As an internist in human medicine, I have to admit, I have always felt a bit condescending towards veterinarians treating my dogs for various medical problems. It is not that I thought that vets were less intelligent than MDs, it is that I felt it would be hard for a person who treats many different species to be thoroughly competent in each one. However, at this veterinary facility, Dr Leiman has treated my Cushingoid diabetic bichone with the skill of a medical internist at a human hospital. This has been a complicated case from the initial diagnosis of diabetes in 2007.
At that time, the condition was compounded by a urinary tract infection, a pyelonephritis, that made my dog need higher levels of insulin than would be expected. Although the urinalysis and urine culture were negative for an infection, Dr Leiman still suspected a problem based on the urine pH and mild changes in the differential on her CBC. A sonogram showed some fluid in the kidney suggestive of an infection, an antibiotic was prescribed for 4 weeks, and her insulin requirement went down by 50 percent. About 6 months ago her diabetes became hard to control again. After ruling out an infection in a similar manner to 2007, Dr Leiman suggested that the changes in her liver enzymes suggested Cushing's disease. Although the sonogram did not show adrenal enlargement, a dexamethasone suppression test confirmed that she did, indeed, have the condition. She was placed on a low dose of a drug called Trilostane, and it has helped her tremendously, not only in the diabetic control, but in her whole attitude. She seems less tired, and the panting she had been doing every night has completely subsided. Basically, my dog has been treated as well as any person would be in this difficult case. The care has gone beyond simple diagnostics and drugs. Home made diets have been a big part of the care. I know there are prescription diets for diabetics, but Dr Leiman and his wife, Dr Eisner, thought a proper home made diet would work better and be more enjoyable for my dog to eat. This was a wonderful recommendation. There is more to say, including the quick response to my phone calls, the professional respect that I have been given by the doctors and staff, as well as the obvious kindness they show to my dog. My experience at this facility has been truly wonderful.