1 00:00:02,200 --> 00:00:23,679 Speaker 1: You're listening to Petlifradio dot com. 2 00:00:23,760 --> 00:00:26,480 Speaker 2: Hey, good morning or good afternoon, depending on where you 3 00:00:26,600 --> 00:00:29,079 have could be in the country at this very moment. 4 00:00:29,440 --> 00:00:31,440 I am your host, Doctor Jeff Wover. We're here with 5 00:00:31,480 --> 00:00:33,880 you for the next thirty minutes on Ask Theavettes. But 6 00:00:34,320 --> 00:00:37,799 Doctor Jeff the only live show here on pet Life 7 00:00:37,880 --> 00:00:40,640 Radio Live call in, and that means I want to 8 00:00:40,679 --> 00:00:42,679 hear from you. So I'm gonna give you a bunch 9 00:00:42,679 --> 00:00:44,399 of ways to do that. Number one is to give 10 00:00:44,439 --> 00:00:46,880 us a call at eight seven seven three eight five 11 00:00:47,000 --> 00:00:49,840 eight eight A two once again eight seven seven three 12 00:00:49,840 --> 00:00:52,520 eight five eight eight eight two. Number two. You can 13 00:00:52,880 --> 00:00:56,520 send me a quick email to Dr Jeff at Petlifradio 14 00:00:56,679 --> 00:01:00,520 dot com and our producer Mark Well send that to 15 00:01:00,560 --> 00:01:03,920 me asap. Or you can actually go on join us 16 00:01:04,200 --> 00:01:07,159 on the website petlife radio dot com. Click on the 17 00:01:07,239 --> 00:01:09,519 Ask Theivets with Doctor Jeff tab and there you're going 18 00:01:09,560 --> 00:01:11,840 to see a box that says join the conversation. That's 19 00:01:11,840 --> 00:01:14,400 all you have to do is join another conversation. It's 20 00:01:14,480 --> 00:01:16,840 that easy, and we want to hear from new As 21 00:01:16,840 --> 00:01:19,079 a matter of fact, we are here to help you 22 00:01:19,560 --> 00:01:21,439 and with because of our sponsors, and I want to 23 00:01:21,439 --> 00:01:24,439 thank them. That's Pro Sense Pet Products and Kong. As 24 00:01:24,439 --> 00:01:26,840 a matter of fact, just by calling in, just by 25 00:01:26,879 --> 00:01:29,239 sending me a text, just by joining in the conversation, 26 00:01:29,439 --> 00:01:31,719 we will send you out a pro Sense pet product 27 00:01:31,719 --> 00:01:34,879 for your pet and an amazing Kong toy as well. 28 00:01:35,079 --> 00:01:38,200 So you can lose free advice. My job here, And 29 00:01:38,239 --> 00:01:40,519 if you've been listening, I am trying to make veteran 30 00:01:40,640 --> 00:01:44,359 medicine practical. It it's become so specialized, it's become you 31 00:01:44,719 --> 00:01:48,719 so advanced that people lose sight of the simple things. 32 00:01:49,159 --> 00:01:51,560 And you know a couple of my favorite expressions. If 33 00:01:51,599 --> 00:01:53,239 it looks like a duck, walks like a duck, waks 34 00:01:53,280 --> 00:01:55,599 like a duck, it's probably a duck. So stop looking 35 00:01:55,599 --> 00:01:58,879 for the darn zebra when it's the duck. And speaking 36 00:01:58,920 --> 00:02:01,040 of zebras, here's another one I love. If you're running 37 00:02:01,040 --> 00:02:03,519 along the beach in Malibu and you hear hoof beats 38 00:02:03,599 --> 00:02:06,439 chasing you from behind, what are you thinking? And anyone 39 00:02:06,480 --> 00:02:09,120 who lives out here in Malibu might know that it's horses, 40 00:02:09,520 --> 00:02:12,199 So why are you looking for zebras? When I say 41 00:02:12,240 --> 00:02:14,479 this to veterinarians all the time, why did you run 42 00:02:14,520 --> 00:02:16,800 that test? Why did you do that? What took you 43 00:02:16,840 --> 00:02:19,280 on that path? You ever even ruled out the most 44 00:02:19,280 --> 00:02:22,199 obvious things first, And that's why I'm here to try 45 00:02:22,199 --> 00:02:26,120 to get everybody thinking simple. My favorite rule the kiss rule, 46 00:02:26,360 --> 00:02:28,960 Keep it simple, stupid, and I use it and I 47 00:02:28,960 --> 00:02:31,479 say it all the time. So we have been if 48 00:02:31,479 --> 00:02:34,319 you've been paying attention, if you've been listening, I'm going 49 00:02:34,360 --> 00:02:38,400 through an entire series of the endocrine systems and all 50 00:02:38,400 --> 00:02:40,680 the things that can go wrong, from Cushing's disease to 51 00:02:40,680 --> 00:02:43,319 Addison's disease, which is one is a hyper secretion of 52 00:02:43,319 --> 00:02:45,159 the adrenals, the other one is a hypo secretion of 53 00:02:45,159 --> 00:02:47,879 the adrenals. We talked about thyroidism, and again we have 54 00:02:48,000 --> 00:02:51,039 hyperthyroidism which we see in cats. We have hypothyroidism which 55 00:02:51,039 --> 00:02:53,120 we see in atalogs. Then we got to the diabetes 56 00:02:53,120 --> 00:02:55,919 melodist and again everything seems to be double well. We 57 00:02:55,960 --> 00:02:59,120 have two types of those, diabetes type two and diabetes 58 00:02:59,120 --> 00:03:01,360 type one. Type one is what we see in dogs, 59 00:03:01,759 --> 00:03:05,439 is the same as the human type one judile set diabetes, 60 00:03:05,439 --> 00:03:08,639 which is what we call insulin dependent diabetes. And then 61 00:03:08,919 --> 00:03:12,159 we also talked about type two diabetes, which between cats. 62 00:03:12,479 --> 00:03:15,479 That's more similar to the human type two, which is 63 00:03:15,520 --> 00:03:20,199 adult onset diabetes often associated with obesity, and as we 64 00:03:20,280 --> 00:03:24,560 discuss that cats, we tend to feed them inappropriately, pushing 65 00:03:24,599 --> 00:03:28,039 too much dry food, too many carbs. Cats are obligate carnivores. 