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**Cara's Mom** · 10-30-2011, 05:25 AM

Re: Aeron

Welcome Aeron's Mom!
You are at the right place

! We all know what you are going thru! Been there , done that! There are very experienced people here who will be happy to help you and Aeron thru this! But let's get over the guilt first, things are not as bad as you think! They are just a bit overwhelming, that's all

!

All the best

**CarolW** · 10-30-2011, 05:25 AM

Re: Aeron

I share with you a tendency to ramble! Had no trouble reading your rambly post.

First, my sympathies on discovering Aeron has diabetes. You have an AlphaTrak! Fabulous! And you can test. Again, fabulous!

Sorry I'm pretty rotten on helping with food. My Kumbi, who died of cancer, NOT diabetes, something over a year ago (his thread is here), was put on a prescription diet by my vets, and though if I'd read the label, that would have scared me like mad, I kept up with that food (Medi-Cal Fibre Formula; lots of corn) - and it suited Kumbi, and even his elder, Kwali, very well. Helped with the insulin-food balance, or race.

If you haven't yet read the first three articles on the main k9diabetes site

www.k9diabetes.com

I recommend you do that. Those are the best-written articles on starting out with a diabetic dog that I've ever read.

By the way, it's not "cc" - but UNITS you're talking about. One vial of NPH insulin contains 10 ml, which is the same as 10 cc (ml=cc), and surely you're not giving half a vial with each shot!

Speaking of rambly, you could always have a look here, for a very rambly set of stories, which would largely be entertainment for you:

http://www.coherentdog.org/vek/merrymeasure.php

By the time you read through all that, you'd be very clear on measurements, probably, almost in an intuitive sense.

If you could answer a few questions, it would help us help you. I notice he's about 9 years old; and I assume he's neutered; is that right?

1) Could you give us Aeron's current weight?

2) his date of diagnosis with diabetes?

Is your vet willing to work with you as a team-mate? This is really important. I gather you're keeping written journals - that is great; really important. You can always take your journal along to the vet's, or make summaries of information from it, to show (or email?) to your vet.

You are probably aware by now that diabetes is a manageable disease. So, what we do is, manage it, as best we can, checking with occasional BG curves, and spot-checks as we perceive they are needed.

The real key to managing diabetes in dogs well is: CONSISTENCY.

As in, feed (usually, with rare exceptions) 12 hours apart (twice a day), always the same food for every meal. Typically, give insulin after the meal. I always waited 30 minutes after feeding before giving Kumbi his insulin, largely, to make sure I didn't put insulin on-board if he were to vomit his meal - which I can't remember him ever doing!.

So he would spike in BGs after a meal, but because his BGs came down nicely with the shot, I didn't worry about the spike.

Kumbi went long periods really stable, and my vets kept saying it was the consistency that did that.

You could discuss feeding with your vet. Vets typically don't have a lot of education about feeding dogs - they vary a lot. Same with diabetes; not very many have a lot of education in managing diabetes, either! If you run into difficulties, you might consider getting a second opinion, perhaps from a specialist in Internal Medicine. My vet IS a specialist in Internal Medicine, which helped us along a lot.

Lots of vets will try to put your dog on a prescription diet, and you might not want to do that. Experience here on the forum, with lots of dogs, tends to suggest that a food like Hills WD helps keep BGs stable. On the other hand, dogs here eat a very wide variety of diets, and do really well with them, including home-cooked. Not too many here on raw; opinions vary on that.

As long as you keep track with BG-testing, you and Aeron should do very well.

I didn't test Kumbi a lot; I did occasional curves, but unlike many here, I didn't check fasting BGs every day. Kumbi simply stressed a lot even with testing at home, and my vets encouraged me to keep testing to a minimum. I was always home with Kumbi, which gave me an advantage; I could observe, and I was sensitive to changes that suggested I might need to do spot checks, perhaps followed by BG curves (testing every two hours, from fasting in the morning, through the day, and fasting in the evening; sometimes adding another couple of tests after Kumbi's supper).

