Glucose is the blood sugar that circulates around the body and it is the principle nutrient that your body’s cells use for energy. The liver stores extra sugar in the form of a starch called glycogen. Your body can then use this glycogen to make extra blood sugar between meals to keep the levels of sugar in the blood stable.
AMH
Canned food - Why is this important?
I recently attended a veterinary conference in Kansas City and was REALLY excited to get to hear one of the clinical professors from Texas A&M talk about feline nutrition, obesity, and diabetes. This is cool stuff. Cats are bad about storing mesenteric fat. This is the belly fat. Fat that gets packed around the intestines, kidneys, and liver. This is where most human men (including ME) tend to pack the fat in. So this is a subject close to my heart (or at least close to my pancreas).
Mesenteric fat is uber bad. Fat in the belly pushes up on your chest and stomach and causes difficulty breathing and stomach reflux simply because of its bulk. It also makes it difficult for blood to circulate around the lower half of the body and helps drive up blood pressure. As if all that wasn't bad enough, we have now found that mesenteric fat cells are also capable of producing lots of their very own hormones as well. But wait - it gets worse. Most of the hormones that these fat cells make actually encourage more fat production, cause inflammatory changes in the body, and increase appetite! How horrible is that!
I guess I'll continue with my cancer theme here and briefly comment on a question I was asked the other day.
Do herbicides cause cancer?
Like all things - it's controversial. There has been some good work done to show that the herbicide 2,4-D is associated with an increased risk of lymphoma in dogs. There's also lots of work to suggest otherwise. (2,4-D is, by the way, a cousin of Agent Orange.)
As I mentioned in my post on cancer development, there is rarely ONE thing you can blame for causing a particular cancer. This is especially true for lymphoma. Genetics, chemical exposures, foods, and hormones are all associated. So the truth probably is that 2,4-D can probably cause cancer in a predisposed individual, but may not in another individual if all other things are equal.
I'm a believer that exposure to environmental chemicals like herbicides HAS to be related to our increased incidence of cancers (in general). Which ones to blame? That's the sticky part! I don't know. But since there is good research that shows 2,4-D is a likely suspect, I try to avoid it as much as physically possible.
AMH
What kinds of treats are OK to give my dog?
Everything in moderation, and nothing to excess. -Aristotle
This is a pretty common question I hear every day in practice. Anyone who has seen me in person (especially in profile :P) would agree that I think treats are pretty important. We get into problems when we forget that they are TREATS and as such should not me a major part of our diet.
In my case - scoop of ice cream=good. PINT of icecream=BAD.
In your dog's case - dog biscuit=good. Handful of biscuits=BAD.
First and foremost, keep in mind that most biscuits and treats for dogs and cats are about as calorie dense as an equal amount of their kibble. I've had owners complain that their dog "only eats a cup of food a day" and are shocked that they have gained weight. After we really look at what goes into the dog over the course of the day, I find out that they get 10 mini-milkbones a day. That's nearly another cup of food!
Just walk down the treat isle at the local pet store and you will be shocked at the sheer number of different options. Notice that nearly all of them are marketed to you, not your dog! Does your dog really care that his food is in the shape of a bone? He eats poop, afterall. Would he like it any better if it were a poop shaped cookie?
There are an unfortunate number of treats that are much to hard to be safe. Nylabones (sorry Nylabone people) and dried beef bones are just plain dangerous. Same goes for ice! Your dog will bust a tooth on one of these. I believe Nylabone does make a flexible/squishy chew. That's OK.
Rawhide: One of the most popular treats. Dried cow skin. Cousins to this would be pig snouts/ears and bully sticks (dried beef penis - I kid you not). Rawhide can be a great treat IF your dog isn't an idiot and tries to swallow it whole. Rawhide does NOT digest once swallowed. Big chunks of rawhide will cause obstruction. Some dogs methodically chew and gnaw the strip down to little bits. Rawhide is great for them. These treats do absolutely nothing for the teeth unless they are enzymatically or antimicrobially treated. They simply turn to slimy wads of old skin. Pretty disgusting, but dogs love them!
