Sweet Pippa's journey has ended... August 19, 2018

[jenny]

Hello everyone, we are new here and this is my first post( hope its ok to add here). I have got so much in the last week from reading others posts and wanted to thank you all for sharing your stories and expereinces and to ask for ongoing support.

Pippa is my wonderful 6.5 year old westie. Shes a fantastic dog, very naughty and willfull and leads a happy active life in rural Wales, UK. I also have George a 7 year old black Lab and Polly, 17 year old mog and Basil 13 year old diabetic cat ( has been on insulin for 3.5 years) and doing ok for a fat lazy mog. I have had all my wonderful animals from kittens/ pups.

Pippa was diagnosed with DM last week

She had been peeing in the house for a few days, and was drinking lots and was lethargic. . lost a small amount of weight. She was treated for a UTI but after 3 days or oral antibiotics was getting no better so I decided to test her urine and found it positive for sugar. Bloods at the vet confirm DM glucose 25mmols ? USA 450. She has been on canninsulin 5u bd 1 week and is no longer excessively thirsty or peeing. She is having weighed meals BD 70g of kibble and 30g wet food ( she is a picky morning eater) and very very few treats or extras. Her weight is 9.5kg. She has never been overweight and has always been exercised viragously and daily. Her thyroid, liver and renal tests were ok. She has an occasional luxating patella but no other health problems and is not on any treatment for this.

Despite having a diabetic cat for many years, I am devastated. It just seems so unfair on my lovely young life-loving puppy. Ever since I read up on dog diabetes I have been distraught about her possibily going blind from diabetic cataracts. Its soo much harder with her, she dislikes the injections and seems to find them painfull where as its easy injecting basil and he never flinches and self regulates his food intake throughout the day.

Is there anything anyone can suggest to reduce the risk of blindness. Are there any younger dogs with DM who dont become blind? If she does wake up blind one day, how quickly should I be asking for her to be assessed for surgery and does anyone know how successful this is? I have tested a few bloods at home myself and have got fasting readings of 14.1mmols and 16.2 mmols. Her 6 hour post insulin BG was 10.2 and 16.6mmols . She doesnt mind the blood tests ( ear) as much as the injections ( scruff of neck). We are on day 8 of her insulin and back at vets saturday.

Its been a whirlwind of emotions this week. Today is a bad day . I want to keep things as normal as possible for her and the other animals and will do everthing to make her life continue as wonderfully as the last 6.5 years have been.

I am a human nurse, ironic isn't it. Shouldn't this make it all easier? Then why does it feel so hard?

Sorry to prattle on, just wanted to introduce ourselves and let off some stream. Thanks for reading. Jen x

[Rubytuesday]

Re: Pippas new journey

Hi Jenny and welcome.


I have a son named Basil, he was named after my very special german shorthaired pointer.


Jim with Spirit is currently doing some research on eye supplements and will probably give you some info. Also if you scroll down a bit you will see a thread
titled "Dr. Peterson on diabetes induced cataracts".


I would say your best prevention against the cataracts would be keeping her well regulated. Your best tool in that would be home testing. I test every fasting before feeding twice daily and often do mini or full curves (prior to feeding and then every 2 hrs until evening meal). Ruby has many issues and we are still struggling to get them all to work together, so still a lot of testing.

What kind of meter are you using, human or animal and what brand?

Tara

[MaryLea]

Re: Pippas new journey

Hello, Jenny and Pippa, and welcome to the forum!

I can't help with suggestions for avoiding cataracts, but there are some in the group who are treating their furry friends and I'm sure they will be along shortly.

To me, the level of intentional activity required makes the journey more difficult. From giving injections to BG testing and watching everything they eat--it's all important. Factor in how much we care for them and wish we could make it easier for them and, well, it's hard.

About the injections: be sure you warm the insulin to higher than room temperature in the syringe before you give the shot and watch that the bevel is turned up when you inject. Since you are a nurse, you probably already do that!

Hang in there and keep posting. This is a great group!

Mary

[JayneN]

Re: Pippas new journey

Welcome Jenny & Pippa! You will receive wonderful advice from the seasoned posters and from those of us with less experience (i.e. we have newly diagnosed dogs) you will receive words of encouragement and support! Good luck with your girl!

