Decker made his journey to the bridge Jan 26, 2013

[momofdecker]

Hi! I'm new to this. I have a 98 pound black lab mix, Decker, who was diagnosed with diabetes in early November. The vet suspects we caught it very early on as he was in the 250 range when it was caught. Decker seems to have gone through a two week 'honeymoon' phase which which we suspect has come to an end. The vet recommended that Decker be given 40 (Humulin N) twice a day. He is tested at 6:30a and 6:30p. The last couple of weeks his numbers have been all over the place. Last week we he finished his first bottle of insulin and we suspect that the potency may have decreased as the shots did not seem to bring his numbers down (was in the 500-600+ range). Using a new bottle has shown reduced numbers - however they seem to be extreme. Yesterday morning he was 72 and the evening he was 21. (We suspect the meter is a bit off as he did not show any signs of his sugar being too low). Yesterday he also drank three bowls of water between 6:30a-8:30a and three bowls of water between 5p-9p at night. Because of the heavy drinking he is waking us up at night and having accidents at night and during the day. My husband & I both work full time and have to had to lock him in the basement during the day because it is easier to clean up the concrete floor rather than the carpet. This morning the meter read 'hi' which means he is over 600. Finding this process to be very frustrating.... Hate having to lock him in the basement (also have a 10 year old mixed breed who gets locked in the basement with him so he doesn't stress too much.) Both have had run of the house since they were about 1.5 years. Looking like we may have to start locking him in the basement at night too if we can't control the potty accidents... Starting to wonder if there may be more going on with him...Looking for any thoughts, suggestions, etc... Thanks!

[k9diabetes]

Re: New to doggie diabetes

Yikes... 40 units is an awful lot of insulin for a 98 pound dog who has only recently maybe come off of a honeymoon. It sounds to me like you need to REDUCE Decker's insulin dose right away. He could be in Somogyi rebound:

http://www.caninediabetes.org/pdorg/somogyi.htm

The water and urination would come naturally from having such high blood sugar. If in fact he's rebounding, reducing his insulin dose will actually improve his blood sugar.

It also would be very helpful to do a full curve as soon as possible to see what his blood sugar is doing throughout the day.

I would cut his insulin dose back substantially as even most large dogs don't wind up on that many units of insulin. Maybe down to 30 units per injection and check as often as possible to see if that is enough of a reduction and whether less insulin improves his blood sugar.

I might even go down to 20 units... I'd look for a place that's not enough insulin and then work up very slowly to the correct dose.

Natalie

[k9diabetes]

Re: New to doggie diabetes

If Decker had just been diagnosed and wasn't honeymooning, I would want him to have started on around 15 units of insulin per injection. I like a 1/5th unit per pound ratio at most for a starting insulin dose so that would be 20 units.

So I really think I would cut down to 15 to 20 units and "start over" as the 40 units is very very likely to be way too much insulin.

Natalie

[CarolW]

Re: New to doggie diabetes

Hi Decker's Mom - so glad you found us.

I totally agree with Natalie; considering Decker's BG (blood glucose) numbers, it looks as though he's rebounding, and if he were mine, I'd immediately follow Natalie's suggestions.

Here's a Big, Fat Welcome to you, to this finest of forums on canine diabetes!
Tue, 13 Dec 2011 18:09:25 (PST)

[ozzi]

Re: New to doggie diabetes

Welcome!

I just wanted to underscore what Natalie said. She has a LOT of experience in this. I have to say with my limited experience, I was SHOCKED to see a 98 pound dog on 40 units of NPH! I agree that really does seem to be way too much and is probably responsible for the crazy numbers. That amount of insulin will drop his sugar so low that his liver sends out glycogen to dramatically increase it, hence the lows and highs.

My vet started Ozzi on 1/4 unit per pound and he was diagnosed with a blood sugar in the 600's. I titrated up SLOWLY to get his correct dosage and it took several weeks. With honeymooning, Natalie is right about getting him down to about 20 units NPH twice/day and then increasing slowly.

