hind leg weakness

[amydunn19]

Re: Low fasting, high nadir, why?

I rarely messed with insulin dose as every time I did, her numbers got wacky. I found looking back at her journals, that we had days where her fasting would be 300, same food, same dose, and get to a nadir of 115, then other days her fasting might be 100, same food, same dose and get to her nadir time and be 115 or within 10 points. It made no sense to me. I think she just had some type of inner working that consistency of dose maybe got her where she needed to be. On days when her fasting was lower than 100, as long as she ate, I only reduced a tiny amount with insulin and her numbers always rose to a higher number at nadir time. The less I messed with her insulin, the better her numbers became. I don't know if that is common so I don't know if it would work for every dog.

If I wanted to tweak anything to change the numbers, food was what I tweaked. The results could be tricky but with testing, I always could figure it out.

[Raysaint]

Re: Low fasting, high nadir, why?

Looking back at my records, it seems there were a few other times when he had a low fasting, I did a curve, and he steadily climbed to a high nadir.

So I think for now, I'll stick with the 8.2 units, as it gets his nadir down if his fasting is 10 (180) or above. If he has a low fasting, I probably should cut back just a bit, as his body seems to indicate that with a low fasting, he isn't going to adjust to the same dose and stay in a good range; he'll climb high.

I don't like adjusting dose but what can I do. I think his fastings will probably be not low most of the time, so a consistent 8.2 will be the majority of his doses.

[jesse girl]

Re: Low fasting, high nadir, why?

Looking back at my records, it seems there were a few other times when he had a low fasting, I did a curve, and he steadily climbed to a high nadir.

So I think for now, I'll stick with the 8.2 units, as it gets his nadir down if his fasting is 10 (180) or above. If he has a low fasting, I probably should cut back just a bit, as his body seems to indicate that with a low fasting, he isn't going to adjust to the same dose and stay in a good range; he'll climb high.

I don't like adjusting dose but what can I do. I think his fastings will probably be not low most of the time, so a consistent 8.2 will be the majority of his doses.

there are times i just have to make adjustments with jesse if mot she maybe elevated for a longer period of time or she may go to low . Jesse was never that type of dog to give her a dose and walk away as far as what i would like as far as regulation

your doing great maybe a few more ideas in that bag of tricks your developing

[Riliey and Mo]

Re: Low fasting, high nadir, why?

I agree with Amy. tweeking or changing the food might be the answer to regulating. wellness is difficult food to meet up with the insulin. 8 units is high for a 25lb dog. Wellness food varies its not a steady food balance with insulin. I.d search this forum to check this food balance out. I did years ago with my Riliey and found it didn't match up or meet up with the insulin. more insulin was needed

mo

[amydunn19]

Re: Low fasting, high nadir, why?

That is the funny thing about these guys - they all react in their own way. No other dog may react like Maggie did but her experience may give you ideas or even rule out certain things. Plus, I also did this over an almost 9 year period, so your dog will change over time in the way they react. As they age, things change. I do believe that Maggie's body did become used to a certain dose and she was always super sensitive to insulin changes. That is why food tweaks made sense for her. At least with food, I found there wasn't an effect that could last days like insulin. I could try something food wise and if she went way high, I knew that may not be worth trying again. If she went a reasonable amount higher, I might try it for a few days to see if it would then adjust downward on its own over time. That is how we got her to four "meals" a day and only two insulin shots to manage pancreatitis and get stable relatively normal blood sugar. Not perfect but acceptable. It was like building Rome, though, it seemed and there were days I thought we might never get there.

I found in the earlier days, I was trying to get her to survive just one day at a time with so many negative vet voices telling me she is only going to be here six months. Once I realized they were idiots and had no idea how determined she and I both were, I started thinking big picture. With you being diabetic, it is probably more frustrating because you know that it shouldn't be rocket science to figure out but these dogs just don't make it easy on us.

You are absolutely doing the right things. Just don't be afraid to go outside the box. I tried things that went against everything I thought I knew and sometimes it worked.

[Raysaint]

Latest curve not what I expected

Haven't posted about my own dog lately, but suffice to say the last 3 months have been ultra frustrating. Combined with the previous months, I still can't get consistent regulation after almost a year. I get 2 or 3 good days, then a surprise high, which corrects over 2 - 4 days.

His dose is 8 units twice daily, and I learned that I need to give slightly more or less depending on his morning fasting. He seemed to rebound if his morning fasting was below around 10 (190).
Night time dose is usually slightly more but many mornings his fasting is still too high.

Daytime spot checks have been inconsistent. Some days at nadir time (around 1:30) he's good (equal or lower than morning fasting), other days he's higher than morning fasting.

