Wiggins Story

[Bnnclvr]

Wiggins is a 9 year old wire-hair fox terrier. We got him when he was a couple of months old, and before he reached 9 months he developed severe skin allergies (he would scratch himself until he bled). We had blood tests run to see what he was allergic to, which was almost everything. They developed an antigen and we gave him shots once a day and eventually once a week. During this period he was on Temaril-P to keep the scratching under control, but he still scratched and his skin quivered every time you touched him, which is does to this day. He does loved to be brushed/scratched. After a couple of years we found the allergy shots did not work and we eventually took him off. About 6 months later, even taking the the Temaril-P he was scratching himself and bleeding. We went to a veterinarian allergy specialist who tried some additional allergy medication and once again did all the blood tests, and put him on a new set of allergy shots. After a year and a half, Wiggins was no better. When he was about 6 years old he was diagnosed with a thyroid condition and put on Soloxine. When he was 8 he was diagnosed with diabetes and we were told he would have to get off the Temaril-P, which was not a pleasant thought. We tried many allergy drugs, including sprays, and found a combination of a spray and Hydroxyzine/atarax that finally got him to stop scratching himself until he bled (although he still scratches himself).

His initial blood sugar was approximately 390, and he was given a dose of 8 units of vetsulin (6 am and 6 pm). We did a wave approximately 1 month later (6 hours after an injection) and his blood sugar was at 280. We moved his dose to 10 units of vetsulin and did another wave 1 month later and it was at around 180 (6 hours after an injection). After the third or fourth wave we finally ended up giving him 15 units and his blood sugar was at 120, which we thought was safe. He was on 15 units for about 1 month and suddently went into shock. I called his regular vet to find out what to do and they could give me no information. We went online and found that you can give them karo syrup via syringe, which we did. We then lowered his dose to 13 units. We had no faith in the vet and assumed since he was at 15 units for so long and was okay, 13 would do the trick. It was around this time that he lost his sight. Approximately 1 month later he again went into shock taking 13 units twice a day. After that his dose was lowered to 11.5 and in 3 weeks he again went into shock. We now have him at 9 units (for the last couple of weeks). We purchased a glucose monitor 1 week ago and we checked his blood sugar that night after we gave him his 6 pm injection. It registered 26. We gave him some karo syrup and hoped for the best. The next morning we took his blood sugar and it was 385. We reduced his insulin to 6 units and that night his blood sugar was 285. The next morning after his injection his blood sugar was 36. We gave him 9 units that night and we checked his blood sugar and it registered 249. The next morning his blood sugar was 82, and the next night 242 (still using 9 units). His blood sugar seems to be all over the place and drawing blood is very difficult (we do it at the base of his tail). We are going to start checking him every Saturday and Sunday (6 hours after his injection) to see where he is at (we both work). At this point we are keeping his dose at 9 units and are mostly depending on how he seems to feel (if his tail wags it is a good day and if he can do his usual 30 min. walk every morning without my carrying him the last few blocks it is a good day). We have him on a diet of homemade whole grain rice/oatmeal, ground turkey and fresh vegies (cooked in a crockpot), along with 1/4 regular dog food. He gets approx. 3/4 cup to 1 cup in the morning and again at night. I would like to be able to level out his blood sugar level, but am feeling pretty helpless right now. Wire hair fox terriers are known for being "fearless." But at this point Wiggins is anything but fearless.

[eyelostit]

Re: Wiggins Story

Hi and Welcome

Is Wiggins getting one shot or two shots a day? If just one shot a day please post back on advise for this.

Aw poor Wiggins, may I ask how much of the rice, oatmeal and veggies, turkey you put in the crockpot?

How much of this mixture goes along with the 1/4 C of dogfood and what type of dogfood does Wiggins eat.

Could be some rebound going on, with getting the lows then the highs, the food and insulin may not be matching to the insulin dose.

Was wondering if you ever tried cider vinegar for his skin allergies.


Dolly

[We Hope]

Re: Wiggins Story

Welcome to you both!

