Does anyone have experience with canine Diabetes?

[goldengal]

Hi there ..... I do not have any experience with Diabetes in canines and thought posssibly someone here might have gone through this with one of their fur kids, and have some suggestions I can pass along to my friend. This is the email I received:

"My 9 1/2 years old Westie (male) lost 5 pounds in roughly 2-3 months and we thought he drank a little more and peed a little more than usual. We took him to the vet and he suspects he has diabetes. He put him on glyburide .5mg per day (1/2 a pill twice a day) and last night he was so lethargic he scared me and I gave him 1 teaspoon of corn syrup.

Buddy (and his sister Cleo) is a rescue from a nasty puppy mill and my little guy has been through hell and back. When we took him out, he had severe mange with bleeding and open sores, emaciated, respiratory problems amongst other things.

2 years ago, he had blood work done and even though his liver enzymes were very high, the glucose levels were normal. He had surgery on his paw (suspected foreign object - it was not), a very expensive visit to a specialist who found nothing wrong, it turned out to be possible allergies but he was on antibiotics for over 2 months and I worked really hard to bring him back to normal. We changed his food to MediCal Hypoallergenic (and I can't get the information about how much sugar is in that food and whether this could have triggered an elevation of the glucose levels).

Last year's exam, he was OK other than the fact that he had crystals in his eyes so that slows him down a little particularly at night.

He still gets the occasional flare up and we clean his paws every night with saline water. This summer, he had dental cleaning because of infected gums.

Before we put him on insulin, I want to make sure he really has diabetes cause I am not too crazy about putting more crap in his little body. "

At this point my friend is most curious about whether a trauma to the body can trigger diabetes (like surgery and persistent infections treated with antibiotics or even the food that he is on which may be high in sugar and which was also changed not long after these episodes).

Thank you so much for any information and/or advice you might have.

Take care,
Pat

[sugarcatmom]

Most of my experience is with feline diabetes, but some things are similar.

Originally Posted by goldengal

We took him to the vet and he suspects he has diabetes.

Did the vet do a fructosamine test to confirm the diabetes?

Originally Posted by goldengal

He put him on glyburide .5mg per day (1/2 a pill twice a day) and last night he was so lethargic he scared me and I gave him 1 teaspoon of corn syrup.

Oral hypoglycemics tend not to be very effective at treating diabetes in animals and can actually cause liver damage, as well as exhausting an already overworked pancreas.

Originally Posted by goldengal

it turned out to be possible allergies but he was on antibiotics for over 2 months

Do you know if steroids were ever used to treat the allergies? These can sometimes result in temporary or even permanent diabetes in some animals.

Originally Posted by goldengal

Before we put him on insulin, I want to make sure he really has diabetes cause I am not too crazy about putting more crap in his little body.

A fructosamine test is the best way to determine if the dog has diabetes mellitus. There are other causes of PU/PD and weight loss, so it's definitely a good idea to figure out what's going on before starting insulin. However, if he really does have diabetes, then insulin is what he needs, and the sooner the better.

And about insulin choices, does your friend know which one the vet is thinking of using? I ask because Caninsulin/Vetsulin, while not technically withdrawn from the market, has some major consistency issues and would not be a good choice to start out on.

Some links worth reading:
http://www.k9diabetes.com/
http://doggydiabetes.com/treatment.htm
http://petdiabetes.wikia.com/wiki/Main_Page

Also, Brenda (aka the gang) has a diabetic minpin, and danam314's dog, Koda, has diabetes, although I'm not sure when she was last on the board. Here is one of her threads on the subject: http://www.pets.ca/forum/showthread....iabetes+canine

[goldengal]

Thanks so much Sugarcatmom for all the info which I will pass along to my friend.

Take care,
Pat

[Dr Lee]

Some good advice sugarcatmom. i would like to add a couple of things.

Fructosamine test. It is a good test but it is not the "be all and end all of tests." It is a good test but it can be misleading. Especially with monitoring. I run the test often, but it must be done in light of other factors.

