Newly diagnosed Newfoundland dog - Boatswain

[jim maceri]

Re: Newly diagnosed Newfoundland dog - Boatswain

You are correct Jesse. Without the walks 3-4 miles a day, spirit would absolutely be on a higher dose. I am fortunate to be able to walk spirit when I see his numbers elevating thus keeping him within a range that is good for him.

As spirit ages I'm expecting to increase the insulin as his activity decreases.

[Boatswain]

Re: Newly diagnosed Newfoundland dog - Boatswain

Hi Natalie,

I have found Boatswain will either make a large drop or his numbers will go way up the first day or so after I increase his insulin but after that his numbers don't change much. I have not seen a big difference in his numbers from the start no matter what the dosage as he is still in the low to mid 300 range and goes into the low 400 range at 16 units. His numbers are better than they were overall but he still is much higher than my vet wants him to be and he does not drop to the 200 range very often at this point.

I am always worried each time I increase it since I never know what will happen. He seems to respond initially but then it does not last and it can take 4 hours or more for his numbers to drop. I am really not sure what this means and think that I may have to go up a lot on the insulin.

My vet did blood work when she diagnosed him and she said the indicators were not there for Cushing's disease so she felt confident that he does not have that. I am going to have follow up blood work done in a few months.

I am going to go up to 16.5 tomorrow and I might even go to 17 since I am not sure 16.5 will make a big difference with his numbers being so high. I had my vet check his eyes a few weeks ago and she saw something very tiny in his eye which may or may not be the start of a cataract so she wanted to get his numbers down asap.

He has been gaining weight and weighed 112 a few weeks ago at my vet's office. I can't weigh him at home but I think he may have gained another pound or so and will find out for sure when I take him back to the vet in a few weeks. He lost at least 20 pounds and I know it will take time for him to gain it back since much of the weight he lost was muscle.

I hope I will see some better progress with his numbers soon and hopefully I will be able to determine the correct dose soon.

Deana

I have seen a few dogs who just aren't very sensitive to insulin and small increases don't make much of a difference long-term. Loretta's Beau was one.

Have also seen dogs with Cushing's disease whose blood sugar kept bouncing up like a cork in response to increases in the insulin dose.

It's difficult to tease things like this out... I'm not worried about Cushing's disease unless the insulin dose has reached 1 unit per pound per injection and blood sugar is still exceeding 400.

If there's a clearly developed pattern that small dose changes don't make much of a difference, even temporarily, you can try making larger increases so you don't spend a year getting to 1 unit per pound and still no regulation... (that was sort of what happened to Beau).

BUT if at first the dose drops the blood sugar significantly toward hypoglycemia - sounds like that's true with Boatswain, you really can't do that unless you compensate for the low blood sugar somehow for a few days.

So it sounds like you can work slowly for a while yet in bringing his dose up and see how it goes.

With the blood sugar you describe, he should be able to maintain weight or even gain it... if that's not happening, then he may need more calories or there may be something else behind his being thin.

Natalie

[Boatswain]

Re: Newly diagnosed Newfoundland dog - Boatswain

Hi Jim,

Boatswain has been stuck in the 300 range for awhile now and I have not seen big changes with the increase in insulin. He is not going into the 500 and 600 range right now so that is a big improvement. I think he may have to go up a lot more. My vet said his dosage could be as high as 25 u twice a day but she thought 16 might be enough. I don't think it will be and will increase to either 16.5 or 17 tomorrow. I am checking him a lot today so I can better decide what to do.

His sensitivity to insulin is in the way of a giant spike in numbers or a rapid drop. It changes all the time so I never know what to expect so I check him every 1 to 2 hours each time I increase his dose. He seems to stabilize after the first day or so then his numbers don't fluctuate that much.

Our streets have finally melted so we walked him today and if we don't get anymore snow today, I am going to walk him 2 more times to see if that will make a difference with the 16 units. This is the first dosage where I have not really been able to walk him much so I am sure that does make a difference but I think it is still not enough based on his numbers.