66 00:03:28,080 --> 00:03:30,639 They need meat, and too much carbs has the same 67 00:03:30,680 --> 00:03:34,680 effect on them as human deter obese has on them. 68 00:03:34,680 --> 00:03:37,159 The obesity has on them, and they are prone to 69 00:03:37,199 --> 00:03:41,400 type two diabetes, which though insulin sometimes is necessary, there 70 00:03:41,439 --> 00:03:44,280 are also other ways, depending on the case, depending on 71 00:03:44,319 --> 00:03:48,080 the pet, to successfully treat type two diabetes diet, some 72 00:03:48,240 --> 00:03:51,240 oral medications, etc. And we may not need or maybe 73 00:03:51,280 --> 00:03:54,039 just start on insulin for a short while and then 74 00:03:54,080 --> 00:03:56,479 gradually wean them off and have them on a non 75 00:03:57,000 --> 00:04:01,599 insulin protocol for type two diabetes. Now, there is also 76 00:04:01,639 --> 00:04:04,520 what's confusing, as we discussed, is that many of these 77 00:04:04,840 --> 00:04:08,840 conditions present similarly. You know a hallmark of for example, 78 00:04:09,319 --> 00:04:14,199 Cushing disease, sometimes even addisons, but definitely diabetes. Melodice is 79 00:04:14,280 --> 00:04:17,000 excessive water drinking, excessive ping. So when you see these 80 00:04:17,040 --> 00:04:19,519 dogs urinating, drinking and urinating and drinking and urinating, with 81 00:04:19,600 --> 00:04:22,519 these casts drinking and urinating so frequently, of course we 82 00:04:22,560 --> 00:04:24,079 have to worry about kidney issues. Of course we have 83 00:04:24,120 --> 00:04:27,600 to wear bet bladder issues. But also we can't forget 84 00:04:27,800 --> 00:04:31,000 to rule in or rule out the possibility that this 85 00:04:31,079 --> 00:04:33,519 could be a cushing disease, this could be an ADISONI, 86 00:04:33,519 --> 00:04:36,519 and this could be a diabetic etc. Now there is 87 00:04:36,680 --> 00:04:38,800 just to confuse things, and I'm going to try to 88 00:04:38,920 --> 00:04:40,680 keep it simple. Stupid, I'm going to try to keep 89 00:04:40,680 --> 00:04:44,439 it simple. But there is another diabetes out there, one 90 00:04:44,480 --> 00:04:48,439 that is not nearly as common as the diabetes melodice, 91 00:04:48,439 --> 00:04:51,399 which is the sugar diabete. Is the insulin dependent or nondependent, 92 00:04:51,600 --> 00:04:55,000 but where the blood sugar rises off the charts high 93 00:04:55,199 --> 00:04:57,279 when it gets past a certain levels just two hundred 94 00:04:57,279 --> 00:04:59,759 and fifty milligrams portest later, then it kind of spills 95 00:04:59,759 --> 00:05:04,560 out into the urine and we start seeing signs of glycosura, 96 00:05:04,639 --> 00:05:07,600 which means glucose in the urine, a clear sign that 97 00:05:07,920 --> 00:05:11,199 there is probably one of the diabetes melodis is on 98 00:05:11,279 --> 00:05:13,240 board type one if it's a dog, type two if 99 00:05:13,240 --> 00:05:16,439 it's a cat. Now, the other diabetes we see is 100 00:05:16,439 --> 00:05:22,360 called diabetes incipitous, and that that is the water drinking diabetes, 101 00:05:22,759 --> 00:05:27,519 and that happens where the kidneys are supposed to interact 102 00:05:27,519 --> 00:05:30,759 with the body and the blood, and there's usually a 103 00:05:30,800 --> 00:05:33,519 signal coming from the brain through a hormone called adh 104 00:05:33,639 --> 00:05:38,439 antidiretic hormone that basically tells the kidneys whose job it 105 00:05:38,519 --> 00:05:40,800 is to filter out all the fluid that we drink. 