Fritz and me: New Diabetes Diagnosis (Update: in ICU)

[caroleh]

My name is Carole and my hubby and I have 10 dogs and 5 cats all rescued. Recently we learned that our 8 or 9 year old Schnauzer has Cushings. I am scared to death. The vet said his alcp was 2000. This vet speaks through her techs so I have no idea what this means. Fritz has been on Lysodren for almost a month. I have recently changed vets and Fritz had an ultrasound which couldn't detect his adrenal glands due to his fat tummy. The new vet is going to do an ACTH test this coming Thursday. Fritz is eating normally, maybe drinking a little more than usual but he goes outside, here of late ,like a good boy. He is still panting but not voraciously as he once was. Anyone with encouraging news would make my day.

[frijole]

Carole -

It's Kim and you posted on my schnauzer Annie's thread but I thought I'd answer your questions here so you can keep track easier.

First off - this is my 2nd dog that was diagnosed with cushings. The first one, Haley was 12 1/2 at time of dx and she was treated successfully for 4 yrs with lysodren. She just passed away, not from cushings in May at 16 1/2 yrs of age. So there is your happy story!

My other dog Annie we believe was misdiagnosed. We do not think she has cushings despite the test results - I'll spare you the details so yes I know about having to fire vets.

Couple thoughts - first off - I don't care if your vet speaks thru the techs - you need to go and get copies of all the blood tests and cushings tests that have been done and put them in a file. The reason is that you will want to track progress over time and it is much easier. Also you can then answer our questions about what testing was done to diagnose the cushings. We will want to know the names and the numbers on those tests.

:p We aren't being snoopy - it's because cushings can be tough to diagnose and sometimes if enough tests aren't done there are misdiagnosed cases. We see it frequently here so we always just want to make sure we have the whole story before we throw out advice.

If Fritz isn't responding to lysodren it is either because Fritz doesn't have cushings OR the dose is too low. OFten inexperienced vets will start at doses that are very low and you must increase it in order to reduce the cortisol levels.

So tell us about Fritz's symptoms, the whole story from the beginning so we can better help out. But please know this disease is not a death sentence. Also check out our important info section to learn more about the disease. Meanwhile here is a handy sheet on the 'loading' process using lysodren. Please read it as it will help you thru this process a great deal... at least it did me! Kim

http://www.k9cushings.com/forum/showthread.php?t=181

[caroleh]

God Bless you Kim. You brought tears to my eyes with your concern. I am a total basket case. I have been so fortunate to find this site. As I told you I had one vet for over 20 years. He failed to diagnose Fritz's problems, enlarged tummy, panting, wetting in the house, excessive water intake. I also have a 17 year old cat that I had checked every six months and this doctor failed to see he was anemic. So I changed vets and the second vet who talked through her techs was fired. Some day I would love to tell you the story there. I have never seen so many hostile people in my life. This new vet was acquired when the (hostile) vet sent me to him for Fritz to have an ultrasound which was of no value because of the fat tummy. Fritz's vet test is only comprised of ALKP which is 2000. The HV( hostile vet) never gave me his panel of tests. So right now I am waiting til this Thursday when the new vet does a ACTH test to see where we stand. Kim, doyou have any understanding of what a 2000 ALKP level means. What kind of serious situation are we in here. Thank you so much for taking the time to answer me.

[labblab]

Hi Carole,

Welcome from me, too. I just wanted to tell you to double-check your emailbox or spam folder for a "confirmation" message that you need to return to us in order to complete your membership. Until that time, your replies will not appear immediately when you type them, but instead they will be held for approval from one of us staff members. If you do not find the confirmation message awaiting you among your email, let us know and we will confirm your membership manually so that you don't get stuck waiting in limbo...

Marianne

[frijole]

God Bless you Kim. You brought tears to my eyes with your concern. I am a total basket case. I have been so fortunate to find this site. As I told you I had one vet for over 20 years. He failed to diagnose Fritz's problems, enlarged tummy, panting, wetting in the house, excessive water intake. I also have a 17 year old cat that I had checked every six months and this doctor failed to see he was anemic. So I changed vets and the second vet who talked through her techs was fired. Some day I would love to tell you the story there. I have never seen so many hostile people in my life. This new vet was acquired when the (hostile) vet sent me to him for Fritz to have an ultrasound which was of no value because of the fat tummy. Fritz's vet test is only comprised of ALKP which is 2000. The HV( hostile vet) never gave me his panel of tests. So right now I am waiting til this Thursday when the new vet does a ACTH test to see where we stand. Kim, doyou have any understanding of what a 2000 ALKP level means. What kind of serious situation are we in here. Thank you so much for taking the time to answer me.

Carole - I understand... I am on vet no. 3. Anyway - real important question... are you SURE that only the blood panel was done? 2000 is an elevated liver reading which means the liver is being stressed. It could be due to cushings but it could be to alot of other things... it is inconclusive for cushings and I would never start a dog on lysodren without additional testing.

You did the ultrasound but couldn't see the adrenals so that couldn't confirm the cushings either.

So unless you did a urine creatine ratio test, the acth test, or the low dose dex suppression test (LDDS) you really don't even have a confirmed diagnosis yet.

Granted you have alot of symptoms that point to cushings but you need the acth test in order to see where the cortisol level is. The reason you give the lysodren is to lower it to a certain level.

Please tell us your dog's weight and the amount of lysodren you are given and the frequency. Thanks! Kim

[frijole]

This group of people helped save me from disaster 5 yrs ago so I'm just helping repay my dues. ;)

I forgot regarding your question on the alk phos, my dog had a reading of 2000 on the alk phos and she did just fine so don't worry about that reading - lets get a confirmed diagnosis and tell us about the dosage you are on. Thanks!!!

[caroleh]

I feel so much better having you alls encouragement. As I said my vet #1 after 20 years was a disappointment. Vet #2 was not the right one due to the rudeness of the staff and the fact that only the tech talked to me. I am now on vet #3 and we will see what happens. My hubby just cleaned up the car and found a paper with some stats which I will list. I do see a urine collection done.

July 27 cort 2.0 ug/dl @8:46 a.m.
July 27 cort 25.7 ug/dl @ 12:39 p.m.

June 21 cort 3.3 " " no time listed
June 21 cort 26.4

Na 155
K 4.6
Ci 115
TP 7.8
Tbil 0.2
Phos 4.5
Glu 123
GLOB 4.5
CREA 0.7
CHOL 268
CA 11.8
BUN 12
AMYL 755
ALT 58
ALKP 2000
ALB 3.3
T4 2.3

I thank you again for all of your information on this site. I feel so much better about my little Fritz. With 10 dogs, we have three seniors and with five cats we have three seniors.

[frijole]

Carole, You probably missed my question in that long post of mine... what is the dosage of lydoren that Fritz is on? (1/2 pill, whole pill etc) and how often does he take them? Thanks.

also what is his weight?

This way we can calculate whether or not the dose is too low.

Looks like you had acth tests done twice once in June and once in July. Were those the first two you had done? Was the first one before giving lysodren?

Thanks! Kim

[caroleh]

Thank you Kim. As you can see I have no knowledge about meds. O.K. the Lysodren says 300 Mg (mitolane) and Fritz has one every 12 hours. Weight is 30 pounds. Yes I do believe the first ATCH was before because the vet had to order the Lysodren.

I keep pinching myself because I am so grateful to have found you. Thank you so very much.

