Kai has gone to the Rainbow Bridge today

[crazydayz]

Hello everyone

My name is Kathy. I have a 7 (almost 8) year old Weimaraner named Kai. He has always been pretty healthy until this past year. We moved from VA to FL and he has seemed a little off. I figured it was the move and him getting older but recently I discovered more. About 8 months ago he started drinking from the toilet. Something he had never done before. OK so its hotter here and maybe the water was cooler. Then the past few months he started waking up a few times a night to go out. So he's getting older and losing some control. He also started to take more time to stand up, Arthritis..maybe. Well last Wednesday our life changed. I have had the gut feeling something was just not right. Then Tuesday night Kai was drinking and peeing like crazy. He went out and then came right back in and peed on the carpet right in front of me. He is very good and has not had an accident since he was a pup. It was very clear, obviously diluted. So first thing in the a.m. I called the vet and got him in. They took lots of blood work and said they would call in the a.m. He had also lost a bit of weight. He was down to 81lbs. His high was 106 but that was overweight as my kids started eating people food. He was a healthy 90lbs just last Sept. So I get the call...Kai is very diabetic. His glucose number was 559! However all of his liver enzymes were elevated. They were worried about Liver cancer. I fell apart. Here my healthy dog was all of a sudden very very sick. Well Memorial weekend and we could not have the ultrasound of his liver until This Wed. That’s 1 week. The vet said to maybe wait for the u/s to see if it was cancer before starting insulin. I know nothing about this and said OK. Well later in the day (still Thurs just received results) Kai started acting more weird and I could tell he did not feel good. Then all of a sudden he was walking weird. His nails on his back feet were pointing straight out. Like he was walking on the back of his paw. I called the vet and said I wanted to start him on the insulin right away. If it makes him feel any better before the u/s than its worth it. We drove right in and she looked at his paw. She said it looks like diabetic neuropathy. Looking concerned she gave us the vetsulin and showed us what to do and look out for. Then to continue my stress the next day I see blood on the carpet. I looked at his other back paw and it is swollen and has 2 spots if I squeeze blood comes out. The vet was worried snake bite. OMG I am about to pass out. Turns out it is an abscess and he was put on antibiotics which have cleared it up perfectly. Well 3 days later he is a new dog. He is barking at "every" car that drives by again. Still drinking and peeing but not nearly as much. Then yesterday was his u/s...great news!! No cancer!! He has vasculars (sp?) on his liver that were most likely caused by the diabetes. She said he should be fine now with controlled diabetes and a holistic idea would be some milk thistle to help the liver repair. (I had already bought some ) So here I went from thinking my poor sweet boy was dying to a ..I can deal with diabetes attitude. I mean over cancer?! Thank God!

Now to help the back paw heal which I have heard can happen with the neuropathy when glucose is controlled. He actually already sometimes puts the toes back correctly while walking. Just not all the time. He is also on pain killers as needed for his arthritis. None today as he seems pretty normal to me! Woohoo!!

He is on Vetsulin 1x a day right now. He takes 30u. In 2 weeks we will go back for glucose testing and possibly adjust his meds.

I look forward to meeting many of you and learning much more about this. How to control and the good and the bad.

[crazydayz]

A newbie Hello

Just wanted to say hello and introduce myself. My name is Kathy and I have a 7 (almost 8) year old Weimaraner who was just diagnosed with Diabetes one week ago today. What an emotional week I have had. I posted his story in the stories thread if you would like to hear about us. I am also mom to a 6 year old boy Drew and 3 year old girl Mara and married to a wonderful man named Drew.

I look forward to learning so much about this and meeting you all!

[We Hope]

Re: A newbie Hello

Welcome, Kathy!

I'm going to copy your post from the stories thread so everyone can read it here.

Kathy

[crazydayz]

Re: A newbie Hello

Welcome, Kathy!

I'm going to copy your post from the stories thread so everyone can read it here.

Kathy

Thanks I was not sure if I should post it here or in the stories. Thanks for the welcome!

[k9diabetes]

Re: A newbie Hello

Hi Kathy!

What a nightmare week or two you had!! Glad the news was good. It's pretty common for the liver enzymes to be somewhat elevated with untreated diabetes.

Just so you know, insulin one time per day is not likely to work.

And with blood sugar so high, I would want to be aggressive in getting it down at least some.

Does the vet have you checking his urine for ketones?

With such high blood sugar, they are a risk. There are simple, inexpensive urine strips you can purchase that will give a rough idea of his glucose levels (vague) but also will tell if he's breaking down his body for energy and producing ketones, which are dangerous. If they are present in more than trace quantities, you should consult with the vet right away.