Please yell for assistance any time. Feel free to ramble about your concerns! SOMEBODY will be along to give you some kind of assistance, before long.

Here's a Big, Fat Welcome to this Fabulous Forum on canine diabetes!
Sun, 30 Oct 2011 05:25:20 (PDT)

**CarolW** · 10-30-2011, 05:42 AM

Re: Aeron

Re-reading your first post, I see you remark on the possibility that the vet might raise Aeron from 4 UNITS (not cc) to 5 units, of Humulin-N.

Well, that would be a fast, large raise. If you've been reading around the forum, as I gather you have been doing, you may have noticed remarks about raising insulin doses too much, too quickly.

It takes a dog's body time to learn to use this injected insulin. In principle, most people here, when raising insulin doses, do so in smaller increments than full units (in part, depending on the dog's body weight, but a Corgi - what, 30 pounds?) probably shouldn't be raised faster than by half-units at a time.

Certain syringes make measuring half-units more easily than others. Here are the syringes I used with Kumbi:

http://www.coherentdog.org/vek/syringes1.php

If you have a Walmart where you can buy syringes, they have similar ones (ReliOn) - that is, with 31-gauge, SHORT (8mm, or, 5/16") needles - so comfortable for the dog! - and half-unit markings. Those would be, 0.3 cc in capacity of the syringe. The ReliOn syringes would make your wallet happy!

With those half-unit markings, you can measure half-units (duh) - but ALSO, you can eyeball smaller increments, such as, 1/4 units. My vets would sometimes increase Kumbi's doses in increments of quarter-units per shot (notice, that's half-units per day).

I developed a technique (simple, really) for drawing up insulin from the vial and then measuring to quarter-units, by twisting the plunger gently, extruding insulin drop by drop, till I seemed to have about the right dose. And I'd check under a lamp-light, using a magnifying glass.

So it took a little time to measure, but I knew I was approximately at the right dose for Kumbi.

Wishing you a ton of luck - and even - happiness! Aeron is clearly in dedicated, good hands - YOURS!

Sun, 30 Oct 2011 05:41:56 (PDT)

**Aeron's Mom** · 10-30-2011, 06:09 AM

Re: Aeron

Thank you both for the welcome!

My sleep schedule is about to expire so am just doing a fast response (I hope??) then heading to bed.

Aeron is 40lbs ((EDIT: Cardigans are bigger than the Pembrokes and he was the huge boy in his litter)) and was diagnosed on Monday Oct 24. My vet is 30 min away and are probably the best in the area. I am in a farming area and sadly dogs and cats take back seat to cows etc. although they are pretty decent..most of the time (have lost a couple of cats in the past 10 years since I moved out here and of course find out later that well things should have been done differently, esp to my beautiful Jynx this past Feb...but happy thoughts now right?) To get a better opinion (best I think) I would need to drive 2 hours back to my old vet from 10 or more years ago. Only problem with them is they upgraded their building and then at least tripled or more their price for everything. (Spay a kitty...$650..they used to be $90...) Still the thought has still crossed my mind and in the coming weeks especially if I feel not getting ?'s answered we will be going there.

I was told to put Aeron on 5 units (

) and to bring him back in 2 weeks. (no mention of monitoring him and 2 wks is way too long imo) I started at 4 jic that initial 560 was off again due to stress at being at the vets, would rather be too low than too high in his insulin. This morning he was 286 before he ate and we went with the 4 units again. Only been testing 3 days now but that # before eating does seem to be dropping gradually. He slowly drops in #'s throughout the day but doesn't get out of the lower 200's (lowest was 215..once), but it is when he is sleeping it tends to go up more. I am guessing as we are very active together during the "day" and that helps keep it lower??

Also I do feed him 12 hr and was nice and easy as that is what he is used to. Can't really discuss food with vets as they are on the Science Diet kick for everyone out this way. Once I learned about grain and by-products I kinda run from SD and saw huge improvements in all my pets. Didn't realize my one poor cat was allergic to corn

I was basically told then to find a low carb diet for him. And now I have a huge list of different brands to check out, but I want his BG a bit more stable.

