Last updated: Sat, 9 Jan 2010 20:39:27
It is now Wed, 26 Apr 2017 06:56:48
[c29426-kumbineed.jpg] Kumbi studies his mostly-invisible world
Here's a checklist and article on the real needs every dog has. (To return here if you go there, use your browser's Back button.)
With diabetes, a dog needs, in particular:
You can use ritual and routine, to keep your dog's life just as stable as possible. It's easiest on the dog, and best for the dog's health, if food, insulin, rest and exercise occur at the same time every day. Normally, the same food should be given in the same amounts, usually, twice a day, 12 hours apart, followed, says my vet, by the insulin injection, 30 minutes later. Sometimes there might be some reasons to alter the time of injection related to when the dog eats. You can discuss such matters with your veterinarian.
Dogs love routine, love ritual, and are least stressed when they know what to expect, when. Actually, this is true for all animals, including humans.
Vekkie and I haven't encountered a human who hasn't at first felt overwhelmed by the implications and prospects of caring for a diabetic companion animal.
But notice! The humans we meet on lists have already made a commitment, to provide the care the animal needs, as best they possibly can. And we - Vekkie and I - have been through this too, though we had it easier than some.
Newcomers to the diabetic-animal email lists often come, sobbing, nervous, tense, having to learn instantly to stick needles into their dogs or cats!
Also, often, their dogs or cats have been very, very sick, and still are sick. They seem not to be the animals they were before the diagnosis.
But when Kumbi was diagnosed with diabetes, my vet cheered! So, naturally, so did I! We were so happy that it was only diabetes, and not something much worse!
Facing the large commitment of caring for my diabetic dog was automatic for me. Kumbi is family. He is always Kumbi. I will always do my best to take care of my family, whether Kumbi or Kwali.
And the newcomers to the diabetic lists are the same. They have already made the decision and the commitment to do all they can for their dogs or cats.
I'm sure our dogs and cats thank us for their care.
Our first need is for a veterinarian who is knowledgeable about diabetes, and preferably, experienced with it. There are vets who aren't so experienced, but many of those will do the research, and study, and consult other vets as well, when needed. The biggest requirement we have of our vets, then, is reasonable knowledge and experience, and willingness to consult others, or research, when necessary.
One other requirement for our vets is that they be willing and able to talk to us, even on short notice, within a reasonable time. They need to listen to us, and take our observations and comments, and questions, seriously, no matter how stupid a question we might feel we're asking.
Then, of course, they need to instruct us and provide the best answers they can to our questions. The vets can tell us when they need to see the animals themselves, or when we can safely monitor the situation at home.
There are many ways you can feed a diabetic dog. Consult your vet. A good diet for a diabetic dog contains a high propertion of fiber, and restricted amounts of fat. Some fat is necessary.
We use a veterinary prescription diet, high in fiber, with restricted fats (Medi-Cal Fibre Formula, both dry and canned). A comparable diet in the U.S. would probably be one of Royal Canin's veterinary prescription diets.
To help our vets help us, we need to keep good records. We would record the major events that affect diabetes:
Those of us who have decided to test blood samples for glucose levels would keep those records as well.
I also keep records of any unusual event in my dogs' lives, as these may bring on extra stress. It's important to understand that good stress - happy stress - has the same physiological result as does bad stress - unhappy stress. See the works of Turid Rugaas for more information.
Oh, please Skip the Numbers for now; I can always come back here later for that.
Measurements of blood glucose levels, around the world - except in the United States - are expressed in millimoles per liter. In the United States they are expressed in milligrams per deciliter.
When communicating or keeping records, we need to express the units involved, and also, identify those units. So, around the world (except in the United States), we would say something like, "The meter is reading ten point one millimoles per liter." The abbreviation for that is written "mmol/L."
In the United States, blood glucose levels are expressed in milligrams per deciliter. The abbreviation for that is written "mg/dL."
