Problems regulating a diabetic dog

[LMcKee]

Storm is a 6 yr old American Staffordshire mix. I rescued him from a dog fighting ring as a puppy. He had an injured leg that needed medical attention but recovered very well and has been a healthy dog until recently. In december, while on our daily 3 mile walk, I noticed that he noticed Christmas decorations in the neighbors yard and was very uncertain about what they were and I wondered if he was having problems with his eyes. I began to notice some weight loss and excessive drinking. About a month later, I opened the door for him to come in the house and he ran into the door. I immediately called the vet and took him in for a visit. Unfortunately, my regular vet was on vacation and the visiting vet told me that he has cataracts that have been developing since he was 3 yrs old. I knew that this was not the case and disagreed with her. I told her that I was concerned about his weight loss and excessive drinking and she told me that Storm had allergies and prescribed eye drops for his eyes. I knew this wasn't the answer but followed the doctors instruction anyway. For the next couple of weeks, I watched my dog continue to lose weight and his eye sight was quickly changing. I took him back to the vet, insisted that they weigh him again AND check his blood sugar. I am hypoglycemic and very aware of 'sugar' symptoms. The vets office quized me for more than 30 minutes on why I thought that Storm was diabetic. I gave them the 999 reasons why I thought that he was diabetic and followed it up with ..."I am the paying customer. Either YOU will test him or I will find another one who will." They tested him. His blood sugar was 783. The vet came in and shook my hand and thanked me for being persistent.

Now, here is my problem. He has been on insulin since March 1st. He goes every 2 weeks for a sugar curve. He is currently on 35 units of insulin and his blood sugar is still 365. I feel like we should be closer to regulating his sugar by now (not completely regulated but close). One other detail, he originally weighed about 100 lbs....perhaps a little on the heavy side......by the time he was diagnosed he weighed only 63 lbs. He is currently about 95 lbs and seems to be holding there for the last couple of weeks. Could this swing in weight loss/gain be affecting his regulation? OR ...should we begin looking at an underlying cause? Cushings or infection of some kind? I don't want to begin testing him for other things if his weight could have been affecting the regulation. The vet wants to begin looking for other causes ...but I don't think that she is considering the weight issue. I did ask her what she thought about the weight issue and she seemed to be clueless about the weight gain/loss. I asked her how much he weighed and she told me 63 lbs. I just looked down at the dog ...looked at her....and said ...I can eyeball that one and know that he is NOT 63 lbs. She walked away and said call me in two weeks. I really like this vet and I think I caught her off guard. But, perhaps I gave her something to think about. I just need a second opinion to see if my I am on track with my thoughts or if the vet is correct.

Has anyone had a dog that was hard to regulate? Your experiences and thoughts would be greatly appreciated.

I have 4 dogs ...love them all dearly...but this one had a rough start in life and he's my buddy. It is killing me to see him struggling again.

[Dr Lee]

I am sorry to hear the problems that Storm and you are facing. Diabetes can be a difficult problem. Also there are many factors that can lead to insulin resistance including being overweight, Cushing's disease, hypothyroid disease, infections such as periodontal and bladder infections, etc...

While being overweight may be from the diabetes it can also be caused by concurrent Cushing's and/or hypothyroidism. Are there changes on the blood test that make your veterinarian concerned regarding one or more of these? Running tests for infections can also prove beneficial.

There are also some nutriceudical and holistic options that some of the members here may help recommend for you. Chromium and vanadium have some positive effects in human medicine, perhaps ask your veterinarian about these. I have also found that some gentle regular exercise can help out the diabetics.

Here are some great websites that I send my clients to..
www.vetsulin.com
www.caninsulin.com (great site - it is the UK version of vetsulin)
www.caninediabetes.org

Also there are some pets that do well with having glucose curves done at home. They can be less stressful and less expensive. The caninsulin website actually helps you make grafts at home for your vet.

Originally Posted by LMcKee

I just looked down at the dog ...looked at her....and said ...I can eyeball that one and know that he is NOT 63 lbs. She walked away and said call me in two weeks. I really like this vet and I think I caught her off guard. But, perhaps I gave her something to think about.

What exactly were you trying to have her think about? That she made a mistake? I do not understand.

[LMcKee]

Thank you so much for your response. I appreciate any suggestions and resources that I can get on this.

