Diabetic dog

Re: Diabetic dog

Martin Atkinson — Thu, 05 Sep 2013 12:48:00 GMT

[quote user="Christina Smith"]

Martin, I'm guessing that you have castrated DM patients and not experienced problems. Did their insulin doses need readjusting and if so how soon after the op?

[/quote] I don't recall having castrated a DM patient I confess but I would have thought the hormonal effect would be wearing off after 2 weeks. So I would be monitoring expected nadir and peak glucose levels maybe every couple of days and maybe do a curve once a week for couple of weeks as I would after any dosage change after that just to see. It would be interesting to see how it goes, but its got to be a better option that giving depot progestogens which will surely degrade at an unknown rate and cause instability many times over not just the once.

Re: Diabetic dog

Christina Smith — Thu, 05 Sep 2013 11:38:14 GMT

[quote user="Martin Atkinson"]/quote] I would be far more concerned with treating this hormonally as you will be giving a steroid progestogen which will completely unstabilise your DM and probably make it worse (indeed progestogens are IME a predisposer to DM). At least with castration if there is a change in dose required it will be once and for all and easily stabilised.[/quote]

Any votes for suprelorin implants as a safer bet, in view of the ferret cushings indication? Martin, I'm guessing that you have castrated DM patients and not experienced problems. Did their insulin doses need readjusting and if so how soon after the op?

Re: Diabetic dog

Martin Atkinson — Thu, 05 Sep 2013 10:23:18 GMT

[quote user="Christina Smith"]

Thanks for your answers. My concern is the change in hormonal status ie the steroid effect due to the withdrawal of testosterone and if that is likely to alter insulin requirements. Has anyone had any problems post castration?

[/quote] I would be far more concerned with treating this hormonally as you will be giving a steroid progestogen which will completely unstabilise your DM and probably make it worse (indeed progestogens are IME a predisposer to DM). At least with castration if there is a change in dose required it will be once and for all and easily stabilised. Never worried about problems with GA in a DM patient, as suggested half dose the morning its starved and monitor glucose pre and post op., or don't starve, just get your ET tube in fast and don't remove until its coughed out but explain the relative risk/benefits to both approaches.

Re: Diabetic dog

Christina Smith — Thu, 05 Sep 2013 09:39:59 GMT

Re: Diabetic dog

scatty — Wed, 04 Sep 2013 23:17:27 GMT

[quote user="Elisabeth Knappett"]

2nd the castrate and remove adenoma at the same time, first op of the day to prevent prolonged starvation and feed on recovery. Half dose insulin in the morning (if on BID). Has worked fine for me in the past.....

[/quote]

Good point about first op of the day Elizabeth! I have also done 'no insulin in the morning'. Could see how half dose insulin would make sense though. My rationale was to try and minimise the chances of hypoglycaemia. However, maybe its best to run a pre - op glucotrend and go from there??

Re: Diabetic dog

Elisabeth Knappett — Wed, 04 Sep 2013 20:12:38 GMT

Re: Diabetic dog

Thomas Johnson — Wed, 04 Sep 2013 15:59:31 GMT

[quote user="Christina Smith"]

Reasonably stable diabetic miniature schnauzer.11yo intact male has recently developed a small anal adenoma, occasionally bleeds. My question is should I castrate or treat with anti-testosterone drugs or just remove the adenoma?

[/quote]

As long as the diabetes is reasonably stable it wouldn't affect my decision on what to do. I would probably remove the adenoma and castrate the dog at the same time.