Annie & Craig - Getting too smart!

[Patty]

Re: Annie is making the switch to NPH

Wow. That is a surprising drop.

It did look like possible rebound. I think you're smart to reduce and see how that goes for a while. You could always increase by 1/4 unit if she starts running consistently higher.

Patty

[peggy0]

Re: Annie is making the switch to NPH

I agree with Patti. It does look like rebound.

[k9diabetes]

Re: Annie is making the switch to NPH

Hi Craig,

Did the insulin reduction do the trick?

Natalie

[CraigM]

Re: Annie is making the switch to NPH

Natalie,
We reduced for two days, but are back at 8iu morning and evening. Haven't done a full curve because she is still on meds for her eye and will see her eye vet on March 5. Fasting numbers are in the low 100s for the most, so we are happy with the change-over to NPH.

Craig & Annie

[CraigM]

Re: Annie is making the switch to NPH

This is a copy of an email I received today that might be of interest to anyone who wants to stay with Vetsulin. I bought from this company last year, and they sent the Vetsulin in a timely manner. Don't know how much they still have in stock.

Craig & Annie






Dear Craig:

As the owner of a diabetic dog, we understand there is a financial strain and a significant time commitment in taking care of your beloved pet. This is why we, here at Pet-Source, are launching the Pet Insulin Preferred (PIP) Customer Program. This program is designed to:

· Save you money!
· Save you time!
· Simplify your purchase process!

The PIP Program allows you to schedule the regular delivery of your pet’s insulin requirements so that it arrives at your doorstep when you want it. You place a one time, recurring order, with an approved script; and we set up automatic shipments to you in compliance with your usage. We will also set up an automatic renewal process to contact your vet for authorized refills throughout the program, and we will strive to do this with enough notice to allow adequate opportunity to rectify any delays due to renewal issues with your vet.

As a member of the PIP program, you will get preferred pricing, shipping, and priority in our system. For those customers currently purchasing Vetsulin, you are aware of the supply limits and price increases that have been put into place as the manufacturing plant works through their regulatory issues. We understand the hardship these adjustments have put on our Vetsulin customers and we want to help; so we are offering a discounted price on Vetsulin to PIP members.

Vetsulin: Current Price – $32.95/vial ³³³ PIP customers – $29.95/vial – 10% Savings!

In addition, for those customers who have already been switched to the NPH – Humulin N and Prozinc for cats, we can accommodate this product selection in our program too. Call us today for pricing and any discounts available.

Give us an opportunity to help you start saving money today by enrolling in our PIP Program, and we will work hard to maintain your trust and business. You can reach us via the web at www.pet-source.com; via email at cstmrsrvc@pet-source.com; or toll free at 1-877-247-4633. We look forward to hearing from you.

Sincerely,

Doug Martin
President
Pet-Source, LLC (Formerly Agri-med)

[Patty]

Re: Annie is making the switch to NPH

That's great Craig. Hopefully others can use this and they still have stock left.
Patty

[CraigM]

Re: Annie is making the switch to NPH

Hello everyone! We haven't made a post in a while because Annie has been doing really well since switching to NPH. I try to read most of the posts, but just haven't had anything to add.

Tonight was interesting: our first fur shot! I made the "tent" of skin and pushed in the syringe. Pushed the plunger and felt my other had get wet! Even though we are using the short needles, looks like the tip went clear through before I pushed the plunger. I gave her a second shot of 50%, not too worried about an overdose because my hand was very wet.

Craig

[k9diabetes]

Re: Annie is making the switch to NPH

Congratulations on finally becoming a full-fledged diabetes dog parent! It's the final test before you're inducted!

[Ladybug]

Re: Annie is making the switch to NPH

Hi Craig,

Congratulations! I've been down that road before! I've had it go right through the tent and squirt on my arm, my hand and the kitchen cabinet!

Hang in there...you'll be a success in no time!

Linda and Ladybug

[CraigM]

Re: Annie is making the switch to NPH

Just a general question / comment.

We generally believe that changes in insulin dosage takes several days to stabilize.

Many of us try to adjust the dosage based on what we believe the physical activity of the next few hours (day) might require. If we plan to have activities that may lower BGs, we cut the dosage. In Annie's case, she has very low activity after her evening shot (couch potato) and her AM fasting numbers are usually higher than the PM fasting number. In the past I've tried to compensate for this by giving slightly more insulin with her evening shot.

