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Old 12-02-2018, 01:39 PM
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Default Cushings, allergies, and newly diagnosed diabetes

Hi everyone. My boy Rocky is an 11 year old n/m boston terrier. He's always weighed about 21-22 pounds but is currently at 18.6 as of this morning. He's had quite the medical history starting out with him being born deaf. I'll keep his history to what I what I feel is relevant to his newly diagnosed diabetes.

Cushing's: A couple years ago Rocky started slowing down. It started out as lack of stamina on walks and shakiness in his rear legs. The vet we had at the time (who I did not like, always seemed to dismiss everything) said it was arthritis and wanted to start him on Rimadyl which I refused. I knew it was something else going on. Next vet did bloodwork and found elevated liver enzymes. Did ultrasound and found enlarged adrenal glands. Due to other symptoms tested for Cushing's but it came back negative. About six months later and after a move, continually elevated enzymes and a new vet he was tested again with a positive result. That was in April. He is currently taking 15mg of trilostane split between 10mg in the morning and 5mg at night. I never felt his symptoms were under control even though his labs were good. Liver enzymes went back down, post act cortisol under 6. Electrolytes normal.

Allergies: He's pretty much allergic to everything. He has seasonal, indoor, and food allergies. We did testing when he was about a year old and even the vet was surprised at his numbers. For example they were on a scale of 0-6 and she had made a joke beforehand about never seeing 4-6 and he had some 5s. He takes hydroxyzine and more recently Benadryl as well when they are worse. We've tried many foods over the years mostly sticking to things like raw, homecooked, the honest kitchen, etc. Still have never found the "perfect" food. He doesn't scratch a lot, mostly rubs his face and ears on the floor and paw licking.

Surgery: In October he was put under anesthesia to check out his airway due to sleep apnea. The surgeon called and said it looked like a mild case of laryngeal paralysis and he performed a tie-back procedure. Not sure if the added stress from this contributed to his diagnosis, but the timing seemed too close not to include.

Diabetes: A few weeks ago his water consumption started to increase, even more so than normal since he already drank a lot with his cushing's. He had also become pretty boney. I increased his food with the result being a boney dog with a pot belly. His weight stayed a consistent 20.5ish but he wasn't looking good. One Sunday the water drinking got excessive and I called to make yet another appointment. He was scheduled for Tuesday morning and over the next 36 hours before his appointment he got pretty sick and I debated to him to the e-vet Monday night. Tuesday came and our vet was pretty shocked when she saw him. He was flushed and exhausted. They tested his blood and found his glucose over 300. They did a urine test and found ketones so she sent us to the animal hospital. There they said his blood pH was okay and since he was eating and stable and wasn't dehydrated we could take him home and start him on 4 units of vetsulin with his dinner. Well, to our surprise he wouldn't eat his dinner. We called the vet and as we were talking to him he started licking our other dog's bowl. The vet said it was fine to give him her food as long as he ate. He wasn't concerned with what he eats, as long as he eats. The next morning we tried his food again and again he wouldn't eat so we gave him some of her raw again and bought him his own prey-style rabbit which is just meat, organs, and bone. After reading on here yesterday and today I see this probably isn't the best. He also tends to get reflux symptoms on raw which are starting to show up, but we just wanted to make sure he ate at the time. They also noted his cataracts, especially in his right eye, that I hadn't really noticed coming on because he'd had that bluish tint older dogs get already for a couple years now. Really nervous about him losing any more sight since he's already deaf.

