Annie just turned 8 lab pointer mix just diag w/cushings

[anniegirl]

Hi all, my girl Annie just diag after 8 hr stim test - #s on blood work were first indication but then last month sudden onset of clin signs: excessive urination, drinking water, panting. diagnosed 2/10 started meds (Trilostane 90mg 1/day) 2/11. Day after she came home (also 2/11) from 8 hr test at vet, had eye infection. given eyedrops w/sterioids. Since day of test has not been herself. On 1/9 regular exam she was 92 lbs (overweight, but has always averaged 85/86). On 2/10 she weighed in at 87. 3/2 was retested (90 min stim test). Per vet numbers were perfect, leaving her at 90mg. Mentioned she was not herself yet, still quiet. He said could be arthritis w/the weather. Ok, thought i'll give it a bit more time. Had to take her back last night to vet for anal sac expression and she weighed in 77lbs. I panicked! 10lbs in 2 wks is huge. She is eating but not as much as she is clearly not ravaneous as she was before. Panting has stopped. Excessive urination and drinking much better, though when she does drink she can still drink 1/2 a bowl, just no where near as frequent. She is clearly not herself. I decided this am i was not going to give her the trilostane and would speak to the vet today. She also vomited once about 5 days ago and then yesterday am a small vomit and then last night liquid/bile type vomit. Any insight or help would be great. I'm heartbroken my girl is so sad and not well. Thank you.

(MODERATOR NOTE: I have moved your first post into our discussion area. This will be Annie's own thread where you can tell us all about her, including test results, questions you may have, things you have discussed with your vet that you wish to share - anything concerning Annie will go in this thread. If you need help learning how to navigate the site, just holler and we will be glad to help!

[addy]

Hi and Welcome,

I am so sorry to hear Annie is sad and not feeling well. When our pups are unwell, we tend not feel good either.

I am glad that you found your way here. Cushings is so complicated and hard to diagnose. No one test is perfect so vets have to rely on history, symptoms, blood work also.

Did Annie have any other tests besides the LDDS? So many diseases mimic Cushings. It can be a puzzle to sort through. Some pups will lose weight once treatment starts but 10 pounds in 2 weeks, I would be concerned too. Trilostane can cause tummy upset, it may be Annie will need a Pepcid type drug. You could talk to your vet.

Do you know the results of her stims? Could you get her ACTH results? I wonder what "perfect" means to the vet.

Others will be along soon to ask a million questions. Don't be worried about that, it just helps sort through things.

hugs,
addy

[Squirt's Mom]

Hi and welcome to you and Annie! :)

You have done the right thing to stop the Trilo for now. Good job, Mom! Anytime there is vomiting, diarrhea, lethargy the meds need to be stopped asap so you done good!

If you could get copies of the actual test results that were done to diagnose Annie and all the subsequent ACTHs, that will help us give you more meaningful feedback. It has been our unfortunate experience that sometimes when a vet says the results are "perfect", "normal", etc, they aren't always correct and it can lead to problems. So we really like to see the actual results of all the tests. Be sure to include the units of measurement like ug/dl, mnol/L, etc, and the normal ranges for each value.

Has Annie had an abdominal ultrasound? Not xray...ultrasound. If not, I strongly suggest you consider having one. This is a non-invasive test that can tell docs a great deal about many of the internal organs as well as help confirm a Cushing's diagnosis and help determine whether it is pituitary or adrenal based - which can be an important distinction when it comes to treatment options. ;)

The eye-drops - a friend of mine has just gone through a horrible time with her pup over eye-drops in an attempt to save his sight - which didn't work. Her pup was sick nearly the whole time he was on the drops and now has heart damage due to one of them. One of her vets told her this could happen if prednisone was included in the drops - his had pred in them. :( He was on several different drops at the same time for nearly a year. If I were you, I would have these drops checked out very well concerning side effects and if heart issues are possible, have Annie's heart checked asap. I don't know what kind you are using and am not familiar with eye-drops myself, but wanted you to know they can cause worse problems than they help sometimes. As mom to two blind babies, losing their sight isn't nearly as bad as what my friend and her baby have gone through. :(

Is Annie taking any other meds, supplements, or herbs?

