|
Comfortably Managing Diabetes Insipidus in Boxers -
By
Kim Barnett
Nearly two decades ago, Freddie came to us as an
overnight stay and ended up staying because of his constant need to drink
and urinate, and limited understanding at the time of how to diagnose and
treat his condition. Thus began our first –but not our only—experience with
diabetes insipidus (DI), a rare pituitary gland disorder that causes
dehydration.
Though DI is rare, it is seen in Boxers more than most
breeds, so it’s important for Boxer lovers to recognize the symptoms and to
understand that it is manageable. Significantly, recent advances in
treatment have reduced the cost and made the disease much easier to manage.
Freddie, an 18-month-old Boxer, was my first venture as
a Boxer rescue volunteer in the early 1990s. I had agreed to help with what
was supposed to be his handover from his former owners to a new adoptive
home.
When they dropped him off, Freddie's family explained
that for months he'd been living in their shed due to his constant need to
drink, urinate and drink. They'd taken him to three vets but had no answers,
were out of money and frustrated. The dog was thin for his size, with his
hipbones and spine protruding. The first thing I observed was that he was
like a bloodhound on a hot trail in constant search of something: water or
any other liquid he could reach. His thirst was truly insatiable. He would
literally drink the bowl dry over and over again. If he couldn't find water,
he would panic, frantically searching and pawing, even tearing at objects to
move them and see if there was water anywhere. He would stand and urinate,
walk and urinate and just urinate non-stop. He never relaxed for one moment
in the 12 hours he was with us.
It's quite distressing to witness a dog in desperation
with a constant thirst who is going crazy before your eyes, when you cannot
do more than offer them a few seconds of relief at a time when they're
drinking. Life can be pure misery for an untreated DI sufferer.
Freddie's new adopters felt confident that they could
handle the situation and immediately took him to their vet. The next day I
had a call that they were returning him to me. Again, the vet had no
definite diagnosis other than a warning that the dog had a "serious kidney
disease" and recommended his return. In his brief stay at their home, he'd
managed to overturn a washing machine, saturate their house and car with
urine and cause chaos.
Fortunately, my vet at the time, Dr Diane Stark, was a
great dog person and fabulous vet. After a quick phone call where I listed
the symptoms, she exclaimed in her no nonsense way: "I'll bet that dog's got
Diabetes Insipidus. It's pretty rare. Bring him down; we'll test him. It's
treatable." It was confirmed: Freddie had DI.
Diabetes Insipidus is a condition caused by the
pituitary gland's inability to produce the anti diuretic hormone (ADH)
that's responsible for helping the kidneys concentrate urine. A normal
body's response to lack of water is to concentrate the urine to prevent
dehydration. Without ADH, the kidneys cannot do this. Without constant water
intake, dehydration is inevitable. Because the urine does not concentrate,
it will look almost colorless, sometimes just like water. Just a matter of
several hours without water put a dog with untreated DI at risk of coma and
death. Even with regular access to water, weight loss and failure to thrive
are common.
Fortunately for sufferers,
Desmopressin Acetate (DDAVP), a synthetic hormone, can reverse all of
the symptoms. However, it can be expensive and must be given for the rest of
the dog’s life.
After tests confirmed her suspicions, I called the
rescue organization, which told me that given what little was known about a
dog's prognosis (at that time) and the high cost of the drug, they couldn't
help or rehome Freddie. So he became ours. We managed his DI through the
best treatment protocol available at that time.
Our vet showed us how to administer the DDAVP drops,
which come packaged as an intra nasal drug for humans, into the eye by
pulling back the lower lid and allowing just one drop at a time to fall
behind the lid where it gets quickly absorbed and enters the bloodstream. A
common mistake with this method is to flood the eye with too many drops at
one time causing an overflow and wastage of the drug so the patient never
gets the desired amount and symptoms return too quickly. In my experience,
more than one drop per eye results in flooding and drug loss.
Stabilizing a dog with just the right amount of DDAVP
took a little bit of trial and error as each dog may require a different
amount. We started with a baseline of two drops then added one drop until we
reached the point where all symptoms disappear. Using this method we had to
treat Freddie four times per day to keep him totally stable. That meant
organizing our lives around his medication. No matter how much we gave in a
dose, if we reduced the frequency to twice per day orally, his symptoms
returned. Occasionally, if he was stressed, he needed an extra drop to keep
him stable; but we learned what worked to give him a happy and normal life.
Freddie lived to be eleven years old and died from a brain tumor.
Freddie in his senior years, he loved the beach!
Several years later another DI Boxer came into a vet's
in New Jersey. After he was diagnosed, the owners chose to surrender to
rescue. I offered to foster him, knowing that I could use the experience
gained with Freddie to help this boy. It only took 12 hours to stabilize
Bert. Just like Freddie, Bert's skinny frame filled out in less than two
weeks once he was stable.
Then we made an exciting discovery that changed the way
we treated him and all subsequent sufferers in our care. We shared that
information with the practice that diagnosed Bert; they still use it and
share with others.
Researching the disease in dogs and cats online, a
Boxer rescue volunteer found an
article that described how an owner had been giving her cat his DDAVP by
simple subcutaneous injection, using a 1ml syringe, just as a diabetic would
inject insulin. Not only could the dosage be significantly reduced, but it
also could be given at twelve-hour intervals. We were astounded to find that
using this method, we reduced Bert's DDAVP usage by 60%; and yes,
twelve-hour intervals were all that was needed. This greatly reduced the
cost and was much more practical.
Bert was adopted by a family and is still happily
living with them many years later, sitting patiently for his twice daily
shot and treats. They tell me that his DI has been completely manageable and
affordable.
Bert in foster care, proving that DI dogs can relax!
Since then we've been able to help successfully treat
several other Boxers with DI. If your dog is diagnosed with DI, we recommend
that you ask your vet to show you how to give a sub-Q injection, and
practice with him or her watching so that you're comfortable. When giving
your dogs an injection, use some high value food like peanut butter or
cheese to associate the injection with a positive experience. Very soon it
will become routine.
Even when DI is diagnosed correctly, many owners chose
to give up or euthanize their dogs because they do not know that the disease
can be managed easily and affordably. We hope that sharing this information
will help more dogs to lead quality lives with their people.
For further reading:
http://www.mirage-samoyeds.com/diabetes2.htm
Kim Barnett provides training services for people
who love dogs. Her thoughtful advice has helped so many AABR Boxers and
their humans. Learn more about Kim at her
website.
© January 2012 Kim Barnett (This article is the
property of the author and may not be copied or altered in any way without
permission of the author) |
il
your stories and/or funny pics to:
Needed
