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**AlisonandMia** · 02-01-2009, 04:58 PM

Re: New Member - Princess Just Diagnosed with Diabetes

Hi and welcome.

Just one question, from what you say a urine test was done that showed high glucose but was a blood test done? If it hasn't been done already, I think you need to have a blood test done to check that her blood glucose is in fact high (and to get a baseline against which to assess response to insulin treatment) before starting on insulin. There is a rare kidney condition that can cause high glucose in the urine even when the blood glucose is not high.

If Princess does have diabetes then she will require insulin as there is no other way of managing the type of diabetes that dogs get. Diet is important in so far as it must be balanced against the insulin given but diet alone will not treat diabetes.

Alison

**k9diabetes** · 02-01-2009, 05:10 PM

Re: New Member - Princess Just Diagnosed with Diabetes

Hi Natalie,

My name is Natalie also! Sorry to hear Princess has developed diabetes.

The trainer is probably somewhat misinformed. You probably know about Type 1 versus Type 2 diabetes in people. Type 1 diabetics are incapable of producing insulin for themselves so must have injections to survive. Type 2 diabetics have some resistance or do not make good use of insulin but are physically able to make insulin so oral medications and diet changes can be used to better control their blood sugar.

Cats are akin to Type 2 diabetics but dogs are almost without exception Type 1 diabetics in that their pancreases suffer damage and lose the ability to make insulin at all. So they nearly always need insulin injections to replace this vital substance.

The one caveat for me is the potential for pancreatitis from all the treats, especially if they are something like hot dogs or anything very high in fat, for example. Pancreatitis could theoretically result in impaired insulin production, resulting in higher blood sugar with the potential to recover once the pancreatitis resolves. I don't think this is very likely but I don't like to say never...

I hope the vet did blood work and the only abnormal value was the blood glucose.

So most likely the diabetes will indeed require insulin injections.

Please get a copy of all of the test results from the vet and post them here, along with the reference range (the range of "normal" values) for each test.

I'm curious, personally, to know how high the blood sugar was and also whether any other test results were out of the ordinary.

If she needs insulin, no problem. Dogs do great and diabetes that's well managed does not reduce a normal healthy lifespan. Our dog was diagnosed at 9 and lived past 14 and he was a pretty big guy with a lot of other health problems already.

Anxious to hear more about Princess,

Natalie

**ladygirl** · 02-01-2009, 05:22 PM

Re: New Member - Princess Just Diagnosed with Diabetes

Hi Allison and Natalie,

Thanks for your response. Looking over the invoice of her visit yesterday, I don't see anything indicating a blood test. Everything listed is as follows:
Urine Sample Collect/Prep
Urinalysis Package
Urinalysis Sediment Exam
Urine Specific Gravity
Urinalysis Test (Individual)
So I think maybe no? The vet assistant said when they took her back that they would be poking a needle into her bladder, I think, to see what she had. They then came back and said they didn't find anything in the urine but that her glucose tested on the strip came back at a brown color as opposed to the deeper teal color. So I don't think any blood test was done.

Update: I just spoke with the vet over the phone and she said looking over labs she sees that they actually didn't do any blood test, so we are going to go in an hour or so to do that.

**k9diabetes** · 02-01-2009, 05:31 PM

Re: New Member - Princess Just Diagnosed with Diabetes

That's odd. I'm glad they are doing it today. I wouldn't want diabetes diagnosed and insulin started without a blood panel.

Given the weight loss, I think plain old diabetes that will require insulin is very likely. It's fairly common in Min Pins.

Will she urinate for you and let you collect a sample?

It would be good to check her urine for ketones - ketodiastix (ketostix if they don't have the glucose/ketone combination) are usually available at any pharmacy and can be used to check to make sure she doesn't have ketones, a product of excessively high blood sugar that can lead to a very dangerous condition called ketoacidosis.

The weight loss suggests that she's been running high glucose for a while so grab a box of the ketodiastix if you can and check that while the diabetes diagnosis gets worked out. I'm assuming they won't have the blood panel results back until tomorrow.