I know what you mean when you say you are heart-broken. When my Squirt was first diagnosed, I cried for months on end. I was a total basket-case by the time we got here. But these kind folk took me in and gently led me along until I could breath again - then they began to teach me. The more I learned, the less afraid I was. That was in 2008; my Sweet Bebe is doing good and I have stopped pulling my hair out - well not every day any way! :p With three "special needs" babies, I can always find something to panic about! :D

You and Annie are not alone on this journey. We will walk with you every step of the way. If you have questions, please ask and we will do all we can to help you understand or research with you so we all learn. I'm sure you didn't set out to do this, but you have just found a new family for you and Annie...and I'm glad you are here.

Hugs,
Leslie and the gang

[Harley PoMMom]

Hi and welcome to you and Annie,

I am so sorry for the reasons that brought you here but very glad you found us.

If you could get copies of all the test/s that were done on Annie and post all the abnormalities here that would really help us to provide you with more meaningful feedback.

Cushing's is one of the most difficult diseases to get a confirmed diagnosis for because not one test is 100% accurate at diagnosing Cushing's and other non-adrenal illnesses, such as diabetes and thyroid problems, share the same symptoms. Was Annie checked for diabetes and any thyroid issue?

Since Annie experienced some vomiting and is not acting herself, not giving her any Trilostane was an excellent choice. When consulting with your vet, if it were me, I would ask if an ACTH stimulation test should be done and most definitely get her electrolytes checked.

I was wondering if Annie's ACTH stimulation tests were done 4-6 hours after her dose of Trilostane and is the Trilostane being given with food?

Was an ultrasound performed and if so, were the adrenals visualized?

We are here to help in any way we can so please do not hesitate to ask any and all questions.

Love and hugs,
Lori

[anniegirl]

Hi everyone, thank you for all the replies! could it still be something mimic'g cushings even though she tested positive on 8 hr stim and her orig blood work before stim test showed elevated #s indicating cushings? off to work but during day will get test results. on the 2nd test he said the "perfect" test results were 4.5. thank you and will speak more later this evening! also only had her on eye drops 2 days, 2x/day then stopped as eye cleared up and didnt love the meds

[anniegirl]

Hi all,
Annie is hypothyroid. she's on thyrotabs .7 for about 2 years now. I spoke to the vet and he feels strongly it is not the trilostane. I'm not convinced and will not give to her until i get some clarification. We are scheduled to see the vet tomorrow to do full blood work and xrays. What is the diff between ultrasound and xrays? should i do ultrasound instead of xrays? he is concerned w/the weight loss and connection to cancer though he said we won't know more until tomorrow's test results are in. he suggested keeping her on trilostane but i prefer to wait until after tomorrow. though stim test diagnosed pituitary tumor for cushings, unlikely but could be adrenal. he doesnt feel it likely is this though. I got a copy of both stim tests but was unable to scan in today at work so had to have faxed and unable to attach. though to understand what they sent was difficult.
thank you so much for all your replies. if anyone knows of trilostane causing rapid weight loss please share. i see weight loss on many posts but over a period of time. i'm very worried for my girl.. she's only 8, and such a baby.. my love. Her brother is 13 and was diagnosed w/cushings 3 yrs ago. never treated but is on meds for liver and heart. he's doing great.. no crazy drinking, mild panting but we keep him very comfy. he's got a good deal of energy and just likes to eat A LOT but is overall doing very well.

[Harley PoMMom]

X-rays, via electromagnetic waves, are usually done to view air-filled structures such as lungs/chest and bones.

Ultrasound imaging is used to view soft tissues in the body such as muscles, joints, and internal organs. These soft tissues are viewed by sending high frequency sound waves.

Choosing between an U/S or a X-ray really depends on the health issue one is trying to determine.

We usually recommend an U/S being performed to visualize the adrenal glands and other internal organs.

[anniegirl]

Hi, thank you Harley PomMom. Annie is off the trilostane day 2 and this am she vomited a very small amount and then drank a good amount of water and then vomited soon after. She is hungry, so i gave her boiled chicken w/rice and she ate it easily. I must hold her food 6 hours prior to her test at 4p so glad she ate. She is still very quiet, but did chase a bird and ran to the window when she heard something so she is alert thank God. Not sure what today's test will bring, but I have a question for the group. Is anyone aware of any financial assistance available for pets? Any info would be appreciated. Thank you again for all your replies.

