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  #1  
Old 03-31-2010, 07:28 AM
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optimystic optimystic is offline
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Default New to forum- more questions than answers

The only answers I have are to the general details about my dog, in fact.
His name is Mischief & he's a mix (don't know what breeds.)
He was a rescued dog & full grown when we got him 10 yrs. ago.
He was diagnosed with diabetes one year ago, almost exactly. At the time, he weighed 47 lbs. Now he's down to 36- mostly due (I hope) to a low cal food & no treats. He eats Science Diet Lite- 2 cups twice daily.
He gets insulin injections after both meals- roughly 12 hours apart.
He started out on Vetsulin (18 units), but we switched to ReliOn N in Dec. He's up to 17 units now, still not where he should be.
I don't believe he was ever regulated on the Vetsulin, although his health seemed to improve fairly quickly with insulin use. I have little understanding of diabetes & ignorantly believed the improvement meant he didn't need more BG curves at the vet.
He's had curves done about every 2 weeks since Jan. bringing up to his current 17 units a couple of units at a time. We (my husband and I) are interested in home monitoring now, but don't really know where or how to begin other than asking for help here.
Last night, we bought a ReliOn Confirm monitoring system at Wal-mart. The box hasn't been opened yet, in case I need to return it in favor of another kind on your advice.
Please give me all the basics, in simple layman's terms so I can get a good understanding of what's in store for us and for Mischief.

Thanks,
optimystic
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Old 03-31-2010, 07:58 AM
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Default Re: New to forum- more questions than answers

My experience is almost exactly the same as yours! I feel like a fool admitting this, but when Ozzi was first diagnosed, I was told to give him 15 units NPH twice/day. He initially responded well, and I foolishly thought I was done! I did not realize that he would need further adjustment, and frequent glucose monitoring. He has not really been adjusted (at least consistently), and I am still working on that and making great headway. So, you are definitely in the RIGHT PLACE, and welcome!!!!!!!!!!!!!!!!

I was scared to death to home test and didn't for the first 6 months of Ozzi's diagnosis. I didn't even know I could! My vet was very layed-back about the whole thing, so I didn't worry! When Ozzi had all kinds of crazy glucose numbers, I felt I needed to take control, and with the help of the people and resources here, I learned to home test, and I could not manage him if I weren't doing so. I am so very happy that you are willing to learn to test Mischief!!!!! That is probably (at least in my opinion), the BEST thing you can do for him!

Please check out the videos here on how to test...they will help you a great deal to understand the process. They can be found at

http://k9diabetes.com/bgtestvideos.html

There are several places that you can test depending on what works for you. The lip is VERY easy and has fewer nerve endings so it doesn't hurt so much. Ozzi doesn't like anyone in his face, so I can't do that. I test from his elbow callus. Others test from the paw pad or the back, just above the tail. I can tell you that the first time was VERY scary for me, and now it's NOTHING to test him. I felt the same way when first injecting him too, and now that's nothing, which I am sure is the same for you now.

In general, after choosing a site to test, you can use a lancet device to poke Mischief, or you can hold the lancet in your hand and prick the area. The device works really well on the lip, and I found it doesn't work so well on the elbow callus, so I hand hold the lancet. You insert the test strip into the meter and when the machine is ready (it says ready or beeps depending on the unit), you touch the end of the test strip to the blood to draw it up, and the machine will calculate the amount of glucose in the blood and display the result. Every meter is a little different, so you need to read how yours works, but those are the basic steps. It feels overwhelming, until you have done it twice, then it is nothing!

I'm not sure how much you paid for the meter, BUT, you can get them for free if you choose to return it. Here are a few sites and there are MANY where you can get a free meter. Of course, you are locked into using their test strips, but many get them cheaper on Ebay, so it might be worth it to you.

https://www.onetouchgold.com/simplestart/
http://www.diabeticlive.com/pages/Fr...ose-Meter.html
https://offers.bayerdiabetes.com/Cou...roduct=contour

A lot of people use the One Touch. I use the Bayer Countour.

