Johanna's Killian

[We Hope]

Re: Johanna's Killian - Trying adding Regular

Johanna,

In this case, I think you should take Killian with you to the vet and let him/her give you some advice with him. Don't give any insulin and see what he's doing when he gets to the vet's, then talk with the vet about what's been happening and possible changes to his routine.

Earlier in the thread, we talked about the possibility (rare) that pancreatitis might cause the pancreas to start producing insulin again.

http://www.vetinfo4dogs.com/ddiabt.h...with%20rebound

"In addition, once in a while a dog with diabetes in conjunction with pancreatitis will suddenly experience a resurgence in insulin producing capability and a sudden "recovery" from diabetes. If you aren't thinking about that possibility it can lead to insulin overdosage."

None of us can tell you if this is happening with Killian, so it's time to take him with you today and see what the vet can advise.

[johanna]

Re: Johanna's Killian - Trying adding Regular

Hi again....
The vet appointment I have is not with my vet......
Because Lu Lu was with my son first, they had her checked by a different vet...
I couldn't get a appointment today with my vet, hes out.... so I called the vet they used.....
I also just called my daughter in law and asked her to take Lu Lu to this appointment.. I don't want to leave Killian....
I just checked him again and hes up to....127... very slow rise.... thats almot 2 hr after food and syrup....
I still didn't give insulin......
I also called the hospital where Killian was that treated him for the pancreatitis and the doctor that treated him wont be in till to night at 8 pm and the vet tech suggested that I talk to her since she knows Killians history......
She also said I could just bring Killian in for a emergency visit and see the doctor on call.......
I hate to go that far with girls coming home from school and me NOT allowed to leave them un attended.....and also pay a high emergency room bill plus Lu Lu's bill if I can handle this my self or at least until one of my vets are in.....
I think I'm going to give him a milk bone... see what that does .
I don't know if this is right or not, but I dont feel like I should be giving him insulin right yet...... what do you think?????

[We Hope]

Re: Johanna's Killian - Trying adding Regular

I would not advise giving him insulin right now. I would make whatever arrangements I needed to to either see or speak to someone who is familiar with Killian's case. In the meantime, check him every two hours and see how the bg's are doing; you then have that information for whatever vet you are able to get hold of.

Using this guide, he's just a bit out of normal range after the syrup and food--

http://www.thepetcenter.com/exa/nv.html

GLUCOSE 67 - 125 mg/dL

At this point, I'd be concerned that giving him insulin might send him too low. The syrup, as we talked about recently, is a simple carb. It's like R insulin in that it goes to work fast and fades quickly--and this is why, when you have a low, you need to feed something a bit after the syrup--the syrup will get the bg's up but it won't hold them up for too long.

If he's eaten and had no insulin, you don't need to give him a Milk Bone--you shouldn't be running any lows now because there's been no insulin since last night. He's shown you that he did make it up from 39 with the help of the syrup and his breakfast.

Right now, it looks like all we can do is wait and see what Killian's bgs are telling you, but you do need to run this by a vet who is familiar with him today, either in person or by phone.

[k9diabetes]

Re: Johanna's Killian - Trying adding Regular

Not sure where you're at with things right now.

I agree on holding off on giving insulin as long as his blood sugar is staying in a normal range up to about the mid-200s.

What you do after that would depend on how many hours have passed, how close he is to his next meal and injection.

Hope you can provide an update.

Looks like Killian needs a reduction in his insulin dose long-term.

[johanna]

Re: Johanna's Killian - Trying adding Regular

Its now 4:40 pm...and still no insulin....
Killian's Bg is now 346..... still not to bad.....
Can I give Killian about 5 unit of R at 5:30 ? that would be the 6 hr mark....
also something small to eat......
I just think waiting till 11 or 11:30 to night to give insulin is toooooo long,

[k9diabetes]

Re: Johanna's Killian - Trying adding Regular

I would give 5 units of R and NO FOOD.

5 units is only about 20% of his usual insulin dose and the point of giving it would be just to cover the blood sugar he has in his system now.

