Sunday, January 11, 2009

Picky eater

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
Scrambled egg with onion and cheese
Cottage 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
Hills A/D with Canidae kibble cleverly hidden inside mouthfuls
Chicken thighs, sauteed
Hamburger, cooked
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.)

Monday, January 05, 2009

Business Plan

Today is Neo's birthday.

Happy Birthday!

Her birthstone is garnet and every year I try to get her a small garnet piece of jewelry. Today we're home, looking at the gray drizzle out our window. We had plans to go down to a fabric store in Berkeley today, but I have to take Hobbes to the vet for a follow-up visit (He's home now, stable, but needs to see his vet for long-term care.) and, here's a bizarre thing, Saul doesn't have school today. He goes back Tuesday. So he's here unexpectedly. The trip to the fabric store is off. OK. Let's go to some funky small antique shops and find a cute piece of jewelry. Then this afternoon I'll bake your birthday cake.

Oops. It's Monday. A lot of shops here are closed on Monday if they're open on Saturday. I'll call first.

Brring, Brring, Brring.

"Hullo?" someone says in a very sleepy voice.

"Um. Hi. Is this Jewel of the Night?"


"I'm sorry. I may have the wrong number. Is this the store Jewel of the Night?"

"Yeah... I mean it's my house. But yeah."

"I was calling to see if you were open today?" Good lord this is weird.

"Well, I was going to, but then I looked outside and you know. It's kind of gross out there. Right?"

"Uhh." Hang up. Hang up!

"I mostly work by appointment these days. What did you have in mind?"

You work by appointment? Really? There's an interesting plan for an inexpensive jewelry shop on Main Street in a small town. It's not like you're selling first editions or something. Soldiering on I offer, "Well, today is my daughter's birthday and we thought we'd come in. You know. See what you have."

"Unh." Lots of rustling noises here as if newspapers are being moved or bedsheets dragged across the phone. "OK. Like, what time did you want to come in?"

I can't believe I'm setting an appointment to buy earrings. "I have to take my dog to the vet's this morning. I dunno. Twelve? Sometime after twelve?"

"Oh good. That gives me time to take a shower."

Boom! Head explodes. I don't need to know how clean you are! What a weird person. Heck of a business plan you've got there, lady.

We're going to the art studio down the street instead.

Sunday, January 04, 2009

Well, now we know

My big lovely boy Hobbes has just been diagnosed with canine diabetes. He's in the emergency hospital racking up an enormous bill, well over a thousand dollars of supportive care.

They've started him on insulin and are trying to regulate his dose. If he stabilizes, then he might come home today, or maybe tomorrow. He doesn't have organ failure or any infections, so that's good. It certainly explains his precipitous weight loss and lethargy though.

He'll have to be tested and given insulin shots twice a day from now on though. I'm fine with doing that, but I'm still reeling from the diagnosis. OK, I should clarify that. I was secretly thinking that it must be cancer as I watched him get thinner and thinner every day. I'm glad it's not cancer. And diabetes is not any sort of a death sentence. I just have to redefine myself as an owner of a dog with a chronic condition.

Ooo! Just thought of an excellent side effect. I can no longer travel to visit my mother nor entertain any conversations regarding travel to visit my mother. "Do you want Hobbes to DIE? I can't leave him with a sitter. He'd DIE!"

His glucose levels were insane. Normal blood glucose is like 120? His was 700. (Forgot the units there. My dad the engineer would kill me for posting a number with no units.) There should be no glucose in the urine. His urine glucose came back at 1,000. Geez, man. How do you have values like that and still bark at the car next to us at the stop light on your way to the hospital? He hasn't been perky in days. But bring a sick animal to the hospital and look out. Ears up, tail wagging, panting at the nurse, walking on a taut lead to the exam room. "Oh boy. Doctor's office. Hi there! I'm Hobbes. Hi! Pleased to meet you!"

I keep thinking I can hear his nails clicking on the sliding door as he taps it to be let in. I think the cat is looking for him too.

Side note: Neo is going to be FOURTEEN years old on Monday. Fourteen. One four. How is that possible?