My Dog is Diabetic … NOW WHAT!!
My Dog is Diabetic
News No One Wants
When we found out our Nattie girl had canine diabetes, we were upset and scared but mostly in the dark about what diabetes actually is and how to manage it. Online searches provided technical information (which we desperately needed), but what really helped reassure and comfort us were the stories of others who were caring for diabetic pets.
NOTE: There is no substitute for your veterinarian’s guidance. This article merely shares our experiences and is not intended as advice or instruction.
December 5 – 8, 2017
It seemed to happen pretty fast. Nattie woke us in the night with an urgent need to go out. The next day after work, we found a large “accident” spot in the hall. We let her out more often and made sure we saw her empty her bladder when she was out.
Two days after the nighttime urgency began, she soaked the sofa cushion (and herself) while we were at work. We called the vet and expected, after researching online, that we would be facing a stretch of hormone therapy for incontinence.
NEVER SELF DIAGNOSE!
A well-behaved dog who begins wetting in the house may not be diabetic but still needs to see the vet for diagnosis and care.
At the Vet’s Office
December 9, 2017
When we made the appointment, the veterinary assistant asked us to try to bring Nattie in with a full bladder or to bring a fresh urine sample. (An offer to wring out the sofa cushion didn’t meet with their approval.) If you’ve ever chased your dog around the yard with an old Cool Whip container, trying to nab that evasive dribble, you’ll understand why I jumped on the “bring her in with a full bladder” option and whisked her to the vet the minute I got home from work.
Always leave it to the professionals! The technician came out with a swell gizmo that looked a little like a condiment cup on the end of a weenie roasting stick. Nattie obliged us almost immediately upon stepping outside.
Nattie and I were alone in the waiting room when the technician came out and said there was sugar in the urine. Naïve of diabetes as I was, I still figured this wasn’t good. A blood test confirmed the diagnosis and minutes later we were talking with the veterinarian.
The Good News … and the Inevitable News
(Still December 9, 2017)
The vet examined Nattie and proclaimed her healthy, otherwise, with clear eyes and a good heart. We had caught it very early and he said most dogs he sees are much sicker. There were no ketones present in her urine or blood (which would have been a sign diabetes had progressed to potentially dangerous ketoacidosis).
Much as I hoped that meant this was just a wakeup call and we’d be admonished to take off some weight with diet and exercise, that’s not how it works with dogs. Diabetic dogs are insulin dependent. Unlike humans, there is no Type 2 Diabetes in dogs. Canine Diabetes is Type 1, Diabetes Mellitus. (There are rare cases of Diabetes Insipidus, which may be treated differently.) Nattie would be on insulin treatment, administered by injection, for the rest of her life.
Because the vet was going out of town for a few days, we decided to start insulin treatment on Monday evening, when he would be available in case of an emergency. This also meant my husband could be there for the insulin instruction as well, essential if we were both to care for Nattie.
My Dog is Diabetic
Making the Commitment
The vet asked if I wanted to discuss things with my husband before deciding treatment. I thought this was odd, but after reading up on canine diabetes, I realized the cost isn’t the only reason people choose to decline insulin treatment. The financial investment is not small. (I’ll detail our costs, later in this lens.) There’s also a time commitment and increased attention to your pet’s behavior and routines. There’s no way around having to poke your dog with a needle. And, some people just don’t believe in medicating their pets to this level. In some cases, conflicted owners are able to “re-home” their pets, adopting them out to a household that can follow the insulin regimen.
December 10 – 12, 2017
Insulin is only part of the treatment. In order to regulate Nattie’s glucose levels, she also needed to make major (for us) dietary changes. Based on the vet’s instructions, this meant no more human food (ever!) and even no more dog treats. Nattie got her usual chow, and that was it.
This was much harder on us than on her, I think. Feeding treats was part of our daily routine. She got a biscuit (half a biscuit, actually) when she came in from outside. In the mornings, she hopped up on the bed for a Beggin’ Strip. (For the uninitiated, that’s a bacon-like treat featured in the world’s most accurate television commercial showing a dog going nuts for “bacon.” It’s also known as “puppy crack,” in our house.) On Saturday nights, Nattie’s enthusiastic greeting of the pizza delivery person was predicated on her certainty of receiving “pizza bones:” the outer crusts of our pizza slices.
Feeding Nattie was a way we showed love. Her diagnosis and the resulting restrictions meant we had to challenge our thinking. We thought of food as a reward, comfort, and even healing. (Think of chicken soup, for a human example.) Now food seemed like the enemy.
Nattie expressed her displeasure by choosing to stay outside more (since there wasn’t a treat for coming in). She also went on a mini- hunger strike, turning up her nose at her usual chow. We spent the weekend feeling sad and worried at this change in our lives.
December 12, 2017
We returned to the vet to begin Nattie’s insulin treatment. The veterinary technician was patient and encouraging and took time to answer the page and a half of questions I’d managed to collect after my online research. Nattie had eaten before our appointment, so we gave her the first shot on the spot, with the vet tech’s guidance. Not nearly as bad as I’d imagined. This was greatly helped by the fact that Nattie didn’t so much as flinch.