Boatswain weighed 112 pounds a few weeks ago at my vet's office. He is still thin but looks much better than he did. The muscle will take awhile to come back but the walks are really helping so hopefully he will build it back by May or June.

I am learning to be patient and I can now see how important that is with this disease. I really hope I can bring his numbers down before further problems develop. I am a little worried about one of his eyes since my vet detected something very small and it was so small so she could not tell if it was the start of a cataract. She is going to re-check him him a few weeks and she said she wanted to get his numbers down asap.

Deana

If I remember correctly, we were having ups and down for the first 4 months and my journal said that in April I started seeing consistency so that was 6 months to finally get consistent numbers under 200.

Patience is truly a virtue with this disease....the key is to stay on track. I think I said that we were on the 3 day wait plan with a half unit change on the 4th day. Spirit is also very sensitive to insulin changes but because he is a giant breed I wasn't too concerned with changing the dose after 3 days. Keep an eye on the numbers once you start walking again.

I've found right now that spirit is getting some very nice numbers at 15.5-16 units....it fluctuates daily. Spirit is 115 lbs so if one was to go with the "charts" he should be close to 30 units 2x per day so you still are on a relatively low dose for a dog his size. Keep up the great work....your almost there.

[Boatswain]

Re: Newly diagnosed Newfoundland dog - Boatswain

Spirit's levels are very well controlled by Jim and it sounds like exercise has made a huge difference. Newfs have slow metabolisms so I think exercise helps a lot. Boatswain is still young and has a lot of energy but I am sure as he ages, he will not be able to handle as much exercise as he gets now.

Our street has finally melted so I was able to walk him today and will hopefully be able to again later today if we don't get more snow today but there is more bad weather in the forecast so I am sure it will be another week or so before I can resume the 3 walks a day. I think his dose might change when I can resume the regular walks. I have been checking him often since I still have no idea where he will end up with the dosing.

I am going to increase his insulin tomorrow since his numbers have not been very good on the 16 units. I might try bigger increases but don't want to do more than 1 unit at a time since he will either take a big drop or a big increase in BG the first day or so after any increase.

Deana

i think jim uses exercise as an important part of spirits regulation maybe the breed is very dependent on metabolism which can affect blood sugar

i believe jims approach is creative and does involve more testing and time within the day to accomplish and his results are very good for his spirit . now it appears he has seasonal adjustments to insulin

now exercise is very limited for your pup at this time due to weather so if jims spirit was getting the same exercise as boatswain spirit maybe on a much higher dose of insulin then what he is getting now

so as natalie suggested you may have the opportunity for a larger dose adjustment . the only thing you might take in consideration is when the weather improves and exercise comes back into the equation you may have to reduce the dose .

[Boatswain]

Re: Newly diagnosed Newfoundland dog - Boatswain

Today is the 2 month mark since Boatswain's diagnosis and 2 days ago his numbers started really dropping. He has gained back 7 pounds with a lot of it being muscle and he is up to 114. He needs to gain about another 11 pounds which will come in time. My vet said he looks really great and is responding very well. My vet is going to do a fructosamine test when his numbers have been in the 200 range for a few weeks.

I found out last week that Boatswain has another UTI so he is back on Keflex. This the 3rd UTI he has had in the last 2 months so my vet wants to keep him on maintenance after the 14 days course with 1 Keflex every other day.

I have also been giving him 30mg of Pepcid twice a day 30 minutes before injection which has helped him a lot and he no longer seems like he feels sick following the injections.

For the last 2 days he has mostly in the low to mid 200 range and even into the low 100 range yesterday. I dropped back to 17.5 today since yesterday at 18 he was dropping quickly so I had to shorten one of his walks and give him 2 biscuits for fear of another hypo event. I will see what happens with 17.5 today and will go back to 18 depending on what his numbers are. I don't want to cut out many walks since he needs to put more muscle back on so if I need to go back to 18 then I might try adding more biscuits to compensate.

