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Hello everyone. I am so relieved to have found this wonderful site. I know this will be long but anyone who would be willing to read my story and provide some insight, I would really appreciate it. I am the mother of a newly diagnosed, diabetic, 6 year old, neutered, male Maltese named Mister Pillow Puff-E-Lumps, but I just call him Lumpy, well most of the time....I also call him my Little Lamb, Bubbie Bear, Buttercup, and a host of other names, depending on the day and my mood. :-) I haven't ever been able to have any children, I have had 13 miscarriages, so he is like my son, for real. 
He was diagnosed 2 weeks ago on Friday, July 22, 2015 when we took him in due to vomiting and diarrhea, which we thought was the flu, but it turned out that he was in DKA and very sick with diabetes. We were in for a rude awakening and a HUGE $5k hospital bill to get his DKA under control. Here is the story:
We took him in for an appointment thinking he had the flu. He had lost from 16 pounds down to 13.6 pounds since his last visit to the groomer 6 weeks prior so we knew something was really wrong. After blood work on Thursday at his vet appointment, we were called back in on Friday to go over the results. His blood glucose was 687 so they were confident he was diabetic, his electrolytes and other blood work was off and they were very worried about DKA due to the weight loss so they suggested a urine test to check for ketones and that is when everything changed. The test came back very positive with ketones showing moderate/large amount in his urine. The vet explained the seriousness of the situation and suggested we have him admitted for round-the-clock care and said if we took him home and tried to do it ourselves, we had a 50/50 chance of him making it. I was devastated and clueless about how to care for him so we took out the credit card and paid whatever the cost to have him cared for. He was admitted to the 24-hour hospital on Friday, July 23rd in the afternoon and they slowly brought his sugar down over a 48 hour period. I was devastated and did not sleep or eat the entire time he was in the hospital. All I kept hearing my vet say was 50/50 chance and I was just sick with worry. The hospital said he was doing very well, acting normal, and that was a great sign that he was going to pull through. When we brought him home on Sunday, he had just been started on 1.5 units of Novolin N every 12 hours and his ketones were still reading trace/small but they were much better than before.
The first week home, we gave him 1.5 units every 12 hours with exactly 5 ounces of Hill's Prescription W/D food, mixed with 2 ounces of Cesar's Chicken and Cheddar Souffle (this is his normal food and he refuses to eat the W/D without some Cesar's mixed in so the vet said to mix some in so he would eat) He eats every 12 hours, 30 minutes before his insulin. At this point, he was still testing trace/small ketones every time I checked, which was several times a day because I am neurotic like that. I went through 40 ketone test strips the first week. I also bought the Bayer urine glucose test strips and his levels were 2000+, the highest brown level every time I checked, which was also several times a day.
On day 7, we took him in for his first glucose curve and the results were not good. He was pretty much in the mid to low 400's all day long with not much of a curve at all and the lowest reading was 427. The Dr. told me to double his dose to 3 units every 12 hours with the same amount of food, every 12 hours. She said the small/trace ketones were to be expected and not to worry unless the stick turned darker than small or trace while were are working on getting his insulin dose regulated. So 6 days ago, on Monday, August 1st, we upped the dose for the first time on his evening dose to 3 units. That night, I check his BG at home with the Alpha Trak monitor I bought and the results were 468. I was discouraged because with double the insulin, I expected a lower number but our vet said it can take a week or so for his body to regulate to the new dose so I tried not to let it worry me too much. The next evening, I checked again and was surprised to see the reading was 102 at 4 hours after his insulin the second night. The next morning, right before insulin on the 3rd day after the increase, his BG was 501 and I started feeling defeated again. I tried not to check his BG at home too much because our vet said unless he is showing signs of low blood sugar, we should only test then, until we get his dose more regulated.
To make a long story short, on the 5th day of the increase (Friday) I started getting negative ketone tests and the urine glucose test started to show a decrease from 2000+ (the darkest level) to the middle color, then on Saturday (today) for the first time, his ketones were negative all day long and his urine glucose strips have been showing in the middle, and the last 2 tests showed negative for urine glucose. I have not tested his blood glucose but I am confident that the negative ketones and lower urine glucose levels are a good sign that the increase is starting to work. Would any of you agree with that?
I have another curve scheduled for Wed. the 10th of Aug. and I am hoping for a better result and that his sugar is starting to get under control. I love this dog more than I could ever explain. I am willing to do whatever it takes so he can live a long, healthy and happy life. For so long I thought I was showing him love by giving him lots of treats and whatever he wanted to eat, little did I know I was hurting him and for that, I will never forgive myself. It is hard to say no and see him want a treat so bad or food in the middle of the day, but I refuse to love him to death. I will be strong because his life depends on it.
My questions are:
If the ketones are now showing negative for the past 2 days and the past 24-36 hours his urine glucose is showing much lower levels, is that a good sign that the insulin increase is starting to work?
Is it normal for it to take close to a week for his body to start to respond to the increase in insulin?
In the beginning, is it normal for the ketone levels to be trace/small, until the dog's glucose levels are not in the 400's/high all the time? In other words, is it normal/typical that my dog still had trace ketones in his urine for almost 2 weeks after starting insulin and coming out of DKA? This worries me a lot because up until 2 days ago, he was still showing slight levels of ketones in the urine, although every day they stick was a lighter and lighter color and was typically only showing small readings first morning and then trace the rest of the day, until it was negative for the past 2 days.