For a diagnosis of DM you need: a chemistry panel and a urinalysis. Typically you will see high blood sugar and high urine sugar. Based upon the presence of ketones in the urine, changes in the liver enzymes, etc... helps create a whole "picture" of DM. For cases that are boarderline, then fructosamine should be run. I will always recommend that fructosamine levels be done when I diagnose DM but more than half the time, it is not the "key" component for the diagnosis. The fructosamine however becomes important when you then go to start monitoring progress.

The good news is that with all the new advances in DM treatment, many dogs and cats are living happier, longer lives. This is great news!

Sugarcatmom gave you a lot of great reference sites.

I would also recommend that any pet with diabetes consider the use of Ocluvet. It is a holistic, antioxidant eye drop that can help prevent cataract formation. (obviously proper and swift regulation is the most important key). Ocluvet was independently tested in two different dog and cat studies with veterinary ophthalmologists who came up with the same statistic: it helps to improve lens clarity in 82-83% of the cases. It is a great supplement for diabetic pets. Here is a link that explains it (and where you can buy it): Ocluvet

I also recommend that you get Keto-Diastix. This allows you to test your pet's urine for the presence of sugar and ketones. A bottle is about 22 dollars and has 100 tests. I can help you determine when there is problems cheaply and helps you know when you need to contact your vet. Here is a information sheet: Keto-Diastix
While it is about cats, it is great information for dogs and cats.

Hope this helps.

[buddingartist]

Hi all
I am the friend that Pat (Goldengal) is referring to as she was kind enough to initiate the enquiries on my behalf (She is Gold).

I am Buddy's mommy

We just got back from the vet today and although his glucose was down, it is still too high. He also lost another 1 1/2 pound in one week. Buddy was never fat and quite muscled, so now when I pick him up I can feel all his bones and it is painful to see him like that.

The glyburide may have helped a little although the vet reminded me that this is a temporary solution until we find the cause of his problem.

Oct 3, 07 ALKP was 945 ALT 153 Glucose 6.61 (surgery on paw for suspected foreign object - it was not, preceeded and followed by 3 months of antibiotics because of persistent infections.

May 19,09 ALKP was 1077 ALT 174 Glucose 6.59 (dental surgery for gum infection)

Jan 11, 10 ALKP was 696 ALT 163 Glucose 37.28

Today his glucose was down to 26

The vet has ordered more tests (including Fructosamine) and since we live in the country, the fructosamine test has to be sent out and we should get the results in a day or 2. He also wants to eliminate Cushing. (heck, I'm already up to $600 including today so I might as well do it right).

I asked him about OcluVet and he has never heard of it however, wrote it down and will check into it.

Buddy has food and environmental allergies and he has been on MediCal HypoAllergenic food and treats for 2 years now and has experienced less flare ups on his paws, although we now clean his paws and in between every night with saline water.

I asked whether we should consider changing the diet and after consultation, our vet tells me that he'd rather keep him on hypoallergenic food, to try and avoid potential/further interdigital cysts and infections and instead, give him Metamucil for fibre.

Since our vet has only been treating Buddy for the last 4 years only, I again reminded him of Buddy's complete history (puppy mill rescue at 10 weeks) had severe mange, open sores and bleeding, bald from the neck down to his tail, respitory problems and one ear burnt&?%??&&. and medical problems (persistent respitory problems, interdigital cysts, anal sac infection, allergies and hip problems although it has been a while since he had any problems).

I also insisted that I wanted to be absolutely sure that it is indeed diabetes before we start him on insulin. I made it quite clear that I want my little guy to have a quality of life, I don't want to watch him suffer out of selfishness but I also don't want to spend thousands of dollars only to watch him suffer and pass on soon (we are both retired and living on a fixed income). So my message was quite clear.... I want my little Buddy to be comfortable and happy.

The next time I go back to the vet, I will also ask about Keto-Diastix.

Sorry for this long post but boy, it felt good to share with other animals lovers.

If only we didn't love them so much.... but then they love us so much and with such unconditional love.

Thank you for any and all suggestions and comments

[sugarcatmom]

Originally Posted by buddingartist

I am Buddy's mommy

Hi Buddy's mommy, welcome to pets.ca! Sorry to hear that Buddy is having so many issues.

