Newly Diagnosed, having issues

[Neirracul]

I think we will keep her at 14 for a few more days and do another curve this weekend before making a decision about her dose. She just might not have good reaction to changes in dose. If she skips another meal I will try the 1/4 dose and see what effect that has. We typically do top her food with something, so far we have used frozen green beans, broccoli, cauliflower, and apple. She loves frozen veggies was excited for those for a while but she gets used to it and then no longer wants them. Currently we are using 1/6 cup of beef broth drizzled on top and 1/6 cup of hot water to simulate a cooked meal. It’s been reasonably successful so far but I don’t know for how long ha ha. She doesn’t like cheese or eggs, but I will try some fish when she starts getting tired of the beef broth. Originally she was nuts for the kibble and ate it plain but all good things must come to an end it seems.

I’ll update y’all after the curve we do this weekend and see where pups numbers are.

[Neirracul]

We did another curve yesterday and got:

445
453
527
523
451
458

The spot checks we did during the week were all super high too. Wondering if she maybe is experiencing a honey moon and that’s why normal insulin doses seem to be too much for her. Im wondering if we should maybe start over again with a .25 dose of NPH per kg. Of all the doses she’s been on so far, she seemed to do best on around 11 units of Vetsulin. We had numbers from 275 - 400 on the 11 and she seemed to be doing a lot better and might benefit from a lower dose with half unit increases every week or so. What do you guys think? I’m afraid to give her too much because of how hard she was rebounding in the beginning on the 20 units of Vetsulin. If this reasoning is totally off please let me know. She’s not doing as good now, very tired and isn’t able to do her normal walk without getting run down. We started using a little chunk of cooked beef to get her to eat her food and that’s been going well.

[Riliey and Mo]

great youve got her eating and that curve is flattening out well.

you doing great . lets see a curve on the weekend and go up one unit at a time from now on.

shes under dosed at 14 units as 65lbs x .25 is 16 units for her weight.

[Neirracul]

Doesn’t a 16 units starting dose seem high, especially since she was in rebound at 20 units? I’m a bit confused. I’ve been reading some journal articles about Vetsulin and NPH use in dogs and all of their dosing schedules are listed in units per KG. This includes the starting doses which are listed as .25 to .50 units per kg. Maura is around 65 lbs which equals about 29 kg.

So in theory her recommended starting dose should be .25 x 29kg = 7.25 units to .50 x 29 kg = 14.5 units as a high starting dose. This sounds kind of low, but I can’t find any sources using units per pound either. The one article I read found that most dogs average around .63 units per kg when fully regulated.

[jesse girl]

You can try the lower dose to see if it makes a difference . You do have some history with better numbers and physical symptoms

My jesse at 26 pounds cant have more than 3 units at one time and that led me to giving her 3 shots a day to accomplish that

Now her numbers dont go low they go high with a higher dose . Maybe its a reaction to injected insulin as it is a foreign substance to the body but who knows for sure . When she runs higher on occasion and I have tried to raise the dose she goes higher .

My jesse early in her diagnosis was at 1 unit for a brief time which I believe a honeymoon period and I guess it ended but her dose remained lower than most

[Riliey and Mo]

the initial recommended dose is 0.5 iu kg insulin body weight
0.5 x 29.48 kg dog is 14.74 twice a day

the initial start dose in .lbs is .25 iu lb insulin per body weight
.25 x 65 .lbs dog is 16.25 twice a day.

i always converted kg to lbs and used the
.25iu as my vet weighed Riles in kg

the important thing is not to follow numbers as every dog is different.

looking forward to Maura.s next curve

[Raysaint]

All my vets told me 0.5 units per kg NPH is the start dose, which is usually conservative.
I believe the AVMA diabetes guideline is the same.

My dog is just over 12 kg, start dose was 6 units, now he's at 9 units of nph.

[Neirracul]

Hi all,

Finally got to do another curve so we did the full 12 hours and then two more tests after that. Still at 14 units of Novolin N.

Numbers:
474 - fasting, fed breakfast right after
401
469
459
397
471
372 - fasting, then dinner right after
499

She’s been eating perfectly, 2.5 cups of chicken Ketona per day with four cubes of beef, 1/3 cup of beef broth, and some hot water added. Split between two meals. No complaints yet.
Her energy level is still low; she can barely get through her normal walk anymore. She gets two leisurely 30 min walks per day after her meals.
The curve today was interesting to me since most of her spot tests during the week have been in the 500s.
This curve seems kind of flat to me, though I’m not sure what the after dinner spike was from or the weird undulations during the day.
Is this where we should increase by another unit?

[jesse girl]

Yes you do have the opportunity to raise the dose

Nice and flat which makes raising the dose a bit easier . Remember a dose adjustment is based on the lowest number in a curve

I would not place much interpretation on the highest number as meters appear to become less accurate at higher levels

well done

[sibhus]

I can tell you my husky like yours was very sluggish when hovering in the 400s. They feel a lot more comfortable when you can get them below 300. Since your nadir or bottom line number is 397, one unit won't make any difference on the larger dogs. You may want to start by increasing 2 units but I have a feeling you'll be closer to giving 20 units to get her nadir closer to 100.

I read a vet article that insulin can be increased no more than 10 percent every 4 days.

How does your husky like the ketona?