November is Pet Diabetes Month. Oh, the irony!

[Originally posted November 8, 2009]

pdm-logoVia my alert pal Constance B. Riggs, a dietitian who focuses on human diabetes at her excellent Eating Soulfully blog, I just discovered that November is Pet Diabetes Month. I’d always wondered who comes up with those designations and now I know: Drug manufacturers who want people to use their products. Yes, the trail through various tweets and blogs led me to discover that the designation had been made by Schering-Plough, the manufacturer of Vetsulin which, the FDA announced in early November, is defective. I blogged all about it a few days ago; see The Vetsulin Crisis: Cold Comfort.

I guess once you publicly dedicate a month to a disease, you can’t take it back.

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The Vetsulin Crisis: Cold Comfort

[originally posted November 4, 2009]

On November 2, the Food and Drug Administration published the following notice about the drug that I depend on to regulate Frankie’s diabetes:

The Food and Drug Administration’s (FDA) Center for Veterinary Medicine (CVM) and Intervet/Schering-Plough Animal Health are alerting veterinarians and pet owners that Vetsulin®, a porcine insulin zinc suspension used to treat diabetes in animals, may have varying amounts of crystalline zinc insulin in the formulation. Because this Intervet/Schering-Plough Animal Health product is out of specification it could cause a delay in insulin action and an overall longer duration of insulin activity. Products having significant problems with stability can affect the management of chronic diseases. Unstable insulin products can result in unpredictable fluctuations in the glucose levels of diabetic patients. Intervet/Schering-Plough Animal Health is unable to assure FDA that each batch of their product is stable.

While Intervet/Schering-Plough is working with FDA on resolving this issue, supplies may be limited. Therefore, veterinarians should consider transitioning their diabetic patients to other insulin products. In addition, FDA encourages veterinarians to report any adverse events with the Intervet/Schering-Plough Animal Health product to the company through the Technical Services Department at 1-800-224-5318.

My first response to the notice was, I’m embarrassed to report, a sense of vindication. I’d told one of the vets in the practice I go to that some bottles of Vetsulin seem to be more effective than others. She scoffed at me, saying I was the only one to report that, and that perhaps I wasn’t giving the shots uniformly. Ah, vets who question owners’ ability to deal with canine diabetes… we’ve been there before (see Showdown in the Canine Diabetes Corral).

But as the implications of the problem set in, that I might have to try to get Frankie adjusted to another type of insulin, I realized this was the kind of cold comfort I experienced with my recent robbery — I’m not crazy, I really was robbed — and akin to the old joke about the gravestone that reads, “See, I told you I was sick.”

Update 1: My vet suggested that I research the Canadian version of Vetsulin, called Caninsulin, to see if it was affected. After calling a Canadian pharmacy that was clueless — and discovering that, for some reason, Caninsulin doesn’t require a prescription — I went to the best resource for all things relating to diabetes in dogs: the forum at k9diabetes.com. The bad news: it’s a global problem with all products, including Caninsulin, coming from Intervet/Schering-Plough, based in Germany. I think that, for the time being, I’m going to stockpile Vetsulin, which has worked fine as long as I continue to do glucose testing. But, as I’ve often said, it’s not my intention to discuss medical issues here — and there’s no reason to, when k9diabetes.com does such a great job.

Update 2: From Natalie, administrator of k9diabetes.com.

I spent a fair amount of time this morning alerting clinics I’m familiar with regarding the Vetsulin issue. Many did not yet seem to be aware of it. Only one thought I was trying to sell something ;)

Your readers could do a great service to diabetic dogs and cats by calling to alert their own veterinarians regarding this issue in case they do not hear about it through other channels.

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Showdown in the Canine Diabetes Corral

I’ve been stewing the last few days about a discussion that I became involved in on a veterinary blog. No point naming names. It’s a vet for whom I have a great deal of respect — which is why I read her site daily.

