Forum Replies Created
I am not stalking you but here’s the deal: you have all the suggestions for people who have come here looking for help and answers they aren’t currently getting from their vets. Your suggestions might be great with a knowledgeable vet in a clinical setting where your suggestions could be very tightly controlled. The average person who looks at your suggestions can’t implement them on their own and shouldn’t because they are dangerous for a person who doesn’t possess a great deal of experience. I don’t think all of your ideas are crap – I know lots of lots of people with diabetic dogs who use Levemir or other types of insulin besides nph. You state that the meals when using other types of insulin don’t need to consistent in size and time frame are like nothing I have ever heard. Even my friends who use other insulin keep their dogs on very tight, consistent schedules. Your statements about nph being outdated are ridiculous. It is a widely accepted starting point for most newly diagnosed dogs because it has a track record of most closely resembling their natural insulin. It doesn’t mean every dog will do great on it, though because each dog has different issues and physical makeup.
By the way, I didn’t know that starting a thread here allowed you to say who can or can’t post to it. Do you own the rights to this thread? I have said it before and I will say it again- this isn’t a simple argument about which food is best. You are messing with people whose dogs have just been diagnosed and they are scared and don’t know what to do. You are giving advice to them that can’t be followed without a knowledgeable and willing vet and honestly your ideas have more to do with human diabetes and dogs are not the same. Not only that, you say you are not a vet, but you counsel people whose dogs have diabetes – do you work with a vet or in research? How do you meet these people you counsel? I have read so much research on diabetes and have never seen any protocols published like the ones you are suggesting. So, I guess I will not invade your thread again since you own it but I feel sorry for the people who come here looking for answers. There are some great canine diabetes forums out there administrated by people who know what they are talking about and who actually have diabetic dogs. No crazy advice there.
Fasting a diabetic dog for 24 hours is one of the most dangerous things I have ever heard. There are many different diets out there for diabetic dogs. The trick is finding the one that works with the insulin to keep your dog well maintained. My dog has been diabetic for five years. What works for my dog may not work for the next person. I personally feed Nutrisca with a topper of either Merrick canned or Grandma Lucy’s Pure Performance. I stay away from potatoes and tapioca for my dog. You might google diabetic diets for dogs and find a great article from the Whole Dog Journal. It is quite informative and gives examples of different diets that owners have successfully used to maintain their dogs. If you don’t home test, I would start ASAP.
My dog’ s attacks seem to start with vomiting so that is when I use Cerenia. I typically don’t use the metro unless she has diarrhea. Anything I treat her with is always cleared through my vet and was actually his idea. If it saves me an emergency vet visit, I am for it. As far as Tramadol, I use a small amount of a pill if she is acting painful which also usually accompanies her pancreatitis attacks.
I don’t use probiotics – it may have benefit but due to her diabetes, I just don’t give her anything extra that might affect her sugar.
I, too, have a Jack Russell who is diabetic and has had several severe bouts of pancreatitis. We almost lost her to pancreatitis after she was bitten by a copperhead. Imagine a JRT taking on a snake – their tenacity certainly can be their downfall. Anyway, for the longest time, I had her on Pepcid with her meals at the suggestion of my vet. Also, I have used Cerenia and Tramadol (prescriptions from vet) immediately when the symptoms started and headed off a full blown attack. If your vet is willing to give you some of those to have on hand at home, that would be a wonderful thing. Something to watch for is steroids and Rimadyl – my dog reacts violently to these. I don’t know if that has anything to do with pancreatitis but both set off some pretty bad bouts with it.
Kristi – that is great news. Maybe the higher dose of insulin is making a difference. You might want to do a curve – starting with your morning food/ shot, check the bg every two hours. You will see how your dog is using insulin and the effects of food and activity. Hopefully, your foods will get there soon.
James – I suggest going first with what the vet recommends, which is nph usually. If that doesn’t work, then you go with another insulin, like Levemir or even Lantus but everyone should get this from the vet after monitoring and testing. You were the one who originally posted that a dog on nph was impossible to regulate and as I explained it is wrong to suggest that especially for people who are new to diabetes and looking for info. I have never said a dog should only be on nph. I know from experience that many diabetic dogs require different combinations of insulins and each one will react to the combination of insulin and food. All of the info for Lantus you posted is information for people using Lantus, correct? Dogs don’t process insulin in the same ways as people or even cats(i know you know this) Not only that, my dog’s actual curve doesn’t look exactly like the standard nph curve that the company posts so those graphs don’t mean anything about what is going on in reality.
