This is all new to us!

[weese]

yesssssssssss! at last we have found a site that is friendly and full of information, thanx. We are very new to this as my dog Alfie was only diagnosed the week before last as having diabetes. It came as a big shock as i thought his weeing around the house was going to be territorial or a bladder infection .. and then the vet hit me with the bomb shell that he has diabetes. Alfie is a Cavalier king charles spainel and is going to be 4 in may this year. We started his insulin injection last monday and he is being as good as gold. However he sometimes squeals when i insert the suringe, is this normal? Its kinda freaking me outand lowering my confidence in giving the injections. I hate having injections myself and have had to over come and deal with this fear in order to give Alfie the injections he needs (i love him to pieces and have had to just bite the bullet). we are trying to get to grips with this new life change. We have been told everything needs to be consistent.Please can someone give me advice on exercise. should he be onlybe exercised a certain amount of time a day? and does this mean he will never be able to go for a day out of walks and picnics with the family ever again? If there are any friendly people out there who can give me some advice and their own experiences i would be grateful. Thanx

[Noodle]

Re: This is all new to us!

Hello & Welcome!

I'm sure you are feeling rather overwhelmed with the unexpected diagnosis. But you have found your way to the right place. I would suggest starting here on this websites home page. You'll find links to a ton of really useful information and even videos showing how to inject. Then if you scroll down further on the forum page, you'll find an entire section divided into subjects with saved posts/threads full of much more information.

If you could post some more information about your dog in this thread, it would help members understand where you are in the process of regulating. We try to keep all of the posts about each dog in their own thread. That way members can look back through the posts to refresh their memories of what has been tried so far without pestering you for the same information again. We love long posts, so the more information the better.

Has your vet performed a curve on your dog yet? If so, do you have the blood glucose numbers to share with us? Is your vet following up with more curves or spot checks? Have you considered home testing? What type of insulin are you using, how many units, and how many injections a day? What food does your pup eat? Does your dog have any other medical conditions? How much do they weigh?

Activity is one of those factors that can make a huge difference in your dogs blood glucose numbers. In many dogs it can help bring down their BG so it can be a useful tool in helping to work toward regulation. But some dogs drop large amounts with activity - my dog (Noodle) is one of them. I home test to make sure he never goes too low.

Injections can be uncomfortable for a number of reasons...

Cold insulin hurts, so you'll want to warm it up a bit. I draw Noodle's insulin into the syringe before I test and feed him. That way the small amount of insulin in the syringe has a few minutes to warm up. After that I roll it gently between my fingers. I've also been known to hold the syringe in my mouth (cross ways, like holding a pencil with your lips, lol) and some members hold the syringe under their arm.

The syringe needles come in different lengths and needle gauge. I use the super fine 31 gauge, short needles and Noodle doesn't even seem to be able to tell if and when I injected him.

There are many different areas you can inject insulin on a dog. Vets often only show families how to inject in the scruff. That's what our vet showed us and Noodle hated it. For many dogs the scruff is less ideal for absorption of the insulin and is prone to building up scar tissue as well. I inject Noodle on his side from beyond his rig cage to before his thigh. I also rotate - right side in the AM and left side in the PM. I believe there is a link on the home page with a diagram of injections sites to try.

Needles are beveled and some dogs seem to be sensitive to how the needle is lined up as it enters the skin. Some members mark their syringes so they know the bevel is facing up and that makes it more comfortable for their dogs.

I know this can all be a LOT to absorb and learn in the beginning - we've all been there at some point. But you will find lots of support here and you'll feel like an 'ole expert in no time. Before you know it, injecting you dog will be just another thing you do every day, like brushing your teeth.

[k9diabetes]

Re: This is all new to us!

Welcome to you and Alfie!

These first few weeks are the most stressful part. It gets a lot easier as time goes on and everybody gets used to things.

And yes you can go on picnics and do all the things you and Alfie used to do. We travelled 1,200 miles one way with our dog on one trip... his insulin, meds (he had other health issues) and food about crowded us out of the car, but he did great! We spent a lot of time at roadside stops with him in the back of the SUV while we filled his insulin syringe and mixed up his meal! I just wish the weather was warmer! It was March in Montana and Idaho and colder than I cared for. But he also got to play in the snow.