[caroleh]

I have been reading about holistic meds like milk thistle and so forth. I know a lot of people laugh about this but I know God brought these things to us and they are for a purpose.

[frijole]

Thank you Kim. As you can see I have no knowledge about meds. O.K. the Lysodren says 300 Mg (mitolane) and Fritz has one every 12 hours. Weight is 30 pounds. Yes I do believe the first ATCH was before because the vet had to order the Lysodren.

I keep pinching myself because I am so grateful to have found you. Thank you so very much.

Please double check because lysodren (aka mitotane) usually comes in 500 mg tablets not 300. Thanks.

[frijole]

I have been reading about holistic meds like milk thistle and so forth. I know a lot of people laugh about this but I know God brought these things to us and they are for a purpose.

Alot of us use these as supplements to help but trust me if they were a cure we wouldn't even be sitting on this board reading and helping out. ;):D

Many of us use fish oil, glucosamine for arthritus and milkthistle for liver.

[caroleh]

I have read everything I could get my hands on and I am still so confused about Cushings. Could someone be kind enough to tell me what tests are involved to ascertain that Fritz has Cushings. is there something in the Vet test that determines the disease. I went to an "iffy" vet and she said the minute she looked at Fritz she knew he was a Cushings dog. Panting, bloated tummy. But his legs are not spindley legs, there is no hair loss. His vet test performed on June 8th showed his ALKP was 2000. She then told me she had to order Lysodren and he has been on that for almost a month. He has had no change during the ACTH testing performed while taking Lysodren. i guess my question is could Fritz have something other than Cushings. I have changed vets due to the last one scolding me cause I went over my 30 minute per patient time. I might also add that her techs take care of her patients with a brief input from her. I was told that I set her back with her other appointments that day because she had to come in to explain something to me. Great vetside manner, huh? Kim has been an angel in helping me. I thank God I found your site and feel blessed to have the support that you offer.

[frijole]

I have read everything I could get my hands on and I am still so confused about Cushings. Could someone be kind enough to tell me what tests are involved to ascertain that Fritz has Cushings. .

Carole - The blood panel that was done would suggest something is going on with the liver enzymes elevated. At that point a vet could NOT diagnose cushings. They could suspect cushings. They should then do testing which could include:

UC:CR urine test to rule out cushings (I don't think this is the one your vet did)

ACTH test to determine the cortisol levels.

Low Dose Dex Suppression test (LDDS) An 8 hr blood draw - the best standard for diagnosing and sometimes determining the type of cushings

Ultrasound to look at the adrenal glands and other organs

From what you told us your vet didn't do the first acth test until AFTER you had been on lysodren for a while.

From the looks of the two acth tests and the symptoms it could be cushings. But if so there was NO significant change after over one month on lysodren... either it isn't cushings or the dose is too low.

[frijole]

It's me again! :D

From the info your husband found in the car and what you have shared so far please confirm this is correct:

June 8th a blood panel was done and the alkp was 2000-ish.

Your vet then ordered lysodren and you started ??? WHEN giving 300 mgs 2 x daily. I assume you have not changed the amount given or you would have told us already

Fritz weighs 30 lbs

6/21 3.3 pre, 26.4 post ACTH test
7/27 2.0 pre, 25.7 post ACTH test

You typed up all the blood panel results which is great but we need to know which ones were either HIGH or LOW and the normal range. This should be on the report.

Be sure to give us the normal range for glucose and the T4 numbers. That way we can rule out/in diabetes and hypothyroidism which mimic cushings.

Kim

[lulusmom]

Hi Carol and welcome to you and Fritz.

Kim has done he usual good job of covering the bases but I wanted to give you my two cents and maybe expand on a few things Kim has already covered.

Like Kim, I have two dogs with cushings and both are being treated with Lysodren. Mitotane is the compounded version of Lysodren which is why you probably have 300mg capsules as opposed to a 500mg pill. My babies are very little so they are also on compounded Mitotane.

The prescribed loading dose for Lysodren is anywhere from 25mg to 50 mg per kg. Fritz' weight converted to kilograms is 30 divided by 2.2, which equals 13.64. His 300mg dose twice daily works out to about 44mg per kg which is a healthy dose. You have listed results from two acth stimulation tests. The dates of these tests are almost a month apart. The average loading time is 5 to 8 days and your vet should have prescribed no more than 8 to 10 days of pills. He should have instructed you that if signs of loading were not observed before 10 days, Fritz should be brought in for an acth stimulation test at the 10 day mark. Did your vet not do this or perhaps you are missing the results of a stim test that was done between the June and July results you posted? If the times you have listed for the blood draws done during the stim test in July are correct, your vet blew it. If the stimulating agent used was cortrosyn, the initial draw is done and then the cortrosyn is injected and a second draw is done one hour later. If the times are correct, Fritz' second draw was done almost four hours later. If an acth gel was used instead of cortrosyn, the second draw should have been done two hours later so either way, somebody was too busy to perform the test according to protocol at your vet's office.

Did your vet also explain what signs you should be looking for to determine if Fritz is loaded? Most dogs have a voracious appetite so it is usually a change in feeding habits that clues us in. It can be as subtle as a dog lifting his head out of the bowl before the food is gone or finishing the food in 40 seconds rather than the normal 10 seconds. :D That may be an exaggeration for some but not my dogs before treatment. As I recall, Fritz has a normal appetite so your job is a lot harder. A change is water intake is also a sign but waiting until you see an improvement in drinking and peeing habits can be problematic. Some dogs have been drinking and peeing buckets for so long that the kidneys go through what is called medullary wash out. Some dogs regain the ability to concentrate the urine right away but some take a lot longer than 8 to 10 days. It is therefore very risky to treat a dog without a big appetite with Mitotane and it is absolutely unacceptable to not do a stim test at 8 to 10 days.

My cushdog, Jojo's bladder was so huge when he had the abdominal ultrasound that they could not visualize the adrenals but the liver was enlarged as is common in cushing's so with all of his raging symptoms, bloodwork abnormalities and positive LDDS, his vet felt comfortable with confirming the diagnosis without seeing the adrenals. Were they able to visualize Fritz' liver and if so, can you tell us what comments were made by the radiologist? Dogs with cushing's, especially one that has severe elevation in alkp, have enlarged livers. The liver of a cushdog will also usually show distinct changes in texture. By the way, alkp is a liver enzyme called alkaline phophatase. This enzyme can be triggered by, I believe, three sources; they can be induced by the gut (GI), any underlying condition that has a direct impact on liver cells and steroids. The most common high elevations in alkp is cushing's so it is this abnormality that is usually a big red flag to vets that cushing's may be involved.

Thank you for posting the results of the bloodwork but can you please repost just the high or low values, including the normal reference ranges and the reporting units, i.e. nmol, ng, ug/dl? Different labs use different ranges so there is no way for us to interpret without the aforementioned ranges and units.

I'm sorry for writing a novel but brevity is not my stronger suit. :D We have all been in your shoes and know the frustrations, fear and confusion that comes with this disease. It isn't an easy concept to grasp so don't beat yourself up for not understanding much of anything right now. Just try to calm down and as time permits, check out the array of reference material available in our Helpful Resources section. I believe Kim has already provided you with a link to some good information but I am including a link to the actual index page. I promise you that the more your learn, the more condifident you will become and the fears and confusion will fade away.

