Resolved Canine Diabetes!??

RE: Resolved Canine Diabetes!??

Marie Richardson — Mon, 22 Jan 2018 23:27:13 GMT

Hi!

I thought I would update this thread. Her cPLI and ACTH stim came back clear.

After a few weeks her diabetic symptoms returned and she has remained on insulin ever since.

The owners are very grateful for everything we have done and your imput has been useful for discussions with with clients along the way. As to why the brief resolution we are still unclear!

RE: Resolved Canine Diabetes!??

Martin Atkinson — Fri, 07 Jul 2017 14:30:19 GMT

So time to perform a full profile: especially liver, electrolytes, cPL instead of just concentrating on glucose? Maybe not ACTH stim or 17-OHP tests just yet but a urine cortisol:creatinine is easy.

RE: Resolved Canine Diabetes!??

Marie Richardson — Fri, 07 Jul 2017 12:42:40 GMT

Thank you everyone for your posts and support.

Yes, I agree they are more pissed off about the bill than anything else. We've been in contact since and they're courteous and friendly. Just those type that will always find something to grumble about I think! Not particularity bothered. I know clinically we've done just fine.

James, we didn't take a fruct to be fair. Just urine and blood glu, but persistently high for 3 days and 2 glu curves taken. One wasn't timed great so was invalid but still have a drop in glu in response to insulin and an increase of glu after time again, hence the second which was text book.

Martin, I hadn't thought of atypical HAC also. Thanks! will keep this in mind.

KMurphy, We've discussed recurrence as being likely too. Interesting, to hear your story- thanks. We will wait and see.

The O's have been checking urine with dipstick at home. they told me they started feeding treats again and got a glu reading on dipstick. Then cut them out and introduced a grain free, organic diet and have had no glu readings since. Martin, as you said there's definitely something going on underneath!

They don't want diagnostics currently though and the dog seems to be bright and happy so time will tell. As you said, Bob, I'm sure she'll be back when things have become full blown and obvious.

Once again, thanks for all your imput. Time will tell!!

Marie

RE: Resolved Canine Diabetes!??

Anthony Dennison — Fri, 07 Jul 2017 11:06:57 GMT

Was there something underlying causing insulin resistance, which has resolved leading to an apparent diabetic remission?

RE: Resolved Canine Diabetes!??

James Laidlaw — Wed, 05 Jul 2017 22:54:52 GMT

How persistent were the signs at diagnosis, or was the diagnosis based on a single high blood glucose and glucosuria measurement? Potentially other causes could exist for a single high BG and concurrent glucosuria - did you run a FRUCT test or other diagnostics prior to starting insulin?

Sounds like one of those frustrating cases where owners go away and say to do what ever needs to be done, and then complain when you do what you feel is in the best interests of their beloved dog... Usually due to costs. Probably just needs a face to face chat with the owners to explain the situation, testing done, reasons for treatment - all the communication that would be done at the start that they might feel they have missed out on being away and coming back in the middle of things, or indeed at the end of things.

RE: Resolved Canine Diabetes!??

Niall Taylor — Wed, 05 Jul 2017 19:11:21 GMT

[quote user="Marie Richardson"]... the owners are angry that we diagnosed the dog with diabetes when it wasn't diabetes...[/quote]

What makes them think it wasn't diabetes?

Niall

RE: Resolved Canine Diabetes!??

Martin Atkinson — Wed, 05 Jul 2017 17:03:44 GMT

Pancreatitis seems the most likely explanation but dogs don't typically become diabetic with that unlike cats which can. But think about other overlying endocrinopathies like atypical HAC, so keep regularly testing.

If anything stands out from this its this: 'owners are angry that we diagnosed the dog with diabetes when it wasn't diabetes instead of being happy their dog doesn't have a life long serious condition'. Hopefully you're not bothered by this because you did everything right under the circumstances. I suspect they're more pissed off because they came home to an unexpected veterinary bill! Personally I would not be happy with them and suggest that they might be happier themselves with another vet!

RE: Resolved Canine Diabetes!??

Bob Russell — Wed, 05 Jul 2017 17:00:50 GMT

Happens quite often in cats of course but never seen it happen in dogs. Make it clear to the owner that at best this is likely to be remission rather than resolved. In early stages of disease symptoms can come and go a bit before the owner accepts that the dog flooding the floor with pee is not normal!

I suspect it will be back and soon!

RE: Resolved Canine Diabetes!??

KMurphy — Wed, 05 Jul 2017 16:51:26 GMT

I had a very similar case in a Border collie a few years back. We were down to something like 4 units of insulin BID for a 20-something kg dog about 6 weeks after diagnosis. Fructosamine levels were coming back awfully low (approx 250) so we stopped treatment. Three weeks after stopping insulin, a repeat fructosamine was still well within normal limits.

About 4 weeks later, the dog re-presented with hyperglycaemia and very shortly after that developed cataracts etc. She stayed on insulin for her remaining years.

I still don't know how or why that came about. Sorry, not terribly helpful for an explanation but things like this do happen!