Diabetic Australian Cattle Dog

[labblab]

Re: Diabetic Australian Cattle Dog

Hi Guys, sorry I haven't had a chance to reply sooner, but I've been out running a bunch of errands today. I just now saw those LDDS results, and I'll definitely add a more thorough reply as soon as I can. Hopefully tonight, but if not, tomorrow morning for sure. But just wanted to let you know that I've seen them and will pass on my thoughts about them and also the trilostane ASAP.

Marianne

[Zoology1603]

Re: Diabetic Australian Cattle Dog

Here's my math if anyone wants to check it.

Given a 792kcal per day requirement.

Hill's a/d: 180kcal/can; 156grams/can; Half a can per meal is 90kcal.
Holistic Select: 3916kcal/1000grams; 3.92kcal/gram

Subtract 180kcal from 792kcal leaving 612kcal left for dry.
156 grams of dry is supposed to have 612kcal. Half per meal is 78 grams.

It differs from the recommended values on the back of the bag because your using kcal per your specific dog's requirements (age, weight, activity level) vs. basic weight. Plus you have to believe all these kcal numbers are accurate.

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

yes i.ve been reading alot these couple of days on blue heelers. there quite fasinating, interesting along with watching the wild animals around here and changing the remote on my tv.

heelers need two meals a day, the more active ones 4 to 5 times a day. holistic is the top food for blues. wellness and solid gold these grain free for seniors.

australian cattle dogs need different foods then say a mixed breed

back in the day dog food got tainted, owners started cooking for their dogs, too worried to buy store dog food, fed mostly chicken overfed getting bowl curves and they got fat. different family owned dog food companys started up. theres lots to choose from

i couldnt find any specific diets for a senior blue heeler but your doing nice on compiling one.

theres a k9 biography section, first page of this site. as you go along maybe you.ll tell us her story.

its important to get the amount of food right in order for regulation. your doing great .

[Zoology1603]

Re: Diabetic Australian Cattle Dog

Thanks for the words of encouragement. I need it some days.


When talking with the vet tech yesterday, I was told she would likely never go below 200.

[labblab]

Re: Diabetic Australian Cattle Dog

labblab this part's for you...
Test: Cortisol (preldds) Results: 323 HI Reference Range: 58 - 144 Units: nmol/L
Test: Cortisol (4hr LDDS) Results: 263 HI Reference Range: blank Units: nmol/L
Test: Cortisol (8hr LDDS) Results: 181 HI Reference Range: 0.0 - 42.0 Units: nmol/L
The results said she is spayed, she is not. The results said she is 6 years old, she is 9. So I don't know if that effects the results in any way. Is this the full test results?
The Trilostane is compounded. 40mg, 1 chew once a day.

OK, here I am back again. Yep, these would be the full test results, and the error about Bear's spaying would not have an effect. Since there's an error about her age, as well, I sure hope they're truly reporting the results of *her* test, though! But assuming this is really her bloodwork, off we go.

First, I'm converting the results into units that are more commonly used here in the U.S., so that they'll look familiar to any of our readers worldwide.

323 nmol/L = 11.7 ug/dL
263 nmol/L = 9.5 ug/dL
181 nmol/L = 6.5 ug/dL
reference range for the 8-hour test: 0-42 nmol/L = 0-1.5 ug/dL

So, Bear definitely exhibits elevated cortisol readings at all three times. We're not as interested in her initial baseline reading because that can be highly variable even for normal dogs, depending on their stress level, etc. However, I will note that Bear's resting cortisol is quite high since the reference range cutoff is around 5.2.

But turning to the diagnostic test results, we look first at the final 8-hour reading. It is way higher than the normal cutoff, so that's indeed a number that's consistent with a general Cushing's diagnosis. Having said that, we explore the numbers further. Depending on the complete pattern of results, it's sometimes possible to conclude that if Cushing's is present, it's being caused by a pituitary tumor as opposed to an adrenal tumor.

