Caturday quickie, part the second: Pupdate

The last time I offered a pupdate, Nuala had been diagnosed with diabetes, we had a VetPen, but were having difficulty regulating her blood sugar. We’d also stopped the prednisone and started an alternate treatment, cyclosporin.

Well, after three glucose curves, her blood sugar is still not regulated, but the vet feels that clinically, she’s doing fine. The stress of a day-long stay at the vet’s may have an impact on her glucose readings, however. So we’re continuing her treatment of 16 units of insulin twice a day.

We ended up returning the VetPen as the maximum dose on it is 16 units and we may have to increase her dosage again, depending on how her symptoms are managed. Phil and I are much more comfortable with syringes anyway, having had previous experience with our cat, Thufir (the caturday quickie mascot).

The cyclosporin was not working and her ears (which the pred and the cyclosporin were prescribed to treat) were once again full of cysts. She had an abscess in one ear, as evidenced by the amount of pus that came out of it, and so the vet has recommended a return to the pred. We have to monitor her water intake and urination and may have to adjust her insulin accordingly . . . because . . .

Nu is once more a piddle pup, incontinence being one of several side effects of the pred. We now have washable incontinence pads made for humans on the bed and the couch, and are otherwise tolerating the occasional dribble. She can’t help it, poor dear.

Other than that, she’s on Fortekor for her proteinurea.

That’s our complex pup in a nutshell.

After only a few days on the pred, her ear cysts are shrinking again, and she seems quite happy.

Nuala December 2014

This is seriously the best picture I could get of her. She’s absurdly camera shy (!)

Our aim is quality of life. She’s nine and a half, even though we still refer to her as the pup.

I hope this will be the last pupdate for a while.

Caturday Quickies

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Pupdate, part the whatever

It’s been a while since I’ve posted one of these. Phil and I had, foolishly, fell into complacency, having felt that the worst of Nuala’s troubles were behind us.

Not so, apparently.

When we had seen the veterinarian in June, following up on Nuala’s persistently inflamed and fibrocystic ear canals, we had been sent home with Nu on a regimen on low dose prednisone and periodic flushing of the problematic canals with TryzEDTA. She would be due for further blood tests in September to follow up on her kidney function and liver function to see how she was tolerating the pred.

September hit and Nuala started to behave poorly again. Her ears started to throw off more crud/pus, and we thought we’d up her pred for a bit to see if we could clear it up. She became listless and her bladder control was practically non-existent. She also started to drink a lot of water. A lot. It was so bad that I’d have to restrain her from drinking from puddles when we walked. We had to remember to keep the toilet lid down.

We noticed she was losing weight, too. We theorized, because we both knew the symptoms, that she might be diabetic, but I preferred to remain in denial for a while and hoped that her difficulties resulted from an existing condition that we could treat.

I thought initially that we could wait until the vet called for her follow up blood work, but week before last, we decided we couldn’t wait any longer and made an appointment for this Tuesday just past.

We brought in a urine sample as well, just in case. Turns out it was good that we did.

The first thing we did upon entering the office was to weigh her. It’s something we do every time. If there is any medication to be doled out or adjusted, the vet needs to know her weight.

She was 25 kilograms. The last time we’d weighed her in June, she was 31.4 kilograms. That was a shock.

In the examination room, though he confirmed the increased inflammation/infection in her ears and her poor physical condition, the vet said that we were to return to the lower dosage of pred with an eye to eliminating it altogether. Pred can apparently exacerbate the onset of diabetes. Joy.

He said that his immediate diagnosis would be diabetes, but that he’d actually like to perform the tests to confirm his diagnosis before prescribing anything.

Wednesday, Phil received the call at work: Nu was indeed diabetic, and there were ketones in her urine.

Now, for those of you who don’t know, this is bad. It means that Nu had depleted her fat stores and that her body was now consuming her muscle mass in an attempt to compensate for her inability to metabolize sugar properly.

I noticed that she had been a bit unsteady on her pegs in the last couple of days.

So, we both took off work early on Thursday to get back to see the vet before he left for the day. Unfortunately he wasn’t able to get the insulin pen and supplies he wanted for Nu, but he had some canine insulin and syringes that had been returned by another client. She’d need 12 units of insulin, morning and night.

We were also given new food, a diabetic diet, and advised to feed Nu between three and four cans of it a day (she was doing well on a half a can and a cup of kibble a day before) to bring her weight back up.

And finally, I’ll be taking her back in this coming Tuesday for a glucose curve to see how she’s doing and if we have to adjust the dosage or the food in the next little bit.

In the three days she’s been on the insulin, I’m happy to say that Nuala is already looking better, drinking less, peeing in the house less, and enjoying her usual activities (like eating garbage on our morning walks) again.

The hope is that getting the diabetes under control will also reduce the stress on Nu’s body and reduce the inflammation in her ears, if nothing else. Otherwise, it’s a game of wait and see. We’ll address her health issues as required, moving forward.

This is not new territory for Phil and me. Our cat, Thufir, was diabetic for the last three years of his life. Plus, Phil was a medical laboratory technician in a past career, so he’s cool with the whole injection thing.

The unfortunate part for me is that Nu needs her insulin an hour before her meals, morning and night. So . . . there will be no more sleeping in for Mellie on the weekends. I’ll either have to take up napping (something I’ve never been good at) or try to find some other way to recover from my weekly sleep deficit from working.

Something tells me I shouldn’t have decided to defer my leave with income averaging until the spring.

The important thing is that Nuala is on the road to recovery again.

I hope I won’t be writing another pupdate for some time. My poor dear has been through quite enough.

Next week: I’ll be posting my Next Chapter monthly update. There are still a few days left in the month and I want to make the most of them 🙂

So, this dog walks into a writer’s office and says, “Whatchya up to?”