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KittyDog
01-21-2009, 07:42 PM
I was referred to this site by someone from the cushings forum. Not sure if you still remember me Natalie. I don't post often over there.

Lily was diagnosed with cushing March 2008. She had a high glucose level then but it dropped and stayed normal. You really questioned me then to make sure it wasn't diabetes.

Well in December I started noticing Lily not doing as well. She was drinking and peeing lots and still eating lots but loosing weight. I thought some had to do with our new puppy and my illness that put me in the hospital. She has a tendency to stress out and have spells when someone in the family is sick.

Anyway, I took her in today because she was having lots of poop and then threw up. Her glucose level was high again, she was dehydrated, and had actually lost 2 more pounds. She is down to 6 pounds now...we started at 12 last March.
I lucked out and my favorite vet was her Dr. today. She kept her and is going to do more testing tomorrow. They rulled out addisons today.
She did say that she thought for sure she would be going on insulin. Her other symptoms where her eyes got very cloudy this weekend. She is not sure why this happened so suddenly but she does have a cataract on one of her eyes.

I would appreciate any of your great advice!
She is a Chihuahua, 9 years old, and takes 15mg of trilistane a day.

Abby

k9diabetes
01-21-2009, 07:44 PM
Hi Abby!

I will search it out but do you have handy the URL to Lily's thread on the Cushings board that you could paste here so I can review it?

Natalie

KittyDog
01-21-2009, 07:46 PM
http://caninecushings.net/forums/showthread.php?t=6610

thanks

k9diabetes
01-21-2009, 08:11 PM
Ah yes... I remember Lily very well! :)

Can you have the vet give you a hard copy of the testing they have done in the past couple of months and post it here? If need be, you can fax it to me (916.372.7161).

Since they say she doesn't have Addison's, I assume they tested her cortisol levels and I would be interested to see what that was.

Did they do a whole blood panel to see how her liver values are?

Also wondered if, after May, she had Stim tests that showed her cortisol back into a healthier level on the smaller dose of trilostane.

The combination of cataracts and high blood sugar definitely sounds like diabetes and as the Cush folks told you it's not uncommon for one to follow the other. There are a lot of dogs who have both.

I'm anxious to hear more tomorrow. Don't worry though. We will be right here with you and Lily,

Best wishes,

Natalie

eyelostit
01-21-2009, 09:40 PM
Just a Hi and Welcome to the board, :) Abby (kittydog) and Lily.

KittyDog
01-22-2009, 07:44 AM
Good Morning Natalie,

I called to check on Lily this morning. Her glucose level was 238 this morning and she did have ketones in her urine. They are giving her fluids and gave her the first dose of insulin. They are going to keep her another night.
I am shocked :eek: she ate can alpo dog food for them sometime during the night. Her lack of cushings medicine must be showing. She rarely eats can food. So I am going to take some of her food up there to her in a little bit.

As far as her previous tests. Her last stem test was inn July. I posted the results in the checking in post so here is a copy of what I posted there. I now can see the importance of putting all this in the original thread! So sorry I didn't check in the rest of the year. She was doing so good until December.


May
I am so glad to say that Lily is doing great right now. She has been on 30mg of Trilostane for about three weeks now. I haven't seen many changes yet in her drinking and peeing and it seems to me that she wants to eat even more than ever some days. I have managed to keep the weight off of her so far.

We had her follow up today and she is down to 9.8 pounds! Her Dr. was thrilled with her continue weight loss. So since day one of taking her to the ER, she has lost 3.8 pounds. (She should weigh not more than 8 pounds) Sickness is not the ideal way to get it off but she feels so much better.

Her ATH Stim test went good too. We will be dropping the Trilostane to 10 mg. twice a day. Her levels are dropping to low.

Encase you don't want to look at my original thread, her are her results.

Original test
Baseline was greater than 30
Stim was 6.7


Today's results
Baseline 1.1
stim .9

July
Lily just had another stem test done this week. The test went great with a before of 1.4 and post of 3.1. I feel she is doing fine other than sleeping a little too much. I am to watch that and adjust dose if needed. They will be switching her to a liquid dose on our next refill since we are on 10mg. now twice a day. That is trilostane for her med.
I sure hope she like the liquid. At least now I can give half a dose in the morning if she is acting to lethargic instead of skipping a dose here and there. It is almost like she need 20 one day and 10 or 15 the next. She is still holding her weight down.

Oh by the way I kept her on the capsules...leary of liquid in the house with a 5 year old.

