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Old 06-12-2014, 07:39 PM
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Default Fragile Doggie and Mommy Need Help!

Hi,
I will try to give you detailed overview of our current situation and am hoping for any general suggestions as well as thoughts on a couple of acute urgent issues I am having right now.

Last summer I rescued a little senior male Min Pin from AC in Michigan. When I picked him up he was a round little sausage and blind in one eye from a cataract. In retrospect, I would guess that he had diabetes then and, perhaps, his owners dumped him by the shelter hoping the shelter would care for/provide treatment for him there. The shelter and animal control for that area have adjoining land, and they suspected the little guy just, unfortunately, wandered the wrong direction.

Anyway, he did not exhibit any concerning symptoms throughout the summer and fall, and when we went to my parents' for Christmas I noticed he seemed to have slimmed down a little and thought it might have been from running in the pasture with the other doggies over Thanksgiving and Christmastime. Right before we left to return home I noticed he was holding up a front paw and not putting any weight on it. We checked for any splinters/thorns from running in the wild but didn't find anything we could see. I also looked to make sure he did not have a split toenail. There were no lumps or bumps, and he would yelp a little when I was searching around his toes. I thought I would watch it for a couple of days to see if it resolved.

After we returned home it he did not seem to have the pain associated with it as much, but he still favored it. And one night as I was doing my re-inspection I saw he had developed a gigantic abscess. So off to the emergency vet we went (It was the weekend and after hours ) After a very traumatic experience there with the very new vet telling me it could be a foreign object or cancer and was probably cancer, I left with a drained and bandaged foot on a woozy Min Pin. Which later became an irritated and infected foot on a naughty Min Pin, who would not stop licking and worrying his foot. So off to our regular vet to get something for what I assumed was now an infection and try to figure out what to do since he managed to rub the ECollar on it to keep it irritated even after I buckled on a gigantic ECollar.

Our vet was very reassuring and told me several times (in case I was still worried) that he felt absolutely no mass or lump that would indicate cancer. We made a plan for the foot, and I thought to ask the vet what he thought about Snowball's weight since it was now obvious to me that he looked thinner. The vet said that for his breed he looked to be a good weight, and I was somewhat relieved to hear he wasn't looking too gaunt. I chalked it up to me being use to the sausage look.

So in January Snowball weighed 12lbs.

Over the next few months I had the sense that he was looking thinner because I was seeing his ribs, but it was like the froggie in the pot of water because I don't think I was seeing the severity as quickly as I should have.

During this time I began to wonder if he did have cancer because he was losing weight, but as his drinking increased and the vision in his other eye began to cloud I thought, "Hmm. . .It sure seems like he might have diabetes, but he is losing weight instead of being overweight so it must be some other disease process." I has just lost my 18 1/2 year old doggie at New Year's this year so I was not ready for another loss, but knowing Snowball's personality I knew he would not be a pleasant candidate for any extremes measures so I decided pallative care as long as he was not in any pain and seeming to be the same ol' happy doggie he always was. I still was thinking cancer because I had not yet ever heard of the nutrient absorption problem and subsequent weight loss that accompanies diabetes.

Another month or two, and I decided it was time to increase calories and bought some calorie booster. I gave him lots of treats and lots of helpings and still couldn't seem to get any weight on the little guy. I couldn't get the classic diabetes symptoms out of my head with some of the red flags I saw with him so I decided to google "weight loss and diabetes". And then I was distraught that I had been slow to the game with this and panicked that I was going about everything ALL WRONG!

Now that I was thinking, "Yes, this must be diabetes" I was also faced with a few things to process. My mom's dog (my sister, of course) many many years ago had been diagnosed with diabetes and died after being on her insulin course. My mom suggested that following Snowball around with a strip to try to catch his urine and stabbing him to test his blood might not be a process he would want to participate in since she knew one of my largest obstacles was the fact that my husband had lost his job almost three years ago and still has not become reemployed.

We have four year old triplets, who named Snowball, of course, and we were barely surviving on Food Stamps and other assistance. In the past I have done extensive tests and treatment for my doggies and spent an exorbitant amount to help diagnose and improve quality of life for my sweet family members but now the cost of everything that might be related to treating diabetes seemed overwhelming and impossible. Somehow in my head I had it that it would be hundreds of dollars each month that we just did not have and couldn't find.