I'm glad you found us, Carol. You don't have to do this alone. We're here to help you and Fritz in any way we can. Fire off the questions, reach out and let us hold your hand and settle into the best place on the web for support and sharing of experience from seasoned veterans of cushing's.

Glynda

[caroleh]

I totally adore you "me again", lol. O.K. glucose level is 123 the range is 73-143. T4 is 2.3 but they don't show the normal range on the page. So I don't know if that is normal or not. I will list everything that is not in the normal range or what is pushing the normal range. glob - 4.5 normal range 2.5 -4.5
Ca - 11.8 normal range 7.9 - 12
Neu - 0.99 normal range 2-12
WBC- 4.35 normal range 5.5 - 16.9

and of course the 2000 ALKP.

Fritz had a ACTH on 6/21 prior to Lysogen. another ACTH on 7/21 and the last one on Aug. 2nd. The last one was when the tech called me and said they were sending Fritz to a different vet because they wanted an ultrasound and they didn't have the equipment. The ultra sound was of no value because the vet could not see the adrenal glands due to Frit'z fatty tummy. He did say that his bladder was huge. Fritz has always held it because he is afraid he is going to miss something if he goes out. He has some accidents in the house but here of late has been a good boy. The vet said that his bladder looked good it was just big. And we wondered if he had just been born with a big bladder. He said his kidneys and liver looked good.

I am wondering if the vet that made the assumption that Fritz had Cushings wondered why the Lysodren wasn't kicking in and maybe wondered if she had made the wrong diagnosis.

Thank you again for your help. I feel so fortunate to have found this site.

[caroleh]

This a postscript. Fritz started on Lysogen on July 9th. The vet had to order the meds.

[frijole]

Thanks Glynda! You clarified my question on the dosage. So Carole - the amount you have been giving is within the range recommended so that is good.

The problem is that as Glynda pointed out - the acth test results which measures your progress were not done as they should be and therefore the results will not be right.

You mentioned that Fritz is eating fine and the peeing is fine now? So are all the signs of cushings other than panting under control?

If so then this is great news. HOWEVER you must go to a vet that will do the test in the proper manner. At this point I'm not sure I wouldn't go to a new clinic or a specialist just out of comfort. If you stick with your current vet let us know and we will give you a document to PRINT OUT and hand to them so they do it right. They should also do it for FREE since these things are expensive and they haven't done them right.

Also, if Fritz is simply panting at this point it could be that the lysodren is working and if so out of precaution I would stop giving the 300 mgs 2 x a day and switch to 300 mgs 2 x a week. That is the next step. It really is the vets job to tell you this but too much lysodren can be very serious and better safe than sorry. But get the ACTH test done ASAP.

Keep asking questions.

[caroleh]

Fritz is having a ACTH this Thursday with a different vet. Do you think I should stop the meds now though. He has been panting the whole time for several months and has had a big tummy. To be honest with you I never had a problem with Fritz eating. He has been eating good and although he is greedy for cat food, which he dreams about having, he shows no signs of advanced greed.

The vet gave me 30 pills at a time, and from the total of the bills that I have paid I seem to have all of the invoices other than the cort levels for Aug ACTH.

Also Fritz did have another ACTH on August 2 but I left the vets office abruptly and didn't get the cort for that day. That was the day that the tech had me go to a different vet for a sonogram which told him nothing. I am sorry I forgot that. I ended up having words with the people at the vets office and at 70 years old with 10 dogs and 5 cats my mind has been on overload plus last week I got to meet my great granddaughter for the first time. So all of my airheadedness wasn't all due to my age, lol.

[frijole]

Carole, Yes if there is NO peeing in the house anymore, NO huge amounts of water being drank, and NO excess hunger. I would stop giving lysodren until you get the acth test done.

We all found this hard to grasp at first and you are doing a FANTASTIC job. Keep it up.

When you meet with the new vet bring the other results with you but be sure to POINT OUT that the 2nd readings were not done within 1 or 2 hrs so they are NOT accurate.

The panting may never fully go away, but could get better over time. My dog's belly never went back to normal after 4 yrs but that was OK because she was otherwise healthy.

[lulusmom]

Hi...only me again.

I know it may be hard to believe but I forgot a few things in my prior post. I forgot to say God bless you for rescuing so many babies. I am an animal rescuer and always have a steady stream of fosters plus my own four dogs and four cats.

I wanted to tell you that there is a third reason why a dog is resistant to Mitotane. That would be an adrenal tumor. About 15% of dogs with cushing's have an adrenal tumor as opposed to the other 84% who have a lesion on the pituitary gland that is causing the problem. Without your vet being able to visualize the adrenals, there is no way for your vet to determine what form of cushing's Fritz has. Dogs with adrenal tumors will usually require very large doses of mitotane, anywhere from 50mg/kg up to 100mg/kg. These are huge doses that usually takes a toll on the tummy so Pepcid AC is a must. The most common side effect for mitotane is GI upset so this makes sense.

I just went back and reread all the posts and would appreciate it if you would confirm that Fritz' only symptoms were panting and a big belly? Appetite always normal? Did you notice a distinct increase in water intake or did you just notice that Fritz had had a few accidents in the house? It is very odd for a dog not to have dilute urine, which is why a cushing's savvy vet will run a urinalysis. Do you recall a urinalysis? If so, can you post the results? We would be especially interested in the urine specific gravity (SG), which is almost always low in a cushdog.

With so few symptoms; few lab abnormalities, aside from the alkp, that are usually found in cushing's; lack of validating diagnostic tests such as the LDDS and an abdominal ultrasound with good visuals of the adrenal; normal looking liver, despite the high alkp; and a resistance to mitotane, I have a question mark above my head. Honestly, you might want to consider a consult with an internal medicine specialist (IMS). I think Kim has mentioned a specialist in one of her post so what do you know, great minds think alike. :D Plus, we both found out the hard way that not all gp vets are experienced enough to properly diagnose and treat a cushingoid dog. My dogs treat strictly with an IMS. If you don't know of any specialists in your area, I have provided a link that you can use to find one. If you are comfortable with letting us know what city you are in or near, one of our members may be able to give you the name of an IMS. It is highly likely that you would need a referral from you gp vet but that is not always the case. My IMS does not require a referral.

http://www.acvim.org/websites/acvim/index.php?p=3

[caroleh]

I am taking your sound advice and although Fritz did have a pill this morning that will be it until I see the new vet Tuesday. I will be taking in my 17 1/2 year old cat so I will have someone let him know that I discontinued the Lysodren. Fritz is not panting like he was. His nose had been clogged up which I suspect is from the meds. I feel really excited right now and pray we are on the road to recovery. I will call the new vet in the morning and see if I can go in for a consulation.

Now I have a question for you. Do all of you wonderful people live in the same city?

Thanks, Carole

[caroleh]

Oh my goodness no I don't mind a big giving you my city. And please don't feel you are asking me anything too personal. I am in Kilgore, Tx. Between Tyler and Longview, Tx.

And the urine collection was done on 8/2 which was the day I had the situation with the vets office and it had nothing to do with Fritz. It is a long story and one day we will talk about it if you want to hear the whole boring thing. It has to do with the attitude and the way I was treated as a customer with a patient at this particular vet. Needless to say I don't have the results of that urine collection. My new vet has a website and I am going to check and see if they have posted the animals records. Perhaps the results may be there. I will be back in touch if they are.

I may be all wet but I am honestly thinking Fritz is feeling better and this last ACTH done on Aug. 2nd, no telling how many hours they waited before they retested. Perhaps that is why that paperwork isn't with my bill.

