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Sidney has passed December 21, 2014

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  • #1

    Sidney has passed December 21, 2014

    Hello,
    My dog Sidney is a 12 year old (13 in August) 58 pound Australian Cattle Dog. I took him to the vet two weeks ago because he was not walking anymore. I thought it was bad arthritis. Turns out he had terrible diabetes and had keytosis. They sent him home with me to start on 10 units of Humulin N. He was worse the next day and I brought him back, they hospitalized him over night, giving him insulin every hour. Bringing his BGS down from 490 to 130, giving him IV. I took him home and again he returned to hardly moving. This was April 9th that we started giving him 10 units of Humulin N, I have now changed to Novolin and finally got my Alphatrak 2 in the mail on Thursday. I have been keeping track of his blood sugar. He's been back to the hospital multiple times for dehydration. He is eating and drinking, but last night his blood sugar was 701 after giving him 11 units in the AM and 14 units in the PM.
    This brought his BGS down to 418 and that held steady through the morning. It is now back to 525 (3 pm) after giving him 15 units of Novolin at 7:30 AM.
    He is on the diabetic food and is being given the same portion each feeding schedule (2 x's a day).

    Yesterday I brought in a urine sample to be mailed out for the CReatin test to see if he might have Cushings.
    My question is, Do you think based on his numbers that I could increase his insulin tonight from 15 to 16? or Even higher?

    I have Karo syrup and a syringe incase his BGS drops too low. I am home all weekend and can check his BGS every hour.

    Last night when he was down to 418 he was walking around again and was markedly different, back to his old wonderful self.

    Any suggestions are GREATLY appreciated!!!

    Thank you!!!
    Brooke- aka Sidney's Best Friend
    Tags: None
  • #2
    Re: Newly Diagnosed, still not Controlled

    Hi and welcome to you and Sidney! The experts might be a little slower to respond with the holiday, but I would suggest staying with no more than 15 units for a week with very careful monitoring, or even backing down to 12 or 13. Most of us only increased a unit at a time each week firing the regulation phase. It does their bodies that long to adjust
    Laura & Charlie 29 lb male lhasapoo diagnosed October 2013. 16ish units of Novolin N. 1 & 1/3 cup of Natural Balance Fat Dog twice a day. An egg with breakfast and chicken with dinner. Shares string cheese with us late afternoon. Cyclosporine ointment for KCS. Blind from cataracts January 2014. Crossed the rainbow bridge 2/1/2016 at 14.5 years

    Comment

    • #3
      Re: Newly Diagnosed, still not Controlled

      I've been keeping a spreadsheet and graph going.
      He is all over the place:
      Date and Time BG UNITS TIME OF INJECTION
      4/17/14 13:30 246 10 4/17/14 7:20 AM
      4/17/14 19:38 515 10 4/17/14 7:00 PM
      4/18/14 8:05 521 11 4/18/14 8:15 AM
      4/18/14 11:33 577 - -
      4/18/14 13:18 667 - -
      4/18/14 13:23 670 - -
      4/18/14 14:58 634 - -
      4/18/14 17:15 567 14.5 4/18/14 18:34
      4/18/14 20:56 701 - -
      4/18/14 22:29 525 - -
      4/19/14 2:00 415 - -
      4/19/14 7:30 418 15 4/19/14 7:52
      4/19/14 11:30 527
      4/19/14 15:03 524 - -
      4/19/14 16:24 579 - -
      Brooke- aka Sidney's Best Friend

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      • #4
        Re: Newly Diagnosed, still not Controlled

        I know i had a few days where i saw readings in the 500s and i tried administering insulin in a different region which brought it down.

        For starters i assume you are mixing the insulin properly. Also make sure you are actually penetrating the skin (you might want to shave 4 patches (my vet did this around the shoulders and rear hinds) and keep rotating. Im sure you know this but just throwing it out there as i made this mistake.

        As someone else noted, it may take a few days before the numbers start coming down. Your dosage sounds about right (ie my 65lb husky uses 12 u in the morning and 16 in the evening as she eats a tad more). I remember my vet started me on 8u but i needed nearly double that. Your dog very well may need more insulin.

        Does your dog doesnt have any parallel ailments which could cause insulin resistance such as hypothyroidism.

        This may sound crazy but when my dogs numbers where high initially, i was actually trying to get her to walk a bit more to help with the bg numbers and also to help her rebound from the rear leg neuropathy.

        Comment

        • #5
          Re: Newly Diagnosed, still not Controlled

          Welcome to the forum. I am also Cattle Dog owned. Never a dull moment.

          Was Sidney diagnosed with Ketosis and not Ketoacidosis? Ketoacidosis is bad news.

          Loss of use of the rear legs isn't unusual. I think it's called neuropathy or something like that. You say he's walking around again. That's good. I believe the subject is covered in one of the stickies.

          I'm sure one of the experts will come along shortly with more useful information.

