Louie has passed...

[affenmom]

My 8 year old affenpinscher, Louie, stopped eating about 2 weeks ago after always being a pretty ravenous eater. So, after a few days, I took him to the vet who found him to be diabetic, as well as suffering from Cushing's. He also noticed that he was anemic too.... currently, Louie is in the hospital undergoing supportive care. I am devastated as this has all happened out of nowhere. He had some of the signs in hindsight (i.e... potbellied, drinking a lot, poor coat) but I wasn't educated on either problem so I never knew to take him in until he was way far gone. He has been in the hospital since Wednesday (4 days ago) and he is doing better medically: no ketones in his urine (they were a 4+ when he was admitted), glucose levels are holding steady and aren't spiking up and down (although still in the high 200's), blood transfusion brought his red blood cell count up for his anemia... but he is STILL not eating. When I go see him, he is shaking and scared and I really want to take him home. They are having to force-feed him with a syringe of baby food to get him nutrients and we are hoping this may spike his appetite again.

My question is this: Is it common to have no appetite with these problems? What is it coming from? Does any one have any experience or suggestions as to how to get him to eat? Have any of you had a dog with both of these diseases and do you think he will come around?

Also, have any of you had these problems coupled with anemia as well? I am so, so sad and will do anything to get him to come home to be with his family again.

[k9diabetes]

Re: Newly diagnosed diabetes, cushing's - hospitalized

I'm so sorry to hear that Louie is having so many problems... I know how scared and worried you are.

Cushing's disease usually causes a dog to be very very hungry. There are exceptions where a few dogs are not hungry when their cortisol levels are high (which is what Cushing's disease involves.

Not wanting to eat is extremely common in a dog with very high blood sugar.

And in any dog who is severely ill.

Have they said what kind of anemia Louie has?

Plus it's also pretty common for dogs not to like to eat in the hospital. If you add the stress of being in a strange place to feeling crummy, well... it's not a stretch for him just to refuse.

Will he eat for you there if you brought him food and sat with him and maybe hand fed it to him?

Our diabetic never cared for baby food and wouldn't eat it, unlike the dog we have now, who loves it.

So maybe different food. Maybe if you fed him. Maybe he just needs to come home - is that a possibility soon?

We have a handful of dogs here at the forum who have had Cushings and diabetes together. It is very difficult to diagnose Cushing's in an ill dog but I get the feeling from your post that Louie may be exhibiting actual visual symptoms of Cushing's disease.

We have a sister forum for Cushing's disease actually and several of the members there also read along her and post occasionally. www.k9cushings.com.

And I have known some dogs with anemia problems as well, though all three is not common.

I think the main thing will be to get Louie's anemia resolved and his blood sugar continuing to be in a better range so that he feels up to eating. And then getting him home undoubtedly would make a big big difference.

I would have a heart to heart talk with the doctors and get as much detail as you can...

What exactly is the cause of Louie's anemia?

Is it regenerative or nonregenerative?

What is the prognosis for his anemia?

Can he safely come home?

There are meds that help improve apetite - you might see if they can give him one of these.

Let us know what the doctors say.

Natalie

[Soaphie & Sydney's Mom]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Welcome! You have come to the right place. So many knowledgeable people.

I'm so sorry to hear what you are going through. Please know that we are all here to help and support you.

Tami & Soaphiedog

[ladysmom06]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Hi,

Welcome to you and Louie. I'm sorry to hear that he is having so many problems but you've come to the right place for help and support.

Have any of you had a dog with both of these diseases and do you think he will come around?

My little girl Lady had both diabetes and cushing's. Having both does make things a little more complicated but with an experienced vet and proper treatment both diseases can be controlled. We were able to get Lady's diabetes and cushing's under control. It took us a little while to get there but once we did she did really well. We lost Lady last March but not from the diabetes or cushing's.

Do you know what tests were done to confirm the cushing's dx?

Please feel free to ask all the questions you want. I know how scary and confusing it is in the beginning. Good luck with Louie and looking forward to hearing more about him.

[affenmom]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Thank you so much for the info! I will definitely post on the k9cushings site as well...

Lynne, I am so thankful to have found someone else who has gone through this!!! I have so many questions if you don't mind.... first of all, was Lady diagnosed with Cushing's or diabetes first? How long did it take to get her regulated? Was she ever out of control and hospitalized? Was she ever at the point of not eating? Louie hasn't eaten a full meal in about 2 weeks. This is NOT like him. Is this from the diabetes? We can't treat him for the Cushing's or even let him come home unless he eats! I think I could get him to eat better here if they let him come home, but they said they can't put him on long term insulin unless he is eating... any advice?

[affenmom]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Oh.... and he has had the LDDH test for Cushing's, the HDDH test (which showed pituitary Cushing's), and the ACTH test.

[k9diabetes]

Re: Newly diagnosed diabetes, cushing's - hospitalized

It's a catch 22 though... Maybe he's not eating because he's in the hospital.

I think it's worth trying taking him home if that's the only reason they are keeping him in the hospital.

Natalie

[k9diabetes]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Once you get a dog on insulin, you can give a reduced dose if they don't eat. A quarter of dose is usually quite safe and sometimes you can give as much as half.

Do they have his blood sugar under control in the hospital?

If not, that's not going to help his appetite either. Lowering the blood sugar should improve his appetite.

I don't know... it just seems like there's a quality of life issue at this point. I could see keeping him if he needed treatment that only a hospital setting can provide. If he doesn't, I say bring him home and see how it goes.

