Bella's story (mini dachshund) Diabetic & Cushing's

[Bella's Mum]

Hi all, new here we have a 9-13 year old mini dachshund (not 100%) on age as was rescure back in 2009. In December 2011 Bella started having accidents in the house which was completely out of character, she was diagnosed with diabeties and is currently on .20 insulin twice daily. Her diabeties is still not 100 under control ( will post test results when get them back). Bella had a down turn in August/September and was dignosed with cushings as well. Since then we had her 30mg twice daily tablets, last two night when she appears to be under some stress she vomits. The vet has recommend to cease the Cushing tablets and commence cortate tablets twice daily. It's been hard at times seeing her so unwell especially over the past couple of months but overall she has been in good health, no back problems etc. interested in all your thoughts on how to continue this journey :)

[frijole]

Hello. Glad you found us. Could you share more info about the testing to confirm cushings and the results? I assume since starting the vetoryl/trilostane you have done acth tests to confirm the cortisol levels? We need those as well as the dates of them.

What stood out to me is that you said she's on 30 mgs twice daily. That sounds like a HUGE dose for a small dog. Please confirm Bella's weight. The vomit is probably a sign of low cortisol caused by too much of the drug. So your vet was right to have you stop it. What are cortate tablets? Usually dogs are given prednisone in emergencies.

THanks! Kim

[mytil]

Hi and welcome to you and Bella,

Sorry for all the questions here, but this will give us an idea of what is actually happening to your girl.

Firstly, when your vet mentioned stopping the meds was an ACTH test performed to check the cortisol levels and they had not fallen too low. Vomiting can be a sign the levels have follow below the safe limits for your girl. And the electrolyte levels should be checked as well, especially when giving Trilostane/Vetoryl.

Let us also know the test results of any test performed to diagnose Cushing's and how much does Bella weigh?

Here is a fantastic resource for diabetic dogs - http://www.k9diabetes.com/forum/ (our sister site). Please do feel free to join.

It can be difficult to regulate the diabetes and Cushing's but not impossible.

Looking forward to your reply
Terry

[Bella's Mum]

Sorry should of mentioned Bella is currently 8kg, the cortate tablets are a cortisone Will need to check the grams in the morning. Bella has now had 3 ACTH tests and we are current waiting on the results from the latest ones ( yesterday) the glucose ounces have come back and still borderline fair.
Vet has also mentioned we are not to 'stress' Bella as it seems to bring on the vomiting.

Once I receive the latest test results will post vs when Bella was first dignosed.

[Bella's Mum]

Sorry should of mentioned Bella is currently 8kg, the cortate tablets are a cortisone Will need to check the grams in the morning. Bella has now had 3 ACTH tests and we are current waiting on the results from the latest ones ( yesterday) the glucose ounces have come back and still borderline fair.
Vet has also mentioned we are not to 'stress' Bella as it seems to bring on the vomiting.

Once I receive the latest test results will post vs when Bella was first dignosed.

Apologies 2 weeks ago Bella's vetroyl tablets were increased to 45mg

[Squirt's Mom]

Please verify weight and dose of 4mg twice a day. That is a massive dose - almost twice the highest recommended for that weight - so I am very concerned about Bella!

[Jenny & Judi in MN]

welcome. My Jenny has cushings and diabetes too. I'll be curious to see Bella's latest ACTH results.

Do you give her the medication with food?

knock wood, I haven't had to deal with throwing up and an upset tummy. Seems like several dogs on both forums have had pancreatitis lately, did the vet rule that out?

sorry I'm no help. Judi

[Bella's Mum]

Please verify weight and dose of 4mg twice a day. That is a massive dose - almost twice the highest recommended for that weight - so I am very concerned about Bella!