You can imagine how he must feel with such low sugar, then sky high sugar, then low sugar again. It's a vicious cycle that really causes a lot of stress on the body.

Please keep us informed on his progress. You will see how much better he will do on 20-25 units as compared to 40. He will most likely need more insulin as you adjust him, but I bet he won't need as much as 40 units, although every dog is different.

I promise that when you get his sugar in better control, his accidents will go away, and no one will need to be locked in the basement! Are you home testing? I think it's crucial that you learn if you're not. Your dog will love you for it!!

Best Wishes,

Kevin

[jesse girl]

Re: New to doggie diabetes

those are some scary lows with high dosage

from what i have seen maybe anything under a 100 might be 30 points off but for my jesse i treat anything under 80 as low blood sugar and anything under a 100 is reality for me as far as the reading i get

wide swings in blood sugar especially if increasing the dose sees more erratic numbers for what i have seen with my jesse is an overdose of insulin .

I think natalie makes some good points and a reduction is warranted without even reading her post 20 units popped into my head also as a more reasonable dose or lower

you must dose for the lows and the lows you have posted are borderline to a hypo incident you may not see any symptoms before the event begins

as natalie suggested high doses of insulin could lead to a response from the body to protect itself with the bodies storage supply of sugar if this supply runs out there is no way for the body to protect itself and if there is no one home to intervene for the body with some karo honey some kind of liquid sugar well hopefully you will not get to that point.

we are not here to frighten you but there is a reality to this disease that the forum has seen time and time again and specific protocols set in place helps to protect the dog and hopefully leads to better regulation

i would reduce the dose see if the drinking and urination subsides a bit test at fasting (wright before food and shot ) and do a full curve this weekend and if you could post the numbers that you get and maybe we can give you some suggestions on how to proceed .

from what i have seen with the honey moon period it can come and go as far as needs for insulin . so you have to proceed cautiously when raising the dose

welcome to both of you and you can definitely improve things for your baby but first you have to determine the correct dose that will not lead to low blood sugar

[ozzi]

Re: New to doggie diabetes

I don't know if your vet mentioned the importance of feeding Decker only twice/day with insulin injections, but mine did not, and Ozzi had lots of crazy numbers with free-feeding. I wanted to mention this in case you weren't aware of the importance of the food-insulin balance, which sadly I was not. Once I started feeding Ozzi twice/day, I was able to get him regulated with the help of the people in this forum.

This is the best place for you to be and we will all be looking forward to updates. Don't be discouraged, his behavior and accidents will dramatically improve with glucose regulation. Stay close to the forum and we will all help you.

Kevin

[MaryLea]

Re: New to doggie diabetes

Hello and welcome to the forum! You have found a good support group; the best of its kind on the internet, we believe.

I agree with the others that Natalie gave good advice. She always does! Although she's not a vet, she gives great advice and has much experience. Our little Ruffles was about 15-16 lbs. and her beginning dose was 4u twice a day (about .25u/lb.). I think most vets begin somewhere in that range.

You must have a way to test or you would not know he was in the 70s or 20s. What are you using? The more information you can give us, the better.

Will be watching your thread. Glad you are here.

Mary

[Shellie]

Re: New to doggie diabetes

Welcome! You found a great place to get the help you need! We've all been there and know what you are going thru!

I also agree with Natalie...that dose seems VERY high! I started my 22 pound dog on just three units 2X a day and have slowly worked up to five 2X a day. With possible honemooning thrown in...def too high. His body doesn't know which end is up and you will very likely end up in a hypo sooner rather than later.

Did the vet explain what to do if he does have an incident? Or if you get those numbers under fifty? Most of use use Karo syrup under the tongue or on the gums followed by a sweet snack and then a snack of something long lasting. I use a chewy granola bar to bring up Hank's sugar when needed. He loves them and will eat the whole thing if I'd let him! lol But it's good due to the carbs AND the sugar...boost him and then keep him up.

Don't hesitate to ask any questions you may have...everyone here will answer to the best of their ability to help you!

