Tag: diabetes (page 1 of 2)

Diabetic Cats – Yes They Can Change!

Sal in hospital

Sal in hospital

The following is a true story (used with permission) of how diabetic cats can change their insulin requirements.

Sal is a 13 year old domestic shorthair cat who was diagnosed with diabetes in 2010.  He had been showing the initial signs of increased urination and having accidents outside the litterbox.  These signs, along with weight loss and increased drinking, are some of the most commonly noted first symptoms of diabetes or an alert to a pet owner that something is wrong.  Some cats may vomit, have a decrease in their appetite, or start to walk in a flat-footed position.  In later stages of not being diagnosed or treated, diabetic cats can have labored breathing and lethargy.

Insulin varieties

Insulin varieties

Back to Sal…  At the time of his diagnosis, he was started on insulin and his diet was changed to a higher protein, lower carbohydrate diet.  He had been doing well for a number of years and was considered to be a well controlled diabetic.  As part of our continuing care of these patients, we recommend doing a glucose curve every 6-12 months as part of their annual examination.  For some cats, we realize that the stress of the clinic setting might be too much for them and encourage home testing (which can be quite easy and most veterinarians will show you how!).  For cats that home testing is difficult either for the patient or the family (not everyone can stand the sight of blood), we do this testing in hospital.  Sal was one of these cats who fit into the latter category.

Hypoglycemia in diabetic cats

Hypoglycemia

Life happens and things don’t always get to go as planned; work or family obligations change, moving might happen, or the budget might be a little tight at times.  That’s okay and can be understandable…it even happens to us as vets too with our own pets and families.  Sal had been delayed in coming in for his annual check up.  His owner brought him in because he was seeming weak and hadn’t been eating well.  I examined him and checked his blood glucose level which was 1.2 (or 21.7 depending on your units)!  The average normal range for a cat is 4.0 – 9.7 (72.6 – 176).

So why did Sal present like this?  His signs were easily attributed to his low blood sugar (hypoglycemia) but his insulin dose had not been increased.  Well, it’s been known for some cats to convert to not needing insulin and their diabetes may be controlled by diet.  This is exactly what happened to Sal.  As he converted, his previously needed insulin dose essentially became that of an overdose.

Normal blood glucose

Normal blood glucose

Rest easy everyone.  Sal is doing fine.  We admitted him to the hospital and put him on intravenous fluids that contained dextrose to help bring his glucose levels up and remove the risk of seizures.  We checked his glucose levels without him getting insulin as well and he never went above the high end of normal so 2 days later he got to go home and now doesn’t need insulin injections!  For now he is doing well, but his family is still going to keep a close eye on him because there may come a time when he might need to start the injections again so he’ll be getting regular checkups from now on.

Disclaimer: All blog posts may contain opinions which are my own and may not reflect those of any current or former employers.

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Pancreatitis…When Organs Attack

Pancreatitis…When Organs Attack

In the past few years, we as the veterinary community have taken more of a look at the pancreas as a potential cause happy-thanksgiving-cat-dogfor some health issues when your pet comes in with more generalized signs.  We know quite a bit about this integral organ but there are still some mysteries to be solved.  With Thanksgiving coming up in the USA (unfortunately we had ours in Kingston already), this might be a good time to take a look at what it does, how it causes problems, and what we can do about it.

The pancreas sits in the abdomen adjacent to the stomach and upper small intestine.  Among it’s more important functions, it produces enzymes to help digest food and also insulin to help regulate blood sugar levels.  There are actually small tubes that secrete these compounds into the digestive tract and blood stream to help these functions happen.  But there are also inhibitors to keep these enzymes from starting to work too early….like while still in the pancreas.  If these inhibitors fail, reactions begin within the pancreas and it actually starts to digest itself.  Sounds nasty right?

pancreatiitis

It really can be quite complicated but I’ll break down the essentials.  We can see both an acute (sudden onset) and chronic (long term) form.  Acutely, the pancreas will become inflamed, can become necrotic (dead tissue), swollen, and potentially hemorrhage.  Chronically, the long term inflammation can lead to the tissue itself turning fibrous essentially killing off cells and rendering them non-functional and this can lead to diabetes or another condition called exocrine pancreatic insufficiency (EPI).

baconBut how does this happen?  That can be hard to distinguish and there are MANY factors.  There is a higher incidence for dogs who get exposed to high amounts of fat whether repeatedly in their diet or the one dog I knew who unfortunately drank from the deep frier at home.  Yes, even bacon is bad for dogs.  Other factors in dogs may include certain drugs, trauma, toxins, and intestinal reflux while in cats, diets & drugs do not play a role but they are more at risk due to infectious diseases, hepatitis, diabetes, and parasites to name a few.  Terrier breeds & miniature schnauzers may be more at risk as well.  Unfortunately, the causes of almost every case of pancreatitis often goes unknown. min schnauzer

But how do you know if your pet has pancreatitis?  Of course there are tests we as veterinarians will do that can give us this answer but first they’ll show you signs at home that will be concerning to you.  Loss of appetite, vomiting, lethargy, fever, abdominal pain, and diarrhea are all possible signs.  Signs in cats may be vague or less noticeable with regards to vomiting and pain.  Cats also uniquely may have hepatitis and inflammatory bowel disease along with pancreatitis; this is often referred to as “triaditis.”  Blood tests will show numerous variations affecting the kidneys, electrolytes, liver, and blood cells.  Diagnostic imaging may be of use in some cases.

