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Speaker 2: Welcome everybody on this glorious Sunday morning. I don't know
how glorious it is, but it's just a special day
for me. This happiness me my birthday, and I am
here in Park City, Utah, enjoying some great snowboarding as
we speak, well not exactly as we speak, but here
for you, and we're here on pet Life Radio Ask
the Best with Doctor Jeff. I am your host, Doctor
Jeff Weber for the next thirty minutes, and we were
here to talk about anything about your pets. So we
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you name it. It's holiday time. Maybe I have about
talking about the pros and cons of getting a pet
for somebody else for the holidays. That's a good one. Anyway,
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And come holiday time we want to include our pets
as well. These are great, great items to put in
gift bad for your pets or for somebody else's pets.
So anyway, while we get started, so once again I
want to hear from you. It's a great time. So
we are doing this whole series over the last several weeks,
except for last week we talked about holiday hazards, and
before we leave that subject, I do want to talk
about pets as gifts. But we're also going to start
on one of our next organ or endocrine systems that
seems to cause a lot of confusion amongst our pet
owners and sometimes even US veterinarians because they're not easy
to deal with. And those are the two diabetes. One
is called diabetes melodie, that's the sugar diabetes, and the
the other one is diabetes incipitous, which is the water
drinking diabetes. And there could be a number of causes
for that one, just to make it even more complicated.
So I want to start thinking about asking us calling
in any questions you might have on diabetes. I am
sure that there are those of you listening are online
right now and have had pets or have known somebody
that whose pets have had diabetes either one, and we
want to hear from you because it really can be
quite the challenge when it comes to treatment and a
lot of confusion because some of the many other diseases
were always worried about can manifest just like diabetes. So
it also takes some diagnostic specialty to rule in or
rule out these diseases. But before we get started, just
to keep in line with the upcoming holidays, we're what
eleven days away from Christmas, so we want to talk
about pets as gifts. Should you or shouldn't you? And
I'd love to hear from you. But my feeling is
this that for your own family and your own children,
when you are ready about it, you've spoken about it,
you are aware, depending on the age of your kids,
that most often when you're going to get a pet,
it's going to be you, not the kids who are
going to be taking care of it. Of course, if
you have older kids that are ready for the responsibility,
then it's fantastic. But then I think it would be
okay and doable. If, however, you are planning on surprising
another family member, a relative, a good friend with a pet,
I would think twice. And I could be talking about
a very close relative who's talked about having a pet,
wants to get a pet, They've discussed it with their kids,
everything's ago. Even these are going to backfire. This is
something it's kind of like a personal type of gift
that you want people to plan on their own, go
down to the shelter by themselves, go to the rescued
group on their own, and pick out their pet. It's
really hard to spring a pet on somebody else unless
you know for one hundred percent sure that this is
the individual pet that they were going to get or
looking for, or have already made plans, then it would
be okay. But I always always caution people, as cute
as it is for the kids, better yet give them
an io, you let them go to the shelter, let
them go down to the rescue group and choose their
own and you could have paid for it already. That
would be a great way to go. But to bring
home a live animal, a live pet, to someone who
did not choose it themselves, to someone who as much
as they said they're ready, they're ready, they're ready, aren't
quite ready yet, it's going to be disaster. So I
just wanted just to add that, take caution. Now, if, however,
you are petless, or you are in a situation where
you recently lost a pet and now you are ready
to replace, then there is nothing better. What a great
time of year to be able to provide and give
that bouncy little puppy or kitten. And I'm telling you
if you go online to any local rescue group or
go to any local shelter, they are inundated. They are
overflowing with pets that need forever homes. And what a
great thing you'd be doing to provide that home for somebody.
So anyway, I'm a total fan, you know, as they said,
I have twelve at homes, so I kind of, you know,
walk the talk, but it is, there's nothing. It'd be
a great way to celebrate the holidays, but if and
when you're truly ready. So let's talk about diabetes. What
is it? There are two types of diabetes. Simply, there
is diabetes type one, we call juvenile onset diabetes in people,
and diabetes type two, which is adult onset diabetes in people.
The type one, juvenile onset in animals, is the one
that affects our dogs ninety nine percent and clearly not
only juvenile on set. But that what's unique about this
type of diabetes is that is what we call instullin
dependent diabetes. Here's where there is truly a fault in
the islet cells of the pancreas. Now, remember we've talked
about this before when we were talking about vomiting. The
pancreas is an interesting organ because it serves two functions.