In Bear's case, the 4-hour reading is also elevated way over the normal range, and neither the 4-hour nor the 8-hour reading drop below 50% of the initial baseline reading. This pattern could occur with either a pituitary tumor or an adrenal tumor. Further testing would be necessary to differentiate between the two. Certain blood testing can be done. More commonly now, we see vets recommending abdominal ultrasounds in order to have direct imaging of the adrenal glands. This way, any masses or abnormalities can be seen that would rule in/out an adrenal tumor, and also the status of the other internal organs can be assessed.

What does all this mean for Bear? Given all the other expense you're already shouldering and the other concerns you have, I doubt an adrenal ultrasound would be the next item on your checklist. Especially since imaging of this nature would undoubtedly require you to travel quite a distance to a specialist. Pituitary vs. adrenal tumors each carry their own sets of issues, and in an ideal world, it would be helpful to know Bear's status in that regard. But in reality, trilostane is used to treat both conditions. So if Bear truly has Cushing's stemming from either type of tumor, you wouldn't have to shift to a different medication.

So finally, do you start treatment or not? You already know my worries about the accuracy of the diagnosis, and prior to seeing these results, I was firmly of the mindset that I'd hold off. I will confess that these cortisol results are highly elevated, however. Thankfully, the trilostane dose of 40 mg. does correspond to that recommended starting formula of a daily total not to exceed 1 mg. per pound. Are the chews scored, by any chance, and able to be split in half? If so, and if you do start treatment, then giving half in the morning and half in the evening along with Bear's meals and insulin is what I've seen recommended for diabetic Cushpups in order to try to keep cortisol levels under more consistent control throughout a 24-hour time period. If the chews can't be split, then they should be given in the morning rather than the evening. Trilostane should always be given alongside a meal in order to be metabolized properly.

Since you're dealing with so many moving pieces right now, if it was me personally, I'd probably still hold off on introducing the trilostane for a while longer. You've got the chews in hand and can start at any time. But if you decide you want to give it a try, I'll stay right here to continue to offer any guidance that I can. I'll also repeat one other kind of "out-there" suggestion, and that is to consider directly consulting with Dr. Bruyette about Bear's situation. I think one-time consultations cost $200, which is a lot since I know you're already spending so much on everything else. And typically his consultation services are undoubtedly set up to deal with vets, but under your circumstances he may be fine with just talking directly to you. Over the years, he's been in direct email contact with various of our K9C members. If you do choose to contact him to ask him about a consultation, be sure to tell him you're a member on both the K9C and K9D websites.

OK, I've written a book so will close for now. Think things over, and remember, it's alright to take whatever time you need to make a decision you're comfortable with.

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

hi

i havent seen a glucose test posted, only once yesterday.

please post :
water intake alot still?
has her constant peeing stopped?
colour, composition of fecal
bg tests yesterday and today

can you cut the cushing pills in half?

[Zoology1603]

Re: Diabetic Australian Cattle Dog

Thanks for the information labblab. I was going to listen to David's lecture again because he breaks down how to understand the results. You did a better job of explaining things for me. I hate that the diabetes could have skewed the test results as otherwise I don't think there would be any doubt. You've given me some good information to think about, I appreciate it.

The chews were made by svpmeds and are not scored. $57 for 30.

https://www.svpmeds.com/product/tril...ded-dogs-cats/

9/20
8:00am :: 549
8:07am :: 50 grams Holistic Dry, 78 grams Hills a/d
8:12am :: 9 Units
2:09pm :: 508
6:18pm :: 460
6:22pm :: 78 grams Holistic Dry, 78 grams Hills a/d
6:26pm :: 9 Units

9/21
6:26am :: 578
6:40am :: 118 grams Pure Balance Wet, 70 grams Holistic Dry
6:43am :: 9 Units

The vet didn't have any Hills w/d. I think there is a shortage. I have some on order but I have to use what I have on hand for now. I did notice that if using the w/d I'll need 88 grams of dry as it doesn't provide much kcal.

