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  #11  
Old 01-14-2014, 05:01 PM
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amydunn19 amydunn19 is offline
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Default Re: Nima's crazy journey

Regulation is a process and if done correctly, it takes a long time. If your vet were to go too fast in raising the dose, the correct dose could be passed easily and overdosing could occur. Overdosing doesn't necessarily manifest as hypoglycemia. Many times, a dog may go higher instead of lower because of a natural defense the liver has in response to low blood sugar - releasing glucose to protect the body. If you continue to increase the insulin and this is occurring, it can be dangerous.

Insulin doses need time to "settle" - generally five to seven days. You may give a certain dosage and see an immediate change and after a couple of days, the bg starts drifting up again. It is also possible that you might not see an immediate change in numbers that day but a couple of days later, the bg might start falling. The body needs time to adjust and not very dog responds in a predictable manner. They are very individual and since they can't communicate in words how they feel, the process just takes longer to get them to a stable dose.
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  #12  
Old 01-14-2014, 08:25 PM
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Default Re: Nima's crazy journey

Quote:
Originally Posted by parisa View Post
I have been using a human glucometer at home, it's Freestyle Lite, but I feel it is very inaccurate. I have purchased the AlphaTrak 2 online and it should be here tomorrow or Wednesday (hooray!). I really want to try and do his curves at home. Has anyone ever noticed or thought that perhaps blood sugars are higher at the vets because they are stressed? Nima really hates going there and I feel like that could possibly be contributing to his blood sugars being elevated?
Hi there,
Bazz and I wanted to extend to you our warm welcome too

You've gotten some great advice so far! I just wanted to touch on what you mentioned here. I've read about a lot of members (myself included) who's pups show totally different numbers at the vet's office than they do at home. I think it was a factor in my boy's original insulin overdose that sent him to the animal ER on more than one occasion. That all happened before I found this forum, and started home testing.

Good for you to start the home testing process . This can be such useful knowledge to have. It made me feel like I had better control over my pup's health, and has brought both our stress levels down. I'm assuming that because you say you were worried about the accuracy of the lite, that you have successfully tested Nima with it.

Bazzle and I have two meters as well. We have the one touch ultra mini, and the alpha track 2. I remember the sticker shock I had when I saw the price of the strips for the AT2 ! We then did a series of same blood drop comparisons between the meters and came up with an average "Bazzle conversion number". I only bring this up because these fur babies can get expensive, and if you can find your "Nima conversion number" you will then have the option to stick with the less expensive freestyle lite strips.

Let us know how things go, we are all here to help

Audrey & Bazzle
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  #13  
Old 01-14-2014, 10:37 PM
parisa parisa is offline
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Default Re: Nima's crazy journey

Auddog,

I have tested him at home for quite sometime, though I'm not sure how accurate the numbers were. He has always been in the 200-300s at home, but at the vet he's in the 300-400s. The Alpha Track 2 comes in the mail tomorrow so I'm going to test his blood sugar once I get it and see how it goes. I want to by the ultra touch mini you mentioned, others have said good things. Then I can figure out his conversion number.

I hope the vet will let me just perform his curves at home. I hate having to take him there just to be stuck in a cage all day

I will keep you all updated!
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  #14  
Old 01-14-2014, 10:42 PM
parisa parisa is offline
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Default Re: Nima's crazy journey

Hi there,

Nima has no other known medical conditions. He did go blind in July and had very successful cataract surgery. The only medication he takes regularly besides insulin is a once a day eye drop, Diclofenac.

We feed him Royal Canin Diabetic food (the can), and pure chicken. He is trying to gain weight at the moment, He is almost 60 lbs and his ideal weight is 75 lbs. He is consuming about 1200 calories a day (instructed per his Internist).
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  #15  
Old 01-14-2014, 10:44 PM
Riliey and Mo Riliey and Mo is offline
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Default Re: Nima's crazy journey

Hi Parisa

You will find the alphatrack uses a real small droplet to get a reading. Glad I got mine. I never use my one touch meter any more.

Your vet is losing money not taking Nima in for curves. Nima is more nervous getting it done there sooo glad your going to home test. Its your decision to be in control if your dog, s bg not your vet

Really looking forwarded to seeing Nina, s first home curve
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  #16  
Old 01-15-2014, 12:18 PM
parisa parisa is offline
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Default Re: Nima's crazy journey

Hi Riliey and Mo,

I got the Alpha Trak 2 today and I love it.

I got in a bit of an argument with my mother. I told her that I wanted to do a curve on Nima tomorrow and I told her that he will eat in the morning at 7 AM, I will give him his first 14 units of NPH then, and then I'll do the curve all day long. I am under the impression that he can't eat until the curve is done at 8 PM. To me, I don't understand the point of the curve if you give the dog food in the middle? Since he is trying to gain weight, she wants to feed him in the middle of the curve. Can anyone give me advice?
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  #17  
Old 01-15-2014, 01:14 PM
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CraigM CraigM is offline
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Default Re: Nima's crazy journey

Quote:
Originally Posted by parisa View Post
Hi Riliey and Mo,

I got the Alpha Trak 2 today and I love it.