[jesse girl]

Re: Pippas new journey

there is another jenny on the forum a poodle with similar problems injections can be a challenge but no problem with testing blood sugar its poodles thread and you might want to take a look her baby did develop cataracts

judi jennys mom may give a thought process on the subject even though she is still trying to figure out why she has a problem with injections and maybe able to give her point of view

my jesse has been diabetic for over 2 years and has yet to develop cataracts without perfect blood sugar while a friend i know whos dog had perfect blood sugar is now developing so there maybe no rhyme or reason the odds are for them to eventually developed cataracts i think 80 percent

so for my jesse the odds are good that this may occur she may have beat the odds temporarily and we dont know why but like others said better blood sugar may play a part

testing at home will be a big help to keep your baby safe and to get to better numbers

curves (testing at fasting then every 2 hours till next fasting some do 24 hours) are used to base a dose adjustment and that is based on the lowest number not the average or highest number. and this can be done at home and results can be given to vet

the few numbers you posted are pretty good for so early into this if spot checking my jesse to get information i may use to compare to a curve i will test at fasting 2 hours after midway through 2 hours before next fasting and next fasting the information i look for from this it lets me know if there is any big drop in the first couple hours and midday lets me know if its continuing or not and 2 hours before lets me know if there is a late drop or rise late in the cycle with may continue into next fasting not as complete as a curve but does give quite a bit info that can be compared to a curve

so you are on your way home testing big plus a nursing background and having experience with a diabetic animal even though cats maybe very different in the approach

so welcome to both of you when you have a complete curve you can post it on your thread and we maybe able to give you an opinion

[farrwf]

Re: Pippas new journey

Hello everyone, we are new here and this is my first post( hope its ok to add here). I have got so much in the last week from reading others posts and wanted to thank you all for sharing your stories and expereinces and to ask for ongoing support.

Is there anything anyone can suggest to reduce the risk of blindness. Are there any younger dogs with DM who dont become blind? If she does wake up blind one day, how quickly should I be asking for her to be assessed for surgery and does anyone know how successful this is?

Sorry to prattle on, just wanted to introduce ourselves and let off some stream. Thanks for reading. Jen x

Hi Jen, and welcome to you & Pippa.

Regarding the vision issue here's a thread that's been active this week on that matter.

Apparently ~75% - 80% of dogs diagnosed with DM will eventually lose their vision to cataract issues. It's a sad situation.

Short of trying to get your pooch regulated to much lower B/G levels ASAP, there is little that can presently be done to avoid the problem. Seems it's the luck of the draw.

You'll read about a drug in clinical trials, Kinostat, that appears to drastically improve the likelihood of a pooch not losing their vision to cataracts. But, it's not available just yet.

Welcome aboard, and good luck!

[Cebe]

Re: Pippas new journey

I'll start by saying that I'm lucky my dog hasn't developed cataracts yet, but if she did, I would not have the wherewithal to do anything about it, so that has led me to a very copacetic attitude about them. If she gets them, I will deal with the effects at the time and worrying about them now is of no help to me or my dog.

To the extent that you can extend the time for your dog to remain sighted, you should try, but I also would not put too much pressure on yourself to prevent it or worse to allow yourself to believe that you can prevent it entirely. It is the common belief that proper regulation will reduce the likelihood, but who knows what is enough regulation for your dog to keep this from happening? I don't think it can be boiled down to a precise number as each dog is so different. My advice is to put aside worries over blindness for the moment, and work on getting Pippa's sugar in a good range and just do your best for her but don't drive yourself crazy thinking about what you should be doing or should have done.

My understanding is that dogs deal much better with blindness than humans do, and so trust that if this happens to Pippa, she will guide you how best to take care of her.

[jim maceri]

Re: Pippas new journey

First off, welcome to the forum Jenny this is one "special" family here. I know how overwhelming this all can be even with the knowledge of having a diabetic cat and being a nurse.

My "spirit" is only 4 and a half years old and I caught his diabetes very early on and with a good vet and the support here he's managed fairly well after 6 months now. Was I absolutely terrified....hell yea, but everyone here gave me the encouragement and information that I needed to try. Then they put up with my daily rants and kept me on track. So much kindness and so much knowledge. They are my "sugar" angels!!

With regard to the eye concerns, I think we all share that fear and as Ruby Tuesday said the best way to prevent or slow down the process is to get regulation so focus on that first.

