Fat, but Happy: An Update on Nemo

Awhile ago I shared a scary event we had with Nemo when he had a seizure in the middle of the night. After rushing him to the vet and having some tests done, we were told that Nemo has pancreatic insulinoma - or small insulin producing tumors on his pancreas. These tumors, and the resulting insulin, cause Nemo's blood sugar to be abnormally low which is what caused the initial seizure. His diagnosis is troubling because there's not much we can do about it. Although pills and surgeries could potentially treat the condition in the future, they aren't a cure. The life expectancy for dogs with pancreatic insulinoma is only about two years after diagnosis (if we're lucky) which is pretty grim.

All that said, we're certainly not the type to sit around wait for bad things to happen, so we've been taking all the steps we can to keep Nemo as healthy as possible. Luckily for now, managing his condition isn't too difficult. It's primarily revolved around three central things: less exercise, frequent feedings, and monitoring his blood sugar.

Reducing Nemo's activity level. Gone are the days when we play fetch for over an hour at a time. Exercise increases insulin production, which lowers blood sugar, and since Nemo already has low blood sugar we have to prevent it from dipping further. This one is tough because Nemo loves playing ball sooooooo much. Playing ball is almost his favorite thing in the world, so it's tough to not be able to do it much anymore (and to only throw the ball a few times before stopping). That doesn't mean he never gets out though. We still walk Nemo and throw the ball a little bit (although never to the point where he's winded) and he always gets a little extra food after he's active.

Feeding him frequently. The same day that we talked to the vet we went out and bought an automatic feeder. After looking at what was available, we bought this one and have been really happy with it (although Melanie broke the first one we had, so if you have a crazy pig-dog like I do who will chew through plastic to get to food this may not work for you).

Mel is such a pig-dog that she'll even try to steal food right out of Nemo's mouth.

So far the automatic feeder has worked out really well. When we're out, we set up the feeder and it rotates at certain times throughout the day so Nemo can eat. We leave him in the guest bedroom while we're out so the other dogs can't eat the food that's meant for him. The only obstacle we've encountered is that sometimes Nemo doesn't eat a meal when it comes around. I'm not sure if he misses meals because he's sleeping during the day (so he doesn't hear the feeder rotate) or if he's just bored with eating sometimes because we're feeding him 6+ times a day now. I've started "hiding" treats in the feeder to get him more eager to eat out of it though.

Monitoring His Blood Sugar. This is the one that's going to seem really crazy to people. On the advice from our vet we bought an AlphaTRAK Blood Glucose Monitoring Meter Kit. It's just like a blood monitoring kit a diabetic would have. At first, the idea of drawing Nemo's blood was really daunting. I hate the idea of hurting him, even it's just a tiny little needle. With a little practice though, T and I have become experts. It's really not hard at all and Nemo doesn't seem to mind (he is more annoyed with us fussing over him than he is with us actually sticking him with the lancet).

For the first week-ish we took his blood several times a day to create a curve of what his blood glucose levels do over time, but since then we only do it once a day. We test his blood first thing in the morning (literally it's the very first thing - he doesn't even get out of bed for it) and record his blood glucose levels in a diary before we feed him. So far we've been lucky that his levels have been relatively normal, but there's no telling how long that will keep up.

Having his blood drawn is no big deal, but Nemo gets annoyed when you interrupt his beauty sleep.

The possibility of medications and surgery is out there. So far we don't have him on any meds on the advice of our vet. When we start to notice that his blood glucose levels aren't in the normal range anymore, that will be the first next step. Surgery to remove the tumors is an option, but it's risky and not a cure. If we did have the surgery the tumors would invariably come back and the pancreas is very tricky to work around. Given all that, plus the stress involved with surgery and subsequent recovery, T and I (and our vet) aren't sure that it's something we'd do, but we'll cross that bridge when we get to it.

The important thing is that now Nemo is happy and feeling good. He gets more snuggles than he knows what to do with some days and, even more than his ball, snuggling is his favorite thing in the world. Thanks to all the extra food and lack of exercise he's gained a few pounds, but as long as he's happy, he can get as fat as he wants.