In order to see where things are happening with Wiggins, you need to either do a curve yourself with your meter or have one done at your vet's. Taking blood and testing it every 2 hours for about 12 hours should give you a good picture of Wiggins' highs and lows and when they are occurring.

http://www.vetsulin.com/vet/Monitoring_About.aspx

http://petdiabetes.wikia.com/wiki/Curve

It could be that Wiggins needs slightly less insulin in the evening than for the daytime; the morning and evening doses don't need to be equal. It just works out that way for some dogs; others need more insulin in the day than at night and vice-versa.

Learning about Wiggins' highs and lows will allow you to see how the insulin is working for him at various points in the day. This means you can give a small snack, for example, if you see he tends to go low at a certain point. It also means you can work with his food to make it work better with his insulin.

Many dogs do well when more fiber is added to their diet. This is what the prescription-type diabetes diets contain and it can be a help to even out glucose absorption (which can translate into better and more stable numbers). Adding fiber can also mean that less insulin is needed for good and stable bg control. You don't need to necessarily go with the prescription "diabetes foods", as you can increase the amount of fiber in the food yourself with things like solid pack (no sugar or spices added) pumpkin, etc.

Am hoping you've found another vet for Wiggins because I can't think of a doctor of any type who wouldn't know what to do for hypoglycemia, especially when it's known the patient has diabetes and is using insulin!

Kathy

[AlisonandMia]

Re: Wiggins Story

When did Wiggins come off the Temeril-P? Was he still on it, being weaned off it, in the early days of being diabetic?

Alison

[Bnnclvr]

Re: Wiggins Story

Dolly - I have never tried cider vinegar - do you mix it with water and spray it on? He gets an insulin shot at 6 am and 6 pm. The food I make is basically one-half bag of whole grain brown rice, 3 lbs. lean ground turkey, and one-half container of oatmeal, along with usually 6 or 8 stalks of celery cut up and froz. peas. I mix it 3/4 c. to 1/4 c. regular dog food. I have been trying different dry dog food and have it in a large tupperware container and don't know what kind I have now.

[Bnnclvr]

Re: Wiggins Story

When did Wiggins come off the Temeril-P? Was he still on it, being weaned off it, in the early days of being diabetic?

Alison

I was told by my vet to take him off Temaril-P immediately because it interfered with the insulin (made it not as effective). We weren't able to back off of it slowly.

[Bnnclvr]

Re: Wiggins Story

Welcome to you both!

In order to see where things are happening with Wiggins, you need to either do a curve yourself with your meter or have one done at your vet's. Taking blood and testing it every 2 hours for about 12 hours should give you a good picture of Wiggins' highs and lows and when they are occurring.

http://www.vetsulin.com/vet/Monitoring_About.aspx

http://petdiabetes.wikia.com/wiki/Curve

It could be that Wiggins needs slightly less insulin in the evening than for the daytime; the morning and evening doses don't need to be equal. It just works out that way for some dogs; others need more insulin in the day than at night and vice-versa.

Learning about Wiggins' highs and lows will allow you to see how the insulin is working for him at various points in the day. This means you can give a small snack, for example, if you see he tends to go low at a certain point. It also means you can work with his food to make it work better with his insulin.

Many dogs do well when more fiber is added to their diet. This is what the prescription-type diabetes diets contain and it can be a help to even out glucose absorption (which can translate into better and more stable numbers). Adding fiber can also mean that less insulin is needed for good and stable bg control. You don't need to necessarily go with the prescription "diabetes foods", as you can increase the amount of fiber in the food yourself with things like solid pack (no sugar or spices added) pumpkin, etc.

Am hoping you've found another vet for Wiggins because I can't think of a doctor of any type who wouldn't know what to do for hypoglycemia, especially when it's known the patient has diabetes and is using insulin!

Kathy

I would like to try the monitoring every two hours. We really have a hard time getting blood from him (we are doing it at the base of his tail and it takes quite some time). We put the needle in all the way and twist it and it takes a lot of massaging to get blood.

[Bnnclvr]

Re: Wiggins Story

I would like to try the monitoring every two hours. We really have a hard time getting blood from him (we are doing it at the base of his tail and it takes quite some time). We put the needle in all the way and twist it and it takes a lot of massaging to get blood.

I didn't know there was prescription dog food for diabetic dogs?

[forloveofandy]

Re: Wiggins Story

How much does Wiggins weigh?

