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  #1  
Old 04-09-2010, 07:03 PM
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Tikobird Tikobird is offline
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Default Dozer (Dozer passed away in late January)

Hi everyone - I am brand new to this forum but what a gift that I found you! My 10 year old lab Dozer was diagnosed on Monday with diabetes. Reading Farmsrock posts I feel like I am reading my own story! I took him to the vet because he was off his feed & his right hind leg was weak - wouldn't even get up on the bed or couch anymore. My vet drew blood & found his glucose at 500. Said the leg weakness was more than likely arthritis. Sent us home & told us to have him fst & bring him back in the morning to re-test...which we did and he was at 350. We asked her to look into pills instead of injections so we took him home again only to get a call the next day that pills wouldn't work & they wanted him back on Wednesday for 3 days to monitor him and work out how much insulin he would need. Well we picked him up this afternoon and brought him home only to have his hind quarters collapsing now - not just weak and he has been sleeping soundly since coming home. I am hoping he is just exhausted due to 3 days of stress living at the vet (he's never been boarded before). I tried to get him to eat when we got home but he refused. I am anxious of what morning will bring as it will be my first time giving him his shot. Vet gave us a bottle of Humulin N and we're to give him 16 units and bring him back on Saturday to re-test. Reading all the posts I am concerned that we were not instructed to test him ourselves. I too am not all that thrilled with this vet. We moved to rural TN about 2 years ago and this vet is the closest to us (30 minutes away). I've been sitting here reading for about 2 hours and have learned so much more here than the vet told us. Thanks for letting me get this off my chest and for the wealth of information this forum shares!
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Old 04-09-2010, 08:19 PM
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ozzi ozzi is offline
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Default Re: Switching From Vetsulin to Humulin N

Hi and Welcome!

Like you, my vet didn't give me much more info than how to give a shot, and then left out many details!! When I asked her about home testing, she looked at me like I was crazy, and reluctantly showed me where to take blood from Ozzi's ear, a location where I have never been successful! It seems that not many vets bring up home testing, unless first brought up by the owners, so sadly, this is not unusual.

This is a GREAT place to be for the motivated doggie parent! You will find an incredible amount of information, help and support. You wrote that you have been reading for 2 hours, so I don't want to repeat things here, but if you have specific questions, PLEASE do ask.

You might want to start a "new thread" about Dozer, to keep all the information together. It would be helpful to know his weight, what he eats and how often, what his sugar was when he was discharged on 16 units Humulin-N, and if you are giving 16 units twice/day. Ozzi has had a lumbar neuropathy that caused hind-leg weakness and his weakness severely increased with high sugars. When his sugar started to come down, his hind leg weakness returned to baseline. That happened within a couple of days after starting insulin. I suspect you will see improvement. Is Dozer drinking and urinating less? You should see improvement there fairly quickly as well.

I wondered if Dozer had Xrays that showed arthritis? Did the hind leg weakness recently start or has he had that for a while? If it was recent and sudden, it sounds more like it's related to the diabetes and will clear with better sugars. Arthritis usually happens over time and is progressive...just something to keep in mind, especially if the hind leg weakness goes away quickly!

You might want to watch his ketones while his sugar is high. Make sure they are coming down (if he had ketones in his urine when diagnosed). You can get urine ketone sticks over the counter at any pharmacy, or WalMart. It's a helpful guide to make sure he is improving and his body is metabolizing the insulin.

Please do give us more info and ask the questions that you have!

Kevin
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Ozzi, Dalmatian/Australian Cattle Dog mix, 12/03/1996 - 08/15/2010. Diabetes, blind from cataracts, cauda equina syndrome, and arthritis of the spine and knees. Daddy loves you Ozzi
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Old 04-09-2010, 09:03 PM
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Default Re: Dozer Newly Diagnosed Lab

Hi Tikobird,
I started a new thread for you and Dozer. Kevin has given you some great information and questions to start.

You mentioned Dozer wasn't wanting to eat. Did your vet give you instructions on how much insulin to give if he doesn't eat? It's important that food and insulin work together. You may want to try some enticement, such as a tiny bit of parmesan cheese sprikled on top of his food or some of the water from a can of tuna (packed in water not oil).

It can really be a vicious circle. High blood sugar can sometimes cause them to not want to eat. But they need food in order to give a full dose of insulin. Some vets will advise to give 1/2 dose if no food, others 1/3 of the dose. This is to prevent blood sugar from bottoming out.

The best thing you can do is be as consistent as possible with food/insulin, activity, etc. So glad you found us

Again, welcome!
Patty
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Old 04-09-2010, 11:00 PM
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Arrow Re: Dozer Newly Diagnosed Lab

Ah, Tikobird - a big, fat welcome to you!

I laughed and laughed to see you upset that your vet hadn't instructed you about testing blood glucose levels yourself (using a glucometer, I assume!)

Quite possibly, the vets will learn from us eventually - it's not all THAT many Human Dog-Parents who are willing even to CONSIDER pricking their dogs for blood samples. Learning to give injections twice daily is very tough for some.