But, perhaps the best part: the vet tech slipped Nattie a treat after her shot. We all perked up at that! Treats!? There are treats? Turns out Nattie can have a controlled number of prescription biscuits every day. Ah. Life makes sense again!
My Dog is Diabetic
Sharing Your News
Who to Tell
There are some practical reasons to tell people about your pet’s diabetes diagnosis. Friends and neighbors who are used to giving your dog treats need to be advised those days are over. It’s also a good idea for them to know what behavior changes might indicate a diabetic complication, so they can advise you immediately if they notice a change in your pet.
For me, telling my friends and associates about Nattie’s diagnosis was completely selfish. I needed to talk about it to cope with it. Most friends expressed concern and offered encouragement. One friend’s empathy and affection for Nattie is so great that the news caused her to lose sleep. I was surprised when I sensed judgment from some we told. Because Nattie is overweight, I think they felt we brought this on ourselves. (Although obesity is a factor in treating diabetes, research has not confirmed it as a primary cause, and our vet assured us we had not caused Nattie’s diabetes.) For the most part, talking about Nattie’s diabetes was positive and helped me feel more hopeful.
Our Cost – Yours May Vary
We left the vet well armed to care for Nattie – and with more than a small charge to the credit card. The cost of veterinary services varies widely, even within a single city. We’ve been told our vet is a little pricey, by those with more experience. Here’s a breakdown of the initial costs (in US dollars):
Initial office visit (examination and comprehensive testing): $152.50
Second visit (insulin instruction): $33.00
Insulin (10ml bottle): $66.39
Syringes (100 count): $23.40
Sharps container (for used needles, with disposal fee) $6.00
Prescription dog food (18 pound bag): $41.00
Prescription dog biscuits (24 ounces): $5.99
It looks like the 18 pound bag of food will last more than a month, as will the insulin. The syringes will last almost 2 months. The biscuits lasted about 3 weeks. We found out our pharmacy provides a sharps container free of cost with the syringe prescription, so that won’t be an ongoing cost.
Don’t worry – I’ll do the math for you when we’ve been at this a while, and post a module on the ongoing costs.
And, a Urinary Tract Infection
Just to Make Things Interesting
While waiting in the exam room on insulin instruction day, I noticed some pale blood drops on the floor. Turns out Nattie had a urinary tract infection.
UTIs aren’t uncommon in diabetic dogs. The glucose in the dog’s urine provides a veritable buffet of goodies to bacteria in the urinary tract. The UTI was confirmed by another urinalysis.
Fortunately, treatment is easy with antibiotics. Nattie was enthusiastic about it: the pills were wrapped in a scrap of fat-free cheese! (Note: be sure to check with your vet about how to administer antibiotics. Some prescriptions, such as tetracycline, are rendered ineffective when combined with dairy products.)
Update: In the Routine
December 24, 2017
It’s been about 2 weeks since Nattie’s diabetes diagnosis. We’re all used to the shots. Nattie sits and lowers her head to let us get at her shoulder area. We alternate the injection location. The fur is the biggest challenge – getting down to skin! The vet tech suggested wetting it down, but we’re doing okay without that.
Nattie was enthusiastic about the prescription food at first, but the novelty wore off after about 3 days. She adores plain old frozen green beans, so we add those to her food, as well as using them as treats. She was unimpressed by the addition of chicken stock (homemade – no fat or salt) on her food, but frozen in a cup, in place of her much beloved frozen soy milk treats, chicken stock is okie dokie. She gets that about twice a week.
Blood Glucose Curve
January 4, 2018
At about the 3 week mark, the vet wanted Nattie back for a day of blood tests, called a BG (Blood Glucose) Curve. She stayed at the vet all day and the tech drew blood about every hour or so, to see how well regulated Nattie’s diabetes is. Normal dogs have a BG level of about 125, the vet said. Nattie’s was over 400 when she was seen initially, in December. (Yikes!) During the BG Curve, her levels ranged from 90 to 111. The vet staff were very pleased and impressed by her diabetic control and we’ve lowered the insulin dose form 10 units to 9 units, still twice a day.
We are tremendously relieved! Some dogs can take months, or even a year, to become regulated on insulin. We still take a small container of Karo (corn) syrup with us when we leave the house. Stress or even too much exercise can cause a hypoglycemic (dangerously low blood sugar) reaction and the syrup could save her life while we get to the vet.
Update: A Very Perky Pup
January 8, 2018
One of the women on the veterinarian’s staff predicted: “you’re going to notice she acts so much better when you didn’t think anything was wrong.” She was right. We hadn’t really noticed a change in Nattie’s behavior. A 9-year-old dog is going to be a little quieter than a 2-year-old. But, since we’ve gotten her regulated, she is much more energetic. She grabs toys and wants to play and enjoys long walks. She is bright and attentive and playful and we all feel much less worried than we did a month ago!