In this particular case, I felt that she had conflated canine and feline diabetes — which are very different — in an overly simplistic fashion, linking both to obesity. So I made what was, in turn, perhaps an overly simplistic comment: That canine diabetes is akin to Type 1 diabetes in humans, and thus not linked causally to obesity; whereas feline diabetes is similar to Type 2 in humans, which means that diet can be implicated as a source of the disease. I mentioned that I had a diabetic dog who was never fat and (more tangentially) that I had written on the topic.

Boy, did I get jumped on! I was accused of  being an owner who extrapolates from a single sample (my dog) to a larger — and dangerous — principle, i.e., that I was letting people off the hook for letting their dogs become obese.

Two things I should make clear before I go further: I later got — and accepted — an apology for the tone, if not the content, of the vet’s comments. And as an unknown poster, there was no reason she should have recognized me as an authority on anything.

As it happens, though, I know a lot about the topic and from genuine authorities: world experts in canine diabetes whom I had consulted for a story that I wrote for Your Dog, the newsletter of the Cummings School of Veterinary Medicine at Tufts University. It’s coming out in the upcoming (November) issue. I wrote a little about my research — mostly about a great study for owners of diabetic dog owners being conducted in the UK — at this post, which features the gorgeous (and not fat, as far as I can tell under all that fur) Miss Jasmine.

Co-poster dog for canine diabetes (with Frankie)

Co-poster dog for canine diabetes (with Frankie)

And I never, ever condone canine obesity. There’s no excuse for endangering your dog’s health by overfeeding her.

On the other hand, this being a guilt free zone for good dog owners and all, people should know that there is a genetic predisposition for canine diabetes (as well as for feline diabetes, although it manifests differently). Yes, obesity exacerbates the condition, but doesn’t cause it. So if you have a diabetic dog and you’ve fed him good food, given him plenty of exercise, and kept him trim, don’t beat yourself up.

The other issue, which I obscured by mentioning obesity, is that dogs and cats are different. This should be obvious, but the vet’s post lumped the species together. I can’t tell you how many times people have told me “Oh, I had a diabetic cat and she was cured by diet” or “My friend had a cat with diabetes and he never got cataracts.” Such comments initially, i.e., before I read more extensively on the topic, gave me false hope about Frankie’s potential for a cure — and nonpotential for cataracts.

So let me be clear: Dogs must be on insulin, twice a day, no matter what diets they’re put on. And no matter how well regulated they are, they may get cataracts. That’s part of the way the disease manifests in dogs, but not in cats.

The discussion ended reasonably amicably, with me making the final points about the difference in cats and dogs and being assured, on the site and in the back channel apology, that it “wasn’t personal.”

That’s actually what I’ve been stewing about. It wasn’t personal to the vet, who wasn’t insulted on a major site, having her integrity as a researcher assailed. And who isn’t the owner of a diabetic dog who gets subjected to a lot of misinformed comments about her dog’s weight — or lack thereof — and its correlation with diabetes, as well as with lots of comments about cats that don’t apply to her dog.

Two good things came out of this discussion, however. I became re-aware of  k9diabetes.com because the creator of that site defended my position in the comments section of the vet’s blog. It’s a great site, which hadn’t been fully operational when Frankie was diagnosed. I highly recommend it to everyone whose dog has diabetes.

And (duh) I also realized that I have a forum too: This blog. It may not be as well trafficked as the one on which I posted my comments, but it has some loyal readers who know that I’m a thorough researcher and would never disseminate misinformation. And that it’s not my fault that Frankie has diabetes.

Update: Natalie, the creator of the k9diabetes.com site I mention above, weighed in on this discussion in the comments section; she had a similar experience with vets to the one that Susanne — the owner of the gorgeous pup pictured here — had. It’s hard to imagine that anyone would discourage home blood glucose testing — whatever helps monitor your dog’s health, I say! — and considered “not having accidents in the house” a criterion for being regulated. Yikes.