I record every morning fasting and spotchecks to try and see patterns and gauge dose effectiveness, but he keeps throwing me curveballs and my expectations are surprised too many times.

So I did a curve yesterday, as his fasting was OK, 11.3 (198).

7:35 a.m. he ate 3/4 can food, tblsp brown rice, tblsp pureed green beans

7:50 a.m. he got exactly 8 units NPH

TIME BS
7:15 a.m. 11.3

10:30 a.m. 9.9

12:00 p.m. 12.2

1:00 p.m. 19.2

2:30 p.m. 16.9

4:00 p.m. 17.6

4:10 a 15 minute walk

6:30 p.m. 18.2

OMG. Not his typical at all. The 9.9 was abnormal, and everything after 1:00 was also. He usually has the standard bowl curve.
His morning fasting today was 10.8 (195). Gave him slightly more than 8 units this time. Checked at noon, BS was 15.4 (275).

What is going on? I can't attribute all the past highs approaching nadir as rebounds.
Will speak with my vet today, once she sees the results.

[jesse girl]

Re: Latest curve now what I expected

well jesse has never been real consistent . she would go on some runs with consistent good range for a few months and then it would get off track .

sometimes we have to use a fast acting insulin . this has been going on for almost 8 years so i accept her inconsistencies and we adapt to them

for the most part she stays in a good range but i could never guess what her numbers would be before i test her

[Daisydog10]

Re: Latest curve now what I expected

Well Daisy is the queen of non regulation so what I did was I took her off the Stewbie. Too many ingredients. I used 3 ingredients so I could watch how she was processing things- chicken, chana dal (you could use brown rice, quinoa, etc.) and green beans with a little kibble. Weighed everything with a food scale and figured 1/3 of each for her calorie intake. We started with 83 grams chicken, 83 grams chana dal and 83 grams green beans and started tweaking from there. I calculated protein, carbs and fat per gram. She had a mountain curve so i gave her less carbs and she is now down to 52 grams chana dal and I added the calories to the chicken and she has a nice bowl curve. She has 15 grams of kibble with only 5 grams of kibble soaked in the microwave for 20 seconds so she can digest it easier and not drop too low during the morning hours. I used the kibble as kind of a protein/carb leverage. Threw in a tbs of pumpkin because she was straining a little (I hate that). I add Balance It vitamins to her meal with some d-mannose before bed time. I did have to raise her insulin a little, but not by much.

What I found was Daisy cannot have more than about 21-23 grams of carbs for each meal, it just spun her numbers out. Now that she's on pretty tight control, if she goes off again, I can look at those ingredients and figure it out.

It's just a thought because I know how frustrating it is.

[amydunn19]

Re: Latest curve now what I expected

I was going to mention that you can just change diet completely. I found that when things get very complicated and if you add on too many supplements or ingredients(not saying that is what you are doing but it might be one component is causing the inconsistency), it gets confusing. It may be something you wouldn’t expect. You could change or eliminate one thing at a time or just blow the whole thing up and go with another brand/type. If you home cook, you could try another protein/carb source combo.

My biggest challenge was keeping her pancreatitis at bay. She could not tolerate rice or potatoes, but it took a while to figure out the common denominator. I was also grateful that I could stick with a combo of dry and canned. My home cooking made her sick or she would spit it out. My vet always laughed at her spitting food out - he said normally they wouldn’t put it in their mouth to begin with.

[Raysaint]

Re: Latest curve not what I expected

I guess what surprised me was, why is the pattern/curve shape so different. No nadir at 5 - 6 hours in, and the drop at 10:30. And why is 8 units not doing the job for the last couple months consistently, even when it should (when fasting is good.)

His urinalysis last week was good, he just isn't drinking enough, and had a few crystals.

Regardless, with many of the numbers high, the vet and I agreed to try a dose increase. I'll spot check at crucial times, and curve in about 10 days.

His diet has been the same forever, and I have achieved some good numbers (it is possible), so I'm going to leave it for now; we'll change one thing at a time.
And when I researched foods to death, there wasn't many canned choices that had similar ratios to W/D (my vet's choice), and that had no turkey.

[amydunn19]

Re: Latest curve not what I expected

The w/d ratio is not necessarily the answer for every dog. Maggie never got close to that much carb in her diet. It just didn’t work for her. If you can’t get results from an increase, you may have to get away from the comfort zone. I tried things with Maggie at times that should have never worked but did. I don’t know what types of foods you have readily available but there are so many choices out there now. Maybe look at Limited Ingredient diets.


I think that you can’t always explain how they change regarding their progression and curves. The only other idea I would have is to look back over what exactly you did during those more stable times and see if you changed or added things along the way. It could be something innocuous that doesn’t stand out or seem to make a difference intellectually.

