New to Diabetes...Cataract surgery?

[Wilson mom]

I'm glad I found this site. My dog Wilson was diagnosed with diabetes in December 2008. He is a 7-year-old brussels griffon/schnauzer mix, and weighs 36 lbs. He is on Humilin N, 17 units, but his levels are still a little high - still trying to regulate him. He's on Health Extension Lite dog food, mixed with boiled chicken breast and broccoli. 2-weeks ago he started bumping into furniture. We took him to the vet and he was diagnosed with cataracts. He is breaking my heart. First the diabetes, now cataracts. We are taking him to Cornell University to get the surgery done on May 5th. Has anyone had this surgery done to their dog? What was the outcome? I'm also concerned that with his sugar levels being high, maybe this surgery is not a good idea. Any thoughts?

[We Hope]

Re: New to Diabetes...Cataract surgery?

Welcome!

We have members whose dogs have had successful cataract surgery; most recent is Cara, http://k9diabetes.com/forum/showthread.php?t=239 and Peggy's Forbin will be having the procedure done quite soon http://k9diabetes.com/forum/showthread.php?t=498

I would believe Wilson has been evaluated by your own vet and the eye specialists who will perform the surgery, and that he apparently was found to be a good candidate for it.

Maybe Marion and Peggy will post to tell you their experiences with the surgery and what leads up to it.

Kathy

[Fishslayer]

Re: New to Diabetes...Cataract surgery?

Welcome to the site! You'll find lots of good information & moral support.

My diabetic Cattle Dog is Lucy. She developed cataracts almost immediately after being rescued.

I think I found a pic of your dog?





Rick

[k9diabetes]

Re: New to Diabetes...Cataract surgery?

In my experience over five years on canine diabetes forums, I think I've seen about the same percentage of good and bad outcomes as they mention in the literature on cataract surgery - that the complication rate is about 5-10%. Usually complications are something like glaucoma following the surgery, requiring that the eye be removed. I am not aware of any dog that has suffered any life-threatening complications.

http://www.animaleyecare.net/diseases/cataract.htm

Cataract surgery is a highly successful procedure, but there are risks. Chances of the pet having improved vision after surgery are high for most patients (90%-95%). But 5% to 10% of dogs will not regain good vision due to complications, and may actually be permanently blind in one or both of the operated eyes.

Usually they want the dog generally regulated and it sounds like Wilson is there.

One thing that helps to know, though, is that dogs generally don't give much thought to being blind. They adapt and go on with their lives. Our diabetic dog went blind about one year after diagnosis and lived his last four years blind because, for a bunch of reasons, he was not a good candidate for cataract surgery. He went on walks, traveled with us and stayed in motels, played in the snow, waded and even sometimes swam in the river on a long lead.

It is devastating for us but dogs don't approach life the way we do... no paw wringing about "why did this have to happen to me, it's not fair!" I know that's how I felt when Chris lost his sight. Chris was more like "Well, this is different. What's for dinner?" He trusted us to guide him and just set out on his walks, with life.

They generally learn to navigate familiar territory extremely well. There are tricks of course to help.

So if the worst happens and ultimately Wilson loses his sight again after the surgery, know that he will be fine and can live a long happy life as a blind dog. They are so amazingly adaptable - it's one of the things I admire about dogs - how they can take things so graciously...

Natalie

[Cara's Mom]

Re: New to Diabetes...Cataract surgery?

Welcome to you and Wilson!
My English Setter, Cara, had cataract removal and lens inplantation surgery done in January. For us the outcome was perfect..she went in with just partial sight in one eye and came out seeing again!!
If you have any particular questions or concerns, do not hesitate to ask me, I'll be pleased to answer them!

[peggy0]

Re: New to Diabetes...Cataract surgery?

