I had an exceptional day at work yesterday. Too bad it was of the impressively depressing kind. Three diabetics––all very sick––made it through my door. All three made it back out...as their owners picked them back up and took them to the internal medicine specialist’s place for more intensive care than I could provide.
So you know, I’m happy to treat diabetics in my hospital. But by the time they present with the degree of clinical signs and frightening labwork that accompanied these three, my owners are inevitably given the choice to move on to higher tech pastures––that is, if they can afford it.
The first was a dog that presented for severe lameness over the weekend. He’d made an appointment for X-rays and I’d found startlingly bad hips that had apparently deteriorated very suddenly. But he’d also lost 21 pounds over the past two months (when I’d last seen him for his annual visit). At that time I’d read the owners the riot act on the dog’s extreme obesity. But something didn’t smell right. The dramatic degree of weight loss was disproportionate to the owners' denial of his obesity.
I should have known right away, but the recent (pristine) labwork had me fooled. Turns out his hips were horrible, yes, but diabetes had debilitated his neurologic pathways in such a way that he was unable to place his limbs properly. Diabetic neuropathy we call it. He’s now doing reasonably well at the specialist’s place and has a great prognosis with insulin and further weight loss...though I do see a hip replacement in his future.
Interestingly, my next two cases suffered from the same. Neither cat could walk and had been walking strangely before they’d collapsed. One had been losing weight for a month while the other had suddenly succumbed almost overnight. Both were in critical shape.
Fatty liver disease accompanied the first patient. This 18-pounder had lost 7 pounds in 30 days! The whites of her eyes gave off a faint yellow glow and her labwork had fatty liver disease all over it (high bilirubin levels accompanied by not-so-high liver enzymes). In other words, the fat she’d so suddenly lost (almost certainly the result of her diabetes) had gummed up her liver’s works.
The second patient fared the worst. The disease had come on fast and furiously while the owners had been out of town. Understandably, the pet sitter was in tears, feeling guilty over having missed the signs of impending doom.
“But she was jumping onto the counters yesterday,” she explained. (And I believed her.) Yet sometimes this is how it goes with some of my older diabetics. And, yes, it often happens when the owners are away, as if the kitties suddenly give up hope in the absence of their loved ones.
Sadly, patient #3 was euthanized last night. And I did not disagree with the decision one bit. Heading into a diabetic coma as she was, her chances were poor and her potential suffering, extreme.
All three completely different scenarios. All three suffering the same primary disease. As if their pancreases had grown very tired all at once and gave up the ghost at their own individual pace, in their own unique ways. The first two influenced by extreme obesity, the last one...who knows?
Needless to say, it was not an auspicious National Pet Obesity Awareness Day for me. Nor was that irony lost on two of three owners as they contemplated the fat pet posters in the lobby.
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...and 20 years ago diabetes in pets was relatively rare.
The incidence is rising dramatically. As pets move from the backyard, to the house, and to the bedroom they eat more often. Pets also eat more table scraps and treats. Pets now exercise less due to lazy or busy human owners (I am one too).
We are loving/feeding our pets to death.
Robert October 15th, 2009 08:41:35 AM
As I try to find the delicate balance of supporting a cat with both chronic renal failure and diabetes, I sometimes wonder about what Robert said above. Is it something I have done that led him to this juncture? This cat was a foundling I bottle-raised. He was part of the turning point in my providing better nuturtition to my cats than I ever had before. He was never obese. Yet now I'm at a juncture where I have to choose: support his kidneys with a low protien diet that won't ever allow his diabetes to be managed with a decent glucose curve, or support his diabetes with a high protien diet that exacerbates his CRF. I have a good, trusted vet, and he admits it's a no-win balancing act. So when I read the "It's all our fault for overfeeding/bringing our cats inside" posts, I get angry and defensive. My cat is soon going to be one of those cases Dr. K wrote about today... only my pending unemployment will mean financial euthanasia rather than an internal medicine specialist. Robert, I dont know if it's always less optimium treatment by owners leading to these ailments in pets or not. But some owners try really hard to do the right things and still end up on the no-win train to suckville. Please be a little kinder in the casting of blame.