There is nothing intuitive about the conversion factor between millimoles per liter and milligrams per deciliter; in fact, it's slightly awkward, as the conversion factor is approximately 18.02. However, considering the significant figures, or, decimal places, included in any kind of glucometer reading, it makes sense to round off the result when expressing measurements in milligrams per deciliter. Glucometers set to display millimoles per liter show only one decimal place, and those set to display milligrams per deciliter show none.
Also, Customer Care at LifeScan, maker of the OneTouch Ultra meters I use, tell me that the margin for error in any single blood glucose reading is plus or minus twenty percent. "What!" I asked; "You mean, a total of forty percent?" "Yes," they answered; "That's right."
So, when recording readings, if you wish to convert in order to communicate with people from strange countries, by all means, multiply mmol/L by 18.02 to determine the equivalant reading in mg/dL. And divide mg/dL by 18.02 to determine the equivalent reading in mmol/L. But - do not get too hung up on decimal places! At least, present readings in mmol/L to one decimal place, as is shown on the meter, and present readings in mg/dL with no decimal places at all.
Records to keep for blood glucose readings, to be meaningful, must include the following:
It's a good idea to mention the meter you are using: brand and model. Because I'm always talking to Canadians and Americans as well, and often people from other countries, I convert my meter's readings, which show in mmol/L, to mg/dL, and show the equivalents, in my BG curve test results.
Here is an example of a day's records made for Kumbi. This is the kind of record I send to my vet by email.
Meter: OneTouch Ultra ("Phyrie Meter II")
I tried for a reading at 0600, but Kumbi went outside and would not come back in. I was reluctant to start his day by carrying him in (force!) - so I just let it go, and relaxed. But I took a 7 a.m. reading instead of a 6 a.m. one.
Readings and Events
0700 - 15.2 mmol/L = 274 mg/dL
07:26 - Breakfast - 1 cup of Medi-Cal Fibre Formula dry; three bits (each about the size of a small grape or smaller) of Medi-Cal Fibre Formula canned on top.
0803 - 23.8 mmol/L = 414 mg/dL
0804 - gave 4.5 units of Novolin ge NPH insulin
0900-0945 Walk - lots of excitement (visiting people)
1002 - 16.5 mmol/L = 297 mg/dL
1158 - Alert-Alarm in yard
1204 - 19.4 mmol/L = 349 mg/dL
1401 - 24.2 mmol/L = 436 mg/dL
1601 - 20.3 mmol/L = 365 mg/dL
1715-1750 Walk - moderate to low excitement
1803 - 20.1 mmol/L = 362 mg/dL
19:26 - Supper - 1 cup of Medi-Cal Fibre Formula dry; three bits (small-grape-size) of Medi-Cal Fibre Formula canned on top.
2001 - 19.7 mmol/L = 355 mg/dL
2001: gave 4.5 units of Novolin ge NPH insulin
2201 - 19.7 mmol/L = 355 mg/dL
End today's (long) curve.
You can pass these records to your vet, by email or voice phone.
It's a great stress-reducer for your dog when you can test blood glucose levels at home, and report the results to your vet. Also, you are in a position to do a spot-check if you think something is going wrong, and can consult your vet about that, if the reading is too high, or if it is too low. Too low a reading is a medical emergency,
I skipped The Numbers, but now I'll at least go take a look!
Then also, we can keep records of "clinical signs." It's a good idea to do that. This would be
I keep all records in a spiral notebook; I number the pages, and record the date at the top of the page. I leave a few pages blank at the beginning, so I can make a kind of index, or table of contents. I can carry this notebook when I take Kumbi to the vet, and when I phone in for information or assistance, I can consult these records.
It can be a bit traumatic to rearrange our schedules to meet a dog's needs. I use my computer calendar program CalendarScope, to keep me on schedule, as my computer is running most of my waking hours, and some of my sleeping ones. There are free calendar programs. This one is not free, but the price is reasonable for what you get.The program is very carefully designed, and extremely flexible and robust. My CalendarScope has never crashed, in years of very heavy use.
I have my CalendarScope program set off alarms which must be acknowledged - checked or ticked off - before the computer will stop signaling me for that particular task.
