Scout - just diagnosed

[bluelabgirl]

Hi, here are the details about our sweet Scout:

She is a Labrador Retriever, will be 12 years-old in August, 82 lbs, and was diagnosed exactly one week ago (Apr. 6, 2015). She gets 4 units of Humulin N two times per day.

We feed her Purina One Vibrant Maturity, and have for years. However, the past week her appetite has drastically diminished. Since we only just discovered she has diabetes, we will monitor it through blood testing at the vet's office. On Monday they recommended us come back in 6 weeks for a glucose test, but since Monday she has gone rapidly downhill in other ways, so I'm taking her back in on Wednesday (two days from now).

Other issues: We were also told along with the diabetes diagnosis that Scout has degenerative neuropathy. We took her in, originally, because she began panting constantly, drinking tons of water, and needing to go out several times a night (the diabetes). But her back legs had also been slipping a bit when she went down the back steps into our carport; she'd also pause and not want to come back up them. So we knew something was wrong.

Previously, she'd been diagnosed with arthritis in her back leg.

Since these diagnoses Scout's condition has seemed to rapidly go downhill. She can't stand up without us using a towel beneath her hind legs to help. She only walks a few feet to sit down again. This is particularly sad and startling because only two weeks ago Scout and I were hiking in the national forest near our house--something we did at least two to three times per week. Two weeks ago, she jumped in the river and swam.

Scout was my dog before I married, has always been my trail partner, and has been a major family member for the past 11+ years. We are really struggling with this; we know she's older and that we're at the end of her life, but the neuropathy seems sudden and completely inhibiting. My husband found this forum and we've been reading through it, hoping there was something we could do for her. We know she probably won't be running and jumping, but her downward descent has been incredibly rapid. She is not herself at all. We wonder if it's mainly because of the diabetes, and whether there's a chance hers is diabetic neuropathy?

Her vet, who's been her vet since she was 2 years old, says that even if we stabilize her blood sugars, the neuropathy is not reversible. We're looking into B12 based on this forum, but would appreciate any other advice.

[farrwf]

Re: Scout - just diagnosed

Neuropathy in the rear legs is not uncommon in newly diagnosed dogs. Tends to go away as the blood glucose levels come down. The neuropathy could have been developing while her B / G levels were very high and just hit "critical mass" recently and presented as weakness in the rear legs.

That's a very, very low insulin dose for a dog Scout's weight??? What did her B/G numbers look like when diagnosed??

[Cara Sandler]

Re: Scout - just diagnosed

Hello, and welcome to you and Scout! I"m sorry to hear about the diabetes.

Diabetic neuropathy usually takes time to develop. That Scout started suddenly showing these symptoms points to something else going on.

The poor appetite is also worrisome, and if she doesn't eat consistently you are going to have a very hard time regulating her. Did the vet indicate why they feel she's eating so poorly? Does she have any complications at this time?

[Riliey and Mo]

Re: Scout - just diagnosed

hello and welcome to you and Scout. yes i have seen dogs back legs improve when their blood sugar regulates with the correct dose of insulin, amount of food measured.

4 units is a very low dose to start with a 82 lb dog
a good dosage start would be around 15 units

i,d call your vet and ask why only 4 units please.

may i ask how much food Scout is eating twice a day
its recommended feeding then injecting insulin right after food

[jesse girl]

Re: Scout - just diagnosed

hi and welcome

yes as the others have commented that dose is small to start . degenerative is a strange word to use because once blood has stabilized and in a better range motion comes back may take a bit of time after improved regulation

the higher blood sugar can increase the inflation and pain from the arthritis and that may limit the ability to walk . now arthritis can be degenerative

now your vet is probably being conservative on the dose just giving it a try and its not unusual to see dog taking less insulin than what a starting dose maybe but this is quite low for a dog this size

now waiting 6 weeks to see how a low dose will work is not acceptable you would no in a week 2 at most to tell if this dose is a good place to start and if it is to small than your dog is remaining in higher numbers for much longer than needed creating more problems and further decline in the neuropathy if thats what is occurring

i would recommend testing blood sugar at home most of us do it and it is the single best way to keep the pups safe . like you said trail running . blood sugar can drop quite significantly with exercise so with the ability to test you catch it before its a crisis and it expedites regulation

the larger breeds are usually very easy to test my jesse is a beagle with big lips that where we test her inner lip above the canine tooth doesnt feel a thing and gives me a kiss after

i am not saying your vet is wrong or wright what matters they feel this is best way to go but common sense says no and you have to do whats best for your pup . just a lack of understanding from the professionals . its a shame because its not rocket science if the care taker just takes up the challenge and if the professionals just nurtured that it would be better for all parties in most situations

[amydunn19]

Re: Scout - just diagnosed

Hi and welcome! Labradors, in particular, have the type of weakness you are talking about when diagnosed. I think it is probably common among larger breeds. It will get better usually when blood sugar is better controlled. Take a look at Eddie's thread:
http://www.k9diabetes.com/forum/show...ighlight=Eddie

Antonia hopefully will chime in - she had a tough time with Eddie and it took some time to get him mobile again but it is doable.

You know I understand your admiration for your vet but you will find that if you take a more active role by home testing your pup that you can most likely add years to their life. It is not that vets are not competent by any means - when you are the caretaker, you just have much more access to the dog and can greatly affect the process. Some vets tend to treat all diabetic dogs the same but if you read the threads more and more you will see that this disease is very individual and dogs don't react the same to insulin and food.

[Eddie]

Re: Scout - just diagnosed

Hi and welcome!

