Help Very High Glucose

[amydunn19]

Re: Testing after regulation

One advantage to testing at least twice a day is that over time, you can catch a problem or infection before it gets out of hand. I got to the point that when Maggie had a couple of readings that were much higher than her usual readings, I would know that something(most likely culprit - urinary tract infection) was wrong and look at some type of infection brewing. It is all a part of staying on top of this disease.

[Eddie]

Re: Testing after regulation

We test twice a day at times when we know he is likely to be running low. It means we can catch it before it goes too low and/or adjust his exercise. We have not done a full curve for a long time.

We do adjust our dog's insulin dose somewhat depending on the test results and also we notice each year a gradual reduction in the dose he needs in the warmer months, and it increases again in the winter. Without consistent testing, we would probably forget to make that adjustment and end up giving him too much insulin in the summer.

Antonia

[KathyLindly]

Re: Testing after regulation

Thanks everyone for your responses, the day after I posted this I ended up in the hospital for 2 1/2 days. During that time Mollie missed three insulin injections but was fed her prescription diet at the regular intervals, 6 AM and 6PM. I did tests that afternoon 5/22 from 12-6 and resumed insulin at 4 units 2X a day on 5/23
12: 327
2:00 351
4:00 400
6:00 284

5/25 12 hour curve
6 AM 417
1/2 can Hills w/d 4 units of insulin Humulin NPH
8 AM 402
10AM 302
12 509
2 400
4 579
6 117

New insulin vial
5/29 12 hour curve
6 AM 382
1/2 can Hills w/d 4 units of insulin
8 192
10 251
12 202
2 196
4 84
6 176
My vet just called and asked if I had changed either insulin or syringes, that she thought the insulin was deteriorating for the 5/25 curve which was significantly higher numbers than the 29 May test. The first vial was about 5 weeks old, will the effectiveness of the insulin deteriorate at 5 weeks? I know the manufacturer recommends discarding it after 30 days but I have also read that there should be some wiggle room for the discard date. Have any of you experienced the loss of effectiveness at greater than 30 days? Why would opening a new box of syringes from Walmart as opposed to Walgreens have an affect on her numbers?
Thanks for your insight into all of this

[Raysaint]

Re: Testing after regulation

Drug expiry dates are usually conservative, they are still effective after. My vet said most of her clients get 7-8 weeks from a vial, me included.
And curves are going to be different, that's the nature of the body. Hard to draw correlations between numbers and just one thing that changed.

[Daisydog10]

Re: Testing after regulation

Raysaint is right about drug expiration. Due to the drug companies and lawsuits, if they even think a drug will lose any efficacy, the expiration date is marked long before that happens.

I had the same experience with Daisy. I had her regulated, opened a new vial of Novolin N and her numbers tanked to the point where I dropped her a whole unit and drove home from work at lunch to check on her. I noticed you had the same issue with Mollie. Makes me wonder.

[Raysaint]

Re: Testing after regulation

Expiry dates for insulin are for unopened vials. Once opened, a lot of websites say that insulin can start to lose potency after 28-30 days. So yes it's still effective after the 30 days, just not as effective.
I didn't buy into that before, but now I'm curious, and I'm going to watch my dog's numbers after 30 days.
And if I'm going to increase his dose after a curve, I'll make sure it's with insulin less than 30 days old, just in case.

[amydunn19]

Re: Testing after regulation

When Maggie was on Humulin N, I could always tell a big difference when the vial was over thirty days old. Her numbers started going up gradually. Novolin N didn't seem as bad - it could always go a little longer. But, once I got my insulin at Wal Mart, it was inexpensive enough that I just replaced it every month.

[KathyLindly]

Mollie's Story

Mollie was diagnosed on April 3 with 4+ keytones , a glucose level >700 and She was immediately treated with fast acting insulin, she remained at the vet as an out patient for the remainder of the day and began insulin therapy (Humulin N) of 2 units 2X a day and eating Hills w/d canned food, ˝ can 2 X a day with outpatient monitoring for 4 days until I received my AlphaTrack

She was at 4 units of insulin but I am still concerned about her numbers. She saw the vet a little over a week ago to have a fructosamine test and urinalysis, she has developed cataracts almost overnight, once the cataracts form can anyone tell me about how long she will have before she looses her vision?

Her urine is clear had no glucose and the vet called Wednesday with the results from the fructosamine tests and is reducing the insulin to 3 units 2X a day and mentioned a somogyi effect which I really do not understand, she is supposed to send me more info in an email but I have not received it yet. I searched the forum and could not find an explanation for this. The results of the curve after 7 days of the reduced insulin are listed below.

She is now at 11 pounds, down from 13.5, she was overweight and experiencing problems with her knees but I do not want her to lose any more weight. I am so new at this that I do not want to add something to her food but I am very concerned about the weight loss. Does anyone have ideas on how to stabilize her weight?