So in late April or early May I decided to brush off my home-cooking skills from when I had a doggie with liver, kidney, and pancreas issues. I researched recipes for diabetes and had experience managing my grandmothers when she was at MD Anderson for a stay so I found a couple of good recipes with complex carbohydrates and good bioavailable protein. I also made sure to serve with a bajillion vitamins and herbs, including cinnamon, bitter melon, Vitamins C & E, Omega 3s, liquid lecithin, aloe vera juice, DHG, and others I am not recalling as I type (they are in Snowballs box in the other room). Snowball has always loved his food and was equally appreciative of this new menu, and as I thought was useful, I made sure he was getting some small portions every two to three or four waking hours so he could not have insulin spikes and crashes.

We were back at the farm over Memorial day weekend and while I didn't weigh him at our arrival, I did have some sense that it looked as though his might be looking a little less anorexic. My mom thought he looked less bony too, over the two weeks we were there. I did weigh him on a scale my dad has for weighing calf formula, and I got a 7lb weight. At that time I did not know he had weighed 12lbs in January, and I knew there is error with the old scales with the dials, but I was trying to be optimistic because I had borrowed one of those from my neighbor a couple of weeks earlier, and it looked as though Snowball was weighing 6lbs. I was hopeful he may have actually gained a pound, and the diet change was helping.

Then we we came back home my husband also thought he looked less bony, but within a few days I was not so certain. I plunked him back on that dial scale, and it looked like it still said 6lbs.

Now I reevaluated the supplements and diet. In my reading I began to wonder about a raw diet with super greens to supplement. I also began to panic a little more because more reading gave more information that no dietary change would help Type I Diabetes, and I was becoming more distraught that I could not do anything to help this baby.

Then, this last Tuesday I rolled out the raw diet. Snowball inhaled his concoction of ground beef, a sardine, and a bit of super greens mixed together. I thought, "Well, this is good" and was surprised since none of my other dogs have ever like raw meat as even a treat! I also FORGOT that my doggie who had been ill years before had a one day stint of a raw diet, which made her ghastly ill for a day or so after she ate it. But I would remember soon enough.

Also on Tuesday night I happened upon a link to something I was researching and it was an old inactive group with posts from a few years ago, but something caught my eye. I saw someone mentioning that their very small dog was able to get insulin for only $25 or so each month! The wheels began turning in my head, and I suddenly thought maybe I could swing insulin after all if that was all it might cost for Snowball. I pondered a while and decided I would call our vet in the morning and ask if they would be willing to do a glucose only test and not a full chem panel since those are quite costly. I went to bed with a doggie with a full tummy and a new plan.

I woke up with a sick doggie. Snowball did not look so good Wednesday morning. It was apparent to me that he seemed more lethargic, weaker, and his eyes and ears were not as perky. Visually, it was enough to worry me. I waited until the vet office was open and immediately called. When I asked about the glucose only testing the front office told me that would be a call the vet would have to make so they scheduled me in for 9am for "bloodwork". All the way to the vet, and while sitting in the van waiting to go in I was in tears feeling horrified at myself for not knowing earlier that I could maybe afford to get insulin and treat Snowball. And with the way he was looking I thought it was providence that I had decided the night before when he was looking mostly fine (although he was getting weaker and doing the toppling over to the side thing more frequently) since by Wednesday morning he looked as though he might not make it much longer.

As I sat and talked with the vet tech it was apparent that they would work with me. Our vet knows our situation with my husband being out of work, and they also know I have run subQs at home, have had doggies overnight with IVs and managed many medications and diet modifications. The vet tech told me they could definitely test his glucose and get an insulin dose figured out based on his current weight. (We don't need RXs in our state for insulin or syringes). She also said they could send home a subQ set for a few days, and I asked about an antibiotic since it appeared Snowball had developed a sinus infection (yellow mucus from his nose). The vet tech and the vet were great. The tech later explained the typical course would be IV and monitoring with insulin dosing over three or four days at the vet, but they were fine with me taking him home with subQs and insulin injections (and antibiotics). One promising thing was that he had been ambulatory without much problem prior to Wednesday so they were not as concerned about the toxicity of Ketones as if they would be if he had been down and out for days.

