Otis Farrell July 24, 1999 - October 4, 2013 RIP

[farrwf]

Re: Bill and Otis

Is the OM the Purina OM Overweight Mmanagement kibble? Does he eat it well?
Pat

Pat,

Otis eats the WD and the Nutro Natural Choice Senior with a small amount of Purina OM Kibble for his two meals.

His snack, mid way between meals, is either a scrambled egg or a small amount of chicken supplemented with just a few kibbles of the OM.

The OM is what he'd been eating for about 9 years, and was left over from his "pre diagnosis" days. That's pretty close to the dry WD, so I saw no problem with using it as an "additive".

BTW, just received a call from "Doctor Bob" and we're increasing his insulin to 8U 2X a day.

As I'd mentioned, he was increased from 5U to 7U on Tuesday afternoon based on his BG curve #'s being around 400. Since then, his thirst has really subsided, and there has been a small decrease in his BG, based on my Diastix tests. I relayed that info to Dr. Bob's office this AM, so now we're at 8U.

[MaryLea]

Re: Bill and Otis

Hello and welcome to the board.

Most of the "first questions" have been asked and answered, so I don't have another one to add right now.

We began home testing blood glucose (BG) levels within about five days of Ruffles' dx with diabetes. I'm sure others here will agree that you should consider beginning them, too, expecially since the levels are beginning to drop. Many vets rely on once-a-week tests in their office, which is not a reliable indication of the pet's BG, IMHO. If you are at the point where the insulin is beginning to have the desired effect, increases in the dosage should be 1/4 or 1/2 unit at a time for no less than 5 days to see the effect. Sounds like you are at or near that place since you are seeing the BG begin to drop.

Anyway, we're glad to have you! Check in often and ask whatever questions you may have. Best wishes to you both.

Mary

[farrwf]

Re: Bill and Otis

Anyone have any recos regarding making sure a sight compromised dog can find his water bowl?

I'm not real sure if Otis is just not as thirsty, or if he's having trouble finding his bowl. I've put his food bowl and his water bowl on a mat so there is a change in texture on the floor.

Seems, when I give him a few pieces of cheddar cheese he finds his water bowl. Today, he hasn't had his first drink of water???

[jjefferjo]

Re: Bill and Otis

hi bill
I leave ED'S in the same place as always and he finds them just my sniff and memory.

[CarolW]

Re: Bill and Otis

Hi Bill,

I can't see the start of your thread from here, but I'm struck by the speed and amount of the insulin raises. Those are fast and big raises, and they could result, after a few days, in Otis going hypoglycemic.

Do you know what to do if he does do that? Do you know what hypoglycemia looks like? Usually (not always) trembling, staggering, restlessness, later, lethargy. Let me encourage you to learn, as soon as possible, to test his blood glucose levels at home, but if you see signs of hypoglycemia, rub Karo syrup (corn syrup) or honey or pancake syrup on his gums. The syrup absorbs very fast that way. As soon as Otis is able to swallow after that, feed him a high-protein, high-carb snack.

Answering your question as best I can - I think likely, Otis's thirst has decreased - with those fast, giant raises in insulin - not necessarily a good thing to go so fast! That's because the body takes several days to accustom itself to injected insulin in the first place, and then also, to increased doses.

Did your vet take blood glucose readings? If so, would you post them, please? If the increase was based on urine test strips, I think most vets would consider that inadequate data on which to base such an increase.

My guess is that Otis CAN find his water-bowl okay - keep an eye on him. If you want to know how much he's drinking, you could use a measuring cup as his water-bowl - make sure it's of a size he's comfortable drinking out of!

Or you could use a regular water bowl, perhaps mark a certain level (300 ml? 500 ml?) on the inside of the bowl with a permanent marker, and keep refilling that from a large measuring cup.

