RawPetMedics Tuesday Live: Diabetes Mellitus Sweet

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Up on us already!

There we go!

Oh my goodness, they're all getting very, very sneaky in their old age, that's for sure. Good evening everybody, we are Crawl Pub Medics. We are going to be talking about diabetes, and I am delighted to be here with Dr. Brendan Clarke and Dr. Conor Brady. Lads, how are you?

I am very, very well. Very well. I've got the heating on at the moment and I'm absolutely sweating. But aside from that, it's a good complaint. Very cold where we are at the moment. When I say cold, it's not like freezing cold, but it's cold. It's like 2 degrees or something. What about you guys? Is it still cold over in England?

Cold, but not too bad. What about you, Brent?

Light frost. Light frost.

Do you know what? I actually heard down in the southeast of the country, Ticks are out. Ticks are out. They're absolutely out. This whole thing about, you know, 3 days, 10 degrees or more, day and night, and they start coming out, and people are already reporting them in the southeast. Thank God I don't live in the southern counties. So watch out if you're down in Essex.

God, I hate them.

I hate ticks so much. I'm in Wicklow. Wicklow and Kerry here in Ireland are the 2 very ticky places because it's where we have the most deer, I suppose. Quite a rugged bit of landscape, and so a lot of ticks around here, but nothing, no evidence of kind of how nasty the ticks are. There isn't a lot of data over like, you know, exactly area by area of what kind of— this is, we surveyed 10,000 ticks and this is what we found. That would be very useful information, wouldn't cost someone a lot to put a 20-year-old science student out there picking up ticks and Lyme disease, you know. It would be, it'd be good information to have. But anyway, so yeah, you're sounding, you're sounding very Mellifluous and boomy and very healthy there.

So your new microphone is doing great things. Good.

Is it boomy? I don't want boomy.

No, boomy's good. No, boomy, I meant rich. Rich.

Oh good, it's the same mic you guys have and you can't control it.

Voluptuous. He's going to start saying words like voluptuous soon. You want to be careful.

Guys, did you see the pet food that Hills Pet brought out there during the week? Proudly announced on the AVMA and all the other fully paid-up American veterinary associations. Yeah, Onk pet food for cancer care. Yeah, high in carbohydrates, you'd be delighted to hear, and chemically preserved. And unfortunately, I mean, I can say this because it is very similar to their standard pet food. I was looking at their standard pet food and trying to compare the two. The side-by-side comparison is It's hilarious. And it's just like, my God, imagine being a veterinary association promoting the food and not talking about the ingredients. I couldn't view the ingredients anywhere. I just thought it was a big shocker. That got a lot of traction during the week. But anyway, that's what riled my boat this week. Anything exciting happen with you guys before we tuck in?

Yes, I'll tell you what I did. I went for an eye test on Saturday because it's 5 years since I last got my eyes tested, right? And I thought, oh my God, you know, you're supposed to get them done every 2 years.

But I thought, I'm not paying for an eye test every 2 years.

So I went along and my eyes are in exactly the same shape as they were 5 years ago. So, and they said that actually I've got slight something and even that is not as bad. So I treated myself to some new reading glasses.

Oh, look at this. This is very social media friendly. These rims are—

How about that?

Unfortunately, I didn't realize we could see his skin.

Okay, I know. So that's— that is actually something I need to think about, because when I put these on, you'll notice they don't show the screen because they've got a special thingy. So I think I might need— but quite funky glasses.

They're very funky. Yeah, I was going to say Elton John wants his glasses back, but I think that would be too damaging, and you won't want to hear that, so I didn't say it.

Sensitivity. I've got one other little thing to ask. And I've been sent very kindly by these guys, and I don't know them at all. This is, this is powdered CBD. So they take CBD, they put it into oil to get all the goodness out, and then they put— they turn the oil into powder, and this is the result. Because the thinking— and I've spoken to one or two specialists in the area, and they're saying Why are you right? Why are you laughing, Brent?

Because I'm waiting for the packet of Rieslings to come up at the same time.

Oh, very good.

Sorry.

No, no, no, no, no.

We're not going to go there.

So this is solid stuff. And the latest thought, which differs from what we were discussing about a year ago, is that if you eat it with food, you get better absorption. You get less taken out by the liver each time. Because we had a— we had— yes, exactly, we had a chat last year, and the thinking last year was that if you take it away from food, then, and it's absorbed in the mouth, then when it does go into the blood and goes through the liver, which takes out most of the CBD, you don't get as much— you get more going into the bloodstream because it's absorbed in the mouth. However, and And Vivienne, this is for you as well. The latest— and I've spoken to a few people— is that if you have it with food, the latest figures— I've got some, I've got some studies to say that you might get better absorption. So I just wanted to ask if anybody's tried this particular— it's called Hempine— and if you tried it, or whether you've seen any studies for taking it with food or taking it without food. I'm very interested.

