Wolfie has passed...

[KramiesSister]

Re: Wolfie and Chuck, both diabetics

Hi Chuck!
My Kramer is a black and silver schnauzer. He's been diabetic for 3 years and we've had a hard time keeping his weight up throughout the ordeal but in the past few months by increasing his food and his insulin we have managed to put a couple of pounds on him.

Your son's dog Buddy is almost a dead-ringer for my Kramer...right down to the studded black collar (thats what it looks like he's wearing in the picture).

Have you tried doing a blood glucose check without using the clicking device? Some people found that helped (but it is hard to know how hard to prick) because the clicking sound can cause agitation.

We had rebound problems with Kramer a lot. Rebound is a "defense mechanism" for the body....it can either happen when the blood sugar goes quite low, or when there is a steep drop in the blood sugar. The body "panics" and releases large amounts of sugar into the blood to keep from going hypoglycemic. Thats the coles notes version anyways, I'm sure someone has some links kicking around to explain it better.

Anyways, good luck with the home testing, and you're doing a great job so far!!

Breanne and Kramer

[Dakotapix]

Re: Wolfie and Chuck, both diabetics

Thanks, Breanne. Yes, Buddy wears the studded black collar. He just this week had surgery to remove stones in his bladder so for now, we're keeping the brothers separated. Wolf had the same problem about two years ago and has been on a special diet that reduces the alkalinity that caused the problem. Tests will be run on Buddy's stones to check their content and then his diet will be modified accordingly.

After posting my question, I did Google the term "Glucose Rebound" and got some good answers and yours seems right in line with those. Because I have Type II diabetes, I've understood that it's a fairly common occurrence for the liver to release glucose while I'm sleeping and I guess that's "rebound" occurring. I asked the question because I see it mentioned so often here that I thought it deserved further discussion.

Back to Wolfie, after nine days of a 50 percent increase in his diet, I think he may have regained one pound or so but still needs more. Of course the increase in his food intake now makes me think that we'll soon be increasing his insulin doses. He was groomed today so I think I'll try to get a blood sample probably from the dew claw area to see how he's doing, maybe try to do the BG curve myself. Otherwise he seems to be doing well and is still chasing the bunnies in our back yard.

[k9diabetes]

Re: Wolfie and Chuck, both diabetics

Here's are some pretty good descriptions of rebound...

http://www.indulgedfurries.com/petdiabetes/somogyi.htm

http://www.caninsulin.com/Somogyi.asp

[KramiesSister]

Re: Wolfie and Chuck, both diabetics

bladder stones hey? Kramer had those a few years ago too. Our old vet put Kramer on a diet for stones as well but we found that there was quite a high fat content in his bladder stone food, so instead our IMS vet told us about supplements to give him daily (calcium citrate) to change the pH of his urine. We haven't had any re-occurences thus far (knock on wood).

We get blood from Kramers dew-claw, and it works like a charm. The key is to press really really hard because the lancet has to get through the tough surface. But I guess as a diabetic you are a pro at getting blood!

Breanne and Kramer

[Dakotapix]

Re: Wolfie and Chuck, both diabetics

Wolfie went through his third BG curve yesterday and I'm pretty disappointed in the results. He was still off the clinic's meters (HIGH) on half his readings and in the mid 400's on the rest. We've moved up to 10 insulin units twice a day for the next two weeks.

If things don't move in the right direction for the dog, we may have to try a different insulin. The internist also mentioned the possibility of Cushings disease as a cause of insulin resistance. Wolfie had gained about a pound and a half but we're continuing with his increase in his diet to gain even more. She did not think the increased food intake was responsible for his high glucose readings. Trouble for me is, he shows all the signs of a happy, healthy dog. His activity and appetite are high and he seems really content. As a diabetic myself though, I know the long-term outlook is not good if we can't get this under control. Wish I could be more positive right now but it's kinda tough.

[We Hope]

Re: Wolfie and Chuck, both diabetics

Chuck,

Schnauzers by breed are predisposed to having high lipids in the blood. This can be a cause of insulin resistance. Has Wolfie ever had his blood checked for them?

Agreed that Cushing's can also be a reason for insulin resistance. Does Wolfie have any of the signs of Cushing's?

http://www.vet.uga.edu/VPP/clerk/Zwicker/

Be happy that the "whole dog" seems happy and healthy; once you get to the bottom of what's causing the insulin resistance and take care of it, Wolfie will stay that way!

Kathy

[k9diabetes]

Re: Wolfie and Chuck, both diabetics

Ten units is still only half a unit per pound so you're still quite a ways from insulin resistance. Some dogs need more than average and if lipids are a problem he might well need a larger than average dose.

It's great that he feels good!

Natalie

[Dakotapix]

Re: Wolfie and Chuck, both diabetics

Thanks for the reassuring words Natalie and Kathy. That's good to know that I still have leeway in his insulin dosage. I have confidence in the internist we're working with. It's just that I'd hope to see better results this past time. I'll hang in there. He's a great little dog, well worth the effort.

[Dakotapix]

Re: Wolfie and Chuck, both diabetics

It's Sunday morning and I just went through a rather frustrating night with Wolfie. He needed to pee three times overnight and seemed to exhibit an unusual thirst although that was not as serious as when he was first diagnosed with diabetes. I'm using Wal-Mart's Novolin N insulin and he's currently getting 10 units twice daily. The bottle I had been using was first used around April 1 and it is getting down to the low points. I've been very careful about mixing it by slowly rolling the bottle (not shaking) since I started injecting. I've also made sure the syringe is being properly filled with no air bubbles. I'm wondering if it's possible that the insulin might be losing its effectiveness?

