C'mon and eat, for crying out loud!

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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 . . .

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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.