I wonder if you chew it like chewing tobacco and you just sort of like put it in a pouch up inside your cheek, whether you get extra hit.

Does anybody remember?

Maybe you could try some, Nick, and let us know next week.

Yeah, I know several pit bull terriers with whom I could try that experiment. In fact, I've tried it 5 times already and it seems to be working well.

Does anybody remember the movie The Outlaw Josie Wells where he used to chew tobacco all the time and spit on things and he'd spit on— in a can, he'd spit on the dog. Do you remember that movie? You know, it's a really old, uh, Western movie. It is one of the funniest scenes ever in a movie, in that where he's chewing the tobacco and he's a pretty obnoxious man, but he's kind of cool. And, uh, he spits on— so this guy comes up in this big white suit and it's like it's late 1800s. He goes, hey sir, would you like to buy my snake elixir to put hair in your head and do all this great stuff? And lists all these things. And Josie Wells, Clint Eastwood, isn't listening. He's just chewing his tobacco. He just looks at him, he goes, and he spits on his chest and he goes, how's it with stains?

You bring Cleaning up stains, young man. Yeah, those shorts are still living in that cupboard somewhere. Yeah.

Oh yeah, those shorts. We can't talk about them again. We've had— we have a broader American audience now. We have to introduce them slowly to my Conorisms. The interesting thing about that CBD, the releasing of it, because it's the same problem with iodide. There's a great— when you start trying to sell seaweed supplements like I do, amazing stuff, and people will always come back. 1 in 10 questions is, oh, this is too much iodine. And what about the effect on the thyroid? And it turns out that the, the problem with iodide is that when it's found in nature, it's bound up in food and with fiber, and it's a slow release of iodide into the blood. And that you can eat all day. Japanese people are eating many times their RDA of iodine every day. No problem. In fact, if anything, probably extremely beneficial. But if you try add iodide to food from a conical flask in powder form, that's completely different and it smashes into the bloodstream and frightens your thyroid into various issues. And so it's actually the artificial supplementation of foods with thyroid. Now, if your dog eats a whole beef thyroid, you might have problems because it's going to contain a lot of stuff. But so that's the, it's the artificial isolation of the actual nutrient was causing the problem. So it just goes to show you, you can't take these things out of the ingredient too easily. There's usually a whole host of beneficial things, particularly when it comes to hemp plants. There's so much goodness in the seed, not just CBD, there's a whole range of things. It's broad spectrum, multitude of vitamins and minerals that come with it as well. Probably all working synergistically to get the job done. And so I love the idea of a whole food version of it. I think that sounds great. I'm all behind it.

Dang, we're gonna miss that THC.

Yeah, you're not allowed to mention that.

You're not allowed to mention that. Exactly.

So look, without further ado, you want to follow us on patreon.com/rawpetmedics, uh, you'll get some of these juicy insights, uh, and a little bit more after the show. So, um, do join us on patreon.com/rawpetmedics, uh, and we look forward to seeing you there as well. But we must crack on tonight. There's loads of people joined us to know more about diabetes. So Nick, do you want to start with a little sort of foray into what diabetes is for the majority?

Do you want— okay, I think I'm quite good at the Peter and Jane approach. Uh, Bren, you like to give us the university approach, but I think that you got the— what I say to people, that's because I'm quite a simple kind of chap actually, but what I say to people is you can't read War and Peace until you can read Peter and Jane. Does everybody know what I mean by that? Okay, our American friends. So basically you can't read the really complex stuff until you can do the really baby stuff. And when I was a kid, there was Peter and Jane. Um, anybody got any— what did you, what did you learn to read on?

Anne and Barry, there you go, Irish names.

Peter and Jane, Peter and Jane, okay, okay, so I think you get the picture, it's basically, it's like Peter went to the shop, Jane went to the shop, Pat the dog was at the shop, they said hello to Pat the dog, etc., okay, brilliant, brilliant, brilliant stuff, if you haven't seen them and you've got kids then buy them the Ladybird books, anyway, so this is the ladybird, so Why don't you want lots of sugar in your bloodstream a lot of the time? There's a thing called glycation. And basically, if you think of it, if the sugar is running around in your blood and imagine if you've got honey in the atmosphere in your kitchen, basically everything gets a coating of honey and it becomes sticky and it doesn't work properly. And you can't put the spoon down on the side because it sticks to your hand and your machines get clogged up with honey. That's what happens if you're permanently perfused with glucose. Okay, glucose, sugar, sugar syrup, syrup, glycation. We did do a thing when we were talking about Shanahan. We were all obsessed, and we still are, to be honest, about Shanahan, Catherine Shanahan, her book Deep Nutrition. And she talks about glycation. And essentially, very simply speaking, these glucose molecules go in and they just they just glue up, they gum up your protein and increase rate of aging. This is what happens. I remember Bren getting very excited about glycation and advanced glycation end products. Basically, the sugar buggers up your protein and you age more rapidly than you would otherwise if you didn't have loads of sugar going around. So that's why we don't like having sugar. It's the same with cats and the same with dogs. The body doesn't like loads of sugar because the body is not designed to use loads and loads of sugar on a regular basis. And the problem with diabetes— and we're talking about diabetes mellitus. Mellitus means honey, as in, as in honey and honeybees. Apis mellifica. Yes, good.