I used insulin from a new bottle this a.m. and will be curious to see if there's a difference tonight. For the most part Wolfie has slept through the night with no episodes like last night's since being diagnosed and treated.

I'll be scheduling another BG curve for this week and if there is no real improvement in his levels, I believe the vet will be suggesting adding a $300 ultrasound test for diagnostic purposes. We passed on that test two months ago but now I am wondering what such a test might reveal? The "Cushings" word came up during our last curve but it has been suggested here that the dog still has a ways to go with insulin increases before we have to take such expensive steps. Your thoughts and ideas would be welcomed.

[CarolW]

Re: Wolfie and Chuck, both diabetics

Oh, Chuck; my vet told me - after I'd used the same vial of Novolin-NPH insulin for four months (I'd asked, but my question got missed!) - to retire a vial after 5 or 6 weeks; she prefers 5 weeks to 6, but says BG-testing will reveal whether, in that 6th week, the insulin has lost potency.

The problem is this: so many rolls (however many, however gently), so many punctures of the rubber stopper and introduction of air from the atmosphere, whatever that be (ha!), and just natrual degradation over a period of weeks. That's even if you keep the vial refrigerated, as I do.

So you've been using the same vial for about 8 weeks or maybe a bit more. I think it's good that you started a new vial. I mark the box and the vial with a fine-point permanent marker: "Op[ened] day, month, year (two digits each), and I keep a spare, fresh vial on hand at all times (once or twice I've dropped a vial, which jolts the insulin and causes the molecules to break down). And after five weeks, I start a new vial, and mark the retiring one "Reitired [day, month, year]."

If you decide to do something similar, I'll bet Wolfie's BG readings - and clinical signs - will start to look better.

Sun, 31 May 2009 06:28:13 (PDT)

[We Hope]

Re: Wolfie and Chuck, both diabetics

Chuck,

I will be curious about what you see with Wolfie with a new vial of insulin, as I think the old one has lost its potency. When we were using the Iletin II Lente, I was able to keep a vial of that for close to 3 months before it started losing effectiveness.

Kept mine in the fridge when it wasn't being used; when it started losing its "pop", there was always about 1/3 to 1/4 of the vial left. They all start losing it from the first use on.

After Lilly decided to discontinue the Iletin II Lente, we got 2 vials which were subpotent from them--brand new, they had less potency than the old one they were meant to replace. It took us about 3 days after we found the insulin was bad to get Lucky's bg's back into line, so I'd say to schedule any curve for later in the week, when you've gotten Wolfie's bg's in line once more. Doing a curve until you've gotten Wolfie past this will only show he has high bg's.

One of our members, Pam and Pip, have had issues with getting potent insulin from their local WalMart. Have a look at this section of Pip's thread:

http://k9diabetes.com/forum/showthread.php?t=513&page=8

In this case, it looks like the insulin isn't being handled properly before you get it from the pharmacy. Insulin goes through a few "hands" before it gets to your pharmacy and you and if someone along the supply chain doesn't take care of it right, you can get a bad vial. After trying other W-M's in her area and still getting bad vials, Pam gave up buying insulin at W-M and switched Pip to Humulin.

This doesn't mean that the ReliOn/Novolin is coming from Novo Nordisk with issues, it means that after it leaves NN, someone's not handling it correctly along the way from NN to the W-M's in Pam's area.

I think you've found the "fix" for Wolfie in changing insulin vials!

Kathy

[Ricksma]

Re: Wolfie and Chuck, both diabetics

I have been remiss in welcoming you and Wolfie to the board, but was reading your thread, and wanted to comment about the insulin potency. I have found that even though Ricky uses a small amount of insulin, I really need to replace the vial every six weeks or so. It seems that his BG levels rise gradually after that amount of time, so it made sense for me to replace the insulin. I would rather waste half a vial of insulin each time than to have Ricky deal with higher numbers. I also had an episode with insulin being cooled in a cooler with ice, instead of a refrigerator when we had a two day power outage a few months ago. Even though it was a new vial of insulin, and I kept it on ice, I found that his numbers were rising the following week. I don't know if the lack of refrigeration had anything at all to do with it, but I replaced it anyway, and his numbers came down. Just info for whatever you think it's worth. Glad to have you here.

Teresa and Ricky

[Dakotapix]

Re: Wolfie and Chuck, both diabetics

WOW!!! Thank you all for this new info. As I stated, I started the new bottle this morning (Sunday). At first I was planning to schedule the curve for Wednesday of this week. How long do you think I should use the new batch before I do another curve? Wednesday would only be three days and I can't do it this coming Friday. Should I wait another week?

[We Hope]

Re: Wolfie and Chuck, both diabetics

Chuck,

Think I would do it next week to be sure any high bg's possibly caused by weak insulin aren't a factor here. While we got Lucky into line in 3 days, it took a bit longer to really straighten out all of the weak insulin bg's. Since pork insulin had to be ordered through the pharmacy at the time, we had to fall back onto the old vial which was being replaced. Found it had more potency to it than the brand new ones.

What you also want to avoid when you do a curve is the sometimes slightly lower bg's which come from starting a new vial. They're not anything to be concerned about seeing, but they are able to be noticed for some. We could always see Lucky going slightly lower right after a new vial was started.

Doing it next week should give you a true picture of how Wolfie's bg's are coming along.

Kathy

[Dakotapix]

Re: Wolfie and Chuck, both diabetics

Chuck,
Doing it next week should give you a true picture of how Wolfie's bg's are coming along.

Kathy

Thanks, Kathy. I had already decided to wait until next week. Your comments help reinforce that decision.