Keto-diastix: http://www.walgreens.com/store/produ...=1&id=prod4852

I have seen only two dogs - both small dogs - out of a hundred that could regulate on one injection a day so I think it would be wise to monitor for ketones and also to check urine for glucose a few times a day if you can. If the insulin is not lasting, you will see lower sugar in the afternoon and evening but very high sugar in the urine in the morning.

Have you considered home blood glucose testing?

Okay... before I totally overwhelm you, welcome!! Glad Kai's getting his diabetes treated to get rid of the neuropathy. That is a pretty common experience when their blood sugar is so high.

Natalie

[crazydayz]

Re: A newbie Hello

Hi Kathy!

What a nightmare week or two you had!! Glad the news was good. It's pretty common for the liver enzymes to be somewhat elevated with untreated diabetes.

Just so you know, insulin one time per day is not likely to work.

And with blood sugar so high, I would want to be aggressive in getting it down at least some.

Does the vet have you checking his urine for ketones?

With such high blood sugar, they are a risk. There are simple, inexpensive urine strips you can purchase that will give a rough idea of his glucose levels (vague) but also will tell if he's breaking down his body for energy and producing ketones, which are dangerous. If they are present in more than trace quantities, you should consult with the vet right away.

Keto-diastix: http://www.walgreens.com/store/produ...=1&id=prod4852

I have seen only two dogs - both small dogs - out of a hundred that could regulate on one injection a day so I think it would be wise to monitor for ketones and also to check urine for glucose a few times a day if you can. If the insulin is not lasting, you will see lower sugar in the afternoon and evening but very high sugar in the urine in the morning.

Have you considered home blood glucose testing?

Okay... before I totally overwhelm you, welcome!! Glad Kai's getting his diabetes treated to get rid of the neuropathy. That is a pretty common experience when their blood sugar is so high.

Natalie

Ok you did go over my head there but I need to know these things so I will read up and follow through. In his tests when she gave me the glucose number she also told me his urine was a +3. What does that mean? I will be switching vets most likely. Was not thrilled at all she wanted me to wait 1 week for the u/s before giving insulin. Lord know what could have happened if in 1 day the neuropathy started. Ketones..is that something I can see? (Off to go read up on that!)

I am not testing at home and am pretty sure he will need more as he is still drinking and peeing a lot. Vet acknowledged that as well. The appt for testing is coming up. Minimum of 3, 1 hour tests and up to 5 possbily depending on how he does.

I think she thought he had cancer and thats all she was thinking. Not sure how much diabetes knowledge she has especially for such a big dog.

[k9diabetes]

Re: A newbie Hello

There just aren't a lot of newbie friendly descriptions of ketones in the blood, which lead to a life-threatening condition called ketoacidosis in diabetic dogs.

Basically, when the blood sugar is very high, the body is starved and it turns on itself for food, breaking down fat into fuel it can use. But when it does this, ketones, which are normal in minute amounts, start piling up.

Ketones are acidic and when too much ketone builds up it makes the blood acidic.

This can kill, which is why it's important to make sure there isn't more than a trace of ketones present in your dog's blood. Hope there are none.

If a dog goes into ketoacidosis - acidic blood from too much ketones, he needs emergency treatment with fluids and IV insulin.

That's a really pared down explanation... most important thing to remember is ketones are BAD! If your dog gets them, he needs treatment right away, usually in the hospital, to bring the blood sugar down.

If you want a much better description, check out the petdiabetese wiki: http://petdiabetes.wikia.com/wiki/Ketoacidosis and also the regular wiki on ketoacidosis: http://en.wikipedia.org/wiki/Diabetic_Ketoacidosis

[crazydayz]

Re: A newbie Hello

That's a really pared down explanation... most important thing to remember is ketones are BAD! If your dog gets them, he needs treatment right away, usually in the hospital, to bring the blood sugar down.

If you want a much better description, check out the petdiabetese wiki: http://petdiabetes.wikia.com/wiki/Ketoacidosis and also the regular wiki on ketoacidosis: http://en.wikipedia.org/wiki/Diabetic_Ketoacidosis

Thank you. I would hope the vet would have told me and I hope they checked. I will give them a call to see if it was checked. How about symptoms? He seems much better than he did last week. He loves to eat so that usually doesn't cause an issue. LOL Although he still drinks and pees a lot. *ETA* I read up on the symptoms. I think he is ok but am still going to check. No vomitting or bathroom issues. Seems pretty ok except the drinking and peeing.

