Yuki has crossed the bridge Dec 2020

[Raysaint]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Make sure the dog food has some carbs in it. The insulin is going to metabolize carbs, and if there isn't enough carbs, the liver can start releasing glucose, which can make BG numbers higher.
You must have enough carbs to balance with the insulin dose.

A high protein, low carb diet doesn't work for insulin dependent humans or dogs.

[Judi]

Re: Diabetes, Cushings and Pancreatitis in my Dog

they are hungry when the diabetes isn't controlled and if it is cushings or like cushings, that makes them hungry too

the hardest part is being patient. It can take 5-7 days for an insulin change to acclimate in their body

if they have any ear or tooth infections that can raise blood sugar too

my Jenny's blood sugar barely budged for over 6 weeks when she was diagnosed. My vet didn't want to overshoot the insulin dosage so it just took forever

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Yukonis on the Royal Canin hydrolized protein dog food right now. I was reading about the Royal Canin glycobalance dog food for diabetes.

Has or does anyone have their dog on this food or know anything about it? I am thinking about switching over to this food.

[MikeMurphy]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Yukonis on the Royal Canin hydrolized protein dog food right now. I was reading about the Royal Canin glycobalance dog food for diabetes.

Has or does anyone have their dog on this food or know anything about it? I am thinking about switching over to this food.

I’ve never used it, but with the glycobalance having less fat, more protein and more fiber than the Hydrolyzed, it should help to manage the pancreatitis.

There are so many possibilities for diet. I’ve found that low fat, moderate protein and moderate fiber works best for my dog.

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Hi Everyone, I am getting a little discouraged because Yukon has been on the Insulin for 10 days now and his Blood Sugar is not going down at all - in fact today it started at 543 at 6:30 a.m. then I gave him his meal and insulin and took it again at 12:00 p.m. and it jumped to 567.

I spoke with the Internal Medicine assistant (we have an appointment on 10/29) and she said that there could be various things that are not allowing the insulin to work in his body. Mentioned it could also be some type of stomach or bowel inflammation since they did suspect IBD in the past.

She told me that his sugar levels should be coming down some and the fact that it is not signals there is a problem.

Has anyone experienced this with their animal? Where the blood stayed the same for almost 10 days?

I hung up so upset and discouraged :-( Am I feeding him too much? He is begging for food and I only give him almost a cup of the Hydrolized Protein with some boiled chicken twice a day.

[Raysaint]

Re: Diabetes, Cushings and Pancreatitis in my Dog

If you are newly diagnosed and just starting insulin, the starting dose is usually pretty conservative and won't cause great changes in BG.
THIS TAKES TIME.

It took me a year to reach good regulation. I had lots of weird periods that defied expectations. It takes a while for the body to decide how it wants to respond. Curves will change, nadir times can change. And dogs can handle high sugar for a time, while you slowly figure out dose, patterns, foods etc.

Higher sugar 6 hours after eating and insulin, why can't that happen? My dog's curve pattern has changed 3 times, from a bowl, to a half mountain, and now back to sort of a bowl.

Please don't expect textbook results.

[jesse girl]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Just to give some perspective it took jesse about 6 months where i considered her regulated but she was difficult for whatever reason

543 and 567 is basically the same number because of the variables of handheld meters especially at a higher range . Now if it was a 100 points lower or higher you may be able to draw some conclusion or if you dog was in the 100s and numbers with a 30 point gap you maybe able to draw some conclusion but not in the 300s or higher

basically at that point in time between those two tests you are seeing resistance in the 500s and if thats the trend throughout the day . Now that maybe because your not giving enough insulin or other medical issues or a combination of both .

Remember full curves are the only way to know how to go forward but spot tests are helpful taking them in a full context over time .

[MikeMurphy]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Right... don’t get discouraged. If Yukon is still on 5 units, that’s below the normal starting dose of 6 units for a 32lb dog.

Are you planning a full 12 hour curve soon?

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Hi,

We were supposed to have the Glucose Curve again tomorrow, but my vet said not to do it because it is still in the 500's.

She wants me to do a blood glucose test 3 times a day for a couple days and see what the results are. Starting today I will be doing the glucose test at 6:30 a.m., 12:00 p.m. and 5:00 p.m. and tracking it.

She said to give it a few days and then she would decide whether to increase his insulin or not.

I am just concerned that it was under 500 when he was diagnosed and now all of a sudden it is sometimes almost 50 -75 points higher. But mostly I am concerned of the long term effects of high blood sugar on his organs.

According to the Emergency Vet they said not to mess with the dosage - the opposite of what my vet is saying. She told me that even if he was on a low does, it would have lowered the Sugar a little and not keep it at the same level.

I am so leary about those 24 hour Emergency Care vets. Seems like all they want to do is give you a price list of how much it is going to cost you and they don't actually care about your dog.

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

So Yukon's primary vet has basically just given up on him. Texted me back and said it sounds like he is not responsive to the insulin. She knows he didn't do well on the trilostane but she wonders if he is not responding well to diabetes treatment because his cushings is a factor. Said she wasn't sure what to tell me - I probably need to go see and Internal Medicine doctor.

I have been doing some research on the internet and one thing that stood out to me is that Melatonin could possibly interfere with the positive actions of insulin.

Has anyone heard of this? Yukon is on 3mg of Melatonin 2x a day for his Cushings. I am thinking about not giving it to him for a while to see if the levels go down.

[Judi]

Re: Diabetes, Cushings and Pancreatitis in my Dog

I think you definitely need to see the internal medicine doctor. When Jenny was diagnosed with Cushings my vet at the time told me it was too complex for him to handle and referred me elsewhere. I was hurt but in the end, he was right.

