Sidney - Cushing's Dependent Diabetic

[Sunripenedsmile]

My Sidney girl was diagnosed with Diabetes on April 4 with suspected Cushing's. We did a low dose Dex test to confirm and an ultrasound. Here are the results -
Initial blood test -
The complete blood count has a normal WBC count of 7,300 (optimally between 5,000 and 8,000), The HCT
is 54.6%. The percentage of Eosinophils is 8% and above the optimal percentage of 2-3 %.
The chemistry shows a Glucose High 447 (74-145), SGPT High 224 (14-151) a liver enzyme, Alk Phos High
2267 (13-289) a bile duct enzyme, Cholesterol High 457 (98-300) can be elevated due to low thyroid (low
thyroid hormone function due to Cushing's Disease) or diet, Albumin High 4.4 (2.6-4.0) due to dehydration,
Potassium High 5.8 (3.4-5.6) due to dehydration. Chloride Low 97 (100-121). GGT High 36 (3-19) a liver
enzyme.

Low Dose Dexamethasone test -
Baseline Cortisone 4.8 (1.0-5.0)
4 hour Post Cortisol 3.4
8 hour Post Cortisol 7.1

She is currently taking 3.5u of insulin 2x daily and 5mg of vetoryl once a day (she is 11yrs old, 16 lbs and a Maltese/Lhasa mix).
Today she has been very lethargic/depressed. I am not sure what to do any help would be wonderful. Thank you!

[pinkie]

Re: New diagnosis... Diabetes and Cushing's

I would call your vet because lethargy is a side effect of vetoryl and diabetes.

My dog Pinkie has Cushing's, hypothyroidism, and diabetes. The k9 cushing's forum at http://www.k9cushings.com/forum/ has been very helpful and supportive as well as this forum.

My dog is on 5 mg vetoryl, 8 units using U-100 syringes translating to 3.3 units of vetsulin, and 1/2 cap thyroxine twice a daily. I test my dog daily using a blood glucose meter to monitor the levels.

We are still working on adjusting her insulin dosage since her diabetes is not under control with the Cushing's. It is a long slow process.

[Sunripenedsmile]

Re: New diagnosis... Diabetes and Cushing's

Thank you. I am on the Cushing's site as well. I am feeling conflicted about her treatment plan. What I'm gathering now is that her high cortisol levels could be a response to the diabetes and that should be maintained first and then to treat Cushing's if it still seems as though she has it. None of her tests prove Cushing's to be the for sure diagnosis, just a "probably" diagnosis. This is all so hard, I just want my girl back to better health.

[Judi]

Re: New diagnosis... Diabetes and Cushing's

my dog had both too. When her blood sugar was high she slept more.

[pinkie]

Re: New diagnosis... Diabetes and Cushing's

I would verify that your dog has Cushing's before treating with trilostane. My dog was diagnosed with Cushing's and then developed diabetes. I would recommend an internal medicine specialist who is familiar with dealing with endocrine issues.

[Sunripenedsmile]

Re: New diagnosis... Diabetes and Cushing's

Her readings are still very high between 400 - 600 consistently. My vet believes she will even out but I'm still very worried constantly. Even with 400 readings she's perky, we went for a long run walk today and she was very active and happy. She's been playful today even with levels in the upper 500s. I'm really worried about her all the time.

[Judi]

Re: New diagnosis... Diabetes and Cushing's

It took a couple of months for my dog to get out of the 400-600 range. If they do have both diseases it's harder to get them regulated. I focused on how she was feeling and if she was feeling good I tried not to obsess

As long as your dog doesn't have ketones due to high blood sugar (mine never did-we were lucky), they can handle higher blood sugar better than too low of blood sugar. too low can be really dangerous

so, hang in there. Eventually we had to start the cushings meds to see any effect from the insulin.

[Sunripenedsmile]

Re: New diagnosis... Diabetes and Cushing's

Judi - thank you so much! I needed to read that. I am obsessing constantly. I sit and watch her breathe just to make sure. I absolutely needed some reassurance that I was doing the right thing.

[Sunripenedsmile]

Sidney's first curve....

First glucose curve - thoughts?

5am - 470 (fasting fed her 1/2c and 4u insulin and 5mg vetoryl)
7am - 519
9am - 551
11am - 515
1pm - 393
3pm - 359
(took a big walk between 4 and 5)
5pm - 245 (fed her 1/2c and 4u insulin)
7pm - 444
9pm - 576

[jesse girl]

Re: Sidney's first curve....

hi and welcome

it looks like the walk gave a large drop but not to bad for being a substantial walk . something to keep in mind as the numbers go lower

a walk maybe an artificial response and not give you a true response because of the drop caused by the walk

dose adjustments are based on the lowest number in the curve and the walk may reduce how much that dose can be raised because of the lower number after the walk

so with walks its ok to incorporate them into the routine and i think its important in keeping a pup happy but like everything else you need to stay consistent with same amount and time of day so the body can adapt to it

[Sunripenedsmile]

Re: Sidney's first curve....

I have updated her for her 7pm and will again for her 9pm. These numbers seem extremely scary to me.

[jesse girl]

Re: Sidney's first curve....

yes sugar is high but we have seen much higher . more than likely you can give a 1 unit increase but watch those walks and dropping blood sugar

not a big deal just part of the process .

[Sunripenedsmile]

Re: Sidney's first curve....

Thank you. I need so much support right now, she's my baby and I know you all understand. My heart is breaking for her.

[jesse girl]

Re: Sidney's first curve....

you will be surprised and not to long from now how things will settle into this new reality and new normal . your dog will return to a happy dogs life and this initial anxiety will abate but at least for me i never get complacent with this disease even though jesse may look quite normal and nothing is wrong with her .

[Sunripenedsmile]

Re: Sidney's first curve....

I will never get complacent. I am her advocate! Your words mean so much. Thank you!!