What could be sweeter then a canine with diabetes!
..

Beringer
To see or Not to see; That is the Question.....

And the Answer is: TO SEE!!!  HELLO!!!! My name is Beringer Belle Canterbury, and today, August 10, 2006, I can see again! First, a little history. I was born March 23, 1999 to a Shih -Tzu/Pug mom and a Schipperkee dad. While still a youngster I had a seizure and my Mom got me phenobarbitol pills for epilepsy which I take twice a day. Shortly after, I had knee surgery, and Mom and I were joined at the hip, so to speak, because I wasn't allowed to move around much on my own. And, then, on April, 13, 2006 (I am 7 years young) I was diagnosed diabetic. Our Vet told us that some dogs never go blind, but that most will, and sometimes a dog can go blind overnight, and sometimes a dog will go blind before their Mom and Dad even know they are diabetic. For me, it was only two months before the cataracts began to form, changing day to day making it harder to see. Mom and Pop took me to Dr. Lavach (DVD, MS, Diplomate, ACVO) in Reno who was nice to listen to as he looked into my eyes. He could see clearly, back to the Retina (which was really important), and there were no inflammations, no infections, no swellings; so as soon as my cataracts were 'fully matured' (3-4 weeks), and my UTI was completely cleared up, I could have surgery. For both eyes, the estimate was $3,045 - $3,056. In the mean time, Mom was to put a drop of Prednisolone Acetate in my eyes twice a day to keep them healthy.

Waiting was the hard part. My depth perception was off, flat surfaces were invisible - each day it became harder to see images. And then Mom took me to our Vet for a Senior Screen which included a complete blood panel and UTI check. Two days later I was back at Dr. Lavach's. Everything looked good (to him, anyway!), and Mom says "Six more days, HoneyBunny!"  I couldn't see my food bowl and I was bumping into my sisters. "Two more days, BeriBelle!"  I couldn't navigate the backyard without hearing Mom's voice to lead me."Tomorrow, Sunshine!" Pop had to carry me to bed 'cuz I couldn't jump up myself. And then it was "Today's the Day, Beringer!"

I had my pills, insulin shot,  and breakfast as usual, at 6:15am. Mom and I drove to Reno (1.5hrs) and she left me and my pillow at Dr. Lavach's Eye Clinic at 8am. He does surgeries on Tuesdays and Thursdays. Today is Thursday. He and his nice assistant put drops in my eyes for the first couple of hours, and then I took a nap. When I woke up I could see them! Not perfect, but better! After a little while, they let me down so I could go exploring, and I was having fun doing that until I looked way down the hall and saw my Mom's shoes! I know my Mom's shoes! I was so happy! Dr. L. told my Mom that the cataracts were nice and soft (intumescent). A +41D artificial lens was placed within the lens capsular bag of each eye, plus a bubble of air to help them seat. And he gave her this huge ugly white cone thing and a bag with meds. The E.Collar was to protect my eyes from myself. Okay. I can see!! And all the new  meds? Okay. I can see!!

Friday, August 11, 2006: My 1st checkup. Dr. L. asked how I did last night. Well, not so good. Mom had put the E.Collar on first thing, and then the meds! I have an eye drop twice a day (Flurbiprofen) and then an eye ointment four times a day (Neopolydex -NPD), plus a tiny white tablet (Methazolamide), a capsule (Cephalexin), and a chewable (Rimadyl), all twice a day. WELL! Turns out the reason I was panting so much and lethargic at the same time was because of the tiny white tablet. But according to Dr. L., I was doing pretty good, but see how I do the next 24hrs, and we could go to evenings only if need be. Hey! I come from sea-faring Schipperkee stock! I can take the tiny white pill twice a day - the sooner I'm done with them! And my eyes look great, by the way!

Wednesday, August 15, 2006: My 2nd checkup. Dr. L. is smiling. No infection, no swelling, everything looks wonderful. And the red corpuscles are forming a bright red line across the incisions. Perfect. I sneak a peek at Mom. She's turning green. Perfect!

