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For people with obesity, a procedure rarely performed in the US more effectively eliminates type 2 diabetes than Roux-en-Y gastric bypass, a small study shows.

Researchers thought that the less common procedurecalled biliopancreatic diversionbetter reduces diabetes because it typically causes greater weight loss than the more common surgery. But in a small study, the researchers found that biliopancreatic diversion appears more effective at eliminating diabetes not just because of greater weight loss but also because the procedure itself seems to make patients more sensitive to insulin.

Our results help explain the high rate of diabetes remission in patients who have biliopancreatic diversion surgery, says senior author Samuel Klein, professor of medicine and nutritional science at Washington University in St. Louis. These data suggest that we should take a closer look to see whether it might be a better option for some bariatric surgery patients.

For the study, published in Cell Metabolism, researchers compared the effects of the two surgeries on insulin and glucose sensitivity in patients who, after their operations, lost 20% of their body weight.

Insulin is the hormone that helps the body keep blood sugar under control. Being more sensitive to insulin allows cells in the body to use glucose in the blood more effectively and helps lower blood sugar.

Roux-en-Y gastric bypass surgery makes a patients stomach smaller by sewing parts of the stomach together to create a pouch about the size of an egg. Surgeons then connect that pouch to the upper section of the small intestine, bypassing a small portion of the upper intestine.

Biliopancreatic diversion is a more complicated surgery. Past studies have found that patients who have the surgery tend to have more postoperative complications.

In this procedure, the surgeon removes the lower part of the stomach, and connects the upper part of the stomach to the end of the small intestine, close to where it empties into the large intestine. Because the procedure bypasses so much of the intestine, the intestine absorbs fewer nutrients from food, putting patients at a higher risk for long-term nutritional deficiencies. So doctors need to closely monitor patients to make sure theyre getting adequate amounts of vitamins and minerals.

The less common procedure, however, results in better blood sugar control and higher rates of diabetes remission than Roux-en-Y gastric bypass surgery. Researchers didnt understand why until, in this study, Kleins team followed 24 patients, half of whom had Roux-en-Y gastric bypass surgery and the other half, biliopancreatic diversion.

The gastric bypass group in the study had average body mass indexes (BMI) of 48. A persons BMI is calculated using weight and height. A higher BMI increases risk of health problems related to weight; a BMI of 30, for example, is considered obese. Those who had biliopancreatic diversion had average BMIs of 56.

Surgeons performed the procedures overseas at Catholic University in Rome because biliopancreatic diversion is more commonly performed in Italy. In the US, surgeons performed some 228,000 bariatric procedures in 2017. Fewer than 3% were biliopancreatic diversion.

After surgery and a 20% loss of body weight, researchers measured the patients metabolic reactions to meals, with close attention paid to glucose levels, sensitivity to insulin, and how much insulin they secreted after eating.

The researchers found no difference in the benefit of surgery-induced weight loss to patients pancreatic function, in terms of insulin secretion, but patients who received biliopancreatic diversion surgery were more sensitive to insulin.

Klein notes that while the patients had obesity, none had a type 2 diabetes diagnosis. Researchers structured the study that way because they wanted to independently measure the insulin sensitivity after a meal, without potential complications caused by diabetes medications.

This study demonstrates that biliopancreatic diversion has unique, beneficial effects on insulin action, independent of any weight loss, he says.

As to whether the findings mean that surgery is preferable, Klein says thats less clear. The main consideration, he says, should be patient safety.

This study demonstrates additional metabolic benefits from biliopancreatic diversion, compared to Roux-en-Y gastric bypass, he says. But the type of bariatric surgery performed on any individual patient depends on many considerations, including an assessment of the effectiveness and safety of the procedure, patient preference, and the surgeons experience.

Klein, chief of the geriatrics and nutritional science division, adds that Roux-en-Y gastric bypass provides considerable benefits in helping people lose weight and in treating type 2 diabetes but does not have the weight-loss-independent benefits on insulin sensitivity of biliopancreatic diversion.

The National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung and Blood Institute of the National Institutes of Health, and the Pershing Square Foundation suppported the work.

Source: Washington University in St. Louis

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This other bariatric surgery better reduces diabetes - Futurity: Research News

Diabetes mellitus (DM) is the body's inability to regulate the level of glucose in the blood. Glucose is the main form of sugar in the body. The body breaks down food into glucose and uses it as a source of energy. In healthy people insulin helps to regulate the glucose (sugar) levels. Insulin is a hormone produced by the pancreas (a long, thin organ located behind the stomach against the back).

In diabetics, the body does not produce enough insulin or does not use the produced insulin effectively. This results in a high level of glucose in the blood ("hyperglycaemia").

There are three main types of diabetes mellitus:

a) Type 1, earlier known as insulin dependent diabetes mellitus (IDDM) or juvenile-onset diabetes mellitus. People with this type of diabetes make little or no insulin in their body, and need regular insulin injections for survival and management of diabetes. It usually starts in childhood, but can occur at any age. This ususally happen before age of 40.

b) Type 2 (DM2), earlier known as non-insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes. This is the most common form of diabetes, and is strongly associated with genetic tendency and obesity. The body produces normal or even high levels of insulin, but certain factors make its utilization ineffective ("insulin resistance"). Sedentary lifestyle, unhealthy dietary patterns, and the consequent obesity are common causes. It usually starts in adulthood, but is beginning to be seen in obese adolescents also.

c) Gestational diabetes mellitus, or pregnancy-induced diabetes.

Gestational diabetes is raised blood glucose levels during pregnancy. It develops in 5 % of all pregnancies but usually disappears when a pregnancy is over. Women who have had gestational diabetes are at increased risk (up to 40%) for later developing type 2 diabetes

Symptoms depend on the type and duration of diabetes. Some of the signs and symptoms are related to the high blood sugar levels.

These include: Increased urination, Increased thirst, Hunger

Other common symptoms:

There may be weight loss, especially if the amount of insulin made by the body is decreasing. If insulin deficiency is marked, the person can become drowsy and then go into coma. This is called Ketoacidosis, and usually occurs in DM1. Rarely, if the diabetes is completely out of control, it can also occur in DM2. Other symptoms of ketoacidosis include: Deep rapid breathing, sometimes with a fruity odour to the breath Pain in the stomach, with nausea and vomiting.

Diabetes mellitus is diagnosed based on a high level of glucose or sugar in the blood. The doctor may suspect diabetes mellitus after taking the medical history and doing a physical examination. There are several blood sugar tests used for diagnosis:

Fasting plasma glucose test: In this test, a person is asked to fast overnight, at least 8 hours, and the level of glucose in the blood is then checked. Normal fasting plasma glucose levels are less than 110 mg/dl. A fasting plasma glucose level of more than 126 mg/dl usually indicates diabetes mellitus. A level of 110-125 mg/dl is called "impaired fasting glucose".

Post prandial (PP) plasma glucose: This is tested two hours after having a meal, which serves as a challenge for the body to regulate the blood sugar. Normal PP levels are <140 mg/dl; a glucose level of more than 200 mg/dl indicates diabetes mellitus, while a level between 140-199 mg/ dl is called "impaired glucose tolerance".

Random plasma glucose test: is that which is done at any other time. A level of 200 mg/dl or higher generally indicates the presence of diabetes.

Oral glucose challenge test (oGTT): The blood glucose is tested 2 hours after giving 75 gm glucose by mouth. This is useful for detecting borderline diabetes and a condition called "impaired glucose tolerance".

Oral glucose tolerance test: is the preferred way to diagnose pregnancy-induced diabetes. Ideally all pregnant women in India should have a blood glucose test done 30 minutes after taking 50 gm gluocse (screening test). If this is abnormal, the lady should undergo an oGTT: with 100 gm glucose (not the conventional 75 gm). Blood samples are then drawn at intervals of one hour upto 3 hours (ie at 1, 2 and 3 hours post-glucose).

Although diabetes cannot be cured, it can be controlled very successfully. The main aim of treatment of all types of diabetes is to achieve blood glucose control, blood pressure and cholesterol levels as near to normal as possible. This, together with a healthy lifestyle, will help to improve wellbeing and protect against long-term complications.

Stay Active

Being active is good for all of us but is especially important for people with diabetes. Physical activity, combined with healthy eating and medication that you may taking will help you to manage your diabetes and prevent long term complications. If you have concerns at all about becoming active, never be afraid to ask for advice.

What are the Medication

People with diabetes often need additional treatment along with making lifestyle changes such as medication to control their Blood Pressure and blood fats. Treatment is decided by your specialist. But you should be aware of timings, dosage and its function in the body.

In diabetes stopping the treatment by your own can create lots of problems.

Hypoglycemia is the common problem which can happen in pt who is being treated with oral medications or Insulin

Hypoglycemia (low blood sugar) can be life threatening condition and its very important to act early.

Low blood sugar: a level below about 60 milligrams per deciliter (mg/dl) occurs when there's too much insulin and not enough sugar (glucose) in your blood. Low blood sugar is most common among people taking insulin, but it can also occur if you're taking oral diabetes medications.

When your blood sugar is low you may feel:

Shaky or nervous, Tired, Sweaty, Hungry, Irritable, Impatient, Cold, Confused

You may also feel tingling around your mouth.

Reasons for blood sugar swings

Although it is frustrating, blood sugar levels can also be too high for no clear reason.

Sometimes these high levels may be the first sign of an infection, illness or stress.

Because blood sugar levels can go very high when you are ill, talk with your health care team about creating a sick day plan to manage your diabetes when you have a cold, flu or other illness.

