lulusmom
06-03-2009, 05:02 PM
Hi Randy,
I was able to find your entire cc.net thread and since it was only four pages, I thought it would be good to bring it forward here so that we have all of sweet old Champ's story. It was a quick and dirty cut and paste so quotes may look weird.
Welcome back and my thanks as well to the dear friend that guided you here.
Glynda
++++++++++++++++++++++++++++++++++++++++
April 4, 2009, 08:30 AM
Randy Abercrombie
Junior Member
Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Hello. My name is Randy and my best fishing buddy is a nine year old beagle named Champ. He has been diabetic for five years. We have been a member of the Muffin diabetic group. Yesterday he was diagnosed with Cushing's and some of my freinds on the Muffin list suggested I post here. I'm not a medically minded sort of person. But I can say my old buddy has really been through the ringer. Diebetes, thyrhoid disease, bad hips, glaucoma from cataract surgery... And now this. My vet assures me we will have this under control with a new wonder drug they have called Trysolene (?). My vet knows I am dilligent with Champ's care....... I just can't get over the hurt and anger that this perfect, happy and loving soul has been forced to endure so much misery in his life. So anyway, I guess I need to get educated on just what my fellow is wrestling with now and what I need to expect and do to help him through this.
Thanks
Randy Abercrombie
April 4, 2009, 08:59 AM
haf549
Senior Member
Re: Getting Over The Shock
Randy:
I just wanted to welcome you to this site and ensure you that you will find much useful information and reassurance here. Others will be by soon to ask all the pertinent questions and give you all the links to information.
I know one of the first things they'll ask is what tests your dog had to confirm his cushings. Also, see if you can get all the test results and post them here. There are many really knowledgeable people on this site that will be able to exam and explain these results to you (I'm not one of them; just a concerned furkid parent).
Heidi
April 4, 2009, 09:01 AM
stardeb55
Senior Member
Re: Getting Over The Shock
Randy, it does sound like Champ has had way too many things to deal with his little life, & I'm sorry he has to deal with one more. I would like to welcome both of you to the group. We have several members who deal with both Cushing's & diabetes, so it's difficult but it most definitely can be done. I won't comment on the diabetes, but will leave that to those members.
What would help us to help both you & Champ is to give us as much specific information as you can. The first thing, if you haven't already done it, is to get copies of all testing that your vet has done to make the Cushing's diagnosis, & please post those results for us. Right now, do you know the name of the tests that were done? This is very important as Cushing's is a very frustrating disease to diagnose because there is no single test that is 100% specific or sensitive, & with the diabetes, it makes an accurate diagnosis that much harder. Could tell us what some of the symptoms are that Chance has been bothered by that led you to go to the vet?
In order to start your Cushing's education, please take a look at the important information & resource section of the forum where you will find a huge number of links that will take you to just about any information you might want or need to know concerning Cushing's. Some of these links provide information about the 2 standard meds, Lysodren & Trilostane, which are used to treat.
Again, welcome & we are here to help in any way we can.
Debbie
April 4, 2009, 09:13 AM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock
Hello... Thank you both... As I said, I'm not a very medically minded person but when my vet gets the medication in, I'll get a copy of the tests that were run Wednesday. Actually a follow up on his eye surgery is what prompted the Cushing's tests. The opthamologist saw blood spots in his retina. Now why that made him suspect Cushing's I do not know, but we went to Champ's regular vet the next day for the Cushing's test. It was an all day test where blood was drawn and tested at several intervals during the day. And that's really about all I know right now. They had to special order the medication and when it arrives I am meeting with them to get more detailed info.
April 4, 2009, 10:06 AM
stardeb55
Senior Member
Re: Getting Over The Shock
This sounds like a low dose dexamethasone test. If it is, the low dose has a huge problem in Champ's situation, it can show a false positive in the presence of non-adrenal illness which is definitely the case with Champ. Was an abdominal ultrasound done to confirm what appears to be a positive low dose dex?
Debbie
Last edited by stardeb55; Today at 12:03 PM.