Monday, August 21, 2006: I get to go to work with Mom and Pop today because I have another check-up with Dr. L. in Reno. So far I haven't had any problems. When I first came home I was able to eat a little and drink water and I slept all through the night. I was pretty out of it the next day, too, I think 'cuz of the meds Mom was giving me, especially that tiny white pill that makes me pant and be lethargic at the same time. But my appetite came back okay and I was allowed outside to play a little, and yesterday we went for a long car ride and Mom took that big cone off my head. Now, that was nice! She had to go in a store, and Pop and I waited in the car. There were a lot of people moving around, but I saw her as soon as she stepped outside. Pop knew cuz my tail was dusting my back and he smiled and gave me a big hug. It was a really nice day, but I blew it big time when we got home. Mom put the ointment on my eyes, and, well, I know she watches me like a hawk, but I started to rub my eyes anyway, and on when the E. Collar! They're right, $2,973.19 is a lot of money. It was a little less than the estimate cuz Mom got my bloodwork done here in Fallon so if there was anything wrong it could be fixed ASAP so surgery wouldn't be delayed, and the anesthesia meds were an estimate (for a 25-50lb dog, which I weigh less). The Up side is the meds and all these checkups are included. 

So today I get the full eye exam again, and Dr. L. is smiling happily because my eyes look wonderful and the red corpuscles are a very bright red which is great, and so of course, he has to show Mom and Pop and rolls my eyelids back a little so they can see the 1/2" long incisions right above each iris that are covered with bright red little bumps. Mom did okay, didn't turn green this time, but how come they didn't get me a mirror so I could see??
 

.
Date: Sat, 25 Aug 2007 
I'm Kathy, and my diabetic pooch is Beringer Belle. 

When she was 1st diagnosed, 17 months ago,  she was put on Vetsulin because
"their options had been eliminated". One of the 1st things I did was switch syringes - those 40U needles were difficult to use, and I could never get the angle right.

Everyone on this list continued to emphasis how important it was to do some kind of testing at home - especially the blood testing if I could - because the curves I was having done at the Vet's would not reflect accurately how the Vetsulin was working. I got the GlucoPet - and the ReliOn people meter at Wal-Mart - but just couldn't do it until Jan. And besides, the Vet said Beri was doing just great. But I did work up the courage one day - and I have done it every day since. It is true, once the dog knows what it is to be expected, they are ready. I just pick up the meter, and Beri decides which chair and what elbow (you can test on the lip, ear, above the tail, dew claw, or elbow callous), and 1,2,3 it's over, and I know how she is doing.

Vetsulin has 30% regular, which goes to work right away. You will need enough carb to offset the regular, because for the 1st 4 hours it will bring her down quickly, so the balance of carb & insulin is very important. When she starts at only 88BG, if she doesn't get enough carb, she will hypo. Period. At the end of 4 hours, there is a lag time between the 'R's effectiveness and when the 2nd insulin starts. For Beringer, it never really happened, but it is suppose to go to work around the 10th hour.

So between the 4th and 10th hrs, the BG will steadily climb, the 2nd part kicks in and the BG comes down just a little bit, before the next shot. That is the way it is suppose to work :)

ANY food - it does not matter what! WILL raise the BG automatically if not counter-acted with the insulin. Regardless of what insulin you use, feeding any inbetween foods or snacks will throw your dog's BG off. It is very important that you feed ONLY when she gets a shot! No other time!

I found with Beri, to get an accurate scale of her BG  when she was on Vetsulin, I had to test damn near every hour for 36 hours to get her first curve. 4 tests in a day can't reflect the changes a dog goes through as the food & insulin goes to work - and let's not even mention stress, depression, heat, excercise, infections, etc, etc. that all have their toll on the pet's BG! A little Pupperoni snack may not seem like much food, but the carbs are high, and probably are the only food keeping Pepper from going hypo!

For Beri, she was under the renal threshhold (250 by the Vet's analyzer) for only an hour or so per cycle; and that was just before, at, and after the nadir - which is when the 'R' hits it's maximum effectiveness at 4hrs. To increase her insulin I would have endangered her with going too low.

