Angel Monk... passed away March 6, 2012

[CarolW]

Re: Please update us on how you are doing

I hadn't thought of the possibility of low cortisol. Betty - if Monk were my dog, he's be on the way to the ER now. To me, it's a matter of safety. Seizures should not be occurring at all; best get to the bottom of things.

Sending you and Monk all the very best,
Wed, 23 Nov 2011 16:25:42 (PST)

[bowens2]

Re: Please update us on how you are doing

I'm taking him. But would some level of his in the past (what ever it is that they test for cushings) showed him borderline cushings if he had Addisons? The value for cushings was 22 or higher and his was 21.22 what ever the test was? This vet keeps pushing about the cushings and having him tested again. She did again today.

[CarolW]

Re: Please update us on how you are doing

I can't answer your questions, Betty, though I got the impression Natalie might have been thinking of temporary lowering of cortisol levels, which would mimic Addisons. SO glad you're getting Monk to the vet. I really think that's crucial. I'll be here watching as often as I can; praying for you and Monk - and awaiting your reports!
Wed, 23 Nov 2011 18:21:45 (PST)

[Patty]

Re: Please update us on how you are doing

I'm just now reading Betty and would take Natalie's 'checklist' of things to have the ER check for with to be sure they do a full assessment.

Not sure how long ago the Cushings test was you were talking about but I'd have them test his cortisol level while there to see if it's low.

[k9diabetes]

Re: Please update us on how you are doing

Hi Betty,

I'm glad he will be seen tonight.

A dog with low blood sugar is UNLIKELY to have Cushing's disease.

So good that they did the cortisol testing at the vet today - just not for the right reason.

Cushing's testing in a diabetic dog is notoriously unreliable because the diabetes not only mimics many Cushing's symptoms but also tends to throw off the results of the testing. I wouldn't accept a Cushing's diagnosis in a diabetic dog unless it was (1) confirmed through more than one kind of test (and it has to be the right tests); (2) the blood sugar refuses to regulate; AND (3) the dog has more than one obvious visible symptom of Cushing's disease.

There is a direct connection between cortisol levels and blood sugar.

Cushing's = high levels of cortisol = high blood sugar and large doses of insulin needed.

Addison's = low levels of cortisol = low blood sugar, often quite severely low, along with weakness and lethargy.

Blood sugar remaining low - perhaps low enough to cause seizures - is not a Cush dog. But it could very well be an Addison's dog.

It's not unusual for a diabetic dog to show a high level of cortisol on the Cushing's test even if he doesn't have Cushing's. And the more stressed a dog is, the higher the cortisol results are likely to be. That's why concurrent illnesses like diabetes throw off the tests.

So the results of the Cushing's test they did today will be important in figuring out what is going on with him but he is not likely to have Cushing's based on what I've heard.

If he truly had Addison's disease (low cortisol), even stressed he won't be able to produce a large amount of cortisol on the test.

Finding out whether his blood sugar is still low will be a big indicator of what might be happening with him also so it really needs to be tested tonight after he's had all that food and syrup.

I think the neurologic exam is also very important because it's possible that something else entirely is going on with him.

I hope that a set of fresh eyes will be able to take a comprehensive objective look at Monk and sort out what's going on.

Natalie

[Patty]

Re: Please update us on how you are doing

If he truly had Addison's disease (low cortisol), even stressed he won't be able to produce a large amount of cortisol on the test.

Finding out whether his blood sugar is still low will be a big indicator of what might be happening with him also so it really needs to be tested tonight after he's had all that food and syrup.

I think the neurologic exam is also very important because it's possible that something else entirely is going on with him.

I hope that a set of fresh eyes will be able to take a comprehensive objective look at Monk and sort out what's going on.

Natalie

I totally agree with Natalie and am hoping the same thing with a new team to sort things out.

The thought also occurred to me that it's possible Monk uses overlap of his Lantus duration (if it's lasting longer than 12 hours for him) to keep his flat profile and if he starts running significantly lower, it may take some time to rid the body of the excess insulin.

But a neuro eval, coritsol levels, etc could help determine if something else entirely is going on.

Will be waiting to hear, Betty.

[heinzle]

Re: Please update us on how you are doing

Addison's also occurred to me but I felt I was too close because Sammie also has Addison's. Please know that if he does have Addison's it is very treatable. I actually believe that it is easier to treat than Cushings because the adrenal glands have just stopped working - easier to treat when that variable has been taken away.

*If* he has Addison's I would absolutely want the 28 day Percoten shot with daily prednisone versus the daily Florinef pill. Percoten is much easier to give/monitor/stabilize and, overall, will be much cheaper.

