Cushing disease v diabetes v overweight

[Dancon]

Been to the vets and his blood sugar should be around 9 but it is currently 27, he used to be over 17kg because of my inability to stop giving him treats, too much love I am afraid and he weighed today 13.6kg so has lost a lot of weight. He has diarrhoea so has been give antibiotics today too and I have given him his first insulin. They want to see him again tomorrow to check his levels again. I am already full of questions and anxiety. They say he has to have it 12 hours apart and has to have the same portion size at each meal in order to have the injection. He won’t hardly eat this morning just now, managed to get a little beef into him so I could inject but nothing like a decent portion for breakfast, this now means I can’t feed him again until 11 tonight and then inject again. He will be starving by then but if I have understood correctly he can’t have anything till 11, does that sound right to anyone who has a diabetic dog? Sorry for sounding stressed but I just want to do it right for himas I have let him down so far with his diet. Thanks again everyone. Lesley

[Oscar 12345]

Lesley, why don't you give your vet a ring. They will confirm for you. We pay them a lot of money when we have a problem and advice by phone is all part of the service. I imagine they deal with a large number of dogs with diabetes issues. There is some real positive news in your post - great loss of weight, that is a significant achievement for both of you. All you can do is try and do the best for the little guy but don't feel that you shouldn't be burdening the vet. Good luck and try to keep positive

[Schnauzer Sam]

Been to the vets and his blood sugar should be around 9 but it is currently 27, he used to be over 17kg because of my inability to stop giving him treats, too much love I am afraid and he weighed today 13.6kg so has lost a lot of weight. He has diarrhoea so has been give antibiotics today too and I have given him his first insulin. They want to see him again tomorrow to check his levels again. I am already full of questions and anxiety. They say he has to have it 12 hours apart and has to have the same portion size at each meal in order to have the injection. He won’t hardly eat this morning just now, managed to get a little beef into him so I could inject but nothing like a decent portion for breakfast, this now means I can’t feed him again until 11 tonight and then inject again. He will be starving by then but if I have understood correctly he can’t have anything till 11, does that sound right to anyone who has a diabetic dog? Sorry for sounding stressed but I just want to do it right for himas I have let him down so far with his diet. Thanks again everyone. Lesley

Lesley,

You've been caught up in a whirlwind due to Stanley's condition and, not surprisingly, it can be very difficult to take it all in or overlook something you think you should have asked. You really should call your vet for clarification.

If the vet is trying to work out an insulin dose based on trial and error then you need to address everything through them. If you are pricking Stanley before every meal and using a home meter to see what his blood glucose levels are then I can help you with the process for calculating the required dose but would need to know what the bolus is for the food ( how many units of insulin are required per x grams of food) and what the offset is for adjusting the bolus ( how many points movement on the blood meter will one unit of insulin cause).

[Dancon]

Thanks for the advice, I will ring the vet to check things up. They have prescribed 6mg of insulin for his weight and I have to go back again tomorrow. Poor little lad is starving and begging constantly at the moment but it is his usual tea time so guess it’s to be expected. He has to wait another two hours before feeding again, I need to gently bring that forward if the vet agrees, will ask tomorrow, don’t want to seem a neurotic woman LOL. The weight loss is good as you say, if he was on a diet and not diabetic I would be thrilled! Thanks again xx Lesley

[Schnauzer Sam]

Lesley,

If he's on a fixed dose for his weight then the question to ask the vet is what size is the window of opportunity for Stanley to eat his food or putting it another way if you know you're going to inject him at 9 in the morning, what is the earliest and latest that Stanley can eat and the insulin will still be effective?

Good luck for tomorrow.

[Dancon]

Hi guys
Things going from bad to worse, Stans levels are rising not falling. He was supposed to be admitted to day but he wouldn’t eat, so they called me back to get him to eat which I did and suggested instead of him staying all day there to bring him back every two hours to do a glucose curve. He started at 29 an dhas just gone to 32! His previous reading last week were 27, then 24 the 21, then as I said 29 and now 32! What happens if they can’t bring it down and get him stable, I am worried sick at the moment, he has lost a bit more weigh too, is now 13.2kg,I just don’t know what comes next, so scared for him, they have said he could be Insulin resistant, but what 5en?