April 4, 2009, 12:00 PM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock
No, no I don't believe any ultrasounds were done on him.
April 4, 2009, 12:05 PM
stardeb55
Senior Member
Re: Getting Over The Shock
The other test that could confirm a positive result on the low dose is a high dose dex. Do you know if that was done or is the low dose the only test that was done? We will be very much looking forward to those test results.
Debbie
April 4, 2009, 04:20 PM
labblab
Moderator
Re: Getting Over The Shock
I just wanted to suggest the ACTH as an alternative confirming blood test for Cushing's. As Debbie has already noted, the LDDS has a higher liklihood of returning a "false positive" result for Cushing's in a dog who instead is suffering from a different illness or disease process. The ACTH is a more specific screening test for Cushing's than is the LDDS, and therefore a "positive" on the ACTH would probably be a more trustworthy indicator of Cushing's in a diabetic dog such as your Champ than would be the case with a "positive" LDDS.
Once the initial diagnosis of Cushing's has been established, then the HDDS can be utilized to try to differentiate between the pituitary and adrenal forms of the disease. But for the HDDS to be useful or valid, you must first presume that the initial general Cushing's diagnosis is accurate (I believe this is because a dog with the pituitary form of the disease can exhibit "normal" results on the HDDS). So if you are wishing for further confirmation of the Cushing's diagnosis itself and you have not already gotten "positive" or abnormal results on both the LDDS and HDDS, I think the ACTH would be your better testing choice.
Marianne
Last edited by labblab; Today at 05:54 PM.
April 6, 2009, 01:48 PM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Made a mistake... He starts 120 mg of trilostane starting tomorrow. Sorry about this boo-boo.
April 6, 2009, 02:46 PM
labblab
Moderator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Quote:
Originally Posted by Randy Abercrombie
Wow... thanks to all that have responded. First off... I just picked up Champ's meds and test results. This is a two page affair entitled ACTH stimulation test. The results appear
Tube Labeled 8.30
Tube Labeled 1.30
Tube Labeled 5.30
Cortisol Pre 13.8
Cortisol 2 3.9
Cortisol 3 9.9
All of this is pretty meaningless to me. Champ starts 60mg of Trilostane beginning tomorrow morning and goes back in two weeks for another day long test.
Hmmmmm...I have to believe that these results are actually for an LDDS test and NOT an ACTH stim test. With the LDDS, three blood samples are drawn, with approx. 4 hours between each sample. Instead, the ACTH stimulation test typically consists of only two blood draws, with only 1-2 hours intervening. So the results given above would fit the "profile" of an LDDS, and would be consistent with a diagnosis of pituitary Cushing's (a "Post" cortisol reading of 9.9 on the ACTH would not indicate Cushing's). Can you check and see whether there are any other test results reported elsewhere on those sheets -- results that would more likely fit the ACTH testing protocol of a "Pre" and a single "Post" Cortisol reading? Was all of Champ's blood testing performed during a single day? I would feel better if I thought that Champ had tested "positive" on an ACTH stimulation test, but these results just don't jive with an ACTH...
When Champ returns for testing in two weeks, the monitoring test definitely ought to be the ACTH stimulation test. So the good news is that the testing should not last the entire day -- just that 1-2 hour time period.
Also, can you tell us how much Champ weighs? According to the manufacturers of Vetoryl (licensed veterinary brand of trilostane), 120 mg. would be the recommended starting dose for a dog weighing between 44-88 lbs. Is Champ that heavy?
Thanks so much for this additional information,
Marianne
Last edited by labblab; Yesterday at 02:52 PM.
April 6, 2009, 03:09 PM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Well.. The easy question is Champ is 44.6 pounds... Close, huh?... The heading of this test states Test Requested, "Cortisol (3 Samples)".... Then it reads the results that I posted previously. The next page and a half are about interpretation of the ACTH Stimulation test and interpretation of the Dexamethasone Suppression tests..... Lord, I just feel so lost.