Every insulin is going to have draw-backs because of the pet - they are all different. What is most important is keeping the pet within a safe range, below the renal threshhold as many hours a day as possible.  Also, double check the carbs she is getting - it will surprise you. With Vetsulin you must have the high carbs!

You can order a GlucoPet meter (usually registers 15-20points lower than a Vet's analyzer) or get an Accucheck or a people meter locally. Take into account that those numbers are representative enough to know what your pet is doing and usually run lower than the GlucoPet which is usually lower than the analyzer.  For example, a 191 on the ReliOn meter that I use on Beri corresponds with 225 on the GlucoPet, which should be around 240 on the analzyer. So anything between 59 (110) and 191 (225), I'm happy & she is happy. But not all meters are created equal, and that is something you would need to compare if you get a couple of different meters. I got the ReliOn
because the strips are 50% less than the GlucoPet, and I can get them locally whenever I need them.

I switched her to Novolin N the beginning of Feb. Margo pulled out all the stops & tried every trick in her bag - but we could not get Beri off of that roller coaster! With the NPH, she's riding gentle waves - most of the time! - such a difference! It's not perfect, and she keeps testing me - she was at 11.5U, now we are trying 9.5U! As if she isn't the center of attention already!

Take a weekend and work with your pet, recording all the BG testing, I think you will be surprised at how much the BG fluctuates. All the hi's & lows has to be very upsetting to the body! Don't get me wrong - lots of people on the list manage their pet's diabetes with urine tests - for others - the blood testing was easier to accomplish & more difinitive. But it is in your power to take control of regulating the BG.

You can switch syringes anytime - some states require that the pharmacy contact the Vet for verification - a prescription. Or you can order U100's online through Hocks.com. Many of us use the 31 gauge short needle - it's much much thinner than what you get at the Vet's, and shorter, so straight in, no guessing at the angle. About $20 for a box of 100.

To switch insulins, just hit the local pharmacy. At Wal-Mart, a vial of ReliOn 'N' is $20.00. ALL vials should be replaced after 28 days - the air injected each time used degrades the insulin a little each time, so the strength of the insulin is not as strong at the end of the 28 days as it is at the beginning. Switching at 28 days alleviates strong strength differences between vials - if you believe the current vial has lost a good portion of it's potency it's best to reduce the dose from the new vial just a bit so the pet doesn't feel overwhelmed.

I was asked last time at Wal-Mart if I wanted the generic insulin??? Anybody know about/try this?

If you do switch to NPH (and I am strongly recommending that you do), the beginning dose is .25 (1/4) the weight of the pet twice a day, and you must use U100 syringes.  Go up .5 (1/2) every other shot till you start getting good fasting BG's. Then you may need to tweek here & there. You also change the food: 1/3 protein (most of us boil or bake chickens), 1/3 veggies (chopped green beans, broccoli...), and 1/3 low carb kibble (Evo, Orijen) or barley or wild/brown rice. I add in 2 tsp of a low carb canned also to mix w/the veggies). Dessert snack, try Waggin Chicken Jerky Strips which is 13% carb; and only 1/2 a piece!

The NPH needs less carbs. 

Beri weighs 24.4lbs now. She gets (you know those little cups that come with Nyquil & liquid calcium???) one of those filled (almost 2oz) of chicken, then veggies. She also gets 1 tsp oats, 1 tsp coconut oil, 125mg cranberry. That's all frozen in 1/2 cup containers; 3 chickens is about 60 servings. I also fix some meals with flounder or tuna for a change.  I thaw, warm, and add 2 heaping tsp. of low carb canned, twice a day with her shot: she gets a little cup full of kibble and 1/2 a piece of jerky for dessert.
 

  Read More Stories about Other Diabetic Pets

More Catarct Journals

 Rosie's Cataract Surgery
Surgery performed in Tampa, Florida at a cost of about $2600.00

 Mackie's Cataract Surgery
Surgery performed at Kansas State University Veterinary Teaching Hospital 
Cost about $1750.00
 

 

Page added on August 21, 2006

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