Franklin has diabetes

[BestBuddy]

Re: Franklin has diabetes

Hi Jane

Sorry to see you and Franklin over here. Noticed an injection at 11am, just wondering if you are feeding and injecting 12 hours apart. Remind me what you are feeding??

Jenny

[Franklin'sMum]

Re: Franklin has diabetes

Hi Craig and Jenny,

Just found our previous thread, and apologise for not checking in and letting you all know what was going on . As it turned out, Franklin wasn't diabetic at that time.

He's eating home cooked (formulated by a canine nutritionist) consisting of sweet potato, butternut pumpkin, brown rice, chicken and lamb. It's low fat and low protein. He also has another recipe of sweet potato, quinoa, oat bran, fish and butternut pumpkin, but the lamb recipe is his favourite one. I've emailed her to see if these are still suitable for him.

Franklin is getting his insulin 12 hourly, but on the first day it was 11am and the locum vet said to give the next dose at 8 pm, making it 9 hours. The thing is Franklin doesn't want to wait 12 hours for his next meal. The information leaflet with the caninsulin says feed, give insulin, then feed 7.5 hours later, with next insulin to be given 12 hours after the first shot.
Locum said to only feed twice a day with no snacks or anything.
Tried that, but he growled for food after 8 -9 hours, so yesterday and today I gave a little food (about 3 table spoons worth) at that time. My vet is due back on Monday and will check with her then.

The 12 hourly dosing will be an issue one week out of 3, I'm a shift worker, so on day shift it can be 6.00/ 6.00 night shift can be 7.15/7.15. I'm hoping the transition day/s won't be a problem. Afternoon shift is where it will be tricky, because at those times I'm meant to be at work. With his phenobarb I move it an hour at a time till it's 11.00/11.15. I asked the locum if I could do the same with the insulin, and first she said yes but later that day she said no. I have to ask our regular vet, and also if I could divide his daily dose into 3 injections so he can have 3 meals, especially on that shift. Or whether he can have some kind of snack, ever again. Or bones.
Or what if he's just eaten, had insulin then 5 minutes later wants more food?
Can I give him a tiny treat at insulin time for being good and staying still?

So many questions to come.....

Thank you,
Jane and Franklin 7.5 years maltese, 7ish kg, 3.5iu caninsulin twice daily, enalfor for proteinuria, melatonin and lignans for atypical cushing's, home cooked, Australia

[jesse girl]

Re: Franklin has diabetes

i to recommend testing blood sugar at home if your baby has accepted shots well it should not be difficult to do it at home we use the inner lip you can role the lip up on franklin identify the canine tooth and rub your finger across that inner lip if hes fine with that more than likely that maybe a possible testing spot you can continue to do that just to see if you can make it a routine lots of videos and info on that or if you have a question just ask

always good to start slow and work your way up to something

with the additional challenges franklin has regulation maybe a bit more difficult not impossible and insulin is working for him as you can see from the curve

probably the only thing problematic with it is starting in a higher range and getting a good drop when insulin starts to work we call onset . if that drop is slowed the starting numbers before food and insulin we call fasting may start lower big swings in blood sugar may make regulation more challenging because in a normal dog the body would never see this and the body may react to this

you may have to lower the dose to see if the drop is slowed and fasting is lower but like i said you have to test at home to have an actual account of what blood sugar is doing in a normal situation which would be home

its nice to see you 2 here it is a very good resource read other post it is quite helpful

[Franklin'sMum]

Re: Franklin has diabetes

Hi all,

The curve was done, and Franklin's dose has been upped. He's now taking 8iu bid caninsulin. He had lost 100grams in weight, but had me fooled because he had filled out a bit.
Franklin's curve went like this
8 hour fasting 08.40 - 22.4mmol then insulin
After breakfast 10.40 - 11.6
12.50 - 10.7
14.50 - 9.3
16.00 - 11.5mmol.

His nadir seems to be around 6 hours. The dose was upped because he had only been getting .25iu per kg, not .50iu. The little muppet started squirming with his bigger dose the next day. I figured out it must be the coldness of the insulin with the bigger dose. I've since taken to having the barrel of the needle in my mouth for a few minutes to warm it up while he eats. And changed his good boy bribe from schmackos to cheese. It went a lot easier this evening.

The vet wants to do another curve in a week and a half or so.

Does anyone have any pointers they can share if Franklin should become a wriggle pup again? There's only the two of us in the home.

Love to all and thanks for everything,
Jane and Franklin, maltese, 7.5 years, 6.9kg, Australia, 8iu caninsulin bid, home cooked meals.

[CraigM]

Re: Franklin has diabetes

I'm concerned if you have gone from 3.5units of Caninsulin straight to 8units! Your curve showed a 9.3mmol (167mg/dL) which isn't all that high, some would say "excellent" for a low (nadir) number done at at vet clinic. That is a BIG increase!

[CraigM]

Re: Franklin has diabetes

Franklin weighs almost 7kg and IF you wanted to give 0.50 units of Caninsulin per kg wouldn't that be 3.5 units and not even close to 8 units?

This link is a little confusing to me, but I THINK it recommends 0.25-0.50 units per kg, twice per day.

http://www.caninsulin.com/Managing-d...lin-dosage.asp


Please confirm what syringe you are using (U-40 or U-100)

[BestBuddy]

Re: Franklin has diabetes

Hi Jane,

Like Craig I am worried about the insulin raise. I have tried messaging you on FB and I hope you see one of these messages.

Jenny

[Franklin'sMum]

Re: Franklin has diabetes

Hi all,

Sorry for the confusion, I thought I'd mentioned we're using u100 syringes, but apparently not.