April 6, 2009, 03:33 PM
labblab
Moderator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Quote:
Originally Posted by Randy Abercrombie
The next page and a half are about interpretation of the ACTH Stimulation test and interpretation of the Dexamethasone Suppression tests.....
AHA! The "LDDS" that I am referring to is the "Low Dose Dexamethasone Suppression" test. So I do believe that the results that you have reported are for the LDDS. Don't get me wrong -- the LDDS is typically the preferred diagnostic blood test for Cushing's. But for the reasons that I stated in my earlier post -- the fact that the LDDS is more likely to be "skewed" by a co-occuring disease like diabetes -- just makes me wish that you had at least one additional source of confirmation for Champ's diagnosis prior to beginning treatment. If for no other reason, performing an ACTH stimulation test prior to treatment would also give you a "baseline" cortisol level against which to measure Champ's progress on the trilostane.
And as if I haven't made you feel uncomfortable enough... ...if it was me, I'd personally prefer to start Champ on the 60 mg. of trilostane that you originally thought he'd be taking. He just BARELY falls within the weight category for the 120 mg. dosing. Our experience here is that many dogs tend to have less side effects and an easier time adjusting to the lowering of their cortisol level when the dosing begins on the lower end, and then is increased if needed.
Do you know whether your vet has had much experience with treating dogs using trilostane? I do not wish, in any way, to be planting seeds of doubt in your mind. But many fine GP vets just do not have the occasion to treat Cushing's frequently. That is why we so often recommend to folks that they may wish to seek consultation with an Internal Medicine Specialist, especially in the case of dogs with complicated issues such as the combination of both Cushing's and diabetes. This is not to suggest that you would want to "leave" your regular vet. Just that having the additional diagnostic/treatment imput of a specialist can be a real help to both you and your vet as you are trying to sort out Champ's care.
Marianne
April 6, 2009, 03:36 PM
gpgscott
Forum Administrator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
A belated welcome, you are getting there, just keep posting and asking and responding to questions.
Best to you and Champ. Scott
April 6, 2009, 04:13 PM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Are the Trilostane side effects difficult for an old fellow like Champ?
April 6, 2009, 04:35 PM
Wylie's Mom
Moderator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Hi Randy & a belated Welcome!
I am not familiar enough with Trilostane, but I think they say that if there is a problem, you can just stop using it and there's no lasting harm done.
I don't know if you have seen the information on Trilostane in our "Important Information and Resources" forum - here's a link:
http://www.caninecushings.net/forums...read.php?t=180
-Susy
P.S. I don't think 9 years old is THAT old .
April 6, 2009, 04:39 PM
stardeb55
Senior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Randy, what Marianne is basically referring to when she says "side effect's, is the issues that may come to the forefront that lowering the cortisol has been masking when it's been at higher levels from the Cushing's. Cortisol is a natural anti-inflammatory so as the meds, either Trilo or lysodren, lower the pup's cortisol, problems such as arthritis & allergies may become apparent or even worsen as they were not as bad because of the elevated cortisol levels. The only real side effect of either med you have to watch for is a low cortisol emergency where you will have symptoms such as nausea, diarrhea, vomiting, & lethargy. A low cortisol emergency seems to be more of an issue with lysodren than Trilo, but it can happen with Trilo. Even though there is less of a chance with Trilo, we always encourage new Trilo parents to talk to their vets about having an emergency supply of prednisone on hand, "just in case".
Debbie
April 6, 2009, 05:07 PM
labblab
Moderator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Debbie has done a great job of summarizing some of the medication issues. In addition, here is a quote from the U.S. Product Insert for Vetoryl that discusses a phenomenon known as "cortisol withdrawal" -- this is the situation where a dog feels unwell due to the abrupt lowering of high circulating cortisol levels associated with Cushing's:
Quote:
A small percentage of dogs may develop corticosteroid withdrawal syndrome within 10 days of starting treatment. This phenomenon results from acute withdrawal of circulating glucocorticoids; clinical signs include weakness, lethargy, anorexia, and weight loss. These clinical signs should be differentiated from an early hypoadrenocortical crisis by measurement of serum electrolyte concentrations and performance of an ACTH stimulation test. Corticosteroid withdrawal syndrome should respond to cessation of VETORYL Capsules (duration of discontinuation based on the severity of the clinical signs) and restarting at a lower dose.
