Dont it Make your Brown Eyes Blu
Blu, a 3 and ½ year old Border Terrier presented to us in November 2013 with some worrying symptoms.
He had been drinking a lot, vomited repeatedly and not been interested in eating for the previous day. When he came in he lacked his usual Terrier enthusiasm, had lost over a kilo in weight and just wanted to lie on the consult table. Further diagnostic work was indicated and he was admitted for blood tests, urine tests and intra-venous fluid support.
Once results came back a clear diagnosis was made – Blu was a diabetic. His pancreas (an organ that sits between the liver and the stomach) had ceased producing insulin – a hormone responsible for enabling the body to use glucose obtained from food. When insulin is not available, the cells and organs essentially starve as they are no longer receiving an energy source and the body kicks into survival mode. It starts to breakdown muscle and organ tissue in an effort to provide energy for itself, and toxins are produced. Without treatment this leads to a catastrophic downward spiral and ultimately coma and death. Blu was already on this downward spiral and was in a seriously bad way.
We immediately began treatment with insulin injections and intravenous fluids in an effort to reverse this process and stabilize him. His blood glucose was monitored hourly throughout the day, while we awaited further blood tests from the external laboratory. The following day he was brighter, had eaten small amount and was more interactive. However by the afternoon he had taken a turn for the worst, with recurrence of the vomiting and no interest in food.
As additional test results became available it was clear that Blu’s pancreas was struggling. As well as producing insulin the pancreas is also responsible for producing digestive enzymes that are secreted into the digestive tract. Dogs commonly get “pancreatitis” – inflammation of the pancreas – and symptoms include vomiting, inappetance, abdominal pain and at times a fever. If the pancreatitis is severe enough and the inflammation widespread then diabetes can occur. Not all dogs with pancreatitis develop diabetes, and not all dogs with diabetes have got pancreatitis – but unfortunately in Blu’s case he had it all. This contributed to him feeling lousy, not wanting to eat, vomiting, and ultimately a worsening diabetic state. As he was becoming weaker, we had to intensify our treatment regime and try to provide a delicate balance of intravenous glucose, electrolytes and insulin to keep him in a safe blood glucose range. At times this involved overnight care with our vet team.
Despite our best efforts Blu continued to deteriorate and we were concerned the pancreas was starting to die off. Blu travelled to a referral centre for an emergency ultrasound. Ultrasound showed that the pancreas was holding up well which was a relief as prognosis would have been very poor if this wasn’t the case. Medical and supportive treatment continued with round the clock blood glucose monitoring and insulin administration.
On day 9 and 10 Blu started to turn the corner, and by day 12 we could get him started on a regular twice daily insulin administration. He was bright, alert and responding well to medication and had got his appetite back. Blu had been to the brink and back, if he was a cat we’d have said he’d lost 8 of his 9 lives. He continued to improve and it was with great pleasure we got him home to his supportive family.
He will always be a diabetic, and is maintained on twice daily insulin injections and visits us every 3-6 months for follow up bloods tests. He has good quality of life, and despite numerous blood tests, intravenous catheters, fluid therapy, insulin injections and needle pricks he still loves coming to visit us. A worthy recipient of the title RAPPAWSOME!
Blu hanging out at one of his current recent visits!