106 00:05:41,120 --> 00:05:45,000 For example, I'm sure none of you have ever gone 107 00:05:45,000 --> 00:05:47,399 out and had a few too many beers. I'm sure 108 00:05:47,399 --> 00:05:50,160 that's never happened, but if it were to happen, you 109 00:05:50,240 --> 00:05:53,360 certainly know that when you get to a certain point, 110 00:05:53,639 --> 00:05:56,240 everything that goes in is coming right back out because 111 00:05:56,240 --> 00:06:00,600 you are now overhydrated. The kidneys feel they're reading the bodies, 112 00:06:00,680 --> 00:06:03,519 the blood, the hydration status of the body and saying, 113 00:06:03,600 --> 00:06:06,959 oh my god, we have way too much fluid already, 114 00:06:07,120 --> 00:06:09,560 So everything that comes through, we're just going to filter 115 00:06:09,800 --> 00:06:13,439 and urinate it right out. Conversely, for those of us 116 00:06:13,519 --> 00:06:16,480 that might do some running or heavy duty exercise and 117 00:06:16,560 --> 00:06:20,160 you're sweating a lot, you're getting very dehydrated. You know 118 00:06:20,480 --> 00:06:24,519 that when you urinate at that time, the urine is 119 00:06:24,639 --> 00:06:28,399 very concentrated, it's very yellow, and as opposed to being 120 00:06:28,399 --> 00:06:33,040 excessively hydrated. Well with diabetes incipidus, the brain, the body 121 00:06:33,439 --> 00:06:37,519 the kidneys are not reading the signals properly. Either there 122 00:06:37,879 --> 00:06:40,120 is a lack of the hormone the ADH, or the 123 00:06:40,199 --> 00:06:43,759 kidneys aren't reading it. They're not responding appropriately to the ADH. 124 00:06:44,079 --> 00:06:48,439 So what's happening is that you end up with continuously 125 00:06:48,560 --> 00:06:53,319 drinking regardless of the hydration status of the body. It's 126 00:06:53,319 --> 00:06:55,959 not being read properly, so everything that comes in goes 127 00:06:56,040 --> 00:06:59,439 right back out. In other words, we cannot concentrate the 128 00:06:59,600 --> 00:07:04,199 urine appropriately for the needs the status of the body. 129 00:07:04,560 --> 00:07:07,000 And fortunately, as I said, this doesn't we don't see 130 00:07:07,000 --> 00:07:09,160 it nearly as commonly as some of the other diabetes, 131 00:07:09,199 --> 00:07:12,680 but it's certainly something that needs to be evaluated. And 132 00:07:13,040 --> 00:07:16,040 it's a problem because these dogs, especially, we see this 133 00:07:16,079 --> 00:07:20,920 in dogs are drinking like crazy and they're urinating like crazy, 134 00:07:21,319 --> 00:07:24,160 but everything is perfect. The only thing you see on 135 00:07:24,199 --> 00:07:29,040 a laboratory work is a isosdeneric urine, which basically is 136 00:07:29,399 --> 00:07:34,319 urine that has the same salute concentration of water, and 137 00:07:34,680 --> 00:07:37,759 the kidneys are not able to concentrate, they're not able 138 00:07:38,040 --> 00:07:42,279 to dilute. It is just the same, and regardless of 139 00:07:42,480 --> 00:07:45,759 how little water they have, the urine is coming out 140 00:07:45,879 --> 00:07:49,079 as if they've been drinking water for the last four 141 00:07:49,079 --> 00:07:55,759 hours NonStop. But because they're losing so much dilute urine, 142 00:07:55,879 --> 00:07:58,240 the body is reading the fact that now we are 143 00:07:58,360 --> 00:08:01,639 thirsty because it interact with the first center of the brain, 144 00:08:02,120 --> 00:08:05,560 and now they are drinking continually to make up for 145 00:08:05,639 --> 00:08:09,720 the loss. And it's an annoying condition. Or first of all, 146 00:08:09,759 --> 00:08:12,079 it's annoying for any of you that have had dogs 147 00:08:12,120 --> 00:08:15,839 with diabetes and sippetis because you are have to walk 148 00:08:15,879 --> 00:08:18,720 these dogs very often. And if you don't have a 149 00:08:18,720 --> 00:08:21,920 dog your door, or if you have like really expensive 150 00:08:21,920 --> 00:08:25,000 berber carpeting, you are going to be one upset pet 151 00:08:25,040 --> 00:08:28,240 parent because all you'll be doing is walking every twenty 152 00:08:28,319 --> 00:08:30,600 minutes half hour. I mean, as fast as they drink, 153 00:08:30,639 --> 00:08:33,120 it's coming right back out, regardless of as I said, 154 00:08:33,159 --> 00:08:35,480 the hydration status of the body. And it gets really 155 00:08:35,559 --> 00:08:38,759 frustrating because you want to do the right thing and 156 00:08:38,840 --> 00:08:41,440 to make matters even more complicated, because that's what I 157 00:08:41,519 --> 00:08:43,080 like to do, is take the complicated and try to 158 00:08:43,120 --> 00:08:45,399 make it a little simple. There is another condition that 159 00:08:45,440 --> 00:08:49,279 we often see which we have to rule out when 160 00:08:49,320 --> 00:08:51,480 we're trying to make a diagnosis of diabetes and sippitis 161 00:08:51,720 --> 00:08:53,600 and that is something we call and we see this 162 00:08:54,000 --> 00:08:57,279 very commonly in puppies, and not even I don't even 163 00:08:57,279 --> 00:08:59,519 little teeny puppies. I mean, you know eight to ten 164 00:08:59,600 --> 00:09:02,360 to twelve month old puppies that they're not quite there 165 00:09:02,360 --> 00:09:05,080 in that young adult stage every four two years of age, 166 00:09:05,159 --> 00:09:09,720 and they have what's called psychogenic polydipsia. And this is 167 00:09:09,759 --> 00:09:14,559 a case where there is absolutely nothing wrong with the body, 168 00:09:14,799 --> 00:09:17,879 nothing wrong with the anti diuretic hormone, nothing wrong