Molly is a 12 year old Yorkshire Terrier. Her owners first became concerned when she started drinking more than usual and having accidents in the house. Increased drinking and urinating can be a sign of many diseases, some of which could make her unwell if left untreated.

Initially we took some blood and urine from Molly. This allowed us to look for problems with organs, such as the liver and kidneys, as well as giving indicators of other things such as glucose (sugar) levels in the blood, something we look at if we are concerned about diabetes.

Whilst we were waiting for Molly’s results to come through she became poorly. Given the possible causes of her increased drinking we took an isolated blood glucose sample to measure the level of sugar in her blood. It was high, indicating that she had diabetes.

When dogs get diabetes it is usually because the body doesn’t produce enough insulin. Insulin is what converts glucose from the blood stream into a different form so that it can be stored in the body. If the body can’t convert the glucose, for example following a meal, then the levels in the blood stream remain high. We therefore had to give Molly insulin to reduce her blood glucose level.

Molly stayed in the hospital overnight following her first insulin injection. By the next day her blood glucose level was reducing so she went home to continue her insulin injections twice a day.

The important factors in managing Molly’s diabetes are to keep a consistent requirement for insulin and to give a consistent amount of insulin. This means keeping her food intake the same each day, as well as giving it at the same time. Molly gets insulin injections twice daily and is fed just before her injection. To work out exactly how much insulin Molly needs we have to check her blood glucose level over the course of a day. We don’t want it too high, but we also don’t want it too low because the body needs it as an energy source, particularly in the brain. We therefore start at quite a low insulin dose and increase it from there, depending on her body’s response. We have to wait a few days between changing her dose and retesting to make sure insulin levels are remaining consistent.

Sometimes diabetes is easily controlled but this is not always the case. Finding the right dose of insulin for Molly has proven to be a bit tricky. If other diseases, such as Cushings disease, are present it can make diabetes harder to control. Therefore a specialist ultrasonographer came and carried out an ultrasound scan of Molly’s abdomen to check for other complicating problems. Thankfully this was all normal.

Molly is now on track and is responding well to her current insulin dose. Since getting her blood sugar levels under control she has been much brighter and happy, and her drinking has greatly reduced, meaning her accidents have too.

She will likely have to continue her insulin injections for the rest of her life and we will keep a close eye on what her glucose levels are doing, as well as managing her food intake. However, aside from this Molly can lead a normal life, doing everything she loves to do!

Scamp is a West Highland White Terrier who came to see us feeling quite unwell. He was very lethargic and drinking more than usual. He had been sick a few days before and didn’t want to eat anything either. On examination he also had a high temperature.

We needed to investigate further as Scamp was feeling so poorly, so initially we took some blood to run some tests. Scamp’s results suggested that his liver was the cause of the problem. There are lots of conditions that can affect the liver and the blood test cannot give us an exact diagnosis. At that stage we could not tell whether Scamp’s condition would carry a good or poor prognosis. An ultrasound scan was the best way to try and get more information.

We organised a specialist to scan Scamp’s abdomen the next day. In the mean time we started him on some intravenous fluids to try and support him. With liver problems we sometimes need to take a sample of the liver to be examined at the laboratory. Because the liver can sometimes bleed when we take a sample with a large biopsy needle it is important to check that the body has enough ingredients to clot the blood effectively In Scamp’s case one of his clotting times was a bit increased so we opted not to take any liver biopsies until the test could be repeated to check whether it was ok.

However, the ultrasound scan itself showed some changes. The ultrasonographer suspected that he had an infection in his bile from his gall bladder, causing inflammation of the bile ducts and possibly the liver itself. We took a sample of the bile to send off so that we could work out which antibiotics would be most effective to treat the infection.

We continued Scamp’s fluids and started some antibiotics and soon he was looking much brighter. We also started some liver supplements to help his liver function. Unfortunately, once we stopped Scamp’s fluids he deteriorated and started vomiting again. Therefore whilst we were waiting for his bacterial culture results we kept Scamp on fluids, his antibiotics and the liver supplement. Unfortunately although he remained stable, he did not continue to improve as we hoped.

The reason became clear when we received Scamps culture results. He did have an infection of his bile but unfortunately the infection was not responsive to the antibiotics he was taking. We started some new antibiotics that the culture results showed should work against Scamp’s infection.

Scamp soon started feeling a bit better and we were able to stop his intravenous fluids. This meant that he was able to go home to continue his course of antibiotics. Since then Scamp has had a few ups and downs but he is now doing much better and enjoying his walks again.