Sidney has passed December 21, 2014

[Fishslayer]

Re: Newly Diagnosed, still not Controlled

When I originally brought him to the vet in January because he was eating everything in sight & stealing food off the counter & digging through the garbage.

My Avatar is a picture of Lucy on her first day with us. That bag of beans was ON TOP of a rack that was ON TOP of a counter!

She was very food motivated. I used that to our advantage.

[amydunn19]

Re: Newly Diagnosed, still not Controlled

Maggie's wounds always heal very fast but her hair takes forever to grow back. It may have more to do with allergies than diabetes - not sure which one.

[Shellie]

Re: Newly Diagnosed, still not Controlled

Hi to you and Sidney! It sounds like your new numbers are actually really good! 300's may not seem like great numbers but in dogs...they aren't that bad! My own buddy, Hank, runs between 150 and 350 on a regular basis due to his utter inability to be regulated (he's a terrier and stubborn! lol) but seriously, I would stay right where you are for a week then re-evaluate at that time. With the 300's, you are going to see more mobility and more of the 'real' pup you love back. Glucose in the urine isn't odd at those levels... I think most of us don't even really look at that as a measure of where they are since they can get concentrated abnormally. Ketones and blood glucose are where it's at. And it sounds like you are heading in the right direction! SO glad you found the forum...it is really the BEST place to be to get help with your pup! Crossing fingers things stay on the up! Hugs!

[NuZooRevu]

Re: Newly Diagnosed, still not Controlled

Hi Brooke,
Wow, your journey is very similar to my journey with Cooper.

I took Cooper in to see the vet because he was lethargic, thirsty and had started stealing food. He was first diagnosed with Cushings last September; we did the weekly tests and the ultrasound too, trying to find the right dose. But with every increase, Cooper would get better for a few days, then get worse. He started going blind in December, but the vet said it was just cataracts.

We went on vacation in March, and drove from WA to CA; the close quarters in the car was probably the reason I noticed a funny acetone smell on his breath. He also became very confused, incontinent, and almost comatose at times. He absolutely could NOT get enough to eat or drink, and drained the water dish at least 5 times a day. When we got home a week later, I took him to the vet and insisted on a glucose test (he initially refused, saying he already ruled out diabetes) Well, Cooper's glucose was thru the roof; so high, that the meter's readout read "HIGH", and didn't even give us a number. He was started on insulin on a Thursday....

Cooper was diagnosed April 3rd and started insulin April 4th. He had absolutely NO change until Monday April 6th...and my impatience nearly cost Cooper his life:

Starting on that Thursday, I was very consistent with Cooper's dose and food, but he continued to decline. He was essentially comatose; lifting him up was like lifting a corpse. My husband and I did not want Cooper to suffer, and he clearly was suffering. He would lay on the floor and wet himself if we did not carry him outside regularly. He was so thirsty, but couldn't get enough to drink; in the middle of the night on Saturday, we found him laying in a puddle of urine, and had actually started drinking it! He was confused and his breathing was so labored; he barely stirred when we cleaned him up. He was literally delirious, like a feverish child. On Sunday, we spent the day saying our good-byes, knowing we were going to put him down on Monday morning. He would still stir when offered food or water, so we gave him his favorite treats and lots of love that day. Instead of laying in his favorite spot by the fire, he would only lay on the cold tile floor by the water dish. His only movement was his struggle to breathe.

Well, Cooper woke up on Monday morning and immediately jumped on the bed and demanded that we wake up too because it was time to... cuddle..!?! WHAAA..??? It was like Christmas! He was weak, but lucid and actually focused on things beyond air and water.

Like you and Sidney, it was rough, and I wanted results NOW. I started increasing his insulin and cutting out carbs, trying to control his blood sugars...but his body's response was to freak out and start breaking down muscles for food, in order fight the drastic change in his sugar levels. That's why we have to go so slow when trying to lower their levels--add a couple units, then monitor for a week or so...and repeat if needed. The vet can get away with it by using IV fluids, monitoring electrolytes and waiting out the auto-response mechanisms.

For now, we have stopped all Cooper's Cushings meds and are focusing on the Diabetes. He's a little underweight at 25lbs (he should be about 26); he's getting 14U twice a day. His blood sugar still spikes after 6 hours on the Humulin N, so I'm debating on creating a sliding scale for Humulin R, which is a fast-acting insulin with a short half-life. It may help prevent the mid-day sugar spikes.