I have read numerous articles from the main page of the site but with work. no sleep and Aeron everything is a blur that is slowly starting to come into focus. I have spiral next to me and have been starting to jot down things from people on here, especially in regards to food.

When I wake up later I will be sure to head over to the coherent dog site, it's always fun to read about people who are as crazy as you are about their pets =)

Have a great day everyone!!!! (and bah this wasn't as short as I had hoped)

**CarolW** · 10-30-2011, 06:52 AM

Re: Aeron

I'm trusting you've gone to bed, and will be reading this many hours after I've posted it.

About commercial and prescription kibble: for me, the main facctor is quality control by the manufacturer. Either commercial or prescription kibble should have carefully-controlled ingredients, the same from one bag or can to the next.

You can check bag/can labels, of course, to find ingredients and analysis. Things have tightened up a lot, I believe, in recent years, since the delightful stink caused by Ann Martin, if I remember the author's name right, in her book _Food Pets Die For_, along with lots of other stinks raised by many people.

Because Kumbi - and Kwali too - did so very well on a prescription vet diet that once I would have turned my nose up at, I no longer worry too much about stuff like corn, as long as the animal isn't allergic to it, like your poor cat! I believe part of Kumbi's stability as a diabetic was due to his always-the-same-food - a food that matched his insulin (Novolin-NPH) really well.

Home-cooking, if you can't stand the ingredients, would probably work for Aeron; assuming you have good local sources; I think quite a few here feed their diabetic dogs on some (not too much) kibble, with mostly home-cooked, such as, chicken (usually skinless, boiled breast, to avoid the higher fat content of thighs - some use thighs, though) - and you add to that something like green beans for fiber (not canned; rather fresh or frozen, very finely chopped), and perhaps some brown rice - that's the stuff that would help with glucose control - slowing down the absorption of the insulin somewhat. I gather people use about 1/3 chicken, 1/3 green beans (or something different), and 1/3 brown rice.

Some calorie calculations will come in there, somewhere, to help keep Aeron's weight stable.

About testing and your results - my vets always said to allow a week at least on a particular insulin dose, because the dog "learns" to use that particular dose, and it doesn't really settle in for a week - or even, sometimes, two weeks. Some people say, allow 3 days on a particular dose before doing the next curve. I prefer the week (at least), unless any LOW BGs start showing up. If you see lows, then you need to reduce the dose right away.

Because Aeron was diagnosed so recently - only six days ago - I think you can be pretty relaxed about the work of starting to get him regulated. Thanks for the weight info - yeah, I didn't know the Cardigans tend to be bigger than the Pembrokes.

With 4.0 iu (units) of insulin per dose, you have about 0.1 units per pound of dog, and that would be regarded as a very safe starting dose. Often, vets or others recommend 0.25 units per pound of dog as a starting dose, but I like your 0.1 unit per pound.

It's in RAISING the dose that I'd take precautions. I think you could safely raise Aeron to 4.5 units pretty well any time now - maybe tomorrow. After a week, you could do a BG curve, testing every two hours all day; then depending on the numbers you get, you might safely raise his dose by another half-unit per injection. Though, the closer to regulation you get, the better is it to keep raises SMALL in increment!

The trick is not to overshoot the right dose for Aeron.

Others may come along with better suggestions than mine.

Fair warning about Coherent Dog - it's full of some of the most OUTRAGEOUS nonsense you could ever want to read - but - I AM careful with facts. And there are facts in there, too!

My vet is about a 40-minute drive from me. Takes me an hour to get there, unless I speed like mad. Which I try to avoid. Sorry about a two-hour drive to your old vet, who sounds good. Perhaps things could work out with the new one - depends on whether the new one is willing to work as a team-mate, to listen to you, and to respect your studies and findings.

Because it's less than a week since diagnosis and starting on insulin, and that IS a LOW dose of insulin, I'd guess Aeron will start to feel better before too long.

