Cushings, allergies, and newly diagnosed diabetes

[Judi]

Re: Cushings, allergies, and newly diagnosed diabetes

so glad you caught it. Don't forget, they can tolerate being a little high better than low. I'd definitely reduce the dose.

the same thing happened to us when my dog's cushings medicine started working too well (we used Lysodren)

I kept reducing her insulin, reducing her insulin till we had to check her cortisol again

hang in there!

[rocksmom]

Re: Cushings, allergies, and newly diagnosed diabetes

I was glad we caught it too and didn't just assume the dose was good after last week's curve. I suspected he was going to be running low after his "good" curve last week where he was dipping below 100. He was definitely a little groggy throughout the week. Quick to sleep and slow to wake up, but otherwise normal. No shakiness or weakness or anything like that. I was expecting numbers in the 80s and 90s. Not 50s.

He ended up a little high before dinner last night at 333, but that was after three extra 1/2 size meals! I gave him his usual dinner and 6 units instead of 8. Checked him at 8:30 and he was still high at 252 so I wasn't super worried about overnight. Fasted this morning he was at 194. Another 6 units with breakfast. By 9:30 he was down to 70 so I gave him karo and a 1/2 size meal. He was at 188 a few hours later. That was our last test strip, I ran out with all the extra testing. A new box is supposed to get here today from Amazon.

Still waiting on a call from the vet.

Assuming I will be dropping the dose again at dinner. 4 units?

[jesse girl]

Re: Cushings, allergies, and newly diagnosed diabetes

good catch once again and without any strips for testing you may have to go with the 2 units you sugested just to be safe

[Judi]

Re: Cushings, allergies, and newly diagnosed diabetes

yeah, I'd listen to Jessegirl. It takes their bodies at least a week to adjust to a new dose so I'd go low and stick if possible.

[rocksmom]

Re: Cushings, allergies, and newly diagnosed diabetes

I was definitely planning on dropping again, but our vet called and she said to stay at 6 and test at 3 hours after dinner and breakfast since that’s his lowest point. She said skip the karo, just do the food if he’s low. My husband spoke with her but it sounded like she wasn’t too concerned about how low he was. She said it’s more the symptoms than the number.

Amazon says the strips should be here between 6:15 and 9:00.

[MikeMurphy]

Re: Cushings, allergies, and newly diagnosed diabetes

I was definitely planning on dropping again, but our vet called and she said to stay at 6 and test at 3 hours after dinner and breakfast since that’s his lowest point. She said skip the karo, just do the food if he’s low. My husband spoke with her but it sounded like she wasn’t too concerned about how low he was. She said it’s more the symptoms than the number.

Amazon says the strips should be here between 6:15 and 9:00.

If he’s low, you really need to intervene and give him Karo Syrup, even if he’s not showing symptoms. That will get his BG up a lot faster than food. You never want to risk the possibility of a seizure.

As everyone else is saying, an insulin reduction is needed.

[LizE]

Re: Cushings, allergies, and newly diagnosed diabetes

I'm a little surprised you were advised to skip the Karo. The effect only lasts about 30 minutes so there is no long term problems with it and you could be preventing a disaster.

The low number is always in the driver's seat, especially since you have seen it more than once, so don't be afraid to be conservative, despite what your vet thinks. Your vet isn't taking care of a diabetic dog 24/7.

My dog has gone thru periods of low numbers bottoming out in the 50's (also without symptoms). I always lower the dosage. Eventually she returns to her normal state. I have no idea what causes it - could be pain she is hiding from me, could be vomiting outside and me not catching it - but I'm at the point where the why doesn't matter so much.

I hope things settle down for you soon but don't worry too much if they don't. It sounds like you're doing a good job of getting to know your dog's unique health profile.

[rocksmom]

Re: Cushings, allergies, and newly diagnosed diabetes

That's what I thought too, that's why I did the karo followed up by food. I was actually kind of mad when my husband was relaying the conversation to me. I was like oh, wait until he's in danger to intervene. That sounds great. [insert sarcasm tag]

Last night with the 6 units he was at 76 at 8:30pm so I gave him food. This morning at 8:30am he was at 137 so I did not give any. Hopefully that's a good sign and the 6 units will work out okay. I guess we'll keep testing at his low points to make sure he's not dropping too low and do a full curve either Sunday or Tuesday. Sunday would be 5 days on the lowered dosage, or a full week on Tuesday.

[jesse girl]

Re: Cushings, allergies, and newly diagnosed diabetes

Well at least the numbers you posted show the dose was to much and it wasn't just an oddball event . Glad you back at testing. i still may have dropped another unit

[rocksmom]

Re: Cushings, allergies, and newly diagnosed diabetes

It's been awhile, so I wanted to stop in and give an update on Rocky. I'll post his last four curves first...

