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The Glucose Curve

In January of 2014, Butterfly, my ten year old Lhasa Apso, was diagnosed with diabetes. We went for monthly visits to a doctor she loved, and did twice daily blood tests and insulin shots, and we seemed to be making progress. But, over the summer, her doctor left the clinic and Butterfly’s sugar started to go up and down like a roller coaster. By the fall, nice doctor or not, we had to go back to the clinic for advice.

Butterfly was not feeling well.

Butterfly was not feeling well.

The doctor who saw Butterfly in October was a per diem, filling in for the day, and he was concerned about her sugar. He made me very nervous, despite his choir boy face and laughing Scottish accent and frequent stops to tickle Butterfly behind her ears, because he said there might be another underlying health problem. He wanted me to do a glucose curve at home: starting first thing in the morning, I would test her blood sugar every hour or two, until I couldn’t stay up any longer, then I should send the results to one of the regular vets, to see if they could recognize a pattern.

But she always loves those ear tickles.

But she always loves her scratchies.

The glucose curve day was, possibly, the best day of Butterfly’s life. Every time I went to take her blood, she made me chase her around the apartment first, and after each test she got another chicken treat. I had to break the chicken treats into tiny pieces to avoid an exploding Butterfly halfway through the day. And, of course, Cricket matched her treat for treat, and attempted to climb the bookshelf to reach the bag of treats when the pieces were too small for her liking.

Butterfly's tail is ready.

Butterfly’s tail is ready.

Cricket's tail is running away.

Cricket’s tail is running away.

Cricket and Butterfly, ready for their treats.

Cricket and Butterfly, ready for their treats.

By the last blood test, at two o’clock in the morning, Butterfly was wiped out and ready for bed, but still willing to grab a last chicken treat on her way down the hall.

We made an excel sheet out of her test results, with comments about her moods, and meals, and exercise, and pooping. The vet we sent it to was duly impressed, but she said she was worried about Butterfly’s very low sugar numbers midday. She wanted us to lower the insulin dose and redo the curve in two weeks.

I liked the compliments – I really love compliments, and I especially like when my organizational skills are noticed and appreciated – but I was hoping for a different response. Anything but “do it again.” The second glucose curve, two weeks later, was closer to normal, and the vet told us to keep everything the same, and redo the test in a few months.

By December, Butterfly’s twice daily blood sugar readings were getting wild again, so I ordered extra test strips and lancets and chicken treats and woke up at 5:45 AM on December 30th and started testing her blood every hour or two, administering an enormous amount of chicken treats to get her, and Cricket, through the ordeal. We stayed up until 2 AM, or I stayed up, Butterfly took a few naps.

Nap time.

Nap time.

When we finally met Butterfly’s new vet in person, she had a theory she wanted to test: that Butterfly’s blood sugar was bouncing up so high as an over-correction to too much insulin, and if we lowered the insulin dose again, maybe things would even out. Two weeks on this dose, and then another glucose curve. This was becoming normal for us.

Cricket sniffed Butterfly all over when we got home, to make sure no extra treats had been consumed, but also to make sure Butterfly was still Butterfly. We’d tried taking Cricket with us to the clinic, once, and she spent the whole time hiding behind my legs and barking at everyone and everything. But still, staying home alone made her disgruntled and suspicious.

Cricket's suspicious face.

Cricket’s suspicious face.

Unfortunately, the low insulin dose skyrocketed Butterfly’s blood sugar levels into the too-high-for-the-meter-to-count range. She was drinking and peeing constantly, in the house and out, so even without a glucose curve, we raised the insulin back up. And, of course, waited two weeks and went through the whole day of testing again, to Butterfly’s delight. And the numbers were still not right.

I was afraid that the doctor would give up on getting Butterfly’s sugar normalized and tell me to accept that she’s just going to die sooner rather than later, and it’s not worth stressing about. But she’s my baby! And I am stressed about it! I was angry that being a conscientious dog mommy hadn’t added up to better health and better luck for Butterfly, and for my carpeting.

“What’s wrong with peeing on the carpet?”

And then Mom came up with a plan (okayed by the vet) to give Butterfly an extra unit of insulin when her blood sugar levels are high, and the regular dose otherwise. I have no idea if this will work long term, or why the doctors haven’t wanted us to try it before now, but so far it seems to be helping.

I just want Butterfly to feel better, and not need to pee every five minutes, and live forever. Is that so wrong?

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About rachelmankowitz

I am a fiction writer, a writing coach, and an obsessive chronicler of my dogs' lives.

144 responses »

  1. Its such an awful feeling when our best friends are feeling unwell. My Jack Russell cross was screaming in agony for 2 months as the vets tried to work out what was wrong with her…it was like torture and I felt so stupid not being able to do something to help. Turns out she had a disc compression on her spinal cord and after surgery she made a good (not full) recovery 🙂 I hope Butterfly starts to feel better soon x

    Reply
    • Oh no!!!!!! I would have been a crazy mess! I’m so glad things are better, if not perfect. Is she still in pain? I really hope not.

      Reply
      • She’s ok now….vet suspected she had been born with it so knew no different. She thought she was super dog after she recovered from the op lol no more pain but sometimes her back leg goes when she’s running and she looks at it really confused 🙂

      • Cricket used to have knee problems. She’d suddenly lift up the leg and not be able to put it down, and she’d give that leg the evil eye. She hated me for putting her through surgery, but man can she run now!

