Angel Monk... passed away March 6, 2012

[Patty]

Re: Monkey

Betty,
So he's on 9u now twice a day. Remind me what his dose was prior to boarding. Was it 8u? Just curious since he's showing negative now on the strips.
Patty

[bowens2]

Re: Monkey

OK I didn't feed Monk this morning or give him his shot. He was showing negative but not acting out of the norm or panting. I took him in and Dr. Merry was really surprised at how low he was. He was 84 but Dr. Merry expected him to be at 300 or more. That was on 9 units of Lantus and probably a bit more treats than usual. When I say treats its Vitality Chicken strips. They are about 4 inches long and thin. They worry me because they are made in China but they work for Monk. He used to only get about 3 a day. 1 1/2 in the morning stuffed in a kong and another one when one of us leaves the house.

So Dr. Merry said there is one of two things going on.
1. His pancreas has started pumping insulin (kind of like a cat will do)
2. Cushings

If its 1 then like a cat it will probably eventually stop or slow down again.

Most likely its 2 but Natalie said its usually high blood sugar not low with a Cushings dog.

He will be tested for Cushings next week. He is now cut back to 6 units of Lantus and we will slowly increase him as needed.

I tried this morning again to test him. I finally took him into our small 1/2 bath with canned chicken. I tried 3 times and could not get enough blood. I am going to try again this evening. He is tolerating it a little better. The sound used to freak him out but I don't think he hears so well any more so that isn't a problem.

Patty, Monks normal dose was up to 15.75 units in the morning and 15.25 in the evening. He used to get 14.75 and 14.25 but when I switched to dry food it took more to get him regulated.

He now weighs only 22.1 lbs. I thought he weighed 24.1. I don't like that at all. He is skin and bones. He looks best at 26 lbs. I am going to discuss this with Dr. Merry on Monday.

So I fed him and gave him his food and 6 units at 9:15 and he is acting normal. I was worried about him dropping more until his food kicked in but he seems ok. He is sleeping and that is normal for him. The other times when he was low he would pace and pant.

He goes back Monday morning but hopefully I can monitor him at least a little. Right now I'll only try when I think he is low because at this time that's my biggest concern. Once again Dr. Merry was concerned that I would change his dosage in big increments and I told him I would not increase or decrease but a half unit to a unit at a time at the most.

[MaryLea]

Re: Monkey

Glad you reduced the dose, and that you are going to follow up next week. The results of his blood panel indicate something else is going on. I'm not experienced enough to know what that is, but when I looked up the high readings, every comment mentioned liver in one way or another. So I'm concerned for him (and you ).

Monk is one lucky pup to have you as his HumanMum!

Mary

[bowens2]

Re: Monkey

Thanks Natalie. Those posts were helpful. I read something about intra-muscular injection. Monk did just get his yearly vacines while there also. I really didn't want him to get them anymore but he had to have them to board.

But I won't have to worry about that again.

[bowens2]

Re: Monkey

Thanks MaryLea. His liver enzymes have been elevated since he became a diabetic but they actually were lower last time (about 5 months ago) than they had been. I forgot to ask Dr. Merry how much they had risen.

Some of you said you give your dogs cheese as treats? Does this not have an affect on their BG? Because maybe I will try that.

I definitely want to see him gain some weight.

[bowens2]

Re: Monkey

I always thought he took an unually high dose for his size but that's what it took to regulate him.

[jesse girl]

Re: Monkey

its just very strange this all happened after being boarded

i see monkey had pancreatits before and with my jesse she had a severe case and almost did not make it but her values on just about everything was out of whack including her liver

maybe there is a flare up going on they say that can shock the system into production of insulin again on rare occasions

with testing you can do practice testing also just go through the motions and let monkey get accustom to the routine and with dogs its all about structure and routine . thats great he is being more tolerable of testing but go slow make it as pleasant as you can stay calm if you dont get a drop come back and do it again later or just do a dry run

it gives you both a chance to get comfortable

[k9diabetes]

Re: Monkey

Betty... I wouldn't let Dr. Merry or anyone else in that clinic treat Monk for Cushing's disease. Please do NOT let them put him on Cushing's medication no matter what the ACTH test results are.

The chances of Monk producing insulin again after all this time are extremely small. And there are other ways for the body to need less insulin.

Right now, he's the complete opposite of a typical Cushing's dog and I think it would be extremely irresponsible to treat this as Cushing's without some expert advice.

What I do think is possible is that there is some type of liver problem - I just don't think it's Cushing's.

He could also be failing to digest his food well and that's why he needs less insulin. Our cat developed IBD. After a few months of just seeming a bit blah, she started losing weight rapidly even though she was on more food than she had been maintaining her weight a few months earlier. In three weeks, she lots 3/4 of a pound and weighed only 10 pounds when she started losing. As soon as we put her on Flagyl, her weight came back up just as quickly.

