Old lady with diabetes and cataracts, help please

[Crazdsky]

Hi I am new to MN and hope someone here can help.
My 'old' lady is 12 and was diagnosed with diabetes 2 months ago, still getting use to twice daily injections and getting her balanced.
My main concern is she is near enough blind now due to cataracts as a side effect of diabetes. I have quite a busy house with 6 DC and 3 other dogs.
Can anyone offer practical tips on how to help her adjust to the loss of her sight (quite a few walking into wall incidents)
Any tips on making the injections easier on her also appreciated.
Aside from the above vet states she is in excellent health so just want to keep her quality of life the best we can make it.

Many thanks in advance

The walking into things gets better quite quickly as long as you don't move the furniture (if you have insurance cataract surgery is also an excellent option).
Feeding at the same time as injection really helps.

It took our spaniel several months to get used to be being blind because it happened so suddenly. A year on, he is doing great. He no longer can be walked though as it stresses him out so much, and sends his blood sugars crazy.

We are in a great routine of injecting now, he barely notices, we always do it after his first few mouthfuls of food.

We find the tricky bit is making sure he doesn't eat during the day from scavenging, especially with children wandering around with random foodstuffs.

Thank you both for taking the time to reply.
Lone cat we usually re arrange for the Christmas tree and I hadn't considered that tree will have to be put somewhere else and out of her way this year.

Barley sugar her sight really went so quickly it seemed to be overnight. She already does not like going out for walks we are fortunate enough to have a large enclosed garden so she can potter about when she feels like it.

Our vet has said that she would not be a good candidate for cataract surgery as she is very "highly strung" and it would take a lot out of her. Insurance company had already said no as they state it is a lifestyle surgery rather than a necessity

Trying to make sure the kids don't feed her is proving hard I have twin DD aged 2 who leave a trail behind them.

I am going to try and do the injection in the morning when she is eating and that will hopefully be less stressful for her.

Oops also meant to ask if you had any advice re cold injections. Honey gets v upset if her insulin is fridge cold so I have to warm it to room temperature, this is meaning I have to get up early to prep the insulin before her morning feed. I spoke to the vet but he said until she was properly stabilised I couldn't prepare her injection the night before and leave it out.
Thank you

If you use the caninsulin vetpen it doesn't need to be kept in the fridge so no cold injections. Plus with the vetpen it is much easier to leave with someone else to use. This formulation is different and has different storage rules to all other veterinary insulin.
Regular insulin must be kept in the fridge till use as it denatures and is less effective.

We are just using the standard syringes and insulin. Vet is not a fan of the vet pen as he says they are overly fiddly. I had looked into them as I thought it might be easier on Honey but his opinion is that I should just stick to the syringes. He also thinks that as our insurance were less than keen to cover cataract surgery that they would be unlikely to cover additional costs of vet pen.
starting wonder what I have been paying £50 a month (just for Honey) for as they are hopeless needless to say I am switching insurance companies for the other dogs.

I tend to warm the syringe in my hand for a few seconds before I give it, but I'm not sure if he feels it any less! You can't keep it at room temperature for any length of time.

Are you making a nice big fist of skin to inject? Luckily our dog is a spaniel so he has lots of spare skin at this neck which makes it quite easy.
Also, do try to vary slightly from time to time where you inject, if my DH does it every time, he gets a bit of a lipoma, if we alternate (I am a leftie!) it's mich better.

We have had no problems claiming the vetpen from any insurance company.

The vets and nurses have to take the time to learn how to use the vetpen properly I have a specialist diabetic vet nurse who is fully trained up.

Once the staff are trained it is actually much, much easier for clients to use, as often clients find the drawing up of a dose into the syringe tricky whereas with the vetpen you dial and go.
The vetpen is exactly the same system as human diabetics use.
We only use the vetpen in our clinic now and clients who have switched from syringes have been delighted with the change. In particular the clients who can now take the dog camping again.

Thank you again.
I try to vary the sites as much as I can but she is quite slight in build she is a collie jack Russell cross, but I am aware that I am probably getting her in the same general area quite a bit.
Unfortunately we don't have a specialist nurse in our practice, vet is currently only treating one other diabetic dog (only found out when I went to pick up food and none in stock as they don't usually use much).
Back at the vets on Monday so will ask about the vet pen again, is it a smaller needle?

Wanted to say hello.

I have a diabetic dog too. She is on canninsulin twice daily. Diagnosed 18 months ago and doing really well. I use a great forum called K9diabetes and have got great help and info and friendship from this international forum . There is lots of information and support available on there about coping with diabetes, injections, blindness etc. Thankfully my dog is not blind and I am managing her diabetes very tightly to try and preserve her vision. I also check my dogs blood sugar levels myself with a human BG machine and save lots of money off vet bills by doing this as well as keeping her in really good control.

I remember someone telling me they wore small cat bells on their shoes or ankles to let their dog know where they were in the home and on walks.

8thplace ask your vet about acutrack a special machine like the humans, but is pec fiscally calibrated for dog and cat blood so gives much more accurate results that the human machine, plus uses less blood so is nicer for the pet and enables even greater control.

Hello 8th place

Thank you for taking the time to reply. I will pop over to the other forum for a wee look. I might have to try the bells as at the minute she is guided by clapping which can be confusing if the kids join in.

