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Old 03-29-2010, 05:43 PM
frijole frijole is offline
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Default Jessie, Min schnauzer just dx-ed

Hi all! I am a mod over on the cushings forum but my mom and stepdad's little girl Jessie was just dxed with diabetes today. Here is what I know for now:

All blood panel normal except for glucose - 450

Her symptoms were ravenous appetite for a while now and just recently excessive thirst and urination in house.

The vet gave them Vetsulin (which even I know is off the market) and told him to give 2 shots a day (6 units) and come back in a week to have the levels checked? Does this sound normal? I was expecting them to keep her and monitor more closely but this is new to me.

The vet did mention that they'd have to change to perhaps human insulin. My quesion - why not start there? Should I be concerned? I think he has a week's supply. Again, not sure.

I asked what he was told to do in emergency and he said give some karo syrup.

My stepdad doesn't ask alot of questions and tends to be very trusting in docs so if there is anything missing - let me know so I can let him know!!

Thanks guys!!! Kim
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Old 03-29-2010, 07:02 PM
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Default Re: Jessie, Min schnauzer just dx-ed

Hi Kim,
I'm sorry about the diagnosis but glad you stopped over here.

I do have some questions...
How much does Jessie weigh?

What is she currently eating?

I'm not a fan of vets starting out on Vetsulin when they aren't going to be able to continue using it. I'd rather see Jessie started on NPH. You might ask or have him ask about Humulin or Novolin N. Walmart sells Novolin N under their contracted brand Relion in the $20 range. This is a U100 insulin (Vetsulin is U40) so the syringes will be different. We can recommend syringes if they do switch.

I am glad the vet recommended 2 shots a day. Some are still starting at 1 shot. Did the vet also tell your stepdad to give them with food 12 hours apart?

Would your mom and stepdad be up for hometesting with a glucometer? Here are some videos Natalie has on different places that can be tested: http://www.k9diabetes.com/bgtestvideos.html The OneTouch Ultra meter is a very good one. The Freestyle meters also work well for smaller dogs.

Some vets do keep newly diagnosed dogs for observation but the majority are sent home with insulin and told to come back in a week for testing. I will tell you that some vets prefer to do fructosamine tests versus a blood glucose curve. The fructosamine is more or less an average of your dog's blood sugar over a 2 week time frame and doesn't provide information on how high or low the blood sugar has gone. So I would opt not to have this test run. A curve provides more information. Blood is drawn every 2 hours starting at premeal/insulin over the next 12 hours to determine how well the food/insulin are working together.

I would recommend picking up some KetoDiastix to test Jessie's urine to get a general idea where her blood sugar is. (Some pharmacies only have Ketostix in stock so I'd call around). If she is running higher, they will want to monitor for ketones. Anything more than trace is considered an emergency and should be addressed immediately by a vet.

I hope that helps get them started. Let us know about the weight and food.

Again welcome Kim
Patty
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Old 03-29-2010, 07:11 PM
frijole frijole is offline
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Default Re: Jessie, Min schnauzer just dx-ed

She weighs 23 lbs. She is short and very stocky. I have suspected diabetes or thyroidism for years.

Yes, he did tell them to feed 12 hrs apart and same with shots.

Food - I don't know the brand but it is kibble. He told the vet and said the vet said that it was fine. It is my understanding that it should be relatively low fat yet high protein - is this right?

Re checking the levels...uhm... maybe in the future. He was quite proud of having given the shot. It took alot out of him. My mom says she won't do it but she is playing hard ball and will come around... so up the road I'll bring that one up.

I like the idea of the urine strips. Thanks.

I am sure he will go with the Walmart brand. You said the syringes are different? What is the easiest one to use with the Walmart Novolin NPH? Thanks so much!

Kim
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Old 03-29-2010, 07:49 PM
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Default Re: Jessie, Min schnauzer just dx-ed

Kim,

If Jessie is 23 pounds, that's 10.4 kg.

"The starting dose of insulin is 0.25-0.50 units per kilogram, twice daily-rounded down to the nearest whole unit." http://k9diabetes.com/forum/showthread.php?t=980

That would be a range of 2-5 units, so a 6 unit starting dose is just above the recommendation. I think the urine strips would be a very good idea to see how Jessie's doing with this.

A consistent schedule will be very important with it comes to regulation. And they should know exercise has the potential to significantly drop blood sugar.

We have dogs that are on a wide range of foods here. Typically you're looking for low fat, higher fiber. You'll know more about how the food is working with the insulin after having a curve done.

As far as the syringes, if they switch to NPH I'd ask for a prescription for:
U100 sryinges 3/10cc, 5/16" length, 31 gauge with 1/2 unit markings. The 1/2 unit markings make it easier to fine tune the dose.

NPH is a more concentrated insulin than Vetsulin which is the reason for the difference in syringes.

Take care,
Patty
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Old 03-29-2010, 08:25 PM
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ozzi ozzi is offline
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Default Re: Jessie, Min schnauzer just dx-ed

Hi Kim!