Pre Diabetes

Pre diabetes is when one has higher than normal glucose level but not high enough to be diagnosed with diabetes. Pre-diabetes is present when hba1c is over 6% -6.4%.

A person with pre-diabetes can be prevented to develop Diabetes by:

1. Improving diet

2. Increasing physical activity at least 30 minutes for 5 days in a week.

3. By reducing body weight, high blood glucose levels can return to normal which reduces the likelihood of developing T2D.

Benefits of weight loss

Benefits of an active lifestyle

Maintaining a healthy weight and eating a healthy balanced diet, low in fat and rich in fiber and fruits and vegetables, as well as being physically active is an important part of managing blood sugar levels and avoiding other health complications.

Read the rest here:
Diabetes: Symptoms, Treatments, Causes, Tests & Preventions

March 19, 2018 | More Articles: Symptoms

Type 2 diabetes is one of the major degenerative diseases in the Western world today. It happens when your body cant use insulin properly, or cant make enough insulin. Insulin is a hormone the assists the bodys cells in utilizing glucose. It also helps the body store extra sugar in fat, liver, and muscle cells. If you dont have insulin, your body cant use the sugar in the bloodstream.

Then, your blood sugar levels get too high. High blood sugar can have a deleterious effect on many parts of your body, including heart, blood vessels, nerves, eyes, and kidneys. Those who are overweight, dont exercise enough, or have a history of type 2 diabetes in their family are more likely to get the disease. Maintaining a healthy weight, eating a healthy diet, and getting enough exercise can prevent type 2 diabetes. If you have a history of diabetes in your family, or if you are overweight, stay ahead of the disease by making healthy lifestyle choices and changing your diet.

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Frequent urination is an early warning symptom of diabetes. When there is too much glucose in the blood, the kidneys work overtime to flush it out of the blood via urination. So, youll find yourself going to bathroom a lot more often than normal. There is also a bigger risk of urinary tractions in both men and women.

Individuals with diabetes have two times the likelihood of getting a urinary tract infection compared to individuals without the disease. If you find yourself getting up every couple of hours in the middle of the night, and you seem to be expelling a lot more urine than you used to, talk to your doctor and find out whether or not you have diabetes.

Increased urinary frequency is called polyuria, and individuals with diabetes are unable to regulate blood sugar levels. When too much sugars in the bloodstream, more fluids will pass through your kidneys.

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16 Early Signs of Diabetes - diabetics.guide

The importance of insulin

Diabetes is a disease in which your body either can't produce insulin or can't properly use the insulin it produces. Insulin is a hormone produced by your pancreas.

Insulin's role is to regulate the amount of glucose (sugar) in the blood. Blood sugar must be carefully regulated to ensure that the body functions properly. Too much blood sugar can cause damage to organs, blood vessels, and nerves. Your body also needs insulin in order to use sugar for energy.

Eleven million Canadians are living with diabetes or prediabetes. Chances are, diabetes affects you or someone you know.

There are three major types of diabetes. Type 2 diabetes is the most common diagnosis, followed by type 1 diabetes. Gestational diabetes occurs during pregnancy, and is usually temporary. In addition, prediabetes is another important diagnosis that indicates an elevated risk of developing diabetes.

Type 1 diabetes is an autoimmune disease and is also known as insulin-dependent diabetes. People with type 1 diabetes aren't able to produce their own insulin (and can't regulate their blood sugar) because their body is attacking the pancreas. Roughly 10 per cent of people living with diabetes have type 1, insulin-dependent diabetes.

Type 1 diabetes generally develops in childhood or adolescence, but can also develop in adulthood. People with type 1 need to inject insulin or use an insulin pump to ensure their bodies have the right amount of insulin.

People with type 2 diabetes can't properly use the insulin made by their bodies, or their bodies aren't able to produce enough insulin. Roughly 90 per cent of people living with diabetes have type 2 diabetes.

Type 2 diabetes is most commonly developed in adulthood, although it can also occur in childhood.Type 2 diabetes can sometimes be managed with healthy eating and regular exercise alone, but may also require medications or insulin therapy.

If you think you or someone you know may have type 2 diabetes, please speak to a doctor or health-care provider.

Link:
What is diabetes? - Diabetes Canada

VA research on Diabetes Introduction

Diabetes is a chronic disease in which the body cannot produce or properly use insulin. Normally, insulin brings sugar out of the bloodstream and into cells. If the body cannot make insulin or does not respond to it, the sugar stays in the bloodstream. As a result of high blood sugar levels, damage eventually occurs to blood vessels and organs.

More than 29 million Americans have diabetes, according to the Centers for Disease Control and Prevention, and 86 million more Americans are at risk to develop the disease. Many Veterans have the disease, including some who developed it as a result of being exposed to herbicides while serving in Vietnam.

Symptoms of diabetes include blurry vision, excessive thirst, fatigue, frequent urination, hunger, and weight loss. Persons with diabetes need to have their hemoglobin A1C levels checked every three to six months.

A1c is a measure of average blood glucose during the previous two to three months. It is one of the markers, along with blood pressure and cholesterol control, of good diabetes care.

There are three major types of diabetes. Type 1 diabetes is usually diagnosed in childhood. In this type of diabetes the body makes little or no insulin, so daily injections of insulin are needed.

Type 2 diabetes usually occurs in adults. In this type of diabetes, the pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to insulin. More than 90 percent of adults with diabetes have type 2 diabetes. More are at risk due to overweight or obesity.

The third type of diabetes is gestational diabetes, high blood glucose that develops during pregnancy in a woman who does not have diabetes.

Diabetes affects nearly 25 percent of VA's patient population. The disease is also the leading cause of blindness, end-stage renal disease, and amputation for VA patients.

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VA researchers are studying innovative strategies and technologies, including group visits, telemedicine, peer counseling, and Internet-based education and case management, to enhance access to diabetes care and to improve outcomes for patients.

In addition, VA researchers are working to develop better ways to prevent or treat diabetes, especially in special populations such as the elderly, amputees, minorities, spinal cord injured patients, and those with kidney or heart disease.

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Two of VA's three Nobel laureates have done important work to benefit Veterans with diabetes. The late Dr. Rosalyn S. Yalow received the Nobel Prize for Physiology or Medicine in 1977 for her work in discovering the radioimmunoassay, an extremely sensitive way to measure insulin and other hormones in the blood. The technique made possible major advances in diabetes research and in diagnosing and treating hormonal problems related to growth, thyroid function, and fertility.

Dr. Andrew V. Schally also received the Nobel Prize in Physiology or Medicine in 1977 for his discovery that the hypothalamus links the nervous system to the endocrine system via the pituitary gland, is currently doing research, along with teams of national and international researchers, on growth hormone-releasing hormone (GHRH). Among other possibilities opened up by Schally's work with GHRH is the possibility of reducing or eliminating the need for diabetics to regularly inject insulin.

In 2013, an international research including Schally devised a way to transplant healthy cells into the body without the usual risk of rejection. The study involved a middle-aged man with diabetes, but it may be relevant to a range of other diseases as well. The researchers developed what amounts to an artificial pancreas (the place where the body makes insulin), which the patient tolerated well without taking drugs to suppress the immune system.

A 2015 study by Schally and his team evaluated newly developed GHRH agonists' ability to promote the growth and function of pancreatic islet cells, and found that these new agonists may provide an improved approach to treating diabetes. Agonists are substances that act like other substances and therefore stimulate an action in the body. Islet cells, also called Islets of Langerhans, sense blood sugar levels and release insulin to maintain normal levels.

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For seven and a half years, researchers involved in a VA cooperative study(CSP 465) looked at nearly 1,800 patients with diabetes. The researchers examined cardiovascular disease, the cause of death in nearly two-thirds of patients with diabetes.

Researchers attempted to determine whether intensive glucose control (using medication and other methods to reduce the level of sugar in the blood in diabetic patients to levels that would be normal in patients without diabetes) reduced heart attacks, strokes, and death from cardiovascular disease.

It had been previously shown that improvements in blood pressure and cholesterol levels can reduce cardiovascular disease in patients with diabetes, but no previous study had shown the beneficial effects of glucose control on cardiovascular disease.

VADT researchers showed that intensive glucose control in patients whose type 2 diabetes had previously been poorly controlled had no significant effect on the rates of major cardiovascular events such as coronary artery disease and stroke, compared to those who were using standard glucose control measures.

The research team also found that the two groups of patients had similar death rates, and that both groups had similar levels of complications such as diabetic neuropathy and retinopathy, except that patients using standard glucose control measures had higher levels of albumin in their urine. (Albumin in the urine is a possible indicator of kidney disease.)

Trial researchers concluded that both very high and very low blood sugar levels can be dangerous, and that big swings between high and low levels are also potentially harmful.

As a follow up to VADT, VA researchers looked at whether the improvements in glucose control made by one of the groups in the trial led to long-term improved consequences. They collected information on the VADT cohort for more than nine years of additional study, using VA's electronic records system.

The team found in 2015 that patients who had been in the intensive-control group had a lower incidence of cardiovascular events after the trial was over, but their survival rates were no better than those of the other group.

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Sleep apnea and poor sleep qualityA 2013 study conducted by researchers at the VA Puget Sound Health Care System that was part of the joint VA-Department of Defense Millennium Cohort Study on the health of service members and Veterans, found that sleep apnea and poor sleep quality predicted diabetes, independent of other diabetes risk factors or mental health status.