I would encourage you to post any and all questions you have, even if you feel like they are stupid! I assure you they are not, and no one here will think that!

Please keep us updated, and we'd love to see a pic of Mischief! Love that name!!

Kevin
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Old 03-31-2010, 11:08 AM
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Default Re: New to forum- more questions than answers

Hi Optimystic and welcome!

I love the name mischief. Too cute.

That's great that you're interested in home monitoring. It really gives you better control over what's happening with your dog's blood sugar and is truly piece of mind. Kevin's given you some great links to start out.

I'm a fan of the OneTouch Ultra meters.

"A recent study of six blood glucose meters reflects favorably on the OneTouch Ultra."
ACVIM 2008 Abstract

Evaluation of Six Portable Blood Glucose Meters in Dogs.
T. Cohen, R. Nelson, P. Kass, E. Feldman
School of Veterinary Medicine, University of California, Davis


The purpose of this study was to evaluate six portable blood glucose meters (PBGMs) - AlphaTrak, OneTouch, Elite XL, AccuChek, Precision, Contour - for use in dogs. One hundred fifty-eight venous blood samples were asayed for glucose using all PBGMs in randomized order and by a reference hexokinase method. Results from the PBGMs and reference hexokinase method (HM) were compared.


HM blood glucose concentrations ranged from 41 to 639 mg/dl. There was excellent correlation between PBGMs and HM results (table). Results were consistently low for 4 PBGMs compared with HM results. High and low results were common with the AlphaTrak. The difference in results between PBGMs and HM increased as blood glucose concentrations increased. Difference in results between PBGM and HM were significantly (p<0.0001) less for the AlphaTrak and OneTouch and significantly (p<0.01) higher for the Contour compared with other PBGMs. Problems with correct identification of hypoglycemia (<70 mg/dl), normoglycemia (70-120 mg/dl), and hyperglycemia (>200 mg/dl) varied between PBGMs (table).


Percent Incorrect from Reference Range
AlphaTrak -- 18
OneTouch -- 21
EliteXL -- 45
AccuChek -- 45
Precision -- 49
Contour -- 73


Results of this study support use of the AlphaTrak and OneTouch glucose meters based on significantly closer results with HM.
http://k9diabetes.com/forum/showthread.php?t=957

Really with any meter you use, once you get the hang of testing you can compare it with your vets results run on a lab machine to find out the degree of difference for your meter.

Also if you have any of Mischief's past curves you can post, we could offer suggestions to help with regulation.

Again, welcome
Patty
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  #4  
Old 03-31-2010, 11:23 AM
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CarolW CarolW is offline
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Thumbs up Re: New to forum- more questions than answers

Hi Optimystic and Mischief, and a big, fat welcome to you! I see you already have some great replies. Hope you'll keep asking questions as they occur to you.

In my Quite Unbiased Opinon (really!) this is the best possible forum on which to learn about canine diabetes - and to get additional information that can help you and your dog. The reason for that is that people are careful and attentive about posting here, following the superb leadership of site and forum-owner, Natalie (k9diabetes).

Just wanted to add my welcome to the others, and also, remark that I use the OneTouch Ultra2 meter. I prefer that one to the other OneTouch Ultra models, because it practically tells you, right on the display, how to do things like setting the date and time, or change other settings you might need to change.

I also like the consistency and reliability of the OneTouch Ultra meters; I see Patty has pointed that out.

And if you consult the pharmacist whee you buy the meter (and test strips), and/or get in touch with OneTouch Customer Care, I believe you can get a full rebate on the price of the meter. That's because it's the TEST STRIPS that cost! There are other good meters as well, and lots of information about them, here on the forum.

You can look over the Answers section, too; see what you find there.

I'll be here cheering you on! My Kumbi, and my RB dog Kwali, join me in welcoming you and Mischief.

