Maize - our yellow Lab - Intro and ur advice

[evetsmd]

Our 9 year old lab, Maize was diagnosed with diabetes just about 13 months ago. She's 80 lbs, some neuropothy in her rear legs, eats WD Special diet diabetic and get 27 units of Novolin N twice a day. Small snack at about 3:30PM every afternoon (1/4 cup fit n trim)

About a week ago Maize was at the Vet for her all day test curve and again the results were high 350 to 425 range......Vet doesn't want to up her dosage any more and we left with no change to anything we are currently doing. Maize gets kind of nervous at the Vet and the Vet feels maybe that is also contributing to the higher readings.

Her energy level is good, we walk about 1/2 to 3/4's of a mile a day or until her back legs start to cause problems....she drinks about 1 1/2 to 2 qts of water per 24hrs and this is consistent.

She's a good dog and if u didn't know u would think she's 100% healthy.....trouble is we are discouraged that the readings are high and 27 units sounds like a lot of insulin.

We want to start testing her sugar levels at home....CR recently has rated the Freestyle Freedom Lite and Accu-Check as two of their top glucometer choices....anyone have any experience with these units?

Finally we are open to any suggestions on steps we could investigate that could lower Maize's numbers.....just found and registered on this forum today and will certainly start looking at everyone's experience and suggestions.

Thanks for any help!

[CraigM]

Re: Maize - our yellow Lab - Intro and ur advice

Welcome to the forum!
I would think if you are seeing some numbers in the 300s, the insulin is working. Just might not be enough, 80 pounds is a pretty large dog. "Every dog is different", but just as a rough example my 18 pound Annie is currently using 8.75 units of Novolin-N. When you start home blood testing, you will get a much better idea of her needs.

Many here like the One Touch Ultra meter. There is info on meters on the main part of this website, and here is a little thing I wrote about meters:

http://www.k9diabetes.com/forum/showthread.php?t=4195

Ask any questions you may come up with!

Craig & Annie

[CraigM]

Re: Maize - our yellow Lab - Intro and ur advice

Forgot to mention about the afternoon snack. That snack probably is causing an increase to her blood glucose (BG). Most get best results, remembering "every dog is different", if food / insulin is matched together. Think about it: shortly after that snack Maize digests the food into sugar. Most feed two identical meals, 12 hours apart, followed by insulin. Some of us actually use a kitchen food scale to measure the food because we don't believe measuring cups are repeatable enough. I swear 10-12 little kibbles (0.1 ounce) of Annie's dry kibble will be noticeable in her BG readings

Of course, some have done well with multiple meals, insulin at different times, etc., but It's probably best to try the more common two meals followed by the injection until you get data from home testing.

[momofdecker]

Re: Maize - our yellow Lab - Intro and ur advice

Welcome to you and Maize! Do you have numbers from the curves at your vets that you can post? Many experienced folks on here that may be able to offer some suggestions and advice based on the numbers of the curves.

My boy was diagnosed at 98 pounds. He was started at 40u of Humulin N and overdosed for nearly six weeks. Reduced to 15u and went back up to 37u. Found we were unable to regulate him on the NPH (blood glucose ran 300-600). Took a change in insulin, from NPH to levemir, and discovering he had high lipids (both triglycerides and cholesterol), chronic pancreatitis and hypothyroidism. Prior to discovering all he had going on he hit regulation range numbers on 10u of levemir. Being that levemir is four times as potent as NPH - it would translate to around 40u of NPH. Yes, it was a lot of insulin but it was what his body needed to break through the resistance he was experiencing. His levemir insulin needs have decreased to 4.5u since starting thyroid treatment.

Guess my long winded point is that every dog is different. Larger dogs may require more insulin and if you continue to increase the novolin and see progress then there should be no reason not to increase. If you continue to increase and see little to no progress it may be worth a discussion with your vet to see if there is an opportunity to try a different insulin or if there may be other concurrent diseases that could be causing insulin resistance.

Best of luck to you in this continued journey! Holli

[jesse girl]

Re: Maize - our yellow Lab - Intro and ur advice

hi and welcome to both of you

testing at home will be a big help it is possible you are getting some elevated numbers at the vets and maybe the numbers are in a much better range it is possible you mat have past the maintenance dose and giving a bit to much due to the raised numbers

there are some clues with him feeling pretty good at home but as you described the leg weakness may point to higher numbers its all speculation

my jesse was very difficult to get in a good range i think it took about 1.5 years to get some real success on a consistent bases but we had to change things up quite a bit

i think every dog has the opportunity to do better doesn't matter how big the challenge but it will take some work .

the larger dogs and labs usually are easy to test we use the lip and you can practice with that just rolling it up and rubbing your finger across it above the canine tooth after a while you can use a napkin which needs to be done in the future to wipe off saliva just to see if he is receptive to that area its getting dogs use to things without stress

as far as meters the strips are the most expensive part as craig said the one touch ultra has a good track record we used it and quite satisfied but for the amount we had to test jesse we could not afford it so we had to use a discount meter with no track record but has done well for jesse

so once you start testing you can post some curves and we can have a look you can also post some curves from the vet over the span since being diabetic there maybe some clues that others may have not noticed

curves can tell so much more than just being high which can give clues on how to move forward

[k9diabetes]

Re: Maize - our yellow Lab - Intro and ur advice

For an 80 pound dog, 27 units is not a particularly large dose of insulin.

She could easily need quite a bit more - 30 to 40 units. If the vet has been unwilling to raise the dose, that's the first thing I would do - you may need to get the 50unit syringes.

She wouldn't be considered resistant to insulin until she was on 80 units twice a day and still had high blood sugar.

