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  #1  
Old 06-17-2014, 02:41 PM
13409whitby 13409whitby is offline
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Question Trying to regulate Macy Girl

HI, We are kinda new here. I've been reading posts for a few weeks, which by the way have been super helpful. But right now I'm kind of in panic mode. I just gave her kayro syrup so that should bring it up. But I suppose my question that I hope someone can answer is this. Is it true that Humulin N causes some dogs sugar to take a nose dive?
She (Our Macy girl) was diagnosed in Dec. and we have her on a steady diet, and regular insulin shots of 4 units at night and 5 units during the day. I stopped giving her 5 units at night because this has happened before, and it usually happens in the morning. I believe I read somewhere that the humulin N does this and I am beginning to think that is the case with our 6 year old toy poodle.
We are looking for a new Vet, because ours does not seem to be as "diabetic friendly" as we need him to be. We cannot seem to get her regulated, and just recently (Wednesday) we started on a new bottle of Humulin N because we thought her other bottle had gone bad. Her blood sugar skyrocketed to 581 Wed. and the vet at the E.R. said he thought the insulin which was about 3 months old needed to be replaced. So far her sugar has not gone down to what I would consider satisfactory, ranging from 223 to 434.
ANY SUGGESTIONS OR INFO ON THE HUMULIN N WOULD BE GREATLY APPRECIATED. THANK YOU SO MUCH.......Ellen
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Old 06-17-2014, 03:32 PM
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Default Re: YIKES! My Pup's blood sugar is 68

I have not heard that in regards to the Humulin. In order to help you we really need for you to do a curve so we can see what's going on. If your dog is going too low (68), the reaction could be that very high reading you are seeing. If you can post a curve, we'll get you some great advise.
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Old 06-17-2014, 03:35 PM
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CraigM CraigM is offline
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Default Re: YIKES! My Pup's blood sugar is 68

Welcome to the forum.

I don't think we can say Humulin-N, or Novolin-N, causes a nose dive without more info. If the insulin & food are a good match, then there shouldn't be a "dive". If the insulin / food ratio is out of wack, then I guess there could be a big dive. Such as if insulin is given without enough food.

Can you tell us what you are feeding, and list some blood glucose readings (curve)? What meter are you using?

Btw, 3 months is really pushing a vial of "N". Most replace "N" every 4-6 weeks. I go 6 weeks and toss about Ĺ vial. If you're in the U.S., are you familar with Novolin-N (very similar to Humulin-N, bought at Walmart for $25/vial?

Craig
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Old 06-17-2014, 03:35 PM
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ceruleanblue ceruleanblue is offline
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Default Re: YIKES! My Pup's blood sugar is 68

Some dogs do put insulin to work faster than food is digested, which causes a large drop in BG after their meal.

If you could give us a little more information about your dog, we might be able to help you figure out how to better regulate her. How much does your dog weigh? Are you testing blood glucose at home (if so, what meter)? Can you post a recent curve or other BG readings and what times they were taken (along with feeding times)? What food is she on, and how much?

Edit: looks like Craig and Peggy beat me to it!
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Old 06-17-2014, 03:40 PM
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Default Re: YIKES! My Pup's blood sugar is 68

As the others said, if the food and insulin are out of balance, their blood sugar can nose dive. I don't know if you test at home but that would help you get your dog regulated.
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Old 06-17-2014, 03:42 PM
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Default Re: YIKES! My Pup's blood sugar is 68

hi an welcome

this can be a very common story . many times its not the insulin but the approach to how the diabetes is treated

information is key . being able to interrupt curves which there really is no set understanding in the medical community. each vet may have there own approach on trying to decipher the information . this is very understandable because we really dont know what is going on for sure .

do you test blood sugar at home ? have complete curves been done before any dose adjustment ? how fast was the dose raised and amount during this process

if you could give a more detailed progression of the events since diagnosis and how you both got here . maybe post some curves recent and past if you have them . diet and times fed is important if done at home any exercise can be important
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Old 06-17-2014, 06:06 PM
13409whitby 13409whitby is offline
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Default Re: YIKES! My Pup's blood sugar is 68

Thank You all so much for responding. I am amazed at how much knowledge you all seem to have. I cannot believe all the questions that were asked, that were never asked by my Vet.
And while writing all this I am amazed at how ignorant I have been. The food to insulin ration is probably a big factor in our not being able to regulate her. It never occurred to me. However I (not being a woman of few words, as hard as I try) will try to answer them all with the hopes that you can make suggestions.

Macy is a 6 & 1/2 year old toy poodle. She weights about 13 lbs. And both of our Dogs have had the same veterinarian, who I have trusted for 6 years. She was diagnosed diabetic late December of 2013.

About 5a.m. every day Macy eats about 4 ounces of W/D Prescription Diet Wet Dog food which she started on 5/29/14. Prior to that she was getting I/D prescription diet.

