False Alarms and other stuff

Image via Wikipedia

The every-other-day dose of Prednisone turned out to be a bust.  Tony immediately became constipated (probably from the combination of his low-residue diet and drinking less water), which is a problem he's had off and on for years, so I gave him a stool softener.  I didn't worry much about that, but it seemed to me that the swellings on his face were coming back up.  I called Dr. Kroll and asked if we could go back to a daily dose.  As she pointed out, normally extending that drug would be a bad idea because of the side effects of long-term use.  However, in Tony's case, long term is not an issue.  She agreed that he should go back to one a day for a couple of weeks, and then we'll switch to half a pill every day rather than skipping every other day.

An aside:  I am getting the most hilarious photos from my Zemanta feed, all apparently based on my use of the words "constipation" and "stool," including one that is of the "Bristol Stool Chart."  It is a series of photos of . . . you guessed it, with comments.  The description reads "Kyle Thompson, self made.  Stool images and text made into document in OpenOffice."  It's the "self made" that cracked me up.  No, I am not going to include the picture here.  Ick.

 So, on Thursday, he had his Prednisone and other pills, which he took eagerly (crushed and mixed into peanut butter), but he didn't want his breakfast.  I took him outside in case he just wanted to "empty his tanks" before he ate, and when he came back in I noticed there was a leaf caught in his tail.  I lifted the tail to pick off the leaf, and -- I am not exaggerating here -- I leapt back in horror.  There was an enormous (about the size of a medium-grade chicken egg; on an 8 pound dog, that's enormous) swelling just to the right of his rectum.

Well, you can imagine what I thought.  This was the end:  the swelling/mass was big enough to cause serious problems for him when he needed to empty that particular tank (it's funny that I considered using 5 other words before settling on that euphemism).  It was tender, too:  he wouldn't let me touch it, not even to clean him up.  As far as I could tell, it looked like his quality of life was about to be destroyed.  Or so it seemed to me.  I called the vet; she was scrubbing for surgery, so I made an appointment for 2PM.  I had conferences with students scheduled from 11AM to 12:15, and I decided not to cancel.  As it turned out, that was a good idea.  I had some trouble concentrating on their issues with syntax and punctuation, but it mostly kept my mind off of the possible outcome --the only one I could imagine, probably because it was the worst.  However, when we went into the examining room, she suggested that it might be a problem with his anal gland.  Apparently infections there can erupt in a hurry, which would explain how he could have such a huge swelling appear overnight.  She took him off into the mysterious depths of the clinic, for which I was grateful.  I had been steeling myself for being with him at the end, but this particular "end" was not something I needed to see.  I used the time to try to adjust to this unexpected turn of events. 

After a few minutes, I heard Tony shriek; less than 30 seconds later, Dr. Kroll appeared.  She was even more certain that it was the anal gland, but Tony was in pain and so upset that they would need to sedate him a bit before they could treat him.  I went off and left them to it.  As I was driving around, my emotions in the spin cycle, I realized that this kind of thing will probably be happening from now on.  In all my efforts to boost his immune system, I was fighting not only his cancer but also his medication:  Prednisone has a negative effect on the immune system, as do antibiotics, and Tony was now going on Clavamox again.  His system has to handle all of that plus the raging infection in his butt.  And that may not be all -- the swelling was so bad that even after it ruptured, which gave Tony a bit of relief, she couldn't tell if there was a mass that might be the lymphoma spreading.  There are nodes right there, too. 

So we have a temporary reprieve, and I'll just be thankful for however long it lasts as I apply warm compresses to his rear end 3 times a day. I am surprised daily by what I am willing to do for him.

It's been a month since the biopsy

Well, it's actually a month and a day since the biopsy, but it seems like a good time to take stock of where we stand.  Yesterday was the next "step-down" point on Tony's Prednisone prescription, so he didn't get a pill.  He'll get one today and every other day from now on.  The nodes in his neck seem a bit smaller to me, as does the swelling in his face, but there's a lump on his back that he's had for years (a fluid-filled cyst; it became hard about a month ago) that hasn't gone back to being soft.

He seems to have adjusted well to the Prednisone -- finally -- and his eating and drinking have levelled off a bit, for which I am grateful.  One funny effect we noticed is that with the salmon and vegetable diet he's been on, his urine has a strong fish odor.  If it weren't fall, we wouldn't have known, but since Tony's firm belief has always been that if the patio is covered with leaves or snow, it's just as good as grass, we're up close and personal with the smell every time we let him out.  I had to hose the patio down a couple days ago; it was that bad.
 
The temperature change that came along with all those fallen leaves is not something he is enjoying, which is too bad.  He's always been a cold weather lover, but with his coat as sparse as it is now, it's already too cold.  He's been coming right in as soon as he takes care of what made him go out.  If the sun is shining, he sometimes will sit in it for a bit, though.  I don't think he's going to be playing in the snow this winter the way he used to, but I think (knock wood) that he will get to see the snow.  I wasn't too sure of that until recently.

His behavior is what makes me think that he'll still be with us for a while.  He's acting more and more like his old self, dominating the big dogs, watching what everyone's doing (despite his cataracts), and barking at noises only he can hear.  I'm glad to see all of this, and even gladder that he's been sleeping somewhat better at night; I've actually gotten 5 hours uninterrupted the past two nights.  Many people might think that's awful, but to me it's almost like getting a vacation.

Tomorrow is Tony's 13th birthday.  I have no idea what to do to celebrate it, but some kind of celebration is clearly in order.

A Status Report

Yesterday was Tony's first day on the stepped-down dose of Prednisone, and I was so glad, I would have danced if not for the pain.  During the week he was on two doses a day, he ate (and begged) constantly, drank vast quantities of water, and had numerous accidents in the house.  By now, we've cleaned the carpets in almost every room (he wasn't the only dog with a problem), so we've got a jump on the holiday cleaning.  I'm trying to keep a positive attitude, as you can see.  And in that vein, Tony's kidneys have been fully flushed during this time, which is also good.  He hasn't shown any real difficulties with the drug, but having to let him out at all hours is a problem for me.  I don't sleep well at the best of times, and the even-worse sleep I've been getting isn't close to enough.  However, he didn't have any accidents last night, and I have hopes for tonight.

Keeping track of all his meds and doses has taught me something that I'm going to pass on:  as soon as you get a dog, start a log of his/her vet visits, medications, etc.  You could, of course, just look back at the vet bills and prescriptions, but I've found that I want a bit more information, especially information that I don't have to decode.  This blog has actually been very helpful in that regard, since I've tended to post when things change.  I now have a record of what was going on when.

In fact, I think we probably ought to do this for other things, too.  For example, you buy a house, and from that point on, repairs are ongoing.  It's handy to have a way to know when you bought the new water heater, or the last time you had the chimney cleaned (was it last winter, or the year before?).  My memory is pretty crummy about things like that, all the more so lately.

Wanna play a game?