It has what we call an execrine function, and that
is the function of secreting and delivering the digestive enzymes
for digestion. When pancreatitis hits, we get vomiting, we have
a very sick dogg or cat. There's all also an
endocrine function, and that is the hormone secretion, manufacture and
secretion and the islet cells of the pancreas of our insulin.
What insulin does is insulin helps regulate the sugar in
the body. And what insulin does is it drives the
sugar from the blood into the cells where it becomes
necessary for cells to function and perform what they are
supposed to perform to run basically the mechanics of the body.
When we are lacking insulin, as we do in type
one diabetes, the blood sugar skyrockets because all of the
sugar that we take in stays in the blood because
without insulin, there's no way to drive that sugar that
glucose into the cells, so the cells start functioning improperly.
They don't get the energy that they need to function
because the energy is coming from the glucose. And you
can imagine the many different types of conditions we see,
not to mention. As this blood high end sugar goes
through the kidneys, it spills out into the urine and
the function. When we have a change in osmodic gradient
and we have all of this concentrated material in the
blood and in the urine to dilute it, the body
starts to deliver more fluid. So these animals get thirsty,
they start drinking more, and that more they drink gets
into the urine along with the high glucose blood and
high glucose urine. And we have these dogs that are
what we call PUPD polyurea polydipsic. They are urinating a
lot and they are drinking a lot. Now, remember we
had talked about earlier about Cushing's disease, which is an
adrenal disease of a hyper secretion of the adrenal gland.
And what did we find as one of the prime
presenting signs was PUPD. So clearly you can see already
our first element of difficulty in diagnosis when that dog
presents PUPD. Also, kidney disease, urinary disease, urinary tract infection.
How can that present also with PUPD. So now we're
getting into that situation where we have a number of
fairly diseases, common diseases that we see frequently that present
with the same presenting sign. So our difficulty now is
to try to determine why is this particular animal PUPD. Now,
one of the telltale signs of a dog with diabetes
type one is not only will it be PUPD, but
when we do a blood test and a urinalysis, we're
going to see very high blood sugar and very high
urine sugar. Now, it's interesting. The normal blood sugar can
be as high as one hundred and ten milligrams for desolator,
sixty is pretty normal. We like to stay between maybe
sixty and ninety, maybe one hundred's okay. Dogs with diabetes
will be well over that, typically four hundred. Sometimes I've
seen it as high as five hundred. But anything above
two fifty passes what we call the urine threshold. So
as soon as the blood sugar gets above two fifty,
now that glucose is spilling into the urine. So when
you start seeing glycoseia, which is the glucose in the urine.
You already know that the blood sugar is at least
two fifty. So that's how we really kind of determine
how frightening is this situation, not to mention as the
whole metabolic process. In these dogs that have chronic diabetes
that has gone unchecked, we will see something called cheto acidosis.
We will see a lot of ketones in the urine
as well, and we will see blood that is acidotic.
It's upset our acid based attic. Now we have a
dog who's not only diabetic, but has what we call
complicated diabetes, and that leads even more problems to our treatment.
So one of the keys simply is that when we
have type one diabetes and dogs, it's insulin dependent. These
dogs will present often with drinking and urinating like crazy.
They seem to want to eat a lot because though
their blood sugar is so high, the sugar's not getting
into the cells. So the body is saying, hey, buddy,
you got to eat more. We need more sugar, not
realizing that that's not the problem. The sugar's there, but
without the insulin, that sugar is not driven into the cells,
and so we have a situation where we can often
get pretty sick dogs. So this can happen at any age.
We see it young to middle age. I've seen it
happen for the first time. It's some older dogs, though
not as common. And it is something that once the
diagnosis is made, once if they are very sick because
of keto acidosis, that we can treat them. We treat
them a little differently. We get them through that phase,
then we can start what we call are testing and
are are regulating. And this is the hard part of titrating,
regulating how much insulin these dogs need. And because of
the often complication of having dogs that have both cushions
and diabetes at the same time, that lends to even
more issues because sometimes now the treatments become almost counter
they counteract each other and leads to some more difficulty.