Yukon needs a specialist. Can you check with the Cushings forum people to see how much it might hurt giving up the melatonin

Jenny had to take prednisone for awhile which can raise blood sugar, so we just increased her insulin. Your goal is to find an insulin dose for his current situation. if he needs the melatonin, you need to find an insulin dose to offset it.

Seriously, I looked at jenny's old records. We spent $1,200 on curves at the vet before her sugar moved much at all. I'd be all excited, go in and they'd tell me no movement.

you can do this. See if you can get in to the specialist earlier. Judi

[Raysaint]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Hi,

We were supposed to have the Glucose Curve again tomorrow, but my vet said not to do it because it is still in the 500's.

She wants me to do a blood glucose test 3 times a day for a couple days and see what the results are. Starting today I will be doing the glucose test at 6:30 a.m., 12:00 p.m. and 5:00 p.m. and tracking it.

She said to give it a few days and then she would decide whether to increase his insulin or not.

I am just concerned that it was under 500 when he was diagnosed and now all of a sudden it is sometimes almost 50 -75 points higher. But mostly I am concerned of the long term effects of high blood sugar on his organs.

According to the Emergency Vet they said not to mess with the dosage - the opposite of what my vet is saying. She told me that even if he was on a low does, it would have lowered the Sugar a little and not keep it at the same level.

I am so leary about those 24 hour Emergency Care vets. Seems like all they want to do is give you a price list of how much it is going to cost you and they don't actually care about your dog.

When a dog is first diagnosed, he can still be producing his own insulin, so BG could be a bit lower than now.

Your dog will probably increase 4-6 units before you see decent numbers. If you have a meter, do the curves at home. You're looking for the lowest number in the 12 hours, that tells you if there's room to increase insulin. Increase by one unit, then curve, increase, repeat.

Dogs do OK organ wise with high sugars for a while. It's built into them, knowing it takes a while to regulate a dog. Don't worry about that.

I'd increase his insulin now, knowing he's under-dosed. You're early in the game and anyone here will tell you this is how it goes. Believe it or not, you dog seems typical for the most part.

I'm not sure how Cushings impacts it, but dogs do manage with both.

My biggest fear for you right now is inexperienced vets, giving poor advice.

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

I truly feel so much better when I write and talk to all of you . I googled all the Meds Yukon is on and tried to figure out if they interact with insulin.

When I got to the melatonin and there were many articles. One article stated that melatonin binds two receptors on pancreatic cells to suppress insulin secretion. This causes them to be more sensitive to the effects of melatonin which results in an exaggerated inhibition of insulin secretion. That makes their bodies less effective at regulating blood sugar levels.

Yukon it's on 3 mg of melatonin twice a day for his Cushing's. We give him the melatonin within an hour of his insulin injection. It picked my curiosity and I called the University of Tennessee to see if maybe they knew anything about melatonin and insulin problems.

I spoke with someone there and he said they didn't have any conclusive evidence but they had heard of many dogs that are having issues with melatonin and diabetes.

So for now I'm taking him off the melatonin. His BG reading at 5 o'clock was 386 which puzzles me but I love it.

I have also made an appointment with an internal medicine doctor on October 29 to evaluate and hopefully advise what needs to be done as well as far as the Cushing's.

[labblab]

Re: Diabetes, Cushings and Pancreatitis in my Dog

I’m really glad you’ve made the appointment with the internist. Yukie’s situation is complicated enough that guidance from a specialist should be very helpful!

In all my years on K9C, I don’t know that we have ever discussed the impact of melatonin on diabetic management. In honesty, I can probably count on one hand the number of dogs on our forum who have presented with the dual diagnosis of “Atypical” Cushing’s as well as diabetes. As I’ve talked about before, it’s the combo of the elevated cortisol of traditional Cushing’s and elevated glucose levels that we commonly encounter. So Yukie’s situation is a bit of a new frontier for us all.

Given Tennessee’s anecdotal report of melatonin complicating diabetic management, I believe I’d stop it, too. Partly because its efficacy in resolving Cushing’s-like symptoms is hit-and-miss even when diabetes is not involved, and partly because I don’t think it helps with lowering progesterone/17-hydroxyprogesterone levels (which sound to me to be the most worrisome elevations in Yukie’s profile in terms of insulin resistance).

Please bear in mind that all of this is largely supposition on my part. I’ll feel a whole lot more comfortable when you can get some professional feedback from a specialist. In general, there remains a lot of controversy about the significance/impact of elevated adrenal hormones other than cortisol, and the “Atypical” diagnosis is not one that is even universally recognized among endocrinologists. So this is a long-winded way of saying that I’d probably ditch the melatonin right now, too, if there’s any chance that it’s interfering with the insulin.

Looking ahead, if elevated adrenal hormones — including cortisol — do seem to be complicating things for Yukie, there is a medication alternative to Vetoryl named Lysodren. It’s an older medication and is no longer used as frequently as Vetoryl to treat traditional Cushing’s. But unlike Vetoryl, it has the ability to lower several of the other adrenal hormones, including progesterone, as well as cortisol. So it is much more powerful than melatonin, and might be considered down the road.

By the way, good job for researching the possible link between melatonin and insulin resistance! This may be very helpful information for all of us on K9C.

Marianne

[Raysaint]

Re: Diabetes, Cushings and Pancreatitis in my Dog

"When I got to the melatonin and there were many articles. One article stated that melatonin binds two receptors on pancreatic cells to suppress insulin secretion. This causes them to be more sensitive to the effects of melatonin which results in an exaggerated inhibition of insulin secretion. That makes their bodies less effective at regulating blood sugar levels."

This info probably applies to a non diabetic, with the pancreas still producing insulin and regulating sugar. Once the pancreas stops working to produce insulin {diabetes), I don't see how anything can affect pancreas insulin secretion.