Sleep apnea increased the risk of diabetes by 78 percent, and simply having trouble sleeping increased the risk of diabetes by 21 percent. The study included more than 47,000 service members and Veterans who were an average age of about 49.

Statin useResearchers at the VA North Texas Health System and their colleagues examined the health records of tens of thousands of Tricare beneficiaries for a nearly 10-year period. Their study, published in 2015, found that the use of statins to lower cholesterol is associated with a significantly higher risk of new-onset diabeteseven in a very healthy population.

They also found that statin use is associated with a very high risk of diabetes complications in this healthy population, and with a higher risk of obesity. High-intensity statin therapy was associated with greater risks for all outcomes.

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Implantation of insulin-producing cellsInsulin-producing cells that respond to glucose and correct blood-sugar levels in diabetic mice have been created by researchers at the Iowa City VA Health Care System and correct blood-sugar levels in diabetic mice.

The researchers took human skin cells and reprogrammed them to create induced pluripotent stem (IPS) cells, which were then coaxed into forming insulin-producing cells. When these cells were transplanted into diabetic mice, the cells secreted insulin and reduced the blood sugar levels of the mice to normal or near normal-levels.

The study raises the possibility that patients with diabetes could be treated with their own cells, which will accelerate treatment.

GRADE trialVA researchers are participating in a five-year National Institutes of Health study to compare the long-term benefits and risks of four diabetes drugs in combination with metformin. The study, called the Glycemic Reduction Approaches in Diabetes (GRADE) trial, is expected to include some 5,000 participants nationwide.

Metformin is the first medication doctors typically use when treating type 2 diabetes. If metformin does not control the disease, doctors may add one of several other drugs, all of which have been shown to lower blood sugar levels in studies. However, no previous long-term study has focused on which drug combination works best and has the least side effects.

The four drugs being studied are sulfonylurea, dipeptidyl peptidase-4 inhibitor, glucagon-like peptide-1 agonist, and long-acting insulin.

Drug combination causes adverse effectsIn 2013, VA researchers stopped a large multicenter study, part of the Veterans Affairs Nephropathy in Diabetes Study (NEPHRON-D), before its scheduled conclusion. They found that the combination of an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin-receptor blocker (ARB) increases the risk for serious adverse effects in patients with diabetic nephropathy, the leading cause of chronic kidney disease in the United States.

The significant increase in risk caused by taking the combination of drugs overshadowed any benefits taking the drugs may have in reducing the progression of kidney disease.

Diabetic kidney diseaseIn 2015, researchers participating in the NEPHRON-D study found that in patients with proteinuric diabetic kidney disease, a mean systolic blood pressure greater than 140 and a mean diastolic blood pressure greater than 80 were associated with a higher risk of kidney failure and death.

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The Veterans Affairs Implantable Insulin Pump Study; effect on cardiovascular risk factors. Duckworth WC, Saudek CD, Giobbie-Hurder A, Henderson WG, Henry RR, Kelley DE, Edelman SV, Zieve FJ, Adler RA, Anderson RJ, Hamilton BP, Donner TW, Kirkman MS, Morgan NA. Implantable insulin pump therapy in insulin-requiring patients with type 2 diabetes has advantages over multiple-dose insulin therapy in decreasing the requirement for antihypertensive therapy and for decreasing total and free insulin and insulin antibodies. Diabetes Care, 1998 Oct;21(10):1596-602.

Glucose control and vascular complications in veterans with type 2 diabetes. Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, Zieve FJ, Marks J, Davis SN, Hayward R, Warren SR, Goldman S, McCarren M, Vitek ME, Henderson WG, Huang GD, VADT investigators. Intensive glucose control in patients with poorly controlled type 2 diabetes had no significant effect on the rates of major cardiovascular events, death, or microvascular complications with the exception of progression of albuminuria. N Engl J Med. 2009 Jan 8;360(2):129-39.

Agonist of growth hormone-releasing hormone as a potential effector for survival and proliferation of pancreatic islets . Ludwig B, Ziegler CG, Schally AV, Richter C, Steffen A, Jabs N, Funk RH, Brendel MD, Block NL, Ehrhart-Bornstein M, Bornstein SR. Evidence that agonists of GHRH represent a promising pharmacological therapy aimed at promoting islet graft growth and proliferation in diabetic patients. Proc Natl Acad Sci USA, 2010 Jul 13;107(28);12623-8.

Sleep characteristics, mental health, and diabetes risk: a prospective study of U.S. military service members in the Millennium Cohort Study. Boyko EJ, Seelig AD, Jacobson IG, Hooper TI, Smith B, Smith TC, Crum-Cianflone NF; Millennium Cohort Study Team. Trouble sleeping and sleep apnea predict diabetes risk independent of mental health conditions and other diabetes risk factors. Diabetes Care. 2013 Oct;36(10):3154-61.

Combined angiotensin inhibition for the treatment of diabetic nephropathy. Fried LF, Emanuele N, Zhang JH, Brophy M, Connor TA, Duckworth W, Leehey DJ, McCullogh PA, O'Connor T, Palevsky PM, Reilly RF, Seliger SL, Warren SR, Watnick S, Peduzzi P, Guarino P; VA NEPHRON-D investigators. Combination therapy with an angiotensin-converting-enzyme (ACE) inhibitor and an angiotensin-receptor-blocker (ARB) was associated with an increased risk of adverse events among patients with diabetic nephropathy. N Engl J Med. 2013 Nov 14;369(20); 1892-903.

Human iPS cell-derived insulin producing cells form vascularized organoids under the kidney capsules of diabetic mice. A pancreatic organ can be created in vivo, providing evidence that human iPS cells might be a novel option for the treatment of type 1 diabetes. PLoS One, 2015 Jan 28;10(1):e0116582.

Enriching the diet with menhaden oil improves peripheral neuropathy in streptozotocin-induced type 1 diabetic rats. Coppey LJ, Davidson EP, Obrosov A, Yorek MA. Enriching the diet with n-3 fatty acids may be a good treatment strategy for diabetic neuropathy. J Neurophysiol. 2015 Feb 1;113(3):701-8.

Follow-up of glycemic control and cardiovascular outcomes in type 2 diabetes. Hayward RA, Reaven PD, Wiitala WL, Bahn GD, Reda DJ, Ge L, McCarren M, Duckworth WC, Emanuele NV, VADT Investigators. After nearly 10 years of follow-up, patients with type 2 diabetes who had been randomly assigned to intensive glucose control for 5.6 years had 8.6 fewer major cardiovascular events per 1000 person years than those assigned to standard therapy, but no improvement was seen in the rate of overall survival. N Engl J Med. 2015 Jun 4; 372(23):2197-206.

Dipeptidyl peptidase-4 inhibition ameliorates Western diet-induced hepatic steatosis and insulin resistance through hepatic lipid remodeling and modulation of hepatic mitochondrial function.Aroor AR, Habibi J, Ford DA, Nistala R, Lastra G, Manrique C, Dunham MM, Ford KD, Thyfault JP, Parks EJ, Sowers JR, Rector RS. Mice fed a diet that includes a DPP-4 inhibitor were found to have less insulin resistance than those not given the inhibitor. Diabetes. 2015 Jun;64(6):1988-2001.

BP and Renal Outcomes in Diabetic Kidney Disease: The Veterans Affairs Nephropathy in Diabetes Trial. Leehey DJ, Zhang JH, Emanuele NV, Whaley-Connell A, Palevsky PM, Reilly RF, Guarino P, Fried LF; VA NEPHRON-D Study Group. In patients with proteinuric diabetic kidney disease, mean systolic blood pressure greater than or equal to 140 mmHg and mean diastolic blood pressure greater than or equal to 80 mmHg were associated with worse renal outcomes. Clin J Am Soc Nephrol. 2015 Oct 19. pii: CJN.02850315. [Epub ahead of print]

Beneficial effects of growth hormone-releasing hormone agonists on rat INS-1 cells and on streptozotocin-induced NOD/SCID mice. Zhang, X, Cui T,He J, Wang H, Cai R, Popovics P, Vidaurre I, Sha W, Schmid J, Ludwig B, Block NL, Bornstein SR, Schally AV. This study provides an improved approach to the therapeutic use of GHRH agonists in the treatment of diabetes mellitus. Proc Natl Acad SCi USA, 2015 Nov 3; 112(44):13651-6.

Practical telemedicine for Veterans with persistently poor diabetes control: a randomized pilot trial. Crowley MJ, Edelman D, McAndrew AT, Kistler S, Danus S, Webb JA, Zanga J, Sanders LL, Coffman CJ, Jackson Gl, Bosworth HB. A comprehensive telemedicine intervention improved outcomes among Veterans with persistently poor diabetes control despite clinic-based care. Telemed J E Health. 2015 Nov 5. (Epub ahead of print.)

Statins and New-- Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults. Mansi I, Frei CR, Wang CP, Mortensen EM. Diabetes, diabetic complications, and overweight/obesity were more commonly diagnosed among statin users than similar nonusers in a healthy cohort of adults. J Gen Intern Med. 2015 Nov;30(11):1599-610.

Rates of deintensification of blood pressure and glycemic medication treatment based on levels of control and life expectancy in older patients with diabetes mellitus. Sussman JB, Kerr EA, Saini SD, Holleman RG, Klamerus ML, Min LC, Vijan S, Hofer TP. Physicians are not likely to cut back on blood pressure and glycemic medication treatments in older patients with diabetes after they reach low BP or hemoglobin A1c levels. JAMA Intern Med. 2015;175(12):1942-1949.

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Diabetes - research.va.gov

Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body.

