# Muscle wasting with Diabetes



## dougalh (Oct 19, 2009)

We're having problems - our Labradoodle, aged 10.5 was diagnosed as diabetic last Friday and started on insulin twice daily. One of the key symptoms that alerted us to it, later than we would have liked, was rear leg weakness which came on /very/ quickly. Early last week he was able to walk pretty much normally and even came up our stairs. By Friday he was going off his back legs and the vet said his muscles there had wasted due to the diabetes.

Anyway now he's on insulin he seems a bit more himself and we can see some improvement generally but /not/ with the leg weakness. He can get up and stand but holding himself up and especially when crouching to wee or pooh is a real problem. He's managed OK until today but when trying to pooh this morning his legs gave way and so he didn't follow through. We've tried to help him by holding him up with a towel etc but this seems to distract him too much. He has an excellent nature and does not appear to be in any pain but we sense that our concern distresses him. He has managed to remain on all four legs enough today for a couple of wees.

What we're really not clear about is whether the muscle problems are being addressed in the treatment; whether we can be confident they should not get any /worse/; and indeed how we can best help them recover and how long this might take.

Is anyone who has been down this road before able to give us some comment and encouragement? As I say he seems pretty bright in himself and I would say he is "struggling" rather than "suffering". We really want to make sure he can at least do the basic functions and need to make sure that whatever steps are being taken to recover his strength are also underway. BTW he is also on glucosamine and omega 3 oil and daily meloxicam (plus he also has to have digoxin and fortekor for heart arrythmia following an op around 6 months ago). He's eating well (new diet Hills w/d) and drinking /seems/ to have stabilised a bit now.

Any help appreciated,
Mark


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## Guest (Oct 19, 2009)

Have a chat with your vet about hydrotherapy. This is one of the best ways to keep muscle function.


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## haeveymolly (Mar 7, 2009)

Ask your vet about a steroid injection, you can try swimming to build up the muscle but if the illness is making the muscles waste then basically they will just waste away again, we had a springer with d.c.m and due to the poor circulation and very low blood pressure which the kidneys are dependent on his kidneys began to struggle and he was losing protein which is a muscle builder. He was given a steroid injection similar to the anabolic body builders take, and they did make a difference but with the problems the d.c.m caused and the fact he didnt live long enough to see the true benefits the injection could have had.


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## Spellweaver (Jul 17, 2009)

If he's on treatment now then hopefully this may halt the muscle-wasting so that you'll only have to treat what's happened already. Road walking (ie walking on a hard surface) is a good way to build up muscle tone - we did this with Quinny after his attack of myositis. The trick is to start off with small distances and gradually build them up as he improves.


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## hairydog (Feb 15, 2009)

Sorry to hear about your dog, but the best way to build his muscles back up is with hydro, my girl had severe muscle wastage in her front legs 2yrs ago, and started her on 2x a wk for 6wks and then cut it dwn to 1 a wk, you would be amazed how quick they build up, she is now 9, so no spring chicken!


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## dougalh (Oct 19, 2009)

Thanks for comments - we're concerned because this part of the problem doesn't seem to have been identified/addressed yet - yesterday he was mobile enough that he did, with a little support and encouragement, manage eventually to wee and pooh before having a good night's sleep - a very stressful day for us and some relief at the end of it.

This morning it seems even worse and his front legs seem weaker and he has thus far resisted all attempts to get him to do a wee at all despite being fully and carefully supported.

The vets say they are not aware of diabetes causing such a degree of "going off his legs" beyond basic muscle wastage so it's hard to know quite where we and he are heading with this.

I guess it looks like we'll take him in again later today and see if they can determine what is the cause of this and what can be done to get him back on track. I'm really not sure it would be fair on him if this is a long-term issue but that's a hard decision to make when we are still in the dark of course and but for the being off his legs he is really good in himself.

M


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## dougalh (Oct 19, 2009)

Also 2 other points in case it's at all relevant:

1) His bark has become hoarse over the last 2-3 weeks
2) I noticed yesterday that when he could go his wee smells like burnt rubber. I googled this and have found quite a few references to humans experiencing this but no conclusive info on what it actually means (a few surmises only).