Last night she drank all but 1/4 of her gallon of water and went out to pee a couple of times. She pooped this morning, dark brown in color and solid but plenty moist inside.

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

thanks, your good

day 7

get Bear more comfortable. bringing blood sugar down to a better range is first on the list and let food change settle.

i.d be raising her insulin 1 unit from 9 to 10 tonight. get her out of the high 500,s. test her 2 hours after and before you go to bed, post

looks like the cushings lab tests are high. can you break the pill in half? 1/2 mixed in with Bears meal am and pm.? if you cant cut them. one in the morning mixed with her food.

cant tell if meds work and bring the blood sugar down till you try .

tomorrow test her fasting at 2 and 4 hours after food and post please.

[Zoology1603]

Re: Diabetic Australian Cattle Dog

She took another poop while we were outside cutting some small trees. If anyone wants to see it the link is below, hopefully no one has any complains about it being shared.

https://imgur.com/UeWcxwU

[Zoology1603]

Re: Diabetic Australian Cattle Dog

12:24pm

AlphaTrak2 :: 510
TrueMetrix :: 304

[Zoology1603]

Re: Diabetic Australian Cattle Dog

i.d be raising her insulin 1 unit from 9 to 10 tonight. get her out of the high 500,s. test her 2 hours after and before you go to bed, post

I'll try. Sometimes I drift off to sleep pretty early given I don't sleep much through the night. New strips are arriving today.

looks like the cushings lab tests are high. can you break the pill in half? 1/2 mixed in with Bears meal am and pm.? if you cant cut them. one in the morning mixed with her food.

No I believe these are poured into a mold and that would not distribute the meds proportionally evenly. They look like little soft doggy treats.

[labblab]

Re: Diabetic Australian Cattle Dog

I hate that the diabetes could have skewed the test results as otherwise I don't think there would be any doubt.

I have to agree that those cortisol levels are elevated enough to make me reconsider things, too. This is where I just don’t know enough myself, though, to be able to judge whether a nonadrenal illness like diabetes would be likely to cause elevations that significant — and why I’d sure be happy to punt to a specialist. My other worry is if, right now while the insulin dose and glucose level remain such moving targets, adding the trilostane will unsettle things even further. Although they’re running higher than you’d like them to remain, would it be better to at least arrive at a more stable plateau with the insulin/glucose before introducing the trilostane? This part I really don’t know and will rely on the guidance here.

If you decide to give the trilostane now, though, you could start out with the one in the morning for the first month, and then reorder in a smaller dosage so that you could give split doses from then on. We can talk about that in more detail later on if you do decide to start now.

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

i wouldnt use the human truemetrix meter its way off. i.d use the ultra2 its close to the alphatrack or the advocate pet test.

[Zoology1603]

Re: Diabetic Australian Cattle Dog

I was going to email the lab but I'm not sure if they would be much help and I couldn't put into words exactly what I wanted to without writing them a novel which I know they wouldn't want to read.

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

quote:

its helpful to obtain at least one glucose measurement prior to performing the ACTH stimulation test to get an idea of the control of the DM. The blood glucose measurement should be between 100-350 mg/dl. If this is not the case, the ACTH stimulation test may not be accurate and should be repeated

with all thats said here and what i.m reading i wouldnt start the trilostane. example is shes not 40 lbs yet one dose might give side effects. 2. studies done on 8 dogs only 4 had reduced glucose. too many side effects , Bear is only 7 days in recovery, its not time to add a foreign med into her system.

making an appointment with a veterinarian internest good idea at this point. she.ll be healthy to travel
redo the cushing tests in a month

do we all agree its a no

lets up the insulin to 10 units and test.
we can always try changing the insulin to nph if the vetinsulin wont bring her down