But of course, for those of us who will do anything humanly possible for our dogs, it's just great when our vets encourage us to test blood samples at home. There are those humans who faint at the sight of blood. I deeply trust you're not one of those!

I really am willing to bet that ten years from now, vets will often suggest to their clients whose dogs they've just diagnosed with diabetes that they CAN test blood glucose levels themselves, if they wish to. it's just that for now, such a thing remains relatively rare.

And a vet in the office is more likely to take a sample from a vein, and use a lab machine to determine glucose level - might not even be familiar with using a glucometer! Some might, though. But even among those, they will most likely use the EarStick (prick the ear) for blood samples for a glucometer (which measures whole capillary blood, rather than venous blood). That's because they use the Ear for CATS - cannot, cannot, cannot risk being bitten by a cat, as such bites are notorious for causing very nasty infections.

Lucky my vet uses the "lip" (really, it's the inner lining of the mouth - sort of like the cheek lining) to do readings on a glucometer - showed me how, and I never looked back. The lovely thing about the "LipStick" is, it doesn't hurt the dog - no pain. That's because the area pricked has very few nerve-endings.

Well, I'm starting to babble - means I need to go to bed. Just wanted to welcome you and Dozer, and add to what others say - you can expect Dozer to feel better - soon! Sounds as though your vet isn't bad!

Ask any question that occurs to you, and somebody will reply.

Fri, 9 Apr 2010 22:58:34 (PDT)
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  #5  
Old 04-10-2010, 06:52 AM
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Default Re: Dozer Newly Diagnosed Lab

Thanks for the welcome & info. I gave Dozer his first shot this morning like a champ (both of us) - I was real nervous about sticking him but it was a breeze! I have 2 glucose meters here already & am off to Walmart to purchase strips as well as Ketone Strips. Having a dad who is insulin dependent is a big help to me, even though he lives in a different state. Vet did NOT mention anything about what to do if he does not eat. Thank you for giving me another question to add to my list for when we go back!

Dozer is 10 years old - currently 115 lbs. He has always been a big lab -my vet in NY used to call him the Paul Bunyan of labs . I was feeding him Nutro large breed food - 2 cups in the morning & 2 cups in late afternoon. Vet now has him on Purina DCO....which he does not care for too much (but will eat, I discovered, if I add a 1/2 can of string beans) 2x/day.

The hind leg weakness was sudden and is what prompted me to take him to the vet "assuming" it was onset of arthritis. Vet told me wasn't worth me spending my $ on X-Ray as she could tell from the way he was shifting his weight around when standing and the way he laid down that it WAS arthritis....After reading through this site I have serious doubts about that now, however, will keep him on the Glucosomine as I am sure it will help him anyway.

It's nice to have a place to come & learn as well as vent about this. My husband is in denial and our friends already think I'm over the top about my dogs (Dozer has 2 chocolate lab brothers - Buster 3 & Bosco 10 months) so thank you for this forum. What fun it will be to go into the vet next week with my new arsenal of information as well as his #'s from home testing!!! I could use some guidance on when to test and what it is I should be watching for. I've already got a call into Dad as he is certainly a pro in tracking this for himself. I work from home so I am with Dozer all day and can do this as much or as little as it takes.

I'll be back later - thanks again
Lori
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Old 04-10-2010, 07:12 AM
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Default Re: Dozer Newly Diagnosed Lab

Hi Lori,
Glad you were able to get Dozer to eat this morning. You might consider switching from canned string beans to frozen - less sodium.

16 units of insulin is a low starting dose for 115 pound dog. Typically the starting dose is 1/4 unit per pound of dog. Are you giving injections twice a day, 12 hours apart?

It is possible the hind leg weakness is related to neuropathy and will diminish when blood sugar is better controlled.

I'm so glad you're up for learning to test. That will be a valuable tool in helping Dozer. You will want to pick up some lancets too. Everyone has their favorites. I use the Accuchek Softclix lancing device and lancets for Ali's lip.

Look forward to hearing how it goes,
Patty
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Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~
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Old 04-10-2010, 08:31 AM
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Default Re: Dozer Newly Diagnosed Lab

Lori, Lori, Lori....

You are SO far ahead on processing all of this information...KUDOS! I am truly impressed!! I am so happy you are going to home test!! It can be difficult at first until you find the right site for you and Dozer, but I promise you it becomes as easy as giving the injections. I was scared to death to start home testing Ozzi even though I wanted to do it, and I honestly wish I had done it from the start as you are. I would have been able to manage his BG much better. I kept bringing him to the vet for curves and spot checks, and he never got regulated. After more than 6 months of disappointment, I found this site, made some changes and Ozzi is doing very well. In fact, he had a great curve (in terms of shape) last Saturday, but his numbers were still too high. I increased his insulin by 1 unit twice/day, and I'm doing a curve today. So far his fasting is 195 and 2h post insulin and food is 162! I have NEVER seen numbers like this from him! So I could not be happier that you are home testing!

I understand family and friends who think we're "over the top." I experienced the same thing, and I suspect many others here also have. The difference will be when everyone sees Dozer with better blood sugars and realizes that it is you who is doing the right thing!