I knew there was a—

I was thinking about honeymoon. And mead, mead and honey. And I couldn't get it all together in my brain at the same moment. So we're talking— so diabetes insipidus is where you pee like mad and you drink like mad. That is water diabetes. And that's a completely different system to sugar diabetes. We're going to be talking about type 1 and type 2 diabetes. And very simply speaking, type 1 diabetes in humans is usually young people children. And this is where your pancreas just doesn't produce enough insulin. Insulin is there in order to pack away glucose and proteins into your tissues so that you've got good glucose metabolism and you haven't got all this sticky glucose running around in your blood the whole time. Diabetes type 2 in humans is where You produce some glucose and you overproduce it day after day after day because you're eating a Western diet. And so you're just pushing screaming insulin into the system. And after a while, your muscles just say, enough already. I've heard what you said about insulin. I'm getting sick of you screaming at me and I'm just going to switch off and I'm not going to respond to insulin. Which— and what happens is the pancreas goes, The muscles aren't listening to me. I'm going to produce even more insulin. And so you get more and more and more insulin, and it's less and less effective at packing away your glucose into your muscles. So you get loads of insulin, you get loads of glucose, and that is diabetes mellitus. The book to read— I'm going to give you a reference— the book to read is by Benjamin Bikman. Ben Bikman, you can see him on Instagram, does loads of Instagram stuff, loads of YouTube stuff and what have you. And it's called Why We Get Sick. and it is a wonderful description of why we get sick, because basically insulin in excess really, really, really damages your cell. It's a growth hormone and so causes problems linked with cancer and all sorts. And lots of glucose is really bad. So diabetes is, is to be avoided at all costs. And this is why we love the raw food diet, because it's a low calorie, low carb diet, low grain carb diet, and therefore you innately have much lower insulin and more balanced glucose. Okay, there you go. That's a little, a little roundup. 19:16, and that's me for a bit.

Sounds good.

Did you get that?

You are a bright boy, but yeah, I've got my head around the two different types of diabetes. I sure have. I'm not quite sure if Bren wanted to elaborate on that because I think that's kind of clear enough as it is. I like, you know, straight out of the traps, you know, I see there's two different types of diabetes. And while the— I totally agree that surely, surely this is related to the Western diet. Diabetes is exploding in the populations that eat high carbohydrate diets. And moreover, you can reverse type 2 diabetes by cutting out those high carbohydrates, not just sugar, really. When Nick says sugar, he means like pasta essentially is sugar, rice essentially is sugar. It's not just the white granulated stuff you put in your coffee. It's gone beyond that. It's any ultra-processed white flour, that's sugar. It's just zapped into sugar in your blood straight away. Too much of that drives this issue. But here the flip is that they would say, first of all, there hasn't been a concrete link to sugar, the molecule yet, and diabetes. This is what I feel the dry food world stands behind. And I wanted Bren to kind of talk to us about cats and dogs, type 1 and type 2 diabetes. What's the story there? And then I'll come at you with my question, Nick, about sugar.

Cool.

Yeah. So it's really interesting, actually, because humans, we will talk a lot about type 2 diabetes just because of the obesity epidemic that we as humans are going through. We see that in our pets too, with all of the processed foods. And Nick sort of touched on why that might come about and actually all of the issues with insulin acting as a growth factor as well, which then sort of changes some of the fat cells to put more fat down. All sorts of interesting things there. But interestingly, cats— and we're going to talk more about this on the 17th of Feb with the Feline Friday. So cat followers, if you want to know more in depth, then we're going to talk about that with Dr. Amaya and Julianne with regards to cats specifically. But we are going to touch on them tonight just to say Cats, like humans, do tend to suffer more from type 2 diabetes, which is wonderful that, you know, they did actually produce a metabolic diet which was higher fat, low carb, you know, good, good level of protein, albeit a processed food, which actually did quite a marvelous thing of improving cats to a point where you often could take them off insulin and get them back. But we saw that with raw feeding cats. Anyway, and it just reiterated that that was the right way to go for those. And so certainly I would say for cats, you know, getting them ketogenic— and this is an important point, remind me to talk about the difference between ketosis and ketoacidosis, okay? That's a really important thing to understand about side effects. We must talk about what can happen in diabetes symptoms. But with cats, You can resolve them. And with humans, if you get them out of being obese, if you reduce their overdosing on sugar and therefore resensitize them to the insulin within their system, they can actually be brought back to normality without ongoing treatment. And now that may mean initially they get some insulin given to them, okay, just to get them through the rough times, but ultimately you get the weight off, you should be able to get cats off insulin and treat them appropriately. Okay, as with humans with type 2 diabetes, type 1 diabetes is literally down to either— or I was always taught autoimmune disease or genetic traits that are there. I think there's a lot to say about pancreatitis and inflammation in there. And I think that you've got a few more additions as to why they're thinking about that, and we'll come to that in a moment. But ultimately, it is wiping out the islets of Langerhans, the cells within the pancreas that produce insulin as a hormone. Okay. And ultimately meaning that they will have a, a lack of insulin in their system to be able to deal with the sugar. And if you've got too much sugar in the diet, in addition to a lack of insulin to deal with that, of course you're going to get rocketing levels of glucose and the consequences to having that. So in your list, I think you were talking about before we went live that we've got a few other things that are coming into the causes that leading to diabetes in dogs.

