Miss Peaches (aka Peach Pie!) 10 y.o. miniature poodle, diabetes & Cushing's

[Bichonluver3]

Well, hello everyone! Here I am back again – almost 1 year from the day we lost Miss Chloe (our cush girl). Miss Chloe was with me through many good times and bad times during her 15 years. She never left my side. I could not have survived without her when our 28 y.o. son died suddenly 2 ½ years ago from pneumonia. She stayed with me as long as she could but it came to the point I couldn’t let her suffer anymore and with a kiss and much love I sent her to be with Ari.
Now, on to the rest of the story.
I have been involved in animal rescue and fostering so my Facebook page is filled with pleas for help for animals during their last days in a high-kill shelter. One night, shortly after Miss Chloe passed away, I spotted a posted picture of the cutest little apricot girl poodle that I had ever seen. There were pleas for foster or adopter for her but time went on and no one would step up to recue her as she was 8 y.o. and diabetic. Next thing I know, I am getting messages to me directly – “Would I take her?” I said that if no one else would take her and if they could get her to me, I would take her. I told my husband, “Here comes another foster!”
The very next morning this scraggly, sad, inderweight little soul arrived at my door accompanied by a filthy cooler with insulin, syringes and a baggy of kibble. The transporter handed her to me along with adoption papers! Peaches was here to stay.
I told my husband to throw the cooler and its contents in the garbage (she was on the wrong insulin, for 1 thing). I started her on my Sparky’s insulin and made an appointment with my vet. Then came many surprises:
Miss Peaches age was more like 10 rather than 8
Her diabetes had not been kept under control
She has beginning cataracts
Her 2 back legs have the patellae turned in to the inside of her legs so she walks stiff-legged
Her front left leg bows out and the knee subluxes (probably an old injury or congenital deformity).
The vet said he would not do surgery as she is not in pain and runs and jumps with the her canine brothers but that, of course, we would work on regulating her diabetes.
We have been doing well but, shortly after she arrived, I have felt there was something else. Yup – Cushing’s. So now I start down the same path I was on with Chloe plus diabetes! We have just started on this journey and I am gathering the values from all the tests and will post them soon. She will have another curve done tomorrow, the first since starting Trilostane. This is a new experience for me as Miss Chloe did so well on Melatonin and ground flax hulls for her whole life. I have dealt with these 2 diseases for many years but never the two in the same dog. :(
Miss Peaches is a dainty, loving little dog and I would not give her up now for anything. She is funny. She is smart. She is our Princess. I truly believe either Chloe or Ari (or both!) sent her to be with me.
Oh, and BTW, she has ALL of Miss Chloe’s quirks, personality and tricks. Everyone is truly amazed at how one dog can be a clone of the other. :)
I am glad to have the benefit of this forum and the support of new friends as well as the oldie but goodies (you know who you are!!). As for me, I guess it is never to late to teach an old dog new tricks!

[Bichonluver3]

Here is my beautiful Miss Peaches!

[molly muffin]

So I see this new thread and opened it and did a double take when I saw your "handle" :)

Welcome back!

What a delight to have such a precious little girl join your wonderful family and what a sweet heart you are for saying, yes, I'll save her.

It isn't particularly uncommon to have both diabetes and cushings and as you know the symptoms can often be the same. I assume the diabetes is under control now? Having the cortisol levels normal will also help keep the diabetes under better control.

You stopped by over to k9diabetes yet?

With trilostane it is start low and go slow, so 1mg/1lb is the current dosage recommendation. Give with food, and ACTH test 4 - 6 hours after the dosage, at the 12 - 14 day mark, at the 30 day mark, then follow up if controlled at 3 months.

Don't adjust dosage up at the 2 week mark, unless very very high still, as it will continue to come down for sometimes over 30 days. With trilostane if the symptoms are controlled and she is doing well, then you can be up to 9.0ug on the post ACTH draw, if not controlled, go down to under 5.0ug

Important note, with diabetic dogs, it is recommended by Dr. Peterson, the cushings expert to spilt the trilostane dosage, and give 1/2 in morning and 1/2 in evening to keep the cortisol at even levels all day with no spikes. We don't want spiking with diabetic dogs, it makes it harder to control the glucose.

