A few years ago a client who I had never met brought me her cat for euthanasia. I was not the cat’s regular veterinarian. The cat had been diabetic, achieved remission for about a year then relapsed shortly before I met the owner. The owner felt she just was not willing nor emotionally able to go through it again.
So what defines successful diabetic treatment? Are there things we can do to decrease such heartfelt tragic goodbyes? I think yes. The mere fact that you are reading this newsletter tells me you are proactive in your pet’s diabetic control. Nonetheless, sometimes simple things such as installing a doggy door or working on your consistency of your daily routine may be enough to improve your perception.
Not going potty in the house can greatly affect an owner’s perception of success. Who wants to come home to a wet rug? Even a well controlled diabetic may have periods in the day when the blood glucose exceeds the kidney glucose threshold, which makes it difficult to concentrate the urine. Well-controlled diabetic pets may yet need to urinate more frequently than a non-diabetic pet. Cats usually have access to a litter box, but dogs may not be able to hold it until you get home from a long day’s work. Clients who have a doggy door or a large family who can let a pet outside every few hours or even a dog walker may perceive their pet’s quality of life better than a client who comes home to discover pee on the rug.
Run your glucose curves every couple months, even if you think you are doing okay. Take it to your vet for evaluation. Pay attention to your pet’s level of thirst and appetite. Don’t just assume that all is fine. Minor adjustments with insulin dosing can improve your pet’s quality of life. Don’t put off routine curves and suddenly find your pet poorly controlled. Is your pet draining the water bowl as soon as you refill it? Is your pet following you around and demanding food as if it hasn’t eaten in weeks? Diabetes is starvation in the midst of plenty. A poorly controlled diabetic will feel hungry and thirsty a good portion of the time. That would surely affect an owner’s perception of quality of life. It’s better to tweak the dose periodically than to postpone regular curves and possibly find a big adjustment is needed.
These all, of course, come down to blood glucose numbers, but sometimes owners get so caught up in the numbers that they miss the big picture. I define successful management of a diabetic pet as a pet who has good quality of life – despite the diabetes. The pet may occasionally have a urinary tract infection or have a bad day, but by and large it feels good. It greets you at the door and acts like it did before the diabetes. It grooms itself (or doesn’t grumble if you give it a hand with grooming). Good days outnumber bad days.
Clearly the best kind of success would be remission, which pretty much just happens for type 2 diabetics (felines usually). That typically happens when a pet owner is proactive and educated about diabetes and adheres to the protocol set forth by the managing veterinarian. Sometimes people get delayed or just can’t be there to give the insulin at the scheduled time. Nonetheless, sticking to the routine means better glucose control, which means improved perceptions of success by the owner.
As always, I enjoy interaction with our readers. If you have any questions, feel free to contact me at Joi.SuttonDVM@adwdiabetes.com.
NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.