This post is meant to familiarize everyone with what pancreatitis, colitis and diabetes really mean.
Pancreatitis
(from http://www.mayoclinic.com/health/pancreatitis/DS00371 and http://www.petdiabetes.com/pdorg/pancreatitis.htm)
Pancreatitis means inflammation of the pancreas. The pancreas produces enzymes that help digestion and hormones that help regulate the way your body processes sugar (or glucose). The inflammation can become severe, and the digestive enzymes that are normally inactive can become active and these enzymes then can cause damage to the pancreas. This causes a cycle of increasing inflammation. The vet thinks Buzz has chronic pancreatitis, or essentially scar tissue has formed in his pancreas, which in turn decreases the ability of his pancreas to function properly, and therefore diabetes can (and did) result.
Colitis
(from http://en.wikipedia.org/wiki/Colitis and http://www.mayoclinic.com/health/ulcerative-colitis/DS00598/DSECTION=symptoms)
Colitis refers to an inflammation of the colon and is often used to describe an inflammation of the large intestine (colon, caecum, and rectum). We think this is a separate medical condition than the pancreatitis/diabetes. This may be one of the causes that his diabetes got so out of control, though.
Diabetes Mellitus
(from the American Heart Association, http://www.americanheart.org/presenter.jhtml?identifier=4546)
Diabetes is a disease in which the body doesn't produce or properly use insulin. Insulin is a hormone produced in the pancreas. Insulin is needed to turn sugar and other food into energy. Buzz doesn’t make enough insulin because of the scarring of his pancreas. This causes sugars to build up too high in his blood. Diabetes mellitus is defined as a fasting blood glucose (or the blood glucose when Buzz isn't eating) of 126 milligrams per deciliter (mg/dL) or more.
To give you an idea of how bad Buzz's diabetes is/was, these are his glucose readings since we picked him up on Thursday night, December 9, 2010. Please keep in mind that after each reading, we administered the proper amount of insulin - usually after texting the internal specialist to get his thought on how much insulin to give (humulin-r initially, then switched to humulin-n after the second reading on Sunday, each was measured in mg/dL)
Friday: 485 at 12:30pm, 260 at 5:00pm, 574 at 10:50pm
Saturday: 484 at 9:40am, 430 at 3:00pm, 541 at 10:10pm, 458 at 12:10am
Sunday: 556 at 8:40am, 599 at 3:00pm, 178 at 7:30pm
Monday: 517 at 8:30am, 452 at 8:30pm
Tuesday: 248 at 8:00am, 610 at 10:00pm
Wednesday: 417 at 9:45am, 413 at 7:45pm
Thursday: 720 at 9:45am, 377 at 8:00pm
Friday: 307 at 7:45am, 695 at 8:40pm
Saturday (today): 203 at 8:15am
Buzz was diagnosed with diabetes 1 week and 4 days ago, and this has been the most stressful 1 week and 4 days of my life.
Buzz came into our lives in March of 2010. We found him on petfinder.com and drove through 3 states to pick him up from a rescue organization. He wasn't the picture of health, but he wasn't rolling over dead anytime soon, either. They thought he was 3 years old, but they also thought he had been with them for only 6 months. When they got all of his paperwork together, they realized he had been there for over a year and a half. I guess that was a sign of the type of care, or should I say lack of care, that he received there.
We had our first big health problems in June when Buzz started vomiting blood. After spending $500 for essentially a babysitter and saline, he got better and we went on with our lives.
At the end of October, we realized he was drinking/peeing A LOT, but we chalked it up to him eating our other dog's food (she's on a special food for bladder stones that she had surgically removed at the beginning of 2010. It makes her drink/pee a lot to flush out her bladder).
At the end of November, he was acting very lethargic and losing his appetite. These were huge red signs because this dog LOVES to eat and play. We thought he was losing some weight as well, but just figured whatever had happened back in June was rearing it's ugly head again. There's no way I'm paying $500 for saline again, I thought.
Then came Monday, December 6th, 2010. The morning started off with Buzz vomiting all over our comforter. Then all over the couch. Then the carpet. Then outside on the patio. Then the carpet again, and eventually in his crate. We made a vet appointment for that afternoon.
We get to the vet and the first thing they always do is weigh him. He had lost 8 pounds. EIGHT POUNDS! This was a big deal because he was only 25 pounds to start with, now down to a low of 17. What kind of a mom am I that I let my best friend lose that much weight and not even notice?! They ran a CBC and chem panel, which came back with glucose levels through the roof. Next, they did a urine test and found that his ketone levels were life-threatening.
