Niki's story-- Final Chapter 1997-2010

[CarolW]

Re: Niki's story

Hi Dolly,

I've put a great deal of thought, study and experimentation into making injections as painless as possible for Kumbi. He helps me, because he complains vocally when it hurts. If the injection doesn't actively hurt, but feels bad in some way, Kumbi shudders while I finish the injection. I consider that a situation that needs improvement, also.

Factors that affect pain include:

ANY air in the syringe that gets injected seems to cause pain. I use a magnifying glass, and really take my time to make sure all air bubbles are excluded (you know - flick the syringe with a finger, holding it needle-up - and I do this AFTER withdrawing the needle from the vial - wasting just a bit of insulin, because I draw up a bit more than I need).

I think it was Kathy who mentioned that Lucky couldn't stand fo have skin pinched up. But I pinch up skin on Kumbi, for every shot. He's used to it, and says it doesn't hurt. Being used to it is a major factor. Do you pinch up skin on Niki? I'm curious.

I actually pinch up skin into a single fold, parallel to the spine, as in the main picture on this page:

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

That's Kwali, not Kumbi, but it was the best picture I had!

And it's apparently not what's meant by "tenting the skin," which, apparently, means pulling up the skin nto a kind of point, or summit!

SOMETIMES (not always), you can desensitize a dog to having skin pinched up.

The next factor would be the angle at which you insert the needle. I think it was Kathy who mentioned keeping the bevel up. I didn't find that necessary with Kumbi. Kathy's illustrations show her going into Lucky's side at practically a 90-degree angle.

This picture:

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

shows more like a 45-degree angle. But I found that tends to make Kumbi hurt (!) Then I remembered I used to shoot more at a 90-degree angle, or nearly so, so I changed my angle again, to nearly 90-degrees - and SURE ENOUGH, the injections stopped hurting!

Finally, how are you warming the insulin? Do you have it really well above room temperature? I warm the filled syringe in my armpit for about 30 seconds, and when I'm through, the filled part of the syringe feels VERY distinctly warm to my fingers.

Of course, also, once you insert the needle, you need to hold everything steady so the needle doesn't wiggle around in the flesh while you press the plunger. And presing, you need to go at a moderate pace, not too fast, not too slow. Too fast, it probably feels like a bullet. Too slow, it probably just takes too long, and makes the dog want to wiggle, or something!

I found the instructions on the BD site quite useful.

http://www.bddiabetes.com/us/main.aspx?cat=1&id=394

But you've probably been there more than once! I can't really understand the pictures of pinching up skin in that series - can't really see what is being done, but it seems some people can!

So really, all I can suggest is that you experiment some. I agree, it's really tough when there's no fat at all, and maybe you need to use the scruff area till Niki puts on a little more weight.

Thu, 20 Nov 2008 19:29:24 (PST)

[We Hope]

Re: Niki's story

This post is not for newly diagnoised pets, Niki has had diabetes for 5 yrs now, so I am used to her system, foods and insulin.

As I have tried and tried over the years with different foods, trying 3 shots a day etc. the 3 shots just made her BG go higher I did this 3 shots thing about a month ago.

So the past week what I have been doing, is mixing her meal of 1/2 Gr Turkey 3/4 veg 1/3 brown rice 1/3 Nutro Senior.

Then I only give her 1/2 of her food , set my timer for 30 min. to give shot. After shot, I set timer again for 30 min and give the rest of her food. She has had great readings, 146, 165, 135 I don't know how to act.

After 4-5 hrs I give about 5 pieces kibble or a teaspoon of veg's and very little rice.

With Niki usually before at fast she would be a 215 or even a 300, then i would feed, this just made the BG go higher, and the insulin was not kicking in till 2 hours. So this resulted in her leaking pee and I had to make sure to let her out after food and 1 hr after food At times when she was over 200 or 300 before meals I would give 1 unit and wait an hour to feed, then decrease her regular shot 1 unit, but i think this just messed things up when i should of gave her the regular dose even after giving the 1 unit 1 hour before food with a hi reading.

I can sort of understand when I went to the vet and she took her BG and it was over 300 it was about 5PM, she told me not to feed her and give her 1/2 her usual insulin if her BG was not down by 10-12 hrs.

Apparently Niki digests her food fast, the BG rises and stays at that level until the insulin kicks to open the cells so the carbs could get into her system. Just like in that "dogs diet and diseses" book where she mentions the horses are waiting at the gate, until that gate rises the horse cannot run, that was a good explaination for me to understand how insulin and food works.

So I am glad this is working so far, of course we may go for a tumble again, but long as she's happy and seems ok to me is all that matters.

I don't advise anyone with newly diagnoised pets to try feeding this way, you are still learning

http://www.brooksidepress.org/Produc..._Section_2.htm

Giving a subcutaneous injection

"Hold the barrel of the syringe between the thumb and the index finger with bevel up."