This is just a quick post to let you know about the Nobelprize.org's The Diabetic Dog Game.  It's basically an online pet simulator, with a blood sugar monitoring bar so that you can keep track of the dog's levels.  If you have a child in the house, this would be a good way to help them understand what is going on with your dog.  I have found that it's hard to make people understand that they can't give Tony treats, and kids often think I'm just being mean.  Playing this game would give them an idea of what happens when you give a diabetic dog food he isn't supposed to have.  And, it's pretty darn cute.

A warning:  if you don't take good care of your diabetic dog, the game takes it away from you.

In case you're wondering what the Nobel Prize has to do with dogs, the answer is that the discoverer of insulin won the prize in 1923, and I guess that using a dog was to make it more appealing so kids would want to play (and not even notice that they are learning).  It would also be good for parents to use to impress upon kids that adopting a dog is a very serious responsibility.

Attacking Cancer Nutritionally in a Diabetic Dog

As part of my "shotgun" approach, I sifted through a bunch of material on diet and cancer in dogs.  It appears to be generally agreed that carbohydrates need to be reduced, especially carbs that are from grains and starches (one site says that the ratio should be 95% protein and fat, 5% carbs-- only non-starchy vegetables and fruits).  There also seems to be agreement that Omega 3 fatty acids must be increased, although Omega 6s are controversial, with some saying they feed the cancer (this is said about carbs, too) while others think that they should be at the same level the dog has always had.  Many vets and pet owners recommended yogurt as well (Tony already gets plain nonfat yogurt as his bedtime snack), and others raved (some ranted) about the benefits of a raw foods diet for dogs with cancer. 

Safflower Image via Wikipedia

Several sites talk about a study that was published in the journal Cancer Letter in 1992, where 75% of a small sample group of dogs went into remission of the skin form of lymphoma with only the addition of safflower oil (high in Omega 6s, especially linoleic acid) to their diet.  I particularly like the Pet Web Library website of the Mar Vista Animal Medical Center in Los Angeles  (http://www.marvistavet.com/index.html), as they have set up pages on most of the conditions their clients are likely to ask about.  The lymphoma page was very helpful when it came to nutrition.  They mention that the safflower oil study remains controversial (there is a later study that produced the same results, but again on a very small sample), and they also point out that the brand preferred for this is Hollywood, not Hain. 

Along with all of this new information, I realized that I already knew some things about supplementation and general nutrition for diabetics that I could apply to the problem.  After all, I live with two diabetic humans, and I have a chronic illness (Still's Disease) as well, and all three of us (one of whom is an R.N.) use nutritional supplements for our various health issues.  Thus armed with a bunch of ideas, I started formulating a basic diet plan, intending to revise it as I learn more and as Tony gives me feedback.

First, I ruled out going the raw food route whole-hog, so to speak, but I would not fry or bake any meat or fish, to avoid the Maillard effect.  This is basically browning, the thing that gives meat a lot of its flavor, but it has been implicated as a risk factor for cancer in many studies, so I decided to stick with boiling and steaming, which means that I can use some canned products.  I discovered on a trip to Woodman's, my very favorite supermarket of all time (even though the store is so enormous that I often have to lie down when I get home after a shopping trip), that there are a number of brands of canned salmon that are reasonably priced (certainly less than premium or prescription dog food) and would work well for my purposes.  I would not eat these brands myself (yes, I'm picky-- the salmon just isn't pretty enough for me; there's skin and those little round vertebrae that creep me out), but Tony loves them, and they have a number of benefits for him.  Additionally, I can boost their Omega 3 content with his 3V oil (from Foster and Smith), which he has been spurning lately, and add anything else I need him to eat, because the smell is so strong that it masks the stuff he doesn't like.  Hurray!

I've already mentioned in a previous posting that I have given him either asparagus (canned spears and tips) or broccoli (frozen) at various times; now he is getting both, twice a day, mixed in with the salmon.  To this I am adding a scant teaspoon of Hollywood  safflower oil, a tablespoon of chicken broth heavily seasoned with turmeric, and a sprinkling of cranberry meal (I'm using the capsules I take), plus a crushed multivitamin in the breakfast bowl.  He eats this eagerly.  

There are other supplements that he takes:  brewer's yeast, which he will take as a whole pill, and a milk thistle supplement (Marin is the brand name), which gets crushed up with his medications and is mixed into a teaspoonful of peanut butter (I'm past worrying about his kidney stones-- he needs the medicine to keep him alive now, and he has never refused peanut butter).  The milk thistle and cranberry meal are to support liver and kidney function respectively; this is important, because most dogs with lymphoma die of liver or kidney complications.  However, most of those dogs are being treated with chemotherapy (non-radiation), which Tony will not be.  As an older dog with diabetes, he is just not a good candidate for chemo.

I have also added another pair of supplements for what is called "immunomodulation."  I don't know if this will help, but I can't see how it would hurt.  The products are K9 Immunity and K9 Transfer Factor, and according to the makers, there is usually some improvement at the ten-day mark.  Of course, this is usually given in conjunction with chemotherapy. 

Tony has been on this diet since Wednesday, 10/7, and he started on the K9 supplements a day later.  Just today, 10/17, I noticed an actual improvement in his condition, which may have nothing to do with any of this, but it's the first positive change in weeks.  It has to do with his skin condition, which has been terrible.  He has had lesions popping up, first on his stomach and then all over.  His beautiful fluffy fur coat turned into a series of giant mats, and removing them was like shearing a very small sheep-- it came off in one solid layer.  Underneath that, his skin was almost covered in a white scaly substance that flaked off when you touched it.  Many of the flakes had sharp edges.  This morning, when I picked him up for his insulin shot, his stomach felt soft.  After the shot -- and the obligatory treat, I rolled him onto his back.  There were only a couple of small lesions left, and very little of the scaly stuff remained in that area.  He has only been on Prednisone for two days.  

So far, I think I'm doing the right things, but I know that I could easily be mistaken.  Dr. Kroll sees no problem with these changes as long as they don't affect his blood sugar adversely (they haven't yet).  We'll see how it goes.  

My diabetic dog has cancer

Image via Wikipedia. "Cytology from a needle aspiration biopsy of a lymph node of a dog with lymphoma. The predominant cells are lymphoblasts. Slide was stained with a modified Wright's stain."

I had to use that as the title for this post, just because it's so hard to say. Today, Tony is wide awake, walking around the way he usually does first thing in the morning. We call this "checking the perimeter," since it does look like that's what he's doing. He wants to know where everyone is; once he knows that, he settles down for a little snooze. It all seems totally routine, but with one look at him, anybody could tell that something's wrong. He had his stitches from the biopsy removed on Wednesday and started Prednisone on Thursday (the wait time from the diagnosis was caused by his taking Rimadyl; he needed to be off it for at least a week before they could give him Prednisone, as the two interact badly, apparently). Dr. Kroll warned me that he would be very hungry and thirsty on the Prednisone, and so it has worked out. Yesterday, he emptied his breakfast and dinner bowls on the first try, which he has never done before (he likes to leave a bit for a snack). This isn't a bad thing, since he's been losing weight (now just over 8 lb.). I had even been cutting back his insulin a bit before this as he wasn't eating as much as usual, what with the change in his food (more about this later)

As to what I've been doing since the diagnosis, you can probably guess. After I finished my last post, I began researching lymphoma in dogs, looking not just at peer-reviewed veterinary journal articles, but also at what ordinary people had to say about their experiences. I felt better once I had done this; it got rid of some of the helplessness I had been feeling. And I found some interesting stuff.

