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-   -   Annie: Diabetic with new Cushings diagnosis (http://k9diabetes.com/forum/showthread.php?t=7878)

katy1 03-14-2019 11:44 AM

Annie: Diabetic with new Cushings diagnosis
 
As a new member, and after reading the info regarding ďthreads, I still wasnít sure how to acquire one so Iím jumping in here to start with. Iím hoping someone will read this and either direct or move me to where my mish-mash postings and questions appropriately belong and I will be able to easily find any responses or make postings on a regular basis.

Today, Annie is at the vet having a glucose curve run. As I mentioned somewhere else, I donít test at home for numerous reasons and I have many questions I know can be answered somewhere here.

Iím already a member of the k9Cushings group and they have been extremely helpful for that part of Annieís profile. Now Iím finding out just how much I DONíT know about diabetes and especially the nomenclature used in posting. Iím an old dog too and am a bit overly zealous regarding the health of my remaining pup. We will meet briefly with the doc when we pick her up later and Iím hoping that he will approve her for a dental and she is scheduled to have cataract removal surgery in May. With all this in front of me Iím pleading for some guidance on this site. It visually appears to operate the same way as the Cushings site, but in reality, it hasnít worked the same for me. I have posted a couple of places and have gotten some replies however, I have not had much luck returning to my previous spot because I canít find it. I am not in any way, shape or form trying to be negative or critical. Iím convinced itís probably ďoperator errorĒ on my part but I need your help with my dual diagnosis pup. Thank you in advance for your patience, guidance and learned words of wisdom. Blessings to all. Karen [/SIZE]

jesse girl 03-14-2019 01:24 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Hi and welcome . Yes you want to post on your own thread which you have done . this way you keep all your info in one spot

I understand why you dont want to home test but its the best thing you can do to give your pup a safe happy life with diabetes

ask any questions you like and go through the info on the site . Its quite helpful

Most find the path of a new normal and flow into a routine that works for the individual dog and there unique circumstances

katy1 03-14-2019 02:22 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Thanks Jesse. Weíre about ready to pick up Annie at the vets and Iíll report back the results and Iíll ask for my own copies of recent tests run earlier this week. Iíll post here later. Karen

Raysaint 03-15-2019 09:49 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
As jessegirl mentioned, home testing is probably the most important thing a diabetic can do. A curve is good for seeing patterns and nadir, but blood sugar changes all the time, maybe not significantly, but every day can be different. Spot checks and fasting sugar is a good way to know what's going on.

labblab 03-15-2019 02:47 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Hi Karen <Waving!!!> :) :)

Iím a member here, too, and just saw your postings. Iím so glad you joined here at K9D! Iíll try to keep tabs on your thread here, as well as your thread on K9C, in case some additional Cushingís discussion comes up. In that vein, I noticed that another one of our ďdualĒ members, Judi, had added a reply to your original posting on the forum here. I donít know whether or not you had a chance to read her Cushingís comments, but hereís a link to your original posting. Once you click on it, youíll be able to scroll up (or down) to read all the replies that were posted to you there, including Judiís.

http://www.k9diabetes.com/forum/show...013#post167013

Iíll continue to watch for you on both forums!
Marianne

katy1 03-16-2019 07:30 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
Hi back Marianne! How nice to see a virtual familiar name. We took Annie to the vet on Thursday for a curve. She has been on 6 units of Novolin for the past week. She started out at 379, bottomed out at 209 about 1:00 pm and her last draw at 5:00 pm was 262. Doc told me it was a great looking curve, just not low enough across the board so he upped her to 7 units.

Now we have a new problem, for the past two days, she has not wanted to eat her breakfast. She is on Glycobalance, one can a day divided between her two meals. Yesterday, I ended up sprinkling some ground up freeze dried chicken breast on top and this morning, I used just a little bit of baby food turkey in broth and she picked around at that for awhile and finally ate everything. I'm scared to death for tomorrow though because it's her Lyso med day. I feel a call to the vet coming on as I type.

I remember seeing some info here regarding loss of appetite, but my big fear is that she may be getting a bit too much Lyso and it has really suppressed her food drive. Annie has never missed a meal in her life, even after bouts of HGE.