I also want to invite Natalie — and any owner of a diabetic dog who has a story that might help other owners cope — to write a guest blog. Early on, I posted that Frankie is a dog, not a disease, and that I don’t want to devote this site to illness. That’s still true. But I want others to know they’re not alone, especially when it comes to questioning the advice they get from “experts” who may not have expertise in this particular area.

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Pet Insurance, Part 2: Jasmine’s story

Today I’m turning my blog over to Susanne Fritz, my Aussie pal who takes care of the lovely Jasmine. I’ve introduced Jasmine before; she’s the pup who is “diabetic and loving it.

The lovely Miss Jasmine

The lovely Miss Jasmine

As I’ve mentioned, with 20-20 hindsight, I wish I had insured Frankie when he was young and before he was diagnosed with diabetes. You’ve seen my vet bill in my first post on this topic. And if you’re thinking you would have  set aside money each month for such emergencies as occurred with Frankie — well, you’re a better (or perhaps richer) person than I am.

Just so you know: I compared my own research in the U.S. with Susanne’s and policies/circumstances are very similar. I’ll add a few of my own things to look for at the end, based on the research I did for my new book, Am I Boring My Dog.

Susanne’s story

“Should I get pet insurance?” you may be wondering. Everyone’s circumstances are different, but from my experience I say YES! It is absolutely worth it. You see my dog Jasmine, like Frankie, has diabetes, but fortunately my insurance covers a large portion of the ongoing costs for her treatment. In the last two years since Jasmine’s diagnosis, I have definitely come out ahead.

I originally decided to insure Jasmine as a puppy because I knew she would grow into a very large dog (currently she weighs in at over 100 lbs), and realized if something went wrong it would be costly. I did not want to find myself in a position where I could not provide her with treatment she may need in an emergency due to expense.

When deciding if pet insurance is worth it, consider that the recent advances in veterinary medicine have been huge. Many treatments available in human medicine are also available to pets; in fact, they are often first developed using animal models. Your pet can get chemotherapy, MRIs, even kidney transplants, but these technologies are not cheap.

If your pet falls ill or has an accident and needs to go to an emergency vet hospital after hours, you could be up for over $1000 a night for intensive emergency care and monitoring. Could you afford this?

Vets would love it if more of their patients were insured, even though it creates additional paperwork for them filling in claim forms. They want to do what is best for an ill animal, but all too often they are limited in their treatment options, or have to euthanize a treatable patient due to the financial situation of the owner.

When I first insured Jasmine nine years ago, the pet insurance industry was relatively new and policies were generous, offering a lot for your money. Over the years the industry has evolved, and in the name of profitability companies have added deductibles and exclusions to their policies. This makes it important to carefully read the policy to understand what is and isn’t covered before signing up.

All policies will have good and bad points, so you will need to weigh these up, decide what you expect from the policy, and see if it meets your expectations.

Most companies offer various levels of insurance, such as accidental injury only, or accident and illness, or accident, illness and routine care. Routine care options provide some cover for routine veterinary expenses, like vaccinations, parasite control, microchipping, and neutering.

Among the questions you should consider when researching pet health insurance:

Does the policy have a deductible?

Most policies have a “condition deductible.” For example, my policy has a condition deductible of $50, so I cannot claim on the first $50 in vet fees for a condition. This is only payable once per condition, so if it recurs or is ongoing I do not have to pay the deductible again for the rest of the policy year. I do have to pay it again for any new conditions, and when I renew the policy each year the deductible is payable again. Often companies will offer lower premiums if you agree to a higher deductible; conversely, you can pay higher premiums to lower the deductible.

Are there exclusions?

Invariably the answer will be yes, and factors like the age and breed of your dog may determine what these are. Some policies do not cover breed specific hereditary diseases, and you will need to get more information from the company website or speak to an agent to find out exactly what this will mean for your breed of dog. For example, hip dysplasia may be covered for some breeds, but excluded in others, such as German shepherds, who are at high risk of developing the disorder. No insurer will cover you for a condition that existed prior to you taking out an insurance policy.