The first thing I discovered is that when this happens to your best friend, you want to talk about it. There are a lot of web pages devoted to dogs who have had lymphoma, along with the stories of their treatment. There are also, as you might expect, pages and sites that are trying to sell you something. I tried to weed out as much of this as I could, but a couple were actually useful. One of these is by a guy named Ted Schneck, who is selling a book titled Curing Canine Cancer: Natural Treatments That Work (Secrets of Marty the Wonderdog). No, I did not buy the book; as I've mentioned before, I'm broke. I've already spent over a quarter of my annual income on Tony's care this year, and I can't even afford to consult with a veterinary oncologist. However, Ted seems to want to help: even if you aren't buying the book, he has free tips that he will e-mail. Of course, that gives him more chances to make his sales pitch, but I didn't mind because a couple of the tips were very helpful to me. One of them was to encourage me to take a "shotgun approach," trying anything that might help as long as it doesn't hurt. I was already leaning in that direction, but the validation, even from a layperson, made me feel that I was doing the right thing for Tony. The other thing was even better; it had to do with my behavior around Tony, and I'll explain that in a later post. In fact, I'll talk about all of these issues in individual posts, I think.

I guess I'll give Ted a plug, since he did me a favor. His url is http://www.curing-canine-cancer.com/.

A new direction

I had meant to post last Tuesday, when Tony was supposed to have his biopsy, but it was postponed until last Thursday. I have an 11AM-12:15PM class Tuesday and Thursday, so I popped him into his carseat and drove him up to the vet for his 8AM appointment, then turned around and went home. About 5 minutes after I walked in the door, the phone rang and the caller ID showed it was the vet. Reading that, you probably have the same sense of foreboding that I had then. It wasn't good. While they were doing the pre-anesthesia exam, Dr. Kroll noticed that Tony's muzzle was swollen on one side. He has a mass there and another on the other side of the mouth towards the back. She began listing my options, and I stopped her as soon as she pointed out that he was there and prepped already, so it would be easy to biopsy the masses as well as his skin lesions. "Do it," I said. I didn't want her to tell me how much it would cost right then, figuring that when I went to pick him up was soon enough for that and I didn't want to be tempted to postpone finding out what this fresh catastrophe was going to mean.

I picked him up Thursday night, and he seemed a bit groggy, but otherwise his same old self. Even the techs were saying that if he didn't look the way he did (much of his fur shaved off, his face swollen, etc.), you wouldn't know there was anything wrong with him from his behavior. All weekend long he was fairly peppy and alert, and he still is today. But when I got home after my 8AM class today, I had another call from Dr. Kroll. The news was bad.

The biopsies showed that the masses and the skin lesions had the same cause: lymphoma. She was more upset than I was; I was numb (still am). I told her that I needed some time to take this in and figure out what questions to ask, and she told me to call her anytime, saying, "I'm always here." That actually made me laugh, because she certainly seems to be there all the time, even on days when I know she is scheduled to be off.

I wanted to get this posted as soon as possible for my family members who live all around the country, but I really don't have much more to say now. It looks as though this blog is about to go in a new direction.

The Zemanta feed just popped up the photo below with the caption "Shuttle's exuberance for life, lymphoma and all." I'm going to take this as a good omen.

Image by dglassme via Flickr

Insomnia strikes again

Can't sleep. Again. I have been like this as long as I can remember, although my mother claims I slept fine as a baby. Tony is a big part of my sleeping trouble. About three or four months before he was diagnosed, he started needing to go out in the middle of the night (one of the most obvious symptoms of diabetes), and my sleep was way out of whack until he went on insulin.

I'm one of those people who has trouble falling asleep and staying asleep (and, of course, falling asleep again). In the mid-1980s, I tried an experiment where I used self-hypnosis tapes to get myself in a pattern where I slept only four and a half hours a night (this was based on the 90 minute sleep cycle most people have); after 3 cycles, I would wake up easily, and I was pretty alert. I did that for almost a year, and accomplished a lot, but I think it made the overall sleep problem worse, not to mention that what made me stop was that my arthritis was getting worse, too.

I eventually got back to where I was getting at least six hours most nights, when Tony developed his bladder problem in June, and that set up another problem, what with the blood sugar crashes and so on. I couldn't sleep because I was afraid he'd have a crash and I wouldn't wake up, and now that he's stabilized, more or less, HE'S not sleeping at night. Part of his problem is almost certainly his skin condition; he's not scratching as much as I expect him to, but he has trouble getting comfortable. The last round of antibiotics doesn't seem to have done much, so on Tuesday, we're back to the vet for his biopsy. I have to trim all of the mats he's developed from the "extreme" shedding this thing causes, and he's going to look like hell. In the past week, he's lost fur on his face for the first time, so he's nowhere near looking his best. His mood seems good, anyway, and since he finished the antibiotic, his appetite is better than it's been since spring.

But he keeps waking me between 2-4 AM. It takes me an hour or so to fall asleep, so it seems as if I only had a few minutes of sleep before he's bouncing against my bed, wanting to go out.
My short-term memory and general recall have been taking a beating from menopause, and the lack of sleep is compounding the problem. Just tonight, I had to stop myself from freaking out because I thought I had lost a set of essays that needed to be graded. It turns out that I returned them on Monday.

I'm taking another shot at sleep now. I really just wanted to update about the biopsy.

How do you deal with frustration?

Well, I tend to do it badly in some circumstances, but there are a few where I really shine, if I do say so myself. For example, when one of my students needs something explained in a dozen different ways before he or she understands, I stick with it until I see the lightbulb going on, no matter how long it takes. This ability is particularly valuable when it comes to dealing with Tony's problems. I mentioned in my last post that he was having blood sugar crashes. After talking with both his vet and another doctor in the practice, we decided to take him off the Royal Canin Urinary SO and put him back on Lamaderm. I had taken him in because he seemed to have injured his right hind leg, but they checked him out on all fronts, which I always appreciate. It makes me wonder why I can't find a doctor for myself who is willing to take the time to cover all the bases (of course, I haven't really been looking, since I'm without health insurance -- for the last 4 years!-- so there's no point, but still . . .).

The results of their examination? Tony has a mild ear infection, which means a daily ear washing; his skin condition has spread from his stomach to other areas; his weight is down to 10.5 pounds; and he's developed osteoarthritis in his knee. At the moment, the tendon on his kneecap is "subluxated," meaning that it's come out of the shallow groove it's supposed to sit in. Dr. Campbell tried for several minutes to pop it back into place, but it wouldn't cooperate. Tony, however, didn't even whimper when she was stretching his leg out and moving it around -- this after he started shrieking at home, which was why I rushed him to the vet in the first place.
So, he's now on Rimadyl twice daily (and probably permanently), along with a daily dose of Torbutrol, since his trachea collapse is bothering him a lot more, and an antibiotic. Do I need to stress the importance of getting health insurance for your pets? I wish somebody had told me about it when Tony first arrived.

