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  #21  
Old 06-20-2011, 12:37 PM
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Default Re: Abby Diagnosed about 4 weeks ago

It looks like abby has a mountain type curve where her low point is at the end of her cycle where my jesse has a bowl type where her low point is 6 hours after shot

now you want to see if that is consistent from day to day

some like that curve because there low point maybe the time they are home from work and not in the middle of the night jesse did have this type of curve early on and the most difficult thing was exercise with this type of curve for us because she was dropping during her only time we could walk her and would drop further so we had to give some honey before that walk
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  #22  
Old 06-20-2011, 01:00 PM
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Default Re: Abby Diagnosed about 4 weeks ago

Abby's water intake has been quite normal, these past several days, so I don't think it is diluted urine... but i will take another look at it (considering her numbers are still high, and not near 180) with another strip. Perhaps the strip was faulty. Ketones are normal. I can see where this curve may be difficult if attempting to walk when you get home from work. I walk Abby in the morning, right after breakfast, so we are out there around 7:00 am, and we don't always get out in the evening, but I am attempting to walk then, but normally if we do walk, it is 9:00 p.m. Are you saying that curves can change?

Also, does everyone monitor ALL the time, or is this something that you can ease up a bit, after you get a good curve and they are regulated. This has been very time consuming.... it is a blessing that I work from home. I'm not sure what I would do if I had to work outside of the house.
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  #23  
Old 06-20-2011, 01:22 PM
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Default Re: Abby Diagnosed about 4 weeks ago

jesse has flip flopped on me quite a few times but that does not seem to be the norm if your at a dose and number are consistent you can spot check the problem areas once in a while I test jesse before every walk and after which is when she gets her insulin and will spot check other times once in a while

of coarse you check more with any changes food dosing exercise as you get more comfortable and know abbys trends you'll develop your own routine for testing . dont ever get to comfortable or complacent because things can change it is definitely not an exact science
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  #24  
Old 06-20-2011, 03:08 PM
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Default Re: Abby Diagnosed about 4 weeks ago

The more I read, the more I have found that what my original vet told me (or I should say the lack of information) has been incorrect.

When I asked about how long the insulin will last in the bottle, his reply was " Oh that will last you 3 months ". I didn't know that there was an expiration date to insulin.

So, off I am going to Walmart (I understand that they sell the Humilin N) without a prescription. My concern is, if the insulin was not as affective, should I keep her on her current units. She is at 4 units now. Her numbers have been high, not below 259.

Abby was sent home on the 13th of May with an already opened bottle. She was at the vets for three days, so the 10th was when they opened the bottle (more than likely). It is now the 20th.

More than one reason why I switched vets!!
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  #25  
Old 06-20-2011, 03:31 PM
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Default Re: Abby Diagnosed about 4 weeks ago

Abby did have a hypo incident, so for sure, you'd want to avoid this.
Perhaps you go back to 3 units with a new bottle?
You do need about a week to see any impact.
Other option would be to stay at 4, but test very frequently (esp around the lows) - but only if you know when she has her lows.
Do you have Abby's previous glucose curve results (when the vet reduced the dosage)?
I recommend you wait to hear from Peggy and Natalie - they should have a far more knowledge about this stuff than me.
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  #26  
Old 06-20-2011, 03:46 PM
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Default Re: Abby Diagnosed about 4 weeks ago

I do check a bit more on a new bottle especially those low points. about 6 weeks is all I get then we are loosing potency I can tell the difference I may have ticked her dose up a tad to cover the lack of potency so I will usually back down a bit with a new bottle . very small increments makes quite a bit of difference in her numbers

It seems like I loose some duration with an older bottle just doesnt last as long and at times I would like the insulin to be weaker because the nph has a strong affect on jesse for the first 6 hours and thought well weaker insulin might be better but it really has the same action even when if it is weaker with less duration thats how it works with jesse
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  #27  
Old 06-21-2011, 10:15 AM
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Talking Re: Abby Diagnosed about 4 weeks ago

Last night I threw away the 'old' insulin. I didn't see any documentation on how long this stuff will last after it has been used. I did speak with the vet, and she was not sure, so perhaps I will contact Lily (she is on NPH Humlin N), but she did say that some human insulins only last 6 weeks. That is a good idea to increase levels a bit when the bottle is getting older.

