TOP #8: Dealing With Canine Diabetes ft. Rachel Poulin, RVT

As pet obesity continues to rise in America, one of the most common and dangerous diseases dog owners encounter is canine diabetes. In our eighth Theory of Pets podcast, we discuss the dangers of diabetes in dogs, its causes, prevention, potential treatments, diet for dogs with diabetes and anything else related to this health problem.

Canine diabetes is directly related to dog food that we feed our canine companions. According to scientific data, this disease continues to rise without any inclination to stop. With that in mind, it's important for all of us pet owners to educate ourselves on the causes of diabetes and learn about foods which would better serve our dogs' health.

In this podcast episode, we've had the pleasure of talking to Rachel Poulin, a Registered Veterinary Technician and the president of the Academy of Internal Medicine Veterinary Technicians (AIMVT), a group of dedicated specialists of different medical backgrounds that focus on internal medicine in veterinary practice. Rachel has provided us with a ton of useful information regarding canine diabetes, and some tips on how to deal with it.

Listen to the episode in the video above and find the full podcast transcript below. For more, visit this episode’s post on the official Theory of Pets website.

Dealing With Canine Diabetes
(raw podcast transcript)

Dealing With Canine Diabetes

Hello everyone and welcome back for Episode Eight of the Theory of Pets.  I am so glad that you guys are back with me today to talk about a really important topic that I don't think gets discussed enough in the pet industry, and I think that we really need to work on helping to spread the education about pet diabetes, and today we're going to be specifically focusing on canine diabetes and feline diabetes.

But the topic of pet diabetes just doesn't come up really until your dog is…or your cat is diagnosed, and I think pet parents don't know what signs to look for and I think a lot of people think if my dog was diagnosed with diabetes that's it, my life's over, they have to be around to do the blood sugar testing and give my dog insulin and I'm going to have to take him with me everywhere or stop doing things, I'm not going to be able to work outside the home.

That's simply not true, and it is a lot of information, it's extremely overwhelming, there are things that you're going to need to do to make sure that your pet has what he needs but it's not going to change your life.  It'll take a little bit of planning and you'll need to spend a little bit of time educating yourself and working with your veterinary team to figure out what's best for your pet but it's certainly not something that will change your life or your pet's life, lots of animals can live a very long healthy happy life after a diagnosis of diabetes as long as their owner is willing to work with the veterinary team and do what's best for the animal.

So today I was able to talk with Rachel Poulin, and she is a registered veterinary technician at Capital Veterinary Services.  Rachel loves to teach and she is passionate about educating and enforcing a higher expectation in our standards of care and client education too in the veterinary field because when you say things like canine diabetes or feline diabetes people aren't educated about that until their pet's actually diagnosed and it becomes a problem and an issue in their life so they become educated.  But really we should be educated before that so that we know the signs to look for.

Rachel actually speaks internationally on internal medicine topics as well as general patient care and client education, she is currently the President of the Academy of Internal Medicine Veterinary Technicians so I wanted to speak with her today to get a little bit of information about diabetes and also to talk about a new app that's released that could really be a huge help for anybody with a pet… any kind of a pet that's been diagnosed with diabetes.

It's a tracker basically that you can input information into, and we've all used different apps that track different things from…for ourselves, maybe the food we eat, maybe the exercise that we do, and also the things for our pets.  So this new app that is out is called PetDialog and it's PetDialog is all one word, the pet log app and it supports the interaction between the pet owner and the veterinarians.

So Rachel had some time to play around a little bit and she actually uses it in her practice so I wanted to speak with her about that and get some information for you guys. I'm going to go ahead and let you listen to the interview and then I will come back and recap for you a little bit.

Interview with Rachel Poulin

Samantha:  Thank you very much for being here Rachel, I really appreciate your time.

Rachel:  Oh it's my pleasure.  I'm very excited about getting the word out about diabetic care.