So don't add any more glucose by feeding him anything between meals.

That should help you get back on track tonight.

[k9diabetes]

Re: Johanna's Killian - Trying adding Regular

What has his regimen been for the past couple of weeks. What food and how much insulin?

[johanna]

Re: Johanna's Killian - Trying adding Regular

Thanks Natale...
See i'm getting it.... sort of !!!!

[eyelostit]

Re: Johanna's Killian

Looking at your post:

3/22/08.. 2:00am.. 279.. ?????????????????????.
Was there a treat between these 9 hrs
3/22/08.. 11:00am.. 46 .. dog food ?. 22oz?.
I would have gave syrup, food and fast carb
3/22/08.. 11:42am . 84 .. ????????????????..
Just the Food not raising BG here

Is this after food at 11:00 am?
3/22/08.. 12:30pm.. 218.. Insulin?25 units?. (raising quickly) Did you feed again at this time?


3/22/08.. 1:10pm .. 241.. ????????????????.
This looks normal after food and shot 1 1/2 hr. the 258
3/22/08.. 2:00pm.. 258.. ........... ..........................[/QUOTE]

Can you do a post on what you are feeding now, and is he still on food and shot 3X day or only shot 3 X day etc.

I think the R is causing trouble, that chicken breast for a treat isn't necessarily gonna going to raise the BG as a carb would.

Let us know what Kill's meal is now and how many units? 25 still?

I know you are having a hard time, but something is wrong with diet or shot that can be corrected.

thanks

[johanna]

Re: Johanna's Killian - Trying adding Regular

Hey Deloris.... hi there !
You were reading a older post......
today....at 11 am he was 39 !!!!!! that is right before food and shot......
So I gave him syrup and food .. No shot.....
Normally food raises him quickly but it was still a slow rise......
a hour and a half later he was only 101 .....
then in two hrs he was 127 still no shot.....
then at 4:18 pm....he was 342... thats 5 hrs after food and still no shot.....
then at 5:30 pm i didn't give him any food but I did give him 5 units of R
then at 6:37 pm....408
....... 9:17 pm... 370
........ 10:00 pm... 397
So in a hour and 15 minutes its time food and shot......
And here's where I'm stumped......
Do I give half of the amount of insulin?
I usually give him 32 units?
I never had these lows before.... Seams since the pancreatitis , he had been having some.....
Killian was the king of running high ... average in the high 200's and better,,,,

[k9diabetes]

Re: Johanna's Killian - Trying adding Regular

This isn't rebound, and frankly I don't believe in cutting the insulin dose in half even if it is rebound.

Reduce the insulin from what you have been giving. Maybe 15%...

I don't have the details of how much you've been giving and what his blood sugar has been doing so you have to decide how much the reduction should be.

And then you need to stay with the reduced insulin amount and watch his numbers.... don't fiddle with it unless there's something dangerous... just watch and see what he does over a period of time. Trends, not chasing individual numbers.

I thought you cut the insulin dose the last time this happened?

We talked then about settling into a lower dose and creating some stability and consistency.

Did you do that?

[johanna]

Re: Johanna's Killian - Trying adding Regular

Hi Nat....
Yes we did talk about cutting the insulin dose.... and I did.
I was giving him 32 units and went down to 25...
What I didn't know was that I was to keep doing that......
So the next day when he stabled out I went back to the original dose.....
Only now are we talking about keeping it at 25 units for a while....
Im doing the 25 units tonight...and will keep it there for a while now that I know.....
Im also wondering if the WD is the difference?