It all just seems so baffling because his legs were pretty much fine this time last week (his gait was becoming a little bandy then though) and it seems to have deteriorated so quickly.

M


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## haeveymolly (Mar 7, 2009)

dougalh said:


> Also 2 other points in case it's at all relevant:
> 
> 1) His bark has become hoarse over the last 2-3 weeks
> 2) I noticed yesterday that when he could go his wee smells like burnt rubber. I googled this and have found quite a few references to humans experiencing this but no conclusive info on what it actually means (a few surmises only).
> ...


Sorry if you have already said this but how old is he and i would have his kidneys checked a sample will be needed, i do hope you get this sorted i know when mine was like this its awfull to see them


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## Guest (Oct 20, 2009)

Are you quite sure that he hasn't had a slight stroke?


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## haeveymolly (Mar 7, 2009)

rona said:


> Are you quite sure that he hasn't had a slight stroke?


Ye thats why i asked his age ive seen now he is 10 it sounds to me i could be that or a circulation problem.


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## dougalh (Oct 19, 2009)

Thank you all for your comments - we took him along to the vet again this morning - he's in a bad shape. They're very good but cannot see any association for the leg weakness with the diabetes (which has already responded to the insulin). We're referred to a neurology specialist tomorrow and will go hoping for the best but prepared for the worst.

M


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## haeveymolly (Mar 7, 2009)

dougalh said:


> Thank you all for your comments - we took him along to the vet again this morning - he's in a bad shape. They're very good but cannot see any association for the leg weakness with the diabetes (which has already responded to the insulin). We're referred to a neurology specialist tomorrow and will go hoping for the best but prepared for the worst.
> 
> M


Oh dear i was hoping for better news good luck tommorow with the specialist.


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## dougalh (Oct 19, 2009)

We saw the extremely capable specialist this morning and she is confident that the problem is directly related to the diabetes and is "diabetic neuropathy". Essentially as well as muscles which have wasted to some degree, the nerve signals and reflexes in the legs (currently) are greatly reduced hence he has much less feeling in and for his legs, resulting in great instability. There are no magic fixes but we are told that the condition /should/ improve with the use of supplements and with physio and care. The expectation is that this will take some weeks or months.

At this stage then it is not possible to determine how viable that will be but what we have decided is to admit him as an inpatient to a rehabiliation centre (who seem wonderful) and see how he progresses over the next 1-3 weeks. We are greatly relieved by this (esp having been up most of the night with him) and it feels like there is some hope there (and indeed, hope which doesn't demand to much of Dougal, who should have a great time at this place). If we do have to make a painful decision in a few weeks then at least we will know that the options were tried and we will have been able to prepare better.

It's been a roller-coaster few days with emotions and fears and while we're certainly not out of the woods yet we have learnt an awful lot and come to terms (at least to a large degree) with something which is usually left unspoken. Dougal for his part, while a little frustrated and confused as to why his legs don't seem to be working like they should, remains bright and happy and it's so good to know he's going to get the best care he can to give him the best chance of a good life yet to come (he's been through a lot in six months - lost 11kg, been diagnosed as having arrhythmia, undergoing a total ear canal ablation, diabetes etc thankfully not all at once as there's no way he would realistically have managed it).

Thanks for all the messages of support.
M


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## dougalh (Oct 19, 2009)

Thanks but for wider reference steroids are an absolute no-no for this diabetic condition.

M


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## Guest (Oct 21, 2009)

All we and you can do is wait and hope 
Lets all hope it's good news in the long run


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## haeveymolly (Mar 7, 2009)

Fingers crossed for you, you are doing allyou can and can do no more than that lets hope for a happy ending to this.


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## kazschow (Oct 23, 2008)

I feel for him, I'm diabetic and have diabetic neuropathy, if canine and human are similar there is light at the end of the tunnel, since being diagnosed, and changing my diet etc, almost all the pain I suffered has gone completely, I used to need to take pain meds to get to sleep, as the shooting pains were so bad, now I need nothing other than socks to keep my feet warm.