The most common ones are Type 1 and Type 2. Type 1 diabetes usually occurs in children. It is also called juvenile onset diabetes mellitus or insulin-dependent diabetes mellitus. In this type, your pancreas does not make enough insulin and you have to take insulin injections for the rest of your life.

Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult onset diabetes mellitus. It is also called non insulin-dependent diabetes mellitus. In Type 2, your pancreas makes insulin, but your body does not use it properly. The high blood sugar level often can be controlled by following a diet and/or taking medication, although some patients must take insulin. Type 2 diabetes is particularly prevalent among African Americans, American Indians, Latin Americans and Asian Americans.

With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.

Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.

About 30 percent of patients with Type 1 (juvenile onset) diabetes and 10 to 40 percent of those with Type 2 (adult onset) diabetes eventually will suffer from kidney failure.

The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This is present long before the usual tests done in your doctor's office show evidence of kidney disease, so it is important for you to have this test on a yearly basis. Weight gain and ankle swelling may occur. You will use the bathroom more at night. Your blood pressure may get too high. As a person with diabetes, you should have your blood, urine and blood pressure checked at least once a year. This will lead to better control of your disease and early treatment of high blood pressure and kidney disease. Maintaining control of your diabetes can lower your risk of developing severe kidney disease.

As your kidneys fail, your blood urea nitrogen (BUN) levels will rise as well as the level of creatinine in your blood. You may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in your legs) and anemia (a low blood count). You may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.

Signs of Kidney Disease in Patients with Diabetes

First, the doctor needs to find out if your diabetes has caused the injury. Other diseases can cause kidney damage. Your kidneys will work better and last longer if you:

If no other problems are found, your doctor will try to keep your kidneys working as long as possible. The use of high blood pressure medicines called angiotensin converting enzyme (ACE) inhibitors has been shown to help slow the loss of kidney function.

The kidney doctor, called a nephrologist, will plan your treatment with you, your family and your dietitian. Two things to keep in mind for keeping your kidneys healthy are controlling high blood pressure in conjunction with an ACE inhibitor and following your renal diabetic diet. Restricting protein in your diet also might be helpful. You and your dietitian can plan your diet together. For Kidney and Diabetes friendly recipes click here to visit our Kidney Kitchen.

End stage renal failure, or kidney failure, occurs when your kidneys are no longer able to support you in a reasonably healthy state, and dialysis or transplantation is needed. This happens when your kidneys function at only 10 to 15 percent.

Three types of treatment can be used once your kidneys have failed: kidney transplantation, hemodialysis and peritoneal dialysis. To learn more about treatment options for kidney failure click here.

Yes. Once you get a new kidney, you may need a higher dose of insulin. Your appetite will improve so your new kidney will break down insulin better than your injured one. You will use steroids to keep your body from rejecting your new kidney. If your new kidney fails, dialysis treatment can be started while you wait for another kidney. To learn more about kidney transplant click here.

Sometimes it is possible to perform a pancreas transplant along with a kidney transplant. Your doctor can advise you about this possibility.

Today, more and more research dollars are spent on diabetes research. Hopefully, the prevention and cure of diabetes is in our future. In the meantime, you can manage your diabetes better with:

If you would like more information, please contact us.

2015 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.

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Diabetes - A Major Risk Factor for Kidney Disease | National ...

According to an analysis of global health trends from the year 1990 up to 2013,1 there has been a striking and alarming rise in the occurrence of diabetes mellitus, a trend that continues now, especially in the United States. In a study published in 2015, its said that at least 50 percent of American adults2 are now either in a state of prediabetes or are already struggling with the illness.

The American Diabetes Association says 30.3 million Americans, or 9.4 percent of the population, have diabetes, while 84.1 million U.S. adults age 18 and older had prediabetes.3 Even children are now being diagnosed with Type 2 diabetes, with the numbers continuing to rise.

Diabetes is an illness that can affect anyone. Its now a leading cause of death according to the Diabetes Research Institute, diabetes now takes more lives compared to breast cancer and AIDS combined claiming the life of one American every three minutes.4 But what exactly is diabetes mellitus? Why does it happen and how can you break free from it?

WebMD defines diabetes mellitus (also known simply as diabetes) as a chronic, lifelong condition that affects your body's ability to use the energy found in food.5 This is a group of metabolic diseases wherein the glucose that you get from food remains in your bloodstream (high blood sugar).

When you eat, your body transforms food into a special sugar (glucose) that your cells use for energy. However, in order for your cells to be able to take in the glucose and use it as fuel, it first needs a particular hormone called insulin.6 This essential hormone is produced in your pancreas.

In normal, healthy people, the pancreas does a good job of providing your body with just the right amount of insulin it needs. Insulin opens your cells and lets glucose enter so it can be used for energy.7

However, if you have diabetes, it means that your insulin production is inadequate, the body's cells do not respond properly to insulin, or a combination of these two factors. Because the cells are unable to take in the glucose, it then builds up in your blood where it wreaks havoc on your health.8

Aside from insulin, however, there are two more hormones that can predispose you to diabetes: leptin and ghrelin. Produced by your fat cells, leptin is a hormone that is responsible for telling the brain three things:

In addition, leptin is also necessary for your immune system, fertility and energy burning.

Meanwhile, ghrelin is the hormone that tells your body that youre hungry. Its secreted by the lining of your stomach. Since ghrelin is influenced by the growth hormone in your body, it tends to work differently in women and men.

These two hormones, along with insulin, are the three primary players (along with other factors) in the occurrence of diabetes.

If there is a problem in your bodys leptin or ghrelin signaling, then you tend to consume too much food for your activity level and metabolism rate, resulting in weight gain and obesity. And once obesity sets in, your cells become insulin-resistant, predisposing you to high blood glucose levels.

The excessively high levels of sugar in your blood cause damage to the tiny blood vessels in different body organs. This includes the heart, kidneys, nervous system and eyes. This is why diabetes has been widely associated with a wide range of health problems, including heart disease, kidney disease, eye problems and blindness, stroke and nerve damage in the feet.9

People with diabetes also experience various symptoms, the most common of which are frequent urination, increasing thirst and always being hungry.10

Living with diabetes can be emotionally and physically overwhelming. Its also a financial burden for most people annually, this illness costs the American public over $245 billion.11

The good news is that diabetes is potentially reversible and completely preventable without having to resort to conventional drugs. All it takes is a few disciplined lifestyle tweaks, particularly in your diet, so that you can avoid this damaging disease.

Diabetes: An Introduction

Causes of Diabetes

Excerpt from:
What Is Diabetes Mellitus? - articles.mercola.com

Skye is a 10-year-old German shepherd whose DNA was tested for degenerative myelopathy (DM) after she stumbled and fell as she walked down the steps outside her homean early warning sign of the disease. Soon after, Skyes family noticed that her back legs were wobbly and slipping out from under her on a regular basis. Her familys fears were confirmed when Skyes DM test results indicated she was at the highest risk level for developing the disease.

What is degenerative myelopathy?A progressive disease of the spinal cord that leaves once-healthy dogs paralyzed and ends their lives prematurely, DM is similar to ALS (Lou Gehrigs disease) in humans. It begins in the spine, when the outer coating (myelin) dies off and stops protecting the inner white matter that sends messages from the brain to control movement of a dogs legs.

DM is seen most often in German shepherd dogs between the ages of 8 and 10. Recently, the disease has been identified in several other breeds, including American Eskimo, Bernese mountain, borzoi, boxer, Cardigan Welsh Corgi, Chesapeake Bay retriever, golden retriever, Great Pyrenees, Kerry blue terrier, Pembroke Welsh Corgi, French poodle, pug, Rhodesian ridgeback, Shetland sheepdog, soft-coated wheaten terrier, and wirehaired fox terrier.

Some early warning signs of DM include:

As DM progresses, the signs become more pronounced:

Drs. Joan Coates and Gary Johnson and associates at the University of Missouri along with Drs. Kirsten Lindblad-Toh and Claire Wade at the Broad Institute at MIT and Harvard have identified the mutated gene responsible for degenerative myelopathy. They found that dogs with two copies of the mutation are at greatest risk of developing the disease.

The team of researchers also developed a DNA test that dog owners can administer at home and mail in for results. The test returns one of three possible results: normal, at risk, or carrier. The home DNA testing kit can be ordered through the Orthopedic Foundation for Animals.

Skye has been lucky; her disease has progressed slowly, and her family has been able to take care of her needs 24 hours per day. Now, 2 years after that first fall, Skyes hind legs are completely paralyzed, she is incontinent, and shes having trouble sitting up on her own. She has gone from using a dog wheelchair and keeping her body strong by swimming regularly to enjoying daily walks in a dog stroller. Despite her handicap, Skyes family says she is still happy and full of lifeand theyre happy to give her the care and love she needs.

Photos of Skye courtesy of Dorri Modic.

Sharon Seltzer is an animal writer who founded Lessons From A Paralyzed Dog, a website for owners of dogs with neurological and mobility disorders.

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Is your dog at risk for degenerative myelopathy? | AAHA

Mindy Tehan, RVT, gives laser therapy treatmentsto a patient at Animal Care Unlimited. Photo courtesy of Lindsay Melia.

Denver resident, Sue Kohut, was alarmed when her Great Dane puppy, Beauxmont, became lethargic and developed swollen legs that were hot to the touch. At just five months old, the pup was diagnosed with hypertrophic osteodystrophy (HOD), a painful bone disease that can occur in fast-growing large and giant breeds.

