Insulin Injections for Your Diabetic Dog

Shelley Cetin Hub Author 3 years ago

Kathy,

Your vet probably tells you to prepared the syringe immediately before you're ready to give your pet its injection because the insulin loses its effectiveness when it is exposed to air temperatures. Most insulins must be refrigerated, and when they're not cooled, they won't work. (I don't know the science behind this.) You might be able to prepare a syringe (i.e. draw the insulin into the syringe) ahead of time; however, you would still need to keep the loaded syringe in the refrigerator. Additionally, you would need to 1) shake the syringe to mix the contents before the injection, and 2) let the syringe warm to air temperature before giving your dog its shot (because injecting cold insulin hurts).

As you can see, it takes just as many steps to prep an insulin shot beforehand. But as long as you keep the insulin syringes in the frig, shake them to mix the insulin, and then let them warm to room temperature before you inject your pet, you probably can prepare them ahead of time. Good luck!

Shelley

Shelley Cetin Hub Author 2 years ago

Hi,Karen.

It's important for any diabetic dog to have its insulin on a regular schedule, so if you're going to be away, you'll need to have a plan in place. Because your little dog's pancreas produces no insulin (which means that her body has no way to metabolize glucose), she needs her shots to help her body use the glucose from food or released in her body through natural processes. Without her insulin, her sugar levels will rise, which probably wouldn't result in anything serious over a 24-hour period, but which could also cause a problem. If you're going to be gone, you need to talk to your vet to develop a plan of action. Even if your dog skips a meal, she still needs to have some insulin to cover the glucose that her body naturally produces. (There's glucose in the body even if we don't eat.)

I think you need to speak to your vet to see what she recommends. If your dog usually takes 2 injections per day - one in the morning and one in the late afternoon - missing the a.m. shot will result in a rise in her blood sugar levels. Over 24 hours, the rise shouldn't become very dangerous, but your vet may recommend extra insulin be given on your return to compensate for the rise in blood glucose while you are away. Still, I'm not a vet and each dog's requirements are different.

At any rate, please either see your vet or call her before you leave. Most vets are very happy to speak to a parent with a diabetic doggie, as they want your pup to stay healthy and avoid dangerous sugar levels. Ask your vet how to handle the missed meal and then ask her how much insulin to administer on your return. (Your vet can make exact calculations based on your dog's age, weight, activity level.) Please let me know how your pup does while you're away!

Shelley Cetin Hub Author 2 years ago

Hi, Jollena.

I know from personal experience (since I've been taking insulin shots myself for nearly 30 years!) that once in a while, you simply hit a spot that is near a nerve or very sensitive for whatever reason. Still, there are a few things you can do to try to prevent minimize discomfort during shots.

1) Give the shot in a different place each time. This prevents a site already irritated by the previous shot from developing more sensitivity and also prevents fat deposits from forming under the skin. When giving injections, try to envision your dog's upper back (below the neck and between the shoulders) as a 'grid.' Each time you give a shot, move down the grid (toward the tail)a bit (maybe 1/2 inch). Then move over and start back up the grid. Remember to stay in the area your vet showed you for insulin injections.

2) If your pet is on the thin side, use two fingers to slightly raise your dog's skin at the injection site in order to inject the insulin into the fat under the skin and to avoid injecting into muscle.

3) Make very sure to warm the syringe after drawing insulin into it. Injecting cold insulin is quite painful - as I can again tell you from personal experience. Load the syringe and then gently roll it between the palms of your hands until it feels warm. It should then be ready for your dog's shot.

Review these suggestions to see if there's anything you aren't doing or aren't doing properly. I hope this helps!

Shelley

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Shelley Cetin Hub Author 2 years ago

Hi, Lindsey.

I don't think I would worry about the tissue on her right side becoming sensitive to her insulin injections as long as you make sure to 'rotate' the injection site each time. (See my posting to Jollena above about this.) You need to avoid repeatedly giving a shot in the same spot over a short period of time, and can avoid it by moving up, down, and across your dog's right side by envisioning it as a 'grid,' giving each shot in a different 'square' of the grid. Your dog is smaller, so you can move up or down his/her back about an inch or so each shot. Your vet can give you more info on this if needed. By moving the site of the insulin injection each time, you allow the previous site to rest. I know in my particular case, my little Maltese Ozzie never had a problem with sensitivity to his insulin shots, although he lived with twice-daily injections for more than 6 years! Remember always to ask your vet, though, if you still have questions. My information comes from long experience caring for myself and my diabetic dog. Good luck!

Shelley

Shelley Cetin Hub Author 2 years ago

Hi, David.

When my Maltese became diabetic, I had the same problems. He would squeal and fight until I finally had my sister help me give him several injections. That couldn't continue, so I finally decided to sit on the floor in a sort of lotus position (the bottoms of my feet together) and put him in that space to "cage" him with my body. It seemed to calm him a bit that I was on his level. Since I had some of his favorite food in the world (turkey deli meat) in the frig, I put the meat on a little saucer in front of him while he was actually standing on the floor (in the circle my legs had created). And then I gave him his shot. He started a little, I remember, but this worked and I kept it up for about a week. We eventually graduated to his sitting on my lap, and once the shots before meals had become routine, he would come when I said, "Ready for your shot?"

You might try putting him on the floor as I suggest here, so that he can't escape. If that doesn't work, could you sit on the floor with him between your knees? That would give you more control if he absolutely refuses to cooperate. Or you might even try a different method, which is to let him start eating his meal while you kneel or stand just over his shoulder, then reach down and give the shot while he's in the middle of eating. (My sister used to do that with my dog, but my eyesight wasn't such that I could manage it.) If he's the type of dog who just inhales his meals, this might work, since he'll be so intent on the contents of his food dish that he'll be distracted. Let me know if any of these ideas work, and good luck with your pup.

Shelley

Shelley Cetin Hub Author 2 years ago

Hi, Anne.

I hope you read this response; I can't reply to you personally from this site. When my little dog Ozzie was first diagnosed, I too had problems getting him to cooperate when I was alone. My sister was my assistant when she could ber, and Ozzie would be okay when a 2nd person was around, but not when it was the two of us alone. I tried several methods, but the one that finally worked (until he got used to our routine) was my getting on floor level with him to give him his shot. I would fix his syringe, roll it gently in my hands to mix it, and then warm it up by holding it for a bit. Once this was done, I'd put my "equipment" on the floor, get Ozzie, and sit down on the floor with him. I made a "circle" with my legs by touching the bottoms of my feet together, and then I saw Ozzie inside the circle, enclosing him as tightly as I could without making him feel trapped. With Ozzie facing away from me, I would place 2 or 3 little treats (his favorites) on my ankles, and after I picked up his syringe, I'd let him go so that he could start eating the treats. Once he had grabbed a treat, I would quickly pull up the skin on his back and give him his shot. I always made sure that I was offering him his favorite treats so that his attention would be on the food and not on what I was doing.

Try this with your little chihuahua and see if it will work. Also, the next time your assistant is there, you could still use this method so that your dog understands that you are always in charge. When your assistant is there and he behaves, he may be seeing your assistant as the boss, not you; this could explain why he doesn't cooperate when you are alone with him. (To you, your assistant is just that, but your dog may understand that when the 2nd person - the 'leader' - is around, he has to submit. This may leave you in a low-dog position in your dog's eyes.)

Please write back and let me know how this works. If it doesn't, maybe I can suggest something else. But do remember to calm yourself before you get ready to give the injection. Your chihuahua can easily pick up on your fear and anxiety, which can lead to a power struggle.

Shelley

Shelley Cetin Hub Author 2 years ago

Hi, Shirley.

Yes, there are smaller needles than the ones you are using on your bichon. They're still the 30 gauge, so the needle is the same diameter/fineness, but the needle is shorter and better suited to a small dog or child that may not have much body fat. My little dog Ozzie (whom we lost to cancer last May) was only 12 pounds and very muscular, so I began using the mini needles on him to make him more comfortable. He just didn't have much fat under the skin, besides his being a small dog, so the mini needles worked better. I'm not sure how large your bichon is, but I know they are generally around 20 pounds, so the 1/2-inch needle may be an appropriate size for him/her. If your dog, however, doesn't have a lot of body fat or if you think a smaller (shorter) needle would make him/her more comfortable or more accepting of shots, you could use the minis. (I think you should ask your vet first, just to make sure the needle would deposit the insulin far enough into the fat layer beneath your dog's skin to be absorbed like it's supposed to be.) If your vet says it's okay to change, the next time you go to buy syringes, just tell the pharmacist you're buying them for your dog and ask for the mini syringes. They're the same price (or nearly so) and still don't require a prescription.

Before I go, can I congratulate you on dealing so well with your dog's diabetes? It sounds like you and your husband have the insulin regimen down to a science (i.e. giving meals within 1/2 hour of shots). It's this kind of routine that will keep your bichon healthy and living a long life. Regular meal and shot times,a good diet, and a regular exercise program will help keep your baby's blood sugar in close-to-normal range, and that's what keeps all of us diabetics healthy and living normally. Good job and good luck!

Shelley

Shelley Cetin Hub Author 2 years ago

Hi, Shirley.

I did give Ozzie his shots right after he ate; however, when he was 13, his stomach became sensitive and he would sometimes throw up, so we started giving his shots about 20 minutes or so after he ate to make sure he could keep it down. (Ozzie was physically very old at 13; since he had been diabetic for 6 years, my vet said he was probably several years older in physical terms.) This delay never affected his fructosamine levels, which were always excellent. (Fructosamine is one test vets run on dogs to check glucose levels over time.)

Your daughter is correct that Max's food is digesting before his insulin is peaking. Novolin begins working at 1-2 hours after injection; it peaks at about 6 hours. The carbs in Max's food will be digesting or digested within a couple of hours. To explain quickly, proteins take several hours to digest, and fats take even longer. A good diet for a diabetic dog is one that balances carbs, proteins, and fats so that over time, the dog's system has sufficient glucose in it to prevent lows but doesn't have so many carbs that glucose levels rise too high. I looked up Max's food online and it seems to have a high level of protein and enough fat to further "buffer" the carbs. I did notice that his food contains blueberries and cranberries, but they're not high on the list of ingredients, so they shouldn't add too much sugar to the mix. If your vet is okay with Max being on this diet, and if Max isn't getting any lows, this looks like a pretty healthy food for him. Ozzie was on Science Diet W/D, which is formulated to control weight and blood sugar levels, and he always did quite well on it.

I also noticed that Max's food is pretty high in fiber (4%). Fiber is good for diabetics,especially if you're trying to lose weight. It keeps you feeling full long after you eat, and if the fiber is soluble, it lowers blood sugar levels. So Max's food will keep him from being hungry even while he's getting slimmer, and it may also help keep his blood sugar in check.

One other thing to consider is how much exercise Max gets. Vigorous exercise in humans lowers blood sugar levels continuously for up to 24 hours! So if you are walking Max 2 or 3 times a day (and he's really walking, not just stopping and sniffing, stopping and sniffing), you are lowering his blood sugar levels. His exercise program should be regular, so if the weather won't permit walks, get him to do some active play inside. (See my article on exercise in diabetic dogs.) The combination of a balanced diet with a high fiber content, a regular injection and meal schedule, and regular exercise will combine to keep Max's glucose levels under good control.

If Max's glucose levels are at the levels your vet wants, you're are doing everything right, and I wouldn't think that the 1/2-hour delay between his meal and his shot will make that much of a difference. (Remember that exercise is lowering his blood sugar levels even as he eats his next meal, and the fiber in his diet is also helping keep the carbs being digested from raising his sugars too high.)

I didn't check Ozzie's glucose levels that often - mostly because he wouldn't tolerate it. I checked his urine 2 or 3 times a day to make sure his sugars weren't getting too high. I also think that vets have only recently been recommending that their clients test their pets sugars by "sticking" them. If I ever noticed that Ozzie's sugar was high (from the urine test strip), I would take him to the vet's for a quick glucose test, but that didn't often happen. His fructosamine tests/glucose curves were always excellent. I also think the fact that I have juvenile diabetes tuned me in to Ozzie's diabetes. I could tell just by looking at him or watching his behavior when his sugar was dropping. If he seemed lethargic, I'd take him off to the vet for a quick blood sugar test. If you are checking Max's sugars regularly, I think that's great! You're helping him to stay healthy.

I know this is a lot of info. Sorry! Let me know how your baby is doing from time to time. I'd love to hear about him!

Shelley

Shelley Cetin Hub Author 2 years ago

Hi, Steve.

Wow, I've never heard this type of situation with a diabetic dog before. Most dogs are on a regimen of a meal before each shot, because that way you can ensure that sufficient food has been digested before the insulin starts to lower blood sugar. (Food is broken down into glucose, and then the insulin "unlocks" the gate in the blood cells to allow the insulin in. Once insulin is in the blood cells, it begins lowering blood sugar by converting the glucose into energy.) The problem I see with your dog is the danger of her not consuming enough food, and thus not getting enough sugar in her system before the insulin starts lowering blood glucose levels. If that happened, your dog would have a hypoglycemic (i.e. low blood sugar)reaction, the results of which could be mild (confusion, hunger) to severe (coma or death).

Since you refer to your dog's "shots," I assume her vet has put her on 2 shots a day.Does he/she know that your dog just "grazes" throughout the day? You also don't say how much insulin your dog is taking, and how much she weighs. Does she take the same amount of insulin in each shot? Does she truly nibble, or does she eat a pretty big breakfast, then nibble during the a.m. and afternoon hours, and then eat more in the evening? That type of eating habit could be okay, since it would be like she's having 2 meals and then some snacks through the day. But if she's truly just eating a bit here and there all day long, I think that could be very dangerous since you have no way of predicting exactly when she'll have sufficient glucose in her system for her insulin to act on. If your vet put her on 2 different amounts of insulin - a small amount in the a.m and a larger amount in the p.m. - your dog might be okay, since a smaller a.m. amount would likely just cover the normal rise in glucose that happens with simple daily stresses. Then the p.m. amount would cover the food amount ingested the rest of the day.

I think this is a real puzzle if you and your vet didn't discuss your dog's eating habits when the shots were prescribed. Since I'm not a vet, I can't advise you as well as your dog's doc can, but I do think that you should at least talk to the vet. He/She can then figure out how to adjust your dog's dosages to ensure that she doesn't start having "lows" when her insulin peaks (becomes most active).

Let me know what you learn. Good luck!

Shelley

Shelley Cetin Hub Author 2 years ago

Hi, Savannah.

I'm sorry Mac is crying when you give him his shots. Poor little guy! He may be scared and cry from his fear, or there may be another reason. Is he a little dog? If so, you might want to switch to the "mini" needle syringes. If you go the pharmacy and tell them you want the smallest needles available, they can give you tiny needles (actually meant for babies). I used these on my little maltese Ozzie, and once I switched, his shots never seemed to hurt him. (Longer needles penetrate more deeply so can hurt more.)

You should, of course, do what your vet recommends regarding Mac's care, but different vets suggest different times for meals and shots for different reasons. Some diabetic dogs also have sensitive stomachs or other problems that can make it better to give them their shots after they eat. That way, if a dog is going to get sick or if he/she won't eat, you don't have to make a trip to the emergency vet clinic to get glucose into their system to compensate for the insulin you just introduced through the shot. That's the reason my vet tells me he suggests giving shots after dogs eat. If you have no doubt that Mac is going to eat, feeding him after his shots won't be a problem. Just remember that if he ever DOES refuse to eat after you've given him his regular shot, you MUST get him to the vet or an emergency clinic asap. If you don't, he could die from low blood sugar. If this possibility worries you, ask your vet whether he thinks you can give Mac his shot after he eats (waiting 15-30 minutes after a meal is usually enough time to be sure he's going to keep the food down).

Good luck with Mac and let me know how he does with his shots if you change to the shorter needles. They really do hurt less!

Shelley

Shelley Cetin Hub Author 24 months ago

Hi, Michele.

I know how overwhelming it is when your dog is first diagnosed. It was overwhelming for me and I had had juvenile diabetes and had been taking care of myself for many, many years. I'm glad Lucy is already feeling better. The insulin she is now on has saved her life!

My husband and I have sometimes had the same problem you and your husband are now having with trying to work Lucy's shots around your work and travel schedules. I'll tell you what we did and try to fill in some blanks for you in regular people speak.

