Shelby is a 7 year old Bischon Frise. In late 2016 she was brought to the Animal Hospital very off form and with a high temperature.
We routinely see cases like this and usually an antibiotic and an anti inflammatory rectifies the problem.

This was not the case for Shelby however………..

Several weeks later all Shelby’s lymph nodes were swollen and she had lost a lot of weight. This is a very worrying sign and and rings a lot of alarm bells. Despite weeks of treatment and further tests here in the Animal Hospital Shelby continued to deteriorate.
Eventually we sent her to the Referral Hospital in UCD, After many investigations Shelby was diagnosed with a problem with her immune system.

She was put on immunosuppressive treament along with other meds. Gradually over the coming months she slowly returned to her old self.

At a check up several days ago she was in fab form. She continues to receive daily meds and will probably do so for life…….

In December 2016 Bobby started drinking and urinating a lot. He also started eating much more food. Blood tests were taken over several weeks and confirmed that Bobby is a diabetic.
Diabetes in dogs is very common, although definitely more common in the female !! The most common clinical signs are excess drinking and urnation. It is really easy to rule it out by a simple in-house blood test.
Bobby is now getting insulin injections morning and evening and in great form – as you can see from todays picture of him.

TIP – if you have a diabetic dog be aware they can get LOW blood sugar when receiving insulin. Weakness and lethargy is usually the main signs. A couple of spoons of honey by mouth will usually sort the problem

What is Diabetes Mellitus?

This month, with the help of Holly’s story, we would like to raise awareness about diabetes mellitus, a common endocrine disorder in our fury friends. Diabetes occurs when there is insufficient insulin production by the pancreas. This is type 1 diabetes and is most common in dogs. Insulin is required for the absorption of glucose. This insulin deficiency results in the inability to transport glucose from the bloodstream into cells leading to a high blood glucose. It is treated by injecting the patient with insulin on a daily basis.

Pet diabetes occurs in both dogs and cats, however it is more common in dogs. Holly’s story will focus on canine diabetes though symptoms are very much the same in both species.

Diagnosis

Holly first presented to the clinic after her owners were concerned she was drinking and urinating more than often. Common symptoms of diabetes mellitus include:

• Increased drinking
• Increased urination
• Increased appetite and often weight loss despite this
• Lethargy
• Poor coat condition

Diabetes can occur at any stage but, most commonly it occurs from the age of 7 onward. Given Holly’s age and her excessive drinking and urination, these factors led our vet to believe she was a diabetic. A simple blood test during her visit revealed she had a blood glucose of 20mmol/L. The normal range for a dog is 3.0 to 5.0mmol/L. This value however can increase during either times of stress or after having a big meal so, to rule out these factors, Holly came for a second visit the next day. During this time her owner was able to obtain a urine sample. Our nurses ran a urinalysis test which revealed that Holly had an excessive amount of glucose in her urine. This, along with a second blood test with a reading of 28.1mmol/L confirmed that Holly was a diabetic.

Treatment

Unfortunately, diabetes cannot be cured but it can be treated so the patient can live a normal healthy life. The aim of treatment is to manage the clinical signs or symptoms. Treatment involves injecting the patient with insulin on a daily basis. A strict daily routine must be followed in regards to diet and exercise as these affect insulin requirements. The times at which insulin is injected must be at the same time each day also. For example, Holly needs to be injected twice daily with insulin. Her first injection of insulin is given just after her breakfast at approximately 7am. These set meal times are to avoid hypoglycemia (low blood glucose). She cannot be fed between these meal times as treats etc will cause her blood glucose to fluctuate. She is fed a special veterinary prescription diet specifically for diabetics. This diet is high in fibre and low in fat and ensures a slow release of glucose. Her daily exercise must be regular also as this too affects insulin requirements. Her second injection is given at 7pm just after her evening meal.  Although Holly’s daily routine is quite strict her owners adapted these times to suit their schedule too. It is important to find a plan that works for both you and your pet and our nurses were able to offer advise of a daily routine during nursing clinics. Understandably, the idea of having a diabetic pet cab be quite daunting at first. Once diagnosed, our nurses work together with the client and the patient to help them gain better understanding about the disease through diabetic nursing clinics.