James – do you have any research articles/studies that support the use of Lantus in dogs? The link you provided from caninediabetes.org was merely the peaks of certain types of insulin but in the information that followed, it only mentioned the use of Lantus in cats. I am trying to understand where you are coming from with your aversion to using nph for diabetes in dogs and why you make statements about it being “impossible” to regulate a dog with nph – that is absolutely not true. Of course, there are dogs that don’t do well on nph but it is by far the most reliable and most prescribed and that is not just my opinion. I looked for some research on using Lantus and all the information I can find doesn’t give a great endorsement for Lantus use in dogs:
(on page 40, Dr. Nelson states: “My experience with insulin glargine in diabetic dogs has been mixed and somewhat disappointing. I currently only use insulin glargine in poorly-controlled diabetic dogs where NPH and lente insulin are ineffective because of problems with short
duration of insulin effect.”)
http://images4.wikia.nocookie.net/diabetesindogs/images/3/3d/2009_V110Diabetes-Western-2010.pdf (on pg 4, Dr. Scott-Moncrieff states “Long acting insulins such as PZI and Glargine
are quite unpredictable in dogs and are not appropriate for the management of most diabetic dogs.”)
The only reason I am posting this is not to change your mind or to try to prove you wrong or even argue for the sake of arguing – I am deeply concerned about people who have newly diagnosed dogs who are desperate for information who might see what you posted and start having doubts about what their vet is doing. I know how scary, confusing, and overwhelming it is to get that diagnosis. Vets don’t usually do a great job of explaining the process to owners or diabetes for that matter and many don’t encourage their clients to test bgs at home.
The fact that you have worked with human diabetics and you are a diabetic and have counseled dog guardians(whatever that means) doesn’t really mean alot for this particular person who is facing Cushings and Diabetes with a vet who doesn’t even specialize in dogs. Do not tell me I am unwilling or unable to provide the care my diabetic dog needs – she was diagnosed over five years ago and she is doing great. What are the statistics of the dogs you have worked with? You are making vague statements of your accomplishments but no real hard data to back it up. How many of those dogs had Cushings, and pancreatitis? You recommended high protein and high fat food to these dogs and that worked? If you have this information, share it specifically. This is the danger in this kind of forum and not at all what I thought it was supposed to be. It is one thing to get on and talk food and ingredients but when you make suggestions for people whose dogs are in life-threatening situations and you suggest taking actions that go against everything that is out there from real experts in dog diabetes( not experts in reading labels and studying ingredients), I have to call BS.
Kristi – please find a canine cushings forum to help you with some of your questions. These people are living with your situation every day.
James- Although I respect that you are successfully managing your diabetes, dogs are different than humans and I think your suggestions are questionable for someone who doesn’t have a vet well-versed in diabetes. First of all, nph insulin most closely resembles the insulin dogs naturally produce which is different from humans. Most dogs are well maintained on this type of insulin and are not”impossible” to control at all. The short acting insulin(R) is sometimes needed for dogs that have insulin resistance but this dog has not had enough time to be regulated and to determine if resistance is the issue. Regardless of the insulin, diabetic dogs should be fed the same amount at the same time every day. To imply anything else is ridiculous. People who have had long term success managing their dog’s disease live by this principle. As far as food goes, a variety of different diets have been proven to work well for a diabetic dog but with Cushings (or pancreatitis like my dog) , a high fat diet is not recommended. A diet with “cheap” carbs is, of course, not good either. I prefer a food like Nutrisca because there is no potato or tapioca or rice or grain and my dog (dx five years now) thrives on it like no other food. Complex carbs work well with the nph insulin and they are necessary to have stable glucose levels throughout the day. There is an excellent article in the Whole Dog Journal which addresses diabetic diets and includes case studies of many dogs on a wide range of diets- raw, commercial, prescription, home-cooked and the success stories of those dogs. Diabetes is not a one size fits all with dogs and many times, you can analyze foods and labels and ingredients until you are blue in the face but you don’t get the results that you should. Personally, I think there are so many factors – metabolism, age, stress, infection or disease, etc that factor in.