She's 8kg and 45mg twice daily, it has been 2 days since last on that dose and vet ceased the vetroyl once the vomit occurred

[Bella's Mum]

Sorry about the late reply. We have finally recieved the results from Bellas latest test.
ACTH
0-38
1-262
Fructosamine
482umol/L
Serum B - Hydroxybutyrate
0.1mmol/L
Sodium - 135 mmol/L (140-155)
Potassium 6.3 mmol/L (3.8 -5.8)
Cloride 106 mmol/L (100-120)
Bicarbonate 13 mmol/L (16-24)
Urea 15mmol/L (2.5-9)
Plasma Glucose 21.4 mmol/L (3.5-6.7)
Glucose 25mmol/L (3.5-6.7)
ALT 178 U/L (<80)
GGT 26U/L (<6)
Alkaine Phosphatase 229 U/L (1-120)
Lipase 186 U/L (1-70)
Cholesterol 18.1 mmol/L (3.6-8.8)
Triglyceride 8.1 mmol/L (0.2-1.7)

Not great results :(

[Bella's Mum]

Went back though our filing and it appears i may have accidently deleted/changed the file type from when Bella was first diagnosed with Cushings. Will request results from Vet during next months test (due in 2 weeks).

[Bella's Mum]

Sorry about the late reply. We have finally recieved the results from Bellas latest test.
ACTH
0-38
1-262
Fructosamine
482umol/L
Serum B - Hydroxybutyrate
0.1mmol/L
Sodium - 135 mmol/L (140-155)
Potassium 6.3 mmol/L (3.8 -5.8)
Cloride 106 mmol/L (100-120)
Bicarbonate 13 mmol/L (16-24)
Urea 15mmol/L (2.5-9)
Plasma Glucose 21.4 mmol/L (3.5-6.7)
Glucose 25mmol/L (3.5-6.7)
ALT 178 U/L (<80)
GGT 26U/L (<6)
Alkaine Phosphatase 229 U/L (1-120)
Lipase 186 U/L (1-70)
Cholesterol 18.1 mmol/L (3.6-8.8)
Triglyceride 8.1 mmol/L (0.2-1.7)

Not great results :(

Bella is now back on 30mg of Vetryol twice daily and havent vomited since so fingers cross, although it appear her cataracts are getting worse and hearing loss is increasing :(

[molly muffin]

Glad there hasn't been any vomiting. How does Bella seem to be doing symptom wise?

Sharlene

[Bella's Mum]

Symptom wise she has been going good. It's almost summer here in Australia she's does appear to be about quieter with the heat, we have been leaving aircon on. She's still hungery as a piglet but

[molly muffin]

Very glad to hear that Bella is doing well on her dosage. Well, you know, piglets can be cute as long as they aren't trying to bite your fingers for a bite. :)

Enjoy the summmer, Canada is getting bloody cold, although there is a rumor that says we might have a warm day this weekend before the cold finds us again. We had snow flurries the other one when I was leaving for work!!!!
time to go to Australia ROFL!

Sharlene

[Bella's Mum]

Well back to the vets today (Sunday) it seems bella has pancretites again :( she did have her monthly test on Wednesday ( no results as yet) and the good news is that the diabeties is under control although cushings not so much :(
Hopefully bells can come home after a few hours at the vets. Will keep updated and post the latest results as soon as known.

[molly muffin]

Oh no. Poor Bella. Just when one things gets under control, something else.

Let us know how she is doing.

Sharlene

[Bella's Mum]

Well Bella came home to see how things go as she seems to stress her self out. Half hour at home and Bella had a seizure :( rushed back to the vets for night. Are seizures common? This is the second time and first being when she was diagnosed? So confused!

[Bella's Mum]

Well since my last post Bella had pancreatic episode and was in hospital for 3 days :(. We have since had our Dcember check up and things seem to be going good (fingers cross stays this way)
ACTH results:
0 - 31
1 - 50
Glucose:
8:30am - 16.3
10:30am - 11.2
12:30pm - 4.9
1:30pm 4.30
2:30pm - 4.30
4:30pm - 4.80

Fructosamine:
408 umol/l

Overall good control does current have a yeast infection in her ear which she has some tablets and cream for.

[molly muffin]

Merry Christmas to you and Bella

Have a safe and wonderful holiday. Glad Bella is recovering from her latest episode.

Sharlene and Molly Muffin