Even though the dog may not actually be in a "crisis" or emergency situation, he/she may still feel pretty crummy for a time. So as I said above, our experience here has been that some members have hoped to avoid any unpleasant effects such as these by starting off at a lower dose so as to have a more gradual lowering of cortisol levels. But the trade-off to starting lower is that it may take a longer time for you to see therapeutic changes in your dog, and dosing changes will incur additional monitoring testing costs.
Marianne
April 6, 2009, 05:23 PM
k9diabetes
Senior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Hi Randy,
Not to worry. We will help you get it all sorted out. Can you fill me in a bit on the timing of various events?...
I see the cataract surgery was in September.
When did the glaucoma begin?
When did the high blood sugar begin?
How high is his blood sugar and how has it been monitored?
Do you test blood glucose at home?
Has he had a blood glucose curve done recently?
How are his eye pressures now and what meds, if any, is he on for that?
Natalie
___________
Champ - beagle - 9 years old - 44.6 pounds
has been diabetic for five years.
Yesterday he was diagnosed with Cushing's
History of diabetes, thyroid disease, bad hips, glaucoma from cataract surgery
Follow up on his eye surgery prompted Cushing's test
Opthamologist saw blood spots in his retina.
Champ's blood suger had been well in check for years. It wasn't until I had cataract surgery done for him last September. Ever since then, he's been a bit high most of the time.
04-06-2009, 06:28 PM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
OK.. Thank you all for helping me to sort all this out. Iv'e had a long history with my vet and was able to ask some frank questions on the phone this evening.
First off there are two primary vets in my veterinarian's office. They both are very familiar with Champ... His primary vet is very in tune with diabetes. We've had great success for a very long time. I asked why her partner is working with me on the Cushing's and as it happens that is one of her partner's specialties. She does have several in her care that are doing well on the trilostane. However Champ is their only diabeteic/Cushing's patient. I quizzed her on the dosage and she was confident that 120 mg was where she wanted Champ started.
She wants me to give him this in the mroning. That concerns me as I have to work usually from about 6 am till 5-6 pm daily. I would never ever forgive myself if something happened during the day starting this new medicine.
After reading some of the info, I was very worried about Champ's appetite. He has to eat with his insulin. The ole boy has always been a chow hound and this is the side affect that worries me most.
About 18 months ago Champ fell over eating his breakfast one morning. Like a light switch was turned off. We immediately went to the hospital. He was tested at that time for Cushing's and found he had a thyroid problem. So the Cushing's would have to be a recent occurance.
Natalie.... My vet knows me well enough to know that I tend to get overly obsessive about Champ's care. At first I tested at home... Probably too frequently. She suggested I bring him in several times a month for her to test. And that has been our routine for nearly five years. She does a curve on him twice a year and he is due now. Lately his BG's have regularly been in the 200's. Up until the surgery, his B/G was steady as a rock. His eye surgery last September had complications and he's been getting weened off several medications from that surgery and have been attibuting most of the high B/G readings to some of these meds. He ended up with vision in one eye and glaucoma in the other. He gets Xalatan drops twice a day for that. His eye pressure was so bad that he had laser surgery done two days after the caract surgery. So the glaucoma was a direct result of the cataract surgery.
I agree that at 9 years he's not "over the hill" old.... But the old fellow is much older than his years. His appearance is more like 12-13 years and I worry about how frail he may be.
Thaks to all again for your help as we travel this new road. Believe me when I say that Champ is worth it. There's not a sweeter heart to be found.
04-06-2009, 06:55 PM
k9diabetes
Senior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Randy,
Here's my concern...
I've seen too many dogs diagnosed with Cushings on top of diabetes and in the end they didn't have Cushings.
