Newly diabetic and insulin doesn't seem to be helping

[CrazyDogMom]

My 13 year old beagle Sammy was diagnosed with diabetes almost a month ago. The vet started him on 10 units of Caninsulin once a day as he only eats once a day at dinner time. After 2 weeks, Sammy was still drinking a lot and urinating a lot, mostly in the evening after eating and over night. During the day, he doesn't seem too thirsty and does not need to urinate as much. The vet had us increase his dose to 11 units and then again to 12 units with no change. He had a glucose curve last week and his blood sugar is rising to 20 after eating and insulin and there is no change after the insulin. His sugar is still high in the morning and the lowest it gets to is 11 right before his next meal. Now we are at 14 units once a day after feeding at 5 pm. It has been 4 days, but he is still as thirsty as ever and having accidents in the house and needing to go out every 30 min to an hour in the evening and over night. He is also very tired. All he does is sleep all the time. We are supposed to go back to the vet in another week and a half. How long did it take until your dog was regulated and how long until the increased thirst and urination went away? If 14 units was enough, would I be seeing a change yet or does it take longer for the dog to adjust? Everything I have read, says it's better to have 2 meals and 2 dosages of insulin, but I have asked my vet about this and he keeps telling me to continue with once a day. He seems to be hinting that there may be underlying issues that are making Sammy not respond to the insulin, but I feel like we need to experiment with the dosage amount, schedule, and insulin type more first before just jumping to that. I haven't started testing his blood at home, but did just get a human blood monitor the other day so that I can start. Any tips or similar experiences would be appreciated. I am new to this and it is breaking my heart to see my baby this way. It's been a month of sleepless nights and constant worrying.

[amydunn19]

Re: Newly diabetic and insulin doesn't seem to be helping

Welcome! I hate to say so bluntly that your vet is steering you wrong - intermediate insulin only lasts 12 hours usually at a max. I think we have had maybe one dog who could make it on one shot a day but it is not the norm. I would recommend finding a new vet with more experience with diabetes.

How much does Sammy weigh? What is he eating? Where do you live - Canada or overseas? I am thinking about alternatives that might be available where you live for food and insulin.

There is a section on the site regarding home testing.
Look through the threads for info on testing and videos to help.

http://www.k9diabetes.com/forum/forumdisplay.php?f=15

Also, we are glad to help. Feel free to post questions, etc. in this thread and someone will be here to help.

[jesse girl]

Re: Newly diabetic and insulin doesn't seem to be helping

hi and welcome

my jesse is also a beagle and was diagnosed over 8 years ago

My jesse eats just one meal a day too and that is not the norm . Now it does work for jesse but i actually give her 3 shots of NPH insulin

Caninsulin was originally designed as a once a day insulin but in most cases that does not work . What your doing different is giving one meal and maybe that could work if you attain a dose that may carry for the entire 24 hour period . I thought it could possibly be done with one meal and one shot especially with long acting human insulin's like levemir . My jesse would only max out at about 18 hours on NPH with one shot so that was not going to work for jesse

Her routine i give her dinner and half her shot at 5:30 pm then i give her the other half of insulin at 7:30 pm . I split her dose for particular reasons . At 7:30 am i give her a reduced shot and a small milk bone snack and that has worked for her for 8 years . Her total amount of insulin is 7 to 9 units and she weighs 26 pounds . Thats on the low side for dogs

After a month on insulin we usually see the diabetic symptoms go away even if the numbers are still kind of high .

A single dose may or may not work with one meal and shot . most do 2 shots and 2 meals that did not work for my jesse and she was difficult to regulate taking almost 6 months to become stable with her routine and sugar

If the one shot has to be changed to 2 you could do something like jesse and give a smaller shot and a snack to carry her through to dinner

My jesse is also 13 years old . beagles are easy to test sugar at least jesse was . I use her inner lip above the canine tooth . No pain and no hair . i have probably tested there 10,000 times or more with no problems . Now a dog can be scared of the spring action of the lance device so doing some practice tests to get your dog use to it is helpful . Beagles have big lips so lots of area to test . The home testing is what will help immensely.

[Raysaint]

Re: Newly diabetic and insulin doesn't seem to be helping

Most dogs are on twice daily meals and insulin shots. I agree with amydunn, your vet seems to be advising differently than most vets.

You're trying to control a whole 24 hours with one dose of insulin, and obviously that won't last past 10 or 12 hours, so continuing to increase the dose makes it dangerous in the first 12 hours.

You need to make a decision, listen to your vet or seek other advice.

It does take some time to regulate, so don't expect great numbers consistently in a month. It took me a year to get things working to my satisfaction.

14 units is a lot for a beagle. Get him on 2 meals/shots a day, and lower his dose to 0.5 units per kg of dog weight. That's the starting point, then wait a week, do a curve, and adjust insulin probably up a unit. Repeat.