          Comment

          • #6
            Re: Newly Diagnosed, still not Controlled

            Welcome

            14.5 looks like he responded to it. Keep it there for 5 to 7 days testing often. Fasting, 2 hours later etc.

            Same thing for 5 to 7 days, same food, same exercise, same insulin

            Consistency is the key
            Riliey . aka Ralphy, Alice, Big Boy
            20 lb male. 5 1/2 nph insulin. 1/2 cup fromms. black cockapoo, dx Apr 2012 . 5 1\2 yrs diabetic. 2000 to 2017

            Comment

            • #7
              Re: Newly Diagnosed, still not Controlled

              hi and welcome

              it would be interesting to know how much fast acting insulin that was given every hour at the vet if that is what they were giving . can you find out the type they gave and amount it could give a clue to how much nph maybe needed. .

              the 10 units is close to a normal starting dose for a dog your size but some dogs like my jesse actually ended up with a dose lower that what would have been a normal starting dose and quite a bit lower.

              a dose adjustment is usually made within a curve and based on the lowest number in that curve . the multiple tests throughout the day determine the fluctuations of blood sugar and hopefully identifies the lowest number .

              big swings in blood sugar can indicate to much insulin has been given . elevated blood sugar that is fairly flat maybe a 100 point from low to high with no quick big drops may indicate not enough insulin given

              now there can be physical symptoms that go along with this and since your pup is showing signs of feeling better with the dose being raised it may show your going in the wright direction .

              it seems that ketones become greatly reduced with numbers in the 400s in general and with numbers in the 300s many dogs feel much better .

              so you want to be on the lookout for big swings in blood sugar maybe over 200 points my jesse had swings from 500 to 70 in a day pointing to an overdose situation which it was . remember a dose adjustment up is based on the lowest number in a curve . normally you would like to give 5 days before reevaluating the dose but that's and average. crises situations maybe a bit sooner and more of a stable situation maybe longer.

              one of the biggest problems with the regulation process is going past the dose that is needed. it can be dificult to get back to where your pup needs to be . that why its a step by step process . no quick way some get lucky but that's few and far between .

              sounds like things are progressing forward glad you home testing that will have a huge positive affect on the process and keeping your pup safe .
              Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
              Jesse earned her wings on 6/21/2021

              Comment

              • #8
                Re: Newly Diagnosed, still not Controlled

                My dog was just diagnosed two weeks ago as well and i am still going through a tuff time with her. One thing that I thought of is that whe i brought my dog to be checked she was high and i had my insulant in me and offered to use it. The vet said no the have a quick acting insulant that wiil bring her down much quicker as to the one I hAve it time released. Not sure but something to think sbout maybe your dog is high but if like mine it msy take hours to drop. Again just a thought.

                Comment

                • #9
                  Re: Newly Diagnosed, still not Controlled

                  Hi Brooke! Welcome to you and Sidney!

                  Sounds like you've had a rough couple of weeks! It does sound like Sidney is making progress though, so that's good news!

                  Sidney's 'all over the place' numbers are probably because his body has not been able to adjust to the dosage of insulin you are giving him. It doesn't look like Sidney's body has been given a chance to stabilize. You need to stay at the same food and insulin for 5-7 days, do a curve and then decide what changes need to happen. It appears that you are reacting to the numbers as you are seeing them...you can do that in humans, but not with dogs. It can be quite confusing.

                  Did the vet suggest the 11 in the am and 14 in the pm? What was the reasoning? I know some pups need differing amounts night and day, I've not seen a 3 unit difference though so I was curious.

                  Also in regards to Cushings...it seems that many vets want to test for this early on in their diagnosis of diabetes. Many symptoms vanish as you get control of the diabetes, especially the symptoms that are the same as diabetes. Does Sidney have other symptoms that point to Cushings? There are several dogs here that have both, those people would be much more likely to be able to answer questions about it.

                  Again, welcome to you both! I hope you find the forum as helpful as I have since arriving here almost a year ago!
                  Mel
                  Mel: My monster is Vinny! He's a black lab, diagnosed with diabetes June 21, 2013. His birthdate was celebrated the last weekend of May. He left this world on July 27, 2018, he was 12 years old.

                  Comment

                  • #10
                    Re: Newly Diagnosed, still not Controlled

                    Originally posted by jesse girl View Post

                    sounds like things are progressing forward glad you home testing that will have a huge positive affect on the process and keeping your pup safe .
                    Yes it does like like you're headed in the right direction. Sometimes the waiting is the hardest part.

                    Natalie, do we still have the patience hat? I think I may have worn it out though...

                    Comment

                    • #11
                      Re: Newly Diagnosed, still not Controlled

                      Does he still have ketones?

                      If so, how high are they?

                      If he could maintain blood sugar in the 400s for a while that would be a good place to start.

                      So it looks like he has been on about 15 units for four days or so...

                      If he does not currently have ketones, I would hold at 15 units a couple more days and then if his blood sugar is still quite high, I would increase to 16 units and hold there for a minimum of 5-7 days.

