Diabetes

Postby pitbullmamaliz » April 3rd, 2010, 10:47 am

My girlfriend's Min Pin, Stuart Little, was recently diagnosed with diabetes. They are having trouble finding the right amount of insulin for the little guy (I think they started around 4 units and now he gets 8 in the morning and 7 at night, or vice versa, can't remember). Every week she has to take him to the vet and have them draw blood to check his glucose. She keeps asking them if she can use a human glucose monitor and prick his ear or something to check it on her own. She's spending about $200 a month on Stuart between insulin and weekly vet checks.

Can she just get a diabetes glucose monitor made for people and use that? She's just trying to save a bit of money and some stress for Stuart. She also said that he now yelps every morning and evening when getting his insulin. :(

Thank you!
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Postby amazincc » April 3rd, 2010, 12:41 pm

She can use a people monitor... but without insurance coverage the test strips are VERY expensive. The meter is usually free, but the costs of the strips are outrageous. :neutral:
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Postby Malli » April 3rd, 2010, 1:04 pm

she can use a people glucometer. I'd contact her vet and ask which they use.
In bringing him in, she is also paying for the education of the Vet to eval. how the insulin is being utilized by his body, so it might not be as cut and dried as just looking at a number and adjusting.

Can she give him something "treat"ish when he gets his shots? It should be subcutaneous shot and they really are not that bad, so IMO he's just being a sissy. Most cats take subcutaneous shots well, let alone dogs!

I think Diabetics need low carbs high protein low sugar? And fibre as well. So, there should be a treat out there that the vet would be ok with and he'd like.
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Postby amazincc » April 3rd, 2010, 1:15 pm

Malli wrote:
Can she give him something "treat"ish when he gets his shots? It should be subcutaneous shot and they really are not that bad, so IMO he's just being a sissy. Most cats take subcutaneous shots well, let alone dogs!



I agree... I am a diabetic, and a wuss on top of that - and while the shots are uncomfortable, they are by no means overly painful. :|
Maybe a few small pieces of cooked chicken as a treat might make them more bearable? :wink:
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Postby plebayo » April 3rd, 2010, 2:11 pm

Doing the glucose readings at home MIGHT make things easier. We have a dog that the owner does the curves at home because he gets so stressed at the clinic we don't get accurate readings. Also - we use a human glucometer, and yes she can do an ear prick or quick a nail. Maybe if she did it at home they could regulate him better because maybe he just gets too stressed in a veterinary environment?

I agree with Christine maybe she could give him a really high prize treat just for when he gets poked so he knows he gets something really good for being brave. The thing that is frustrating for me is that you can't change the needles on the insulin syringes, so you have to poke the bottle and then poke the patient so you're essentially using a now dull needle. It's hard to be stoic haha. I think a treat would be fair enough considering high glucose is better than low glucose, so maybe just have her feed him a little less to make up for the treat she gives him [whatever it may be].
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Postby BullyLady » April 3rd, 2010, 9:42 pm

Totally she can use a human monitor! Like someone else said, the strips are crazy spendy. My mom has been monitoring her glucose at home to try and ward off diabetes and she paid $75 for 100 strips. :o As of Thursday she's diabetic though, so they are covered by insurance now. :neutral:
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Postby call2arms » April 4th, 2010, 12:03 am

If they're having a hard time finding the right amount of glucose to give, it would be a good idea to do a glucose curve (at the clinic or at home, it's better to do it at home though, less stress induced hyperglycemia), and the vet can evaluate that instead... Normally when an animal is not well regulated there's no point to do a blood test every week, unless they're doing a fructosamine instead of a glucose, which needs to be sent to the lab and gives different info. Usually a glucose curve is more indicated, and you don't need to do that every week.

For the insulin needles, maybe one syringe can be reserved to draw up the right amount of insulin, and that amount can be put in another new syringe if the plunger can be removed, but... you might not end up giving the exact dose in the end.

It's possible that the poor guy is really anticipating the shot, and making it a bit of a bigger deal than it really is... If they know he'll eat well (some animals do, some don't) they can try giving it while he eats, works well with cats. Hopefully if the end up using a human glucometer at home (which is fine) he doesn't also anticipate the ear prick. I personally dislike the nail quicking to get blood, it's usually big enough a deal to trim the nails, let alone quick them on purpose!

They should also vary the area where the insulin is given, as giving it always in the same spot can cause sensitiveness, as well as scar tissue which can inhibit proper absorption of insulin. I think it's recommended to go in a zigzag pattern, down the back (obviously in areas where there's enough loose skin)...
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Postby Malli » April 4th, 2010, 2:56 am

yeah I agree on the nail quicking.