Craig suggested I look into a pharmaceutical fish oil as a supplement for the eyes, which was a great idea. Lots of other wonderful health benefits and eye health is one of them. I puncture the capsule and squirt it on his food everyday. Spirit weighs 122 pounds so he gets one capsule with each meal. I'm also looking into the best type of vitamin E and C as a supplement as both are also good for eye health. I was hoping to be done with the research and have a "product" to try but not yet. Craig may also chime in here....I'm a bit leary of adding anything new to his regiment for fear it may throw off his regulation and I would only add one supplement at a time so I know how that affects him. It's a slow process just like managing this disease.

I went to the vet on Monday and had spirits eyes checked and they are "normal" for a dog of his age and size and has no more cataract formation than a dog without diabetes, like age and size. Since both my vet and I are keyed in on this we will just keep checking every 3 months. It would be good to get a "baseline" with your vet or opthomologist early on to see how it progresses. Unfortunately, most dogs will develop cataracts because of this disease but to what degree, in one eye? both eyes? partial eye site loss? total blindness?...... and why some dogs don't get it at all Is just not known.

All that being said, my vet reminded me that a dog relies on his scent of smell much like we rely on our eyes as windows to the world. He has many dogs in his practice that for all intents are blind and they are all healthy and happy and adapted quickly. Although it may "worry" me I've come to realize that it isn't the worst thing by far that could happen and I will cross that bridge when we get to it.

Just for fun....I've been doing some new training with spirit like giving him a command to put his front paws on the ramp (to get in the jeep) and wait....after several seconds I tell him "get in" and he goes up his ramp into the car much slower than he is used to. Another one....While on leash I make spirit stop at the front steps to the house and tell him "up" while I give a light jerk to the leash. We do this command and leash pull with every step. One other thing I read about and works great is I put a small piece of boiled chicken in my pocket to get spirits attention and then we walk around the property and he pretty much stays at my side...when he circles the whole property I give him the treat.

Like I said earlier, the best thing you can do for pippa is focus on managing the diabetes right now. We are all here to support you.

[jenny]

Re: Pippas new journey

Thank you all so much for replying.

Jim, Tara, Mary, Jayne, Jessie, Farruf and everyone else.

Such good sensible words, I just feel so supported knowing there are people there who have been through this and can understand. I am going to talk to my vet about the eye Klindostat to see if they have heard of trials of it in UK ( unlikely I know but worth a punt). I am going to find and read poodles (? Jennys) thread and next injection going to warm it to above room temp.

I am also going to take some deep breaths....and then more deep breaths.....and I'm going to be prepared for the future and what it may bring , but not to the detrement of today and what it may bring.

Pippa has tonight decided to sabotage our home made upstairs/ downstairs barrier and managed to scoff a bowl of basils cat food, has been safe upstairs for a week now. Did i mention that shes very naughty? Looks like we are going to have to get a baby gate up to stop her going upstairs to eat cat food. Basil is also very pissed tonight! life is complicated, but at least I admire her agility and intelligence. She does seem very hungry and I would probably do the same in her situation.

thank you all so much again, we look forward to getting to know you all and tomorrow will bring what it will, and it cant be that bad!

BTW Basil cat was named after the Basil Fawlty of Fawlty Towers and we still have a Polly cat, but sadly Cybil cat died 2 years ago very suddenly but never forgotten. Pippa was named after a junior Dr caring for my father in law whilst in hospital with diabetes ( how strange is that now), it as just a name we liked and she was a very sweet Dr and it suits her down to the ground.

Jen x

[Cebe]

Re: Pippas new journey

To the extent that many of us are Yanks and you are in Wales, when you say your cat is pissed, do you mean drunk? Thinking of that whole separated by a common language thing.

Oh and it sounds like you need to get a cat named Manuel now.

[buddingartist]

Re: Pippas new journey

Hi Jenny

OK, I will confess right now.... I am biaised toward Westies. I lost my little Buddy in March last year but I still have Cleo, his sister.

If Pippa is anything like my Cleo, I get you. Spunky, bossy, temperamental and just absolutely lovable.

I am no expert in giving advice, just here to welcome you, give support and encouragement and wish you the best of luck.

Louise

[Rubytuesday]

Re: Pippas new journey

Pippa has tonight decided to sabotage our home made upstairs/ downstairs barrier and managed to scoff a bowl of basils cat food, has been safe upstairs for a week now. Did i mention that shes very naughty?

When we had a cat, to keep the food and litter box (YUK) away from from my labby, we put both behind a closet door and then left the door open but attached with a hook and eye. It was enough for the cat to squeeze in but not the lab.