September
I can't believe it is already September. My "baby" started Kindergarten and I am enjoying my free time again. Lily is doing very well. It is hard not to worry about her. I have been allowing her to put a little bit of weight back on. I am sorry Vets...she is just to thin. I can't stand feeling her bones. I think we may have let her drop to much.

k9diabetes
01-22-2009, 09:59 AM
I'm anxious for her to get home and see what her test results are!

KittyDog
01-22-2009, 01:03 PM
I am getting ready to go back and check on her again. They may let me bring her home tonight after all. I stayed for about an hour earlier today. I got her to eat a few pieces of dry food and 2 baby meat sticks. They did another glucose test while I was there and the insulin had dropped it to 86..hence the reason they wanted me to get her to eat some more.

I talked with the main vet today. He thinks she has a very mild case of diabetes and that the cushings brought this episode on. With me being sick she missed lots of medicine and we were trying hard to get her back on schedule to have that stem test done this week. He still doesn't understand why her eyes went bad so fast. She was fine on Thursday and they were both clouded over on Sat.

We do think that her cushings medicine dose is still too high. Also there has been some new studies even saying that. The new standards for a dog Lily's size is 5mg. twice a day. So we will be going on liquid now since they don't make that small of a dose in pills.

I will update again when I get back.

KittyDog
01-22-2009, 03:46 PM
I brought her home! Her BG at 5 was back up to 220. He doesn't think she needs insulin yet since it brought it down too low. He also still thinks that the cushing med being to high in dosage caused alot of the problems and getting her back on the right dose will make it all better. For now I am going to open the capsules and take out half and mix with food and give it to her twice a day. He wants to check on her again tomorrow.

I have a meter and I think I will be keeping a check on her myself. Just pray she does fine this weekend and the first of the week. I am scheduled for gallbladder surgery Monday. He did say if I need him over the weekend or off hours because of my surgery just come up and bang away..he would most likely be there.

I took him some pictures I had taken right before Christmas. He agreed that she looked so healthy. I had a close up of her eyes though and he said he could tell the cataracts had already started then. It is amazing that the picture I had on Jan. 7th. showed that she wasn't feeling well and how fast she took the downward turn from that day.

So now tell me what you think!

AlisonandMia
01-22-2009, 04:53 PM
DON'T OPEN THE CAPSULES!:eek: This is something that must never be done. It is dangerous for both you and for Lily and even other household members. Trilostane is highly irritant to mucous membranes and we have had some dogs having terrible problems for this reason when capsules were opened and sprinkled on food. Handling the drug is also very dangerous for you as it interferes with cortisol production in humans as well - and also messes with the synthesis of some of the female hormones. Another way that this is dangerous for Lily is that it is just about impossible to get an accurate dose this way and Trilostane is a short-acting med that needs to be very accurately dosed.

You can get your existing capsules repackaged into smaller capsules by a compounding pharmacy and this would be the thing to do. Alternatively you could order some small capsules (10 or even 5mg) for tweaking purposes. A lot of people do this.

Too high a dose of Trilostane (ie dropping cortisol too far) will not cause high blood glucose - in fact the reverse is the case - it is linked to a low blood glucose even in a non-diabetic dog so this episode of high BG cannot really be attributed to too high a dose of Trilostane.

If her BG dropped to rapidly with a dose of insulin it could have been that the dose was too high either absolutely too high or too high for the amount of food. I think you mentioned on the Cushing's board that she had ketones in her urine - this suggests that she really does need to have her BG addressed - unless of course she had not been eating for some time. (Natalie and others: do dogs get ketones with starvation even in the absence of diabetes?) If she had a dose of Trilo with the meal and around the time of insulin injection this could also have lead to her going too low - especially if the dose of Trilo is a tad too high. (Sorry to be so confusing on the Trilo dose:p thing but basically high cortisol = high BG and low cortisol = low BG)

In the early days of diabetes it is common for dogs (and humans with type 1 diabetes) to be very unstable and to have very irregular insulin requirements as their pancreas is still producing some insulin - more some days that others it would appear. The diabetes can even all but disappear for a short while before the pancreas completely conks out and stops producing insulin at all. This is called "honeymooning" and can be a real hassle both in people and dogs. In humans (because of our longer life span) it can go on for years in some cases! My brother-in-law is diabetic and had quite bad regulation problems for several years.