Because of the quantities of pills involved, I asked Dr. Campbell to give me prescriptions for both drugs, but now I'm kind of sorry I did that rather than just have them dispense -- I thought I could save money on the Rimadyl by getting the generic Novox instead (it's about half the price), but it's been a real hassle, and I still don't have the prescriptions filled after a week! Hence the title of this post. First, the pharmacy (at Drs. Foster & Smith) has to have an actual prescription or one faxed from the vet, which I understand and actually agree with as a policy, but mailing the rx's delayed the order a few days, and then yesterday, Fed Ex failed to deliver, leaving a sticker on the front door instructing me to pick up the package before close of business or they would have to wait until Tuesday (Labor Day weekend, remember?) to try again. Unfortunately, I didn't go out the front door until 7PM. The sticker said that the attempt was made at 9:57AM. This is what ticks me off. I taught an 8AM class and was home by 9:45; my mother, sister, and brother-in-law were all home and awake, too, as were all three dogs. The doorbell never rang -- when it does, it triggers a mammoth barkfest -- and we couldn't have missed that, even if we didn't hear our extremely loud doorbell!

I would love to boycott FedEx, but that's pretty much out of the question -- I do most of my shopping online. However, I am going to file a complaint with them. There's no excuse for what they did, and Tony will be out of his meds before the shipment gets here. I'm guessing that the dogs frightened the driver (they bark over noises outside, and the neighbor was mowing, so we probably thought that was what they were barking at). The two Great Pyrenees sound like all the hounds of hell when they get going; if just their minor warning barks scared him, it's too bad he didn't ring the bell. He probably would have lost control of his bladder over the ruckus that raises, a thought that I find very satisfying right now.

I hate to think that Tony might have to suffer even for a minute because of FedEx. I think that I'm going to start favoring businesses that use UPS. It's not a boycott, but it's the best I can do, and my frustration really needs some kind of outlet.

We're Baaack

We took a brief hiatus (it was the end-of-term grading frenzy), but now we're back. And for once, Tony is back to "normal." He ate breakfast today, early enough so that he got his shot before noon, and he's been awake since around 9AM (with a couple of short naps), which is a vast improvement over the last couple of weeks. In fact, until today, August has been a lousy month. Introducing the new food has produced several problems, including his first blood-sugar crashes ever, a scary experience for all of us. He has, as predicted, been drinking and urinating more -- both of which can affect blood sugar.

A complete aside: I just glanced over at my Zemanta feed, and for some reason, it's suggesting a bunch of images and links connected to Napoleon. Hmm. Ahh, now it's showing something interesting, a chart about sugar consumption.

Image via Wikipedia

The high-fructose corn syrup band is rather telling, I think. I got into a discussion with some students in my summer composition class about HFCS, back around the Fourth of July. Actually, what brought this up was somebody's comment on recycling. Back in "the day" (and what exactly does that colloquialism mean?), we bought our Coke in 8-packs of 16 oz. returnable glass bottles. These were pretty heavy, so we only had soda, of any kind, on holidays and other special occasions. All of these were sweetened with real sugar (and tasted so much better than the HCFS stuff you get nowadays, I can't believe people drink as much soda as they do now), which was a problem in the early '70s when there was a big crop failure and sugar prices went through the roof (the price of a Milky Way went from a dime to a quarter overnight. Sigh). Enter HCFS. I don't remember when the glass bottles were phased out, but all of a sudden, they were gone, and the more expensive cans and plastic bottles were all you could get. These were also significantly lighter in weight, so it wasn't such a big deal to pick some up on an ordinary day, and I made the argument that this was an important factor in the rising rate of HCFS consumption, as well as in landfill density. The kids couldn't believe that there had been an effective recycling program in place, one that was jettisoned without a thought to the consequences. But the consequences are exactly what the soft-drink companies want, aren't they? They moved more product, at a higher price (and lower cost, so far more profit), they cut down on labor costs and processing of the bottles, and now people drink soda at every meal. It couldn't have worked out better if they had planned the crop failure themselves!

The really insidious thing about HCFS is that it has found its way into all sorts of products that don't need sweetening in the first place, things like dog food, for example (as I noted in my 6/16/09 post about Ol' Roy's Dinner Rounds, which was Tony's favorite food up until he was diagnosed with diabetes). Now, the corn syrup producers can run all of the informational ads that they want, but I'm here to tell you, there's something morally wrong with people who would knowingly hook a dog on their product by sweetening it. You notice that I didn't complain about whatever the effects may be on people? I don't have a problem with that: people can choose for themselves, but our dogs rely on us not to feed them things that will lead to serious health problems like diabetes. Yeah, I still feel guilty about my role in Tony's condition.

Am I saying that HCFS causes diabetes? Not really. It may very well do so, but this is probably going to be one of those research topics that's going to result in a lot of junk-science articles about studies that were financed by corn-syrup producers. We may never know the truth.

Check out those ads on Youtube! Then check out all the responses. DECIDE FOR YOURSELF!

Baby Talk? Maybe

I don't like to think of myself as a stock character, although I suppose other people may see me that way when they hear that I have a Pom. You know the stereotype: a largish middle-aged woman with a tiny dog that she carries around with her, either in her arms or in a tote chosen to complement the dog (and probably her outfit, too); she lets the dog do whatever it wants, feeds it filet mignon, and considers it her baby, talking to it as if it were. Well, I don't carry Tony around, although I do pick him up from time to time, he doesn't sleep on my bed, you know what I feed him, and I don't let him run wild all over the house. However, I do talk to him all the time, and some of that, I must admit, is in baby talk.

I can't help it. He's little and cute, and that just brings it out. I call him by several pet names (and yes, I know that's not a good idea in terms of obedience, but he seems to know I mean him, and when I'm actually giving a command I always use his actual name), including Sweetie (ironic, considering his diabetes), Baby, Cutieboots (I have no idea where I got that), T-Dog, Tony Bambino, Tootsiebelle (yes, I know that should be for a female), and so on. My younger brother, Alex (not the one who gave me Tony), came up with a weird prank when Tony first came here, which was designed to annoy Eric, the brother who did give me Tony. Before Tony arrived, Alex said that we should change Tony's name to "Cha Cha," for reasons I never fully understood. Since then, whenever Alex sees him, he calls him "Tony the Cha Cha," as if it were all one word. I think Tony only hears the beginning of it, but he does answer to it.

I sing to him, too. In fact, Tony is pretty much the only one to hear me sing, since I only do it when we're alone. There's the "Tony-baby" song, the Naptime song, "Me and my baby," and, of course, "It's Bedtime." I sort of use the naptime and bedtime songs as indicators that I expect him to sleep, and they seem to work that way, at least some of the time. The others pop up spontaneously, and sometimes, if I'm holding him when they do, I help him dance (he does a mean Cabbage Patch). Yeah, it's sickeningly cute.