Chris, who was in good health, though his blood sugar was high, spent one night at the vet early on to have a full 24-hour curve done shortly before we took over all of his testing.

He would not eat his food until I came in, sat on the floor with him, and hand fed him his food and a bit of hammie (fast food burger).

Natalie

[ladysmom06]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Hi,

Lady was first dx with cushing's but also had diabetes at that time - the vet that was treating her missed the diabetes. Here is the link to her story - it will answer some of your questions -

http://k9diabetes.com/forum/showthread.php?t=73

When we first started on insulin she would not eat - the vet had her on W/D dog food. She hated it. Mornings were the worse. She never ate when she first woke up. I started home cooking for her and she loved it. We never had a problem after that.

I know how scary all of this is. We are all here to help you so ask all the questions you want. Also, join the cushing's site - tons of info and caring people there. Hugs to you and Louie.

[ladysmom06]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Hi,

Was wondering how Louie is doing - is he eating yet? Hugs to you and him.

[affenmom]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Hi,

I am going to pick up Louie in a few minutes and am so anxious to see him... they say he is eating small amounts so that is good news. Unfortunately, since I posted last, something new has arisen. The IMS thinks Louie has hepatocutaneous syndrome. This is a very fatal and rare liver disease and I am so, so sad about it. I will talk to the dr more about it today and post more later. In the meantime, thank you so much for all of your help. I will keep you posted.

Syd & Louie.

[k9diabetes]

Re: Newly diagnosed diabetes, cushing's - hospitalized

http://veterinarynews.dvm360.com/dvm...e/detail/18429

Identifying the disease Skin biopsies may offer the first indication of the presence of hepatocutaneous syndrome. The biopsy results indicate a "red, white and blue" sign characteristic of an overlying hemorrhagic crust topping edema under which is an accumulation of neutrophils. It is this characteristic biopsy finding that suggests we look further for underlying liver or pancreatic problems. Serum profiles may show elevated liver enzymes, hypercholesterolemia, hypertriglyceridemia or elevated serum glucose. Complete blood counts may show an elevated blood glucose and normocytic normochromic anemia due to chronic disease. Urinalysis may confirm diabetes via glucosuria, proteinuria and/or ketonuria depending on the stage of diabetes.

It seems that a lot depends on what is the underlying cause so you should be able to take your time in finding out more about this before making any decisions...

I hope it's not as dire as it seems right now.

Natalie

[ladysmom06]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Hi Syd,

Just checking to see how Louie is doing? Hugs to you and him.

[Dollydog]

Re: Newly diagnosed diabetes, cushing's - hospitalized

Hi Syd,
Just saw this thread and want to post. My dog had both diseases, Cushings and diabetes, and we treated her for 32 months. I let her go last September and she was 13 years+.

I know things seem bleak right now but hope you have your little one home. There is a lot of valuable info and help on the diabetes and cushings forums so you're in good hands. Members here will help you determine if your vet has a good handle on your dogs situation.
Will check back for your update.
Jo-Ann & my Dollydog angel

[affenmom]

Re: Newly diagnosed diabetes, cushing's - hospitalized

I have a very sad update about Louie... we made the very, very difficult decision to end his suffering last week. I have been just devastated over this and just lost as to how this happened so fast. Let me give you his full story...

First, let me start with us going to the vet back in Feb 2009 when I noticed Louie's skin had weird crusty legions on his skin, mostly his back. We cleared it up with antibiotics after being told it was from allergies. They came and went over the last year, while Louie licked his paws incessantly and rubbed his face and back on everything. I was always told he had severe allergies/dry skin, etc...we even ran a Cushing's test (LDDS) and it came back negative...

Then, Louie started bleeding from his paws this past November and the vet told me it was from his severe allergies and excessive licking.. Louie was an 8 year old affenpinscher by the way. So, we put an E-collar on him (which makes me cringe to think I made him wear it for several weeks) and loaded him with antibiotics which never seemed to work.

Then, after two different types of antibiotics, soaking his feet twice a week, trying natural creams, putting goofy toddler socks on him, etc, etc, we finally saw it going away enough that it was manageable for him.

Then, in late December, Louie started becoming a "picky eater".... leaving half of his food in the bowl, after being a ravenous eater for years and being overweight and struggling to get this weight under control. It slowly got worse, and by the second week in January, he stopped eating altogether. NOTHING we gave him would suffice. So, the vet ran some blood and did another Cushing's test (this time ACTH and HDDS) , and it was discovered he had diabetes, DKA (4+), and tested positive for Cushing's.... he was admitted immediately to an animal hospital, put on insulin and IVs for several days, and sent home.... still no eating.... two days later, more blood tests found Louie to be anemic. This time, Louie was admitted to see a IMS, as well as kept under very supportive care.

After almost a week there and although his sugar levels were much better, his DKA was gone, and the anemia was a little better after a transfusion, Louie was trembling in pain (even with pain killers), he was still refusing to eat, and he couldn't walk on his paws at all (we carried him everywhere). At this point, the vet told us he had this Hepatocutaneous syndrome after seeing an ultrasound of his liver (it resembled a honeycomb pattern) and from the other symptoms.

We were hoping to bring him home and have him get better, well enough to live a while on pain killers and supplements....But, he was home for one day and living a miserable existence and we knew what we had to do. He was down from 26 pounds 2-3 weeks ago to 17 now and shaking uncontrollably and still refusing to eat... We made the TERRIBLE decision to end his suffering last week.

This all happened so fast and I am so heartbroken over this... Does anyone know anyone with a pet with this terrible disease?? I am so lost and just looking for answers.