Lazy Wednesday

I haven’t given a Cara update in a while, so thought I might just do that–I have been busy working on my Crazy Animal Lady Blog (https://crazyanimalladyblog.wordpress.com/).  Cara hasn’t been back to the vet for about 3 weeks–it’s a money issue, although she is doing better.  She is starting to act like a normal Schnauzer, that is, she’s getting the terrier attitude in spades.  I can tell by her attitude and activity that, although she’s still not under control, we are moving in that direction.  I also think she is going to need a grooming soon.

A funny thing happened to me a month ago.  I check the local Craigslist listings in my are regularly, looking for possible dogs for the rescue I volunteer at.  I saw a listing for a woman with a newly diagnosed diabetic dog who didn’t have the money for the weekly vet visits.  I sent her some information–not that I was an expert, but I had already been working with Cara for a month, and, since I am also diabetic, I know a lot about the disease–only not in animals.  Her dog was a little bigger than Cara–after he lost about 30% of his weight, never a good sign.  So I told her to increase the insulin–at least double it, as her dog was going into ketoacidosis and the blood sugar needed to drop quickly.  I also gave her the names of a few sites that help people dealing with diabetic dogs.  I think one of her problems was that her vet didn’t have experience with diabetic dogs, and was going strictly by the book.  After 3 vet visits, her dog was practically comatose, and insulin had not been increased.  Cara’s insulin was doubled on her 2nd visit.  The woman and I email each other now and then, and she said her dog was still thin as a rail, but was almost as alert and active as before he got sick.  Together we will get through this.

Cara Begins Acting Like a Dog

Cara acts more and more like a normal dog each day. I may be creating a monster. It turns out she loves cucumbers. I grow them in my garden, and threw out the overgrown ones that hid from me for the birds. She found one and started chomping away. Now I guess I’ll have to save her some.

Her next discovery was strawberries, so I had to share mine with her. She also loves scrambled eggs–hold the milk, add the cheese.

She is also telling me when she has to go–heads straight for the patio door. She motors straight for the door at night, when I get up to let the rest of the dogs out–no accidents at night for almost 2 weeks. Of course, there are the messes for cucumbers and strawberries, but I don’t mind them.

Cara is not about to let the bigger dogs boss her around or take  her treats. She snarls like a wolf when someone tries it, even though the other dogs are 2-3 times her size. If she could see, she would probably be bossing  them around all the time.

Diabetes in Dogs

At this point, I think it is time to contrast diabetes in dogs and humans–insofar as I understand it at this point in Cara’s life.  Diabetic dogs are almost always Type 1.  Their pancreas no longer produces enough insulin. No doubt this at least partly genetic–several breeds are prone to developing diabetes, although any dog, purebred or mutt, can do so. It is more likely to develop in older dogs. Car a is around 6, not old for a small breed (she weighs a whopping 10 pounds). Without diabetes she would probably live another 8-10 years.

Dogs are considered under control when their blood sugar is mostly in the 150-200 range. That would be a high range for humans. I read in one website that high blood sugar for as little as 5 days can lead to eye damage–it is probably the reason Cara is blind. It take years of high blood sugar for eye damage to occur in humans.

Human Type 1’s can do multiple shots of insulin per day to get their insulin; they use long-acting 12 hour insulin for their base insulin and short-acting 4 hour insulin to cover meals/snacks. Dog Type 1’s use only long acting insulin given twice a day. For that reason, it is necessary to feed regular meals, about 20-30 minutes before giving insulin, of about the same size. So far I would give myself a C grade. I’m still working on meals–finding out what Cara likes–and consistency in her shots–sometimes they go swimmingly, sometimes not so good. She was so thin when I got her I want to give her more food. She’s gained almost a pound, the next time we go to the vet I should ask what she should weigh.

There are prescription diets for animal diabetes; they cost in the area of $25-30 for a 7.7 lb bag.  they feature high protein and fiber. What I found strange is that both brands have a grain as the first ingredient. Human diabetics should be limiting grains, most of which are high carb. High fiber is fine–it draws out blood sugar rise. Prescription food, however, has about 10% fiber as opposed to around 1-2% for regular dog food. Some of the newer research shows fiber  should be around 5%, anything more can lead to digestive problems, one more problem for an animal under stress. A high quality premium food seems like a better choice–it meets the requirements for diabetes, and doesn’t have extra fillers that may or may not be good for the dog.

I have enough problems/decisions to handle my own diabetes. Now I am also handling Cara’s diabetes. I may be fumbling my way, but I know she feels better. She can hold liquids, sometimes all night, she craves cuddles and ear rubs, and the famous terrier attitude is showing.