What I don't do is baby talk in public, beyond the pet names. I see this as respecting his dignity, but other people are less concerned with this. My mother, for just one example, talks to him as if he is a baby, without using baby talk per se, saying things like, "Oh, you little sweetie." She's a retired neo-natal nurse, so it's probably an incurable habit by now. When I have Tony out in public, perfect strangers come running up to him and gush over and at him, in torrents of extra-gooey baby talk: "Ooh! What a pwecious widdo sweetie! Is oo a good doggie?" Then they ask what I think of as the Tony FAQ: What kind of dog is he? Is he a puppy? Do they cost much? etc.

Now, I must confess that Tony does have some "clothing," but he only wears it on special occasions. He has a sweater and a coat, both of which only come out in extremely cold weather. He has elastic jester collars for Halloween and Christmas, but I usually take those off of him after everyone has seen them on him, since the bells appear to get on his nerves. He has a special bandanna for the Fourth of July, too. The only truly silly outfit he has is a teeny Hawaiian shirt that I found on clearance back in 2001. I bought it because we had "Tiki'd" the wet bar in our basement as part of a family-reunion sort of thing when my mom turned 70. He had it on for about 20 minutes before he figured out how to get his legs out of it, then he rolled around on the floor until it was off all the way. I never did see how he did the first part of his escape act. I don't put rhinestones, polka dots, or anything of that ilk on him. I still haven't needed to put his "incontinence garment" on him, but I expect him to try to get out of that when the time comes.

So, if you've read Dogology, you can tell that I don't fit any of their categories. And I bet you don't either.

Dogs acting weird

It's been a week since Tony started getting the new food, Royal Canin Urinary SO. I was not impressed when I opened the can. SO (I don't want to keep typing "Urinary"-- kind of a gross name for something edible, isn't it?) is very dense and dry, which surprised me. The Lamaderm Tony usually eats is much looser and wetter, and I guess I expected the SO to be about the same, but it's so dry and solid that you really have to work to break it up. I started by mixing about 2 teaspoons worth into a slightly smaller than usual amount of Lamaderm, added the usual teaspoonful of cooked chopped broccoli (Tony loves this, and it does not produce oxalic acid, thank goodness), and set it in front of him. I'd like to say that he was intrigued by the new addition, but no, he was in one of his moods, and refused to look at the bowl. He does this once or twice a week, just to keep me on my toes, I guess, but I was in a kind of anticipatory frenzy over this, so, instead of ignoring his behavior, I followed him around for a bit, tapping my fingernail on the bowl and chanting, "Eat! Eat! Eat!"
After a few minutes of this, he went into his favorite corner, yawned, and -- very ostentatiously -- went to sleep. My family started drifting into the room, each asking about dinner. I'm now thinking about adding a sock-puppet component to my coaxing ritual.

As usual, after an hour or so of concentrated spurning, Tony deigned to stroll over for a taste, and apparently found it to be acceptable. What a relief! I'm sure I've mentioned that he (like all dogs) refuses to eat at all every so often, and I was really keyed up over the potential effects of the SO. I was so hyped about it, in fact, that on my way back from picking up the food at the vet's, I stopped at a Petco and bought a "Male Incontinence Wrap." It cost $22, which is an outrageous price for what is basically a strip of denim and vinyl with a Velcro closure. I did not buy any liner pads, because they were priced even more outrageously-- $17 for a pack of 12! My sister has been using one of these on the older of her two Great Pyrenees, and she uses Serenity pads (for humans), which are much cheaper, so I'm going that route. For the next couple of hours everyone was watching Tony, but there wasn't much of a payoff. He didn't start drinking copious amounts of water, didn't scratch at the door, no blood-sugar crash, nothing. In a way, it was encouraging, but it was too early to tell anything.

Then, a couple of days ago (he was up to a tablespoon of SO by then), he seemed to stop drinking altogether. I came home from work (I'm teaching an evening class this summer), and my mother told me that she hadn't seen him take a drink in the four hours I was gone, and he hadn't wanted to go outside either. Now we were all watching him, and she was right, he didn't seem to drink, and we had to take him outside, rather against his will. He was, however, sleeping a lot more than usual. What did that mean? Who the heck knows?! Dogs sometimes act weirdly. You try and try to figure them out, but in the end, you're just guessing, and you know it. My best guess is that he was drinking when we weren't looking, ditto for urinating-- it's a big yard, and you can't watch him every second. If he really wasn't drinking, he may have only been adjusting to the reverse-osmosis water that's now in the bowl. Or he may have been registering a complaint about that change. Whatever. Yesterday he was acting "normally" again.

All of this behavioral observation seems to feed my anxiety, so I'm trying to cut back a bit, but at the same time, I have to watch for problems. His latest appears to be stiffness in his right hind leg, which he gets now and then (he is pushing thirteen years old, after all), but it seems to be coming and going throughout the day. Meanwhile, the other dogs have their own problems. Gus's incontinence has expanded to include defecation accidents (this started at my brother-in-law's birthday party, oddly enough). He's always been a bit strange in that area anyway; he prefers to do it on concrete as a rule, on the patio or the deck around the pool. In a way, it makes it easier to clean up, but it's also kind of annoying. Doc is not a patio-pooper, but he does have a problem leg himself (hey, maybe Tony's just imitating him for the attention. Hmm.); he's had surgery on it, without much success. Lately he's been flopping down at odd intervals, but Steve, my sister's husband, says that he's just as lively as ever at the dog park.

We'll see.

Things that make you go, "Huh?"

I don't think I'll ever be surprised again by the odd things that turn out to be important to anybody's health, be they human or not. On Wednesday, while I was at work, my vet called about the report on the stones they removed from Tony's bladder. His stones were oxalate, not struvite. Struvite stones can be dissolved; oxalate stones must be removed surgically. I already knew that whichever it was, I was going to have to change food, but I was hoping that we were not looking at more surgeries in the future to remove stones.

I spent yesterday morning researching the situation. I wanted to know the right questions to ask Dr. Kroll when I returned her call. She had told my mother that she wanted to switch Tony to Royal Canin Urinary SO food, so I read up on that, and I realized that there were going to be problems. This food has meat by-products and corn, both of which I have scrupulously avoided since they are linked to various health issues, and this remains a concern. As Tony eats around half a can of food a day, the $1+ increase in the price per can was not as bad as it would be for a larger dog; I checked around online for suppliers who might have a better price than the vet, but that didn't work out, thanks to shipping charges. The food is supposed to adjust the ph and dilute his urine so that stones don't form, but I was still worried about the diabetic aspect. Tony's diabetes has been under good control, and I have no idea how the Royal Canin food would work in that regard. However, the bottom line was, and is still, that more stones are almost inevitable, at least according to my research, so I'm going to switch.

