geekery, drawing and then some
Somewhere earlier this year, Nano started acting a little weird. She seemed more sluggish and slow, and at the same time more bitchy -- I think I can use 'bitchy' here, she is a female dog and all -- and easily annoyed.
Normally, we'd go out at around 22:00 and then again at 08:00 or maybe 09:00. She needed to go pee more. And she drank a lot. I had to refill her bowl four or five times per day.
After a week of waking up at 01:00 and 03:00 and 05:00 and 07:00 because she had to go pee, I made an appointment with the vet. They did some tests, including an extensive blood-test, and the cause of her malaise became very clear: high bloodsugar. Since the other tests showed no anomalies, the vet concluded diabetes. She told us to start doing shots, and then bring Nano in for another bloodsugar-test in a week or so. I asked about checking her levels myself, since I did own a glucosemeter. They showed me how to do it, and told me to phone in the results after a week of doing 2 units per meal (4 per day), 12 hours apart.
A few things became almost immediately clear:
- Nano doesn't like the way the vet said to check her glucose
- She almost instantly stopped drinking and peeing so much, I could sleep through the night once more!
- Nano should have her head checked, she does not care at all about getting needles in her ear or shoulders. In fact, these days, when I take out the glucosemeter she comes running as soon as she hears the pop of the strips container.
- Nano's levels do better on a raw meat diet, they go through the roof on dry food.
- Nano's seemingly innocent snacks made her levels go very high (above 30mmol/L (or 540mg/dL), from around 9 or 10 (or ~160-180mg/dL)).
- Tiny insuline bottles fall over easily in the fridge 1
Glucose-levels for dogs need to follow a similar pattern as they do for humans. Ideally, she'll have values between 5 and 10 mmol/L. We have discovered, however, that if she drops below ~6.5, her glucose will shoot up in the next hour or so (up to and sometimes even over 20). I've tried various meters and they mostly seem to agree on the values, and that the glucose bounces back up when it drops below 6-ish.
In the early days, I used a Launch Center Pro action to keep track of her values and the amount of food she had. It looked like this:
It adds a new event in a Google calendar through the wonderful Fantastical 2 and then creates a reminder for 11 hours later to feed Nano again, in Due It relies on several TextExpander snippets to fill in the correct date and dosage. I also have an IFTTT rule set up to check new events in that calendar and add them as a new row to a spreadsheet. I don't use Google Calendar for much, but it proved useful in this case.
A few weeks ago, I found the Glucodock , a glucosemeter that clicks into the iPhone and lets the phone do the hard work. For €9.95 I figured I could take the risk and try it for a while. It works really well, and the strips actually cost less than the previous meter I used, always a bonus.
Nano has improved healthwise. She drinks normal amounts and sleeps through the night again. Last week she had surgery to remove a cyste from her toe, and the wound healed up quick. It seems she doesn't have the slow wound healing associated with diabetes and in fact, she didn't seem bother by the stitches at all. She did seem bothered by the bandage and boot she had to wear for a few days, and as soon as I removed those, she ran around like a happy little puppy.
Her bloodsugar still bounces around a bit, higher in the morning, but low enough in the afternoon and evening. She has stayed at the doggy hotel and with friends and all went well. She still tries to steal food -- usually the kind she shouldn't eat.
Over the past few months I've heard that I overanalyse the data and check her levels too often (before breakfast and dinner, and then in the afternoon and before bed). Perhaps I do, however, I'd do the same for me. I don't do it because I freak out over her levels, I do it to find patterns to find the best treatment possible.
And I also get to geek out in the meantime.