I did his curve today, and here are his numbers:
5:30am 332 (breakfast + 14U)
7:30am 332
9:30am 275** Lowest, 6hrs after dose
1130am 316*** Sugar starts to spike
1:30pm 368 30min walk
3:30pm 398
5:30pm 403


It's a work in progress, but we're getting there...these message boards have a lot of information, and have helped me far more than my vet has...but he's not as personally invested as we are--Cooper is our child, and he deserves the very best!

Good luck to you and Sydney...and hang in there. You're not alone in your journey, and I look forward to hearing your experiences.

[SidneyDog]

Re: Newly Diagnosed, still not Controlled

Thank you for all of the responses. I am still very devastated that he is still in the hi 600's and the 500's, we increased him to 16 units of novolin twice a day.
Even 4-6 hours after insulin he is still very high.

I feel like taking him into the hospital monday morning and just letting them give him the fast acting insulin to get him back down to 150 like when they hospitalized him.

I dont know if this insulin is just not working, but i'd think he'd be much lower by now.
Last week his numbers looked like they were getting better and then one morning he was at 662. I thought maybe I gave him insulin wrong, but I dont really think I did. But maybe... But since then we've increased him from 15 to 16 and he's still so high.

I do feel like I'm in a race against time because we are approaching 20 days using insulin and he is still so high. I suspect he was probably sick since January or February. I'm afraid he's going to go blind or damage his heart or worse.

I spent most of Friday night crying in my bed with him because I feel so bad that I cant help him.

Is the novolin not working? Does he need a fast acting insulin? Should I try to get Vetsulin? Ugh... I dont know what to do at this point. I wish we were in the 200's by now.

Feeling really depressed about the whole thing.

[Riliey and Mo]

Re: Newly Diagnosed, still not Controlled

Hey Brook

Yes get your vet involved, they can bring his bg down, do a curve, c whats going on with him to take the worry off you.

Take care, he, ll be okay

[amydunn19]

Re: Newly Diagnosed, still not Controlled

Do you have any curves that you have done? You have been increasing and now the numbers seem to be going higher and I am wondering if maybe he is overdosed. It is a possibility at this point. His numbers were much better at a lower dosage. This process requires a patient hand and rushing up the dose is not helping you get there. I would just like to see a full 12 hour curve if you have one.

It is important to stay calm and not panic - it sounds like you are quite anxious and for good reason but this is a process that takes time and you are going to have a nervous breakdown. Sydney needs you so slow down, take a breath and let's figure this out.

Just for clarification :What exactly are you feeding and how much? What schedule are you giving insulin and food?

[jesse girl]

Re: Newly Diagnosed, still not Controlled

remember you need to focus on curves . that gives us the direction to go in .this helps us not to pass the dose that is needed which i believe is the largest problem to regulation that we have control of .

now the dose your are giving is not at a high dose for your pups weight .

with a dog of your size and if seeing numbers in the 400s and higher in a curve and fairly flat with no big swings in blood sugar gives the opportunity to raise the dose up to 2 units every 5 days after a curve .

we have no crystal ball of how much insulin is needed with an individual dog and with that being known that can change like my jesse which constantly fluctuates and i have to alter her dose up or down .

i think you can go as high as 25 units with little worries about that dose being to much as long as you follow those simple protocols . curves , flat elevated blood sugar, no adverse reactions to the dose adjustment upward physically .

as far as changing things up , its just a guess and a roll of the dice you may get lucky it does happen . one insulin can do better than another for an individual dog . sometimes a change in the diet can be helpful .

hypothetically if you raised the dose 2 units every 5 days that would get you to that 25 units in a month where you can reevaluate if you want to change things up . this maybe a bit fast for some but if you follow the plan and testing regularly it is doable

once you see a change in the numbers lower its time to slow things down and give a bit more time to settle with smaller dose adjustments . usually in the 300s is a time to slow it down but it does depend on the situation and the immediate health of a pup .

if you see things abruptly go into the 200s you might want to back off the dose a bit and see if you can hold those 200s at a lower dose. if not you know you are going in the wright direction and very slowly raise that dose and giving more time to settle

it kind of like braking a car into a traffic stop as you get closer you put more pressure on the brakes to stop .