You will probably find that Lily will do a lot better on twice-daily Trilostane dosing as once daily dosing seldom controls the cortisol for the full 24 hours. A diabetic (or a dog that is tending in that direction) really needs its cortisol controlled around the clock and most diabetic Cushing's dogs that are on Trilo are on twice-a-day dosing. Usually the dose used is two twelve hourly doses with each dose being slightly smaller than the dose used when it was given once a day. If you were giving, say, 30mg once per day then you might try 20mg twice a day. Trilsotane is quite short acting and is often not doing much to control the cortisol once you are about 8 -12 hours post dose.

Good luck and keep us posted.

Alison

AlisonandMia
01-22-2009, 04:56 PM
You can get pills or capsules compounded in any size but the liquid is also an option too. Some people have had trouble with the liquid preparation though - you may want to ask on the Cushing's board about that. I believe Glynda (LulusMom) has had experience with liquid Trilo and should be able to point you in the right direction with that.

Alison

PS: Don't miss my post at bottom of the previous page.

KittyDog
01-22-2009, 05:26 PM
I guess I show explain that the symptoms came on while we were doing 10mg. of Trilostane once a day. She hasn't had a dose of Trilostane since Sat. Does that make sense now for his thoughts of why the BG went high? He does think she has Diabetes but at this time just very mild. His thoughts right now was to get her back on the trilostane and then start monitoring the BG levels.

They had only given her 1 unit of insulin.

They also put her on pepcid for a few more weeks and a short course of antibiotics.

We Hope
01-22-2009, 06:55 PM
Yes, it does when Cushing's is involved. Basically, Cushing's is an over-production of cortisol. The Trilostane stops the over-production of cortisol.

Where cortisol and high blood glucose levels come together is because cortisol is one of the counter-regulatory hormones that raises bg levels.

http://petdiabetes.wikia.com/wiki/Cushing%27s_disease#Cushing.27s.2Fdiabetes_connect ion

"The basic connection between Cushing's and diabetes is this: the excess cortisol produced by the faulty adrenal gland is a signal for the body to produce new, non-sugar sourced glucose (Gluconeogenesis).

"When this additional glucose reaches the bloodstream, another signal goes off; this one to the endocrine pancreas to produce more insulin to handle the glucose present in the blood.

"When the insulin production ability of the pancreas can no longer keep up with the additional blood glucose which the excess cortisol from the malfunctioning adrenal gland keeps emitting, the islet cells of the endocrine pancreas are exhausted, and diabetes results. In effect, the overproductive adrenal gland has the capability to "burn out" the insulin producing capability of the pancreas.

"If the islet cells of the pancreas are still able to produce sufficient endogenous insulin for the body's needs, controlling the Cushing's will also control the blood glucose, meaning there would be no need for insulin injections. If the pancreas' islet cells have sustained such damage as to be unable to produce enough insulin for the body, insulin shots are necessary."

http://petdiabetes.wikia.com/wiki/Counterregulatory_hormones

"Counterregulatory hormones have opposing effects to the actions of insulin. Where insulin, endogenous or exogenous, lowers blood glucose, one effect of these counterregulatory hormones is to raise it.

"Cortisol, growth hormone, adrenalin AKA epinephrine, glucagon, progesterone and thyroid hormone are considered counter-regulatory hormones as far as diabetes and blood glucose levels are concerned.

"They need just as much consideration as insulin, because changes in their bloodstream levels, can mean a possible interference with insulin, or a need for more of it."

So if you have Cushing's and diabetes and the Cushing's isn't being controlled by treatment, the adrenal glands go back to producing too much cortisol. This cortisol drives up blood glucose levels, and you start going in a vicious circle.

On a side note re: the suggestion that perhaps Lilly might do better with a twice daily dose of Trilostane rather than a once daily one seems to be well worth considering.

Comparing it to using insulin for diabetes--at one time, it was thought to be the "norm" for Caninsulin/Vetsulin to be given only once a day. What this meant was that you gave an entire day's worth of insulin dose in the morning after breakfast, and then gave a meal without giving insulin a few hours later--shortly before the insulin was set to be working at its hardest. Giving the meal before that was supposed to keep the animal from going hypo.

I know people who were started on that one shot a day regimen and none of them got their dog's diabetes regulated until they went to the two shots a day, 2 meals a day, given 12 hours apart, with the insulin shots following the meal. The most common problem with the one shot a day routine was that most went through frequent hypo attacks because the large amount of insulin being given in the morning and expected to last 24 hours was just too much for the dog. All regulated very easily and quickly after going on the two meals, two shots a day program.

So looking at this from a "diabetes" standpoint, where 10 units of insulin--for example--given all at once might be too much, giving 5 units of it twice a day can work out just fine.

