Buddy and Cushings

[glendapalmer]

Buddy was diagnosed with diabetes and after four months was just not improving. We changed vets and he immediately tested for cushings. His test was a 10. He started taking Vitoryl 60mg today. I stopped the insulin yesterday.

I feel so sorry for him. He is drinking water like crazy and is so hungry. He cannot hold his urine. This is a well trained rescue dog and he looks at me so ashamed.

My main question is how long will this medicine take to start working like it should. I go back to the vet in two weeks. Thank you, glenda palmer:)

[frijole]

Hi and welcome. We need to ask questions in order to help you. first off what test are you referring to was a 10? I ask because if it was the acth test then a 10 is not considered cushings. Any other test has 3 numbers and not one... so I'm really wanting to know what test you are referring to. Are you in the US?

also tell us how much Buddy weighs so we can check the dosage on the trilostane ok?

Did your vet tell you what to look for in terms of improvement, signs of overdose etc? Just want to make sure you are up to speed on the drug.

Thanks
Kim

[molly muffin]

hello and welcome. yea, all that Kim said. So, does buddy Not have diabetes? Or does and is controlled?

Welcome to the forum. We have some great people here who will try and help as much as they can. They are pretty knowledgeable.

Sharlene and Molly Muffin

[mytil]

Hi

I wanted to welcome you both as well. I am sorry you both are having these troubles.

If your Buddy has diabetes it is not wise at all to stop his insulin regime.

Even though the symptoms may be bad Cushing's is a slow progressing disease; not like diabetes which can turn life threatening rather quickly. Here is our great sister site on diabetes - http://www.k9diabetes.com/forum/.

As Kim mentioned, please describe more about the test with the result of 10.

Keep in mind, it could be something else going on instead of Cushing's.


Please do keep us posted.
Terry

[Jenny & Judi in MN]

Hi Glenda: I'm happy to see you asking questions over here. I'm really worried about Buddy being on no insulin at all. Poor boy looking ashamed when he is just sick.

I know changing vets is stressful and expensive but I wish you would. It is so overwhelming and Buddy is lucky to have you.

hugs, Judi

[glendapalmer]

Buddy is now at the vet's for a few days. He was also diagnosed with diabetes after the second test. I am reading from the vet bill. He was tested for cortisol level which was ten and the second time they tested him it was normal. He is taking vitoryl 60mg. they have done a basic CBC test on him. [I] know that is a test that they see about thyroid and other ailments. this is all I have. I do trust my new vet. He is an old time vet and seen many things. he has said Buddy could live two to three yrs with the cushings, but my Westie died within 6 months of diagnosis. I will tell you that he is on Science WD food.

Before he went to the vet the last time he was feeling very poorly and that is because of the diabetes.

Any information or suggestions is greatly appreciated. glenda

[lulusmom]

Buddy is now at the vet's for a few days. He was also diagnosed with diabetes after the second test.

Was Buddy diagnosed with diabetes first? Did your vet have a hard time getting him regulated so he assumed he may have cushing's. If so, I would be very concerned because testing an uncontrolled diabetic dog for cushing's is a bad idea. All diagnostic tests for cushing's can yield false positive results and I would be surprised if a dog with uncontrolled diabetes to test normal.

What has happened that Buddy is now in the hospital? What did your vet tell you about his condition?


I am reading from the vet bill. He was tested for cortisol level which was ten and the second time they tested him it was normal. He is taking vitoryl 60mg.

The vet bill does not provide actual test results so it would be great if you would please get a copy of the actual results and post the results here. If 10 is the resting cortisol, that is high. The second blood draw is done after injecting the stimulating agent and that is the number that we need to know. Normal reference ranges for this second draw cannot be used for purposes of monitoring treatment.

60mg is a healthy dose so I am assuming that Buddy is not a small dog. How old is Buddy, what is his breeding and how much does he weigh?


they have done a basic CBC test on him. [I] know that is a test that they see about thyroid and other ailments. this is all I have.

A CBC (complete blood count) does not include a thyroid assessment. A blood chemistry includes only the T4 thyroid hormone and if Buddy has cushing's and diabetes, neither of which are controlled, I would be shocked if the T4 was normal.


I do trust my new vet. He is an old time vet and seen many things. he has said Buddy could live two to three yrs with the cushings, but my Westie died within 6 months of diagnosis.

My best advice to you is to never place blind faith in any vet and it is very important that you be an active participant in Buddy's treatment. I am hoping that you are a member of k9diabetes and are absorbing all of the information they are providing you. It is difficult enough to deal with cushing's or diabetes but when your dog has both, it is very difficult to get a dog stabilized. Some of the best internal medicine specialist have a rough time of it so I would be hard pressed to trust any general practitioner vet.

