New here...and my head is spinning

[Betsy918]

Hi!

I'll try not to make this too long. I'm not even sure if I'm posting in the right spot. Anyway, our dog Lincoln is 9 1/2. Since we adopted him 9 years ago, he's been to the vet maybe 4 or 5 times for something other than his yearly check ups. So he's always been pretty healthy. But the past few months things have been crazy.

The week before Valentine's Day he started kind of not acting like his normal self. Toward the end of the week I noticed that he was drinking a lot more than usual. Saturday night he seemed really lethargic and by 4am Sunday he was vomiting. My husband had to take him to an emergency vet. He was diagnosed with advanced DKA. They gave him some fluids and insulin and he came home. Oh and he had lost 15 pounds...which we felt AWFUL about because we hadn't noticed it until someone commented on it. The rest of the day was awful. We really thought we were going to lose him. He basically laid around and would just get up and move positions.

The next day he had an appointment with his regular doctor and he was doing MUCH bettter. He was excited for his breakfast and up moving around. They kept him for the rest of the day and gave him fluids and we picked him up that night. Then we dropped him off the next morning and he stayed all day again. They got him started on insulin. We started at 12 units twice a day and now he's up to 18 twice a day.

Now we have an appointment on Monday for the test for Cushings. I'm really nervous about this. I was reading up on the medication he'd be on (Vetoryl) and just the side effects of that has me freaked out. Lethargy...depression...loss of appetite...weight loss. He's only gained back about 3 of what he had lost. Is anyone's dog taking that? How is it? Should I ask this in the Cushings forum?

Anyway, like I said, my head is just spinning. It just makes me so sad that he's always been so healthy. Now he's at the vet every other week.

[Judi]

Re: New here...and my head is spinning

Hi Betsy: first big hugs to you what a stressful week.

I'll give you the standard warning about Cushings and Diabetes. There have been a LOT of dogs incorrectly diagnosed with cushings when they have diabetes.

Since all of the medical issues Lincoln has been through could cause his body to stress out, his cortisol level may be higher than normal just in reaction to those. The 2 tests that are out there for cushings are not definitively positive ever. My vet told me that and it was reinforced here and on the cushings forum.

Cushings is a very slow moving disease. Most recommend getting the diabetes under control THEN testing to see if cushings is an issue

Does Lincoln have a ravenous appetite? pot belly? crappy skin? The Cushings test can be expensive. If I were you I'd ask the vet if this could wait.

If Lincoln does have cushings the meds sound scarier than they are. My Jenny takes Lysodren and has been doing ok since we got her on a maintenance dose.

What kind of dog is Lincoln? How much does he weigh? Hang in there. A year ago I wondered if Jenny had been given a death sentence. It wasn't. She is still Jenny

hugs, Judi

[Judi]

Re: New here...and my head is spinning

here is a link to Quinn's thread: http://k9diabetes.com/forum/showthread.php?t=3511

look at the last page. Natalie gave some very excellent advice to Quinn's Mom.

Judi

[Betsy918]

Re: New here...and my head is spinning

Hi Betsy: first big hugs to you what a stressful week.

I'll give you the standard warning about Cushings and Diabetes. There have been a LOT of dogs incorrectly diagnosed with cushings when they have diabetes.

Since all of the medical issues Lincoln has been through could cause his body to stress out, his cortisol level may be higher than normal just in reaction to those. The 2 tests that are out there for cushings are not definitively positive ever. My vet told me that and it was reinforced here and on the cushings forum.

Cushings is a very slow moving disease. Most recommend getting the diabetes under control THEN testing to see if cushings is an issue

Does Lincoln have a ravenous appetite? pot belly? crappy skin? The Cushings test can be expensive. If I were you I'd ask the vet if this could wait.

If Lincoln does have cushings the meds sound scarier than they are. My Jenny takes Lysodren and has been doing ok since we got her on a maintenance dose.

What kind of dog is Lincoln? How much does he weigh? Hang in there. A year ago I wondered if Jenny had been given a death sentence. It wasn't. She is still Jenny

hugs, Judi

Thank you so much!

Lincoln is a Lab/Border Collie mix. He is currently about 67 pounds. This is why my head is spinning...when the vet first suggested Cushings I read up on it and he does not have hair loss. He also doesn't seem to be any hungrier than he was before. I can't tell if he has a pot belly or not. We were very hesitant about doing the test because of this but then I read something else that said not all dogs have the hair loss. But the vet said that there was something else when they tested his urine (and I forget what it was because just my husband was there at the time) that he was pretty sure it was Cushings. He also wanted to do it because we keep having to increase his insulin dosage. He wants to find the reason that the insulin isn't as effective.

[SandyL]

Re: New here...and my head is spinning

Welcome Betsy!

First of all, take a deep breath... You'be found the right place for info!!! We've all been where you are right now, and it does get better!!!

What is Lincoln eating? Are you feeding him twice a day, 12 hrs apart with his injections following?? Is he eating the same thing at each meal? Food has a lot to do with the effectiveness of insulin and welcome do vets explain this

What kind of insulin is he on??

Don't worry about lengthy post, the more info you can give about your baby, the better!!

Sandy

[eileen]

Re: New here...and my head is spinning

Welcome Betsy!

Hypothyroidism can mimic diabetes and Cushings symptoms. It often goes hand in hand with many of our diabetic pups.