with 169 00:09:17,919 --> 00:09:21,440 the kidneys, nothing wrong with the brain. Everything is working 170 00:09:21,919 --> 00:09:26,200 in concert, in unison. It's perfect. These dogs just like 171 00:09:26,240 --> 00:09:28,840 to drink and they don't have a turnoff switch. So 172 00:09:28,879 --> 00:09:30,440 they go to that water bowl because they've played for 173 00:09:30,440 --> 00:09:32,639 a little while, and instead of drinking I don't know, 174 00:09:33,000 --> 00:09:35,679 a cup, they drink a gallon and they keep drinking 175 00:09:35,720 --> 00:09:37,399 and they'll run over to the water bowl whenever it's full, 176 00:09:37,440 --> 00:09:41,200 and they just like to drink. So clearly, let's go 177 00:09:41,279 --> 00:09:45,639 back to that original beer scenario. What happens when you 178 00:09:45,720 --> 00:09:49,240 are drinking more than your body needs. It all comes 179 00:09:49,279 --> 00:09:52,639 out in the urine as very dilute urine, and you're 180 00:09:52,639 --> 00:09:54,960 scratching your head and saying, wait a second, that's exactly 181 00:09:55,000 --> 00:09:57,840 like diabetes and sipitus. They're drinking a ton and it's 182 00:09:57,879 --> 00:10:02,240 coming out straight clear. Austenic Urine means that the solude 183 00:10:02,240 --> 00:10:05,440 concentration of water. It's between what we called one point 184 00:10:05,519 --> 00:10:07,799 zero zero eight and one point zero one too, if 185 00:10:07,799 --> 00:10:10,039 you want to get a little technical, But the key is, 186 00:10:10,159 --> 00:10:11,759 oh my god, now we have a little bit of 187 00:10:11,799 --> 00:10:14,879 a diagnostic challenge, and we have to sort of sift 188 00:10:15,000 --> 00:10:17,960 through that challenge because we have to know the difference, 189 00:10:17,960 --> 00:10:21,519 because it's a tremendous difference in treatment. I mean, one 190 00:10:21,639 --> 00:10:25,080 is a little behavior modification and starting to ration water 191 00:10:25,360 --> 00:10:26,960 and the other one, Oh my god, the other one 192 00:10:27,200 --> 00:10:28,879 is a real treatment. It's a condition that we have 193 00:10:28,919 --> 00:10:31,480 to deal with. So that, as I said, so when 194 00:10:31,480 --> 00:10:34,320 it comes to things like that, we have to sit there. 195 00:10:34,320 --> 00:10:34,440 Speaker 3: You know. 196 00:10:34,480 --> 00:10:37,799 Speaker 2: I always feel like a good diagnostician is we ever 197 00:10:37,840 --> 00:10:41,320 watched Doctor House Gregory House, Remember House MD. That was 198 00:10:41,360 --> 00:10:45,559 a show where it really took the art of diagnostics 199 00:10:45,799 --> 00:10:48,919 and highlighted the techniques involved in and one is you 200 00:10:49,039 --> 00:10:51,120 really have to I say, to be a good diagnostician, 201 00:10:51,440 --> 00:10:54,440 you have to get a really thorough history. And that's important. 202 00:10:54,440 --> 00:10:56,440 That's why if you've ever been referred to a specialist, 203 00:10:56,519 --> 00:10:59,720 whether it's a dramatologist, whether it's a behavior specialist, whatever 204 00:10:59,759 --> 00:11:01,879 the case may be. One of the most important things 205 00:11:01,879 --> 00:11:04,000 that you are going to spend so much time initially 206 00:11:04,200 --> 00:11:06,799 getting that thorough history, because that is going to help 207 00:11:07,000 --> 00:11:09,080 rule in a lot of possibilities. It's also going to 208 00:11:09,120 --> 00:11:11,240 rule out probably more than it's going to rule in 209 00:11:11,360 --> 00:11:13,919 where you're going to say it can't be that, because 210 00:11:14,279 --> 00:11:16,080 if it were, then it's all going to be doing XYZ. 211 00:11:16,519 --> 00:11:17,519 Just he's not doing X y Z. 212 00:11:17,840 --> 00:11:18,320 Speaker 1: It's not that. 213 00:11:18,639 --> 00:11:22,559 Speaker 2: So the goal here is to reason, to think, to analyze, 214 00:11:22,759 --> 00:11:25,320 and then to choose the appropriate tests to help you 215 00:11:25,519 --> 00:11:28,039 come up your diagnosis. And as I say, and this 216 00:11:28,080 --> 00:11:31,039 is my soapbox, you don't feel, and your veterinarians shouldn't 217 00:11:31,039 --> 00:11:33,559 feel that they have to do all the tests in 218 00:11:33,639 --> 00:11:37,000 one day, unless, of course, you're faced with an emergency 219 00:11:37,039 --> 00:11:40,200 situation and you need to rule everything out now. But 220 00:11:40,360 --> 00:11:43,039 most of these conditions are not emergencies. Your pet's been 221 00:11:43,120 --> 00:11:45,480 living in them for weeks, for months. The extra two 222 00:11:45,480 --> 00:11:47,200 to three days is not going to make a difference, 223 00:11:47,440 --> 00:11:49,679 and you want to approach them by getting a thorough 224 00:11:49,720 --> 00:11:52,600 history and doing your work so having said that, we're 225 00:11:52,639 --> 00:11:54,480 time for a quick little break. When we come back, 226 00:11:54,519 --> 00:11:57,159 we are going to talk about some diagnostics involved and 227 00:11:57,320 --> 00:12:00,559 treatment of how to tell do we have a psychogenic pollidipsy? 