Wed, 31 Mar 2010 11:18:55 (PDT)
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  #5  
Old 03-31-2010, 11:30 AM
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optimystic optimystic is offline
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Default Re: New to forum- more questions than answers

Thanks, Kevin for the welcome, encouragment and advice. I'd be glad to post a picture of Mischief, because he's a sweet, dear old guy...black, with a graying snout. For some reason, the posting rules say I may not post attachments, maybe because I'm new? Regarding the cost of the monitor we bought, it was $12 with additional lancets & strips bringing the total up to less than $20. Of course, if the meter isn't a good one- or not good for dogs- it doesn't matter how inexpensive it was. I'm hoping someone on this forum has some knowledge of ReliOn Confirm.
My husband has agreed to test Mischief until I feel comfortable doing it. He did the first few insulin injections, also. He's not an unfeeling person, but a little less tender-hearted than me, thankfully.

OK...figured out how to show off my Mischief, so that's progress. And I appreciate the information from Carol and Patty about recommended monitors. Since I've read several references to strips being costly, should I assume that the ones I bought for the ReliOn Confirm aren't good quality, maybe? I bought it based on using the ReliOn-N insulin.

Well, this is my second edit but I've got to correct myself: it was $22 for 50 strips. The lancets were less than $4 & for some reason, I thought the strips were also. I finally realized that my husband had paid for the strips when he bought 100 more syringes & I just checked the receipt. For some reason, the fact that the strips weren't as inexpensive as I thought gives me hope...

Last edited by optimystic; 03-31-2010 at 11:45 AM.
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  #6  
Old 03-31-2010, 12:49 PM
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Taylor Taylor is offline
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Default Re: New to forum- more questions than answers

I think the ReliOn meter and strips will be good to start with. My vet who is diabetic himself uses the ReliOn. The important thing is that the strips are easily obtained and afordable. Pat
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Old 03-31-2010, 07:57 PM
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Default Re: New to forum- more questions than answers

Nice pic of Mischief!! What a cutie! The fact that the strips are cheaper does not imply they are of a lesser quality, just as the Relion Novolin N insulin is cheaper but essentially interchangeable with the more expensive Humulin N. So don't worry about that. The accuracy of the meter is more important, which is what Patty was pointing out. I just don't happen to know anyone who uses a Relion meter and have never used one, but I don't think there would be an issue with it. If you don't like it, you can always get a free one, and that was the only thing I wanted to mention. Again, testing is so important, I think the meter you use is secondary at this point, and whichever one you use, you can get an idea of its accuracy by testing your dog at the vet's office when he has his blood taken and sent to the lab (not using their meter), as others have suggested. Good luck and let us know what you decide!
Kevin
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Old 03-31-2010, 09:10 PM
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Default Re: New to forum- more questions than answers

Welcome to you and Mischief - he looks so sweet!

Every member of the forum also has available a photo album. If you click on the UserCP link at the top of the forum, that takes you to your Control Panel and you can start a photo album and upload pictures directly from your computer. It's nice because they show up full size.

It would be very helpful if you would get copies of Mischief's last two curves from the vet and post them here so we can see how his regulation is on NPH.

Pretty much every dog we have seen switch over has needed about the same number of units of insulin so he may need 19 or 20 or even more if he wasn't actually well regulated on 19 units of Vetsulin.

You can start with the Relion Meter and then if you want to switch later you can. The strips are the real cost over time. I think you will probably love home testing once you master it. If you watch the video I made of Chris, you will see that he didn't care a bit about being tested. They generally accept it really well and it's more our human imagination that is worried about it.

My first diabetic was a cat and I was SO SO SO scared to inject her! I wanted to cry and throw up and pass out all at the same time just at the thought of it! But I lived alone and she needed me so eventually I sucked up the courage and did it. She didn't even notice! Didn't flinch, didn't cry, didn't blink. I had to laugh at that point given all the drama my brain went through!