[Squirt's Mom]

Mornin',

Check out these links. Several of us use Care Credit. ;)

http://www.k9cushings.com/forum/showthread.php?t=212

Hugs,
Leslie and the gang

[Harley PoMMom]

I am sorry to hear that sweet Annie is not feeling like herself. With the continuation of the vomiting episodes I am wondering if pancreatitis is brewing.

The only way that I am aware of to confirm pancreatitis is with a spec cPL test. Here is a link about the spec cPL test: http://www.idexx.com/view/xhtml/en_us/smallanimal/reference-laboratories/testmenu/innovative-tests/spec-cpl.jsf?SSOTOKEN=0

[jmac]

Hi there-

I just wanted to welcome you and Annie. I am sorry to hear she is not doing well. I would be worried too. I am glad you are not giving her the Trilo if she is not feeling well. I would want to wait and see what is going on first as well. I'm glad you will be seeing the vet to do some further testing.

Please know that we are here to help in any way you can. Feel free to ask questions, and please post whatever test results you get so the knowledgeable people here can give you their best advice. We will be here to support you and Annie!

Julie & Hannah

[anniegirl]

Hi again. Annie's bloodwork came back and she is diabetic. Her glucose is very high and she's got an appt first thing tomorrow morning to be monitored all day to determine exactly what she needs. We found out this afternoon. She was ok today but this eve not eating too much. ate some earlier but this eve vomited. small pieces of boiled chicken she's kept down. drinking regular. We put her back on trilostane as vet directed without it and with the glucose #s her condition can worsen. He mentioned making sure she doesnt go into ketone (i'm prob saying it wrong forgive me i've been researching and worrying all night). All i want at this point is for her to be ok enough and get to the vet tomorrow. her glucose # is 523 per yesterdays blood work. Now that i have read just how high that is, I'm panicking. Fructosamine 2/19 was 434. It seems that was high then but he associated it w/the cushings. I'm really confused but the worst part is worrying for my baby.. will she make it thru the night??? I have the address handy of 24 hour vet but praying she will be ok.
Started trilo again today. he decided to wait w/the xray and see what the bloods showed first. thanks so much for financial info too - care core denied me but will check w/others.

[jmac]

I am so sorry to hear that you are worrying. I don't have any help to offer you, as I am not familiar with diabetes, but I just wanted to tell you that I am sending support and prayers for you and Annie. I am hopeful that she will be fine tonight, but I am glad you have the number of an ER vet if needed.

Julie & Hannah

[StarDeb55]

A belated welcome to you & Annie! I wanted to let you know that I'm a lab tech with 30+ years experience, so I am used to reading lab results. I know you are all ready scared to death, but I can't make this sound any better, a glucose reading of 523 is critically high to the point of being life threatening, especially if Annie is spilling ketones in her urine. She could easily go in to diabetic ketoacidosis. I'm not sure why your vet thinks that medical treatment can wait until tomorrow morning, but if Annie were my pup, I would either be getting in touch with her vet, or heading to an ER clinic, especially since she has vomited. Diabetic ketoacidosis is nothing to fool around with. Please consider taking Annie to an ER clinic this evening.

Debbie

[anniegirl]

Debbie she is resting and hasnt vomited since early evening, has urinated and held the chicken. idk that she is spilling ketones, the doc said he would test for that in the morning. would there be any behavior to look for now? i'm not one to brush off anything i just thought he would tell me bring her in now this afternoon. I am in such a bad state financially but could possibly borrow a credit card. do you feel as a lab tech I should do this? i am so scared now i am trembling.

[StarDeb55]

Take a deep breath, we can get you through this. I have already PM'd, Natalie, who is the administrator of our sister site k9diabetes.com, & she is one of the admins for our site. Nat normally checks in once a day or so, but not until late. One of our other admins who has experience with diabetes is on right now, hopefully, she will stop by soon. There is an easy way to check for ketones in her urine. Most drugstores sell a product called "ketodiastix" or something like that. You shouldn't need a prescription, & if you don't remember the name, just tell the pharmacist that you need the strips the check for ketones in urine. I hope you can get to a drugstore tonight, or someone can go for you.