Samantha:  Yeah.  I think canine diabetes is something that just isn't talked about a lot unless your dog has diabetes, and I think a lot of pet parents don't really think about it until their dog's not feeling well and they go to the vet and they're diagnosed and then that's when they start trying to learn about it and get as much education as possible.  But it is a growing issue in… I guess pets, but we're talking about specifically dogs, and I think it's something that all pet owners should be aware of even before maybe they jump into owning a pet, it's just something that maybe should be in the back of their mind.

Rachel:  Absolutely, absolutely.  You know I'm frequently told my owners that they didn't even know their pets could get diabetes, that they didn't even realize this was an issue that pets could possibly struggle with until they get the diagnosis, and there are so many diseases that human get that animals can only struggle with.  And you're absolutely right, diabetes is a huge prevalent one.  I believe the latest statistics is one in five dogs and one in four cats will be affected by diabetes mellitus.

Samantha:  Now is it something that they kind of grow into?  What's like the average age that dogs or cats are diagnosed with diabetes?

Rachel:  It's more prevalent in female dogs than male dogs; in cats I would have to get those numbers to you, I don't have them off the top of my head.  And in terms of age we're sort of looking at younger to middle-aged dogs, like maybe five, six, seven, eight, sort of in there, but that's the…you know we always have the dogs that defy the statistics no matter what, but that would be sort of a…female dogs is normally the typical what we see.

Samantha:  Is there a reason that it's more common in female dogs?

Rachel:  You know I can't answer that, I actually am not particularly sure, they definitely have different core build…physiology and biochemistry which can make them a little more vulnerable to pancreatitis hormone issues just like that, but in terms of the actual type of physiology between the male and the female I couldn't actually tell you why the females seem to be more prevalent than the males. It isn't business to say I mean that the males don't get it, cause they do, it's just a little more common in females.

Samantha:  Yeah that's interesting, and I know there are some things like obesity that can kind of add to the risk of diabetes, but are there other things that would stick out as like risk factors?  Are there certain diseases maybe that are more prevalent?

Rachel:  Absolutely. So obesity is a big one, obesity because just like in humans it makes them insulin-resistant so the insulin doesn't work quite as well in the body as it should because of the fat, and other factors are lack of exercise, which also lends itself to obesity.  Diet is a big part of it, just like humans if your dog or cat is not getting a good well-balanced diet they can become more at risk for diabetes.  Dogs particularly as they age they develop pancreatitis which happens for a variety of different reasons and I can certainly go into detail with you on that.

They can develop diabetes because the pancreas doesn't work as efficiently, it doesn't produce enough insulin or it becomes, the body becomes insulin-resistant.  So there's all different kinds of ways that it can happen.  I've seen it happen every way, I've seen it happen where because of obesity or because of pancreatitis, but those are a few of the big ones that can cause diabetes.

And sometimes it is just the luck of the draw, some breeds are more predisposed to it, Schnauzers are more predisposed to diabetes; Bichons, Yorkies, and there are some bigger breeds that I see, but those are the big ones.  So unfortunately sometimes it's the luck of the draw, the luck of the breed and the dog is not obese at all, it doesn't have pancreatitis, doing perfectly fine and then one day you find out your dog has diabetes.  But there are things that you can do to sort of decrease their risk, keep your dog fit, give it a good healthy diet, plenty of exercise.

Samantha:  So if somebody has maybe one of the breeds that are more prone, or their dog's obese, what are some of the signs maybe that they should be keeping an eye out for if they are worried about canine diabetes?

Rachel:  When I do my lecturing on canine and feline diabetes and I'm teaching other nurses how to treat and how to recognize, the first thing I tell them is excessive water consumption and excessive peeing, that's probably one of the very very first things you see.  Now this is not necessarily diagnostic for diabetes because there's other diseases that could cause that, for example Cushing's disease but it is definitely a red flag that should bring you into the hospital for a test of some sort.