I'm not saying that IS the case here, only that it is a possibility. As others have noted, there is potential for the LDDS test to be giving a false positive because of his many other issues.
If his blood sugar is only up into the 200s, I would not consider that as the kind of regulation problems typically generated by presence of Cushings. Usually blood sugar would be much higher if Cushings is in play in a diabetic dog.
In fact, with all that's been going on with him with glaucoma and undoubtedly some inflammation associated with the eyes, I would have looked to just increase his insulin slightly and see whether his blood sugar responds. Inflammation, pain, infections, and allergies all can increase the amount of insulin needed to control the blood sugar.
So I'm worried about him starting Trilostane when I'm not SURE that he needs it.
Whether he needs it or not, giving him Trilostane will decrease the amount of insulin he needs, possibly very quickly and possibly quite drastically, because there is a pretty direct link between cortisol levels and insulin requirements.
So his blood sugar will have to be very carefully monitored - I'd go back to home testing since lows are what you're worried about in this case - and I'd even advocate for immediately reducing his insulin somewhat.
Usually there is no urgency to starting Cushings treatment and unless his blood sugar is a lot higher, there's no urgency based on loss of diabetes control either.
Then I'm doubly worried about giving a dog who might not actually have Cushings and who is an injection-dependent diabetic what folks feel is an awfully large starting dose.
Seems to me that IF you choose to start the Trilostane, and I don't think you have to start it right away unless the vets can give you some justification for the urgency... I would start him at the lower dose. You can always increase it later if needed. No harm is done by starting slow.
I urge caution at this point. If there is some truly driving urgency to proceed, then I could understand. But typically there isn't and you have time to think this through and evaluate his Cushings diagnosis further.
It is very tricky giving these meds to a diabetic. And while Trilostane has a shorter half-life, there is still the potential for problems, including Addison's disease, especially if the Cushings has been misdiagnosed.
I fear that the higher blood sugar is mainly a side effect of inflammation and not fueled by Cushings.
Does he look like he has Cushings?
I am rambling a bit I realize but I just feel very strongly that, if Champ was my dog, they would have to give me a very compelling reason for starting Cushings treatment right away. I would opt instead for an ACTH test and, ideally, for a full adrenal panel sent to the University of Tennessee to check for elevated sex hormones (atypical Cushings) plus try increasing the insulin slightly to see if the blood sugar will come down that way and hold off on any treatment for Cushings until the additional testing is done and increased insulin is tried.
I know you're on the Muffin list but you might also be interested in my canine diabetes forum - www.k9diabetes.com/forum.
Natalie
04-06-2009, 07:14 PM
k9diabetes
Senior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Once again I will throw out a caveat here and make it clear that what I'm about to say is only a possibility...
But an interest in Cushings and skill in Cushings is not necessarily the same thing. Given that they've never worked with a diabetic for Cushings, that's a flag of concern as it is much trickier with a diabetic.
And sometimes it seems like an interest in Cushings can lead to a tendency to want to diagnose/treat it because it's an interesting problem for the vet. It's like a "sexy" problem... more fun than your run-of-the-mill diabetic or thyroid case.
I have seen IMs do poorly diagnosing and treating Cushings and many dogs saved from disaster by the folks here so this is again why I urge caution in proceeding.
04-06-2009, 08:35 PM
labblab
Moderator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Randy, as if I have not pestered you enough today, here are a couple more questions that have come to my mind. First, you mentioned that Champ is in the process of being weaned off some medications subsequent to his cataract surgery. By any chance, do any of these medications contain steroids?
Secondly, does Champ exhibit symptoms (or a worsening of symptoms) that are traditionally associated with Cushing's (and I do realize that some of the symptoms overlap with diabetes which complicates the issue). These would include excessive appetite and thirst, panting, hair loss, pot-bellied appearance, muscle weakness.
Also, I am really puzzling over the fact that the "trigger" for the Cushing's testing was retinal blood spots. I would think that retinal hemorrhages are not uncommonly associated with diabetic retinopathy. So I am wondering why you would look for an alternative cause in a diabetic dog. Has your vet commented any more as to why retinal issues raised the suspicion of Cushing's?
