Diabetes

Short of sounding like Wilfred Brimley, everyone's favorite diabetes spokesperson, I'm going to talk about diabetes and two extremes that I saw this week.

So to start off, there are two forms of diabetes in animals: diabetes inspidus and diabetes mellitus. Diabetes inspidus is rare and is caused by the kidneys not responding to a hormone and so water is not concentrated thus the animal pees a lot. Diabetes mellitus is sugar diabetes where the body can not maintain normal blood sugar control. Animals drink and pee a lot because of the change in the osmotic gradient of urine (or something like that). This is the form we'll talk about.

So anyway, in diabetes (from here on diabetes refers to diabetes mellitus only) there is a lack of insulin which is what helps control blood sugar. Blood sugar spikes after eating and then insulin is released to average it out. Insulin is made in some very specific cells in the pancreas which is this funny little organ that lays near the stomach and small intestine. For a variety of reasons, these cells stop producing insulin and animals become diabetic. These days we see diabetes more and more commonly for the same reason it's on the rise in humans-obesity.

Clinical signs of diabetes include drinking and urinating excessively (PU/PD), weight and muscle loss, poor hair coat, lethargy, and urinary tract infections. With these clinical signs some blood and urine tests will be performed. I like looking at organ function to rule out other causes, blood sugar and to see if there is sugar in the urine. A single blood sugar alone won't tell you if an animal is diabetic. Animals can increase their blood sugar in times of stress and so may look diabetic but may not have sugar in their urine.

Treatment consists if weight loss, diet change and most often insulin. Once on insulin. Monitoring must be done to check sugar levels and insulin doses. We use fructosamine levels in our office which looks at the average blood sugar over the past month. Fasting blood glucoses and glucose curves can be used as well. Insulin is fairly cheap in the grand scheme of things but the testing can be more expensive. Diabetes is a commitment and lifestyle change. This can not be reiterated to the client enough. Animals can live good lives with good control.

So now for the cases...

I was finishing appointments the other night when I was alerted that a diabetic dog that we hadn't seen since October of 2012 was lethargic at home. The owners wanted to bring the dog in. The first thing I wanted to know was what was the dog's blood sugar so the techs pulled that and a bunch of other blood samples for potential testing.
The poor dog's blood sugar was like 41! Normal is somewhere around 70-150. In diabetic animals, I'm okay with up to about 300 in the hospital.
My exam wasn't too exciting so I have the dog a bowl of karyo corn syrup and sent some home. I instructed them to give a midday meal until they heard back from me. Today, we got back the fructosamine results. The number was 143!! This means the dog was suffering from prolonged low blood sugar. I cut the insulin dose by 25% and will recheck the fructosamine again in one month. I'm glad it seemed to be a simple problem with hopefully a simple answer.

My next diabetic animal was a cat diagnosed by another vet who was on vacation. The cat was on a type of insulin that I generally use specifically for dogs. The owner wasn't happy and the cat wasn't looking great. His hair coat was rough, he was thin and the owner complained that he wasn't drinking well. I pulled again a ton of blood for a variety of tests. His blood sugar came back in the 300s which wasn't surprising and some of his electrolytes were off. I sent out a fructosamine on him too. It came back at 703!!! I've never seen one this high before! Needless to say, his diabetes is poorly controlled so I changed his insulin type to what I feel is the proper cat insulin and we are starting as if he was just diagnosed. We'll check him out again in a month. Hopefully, that was his only problem.

Harvested my pumpkin today. It weighed 15.8#! And would have weighed more if it wasn't rotting from the inside out. Also suffering from a bad case of vine boring beetles. And there was a hole on the bottom with a hole in the soil beneath.
Needless to say, it's not making it to the fair. :(

Organic Farming is For The Birds

So I've made the attempt to become a gardener. I think I've mentioned it before how I think that most people have the innate desire to grow something. Something primal in us wants to create something and provide for ourselves.
DE gave everyone a bunch of seedlings to plant this spring. I brought home two tomato plants, several collard greens, several brussel sprouts, broccoli, and cauliflower. I also sprouted a few pumpkin plants and some beans in pots. The plants less the tomatoes, two collard greens and the aforementioned beans went into my very tiny gardening plot next to the black raspberries that I only just discovered when they were getting ripe.
And as mentioned previously, too, the plants that were in the garden except for the pumpkins were eaten by a rabbit not once but twice! The pumpkins were left with plenty of space to spread out. In the beginning of July, I had a small pumpkin growing and growing and growing. Its nearly ripe now and I estimate it to be about twenty pounds. I'm planning on harvesting it this weekend. Then providing that it doesn't rot before then, I'm going to enter it for better or worse into the Jamestown Community Fair.
Unfortunately, I didn't do much in the way of preventative medicine for my plants. I gave them plenty of Miracle Gro in the early days but now the pumpkins are on their own for watering.