Other exclusions may include preventable diseases, that is, those for which routine vaccines are available. Pregnancy-related expenses and nonessential procedures are other common exclusions. An exclusion on my own policy is they will not cover stem cell therapy. This did not concern me a few years ago, but there is now a new stem cell treatment available here in Australia for treating arthritic dogs which looks promising. If it was something I thought Jasmine might benefit from in the future I would not be able to make a claim on it unless the insurance company changes its stance.

I can’t stress enough to be aware of exclusions; they will vary between companies and between breeds, so make sure you are not paying good money for a policy that covers your particular breed for very little.

Does the policy cover all or part of the vet bill?

Most insurers only cover part of the vet fees, say 70 or 80%. This is in addition to the deductible, and again you can often make this amount higher or lower by increasing or decreasing your premium.

What are the age restrictions?

Most insurers have age limits on new policies, and will not accept older animals — usually over 9 years old — as new clients. A pet insured continuously from a younger age, however, should be eligible to remain insured for its entire life. The company I have Jasmine’s insurance with has just changed its policy for illness claims: For dogs over 7 years old they will only reimburse 70% of vet expenses. For dogs younger than 7 they will continue paying 80%.

What are the annual limits and sub-limits?

Insurers have an annual limit on what they will pay out on a policy, and within this limit there may be sub-limits, such as condition limits – where they will pay up to a set amount for a single condition; and medication sub-limits – only a set maximum amount will be paid each year for medications.

Do they pay the vet directly, or are you expected to pay the vet and then the insurance company reimburses you?

What are the payment options?

Usually you will have flexible options allowing you to pay annually, 6 monthly, or monthly to make the premium costs more manageable depending on your circumstances.

There may be other extras included in policies, and these will differ between companies. i.e. Jasmine’s policy will pay for her to stay at a boarding kennel for up to two weeks if I am hospitalized.

My additions

Other things you should look for in a policy include:

Choice of veterinarian

Most plans let you see anyone you like; others are similar to HMOs, limiting you to certain health-care providers.

Waiting period

There’s usually at least a 10-day wait so that people don’t sign up immediately after their dog leaps off a precipice. Check and see when a policy will take effect–and watch your pup like a hawk until then.

Prescriptions

You often end up spending far more money on medicines than on office visits and services, so be sure your plan offers good coverage.

Specificity

You’ll find plans that say they reimburse you for “reasonable and customary fees.” That’s way too much wiggle room. You’re far better off with an insurer that provides a chart detailing what you can expect to get back for what you pay out.

Rate guarantee

Some companies adjust their premiums on a quarterly basis; that means if they pay a claim they can raise your rates in the next period. Make sure the company you choose offers contracts for at least one year, with no fee-rise adjustments if you submit a claim.

Renewability

You want a plan that doesn’t consider a condition diagnosed after you first contracted with the company as pre-existing, and thus as a reason for not renewing your insurance.

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The death of the world’s oldest dog

I suspect I’m not the first author to experience post-partum depression after giving birth to a book. There’s a sense of let down. The joy of seeing the book in print and, in my case, the fun of getting the promotional videos produced and posted…. that’s done. There it is, a physical artifact, small but all powerful to affect your moods. Will others love it, you worry? Be cruel to it? Ignore it?

And then there’s the big Now what? The only answers I can come up with: Selling the book.  Selling yourself.

Aargh.

It didn’t help that, just before the big day, my dog, my muse, the reason the book exists, got sick. Really sick. Hooked up to an IV sick. People joked that Frankie was getting pre-publication jitters. I laughed, but the possibility that it might be true nagged at me. Had I imparted my stress to the little guy?

It’s in this context that PeoplePet.com‘s report on the death of Chanel, who won a place in the Guiness World Records as the World’s Oldest Dog, hit me a bit hard.

It’s not that I felt she’d been taken prematurely. Who could argue with a lifespan of 21 years? No cause of death was offered — no surprise — but I knew  Chanel had been healthy as recently as May. How did I know? Because Chanel had her 15 minutes of fame back then, when she did the rounds of the talk shows for her 21st birthday.