I used both methods with Kumbi. His drinking "bowl" was a one-liter measuring cup, and I kept a reserve supply of water in another one. Then I had two ways to measure Kumbi's water consumption. It's not a bad idea to measure, say, for several weeks at this stage.

It's possible you'll have to reduce Otis's insulin dose, and re-begin increases from there, at a slower rate. Vets just aren't very often widely nor completely educated in canine diabetes specifically - they have so many things on their plates.

Best keep in close touch with your vet - I hope your vet listens to you; should be working with you as a team on Otis's behalf.

Please, please keep us posted on how things are going; I feel quite concerned about that large increase in insulin, so soon after the last increase. Normally, you'd only increase once in about 7 days; my vets always said, it's from 7 to 14 days before we see the full effects of an increase (or decrease) in insulin dose.

And let us know how Otis makes out with finding his water! I liked your idea of a textured mat under the water bowl - good thinking!

Sun, 27 Feb 2011 12:13:22 (PST)

[pat3332]

Re: Bill and Otis

Hi Bill,

If Otis has slowed down on his drinking, that could be associated with his blindness which is worrying you right now. Maybe he's also adjusting to his blindness, but it also could be good news and an indication hat his glucose levels are coming down as a result of the insulin increase and he's not needing to drink as much. That's another reason why home testing is so important. It can answer a lot of questions about how your dog is reacting at different times. The urine test gives you different ranges, but not as close as the blood tests. I do realize that it's hard for you to do right now, just something for you to work toward. When does he see his vet next?

My experience with a blind dog was years ago and we had a little rat terrier mix that went blind. We didn't treat him any differently than we had when he could see and he quickly adapted and learned his way around the house and soon was running up and down steps and jumping over things like he could see them. We just had to be careful about rearranging, moving or adding things, in the house and yard, but even then he adapted quickly. The same applied to his food and water. We just put it where we always had and he had no problems finding it. Even if his outside water dish got moved, he soon found it with no trouble.

Other dogs may have more trouble than he did, but he really wasn't exceptional as far as intelligence and I may be wrong and others may disagree, but I think just not treating him any differently than when he could see, or making a big deal out of it may have helped him learn faster. I'm sure they adapt much better and quicker than we would.

Good luck, but it sounds like you're doing a great job so far.

Pat

[farrwf]

Re: Bill and Otis

Hi Bill,

I'm struck by the speed and amount of the insulin raises. Those are fast and big raises, and they could result, after a few days, in Otis going hypoglycemic.

Do you know what to do if he does do that? Do you know what hypoglycemia looks like? Usually (not always) trembling, staggering, restlessness, later, lethargy. Let me encourage you to learn, as soon as possible, to test his blood glucose levels at home, but if you see signs of hypoglycemia, rub Karo syrup (corn syrup) or honey or pancake syrup on his gums. The syrup absorbs very fast that way. As soon as Otis is able to swallow after that, feed him a high-protein, high-carb snack.

Answering your question as best I can - I think likely, Otis's thirst has decreased - with those fast, giant raises in insulin - not necessarily a good thing to go so fast! That's because the body takes several days to accustom itself to injected insulin in the first place, and then also, to increased doses.

Did your vet take blood glucose readings? If so, would you post them, please? If the increase was based on urine test strips, I think most vets would consider that inadequate data on which to base such an increase.

My guess is that Otis CAN find his water-bowl okay - keep an eye on him. If you want to know how much he's drinking, you could use a measuring cup as his water-bowl - make sure it's of a size he's comfortable drinking out of!

Or you could use a regular water bowl, perhaps mark a certain level (300 ml? 500 ml?) on the inside of the bowl with a permanent marker, and keep refilling that from a large measuring cup.

I used both methods with Kumbi. His drinking "bowl" was a one-liter measuring cup, and I kept a reserve supply of water in another one. Then I had two ways to measure Kumbi's water consumption. It's not a bad idea to measure, say, for several weeks at this stage.

