Harry, 11 y/o Llasa/King Charles Cavalier - Cushing's & Diabetes

[momakah]

Hello from the UK . My heart goes out to you. Thank goodness I found this site whilst searching for answers about Cushings. I dont think we have this in the UK, and people I talk to dont seem to know what this is about . I feel so powerless. My 11 year old Harry ( cross Llasa Apso/ King Charles Cavalier Spaniel) has been diagnosed with Cushings and Diabetes in late November 2014.Harrry weighs now 9.6 kilos, lost 4 kilos so fast.
He has all the major Cushings symptoms: started with panting, then less energy, sleeping a lot, followed in November by weeing at night, now drinking lots of water( 3-4 bowlfuls) Appetite is up and down. He cant walk far now. He has been prescribed Vetryl , at first 30mgs, increased to 40mgs once daily. 4 days ago he went on to insulin 5mgs x twice daily.He seemed to improve on the insulin but its variable. He doesnt seem right this morning so Im taking him to the vet again in an hour. The vet seemed to be saying theres not a lot of hope as the ACTH test shows high on our last visit. Ill ask for copies this morning. Theres so much good advice and support here, thank you so much. It gives me comfort to know you understand.

[labblab]

Hello and welcome to you and Harry! You will see that I have taken the liberty of moving your reply so as to create a brand new thread that is yours and Harry's alone. This way, it will be easier for our members to reply to you directly. :)

I will come back myself later on today to offer some thoughts about Harry's situation. But I wanted to first go ahead and quickly make this change in order to give your questions higher visibility. ;)

Once again, welcome!
Marianne

[momakah]

Hello Marianne, thank you very much for doing that for us. I would appreciate any help or advice.
The vet told me this morning that it is very difficult to regulate a dog with Cushings and Diabetes. Today his glucose levels were actually ok.

I asked for the ACTH results:
16th December2014: pre ACTH 99 post 226
29th December2014: " " 266 " 660

The second results are high, not sure if this is reading was affected as he brought up all his food and maybe the Vetryl too?

I forgot to add that Harry has the darkened skin underneath and he has a pot belly appearance; his hair has thinned out on his body but not around his face or legs. I can feel his backbone . The vet said to take one day at a time : it seems to have gone really fast, from being a happy dog in October to a sad one now.
Im giving Harry Cushex Drops , also Arsenicum and Sulphur, all of which I read can help alongside the Vetryl. I would prefer homeopathic remedies ; is it wise to stop the Vetryl ?
Thanks for reading and all the wonderful posts on this site.

[Squirt's Mom]

Hi and welcome to you and Harry! :)

First I want to direct you to our sister site, K9diabetes. They are the experts on diabetes in dogs. You can find the forum and register here -

http://www.k9diabetes.com/forum/

Register and start talking to them asap.

Second, stop the Cushex, sulfur and arsenic (yes, Arsenicum contains arsenic.) None of these things will help control the cortisol nor blood sugars and could be causing problems. So stop them today. ;) It is ALWAYS best to use only what the vet suggests at first, making no changes with feed, supplements, etc. That will prevent any confusion if problems arise.

Now go register at k9diabetes and stay in close touch with both them and us. You and Harry now have TWO brand new families that will walk with you every step of this journey.

Hugs,
Leslie and the gang

[labblab]

Hello again! Thanks so much for this additional information. I know it is hard, but please try not to be too down-hearted. You are still in the very early stages of treatment and it may very well take several dosage adjustment before ideal levels are reached. And yes, if Harry had vomited prior to the second ACTH test, that could certainly have affected the test results.

First off, I hope you will also join our sister forum, K9diabetes.com, because the folks there will be able to give you great support re: Harry's diabetic issues:

http://www.k9diabetes.com/forum/

Secondly, if the Cushing's diagnosis is truly accurate, the experts recommend that diabetic dogs be treated with a half dose of Vetoryl given every 12 hours rather than a single dose given once daily. This is preferable so that insulin and cortisol levels are kept as consistently controlled as possible throughout a 24-hour time period.

But in terms of the even bigger picture, I am wondering why your vet chose to treat the Cushing's before even starting with the insulin. Normally, the treatment regimen would be reversed, especially since uncontrolled diabetes can result in "false positives" on Cushing's tests. Were Harry's cortisol and glucose levels both elevated at the time of the initial diagnostics? If so, do you know why your vet decided to start first with the Vetoryl instead of the insulin?

As far as homeopathic remedies, no, I am afraid that none have been proven effective in this situation. If Harry truly has both Cushing's and diabetes, his prescription medicine will be required in order to gain proper control.

Please do check in on the diabetic forum, OK? We have several folks here who are members of both.

Marianne

[momakah]

Thank you both so much for your swift replies and kindness too, yes, I will register with the diabetes site tonight.