Currently: He had his first blood glucose curve done last Tuesday (11/27) after one week at the 4 units. It was still high and pretty flat with what this noob is seeing as an odd spike: 343, 295, 348, 300, 329, and 349. They increased it to 5 units and he goes back tomorrow for his second curve. Over that first week he lost just under 2 pounds but it was all the potbelly. I think some of it was due to inflammation in his intestines. He's been acting more himself and the water consumption has gone down some. However he's still flushing and has bloodshot eyes. He definitely seems better at certain times of the day such as before his meals. He's also starting licking his lips which I'm not sure if that's from the reflux due to the food or nausea related to the diabetes. I tested his urine today and the strip read "small amount." He also has some skin rash or infection which I made an appointment with our family vet to look at and I assume started due to the uncontrolled diabetes. I know we are early in this so I don't think I have any specific questions at the moment. I'm just kind of at my wit's end between the forever struggle with food, seeing how terrible he looks with the muscle atrophy and skin problems, plus his quality of life. We always took him to restaurants and hikes and he loved treat puzzles and snacks throughout the day. Now he's lost all of that. Sorry for the pity party guys. I appreciate if anyone made it through this book of a post! I keep thinking of more I want to include, but I'll spare you all.
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Old 12-02-2018, 04:32 PM
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Default Re: Cushings, allergies, and newly diagnosed diabetes

Hi and welcome

sounds like your pup is a fighter

your dog has been started on an appropriate starting dose at 4 units

The numbers you posted are not all that high .very common to see numbers in the 500s and higher for a newly diagnosed dog .Another factor a cushings dog can see resistance to insulin but usually a treated dog as yours usually can do well

With all the other challenges with your dog you do need to test sugar at home if your not

sounds like you are off to a good start
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Jesse-26 lbs - 15.5 years old ,10 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin a day . Total insulin for a 24 hour period is 8 units of NPH insulin .
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Old 12-02-2018, 09:50 PM
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Default Re: Cushings, allergies, and newly diagnosed diabetes

Thanks for the welcome. I ordered the Alpha Trak 2 today and it should be here Tuesday. I tried collecting blood from him unsuccessfully yesterday to use with my tester (Iím not diabetic, I have autoimmune anemia and my tester also gives values that give me an idea of how my anemia is doing. Not sure if they all do this.).

I tried three areas. At the base of the tail I was able to see blood but couldnít get enough to use. Nothing at all on the elbow, he definitely felt it and reacted. And again nothing on the pad. He jumped away before I could even break the skin. Iím alone with him right now as my husband is away on a business trip until Wednesday. Iím hoping we will be more successful with one of us holding him until he gets used to it.

Dropping him off at 630 am tomorrow for his curve. Iím definitely worried as he gets super anxious in the crate and barks his head off all day. Last time he came home a wreck and took a day to recover. Iím debating asking if I can keep him in between. Not sure what we would do since the hospital is about 45 mins away. Also debating on asking about the libre. The day he was diagnosed the vet mentioned a continuous monitor but I donít know if he meant the libre or something else. That would be a really valuable tool for us right now, especially since Iíd like to change foods as well to control the reflux.
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Old 12-03-2018, 07:13 AM
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Default Re: Cushings, allergies, and newly diagnosed diabetes

Yeah if he is anxious that can skew the curve and may not give true results which can be a problem for dosing

I have used jesses inner lip for over 8 years and maybe 10,000 tests or more

you can do some practice tests just rolling up the lip exposing it just above the canine tooth rub the saliva off with a napkin and see how he does .just take small steps until the actual test to get both of you comfortable

you will get there its kind of a no choice and needs to be done
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Jesse-26 lbs - 15.5 years old ,10 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin a day . Total insulin for a 24 hour period is 8 units of NPH insulin .
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Old 12-03-2018, 05:54 PM
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Default Re: Cushings, allergies, and newly diagnosed diabetes

Got home a little bit ago from his curve. I stayed with him and we spent most of the day hanging out in my car. He didn't mind. He was snoring away in the back. Such a difference in him tonight compared to last time. You wouldn't even know anything was out of the ordinary today.

