Hondo lane ..my dog has been diagnosed with cushings .need help with ? for specialist

[coolhndlk777]

My dog Hondo Lane blue heller, age 11, has been in the last month diagnosed cushings disease,diabetes mellitus,lumbosacral joint,intervertebral disc diesease,and seziures that started it all off for a emergency room visit on dec 26th 2014...hes home now as of the 28th he on a mirage of drugs ..pheno b,antibiotics,valium,trilostane,and humulin-n u100 insulin, to date he still cant use his rear legs almost paralized in a way,i dont know if its sideffects of the P barb or somthing more has anyone experienced this or can help me with questions,I GO TO THE SPECIALIST IN THE MORNING NEED ADVICE...ANY FEEDBACK WOULD BE APPRECIATED... lotta sleepless nites latley.. THANK YOU LUKE ...tx

[coolhndlk777]

MY dog Hondo Lane.. blue heller, age 11, tested positve for cushings disease,all started on dec 26th 2014 with seziures and a emergency room visit, diabetes mellitus,lumbosacral joint,intervertebral disc disease,since hes on Pheno barb,valium,antibotics,humilin n insulin,trilostane,he still cant get up back legs almost paralized, NEED HELP I SEE SPECIALISTS TOMMROW NEED BEST COURSE OF ACTION TO GO WITH>>any feedback would be appreciated greatly..THANK YOU ...luke tx

[Harley PoMMom]

Hi Luke,

Welcome to you and Hondo Lane, gosh so sorry for the reasons that brought you here but glad you found us.

I have manually approved your membership so now all your posts will be seen right away. Also please just disregard the validation email that was sent to you from k9cushings.

Could you tell us the reason Hondo Lane was at the emergency clinic? Is he still taking the Trilostane? If so, my first recommendation would be to stop the Trilostane because it should never be given to a dog that is feeling unwell.

It would help us if you could get copies of all tests that were done on Hondo Lane and post any abnormalities that are listed along with the references ranges and units of measurement...as an example.....ALT 150 U/L (5-50) Also we are especially interested in the results of the diagnostic tests that were performed to diagnose his Cushing's.

Were the seizures something new that has happened or has Hondo Lane been experiencing them for a while? Is the diabetes under control? We have a sister site that deals with canine diabetes and I do urge you to join there too, here's a link to their forum: http://www.k9diabetes.com/forum/ They are wonderful people and can answer all your questions about canine diabetes that you may have.

Could you tell us the strengths and how many times a day of each of the medications he is taking and post how much he weighs?

We will help in any way we can, ok, so please do not hesitate to ask all the questions you want.

Hugs, Lori

[molly muffin]

Welcome to the forum.

What did the specialist have to say?

[coolhndlk777]

yes hondo went to the specialist today and he was there from 10am to 4.30 pm. Im trying to take this all in just got him home wile back gotta change around his meds. I think these vets see me a a jackpot since 11/26/14 to present. I've spent 4.000. almost like there just passin around the buck, so to speak. So they all get a piece. And one vet says one thing the emergency room says another now the specialist says they may be wrong. And want to take a another course of action and treatment. Taking him off off trilostane and the valium cutting the phenob dose to wheen him off and giving keppra instead. Said insulin dose was too little and needed 2 x daily not just one injection. I will post again later more in length and details and vet forms and test read outs you asked about. So you can help me. Thank you so much for your replys. I'm gonna be glued to the computer this weeknd. To learn as much as i can. Another sleeplless nite. luke

[molly muffin]

Oh gosh, this sounds horrid. Like they don't know and everyone is guessing at what is wrong and what to do.

Okay, when it comes to test results, we need the ones that are not in normal range, so for example like this:

ALKP 860ug (range 50 - 150ug)

It is all a learning curve with these and cushings itself can be tricky, along with diabetes. (definitely join the k9diabetes.com sister site, as they are very knowledgable) Remember with diabetes if you have cushings, then it's dosing, every 12 hours, no more than 1mg/1lb total. So, weight is very important and the twice a day dosing is important. Although you said, the specialist said to stop the trilostane. (so if you go back to it, then that is the dosing regime)

[coolhndlk777]

ty very much.im waiting on the specialists test results as well. should get call in next two days,from acth test and blood work,which were already confirmed cushin by my vet.

[Harley PoMMom]

I am glad to see that the specialist has stopped the Trilostane, when a dog has a non-adrenal illness, such as uncontrolled diabetes, it can create a false positive result on the Cushing's tests.