Tara

[Judi]

Re: Pippas new journey

Hi Jenny! My Jenny is an 11 (almost 12 year old poodle) who did go blind from cataracts. But her blood sugar was in the 500-600 range for quite awhile. she was tough to get regulated in the beginning because she also has Cushings disease.

I asked Jenny the dog's eye doctor what makes the difference in the dogs she has seen (she has seen a lot). She said she has never been able to quantify it that it may just be genetic luck of the draw. Some dogs go blind quickly, some dogs go for years with their sight.

At Pippa's young age I sure hope you can get her regulated quickly and keep her cataract free. I know some of the folks who have replied to you have had good luck with some vitamins.

I will say that I was devastated when Jenny went blind. Jenny handles it much better than I have. She still cornered a chipmunk in a rain gutter this fall and still veers around my husband's running shoes when he drops them on the floor! She has days where she sees shadows better than others.

You sound like you have your hands full but this is doable, honest! and welcome, Judi

[Patty]

Re: Pippas new journey

Hi Jen and welcome to you and Pippa!

I've been having some internet connection issues the past couple of days so hopefully this will go through.

I have tested a few bloods at home myself and have got fasting readings of 14.1mmols/254 and 16.2 mmols/292. Her 6 hour post insulin BG was 10.2/184 and 16.6mmols/299 .

These are some pretty great numbers for just starting out. Will the vet be doing a full curve on Saturday?

What type of meter are you using at home? You might want to compare it (testing as you normally would on the ear with capillary blood) with the vet's lab machine to see what the difference is.

As far as cataracts, about 80% of dogs do develop them. Better blood sugar can help but is no guarantee. Higher blood sugar can cause sorbitol to accumulate in the lens of the eye and causes oxidation and damages the lens proteins (pg 297 1st full paragraph on right hand side of this book: http://books.google.com/books?id=vT9...aracts&f=false)

As I understand it, the Kinostat is an aldose reductase inhibitor and so helps to prevent the glucose from being converted to sorbitol. But I believe the drug is still in clinical trials. http://www.ncbi.nlm.nih.gov/pubmed/21182720

I've added Vit C, E, and krill oil which contains astaxanthin to help prevent oxidation in general in my pup (I can elaborate of you want to know more). You'll find a lot of differing opinions on vitamins and supplements. My ophthalmologist recommends Ocu-glo to support eye health in some of his patients. But there's certainly no guarantee when it comes to preventing cataracts in our diabetic pups.

I think Cebe's advice is great :

My advice is to put aside worries over blindness for the moment, and work on getting Pippa's sugar in a good range and just do your best for her but don't drive yourself crazy thinking about what you should be doing or should have done.

You are off to a great start! Hoping the visit on Saturday goes well!
Patty

[jenny]

Re: Pippas new journey

Hi, Morning here in UK.
Thanks again for your advice and support, its priceless.

Regarding meters: The vet nurse has lent me an alpha Trak one and I also have a human one ( the Contour). I have mainly used my human machine (as i dont want to waste all the vets strips not knowing how to easily replace them, when I have easy access to all types of human BG testing equiptment). I will take my machine to vets to compare readings on sat. My BG with human machine was 4.9mmols and I tested myself on the alpha trak and it was higher at 7.9mmols ??? I know that none of these machines are exact, so I think for me its about looking at trends and recognising really high/ low readings . My vet has not mentioned doing any curves as yet, early days I suppose.

Im so glad you seem to think her readings are ok so far. I was initially shocked at their range and pushed vet nurse to consider increase of insulin, however I have seen from reading posts on here that its maybe not too bad and slowly cautiously is the way forward.

Pippa did not venture upstairs again in the night, barrier intact. The design of a permanent barrier is top of my list, unfortunatley Basil and Pippa are of very similar size ( even on same dose of insulin), so it has to let bas up and over without pippa destroying it. ( or it killing me or husband coming downstairs).

Just done this mornings meal and injection. She is so not hungry in the mornings and starving later in afternoon/ evening. Have to watch her eat every bite and play with the kibbles by dropping them one by one out of the bowl then pushing them around floor ( pippa not me). She eventually eats them all after 15 mins and I feel like the police having to patrol George Lab in not helping her out. Todays injection, syringe under arm 5 mins, Shes on work top on towel, did a few sit, paw treat (tiny bits of chicken), but she still wimpers and flinches. Bevel was up too. Perhaps I need to think about changing site from scruff of neck.

Off to work soon, will check by later.
Jen x