5:30 breakfast and 5 units
6:30 422
8:30 335
10:30 258
12:30 267
2:30 278

So one higher spike an hour after he ate but overall lower than the last one. Increasing to 6 units tonight. Going shopping tonight for stuff to switch his food in the am. Going to try cooked ground bison. Undecided on carbs yet. Debating on a little bit of oats and pumpkin or possibly some butternut squash with a green veggie. Planning to see what baby foods Costco carries. I've seen that a few people use it for their veggies. Makes sense to me since its cooked and blended.

Asked about the Libre but I guess since they are doing it as a clinical trial he has to be regulated first. I was really hoping to have it now to help with the process, but at least we have the alpha trak coming tomorrow.
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Old 12-03-2018, 06:42 PM
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Default Re: Cushings, allergies, and newly diagnosed diabetes

Now remember its possible a different food can change the amount of insulin that is needed . Sometimes a change may require more insulin and sometimes it could require less and thats where you can run into problems

you would like to keep both meals consistent and basically the same . Same for exercise and just about everything especially during the regulation process . Once thats accomplished you maybe able to vary things according to blood sugar
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Jesse-26 lbs - 15.5 years old ,10 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin a day . Total insulin for a 24 hour period is 8 units of NPH insulin .
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Old 12-03-2018, 06:49 PM
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Default Re: Cushings, allergies, and newly diagnosed diabetes

I know, I definitely am not changing for the fun of it. If he wasn't having reflux and what looks like allergy symptoms I would wait. I'm going to try to keep the amount the same as far as total calories and keep the sugars down on the carb sources. It will definitely still be a predominately meat based meal. I'll keep an eye on him and we will hopefully start home testing sometime tomorrow as well once his tester gets here.
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Old 12-04-2018, 06:23 AM
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Default Re: Cushings, allergies, and newly diagnosed diabetes

Check the labels of baby food or anything like that, could be sugar in it.

And don't be afraid of carbs, they are important for diabetics. Fiber does many good things. Sometimes people think eliminating carbs will keep sugars down, but it can end up causing other problems.

And any food change will probably affect sugars, so lower your glucose expectations while adapting to a new food plan.
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Riley, 8 yr. old maltipoo, 25 lbs., diagnosed Feb 2017, taking thyroid meds, had pancreatitis and DKA mid March, eating Wellness Senior formula can food. NPH dosage now at 9.0 units Humulin N. Adding either pumpkin, spinach, blueberries, yams, or green beans to his food. Also omega-3 oil.
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Old 12-04-2018, 12:08 PM
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Default Re: Cushings, allergies, and newly diagnosed diabetes

I always read labels with him, I've gotten so used to it over the years. I decided to go with the pumpkin and oatmeal because I thought he'd eat those better. He's definitely not a veggie dog. It always baffles me when people say they use things like green beans for treats. Rocky used to suck the liquid off peas and then spit them out!

He ate everything this morning and it seems like he didn't have the immediate reaction he was having with the rabbit. The obsessive licking and pink face. He's been pretty much sleeping all morning, but he's always been a couch potato so it's hard to tell with him. He doesn't seem weak or wobbly and normal drinking so I'm hoping that means his blood glucose is about the same as it has been. I was going to do a check with my monitor just to get an idea but again was unsuccessful at getting any blood. I tried just the lancet in my hand which it sounds like most people do, but without anyone to hold him he just moved too much. I wish I would have conditioned him as a puppy to accept face and feet touching better. The insulin injections were so easy, I wonder why he fights me so much with the lancet.
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Old 12-04-2018, 01:40 PM
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Default Re: Cushings, allergies, and newly diagnosed diabetes

You will get it . most always do and you are highly motivated . Just keep trying dont overdo it to a point that both of you get frustrated . walk away when you need to

break testing into steps and goals . getting you dog calm before a test . Just find the best position and work on just keeping your dog from moving and just work on that and once mastered move onto the next step
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Jesse-26 lbs - 15.5 years old ,10 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin a day . Total insulin for a 24 hour period is 8 units of NPH insulin .
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