It's possible you'll have to reduce Otis's insulin dose, and re-begin increases from there, at a slower rate. Vets just aren't very often widely nor completely educated in canine diabetes specifically - they have so many things on their plates.

Best keep in close touch with your vet - I hope your vet listens to you; should be working with you as a team on Otis's behalf.

Please, please keep us posted on how things are going; I feel quite concerned about that large increase in insulin, so soon after the last increase. Normally, you'd only increase once in about 7 days; my vets always said, it's from 7 to 14 days before we see the full effects of an increase (or decrease) in insulin dose.

And let us know how Otis makes out with finding his water! I liked your idea of a textured mat under the water bowl - good thinking!

Sun, 27 Feb 2011 12:13:22 (PST)

Hi Carol,

Otis was diagnosed in mid December and was started on 4U of Humulin N 2X a day. A bit of history ...

• I took Otis to his EX vet in November for folliculitis and the vet loaded him up with a couple injections of some serious corticosteroids Triamcinolone Acetonide and Dexamethasone, in addition to an antihistamine injection and some antibiotics.
• Otis, who previously exhibited no excessive thirst, immediately began to drink water and urinate to "beat the band".
• I attributed this behavior to his steroid injections until around December 14th I took him in the backyard to relieve himself, and he was walking like he was drunk. When we came back into the house, he walked directly into a kitchen cabinet. ... At that point, I packed him up in the car and heade to his new vet, who is a great vet & person.
• The Doc was in surgery all day, so I left Otis and the Doc would see him between surgeries. I received a call later that day from the Doc telling me I had a very sick boy. His blood sugar was very high and he had ketones. They kept him there on IV's for a couple of days to flush the ketones and to reduce his blood sugar.
• I went home with instructions to start him on 4U of Humulin N 2X a day.
• After a few weeks, Otis was still drinking and urinating excessively. He went in for a glucose curve and I was told his BG never got much below 300. At that point he was raised to 5U.
• I bought some Diastix urine test strips and started to check his urine several times a day. His test results were consistantly very high, although there was no evidence of ketones.
• A couple of weeks using the 5U doses, I took him in for another curve and the Doc said his high BG levels were in the 400's and he increased his dosage to 7U, and said to get back to him in about 3 - 4 days.
• At the 7U dose, Otis excessive thirst subsided and the urine test strips backed off a bit to between .5% & 1%, and stayed there.
• Talked to the Doc after 4 days and explained what was going on & he increased the dose to 8U.

Carol, these don't seem to be "giant" increases in insulin doses, considering the elapsed time, and the fact that we hadn't really seen any positive results. To sum it up ... O has had two curves done at the vet's office, and I now test his urine 3 - 4 times a day for glucose & ketones. That's gonna have to do for now, as it's enough of a task to give O his injection. Can't imagine what he would do if I start sticking him several times a day.

Given the frequency of my testing, I believe when we begin to see some greater change in my "tests", we'll go in for another curve and see where we're at. If I could test his blood, I certainly would. At this point, he won't stand for it.

Regarding the risk of "hypo", it's not likely based on his Diastix results. He's still consistantly very positive. I've read about that and am on the alert for it, and am prepared.

Regarding the water ... last night after he ate, he had a couple of "good" drinks of his water. I guess he wasn't very thirsty during the day. Also I've become so used to him having that unquenchable thirst, that perhaps I may have made too much of his reduced H2O consumption. After all, being on the canned food now ... that's ~80% water.

In any event ... thanks for your concern. We really appreciate it!

[farrwf]

Re: Bill and Otis

My dog went blind very quickly at age 10 after being diagnosed and he was very frightened. he worked it out but wanted to be with me all the time. I had his cataracts removed and he did very well. Could see immediately.

Hi Peggy ...

How long did it take for you to get your dog regulated ... and, how long after that did you have the cataract surgery done?