Hugs!

[jim maceri]

Re: New to doggie diabetes

Hi and welcome to the forum.....I too was a bit shocked at the dose....I have a 125# Newfie who was diagnosed in late October. I started giving him 15u 2x per day at the direction of the vet. We are currently at 12u 2x per day and most of his BG levels are between 100-200 with of course some fluctuations on the high and low end. We too caught it very early since one CBC blood work-up showed everything normal and then 2 weeks later a urinary tract infection and another blood test showed him at 254......Thinking out loud here but with that much insulin for an early diagnosed dog it could be rebounding.

I am positive my dog is still "honeymooning" so the low dose will eventually come to an end but for now it is plenty with the exercise and food regiment he is on.

Lots of great info and support here but I would tend to agree with others who suggest to back down the dose and start again......

[farrwf]

Re: New to doggie diabetes

Hi and welcome!

Some great observations and suggestions have been made. You just may solve Decker's leak problem with a much lower dose.

Natalie's reco makes a whole lot of sense ...

"I'd look for a place that's not enough insulin and then work up very slowly to the correct dose."

[Judi]

Re: New to doggie diabetes

Something that was scary to me was talking to my vet on Monday, he went to a conference a year ago and spoke to 4 different endocronologists. All 4 treated diabetes differently but most of them didn't think blood glucose testing was important

One used a huge dose till the excessive urination went away. Which could be what we are seeing here.

I'm very grateful that both of my vets DO think BG testing is important. Especially when low blood sugar can cause seizures or death.

The folks on this forum have lived with canine diabetes for a long long time. I would strongly urge you to listen to their suggestions and incorporate them. You have to be the patient advocate for your dog. Not all vets fully understand this.

Judi

[ozzi]

Re: New to doggie diabetes

Amen Judi! I found the same thing with various vets, but was surprised to see that endocrinologists aren't exactly on board...ugh! Imagine telling a human that testing and BG aren't important! My vet's goal for Ozzi was to get his blood sugar to around 300. After coming here, I mostly had him between 100-200 all day and brought her glucose curves that she couldn't believe! I remember thinking that we can all change canine diabetes care and management, one vet at a time!

I do hope we get an update on Decker today...I actually woke up this morning worrying about him.

Kevin

[jim maceri]

Re: New to doggie diabetes

I just remembered that my vet during the two day stay over used a VERY HIGH dose to get his sugar down during the day he was there and monitoring. It went from 313 to 50!!!!! but he only did that with one shot and watched him very closely...then he went to 30 units, 20 units and sent me home with the direction of doing 15 units.....maybe my vet or many vets subscribe to that policy of large dosing to get the bg down.

[momofdecker]

Re: New to doggie diabetes

Thank you all so much - This forum has proven to be extremely helpful already! Your feedback and quick responses are greatly appreciated! I have actually taken a few sporadic days off from work to be home with Decker because I've been so worried about the low numbers. I was shocked (in a good way) when I read Natalie's reply. I've been doing a lot of reading about diabetes (have no prior experience with it - human or animal). I had not come across the rebounding information. Once I read it I called my husband in to read it as well...it does seem to describe a lot of what has been happening to Decker. Last night he tested at 41. We do keep Karo syrup in the house and he gets some on his gums when his numbers are under 70. We also give him a bowl of food, some frozen veggies or some hard boiled egg (minus the yolk) as well. He tested at 580 this morning and got a shot of 20. I am interested to see what he tests at tonight. Decker is fed twice a day and I try to leave food in his dish so he can 'snack' throughout the day, however, when he sees the food in his dish he eats it right away. Prior to this happening he was a quite a spirited, high energy dog who loved to be in the middle of everything. This has taken a toll on him physically as he has a hard time with his back legs getting up and down and it seems to have broken his spirit as well. It has been obvious he does not feel well because he has not been barking, playing, chasing the cats, harassing the 10 year old dog, swiping the daughter's toys, etc.. I really miss his spirit and hope to get him to a point where he has a good quality of life. Thank you all again!