going it alone, advice welcome

[Mischa]

Mischa is a 12 year old pom/chihuahua cross, approx 10 pounds, who recently (10 days ago) started urinating in the house. Clean-up was sticky, I noticed her drinking much more than usual, and I suspected diabetes. I live in a remote area in Mexico, where vets barely give vaccinations, so I have no confidence that they would have the knowledge or experience to treat canine diabetes. I drove to the nearest town (60 miles round trip) and purchased urine test strips (ten different tests, including glucose and keytone). Her result indicated her BG was in the 1000+ range, keytone was negative. I went to see a local MD, with a syringe filled with a 20 minute old urine sample, and the test strips. When I explained the patient was my little dog, he looked at me like I was from another planet. I explained my lack of confidence in local vets concerning their inexperience with diabetes. Eventually I convinced him to do the BG test himself, and once he did that, his concern grew. He disclaimed any responsibility for treating a dog, and I agreed not to hold him in any way responsible if anything negative occured, then we discussed dosages, when and how much to start her on. He gave me a bottle of Novolin N, suggested I give her 2 U AM, and 1 U PM. He suggested I could adjust the dosage up or down every three days at 1/2 U increments. I'm going this alone, without any help from a vet or the MD, so finding this forum to give me suggestions and advice has been a Godsend. I've never joined a forum before and had to learn how to post a thread. I've been keeping track of her BG levels as best I can, testing Mischa's urine samples numerous (3-5) times a day. She remained in the 1000+ range until I increased her dosage to 2 1/2 U am and 1 1/2 U pm, which brought her down to the 500+ range. Two days ago I increased her to 3 U am, and 2 U pm. The following day she tested at 500+ at 8:00 am, 500+ at 11:00 am, 500+ at 2:00 pm, then negative at 6:00 pm. I immediately gave her some oatmeal as a snack, and she has not had a hypoglycemic reaction. Last night I reduced her insulin back to 1 1/2 U. This morning she had 2 1/2 U. She is eating twice a day, after injections, and gets raw asparagus spears or broccoli for occasional snacks. Her food consists of oatmeal, green beans, and either small cubes of steak, or boiled extra lean hamburger. I hope to get to the US soon to purchase some dry food for her, there is nothing available here suitable for a diabetic dog. Personally, I think collecting a urine sample from a small, short legged, very furry female who is extremely fast when she squats, and tends to pee like a male by spreading a drop or two all around the yard, should be considered for an olympic event! The agility, speed and accuracy required by myself, swooping in behind her with a small collection dish is a learned artform. At least she's stopped turning around to look at me like I've completely lost my mind. This experience has been a challenge for me, however I am confident that I can manage this, with your support. Thanks, Lorrie

[jesse girl]

Re: going it alone, advice welcome

welcome to you and your fury friend

yes you can manage it on your own me and my dog jesse have been doing it for over a year I felt the same way about the vets in my area and they just seemed to be behind the times and i am in the states.

the best way to test is with a meter we use a human meter many different kinds. seems to work better on smaller dogs for some reason and your dog does qualify for that . We use the prodigy auto code we need to test quite a bit and strips for us was very cheap off ebay and you can get them in bulk if you want its always good idea to have another meter a different brand in case you get some bad strips or your battery dies or the readings your getting doesn't seem wright to you and you can double check.

its a good idea to compare it to a vets Analyzer but that may be difficult where you are but i am sure you can figure something out they do make a meter just for pets ( expensive for meter and strips not sure if its worth it we do fine with humane style)

It does sound like you went a little fast on dosage and without a meter what your doing may be difficult others will give more information on that and different types of meters also stay consistent with what you do feeding shot times and exercise . also be careful with exercise it can speed up the metabolism and make the insulin work faster thats what happened to my jesse

[CarolW]

Re: going it alone, advice welcome

Hi Lorrie and Mischa,

Okay; Olympic champion you are! Congratulations on getting Mischa started. That took some doing! I don't suppose the syringes you're using have half-unit markings on the barrel - or do they? If you can find some, that would be a BIG help.

Is Mischa spayed (neutered)? If not, it would be wise to try to arrange to have her spayed, as her numbers will vary pretty wildly, otherwise.

And that will be tricky, as your local vets may not be accustomed to operating on a diabetic dog.

Maybe you could get it done in the States, if you're coming to the U.S.?

