# PMR and Diabetic dogs



## Kbug (Oct 23, 2011)

I've been open to switching my dogs to a raw diet. More importantly, my husband is open to me switching them. I have 4 Labrador retrievers so cost has been a big concern....they eat, and eat, and eat....

However, one of my sweeties was diagnosed diabetic on Labor Day and I'm concerned about feeding her a PMR diet. Has anyone here actually fed a diabetic dog on this type of diet?

From my understanding, the primary concern with a raw, and even BARF, diet is that it often becomes more difficult to maintain even and consistent blood glucose levels. I do home test her blood sugar levels.

Also, please, no cat diabetes references. Diabetes doesn't translate across the species, the end result is essentially the same, but the mechanisms are completely different. 

Kbug


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## eternalstudent (Jul 22, 2010)

First of Hi and welcome to the thread. 

I'm glad you are open to switching to raw as I believe it is the best thing we can do for our dogs .

As far as cost is concerned I have found PMR to be cheeper than kibble and I know a lot on here have also found this (this obviously does depend what kibble you feed...).

Labs may as you say eat and eat and eat. But they still only need a relatively small amount of food. There are exceptions but as a guideline we use 2 - 3 % of ideal weight. You can pretty much work out how much it is going to cost you from that. There are ways of keeping costs down by bulk buying or using a co-op. 

As for the Diabetes problem my dog does not have it but people on here do have diabetic dogs and I am currently helping a friend transition his yorkie to a better diet because of diabetes.

Most kibbles create two additional loads on the pancreas that PMR does not. 

1- production of amylase - this is produced to break down long chain carbohydrates found in corn, rice, wheat veg etc.
2- production of insulin - if the carbs are broken down into sugars then the pancreas also tries to sort out the blood sugar with insulin.

In a PMR diet we do not feed carbs this means that both of these loads are reduced - essentially think about type 2 diabetes being controlled by diet.

The reason that there is a belief that the sugar levels are hard to monitor and change in PMR fed dogs is that the sugar that is in the blood stream is produced as a direct result of exercise. This is how dogs get their sugar to power brain, heart and blood. If however, you carry on as you are and home test while reducing the amount of sugars fed you will find you are able to get a fairly good idea of when they need insulin and not (for this look at physically active Type 1 diabetes suffers). 

I hope this helps (I know nothing by the way of cats or cat diabetes but all the original research into human diabetes was carried out on dogs and is very well documented).

Others will chime in, and hopefully the personal experiences will help you make a decision.


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## Kbug (Oct 23, 2011)

Eternalstudent,

Thanks for the quick reply....

However you second point doesn't really hold true. The dog is a Type 1 diabetic, she DOES NOT produce insulin, and never will again produce insulin (and no, not caused by her kibble either). Diet changes will never eliminate her need for insulin injections although it can change the amount of insulin needed. Cats are considered Type II, which is an ineffective use of insulin and you can sometimes manage a cat's diet to eliminate the need for insulin. You also can't compare human and dog reactions to diabetes because:

1. They are managed differently
2. Dogs don't process human insulin the way humans do

All nutrients (carbs, proteins, and fat) wind up in the blood as glucose, the only difference is the body's preference for the nutrient, process involved in the conversion and the length of time it takes to convert the nutrient. Carbs are the body's preferential nutrient to convert to glucose. From the diabetic standpoint it is the dietary variation necessary with these diets that contribute to the regulation difficulties, not the presence of carbs or exercise. The diabetic kibble diet lets you really control the calorie/nutrient intake and once you get your insulin dose regulated you can stay pretty consistent with your blood glucose numbers. I'm not sure where you get that exercise would affect a PMR diet any more than a kibble diet. Exercise is managed around when its best for the individual dog based on the relationship between exercise, insulin and blood glucose. Exercise causes the insulin to work faster, so if the exercise is timed poorly you can cause your dog to become hypoglycemic. 

Kbug


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## eternalstudent (Jul 22, 2010)

Kbug said:


> Eternalstudent,
> 
> Thanks for the quick reply....
> 
> ...


