New here with Tali, 10 yr old poodle terrier mix (Diabetes and Cushing's)

[tomswife29]

Hi, my name is Heather, and my 28 lb 10 year old poodle terrier mix Tali was diagnosed with cushings today. she was diagnosed with dibaetes about two weeks ago, but the vets were having a hard time regulating her. $3400 later they hardly ran any tests and still couldnt tell us what was wrong with her (some vommiting and lack of apetite, along with the bg being out of whack). we went to another vet who i was recommended to and he kept her overnight to do tests. he started her on vetoryl trilostane 60 mg and shes taking pet tinic for her anemia, along with the insulin for her diabetes. if anyone has some advice for me on this medication (trilostane) it would be greatly appreciated as i know there are side effects and im wondering what to expect in the next week.

Heather and Tali

[BestBuddy]

Hi heather and Tali.

I am one of those that has a leg in both camps (k9 diabetes and here) as I had a dog with both. Buddy had been diabetic for over 4 years before we got the diagnosis of cushings. Buddy was only around 11lbs and we started our treatment with trilostane at 30mg. We got some good results at the 10 day test and even better at 30 days but our cushings journey was a strange one so I won't go into that here.

I do want to mention that you must keep a close watch on Tali for changes in eating and behavior. You need to keep a close check on the BG's because if the trilo starts working as it should you may see a decrease in insulin needs fairly quickly. Sometimes it takes a while but you just never know. Making sure you get the required testing along the way to monitor Tali will be very important.

Jenny

[tomswife29]

we are giving her a higher dose for this weekend (10 iu) where normally she had been getting 8 iu. my vet said we will probobly lower the dose next week. i feel sooooo lost right now it would really help to hear about someone elses experience with both diseases!

Heather and Tali

[StarDeb55]

Heather, welcome to you & Tali! I'm very sorry to hear that Tali has bee hit with both of these illnesses. I have no experience with dealing with both at the same time, other than to say that I know that BG's can be more difficult to regulate until the Cushing's is controlled. We do have several other members who have successfully dealt with both issues, so hopefully they will be along.

Could you tell us exactly what diagnostic tests were done to determine Cushing's? If possible, it would be extremely helpful, if you could post the results for us. We are not trying to second guess your vet, but we have seen too many pups misdiagnosed due to incomplete diagnostic testing, a vet with little experience treating Cushing's or both. I'm going to hazard a guess that with your vet suspecting Cushing's due to the difficult to regulate BG's, he/she probably has experience. The more information you are willing to give us about Tali's medical background, including symptoms, testing, etc, the better we can help.

I can't comment in depth on trilostane usage as I have used lysodren to treat 2 pups for Cushing's. What I can tell you is trilo has a half life in the body of about 12 hours. Possible signs of a problem might be nausea, vomiting, diarrhea, lethargy, & muscle weakness. This is going to be hard to tell I know, because signs of DKA are pretty much the same. Trilo is an excellent drug & we have a lot of members who are using it quite successfully to treat their pups. Did your vet also tell you that Tali will need an ACTH test done 10-14 day after beginning the trilostane, so both of you can see how she is responding? The last thing the trilo parents will want to know is what is the dosage that your vet has started Tali on.

Last, but not least with have a sister site.

http://www.k9diabetes.com/

The members over there have tons of experience with taking care of pups with diabetes, & pretty much can answer all of your questions along those lines.

Looking forward to hearing more.

Debbie

[tomswife29]

thank you, i also belong to the diabetes forum as well, they have been so supportive to me during all of this. tali takes 1 60 mg trilostane once a day. im cant remember the exact tests he did off the top of my head but i believe they are all on the bill (somewhere in my car). i know he did acth stimulation test pre and post, urinalysis w/reflex, cbc/ chem 10 and xrays (this is what i wrote down, im not sure if there was anything else done besides thyroid tests and stuff to rule out other issues). talis symptoms include excessive water intake and urination in the house, panting, seeking out tile to lay on, hyperpigmentation, weekness in hind legs, increase in appetite, and a pot belly to name a few symptoms she has been experiencing. i know it is hard to distinguish some diseases from others especially when the symptoms are the same, but the vet seemed pretty confident after looking at different blood tests and her acth. a well as her symptoms. i dont have the results to the tests, i was so happy to pick her up i forgot, but were going back mon or tue and i will get the coppies of everything. its so crazy learning about all of this in a week (cushings in a day) i dont want to do anything wrong and want to stay on top of everything. its diffucult because i also have a hyperthyroid 18 yr old cat with a heart murmur and beg. renal failure as well as 2 rabbits so i am trying my best but would appreciate any advice!! thank you!