Many thanks again.

[lulusmom]

Hi again,

Very few of us live close to each other, which is a bummer. :( Most of us are scattered across the U.S. but we have a fair number of members in other countries...Canada, Australia, UK, Netherlands, New Zealand. I'm sure I missed a few but I think you get the idea...we are international. :D

Hopefully we have some members that are familiar with your location and can provide you with a name of an internal medicine specialist that isn't too terribly far away. In the meantime, please do use the link I provided to do your own search.

Glynda

[sunimist]

Hi Carole, and a belated "welcome' from me!

I am somewhat familiar with your location and I might suggest that Texas A&M has a wonderful teaching hospital with great specialists.
If it is not too far for you to commute, it would be a great place to have Fritz diagnosed and treated. I would imagine they would also work with your local vet once all testing and diagnosis is confirmed.
You could ask your GP to refer you to A&M. My wonderful GP vet is in Texarkana and she consults with A&M on a regular basis, as she is a graduate of A&M.

Hope this is helpful for you and your precious Fritz.

Shelba and Suni~~

[marie adams]

Hi Carole,
Welcome to you and Fritz to the cushings club. What a journey it will be, but you have definitely come to the BEST place for info and support!!!

My dog Maddie, has been on Lyso since February of this year and we are now seeing results in the areas that come back slower (she has only been on a true maintenance the last couple of months). In the beginning the eating, drinking, panting, peeing showed the fastest results. Now her fur is starting to come back (a little different in texture, but I will take it any which way). She still has the weakness in her hind legs along with the shaking, but I think that is on the road to recovery since she has started running more longer distances. She still has her rounded tummy (she was always trim before) so if that doesn't go away I will take it this way, maybe once the fur comes back in longer in length it will hide it--haha!!!:D:D She still has a little panting when she is on walks to running, but really not much at night that I notice.

Maddie use to attack the cat's food in my daughter's room--she would lie in wait for us to turn our backs and slip in there, but she has slowed down to almost never going in to eat it. She also ate a few other things dealing with the cat, but that too has stopped.:eek:

All in all she is getting more of the quality of life back, but I do have to take into consideration she will be 12 in December. She still has her eye sight and hearing. She still can climb stairs, but cannot jump up on the bed any longer. So we take little things one at a time and are greatful.

All in all no side effects from the lyso, so that is also good. We did change vets in all the process which you will find a lot of us have done.

Take care and ask a lot of questions because everyone here is great with the info and support!!!!:)

[caroleh]

Lulus Mom, Sunimist and Marie Adams: I have to tell you that my husband and I are flabberghasted at the love we feel from this site. I really never dreamed of the support I have received. I am in a bad place with Fritz right now because the "quack" vet that did the cortoid tests waited too long before performing the second test so we have no idea where we are with the Cushings. I am taking some very good advice that you gave me and I have stopped the Lysodren until I see the new vet.

Now a big question. If we can get this Cushings under control for Fritz do you think we should still take him to A & M ? or perhaps Texarkana? Actually we are closer to Texarkana. Is that where you live Sunimist? Or do you think that after he is under control (which I pray will happen) and has tests every so often he will be o.k. Our problem is that with 10 dogs and 5 cats sometimes it is hard for both of us to jump in the car and leave.

And I have to laugh at you Marie. I know what you mean about dogs and cats tootsie rolls. I have a feeling Fritz would still be interested, lol and Ugh!!!!!!!! Fritz never had any symptoms other than panting and a big tummy. His appetite was the same, he still is cranky at the cats when they try to steal his food. Thats why I am so totally confused.

[frijole]

I think the main thing is you want to be sure that the dog really has cushings. Whatever vet you go to you really need to be sure they know their stuff and that is why we have recommended a specialist. And I would lose the vet that started you on drugs that could be fatal without doing proper testing... really...

Yes, this site is amazing. I wish I could find this kind of support for human ailments. :D;) We've all just been in the same spot so it is easy to help.

Take the night off, put your feet up and at least know you are no longer alone on the journey. Kim

[lulusmom]

Just me again.

Like I mentioned before, it is so difficult to determine if a dog is loaded by watching water intake, unless you measured Fritz' water intake three or four days before you started dosing. I can't say for certain that he's loaded but if you noticed a definite improvement in the amount of water he's drinking, I wouldn't take any chances and agree with Kim that you need to have an acth stim done. If his post cortisol is not within 1 - 5 ug/dl, then he's not loaded and you will have to continue. At that point, I would definitely consult with an IMS and let him reconfirm the diagnosis and direct the treatment. The decision to let your gp vet work with the IMS is up to you but considering your gp did not do the stim test according to protocol, I would be very wary of letting him do any more.

The optimum time to do an acth stim test after stopping the mitotane is 48 hours so you don't want to wait any longer than that. Mitotane has a cumulative effect so it continues to do its thing for the next 48 hours. If you wait any longer than that, you won't get an accurate assessment of cortisol levels. If you can't get in to see another vet by Tuesday, you may want to bite the bullet and have one done by your existing vet. Just make sure that you remind him that he needs to follow protocol. If he is unsure, he should check with the lab.

Now I'm going to give you a tip that can save you some money. Us rescuers with a house full critters need all the handy tips we can find. ACTH stim tests are very expensive because the stimulating agent, cortrosyn, is liquid gold. I have no idea why the dang stuff is so ridiculously expensive!

Experienced vets will usually use cortrosyn because it is gives them the most accurate reading. If your vet uses an acth gel, then it won't apply to him but it can apply to your next vet. Cortrosyn comes in .25mg vials and standard instructions are to inject the entire vial; however, there have been studies that show that you don't need the entire vial. You actually only need 5 micrograms (mcg) per kg. Since a .25mg vial is equal to 250 mcg, I think you can see where I'm going with this. Fritz' weight in kg is 30 lbs divided by 2.2 which equals 13.64 kg. Rounded out to 14kg, Fritz would require approximately 70 mcgs of cortrosyn for each stim test. One vial would therefore be good for three acth stim tests. The unused portion can be frozen for up to six months. Most gp vets don't know this so I recommend that members discuss this with their vet. If you need some support, provide your vet with the link I've provided below. Better yet, print out the paper and hand it to him. It's rather hard to dispute when you are armed with the facts. This paper has protocol for a lot more than the acth stimulation test and references are shown.

http://vonallmen.net/gi-liver-pancreas/Appendix4-adrenaltesting.pdf

Glynda

[sunimist]

Carole, I am sending you a link of Texas specialists. Please check and see if any of them are close to you. There are 3 pages, so be sure and click "next" at the bottom of each list.
http://www.acvim.org/websites/acvim/index.php?p=228

Check it out and let us know.

[caroleh]

I would love it if someone would give me their two cents worth about my latest diagnosis of Fritz. I have a new vet and I honestly feel he is on top of things. Fritz had been put on Lysodren by a previous vet and after ACTH testing over a month's period of time she said Fritz levels were not coming down. She sent me to another vet for an ultrasound because she didn't have the equipment. Guess that should have been a tipoff. The ultrasound did not show his adrenal glands cause his tummy was so big. This vet also neglected to give me prednisone should Fritz crash on Lysodren. I got panic stricken when I felt Fritz had improved and was concerned with continuing the Ly. I took him off of it and changed vets. The new vet did an ACTH on Fritz and his levels were 2.7 and 21.3 which he explained was in the grey area. He put Fritz on Vetoryl and he will be retested. What is anyone's opinion of this. Thanks, Carole

[Squirt's Mom]

Hi Carol,

My first question is how long was Fritz off the Lyso before he started the Trilo? He really needs a 30 day period between meds to make sure there is no overlap and possible overdose.

