Fragile Doggie and Mommy Need Help!

[runtotorun121]

Re: Fragile Doggie and Mommy Need Help!

Not back to normal yet, but we have achieved something other than the pudding-ey or liquid-ey diarrhea! We'll have to see how it all plays out after we resume our normal diet in a day or two, but last night Snowball was really beside himself. . .with excitement! because he manipulated me into a bedtime snack (aka BG was a bit low and he insisted it would go lower without sustenance. . . ) So at 84 I went ahead and caved in and gave him an ounce and a half of plain fat free yogurt. Sprinkled additional probiotics, and voila!, snacky time for the sad little starving Min Pin.

I expected some higher numbers with that, but they weren't horrible, and I told myself he really could use that yogurt for some good buggies in his belly and for the added calories.

He still had diarrhea at morning pre-breakfast poos. When he first got up he pee peed and then had a little diarrhea followed by some poo that looked as though it was trying to form. The best description I had for my mom was it was like those 4th of July snakes the babies and I did on the driveway this year. Skinnier, more like a pencil, and definitely soft, but not just applesauce-ey or runny. I had to haul him to Sunday School again because my husband disappeared this morning, but we have a tiny church, and our Pastor told me last week that Snowball is "family". So he had his breakfast and AM shot there. When he pottied after eating he had some diarrhea liquid, and I was hoping (but still a bit worried) that we might be coming to the end of getting out all the ickiness. He also had a little accident in his pet taxi while he was waiting for Sunday School to end so he could get his breakfast on.

When we got home this afternoon I decided to give just a little Pepto Bismol to try to reinforce the pumpkin (I increased his breakfast and supper amounts today). I figured I would try a day or so of that before loading up for the vet. So we had supper tonight, and after supper he pottied, and we had more of the formed soft stuff. Most certainly not back to normal yet, but I am happy it is not a pile of mooshy diarrhea. Also glad I didn't constipate the ol' boy. I will add the pumpkin for another day or two and just deal with the slightly elevated numbers. Really not too much of a big deal. The yogurt gave him a little kick in the BG pants, but the pumpkin is not horrid. Then hopefully when I get back to things as usual the poop will be okay and revert back to diarrhea. I have a sense that even with intervention, if he had some significant issue causing the diarrhea it would not resolve so I am feeling better. Of course he looks the same as always. Hungry and perturbed at the lip-jabbing and lack of tasty morsels.

And I was noticing tonight that when he pees his pee pee stream is nice and strong and aimed somewhere besides down his front or back leg. And he can get into position and hold himself up to poo with no problem. Last night I skimmed back over some of what I posted when I first arrived here, and it really drove home how significantly he has improved over the last couple of weeks. Sure makes me feel better. Now to master that poo!

[runtotorun121]

Re: Fragile Doggie and Mommy Need Help!

Well crum, Crum, CRUM. This morning we had even more of the forming poo, but after breakfast we had diarrhea again. I know Pepto indications are one to two days. We have only done one. . .trying to figure whether or not to continue with it another day.

I did not give the pumpkin this morning since it can act on both diarrhea and constipation. Didn't want it to be working the wrong way. Pondering whether subQs might help. They help with kidney related diarrhea. . .

On a positive note, he still looks unphased by the diarrhea, and still getting plenty of liquids in him.

[peggy0]

Re: Fragile Doggie and Mommy Need Help!

i'd ask the vet for some flagyl. it works almost immediately. I know its an antibiotic, but …. there will be times when you've got to provide them anyway.

[runtotorun121]

Re: Fragile Doggie and Mommy Need Help!

Yes! Excellent suggestion!!! I have the call in. They are in surgery right now, but the front desk pulled Snowball's chart and have a message to give me a call and/or get a Rx ready. Hope that goes well and is not a "We need you to bring him in" (AKA "Give us some money!"). Since Flagyl is pretty harmless I hope there is no problem.

[peggy0]

Re: Fragile Doggie and Mommy Need Help!

I've never had an issue with it and have not needed to give it the full 14 days. My vet said a good 3 days should do the trick unless there is a parasite or something causing the issue

[runtotorun121]

Re: Fragile Doggie and Mommy Need Help!

Oh, yes! I meant to say "no problem with them Rxing some"!

I actually just spent 45 minutes on the phone with them. Tell me that they are not invested in trying to be helpful. The said some Flagyl would be okie dokie but answered my question and confirmed that if there was some underlying more serious problem neither the pumpkin nor the Pepto intervention would have made the poo begin to from the way it was. It would have just stayed diarrhea and gotten worse. So it is not as they they helped a wee bit and just couldn't battle it.

Like me, they suspect stress colitis, and they said he is not danger (based on his clinical presentation. . .well my description. . .and knowing I am a bit of a protective Bear of her little cub and doing a lovely job of caring for him ), and they would think that in another day or two he would be better. They said I could get the Flagyl Rx now or wait. And I can continue pumpkin and/or Pepto or wait. They said there is really nothing I can do wrong right now. I think it helps that I know he is drinking enough fluids to stay hydrated since I mix them into his food/soup!

