Case:Chris

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Chris:Canine
Male Aust. Shepherd/Large terrier mix most likely. White with black spots.
Chris
Born	April-1993
Dx	Mar-2004
Oral meds	No:
Regulated	Aug-2005
Regulated between 100 and 250
Chris has many challenges - delayed processing of L, allergic to N, lack of duration on all insulins tried, now using R four times daily
Remission	DNA-
Insulin	R given 4 times a day 6 hours apart.

Our dog Chris is twelve years old and has been insulin dependent for two and a half years. He is the "mystery dog" of diabetes - never doing anything the way the doctors expect him to. We started out on Humulin L but Chris did very poorly on it. It would sit around in his system doing nothing for nearly seven hours and then abruptly kick in and drop his blood sugar drastically from 400s down to 100s. We then went to Humulin 50/50 briefly before going to Humulin Regular three times a day 8 hours apart. His response was more normal but the insulin did not last 8 hours, so eventually we went to Regular four times a day 6 hours apart. That's where we are now. He is allergic to NPH and we haven't tried Vetsulin mainly because its action is extended the same way L is.

We did briefly try Lantus a couple of times to see if we could reduce the number of injections Chris gets a day without much success. He seems to get very uneven bursts of activty from it. It was making life harder instead of easier, so we have given up for now and returned to four injections a day of Regular.

Most of the story of Chris' long road to regulation is contained in this case study:^[1]

Chris is also a member of the Canine Diabetes Web Board^[2] , which has been our lifeline in learning the ins and outs of diabetes. We owe everyone there a debt of gratitude for helping to guide his care and save our sanity.

We home test using a One Touch Ultra meter. Have used several other meters along the way. I couldn't imagine maintaining Chris' diabetes without home testing. I'd worry about him all the time or have to let his blood sugar be so much higher to ensure no hypos. It is probably the most important tool to me in this.

Chris went blind in 2004 but has adjusted well. He just forges ahead anywhere we take him - wades in the river, combs the beach, loves his walks. And he doesn't let a few bumps into lamp posts or walls bother him! :)

My big challenge now is to remember that other people's dogs are NOT blind. I constantly worry about them running into things!

For a long time Chris wasn't well enough regulated to even consider cataract surgery. But we ruled out surgery early on anyway because of all his allergies to eye medications and his heart problems from a PDA as a puppy. We felt that the risks outweighed the benefits since he is happy and healthy. The six weeks he spent at the end of 2005 in an e-collar with what turned out to be a viral corneal ulcer confirmed for us that an eye operation would not be in his best interest. His corneas are very slow to heal.

It is important to know that cataracts that are left in place tend to cause inflammation in the eye. Chris gets a nonsteroidal antiinflammatory drop in his eyes to control that inflammation and sees the veterinary ophthalmologist periodically.

Most recently he started seeing a cardiologist for a longstanding heart murmur and irregular beat. He has begun taking Toprol, a beta blocker, which seems to be giving him a better heart rhythm. I believe he has had this problem since he was very young as his exercise and heat tolerance have always been poor.

Chris' medications, in addition to insulin, include Metacam for arthritis, Voltaren to control eye inflammation, a glucosamine supplement, and now his beta blocker.

So he's an ongoing project - our favorite project!

The most important thing is that he's so happy. The diabetes for him is no big deal. In fact, it has a few benefits. He gets 4 meals a day! Plus he gets a baby milkbone after each injection and he really looks forward to those. What's amazing to me about diabetes is the bond it has forged for me with this dog through this routine.

March 2006.