So we're gonna get to treatment just a second before
we move on to cats and type two diabetes. Still
would love to hear from you about any questions you
may have about this or about holidays, about getting pets
for the holidays, So stay tuned. You'll be back here
with doctor Jeff here on Pet Life's radio, Ask the
bets with doctor Jeff. We'll be back in a minute.
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Speaker 2: Let's Talk Past, Let's done, Pets, Talk about Life.
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Speaker 4: Pet Live Radio dot com.
Speaker 2: And welcome back to ask the best with doctor Jeff
here on pet Life Radio. I'm your host, doctor Jeff
Werber here, coming to live from Park City, Utah, where
it's stunning and we are getting snow, which is making
me very happy. And I'm about to hit the slopes
with my board after the show. And anyway, before the break,
we were talking about type one diabetes melodis. This is
the sugar diabetes that is the equivalent of juvenile onset
diabetes in children, that is an insulin dependent diabetes. And
we talked about the clinical signs, the diagnostics. We're going
to see a lot of urine sugar. We're gonna see blodugar.
We're gonna have a dog that's drinking and urinating like crazy,
often eating like crazy, sometimes gaining weight, and yet starting
to feel really sick. And the more this goes unchecked,
the sicker they get, because, as I said, the sugar,
the necessary sugar to run the functions of the cell,
is not getting into the cell to provide the energy
it is supposed to, and these dogs really start breaking down.
So okay, so assume we have our uncomplicated diabetes, and
that means that we do not have ketoacidosis, and it
is basically a fairly simple caught early diabetes. We need
to start insulin therapy. There are a number of different
insulins out there to be discussed with your veterinarian, which
fits best for you, what he or she has had
the most success with. Personally, for dogs, I'm still a
big fan of what we call humlin n NPH. I
also can use prosinc, while I use that more for cats.
Vetsallin is another one. There's another out there called Atlantis.
But again, there are so many insulin options there you
want to go over those with your veterinarian. But most
insulins and dogs turn out to be twice a day.
I feel lucky. You can get one that might work
once a day, minor usually twice a day. The goal
here is to provide that which the body is lacking.
It's to have you administer injections at home, very easy
to do. It is given subcutaneously, that means under the skin,
and at first, typically what we do is we'll take
a pet in and we will keep them for a
day or two and we'll start the process. We want
to get to the point where we get a drop
in that blood sugar level, maybe down to well, obviously
we want to stay below two fifty because we want
to make sure we're not spilling the glucose into the urine.
Once we're there, at least we know in the ballpark.
Now we got to be careful because, as I'm sure
if you've known people that have had diabetes, they always
walk around with something really sweet, a chocolate bar, some honey.
Because if you end up giving too much insulin or
not eating well, then you run the risk of getting
what we call hypo glycemic, which is low blood sugar
that is not enough because too much of the sugar
was pushed into the cells. And now we have a
situation where we're hypo glycemic low blood sugar. So that's
why it's sort of a dance. It's a delicate balance
between the insulin we're giving and how well it's working
driving that sugar into the cells. And once we're in
that ballpark, we're going to send a pet home with
instructions to give some insulin in the morning, then about
ten to fifteen minutes later, feed and then get on
this twice a day schedule. I like to have them
home for about a week doing this as long as
they're acting fine and monitoring the water intake, making sure
the water intake is coming down, and then have them
come in for what we call a glucose curve. Now,
there are also some urine sticks that can measure urine
glucose to give you an idea if you're still getting
a lot of urine glucose, then the most likely you're
still getting a lot of blood sugar. And also some
nifty little kits that you can prick of a little
toe or the ear, and you can actually measure at
home your own blood glucose, just like people do themselves
when they're diabetic. So there are options to sort of
give you an idea of how much insulin needs to
be done. Now, when we have a complicated diabetes maladoys
where the dog is actually keto acidotic, then that's a
hospital case. That's something that we have to regulate. These animals.
We have to use a special kind of insulin called
regular insulin, first, monitoring them several times a day, and
we have to actually get them well. We have to
take care of the acidosis, We have to get rid
of the keytones in the body and the blood, and
only then then we can have you start with a
regular course of insulin treatment, insulin therapy. It's important that
with a dog, and this is going to be a
little different with cats, as we'll get to when we
talk about cats, is that the pet needs to be eating.