Now, the strip will have one or two small pads on it which you will need to wet with Annie's urine. There will be a color chart on the bottle which you will compare the color of the pad to, to see if the urine is positive. A lot of members will use a long handled spoon or ladle to collect urine, or even a small pan that you can slip in underneath Annie when she pees. You will not need to collect very much, just a few drops. If the the stick shows that there are ketones present, IMO, Annie needs to be seen tonight, especially if she has any more vomiting, becomes lethargic, or any other symptoms that are unusual.

Debbie

[k9diabetes]

I know it's really late where you are but if you are around, I suggest checking her yourself for ketones. You want Ketodiastix or Ketostix, which are generally available at any pharmacy.

Do you have a 24-hour or late-night pharmacy you could go to?

The sticks are inexpenisve and will quickly tell you if she has ketones now or not, which would determine whether she needs emergency treatment.

Dogs can often tolerate blood sugar that high and not have ketones. It seems to vary quite a bit from dog to dog. Our diabetic dog had blood sugar at those levels for extended periods of time and did okay.

But vomiting is common with severe ketones and ketoacidosis and time is of the essence if ketoacidosis has set in.

So if there is any way at all that you could check for that tonight, it would be clear whether there is an emergency or not.

Natalie

[BestBuddy]

Hi,

Ketones are really dangerous and as Natalie has said if you could test them yourself you would know if you needed vet care. High glucose isn't good but if there are no ketones then you could wait for the scheduled vet visit.

Jenny

[jmac]

Hi-

I am just checking in to see how Annie and you are doing. I am so glad you got advice from people who understand diabetes, and I am hopeful you figured out whether or not you had an emergency.

I hope you are both doing okay today. Please let us know how things are going.

Julie & Hannah

[k9diabetes]

I got a note from Annie's mom this morning. Annie got through the night okay and is at the vet for a couple of days as pancreatitis has been added to the list of her problems. She has some ketones but is not in ketoacidosis.

With all of this going on, I definitely would recommend that Trilostane be stopped until everything else is sorted out and proper Cushing's testing can be done. The pancreatitis and diabetes are much more important to tackle first.

Natalie

[frijole]

Thanks Natalie. Please tell her that we are all praying for Annie and send love and strength. Kim

[Cyn719]

Thinking of you and Sending you lots of love prayers support and strength that your Annie will be on the road to recovery soon.

Hugs xoxo

[k9diabetes]

I've been conversing with Annie's mom by email. Annie's still at the vet because she hasn't been willing to eat for them. They hope to have her home tomorrow. I hear her blood sugar is down substantially, into the 200s at least part of the time.

I've been asking a lot of questions about the process of Annie being diagnosed with Cushing's disease and today her mom kindly sent me copies of Annie's labwork for the past year.

I hope I'm confused because as far as I can tell, Annie was "diagnosed" with Cushing's without any testing for Cushing's disease - just a standard blood panel was done in October that showed high AlkP: 341 with a reference range of 10-150 U/L. The AlkP has been elevated for quite a while. It was 253 in February of 2010.

That high AlkP on a standard blood panel seems to have been the basis for the decision that Annie had Cushing's and then when she started drinking a lot of water, urinating all that water, and panting (all of which could have been diabetes), she was put on Trilostane... :(

I'm going to confirm this but so far everything I've heard leads me to believe that essentially no diagnostic process was done until February 17, when she had the LDDS and was started on Trilostane.

Results of the LDDS on February 17 - and I don't know why I'm even posting them since she probably had diabetes at the time - were:

Pre 10.9 RR 1.0-6.0 ug/dL
Plus 4 1.6
Plus 8 2.2

She started losing weight in February and starting getting thirsty and heavy urination in January but there doesn't appear to have been any testing done then.

The ACTH test done on March 2 to check how the Trilostane was working gave results of:

Pre 1.2 ug/dL
Post 5.1 ug/dL

Definitely not a good diagnostic process...