228 00:12:00,879 --> 00:12:03,919 Do we have diabetes incipitous as opposed to diabetes melodist 229 00:12:04,200 --> 00:12:06,320 and let's get some answers for you and let's figure 230 00:12:06,320 --> 00:12:08,039 out how to treat it. Don't go well with right 231 00:12:08,080 --> 00:12:10,360 back here on pet Life Radios. Ask the vets with 232 00:12:10,399 --> 00:12:12,200 doctor Jeff and I'm doctor Jeff Weerbert. 233 00:12:12,200 --> 00:12:18,919 Speaker 1: Don't go away, We'll be right back right after these messages. 234 00:12:19,080 --> 00:12:19,720 Stay tuned. 235 00:12:21,840 --> 00:12:25,080 Speaker 4: I'm who My heart's cheered now what bring home? 236 00:12:25,120 --> 00:12:27,480 Speaker 2: A puppy or new dog is exciting and he's depending 237 00:12:27,480 --> 00:12:29,559 on you to keep him in good health. Dogs need 238 00:12:29,600 --> 00:12:31,879 special care to keep them healthy as they grow throughout 239 00:12:31,879 --> 00:12:34,320 their entire life. Caring for their health is critical in 240 00:12:34,399 --> 00:12:38,000 all stages. With pro Sense, it's simple and convenient to 241 00:12:38,000 --> 00:12:40,759 give your dog the care it needs. 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I'm Dana Humphrey at wyke EPR 260 00:13:47,279 --> 00:13:50,200 and we have been specializing in pet product PR for 261 00:13:50,240 --> 00:13:53,799 over ten years and can get your brand featured in 262 00:13:53,840 --> 00:13:57,360 the media from TV to radio, to print to blogs. 263 00:13:57,600 --> 00:14:01,720 You can find out more at www dot white gatepr 264 00:14:01,960 --> 00:14:04,840 dot com. 265 00:14:04,879 --> 00:14:07,720 Speaker 4: Hey there, pet parents, this is Christy Vaughan post of 266 00:14:07,759 --> 00:14:10,399 the Doggie Dish. Do you love your furry companion? Do 267 00:14:10,440 --> 00:14:12,840 you love making him or her healthy treats but can't 268 00:14:12,840 --> 00:14:15,799 seem to find the time great news. The doggye Dish 269 00:14:15,840 --> 00:14:18,799 is the perfect show for you. Every episode is chock 270 00:14:18,879 --> 00:14:21,799 full of healthy and easy recipes that are made with 271 00:14:22,000 --> 00:14:25,080 ingredients you most likely have on hand. Tune into The 272 00:14:25,120 --> 00:14:28,840 Doggy Dish for yummy and healthy recipes for your canine kids. 273 00:14:28,840 --> 00:14:36,320 Speaker 1: Every week only on petlife Radio dot Com. Let's Talk Past, 274 00:14:36,639 --> 00:14:38,399 Let's done Past, Talk about Life. 275 00:14:38,240 --> 00:14:39,679 Speaker 5: Radio, Hetline Radio. 276 00:14:39,840 --> 00:14:41,960 Speaker 1: Pet live Radio dot. 277 00:14:41,679 --> 00:15:04,559 Speaker 2: Com And welcome back you are You're live with doctor 278 00:15:04,639 --> 00:15:08,000 Jeff Berber, your host for the next ten or twelve 279 00:15:08,039 --> 00:15:10,200 minutes or so. Here on bet Life Data, wh asked 280 00:15:10,240 --> 00:15:13,200 bets with doctor Jeff. Before the break, we were sifting 281 00:15:13,240 --> 00:15:15,799 through a new kind of diabetes for some of you. 282 00:15:15,840 --> 00:15:19,279 It's called diabetes incipetus. It's the water diabetes where the 283 00:15:19,559 --> 00:15:22,840 body is not correctly talking to its each other parts, 284 00:15:22,840 --> 00:15:26,120 the kidney's, the brain, the blood, the hydration status, et cetera. 285 00:15:26,440 --> 00:15:29,279 And these dogs, typically dogs that have this disease will 286 00:15:29,360 --> 00:15:31,879 just continually drink and drink and drink. The urine is 287 00:15:31,879 --> 00:15:34,320 always coming out very dilute, and the fault may be 288 00:15:34,559 --> 00:15:37,039 a number of things that could be either the lack 289 00:15:37,080 --> 00:15:40,879 of antidiretic hormone coming from the brain or the lack 290 00:15:40,919 --> 00:15:44,559 of receptors in the kidney that the ADH is there. 291 00:15:44,679 --> 00:15:47,000 So what's happening is everything that comes in is going 292 00:15:47,000 --> 00:15:49,399 straight back out. And these animals are always there for 293 00:15:49,679 --> 00:15:52,320 thirsty and they continually drink, and every time they drink 294 00:15:52,639 --> 00:15:55,240 urinate more, and clearly you could see the vicious cycle. 295 00:15:55,519 --> 00:15:58,320 So we need to make a diagnosis, and a number 296 00:15:58,399 --> 00:16:01,159 of ways. There is the old fashioned way, which I 297 00:16:01,159 --> 00:16:03,399 still like doing as a matter of fact, is called 298 00:16:03,639 --> 00:16:07,919 a water deprivation study, and that is on the following premise. 