Bloodwork, and possible diabetes?

12/12/12 - I couldn't resist updating the blog on this date, could I?  :)

On Monday, I took all of the dogs in for their annual exams and bloodwork.  Having 3 senior ladies means keeping check of health on the inside, even though everyone looks healthy on the outside!

Reo got blood taken for both an EI-1 panel from NVDS, as well as regular chemistry/CBC.  Apparently, the nurses took too much blood too quickly - Reo passed out right after the blood draw!  It was super scary at first, but they gave her some oxygen and she perked right back up.  The vet likened it to standing up too quickly and getting lightheaded.  That's never happened before, so we'll have to be more careful on blood draws next time!

Though we need to wait until next week on the EI-1 panel, we already got the chemistry results back.  First of all, Reo's blood remains lipemic (fatty).  It has been this way for the past year or so, and I wasn't too surprised, but it does affect the CBC portion of the results.  Her cholesterol is normal.

She had very slight elevations in two liver enzymes, ALT and ALP.  Because they are very mild, the vet is not concerned, especially as she has been on long-term Medrol.  However, her blood glucose was very elevated (377!), and our vet is concerned that Reo could have diabetes.  :(  Though she was 7 hours post-meal, we will do a fasting blood glucose, and possibly a fructosamine test as well, to see where we stand.  At the same time, we will do a urinalysis and urine culture to see where we stand there.

The strange part is, Reo is not drinking or urinating more frequently.  She does not have accidents in the house.  She has not gained any weight (in fact, she lost a bit since our appointment in June), and is not more hungry.  We keep a close eye on her PU/PP/PD, given our experiences in the past.  Reo is also on grain-free, low-glycemic dehydrated/freeze-dried raw food.

First, cortisol is insulin's counter point.  As insulin LOWERS blood sugar, cortisol INCREASES blood sugar.  This is important to remember.  Many Cushingoid dogs (high cortisol) also have diabetes - I think about 20% of dogs who are Cushingoid also have diabetes.

I have been thinking a lot (I know my readers are surprised!) about what could have brought this on.  In the past few months, I discontinued Reo's phosphatidyl serine supplement.  Phosphatidyl serine is thought to blunt the cortisol response/spikes in cortisol.  It's possible that my giving her PS was reducing the amount of circulating cortisol in Reo's body, and when I stopped giving this supplement, she had an increase in cortisol, resulting in an increase in blood sugar (this will become apparent when we get the EI-1 panel results back - if her cortisol is high, perhaps this is the case).

For the past couple of years, I have been operating under the assumption that Reo has very, very little adrenal function (if at all).  However, perhaps her adrenals can make a bit of cortisol, and her daily dose is giving her a bit too much.  We may need to adjust the dose of her Medrol.  I plan to wait and see what the repeat blood tests say, and then I will contact Dr. Plechner and see if any adjustments need to be made.

Reo, our little problem child!  The great news is that she is happy, healthy, and not displaying any "symptoms".  I hope the glucose reading was a fluke somehow, and she is not diabetic.  I can't imagine having to stick her twice per day, although of course we are totally committed to her for life!  <3