The main thing is to be as consistent as possible with timing of food and insulin and how much food you give and the timing of any fairly strenuous exercise until you get a handle on how things work with your dog. Then, when you're a pro, you can manage changes as needed because you will have the tools you need, one of which is knowing your dog's diabetes inside and out.

Here: http://www.k9diabetes.com/forum/forumdisplay.php?f=14 you will find tons of tips on giving injections.

Please do tell us more about Alfie:

Weight
Type of insulin and number of units per injection
Diet
How his blood sugar is being monitored
What kind of exercise he usually gets

Natalie

[ozzi]

Re: This is all new to us!

Hey Weese,

Welcome to you and Alfie!

As I read your post, I was thinking about how all of our experiences are so very different and yet the same! One night I came home from having been out and my dog Ozzi was lying in his bed, in a pool of urine. He never had accidents, and I was panicked! Because he is 13, I was worried that he had a stroke, and was actually relieved to hear he had diabetes! Since Alfie is only 4, I am absolutely sure you were shocked to hear the same news.

I read the advice that both Natalie and Noodle gave you, and it is so correct! I want to underscore that warming the insulin under your arm or however works best for you and injecting with the bevel up (the opening to the needle that "shines" when you look at the tip of the needle in the light) are really important for comfort when injecting.

I get how overwhelming all of this can be at first and I promise it will get better soon and before you know it, you will be a diabetes expert yourself! I hate to throw out another thing for you to think about, but during your free time (LOL), consider learning how to test Alfie's blood sugars yourself. This was something that I was afraid to do for a long time, and finally bit the bullet and started doing it about a month ago. Today, I cannot imagine not testing him. If I'm worried that his sugar is too high or too low, I can find out without running to the vet. In time, if you do this, I think you will find it to be a critical part of Alfie's management. It will also help you know how Alfie deals with exercise. Exercise decreases blood sugar (the extent to which it does varies by the strength of exercise and the dog himself). If you test him before and after exercise, you will know yourself how he tolerates exercise and how his blood sugar is affected. Some people here know that their dog drops too low, so they give a snack (peanut butter or a biscuit) prior to exercise to accommodate the decrease in blood sugar with insulin already on board.

You are correct about consistency and that is key in his diabetes management. It's important to feed him the same amount each time with insulin 12 hours apart. You will get his sugar under control and Alfie will lead a long life full of love, family picnics and exercise! This is the right place to be for any questions you have. There are many incredibly experienced people here, without whom I would still be in the dark.

My best,
Kevin

[connieandgypsy]

Re: This is all new to us!

Hi Weese,
Just wanted to let you know that you have definitely found the right people. my 10 year old kelpie gypsy was diagnosed with diabetes in january this year. yes everything needs to be consistent. my vet and I picked the times gypsy would be fed together so it suited me with work which was great, this is so she always gets fed the same time each day, my employer knows not to start me before 8:30am as I give gypsy her insulin at 8am. so that was nice of her.

your question about exercise. it gets really hot here and i no longer like to take her out in the heat for exercise. so i walk her every morning before she eats and has insulin as it is cooler. this seems to work for her. but i also take her to the beach and different places for her own interest, she loves it. so my input would be more about the type of weather you live in may effect your dog.

by all means i think you should still go on picnics and outings, i think it will do wonders for your dogs mood.

you will get the hang of everything, i have.

regarding injection. i give gypsy a piece of brocolli or carrot as i do the injection as a treat. so she thinks its great. just remember bevel up, warm the insulin and inject at the right angle...i will leave the rest of the advice up to those who know alot more..

connie

[weese]

Re: This is all new to us!

Thank you all for your kind and supportive words. At last i don't feel so alone.

Here is some more info on Alfie:
Because we are near the begining of this, his current weight is changing (due to previous weight loss prior to being diagnosed). His last weight check was 12.55 kg

The vet is currently doing glucose checks whilst trying to settle his levels. On monday his levels had dropped to 14 but had increased to 24 on friday. He is currrently taking 15 units of caninsulin using cainsulin syringes 29G x 1/2" fixed needles 40IU per ml . He is having 1 injection at 7:30pm with 100g of royal canin weight control food and then 8 hours later at 3:30am another 100g of the food. and thats it. (so 1 jab and 2 feeds). We have a alarm clock for each of the times that goes off so we do this at the same time every day. I am starting to get use to waking up to feed him the 3.30am meal and then getting a couple of hours sleep before getting up again for work.

