Yuki has crossed the bridge Dec 2020

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

I am working with the internal medicine doctor with Yukon and getting discouraged. We are up to ten units 2x day of Vetsulin and his BG is getting higher. She said next curve I need to do a 24 hour every 2 hours. She wants to see if the Symogi effect is happening.

I have noticed that his BG seems to be higher at night after I give him the insulin. She took them off the melatonin again so I'm not sure if that's what's causing the high night BG's. It seems like his levels were lower on the lower dose of insulin.

Here is the last two days on 10 units of Vetsulin:

11/19 (9 units) 281 6:30 p.m. Gave food and shot
677 10:40p.m.

11/20 (10 units) 321 6:15 a.m.
440 8:30 a.m.
389 3:30 p.m.
621 6:15 p.m. Gave food and shot at 6:30 p.m.
676 8:20 p.m.
621 10:00 p.m.

11/21 (10 units) 475 6:15 a.m.
HI 8:00 a.m.
564 1:30 p.m.
333 6:00 p.m.

I will take it again at 8:30 p.m. and it will most likely be in the 600's.

Is he resisting this insulin?

[jesse girl]

Re: Diabetes, Cushings and Pancreatitis in my Dog

I have seen this with jesse raising the dose seen higher highs . for jesse she only could tolerate so much insulin at one time i guess .she did not show classic rebound just kept going higher and higher

maybe its a reaction to insulin

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

So did you end up lowering the dosage? I am also worried because she took him off the melatonin and he's been panting and drinking a ton.

[jesse girl]

Re: Diabetes, Cushings and Pancreatitis in my Dog

for jesse 3 units is about all i can give her at shot time and why i have to give her 3 shots in a day instead of 2. I felt her body may not be completely happy with human insulin and that maybe the reason a smaller amount is needed .

its hard to say if the melatonin played a factor .the only way to know that is to reintroduce it but if it was making insulin more sensitive and without it you may need more insulin

it can be hard even with the best minds to know what direction to go . The symptoms you are seeing sounds like high sugar . You should test for ketones to correlate that high sugar

[Raysaint]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Could be resistance. I just had my dog in today for bloodwork as a starting point {his fastings have been erratic.)
Organs, hidden infection or some abnormality, thyroid, triglycerides, all possible causes.

[k9diabetes]

Re: Diabetes, Cushings and Pancreatitis in my Dog

I don't know a lot about the hydrolyzed diet but would suspect that it is digested a lot faster than unhydrolized protein.

So if Yuki is slow to put the insulin to work and digests the food very quickly, you would see the kind of numbers you have in the morning in this mountain-style curve. and that would require the insulin to bring it a long way back down.

In this curve, he returns to his fasting glucose level about 12:30 pm, likely a combination of the food has mostly been digested and the insulin started working seriously about 9:30, three hours after his meal and injection.

Then his walk may have pushed him into low blood sugar. Exercise usually decreases blood sugar levels, often quite sharply. We used to have to test our dog before his walk and give him a snack to raise his blood sugar if it was on the low side before leaving.
. . . .

Fixing this imbalance should flatten out the curve and give better regulation. Since you can't change the food, you would have to work with the insulin. And in this case giving some fast acting insulin could work well to tame his blood sugar the first couple of hours after eating.

I haven't checked to see if he's still on Vetsulin - a separate injection of something like R (Regular) insulin with his normal insulin and food could be very helpful.

Some dogs are quite sensitive to Regular insulin so you would start with a small dose - 1 unit at most - and see how that shifts his blood sugar, hopefully downward, in the first few hours.

. . . .

I wouldn't worry about the dose - it's still well within normal limits. I don't even blink at anything under half a unit per pound and they can sometimes need even more if they aren't particularly sensitive to the insulin. They aren't considered insulin resistant until they are getting 1 unit per pound and still have high blood sugar.

And a dog with Cushing's could need beyond that.

Natalie

Here are Yukon's BG Levels from the 11/03 Curve Test:

6:30 a.m. 393 Yukon’s Blood Glucose getting up no food
6:30 a.m. Gave Yukon Food and then Shot after Food 8.0 Units
8:30 a.m. 587
9:30 a.m. 470
10:30 a.m. 433 Walked and he pooped before 10:30 BG Reading,
gave Yukon small amount of Green Beans after
12:30 p.m. 389
2:30 p.m. 421
4:30 p.m. 245 Walked before BG draw and gave Green Beans.
6:45 p.m. 156 ????????
7:45 p.m. 663 Gave Yukon Food and then Shot after food 8.0 Units
How can it go up over 500?Drinking a little more.
9:05 p.m. 648 Gave Melatonin 3mg at 8:00 p.m.

[k9diabetes]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Was there a walk in here?

If not, then the insulin appears to be running out early, leading to the much higher blood sugar late in the afternoon.

