I dreaded this day would come from 2008

Cashew crossed the rainbow bridge on August 15th, 2024.

2008 - when we started living together

I still remember my brother "tricked me" into taking Cashew for the weekend to see if I wanted to keep her.  I didn't want to commit to taking care of a dog.  We entered my apartment.  I sat on my big couch to play video games as usual.  She hopped up and sat next to me.  My heart melted.  That's all it took for me to decide to keep her forever.

I don't regret the 16 years we've spent together.  You made me laugh almost everyday.

2023 - one of our great walks

As I write this, I realized even after almost 2 years, I'm still heart broken.

Anytime something good happens around me, I imagine it's you helping me out Cashew😂

Thank you buddy.  Hope you are having a good time up there.

Cashew is doing well after 3 years from Insulinoma Surgery!

 I can't believe it's almost 3.5 years since Cashew's insulinoma surgery!  She's now almost 16 and she's doing well!

Her vision has good days and bad days, but she can smell when someone comes in the front entry from anywhere in the house.

She still starts hopping and skipping around the house when "walk" is mentioned.

Her schedule is pretty set everyday.

Cashew still wants to join the dinner table everyday with grandpa and grandma.  Grandpa hooks it up with human food so she likes to sit between them.

Cashew is doing fine!

 

So the random panting at night was due to pain.  We stopped playing fetch and she's now doing fine.

She still wants to play fetch, but she forgets how old she is and runs full speed only to be in pain later.

I'm forced to go for walks after dinner.

Always makes me laugh when I ask her "walk?" and she gets all excited.  Happy feet.

How could someone be so beautiful and cute and funny at the same time.  I can't stand her.  My parents just laugh just because she's sleeping in the middle of the hallway.

Cashew unable to sleep at night

Cashew for two nights have been panting heavily in the middle of the night

• Unable to sleep for ~4 hours in the middle of the night
• Panting
• Wondering around aimlessly
• Keeps scratching me to do something about it.  The last time she did this was when she got a bee sting
• Generally, vision has been getting worse but this is expected for a diabetic dog
• BG levels are perfect!  100 - 250 so it's not diabetes.

Visited Adobe Hospital and met with Dr. Cristi Blackwolf and she really had good news!

• Staring off is probably due to her not being able to see well anymore.  
• Not a heart issue - listened to heart.  weight is the same.  still eats, etc.
• High blood pressure wouldn't say much since perfectly normal dogs can have high BP and vice versa.
• Not a liver issue
• Probably either anxiety or body hurts at night
• Gave me pain medication
• Gave me supplement suggestions IF it's anxiety
• Not neurological because she knows where she is and she knows who I am

So I have been thinking of what I have done differently when she suffered.

• This happened 6 hours after a meal.  That's usually the time when I play fetch with her.  So I'm going to cut down on ball time.
• Probably not her food, but switching back to Nulo Raw Freeze Dried Meat.

Does not like the hospital...

My favorite shoes and shoes notes in general

I've struggled to find the right shoe until my mid 30s.

It turns out I just had 4E wide feet.  Combined with New Balance, my feet have been really happy.

993 blue - bought wrong size

928 (white/white) - my favorite!  They look beautiful and super most comfortable

928 (white/leather white) - wow, these are just great.  They are like $150+, but this is it.

Big downside is that these get dirty very easily.  One step on dirt and the white mesh is toast.  But these are so comfortable.

813 - Bought on Mercari (perfect)

812 - for some reason i don't remember these

623 v3 - a little pointy on front, squeaky bottom, feels a tad bit tight in the toe area

608 v5 - feels a little tight in the toe area

587 - wrong size

574 v1 - bought wrong size

Cataracts.. To have surgery or not...

It's been 28 months since Cashew's insulinoma surgery.  She is now 14 going on 15!

We are getting old buddy!

Cashew has diabetes and unfortunately one of the side effect is building cataracts (to go blind)

It's sad that Cashew still wants to play fetch, but she is unable to see like before.  She can still see, just not well.  She can't see fast ball movements.  Gee, I remember when she could see a tennis ball sitting in a field very far away.

She still eats dinner with us.

Still barks at me to go out.  Quite loud these days.

I've learned to make big hand gestures to tell her to come over.  She does every time!

I try to make big swinging movements and throw the ball near her so she can still fetch. 

Now.  She's almost 15.  Should I have her go through another surgery for her eyes?

She gets insulin injections twice daily.  Do I want to make her go through eye drops too?

We go on very slow walks fine.

I certainly want her to see well again...

Cashew is doing great! It's now 2+ years since her insulinoma surgery

Everyday is a blessing.  We were told 1.5 years on average to live after the insulinoma surgery and now it's been 2 years!  

Cashew gets to use my bed until I go to sleep.  When I go to bed, she gets up and goes to her bed. Very considerate creature.

Sometimes, I let her sleep on my bed and I sleep on her small bed, but she gets up and stares at me like I'm doing something wrong.