First, when you say you've been told the insulin is more important than the food, that is only partly true. Lucy needs insulin to live, so her shots ARE of primary importance. However, she CANNOT be given her normal (full) dosage of insulin without eating. To do this would be tantamount to killing her - your vet may very well not have explained this to you

Anyway, you probably have basic knowledge of how the digestive system works. When Lucy eats, her digestive system breaks her food down into glucose. The glucose needs to get into her blood cells and be converted into energy. Insulin is like the key which opens a "gate" into her blood cells. Without the key, the glucose can't get into her cells, so her body literally starves no matter how much she eats. This is why she had lost so much weight and was so tired before she was diagnosed. She was starving. When she started taking insulin, her body once again was able to use the food she ate, thus the immediate weight gain and increased energy. Make sense?

Now for the complications. When a normal dog eats, its pancreas produces just enough insulin to compensate for the corresponding rise in blood sugar. If the dog eats a little, the pancreas produces a little insulin, a lot, it makes a lot of insulin. Since Lucy's pancreas no longer produces insulin, you have to introduce it in the form of shots - and if Lucy doesn't take in the correct amount of food (ultimately, glucose) to balance out the insulin, she will have low blood sugar. Insulin moves glucose out of the blood system. Too little insulin and too much food = high blood sugar. Too much insulin and too little food = low blood sugar. You want to achieve a balance of insulin to food and exercise (which has a lowering effect on blood sugar) in order to keep your little Lucy in the best health and avoid problems.

So...now to your question. What to do when you have to postpone her evening shot? Your vet told you to administer the insulin every 12 hours. If you have to give a shot an hour or two later, and thus feed Lucy an hour or two later, that probably won't make that big a difference. (Remember that when you give her shot late, that means that her next a.m. shot is going to be coinciding with her previous evening shot, so she'll have a 1- or 2-hour "double dose" in her system. That could compensate for a higher blood sugar level resulting from the late shot.) If you go later than that window, you could be asking for trouble. With no insulin in her system, Lucy's blood sugar will rise, and the more you play with her established regimen, the harder it will be to control her diabetes. It's the delicate balance which will keep her healthy. (Read my articles on the importance of exercise and on low blood sugar to get familiar with the food/insulin/exercise regimen.)

What to do? Well, if the delays don't happen often, I personally wouldn't worry about it too much. You can check her blood sugar when you get home late to see if it's very high. (Did your vet ask you to check her blood sugars or are you doing simple urine tests to track them?) If her sugar is a bit high, that 2-hour overlap I talked about earlier may take care of it when she has her shot in the morning. This is what I used to do with my little Ozzie, and his fructosamine tests were always excellent. (That test can track your dog's blood sugar over time to see how well the diabetes is being managed, and you should probably have this done periodically to make sure Lucy is on track and well managed.)

If you're going to be very late - 4 hours or more - you can do several things. The easiest is to have another person administer Lucy's shot on time. Have both you and your husband learned to give her shots? If not, you should, so that that if one of you is late, the other can give it. What if you're both gone? Do you have a friend or a family member who would be willing to learn to give Lucy her injections? My sister learned to give Ozzie his shots and helped us out a lot until we moved across the country (from Kansas City to the D.C. area).

Another possiblity if you're going to be very late is to hire a pet sitting service that has people qualified to give injections. I'm not sure where you live, but in most cities you can find services that will come to your house (find one that's bonded and insured) to give a shot. When I was working long hours along with my husband, we hired such a service. It had several former vet techs working, and when we were both unable to get home, one would come to our house, give Ozzie his shot, and then feed both him and Molly (our cairn terrier). If we wanted, they'd stay and walk or play with them. We used this service a couple of times when we were gone for several days, and it worked great. (I left detailed instructions and they came to meet Ozzie a couple of days before we left so he would feel comfortable getting his shots from them.) To find a reputable service, ask your vet's office to recommend several, and then make your choice.

I know this is a lot of information, but I wanted to make sure I gave you enough info to answer all your questions. If you have any other questions, write again. (You can send me a personal email by clicking on my name at the top of this page or by going to my profile.) Please let me know what you do and how everything is going for Lucy!

Shelley

Shelley Cetin Hub Author 24 months ago

Hi, Patty.

I'm REALLY concerned about your dog. If your vet can't get his sugar under control soon, he could die. 450 is way, way too high for him, and if that's the lowest his sugar has been since diagnosis, something is terribly wrong (which you already know).

I have a couple of comments about your vet's treatment, but please remember that I'm basing my comments on my own experience and knowledge about dogs and diabetes. (I'm not a vet.)

1) Did you know that Vetsulin was recalled by the FDA in the U.S. back in November? It is now available only to vets and the FDA has recommended that vets put dogs on another insulin. You're the second person who has told me their vet has had their dog on Vetsulin after the recall, and I cannot understand why a vet would do this. Vetsulin is a) considerably more expensive than other insulins and b) questionably safe for pets. I suspect that some vets are trying to get rid of their supply because it's now only sold through their offices. I can't say this for sure, but I wouldn't want my dog on it, and obviously it didn't help your St. Bernard.

2) PZI insulin is primarily used for cats. Did you vet give you a specific reason for putting your dog on PZI? PZI is unique in that it is an insulin mixed with protein, which slows the absortion of the insulin from the injection site. However, PZI is sometimes poorly absorbed; this could be what's causing your dog's high blood sugar levels.

3) Most dogs respond well to human insulins meant for people (for instance, Humulin N or Novolin N). (Vetsulin and PZI are for animals.) Is there a specific reason your vet has not tried your dog out on Humulin N or Novolin N?

If this were my pet, I would either insist the vet put my dog on a more commonly used insulin (like an N), or I would go to another vet. Three weeks is just way too long. Most dogs respond immediately to being on insulin, so something is seriously wrong with this picture. Vets who both prescribe and dispense prescription pet insulins do get a "cut" from sales, and the two insulins you mention are more expensive than Humulin N and Novolin N. (The latter 2 mentioned are 12-hour insulins your dog would take twice a day and they are non-prescription...you can get them at any pharmacy. They are also generally less expensive.)

4) The costs you have incurred so far in attempting to get your dog regulated are pretty close to inexcusable, expecially since your vet's actions about the dog's not responding well to the PZI aren't very responsive. Yes, it's costly to treat an animal who is acutely ill, but when he changed the insulin to PZI and it still hasn't worked, he forced you to spend even more money on repeated visits to his office - with no results. Why in the world did he ever send your dog home with such high blood sugar levels? He should have been regulated before he left the hospital! These sugar levels mean your dog's internal organs are being damaged, his eyes, his nervous system, his digestive system, his heart, etc....all are being damaged every minute his blood sugar isn't under control. Leaving him at 450 and continuing to just raise the dosage of an obviously ineffective insulin is at best callous. (This is unless he has a very good reason to believe no other insulin would work, which you don't mention.)

Be assertive and insist that your vet do something immediately to lower your dog's blood sugar (i.e. change his insulin type)or give you specific reasons why he can't/won't do so. If he can't/won't give you a good explanation, take your dog to another vet. I say this as someone who has a very responsive - and responsible - vet who has always tried to keep my dog healthy and who keeps me apprised of costs. I am mortified that your vet has allowed your poor dog to go for so long in such a dangerous condition and you should insist on knowing why he has done so.

Shelley

Shelley Cetin Hub Author 23 months ago

Hi, Binkie!

(Sorry, but that's the only I.D. I had for you!) It sounds like your little dog is moving toward where she needs to be, but 285 is still pretty high. If you can get her glucose checked again in 2 or 3 days and see where she is - or check it yourself - make sure her numbers are still moving down. I know vets say they are happy if a dog's glucose is at or below 200, so if you can get her stabilized below that number, she'll feel much better. Remember, too, that regular exercise will help keep her blood sugar levels under control. (Exercise helps lower blood sugar, and should be a regular part of her routine - walks, etc., at the same time and for the same length of time each day. But get her sugars under control first and then ask your vet how much exercise to give her and how to adjust her food/treats to compensate for the lower sugars.)

Good luck with your little dog. Keep working at her regimen and she should be able to feel like her old pre-diabetic self!

Shelley

Shelley Cetin Hub Author 23 months ago

Hi, Binkie!

(Sorry, but that's the only I.D. I had for you!) It sounds like your little dog is moving toward where she needs to be, but 285 is still pretty high. If you can get her glucose checked again in 2 or 3 days and see where she is - or check it yourself - make sure her numbers are still moving down. I know vets say they are happy if a dog's glucose is at or below 200, so if you can get her stabilized below that number, she'll feel much better. Remember, too, that regular exercise will help keep her blood sugar levels under control. (Exercise helps lower blood sugar, and should be a regular part of her routine - walks, etc., at the same time and for the same length of time each day. But get her sugars under control first and then ask your vet how much exercise to give her and how to adjust her food/treats to compensate for the lower sugars.)

Good luck with your little dog. Keep working at her regimen and she should be able to feel like her old pre-diabetic self!

Shelley

P.S. You said you weren't sure where to give her shots. In your mind, create a 'grid' along each side of her back. With each shot, move about 1" down the grid to about 1/3 of the way down her back, then move over 1" and go back up, then over and down, etc. Start over at the beginning point once you've completed the grid. This is the best way to keep her body from forming fat deposits from the shots and from irritating the tissue. Good luck! S

Shelley Cetin Hub Author 23 months ago

Hi, Patty.

I'm glad your vet agreed to put your dog on generic Novolin. Over the long run it will save you money and it sounds like your dog is responding to it better than to the other two insulins the vet was using. It sounds like the generic Novolin is having a good effect. Your vet has told you he can't increase your dog's insulin too fast for a good reason. If he moves it up too quickly, your dog's system could become overloaded with insulin and he could have a hypoglycemic (low blood sugar) reaction. Low blood sugar is dangerous, too, and at extremely low levels can be fatal. So it sounds like your vet is being careful by increasing the dosage every couple of days. He's giving your dog's body time to process the new dose on the new insulin before he adds anything else to the mix. If your dog's blood sugar is now wavering between 400 and 300, he's on the right track, and those numbers are a great improvement over the 500s and 600s he was probably at before. (Most home meters will read numbers up to 600.) If he went down to 303 on 35 units and the vet is going to up the dosage by 5 units every 2 days, it won't be long before your dog's numbers are where they should be, so already the extremely high sugar levels that were making him so sick have been greatly reduced. You don't want the opposite effect (low blood sugar) to hurt your dog either, so can afford a little patience now that the vet has him on the right path. (Your dog's at 35 units now, so that's only a week before he's at 50 units 2x daily - where the vet says he should be.)

The vet probably doesn't want you to change your dog's diet while he's still trying to get him stabilized. He wants to be sure the dog is ingesting the same amount of food, the same quantity of carbs, etc. so that he can avoid more blood sugar swings that necessary. Once your dog is stabilized, you can then discuss a change to a healthier diet for your dog. But be aware that when you do make a diet change, your vet or you will have to observe him closely for the first couple of days - checking his blood sugar often - to see how the food affects his blood sugar. A high fiber, low-fat diet will lower his blood sugar somewhat, so you/the vet will need to lower your dog's insulin dosage as well.

It sounds like your vet is taking as quick a course of action as he can safely do now that your dog is on a more effective insulin. Remember that it won't be much longer before he'll be at the optimum level of insulin for his weight, and then he'll stabilize. Is your dog showing any signs that he's feeling better? Does he seem to have more energy through the day and evening? Does he seem more alert (not so drowsy and lethargic)? Has his water intake decreased to a more normal level? Is he not panting excessively? Is he trying to play a little if you offer him a toy (even if he can't see it)? Does he again have a playful attitude when you approach him, pet him, scratch his ears, talk to him? These are all signs that his body is recovering and that the insulin is doing its job. With the already lowered blood sugar levels, his organs are already in less danger of damage, so as his blood sugar becomes more normal, they'll once again be in a "safe" environment.

By the way, I'm so sorry your baby is now blind. (Is he completely blind or does he have some residual sight left?) Lots of diabetic dogs gradually lose their sight, and the chance of their becoming blind if they go into a coma is much greater. (Blood sugar levels have to be really high to cause coma, and that excess sugar can damage the retina and blood vessels in the eye.) Ozzie started losing his sight about 4 1/2 years into his diabetes, and when he died, he has lost all of the sight in his left eye and had about 30% vision in his right. However, dogs are amazingly resilient creatures and can learn to function despite handicaps. You'll find that your dog will start to use his sense of smell and his hearing to guide him at first. It won't be long before he has the layout of your home memorized and he'll be able to walk freely from room to room without being scared to move. If you have a yard, he'll use his nose and ears to scope it out and to memorize its dimensions and size. One suggestion: when he does feel well enough to begin exploring, make sure you don't move the furniture around or he'll run into it and could hurt himself. Walk the yard periodically to remove branches and sticks that could pose a danger to him; you don't want a branch poking him and possibly cutting him. Check the fence to be sure there aren't any sharp edges sticking out - either repair them or cover them with duct tape. It'll be like babyproofing your house to keep him from hurting himself.

Let me know how your dog does over the next week. I expect to hear that he's feeling better, getting some energy back, and starting to act like his old self again.

Shelley

P.S. What's his name?

Shelley Cetin Hub Author 23 months ago

Hi, Patty.

I'm so glad to hear that Buckwheat is doing much better. It looks like he's responding like he should to his new insulin, and if you can keep him on a regular regimen - with the same amount of food, same number of treats, and same level of exercise each day - he should be able to live a pretty healthy life. I think I mentioned that Ozzie lived for 7 years with diabetes, so it's possible.

I still don't understand why some vets are continuing to give diabetic dogs Vetsulin. The FDA recalled it for good reason, and you're the 4th person who has told me that their dog didn't respond to it (and whose dog then got much better when put on Novolin or Humulin N). Congratulate yourself that you were assertive enough to see that Buckwheat got the right insulin and that he's now doing better because of it. You said he's jumping up in the morning and now feels like going for a walk. That's because his blood sugar levels are stabilizing and he is feeling better. Keep up the walks, which will help his diabetes stay stable, try to get some fiber in his diet, and he should do fine.

Good luck with Buckwheat and with your other dog, Titan. I hope he gets better, too!

Shelley

Shelley Cetin Hub Author 22 months ago

Hi, Becca.

I've been on vacation and unable to anwer you until now. I can somewhat understand why your vet doesn't want to increase your dog's insulin if her levels aren't under control - except that even on 35 units 1x daily, her levels are still very high. You've got a difficult situation - your dog needs more insulin to lower her blood sugar, but if you give her more insulin and she doesn't eat, her levels could go low enough to kill her. Either way, it's not good.

Has your dog never eaten food in the morning? Does she generally not like her dog food, or are you certain that it's just a dislike of eating at that time of day? If she used to eat in the morning and has recently stopped (maybe you changed her diet some time back and that triggered the behavioral change?), you might try a different food. Ask your vet if he can suggest a food for "picky eaters." (Several companies make them and they're supposed to be more flavorful and therefore encourage picky dogs to eat.) That's the first thing I'd do.

Alternately, if you give her dry food in the morning, you might try adding something more appetizing to it to coax her into eating. For example, add some moist food to the dry, or cook white meat, skinless chicken for her and add little bits to the dry food. This will often help train a dog to eat more often.

A final suggestion would only work if your dogs is not getting hungry because she's eating too many treat between meals. If that were true, she simply might not be hungry in the a.m. because she's relying on treats to satiate her hunger. In this case, you have to take away ALL between-meal treats. Offer your dog treats ONLY after she eats her regular meal so that she learns to associate getting a treat with eating her breakfast/dinner. Eventually, this will help adjust her hunger levels so that she'll always be ready to eat her two daily meals.

Once you can get her to eat in the morning, you'll probably find that your vet will be willing to increase your dog's insulin dosage. Right now, he's doing the only thing he can in order for your dog not to have hypoglycemic (low blood sugar) reactions, which can be even more immediately critical than raised blood sugar levels.

Good luck! Let me know what happens. (I won't be going on another vacation for some time.)

Shelley Cetin Hub Author 21 months ago

Thanks for the helpful hint about giving shots in the upper thigh, Sherry! I've never had a vet mention that, so maybe other "parents" of dibetic dogs will be able to use that if their dog is hard to control during injections. This idea of giving the injection in a closet or bathroom - where there's less room to move around - is also a great idea.

I hope your Bichon will soon be regulated. As you can see from some of the other posts on this site, it can take a while to find the right insulin. (Be careful of Vetsulin, though, if that's what your vet has your pup on!!!! The FDA has recalled it, but some vets are still using it, possibly to use up their supplies.)