                      If he has ketones, he needs more aggressive insulin treatment to get beyond those and I would up his insulin dose immediately to 16 units and hold there for three to five days while checking his levels and his ketones.

                      Once the ketones are gone or at least trace, then you could move more slowly to fine tune his dose.

                      Does he have many physical symptoms of Cushing's disease outwardly?

                      If not, I wouldn't do anything with Cushing's right now. His response to the insulin will help diagnose whether he has Cushing's disease.

                      Natalie

                      Originally posted by SidneyDog View Post
                      I've been keeping a spreadsheet and graph going.
                      He is all over the place:
                      Date and Time BG UNITS TIME OF INJECTION
                      4/17/14 13:30 246 10 4/17/14 7:20 AM
                      4/17/14 19:38 515 10 4/17/14 7:00 PM
                      4/18/14 8:05 521 11 4/18/14 8:15 AM
                      4/18/14 11:33 577 - -
                      4/18/14 13:18 667 - -
                      4/18/14 13:23 670 - -
                      4/18/14 14:58 634 - -
                      4/18/14 17:15 567 14.5 4/18/14 18:34
                      4/18/14 20:56 701 - -
                      4/18/14 22:29 525 - -
                      4/19/14 2:00 415 - -
                      4/19/14 7:30 418 15 4/19/14 7:52
                      4/19/14 11:30 527
                      4/19/14 15:03 524 - -
                      4/19/14 16:24 579 - -

                      Comment

                      • #12
                        Re: Newly Diagnosed, still not Controlled

                        Thank you all for the wonderful responses and the support. What a stressful trying time this has been. It's so devastating when your best friend feels so awful and you can't do anything to help. On Friday night even after giving him the 14.5 units he shot up to 701! Poor thing. So, its a good thing I brought him that day for fluids because he certainly would have been severely dehydrated. Today is day 4 giving him insulin at 15 units twice a day.
                        Last night he was at his lowest reading yet, 307. This am he was at 379 & at lunch he is down to 346. These numbers are still so high.
                        Do you think day 5 or 6 he will drop down even more?
                        Since reading all the comments on this thread & others I am hesitant to increase him anymore, but I feel like he has a long way to go to get within normal range.

                        My other question is, has anyone experienced in healing wounds with their diabetic dog? Sidney has a calloused elbow that is very raw looking. I am now concerned he won't heal proper, like a human with diabetes. Any experience with this?

                        Thank you!!!
                        I'm thinking he'll end up with high dosages of insulin. The urine test for Cushings came up positive, which means he might have it, but would need more of the expensive tests & an ultra sound. I'm going to hold off & see how well he does with the insulin.
                        Brooke- aka Sidney's Best Friend

                        Comment

                        • #13
                          Re: Newly Diagnosed, still not Controlled

                          300 level is ok

                          and i think at these levels without big swings a 1 unit increases every 5 days or longer after a curve maybe a good protocol to follow .

                          big swings in blood sugar can be a clue of to much insulin given so something to look for

                          physical symptoms can also give some clues but they can contradict themselves .

                          my jesse healed ok after surgery when her numbers were very high . other medical issues like cushings may have an affect on healing .

                          i think your doing great making a bit of progress and thats all we can ask for and is normal for most of us .
                          Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
                          Jesse earned her wings on 6/21/2021

                          Comment

                          • #14
                            Re: Newly Diagnosed, still not Controlled

                            Into the 300s is a GOOD thing! You're heading in the right direction. It takes time for things to even out. One of the hardest things for me was waiting the 5 days after an adjustment to do a curve.

                            Lucy did have a small wound on her inner thigh that took quite awhile to heal. It was on some thin tight scar tissue left over from a dog attack though. I just kept it clean & kept an eye on it.
                            Last edited by Fishslayer; 04-22-2014, 10:22 AM.

                            Comment

                            • #15
                              Re: Newly Diagnosed, still not Controlled

                              He does not have keytones present. They kept him overnight and gave him the fast acting insulin. I think it's a good sign he has not had them back since April 9th. He still has a ton of glucose in his urine.
                              When I originally brought him to the vet in January because he was eating everything in sight & stealing food off the counter & digging through the garbage. He also had a few accidents in the house. This is not characteristic of him. My dogs are very well trained to not even be in the kitchen when I'm cooking or eating or to ever steal food. So I brought him in.
                              My vet thought he could have Cushings but the tests are $250 for blood and them it's repeated again for $250 & then an ultrasound at $450 would be needed for a proper diagnoses & treatment plan. So she said to wait. I wish we did blood work then because perhaps he had diabetes onset then.
                              It doesn't matter now I guess, I'll keep treating him for diabetes & hope we get it under control and that's it's not any other issues. Like a pancreatic tumor or cancer or Cushings.
                              Tomorrow I go back to the vet to follow up on everything going on.
                              Waiting the 5 days is definitely very hard. I'm just trying to take it one day at a time and make sure he is drinking and keeping him on schedule.
                              Thanks again for all the support!
                              Brooke
                              Brooke- aka Sidney's Best Friend

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