How much does Miss Peaches weigh? Say she weights 8lbs, you'd give her 4mg in the am and 4mg in the pm, if following the 1mg/1lb recommendations.

Great to see you on the forum, rather sorry you have both diabetes and cushings to handle.

[Bichonluver3]

Hi Sharlene!
Yes, Miss Peaches is good on her curves. She weighs 11 lbs. Doc says he is conservative and started her on 5 mg every 12 hrs along with a reduction in insulin (Novolin) from 4u to 2u twice a day. She is acting like a "normal" happy dog except for pot belly and slight hair loss on her back. I made the same promise to her that I made to Miss Chloe and Grover and Sparky (diabetic/blind) who are still with us: I will do everything in my power to give them a long, healthy life. So, we're off and running! Thanks for your great advice!
Carrol & Miss Peaches

[addy]

An old friend stopping by to say hi, Carol.:)
Peaches is one beautiful and lucky girl. I love your new avatar and am glad to read about your new best girl. I know she is in good hands.
Sharlene has given you good advice and I dont think I can add to her post at the moment. I did want to stop and send hugs when I saw your post.

[molly muffin]

Oh great, your vet obviously knows what he is doing with the trilostane and diabetes. That makes me feel so much better. Miss Peaches is gorgeous btw. Just a doll. I love that hair cut on her.

[Bichonluver3]

Addy, it is soooooo great to hear from you! (((HUGS))! I will do my best for her. :) Doc says, all things considered, she looks good and acts even better!
Sharlene, I love this doc. He is very gentle, conservative and has other Diabetic/Cush patients. When Miss Chloe passed away, he stroked her gently and said "Go to Ari". Need I say more? Yup, love the man!

[molly muffin]

OMG!


When Miss Chloe passed away, he stroked her gently and said "Go to Ari". Need I say more? Yup, love the man!

Nope, no need to say another word. I love him too!

[addy]

He is a keeper for sure, a good vet is hard to find and it sounds like he is on the right track so far.

Keeping our fingers crossed Peaches cortisol comes down in to range and all goes well.

When does Peach Pie have her next ACTH test?

[Bichonluver3]

Peaches started her Trilostane 2 1/2 weeks ago and had an ACTH stim yesterday. Doc is now doing a glucose curve on her tomorrow. Then we can see how to proceed. He says another ACTH in a month$$$$$$$ :)

[addy]

It can be pricey in the beginning with all the testing, I know, and Trilostane can need some adjusting.

We will think positively:)

Good curve and good acth test coming right up!

[Bichonluver3]

Yes, Ma'am!!!

[Squirt's Mom]

Dear sweet Carrol,

What a very lucky lady Miss Peaches is to have landed in your arms. She knew where to find the best mom!

You are off to a great start, naturally, and I am very glad to see you back here tho I wish Peaches didn't have to have Cushing's in order for that to happen. BUT she is in great hands and has a brand new family here now. BTW, she is a DOLL! :)

Hugs,
Leslie and the gang

[Bichonluver3]

Thanks, Leslie. I know I will, once again, need your help and direction. Love you tons.

[Bichonluver3]

Just picked Miss Peaches up from the vet's. I have them do the curves right now on her as my hands are not as steady as they were and she is so tiny. Doc says her glucose was way up (484 - 682 being the highest between 11:00 and 1:00) but she shows none of the signs of hyperglycemia. So...we are increasing her insulin from 2u to 3u and he will see her again in a week.
I am getting the results from all her tests so far emailed to me tomorrow so I can work all this through for myself. It was too late tonight to get them as they were getting ready to close and Miss Peaches made it very clear that she wanted to go home! :)

[molly muffin]

I was just reading on Harry's thread where Judi had posted about her Jenny who also had diabetes and cushings.

http://www.k9cushings.com/forum/showthread.php?p=168954#post168954


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

So getting the cortisol under control can help to get the diabetes under control and you might not end up needing the higher dose that you are going to now, down the road a bit.
I thought you would probably find that interesting.
The two certainly do have a profound affect on each other.