In reference to the weight comment. She is basing the insulin dose on his old weight which was 63 lbs. She has not weighed the dog again since that original visit. She is calculating his dosage at 63 lbs and saying that he is getting close to receiving 2.5 times the amount of insulin and at this point we should be looking at other underlying conditions. I was trying to make the point that we need to "recalculate" his insulin dose based on his new weight which is somewhere in the 90-100 lb range. I'm not opposed to further testing, however, I want to minimize the stress on Storm as much as possible.

[Dr Lee]

I understand.

Often with diabetes regulation we will base dose off of an 'ideal body weight'. A 90lbs dose is 50% more than what a 60lb dog would normally get. While with some medications like antibiotics, this increased biomass will change dosing, often with insulin, many clinicians will not. At this point, it would make sense to base dosing changes off of a combination of glucose curve and clinical response.

Also have fructosamine levels been done? Have they been improving despite the lack of glucose curve response?

[sugarcatmom]

I'm going to second Dr. Lee's suggestion of testing your dog's blood glucose yourself. Diabetes is essentially a home-managed condition and knowing what your pet's glucose levels are at any given time is an extremely valuable tool. You can use a human glucometer and test strips from the pharmacy. More details are found at this link: http://www.petdiabetes.org/home_bg_testing.htm And this one has lots of diabetes related info, including record-keeping templates: http://www.petdiabetes.org/ and a canine diabetes message board: http://petswithdiabetes.yuku.com/for...-Diabetes.html

[punky]

My dog is a diabetic, diagnoised 5 yrs ago, I do belong to 2 forums for diabetic pets, my dog was mis diagnoised at first, the vet only did a BG draw once a week and kept up-ing her insulin, which only did worse, I have since found a new vet. More insulin does not necessarily mean you will get a lower BG reading, please get yourself a glucose meter there are ones for pets now. What food are you feeding your pet? The sites below are a Godsend, they were for me, if I would not of found them, my pet may not be with me today Also, I suggest finding another vet who knows something about diabetes and about matching food and insulin, allerigies and eye drops? Quizing you? Who is the doctor here? How could the The excesive thirst be overlooked.

here are the two links to canine diabetes sites as well as the pet glucose meter, I hope you will join the board, take a look, you will know you found the right place, you are not alone and help is there. tell them ilostit sent you, they will know who you mean

Hang in there, glad I stopped at this board today

http://petswithdiabetes.yuku.com/
http://k9diabetes.com/forum/index.php

here is link to pet meter

http://www.animaldiabetes.com/glucopet

Take care, keep me posted

[sugarcatmom]

Originally Posted by punky

please get yourself a glucose meter there are ones for pets now.

I just wanted to point out that you don't need the glucometer for pets, the ones for humans work just as well (in fact, that's what most vet clinics use) and they're cheaper, not to mention readily available (what happens if you run out of test strips when the clinic is closed?).

[punky]

Yes you can get the human ones also, but I like the idea that the ones for pets seem more accurate, as i can test on my other non db dog.

My vet always takes the blood from the vein for bg test or a curve, my other vet did the same, I never had a vet who used a meter.

I wonder if some of them now use the Glucovet, that came out about a year ago I think for vets.

I just wish more research was done for DB pets, and that the petfood industry would list their labels like human foods.

[sugarcatmom]

Originally Posted by punky

Yes you can get the human ones also, but I like the idea that the ones for pets seem more accurate,

That's debatable. Certainly ADM and Abbott Laboratories would like for us to believe that, but the independent tests I'm familiar with don't show this to be the case. Certainly the extreme difference in price doesn't make up for any miniscule difference in "accuracy". You might find this link interesting: http://felinediabetes.com/glucometer.htm

Several companies are now marketing animal specific glucometers, claiming that human glucometers give inaccurate results. These glucometers include the GlucoPet® and the GlucoVet® by ADM, available since 1999, and the AlphaTRAKTM marketed by Abbott Laboratories since 2006.

