Help needed please, we are so distressed

[Kholcomb]

Not even sure where to start, I guess from the very beginning. My name is Krista and I have a 2.5 year old 6.8lb chihuahua mix. She recently (maybe 6 weeks ago) got diagnosed with diabetes. Her numbers were in the 500s when we found out. The vet started her on Novalin N 2 units twice daily, and told us to bring her in a week. When we brought her for the first curve test her numbers were still so elevated they didn't even go all the way through the test. The vet told us to up her to 4 units twice daily so we did. We brought her back a week later for another curve test and the vet said her numbers got a little too low so to back her off to 3.5 units twice daily. We followed instructions and she seemed to be doing really well. The vet told us to bring her in two weeks and we'd test again, that would've been tomorrow morning.
We were at home tonight and she had been doing really well these past two weeks but that took a major turn tonight. She got her insulin at 5:00 pm and went on about her normal evening, at about 8:30 she got up on the couch to nap. At about 9:15 she started throwing up, pooping herself and seizing. She fell off the couch. We rushed to her and gave her some sugar water. Called the first 24hr vet we could find and got het there. They got the seizure stopped and got her sedated. They tested her and said her glucose levels were dangerously low. They started her on i.v.'s and wanted to keep her overnight to monitor her. They have her now. I am just at a loss. I am so confused and heartbroken for my poor baby. Please someone help, any advice at all.

[k9diabetes]

Re: Help needed please, we are so distressed

She was very definitely on too much insulin for her size... which worries me about your vet's knowledge of managing diabetes.

It is quite rare for a dog to ever need more than half a unit per pound. And a good starting dose for a dog her size was at most 2 units - that could actually be too much. She should have never been given such a large dose.

Is she at the same vet who gave you that advice?

Natalie

[k9diabetes]

Re: Help needed please, we are so distressed

It can be difficult to dose insulin for small dogs.

As a general rule, I like to see insulin started at 1/5 of a unit per pound. In her case, maybe 1.5 units twice a day.

And I would say the average dose once their bodies have adjusted to having insulin again would be around 1/4 of a unit per pound - still less than 2.0 units in her case.

When their blood sugar has been high for a while, the body can be somewhat resistant to the effects of insulin. But once you bring their blood sugar down to a more reasonable level - not even close to good regulation, just a lot better than 500-plus all the time - that insulin resistance is broken and a dose that wasn't enough a week ago can be too much now.

That's why it's very important to start with less insulin than you think you will need and make small upward adjustments in the dose in the smallest increments possible - in her case, no more than half a unit at a time.

Doubling her insulin dose from 2.0 to 4.0 was completely inappropriate and she's lucky to have survived. I am so relieved that you took her to the emergency vet.

If she had lost consciousness, you could have rubbed either karo syrup or pancake syrup on her gums. It gets absorbed directly into the blood stream that way.

So the approach to her regulation needs to be much more careful and slow moving when she comes home.

Please let us know how she is doing and talk to the emergency vet about a safe insulin dosing plan for her and, potentially, a different veterinarian if the original one does not go back and review the advice given and realize the mistakes that were made.

Natalie

[bichons9]

Re: Help needed please, we are so distressed

I found and just now looked at unread messages..will keep reading..Thanks!!!

[Raysaint]

Re: Help needed please, we are so distressed

When first diagnosed, a dog can still be producing a bit of insulin at times, so a low dose to start is best. But you have to give that dose some time to see what it's going to accomplish. It may slowly bring sugars down and then it's not going to be enough.
Then you start increasing a bit, curving, and increasing slightly.
Trying to bring sugar down quickly with a big insulin increase is not normal. Expecting better sugars in a week, when her numbers were so high, is not realistic. It takes time to regulate a dog.
And your situation shows the importance of home testing. Get a meter.

[jesse girl]

Re: Help needed please, we are so distressed

after something like this occurs it should be your priority to never let it happen again and that is possible with you taking control and management of the situation and getting a glucose meter to test sugar at home

if the vet resists that idea you let them know you tried it there way and now your taking charge

my jesse has never had a hypoglycemic event in her 7.5 years of being diabetic ( knock on wood ) and i attributed that to testing blood sugar at home

your pup is a young dog and with the correct treatment can have a normal lifespan and a happy dogs life with some limitations

[amydunn19]

Re: Help needed please, we are so distressed

I was in your shoes - my original vet had my 11 lb dog on 9 units. I just went along with what they were telling me since they were the vets, right? No. They kept upping it without doing all day curves and I had no reason to doubt them. Then, Maggie had a hypoglycemic episode and started seizing one morning early. If my other dog hadn't awakened me, I would have slept through it. Once I finally got her "revived " with grape jelly all over her gums(all I had), I tested her with the meter a friend had just given me the night before. I don't know how I got blood because I was in a panic and shaking, but she was 25. I left that vet quickly.

Once we got her settled at her new vet, and we worked together to get herneating properly and regulated, she only needed 2.5 units. Imagine what could have happened to her. You can learn all about diabetes and we can help you with testing or any questions. Taking charge and home testing changed Maggie's life. You can do this! Please keep us posted on her.