We all react to medications differently. My mother had used a high blood pressure medication for years twice a day. It did the job for her well. The doctor who treated her for years thought he might make things more convenient and a little cheaper for her by switching her to the same total amount of medication taken once a day.

She had issues with this, despite it being the same total amount of the medication she was taking every day. He put her back on the two pills a day routine and all was well again.

I think the plan put forth by your vet seems to be a good one. In order to determine how much insulin Lilly may need will depend on how well the Cushing's is being controlled.

HTH!

Kathy

k9diabetes
01-22-2009, 07:46 PM
If her BG dropped to rapidly with a dose of insulin it could have been that the dose was too high - either absolutely too high or too high for the amount of food. I think you mentioned on the Cushing's board that she had ketones in her urine - this suggests that she really does need to have her BG addressed - unless of course she had not been eating for some time. (Natalie and others: do dogs get ketones with starvation even in the absence of diabetes?)

I don't know but I would think that any process that forces the body to turn on itself for fuel could produce ketones.

The more I read through this, though, the more I wonder if maybe diabetes has been an issue for some time and the overdosing of trilostane reduced her insulin needs enough that it wasn't apparent. Her cortisol production was awfully low for a while and still is on the low end of the goal for a dog being treated for Cushings with a prestim value in July of 1 something.

The weight loss, ketones, and cataracts make me think that the blood sugar has been out of control longer than realized. From what I've seen over the years, cataracts usually take a couple of months of high blood sugar to show up. Weight loss started in December... could be the blood sugar has been out of whack since sometime in Late November or early December.

So I'm glad you will be monitoring her blood sugar because I think you are going to find that she will wind up needing insulin.

And if that happens, I think it will be important to keep her cortisol at a higher level than it has been maintained so far - maybe even slightly above the standard for treating Cushings.

My concern is that such heavy suppression of cortisol will make her extremely sensitive to even very small amounts of insulin and her tiny size will already likely mean she won't need much.

I had this long discussion years ago with Patti about her Max, a toy poodle who weighed all of about four or five pounds and was extremely sensitive to every insulin tried. He could drop into hypoglycemia on 1/2 a unit of insulin and have high blood sugar on 3/4 of a unit!

We talked about how it would have been interesting to give him a little prednisone to intentionally make him more insulin resistant so that he wasn't in constant jeopardy from low blood sugar.

If Lily winds up needing insulin, you won't need to give prednisone - you could just loosen the control of her Cushings to make sure she's able to produce enough cortisol that she's not overly sensitive to insulin injections.

Natalie

KittyDog
01-23-2009, 09:58 AM
I took her back in this morning. Her BG was 318 so they gave her 1 unit of insulin and some more fluids. She is blind at this point with some limited sight in distance. I am going out to get a meter to start keeping an eye of what her glucose is doing. She is eating right now. Matter of fact she ate the whole jar of chicken sticks and has now moved on to her dry food.

I will say again I love this Dr. He told me again i she still acts punny later on today...just bring her back and he will take care of her this weekend. He also said that if it would make be more comfortable Monday to have somebody drop her off and they will keep a watch o her while I am in surgery. He also only charged me for the insulin and fluids today. $26.00

I still feel so guilty about her being blind..but he assured me I couldn't have prevented it since it came on so suddenly. I worry that she will just give up on life but she seems to know where to go most times. She ran into the bed last night and just night got herself into a corner and didn't know which way to go. He thinks if we get her well, she will adjust much better and that I need to remember how sick she is and that she is also very weak.
I will check back in later on today with her progress. Thanks for all the help. I have read the last two replies...just need to read them over again to fully understand all the info.

Abby

We Hope
01-23-2009, 10:03 AM
Abby,

Just take it one step at a time. The big important step right now is to get Lilly feeling well again.

Kathy

peggy0
01-23-2009, 03:50 PM
Hang in there. These folks will support you! I feel guilty about my Forbin as well and my new vet told me as well that it came on sooo fast there was nothing to be done. I'm getting him well, so I he can be like Cara! Forbin was bewildered about being blind and bumping into things but now 6 weeks later he is a pro at maneuvering around the house and yard and going for walks. he stops in all his familiar places listening for one of the neighbor dogs to dare him to come in front of their house! He's still a happy dog.

KittyDog
01-23-2009, 06:16 PM
Thanks Peggy! I needed that.

She did fine all afternoon. Slept lots but she did get up and drink and potty for me. She ate another good supper and took all her meds.

