Pet vet

Northwest Arkansas Democrat-Gazette - - STYLE - JEFF KAHLER Jeff Kahler is a vet­eri­nar­ian in Modesto, Calif. Ques­tions can be sub­mit­ted to Your Pet in care of Life­Styles, The Modesto Bee, P.O. Box 5256, Modesto, Calif. 95352.

Mac­in­tosh is a 10-year-old Sch­nauzer with di­a­betes. His care­taker, Paula, has been treat­ing him with an in­jec­tion of in­sulin twice daily for the past 16 months, and he has been do­ing quite well. Paula checks Mac’s blood sugar level three to four times weekly, and he ap­pears to be well-reg­u­lated. Re­cently, Mac has de­vel­oped a mass along the top of his back just be­hind his shoul­ders. When Paula first no­ticed the mass, it was raised and about the size of pea. It now has grown to about one-inch in di­am­e­ter and has turned red. Paula is un­der­stand­ably con­cerned about this mass and wants to have it re­moved but is also very con­cerned with the in­creased risk of in­fec­tion associated with di­a­betes and surgery.

First of all I want to con­grat­u­late Paula for her good work in treat­ing Mac’s di­a­betes. Di­a­betes is a com­mon dis­ease in our com­pan­ions and is a fa­tal process. It can, how­ever, be very ef­fec­tively treated with long sur­vival times when the blood sugar is well-reg­u­lated. I also am thrilled to hear that Paula is able to mon­i­tor Mac’s blood sugar.

Mon­i­tor­ing blood sugar re­quires a blood sam­ple that is ap­plied to a spe­cial strip which is in­serted into a blood sugar or glu­cose me­ter. Within a few sec­onds, the me­ter re­sponds with a blood sugar num­ber that is ideally kept be­tween 60 and 150 in dogs. His­tor­i­cally, it was very un­com­mon for care­tak­ers to mon­i­tor their com­pan­ion’s blood sugar, but with the ad­vent of newer me­ters re­quir­ing very tiny blood sam­ples, it is now a much eas­ier process.

I won’t use the rest of my col­umn to dis­cuss di­a­betes only be­cause Paula has a valid con­cern in­volv­ing Mac’s likely need for surgery.

With­out ques­tion, di­a­betic pa­tients are at a greater risk of de­vel­op­ing in­fec­tion when com­pared with pa­tients that do not have the dis­ease. This is due to the mi­cro­scopic tis­sue changes that oc­cur with di­a­betes, as well as the ef­fects the dis­ease has on the im­mune sys­tem. As a re­sult, Mac is at a greater risk of de­vel­op­ing an in­fec­tion with surgery to re­move his mass. This does not mean he can’t have the surgery. To put this in what I con­sider to be proper per­spec­tive, let’s say there is a one half of 1 per­cent chance of a “nor­mal” pa­tient de­vel­op­ing an in­fec­tion with surgery to re­move a mass such as Mac’s. If a pa­tient with di­a­betes has a 100 per­cent in­crease in the risk for de­vel­op­ing in­fec­tion from a surgery of this type, we are still look­ing at a mere 1 per­cent chance on in­fec­tion. Th­ese are not real num­bers, but the point is made.

Mac should have the surgery and while he’s un­der anes­the­sia if needed, he should have his teeth cleaned as well. Dental dis­ease can be a source of in­fec­tion within the body and as we know, di­a­betes can in­crease the chances that this type of in­fec­tion will spread. I feel with what I know about Mac’s case, there is a greater risk for him if the mass is left un­ad­dressed when com­pared to the chance of in­fec­tion from the surgery it­self. It’s also im­por­tant to have the mass biop­sied af­ter re­moval to know whether or not it will re­quire fur­ther fol­low-up.

Spe­cial to the Democrat-Gazette/DUSTY HIGGINS

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