Originally Posted by buddingartist

Today his glucose was down to 26

Yup, that's still way high. Sometimes infection or stress can cause transient hyperglycemia (in cats at least, I imagine that holds somewhat true for dogs as well), but it wouldn't likely be THAT high.

Originally Posted by buddingartist

Buddy has food and environmental allergies and he has been on MediCal HypoAllergenic food and treats for 2 years now

Ever consider a homemade raw diet with a novel protein source, such as venison, duck or rabbit? That helps many animals with food allergies, and would be higher quality ingredients than are found in the prescription diets. Cheaper too.

Originally Posted by buddingartist

I made it quite clear that I want my little guy to have a quality of life, I don't want to watch him suffer out of selfishness but I also don't want to spend thousands of dollars only to watch him suffer and pass on soon (we are both retired and living on a fixed income). So my message was quite clear.... I want my little Buddy to be comfortable and happy.

The good news is that if it is diabetes (and it really looks like it with those high glucose numbers and weight loss), it's very treatable. Insulin injections are easy once you get the hang of it, and you can even learn to home test Buddy's blood glucose yourself, which will help with regulation and will save you a bundle in vet bills.

Originally Posted by buddingartist

The next time I go back to the vet, I will also ask about Keto-Diastix.

The Keto-Diastix are purchased from behind the counter of any pharmacy, so you could get those right away and start testing Buddy's urine yourself if you like.

Originally Posted by buddingartist

Sorry for this long post but boy, it felt good to share with other animals lovers.

Share away, that's what we're here for! Let us know how everything goes.

[Frenchy]

Originally Posted by buddingartist

He also wants to eliminate Cushing. (heck, I'm already up to $600 including today so I might as well do it right).

Welcome to pets.ca ! Yes it is quite expensive to test for diabetes and cushing / addison. I've been there. My dog had cushing ... I can't help you with the diabetes but , I can give you the recipe for satin balls if you like , they're full of proteins and works great to get them to put the weight back on.

[Frenchy]

satin balls :

5 pounds of ground beef (lean) raw
5 cups of oats
3/4 cup olive oil
3/4 cup of molasses (melasse)
6 eggs
1 can of pumpkin puree (not the pie filing , the pure one)
500 mg of cottage cheese

you don't cook them , everything has to be raw.

[buddingartist]

Thank you Sugarcatmom and Frenchy.

When Buddy started with all his allergy problems, I did consider the raw diet or home made diets and opted for the best store bought instead. It may sound a little crazy but in light of my age and my husband's as well as personal circumstances (e.g. having to go back to Montreal for an extended period of time for funeral etc), or if anything happened to either one of us (be it temporarily or permanent) that someone could easily care for our babies without too much imposition.

Back then, I did find a great recipes for treats which was homemade (salmon, oats, eggs) and they just loved it and were hovering around the stove all the time they were cooking. It happened at a time where Buddy was getting multiple interdigital cysts and ear infections and it was then recommended that I stick strictly to hypoallergenic foods.

I will try and get those KetoDiastix today. Dr. Lee pointed me to a link where it explains which one to use.

Right now, we are both like >the hell with the allergies and last night our little monkeys got some low fat cheddar cheese bits (which they love). This morning after their walk, daddy is making breakfast (french toasts) and the kids will be getting scambled eggs (more protein).



Frenchy, I will keep that recipe. The challenge will be to find the canned pumpkin puree. I guess the only place to find that would be a Health Store? For that, I'm going to have to take a drive to the >big city> (2 hour return trip). Ah the joys of living in the country which can sometimes present a challenge in finding fresh or different produce.

The vet called end of day yesterday and gave me some of the results and told me that he would definitely get the results of Fructosamine by Friday. Now I need to read about Fructosamine. I also asked him if I could chat with another client who has a diabetic dog so that she/he could let me know where in this neck of the wood I could get some items etc.etc etc

Have a great day everyone and again thank you so very much for the support, suggestions etc.