The question I have is where else can you get a blood sample from her for the BG Meters. I couldn't get any from her ear and she kept biting me when I would touch her legs. Yeah...good sign she is feeling better. Never liked anybody touching her paws.

eyelostit
01-24-2009, 01:22 AM
Re: Ketone question: I just remembered something about Ketones with humans, years ago when dieting using the Dr. Stillman's book, I think he mentioned when you were dieting to buy the ketone strips that way you could tell you were burning fat, I still have those books, geez 20 yrs old, can't I ever throw things alway. If I find them, I'll look, but I'm pretty sure thats in his "The Doctors Quick Weight Loss Program"

Cara's Mom
01-24-2009, 06:14 AM
Hello Abby and Lily! Welcome to the forum :)
Please do NOT feel guilty about Lili's blindness, it's NOT your fault. You are doing a great job with her, with all her health problems. I admire you !
I am just dealing with diabetes with Cara and recently her blindess. She did have some lateral vision left in one eye. She adjusted very well ! I believe it's harder on us to watch our babies bump into things and getting lost in corners. It breaks your heart. But after a little while they just seem to develop some kind of instinct ("radar" is what one member called it:)) and just keep going without blaming anybody, just accepting.
So you do the same:):). Keep up the good work! It sounds like you have full support from your Vet and you are lucky there!
Take care of yourself too and I hope all goes well with your own surgery!

Best wishes to both of you

peggy0
01-24-2009, 06:57 AM
I get forbins blood from the callouses on his elbow. Doesn't seem to bother him at all :)

KittyDog
01-24-2009, 07:46 AM
Well so far DH couldn't get blood either. She is just to grumpy and bit him also. I will let her rest for now and we will try together later.
She doesn't have a callus on her elbow...wonder if that is just a big dog thing.
I did find the link to some videos and I think I will try the above the tail place.

Thanks Cara...I hope your baby is doing great today.

eyelostit
01-24-2009, 01:39 PM
The tail was the lucky spot for me, just got to shave the area some, hang in there.;)

k9diabetes
01-24-2009, 07:59 PM
Most dog's Lily's size that I know are tested at the base of the tail. It's probably the most common spot used for small dogs.

KittyDog
01-26-2009, 03:59 AM
I am happy to say that Lily is perky today. We have decided to take her back to the vets for today while I am i surgery. I am going to request they do a BG on her just to see. We still haven't been able to get blood from her. She is biting at everything that gets near to her that she doesn't seem to recognize or startles her.

eyelostit
01-27-2009, 04:49 PM
Anxious to see the readings:)

k9diabetes
01-27-2009, 10:08 PM
Hope your surgery went well and that Lily's blood sugar has been good! Take care of yourself and let us know how you are doing when you can.

Natalie

Ricksma
01-28-2009, 05:37 AM
Hoping everything went well, and we are waiting to hear about you and your baby's readings!!

Love and hugs, Teresa and Ricky

Cara's Mom
01-28-2009, 06:13 AM
Hoping for good news all around:)

KittyDog
01-28-2009, 12:45 PM
sorry I didn't get back on sooner. Surgery went well and they were able to remove my gallbladder laproscopy. It had one gallstone in it but the Dr. thought that probably my illness at Christmas I passed a cluster of small stones and that is what clogged up the pancreas duct. Unfortunately the tylox knocks me out.

Lily's sugar was 200 Monday. They gave her some more insulin and fluids. They also noticed she had an infected anal gland and drained that and now she is on meds for that. I am suppose to try and bring her back in next week when I am able to get up and around more. oh and she had put some weight on all ready. so we will continue the three small meals for now.

thanks

Ricksma
01-28-2009, 01:32 PM
If she has had an infection, that would affect the BG, and the with the antibiotics, her BG may go down...I would keep an eye on her for a few days. Just to be on the safe side.

Teresa

BaileyBear
01-28-2009, 05:16 PM
Glad to hear your surgery went smoothly. It must be tough to deal with recovery and taking care of Lily's needs at the same time. Hope you get lots of rest and your recovery is speedy. :)

eyelostit
01-28-2009, 11:07 PM
Glad your surgery went well, and the BG came down to 200, Niki has been blind for about 3 yrs now, I felt guilty too, but I had no control over it at the time, back when DX had a terrible vet, did not know all these things I do now, I trusted the vet :mad:, only found the boards 9 mo. later and had to work with a new Vet and Niki starting new diet etc.

k9diabetes
01-29-2009, 10:10 PM
Good to hear you are recovering and that Lily's blood sugar is in a decent range with all that's been going on. Take care of yourself!