[jesse girl]

Re: Latest curve not what I expected

it could be just a unknown medical condition affecting regulation the crystal formation maybe a problem . days you pup is good you see good regulation days that is not internally balanced regulation decays

my jesse has epilepsy and that has had an affect during times the epilepsy was present her sugar would spike . other factors is the pancreas who knows if you have mild flare ups from time to time and you barely see symptoms and heals on its own

so always look for that lack of appetite change in stools and being uncomfortable and with that you my see excessive stretching because the abdomen is not feeling well

for me i believe many problems happen in the gut and digestion . i can look at jesses stools and from consistency and coloration i can give a pretty good guess where regulation is going

she had a very acute version of pancreatitis and i believe once that happens she was never the same internally . i believe her one meal a day was helpful holding back a major attack (knock on wood ) we may have seen undiagnosed flareups from time to time

as amy sugested it could be one thing in the diet that keeps that gut on a better path but its a long trial and error thing and a hit or miss

the goal is to get that 150 to 250 level for most of the day going down to a 100 is ok and a bit higher is to . for me if we see more than 200 points from low to high on a consistent bases i would like to reduce that .some people never get there . 100 points or lower is very stable sugar in dogs from low to high for the day

its real hard to get out of a comfort zone most times .its easier if things are completely off the tracks . thats how i ended up with jesse on one meal . she was a train wreck . so it was easy to head out of the box we didnt have much to loose . if your somewhere in the middle good days and not so good its hard for change because you dont want to enter what you saw in the beginning it was so hard for many . when i saw adequate regulation in jesse maybe not as consistent as i like i was kind of done and didnt want to do any major changes unless she went off the tracks again and when things get a bit with loss of control we add a fast acting when needed

i may have ended being more reactionary and adapt more with jesse not what most would do but with jesse we tried stringent consistency and it doesnt work for her . she would just spend to many days in a higher range and possibly going to low . so we adapt to her reality . its finding your comfort zone and your pups reality as far as regulation . thats sometimes the hardest thing because that may not match up very well

[LizE]

Re: Latest curve not what I expected

My dog went through a crazy phase like this. Numbers all over the place with no rhyme or reason. I tried different things with dosage, food and timing and nothing really helped. Then suddenly everything settled down. Food and insulin stayed the same. The only real change was the shape of her curve going from a bowl shape to a mountain shape.

I have no idea what happened. I suspect it was her rabies vaccine that set the whole fiasco in motion but there is no way of knowing. It could have also been some tooth issues but we didn't get an x-ray to verify.

For me, I just keep plugging along with her standard food and insulin. When I get numbers outside of her "acceptable range" I adjust her physical activity or snacks. I also find that snacks of baby carrots (cut into 4 to 6 lengthwise strips per carrot) before dinner and again just before bedtime help to keep Snickers' numbers from fluctuating so much.

Hope this is just a phase for you too. The unpredictability is almost as bad as not regulated.

[Raysaint]

Re: Latest curve not what I expected

Being that I've never really had good consistent regulation, this isn't really a phase; but the change in curve pattern is what puzzles me.

I increased his dose today, from 8 to about 8.3, his morning fasting was 16 (290). Spot checked at 1:00 p.m. (normally would be coming into nadir) and he was 16.1. So it seems like this new pattern is here to stay.

If you look at his curve in lower thread, the mid morning drop is what I'll spot check now, hoping that it doesn't get too low so that I can increase his dose enough to get his afternoon numbers down.
And that crazy increase between 12:00 and 1:00, from 12.2 to 19.7, what the heck. Sugar usually rises or drops gradually.

Hopefully the insulin increases will help over the next few weeks. If not, then I'm determined to change whatever I have to, and have the vet start checking into the issues/conditions that can affect sugar levels, i.e., other infections, dehydration, etc.

[Raysaint]

Re: Latest curve not what I expected

So since his dosage increase of half a unit, up to 8.5 now, his sugars are worse. So I think this new curve pattern has something to do with it. His body is using insulin differently, in my opinion, as evidenced by the weird curve pattern and his numbers.

The question is why. In the recent past, on 8 units, I had some good days, some bad, no consistency. Then I seemed to have more bad days, so a curve showed this new pattern of sugar dropping by mid morning (3 hours after eating/insulin) then a big rise by 1:00. (his old curve was a gradual bowl, nadir 6 hours after eating). So we increased his dose.

Off to the vet Wednesday. I don't think it's a simple as increasing again. Why suddenly would he be underdosed? I think it's time to fish for reasons and at least be able to rule some things out.