Here's my pumpkin just days till harvesting. 

One of the first problems that I noticed with my pumpkin plants was powdery mildew on the leaves. I did some reading on the subject and found that it was often from high humidity and the leaves not getting sufficiently dry. We had a really humid spell but I think the biggest problem is that my gardening plot stays shady for a prolonged period and allows for the mildew to set up. I did some further reading and read that a mixture of milk and water sprayed on the leaves every three days could treat the mildew once spread. I did not however read the directions well enough and thought that it was sprayed daily for three days and not every three days. That explained why my leaves were getting sort of yellow and trying to die. 

Powdery mildew wasn't the only problem that I had with the pumpkins. I've also had a recent outbreak of squash vine borer bugs. Here they are hanging out on my second pumpkin. And below that are the eggs. 

And finally, what might actually be the most tragic are these giant holes in my beautiful pumpkin. They've been there from the beginning and haven't seemed to affect the pumpkin's growth or health. They are sort of soft but not really rotten. I hope bees don't fly out of them or something equally horrible.

The other plants haven't been free of problems either.

In my awesome wisdom, I decided that the five gallon buckets used for the tomatoes didn't need to be completely full of dirt so I put a gallon milk jug in the bottom to take up some room. While this was a great idea at first, when you have four foot plants loaded with tomatoes, it doesn't hold up. My soil has been leached of nutrients and daily is leached of water. Enter blossom end rot. 

The collard greens in the pot have been attacked not once but twice by very hungry green caterpillars. Yuck.

And even my beautiful impatiens in the front flowerbed have given up. They've gone from full and lush to leggy and translucent. 

Next year...chemical warfare.

The Very Long, No Good Week...

This has been a very long week. And it's about to wrap up and start all over again. With hopefully less exhaustion. I can't think of the phrase I want to describe how busy I was...something about catching up with myself. All I can think of is 'their heads on fire and their asses a catchin' ' from that Charlie Daniels song.

So Monday, there were two horse calls on the book but two more got added on. DE didn't feel that with his bum knee that he would be up for horse calls no matter how simple. So he did my morning appointments and I headed to all the extents of our practice range.
The first call was vaccinations and floating teeth on two nice horses with nice owners. Then I went and revisited the choked horse from the night before. I was there three hours and felt that when I left I had managed to relieve the choke. (Sadly, the horse either wasn't relieved or rechoked by the next day. CB euthanized it.) Then I ran back to the office to change my clothes; I was covered with snot, diet and blood. Then I saw a pony that looked like he had broken his ankle. Unfortunately, they didn't have electricity for X-rays but fortunately I think the pony had a contracted tendon. Then finally to Ohio to check out skin issues on a horse.

Skin Issues on Said Horse

Tuesday...I was super busy with morning appointments and then went and cut a DA.

Wednesday was another long day. I was still dealing with a Basset Hound I had hospitalized. We started a barium study which by the end of the day looked very suspicious. I did surgery in the morning then I randomly broke my tooth on a tootsie roll. It was already chipped but seriously broke in half. It was a baby tooth and I knew it needed to just be pulled out. I called a dentist that was recommended and within an hour was in the chair and got the tooth pulled. $133. Not bad.
Then I pulled health papers on some goats. It was really late when I finally got home.

Thursday, it was decided not to take the Bassett to surgery. He was running around jumping on people. How can you take that to surgery?
I did some appointments and then headed out for more calls. I put in a prolapsed uterus and it was awful. I had to change my clothes in the milk house. Then I checked a pony mare that had a cute little foal. This mare was wonderful and her foal was super cute!! Then I checked on the mare without her mare parts. Then into Ohio for health papers. Another long day.

Friday I did some health papers in the morning before having a pretty slow afternoon. Slow enough to get all my charts written up!!

Here's to a slower week!!