[amydunn19]

Re: Newly Diagnosed, still not Controlled

Jesse Girl makes a good point and it is a strong possibility that the dose may not be high enough yet but all the possibilities are just guesses until you do a curve.

[SidneyDog]

Re: Newly Diagnosed, still not Controlled

Hello,

I have been keeping a spreadsheet on his blood sugars, when I gave him the injection, how much, etc. When I first got my monitor I tested him every hour since I was off work for Good Friday, Saturday and Sunday. I've been testing him at the 4-6 hour intervals and sometimes in between just because I'm paranoid and want to know. My vet said the 4-6 hour readings are key for her so she can see how effective the insulin is for him. She did also explain that too much insulin would give big swings, like really low and then shoot up to really high.
He is pretty steadily high. I'm going to try to insert the data from his spreadsheet to see if you guys have any advice.
I also want to add he is in the Hill's prescription W/D dry mixed with wet food. He is getting a little more than a cup of the dry and about 1/3 the can twice per day. It says it is made for glucose management.

[SidneyDog]

Re: Newly Diagnosed, still not Controlled

https://www.dropbox.com/s/2eg769j740...on%201%29.xlsx

https://www.dropbox.com/s/2eg769j740...on%201%29.xlsx

Here's a link to his excel spreadsheet, I uploaded it to dropbox.
So you can see all these awful numbers.

[SidneyDog]

Re: Newly Diagnosed, still not Controlled

I also found this link from last March, talking about using Vetsulin vs NPH.
http://endocrinevet.blogspot.com/201...etic-cats.html

I wonder if this would make more sense than to keep pursing Novolin with him.

[Monsters Momma]

Re: Newly Diagnosed, still not Controlled

I also found this link from last March, talking about using Vetsulin vs NPH.
http://endocrinevet.blogspot.com/201...etic-cats.html

I wonder if this would make more sense than to keep pursing Novolin with him.

The only comment I have is that I want to know where he gets Vetsulin that cheep!? I have no idea if it's better than NPH, but I haven't seen it for $24 a vial since we've been buying it!

[SidneyDog]

Re: Newly Diagnosed, still not Controlled

How much is the Vetsulin?

[jesse girl]

Re: Newly Diagnosed, still not Controlled

many dogs dont need that short acting component that is described with vetsulin. nph does have some peaky action with many dogs . so that comparison does not hold up that well .

duration does not seem to be much different for most .

cost is more for vetsulin if using wal mart to purchase insulin and syringes for nph. availability of vetsulin can be a factor as nph is more available to purchase

more variety of syringes you can use .

cost for most is not a factor if you can get better regulation we would find a way to pay for it which is the single most reason to change .

i think levemir is more appropriate to try with your pup just because you dont want any peaky action because your pup seems to be sensitive to drops and a flat profile looks more appropriate with the curve you posted . thats just my opinion.

its a decision for the individual and you have to be comfortable with what you decide to continue or make a change

if you do change i might start at a much lower dose to give a reset to make sure you just didnt pass the dose that was needed for nph . vetsulin seems to match up as the same units of insulin compared to nph with the different syringes used . volume of liquid is different but unit measurement is usually the same for most .

using physical symptoms and home testing and correlate the 2 to determine if the reduction was to much

if you use levemir that is 4 times more potent so you would use allot less insulin than what you used on nph . this insulin is the most expensive but lasts for many a long time. it is a clear insulin. i have not used but have used a fast acting insulin which is also clear and have used them for 6 months and longer without any decline in potency . for me if it stay clear its still good . if it gets murky its time to change

i did uses a fast acting insulin like r every six hours for jesse at one time just to beat down those higher numbers . i am not sure if it slowed down the process of regulation or muddled the waters . its what we did at that time and i would have done it full time if needed but she settled down so we use it once in a while

there is not one person in this world that can tell you for sure what direction to go . it is a guess but you would like that to be as educated as possible . you have to decide how long your willing to stick with the plan and whats you goals and when to move on to something else

jesses routine does not resemble much of the normal 12 /12 routine thats just where we ended up

i have seen dogs on the forum that were just a few doses from regulation where they weren't in a good place a couple weeks before and some continued for a long time with no change.

i think it comes down to how you feel. i usually go to a quite place and turn off the noise and come up with a plan .