This again can be associated with a poor balance - such high blood sugar earlier in the day uses up the insulin quickly and exhausts it. It can actually last longer if it's used at a more moderate pace.

Cush dogs do sometimes show a pattern in which they respond briefly to a higher dose and then bounce back up. But with a Cush dog it's okay to give more insulin that you might with a non-Cush dog.

I think getting a better food/insulin balance is the key.

Natalie

I am working with the internal medicine doctor with Yukon and getting discouraged. We are up to ten units 2x day of Vetsulin and his BG is getting higher. She said next curve I need to do a 24 hour every 2 hours. She wants to see if the Symogi effect is happening.

I have noticed that his BG seems to be higher at night after I give him the insulin. She took them off the melatonin again so I'm not sure if that's what's causing the high night BG's. It seems like his levels were lower on the lower dose of insulin.

Here is the last two days on 10 units of Vetsulin:

11/19 (9 units) 281 6:30 p.m. Gave food and shot
677 10:40p.m.

11/20 (10 units) 321 6:15 a.m.
440 8:30 a.m.
389 3:30 p.m.
621 6:15 p.m. Gave food and shot at 6:30 p.m.
676 8:20 p.m.
621 10:00 p.m.

11/21 (10 units) 475 6:15 a.m.
HI 8:00 a.m.
564 1:30 p.m.
333 6:00 p.m.

I will take it again at 8:30 p.m. and it will most likely be in the 600's.

Is he resisting this insulin?

[k9diabetes]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Another option is a small dose of Regular insulin given in the afternoon... maybe an hour before dinner and normal insulin to bring that high blood sugar down.

That would make up for the lack of the normal insulin at that time.

Have you seen our case study?

A few vets have used it to make a creative insulin and feeding schedule to solve specific problems.

http://www.k9diabetes.com/k9diabetes.pdf

Natalie

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Thank you for the suggestion Natalie I will ask the internal medicine doctor.

After the 24 hour glucose curve she had me raise his vetsulin to 11 units and put him on Keflex three times a day to 250 mg for 14 days because I told her he was licking his privates still all the time.

He's been acting really good just drinking a ton of water and I waited a few days and did some random blood testing. This morning at 6:30 AM before his food and insulin his blood glucose was 565. This evening 1 1/2 hours after administering his insulin and food he is at 665.

I am getting so frustrated. I would love to have a day where he's at least 200 to 300 all day. 11 units is a lot to me can someone please give me advice what to do?

[MikeMurphy]

Re: Diabetes, Cushings and Pancreatitis in my Dog

At 11 units, I think you have plenty of room for increases, especially considering his Cushings.

I like Natalie’s suggestion of maybe introducing a fast acting insulin like Novolin R to get his BG down. Don’t do this on your own. Make sure you run it by your Internal Medicine Specialist.

[jesse girl]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Thats the difficult part of this disease is figuring what direction to go . At this time you dont know if your going in the correct direction and if you have other medical conditions occurring that can put regulation on hold

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

You are correct, but according to the internal medicine doctor after doing ultrasound and tons of blood work there's nothing else going out of the ordinary.

They now want to do the 14 day freestyle libre monitoring system. My husband and I feel like we are just experimenting and trying things.

[Raysaint]

Re: Diabetes, Cushings and Pancreatitis in my Dog

What is the dog's weight? Maybe he's just underdosed.

[jesse girl]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Yes raysaint I believe the pup is 30 pounds so at 11 units is not a high dose

I guess the reason your vet wants to go with the libre system is to catch any possible low trends that may not being caught and if there isnt any then there is more confidence moving the dose higher

Now is your dog diagnosed and treated for cushings ?

If you want you can do a signature under your post describing insulin ,food , weight and any other challenges that may have an impact which can help with people reading your post

[YukiesMom]

Re: Diabetes, Cushings and Pancreatitis in my Dog

Hi there,

Yukon was diagnosed with Atypical Cushings disease from the University of Tennessee in May, 2018. His Cortisol was in normal range at that time, but the Androstenedione, Estradiol, Progesterone and 17 OH Progesterone were fairly high.

Because of these reasons the Vetoryl did not work so we put him on Melatonin and Lignans per UofT's suggestion.

I am going to have another Adrenal Panel ran through U of T in the next week or so to see if anything has changed. We took him off the Melatonin because I had heard that it sometimes causes insulin resistance.

One thing I do want to ask anyone out there is if they have ever heard of clove lower blood glucose? I started using the Dentacetic Wipes again on Yukon's teeth - I was always afraid there was sugar in them and didn't want to create an even bigger problem to my 400-500 ranges.

One of the ingredients in the wipes is clove, and I have noticed that over the last three days that I have been cleaning his teeth with the wipes, a couple hours after I give him his food and injection his BG is around 300's - it is usually in the 500's!

I am not sure if that is what is causing it, but I am not going to complain if it is.