I think after over 5 years of giving insulin shots to Niki, Dolly has the basics downpat.

Kathy

[eyelostit]

Re: Niki's story

I've been giving shots for into 7 yrs now, she needs to put on some weight no doubt

[k9diabetes]

Re: Niki's story

I'd increase the quantity of food substantially and see if she manages to put some weight on. Your proportions of additional food and insulin sound like a good place to start - I know you'll get them matched up with a few days or experimenting.

If she doesn't gain weight with a healthy increase in her food, then there may be another issue brewing that's causing her to lose weight.

Any possibility there's something on or under her skin that's causing her pain from the injection?

Where do you inject now - in the scruff?

I know you said she only likes one side but will she let you inject elsewhere on that side?

I considered whether handedness didn't play a part in Chris' preferring the injection on one side or the other. The angle is different when I switched so I think it felt different to him.

Could even just trying changing injection technique - different angle, different tent, face the opposite direction... still, I think the best bet is to inject somewhere else if you can.

Natalie

[eyelostit]

Re: Niki's story

I'll try again tommorrow, odd when you have to sit or stand or kneel or go down on the floor to get the other side, why she never liked that side i have no idea.

[k9diabetes]

Re: Niki's story

Another thought... if all fat is gone, maybe the needle is going too far and striking skin on the other side? Can you put the needle in just a little way and inject?

When does she show pain - when you just pierce the skin or when the needle is further in, or when you actually inject the insulin?

[Ricksma]

Re: Niki's story

I don't know if this is relevant to what is going on with Niki or not, but Ricky seems much more comfortable when I am injecting him on the left side of his neck....I am right-handed. I am inclined to think like Natalie that I must be a little awkward injecting on the right side, and it feels a little different to him. Gosh, I hope you get this figured out. I hate it when I don't feel really confident with a shot.

Love and hugs, Teresa

[eyelostit]

Re: Niki's story

She squirmers a bit when i get the needle in, when i inject she will cry and move and I have to do it again.

I use her right side scruff area, with her head left side against me. Thats hard to figure

[eyelostit]

Re: Niki's story

I'm trying to find info on Hematology, vet told me not to worry about these being High being WBC is Ok,

HGB
MCH
MCV
PLT

Only thing i could find online was elevated MCV could be B-12 defiecny.

Looked at the links and did search on canine hematogly but all i am getting is the lab test explained a bit and normal values, i want to know what makes these go up.

Any help appreciated, thanks dolly

[We Hope]

Re: Niki's story

http://www.acreaturecomfort.com/caninebloodwork.htm

Try this.

Kathy

[eyelostit]

Re: Niki's story

Thats what I wanted, thanks again "Oh Wise One"

[eyelostit]

Re: Niki's story

See if I understand this right.

HGB is high 24.4
MCH is high 37.23
MCV 72.8 is normal moving to high indicates to me needed B-12 folic acid
PLT 603 is high relates to HGB and MCH
WBC is normal heading to low 7.02
Ca Calcium 11.4 normal moving to high-- so i would not want more calcium? Is this calcium coming from fooed?

so from what I've read, to me it means some dehydration and lack of B-12 folic acid. So more water intake?


So per the vet these blood results are all OK cause WBC and HCT 47.6% is ok, and nothing indicates infection or other problems.
Her AMYL was good 351 in the low range so that means no pancreatis is indicated.

If calcium level is high, would that indicate magnesium is needed?

What are your thoughts?

[k9diabetes]

Re: Niki's story

Whether I worry about anything being high or low depends a lot on how high or low it is. Small variations are usually not a big deal and I don't worry about anything that's within the reference range even if it's on the high or low end of the reference range.

[k9diabetes]

Re: Niki's story

Any luck with the injections?

[eyelostit]

Re: Niki's story

Still having trouble with injections, I called the vet regarding that blood work I posted and told her about the injections, she said Niki's bloodwork was fine, i told her i looked up some of those results and if Niki was not intaking alot of water could that have to do with the sub q area, she said no and quit worrying, she said Niki is getting older and most likely tired of being injected, to give her a treat,when doing this, I've never had to give her a treat to do this, i just usually just say good girl and then she is playful.

The vet said sometimes their machines can be off with the blood etc separating and if i was worried to bring Niki in for a curve, so I already do that, she did not mention that anything could be wrong with her skin etc.


I also asked what to give for Niki to gain a few pounds and she said canned dog food that i could get there, but that would be the WD no doubt, that makes me think of trying Merricks canned again, but that seems to run up BG, ah, i just don't know what to do. At least the AML is low so i don't have to worry about pancretis.


I'm checking the possiblitys of why this is happening, I guess i am just going nuts and being overly concerned.

thanks