I am so glad you found this board. There is a wealth of information here.

Hang in there. It is going to get better.

[k9diabetes]

Re: Wiggins Story

Hi and welcome to you and Wiggins!

I'm sorry you have had such a rough time of it. I don't know if you have ever read my dog Chris' case study but he had a somewhat similar experience in that once he started insulin his dose kept dropping. In his case, his pancreas got a break from injected insulin and he "honeymooned" - his insulin production started up again. This can happen, especially if you catch the diabetes fairly early. Eventually, though, the pancrease fails altogther. Chris honeymooned for about six months, which is a long time. His case study is at www.k9diabetes.com/k9diabetes.pdf.

I had a couple of thoughts while reading through your story, which I summarized below.

One is that his pancreas might have recovered some, as Chris' did, allowing him to need less injected insulin. Especially after many years on Temaril-P, which contains some steroid.

Another is that while his blood sugar was high he built up some resistance to the effects of insulin. That is fairly common. Eventually, as the body spends more time at more normal blood sugar, the resistance dissipates and then you need less insulin to get the same effect.

Another is that the thyroid medication may need adjusting. Thyroid affects metabolism and insulin processing.

Most likely your meter reads the blood sugar somewhat lower than it actually is but still I would like to have his lower readings like the 82 come up a bit for safety given what's happened already.

After a hypoglycemic episode, the blood sugar can be out of whack for several days afterward so you might see higher numbers in the 48 hours after a hypoglycemia and think he needs more insulin when really it's just a short term spike from jolt of hormones caused by the low blood sugar.

The other complication is that the level of his allergies will also affect his blood sugar so you may always see some variability.

I recommend that you settle on a dose of insulin where his blood sugar never goes too low... 6, 7 units, 8 at most. And stay on that dose for a full seven days after any low blood sugar episodes.

Let's say you drop the dose to 7 units. If no hypo occurs, stay at 7 units for a full 7 days and then evaluate the blood sugar at that point. If he still goes low on 7 units, drop to 5 and stay at that dose for a full 7 days.

You need to give his body time to stay on one dose for an extended period without the influence of the panic hormones that come into play when the blood sugar goes too low. Then, once you have done that, you can do a curve or mini-curve - as much testing as you can manage - and see how the blood sugar is after a week on a stable schedule of food and insulin.

The other thing is the exercise - that can have a HUGE effect on blood sugar. It has to be timed very carefully and it could send his blood sugar very low if it's on the low side already. I love exercise for any dog but right now, if you think it won't torture him, I'd skip the walks so you can limit the variables involved and find out more about what his blood sugar is doing.

You may find, after doing this, that he needs a different amount of insulin at night, as Kathy mentioned. The best way to find out is to eliminate as many variables as you can, stay at a safe dose even if it means his blood sugar is sometimes higher than you would like, and then assess his progress on that dose. We can help you sort out the results of this and make decisions about what to do next.

Sorry it's so long an answer... hope it makes some sense!

Please tell us how much Wiggins weighs also.

Natalie
_________

Wiggins
9 year old wire-hair fox terrier
6 years old diagnosed thyroid condition, put on Soloxine
8 years old diagnosed with diabetes, taken off Temaril-P

first dose 8 units of vetsulin (6 am and 6 pm), upped to 10, then to 15
stayed at 15 units about a month, then hypo
lowered to 13 for one month, another hypo
lost his sight
lowered to 11.5 units for three weeks, another hypo
lowered to 9 units a few weeks ago
Started home testing about a week ago at base of tail
Meter read 26 after 9 units.
lowered to 6 units
On 9 units, 249 evening, 82 morning, 242 next evening

usual 30 min. walk every morning

Diet homemade whole grain rice/oatmeal, ground turkey and fresh vegies (cooked in a crockpot), along with 1/4 regular dog food. He gets approx. 3/4 cup to 1 cup in the morning and again at night.

[eyelostit]

Re: Wiggins Story

Dolly - I have never tried cider vinegar - do you mix it with water and spray it on? He gets an insulin shot at 6 am and 6 pm. The food I make is basically one-half bag of whole grain brown rice, 3 lbs. lean ground turkey, and one-half container of oatmeal, along with usually 6 or 8 stalks of celery cut up and froz. peas. I mix it 3/4 c. to 1/4 c. regular dog food. I have been trying different dry dog food and have it in a large tupperware container and don't know what kind I have now.