I am so worried about him but reading this site makes me feel empowered and I have a good feeling about it. I believe with the support of others, I will be able to help my Lumpy make it through this.
Thank you all so much for reading and any insight would be greatly appreciated.
He was diagnosed 2 weeks ago on Friday, July 22, 2015 when we took him in due to vomiting and diarrhea, which we thought was the flu, but it turned out that he was in DKA and very sick with diabetes. We were in for a rude awakening and a HUGE $5k hospital bill to get his DKA under control. Here is the story:We took him in for an appointment thinking he had the flu. He had lost from 16 pounds down to 13.6 pounds since his last visit to the groomer 6 weeks prior so we knew something was really wrong. After blood work on Thursday at his vet appointment, we were called back in on Friday to go over the results. His blood glucose was 687 so they were confident he was diabetic, his electrolytes and other blood work was off and they were very worried about DKA due to the weight loss so they suggested a urine test to check for ketones and that is when everything changed. The test came back very positive with ketones showing moderate/large amount in his urine. The vet explained the seriousness of the situation and suggested we have him admitted for round-the-clock care and said if we took him home and tried to do it ourselves, we had a 50/50 chance of him making it. I was devastated and clueless about how to care for him so we took out the credit card and paid whatever the cost to have him cared for. He was admitted to the 24-hour hospital on Friday, July 23rd in the afternoon and they slowly brought his sugar down over a 48 hour period. I was devastated and did not sleep or eat the entire time he was in the hospital. All I kept hearing my vet say was 50/50 chance and I was just sick with worry. The hospital said he was doing very well, acting normal, and that was a great sign that he was going to pull through. When we brought him home on Sunday, he had just been started on 1.5 units of Novolin N every 12 hours and his ketones were still reading trace/small but they were much better than before.
The first week home, we gave him 1.5 units every 12 hours with exactly 5 ounces of Hill's Prescription W/D food, mixed with 2 ounces of Cesar's Chicken and Cheddar Souffle (this is his normal food and he refuses to eat the W/D without some Cesar's mixed in so the vet said to mix some in so he would eat) He eats every 12 hours, 30 minutes before his insulin. At this point, he was still testing trace/small ketones every time I checked, which was several times a day because I am neurotic like that. I went through 40 ketone test strips the first week. I also bought the Bayer urine glucose test strips and his levels were 2000+, the highest brown level every time I checked, which was also several times a day.
On day 7, we took him in for his first glucose curve and the results were not good. He was pretty much in the mid to low 400's all day long with not much of a curve at all and the lowest reading was 427. The Dr. told me to double his dose to 3 units every 12 hours with the same amount of food, every 12 hours. She said the small/trace ketones were to be expected and not to worry unless the stick turned darker than small or trace while were are working on getting his insulin dose regulated. So 6 days ago, on Monday, August 1st, we upped the dose for the first time on his evening dose to 3 units. That night, I check his BG at home with the Alpha Trak monitor I bought and the results were 468. I was discouraged because with double the insulin, I expected a lower number but our vet said it can take a week or so for his body to regulate to the new dose so I tried not to let it worry me too much. The next evening, I checked again and was surprised to see the reading was 102 at 4 hours after his insulin the second night. The next morning, right before insulin on the 3rd day after the increase, his BG was 501 and I started feeling defeated again. I tried not to check his BG at home too much because our vet said unless he is showing signs of low blood sugar, we should only test then, until we get his dose more regulated.
To make a long story short, on the 5th day of the increase (Friday) I started getting negative ketone tests and the urine glucose test started to show a decrease from 2000+ (the darkest level) to the middle color, then on Saturday (today) for the first time, his ketones were negative all day long and his urine glucose strips have been showing in the middle, and the last 2 tests showed negative for urine glucose. I have not tested his blood glucose but I am confident that the negative ketones and lower urine glucose levels are a good sign that the increase is starting to work. Would any of you agree with that?
I have another curve scheduled for Wed. the 10th of Aug. and I am hoping for a better result and that his sugar is starting to get under control. I love this dog more than I could ever explain. I am willing to do whatever it takes so he can live a long, healthy and happy life. For so long I thought I was showing him love by giving him lots of treats and whatever he wanted to eat, little did I know I was hurting him and for that, I will never forgive myself. It is hard to say no and see him want a treat so bad or food in the middle of the day, but I refuse to love him to death. I will be strong because his life depends on it.
My questions are:
If the ketones are now showing negative for the past 2 days and the past 24-36 hours his urine glucose is showing much lower levels, is that a good sign that the insulin increase is starting to work?
Is it normal for it to take close to a week for his body to start to respond to the increase in insulin?
In the beginning, is it normal for the ketone levels to be trace/small, until the dog's glucose levels are not in the 400's/high all the time? In other words, is it normal/typical that my dog still had trace ketones in his urine for almost 2 weeks after starting insulin and coming out of DKA? This worries me a lot because up until 2 days ago, he was still showing slight levels of ketones in the urine, although every day they stick was a lighter and lighter color and was typically only showing small readings first morning and then trace the rest of the day, until it was negative for the past 2 days.
I am so worried about him but reading this site makes me feel empowered and I have a good feeling about it. I believe with the support of others, I will be able to help my Lumpy make it through this.
Thank you all so much for reading and any insight would be greatly appreciated.
I was really hoping to see a lower number but hopefully the next curve will give us a better idea of the right amount to give of insulin so he doesn't have such a high number just before his insulin dose. 
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