299 00:16:08,480 --> 00:16:12,200 If you have a dog, for example, as I mentioned before, 300 00:16:12,200 --> 00:16:15,120 the break was psychogenic polydipsia, or a dog which just 301 00:16:15,240 --> 00:16:17,159 for some reason likes to drink or is drinking more 302 00:16:17,159 --> 00:16:20,039 than it really should, but everything is working properly. Think 303 00:16:20,039 --> 00:16:24,559 about it. What would happen if we mechanically physically remove 304 00:16:25,080 --> 00:16:27,840 the water from this dog. Well, what's going to happen 305 00:16:28,200 --> 00:16:31,000 is that the urine will start to concentrate, because nothing 306 00:16:31,039 --> 00:16:33,440 was wrong, the only thing, the only problem there was 307 00:16:33,519 --> 00:16:36,440 that they were drinking too much. So you physically stop 308 00:16:36,480 --> 00:16:38,759 them from drinking too much, and within a few days 309 00:16:38,759 --> 00:16:40,919 the urine will start concentrating. Everything's normal, and then you're 310 00:16:40,919 --> 00:16:43,159 going to stract your head. You go, perfect, this is 311 00:16:43,159 --> 00:16:46,240 not de eyes, not diabetes and sippetis, it's psychogenic. We're 312 00:16:46,279 --> 00:16:49,360 just gonna have to start monitoring our dog's water intake. Now, 313 00:16:49,480 --> 00:16:52,039 what would happen to a dog, however, that has true 314 00:16:52,320 --> 00:16:55,960 diabetes and sippitus where there's a either a lack of 315 00:16:56,000 --> 00:16:59,639 the antidiretic hormone the eighth or there is a problem 316 00:16:59,639 --> 00:17:03,440 with the kid not with the receptors not evaluating how 317 00:17:03,519 --> 00:17:06,799 much ADH is there. It's not responding to the ADH 318 00:17:06,880 --> 00:17:09,920 is there. So what's gonna happen is that even though 319 00:17:10,279 --> 00:17:13,240 you withhold water, the kidneys are still going to be 320 00:17:13,680 --> 00:17:17,680 creating dilute isoseneric urine. So there we have a problem 321 00:17:17,759 --> 00:17:21,640 because there we have to provide the eighty eight in 322 00:17:21,680 --> 00:17:25,559 one form or another, and that's where we have some 323 00:17:25,680 --> 00:17:28,759 options you know, to use there. So let's to make 324 00:17:28,759 --> 00:17:32,599 it simple that when you start withholding water initially, and 325 00:17:32,599 --> 00:17:35,759 if you do it abruptly from a dog that has 326 00:17:35,960 --> 00:17:39,039 been urinating excessively because the water the urine is very concentrated, 327 00:17:39,240 --> 00:17:42,839 you can suffer what's called for a while medullary wash out. 328 00:17:43,079 --> 00:17:45,720 So that is that there nothing is working in the 329 00:17:45,799 --> 00:17:48,519 kidneys even though everything is fine, but they're so washed 330 00:17:48,519 --> 00:17:51,720 out because of all the dilute urine, the dilute fluid 331 00:17:51,759 --> 00:17:56,039 it's going through that it takes several days. Again, So 332 00:17:56,200 --> 00:17:59,519 even though it's gonna work, if you just automatically, like 333 00:17:59,680 --> 00:18:02,880 the night before the tests, withhold water and do what's 334 00:18:02,880 --> 00:18:05,960 called the twenty four water deprivation, having had these dogs 335 00:18:06,000 --> 00:18:09,880 drinking so much, even a psychogenic polydipsia, it may still 336 00:18:09,920 --> 00:18:13,880 show the next day that the dog is still urinating 337 00:18:14,000 --> 00:18:16,400 very dilute urine, and you might think, oh my god, 338 00:18:16,440 --> 00:18:19,599 then this dog must truly have diabetes zippitis and start treating. 339 00:18:19,759 --> 00:18:22,039 But that's inappropriate because what we have to do is 340 00:18:22,240 --> 00:18:26,480 to in order to avoid this concept, this potential for 341 00:18:26,559 --> 00:18:29,880 medjul a wash out, we need to start withholding water 342 00:18:30,240 --> 00:18:34,039 and measuring water and only giving your dog the amount 343 00:18:34,039 --> 00:18:35,680 of water it should have, and you work that out 344 00:18:35,680 --> 00:18:38,960 with your veterinarian for several days before the beginning of 345 00:18:39,000 --> 00:18:42,480 the actual twenty four hour Now, when we get to 346 00:18:42,519 --> 00:18:45,640 that point, we do a few things. We continually it's 347 00:18:45,640 --> 00:18:48,880 done in the hospital, and we are our stopping point 348 00:18:49,240 --> 00:18:51,960 for this test to determine whether this is a psychogenic 349 00:18:52,039 --> 00:18:55,319 problem or true diabetes andcipitous one of two things. Either 350 00:18:55,680 --> 00:18:58,079 the urine starts to concentrate we typically say above ten 351 00:18:58,160 --> 00:19:01,079 twenty one point two or even ten twenty five. Then 352 00:19:01,119 --> 00:19:03,240 we know that the kidney's are working fine. The AD 353 00:19:03,319 --> 00:19:05,559 eight is working fine, they're reading the AD eight. Everything 