Happy to help (if not helpful just say as I am not wanting to rile you on your fist thread ) )

Only some proteins and carbs end up as glucose in the blood. Fat is converted to energy within the cells and is a dogs primary source of energy. Only half of amino acids can be converted to glucose and it is these that a dog uses to make the majority of its glucose. If you look at the diet that is fed to working huskies in the arctic circle region it is mainly blubber and it is this that keeps them going for days on end.

Exercise causes the release of glucagon which triggers the braking down of glycogen (made by the release of insulin) to glucose. When a dog exercises this happens and causes a spike in blood sugar in the same way that eating a high carb meal will.

I will freely admit I have not come across a lot of diabetic dogs but most of them have acquired diabetes rather than been borne with it (the one pup I saw with diabetes was such a sorry state it really did brake my heart). It is unfortunate that dogs do not show the same symptoms as humans but they generally do not show until they are completely insulin depleted, and become insulin dependant.

When you feed a high fat high protein meal you still need to give insulin as it has other anabolic functions, not just sugar related however, the amounts will be vastly different.

Any diet that is easy on a pancreas is good for diabetes, as close to a natural diet for you dog I believe will be the best on their internal organs .


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## Kbug (Oct 23, 2011)

eternalstudent said:


> Happy to help (if not helpful just say as I am not wanting to rile you on your fist thread ) )
> 
> I will freely admit I have not come across a lot of diabetic dogs but most of them have acquired diabetes rather than been borne with it (the one pup I saw with diabetes was such a sorry state it really did brake my heart). It is unfortunate that dogs do not show the same symptoms as humans but they generally do not show until they are completely insulin depleted, and become insulin dependant.
> 
> ...


Your not riling me. I've got an animal science degree so I am fairly well educated on nutrition (in theory) and the hormones involved ...and what all the kibble ingredients really are. I'm not necessarily needing to be converted...but with the diabetic dog, I have to look at what is "best" a little more closely within the parameters of the disease. After all, diabetes that isn't well controlled will harm her a lot more and a heck of a lot faster than any kibble will. One of the things that was really annoying trying to research this was the claim that this type of diet will "cure" the diabetes....which it won't.

As far as the dog, according to ultrasounds, her pancreas is just fine otherwise.....its her liver that is enlarged and of concern (as is common in poorly controlled diabetics, so I'm told by her vet) but expected to normalize over time as she becomes better controlled. 

Back to the diet....I found the references I couldn't find last night....the standard school of thought is that you want to keep your numbers as even as possible throughout the day and below 250, without going to low and triggering a "rebound" effect from the system trying to auto correct with glucagon. The specific concerns with high protein high fat diets is that the meal will digest too slowly to keep pace with the insulin in some dogs and then kick in when the insulin starts to become less effective. Currently, on her kibble and insulin type, my dog has the strongest reaction in the first 4 - 6 hours (drops the sugars 100 - 150 points) with the effects tapering off and her sugars rising back up after 6 hours. She probably really would need some carb based food stuffs to keep the current insulin dose from being too much and certainly in the case of a hypo event. This in particular is why diabetic kibbles include so much carb and fiber ingredients....to provide a diet that can handle the broadest spectrum of dog reactions to insulin and food. They can be highly variable and very sensitive to even the smallest day to day changes in diet or exercise.

The reason I'm so hesitant to just up and switch her to PMR is because her whole reaction to insulin could change in unexpected ways. A glucose curve done on a PMR diet could be completely unrecognizable from a curve done on a kibble diet from the same dog. I personally have seen some evidence, for my dog specifically, that her reaction to insulin is relative to the dose. Larger doses create a more pronounced drop while the lower doses have shown less pronounced drops. If the theory holds true, and a PMR diet reduces her insulin requirements......

But I still want to hear from people with direct experiences on how a PMR diet works with a diabetic dog, both in the change over and in the long-term. 

Kbug


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## cprcheetah (Jul 14, 2010)

While I don't have a diabetic dog, I have a diabetic husband, who since switching to a grain free/extremely low carb diet has taken his diabetes from the point of needing insulin to just being regulated with 1 metformin pill per day, and the Dr thinks when he loses more weight he will be able to control the diabetes with diet alone. I know if I had a diabetic animal I wouldn't think twice about switching them to a PMR diet, Carbs are extremely bad for diabetics of ANY species. And PMR isn't actually 'high' protein due to the moisture in the diet it's about 20-23% protein.