Life Goes On

Life is progressing, and we are getting into a routine—good thing it’s summer and the weather is nice, at least in the morning.  I can leave the back door open and Cara (and other dogs/cats) can come and go at their leisure.  She now goes out when she has to do her business, about 90% of the time—good girl Cara!  I’m trying to come up with a plan for cold, wet weather—maybe one of those fake lawn spots.  My other dogs don’t like getting their feet wet or cold, I’m sure she won’t either.

It’s pretty much a done deal, I think—I will have Cara for the duration.  It is almost impossible to adopt out a diabetic dog—maybe a 2-3% chance.  If I don’t keep her the only alternative is to put her to sleep.  If she starts getting complications, that would be the humane thing to do, but so far she has none—except for the blindness, and there are a lot of blind dogs who live a normal life—and she has a strong will to live.  She is almost house trained—most of the time she goes to the door and looks at me, but sometimes I’m not looking, and she can’t hold it any longer—human booboo, she tried.  I love my Spot Bot.

Until I get another appointment to have her blood sugar checked, there will probably not be regular Cara posts—other than the cute Cara behavior ones, of course.

 

I Get Serious

Cara may be a small dog, but she doesn’t take any guff from anyone, including me.  Her personality is starting to emerge, and it turns out she is a feisty little girl, with terrier attitude.  After the bite, the next morning I went to the pet store and got a soft muzzle—no little dog was going to snow me!    R-i-g-h-t

We are getting into a routine now—I feed her, and anything she doesn’t eat gets saved for later—that rarely happens, though.  At the same time, I take the insulin out of the refrigerator to warm up a little.  About 20-30 minutes later I fill the syringe with her dose, pick her up and put on the muzzle.  I now do this on the counter top, as I can control her better without having to sit on her—we both found that prospect unpleasant.  She wiggles a bit, and if she turns and tries to nip, I flinch, even though I know she is muzzled—that little girl really has me spooked, bless her terrier heart.  After getting the shot she gets a treat.  One of her favorites is beef jerky, which I ordinarily don’t let my dogs have, too many additives/toxins in China, but this brand is made AND SOURCED in America, and the only ingredient is beef, so no extra carbs, and it gives her something to chew on.  The part about source is very important.  Any company can get ingredients from anywhere, as long as they mix it in the US then can call it American made.  The companies who care about what they are putting in their pet food always say where it came from, that’s one reason I like Acana/Orijen so much.  I think I will write down the content in the 2 vet-approved (and sold) prescription diets and go to my local pet store experts to see what foods are close–and which ones she will eat.  Enough for the lectures.

As soon as I can afford another checkup appointment, I think I will schedule a trip to the 24-hour vet each evening a week before the appointment to be sure she gets most, if not all of her shots—I will do the morning ones.  I will watch them carefully and ask questions, and hopefully learn better technique.  Cara and I will muddle through this.  I was dreaming about that day when I win the lotto—just a “small” pot, I don’t need millions—and I could take Cara to an eye specialist to see if vision could be restored in either eye.  Then I shuddered at the prospect of her seeing the muzzle coming!

The Second Treatment

Fast forward a week.  Cara went back next week for her 2^nd all day checkup/treatment at the vet—weekly visits are recommended until the blood sugar is under control, then testing every 3 months and a more thorough exam every 6 months.  That is why treatment starts out very expensive and drops drastically when she is under control.

Of all things, I was having trouble giving her shots—me, who took them for a while.  Of course, I was a human and knew what was going on.  Poor Cara just knew I was stabbing her, and very ineptly.  Humans only have to penetrate the skin to get insulin.  Dogs have to get the shot under the skin.  There are plenty of articles/videos on this, and they all say most dogs don’t feel it.  Of course, most of their ‘patients’ are large dogs with loose skin.  Cara is a small dog with little loose skin.  She quickly let me know she didn’t like it, and when I paid no attention to her, she bit me.  Didn’t do her much good, as I loaded her, the syringes, and insulin into the car, drove to a 24-hour vet, and asked a vet tech to give her the shot.  That’s when I found out they would do it for free if I came in occasionally, charge $5 if I came in regularly.  Wish they were a little closer, I’d do it in a heartbeat.

I was expecting improvement.  Cara was no longer drinking a lot, and she could hold her water half the night (I know that because my dogs go out in the middle of the night, and she went with them.  She was also, fortunately trying to tell me when she had to go, so I could take her outside.  They took the blood sugar before I left, and now it was over 700.  As a caregiver, I was a miserable failure.  They got it down to the low 500’s, and doubled her dose to 2 units twice a day.  I resolved to suck it up and do better, and cancelled her next appointment, as my card was now almost maxed out.  I hope to go back in 2 weeks.

