Rustybutt

[Deniselaine]

Hi, My name is Denise and Rusty my Australian terrier is 13 years old. He has been living with diabetes for 2 years. I have been having problems regulating his blood sugars and my vet thought he may have Cushing's disease. The vet said that she would not recommend treatment as it is hard on the pet and considering his age thought it would be a lot to put him through. Rusty wants to drink a lot of water but then cannot hold his urine and I am also having problems with accidents with his bowels. I have been limiting his water to 3 cups a day. It seems he does not really process the food, it just goes right through him, and he has lost some weight. Is this normal for these diagnoses? I wonder if he is suffering through all this as his outward appearance seems to be fine although I know he is not feeling “great’. Also I know that his insatiable thirst for water is stressful for him.

He gets 2 shots a day 24 units of Humulin N in the morning and 23 units at dinner.

Please write if you have any suggestions or comments.

Sincerely, Denise

[CarolW]

Re: Rustybutt

Hey, Denise - a big fat welcome to you!

Please do NOT limit the amount of water Rusty drinks! Diabetics need to be allowed all the water they want.

I AM struck by what looks like a HUGE insulin dose for Rusty. How much does Rusty weigh? Is he big for an Australian Terrier? How tall is he at the withers, for instance (approximately)? My two are a bit on the large side; bigger than the standard. Kumbi, the diabetic is about 13" (if I remember right; I should re-measure him; it's been years), and Kwali, about 12" (need to re-measure her, too).

Kumbi weighs 20 pounds (or just short of that); a perfect weight for him. Kwali is very slightly chubby, at 22 pounds.

Kumbi is on Novolin-NPH insulin, and his dose is 6.5 units, which has been stable for the last year or so; no changes required.

When was the last BG curve done on Rusty? Do you have some figures you can post? I'm wondering if something in Rusty's physiology is fighting his absorption of insulin, or what! ("insulin resistance"?) Where on his body are you injecting insulin?

I'll let our more expert people weigh in on this. Delighted to find you and Rusty here! Kwali will be 14 in April; she had a mild stroke mid-June past, but recovered quite nicely; Kumbi is in glowing good health.

Sun, 8 Feb 2009 09:32:17 (PST)

[k9diabetes]

Re: Rustybutt

Hi Denise,

If Rusty has Cushings I would treat him... more on that in a minute.

I am concerned about the weight loss and your feeling that the food is going right through him. That would not be typical of Cushings or diabetes but makes me think of something more along the lines of IBD or protein losing enteropathy.

I'm acquainted with someone who has a Tibetan terrier who was diabetic and was being diagnosed with Cushings... his symptoms were very similar to what you describe in Rusty.

But the Cushings diagnosis was at best questionable and really the least of his problems. She took Oreo to a new Internal Medicine specialist who, wisely in my opinion, ignored the concerns about Cushings and focused on the digestive/weight loss problem instead. Testing showed Oreo had protein losing enteropathy. He never was treated for Cushings. A drastic change in his diet made marked improvement to his symptoms.

Do you have access to a speciality clinic that would have an internal medicine specialist? I'm sure Rusty could benefit from the greater experience with these types of disorders.

If Cushings is accurately diagnosed, I would definitely treat it. I'm associated with a Cushings forum very much like this one and you will see dozens of dogs there currently being treated very effectively and feeling so much better! www.caninecushings.net.

Treating Cushings does require an experienced vet and it sounds like your vet is not experienced with it. That's a second vote for an appointment with a specialist.

But I am not convinced that Cushings is the primary problem that needs attention. Rusty sounds so much like Oreo that I suspect something else entirely is involved and I think you will need a really experienced vet like an IM to help you sort out and treat whatever it is.

Natalie

Hi, My name is Denise and Rusty my Australian terrier is 13 years old. He has been living with diabetes for 2 years. I have been having problems regulating his blood sugars and my vet thought he may have Cushing's disease. The vet said that she would not recommend treatment as it is hard on the pet and considering his age thought it would be a lot to put him through. Rusty wants to drink a lot of water but then cannot hold his urine and I am also having problems with accidents with his bowels. I have been limiting his water to 3 cups a day. It seems he does not really process the food, it just goes right through him, and he has lost some weight. Is this normal for these diagnoses? I wonder if he is suffering through all this as his outward appearance seems to be fine although I know he is not feeling “great’. Also I know that his insatiable thirst for water is stressful for him.

He gets 2 shots a day 24 units of Humulin N in the morning and 23 units at dinner.

Please write if you have any suggestions or comments.

[CarolW]

Re: Rustybutt

Denise - I think Natalie is making good suggestions. I have another to add. Go get yourself a copy of a fairly new book called _Speaking For Spot_, by Dr Nancy Kay. You can find more information about it here:

http://www.coherentdog.org/links.php

I think this book would make a useful upplenent to the informatin you're getting here, and help you work out a focus.

