Dog diagnosed 1/30... Need advice/help!

[jesse girl]

Re: Dog diagnosed 1/30... Need advice/help!

thats the hard part if you do believe the dose is to much what would the appropriate dose be ? The body maybe out of whack and may take awhile to settle . My jesse was overdosed by double . It was so bad i had to give spoonfuls of honey over a couple hours to just keep her from going into crisis

Seen others on the forum dosed by large amounts that was not needed . Sometimes resistance caused it . Maybe a medical condition . Lots of factors out there . Some just went to fast or to much or both

if your reduction is not enough you may see higher numbers . Sometimes you have to start over . which is where i went with jesse which was really hard to do because it said what i was doing was not the correct path

What you look for is blood sugar to become more stable

[Lolo]

Re: Dog diagnosed 1/30... Need advice/help!

I texted her vet and he said to take her down to 17 tonight. It’s all so confusing and frustrating. Even with these super lows 5-6 hrs in, she’s still in high 400s in the AM and PM a few hours before her PM meal/insulin. She’s on Novolin 70/30. I wonder if she wouldn’t be better on NPH. Does NPH last longer so maybe her doses would overlap somewhat and flatten out those highs? I’m not sure why my vet favors 70/30 but I think it’s the version he usually starts with.

[jesse girl]

Re: Dog diagnosed 1/30... Need advice/help!

Its very possible that 30 % of r maybe dropping her to fast . As discussed some do use R in conjunction with N and i have done that with jesse but not as a daily dose and only a correction to higher sugar

I think your pup maybe the only active member using it at this time as most have chose to dose the 2 insulin's separately and adjust them that way

I understand its frustrating as jesse has been diabetic almost 8 years and i cant say for sure what is going on with her and i have changed my mind many times on what i thought

[MikeMurphy]

Re: Dog diagnosed 1/30... Need advice/help!

I texted her vet and he said to take her down to 17 tonight. It’s all so confusing and frustrating. Even with these super lows 5-6 hrs in, she’s still in high 400s in the AM and PM a few hours before her PM meal/insulin. She’s on Novolin 70/30. I wonder if she wouldn’t be better on NPH. Does NPH last longer so maybe her doses would overlap somewhat and flatten out those highs? I’m not sure why my vet favors 70/30 but I think it’s the version he usually starts with.

As jesse girl says, the 30% R may be dropping her too fast. Novolin N may be a better option.

As you can see from the chart below, Novolin N lasts a bit longer in humans than Novolin 70/30. Of course, we have learned here on the forum that dogs process insulin differently from humans and every dog is different.

Going back to 17 units is a good move because you don’t want her going too low. Switching to N may be an even better move.

[Lolo]

Re: Dog diagnosed 1/30... Need advice/help!

It feels so awkward making suggestions to my vet (like suggesting switching formulas). I really have to get over that and just remind myself that being a pain in the ass is in the best interest of my dog.
He actually texted back and said to drop her to 16 to play it safe because I’m not going to be home during the day on Tues or Wed. I feel a little better about that because I’m afraid of her dropping too low when I’m not there to notice and give her something.

Ok. So I asked the question of whether she may do better on Novolin N. Whether it would last longer and then maybe she wouldn’t drop so low and then spike up hours before her next dose. This was the response:
“It would probably do the opposite of that. 70 percent is Novolin n and 30 percent regular. Short/long acting is referring to the onset of the peak effect. R is in the 1-2 hr and n is at abt hr 5 or 6. There are insulin types like Lantus and Toujeo but they can become cost prohibitive but if prices have come down they might be doable.”

Would it do the opposite of what I’m thinking?? I was thinking that maybe with a lower dose and it possibly lasting a couple hours longer that she’d never get up into the 400s at the point it seems to be wearing off or pre-kicking in.

[CraigM]

Re: Dog diagnosed 1/30... Need advice/help!

Sounds like your vet thought you were asking about Novolin-70/30, and not Novolin-N.

Craig

[Lolo]

Re: Dog diagnosed 1/30... Need advice/help!

Sounds like your vet thought you were asking about Novolin-70/30, and not Novolin-N.

Craig

He knows what I was asking. He’s saying that what she’s on (70/30) is better for aiming to get her flatter longer Vs N. He’s saying N would do the opposite of what I’m thinking/asking and explaining what 70/30 does with both short and long acting. In a follow up message he said both preps (n and 70/30) have the same length of effect.

[CraigM]

Re: Dog diagnosed 1/30... Need advice/help!

He knows what I was asking. He’s saying that what she’s on (70/30) is better for aiming to get her flatter longer Vs N. He’s saying N would do the opposite of what I’m thinking/asking and explaining what 70/30 does with both short and long acting. In a follow up message he said both preps (n and 70/30) have the same length of effect.

OK, guess I’m reading posts incorrectly.

Look at the charts Mike provided. If the charts are correct (every dog is different), it indicates “N” has a longer duration than the “70/30”.

Craig

[jesse girl]

Re: Dog diagnosed 1/30... Need advice/help!