As Amy says, we went through quite a bout of diabetic neuropathy with our lab cross, Eddie, when he was first diagnosed. For several weeks he simply could not walk or stand without our help. His rear legs lost all their strength and he slept almost the entire time. It also came on very suddenly. He lost lots of weight and looked like a poor little shadow of his former self. The vet thought he had about 3 weeks to live.

Thanks entirely to this forum I learnt about diabetic neuropathy and how it sometimes just goes away as blood sugar gets regulated (plus maybe with help from B12 methyl).

We gave Eddie loads of B12 and gradually increased his insulin dose to his present level (much higher than your dog's dose) and his legs slowly started working again (over maybe a two month period). He now (two and a half years later!) runs and chases balls and does all his usual doggy things. In his case the neuropathy absolutely was reversible.

I have no idea whether your dog is likely to respond the same way as Eddie but I would suggest it is definitely worth a try. Your dog is older than Eddie (who was 9 when he had neuropathy) so there may be more arthritis type factors involved.

I'd suggest getting your vet to do a day long curve ie taking blood sugar measurements every two hours to see what her blood sugar does over a whole day. Based on that you can decide if she needs a bigger dose of insulin.

I have no idea whether the B12 helped Eddie but it might have done and so if I were in the same situation again, I would give it again. We gave him a lot partly because it felt as if we really had nothing to lose and we also understood that any excess is peed out so you can't really overdose. The vet knew we were giving it but did not have input into the dose which I made up myself.

Anyway, that's our experience which had a really happy ending. I hope you are able to do something similar with your girl - it is awful watching them struggle, but equally it is fantastic if you can turn it round for them.
Antonia

[k9diabetes]

Re: Scout - just diagnosed

That dose of insulin is far too small and should be increased immediately if the blood sugar is still high. Even doubling it would be a very conservative starting dose.

How high is the blood sugar?

Any ketones?

Natalie

[abdamurph]

Re: Scout - just diagnosed

I totally agree with everyone else we started Murphy who was 62 lbs at 12 units twice daily and have gone up slowly since then, the amount your Vet has started you on would be for a very small dog not an 82 lb dog. I am very surprised, this Vet obviously doesn't know much about diabetes and if she stays this course I would find another Vet right away and make sure they know more about diabetes! Please do not wait for 6 weeks on this low dose test in one week and if numbers are still high tell the Vet you want to go up to 15 units twice daily.

[bluelabgirl]

Re: Scout - just diagnosed

Thanks to all of you for your help and suggestions.

As of last Wednesday, April 15 we have upped Scout's insulin to 15 units twice per day. Though she tends to perk up a tiny bit about an hour after getting the insulin, her back legs have seemed to have gotten worse. She has lost quite a bit of weight and muscle mass; her spine and hipbones can now easily be felt, and she cannot walk without help. She is also dragging (knuckling) her back paws when we do help her.

She is barely eating and drinking, and definitely refuses to eat her dog food even when it's mixed with other food. I'd been pouring chicken broth over her food, but that only worked a couple of times. She will occasionally eat turkey, boiled chicken, green beans. She does not want her dog treats any more.

The vet did say that there were keytones present.

We are taking Scout to a holistic veterinary practice this afternoon.

[jesse girl]

Re: Scout - just diagnosed

if you are seeing ketones and anything more than a trace this can be life threatening and may need immediate medical attention and possibly a stay in hospital to clear them . this is called ketoacidosis where the body feeds on it self which may explain the muscle and weight loss

i dont think this is a holistic approach at this time but immediate medical attention from a vet who is qualified in these matters

the best thing you can do for your pup is testing blood sugar at home

[Riliey and Mo]

Re: Scout - just diagnosed

i would only go the holistic approach when scout is regulated.

what Scout needs right now is to be seen by an Internal Medicine Veterinarian to clear the ketones out of his body and an IV tube to get him feeling better.

[Cara Sandler]

Re: Scout - just diagnosed

Agreed that Scout needs to be seen by a regular vet to address the ketones.

[Rubytuesday]

Re: Scout - just diagnosed

I hope you can hang tough as for some reason your thread pulls at me.

It is clear from your initial post and your willingness to search for answers how much you love Scout and will do anything to help her.

It is so hard for the caregiver initially as there is so much to know about this disease that you can't possibly know yet. Unfortunately....most vets don't have a basic safe understanding of this disease either.

This is how I see it:

• if the ketones are above "Trace" it is a medical emergency and she most probably needs to be hospitalized and receive IV fluids to flush the ketones. A competent vet would also be giving her a fast acting insulin to bring her numbers down quicker to aid in the removal of ketones. I know your worried about her legs, but they can die from Diabetic Ketoacidosis, which could be contributing to the weakness as well.

• Stick with conventional treatment right now. this may be able to be done with the holistic vet if they have a good understanding of diabetes, but I wouldn't want to be adding anything except insulin right now as different things in different dogs can make insulin go wonky.

• I would purchase a One Touch Ultra 2 meter and strips at your local pharmacy. It will be expensive, but I think she is critical and you don't have time to order online for less money. I also don't think you should get a less expensive brand at the pharmacy as not all brands are reliable.

If it takes you time to find a competent vet for the day to day management of diabetes we can be a resource for you, but the ketones need to be addressed immediately.

Feel free to ask questions after your appt. I used to bring the vets recommendations back to the forum to get others input before implementing.

Tara

[amydunn19]

Re: Scout - just diagnosed

I have to agree with everyone else about the ketones - that should be addressed immediately.

Holistic methods are not quite as reliable with diabetes - it is the kind of thing that initially should be treated conventionally. If that is an approach you want to take later, then you can always do so but this situation is too critical. I would find a vet fast who can address this.