Shelley

Shelley Cetin Hub Author 21 months ago

Hi, Lisa.

I just happened to be online and your question came to my email. You know, my vet initially told me to give my dog his shots and then feed him (he said 30 minutes to one hour after), but several times Ozzie didn't want to eat after he'd had his shot. (And we ended up in an emergency clinic to get glucose in his sytem.) So I asked my vet, who said to let him eat first just to be sure he had food in his system before introducing the insulin. Ideally, by waiting the hour, your bichon's system won't be "hit" so hard by the glucose his food is converted to after he eats. The one hour gives the insulin a chance to start gearing up to lower his sugar, and then the food hits his system. That means there's a shorter period of time with a "surge" of glucose in his system from his digested meal. (Depending on what type of insulin he's on - I assume a 12-hour N or something similar - the insulin takes about 4 hours to "hit" his system, and it peaks - or has fullest effect - 6 hours after the injection.) Your vet is trying to keep your dog's glucose levels as flat as possible, or keep your dog's blood sugars as close to those of a non-diabetic doggie as he can.

If your dog doesn't have a sensitive stomach, doesn't ever throw up after a meal, and has a good appetite, you're probably fine continuing with your current regimen. Some vets recommend giving shots before meals, some recommend giving them after. It often depends on the dog. But if your dog has never had a problem, there's no reason to change. If you are around when he eats - and for a while afterwards to make sure he keeps it down if he ever shows signs of illness - he should be find. But if he does ever seem a little "off" or sick to his stomach, be very careful what you do. Call your vet to see how to administer the insulin on a "sick day."

Regarding whether or not it's dangerous to give your dog his p.m. shot one hour earlier than usual, I would say no. By having his shot one hour earlier, there will be a one-hour overlap of his two insulin doses; however, his insulin (if it's an N), doesn't start really lowering his blood sugar for 3-4 hours, so the one-hour overlap isn't going to hurt him. The one way it could, I think, is if your dog's blood sugar is low for some reason, but if you check his sugars before he eats, you should be fine. (When I was on Humulin N several years ago, I sometimes had to take my nighttime shot a bit earlier or later, and I never had a problem. And we occasionally had to give Ozzie his shot a bit early or late - if we had to work a little later than usual, for instance - and he never had a problem related to that one-hour overlap.)

Good luck with your little bichon. I'm glad he's doing so well on his insulin shots. Dogs are such amazing creatures, aren't they. They get used to their new routines so quickly!

Shelley

Shelley Cetin Hub Author 21 months ago

Hi, Frankie.

I assume your dog has had insulin injections from your vet or his/her tech. So your dog is actually accustomed to getting shots from certain people. What's different about this situation is that she'll now be getting a shot from you, and this is likely to make her nervous because it's likely to make YOU nervous. If you've read all my suggestions above - and you've practiced a lot on an orange - I think the worst thing that could happend is that your dog could flinch when the needle goes into her skin...and that could hurt her some. But dogs can generally can be distracted from the tiny prick of the needle with a treat. If you have someone to help you, have that person stand in front of your dog and offer treats (little ones or one that will break into smaller pieces that she'll have to keep fishing for) while you are doing the injection. That way, your dog will be more interested in the treats and if she does flinch, your helper can keep her eyes on the treats. This will get easier over the first week or so, as she begins to realize this is her routine from now on. She'll start to accept it. The worst - but very, very unlikely - thing that could possibly happen would be that you hit a little vein and inject the insulin directly into her bloodstream. In giving my dog shots for 7 years, I only saw blood once and immediately stopped the shot before I injected him. If you ever do finish injecting the insulin and you see blood coming from the skin, take your dog to the vet IMMEDIATELY. (If this ever happened, the insulin would immediately enter your dog's bloodstream and could kill her very quickly.) Quickly grab some treats, get some sugar from the kitchen, put it in some type of little container, run a tiny bit of water into the sugar to make a thick paste, and while you're in the car (hopefully with another person driving), feed the sugar paste to her on your finger. Give her treats, too. The idea would be to get as many carbs into her system as quickly as possible because her blood sugar would drop very, very quickly. You should program your vet's number into your phone for emergencies with your dog, but especially an emergency like this one. Your vet would have to give your dog an I.V. with glucose to keep her safe.

However, as I said, this is almost an impossible situation. I know somebody wrote me a couple of months ago and told me this had happened to her, but I can't find the comment on this page - it may be on my page about hypoglycemic reactions in dogs. You might want to go to that other article and read it, too, because it has some good information about what to do if your dog's blood sugar gets too low and also about how to recognize low blood sugar. It's my experience that most vets don't information their clients about low blood sugars, but you should inform yourself just in case.

I've probably scared you here by outlining these worst-case scenarios, but it's always better to know what would happen beforehand. That way, if the worst does happen, you already know what to do and can handle it - and save your dog. With your dog's shots, just make sure to practice. And to avoid injecting the insulin into her bloodstream (if, for instance, she's very thin), you can insert the needle, pull BACK on the plunger, and if there's no pink or red in the syringe, you can safely give the shot. Good luck with your dog!

Shelley

Shelley Cetin Hub Author 21 months ago

Hi, Linda.

I've never heard of any fungal growth being associated with diabetes in dog; however, I suppose that since diabetes weakens the immune system, it could make it hard for a dog's body to fight a fungal infection. Has your vet not given you a name for this fungus? The first thing I thought of when I read your description was ringworm! It's a fungus, causes hard, crusty growths, and can occur on paws. You say that your dog is on meds that that they're not working; however, you should remember that fungal infections are typically hard to get rid of. (Think of how long human has to use anti-fungal meds to cure foot fungal infections, or how long it takes to get rid of a simple wart.) So the meds could be working, just not yet showing their effects.

Be very careful when handling your dog's feet! If in fact she has ringworm, you should wash, wash, wash your hands, even after wearing disposable protective gloves while removing the fungus. Ringworm is highly contagious and can spread to humans. If your vet hasn't told you this is ringworm, or given you a name for the fungus, you might ask if there's a specific test he/she can do to determine exactly what the fungus is. (I.e. has the vet done a culture?) There are lots of different fungal infections, and they require different treatments, so it's important that you know which fungus and which treatment.

Good luck with your little fur kid. I really hope her little paws get better. In the meantime, be careful when cleaning her paws!

Shelley

Shelley Cetin Hub Author 20 months ago

Hi, Mary.

I'm SO glad that this site helped you with your diabetic Aussie mix! It sounds like you've worked hard to find a 'system' that works for you both and that he's finally settled into his new diabetic routine. His diet sounds interesting (dog food + cat food!) but it must be working since he's now regulated and has a good appetite. Congrats!

Thanks so much for your kind comments about my site. I wrote these pages because I felt so sorry for other parents of diabetic fur kids who - unlike me - had never cared for a diabetic, had no idea what the disease was or what it entailed, and hadn't received much (if any) training from their vets When our little Ozzie was diagnosed, it was heartbreaking, but at least I had a pretty good idea of how to care for him because I had been living with juvenile diabetes for so long. The idea that there were people who might put their dogs down due to being unable to cope or due to a lack of knowledge just killed me, so I started writing these pages!

I hope your baby stays well and has a long, healthy, normal doggie life. It's possible for so many diabetic dogs...and they deserve to be healthy as much as human diabetics do! Best of luck!!! Shelley

Shelley Cetin Hub Author 20 months ago

Hi, Kimberly.

I'm so sorry it took such a long time to find out about little Teddy's diabetes. Shame on that first vet! If your dog was urinating constantly, the first test the vet should have done was a blood sugar (or even a urine dip to check for ketones in the urine). That vet was an idiot and now your little guy is going blind.

You don't say in your message how much Teddy weighs. I assume he's a very little dog if he's only getting one unit of insulin twice daily. That's not much at all; however, if he's then having reactions (i.e. low blood sugar), the amount obviously isn't too little. You seem to be associating his shaking with both low blood sugar and fear of his shots, but I assume that you're checking his blood sugar before administering his insulin shots. Does he shake because he's still upset even after his shots? I need to know several things before I can tell you what I'd do for Teddy:

1) What kind of insulin is he taking? I assume he's on an N (Humulin N or Novolin N), which is what most vets put dogs on. There's another kind of insulin - Vetsulin - which was recalled by the FDA but which some vets are still selling. If Teddy is taking Vetsulin, I would immediately go to your vet and demand (yes, demand!) that he put him on another insulin,. Vetsulin can be poorly absorbed in dogs and can cause inconsistent blood sugar levels. I don't know if it can cause hypoglycemic reactions, but you could ask.

If Teddy's on an N formula, that means he's on a slow-acting insulin which will peak about 6 hours after he has his shot. Ns don't even start to lower blood sugar for several hours after injection, so if he's on an N, but having low blood sugar shortly after you give his injections, it can't be from the shot itself. It could be that his blood sugar has been low all night (if he's shaking from low blood sugar in the a.m.) and that when he gets up, he's actually on the verge of "bottoming out" from his previous evening shot, his blood glucose getting really, really low overnight.

2) You don't say, but are you actually checking his blood sugar levels when he is shaking to verify that the shaking is caused by low blood glucose? If not, you must do this. His shaking could be caused by nothing but fear, in which case treating the shaking with gel glucose and Karo syrup will only result in high sugar levels.

If you are checking and thus know that he's shaking from hypoglycemia, you're correctly treating the low. I'm going to give you a 3rd possible explanation for his shaking, though. It could be that simply going through low blood sugar - how he feels shaky, how he can't think clearly, how he may not be able to control his body, walk, move normally - may be scaring the little guy to death. Having a reaction is - and I speak from personal experience, having lived with juvenile diabetes for many, many years - a very frightening experience. Humans can understand what has happened - at least after the fact if not during - but a dog can't. Dogs are used to being in control of their limited environments, so if Teddy finds himself confused, dizzy, shaking uncontrollably, feeling numb, he may be terrified. He literally doesn't know what's happening to him, so even after his blood sugar comes back up, he may be remembering the inexplicable way he was feeling a few minutes ago and feeling scared to death that it's going to happen again. He may feel completely unable to control his environment, and his sense of "normal" has been changed, so he's finding himself in a new world. This can take some getting used to for a newly diabetic pup. If this could be what's bothering Teddy, I recommend first (and you're already doing this) working to get his sugars under control to prevent the lows and second, lots and lots of cuddling and reassurance when he has a reaction and afterward.

3) You ask about signs that your dog needs insulin. There aren't any specific signs to speak of until a dog gets into the high danger zone. There, you'll see constant urinating, panting, lethargy, etc. When a diabetic dog's blood glucose is under good control, or even moderate control, you just can't tell from appearance or behavior that he needs insulin. So you're right to test Teddy. I think that 120 is kind of low to be administering an insulin shot in a dog that has a history of hypoglycemic reactions. It sounds as if Teddy's constantly having trouble keeping his sugars "up," so for him, a 120 may be a 6- or 7-hour high. If he's at 120 when you give his shot, and he's on a good diet and a regular exercise program, he may not be topping out very high, so he can end up having too much insulin in his system. I'm not a vet, so I can't tell you exactly where his blood sugar should be before you give an injection, but I would definitely ask the vet what level he should be at before you give him any insulin.

4) Does Teddy get any treats during the day and evening? If not, I would start giving him periodic treats. These can provide the boost he needs to prevent low blood sugars. Find something healthy - no more than 7% maximum fat to keep his heart and circulatory systems healthy. There are a number of good brands on the market that make low-fat treats - look for Grreat Choice (not a mis-spelling) or check out the famous brands (Science Diet has some and so does I-Vet). If you can find something that's the size of a small Milkbone, give him one after breakfast, one at mid-day, maybe one mid-afternoon (depending on his blood sugar level) and one after dinner(ditto). Decrease or increase the number of treats according to how his sugar levels look until he stabilizes. You may find he does well with 3 treats a day, or maybe with 2 or 4. But treats are a good way to start to keep his sugars from going so low, and a treat or two after dinner may keep his nighttime sugars from getting so low that he's shaky at breakfast time.

Good luck with Teddy! Keep working to get his food, exercise, insulin, and treat balance at a good level and he should stabilize. But please talk to your vet about what level his blood sugar should be at when you give him his insulin shots. Shelley

Shelley Cetin Hub Author 19 months ago

Hi, Beryl.

I only now got your email and it's Thursday morning. However, I hope that you gave your poodle his shot last night. Any time you think (or are certain) that not all the insulin in your dog's injection went in, you need to call your vet. Your dog needs a specific amount of insulin daily in order to live. With less than that amount, or with no amount at all, his blood sugar levels will rise. If they rise high enough (i.e. if not all the insulin in his shot goes in several times or if you completely miss a shot), your dog could have severely high blood sugar levels. This is very dangerous and could even result in death. So please call your vet as soon as you see this message! He/She needs to do a blood sugar test to see where your dog's glucose level is so that he/she can administer insulin and get your dog's levels back to normal.

I'm sorry you're having such anxiety giving your baby his shots. I know it's hard, but you really do need to calm yourself, especially because when you're afraid and nervous, your dog is afraid and nervous. Is there another person who can help you with shots until you feel more comfortable? If so, ask someone else to hold your dog - or to sit on the floor and pet and distract your dog - while you give the shot. This might help you to see that the shots aren't painful. (I'm diabetic and take several shots a day; you really barely feel a thing.) Read the other comments above to see how I've advised other people with similar problems and try various "tricks" until you start to feel more relaxed. If your dog is little, ask the vet if you can use the mini needles for his syringes. These are syringes with very short needles meant for babies and small children. They don't go in so deep, and so aren't appropriate for all dogs, but I used them on my maltese after the regular-sized needles sometimes hurt him. (Ozzie weighed about 15 pounds; if your dog is about that size or smaller, mini needles should be fine for him.)

Most important: remember that you are giving your dog his shots to keep him healthy, to KEEP HIM ALIVE! If you think of the shots this way, knowing that if you dont' give his shots he'll die, it may be easier to administer them. The insulin you are giving your dog is life-giving, and each time you give a shot, you are literally saving his life. In that way, the shots should become a positive in your mind and help you relax so you can give the shots more comfortably.

Good luck!

Shelley

Shelley Cetin Hub Author 19 months ago

Hi, Beryl!

I'm SO glad you're doing better at giving shots to Quassi. (What a great name!) You're right...it is very difficult to give a shot at the beginning. When my little Ozzie became diabetic, I was very nervous - even though I'm diabetic and knew that the needles don't hurt much at all! I think it's because they're like our babies, and we're afraid to do anything that might cause them pain. But I got used to it by telling myself that I was giving him something he needed to live. I used to give myself a little pep talk just before the shot, then take a few deep breaths and call him to me. In time, once I was used to it and calm, it became a little ritual. It also helped that I always gave him a treat afterwards, so he learned to associate something positive (the treat) with the injections. I would say, "Ready for your medicine?" and he would come running! So you and Quassi will develop your own routine and become comfortable with it in time. Best of luck and health to you and Quassi!

Shelley

Shelley Cetin Hub Author 19 months ago

Hi, Linda.

I know that a lot of owners of diabetic pets like the Ascencia Contour meter or the Freestyle Flash, since these two meters use very small amounts of blood and also pull the blood into the test strip. These are newer meters and seem quite popular. There are also meters calibrated specifically for dogs (or cats), but the ones for humans seem to be as accurate according to some.

Remember that you'll still need to make an appointment with your vet to learn how to get blood from Sassy's ear. You might ask if you can make a tech appointment, telling the front desk that you need someone to teach you to check your dog's blood sugar levels. (If you can do this, it will cost less than seeing the vet, who will then most likely turn you over to a tech anyway.) Tell them that you want the tech to check Sassy's sugar in front of you, then show you how to do it and watch you try it yourself. The tech will, in the appoinment, show you how use the meter, read it, etc. He/She can recommend meters as well, and some vets can offer discounts on the meters and the test strips.

The strips are not cheap. If you have pet insurance, call to see what they will cover, if anything. However, the cost of the meter and that of the strips will pay off in the long run, because (like you said) they will make trips to the vet infrequent and help you get better control of Sassy's blood sugar levels, which will in turn keep her healthy and save on vet bills.

The tech/vet will also recommend a testing schedule (usually first thing in the morning, sometimes also before dinner). They can discuss how to adjust Sassy's insulin levels if she's low before a meal, if she exercises more than usual (which will lower her blood sugar over 24 hours), or if she's sick, vomiting, or has diarhhea.