Yeah, absolutely. So this is a list, and I will try and post it onto Patreon. And this is a 2014 paper by Nelson and Rusch from the University of California and University of Zurich in Switzerland, and it's just Nice little resume of the difference between cats and dogs. And just to reiterate, Bren's given you a nice little rundown there. Cats tend to get diabetes like people. They get overweight and they get an insulin resistance. Yeah, more and more, the pancreas produces more and more and more insulin and the tissues just go, no, I'm not listening. Okay, whereas dogs, and we don't really know why, tend to do the, the type 1 type diabetes, which is the pancreas just produces less and less and less insulin, and, and, and thus you get this problem with a lot of glucose in the blood. Both models, the problem is too much glucose in the, in the blood, and this is why it's called diabetes mellitus, because in the old days, the way they used to diagnose it You know, you'd have these people in front of you and they'd just be wasting away. And the way that the old doctors used to diagnose it would be they would taste the urine from the client, from the patient, human patient, and they would say, this urine, which normally, I don't know, tastes kind of uriney and kind of slightly salty and what have you, and they would taste it and go, bloody hell, this is sweet. So that's why it was called honey diabetes. Yeah, you waste away and you've got sugar in your urine. Anyway, so just going back to this list, so I'm going to look at dogs. We can compare cats because I think cats is quite easy because the two lists are almost opposite. So for dogs, I'll give you the first four: genetics, immune-mediated insulinitis, which is where the body attacks the beta cells, which the beta cells produce the insulin, Then we've got number 3 is pancreatitis, and number 4 is obesity. So obesity plays into diabetes in dogs, and yet we, in dogs, we get type 1 diabetes, okay? Whereas in humans, when they put on excessive weight, they get type 2 diabetes. I'd really like to talk about that because that's interesting. In the article here, they do mention that there is an autoimmune response because most dogs don't get diabetes type 1 in dogs until about 8 years of age. Okay, and that's why you've had time to have really, you know, poor metabolic function. And I think that increased triglycerides in the presence of high grain carb And Conor, I'm sure you've got something to say about that, because we've been increasing the amount of grain carbohydrates in kibbles and things like this over the last 30, 50 years, and thus we've got increased triglycerides. Therefore we get more stress. And for me, this is my personal theory, we get more stress on the pancreas, and thus the pancreas is more inflamed and thus is more likely to have autoimmune effects. Now, I'm sure the specialists will go absolutely nuts when I say that, but it kind of rings true for me. So top 4 for dog is genetics, immune-mediated insulinitis. Yeah, so this is autoimmune disease, pancreatitis, which we know is very common and is related to high triglycerides and obesity. Whereas with cats, we've got islet amyloidosis, so deposition of fatty proteinaceous material in the pancreas. We then got obesity, okay, obesity and pancreatitis. Diabetes is big with humans, and then we've got pancreatitis. So it's number 3 in both of the— both the cat and the dog, which is interesting. And then we've got hormonal disease, which includes hyperthyroidism in cats, dogs hypo— hypo— oh no, it actually says hyperthyroidism. I think that's a typo. Yeah, very rarely get hyper. I think that's a typo. I've only just seen it. We'll call it hypothyroidism. Thyroidism, because Jean Dodds, in her book The Canine Thyroid Epidemic, she does mention that if you've got thyroid disease, that can predispose to diabetes and all sorts of metabolic disease. And Conor, you were saying that you've got—