When I spoke with her, Dr. Kroll expressed some of the same concerns I had about the potential for more stones and about the effect the new food would have on Tony's blood sugar. I asked her about alternatives (she guessed that I wouldn't be thrilled with the idea of the Hill's brand of anti-stone food; she was right), and she said that if I wanted to try it, we (she and I) could consult with a nutritionist to develop a diet that specifically addressed both problems. While I wouldn't mind cooking for Tony, I decided to try the Royal Canin first, to see how that worked before going the homemade route. But there are still a few details that I expect will be hard to deal with because of the food. For one thing, Urinary SO is supposed to increase thirst and frequency of urination, which in itself can affect blood sugar, and we've already had a few incidences of Tony having accidents in the house during his recovery from the surgery and the bladder infection. I'm going to look into "doggy diapers," but he still has the mysterious irritation on his skin, and the diapers might exacerbate that condition. He's also lost some fur recently, and I wonder how the new food will affect that. She is still looking into the skin problem, so I should have more about that later, but for now, she recommends continuing the antibacterial shampoo. In regard to the urinary situation, she wants him to drink only the reverse-osmosis water (we have a household filter system for that because our water comes from a well) that we drink, which means all three dogs will have to switch to that. The only problem I can see with giving them the r/o water is that they seem to prefer their water straight from the well, even though it is extremely hard water with lots of iron and a horrible phosphorus smell. We'll see how that goes.

I'll be picking up the new food this afternoon. Based on Dr. Kroll's instructions, Tony will switch over slowly, over a two to three week period. He'll also have some new restrictions on his diet to eliminate oxalic-acid-producing foods, like spinach and peanut butter, which are particular favorites of his. I sure hope this works!

A Three Dog Household

I have probably mentioned that there are other dogs here, but it's worth talking about in more detail, since there are problems connected with having other dogs living with your diabetic dog. In my case, the problem is exacerbated by the size of the other dogs and my dog's attitude issues. You guessed it: Tony has delusions of grandeur, mostly related to his conviction that he is the biggest, the toughest, the baaadest dog on the planet (or at least in the house). What's surprising is that the other dogs seem to buy into his domination fantasy, all the moreso since they are Great Pyrenees,
giants who were originally bred to protect flocks of sheep by fighting wolves. Doc (age 5, 130 pounds) and Gus (9 years old, getting skinny-- only 85 pounds) both let 11-pound Tony call the shots most of the time. When all three of them were younger, it wasn't unusual to see Tony jumping up to bite them in the throat (I had to pull wads of fur out of his teeth almost every day. Good times.). I kept thinking that someday Doc would walk in with Tony hanging off his neck like an earring, but that never materialized (a pity, since it would have been a heck of a picture). Nowadays he mostly just growls at them as needed. He still occasionally mounts them, which is pretty funny-- after a few seconds of this, the big dog will turn around and look to see what's going on back there. So much for making the big domination move, little guy.



He's still leader of the pack, however. When Tony was first diagnosed with diabetes, I worried that their dog games would be a problem. Before then, I mostly worried about one of them stepping on him -- their feet are bigger than his head-- but he would get a scratch from time to time as he tried to show them who was boss. Now that he could be expected to have trouble healing, I had something new to worry about. Luckily, he hasn't been scratched or stepped on in the last three years, so my fears haven't panned out. Gus and Doc still want to sniff him all the time, which he usually does not permit, although he likes to play "dog vet" with them, sniffing them from one end to the other until he's sure they're not coming down with some dread disease. They stand stock-still when he does this, and they don't relax until he walks away (actually, he kind of swaggers). Tony's cataracts (a common side effect of diabetes) have been getting worse, but his vision impairment hasn't been as much of a problem with the boys as it has been with the humans, who are used to Tony getting out of their way rather than the other way around.

Most of the problems we've had have had to do with food. Doc eats a lot, where Gus is very picky, but neither is what you might call a dainty eater. Tony has been in the habit of batting cleanup after their meal, and it's sometimes hard to stop this. When he was first diagnosed, my sister found a couple of plant stands for Gus and Doc's food bowls, which turned out to be a perfect height for all of them. They're over Tony's head, but easy and more comfortable for the Pyrs. When it comes to treats, however, all bets are off. My mother was in the habit of giving Tony treats whenever he seemed to want one (a classic grandmother!). She still does this with the other two, but now she lets me know if she's given Tony anything, and her contributions to his diet tend to be things like the last bit of scrambled Egg Beaters on her plate; in other words, protein. She doesn't do it often, thankfully. Dealing with the treats is tough for me, too. It's so sad when the big dogs are being showered with rawhides or whatever, and the Pomeranian can't share in the fun. It would be easier if Tony liked toys, but he rarely plays with them.

If your dog is in frequent contact with other, non-diabetic dogs, you will probably find that the most difficult thing is getting the people of the other dogs to cooperate. They may need continual education and reminders about how their actions affect your dog, and after a while, this becomes tedious for both parties. I can't help you there. One of my housemates has memory issues, yet he becomes upset if you remind him (or if you don't remind him, for that matter). Your best bet is to establish as rigid a routine as you can, so that it becomes second nature for everyone in the household, not just you and your dog.

I'll leave this here for now, but I expect to revisit it from time to time. Right now, Tony still hasn't eaten, and I need to shop for our 4th of July celebration.

C'mon and eat, for crying out loud!

Image via Wikipedia

Tony had the staples from his surgery out yesterday, and, unfortunately that was the high point of our day. It started when he turned up his nose at his food. All dogs spurn their food now and then, but when the dog is diabetic, it causes problems. Our appointment was at 11:45, and he still hadn't eaten by the time we were to leave. This meant that it would be at least an hour and a half before he could eat and have his shot. I tried everything I could think of, but he just wasn't interested. In the past, he has occasionally not eaten in the morning at all, and it seemed this was one of those days. It was frustrating for me, though, since I knew that the vet visit was going to put some added stress on him, which can affect blood sugar. Even worse, the vet wanted to keep him for a few hours because she was having trouble getting a urine sample.

I was relieved when she called to say that I could pick him up (by this time it was 3PM-- a long time to go without food), and I figured that I could get him home by 4 and set him up with an early dinner. Alas, it was not to be.

It was a hot day, and I had been running errands while waiting for her call. When I went out to my car and started it, the oil light and electrical light both stayed on. AARGH! I checked the oil -- it was fine. I got out the manual, read up on both lights, decided that a. I couldn't do anything about this myself, and b. I couldn't drive the car without running the risk of ruining my engine. And things didn't get any better. My sister was going to drive me, so I needed to clean out Tony's carrier (he rides in a car seat in my car, but it couldn't fit on the back seat of her car). I discovered that my brother, who had borrowed the carrier a while back for a truly obnoxious Schipperke puppy he had at the time (the pup ate a huge hole in his kitchen linoleum, and that was just the tip of the iceberg), had forgotten to tell me that his chewing machine had been at work on the carrier. It was a mess. I washed it out, put it back together, and realized that I had to put the door in while it was apart. I had broken three nails getting it apart in the first place, and I was in a hurry, and I discovered that I couldn't get the clamps off again. AARGH! AARGH! (yes, that's a double AARGH). I'm ashamed to admit that I burst into hysterical tears.

The upshot of the whole deal was that my sister went by herself (with the car seat) and left me at home to recover (thanks, Leslie). After some sleep, I felt that I could maintain again. But he did it again! Right now, I'm typing this with his untouched bowl sitting next to me, it's 11:30, and he's taking a little nap. About an hour ago, I offered him a Liv-a-Snap (something he gets very rarely), hoping to "prime the pump," so to speak, but it was not to be.