It can be cripplingin certain cases, a puppy would have to be euthanized, Kohut said. I had this big puppy who was in so much pain. I was like, Just fix him!

Fortunately, Kohuts veterinarian developed a treatment protocol that included laser therapy. Unlike surgical lasers that cut through tissue, therapy lasersor cold lasersstimulate the bodys cells to promote healing and alleviate pain.

I literally noticed an improvement after his first treatment, Kohut said. He was less lethargic and seemed like he was in less pain.

After three or four laser therapy treatments, Beauxmonts condition was completely resolved. Two years later, Beauxmont, who is also deaf and blind in one eye, is a loving pet who is simultaneously graceful and goofy.

Beauxmont is just one of a growing number of pets who have benefitted from laser therapy, particularly over the last decade as the technology has evolved. Jamie Bobulsky, DVM and medical director at AAHA-accredited Animal Care Unlimited in Columbus, Ohio, said the practice invested in a therapy laser in 2010 and has since seen some remarkable results. In fact, the hospital now includes laser therapy in treatment plans for everything from surgery to arthritis to ear infections.

Laser [therapy] causes many physiological and biochemical processes to occur, Bobulsky said. It stimulates the release of endorphins, causes vasodilation, and promotes lymphatic flow, which brings more blood to the area and flushes out inflammatory mediators and swelling, and accelerates tissue repair by increasing the rate of cell division and activating cells needed for repair. I explain this to clients as bringing in the good cells and taking out the bad ones.

Bobulsky said laser therapy is a valuable pain management tool, particularly for older dogs with arthritis who are starting to lose the use of their back legs, or those with compromised livers that prevent them from being able to take pain medication. It is a great option for cats as well, since there are fewer pain control options considered safe for them.

Therapy lasers are also useful in treating exotic animals that may not take medication easily, Bobulsky said. In addition to dogs and cats, her team has performed laser therapy treatments on birds, rabbits, guinea pigs, rats, ducks, sugar gliders, and wildlife, including owls, hawks, bald eagles, peregrine falcons, red-tailed hawks, and turtles.

There was a cockatiel named Beaker that suffered an unknown injury to the base of his tail and plucked out all of the surrounding feathers. After several laser treatments and some pain medication, he healed beautifully and all of his feathers grew back, she said. We have also used laser therapy on raptors with a condition called bumblefootsores on the bottoms of their feet. This is notoriously difficult to correct and sometimes requires medications and bandaging. They heal more quickly when we use the laser.

Software on many therapy lasers helps calibrate the proper dosage for each animal and length of each session by prompting the veterinary team to enter the pets weight, skin color, and hair coat length, as well as the medical issue and area to be treated.

Therapy lasers emit a pleasant warming sensation and most patients seem to relax and enjoy their sessions, she said. Typically, multiple sessions are most effective, so the practice offers special packages to achieve the best results.

Though the laser cost about $25,000, Bobulsky said it has been a good investment. She expects the technology to continue to evolve so the machines become more affordable, allowing more veterinarians to offer the modality to their clients.

Bobulsky absolutely suggests pet owners try laser therapy for their pet if their veterinarian recommends it.

It is noninvasive and can be very beneficial, she said.

Freelance journalist Jen Reeder loves writing about lasers of any kind because she grew up watching "Star Wars" and "Battlestar Galactica."

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Laser therapy: A promising trend in veterinary medicine | AAHA

5 things you need to know about the AAHA/AAFP Fluid Therapy Guidelines

We all know how important water is to living beingswithout it, we couldnt survive. Water in our cells helps regulate body temperature, aids in digestion, transports oxygen and nutrients (as well as waste), lubricates joints, energizes muscles, and basically keeps our organs functioning.

Thats why fluid therapy is such an important part of veterinary medicine. If an animal is dehydrated due to illnessor needs a boost during surgeryveterinary teams can administer fluids to help them stabilize. The AAHA/AAFP fluid therapy guidelines thoroughly prepare animal hospitals to best administer these life-saving fluids and customize treatment to the needs of each individual dog or cat.

Here are the top five things to know:

Lift your pets lip and run your fingers along his gums. If he is well-hydrated, his gums will be slippery and moist to the touch. If your finger sticks to the gums because they are dry or tacky, then he is dehydrated and you should seek veterinary care immediately.

Gently pinch your pets skin between his shoulder blades or at the top of his head between his ears. If he is well-hydrated, once you let go of the skin, it will quickly flatten out back to normal. If he is dehydrated, the skin will remain tented for a second or two. Seek veterinary care if this is the case.

Look at your pets eyes. His eyeballs should be slightly jutting out of his eye sockets. With severe dehydration, the tissue and fat behind the eyeball shrinks and the eye sinks deep into the sockets. You guessed it: Call your veterinarian if you suspect dehydration.

What to ask your veterinarian about fluid therapy:

Related articles:Heatstroke and your petKeep it cool for pets on warm daysSix things to consider when choosing a new veterinarianWhy theres no substitute for advice from your own veterinarianCommunication 101: Get the most out of your vet visit

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Fluid Therapy Guidelines | AAHA

What is a pet wellness plan?A wellness plan offers a way to prepay for pet health care services. Different than insurance, a wellness plan often requires a pet owner to sign a contract for a particular time period, usually 12 months. The pet owner then pays a monthly fee and receives a set of services that may include exams, laboratory tests, vaccinations, spaying or neutering, nail trims, deworming, heartworm testing, dental care, and others. Participants in pet wellness plans also often receive discounts on additional veterinary services. Several plans may be available based upon the type of pet you have and how old he or she is. There may also be different tiers or levels depending on the services bundled into the plan. For example, a puppy plan that includes spay/neuter, microchipping, and other services may be more expensive than an adult dog plan that doesnt include these one-time services. In addition to the monthly fee, there is often a sign-up fee or one-time membership fee, which is paid up front.

How can a wellness plan help your pet?A wellness plan makes it easier for you to take your pet to the veterinarian as soon as you suspect a problem without worrying about the cost of the office visit or exam. Getting your pet to the veterinarian early means a diagnosis can be made earlier and treatment can begin earlierboth of which are potential life savers. Preventing health care problems or addressing them early gives your pet the best chance for a long and healthy life.

How will a wellness plan assist you in paying for veterinary care?Being able to budget for the cost of veterinary care is one of the many benefits of pet wellness plans. Rather than facing a large veterinary bill after your pets annual exam, vaccinations, or other health care services, a wellness plan allows you to pay for your pets care in manageable, monthly payments.

Will a wellness plan save you money?Preventing an illness is much easier and less expensive than treating it. A wellness plan allows and encourages pet owners to seek medical care for their pets when needed, rather than putting it off for financial reasons. Wellness plans offer more veterinary visits and services and can save you several hundred dollars each year because of the discounted services.

Does your veterinarian offer a wellness plan?Pet wellness plans are beginning to appear in veterinary hospitals across the country. Some hospitals have had them for years. Ask your veterinarian if he or she offers prepaid wellness plans to help keep your pet (and your wallet) healthy.

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What a wellness plan can do for your pet (and your ...

This summer, U.S. pet owners will celebrate Take Your Pet to Work Week, which wraps up with Take Your Dog to Work Day on June 22. This is a great opportunity for animal lovers to bring their dogs and cats to the office, and for employers to see the benefits of pets in the workplaceand in fact, those benefits are prompting a growing number of businesses to be pet-friendly all year long.

According to Chris Meiering, director of innovation at Zukes, a natural pet treat company located in Durango, Colorado, an average day at the office includes 25 staff members and 10 dogs, though sometimes there are more than 20 dogs on the companys campus at one time.

Having them by our side makes us happy, lowers our stress levels, and creates an environment that is comfortable, open, and flexible, he said. Some offices have water cooler conversations; we have dog playtime conversations. Their presence really builds camaraderie in the office.

Meiering said the dogs also remind employees to take breaks throughout the day.

They may need a walk, but really, we need one too! Its not uncommon for a lunch at Zukes to include a romp alongside the stream or a hike through the mountains, and a midday stretch can easily turn into a game of fetch among the trees, he said. This time with our dogs rejuvenates us and makes us more productive.

In addition, Meiering said the pet-friendly policy has led to staff retention over the past 20 years.

Life is better with the love of a dog, and if a tail-wagging friend is with you at the office, the same holds true for work, he said.

Tips for a dog-friendly workplace

Chris Meiering, director of innovation at Zukes, offers these tips for a successful dog-friendly workplace:

Weve been dog-friendly for over 20 years, so its an easy, natural environment for us, but from time to time, there will be problems, such as a dog that is consistently disruptive or aggressive, or an older dog with bladder issues. The best way to handle issues is to talk about them, Meiering said. Work together to find a solution thats best for the workplace and the dog.

Scientific studies have also confirmed the benefits of pets in the workplace. For example, a 2012 study by researchers at Virginia Commonwealth University found employees who brought their dogs to work had reduced stress throughout the day compared to colleagues without pets.

Studies have demonstrated that pets in the workplace contribute to stress reduction, as well as employee teamwork and satisfaction. Employees who can bring their pets to work are also more productive, said Steven Feldman, executive director of the Human Animal Bond Research Initiative (HABRI) Foundation in Washington, D.C. Employees feel supported and have a better perception of their employers if they can bring their pets to work. They are also more likely to collaborate and work better in teams because pets help forge social connections.

Humans arent the only ones benefitting from pet-friendly policies, either. In 2004, researchers at the University of Missouri-Columbia found that humans who petted a dog for 1530 minutes during a study experienced approximately a 10 percent drop in blood pressure, while the dogs blood pressure dropped as soon as the humans began petting them. A day at the office also provides more stimulation for a dog than a day spent home alone in a crate or the backyard.

