dates). Soaphie doesn't do well on NPH. Hopefully Intervet will get their act together and fix the issue before the supply runs out...

Good luck to you!

Tami & Soaphie

[CarolW]

Re: Taylor - Road to Regulation

Hi Pat -and Taylor!

I like how you're going about this.

Carol, Thanks for all your advice and the link to your website. Will spend lots of time there. I just read one of the chapter's in Dr Kay's book and found it helpful. I live in a remote area with limited vet choices. A specialist or emergency vet clinic would be hundreds of miles away. I have not given up on convincing my vet to change to nph. She is young and new to the area and willing to work with me. To her credit, she is the one who convinced me we could get the diabetes under control. I also consulted a friend who is a large animal vet and lives a couple of hours away. She consulted with the small animal vets in her practice and also advised me to stick with the vetsulin at this point. I actually bought the nph and syringes at Wal-mart and have it ready for when I feel confidant enough to make the change. I am living and breathing diabetes at this point and probably obsessed with testing, so I would like to wait until I have educated myself more thoroughly and calmed down. I am on the lookout for a deal on the one touch meter, but so far haven't found one. Thanks for your help and support. Pat

If that's what your vets advise - sticking with Vetsulin for the moment - then I'd do that. Thought maybe this is a good opportunity to make the switch! But I would follow my vet's advice - even a fairly new, young one - BECAUSE she is consulting with others - and will work as your teammate.

I'm REALLY glad you're learning to test blood samples, because that is such a great safeguard, and provides you with very much-needed information. The Bayer Contour will do for the moment!

Lifescan, makers of One-Touch, might well see to it you get a rebate on the Ultra2, if you phone them. I think they have a toll-free number - possibly on their web site.

I like their Ultra2 meter. the Mini, I don't like, because although it's nice and small and handy to carry around, its date-and-time display kind of disappears under the edges of the casing - and - it doesn't have all the fabulous prompting for adjusting date-and-time, and other stuff, that otherwise, I have to consult the manual to remember how to do it! But with the Ultra2, it practically tells me how to do it, right on the display.

There's this about the Ultra2 - it sits so nicely in the palm of your hand, and so EASILY slides OUT of it, too! (|haha). (I don't think I did drop mine, though - but I did drop my earlier Ultra model - however, it was fine, even after dropping!)

And I'm SO GLAD she convinced you you can bring the diabetes under control, because I VERY firmly believe THAT! Often enough, too, the new younger vets are up on the new stuff, when sometimes the older ones can't keep up with all the new research, so I think you have double-good-stuff in your favor.

And, Pat, I really like how you're approaching this. Taking your time to study, and to calm down. Very good idea! Since you're out in the boonies, it's nice that you have the NPH and syringes on hand, in case you come to making a change later.

I also did a lot of testing at first, once I learned to. Now I find Kumbi is so stable, I don't have to test much.

But we changed his dose a couple of weeks ago, and I plan another curve in a couple of weeks.

We'll be here cheering you on!

Sat, 2 Jan 2010 15:00:24 (PST)

[k9diabetes]

Re: Taylor - Road to Regulation

Hi Pat,

Welcome to you and Taylor, who is a beautiful dog! Love the pictures in your photo album!

Some dogs do need a different dose at night and in the daytime - in part perhaps because of the different activity levels.

I would go with the increase you made in the daytime level but leave the evening injection at 23 units for now. As you bring down the daytime numbers with more insulin, the nighttime numbers also can drop... you have dropped the starting point so there is less blood sugar for the evening injection to work with.

So try 27 units a.m. and 23 units p.m. for a few days and see how it goes. After 5-7 days, see whether another increase is needed. And I like the diet he's on right now.

Most likely the Bayer meeter is reading somewhat lower than the actual blood sugar so you definitely have some leeway even with the 190.

There are very few dogs who can't use NPH but there are a few... so my preference is to try to change to NPH sooner rather than later, while you can still get hold of Vetsulin if the NPH doesn't work.

Like I said, it's rare. But if you wait to change until Vetsulin is all gone and then you find out NPH doesn't work, you're really up a creek.

Intervet itself is pretty strongly recommending changing over and it's not like you have a regulated dog and would have to sacrifice his regulation to change. So now seems like a good time to me.

Check and make sure the vet has read the November 30th update by Intervet as it pretty strongly suggests dogs need to be changed over.

http://www.vetsulin.com/vet/Vet_ProductAlert.aspx

Be sure she reads the bottom part.

Natalie

[eyelostit]

Re: Taylor - Road to Regulation

Hi and welcome Pat and Taylor

I'd try what Natalie suggested and see how that goes.

You mentioned you got better readings with just using the cans of WD, the WD is thick but does have water content meaning less food.

At a later date you could try this modifying with what you are already feeding

1 can of WD and 1 Cup of Science diet
or 1 Cup of Science Diet and 1/2 C of canned WD

If you decide to try this, do it on a weekend when you will be home to monitor the bg.

Taylor will gain weight once his food and insulin are matched, its hard to understand at first, it doesn't matter how much food or even the kind of food at the beginning of diabetes if there is not enough insulin to cover the food given the nourishment will not get into the cells to gain weight it sort of just stays in the blood which causes high blood glucose and in turn the pet wil leak urine or drink alot of water or pant heavy to rid the body of excess glucose or Taylor may just not feel well and will limit activity.