Priming the pump actually works a lot of the time. It's as if the dog doesn't realize he's hungry, and a special treat reminds him. The problem with treats is that you're trying to control what he eats -- the carbs, the protein, and the fat -- and you really don't want to screw that up. When he won't eat, I sometimes think that he's holding out for the treat he gets after his shot (I use freeze-dried lamb lung slices for that; he doesn't get them at any other time, and they seem to be highly addictive). He hasn't quite gotten the idea that he can't have the shot and get the lamb lung unless he eats his food. And sometimes, it's as if he needs to make room for food: he wants to go out in the yard and empty the tanks before he eats. I thought he was doing that just now, but no such luck. He came back in, raring to go, sniffed at the food and walked away. It's pretty annoying, since I need to take the car in asap. Well, he'll eat or he won't. He's had enough disruptions to his routine the last few weeks to put anyone off eating, so I'm not going to panic. The bottom line, I guess, is that you have to be flexible, if you can.

So you think your dog may be diabetic, and you're afraid of needles . . .

Image via Wikipedia

It occurs to me that I haven't mentioned what led me to start this blog. A veterinary technician in the animal emergency room suggested it when she was taking Tony's medical history. According to her, many people in this situation give up quickly, if not right off the bat. I have to believe that she wasn't making it up, but I find it very hard to believe that there are a lot of people who would have their best friend put down (or take some other option) just because they didn't want to deal with his or her diabetes. If you've recently learned that your dog is diabetic, you need to know that -- with some planning and thought -- you can manage your dog's care. It may not always be easy, but it's not necessarily the disaster it seems to be at first.

I'd be willing to bet that the one thing that people feel is overwhelmingly difficult is the idea of giving their dog injections: they don't want to cause their pal (or their baby, or however they see the relationship) any pain, they're afraid of the potential for accidents in giving shots, or they're afraid of needles in general. I'm going to take these in a different order than I just listed them, because what I was most worried about, and still am to some degree, is the second, the possibility of screwing up. I am cursed with a vivid imagination, and I thought of a number of ways in which I could do it badly and make matters worse. I remain worried about Tony doing one of those full-body wiggling escape attempts while he's getting his shot, because I have this horrible vision of the needle breaking off the syringe, even though I KNOW that it is unlikely in the extreme. He has tried to get away on occasion, but after a lot of experience with syringes, I can tell you that what is most likely to happen is that the needle will simply come out. They are pretty short (although not quite as short as the one for humans in the picture above) and very flexible. At the worst, the needle might bend, but that has never happened to me so far. After you've been doing it for a while, you'll find that you worry a lot less about accidents than you did at first.

What about the fear of causing pain? This is a legitimate fear, but as you get a routine going you'll find that it becomes less and less of a worry. The needles are so thin that the dog barely feels it -- really. Tony doesn't even react most of the time now, and I'd know if he did, since I'm holding him tightly while it's happening. Even his breathing doesn't change, as a rule. From that you can guess that I'm not the one giving him his shot. I'm lucky in that regard. I live with my mother (a sort of reciprocal-disability-caregiver situation), who is a retired registered nurse, and she gives a helluva good shot. I give shots only when she can't, because we've found that Tony likes it better when I'm holding and she's shooting. In many cases, if not most, you will need to have someone hold the dog while you give the shot, at least until the dog is used to it, but possibly forever, since there is often a need for reassurance on the dog's part. The main advice that I can give about reducing the chance of causing pain is to spend a little time before the shot running your hands over the spot where you will be injecting to see if there is any swelling or tenderness. The only times Tony has shown pain are those times when I forgot to check. It may be easier for one person to hold and shoot if the dog is bigger than my little Pom. My brother generally held onto his Labrador and gave him his shots without much trouble. Of course, my brother has a great deal of experience with animals, which helps, but it also seems as though the bigger dogs feel it less than the little ones. There's a good discussion of painful shots at http://www.petdiabetes.com/painful.htm and some good ideas, too.

And that brings me to the fear of needles. I have a lot of phobias, but not this one, so I can sympathize even if I can't share your pain over this. As with anything else, you'll probably find that you actually can do something if you have to do it to save a life (and that's exactly what I'm talking about), but there are ways to make it easier on yourself if that's what you need to do. Get somebody to help you, if you can. You can hold the dog, but keep in mind that he or she will feel your fear and tension. I don't want to sound all metaphysical, but you need to take a few deep breaths and clear your mind of thoughts that have any anxiety attached to them. Try it. With a little practice, it works.

Finally, if after you've made a serious effort over a period of several months and you really can't do this, find someone who can. Your vet may know of somebody who would be willing to take your dog. If I could afford to take on the cost of another diabetic dog, I certainly would do so if the alternative was the dog being put down. I'd prefer not to make a big emotional appeal here, but we all need to remember that when we get a dog we are making a commitment that can't be ignored when the going gets tough. Your dogs trust you to care for them. How can you let them down?

Food for thought (and diabetic dogs)

As predicted, things are getting back to normal: Tony is eating his usual amount, getting his shots on time, and -- thank goodness!-- sleeping through the night, which means that I can, too. His incision seems in good shape, no oozing or pulling, not inflamed, etc., so I'm feeling pretty positive. I have noticed one other change. His tail is up all the time now. I hadn't realized how often it was down before, until I saw him wandering around in the yard with it up. I guess that this should go on my list of things to watch for. Now I can get back to the main discussion, starting with food.

Before Tony was diagnosed, I had him on an inexpensive dry food (Ol' Roy's Dinner Rounds from WalMart). I am now, of course, horrified that I did that, but at the time, I didn't know any better. Tony loved Dinner Rounds, and after I got a good look at the ingredients, I wasn't surprised, nor was I surprised that his weight had gotten up to 15 pounds. I was only concerned that they did not contain meat by-products (these can include brains -- ick -- and have been implicated in several diseases, including mad cow disease). Well, there was none of that, but there was:
"Wheat Flour, Soybean Meal, Water, Cereal Food Fines, Corn Syrup, Beef, Meat and Bone Meal, Animal Fat (Bha Used As A Preservative), Dicalcium Phosphate, Propylene Glycol, Salt, Potassium Sorbate (Used As A Preservative), Potassium Chloride, Phosphoric Acid, Choline Chloride, Minerals (Ferrous Sulfate, Zinc Oxide, Manganous Oxide, Copper Sulfate, Calcium Iodate, Sodium Selenite), Vitamins (Vitamin E Supplement, Niacin Supplement, D-Calcium Pantothenate, Riboflavin Supplement, Pyridoxine Hydrochloride, Thiamine Mononitrate, Vitamin A Supplement, Folic Acid, Biotin, Vitamin B12 Supplement, Vitamin D3 Supplement), Iron Oxide, Caramel Color, Dc Red #40. "
In other words, lots o' carbs (more corn syrup than beef?!), which led to the weight gain and screwed with his blood sugar. Shame on me.

