Hobbes won't eat. His diabetes is giving him indigestion.
This is bad for a diabetic dog. In order to get insulin, they must have eaten a full meal. Diabetic dogs get fed twice a day, no snacks, each meal to be followed by a shot. Food makes blood sugar go up, insulin makes it come down, so you give the shot after you've made the sugar go up. Dogs apparently (and I'm still learning here, bear with me) have more spikes in their blood sugar throughout the day, so there isn't as much blood sugar testing as there is with humans.
Hobbes is still dumping ketones in his urine, which means his diabetes isn't under control. He's not in "full blown ketoacidosis" but I'm not clear where the dividing line is. I've asked about sub-q fluids and the vet says not yet. She also says that sub-q's don't really flush the ketones and that we should rely on getting the insulin to take effect.? (This seems fishy.) He's not at danger levels. Let's tempt his appetite a little more, and then we can increase the insulin safely without throwing him into a low-blood sugar episode. Yeah, but the ketones make his nauseated. I'm stuck in an endless loop and I can't get out.
Hobbes is hungry all the time. He sniffs at the cutting board whenever I'm in the kitchen. When I make him a meal, he walks towards it very slowly, sniffs, wags his tail, and then usually gently burps, tucks his tail between his legs and slinks out of the room.
Vet says that food will get him going and will settle his stomach. Vet says: try baby food. Yay! He likes veal baby food! Until the next meal, when he sniffs it and slinks out of the room.
Vet says to try Hills Scientific diet A/D (which has about as many forms of liver I have ever seen in one food concoction). She says they use it after surgery to tempt appetite. Yay! Hobbes wolfs down A/D. Off I go to the vet to buy more cans. Hobbes still likes it. I mix a little kibble in. He still likes it! Until the fourth meal, when he sniffs it and slinks out of the room burping.
Vet says to start him on Pepcid AC. He is probably rejecting foods that have made his stomach hurt in the past. Vet says: change all the associations. Get a whole new type of dry food. A whole new brand of canned food. Get rid of everything else, he'll probably never eat it again. Start with bland stuff and work up to the new brand. Something mild tasting. No liver. No lamb. Let me know how it goes.
The Pepcid seems to be working somewhat. However I am at a loss to figure out what I can use that is bland and tempting. Here's everything he once ate that he now walks away from after a few bites.
Chicken broth, canned.
Chicken broth, homemade
Veal baby food
Ham baby food
Beef baby food
Turkey baby food
Raw egg yolk
Raw whole egg
Scrambled egg with onion and cheese
Cottage cheese and rice
Iams dry dog food
Canidae dry dog food
Canidae canned food
Canidae dry and canned food, mixed
Hills A/D with Canidae kibble cleverly hidden inside mouthfuls
Chicken thighs, sauteed
Hamburger meatballs, homemade, including dog vitamins, bound with oatmeal and egg
Cheese, all kinds.
Pork chops, leftovers, meat only
Dog vitamins as treats
All of these things he once ate. All of these things I have resorted to feeding him by hand, mouthful by mouthful.
Then I think to myself, "He ate about one cup. That's close to a meal, right? And I know what I can feed him tomorrow."
Only to have him refuse the next day.
But he is gaining weight. So something's working. And he puts up with the shots fine. He still eats baby carrots as a treat (those have always been his favorite), and I don't want him to stop, so I've stopped handing them out after every shot. So now he's getting pricked but not always getting a treat for it. (Why won't you eat cheese, for goodness sake?)
I have another phone consult with the vet in the morning. I think we just have to increase his insulin by a unit and see what happens. And I'm ready to do sq's. I think the vet thinks I'm not. I'm not fighting with the vet, not by any means. I really like her.
But it's a strange thing to wake up in the morning planning your children's lunches and breakfasts (Does Saul get home lunch today? School lunch? Does Phebe have her snack? Do we have milk for cereal this morning?) while also trying to be creative with the dog's breakfast. (Must feed him no later than 7:30. Rice? No. Maybe pasta and broth? No. Kibble and... No. Maybe if I cook him something.)