James – While I agree with some of what you say in theory, it doesn’t always hold true in reality. I think Kristi probably would get better results with a long-acting insulin such as R, but without a vet who is well versed in diabetes, it is a dangerous proposition. Comparing diabetes in humans to diabetes in dogs is helpful in many respects as there are similarities, the flaw with that is dogs can’t communicate in terms we can understand until trouble is there. They can’t say they are feeling bad or shaky and short of checking their sugar many times a day, there is no way to know. If you can stay home non-stop with your dog, then great but most people don’t have that luxury. Also, to say diabetes is impossible to control with nph insulin is just wrong. I have done it for five years now and there are many others out there who have – in fact most dogs are maintained on nph. And just because someone uses a long acting insulin doesn’t mean you throw routine out the window. These dogs are best maintained on the same amount of food at the same time every day. As far as low glycemic foods are concerned, I have found just through my personal experience, that my dog’s blood sugar is just consistently lower and better since she is on Nutrisca. She feels better, looks better and it helps with her allergies. I actually tried Evo when she was first diagnosed and her bg was sky-high on it. The one thing I have found is that diabetic dogs react differently to different food. There was a series in the Whole Dog Journal last year about diabetic diets and the interesting part was there were many different case studies of diabetic dogs and almost all of them were on completely different foods. Some were on commercial diets, home cooked, raw, and even prescription diets but the owners all had great success by finding the food that worked for their dog. You can analyze the numbers and ingredients until your face is blue but if the theoretical “best” food doesn’t give you results, then you have to consider how your dog processes insulin and food.
Kristi, I would find an online forum for dogs with Cushings and/or diabetes so you can talk to people who are going through what you are with their dogs. There are tons of knowledgeable people out there who can really tell you about Cushings and diabetes who live it everyday.
I would avoid g/d – the ingredients are terrible. I would start looking beyond the vet for food. Has your vet mentioned increasing the insulin dose? Those numbers need to come down before too much damage is done. I wouldn’t increase the insulin dose and food at the same time though. You won’t know which change worked. Most vets in the early stages gradually increase the insulin dosages until the bg comes down to a better level. 550 is a risk of ketoacidosis and organ damage. My 14 lb dog was started at 5 units, increased gradually to 7 units where she stayed for some time. Once I got her settled on a good food that she likes , she is now at 4 units. You will see that as time goes on, their insulin needs change and so regulation is not permanent. I would make the food change first and after 5 – 7 days, explore an insulin change.
krist117 – I don’t have experience with Cushings but I have a diabetic JRT who was diagnosed five years ago. I have friends who have dogs with both conditions and I know once you get the Cushings under control, the diabetes will be easier to get regulated. I am worried that your vet admits his lack of experience with dogs – if it is possible, I would find a vet with dog and diabetes experience. If it is not possible, you will have to do the best you can. IMO you need to test your dog’s blood sugar at home. This dog needs to be monitored to determine how his body uses insulin. Buy a human meter(I use the One Touch Ultra) and buy your strips on Amazon or eBay. I test at fasting(before eating), six hours after that and then 6 hours after that at the evening meal. Take your meter with you to your vet and check against his lab. Human blood and canine blood are different but you will get an idea of how to adjust your number based on the difference between your reading and his reading. Testing is vital and don’t waste your time with urine strips – they are not reliable. As for food, I prefer Nutrisca which is low glycemic and my dogs love it. I top it with Nutrisca wet food or Merrrick wet food. I also use Grandma Lucy’s Pure Performance, another low glycemic option to change it up but worry about variety until you have him regulated. I stay away from potatoes and tapioca. Also, remember the most important thing is to find a food your dog will eat willingly. This is not a battle you want to fight – your dog must eat. You can also top the food with boiled chicken or homemade broth(not canned ) to make any dry more appealing.
I have a diabetic JRT who was diagnosed almost 5 years ago. Search Canine Support Group – it is a forum of very knowledgeable people who have experience with the disease. They helped me so much. One of the biggest challenges is to find a suitable food your dog will willingly eat and follow the same schedule without fail every day. Do you live in the U.S? Canisulin is not an insulin many U.S. vets use anymore because dogs using it are very hard to regulate. It would be great if you could get Novolin NPH or Humulin. You might want to check out a back issue of Whole Dog Journal which had an article about diets for diabetic dogs and all the options.