Sweet Dutch has passed December 6, 2015

[Timothy]

Re: Diabetic Rottweiler/Meter & Curves

I tried to leave gaps in spots where testing was done several hours apart.
Here is a photo of random tests that were done April into May.




Below is his curve for 5/15/2012

[Rubytuesday]

Re: Diabetic Rottweiler/Meter & Curves

Timothy, I was so glad to see your post today. I worry about you and Dutch.

So, what I see on the curve from yesterday...
firstly whenever you get a reading...probably below 100.... it is safe to reduce the dose. There are a lot of variables to that, if you are with him all day, if it is just after a dose change, ect, ect,
I would definitely say he is on too much insulin. How do you feel about reducing his dose? I know I have suggested it before.

He is getting 2 extra cups of food and it doesn't seem to be keeping him safe.

What is it you are feeding him?

I know you sometimes exercise him. Was any exercise done yesterday and if so what were the times?

[jesse girl]

Re: Diabetic Rottweiler/Meter & Curves

tara makes some good points a reduction maybe warranted if the fasting is lower than the amount of the drop which may occur

i have reached a point with jesse instead of reducing insulin i am able to give her a snack and maybe some honey to boost her up before onset of insulin it took some time to figure that out

most times if jesse is at a lower fasting jesse body will bounce her up but if i do it for her its not as dramatic as if her body does it but of coarse we cant always depend on the body

when you did intervene with low blood sugar with some food he did comeup to 171 and then continued to 215 and then back down to 175 maybe over 4 hours of blood sugar that is less than 50 points form lowest to highest very nice and the food may have helped with that the later bounce up to 300 is not uncommon especially if the body recognizes that it needs that wiggle room for the drop for the next 12 hour cycle just a theory but makes sense life is smart

the point i am making that episode may give you a clue on how to approach maybe a snack or a small target meal later in the cycle may keep him more flat (no big drops or rises ) some times more meals are better if it can be worked into your schedule i actually have gotten an automatic dog feeder for jesse to help with that

[Timothy]

Re: Diabetic Rottweiler/Meter & Curves

How do you feel about reducing his dose?

I think it might be a good idea. I'm not sure though because I don't want to mess everything up. I asked the vet about it last time and they said wait till after his antibiotics are done, and mentioned possibly giving him smaller doses of insulin throughout the day instead of two big ones in the morning and at night. I would imagine they would change his insulin if they did that? I don't know what the vet thinks about reducing it though.

What is it you are feeding him?

Purina One Smart Blend Healthy Weight Formula

I know you sometimes exercise him. Was any exercise done yesterday and if so what were the times?

Not really, we went outside for a few minutes up in the woods and he chased after a squirrel. We weren't out long though at all that was at about 4-5 PM.

[Rubytuesday]

Re: Diabetic Rottweiler/Meter & Curves

I think it might be a good idea. I'm not sure though because I don't want to mess everything up. I asked the vet about it last time and they said wait till after his antibiotics are done, and mentioned possibly giving him smaller doses of insulin throughout the day instead of two big ones in the morning and at night. I would imagine they would change his insulin if they did that? I don't know what the vet thinks about reducing it though.

If you are uncomfortable changing the dose on your own then I hope you can call the vet asap to get their recommendation. It is true that infection tends to raise the numbers and sometimes antibiotics will too, but I think if you raise the insulin dose to accommodate that you need to be on top of things and regigger as soon as you see the numbers change due to the infection clearing or the antibiotics being stopped. Did you talk with the vet yesterday. I get so worried when I see numbers like Dutch had along with some of the confusion you have described.

Purina One Smart Blend Healthy Weight Formula
So my question about this would be how much food should he be getting for his ideal weight? I think you said the vet thought he needs to lose weight? At this point he is getting 8 cups of food. Seems like a lot, but I realize this is to combat the lows.

Not really, we went outside for a few minutes up in the woods and he chased after a squirrel. We weren't out long though at all that was at about 4-5 PM.
So it looks like the squirrel chase didn't drop his numbers and will be good info for future exercise.

Hope that worked responding in a different color, first time I've done it that way.

I have seen many diabetic dog's be started on insulin and somewhere along the line questionable recommendations are given, in your case raising by 2 units without a curve. Then what you end up with is reacting to highs or lows, but maybe not in the right way because the picture has become so skewed. Ideally curves would have been done at each increase so you could then reflect back and see how he did at each dose, but unfortunately you don't have any of those baselines.

This is only said out of concern as many of us have our scary stories to share and some of them happened under the care of good vets. I think this disease is just so tricky and owner intensive that it is hard for the vets to really handle it appropriately on their own.

If I was in your shoes I would look to see how much food he should be on for his ideal weight and then talk to the vet about reducing the insulin to match the reduced amount of food. Then I would leave him at that dose watching carefully for any lows. I would not snack him unless there was a low. Then you will have a very clear picture of how he does at that dose. From there you could increase roughly every three days depending on the results of a curve run on day three to be sure of no lows.

