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Old 10-05-2009, 11:06 AM
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chasing_bella chasing_bella is offline
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Default Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

When Bella was diagnosed last Saturday with diabetes mellitus, it wasn't a big surprise. My 10 yr old mini schnauzer has been tested for both diabetes and cushing's about 11 months ago with negative results. Her prior history with bouts of pancreatitis (not acute), liver inflammation, and low grade heart murmur (1 on a scale from 1-5) has kept me on my toes. In August, she had her annual cardio work up & geriatric blood work done. Every thing came back normal. 8 weeks later, a rush to the emergency clinic, and it was confirmed. She had developed diabetes mellitus. The good news is that there were no ketones in her urine, the upsetting news, the emergency vet strongly recommended testing for cushing's asap. Bella spent 4 days at the regular vet clinic for the sugar curve test and was put on insulin (2x's daily). We are waiting for her to regulate/stabilize b/f testing for cushing's.

So now that our journey has begun, I'm not as prepared as I thought I would be. My hopes and prayers were for her to live out her golden years without having to go through this. Bella is hanging in there like a trooper. As for me, I'm a total mess. Between the nervous breakdowns, sleepless nights, worrying, and tears, its a wonder I can even get my thoughts together to administer the right dosage of insulin.

Here are some questions I have.

-Bella has been on Hill's RX W/D diet for the last 2 years. Her treats were apples, bananas, carrots, and milkbones. I have changed over to veggies because of the sugar content in these fruits. She now gets romaine lettuce, peeled cucumbers, celery, and raw string beans. How much can I give her for snacks during the day? She struggles during the 12 hr span between breakfast and dinner (7am-7pm).

-Will waiting a month b/f testing for cushing's going to cause more damage to her? (not that we have a choice, just trying to prepare).

-How manageable are both diseases?

I could call my vet again & ask, but I'm trying to save my phone calls for emergency situations. I believe I've talked to him about 50 times in the last week.

Thanks for the advice and support.
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Old 10-05-2009, 11:41 AM
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Default Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Hello and welcome. You've come to a great place for advise and support. All of us have gone through what you are feeling at the moment. I'm so sorry your Bella has to join our club. We manage though and have happy pups to prove it. My forbin is 10 and was diagnosed last Christmas. The people here helped me get through. Forin went blind from cataracts and was just operated on to remove them. He can see again.

I'm not sure why your vet wants to check for Cushings. Kathy and Natalie will give you advise on that one as I am not familiar with it. My dog shows no symptoms of cushings, just has diabetes. Once you stabilize bella on the right dosage, you can experiement with treats. There are some out there that don't seem to bother diabetic dogs. I use Neumanns Organic Chicken treats. They have no sugar and don't raise Forbins BGs. Others do feed their dogs veggies like you, but I'm not sure the quantity that they give. If you home test, you will have peace of mind. Do you have a monitor? There is a lot of advise about monitoring as well. Knowing your dogs BG patterns not only gives you some peace of mind but also helps determine how food and treats are affecting it.

You'll feel much better given a little bit of time and sticking to the board here. We are all here for each other and you can reach out day and night.

There are several schnauzer friends here to talk to. Welcome again.
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Old 10-05-2009, 12:59 PM
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Default Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Welcome to you and Bella!

What you've posted about the plan to test Bella for Cushing's sounds VERY right!

There are times when the initial diabetes diagnosis is made that the results of the tests indicate there's diabetes, but there also may be Cushing's too. Waiting until the diabetes is under control and then, if it's still suspected, testing for Cushing's, would be the right way to go.

The initial lab values may indicate the possibility of Cushing's, but as you get the diabetes under control and then do a Chem 21/full panel again, if there's no Cushing's, you will see that those abnormal values that made you wonder if there might be Cushing's have gone back to normal levels.

If Cushing's is present, you will notice that it's very difficult to get regulation (lower bg's). Cushing's is basically an excess of cortisol and cortisol is one of the hormones that drives bg's up.

Waiting until Bella's diabetes is better under control before doing any Cushing's testing sounds right--we've had members whose dogs were initially diagnosed as having diabetes and also possibly having Cushing's.

They concentrated on getting the diabetes under control and in doing that, later blood tests showed that the only problem was the diabetes. Why not wait to worry about Cushing's until after you've been working with Bella and her diabetes a little longer?

Kathy
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Old 10-05-2009, 01:14 PM
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Default Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Both diseases are entirely manageable. Diabetes is probably the less expensive one. Cushings can be difficult to properly diagnose and really requires a skilled veterinarian just to make the diagnosis while diabetes is pretty easy to identify.

Damage from Cushings disease occurs only very slowly over the long term so whenever diabetes and Cushings come up together as potential problems, I always like to see the diabetes addressed first. Unresolved diabetes leads to considerable damage from very high blood sugar, including ketoacidosis, which is fatal if not treated quickly.

Cushings will make the diabetes difficult to control so in some ways starting to treat the diabetes helps to sort out whether Cushings is present also! If you get good regulation, you can forget about Cushings.

Lots of Schnauzer folks here alright! I am starting to think that if you bring home a mini Schnauzer, you might just as well plan on diabetes!

Those snacks are virtually calorie-less so I think you can be pretty liberal with them.

Welcom to you and Bella... love your user name!

Natalie
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Old 10-05-2009, 02:12 PM
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Default Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Natalie can you please explain the difference between glucose in the urine vs. ketones in the urine?

Bella (my little chunky monkey) will be happy to know I can be a little more generous with her veggie treats.