In addition, Feldman says the trend will increase the positive impact pet ownership has on U.S. health care costs.

We know that pets reduce stress, alleviate depression, improve heart health, and reduce obesity. We also know that pet owners visit the doctor less often than non-pet owners. In fact, pet ownership saves the U.S. healthcare system $11.7 billion every year, he said. Once we calculate the improved workplace productivity, the benefits will be even higher.

Feldman said companies considering a pet-friendly workplace should first develop common-sense policies for pets.

For example, pets must be current on their vaccinations, be on flea and tick prevention, and be well-trained. Veterinarians play a key role in partnering with pet owners so that their pets are ready for the office, he said. If having a happy, motivated workforce that works together is important, companies should strongly consider written pets-at-work policies.

Award-winning freelance journalist Jen Reeder considers herself extremely fortunate to work at home with her Labrador retriever mix, Rio.

Photo courtesy of Sarah Sturm

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The many benefits of pets in the workplace | AAHA

As too many cat lovers know, kidney disease is very common in felines, particularly as they age. The kidneys are responsible for many key bodily functions, from regulating blood pressure to removing toxins from the bloodstream. Unlike acute kidney failure, which occurs when a cat ingests something toxic, like antifreeze, lilies, or human anti-inflammatory medication, chronic kidney failure is irreversiblefunctioning kidney tissue is replaced by scar tissue, resulting in a loss of kidney function over time.

Treatment options can be daunting, particularly if the disease is advanced. Your veterinarian may recommend dialysis or other methods of keeping your cat comfortable. But theres another alternative to consider: kidney transplantation.

Success rates have been high for the few dedicated veterinary surgeons who perform feline renal transplants in the U.S. While most cats live an average of three years post-transplant, Lillian Aronson, VMD, BS, CACVS, founder and coordinator of the Feline Renal Transplant Program at the University of Pennsylvania School of Veterinary Medicine, had one feline patient live an additional 13 years with his transplanted kidney.

For the right cat, it can be an excellent treatment option, said Aronson, who has performed over 150 feline kidney transplants. Ninety-three percent of our patients have left the hospital. Approximately 70 percent are alive and doing well at one year [post-transplant].

One of the things that makes kidney transplants a viable option for cats is the relative ease in finding a donor match.

Most cats have the same blood typeAand unlike dogs, they dont need to be related to be considered compatible.

Additionally, cats, like people, can live normal, healthy lives with just one kidney. In fact, Aronsons team conducted a study of 99 feline kidney donors from the program and found most had no associated long-term effects from kidney donation.

There is one caveat, however: If your cat needs a kidney transplant and a potential donor is found from an animal shelter or elsewhere, you must adopt the donor cat regardless of the outcome of the surgery, an ethical practice supported by the American Society for the Prevention of Cruelty to Animals (ASPCA).

Fortunately, Aronson said thats typically not an issue. Most owners are so grateful to the donor cat for helping save the life of their pet, they happily welcome a new addition into their home.

People get very attached, very quickly, Aronson said. Its really nice to see.

Feline renal transplants require a great amount of commitment, and whether youre ready to adopt a donor cat isnt the only thing to keep in mind. An uncomplicated surgery can cost anywhere from $15,000$18,000, plus $60$100 a month for anti-rejection medications and other drugs. While some pet insurance companies will help cover the cost of feline kidney transplant surgery and associated treatments, it is important to read your policy carefully and be mindful of any pre-existing conditions before scheduling the procedure.

After surgery, the recipient cat will need to have frequent veterinary exams to make sure the new kidney is working and to monitor potential complications. You will also need to give immunosuppressive medications at the same time every day to prevent your cats body from rejecting the new kidney.

While pursuing a kidney transplant for your cat is not a decision to be made lightly, some owners say its worthwhile despite the high level of commitment involved.

New York archeologist Andre Gonciar said he is glad he and his wife, Laure, decided to pursue a kidney transplant for their beloved cat, Oki, who was a sick, abandoned kitten when Gonciar rescued him years ago. Aronson performed Okis kidney transplant on May 18, 2015, removing a kidney from a donor cat named Cherry.

Now Oki and Cherry have celebrated their first transplantiversary and are both doing great. Cherry is settling into life in the Gonciar household, and Oki is a happy bubble of a cat, according to Gonciar.

There is no doubt in my mind that we have done the right thing, he said. Some sacrifices had to be made and caring for Oki forced quite a few changes in our lifestyle, getting it on a rather strict schedule. But at the end of the day, he falls asleep purring in my arms and we are all happy.

Award-winning pet writer Jen Reeder was thrilled to be able to donate her left kidney to her husband in 2012.

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Kidney transplants for cats: A viable option | AAHA

Learning your dog has cancer is a frightening experience, but according to the National Canine Cancer Foundation (NCCF), it is a diagnosis one out of every three dogs will receive during their lifetime. The good news is, about half of all canine cancers are treatable if they are caught early and several promising research studies are currently being conducted to help find a cure.

Cancer comes in many forms, including carcinoma, sarcoma, melanoma, lymphoma, and leukemia, and can occur at any age in both mixed breeds and purebreds. Listed below are the most common types of cancer affecting dogs and the signs to look for at home.

Lymphoma: Lymphoma occurs in cells in the lymph nodes or bone marrow and is most commonly diagnosed in dogs between the ages of 6 and 9 years old. Lymphoma affects the dogs immune system and can spread rapidly if left untreated. It is classified in five progressive stages and treatment options vary depending on the stage. The first sign of lymphoma is typically a painless, swollen lymph node in the neck or behind the knees.

Hemangiosarcoma: Hemangiosarcoma is a malignant cancer of the blood vessels. It is more common in dogs than any other species. Hemangiosarcoma is commonly diagnosed in the spleen, liver, and heart, but can travel to any organ or occur just under the skin. Because there are no distinct early warning signs for hemangiosarcoma, many dogs are not diagnosed until the disease has reached its advanced stages. It is often seen in German shepherd dogs, golden retrievers, and other large breeds.

Early warning signs of cancer:

Abnormal swelling

A sore that does not heal

Weight loss

Loss of appetite

Bleeding or discharge from anyopening on the body

Unpleasant or unusual odor

Difficulty eating or swallowing

Loss of energy

Ongoing lameness or stiffness

Difficulty breathing, urinating, or defecating

*Information from the National Canine Cancer Foundation (NCCF)

Mast cell tumors: Mast cell tumors are an extremely common form of cancer in older dogs and mixed breeds, as well as boxers, Boston terriers, Labrador retrievers, beagles, and schnauzers. Mast cells are found in the skin and other tissues, like the intestines or respiratory tract. They contain large amounts of histamines and enzymes that protect the body, but when tumors develop, that protection turns against the immune system. The first sign of a mast cell tumor is usually a lesion on the skin. Some mast cell tumors can also be uncomfortable and cause agitation.

Melanoma: Melanoma is a type of skin cancer that can be found in the nail beds, footpads, and eyes, but the vast majority of melanoma tumors start in the mouth or around the lips. Melanoma tumors are highly aggressive, growing deep into the skin to invade vital organs. The first sign of melanoma might appear as a swollen paw, an eye that drains, or a sore in or near the mouth.

Osteosarcoma: Osteosarcoma is cancer of the bone. Approximately 85 percent of osteosarcoma tumors are malignant, and grow very quickly. Osteosarcoma commonly affects large breeds between the ages of 4 and 7 years old, including Great Danes, Irish setters, Doberman pinschers, Rottweilers, German shepherd dogs, and golden retrievers. While osteosarcoma can occur in any bone, it most commonly affects the limbs. Initial signs of osteosarcoma may include swelling and lameness.

Mammary cancer: According to the American College of Veterinary Surgeons (ACVS), mammary tumors are more common in female dogs that are either not spayed or were spayed after 2 years of age. About 50 percent of all mammary tumors are malignant and have metastasized, or spread to other areas of the body, by the time they are surgically removed. Signs of mammary cancer are often overlooked because the tumors appear as a small nodule on or around the dogs nipple; however, this type of cancer can also present itself as a painful tumor around the nipple.

Promising canine cancer research

Yale School of Medicine has developed a new vaccine that may help dogs with cancer. They have teamed up with the Veterinary Cancer Center in Norwalk, Connecticut for a clinical trial to test the vaccine on real cancer patients. The vaccine is injected into a dog with the goal of producing antibodies to fight cancer. Yale University tested this vaccine in the laboratory and found it was successful at targeting and shrinking malignant tumors. Now they hope to create the same results with dogs battling the disease.

UC Davis School of Veterinary Medicine is also performing a clinical trial to help dogs with lymphoma. They are reformulating the way the popular cancer drug, doxorubicin, is administered. Doxorubicin is widely used to treat cancer, but the medication can affect a dogs heart. UC Davis has developed a method to turn the drug into tiny particles and administer it by infusion. The goal is to have the medication flow directly to the tumor and lessen the chance of damaging other organs.

Both studies are in need of patients for the clinical trials.

Sharon Seltzer is a freelance writer and founder of Lessons From A Paralyzed Dog, a website for owners of dogs with paralysis and other mobility disorders. Shes a pet mom to two dogs and two semi-feral cats.

iStock.com/JfJacobsz

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6 most common canine cancers | AAHA

Vaccines have become an emotional issue among pet owners. And, while the science of pet vaccines is always a work in progress, there are some undeniable facts.

