Help! Diabetes

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
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Bpcooper14
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Location: Lynchburg, VA
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Help! Diabetes

Post by Bpcooper14 » 28 Jul 2018, 08:49

Morning all. You all have been such a help so far and I now need a bit more encouragement/ideas on how to move forward. Ace has been having some issues with excessive thirst and urination. With google as my friend and my limited knowledge of EPI to this point I had it narrowed down to anything from a kidney infection/UTI to Cushings/Addisons and most likely it would point to diabetes.
Well just got the phone call from the vet and his levels are elevated. The figure they gave was 290(?). Full blown diabetes was typically 600+ levels(?). They want to run a Fructosamine test, and want Ace to be on a diabetic diet plus insulin shots. They also want me to bring him in for a day for them to monitor (I'm assuming intake/output).
I know from perusing the old forum that diabetes is something that some of you have dealt with. Ace is 2 so this is going to be a long long road ahead for us and, quite honestly, i'm at the lowest I have been since this journey has started.
Hi all, I'm Bill. Ace was diagnosed with EPI on 5/31/18. In January, 2018 he was at the vet for routine check-up and weighed in at 34 lbs. In May after fighting with weeks of poor poo, he weighed 24.6 lbs. On Saturday July 28th, Ace was diagnosed as diabetic.
2 meals per day. He receives 6 units Vetsulin injections twice daily with each meal.
1 cup Victor Multi pro with 1/2 cup ground chicken breast, 1/4 cup sweet potato, 1/4 fat free cottage cheese. 1/2 tsp Pantenex enzymes, incubated 20-30 minutes.

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jilbert57
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Re: Help! Diabetes

Post by jilbert57 » 28 Jul 2018, 09:31

Good morning. Sorry to hear that Ace has elevated glucose levels. There are folks with pups with Addisons and diabetes and they will be on shortly. All of this can be managed jt is just a juggling act! You are doing a great job with Ace.
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 8 and Sadie is 2.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

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Olesia711
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My name: olesia

Re: Help! Diabetes

Post by Olesia711 » 28 Jul 2018, 11:54

Hi Bill,
So sorry to hear that Ace now most likely has Diabetes in addition to EPI.... that is what happened to us too! In short, it sucks... BUT..... it can be managed. We have been managing EPI + Diabetes for 5+ years now :)

Let me give you a little background that many vets are not up to speed on.... when dealing with Diabetes and another health condition, especially a concurrent pancreatic condition,- -the typical Diabetic recommendations do not always apply.

First, i applaud the fact that your vet wants to do the following: "They want to run a Fructosamine test, and want Ace to be on a diabetic diet plus insulin shots. They also want me to bring him in for a day for them to monitor (I'm assuming intake/output). " .... EXCELLENT!!!!

Next...don't freak out too much..... of course that is easy for me to say now that i have been dealing with EPI + Diabetes for 5+ years and finally figured things out... but it took me 2 years of trial and error to find the right protocol- -home blood curves is what finally put me on the right path!. Finding the happy middle ground for both conditions can be a challenge, but, if this is Diabetes, i will help you until you find the right balance for Ace.

First.... work closely with your vet and please share everything i suggest to you with your vet.

1. If Ace does have Diabetes.... the BEST thing you can do is have your vet teach you how to test the blood sugar at home... this is invaluable!!!! It WILL help you figure out what foods, portions, activity, insulin dose, etc works best or doesn't work....Unfortunately if you only depend on testing the blood sugar at the vets office (after the initial diagnosis).... you will never get all the information that can really help you find the best solutions.....AND often times, the dog gets more nervous just by going to the vets and that can also skew the results to some degree- -not to where you have a false read, but it can be off a bit because they are nervous and you are better off with more accurate information.

ALSO.... once you start doing curves yourself and keeping track of blood sugar and the food composition/portions, meds, activity, insulin, etc..... keep notes of the curves and OMG... you will be blown away by all the valuable information you will then have and be able to really help Ace get settled. Trust me.... this is the cornerstone of effectively managing Diabetes in an EPI dog.

2. Next, if this is Diabetes, your vet will most likely start Ace on Novolin or Humolin intermediate Insulin. These are human-synthetic insulins and usually works well... BUT some dogs dealing with EPI + Diabetes.... don't level out as well as expected and do better on Vetsulin.... a porcine based insulin..... but this too can be tricky to use until you get the hang of it. I'll help you if need be. So use whatever insulin your vet recommends, but if it doesn't work as well as expected.... let me know.

