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  #1  
Old 11-27-2012, 04:51 PM
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Wilbur Wilbur is offline
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Default How do you manage blood sugar when not home?

Hi everyone, I consider myself lucky to have found this site. Our boy Willie was diagnosed almost 3 weeks ago and I am nervous for him. We adopted him from a family that could no longer keep him. He came with a laundry list of problems according to his previous mom. They had him on Prednisone for allergies and Prozac for anxiety both of which he no longer uses at our home. We got him in early Sept and his blood work was done last March which showed him at a normal glucose level so my vet thought that he had a predisposition to the diabetes and that the steroid perpetuated the problem. We caught it early as I noticed excessive drinking and peeing. His first blood work showed a level of 380 and the vet put him on insulin 4 units twice a day. We had him tested again last Friday at 2pm and his blood glucose was 540. He is now taking 7 units twice a day. She (vet) hasn't recommended us testing him at home but even at 7 units he is still drinking quite a bit a water.
While we are still working at regulating him my question is how do I go about testing him at work when we work all day? I'm not sure the testing at the vets every two weeks is really going to work. I know he spikes during the day and the poor thing drinks all of his water and is holding his urine until we get home. He has had a few accidents. I feel so badly for him and think about him all day long when I am at work. Any advice for working parents would be greatly appreciated.

Willie (6 yrs old), 7 units twice a day, 32 lbs, Cockapoo, eats twice a day.
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  #2  
Old 11-27-2012, 06:13 PM
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jesse girl jesse girl is offline
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Default Re: How do you manage blood sugar when not home?

hi and welcome to both of you i felt the same way when i found this site it was like coming out of the darkness and ito the light with this disease

yes you do want to home test catching it early may still have the possibility of your pup still producing insulin

the process the medical community is flawed to some extent with the disease testing evry couple weeks or longer and actually deter from home testing to me very unproductive they have moved forward but still i believe behind individual owners who do want to improve there pups lives with this disease

here on the site you will find some of those amazing care takers

for me red flags do go up when numbers seem to rise when the dose is adjusted upward which is one clue to possible overdose of insulin starting at a number in the 300s without insulin and then 500s with

so you would like to start testing just to be sure you are not going in the wrong direction and its very easy to do many of us have been down that road of coarse it is possible he may need more insulin but you do want to be sure


lots of info on testing on the site and you can also find videos on youtube just ask if you have any questions on testing or anything else
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  #3  
Old 11-27-2012, 07:06 PM
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Rubytuesday Rubytuesday is offline
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Default Re: How do you manage blood sugar when not home?

EGADS, just lost a long post.....
Anyhow, welcome!
So it sounds as though some of these increases have been based on spot checks? Has a full curve ever been done by the vet? The best approach in my opinion, is to start a dog on a conservative starting dose, run a full curve (testing right before food, then every 2 hrs. until the second feeding) 3-5 days later, and use the whole curve to evaluate for an increase and to ensure that the dog isn't at some point dropping too low.

Here is a good link that explains why it is not good to base increases on spot readings:

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

I do all of our testing at home. These are the 3 meters I would recommend:

* Alphatrack- best, animal validated, strips are costly. I have one and use it to run comparisons with my other meters or if I see a low that I need to confirm.
* One touch ultra 2- human meter so will read a bit lower then the AT above. Very consistent, reliable and easy to use. Can purchase on ebay for $20 for the meter, strips about $25 for 50, just be sure to check the expiration dates.
*Walmart Prime- initially was frustrated with this meter as I would get a lot of errors or would get a lower reading when it didn't draw up enough blood. I persisted though as I know others on here who are able to work with it and the cost can't be beat. $20 for the meter and $10 for 50 strips, all at the local walmart instead of having to order. I have found the trick to this meter is getting a nice fat drop of blood and just touching the top of the drop with the strip. I am also very familiar with Ruby's trends so I know if I get a funny reading to recheck, but haven't had any problems for a while now.

You could run a curve this weekend and get a lot of answers from it. Other then that you could do an overnight curve , I know I have done my share. Once you have a curve that will give you the lowest point of the day and a lot of piece of mind. A lot of folks that work from home try to leave a bit of a cushion at the low point so there is room for day to day fluctuations. Beyond the occasional curve most most feel best checking fastings ( right before food) so they can detect any changes and adjust accordingly.

Tara
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She was a courageous Boston Terrier who marched right on through diabetes, megaesophagus, and EPI until 14.
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Old 11-27-2012, 08:01 PM
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Wilbur Wilbur is offline
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Default Re: How do you manage blood sugar when not home?

Thanks for the info. I am actually gone from home about 9 hrs a day so while I could spot check him on the weekend I wouldn't be able to do it during the week. Do you think the weekend curve would be enough to go by? I am going to speak with my vet as I do not want to give him too much insulin without knowing for sure. Further, even with being on the 7 units twice a day now he still is drinking loads of water.
Has anyone tried Restadvantage (Resveratrol) for dogs? It is touted to help with blood sugar control in both animals and humans.
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  #5  
Old 11-27-2012, 08:20 PM
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Rubytuesday Rubytuesday is offline
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Default Re: How do you manage blood sugar when not home?