Feline October 15th, 2009 09:13:42 AM
Twenty years ago, a much greater percentage of pets, especially cats but dogs too, died under the tires of cars, got badly injured in fights, or just disappeared, with the owner never knowing what the pet's fate was. And you can't die of diabetes at eleven, if you were killed by a car at four.
Lis October 15th, 2009 09:21:17 AM
Feline: "Is it something I have done that led him to this juncture?"
Sometimes yes, sometimes no. Genetics clearly accounts not only for some of the obesity we see, but undeniably for most of the diabetes. Yet we do know that the diabetes risks in genetically susceptible humans can be mitigated. Same goes for cats.
For example, for my well-maintained older patient (who was not overweight at all), only a crystal ball would have helped.
Dr. Patty Khuly October 15th, 2009 09:23:11 AM
Diabetes in dogs and cats manifests very differently -- in the former, it's more akin to type 1 in humans, in the latter more similar to type 2. So in dogs it's almost uniformly a late onset (older than 7) hereditary condition. Obesity certainly isn't helpful -- but it's not causal either. I know this because I'm the owner of a diabetic dog and writer on the topic who has interviewed many veterinary experts. And my dog was never overweight.
All this to say, there was nothing I could have done to prevent my dog's diabetes. I always gave him good food and plenty of exercise. So although obesity is bad for many many reasons, people with overweight dogs shouldn't feel they're responsible for giving them this particular disease. Cats on the other hand... but the good news is that feline diabetes can often be reversed with diet and -- possibly -- new drugs. Dogs have to be on insulin the rest of their lives. Yup, it's a bit pesky. But as I can attest after two years, if they're well regulated, diabetic dogs can have a happy, normal existence. So can their owners.
Edie (http://WillMyDogHateMe.com) October 15th, 2009 09:26:22 AM
Pets in the home are great. My family sleeps with our large dogs. We wouldn't have it any other way. The point is that when pets adopt by default our human lifestyle and eating habits they will begin to acquire our lifestyle issues: obesity, second-hand smoke, diabetes, etc..
And yes, there are kind souls out there that seem to end up with pets with endless problems.
Please, I'm only looking at data and treads and forming conclusions.
Take care,
Robert October 15th, 2009 09:29:29 AM
Edie: Obesity DOES predispose dogs to diabetes. There is a large body of research on this issue. Please don't disseminate incomplete––or potentially injurious––advice based on your dog's condition alone.
Sorry to be so persnickety about it but it's a pet peeve of mine when bad info gets passed off as gospel when the science clearly says otherwise.
In case you don't "agree", reference a recent conference proceeding (April 2009). It took me two seconds to find this information.
Dr. Patty Khuly October 15th, 2009 11:11:36 AM
Robert, you're ignoring the "trend" of pets not dying earlier of other causes while you try to account for them dying later of diabetes etc.
The death rate is always going to be 100% of the population in the long run. If you don't die of one thing, you will die of another thing. Cats passed through a very narrow evolutionary bottleneck, and unlike dogs have little genetic diversity. But dogs or cats, they have to die of something. And the decline in the percentages of dogs and cats dying of accidents, or of illnesses that they are now either less exposed to or vaccinated against, automatically means an increase in the percentage dying of conditions like diabetes, kidney failure, or liver cancer.
Undoubtedly as we learn more about nutrition, and get better at providing planned, intentional exercise in place of the free roaming that's no longer allowed, we can delay or prevent the onset of any particular condition in any particular animal. In the long run, though, they'll die, and the death will have a cause, and we'll call it something--and whatever it is, it will be something that was less common back in the "good old days" when they died under car wheels or in the jaws of larger predators.
Even if that cause is, as we all hope for, extreme old age.