I got in a bit of an argument with my mother. I told her that I wanted to do a curve on Nima tomorrow and I told her that he will eat in the morning at 7 AM, I will give him his first 14 units of NPH then, and then I'll do the curve all day long. I am under the impression that he can't eat until the curve is done at 8 PM. To me, I don't understand the point of the curve if you give the dog food in the middle? Since he is trying to gain weight, she wants to feed him in the middle of the curve. Can anyone give me advice?
You're both basically correct. You need "curve day" to be a typical day. If you would always give a mid-day meal / snack then that might not be totally wrong either. But then you would want to do a full 24 hour curve because you probably wouldn't get up at 3AM to give a mid-night meal. We are trying to determine the correct insulin dose, and changing the amount of food, time of food, time of insulin would mess up the curve.

For gaining weight, possibly a better plan would be to add a little more food at the normal meals. Of course you would need to curve again (to reduce the insulin) in a month or two after he gets to the desired weight.

"Curve day" should be as typical as possible: no longer walks than normal, no home repairmen causing him to get worked-up, no unusual trip to the dog park, etc. I wasted many "curve days" when in the mid-afternoon the grandkids came over and got Annie worked-up

My theory.

Craig
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  #18  
Old 01-15-2014, 03:38 PM
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CraigM CraigM is offline
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Default Re: Nima's crazy journey

Just came in from my daily walk / exercise and I was thinking about Nima's desired weight gain. If his BGs have been mostly 300+, he might not really need additional food if you can get his BGs down into the 100-250 range. As you know, he needs "proper" insulin to go along with his food/glucose. If there isn't enough insulin to work with the food/glucose, the glucose gets filtered by the kidneys and gets disposed in the urine (hopefully outside and not on your floors). Increasing food might not have him gain weight, just make bigger puddles to expel the unusable glucose in the urine.

So unless he is VERY underweight it might be better to skip the snacks and concentrate on getting the BGs into a better range. Then, if he still needs to gain weight you might increase his meals & a tiny increase of insulin?

Craig
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  #19  
Old 01-15-2014, 03:53 PM
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Default Re: Nima's crazy journey

Actually, your vet may be adjusting insulin faster than I would recommend - I almost never think a 2 unit increase is a good idea unless the dose is quite large.

A dog is considered "resistant" to the effects of insulin at 1 unit per pound but the most common dose for a diabetic dog is closer to 1/4 unit per pound. It varies a lot from dog to dog and it's easy to overshoot the dose if you don't proceed slowly.

Our 60-65 pound dog needed only about 8-9 units of insulin per injection.

Also, the first response you see to a dose of insulin isn't necessarily the long-term response. Especially at first, simply having had high blood sugar can make the body somewhat resistant to the effect of insulin. When that happens, after they have been on insulin for a while, a dose that used to be about right can become more than they need. Also, there can be overlaps of insulin injections, and the effect of those won't show up in a day or two or three.

So paradoxically, the fastest way to regulation is a slow methodical approach of small increases in dose with at least a week - and sometimes two or three weeks - in between dose increases so the body has time to develop a long-term response.

I've worked with a bunch of dogs who were rushed through the dosing process and wound up having to start over again.

Natalie

Quote:
Originally Posted by parisa View Post
Thanks for your reply! He is doing tons better in terms of attitude, activity level.

I am curious if you have any in put, why does the vet adjust his insulin so slowly? Every week she's doing a curve and then only increasing by 2 units each time. I have read in multiple places that dogs can require 1 unit/1 lb so I don't understand why we're moving so slowly. Nima has never, ever, ever been hypoglycemic or anywhere close.

Thanks again!
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  #20  
Old 01-15-2014, 08:19 PM
parisa parisa is offline
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Default Re: Nima's crazy journey

Hi Craig,

I completely agree with you about skipping the snacks. This is where it gets tricky: Nima was MY dog, I got him when I was 19 years old. I lived with my parents while I went to college, then when I moved out I wanted to take him with me however my parents became very attached to him and thus "he's our baby! don't take him". So I don't live with my parents anymore, I do go there everyday I have off (I only work 3 days/week) and sometimes after my 12 hr shifts to see him.

I have explained to my mom that food is no good if you don't have insulin to absorb the calories, but she feels like she needs to feed him when he's hungry and feels guilty starving him. He was 50 lbs when we first went to the Internist, he looked like literally skin and bones, absolutely horrible. He is 59 lbs right now and is still very thin, but looking much better. I should add that he gained the 9 lbs within 3 weeks of being on NPH v.s. Regular insulin.

I think once he has gained a little bit more weight my mom will be a bit better about understanding that 2 well measured meals a day is the way to go but trust me I am on the same page as you completely.

I also very strongly feel Nima was Cushing's. The hair loss on the abdomen, some on his inner legs (all the way from the thigh to ankles), a bit on his tail, the calluses on his elbows, boney head shape, and BGs that have been crazy really make me impatient for him to have the urine cortisol test done.

I am going to do a curve tomorrow and I will detail everything he ate and times for anyone who is interested and would like to perform input. Keep in mind he is takng antibiotics for suspected pyleonephritis and that he was only switched to 14 units NPH BID on Monday

Last edited by parisa; 01-15-2014 at 10:51 PM.
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