A weekend curve done at home, testing right before food and every two hrs. after, until the evening meal, done with a good meter would be best. Then the dog is in their own surroundings so stress shouldn't upset the readings. Leading up to the curve you want things to stay the same. If you were concerned about him dropping too low during the day you could do a spot check over night at the 6-8 hr mark. That is when a lot of dogs hit the low point. Not guaranteed, but will give you an idea. Other then that you could board him during the day and have the vet do the curve, I would just be sure that they are able to test him before he eats and hopefully that would not hold up his meal time due to them not being open when his usual meal time is. Then you could bring his food with you to the vet.

It is a tricky spot. I understand your concern that he may go too low during the day, but if the high isn't in response to a symogi rebound then I would also hate to reduce his dose with those high readings.

When you are seeing high numbers you want to test for ketones. You can get Diastix at most pharmacies and they will let you know if he is spilling ketones. Some dogs produce ketones quicker then others, but it can become dangerous quickly.

Hang in there.

Tara
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Tara in honor of Ruby.
She was a courageous Boston Terrier who marched right on through diabetes, megaesophagus, and EPI until 14.
Lucky for both of us we found each other. I'd do it all again girly.
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Old 11-27-2012, 08:33 PM
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Default Re: How do you manage blood sugar when not home?

your curves on the weekend will give you the information when your pup is at his lowest (nadir) and multiple curves will confirm that and establish a pattern

its important keeping everything consistent especially during this process of regulation

testing during the week would be at fasting (wright before food and insulin ) nice to know where blood sugar is before a full dose of insulin is given and some additional spot checks while your at home

now doing your curves you just see elevated numbers in conjunction with spot checks seeing no big swings in blood sugar from high to low but just elevated numbers then a dose adjustment higher maybe appropriate if you do see big swings in blood sugar then that maybe problematic and you may hold off raising the dose until you figure what is going on

physical symptoms are important also if lethargic and just seems out of it can point to to much insulin or not enough it can be challenging to figure but overtime you start figuring out your pups book as he wrights the story for you and things will improve and before you know it this will be the new reality and becomes part of life and things just role forward with your lives they can live very happy lives with this disease and for most people they would never know your pup was diabetic

the advantage of being a dog we do have allot of control over there daily routine and able to keep consistent
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  #7  
Old 11-28-2012, 10:59 PM
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Default Re: How do you manage blood sugar when not home?

Hi and welcome to you and Willie - who looks adorable!

At 32 pounds, 7 units is just under 1/4 unit per pound. It's a pretty quick advance in the insulin and I would be uncomfortable with the increase from 4 units to 7 if it was done without a full blood glucose curve.

Dogs are notorious for ignoring what "the book" says and doing their own thing. So although highest blood sugar at meal times and lowest blood sugar about 6 hours in between is typical, it's definitely not what all dogs do. Some put the insulin to work quick and the food slow and wind up with a sharp drop in blood sugar right after eating. Some put the insulin to work very slowly and wind up with a "mountain" curve instead of a "valley" curve - their blood sugar is lowest at meal time.

So you need a curve to see what the blood sugar is doing in response to the insulin injection throughout the day before deciding more insulin is needed.

It's very important to adjust insulin not on the highest blood sugar of the day but on the lowest. So you need to know what that is.

Curves on weekends are fine. You can actually bury yourself in random data by testing every day, especially at first. Waiting until the weekend gives his body time to adapt and adjust to having insulin again and to develop a long-term response.

With a quick catch of his diabetes, honeymooning is a distinct possibility so it will be especially important to move slowly and conservatively with his insulin dose and give him lots of time to show you what the long term response is.

http://www.k9diabetes.com/dogdiabeteshoneymoon.html

It's hard with random high readings - could be he had some remaining insulin producing capability and now doesn't. could be he has started honeymooning and/or breaking through some insulin resistance and he's actually on too much insulin and is rebounding.

http://www.caninediabetes.org/pdorg/somogyi.htm

Again, this is where a curve is handy.

Natalie
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  #8  
Old 11-29-2012, 06:57 AM
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farrwf farrwf is offline
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Default Re: How do you manage blood sugar when not home?

Quote:
Originally Posted by Wilbur View Post
Has anyone tried Restadvantage (Resveratrol) for dogs? It is touted to help with blood sugar control in both animals and humans.
Hello and welcome to you & Willie.

Resveratrol: Don't Buy the Hype
Stephen Barrett, M.D.
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  #9  
Old 11-29-2012, 02:15 PM
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Default Re: How do you manage blood sugar when not home?

Hi
and welcome. I work outside the home 8-9 hours and Ed has been fine for the last 2 yrs. I check fasting 5;45am and then 2 hrs later before I am leaving for work.
Maybe twice in the past yr have opted to go in late as he wasn't coming up as I woudl have liked. His nadir is around 2:30pm
After his 2nd eye surgery I started having a pet sitter come in at noon and give him a treat and potty/play break.
But I will run home on occasion and check him if I think something is up.
I am still pondering a survey on folks who work outside the home, work at home etc..
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Old 12-05-2012, 02:38 PM
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Default Re: How do you manage blood sugar when not home?

Hi! A belated welcome to you and your Willie! What a cutie he looks like! You've gotten some great advice so won't just go over the same old all over again! I'm gone all day working as well but am lucky enough to have a friend who comes over to walk Hank during the day. Is there any way you could have someone do that? Even just a quick check could help. It's hard when you can't be there and I'm always so jealous of the folks that work from home! Good luck and let us know how things are going! Hugs!
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