Natalie

[StarDeb55]

Well, why am I not surprised. We have seen some pretty atrocious diagnostic workups for Cushing's in this group, but to make this diagnosis based on an elevated alk phos, SERIOUSLY!! To quote my derm vet, "I think you could sneeze on these guys & it would elevate their alk phos." Diabetes can cause the elevated alk phos, & probably everything else. You can throw out the low dose because of the diabetes. The ACTH is actually the preferred test in a diabetic dog & that's within normal range. I would bet the "farm" that Annie doesn't have Cushing's & the problem has been diabetes all along. Now, enough of my rant for today. Nat, thanks for keeping us posted. Please tell Annie's Mom that we all care about both of them, & are keeping them in our thoughts & prayers.

Debbie

Oops, forgot that the ACTH was done after starting trilo, so never mind my comments about the ACTH result.

[k9diabetes]

In fleshing it out further tonight, there was a "suspicion" of Cushing's in October based solely on the AlkP level. But that level had been bouncing around mostly over normal for more than a year. No testing was done at that time because... she had no symptoms... went with watch and wait. One of the better decisions in this story!

So in January Annie she had a temporary bout of excessive thirst and urination and didn't seem to be herself, prompting a vet visit. She was seen by another vet who said Annie looked great and to just keep an eye on her. At that time, only a urinalysis was done (Annie's mom declined the blood panel at the time and that wouldn't have told her anything more about Cushing's anyway) and was supposedly normal but the results of that test are missing from the notes. So not sure whether they just checked for bacteria or actually sent it out for a full analysis.

Sounds like the January appt was the third to fourth week of January.

Interesting that it was only temporary drinking and urinating and abated for a couple of weeks after that.

A few weeks later the thirst, urination, and panting started in earnest and that prompted the LDDS on February 18th.

By then, Annie's blood sugar was in the 500s and her fructosamine was 434, indicating she'd had diabetes for several weeks at least. 450 and greater is poor on that version of the fructosamine. She began losing weight at the same time that the thirst and urination became serious and constant.

So pretty much everything Annie experienced in the past two and a half months could be entirely the fault of diabetes.

The vet also suggested that the diabetes might clear up once the Cushing's was controlled. If Annie actually has Cushing's, she also has diabetes independently. I've never seen an untreated Cush dog have the kind of very high, sustained high blood sugar that Annie has. No question in my mind that she has diabetes. BIG question in my mind about whether she ever had Cushing's disease.

The big thing now is to get Annie past the pancreatitis, then concentrate on the diabetes.

I'm hoping that Annie actually doesn't have Cushing's as that will save a lot of money, medicating, and monitoring. The diabetes can be managed for around $40 to $50 a month in a dog Annie's size with blood testing at home.

Natalie

[labblab]

So am I understanding things correctly that a standard blood panel was performed in October (presumably with a normal glucose level), Annie started drinking/peeing excessively in January (mom declined repeat standard blood panel), thirst/urination temporarily resolved but then returned, LDDS is performed in February, but no standard blood panel was done until now (March) and the glucose is sky-high?

If so, it's a lesson for us all to take to heart, and that is the value of a standard blood panel whenever our dogs are acting abnormally. I certainly don't mean this as a criticism of Annie's mom, because I think we've all been at that place at one time or another -- thinking OMG, do we REALLY have to do yet another test, yet one more time? But it highlights the responsibility of a vet to thoroughly explain and advocate for the importance of testing in the presence of certain symptoms. It seems as though the diabetes might have been identified back in January with a standard panel, and it certainly would have been identified at the time of the LDDS. That part really befuddles me, that the vet would push an owner for an LDDS in the absence of stressing the necessity of a simple, standard blood panel when a dog is drinking/peeing excessively. :confused:

What with Peg's phenobarb level checks, and liver panels, and pancreatitis -- I know there's been more than one time during the past year when I've thought, "Time for another blood panel, again, REALLY?" But I'll take Annie's experience to heart, and try to realize that just a simple blood panel can often be the single most important key to proper diagnosis and treatment (including for myself, since I'm long overdue for my own regular exam :o).

Marianne

[Squirt's Mom]

Please let Annie's family know that we are thinking of them and keeping them all in our thoughts and prayers.

Hugs,
Leslie and the gang

[k9diabetes]

She did have bloodwork at the same time as the LDDS and a fructosamine (gives an average of the blood sugar over the preceding two weeks or so - Annie's average very high) as at that point apparently the vet discovered the diabetes right away. He felt that the diabetes was coming from the Cushing's...