During our conversation she actually said he is a "miracle" and discussed how anyone who had seen his chart that day I took him in would have believed he was dying and wouldn't make it another day. We laughed because I told her I can't even imagine the things they thought or said after I walked out with my Rxs, bag of fluids, and little bag of Min Pin skin and bones. I imagine they felt quite sorry for me. She was laughing and said something really must be at work because they definitely thought he was not going to survive. Ahem.

And when I told her about his NOC glucose being lower than his daytime glucose she said he certainly is his own unique self. She even mentioned the idea of cutting out carbs and going no-insulin. I can talk more about that later, but let's just say I was not quite convinced, and she was not pushing it. She just wondered about it instead of trying to push diet and increase to 1u whether or not going the other way was the thing to do because he might be producing insulin? I mentioned honeymooning and such, and she was open to whatever I want to do with him, but she was just flabbergasted that he is only on 0.5u and still is getting lows where he needs some glucose-boosting. Since he was off the meter (over 750 or so ) in their office. She said 2.5 would be the starting dose for his weight. I didn't argue since we have already been through it being too high once I found my way here and heard from you all. But I did say something about initially getting the "wrong" insulin, and she said, "yes". Mmhmm. Trying to snuff out my Snowball with R!!!

Okay, gotta' go pick up the toddler from VBS. So I guess I may hold on the Flagyl for another day or so, but she said no problem to get me a script.

[jesse girl]

Re: Fragile Doggie and Mommy Need Help!

yes isnt it just amazing if given the opportunity how well they can come back from the brink

[runtotorun121]

Re: Fragile Doggie and Mommy Need Help!

Oh yeeesss, I am a ginormous anxiety freak-ball who decided to call the vet and request to have the Flagyl on hand 'just in case' I found I couldn't wait in the middle of the night.

Even though they confirmed that his poo wouldn't show improvement with form, no matter how much pumpkin or Pepto I gave him if it was something unresponsive/untreatable by those, and I think I recall her saying it was a normal course to go from diarrhea to a bit formed and back and forth again, especially if he was still a little stressed and maybe out of kilter. . .but this afternoon we had teensy form at beginning of poo and then the rest liquidy.

So back-and-forth normality or not, I am going to pick up the Flagyl in a bit so I have it. Even if I don't use it this time I will feel reassured knowing it is sitting there.

[amydunn19]

Re: Fragile Doggie and Mommy Need Help!

I started to say that maybe you should get it and that way you have it - it is a good thing to have on hand.

[runtotorun121]

Re: Fragile Doggie and Mommy Need Help!

Got it. I don't feel as pressured to use it right away, but I feel some relief knowing I have it in my bag.

[runtotorun121]

Re: Fragile Doggie and Mommy Need Help!

Geeze Louise, Snowball.

I can do more numbers later, but let's just say I keep having to pull out the snacks post-insulin because we are dipping. At the very least, I am having to watch like a hawk.

That being said, today at our one-hour-post mark (after breakfast) we had a crisis BG! My Prime said 23, which scared the crap out of me! I was just getting ready to head out the door to take the toddlers to the dentist, and I thought, OH doG! Snowball was not shivering and just laying there looking at me as though I was insane, but when I came back with the Karo-dripping mini Milkbones he was, as though you have any doubt, like a wild beast on food! Nope, he was not lethargic or uninterested in food. . .hmmm. When I calculated what the level might be I got 33!!!!!!! So now WHY in the world was he not looking peaked at all???? I mean he was excited about the snack!

I put out the SOS and begged my husband to get to the house to do a BG in 15-30". I ended up racing back to the house after I picked up the kiddos from VBS and on our way to the dentist (by way of our house ) and ran a quick test, and it was 114. I thought that was a good sign and told my husband to test again in one hour to make sure he was still trending up since I would be at the dentist for a couple of hours. When he tested it was only up to 116. If I had been there I would have let it ride and tested in another hour, but he made the determination to go ahead and douse a couple more minis because he was going to have to leave the house and remembered me saying it is always better to be too high than too low, and with both of us gone he wanted to err on the side of caution. So when I got home Snowball had, of course, CRAZY BG!!! But I was relieved it was high and not low. It was a ridiculous 539. Not that Snowball was complaining about the four Karo drenched bones. . . And put into perspective, still not off the meter like when he went to the vet's. . .

So an hour later, right before his supper it was down to 500, and I am thinking, "Well tonight is a night we can sleep because certainly the insulin is not going to tank that number in the middle of the night". . .but this is Snowball, right? So One, YES, ONE hour post insulin he had dropped to 178. SERIOUSLY??? Below 200 in one hour??? Now I am thinking we obviously are not going to be slipping though the night tonight. Any bets as to whether or not we are going loooowwwww again? I mean we are only one hour in!