Greenies (all all associated copy cats): Greenies were the chlorophyl treat that made all of the other "edible compressed starch" chewies popular. The original form of the treat was too hard and if swallowed in big pieces, would cause obstruction. The company has long since reformulated them and they are now completely digestible. Some dogs get diarrhea when eating a Greenie (or similar). This is probably the case with all treats, but Greenies seems to be accused more than others. Don't know why. Any of the compressed corn starch treats or compressed veggie treats are probably fine.
Table foods: Look below for a list of acceptable fruits and veggies. This section is specifically addressing table foods. We humans eat some very, very calorie dense foods. It doesn't take much "table food" to provide big-time calories to our pets. We MUST be careful with this one.
Fats: High fat items are dangerous for your dog. Steak trimmings, bacon, nut butters, and dairy butter are very effective triggers of pancreatitis. Pancreatitis can be exceptionally dangerous and even fatal. High fat foods must be fed in small quantities only if they are fed at all.
Bones: Raw bones are soft and can be great to chew on. You have the issue of microbial food safety, but the bones won't cause damage. COOKED bones are an entirely different story. Ribs, steak, hambones are all popular treats but should not be fed. Cooked bones have all of the fat and soft tissue cooked out of them and the result is that only the hard calcium matrix. This can not be chewed through. It's harder than a tooth and will break a tooth pretty easily. Once swallowed, cooked bones cannot be digested and can cause obstructions or perforations.
Fruits and veggies:
Pretty much any fruit or veggie is OK with a couple of major exceptions:
Grapes and raisins are expressely forbidden! Bad. Some dogs die of horrid renal failure after eating grapes or raisins. Others have absolutely no problems. So, NO GRAPES FOR YOU!
Onions and garlic (allium family veggies) are dangerous to cats. Dogs can handle small amounts, but you must be careful. Cats have acutally died from drinking onion soup broth. The reason for this toxicity is that cat red blood cells (and to a lesser extent, dogs) are very sensitive to the oxidative damage that allium species do to the surface of the cell. They get damaged, the body takes them out, and the pet ends up with dangerous anemia and expires. Onions-cats-bad.
Some favorites I've had people give: frozen green beans (or fresh - dogs seem to like the crunch), carrots (fresh - NOT frozen), celery stick, sliced apple, sliced pear, and red or green bell pepper.
Post a comment on your favorite treat for your pet. There are tons out there. I'll comment back if you'd like.
AMH
The title sounds a bit hard-core, but it's the truth.
Our last discussion was about how and why we get tumors. Some of these tumors become what we would refer to as cancer. Once a particular tumor has been identified and we know what we are dealing with, we can then begin discussing treatment.
The words radiation or chemotherapy often begin to evoke visceral reactions from owners. Most people have been exposed to the idea of chemotherapy or radiation because of a family member or friend who has battled cancer. Some chemotherapy and radiation options are pretty rough on the body. Some patients get very sick. But not everything that counts as chemo or radiation is hard on the body at all It really depends on the specific protocol.
In my opinion, it's all about QUALITY of life. Some would see it differently and say that QUANTITY is the more important half of the equation. I disagree. Quantity is nothing without quality. The sticking point becomes defining the point at which quality and quantity intersect at an acceptable point for YOU and YOUR PET.
By example, I am currently treating my own dog for stage 4-b lymphoma. That's about as bad as it gets. We decided to start chemotherapy because many of the initial drugs I was going to use in her treatment were fairly benign and it was worth a shot. Surprisingly, she's responded very well to her chemo and hasn't had any bad days because of it.
Until now.
I made the decision to go ahead and give her the doxorubicin. That is the one most likely to make her 'feel bad' for a few days. My decision to use that drug was based on the fact that a few days of nasty were worth the few weeks or months of happy. That was my take on it. Others would argue that the cost and misery of a few days is not an acceptable price to pay for a few weeks or months.