I'm providing an excerpt and a link to an article regarding diagnosing Cushing's in a dog with diabetes, it is written on Dr Mark Peterson's blog:
The problem with diabetic dogs is that it's very difficult to make a diagnosis of Cushing's with certainty unless we see cutaneous changes. PU/PD, polyphagia, and high liver values all could be secondary to the diabetes. False-positive test results on a LDDST are very common in dogs with nonadrenal illness, such as diabetes

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

Dr Peterson is a renown Cushing's expert and also is a contributor to Dechra's continuing education site.

Hugs, Lori

[Squirt's Mom]

If Hondo's diabetes isn't controlled, the Cushing's tests results cannot be counted on to be accurate. It also sounds like the vets he has seen thing something other than diabetes and Cushing's could be going on. Any illness can skew the tests for Cushing's so you want to address everything else first.

I am so sorry this is such a mess with the vets saying different things. And I so understand those sleepless nights! That's what happens to good pet parents when our babies get sick. ;)

[Dixie'sMom]

Oh wow. How frustrating for you. And especially after all of the expense to feel like you are back at square 1. Don't give up hope... it will all get resolved, but it may be quite crazy until it does. We're here for you! Be sure and post those test results when you get them.

[coolhndlk777]

thank you for all support and kind wishes,will post results when i get all them in..ty for links and sister site info as well..luke tx

[coolhndlk777]

I have the test results the specialist says its definitly cushings put him on (keppra levetiracetam500mg) reduced( P. barb.) dose to 60 mg 2x daily his dose was twice that before he is back on( trilostane 60mg) x 2 daily also kidney med called (Benazapril 10mg) x 1 1/2 daily.insulin went from 10 units x 1 daily of( Humilin N) to 16 units X 2 times daily suggested by specialist.i do see moderate changes he is still very groggy and tired seems out of it.my concern is his inability to walk or use his hind legs almost paralized but he can move them his mind is willing but his body is not.the vets both dont know if it coming from the Pheno Barb and its sideffects or from something else hence tumor or cerbral.now if he doesnt get better they want to do mri on brain and spine.he has been diagnosed with the following ,sezuires,cushings disease,diabetes mellitus,lumbosacral joint,intervertebral disc disease,osteoarthritis,11yr,male intact,blue heller,67lbs,PLEASE HELP AT THIS POINT ANY FEEDBACK OR ADVICE WOULD BE GREAT.ty luke tx.i tried to attach test results.is there a easier way to do so ..

[Harley PoMMom]

I have merged your post into Hondo’s original thread. We normally like to keep all posts about each pup in a single thread as it makes it easier for members to refer back to the pup's history when needed. Thanks!

With all that is going on with Hondo I wonder why they are preceding with treating the Cushing's right now. With his difficulty in walking that extra cortisol may help if he does have any arthritic problems.

The Benazapril 10mg, was Hondo diagnosed with a kidney issue? Also is the diabetes under control?

As for the test results, just type them in a post, we need only to see the ones that are abnormal with the reference ranges and units of measurement...example: ALT 150 U/L (5-50).

Hang in there, we will help in any way we can, ok ;)

Hugs, Lori

[coolhndlk777]

I have the test results the specialist says its definitly cushings. Put him on keppra levetiracetam500mg, reduced P. barb. dose to 60 mg 2x daily. His dose was twice that before. He is back on trilostane 60mg x 2 daily also kidney med called Benazapril 10mg x 1 1/2 daily. Insulin went from 10 units x 1 daily of Humilin N to 16 units X 2 times daily suggested by specialist. I do see moderate changes he is still very groggy and tired seems out of it. My concern is his inability to walk or use his hind legs; almost paralized but he can move them. His mind is willing but his body is not. The vets both don't know if it coming from the Pheno Barb and its side effects or from something else hence tumor or cerbral. Now if he doesn't get better they want to do mri on brain and spine. He has been diagnosed with the following - sezuires, cushings disease, diabetes mellitus, lumbosacral joint, intervertebral disc disease, osteoarthritis. 11yr,male intact, blue heller, 67lbs.

PLEASE HELP AT THIS POINT ANY FEEDBACK OR ADVICE WOULD BE GREAT.ty luke tx. ..HAS ANYONE HAD A DOG WITH SIMILAIR SYMPTOMS THAT WAS CUSHINGS OR DIABETIC RATHER THAN A TUMOR OR NUROLOGICAL IN ORIGIN.