Louise

[hazelrunpack]

Hi, buddingartist. I don't have any experience with canine diabetes, but I do know about the pumpkin You should be able to get it at the grocery store in the canned goods aisle or over by the pie fillings. Just make sure you get the 100% pumpkin without the pie spices and sugar in it.

I hope you get some good news from the vet. And welcome to the board to you and Buddy!

[buddingartist]

Tks Hazelrunpack. Just added it to my grocery list, will check in out.

Cheers
Louise

[buddingartist]

Frenchy, a few more questions about the recipe

If I find the pumpkin and make that recipe, I only have 2 little Westies so I would need to cut back on the quantities.

Also, I have to keep Buddy's allergies in mind and wouldn't want to overfeed him on these treats. I'm sure Cleo (my other Westie) would love those as well, so I am not concerned about that but she is on the heavy side (she is our little porky because she had hip surgery when she was only 7 months old and was restricted from doing stairs and exercices for a year, she never developed to be the athletic type

Since it is raw, does it keep fresh in the fridge? and if so, for how long?

Or should I just cut the quantities way back and serve it fresh for a day or two?

Also is the cottage cheese low fat or regular?

[buddingartist]

An update on my little Buddy. He had a very rough evening and night and hubby was up at 4:30 to put him outside. Panting excessively and his nose is so dry.

The vet called and the fructosomine results are 613 and Buddy is going in on Monday for the full day to determine the insulin levels.

I found pure pumpkin yesterday and gave him some this morning with his pill and a bit of food. He loves it whereas Cleo spitted up on the floor. I am thankful the dog who needs it is the one who loves it.

I also bought the Ketostix and Diastix. Here in the >boondocks> they sell them separately. I am going to test his urine this weekend and before he starts the insulin so I get a benchmark measure.

Tks everyone

[sugarcatmom]

Originally Posted by buddingartist

The vet called and the fructosomine results are 613 and Buddy is going in on Monday for the full day to determine the insulin levels.

Sorry to hear about the diagnosis, but on the other hand, at least diabetes is treatable. I'm a little concerned about waiting until Monday to start insulin, especially since it sounds like Buddy is suffering right now. There is a risk of ketoacidosis developing, so at the very least I'd recommend checking his urine for ketones every chance you get, starting today. If any show up, he needs immediate vet care, at an emergency clinic if necessary. Animals can go downhill extremely quickly (within hours) if the ketones aren't dealt with.

Another thing, (especially if money is an issue), you don't have to leave Buddy at the vet for monitoring when he starts insulin. If you're going to be home, you can do that yourself. Plus, nodody gets "regulated" in a day. This will be an ongoing process with possibly many dose adjustments. I can understand the vet wanting to make sure Buddy doesn't go too low on the first dose and suffer from hypoglycemia, but if he starts out on a reasonable dose and you're there to watch him (or even better, test his blood glucose yourself using a human glucometer), then he would probably be better off at home.

Did the vet mention what insulin they're going to use?

[buddingartist]

Tks Sugarcatmom.

I will test his keytones this afternoon and if they are high, I'll call the vet and the clinic is open on Saturday mornings. (I'm reading the instructions right now on how to use this test).

While I appreciate that Buddy will need close monitoring, we'll cut back on something else but we have decided to leave him there for the day and at the end of the day, the vet is going to teach us how to inject him (yep, we are still freaking out on this).

Once we are comfortable with injecting him with insulin, I'll get a clucometer and start monitoring his blood at home as well as using both the Ketostix and Diastix.

He is still taking the Glyburide and I have been watching him very closely and have started a log of how much he drinks, how frequently he pees, his mood and pretty well know when he starts crashing and panting. We give him corn syrup and this morning, I also gave him pure pumpkin and will give him another teaspoon tonight.

I asked the vet about the insulin and he used Caninsulin. I did mention about the inconsistencies and fluctuations and he mentioned that yes he is aware that the last batch caused those problems.

Thank you so very much Sugarcatmom. Buddy thanks you from the bottom of his little heart. His sis Cleo can't wait for him to get back into shape cause she is wanting to play with him and tease the daily light out of him.

[buddingartist]

Hi Sugarcatmom

I just tested Buddy's urine and it is 4, which the bottle indicates as Moderate.