yeah, yeah, like, you know, I think there's a— I don't, I don't trust a lot of the information out there on diabetes for very good good reason, because, you know, there is a very big effort made in the world today to keep the idea that sugar or diet is the cause of diabetes and may possibly be the solution, because there's an enormous industry around diabetes, and that's just a fact, okay? It's an extremely profitable— lifelong drugs is what it's about for pharma. And so if there's a lifelong drug to be had, believe me, the solution to that illness, like diabetes 2, it's quite a quite a simple solution, but you can certainly help a lot more than the drugs do. So look, before I get into the darkness, here's some stats on the rate of increase in diabetes 1, which was, you know, up until recently, oh, it's just a genetic issue, it's an autoimmune disease. The prevalence of diabetes in dogs presented to veterinary teaching hospitals increased from 19 cases per 10,000 in 1970 to 64 cases per 10,000 by 1999. From 2006 to 2016, 2.5 million US dogs were surveyed and it revealed that canine diabetes increased by 80% in that time. So it doubled again from 2006 to 2016. So the rates are positively exploding. Cats actually far quicker than dogs, but there's a whole cacophony of reasons of why that it might be, and there's some really legitimate ones. Nick's gone through them all. But coming back to the diet and the carb thing, it's very interesting that if you go through the literature on a human literature, they say that there is no definite causal link between, you know, sugar. They always say sugar, not carbohydrates, and diabetes too. But like when you look at these associations that are making these statements and here comes a bit of the darkness. The US, for example, the US government were involved recently. They wanted to— there was an average, they said the Americans were eating 100 pounds, 100 pounds lb of sugar per year. And the US Department of Agriculture came in and tweaked the way they were analyzing how many pounds of sugar they're eating. They dropped it down to 80 pounds of sugar. This was covered by the New York Times by Dr. Michael Jacobson, executive director of the Center for Science. What they found was the New York Times dug further and revealed an email from Jack Rowney, the then director of economics and policy analysis at the American Sugar Alliance. It's a thing. Sounds like something run by Darth Vader, where he states, we perceive it to be in our interest to see as low a per capita sweetener consumption estimate possible. So if you were to be a little bit of a conspiracy theorist, you'd say, oh, they really are trying to hide the sugar consumption, and they just can't seem to find a causal link between sugar, high carbohydrate diets. But we know since 1970, diabetes has been exploding in the pet population, exactly when obesity took off. So they say that like sugar doesn't cause diabetes, there's no link. And it's like standing around and saying there's an increase in car crashes and someone saying cars don't cause car crashes. And you go, what? And they'll say, well, have you ever seen a car? It just, it just sits at the side of the road. It's not the car's fault that gets in the crash. It's what happened and who was driving the car. And you go, well, of course, you know, that, that's the case. But to say that sugar or carbohydrate, ultra-processed food is not behind this diabetes issue, certainly type 2, is, is absolutely ridiculous. It's been hidden from you the same way vitamin D was clearly something we should have been doing during the latest crisis. And now all this huge study that came out in the last few months said it would have saved thousands of lives, had this very approach being taken. It was hidden from us because it's a very simple, cost-free way of tackling it. And so it doesn't do, in my opinion, to have a diet solution. So when I see studies coming out on, you know, obesity being very low down— obesity is well up there. I mean, if you look at the Hills Prescription Diet for diabetes, have you looked at the ingredients in this Hills Prescription Diet? Bearing in mind, all the studies show the less carbohydrates you feed a cat and dog, the less carbohydrates you feed a cat and dog, the more protein, the better they do in terms of diabetes management. Okay, so we have those studies. And Hill's Prescription Diet food contains— listen, just listen to this spiel— specially formulated to help regulate the glucose supply. That's nice for a change. It can also support a reduction in body weight in obese cats.

Oh, hurrah!

After who caused it? Low energy food and this kind of stuff. So we say, what is in this magic formula that they're making? There's no available sugars in this food. So I think, okay, this sounds good, and they've added in L-carnitine. And you go to the ingredients. Do you know what the number one ingredient is in this high protein— 48% protein, in fairness, it's only about maybe 20% carbohydrates— 48% protein, which is a luxurious amount of protein compared to the usual crap they churn out. And what's the number one ingredient? Maize gluten meal. Maize gluten meal. Is an indigestible protein source. You can't— you get— it's completely not available to the dog. The bioavailability of corn gluten is the stuff that comes out in your poo that, you know, you can't digest. So they put this in there. Why do they make that the number one ingredient? Because they suddenly have to make a high protein diet, and God forbid they should give these meat eaters more meat in their diet that they could digest. They give them shit that they can't digest. So now a large portion of the protein in that food is not available to your dog since Croxdale et al. in 2016 showed that a lot of, like 30% of the protein in puppy foods isn't available to the puppies and they're already at the minimum intake, so that drops them below the minimum. This is dire, but I suppose in a way you want your animal to lose weight, that's one way to do it, if 20% of it is tissue, you know. So this Hill's Prescription Diet for, which 48% protein, number 1 corn gluten meal, the second ingredient is chicken and turkey meal, 30% chicken and turkey meal. And bioavailability of protein, how easy it is to digest, is really important in diabetes 'cause you know what's digesting all this crap that they're trying to consume? The pancreas. And the pancreas is already struggling. So the dream would be the pancreas has a nice, easy-to-digest meal. And the last thing is it calls into question ultra-processed food, overcooking these foods, or even cooked foods at all 'cause it annihilates the enzymes in the food and the pancreas is struggling. So you're trying to help it, give it nice meals and nice meals do not begin with corn gluten meal number 1 and chicken and turkey meal number 2. But it does show that they're at least reading the literature and saying high carbohydrate diets are the problem here, and the solution is clearly backing away from carbohydrates as they did. So little rant out of the way, and I just— a lot of bullshit out there, um, I think, when it comes to this issue. Breathe, Conor, I see you.