There will come a time when giving Mischief his injection is about as stressful to you as brushing your teeth, so much a part of your daily routine that you hardly think about it.

Natalie

ADDING: Sorry about my little mind wander there about injections! That happens sometimes when I respond to too many people in one sitting.

Last edited by k9diabetes; 04-01-2010 at 09:36 AM. Reason: Deconvolute my post... apparently my mind wandered
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Old 04-01-2010, 07:07 AM
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optimystic optimystic is offline
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Default Re: New to forum- more questions than answers

Natalie- I'm already comfortable with Mischief's injections & have taught my 22 yr. old son to do them when my husband & I aren't available. I'm sure home monitoring will become routine, also, once we get started. I'll admit that I dread bringing up the subject of home monitoring with the vet. They might be receptive to the idea, I don't know. Either way, I can't make an appt. for the next curve until this coming Wed. which will be 3 wks. since the last one. On my own, I've already raised the insulin dose by 1 unit (from 16 to 17) and plan to do it again beginning this weekend. I watch Mischief carefully for signs of trouble & am ready with Karo. Like you mentioned, I imagine he will need a higher dose than he took of Vetsulin because he wasn't regulated yet back then.
What I need to decide in the next few days is whether or not to change vets. Mischief was diagnosed by a vet close to home & we used them until the end of the year when the whole problem with Vetsulin came to light. They had continued selling it to us, without ever mentioning a possible problem & didn't monitor Mischief closely as the FDA had suggested. They claimed that they'd still be prescribing Vetsulin if it was available, despite the "little quality control issue" the company suffered. What made it worse was that we had discussed with the vet the idea of switching Mischief from Vetsulin to a human insulin weeks prior to the problem. Our motivation was saving money as the Vetsulin was costing us $45 per vial & wasn't lasting 2 weeks. For months they had sold us the needles- $40 per 100 and prescription Science Diet food at $60 per bag and we needed to save some money, if at all possible. I did some research and found that Science Diet Lite food was fairly comparable to the prescription-only formula & the vet reluctantly agreed to the change. Mischief seemed to do well on the less expensive food, so that was progress. But the vet refused to change to a human insulin, giving us vague reasons like "Vetsulin is concentrated differently & would need a different size needle" and "we would have to start all over trying to get Mischief regulated" which was all true. Except he led us to think that using human insulin would definitely be more expensive & it wouldn't work as well. And Mischief wasn't regulated, anyway. They had only done 2 curves on him in 8 months. Then, we got a message on our voicemail that we had to switch over from Vetsulin to NPH due to Vetsulin being discontinued. After that call, they even sold us 3 bottles at a time so we could postpone switching to what they led us to believe was an inferior insulin. I learned of the Vetsulin problem via the net & felt we had been taken advantage of. At the very least, we should have been fully informed & allowed to make a decision about continuing to use a product that had a "little quality control issue."
So I switched to a vet recommended by a co-worker & that's where we've been going since Jan. I just want to find one a little closer to home & wonder if that should be done at the beginning of home monitoring or not.
Any advice would be welcome & I apologize for the length of this post. I will try and get Mischief's curves to share with you. And I'm really glad to have found this forum.

Melanie
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Old 04-01-2010, 08:42 AM
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Default Re: New to forum- more questions than answers

Hi Melanie and welcome. Mischief looks alot like my forbes who is a lab/border collie/shepard something or other. Your story is a familiar one. We've all had vets that had their way of dealing with diabetes with a certain insulin, food and way of monitoring. The fact is, you need to do whats best for you and your dog. Many people on this board have regulated their dogs without changing the food. Others, like me, have experimented with many brands of food trying to find the one that matches the dog and insulin. And it really is a match of all 3 things as all dogs are different. Home monitoring is peace of mind and I would insist on it. Its really not up to the vet to decide. I was hesitant to change to Human insulin from vetsulin and had a very positive experience with Humulin N. Everyone on the board is here to help!!
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