Then as we were talking I realized he had eaten a whole day of raw diet, and I heard his tummy working. And I remembered how my other doggie looked as though she was dying for a day or two after trying a raw diet. . . So at this point I wasn't sure if Snowball was crashing from the diabetes or if his digestive system was protesting the change to rich food. The vet went ahead and gave a dose of insulin while we were there, and Snowball ate four our five treats so felt positive about that.

So yesterday evening I had an appointment with the toddlers, and when we got home at 9pm I was VERY concerned about the way Snowball looked. His eyes and ears were not bright and perky, and he was just laying on his side and did not appear to be able to move his front leg much in response me petting him. After he had gotten home from the vet in the morning he was twitching his tail and looking okay-ish but not good, but now I was afraid he was dying. I dropped everything and delayed getting the children to bed and set up his subQs. I then tried to get him to eat, but he wouldn't eat a bite. I even sauteed some chicken in olive oil and garlic as an enticement and he wouldn't have a thing to do with it. At that time I had no idea to only give half or so of the insulin so I went ahead and gave him his dose. And then we went to sleep. He was in bed next to me, and I was fearful he wouldn't make it through the night. His antibiotic course is 12 and 12, so I was up at midnight and thought to give a dose of simethicone and then his antibiotic.

(CONT'D -Due to LENGTH!)
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Old 06-12-2014, 07:40 PM
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Default URGENT - Fragile Doggie and Mommy Need Help! (CONT'D)

(CONT'D - DUE TO LENGTH! )

So, this morning when I rolled over to look at him I immediately thought his eyes and ears look BETTER! I picked him up and took him out to potty. He was unsteady and took a little steadying by me but he was then able to pee pee standing on his on and walk around a bit. I took him to the kitchen and was ready to run to the store for baby food to dilute and syringe so we could get some insulin in him, but when I opened up the bag of refrigerated chicken from last night he just about bit my fingers off my hand! My husband was holding him and had thought he looked way better than last night so now we were convinced he was definitely better than he was at bedtime.

I then made him a bowl of my home cooked food, to which he politely turned up his nose. I then sprinkled some more of the chicken over it, to which he tweezered it off with his teeth. To which I sat on the floor and hand-fed him globs of much with chicken bits sticking out, and so he ate his breakfast. Now I was back on schedule and quite optimistic that we were going to get rolling with this and in a few days he would be doing better. I gave him his insulin dose and then did his subQs. I adjusted him in his little doggie bed in the living room, and my husband noted that he looked much better because he wasn't layed out on his side, he was actually curled up in his usual position. Throughout the morning he was laying and would lift his head and had alert eyes and ears as I was doing things or talking to him.

And then this afternoon. When I went into the living room I saw him laying out of his bed and on his side. I wasn't too panicked because if he gets up to potty and then runs into something or topples over he tends to have a hard time getting back up so I just scooped him up and put him back in his bed. I kept checking on him, and I was feeling less confident because he no longer had that alert eyes and ears thing. I also found he was seemingly weaker. When I would help stand him up he seemed to not be able to keep himself up. And not just hind leg weakness. He appeared to just collapse in a heap. I thought he might be stiff from laying so much I supported him and helped him mobilate a bit, but he was not able to stand up for any amount of time by himself.

Finally, this evening I sat in the tub with him and gave him a bath to bet the pee pee off of him where he sometimes his his front legs now and from when he either doesn't get up and lays in his pee pee or has toppled over into it after he pee pees. Once we got out of the tub I took him outside and became increasingly worried because he just didn't seem to be able to support himself at all. So I opted to go for a round of subQs earlier in the evening rather than later. So around 6pm I did his subQs. He had enough energy to move his head and elbows around to try to squish away, but we finished them. Then I took him into the hallway and tried helping him stand again. I knew the subQs couldn't have helped immediately, but he did seem able to stand on his own for more seconds.

So here is where we are at: His schedule for insulin is around 9:30 or 9:45 q 12 hours. I am getting ready for food and insulin. The vet told me today to halve his insulin if he doesn't eat, but because his glucose was so high yesterday it probably didn't hurt to give the whole dose last night even with no food (I did have corn syrup and a syringe by the bed last night, though). BTW, his glucose measured "HI", which the vet tech said meant it was over either 650 or 750 yesterday morning.

Again, we have already done subQs tonight. He is 5.8lbs, and I am doing 100 ccs of Normosol R BID for 2 days, which was yesterday and today, and then supposedly 150 daily after that until the bag is gone.

