Sweet Dutch has passed December 6, 2015

[Rubytuesday]

Re: Diabetic Rottweiler/Meter & Curves

Do you have karo syrup or honey to rub on his gums.

I have no idea....give him a tablespoon....better safe then sorry.


As you just gave the insulin and I don't know how long it will take for his food to start to rise the BGs please, you need to call your vet or find an emergency vet.

[farrwf]

Re: Diabetic Rottweiler/Meter & Curves

I would give him some corn syrup to stop the drop and a carby treat like a milk bone

Agree, better safe than sorry.

[Patty]

Re: Diabetic Rottweiler/Meter & Curves

I would definitely give some honey, karo, or regular pancake syrup. If he won't take it rub some on his gums.

[farrwf]

Re: Diabetic Rottweiler/Meter & Curves

Seems he's real sensitive to the lower BG levels. You begin to see him display hypo symptoms at borderline low levels????

I wonder how accurate your meter is at low BG levels.

[Patty]

Re: Diabetic Rottweiler/Meter & Curves

Sounds like he got his regular dose of insulin?
If he's typically starting at 400 and drops to 70s-100s during the day, you may need to feed more as well. Starting in the 80s, he doesn't have any room to drop on a regular dose of insulin.

[Patty]

Re: Diabetic Rottweiler/Meter & Curves

I'm going to have to go but am concerned about keeping Dutch's blood sugar up. Don't hesitate to give him more honey/syrup and food if he's not rising/continuing to drop.

Better to be safe than sorry and you can always start over if he's high later. It sounds like longer term his food/insulin may not be balanced which is something a well timed snack might help.

[Rubytuesday]

Re: Diabetic Rottweiler/Meter & Curves

After the dust settles from this mornings episode, these are some things to consider.

The starting range for insulin is .25-.50 units pre kilo. At 115 lbs. the conservative dose would be 13 units. I looked back at your initial post and see Dutch was on 30U when you posted. Was he started on that?

What sometimes happens with a insulin sensitive dog is they are started too high and then when high numbers are seen the dose is increased.

Do you have any recent curves that you can post?

The other thing that jumped out at me was you say he has lost muscle tone and has a pot belly. The pot belly can be one of the symptoms of Cushings disease and can make diabetes very hard to control.

To complicate things uncontrolled diabetes can look like Cushings.

Definitively diagnosing Cushings is difficult, but ruling it out isn't. There is a urine cortisol/ creatinine ratio test that can rule it out.

I know you said your other Rotties didn't last much past 8-9 and you may be thinking this is Dutch winding down, but I think he could get much better if these thing turn out to be a problem.

[jesse girl]

Re: Diabetic Rottweiler/Meter & Curves

more than likely he will bounce back up which he has done in the past but you cant depend on that i like karo in these situations i would give him a hole spoonful and let him lick it off the spoon check again in a half hour if he is not over 100 i would give another spoonful another check in a half hour i continue till that number is over a 100

hopefully at that point you are seeing a rise make periodic checks throughout the day and maybe add a snack or two during the day if he wants to pull lower again

[Timothy]

Re: Diabetic Rottweiler/Meter & Curves

At 115 lbs. the conservative dose would be 13 units. I looked back at your initial post and see Dutch was on 30U when you posted. Was he started on that?

No, I can't remember off hand what he was started on, but I remember we did go back to the vet every week to have his blood glucose checked for a while and they upped it each time by 2 units.

The most recent curve I have was one I posted a couple weeks ago, Since then I just have a collection of random test times.

I have to read more about Cushings, I don't know anything about it.
Also Dutch used to be on a steroid because he has chronic ear problems. When he was diagnosed with diabetes the vet said not to give this to him anymore.


Also I just tested his blood sugar again at 9:00Am/84 mg/dl and just now at 10:00 AM and its back up to 171 mg/dl

[Rubytuesday]

Re: Diabetic Rottweiler/Meter & Curves

No, I can't remember off hand what he was started on, but I remember we did go back to the vet every week to have his blood glucose checked for a while and they upped it each time by 2 units.

The most recent curve I have was one I posted a couple weeks ago, Since then I just have a collection of random test times.

I have to read more about Cushings, I don't know anything about it.
Also Dutch used to be on a steroid because he has chronic ear problems. When he was diagnosed with diabetes the vet said not to give this to him anymore.

Sometimes by increasing by 2 units the correct dose can be passed. I am highly suspicious that he is on too much insulin, and a big reduction is where I would start. When seeing some high numbers it can be very hard to take the leap of faith and reduce the dose but sometimes that is the only way to make things clearer.

With the recent ending of the antibiotics that might also be clouding the picture. Some dogs will be erratic while taking them.

Reading your initial thread again I see you give the second meal "in the afternoon"? But does he get his insulin at 7pm. The insulin and food should be happening at the same time.