 

Cara’s First Treatment

I decided to give Cara a chance, and try to get her blood sugar under control, so off we went to a different vet—this one was further away, but gave a 10% discount to seniors, which would add up to a pretty total before things were all said and done.

She spent all day at the vet while they worked on getting her blood sugar down and seeing how advanced her ketoacidosis was.  Her blood sugar started at around 680+; a glucometer (meter) for humans (and yes, there are glucometers for dogs, calibrated differently) read extremely high—they stop giving a figure over 600.  It turns out her ketoacidosis was only 1 on a scale of 1 to 5.  Her blood sugar had gone down to near 400 by the afternoon.  A dog is considered under control if their blood sugar is 150-200.

Dogs and cats are treated with insulin—either human insulin, which is up to $600/vial (I paid $155 at a discount pharmacy), or dog insulin, $35-$65/vial.  A dog Cara’s size, roughly 10 lbs, starts at 1 unit twice a day and goes up from there until they are under control.  That means a vial of human insulin could theoretically last for 6 months or—except that it starts losing potency 2 months after opening, so there’s a lot of waste, not to mention money down the drain.  That was reason enough for me to switch to dog insulin.  The dog insulin is 40% as potent as the human insulin, so you use more, and there is a lot less waste.

I went home with my dog (and she is now, for all intents and purposes—no one else wants her), her insulin, and a box of syringes, and my part in the treatment started.

Cara’s Diagnosis

I knew Cara was hurting when I picked her up—she was limping on one hind leg, sometimes lifting it off the ground.  She peed a lot—the most common cause of that is UTI.  She was starting to get kennel cough—I expect that from every dog I pick up at a shelter.  I took her to the vet, and they found a couple of wounds on her from foxtails—the reason she was limping.  They gave me pills for the kennel cough, and they did a blood panel to see if she had an infection—not a bad report, as all that could be fixed relatively easily.

The next morning the blood panel came back, and things got serious.  She was diabetic, frequently a death sentence for dogs and cats, as it takes work to get it under control, and initial costs are high.  Not only was she diabetic with very high blood sugar, but she was in ketoacidosis, a serious condition that sends diabetics to the emergency room frequently.

I am diabetic also, so it was hard for me to consider putting her to sleep, as she has the same disease I have.  I talked to my rescue, and they agreed to a cross posting for her, then suggested I contact schnauzer rescue, as she was a schnauzer.  Both rescues were extremely sure she would never be adopted.  There is a federal program that matches injured and ill veterans with dogs with the same illness/injury, but they don’t take difficult illnesses, so that was out.

Background for Cara

I will start from the beginning.  I pick up and transport dogs for a Bay Area dog rescue group.  My “territory” is the Central Valley of California, more specifically, the Highway 99 corridor, from Yuba City in the north as far down as Merced in the south.  The rescue group only has 3 volunteers for this area—something we are trying to remedy.  Most of the Central Valley towns are very short on money for services—their main industry is agriculture, and with the drought, there are a lot of fallow fields.  Most, if not all, of the public animal shelters are full of animals, and they are trying to build up a network of rescue groups so they don’t have to put so many animals to sleep.  Many of the shelters only have a 3 day hold period—if they are full, on the 4^th day the animals may be put to sleep.  Spay/neuter doesn’t seem to be on the radar of a lot of owners.

Cara came from the Manteca Animal Shelter.  She was horribly matted when she arrived, and looked kind of like a grey or black Maltese/poodle.  She was so badly matted she was not walking on the ground, most of the time her feet weren’t really touching the ground, she was walking on her mats.  On the way home I dropped her off at the groomer’s, and when I picked her up, lo and behold, she was a small miniature schnauzer.

To make her life harder, she has cataracts in both eyes—not unusual for dogs with uncontrolled diabetes—and can’t see.  I have read that a diabetic dog can develop cataracts in a couple of weeks if their diabetes is out of control.  If eyesight is salvageable—not always the case—the dog lens has to be replaced by an artificial lens or the cataracts will just grow back.

I Acquire a Diabetic Dog

I started this blog to tell the story of living with a diabetic dog.  Many owners, when they get the diagnosis their dog has diabetes, choose to put the dog to sleep.  Treatment of diabetes in dogs—and cats—can be very expensive and time consuming at the beginning.  It requires a lot of work, and weekly trips to the vet for testing and a blood glucose curve.    My vet told me about 80% of the cost occurs in the first 2 months or so–when you are trying to get the diabetes under control.  When the dog is stabilized, which usually takes around 2 months, there are fewer appointments and all the work, which seems overwhelming at first, becomes second nature.  I decided to give Cara a chance.