No medical development has had a greater impact on the prevention of diseases and general health of people and animals than the development of vaccines against various diseases, says Michael Paul, DVM, past president of the American Animal Hospital Association (AAHA), and frequent vaccine task force advisor.

Animal vaccines help to control disease, many of which can affect people. At the top of the list is rabies. On WGN radio, Cook County Administrator of Rabies Control Donna Alexander, DVM said, Make no mistake, rabies does occur in the United States. We have a wildlife reservoir of rabies. The only reasonand I do mean the only reasonwe dont see it in [people] in this country is because we have laws mandating vaccination.

According to the Centers for Disease Control and Prevention (CDC), more than 55,000 people around the world die from rabies each yearthats approximately one death every 10 minutes. In the U.S., one to three people succumb to rabies each year.

Another disease controlled by vaccination is canine parvovirus. The disease emerged in the 1970s, and for some time veterinarians were powerless to stop it; dogs with parvovirus often died, and they still can. Today, however, the canine parvovirus barely occurs in some places. Its not because the virus has done a disappearing act; its because enough dogs are vaccinated to provide community protection, or herd immunity.

Where populations are less protected against the canine parvovirus, such as shelter populations, the virus appears and often spreads among those individuals not vaccinated.

So, vaccinations do what theyre supposed to do. But can there be too much of a good thing? Are we vaccinating our pets too often? This is a topic often discussed, and while theres some disagreement within the ranks, veterinarians do agree that just because a vaccine is available doesnt mean that all pets should receive it.

Factors that affect vaccine protocolsAccording to the AAHA Canine Vaccination Guidelines, whether a vaccine is suggested or not is dependent on the following factors:

Also, to lessen the possibility of adverse reactions or side effects, its often suggested that not all vaccines are given during the same veterinary visit.

To vaccinate or not to vaccinateSometimes choosing whether or not to vaccinate is easy. For rabies, its the law. Sometimes, however, those decisions arent so black and white.

During the recent canine influenza epidemic in Chicago, veterinarians werent all in agreement about supporting vaccination with the dog flu vaccine. Thats because the current vaccine was created for a flu strain called H3N8, and may not be effective against the strain of dog flu that infiltrated the Chicago area, called H3N2. Anecdotal evidence indicated the vaccine did offer some protection against the newer flu strain, and because the old flu strain still existed most veterinarians did recommend the vaccine for social dogs.

Far less was known 20 years ago about how often to immunize our pets and when to booster. Today we know more, but theres still much to learn. Organizations like AAHA, the American Association of Feline Practitioners, and others have created guidelines based on current scientific and medical knowledge, which veterinarians can consult when making health care recommendations for their patients.

Another tool to help determine which vaccinations are appropriate for a particular pet is a titer, although this tool is somewhat controversial. A titer is a laboratory test that measures the presence and amount of antibodies in blood that could defend against a particular disease. For example, instead of receiving a vaccine against the canine parvovirus, the dog could be titered. If the dogs titers are at a specific level, the veterinarian may deem no vaccine is necessary. Titering is not a perfect tool, however, and titers arent available for all vaccinations. Many veterinarians dont believe titering is an effective way to ensure a pets ability to fight off certain diseasesthey believe vaccinating the pet is the safest and most effective way to prevent disease.

At the end of the day, my hope is that pet owners develop a trusting relationship with their veterinarian, says Paul. Discussing each immunization is serious business, and you should review with your veterinarian whats right for your individual pet.

Steve Dale is a certified animal behavior consultant, author of a syndicated newspaper column (Tribune Content Agency), and the host of two national radio shows, including Steve Dales Pet World on WGN radio in Chicago, Ill.

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Pet vaccinations 101: What you need to know | AAHA

When a pet is diagnosed with cancer, chemotherapy treatment is often offered as a possible treatment option. The thought of putting a pet through chemotherapy can be frightening for some pet owners, though, particularly those who may have seen family or friends suffer through the side effects of chemo, or even experienced those side effects themselves. Dogs and cats, however, usually fare much better than their human counterparts when undergoing chemotherapy and dealing with the side effects of treatment.

Your veterinarian will advise you of specific side effects associated with the drugs theyre using to treat your pets cancer. While it is important to be aware of these possible side effects, it is also wise to watch your pet closely for any other signs that something is awry. Fever is a sign of infection and should be brought to the attention of your veterinarian immediately. Also watch for signs of lethargy or changes in appetite. Remember: No one knows your pet better than you, so if you think something is wrong, tell your veterinarian.

The three most common side effects of chemotherapy are bone marrow suppression, alopecia, and gastrointestinal upset.

Bone marrow suppressionChemotherapy drugs attack cells in the body that are rapidly dividing and producing, which is precisely what cancer cells typically do. There are good cells in the body, however, which also rapidly divide. White blood cells, produced in the bone marrow, are an example of these. Red blood cells can also become suppressed during chemotherapy, causing anemia in the animal.

Your veterinarian will check your pets white blood cell count through regular blood tests to determine how the chemotherapy is affecting the bone marrow. If the level of white blood cells is low, your veterinarian may prescribe antibiotics to prevent infection introduced by opportunistic bacteria, which are normally kept in check by the white blood cells.

AlopeciaWhile alopecia, or hair loss, is a common side effect of chemotherapy in humans, it is not all that common in animals. Certain breeds are more likely to experience hair loss, and they are usually breeds with continuously growing hair, such as poodles, Portuguese water dogs, shih tzu, and Maltese. These breeds may expect to see a general thinning of the hair coat, rather than a total loss of hair.

Hair may also be slow to regrow in areas that have been shaved. If your pet is receiving chemotherapy via injection into a blood vessel, your veterinarian will need to shave a spot to place an IV catheter to give the injection.

The coat usually grows back after the course of chemotherapy is completed, however, like humans who receive chemotherapy, the hair that regrows is sometimes a different color or texture than it was before chemotherapy. This may or may not change back over time.

Cats, and sometimes dogs, can also lose their whiskers during chemotherapy treatments. Like the hair coat, the whiskers may grow back after chemo looking different than they previously did.

Gastrointestinal upsetLike blood cells in the bone marrow, the gastrointestinal tract (throat, stomach, and intestines) is also made of rapidly dividing cells. Chemotherapy drugs are unable to discern these good cells from the bad cancer cells and will attack them. If the good gastrointestinal cells are seeing more than their fair share of attack from the chemo drugs, your veterinarian may adjust the dose of the chemo to balance the effect on your pet.

Vomiting and diarrhea may be seen 1-3 days post-chemotherapy treatment. Duration is usually short term, and your veterinarian may prescribe medications to ease these side effects. You might also want to adjust your pets diet during this time; a bland diet may be easier on your pets tender tummy. Boiled chicken and rice are often go-to options to try when your pets regular food doesnt seem to be sitting well.

If you notice signs of gastrointestinal upset, be sure to notify your veterinarian: she may want to treat the side effects if they warrant it.

Are the side effects worth it?The main goal of veterinary cancer treatment is to maintain quality of life. Although pets may experience some side effects of treatment, those symptoms are typically milder than symptoms that humans experience, and many pets go into remission after just a few doses of chemotherapy.

If your veterinarian recommends chemotherapy for your pet, be sure to discuss all the ramifications thoroughly. While your pet may experience some unpleasant side effects, the hope is that all those bad cancer cells will be wiped out by the chemotherapy drugs, and your pet will go on to live a happy life.

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Originally posted here:
Pets and chemotherapy: Side effects to prepare for | AAHA

Ive never seen such a look of betrayal as was in Tomkins eyes when he came home from the veterinary hospital. Traumatized by the poking, prodding, bright lights, and sharp tools, he cowered in his corner, refusing even his favorite treats. It took days before he finally showed his sparkly new grin, and I knew I could never subject him to a nonanesthetic dental cleaning again.

The 2013 AAHA Dental Care Guidelines for Dogs and Cats clearly state cleaning a companion animals teeth without general anesthesia is considered unacceptable and below the standard of care. This means the pain and stress a pet faces during a nonanesthetic dental cleaning are so great that to subject your pet to this type of procedure when safer, more comfortable methods are available is considered cruel. Thankfully, the use of anesthesia and a personalized pain control plan can mitigate many of the risks associated with nonanesthetic procedures.

Pets rely on their owners to provide for their needs. When dogs and cats undergo a nonanesthetic dental cleaning, they can often be overwhelmed by the bright lights, loud equipment, and strange people restraining them. This can place your pet under significant stress and even cause lasting trauma. Anesthetized dental procedures allow your pet to rest comfortably while the veterinary team performs a thorough exam and cleaning without the risk of injury to himself or others.

Anesthesia also allows your veterinarian to properly evaluate your pets teeth. Did you know that 60 percent of a dog or cats tooth is hidden beneath the gum line? Dental X-rays obtained while the pet is under anesthesia allow the veterinarian to fully examine each tooth and identify problems that cannot be seen with the naked eyeand additional treatment can often be provided on the spot.

So, what should you expect when your pet undergoes general anesthesia? First, your veterinarian will want to examine your pet and perform a blood test to ensure there are no health issues prior to the procedure. Based on the results and your pets medical history, your veterinarian will create a customized plan and anesthetic protocol for your pet.

Most pets recover from anesthesia quickly. According to the American Veterinary Dental College (AVDC), many patients are fully recoveredmeaning they are awake and standingjust 1520 minutes after the procedure is completed. Anesthetized dental cleanings are also an outpatient procedure, so your pet can go home with you the same day.