Have you done any reading about Symogi rebound. I'm sure you can find some good info on the home page. If he does rebound you can see crazy readings for the next 3-5 days. If you do decide to reduce the dose I would stick with it for at least three days regardless of the numbers you see. Then after 3 days you could run a curve and hopefully the numbers would be a little more consistent.

In your reading about Cushings.....don't panic! A lot of dogs come here looking Cushnoid and once the diabetes is controlled the Cushings symptoms go away.
But if it does strike a cord ruling it out may be wise.

It would be great if you could post any numbers you get today and some of the veterans here could give their input.

[Rubytuesday]

Re: Diabetic Rottweiler/Meter & Curves

Hi Timothy, I hope Dutch is doing better.

I had a thought....
When the vet made each 2 unit increase did they run a curve before the increase. That is the recommended way to go, but not all vets do it that way. They might see a high and think the dog needs more insulin. But if the high was created by a bounce due to too much insulin, an increase would be exactly the wrong thing to do.

The only way you can be sure the high didn't come from a low is to do a curve. Keep in mind curves done at the vet's office will often be a bit elevated due to the stress.

But, as I said, I am the rebound queen. See it hiding everywhere!

I just looked at your curve from 4/16 and it didn't look too crazy. Except after the evening meal he doesn't seem to get the food rise and start acting strange with the 90s. Maybe well timed snacks are the answer. Jessie Girl would be one thread and poster to follow. She has made a fine art of snacking.

If people with more experience don't weigh in don't hesitate to send out another shout tonight.

[Patty]

Re: Diabetic Rottweiler/Meter & Curves

A snack at about 10:30am might help as he's on his way down. Given early enough that the body has time to process it and slow the drop.

Hi Timothy,
So glad his blood sugar is on its way up. Since his last curve, have there been any changes to his food routine? Snacks, etc? I know you said he's still on 30u.

I know I'd mentioned previously a snack around 10:30am might prevent the downward slope he gets during the day.

Patty

[Timothy]

Re: Diabetic Rottweiler/Meter & Curves

Reading your initial thread again I see you give the second meal "in the afternoon"? But does he get his insulin at 7pm. The insulin and food should be happening at the same time.

Yes, he eats every morning and afternoon at 6:30 and gets his insulin at 7 AM/PM

When the vet made each 2 unit increase did they run a curve before the increase.

No, he never had a curve measured untill i bought a meter back when I started this thread. The vet would take a glucose check sometime around 10 or 11 AM during his appointment and then after a couple weeks when it was at a good level they did a fructosamine test. The last couple times he went they wanted him to loose weight and to reduce his food. Then a couple weeks later was when he started having problems with the hypoglycemia, He went back to the vet and they did a fructosamine test and didn't say much that I can remember, they wanted to do bloodwork but it had to wait another week or two. He was good for a couple days then started having problems with lows again so i bought a meter. Then when he went back to the vet for his bloodwork they did that and took a pee sample and I gave them printouts of curves that I measured. They said he had bladder infection and wanted to wait till he was done his anti-biotic and make sure his bladder infection is gone before they started making any adjustments to his insulin or food. So that's where Im at now.

Since his last curve, have there been any changes to his food routine? Snacks, etc?

No not really.

[Rubytuesday]

Re: Diabetic Rottweiler/Meter & Curves

Here is a good explanation of why fructosamine test are not a good test to base much of anything on. It is so frustrating that vets continue to rely so heavily on them.

http://www.vet.uga.edu/vpp/clerk/Bates/index.php

Limitations of Fructosamine Measurement in Monitoring of Glycemic Control

While fructosamine levels provide a useful tool for the evaluation of overall control of diabetes mellitus and long-term glucose regulation, this test is unable to detect short-term or transient abnormalities in blood glucose values. For instance, a patient may have an average blood glucose level within the reference interval over a period of 1-2 weeks preceding the test, but still have transient daily episodes of hypoglycemia and/or hyperglycemia. Serial measurements of blood and/or urine glucose are necessary for the detection of these short-term alterations, and are useful in establishing an initial protocol for the feeding and medication of a diabetic patient. Fructosamine levels are more useful for the evaluation of longer-term control, as well as owner compliance with the administration of insulin.

Okay, based on what you just said I go back to my original thought of reducing his dose. Then staying there until things settle down. Then you could run your own curve and have some concrete numbers to work off of.

[nibbles-mommy]

Re: Diabetic Rottweiler/Meter & Curves

Another point on the Fructosamine test-

On my Relion Ultima meter, there's a setting that will tell me the average of his reading from 7-day, 14-day, 30-day, 60-day and so on... If there was a 470, 68, 44, 344, 510, 480, 250 then the average would be 352. It's the same as a fructosamine test. So the result will seem high but doesn't take into account the lows.