MY Vets tests
(12/31/14) -
Pre acth cortisal 9.6 ug.
Post acth cortisal 42.0 ug...
ALP -2277 (HIGH).
ALT- 1054 (HIGH).
AST-89 (HIGH).
GGT-123 (HIGH).
Cholesterol-516 mg(HIGH)...
Chloride-106 k/ul(HIGH)..
NA/k ratio -28-37 (LOW)
MCV-77fl (HIGH).
Platelet-485 K/ul(HIGH).
Lymphocyte-806 ul (LOW).
Eosinophil- 57 ul (LOW).
T4-0.6 (LOW)........

Specialists test results
(1/8/15) cortisal sample#1-3.3 ug
cortisal sample#2-9.0 ug
taken 1 hr apart......

P Barb levels 31.1 ug.....
PH 6.0....
Protein 62.6 mg.....
Creatine 33.3 mg....
UA/protein creatine ratio 1.9........
hope these helps...

ty luke

[coolhndlk777]

The only way they gave me to monitor his levels were test strips keodiastix..gloucose and keytones,they always seem to measure the same key-negitive or under 0.5........glucose-1500-2000 every time..is there a better way to test without running to vet all the time..between his diabetes and cushing i dont think he is curved like they say..he was at 541 when specialist tested him..i have not visted sister site for diabetic dogs ..ty luke

[Squirt's Mom]

I have edited your post that contained the lab results to include punctuation and spacing between the words so it could be read.

[k9diabetes]

Glad to see you at K9D Luke. You can test his blood sugar yourself at home. See www.k9diabetes.com/bgtestvideos.html (http://www.k9diabetes.com/bgtestvideos.html) for some video tutorials on getting a blood sample for use with a human meter. Among human meters, I recommend the OneTouch Ultra family.

Natalie

[coolhndlk777]

ty will do..

[momakah]

Hello Luke, so sorry to hear that your dog ,his name is Hondo? has been so unwell . It is so hard, our dogs cant tell us how they feel. Good news is that the people who give advice on this site are amazing and will support you and give you great advice and be there..... I hope you feel less alone and that your guy gets the help he needs.

[Spencersmom]

Hi Luke! So sorry to hear abou Hondo! My Spencer had Cushings as well as seizures! It's really good that your vet is moving to Keppra, as that can actually be tested to see if your pup is within theraputic levels!

We had our baby on Keppra, Vetoryl, Valium and finally at the end one more anti seizure med!

At this point, if your pup is having seizures due to brain lesions, you might want to think twice about the cortisol control. Our neurologist was hesitant with agressive cushings control because the excess cortisol actually helped naturally control brain swelling. We opted instead with minimal cushings treatment, focusing on the seizures as priority.

The meds will make him groggy, and he could exibit hind quarter weakness, as did Spencer especially early on. With therapy that did improve. He did regress as his lesions progressed!

I encourage you to continue sharing what is going on with Hondo! The wonderful love and support you have here is priceless and the experience is immeasurable!!!

[coolhndlk777]

THANK YOU>> for your kind words and encouragement ..they mean alot...im trying to take all this in one day at a time,from new feeding schedule,meds,and times injections.pills,cleaning up after him,etc.any feed back and ideals or shared thoughts are greatly appreciated HONDO thanks you as well....luke tx....

[Squirt's Mom]

Luke, you are doing a superb job under difficult circumstances. Keep your chin up and keep on plugging!

[coolhndlk777]

Hondo spent the day at specialist curve BG's was still quite high 636, 579, 527 at end.Higher than last visit.Here are test results and the assesment by internal med specialist.

Diabetes is not well regulated even after insulin increase from 10 unts x 1 daily to 16 unts x 2 daily.

Causes of diabetic resistance include,Cushing (which he has),pancreatitis(which he does not have evidence of on ultrasound or clinically,though blood testing could be considered (qcPLI),very high lipids (his are only mildly high)Obesity (which he has evidence of)Possible Hypothyroidism(Which he potentially might have),Cancer (that we have not detected)

And she goes on to say we disscused the possibility that he might have hypothyroidism,its funny when i droped him off this morning she didnt think he had it then after talking with neurologist she changed her mind said he might be,her exact quotes in (Which he potentially might have)no adverse affect to Benazepril ,so continue dosage recommended.Thyroid supplement Levothyroxine 2 x daily.and to continue Trilostane,P barb,Keppra,AND INCREASE INSULIN DOSE TO #30 unts x 2 daily.is that safe wow seems like there guessing.

