Mini has Cushings and Diabetic, Trilostane, skipping meals

[esark33]

Hi everyone,

I've transferred here from k9diabetes.com so some of you may recognize me, but just a bit of background:

My 10 yr. old chihuahua mix (I'm guessing PomChi + more) was diagnosed with diabetes in February, and Cushing's in March. She's been on 4 units of Novolin N and 0.06 units of trilostane.

Her last 2 Stim tests are as follows:

4/8/13
PRE-ACTH 1.7 ug/dL
POST-ACTH 8.4 ug/dL

5/6/13
PRE-ACTH 6.2 ug/dL
POST-ACTH 5.9 ug/dL

Even though her ACTH tests look good, I've lowered her trilostane to 0.05 units for the past month because she keeps skipping meals every couple days (sometimes skips both meals), and she keeps losing weight. Should I lower it further to increase her appetite?

The doc says her ACTH levels are where they should be so don't lower the dose. But she's not the one struggling through every feeding hoping that she'll eat.

Mini's about 11 lbs now, down from 12 lbs. a month ago and 13 lbs. a month before that. Poor thing has been through two moves since her diagnosis in Feb, and has recently lost her vision quite rapidly to where she's nearly blind. Luckily we settled into our final home a few weeks before her vision really declined.

Thanks, appreciate the help.
Ed

[Squirt's Mom]

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[molly muffin]

Hello and welcome Ed and Mimi to the cushing forum. I'm glad to see that you are already a member at our sister site, k9diabetes.

At this point, the trilostane should not be what is affecting her eating. How have her BG levels been? Diabetes can have quite a effect on hunger.

I don't think I would lower the trilostane any further, but the pre number certainly did go from low to higher.
Has her blood levels been checked recently CBC? To see how her liver enzymes and electrolytes are? Every time you have a stim, (ACTH) you should have those electrolytes checked just to be sure everything is staying on an even keel.

Again welcome to the forum some of the others will be by to say hello soon too.

Sharlene and Molly Muffin

[Roxee's Dad]

Hi Ed,
I just wanted to stop by and welcome you and Mini. Dealing with Cushings and diabetes is very challenging. It looks like her Trilo dosage is about right, although Mini is at the high end of what is considered normal range for a cush pup on Trilo.

I hope some of our members that are dealing with both stop by and help you through this. Do you mind if I change your title to include diabetes and cushings? They may notice it easier.

[frijole]

I agree that it could very well be something other than the trilostane causing the lack of appetite because the numbers are fine. Cush dogs are prone to pancreatitis. Have you tested for that? Have you had general blood panel done recently? I'd like to see the results if you have. If not I'd start there. I lived with the eating issue for over 2 years and it is so stressful. There has to be a reason. Kim

[doxiesrock912]

I am going through this very issue with Daisy Mae right now. Her IMS vet suggested that I lower her dosage of Trilo. Each dog has a unique tolerance regardless of what the numbers indicate.

Please consult with your vet/IMS specialist.

[Budsters Mom]

Hello and welcome from me too. :)
You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. We will do all we can to help, but be ready for lots of questions! So again, welcome Ed and Mini.

Hugs,
Kathy

[Squirt's Mom]

You say your baby went suddenly blind. There is a condition called SARDS - Sudden Acquired Retinal Degeneration Syndrome - which mimics Cushing's yet is not Cushing's. Here is some info on SARDS - http://www.k9cushings.com/forum/showthread.php?t=213

[esark33]

Thank you so much for the warm welcome! Hope you all had a good 4th.


At this point, the trilostane should not be what is affecting her eating. How have her BG levels been? Diabetes can have quite a effect on hunger.

Thanks Sharlene. Her last BG curve was a couple weeks ago and it looked fine: nadir was around 150, with the high around 300. Re: liver enzymes and electrolytes, we had a CBC done at her first diagnosis in February but not since.

Roxee's Dad: don't mind at all, feel free to change the title.

Squirt's mom: I really don't think it's SARDS.

If it's determined she has pancreatitis, what can be done?

You guys like details? Here are some details... :)

Her meals consist of:

50g chicken, boiled or roasted (estimated 105 cals)
40g whole wheat pasta (estimated 51 cals)
10g green beans or carrots (estimated 5 cals)
1 slice bacon or 2 tiny smoked sausages

I know what you're thinking - don't give bacon to a diabetic dog! We added it for these reasons:

- add some flavor so she'd hopefully eat more consistently
- add a few more calories because her weight was dropping
- lower the total volume of food. Previously we were giving 70g chicken and 50g pasta, and the volume of food looked huge. Again, thought perhaps that was contributing to her not eating consistently.
- add some fat to her diet. Her skin is flaky. We previously tried fish oil but she seemed to eat less often, and actually had diarrhea and vomiting 2 days after starting it. Not sure if it was a one-off unrelated occurrence, but it scared us into removing it from her diet.

Could it be some sort of depression related to her sudden loss of sight? Although to be honest, she was always a finicky eater - even when she was "healthy".