I wanted to ask about how much I should lower the dose depending on what his numbers are before injection? I am having a hard time figuring that out. I gave 16.5 last night since he was 237 at injection time. I am not sure if I should always give the same dose or adjust it?

Thanks!
Deana

[Monsters Momma]

Re: Newly diagnosed Newfoundland dog - Boatswain

Today is the 2 month mark since Boatswain's diagnosis and 2 days ago his numbers started really dropping. He has gained back 7 pounds with a lot of it being muscle and he is up to 114. He needs to gain about another 11 pounds which will come in time. My vet said he looks really great and is responding very well. My vet is going to do a fructosamine test when his numbers have been in the 200 range for a few weeks.

I found out last week that Boatswain has another UTI so he is back on Keflex. This the 3rd UTI he has had in the last 2 months so my vet wants to keep him on maintenance after the 14 days course with 1 Keflex every other day.

I have also been giving him 30mg of Pepcid twice a day 30 minutes before injection which has helped him a lot and he no longer seems like he feels sick following the injections.

For the last 2 days he has mostly in the low to mid 200 range and even into the low 100 range yesterday. I dropped back to 17.5 today since yesterday at 18 he was dropping quickly so I had to shorten one of his walks and give him 2 biscuits for fear of another hypo event. I will see what happens with 17.5 today and will go back to 18 depending on what his numbers are. I don't want to cut out many walks since he needs to put more muscle back on so if I need to go back to 18 then I might try adding more biscuits to compensate.

I wanted to ask about how much I should lower the dose depending on what his numbers are before injection? I am having a hard time figuring that out. I gave 16.5 last night since he was 237 at injection time. I am not sure if I should always give the same dose or adjust it?

Thanks!
Deana

Poor thing! We've been fortunate that Vinny is very healthy...with the obvious exception of the diabetes (she says knocking on anything with wood )! I hate hearing about others' struggles and only being able to offer prayers! I'm sure others will come along with input on the UTI's.

As far as your last question about adjusting doses...the only times I have adjusted Vinny's dosages is after a curve (or two lately) or if his numbers at fasting were very low. Others will tell you that if their dogs don't eat their full meals is also a time to adjust...Vinny always finishes his meals! If you are constantly adjusting, Boatswain's body can't get used to it. It's just like if you weren't giving him the same meal and always changing it. He needs to get used to having the same amount of food, insulin, exercise, etc. before you can determine if everything is working for him. Only then will you have a curve that is truly representative of what is going on with Boatswain on a consistent basis.

If you haven't read the Milk Shake Analogy, http://www.k9diabetes.com/forum/showthread.php?t=4051 this really helped me to understand the relationship between food and insulin.

It really looks like you are doing great!! Especially with only being at this for two months!! I wish it had been that easy for us!
Mel

[Boatswain]

Re: Newly diagnosed Newfoundland dog - Boatswain

Hi Mel,
Your Vinny is adorable!! I have always loved black dogs! I am so glad he is healthy and doing so well. I think Boatswain's UTI's will lessen when his numbers remain lower for longer and with any luck maybe he will not get them any longer.

Thanks for the link and I had not read this before. Natalie really explains this well and I have a better understanding of how insulin works. I am still not sure about the drop though and don't know if I give him the current dose then might he drop too low since his range was so much higher when I got to this dose.

He is down to 188 now and due for a shot at 7:30 pm. I feed a low card grain free food which takes awhile to digest so I am not sure what will happen when I inject him. I am not used to the 100 range yet since this is only the 2nd day so this is a new aspect of the disease I need to learn. It is so nice to not be seeing the really high numbers right now.

Deana

Poor thing! We've been fortunate that Vinny is very healthy...with the obvious exception of the diabetes (she says knocking on anything with wood )! I hate hearing about others' struggles and only being able to offer prayers! I'm sure others will come along with input on the UTI's.