[Oscar 12345]

Lesley, sending big hugs.... I have read on the internet that resistance to insulin could mean there is a primary underlying condition which is affecting the insulin. Injected insulin levels are usually reduced when this happens whilst I assume other tests are carried out to find out why the insulin isn't doing what it should. You are going to the vet every two hours so they should be able to tell you all the options/possibilities. If I were you I would read up as much as I could on blood glucose curves etc. It is confusing at first but the more you research, the more informed, the better your questions. Really wish you the best and hope that Stan can stabilise. Hopefully Sam will respond with more knowledgeable info on this for you.

[Schnauzer Sam]

Hi Lesley,

Sorry to hear that things aren't working out as hoped for with Stan at the moment.

I'm surprised that they think he might be insulin resistant at the moment as this is something that develops over a long time , if it happens at all. If this is all happening at the vet's surgery and Stan is anxious about the situation, this could be causing his readings to be high.

Everyone reacts differently to insulin and how the body responds depends on many factors. While the manufacturer of the insulin may say that a dog weighing x kilos needs y ml of insulin, it is not as straight forward as that. If you take 3 diabetic kids of the same weight with the same level of glucose in their blood, give them the same meal, they will all require a different amount of insulin and you "play around" with the ration until you get it right. My stepdaughter used to require 1 unit of insulin per 10g of carbs, now it is 1 unit per 6g of carbs except at tea time when it's 1 unit per 4g of carbs.

What I'm trying to say is that it's not an exact science and you shouldn't get too down about it so soon. There will be a period of trial and error until you hit on the right dose for Stan and you will enjoy long periods of stability with his diabetes as well as other times when you need to adjust again.

If you felt confident enough to do it, and if your vet was willing to let you have a portable blood glucose monitor, would you be able to take the 2 hourly readings at home so that Stan would be more relaxed? If you use a new lancet each time to prick the vein at the bottom of his leg or on his neck, it should be fast and painless for him.

[Dancon]

Thanks everyone. I have calmed down a little now after diagnosis anxiety! Stan has had a glucose curve done and he is now on 9.5 u it’s twice a day. He seems happier, bouncier and much more like his old self thankfully. The insulin is working, he isn’t resistant and I have changed vets as I really was not happy with how we were being treated, I had to wait an hour twice to have a glucose test done, they overcharged me and gave me the wrong dose and wrong appointment time, I now have a lovely vet who is really helping us. We are still struggling with beggin from five ish in the evening till he can eat again at eightish but if that is the only thing we can cope! He is due to have a fructose test in a fortnight which will help see how his body is coping I believe, so fingers crossed. Thanks again everyone and I apologise for the drama xxxxx

[Schnauzer Sam]

Hi Lesley,

Firstly, no need to apologise. We come here to be supportive and pass on any knowledge or experience we have.

It's good to hear that Stanley's responding well. I note that his dose has changed from 6 to 9.5 units each jab. When you first said that he was still running high and you'd been advised that he may be insulin resistant I thought that they were wrong ( I restrained my self to being surprised).

Glad to hear that you voted with your feet and have found a vet much more in tune with Stanley's (and your) needs.

You should be able to give him little treats around 5 that will keep the hunger away. Ask your vet if he could have a little bit of protein ( I'm thinking of small pieces of chicken breast or a few flakes of tuna in spring water). Another possibility would be carrot sticks. These all have little or no carbs in them and should therefore be OK but do check with your vet.

Do let us know how things progress.

[Dancon]

That’s great news, he is particularly hungry about 5pm so a bit of chicken will go down well I would think, thanks for the advice ! He has to go for a fructose test next Wednesday, so will let you know how we get on. What a fantastic group you all are, helping when a schnauzer mum gets a bit stressed, bless you x