I just sort of nodded nicely at the vet tech's thought yesterday that perhaps Snowball could come off the insulin entirely. I mean I have done some reading, and it seems canine diabetes is almost always (or ALWAYS?) insulin dependent, right? Her idea was to eliminate all carbs from his diet and do away with insulin. So what, an all protein diet??? I am not sure that is even possible. I mean how could that be healthy??? And isn't she insane to think that is something that would work? But what in the world is going on that 0.5u is too much for the 5-6lb Min Pin???????? She still maintains his calculated dose would be 2.5u.

Any ideas???

(off to jab lip again. . . )

[k9diabetes]

Re: Fragile Doggie and Mommy Need Help!

I would not have given the snack once you had level blood sugar in the 100s. I would have let that ride.

While to a point, it's better to be safe than sorry, you also can create additional drama that way and muddy up the food / insulin balance so much that you can't really know what to expect or what's working and what isn't.

Some dogs are very sensitive to insulin. My 65 pound diabetic dog needed just 11 units of NPH per injection and 7-8 units of a faster acting insulin given more often. So that was approaching 1/10th of a unit per pound.

That's about where you are at 0.5 units per injection - it's just really challenging with a tiny dog who is sensitive to insulin.

I would also caution that sharp drops do not necessarily mean he's on too much insulin. It can mean that, but it can be many other things as well.

I personally think too many dogs' swings in blood sugar get attributed to overdosing. Sometimes it's really just a matter of how they absorb food and insulin despite the dose being essentially correct. So it's a matter of how it gets delivered, not how much is injected.

There are also conditions that can make a dog highly sensitive to insulin, such as a lack of cortisol production.

And there can be times when diabetes is more about some other process gone haywire than about the pancreatic insulin-producing cells failing. The liver, for example, is involved in maintaining a baseline blood glucose level. If the liver has a problem, or the signals to the liver involved in regulating that process, you can have a diabetic dog who suddenly needs far less insulin.
.........

It's going to be a bit before I can go back through your thread... my gut instinct is that you need to find a place, even if it's giving 1/4 unit of insulin once a day, where there is no need to panic or give snacks, etc.

Unless you find that stable place, you can't sort out what IS needed to the best regulation possible.

This is one case where going to once a day dosing or, if necessary, every other day dosing, may be the only way to get a handle on what works and what doesn't.

And you will have to don eight or ten patience hats - because in the end, patience and slow, steady, methodical, nonpanicked is the only way to get this kind of thing sorted out. With some higher than ideal blood sugar along the way.

Natalie

[runtotorun121]

Re: Fragile Doggie and Mommy Need Help!

First, we began at 500 at suppertime (after the incredibly copious amounts of Karo and milkbone ), and now at 3hrs-post we are down to 94.

Second, I completely agree that getting to a place where no panic about lows and no snacking is imperative. I am okay with higher numbers since he was obviously insanely high before we began trying to lower those a bit, and I don't mind slow-but-steady at all. I just don't know how I am suppose to get there. I feel as though I don't have a map so I feel like we are lost and just wandering around wishing we had some definitive direction to head.

I have had the suggestion to try to raise his BG with food so we can increase his insulin to a full 1u, which would give me some 'play' if necessary at some point, but I am a bit unsure how to proceed with that. I could change over from chicken to beef, but beef would be harder on kidneys and liver function so if there could begin to be any compromise there then that is not good. I know I don't want to increase the oatmeal carb. . .Sort of perplexing. If there are liver issues, then cod would be the best alternative for protein, but I would guess it is lower in calories than the chicken, and we are already struggling to get enough calories out of his "good-for-him" food.

I had no idea that some alternatives, based on presentation and response to the insulin might ever be once a day or even every other day. That is helpful information for me to know it is there on the shelf for inspection.

Okay, we are only at 94, but I am going to test him in 30" or so to see how things are going.

[k9diabetes]

Re: Fragile Doggie and Mommy Need Help!

I don't know that I would want to stuff him with food to get him up to 1 unit of insulin... even if you can't very accurately measure such small amounts, you still know you're giving less than 1 unit and more than zero.

Has honeymooning been discussed?

(Pardon if that's a stupid question - I have been swamped and unable to keep up with things at the forum recently.)

Personally, I would cut him back to once a day or even skip a day and check his blood sugar and see what happens.

If nothing else, you should be able to find out whether insulin overdose has anything to do with the problem that way.

Our dog was diagnosed very soon after onset and he honeymooned for six months. At one point, our 65 pound dog was on 1 unit of insulin once a day and had normal blood sugar.

Lows are dangerous so I would move quickly to prevent them, even if that means giving insulin less often.

If he really needs the insulin twice a day, you will find that out quickly.

Natalie

[k9diabetes]

Re: Fragile Doggie and Mommy Need Help!

I have heard of two dogs who supposedly were regulated on once-daily NPH.

It's always hard to know if what we were being told is true, but it's not impossible for once a day to work, just rare. That's two dogs out of probably a thousand I've seen pass through forums over the last 10 years.

I think messing with food is just too complicated. First drastically reduce the insulin or stop it for a day or two and see what happens to the blood sugar after 48 hours - long enough for effects of any possible overdosing to clear.

Natalie