I dont have any idea why the vet decided to treat the Cushings first: we recently moved house its new with several different vets( we've seen 3) I have the feeling from them that they find it very complicated and they are basically fairly pessimistic. I sense you have much more knowledge sharing in the US, maybe more research too?

I will stop the homeopathic additions, I dont want to compromise Harry's chances.

Im still finding my way around the site and not sure how it all works yet, but I am so thankful to have found you, :)

[momakah]

Hello Marianne,Hello Lesley,
Harry was at the vet today: Im working so my husband took him along with a list of questions.
The vet would like to increase the Vetoryl to 60mgs daily and said this would be fine to give in two doses of 30mgs. This to bring down the levels from the last test.....I havent decided yet, is it safe to go higher ?:confused:
Harry did have a urine test; no UTI found.
Harrys right eye looks opaque/cloudy. Unfortunately the vet forgot to examine it. :( ! despite the list; the beginnings of a cataract?
Still drinking a lot; hoty and looking for cool places to sleep,lie. Even to staying outside in the cold at night for 10 minutes.

Good news is this :Harry is showing his character again to some extent: he is walking a bit further , he's interested and happy on the walk, he has gained a bit of weight: up to 10.3 kgs:D thats on a diet of his normal food but the evening meal is of cooked chicken which he loves:cool: He was "speaking" to me which he would always do if he wanted attention, treats, cuddles:D Thank you for any advice, oh, and I registered with k9diabetes, will try to post there too, bye for now ,from Sue and Harry

[molly muffin]

Hi and welcome to the forum. Sorry I'm late with that.

Harry is on on 40mg vetroyl now? If the second result was off due to his throwing up, then I don't know how much you can trust that the cortisol has rebounded into a high zone. The test on 16 December is very good. Based on that not sure I'd raise the dosage of vetroyl at this point, as long as his diabetes is doing okay and his symptoms are controlled fairly well.
After the next ACTH test, then you could revisit the question if needed. I would divide the dosage though and try a 20mg am and 20 mg pm for the diabetes.
If you do raise it later, then you might consider, not going up to 60mg, but doing a 30mg am, 20mg pm or if close not raising it at all, but because that last test Could be off, I wouldn't raise it at this point, only divide it.

Harry sure is a handsome lad. :)

[Dixie'sMom]

Hello to you and Harry! He is so cute! I hate to hear he is having problems but you are in good hands here and on the K9 diabetes forum.

I also would not raise the Vetoryl dose until his diabetes is under control and you have had an ACTH with no unusual circumstances, e.g., when he hasn't thrown up his food and possibly his medication. It's just important in the management of Cushing's to pay very close attention to the details and you just can't count on that test being accurate. It's better to be safe than sorry and more harm could be done by increasing the dose if he doesn't need the increase, than by staying at the current dosage. If Harry were to get in a crisis situation, the vet could waste valuable time trying to determine if the problem is coming from the diabetes or the Vetoryl increase. If you stay at the same dose until the diabetes is under good control, then that wouldn't be an issue. Although the symptoms of Cushing's are worrisome, the diabetes is the one that you need to get under control fairly quickly. The Cushing's can wait.

Having said all of that, there are many here with first hand experience that can and will be by to help guide you through what can be a terribly confusing maze of medical mess.

Again, welcome and I look forward to getting to know you and Harry.

[LauraA]

Have to agree about the test not being accurate after he threw up. Same thing happened to my Cush baby and the vet cancelled the test and said to wait a week and reschedule so that we knew the results were correct and we weren't wasting our money - as you know Cush babies are so expensive :)

Hope he is feeling better now and that he is back to his sparkling old self in no time.

[Spiceysmum]

Hi and welcome to you and Harry,
I am also from UK and can assure you that there is always hope despite what the vet said! I don't have any experience with diabetes but just from being here I know that you do need to get that under control first.
My dog, Spicey, was treated successfully for 18 months then went into remission for 18 months and then restarted back on vetoryl for 6 months before she sadly passed away 4 years ago. She was 11, the same age as Harry when she was first diagnosed and lived to be fourteen and a half so there is plenty of hope for Harry. I wouldn't rush into raising the dosage yet either.
Glad that Harry has improved slightly and will hopefully continue to do so.
Linda

[picklespie]

Hi, I am also in the U.K. (I have a little king Charles cavi) he was diagnosed at Christmas. Like you I haven't found a similar site to this in the U.K and felt very much alone when my boy was diagnosed. He is on day 8 of taking 30mg of Vetoryl, he is booked in for another ACTH test next week. My vet said he preferred to start him on a lower dose and adjust should he need to. I haven't seen a huge improvement yet, I'm unsure of when into his treatment I should see improvement... He just looks so sad... you feel helpless don't you?
Hope you see an improvement soon.