[Bichonluver3]

Hi Sharlene!
This is exactly what the Doc said. That is why he only upped her insulin from 2u to 3 u and not back ti the 4u she had been getting even though her glucose curve was extremely high. He will see her again next week and do another curve.
I will check out Judi's thread for additional info.
I am a nurse so I understand interrelationships between diseases and medications in humans but I am dumb as dirt when it comes to animals!:confused:

[Bichonluver3]

How many furries do we have on the forum that have Cushing's and Diabetes?

[Squirt's Mom]

MODERATOR NOTE - I have moved your post to the board where discussions are held. You are apt to get more response from members treating both disease here. ;)

[Harley PoMMom]

Hi Carrol,

I have taken the liberty and merged your post into Peaches’ 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!

I just did a quick search and found 4 members (there's probably more) with dogs that have both diseases.

Here are links to their threads: Another newbie - Diabetes and Cushing's (http://www.k9cushings.com/forum/showthread.php?t=6649)

Harry, 11 y/o Llasa/King Charles Cavalier - Cushing's & Diabetes (http://www.k9cushings.com/forum/showthread.php?t=6857)

14 year old Chorkie with Cushing's, Diabetes, Bloat... (http://www.k9cushings.com/forum/showthread.php?t=6917)

Cushing's, Diabetes + Trilostane (http://www.k9cushings.com/forum/showthread.php?t=4027)

Hugs, Lori

[Bichonluver3]

Back, again!
Here are some of Peaches' results (I just noticed they didn't give me a copy of the ultrasound report or the first ACTH):


4/8/14 - Superchem - AST (SGOT) high 104 (15-66)
ALT (SGPT) high 529 (12-118)
Alk Phos high 776 (5-131
Glucose high 332 (70-138)
BUN/Creatinine Ratio high - 32 (4-27)
Cholesterol - high 522 (92-324)
Amylase - low 252 (290-1125)
Platelets high 500 ( (170-400)
Differential - Absolute

4/18/14 GLUCOSE CURVE (3u Novolin N @ 6:45)
no FBS drawn @ vet
8:20 223
9:20 274
10:20 254
11:20 243
12:20 267
1:20 220
2:20 216
3:20 285
Shows poor response to insulin


6/16/14 - GLUCOSE CURVE (3u Novolin N @ 7:30)
no FBS drawn @vet
8:40 287
9:40 176
10:40 163
11:40 158
12:40 185
1:40 176
3:05 195
4:10 187
5:00 195



9/25/14 - CBC - Platelets high 537 ( normal range 170-400)
Chem. - Alk Phos high 514 (5-131)
Urinalysis - glucose strip high 3+
pH - low 5.0 (5.5 -7.0)

12/12/14 - GLUCOSE CURVE (3u Novolin N @ 8:10)
FBS 687
9:50 299
10:50 276
11:50 242
12:50 266
1:55 252
2:50 291

Insulin decreased to 2 u and Trilostane 5mg every 12 hours

1/6/15 - ACTH 3.1 (1.0-5.0)
11.3 (8.0-17.0)

1/7/15 - GLUCOSE CURVE (2u Novolin N @ 7:35)
no FBS taken @vet
8:00 567
9:00 514
11:00 484
1:00 682

Increase Insulin to 3u Novolin N

1/19/15 - GLUCOSE CURVE (3u Novolin N @ 7:45)
8:10 697
9:10 464
10:10 451
11:10 402
12:10 357
1:10 378
2:10 344
3:50 498

[Squirt's Mom]

Ya know....I kept looking at that name and thinking "you know this person" but the post count was 1 so I set up a new thread. :o:o:o

[Bichonluver3]

Yeah, yeah, "Squirt's Mom"..you know who I am! Just had a senior moment and ended up on wrong thread. LOL
Thanks to everyone for moving the comment! :)