Right, yeah, yeah, definitely. So I'm just going to say again, A really good resume of this is the Ben Bikman Why We Get Sick. It's all about human insulin and diabetes and all that.

We'll post that book afterwards.

Yeah, yeah, yeah. It's a biggie. Yeah, it's a real biggie and it's a delight to read. The other one is The Case Against Sugar by Gary Taubes, which is kind of— it's like the Bible. That's a really, you know, if you've got a big long journey or a holiday or something, that's the one you want to get into. It's really nice.

As long as you're not driving.

Uh, no, no, no, no, no, no, he tells a great story. He's— no, he's all right. Is Gary— I will hear no bad said of Gary Taubes. He's coming out with a new book soon, apparently.

Oh yes, yes, we've got some great stuff to keep going after this on Patreon, so do join us on patreon.com/rawpetmedics if you want to know a little bit more about and hear some Conor rants because I see a massive raft of people wanting to go, Conor. So, but we need to touch because so many people are asking symptoms and why people, why they get cataracts. So we really should touch on some of the general symptoms out there. The main one, and hence the picture for tonight, which was dog drinking, is just an insatiable thirst and a massive drive therefore to produce urine as the sugar sucks the fluid out of the body in the urine. So that's going to be your number one. You've got a really thirsty dog, you know, you've got loads of urine being produced, and as Nick says, then dip your finger in and taste it. And if it's— no, I was joking, don't do that.

How many wees do they have to taste before they taste the sugary one? Do they have to do like 5 and I'll go normal wee. That's normal wee. Taste that one. Oh yeah, that's it. And then—

Oh, I've spurted already.

First story when we go to Patreon, I've got a really lovely medical stools, school story about stools.

No, no, we're not going that end as well.

Remind me, first one when we get to Patreon, I've got a really nice little story.

Okay, so symptoms, uh, so that's the first one. Lots of thirst, Now it has to be differentiated from kidney disease, Cushing's, thyroid even. I've seen dogs that get PUPD, liver disease. There's so many other things, you know, getting a, you know, for females pyometra. So any purulent endotoxic disease that can cause problems. So please, lots of differentiation. So don't just assume that it's diabetes, if it's drinking loads and urinating loads, see your vet. Okay.

And it is all day, Pam. It's an all day. They just can't help themselves. Yeah.

So I mean, even actually, we had one in the other day. Somebody came in, my dog is drinking loads, urinating loads. What was it? It was on a high salty processed diet. Okay. It's just that they hadn't realized how much salt was in that that particular— I couldn't believe the amount of salt that was in that diet. But anyway, that's another matter. So that's the first thing. So the easiest thing to do, it's probably the cheapest thing to do, is to collect some urine, take it into your vet's if you haven't got strips of your own, dip test it and check if there's lots of glucose. That pretty much should line you up with, okay, we've got to start investigating why this dog or cat has loads of glucose in the urine, probably diabetes mellitus. Okay, and that's probably the simplest thing to look at. Now be warned, if you take blood off a stressed cat, then its glucose will probably be through the roof just because of stress releasing— causes the body to release glucose ready for utilization. It is not necessarily going to be diabetic. If the urine is negative, that is not a diabetic cat, it's a stressed cat. And I have seen also if dogs are fed and have bloods taken, again, especially if it's a processed diet, you will see glucose raised within that dog's blood. It is not because they're diabetic, it is probably because they've just been fed If their urine is still negative, okay, for glucose, then it is not diabetic.

How long should they fast for?

Sorry?

How long should they fast for?

So 8 to 12 hours. I think the easiest thing is do an overnight fast, test them in the morning. Okay, so, you know, if they've eaten their tea at 8 o'clock the night before, they're going into the vets for a test in the morning, that's going to be just after 8 o'clock. You know, they're not really going to be pestering you too much through the night for food, so that's the easiest time to fast them. It also means that you're unifying when you take bloods on the animal to being in the morning, and therefore they are comparable every time you look at them. Whereas if you start testing at all times of day, then all sorts of things change, such as when their natural body steroids are released, you know, their normal processes. And if you add the complexity of feeding them into that, then it can absolutely turn blood upside down as far as what's going on. People have come to me saying, my dog's liver and kidneys are failing, and, you know, its steroids was through the roof, it must have Cushing's, you know. And you look at that and you just say, well, was it starved? No, I was never told to starve it. Yeah. And it's like, you know, well, there's all sorts of stuff going on there, you know, stress levels, let alone all of the organs all over the case, because they're just trying to help deal with the food that you've fed. So don't get mixed up with that.

If you have the case, guys, if you are looking at a diagnosis of diabetes in your cat, say start off, Brendon, give us 2 minutes on what you would do with diabetes in your cat, and then Nick can do diabetes in your dog, and then I've got a tip.