There are also issues like hungry, diabetic dogs they never feel full where dogs in general don't really… they always kind of want to eat right, but diabetic dogs take it to another level.  The difference is if you have an uncontrolled diabetic in your house and you're not aware of it they're going to be drinking and peeing more, probably having access to your house and they're going to be eating a lot but they won't be gaining weight, in fact they could be losing weight, and those are usually the signs when they come into the clinic and they say “Something's off, they're peeing all over the place…I'm pretty sure they're losing weight…I've never seen him feel hungry.”  As soon as I hear things like that I test the glucose.

Samantha:  And that's just a simple blood test that can be done at your veterinarian office?

Rachel:  Yes.  The blood glucose… and we use the AlphaTrak because it's animal calibrated for a dog or a cat, that will tell us the reading of the blood sugar in real time, it won't tell us necessarily what it's been doing, how long the animal has been diabetic, and it doesn't eliminate the need of a full work up, but in real time you bring your dog in and I take a blood sugar and it's 350, I know we're heading toward the diabetic track.

Samantha:  So let's just say somebody brings their dog in, he is diagnosed diabetic, I know a lot of people hear diabetes and they immediately think of needles and insulin, I'm sure obviously it's going to depend on the severity of condition at the time, but what can a dog owner kind of expect to be doing now for their dog after they're diagnosed?

Rachel:  Well the number one treatment for diabetes is insulin, if there is a situation where insulin can't be given then we tell you how to fix that because if we can't get insulin into the animal, the animal will not strive and it will continue to suffer from the disease.  So any pet owner that has a animal diagnosed with diabetes needs to just expect that insulin needs to be given, just like in people.  If you're diagnosed with insulin-dependent diabetes, which is what our dogs and cats get, then yes, of course you're going to have to give insulin.

Now a bit of a difference between dogs and cats is dogs sometimes… I'm sorry, cats sometimes go into a diabetic remission and they can get to a point where they no longer are insulin dependent, and that requires very…again checking glucose and stuff like that.  Dogs are usually always insulin dependent so a dog owner should expect to be checking glucoses, be giving insulin, be very strict about diet, it is a commitment, it is a time commitment, it can be a monetary commitment but they can live a perfectly normal life as long as the medical team and that owner communicate well with each other and the dog is getting all of the medical requirements that it needs.

Samantha:  And for checking glucose, would that be a blood test?  Like I know with humans the pricking the finger and you have little monitors, is it similar in dogs?

Rachel:  Yes absolutely.  There are a couple of different monitors out there, I've only ever used the AlphaTrak because it requires the least amount of blood, and slowly I get it on the ear, the inside of the ear.  I had one client that had a cat that was diabetic and she always used the cat's pad and every night at 7:00 o'clock at night it would jump up on the counter lie down on its belly and they would have their little moment of getting the blood sugar.  And it takes a couple of seconds once you get the hang of it.  But it's very similar to humans you know, human diabetics they take their blood sugar several times a day, so in our clinic we do advocate that our animals attract …their blood sugar attract both dogs and cats.

Samantha:  So I think this is a good time now to talk a little bit about Pet Dialog app because this is something that seems to be a really new and very innovative and you know the veterinary..

Rachel:  So the app, I've had it…played with it, talked to the people…some of the people that help make it.  I really like it. I've been teaching diabetes to nurses and also teaching clients for several years and one of the biggest issues that have come along is the tracking, and owners to bring results and getting questions and trying to figure out how to bridge the gap when you're at home and you get an abnormal reading, “What do we do?  How do I get my results to you in a family matter?  Do we need to increase this?  Do we need to decrease this?”  And we always tell our pet owners, please don't change it… administration of the unit without our consent or without the doctor telling you to do so.

With this app you put in the readings as you get them and you can send those readings directly to your doctor's office.  I was playing around with it today, I put in a couple of different…I created this diabetic animal, I put in some high readings, I put in some regular readings, but just to see what happened I put in a very very low reading and it alerted me that the reading was dangerously low and I should call my hospital.

And that's very important because when you're in the office and you're talking to the client they have very… it's so easy to get overwhelmed with a diabetic diagnosis, you can imagine it's twice a day of injecting insulin to twice a day of getting a blood glucose reading, it's going to be more frequent doctors checks, it can be pretty devastating when you first get that news.