[KathyLindly]

Re: Help needed please, we are so distressed

I am very new to the forum, Mollie was diagnosed in April and is still not stabilized. She weighed 13 pounds the day that she was diagnosed and her glucose was >700, with ketones in her urine and a UTI. My vet immediately treated her with a fast acting insulin, kept her for about 4 hours and sent me to pick up insulin at Walgreens, At 13 pounds she started with 2 units and after a week raised it to 3, but never a 2 unit increase. My point is, like others that such a huge raise in the dose for such a small dog just does't seem right. I know this may sound condescending but have you double checked the syringes to ensure that you have the correct syringe for the type of insulin that you are using? The last time I purchased syringes the pharmacist gave me the wrong syringe, I now have a picture on my phone of the box info so that will not happen again. I also test her a couple of times a week three times a day and do a full curve once a week. A glucose monitor would be helpful, I use AlphaTrak but there are others available. There is a thread on the forum dedicated to monitors that would be helpful for you to read.
I hope that you and your pup are doing much better

[Leonardsmom]

Re: Help needed please, we are so distressed

Hi! I am new to this also, my dog was just diagnosed in June-so, I'm no expert..However-you said your dog was about 6 lbs? So at .25 times her 6lbs. she should've been started on about 1.5 units of insulin at the low range and .50 times 6 is 3 units at the high range. A small dog would only be increased in quarter or half units also-is my understanding. Also, adjustments are typically made slowly to give their little bodies time to adjust and decide how to use the insulin-so for example, if you would start with 1.5 units, you would stay at that amount for a week, do a blood glucose curve, and then slowly increase to 1.75 units or 2 if your numbers on your curve indicated the need for more, and so on.. Have you looked in to the idea of home Blood Glucose monitoring and Keto-diastix for urine measurements? Not only could you do your own curves, but you can spot check your dog before you administer insulin so you don't accidentally cause another hypoglycemic episode. Alpha Trak 2 meters are only about 30 bucks-the strips are kinda expensive, especially in the beginning when you're trying to establish the correct dosage and doing lots of curves, but way cheaper and less stressful than paying for vet appointments every week and emergency visits also... Bayer Keto-Diasix are about 17 bucks for 50 strips. I hope some of this helps, I understand how disheartening this is, we can't seem to find a good level of control for my Schnauzer, Leonard, right now, so I feel your pain. Good luck!

[Raysaint]

Re: Help needed please, we are so distressed

And like I said, in the early stages, they can still be producing a bit of their own insulin, so a low dose is best, and then small increases like was mentioned.
Don't expect regulation to come quickly, don't get too hung up on numbers. Minimizing the clinical signs is your initial goal.

[bichons9]

Re: Help needed please, we are so distressed

So how is your baby doing??? She was last..still at ER.

[bichons9]

Re: Help needed please, we are so distressed

I was in your shoes - my original vet had my 11 lb dog on 9 units. I just went along with what they were telling me since they were the vets, right? No. They kept upping it without doing all day curves and I had no reason to doubt them. Then, Maggie had a hypoglycemic episode and started seizing one morning early. If my other dog hadn't awakened me, I would have slept through it. Once I finally got her "revived " with grape jelly all over her gums(all I had), I tested her with the meter a friend had just given me the night before. I don't know how I got blood because I was in a panic and shaking, but she was 25. I left that vet quickly.

Once we got her settled at her new vet, and we worked together to get herneating properly and regulated, she only needed 2.5 units. Imagine what could have happened to her. You can learn all about diabetes and we can help you with testing or any questions. Taking charge and home testing changed Maggie's life. You can do this! Please keep us posted on her.

So, can you provide the lab values? For the DVM to decrease the insulin, I take it that there were many lows? Eventually, I would hope Suzie's BG to be WNL equal or <125...with wishful thinking that she could be the rare case of Type 2 DM. Either way, Suzie is at 4 u NPH..How does one decrease dose with 2-300 BG? If it stays as is, I guess I'll bup up .5u or ook for another longer lasting insulin.

[amydunn19]

Re: Help needed please, we are so distressed

After I started testing her after that horrible morning, I reduced her dose dramatically myself (I knew her values were super low and she obviously was on too much insulin). On the high dose, she would experience highs because I think her liver was dumping glucose in her system to "save" her. It is the only explanation that makes sense. She could be as high as 500 but she could fall quickly to the 30-40 range. But, the body can't save them - eventually the overdosing can take a toll.

I know you want her to be a type 2 diabetic but that is just not realistic. I think at first, it is so overwhelming and there is a lot to learn. But, you will see that eventually you will get to a new normal that is not so bad. I always say that Maggie's diabetes made me a much better person and if she had never gotten diabetes, I never would have developed such a strong relationship with her and I never would have become a patient and structured person. I also learned to appreciate being uncomfortable in a situation- surviving is easy if you are always in your comfort zone. Maggie put me way outside my comfort zone.

Things will get better. You will see.

[Kholcomb]

Re: Help needed please, we are so distressed

Thank everyone so much for your replies and concerns. Moo is doing much better. Her pancreas responded better to the insulin than we could have expected or predicted. Her vet has moved her back to 1 unit twice daily and we are following this for 2 weeks (on week 2 now) to give her body time to adjust and we will do a curve test in a week. She is full of energy and gaining weight like crazy which is wonderful, being as she had lost a lot of weight at the start of all this. Moo is up to 7.7 pounds and has a wonderful appetite and energy levels. I will let you guys know what happens at the curve next week. We did buy the AlphaTrak 2 so we can test at home, so far so good. Her pad on her back paw works best for us as her ear was not getting a good blood sample. Hopefully we are on the uphill side of this battle. I can say without a doubt, she is feeling better than she has in a LONG time. Her energy levels are just amazing now!

Again, thanks to everyone for your concern and compassion. I appreciate all the willingness to help. This is a scary disease and a very scary roller-coaster ride to be on.

[jesse girl]

Re: Help needed please, we are so distressed

thanks for the update glad things are improving