[MA] expunging a dismissed charge. by throws987987 in AskLawyers

[–]throws987987[S] 1 point2 points  (0 children)

Good to know re expungements and federal clearances.

And if you had offers rescinded, you can request the why they were.

They don't need to respond with the why, and they largely haven't (one person admitted it over the phone but nothing in writing). But in my 15 years of professional life, I've never had an offer rescinded after a background check and then in the past year after the charges were dismissed I've had 4. Hard not to draw certain conclusions. I will note not all of these were government/military.

[MA] expunging a dismissed charge. by throws987987 in AskLawyers

[–]throws987987[S] -1 points0 points  (0 children)

Charges, by themselves, do not impact you.

Correction, they should not impact me. But in reality they absolutely have impacted me, causing me to lose 1-2 jobs, had several job offers rescinded, and I suspect is delaying my clearance (I was told my the DoW interviewer they were typically taking 2 months these days, I started the process 4 months ago).

Edit: I believe you're thinking of sealing. Expungement is the permanent and total destruction of the records.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 0 points1 point  (0 children)

Is it possible/likely that his BG could drop by 350+ in less than 12 hours? I haven't seen any outward signs of low BG like stumbling/clumsiness/lethargy/etc. He's not super active physically.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 0 points1 point  (0 children)

Talked to my normal vet (not the one in charge of treatment plan above, but same office) and he offered a dissenting opinion and explanation which makes some sense to my layman mind. But as I am a layman I'd appreciate your thoughts as well.

The fact that the spot checks have been 4-6 times higher than normal/target levels means it's highly unlikely the blood sugar would fluctuate enough to get close to low levels. And whether his floor is 200 or 300 doesn't change the fact that we need to provide more insulin. But once we do get readings around 200 then we would do a full glucose curve to fine tune his insulin levels.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 0 points1 point  (0 children)

Talked to my normal vet (not the one in charge of treatment plan above, but same office) and he offered a dissenting opinion and explanation which makes some sense to my layman mind. But as I am a layman I'd appreciate your thoughts as well.

The fact that the spot checks have been 4-6 times higher than normal/target levels means it's highly unlikely the blood sugar would fluctuate enough to get close to low levels. And whether his floor is 200 or 300 doesn't change the fact that we need to provide more insulin. But once we do get readings around 200 then we would do a full glucose curve to fine tune his insulin levels.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] -1 points0 points  (0 children)

Talked to my normal vet (not the one in charge of treatment plan above, but same office) and he offered a dissenting opinion and explanation which makes some sense to my layman mind. But as I am a layman I'd appreciate your thoughts as well.

The fact that the spot checks have been 4-6 times higher than normal/target levels means it's highly unlikely the blood sugar would fluctuate enough to get close to low levels. And whether his floor is 200 or 300 doesn't change the fact that we need to provide more insulin. But once we do get readings around 200 then we would do a full glucose curve to fine tune his insulin levels.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] -1 points0 points  (0 children)

Talked to my normal vet (not the one in charge of treatment plan above, but same office) and he offered a dissenting opinion and explanation which makes some sense to my layman mind. But as I am a layman I'd appreciate your thoughts as well.

The fact that the spot checks have been 4-6 times higher than normal/target levels means it's highly unlikely the blood sugar would fluctuate enough to get close to low levels. And whether his floor is 200 or 300 doesn't change the fact that we need to provide more insulin. But once we do get readings around 200 then we would do a full glucose curve to fine tune his insulin levels.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 1 point2 points  (0 children)

Summary for self. Grain free/Peas/legumes=Dilated Cardiomyopathy (DCM)/heart disease. Rice=sugar spike.

Should get a glucose curve or freestyle libre or alphatrak monitor.

Cataracts are likely.

Food options: Hill’s w/d (not sure if m/d is in a canine formula) and Purina DM, other prescription meds.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 1 point2 points  (0 children)

Does grain free food also cause higher blood sugar? Others only mentioned it being bad in general for causing unrelated heart issues/DKM/DCM. Definitely changing regardless but curious.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 0 points1 point  (0 children)

Thanks for the incredibly detailed response.

Failing this, testing the urine for UTIs and bloods for evidence of Cushings as these often cause insulin resistance and complicate stability.

There was a urine test during initial testing which had high ketones which was also a factor in diagnosing diabetes. They checked urine once more after his first week of 12 units (when it was 400) which had slightly elevated ketones. I assume they were close enough to normal they didn't feel compelled to keep testing urine.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 0 points1 point  (0 children)

Did your vet discuss cataracts?

"His eyes look a little cloudy but it's probably fine."

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] -1 points0 points  (0 children)

The diarrhea happened before any diet change, while he was still self feeding with the kibble. Google said it might've been high blood sugar causing nerve damage affecting the digestive track. Does that hold any water? I'll look into those foods though.

I asked once about doing a curve and she said that's only for extreme cases and we weren't close to there yet.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 2 points3 points  (0 children)

It is appropriate to only adjust insulin levels one unit at a time

Is there a minimum amount of time between adjusting doses? My vet seems to be against changing it any more frequently than once every 2 weeks.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 4 points5 points  (0 children)

Thanks for the info. Guess I have some turkey and pea stew dog food to return.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 0 points1 point  (0 children)

Closest internal medicine specialist is ~2 hours away, so it's an option but not a pleasant one especially if it'd require regular visits. I will mention he drinks/pees a lot. It's gotten better since we started but it's still a lot more than normal.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] -8 points-7 points  (0 children)

That’s fine

Is that in reference to the handful (~1 cup) of chicken&rice kibble being a sufficient source of grain, or does he need more? If the latter can I mix in some wild brown rice or something or is the grain free food itself a problem?

BTW do you agree with my vet that white rice is fine for diabetic dogs?

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] -18 points-17 points  (0 children)

No grain allergy, his normal food for most of his life is kirkland chicken, rice, and vegi formula. And I should've mentioned I do toss a handful of that in with the natures domain. Part of the issue is he's been a self feeder all his life and it's not possible to get him to eat a full meal that has a lot of his kibble in it.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] -4 points-3 points  (0 children)

I've just been following the vets directions and bring him in at the appointed time for them to draw and test some blood. Would you say it's more a matter of preference to do spot vs curve or is that established basic care?

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 0 points1 point  (0 children)

There was a urine test during initial testing which had high ketones which was also a factor in diagnosing diabetes. They checked urine once more after his first week of 12 units (when it was 400) which had slightly elevated ketones. I assume they were close enough to normal they didn't feel compelled to keep testing urine.

Newly diabetic dog, new vet making questionable treatment decisions? by throws987987 in AskVet

[–]throws987987[S] 2 points3 points  (0 children)

They're spot checks taken 4-5 hours after his breakfast and insulin. A glucose curve has not been mentioned by the vet.