Chanel, RIP

Chanel, RIP

I blogged about Chanel, calling her the world’s oldest fashionista – this was still a dog fashion blog then — and citing her appearance on the Today show with Matt Lauer and Meredith Viera.

But it’s not just that I felt I knew her that created my dismay over her death, though that was part of it.

It’s that I worry it was her public appearances that did her in. Bright lights. Bad food. Too many people disturbing her much needed — hey, she was very very geriatric — rest.

And that, by extension, I’ll destroy Frankie’s precarious health if I take him with me on book tours.

He’s a shy guy. He hates car rides. And I’ve never even taken him on a plane. Not to mention, he has diabetes.

Forget Am I Boring My Dog? Am I Killing My Dog? is more to the point.

And now that I’ve put it out there, it seems absurd.  At the moment, the only thing I’ve got lined up are appearances at local book stores and resorts.

And, after all, this blog supposed to be a guilt-free zone for good dog owners.

So I think I’ll put my worry about the harm I’m doing Frankie on hold until either Ellen or Oprah invites me to be on her show.

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The best medicine

One of my favorite books about animals is Tell Me Where It Hurts, by Dr. Nick Trout. Compressing a great many cases into one day of veterinary ER drama, Dr. Trout’s book is not only passionate, well written, and poignant but it explores our central frustration when dealing with illness in animals: They can’t express themselves.

Tell Me Where It Hurts

I’ve been thinking a lot about that book today because Frankie is in a veterinary hospital, being prodded and poked and hooked up to IVs. He got himself there by vomiting voraciously (on my rugs and in my bed, where else?) and pooping prodigiously (happily, in my backyard).

This is worrying under the best of circumstances, but when diabetes is involved it becomes even more complicated: You have to balance the need for insulin with the need not to cause hypoglycemia by giving shots on an empty stomach.

Then there are the pancreatitis, liver problems, urinary tract infections… all conditions associated with diabetes, all rather worrying.

But until I get medical answers — which won’t be until tomorrow morning at the earliest — I’ve decided I like the suggestions that several of my friends on Facebook made about the causes of Frankie’s disease:

  • That he is nervous about the imminent publication of my book. My nervousness tends to manifest in overeating rather than in vomiting and diarrhea but sympathy symptoms do not have to be identical.
  • That he is suffering from air sickness as a result of all that hot air balloon travel. Given his latest venture, into the oxygen-deprived atmosphere of outer space, I don’t think that’s an unreasonable hypothesis.

The entries that people have been sending in to my Win A Copy of Am I Boring My Dog contest have also been restorative — to me, if not to Frankie. So keep ‘em coming.

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The Dog Food Debate: Opening Up a Can of Worms

I don’t mean the title of this post literally, though fresh worms would be an improvement over the ingredients contained in  some dog food. But a discussion on Twitter — if you can call a series of 140-character bursts a discussion — spurred me to venture into the arena.

When it comes to dog food, I believe in two key principles.

Different people and different dogs have different needs, both in terms of time, budget, and health requirements. Do the best you can.

Freeze-dried, raw, and home-cooked food are great for some dogs and some people but not for others. When Frankie was diagnosed with diabetes, I consulted several holistic vets to find a good diet to supplement the insulin shots. Frankie didn’t like the freeze-dried fare that the first one recommended. I don’t know whether it was the consistency (mushy) or the taste; Frankie didn’t wish to discuss it. I didn’t particularly like the food either: It took 10 minutes to reconstitute itself in water — far longer than it took me to reheat the fresh food I’d been preparing.

As for the fresh food, after reading several books and consulting with nutritionists, I was still struggling with finding the correct proportions of cooked tepary beans — a high protein Native American bean that’s effective for diabetes in humans — meat, and vegetables to feed Frankie. I was relieved when the second holistic vet I went to for nutritional advice suggested a good brand kibble (more on which in minute) topped with lean meat, plus a supplement. It made my life easier and Frankie was happy to have the kibble crunch back.