[k9diabetes]

Re: Bill and Otis

Hi Bill,

At 26.5 pounds, Otis' dose is not unusually large so it seems very reasonable that 8 might be closing in on the right number.

He might have started out back in November with some residual insulin production since you caught his diabetes right away after the steroid treatment. Now that's probably been exhausted and he's fully dependent on the injected insulin.

Canned food would make a huge difference too. When I switched my cats from dry to canned, they basically stopped drinking water out of a bowl altogether. I still keep it out there but they don't drink much of it.

I'm glad he seems to be improving!

Natalie

[farrwf]

Otis won't eat his breakfast ....

The advice I've come across is all over the board:

• 1/4 of the normal insulin dose
• 1/2 of the normal insulin dose
• no insulin

Which is correct? ....

What to do if he won't eat the next meal???

[peggy0]

Re: Otis won't eat his breakfast ....

I"d give him 1/4 given his size . If his BG is lower he may want to eat

[Bichonluver3]

Re: Otis won't eat his breakfast ....

Did you try putting something yummy on it? If Sparky doesn't want to eat I mix Evo 95% chicken % turkey (no grains, low carbs) in with his meal and he goes for the food. How about some cottage cheese? Also, do you know what Otis' blood sugar is? I'll leave the experts to answer but i think when their BS is high, they are not inclined to eat.

[farrwf]

Re: Otis won't eat his breakfast ....

I"d give him 1/4 given his size . If his BG is lower he may want to eat

Doctor Bob sustained the 2U dose. Said to continue the Diastix urine tests, and as long as Otis is positive, to continue the 2U if he still hasn't eaten. ... If, God forbid, he hasn't eaten by Monday AM, Doc says to be at his office @7:00AM.

Did you try putting something yummy on it? Also, do you know what Otis' blood sugar is? I'll leave the experts to answer but i think when their BS is high, they are not inclined to eat.

Don't know what the blood sugar is. He's currently not a candidate for blood testing. It's tough enough to get his insulin in him.

I always have his "favs" on hand. If "O" doesn't feel like eating, it doesn't matter what is offered, he won't eat. He hasn't done this for a while. One thing that's encouraging is that he's drinking water. Usually, when this occured he wouldn't eat or drink for a while.

Usually, he doesn't go past one meal. Having the diabetes in play here makes me very, very concerned, though. Just hope he snaps out of it before dinner time.

Thanks for the inputs!

[Patty]

Re: Otis won't eat his breakfast ....

I played this game with Ali when she was first diagnosed and didn't want to eat. I'd been giving her reduced doses when she absolutely refused to eat and my vet thought perhaps her lack of appetite was due to higher blood sugar. I also wasn't home testing at the time. He said try giving her full dose and see if the drop in blood sugar will stimulate her to eat.

Problem with this is a full dose of insulin can bring them too low before they realize/if they realize they need to eat. By then regular food may digest too slowly to bring the blood sugar up and syrup may be needed.

The other thing that can happen is a full dose of insulin without food, even if he doesn't go too low, can create overlap into the next shot without the food to essentially shorten the duration. So even if blood sugar goes from 500 to 200 in the day, the next cycle could drop lower if the insulin is still active from his first shot. I had this happen with Ali early on.

I guess ultimately I wouldn't gamble with a full dose if you won't be home on any particular day.

I'm in favor of 1/4 of the usual dose to be safe.

Hope dinner time goes well!

[farrwf]

Re: Otis won't eat his breakfast ....

I'm in favor of 1/4 of the usual dose to be safe.

Hope dinner time goes well!

Thanks, ... me too!

Otis has ongoing allergy "issues". Has since he was a baby. I noticed his eyes and nose are quite wet today, so I just wrapped a benadryl in some cheddar cheese and "force fed" it to the rascal. ... Thought while I was at it, I'd put a couple of extra pieces of cheese and chicken down the hatch. So, he's got a tiny bit of food in him. Better than nothing, I guess???