Cushings in Shetland Sheepdog, Saskatchewan Canada

[Mrs_Gumby]

A brief history of what seems a very sudden onset in less than a month, from first symptoms, to a dog in crisis.

In the second week of December 2013, we noticed some hair loss, increased thirst and urination in our 10-yr old sheltie. Initial vet visit on Dec. 19th, (results returned Dec. 23rd) indicated diabetes, and suspected cushings. He visited the vet again for additional testing on Jan 2nd, today on Jan 7 vet confirmed Cushings & Diabetes. Late on Sunday Jan 5th, our sheltie stopped drinking water, and refusing food. Same on Monday Jan 6th. Today we visited the vet as he was vomiting bile today and yesterday. He is very lethargic and doesn't like to move around. Even With the extreme cold of the last month, he lingers outside, and likes to lay against the freezing door, but yesterday & today, could not climb the stairs due to weakness in his hindquarters. Today he could hardly stand, and still vomits, and the bile is browner. At 3pm he was admitted to the vet clinic for IV, insulin, and antibiotics for symptoms of pancreatitis. (Fever, diarrhea, and vomiting) I hope I have news of improvement to report in the morning.

Do these diseases usually progress quite so rapidly? Once the vomiting is under control, and our sheltie is drinking & eating, the vet is going to treat the cushings and the diabetes. Any ideas?

[doxiesrock912]

No, Cushings is generally a slow progression.

What tests have they done to confirm Cushings and can you post the results here please along with your dogs age and weight?

Also, is he currently on meds for Cushings?

[lulusmom]

Hi and welcome to the forum.

Symptoms of diabetes can come on quickly; however, not so in cushing's. This plus the fact that your vet diagnosed both at the same time is very concerning. It is very important that you get the diabetes under control before you even start testing for cushing's as uncontrolled diabetes will absolutely cause false positive results on the acth stimulation test, low dose dexamethasone test and the urine cortisol creatinine ratio. We usually ask members to post results of any of those three tests that may have been done but if they were done before the diabetes was under control, the results are of no value. It is important to know that a lot of the symptoms and blood and urine abnormalities are associated with both diabetes and cushing's so if blood glucose was severely elevated, that should have been the initial diagnosis and insulin started. Cushing's can make control of diabetes very difficult, which is when an experience vet may start to suspect cushing's. Since this all started in mid December, I don't believe there has been enough time for your vet to make that determination.

We have a sister site, www.k9diabetes.com, and I highly recommend that you join there. The members there are amazing and I promise you that they will tell you the same thing I have just told you. They will guide you through everything and help you get your pup's diabetes under control. Join there and you will have the best of two worlds, including fellow Canadian members. Many of us are also members there and we do communicate.

Based on the information you have provided, I have serious concerns about your vet's knowledge and experience. I would highly recommend that you consider consulting with an internal medicine specialist but right now, I would suggest that you put Vetoryl on hold and address the diabetes and pancreatitis, as the combination can be fatal for a pup. Your pup is very sick right now and the last thing she needs is Vetoryl, especially given the huge question of a misdiagnosis.

None of us are vets here but we're educated and experienced....and can provide supporting documentation for any feedback we may give. I am providing a url below to Dr. Mark Peterson's veterinary Q & A blog that addresses dogs with diabetes mellitus and suspected cushing's. Dr. Peterson is a world renown endocrine specialist who maintains this blog for veterinarian and pet owner education. Your vet would do well to follow his blog and ask questions.

http://endocrinevet.blogspot.com/2012/01/q-diagnosing-cushings-disease-in-dogs.html

If you join our sister site, and I highly recommend you do, I'll make sure that I post a link to your thread here on your thread at k9diabetes so we can all stay updated. Please do round up all testing that was done, particularly the blood chemistry, complete blood count and any blood glucose tests that have been done since the original blood chemistry. We would be interested in seeing only the high and low values on the blood chemistry and please include the normal reference ranges. You will undoubtedly be asked for similar information on the diabetes forum.

I'm so sorry that your boy is so sick but hopefully, we can all work together to get him through this rough patch and on to a much better quality of life.

Glynda

[Mrs_Gumby]

I just got back from the vet. Chevy doesn't look good. He is very limp, and isn't moving on his own. His breathing is very heavy. He occasionally vomits brown stuff. He's gone downhill really fast in a space of only 3 days. I really don't think he's going to make it through the night. And there isn't much else they can do.

Chevy is 10 1/2, weighed 38 pounds last week. The first test, was urinalysis and general blood work. We don't have a local lab, so this had to be sent out for analysis. This was just a few days before Christmas. I don't have the numbers. I do know that glucose came back high, but some of the other results were inconsistent. And didn't account for the hair loss among other things. Our vet conferred with a specialist at the lab in the city, and after Christmas we took him in to run the cushings test. He had to stay at the vet clinic for the day for that one. Then there was a weekend while we waited for lab results. The vet was didn't want to start him on insulin until after the test so as not to interfere with results. Either way, he was fine on friday, still drinking lots, but had an appetite. Then suddenly on Sunday night / Monday he stops drinking and becomes lethargic / same day we get the results as positive for cushings. It's possible for him to have both. I take him in on tuesday for I.V. Doctor suspects Pancreatitis as well. Gives him some insulin, to bring down the glucose, and some antibiotics / anti-inflammatories for the pancreatitis. Some Vetoryl this last night or this morning for the cushings.

[Mrs_Gumby]

FYI we live in a small town, one vet only sees small animals on Mondays & Wednesdays. The other one is the one we took our dog to. There are no specialists here. Closest city is 3 hours away.

[Renee]

Hi, welcome to the forum.

Frankly, things sound out of control with your dog, and I have concerns about the damage that may be done. Never, ever, ever give vetoryl to a sick dog -- and your pup is sounding very sick.

The thing with cushings is that you can go quite a while without actively treating it, while you are clearing up the other issues. His cortisol could be raised for any number of reasons, and it may not be cushings at all.

That said, even if it is cushings, there is no rush to treat it, as the most pressing issues are likely not related to cushings, and those should be cleared up first.

It might be worth making a road trip to your nearest city to see a more experienced vet.

[Mrs_Gumby]

is he safe to be moved? he's not moving on his own and on IV support right now. I did call the other vet in town. They said the iv treatment sounds about right.

[molly muffin]

Oh my gosh, no vetroyl! never, ever give vetroyl to a dog that is vomiting, lethargic, or showing any other signs of illness.

Possibly IV fluids to get him stablized if electrolytes are off, insuline to get his glucose under control. I'm thinking maybe an ultrasound at this point to see what else is going on with the dark vomit, looking like bile.

Can you get him to the University Vet hosptial? I know they have one in Saskatchewan, maybe in Saskatoon? Would have to check with another member who uses them. Or if you are closer to Alberta, Calgary has a good vet hospital too.

Frankly, not being able to move and the current situation does not sound good, but do not Please, let them give him any more vetroyl. First things first and stabilizing is most important.

let us know what is going on, we'll give you all the input we can.
I do hope things will turn around.

[molly muffin]

I don't know if he could make a 3 hour car trip at this time. Lets see if this vet can get him stablized? What about a call to an internist from the vet? to help them.

[Harley PoMMom]

Hi and a belated welcome from me as well,

Sharlene is absolutely correct, Vetoryl should never be given to a dog that is ill.

Since the glucose was high, diabetes takes priority over the Cushing's, we have a sister site that deals with canine diabetes: http://k9diabetes.com/ Please do join there as well.

We are here to help in any way we can so ask all the questions you want. ;)

Hugs, Lori