I am concerned that her numbers are still too high I am home testing using the Alphatrack 2, it appeared that she was on the way to regulation on 6/9 and 6/20 then on 6/27 the numbers were on the rise again. Any time I have an extremely high or low number I check the meter using the control solution. The last four 12 hour curves .
6/9
6 AM fasting 137 4 units insulin 1/2 can Hills w/d
8 AM 164
10 AM 192
12 PM 343
2 PM 296
4 PM 286
6 PM fasting 209

6/20
6 AM fasting 179 4 units insulin 1/2 can Hills w/d
8 AM 238
10 AM 349
12 PM 301
2 PM 211
4 PM 142
6 PM 129


6/27
6 AM fasting 434 4 units insulin 1/2 can Hills w/d
8 AM 231
10 AM 309
12 PM 332
2 PM 300
4 PM 164
6 PM fasting 159

07/06
6 AM fasting 513 3 units Humulin 2X a day 1/2 can Hills w/d
8 AM 385
10 AM 390
12 PM 479
2 PM 363
4 PM 469
6 PM Fasting 494

I would appreciate any comments because I am very confused about wy reducing the insulin amount and having higher numbers is good for her.
Tomorrow she will begin using the Novolin from Walmart instead of the Humulin, should I check her before the 7 days of continuous use on the new insulin?

[CraigM]

Re: Mollie's Story

I'm also confused why the vet suggested the insulin reduction. She seemed good on 4 units, and is higher on 3 units. Also, I don't believe you can determine Somogyi overswing from a fructosamine test. I personally, would return to 4 units. You are home testing and haven't seen any readings below 100ish?

About her weight. You are feeding w/d which is a high fiber diet. This would be a great diet to loose weight, but not gain weight. If you want to stay with w/d, and gain weight, you'll probably have to increase the portion size. Of course a larger portion size might need slightly more insulin. Another way would be to swap out some the the w/d with a more normal (less fiber) food.

Cataracts vary from dog to dog. You might want to see a specialist. My Annie battled eye problems for years (eye drops, surgeries and more eye drops) before going totally blind. Actually, blindness isn't so bad for Annie.

If you feel like testing when switching to Novolin-N, go ahead. More than likely the numbers won't be that different than with Humulin-N.

Craig

[jesse girl]

Re: Mollie's Story

hi and welcome

i would do another curve at 3 units on july 13th ( week from the last curve )

if still at the same levels as the last curve i would bump it up to 3.5 units then wait a week and do another curve

it looks like the 4 units is as high as you can go for now . so you know the top end of the equation and maybe you will now the bottom with another curve

now if the numbers turn much lower on 3 its possible you may have to reduce further

your vet is talking about rebound . when a dose is to much you may see big swings in blood sugar from low to high and high to low . its a protection mechanism of the body to keep an individual dog from going to low so the body dumps sugar from its stored reserves thats why you see these big swings

now its possible the 4 units may level out a bit better many of the ranges was pretty good but i understand your vets concern and why what he did

as far as cataracts its and individual dog thing but for dogs sight isn't their primary sense and actually a dogs sight isn't the best to start with . usually they adapt very well to the new reality. of course we have a harder time with it

doing really well this new into this and glad your testing sugar at home it will be a big help

[Raysaint]

Re: Mollie's Story

I'm confused why the vet reduced the insulin when the curves were good on 4 units. You usually don't reduce based on fructosamine.
4 units is a good dose based on his weight. Once he is regulated he'll probably gain a pound or two. My dog lost about 4 lbs but gained it all back.

[amydunn19]

Re: Mollie's Story

I don't see how the vet determined from a fructosimine test that she was experiencing somogyi. I would go back to 4 since the numbers at 3 are across the board higher. The curves tell the story. At the very least, go to 3.5 units. The logic doesn't make any sense.

[Monsters Momma]

Re: Mollie's Story

Hi there!
I just wanted to add my welcome! You and Miss Mollie have found a wealth of information when you found this forum, and of course, people that live this diabetes thing day to day! I have always found everyone to be very caring and extremely supportive!

I found this website http://www.vetsulin.com/vet/Monitoring_Somogyi.aspx that explains the Somogyi effect better than I could. I thought graph they used was a great illustration. I'm no expert, but I didn't really see that in the numbers you shared.

You've already had some good advise, I don't have a thing to add to that. You already have a really good handle I think this. I'm glad you've found us!
Mel and her Monster Vinny

[Daisydog10]

Re: Mollie's Story

The curves on the 4 units don't look that bad and the 4 unit low number is pretty much there.

But... I overshot Daisy by only .2 units and her numbers were back in the 300-400's on fasting. Daisy lost 6 lbs with high glucose numbers so I stabilized her weight by adding a little food (1/4c) very slowly. I thought because of the extra food, I needed to up her insulin. It was suggested here that I drop back the dosage a little and when I did, she was back in normal range.

[MikeMurphy]

Re: Mollie's Story

As veryone else has mentioned, I also don't see anything in her curves that would indicate somogyi rebound.

Her numbers at 4 units look pretty good. If you are switching to Novolin N tomorrow, it wouldn't hurt to leave her at 3 units for 5-7 days while doing spot checks and let it settle in, re-evaluate and adjust the dose accordingly.

It looks like you are very close to the proper dose, so I would only make .5 unit adjustments.