Doing the best you can doesn’t include feeding most commercial foods, even the so-called premium and science diets.

Commercial dog food manufacturers and puppy mills have two things in common: They are regulated by government agencies that operate on a lowest common denominator basis.

Many vets –- including my primary, nonholistic one, who I’m crazy about – warn patients away from food that isn’t approved by the Association of American Feed Control Officials (AAFCO), the organization that establishes standards for nutritional balance in all kinds of animal feed, not just pet food. I won’t go into the limitations of the trials used to establish those standards, or discuss which pet food manufacturers are on the board of AAFCO. For the purposes of this post, suffice it to say that balanced doesn’t necessarily mean healthy.

Corn byproducts, preservatives, and taste enhancers like salt or artificial sweeteners are common in most commercial brands, which spend more money on advertising than on high-quality ingredients. And the “crude protein” requirement, to use one example among many, says nothing about digestibility, so the protein source could be old shoes. Or dead dogs. As long as the label is vague enough — listing  “meat” or “animal,” as opposed to “chicken” or “beef,” for example — there’s no problem. It’s okay to include substandard ingredients if you don’t lie about it.

You can spend hours trying to decode the different ingredient listed on labels, a kind of canine Da Vinci Code. The Dog Food Project, the source of a good deal of my information about AAFCO and its labeling/nutritional requirements, can show you how.

Or you can buy better quality dog food, whether in kibble, canned, or freeze-dried form.

Cost? Pay now or pay later, with higher vet bills because of food allergies or — in the cases of brands that have been recalled because of melamine or salmonella tainting — heartbreak.  I’m not saying that plenty of dogs don’t do fine on commercial food. But why take the chance?

The Whole Dog Journal has done the work of evaluating a great many high-quality brands, and publishes annual reviews of different varieties (discounted for subscribers).

Of course, as anyone who watches or reads the news knows, the problem is by no means restricted to dog food. Tainted peanut butter, spinach, meat… I could go on and on. My only point is that it’s worse in dog food, which is even less closely regulated than the human variety. If you’re interested in details, read Pet Food Politics: The Chihuahua in the Coal Mine, by Marion Nestle; or check out her Food Politics blog.

And yes, I’ve devoted a chapter to the topic of dog food in my new book, Am I Boring My Dog.

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Diabetic and loving it? Yes, says an Alaskan malamute

At first, she seemed like just another Twitter dog; great looking, I’ll grant, and with an exotic home base in Australia, but not otherwise distinguishable from the pack of tweeting pooches. She was a dog without a blog, unaffiliated with either a pet business or  rescue organization.

But a phrase in the short biography of Jasmine_woo_woo, an Alaskan malamute, caught my eye: “Diabetic since 2007 (and loving it!)”

What an odd and interesting thing to say, I thought.  Frankie is diabetic and more or less tolerating it. What could Jasmine’s owner possibly mean?

Wanting an explanation that went beyond 140 characters, I sent a direct message with my email address. And thus began a beautiful intercontinental friendship.

Jasmine Woo Woo, love hound

Jasmine Woo Woo, love hound

Jasmine, it turned out, was loving her disease — or, rather, the attention that it brought her. Susanne, the self described “administer of the insulin,” wrote, “Jasmine has taken everything in her stride; she is very people oriented, which means she absolutely loves getting attention, even if it is from vets doing yet another blood glucose test.”

Jasmine may not have minded her disease in the least, but some humans seemed to be of the opinion that her quality of life and Susanne’s were somehow substandard (just as happened with Frankie; see May 28 post). People asked, “Wouldn’t it be cheaper/easier to just get another dog?”

Right.