      • Lol that’s what poppy does….just looks at it in disgust and then carries on running! She’s like a puppy now after her surgery. All the way home afterwards in the car she was staring at me and every time I glanced at her she wagged her tail. She was so happy to be pain free! Problem was keeping her still while she healed lol 🙂

      • Ah, Cricket was drugged for a while after her surgery. She didn’t want to go anywhere. She stayed on Grandma’s bed and gave me nasty looks with her heavy-lidded eyes.

      • Bless her! I do hope she starts to feel better soon! It’s so awful when they are ill x

  2. exiledprospero

    But she’s my baby. That says it all, Rachel.

    Reply
  3. It’s not wrong at all. As was already pointed out: “But she’s my baby.” Nothing wrong when you can say that and it’s from the heart. *hugs* Hope this new routine works for Butterfly (and you!).

    Reply
  4. Having diabetes myself, I sympathize with Butterfly. Human doctors make humans do that ‘test all the freakin’ day long ((or so it seems)) so we can tell you that we don’t know WHY your sugar is bouncing around like a ping pong ball on ritalin or something… I found a ‘recipe’ that works for me (at least for now) and so I just do that, regardless of what the doctors say. The extra insulin when Butterfly’s sugars are high seems sensible, and a regular dose when she is having what I call a ‘good day’ seems sensible to me. I have a theory that diabetes is an individual (and species) specific disease – common factors (eye problems, weight gain/loss, kidney damage etc etc) which is treated with insulin, but after that point it depends on the individual whether canine, feline or human or whatever. I think one day the doctors will come to figure that out..we’re all so different in our sizes, food tolerances, what medications we may take, what level of fitness we’re at (and this is true for dogs as well as humans) that I think it’s sort of foolish for the medical community to try to make a ‘one remedy plan fits all” for diabetes. But I’m not a doctor and in my opinion? Butterfly has a great ‘mom’ who loves her and is doing the very best for her that is possible. 🙂

    Reply
    • Thank you! I think you must be right about the individual differences from body to body, I just wish there were something I could do to find the exact right answer for Butterfly. She’s such a happy girl! She loves to gallop across the lawn, and eat her special dog food, and smile, and snore. And she doesn’t get freaked out when her sugar is high, it’s just me.

      Reply
  5. I hope Butterfly is well soon. My parents had a Shih Tzu, Tess, who had diabetes. Those daily shots were so awful for her. But she lived to a ripe old age and enjoyed every non-injection minute of it. May the same be true for your little companion.

    Reply
  6. My Dear Rachel! Your post brings tears to my eyes, I know how you love Butterfly and Cricket too. I have a new 24 hr. emergency vet across the street from me, and I was so upset about an ear infection that Cleo had that I took her there at midnight on a Sunday and paid right around 400 for the visit and meds! Yes- they are our babies!!! Kiko and Izzy and Cleo all wish Butterfly the VERY BEST! And they wanted to send her and Crickee-wickee some treats in a card but Baby Clee ate them all! Um, maybe I ate them all…??

    Reply
  7. You are a good mommy. I admire your conscientious curves and trust that Butterfly will even out with her meds. Red is also having health issues. I truly believe he has a doggy version of Alzheimers. We go to the vet again this week, and I am set to have a heart-to-heart talk with her. We love our babies. We want them to be healthy. We want them to be happy. We wish they wouldn’t pee everywhere.

    Reply
    • When my Dina was fifteen she had dementia and started to pee pretty much everywhere But she was still my Dina. So we covered the floors with pee pads, and gently reminded her when she’d paced the same hall ten times in a row. She was loved, and she knew it.

      Reply
  8. So sorry to read she’s having troubles and all those glucose tests must be driving you all mad…even though I know you’d do anything for your precious pups. Hope it settles down soon!! xx Rowena

    Reply
  9. SASS-A-FR-ASS

    Oh dear… While I was reading this, I kept thinking to myself “come on Butterfly you are going to be okay!”
    Sending hugs to you for the long nights and scratches to Butterfly and Cricket too of course. XX

    Reply
  10. Hi Rachel,
    Your pups are so lucky to have you for a Mom!

    Just a comment about glucose monitoring and insuline administration:
    One of your readers made the complaint that doctors try to do a one-size-fits-all for diabetics, and I am sorry that that has been her experience. As a doctor (internal medicine), I know we try hard to get our patients on a regimen that is tailored to the severity of their disease, their level of activity, their metabolism, existing complications of the disease itself, and any other comorbid conditios. So yes, some patients will need just one pill a day, but since diabetes is a progressive disease, at some point they will end up on insulin, at which point the fine tuning starts with how much, which type/combination of insulin, how many times a day, and how tight a control the patient can tolerate.

    One final reminder: the insulin you administer is NOT for the glucose reading you just took. The insulin you give someone (or your dog, in your case) is for the expected glucose rise in the next few hours.

    I know, more information than you wanted, I’m sure.

    Thank you for stopping by my blog, I enjoy your writing.

    Opie

    Reply
  11. So sorry you’re dealing with such a frustrating illness. My Mom had it and never got her sugar levels under control. My hat is off to you for your efforts. Butterfly is one lucky pup.

    Reply
  12. Oh I did not realize that dogs can get it too….are you still keeping up with that now (insulin and glucose tests)?

    Reply

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