Take a notepad and pen to the appointment so that you can take lots of notes, because you'll probably not remember everything they tell you. And don't be afraid to ask questions. They can be your best friend in getting a handle on Sassy's diabetesd. Good luck!

Shelley

Shelley Cetin Hub Author 18 months ago

Hi, Linda.

Yes, you can do urine tests to check Sassy's sugar levels. Just remember that they are not nearly as accurate as a blood test; they give you a RANGE of blood sugar possibilities as opposed to a specific NUMBER. You can buy test strips over the counter. Ask the pharmacist if he knows what kind most vets recommend. (I used to use Ketostrips for Ozzie.) These tests can be a bit tricky, especially for a female dog, because you have to catch the urine on the end of the strip. However, the strips are pretty long, so if Sassy has a certain spot where she goes in the morning, you can just follow her out and - there's no other way to say it - put the strip underneath her while she urinates.

To get the best control for Sassy, test her in the morning after she wakes up (and before she has food or insulin) and in the evening (before dinner or her second shot). You don't have to talk to a vet to do these tests unless you have a particular question. Read the instructions in the strip box/on the enclosed pamphlet for how to interpret the strip results. (You'll compare the color of the end of the strip to colors on the strip bottle - easy.)

Good luck with little Sassy. I hope she keeps getting better for you!

Shelley

Shelley Cetin Hub Author 18 months ago

Hi, Linda.

I completely forgot to tell you earlier that our little Ozzie eventually went nearly blind (after living with diabetes for 6 1/2 years. He was completely blind in his left eye and had about 30% vision left in the right one. Dogs are so incredibly resilient. I think he adjusted well, but his blindness was gradual, so your little baby's having a harder time of it. Ozzie eventually learned to navigate the rooms of the house (at least on the first floor). He knew that he couldn't go down steps, so he would bark when he wanted out and wait for us to carry him outside (where he used to go through a pet door). Just don't move the furniture ever again, as your dog will learn the current floor plan and any change could throw her off and cause her to hit her little head pretty hard.

If you have steps in your house that your dog is accustomed to going up or down, you may want to gate them off so that she won't fall. Ozzie fell once (when he found a way past the gate - trying to get to his sister in the basement family room) but the stairs had very thick carpet and padding so he wasn't hurt. (Scared me to death, though!) We mounted stronger baby gates baby gates, anchoring them into the newel posts of the stairs.

Your baby will quickly learn to live in her new world even without sight. It sounds like she's already braving the darkness and trying to find her way around. What a brave puppy! You're right that she depends on you now, but she loves you as much or more than you love her, and she'll find ways to show you, too. Let me know how she does.

Shelley

Shelley Cetin Hub Author 18 months ago

Hi, Kaylee.

I'm so sorry that your little Lilly has received this life-changing diagnosis. Although I know you are all in shock and are worried about how you'll now care for your little girl, you should trust that you can get through this initial adjustment and learn to give Lilly a normal, healthy lifestyle. Lilly, it is true, will have to become used to a completely different routine which will now include insulin injections, a specific food and exercise schedule, and quite possibly glucose tests so you can adjust her insulin according to her sugar levels. There is a lot of information to absorb, but you will soon be accustomed to dealing with all the changes and they will become your new "norm."

You read my article on giving your dog insulin injections. My most important tip for you at this point is to practice, practice, practice giving injections (as I suggest above) until you have the steps down pat and don't have to hesitate too much. This is imperative - if you don't feel secure about the shot routine, Lilly will pick up on your fear and she'll become afraid. So get out a couple of oranges and start loading and reloading a syringe with water and then injecting the orange with it. It really is the best way to get used to giving a real injection.

I hope your vet told you that pancreatitis means that Lilly's body has had a sort of "reaction" to fat in her diet. Once a dog has had one bout of pancreatitis, it can have another, so Lilly will now need a special diet. Because she is also diabetic, her diabetes will be easier to control if she is also on a high fiber diet. Ask your vet if you can start Lilly on Science Diet W/D, a low-fat, high-fiber prescription diet specially formulated for diabetic dogs (but also good for dogs who've had pancreatitis). It comes in both dry and canned formulations; my little diabetic baby Ozzie (whom we lost to cancer after he had lived for 7 years with diabetes) was on W/D for years and had very few problems with high blood sugars. (I have another article on pancreatitis, and you can find information on that condition online.)

Questions to ask your vet:

1) Diet...can Lilly have Science Diet W/D or another high-fiber, low-fat canine diet?

2) Insulin adjustments for illness and exercise...how should I adjust Lilly's insulin from day to day? Can the vet give you a formula to help calculate how much to increase Lilly's dosage if she goes low or high? (For instance, if Lilly's blood sugar is low in the a.m., how much less insulin should you give her? If it's high, how much more should you give her?

3) Should you check her blood sugar levels or is it good enough to check her urine before her meals? (If the vet wants you to do blood sugar tests, DO NOT LEAVE HIS/HER OFFICE WITHOUT BEING SHOWN HOW TO DO THIS and doing a practice "run" yourself in front of the vet or tech.

4) Does the vet have any info on hypoglycemia (low blood sugar) for you? (Read my article on low blood sugar for my tips; find other info online to learn how to recognize and treat low blood sugar. Do this SOON, as Lilly could have low sugars while she is stabilizing over the next few weeks.)

5) Re: pancreatitis...Does the vet have handouts about pancreatitis? Can he/she give you information on what types of foods to avoid so Lilly doesn't have a recurrence? Can the vet recommend any particular brand/type of treats that is low-fat so that Lilly can have a treat if she is hungry, has a blood sugar level tending toward low, or if she has just exercised and needs treats to prevent low blood sugar over the following hours? (My writing can give you some recommendations, but the vet may have others.)

6) What should we do if Lilly doesn't want to eat? (Still give insulin? Give her 1/2 her regular dose?) What to do if Lilly throws up her food after you've given her a shot? This is key...if you've given Lilly her insulin and she throws up her food, she could die because the food won't be in her system to provide the carbs which will turn to glucose in her system. Since insulin lowers glucose levels, if Lilly has insulin in her system but no carbs (glucose), she could go into a coma and die, so your vet should give you an emergency plan to act on if this should ever happen. My little Ozzie was diabetic for 7 years and this happened to him 3 times, but I was prepared. Have Karo syrup on hand to treat low blood sugar, but that won't be enough in a emergency situation, so your vet should let you know exactly what you need to do and how soon.)

7) How much should you exercise Lilly and how often? (i.e. how many minutes a day, walking how fast, etc.) Exercise helps lower blood sugar levels, so it's an important part of the diabetic's routine. Lilly is a small dog, so you need to know how to start her out, how much to increase her exercise, and how to adjust her food/insulin amounts if she can't exercise (because of bad weather or illness).

8)Can you use mini-needle syringes on Lilly? These are insulin syringes with tiny needles, which are actually made for babies. I used them on Ozzie because he was little, and he was much happier to accept his injections after I made the switch. Ask your vet if it's okay for you to use them on Lilly.

9) What emergency clinic does the vet recommend if you have a diabetes-related emergency wtih Lilly after office hours? You and your family should be familiar with the route to the clinic in case you ever have to drive Lilly there. Again, I don't want to scare you, but it's always better to be over- than underprepared, especially if Lilly is ever sick and can't keep food down after she's had a shot.

Finally, you need to sit your family down and discuss with them the absolute important of NOT giving Lilly greasy or fatty table scraps. Since she's had pancreatitis, even a small amount of greasy food could now kill her. Ask your vet if you can give her little bits of white meat chicken (cooked/steamed in a non-stick skillet) or other very low-fat meat if she is ever hungry. But please, please, please, make your family understand that giving her table scraps (unless they know for certain the food is low in fat) could make Lilly very sick or even kill her. This is also important because Lilly's food intake must now be geared to her insulin dosage. Extra carbs can raise her blood sugar and hurt her over time.

This sounds, I'm sure, like an awful lot of information to absorb. But read it over several times until you start to remember it (or print it off and have everyone in your family read it). It's also not a bad idea to read the other comments on the page for info on problems and questions other pet owners have had about their diabetic dogs.

One last thing, before you take Lilly home, find out exactly where her blood sugar is. Then ask what the vet expects her levels to do over the next few days/the next week. If her levels are much over 200 (i.e 250+), ask why the vet is sending her home when she's not yet under control. Personally, I don't think vets have any business sending newly diagnosed dogs home with high sugar levels, but I've heard so many people say that their vets did just that and then owners then had to watch helplessly as their dogs sugars stayed in the 400s and even higher. Or that the vets would keep asking the owners to bring their dogs back time and time again for expensive blood tests. If your vet does/has already done this, call him/her on it immediately! Demand to know what a normal blood sugar level for your dog is(at 6 hours after a meal and in the morning) and ask why the vet wants to leave her in your care so soon when you're not yet equipped to handle the situation.

Let me know how Lilly does. If you have any questions, you can click on the direct link on any of my articles and send me an email.

Shelley

Shelley Cetin Hub Author 18 months ago

Hi, Kaylee.

Your family sounds very lucky to have such a good little dog as Lilly. Taking her shots and eating her new diet are big changes for her but it sounds like she's very cooperative. Sometimes they do surprise you, don't they? My little Ozzie was the same way. Once he got over the surprise of his new injection routine, he settled into it. In fact, I could just call him by saying, "Ready for your medicine?" and he would just jump on my lap and wait for me to give him his shot. Of course he then got a little treat, but it's such a relief to have a positive experience like that.

Sounds like your vet is on top of everything with Lilly. Since she's so cooperative, it may not be long before you and your vet can get her sugars below 200 like he wants them. Good luck in her progress!

You mention diabetic treats for Lilly. There are some treats on the market that are low-fat and that don't necessarily have anything in them detrimental to a diabetic dog's diet. I Vet makes a low-fat chicken treat which are tiny and a good size for little dogs like Lilly. I don't think these are sold in big stores, but your vet may have them or you may be able to find them online. Also, Grreat Choice (not a mis-spelling) makes 2 low-fat dog biscuits, one with veggies and another with shark cartilege which my dogs like. These are available at some Petsmart and Petco stores and probably online, too. These are bigger, shaped like hearts. I broke them in half for my little guys and they always got one after their mid-day walk. (When you exercise Lilly, it may be a good idea to give her a treat before or after to prevent low blood sugar caused by the exercise.) There are also some little fruit and veggie treats made by (I think) Nutro and carried by Petsmart. Can't remember the name, but they come in apple, carrot, and blueberry flavors and are a tiny size, again good for a Lilly-sized dog. :) I've also heard of (but never seen) a treat called Gentle Snackers, which were once recommended to me for Ozzie after his first bout with pancreatitis. All of these treats have a maximum fat content of 7% or below. You mnay also be able to find some dried meat strips (dried chicken or duck) that are low-fat, but I'd ask the vet before getting these since they are meat and not grains. I'm not sure if the meat could bring on another bout of pancreatitis.

When you start reading dog food labels, always look for MAXIMUM fat content. (Some labels only give a minimum, but that's a useless number.If something has a 2% minimum fat content, it could still have 25% fat!) If you don't see a maximum, don't buy the treat. You'll be surprised to learn the fat content of even the most common treats. (MilkBones have something like 11%!) You can also try to get Lilly to eat little bits of apple (try Pink Lady or Honey Crisp. These are sweet, yes, but a few tiny bits won't raise her blood sugar much and can help out if she's hungry.

Good luck with your baby Lilly, Kaylee. You've gotten her through the worst part and she's already getting used to her new routine. She sounds like she has a great disposition, which will help your family a lot. My little Ozzie lived with diabetes for 7 years - imagine how many human years that is! That's a long time to live with a chronic condition, but he was happy and healthy until he got cancer. (Well, even then he was a good-natured little guy!) Yes, it was a big adjustment for us and him, but he was totally worth it. I'm sure Lilly is just as precious to you. She's lucky to have people who love her and want her to be healthy. Let me know how she does, Kaylee. It's always great to hear about another healthy little diabetic dog!

Shelley

Shelley Cetin Hub Author 17 months ago

Hi, Laura.

I'm really sorry about your little Shih-tzu baby. Poor little thing. She sounds very brave and I'm sure she's very sweet. I haven't ever heard of anything like this happening with a diabetic animal. I know that dogs (like people) can develop reactions to the insulin at injection sites, but this sounds like a very extreme case. Do you live in an area where there are speciality vets available? The only thing I can suggest is for you to ask your vet to try to locate someone who specializes in canine diabetes (or who knows a lot about it) and/or someone who knows about skin conditions. A dermatologist might know something more. Call your vet for recommendations; if he/she can't help, go online and look for speciality vets in your area. Even an emergency vet would probably know more about diabetes than a regular vet, as such vets have seen a lot of critical cases. It's just possible an emergency vet may have seem something like this.

I recommend asking about a dermatologist because it is possible that your dog is reacting to something in the insulin, not the insulin itself. Insulin mixtures do contain minute amounts of other substances (like zinc oxide, hydrochloride acid - I don't know their chemical functions). Maybe your little baby is actually allergic to one of those elements in her insulin and an antihistamine (like Benadryl) would help. (I do know there are antihistamines made for dogs and cats.) Can you call or see your vet tomorrow and ask whether an antihistamine would help? I have read about some skin reactions that diabetic people have had at injection sites that responded to antihistamines.

I wish I could tell you more, but I've just never heard of anything like this, and your little baby needs her shots. Ask your vet about antihistamines and about vets in your area specializing in skin conditions and in emergency treatment of diabetes. I wish you the best of luck with your little baby. And let me know how she does, please. Shelley

Shelley Cetin Hub Author 17 months ago

Hi, Tracey.

You want to look for treats that have 7% fat content or less for your little Shih Tzu. You're going to have to start reading the labels on dog treat packages to find these. Many treats only give a "minimum fat content" on the label. Avoid these. The minimum could be 1% but the maximum could be 12% or nmore. Look for treats that give both minimum and maximum fat content, or for treats that specify a fat content on the package. (Some treats, for example, may say "97% fat free," so they're good choices.)

Since dog treats don't list calorie content, you can look for things that say "low fat," but in general, low fat is going to be low cal. Some treats to try: Ivet healthy rewards (sold by some vets); Nutro Natural Choice Crunchy Treats (available in Petsmart, I think); Grreat Choice (not a mis-spelling) Healthy Treats, available in vegetable and shark cartilege varieties; Gentle Snackers (not sold everywhere).

You can also ask your vet for recommendations. If the vet doesn't sell Ivet, ask if he/she can get them. My dog loves them.

Good luck!

Shelley

Shelley Cetin Hub Author 17 months ago

Hi, Allie.

I'm glad to hear that your dog is doing well on his insulin, but I'm sorry you've all hit this little 'snag' in your injection routine. I'm not sure if you read through this entire article or through any of the comments, but if you do, you'll see some suggestions. What always worked best for my dog was offering a treat of some type just after the injection. I started by giving his injection (after putting the treat nearby where I could reach it quickly). I would then immediately give him his treat. After just a few times, he learned that something good would come after his shot and there was never a struggle after that. If you haven't yet tried this, it'll be important that you figure out just what treat your dog really loves so he'll look forward to it. Don't offer something that he sometimes turns down.

Another suggestion is to give the shot in a confined space such as a small bathroom or even a corner of a room where you can sit with your pup and keep him still. Sometimes putting a dog in a smaller space will calm anxiety - maybe just because you're closer and he feels protected by your body.

A further possibility is to actually administer the injection while your dog is eating a meal. I don't like this method as well (because I always think it's better to give the shot after you know the dog will keep the food down); however, if your dog has no digestive problems, and if you are generally with him for some times after he has his insulin, this might work for you. This is what my sister used to do when she babysat our little Ozzie. He was always so busy eating that she would just walk up behind him on one side and give the injection before he knew what had happened. I've heard from several people who said this has worked for them. Using this method, you can still give the promised treat afterwards so your dog learns to associate the shot with something good. Make sure you have the injection prepped before you feed him - and it's probably best to do it while he's not watching or at least isn't in the kitchen, since he undoubtedly knows what the presence of the syringe indicates.

If you decide to confine him or reward him after his shots, you may want to start the new routine by offering him a treat before the shot to get him near enough for you the administer it. If one person can hold the treat in his/her hand while you actually do the injection, your pup can concentrate on the hand with the goody in it rather than the shot. Then give the treat afterwards as a reward. Hopeully, you can eventually back off the "before" treat as he'll be conditioned to look forward to the "after" treat and so won't fear the injection.

Good luck trying out these suggestions. Let me know what works!

