Re: My Pug Scoop-diabetes and Cushing's
I wholeheartedly agree with Natalie in her concern about your vet's approach. I see many areas where I disagree with your doctors approach. Most troubling is the halving and the doubling back on the dose based on one high spot check.
If there was a delay to seeing an internal med specialist I would want to find another vet that has more experience with diabetes to run a proper curve.
Questions in your posts:
Yes, the first test needs to be before the dog eats or has insulin. That test is called the "fasting". That and the nadir (when insulin is the strongest so bgs are the lowest) are the two most important numbers in a curve. Insulin doses should be based on true curves, not spot checks. They should also be based on the low number not the highs.
In response to the small amount of keytones being present I would get Ketodiastix and keep an eye on those at home daily. It can become a very serious situation quickly. You can increase his drinking by adding juice from tuna soaked in water to his drinking water.
Yes, when I say "the numbers" i am refering to the BG (blood glucose) numbers. In hindsight I realize you have been dealing with a lot of numbers.
Infections can raise the bg numbers and that is the first thing my doctor does when I take Ruby in with unexplained high numbers is they look in her mouth.
The other red flag I see is a doctor who wants to change the dog's diet without having a plan as to how to monitor the affect on the numbers. BGs can change drastically with a change in diet. I would be inclined not to make the change until a curve was run.
I am concerned that with the specialist recommending that the insulin dose be halved and then it being jumped back up on one high spot check that you dog could be rebounding repeatedly. High bgs can also be a result of the body overcompensating for a too high insulin dose by the liver releasing stored glucose. It is a body saving mechanism and is why a full curve needs to be done.
Here is a link that explains it:
http://diabetesindogs.wikia.com/wiki/Somogyi_rebound
I do feel for you. You are scared and have not been given good guidance by your vet. Your case by no means sounds easy, but it may not be as bad as it sounds either. Keep your chin up.
Please let us know how you make out.
Tara
I wholeheartedly agree with Natalie in her concern about your vet's approach. I see many areas where I disagree with your doctors approach. Most troubling is the halving and the doubling back on the dose based on one high spot check.
If there was a delay to seeing an internal med specialist I would want to find another vet that has more experience with diabetes to run a proper curve.
Questions in your posts:
Yes, the first test needs to be before the dog eats or has insulin. That test is called the "fasting". That and the nadir (when insulin is the strongest so bgs are the lowest) are the two most important numbers in a curve. Insulin doses should be based on true curves, not spot checks. They should also be based on the low number not the highs.
In response to the small amount of keytones being present I would get Ketodiastix and keep an eye on those at home daily. It can become a very serious situation quickly. You can increase his drinking by adding juice from tuna soaked in water to his drinking water.
Yes, when I say "the numbers" i am refering to the BG (blood glucose) numbers. In hindsight I realize you have been dealing with a lot of numbers.
Infections can raise the bg numbers and that is the first thing my doctor does when I take Ruby in with unexplained high numbers is they look in her mouth.
The other red flag I see is a doctor who wants to change the dog's diet without having a plan as to how to monitor the affect on the numbers. BGs can change drastically with a change in diet. I would be inclined not to make the change until a curve was run.
I am concerned that with the specialist recommending that the insulin dose be halved and then it being jumped back up on one high spot check that you dog could be rebounding repeatedly. High bgs can also be a result of the body overcompensating for a too high insulin dose by the liver releasing stored glucose. It is a body saving mechanism and is why a full curve needs to be done.
Here is a link that explains it:
http://diabetesindogs.wikia.com/wiki/Somogyi_rebound
I do feel for you. You are scared and have not been given good guidance by your vet. Your case by no means sounds easy, but it may not be as bad as it sounds either. Keep your chin up.
Please let us know how you make out.
Tara
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