Sweet Pippa's journey has ended... August 19, 2018

[Rubytuesday]

Re: Pippas new journey

Morning Jenny, a lot of folks work with a human meter. Some are better than others, not sure about the contour. The One Touch Ultra is very reliable. Dog's blood is a bit different than our blood (something about the platelets or cells, don't remember) which the alpha track (AT) is set to read and why you will get two different numbers on a human versus animal meter machines.

But you are right, you want to look at the trends more then anything. I'm sure others will chime in that use human meters. There will be variances that change whether the reading is high or low. All of this can be figured out with your particular meter by bring it and the dog to the vet when they have a high or a low reading and comparing what your meter reads with what the vet's meter reads.

Can't help with that as I use the AT meter.

A lot of folks work with toppers to get the dog to eat. I imagine someone will give you ideas with that, I don't need to use them. There are some that won't affect the BGs....tuna juice I think is one of them.

Tara

[Cebe]

Re: Pippas new journey

Re: eating in the morning. I have a theory on this, that some dogs are like humans, they need their coffee to fully wake up and aren't all that hungry first thing in the morning. The suggested solution isn't coffee of course but I think going outside - a little excercise might get the juices flowing and work up an appetite.

I use a meat topper for my dog's food cuz she's not all that interested in the kibble when it's plain. Anything like that, a gravy or other enticement works. Ooh, cat food is a great enticement. Just a touch of it will make that food irresistible.

[jenny]

Re: Pippas new journey

Morning all, Friday 27th April here- Day 10 and back at vets tom am.

Vet asked me to do a Fasting BG this am. It was 21.4mmols on the alphatrak and 19.7mmols on the contour ( human meter). These seem really high to me and confusing. Yesteday at 14.30 they were 14.1mmols on the contour and 19.2mmols on the alphatrak. Pippa does not mind the blood tests at all thankfully.

I have not been given info about her diet, the vet was very non commital about this and said not to change anything and not to go onto a perscription diet as shes not overweight. As long as she gets 2 identical meals 12 hours apart then insulin thats fine.

I have been to discuss with a nutritionalist at Burns dog food and am slowly planning to change her kibbles over to a high oats (low GI index) prep in place of her senior premium kibbles. I started the change on wed pm and have only substituted 10g of new food for 10g of old kibble so far. Which she is tolerating and liking as long as it has the wet pate type topper (30g each meal) on it. The only other treats are tiny bits of chicken for BG test and injection or 95% pure fish treats ( small and sparing) . She is eating breakfast better now and getting used to no cat food! The barrier is working again! I also have always given both my dogs an evening dental chew treat and phoned the company today, pedigree, to fing her size although labelled as no added sugar does contain 51 calories! We tend to alternate between dental chew and small rawhide chew in the evenings and I have not been able to find out how many calories in these.

Injections have alos gone slightly better the last 2 days. Good news.

Does anyone know how to calculate dietry needs and what sort of principles show I be trying to follow? Would low GI high oats be good? makes sense to me as a human.

Many thanks for any advice. Jen and pippa x

[jenny]

Re: Pippas new journey

I just though In add in the nutrtional infor of her kibbles for help with my previous post...
Old food , Wainwrights turkey and rice complete senior
Protein 20%
Fibre 4.5%
Fat 8.5%
Ash 8%
Moisture 8%
recommended feeding for her size 200g per day

New food I think is better and want to change to
Burns High oats complete dogfood
Protein 20%
Fibre 6.5%
Fat 7.5%
Ash 7.5%
Moisture 8%
Recommended feeding for her size 100g per day

The Pate / tray food she has is 30g in each meal of Wainwights turkey and rice light food which contains
Protein 10.6%
Fibre 8.7%
Fat 3.6%
Ash 2.7%
Moisture 74.4%
The trays contain 400g so she really only had a tablespoon on each meal, I do weigh it all though.

Bit of a difference in the recommended feeding amounts and i'm very confused as to what to do. Should I be reducing her amount at the same time as changing her over slowly to the burns food???

Many thanks. x

[CraigM]

Re: Pippas new journey

Good morning, and welcome to the forum. I only have a few minutes since it's already 1AM here and I REALLY need my beauty sleep!

I know you are a nurse and have also been treating a diabetic cat for several years. I'm sure you know Canninsulin is a U-40 insulin, but could you please verify that you are using U-40 syringes?

Yes, 21.4mmol (385mg/dl) is high, but you are still basically on a starter dosage (5 units). The vet will probably either do, or have you do, a curve soon. Remember, dosage is based on the lowest reading so you really can't increase the dosage until the curve is done.

Recommended food amounts: I think the recommendations on the bag is sometimes just a very rough guess on their part. I guess if you wanted Pippa to gain a little weight, I'd go for 200g of the new food.