Natalie

KittyDog
02-08-2009, 08:14 PM
I was finally able to get a BG on Lily. I seems my sticker is not working right. I used DH's and drew blood with no problem. Her BG was 300. I will be taking her back to the vets office tomorrow. I personally think she is diabetic. She has had a few spells this past week of being very lethargic, panting, and very hot skin. I had planned on taking her last week but it just didn't work out with my personal Dr. appointments.

I guess my question is when do you decide she is been put through to much. She still acts so depressed. Though today she seemed happy after we trimmed her nails and gave her a bath. She is coping with getting around better. I just wish I had a solution to making it all better.

Just adding my personal update. Turns out I was a very sick lady. i got the lab results Wed. on my gallbladder. It had an infection in it and over 50 small brown stones. The cystic duct was also lodged with three stones. I am doing much better today. Still being careful about picking up heavy things but other than that I feel so much better.

Abby

k9diabetes
02-08-2009, 08:32 PM
Gosh you have been through a lot! Glad you are on the mend.

I think Lily will feel much better when her blood sugar is under control. And the blindness is an adjustment process that can take a while but I know she will get there. Sometimes it takes a while...

I will always remember Karin's Sandy, a tiny little Yorkie trying to navigate a couple of steps and snow drifts to go out to potty after losing her vision. Karin really didn't think they were going to make it through that... she was ready to give up. Then one day Sandy figured things out and life went on with it being no big deal!

Once Lily's diabetes is controlled, life can be perfectly normal. Our dog lived with diabetes for a third of his entire life! And he was blind for four of those five years. Imagine what he and we would have missed if we decided it was too much to handle!

I haven't had a chance to check... so is Lily taking any Cushings meds now?

Natalie

KittyDog
02-08-2009, 08:47 PM
Thanks...I needed that reminder that she will adjust. I think with all I have been through, I am just having a hard time dealing with it all too.

She is still taking cushing's meds. We are doing the trilostane. It was suppose to be 5 mg twice a day. The middle of the week we went back to 5mg. daily because she again became extremely lethargic and wouldn't even eat. I am beginning to think she needs about 6 to 8 mg total a day. 10 just seems to be to much. I am almost wondering if the diabetes isn't causing her to be on the low side of her cushings. I just don't know and don't understand enough about either one of the problems. I have lots of questions again tomorrow.

Oh and I think Lily is playing with us for sympathy about her blindness. All day long she waits and listens for us to tell her stop go the other way...ect. I caught her the other night coming and going out of the rooms with little problems. Still runs into things but once she does, she know which way to go. As far as steps..I am not sure she will ever be comfortable with the steps. She had problems going up and down steps before all her illness due to her knee caps popping in and out. I will keep my fingers crossed on that one! She doesn't like going out much either. I am hoping as I am able to bend over and put her down outside that this will improve. She has finally figured out when my DD has her. Her smell is becoming much stronger.

KittyDog
02-09-2009, 09:40 AM
Well I took her to the vets today and we are now going on insulin. Just love when they say they are going to do something and don't do it right away. They were suppose to call the insulin in...yeah two hour later that still hadn't called so I had to leave. It's the most I have done in two weeks...I am exhausted.

She will be getting 1cc twice a day and we are to check her BG too. He also thinks that her trilostane level is too high and we are now going to 2.5mg. twice a day and to use my judgment if we need to come down even lower. If she starts having more problems, he said we may have to switch to the other drug...which he really doesn't want to do. When she gets to doing better, then we will run the stem cell test again.

She is already acting better with that one dose of insulin. She is laying her have a good time chewing on her Dingo bone...even gave me a kisses for picking her up...lol she had gotten her self in a corner and didn't know where to go again.

Thanks again for all the great advice. I think Dr. Brown is happy too because I already new what he thought he would have to explain in details.

k9diabetes
02-09-2009, 07:59 PM
Their ability to adjust to blindness is just amazing... Most people who saw Chris out walking didn't realize he was blind - used to comment on what an unusual color his eyes were!

As I was telling Rick about Lucy, someone who hasn't ever had a blind dog won't know how well they usually do. It's so devastating for the people caring for them but most dogs just take it in stride.

Chris would have deeply mourned losing his sense of smell...

Natalie

KittyDog
02-10-2009, 09:11 PM
So how do you know if you get the insulin actually in the body? We are only giving her one unit. It is so little. We are using 3/10 cc short needles 30 gauge. We gave her the first shot and there was no wetness around the area.

