Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

[chasing_bella]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Yes. The hair on her back & on the sides are really thin. Her skin pigmentation has gotten a lot darker, and she has some whitish color moles on her back & sides. She has always been a really itchy dog. We ruled out food allergies & pretty much determined it was environmental (4 yrs ago).

I started noticing her hair thinning last year and with her prior health history requested diabetes & cushing's testing. The tests came back negative. She has always been a polite lady when taking treats from my hand, now you have to drop it on the floor or she'll take your hand off. I just bought a "Break-fast" bowl to slow her down when eating. I posted pictures (album section) if you want to get a better look at her. As far as appetite.... Bella loves to eat, but she's been that way since she was young.

I just shaved her back down so it would be easier for me to see what I'm doing when giving her the injections. You can see the discoloration on her paws from chewing.

I had my husband stop and buy the Bayer Ketostix today. I'm going to monitor her urine at least.

BTW, I just watched the video of you home testing Chris. He was such a handsome fella (sorry for your lost). If or when it comes to that, it's going to be a wrestling match from hell.

Sam

[k9diabetes]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Bella's not likely to cooperate, huh?

Chris didn't fight me but he didn't cooperate at first either. He would fidget and lick his lips... we were quite the sight!

Cushings usually will cause the insulin dose to rise, rise, rise and the blood sugar to never get much below 300. Some dogs stay at high BG levels with uncontrolled Cushings. Others will respond for a week or two to a higher dose of insulin and then, like clockwork, bounce back up into high blood sugar again.

Once a dog gets to about 1 unit per pound and still is nowhere near good blood sugar levels, they are technically labeled as resistant to the effects of the insulin and this is typically a give away that Cushings may be involved.

When you test for Cushings, I suggest, if you can afford it, that you do a full blood panel sent to the University of Tennessee Knoxville to check all of the various hormones that can cause Cushings. Cortisol is what they usually test for but atypical Cushings looks just the same on the dog but is caused by elevated sex hormones. The UT panel checks it all. It is conducted just like the ACTH but then sent to them to process. So same number of tests for Bella but covers more potential causes of Cushings. You could have had the Cush test before but have atypical Cushings causing her symptoms and the regular ACTH wouldn't catch that.

Natalie

[eyelostit]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Hi Sam & Bella Welcome

I'm glad you are going to start urine testing.

My first vet just did one reading per week and based the insulin dosages on that one reading, it was really the wrong thing for the vet to do.

You'll get the hang of this and be home testing in no time.

Dolly

[chasing_bella]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

When you test for Cushings, I suggest, if you can afford it, that you do a full blood panel sent to the University of Tennessee Knoxville to check all of the various hormones that can cause Cushings. Cortisol is what they usually test for but atypical Cushings looks just the same on the dog but is caused by elevated sex hormones. The UT panel checks it all. It is conducted just like the ACTH but then sent to them to process. So same number of tests for Bella but covers more potential causes of Cushings. You could have had the Cush test before but have atypical Cushings causing her symptoms and the regular ACTH wouldn't catch that.

Natalie

Does the University of GA do full panel blood work for Cushing's or just University of TN @ Knoxville? Just wondering since I live in GA and UGA is about 1 1/2 hrs away. If not, when it's time for testing, I'll request it be sent to TN. How long does it take for the results to come back? As far as cost.... let's see, in last 2 years, I believe we've spent close to $4000.00 bucks on Bella (not to count the other 5 we have). The things we do for our fur babies. Worse case, I could start pawning family heirlooms

Sam

[k9diabetes]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

I LOVE UGA!!! Truly, I have seen them do exceptional work with a diabetic dog and they are at the top of my list of vets schools. So I think you are really lucky to be so close to them.

I believe UT is the only place currently doing this test. The guy who is responsible for it is Dr. Jack Oliver, who is a saint in the view of all of the folks I know dealing with Cushings. He takes time to answer individual owners' emails.

So your local vet can get the instructions from UT and take the pre and post ACTH blood samples and then ship them off to UT. I think it takes a few weeks to get the results back.

It's actually not that much more expensive than a standard ACTH and you get a lot more information. I thought of it with Bella because the vet feels Cushings is a possibility given some clinical signs but the cortisol test came back negative. So atypical Cushings is a possiblity.

Bonnie, user bgdavis, is a poster child for atypical Cushings. Her dog Crissy Ann, who passed away this year, was a screaming case of Cushings to look at her but kept coming back negative on the standard tests. They finally discovered she was atypical and once they started treating her, she got all her hair back... got her life back! I'm actually going to post some pictures of her later today so will give you a link to them.

We have a "sister" forum for Cushings in dogs that you might find interesting. They have a large reference section. www.k9cushings.com.

Natalie

[k9diabetes]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

I just added Crissy Ann's photos to her story in the Stories Section.

http://www.k9diabetes.com/forum/show...?p=451#post451

It is hard to look at that first photo... poor Crissy looks so miserable! But fortunately it's followed by her recovered picture, which is gorgeous.

Natalie

[chasing_bella]

Re: Isabella Kelly (UTI)

Just curious, Bella's been on Baytril for an UTI. She finished her last pill yesterday but still has to pee often. Tinkle here, a tinkle there. Her water consumption has slowed down a lot, but she still drinks often (which the vet told me she might do- waiting to test for Cushing's). I'm just concerned- with the water consumption, I expected her to have longer streams of urine. Wouldn't the Baytril have knocked out the infection already?

[We Hope]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

When the UTI was diagnosed, did Bella have a urine culture? There are times when it's difficult to get rid of an infection with those who have diabetes, because the diabetes affects the immune system.

If you believe Bella still has the UTI, I think I'd ask the vet to check the urine with a culture. Sometimes this is the only way to find infections which give few "clues" as to their either being there or still being there.