We were referred to an internal specialist who would be able to get his diabetes under control over the course of a few days. I knew this was going to be expensive, but it's worth it for the health of my baby. The IS assured me that he had never had a dog who's diabetes he couldn't get under control. I felt pretty good with that and left Buzz in his hands.
Tuesday. I left work at 5PM and went to visit my little friend at the pet-hospital. The IS informed me that his diabetes had been well-controlled on a very small amount of insulin my vet had given him the previous day, so he was thinking maybe it was just transient diabetes brought on by some sort of infection? I liked this idea. I liked it a lot, actually. The diabetes would go away, no pricking, no insulin, just a healthy dog again. Too bad this idea only lasted for a few hours.
I got a call Tuesday night that Buzz's sugar had spiked (roughly 24 hours after that first insulin injection). They gave him the same amount and expected it to last 24 hours again.
Wednesday. The IS calls to let me know that while Buzz's diabetes is pretty much under control now, he is just not feeling better. The IS did a mini-ultrasound and saw some abnormalities so he wanted to call in a radiologist who wasn't available til Thursday. Great, I thought, another $200 in an overnight hospital stay for something that should've been taken care of already. Oh well, he is my best friend, right?
Thursday. Buzz has been diagnosed with pancreatitis (something the IS thought was a big possibility) and colitis and pretty much inflammation of every internal organ he has. The prognosis isn't good. He isn't feeling better, he isn't eating (down to 16 pounds!!?!?), and the diabetes is still being weird. The IS decides that a steroid injection will be the only thing to help the inflammation, and he is right - however, steroids make diabetes worse. Thankfully, we got to pick Buzz up Thursday night and take him home. They were hoping he would be more comfortable there and maybe even get his appetite back.
Friday. I stay home from work to chill with Buzz (and Bella, our other dog). He's still not eating, and really all he's interested in is sleeping. We had picked up an AlphaTRAK glucometer system from the IS the day before and were testing his blood glucose every 3 hours or so, but it was always above 300 regardless if we had given him insulin or not (he was then on humulin-r, a fast-acting insulin). I headed back to the IS Friday afternoon to pick up some antibiotics for Buzz (he had a very stuffy nose). At this point, Buzz was on cerenia (anti-nausea), metoclopramide (gets everything moving through his intestines), famotidine (stops him from spitting up), and now the antibiotic (plus insulin) - all injectable because he wasn't eating anything. Friday came and went without anything too crazy happening.
Side-note: Our internal specialist was awesome. He was available through text message anytime, day or night. This was especially helpful because although I knew a lot about diabetes being in the health field, I had never actually dealt with a diabetic dog.
Saturday. Buzz still wasn't eating. I made an emergency visit to our primary care vet, where they filled him with subcutaneous fluids (and sent me home with more fluid and needles) and did an xray to rule out pneumonia. Which he didn't have - thank goodness! They also gave him another steroid injection to help increase his appetite and fight off all of that inflammation. Buzz started eating small pieces of boiled chicken later that night, but refused any other food - rice, broccoli, wet low-residue food, everything.
Sunday. The end of the weekend. We were really exhausted by this point. Buzz was making very small improvements, and we were honestly not sure he would pull through (which is still a very sad thought for me).
Monday. Buzz was finally starting to eat small amounts of wet low-residue food as long as there was plenty of boiled chicken mixed in. Still no rice or anything else, though. His diabetes had progressed to the point where we switched to humulin-n (a longer-lasting insulin) and we were injecting 4 units twice a day.
Tuesday. Recheck day at the IS. Buzz wasn't dehydrated (yay!), but they wanted to keep him to monitor his glucose since it had been so wacky since he went home on Thursday. They kept him all day, but after they gave him his morning insulin, his sugar dropped to 52. They were able to give him food, etc., but the thought that he could dip so low when we were at work really scared me.
And this leads us to where we are now. We are checking Buzz's blood glucose twice a day - trying to keep it at 8AM and 8PM - with the insulin injection being given immediately after. His eating is still strange because he will eat the wet food sometimes, but won't at other times. So he basically is eating now whenever he wants, whatever he wants. I think he is starting to gain back weight, but that's almost the last thing on our priority list right now.
He is starting to become playful again, just last night he got in a tussle with Bella over their favorite toy (they love those stuffing-less toys, we had a raccoon and a fox but the raccoon was lost at the IS - so they are now fighting over the fox). His ears perk up when he hears the treat jar open and close and he comes galloping in the kitchen to gobble down whatever food is in his bowl.
I think he is making progress. I try to not get too excited if I see some of the old Buzz (such as gobbling down all of his food!) because I know we still have a LONG road ahead of us. But I know that as long as Buzz has us and we have Buzz, everything is going to be fine.