I'm going to post this on the Cushing site as well. Take care. Karen

Judi 03-16-2019 05:40 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
We've had some dogs that had some type of acid reflux in the morning that made them not want to eat breakfast. Your vet may suggest trying some type of antacid. yay, more pills

Hopefully it isn't her cortisol

katy1 03-16-2019 10:23 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Hi Judi,

The reflux thing didnít occur to me until you mentioned it. About a year ago,doc told me to give her 1/2 a Zantac when she was having some tummy troubles and I still have some. We ended up taking her in at 3:00pm today and thankfully, OMGó-all her numbers were good. Doc checked her bg and it was only 119 and then he was trying to explain what the electrolyte panel meant regarding the Cushings.

I was crying all the way there and crying the whole time doc was
talking to me. He knows Iím a crier and gave me a hug and told me that I was doing a good job with Annieó-to which I replied, But iím not, I donít feel like I have a good handle on the situation. He had told me earlier through a tearful plea, that as long as she had some ďgroceriesĒ in her system, even if it took a couple of hours, I could give her insulin.

He said he would set me up soon with one of his techs to teach me how to test Annieís bg at home. Anyway, I left the clinic still in tears, because my baby was ok, but also with a huge sense of relief that doc understood where my exaggerated concern was coming from.

He also knew that I was scared to death that her cortisol had dropped below range, which it hadnít as he could tell from her electrolytes. He said to me, ďjust watch her like I know you always do. If youíre scared itís okóI get it and reach out to your support system. ( Heís totally on board with the k9 forums.). Anyway, thanks for listening. Blessings to you all and your beloved pups. Karen

Judi 03-17-2019 08:16 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
your vet sounds like a good one. It can be so overwhelming when they have multiple issues. I cried a lot too.

I finally revamped my thinking and just focused on if Jenny was happy. Our goals were to 1. not kill her and 2. keep her fairly happy

It's easy to start obsessing over perfect #'s. You have to be aware and alert and it sounds like you are but I really feel it's important to take a deep breath and love your dog. She knows you love her and are doing everything you absolutely can.

Hang in there. These forums are an excellent place to vent because we get it.

xoxo Judi

Judi 03-17-2019 09:43 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
one other rule a lot of us have followed around here is if she eats half of her meal, give her half her dose of insulin

if she barely eats anything maybe give her 1/4

once you are testing blood sugar that will be easier to do but with each dose of insulin, part of it is to just cover their normal system and part of it is to counteract the food.

katy1 03-18-2019 12:55 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Oh man Judi, you hit the nail on the head!

The goals you mentioned are mineó-I just donít want to kill my baby.

katy1 03-19-2019 09:24 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Judió-Well, itís 10:50 pm in my part of the word and Annie just finished eating less than half of her normal food. She hadnít eaten since last night and I now have your insulin dosage suggestions burned into my brain. An hour ago, she was still not really moving, so I through caution to the wind and gave her 1.5 units of insulin after reading here about the dangers of ketoacedoses (sp?) After about 20 minutes, and I donít think I took a breath the entire time, she wanted to go outside. While she was out, I opened a can of food for her and doled out less then half of a regular meal. I didnít want to overwhelm her little tummy but she just inhaled her food and after about 20 more minutes, I gave her an additional 3.5 units of insulin. She had a total of 5 units of insulin which is 2 units less then normal, but I also gave her less food.

Anyway, now Annie finished a big drink of water and jumped up on the couch and is snoozing peacefully in her favorite spot. After this fret filled day, the baby is fed and asleep, hubby just turned off his light and Iím probably going to be up the rest oof this night reveling in the fact that everyone is ok for right now. Hugs and Blessings to all. Karen

Judi 03-19-2019 11:28 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Aw. This is a real positive step! Give her a kiss from me and try to get some rest. You are doing great! Xo

katy1 03-21-2019 07:01 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
Good Morning All, Annie has finally bounced back from her dental. Iím really glad I rescheduled her groom to next week. The less stress the better right now!