Susanne and I also shared the experience of being humiliated by our dogs’ pee collection routine. In response to the July 3 post on this blog, she commented, “Can totally relate — the only time Jasmine will reliably pee is on her walk. She will happily lead me round the backyard for half an hour and not give anything up, but a walk halfway down the street yields pee everytime! Am sure the neighbours think I am obsessive compulsive collecting not only poo, but pee as well. I imagine them saying, ‘Such a lovely dog, not too sure about her pee toting owner though…’”

But we didn’t only share comforting and amusing anecdotes. One of the things besides curiosity that spurred me to contact Susanne was that I was writing a story on canine diabetes for Your Dog, the newsletter of Cummings School of Veterinary Medicine at Tufts University. To help me with my research, Susanne sent me a very useful link to a survey being done on owners of diabetic pets by the Royal Veterinary College, University of London — part of a study that is likely to provide invaluable information on the topic when completed.

I tracked down the head of the project, Stijn Niesse, DVM DipECVIM-CA MRCVS, European Veterinary Specialist Internal Medicine. While he did not want me to publicize the link to the survey — to prevent misuse and entering of false data– he suggested that diabetic pet owners could contact him directly at sniessen at rvc.ac.uk for more information.

Naturally, Jasmine and Susanne both ended up in the story, too. Jasmine and Frankie will give a face — well, two, and mighty attractive ones at that — to canine diabetes in the article, due out around October.

When I thanked Susanne for posting the bio that started the whole discussion, she wrote back, “You know when I set up Miss Jasmine’s Twitter account I only threw in that Jasmine was a diabetic at the last moment. I did not want people thinking she was sick, because at the moment with it being well managed she is not unwell at all. But then I thought maybe there are people out there with diabetic pets who may be struggling with it a bit, and may like some encouragement from someone else in the same situation. Or there may be people who have just had a pet diagnosed and need some reassurance. And so here we are!”

Indeed. Thanks again, Susanne. And live long and prosper, Jasmine Woo Woo, you gorgeous girl.

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The pee strip chronicles: San Diego

Picture this. You are enjoying a relaxing drink, perhaps some appetizers, on the outdoor patio of McCormick & Schmick’s, an upscale seafood restaurant at the Omni San Diego in the trendy  Gaslamp Quarter. You spot a small dog lifting his leg on a strip of grass flanking the sidewalk directly in front of you. Not a big deal. Nature calls, it’s a cute dog, and the performance is oddly acrobatic: you’ve never seen a dog take such an extended, three-legged pee.

But during this golden showers show, the woman accompanying the pup fumbles in her large black tote, takes out a kidney-shaped glass dish, and places it under him. She then proceeds to transfer the urine she’s collected into a jar with a top, giving the original glass dish a cursory wipe with a napkin before bundling everything (except the dog) back into the bag and scuttling away.

At best, you experience amusement; at worst, a loss of appetite.

I am, of course, the fumbler responsible for this humiliating display. Welcome to my first post-diabetes vacation with Frankie.

Here’s the thing. In order for me to administer the correct insulin dose, I use Diastix strips to test Frankie’s urine glucose levels. Usually I do it in the privacy of my backyard, bringing the glass dish (a former ashtray, only kidney-shaped by coincidence) inside and letting the microwave timer count off the requisite 30 seconds for the test.

Lacking a watch with a second hand or anything else to measure off the time in San Diego, I’ve devised this elaborate scheme for bringing the pee back into our hotel room, where, I’ve discovered, my laptop has the requisite clock.

Yes, the stretch of grass Frankie chose was the closest to the hotel entrance and I’m pleased he didn’t take me on a long excursion away from the hotel. That said, I’m convinced he took pleasure in finding a spot that was maximally embarrassing to me; it’s a mischievous terrier trait he’s perfected at home and, I’ve now discovered, can take on the road.

But the story gets even more embarrassing.

Back in the hotel room, when I told my friend, Clare,  about Frankie’s urinary exhibitionism, she asked me why I have to go through the complicated glass jar transfer process. “Why can’t you just put the urine test strip in his pee stream?”

I explained the need for the 30 second computer count.

Clare was still perplexed. She believes I am a smart person — in fact, I often depend on her to assure me of this.”But can’t you just count to 30?” she asked.

