Sushi the Shih Tzu- A Fictional Diabetic Dog

English: Shih Tzu (Photo credit: Wikipedia)

About this time of year I start looking for novels to add to the Christmas shelf on my Nook, and I picked up Antiques Slay Ride by Barbara Allan the other day.  It's a 99-cent short story ebook, and it's part of an ongoing series.  I can't vouch for the other entries in the series, except to say that Sushi, a diabetic and blind Shih Tzu is one of the recurring characters.  It left me wanting more Sushi, which is how I usually feel anyway. 

Anyway, it's not great art, but it's about time that somebody thought of including a diabetic dog in a story.  If nothing else, it raises awareness, not just about diabetes, but also about daily life in this situation.  My one caveat about Sushi's treatment in the story is that her owner seems rather cavalier about giving her treats -- as you know, not a good idea with a diabetic dog.

I'm putting up a list of other Christmas stories I've enjoyed, in the box on the right.  I hope your holidays are everything you want them to be.

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Diabetes Awareness Month is Here- Diabetes in Animals Needs Some Attention, Too!

English: Prevalence of diabetes worldwide in 2000 (per 1000 inhabitants). World average was 28.23‰. no data less than 7.5 7.5-15 15-22.5 22.5-30 30-37.5 37.5-45 45-52.5 52.5-60 60-67.5 67.5-75 75-82.5 more than 82.5 Note: I interpreted France in the data as including the overseas departments of Reunion, Guadeloupe, Martinique, and French Guiana as they are integral parts of France. China includes the SARs of Hong Kong and Macao. (Photo credit: Wikipedia)

November is Diabetes Awareness Month, in case you didn't know that already, and I'm going to give a plug to another website from the Greater Good Network, this time for their Diabetes Site.  When you get there, click on the box and let their advertisers pay for it, with the money going to fund diabetes research.  If a cure is found, animals will benefit just as humans will, except nobody ever had a human euthanized because he or she was diabetic.  Lives are at stake here.

And, check out their online store.  Part of every purchase goes to research, too.  I do a lot of my Christmas shopping through all of the Greater Good shops.

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Got a new dog?

Image by kalavinka via FlickrWell, you probably know what I'm going to say first:  get health insurance for your new dogs ASAP, since their health needs don't end with shots and spaying.  Next, you might want to check out DogChannel's New Dog page, which is organized into categories that are actually relevant and helpful, unlike some other sites I could mention.  Additionally, they have downloads for new dog owners, like a shopping list (helpful, since you're going to want to buy everything you see, and you might miss a few important necessities), plus an "ask an expert" feature where you can get advice from a vet, a trainer, a groomer, etc.

I zeroed in on the Guide to Feeding Your Pets download, since I had so many different -- and difficult -- experiences while I was dealing with Tony's diabetes and his later bout with lymphoma.  It has material on food recalls, people food that is toxic for pets, the wet vs. dry debate, raw diets, and so on.  Overall, it's a good basic discussion of the topic, but I was disappointed that they didn't warn about the use of sweeteners (including HFCS) in the semi-moist foods.  I remain convinced that this was what led to Tony's weight gain and his subsequent diabetes.
In any event, here are a few interesting articles:

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Blood Sugar Monitoring

Image via Wikipedia

Got an email the other day about monitoring a dog's blood sugar.  I've mentioned before that my brother Eric monitored his dog's blood sugar, while I didn't.  Tony had regular blood sugar curves done, and they were always consistent after the first couple of months.  Eric's dog Lucky (always a bad choice for a dog name), however, was almost always out of control in that area.  Eric had several things going for him that I didn't:  at the time, he himself was diabetic (he isn't anymore, thanks to some pretty serious lifestyle changes), so he was hyperaware of everything connected with that; Lucky was a BIG Labrador retriever, which made it easier to draw the tiny bit of blood needed for the test (trying to do this without help to a Pomeranian ain't easy; you can't ever get the right grip); and, Eric is a behavioral psychologist with tons of experience with animals and many medical procedures.
At any rate, if it had been necessary to test Tony's sugar, I would have found a method of getting the blood, and it would have become routine in a hurry-- that's just the way it is.  If your vet tells you to do this, DO IT.  Like giving the insulin injections, you'll get better with practice over time, and you'll definitely get better control over your dog's diabetes.  There's a veterinarian's discussion of this at Pet Place; it's a basic explanation that should give you enough information to ask your vet the right questions.

Incidentally, there's something new and exciting in the monitoring pipeline for humans, which should eventually work itself into veterinary applications.  See the article below.

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It's the heat AND the humidity when it comes to dogs in the summer

Image via Wikipedia

A while back, I complained about an article on winter care for dogs because it wasn't published until winter was nearly over.  Fortunately, the folks over at DogChannel.com have put out their warnings early enough for us to make some use of them, especially since we've been having an early heat wave here in the Midwest.  You probably -- I hope!-- know enough not to leave your dog in a closed car, but you may not know how to recognize when your dog is in trouble. 
According to the article:
'Heatstroke’s early signs include rapid breathing, rapid heart rate, thick drooling saliva and a dry nose and mouth. “The dog often has a panicked or wild expression,” Chodrow says. “If you lift up a lip, the gums above the teeth will be a muddy grayish-pink or a brick-red instead of their normal clear pink color. As heatstroke progresses, the dog may stagger or have seizures. In advanced stages, she may show bloody diarrhea, coma and death. Heatstroke is a medical emergency: If untreated, it can be fatal.”'