I agree with you completely...why start Jessie on an insulin that is in short supply?? It seems that it would be a great idea to start her on NPH now rather than have to readjust her later, since she's just starting out! WalMart and Sam's Club sell Relion Novolin-N which is manufactured exclusively for them and it is about half the cost of the NPH's at retail pharmacies. I use Humulin-N simply because Ozzi peaked too early on Relion Novolin-N, but for most dogs, it is interchangeable. Regarding syringes, Relion also makes U-100 syringes which are also half the cost of the retail pharmacy. I still use those and having used both, they are the same from what I can tell (except for the cost!) They make different sizes. I use the 29 gauge 1/2" length because Ozzi is a big boy with lots of fur and found the shorter needles too difficult for him. In Jessie's case, she is smaller, so you might do very well with the shorter needles. Also, the shorter needles are 31 gauge (which has a smaller lumen), so that is desirable as well!

There are lots of dogs here on lots of diets. Personally, I am trying to manage Ozzi as humans manage diabetes, and I am using a low-carbohydrate, high-protein, grain-free product, Blue Buffalo Wilderness. I am very happy with that, but there are many here who use every other kind of diet successfully, from raw diets to every commercial dog food out there. If you can control her glucose with her current food, you probably don't even need to change, unless you want to. Others here will probably have more helpful suggestions for you.

It's super important to give the insulin and feedings twelve hours apart. Consistency is critical. I learned that the hard way! Ozzi used to free feed, and my vet told me to continue that, but it was impossible for me to get him regulated that way. Having changed to two feedings a day has changed his sugars in a positive way. Others feed 3 or 4 times/day. Alot depends on what you are doing now, and how Jessie's glucose curve goes. Is she having one soon? That will really be telling regarding how her body metabolizes insulin and how quickly it does or doesn't react with food.

Two important things regarding injections. The insulin can be painful. Ozzi yelped in the beginning. Then I learned about drawing it up in the syringe and warming it under my arm. That helps IMMENSELY to take the sting out! Also, the bevel (the opening on the tip of the needle, which "shines" in the light) should be UP when injecting. Those two things will make it easier for Jessie and less painful.

Congrats to your Dad for giving the shot...I remember how nervous I was the first time, and was sure I had screwed it up!! As soon as he's comfortable with that, ask him how he feels about learning to test her blood glucose!! There are lots of videos and resources here to learn, and I personally cannot imagine managing Ozzi's glucose without home testing. It's just like giving the injection...scary at first, then it becomes old hat....I promise!!!!

I test Ozzi's urine for ketones when he has high sugars. I haven't had a hypoglycemic event, but my understanding is that you want to rub a teaspoon of Karo syrup on the dog's gums (if unconscious) or give it to them orally if conscious, and then feed them.

Best of luck,
Kevin
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Last edited by ozzi; 03-29-2010 at 08:42 PM.
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Old 03-30-2010, 04:23 AM
frijole frijole is offline
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Default Re: Jessie, Min schnauzer just dx-ed

Thanks everyone! We have lots to learn. I don't know what I don't know yet so will ask along the way. You have been very helpful. Thanks so much. Kim
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Old 04-02-2010, 07:30 PM
frijole frijole is offline
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Default Re: Jessie, Min schnauzer just dx-ed

Hi all. Jessie seems to be adjusting to the insulin. I saw her get her first shot last night and she was fine.

I have been reading other newbie's posts to see what I can pick up and pass along to my mom and stepdad. Something caught my eye. I just read a post from Natalie saying it was important that the dog eat a full meal before the injection.

My stepdad gave her a treat, then a shot and then the meal. I am wondering if he was told wrong, not told or what... can someone explain this to me so I can pass along? Thanks!! Kim
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Old 04-02-2010, 07:50 PM
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Patty Patty is offline
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Default Re: Jessie, Min schnauzer just dx-ed

Hi Kim,
It's wise to give the meal before the injection. If for some reason, the dog refuses to eat or only eats part of a meal and the full dose of insulin has already been given, hypoglycemia can result. Too much insulin for not enough food.

Some people have dogs that are prone to vomiting after eating. They may wait 30 minutes to be sure the dog keeps the food down. But if that's not an issue, usually insulin is given right after the meal.

Hope that helps
Patty
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Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~
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Old 04-02-2010, 08:04 PM
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Default Re: Jessie, Min schnauzer just dx-ed

Kim,
If you have the time, Linda and Ladybug's thread is a good one to go back through http://k9diabetes.com/forum/showthread.php?t=1614 As she was learning there were a lot of tips and tricks that seemed to come out in her thread.

Take care,
Patty
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Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~
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Old 04-02-2010, 08:08 PM
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Default Re: Jessie, Min schnauzer just dx-ed

Kim,
The important thing is that Jessie eats when she gets insulin so that the insulin can work together with the glucose. Theoretically, it doesn't matter if you feed just before insulin or just after, as long as the dog eats! However, it is safer to feed first and give the insulin after because if the dog doesn't eat, or vomits the food for some reason, the insulin is already given, and you can't take it back. I think many people here either give insulin right after eating or wait 20-30 minutes after feeding. Maybe your step-dad could change the order, and give Jessie the meal, then the injection, and then the treat.
Kevin
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