All just information from a caring caregiver of a fellow diabetic dog...and Rottie lover.

[Rubytuesday]

Re: Diabetic Rottweiler/Meter & Curves

Nope, didn't work....look for some part of my responses imbedded in with your qoutes

[Patty]

Re: Diabetic Rottweiler/Meter & Curves

Timothy,
I'm going to pull together some comprehensive information on Dutch that you've posted for my sake.

Has been on antibiotics for UTI
Weight = 115 lbs
Food = Purina One Smart Blend Healthy Weight Formula
He eats every morning and afternoon at 6:30 and gets his insulin at 7 AM/PM
Vet does spot checks and fructosamines; owner does curves at home
Meter = OneTouch UltraMini

4/16/12
6:39a – 222 30u; 3 cups
10:00a – 340
12:28p – 234
2:44p – 218
4:56p – 172
6:32p – 143 30u; 3 cups
8:30p – 134
10:20p – 94 1 cup of food
11:32p – 99

4/17/12
12:49a – 154
6:27a – 237 30u; 3 cups
11:57a – 289

4/25/12
I just tested him once at about 12:30 pm today and his blood sugar was at 258, this was about 2 hours after his snack. I’ve been giving him a snack around 10:00 am and pm. just a small .5-1 cup of food.

5/15/12
Dutch's blood sugar was at 333 before I went to bed last night at midnight but this morning at 6:30 it was at 86! He has to get his insulin shot at 7. It took him a couple minutes to get him to eat.
The past couple days his sugar in the morning has been up in the upper 400's mg/dl and then going down to around 70 mg/dl.

5/14/12
1:11a – 97
12:06p – 297
3:48p – 232
10:56p – 333

5/15/12
6:42a – 86 30u; 3 cups Took him a few minutes to get him to eat
8:02a – 58 Gave 1 cup food/peanut butter/sugar
9:02a – 84
10:02a – 171
12:05p – 215
4:00p – 175 4-5pm out to woods; chased squirrel
6:35p – 334 30u; 3 cups
8:04p – 381
10:13p – 230
11:46p – 123 1 cup of food

5/16/12
6:39a – 300 30u; 3 cups

[Patty]

Re: Diabetic Rottweiler/Meter & Curves

You mentioned on 4/25 that you'd started giving a snack at 10am/10pm of 1/2 to 1 cup of food. I don't see this included in your chart. Are you still doing this?

Dutch's blood sugar really is swinging quite a bit. Even when he starts in the 300s, he's coming down into double digit numbers. I would reduce his insulin by a unit or two. It's always appropriate to reduce insulin when blood sugar is falling too low.

Tara asked how much food is required to maintain his weight. I remember you'd written this on 4/10: "He normally eats 2-cups of Purina One Smart Blend Healthy Weight Formula. But the last few times ive changed it up a couple times and noted it."

If he's maintaining his weight on 3 cups twice a day that's fine. If he's gaining more weight than needed, you'll need to reduce his food, which will also require a reduction in insulin.

I'd like to see his insulin reduced so he's not producting any lows and re-evaluate his pattern in 5 days or so. Waiting until his antibiotics are complete to adjust insulin is dangerous when you are having to intervene for low blood sugar so I wouldn't factor that into the decision when it comes to reducing insulin.

Let us know about the snacks and meal portions for his weight.
Take care
Patty

[k9diabetes]

Re: Diabetic Rottweiler/Meter & Curves



This picture says it all for me - his insulin dose must be reduced, 1-2 units at least. I would actually probably cut back 4-5 units since even that would only be about 1/6th of his dose.

You want to ignore the high levels for now and work solely on getting rid of any low blood sugar, ever. Once you have found an insulin dose where his blood sugar never ever goes below 100, then let him stay there for five days and then do a curve and we can figure out from that curve what the next step should be.

And during this time of getting him stable, pick a food quantity and content and stick with it. Don't think about tweaking anything related to diet until you get the dose down below the level that causes hypoglycemia.

This is truly the fastest, most efficient way to determine how much insulin he needs. You find the dose first that's always safe, and then tweak the diet, etc. to the curve that you get once he's stable on that dose for five days.

Natalie

[Timothy]

Re: Diabetic Rottweiler/Meter & Curves

...his insulin dose must be reduced, 1-2 units at least...

Ok thanks Natalie, I'll speak with the family tomorrow about it and see what we can do. That way were all on the same page.

You mentioned on 4/25 that you'd started giving a snack at 10am/10pm of 1/2 to 1 cup of food. I don't see this included in your chart. Are you still doing this?

Yes Patty, I did do this for a while, but I kept getting high readings with the random testing which isn't well noted and mostly spontaneous, so I ended up only giving him an extra meal around 10-11 PM. He started drinking alot of water and would have to go out really bad the next morning/have a high number. This happened for a few days around the time his anti-biotics were done. Then I would only give him an extra snack at around midnight around every other day or so. During that time I hadn't measured his curve. I then took out the extra meal entirely and wanted to wait about 3 days to measure his curve. He was still drinking alot of water and having to go out often. The morning that I measured his curve he was a acting a little off and that's when I measured his curve starting at 86 mg/dl that morning.

