Finding the right vetsulin dosage and schedule that works

Couple of things since last post.

• Her blood glucose are highest before breakfast and before dinner so measure those two.  Currently, Dr. Jennifer Koga and I negotiated to 4u vetsulin in the morning and 5u before dinner
• Cashew is doing well at 203mg in the morning and 247 at night.

• Cashew wants to eat breakfast when she wakes up (can be anytime from 9am to 11:30am). and she wants to eat dinner with the hoomans (6pm-7pm).  Otherwise, we are stuck with her begging every 5 minutes.  So, I'm hoping this schedule/dosage works for her

1. Wake up and eat breakfast
2. 4u vetsulin
3. 8 hours later, eat dinner (eat carrots and veggies for fillers)
4. 5u vetsulin
5. 16 hours of walk / sleep time

• Family has been very supportive.  Dad boiling carrots for Cashew and mom making sure he's not giving too much. 👴👵🐕 

Figuring out how to keep Cashew's Blood Glucose between 100-250mg/dl

The goal is to keep Cashew's blood glucose between 100-250mg/dl

This was the result of today.

Current dosage - Vetsulin U-40 - 6 units twice a day

Previous Night 8pm - Fed Her - Vetsulin 6 units

9:30am - BG 154mg - Woke her up.   - Fed Her - Vetsulin 6 units

12:30pm - Gave her some small carrot pieces

4:00pm - BG 98mg

6:30pm - Gave her some small carrot pieces

7:30pm - BG 265mg - Fed Her - Vetsulin 6 units

Cashew has pancreatitis / diabetes

Cashew is now Diabetic

It's been a good ~20 months after Cashew's Insulinoma Surgery and she has been living normally until this week! Cashew has been drinking a lot of water and she wet her bed (first time in over 10 years?)!

I decided to check her blood glucose and it was at 350-400mg/dl! Took her to the doctor and she is diagnosed with diabetes.

All About Canine Diabetes <- sent to me by Dr. Koga

What does this mean?

• Cashew needs to take insulin after her meal every 12 hours to control her BGs. Goal is to keep it between 100-200mg/dl. Starting Vetsulin at 6 units on a U-40ml syringe.
• Spot check Cashew's blood glucose to see if this is the right amount for her
• Watch out for signs of hypoglycemia (when BG is too low)
• Watch out for lethargy, inappetence, vomiting - ketoacidosis
• Cataracts develop in 100% of dogs with diabetes so be ready for it :(

Notes on Blood Test

Since her precision pSL was at 150, looks like pancreatitis?

Before having Cashew's insulinoma surgery, I was told pancreatitis was a risk, but just didn't know it can come 20 months later.

Notes from Dr. Koga over at Adobe Animal Hospital

1) Mild elevation in alkaline phosphatase,: This is an enzyme that is associated with several things (liver, excess corticosteroid, bones, amongst others). This is considered a mild elevation, and I suggest this just be monitored (i.e. check again in 6 months).

2) blood glucose=396, consistent with Diabetes

3) elevation in precision pSL: this is associated with the pancreas. I actually do not like this test at all, because it can be elevated in dogs without pancreatic disease. If she were vomiting or having other GI signs then I would consider this significant.

4) urinalysis: elevated glucose, consistent with Diabetes. There was trace ketones in the urine, which is indicative of a dog who is utilizing fat to get energy to the cells, since the glucose wasn't being transported by insulin into the cells. When ketones rise dogs can start to act very sick.

So, there is nothing on the blood test to indicate there is an underlying disease that could make her insulin resistant.

 

And her Blood Test Result.

Cashew has diabetes now?!

It's been 20 months since Cashew's insulinoma surgery so it's awesome!

However, Cashew has been drinking a lot of water (maybe even more than me!) and peeing a lot!  I mean, her pee sounds like a water hose.

Something seemed off so I Googled what it can be.  Of course, the usual all sorts of cancer/disease or... diabetes.

So, I gave Cashew a night to sleep it off and checked in the morning with her enemy, Alphatrak 2 and OH NO, her Blood Glucose is 412mg/dl!

Relatively good news is that, if it's diabetes, it can be controlled with insulin.  It sucks, but I'm a bit relieved.

Sent a message over to Cashew's vet at Adobe Animal Hospital to see what are the next steps.

Don't worry buddy!  You will feel normal again soon!

Other than that, she's doing alright.  Walks and ball playing are getting shorter, but we still fight for bed space, she still tries to get out of my hugs, eats at the dinner table, loves my magic tricks, she's living fine.

1.5 Years After Dog's Insulinoma Surgery

I apologize for not updating on my Cashew cutie pie baby for a while.

Knock on wood, but Cashew is doing just fine.

I haven't checked her BGs for the last 6 months, but she does go to the doctor here and there to get an examination.

Cashew is about to reach the age of 14!

For every month from now, is a bonus time we get to spend with her since the insulinoma documentation said the average length of a dog's life after insulinoma surgery is 18 months.

It's now 18 months.

She is having the usual old people symptoms like arthritis and her hearing isn't as good anymore, but it's ok buddy baby, I'll be there soon too!

She still makes me laugh everyday

We still fight over bed space

She still snores every night

She still gets angry at me if I don't take her out.

Every single day we play catch or I show her magic tricks

Once a week, I lie down at the park until SHE wants to go home.