Just like humans, pets are at risk for cavities, periodontal disease, and broken teethall of which are sources of significant pain. By taking your dog or cat in for an anesthetized dental procedure in which the veterinary team can thoroughly examine and clean all their teeth safely, you ensure a healthy, happy future for your pet.

Chris Nichols is a freelance writer living in Michigan with her cranky cat and elderly dog.

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The truth about dental anesthesia | AAHA

If your aging dog or cat starts acting strange, dont chalk it up to old age or think he needs a refresher course in potty trainingmake an appointment with your veterinarian.

Why? There may be several causes for unusual behavior in senior pets, including one most owners typically dont think about: cognitive dysfunction syndrome or CDS.

Many pet owners mistake the gradual advancement of dementia as aging changes that are to be expected in an elderly dog or cat, says author and columnist Jeff Nichol, DVM, of the Veterinary Emergency & Specialty Hospital of New Mexico in Albuquerque, New Mexico.

Senior pets should function mentally almost as well, if not as well, as they did as youngsters, Nichol says. While older pets may have moderate hearing and/or sight impairment, they should not have noticeable changes in their mental activity.

For pets with CDS, however, it is another story. CDS is a degenerative inflammatory disease of the brain very similar to the human dementia of Alzheimers disease. Studies show that it affects more than a third of dogs over age 11 and more than two-thirds over age 15. In cats, those numbers are likely similar; however, less is known about cats because fewer studies have been conducted.

Because they are with their pets daily, pet owners will be the first to notice the symptoms, says Gary Landsberg, DVM,DACVB,DECAWBM, veterinarybehaviorist at North Toronto Veterinary Behaviour Specialty Clinic.

Pets suffering from CDS may seem disoriented, perhaps going to the wrong side of the door when wanting to go outside or wandering aimlessly around the home. They may be restless or wake at night and be less active during the day. They may become anxious and irritable. They may have decreased interest in interacting or, just the opposite, may become clingy. They may also forget their house training behaviors.

While research is advancing understanding of CDS, a cure has not yet been found. However, there are ways to slow its progress. Because the disease can be significant, a visit to the veterinarian at the first sign of atypical behavior is key.

Diagnosis is based on recognizing the behavioral changes and excluding other medical conditions and drug side effects. If it is determined that your pet has CDS, discuss possible treatment options with your veterinarian.

Treatment options may include:

Nichol has been working on his own research into CDS and found that a varied approach of supplements and daily exercise is helping many of his patients.

If you dont get on it early and decisively, you may not have time, he says, noting that some pets deteriorate rapidly while others have a slow decline.

Some of these pets get so totally confused. They dont remember their owners or their house training. They walk into corners and stand there. They really have no life anymore, he says. [Thats why] pet owners need to bring their concerns to the veterinarians attention.

Maureen Blaney Flietner, an award-winning freelance writer, photographer and artist, has been mom to several dogs, cats, and horses over the years.

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Alzheimers-like disease in pets needs quick attention | AAHA

One of the most common questions veterinarians hear each week is, When should I spay or neuter my dog or cat? With so much conflicting advice from friends, breeders, and the Internet, it can be difficult to find an answer, which is why the best option is to talk to your pets veterinarian.

Patrick Mares-Ziehmn, DVM, veterinarian at AAHA-accredited Prescott Animal Hospital in Prescott, Ariz., says he counsels pet owners about spay and neuter issues every week. If clients are not planning to breed their pets, Mares-Ziehmn says he typically recommends spaying female dogs or cats when they are 4 to 6 months oldbefore the first heat cycledue to the medical benefits.

If you spay a dog after her first heat cycle, she goes from having a 0.5 percent risk of [developing] mammary tumors up to an 8 percent risk, he says. If you wait until after her second heat cycle, its almost a 26 percent risk.

This benefit extends to cats as well. According to the American College of Veterinary Surgeons (ACVS), kittens spayed before 6 months old are seven times less likely to develop mammary cancer.

Mares-Ziehmn also suggests spaying dogs to avoid pyometra, a life-threatening infection of the uterus. By age 4, he says 15.2 percent of unaltered female dogs will develop pyometra. By age 10, that risk rises to 2324 percent.

While Mares-Ziehmn notes that the risk is reduced if the dog has several litters, a spay surgery, which removes the uterus and ovaries, eliminates the risk completely.

Neutering a young dog or cat is a simple procedure that may be performed as early as 8 weeks of age. In fact, AAHA supports pediatric neutering to help reduce the overpopulation problems affecting companion animals.

One major health benefit to neutering a dog is that it virtually eliminates the risk of prostate issues, including infection and prostatic hyperplasia, an enlargement of the prostate that creates difficulty defecating.

By age 6, 7580 percent of unaltered male dogs will have benign prostatic hyperplasia, thanks to testosterone, Mares-Ziehmn says. By age 9, its 95100 percent. If you neuter them, you take that [risk] off the table.

He adds that neutering dogs also prevents the spread of transmissible venereal tumors (a sexually transmitted disease) and perineal hernias, in which testosterone weakens the muscles around the anus and allows abdominal content to push though, while neutering cats protects against testicular cancer.

Neutering also reduces or eliminates unwanted behaviors like spraying in male cats, roaming in dogs, and aggression before theyve had all that testosterone build up in their system, he says.

Some pet owners may have concerns that sterilizing their pets will lead to obesity. This is a valid concern, though Mares-Ziehmn points out that proper diet and exercise can easily solve the issue.

We have control of the food. Most dogs and cats cant access the refrigerator or our food, he says. That should be a non-problem when deciding whether to spay or neuter, in my opinion.

Other pet owners say they want to wait to spay their dogs or cats until after they produce a litter so their children can witness the miracle of birth. However, Mares-Ziehmn says, not every birth is smooth, and animals shouldnt have a litter until they have reached full adult size if they are to be bred responsibly.

Instead, he suggests his clients consider fostering a pregnant dog or cat from a local animal shelter.

Then youre doing a good deed and not bringing even more animals into the world, he says.

Mares-Ziehmn has also heard concerns about the risks of anesthesia, and questions about Zeutering, a chemical castration process. He says he has never performed a neuter this way because there are not any long-term studies on the procedure.

Instead, he says AAHA mandates excellent anesthesia protocols that make the risk of anesthesia for young, healthy animals astronomically low. As a matter of fact, Mares-Ziehmn says AAHAs strong anesthesia protocols are one reason he works at an accredited practice.

Finally, Mares-Ziehmn said spaying and neutering pets is important not just from a health and behavior standpoint, but because it helps address the issue of pet overpopulation. Each year, approximately 1.2 million dogs and 1.4 million cats are euthanized in the U.S., according to the American Society for the Prevention of Cruelty to Animals (ASPCA).

As a society, we need to make that choice of whether we want to tackle that problem head on, he says.

Freelance journalist Jen Reeders dog, Rio, was neutered at an animal shelter when he was 12 weeks old, and he has been healthy and happy ever since.

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Spay and neuter when the time is right | AAHA

January is Walk Your Pet Month, a great time to get outside and exercise with your pup. But what if your dog needs space from other dogs or people? Dont resort to walking your dog at midnight. With patience, ongoing training, and expert advice, you can successfully manage your dogs leash reactivity.

It's easy to get overwhelmed with all the information circulating out there about what to do with your reactive dog and how best to help them improve, said Scott Raymond, MS, CPDT-KA, a certified professional dog trainer with Synergy Behavior Solutions in Portland, Oregon.

Misleading information can also result in the development of even more significant behavioral issues, he said.

Contrary to popular belief, you don't need to punish a dog to make them act better, Raymond said. Having a consistent management plan and a solid rewards-based approach to training can help a lot.

According to animal behaviorist, ethologist, and adjunct professor in zoology at the University of WisconsinMadison, Patricia McConnell, PhD, CAAB, it is important to gain confidence walking your reactive dog to build resiliencethe process of adapting well in the face of significant stress.

Exercise and time outdoors have a profound effect on dogs and people, both on healing from drama and building resilience, she said.

Below are great resources and tips you can put to use right away to help correct and manage reactive behaviorand create a better walk for you and your dog.

Setting your reactive dog up for success

Training ideas

At the veterinarian

Living with a reactive dog also presents challenges when it comes to veterinary appointments.

AAHA-accreditedFrontier Veterinary Hospitalin Hillsboro, Oregon, created special corrals that keep reactive pets separate in the waiting room for this very purpose.

Our biggest tool, however, is our workflow, Frontier's practice development director, Sara Fleissner, said. We room clients as soon as possible upon entering the building. Sometimes, the customer service representative sees [clients] in the parking lot and greets them the moment they walk in. Then, everything happens in the room: taking of history, doctor exam and communication, and most importantly, checkout. This minimizes the interaction between patients in the building.

This is important for all patients, whether they are fearful, reactive, or excited, Fleissner added.

Many dogs need space. If you live with a dog that has leash reactivity, there are many solutions and tools at your disposal. Remember that walking a reactive dog at midnight is one option, but not the only option.

As a certified veterinary technician, longtime PR veteran, and content marketing expert, Christy Caplan brings her unique understanding of social and digital media to connect dog lovers to brands both on and offline. She lives with three houndstwo doxies and a beagle/basset hound mixwho constantly teach her about life and companionship. Christy is a member of the Dog Writers Association of America and writes for Spot Magazine, City Dog Magazine, and regional animal publications. Follow Christy at mylifewithdogspdx.com.

Originally posted here:
Walking a reactive dog: Tips and tricks | AAHA