Its very simple I think the more you give of N the longer it will stay in the system depending on how the body processe it

I have had a few observations with jesse . She has used 5 different types of insulin's and 2 different manufactures of nph insulin

She also is on one meal a day so i get a look at what insulin does without a food component . what i figured and its not set in stone that jesse can get about
4 to 6 hours of length from R insulin . about 16 to 18 hours from NPh

I dont think insulin runs out in less than 12 hours and a big misconception . I think its either overwhelmed by sugar or some how the body negates it . the concept a food can lengthen the action of insulin does not holed true for me . As i sugested it prevent a bodies response from using sugar to try to offset injected insulin

for me i look at whats problematic in jesses curve . for you its not the higher numbers but the big drop and lower numbers . you solve that and those higher numbers should come down

so what would you expect from a lower dose of 70/30 ? not what you hope for but what you think will happen and right it down .

most times with this disease we guess . i think our understanding of diabetes including the professionals is quite small . thats why vets dont like home testing they have to answer the question why and most times they dont know . Doing this for 8 years and i still shrug my shoulders

i was angry in the beginning at everybody my vet the forum why could nobody give me a straight answer? because there isnt one

you do know insulin works thats very positive you just want to smooth it out a bit and you will . most do

[amydunn19]

Re: Dog diagnosed 1/30... Need advice/help!

I think the reason 70/30 is not a great choice for most dogs is that the 30% is too high of a percentage of faster acting insulin. Since 70/30 is formulated for human use and the way the human body uses insulin will not be the same as for a dog because they tend to process insulin faster. Many dogs who can’t get an effective result with Novolin N by itself may use a small dose of Novolin R to go along with the N. So, just a smaller percentage of fast acting.

My thought is why your dog was even started on 70/30 - most dogs do well on intermediate insulin (N) and then maybe if they need some fast acting added, the 70/30 might be tried later. It is just a bit strange to start there. IMO it is best to start with something basic that gives a good result for most dogs, then you move to alternatives that involve fast acting if needed.

I think it would be interesting to see if your dog could get results on just NPH. To me, you are seeing this risk of the fast acting portion dropping the sugar too much.

So many of us developed our own theories on insulin action from our own dogs because we had to figure out answers we weren’t getting from our vets. To me, there are not many absolutes with diabetes in theory but I think when you do your own testing, you can see some things coming together pretty clearly.

Is getting a second opinion an option? I think you might be lacking confidence in the advice of your vet. I think we look at vets as these all knowing beings about every aspect of our dog’s health, but diabetes is just different. The training is limited and the vet just doesn’t have as much access to our dogs in their every day life to really know what is going on. Treating all diabetics the same is tricky as you can see just from all of the different dogs here.

[Lolo]

Re: Dog diagnosed 1/30... Need advice/help!

I guess I may have to get another opinion.
I just tested her and she’s at 555 at just over hour 11.. so almost time for next dose. She went up 200pts in 1.5 hrs. I just don’t understand what explains or would fix the huge swings she has in a day.

Here’s a super basic question... do I need to feed her more at mealtimes?? Would that help the high evening numbers or do just the opposite? She’s a good weight - doesn’t need to lose or gain.

[Raysaint]

Re: Dog diagnosed 1/30... Need advice/help!

Quite possibly the 70 part of the insulin is running out. NPH might have a longer staying power, and then you can adjust dose or food to keep the earlier part of the day in good range.

[CraigM]

Re: Dog diagnosed 1/30... Need advice/help!

Just guessing, throwing out ideas.

I’m thinking big increases late in the insulin and food cycle might be because the body is needing glucose (food) to fuel the body. For example, if the body is running out of fuel two hours before the next meal, the body might release stored glucose. The problem would be that the body can release stored glucose, but can’t produce insulin, so the blood glucose rises. The body over releases too much stored glucose. You might feed a small snack 2½ hours before the next meal so that the body doesn’t feel the need to release any stored glucose?

Just a thought / experiment.

Craig

[Riliey and Mo]

Re: Dog diagnosed 1/30... Need advice/help!

I wouldn't feed more till you find out from the manufacturers dog food the correct amount to feed a 60 lb dog

can you tell us what Lola is eating and how much?

also if the infection is gone she might be getting too much insulin.

60 lbs x .2 = 12 unit. Lola was on a higher dose because of the infection.

[Lolo]

Re: Dog diagnosed 1/30... Need advice/help!

She eats Fromms and their guidelines for 40-60 lb dogs is 2-1/8 to 3 cups a day... but notes spayed females may need less. Though I just noticed the measurement specifies fluid ounce cups not dry. I’ve always fed her a little under 1-1/4 per meal (2x) because she used to get a decent sized treat (or two) during the day. But turns out in liquid measurements she was getting closer to 1 cup per meal. I’m not really doing treats now so maybe she needs more food. But I have been adding 1/4 cup chicken and 1tbs pumpkin to her food lately to get her to eat it on time and completely. Maybe I should try upping her dry by 1/4 cup per meal? And try a 4p ish treat/snack and just see if it brings her number up or down.