Heather and Tali

[AlisonandMia]

Did Tali have some of these symptoms before the diabetes hit? It is very hard to tell what is causing what but if she was showing signs of Cushing's before she developed diabetes it makes it more likely that she does indeed have Cushing's - and that trilostane will help.

It always worries me when a diabetic (particularly a newly diagnosed and unstable diabetic) is diagnosed with Cushing's because the stress of the diabetes can very definitely cause false positives on the Cushing's tests.

Alison

[acushdogsmom]

Welcome, Heather and Tali,

Here's a link to a topic in our Resources part of the board where you'll find a few links to sites that are very helpful for new members to learn the basics about Cushing's:

Links to Cushings Websites (especially helpful for new members!) (http://www.k9cushings.com/forum/showthread.php?t=180)

Here's a direct link to our Resources Forum's topic about trilostane:

Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185)

And here's the main link to our Resources section of the board where there are many different topics of interest:

Helpful Resources for Owners of Cushing's Dogs (http://www.k9cushings.com/forum/forumdisplay.php?f=10)

As for the Cushing's diagnostic test that your new Vet did (the ACTH stimulation test) if you can get the results (pre and post numbers) and post them here, that would be great. The ACTH stim test is supposed to be more reliable (than the LDDS test) in a dog who also has a non-adrenal illness such as Diabetes. So in my opinion, your new Vet chose well between the two usual Cushing's diagnostic tests.

Most of us keep copies of our dogs' test results in a folder or binder at home. It's really helpful sometimes if we have copies of all the test results - like for example if we have to see an ER Vet over a w/end when our usual Vet is unavailable - for something totally unrelated to our dogs' Cushing's (or in your case, Diabetes too). If we have all the results to be able to show that ER Vet, it's hugely helpful for them to be able to read through the test history. Hopefully you never actually need to do that, but if you do, you'll be glad to have that binder.

My dog was not treated with trilostane (we used an older medication called Lysodren) but there are many people here using trilostane and several whose dogs also have Diabetes, so hopefully you'll be getting lots of good input from them, too.

What I do know about trilostane is that it is supposed to have a fairly short "half-life", which means that it doesn't stay on and work in the body for a long time - so that's why it has to be given every day. I don't think there are usually any side effects, as long as the dose being given is the right dose. If the dog does have side effects from the trilostane (like vomiting, diarrhea, lethargy, very poor appetite, etc) that usually is a sign that the cortisol production may have gone too low and that a trilostane dose adjustment is needed. They'd test with an ACTH stim and they'd check the electrolytes (sodium, potassium) and then make the dose correction based on the results.

Even if the dog is doing great and has no side effects at all, you'll need to do ACTH stim tests periodically along the way during treatment - so once the dose is figured out, you will still probably need to do ACTH stim tests every 4 to 6 months (2 or 3 times a year) for the rest of Tali's life to monitor the trilostane treatment/cortisol production, to be sure that the dose you are giving is just right for Tali. It's the same test that we do as a diagnostic test, and it takes about an hour to do.

As the trilostane "kicks in" and causes the cortisol production to be less, the dog will likely need less insulin. That's because cortisol is an insulin antagonist and can cause insulin resistance, so the higher the cortisol levels are, the more insulin is needed. The lower cortisol levels will allow less insulin to work properly to control the bg.

There's much more information about trilostane in the link I gave you above, but if you have any questions and can't easily find the answers, please feel free to ask us and someone will gladly answer and explain to you. :)

I think it's a good idea if I post a link here to your thread over at our "sister board" (k9diabetes) so that folks here can go read your thread there if they like, to catch up on Tali's story - so here's the link to your thread over there:

http://www.k9diabetes.com/forum/showthread.php?t=2035

Although it can be difficult at first to figure out that a dog does indeed have Cushing's and Diabetes, once you do get it all figured out, the dog is very likely to get very much better and live out a happy and normal lifespan for their breed. Hang in there!

(((hugs)))

P.S. I just saw Tali's picture! Sooo cute! :D

[Squirt's Mom]

Hi Heather and welcome to you and Tali! :)

We don't treat with Trilo nor do we deal with diabetes so I can't help with those much at all. It is GREAT that you are on k9diabetes, tho. They will be able to give you really good direction with the diabetes. And now you have us for the Cushing's...so you and Tali are in good hands all around.

Keep in touch, read a LOT and ask as many questions you may have and we will do our best to help you understand. You and Tali have many folks walking this path with you now so you don't have to travel alone.

Hugs,
Leslie and the girls - always