I asked my vet about testing blood at home and he said that this is old school and can only cause probs when adjusting insulin levels as it takes upto 3 days for an insulin changed level to get into the system. He said once his levels have settle i will have to go in to vet every 6-8 weeks for glucose check.. meanwhile i being his owner would be able to recognise if he isnt right and low. This kinda worries me that for 6 -8 weeeks no checking. also myself and partner both work and therefore i am worried about Alfies levels changing and me not even noticing this happening.(i guess im just worrying about all of it at the mo).

As for exercise due to us both working this happens mostly in the morning and evening. In the morning he gets about 15 mins road walking. In the early evening he would have usually got about a 30-50 min off lead walk along our local beach (a 5 min walk away). But recently he seems to get tired quickly and after walking for about 10 mins flags. so what do i do? keep giving him the beach walk? or not? and if he looks tired then should i not walk him or is it still important he gets that walk?

As for the weather. We live in southeast england and therefore this time of year it is often chilly or raining at the moment.


Sorry for all the questions but i feel as though im gonna burst if i dont find any answers to this questions going around and around in my head.

thank you for your time

weese and Alfie "woof"

[ozzi]

Re: This is all new to us!

Weese,

Thanks for all the information! You are NOT alone, and that's a great thing!

For those of us not using the metric system, Alfie weighs just over 31 pounds. I don't know a thing about caninsulin, so others will be a better source for you regarding dosing. Generally speaking however, dogs usually receive two, not one, injections per day based on weight. If Alfie got 1/4 unit per pound, (often the starting dose) then I would expect him to get two injections of about 8 units each, 12 hours apart with feedings at the times of injection. It seems he's getting the entire daily dose of 15 units all at once. I have heard that some vets do this, but I don't have enough experience to comment on it outside of the fact that insulin generally wanes after 12 hours, which is why a "boost" or second dose is given. I'm guessing the vet expects the insulin to peak at about 8 hours since you are feeding with insulin and then 8 hours later.

I have several concerns. One of which is the once daily dosing of insulin. The next is that it seems awful that you have to get up at 3:30am to feed him! Diabetes management should not be so difficult and life altering!!

I was sad to see that your vet thinks home testing is "old school." People with diabetes check their sugars all the time! I was afraid to test for 6 months and when I started testing, I wondered how I ever managed Ozzi's diabetes without doing so. The truth is, I did not. I never knew what his sugars were running. I have personally found home testing to be a necessary part of Ozzi's management and not an option. I encourage you to consider getting a home meter and learning how to test. There are many links on this site to do so. As far as the owner being able to recognize when the sugar is off, my experience is that is not true. Ozzi has no symptoms of hyperglycemia until he is in the mid to high 500's. Some here have had dogs go down to 40 and there were no behavioral changes. So it is not true that you will always know how Alfie is doing just going by his behavior. I also don't understand starting him on insulin and not repeating a BG for 6-8 weeks!

I don't mean to sound rude, but it sounds to me that your vet is "old school," and may not be the best person to manage Alfie's diabetes. It sounds as though you are willing to home test, and I encourage you to do so. If my vet did not support me, I would have to change vets!! Many of us here have learned that we need to manage our dog's diabetes, working with the vet for support and guidance. After all, how often does the vet see Alfie compared to how often you are with Alfie?

Finally, regarding your question on exercise, I would suggest that you might want to substitute the 30-50 min off-lead beach walks with a more controlled walk until you know how exercise affects Alfie. Any exercise will lower BG, and usually the more strenuous the exercise, the more it will decrease it. Since you're just starting to regulate Alfie on insulin, it might be a good idea to avoid strenuous activity (just for now).

I look forward to the replies of others who are more experienced, and I wanted to throw out a couple of thoughts I had which I felt were glaringly worrisome.

Please keep us informed on Alfie's progress. Read through this forum, and make an educated decision for yourself about how to best manage Alfie's diabetes. There are some wonderful people here to help and support you with any questions you have.
Kevin

[peggy0]

Re: This is all new to us!