Iím now faced with a new problem. I want to keep her newly cleaned choppers clean but I canít find a canine toothpaste for diabetic dogs that doesnít have a bunch of artificial everything in it. I know to stay away from anything that has xylitol in it. From what Iíve read, sorbitol is supposed to be ok but that stuff bothers me physically. My doc had nothing to offer and told me to start looking on-line. Any suggestions please? Blessings to you all. Karen

jesse girl 03-21-2019 08:24 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
Zymox puts out some good products and one of them is Oratene brushless oral care toothpaste gel .

LizE 03-21-2019 08:47 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
I brush my dog's teeth every day because she is not a candidate for a regular dental cleaning. For years I used Virbac CET enzymatic toothpaste. Snickers really liked the taste of if. I switched her recently when she was having some stomach troubles because I thought maybe she developed an intolerance to one of the ingredients (she hadn't, she had pancreatitis). She is now using Petrodex enzymatic toothpaste. Both seem to work equally well.

I think the benefits of regular brushing overcome the potential problems from exposure to toothpaste ingredients. Plus it really does help with what my son calls "mummy breath" with Snickers.

katy1 03-21-2019 09:51 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
Thanks for the suggestions! If those have worked for your pups without effecting glucose they should be good enough for Annie. Blessings. Karen

Raysaint 03-21-2019 12:23 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
And I believe Dechra makes a brand called Vetradent. Vets use them a lot. Just read the ingredient list.
I just ordered the wipes for my other dog, who has bad dental problems.

amydunn19 03-23-2019 07:45 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Zymox is Oratene now I think. It fights the dry mouth that many dogs develop and it can make teeth really bad. It causes so much build up on the teeth. Oratene was developed by the scientists who cameup with Biotene for people. I highly recommend all their products. Maggieís teeth improved greatly after I started using it. Also, if you donít want to use a gel or paste, if you can get a finger brush and at least get the food particles trapped swept out. It will help.

katy1 04-14-2019 02:55 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Well, I’m back for more advice from you wonderful folks. Annie has cataracts and she is going in for double cataract with lens replacement on May 17th.

Does anyone here have experience with cataract surgery? We are finally stable on her insulin. She’s on 7 units 2xday after meals. She is eating 1/2 can glycobalance twice a day plus a few freeze dried chicken breast bites. She had a fructosamine test last week and the vet said it was normal. Sorry I don’t have numbers yet. I also still have not learned to test at home.

I’ll wait for a response then ask more questions. Blessings to you all and your pups. Karen

MikeMurphy 04-14-2019 04:51 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Hi Karen,

My Lily had successful cataract surgery back in 2014 and her sight and eye health is still very good. She still gets a daily non steroid anti inflammatory eye drop and visits the opthalmologist every 6 months.

Lilyís opthalmologist monitored her blood glucose during the surgery. Be prepared to follow a very strict regiment of eye drops following surgery.

Best of luck with the surgery.

katy1 04-14-2019 05:44 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
My next question is, how tough is the post surgical careóI mean the day of the surgery or evening of.... We live 2.5 hours away from the surgeon and we will be in a motel the night of the surgery so we can take her in the next morning for a check-up.

I know sheíll be in a cone for a week and sheís never had to wear one before so Iím just freaking out about all these unknowns.

Iíd be asking the surgeon herself, but she is recovering from her own surgeryóhad to have her right foot rebuilt and is in sole practice. She wonít be back in her office until a week before Annieís surgery.

It is encouraging to hear that your Lily is doing so well. I appreciate your input.Blessings, Karen

CraigM 04-14-2019 08:09 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
My Annie also had cataract surgery to both eyes. The surgery was successful in one eye, but she lost vision in the other eye. In hindsight I wonder if I just wasnít attentive enough. Be prepared for follow up appointments that may add up to real $$$. Hopefully, your Annie wonít have the problems my Annie did. As Mike mentioned, expect several eye drops / ointments that are administered at different times. At one time, she was on 7 or 8 medications that I needed a matrix to remember the various scheduling😁😁.

I hope Iím not scarring you, because many pups make it through without problems.