Natalie

**ladygirl** · 02-01-2009, 05:45 PM

Re: New Member - Princess Just Diagnosed with Diabetes

That's a good idea. Do you think they would have that at PetsMart? We go to the Banfield in there as her regular veterinary clinics. I was surprised as well after reading everyone's posts that some form of blood work wasn't done. Though the vet is very nice, she seems VERY inexperienced as far as diabetes. She says that she had to search some more about diabetes in dogs on the internet earlier today. But she said that when we come in she's going to do some blood work and a chem panel to get more definitive results, and do another urine test on the stick to make sure.
She also said while it would be a good idea to start regulating her diet first and foremost, she doesn't want to say for sure to try this for a couple weeks because it could be that the diabetes progresses and something else may occur during that time that could have been prevented. But she said it would probably help to manage her diet for a week and come back then to see if there are any changes.
She didn't really give me any results because she said she didn't have the stick right after the test? But she brought in a sample one and said, "Where most dogs are around negative and a teal color, Princess was a brown and around 1000" (regarding glucose levels in the urine), but nothing really concrete. So I guess I'll have to ask more questions when I get there, and perhaps go get a second opinion elsewhere? Again she is very nice but I want to make sure I have an vet who is experienced with diabetes before putting Princess on insulin.

And honestly you guys are a god send, really. : )

Oh also one thing I wanted to add is I just noticed her constantly licking her private area for about 10 minutes straight. She keeps doing it on and off just recently today, do you think that could be something to point out?

**k9diabetes** · 02-01-2009, 06:26 PM

Re: New Member - Princess Just Diagnosed with Diabetes

I don't think they will have them at Petsmart except possibly at Banfield itself and may not have boxes to sell - usually have to go to a pharmacy. The Diastix used to be very easy to get but with people all moving over to meters instead of urine testing, they are tough to find. Ketostix are still used fairly frequently because only one or two meters test ketones.

For diabetic dogs, the ideal is ketodiastix as they will give you a very rough idea of how high the glucose is - that's what the vet used - plus check for ketones.

I agree that you will want someone more experienced. Even that isn't always enough but this vet sounds like she will not really be able to guide you. We are here to help you assess whether the veterinary expertise seems to be up to snuff.

Urinary tract infections are quite common in diabetics, especially uncontrolled ones. The sugar in the urine is a real treat for bacteria. Presumably they are checking the urine for bacteria so should be able to sort that out for you when the UA results come back but it wouldn't be surprising. Do mention it to them.

Take a look at the information on the main website if you haven't already, www.k9diabetes.com, and then we can sort this out more when the chem panel results come back. At the Links page there are many additional resources about managing and treating diabetes in dogs too.

Natalie

**ladygirl** · 02-01-2009, 06:33 PM

Re: New Member - Princess Just Diagnosed with Diabetes

Thanks Natalie. Just looking at my dog right now brought all my emotions to the surface. I can't help but feel I did this to her, and that is something she really doesn't deserve. I'm trying to compose myself before I head out for the vet.
And I'm sorry for perhaps not understanding entirely, as I'm a little out of my realm right now, but what is it exactly that I shouldn't be mentioning to them? (I mean as far as the whole UA test thing, my mind is just a little foggy right now.)

I'm also a little frustrated that she didn't do all of this yesterday, because going back now means I have to pay ANOTHER office visit fee for something they didn't bother doing. She told me she thought she had done them but apparently didn't. They were busy yesterday with ONE doctor seeing everybody and I spent about 3 hours there to do everything, it was sort of irritating.

**k9diabetes** · 02-01-2009, 06:46 PM

Re: New Member - Princess Just Diagnosed with Diabetes

Mention the licking... it sounds like they already sent a urine sample to the lab to check for bacteria but it's good to tell them that she's been licking at herself.

**k9diabetes** · 02-01-2009, 06:52 PM

Re: New Member - Princess Just Diagnosed with Diabetes

We have ALL been where you are right now and know how scary and emotional it is... funny thing is, you reach a point after things settle down where you wonder what you were so worried about... remind me to tell you my "Chris' skull" story when I have more time!

I think the most likely case is that Princess just plain old developed diabetes - that's how it goes. One day they don't have it, next day they do and you didn't do anything to cause it. It's pretty common in dogs and Min Pins are well represented. We have a few members here with Min Pins -- Helen just was by a few days ago. Her diabetic Min Pin, BeBe, passed away a few years ago (her story is on the website) but she has two new girls now and is looking at getting a third.

It will all be okay and you have time to sort things out. Does sound, though, like you will need a vet at a clinic where there is more experience and good follow up.