I do think there's something very odd going on, and it's a good idea to find out what it is!

Sun, 8 Feb 2009 10:26:13 (PST)

[k9diabetes]

Re: Rustybutt

Looks like an interesting book... http://www.speakingforspot.com/

[rhodesian46]

Re: Rustybutt

Hi and Welcome Denise,
What kind of food are you feeding him? Are you adding any veggies and how much? How much does he weigh? Any blood work done recently? Can you post it? PLease let him have as much water as he wants. Are you home testing? ANd if so how often?
I agree with non this one An internal med specialist is more qualified to treat cushings and diabetes at the same time ALso if it is not the food that is making him have loose stool an IMS has more experience with this. PLease give us a little more details
Also always have a special folder with all of his tests and Dr's notes just in case of emergency.

[k9diabetes]

Re: Rustybutt

We LOVE details so as much as you can tell us about Rusty's regulation, testing, etc. would be great.

I have all of my pet's test results faxed or mailed to me as soon as they are available and keep a file of them so that I can refer back and also read them and understand them myself.

Since Rusty seems to look good, that's another indicator that Cushings may not be the problem. So I'll be very interested to see how his blood glucose regulation has been and how you are monitoring it.

Natalie

[Deniselaine]

Re: Rustybutt

Wow, I can't believe the overwhelming response. Thanks!!!

First on the agenda is that if I did not limit his water intake I would be cleaning up after him 20 times a day. He just stops and goes. I was getting up in the morning with my entire kitchen covered in urine.

I feed him Prairie Dog Food. They make it here in Nebraska and it is a superior dog food. He gets a cup a day.

Rusty weights about 21 pounds. My other dog Chili also had diabetes and he gets 21 units of insulin BID and has been on that dose for years. The vet said it is a lot of insulin but he needs it.

The reason she thinks he has Cushings is that his blood sugars are all over the place. Yesterday it was 96 at 11:30 am and then at 6:00 pm it was at 331. He also has skin problems and this is pretty normal in Cushing dogs. He has lost a lot of fur and gets yeast infections on his skin. Poor boy!

[acushdogsmom]

Re: Rustybutt

Hi Denise,

I received your PM and thought it might be better to reply to you here.

By the way, I think you are doing just fine in the finding-your-way-around-here department.

This is a terrific place to learn everything you need to know about managing a dog with diabetes. And I think the most important thing for right now would be to concentrate on the diabetes.

If it does turn out to be that your dog has Cushing's too, the Cushing's board that Natalie mentioned to you is a great place for people with Cushing's dogs to learn what they need to know about Cushing's (and they are really friendly over there too)

Natalie already gave you the link for their home page. Here's a direct link to the forum there: http://caninecushings.net/forums/index.php

My dog passed away a couple of years ago ... he didn't have diabetes but he did have Cushing's. We treated his Cushing's after leaving our original Vet who told us that the treatment was "worse than the disease" and then finding a Specialist who told us that a properly treated Cushing's dog should live out a normal lifespan for the breed with an excellent quality of life. In my opinion, the outcome of treating a dog for Cushing's has a lot to do with the expertise of the Vet who is directing the treatment. If they know how to dose and monitor the treatment properly and if they know that it can be done successfully and how to do it successfully and with a cooperative owner as a partner, the outcome is bound to be way better than if the Vet doesn't even believe that the treatment will help the dog. So you really might need to find an Internal Medicine Specialist to work with (you may need a referral from a GP Vet to get in to see a specialist but if you want a referral then the vet has to give it to you)

My boy did wonderfully for more than 6 years with Cushing's. He was treated with a drug called Lysodren. Back when we started Lysodren was the only really effective choice, but there is now another drug called Vetoryl/trilostane that is also very effective for treating Cushing's. And for the record, I never found the treatment to be "hard on him" at all. In fact, after starting the Lysodren treatment you would never have even been able to guess there was a thing wrong with him! My boy's Cushing's symptoms all disappeared and he practically got younger right before our eyes! Bouncing around here wanting to play again (I really never thought I'd see him doing that again!) and looking and feeling perfectly well again too.

We did have to monitor the treatment with a blood test every 4-6 months and make a few dose adjustments along the way, but I wouldn't call that hard on him at all. A bit of a workout for my credit card maybe, but not hard on my young again, healthy-looking and acting little Bichon.

For now, I'd say you should work with the folks here on the diabetes part. They'll be telling you to look at the possibility of Cushing's and treatment for Cushing's if they think you need to do that.

There are several folks here who have dogs with both Diabetes and Cushings and some of them are also members over at the Cushing's message board.

You are in good hands here!