This is like having a little buddy that can help you track your pet's health, and can give you a little work as to “Hey this should be checked out….Okay that's normal, I don't need to alert you.”  And then you hit the button after the program and within 30 seconds you're seeing your doctor's email.  So I sent it to myself today and I trained it, the email took about 20 or 30 seconds to get into my email and it comes up with a spreadsheet and the entire curb was there, and that's really really really helpful…

Samantha:  Absolutely.

Rachel: …to have that kind of communication with diabetics.  Very helpful.

Samantha: Absolutely, and what a wonderful tool for the pet parents, I think like you said the overwhelming… we have a boxer who has cardiomyopathy and she takes five pills a day, and of course we have to monitor her heart rate frequently and things like that, and then when she was first… yeah when she was first diagnosed I had a book that I carried around and we set alarms on our phone I think the same thing can be said for diabetes like there is so much to remember and there are so much new information to try and learn, and just to have that open communication with your vet at all times is really fantastic.  So I kind of jumped on this when it came across my desk because it just seems like such a great tool for any pet owner who has an animal that's been diagnosed with diabetes.

Rachel:  I totally agree.  I totally agree. I had the chance to play with it right before it got rolled out to the hospital. I heard about it in a conference and I had a chance to play with it and then it got rolled out about two weeks ago to hospitals, and I just think that it serves the purpose of being a little assistant to the pet owner, reminding them of things, letting them know this is off, getting the information to the doctor quickly.

You know diabetes isn't like so many of the diseases we treat where if you have a dog that has just say for the sake of argument, inflammatory bowel disease that is a serious condition, and yes it needs to be treated and treated well, but something that's going to be life threatening in a matter of a couple of hours probably isn't going to happen with inflammatory bowel disease whereas a blood sugar reading of 47 can be life threatening very quickly.

So you definitely need to be on top of these things but to have a little support from an app that can connect you to your clinic or give you a little reminder “Hey it's time for these things.  But to have a little support from this app that can connect you to your clinic or give you a little reminder, “Hey it's time for this…hey it's time for this…” a lot of times we send people out to the clinic, I know they're alone and I can feel they're all alone and I try to give them as much support as I can, and so does my doctor, but I can't go home with them but the app can.  The app can absolutely go with them and help them and remind them, and if I didn't have this position and the knowledge that I have and I was treating a diabetic donor… diabetic pet, I'm sorry, I would want as much help as possible.

Samantha:  Absolutely.  Absolutely.  I know there is…I mean this is a tool that it seems like it's so far advanced from the other things that are out there, but are there other things that you recommend to pet owners who come in and like you said they're just in that state of…they're so overwhelmed and there's so much to learn.  Are there any references or things that you recommend for them, especially in the beginning stages?

Rachel:  Yes, I always tell our pet owners to go to the AlphaTrak Meter dot com website, there's great great videos, even if for some reason you're not using the AlphaTrak, if you're using another animal app…sorry not app, animal blood acquisition tool, I still recommend going to the AlphaTrak Meter Website and learning through a video, there's support team, literature on there and there's tools to help you how to…to help you learn how to use the monitor itself and why it's so important to track.

I also spend a lot of time with my pet owners after a diagnosis, my doctor obviously makes the diagnosis and introduces the topic but then I'm usually, I'm there for about 45 minutes just talking to them about diabetes.  And I would hope that pet owners have that kind of time with somebody to hold their hand and let them know.  And if they don't, that's okay, there's other references available.  Like I said, there's a lot of information out there online, my favorite site right now that I found is the AlphaTrak website because it has great tools and it teaches you how to use the device and explains why it's so important to track.

Samantha:  Great!  I'll make sure that I link that in our show notes as well so anybody that is listening that wants to check that out can definitely do that really easily.  I think that…

Rachel:  That'd be great.

Samantha:  Yeah, definitely.  I think that going back to our dog and having that diagnosis, it is scary in the beginning and I think one of the things that helps you, kind of soothes you or makes you feel better as a pet owner is to get as much information as you can because you're so scared in the beginning and there's so many things that you just don't know.  So having any resources that you can get to try and figure out as much as you can is always beneficial.  So I'll be sure to link that.