Okay, well, I will go very quickly on that. There is some other symptoms we need to talk about. Because we will need to talk about cataracts and stuff. So you understand if you've got high glucose in your bloodstream for a long period of time, that glucose will leach out into any other body fluids, and you may find that it will build up in the eye. If it leaches into the lens of the eye, that draws fluid into it, into a relatively dehydrated protein structure that makes it clear. And as soon as you swell it with fluid, it will start to damage the cells within the lens. That can lead then on to cataracts, but just swelling it will mean that the light is refracted through the lens rather than actually passing through to the retina. So they look quite blue quite quickly, and then further damage will mean that they start to scar and you'll actually get true cataracts.

Okay, but if your dog has cataracts, doesn't necessarily mean that they've got diabetes, and a simple urine test can rule them in, rule them out. Yeah, just as a simple thing.

Okay, so back to cats. So for cats, if they're urinating urine— now, one thing for cats as well is that you will probably also be monitoring and checking with something called fructosamine. This is protein-bound glucose, okay, within the bloodstream, and it doesn't vary as sharply as the glucose, the pure glucose level. So sometimes we have to look at fructosamine levels to check if they are balanced, okay, rather than looking at glucose levels in that case. So if they've got urine and glucose in the urine, they've got symptoms, if they're overweight, then we'll be strongly suspicious of them having type 2 diabetes. If they've got no history of chronic pancreatitis or other inflammatory processes, IBD-like symptoms, so inflammatory bowel disease symptoms, then, you know, those would be occasions when we'd think type 2. If they've got those inflammatory conditions, we'd think possibly type 1. But we generally will try and stabilise them as quickly as possible because if we don't, they are at risk of the liver suddenly utilizing all of the fats to generate ketones, and that becomes quite acidotic. So it increases the acid levels within the blood, and that can damage the tissues and cause all sorts of problems, from seizures all the way through to, you know, massive vomiting, diarrhea, dehydration. You know, they can be in a really sorry way if they get to that point. So we do need to try and stabilize them quite quickly. And this is a time to sometimes have to embrace using insulin at that point whilst we then can come in with dietary change, you know, improving the diet that we want to touch on before we get too much further in and, you know, reducing any inflammation and being able to monitor carefully what's happening with their glucose so that we can start to reduce their insulin as they no longer need it. Okay, so that's a tapering down that level of insulin. You can these days, which you couldn't when I qualified, start looking at their actual blood insulin levels. So you can start to look at what they're like. So if they're sky high and they've got sky high glucose, okay, and fructosamine, then you look at— that's another way of telling that they are probably insulin resistant, i.e., got type 2 diabetes. That's my brief. Nick, go for dogs.

Okay, I'm going to do even briefer on dogs. If you've got a dog and they're drinking like mad and they're peeing like mad and they might or might not be overweight, then I think get to the vet, take a urine sample. If it's warm, even better, fresh urine samples because they will degrade pretty rapidly. And just say to them, you know, please can you 'Can you have a look at the dog?' And please, can you test the urine? Okay, so if in doubt, just take a urine sample. What's there to lose? Make sure that the jam jar is really, really, really, really clean, because if you've got a little bit of jam left in jam jar, you will suddenly have given your dog diabetes because there will be sugar in the urine from the jam. Just a little word to the wise. Okay, so I think really it's as simple as that. If the dog is drinking like mad and peeing like mad and there is any suspicion, I think get along to the vet. They will, with a urine sample, they will take a blood to confirm or refute the idea that there may be diabetes, and they will begin a treatment with insulin. Because remember, in dogs, it's usually type 1 pancreatitis, which is that your pancreas is giving up the ghost from giving, from producing insulin. And so you just have to supplement that insulin. In, it's much more difficult to treat using diet, using lots of other things than cats. There's a lovely vet, there was a lovely vet, he's now retired, still going, Tom, if you're watching, then hello to you, Tom Farrington in Ireland, and he said he had no cats in his practice with diabetes because he just managed weight, put them on a raw food diet, and they all got better. That was his quote. But with dogs, it's more tricky, so I would suggest do see your local vet, and get a diagnosis and then do see a local raw food vet in order to optimize diet. You know, everybody can benefit from having the best diet possible, and as far as we're concerned, that is a raw food diet with zero grains in it, with, with a moderate amount of green and proper fresh, highly nutritious vegetable material, and that's the basis of it. That would be my very, very simple summary. Any final thoughts?