In the afternoon both dogs have a snack, which Macy hardly ever eats, just once in a while. Which is one pup-peroni stick and less than a Ĺ tsp. of peanut butter

In the evening at 5 p.m. She has either boiled or rotisserie Chicken and Whole grain Rice. About 5 ounces, and ľ cup of that is the rice, the rest is chicken.

As far as other snacks she gets one (good girl treat) mini milk bone biscuit after each insulin shot and each time I do a blood test.
To the best of my knowledge the milk bone mini’s do not have any sugar.

We have only recently been doing her blood tests on our own. In the first few months we were testing with the urine sticks every time she went out to pee (Bayer Diastix). It cracked me up, as it did the neighbors as I followed her around with a ladle. (At least there was some entertainment with this dilemma).

Macy was on 4 & 4 units and being tested at the Vets every couple of weeks and the readings were good to not too bad. 150, to high 200’s, she was always tested about 4 hours after her shot. The Vet always seemed confused at my records of what the Diastix were reading. He said the numbers were all over the place every time I showed him, and he said not to use them any more. So this is when we decided to bite the bullet and do blood tests. (And when if I had done my homework I should have gotten my first clue that he is not familiar with canine diabetes, but like I said, he had been our Vet for 6 years and we completely trusted him.)

Sometime in April her blood tests were not looking too good, and our Vet increased her dosage to five and five, and next blood test she was very low so it was lowered again. A BLOOD CURVE WAS NEVER MENTIONED OR SUGGESTED AT ANY TIME BY MY VET

Macy also had been periodic bouts with an upset tummy and not eating in the morning (therefore no insulin shot). I kept a record of how many days passed between upset tummy episodes and it went like this 2 days passed, then 10, then 2 then 5 then 5 then 3, then 4 then 10 then 17. The Vet insisted she must be getting into something, but my house is immaculate, and I watch them like a hawk on walks, and we play food police to make sure she only eats her food. (This should have been my second clue about my Vet).

I still was not doing any research on my own, but felt it was time to get proactive. I had never heard of a blood curve until recently. So the only ones I have are what we have done on our own. As of June 2nd we started using the Alpha Trak 2 to test Macy’s blood on our own. This is when we noticed how irregular her readings were and are in search of a “Canine Diabetes Vet” for her. I have contacted a few Vets Via E-mail requesting to know if they have had or do have any diabetic patients. None have responded. But we were referred this week by the Emergency Room Veterinarian to one that is only about 20 minutes from home.

Well Blood Curves……This is what we have. Remember we only started doing blood tests on our own recently.

6/8/14 The first “dry run partial blood curve” (Macy would not eat.
6 a.m. BG 65 YIKES! We gave her 1.5 cc of Kayro syrup and of course no insulin
7 a.m. BG 110 She had finally eaten and (probably a mistake) 5 units of insulin
9 a.m. BG 86
11:40 a.m. BG 233
4:45 p.m. BG 241
5:30 p.m. she ate her dinner and got 5 units of insulin

6/9 We tested her and her blood was in the 250 to 260 range, we only tested a couple of times
6/10 we tested twice BG a.m. 335 and p.m. 336 (insulin 5&4)
6/11 a.m BG 464 and p.m. 131 (insulin 5&4)
6/12 a.m. BG 388 and p.m. 391 (insulin 5&4)
The same amt. of food every day


6/13
4:40 a.m BG 351---5 a.m. 5 units
9:30 a.m. BG 113
12:20 p.m. BG 47 YIKES 1.5 cc. kayro
1:35 p.m. BG 172
5:10 P.M. BG 375---5:30 p.m. 4 units insulin
10:20 p.m. BG 392




6/14
5:30 a.m. BG 234 (my poor pup is feeling like a pin cushion)
7:30 a.m. BG 287
9:30 a.m. BG 228
11:30 a.m. BG 350
1:30 p.m. BG 474
2:00 P.M. BG 581 ---OMG---LEFT FOR EMERGENCY ROOM
3:30 TO 4 P.M. E.R. BG 403 E.R. Vet thinks it’s bad insulin, said to start fresh insulin and wait a couple of days and do another curve.
5:10 p.m. BG 355
8:30 p.m. BG 235



6/15
BG’s 5 a.m. two readings 386 and 436 ???
9:30 a.m. 349
1:15 p.m. 408
3:30 p.m. 307
8:30 p.m. 223


6/16
5 a.m. 434
8:45 a.m 205
12:30 p.m. 311
5:15 p.m. 443

6/18
5 a.m. 395
5:10 p.m. 68 – 1.5cc’s Kayro, no insulin and she would not eat, so I made her a scrambled egg and she ate that
8:45 p.m. 383


I take her out to play catch 2 to 3 times a day for only 10 minutes at a time because she limps for days if she overdoes it. (she loves it when she is feeling well). Also 2 - 15 to 20 minute walks

I know this is a lot to read but I tried to give as much info as possible. Thanks for your help!!!!!!!!!!...... Ellen (Macy's Mom)

Last edited by 13409whitby; 06-17-2014 at 06:10 PM. Reason: missing info
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  #8  
Old 06-17-2014, 08:13 PM
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amydunn19 amydunn19 is offline
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Default Re: YIKES! My Pup's blood sugar is 68

Welcome!