Rachel:  Absolutely.  And I also recommend… you know Google is a wonderful tool but it doesn't always give you… it gives you websites but you don't always know what sites are good and what websites maybe don't have the best information.  So I would ask your veterinary team what sort of resources they recommend and start doing some Internet searches based on their recommendation so that they know that they're going to reputable websites that can give them information.

The other thing that we started in my last hospital in Coral Springs, Florida, is we did …as a support group that met every other month and it was literally like coffee and some cookies and about a dozen or so diabetic owners and it was just a round-table discussion about questions and ideas and experiences, and it was really really successful and I do hope to launch it at the hospital that I'm at now in the next couple of months.

Samantha:  Oh that's a wonderful tool I think, having people that are in your same shoes can be a huge help and a huge support. So that's kudos to you, that's wonderful.

Rachel:  Yeah, and I would hope other hospitals…I know that there are some hospitals that offer it, but people can always ask is that something that this hospital would consider doing?  “Could I meet some other diabetic pet owners?”  Because there is very good support, exchanging of ideas, “This is how I do this…this is how I do that…”  We got a lot of answers…and we as the veterinary team learned a lot. So it was very very successful, we learned so much from that.

Samantha:  Yeah absolutely, I mean every pet…so like you said you knew the lady with the cat who would just jump up there and give her her paw, but that doesn't happen…that's one in a million you know, so anybody with…Anybody that can share tips and tricks for those dogs that are harder to handle.  We're very lucky with our Boxer, she takes her pills fine, but we have a Chocolate Lab who takes supplements, only supplements, and it's so hard to give them to her. So every dog's different, and just getting together with some people that maybe have some stories to share, some ideas that they've tried that worked or haven't worked, that's absolutely a great benefit to parents that are trying to deal with a diabetic animal.

Rachel:  Absolutely.  You know the more the merrier, I mean everybody's in the same boat whether it's a cat or dog, they're all trying to understand the disease the best they can.  You know I would say that the single best tool obviously after insulin is blood monitoring and blood tracking, and that seems to be one of the biggest challenges that I face in teaching, and I've taught, I don't know how many people how to do it, but that was one thing that our diabetic support group also did is we did blood acquisition modules so that they could…so their owners could discuss the problems they were having at home and we could work through them.

What I find when we first diagnose these guys and we talk to the owners, the insulin isn't necessarily as scary as getting that blood sample, and it is a very daunting idea.  I actually don't introduce it to them until they come back in the following and get it rechecked because they're already so overwhelmed.  And then when I introduce it I spend time with them and I show them, and they usually, 90% of them do you get it and they're like “Oh I didn't realize it would be so easy.”

But the idea of having to get blood from their pet you know twice a day, sometimes more than that, is overwhelming. So I guess what I want to try to convey is that it's very doable and the website that I mentioned before the AlphaTrak website does show videos, but also ask your veterinary nurse to show you how to do it because it is a very simple thing to do once you get the hang of it, and it's a life-saving tool.  Absolutely a life-saving tool.

Samantha: Wonderful.  That's great.  Those are really the only questions that I had for you but if there's anything about diabetes, or the app, or really anything that you want to discuss that we haven't discussed yet absolutely feel free.

Rachel:  I think it is on the app that a tool to add medication which I thought was really cool because you can even use it if your pet's not diabetic as reminders, you can schedule…you can set up calendars for like when their next appointments are due, when their… medication is due.  So if you're somebody that works crazy hours like me, it actually serves as a little reminder tool even if you don't have a diabetic animal, and I thought that was pretty good, I'm going to…mine up with Doctor Gayle.

Samantha:  Yeah, absolutely.  I mean I would do it just like I said we've got alarms on our phone but that's great and I know the flea and tick medication just whether you do it monthly or you take the ingestibles that are every six months, sometimes that can be hard to remember, so that is definitely a benefit….yeah.