Ok, Natalie (K9diabetes) suggested lowering the dose and staying with that for a week while checking the bg to prevent the lows you have been seeing.

When are you seeing the high readings AM fast or PM fast?

Are you giving any treat? and does Wiggins get some exercise before you see the low readings.

If you lower the dose and we don't see the lows anymore we can then suggest some food tweaks if you are getting high numbers again, its hard to tell without seeing those lows going away and you have had a hypo event.

If you can please post a full days curve, and let us know what meter you are using.

Below are 2 links about the cider vinegar, the other is the search I did on it and there are various links listed.

http://www.paw-rescue.org/PAW/PETTIPS/DogTip_InsectBites.php

http://www.google.com/search?q=cigar+vinegar+for+pet+skin+allergies&rls= com.microsoft:en-us&ie=UTF-8&oe=UTF-8&startIndex=&startPage=1

I hope this helps and hang in there

Take care
Dolly

[Bnnclvr]

Re: Wiggins Story

Natalie - All that you said makes a lot of sense. Today is Saturday, so we are going to check his blood sugar every two hours. I have had him on 9 units for the past week, including this morning (I just read your post). His tail is wagging again, but I am going to reduce it to 8 to be on the safe side. I didn't realize that the pancreas can actually recover to some degree and how that related to the Temaril-P. He is also starting to drink a little more water, which he wasn't doing with the high dose of insulin. I can now see hope for Wigs getting his diabetes under control. I really appreciate your time and your clear message. Thank you.

[Bnnclvr]

Re: Wiggins Story

Natalie - I live in Denver. I have tried looking on the internet for dog diabetes specialists but have not come up with anything. Are you aware of any good vets in this area?

[k9diabetes]

Re: Wiggins Story

I am very anxious to see the results of the curve!

There aren't really diabetes specialists... there are Internal Medicine Specialist veterinarians who specialize basically in all things more complicated, including diabetes, and it is often helpful to see an IMS. They are likely to have treated more diabetics than a general practice veterinarian.

Even among IMSs, there are still those who are good and bad with diabetes.

The vet schools for years have not only not taught vets to put home blood glucose testing to work but have actively discouraged it and the better regulation that comes with it. We took Chris to an endocrinologist at a veterinary teaching hospital and he was dismissive of home testing and saw dogs as "regulated" when they become an acceptable pet again because they no longer have accidents in the house - Chris never had one to begin with. For a while that vet school was hammering away at using only fructosamine testing and clinical signs. So those approaches radiate out from the vet schools through all of their students.

Fortunately, many vets have come to appreciate home testing and it's a matter of finding a vet who is flexible, open to new information and ideas, and interested in getting the best regulation possible. They also need to take your expectations and desires into account - if they dictate to you instead of treating you like an essential part of your dog's treatment team, that's a problem. You know your dog better than anyone on the planet so your input is essential. And you're the one who has to day by day make decisions.

Some states seem to fall into the "difficult" category when it comes to vets! I know that sounds strange and it's strictly anecdotal but after five years participating on diabetes forums, it seems there are geographic areas where good vet care is really hard to find for a diabetic dog and Colorado has been one of those. I hope you will put a dent in that impression by finding a really great vet for Wiggins.

I don't think we have a Coloradan on the forum right now. But you can look up IMS through the the ACVIM:

http://www.acvim.org/websites/acvim/index.php?p=3

This database may not be up to date and if you find a clinic that interests you, the large specialty ones typically offer IMS and their websites will usually tell you a bit about the doctors.

Natalie

[peggy0]

Re: Wiggins Story

My favorite Vet moved from Dallas to Colorado Springs. He is not a specialist but one of the most caring vets I ever worked with. One of my springers had a very rare platelet disorder and was urinating blood, pure red urine. It was terrifying. He worked for days with Internal Medicine Group determining what it was, diagnosed it and he is now 13 years old and fine. I don't know how far Colorado Springs is from Denver, but he is a young great vet. I can email him if you'd like and see if he can refer an Internal Medicine Doctor in Denver.