The one huge question I still have, thought of it lying in bed last night, is whether on February 18th he started Annie on insulin.

Natalie

[k9diabetes]

Annie's mom asked me to pass on a huge hug and thank you to everyone here who has been concerned about them. She is so grateful for all of the help that she's received and especially for Deb getting her started in the right direction. Once they both have had time to catch up on some sleep, she will post over here herself.

Good news - Annie is home! Her blood sugar is down and... BEST of all... Annie has a wonderful NEW veterinarian who reviewed all of her tests and treatment. One who isn't concerned about Cushing's disease and is very anxious to get her diabetes sorted out.

As I had feared, the previous vet did NOT start Annie on insulin on February 17th... Annie is very lucky to have come through this past month as well as she did.

Natalie

[Harley PoMMom]

So glad to hear that Annie is home! Sending huge and loving hugs to sweet Annie and her mom.

[labblab]

That's terrific news, Natalie. Thanks so much for letting us know, and please tell Annie's mom that we are so anxious to have her back here, regardless of whether or not Cushing's ever turns out to be a genuine issue!

Marianne

[anniegirl]

Hi all, first want to thank you all SO MUCH for all the love and support !! What an amazingly kind wonderful group of friends I have here : ) I have to get ready for annie's appt - she is starting back on insulin today so we can start getting it regulated. Thank God for Deb and Natalie for their persistence, it literally has saved Annie's life!! I will write more later but did want to ask a few things. Annie is eating very little. I suspect due to the pancreatitis and diabetes and weakness and stress. I did get her to eat a small amount last night and this am. Will she eat more w/insulin ? The prev vet (bad one) sent me home w/all kinds of meds but no antibiotics for the pancreatitis. new vet said pepcid was good, no painkillers though (bad vet gave) as it will upset her stomach further. she has had no vomiting at all and a good stool last night. she is hypothyroid, has been for a few years. while w/the bad vet for the 2 days they did not give her thyroid meds (they didnt think to look at her chart i guess or else didnt feel urgent and not sure if it is?) so my question is, she was weak, rightfully so, yesterday when we picked her up but walked ok, just a bit slower. well this am she woke up and now her hind left leg - she is tippy towing, as if she cannot walk on it. Years ago she had this and vet thought could be a ligament pull . she went on adequan shots for about 2 wks and was good after. does this have anything to do w/her current condition? lack of thyroid med? I wont feel better until she does but am thankful she is out of that very high danger zone she was in. thanks everyone.. if no reply back right away will w/b when i get home from the new vet : ) xoxo

[anniegirl]

Hi, back from Dr K! Annie got her shot of insulin and didnt even know it! in fact, I did it!! doc directed me and it really is much better than i had expected.. what a relief!! he suspects the leg may be where the iv was while she was in the hospital w/other vet ("Dr G"). or, she may have fallen or hurt herself but not while w/us so we have to just watch it. Just wanted to comment on prev posts about the blood work I opted to hold off on in January. For starters - ABSOLUTELY do blood work at least yearly and for seniors every 6 mos, which is what we have always done. If something is wrong or suspected, again, going forward I would def opt for the blood work. The reason in January that I didnt, was because Annie had just gotten blood work 10/31/11, and I was planning to do again in March. If the clin signs in Jan had continued, i was planning to do the b/w but they stopped (which was weird) in a few days. Did not come up again until mid Feb. that was when Dr G insisted we do the cushings test, he convinced me that was it, he was so confident.. I had asked at that point can't it be diabetes? he said we'll do the fructosamine test w/the cushings too. I assumed w/both tests, he would diagnose if diabetes, not aware at the time of what you all have taught me about the diabetes and cushings symptoms being identical in so many ways. He as a vet should have known, tested, etc. I am angry about it all but I have to let it go and focus on my girl and so happy she is now in good hands. Any good ideas for diet for her are welcome. Once she is better and appetite back in full she's going to be looking for all the goodies she can no longer have! She has no interest in fresh veggies, never did. Loved her greenie every night after dinner and boiled chicken w/her meal, neither of which she can have no. Look forward to hearing from you all! Hugs !