Have they talked about putting him on supplements good for the liver, like SamE?

This just screams for a really good internal medicine specialist...

Natalie

[bowens2]

Re: Monkey

I've never tried SamE but I do have him on milk thistle. Dr. Merry doesn't act like he wants to put him on Cushings medicine, although there is a new one out that isn't as hard on the system. They have been using it in Europe and it was just approved over here but Dr. Merry has not used it yet. Dr. Whitaker wants to keep exploring the Cushings end of it. Dr. Merry never pushed the Cushings medicine on Monk or Pepper who's values showed she probably did have cushings. He said the medicine was worse than the disease.

At 1:30pm Monk showed a 1 on the diastix which is very high. He ate at 9:15am and received 6 units of insulin. So I may up him to 7 at dinner.

[bowens2]

Re: Monkey

He bowel movements are very healthy and very frequent. He used to go about 6 times a day now I think its about 8 times a day. I don't count but it seems like it is about 8. But they are solid and not off colored or all that smelly.

[bowens2]

Re: Monkey

Betty,
So he's on 9u now twice a day. Remind me what his dose was prior to boarding. Was it 8u? Just curious since he's showing negative now on the strips.
Patty

Patty
He pretty much showed negative all the time before this started happening. He stays pretty even. That's why he has always done so well.

I think you can tell from his test results he normally stays pretty regulated.
Fructosamine 292

[k9diabetes]

Re: Monkey

The newer drug is Trilostane, the older one Lysodren. Trilostane has been used for a while in the U.S. by being ordered but was approved in the U.S. a couple of years ago.

I would disagree that Trilostane is "safer" - it has just as many potential side effects as Lysodren, they are just somewhat different. It is perhaps less expensive to monitor than Lysodren but both are extremely powerful drugs.

There's an ongoing myth out there about Cushing's treatment being worse than the disease and that tells me that the vet doesn't know enough about it. The treatment has to be managed carefully by someone skilled - the lack of that is almost always the source of problems. There are well established protocols for these treatments.

If I had a Cushing's dog, I would treat when symptoms appear and after a very thorough diagnostic workup. My friends at the Cushing's forum (www.k9cushings.com/forum) prefer that Cushing's be confirmed with more than one kind of test and also for there to be visual symptoms of Cushing's disease. They absolutely do not support a diagnosis on a single test.

And I would find the best IMS in the area, plus read up even more at the Cushing's forum than I already have.

Probably the bigger impediment to Cushing's treatment is the expense. The tests are expensive, the meds are expensive, and the amount of monitoring required can be expensive.

But the treatment in a dog who clearly has Cushing's disease and who responds well to the treatment medication can go on to live a very healthy life and normal lifespan.

Natalie

[k9diabetes]

Re: Monkey

Our cat didn't have any diarrhea or other poop problems either. The only Gi sign was that she was having a lot of hairball problems - she has long fur. And in her case, her blood panel was great. But she didn't look good or act normal - she just seemed "off" - so when she suddenly lost weight we had x-rays and an abdominal ultrasound done. The x-rays picked up signs of possible inflammation of the bowel that were confirmed and located precisely with the ultrasound.

Within days of starting Flagyl, she started gaining weight back.

Her brother Gus had severe IBD that shaded into lymphoma. And he eventually died after a large tumor developed at the end of the colon. Katie's inflammation is in the same area of the colon but caught much earlier. And she takes her pills cheerfully. Gus was always almost impossible to medicate.

Both Gus and Katie were very sensitive to food changes all their lives and Gus as a youngster had a very bad bout of inflammation that resulted in cups and cups of clear white mucus. Gus was on prednisone and a mild chemotherapy agent and the tumor that developed was a different type of cancer from lymphoma but I wonder if all that inflammation isn't how it got started.

Natalie

[Soaphie & Sydney's Mom]

Re: Monkey

He bowel movements are very healthy and very frequent. He used to go about 6 times a day now I think its about 8 times a day. I don't count but it seems like it is about 8. But they are solid and not off colored or all that smelly.

Hi!

In my opinion, this is a lot of bowel movements....alot. I know every dog is different - but it seems to me that if your dog is having this many BM's each day, it may contribute to the weight loss - everything is just moving right through him.

Sydney typically goes once per day and Soaphie always 2....sometimes 3 times a day.

Any thoughts?

[k9diabetes]

Re: Monkey

That was my thought as well. Jack takes exactly two a day, about 12 hours apart. Chris... on WD he might have gone four times with all the fiber in his diet. I think without all the fiber it was twice a day.