When he was diagnosed, I discovered this problem with his food and went looking for a better choice. At that time he also had a UTI, so when I found a food that had cranberries, I tried that immediately. The food was Lamaderm, from Natural Life (website at Lamaderm.com). I went with the canned food, since a friend of mine had had a dog that developed a twisted stomach from dry food, and I figured I had all the canine health issues I could handle already. Lamaderm contains:
"Lamb, Water Sufficient for Processing, Lamb Liver, Rice, Rice Flour, Flaxseed, DiCalcium Phosphate, Guar Gum, Carrots, Peas, Salt, Lecithin, Choline Chloride, Potassium Chloride, Carageenan, Cassia, Yucca Schidigera Extract, Cranberries, Zinc Sulfate, Ferrous Sulfate, Vitamin E Supplement, Vitamin B12 Supplement, Copper Sulfate, Niacin Supplement, Calcium Pantothenate, Biotin Supplement, Manganese Sulfate, Sodium Selenite, Folic Acid, Vitamin A Supplement, Riboflavin Supplement, Thiamine Mononitrate, Calcium Iodate, Pyridoxine Hydrochloride, Vitamin D Supplement. " This food is especially recommended for dogs with skin problems, which he had right then (he had lost a lot of fur-- more about that in a later post), and he liked it. Within a few months, we had his condition under good control and from then until a few weeks ago, he never had another UTI. Unfortunately, he's almost certainly going to have to change foods again as soon as the analysis of his stones comes back from the lab. I'll let you know how that turns out.

What a Dog!

Tony is doing well! He came through the surgery just fine. Luckily, they were able to flush the stones back up the urethra into his bladder, where they could remove all of the stones without too much trouble (cutting into the urethra itself would have caused a lot of problems, not least of which is that diabetics don't heal easily and that incision couldn't be sutured lest scar tissue develop and screw up his ability to urinate!). His vet warned me that there might be blood in his urine for the next 3-5 days (and there was some last night), but otherwise he should just take it easy for the next few days.

So, things will probably get back to normal now (I hope), and that's the way it is with this disease: days of routine interspersed with emergencies of varying degrees of seriousness. We've been lucky that Tony hasn't had any major blood sugar crashes, a problem that plagues my diabetic mother. In fact, when he has his blood sugar curve tracked, which necessitates him spending the whole day at the vet's, he has always shown the best possible reactions to food and his insulin. Obviously, this isn't always the case, and I'd love to hear how other people have handled problems with their diabetic dogs.

What did I mean by "fairly healthy"?

I'm just back from dropping Tony off for his surgery, and it occurred to me as I was driving that I'd used the phrase "fairly healthy" about him as if everyone would know what that meant. Tony was given to me as a gift, and he was a pet store puppy. Now that's something that many people should understand. I never met his breeder or his parents, and I don't know the medical history for his "family." For all I know, he's a puppy mill dog. So, in his case, when I say he's "fairly healthy," I mean that he doesn't have an outrageous number of problems, considering his age. He has some issues that are bothersome besides the diabetes: developing cataracts, allergies, a collapsed trachea, and soft teeth (the last two are common in Pomeranians).

Additionally, a couple of years ago when I took him in for a dental cleaning, he had a bad reaction to the anesthesia they used. This time they're using a different anesthetic, but they are worried about the trachea problem. I felt very guilty leaving him there; I know I'm doing the right thing, but I felt like a traitor!

Another day, another crisis?

Since my last posting was the first on this blog, I wanted to establish what I'm doing here before getting into what's currently going on with Tony, but something happened yesterday that I need to discuss.

Although, as I said, his health hasn't been too bad overall, 2 weeks ago Tony came down with a massive bladder infection, his first since he was diagnosed. It was pretty horrifying-- we discovered he had a problem when a little pool of bloody liquid appeared on the kitchen floor. I called the vet (it was 8PM!), and by some miracle she was there. She told me to take him to the animal emergency room right away, which I did. We weren't sure whether the liquid was urine or a very thin vomit, but within 2 minutes of arriving at the hospital, it became obvious that it was urine: Tony, who never has accidents, was straining to urinate on the waiting room floor, and he did this 5 times during the hour and a half we were there. Poor little guy! He was mortified, refusing to make eye contact and keeping his head down, but he wasn't whimpering or giving any indication that he was in pain. Can I emphasize this enough? Many dogs are stoic when it comes to pain (according to a vet I know, it's a survival trait), and the first indication that a dog has a serious problem is often something like Tony's bloody urine. It sure would help if I were psychic-- that's the only way I could have known that the infection was there.

At any rate, yesterday we went to his regular vet for a followup visit. Tony had responded well to the antibiotics, and we weren't anticipating any problems. The vet did an ultrasound as part of the urine collection process, so that they could do a culture and make sure that the infection was gone, and she practically ran into the examining room where I was waiting. The ultrasound showed that there was a stone in his bladder. They took an x-ray then, which revealed that not only was there a good-sized stone in his bladder, there were 5 or 6 smaller stones in his urethra (when I saw the x-ray, the first thought I had was that it looked like a string of beads). The poor guy had probably been having problems from this for a while, but he's so tough, I didn't have a clue. Incidentally, the vet seems to share my feeling that we should have had some psychic awareness of this, because she kept apologizing as if she should have known, even though she couldn't have.

So, in a couple of hours Tony and I will be at the vet's, where he will be having surgery to remove all of the stones. I'll let you know how it goes.

Welcome, folks!

If you're here, you probably have a diabetic dog, or you know somebody who has one. I hope that we can help each other deal with the many problems that arise in a situation like this. This is my story:

My friend Tony was born on 11/7/96 and enjoyed fairly good health (he did have an ongoing weight problem and low thyroid) until January of 2006, although I didn't recognize that anything had changed for a couple of months after that. It started with a few small things. He wanted to go outside in the middle of the night a couple of times a week, which was unusual for him, but not unusual enough that I worried about it. Over the next few weeks, the nighttime visits to the backyard became the norm, and I was going to work on 4 or 5 hours sleep. Sleep deprivation is my only explanation for why this went on so long.

In early March, my brother came down from Minnesota for a visit, and one evening we were about to have dinner when Tony came up to me, made sure I was paying attention, and urinated on the carpet. I couldn't write this off to excitement, either, because he has always been the most thoroughly housebroken dog I've ever encountered. If a nine-year-old dog hasn't had an accident in the house since he was a puppy, you know something is wrong when he does.

For the next couple of days I watched him constantly, and now I saw what I had missed. He was drinking a lot more water in the evening, starting about an hour after he ate and continuing even when we went to bed. I suddenly realized that I had been filling the little water bowl in the bedroom almost every day (the big water bowl in the kitchen was also used by 2 very large dogs in addition to Tony, and I couldn't tell that anything had changed there). Well, I had a pretty good idea what this meant. My parents and two of my siblings are diabetic, so I called the vet and made an appointment. I was not surprised when she confirmed my layman's diagnosis, but I was shocked to discover that Tony had lost nearly a third of his body weight -- and I hadn't noticed!

Tony started out on 4 units of Vetsulin once a day; now, three years later, he gets two shots a day, 3 units each. His diabetes has generally been under good control, but he's also been having some of the health problems that often occur in diabetics. I'll talk about that next time.