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## xellil (Apr 4, 2011)

cprcheetah said:


> While I don't have a diabetic dog, I have a diabetic husband, who since switching to a grain free/extremely low carb diet has taken his diabetes from the point of needing insulin to just being regulated with 1 metformin pill per day, and the Dr thinks when he loses more weight he will be able to control the diabetes with diet alone. I know if I had a diabetic animal I wouldn't think twice about switching them to a PMR diet, Carbs are extremely bad for diabetics of ANY species. And PMR isn't actually 'high' protein due to the moisture in the diet it's about 20-23% protein.


I agree - maybe dogs and people do process sugars differently, but they both use insulin to do it. I know two people from my Atkins days who reversed type 2 diabetes by cutting out carbs except for the good carbs like broccoli.

and people didn't get type 2 diabetes until the modern diet. I think it's probably the same with dogs - diets high in corn etc. can't be good for them for that reason alone.


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## Kbug (Oct 23, 2011)

cprcheetah said:


> While I don't have a diabetic dog, I have a diabetic husband, who since switching to a grain free/extremely low carb diet has taken his diabetes from the point of needing insulin to just being regulated with 1 metformin pill per day, and the Dr thinks when he loses more weight he will be able to control the diabetes with diet alone. I know if I had a diabetic animal I wouldn't think twice about switching them to a PMR diet, Carbs are extremely bad for diabetics of ANY species. And PMR isn't actually 'high' protein due to the moisture in the diet it's about 20-23% protein.


Once again, the two don't compare. If your husband is not requiring insulin then he is not a Type 1, he is a Type 2. My dog is a Type 1. Even human and dog type 1's don't compare because the management is much different. 

I know of only one person with a diabetic dog that fed raw. She wound up switching to a kibble for the reason I'm concerned with. She got very uneven blood sugar spikes and drops because the insulin didn't match the food. The most common complaint I hear is that the protein kicks in too late for the insulin and high fat contents drive sugars up too much with the end result being the dog goes through a series of sharp up and downs in their blood sugar instead of the more desirable gradual curve. I know several who use a BARF type diet that incorporates complex carbs and they work well enough. 

xellil:

No, the problem isn't that the sugars are processed differently, the problem is the insulin itself is processed differently by the body. And corn didn't do this to my dog....a virus did.

I'm REALLY not looking to be preached at about the evilness of corn, nor how a low carb diet affects type 2 humans. First, I can get my dog off corn without using a PMR diet and second, she's a dog, not a type 2 human. Their diabetes management truely IS different and not comparable. I am looking for someone who has successfully moved a diabetic dog to a PMR diet and how it has impacted their regulation.

Kbug


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## cprcheetah (Jul 14, 2010)

Kbug said:


> Once again, the two don't compare. If your husband is not requiring insulin then he is not a Type 1, he is a Type 2. My dog is a Type 1. Even human and dog type 1's don't compare because the management is much different.
> 
> I know of only one person with a diabetic dog that fed raw. She wound up switching to a kibble for the reason I'm concerned with. She got very uneven blood sugar spikes and drops because the insulin didn't match the food. The most common complaint I hear is that the protein kicks in too late for the insulin and high fat contents drive sugars up too much with the end result being the dog goes through a series of sharp up and downs in their blood sugar instead of the more desirable gradual curve. I know several who use a BARF type diet that incorporates complex carbs and they work well enough.
> 
> ...


What virus caused Diabetes? I've worked for a Vet for 20+ years (also my father) and never heard of a virus causing diabetes, am very interested in hearing about it. And YES you actually can control type 1 with diet, we have SEVERAL kitty patients who are on the Royal Canin Diabetic formula who no longer need insulin (while that diet's not ideal it seems to be working). And wasn't preaching was sharing an experience which I thought would be helpful.