[We Hope]

Re: Rustybutt

Wow, I can't believe the overwhelming response. Thanks!!!

First on the agenda is that if I did not limit his water intake I would be cleaning up after him 20 times a day. He just stops and goes. I was getting up in the morning with my entire kitchen covered in urine.

I feed him Prairie Dog Food. They make it here in Nebraska and it is a superior dog food. He gets a cup a day.

Rusty weights about 21 pounds. My other dog Chili also had diabetes and he gets 21 units of insulin BID and has been on that dose for years. The vet said it is a lot of insulin but he needs it.

The reason she thinks he has Cushings is that his blood sugars are all over the place. Yesterday it was 96 at 11:30 am and then at 6:00 pm it was at 331. He also has skin problems and this is pretty normal in Cushing dogs. He has lost a lot of fur and gets yeast infections on his skin. Poor boy!

Diabetics are prone to infections--it's because diabetes affects one's immune system. This makes anyone (no matter how many legs they have) more prone to all types of them.

Seeing the 96 at 11:30 AM and then 331 at 6 PM makes me wonder if there's not some rebound going on here.

I'm seriously wondering about the Cushing's because when Rusty gets down to 96, you ARE seeing response to the insulin.

This is what insulin resistance looks like--it can be caused by not enough insulin, by Cushing's or other endocrine diseases, and by immune-mediated insulin resistance. Regardless of the cause of the resistance, this is basically how it looks when you graph out a curve.

This is what Somogyii rebound can look like. You see the blood glucose going down in response to the insulin, and then you see it hitting a low. This triggers the counter-regulatory hormones like cortisol, and they respond by sending the blood glucose back up. The trigger is in all of us and it's automatic. It's the body sensing that the blood glucose levels are dropping at a faster than normal rate, so the body sends the signal for the counter-regulatory hormone to raise the blood glucose levels--this is the body's "fail safe" mechanism to save itself.

I think if you would consider switching Rusty to a dog food which has more fiber in it--this can be either one of the prescription brands or one of the non-prescription "Lite" or "Senior" varieties (they usually have more fiber in them for keeping weight off), you would find Rusty to have more "predictable", stable bg's.

I'm also going to suggest contacting an internal medicine specialist in your area because there could be other issues such as gastrointestinal ones or possibly diabetes insipidus going on with Rusty in addition to his diabetes mellitus. Here's how:

http://www.acvim.org/websites/acvim/index.php?p=3

American College of Veterinary Internal Medicine specialist finder. When you look, make sure you pick "small animal" because they consider large ones to be animals like cows and pigs.

Hoping this is at least a start,

Kathy

[Deniselaine]

Re: Rustybutt

Most of the testing I have done myself regarding BS, he has a granular wart that I get the blood samples from. Actually the vet has not done any tests other than the bs due to the diabetes running in his family. The only other test she wanted to do was for the Cushing and it was $300.00 and she did not recommend treating so what was the point. She had also suggested that I would have to put him down and that's when I knew I had to find a better way.

I don't know of any specialists around here but will check into it.

What food do you suggest? I don't know if you have heard about the Prairie but it is supposed to be one of the best out there with whole grain. It was one of the few that was not on the recall a while back.

As far as testing goes I do random checks. I can usually tell if he is not feeling well and start testing.

So far I have been lucky that he has not got cataracts but I have been pretty aggressive with treatment as Chili got them right away and we took him to the University of Kansas for eye surgery so he could see again.

You all have given me so much information, thank you so much. Looks like I have my work cut out for me! I will call tomorrow and run this by my vet and see about a specialist.

[We Hope]

Re: Rustybutt

You can look up a specialist yourself at the ACVIM link and you don't need a referral from anyone to see someone on their list.

We used Hill's Prescription Diet W/D canned--we have some people here who are using other prescription foods for diabetes, and we have still others who are using things like Science Diet Lite and have had good results with that.

Keep us posted about Rusty!

Kathy

[Deniselaine]

Re: Rustybutt

I just went to the site and did not have any luck. I looked for small animal in Lincoln Ne and it did not come up with anything. I must be doing something wrong. I am not the best at this and am trying to learn at warp speed.

[We Hope]

Re: Rustybutt

I don't think it's you. I tried asking for Small Aminal specialists in Nebraska and got someone in New Jersey--twice.

http://www.acvim.org/websites/acvim/index.php?p=3

If you require further assistance please contact the ACVIM office, ACVIM@ACVIM.org.

I'd e-mail them, telling them you're in Lincoln, NE and asking about a specialist in your area for Rusty.

Kathy

[Deniselaine]

Re: Rustybutt

Kathy, I can't thank you enough for all the information. This gives me new hope for Rusty. I will be getting some new food tomorrow and getting in touch with my vet.