I have been tracking Cashew's blood glucose here and there to make sure her numbers are under 400mg when her insulins at the weakest levels and the times of her insulin.

My niece came over during the holidays and she played UNO with Cashew.  She said "When I grow up, I hope I can have a dog like Cashew" 😭 and my dad told me to just give her Cashew now. 😂

Cashew and I also got our 15 seconds of small fame thanks to my brother.

So we took this photo with cashew and my nephew / niece before they left for the holidays.

My brother was giving a talk and at one part talked about how Cashew was told she didn't have much longer to live, but survived cancer and living fine with diabetes 2 years later and the crowd cheered

Good job Cashew! 😁

👏👏👏   🐕?

Finding the right vetsulin dosage and schedule that works

Couple of things since last post.

• Her blood glucose are highest before breakfast and before dinner so measure those two.  Currently, Dr. Jennifer Koga and I negotiated to 4u vetsulin in the morning and 5u before dinner
• Cashew is doing well at 203mg in the morning and 247 at night.

• Cashew wants to eat breakfast when she wakes up (can be anytime from 9am to 11:30am). and she wants to eat dinner with the hoomans (6pm-7pm).  Otherwise, we are stuck with her begging every 5 minutes.  So, I'm hoping this schedule/dosage works for her

1. Wake up and eat breakfast
2. 4u vetsulin
3. 8 hours later, eat dinner (eat carrots and veggies for fillers)
4. 5u vetsulin
5. 16 hours of walk / sleep time

• Family has been very supportive.  Dad boiling carrots for Cashew and mom making sure he's not giving too much. 👴👵🐕 

Figuring out how to keep Cashew's Blood Glucose between 100-250mg/dl

The goal is to keep Cashew's blood glucose between 100-250mg/dl

This was the result of today.

Current dosage - Vetsulin U-40 - 6 units twice a day

Previous Night 8pm - Fed Her - Vetsulin 6 units

9:30am - BG 154mg - Woke her up.   - Fed Her - Vetsulin 6 units

12:30pm - Gave her some small carrot pieces

4:00pm - BG 98mg

6:30pm - Gave her some small carrot pieces

7:30pm - BG 265mg - Fed Her - Vetsulin 6 units

Cashew has pancreatitis / diabetes

Cashew is now Diabetic

It's been a good ~20 months after Cashew's Insulinoma Surgery and she has been living normally until this week! Cashew has been drinking a lot of water and she wet her bed (first time in over 10 years?)!

I decided to check her blood glucose and it was at 350-400mg/dl! Took her to the doctor and she is diagnosed with diabetes.

All About Canine Diabetes <- sent to me by Dr. Koga

What does this mean?

• Cashew needs to take insulin after her meal every 12 hours to control her BGs. Goal is to keep it between 100-200mg/dl. Starting Vetsulin at 6 units on a U-40ml syringe.
• Spot check Cashew's blood glucose to see if this is the right amount for her
• Watch out for signs of hypoglycemia (when BG is too low)
• Watch out for lethargy, inappetence, vomiting - ketoacidosis
• Cataracts develop in 100% of dogs with diabetes so be ready for it :(

Notes on Blood Test

Since her precision pSL was at 150, looks like pancreatitis?

Before having Cashew's insulinoma surgery, I was told pancreatitis was a risk, but just didn't know it can come 20 months later.

Notes from Dr. Koga over at Adobe Animal Hospital

1) Mild elevation in alkaline phosphatase,: This is an enzyme that is associated with several things (liver, excess corticosteroid, bones, amongst others). This is considered a mild elevation, and I suggest this just be monitored (i.e. check again in 6 months).

2) blood glucose=396, consistent with Diabetes

3) elevation in precision pSL: this is associated with the pancreas. I actually do not like this test at all, because it can be elevated in dogs without pancreatic disease. If she were vomiting or having other GI signs then I would consider this significant.

4) urinalysis: elevated glucose, consistent with Diabetes. There was trace ketones in the urine, which is indicative of a dog who is utilizing fat to get energy to the cells, since the glucose wasn't being transported by insulin into the cells. When ketones rise dogs can start to act very sick.

So, there is nothing on the blood test to indicate there is an underlying disease that could make her insulin resistant.

 

And her Blood Test Result.

Cashew has diabetes now?!

It's been 20 months since Cashew's insulinoma surgery so it's awesome!

However, Cashew has been drinking a lot of water (maybe even more than me!) and peeing a lot!  I mean, her pee sounds like a water hose.

Something seemed off so I Googled what it can be.  Of course, the usual all sorts of cancer/disease or... diabetes.

So, I gave Cashew a night to sleep it off and checked in the morning with her enemy, Alphatrak 2 and OH NO, her Blood Glucose is 412mg/dl!

Relatively good news is that, if it's diabetes, it can be controlled with insulin.  It sucks, but I'm a bit relieved.

Sent a message over to Cashew's vet at Adobe Animal Hospital to see what are the next steps.

Don't worry buddy!  You will feel normal again soon!