sick dog

Once the diagnosis is made, treatment can begin which will often include intravenous fluids, anti-nausea, anti-vomiting, pain, & appetite stimulant medications, vitamin supplementation, and in some cases antibiotics.  In certain cases, plasma transfusions can be given.  For dogs, long term management may often include low-fat diets, whereas in cats diet selection is not as important as getting them to eat what they will eat.  Despite all our options, there is no specific treatment or guaranteed course of action that will resolve a pancreatitis case but many patients will do well with these plans. hospitalized cat

This is just the basics of pancreatitis as there can be more complex problems such as abscesses or tumors though these are less common.  The important thing to keep in mind is that if your pet is showing abnormal signs, don’t delay.  It can be okay to wait a day in case of the uncommon upset stomach but it’s best to not make your pet wait almost a week to get them veterinary attention as it will only make the problem worse.  So this Thanksgiving, keep your pets safe and avoid the table foods just in case (not to mention possible toxicities)!

Disclaimer: All blog posts are personally written and my opinion and do not reflect those of current or former employers.

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Thankfulness for a Cat and a Veterinarian

Thankfulness for a Cat and a Veterinarian

At this time of year, I wanted to reflect something I’m thankful for.  During my time in practice in both Florida and Kingston, a question I’ve been asked a lot is “why did you become a veterinarian?”  Whether it is because a kid is curious how they can be a vet, somebody wants to know how I can do certain parts of my job (typically euthanasia), or if I’m being accused of being in it for the money, during this time of year I wanted to share my story about why I’m thankful for a veterinarian and a cat.

Zorro settling in

Zorro settling in

April 1986 – My dad arrives home with a new “dependent” for mom to declare during tax season.  A small kitten was found playing with a plastic bag in the middle of the street and he was scooped up by my dad.  We named him Zorro, an amazing tuxedo cat who found his way into our home and my heart.  Mom had given me the responsibility of caring for Zorro and he & I bonded.  I was especially fond of his crooked tail (shaped like a “Z”) that had been previously broken and the strong headbutts he would give to show that he cared.  In 1995 around American Thanksgiving-time, he became acutely ill…or so we thought.  Zorro had been showing all the signs of diabetic ketoacidosis except my mom & I had no clue what the signs were at the time or even knew that cats could even become diabetic.  We arrived home one Sunday from a weekend campout and found Zorro in a semi-comatose state on the floor but with 2 other cats we hadn’t noticed any changes in drinking, urination, or appetite.

First thing Monday morning, we took him to our regular vet who diagnosed him then advised us he would need ICU care so we took him to Hollywood Animal Hospital where received a more thorough explanation off the diagnosis and a guarded prognosis for the return to good health of a cat who was “mine.”  The veterinarian who took on Zorro’s case explained everything to us and she was very honest about the difficult road ahead.  He was admitted to the clinic and each day he got progressively better.

On Thanksgiving night, we had our dinner and prepared some turkey to take to Zorro in the hospital when we were going to pick him up.  While we were waiting in the room to see him again and go over the discharge instructions, the veterinarian came in and told us he had unexpectedly passed away.  I had known death before but not one that affected me so greatly.  Even though he was gone, our veterinarian still took the time to answer any questions we had and assured us that we hadn’t done anything wrong.  We simply had been uninformed to be able to recognize the problem and get him help sooner but as he had improved, his passing was not fully explainable.

Zorro, an educated cat

The light bulb clicked on…I made the decision to pursue a career as a veterinarian.  Sure I loved animals all along.  It wasn’t because of the money (because honestly, veterinarians don’t get paid as much as people think).  It wasn’t because of the high ratios of women to men in the profession (as my grandfather kidded me).  It was simply a chance to be able to help both people and animals at the same time.  I had always been community service oriented and enjoyed helping others but until this moment it hadn’t clicked.

I investigated what I needed to do and pursued my goal of becoming a veterinarian.  After graduating from the University of Illinois, I returned to Hollywood Animal Hospital as an intern and later an associate.  To this day, I make a point to return the kindness and compassion to my patients and their families especially when facing a potential end of life scenario.  It’s also the reason I do this blog to help others have a reliable source of information so that they don’t have the same experience.

Shutterbug shortly after diabetes diagnosis

Shutterbug shortly after diabetes diagnosis

I regret not knowing back then what we should have been looking for.  Our veterinarian didn’t have to take the time explain things to us, but she did, and ultimately we were able to recognize the signs later on in our other cat Shutterbug who also became diabetic.  Because of our experience with Zorro, Shutterbug was able to have a great long life with controlled diabetes for many years.  Yes, it was sad that we lost our cat Zorro but I’m thankful for the compassion of a veterinarian who made it easier to accept the experience and set me on the road to paying it forward.

Acknowledgements: Dad, thanks for picking up the little guy all those years ago.  Now you know the truth, it wasn’t the baby opossums.  Mom, thank you for not writing Zorro off all those years ago and finding a way to try and help him.  I love you guys!

Disclaimer: All blog posts are personally written and my opinion and do not reflect those of current or former employers.

Don’t forget to check me out on Facebook, Twitter, and now Pinterest to see more events in my day & more shared info!  And on the right side of my blog you can now subscribe so you can always get the updates when a new post is published!

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