Yeah, the difference between like 1 and 2 in cats, you know, a nutritional role is really important to focus on. And so your higher fat diets, your moderate protein, and you're getting rid of your carbs, because if you're in ketosis, even protein can can be a bit of an issue. So the higher fat diets are very well tolerated. They're just easy to manage. Any vet can give you a bit of simple advice on that. With dogs, it's not like you're going to have this complete turnaround by getting the diet spot on, because as Nick said, the actual cells are inaccurate and they're not going to come back just because we feed spot on. It's not a reason to aggravate it. But there's another thing you can add into these diets now is pancreas. Pancreas, it's not just insulin. You won't get any insulin by feeding pancreas. Insulin is protein-based, so the dog's dogs expect to digest a lot of it, not a lot of it is expected to hit the intestines. But you can feed small amounts of pancreas to a dog, say 2% of the diet, particularly for the fact that it contains digestive enzymes. If you've got a pancreas that's kind of knackered and struggling, feeding the pancreas, it's not just digestive enzymes. I highlighted this paragraph from this awesome book that I wrote there. I'm not sure if anybody saw that. But so listen to this, the pancreas also, it's not just insulin that this organ contains, the pancreas also produces glucagon, which assists in blood glucose levels, amylin, which controls how fast the gut empties and ultimately the food intake, as well as pancreatic and vasoactive polypeptides, which function in various gut contractions. Anyway, on and on. Notably, some, notably the protein-based one, but many do make it through, including all the steroids. So these are the protein-based kind of hormones that get through. But most importantly is the enzymes present in the organ. So when you have a pancreas that's struggling, you may need to add digestive of enzymes. It's, it's, it's, it's, it's just to help with the digestion of the food. This is an insulin thing we're talking about.

Absolutely.

But feeding pancreas, the point is it comes at you with 5 or 6 different offerings. So why wouldn't you put this organ in? Finding it fresh and raw is hard. Buy it dry and you can add it into the food like salt or pepper.

So we're going to talk more on Patreon about this. But something really useful for the guys out there is to know that for humans looking at that, adipokines, which is things like adiponectin, which is one of the peptides. Taking these orally are becoming a new way of trying to help those humans with diabetes. Okay, so now we know for dogs it's not quite as simple as that. There's some things going on that means they're not necessarily reflected of that, but they have anti-inflammatory properties 2. And so all of those peptides can be really, really useful, Conor. So some of those pancreas items that you've just talked about there may well be feeding into a natural way of accessing those peptides rather than necessarily having to artificially—

that's interesting.

Yeah, so that's brilliant. So we're going to talk more about that. Last but not least, somebody asked about why raw food feeding could still help up the diabetic patient. Okay. And they talk about increasing fiber for the conventional processed foods, and it's full of undigestible stuff that delays absorption of sugars. I do use raw personally for that because it reduces the sugar load, it spreads things out, it allows them access to energy through their fat metabolism. Yes, using— if we add any fiber at all, then I would tend to look at things like butternut squash or something like that as a long-chain fiber. But I think just making it more of a fiber source, you still need some insulin within the system for other purposes. It's another— it has loads of other hormonal activities, including growth factors, etc., for maintaining muscle mass. You need some degree of glucose to create the glycogen stores because otherwise you'll get a really tired dog. But I think the majority can be dealt with by moving them to a low inflammatory diet by being raw and fresh.

Awesome.

I've got an announcement just at the end. The lovely Penny said that she is once again— which she did, she came on, uh, with us when August-ish last year, um, and she is, uh, petandparentlongevity.com, and they are doing another Pet and Parent Longevity Summit, and it's— and it started I think yesterday, and it's going on. So pet petandparentlongevity.com.

The people in that are— it's all free to view, so, uh, it's, um, it's— you shouldn't miss it.

And it's free. And Rita Hogan is there, Odette Souter is there, Julianne Lee from Adored Beast is there, and my amazing osteopath called, uh, Tony Nevin is there. He's a guy to talk to, he's got some stories. And, and so that's really going to be good. So that's for you, Penny. Great stuff. Okay guys, are we going to jump over to the thing we call Patreon?

I have some, I have some darkness from the diabetes associations in the UK, in the US.

I can't wait to share it with you. Good.

Juicy.

Well, we hope you've enjoyed tonight. Look, next week, uh, we have some more on emotion and interaction with our dogs because it's gonna be the wonderful Valentine's evening. I hope that we're not going to be distracting you away from your loved ones. But do come and join us. We're their loved ones. Yeah, I love it, Conor. And for the week after that, we've got Caroline.

Yes, England on 21st.

It's going to come and join us.

ZooPharmacognosy.

Yes, indeed. Perfect.

Remember, if you want to know more about cats on the 17th, that's a Feline Friday. We're going to also deal with diabetes a bit more detail, for cats. So please, if you're interested in cats, join us. Also, we're going to be part of the Give Cats a Voice conference on the Saturday the 25th and 26th. So I'm on the 26th, I think, with Amaya. So do have a look at that. And we've also got the Dog Training College. Cool, we've got a busy February. Yeah, we're packing it in this month.

My fresh material already. Absolutely.

If you want to find us at one of those conferences or occasions, please come join us. Otherwise, look forward to seeing you next week. The Patreon lovers, please come and join us when we release this in about an hour or so. Perfect. Take care, guys.

Adios, guys. Thank you. Too soon.