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Old 12-19-2009, 07:24 AM
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ajtony ajtony is offline
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Default Tony's Jessie earned her wings

Just wanted to say hello to everyone and tell you a bit about our Jessie. She is an 8 year old Westie, diagnosed about 3 weeks ago with diabetes and cushings disease. Three days after diagnosis she went blind with cataracts. Her b/g level 2 weeks ago was 29 (UK measurement - US I believe 522?) and she was prescribed 5 units of caninsulin once a day and 30 mg of vetoryl. I was concerned that the vetoryl dose may be too high and mentioned this to the vet (he'd only been our vet for 10 days). The next day we got a letter saying they wouldn't be our vet anymore, the reason being, 'we cannot have clients questioning our treatment of their pet'. I was gobsmacked and tried to speak with the vet but they wouldn't say anymore.

To cut a long story short we now have a new vet. Jessie is now on 2 x 5 units of caninsulin and 30mg vetoryl, and is due to go in for a 'curve' next tuesday. Her skin is very sore and itchy and she has 'lumps' all over the place (is this due to the Cushings?) but she is eating well and manages to go for a walk each day (apart from today as her rear paw is very sore and she can't walk on it).

Everything has been a bit of a blur for the last 3 weeks - we have so much to learn about the diabetes and the cushings. We are feeding her on a dry food, 'Bakers Complete' and injecting her 8.30am and then 12 hours later, after food. We are testing her urine with diastix strips and the colour has changed from the very darkest brown, to the third one up which id green (we took this as a good sign).

I will be trawling through this website and trying to do the best for Jessie.
cheers, Tony (Scotland UK)
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Old 12-19-2009, 07:52 AM
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Jaime Jaime is offline
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Default Re: Hi guys, new member

Welcome to you and Jessie! I don't have much advice to offer being that my dog was diagnosed about 2 1/2 weeks ago, but everyone on here is very helpful.

I would recommend reading back through the posts, many of my questions were answered there!

Wow, what a vet...one would think that they would want the owner's to be involved because it shows that the owner will follow the treatment plan. You are better off without them and moving on to a vet who listens and respects that you know your pet better than anyone!

Diabetes and Cushings? They may go down the Cushing road with Abby when she is better regulated but she is doing good now.

Welcome again!

Jaime and Abby
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Old 12-19-2009, 08:13 AM
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Margaret Boyle Margaret Boyle is offline
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Default Re: Hi guys, new member

Quote:
Originally Posted by ajtony View Post
Just wanted to say hello to everyone and tell you a bit about our Jessie. She is an 8 year old Westie, diagnosed about 3 weeks ago with diabetes and cushings disease. Three days after diagnosis she went blind with cataracts. Her b/g level 2 weeks ago was 29 (UK measurement - US I believe 522?) and she was prescribed 5 units of caninsulin once a day and 30 mg of vetoryl. I was concerned that the vetoryl dose may be too high and mentioned this to the vet (he'd only been our vet for 10 days). The next day we got a letter saying they wouldn't be our vet anymore, the reason being, 'we cannot have clients questioning our treatment of their pet'. I was gobsmacked and tried to speak with the vet but they wouldn't say anymore.

To cut a long story short we now have a new vet. Jessie is now on 2 x 5 units of caninsulin and 30mg vetoryl, and is due to go in for a 'curve' next tuesday. Her skin is very sore and itchy and she has 'lumps' all over the place (is this due to the Cushings?) but she is eating well and manages to go for a walk each day (apart from today as her rear paw is very sore and she can't walk on it).

Everything has been a bit of a blur for the last 3 weeks - we have so much to learn about the diabetes and the cushings. We are feeding her on a dry food, 'Bakers Complete' and injecting her 8.30am and then 12 hours later, after food. We are testing her urine with diastix strips and the colour has changed from the very darkest brown, to the third one up which id green (we took this as a good sign).

I will be trawling through this website and trying to do the best for Jessie.
cheers, Tony (Scotland UK)

Hi Tony,

Glad to see you posting and I hope things are settling down a bit

Marg
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Old 12-19-2009, 12:07 PM
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Default Re: Hi guys, new member

You and Jessie have come to the right place, Tony. Frankly, your first vet probably did you a favor by bowing out of Jessie's treatment. My own experience with vets who treated my dog was that they welcomed my seeking knowledge about my dog's welfare. Sounds as though you'll be much happier with your new association. Welcome to this forum and good luck.
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Old 12-19-2009, 12:14 PM
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CarolW CarolW is offline
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Default Re: Hi guys, new member

Hey, Tony! A big fat welcome to you and Jessie! I ADORE Westies!

That's quite a whammy of diagnoses you have on Jessie - not fun, but I truly trust you and Jessie will do really well, because you GOT RID of at least one vet, sounds as though, maybe, two!

I'm gobsmacked, too, at the letter you received from the most recent ex-vet. How ridiculous can a vet get! It's the vet's job to work WITH the human client, regardless of what the problem is.

On the other hand, I suppose I know quite a few humans who behave in similar fashion; they seem to be people who lack confidence, and maybe that vet lacked confidence [grin]

I don't follow the Cushings forum - just too busy, and my dog doesn't have it; I'd be there if he did! But I have read some - for a few months, and wondered, too about 30 mg of Vetoryl (I think that's also called Trilostane?) for a dog Jessie's size - that is, Westie-size. How much does Jessie weigh?

