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  • #16
    Re: New member looking for advice

    Maybe you coulld phone around for an ophthamologist?

    You.ll probably know more after the cushings test and her eye healing.
    Both will raise blood sugar and i would not raise the insulin anymore. Changng to novolin nph insulin could be considered.

    Please post any updates.

    Symogi? Testing after a meal before giving insulin and waiting till bg is over 200.

    Consider home testing if your not already ...doing a nighttime curve?
    Riliey . aka Ralphy, Alice, Big Boy
    20 lb male. 5 1/2 nph insulin. 1/2 cup fromms. black cockapoo, dx Apr 2012 . 5 1\2 yrs diabetic. 2000 to 2017

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    • #17
      Re: New member looking for advice

      Agreed, will wait to see how her eye recovers and what the Cushings test shows.

      We have been testing blood glucose at home, and at this point I feel confident raising the dosage quicker than the vet has suggested. I do wish I'd listened to the suggestions here to be less conservative early on.

      If the Cushings test is positive, it sounds like she'll be put on Trilostane. I'll give an update on how that all goes.

      Also, there is also a potentially safer and simpler treatment for Cushingss, using Melatonin and Lignans, which seems to have some promise: https://www.amazon.com/gp/product/B0...84158FP9&psc=1

      As for her blindness, a chat with the ophthalmologist brought up cataract surgery. I don't think we'll consider that unless there's a turnaround in her overall health, but I would be curious to hear if anyone has had that done with their diabetic pup.

      Thanks again everyone!

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      • #18
        Re: New member looking for advice

        You may want to talk to our sister site k9 cushings just to make sure your going in the correct direction on that subject . Sometimes vets go to that with higher numbers as a reason with blood work than can be skewed by unregulated diabetes . you just want to make sure your on the right page .

        I agree I would not worry about cataract surgery until things look a bit clearer
        Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
        Jesse earned her wings on 6/21/2021

        Comment


        • #19
          Re: New member looking for advice

          Just an update re: cushings. Bella tested negative with the ACTH test. I'm still suspicious of it though, since her bloodwork looks like cushings, and the test can give false negatives. There is an "atypical" cushings also that there's no good test for; the recommendation for that is a simple and safe supplement of lignans and melatonin, so I figure I'll start her on that since it can't hurt.

          Otherwise, she's currently up to 14 units of Vetsulin twice a day, and weighing in at 35 lbs. Her vet says if she gets up to 16 units and is still over 300 blood glucose, she is then considered insulin resistant, and that could mean any number of things at his point. The vet suggested an ultrasound and a visit to the ophthalmologist, with the caveat that returns may be diminishing at this point. Since shes almost 12, now blind, and has declined quite a bit and been through a lot recently, I'm thinking it may be time to focus on comfort and good spirits and not continue with further medical intervention beyond what we're doing now.

          I'll report back with her next blood glucose curve tomorrow, we've gone from 11 units to 14 in the past 2 weeks so I'm hoping to see some improvement there.

          On the upside, she's eating great, and adjusting to being blind.

          Thanks again everyone!
          Last edited by Bellandanny; 04-30-2021, 01:22 PM.

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          • #20
            Re: New member looking for advice

            Here's Bella's latest blood glucose curve, at 14 units Vetsulin (up from 11 units 2 weeks ago, the curve for which posted here five posts back):

            08:00am: 445 (before meal)
            10:00am: 576
            12:00pm: 477
            02:00pm: 371
            04:00pm: 442
            06:00pm: 432
            08:00pm: 411 (before meal)

            So, showing improvement finally? She's definitely drinking less water now around mealtime, and drinking about the same or a little less an hour or so after eating.

            We'll go up to 16 units from here. She weighs 16kg, so I gather this is getting close to the indicator level of insulin resistance, of 2.2 units/kg? However I'm unsure if that 2.2 units means for the whole day, or per dose?

            Has anyone here had to go much over 1.1 units/kg per dose twice daily?

            Either way, increasing the insulin seems to be the only trick left. The cushings test was negative (tho it sounds like it can be iffy), seemingly no infection (per blood work and urinalysis), pancreatitis is unlikely (never any vomiting, diarrhea) - so we're kinda at a loss as to what could be going on, besides the diabetes and insulin resistance for some unknown reason.

            Thanks again, and if anyone has further input or advice, please let us know!

            Comment


            • #21
              Re: New member looking for advice

              Finally yes. She should of started on at least 9 units.