Neuro consult
The consult did shed light on some things i was fearing hence tumor apparently they got toghther and disscused the hypothyroid debate and although one belives he dosent have it the neuro doc thinks it might be a possibility but also added it wont hurt him to treat for it and they say P BARB will effect test result if given a full panel now.she says he is not paralized but his movement is small or slight with knuckling starting in front,she recommended mri to brain she thinks its a tumor pituitary to be exact so worse fears are now very possible now.She added due to his many conditions he would be a high risk case for anisthesia under MRI.and steriods would not even be a consideration because of there negitive effects due to his condition.Her outlook was not good they kept telling me ive done all i can and they will help me if i wanna due MRI..I dont know what to due..either way they both seem to give me the impression they dont see many dogs with as many conditions all at once,also gave me the all to clear but subtle hints that he will only get worse and have no real ideal how to get diabetes under control due to the possible cancer.. luke tx..please excuse my grammer or spelling..my spell check is on fritz
z

Thank you..to all who took the time.....im at a crossroads..

[Harley PoMMom]

We define insulin resistance as doses greater than 2.2 U/kg/injection to control hyperglycemia

This excerpt is from Dr Mark Peterson, who is a world-renowned veterinarian specializing in endocrinology. This quote can be found here: http://endocrinevet.blogspot.com/2012/01/q-diagnosing-cushings-disease-in-dogs.html

So it seems that the new dosage of 30 unts x 2 daily is reasonable, but I am sure those on the k9diabetes forum will be able to tell you if this ok, please do post this there too.

We all want to do whatever we can for our furbaby because we love them so much but at one point we do have to make sure that their quality of life is more important than the quantity, losing them is so very hard and that decision is one of the most difficult ones to make.

Only you know Hondo best and I am sure you will do what is in his best interest, don't let any one try to persuade you to do something that you don't think is right or that makes you uncomfortable.

We are here for you both, sending huge and loving hugs, Lori

[Spencersmom]

Luke, I can so relate to what you are feeling right now, as I went thru the same neurlogical assessment with Spencer early last year. The prognosis was not good for my baby! I opted out of the MRI, since the outcome would have been no different. Instead, I worked with my regular Vet & the neurologist to provide Spencer as much support as possible. We didn't expect him to make it to summer, but he fought a difficult battle, overcoming setbacks along the way....until his brain lesions eventually progressed to the point we knew keeping him alive was no longer fair to him.

You are not alone, we will be here with you as you help Hondo fight his battle! Just love him with all your heart! He will gather strength from you!

[coolhndlk777]

ty so much the support here is amazing i truly thankful for all advice and feedback its been invaluable to me...

HONDO L...12yrs
male intact
blue heller
67lbs
hills canned w/d 3.25 cans a day or 4 cups w/d hills dry a day

diagnosed.. Sezuires.Cushings.Diabetic.Hyperadrenocorticism.Pr oteinuria.Intervertebral disc disease..pending mri..Possible pituitary tumor..
30 unts 2x daily 10 min after food.. humilin N
kediastix..g..k..levels
meds..insulin.trilostane.P barb.keppra..benazapril.

last curve was 636 579 527..at specialist 1/15/15..hence the high dose wanna see him back in a week to re check cure

I DONT WANNA WAIT GIVEN HIS HIGH LEVELS NEED A GOOD RE LIABLE TEST AT HOME CAN ANYONE TELL ME WHICH ONE ARE CLOSER TO VETS RESULTS>>IVE SEEN NUMEROUS BRANDS DISCUSSED ON HERE>>

also can i do his curve at home the vets visits stress him out so in his current condition....ALSO CAN A DOG BE RESISTANT TO NPH my current insulin dosent seem to ever bring the levels down hence high dose or its due to possible pituitary tumors working against insulin or cushings meds counteracting cortisal production..Either way his insulin resistence is getting out of control..NEED ADVICE LUKE TX>>TY everyone one this site and k9cushings is great....

[Harley PoMMom]

Luke, my knowledge regarding diabetes is almost nil, so I do urge you to post your concerns with the insulin over at our sister site, the k9diabetes forum, are you posting there too?

[coolhndlk777]

i did ty for your quick reply,,im jus waiting for a response