Rachel:  Exactly, exactly.  Ultimately when it comes to diabetes you need to have a great health care team that you trust and you need to be open and willing to adjust your life to helping this animal but it doesn't have to take over your life, and I think that's what people are afraid of that they have this diabetic animal and “Oh my God, I'm never going to be able to see a movie at 7:00 o'clock at night because I'm going to have to be home giving insulin to my pet.”

All of that can be worked out, you can still have a diabetic animal that is well controlled and have a life.  It can be done.  So I would just encourage people to stay open and ask lots of questions and work with your team, and hopefully get these animals into a really good state of diabetic control or incase of cats, diabetic remission, but it does not have to be the end of your social life if you have a diabetic animal.

Samantha:  I would agree with that, and that was something that I do hear from other pet parents, not just with diabetes but a lot of health conditions can take time and some effort on the owner's part to control, so that's definitely something to remind people that you can still do the things that you need to do whether it's work or your social life, or whatever it might be and make sure that your pet is cared for at the same time.

Rachel:  Yes, absolutely possible.

Samantha: Wonderful!  Thank you so much again for your time.  I really appreciate you speaking with us, I think this is a really important topic and I'm excited to educate as many pet owners as possible about it.

Rachel:  It really was my pleasure.  This is a topic that I'm very passionate about and I applaud you for getting the word out there on this. I do agree with you a hundred  percent, we do need to increase awareness about veterinarian and dog and cat diabetic patients.

End of the interview

As always I hope you guys learned as much from that conversation as I did.  You know I can't say it enough that I think this is a topic that we really need to educate ourselves on and help educate other pet parents as well because it's something that, as Rachel mentioned you know it's something that within just a matter of a few hours can be life threatening.  So if you know those signs, you're looking for those things, some of the signs that she mentioned like drinking a lot, peeing a lot, eating food but not necessarily gaining weight.

Those things you might think “Oh he's just not feeling well today,” or “He's just a little dehydrated,” so you kind of let it go because you don't want to go into the vet for a visit and spend a hundred and 50 dollars for your vet to say, “Oh I think he's just not feeling well.  Give it a couple of days,” or “I think he's just a little dehydrated so make sure you put plenty of water down him.”  So you kind of wait that out, and if it's diabetes and you end up waiting it out you can have some major problems in the long run. So I think it's something that we need to educate ourselves about; help educate other pet parents.

Of course if you have any questions, feel free to leave those on our website which is, there is a section for comments and questions, you can type those comments and questions or you can make a voice recording of those and I may use them on a podcast in the future, so that would be really great if you want your chance to be on our podcast.  And of course if I can't find…if I don't know the answer to the question that you're asking I'll certainly find it for you, I’ll reach out to some of my contacts like Rachel Poulin and other experts in the industry to try and get that information for you.  If it's a question that you're just curious about, of course if it's a question that you're asking about your own pet and it's something that you need an answer on very quickly you should certainly contact your veterinarian and see what they have for advice for you.

Of course there's show notes on our website as well so you can jump on, you can find all my old website…ah sorry, all my old website…all my old podcasts, and you can find the previous episodes as well as the show notes from all those.  You can find the show notes from this week and those links that we had talked about.  If you're looking for more information on pet diabetes there are a few links there that might give you some more information that are great references that Rachel had mentioned; and then of course leave your comments and questions.

I will be back next time with another episode for you guys.  I appreciate you all listening.  If you enjoyed this podcast, please take just a couple of minutes, jump on iTunes and leave me a review, that will help me grow the podcast and be able to reach out to some more experts in the industry and get some of our questions answered.  So if you could do that I would really appreciate it, you can jump in on iTunes and do that.  I'll see you guys in fact next time.  Thank you so much for listening, I really appreciate it guys. Have a great day.

Samantha’s biggest passion in life is spending time with her Boxer dogs. After she rescued her first Boxer in 2004, Samantha fell in love with the breed and has continued to rescue three other Boxers since then. She enjoys hiking and swimming with her Boxers, Maddie and Chloe.