              Ruling out symogi
              I dont see insulin resistants Bella just started on tooo low of a dose and is now levelling out her curves.
              Fyi:
              Upping insulin 2 units at a time
              Last up lowest bg dropped 78
              So upping to 14 with lowest number at 371 should be in the safe zone next curve 293.
              No changes. Nothing added
              But bg could drop by 100 a unit then 2 units is 200 might be 371_200 giving Bella a 171
              Keep this in mind . You are thinking out of the box..good.

              Keep checking ketones

              Please post her food and how much thanks?
              Last edited by Riliey and Mo; 05-03-2021, 10:08 AM.
              Riliey . aka Ralphy, Alice, Big Boy
              20 lb male. 5 1/2 nph insulin. 1/2 cup fromms. black cockapoo, dx Apr 2012 . 5 1\2 yrs diabetic. 2000 to 2017

              Comment


              • #22
                Re: New member looking for advice

                the only other reason that I am aware of besides Cushing's is a thyroid problem that can cause resistance to insulin but your not there yet . Its been suggested that total resistance is one unit per pound but I would not be comfortable giving that much insulin

                I would not see a problem giving 22 to 25 units if thats what it takes for a 38lb dog

                Its great your seeing progress . Now be careful with numbers going lower and resistance broken . Blood sugar can take a big jump lower unpredictably

                Once in the 200s you would like to slow things down a bit . Maybe letting an insulin dose settle for a bit longer and make smaller dosing adjustments with not more than a unit . This is where you begin to make fine adjustments

                Remember the goal is not to get to what normal blood sugar levels look like . 100 to 250 is adequate and where my jesse was at for a time but the last few years she has been between 100 to 150 .

                hope to see continued progress
                Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
                Jesse earned her wings on 6/21/2021

                Comment


                • #23
                  Re: New member looking for advice

                  Did a spot check today at Bella's usual blood glucose low, at she's down to 273! Never thought I'd be so happy about such a thing

                  We'll do another curve this weekend, but things are looking up overall. Thanks to you guys - I probably wouldn't have had the courage to make a bigger jump in the insulin otherwise.

                  Now the immediate concern has become her eye - she's totally blind and the one eye is looking like more like glaucoma vs. cataracts with uveitis (as vet suspected). She has an ophthalmologist appointment May 19th which is the earliest around.

                  Wondering if anyone else's pup has had glaucoma and what your experience was? From what I'm reading there's almost no chance of regaining vision, but I'm unsure how much of an emergency it is, what if anything I should be doing right now to help, etc. It doesn't seem to bother her much, no pawing or blinking, but she has bumped it a few times and yelps.

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                  • #24
                    Re: New member looking for advice

                    Originally posted by Bellandanny View Post
                    Did a spot check today at Bella's usual blood glucose low, at she's down to 273! Never thought I'd be so happy about such a thing

                    We'll do another curve this weekend, but things are looking up overall. Thanks to you guys - I probably wouldn't have had the courage to make a bigger jump in the insulin otherwise.

                    Now the immediate concern has become her eye - she's totally blind and the one eye is looking like more like glaucoma vs. cataracts with uveitis (as vet suspected). She has an ophthalmologist appointment May 19th which is the earliest around.

                    Wondering if anyone else's pup has had glaucoma and what your experience was? From what I'm reading there's almost no chance of regaining vision, but I'm unsure how much of an emergency it is, what if anything I should be doing right now to help, etc. It doesn't seem to bother her much, no pawing or blinking, but she has bumped it a few times and yelps.
                    Glad Bella,s blood sugar is improving. Please post her curve results.
                    Theres a device called protective Halo for blind dogs you can inquire, there on amazon.

                    Fyi

                    Personally i didnt and wouldnt advise a 2 unit increase. Seeing that you already jumped up by 2 i gave you information to avoid an overdose.
                    Please check test bg after food and wait till bg is over 200 until you inject 14 units
                    Riliey . aka Ralphy, Alice, Big Boy
                    20 lb male. 5 1/2 nph insulin. 1/2 cup fromms. black cockapoo, dx Apr 2012 . 5 1\2 yrs diabetic. 2000 to 2017

                    Comment


                    • #25
                      Re: New member looking for advice

                      the eye problems can get serious from what I have seen on the forum . The worse case scenario would be the eye needing to be removed . Drops will be prescribed to reduce pressures . You have to keep a watchful eye on any pain increase

                      Its good news that blood sugar is improving . It sounds like you may need to slow things down . The eye problems could be causing the need for more insulin so when thats taken care of you may need to drop the dose a bit but thats why we test blood sugar at home . keep up the good work
                      Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
                      Jesse earned her wings on 6/21/2021

                      Comment


                      • #26
                        Re: New member looking for advice

                        Well, Bella's latest curve is disappointing. We went from 14 units (that curve posted earlier, the low point was 371), to 15 units:

                        10:00am: High
                        01:00pm: High
                        03:00pm: 488
                        05:00pm: 525

                        Didn't have enough test strips to do all day, but captured the usual low hours. More strips on the way and next curve will be complete.