HI Weese and welcome to the board! Home testing is your peace of mind and is the only way you will know if your dog is doing well or not on the current insulin dosage and food. Insulin is provided twice a day typically with meals every 12 hours. I don't believe caninsulin is a once a day insulin. Caninsulin is the same insulin as vetsulin that we get here in the states. My dog used this insulin until 2 months ago when I switched him to Humulin N. Margaret is in Scotland and uses Caninsulin for her schnauzer. Exercise is good for your dog, but it does affect their Blood Glucose readings. The trick is how much? It typically lowers it, so unless you know your dogs blood glucose level, its hard to determine whether a short or long walk is in order. Please consider getting a meter and monitoring your dog. Its not old school at all. It's definately the thing to do. You may also want to check out Intervets site. They make caninsulin and you will see their advise to vets as to how to adminster this insulin. Hope this helps!

[eyelostit]

Re: This is all new to us!

Hi Weeze, and Welcome !

Food and insulin are given 2 times a day 12 hours apart.

You may ask your vet to check the Intervet site, it says only a small % of dogs are regulated on the 1 shot per day.

http://k9diabetes.com/forum/showthre...light=intervet

With the 1 shot per day you are giving the full amount of insulin then by 8 hrs later when you feed again the insulin is wearing down and most likely will result with a high reading by next feeding.

You may check with the vet as to giving 7 1/2 units 2 X a day after meal which is 1/2 of the current dose.

You will be able to keep the food times with a regular schedule and not have to feed at 3:30 am, did the vet tell you to feed at 3:30 am?

No, home testing is not old school, its more new school as now there are blood glucose meters for pets, alot of us here use human meters but thats a matter of choice and costs.

I know this is alot to absorb at first and some vets just go by old standards, if in time you feel you are getting uncomfortable with your vet or they are not giving you answers, please go to a new one, I'd say more than 1/2 of us have switched vets from the beginning of our pets diagnosis.

Keep asking questions, if you get overwhelmed, take a break for yourself.

You will do just fine, the first 2 weeks or month is the hardest part.

Hang in there

Dolly & Niki

[Margaret Boyle]

Re: This is all new to us!

Hi Weeze,

Welcome you will get plenty support on the forum.

I am just saying the same as Peggy and Dolly-----Speak to your vet about giving the insulin twice a day 12 hours apart. This is how it should be given about 30mins after meals.

Please do not be afraid to ask your vet questions, and blood testing is " NOT"
old school, I am afraid it is your vet who is old school.

I am in Scotland and I have built up a relationship with my vet----it was hard going at first but we have got there.

Blood testing will save you money and also peace of mind.

Tell your vet you want to work with him not against him, and if he is not happy with this, I would certainly find a vet who is.

Do not worry Weeze it is all so confusing, we all started like this---to the point you think your head is going to burst, but it will all become much clearer as you go along.

There is always someone who will answer and explain things, we all have some input that we can help with.

You will be fine.

Marg

[Ladybug]

Re: This is all new to us!

Hi Weeze!

I just want to say welcome to you and Alfie and let you know that you are in excellent hands here on the forum.

I came to the forum on January 15, 2010 and have learned SOOOO much in a two-month period of time with the help of the many many people here. I am not in a position to give expert advice, but there are many who can! Take your time and absorb everything you can. These folks are pros!

I hope soon that you Alfie can join me and Ladybug in our happy dance!

Linda and Ladybug

[ladysmom06]

Re: This is all new to us!

Hi,

Welcome to you and Alfie. Glad you found us. Lots of info here and very caring people who are always ready to help. Good luck to you and Alfie.

[Patty]

Re: This is all new to us!

Hi Weeze,
You've gotten some great advice from the others so I just wanted to say welcome!
Patty

[weese]

Re: This is all new to us!

Hi all people and dogs, Just popped on to place a quick update as work is busy busy busy at mo.

Thank you for all your kind words, welcoming and further advice.

Dolly + nikki
It wasnt my vet that advised the 3.30am feed it was our idea. The trouble being that witht he one injection you have to feed again 8 hours later. However if we injected in the morning then we wouldnt be at home 8 hours later to feed Afie again as we both work. Therefore we felt the only way and best thing for Alf is to do the early hour feed.


