draggonlaady: (Grinding Bones)
So mid-morning this morning, as I'm examining and vaccinating a dog in the back of the clinic, and preparing to go into my next appointmen, Sir Fuckwad and the diabetic dog come wandering into the treatment area. No appointment. Unescorted. Unleashed. Dog starts urinating on the floor and wandering around, tracking muddy urine all over the room. Sir F says "my way's not working, I brought him in to recheck his sugar and see if there's anything you can do for him."
"We can start him on insulin, like I discussed with you last week. But right now, I'm rather in the middle of something, so you'll have to go back up to the lobby and wait until I'm done with this appointment."
I have one of the techs round the dog up and put him in a run, since Sir F seems incapable of understanding the concept of a leash, and I go see the cat that's waiting for me.
So when I pull more blood from diabeticboy (DB), who's now quite a bit more depressed and wobbly than he was last Friday, and by golly guess what? On antibiotics and diet change, as expected, his blood sugar has gone up another 250g/dl. (For the curious, normal is about 100. Today, he's above 600.)
Go up and talk things over with Sir F, and it seems that (gasp, shock!) DB had been getting worse. He drinks incessantly and then vomits it back up. Pees all over the place, and won't eat anything, won't get up and do anything. I once again discuss diabetes, and inability to get sugar into the cells, starving to death on a cellular level, blah blah. Because DB is vomiting, I tell SirF that we really should hospitalize him and start on injected fluids to prevent severe dehydration. But unless we start insulin, there's no point doing anything. At which point I expected him to say that we should just put the dog down.
So here's the actual, real shocker--DB's in hospital on IV and insulin now. He's actually letting me try to treat him (now that he's in terrible condition, of course). So send good wishes for the lug, I suppose.

http://draggonlaady.livejournal.com/89086.html
draggonlaady: (Grinding Bones)
So I diagnosed a dog as diabetic today. Nothing terribly unusual about that, really. Was discussing with the owner the disease, and rechecking blood sugar after starting treatment, and insulin, changing his diet, that sort of thing. Owner wanted to know if he could check his sugar at home with his own monitor. Sure, why the hell not? Dog probably won't particularly like it when you lancet him, but go for it. So obviously, the guy's at least minorly aware of diabetes if he has to monitor his own blood sugar. Mentioned that we'll start him on antibiotics for a urinary tract infection (quite common when there's sugar in the urine). At which point he asks if I think that the infection is what's making the dog not feel well.
NO. No, I'm pretty sure that what's making your dog not feel well is the fact that he's an UNREGULATED DIABETIC who can't get any energy from his food. Once again discuss insulin, and ask him if giving the dog a shot every day will be a problem. And the owner tells me that he'll take the antibiotics, and follow my advice about the food, but he's not going to pick up any insulin today...he'll "take my recommendations under advisement".
I tell him that changing the food and using the antibiotics are NOT the important thing here, and will make at best a minor effect on the dog's health. The important thing is that he HAS NO INSULIN because his pancreas has just crapped out on a fairly major function. If he does not treat the dog, it will not get better. Diabetes does not just go away, and antibiotics will NOT help the major issue. He NEEDS to treat the diabetes or the dog will just continue to be sick and will get worse.
He repeats that he'll "take my recommendations under advisement".
Fucking bastard. If you're not going to treat the dog, you might as well just shoot him, instead of letting him slowly starve to death while tormenting him by giving him food he can't benefit from. There is absolutely no fucking way to classify that as anything but cruelty by neglect.
I will be calling Sir Fuckwad in a couple days to check on the dog, and if he is still not willing to start treatment with insulin, I will be telling him that in as many words.

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