Natalie

**We Hope** · 02-01-2009, 06:55 PM

Re: New Member - Princess Just Diagnosed with Diabetes

FWIW, Ketodiastix shouldn't be too hard to get at a large "chain" type pharmacy, even if you need to ask the pharmacist for them (behind the counter to keep them from just "walking out"

). We had no problem getting them on the spot at Walgreen's when the visually impaired lady had the emergency.

Why we're talking so much about blood work needing to be done re: the "formal" diagnosis of diabetes is because there are other potentially serious medical problems for which one of the signs is sugar in the urine--diabetes isn't the only one.

As far as diet and changes to it are concerned, they can be a help to you with canine diabetes, but they can't solely be the control of it. When dogs are diagnosed with diabetes, they become insulin-dependent, meaning their pancreas has stopped producing enough insulin for the needs of their body.

This means you need to get another source of the needed insulin, and that's where the shots come in.

Most humans with diabetes don't require insulin shots. They can manage their diabetes by diet, or by a combination of diet and oral medications. Many cats with diabetes are the same way in that they can keep the disease under control with the proper diet. Still, you find a lot of cats using insulin and now you also find many humans with diabetes who are not classed as insulin dependent using some insulin to help them manage their diabetes better.

We'll try to help you and Princess in every way we can!

Kathy

**ladygirl** · 02-01-2009, 07:50 PM

Re: New Member - Princess Just Diagnosed with Diabetes

Thanks again Natalie.

So some update, I have decided not to go back to the vet tonight, the same one that we saw yesterday. They just seem very inexperienced (despite being Banfield), and the staff there just give off the feeling that they don't care that much for the animals. I called them to let them know that I won't make it tonight but may come back on Tuesday, but in the meantime if they could suggest any better food to give her, perhaps something homemade like peas and carrots and some type of lean meat. The receptionist put me on hold to go ask and came back very rudely and said, "Yeah um no, the doctor won't recommend anything, so I guess you'll have to wait. In the meantime just keep giving her the same food you've been giving her." (which i'm pretty sure the food is not nutritional at all for a dog with diabetes).

Anyways, I just don't feel comfortable going back there and being charged another $200 for them to do more preliminary tests for them to confirm her diabetes, on top of then having to buy all her diabetic equipment. The vet my sister goes to is nearby and she says they provide her with excellent services and care/check up on the dogs and make sure to see all options possible. So I think I may go to them tomorrow to do tests. My one concern was perhaps trying to get on a Wellness Plan before the other vet does some tests on her, so that way it perhaps begins to cover all these things? I'm thinking they may want to get any records from any previous vets, which then I'm sure they'll get the record that she was diagnosed with Diabetes, which then could present a problem, as they most likely won't let her go on a Wellness Plan.

I was wondering if anybody could advise how you go about with expenses? Are most on some sort of insurance plan before your canine was diagnosed, or were you able to get it after?

And perhaps any suggestions of what I can possibly feed her in the meantime before going to a new vet? I would just prefer not to continue her on her dry food, as I don't think it will help her any. It was cheap brand I got as a filler before buying another big bag of her regular food, so I'm pretty sure it's VERY LOW in nutritional value, if any at all.

As of right now you guys have given me 100x information than my vet or her staff did. I can't thank you guys enough.

*Oh also, Natalie I was wondering if you could explain to me a little bit more about the Ketodiastix? I've been looking over the posts, and excuse me as I'm still trying to understand all this, but what is that they do and what information will they be giving me as far as further confirming her diabetes? I hate to bother you as you've been so much help already.*

**We Hope** · 02-01-2009, 09:22 PM

Re: New Member - Princess Just Diagnosed with Diabetes

Ketodiastix will let you monitor the amount of glucose in Princess' urine as well as check for ketones. You need to know how much glucose is in the urine and if there are ketones. When ketones are present, they can be an emergency situation. They will also help you keep track of how Princess is doing once she starts on insulin. Many people do blood glucose testing on their dogs and cats, just as persons wth diabetes do for themselves with meters. You don't need to worry about this right now--using the Ketodiastix will let you keep track of how Princess is doing.

http://www.fifty50pharmacy.com/Merch...ode=TestStrips

"Keto-Diastix Reagent Strips By Bayer Urine Test for Ketones. Ketone is a substance which is usually not harmful when found in small amounts in the urine. Keto-Diastix Reagent Strips By Bayer Urine Test for Glucose. These are the basic test strips for testing for Glucose in the urine. The strip turns a specific color and that color is matched to a color chart on the Diastix bottle. This is an alternative to blood testing for glucose."