[momakah]

Hello Sharlene, thanks for your advice. I have kept Harry on 40mgs once a day and he seems to be stable at the moment and yes, it seems better to wait, thank you again::)

[momakah]

Hello Susie and Laura,
thanks so much for the encouragement and advice. Ill take Harry to our old vet on Thursday as he knows him well. In the meantime he seems to be stable on the insulin too.:) I wont be increasing the Vetoryl ,good idea to wait until the next ACTH.

He still sleeps alot but has energy to bark again.:) Music to our ears!

I love seeing the gorgeous pictures and reading the stories.Im working so by evening am glad to visit here, heartfelt thanks, last week I felt helpless, but not any more! Take care, from Sue and Harry

[picklespie]

Hi Sue, with regards to Harry getting very hot, I bought Pickles a cool pad which I find invaluable... you place it in the freezer for a while then take it out and it stays cold for quite some time... then you can pop it back in... They are not expensive, they sell them on Amazon for about £13... He loves the cool relief....

[LauraA]

A cooling pad is a great idea :) My girl used to pant really bad as well, even in the middle of the night where she would wake me up by barking and I would have to follow her as she roamed around the house. Even now she pants quite easily but nowhere near as bad as she she did pre the Vetoryl/trilostane. She took a good month for her symptoms to really show signs of abating, some dogs respond quicker some take longer. The first symptom that improved was her being able to control her bladder - pure bliss for us all hehe.

It is really important to have regular testing done throughout the year once you get your dose right. I had to increase my girls after about 8 months as her cortisol was rising. Also if they have lost weight it may be that you need to reduce the dose after some time.

[Jenny & Judi in MN]

hi: I found your post on the diabetes forum and just wanted to give you a heads up about low blood sugar. My Jenny was impossible to get regulated for her diabetes till we started getting the cushings under control. She was on a very high dose of insulin for her weight.

After about a month on the cushings meds, her blood sugar went really low because with her cortisol down, her insulin needs dropped by about half. that was when I got my courage up and started testing her blood sugar at home.

If you aren't testing Harry's sugar at home (we used a human meter, a One Touch Ultra), you might want to consider doing it and be super vigilant. Jenny's back legs started shaking, that was her only symptom.

they feel so much better once the cortisol is down. Judi

[Dixie'sMom]

That's really interesting that Jenny's cortisol had to be controlled before the diabetes could get under good control. Thats the great thing about this forum. There is just no substitute for real life experience. :)

[labblab]

Yes, that's one of the signals that a diabetic dog truly suffers from Cushing's as well -- if it is seemingly impossible to gain control of the glucose levels even when very high doses of insulin are being given. Otherwise, the overlapping symptoms and risk of "false positives" for diabetic dogs on Cushing's blood tests can complicate the Cushing's diagnostics.

Marianne

[momakah]

Hello, thank you all so much for all the help and advice: I think a cool pad sounds like a great idea. I have been putting on a male nappy wrap (a diaper) on Harry at night due to so many accidents, also bought from Amazon, I use them with Ladies Tena Pads and they hold a lot.
I have been with Harry to our old vet today: he was great and could see the change in Harry, he checked Harrys eyes: start of cataract in the right and a different problem in his left eye, some kind of ulcer so antibiotics for that and corneal repair gel.
Harry is eating well, he had a great walk( short) around one of his favourite places , a bit wobbly from time to time, but the main thing is he enjoyed it.
We are moving back home next week, cant wait to be in our old place, and hopefully start to test glucose levels at home.
Apologies for not answering individually, it is so great to know you are out there!:) take care and I hope you are all doing ok tonight with whatever is on your mind, lovefrom Harry and Sue:)

[momakah]

Good Evening to all from a cold windy UK

:confused:I am wondering if anyone decided to stop using Vetoryl altogether? and how was that? I missed a dose and that day Harry was so much more present and slept less. He was more responsive too, like the old Harry.
My old vet did say that we may want to do that .( stop the Vetoryl) Harry is doing well on the insulin. Ive been on the K9diabetes forum, also very helpful and welcoming
I am not convinced about giving him a drug that doesnt seem to agree with him overall.
Would really appreciate your advice...
Thanks everyone.

[molly muffin]

Maybe the dosage of trilostane needs to be dropped? Some dogs do a bit better with a lower dose and maintaining a higher cortisol level, but with diabetes in the mix, you don't want to let the cortisol get out of control so that it makes it more difficult to regulate the blood sugar levels.

cold and windy eh. I heard you had some bad storms there recently. It's cold, snowy, windy and the whole works here in canada.