Annie eventually went blind to glaucoma at around age 15-16 (Iím not remembering and you can check her thread). This is hard to believe, but I really think she had a better life after she went totally blind! She still went on walks and folks didnít believe she was blind. She DEFINITELY could find her food bowl😁. We had good times playing ďhide and seekĒ😁

Craig

MikeMurphy 04-15-2019 06:26 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
In regard to post surgery care and the whole process, take a look at what Lilyís opthalmologist has to say... http://www.animaleyecareofwny.com/re...cataracts.html

Your surgeon may be less stringent.

katy1 04-18-2019 07:44 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
We ran into a major road block this week. On Sunday, Annie was as spunky and more playful then we’ve seen her in years. Then, Monday she started vomiting bile so we got her to our vet ASAP. He ultrasounded her and found that her gallbladder was twice the size of a normal one. She also had pancreatitis so they kept her, stabilized her and we drove her to a vet specialty clinic in Chicago. The surgeon removed her gallbladder and filled with a mucocele today, and so far, she is holding her own.

Everything is now up in the air regarding her cataract surgery. I’m almost positive we are going to have to postpone it again.

Thanks for your information from your ophthalmologist—pretty much the same and I started using all the drops and salves to keep her eyes in the best shape possible. I just hope we will be able to keep her blood glucose stabilized once she is released from the hospital. This has just been a nightmare! Blessings to you all and your pups. Karen

jesse girl 04-19-2019 06:40 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
Wow have not heard of emergency surgery to remove a gall bladder on this forum . My jesse was spayed after emergency surgery for a uterus infection when she also was diagnosed diabetic , DKA and pancreatitis .

Pancreatitis is a complication of diabetes and can be a cause . On rare occasions it can spark the pancreas to work again mostly in a short term so watch blood sugar the need for insulin may need to be reduced temporarily .

hope Annie gets well soon

katy1 04-19-2019 03:32 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Hi, Just a quick update on Annie. We visited her at the specialty clinic in Chicago this morning. We expected to be taken back to the ICU to see her but low and behold, they led us into an exam room and shortly after, in waddles Annie on all fours lugging her heart monitor and still sporting the feeding tube. We just cried for joy!

She is starting to eat baby food and a few small bites of chicken. They are going to let her eat anything she wants and regulate her insulin as needed. I’m sure I ‘ll be given a boatload of instructions regarding her diabetes and insulin regulation when she is released.

This is a very specialized surgery because the liver can also be involved. Our surgeon has preformed hundreds of these surgeries with an 85% success rate. Cushings can cause these mucoceles to form inside the gallbladder. The fact that she had sudden onset pancreatitis didn’t help.

We also met with an internist assigned to her case, not only for the diabetes but because she has cushings. She will need to be on a very low fat diet once she is home. The doc said she eventually wanted her back on the Glycobalance which I was glad to hear.

Annie may be well enough to come home on Sunday or Monday. She has had no complications so far but I think we got her there in time and were very lucky. So far, she is our little miracle with all the strikes against her. Blessings to you all and your pups. Karen

jesse girl 04-19-2019 06:18 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
glad things seem to be going in a positive direction and hope you can get Annie home soon

katy1 04-28-2019 04:04 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Annie continues to improve everyday. She will get her 33 staples out next Thursday. Our regular doc checked her out this past week to make sure that everything was on trackó which she is. Her doc also bumped up her food intake from one can of Glycobalance per day to 2 full cans to put some weight on her. I have no idea what this is doing to her bg levels. Before all this happened, she was well controlled on 7 units twice a day on just 1 can of food. After the surgery they had her on 5 units. With doubling her food intake I have bumped it back up to 7. She is handling that just fine.

Iím sure weíll have many adjustments to make going forward. We had to postpone her cataract surgery for obvious reasons but also the eye doc had foot surgery and had some complications. This has just been overwhelming!

On the advice of the wonderful people on the cushings site, we bought her a play pen to contain her as she was starting to jump on the couch and was just too active for her own good right now. She is not a happy camper but we donít have much longer to go. Blessings to you all and your pups. Karen

Raysaint 04-29-2019 04:51 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
Are you not home testing? Doubling her food will surely affect her sugars. You could be testing and adjusting the dose once a week as needed.