Dogs can live out there normal life expectancy with a good quality of life with appropriate treatment so the law of averages don't apply to all dogs. Did your vet tell you what he based his 2 to 3 year prognosis on? My own dog was diagnosed at three years old and if the statistics are correct, she should have left this world many years ago. She's 11 years old now. However, diabetes can complicate matters greatly but again, if both conditions are well controlled by a knowledgable vet and an educated pet owner, they can lead a great dog worthy life.

I am so sorry for the loss of your Westie. Cushing's is rarely fatal and even then, the disease has to have progressed for a very, very long time to cause organ failure or massive systemic bacterial infection brought on by an extremely compromised immune system. If you don't mind me asking, can you tell me how your Westie passed?

Glynda

[glendapalmer]

buddy is at the vet's to get his insulin regulated. I do trust this vet but I have had so many dogs that I know they are not always right. someone ask about buddy's weight. He was 30 lbs when we got him and the other day he was 23.6 lbs. I do not think there is any doubt that he has diabetes along with Cushings. That is why he is at the vet's also, they will run test the full four days he is there and hopefully get a handle on this problem. glenda

[lulusmom]

Hi Glenda,

I asked a number of questions in my last post which I am listing below as well as a few more. It would be great if you would please post your answers.

1. Was Buddy diagnosed with diabetes first?
2. Did your vet have a hard time getting him regulated so he assumed he may have cushing's?
3. Was Buddy's diabetes under control when the test for cushing's was done?
4. Can you please ask your vet for a copy of the test done to diagnose cushing's and post the results here?
5. How old is Buddy and what breed is he?

Glynda

[glendapalmer]

1. Was Buddy diagnosed with diabetes first? yes

2. Did your vet have a hard time getting him regulated so he assumed he may have cushing's? no

3. Was Buddy's diabetes under control when the test for cushing's was done? no

4. Can you please ask your vet for a copy of the test done to diagnose cushing's and post the results here?
I can but I know the test showed 10 and then after being on vitoryl for over a week, he registered normal

5. How old is Buddy and what breed is he?
buddy is 9 or 10 yrs old and is a daucshund/jack russell, we think. Buddy is a rescue dog that I picked up in the parking lot of our local grocery.

I hope this answers your questions. I may add that we went to go get Buddy this morning. All test showed normal yesterday, so we are able to bring him home. He is on 10 units of Novilin N and also 60 mg of vitoryl.

[lulusmom]

Hi Glenda,

Thank you for answering my questions. We now have a better picture of the chronological order of things. Now I'd like to share my concerns with a few of those answers. I believe the folks over on k9diabetes have already mentioned to you that it is very difficult to diagnose cushing's in an uncontrolled diabetic dog and you did say Buddy's diabetes was not under control. That is a huge flag for me that a cushing's could have been misdiagnosed. The fact that your vet did not have a difficult time regulating Buddy is also a big red flag.

With respect to the testing that was done to diagnose cushing's, I have no idea which test you are referring to when you say the number was 10. If it was an acth stimulation test, then 10 is definitely not consistent with cushing's and I don't know what normal means on all of the tests that were just done. It really would be great if you would get copies of them and post the results here. We recommend that all members keep copies of their dog's medical records as you never know when you might need them. I've taken my files to the emergency clinic more than once and the vets on call really appreciated having my dog's complete medical history in front of him/her. They also come in handy when we nag you to post results for us. :D

Glynda

P.S. Thank you for rescuing Buddy and opening up your heart and home to him. What a lucky guy he is to have crossed paths with you.

[Patty]

I may add that we went to go get Buddy this morning. All test showed normal yesterday, so we are able to bring him home. He is on 10 units of Novilin N and also 60 mg of vitoryl.
Hi Glenda,
Just reading up on Buddy. I'm glad to hear he is back on insulin. I am however wondering how his blood sugar is doing. I know he'd been trending lower on the previously started 6 units but was increased to 13u over time. I believe the diabetes members were questioning rebound and that you'd gone back to 6u prior to discontinuing his insulin.

From 11/29:

I got the curves today from the vet. Not sure how to post them. Will just put the amounts that were taken in the am and the pm for two days

September when first diagnosed at 6 units insulin
Am 72, 115
PM 94,72,72

October curve when he was on 5 units a day
AM 390,269,290,246

He was then increased to 7 units and then to 10 units and [I] took him today for a test and it was 450. she is now giving him 13units twice a day

- Do you have any of his glucose numbers from the vet?
- Are you still seeing the vet that initially diagnosed him?

Like Glynda, I wonder about his Cushings diagnosis. It can be very difficult to diagnose Cushings in the presence of unregulated diabetes.

I am glad his CBC looked good and that he will be coming home.

Please do let us know about his glucose numbers. Typical starting dose for insulin is usually around 20% of the dog's body weight which would be closer to 5 units in a 24lb dog.

Take care,
Patty

Buddy's k9diabetes thread: http://www.k9diabetes.com/forum/showthread.php?t=4455