Do you see an urgency in calling the vet tomorrow morning or would you consider this safe and OK to wait until Monday?

Tks

[hazelrunpack]

I just wanted to say, buddingartist, that the first time I injected one of the dogs, I about passed out. The first time is the hardest and if my experience is any indication, it will probably much harder on you than on Buddy. I practiced the motion all day, concentrating on getting the plunger depressed quickly after the imagined stick...but when it came right down to it, I stuck the needle in and froze, waiting for the scream...which never came. Macie never even noticed the needle. I hit the plunger, withdrew the needle and she was never any the wiser. All that angst over next to nothing

Anyway, things get so much easier after that first plunge! You'll do great!!

[buddingartist]

Tks Hazelrunpack.

The timing of you post couldn't be better cause right now, I am bawling my eyes out. Cleo may be daddy's little girl, but he is my >little man> and my heart just breaks watching him with so little energy.

I know things will get better. We are both committed to giving Buddy the best of care even if it means modifying our lifestyle (we already cancelled a dinner engagement for next Tuesday cause we figure it will only be 2 days on insulin for him).

Tks a bunch for everyone's support

[sugarcatmom]

Originally Posted by buddingartist

I just tested Buddy's urine and it is 4, which the bottle indicates as Moderate.

Do you see an urgency in calling the vet tomorrow morning or would you consider this safe and OK to wait until Monday?

I don't mean to scare you, but if it were me, I'd be calling an emergency clinic tonight. He needs insulin NOW. Ketones are scary business and the longer you wait to deal with them, the more expensive it's going to be to get a handle on them and the greater the risk to Buddy's health. My cat went through DKA (diabetic ketoacidosis) twice, the first time when he was initially diagnosed and I didn't realize the seriousness of it. He spent a week in intensive care at a 24hr vet hospital and it cost me $3,000 (including the feeding tube he needed implanted when he became anorexic). I'm just happy he lived.

Treatment for ketones is fast acting insulin (provided electrolyte levels, particularly potassium, aren't too far outta whack) and IV fluids. Frequent monitoring is necessary to ensure blood glucose doesn't go too low, but low enough to prevent further ketones. Please read this link on DKA: http://petdiabetes.wikia.com/wiki/Ketoacidosis

Do you have an emergency vet clinic in your area you can call?

[sugarcatmom]

Originally Posted by buddingartist

I asked the vet about the insulin and he used Caninsulin. I did mention about the inconsistencies and fluctuations and he mentioned that yes he is aware that the last batch caused those problems.

It's not just "the last batch" that is affected, it's ALL Caninsulin on the market. Here is a pdf from the AAHA on the subject (the Vetsulin they refer to is the same thing as Caninsulin, it's called Vetsulin in the U.S.): http://www.aahanet.org/resources/gra...n_11-16-09.pdf

Particularly this part:

All new diabetic patients should be started on non-Vetsulin insulin products.

[Frenchy]

hi buddingartist , I'm glad you found the puree , but you could have done without too.

I make the whole recipe ,I make the balls and package them individually (I use saran wrap) and keep them in the freezer. I take 2 each night and put them in the fridge so they're unfrozen for the next day. For Bailey , who was about 70 lbs , I made them tennis ball size. I'm guessing for yours , it would be a bit more than half ... I use the regular cottage cheese.

I'm sure you will get used to giving him his insulin , and he will too. I'm so sorry you're having to go through this

[goldengal]

Hi buddingartist ... I just knew there would be so many kind people here to help you. We have fingers and paws crossed here in the House of Dogs that Buddy will soon be tormenting Cleo.

Take care,
Pat

[sugarcatmom]

Hi buddingartist, how is Buddy doing?

[rainbow]

Just adding my here ......hope that Buddy is doing okay.

[buddingartist]

Good morning to all you kind people.

Buddy seems to be doing much better. At your suggestion, Thursday evening, I started giving him pumpkin (starting with 1 teaspoon) morning and night. Also, if I noticed that he wasn't eating, I started hand feeding him a few kibbles approximately every 3 hours and still keeping track of his water intake, which is going down.