The peeing, drinking and things like that are normal at first but will diminish as the new routine starts to regulate.

[Lolo]

Re: Newly diabetic and insulin doesn't seem to be helping

Agree with all the other comments. I would see another vet or a specialist because I don’t think 1x/day is best practice. My vet wasn’t very knowledgeable on diabetes and was steering us wrong. It took me awhile to seek another opinion because I really liked my vet, but it wasn’t until I saw a specialist and got better guidance and a change in meds that I saw an improvement.
I think if you test at Home you’ll be able to see that it’s not lasting 24 hours and that Sammy should be getting a food and insulin every 12 hours.

[CrazyDogMom]

Re: Newly diabetic and insulin doesn't seem to be helping

Sammy is 36 lbs, down from 40 lbs when first diagnosed (he's never been overweight, just is a lot taller and longer than most beagles - I rescued him so good possibility he may be mixed with another breed as well). He's actually looking too skinny right now. He eats 3 cups of Actrium dry food once a day, which is what he has been eating for a long time. He has always done well on this food and we have tried a lot throughout the years since most foods seem to bother his stomach. I live in Canada. I think the biggest problem is that even with this large dose, his glucose levels do not go down after he eats and gets his insulin. They dont seem to decrease until about 12 hours after his food and insulin shot. The vet said it remained at 20, 2 hours after eating and then again was checked every 2 hours and was still at a 20 the following morning. I tried to check his sugar at home last night, but made the mistake of using his ear and could not get enough blood. I am going to watch some more videos and try again today as I want to see if the 14 units are decreasing his sugar at all throughout the evening. I want to try his lip, but am nervous he may bite me. He's been pretty grumpy since he first started not feeling well. We go back to the vet end of next week to see if the 14 units are doing anything to his glucose levels, but I am looking around to try to find a different vet in my area with more knowledge of diabetes. One more question - is the extreme fatigue normal? He is older so he already sleeps a lot to begin with, but since about a week before diagnosis, all he does is sleep and when he is awake, he just lays on the floor. He never used to just lay on the floor. Same with after he goes to the bathroom outside, he just lays down in the grass, which he has never done before, other than when he is sun bathing. Usually he likes to explore while he is outside. I know it takes time to find what works for your dog and he is obviously feeling pretty yucky since he is far from being regulated, but just want to make sure this is normal. I have 3 dogs, but I have been really lucky and they've never been sick, other than small infections here and there, so this is very new to me.

[Lolo]

Re: Newly diabetic and insulin doesn't seem to be helping

Does he have a callus or small baldish spot on his elbow? That’s what I use for a testing spot for my dog. It works really well for us.

[jesse girl]

Re: Newly diabetic and insulin doesn't seem to be helping

wow thats a big beagle . Well for your dogs size a staring dose would be 7 units 2 times a day so that would be 14 units for the day . Now how that works with a single dose i am not sure but as far a dosing twice a day the amount you are giving for a 36 pound dog for the totality is quite small .

Numbers at around 20 ( 360 in the states ) is not to bad . The problem and what you eluded to you dont know what blood sugar is doing after given at dinner and into the night and next morning . That is a critical time to be sure insulin is not dropping to low with the single 14 units

You have to figure how to test sugar because testing it at the vet 12 hours or longer after a shot is given wont do much good to tell whats going on .

I had the same difficulty testing the ear and moved onto the lip . Just play around with the mouth . Role the lip over and expose the canine tooth and maybe rub a napkin across the inner lip removing the saliva and just kind of practice that a bit . See if your dog can be comfortable with that . If not there are other places and sometimes more so for older dogs .

[amydunn19]

Re: Newly diabetic and insulin doesn't seem to be helping

Lethargy is common with high blood sugar - as you go along, his energy should get better. It takes time.

What is the fat content of the food? He may be able to stay on the same food. Prescription food is not a requirement. Although, it does work for many dogs.
My dog was super picky so we were unable to use it.


An option for you may be to buy NPH insulin at your local Walmart(you guys have those, right?). It is human insulin and much cheaper. Like $24 a bottle. It is generally the same type of insulin as caninsulin but the action is a bit different. It has a faster component to it. Keep it in mind if caninsulin doesn’t work as well.

[CrazyDogMom]

Re: Newly diabetic and insulin doesn't seem to be helping

Thank you everyone. This site has been a life saver. Was devastated when I first found out and have been browsing this site for the past few weeks and it has made me feel a lot better. The fat content of his food is 14%.

[amydunn19]

Re: Newly diabetic and insulin doesn't seem to be helping

14 % is a pretty good number. The lowest I found in commercial food was about 11%.

[k9diabetes]

Re: Newly diabetic and insulin doesn't seem to be helping

The weak and lethargic behavior worries me that ketones might be present.