Shelley

Shelley Cetin Hub Author 15 months ago

Hi there!

I'm so sorry your Jack Russell has been so afraid of getting his shots lately. From what you describe, your dog is actually getting upset because he is anticipating the shots. It doesn't sound like the actual shot bothers him since you don't mention his crying or whimpering when you administer the injection. He has obviously learned that the sight of the syringe means something unpleasant is coming.

Not sure if this will help (and I assume you've read all the other comments from other readers and from me above), can you prep the syringe some time before you plan to give the injection, perhaps then laying it on a table nearby where your Jack Russell can't see it? That would allow 1) the insulin to warm to room temperature, important because cold insulin is very painful and 2) you to distract your dog by playing with him or perhaps offering a tiny bite of a treat to begin to get him to associate the time with something pleasant. This could help in several ways.

First, if you can prep the syringe out of your dog's sight, it might initial diminish his dread of the coming moment. Put the prepped syringe on a table near where you give him his shot, but out of his sight. Then district him for 15 minutes or so. If you usually cuddle him, hold him, play with him, do the same thing. Then put him down and let him run off for a few minutes. He'll figure out that your holding him, cuddling, hasn't led to anything "bad." Pick him up a few minutes later, and maybe offer him a tiny bit of a treat. Then let him down to run, play, whatever. Do this several times before you actually pick him up to give him his shot. The idea is to "decondition" his fear of the moment.

When it's time for his injection, pick him up and carry him to a chair by the table where the syringe is...but try to keep the syringe from his view. (Maybe you can even put the syringe under a kitchen towel after you prep it so that it's out of sight.) Put your dog on your lap, facing away from you, and talk to him while you uncap the syringe and gently roll it to mix his insulin (if necessary). Your talking to him will mask the sound of your uncapping the syringe. Then, with one hand offer him a treat, and when he takes it and begins chewing, quickly give him the shot. Immediately pet him, hug him, tell him he's good, and offer him another treat. Make sure that each time you give the shot, you are moving down an invisible "grid" at the top of his back (between his shoulders) at 1/2 to 1-inch increments so that his skin doesn't develop a painful sensitivity to the insulin. (I talk about this in a couple of posts above, I think.)

Each time you give your dog his shot, the idea is to create more positive situations than negative ones. Get him to understand that when you pick him up in the morning, love him, hug him, he's not "trapped." He'll soon feel comfortable with that idea. By eliminating his visual fear of the syringe by prepping it, uncapping it, and rolling it to mix the insulin out of his sight, his psychological dread of the moment should begin to subside. Your talking to him while you offer a treat and simultaneously give the shot will create a positive association. Hopefully, the combination of so many positives along with the injection will help him overcome his fear and thus his aggressiveness. It may take some time, but I know this has helped with a lot of other dogs...including my own. Good luck!

Shelley

P.S. You are absolutely correct that you cannot administer insulin into very muscular tissue. Only do the area between his shoulders or near his thigh/buttocks, and ALWAYS remember to rotate every injection. (That is, move down the imaginary grid, then across, then up, then across, then down, giving each shot 1/2 to 1 inch apart. This will prevent painful sensitivity from developing and will also prevent fat deposition from forming at the injection sites.)

Shelley Cetin Hub Author 14 months ago

Please note: Rachel and Shelly, I'm having to answer both your questions in this one comment space as one never popped up for Rachel's question. S-

Rachel,

I hope your little dog is doing better. You can read my article above and go through all the comments below it for all my previous about how to do the shots and what to feed your dog. I've answered lots of similar questions and hope you'll be able to find something above that will help you.

Science Diet has some special prescription foods for diabetic dogs. Science Diet W/D is very good. It is both low-fat and high fiber, and high levels of fiber help control blood sugar levels. You also don't want your little Min-Pin to be overweight, so the low-fat formula will prevent that. Because this is an RX dog food, you'll have to get if from a vet. It comes in both dry and canned types - I generally mix the two to get my dog to eat well.

You say your dog bites, so a muzzle is definitely the way to go. If he won't let you do the shot in his thigh, try the area below his neck and to each side of the middle of his back. (As you said, his scruff.) Imagine that the area is a "grid"; each time you give a shot, you want to move down the grid by 1/2 to 1 inch. When you get past the scruff (toward the middle of the length of his body),move the shot over 1/2 to 1 inch and make your way back up the "grid." This important so that your dog's skin doesn't become irritated by the insulin and so that he won't develop fat deposits at the injection site. Rotating prevents both of these.

See my comments above about how to give a shot to dogs that won't easily accept them. You can prep the shot first, put it on the table (out of his sight), then pick him up, put him on your lap, and while he's facing away, pick up the syringe and remove the cap. Then give your dog his favorite treat and when he starts eating it, give the shot. Generally dogs are so interested in getting the food that they don't worry too much about the little prick of the injection.

You could also have another person hold the treat in front of your dog while he's on your lap. You can then give the shot while he takes the treat from someone else's hand - though since he bites, this might not work. If he gets really agitated, it may help to isolate him in a small space when you give the injection - even a corner of the kitchen or living room where he's in a small space with you might help lessen his anxiety.

Please read all the comments above, as there is a ton of information that could help. I also have articles about exercising diabetic dogs and how to recognize low blood sugar, something you should also educate yourself about.

Good luck!

Shelley

-----------------

Shelly,

I'm not a vet, but I've taken care of diabetic dogs and nursed my Maltese through several bouts of pancreatitis. I'm really afraid for your little dog. First of all, did the vet put her on antibiotics? If her white cell count was so high, he should have addressed that immediately.

Secondly, your dog was diagnosed with pancreatitis only on Friday, and you say you've been giving her shots and food for several days. This is not the usual course of treatment. Most dogs have to stay off food for at least 48 hours once they're diagnosed. This is to allow the pancreas to rest and recover. If your vet never told you not to feed her, her pancreatitis could be getting more serious, which would explain why she's getting worse every day. I suspect that her pancreatitis is very serious since your little dog can't walk.

Finally, you need to talk to a vet who will walk you through the first steps of caring for your newly diabetic dog. Read my article and comments above and my articles on exercise and low blood sugar in diabetic dogs. You want to familiarize yourself with all these things. HOWEVER, if this were my little dog, I would IMMEDIATELY take her to an emergency clinic to see a vet who specializes in critical cases. Your baby is really sick and to me, your vet has not been doing his/her job. Please find someone as soon as possible who is accustomed to treating emergency cases and take your dog there. It could save her life. Please don't wait. Good luck, and let me know how she is.

Shelley

Shelley Cetin Hub Author 14 months ago

You're so very welcome! I'm just glad this website helped you and your dog. Please be sure to inform yourself about what to do in case your dog ever has low blood sugar (hypoglycemia). And good luck with your baby!

Shelley

Shelley Cetin Hub Author 14 months ago

Hi, Lauren.

I'm sure you are overwhelmed right now, but I can assure you that you and your baby will soon get settled into your new routine. It will become like brushing your teeth...just one more thing to do in the morning.

You ask about changing your dog's injection schedule so that she can have her shots earlier in the day. Since she had her injection this morning at 9:00, you can move her up by one hour tonight with little risk of a problem. That will put her p.m. shot at 8:00. Then could you give her her morning shot at 7:30? And her p.m. shot tomorrow at 7:30? Then the next day, move the a.m. shot to 7:00 a.m., the p.m. shot at 7:00 p.m. You can basically keep moving the injection time back by 30-minutes increments (after the first 1-hour adjustment) without much risk of her running a low blood sugar. That's the basic risk of giving injections earlier, because her previous shot won't have all left her system. However, I assume she's on an N/Nph insulin with a 12-hour activity level. If so, by giving her her p.m. shot tonight at 8:00, she'll have the very last bit of her a.m. shot left in her system, so the overlap shouldn't be a problem. (Remember that I'm not a vet, but I've done this numerous times with myself and with my own dog, and I've spoken to lots of other owners of diabetic dogs who've done the same thing.) If you move the initial evening injection back by 1 hour, then 30-minute increments, there won't be that much "overlap" and thus less change of your dog's having low blood sugar. You can move the injections back by 30 minutes until you get to the time you want her injection schedule to fall on, then just keep that schedule. If you want to move the injection back faster, call your vet, as he/she may need to adjust your dog's insulin level for a day or two to avoid her having really low sugar levels. (By the way, you need to read up on what to do if her sugar ever drops. You can search canine hypoglycemia, or canine low blood sugar, for articles on hubpages. I have one out there and I'm sure there are others.)

You say that your vet told you to pull back on the syringe plunger before you inject the insulin to make sure the needle isn't in a blood vessel. This is absolutely correct...and something that vets do that infuriates me! Why didn't he also tell you why and then tell you what to do if you ever accidentally inject the insulin into a vessel? Grrrr....

So here's the story. Insulin is injected subcutaneously, i.e. into fat over muscle. It is then slowly absorbed into your dog's body through the fat, and it eventually gets into her bloodstream little by little. If insulin is injected directly into the bloodstream, it immediately starts to react and lowers the dog's blood sugar - precipitously. Within a matter of minutes, your dog could die because her system would be overloaded with insulin and her blood sugar would drop to zero. Vets and doctors thus tell people to pull back on the syringe plunger because if the end of the needle is in a vessel, you'll see blood come back into the barrel of the syringe. If that happens, immediately pull the syringe out, empty it, and start all over with a new syringe (because you don't want any of the blood from the first syringe to get into the insulin bottle).

So...when you give your dog her shot, put the needle into her scruff (or wherever you give her shot). Hold the syringe normally, with your index and middle fingers under the little "rim" (which looks like a little "hat" on each side of the barrel), and your thumb on top of the rim. Once the needle is in the skin, move your index finger above the rim, and use the bottom of your thumb to pull back on the plunger just a little. If you see anything pink or red, remove the needle and start over. This sounds hard, but it's really easy with practice. So to practice, take an orange (or a ripe lemon or lime - a citrus fruit) and practice injecting water in the orange, pulling back the plunger just as if you were checking for blood in the syringe.

To make this easier on your dog the first couple of times (or until you've gotten comfortable with the process), have a friend or family member distract your dog by holding treat for her to nibble on. I promise you'll get through this. And remember...the needles are very small. The dog will only feel a little prick and once the needle is in the skin, she won't feel anything else. (Remember to always warm the insulin once it's in the syringe. Cold insulin is very painful!)

If you ever do accidentally inject the insulin into a blood vessel, IMMEDIATELY get your dog into the car and to the nearest emergency clinic. (Not your regular vet unless you've first verified (soon) that the office can treat a dog with very low blood sugar.) Also, go to the pharmacy (any big chain or even Walmart) and buy a couple of tubes of GLUCOSE GEL. (They're between $3.50 and $4.00 each.) If you know - or even suspect - that insulin has gone into your dog's bloodstream, grab the tubes of glucose gel and squirt some into her mouth asap - before you load her into the car. See that she swallows. If another person is with you, have them hold your dog an administer more glucose gel while you're driving. Don't delay. With insulin injected directly into her bloodstream, you have maybe one minute before she starts "crashing." She could go into a coma and die if she doesn't get glucose immediately. That's why I say go to the pharmacy as soon as you can to get some gel to keep on hand. Tell everyone in your family and everyone who is around your dog where the glucose is and tell them how to administer it. One more thing....when you buy the tubes, open them up and remove the little film on top of the opening. It can be tricky to get off and you don't want to have to fumble when your dog needs the glucose.

I'm probably scaring you to death, but I really believe in the saying that "It's better safe than sorry." Prevention is everything with a diabetic pet. It is extremely, extremely unlike that this would ever happen, but if it should, you want to know how to react, not be running around wondering what to do.

Good luck with your baby. Remember to practice on that orange! The rind is very similar to human skin in toughness. Let me know how she does!

Shelley

Shelley Cetin Hub Author 14 months ago

Lauren,

Here is a website that tells about ReliOn insulin. It is apparently Humulin insulin that is dual-branded as HumulinReliOn insulin in a cooperative agreement between Lilly and WalMart. If you can't decide from this info whether to put your dog on it, you should be able to print out this information and give you an opinion.

http://www.prnewswire.com/news-releases/walmart-li Shelley

Shelley Cetin Hub Author 13 months ago

Sounds like you have a great vet. Good luck with little Gambit. I hope he does well on his new diet, and thanks for the info on the pet nutrition website (www.petdiets.com). I'm sure it will help lots of people.

Shelley

Shelley Cetin Hub Author 12 months ago

Hi, Susie.

I'm so sorry about your baby becoming dibetic. But don't be afraid. Diabetes is NOT a death sentence. You can learn to take care of her and it doesn't take that long. The "learning curve" is actually pretty short; if you have a friend or family member who can help you, it's even shorter.

It's true that many vets do offer to put down dogs diagnosed with diabetes. I think it's because there are actually some pet owners who don't want to make the effort, and the vets don't want to dogs to suffer. You are obviously not that type! You're ready to commit to helping your fur kid get back to health. You're not alone, either. When my little Ozzie was first diagnosed, my vet (who didn't know that I have juvenile diabetes), told me that some owners choose to put their pets down. My response? "They didn't kill me when I was diagnosed!" You just have to learn what to do, adopt a new regimen, and then stick to it.

First some questions: Why does your vet insist on keeping your dog for such a long time? If this is your regular vet, you may want to take your dog to an amergency vet clinic, where they are better accustomed to dealing with a diabetic dog in an acute stage. There's no reason it should take 2 weeks to stabilize a dog - unless the vet is used to doing it and doesn't know how handle an acutely ill diabetic dog. The problem I see here is that if the vet is only giving the dog small amounts of insulin for 2 entire weeks - just enough to keep her blood sugar on a slow downward curve - a lot of serious damage can be done to your dog's organs in 2 weeks. An emergency vet will be used to dealing with dogs that come in with very high blood sugar and can deal with the problem much more quickly. (Even a whole week is an unusually long time.)

Here's what scares me about your situation: You say your vet will give your pup the "injection" she needs every day. The vast majority of dogs are on two injections per day to keep their sugar levels stable. I"m not a vet, so I can't give you medical advice, but I would start asking questions. Your vet may have very good intentions, but this situation doesn't sound normal to me. It sounds like he/she isn't really equipped to bring a dog out of acutely high blood sugar, so he/she is just giving a bit of insulin every day. That's just not right. High blood sugar damages internal organs - kidneys, heart, nervous system, digestive system, eyes, skin, etc. It MUST be brought under control as quickly as possible, and the people at an emergency clinic may be much better at doing this than your vet.

Problem 2 is a practical one: It's SUPER expensive to take your dog for daily vet visits. They're feeding her, giving her her injections, and, I assume, checking her blood sugar several times a day. This adds up fast,and few of us can afford two weeks of this level of care. If you have told your vet that you can't afford for your dog to stay at the emergency clinic for 3 or 4 days while she is stabilized, that's a different situation. But the combination of 2 weeks of vet bills and ongoing damage from still-high blood sugars is odd.

Number three, why doesn't the vet want you administering shots yet? Probably because your dog isn't yet stabilized, but again, why aren't they stabilizing her nmore quickly? An emergency clinic would keep your dog for 2 - 4 days, but would have her on an insulin drip 24 hours to bring her sugars down. Yes, that's expensive, too, but your dog would be stable much more quickly and you'd avoid the damage to her organs.

Finally, your vet shouldn't let you be so scared. You can definitely take care of your baby. Thousands upon thousands of us do it every day, and most parents of dibaetic dogs aren't diabetic like I am. They start from square one, just like you, when their pets are diagnosed. You need to start reading about how to care for a diabetic dog. You can start her on hubpages with my articles and others. Read about how to give injections; diet (ask the vet about putting her on Hills Science Diet W/D formula, a dog food especially for diabetic dogs); how to recognize and respond to low blood sugar; and how to balance food, insulin, and exercise. If you already read the above article, you've learned the basic info about how to give shots. Now you can start practicing. Read through all the questions and responses, too, as they cover lots of material.

Now go talk to your vet and find out why he/she doesn't want you to be more involved in taking care of your baby. Ask why it's going to take so long to stabilize hegr and why he can't do it sooner. (The answer can tell you whether to take your pup to an emergency clinic - if the vet seems nervous or uncomfortable or sounds like it's the only way he knows to do things.) Tell the vet you want to be directly involved. Why can't you check your pup's urine and blood sugar at home? Why won't his/her office show you how to do these tests on your own to save (lots of) money? They should. Why won't they tell you more about their strategy for bringing her sugar into normal range? If he/she insists that doing this over 2 weeks is the only way to go, I'd head to an emergency clinic or another vet. Your pup probably doesn't feel well, may be urinating a lot, drinking a lot, and feeling drowsy and lethargic. These are all signs of high blood sugar, and signs that her sugar levels are hurting her. Ask these questions of your vet tomorrow and see what he/she can do to speed up this process or take your pup somewhere that can get her well sooner. And read, read, read. Good luck!