Regarding testing, you should definitely try it asap, so you can get comfortable with it and see how Dozer is. Just try a test as soon as you can to see if you have any issues that we can help you with. Once you are successful, it will probably take 2-3 tests to feel comfortable with it, just like injecting the insulin. Then, it would be very helpful to do a curve. A curve requires checking Dozer's blood in the morning just before giving food and insulin, and then every two hours thereafter for at least 12 hours (7 sticks). You can post the results and we will help you interpret them. The curve will show how Dozer is responding to the insulin and how he metabolizes it with food. As an example, I found last week that Ozzi starts to "run out" of insulin at about 3:30pm and his sugars begin an upward trend, so I added a short walk at 3:30 to try to see if exercise will bring that number down to smooth out the curve better. If you look at my thread here "Starting Over with Ozzi, Need Advice" you will see what a curve is. I graphed it in Excel and posted the results from last week. I will be doing the same tonight when we are done.

Essentially, you are looking initially to make sure Dozer responds to insulin, meaning that his numbers come down after injection. Then you want to see where the insulin peaks (the lowest BG for the day), and how it goes up and where it ends at the nightly pre-feeding and insulin. This might sound confusing, but we will help you, and it will all become very clear to you very soon.

Dozer is definitely a big boy...lol. I agree with Patty, 16units is a small starting dose, so I'm thinking Dozer's BG is still probably high, although better than it was when you brought him in to the vet. If he still is running high, this might explain the persistent hind leg weakness. Since the weakness came on suddenly, I really do think that it sounds like its related to the high sugars and will clear with glucose management. I will be curious to see if that happens (and hope it does!). One thing I learned that is extremely valuable is that you cannot increase insulin quickly! You have to increase slowly and see the effect on the dog. Increases should only be every 3-5 days, if you do so earlier, you could overshoot the correct dose and get something called rebound (where the insulin brings down the glucose too fast and the body's protective mechanisms kick in and respond by producing more glucose, causing a spike in glucose. Don't worry about understanding all the technicalities like rebound, etc. right now; it will come soon enough just by reading posts here.

I can't wait to hear back from you on Dozer's first blood test!!!!!!!!!!

I don't know if Dozer has arthritis or not, and I don't know that you need to have him Xrayed, nor was I suggesting it....I was just wondering if that had been done already to establish that diagnosis. I'm really hoping, given the onset of symptoms, that the weakness is related to the high sugars. Please let us know how that goes. Regarding glucosamine, I personally think that's a great idea, arthritis or not, since it will help his joints anyways. A larger (and he's HUGE), older dog is more susceptible to joint issues, so I think that's a good thing!

My best,
Kevin
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Ozzi, Dalmatian/Australian Cattle Dog mix, 12/03/1996 - 08/15/2010. Diabetes, blind from cataracts, cauda equina syndrome, and arthritis of the spine and knees. Daddy loves you Ozzi

Last edited by ozzi; 04-10-2010 at 08:40 AM.
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Old 04-10-2010, 08:40 AM
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Default Re: Dozer Newly Diagnosed Lab

Patty, can you give a source for the Softclix device?! Thanks.


Cheers
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Old 04-10-2010, 08:47 AM
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Hey, Lori! You are doing super-well; congratulations! So you have the insulin shots all set now!

About testing - purposes - when and why, you'll learn a lot in time. There's some basic information here:

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

to give you an idea of what curves look like. Also, lots of charts, with several different dogs, here:

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

I'm still sweating over making charts (using Open Office Calc - free spreadsheet program) - largely because I INSIST on taking the chart into my photo-editing program, to add other visual information. But gradually, I'll get there, and where once I turned my nose up at charts, I discovered they can REALLY be useful for a visually-oriented person like me!

I use the LipStick, which is also closely documented (excruciating detail), here:

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

I lance by hand. Recently, I changed from 25-gauge to 21-gauge lancets; Kumbi doesn't bleed that easily - and I found the 21-gauge lancets make all the difference. (Thicker needle than the 25-gauge ones.)

So, somebody still knows about Paul Bunyan! I'm so happy when people know the old stories! Indeed, Dozer sounds like the Paul Bunyan of Labs! Is he a Yellow Lab? The picture is a bit small, and hard to see. But you can upload bigger pictures into your own photo album, here on the forum. Hope you'll do that!

And about people thinking we're over-the-top about our dogs, well, yes; I do believe they are right, and of course, that WE are right to BE that way! After all, these ARE our animal companions; they are as much a part of the family as AnyBodyBrain ELSE! Yes?

Heh; with two younger ones of those ages, I'm sure you have your hands delightfully full!

Sat, 10 Apr 2010 08:45:58 (PDT)
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Old 04-10-2010, 09:19 AM
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Default Re: Dozer Newly Diagnosed Lab

Harry,
I posted the source in your thread. I do remember someone trying the new Accuchek Multiclix which is what most pharmacies are carrying now and they didn't like it as well. I'd look for the Softclix given a choice between the two.
Patty
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