Did we do it right? lol Such fun new stuff to learn.

Any help is more than appreciated.

eyelostit
02-10-2009, 10:15 PM
Sounds like you did it right, no wet fur, with those smaller needles it really helps with the wee doggies, if you check bg in am the bg may have gone down some, tho it may take a few days to show some results.

Sounds like Lily will get around fine with her blindness, Niki really does not bang into anything, unless we are playing soccer with her ball and she forgets where she is at the moment, but when bangs her head alittle its usually on the ottoman, since that sticks out, I usually roll or throw her ball in the living room, so at times she may just bump the ottoman, but other than that she gets around just fine, can jump up and down in my SUV, its just amazing what dogs can do.

Fishslayer
02-10-2009, 10:21 PM
Oh and I think Lily is playing with us for sympathy about her blindness. All day long she waits and listens for us to tell her stop go the other way...ect. I caught her the other night coming and going out of the rooms with little problems. Still runs into things but once she does, she know which way to go.

Sometimes I wonder the same thing about Lucy. We are pretty close to Lily's stage at the moment.

She walks into things but out in the open yard she runs & plays.

Today she put a classic Cattle Dog herding chomp on our poor GSD's hind leg. So she can see at least a little bit. And she had enough energy to go counter surfing this afternoon...:mad:

I also feel around for wet fur after injecting. Missing a bit is no reason to panic. I squirted some once (no idea how much) & was beside myself with worry till Lucy's morning test. It was higher than usual but not by much.


Rick

KittyDog
02-11-2009, 03:47 PM
Thank you! She has been great today until a little while ago. she is laying her breathing fast again. It makes me worry about her. Darn illness! :(

We Hope
02-11-2009, 04:01 PM
Have you an idea as to what her bg's are now?

KittyDog
02-11-2009, 04:57 PM
Just got a BG on her and it was 299. It was also time for her insulin.

At the rate we are wasting strips trying to get blood to come out, I don't think we will be able to test often. I think I stuck her 4 times before drawing blood. She was very stressed out by them. DH was covered in hair.

We Hope
02-11-2009, 05:02 PM
You can also try using the Ketodiastix to do some urine testing. It will give you some idea of how her bg's are doing unless/until you can work out some blood testing with the meter.

Some people can't blood test for one reason or another, so if it turns out like that for all of you, it's nothing to beat yourselves up about.

I think Lilly's doing very nicely with her couple of days on insulin! ;)

Kathy

dctexan
02-12-2009, 07:30 AM
Blood testing was also a challenge for Dixon. Not because I wasn't willing to do it, but because he just refuses to bleed. I tried the ear and inner lip repeatedly (much to Dixon's dismay) and could never get more than the tiniest pin prick of blood. Who knows why. The ONLY place I can reliably get blood is from the side of the pad that is on his "wrist" (for lack of a better word). None of the foot pads bleed, and the bottom of the wrist pad won't bleed. It HAS to be the side. I don't think this is a typical testing spot, but I wanted to put it out there in case it helps someone.

I've also started to be able to gauge whether the blood drop is going to be big enough for a valid test or not. If it isn't the only way to get a successful reading is to re-stick. It sucks, but it is less costly than wasting a test strip on too small a blood bead. Good luck!

Fishslayer
02-12-2009, 09:00 AM
Just got a BG on her and it was 299. It was also time for her insulin.

At the rate we are wasting strips trying to get blood to come out, I don't think we will be able to test often. I think I stuck her 4 times before drawing blood. She was very stressed out by them. DH was covered in hair.

The biggest problem I had was setting the lance deep enough. I was scared to death of hurting Lucy. Now I know that sticking her in the lip really doesn't hurt. Some areas just won't give up the blood so I stick 'er again. No problem.

You will also learn to judge how much blood is enough.

You'll get it!;)

Rick

eileen
02-12-2009, 04:45 PM
I find it easier to use the lancet in hand without the device as it gives me much better control without the hassel of the intrusive device or the noise. Also, NPH has an odor that smells similar to a bandage so not only do you want to rub your hand across the area if in doubt but if this odor is detected it is possible that all of the insulin did not find its way into the dog. Eileen

We Hope
02-12-2009, 04:53 PM
Some pets are put off and/or frightened by the clicking noise of the lancet device. I must confess to never being able to get the AccuChek one to work right for me and going to holding the lancet in my hand and doing the job when it came to testing my mother.