[We Hope]

Re: Johanna's Killian - Trying adding Regular

Until now, we didn't know that you stayed with the W/D.

http://www.vin.com/VINDBPub/SearchPB...00/PR00105.htm

WSAVA 2001|Diabetes Mellitus: Treatment Options

"Diet—Canine

There is a considerable amount of reliable research data showing that diets high in carbohydrates, low in fat and high in fiber are helpful in regulating diabetic dogs. These types of diets also lowers the average insulin dose, lowers the average blood sugar, lowers the amount of urine being produced and lowers glycosolated hemoglobins and fructosamine levels. The carbohydrates in these diets are complex carbohydrates. It is important to avoid diets high in simple sugars, which includes any commercial diet semi-moist food, primarily those packaged in foil packets. Diets high in sugars are absorbed very rapidly before the insulin has time to work. The goal in controlling the diabetes with diet is to balance the absorption of sugar with onset of action of the insulin. A high carbo-hydrate/low fat diet also decreases plasma free fatty acids, increases the number of insulin receptors, increases insulin action at the receptors, and finally, it decreases cholesterol. High fiber diets reduce insulin resistance. The fiber acts to decrease postprandial hyperglycemia, primarily because it delays gastric emptying. A high fiber diet also decreases absorption of glucose and increases insulin action at the receptor."

We switched to the canned W/D before we switched to pork Lente insulin. Did this while we ordered the insulin and had to wait for the pharmacy to get it from their supplier. We were quitting the insulin we were using because we were at resistance level with it and it wasn't working at all.

Within 24 hours of starting on W/D, Lucky's bg's came down--it was the first time we saw them move that way and stay there. The PU/PD was markedly decreased--and it wasn't the insulin because it was doing nothing before. As a precaution, we cut back on the insulin we were switching from. Had we changed both food and insulin at the same time, I believe Lucky would have had a hypo and he never had one ever.

We had a little guy on the other board who was VERY easy to manage. His vet suggested the W/D would be good for him, so his person switched him to it. The first day he was eating it, it reduced his insulin needs enough to send him into a hypo.

You're now feeding a food with more fiber to it and that makes for better all-round glucose control.

http://petdiabetes.wikia.com/wiki/Fibre#In_Dogs

"Canine studies indicate that a higher-fiber diet improved all glycemic indices: significantly lower fructosamine results and reduction in post-prandial hyperglycemia, among them. Unlike their human counterparts, who, despite other significant improvements, were unable to lower their insulin requirements by the addition of soluble fiber, 9 of 11 dogs in a particular study lowered theirs with adding soluble fiber. Higher fiber diets reduce insulin resistance. Choice of a diet which includes higher fiber is also effective in managing the Post-meal blood glucose rise in dogs; managing this successfully means better overall blood glucose control."

http://www.walthamusa.com/articles/wf103fle.pdf

Page 4

http://www.vetsulin.com/PDF/20585.pdf

Page 13

"Fibre-rich diets have been shown to slow the postprandial glucose surge in dogs, which consequently improves glycemic control."

http://petdiabetes.wikia.com/wiki/Post-prandial

Post-prandial

What this means is that the blood glucose rises when the body begins to digest the food--also known as post-meal spiking or a food spike. This is the rise you see after Killian eats. The higher fiber food keeps this under control better than what he was eating before and this is why you don't see the "fire alarm" bg's he used to have after eating.

[k9diabetes]

Re: Johanna's Killian - Trying adding Regular

Given three hypo episodes in a month, you cannot safely give him 32 units of insuliln. His daily dose will have to come down.

If Killian processes his NPH fairly quickly, he may go too low when the insulin action peaks if the food is digested slowly.

So how long has he been on the same diet and what exactly is that food?

Natalie

[johanna]

Re: Johanna's Killian - Trying adding Regular

WOW... that was impressive .... It just might be the wd !
If this is why hes going low... i could kick myself for not using it from the beginning.....
I do add some cooked meat in it.... and some wd dry.....
For the past 2 days hes has been getting 2 meals a day again.....
could that have something to do with this?
The amount of food did change some.... I no longer force him to finish everything... he usually leaves about a half of cup of food.. I wont let him leave more then that...
He getting a bit over weight and I feel that 3rd meal didn't help his waste line.
I do think he wants something around the 6 hr mark... but a full meal he don't want...
He ate about hour anda half ago and his BG is ,,, Oh MY God...
I just checked him and the meter is saying ,... Warning high glucose above 600........
Now what !!!!!!!!!! should I use some R???????? Fast.... need help !!!!