Here are some links I found that you might find helpful.
http://www.k9natural.com/component/wordpress/nalas-song-a-diabetic-dogs-story/?Itemid=12

http://healthy-food-recipe.com/the-barf-diet-for-diabetic-dogs/

http://www.onlynaturalpet.com/KnowledgeBase/knowledgebasedetail.aspx?articleid=48


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## xellil (Apr 4, 2011)

Type 1 and Type 2 are totally different animals. I am talking about Type 2.

I find the virus comment interesting. I work for a company that makes insulin and never heard that.


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## Kbug (Oct 23, 2011)

xellil said:


> Type 1 and Type 2 are totally different animals. I am talking about Type 2.
> 
> I find the virus comment interesting. I work for a company that makes insulin and never heard that.


I am talking about a type 1. Yes, cats can be controlled via diet alone. No, dogs can not. The only dogs who can be "cured" of diabetes are the ones who suffer from insulin resistance related to their heat cycles. It is widely considered in both dogs and humans that type 1 diabetes is caused by an immune response that is triggered by a virus. Both my dog's internal medicine doctor and all the human internal medicine doctors I know believe this to be the most common cause of type 1 diabetes, especially in children, although they have no concrete proof. However, if you'll excuse my departure into anecdotal human diabetes, I do know a doctor who says both his child and their best friend were diagnoses as type 1 diabetics within 1 week of each other. It would also explain why many dogs and people who have no problems become diabetic very rapidly. 

Kbug


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## xellil (Apr 4, 2011)

Well, i know the medical world was pretty much turned upside down when someone proved ulcers were caused by a virus. 

one thing has to be true for all animals, though - it takes insulin to process sugar. It makes sense to me that removing the sugars would reduce the need for insulin.


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## eternalstudent (Jul 22, 2010)

Sorry don't know how to do the fancy splitting of quotes but here goes ;-)

_As far as the dog, according to ultrasounds, her pancreas is just fine otherwise.....its her *liver that is enlarged* and of concern (as is common in poorly controlled diabetics, so I'm told by her vet) but expected to normalize over time as she becomes better controlled. _

The liver enlargment in nearly all cases of this in diabetics is due to increased deposits of glycogen it causes a disease like state similar to that of von Gierke's disease. Simply put the subject whether human or canine has taken in more sugar than required then taken insulin to balance which results in a build up of glycogen. It happens especially at the start of the disease as it takes some time for people to down regulate their diet.

_The specific concerns with high protein high fat diets is that the meal will digest too slowly to keep pace with the insulin in some dogs and then kick in when the insulin starts to become less effective. Currently, on her kibble and insulin type, my dog has the strongest reaction in the first 4 - 6 hours (drops the sugars 100 - 150 points) with the effects tapering off and her sugars rising back up after 6 hours. She probably really would need some carb based food stuffs to keep the current insulin dose from being too much and certainly in the case of a hypo event. This in particular is why diabetic *kibbles include so much carb and fiber ingredients....*to provide a diet that can handle the broadest spectrum of dog reactions to insulin and food. They can be highly variable and very sensitive to even the smallest day to day changes in diet or exercise._

This is simply the easy option which does not make it the best. I am not sure whether you are reluctant to remove carbs or you are hoping to remove carbs?
If you want to reduce the amount of medication your puppers will be on indefinitely, then reducing the carb load to me sounds sensible and obvious. This however will mean you have to monitor and find a new regime for the insulin. 

_The reason I'm so hesitant to just up and switch her to PMR is because her whole reaction to insulin could change in unexpected ways. A glucose curve done on a PMR diet could be completely unrecognizable from a curve done on a kibble diet from the same dog. I personally have seen some evidence, for my dog specifically, that her reaction to insulin is relative to the dose. Larger doses create a more pronounced drop while the lower doses have shown less pronounced drops. If the theory holds true, and a PMR diet reduces her insulin requirements......_

I am not familiar with the different types of insulin available to you but you need to be looking for a long acting insulin not a short acting one. This would allow you to feed low carb diets to your hearts content.


_But I still want to hear from people with direct experiences on how a PMR diet works with a diabetic dog, both in the change over and in the long-term._ 

I really do hope someone here can help with this bit.