Think of it this way,
Ex:the horses are at the gate (food), the insulin opens the door (to cells) so if there isn't enough of insulin to get the food into the cells the pet will not gain weight.
There is also a book "Dogs, Diets and Diseases" which helped me alot when Niki was first diagnosed,.

You doing fine, we'll figure this out, its usually a bit of an insulin tweak or a food tweak that makes the difference, all dogs handle things differently.

Hang in there & Take Care
Dolly and Niki

[Taylor]

Re: Taylor - Road to Regulation

Thanks everyone! New plan- get one touch meter and strips, talk to vet one more time and get Taylor weighed, then try switch to nph before vetsulin supplies are gone. Did 27u/23u yesterday and got readings: 201,390,417,276, and 180 before 5pm feeding. Then this morning surprise 415
retook minutes later 351, gave 27u and retook hour after eating 488. Here are the possibilities as I see them. It got way below zero last night and house popped, causing Taylor stress? Or the morning dose was still working along with the evening dose which caused it to go too low and rebound? Wish I would have taken some evening readings. I'm wondering if I should lower the evening dose or stay the same and test during the night? Any thoughts? Also is the nph likely to be faster acting than the vetsulin?
Pat

[Taylor]

Re: Taylor - Road to Regulation

Dolly, I like your suggestion of one can W/D and one cup science diet lite 2xday. It probably makes sense to wait until he is better regulated to try it. I am really amazed at how even the slightest change in diet affects blood sugar. Luckily Taylor thinks vegetables are great treats. Pat

[Taylor]

Re: Taylor - Road to Regulation

I am getting good readings today, 380 at 11am and 282 at 1pm so I think that initial 415 this morning was due to the extreme cold temperatures and Taylor's now skinny body. My husband said he took Taylor outside just before I did the reading. Guess I'll have to find him a dog coat. I think I will be safe in giving him 23u at 5pm and maybe doing a couple spot checks during the night. Then doing tomorrow morning's reading before he goes outside. I used to be one of those people who had to have two cups of coffee before anyone even spoke to me. Now I have to jump out of bed ready for action!
Pat

[CraigM]

Re: Taylor - Road to Regulation

Pat,
Just a couple of observations of our Annie:

Her BG always rises, I think usually more than 100 points, after a meal/injection. She takes about 3 - 4 hours to come down to the pre-meal reading. It takes awhile for the Vetsulin to kick-in.

If I give identical amounts of Vetsulin after both meals, the morning BG reading is usually higher than before the evening meal. I frequently try to counter this by giving .25iu more with the after dinner injection. Her "normal" injection is 7.25iu in the morning, and either 7.25 or 7.5 after dinner. I don't know, but suspect, her neopolydex eye drops that we administer before bed might be affecting the overnite BG.

Craig & Annie

[k9diabetes]

Re: Taylor - Road to Regulation

If the two readings were taken very close together, one of them could have been an off reading. Hard to say which one.

But if two readings are taken within a couple of minutes and the dog hasn't been given a ton of pure glucose in those couple of minutes, the readings should be more similar than what you got.

Off readings happen sometimes - maybe the strip doesn't fill completely or overfills or isn't in the meter quite right.

Natalie

[Taylor]

Re: Taylor - Road to Regulation

Update on Taylor diagnosed 11/12/09. Taylor weighed 83 lbs on the 5th of January, down from 88 lbs on Dec 8th. I decided to add a cooked egg to his 1 and 1/2 cans W/D and 1/2 cup dry science diet lite 2 X per day at 6am and 5pm and upped his units to 28 am and 24 pm. The vet will work with me on the change from vetsulin to nph and suggested I could start at 20 units am and pm. I would like to make the change on the 16th or the 23rd. I now have a one touch ultra mini meter and 60 test strips. On two tests it read 50 points higher than the Bayer contour meter. The following readings were taken with the contour so they are probably 80 points low?

1/6 5:30am-287, 1:20pm-294, 4:30pm-131, 10pm-214
1/7 6am-171, 9:30am-253, 12:30pm-204, 3:30pm-139, 5pm-119, 10pm-200
1/8 6am-385, 12:30pm-282, 3pm-268, 5pm-268
1/9 6am-202, 9am-310, 5pm-123
1/10 6am-111, 8am-323, 11am-233, 1pm-184, 3pm-193, 5pm-209, 10pm-332
1/11 6am-135, 1pm-230,4:30pm-116
1/12 6am-250, 5pm-202
1/13 6am-262, 8am-437, 10am-429, 12noon-410, 2pm-279, 4pm-179

Taylor has severe neuropathy in his hind legs when his levels go high and his right lower eyelid droops away from the eye and turns very red. We treated it for infection but it didn't seem to help. The vet said his actual eye looks okay. I need to start him on the highest safe dose and move up as quickly as possible since he is a large dog and it becomes very difficult to take care of business when he can't walk. Would starting at 22 units be irresponsible? I can monitor him and he is always willing to eat!
Pat