My angel Bandit... Mar 30, 2018

[carolc]

my dog bandit (i call him johnny) is a 12 year old minpin/jack russell mix.
4 years ago the vet noticed a heart murmur during his teeth cleaning. they never noticed before because he's so hyper. they did xrays and his hearts enlarged. so he went on meds.
2 years ago he was diagnosed with cushings. its taken time but we finally have that under control.
about a month a half ago i took him to the vet for his reverse sneezing and restlessness. something was off about him. they did blood work, took stool samples, took an xray, and did a normal check. xray showed possible growth on his liver. he told me he wanted me to take him to an internist to check the rays. she wasnt concerned about his liver, but his BS was 650. (he was 23 lbs) so she put him on novolin, 4 units.
the next week we go back for his curve. still 650,they upped him to 6 units. took him back the next week, same thing. now we're up to 9. he goes back tomorrow for another curve.
the vet hasnt suggested any home monitoring but i think i'm going to go ahead and do it anyway.
my questions are
1. about a week or 2 before his diagnosis he's been having trouble jumping up on the couch, going upstairs, etc. is that normal and will it change?

2. he's losing weight, muscle weight. i can feel his bones. will he gain once we get this under control? last week he was 21 lbs, i'm sure he's less now.
his appetite is great, that hasnt changed.

3. he's a couch potato all day, with very shallow breathing. at night, he wakes around 1 or 2am, goes to get a drink and lets himself out. he's in and out and pacing the rest of the night. why is he out of it all day but up all night?

4. i dont know if this is related to diabetes but sometimes when he eats, he will start wheezing and choking. he's always inhaled his food but now he cant handle it. a few weeks ago he was choking and fell on the floor with his legs straight. i picked him up and he managed to get the food out. he doesnt wear a collar. so its not that. after he's done eating it looks like someone blew up a balloon in his belly. has anyone had the same issue?

[jesse girl]

Re: trying to control this

hi and welcome

did you see weight loss with the cushings under control before diabetes DX ?

not sure if there is a relationship between cushings and diabetes but there seems to be but we also see false positives for cushings newly diagnosed in diabetic dogs but your dog was diagnosed awhile ago and has been successfully treated

i guess its possible the cushings may cause diabetes with the over production of hormones

are you doing complete curves and basing dose adjustments on that complete curve ?

[amydunn19]

Re: trying to control this

Hi and welcome! Some dogs do experience leg weakness. It does improve for most as they become regulated.

In a month’s time, your dog has been raised from 4 units to 9 units. Normal starting dosage is about 4 units. That is too fast, in my opinion, to raise insulin. Did you vet do an all day curve? Do you have more readings than the 650 you posted? The actual curve(testing every two hours from breakfast to nighttime meal) tells the whole story. Not much can be determined by one number. Normal schedule for raising dosage is to let a dosage increase settle for 5-7 days then do a curve and if needed, raise only one or two units, especially on a dog so small. Let the new dose settle for 5-7 days and so on until the curve starts showing favorable numbers.

Until blood sugar comes down, the weight won’t come back even if you increased food. It is like the body doesn’t use the food at all when blood sugar is high.

The schedule he is on is likely just due to high sugar - they feel thirsty and restless. He may just feel better during the day. Without blood sugar readings, it is hard to know.

Please start testing - I am a bit concerned about the impatience of the vet. This process is one that can’t be rushed.

Have you had any current Cushings tests to determine levels?

[carolc]

Re: trying to control this

hi and thank you!

he's going today for his all day curve. he's had 2 now, i dont know the exact numbers but his number seems to be 650 on average. he's gone in for one test in between the curves. the vet ups his units by 2 each week, he seems to be more concerned with the high numbers. he did call the internest last week to get her opinion. she said he can go as high as 15 but if there is still no change in numbers then we'll have to do something else. after i drop him off today, i'm going to get a home test kit, just so i can see whats going on during the week.

i feel so bad he's not himself. i'm off to take him, i'll let you know how today goes.

[carolc]

Re: trying to control this

we're back. he did a little better today, the vet said he was in the 400 range all day. its not "good" but its an improvement. so he's at 10 units now and goes back next week for a quick test. i asked about the home testing, she said yes definitely get one. its easier to get a reading at home where they are comfortable.
I didnt buy it early due to family stuff happening. anyway, thats on my long list of things to get tomorrow.