I'm guessing the change in diet might make a small difference in her blood glucose, but you are still at the starting point, so I'm hoping the food change won't affect the BGs too much.

I better get to bed. Have to be up to take care of Annie in six hours.

[Rubytuesday]

Re: Pippas new journey

Hi Jenny, I can remember when a high reading used to concern me but now what I look at more is the trends and how my dog is feeling. For you to be seeing this number so early in the regulation process isn't unusual, and it is important to let a dose settle in and get info (curve) that can be referred back to later before increasing a dose. Even though this is a higher fasting than you would like to see, you have no idea what the rest of the day would test at. There is the nadir time ( when the insulin is at it's strongest so bgs are at it's lowest) that will be lower then the fasting. In this disease, while continuous highs need to be addressed, it is all about the lows.

I forget, how long has she been on the insulin and at this dose. Would you want to do a curve yourself at home? If she hasn't been on the insulin for that long....5-7 days for the first curve???, it may only be for your learning purposes and not so much to base an increase on. I for one test a lot more then I need to and will often do mini curves to see how ruby is trending on a recent change or to check to see if the nadir is still occurring at the same time.

The point of a curve such as this would be for you to see the interplay between
food and insulin, but not to make any changes based on the readings. My vet says a dog needs 7-10 days to settle into a new dose. I may make changes quicker (never sooner then 6 doses or 3 days), but this is with a dog that has been on insulin for 8 mo. and I know her trends very well.

There are different schools of thought with regards to diet. There is the low carb/higher fiber approach and than the high protien/grain free approach. Often times you have to find what works for your dog as they will respond differently. Because of Ruby's other issues I have to do the high protein/grain free food, but the one we have settled on is also low carb.

Tara

[Cebe]

Re: Pippas new journey

Just a quick thought: I would slow down on the food changes until you get the insulin more regular. If you change everything at once, you don't know what works and what doesn't. So, as frustrating is it is to have to go slowly, try to make only one or two changes at a time so you can track the effect better.

Best wishes!

[jenny]

Re: Pippas new journey

Thanks Tara and Craig.

Pippa is having the 40u syringes with her caninsulin 5u bd starting dose.

I will be asking vets tom re different syringes with shorter needles as they do seem to hurt her more than I would expect. I will also ask about doing a curve too, either them or me. I know its early days but I hate her readings being this high at fasting, but better than going hypo still.

Many thanks x Jen

[jenny]

Re: Pippas new journey

Dear Cebe, You are so right.

I AM RUBBISH AT GOING SLOW.

Must practice more and get better at it.

(My husband always says to me " its a marathon not a sprint")

x jen

[diggydog]

Re: Pippas new journey

Hi Jen,

Welcome!

Just really quickly - I dont have a lot of time right now but Alfie was first on caninsulin when he was diagnosed and we used the 40iu syringes then we switched insulins and needed different syringes. We use the 100iu, 0.3ml with demi BD syringes. We went back to using caninsulin and Alfie freaked every injection with the 40iu syringes so we switch to using the 100u syringes and converting the amount.

We used this chart to get us started converting but basically all you do is multiply the amount of 40ui units by 2.5 to get how much on a 100iu you should fill your syringe (the web pages explains it so much better!)

http://www.petdiabetes.com/pdorg/u40_conv.htm

I have had Alfie on Burns High Oats before but it never really worked out for him. Out of interest (forgive me if I have missed a post on it) why the decision to change Pippa's food??

Allison & Alfie

[CraigM]

Re: Pippas new journey

Pippa is having the 40u syringes with her caninsulin 5u bd starting dose.

Thanks for putting my mind at ease. When many in the States switched from Vetsulin (same as Caninsulin) there was always a fear they didn't switch out their syringes for the proper one. Even worse would be someone switching from Caninsulin to NPH insulin, and continuing with the U-40s.

Hope your visit with the vet goes well.

[CraigM]

Re: Pippas new journey

Hi Jen,

Welcome!

Just really quickly - I dont have a lot of time right now but Alfie was first on caninsulin when he was diagnosed and we used the 40iu syringes then we switched insulins and needed different syringes. We use the 100iu, 0.3ml with demi BD syringes. We went back to using caninsulin and Alfie freaked every injection with the 40iu syringes so we switch to using the 100u syringes and converting the amount.

We used this chart to get us started converting but basically all you do is multiply the amount of 40ui units by 2.5 to get how much on a 100iu you should fill your syringe (the web pages explains it so much better!)

http://www.petdiabetes.com/pdorg/u40_conv.htm

I have had Alfie on Burns High Oats before but it never really worked out for him. Out of interest (forgive me if I have missed a post on it) why the decision to change Pippa's food??

Allison & Alfie

Very true, and I suppose there are many that do just this. You get a much wider choice of syringes, and I'd bet at a substantially lower price.