Do you have the tests that were done while he was on the Lyso and could you post the actual results of those? Usually an ACTH is done to monitor the cortisol levels.

Regardless of which drug you are using, Pred is a necessity not an option. So even tho Trilo is touted as "safer", you still need the Pred for emergencies...because it has the very same potential to cause an Addisonian crisis and adrenal damage as Lyso does.

I would recommend having another ultrasound done. If Fritz has ADH it could take much larger doses of the meds, either one, to have any effect on the tumor. Surgery is the best option for ADH; removing an adrenal tumor associated with Cushing's will mean a cure for Fritz. You might also find there is another, non-adrenal, reason for his elevated cortisol as was the case with my Squirt.

BTW, most GP vets don't have ultrasound equipment. That is most often done with an IMS at a specialty clinic tho we have heard of mobile US being used. Reading the findings and doing the procedure are not things a GP vet usually does. ;)

If he has PDH, it could be that he is just more tolerant of Lyso and the Trilo will work better for him.

What dose of Trilo is he on? How much does Fritz weigh?

I hope you are happier and more comfortable with your new vet. That is important in this adventure!

Hugs,
Leslie and the girls - always

[Harley PoMMom]

Hi Carol,

If a pup is being switched from one medicine to another then the wash-out period is very important.

According to this answer given by Dr Feldman:
DVM:...Is there a particular protocol you use if you switch between the two medications to avoid possible complications, in light of a couple of reported cases of acute adrenocortical necrosis following a switch?

Feldman:...Any dog switched from one to the other should receive no medication for at least six weeks.
http://veterinarynews.dvm360.com/dvm/article/articleDetail.jsp?id=672663&sk=&date=&%0A%09%09%09&pageID=2

This is the Editor's Note about Dr. Feldman:
Edward C. Feldman, DVM, Dipl. ACVIM, is the chair of the Department of Medicine and Epidemiology at the University of California-Davis School of Veterinary Medicine. He is a co-founder and former president of the Society of Comparative Endocrinology, a special interest group open to all veterinarians, and is a co-author of the Textbook of Veterinary Internal Medicine with Dr. Stephen Ettinger and Canine and Feline Endocrinology and Reproduction with Dr. Richard Nelson.

I tried unsuccessfully in June to load my boy Harley with Lysodren. Harley is now on his wash-out period. His last dose of Lysodren was July 13 and he will start Vetoryl September 13.

We are here for you, remember that, ok?

Love and hugs,
Lori

[frijole]

Since the first drug didn't work and the acth test is pretty borderline... and acth tests can have false positives... can you confirm whether or not any other tests were done to dx cushings? Is there any infection or illness of any sort that might be going on? I ask because it can affect test results. Kim

[frijole]

Carole, I am responding to something you mentioned on another thread and that is you went to a new vet who wants to switch from lysodren to trilostane.

Couple things - first off - you need to wait at least 4 weeks, up to 6 per Dechra.

Second - if I am remembering correctly we were questioning the testing done and whether or not Fritz has cushings. Have you had any additional testing done? Trying to get up to speed. I would NOT try trilo until I had a solid confirmed dx of cushings. Otherwise you are just out more money and no further along.

Give us an update when you can. Thanks! Kim

[caroleh]

Hello this is Carole and I have a Schnauzer that has been to three vets and was diagnosed with Cushings Disease. Glenda has been so informative and so wonderful in supporting me and has suggested that I take Fritz to a specialist. I am closest to clinics in the Dallas, Tx. area and wondered if anyone on this site has had an experience with any of the specialists in Dallas.

The puzzling thing is that Fritz doesn't have all of the symptoms of Cushings and at this point it is questionable. He has seizures and has been on phenobarbital since i rescued him five years ago. He had bloat, excessive drinking, and peeing urgency. However he was on Lysogen for a month and his levels came down to a gray area. I am wondering now if he had a couple of things going on and perhaps the Lysogen was helping the Cushings because although he is still panting he is no longer peeing. He always had muscle strength, can still jump on the couch and climb stairs and his coat is good. At this point I am going to have his liver tested and then I will go from there because my latest vet said they wanted to do a liver test before giving me a refill for Pheno.

I feel so fortunate to have found this site and I appreciate everyone's input. Thank you so much, Carole

[lulusmom]

I'm glad to see that Carole has updated her thread. As you can see, Fritz is on phenobarbital. Carole actually upped his dose in May to twice a day as he was still having seizures. This certainly explains the reason why Fritz was so resistant to Lysodren with little change in post cortisol between stims. It greatly impacts the metabolism of Lysodren, requiring much larger doses. It can and usually does greatly impact the liver so the more than moderate elevation of ALKP is probably due to the Phenobarbital.

Fritz' only cushing's symptom have been and still are his panting and big belly. As I recall, aside from the elevated ALKP, the rest of the bloodwork was normal. That's a bit strange in a cushdog but not for a dog on Pheno. We have a stim test consistent with cushing's, a failed ultrasound due to the radiologists inability to visualize the adrenals due to too much belly fat so basically, we have no validating test nor differentiating tests. If Fritz does have cushing's, neither the old vet nor her new vet seemed to care about making that determination.

The first vet did a woefully inadequate job of testing and assessing Fritz' physical symptoms in reaching a confirmed cushing's diagnosis. He was clueless about the need to monitor liver values in his Phenobarbital patients and was apparently clueless that Pheno and Lyso don't mix very well. The second vet didn't seem to understand that Fritz had been loading for a month and that he should have done a stim 48 hours after Carole thought he was loaded and stopped dosing. He kept insisting that she wait two additional days to make sure the Lysodren was out of Fritz' system. :confused: The post stim was 20 or 21 ug/dl and apparently since the number was high enough, he never questioned the the old vet's diagnosis and felt it perfectly safe to start Fritz on Trilostane immediately. :eek:

The good news, if there is any relative these vets' knowledge, is that vet number two was knowledgable enough about Phenobarbital that he would not refill the Phenobarbital without checking liver values. I suspect they are going to look much the same as the last bloodwork that was done. With Fritz being on Phenobarbital, he should have been on liver support already so I have recommended that she discuss this with her new vet.

Currently, Carole has decided not to start the Trilostane before more overt cushing's symptoms are apparent and/or Fritz sees an internal medicine specialist who can confirm the diagnosis.

I hope I have remembered everything Carole and I have discussed via PM. All future posts regarding Fritz will be done here on Carole's thread.

[caroleh]

I thank God every day for guiding me to this site. I feel so blessed to have found Glenda and everyone else on this site.

The original vet I went to for 20 plus years never even suspected that Fritz had Cushings. And he kept letting me refill Pheno without doing a liver diagnosis for the past five years. I thought this vet was my hero until I lost one animal that I had spent $800.00 on and she died within two days. He also had told me my cat had a 25% chance when I should be ashamed to have put Toby through all of that.