Finally, here is a quote (from an article by Dr. Mark Peterson) that characterizes my worry over basing a Cushing's diagnosis in a diabetic dog solely upon the results of an LDDS:
Quote:
The specificity of the low-dose dexamethasone suppression
test, however, can be low, especially when measured in
a population of sick dogs. In fact, the specificity of the
low-dose dexamethasone suppression test is considerable
lower than that of the ACTH stimulation test. Because of
the low specificity of the low-dose dexamethasone suppression
test, diagnosis of hyperadrenocorticism should never be
based on results of a low-dose dexamethasone suppression
test alone, especially in a dog with nonadrenal disease...
I hope we are not exhausting you with our questions and our concerns. But we are truly wanting the best for Champ, as do you. It is clear how much he means to you, and how hard you have been working to address his needs. He is a lucky boy to have you as his dad!
Marianne
Last edited by labblab; 04-06-2009 at 09:19 PM.
April 7, 2009, 05:47 AM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
OK... Thanks again for your help and support. I weeped, considered and prayed last night. And ultimately I am trusting in my vet. They have done well by the old boy and I do think they have his health and best interest at heart. He received his fist dose this morning and I'm trying to work..... When Champ went in for his six month eye check the opthamologist saw the blood spots. So he did a blood test. That test came back with bad liver readings that led him to think that Champ may need to be tested further for Cushing's. That's how that whole deal panned out.... Now when I think about it, his appetite and thirst are voracious. He even had a pee-pee accident at the vet. And I mean gallons of pee-pee. He hasn't had an accident since he was a pup..... Anyway, I am pretty weepy over the ole boy right now but wanted to let you know that I am trusting in my vet and will report back on how things go.
April 7, 2009, 06:50 AM
labblab
Moderator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Randy, I remember how terrified and upset I was when my boy was being diagnosed and we were considering treatment options. So I do feel very badly that we are compounding your worry by raising all of these questions. But in a way, I feel as though that is our job here -- to help you think of every single "angle" so that you can be as well informed as possible, and an active participant in Champ's care. In no way do I wish to interfere with your relationship with your vet, and especially a trusted vet of long-standing. But I just want to arm you with knowledge and information, so that you will have the power and ability to assess Champ's treatment plan and request changes if you feel concerned about his progress along the way.
Now that you are starting the trilostane, we will be here to support you along that path. We will be shifting from diagnostics to treatment. So we'll probably have a whole new batch of questions to ask you . But I hope that you will never feel as though you don't wish to return to us out of a fear that we will be critical of you or your vet. You are the ones who are actually living day-to-day with Champ's challenges. We are the "peanut gallery," so to speak. But it is only because we do care about you guys that we are blabbing so much.
By the way, the fact that the blood testing that the eye doctor requested showed elevated liver enzymes now makes much more sense to me as to why Cushing's was suspected. Elevations in liver readings is a common symptom of the disease. So thank you for adding that info!
Please give us a report after you get home and see Champ tonight. We're all in this with you for the long haul!
Marianne
Last edited by labblab; April 7, 2009 at 06:55 AM.
April 7, 2009, 07:02 AM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Hey, thanks for that note Marianne. I knew what you were doing and appreciate all information and angles to consider as I am so lost here and desperately want what's best for Champ. I look forward to the folks on this board teaming up with me as we face this challenge in his life. I didn't think you were challenging my relationship with my vet at all. Please don't hold back anything you believe may be useful to me....... Do I need to leave work and watch him as he starts this trilostane treatment?
April 7, 2009, 07:06 AM
CarolW
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Randy - I just dropped by to find out if you'd picked up on my lead to this forum, and I'm SO GLAD for you and Champ that you did!
Also, you know me; I'm generally interested in technical details. However, I haven't begun to try to understand Cushings; only diabetes.