If it were me, I'd probably test fastings every day for now, and perhaps sometime half-way between injections, to find out (if possible) what shape of BG curve Aeron has.

When you change something, remember to change only one thing at a time - change the insulin, or change the food, but not both at once; otherwise, you have no way to assess what is making a difference.

Hope you slept well! You can bet, I'll be watching, and looking forward to your reports, however rambly! (From one rambler to another!)
Sun, 30 Oct 2011 06:52:06 (PDT)

**pgcor** · 10-30-2011, 08:56 AM

Re: Aeron

I love Aeron's picture. What a cuddly boy!! I live in the Chicago area - and it's the same thing here about food! For me it was W/D. Same for every dog!

I did learn quite a bit about food from a book called "Dogs, Diet and Disease".

It's more expensive for me to home cook, but my Pip seems to be healthier because of it.

I found a protein source that he did well on - which was chicken and then added green beans and zucchini, plus other additives. But this happened over time. I don't home test so it was a very difficult transition for me to change Pip's food. If you home test it should be easier.

Welcome!

Pam and Pip

**SandyL** · 10-30-2011, 09:21 AM

Re: Aeron

Welcome to Aron's mom!!!

Take a deep breath.....breath.....everything will be fine

. You have found the right place for some great knowledge and WONDERFUL support through this journey with your baby!!

First of all it's great that your home testing already!! That in itself it half the battle!

Carol hit on alot of the basics and I totally agree with her warning on raising Aron to 5 units..... We always go by the lows around here for our adjustments and since Aron has gotten as low as 215 ( even if it was only once) I personally would only go to 4 1/2 u. Stay there to let his dose settle for at least 5 days. Ya I know, patience is not a virtue with me either

. But you need their little bodies the time to adjust.

If he eating well now on what your feeding I'd stick to it until he comes down a little. You can always play with the food later... Think of it like a science experiment

. You don't want to be changing foods AND doseages at the same
time. ONE THING AT A TIME... That way you know what works and what doesn't.

Gotta run, but just know you're not alone and we've all been where you are.... It will get better and just become a way of life!!! And never feel bad about rambling. Lol we ALL have our moments!!

Sandy

**Shellie** · 10-30-2011, 02:05 PM

Re: Aeron

Welcome to you and Aaron! This is a great place and you've found some of the best folks to help you out!

My pup and I are still working on the regulation after two months so don't get worried if it takes a bit of time to get there...we all will!

But like Sandy said...breathe! Nice deep breaths! This IS a manageable disease and better than a lot of crappy diseases out there that your Aaron could have gotten! So if you had to have one...this is it! lol

As Carol said....(and Sandy)...take your time with changes. You have to let each one settle in a bit before making a new change. If you change both dosage and food at the same time, you'll never know which one is to blame for either good effects or bad ones. Everyone here always cautions to go slowly. It's better for your dog and much easier on you (even if you really, really want regulation NOW). Patience is not a virtue many of us on here have! LOL

But saying all that...you're among friends and we'll all help any way we can...whether it's technical advice or just a shoulder! Hugs!

**Aeron's Mom** · 10-30-2011, 07:45 PM

Re: Aeron

Carol-

Thanks for the syringe info! Will be going to Walmart in the next day or two and I still have his prescription for needles (been using Stormy's which we get from our local pharmacy and they are the 40 units and ya no way to accurately get the 1/2)

As for food I am going to start an accurate food journal tonight as I have kept his kibble the same for years, but he will sometimes get half to 3/4 of his kibble with some canned thrown on top. Wanting to watch what does what to his BG. Will keep the kibble the same at least until he is more regulated, but when he gets his canned I want to see if any of the different types affect him either pos or neg and make adjustments from there.