I would try to make those two meals exactly the same if possible. I think that you have two different types of meals and that is impossible to balance.

Was she started at 4 units? I suspect that she may be in an overdose situation, which can manifest in wild swings in blood sugar. I would take your dog down to a reasonable starting dose and start over with slow raises based on curves.

Honestly, there are some good vets out there with diabetes but for the most part, if your dog isn't a textbook case, they don't know what to do. Look for an internal medicine specialist. They should be pretty well versed in diabetes. You will still do most of the heavy lifting here and you have a great meter so we can probably help you work out of this.

It is already impressive you are taking initiative to home test without much help.
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Old 06-17-2014, 09:04 PM
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Default Re: YIKES! My Pup's blood sugar is 68

now just a 10 minute playtime can drop blood sugar substantially during active insulin . a test before and after can see how your pup does with that .

i share the concerns with amy and your pup maybe overdosed . the problem with the possibility of passing the dose that is needed . most times the reason was dose adjustments were based on just one number and not curves . sometime we just move to fast not giving the body a chance to get use to the new dose adjustment ..

its maybe a good idea to kind of start over as far as dosing . the insulin looks to be just fine just to much . the question is how much to reduced . if your feeding 2 different meals it may require 2 different doses and you may have to do all night curves to establish the patterns for both meals . thats kind of what amy is saying about keeping everything the same . not saying it cant be done but it involves more work and research to establish those 2 meals will work with insulin which you will have to establish a dose for the 2 different meals but you never know things may work out the same

i would never tell anybody that its impossible what you are doing and it wont work because my jesse ended up on a unorthodox routine but you should understand what your up against

you may want to drop that dose down to maybe 2 units. seeing anything below 100 i would not hesitate to lower the dose further . just to give some perspective my jesse cant have more than 3 units at shot time and she is a 30 pound beagle so some dogs need allot less insulin than what a normal starting dose based on weight would be and i have seen many on the forum that ended up on that lower dose .

its really not complicated you let the dose settle for 5 to 7 days . do a curve, and evaluate on how you would like to proceed . at this point you dont want anything below a 100 and would prefer all numbers above 150 . seeing numbers in the 200s for the most part of the day would be great . you just want to stabilize things . remember we base dose adjustments on the lowest number in a curve not the highest or average and NEVER on just one number.

its great your testing . the numbers you posted it appears you dog has the potential for pretty good regulation in the future
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Old 06-18-2014, 07:55 AM
13409whitby 13409whitby is offline
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Default Re: YIKES! My Pup's blood sugar is 68

OMG!! It is such a relief to hear the voices of experience. Things that I would never have thought of on my own make such perfect sense. I am actually in tears!
I am definitely going to try feeding her exactly the same morning and night. Since I think she absolutely needs the W/D and loves the Chicken and Rice, I will try mixing them both for morning and night meals. I hope she approves and eats it ☺


As far as the possibility of being in an overdose situation, that REALLY seems to make sense also. But I have to admit I am terrified of the high numbers, even though I know the lower is more dangerous.
I think we will lower it to 3 & 3 and keep an eye on her BG every 2 or 3 hours for a day or two, and if any of the numbers drop below 100 lower it to 2+2. PLEASE PLEASE FEEL FREE TO COMMENT IF YOU THINK THIS IS WRONG.

On 5/21 Macy saw another Vet at the same Vetís office, and he increased her a.m. dosage to 6 units, since he thought her numbers were high. We did this for 5 days. We were very uncomfortable with this and changed her back to 5 & 4.

At the time (Early May), we had just started testing twice a day, before meals and insulin with a Reli-On Confirm. We had the Vet test her with their Glucometer (Assure Pro-BG 294 and our Reli-On BG 316) so the difference did not seem significant.

(WRONG!!!! We started a comparison routine 6/2 Reli-on vs. Alpha Trak . Over 40 tests. The differences ranged from the Alpha being + 9 to +144). So much for trying to save money.

As far as the exercise, (Playing ball). I never tested after her playtime, I did think it would affect the numbers so only tested her before. I thought it would raise her BG because of the excitement. I will test both before and after soon just to see how it affects her. But as much as she loves (more like is obsessed with) her ball playing routine, she is not interested when her numbers are off.

AGAIN, THANK YOU ALL SO MUCH FOR YOUR HELP AND SUPPORT. I have been a total wreck, not knowing where to turn. With the Veterinarians seeming to be floundering as much as I am, and even the Emergency Rooms Glucometer, being wrong. I didnít know who or what to trust. I have actually been having nightmares. I am going to contact the closest Veterinary College and ask if they can recommend someone that specializes in internal medicine.
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