Lis October 15th, 2009 11:16:30 AM
An explanation:
Dogs and Type 2 diabetes:
Mattheeuws, D., Rottiers, R., Kaneko, J. J. & Vermeulen, A.(1984)Diabetes mellitus in dogs: relationship of obesity to glucose tolerance and insulin response. Am. J. Vet. Res. 45: 98–103.[Medline]
Because dogs are usually insulin dependent diabetics, we tend to classify them as Type 1. Type 2 is currently considered uncommon in dogs. And this is the kind of diabetes for which an obesity predisposition is considered causal.
However, obesity has been reproducibly correlated with diabetes in dogs––even with Type 1. Saying it's not causal is a persnickety point––because the pathogenesis of canine diabetes has not revealed a direct connection to obesity as it has in cats.
Nonetheless, most veterinary internal medicine specialists assume some degree of causation in cases like yesterday's patient. I have an internist looking for a recent paper detailing the incidence of Type 2 and the role of obesity in dogs––we can't remember which journal but we're on it.
Dr. Patty Khuly October 15th, 2009 11:51:44 AM
Dr Khuly, Actually, I was going to back channel this because *I* didn't want to seem persnickity but couldn't find a direct email address on this site. As you'll see if you read my post fully, I mentioned that I also wrote on the topic. The article I wrote appeared in a recent issue of Your Dog, the publication of the Cummings School of Veterinary Science at Tufts University; there is no link to the site but I'm happy to provide more specific information. I interviewed veterinarians on staff at Tufts and a variety of world experts. I'm not dessiminating incorrect information; I felt that you were, which is why I posted here.
Edie Jarolim, PhD
Edie (http://WillMyDogHateMe.com) October 15th, 2009 11:56:20 AM
P.S. I realized that the reason I couldn't find the issue I was looking for is that it hasn't been published yet; it's coming out in November. I'm happy to send you the pdf of the issue that I looked at in proof.
Edie (http://WillMyDogHateMe.com) October 15th, 2009 12:02:37 PM
I've been lurking for awhile but never commented, so hope this works OK. In response to Feline's CRF-diabetic diet quandary, I believe the jury is still out on whether a high-protein/low-carbohydrate diet will exacerbate CRF. Unfortunately, with high protein usually comes increased phosphorous which is a more likely culprit, but using a highly digestible protein and possibly a phosphate binder, if needed, is an option. My Siamese, Bali, was euthanized in August 2007 when her kidneys were finally kaput, four years after being diagnosed with CRF which surfaced after radioactive iodine treatment for hyperthyroidism. When she wouldn't eat the Rx kidney diets, I fed her a commercial grain-free wet food and she did very well. My current CRF kitty was diagnosed three years ago and has been eating that same diet, which also works for her cancer (nasal adenocarcinoma--carbohydrates can be a source of nutrition to tumors); she was also diagnosed with hypertrophic cardiomyopathy two years ago, but it is stable. She turned 19 in August and is happy, active and agile, and gets pretty excited at meal time. This is only my opinion/experience, but something to consider.
Kaatje October 15th, 2009 12:55:39 PM
How very sad. Diabetes in pets is something that breaks my heart because it's so very unnecessary yet most of us don't know how to prevent it till it's too late.
As for prognosis in the face of DKA, there are lots of kitties over on the feline diabetes board who are in DKA when their diabetes is discovered or shortly thereafter but with intensive care for DKA, turn around, come back. I'm not saying your clients made the wrong choice to PTS but perhaps they believed the situation to be more hopeless than it really was?
I hope you gave the owner of Kitty # 2 (or rather Patient #2) a suggestion to check out the FDMB site which you have a link to here on your blog.
An interesting fact, as reported at a public health conference I attended in the past few years:
THIRTY PERCENT of children born in the year 2000 or later will develop diabetes in their lifetime, due to poor diet, lack of exercise and obesity. If we aren't doing better for human children than that, how much hope is there for our pets?