One more question. How fast does blood sugar get that high? Has he had this a while or could it have happened within the year? Just want to make sure I know enough before I switch vets too. His vet is "ok" but I have that feeling I need to find another. We moved here 1 year ago and he has only seen that vet maybe 2x. My sister uses them but I have no ties. LOL

[crazydayz]

Kai had Ketones present today

Kai was just diagnosed last week and started the vetsulin one week ago today. They set up an appt for June 10th to do in depth glucose testing. So my question is should we be waiting that long? (will be 3 weeks from starting vetsulin) How long do you normally wait to see how a certain dose effects you? He is a large dog with high starting numbers and I am sure 1 shot a day will not be enough.

So is the appt 3 weeks from starting OK or should I call for a sooner one? Within the past week we have spent $1000 finding out what is wrong. So the vet did say once your finances catch up. So is she only waiting that long because she knows how much we spent? Shoot this next visit will be nothing compared to what we have spent especially with the ultrasound! LOL

TIA!

[We Hope]

Re: Treament and testing question

I would move the appointment up and try getting one as soon as possible. I knew people who began with Caninsulin/Vetsulin once a day and none of them, whether their dog was large or small, was successful at regulating until he or she was switched to twice daily shots.

The dogs ranged in size from a yellow lab to a Westie; none of them had any success with the once daily routine. The person with the yellow lab certainly gave one shot a day a chance; she tried to get Roy regulated for 7 months on that. At the time, there was no Vetsulin in the US; the insulin was available just about everywhere else in the world under the name Caninsulin. Back then, the once-daily protocol was the only one presented by Intervet for the insulin.

My Lucky was regulated with a similar insulin Lilly used to produce, Iletin II Lente. The difference in the two insulins outside of the producer is that Iletin II Lente was U 100 strength and Caninsulin/Vetsulin is U 40 strength insulin. When it became clear that the insulin Lucky was using in the US having two shots a day of and the insulin Roy was using in Belgium once a day were the same except for strength, the veterinary college there was consulted. Their opinion was that Roy should be placed on two shots a day; he regulated quickly after that.

When Lilly stopped making their pork Lente insulin, we tried Lucky with their pork NPH. He had problems with the protamine suspension and preservatives of that type; they're different from Lente. Lucky had what's known as immune-mediated insulin resistance; giving him an injection of anything but pork insulin (because pork insulin is identical to canine insulin) did nothing about controlling his bg's. And so we applied for permission to import Caninsulin because it was not yet approved in the US.

We'd done a lot of reading about the insulin long before we asked for it. The link below is one of the articles we read, where Dr. Church equated Caninsulin with Monotard Pork, a U 100 Pork Lente Novo Nordisk used to make and therefore as an intermediate-length insulin, the need was for two shots a day of it. It was identical to the Lilly Iletin.

http://web.archive.org/web/200702211...2/00120831.pdf

Drs. Horn & Mitten Evaluate Caninsulin (Vetsulin) and once daily dosing.

We made the decision to use the Caninsulin just as we'd been using the Iletin II Lente and Iletin II NPH--shots given twice a day, basing the initial dose on his current one (which initially was based on body weight). Lucky was very tight and low on the Iletin II Lente (low 100's) but did even better once he got hold of the U 40 Caninsulin/Vetsulin; 8-10 hours after breakfast and morning insulin, he'd be at 85. He also never had a hypo.

It can take anywhere from 3-7 days or more to see the full effect of an insulin dose change, depending on the dog. I believe Kai's been on the one shot long enough to be able to tell how his bg's are doing. I think Kai's gotten some help from having the insulin, but I believe he would do much better with control of them if he was changed to two shots per day and any needed increases in future made from that standpoint.

You'd like to get Kai's bg's in hand as soon as possible and I think he will need to move to two shots a day to really get started with that. There's just no good way to stretch an intermediate-length insulin, as Lente types are, into long-acting insulins.

HTH!

Kathy

[crazydayz]

Re: Treament and testing question

I would move the appointment up and try getting one as soon as possible. I knew people who began with Caninsulin/Vetsulin once a day and none of them, whether their dog was large or small, was successful at regulating until he or she was switched to twice daily shots.


HTH!

Kathy

Thank you so much for all your information. i think I was pretty sure I needed to move it up but needed to hear it. I should go with my gut more! He seemed sluggish today although I did not give him a pain killer for his hips so maybe that was it. Since he is up and down in moods daily I think we need to get moving on this. I hate seeing him look down.