Keeping an eye on your dog in this kind of weather is all the more important if he or she has other health issues, such as diabetes, which affect hydration (if his or her blood sugar is not under good control, you really need to limit outdoor play in the summertime).  It's a good idea to limit outdoor play time for any dog on a hot day, and you need to make sure that shade is available no matter how short a time you will be outdoors. 
I've talked about my brother-in-law's group at the dog park before, and there can be some other problems with that kind of setting in the heat.  For one thing, people go there not just so their dogs can have fun, but also to socialize with other dog owners.  The group that Steve hangs out with are  Great Pyrenees owners, and he's lost track of time more than once while chatting with them.  They all wait until early evening to take the dogs to the park to help prevent heat-related problems, which is good, but as the DogChannel article points out, humidity is a problem all by itself.  If the humidity is high, evaporation is slowed, and since the dogs cool themselves by panting, heat stress can build up even after the sun goes down.
There are a couple of other factors that the article mentions that I want to talk about, but the first is most important for diabetic dogs, many of whom have excess weight.  As the article points out, that can have an effect on breathing as well as retaining heat, since the weight acts as extra insulation.  The other problem they cite is dogs with double coats (like Pomeranians, for example).  Although their coats can insulate against the heat, once they do get hot, the coat holds it in.  And, of course, the kind of exercise matters, too.  Here again, I'm thinking of dog parks, where many dogs get a far more intense workout than they do at home, and where they may forgo drinking at times because they are so involved with their play.
The article has a lot of good advice, and I can't recommend it highly enough.  Read it, protect your best friend, and remember -- warnings for heat danger for humans also apply to pets.

I would also recommend the article below about outdoor dogs.  It's kind of surprising, to me at least, how people rationalize their worst decisions.

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No Miracle for Tony

I wrote most of the following on December 10, 2009, but I haven’t posted it until now because I was trying to come up with something that would cover all that I was feeling. I’m not sure that’s possible now, after trying again and again to do it.  Grief is not just an emotion; it's a process.



I’m sorry to report that Tony died on Wednesday, December 2. I haven’t been able to write about it until now, but I’m hoping that doing so will help me sort out how I feel. Despite everything that was going on with him, it was sudden, almost unexpected. On Tuesday, I took him to the vet for the follow up on his abscess. He had refused his breakfast, but other than that, he seemed perfectly normal. Dr. Kroll was amazed by how well the abscess had healed, which I was pleased to hear. I had them trim his nails, and I picked up a fresh bottle of insulin. When we got home, he still didn’t want to eat, but he took his usual late afternoon nap, waking briefly to bark with the other dogs every time one of them heard something outside.

He didn’t want his dinner, but he’d done that before from time to time, so I wasn’t too worried. When we went to bed, I couldn’t sleep until I heard his tags clink against his water bowl as he drank. He got me up about an hour later. I took him out, he did what he had to do, and then we came in. But he didn’t want to go back to bed. He went up his steps to his favorite spot on a loveseat. I sat next to him and rubbed his back. After about half an hour of that, he was willing for me to carry him back to the bedroom. I remember being surprised at how light he felt. Before he developed diabetes, he had weighed as much as 15 pounds (my brother Alex was prone to call him “Pomzilla” at the time), and he had lost 5 pounds before he went on insulin. His weight stabilized at 10.5 pounds for over two years, but he had been losing weight steadily since his bladder infection developed. He was down to 8 pounds.



The big change came in the morning. I got up to get ready for my 8AM class, but he didn’t follow me out of the room as he usually did. At 7:15, I took him outside, carrying him to the edge of the patio, since he seemed kind of out of it. Instead of taking a couple of steps off the patio and whizzing, however, he walked a few steps out and made a sharp left turn. He just kept walking, and he was headed toward the pool. The pool is covered, but it hadn’t been drained down for the winter yet, so the water was almost to the top. I went around on the concrete toward the pool, but I’ve been having a truly horrendous year arthritis-wise, and I couldn’t move very fast. I heard a splash just as I rounded a bush. Tony had walked right onto the pool cover, and the water was up to his knees. He was just standing there when I reached him. I managed to grab his collar and pulled him toward me enough to be able to pick him up. He was not reacting to anything; his eyes were open, but he just didn’t seem aware. I took him in and dried him off, setting him on the floor in the den. He lay down and appeared to go to sleep. By this time, I was pretty worried, but my mother assured me that she could watch him for the hour or so that I would be gone.



I have never prepped a class for their final exam as quickly as I did that morning, but as I was driving back home, I found myself slowing down a couple of times. I was dreading what I was going to find there. Tony had never acted that way before, not even close to that. As I came through the door (no Tony barking to greet me), my mother told me that he hadn’t moved but had vomited a bit. I checked and found only a small spot, about the size of a quarter, on the carpet. I went to call the vet.


We’ve been going to the Animal Medical Clinic of St. Charles for so long that everyone there knows Tony. When I identified myself to Nada, the receptionist, she immediately asked about Tony. I said the first thing that came to mind: “I think he’s dying.” She told me to bring him right in, they’d be waiting for me. And they were. I had had to cram Tony into his travel kennel (this normally involves a lot of activity on his part, but this time he just let me put him in), and one of the techs took it from me as soon as I got there. They left me in an examining room for a couple of minutes while they looked at him in the back area. Dr. Kroll came in from the back, and I knew from the look on her face that this was it.




In the weeks since this happened, I’ve been thinking about how different it is when a beloved pet dies as opposed to a human being. It seems that only people who have had pets accept that this is a significant loss, which is difficult to deal with, for me, at least. I just lost my best friend.

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!

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.

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!