Buzz's appointment with the internal specialist vet was this morning. We got there and I swear I saw a look of panic flash on his face, most likely from remembering the last time he stepped foot in that building. All the shots, pokes, bad medicine, not being near us, etc. Certainly that wouldn't happen this time.
The point of this appointment was to talk strategy about how to get him regulated, figure out what to do about his allergies, how he is going to gain weight without the excess food effecting the diabetes, and some general questions I had (where to poke him, should the insulin be refrigerated or not, what should we do about exercise, etc).
The vet said he isn't worried about Buzz's glucose being high (above 500) when it's time to give him insulin, since diabetics are hyperglycemic in nature, whereas I thought Buzz's glucose readings should always be between 200 and 300 to be considered 'regulated'. Check.
There isn't much we can do about his allergies other than benadryl, which he's on 2x a day, so I think we're going to revisit this issue later. Buzz obviously can't go on steroids. Check.
His weight isn't a big concern to the vet. Buzz is gaining weight and is HEALTHIER, which is the key word. I am still a little worried though because if he has another ketoacidosis attack, he could lose weight. I explained this in a post a few days ago. Check.
The vet pokes his diabetic dogs in the scruff (just like I do! yay!). Says the flank area is usually too sensitive, which it is for Buzz (posted about this a few days ago). So we are going to stick with the scruff. Check.
Even though the bottle says the Eli Lilly insulin doesn't need to be refrigerated, we are doing the right thing by keeping it refrigerated and keeping the temperature constant. This makes sure the protein doesn't denature (or come apart) and become useless. So if anyone has humulin-n from Wal-Mart, keep it refrigerated even though it says you don't need to! Check.
There really isn't any research out there on how exercise affects the blood glucose levels in a diabetic dog, so seeing as my husband and I are both in the research field and have to write and publish papers on our areas of interest, our vet suggested we take Buzz's glucose reading immediately before and after a short walk (say, 30 minutes at 6PM every single day) and after a month or so, extend the walk (45 mintes at 6PM every day) and see what it does to his sugar, write it up and publish it along with our vet. I think that would be pretty cool. Buzz would become famous, like he isn't already... hah. :) Check and check.
Anyways, I brought Buzz's diabetic journal with us (where I record all his glucose readings) and the vet looked through it and decided that a 24 hour glucose curve was going to give us some of the answers we want about how to get him regulated.
So that's where he is. Sitting in a crate, getting his glucose checked every 2 hours for the next 24 hours. Poor boy. Just another step to getting him regulated and happy!