Hi and welcome!! You'll get tons of support here for sure. My forbin is having surgery in 2 weeks. He is totally blind and got there very quickly, within weeks of his diabetic symptoms. The regulation of BG for surgery isn't just for cataract surgery its for any type of procedure that requires anisthetic. They would prefer your dog be stabilized in that regard. Forbin had his teeth clean and came through the anisthetic with flying colors. He just had a test to determine if his retina's were still working properly and had to be sedated and was fine there as well. I don't know what you consider high, but Forbins BGs run between 100 and 300 typically. If he cheats on his food we can soar into the 400's. You'll read here where our lovely rascals have found bagels, food scraps from grandma and grandpa or even girl scout cookies - grand theft from dad. If the doctors feel he is ready for surgery, I wouldn't be concerned at all. Of course, when Forbin had his teeth cleaned and had to go under anisthetic I was panicked!! Read my thread and you'll see. I even cancelled it once!! Everyone here got me through and the vet who is working with me to return his sight is a wonderful man. I use to live in NY area and my vets there were from Cornell and used the University alot. It's a great school. He'll be in good hands.

[bgdavis]

Re: New to Diabetes...Cataract surgery?

Hi and welcome,

You can read about my Crissy's 'bad' outcome from cataract surgery here.

http://www.k9diabetes.com/forum/showthread.php?t=83

Criss was a trooper. She passed away March 11, 2009.

Bonnie and Angel Criss

[Wilson mom]

Re: New to Diabetes...Cataract surgery?

Hi Everyone,
Thank you so much for your helpful information.Wilson will be going to the vet on Monday to get his sugar level check out.I do not use a meter.Iuse the urine strips.His levels been around 500 on the strips.Maybe I should consider using a meter,but afraid of doing it.So much to learn!!!I raised his insulin to 18 units today.He is 36lbs.does this seem like alot of Insulin?Maybe I should change his food,my vet said to keep him on what he been on,or the insulin.I dont know it very confusing.Also he is now on eye drops could that raise his levels.I am also still nervous about the eye surgery.Im having second thoughts.Im afraid he will get glaucoma.He is adjusting to being vision impaired and seems very happy.He such a sweet little boy.Thanks for any help you can give me.

[Cara's Mom]

Re: New to Diabetes...Cataract surgery?

Which eyedrops is he on? Cara is still on Prednisolone (a steroidal eyedrop) and they sure do bring BG up!!!

[We Hope]

Re: New to Diabetes...Cataract surgery?

It's good that Wilson will be going in on Monday to have blood glucose taken; having the vet do a curve will tell you how he's doing overall.

There's sometimes quite a difference between the results you get when you test urine and when you test blood. The urine results can be a lot higher than the blood results depending on how long the urine has been in the bladder.

When you test urine, you get a negative glucose reading if Wilson has been under the renal threshold figure of 180 and stayed there a while; you get measureable urine glucose if he's been above that 180 and stayed there for a while. When you get a negative urine glucose reading, all you basically know is that Wilson is somewhere under 180; you know that he's not too high, but you don't know if he's too low.

I would encourage you to think about getting a blood glucose meter and learning how to test Wilson. He does seem to be using a lot of insulin for his weight, so there's also the possibility that he may be rebounding, having periods where he goes too low, and the counter-regulatory hormones respond to it by sending him high. If you're having a curve done by the vet on Monday, they should be able to see if this is happening when they take the blood draws every 2 hours.

It's not the best policy to raise insulin on the basis of a urine test because they are not as accurate as blood tests are; the readings you get from a urine test may be 2 + hours old while testing the blood tells you what's happening in the body now.

Marion (Cara's Mom) is right about the steroidal eye drops raising bg's, and as long as Wilson's using drops, part of the bg problem could be related to them.

Kathy

[Cara's Mom]

Re: New to Diabetes...Cataract surgery?

It was not that long ago, I was just as worried and panicky as you are right now! Cara was diagnosed Aug 1/08. To me that sounded like the end of the world! I remember the first shot of insulin I gave her......scary
I could not leave her at the vet to get a curve done....she would howl and was very upset. That does not give a right reading . Found out she would be very low at the vet because so was sooo upset!. So I had to start home testing if I liked it or not. Had no other choice for mine and her sanity
With the help of my vet and the caring people on this forum it took a couple of days for me to get reasonable succes in drawing blood and trying curves and learning to read curves. I have never looked back and now it's all routine I started out on the ear, but have changed to the inside lip.

The journey with your diabetic dog is a learning experience. You learn and your fur-baby benifits!!!
I have been there and I have done it.........there will be ups and there will by down, but there will be a day that you look back and you wonder why you were so scared and you can laugh about yourself, because it's all become a regular daily routine!!