The take-home point is that the decision to treat and the decision how to treat is not something that can be made for you. Your doctor should give you options and you should consider the total picture and make an informed decision. For some, the answer is an easy. Hopefully you enjoy the support of a caring oncologist or primary care veterinarian and you will be an active part in the decision making process.
Staging the tumor:
Staging is something done when we are dealing with a malignancy (cancer). The goal of staging is to evaluate how 'badly' the tumor is behaving so that we can determine what therapy is required. It is necessary to help direct types of therapy in most cancers.
How we stage a tumor depends on tumor type. Some tumors tend to metastasize to the lungs first. Others met to a regional lymph node first. In the case of lymphoma we have to determine if the tumor is in the spleen, liver, or thymus and if it is in lymph nodes. Different locations have different prognoses because. Believe it or not - the same tumor found in two different places could behave dramatically differently.
Surgery:
If we are able to physically remove the tumor then we often take this as our first course of action. After all, why would we poison the entire body if we can cure the cancer by physically removing it from the body. There are many tumors where this is the ONLY treatment recommended.
Other times, our goal is to de-bulk the tumor. We know we won't get the entire tumor. We know there will be microscopic tumor left behind. But if we get all of the visible tumor, it makes the microscopic much easier to heal.
Because there is often microscopic invasion of the tumor in surrounding tissues, the amount of tissue to remove is sometimes impressively large. As an example, mast cell tumors require margins of approximately 3cm in every direction. By the time you account for the shape required to close the defect, a patient with a 1/2" mass may end up with a 6 inch incision.
Just like with real estate, it can all be about location, location, location. That same mast cell tumor on the foot simply can't be removed. There's not enough foot left to close the wound. So there are times that tumor location may dictate amputation of a particular body part (toe, ear, etc). Amputation doesn't have to be a bad word. Life without a toe isn't a bad idea if the only other option is death.
Radiation:
Radiation therapy means that energy in the form of radiation (gamma rays, x-rays) is poured into the tumor in hopes of causing such severe damage to the tumor cells that they die off. Unfortunately, normal tissues always get caught in the crossfire. There are some great new technologies that allow for the very precise delivery of radiation to a very tiny area and help minimize the amount of collateral radiation damage. Local reactions like burns (mild or severe) are the usual side-effects. When talking about the skin, that's not so bad. But if you are trying to irradiate a tumor in the pelvic canal, you end up burning the colon a bit, and the colon does not handle this very well. Again - Location, location, location.
Some tumors are particularly sensitive to radiation and die off quickly and easily. Some are very resistant and radiation doesn't really work. Radiation is usually applied to a very specific and focused location, but there are times where it is appropriate to irradiate an entire limb or an entire body. Whole-body radiation is something usually reserved for killing off the bone marrow in leukemia patients prior to marrow transplantation.
Chemotherapy - The 'other' Big C:
The goal of chemotherapy is to poison the body JUST ENOUGH that the tumor cells die but the patient does not. Chemotherapy is generally administered to the entire body. This is good if you have tumor around the entire body, but it also means that you are exposing all the normal cells in the body to the drug.
Nearly all chemo drugs target fast growing cells. This makes sense because the tumors are usually growing quickly. However, there are lots of cells in the body that have to grow quickly. Bone marrow, cells lining the intestines, and hair follicles are the major players. Not all drugs cause the same problems. For instance - vincristine is one of the drugs in lymphoma treatment. It is VERY well tolerated and is pretty uncommon to cause any issues. Doxorubicin, on the other hand, is quite likely to cause pretty severe gastrointestinal problems. In some dogs, it will cause balding.
The moral of the story is that you should not let the name chemotherapy scare you away all together. Some drugs are fairly simple and may provide excellent responses with nearly NO side effects. Others may be tolerated well in one patient but horribly in another. You simply have to weigh all the variables - patient, prognosis, finances, transportation, side-effects.
This posting does not even begin to cover everything. My hope was to at least cover the big picture. Like I say - I'm happy to entertain questions about specific tumors, drugs, or topics anytime. Just e-mail me!
AMH
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