3. Again, if this is Diabetes..... no matter what the typical Canine Diabetic protocols are.... with EPI + Diabetes.... our dogs often do MUCH better with very limited fat... and i mean limited... even low fat cottage cheese vs. fat free cottage cheese can make a big difference in the blood sugar! BUT.... they still need EFAs... so what usually works is EFA supplements (fish oil supplements) as these typically will not raise the blood sugar- -but you will have to do a curve to confirm.

4. With EPI + Diabetes, many vets will tell you they want the blood glucose to be maintained in the 100's.... hahahaha! most likely not going to happen unless you are really lucky! ... if you read the veterinarian endocrinology journals, and dig deep into the details, look for dealing with exocrine pancreatic insufficiency and diabetes....it will tell you right there, that if you can keep the blood sugar to range no higher than 250 at the peak than that is good for an EPI + Diabetic dog..... there will be swings, but you don't want high swings or staying in the 350+ levels. Unfortunately, the details on how to deal with concurrent conditions such as EPI + Diabetes is not considered very common, so sometimes the itty bitty details are not well known... and even then, specialised veterinarian endocrinologist will let you know it can still be tricky.

5. Tidbit.... important.... i suspect your vet will put Ace on insulin twice a day- -and i suspect the intermediate insulin.... if so... be sure to feed twice a day 12 hours apart...you've got a 30 minute leeway one way or another.... but other than that don't monkey around more than that with the times that you feed Ace... as that will really mess his blood sugar levels and you could be dealing with spikes and lows............

There is so much more that i can tell you/ help you with, but no sense going on and on (i talk a lot and tend to give tons of details- -sometimes too much!) until you find out from your vet If Ace does have Diabetes. If he does, he also may be in a honeymoon phase right now :)

Anyway... keep us posted, and if this is Diabetes... i will help you and once you find the right protocol for Ace... it will not be as bad as it seems in the beginning!
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

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Bpcooper14
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Re: Help! Diabetes

Post by Bpcooper14 » 28 Jul 2018, 12:57

Thank you so much for all of the information. I am the same way. I will continue to talk and talk and talk and talk and talk and........
Anyway. The results of the test are not all that unexpected given my research prior to scheduling the vet appointment and the vast amount of information that is included here. Knowing (somewhat) how EPI comes about and it's effects on the animal were able to let me narrow down in my opinion what it was I was dealing with.
A couple things.
1. Based on the information you provided (keep the blood sugar to range no higher than 250 at the peak than that is good for an EPI + Diabetic dog..... there will be swings, but you don't want high swings or staying in the 350+ levels), his tested fasting levels are currently at 290 which is higher than the 250 but not significantly so. To me, this indicates he is trending towards "diabetic symptomology" but not full blown diabetic. We have had a rough couple of weeks with food, travel, etc. and I wonder if any of that could have lead to elevated numbers. His current food is Purina Pro Plan Focus Sensitive skin & stomach lamb and rice. I know, not ideal on the list BUT his poos have finally settled as some of the best we have had since this whole journey started about 2 months ago. The makeup is 26%/16%/4% with 1 tsp enzyme per cup. My understanding is a lower fat food is imperative for the diabetes. Do I have anything else in particular I should look for (trying to avoid the prescription diet the vet is going to try to sell me on)
2. (i talk a lot and tend to give tons of details- -sometimes too much!) until you find out from your vet If Ace does have Diabetes. If he does, he also may be in a honeymoon phase right now What do you mean by "honeymoon phase"? Ace or the vet might be in the honeymoon phase? And I hope we don't get to a "divorce phase" as I don't think I can handle that especially how I felt upon hanging up with the vet this morning.
3. Given that his numbers seemingly are on the slightly elevated level for an EPI dog, is it possible that there is an oral supplementation/alternative to insulin treatment that is effective in lowering blood sugar levels? I saw something somewhere about an alternative (Primalix food drops for diabeties in dogs and cats)

I am trying to formulate my response to the vet instead of blindly taking their suggestions without questions or additional information to present them with. As it stands, I am planning on purchasing a meter for home and running the blood sugar tests at home and keeping a log. OH GOOD, I CAN NOW PUT TOGETHER ANOTHER HELPFUL ONLINE LOG FOR EPI+DIABETES DOGS!!!!! I also plan on doing the insulin shots at home as needed as well. Obviously, there are financial implications and I am trying to plan accordingly at how can i do this the best possible way without sacrificing his happiness and health. I'm sure there are more questions coming, I just don't know what all to ask at this point and haven't been able to do my deep dive into online research and google info! :lol:
Hi all, I'm Bill. Ace was diagnosed with EPI on 5/31/18. In January, 2018 he was at the vet for routine check-up and weighed in at 34 lbs. In May after fighting with weeks of poor poo, he weighed 24.6 lbs. On Saturday July 28th, Ace was diagnosed as diabetic.
2 meals per day. He receives 6 units Vetsulin injections twice daily with each meal.
1 cup Victor Multi pro with 1/2 cup ground chicken breast, 1/4 cup sweet potato, 1/4 fat free cottage cheese. 1/2 tsp Pantenex enzymes, incubated 20-30 minutes.