My concern would be with communicating what dose you are actually giving. For example: you are currently giving 5 units using a U-40 syringe, which would be the same "liquid amount" as filling to the 12.5 mark in a U-100 syringe. YOU would know what you were giving, but there might be confusion if you had to have someone else give the injection (boarding, at the vet office, etc).

Guess I worry too much about this!

Out of curiosity, I wonder what the price difference is between Caninsulin and NPH (or whatever it may be named in Scotland)? Most dogs here in the States are using NPH at a big cost savings. You might check it out with your vet. BUT THEN REMEMBER THE CORRECT SYRINGE!

Whoops!! I meant Wales, not Scotland!

[jenny]

Re: Pippas new journey

Hi Allison,
It is me that has the strong urge to optimise her food. The vets seem to have given me very little advice about this. Shes not overweight, she has a waist and you can feel her ribs . In adulthood she has been between 9-10kg ( currently 9.5kg) . I think its the nurse in me wants to get everything right at once to try and reduce her risk of cataracts forming ( since I found this out its been a hugh issue for me as i didnt know about it and it does not happen in cats or people for the same reasons).

In a new human diabetic a low GI food which is absorbed slower will give a steader glucose with fewer peaks and troughs and less hunger. Thats what i hope the high oats might do. I have only substituted 10g new food for 10g old so far. My dogs always used to eat Burns ( they are a very local company to where I live and have high ethical standards). I still buy some eggs and veg from their farm shop locally too . They stopped having burns when pippa became a picky eater post a GI upset and hospitalisation 3 years ago. Nothing was ever diagnosed at the time but I now retrospectively wonder if that was a brief episode of acture pancreatitis. Never will know now as have changed vets since then.

What do you feed little Alfie and why didn't the Burns high oats suit him, if you dont mind me asking.

Thanks for your advice re 100u syringes which have shorter needles. I will add to my list (getting long now) of things to discuss with vet tom! Thanks Craig too, will bear in mind the convertion from 40u- 100u syringe issues too. As no one but me will be giving the injections it should not be too much of an issue but important so glad you raised it.

xxxJen

[diggydog]

Re: Pippas new journey

Hi Jen,

I first fed Alfie on Hill W/d when he was diagnosed but he was constantly hungry to the point he was waking me up at 4 or 5 am to sit and beg by his food bowl.
I met Mr Burns at Crufts a few years ago and he spent a long time with me discussing the Burns food range and I started feeding Alfie High Oats after that.

Alfie was a bit overweight (ok ok a lot overweight) so High Oats was a great choice for him - initially it looks like a really small amount of food to feed but Alfie wasn't as hungry as when I fed him the W/d.
Our problem with High Oats was that Alfie lost a lot of weight but continued to lose weight to the point someone reported me to the SPCA. He was just skin and bone - despite me increasing the amount I was feeding him he keep dropping his weight. In the end I was feeding him more than 3x the recommended without any weight gain.

I had to change his food to try and get his weight back up and I think I had him on almost every food that Pets At Home stock but most of them ended up throwing his bg's even more crazy than normal or making him really sick.




I see a specialist at the Dick Vet School in Edinburgh and to my horror she suggested I try feeding Alfie Chappie dry.
I didn't even know Chappie came in a dry food and had always had a really bad impression of Chappie food in general but thought it was worth a shot as nothing else seemed to be working and that was 2 years ago and Alfie is still eating dry Chappie and does really well on it.

Let me know if you decide to change syringes - I know a few good websites for getting them at a really good price!

Allison

[Patty]

Re: Pippas new journey

Margaret used Burn's High Oats with Lucy, though I believe Peggy helped her out with substituting some cottage cheese to prevent a spike at one point. http://www.k9diabetes.com/forum/show...?t=596&page=61

Likely the difference in recommended feeding amounts has to do with the amount of calories. If you are switching, you'll want to provide the same number of calories you were feeding of the old food to maintain her weight. Here's a metabolic calculator http://www.mycockerspaniel.com/mer.htm But I'd base her needs off of what she was getting previously.

Personally, I think I'd see what a curve looks like on her current food to see if she needs anything changed. But if you decide to switch, you'll want to keep in mind a curve won't be completely accurate until you've completely switched over.

When discussing how much insulin she's getting (like with vet or online) if you wind up making a conversion with syringes as some people do (I know Jenny did this with Buddy for most of his life in order to use smaller needles), you always want to relate the dose in actual "Units." Using Craig's example:

For example: you are currently giving 5 units using a U-40 syringe, which would be the same "liquid amount" as filling to the 12.5 mark in a U-100 syringe.

But when filling the U100 syringe with U40 insulin, you reference what "Mark" you are filling to.

Take care,
Patty