Mik is gone...

[robertpri]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

"Am going to suggest something because you are on the once a day plan-do you think it would be easier for you to try moving Mik's once daily to the afternoon or early evening when you're going to be at home?"

Yes, that is my desire, but I fear leaving him for 6-7 hours with no insulin in his system. It would be FAR better for me to administer and monitor, but I'm afraid of leaving him without insulin.

Of course, being zonked out, I cannot see behavior or use a test strip.

As I noted, Karen had 13 years to train these guys that they don't eat until noon. I have never understood how she did this, but 33 years of 5 dogs was the same. They don't even get up until 11 or so.

[robertpri]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

"We did these tables of insulin starting doses recently. They're based on starting insulin at 0.25 to 0.50 (1/4 to 1/2) unit of insulin per 2.2 pounds of body weight. "

This has been discussed here, and I'm kinda stuck. The Vetsulin site calculations is 1 unit per kilo or 5 units a day. I was going to give him 1 unit, if he eats.

[We Hope]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

http://www.vetsulin.com/PDF/Vetsulin...tor_Letter.pdf

Vetsulin-Page 1

"The revised starting dose for dogs (0.5 IU insulin/kg body weight) is based on the average dose required to maintain adequate control in the original approval as well as in current recommendations in literature."

This Vetsulin dosing change was made last year--in early 2008.

http://www.intervet.com.au/binaries/82_103335.pdf

Intervet, Australia-Caninsulin Page 6

"The starting dose of insulin is 0.25-0.50 units per kilogram, twice daily-rounded down to the nearest whole unit."

http://www.anibrands.com/vitabone/ingredients.htm

Vitabone ingredients:

"Wheat Flour, Poultry Meal, Ground Wheat, Ground Corn, Corn Gluten Meal, Animal Fat (Preserved with BHA), Fish Meal, Brewers Dried Yeast with Molasses and Yeast Extract, Salt, Calcium Carbonate…"

Mik's Vitabones qualify as a complex carb; you can also find out how many carbs are in the baby food by reading the label.

Kathy

[robertpri]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

OMG! The paper that came with the vetsulin says 1 unit /kilo! That's double what this letter says!

Scheesh--thanks. You can be sure I will discuss with vet.

Good news on vitabones--!

baby food says

carb= 9g
fat = 1
sodium = 20
fiber = 2
sugars - 3
protein = 2
potassium = 200
calories = 70

this is per jar. Best I have ever done is about 1/2 jar, so half of those numbers.

[We Hope]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

Robert,

When you read the "Dear Doctor" letter further, it will tell you that some packages were shipped with the old instructions in them and that they obviously will be available until those with the old ones are gone.

But they did instruct the vets to go with the 0.50 IU per kg despite what the package insert says.

Hope this helps!

Kathy

[robertpri]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

It helps a great deal! thanks

I faxed that letter to vet, but he is difficult reach in the am. will call him later.

Meanwhile, plan B: if little or no meal, then it's .5 unit for this am.

[We Hope]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

I agree with what you want to do if Mik doesn't eat or only picks, and that you and the vet need to talk about the letter and how those dosing changes can affect Mik's daily dose.

While we all want to see Mik's numbers come down and do that as fast as possible, we sure don't want it at the expense of a hypo.

Kathy

Adding here--when we looked into Caninsulin/Vetsulin for Lucky, part of what we looked at was their 1 IU per kg dosing scheme (had only that at the time). Had we gone with it, it would have worked out that we would have been starting him on more insulin than he wound up regulating very well on, which was just slightly less than 1 IU per kilo.

[robertpri]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

How dramatic!

Old news to you guys, but this was my first shot.

Feels like a space launch!

Skinny and so little body fat, it was a challenge to pinch right, and a few false efforts, but finally got it.

Whew! Yes, I know it will become simple...thanks!

measuring .5 unit is tough--the syringe dividing lines are so close

add:

he did eat about 20 little pellet things that I had bought for a treat. would not touch anything else. Pellets are about 1/2 the size of a child's marble. I will go to that store tonight and see what's in them. The details were posted but I failed to write them down.

Mik went back to bed, as is normal.

Off to work--many thanks

[We Hope]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

Robert,

If you think getting a half unit on a U 40 syringe is tough, it's even harder with the U 100 ones (for NPH and the like) if you're not using the 3/10 cc syringes with half unit markings.

At one time, I had to do both--was a lot more comfortable with doing it on the U 40 ones than the U 100's!

Step by step, you'll both get there!

Kathy

[ladysmom06]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

Hi Robert,

Nothing to add - just wanted to welcome you to the board and wish you luck with Mik.

Luv,
Lynne and Lady

[k9diabetes]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

Have been trying to be a good patient and elevate my ankle so haven't been around much today. Glad to see you are getting lots of good input!

Natalie

[robertpri]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

Wow--installed something and my post went away. Sorry if this doubled.

Came home and Mik seemed okay, not better, but OK.

He ate his dog food [surprise] and then I gave him the remainder of his daily dose or 2 units, making 2.5 for the day.

Later urine test shows

ketones = negative
glucose = around 250, but hard to say with those test colors so close. But it's WAY better than last night!

Talked to vet and knowing my horrible work schedule and Mik's non-existing morning appetite, suggests that I might try the once/day insulin regiment, but if not, then 25% in the am and the balance when I get home.

many thanks to ALL for the support and knowledge on this forum!

[peggy0]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

wow Robert what a turn around That's great news!! Congratulations

[We Hope]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

Robert,

You're fine--we got only the one post.

It sounds like Mik has had a LOT of improvement in the last day! With him now getting insulin regularly and no more ketones, he's feeling better.

When they're so high, most of them don't want to eat, which is really tough because without eating as you know, they can't get their full dose of insulin. Of course, leave it to mine to have been so high before pork insulin and to be so hungry, he could have eaten the furniture if it wasn't a LOT bigger than him!

The insulin has done a tremendous job with bringing down those "red hot" results you were getting on the ketodiastix. With the results you had tonight, I'm so glad you had a word with the vet and Mik's daily dose has been cut--I would worry that a total of 5 units might mean he could have a hypo; he's come down so far and so fast.

If Mik wasn't feeling better, I don't think you would have had a "taker" for plain old dog food!

I think what your vet has said about the 25%/75% dosing depending on Mik's eating habits is a good one. It makes sure he gets enough insulin in the morning to take care of his body, but not too much so he goes hypo without having eaten enough food. It also has you at home when the larger dose is given, so you can keep an eye on him.

Maybe NASA ought to give you a job offer since it seems you have a real knack with "launches".

Kathy

[robertpri]

Re: Mik: 13 yr old Shih-Tzu: importance of scheduled meals & insulin?

Thanks all!

I knew that I would be home late today [5 is late for me] but this job is not X-o'clock to Y-o'clock. I respond to the site situation, and impossible to predict. I could go in at 7am and be done by 10, or get stuck for 10 hours.

This was another reason I want to give Mik a small does in the am. I figure 25% [or 1/2 unit] is about as low or find as I can measure.

He is barking like crazy now, demanding something, which I never figure out. I have about five choices of food and he wants none of them right now.

Still, his barking is music to my ears...