354 00:19:05,599 --> 00:19:09,039 is perfect. This dog just likes to drink. Or you've 355 00:19:09,079 --> 00:19:13,119 gone so long that the dog has lost ten percent 356 00:19:13,119 --> 00:19:15,119 of its body weight, meaning if it's a twenty five 357 00:19:15,160 --> 00:19:18,000 pound dog, if it loses two and a half pounds, 358 00:19:18,079 --> 00:19:21,640 and the urine is still dilute, meaning the dog is 359 00:19:21,680 --> 00:19:24,839 not concentrated even after that, and this could before the 360 00:19:24,920 --> 00:19:26,839 twenty four hours, this could be an hour seven or 361 00:19:26,839 --> 00:19:29,519 eight or ten, then you stop the test because now 362 00:19:29,519 --> 00:19:33,519 you're looking at dangerous dehydration and you can therefore pretty 363 00:19:33,519 --> 00:19:38,000 safely assume that yes, your dog has diabetes and sipetus. Now, 364 00:19:38,039 --> 00:19:42,079 with the advent of a newer medication, what a lot 365 00:19:42,079 --> 00:19:45,000 of dogs are doing is saying this, and it's again 366 00:19:45,039 --> 00:19:48,359 it's a great way. It's actually easier. It's expensive because 367 00:19:48,359 --> 00:19:51,480 the stuff we have to use is very expensive, and 368 00:19:51,680 --> 00:19:55,799 that is getting a product it's actually really meant to 369 00:19:55,839 --> 00:19:59,480 be used as a nose dropping people. It's a spray 370 00:20:00,000 --> 00:20:02,799 and it's something called desma pressin' And what we do 371 00:20:02,920 --> 00:20:04,680 is you have to get it. As I said, it's 372 00:20:04,720 --> 00:20:08,240 very costly, and you have your veterinarian. You have to 373 00:20:08,240 --> 00:20:09,960 open it because it's got those one of those sealed 374 00:20:10,279 --> 00:20:12,799 like aluminum rings around. It's very hard to get in 375 00:20:12,839 --> 00:20:15,400 there because it's in one of those like pump sprays things, 376 00:20:15,440 --> 00:20:18,359 you know, for nose and we undo it. We put 377 00:20:18,359 --> 00:20:19,759 it in a little yorker a little bottle with it, 378 00:20:20,079 --> 00:20:22,240 or like an eye drop bottle, and you can put 379 00:20:22,519 --> 00:20:25,640 like a drop in the eye once a day, and 380 00:20:25,680 --> 00:20:29,680 it's really cool. It's so easy to use and it 381 00:20:29,720 --> 00:20:34,720 works beautifully. If in fact, your dog has diabetes and sippitis, 382 00:20:34,960 --> 00:20:37,279 I want you to think for a second, how with 383 00:20:37,359 --> 00:20:41,119 this amazing drug, how might it still not work? All right, 384 00:20:41,279 --> 00:20:44,119 I'm gonna do this. This is the jeopardy question. Done, done, done, Okay, 385 00:20:44,200 --> 00:20:46,920 right anyway, Well, here's the thing. If the problem is 386 00:20:47,200 --> 00:20:49,880 which it normally is, the issue in the case of 387 00:20:49,920 --> 00:20:52,519 diabetes and sippitis, has to do with the amount of 388 00:20:52,640 --> 00:20:57,480 anti diiretic hormone coming from the brain, then the glands 389 00:20:57,519 --> 00:20:59,680 that do all this then what's going to happen is 390 00:20:59,799 --> 00:21:03,720 the the body is going to respond beautifully. All right, 391 00:21:03,759 --> 00:21:06,039 there's a whole cascade of events where the brain, as 392 00:21:06,079 --> 00:21:09,039 I said, signals the glands and they spit out the ADH, 393 00:21:09,359 --> 00:21:12,799 the kidneys respond, and you end up with concentrated urine. 394 00:21:12,880 --> 00:21:15,960 What happens, however, if the problem is not the amount 395 00:21:15,960 --> 00:21:18,400 of anti diuretic hormone it's being secreted from the glands, 396 00:21:18,559 --> 00:21:24,160 but rather the kidney's receptors responding to the ADH, then 397 00:21:24,200 --> 00:21:26,640 you have a different problem because now it's not the 398 00:21:26,640 --> 00:21:29,440 ADH it's the problem. It's the kidneys aren't working. So 399 00:21:29,720 --> 00:21:32,960 we're still not going to have a response if even 400 00:21:33,000 --> 00:21:36,400 with this chemical, this medication going in the eye drops, 401 00:21:36,680 --> 00:21:39,799 because what's happening is the kidneys are the problem. They're 402 00:21:39,839 --> 00:21:42,920 not responding, and that's just stuff. That's a whole different ballgame, 403 00:21:43,200 --> 00:21:46,519 one that is a lot more of a challenge because 404 00:21:46,720 --> 00:21:49,559 there's really no way to turn these recepts. Well I 405 00:21:49,680 --> 00:21:52,440 never say never, but not a simple way or a 406 00:21:53,160 --> 00:21:58,079 clearly used technique, easily use technique to turn these receptors on. 407 00:21:58,440 --> 00:22:00,279 So it just means that we're gonna have to live 408 00:22:00,599 --> 00:22:03,119 with the excessive water drinking and you have to let 409 00:22:03,160 --> 00:22:05,400 them drink and let them urinate because there's really no 410 00:22:05,559 --> 00:22:08,960 way to get to the bottom of it. So again 411 00:22:09,119 --> 00:22:14,279 psychogenetic polydipsia, you withhold water appropriately and to avoid medullary 412 00:22:14,400 --> 00:22:16,720 wash out. You do your test over several days. You 413 00:22:16,759 --> 00:22:19,200 minimize the water intake based on just their body weight. 