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Dr. Bruce
Dr. Bruce, Veterinarian
Category: Dog
Satisfied Customers: 19293
Experience:  15 years of experience as a small animal veterinarian
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15 lb. Min-Pin has had diabetes for a few months. Weve adjusted

Customer Question

15 lb. Min-Pin has had diabetes for a few months. We've adjusted his insulin (Vetsulin) dosage several times. He is currently just not acting himself, and his heart is beating hard – not fast, but forcefully. He is lethargic and despondent, but his breath is not foul as if he was experiencing ketosis. He's also not drinking an unusual amount of water or peeing in the house, as he did before he was diagnosed. What's going on with him?
Submitted: 8 years ago.
Category: Dog
Expert:  Dr. Bruce replied 8 years ago.

Can you answer a couple questions for me?
1) How many units of Vetsulin is your dog on? Twice a day?
2) Has he been eating?
3) Is he breathing hard?
4) How old is he?

Dr. Bruce
Customer: replied 8 years ago.
1) 3 units, twice daily.
2) He has been eating, but it was strange that for the first time EVER, today he only ate half his breakfast (raw beef and sprouts - carb-free diet). But then he was happy to eat some dehydrated chicken breast and ate some vegetables tonight. It's actually about dinner time for him now, so I should see if he wants to eat his dinner.
3) He seems to be breathing normally.
4) He's 9, lean and in good shape.

Expert:  Dr. Bruce replied 8 years ago.
I would offer him his dinner and see how aggressively he eats it. If he eats his normal amount tonight, I would go ahead and give him his 3 units of Vetsulin tonight. If he doesn't eat real well, I would only give 1 unit tonight. In the short term, us underdosing his insulin for a 12 hour period of time is much safer than continuing with his regular dosing and possibly dropping his blood glucose too low.

His just not acting himself. That is always a tough one. Maybe his blood glucose is a little low from him only eating half his breakfast. Another thought is, that he is under the weather from something entirely unrelated to his diabetes - a bout of stomach upset (not enough to cause diarrhea or vomiting...yet?), an early upper respiratory infection, and the list goes on.

As long as he is not extremely lethargic, breathing hard, or increased respiratory rate, I would follow the above and see how he does. Keep him in a quiet area of the house where he can rest and be observed.

Hope all goes well!
Dr. Bruce
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Customer: replied 8 years ago.
Hi. Thanks. Not sure if you saw the "optional information" I added after posting the initial question, as the site timed-out on me, but he has actually not been himself for a couple days. I noticed that half-way through our walks he is slowing down, not pulling and tenacious, as a normal Min-Pin should be. He also didn't even get up when I came home today.

Again, he only ate half his dinner. This is definitely unusual. But he is happy to eat a dehydrated chicken strip... If you have any more thoughts on this, please let me know. If not, that's fine. I'll give him 1 unit and see how he is tomorrow. Thank you.
Expert:  Dr. Bruce replied 8 years ago.
I didn't see the "optional information", it still hasn't come up sorry. I forgot to ask how old your little one is? Him not being himself for a couple days, not pulling and being as excited for his walks...that has me wondering what has your little one down. When was the last time your vet examined him?
Customer: replied 8 years ago.
He's 9. He hasn't been to the vet in about a month. 2.5 months ago he had a major seizure from hypoglycemia, due to his original 6-unit dose (which originally saved his life). The vet wanted to do a glucose curve, but I couldn't afford the hospitalization and I am not able to get blood from him myself. I've tried every way. He won't bleed enough with the "punch" that comes with the glucose monitor and I can't seem to get blood from him with a syringe.

By the way, my other dog, who he has always lived with, died 3 weeks ago, so he has definitely been depressed, but this hasn't seemed to affect his energy level when walking, or when I come home.

I think I'm remembering that he was kind of acting like this before his seizure, so I am definitely going to keep his dosage down for now.
Expert:  Dr. Bruce replied 8 years ago.
If you can't get the glucose curve done, and you can't check his glucose at home (not something very many owners can don't feel bad!), you can ask your vet for urine dip sticks to check occasional urine glucose levels. This is a very crude and simple way to see how effective your management of the diabetes is going. If your seeing constantly high glucose in the urine, the dosing is low. If your hardly ever seeing any glucose in the urine, your dosing might be high.

Ask your vet about these.
Dr. Bruce
Customer: replied 8 years ago.
Thanks. XXXXX have some of those. Sorry, last question: What would be the optimal glucose reading on the sticks? I haven't been able to figure out what the units of measurement on the bottle correspond to. It ranges from 100 to 2000+ mg/dL.
Expert:  Dr. Bruce replied 8 years ago.
To be honest, the optimal situation with the urine glucose strips is a combination of readings. You'd like to see a lot being negative (but also the patient being very alert, eating great, and acting great) and occasional readings in the 100+ range. What this combination tells you is that your keeping the blood glucose pretty well regulated, but not too tightly regulated (that is when you actually drop them too low most of the time.... of which, you've seen that happen).

I usually ask my diabetic owners to come in every 4 to 6 months to run a blood fructosamine level. It isn't too expensive and it tells how well managed they are over the past 3 weeks. You might consider having these checked every once in a while with your vet.

Dr. Bruce
Customer: replied 8 years ago.
Will do. Thanks a lot for your time and answers. :)
Expert:  Dr. Bruce replied 8 years ago.
Hope all goes well!
Dr. Bruce