Rudysmom

Re: Help! Diabetes

Post by Rudysmom » 28 Jul 2018, 13:31

I'm sorry to hear that Ace might have another diagnosis. I am right with you on feeling low and just wanted to let you know that you aren't alone! I can't offer any advice on the diabetes but will follow your journey closely. Wishing the best!

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Bpcooper14
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Location: Lynchburg, VA
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Re: Help! Diabetes

Post by Bpcooper14 » 28 Jul 2018, 16:12

Thank for the words of support. I'm hopeful that I'll be able to get a handle on it. It's a lot to digest in a relatively short time even though I had an inkling of the results before I got the phone call this morning
Hi all, I'm Bill. Ace was diagnosed with EPI on 5/31/18. In January, 2018 he was at the vet for routine check-up and weighed in at 34 lbs. In May after fighting with weeks of poor poo, he weighed 24.6 lbs. On Saturday July 28th, Ace was diagnosed as diabetic.
2 meals per day. He receives 6 units Vetsulin injections twice daily with each meal.
1 cup Victor Multi pro with 1/2 cup ground chicken breast, 1/4 cup sweet potato, 1/4 fat free cottage cheese. 1/2 tsp Pantenex enzymes, incubated 20-30 minutes.

Barb
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Re: Help! Diabetes

Post by Barb » 28 Jul 2018, 22:32

Hello, and welcome to you and Ace. I am so sorry that you are dealing with two conditions to manage. But you couldn't have a better source of information and advice than Olesia......as you can see from her post. I know the information is a lot for you to absorb, so give yourself time to adjust, and try to take one day at a time. It sounds like you have a good vet who is doing all the right things.

Hang in there. Give Ace a big hug.

Barb

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Madelon
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Re: Help! Diabetes

Post by Madelon » 29 Jul 2018, 21:19

Ace couldn't have asked for a better human!!! So glad he has you to be his advocate. I don't have any experience with diabetes but you are in the best hands with Olesia. Please know we are all here and all rooting for you and Ace.
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

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Bpcooper14
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Location: Lynchburg, VA
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Re: Help! Diabetes

Post by Bpcooper14 » 01 Aug 2018, 17:56

Latest update (with more info to come after talking to the vet-playing phone tag right now). Fructosamine test came back with elevated levels of fructosamine so we are going to need to start insulin regimen. I've yet to talk what type of insulin or dosage yet since I am waiting to have a conversation with her. Hopefully we are able to get things regulated. Once I have a conversation with the vet, I will update details here. For those of you dealing with diabetes (or know those that have), where do you purchase your insulin and what type are you using? I've seen lots of different people talking about Vetsulin (sp?) and a Novolin-N or Relion Novolin-N that can be found for around $25 per vial.

Most importantly, A HUGE THANK YOU to Olesia! I received your package today and the timing couldn't be better. The generosity and support still blows me away!
Hi all, I'm Bill. Ace was diagnosed with EPI on 5/31/18. In January, 2018 he was at the vet for routine check-up and weighed in at 34 lbs. In May after fighting with weeks of poor poo, he weighed 24.6 lbs. On Saturday July 28th, Ace was diagnosed as diabetic.
2 meals per day. He receives 6 units Vetsulin injections twice daily with each meal.
1 cup Victor Multi pro with 1/2 cup ground chicken breast, 1/4 cup sweet potato, 1/4 fat free cottage cheese. 1/2 tsp Pantenex enzymes, incubated 20-30 minutes.

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Madelon
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Location: Nashville, TN
Country: United States
State: Tennessee
Pet name: Doc

Re: Help! Diabetes

Post by Madelon » 01 Aug 2018, 21:22

Olesia is a blessing to all of us for sure!! She will be the best one to advise you regarding diabetes since her dog has diabetes but if I remember correctly the Vetsulin has worked best for those with diabetes but she will let you know for sure as I'm just relying on memory :)
Madelon, owned by DOC. DOC dx EPI 5/2015 = TLI < .4, B12 406; Folate >24. DOC taught me so much and together we battled and overcame EPI, food sensitivies, environmental allergies but we lost the cancer battle. DOC was dx with hemangiosarcoma 5/2022 and crossed the rainbow bridge July 24, 2022. He is and always will be the love of my life, my soulmate, my heart dog.

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