I changed vets when I found a lump on Fritz's side which took me to vet #2. I was uncomfortable the minute I entered that office and I should have turned on my heels and left but didn't. We went into the examining room and Fritz was weighed by the tech and then taken elsewhere to be examined while I waited in the examining room. Wonder why they bother to have a patients room. The vet then came in and I am sorry to say she had "smart-ass" written all over her face. She said she thought Fritz was a Cushingoid dog and ordered Lysogen for him which she had to order. Between the three animals I took there I guess in between visits I asked too many questions about the other animal cause the receptionist called me one day after I had made an appointment and told me that I needed to keep my questions to a minimum cause I had gone over the 30 minute allotment that the vet gives each patient. I should have left then but I felt grateful that she had found Fritz's problem - or had she?

A month after Lysogen Fritz's Acth was still high. As I move along education wise I realize she dropped the ball in not taking into consideration the pheno interfered with the Lysogen and also that the pheno and liver issues could be the reason for the bloating, panting, peeing and excessive thirst. She sent me to vet #3 for a ultra sound which didn't show his adrenal glands due to tummy fat.
After some other unpleasantries with Vet #2 I changed to vet #3.

My whole reason for reiterating this tale of woe is DON'T be afraid to ask questions as I was. For goodness sakes we are paying these vets premium money to take care of our babies. I am becoming mighty savvy and I have to wonder now if Fritz is even a cushingoid dog. Time will tell and I will now be a fearless protector of my furry best friend.


Carole

[Roxee's Dad]

Hi Carole,
Haven't posted but have been following along.


My whole reason for reiterating this tale of woe is DON'T be afraid to ask questions as I was. For goodness sakes we are paying these vets premium money to take care of our babies. I am becoming mighty savvy and I have to wonder now if Fritz is even a cushingoid dog. Time will tell and I will now be a fearless protector of my furry best friend.

Just wanted to say...You go girl! :)

[frijole]

standing ovation!!!!!!! :):):):):):)

[Bichonluver3]

From one Carrol to another Carole - RIGHT ON!!!!!!!

[jrepac]

I thank God every day for guiding me to this site. I feel so blessed to have found Glenda and everyone else on this site.

The original vet I went to for 20 plus years never even suspected that Fritz had Cushings. And he kept letting me refill Pheno without doing a liver diagnosis for the past five years. I thought this vet was my hero until I lost one animal that I had spent $800.00 on and she died within two days. He also had told me my cat had a 25% chance when I should be ashamed to have put Toby through all of that.

I changed vets when I found a lump on Fritz's side which took me to vet #2. I was uncomfortable the minute I entered that office and I should have turned on my heels and left but didn't. We went into the examining room and Fritz was weighed by the tech and then taken elsewhere to be examined while I waited in the examining room. Wonder why they bother to have a patients room. The vet then came in and I am sorry to say she had "smart-ass" written all over her face. She said she thought Fritz was a Cushingoid dog and ordered Lysogen for him which she had to order. Between the three animals I took there I guess in between visits I asked too many questions about the other animal cause the receptionist called me one day after I had made an appointment and told me that I needed to keep my questions to a minimum cause I had gone over the 30 minute allotment that the vet gives each patient. I should have left then but I felt grateful that she had found Fritz's problem - or had she?

A month after Lysogen Fritz's Acth was still high. As I move along education wise I realize she dropped the ball in not taking into consideration the pheno interfered with the Lysogen and also that the pheno and liver issues could be the reason for the bloating, panting, peeing and excessive thirst. She sent me to vet #3 for a ultra sound which didn't show his adrenal glands due to tummy fat.
After some other unpleasantries with Vet #2 I changed to vet #3.

My whole reason for reiterating this tale of woe is DON'T be afraid to ask questions as I was. For goodness sakes we are paying these vets premium money to take care of our babies. I am becoming mighty savvy and I have to wonder now if Fritz is even a cushingoid dog. Time will tell and I will now be a fearless protector of my furry best friend.


Carole

Yikes! some of these vets really piss me off....any vet that refuses to have a conversation, asserts a diagnosis w/out full testing and/or says something like "the only way to treat this is x" (i.e. his/her way)....that's a red flag for me to take off....

I had gone to a 2nd vet for some additional testing which was warranted, but I ran into some arrogance and insistence that just turned me off and I never went back (ex. "the only way to treat this is with lysodren"...Question to vet: have you heard of vetoryl? to which I got a dead pause and a big stare followed by, "well yes, but we don't use that." that alone was enough for me to take off. Unreal crap goes on out there; it is scary. Many of the vets are incredibly uneducated on this disease, not to mention the atypical version. This site is a great resource for everyone)

[apollo6]

Welcome
Nothing to laugh about , but first get the diagnosis to which cushing he has. If both adrenals are enlarged similarly shown in an ultrasound, would probably be pituitary.
I started Apollo on milk thistle after checking with the members and asking my holistic vet if it would be okay. Good for the liver.
My specialist doesn't believe in holistic.

It's late and I will have to read your thread more.
Hang in there.
Hugs from Sonja and Apollo

[addy]

We have to check and recheck everything. I can't tell you how many times I have been handed the wrong medicine or the wrong doseage by the"desk help" and this has happened at more than one vet's office.:eek:

Speaking for Spot, was a great book to read. I figure, if I have been misdiagnosed and overdosed, who knows what will happen to my dog?:confused:

Check, check and recheck!!!!!:):):) I even have to check to make sure I have the right brand of heartworm medicine and the right doseage becasue they have even screwed that up!!!!!!!!

Addy

[caroleh]

Thank you everyone for your input. Believe me there is far more to vet #2's story. I have no idea how they keep patients.

I have an appointment for Fritz on Tuesday and his liver will be tested. I am so excited to go to this appointment cause I can say so many Cushings savvy things to the vet. I can hardly wait to see how I have grown in knowledge thanks to each and every one of you. I will let you know how far his jaw drops at my expertise, lol.

I am loving it.

[caroleh]

Fritz and I just got back from the vets office where he was given a phenobarb level test and a liver enzymes test which will be sent to A&M for results.

The vet and I at this point have to wonder if Fritz even has Cushings. His only symptom is panting and a fat tummy which I guess could be caused by the pheno and the panting from pressure on his diaphram due to his fat tummy. His eating is just as regular as usual, his peeing in the house has stopped and he has no hind quarter problems and when I took him to be groomed the groomer commented on his beautiful fur.

My husband is a cancer survivor and this is his time of year for appointments. So after hubby is taken care if need be I will take Fritz to a specialist. Hubby is still #1 but Fritz runs a close second.

[lulusmom]

Hi Carole,

I've merged your latest post with your original thread so that all of Fritz' information is in one place.

I am happy to hear that your vet is questioning whether Fritz has cushing's at this point. Did you have to twist his arm? :D With so few symptoms, both of which can be attributed to Fritz being on the portly side, I would tend to agree. I'll be looking forward to hearing about the results from Texas A&M.

I'm sorry that hubby is having to deal with all those appointments but I'm delighted to hear that he is a cancer SURVIVOR. Good luck with getting him to his appointments and I'm sure that he would be very happy to know that you have placed his well being above Fritz' by just a hair. :D

Glynda

[caroleh]

This is Carole and I thought I would update info on Fritz. He was diagnosed as a Cushingoid dog from his ALKP test only, plus the fact that he had been panting, peeing in the house, had a fat tummy. Those were his only symptoms. His fur is beautiful, he has no motor problems, his appetite is normal. He was placed on Lysogen for a month and also takes pheno for seizures. After a month his level was still high so I changed vets. I was sent home with Trilostane but after listening to fabulous advice from Glenda decided to stop all meds until he was completely washed out. In the meantime Fritz is still fat but his panting has stopped, he is no longer peeing in the house and everything that he had that leaned towards Cushings is not there physically however we did a liver enzyme test and a pheno test. Dr. Howard said he also had a ALKP run. The vet called me today with results.
Bun 12
steroids 14
alt 64
liver 62
pheno 7.8 which vet said was low should be 15-40
electrolytes normal
ALKP 3060 - This is what is driving me crazy.