Does the vet want her to stay on 2 cans a day? Her weight might climb too much and then youíre cutting it back and adjusting again. Dogs will usually slowly put weight back on once their ordeal is over.

katy1 04-29-2019 08:42 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
I have to admit, that I do not test at home. I have to rely on my vet tech for that. I’m not sure how long he will keep her on the current amount, but the weight she is at, Royal Canin recommends 1 2/3 can so we just rounded it up.

Raysaint 05-02-2019 06:41 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
I think most believe that home testing is so important. It lets you have more control over the management. And it saves you trips and money.

katy1 05-08-2019 08:11 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Annie had a bg curve today and as a result, doc raised her insulin from 7 to 8 units 2x a day. They will do another curve next Thursday.

If anyone is interested, I Ďll be happy to post numbers. Doc said the curve looked good but it was too high. Blessings to you all. Karen

jesse girl 05-09-2019 07:11 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
Yes you can post the curve and we can have a look see

katy1 05-09-2019 09:56 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
Annie's curve based on 7 units of insulin. Doc has bumped it up to 8.

8:50.............438

9:46.............344

10:49...........259

11:48...........213

12.51...........232

1:57............229

3:00............267

4:00............290


Thanks for any input. Karen

jesse girl 05-09-2019 10:13 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
one unit is reasonable

MikeMurphy 05-09-2019 12:36 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
Nice curve! Sheís making good progress:)

katy1 05-11-2019 11:01 PM

Re: Annie: Diabetic with new Cushings diagnosis
 
I have a question. Does Lysodren have any effect on insulin in a dual diagnosis pup? Annie is currently on 250mg of Lysodren 2x per week and was just bumped up to 8 units of insulin 2x a day after meals, but her food intake has doubled also........just curious if there is any connection between the Lysodren and insulin.

It’s so frustrating sometimes to have to come here to get info for her diabetes and then have to source the k9C site for her cushings. I feel like I’m the only person in the world with a dual diagnosis pup. I apologize for th little rant.

I’m truly grateful my little baby is still alive and thriving after everything she has been through over the past month. I’m talking about a 10 year old miniature schnauzer, diabetic, pancreatitis, gallbladder removal surgery and the list goes on.

Blessings to you all.

labblab 05-12-2019 07:05 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
Hi Karen! It’ll be great for the folks here to also add their insight. But from what I understand about dual diagnosis dogs, I believe this is the relationship. Excessively high cortisol levels in the body can fuel elevations in glucose levels, as well. When cortisol levels are high and uncontrolled, it can be difficult to effectively reduce glucose levels, even when giving increasingly higher doses of insulin. Insulin resistance of this type can be one of the diagnostic indicators that a diabetic dog may be suffering from Cushing’s, as well.

Once the elevated cortisol of Cushing’s comes under therapeutic control, then the glucose level and insulin requirement will likely be reduced, too. Any medication that lowers cortisol — be it Lysodren or trilostane — will have this effect. So it’s an inverse relationship: As Lysodren or trilostane doses are increased, insulin needs may be reduced.

In Annie’s case, her maintenance Lysodren dose has remained unchanged since March. Per her recent ACTH test, her cortisol level has increased a bit during this time, but not enough that I would think it would noticeably affect her glucose level or insulin needs. But this is one of the reasons why I think it would be good to have her cortisol level rechecked in about a month. There are so many interlocking pieces to the dual diagnosis puzzle that it’s important to monitor lab results on a regular basis so that medication doses can be altered in a timely fashion. If her cortisol level continues to rise on the unchanged Lysodren dose, that could account for ever higher glucose readings, too, and the need for more insulin.

Marianne

jesse girl 05-12-2019 07:45 AM

Re: Annie: Diabetic with new Cushings diagnosis
 
As Marianne suggested There is a symbiotic relationship between the 2 diseases

You are seeing a good response from insulin without a high dose that may point to cortisol levels in an adequate range

Actually its quite amazing the response you are seeing from insulin and hope that continues but expect ups and downs thats the nature of the disease


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