A Regular Patient

These days Holly is a regular visitor to the hospital. She comes for her blood glucose curve, a series of blood tests carried out throughout the day to check if her insulin dose is correct for her. Both our vets and nurses love to make a fuss of her and enjoy seeing her wagging tail greet us as she comes to the door. Her brother Tyson also comes along for the day to keep her company. We look fordward to seeing them both very soon at Holly’s next visit!

Tommy

Tommy first came to the practice following a suspected road traffic accident. Radiographs revealed he had multiple fractures to his left femur, ultimately resulting in his left hind leg having to be amputated. Usually cats manage quite well on three legs but, unfortunately for Tommy, he had some common complications after his surgery including wound break down and partial blockage of the urethra.

Because of theses issues, he spent a long time with us as an inpatient here in the hospital. His favorite spot in the hospital was right under the radiator in the kitchen, where he received lots of TLC from our nurses and vets and the occasional piece of chicken at lunch time!

Owner compliance was key in treating Tommy for his injuries and though his case was quite complicated, his owner wanted us to do everything we could for him, and so we did. His surgical wound needed to be bathed twice daily after the tissue began to break down. We used an antibacterial wash and intrasite gel, a hydrogel used to rehydrate narcrotic tissue. This took some time and patience from both Tommy and the nurses. He soon got used to the process however and enjoyed the routine of chin scratches during bath time. Eventually, the necrotic tissue began to fall off and his wound was restitched . The underlying issue of urethral narrowing was a more difficult one however. Throughout his time in the hospital the nurses would monitor his urination, which, unfortunately gradually worsened over time. Tommy was prescribed Hypovase for this issue, a drug used to increase patiency of the urethra. Unfortunately, as time went on Tommy’s urethra continued to block until one day he was struggling to pass urine. Previous attempts to try and pass a urinary catheter had failed as scar tissue had formed at the opening to the bladder and made this impossible. Unfortunately, Tommy could no longer battle this problem and so the difficult decision had to me made to put him to sleep.

I think we all fell in love with Tommy because of his loving nature. We all sympathised with what he was going through but he remained in such high spirits despite everything. He truly was a special cat and his presence will be missed here in the hospital.

Winston

Meet the very handsome Winston! He is a 6 year old crossbreed dog.  He was out for a walk with his owner late November last year and was unfortunately attacked by a German Shepherd dog in the park. He had severe bite wounds on both sides of his neck, his chest, abdomen and groin. They were quite extensive for such a small dog. His terrified owner brought him immediately to the after hours service of the pet emergency hospital for care. After examination, they decided they needed to hospitalise Winston for stabilisation, treatment of shock, to clip and clean his wounds and suture where necessary. They also needed to take xrays, as they were very concerned about the bite wound on his chest.

Chest xrays showed air in his chest but no obvious rib fractures. During his surgery, they found that his right chest had a large extensive wound in his chest wall between two ribs, the size and length of a finger! They were surprised that Winston had been so stable up to this point. Concerned for his safety, once this was repaired they left his other wounds to fix another day as they were not life threatening and they did not want to prolong his general anesthetic. They had to leave a chest drain in place to remove any excess air or fluid that may be trapped in the thoracic cavity. The remaining wounds were cleaned and flushed. After his surgery, he was kept on oxygen, fluid therapy and pain relief as well as constant monitoring. Due to the vulnerable nature of his injuries, Winston was directly transferred to the UCD hospital the following morning. As you can see from the photos his injuries were drastic and poor Winston was very sore and swollen from the attack.

The remaining wounds were fixed in UCD and he was allowed home to his worried owner after a few days stay in the hospital as they were now happy he was stable and doing well on his own. He was transferred back into the care of the Animal Hospital Tallaght. He was on a cocktail of drugs during that time, including antibiotics, anti-inflammatories, strong pain relief and antacid. He needed regular visits to evaluate his condition and assess his wound healing. There is always a risk in these cases due to extensive tissue trauma, that wounds can break down, infection can set in, or in Winstons case his chest wound was so severe, that he could have further breathing problems. Thankfully, his physical exams continued to show favourable improvement over the following weeks. He has been such a great patient and a very lucky little dog, that he has been rewarded January pet of the month. His owners should be very proud of him, as well as themselves for the dedication and love they showed him during this difficult time.

WELL DONE WINSTON!!!!