I am not able to get Fritz to a specialist at this time since the nearest is several hours away and my husband has health issues and has several upcoming appointments of which we do not have the dates yet so I can't schedule Fritz an appointment until we get info on my hubbys appts. At this point I am beside myself. Thank you all for being so wonderful, Carole

[caroleh]

Hi Everyone:

I want to wish everyone a Very Merry Christmas and a Prosperous and Safe New Year. And for all with sick furries I pray for a blessing for wellness.

I have been gone for a while. My hubby is a cancer survivor and was scheduled for a multitide of tests.

Fritz our Schnauzer was the purpose of me finding this site and I am now able to take him to a specialist in Dallas to determine his Cushings. Today I am concerned cause he hasn't wanted to eat. I am going to monitor this and call tomorrow for an appointment in Dallas. If anyone has had an experience with any vets in Dallas specializing in Cushings i would appreciate your letting me know your experience. Thank you, Carole

[fivebichons]

Hi,

I wish you a special blessing for this holiday as well. Please check the smallpawsrescue.org website. They will also know some of the best docs in Dallas. They have many resources as well.

I wish you the best for your little fluffer and for your hubby!!!

God bless,
Heidi and the bichons

[Squirt's Mom]

Hi Carole,

A quick question - you say Fritz isn't wanting to eat today...is he already on treatment for Cushing's with either Trilostane (Vetoryl) or Lysodren (Mitotane)? If so, please do not give another dose until our members can chat with you for a minute or so, ok?

Hugs,
Leslie and the girls - always

[caroleh]

Hello all:

We wish a very Merry Christmas to you and your precious furries.

I have been out of touch for a while as my hubby has had to go through some tests yearly as he is a cancer survivor. I have had to put my Fritz on hold in taking him to a specialist in Dallas. He has been seeing our local vet in the meantime.

I have been so lucky in having Glynda go into detail about Cushings. However, I have written to her and she has answered some of my messages but not all. Is Glynda still active with K9Cushings. I had wanted to go more into detail with her about the vets in Dallas specializing in Cushings. Glynda had given me some advice but I wanted to ask her some more questions or if someone else could advise I would be appreciative. I need the best doctor in the Dallas area that would be able to help Fritz. Fritz is now having trouble getting up once he is laying down. Once he gets up he is fine. My local vet has put him on Rimadyl for five days to see if it helps and if it does he will put him on a med that won't affect his liver.

If anyone has info on Dallas, Texas Vets specializing in Cushings or has had an experience with one of them I would more than appreciate your input.

Thank you,
Carole

Moderator's Note: Carole, I have merged your update posts from 12/12 & today into Fritz's original thread. We prefer to keep all posts on a pup in a single thread as it makes it easier for other members to review the pup's history when necessary.

[Bichonluver3]

Hi Carole!
I'm Carrol! My 12 yo Bichon (on the left in my avatar) was diagnosed with Atypical Cushings last April. She has been doing well on melatonin twice a day plus her ground flax hulls. She gets Cosequin twice a day for her joints (just because, like me, she's old;). When the vet first discovered the beginnings of cataracts, I started her on Ocu-Glo at bedtime. At the last visit, the vet was surprised to see an improvement in the eyes. My vet is wonderful and spends hours on the phone with me (I also have a diabetic Bichon). Dr. Oliver, at the University of Tennessee, has been a mainstay for both my vet and me. If we have a question or concern, he gets back to you right away with suggestions. I was terrified when I learned that Chloe had Cushing's but I am not now. While i may be worried from time to time, there are always answers somewhere and I stand in awe of our senior members and administrators who are exceedingly knowledgeable and will take you in the right direction. Cushing's is not a death sentence. It is an aggravating annoyance and somewhat disconcerting at times but there are things we can do. Just ask Miss Chloe as she dances around her food bowl. BTW, Chloe has her "belly" and some fat deposits over her hind legs but no panting, thirst, overeating or any of those other frightening signs she had. Take it one day at a time. You have lots of support here whenever you need it.
Hugs & tail wags,
Carrol

[lulusmom]

Hi Carole,

Sorry for not being around much but have had a busy couple of months and now sick with the flue. I could have sworn that I responded to all of your questions. I do recall, you were having some issues with your inbox nearing max capacity so hopefully, you were able to delete some messages with my instructions. In the event you didn't receive my last pm to you, I am copying and pasting here.


I forgot to mention that the internal medicine specialists at both facilities, the one you found and the one I found, graduated or did their internship at Texas A & M. Im sorry but I don't know of anybody on the forum that has taken their dog to either of them. As I mentioned before, most members went to Texas A & M. I think you should be okay with any of the specialists that I saw. The one thing I will say is that I couldn't find any negative feedback about the Veterinary Specialty Clinic of North Texas. The other facility had a mixed bag of ratings. As usual, most people that complain are not happy with the cost of specialty services. I take my dog to an excellent specialty clinic and they have some bad ratings too. Good luck and keep me posted.

http://www.vcaspecialtyvets.com/animal-diagnostic-clinic-dallas/departments-doctors/doctors

Here is a link to the specialist Carole found and hopefully, somebody will be able to provide feedback on one or the other:

http://www.vsnt.com/index.htm

Glynda

[caroleh]

This is Carole Fritz's mom and I need prayers and encouragement. Three vets later and so many diagnosies down the road with inept vets I took Fritz to a specialist in Dallas. Fritz was suspected as having Cushings and in the last few days was really feeling badly. Local vets I can't comment on cause four letter words aren't allowed on this site. Fritz was diagnosed with Diabetis. He is very very sick little Schnauzer boy. We live 2 1/2 hours from Dallas and my husband is a cancer survivor with his own medical limitations but he insisted on going to Dallas with me. Fritz is now in the hospital there and will remain for five days provided he responds to treatment. He is about nine years old and I wondered if anyone on this site could offer me some words of encouragement. Believe me I need it.

Moderator's Note: Carole, I have merged your two new updates on Fritz concerning his diabetes diagnosis into the original thread for Fritz. We normally like to keep all posts on one pup in a single thread as it makes it easier for other members to refer back to the pup's history, if needed.

[caroleh]

Just wanted to add a heading to my previous thread so someone could comment

[StarDeb55]

Carole, we have had several members who have successfully managed both conditions in their pups. I'm sure they will be along to comment. We have a sister site K9 diabetes that is an on-line support group for diabetic pups & their families where you will find a wonderful group of caring, concerned individuals who are caring for their diabetic pups. They have a wealth of information & experience which I think you will find helpful.

http://k9diabetes.com/

Debbie

[Squirt's Mom]

Hi Carole,

I am so sorry you, hubby and Fritz have been having such a hard time! One would think diabetes would be easier to diagnose! Is it diabetes mellitus or diabetes insipidus? The DI is much rarer so I could see that being missed for a bit but not DM.