[labblab]

I am so sorry if what I wrote about the blood panels has made you feel badly in any way :o. I do apologize, because at the time I wrote, I didn't understand the whole chronology very clearly and it was your vet with whom I was frustrated. It is so clear how much you love Annie and what good care you have always taken of her. At the time I wrote my reply, I was feeling very cross with your old vet (which I still do!). I just didn't believe you were getting good advice re: Annie's care and appropriate testing. So I am totally relieved that you are on the right track with a new vet!!!

Sending you my well wishes, and hoping you'll give Annie a big hug for me.
Marianne

[anniegirl]

Hi Marianne, please no apology needed!! I def did not take offense, i knew exactly what you meant and i think its such an important point to share so everyone can be on top of their game. I am still frustrated at what went down and all the $ spent (which a lot of was w/help of family and friends) - mainly because I could be using that $ for her care now as its been so tough. But, i am so glad we were able to realize what was happening before it was too late.. that is how i must look at it. I just worry that it can happen to another voiceless animal who's guardian may be unaware as I was.
Hugs right back to you from me and Annie : )

[nibbles-mommy]

As Natalie probably has already mentioned, the k9diabetes message board can give you all kinds of food ideas, there are great, supportive people over there too. You can still give normal food and definitely boiled chicken. The important thing is 12hr. scheduled feedings. Home blood glucose testing is the most important thing you can do for Annie also. You can monitor her glucose and make necessary adjustments to food and insulin when needed. You can also do at home curves when you feel comfortable and show your vet the progress.

You can also get Humulin-N ($25.00 a bottle) (if that's the insulin you are using), syringes (about $13.00 100/pk) and the testing meter and strips cheap at walmart.

My dog Nibbles has been diabetic for 1 year and was treated for Cushings for awhile.

here's the link http://www.k9diabetes.com/forum/forumdisplay.php?f=2

Good luck.

[Squirt's Mom]

I am *so* glad Annie is back home where she belongs and feeling much better! :)

One thing I have learned since starting our cush journey - I never knew how much I didn't know and how much there is to learn! :eek::p When our babies get sick like ours are, we find ourselves sitting in the hugest classroom in the world with tons of info being piled on our desks demanding understanding. It is so overwhelming we often do good just to remember our names much less take on something so complex. So we rely on those who are supposed to already know - our vets. Usually ones we have used and trusted for years so there is no reason to doubt anything they tell us when we present a new issue in our babies. When we do learn that our trusted vets are not infallible after all, we learn a hard lesson but one we do not forget....and one we are more than happy to share with every pet parent we know! :D "Listen to your gut. Ask lots of questions of your vet. Do your own research. Learn all you can about the problem at hand. Find a group of folks who have been where you are and learn from them." My friends are rather sick of that mantra but I still continue to spout it at every chance. ;) You are doing all of this and your baby is now on her way to feeling better. We learn as we go and use those lesson to face tomorrow.

I have no doubt that Annie is in the best of hands with ya'll and that she will benefit from the lessons you have learned in the past few months. That is a good thing so stop beating yourself up. Besides, I am the Queen of Guilt and I guard my throne jealously! :p

Hugs,
Leslie and the gang

[anniegirl]

Hi there! vet prescribed Humulin N - since not yet regulated he gave her 4 units this am and if she eats good, 15 tonight otherwise 8. tomorrow, 8 and 8 if not eating great. call w/status tomorrow am of how she is doing. she still not eating great but only thing she would eat is science diet light. she wouldnt eat the w/d. actually i went out and left her food forgetting that now my other dog is so ravenous now and when i came back the food was gone. Now i dont know for sure who ate it. i tried to give her a little more by hand of the light food but she wouldnt eat it. she also must have drank a decent amount of water and then regurgitated it. no vomit, just water on the floor close to the door. do these #s sound reasonable to give her ? I am asking because as I read my notes that i took as he told me what to give, I am now not able to read them back so clear as far as the dosage goes. He's gone for the day. I wrote everything else down so perfectly.. of course : ( She is 70 lbs. can you tell me if this all sounds ok? Also, her left hind leg is not getting any better she's hopping barely letting it touch. I really dont know where she hurt herself as she is moving so slowly - only thing i can think is that when we were at the vet yesterday she kept moving around in fear because she is afraid of beeping sounds and every time a door there opens it beeps. she had the same thing years ago and was treated w/adequan injections which cured it. only problem is i dont remember if it was that same leg. ugh...i feel like such a bad mom sometimes!! i have been so anxious and worried about her that taking in all the info this am was overkill on my brain cells. Please most important if someone can tell me if this sounds right on insulin dose. every 12 hours. tonight around 8p she's due.
thanks again guys : )