They told me to dose his insulin, which is Novolin R, at 2.5 units BID.

I am sitting here and smell him farting gassy farts so I am wondering if I need to do some simethicone again before seeing if he will eat food before his insulin tonight.

And then his antibiotic is Amoxicillin suspension 2mg BID. Although yesterday they miscalculated and told me to give 2.5mg BID and called this morning to change it.

When I left the vet office they did not tell me I needed to return for any follow up other than as I felt necessary. They said that I should notice him gaining weight and increasing activity level as the insulin begins to work. . .

So here are some questions, aside from other recommendations you may have:

1. I am very concerned about this sudden total inability to stand. He stood a little this morning, but by afternoon it was worse. But he looked worse last night compared to morning too. . .Am I doing something wrong? Or do I need to do something to help???

2.
I am wondering if it is too soon to go to once daily subQs? Is it possible I should continue BID for another day at least? I do want to ensure I don't overload his heart, but I don't know what the acute total weakness is about.

3. I noticed in skimming one thread here briefly that there was discussion about amount of food given. The vet gave me absolutely no direction about how much or little feed Snowball other than to try to go to two meals instead of throughout the day, and maybe give a snack if he seems to not eat his meals because of the timing change. In the thread I was reading it looked critical to maintain similar amounts over mealtime, but I have zero idea about that!

4. Which brings me to the next question, which is how I would know if the insulin is working at this 2.5units and/or if it just takes time to begin to have a positive effect on the disease process. The vet tech told me they calculate based on his weight. So am I correct that they wouldn't give a higher dose just because his glucose is higher? So I shouldn't be concerned his dose is too low since he was off the monitor with his glucose number?

I did ask the vet this morning if the insulin has a load time for it to work or if it would bring down his glucose within the day. He mumbled a few things like either? So I don't really know what I should be watching for.

And he said I didn't need to necessarily monitor Snowball's glucose at home right now.

And I am wondering if he is sort of acutely fragile how can I know I am doing the best right now if I am not checking? Or is this typical in the beginning?

He did say I could get the urine strips, which I did, but from what I understand they measure ketones, and we are doing these subQs to try to flush any of that toxic stuff out of his system. So?

Okay, I think that covers my immediate questions. I know it is late, and it looks as though my posts are to be moderated so I am hoping someone is awake out there. I am scared to death I am missing something and it will cause him to die tonight. I already feel such incredible guilt that I didn't pursue insulin a month ago. Or even last week. That would have made all the difference.

Thank you in advance for your time and any replies,
Kristie
and Snowball (who is a brown Min Pin )
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Old 06-12-2014, 08:13 PM
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Default Re: URGENT - Fragile Doggie and Mommy Need Help!

Oh, and 5. Is it better if he doesn't want to eat supper now to just give him the half dose of insulin or to get baby food and a syringe so he can get a little food in him and then the insulin?

He was very interested and excited about the chicken again and ate a couple of small bites, and he also ate a bite of the goo mixed with the chicken when I hand fed it to him, but then that was it. His lips were Fort Knox, and he turned his head into my arm.
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Old 06-12-2014, 08:31 PM
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Default Re: URGENT - Fragile Doggie and Mommy Need Help!

Kristie,

Hi and welcome. Wow, that has been a whole lot going on! I will try to help you by answering a few of these questions first. I will tell you right away that I understand you have been trying to handle this yourself. I am concerned about your vet with some of the details you have given so hopefully some others will help us in sorting this out. I believe you have a very sick pup and he may not yet be out of the woods.

Novolin R is the insulin you are using? Not Novolin N? Novolin R does not have the 12 hour cycle, it is designed to bring them down quickly as it is fast acting. He probably needs to be on Novolin N or one of the longer acting insulins.

As far as the weakness, it is very common in an unregulated diabetic to not be able to stand plus he is probably still very weak from being ill. Usually, we see weakness in bigger dogs but it sounds like this has been out of control for some time. Another thought is if his blood sugar is very high, he may just be very lethargic and not feel like getting up. I would continue the fluids if he is not eating or drinking much.

As far as food, my vet never told me how many calories to give. You can look up how many calories a dog his size would need and go with that. Consistency is key - same amounts of the same food at the same time followed by injection twice a day every day. If your dog is not eating, then it is harder but many give 1/4 unit for no food eaten, 1/2 unit for half a meal, etc. although, I am worried you are on the wrong insulin though so getting results from R insulin with a N insulin routine won't work the same.