Love those Border Collies ;-)

[JayneN]

Re: New here...and my head is spinning

Welcome Betsy & Lincoln

[Shellie]

Re: New here...and my head is spinning

Welcome to you Betsy and Lincoln! This is one of the best places to get your head to stop spinning, I swear! lol

You've got a lot on your plate and first thing is always to remember to breathe! Now that you have the ketones (DKA) under control (am assuming you are testing that with ketodiastix in his urine? If not, pharmacy has them and are easy to use and understand.)...you can tackle the diabetes. Diabetes is a disease that just takes time to get a handle on and get a dog regulated. Even tho you've been doing this for two months...that is still SO early in this disease! Many dogs don't become regulated within that time frame, although luckily some do.

I think what I'm trying to say is that at this point, I'm not sure I'd be necessarily looking at doing Cushings testing. With no symptoms, and unregulated diabetes, it's rather useless. There is no cure for Cushings and all you ever do is treat symptoms but it sounds like Lincoln doesn't have any other than a possible resistance to insulin. THAT is not, at least to me, a reason to have the testing and possibly get a false positive which would lead you to medication you might not need.

As Eileen and Sandy mentioned, there are a lot more causes of possible resistance than Cushings. His dosage isn't excessive for a dog his size. Are you feeding him twice a day? What are you feeding him? And how about numbers? Are you testing him or is just the doctor doing so? And if the doc is just doing it...is he basing his advice on one test a day or on a full curve (blood test every two hours for twelve hours)? These are some of the things that you might consider before spending the money on Cushings testing.

I don't say this nearly as well as Natalie does...she gets right to the point! LOL I'm awful glad you found us and I hope we can help you get to the bottom of this possible resistance. Hugs to you and to Lincoln!

[spiritdog6]

Re: New here...and my head is spinning

I was at where you are now, but 2 years ago.

My dog was perfectly normal and healthy for 10 years, looking back life was a breeze for both of us.

My dog is hypothyroid, Cushings, diabetic, and 5 other diseases.

He has been on Vetoryl for over a year now, and all Cushing signs disappeared.
I call it the "gift of life" drug at least it has been for us.

He loves to play with the other dogs at the park, chases the ball constantly, loves going for car rides, etc.

You must learn to be an advocate for your dog to get him in top condition. I fought many a vet, a Spec. or 2 to get where we are now.

Learn, read, ask questions, and rely on your gut telling you what is right. A lot of GP vets know very little about Cushings, many will not treat it at all.

It is not a death sentence by any means. But it doesn't sound like, from what I read that your dog has full blown (if at all) Cushings.

[nibbles-mommy]

Re: New here...and my head is spinning

my nibbles was on vetoryl for 10 mmonths last year. he was originally tested for cushings in nov '10, but he didn't have any symptoms so we didn't treat. the vet also said our other dog had cushings the previous year but she really had no sign of it so didn't treat her either. both went through all the testing too. then when nibbles became diabetic, the vet kinda scared me into the vetoryl saying his bg would be crazy and difficult to control without it. there's a detailed explanation and responses from our administrator natalie on nibbles' thread.

i wouldn't rush into treatment right now unless there are unbearable symptoms that are impacting life.

good luck!

debbie

[momofdecker]

Re: New here...and my head is spinning

Hello and welcome! I can't speak much about cushings but it does seem to be early for your vet to state Lincoln may be insulin resistant. Going from 12u to 18u for a 67lb dog is not unreasonable. My boy is 98lbs. We've gone from 15u to 30u and seen little movement in his bg over a four month period (he ranges from 400-600). He also has trouble with his back legs from time to time. No mentnion of cushings has been made with him. Is the 67lbs a good weight for Lincoln or are you trying to put some of the 15lbs back on him? Lots of good information to read on this site. Hang in there! Holli

[k9diabetes]

Re: New here...and my head is spinning

I agree that I wouldn't do anything with Cushing's - not diagnosis and certainly not treatment - until you have a chance to see how Lincoln's blood sugar regulates.

Even at 18 units, he's nowhere near insulin resistant. Insulin resistance is defined as receiving 1 unit per pound or more and still not getting decent blood sugar.

Something helpful with the vet if needed is the following blog by Dr. Mark Peterson, who is a veterinary endocrinologist, so your vet doesn't have to take my word for it!

http://endocrinevet.blogspot.com/201...e-in-dogs.html

So he'd have to be getting 60 units or more and still not responding!!

Unfortunately there are some vets who set a pointlessly low limit for insulin and consider the dog resistant if they go over it.

Anywhere from 1/4 to 1/2 unit per pound is completely normal and typical. And I've seen a few terriers who needed more than average - 21 units for 25 pounds dogs - but who got great regulation. They just needed a larger than average dose.

That means he could go up to 30-35 units and be a completely normal diabetic processing the insulin normally.

Do you the curves the vets has done?

If you could get copies of those and post them here, we could offer some additional thoughts.

If his blood sugar is 700 on 18 units, then I might see some cause for concern for Cushing's or something else going on. But sometimes the difference in units makes a huge change in their blood sugar. Our dog was started on 8 or 9 units and his blood sugar stayed in the high 400s and 500s all day long. But with a couple more units and some time to adjust and get more sensitive to the insulin, he did fine on 12-13 units.

Natalie