[crazydayz]

Kai had Ketones present today

Well thanks to lots of advice on here. I called the vet today and let them know something was not right again. He went from feeling pretty good to not wanting to do anything but drink and pee. He fell trying to pee this morning and I had to help lift him back up. I brought him in and he had ketones in his urine and his blood glucose was 568! (higher than when he first started the vetsulin) He was also down 2 lbs from just last week. (of course I cant remember if he had eaten before the first appt but I have seen him eat this week that I thought he would have gained some.

She said he is just in the start and as he is not showing too many symptoms we are to go home and watch him close. We moved him to 20u 2x a day of the vetsulin although tonight he will get the single shot of 30u. I will make sure he gets plenty of water and eats. I have the emergency vet number and they mentioned there is still a good chance he will need to go there.

I am a little stressed thinking of all this. We have spent so much money this week and now if he needs the hospital. Yikes! I mean I want whatever it takes for him right now but we are starting to feel it. My son is at an age he is just starting to understand insurance and stuff. He said when he grows up he is running for president so he can make companies' let you add your pet to your health insurance! LOL He is so sweet.

[We Hope]

Re: Treament and testing question

Kathy,

Glad Kai saw the vet today! You can get ketodiastix to check his urine for both glucose and ketones. Some phamacies have them behind the counter (theft prevention) and you need to ask for them. If you can't get hold of them, you should be able to get a box of ketostix, which test for just ketones, easily. While they don't check glucose, they would at least let you know if there are ketones, which can show up with high bg's like Kai's.

The situation right now is that Kai can't gain the lost weight back until his body gets back into the right "mode". We're all supposed to burn glucose for energy, but when there's either no insulin or not enough (from inside or out), the body loses its ability to burn the "right stuff". It starts burning things like fat, etc. for energy instead of the glucose it's meant to.

Some members here also had weight loss with their dogs when they were newly-diagnosed; as their control got better, they began to gain the weight they'd lost at first, so Kai will be able to do that once he's on the right number of insulin units. Any neuropathy Kai has should begin getting better when his bg's come down.

Tell your son he has my vote when he's old enough to be able to run!

Kathy

[crazydayz]

Re: Treament and testing question

Kathy,

Glad Kai saw the vet today! You can get ketodiastix to check his urine for both glucose and ketones. Some phamacies have them behind the counter (theft prevention) and you need to ask for them. If you can't get hold of them, you should be able to get a box of ketostix, which test for just ketones, easily. While they don't check glucose, they would at least let you know if there are ketones, which can show up with high bg's like Kai's.

The situation right now is that Kai can't gain the lost weight back until his body gets back into the right "mode". We're all supposed to burn glucose for energy, but when there's either no insulin or not enough (from inside or out), the body loses its ability to burn the "right stuff". It starts burning things like fat, etc. for energy instead of the glucose it's meant to.

Some members here also had weight loss with their dogs when they were newly-diagnosed; as their control got better, they began to gain the weight they'd lost at first, so Kai will be able to do that once he's on the right number of insulin units. Any neuropathy Kai has should begin getting better when his bg's come down.

Tell your son he has my vote when he's old enough to be able to run!

Kathy

Can I really nurse him at home even though there were ketones present? Is it more likely we will be running to the ER vet sometime this weekend? I told them I would be checking for ketones from now on. From here how often should I check since I know they are there. He is drinking plently and I will make sure he eats tonight. Any more advice to help?

Wow I am learning more about diabetes quicker than I ever thought I would. Please pray he gets this straigtened out and we can live a few more calm years.

[We Hope]

Re: Treament and testing question

I'd believe Kai tested about trace for ketones. If you monitor his urine with either the ketodiastix or ketostix, whichever you can get your hands on the easiest, you need to watch the urine to see they're not getting worse.

http://petdiabetes.wikia.com/wiki/Ketoacidosis

This is a good page of information about signs that mean it's time to get into a vet.

I'd check his urine every time I had the chance, to see if the ketones are getting better, holding their own or worse. I'm fairly sure your vet checked Kai for signs of dehydration, but it would be good for you to check them at home, using the information at the link.

Once Kai gets this behind him, I'd check for them every time he's registering high at home. The ketodiastix do two jobs at once--they check the urine glucose level and whether or not there are any ketones.

You just need to keep a good eye on him and if you notice something wrong, call the local ER about it, then bring Kai if it's necessary.

When the ketones are a very serious affair, they have to be kept in the hospital, getting fast-acting insulin to bring the bg's down quickly and various fluids to "re-balance" their body. My belief is that if your vet allowed Kai to go home, you can look after him with this unless things start taking a turn for the worse.

Kathy