Interesting that the new vet didn't drop the Caninsulin dose size when putting Jessie on twice a day. But I totally agree with the principle of injecting twice a day, rather than once. I think it makes a smoother 24-hours for the dog!

I'm starting to fall asleep at the keyboard, so will come back later - I'll be watching for your reports!

Sat, 19 Dec 2009 11:06:10 (PST)
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Old 12-19-2009, 02:42 PM
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BestBuddy BestBuddy is offline
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Default Re: Hi guys, new member

Hi and welcome.

It can be a tough job getting the cushings and diabetes under control but it can be done. I think i's best that you have changed vets because the only reason a vet wouldn't listen to your concerns or suggestions was if they were worried you would know more than them and over time you will be the one living with Jesse so you will know more about the diseases and her than anybody else regardless of their qualifications.

Have you had any follow up ACTH testing done to see what is happening the the cortisol levels?

Jenny

PS I don't want to overwhelm you but when you are ready (if you haven't already) head over to the cushings board for some more welcoming and support. http://www.k9cushings.com/forum/

Last edited by BestBuddy; 12-19-2009 at 02:48 PM.
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Old 12-19-2009, 08:31 PM
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k9diabetes k9diabetes is offline
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Default Re: Hi guys, new member

Hi Tony! Nice to see you hear and I am so relieved that you were able to find a vet who will work with you.

I didn't realize... and hadn't really put together the pieces... that the Cushings and diabetes were diagnosed at the same time.

I know you're participating in the CCAC Cushings group - did they feel comfortable that the Cushings diagnosis was done properly and there was no question at all about whether Jessie has Cushings?

Way too often we see a misdiagnosis of Cushings in a dog who only has diabetes because the testing can be skewed by the diabetes. So I wanted to be sure.

Re the lumps and bumps... were those present before her being treated for the Cushings and diabetes or did they start after?

If they started after, I'd be concerned about a potential allergic reaction to th one of the new meds.

Natalie
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Old 12-20-2009, 05:33 AM
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Default Re: Hi guys, new member

Hi Tony,

Welcome to you and Jessie. Having diabetes and cushing's makes things a little complicated but both diseases can be treated and controlled. My little girl Lady had the two and did very well. We lost her this past March but not from either disease. Lady was first dx with cushing's and then 2 weeks later diabetes. She had diabetes when she was dx with cushing's but the vet that was treating her at that time missed the diabetes. The new vet wasn't even sure she had cushing's. Unregulated diabetes can give false positives on the cushing's tests. We tried to get the diabetes regulated and when we couldn't we repeated the tests for cushing's - we were also seeing an IMS. All cushing's tests were positive but he still wasn't sure she had cushing's. He had us switch insulin and when we still couldn't get the diabetes under control we starting treating her with trilostane. In a matter of weeks her bg's came down. Getting a cushing's dx requires more than one test. What tests were done on Jessie to confirm cushing's? What cushing's symptoms does she have? Not trying to confuse you but just want to make sure she really has cushing's. Have you joined the cushing's forum yet? Tons of info and support there. Good luck with Jessie and please keep us posted. Hugs to the two of you.
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Old 12-20-2009, 05:37 AM
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ajtony ajtony is offline
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Default Re: Hi guys, new member

Thanks Nathalie and all for the warm welcome and the advice. I hadn't even considered a misdiagnosis for Cushings. However, about 4 months ago Jessie did develop Cushing symptoms, e.g. swollen abdomen, drinking and urinating lots and eating more. She was on steroids at the time and had been for almost a year without any monitoring by the ex vet. I suggested steroid induced Cushings to the vet and we stopped the steroids immediately, and over a week or two there was a vast improvement. Then a few months later she started drinking lots again (no swelling abdomen), urinating and we noticed she had lost a few kilos in weight. I have the blood test results in front of me but they don't mean much to me apart from the fact I can read that her b/g level is high. Would it be worth posting the results on the Cushing Discussion site to see what more knowledgable people than me think.
The last two lines of figures reads:
Cortisol Base 157.3nmol/L (5.68ug/dl)
Post 678.7nmol?l (24.5ug/dl)
Jessie has had skin problems for many years but it does seem to have gone worse in last 3 weeks or so. best wishes, Tony
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Old 12-20-2009, 11:33 AM
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Default Re: Hi guys, new member

Yes, please do ask the question of the Cushings group. We have seen many dogs whose cortisol tests are misleading because of the diabetes.

Our sister forum for Cushings, www.k9cushings.com, is also very skilled at evaluating the test results. I haven't really taken the time to learn to properly evaluate the results.

Your description of the recurrence and the fact that dropping off the steroids showed improvement for several months makes me think more of the steroids kicking off the diabetes at that point than Cushings and diabetics can have skin problems as well.

Of course, I don't want to tick off your new vet! I hope s/he is more flexible in approach. But I would absolutely explore this possibility with the Cushings discussions because it is a very common mistake vets make.

Usually if Cushings is suspected, we suggest treating the diabetes first since that is the life threatening condition and then see what happens with Cushings later. If the blood sugar is readily controlled, Cushings disease is very very unlikely.

So whether you can get control of the blood sugar becomes kind of a litmus test for whether Cushings is really present and often it's not.

Natalie
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