A few days ago my vet called me with what I thought would be lab results for Lacy's E. cuniculi titer test. Instead she told me that the lab had changed how they ran the tests and now they were only sort of giving a pass/fail test. So, I couldn't really tell what her level of infection is. They only sort of give you a range. Not an actual number.
When my vet pushed back the lab said - well, what does she care what the number is - the bunny is positive. I think my vet managed to say something like - thanks professor obvious. We already knew that. And remember.... this is a 200 dollar test.
From the labs point of view I should stop testing because she was positive and will always be positive and I'm probably wasting my money because she is a throwaway pet. Which I could be. If she had "the diabetes" they wouldn't ask - well, what do you care what the number is? And clearly she doesn't understand the luxury of time when a rabbit is sick. You literally have one week to figure this crap out before the rabbit either lives or dies. And I would lean heavily on the latter. When a rabbit finally starts showing illness - it's almost always a fight to the death. That plane is in a tailspin and you have to get that rabbit out of it. Your success rate is gonna be less than 50%.
I mean, when she comes down sick (and one day she will) - she will be treated in a completely different way now because I already know she is positive. When a rabbit is in distress and you are force feeding them medication three times a day it can really be quite overwhelming for them. You are trying to get them to eat and take all the meds. Sometimes you are force feeding them.
So to have one less medication that you might need to give when that time comes is really valuable - I think. Keeping her non symptomatic positive is the goal. Most people only find out about this when the bunnies are symptomatic and by then there is a 50% chance you are too late.
"If she had 'the diabetes' they wouldn't ask - well, what do you care what the number is?"
ReplyDelete"Mister Refugee, the doctor would like to talk to you about your mother ..."
That's how things started with my mother's diabetic doctor many years ago when she was still alive, but it wasn't bad news.
My mother was fantastic at messing up her health and didn't exactly make it great for anyone else in the family either, so when I moved away, I learned how to cook well, how to eat the right stuff, and so on.
I also went vegetarian for about fifteen years, which I'd mentioned before, and it was during this vegetarian period when I stayed for a while to help out my father with my mother's various health conditions. I did all of the cooking, and so I put all of them on a mostly vegetarian diet, making the occasional chicken breast or something like that as a side just for them.
An appointment with the diabetic specialist had to be advanced by several months because very drastic things were happening with my mother's medicine, and everyone was worried about it.
What the doctor told me is that her A1c level had improved over the past four weeks to the point that she was now only "borderline diabetic", and that if she could keep this up, she'd be off insulin injections within six months. Already he was cutting her insulin intake per day by half, and the doctor had never seen anything like this in his entire career.
I taught my father how to cook what was working, and he actually liked the switch from heavier stuff to stir-fry dishes with tempeh and chicken. They kept it up and it actually took only four months for the insulin injections to end.
She was diagnosed as "in remission" and after five years was deemed "no longer diabetic", which is what doctors say when they can't bear to use the word "cured" in any context.
So yes, the actual number often matters.
But with A1c levels, doctors don't like sending people off for A1c tests more than every three months because that's the amount of time that the A1c number is regarded as "fixed", despite the fact that the A1c number is itself a running snapshot of the underlying conditions. And so an A1c change from slightly over 11 to somewhere below 7 over the course of six weeks wasn't something the labs or the doctors had ever seen.
The doctor asked for the A1c test to be done again a week later with even lower results, just because they couldn't believe the numbers were changing that fast.
Anyway, who really knows whether there'll be something you'll luck into that'll turn into a long-term solution. (Maybe nobody's tried artemisinin on rabbits -- it works great on malaria in humans.)
If I had a doctor or a lab complaining about testing that I'm paying for, I'd be highly inclined to find another doctor or lab, actually ...
Well... for the most part I'm tilting at windmills. I'm fighting against their very evolution. But if they can make cats live so long... Cats have won the evolutionary lottery. Dogs not as much. But cats have drugs for ~everything~ including "the diabetes". Every time I take my rabbit to the vet a I hear some story about cats and all the crap they are on.
ReplyDeleteSome day I will tell you about my Aunt and her diabetes. She has this skin crap that is ~crazy~. When she had surgery recently I was like - I wonder who had to draw the short straw to put in that catheter. It's actually quite amazing what the human body will tolerate.
Dogs have lost because humans keep screwing with their genetics. Humans keep trying to do it to cats, but so far it hasn't hit the overall population yet.....
ReplyDeleteAre there other options for labs to use, at least for next time? I titer my dogs (instead of auto vaccinating) and I have a choice of labs in my immediate area, should one lab decide to go screwy.
Oh.. that actually makes a lot of sense. And it might also be why house rabbits haven't made any strides yet. They keep tinkering with their DNA too. It's interesting you can test your dogs.
ReplyDeleteThey eventually agreed to re-run the test... but that is a good idea for the future to see if they can use a different lab. Thanks.@!