I had an exceptional day at work yesterday. Too bad it was of the impressively depressing kind. Three diabetics––all very sick––made it through my door. All three made it back out...as their owners picked them back up and took them to the internal medicine specialist’s place for more intensive care than I could provide. 

So you know, I’m happy to treat diabetics in my hospital. But by the time they present with the degree of clinical signs and frightening labwork that accompanied these three, my owners are inevitably given the choice to move on to higher tech pastures––that is, if they can afford it. 

The first was a dog that presented for severe lameness over the weekend. He’d made an appointment for X-rays and I’d found startlingly bad hips that had apparently deteriorated very suddenly. But  he’d also lost 21 pounds over the past two months (when I’d last seen him for his annual visit). At that time I’d read the owners the riot act on the dog’s extreme obesity. But something didn’t smell right. The dramatic degree of weight loss was disproportionate to the owners' denial of his obesity. 

I should have known right away, but the recent (pristine) labwork had me fooled. Turns out his hips were horrible, yes, but diabetes had debilitated his neurologic pathways in such a way that he was unable to place his limbs properly. Diabetic neuropathy we call it. He’s now doing reasonably well at the specialist’s place and has a great prognosis with insulin and further weight loss...though I do see a hip replacement in his future. 

Interestingly, my next two cases suffered from the same. Neither cat could walk and had been walking strangely before they’d collapsed. One had been losing weight for a month while the other had suddenly succumbed almost overnight. Both were in critical shape. 

Fatty liver disease accompanied the first patient. This 18-pounder had lost 7 pounds in 30 days! The whites of her eyes gave off a faint yellow glow and her labwork had fatty liver disease all over it (high bilirubin levels accompanied by not-so-high liver enzymes). In other words, the fat she’d so suddenly lost (almost certainly the result of her diabetes) had gummed up her liver’s works. 

The second patient fared the worst. The disease had come on fast and furiously while the owners had been out of town. Understandably, the pet sitter was in tears, feeling guilty over having missed the signs of impending doom. 

“But she was jumping onto the counters yesterday,” she explained. (And I believed her.) Yet sometimes this is how it goes with some of my older diabetics. And, yes, it often happens when the owners are away, as if the kitties suddenly give up hope in the absence of their loved ones. 

Sadly, patient #3 was euthanized last night. And I did not disagree with the decision one bit. Heading into a diabetic coma as she was, her chances were poor and her potential suffering, extreme. 

All three completely different scenarios. All three suffering the same primary disease. As if their pancreases had grown very tired all at once and gave up the ghost at their own individual pace, in their own unique ways. The first two influenced by extreme obesity, the last one...who knows? 

Needless to say, it was not an auspicious National Pet Obesity Awareness Day for me. Nor was that irony lost on two of three owners as they contemplated the fat pet posters in the lobby.