Shelley

P.S. Read about practicing giving injections above. Get some oranges to practice on and some little low-fat treats to reward your dog with after her shots.

P.P.S. If you go to the upper righthand portion of this page,you'll see a place where you can contact me directly instead of writing on this page and waiting for me to see it.

Shelley Cetin Hub Author 12 months ago

Hi, Brandy.

I'm glad your Sadie is doing well with her diabetes. My little Oz-Oz lived with diabetes for 7 years! When we lost him to cancer, he was mostly blind in one eye and had about 40% vision left in the other one, but he didn't start getting cataracts until he'd had diabetes for 5 years. You must be doing a good job with Sadie if she's still active and doing well. Dogs are so brave and resilent! Like my Ozzie, I'm sure Sadie is learning the layout of her home and learning to navigate every corner and piece of furniture. The last couple of years with Ozzie, we had to carry him down stairs because he had lost his depth perception. He would go up on his own (slowly), but learned to "tell" us when he wanted to go down. They are so amazing.

You don't have to discard the bottle of Humulin you left out this a.m. Since I now use insulin pens (which must be used within 28 days if you leave them out), I can't remember how long you can safely use a bottle of Humulin once it's out of the frig, but I know you can do it because I carried my Humulin bottle around in my purse for years. Go ahead and use your same bottle, but note the date. Then call your pharmacist to find out how long you can keep it.

Best of luck with Sadie. You sound like a great mom to her!

Shelley

Shelley Cetin Hub Author 11 months ago

Hi, Judy.

I'm not sure where you're writing from; that could have something to do with the price of NPH if you're in a rural area or an area with a sparse population. If not (and you're in the U.S.), you might try a Costco or Sam's Club pharmacy (if you are a member) or a WalMart pharmacy. Those places often have much lower Rx prices.

Some things to remember when calculating the cost of insulin injections are the size of your dog and the amount of insulin he/she takes in each injection. If you have little dog, it may take only 5-6 units twice a day, or 10-12 units per day. That means a bottle can last weeks, maybe even nearly 2 months. (Remember to refrigerate it.) So if you have to pay $69/bottle, and it lasts say, 7 weeks, that's not even $10/week, a pretty low cost for a life-saving drug despite the higher initial cost. Good luck.

Can anyone else give Judy suggestions? If so, please post for all to see.

Shelley

Shelley Cetin Hub Author 11 months ago

Judy,

I'm glad your puppy is feeling better! The poor baby is probably wondering what's going on. It's so hard that they can't understand us. Also, it sounds like his insulin will last a pretty long time, so that's good to know. Good luck with finding that insulin.

One other suggestion for you: you may want to start doing urine tests on your pup if checking his blood sugar is too expensive. You really do need to know where his sugars are before you give him his insulin, especially in the a.m. You can buy a glucose meter and strips and check that way. Strips are sold in quantities of 25 and run about $1 each. (The meters are pretty cheap.) If that's not possible, you can go to the pharmacy and ask for strip to test his urine. They're about half the cost of blood test strips (or less), and while they won't tell you and exact sugar level for your pup, they will give you a range. That can at least let you know if his sugar is getting too high, which is probably why he's been feeling so lethargic. Then you can adjust his insulin accordingly. (Ask the vet how much extra to give him if his sugar is high. He can give you a calculation to use to figure out how much more your dog needs. But remember to err on the conservative side; you don't want the opposite problem - hypoglycemia. Read up on that, by the way, so you know what to do if your baby's sugar ever gets too low. It's very important.

Good luck with your baby. If you inform yourself and help him maintain a good balance of insulin, food, and exercise, he can live a long, happy, active life.

Shelley

Shelley Cetin Hub Author 11 months ago

Good luck with the mini needles, Judy. Since your dog is so little, I'm willing to bet that much of the discomfort he was feeling was due to the length/size of the needles. The mini needles are really tiny, so they won't go very far beneath his skin, just far enough to deliver the insulin into the fat layer beneath. I used them on my little Ozzie. He was about 14 pounds, so they should really help your baby. Again, best of luck!

Shelley

Shelley Cetin Hub Author 11 months ago

Hi, Krystal.

From your description it seems like there's something definitely out of balance in your pup's routine. But it's not necessarity something you can't fix. I'll give you some suggestions based on what I'd do. You may still need to talk to your vet about adjusting your poodle's insulin. More on that later.

First, be sure that your dog has a regular routine including a set amount of exercise every day. To successfully control diabetes, a dog (or person) needs to balance insulin, food intake, and exercise. Without the correct amount of any of these, high or low blood sugar levels can result. Too little insulin or exercise = high blood sugar. Too little food = low blood sugar. Too much insulin or exercise = low blood sugar. Too much food = high blood sugar. (These are generalizations that depend on general health.) Looking at your dog's high a.m. levels, which then decrease throughout the day and into the evening, leads me to think that your dog may not be on a regular (or sufficient) exercise program. If her insulin dose was generally too low, her evening sugars wouldn't be so good. Probably she's at her highest in the a.m. (fasting and then right after eating), and when her humulin N peaks (6 hours after she eats), her sugars start falling and continue to fall because she's got lots of insulin in her system but hasn't eaten since the morning. Before she has her evening meal (and more insulin), her blood sugar is probably good before her shot, so you continue to get that drop to 90 or 100 after the p.m. injection.

Here's the problem: if your dog's blood sugar is 100 before bedtime, that tells me her insulin dosage is good. But overnight, blood sugar can rise for a number of reasons. If she were exercising sufficiently, that exercise would help prevent those a.m. highs, as it lowers blood sugar levels. So...the first thing you need to do is ask your vet how much exercise your pup should be getting. You don't say how large your poodle is, but most dogs' sugars can benefit from an hour of exercise every day. (Just walking is enough.)

To remember: the lowering effect exercise has on blood sugar levels can continue over the ensuing 24 hours, so if you do introduce a new exercise plan (i.e. if your pup isn't walking now and she starts), that's going to end up dropping her evening sugar levels even more than at present. So you'll need to either increase her evening food, give treats before bedtime (to prevent lows), or decrease her p.m. insulin dosage. Again, you'll need to have a conversation with your vet to determine how to adjust her insulin, food, and or treats. Just don't forgot or your pup's blood sugar could go too low at night, which is very dangerous (and in extreme cases can be fatal. You need to read up on hypoglycemia in dogs and learn to treat it; you can find info here or on other sites.)

Concerning your dog's diet, I wouldn't worry so much about the carbs contained in her food as the lack of fiber in it. Fiber is a type of carbohydrate that passes through the system without being absorbed like a sugar. It has the effect of LOWERING blood sugar levels. Any diabetic dog should be on a high fiber diet. Purina DCO is such a food, so it's definitely not that your dog is consuming too many carbs. DO NOT change to another food that's not high fiber or your dog's blood sugars will go even higher. People tend to think that carbs are bad. They're not. They're a necessary part of any good diet, and dogs need them for energy. I don't know how Purina DCO compares with Hill's Science Diet W/D (their prescription diabetic dog food); you can ask your vet if one is preferable. (But if your vet sells Purina and not Hill's, you may want to do some research to see which has more nutritional value, as your vet may well have an agreement with Purina - not that that's necessarily bad.)

So, don't change your to another food (Orijen). Only 25% carbs is a very low amount for any dog and very misleading. Because people think carbs are bad, they (like you) see that 25% figure on the label and think it must be better. But remember that your dog needs carbs as well as protein. It's the fiber that's more important. (And remember that fiber will be included in that carb count, so I imagine any food with only 25% carbs can't also be high in fiber.)

You can also ask your vet about increasing your dog's a.m. insulin dosage just a bit (maybe by 1 unit) along with increasing her exercise to include a morning walk (after her a.m. levels get down to more manageable levels. Ask your vet if it's okay to walk her when her blood sugar is over about 250.) Once her sugars are okay in the a.m., you can walk her after she eats, or you can simply wait until mid-afternoon (when she's around 200 or lower) to exercise her. 2 30-minute walks, or 3 20-minute walks, or 1 1-hour walk will do wonders for her sugar levels.

If your vet agrees to slightly increase her a.m. insulin to lower her high a.m. sugars, also ask if you should accordingly decrease her p.m. insulin by the same amount (so your dog will still be getting 16 units per day). If the vet makes any changes to your pup's insulin and okays the exercise, you'll then need to monitor her blood sugar closely for a couple of weeks, especially checking her fasting levels and bedtime levels. (Once she starts exercising, her blood sugar is going to drop overnight, not rise as much as it has been, so you may need to start giving her some treats (i.e. carbs!) before she sleeps to prevent a low blood sugar during the night.) Give her a couple of Milkbones or something similar until you learn how many carbs will result in a good a.m. blood sugar - and start with more rather than fewer or she could go too low. Read up on low blood sugar in dogs and learn how to prevent and treat it before you make any changes in insulin or exercise.

I know this is a lot of information, but I'd rather give you too much than too little. Ask your vet about adjusting Mocha's insulin levels (both a.m. and p.m.) and adding more exercise to her daily regimen. If you can get her on a balanced daily schedule (to include some p.m. carbs), you should see her sugar levels even out after a week or two. She may not have perfect levels, but she should have more even ones, and once that happens, you and your vet can tweak her insulin/food/exercise balance more to get her where she needs to be.

Good luck wth little Mocha!

Shelley

Shelley Cetin Hub Author 11 months ago

Hi, Krystal.

I'm glad I can help you a little with this page, but I hope you'll try to get your little couch potato off the couch and taking short walks. Without exercise, it's going to be very, very hard for you ever to get her diabetes under control. You might try putting her leash on her to start with, carrying her outside, and just making her walk around the house, for instance. If she gets overexerted easily, that tells you that she's in poor shape and really needs the exercise. And even an older dog can learn to accept some exercise if you increase it in small increments.

Since Mocha's blood sugars are running between 90 and 100 before, I sure wouldn't stop her evening meal or she'll be in big trouble from low blood sugar. Sounds like your vet wants to give her more insulin in the a.m. shot. (?)

Sounds reasonable, but carefully watch Mocha at night and if she gets confused, trembles for no reason, starts hiding, or seems wobbly on her feet, give her glucose. You can go to the Wal-Mart pharmacy for it. Look for the diabetic supplies, and you'll find little tubes of glucose gel meant to raise low blood sugar levels. You should ALWAYS have tubes on hand and make sure everyone in the house knows where they are and how to administer the gel. They cost around $3.50 per tube but last forever. (No refrigeration needed.) I recommend keeping them in a kitchen cabinet where they're easy to get to. When you buy them, take off the cap and remove the little plastic cover from the opening; it can be tricky to remove and you don't want to be losing time messing with it if Mocha ever needs glucose. You can then either put the end of the tube in her mouth and squirt a little bit in, or you can put a little on your finger and put your finger near her lips for her to lick off. (The latter might be easier for little dog, as that way you won't squirt too much into her mouth and make her gag.) A tube has 15 grams of carbs, so I'd try to give her about 1/3 of the tube to start with. Wait 5 minutues or so and if she's not acting more normal, give her a little more. Once she's back to normal, feed her a little or give her a couple of treats to prevent another drop in her sugar levels. I'm telling you all this because when a dog's glucose is at 90, it's actually getting low, and you don't want her sugar to go too low while she's asleep and might not wake up for you to know something is wrong. (Dogs' levels tend to be somewhat higher than human levels.)

I don't know what rural vets recommend for diabetic dogs to eat, but I'm in Kansas City, and vets around here seem to recommend Hill's Science Diet W/D formula hands down. I actually hope you haven't bought it yet because it's a low carb diet. Such a diet can be VERY DANGEROUS for a diabetic dog! Diabetic dogs need carbs, and EVO is almost completely protein. If your dog is on insulin, the insulin is lowering her blood sugar all the time is reacting in her blood. Carbs are converted into sugar (glucose), which insulin allows her body to convert into energy. If you feed her a food with too few carbs, there will be insufficient glucose in her system for the insulin to convert. The dangers of this are confusion, seizures, brain damage, and even death. I cannot emphasize enough how important it is for Mocha to be on a high fiber, low fat diet - not a low carb diet. I know you're trying to help lower her blood sugar, but EVO is not the way to go with your dog, especially since her sugars are getting near 100 in the evening. If she has no carbs in her system, she's going to have a hypoglycemic reaction (or many and frequently) and she could die. So please rethink your choice, and be careful to do general research on any other food you try out. Mocha needs a diet with a balance of protein and carbs, and without those carbs she could die. Seriously.

I know you're desperate to help her, but be very careful about dietary changes. You can talk to your vet but I'm sure he'll tell you the same thing, that Mocha does need carbs. You should stop thinking that carbs are bad for her. They're not as long as she's not getting an excess amount, but the Purina DCO and Science Diet W/D are especially balanced with carbs and protein to make sure your dog's blood sugar stays within range and doesn't get too low or too high. Your vet is doing the right thing in trying to give Mocha more insulin in the a.m., but remember that the more insulin she takes, the MORE CARBS SHE NEEDS.

I feel bad about frightening you, but I feel like I have to as changing to this type of diet can truly endanger Mocha's life. And remember I'm speaking to you as a diabetic on insulin for more than half of my life. I have felt the effects of low blood sugar. It's not fun, and I've been in the E.R. a number of times, unconscious because I'd gotten too much exercise, too much insulin, or too little food (i.e. carbs. I know that you may have found some info on the web about EVO being good for diabetic dogs, but the fact is that it is not formulated for diabetic animals and their shtick about how it's a back-to-nature, carnivorous diet is just that...a shtick - at least as far as diabetic pets are concerned. Your dog is no longer a member of the carnivore club. She's on insulin, so she's now in the omnivore club or the protein-plus-carb club. So please either keep her on Purina DCO or change her to another formula especially intended for dogs on insulin. Mocha might not survive if you don't.

Shelley Cetin Hub Author 10 months ago

Hi, Judy.

It's important to mix the insulin before filling the syringe. If you don't, your dog can get either too much or too little insulin (which is in the little crystals you see in the bottle). Check his blood sugar to see if he's gotten high over the past few days. If so, call your vet and ask how much extra insulin (or how much less food) to give him to get his sugar back on track.

Krystal,

I got your email about the dog foods. It sounds like you come up with a viable solution for Mocha and your other dogs regarding their food. You need to remember that dogs aren't strict carnivores; since they're both natural hunters and scavengers, they eat plants (like grass) in the wild. They sometimes eat berries and fruit if they run across it. Also, the prey that dogs hunt are often omnivores or vegetarians. This means that when a dog kills and eats a rabbit (or whatever animal), the dog is consuming the stomach contents of its prey. If the prey eats carbs, so does the dog that kills the prey (if indirectly).

Since dog foods like DCO and W/D have been scientifically developed to meet the needs of dogs on insulin (which requires carbs in order for a dog's blood sugar not to fall to dangerously low levels), they contain carbs. A non-diabetic dog's pancreas would produce insulin only when the dog's blood sugar rises to a certain level, and even then in very small amounts. So a non-diabetic dog can eat an all-protein diet without a problem. But when we inject insulin into our diabetic pets, the insulin dose and the insulin's reaction make it necessary for a certain amount of glucose to be in the dog's system when the insulin begins to lower blood sugar. Thus the carbs in scientifically developed diabetic dog foods. They anticipate the steep drop in blood sugar that will come when the insulin begins to react and especially when it peaks. That's really the reason these food have carbs in them.

There's nothing wrong with giving your dog carbs along with protein, which is what DCO and W/D do. They also provide high fiber, which helps balance out blood sugar levels. (And remember: fiber is one of the carbs included in the total carb count of a prescription dog food like W/D.) All diabetics - human and canine alike - need high levels of fiber to help maintain the delicate balance between food intake and insulin dosage.

I'm not sure why a high protein food would cause your dog to have loose stools; however, I can tell you that diabetes affects the digestive system, so any change (as you learned) has to be made very carefully. It could well be that the extra protein is just too much for Mocha. Since you know she does well on DCO, maybe you can keep her on it and - as I suggested to you before - force her to get some exercise. That will go a long way to improve her blood sugar. Personally, I'd keep Mocha on a prescription diabetic dog food for her best overall chance to control her diabetes.