Thursday and Friday evening around 9:30, he went into heavy panting and both nights he had us up at 4 and 6 in the morning wanting to go out to pee and lick snow (which he always loved to do).

Yesterday, his keytone were down from 4 to 1.5 and last night he wasn't as bad as previous nights.

Magically, he slept through the night and woke up at 8am this morning. Our babies are not <morning dogs< so they are now both sleeping peacefully on the couch and this afternoon and evening is a full day watching football cuddled with daddy.

I say magically because back 2 weeks ago, hubby and I decided to redo the ceramic tiles in our bathroom. It has been quite the ordeal (shower leak - fixed. Roof leak - fixed. broken flange - fixed. Recaulked the shower stall only to discover that the caulking was dated 2006, now removing the caulking to redo. second layer of sub floor ripped out. subfloor reinforced. and we finally started layting tiles. All this coinciding with Buddy going downhill, having to monitor his water intake etc, etc..... so it has been quite stressful in our house.

Last night hubby and I were cringing in pain that a hot shower could not take care of and therefore, MAGICALLY, we were able to sleep right through the night.

Hubby now refers to pumpkin as the magic food and maybe that is the little added fiber that he needed in his diet.

With all that's happening, I had forgotten that I have a baby shower to go to and also pay a visit to friend in the hospital today. yuk and here I thought today would be a day of rest.

Thank you again for your concern.

Louise

[hazelrunpack]

I'm glad to hear Buddy is doing a bit better!

Oy!! And I can entirely relate to the bathroom project being an ordeal. We got an estimate for 3 wks/$3,000 and it turned into 8 wks/$8,000 once the problems were uncovered. So I hope that goes smoothly from her on out for you now!

for the vet visit tomorrow!

[buddingartist]

To Sugarcatmom

I sent a copy of your document to the vet clinic and here is the reply that the vet sent

Hi Louise:
Thanks for your concern/interest/research.
This alert was brought to our attention in November. The product was not recalled and we had no issues with any of our patients during any time. It appears that a batch or number of batches had variable concentration during that time.
No further alerts or changes have been issued. We continue to use Caninsulin on a daily basis in a multiple number of our diabetics with no problems.
This product remains our best option in dogs with diabetes. The human products that remain on the market must be given at least twice a day and have very short action in dogs.
Lantus (glargine) insulin is our first option in cats but does not work in dogs.
Our awareness of this situation exists and we will continue to monitor it and keep you informed. In the meantime, I have every confidence in starting Buddy on Caninsulin. We initiated a diabetic dog less than a month ago and are getting excellent results, which we will also expect in this case.
Sincerely,
Kevin

Living in the country we don't have the luxury of having vet clinic in every corner to seek a second opinion. Having said that, he has been good to us in the past and I have to continue to trust in his competence. I also need to mention that his practice treats a lot of diabetic animals.

Buddy's keytone 1.5 again today and glucose went down today from 2+ yesterday down to 1.

Many thanks again

[GoldenAngel]

Just thought I'd mention to watch for signs of hypoglycemia if he is on glyburide and insulin concurrently (it is a side effect of both meds and when used together can often exacerbate things - even in humans).

The reason:

glyburide - forces the pancreas to produce more insulin than it would naturally... you can think of it like squeezing a sponge over and over again.

insulin - you are just adding insulin from an external source.

Combined - it can potentially be a lot of insulin so I would just be cautious and watchful, or if possible - ask about discontinuing the glyburide if you're moving straight to insulin.

Good luck... this is a tough one...

[buddingartist]

Hi GoldenAngel

The vet made it very clear that the glyburide was a temporary med until he was definite that it was indeed diabetes. Once he starts him on insulin, the glyburide will be discontinued. What he also said is that the glyburide works well with cats but has had very little positive effect on dogs.

The dosage was 1 1/2 pill (.5mg) in the morning and one at night.

He was doing poorly and by the third day, he did in fact go into hypoglycemia and I had to give him corn syrup on 2 occasions.

So we decided to discontinue the 1/2 at night.

Cheers

[Frenchy]

I'm glad Buddy is doing better !!