This is what the color codes for glucose and for ketones look like. Here also is a link to a previous post about collecting and testing urine:

http://k9diabetes.com/forum/showpost...4&postcount=15

http://petdiabetes.wikia.com/wiki/Ketoacidosis

This is a link to a page on ketones and ketoacidosis and why can be so dangerous for those with diabetes.

Ketones: When there's not enough insulin, the body begins to break down fat cells, which produce fatty acids. These fatty acids are passed through the kidneys into the urine--we know them as ketones.

http://www.vetsulin.com/vet/Monitoring_Urine.aspx

"Urine monitoring is also a quick and easy method of detecting ketones (ketonuria) and hence a potential emergency - see diabetic ketoacidosis."

I think your idea of seeing your sister's vet as soon as possible is a good one and believe I would continue on with what Princess has been eating until you see the new vet, who may have some suggestions as to what he/she would like to see in the way of a diet for her.

The sooner you get some bloodwork done for Princess the better because I believe she does have a urinary tract infection. Most of the time that makes the blood glucose go quite high--treating them brings the glucose levels down. With some of our diabetic dogs, the higher than normal bg's are often the first sign there's an infection that needs to be treated. I think once you get Princess' bloodwork done and start with whatever treatments she needs, things will seem a lot clearer than they might seem now.

Kathy

**ladygirl** · 02-01-2009, 09:42 PM

Re: New Member - Princess Just Diagnosed with Diabetes

Kathy thanks for explaining that, it helps a lot. And I can't thank you enough for your kind words, it truly helps.
I think the blood work will really help clear up things.
Princess hasn't been drinking a lot of water as incessantly as she has been in the past couple weeks and hasn't been peeing as much as well, but she was up for eating carrots, so maybe that's a good sign? Right now she has just been lounging around/sleeping, which is not uncommon for her, she is/was usually like that before the diagnosis.

Gosh I guess waiting is the hardest part.

**eyelostit** · 02-01-2009, 10:03 PM

Re: New Member - Princess Just Diagnosed with Diabetes

Hi Natalie and Princess Welcome

I am glad you are seeing a new vet, yes you need the blood test to confirm the diabetes. I get the Ketodiastix at Walmart and at times they have them but any other pharmacy like Rite Aid, CVS may just have them, I know if walmart does not have what I want I order it and get it by 2 days.

I'd go to the new vet ASAP, as for feeding No Peas and carrots very high in sugar, I am thinking now, as to food with no insulin at the moment, turkey and chicken is good, cooked egg, I get ground turkey in tubes at Aldi's or Save a lot, they are a discount food store. It does not cost alot to take care of a diabetic pet.

Alot of us use NPH Insulin Walmarts brand is Relion NPH and you do 2 injections per day 12 hours apart. That insulin runs about 20.00 and will last about month depending on size of your dog. The Vetsulin you get at the vet is more expensive, some dogs are on this kind, then some owners chose to use the NPH. Whatever the vet says insulin is injected 2 X day 12 hours apart, if they tell you one time per day ask them why and what type of insulin they are prescribing.

Also if the vet prescribes N insulin (NPH) you can get this without a presription at walmart, Eli Lily brand is over 45.00, what you want is Relion Novolin NPH. Relion brand is same as Novolin, but box has to say Relion Novolin NPH to get the price for 20.00.

If Princess is DX with diabetes, that is why she is losing weight, she needs insulin to get the nourishment from food into her system with out it, she will continue to pee, leak urine and drink alot of water that is how they get rid of the excess sugar they cannot process. Have you noticed a nail polish like smell with her breath?

It does not cost alot to manage a diabetic pet, I manage my Niki very well, she eats some dog food (mid priced one) vegetables (gr. beans and brocolli) and turkey, she has been diabetec for over 6 yrs now, she is 11.

Don't let this get you down, this is not your fault, I have had dogs most of my life and Niki just happened to get diabetes, I cryed, cryed and got that out of my system, then just said, OK, lets get ahold of ourself and just take control of this. You can do it too, like all of us.

You are not alone, we are all here for you, hang in there, chin up.

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