Question on the chicken. Should it be fresh or is frozen ok? We eat a lot of boneless, skinless frozen breast and if the frozen is going to be ok, then I am stocked up on that already lol

Thanks for the advice on how often to test. He has been getting the every 2 hours for the last couple of days as I wanted to make sure he didn't suddenly go low on me. Will back off on the frequency now as he is seeming to not drop way down. He may get disappointed by this as he quickly learned after he gets poked we go outside for a round of soccer =) He sees me get the testing case and comes over lays on his side and and waits for me to poke his elbow. (he made sure to let me know the mouth was NOT going to happen

) And after the beep he is ready for action lol I swear he has figured out the "enough blood" beep means he is done.

I think some of this over doing it and over caution is because we have a home business and it is in the most basic sense a year round haunted house (the not the bloody gorey type more goofy scares with humor and slides etc) and well tis the season =/ So have hardly had time for myself and wanting to triple check everything with him before a crisis were to happen, especially to then be sure I would have a way to handle customers while taking care of Aeron. After next weekend tho business will drop waaay off and I can relax more. Just in waay to much of an overload with everything right now.

PGCOR- thanks for the comment on the picture. This was from the day I got him, tho I still say he picked me =) There were 5 pups and the breeder opened their cage and they all took off..but he ran right to me. When we came back the next day to get him, he saw me and started squealing like crazy. And he has been my little wiggle butt ever since

I too was from the Chicago area (Batavia and used to use St. Charles Vet) but then moved about 2 hours west to the middle of no where (our COUNTY has 1 stop light lol) It's great to be able to go back and visit family to realize that yes civilization is still out there

Sandy and Shellie thank you for the encouragement and kind words. And for helping me to get myself to stop and breathe for a second and not try to change the world in one day but to get things under control a little at a time. Panic mode had set in, in a major way and tho I actually knew things would take time, reason had sort of left the building, so the reassuring comments have helped a ton!!!

Again thank you everyone and :;HUGS:: to you and your furbabies!!

Jessica

**MaryLea** · 10-30-2011, 07:49 PM

Re: Aeron

Welcome to the forum. We believe it is one of the best to be found!

You've alrady gotten alot of good information and advice. That is the standard here, plus generous encouragement.

Good to have you here.

Mary

**SandyL** · 10-30-2011, 08:14 PM

Re: Aeron

Hi Jessica
I can definitely see why you're overwhelmed.... For your sake thank goodness Holloween is tomorrow!!

My Tiggy won't eat ANY kibble at all since diagnosis. She was the pickiest eater on the forum back then... Wouldn't eat, I'd sit on the floor and hand feed all the while in tears. I was a mess for the first month or so. My house looked like a pet food store , trying to find kibble she would eat. Back then EVERYONE On here had their dogs on a very regimented consistent diet. I felt like a failure Things have changed somewhat and people's opinions of diet have become a little more relaxed.

I kinda proved to myself that I could get her regulated without being totally consistent. The ONLY dog food she gets is canned and I switch kinds every other day or so. I buy innova low fat and adult formula, Merrick turduncan, Natural Balance ( pretty much all their favors) and Nutro Max
I keep her chicken,pasta, and fiber consistent. Her numbers stay pretty much in the same range no matter which dog food I feed!!! I know, surprised me as well

. Count me as lucky and for the most part her pickyness is a thing of the past.... I've since relinquished that problem to Shellie and Hank lol

And frozen chicken is fine.....I hit all the chicken breast sales and have a crap load in my freezer!!!!!

Hugs
Sandy

**CarolW** · 10-30-2011, 08:47 PM

Re: Aeron

Jessica - you are TERRIFYING me!

I'd like to make sure we have the measurements of insulin doses correct - for both dogs - Stormy and Aeron.

What kind of insulin is Stormy on? And what's this about 40-unit syringes? I haven't heard of a sryinge that has a capacity of 40 units - unless perhaps it's a U-40 syringe.

But typically, pharmacies DO NOT SELL U-40 syringes! so if you're getting your syringes from the local pharmacy, they should, I THINK, be U-100 syringes.

U-100 syringes will measure doses of Humulin-N, which is what you said Aeron is getting - correctly.

So for 4 units of Humulin-N, you'd draw up to the 4-unit marker - on your U-100 syringe.