Thanks all
Jane

[BestBuddy]

Re: Franklin has diabetes

Hi Jane

Just sent reply to FB and glad to see things look okay. Nothing like getting the heart beating fast in the morning with a scare Looks like you are giving 3.2iu of Caninsulin and that sounds fine. (8 divided by 2.5)

Jenny

[CraigM]

Re: Franklin has diabetes

Hi all,

Sorry for the confusion, I thought I'd mentioned we're using u100 syringes, but apparently not.

Thanks all
Jane

I think I feel a little better! The 8 "line" on a U-100 syringe would be about 3.2 units if done in a U-40 syringe. I think.

[k9diabetes]

Re: Franklin has diabetes

Hi Jane,

Hope you won't have problems in the future, but if so, it generally is a matter of experimenting to see what works better since it's so individual to the dog.

We have saved a thread about injection tips in the Answers forum.

I'm going to give you a link to the Injections and Syringes section of the Answers forum as there are several threads there you might be interested in.

http://www.k9diabetes.com/forum/forumdisplay.php?f=14

Natalie

[Franklin'sMum]

Re: Franklin has diabetes

HI everyone,

Thank you so much for all the links, tips and info, very helpful. He's still being a wriggle butt though. Gah! Franklin went for another curve on Wednesday and this is how things went.
Fasting 08.30 22.5mmol multiplied by 18 = (405 ug/dl)
08.45 .088 insulin
10.30 12.8 (230)
12.00 10.2 (183)
14.00 18.5 (333)
Dose to go up to .09 (9 on the marker) of a u100 syringe, making his new dose 3.6iu.
His nadir came early. Insulin ran out early, Franklin quiet ish and content in cage.
6.8kg (stayed the same weight as last Friday). The vet injected him, I wanted to see how an experienced person does it. I'm in awe.
Franklin hasn't been eating as much as he should be, only eating about 300grams at most per day, even with chicken broth on top. Our nutritionist can't get to his recipe before Monday, and I need him to eat. I've added in some wet commercial food and some Royal Canin weight control kibble (which is good for diabetics). Now Franklin is really having a go.
Just to recap, dose is now 3.6iu caninsulin which is 9.0 on the marker of u100 syringe.

A friend loaned me her pup's halti collar yesterday, and he stood on the floor glaring at me, sooky and sullen. AND STILL!!! I got him so easy last night. Then this morning back to the same old squirming. ARGH!
Thinking that the injecting problem is my lack of skills, maybe the gauge and depth of injecting, we went to the chemist and got some 30gauge 5/8" u100 insulin syringes. He squealed in my ear this morning. So we went for a drive to mum and dad's. 10 seconds later and done. He likes to be cuddled for his shot. Think I need to take up yoga to get my legs in a pretzel/hug/death grip type position .
The bathroom sink has worked twice for us, so thank you for a reasonably easy 2 shots.

Due to go back to vet's next Friday for a curve. Got to work up the courage to begin home testing soon.

Jane and the ever squirming wriggle butt Franklin, maltese 6.8kg, 3.6iu caninsulin, at moment combo of home cooking, wet commercial and RC weight control kibble, Australia.

[Shellie]

Re: Franklin has diabetes

Wriggly butt! What a pooper he is! Keep at it tho and you'll get to be a real pro. Sometimes it just takes them learning that they have no control and they are getting it whether they like it or not. Try the distraction treat technique or nab him while he's eating...anything so he's NOT focusing on what you're doing back there. By the time they realize...oh darn, it's all over. lol Good luck!

[Patty]

Re: Franklin has diabetes

Think I need to take up yoga to get my legs in a pretzel/hug/death grip type position .

Funny Jane. That would be a video we'd need to see . Glad the sink has worked at least a couple of times for you.

His curve is quite deep but I wonder of part of that is because he's not eating the same for you. Look forward to the curve Friday.

[Franklin'sMum]

Re: Franklin has diabetes

3 August
08.30 20.1mmol (361.8)mg fasting
08.50 .1ml insulin given (10 on marker)
10.50 17.7mmol (318.6)
12.50 14.1 (253.8)
14.45 11 (198)
16.00 8.9 (160.2)
16.45 8.5 (153)
17.15 9.3 (167.4)
Nadir came at 8hrs which the vet was very happy with. Combo home cooked diabetic recipe, royal canin weight control kibble and a little bit of commercial food. 6.8kg (15.3lbs) and body type changing.

17 August
6.6 kg (14.8lbs). Fasting 11.7mmol (210.6mgdl) WOO HOO! Franklin seems to have stabilized! YAY!!! So vet decided not to do a curve. Franklin's body is much more muscular over his ribs now but I can still feel his spine without much effort.
We're still waiting for a recipe tweak, he's not too keen on the swedes/rutabagas that feature in the home cooked diet. To try and help him put on some weight, or at least not lose any more, this morning I added a small sprinkle of rice flour to his commercial food for some extra calories.

It's now been more than 2 weeks since I've needed a helper to give Franklin his shot. It began with smearing a little cream cheese on my shin and jabbing while he was distracted. We've had to evolve, now I've taken to putting a few bits of sliced cheese on a plate, and I've added a prize also. Could be a little chunk of chicken, or a bit of ham. Hey, it's working.

Since there was no curve on Friday, and I'd been practicing playing with Franklin's lips, I tried for a home bg test. Twice. First one not enough blood. Gah! Second time the little booger started flinging his head around like Linda Blair. Argh!

So today we went to see his blood pressure vet practice. They do ear prick testing and they showed me how to get it done. He has a yeast ear infection I found out, so I'll leave the ear pricking for a few days till his ears are feeling a bit better. He's on surolan for the yeast infection.

Eternal gratitude for all of your help to get us (me) to this point.

Jane and Franklin