To show you the difference between one shot of Caninsulin / Vetsulin a day and two, take a look at this thread:

http://www.k9diabetes.com/forum/showthread.php?t=3990

The difference in Chewy's photos is down to one simple thing: two shots of insulin a day instead of one.

Chewy lived out in Newfoundland and had access to a vet only once or twice a month. And that vet was following the guidelines for Caninsulin and refused to give it twice a day.

So we finally just had to convince Chewy's human to give her insulin twice a day - she did. Problem solved.

The dose may need to be dropped when going to twice a day.

Natalie

[k9diabetes]

Re: Newly diabetic and insulin doesn't seem to be helping

The U.S. version of Caninsulin (Vetsulin) eventually dropped the emphasis on starting with one injection per day, wisely, and I really wish the Canadian and British guidelines would do the same.

There was never any reason to believe that Caninsulin would last 24 hours. It's the same preparation as Humulin L except with a different insulin molecule, and Humulin L was always given twice a day.

The Caninsulin guidelines do recommend doing a curve on once-a-day dosing and switching to twice daily dosing if once a day is not controlling their blood sugar.

The healthy ‘uncomplicated’ diabetic dog is usually started on CANINSULIN

® at 0.5 unit per kilogram bodyweight injected subcutaneously twice-daily. All diabetic dogs can be treated with twice-daily administration of CANINSULIN®.

In some dogs, it is possible to achieve acceptable diabetic control with

once-daily administration.

Early trial work showed that approximately 60% of diabetic dogs could be stabilised on once-daily CANINSULIN® therapy with a starting dose of 1.0 unit per kilogram bodyweight.

However, experience has shown that for intermediate-acting insulin like (CANINSULIN®), 0.5 units per kilogram bodyweight may be a safer starting dose and that many dogs ultimately stabilise better on twice-daily injections. Because the dose required with twice-daily therapy is less insulin per injection than those dogs on a single daily injection, there is reduced risk of hypoglycaemia and better glycaemic control over 24 hours by giving less insulin more often.

http://images1.wikia.nocookie.net/__...u_binaries.pdf

[ReidWHopkins]

Re: Newly diabetic and insulin doesn't seem to be helping

I have a similar situation with my MinPin mix (Paxton). He was diagnosed with diabetes last December. He is a big MinPin, about 28 lbs when diagnosed. We have 2 vets since we travel between Alabama and Florida a lot. Our vet in FL prescribed 5 units of Vetsulin twice a day. His BG starts at ~400 and then drops slowly during the day, staying over 300 until the last reading is ~250 near feeding time. The next check showed the same trend, so the dose was upped to 6 units twice a day. After some more occasions of excess urination and thirst we upped to 8 units twice a day. In March of 2018 our original vet started a BG curve which showed exactly the same trend (starts at 400 drops slowly through 300s) until Paxton started to vomit, where she cut off the test in the early PM. She changed the dose to 15 units, twice a day (the dog only weighs 22.5 lbs now). Just had a new curve done in FL - same result. Starts at 400, drops slowly through the 300s. Last one didn't do a late (5 pm) test so it didn't quite reach 250s. This data seems to show resistance to Vetsulin in particular and maybe insulin in general. Vet wants to increase dose to 17 units twice a day. Don't know what to do!

[MikeMurphy]

Re: Newly diabetic and insulin doesn't seem to be helping

I have a similar situation with my MinPin mix (Paxton). He was diagnosed with diabetes last December. He is a big MinPin, about 28 lbs when diagnosed. We have 2 vets since we travel between Alabama and Florida a lot. Our vet in FL prescribed 5 units of Vetsulin twice a day. His BG starts at ~400 and then drops slowly during the day, staying over 300 until the last reading is ~250 near feeding time. The next check showed the same trend, so the dose was upped to 6 units twice a day. After some more occasions of excess urination and thirst we upped to 8 units twice a day. In March of 2018 our original vet started a BG curve which showed exactly the same trend (starts at 400 drops slowly through 300s) until Paxton started to vomit, where she cut off the test in the early PM. She changed the dose to 15 units, twice a day (the dog only weighs 22.5 lbs now). Just had a new curve done in FL - same result. Starts at 400, drops slowly through the 300s. Last one didn't do a late (5 pm) test so it didn't quite reach 250s. This data seems to show resistance to Vetsulin in particular and maybe insulin in general. Vet wants to increase dose to 17 units twice a day. Don't know what to do!

Hi and welcome. You might want to open a new thread for Paxton, so that we can track everything about his journey with diabetes.

At 17 units and weighing 22 lbs, you are starting to approach the possibility that he is insulin resistant. Have the vets rule out any concurrent disorders like hypothyroidism or any infections? Hypothyroidism, in particular, can cause insulin resistance. After being diagnosed with diabetes, my dog Lily went 4 months with similar BG numbers as Paxton. We took her to an Internal Medicine Specialist who diagnosed her as hypothyroid. Once on the thyroid meds, her BG numbers came down to a manageable range.