[momakah]

Thanks Sharlene! I think I will feel more able to understand Harrys needs once we are home again and settled, able to go to our own vet, I will be testing his blood sugar levels then: Good advice from the K9 diabetes sister site too , I dont feel so phased at doing a "curve". Harry is asleep now, wind isnt too bad now, we havent had snow, we dont often get much where we are and when we do the whole place kind of seizes up! ( nice to stay at home!):)

[Harley PoMMom]

My 11 year old Harry ( cross Llasa Apso/ King Charles Cavalier Spaniel) has been diagnosed with Cushings and Diabetes in late November 2014.Harrry weighs now 9.6 kilos, lost 4 kilos so fast.


I see that Harry was diagnosed with Cushing's in November 2014, what test/s were performed and could you post those results? Thanks!

Hugs, Lori

[momakah]

Hi Lori, seem to have lost my reply to you, took me too long I think.
Please scroll to earlier, 1 or 2nd page where I put the test results , hope thats ok. I hope Im not storing up trouble but I havent given the Vetoryl for two days now and Harry seems much more alert and happier:confused: :)

Ill post again soon, time for sleep: good news Harry slept through the night last night:)

[molly muffin]

If you are planning on doing a long reply, rather than a quick jot down, you can click "go Advanced" underneath the typing box and then you'll see it in the preview pane and you can make changes. I've been known to do that. If it takes too terribly long I've also been known to do a control A, control C and then control v onto a notepad page and then copy it back over (that is the quick short cut for copy paste, which you might have already known. If so sorry. LOL

[labblab]

Also, take a look at this thread for hints on how to keep from timing out when you are typing longer posts:

http://www.k9cushings.com/forum/showthread.php?t=1329

Marianne

[Harley PoMMom]

Hi Lori, seem to have lost my reply to you, took me too long I think.
Please scroll to earlier, 1 or 2nd page where I put the test results , hope thats ok. I hope Im not storing up trouble but I havent given the Vetoryl for two days now and Harry seems much more alert and happier:confused: :)




I asked for the ACTH results:
16th December2014: pre ACTH 99 post 226
29th December2014: " " 266 " 660



I may be missing something :eek: but the only ACTH stimulation results I see are from December.


My 11 year old Harry ( cross Llasa Apso/ King Charles Cavalier Spaniel) has been diagnosed with Cushings and Diabetes in late November 2014.Harrry weighs now 9.6 kilos, lost 4 kilos so fast.


I'm looking for those test results that were performed in November that were used to originally diagnose Harry's Cushing's. If you have those results and can post them that would be great.

Hugs, Lori

[momakah]

Hi Lori,
those are the only tests we have: we were at a new vet late November and she suspected Cushings from all the clinical signs:Peeing, drinking a lot,panting, losing weight etc. Harry went on to the Vetoryl then had the ACTH tests in December.

They( we saw at least 3 vets) suspected Diabetes but advised to treat the Cushings first.I have seen an improvement only since the insulin injections started.
Thanks for your time in thinking all this through: no Vetoryl for 3 days and Harry seems to be doing well, not brilliantly but much better than on the V.:D
Harry and Sue

[momakah]

Thanks for the tip, Sharlene.

[momakah]

Thanks for the link Marianne!

[Harley PoMMom]

Thanks for getting me straight ;) I, too, believe that since it hasn't been such an effort in seeing improvements in Harry's diabetes that it just may be that he does not have Cushing's, so in this situation stopping the Vetoryl was the correct thing to do.

You're doing a great job!! Keep us updated, please!

Hugs, Lori

[momakah]

Hello again everyone, just to let you know that we are back home; all of us very glad, and Harry too.He just seems happier. He saw the vet last Monday: good news the eye treatment seems to have worked and the ulcer is healed vigilance with the antibiotics and corneal repair gel did the job! Monitoring the cataract in the other eye.
Vet increased the insulin to 7 u x 2 daily as Harry was drinking lots of water again. It once again had an immediate effect and Harry is responding well; only the odd accident at night as the " nappy " slipped.
Harry still has Cushings, so that is something we still need to deal with: as he didnt do well on Vetoryl I stopped giving it, some dogs dont do well on it and Harry was so low and lethargic I felt he needed something different.
Our vet is working homeopathically and so we are trying that .( sorry forgot to ask what the name of the drops are,but will ask next time)
He also suggested a raw diet supplemented with bones: just started on Monday ,3 days, and Harry seems to love it , to my surprise after all these years on ordinary dog food:
its a UK company called Natures Menu. Early days but the signs are very positive.
Will be reading through posts again and hope anyone who has worries will feel they are not alone when communicating on this great forum, warm wishes, Harry and Sue

[Harley PoMMom]

Oh just so glad to read that Harry is doing so!!! I am really interested to know what homeopathic treatments Harry is receiving from the vet, so if you don't mind asking the vet I sure would appreciate it, thanks!!