Shelley

Shelley Cetin Hub Author 10 months ago

Hi, Judy.

Dogs do need some carbs if they're on insulin, but there's a "but" attached to that statement. Your dog's body naturally produces glucose whether he's eating carbs or not. Stress causes rises in blood sugar, as does illness. In fact, just the stress of everyday activity makes the blood sugar rise. Your liver (and your dog's) also produces glucose in small amounts (and stores it for emergencies). So how many carbs your dog needs depends on how much insulin he's taking. Since Krystal's dog is experiencing blood sugars in the 90s and 100s toward the late afternoon, her dog probably needs carbs in her food to avoid low blood glucose. But if your dog is having good sugar levels even just on chicken, his insulin dosage may be calculated perfectly just for the chicken and the glucose his own body produces throughout the day.

If you check your dog's blood sugar (or do periodic urine tests), make a note any time his blood sugar gets below 140 or so, and then tell his vet when you go for the blood workup. Also, if you dog ever gets shaky, seems disoriented or confused, seems dizzy, has trouble walking, or falls down for now apparent reason, his blood sugar may be low. You need to learn how to handle low blood sugar (read notes above), but also tell your vet because that can be an indication that your dog does need to eat some rice with his food or have some treats with carbs in them. If your dog doesn't like W/D, you might ask the vet if he can have R/D (or if you can mix R/D with his W/D). R/D is another high fiber Rx food but it has a little higher fat content. Because of the higher fat level, it is more flavorful, and sometimes you can get a dog interested in his W/D if you mix in a little R/D. It comes in both canned and dry forms. Shelley

Shelley Cetin Hub Author 10 months ago

Hi, Judy.

I'm glad your dog is doing so much better on the diet you're giving him. You know you're on the right track if his glucose curve was good. From what I understand, a dog's blood glucose levels generally run somewhat higher than a dog's. However, the 70 and 60 are technically hypoglycemic in a dog. In fact, the AAHA (American Animal Hospital Association) recommends slightly reducing the insulin dosage in any dog whose blood glucose level falls below 80 at peak insulin activity (i.e. lowest blood glucose level during a curve). There could be reasons your vet wasn't concerned: maybe your dog didn't eat that morning or didn't eat well the night before. But those glucose levels are getting close to levels that could cause your dog to have low blood sugar problems (tremors or worse) so I would definitely ask the vet about the lower numbers. I think that dog's glucose levels are supposed to be between 80 and 150 at insulin peak time, but several vets have told me that they are happy when a dog's average glucose is below 200. The AAHA also recommends no change in a dog's insulin dosage if blood glucose at peak insulin time (low BG) is below 250.

The difference between chicken breast and thigh meat is that the breast is white (low fat) meat and the thigh is dark (higher fat) meat. There is quite a bit more fat in dark meat. While feeding your dog chicken thighs isn't going to affect his blood sugar levels, you vet has told you to feed him breast meat because he wants your dog on a low-fat diet. Eating dark meat once or twice isn't going to hurt your dog; your vet is thinking about keeping him healthy over time. Maybe you could use the thigh meat in some meals for the family - spread out over time, too, so their hearts don't suffer either.

Be sure to ask your vet about those lower blood glucose numbers, Judy, and make sure you know how to treat for low blood sugar if your dog ever starts shaking or showing other signs that his blood sugar is getting dangerously low. Ask if you can/should give your dog some extra carbs in the early afternoon (a little rice, a couple of biscuits) to avoid lows.

Shelley Cetin Hub Author 10 months ago

have lots of questions so I'll answer them in order.

1) DO NOT give your dog an insulin injection in the stomach. (From "stomach," I understand you're giving the injection directly onto the underside of his body.) Dogs are not people and you can't treat your dog's diabetes the way your grandmother treated hers. There are several places to safely give a dog an insulin injection: around the nape of his neck (into the fat where the skin is loose) and in the flank (the fatty area above and in front of your dog's thigh). If you don't check your dog's sugars daily, you should take your Jack Russell to the vet to have it tested. Your having given him shots in different (possibly inappropriate) places could mean that his sugars have become high (or are getting too low).

2) Most owners give their dogs injections at 10-12 hour intervals. The time you give for your dog's shots is okay as long as you're feeding him at those times. (Don't move his shots any closer together than 10 hours without talking to the vet. It can be dangerous as the reaction times of the insulin shots will be overlapping.)This is VERY important: You must give your dog his injection close to his feeding times, say within 30 minutes. As you don't mention when you feed Russell, but you give his shots so late in the morning and late at night, I'm imagining that you are feeding him earlier in the a.m. and postponing the shot for several hours. This is the worst possible thing you can do. You dog is almost certainly on an N type of insulin, which has about a 12-hour reaction cycle. It won't become active for a couple of hours, and it's activity peaks at 6 hours after injection. When your dog eats, his food is digested and converted into glucose; he needs insulin to help him convert the glucose into energy. If you don't give him his shot when he eats (preferably a little bit after to make sure he'll keep his food down), but instead wait several hours, his glucose is going to build up to a dangerous high over the course of the day because of that lag time. So make sure you're administering the shot shortly after he eats. If you haven't been doing this - and if you don't check his sugars - take him to the vet to have his glucose checked. He could have high blood sugar that needs to be brought back under control.

3) Diabetes affects virtually every system in the body, and dry skin is a pretty common side affect. You can buy a very soft-bristled brush for your little Russell, take him outside, and brush him all over (against the grain) to remove dead skin. Brush his tummy, too. Then you can spray him with a moisturing spray for his skin; these are easy to find at big pet stores like Petco and Petsmart.

Please talk to your vet about what you've been doing with Russell's shots. It's very dangerous to give him shots in inappropriate spots on his body as different tissues absorb insulin at different rates. Have him show you exactly where on Russell's thighs you can give the shots. And please don't rely on things you remember or have heard about what family members have done for their own diabetes. Sometimes things are the same, but often they are very, very different for diabetic dogs and people.

Shelley Cetin Hub Author 10 months ago

Hi, Krystal. From what you describe, you're giving your dog his shot just above and in front of his thigh - the flank. That is one safe place to give a shot, so if this is what your vet showed you, you should be okay. Scared me when you said stomach, but the place you're doing it isn't really the stomach and is a good place for an injection. Good luck with your pup!

Shelley

Shelley Cetin Hub Author 9 months ago

Hi, Judy.

Sounds like your having some challenges with your pup trying to get used to his new routine. Once you get your lancet, testing him will probably be easier because the tests really do hurt less with a lancet device. When you get it, you may want to test it on your own finger in order to determine at what depth to set the needle. Most lancing devices have a "top" that turns, moving the needle up (more shallow) or down (deeper) with each turn/click. Try it on your finger,turning and clicking the top until you get it to a depth that draws blood easily without hurting too much. It really hurts much less with a lancet than it does in the doctor's office, where the nurse usually sticks a needle into your finger. Ouch!

Glad your insulin was okay. If a bottle is left out for some time but is still cool, it should be okay. I'm not sure about the exact temperature at which Humulin N starts to break down, but a doctor once told me that a bottle is okay up to about 85 degrees. You might want to ask the vet if you think it could happen again,especially since Humulin is a newer formulation which may be more stable at warm temperatures.

Good news that the urine test was negative, but remember that a urine strip only tests a blood sugar range. Some urinalysis strips give you a color indication of a range of blood sugars, not just a positive or negative for ketones. You may want to get those. The strips you describe, I think, just test for ketones, not for blood sugar level. They will only help you if your dog's sugar is high, but they won't tell you how high the pup's blood glucose is. For that (untily your meter arrives), you can get glucose test strips. They work the same way as the ketone strips but the strip turns color in a range (i.e. from light beige to deeper colors). The color will tell you, for instance, that your dog's sugar is BETWEEN 100 and 150. That's much more valuable when trying to get a diabetic dog under control.

One other thing about the ketone strips: Ketones will only show up when blood sugar gets pretty high, but your dog can feel the effects of high blood sugar even if there are no ketones present in his urine. If, for instance, his glucose is running around 250 or so, he may feel tired and not feel like running and playing. This might explain your dog's lethargy - which, by the way, is a typical symptom of high blood sugar.

You say you're giving your dog only 2 units once a day since he hasn't been eating. Is this the "sick day" dosage your vet gave you or did you just determine that amount? In general, a dog that doesn't eat still needs a basal amount of insulin in the blood round the clock, and for a diabetic dog, a once-a-day shot of Humulin N wouldn't be enough because it only lasts for about 12 hours. That means your pup would have no insulin whatsoever in his system for half the day, which is really dangerous. If you can't check your pup's sugar with a meter, test the urine with a glucose urine stick to get a range. If it's over 250 or so, ask the vet to calculate a "sick day" dosage for your dog; it should still include 2 shots per day. That will be the amount to give your pup when he won't eat or is sick. If he's only on 2 units once a day, I'm going to bet that his sugar is pretty high, which is probably what's making him lethargic and tired all the time. Don't just break up the one shot's amount into 2 doses, either. He still won't have enough insulin in his system if his sugar is currently high. Anyway...do ask your vet exactly how much insulin to give your dog when he won't eat and if the vet only wants the dog to have one shot per day, ask why.

Your poor baby may actually be hungry, but if his sugar is really high, he could actually be feeling nauseous or have an upset stomach, which could explain his not wanting to eat. Very high blood sugar can (yes) increase the appetite, but high (but not accutely high) levels can also commonly cause a decrease in appetite. I know that if I'm sick and my sugar is high, I never want to eat. The very thought of food makes me sick to my stomach. So make sure you get a reading on the dog's glucose (not just ketones), as a high but not immediately dangerous high level could make him not want to eat.

Good luck!

Shelley

Shelley Cetin Hub Author 9 months ago

John,

I'm so glad this hub has given you the confidence to help your dog live with diabetes. It is a challenge, but just like any big change, once you get used to the routine, it becomes just another part of your day. You and your dog will get used to it and as long as you can maintain a balance between his insulin, his diet, and an exercise program, there's no reason why he can't live a healthy, productive, and comfortable life. My little diabetic Ozzie lived for 7 years with diabetes, and in the end, he died from cancer, not the diabetes. My husand and I took good care of him, but it wasn't that much trouble really, and if you can keep the food, insulin, and exercise balanced, you can help your dog avoid serious health problems so that his everyday care isn't too expensive. Make sure to read up on exercising a dog with diabetes and about hypoglycemia (low blood sugar) in dogs. You can find other hubs (by me and by other writers) about those topics here on hubpages. Most important, make your vet part of your team. Stay in touch with him or her and if you have questions, always ask - don't wait. By keeping on top of things, you'll keep your pup healthy and happy.

As I said, if you can balance the 3 areas of diabetic care, your dog can live much longer than 2 years - maybe 7 or more like my little Oz-Oz did. And you don't have to be diabetic like me to learn. You'll have to follow a reasonably consistent schedule for his shots and food, but he'll get used to it. If you can keep his blood sugars under control, he doesn't have to get the secondary illnesses that many diabetic pet owners worry about. Lots of people think that a diabetic dog will become blind no matter what: not true. Dogs whose diabetes isn't controlled will almost certainly become blind, but again, my Ozzie kept his eyesight. It was only the last year of his life that he developed cataracts serious enough to compromise his sight. When he died (after 7 years as a diabetic), he had lost all the sight in one eye but still had about 40% in the other and could still run and play. (We did carry him up and down stairs his last year.) He was a happy little guy who enjoyed his life and who even looked forward to his "medicine" because he knew that getting his shot meant he got his favorite treat afterwards.

I know what you mean when you say that you were afraid you might have to put your friend down; in fact, when Ozzie was diagnosed, the vet told me that many people chose to euthanize their diabetic pets. My response: they didn't kill me! I had a chance to live on insulin

and I wanted the same for my little pal. So keep your chin up, be ready for a few challenges, but know that things will be progressively easier and more routine once you know what you're. If you ever have a question for me, please write and tell me. Write me at my personal email address to make sure I see your message the same day - you can click on the "Contact Shelley Cetin" mail icon at the top right of this page.

Good luck!

Shelley

Shelley Cetin Hub Author 9 months ago

Aurora,

I'm glad your little guy is a fighter! Aren't our dogs amazing? Sounds like Chester is having a tough time, but you're lucky he has a great vet who knows how to treat his various problems. When Chester's diabetes is under control, you'll see a big difference in him. His lethargy will be gone, he'll eat and drink normally, and he should stop having those accidents. (Some dogs need a little refresher house-training after coming back home because they've not been able to control their bladders for a while when their diabetes was acute. Usually it doesn't take to long to get them back on track.)

I hope you are settling into your new routine with your baby. (Is he home yet?) Keep reading about diabetes - especially about hypoglycemia (low blood sugar) so you know how to treat it if it ever happens. You'll also need to read up on exercise so Chester's diabetes is as well controlled as possible. It's hard to keep diabetes in check without regular exercise, which greatly stabilizes glucose levels when balanced with insulin and food.

The key word for Chester now is balance. Learn his new routine and try to maintain it as much as possible. Keep an open line of communication with your vet and don't be afraid to ask him to give you information about something you don't understand or show you how to care for Chester. Find out how to treat hypoglycemia (find articles here on hubpages), learn to recognize its symptoms and those of high blood sugar. If your vet is willing, ask him to teach you how to adjust Chester's insulin if a test shows his glucose is high. (You'll need to reduce exercise and increase insulin, but NEVER give Chester more insulin blindly; even a little too much could kill him!)

It's scary to get a diagnosis of diabetes for a pet, but you'll learn and the two of you will soon feel comfortable with your new lifestyle. My little baby Ozzie got so used to his shot routine that I would ask him, "Ready for your medicine?" and he would run to me and jump on my lap! (He knew he'd get a little treat as soon as he had his shot.) Since Chester is a little guy, get the mini needles for his shots; they're thinner and shorter (actually made for human babies), and they are much less painful for little dogs.

You can't do it all at once because there are so many comments and answers here, but do read through them a few at a time. You can learn a lot from what other people have dealt with, and the more you learn, the better armed you'll be if a crisis ever happens.

Good luck with your little Chester. I hope he'll be healthy and happy for a long time to come!

Shelley

Shelley Cetin Hub Author 8 months ago

Thanks for the positive feedback! It's good to know the info here is helping dog owners learn about diabetes and their pups.

Shelley

Shelley Cetin Hub Author 8 months ago

Hi, Lisa.

Those typos do get us into trouble, don't they? ;

Shelley Cetin Hub Author 8 months ago

Lisa, I just wrote a LONG comment but it's not appearing for some reason. Will check back in the a.m. to see if it shows up and if not, I'll rewrite it so you can see what my recommendations are.

Shelley

Shelley Cetin Hub Author 8 months ago

Hi, Lisa.

Let's see if I can get this to work this this time. You have 3 (possibly 4) choices as I see it concerning how to handle your upcoming situation. I'll list each of them and explain the pros and cons of each.

1) You're going to be home 5 hours later than your dog needs his shot. If you give him his shot that late, his body is going to be without insulin for about 8 hours because Humulin N is a long-lasting insulin that takes several hours to begin its activity. In the meatime, your dog's blood sugar will continue to rise. His liver produces some glucose. Adrenalin causes rises in blood sugar. If he eats, of course, the food is transformed into glucose. Just being alive ,we produce glucose.

So the problem of just delaying his shot is that over the delay his blood sugar is going to go pretty high - even if he misses only one shot. I know some pet owners do delay their dog's shots like this, but it's not a good idea. HOWEVER...if you decided to do this, here's my recommendation:

Don't feed your dog his p.m. meal that day. He'll be hungry but it would be more harmful to feed him. Then, first thing in the morning, take him to the vet's office to get a blood sugar count on him. Ask the vet how to adjust your dog's next several shots to compensate for the rise in blood sugar caused by the delay. He/She might recommend that you add 2 or 3 units to the next 2 or 3 shots.

The downside to doing this is a) your dog's blood sugar is going to be high b) you're going to have to take him to the vet's, which will incur expense and c) you'll have to adjust his insulin dosage according to the vet's instructions, perhaps also adjusting his food intake over the following day or two. DO NOT DO THIS OPTION WITHOUT FIRST INFORMING YOUR VET AND FOLLOWING UP.