The friday before last we went back to vets for blood test reading of glucose. He measured 14 units. then on the monday we went back again and he measured 24 units. then on the friday we went back again and he measured 15 units. The vet has left him on 15units of insulin and go back for another reading in a month (unless any probs arise). Whilst there i spoke to the vet ( not my usual vet a different younger female vet) about testing glucose levels at home and she agreed that its a good idea. (yessss some support!) So she has ordered me a machine and i will shortly be going in to get it and be shown how to use it. Even though i havent yet got it, i already feel a bit better as i know i will have it there if need be to check as peace of mind.

Has anyone come across the product FRIO ? An insulin cool and safe wallet? My mum found it online and has brought Alf one to keep his insulin in when we go out. IT sounds fantastic not yet tried it but reviews are great. You soak the wallet in cold water towel dry it and the crystals inside swell up and keep the insulin cool for days (upto 4 days i think). no need for refrigeation so great for days out ect. it also stops the insulin from freezing in low temperature atmospheres. Cant wait to try it out.. ill let you know how it goes.

Right gotta go Alfies insulin is due soon.

Oh before i go any advise or ideas on how to keep Alfie from wriggling whilst i do his jab as he is now trying to roll over and spin his head back and fourth making it tricky to jab him (especailly as im still not that confident at jabbing) ? All ideas received gratefully.

Thanx everyone for your time. Take care

Weese + Alfie 'woof woof'

[k9diabetes]

Re: This is all new to us!

Hi Weese,

I had to laugh about the vet saying testing blood glucose at home was "old school." Compared to what?!?!?! Since the vet is checking his blood glucose levels, we know the information is useful to him.

It sounds like the vet is worried that you will take matters into your own hands if you were checking things at home. That's a pretty common concern vets have about home testing blood sugar. And I'm sure they have had clients who have gone and done crazy things. But that's not every client or even most clients.

Not every dog gives obvious signs of high or low blood sugar. Our dog, for example, didn't show any sign of increased thirst and urination until his blood sugar was sustained above 450 mg/dL (25 mmol/L) so that was a horrible way to try to keep track of his blood sugar.

The other big plus about home blood glucose testing is you don't have to guess about whether a dog who isn't acting right has high blood sugar or low blood sugar. You check it and you know and can act accordingly.

I'm concerned about the one injection a day. That rarely works for dogs. The only dogs I've seen who could get by on once a day insulin were all small dogs. And sometimes the vet gives a big dose of insulin as a way of trying to make it last. Which also almost never works.

Given the jump from 14 to 24, somogyi rebound is a possibility.

He could be going low first and then rebounding and going high. This can happen especially with once daily dosing of insulin.

The food plan also doesn't make sense to me... Caninsulin doesn't automatically show a second "Peak" of insulin activity later - I assume that's why the vet is having you give food 8 hours later is for that peak.

Your description of him getting tired on walks is indicative that his blood sugar may be going too low on walks... this is another reason why home testing blood glucose would be helpful.

Please do be sure to carry honey or syrup on your walks and give Alfie some if he starts to look weak or tired. You can even give him some syrup just before you leave to boost his blood sugar up for exercise.

All in all, there are numerous red flags here for me as far as how your dog's insulin and food regimen is being handled. I think he's at risk for both high and low blood sugar and I'm concerned that the dose may be too much insulin at certain times of the day.

Can you get copies of all of Alfie's test results - his blood glucose checks, any curves done, etc. and post them here.

If a curve hasn't been done, it needs to be.

Are you willing to try home blood glucose testing?

We can help you get started and then you would KNOW instead of having to guess what is going on with Alfie's blood sugar and could talk to the vet about improving his regulation if need be.

Alfie will need you to advocate for him and challenge some of the vet's assumptions. This is often the case when diabetes comes along. In fact, quite a few members have had to change vets after their dogs were diagnosed with diabetes. I am worried about how the vet is handling this.

Start at the main website: www.k9diabetes.com and also see the pages specifically on home blood glucose testing: www.k9diabetes.com/bgtestvideos.html. If you can read and learn as much as you can, you will be better able to help Alfie.

Natalie