1/29
Fasted- 248
5:30- 4 oz of food and 6u
6:30- 215
8:30- 118
10:30- 111
12:30- 112
2:30- 129

2/5
Fasted-150
5:30-4.5 oz of food and 6u
6:30- 191
8:30- 120
10:30- 88
12:30- N/A - Stopped early for vet appointment

2/12
Fasted- 168
5:30- 5 oz of food and 6u
6:30- 199
8:30- 144
10:30- 100
12:30- 128

2/19
Fasted- 135
5:30- 5.5 oz of food and 6u
6:30- 150
8:30- 133
10:30- 68
12:30- 100

His body definitely seems to be getting more efficient at using the insulin, even with the increases in food. We hit that low again today with an overall lower curve. I'm planning on doing one more increase in food to 6 oz (that will be 150% of the label's feeding guide which is what is recommended on the epi forum during the weight gain period) and dropping the insulin to 5.5 units.

He has definitely been feeling better over the last month. The muscle weakness has improved a ton. He no longer dribbles urine and knows when he has to go out. He can stop the flow as well. No more walking and peeing. He's been playing more and wants to walk like he did two years ago, pulling in the opposite direction when it's time to come back. So much different than during the holidays when he barely made it outside and I had to carry him back. The only two things left to work on are his skin and weight. He looks like he's starting to put some weight/muscle back on but my scale has been wonky. I ordered a baby scale from Amazon to get more accurate measurements. Whatever is on his skin is still an issue. I switched last week from the antibacterial shampoo recommended by the vet to a glycolic acid and sulfur shampoo because from looking at pictures it looks like it may be a mild case of demodectic mange. The timing would make sense since it started about a week or two after the diabetes when he was "compromised." If it doesn't start clearing up in a week or two we may have to go ahead and see the dermatologist.

I honestly can't get over the difference in him between the holidays and now. The enzymes just turned everything around. He was literally starving to death. My vet never tested for it, so if my sister's dog hadn't been diagnosed a couple years ago making me aware of it, Rocky would probably be gone by now. We really considered putting him to sleep on Christmas eve because things were so bad.

[jesse girl]

Re: Cushings, allergies, and newly diagnosed diabetes

A very nice update . Glad things turned around and a dogs life is getting to that new normal . Hopefully the skin thing is not a big deal and it doesnt appear to be affecting Rocky's attitude

Great detective work and sometimes thats what you have to be

[Judi]

Re: Cushings, allergies, and newly diagnosed diabetes

that is such great news! enjoy Rocky!

[MikeMurphy]

Re: Cushings, allergies, and newly diagnosed diabetes

Yay Rocky!

I hope the skin issues clear up. A couple of years ago, my Lily somehow got sarcoptic mange. The itching and infections were really bad. She wound up seeing a dermatologist and it took several months to clear up. It’s the only time I’ve ever heard her cry.

Dropping down .5 units is a good idea.

[rocksmom]

Re: Cushings, allergies, and newly diagnosed diabetes

Unfortunately this update will not be as good as the last.

The vet advised us to keep the dose at 6 after his curve on 2/19 despite the low numbers so we continued at 6 with 5.5 ounces of food. His next curve was high. Numbers back up in the 300 and 400s with a 300 point swing and a later than usual nadir. I dropped it on my own to 5 then but his numbers are still high 5 days after the drop. I decided to do a spot check this afternoon because he was particularly sleepy and I thought we might see a low number. I’m pretty much freaking out because I feel so bad for him. My husband wants to increase the dose and decrease the food. He thinks the dose is low, I’m afraid he’s rebounding. We did not hear from the vet this week, but frankly I don’t think she’s knows any more than I do at this point.

He’s drinking more, particularly after he eats. Acting sleepy and weaker. Lots of lip licking.

Here’s the curve from 2/26:
Fasted- 345
5:30- 5.5 oz of food and 6u
6:30- 471
8:30- 340
10:30- 274
12:30- 171
2:30- 219

Today he was 400 at 4:00pm. Tomorrow will be another curve after 6 days at 5. Does the shape of that curve and the late nadir seem to signify not enough insulin? From what I’ve read Somogyi tends to show as high flat curves. I’m just so confused at this point and don’t know to go up or down. His dinner is in 15 minutes and I’m dreading it...

[MikeMurphy]

Re: Cushings, allergies, and newly diagnosed diabetes

Let us know how today’s curve goes. That will tell us more.

I’d be careful about changing the amount of food and insulin at the same time. We usually like to only change one thing at a time.

How is the possible skin infection doing? That could be a cause of higher BG.

Rebound, which is caused by too much insulin, starts out as a rapid decrease in BG followed by a rapid increase. Sometimes the BG can then stay high, hiding the reason for the high BG... or the high/low BG cycle can keep repeating itself...


http://www.caninediabetes.org/pdorg/somogyi.htm

Hang in there. You’re doing a great job being a detective and managing his diabetes