Sunday:
6:30 am 475 Fed
10:30 am 321
12:30 pm 352
3:30 pm 259
9:33 pm 284


Monday
6:30 am 334 Fed
7:00 walk
11:00 am 383
2:00 pm 304
5:00 pm 388
6:30 Fed
8:30 pm 384

Today, her numbers are looking better from yesterday (I'll keep my finger's crossed)

Tuesday her numbers are:
5:47 am 350
6:30 Fed
8:57 am 263
11:47 am 262

So, if we stay on this curve, her low point should be 3:30 today She seems to be very consistent in how the insulin is reacting. I will keep on her 4 units 2x a day for the remainder of the week.

I have a vet appointment on Thursday to discuss putting her on Trilostane again but this time with 10 mg 2x a day along with the insulin and see how this goes. I would feel better if I could get her numbers down a bit more before we start treatment, because she does seem consistent (in my opinion... chime in here anyone ). My vet is very open to suggestions (that I am thankful for).

Also, I will have my meter tested against their BG test so I can get a better handle on how off my meter is to theirs.
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  #28  
Old 06-21-2011, 10:36 AM
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Default Re: Abby Diagnosed about 4 weeks ago

I recommend that you seek an internal medicine specialist before starting Trilostane. Your vet's starting dosage was way too aggressive, esp for a dog whose post ACTH cortisol was barely elevated. I am not sure if your vet is experienced with Cushing's.
My vet is really really experienced and good, but she referred me to a specialist when we thought Harry needed to start Cushing's treatment. Even another vet in Tahoe (an ER vet we saw during vacation) really thought that we needed an expert opinion before he even attempted to treat a diabetic / Cushingoid dog.
I am not sure if your dog has Cushing's, and if your dog does, whether at this stage to start Trilostane - with Cushing's, sometimes treatment can be worse than disease as both meds (Lysodren and Trilostane) can have severe side effects.
If Abby has raging Cushing's going on, she would not likely have the stable glucose numbers you see here (it will just stay HIGH with some erratic movements). You will also defintely see Cushing's symptoms (hunger, PU/PD, skin problems, rearend weakness, 3-5x elevation in Alk Phos, high choleterol, hair problems). I have not seen your dog, and I am not a vet. However, I really think you should look into a second opinion from an IMS before actually restarting Trilostane.
You should look into K9Cushings.com site. Yahoo also has a great group. http://pets.groups.yahoo.com/group/C...utoimmuneCare/
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  #29  
Old 06-21-2011, 10:47 AM
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Default Re: Abby Diagnosed about 4 weeks ago

what you would want to see if you can be in the 200s most of the time and hold for 5 days to a week the new bottle seems to be doing better keep a watchful eye the new bottle may be allot more potent than the old bottle

I can see a difference from a 6 week bottle compared to a new bottle

once you get that stability in the 200s i would dose upward in tiny increments 1/4 is what i would do at the most I have gone smaller than that and I call that a micro dose dont ask how i get that its an eyeball thing and it has an affect on jesse

I believe letting there bodies get used to the new level is important before making the next step lower

your really doing great I would have liked that consistency in my jesse at the beginning we were on a roller coaster ride at the point your at now
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  #30  
Old 06-22-2011, 06:17 AM
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Default Re: Abby Diagnosed about 4 weeks ago

First reading of today was
346 at 6:30
113 at 9:00 (after walk)
This is going to a either a good day or a rough one!!

@ 4units given at 6:30
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