Other than that, she's doing alright.  Walks and ball playing are getting shorter, but we still fight for bed space, she still tries to get out of my hugs, eats at the dinner table, loves my magic tricks, she's living fine.

1.5 Years After Dog's Insulinoma Surgery

I apologize for not updating on my Cashew cutie pie baby for a while.

Knock on wood, but Cashew is doing just fine.

I haven't checked her BGs for the last 6 months, but she does go to the doctor here and there to get an examination.

Cashew is about to reach the age of 14!

For every month from now, is a bonus time we get to spend with her since the insulinoma documentation said the average length of a dog's life after insulinoma surgery is 18 months.

It's now 18 months.

She is having the usual old people symptoms like arthritis and her hearing isn't as good anymore, but it's ok buddy baby, I'll be there soon too!

She still makes me laugh everyday

We still fight over bed space

She still snores every night

She still gets angry at me if I don't take her out.

Every single day we play catch or I show her magic tricks

Once a week, I lie down at the park until SHE wants to go home.

8 Months Since Insulinoma Surgery for Dogs

Every month when I see Cashew looking a little sad or less energetic than usual, I start to worry.

September 1st, I sucked it up and tested her blood glucose level before breakfast.

Still in a good range!!!

This is her looking a little upset that I poked her.

Sorry bu bu.

 

You are doing great buddy! 

I love you so much, it breaks me as the month goes by and to know the cancer will come back.

I smell her paws everyday.

Oh! Normally, I sleep next to her and when she farts, it makes like this air sound because she doesn't have the butt cheeks to give it that bass sound.  Usually I just look away until the smell fades.

Well Today!  she was sleeping next to me and I farted.  She actually looked back at me then got up and left.  😂

Cashew Updates!

It's been 6 months since Cashew's Insulinoma surgery and her blood glucose has been great!

This is Cashew waiting for my sister to arrive at the Caltrain station

Doctor recommended Omega-3 to help with her arthritis.

I read about all the benefits and had to get a bottle myself.

So we are both in this together.

This is her watching me plant strawberries.

Probably fun for her to see me doing something other than staring at a computer screen .

5.5 Months After Insulinoma Surgery

I'm thankful everyday.

She makes me laugh everyday and she doesn't have to do much to do that.  

Just snoring or fighting for bed space with me with her small body just makes me laugh.

Knock on wood, BG is normal, but I can see her getting older.

She still loves ball time.  My gosh she loves it, she stays out in the backyard long as she can.

I was watching over some older videos and saw that Cashew was totally normal last October 20th.  By January, she was having grand mal seizures.

I have to keep in mind that this will come back and when it does, it'll be very sudden.

It's been over 4 months after insulinoma surgery

How is Cashew?!

It's been over 4 months and it's been getting hot.  We're talking 90+ degrees.

Cashew has been great!

Walks - I let her choose the path and how long she wants to go and it's always around a hour.  Now that I think about it, it's quite amazing she chooses left / right just perfectly so we end up home in about a hour every time.

Fetch - Still demands it in the afternoon and looking like joker waiting for the ball to be thrown.

I really can't believe we've been given this time back.  Just 5-6 months ago, things were deteriorating so fast, I was almost about to give up on her 😭 Thank you so much to everyone at Sage and I'm thankful every time Cashew snores, eats, stretches, you name it. 🙏🏻 I know that it's not going to last, so I really bug her a lot.

This is her tired of me pointing my phone at her.

I show the pics I take of her, but she's not impressed.

Cashew has been looking tired the last few days (sleeping on the floor and panting through walks), but it must've just been the heat wave, becaaauuuuse....

I did the alpha trak blood glucose test today morning before her meal and the results are in!

BG 118!

Her BG is supposed to be between 75-120 so it's almost on the higher side, but this is normal with the heat.

According to Dr. Google, dehydration increases blood glucose levels.

What else is new?

Since the vet hospital told me to only come in for emergencies, I ordered Cytopoint (relatively new medication for allergies) online and gave it to her myself.

Now, Cashew isn't itchy anymore!

It was hailing outside today

It was hailing outside today and someone's bathroom is located outside (hint : not mine)

Love having this on the side

40 Days After Insulinoma Surgery

Cashew is doing well!

Blood glucose at the lowest levels (in the morning after she woke up) was at 92

She gets a little variety in her food now and she loves it.

Found this on Amazon and looks like it's made from a good recipe.

Everyday boiler plate routine

• wakes up
• eat breakfast
• goes out for a morning walk with dad
• self cleaning / take a nap
• lunch
• nap in the yard / ball time / continuously bugging anyone in the house to please come out to play
• dinner at dinner table.  Usually gets 2-3 different kinds of food now
• walk around the neighborhood + play fight with me.  If she has extra energy, she usually runs around the house by herself.
• sleep

This is a demo of what she does after her morning walk.

and the Video Version

Scent of a women

What is the smell of Cashew?

This is a solution to smell like her.

Everyday