Now why didn’t I think of that? I can’t really explain it, except that I have a tendency to ignore horses in favor of zebras when seeking solutions.  So instead of streamlining the pee strip process, as it were, for my trip, I complicated it by adding steps.

I’m sure this story has a moral, perhaps one involving the need for fresh perspectives — and vacations. Then again, I’ve started visualizing Frankie deviating from his usual balletic routine and making a sudden turn, while I squat, test strip in hand. He too will adjust his behavior and take his perverse terrier pleasure by peeing on me.

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Car travel, Part 5: Why driving won out

I let my reservation on Southwest from Tucson to San Diego lapse because of:

Money

Part of it is my fault. I came up with the idea of flying too late to be eligible for the 14-day advance fares that ordinarily make the trip from Tucson to San Diego so appealing on Southwest. But no matter how far in advance you book, flying with a pet on Southwest adds $150 round trip (plus tax) to the fare, which makes it a far pricier proposition. Another no-frills carrier, Jet Blue, charges $100 each way to let you tuck your small dog or cat under your seat. Note to airlines: Frankie can’t be both carry-on baggage (as his “in lieu of” status was described to me on the phone by the very nice Southwest rep) and a frill.

In addition, I would have to pay for a rental car. San Diego’s not a city you can easily navigate without your own wheels. And with a pup in tow? Not an option.

Hassle

The flight to San Diego is  50 minutes, as opposed to the 7-to 7.5- hour drive –  the main appeal of air travel. But then there’s the drive to the airport. The car drop off in the parking lot. The separate check-in and payment for Frankie (a.k.a. “canine carry on”).  The security check. Frankie, being part terrier, is very stubborn. Getting him to empty his pockets of coins and cell phone would not be easy.

And Frankie is diabetic. The idea of having to explain canine diabetes — “yes, they need insulin shots, yes, those needles are for him” — to a security guard seemed daunting.

Baggage

Given that Frankie would serve as my carry-on and my secondary bag would include medication, an ice pack for the insulin, and some special food for Frankie, who can’t get shots on an empty stomach, I would have to check everything else: Clothes, dog toys, more food. I probably wouldn’t have been able to take my laptop (hmmm, that might not have been a bad thing).

One reason I love car trips is that you can throw everything you can possibly envision needing into the trunk. As the queen of the bad packers (yes, even though I’m a sometimes travel writer) I hate to forgo that.

Stress

Frankie may not be thrilled about being in a car, but there’s no reason to assume that sitting in the dark under my feet in a vehicle that is not only moving but making really loud noises would please him either. And tranquilizers of any kind are contraindicated for air travel (even in the cabin, and even for normally nosed — as opposed to brachycephalic — dogs).  I’m thinking that 50 minutes under those circumstances — not to mention all the encounters with strangers that my shy guy would be forced to endure — might easily be the equivalent of seven hours in a loathed but at least familiar form of transport.

Bathroom

The bathroom problem (mine, not Frankie’s) that was distressing me (see previous post) has been solved.  You can teach an old dog (me, not Frankie) new tricks. On my friend Karyn’s suggestion, I found a ride share on Craigslist, a University of Arizona student who described herself as “harmless.”  I can’t speak for her driving yet.

My driveshare & a friend. Harmless?

My driveshare & a friend. Harmless?

The drug problem (Frankie’s, not mine) remains. Clare, my best friend, who is meeting me in San Diego with her dog, Archie, tells me that I have to use pure lavender oil in order for it to work. I’m going to the vet later to see about another go at Valium, and maybe a try at Buspirone, mentioned by one of the many helpful people on Twitter as recommended by Dr. Nicholas Dodman, renowned veterinary behaviorist and pharmacologist, for carsickness.

Update: My vet prescribed Xanax, 1/8 of a pill to start. Fingers (and paws) crossed. If it doesn’t work, I’ll take the rest of the pills.

This is my last post until…well, I feel like it, since I’ll be on vacation, but I’ll report back on the car trip, Archie and Clare, and of course the Surf Dog festival.

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