kinds of drugs and its side effects

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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10 Comments

  1. Clare
    Posted October 17, 2009 at 8:09 pm | Permalink

    So, let’s see: cataracts? not cured by diet? insulin twice daily? Call me crazy, but that sounds like human, Type I, to which I lost a dear friend. Lots of research? Published regularly by Tufts? Call me loyal, but you get my vote of confidence!

    • admin
      Posted October 18, 2009 at 5:58 am | Permalink

      Thank you, Clare. It’s always nice to be among friends.

  2. Susanne
    Posted October 18, 2009 at 5:32 am | Permalink

    Ahh the frustration of misinformation. I have just read the post you are referring to, and I have to say the blogger’s responses to your comments irked me even more than the original post.

    This highlights an issue I had early in Jasmine’s treatment for diabetes – vets don’t know everything about every disease, it is too much information. When the highly experienced vet who diagnosed Jasmine retired, I then encountered several vets who had varying degrees of experience with the condition, and each had equally varying, sometimes contradictory, ideas on treatment parameters (all within the same clinic I should add!).

    Anyone who ever has concerns about information given to them by their vet should not feel obliged to blindly accept it, and absolutely should feel free to seek a second opinion – your priority is for the well being of your pet, not fear of hurting the vet’s feelings. Like human doctors, vets will have more knowledge and experience in some areas than others. I have since gone to another clinic with vets who really know their stuff about diabetes, and they also have access to a wealth of information from a vet at a sister clinic with a special interest in diabetes. My stress levels have gone way down and the uneasy feeling I started getting at the previous clinic is no more.

    p.s. thanks for posting the pic of Jasmine’s cute mug again, not that I’m biased or anything 😉

    • admin
      Posted October 18, 2009 at 5:56 am | Permalink

      Thanks, Susanne. I was hoping you’d jump in here. It’s difficult to question medical authority figures, whether on line or — even more difficult — in person. It’s helped that two of my good friends are physicians. I don’t know anything about their diagnoses but I do know how fallibly human they are, just like the rest of us.

      And it’s always fun to get to put Jasmine on my blog. She’s my second favorite diabetic dog!

  3. Posted October 19, 2009 at 12:01 pm | Permalink

    Jasmine is a beauty Susanne! What a happy looking girl! How do you find her skin down there to give injections!! LOL

    Edie, thanks much for your kind words – I was quite surprised to read about myself here today! And glad to hear that the vet in question owned up to her part of the showdown.

    We had a difficult time with our dog’s diabetes – the standard insulins didn’t work well for him and I was especially frustrated by a veterinary endocrinologist who basically ruled against our changing insulins because his standard for regulation was the dog didn’t have accidents in the house. Our dog never had an accident, even when his blood sugar was 400+ all day. So we had to dig in and sort things out ourselves.

    It definitely wasn’t easy to go against what many called the worldwide expert on this particular disorder. But I knew in my heart that we could do better for Chris. I did have to change vets to accomplish it and eventually started to manage Chris’ diabetes entirely on my own with home blood glucose testing.

    We also bumped into or were connected with a few people locally who were having similar problems, like a husky who was seizing from hypoglycemia but the same vet school clinic had “forbidden” home blood glucose testing. We found, as you have, that vet skill with diabetes varies widely, including in a single practice.

    It was along that path that I got involved in forums for canine diabetes and eventually started my own, a labor of love dedicated to Chris, who passed in August 2008. He was a large dog and survived to fourteen and a half despite severe heart disease and the diabetes.

    My moderator, Kathy, had a diabetic dog Lucky who was the first dog in the U.S. to be put on Caninsulin… years before it was offered in the U.S. as Vetsulin… because her dog didn’t do well on anything but pork-based insulin. Intervet worked with her and her vet to get her the insulin her Lucky needed to survive.

    So we both try to make things a little easier for others.

    It’s a joy to meet you all and I will be checking in when I can.

    • admin
      Posted October 19, 2009 at 2:59 pm | Permalink

      Actually, Natalie, I emailed you to tell you that your ears would be burning but I guess you didn’t receive the message. Glad you found the mention on my site! Your site is a huge help to newly diagnosed diabetics — and those who don’t have a knowledgeable community to discuss issues with. And it bears repeating that you have to do find a vet who will do right by your dog, no matter that a big name said otherwise.

      I can’t believe that some vets don’t believe in home blood glucose testing — and that one kept Chris with a blood sugar level of over 400 because he didn’t have accidents! That’s nutty. A couple of vets in the practice I go to don’t believe in urine strip testing (although a vet in another practice suggested it) because it’s “inaccurate.” Well, Frankie’s too small to be pricked with a blood glucose monitor and I should think an approximate reading is better than no reading at all. Bottom line: I feel comfortable fine tuning the insulin and Frankie hasn’t had a hypoglycemic incident.

  4. Posted October 20, 2009 at 8:58 am | Permalink

    Unfortunately many vets actively discourage or even forbid home blood glucose testing. This comes up very frequently among new members at the forum. We were lucky that our vet, before sending us to the endocrinologist, pointed us to SugarCats and suggested that we start checking Chris’ blood sugar at home since he was so difficult to sort out.

    This spring I attended a lecture by Dr. Bruyette on diabetes in cats and dogs. It was sponsored by Abbott, which makes the AlphaTrak meter for pets, so the lecture was promoting home blood glucose testing and there were reps on hand to sell meters to the vets there. During the break, I heard many of the vets talking about having no idea how to teach owners to do home blood glucose testing or where to test, since they usually take blood from a vein. Or they use the ear, which is not usually a good place to test with dogs – works much better with cats. Naturally, I can understand the vet not wanting to try the lip with a scared and stressed dog to whom they may be the enemy. But the dog’s caretaker at home usually has great success with that technique or with the tail stick method.

    One of my goals has been to promote home blood glucose testing among local vets who have been trained by the vet school to discourage it. We made sure that every single specialist and vet Chris saw heard about what we were able to achieve thanks to home testing!

    • admin
      Posted October 20, 2009 at 5:44 pm | Permalink

      Thanks again for your input. I don’t tend to feel good about the impact of drug companies and their product pushing, but in this case it seems like owners of diabetic pets can really benefit. And good for you for fighting the good fight! Testing gives many people far more control over their diabetic pets’ health. And it can cut costs. Hypoglycemic episodes are expensive!

  5. Posted October 28, 2009 at 12:11 pm | Permalink

    There is no such thing as hate in a dog. There can be fear or a pure lack of respect, but hate is a human emotion.

    Walter Donovan
    Veterinary School Adminstration
    Veterinary College Abroad

    • admin
      Posted October 28, 2009 at 12:16 pm | Permalink

      Hi Walter,
      I’m assuming you’re referring to the name of my blog? It’s tongue in cheek. People worry about a lot of things irrationally and the notion that dogs hate, hold grudges, etc. is among them.

One Trackback

  1. […] 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). […]

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