Unfortunately, some vets have an artificially low limit on the insulin... we had a couple of terriers who each weighed about 24 pounds and needed 21 units of insulin per injection... I'll let that sink in... but had lovely blood sugar. They just needed a lot more insulin than the average dog.

I would say the "average dose" is between 1/4 and 1/2 unit per pound so Maize's dose isn't even abnormal yet.

Natalie

[Cebe]

Re: Maize - our yellow Lab - Intro and ur advice

Could you explain your feeding schedule? I agree with Craig that an afternoon snack could be sabotaging your regulation.

And I will echo everyone else: every dog is different. My black lab mix is 69 lbs and gets about 13 units NPH 2x daily. She started at 15 but just doesn't need that much. Other dogs need more.

Home testing is a great resource to give you better control over yoir dog's care. The vet will also have more info to analyze and you can take readings at home where there is less stress. I use an alphatrak meter (meant for animals) and also a nova max plus. I like both. I tried the freestyle lite but really didn't trust the results as they were wildly different than my alphatrak.

[Cebe]

Re: Maize - our yellow Lab - Intro and ur advice

I also want to suggest a thyroid test, as Decker's mom mentioned.

[evetsmd]

Re: Maize - our yellow Lab - Intro and ur advice

Thank you for everyone's inputs....I'm late in responding but we are making a little progress.
We did take our first step in getting a glucose meter.....since we are not sure about how this would work, we bought a Walgreen's meter with everything including strips that with all of the rebates landed up costing us nothing! As it turns out Consumer Reports latest tests gave this unit a "recommended buy rating".

We have no experinece with this type of testing. Anyway we ran the control test with the first strip, checked all the meters settings and things looked good to go. Next step was how would the dog react.

No problem.....Maize was great, we got the blood from her callus on her front leg at 3:30PM, the meter read 160.

Actually we were very surprised to see the reading at this level....typical curves at the Vet had readings much higher.....

Next step is to pick a day and run the tests. Test about every 2 hours...is this correct? Do u folks give the insulin and then feed the dog or feed first followed by the insulin......have read various reports..

Anyway we are started....thanks for your help, look forward to inputs and advice.

Thank You

[Judi]

Re: Maize - our yellow Lab - Intro and ur advice

that is great that Maize didn't mind you testing her.

Next time you are at the vet's office, take your meter in, have them test her sugar and you test it on your meter at the same time, that will give you a clue.

I use a one touch ultra and at the 250+ ranges it may read 40 or 50 points lower than the vet would but as her sugar goes down it is closer.

Most of us feed before we give insulin because if they don't eat or if they throw up, you won't want to give the full insulin dose.

Part of the insulin dose is to counteract the spike in the blood sugar from the food and a lot of dogs get picky and don't want to eat.

sounds like you are doing great and most important, Maize is doing great!

[evetsmd]

Re: Maize - our yellow Lab - Intro and ur advice

Thank You Judi! appreciate your help!

Where in N MN. Before retirement, I used to travel to Thief River Falls visiting a customer......I always remember, straight roads, sugar beets, mosquito's and some of the coldest weather I have ever experienced.....the hotel was called "Come on Inn" I enjoyed my visits!

Steve

[Judi]

Re: Maize - our yellow Lab - Intro and ur advice

Steve. I am Detroit Lakes about 90 miles south of Thief but my husband works up in that area now. I'm originally from Indiana and complain every Feb. about the frozen tundra when the temps get do low. Our 20 days if summer are beautiful though! I've seen the Come on Inn lol

[CraigM]

Re: Maize - our yellow Lab - Intro and ur advice

Good work!

As Judi suggested, I'd take the meter to the vet clinic and YOU take a BG reading in the same manner you would at home (same testing location) and compare to what the clinic gets from THEIR test. Do the test comparison as close together in time as possible, a few minutes, if stressed, might skew the results. This will give you a rough idea how close your meter is to the clinic's at that particular reading. As Judi said, the difference is usually small at very low numbers, but depending on the meter could be well over 100+ off at higher readings.

Even with not knowing the exact number, you will see interesting data/trends; does the patient's BG have a big rise after a meal? What time (hours after injection) does she normally have the lowest reading? Does her BG drop after a walk? Lots of interesting things to learn.

[Patty]

Re: Maize - our yellow Lab - Intro and ur advice

Just wanted to add my belated welcome to you and Maize, Steve.

[evetsmd]

Re: Maize - our yellow Lab - Intro and ur advice

Hello Patty...thank you for the Welcome! We are learning a lot from this forum.

Yesterday we ran our first curve....new meter/strips etc. Maize was great but the results left us confused. We tested from the calouse on the leg (could use advise regarding the best lance to use.....it took about 2/3 hits to get blood using the lance that came with the kit

we started at 7AM, an hour after Maize eat and had her 27u. We tested ever two hours.

The test results read between 157 and 205 all day long.....now normally I would have thought Wow! that's great but mid day we took a reagent strip to test urine and it read the highest, a 4 (the reagent strip has always read off the chart) also no Ketones. These readings are also inconsistent with a curve run by the vet about 2 weeks ago. The vets readings ran from 250 to 375.

The whole idea was to test at home to eliminate the stress of the Vet and monitor her levels to gain more insight.

From my previous post u'll see we are using a new, after coupons, free Walgreen TrueTest meter made by a company called Nipro Diagnostics. So now we are thinking if we are really serious about this we need a meter and strip for dogs. I found two, AplhaTrak 2 and iPet.

The interesting thing is Maize is and has been doing great....no outward signs of this nasty problem.

Our Vet will be back in her office on Wednesday, we'll try and talk with her then....

as usual anyone's inputs are welcome and appreciated.

Thanks,

Steve