Are you a member at our sister site, k9diabetes.com? If not, go on over and introduce yourselves. They are a great bunch of folks who have much experience with diabetes to share. I know they would love to have you!

http://k9diabetes.com/forum

We have several folks who have diabetic babies and I am sure they will be along to share their experiences with you soon. For now, Fritz is in the best place so he can get balanced out then regulated under care. I know it is hard for him to be so far away and sick, but I just bet he will be back home with you and hubby in no time. Diabetes is scary, but it is very doable so keep the faith and know you will have lots of folks to help here and at k9diabetes.

Hugs,
Leslie and the girls - always

[BestBuddy]

Hi,

Is Fritz in the hospital because of the diabetes? It is the best place for him at the moment.

As for the future and diabetes well it just becomes part of your routine. I know that sounds like a big fib but Buddy my boy had diabetes for over 6 years and apart from the first months (really terrified and scared of needles) it just became part of our lives and it really was not something that changed our lives or his much at all.

Once we had our food sorted out and the insulin amounts he was just like any other dog. We home BG tested in the later years and it really is a great tool so that you know what is happening and if you can manage to do it you will be able to get much better control earlier by knowing how things are working together (food/insulin/activity).

Jenny

[k9diabetes]

Hi Carole!

I administer the canine diabetes forum and wanted to let you know that you're approved over there - no need to complete email confirmation.

I have just scanned your thread here... Wow, you have been through the ringer! I hope the specialist is the turning point in your veterinary experiences.

I was wondering whether Fritz has ketones so they are having to give fluids and get his blood sugar down right away or whether they are just aiming to zero in on an insulin dose and check him out for other issues with the hospitalization.

One way Diabetes is easier to deal with than Cushing's is that you can test blood sugar levels inexpensively at home so can know for yourself how Fritz is doing.

Looking forwart to hearing more about Fritz,

Natalie

[frijole]

Carole - I remember you and Fritz! I never was convinced Fritz had cushing's... so now that you have the diabetes dx, did the specialist RULE OUT cushing's?

My mom and my brother both have schnauzers with diabetes. Very very common. Key right now is to get dear Fritz regulated. So glad you made it to a specialist and could start the healing process.

Hugs to you both and prayers too.
Kim

[caroleh]

I will be the first to admit that I am totally baffled about how to use this site. I don't know if it is because I am meeting myself coming and going or what. I have the hardest time starting a new thread.

I want to personally thank Lulusmom, Frijole, K9Diabetes, BestBuddy Squirts mom and StarDeb55 for all of your support and to update you all on Fritz's progress. Fritz is in ICU in Dallas and his doctor Dr. Miller called this morning to tell me that Fritz's insulin has dropped from 800 to 400 and that he thinks Fritz has a 60% chance to survive this. Fritz has other issues and is about 10 years old. He has pancreatitis, Cushings, and has a problem with his right hind leg which could be part of the Diabetes. He has gone out with the ICU tech and used the potty. The doctor said that he thought if have continues to improve he will have some solid food tomorrow. I know he mentioned a couple of other things but I have been in such distressed state I can't absorb it all. That plus I am an old gal, had to inject some humor to get through this.

Any encouraging words as to how you all feel about Fritz recovering from this would be appreciated. The doctor said Fritz was a strong boy.

Another question is that Fritz will be in the hospital for a while more. The drive to Dallas is 130 miles. Do you all think it would be advantageous to go and visit him even if it is just for a few minutes. Would that encourage him or should I not confuse things and leave him in the doctors hands. I love all of you for helping me. Thank you so much and Happy New Year.

[StarDeb55]

Carole, I think the drop in the glucose is a good start. The next time you talk to the vet try to find it out if Fritz had or had what are called ketones in his urine. Ketones are a breakdown product of glucose & usually only spill into the urine when the glucose has been extremely high for a period of time. If Fritz did have ketones, but they are now gone, that is a good sign. I would talk to the vet about visiting as they may want to keep Fritz as quiet a possible for now. One thing you can do is take an old blanket or shirt that has your scent on it that may give him some sense of comfort.

Carole, I would strongly suggest that you take notes during your phone conversations with the vet. There is going to be a huge amount for you to learn in a short period of time. I would also suggest you take a tape recorder during any face to face conversations with the vet. You have been on overdrive for quite a period of time trying to get Fritz the care he needs, so I'm sure your brain is overloaded. I know mine would be.

By the way, you did just fine getting this post onto Fritz's original thread. Just click on the link I sent you in the PM yesterday, & you'll be right there to update us.

Debbie

[addy]

Hi Carole,

I am so sorry to hear about Fritz and all you are going through. I am saying a prayer your little boy gets home soon. I can't really help with the diabetes but just wanted you to know I am saying prayers for all of you.

Hugs,
Addy

[k9diabetes]

I'm sorry to learn that the vet sees Fritz as so seriously at risk. From the sound of things, maybe ketoacidosis and/or pancreatitis.

I would ask the vet what he thinks but given how serious his condition apparently is, I would go and see him unless they forbid it and would leave a shirt or blanket or other comforting object with him on the way out. I think they would have to give me a really strong reason not to go and see him.

Everything here is crossed for Fritz's complete recovery. The fact that they have gotten his blood sugar down significantly is definitely a sign in his favor.

Natalie

[k9diabetes]

I think this will work... to post a reply to this thread, click on the following link:

http://www.k9cushings.com/forum/newreply.php?do=newreply&noquote=1&p=46074

You can accomplish the same thing by opening up this existing thread about Fritz and clicking on the Reply button while viewing the thread. You are doing it right - you just need to take the additional step of viewing Fritz's thread before trying to reply.

Forums are always a bit intimidating at first. Don't worry about it.

Natalie

[Squirt's Mom]

Hi Carole,

SOOOO glad to hear that Fritz's numbers are down and that he seems to be feeling better! That is a GREAT start! With help from the hospital and his docs, the k9diabetes folks and Natalie, plus your obvious deep love for him, I am sure he will do just fine.

I don't mind telling you that diabetes scares the pee-waddle out of me! :eek::o:o:rolleyes: But, so did Cushing's when I first learned of it and I survived that! :p I am always amazed at what we are actually capable of when the need arises yet when I take the time to really think about it, that is what love does - it takes us far and above what we thought were our limits, opening our horizons and broadening our foundations. So, I have no doubt that you will learn to deal with Fritz's diabetes like a pro in no time. Do as Debbie suggested and give yourself a little extra help until you get this down - it will go a long way toward understanding. My poor vets....in I came with notebooks, recorders, and other warm bodies for the first many months after Squirt's Cushing's diagnosis. In time, all I needed were the notebooks and, in time, they stopped rolling their eyes when they saw me with them. :p And, by all means, hang on to that humor! ;)

Thank you for your note on Trink's thread. I can turn that around and say the same to you for taking time to give us. But, you see, it is you and Fritz, and all the other moms/dads with their babies that keep me going when times are tough. I really don't know what I would do if ya'll weren't here. So, thanks!

Hugs,
Leslie and the girls - always

[BestBuddy]

Hi Carole,

Just a little note about visiting Fritz. If you can manage it then I'm sure a visit will rally him.

Buddy also had pancreatitis and was very sick when he was diagnosed with diabetes. He was 9 1/2 at the time and I was told to come in the next day to say goodbye but as soon as I arrived he started fighting and I stayed sitting on the floor all day holding his paw. The rest is history.

Jenny

PS
Good idea on leaving something that smells like you for Fritz. I used a t shirt that I had slept in for that purpose.