Because of poor and conflicting instructions from multiple vets we have had to do our own research and learn to care for Molly largely on our own. You can read more about the ordeal and our journey here. When we obtained our first instructions from the veterinarians they overly stressed keeping her glucose “below 200 around the clock.” This created a great deal of confusion and sent us down a path to basically increase her insulin by 1 unit every two weeks after doing a glucose curve until we were able to maintain her glucose under 200. This was very bad advice.
Dosages
After reaching doses as high as 21U, Molly has now been on a consistent dose of 16U of insulin for over two weeks and is doing well. Her fasting glucose varies widely but is almost always between about 270-370 with periodic spikes over 400. The things we watch for are her behavior and if she were to start drinking massive amounts of water like she did just before the diagnosis. She is probably as playful as she has ever been and certainly more playful than she’s been the past few years. We believe taking her off Mycophenalate two years ago helped her sensitive stomach and now she’s no longer taking prednisone, she is much healthier. Apoquel has replaced prednisone for her skin condition and has worked wonderfully.
Glucose Spikes
It is important to understand that a dog’s glucose can vary widely and spikes are normal. Many things can affect their glucose levels, especially stressful situations. Molly is a nervous-natured canine so many things can cause this for her. Thunder, loud noises, a power outage that causes electronics to beep and reset, or even the sound of moving the camera we use to keep an eye on her–she is definitely a Nervous Nellie. As long as her glucose tends to fluctuate and for the most part stay in the 270-370 range when fasting, it seems to work well for her.
Glucose Dips
Molly’s glucose can dip 100-150 points at times after a dose of insulin so the importance of fasting glucose level is important. Anytime we see an abnormally high or low reading we check it a second time because it can be a bad read and often times it proves to be just that. Anytime her glucose tests below 250 we pay a little more attention and if it’s below about 220 we will administer a 75% dose and if it’s below about 200 we will skip the dose.