Just like parents are bombarded with commercials for fruit juice, snack foods, etc. so are pet owners bombarded by commercials telling them that
DRY FOOD is actually good for their pets!
Which IMHO is a huge part of the problem.
My cats are pretty sedentary, but they are not obese. I think its because of their maniacally contolled diet. Then again, what got me to pracrtice maniacal control was having my most beloved pet ever get diabetes )and get OD'd by a vet's kid when he was under treatment, as you know).
One of the reasons I believe it is IMPERATIVE that more vets get up to speed on diabetes in pets, appropriate treatment, etc. is that this disease is sadly NOT going anywhere, and we are all going to be seeing more and more of it.
Stefani October 15th, 2009 02:04:00 PM
Edie: Note that I did not say that obesity causes diabetes in dogs. A predisposition denotes correlation not causation.
To harp on the exact mode of causation vs correlation because the pathophysiology has not been worked out lends fuel to the fire of those who would persist in maintaining an obese animal against all rational arguments to the contrary.
In turn, I tend to believe that a point of view that states "we don't know but there's a correlation there" is the safe one. To say "there's no proof that diabetes is caused by obesity in dogs" might be OK, too, as long as it's also implied that the question remains open. But to say that owners of obese, diabetic dogs have played no role in their pets' illnesses is irresponsible at best.
That's even more true when you dig deeper and you find that obese diabetic dogs suffer the disease more severely upon initial presentation. They are more likely to be ketotic, for example. Does it not stand to reason that the owners bear some responsibility for the degree of their pet's severity in these cases?
It's sort of like saying the owners of a once-obese cat with fatty liver disease are off the hook because the obesity itself did not cause it––it merely predisposed the cat to mobilize its fats upon anorexia.
A strict view of causation is not everything.
To discount, out of hand, the role of obesity in canine diabetes is an unfortunate leap that you cannot support. It does everyone in the veterinary community––not to mention our pets––a disservice as we try to explain how obesity influences disease processes. Upon more pointed questioning, I'd venture to guess that the veterinarians you consulted would hasten to agree.
Dr. Patty Khuly October 15th, 2009 02:08:29 PM
BTW, my house is made of glass so please don't think there is any judgement in that post. I felt like an idiot when my cat got diabetes, but in truth, I was feeding him the way I ** thought** I was supposed to at the time.
Also, sounds from your posts like I don't know much about diabetes in dogs so this is just about cats.
Kaatje re: phosphorous vs. protein in CRF. Yeh, seems to be a big controversy.
I had a CRF foster kitty/diabetic, Dr. Lisa Pierson consulted with me to create a low-phospohorous, moderate/high protein, low/carb recipe. I don't know if it worked -- she got lymphoma and had to be PTS when it went to her brain.
But I'm now using a modified version of the same recipe for my other cats 3 of whom are 9+ y/o and one of them with borderline kidneys. I'm hoping reducing phosphorous now will be protective, but time will tell . . . or not.
Stefani October 15th, 2009 02:12:26 PM
I''ll add to what Dr. K said and say to Edie: Why go there? What's the point of taking the time to explain to folks in an article that obesity isn't bad because they mostly only suffer Type 1? While I'll agree that we can't say anything definitive about causality in diabetes with respect to obesity, we do know that we know very little about endocrinological disease causality and the workings of the immune system in general. Feline hyperthyroidism would be another example where that's the case. We know that exposure to certain chemicals is correlated but we don't understand causality. MOre research is needed. Until then it makes no sense to offer this point of view on obesity and diabetes. It's almost like you want people to feel better about not having contributed to their dogs' diabetes when we can't always say thats the case.
Dr. G. October 15th, 2009 02:56:59 PM
Sorry, but this pileon is distressing. Dr G, you ask Why go there re: diabetes and obesity? Because it happens to be the truth. Sorry, but I did my research and a great deal of it with -- as I noted -- world renowned experts and very current studies. I never suggested it's ok for pets to be obese. It isn't. And I made it clear there is a causal relationships between obesity and diabetes with cats. But there is no causality with dogs, though it does exacerbate symptoms, and that's just a fact, like it or not.