Another adjustment I'd make, for safety, would be to feed first, then wait 15 to 30 minutes before injecting the insulin - that, in case she vomits her meal - then you have insulin on board - without food! Which risks a hypoglycemic episode.

Or at least, inject while she's eating.

It sounds as though the suggested starting dose was quite reasonable, but when raising the amount, doing so in quarter-units seems to me a lot safer than in half-units, and raising by whole units is probably asking too much of the dog's body.

I'd suggest trying to get a OneTouch Ultra2 meter, as it's a very consistent meter. Yell for help when you need it, and we'll help you learn to test with the meter. Somebody here can point you to the videos that show how to test.

With my Kumbi, I used his "Lip" - bleeds easily, heals fast, and causes no pain.

http://www.coherentdog.org/vek/bgtest.php

Here are pictures of the syringes we used:

http://www.coherentdog.org/vek/syringes1.php

You can see the half-unit markings in those pictures.

You don't necessarily need to buy a dry food for Mischa; it's possible to feed a dog a good diet - make sure it's relatively low-fat, and high in fiber. I did feed a dry food to Kumbi, and he did very well on it. It was by Medi-Cal, now merged with Royal Canin.

I hope one of the real experts will soon check in and provide some aid for you - Natalie, or Patty, or Peggy. Meantime, I'll be here watching, and rooting for you.

P.S. I'd keep some honey or corn syrup or pancake syrup available. If Mischa suffers a hypoglycemic episode, the first step is to rub about a teaspoon of any of these on her gums. That sends sugar directly into the bloodstream, to bring BG (blood glucose) levels up right away. When she recovers enough to swallow reliably, then feed protein or carbohydrate, or both, otherwise, the sugar is fast used-up and another crash can occur.

Mon, 11 Apr 2011 13:04:29 (PDT)

[Soaphie & Sydney's Mom]

Re: going it alone, advice welcome

Honestly, the people on this forum helped me waaaayyyyy more than any vet did at initial diagnosis. You have come to the right place!

Tami, Syd and Soapher

[SandyL]

Re: going it alone, advice welcome

Soooo true Tami! If it weren't for all the excellent advice on here, I honestly don't know where Tiggy and I would be with this situation!!!

And Lorri, welcome and thanks so much for the smile you brought me (an outloud giggle actually) pictureing you trying to get a urine sample I too have a female chihuahua and could NEVER get her to squat long enough to get a urine!! I think that's why I was so determined to get the blood samples down pat so quick, I couldn't chase her fast enough!!!

Sandy

[Patty]

Re: going it alone, advice welcome

Hi and welcome Lorrie!

Bless your local doc for helping you out and your knowledge in knowing what was best for Mischa.

I agree with Carol. The OneTouch Ultra2 is a good track record for consistency and will give you more accurate results in home testing if you're up for it. And you won't have to train for an olympic event

Ebay is a great source for test strips as they tend to be the most expensive part. I usually try to stay under 50 cents a strip. You would need to watch for factory sealed boxes, expiration dates, and reputable sellers. I'd also try to stock up before it gets too hot for shipping. There are sellers that will ship internationally as well.

Here is a link to videos showing the different places you can test: http://www.k9diabetes.com/bgtestvideos.html

I like Carol's suggestion for getting syringes with 1/2 unit markings as well, especially with the small doses you are using. You'd be able to move in 1/4 unit changes that way if needed. What type of syringes are you currently using?

You certainly could continue to home cook if you want to. There are many here that do and could offer suggestions. You'd likely need to add a calcium supplement and perhaps some vitamin supplements for balanced nutrition.

You've done a great deal of research already and I have no doubt you'll be able to handle Mischa's diabetes!

Again welcome!
Patty

[CarolW]

Re: going it alone, advice welcome

As Patty is one of our experts, I'm pleased she's adding her suggestions about food, and meters, and getting test strips.

Also about how to supplement the diet.

Especially, though, I agree you can manage Mischa's diabetes!