We had this happen with my non-diabetic recently. He'd used Clavamox for his UTI, and from outward signs, it appeared to be gone. In the meantime, I saw him pass a drop of blood; the results of that was he had bladder stones and needed surgery.

After the surgery, the urine culture said that the Clavamox didn't get rid of the infection entirely. By doing the culture, it also indicated that Baytril was a better antibiotic choice for getting rid of that particular bacteria.

HTH!

Kathy

[peggy0]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Forbin had to be cultured as well. He was on Baytril last UTI and needed Clavamox. My vet always starts them on Baytril, cultures and then if need be switches over to another antibiotic that will get to the bacteria.

[chasing_bella]

Re: UTI follow up

Bella & I just got back from the Vet. She's gain 2 lbs. Blood sugar/urine good to go. Insulin is doing it's job. She's schedule for Cushing's testing tomorrow. We discussed the different tests for Cushing's. My vet will be sending blood work off UT@Knox. if she doesn't test positive. He wouldn't confirm or agree at this point that she might have it, but said he would be very surprise if the test came back negative (he did indicate all the physical signs are present). So first test is ACTH Stim test. If no positive result, she comes back for low dose dex test, if still no positive results, blood work will be sent to UT@Knox.

So, hopefully I'll know what's going on tomorrow. Thanks Bonnie and Natalie for sharing Chrissy Ann's story with me. Although it brings me to tears when I read it, it gives me the courage, determination & hope for my Bella. I pray she doesn't have Cushing's but if she does than she does & we'll go from there.

Thanks everyone for the support. I'm surprise I'm not a raging alcoholic at this point...

-Sam

[acushdogsmom]

Re: UTI follow up

We discussed the different tests for Cushing's. My vet will be sending blood work off UT@Knox ... So first test is ACTH Stim test. If no positive result, she comes back for low dose dex test, if still no positive results, blood work will be sent to UT@Knox.

Hi Sam,

I haven't posted to you before but have been reading your thread.

Just wanted to point out that if you're going to do an ACTH stimulation test anyway, it might be a good idea to have the full ACTH stim/adrenal panel done by UTenn@Knoxville, where they will measure for Cortisol, Estradiol, Androstenedione, 17-Hydroxyprogesterone, Progesterone and Aldosterone, instead of just the regular ACTH stim test where they only measure the cortisol levels. (This may be what your Vet is planning to do, but if so, it wasn't really clear to me from your post)

The actual test (ie number of blood draws etc) is the same, the only difference is how many hormones the Lab actually will analyse.

If the cortisol is elevated but the other hormones are normal, then you may be looking at "regular" Cushing's - either Pituitary or adrenal dependant. If the cortisol is normal but one or more of the other adrenal hormones is "off" that would be consistent with what they call "atypical Cushing's"

Here's a link to where they mention the various tests that UTenn can perform on the blood samples:

http://www.vet.utk.edu/diagnostic/en...ts_info_07.pdf

Look at 3,g:

Adrenal Panel for Dogs and Cats (ACTH Stim) -Test for congenital adrenohyperplasia-like syndrome (dogs, cats), or Alopecia-X, Atypical Cushings Syndrome:

Note: All Adrenal function tests use serum samples.

*Adrenal panels are batch-run weekly (DHEAS is no longer available)

i. Collect baseline serum sample (2.0 ml.).
ii. Centrifuge sample as soon as possible, separate and freeze.
iii. Administer the ACTH Stim test as above (3A). Collect Post-ACTH serum sample (2.0 ml) at 1 hr (2 hrs if gel-ACTH is used).
iv. Centrifuge sample as soon as possible, separate and freeze. (NOTE: If samples are grossly hemolyzed, repeat test in one week).

1. The following hormones will be assayed: Cortisol, Estradiol, Androstenedione, 17-Hydroxyprogesterone, Progesterone and Aldosterone.

Once you've had the blood sent to UTenn's Lab for analysis and particularly if you have the full ACTH stim/Adrenal panel run instead of just the ACTH stim test, Dr. Oliver at UTenn witll be able to give you his input on Isabella's case. Dr. Oliver is considered by many to be the "guru" where Atypical Cushing's is concerned.

And here's where you can read more about "Atypical Cushing's" at the Cushing's message board (where I know you have already also joined up)

http://www.k9cushings.com/forum/showthread.php?t=198

[acushdogsmom]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Just wanted to post the link to Sam and Bella's thread at the Canine Cushing's board, so anyone here who wants to see what has been said over there can follow along.

http://www.k9cushings.com/forum/showthread.php?t=1295

[chasing_bella]

Re: Isabella Kelly Update

Just wanted to update you guys:

Results came back from UT... She doesn't have Cushing's but came back with a recommendation to test in 6 months again. Also, no thyroid problems.

So we are just dealing with the diabetes (and preexisting illnesses).

She's maintaining her weight at 25 lbs and still receives 17 units of insulin x 2 daily. She misses her doggie biscuits but has settled for the fresh veggie snacks (especially peeled cucumbers).

All in all, Bella is doing really well

Thanks everyone for all the support. Giving Bella her shots is second nature now, no big deal Next step, home testing.

God Bless,
Isabella & Samantha

[ladysmom06]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Hi Samantha,

Results came back from UT... She doesn't have Cushing's but came back with a recommendation to test in 6 months again. Also, no thyroid problems

GREAT NEWS!!!!!!!!!!!

All in all, Bella is doing really well

Happy to hear that Bella is doing well . Good luck with the home testing. Hugs to you and Bella.

[k9diabetes]

Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

That's great news!

I skimmed very quickly and must have missed it - are you using Vetsulin or NPH?

You've probably seen the posts are the FDA alert regarding Vetsulin and lots of dogs switching.

Natalie