There is a fantastic Addison's dog site at http://pets.groups.yahoo.com/group/AddisonDogs_/ that will help you through all this *if* he has Addison's. Trust me when I say the Addison's is easy to treat but it's hard to detect. Once detected it is downhill but kind of a balance when it comes to diabetes management.

I'm watching and waiting for your next post.

[k9diabetes]

Re: Please update us on how you are doing

Another thing that occurred to me is that maybe he was running low blood sugar throughout the time he was at the vet and exhausted his glucose reserves so is unable to maintain basal blood sugar.

Natalie

[Soaphie & Sydney's Mom]

Re: Please update us on how you are doing

Any update on Monk?

[CarolW]

Re: Please update us on how you are doing

Tami - probably half the forum is here watching, all holding our breaths. I have to go on my weekly Hunt Day, so will come look after I get back. Prayers flowing and flowing for Monk and Betty. I surely hope the vet is finding out (or found out) what problems Monk has.
Thu, 24 Nov 2011 10:22:30 (PST)

[MaryLea]

Re: Please update us on how you are doing

Watching from Texas for your report, too.

Mary

[k9diabetes]

Re: Please update us on how you are doing

I've worried all day about you and Monk...

Natalie

[bowens2]

Monkey

Monk's sugar came back up really high so I did not take him to the ER. But here is what has happened since then. Thursday I gave him 8 units of Lantus and fed him. I had given him probably too much sugar during the previous evening after his seizures. He had no insulin that night. I gave him 8 units the next more with his regular food. He stayed high but we took him to Columbus (my son's house about an hour and half away)with us. He was high when we got to Columbus. I fed him about 5pm and gave him 10 units of Lantus. He paced and panted for awhile. He was nervous and shaking but I think he thought he was going to the vets. Took him a couple of hours to really settle down but it is no different than what he has been doing at home. He finally zonked out for awhile. I got him home about 11:30 and he was negative. Now when everything is normal he pretty much stays at negative and that has never been a problem until now. I guess I panicked and may have read into his behavior differently because of all that is going on. He doesn't like to be picked up at all but I wanted him to go to bed and he would not get off the sofa so I started to pick him up and he acted terrified, whined, and even growled a little. So once again I started giving him treats and syrup. He was pretty much fine during the night. I fed him at 7am because he was negative still and didn't want to wait until 9:15 when we saw the vet but he did not get insulin.

I discussed all that was going on with my regular vet. He had the test results back while he says he can't rule out cushings he definitely does not think he has Addison's Disease. His liver phosphates are very high but they have always been somewhat high. He was going to look and tell me if they were higher than last time but I guess we both got side tracked.

He really wanted to keep him but I said no because they leave at 5pm and are not back in the office until 8am. If he did have a seizure or his blood dropped there would be no one there. He said I could take him to the emergency vets because they were there 24/7. But for me that's not an option. One because you don't know which vet you will get. Two I could not afford to leave him there all weekend regretfully and can monitor him better myself and if he has a problem again if nothing else but for a second opinion.

While he was there they did a blood glucose test and he was at 400. The vet assured me he would not drop dangerously low in one day. He wanted me to be consistent the next three days and give him 10 units but after having 8 and then 10 units and dropping low. I told him I would comprise and start with 9 units. He is going back into have another bg test at 9am in the morning. What I didn't know is since he ate at 7am but took his shot at 10am should I give him his insulin when I fed him which I did at 4:15pm because he was whining and pacing. I think while he was boarding they were feeding him and giving him his shot at 8am and 4 or 5pm. His normal is like 8am and 6pm or 7pm. He is definitely a creature of habit so I think everything has been thrown off.

So should I give him his insulin now? or wait an hour and give it with his broccoli around 6pm?

I was going to attach test results but I haven't figured out how to insert or attach them.

[bowens2]

Re: Monkey

The vet thinks its all of the ups and downs that are really causing the problem. I did make him show me how to take blood from ear. My first attempt was a failure so I tried it on myself so I think I may be able to do it and I am going to try again in a little while. I know I could do it if I had someone here but my husband is out of town. I think it didn't work because of the time lapse of putting the test strip in and actually getting his ear pricked. He did squeal and hid from me as soon as I let him go.

I tried to have the vet give me his number if something did happen but he wouldn't so after this is resolved I am going to find a vet I can contact in situations like this.

[bowens2]

Re: Monkey

I thought they were doing a cushings test but they did not. He has told me that a cushings test is not conclusive. Its the other vet that really thinks he might have cushings. If he can get him stable we are going to do a cushings next week since they didn't do one the other day.

Natalie I am going to email his test results.