2) Option two is, as you mentioned, boarding your dog with your vet. There, the dog will be well cared for, will have his food and insulin on schedule, but will be stressed. The additional stress could make his blood sugar go up somewhat, but your vet will undoubtedly check the dog's blood sugar several times while he's there, and he/she can adjust the dosage for that time period to make sure your pup comes home with a good blood sugar level.

This option isn't the best option for you because you feel guilty about leaving your dog in a place you kinow he doesn't like. None of us like to think that our beloved pets are unhappy, even for a short time. However, this would be a short-term solution and remember that you would pick up your pup the following morning. He'd be asleep much of the time he's away from home. While my dog wouldn't like being at the vet's, I would definitely take him there if it meant the difference between keeping his blood sugar and routine on track and his blood sugar levels going crazy for several days.

3) Your final option is the one I used wth my little Ozzie many times. We used to live outside Washington, D.C., where our work and commuting schedules were crazy. Sometimes we just couldn't get home to give him a shot, sometimes we had to travel for work, and sometimes we just needed to get away. We asked our vet to recommend a pet-sitting service that could take care of diabetic dogs that needed insulin injections., I contacted several and chose one that had several former vet techs on staff.

This business offered overnight pet sitters, sitters who would feed or give shots, or sitters who would just check on dogs and walk them. I had to fill out an application (complete with medical info on our dogs), and I checked out the business's insurance and made sure they were bonded (since they were going to be in our home). I explained that I wanted to leave my dogs at home where they'd at least be comfortable and not so stressed, and that I wanted someone to come by 4x a day: once in the early a.m. to let them out, give Ozzie his shot, feed them, and walk them. I specified another mid-day visit (another walkand a treat), a 7:00 p.m. visit (another shot, dinner, and a walk), and a 10:30 visit (final trip outside and a nighttime treat).

A couple of days before we left, the owner came by with the tech and the dog walker who would be taking care of our babies. The tech watched me prep their food and give Ozzie his shot; then both caretakers played with the pups to become acquainted. They told me the tech could come by the following morning to give Ozzie his shot while I was still there, but I didn't think it was necessary since Ozzie seemed so comfortable with him. We gave them the house key and 2 days later we left on a long weekend. We asked the tech to call us after the first shot and meal - all went fine. When we got home 3 days later, Ozzie and Molly (our other baby) were as happy as little clams. They hadn't had to be boarded, but had had the best possiblle care.

If you only needed to do this for one evening, it would be much less expensive than boarding your dog with your vet. You could still ask your friend to come by to check on things and keep your pup company, but he wouldn't have to worry about the dog's injection.

This is the option I would choose if I were you. But if you don't live near a sizable city, you probably won't be able to find a similar service. (I now live in Kansas City and we have a service here that does the same thing.)

4) The last option might be possible. I have heard other pet owners tell me that they actually hired a vet tech from their vet's office (with the vet's okay) to administer a shot. This could work, but you'd have to be really sure of the tech's reliability and honesty since such a person wouldn't be bonded. If anything happened the house (such as something getting broken), you would be responsible. But if you know your vet well or know a tech well, you might be able to get the techn to come over for the shot. And your could always specify that he/she come over while your elderly friend was in the house so you wouldn't have to give anyone else a key.

So here are your options, Lisa. I hope I've given you enough information to help you come up with a feasible solution. Good luck with your diabetic baby. Sounds like you're doing a great job with him!

Shelley Cetin Hub Author 8 months ago

Hi, Janina.

I'm sorry your little baby is having trauma about her shots, but I think there's something really simple you can do to help ease her pain. You say you're using a 1/2" needle; that length of syringe is just too long for such a little dog. She's hurting because the needle goes in too far for her little body. If you go to the pharmacy, you can ask for the "mini" needles (Tell the pharmacist you have a tiny dog and want the ones for babies). These syringes are the same gauge, but the needles themselves are much shorter, so they don't go in as far under the skin. With a little dog like Cookie, that's about the only way you can get her to feel comfortable with her shots. This will mean that you won't use up whatever supply of syringes you still have, but maybe you can donate them to your vet or an animal shelter. You should be able to donate whatever packages haven't been opened. Then use the tiny needles on Cookie; I can almost guarantee she won't cry and she'll soon get used to the fact that her injections don't hurt any more. This is what I did with my little Oz-Oz and it made his life SO much easier.

To get Cookie eased out of the fear she's already developed about her shots, is there any way another person could help you give her shots for a few days? If another person could distract her by sitting in front of her with a treat while you give the injection, it might help since she'll soon realize that while she's getting a shot, it just doesn't hurt like it used to. If that won't work, you can either sit on the floor, making a sort of "triangle" with your legs and putting Cookie in the triangle to hold her. If you then put her treat(s) on your leg, you'll have a few moments in which to give her the shot while she's occupied with the food. I know a couple of people have also told me they've actually sat in the bathtub with their dog. The isolation seemed to calm them a bit. It may take Cookie a while to understand that her shots don't hurt much any more, but I'm pretty sure she'll get there if you use the tiny needles.

The best way to ensure that Cookie doesn't go blind due to cataracts is to control her blood sugar as well as possible. That means establishing and maintaining a routine balancing her food, insulin, and exercise to best control the disease. If Cookie isn't currently on a regular exercise (i.e walking) program. she should be. Exercise greatly stabilizes blood sugar levels. She should also be on a low-fat, high-fiber diet since fiber also helps stabilize blood sugar levels by absorbing some glucose and helping to flush it from the body. If she's not on such a diet, ask your vet if she can go on Science Diet W/D (a diabetic formula) or another such food. A prescription diet is best for a diabetic dog. She can still have some treats after her shot (and maybe before and/or after her walks), but her main food should be low in fat and high in fiber.

Before you put Cookie on a regular exercise program (if she isn't on one now), you'll need to talk to your vet. Because exercise lowers blood sugar levels for 24 hours, Cookie's insulin dosage will need to be adjusted (i.e. lowered). DO NOT TRY TO ADJUST HER INSULIN YOURSELF. You vet will do precise calculations to determine how much less insulin she will need. Along with a lower insulin dosage, she may also need a little more food, so be sure to ask the vet how much (if any) to increase food intake. He/She may just say to give her a few extra treats before her walks, but it's important to know this before you start her on a new exercise program. Too much insulin before exercise can result in hypoglycemia - or low blood sugar - and this can be very dangerous.

Because balanced blood sugar levels are the best way to protect a diabetic dog's eyes, it will be important to keep Cookie's sugars from getting either too high or too low. Exercise, the correct insulin dosage, and the correct intake of a good prescription will help. There are things you should know about, though, if you try to do relatively intensive management of Cookie's diabetes. Unfortunately, the better controlled one's diabetes is, the higher the risk of developing low blood sugar because just a little too much exercise, slightly too little food, or even the tiniest bit too much insulin can drop insulin levels. So read up on canine hypoglycemia. (There are articles on hubpages on this topic if you do a search.) Before you increase Cookie's exercise, go to the pharmacy (in fact, please do this when you get her new syringes). Ask the pharmacist for glucose gel. It comes in little tubes which cost about $3.50 each. If Cookie should ever become hypoglycemic, you need to administer glucose immediately to prevent her from having serious problems. (Too low blood sugar can be fatal.) Read up on the signs of hypoglycemia in dogs and memorize them. If you ever see any of them in Cookie, put some glucose gel on your finger and rub it insider her gums or squirt a little into her mouth. (You can ask your vet how much to give her; each tube contains 15 carbs, and there are lines on the tube to guage how many carbs you are giving.) You should keep a tube in the kitchen and tell everyone where it is and how to give it to Cookie. If Cookie goes out with you (in the car, on a walk), always keep a tube in your purse or in your pocket in case her blood sugar should ever fall too low. I'm not trying to scare you, and if Cookie is on a well balanced regimen, chances are small she will ever have a problem, but it's better to be safe than sorry! (Really.)

These are the best things to do to help Cookie maintain her eyesight. I was lucky because I have juvenile diabetes and knew how to take care of Ozzie, so I was able carefully control his blood sugars. But by communicating with your vet, asking questions, and learning as much as you can about the signs of low (and high) blood sugar, you can keep Cookie at pretty normal levels. Ask your vet how often she should have a fructosamine level done (a test that tracks diabetes control) and never be afraid to pester the vet with questions. The squeaky wheel gets the grease, so ask, ask, ask.

You may be surprised, but in 6 months time you and Cookie will find this seemingly complex routine to be old hat. It will be like brushing your teeth, you'll be so used to it. (And that reminds me to tell you to brush Cookie's teeth every day to make sure she doesn't get infections, which can cause high blood sugars.) And yes, well controlled diabetes can prevent blindness. I once had a neighbor whose dog was diabetic, and her little guy (also a Min-Pin) still had good eyesight after 5 years with the disease. So educate yourself and discipline yourself to keep Cookie on that regular schedule; chances are that in 5 years she'll still be romping around the yard and chasing squirrels!

Good luck and let me know how the mini syringes work out.

Shelley

Shelley Cetin Hub Author 6 months ago

Hi, Jonny.

It sounds like you're trying to get a handle on managing your pup's diabetes. I know it's pretty overwhelming at the beginning because we parents are always so worried about our fur kids.

Your pup is on an insulin which has aout a 12-hour reaction cycle. If nobody explained this to you, insulin, when injected, begins to "react" on the glucose in the bloodstream. To do this, the insulin allows glucose molecules to enter blood cells, where the glucose can then be converted to energy. Without insulin, your dog will starve no matter how much he eats, because glucose will just keep building in his bloodstream and never be able to enter cells and become energy (basically). Humulin N doesn't begin reacting (lowering blood sugar levels) until about 4 hours after injection. It "peaks" (becomes most active) at 6 hours, when the reaction curves downward until there's no more Humulin N in the system after about 12 to 14 hours. That's why the vet told you to give your dog his injections 12 to 14 hours apart.

So what does this mean if you want to change your dog's injection schedule as you want to do? You can generally move a shot up or back an hour or two without needing to worry that you're going to endanger your dog. (Notice that your vet gave you a 2-hour window when he said 12 to 14 hours.) If your dog is now having his shot at 9:00 and you move it to 7:00, here's what will happen. Since the Humulin N takes about 4 hours to begin reacting, your dog is virtually without insulin for the first 4 hours or so after his shot, and during that time, he eats and his blood sugar begins to rise. When the insulin starts to react, his sugar goes back down to (hopefully) normal levels; his blood sugar will follow these reaction curves throughout the day as his insulin reactivity surges and diminishes, and there will be some periods where there's no or hardly any insulin in his system.

If you move his injection time up by two hours, you're going to be cutting the amount of time between the exhaustion of the last insulin and the reaction of the current one. In your dog's case, since his sugar is still abnormally high (if it's in the 300s), that could actually be a good thing. However (and this is an important qualification), you CANNOT continue to move his shots back and forth. Doing so would risk his developing either really high or really low blood sugar levels since the space between those reaction curves would increase or decrease. But unless your dog's blood sugar is very well controlled (and it sounds like your pup's isn't yet), you can therefore move the time of his shot back 2 hours. (If his blood sugar levels were perfect, this could be risky; it could cause low blood sugar).

So I would go ahead and give his evening insulin 2 hours earlier, and then continue to administer the shot at the same time after that. Just remember your vet's admonition to do the injections 12 to 14 hours apart; 12 hours is better than 14 since you're actually trying to approximately natural blood sugar levels.

One note of caution: you should give your dog his shot after he eats, not before, to make sure he doesn't vomit. If you were to give him his injection and he then got sick, the insulin would be in his system and there would be no carbs to be converted into glucose once the insulin started to react. The result would be hypoglycemia (low blood sugar), and if his blood sugar got low enough, he could die. When Ozzie was first diagnosed, since he responded so well to his insulin therapy, I gave him his shot right after he ate, but as he got older and his health more fragile, I began waiting 15 to 30 minutes to make sure he would keep it down. If you have any reason to suspect your dog might get nauseous, don't give him his shot until you're sure he can keep the food down. I don't want to scare you, but just remember this if your dog has a sour tummy or is sick.

You don't mention whether you're testing your dog's blood sugar or his urine. If not, please consider at minimum doing urine strip tests on him prior to his shots. You can buy urine test strips over the counter, and they're not very expensive. If checking his blood sugar is too expensive, you can use the urine test strips before he eats to get an idea of his level. Urine testing is not as accurate as a glucose test, since the strips give you a range, not a specific number, but they will tell you whether your dog's sugar is in normal levels before you give him his shot. You should do one or the other to make sure your dog's glucose levels don't get too high or too low before an injection, and your vet can teach you how to adjust your dog's insulin if his glucose is too high or too low.

Hope this helps, Jonny. There's a lot of information to learn when a dog is first diagnosed, but you'll soon internalize it and your dog will get used to his new routine. If your dog's sugars are still running in the 300s, don't let it go on more than a few days without consulting your vet about giving him more insulin. 377 is just way too high; he should be closer to 200 to be safe, and if his sugars continue at their current level, your dog will certainly go blind. The closer you can get his sugar levels to normal, the better the chance you can preserve his remaining eyesight.

Best of luck!

Shelley

Shelley Cetin Hub Author 6 months ago

Jonny,

I thought I had posted an answer to your last comment but apparently it didn't "take" for some reason. So sorry.

I'll try to answer your questions in order:

1) You mention that you're going to keep honey sticks with you at all times in case your pup's sugar gets low. Just FYI...honey is much more slowly metabolized than many sweets. Even regular table sugar gets into the bloodstream faster. I can't remember if I mentioned the tubes of glucose you can buy at any drugstore (or at WalMart). They're actually the best thing you can carry with you. If your dog seems confused, woozy, unsure on his feet, wobbly, or if he's shaking or goes off to "hide" somewhere, his blood sugar could be low. WIth the tubes, you just squirt a little into his mouth (you might ask the vet how much, as how much he requires will depend on your dog's size) and the glucose will immediately begin raising his blood sugar. Once he's gets closer to "normal" again (i.e. he's alert, can stand securely, stops shaking), you can give him some food to make sure his sugar doesn't drop again. The tubes cost between $3 and $4 each, but you (hopefully) won't use them often (and they do keep even after they're opened).

2) Re: how to make sure the insulin is warm enough to inject. Since the syringes are small, you can just gently roll the syringe between the palms of your hands if you can't hold onto it, or just put it between your two hands for a couple of minutes. That should be enough to warm 2 units. Another thing you can do if it's easier is to hold the loaded syringe between your arm and your body to warm it up.

3) You can find the urine test strips at any pharmacy, even WalMart. You don't need special ones for animals. Just go to any pharmacy and ask the pharmacist (or tech) where to find them. (Some pharmacies keep them behind the counter.) I can't remember how much they cost, but I'm pretty sure it's under $20 for 30 of them. If you can't afford to test more than once a day, the fasting test (before breakfast) is the most important. It will give you a range of glucose levels according to the color the strip changes once touched by urine. SInce your dog is a boy, it's really easy to do the test. You'll have to follow him to wherever he wants to "go," and when he starts to urinate, put the end of the stick (with the little fuzzy tab on it) into the urine stream. The sticks are pretty long so there's not much danger of getting any on your hand. You then wait the amount of time the instructions tell you to wait while the strip end turns color. Then you compare the color of the strip to the color on the side of the bottle to get a range. These tests aren't as accurate as doing a glucose test, but they are cheaper, easier, and less invasive as there's no sticking the dog anywhere. And they do let you know if your dog's glucose is getting too high or too low. To give you an example, the color on the strip might point to a range between 70 and 130 - that's actually pretty low for a dog. If you get that reading in the morning before he eats, you'll want to give him extra food, or maybe give him some treats a couple of hours after his breakfast (if you think you won't forget. If you're not sure you can remember, just give him extra food at breakfast.) On the other hand, if the strip indicates a range, for instance, between 220 and 300, you know that your dog's sugar is getting high so you can give him a little less food (and the same insulin dosage). If ever the reading approaches 300, I would call the vet and ask if you can adjust the dog's insulin dosage to compensate or if he recommends something else.

4) You seem really worried about your dog's being hungry now that he can only eat twice a day. Wait until your pup is fully stabilized, but you can ask the vet if your dog can have a treat or two between meals. The vet will suggest what to give him and will tell you when and how much/many to give. That might help to get his mind off food and once established as his routine, you'll find that you're pup stops begging for more food at meals and looks forward to his treat time(s).

Good luck, Jonny. If ever you have a question you need answered and you want to make sure I see it quickly, on my home page, there should be a link that says "Email Shelley." Those messages go directly to my email inbox. Kisses to your baby from me!

Shelley