Edie October 15th, 2009 04:57:37 PM
I still wonder if there are other factors influencing the onset of diabetes that we aren't aware of yet. Not only do I know several diabetic dogs who were trim, athletic and under 5 years old, but here in Wyoming a substantial number of the type 2 human diabetics I know do not fit the profile: no family history, always thin and very active ranchers, less than 50 years at onset. I wonder if all this environmental contamination or an infectious agent might be involved as well.
Maria Shanley October 15th, 2009 07:13:44 PM
Edie, I do not see any "pileon." I see several people including Dr. Khuly disagreeing with you, and not accepting your statements, citing only your own not-yet-published paper, as settling the matter in your favor.
This is not, in fact, the same thing as a "pileon."
Lis October 15th, 2009 08:02:33 PM
I think we will eventually learn that much of the obesity and Type 2 diabetes in people has a very strong genetic link and that the growing prevalence of these conditions may be expanding because, like near-sightedness, it is a trait that is readily passed down. I also suspect personally that our sense of direct control and hence causation (and disdain for people perceived not exercising self-control) over many conditions is illusory. It's nice to think that overweight people "just eat too much" but science has already shown that that is a horrendous oversimplication and that there are physiological causes for the inability to lose weight in many cases.
I read recently that there is evidence that many auto-immune disorders in people are linked to a genetic abnormality that causes them to have a "leaky gut" and that the interaction between proteins escaping the gut and the gut's immune system cells may be the cause of these disorders.
I've spent five years working with people with diabetic dogs, meeting several hundred dogs over that time online, and cared for my own diabetic dog for five years. I can tell you that my dog was never overweight and many many dogs who develop diabetes are perfectly trim. So it seems pointless to me to be arguing about whether a dog being overweight is "linked" to diabetes. Unless it's causal, which we all seem to agree that it's not, what's the point? The earlier post here about feline diets noted that they have yet to find any real strong correlation between obesity and cats with diabetes. My understanding of feline diabetes, from a presentation by Dr. Bruyette at VCA LA, is that feline diabetes is related to amyloid deposition and that switching to a high protein diet and aggressively tackling the need for insulin can often bring about a full remission if started early enough.
I don't see canine diabetes as having a strong enough link to obesity for it to be a major part of a canine diabetes discussion. Probably more often a factor is administration of steroids for allergies, for example. And other endocrine and auto-immune disorders, which also often wind up being treated with steroids. Anecdotally, there are a LOT of cases of canine diabetes where the dog also has hypothyroid and often Cushing's disease.
www.k9diabetes.com
Natalie October 15th, 2009 11:10:14 PM
Natalie: In an earlier post on feline feeding and diabetes, the link between wet diets and diabetes was not yet established but the causal relationship between feline and obesity and diabetes is a pretty solid one.
Yes, it's true that many diabetic dogs are perfectly trim and have always been so. But it's nonetheless important to recognize all factors associated with the disease.
To your point on causality and correlation: I'll have to argue against your contention that unless there's established causality there's no point in talking about it.
1-Because correlation drives research to explore the underpinnings of disease processes like this one.
2-Because correlation gives us a starting point when advising owners. For example, if we know there's a correlation between dry food diets and obesity in cats, why would we not advise our clients to avoid dry diets if they can?
Ultimately, there's much that we do not know about diabetes and other diseases. In the meantime, keeping our eyes open to what we do know––or strongly suspect––is critical.
Should it be a major part of the discussion? Perhaps not. But when you're presented with a 138-pound Lab who's a ketoacidotic diabetic, obesity deserves a mention in a post on diabetes.
(btw, I love your site and recommend it to all my diabetic dog owners.)
Dr. Patty Khuly October 16th, 2009 06:49:46 AM
Dr. Khuly,
Posting here because I'm not sure you're looking at earlier blogs and posts.