However, if you are using U-40 syringes, those are designed, including markings on the barrels, to deliver U-40 insulins - which would be, in the U.S., Vetsulin, elsewhere, Caninsulin. (Vetsulin and Caninsulin are exactly the same insulins - but Vetsulin is no longer shipped into the U.S. - hasn't been for nearly two years now - the FDA forbad shipment into the U.S. on 2 November, 2009.

Humulin-N and Novolin-N are U-100 insuilns. They are far more concentrated than Vetsulin/Caninsulin. So markings on the corresponding syringe barrels are adjusted accordingly.

One unit of Caninsulin/Vetsulin is 2.5 times LARGER in VOLUME than one unit of Humulin-N or Novolin-N.

Because my Kumbi was on Novolin-N, it's "Novalin" (a purposeful misspelling of "Novolin" that's the NPH star of my Merry Measure series (on Coherent Dog). But all that's said about "Novalin" (Novolin-NPH) there applies equally to Humulin-N. So instead of having "Little Novie," I could have had "Little Who-Me?" And instead of Big Vetsie, I could have had Big Canny!

I shouldn't get so silly and nonsensical here on the forum, but I do think this might help you comprehend the Merry Measure series I pointed you to earlier.

Insulin syringes have marks and text on the barrels. Please check Stormy's syringes. They should say, "U-100" on the barrel - likely, the back-side, away from the unit markings.

Do they say that? I fervently hope so! If they DO say that, Stormy is getting the right doses, and so would Aeron.

If they say "U-40," you are apparently giving 2.5 times MORE insulin than is prescribed! This can get exceedingly dangerous to the dog! Since Stormy appears to be still alive, I'm trusting the syringes you're using ARE U-100 syringes, but please, please, check, and report back that they are. Or if not, that they aren't!

Awaiting your report!

Meantime, I'll see if I can find one or two pages in the Merry Measure series that would illustrate rather graphically what I'm talking about - in terms of the concentrations of U-40 (Vetsulin, Caninsulin), and of U-100 (Novolin-N, Humulin-N) insulins.

If I can find them, I'll point to them in my next post. (I designed the Merry Measure series to help people use "the wrong syringes" if injecting Vetsulin or Caninsulin - because the U-40 syringes, which measure those insulins correctly, typically only come with longer, thicker needles than the syringes for U-100 insulin - and people with cats or small dogs find using U-100 needles with U-40 insulins much more comfortable for the cat or small dog.

Back shortly, I hope.
Sun, 30 Oct 2011 20:46:50 (PDT)

**SandyL** · 10-30-2011, 08:55 PM

Re: Aeron

Carol, I was sooo hoping you would get on here tonight!!! I saw that u40 and said to myself "What the he**". But I have NO experience with the various kinds of syringes but just knew that wasn't right. That's your area of expertise

Sandy

**CarolW** · 10-30-2011, 09:12 PM

Re: Aeron

Jessica - I'm going to point you to a few pages with diagrams that illustrate the difference in fluid VOLUME between units of U-40 and units of U-100 insulins.

When you draw up a dose of insulin into the syringe, you are measuring fluid volume.

The picture on this page should be helpful:

http://www.coherentdog.org/vek/howbig.php

You can see in that picture alone that unit SIZES are different for U-100 and U-40 insulins.

One unit always contains 1/22 mg of biologically-active insulin, regardless of the concentration of the insulin (U-100 or U-40).

A couple more pages that deal with volume and concentration:

http://www.coherentdog.org/vek/bigsmall.php

http://www.coherentdog.org/vek/fluiddiff.php

On this page:

http://www.coherentdog.org/vek/vetnovcrystals.php

you can see (grpahically illustrated) the difference in CONCENTRATION of the two different insulins - U-40 (Vetsulin or Caninsulin) and U-100 (Novolin-N or Humulin-N).

I deeply trust I'm panicking over nothing - at least, I fervently HOPE SO!

Now awaiting your next report.
Sun, 30 Oct 2011 21:12:21 (PDT)

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