[jesse girl]

Re: trying to control this

great to have a vet thats supportive

remember you only want to adjust a dose with a complete curve

[amydunn19]

Re: trying to control this

Good that your vet agrees with home testing. A quick test will not tell much at this stage. If you can get a copy of those curves, and post one, I would be interested to see it.

400’s are progress and should get you out of the danger zone with ketones. But, the increases seem really fast. Overshooting the dose can really get you some confusing numbers because instead of seeing low numbers with too much insulin, you can still see high numbers. My dog was grossly overdosed because her number was high every time she went in.

[carolc]

Re: trying to control this

The vet i use is very reasonable and listens to pet parents, i totally trust them. they keep their prices down too so people can afford to treat their animals. the internist he sent me to was VERY $$! i didnt really care for her, i dont know why? But i'm trying to not go there again.

I ordered test strips through amazon, it was cheaper. i bought the monitor not realizing it doesnt come with strips. (this is all new territory for me)
when he goes in next week i'll ask for his readings from last week.

One of you asked about the cushings, i forgot to respond. He's had it for some time now. he has all the classic signs, hair loss, crazy appetite and thirst, pot belly, etc. he went on trilostane, after tweaking the dose for a while, he's just recently in the right number range. I'm assuming the cushings is what caused his diabetes. i think he may have had cushings way before we knew. he was 3 when we adopted him, 29 lbs! way too fat for his breed! we thought the foster family was over feeding him but maybe it was the beginning of all this?

[jesse girl]

Re: trying to control this

getting a meter will definitely help with managing the disease and improving the quality of life of your pup

[Scooterspal]

Re: trying to control this

I ordered test strips through amazon, it was cheaper. i bought the monitor not realizing it doesnt come with strips.

For what it's worth, and it appears you already bought a meter... the ReliOn system sold at Walmart is a "gift" to us dog owners.

The meter is $9 and the test stips are $18 for 100. I have had excellent results for Scooter. It works as well as more costly systems and you only need a tiny amount of flowing blood to get a reading. It stores the results by day and time, should you forget to post the results immediately. It even shows averages by week, month, etc. Remember, you're looking for swings and trends. A few points one way of the other makes no difference.

If you're charting around the clock, as I am, those low cost test strips make this less painful, $$ wise.

Walmart also sells their Novolin R and N insulins for $24, and for pets. Their syringes are also very reasonable, at $10 for a box of 100. You will need a script but only for the needles. I use the most recent one to prick Scooter for the next round of tests.

Again, a gift!

Good luck.

[carolc]

Re: trying to control this

Thanks! i did buy one, one touch ultra mini. i brought it with me to the vet, she wanted to make sure it was accurate. it was spot on. by the way, his BG was 229, woohoo!
my next problem, i cant get blood. i'm beginning to think he doesnt have any. ha ha! i have tried every area on his body thats bald. (being cushingoid means his whole underneath is bald) nothing. his fur is black so where there's hair its impossible to see. the only spot i didnt try is his lip, i'm not sure i'm ready to go there. he already "bit" me doing his armpit this morning. he wont really bite me, but i did get warnings. so i think he will if i piss him off enough.
he goes back wednesday, i'll ask the vet to show me. in the mean time, any tips?

[jesse girl]

Re: trying to control this

i felt the same way about the lip and as you i was struggling to get blood from jesses ear. so went to the inner lip and oh how easy it was and that was over 7 years ago with no problems

you can do some practice test to start breaking down the process in steps to get both of you comfortable with it

one caveat is jesse gives me a kiss after her test on her inner lip

[carolc]

Re: trying to control this

I will definitely try that, thank you! i'll wait till he's not excited, being part JRT thats a small window.
So your just pulling his lip up and poking him there? i know there will be blood in his mouth, i just hope he allows it. getting a kiss would be totally worth it!

[jesse girl]

Re: trying to control this

yeah you just role the lip up and line it up above the canine tooth and test there .

you could just role the lip up and wipe the saliva off the inner lip and call it good for a practice test . and incrementally getting closer to actually testing with each new practice test

take your time no rush and hope that will make it less stressful for your pup

[amydunn19]

Re: trying to control this

You could try any warts or skin tags - most have no nerve endings and give good blood. Make sure you have a larger lancet like a 25 or 26 gauge. I also used the base of the tail - just shave some hair and try a spot there. The skin is thick in that area so it might take a bit more effort but may not be as tricky to get them to be still.