When you are worried about something, there is always somebody here that can help you out or encourage you! So make sure you ask questions and post often! We are all here to help you where we can!!!

PS. Would love to see a picture of the "real" Wilson!

[peggy0]

Re: New to Diabetes...Cataract surgery?

Marion's correct. She describes what I felt initially perfect. Forbins BG always drops at the vet because he is scared and I to learned to monitor. What peace of mind it brings you! and this forum will guide you as you go. Forbin is on pred drops as well and they don't seem to affect his BGs for some reason at all. Thunder is another story!! another storm yesterday and the BG came on down

[k9diabetes]

Re: New to Diabetes...Cataract surgery?

Wilson will be going to the vet on Monday to get his sugar level check out.

I do not use a meter. I use the urine strips. His levels been around 500 on the strips. Maybe I should consider using a meter, but afraid of doing it. So much to learn!!!

I raised his insulin to 18 units today. He is 36 lbs. Does this seem like alot of Insulin?

Maybe I should change his food, my vet said to keep him on what he been on, or the insulin. I dont know it very confusing.

Also he is now on eye drops could that raise his levels.I am also still nervous about the eye surgery. I'm having second thoughts. I'm afraid he will get glaucoma. He is adjusting to being vision impaired and seems very happy. He such a sweet little boy. Thanks for any help you can give me.

I think you would love home testing! Definitely worth trying! We could never have gotten Chris regulated without it.

18 units for a 36 pound dog is a pretty normal insulin dose.

Are you working with the vet on changing the insulin dose?

With diabetic dogs, you have to take a carefully planned, one-step-at-a-time approach to their diabetes in order to sort out what's happening with them. Diabetes in dogs is somewhat different than in humans - they respond to insulins differently and since they can't tell us how they feel we have to be careful not to overdose them on insulin, especially when relying only on urine tests.

So if you're going to make any changes, with or without a vet's help (preferably with), it's really important to change only one thing at a time and give five to seven days following the change before you assess whether it has been successful.

So if I want to better regulate my dog, I would change either his diet or his insulin dose, not both at the same time.

Without curves, I wouldn't want to do either with Wilson.

You change diet primarily to adjust the "shape" of his curve. Like if there is too much difference between his highest and lowest blood sugar and you want to reduce that difference.

You increase insulin if ALL of his blood sugar levels are too high.

Without a curve, you don't know what Wilson's blood sugar is doing and whether an increase in insulin might send the lowest point of his blood sugar during the day too low.

Some dogs, like mine on Humulin L (no longer sold) swing from 90 to 400 on a dose of insulin. If I looked only at his urine tests and saw all the sugar in his urine because of the blood sugar of 400, I would think he needed an increase in his insulin dose.

But if I increased his insulin dose, that low of 90 would go even lower, quite possibly right down into hypoglycemia!

So that's why you really need a curve done to see how well balanced Wilson's food and insulin are, when his lowest blood sugar tends to be, and how much difference there is between his highest and lowest blood sugars.

While you're working your way toward cataract surgery, I would not change anything I didn't have to. Keep things predictable and stable so the vets can count on his regimen at this point.

Cataract surgery is a tough decision... Chris had many many eye problems and allergies to medications that pretty much convinced us early on that surgery was not right for him. I have known dogs who did not have their cataracts removed and developed glaucoma too. So there are no guarantees about any of this. You have to follow your heart about what is best for Wilson and try to keep your feelings about his blindness to one side.

Hang in there,

Natalie

[Wilson mom]

Re: New to Diabetes...Cataract surgery?

Welcome to you and Wilson!
My English Setter, Cara, had cataract removal and lens inplantation surgery done in January. For us the outcome was perfect..she went in with just partial sight in one eye and came out seeing again!!
If you have any particular questions or concerns, do not hesitate to ask me, I'll be pleased to answer them!

Hi ,How did cara do after the surgery.Was she in any pain?Did she have to wear the E collar if so how long?Also how long was the recovery?I appreciate all the information you give me and everyone else.Thanks so much.Janie Wilson's mom:

[Wilson mom]

Re: New to Diabetes...Cataract surgery?

Wilson is on Flurbiprofen sodium solution one drop in each eye twice a day