Home testing will help you tremendously in regulating him. We can help you - most vets are zero help with that. But, with this vet, I think you need to be testing.

First of all, please get clarification on the type of insulin you are supposed to be giving. I haven't heard of a dog on R insulin only doing two shots a day. Before we can help much more, I think that needs to be settled.

I also think you should go very easy with his food. I know you are trying to get him to gain weight but in an uncontrolled diabetic you could feed a bag of food every meal,and he won't gain weight until you get this glucose under control. High blood sugar will not allow him to convert that food he is eating to something useful.

Do you have any options with another vet? I don't think your vet is well versed. I hope some others will jump in here.
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Old 06-12-2014, 08:34 PM
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Default Re: URGENT - Fragile Doggie and Mommy Need Help!

We have been discussing the force feeding thing on other threads and my personal opinion is not to force feed - his body cannot tolerate food right now and he is telling you that. I am worried that he should be under a vet's care. That is not your fault so don't think I am saying you haven't done your very best. I just think he may be sicker than you think and your vet doesn't sound like he is much help.
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Old 06-12-2014, 09:01 PM
Riliey and Mo Riliey and Mo is offline
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Default Re: URGENT - Fragile Doggie and Mommy Need Help!

hello Kristie, welcome to the forum

from the info you posted your Snowball needs vetrinarian care immediately.

is there a emergency clinic you get can him into tonight

this is your only option with all thats going on. His diabetes is not being addressed with fast acting insulin.

please post before you go to bed

thanks

mo
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Old 06-12-2014, 09:04 PM
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Default Re: URGENT - Fragile Doggie and Mommy Need Help!

i share amys concerns with r . usually this is given at the vets maybe every 6 hours to lower very high blood sugar . this approach really needs extensive monitoring blood sugar . the 2.5 units would be a very large dose of r for a 7 pound dog

i do have some experience with r with my jesse and 1 unit is the maximum i can give her and she is a 30 pound dog .

you pup could be having huge swings in blood sugar and usually they will not feel very good in this situation .

i would also recommend going to relion n insulin 2 shots a day maybe 1 unit to start . we know it can be difficult to home test min pins but some have been able to do it . without the ability to afford testing at the vet its maybe a no choice . if your dog shows improvement and it should not take long you know you are going in the wright direction

walmart does have a relion brand of blood testing equipment at a low cost may not be perfect but can get the job done

i have managed my jesses diabetes without a vets supervision so it can be done . i do test her blood sugar about 3 times a day. she was on the brink for sometime but she clawed her way back and is a happy beagle today

there are things in your control and diabetes is one of them that you can do that wont break the bank if you pay attention which i am sure your already doing to survive
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Old 06-12-2014, 09:14 PM
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Default Re: URGENT - Fragile Doggie and Mommy Need Help!

Amy,

Thank you for your reply.

Yes, He is most definitely on Novolin R and not N. The vet tech who was there Wednesday will be back tomorrow morning, and I found out we knew one another through someone else. She was kind and empathetic and tried to be helpful so I fee quite comfortable calling tomorrow morning and asking about the R vs. the N. It looks as though the cost is the same so I am not sure why they would choose the R over the N. We don't need a RX for R, but they wrote me a script for the R and syringes anyway, just in case there was some snag. . .

Okay, I am going to eat something myself and then lay down with Snowball. The toddlers will be up earlier than we want to get up.

Thank you, again, for your thoughts and suggestions so far,
Kristie
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Old 06-12-2014, 09:18 PM
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Default Re: URGENT - Fragile Doggie and Mommy Need Help!

Hi Kristie

Such a good dog parent you are with everything else you have going on.

If you are using Novolin R, what time did you give the 2.5 units? Since that is a short term insulin, it may have been too much insulin or you MAY need to give more. You may be able to call an emergency clinic for advise on the dosage.

Good luck and keep us posted.

Laura
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Last edited by Charlie's mom; 06-12-2014 at 09:21 PM.
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Old 06-12-2014, 10:06 PM
Riliey and Mo Riliey and Mo is offline
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Default Re: URGENT - Fragile Doggie and Mommy Need Help!

kristie how is Snowball doing tonight?

just got back in from walking my dog. I.m here for a few hours late.
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