Pets with Diabetes: Powell's Story

Powell's diabetes mellitus was diagnosed in March 2000, when he was 5 years old. His diabetes is under control now, but we've had our share of bumps on the road, and I expect we'll have more. I think that our experience has been pretty good overall, in no small part due to our careful and consistent efforts.

He had a rough beginning this Spring, though. He was diagnosed when his BG was about 510 as I recall. We were on our way out of town for the weekend, so our vet kept him to begin his insulin, observe him, and do additional BG curves. Unfortunately, it appears he was started on the last vial of Iletin available anywhere in the country, so an additional round of adjustment was required at the beginning of June, when it expired and we switched to Humulin NPH.

Even worse, Powell's urethra was blocked by bladder stones on the Tuesday following the initiation of his insulin therapy. He required a visit to the doggy ER that midnight (our local vets cooperate on an all-night emergency clinic), then surgery the next day, all before we had his BG under control. That was scary for us, but in fact he did very well, despite not being able to have prednisone, which I understand is normally used to control swelling for the bladder surgery. He has been a real trooper through it all.

We had a second bout of trouble in late May/early June when we found a fast-growing tumor on Powell's rear end, about an inch away and at about the same level as his tale base. Our vet did a needle biopsy and found it to be a MAST cell tumor, something not found in humans (and not a bad problem for cats) but a malignant and sometimes very fast growing tumor in dogs. She was able to successfully excise it without involving his sphincter muscle and again he did extremely well post surgery. Unfortunately we had a bump on the road to recovery as we switched his insulin at the same time, but he did well with the change (after bringing him up from 6 to 9 units of Humulin NPH) and now is doing fine.

We have him on a closely controlled low fat and moderate fiber diet, using Hill's Prescription Diet (canine w/d) to help control both the stones and his diabetes. It took some adjustment and calculations of how much food he should receive based on his weight and the calories he needed, along with close observation of his behavior for signs of satiation & appetite, etc. At first we tried to keep the two dogs on separate diets, but neither one tolerated the thought of being treated differently very well.

Now we feed them both the same thing, one half can of wet food plus one quarter cup of dry food in the morning, and one cup of dry food (each) in the evening with an additional low fat biscuit most nights.

Regular scheduling of walks, feeding, insulin, etc. seems to have served him well. He seems to tolerate the needle sticks well, though the week after his second surgery he passively resisted to the best of his ability. Normally he now jumps up on a kitchen chair and sits to let me or my wife inject him. We don't do any home BG tests, but any time he appears to be urinating abnormally we've taken him in to the vet for a new BG curve. We went through perhaps ten cycles of increasing his dose very conservatively and rechecking his curves before we got him up to his current 9 units, which so far has served him very well. Knock on wood, but he's never had an episode of insulin shock. Our goal has been to keep him under 200, which he was at last check-up.

I hope Powell's case doesn't sound too unrealistically successful. I was trying to "accentuate the positive" in reaction to what seems to be a bias toward hard-luck "war story" accounts that owners often read. Maybe we've just been lucky, but I'd like to think that part of Powell's success is attributable to consistent and careful management using the standard, tested, conservative techniques recommended by his vet.

Upadates

May 2001
We had a bit of a rough time with Powell this past winter. He had shown signs of bladder stones on an x-ray in January, but in fact none were found during an operation despite the same images appearing on the post-op films. Possibly there is some calcification within the bladder wall? We don't know, and haven't done an ultrasound, which we are told might clarify the situation. Both he and his sister (who also had bladder stones) now take Eurocit to alkalize their urine, and this seems to be effective.

Since the surgery, Powell has done very well. He always seems to require less insulin post-op. I think he was down to 4 units or so immediately afterwards (before surgery he was at 14 units, which he is now back up to about 4 months later). Anyway, the vet tells us that of all her diabetes patients, Powell has had the fewest problems and appears the best managed. We are grateful that he has done so well in the year (and two months!) since he was first diagnosed.

September 2001
We've been teaching my parents to care for Powell and to give him his shots in preparation for a ten day vacation. Luckily our vet is very helpful and will act as a backup, with one of the techs willing to be on call for assistance the whole time.

March 2005
I was just realizing the other day that this month (March 2005) marks Powell's 5th year post-diagnosis.

We've had our ups and downs, but overall Powell is under good control. Possibly our biggest challenge was with his unrelated bladder stone problems (a trait shared by his female litter-mate "sibling" Mason). We contacted an endocrinologist at the university Vet School some time ago and got some good advice: treat the stones by limiting oxalates in the diet, then use insulin to control the diabetes. We switched the dogs food to Royal Canin "Urinary LP 18" (formerly made by Waltham--they were very responsive as we inquired about lots of specifics regarding carbohydrates in the formula, Hill's Science Diet was NOT). So far (after about 2 years or so) this has been a very successful strategy.

Powell currently gets 60 grams of dry kibbles per feeding (6 a.m., 6 p.m.), followed in about 30 min. by 14 units of NPH Humulin insulin. He gets a small treat before bed that we make at home to avoid wheat and other oxalate containing ingredients. We make a big batch about once per month. They're small but greatly appreciated every single time!

We're still not without problems. Powell seems not to have much appetite in the morning, when we are often in a hurry to get to work. We coax him to eat so we can give him his shot. This is worse if there is any other health problem going on (especially G.I. related--he's a chewer) or if he has to be on any other medication at all, it seems. He's had a half-dozen or so hypoglycemic incidents at unpredictable times in the last year or so. Luckily, we've been at home and recognized his symptoms each time up until now. The red gel tubes of glucose available at the drug store are available in several places in our house and he's responded well to this, followed by a treat when he can eat it. At some point we probably won't be there when this happens, but at this point we are comfortable knowing that we've given him five good years so far since he was first diagnosed.

-- Contributed by Dan R. and Ann G.

	Powell's Story