Does this activity adjustment REALLY make sense? Just wondering.

Craig & Annie

[eileen]

Re: Annie is making the switch to NPH

Hi Craig,

Speaking from my own experience I have never, nor would I, lowered Mil's insulin dose based on her upcoming activity level.
Instead if I were to be concerned I would feed before the activity so to not have the drop.

Have you done any curves during the night to see what might be leading up to Annie's higher morning fasting?

[CraigM]

Re: Annie is making the switch to NPH

Eileen,
Yes, I see that adding a very small snack would be better than lowering the insulin. I THINK I've read in other threads that some "parents" try to adjust the insulin.

I haven't done a full night time curve in a long time. I have done spot checks in the 4AM - 6AM timeframe and they would usually be a little higher than a check done between 4PM - 6PM. I figure this is due to her being an evening / night time couch potato? Her normal feeding / insulin time is 8AM - 8PM.

Craig

[Patty]

Re: Annie is making the switch to NPH

Hi Craig,
I've done both, adjust insulin and preemptively feed before activity/excitement. I think it depends on how long the activity is going to last that may drop bgs whether I cut back insulin or not.

Activity helps with circulation which can increase insulin absorption. I think you are probably right, the lack of activity at night is causing higher bgs.

You could do a night time curve to know for sure. But I would do exactly what you are doing by increasing the evening dose a bit to compensate. Just know that if Annie were to be more active one evening due to company, etc., you may find her lower with the change in activity.

Patty

[k9diabetes]

Re: Annie is making the switch to NPH

It's not uncommon for a dog to need a different morning and nighttime dose. In that case, not an "adjustment" that varies from day to day but an acknowledgment that the levels of activity are different in those two periods and so requires a different amount of insulin for each one.

As far as I'm concerned, it makes sense if it works!

You do have to be careful truly "adjusting" insulin doses on a daily basis.

I did do that in small increments with Chris, whose insulin needs tended to follow a pattern of a slow rolling wave - slowly increasing, then stable, then decreasing, then increasing, etc. All within about 1 unit of insulin, so between 7 and 8 units in his case. So he would go from 7.0 to 7.25 to 7.50 to 7.25 to 7.0, etc.

I had done a lot of experimenting and testing and felt comfortable that the insulin's duration was limited to approximate injection times. And he was on faster acting insulin that is given for corrections.

Here's my theory on the whole thing...

I think some dogs do and some dogs don't take a few days to give you their long-term response to a dose of insulin once they are regulated.

Which is different than for a dog who is in the process of being regulated.

When still at the stage of trying to figure out the basic insulin dose, just go with the assumption that changes should be made slowly with time in between for the body to adjust because it's new to them and new to you. A dog who is not regulated is very different from one who is.

And of course I would never ever adjust insulin on a daily basis without home testing and only after I've done a lot of work to determine what my dog's typical response is over an extended period of time so I'm sure of the insulin's duration and that there is a need for adjustments.

In Chris' case, if I was to give him the same dose every day, it would have to have been 7.0 units to avoid low blood sugar. But 7.0 units wouldn't be enough to keep his blood sugar in a good range more than about 1/3 of the time. By varying it between 7.0 and 8.0, he stayed in a better range throughout the month.

I would have done it with NPH too if we had stuck with it because I had determined its duration at 8-9 hours for Chris so wasn't concerned about overlapping injections.

Without that footwork, things can get very very mucked up.

Natalie

[CraigM]

Re: Annie is making the switch to NPH

Annie had an appointment with her eye doctor yesterday and was put on one drop of DORZOLAMIDE once per day. Her 8AM fasting was 170 which was a little higher than normal, but I didn't panic. We gave the eye drop around 10:30AM and I did a spot BG test at 2PM and she was 366 This is the highest she's has been in many months and I'm wondering if the eye drops could be a problem? I specifically asked the vet yesterday about BGs and she said "no problem". I've done a little internet browsing and found some comments that you (humans) should notify the eye doctor if you are diabetic.

I called the eye vet, but she is gone for the weekend. Her vet tech suggests I hold off the drops until I talk with the vet on Monday. Any comments?