I would love to here more about the virus theory as I have never heard of it other than a wild proposition. Do you have any blood work done in the lead up to the pancreatic failing - this would show an immune response. Likewise I would also be interested to know how they know that the islet cells have been completely destroyed beyond regeneration? 

Also a just for my sake can we have a bit of info about your dogs. and maybe some pics of them in the newbie or pics sections  as it is always nice to get to see the puppers that we are talking about :thumb:


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## xellil (Apr 4, 2011)

I know lots of people with diabetic cats who have to give them insulin shots. i don't know anyone with a diabetic dog.


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## Celt (Dec 27, 2010)

owning a hypoglycemic dog and being hypoglycemic (I know it's the opposite), I've learned that carbs are processed quicker than proteins, but proteins "sustain" longer. This means to balance "sugars" on protein only, you have to plan "digestion rate" into your feeding so that insulin and sugar levels "match up". It's a lot like figuring out exercise to "sugar use". I know my experience is different from yours, but I hope it'll give you another viewpoint.


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## Kbug (Oct 23, 2011)

eternalstudent said:


> Sorry don't know how to do the fancy splitting of quotes but here goes ;-)
> 
> _The specific concerns with high protein high fat diets is that the meal will digest too slowly to keep pace with the insulin in some dogs and then kick in when the insulin starts to become less effective. Currently, on her kibble and insulin type, my dog has the strongest reaction in the first 4 - 6 hours (drops the sugars 100 - 150 points) with the effects tapering off and her sugars rising back up after 6 hours. She probably really would need some carb based food stuffs to keep the current insulin dose from being too much and certainly in the case of a hypo event. This in particular is why diabetic *kibbles include so much carb and fiber ingredients....*to provide a diet that can handle the broadest spectrum of dog reactions to insulin and food. They can be highly variable and very sensitive to even the smallest day to day changes in diet or exercise._
> 
> ...


I agree, its an easy option, which is why I'm even considering switching her to a PMR diet. I am willing to remove all carbs, eventually, but I not willing to really yo-yo her sugars for months on end trying to get a PMR diet to work. And, from what I can tell based on other people's stories, she can handle the changes with grace....or not. Honestly, I'll be content if she winds up eating a mostly raw diet supplemented with some green beans or something if that is what is necessary.



> _The reason I'm so hesitant to just up and switch her to PMR is because her whole reaction to insulin could change in unexpected ways. A glucose curve done on a PMR diet could be completely unrecognizable from a curve done on a kibble diet from the same dog. I personally have seen some evidence, for my dog specifically, that her reaction to insulin is relative to the dose. Larger doses create a more pronounced drop while the lower doses have shown less pronounced drops. If the theory holds true, and a PMR diet reduces her insulin requirements......_
> 
> I am not familiar with the different types of insulin available to you but you need to be looking for a long acting insulin not a short acting one. This would allow you to feed low carb diets to your hearts content.


She is on a long term insulin. Most dogs are. Very few can tolerate the short acting insulin. For my girl, even 1 unit of the short acting insulin was enough to send her into rebound. In the states we have two choices: human or pork insulin. And you would think it would, but just because it looks good on paper doesn't mean anything. A 70/30% mix of long and short acting insulin looks really good on paper for my dog, but doesn't work in reality. Her reaction to the insulin could drastically change in the face of a diet change or the way her body processes the insulin could just not match up very well to how she digests a PMR diet. 




> I would love to here more about the virus theory as I have never heard of it other than a wild proposition. Do you have any blood work done in the lead up to the pancreatic failing - this would show an immune response. Likewise I would also be interested to know how they know that the islet cells have been completely destroyed beyond regeneration?