The biggest difference I made was removing carbs from my diet, I suspect this will be the same in dogs... carbs turn straight to sugar in the digestive tract so cause big fast shifts in your blood sugar levels... It's the high blood sugar levels that attack the nerve ending.... I'd take your dog off any carbs in it's diet for a start, rice, pasta, potatoes etc including grain based kibble.

If you think my personal experience can help you, plese feel free to PM me


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## hairydog (Feb 15, 2009)

Really glad you have some answers at last, and by admitting him to this health place, he will get great treatment, hope it all goes well for you, sounds like he has been having a rough time, know what it's like when you have somthing wrong with your dog, the worry is like a weight on your shoulders, 2 years ago my girl could hardly walk, but after intense hydro, shes now more than happy just plodding around, and i take each day at a time.


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## clyde (Apr 28, 2009)

I am not a vet. I am however a hydrotherapist. i have have been treating dogs for approx 6 to years. I work very closely wit the RSPCA centre in Southridge, Hertfordshire.

As far as the muscle wastage is concerned, hydrotherapy will definitely build up the muscle toneage. I come across a lot of GSD's who get CDRM as they get older. In many cases bar a few, i have been able to reverse the symptoms or stabilise them through intensive hydrotherapy swimming. This would mean building up the dogs to swimming for 10minutes, 3 times per session with 5 minute breaks. so altogether the dog swims for 30 minutes per session. At the age your dog is and the condition and breed, i would estimate that your dog should be doing this by the sixth session.

If the hydrotherapist was to measure the legs at the beginning and then after the 10th swim, you should see a fantastic growth in the muscles. I would also recommend that the swimming be done twice a week initially for the first 5 weeks and the you can chose to reduce this to once a week.

Remember that swimming is totally weightless. Just check with the center first that they would be willing to spent the time on your dog and set an hour aside for each session. If they only plan to do ten minutes per session, this is pointless as you would then have to give your dog five to six sessions a week of 10 minute swims!!!

If they do it the way i mentioned, then you will find that your dog will be tired that evening and the next day. By the thrid day he should be a lot more lively and then on the fourth day, thats when he goes back into the swimming.

Try and use a CHA member as then you should be able to claim on your insurance policy under alternative therapy.

If you want some information please feel free to check out my website or call or email me for any advice. Quincys Hydrotherapy For Dogs - Home Page

Good luck

Josh
Quincy's Hydrotherapy Centre
07957 167 824


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## dougalh (Oct 19, 2009)

By way update about 10 days down the line - Dougal is stable with the rehabilitation centre who are really taking great care of him. Despite a blip with his blood glucose which was thankfully spotted early by the vet (early onset of ketoacisdosis which was sorted out by getting him in on a drip overnight) he is quite perky and while he has no use of his legs at all he is settling into a routine where he can eat, drink and perform all his functions so that the treatment can progress.

The key thing is getting the diabetes itself under control so he is due another glucometer check on Monday after which we would expect his insulin dosage gets tweaked up a notch - this can happen every 3-5 days AIUI to get him to his appropriate level. Once that is established (which could be a couple of weeks or even more) only really then can we look for the neuropathy itself to ease. In the meantime he is having some electro-stim and gentle hydro work to keep his muscles from disappearing completely.

He's in good spirits and has lost no use of his tail whatsoever (one of his prized assets), though he cannot bark (another facet of the neuropathy). For our part we've realised that all along we've had little "choice" anyway - there is really no question in the short and medium term (at least as long as there are no new complications) of considering any "unpleasant decisions" though we're really pleased (that's probably not the right word) to have gone through all this and had to face those issues.

All the vets and physios love him and even our postman has missed him and sent his love  He's a very special dog and he's going to carry on touching peoples hearts for a while yet, god willing 

M


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## haeveymolly (Mar 7, 2009)

Bless him we're rooting for him good luck


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## Guest (Nov 1, 2009)

Thanks for the update.
I'm glad it's quite positive


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