Diabetic Australian Cattle Dog

[labblab]

That was such a smart thing to do — good job!

[Zoology1603]

I just sent off a pdf of everything I have kept notes on, so hopefully she/he will be prepared for the appointment.

[MomtoMax]

Next week is excellent! Next year was rough for me…
I’ve had two Cushing dogs, but I’ve only ever used Lysondren, so I cannot help

[labblab]

Congrats on getting an appointment! Whew!! And yeah, for sure it seems like a loose tooth/infection could be throwing a wrench into things. Seems like it might explain some of her inappetance, for instance. Good job on persevering with the vet <thumbs up!>

[Zoology1603]

I got the appointment. Couldn't get in until next week and we also had some doctor appointments to dance around.

As a side note: I noticed she has a loose tooth in front. She could be fighting off a tooth infection which would throw her off.

[MomtoMax]

Do it ASAP! It has been a minefield getting a vet around here… I think you mentioned you are pretty rural, as are we. We drive an hour for our new vet, but they are worth it!
Donna

[Zoology1603]

I think I managed to find a vet. Looks like a long drive. I still have to make an appointment.

[MomtoMax]

Since the pandemic, it’s been very difficult to find a vet, My practice of 40 years sold out when the doctors all returned and I had to be on a year long waiting list for more than a year!
As to using the old bottle of Vetsulin, I wouldn’t advise it as I was told they’re only good for thirty days after the first puncture, but that came from one of the doctors at my old clinic that I no longer go to, so you might want to research that…
Donna

[Zoology1603]

The pills are scored down the middle. So I have been using them in the exact same way as I was the soft chews. 20 in the morning and 20 in the evening. I did not add the 1/4th of a pill this morning. I did so the 2 previous days because I could monitor her all day long and had prednisone in abeyance if needed. So it's normal routine again today.

I'm getting pretty frustrated finding a new vet. The ones I am being recommended don't take new clients. Some just aren't capable of handling a dog with her conditions. Doing the tests you recommend.

[labblab]

OK, here I am back again. I’m guessing you’re right — getting Bear spayed may go a long way towards stabilizing her whole endocrinological picture. If so, that would be great. In the meantime, as always I totally defer to the good folks here in terms of her diabetic issues.

As far as her Cushing’s, I’m afraid I don’t have much to offer right now other than to continue to press you to get her cortisol level checked just as soon as you can make a new vet appointment. Dosage increases make me extra nervous, especially in view of the fact that she’s been having some episodes of inappetance recently. In order to monitor her cortisol level, an ACTH stimulation test would be preferred. But as I think we discussed before, even a simple pre-trilostane baseline cortisol level would offer helpful information. At a minimum, it could provide some peace of mind that Bear’s cortisol level is not dropping too low on her current dose. From a safety standpoint, that’s our biggest concern. Once again, here’s a link to the pre-pill monitoring protocol:

https://drive.google.com/file/d/1aQO...ZWjCrdlG4CE7p0

As far as Wedgewood, as I mentioned on K9C, many years ago there seemed to be some issues with Wedgewood. However, they are nationally known and many vets use them for compounded products. We haven’t had much discussion of specific compounders on K9C for quite some time, so I can’t offer any relevant current feedback. However, I just checked and they are accredited by the national Pharmacy Compounding Accreditation Board (PCAB), so that’s a good point in their favor. However, since there’s now been a change in the delivery system of Bear’s trilostane (chewable tablet to pill), it seems possible to me that the medication may be metabolized a bit differently. In that vein, I know you’d said that her chewables could be divided in order to manipulate her dosage. What’s the situation with the pills? Are they scored in such a way that you can reliably make dosage alterations? If not, that’s another reason why I’d be very cautious about trying to increase her dose, especially until you can get that cortisol testing done.

That’s all I can think of for the moment. Hopefully Bear can soon be seen by a new vet and you guys can establish a good working relationship going forward.

Marianne

[Zoology1603]

I think once I find a new vet and can actually get her in for a spay things may turn over again. I feel that's probably the issue.

[labblab]

Hi again, although I’m really sorry you and Bear are hitting another rough patch. I had so hoped that things were going well for you guys. I just now saw your note over on K9C and I posted a short reply there. I’ll return again here, though, later today or tomorrow in order to consolidate my thoughts alongside the other folks here. That way you won’t have to keep updating in both places, plus we’ll all be on the same page. So I’ll be back again soon.

Marianne

[Zoology1603]

Not sure what we are seeing now. Current vet has not responded so I'm looking for a new one. Was planning on having her spayed after her last heat cycle finished. Not sure if that is why she is experiencing excessive thirst again or if it is something else. Didn't write things down like I should have. Vet changed pharmacies and switched from chewable Trilostane to a pill form. I believe she started drinking more before the switch though. The last 2 days I added 10mg more Trilostane for the day to see if I could notice any changes. (That's 50 instead of 40) Dogs sometimes need their doses changed over time I read from the cushings forums. Today we used the old Vetsulin bottle to see if that insulin is where we should have stayed but the Novulin N was doing good I had thought. Maybe she has an infection but I don't think so. Nothing much I can do on my end without a vet. Here is the best timeline I could put together.

November 16, 2022			New bottle of Vetsulin.
December 5, 2022			Started using Novolin N. Switch from Vetsulin, looked good.
December 18, 2022	71 mg/dL	11:52:00 AM	Curve done. Lowest reading.
December 21, 2022	276 mg/dL	02:36:00 PM
January 1, 2023			Started drinking more water sometime here while on old Trilostane I think.
January 1, 2023			Heat cycle sometime around here.
January 2, 2023	291 mg/dL	11:34:00 PM
January 2, 2023			Finished last Hills, started using Nulo wet/dry combo exclusively.
January 11, 2023			New Trilostane in pill form.
January 22, 2023			New bottle of Novolin N.
February 7, 2023			Not wanting to finish morning meal. Finished it later.
February 18, 2023			Not wanting to finish morning meal. Finished it later.
February 19, 2023	531 mg/dL	03:27:00 PM
February 26, 2023	472 mg/dL	01:24:00 PM

The new pharmacy is called Wedgewood. I don't think it's well liked on the cushings forums. Would love to say for certain that is the issue but I have no grounds to stand on that.

[jesse girl]

Good news and continued progress . It definitely simplifies things a bit . I still have Jesse's original first vial of vetsulin . I thought I would be reimbursed for it when it was removed from the market . That never happened . Now it's just a memory of a time of great change

[Riliey and Mo]

i found your recent post just scroll down the bottom of the page click on trending. Then scroll down the bottom of the post page till you get to the most recent post. If theres an easier way to get to the recent post let me know lol. FOund it, click on the post then options the recent activity

the change over of insulin is easy as long as the dose is dropped back which you did.
take it slow, wait 7 days on each dose without any othe changes and Bear will do just fine.
10 units is pushing it as theres no room for changes if she gets an infection.
And of course take into consideration her blood sugar fluctuations when shes in heat.
your doing great. Keep warm
hugs to Bear