Tue, 12 Apr 2011 00:28:58 (PDT)

[Mischa]

Re: going it alone, advice welcome

Thank you all for your suggestions and support... that's exactly what I need right now. The syringes I was given by the MD were 100U, so each increment was 2 U. I was about going crosseyed trying to go from 1 to 1 1/2. I had no idea they made smaller syringes, but I knew I wasn't able to be accurate with what I had. A few days ago I was in town and went to the pharmacy to ask about a smaller diameter syringe and was thrilled to discover I could get them in a scale I could actually see. I'm getting better at dealing with the second looks I receive from the locals when they ask me if it's for a baby, and I say "no, it's for my dog". First obstacle overcome! Now, I feel I really need to get a blood monitor for her. Those urine test strips were very useful to let me know she had a problem (and to check keytone), but the gradient scale at the high end is absurd. Mischa originally registered in the 1000+ range, she could have dropped over 900 points in the first week and I wouldn't even have known. I need to understand what is going on with her BG levels much more than just guessing like that. Thank you for your suggestions on which monitor to get. Really good idea to feed her before I inject her too, I never considered that she might not eat. So far she's been good about eating, however she can be finicky at times too. After doing some more reading on this forum, I decided I was increasing her dosage too much, too fast, so I've reduced her back to 2 1/2 AM, and 1 1/2 PM again (accurate amounts now!). I'll keep her at this level for at least a week and see how things go. I'm in this for the long haul with my little girl, and I'm beginning to understand I don't have to be frantic about getting her BG levels down immediately. Your forum has given me a great deal of knowledge and understand already, greatly appreciated for a novice who went into panic mode when I realized what was going on with her. Your support has calmed me down, and now I can deal with whatever comes along. BTW, Mischa is neutered, has been for 10 years. Her vaccinations are all current, and she had dental work done two years ago. Her eye sight is failing, and I suspect cataracts, however she can still see an "intruder" dog frollicing on the beach! Other than this new development, she is in good health.

[Mickey'sMom123]

Re: going it alone, advice welcome

We are new to the diabetes club too (as I like to say - unless someone else has already suggested it, you want to feed your dog first, then give the insulin injection. This is a good rule of thumb in case he vomits up his food - you don't want insulin in him and no food; it can cause a hypoglycemic episode. While Mickey is eating, I get everything prepared. I always write down when I feed him and when I give him his insulin, and it always happens to be about 10 minutes after being fed.

You've come to the right place. The people on this site are extremely knowledgeable and experience and just simply a Godsend.

[CarolW]

Re: going it alone, advice welcome

Oh, Lorrie, you are doing SO WELL! I'm really thrilled with your progress!

When you go to get a OneTouch Ultra2, which does seem the best meter for you (though a Freestyle Lite would do also), make SURE you talk to the people as though the meter is for YOU, NOT YOUR DOG!

Reason? The instant you start talking about dogs, they shut up, and won't help. It's a matter of liability for the company that makes and sells the meters. They will tell you their meters are "not recommended for animals." It's an industry standard. (The meters aren't made for animals; duh!)

However, I talked to OneTouch Customer Care, on the phone, at least 8 times, and as long as I talked as though I were the one I was testing, everything was fine; they were wonderfully helpful.

Glad you found some smaller-capacity syringes - that makes a world of difference! Somewhere here, perhaps in the Answers section, there's a picture of different syringes with their capacities.

I REALLY, REALLY like the ones I used for Kumbi, and I think I pointed to those for you. The very thin and fine, short needle, makes it very comfortable for the dog; the only other stuff you need to attend to is to warm the insulin (in the syringe, needle capped), to something close to dog's body temperature, and to place the bevel up (toward you) when injecting. And, of course, location of the injection on the dog's body. The link in my signature has details.

With everything else you said, I think you and Mischa will do really, really well with the diabetes. Kumbi had quite an easy time, till his cancer; that made things difficult, and that was what he died of.

He was very consistent and stable for years before that. So glad Mischa is already neutered; that keeps things simple and easy!

Have to rush off to Camellia's grooming with Fabulous Groomer Kate, who handles her exquisitely (how did we get so lucky?). Pics in my albums.

I'll be back later, watching again! Hugs to you and Mischa!

Tue, 12 Apr 2011 10:33:31 (PDT)

[Patty]

Re: going it alone, advice welcome

Oh my! Mischa's picture is so adorable

Sounds like you are on the right track with syringes. The ones with 1/2 unit marks are great for fine tuning doses.

If you have a day that Mischa doesn't eat, the body does still need insulin for it's basic needs. We often suggest giving 1/4 of her usual dose if it's without food and see how she does with that. You definitely don't want to give a full dose of insulin if she won't eat for you.

I'm glad you're up for home testing. That will be a huge benefit for you. It will also give you tighter control over her numbers.

Let us know how we can help as you go along!
Patty

[bgdavis]

Re: going it alone, advice welcome

Lorrie,

You're doing great! Hang in there!

Bonnie and Angel Criss