Nope, sorry...."healthy" one day, sick the next. I didn't even take the dog in for diabetes, but for a suspected Staph infection, and was completely blindsided. None of my dogs ate well this summer (one still isn't really), another thing prompting the idea to change diet, and the vet and I attributed it to the heat. Could it have been a little bit of a virus, maybe...all 4 of them were off their feed for a couple of months. The diabetic dog was starting to show the "wasting away" symptoms, but once again, attributed it to not eating well. Noticed a cut on her elbow and just kept my eye on it and within 2 days the swelling fully encircled her elbow joint and it was slightly necrotic. That and the extreme lethargy prompted the ER visit. Then the diabetes diagnosis. We thought we might have to amputate for a while too. From what I understand, its also not unheard of for owners of multiple dogs to have one come down with diabetes, and then later (months and years) have another one come down with it. Some even have subsequent dogs come down with the disease after the initial diabetic dog has passed on. It could be random chance, but what are the odds that you'll have two dogs come up diabetic in any given time span? And they know because the dogs don't come off insulin, regardless of diet changes, and there are stimulation tests that can be done in the lab.





> Also a just for my sake can we have a bit of info about your dogs. and maybe some pics of them in the newbie or pics sections  as it is always nice to get to see the puppers that we are talking about :thumb:


I have 3 purebred yellow labs and 1 yellow lab mix. Here they are, oldest to youngest.

Kaiden - just turned 6 - spaz, drama queen, and poser. He is my only boy and he likes to pretend he's in charge.....when Fayt isn't around. He weighed 115 before the summer, lost 10 lbs, and still needs to lose another 10. I'll be happy to settle him around 95 lbs since that is about what he weighed at the 1 year mark. But, he's a big boy for a Lab and is the lover type.

Fayt (Fate) - turning 6 in late Nov - the diabetic one is my alpha. She's the smallest at about 60 lbs ideally. She was about 5 lbs too chunky but is now about 10 lbs too thin. Too smart for her own good and is very much entitled. She's a dudley lab.

Dixie - turning 6 in Dec. - pushover. She the least dominant. This is my Lab mix that I "rescued" as a 6 month puppy. She was a stray that wandered up to my grandma's farm and I originally only brought her home to get her spayed and then was going to return her to the farm.....ha ha, that worked out as planned. I suspect she may have been abused before I found her and she was definitely starved to some extent. She's the least overweight being around 75 lbs. 

Aerith - turning 3 in March - I call her princess pork. She's probably more dominant personality than Dixie, but she has such good manners that she defers to age. One of my more immediate concerns is that she is very obese. She is probably close to 30 lbs overweight since she is fairly similarly framed as Fayt. She lives to fetch. She is also a dudley lab.

Kbug


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## Pimzilla (May 1, 2011)

I don't know too much about diabetes and dogs. But do you check her blood glucose as you would with a human?

When a person got type 1 diabetes you can't ever stop giving insulin even if they don't eat much carbs because the liver will keep releasing glucose to the blood. I got no idea how this would work with dogs who are not made to eat carbs. If you do check her blood glucose regularly I would just try switch her to pmr and keep a close eye on the glucose level (whatever normal glucose levels are for dogs :wacko. I would try be around her as much as possible during a switch though to keep an eye on her and how she reacts. I know hypoglycaemia is not dangerous for people (just not something diabetics enjoy) but I would probably be little bit worried anyway. Hopefully you will be able to put her on a very low insulin dose with a pmr diet. I don't know much about dog physiology but if they can convert fat and proteins to glucose as humans can I guess that a low dose is what would be required.

Please let us know how it goes, I find this very interesting and it can possibly help others!


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## oddjob (Aug 24, 2011)

I have a diabetic dog and I do mostly raw except for a little bit that's in a grain free kibble that I give a tad at the 2 daily shot times. I'm going to try to eliminate the few carbs and see what happens. I've been keeping her blood sugar at under a 100 for the most part, but she's had a few mild hypos so I'm going to try to stay above a 100 now. I use a relion meter and do the lip check. haven't been back to the vet since the initial diagnosis and $2500 later.
Apparently, 75% of diabetic dogs will eventually get cataracts and at $2,000 an eye, no thanks.
I think a bout of pancreatisis caused by too many slices of cheese given as a treat and as a fish oil pill holder caused her pancreas to short out. That and she was bit overweight.

I always keep a tube of glucose with me whenever I take her on her daily walk just in case. 
I think I'll eliminate the bit of kibble I give her to counteract the initial jolt the insulin gives tommorrow and try straight chicken thighs. I'll let you know how it goes.


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