On their web site, Abbott Labs provides the clinical data obtained in testing their AlphaTRAKTM meter against two human meters, the Bayer Ascensia ContourTM and the Roche Accu-Chek AdvantageTM. This clinical trail was not done independently of Abbott Laboratories. No mention was made of why these two meters were selected. The meters were tested in both dogs and cats. Results seem to indicate that the AlphaTRAKTM is a more accurate meter than the other two tested meters but in no way prove that other hand-held meters are not also accurate. It would have been very nice if Abbott had compared the AlphaTRAKTM to their own "human" meter, the Freestyle.TM

Do you need these "animal-validated" glucometers instead of the more readily available and much less expensive "human" glucometers? Probably not. What is more important is that your glucometer gives results that are comparable to the results obtained by your veterinarian's glucometer. You should always compare your readings against the readings obtained in the vet's office by directly comparing readings taken at the same time. Your veterinarian should also know how their glucometer compares to needle puncture readings. The blood obtained by each method is slightly different. You can read a nice explanation of this in the article published in DVM, a veterinary medicine newsmagazine.

Originally Posted by punky

I just wish more research was done for DB pets, and that the petfood industry would list their labels like human foods.

You should send a letter on this topic to the FDA before May 13th. That's when they're holding a public meeting on pet food standards and labeling: http://www.fda.gov/cvm/CVM_Updates/petfoodstandards.htm Here's more info, with some sample letters: http://www.mousabilities.com/nutrition/carbaafco.html

[LMcKee]

I certainly test Storm's glucose levels at home. I am hypoglycemic and have to monitor my bg and food intake/choices very carefully and I do the same with Stormie. However, I have his vet do a bg curve every 2 weeks and then we discuss where we are and where we need to be. This is done with blood draws from the vein and not with a bg monitor. This is the same procedure that my doctor followed when we began regulating my own bg levels. Storm has eaten Science Diet since his rescue and after diagnosis I switched him to Science Diet W/D. I just like to do my homework/research so that I can discuss all of our options and know that I am making the right choices for Stormie. We lost 4 weeks of time with the misdiagnosis of allergies by the first vet. I want to make educated decisions going forward and I think it is premature at this point (less than 8 weeks into this) to decide that he is hard to regulate and put him through further testing for possibly no reason. My own regulation took close to 6 months to turn everything around.

A HUGE thank you to all of you that have provided websites. It is good to have recommended websites that have been useful tools to others in the same situation than just googling any website out there.

Quick update on Storm.....we bumped his insulin up to 40 units on Sunday. When I took his bg after work yesterday, it was 103
Today, wasn't so good. He was at 343 when I got home BUT that is down from 450 + .

[punky]

sugarcat,

thanks for that info, will do

[Dr Lee]

Originally Posted by sugarcatmom

I just wanted to point out that you don't need the glucometer for pets, the ones for humans work just as well (in fact, that's what most vet clinics use) and they're cheaper, not to mention readily available (what happens if you run out of test strips when the clinic is closed?).

The glucometer we have is a human glucometer from Walgreens. When looking at them I noticed that they ranged from $40 to a couple of hundred. The difference in price is attributed to graphing ability and looks, not accuracy. The FDA standard requires a level of accuracy for human (and pets too, I guess) safety. I have spoken to several pharmacists who love the inexpensive models for both accuracy and ease of use. Also the technology of looking for blood glucose is the same for humans, dogs, or any other mammmal and birds.

As far as accuracy, our in house laboratory is the same model as used in the Mayo Clinic and we love them. Our glucometer has read very acceptable compared to our in house chemistry analyzer.

As far as obtaining blood for glucometer readings at home. I usually teach my clients that want to do glucose curves, how to obtain the blood at home with the insulin syringes. These syringes are great because the needle size is so small, that minimal trauma is used during venipuncture. A 50 cent penrose tube works as a tourniquet for vein on the forearm. And with the graph abilities at the www.caninsulin.com website (we usually send our clients home with a cd or email them the form that is adjusted for US values) we have had great success and compliance with the curves. I think that veterinary obtained curves are also of great value but the choice is individual and based on many factors. I have clients that do one or the other and a few that we do both ways for. So - not trying to push it one way or the other.

[LMcKee]

Storm's bg when I got home from work was 181 yesterday and 143 today. WOOHOO I am SOOOO encouraged! He is acting like his old self again. His Eyes are bright...he's playing with the other dogs AND he is asking to go on his walks again.

Dr. Lee, I am currently using a prick to Stormie's lip. He doesn't seem to mind ...He doesn't love it but he doesn't flinch and sits very still for me. Just wondering, if the stick to the leg is less stressful? Is one better than the other? If it were your dog.... which method would be your choice? My own doc hates it when I ask that question.