I'll be here tracking how you and Champ are doing. I hope you'll stay with us on Muffin, and report there occasionally, because you know you are very dearly loved there, and Muffins will want to know - not just me, but lots of others.
Also, you could follow up on Natalie's suggestion, and join the k9diabetes forum as well; I'd suggest doing that. You will find it here:
http://www.k9diabetes.com/forum/
There are a number of Cushings dogs there who have diabetes as well, so you'd be in good company there.
We're rooting for you and Champ. You know Kwali and Kumbi, being Terriers, are great diggers and rooters! (Kumbi is my diabetic dog; Kwali, my stroke-dog; hope neither gets Cushings, but I know where to come if either does.)
Please stay in touch, Randy. Huge hugs to you, Champ, and Saltydog.
CarolW
April 7, 2009, 07:17 AM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Hi Carol.... Thank you so much for the support. You guys at Muffin have been a life saver to us far too many times. I won't be leaving. I do need to get a handle on this Cushing's thing though. It just has me so twisted up in knots and I know that Champ can tune into my moods and feelings. I have to get a grip on this so MY mind gets right for Champ's sake and well being. Thanks for the note. It means alot to me.
April 7, 2009, 07:21 AM
labblab
Moderator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
If Champ were not diabetic, I would have confidence in telling you that he should be alright. Tyically, any ill effects from the trilostane should not be that immediately dramatic or acute. The "monkey-wrench" for me is the diabetes. I am just not very knowledgeable about the interplay of the two diseases. But I'm sure that Natalie will be checking back in just as soon as she is able. As you have already seen, she is wonderful and so thorough. And she has had the experience of supporting numerous "dual diagnosis" members both on our forum and her forum. I'm also hoping that some of other members who have dogs with both diseases will be stopping by today, as well.
I am guessing that you may live a distance from work? Would there be any possibility at all of shifting your hours a bit so that you could return home at lunchtime during these first few days of treatment? I remember when I first came home with my boy when he was only a puppy, I actually negotiated "maternity leave" out of my vacation time so that I could have a longer mid-day break. My co-workers teased me mercilessly, but I didn't care! But your work may be so far from home that it would not even be an option for you. It's just a thought.
Hang in there! I'm certain we'll have some "diabetic folks" checking in here soon.
Big (((hugs))) to you,
Marianne
April 7, 2009, 07:31 AM
CarolW
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle)
Hey, Randy, what a lovely surprise to have an instant reply from you - maybe I can catch you before you leave for work; if not, then later!
Just want you to know how deeply you and Champ are loved, and you are so right about mood and stress.
Reading the suggestions to you, Randy, I like the idea of you getting a second opinion in some way; most likely, from a specialist in Intermal Medicine. I know totally NOTHING of Cushings, and repeat that the k9diabetes forum is a good place for hugs and some cheering up concerning the combination of diabetes and Cushings.
This is probably the toughest time - right at the start - when you aren't sure what's happening, and feel so lost. So glad you'll stay with Muffin; please report there, too, because you have a lot of people there who care deeply.
A ton of hugs to you, Champ, and Saltydog.
CarolW
April 7, 2009, 10:17 AM
labblab
Moderator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle beginning trilostane)
Hi again, Randy!
While we're awaiting some of the diabetic folks to check in, I went back and re-read Natalie's earlier posts to you. I am wondering whether your vets have given you any new instructions about insulin changes, now that you have started the trilostane?
Marianne
April 7, 2009, 10:54 AM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle beginning trilostane)
Waiting to hear from my vet on that one. Just went home and checked up on Champ. He seems to be himself.
April 7, 2009, 11:49 AM
labblab
Moderator
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle beginning trilostane)
I'm so glad you were able to check on Champ. That should make the afternoon go by a bit easier! The first few hours after you give a new medicine just feel so AWFUL, don't they? -- you're always thinking, "oh, what have I done?????"
Marianne
April 7, 2009, 11:52 AM
Randy Abercrombie
Junior Member
Re: Getting Over The Shock (Champ - 9 y/o diabetic beagle beginning trilostane)
Man oh man... You are so right.
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