Of course, it only works when the computer is turned on, but mine is on most hours of the day, and many at night as well.
When the power fails, my body and my dogs do a good job substituting for this program! It works because the program keeps me firmly on-schedule - my BodyBrain has learned the routines and rituals! That's a very good example of why it's healthy to keep to a regular schedule as far as possible - though it's okay to have some flexibility at times. Food and insulin, though, are best used by the body if given on quite a strict schedule.
When blood glucose levels drop too low, the dog has hypoglycemia. Typical symptoms are staggering, disorentation, or trembling, even seizures. A "hypo," as it is called, is a medical emergency.
If your dog suffers a hypoglycemic episode, smear corn syrup or some other similar sugary food on the dog's gums, then call your vet. Corn syrup is the most commonly used. Carry packets of it with you when you hike or travel. For details, on hypoglycemia, you can consult this page on Hypoglycemia
Our veterinarians and their technicians are our first and most crucial resource when our dogs have diabetes.
Once we have the very basics, in which our vets should be instructing us, we can also share information with others who have diabetic dogs or cats.
I use email lists, and enjoy them very much! It's amazing how much we can learn there, and we make good friends, and also, we discover we are not alone! Others have been there before us. Often, they have very good suggestions. Do remember, though, that it is your veterinarian who is your ultimate resource. Do ask your vet the questions you need answered.
I also read, and occasionally post, on one online forum about diabetes in dogs. This is the forum provided by k9diabetes. The forum is located at Diabetic Dogs - Online Forum. A particular advantage of this forum is that each dog has its own thread, so you can track information on one dog from the beginning. It is very educational to read one of these thread from start to finish. Even more, of course, to read seeral threads that way!
Because messages are open to the public, you can read without having to become a member. If you wish to post, you need to register as a member.
A site that's useful for learning the basics is the Wiki site located here: Diabetes in cats and dogs. Always check with your veterinarian before leaning on a web site.
Another site that offers helpful information on diabetes is at Pet Diabetes. This is a Wiki, with many contributors. Information found here should be quite accurate. All the same, check everything out with your vet, before leaning on what you find there!
In principle, if you are studying on the Internet, it helps to use more than one source or resource. Each of the email lists or Yahoo Groups or online forums I have visited have their particular human populations; some groups tending toward more astuteness and accuracy and responsibility than others. Responsible group participants do not try to prescribe over the Internet, and they explain and qualify their statements, so you can tell what they are talking about!
It is thanks to the people who put together and maintain these groups and sites that Vekkie and I can concentrate solely on very limited aspects of coping with diabetes - namely, reducing stress in humans and dogs, and easing procedures such as giving injections and testing for glucose on blood samples from your dog.
Do keep in mind that our companion animals have, in the end, only us to care for them (any pun intended). It is not our vets, not our human friends, not our next-door neighbors, not our parents, nor children, who are responsible. Our animals have only us to depend on; we must make all the decisions.
Therefore, we need to do all we can to inform ourselves, even when scientific or other information is beyond our ken. With careful observation, and by paying close attention, we can indeed make reasonable decisions about the care of our animals. We do need to assess the abilities of those we ask for help. So, we just do the best we can. But I trust we never stop studying, and never stop learning. I think we owe that to these animals, who ask for nothing but to have their very real needs met - and to have us be their human families.
You may be given advice, or even instructions, on email lists, to do this or that; perhaps to alter a dose, or even a type, of insulin. Some lists specialize in prescribing for others. Beware of ANY prescription given on the Internet. Please remember that it is your veterinarian who has seen and examined your animal, and has access to the full range of information that might affect your dog or cat. You do need your vet to be both knowledgeable and helpful, and if that is not turning out to be so, then you need to seek out a vet better qualified for your needs.
Please do not follow instructions from people who are not qualified to issue them. Do remember that we are solely responsible for the well-beings of our animals, so that all we can learn is helpful. Do discuss any information you pick up on the web or on an email list with your own vet.