Hi Dr. Khuly,
You wrote: "Matt: Thanks for that on ASPCA's Poison Control. I revere their work but I've sensed a certain degree of temerity on the subject of topicals. Your comment helps explain it. But how can I verify this is the case?"
Here's the verification:
Animal Poison Control Home>Animal Poison Control>APCC Consulting Services > ASPCA Animal Product Safety Service ASPCA Animal Product Safety Service
"The ASPCA Animal Product Safety Service (APSS) leads the way in providing customized solutions that support our clients’ product stewardship.
The pillars of the Animal Product Safety Service are our incomparable staff and advanced information systems. Our veterinary experts share more than 125 years of combined poison control center experience and more than 75 years of combined general toxicology, clinical, and diagnostic experience.
Our Animal Product Safety Service (APSS) division provides services to corporations. We manage adverse event cases and provide extensive veterinary toxicology consulting on legal cases, formulation issues, product liability, regulatory reporting, and biosurveillance. We assist industry through technical support, pharmacovigilance, and related services."
Here's the link: http://www2.aspca.org/site/PageServer?pagename=aspcaproapc_consulting_apss
I can provide more verification if needed.
Thanks again for your strong and courageous voice on issues that most in the veterinary industry would never consider touching with a ten foot pole.
Matt October 16th, 2009 10:43:04 AM
Let us also not lose sight of the other afflictions which MAY be related to and/or caused by obesity:
Heart disease
Fatty Liver disease
Osteoarthritis
Stroke
Asthma
I've had a Golden Retriever who summitted more mountains that most people I know. She was fit, trim, happy, running, swimming every day - then passed quickly at 15. She was ill for 2 days, and euthenized when blood tests showed kidney failure. Now we have a 2yo Rottweiler. He is on the same diet as the Golden - meat, egg, and vegetable scraps. Never processed foods, no dairy except the occasional bite of cheese. In place of "kibble" foods he gets the same as the horses - beet pulp, rice bran, and a salt and mineral supplement. I am no vet, and am feeding just exactly what clearly worked for my beloved Golden - so if anyone knows why any of these ingredients would harm him please let me know! I don't count his calories, but we are extremely active, and while I am trailriding he runs alongside for 2-5 hours each day. Then there's swimming with the kids, and hiking on the weekends.
Jessica October 16th, 2009 10:57:25 AM
Re:
" . . . switching to a high protein diet and aggressively tackling the need for insulin can often bring about a full remission if started early enough."
I agree with Dr. Khuly about the link between dry diet and both obesity and diabetes. My laypersons opinion based on what I've seen is that dry diet has a link to diabetes even in non-obese cats. My Toonces was not obese when he was dx'd; my foster cat Chloe was definitely not obese. Both, however, had been on diets of primarily dry food prior to dx.
As for remission in cats, Natalie, I can also say anecdotally that I have seen the dietary change and insulin therapy bring about remission fairly quickly in my two fosters.
Chloe -- non obese. Dry diet. Owner would not give shots, glipizide (oral) not working. Owner surrendered. As soon as I got Chloe, I put her on a diet of high protein, no grain, low carb wet food and started Lantus insulin. She was 400+ bgs at first. Turned out, Chloe was SUPER insulin sensitive and in the first 3 days of therapy I had to lower her dose from 1 unit 2x day to .25 units 2x day (numbers in the 40s on just .25 u . . . whoah! Eat Chloe! Eat!) But this was a good sign. She got to where she only needed a DROP of insulin every 16 hours or so, and BAM! Chloe went into remission (no longer needing insulin) in 3 weeks flat.
After she went to her new home, she ended up needing insulin for a brief period again and guess what . . . I think it was after she'd managed to get her hands on some dry food. But she went back into remission even more quickly the 2nd time.