[nibbles-mommy]

I'm not great with dosing, but quickly head over to the other board and they may be able to help. Also email Natalie if it's urgent she may be able to help.

I know you can't give a full dose without a full meal. If she's eating less definetly reduce. Others can maybe help determine a sliding scale for dosing.

Copy and paste your info into a new thread.

They are gonna wanna know-breed, weight, and some other info.

[nibbles-mommy]

I know you have to be approved before posting on the boards, so that might take awhile. In the mean time:

Do you have any of the readings from the vet? What was her reading after the 4 units this morning with no food?

Thinking over more, my vet always instructed to give half the dose if he didn't eat at all to cover basal needs. Which pretty much sounds on target with the 8 units. I don't know the recent glucose readings to know how low her bg is and any trends she might have with rises and drops. The vet also instructed that the starting dose is normally 1/4 unit for every pound. Which is also on target (pretty much) with the full 15 units for a 70lb dog.

Also if you can't home test with the meter. May be grab some ketodiastix at a pharmacy like CVS. That can give you a general idea of what her sugar has been over the last couple hours-to possibly the day before. If you keep getting consistent readings in the highest square (all the way to the right-dark brown) then you know her sugar is most likely high. The strips also measure ketones.

[StarDeb55]

You're very welcome! All the thanks I need is that Annie is home & doing much better. I'm glad to hear that you seem to be getting the hang of doing her injections. I have to give my Lhasa his allergy shots, & it was pretty easy. Even though Annie may not have Cushing's, please do keep us posted on how she is doing.

Debbie

[anniegirl]

thank you nibbles : ) she didnt eat a ton but def improving so tonight we'll do the 8 but tomorrow am is my concern, so we'll go w/the 4 as he did this am. I would rather shoot low than over. i'll be calling him by 10:30 so i think she'll be ok. i'm still feeling overwhelmed as now her leg is really bad we had to hold her up to urinate. I suspect its a coincidence that in her weakened state at some point she must have twisted something or pulled a ligament. I will have to speak to the vet tomorrow. My poor girl.. i wont be right until she is. I'm really functioning at 80% it seems. I have lost weight right there w/her as I cant eat much when upset though it really wont do me any harm as i can afford a few lbs lost.. lol... thank you again ..

[nibbles-mommy]

you're welcome. glad annie ate some. it is very overwhelming in the beginning (who am i kidding i am still overwhelmed at times). i have gone on many hunger strikes along with my babies. nibbles was very sick when first diagnosed. he was feeling better within a week of regular dosing.
did he explain the signs of low blood sugar to you? hypoglycemia is the drop in sugar to dangerous levels. if she seems shaky, wobbly, disoriented and the like. her sugar could be low.. always have karo syrup on hand and if needed rub some syrup on her gums.

if you can, try to get some gluccose readings from the vet. i'm a little confused by the 4, 8,15 unit combo. if he thinks 15 is a good number that gave good safe results than that would be the regular dose with a full meal. 8 units would be about half and i would think that would be with little to no food. i am curious to see the numbers from this morning that he based the 4 units on. these are quite dramatic reduction in my opinion. like i said i am by far an expert at this.

good luck to you two and eat something. you're gonna need your strength! keep us posted.

debbie

[anniegirl]

Hi ! My girl is feeling better and better every day ! so happy : ) Her leg is much better today as well. Tomorrow she'll go back for a glucose reading. The 4 units was based on her eating so little. She ate more last night and ate well this am so this am we gave her 8 u. Tonight if she eats a full can of food we will do 15u. Doc said give insulin within hour after she eats. her appt tomorrow is 6-8 hours after last insulin shot. Will keep you posted and I'm eating more too now! : )
thanks so much!!