Thanks again!
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Old 10-05-2009, 03:01 PM
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Default Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Hi and welcome to you and Bella.
My Buddy was diabetic and also had cushings. He had already had diabetes for 4 years before we got the cushings dx and one of the reasons for testing for it was that his normally regulated BG was all over the place.
Diabetes and cushings have a lot of similar symptoms so you need to start one first and diabetes is the right choice. Uncontrolled diabetes can skew the results on cushings tests and if you can get the diabetes side under control you may find that the cushings isn't an issue because regulated diabetes is usually not possible with cushings.
Good luck.
Jenny
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Old 10-05-2009, 03:29 PM
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Margaret Boyle Margaret Boyle is offline
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Default Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Quote:
Originally Posted by BestBuddy View Post
Hi and welcome to you and Bella.
My Buddy was diabetic and also had cushings. He had already had diabetes for 4 years before we got the cushings dx and one of the reasons for testing for it was that his normally regulated BG was all over the place.
Diabetes and cushings have a lot of similar symptoms so you need to start one first and diabetes is the right choice. Uncontrolled diabetes can skew the results on cushings tests and if you can get the diabetes side under control you may find that the cushings isn't an issue because regulated diabetes is usually not possible with cushings.
Good luck.
Jenny
Hi Welcome to You and Bella,

I have an 8yr old mini Schnauzer called Lucy. She was dx in Dec 2007.
She was tested for cushings but came back neg.

She has just recently had cataract surgery and has her sight back.

The well known fact about Schnauzers are they are difficult to regulate, but you do get there it has taken us 1/1/2 years to get Lucy's numbers down and we still have problems. She is still with us and this is the main thing.

You will get plenty of support here, just take it step by step.

Lucy is a happy wee dog and enjoys life, this is what the ultimate aim is and you will be the same.

I will follow your thread you and Bella will be fine.
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Last edited by Margaret Boyle; 10-05-2009 at 03:30 PM. Reason: mistake
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Old 10-05-2009, 10:59 PM
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Default Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Glucose or sugar is always present in the blood - we need it to survive. And when insulin is handy, it gets moved into the cells and used for fuel.

When there isn't any insulin or not enough insulin, glucose piles up in the blood and at about 180 mg/dl, it starts getting flushed out into the urine. So with a diabetic dog you will see glucose/sugar in the urine any time the amount in the blood exceeds that 180 threshold. Normal blood sugar for dogs and people is about 80-130.

This is why diabetic dogs are very thirsty - the body is trying to get rid of that excess sugar.

When there hasn't been any insulin for a long time, the body is starving and it is forced to turn on itself to produce fuel to stay alive. That process of breaking down the body's stores produces ketones.

Ketones are dangerous because they are very acidic and as they pile up, they turn the blood acidic. It's a toxic reaction that can be fatal.

And the way to get rid of ketones is to give the body insulin so all that sugar floating around goes into the cells instead of flushing out through the urine and the body doesn't have to turn on itself.

Fortunately even with blood sugar at 300 to 400 ketones are a rare occurrence. Usually they show up after sustained very high blood sugar.

Every once in a while I see a dog who throws ketones at lower levels but not too often.

It is very important to get veterinary treatment for anything more than trace amounts of ketones on a urine test - the vet will give fluids and IV insulin to get the blood sugar down right away.

Hope that makes some sense.

Natalie
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  #9  
Old 10-06-2009, 06:29 AM
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Default Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Welcome to you and Bella,

My girl, Crissy Ann, had both diabetes and Cushings', as well as discoid lupus and hypothyroidism! She did pretty well over the years and managed to live her normal life span. She passed away in March.

You can read about her experiences here: http://www.k9diabetes.com/forum/showthread.php?t=83

Bonnie and Angel Criss
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  #10  
Old 10-06-2009, 09:18 AM
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Post Re: Isabella Kelly (Diabetes Mellitus & Cushing's Disease)

Thanks Natalie for the explanation.

What do you guys think:

When Bella’s urine was tested at the emergency vet clinic it had high amounts of glucose 2000 ++++ so they ran the blood test which confirmed her diabetes (results 596 mg/dl, reference range 70-143). She was negative on the ketones (but has an UTI).

Bella isn’t being tightly regulated. My vet wants to rule out Cushing’s before I purchase a glucometer and urine test strips. He did ask me to get in the habit of keeping a recorded journal just in case.

The reason Bella isn’t being tightly regulated right now is because we caught her diabetes within 8 weeks (early onset, which according to him is pretty amazing). It just happen that she had geriatric blood work done in August & everything came back normal.

So I’m kinda flying blind here as far as her sugar levels during the day. Should I at least go buy the urine strips? Or am I over reacting? We’ve been with this vet for almost 6 years & he’s been there for us through ever crisis. We do work closely together in managing Bella’s health especially in the last two years. I just don’t want to find her hypoglycemic. The vet said she might continue to drink water often b/c of possible Cushing’s, but it shouldn’t be anything like it was last Saturday (which is true, she drinks often but not every minute). I do watch her closely around 12-3 PM when the insulin is at its peak & check on her thru the night (she sleeps right next to me).

Bella’s RX & Feed Schedule

17 units NPH @ 7AM/PM
Ursodiol @ 9PM (liver disease)
Baytril @ 7:30 AM/PM (UTI)
Metacam (as needed for arthritis, usually given in winter months)
Heartguard Plus (once a month)
Frontline Plus (once a month)

Hill’s RX diet- dry W/D 1 ½ cups, wet W/D ¼ can 7AM/PM
Insulin injection immediately after eating.

Veggies through out the day for snacks.

Bella’s 23 lbs, 10 yrs old

We made it through our first week without incident.

Thanks again guys!
- Isabella & Samantha
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