                        This is all the more confusing since as mentioned, 2 days ago I tested her at 3pm and she was at 273.

                        Is it normal to be so up and down like this? Could feeding her about 200 calories more per day (she's put on a couple needed pounds) make a difference? Going on, then off Prednisone steroid eye drops (they didn't seem to helping, but perhaps were keeping an unseen infection at bay)?

                        I'm assuming the vet will say to bump her to 16 units and test again in a week. Sound like a good plan?

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                        • #27
                          Re: New member looking for advice

                          Thanks for posting the wkend curve
                          There doesnt seem to be a hole lot of diffence from the curve you posted on 4. Units!

                          Please. Post

                          Food, amount?
                          Treats
                          Medical conditions

                          Is Bella spade?
                          Riliey . aka Ralphy, Alice, Big Boy
                          20 lb male. 5 1/2 nph insulin. 1/2 cup fromms. black cockapoo, dx Apr 2012 . 5 1\2 yrs diabetic. 2000 to 2017

                          Comment


                          • #28
                            Re: New member looking for advice

                            Yeah, it was a disappointing result this week. She seems to be feeling okay and drinking less however.

                            I think we'll put her back on the Prednisone eye drops, in case that was handling infection (she was on that when she had the good numbers week). From what I read infection can cause blood glucose numbers to rise?

                            My only other thought is that there may be inconsistency in the Vetsulin - this last result was right after opening a fresh vial. Will try a new vial for the next curve.

                            Or possibly what they call atypical Cushings, for which the best advice I've seen is a safe combo of lignans and melatonin. We'll try that if the eye drops and new Vetsulin don't lower her numbers back.

                            And fyi she's eating a mix of Ketona dry food and Purina one grain free chicken wet, about 500 calories per meal. We settled on this mainly because she eats it, whereas she had no appetite for the prescription wet or dry. She eating a few Ella's diabetic dog treat per day.

                            Also, hadn't mentioned, but she's on 37.5mg Carprovet NSAID with each meal. Her vet initially prescribed this for arthritis, and says to keep on it even tho she's not limping at all anymore (likely improvement from weight loss and less activity).

                            She is spayed, and hasn't tested positive for anything other than diabetes. We haven't done an ultrasound, which is about the only thing left to do.

                            Thanks again!

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                            • #29
                              Re: New member looking for advice

                              Check bg frequently if your adding back in the prednisone. Bg can drop.

                              I wouldnt advice raising the insulin until you least try tweeking the food or and changing insulin.

                              Check her weight. Is 500 calories the right amount for her weight. Try to be consistent with food ..itsjust as important as insulin.

                              How many callories is the dog treats?

                              Try switching to novolin insulin ..its more stable. Because is concentrated starting dose minimum. Not 14 units.

                              Keep testing after food. Check for that low which will happen when the infectiin is gone. Inject only over 200.

                              First try tweeking the food. Feed according to manufacturers feed guide.

                              I.d like to see a bg test. 1 1/2 hours after foood please. To see how food is meeting up with insulin.

                              Heres a link to feed guide. Looks like. 2 cups a day or 900 calories for 38 lbs.

                              https://www.petmd.com/blogs/nutritio...t-amount-32905
                              Last edited by Riliey and Mo; 05-10-2021, 09:39 PM.
                              Riliey . aka Ralphy, Alice, Big Boy
                              20 lb male. 5 1/2 nph insulin. 1/2 cup fromms. black cockapoo, dx Apr 2012 . 5 1\2 yrs diabetic. 2000 to 2017

                              Comment


                              • #30
                                Re: New member looking for advice

                                They say steroids' can create higher sugar when used but if it reduces inflation then that could help with blood sugar . Its a up and down process . It took jesse about 6 months to get her somewhat consistent and a year to establish her routine for the long haul which has been 11 years . The eye problems could be having an affect on blood sugar and the prednisone may have helped with that

                                If the eye problems you described are real that could affect blood sugar so getting that check out and solving that is the priority
                                Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
                                Jesse earned her wings on 6/21/2021

                                Comment

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