Thanks Lonecat

I have used the accutrack previously and find it gives very comparable results to the human meter I now use at a fraction of the cost. In fact at my last vet appt we checked both my machine and the accutrak and got identical results from the same drop of blood, confirmed by lab analysis too. I now do all her own glucose curves at home and then email my vet the results. I also test before walks as I am keeping her in a tight range. She has never had a hypo and is in the excellent control range . My dog does not mind the blood tests at all, they are easy and painless. She did however initially dislike the injections and found they hurt so I have changed her to shorter needles and now do a calculation to change her dose from 40iu TO 100 ius.

I am a bit of a control freak in relation to my dogs diabetes! I have alot of knowledge re human and animal diabetes ( have a diabetic cat too) and am a human nurse.

When she was first diagnosed I was told and read 80% of diabetic dogs go blind from cataracts within a year. Most vets and owners I have spoken to have this experience. Thankfully ( I consider down to her tight control and the help of the above mentioned forum) this has not been my dogs experience yet. I do think that in the UK we are behind in managing and treating animal diabetes in comparison to other countries.

Do you have a diabetic pet lonecat or are you a vet nurse, im not too sure?

I'm a vet with a strong interest I endocrine disorders. I agree it is not necessary for pets to develop cataracts, however with the massive contraction of the veterinary insulin market it is much more difficult. I guess as you talk about switch from 40IU to 100IU you are now using an off licence human product I have used some, but have very few clients that will do blood testing at home. Around 90% of my clients on being told their pet is diabetic are immediately thinking euthanasia. I have to say we do manage to talk them round partly due to my amazing diabetic vet nurse (I can't give her enough credit for this). However, home testing is a step to far.

Lonecat I read your post with interest. I had asked about home testing but was told that it would be unnecessary and cause the dog more distress as it should be done with a prick from the ear but have never been able to get a sam

Sorry posted to soon
.... Sample from there.
I was horrified to hear of the PTS option which was offered to us but certainly would not consider as she is in good health otherwise.
I am kicking myself that diabetes was not picked up sooner and this has led to cataracts. We took Honey to our previous vets 6 months ago when she started having continence issues but it was diagnosed as being a result of her age and as she was an older neutered female and treated with oestrogen meds. Increased thirst over the next few months was put down to weather. When her symptons were not improving and she started to lose weight I took her to our current vet who diagnosed diabetes.
I am determined to do all I can to give my girl the best quality of life I can and need to do a lot more research on what I can do for her.
I don't suppose your practice is in N Ireland?

Sorry no I'm not. Can I suggest this website as a good place to start it is not comprehensive, but is a good start. Most of the key opinion leaders in canine diabetes contributed to it.
I like using fructosamine testing to get an idea of long term control as well as blood glucose.
I have never had any trouble claiming diabetic treatment including cataract surgery ( which I would argue is not a lifestyle choice) from any insurance companies and boy I have I claimed from a lot.

Lone cat thank you I have just followed your link and am now of the conclusion that our current care plan is lacking. We are currently having once weekly trips to the vets as a result of a hypo 3 weeks ago prior to this we had 3 weeks free of visits as she was "stable" . We have not had any mention of curves etc
I definitely need to discuss my concerns with our vet and implement some changes to tighten up the control and treatment.
I never want to experience a hypo which was treated and picked up swiftly but was a very scary experience ( could not sleep that night and was up and down checking her every hour)
I cannot thank you enough for taking the time to answer my questions.

Lonecat,

I'm so pleased that you are a vet, and a very good one I'm sure , but I have to comment on a couple of things you have said from my personal experiences.

When my cat was diagnosed as diabetic 5 years ago, he was very unwell and the vet pushed us towards euthanasia, suggesting he would not improve and have no quality of life. I did not agree with this and cat is still leading a healthy life on bd insulin. The vet wanted to put him to sleep, not the owner.

Home testing of diabetic pets ( cats and dogs) is not a step too far. Its easy to learn, painless for the animal and relatively inexpensive. The reason most owners in the UK do not home test is either that it is not suggested or they are put off by their vets and staff who have little or no experience of it. I watched my current and past vets fumbling to get samples from my animals ears and was shocked. Its much easier to test on the inner lip or carpel pad. Have a look at the amazing K9 diabetes website and you tube for more info. I have since then taught my wonderful vet and his staff and other owners to home test and they manage fine and love the lack of distress to their pets and valuable information it gives.

Fructosamine testing is really not that useful IMO as it only shown average readings over the last 4-6 weeks, It completely misses highs and lows and these are what give rise to problems in animal diabetes. For example a dog could be having lows of 3 and highs of 20 and the fructosamine may show "good control" .

As a human nurse I know we would never start a patient on insulin and not start home blood testing. Its far too dangerous. Its not a step too far for parents to learn to test their childrens blood. No one would question this, in fact it would be dangerous not to.

I do offer home testing to my clients, but most are scared of the injections let alone taking samples.
I never offer euthanasia, however, nearly everyone of my clients bring it up.
I know fructosamine is not perfect and it can appear normal even in patients having zygomi over swings, but it can provide some information.
You are an almost unique client, I have had one human nurse with a diabetic cat and she was much less dedicated than you.