Also am gonna confess that I killed off the 10 strips that came with the meter in record time because it was either not enough blood or too much. :D

We were talking about how a little of the NPH preservative smell goes a LONG way recently here:

http://k9diabetes.com/forum/showthread.php?t=495&page=4

Lente insulin has a only one preservative in it, methylparaben, and it has no odor. NPH has two, phenol and meta-cresol, while R has meta-cresol in it. Both phenol and meta-cresol have a sort of odor.

Kathy

KittyDog
02-15-2009, 06:03 PM
Lily is starting to feel better..I think. She has had some good days here and I think the insulin is working. Her new Trilostane also came Friday and I must say it has been a breeze to get the liquid in her. They flavored it peanut butter her favorite treat. Hopefully we will see more improvement in her quality of life this week.

I am still seeing some heavy drinking and panting on occasions. I am still wondering if she doesn't have an infection still going own. When she is panting, her body is very hot. However we have also been warmer than normal in our area too. so the house has been about 6 degrees warmer.

We Hope
02-15-2009, 06:27 PM
Know panting can be a Cushing's sign--it can also be a diabetes one when the bg's are higher.

Sometimes with diabetes, you will see this panting, etc. happening not long after eating because of the post-meal rise in blood glucose. Getting regulated or back to regulation should make that go away.

When we had a vial of weak Lilly pork Lente insulin, Lucky started this two hours after eating--it was a visible sign of his post-meal spike in blood glucose because the insulin itself was too weak to manage his bg's properly. It took about 2-3 days with a better vial of insulin to get the panting two hours after meals to stop for good.

Most of the time, you will see higher bg's when there's an infection; it's also possible to see lower than usual ones with them too, similar to how you can either have a fever or have a below normal temperature when you have one. For many people caring for dogs with diabetes, getting unexpected high readings on blood or urine tests is the first sign that an infection may be brewing.

I think you will see more good things with Lilly this week as she adjusts to both the Trilostane and the insulin. While it is possible that she may still need the insulin to be increased somewhere along the way, I think Lilly's on her way! :)

Kathy

eileen
02-16-2009, 05:27 AM
Mildred will pant and have a runny nose when she's >300, she'll also seek out the cooler tile floor to lay on instead of her bed or the carpet. Eileen

KittyDog
02-16-2009, 07:15 AM
Thanks for that info. I will have to pay closer attention to whether she has had something to eat next time it happens.

We Hope
02-16-2009, 07:26 AM
As Eileen has just said about Mildred, Mildred can start doing the same thing even if it's not soon after food. It depends on whether Mildred has managed to somehow get into the higher bg ranges.

You do see this with some dogs when they get into the higher bg's, period. It's not strictly confined to a bit after a meal. It's more likely to happen after a meal because the bg's raise after eating, as the body starts digesting the food. After most to all of it has been digested, they start going back down again.

Kathy

eyelostit
02-17-2009, 03:25 AM
HI,
I get the panting at times usually an hour or two after the meal, then it will stop once the insulin kicks in

I just use the lancet itself for testing, the clicker thing just did not penetrate the skin enough to get some blood to test

Dolly

KittyDog
02-17-2009, 09:10 PM
Of course since I mentioned the panting she hasn't done it since. :D She is acting so much better and I feel sure she has put some weight back on. If I had the extra money I would take her in just to see.

Just makes me feel better seeing her a wee bit perky. Now I just have to get her confidence up enough to show her she can still play and have fun!

eyelostit
02-18-2009, 12:39 AM
I think even today or next day she should be perking up, she'll get back to herself again in no time.:)

ladysmom06
02-18-2009, 05:47 AM
Lily is starting to feel better..I think. She has had some good days here and I think the insulin is working. Her new Trilostane also came Friday and I must say it has been a breeze to get the liquid in her. They flavored it peanut butter her favorite treat. Hopefully we will see more improvement in her quality of life this week.

Hi Abby,

Happy to hear that Lily is feeling better. My little girl Lady also has diabetes and cushing's. She's been on insulin since Sept.06 and trilostane since March 07. She is doing really well - both diseases are under control and to look at her you would never know she has both diseases. Good luck with Lily. Hugs to the two of you.

Luv,
Lynne and Lady

We Hope
02-18-2009, 06:19 AM
Diabetes that's not yet under good control can make for weight loss. Cara had lost quite a bit of weight initially but now that she's regulated, she's managed to regain the weight she lost. Peggy's Forbin has regained most of the weight he lost, and is working toward regaining the rest.

Lily still has that spunk and eagerness to have fun; feeling better means she's going to feel more like it! :)

Kathy