Sweetpea, my 2nd diabetic foster, was very overweight, also had been on a diet of ALL dry food. Same diet switch, started insulin. Sweetpea took 7 weeks to get into remission. She was also slowly losing weight during that time. Same signs -- lower and lower insulin requirements. I also used a method with her of feeding her VERY small meals multiple times a day. It worked. She stayed in remission until sadly she got lymphoma.
The only one of 3 diabetics I had that didn't go into remission on the diet change + insulin was my own Toonces. Because he had been brain damaged by a veterinary administered insulin overdose, he would never have shown signs of hypo, so I was terrified to be as aggressive with him as I would have needed to for getting him into remission. Still, the lantus/low carb food regimen was definitely the best for his control.
From 5 years hanging out over on the Feline Diabetes group, I can say I've seen some interesting improvements in what's available. From what I've seen, lantus seems to have the most newly diagnosed cats go into remission compared to other insulins. Levimir seems to have benefits for long term control of cats that do not go into remission, because it gives a nice flat curve, using lots of overlap, that keeps the numbers in a good, narrow range. Slow, long onset. Lots of folks successfully still use PZI when they can get it. The WORST seem to be Humulin N and Vetsulin. Numbers all over the place. Short duration. Works for a handful of cats but I've seen much better stories on Lantus and Lev.
Stefani October 16th, 2009 11:36:50 AM
Since this discussion is still on, I'm going to jump in here again with one thing I'd like to clarify. It seems to me that the whole obesity question clouded the main point I was trying to make: That diabetes is very different in cats and dogs. My prime objection to the original post was that the species were not distinguished from one another sufficiently.
I can't tell you how many times I've heard "I know a cat that was cured with dietary changes." This gives false hope to the owner of a diabetic dog who must go on insulin for the rest of his life. Similarly, cats aren't subject to cataracts in the same way that dogs are. I have had to explain patiently, over and over, that cats and dogs are different. This should be obvious but it isn't. We're not supposed to give cats flea medication for dogs and vice versa. Why should a disease that's very different in the two species be lumped together under a single discussion? This perpetuates the same misconceptions.
Edie (http://WillMyDogHateMe.com) October 16th, 2009 03:34:55 PM
Thanks for clarifying that, Edie. It's a critical point that's too often overlooked––usually to the detriment of cats but sometimes to dogs (and their owners, too). And thanks for being a good sport. We debate a lot in this community and I'd like to think that it makes for a richer learning experience for everyone (me, too, of course).
Dr. Patty Khuly October 16th, 2009 04:20:33 PM
mike - I'd say it's more like as both their AND our food becomes more and more over-processed and additive-filled, those of us (and them) that continue to eat it will suffer predictable health outcomes.
It's not about 'people food' and 'dog food', because in the end, it all comes from the same source.
Pai October 16th, 2009 08:21:37 PM
Please delete:
Ugg boots rise corelated to rise in human diabetes.
Beginning in the late 19070's the surfing community saw a marked rise in diabetes around the introduction of the original Ugg boots from Australia. Obviously it was merely natural selection and fashion sense at play. Recently however, the more recent explosion of both Type I and Type II diabetes in the general population (and especially in the female population) is almost directly corelated to both the number of adds for Ugg boots (and similar knock-offs) and the amount sold. Further evidence may be found in the population of Types I and II diabetes patients who also wear Ugg boots. This warrants future examination.
See also: Rise in pet diabetes cases corelated to number of both human and pet Snuggie advertisements.
Robert October 17th, 2009 07:03:25 AM
...sorry. The above "comment" is only relevant with the deleted spam post for Ugg boots.
Robert October 17th, 2009 07:06:16 AM
Robert: Very funny!! Yes, I find Ugg boots and Tiffany jewelry so anti-apropos to veterinary medicine that I can't help but wonder why they bother spamming here.
Dr. Patty Khuly October 17th, 2009 10:09:01 AM
A belated thanks Dr. K for your kind words about my website! :)
Natalie October 23rd, 2009 06:18:14 PM
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