414 00:22:19,279 --> 00:22:21,200 Then you do the twenty four hour They are going 415 00:22:21,200 --> 00:22:24,119 to respond. Done deal. Now you know for treatment all 416 00:22:24,119 --> 00:22:27,200 you need to do is control their water intake. Diabetes 417 00:22:27,200 --> 00:22:30,039 and sipetus the more common one, which is an antidiuretic 418 00:22:30,160 --> 00:22:33,640 hormone issue. We make the diagnosis either they did not 419 00:22:33,960 --> 00:22:36,799 concentrate at all or they lost ten percent of their 420 00:22:36,799 --> 00:22:39,079 body weight during the test. Then you know it's time 421 00:22:39,359 --> 00:22:41,839 to have to treat with the desert pressing, which is 422 00:22:42,200 --> 00:22:44,279 probably the best way to go. It's a little expensive, 423 00:22:44,599 --> 00:22:47,359 but very worth it. It's an eye drop. You alternately 424 00:22:47,359 --> 00:22:51,599 recommend alternating eyes. It gets absorbed, it provides the impetus 425 00:22:51,640 --> 00:22:55,160 to the kidneys as the adaight's antidiretic hormone. Then these 426 00:22:55,200 --> 00:22:59,519 animals do just fine. And lastly, we have the type 427 00:22:59,519 --> 00:23:02,079 of dietet beads and scimpetus where they're not reading the 428 00:23:02,119 --> 00:23:04,880 antidretic hormone. And these are ones that you really are 429 00:23:05,039 --> 00:23:08,880 not easily controllable because the problem is there's no way 430 00:23:09,200 --> 00:23:11,799 really turn on these receptors that're either are not functioning. 431 00:23:12,240 --> 00:23:14,960 Why this happens, we're not sure. I still would recommend 432 00:23:15,240 --> 00:23:17,279 you have to go through the test anyway, but that's 433 00:23:17,319 --> 00:23:19,480 one you're going to see your veterinarian. Your veterinating might 434 00:23:19,519 --> 00:23:23,319 send you to a board certified veterinarian internist, someone who 435 00:23:23,400 --> 00:23:27,440 works with the endocrine system, the hormones, the kidneys and 436 00:23:27,920 --> 00:23:30,200 might be able to make some suggestions to help you out. 437 00:23:30,440 --> 00:23:32,240 So if you have any questions about this, I want 438 00:23:32,279 --> 00:23:34,119 to hear from you. If you send us an email, 439 00:23:34,319 --> 00:23:37,000 tell us about a problem your pet's been having, especially 440 00:23:37,079 --> 00:23:40,400 with Remember there's a lot excessive water drinking, excessive urinating. 441 00:23:40,599 --> 00:23:43,960 As you know now, it covers a wide range of possibilities, 442 00:23:44,079 --> 00:23:46,839 and our challenge is to make the diagnosis appropriately, to 443 00:23:46,920 --> 00:23:50,200 differentiate between all of them and make the right call 444 00:23:50,279 --> 00:23:52,680 for you. And again there's complications along the way because 445 00:23:52,680 --> 00:23:54,160 a lot of times we see older dogs that have 446 00:23:54,319 --> 00:23:57,640 can currently cushings and diabetes. Melodist boy, that makes it 447 00:23:57,680 --> 00:23:59,839 tough for us. So send us a question. You can 448 00:23:59,839 --> 00:24:01,640 get a hold of me at Dr Jeff Doctor Jeff 449 00:24:01,640 --> 00:24:04,279 at petlife radio dot com and we will have to 450 00:24:04,279 --> 00:24:05,920 answer once again. I want to take our sponsors, pro 451 00:24:05,960 --> 00:24:08,799 Sent Pet Products and Calm, and we will be here 452 00:24:08,839 --> 00:24:10,599 next week. I think we're gonna I want to start 453 00:24:10,640 --> 00:24:14,680 a whole series on eyes. So we're gonna talk a 454 00:24:14,720 --> 00:24:17,640 lot about eye problems, if any of your pets have 455 00:24:17,759 --> 00:24:21,079 had them, what they are, how many there are. There 456 00:24:21,079 --> 00:24:23,680 are quite a few to think about. So we'll get 457 00:24:23,720 --> 00:24:25,920 started and next week, the week after that, I'll be 458 00:24:25,960 --> 00:24:29,680 coming to you live from Orlando, Florida again. Doctor Dan 459 00:24:29,799 --> 00:24:32,599 mcfade will be my co host, and we're gonna probably 460 00:24:32,640 --> 00:24:35,559 talk about some really high tech stuff in veterinary medicine 461 00:24:35,799 --> 00:24:38,920 and just some basics about what you should be looking 462 00:24:38,960 --> 00:24:41,960 for in your veteran Have a great week, see you 463 00:24:42,039 --> 00:24:42,440 next week. 464 00:24:42,720 --> 00:24:47,319 Speaker 1: Let's Talk Pets every week on demand only on petlive 465 00:24:47,440 --> 00:25:00,799 radio dot com.