As far as your last question about adjusting doses...the only times I have adjusted Vinny's dosages is after a curve (or two lately) or if his numbers at fasting were very low. Others will tell you that if their dogs don't eat their full meals is also a time to adjust...Vinny always finishes his meals! If you are constantly adjusting, Boatswain's body can't get used to it. It's just like if you weren't giving him the same meal and always changing it. He needs to get used to having the same amount of food, insulin, exercise, etc. before you can determine if everything is working for him. Only then will you have a curve that is truly representative of what is going on with Boatswain on a consistent basis.

If you haven't read the Milk Shake Analogy, http://www.k9diabetes.com/forum/showthread.php?t=4051 this really helped me to understand the relationship between food and insulin.

It really looks like you are doing great!! Especially with only being at this for two months!! I wish it had been that easy for us!
Mel

[jim maceri]

Re: Newly diagnosed Newfoundland dog - Boatswain

Hi Deanna!

I am thrilled you are seeing better numbers. Spirit is now 115 pounds and I have his day dose at 15.75 now and night at 16. I may drop the day dose a bit because he has been going low (120) early and it is affecting our walk schedule.

With regard to dosing...I always keep spirits the same. If he is low at shot time, (100) or lower, I simply feed him and wait 15 minutes to give him his normal dose so the food gets a head start. I'm a fan of keeping the food and insulin the same and using "treats" if he needs a boost. I've found that changing insulin for him can really give me some odd swings.

I know you've heard this a hundred times but every dog is different and you are writing your own book for Boatswain. BTW....you are really doing great and your commitment is really paying off quickly! Before you know it this will get easier and easier for both of you. Congratulations on the great results.

Jim

[Boatswain]

Re: Newly diagnosed Newfoundland dog - Boatswain

Hi Jim!

I so glad Spirit is doing great and hopefully you can get back to your walking schedule soon. I hope his UTI is gone now.

It is really exciting to be seeing the lower numbers and Boatswain is doing really well. I still trying to work out issues with his dosage and I am going through the same thing right now with Boatswain regarding his walks.

I went back to 18 since he was not dropping low enough with 17.5 but now all of a sudden he is coming down more rapidly. I usually walk him in the morning but I did not today and when I checked him at noon he was 150 so he would have been below 100 if I had walked him. I want to be able to walk him at least 2 times a day and this is tough with his numbers being so low.

I have been keeping his insulin the same but am wondering if this is working for Boatswain. My vet wanted me to decrease it by 1 or 2 units if he was lower and it seems some people do and some don't. I find the lower his numbers are at injection time then his drops are much larger and occur quicker.

He was more stable at 17.5 but was not dropping low enough. I know in time I will figure it all out and maybe adding extra food will help. He can use the extra food and has no fat on him right now so his shots can only be on the shoulder right now. I decreased his food early on since his numbers were going so high but I think now he might be able to tolerate it with the higher dose.

I am still trying to decide what to do and may reduce his dose again if increasing his food does not help. I would like to try 17.75 but can't really do that with the syringes I have. Which ones do you use?

Deana

Hi Deanna!

I am thrilled you are seeing better numbers. Spirit is now 115 pounds and I have his day dose at 15.75 now and night at 16. I may drop the day dose a bit because he has been going low (120) early and it is affecting our walk schedule.

With regard to dosing...I always keep spirits the same. If he is low at shot time, (100) or lower, I simply feed him and wait 15 minutes to give him his normal dose so the food gets a head start. I'm a fan of keeping the food and insulin the same and using "treats" if he needs a boost. I've found that changing insulin for him can really give me some odd swings.

I know you've heard this a hundred times but every dog is different and you are writing your own book for Boatswain. BTW....you are really doing great and your commitment is really paying off quickly! Before you know it this will get easier and easier for both of you. Congratulations on the great results.

Jim