I was trying to find a balance to keep it from getting to high and to low. With the extra food it gets high, without the extra food it gets entirely to low.

I know you sometimes exercise him. Was any exercise done yesterday and if so what were the times?

As a matter of fact I haven't been doing alot of exercise with him lately because I wanted to see what his curve was like without it & also to keep his sugar from dropping to low. The few times we did go for long walks was when I checked his sugar and it was kind of high.

[Patty]

Re: Diabetic Rottweiler/Meter & Curves

Ok thanks Natalie, I'll speak with the family tomorrow about it and see what we can do. That way were all on the same page.

Do you have multiple people in the household that give his injections? I would make a large note on his journal about the reduced dose as well as speak to whoever would give his shot. He's really in danger of hypo if you aren't there to catch the lows.

This disease really can be a tedious process. Any changes have to settle in for a couple of days for the body to adapt. Then you have to look at the full picture to evaluate the next step. Like with the snack times, make sure you aren't basing changes off of spot checks but do a curve to see how it's affecting the entire day.

[Timothy]

Re: Diabetic Rottweiler/Meter & Curves

Reduced Dutch's insulin tonight to 28 units/3-cups of food/no extra meals in-between. Gonna keep an eye on him the next couple days checking him if I have too, then I'll most likely measure a 24 hour curve.

Other then that he hasn't been feeling well the past few days, not much of an appetite/eating grass outside, that kind of thing. It took him a few minutes to get him to eat last night and then he vomited after eating I had to feed him again. Took him on a little walk today he wasn't feeling well, he was kind of weak and trembling but his sugar was in the 200's, ate some grass, and vomited about 1/2 hour before dinner. Didn't have much of an appetite again, had to mix a little treat in with his food.

Normally I would be pretty worried about him throwing up, but my female Rottie who is in great health has been doing it also for the last few days... So I figure they might have snuck something out of the trash when I wasn't looking or something...

[Patty]

Re: Diabetic Rottweiler/Meter & Curves

So I figure they might have snuck something out of the trash when I wasn't looking or something...

Hope they both start feeling better. Do they both eat the same food?

[Rubytuesday]

Re: Diabetic Rottweiler/Meter & Curves

Reduced Dutch's insulin tonight to 28 units/3-cups of food/no extra meals in-between. Gonna keep an eye on him the next couple days checking him if I have too, then I'll most likely measure a 24 hour curve.

I looked back on Dutch's curve from 5/15 and on that day he had 2 additional cups of food. It seems sometimes he got that and sometimes he didn't. If he did more often then not, without the extra 2 cups of food he may still drop too low.
Might be worth doing a curve tomorrow just to rule it out. The curve results wouldn't be worthy of basing a dose change on it, but would let you know if he was still dropping too low with out that extra food.

I hope they both feel better soon. The last thing you need is to worry about him throwing up on top of everything else.

[Timothy]

Re: Diabetic Rottweiler/Meter & Curves

Hope they both start feeling better. Do they both eat the same food?

yea, they both eat the same food, it was at the bottom of the bag so maby it was pretty stale or something, he turned his nose up to it and wanted the new bag yesterday.

I looked back on Dutch's curve from 5/15 and on that day he had 2 additional cups of food. It seems sometimes he got that and sometimes he didn't....Might be worth doing a curve tomorrow just to rule it out...

Well yes, sometimes he got the extra meals, some days he didn't. From what I can tell the extra meals cause his sugars to be to much on the high side countering the insulin, & then I would have to have him skip one here and there. But then it would drop to low eventually and have to give them to him again. It's kind of confusing...

He was originally on around 4 cups of food for a long time on 30Units and had never had a curve done. He was going in to the vet everyweek for a glucose check around 11 AM. I don't suspect that his blood sugar had ever gotten dangerously low, but there was one time when his sugar was down to 112-113 when we went and they said that that was ok. After a while they kept getting on me about his weight that he needed to lose weight, cut his food back. Well around the time I started this thread he was down to 2-cups & that's when problems started, It didn't even occur to me really that less food = less insulin... I'm still kind of new to diabetes, I didn't know a single thing about it until I found out he had it.

So everything has been kind of set off balance from what it was before which I don't actually know how well balanced it was in the first place, and I'm trying to get everything balanced.

Reduced Dutch's insulin tonight to 28 units/3-cups of food/no extra meals in-between.

Actually I just had to intervene... He woke up from a nap and walked out into the kitchen panting, I checked his sugar and it was at 86 mg/dl. So I just gave him an additional 2-cups.

5/18/2012 6:18 PM 213 mg/dl 3-cups / 28 Units
5/18/2012 10:55 PM 86mg/dl Gave him 2-cups