If you have a dog who is an unpredictable eater,
we have to be very careful with the amount of
insulin given because we don't want to run the risk
of giving insulin and then not having your dog eat,
because clearly then we will end up in a situation
where we are going to create a hypo glycemic a
low blood sugar situation in your dog. So for these dogs,
we recommend actually feeding something first, making sure they're going
to eat before you give the insulin. And the insulin
is given every twelve hours, whatever day is you want
it as best you can get on a twelve hour
schedule to deliver the injection, and as your veterinarian will
go over with you, the insulin has to be treated
very delicately. It's when you're given that vile. First of all,
it needs to stay in the refrigerator and we don't
want to shake the bottom. A lot of times that
we have medications that we give that the solute certain
part will dissolvel, will sort of drop to the bottom
in suspension and we need to resuspend. We'll take the
bottle and we'll starting. You can't do that with insulin
because you will de nature destroy the beneficial properties of
the insulin. So your doctor will teach you how to
gently roll the bottle back and forth. And as you're
rolling it back and forth, you're turning it all the
way one hundred and eighty degrees back and forth until
you get it all back into suspension, and at that
time you can go ahead and administer the injection. So
it's something that's very easy to do. What The good
news about diabetes is that if you have an uncomplicated
diabetes and you have the right patient, you're very comfortable
giving injections. That this is a condition just like in people,
that could be controlled for the life of your pet. Now,
let me give you some other complicators of diabetes, and
any of you who had a diabetic pet might have
seen this already, and that is cataracts. And one of
the keys to the developing cataracts is this high blood
sugar and we seem to get a lot of film
and ultimately a cataract formation, and these dogs can often
go blind. So it's another sign that we are having
a unregulated diabetes. And unfortunately, in some dogs, this cataract
formation can happen very quickly. So even though once you're
on track and you're doing a wonderful job regulating your
pets blood sugar, the cataracts have already formed, so that
could be an issue. The good news is the cataracts
can be treated, as can the diabetes. And the worst
scenario is that if you have a dog gets young enough,
you go to see the veterinari alphalmologists cataract surgery that
can be done. They will reimplant a lens that cannot
become cataractus, that can actually improve their vision over what
it was before they even developed the cataracts in the
first place. And so that's a real possibility, but you
have to be aware that that can happen. Now, another
test that we often do long term, and this is
sort of on the newer edge, and I'm sure your
veterinarian will talk to you about this. If you have
a pet that is a diabetic and that is a
fruitosamine when we have regulated diabetics coming in for spot
or you're doing your spot checks at home, understand that
that's a moment in time. You are taking blood at
one moment and you are seeing, for example, a blood
sugar of one to eighty, well one eight for a
diabetic's livable, right, it's less than two fifty probably not ideal.
I'd love to be being around one forty, one, thirty,
one twenty, even one hundred, it would be great. But
the fear is that if you get so low and
you let's say you do a blood test and it's
low one hundred, do you know what it's lowest was?
You don't unless you're gonna do what it's called a
blood curve, a glucose curve. But the frutosamine is a
cool test because frutosamine will give you a broad picture,
maybe covering four to six weeks of blood sugar. In
other words, it'll give you kind of an average, And
if your fructosamine level is within the normal range, that
means you've been doing a pretty darn good job of
regulating overall regulating the blood sugar. So it's just another
way that we can get a really good handle on
keeping these pets under control. So to recap, and I see,
I'm not even getting to type two yet, So we're
going to push off diabetes for two weeks and next
week we're going to talk about type two diabetes and cats.
It's all different ballgame and type two. You can imagine
if you know anyone who's a type two diabetic as
a person adult onset, what they often have in common
is obesity. And i'll explain the link to our type
two diabetic feeline and the obesity issue affecting many adults
people human adults and type two diabetes. We'll get to
that next week anyway, So don't fear if you have
a dog gets drinking and urinating a lot. Of course,
you're going to take them to your veterinarian anyway, and
we will get to the answer as to whether this
is cushings, whether this is diabetes, whether this is a combination,
whether this is urinary track infection, kidney disease. Whatever, we
will get your answer and we will start treating accordingly. Anyway,
I want to thank you for joining me feel Free
this week. If you want to email me to talk
to Jeff at pet Life Radio, go ahead. Thanks again
to our sponsors, pro Sens, Pet Products and Comtoys. And
while you're having a great week, I am leaving here
to hit the slopes of Park City. We'll see you
next week.
Speaker 1: Let's Talk Pets every week on demand only on Petlife
Radio dot com.