Theres a trick on the ear prick, but it will probably be easier with a min pin if he's ears are natural as they are fairly big and thin so the vessels are easy to see ;)
I'm thinking a very small piece of boiled chicken can't be too harmful...
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Postby pitbullmamaliz » April 4th, 2010, 7:55 am

Thank you all so much! I'm seeing her today so I'll pass this info along. You guys are the best! :)
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Postby blabsforbullies » April 4th, 2010, 8:24 pm

Just my professional and personal opinion: :wink:

She can use a human glucometer, but they are not calibrated for animals. So, in order to get an accurate reading, she should, ideally, have a blood glucose (BG) curve done at the hospital on a machine that IS calibrated for animals and do a test with the glucometer she chooses at the same time for comparison.

One of my cats is diabetic, and I am VERY distrustful of glucometers for animals, as a general rule. I find them to be off by 70 points or more on the in hospital studies I have done (especially in the high and low values, which, in my opinion, are the really dangerous ones). The only glucometer that I am aware of (there may be others, however) that is calibrated for animals is called Alpha Trak (I got mine on Amazon.com). It was about $175 for the kit, and it comes with 50 test strips and instructions, etc. The first BG curve I did on my cat was done with both the Alpha Trak and the in house lab machine. That way I could at least see what the difference in numbers were for myself. I have never been able, nor have I ever heard recommended, to take one blodd sugar value at one time on one day and be able to adjust insulin levels that way. Too many factors can affect a single reading, and it is, in my opinion, far more important to see a trend in a given day than to spot check values here and there and then not know where they go from there (some can be plotted as a bell curve, some are up and down multiple times through the day).

Diabetes is a life changing disease for animals and their owners. I don't think I truly understood that until my own cat was diagnosed. I understand the frustration and I really hope that things get worked out for your friend. :D
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Postby BullyLady » April 4th, 2010, 9:50 pm

Dr. Blabs, why can't animals use glucophage like humans? A pill would be SO much easier than an injection for animals!
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Postby call2arms » April 5th, 2010, 12:00 am

The only disadvantage with the Alphatrak is that the clients have to order strips through the clinic, instead of having them available at the pharmacy at any time. I think the strips are abut 50$ cost price for a pack of 50. It is much better though, we tested a super diabetic dog with both to compare and the human glucometer would just read "HI" when the Alphatrak would actually still give numbers.
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Postby amazincc » April 5th, 2010, 12:34 am

call2arms wrote: the human glucometer would just read "HI"

:shock: :shock: :shock: 600+ ... poor dog.
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Postby call2arms » April 5th, 2010, 12:51 am

Not THAT bad, I think it read something around 27-28 mmol/L (which is bad, but nothing like 600)...
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Postby amazincc » April 5th, 2010, 1:17 am

call2arms wrote:Not THAT bad, I think it read something around 27-28 mmol/L (which is bad, but nothing like 600)...



Oh, it must be different in Canada... here a HI reading on a human glucometer is anything higher than 600.
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Postby call2arms » April 5th, 2010, 9:20 am

it must be differnt units, for sure.
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Postby blabsforbullies » April 5th, 2010, 9:10 pm

BullyLady wrote:Dr. Blabs, why can't animals use glucophage like humans? A pill would be SO much easier than an injection for animals!



Well, I'd have to look into that specific drug, because I'm not familiar with it, but oral meds, as a general rule, aren't absorbed well and do very little to the overall blood sugar level. Occasionally, a cat will respond somewhat to oral hypoglycemic meds, but unfortunately, insulin is still the best option right now. Man, I would LOVE to give pills!!! :)
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Postby PoodleMaMaKat » April 5th, 2010, 10:32 pm

BullyLady wrote:why can't animals use glucophage like humans? A pill would be SO much easier than an injection for animals!

There are 2 types of diabetes in humans, type 1 and 2. In type 1 diabetes the body does not produce insulin. Dogs typically have type 1 diabetes. The only treatment for type 1 diabetes is insulin replacement with injections. In type 2 diabetes the body doesn't produce enough insulin or it doesn't work as well as it used to. Oral diabetes medications are only used in type 2 diabetes because the body must produce insulin to work. They either help the insulin work better or increase insulin production. Cats can get type 1 or type 2 diabetes, although type 2 is less common.

call2arms wrote:it must be different units, for sure.

yes Canada uses mmol/L and the US uses mg/dL. 10mmol/L is about 180mg/dL.

There are some machines that are less expensive. We sell one at work that you can get strips for under $20. It doesn't do all the fancy functions like the more expensive machines, nor is it a name brand. So I would suggest shopping around a bit before you make a purchase. Some machines require calibration("coding") with each new box of strips (this can get annoying). Most of the new machines require no coding, but may be more expensive. I would also recommend comparing your reading to a vet reading just to make sure the machine is accurate.
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