scared,sad and overwhelmed/diabetes

[sunny bear]

Hi everyone,so grateful for this websit! So,my amazing 10yr old pit-lab was just diagnosed with diabetes and cushings . A little over 3weeks ago my dog allthe sudden just started laying there crying,and he never does this. We brought him to the vet and he had a bladdet infection and eventually diabetes and cushings. He's on insulin twice a day and 120mg of vetoryl once daily. Plus, we went from derramax to tramadol for pain. Although he doesn't need the pain pills as often,he still seems to be in pain. He drinks buckets of water,is very lethargic. His blood sugar was at one point 600,and is at 430 for the past few days. Is it the cushings and diabetes the cause of why he is obviously in pain? Any info would be much appreciated. Thank you so much,just so worried!

[doxiesrock912]

Hello, I have no experience with canine diabetes but others here do. Also, here is a forum specifically for diabetes. http://www.k9diabetes.com/forum/

[sunny bear]

Thank you so much,I really appreciate your kindness! Oh and I love your quote,especially because my dogs' name is Sunshine(aka sunny bear,love of my life,etc ):)

[Squirt's Mom]

When diabetes and Cushing's are diagnosed at the same time, I am always suspicious of the Cushing's diagnosis. In your shoes, I would stop the Trilo and continue to work only on the diabetes for now. And do go to the diabetes forum, register, talk with them, but most of all listen to them - they are the experts on canine diabetes. ;)

[Harley PoMMom]

Hi and welcome to you and your boy!

I have taken the liberty of adding diabetes to your thread title, that way our members that are dealing with both endocrine disorders will see this and reply.

So sorry for the reasons that brought you here but glad you found us. In order for us to provide you with meaning feedback we need to know more about your boy, ok? So here are some questions that I have :eek:;)

How much does your boy weigh? What symptoms did your boy display that led you or your vet to test for Cushing's in the first place? Was a recent blood panel done, and if so, could you post those values that are marked abnormal with the reference ranges and units of measurement? As an example....ALT 150 U/L (5-50)...thanks! We are especially interested in the results from all tests that were done to diagnose his Cushings. Is he taking any other herbs/supplements/medications? Besides the diabetes, does he have any other health issues?

As the others have stated we have a sister site that deals with canine diabetes and I, too, strongly urge you to join there also. Some of our members here that are dealing with both diseases belong to both forums. Here's a handy link to the diabetes forum: http://www.k9diabetes.com/forum/

Generally when a dog has uncontrolled diabetes and Cushing's is suspected, getting the diabetes under control is the priority because uncontrolled diabetes has the ability to create false-positive results on the tests for Cushing's. One of the top canine endocrinologists, Dr. Peterson, states in his blog that it is challenging to diagnose Cushing's in a diabetic dog:
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 This article can be found here: http://endocrinevet.blogspot.com/2012/01/q-diagnosing-cushings-disease-in-dogs.html?utm_source=dlvr.it&utm_medium=facebook

Also when a dog is diabetic it is recommended that the Vetoryl be administered twice a day to better regulate the cortisol.

Please know we are here to help in any way we can so do not hesitate to ask all the questions you want. ;)

Hugs, Lori

[Renee]

Just popping in to welcome you too, and encourage you to let us help you navigate through these diseases. There is a lot of knowledge and experience here, and even better, now that you've joined, you are part of our extended family!

[sunny bear]

Wow,I just want to thank you all so much for caring,I am now overwhelmed with gratitude and the feeling that I'm not alone! So, Sunshine is 70lbs, which I am now concerned that he is on 120mg of vetoryl, I am gonna talk to my vet about this. So,about 3 1/2 weeks ago sunny is just laying there moaning. Now he does not cry unless he is in a lot of pain. Now if I called his name or kept him busy he would smile and wag his tail, but as soon as he was laying down, he would moan. I thought he maybe had arthritis. So, we got blood tests,urine,xrays, turns out his blood sugar is really high. We start on 8 units of insulin,twice daily,then 11 units, then 13 units. Oh and he was on antibiotics for the bladder infection. He was on derramax for the pain,but it was not working that well, so got him tramidal, which took away the pain. Today's the first time he hasn't needed pain meds in over
24hrs, but now he is so slow,I can't even walk him a few houses down with out him needing to lay down. A few days ago I was walking him and as we approached a house with a dog barking behind a gate, all the sudden he must of got scared and he fell over on his side. When he got up his legs were shaking. He's never done that before. Anyway, the way he was diagnosed with cushings was given a low dose dex/supp test, where we had to leave him for 8hrs. when I questioned my vet after reading some of the info on this website,the vet said they're almost 100 percent certain he has cushings. After the diagnosis, the vet told me to give 10 units of insulin twice daily along with the vetoryl. That's now the only meds I give. I don't know when we're gonna see results,but I am very worried about him. And he drinks ridiculous amounts of water and pees a lot. I don't have the test results,but in a week I can get them when we go back to the vet. Sorry this is such a long post,but there is so much going on! Thank you so much again and lots of love to you and your pups, noel :-)

[addy]

Hi and Welcome from me as well. I'm trying to figure out how many days your pup has been on Vetoryl. An ACTH monitoring test should be done 10 -14 days after starting the drug. I think you mentioned something about going back to the vets next week?

I am worried too about Sunny Bear falling down on his side. I am concerned about his cortisol.

Please mention that incident to our sister site, ok?

[Harley PoMMom]

Anyway, the way he was diagnosed with cushings was given a low dose dex/supp test, where we had to leave him for 8hrs. when I questioned my vet after reading some of the info on this website,the vet said they're almost 100 percent certain he has cushings.

This isn't one test that is 100% accurate at diagnosing Cushing's. The LDDS is more prone to false positives in the face of a non adrenal illness, such as diabetes, or any other underlying issue that puts stress on the body.



After the diagnosis, the vet told me to give 10 units of insulin twice daily along with the vetoryl. That's now the only meds I give. I don't know when we're gonna see results,but I am very worried about him. And he drinks ridiculous amounts of water and pees a lot. I don't have the test results,but in a week I can get them when we go back to the vet. Sorry this is such a long post,but there is so much going on! Thank you so much again and lots of love to you and your pups, noel :-)

Sunshine's symptoms of increased drinking/urinating can be attributed to diabetes as well as Cushing's. Along with the PU/PD, dog's with Cushing's generally have a ravenous appetite, thin skin, and hair loss, does Sunshine have any of these clinical signs?

Also, were any ketones found in Sunshine's urinalysis? Was the blood sugar diagnosed through a blood chemistry panel and/or was glucose spilling into her urine?

Hugs, Lori

PS, Sunshine is such a pretty name.

[sunny bear]

Thank you so much! And sunny has been on vetoryl since Monday, and the falling incident happened,like, the 2nd day he had been on vetoryl. Actually,it was an hour after he got his pill and shot,and about 2hrs after I gave him the tramadol,so I don't know if it was over-medication, combined with getting scared? He hasn't done it since,but he is just so slow,it's alarming. I pretty much burst into tears a few times a day! Oh,also the vet said he has a benign tumor in his brain,I think that's why they said he has the cushings. For now,I just appreciate every moment we have,I would do anything to make him better! Thanks again, lots of love :-)

[sunny bear]

And Lori, I'm not sure about the ketones and if there is sugar in his urine analysis. But I will deff find out. I actually appreciate these questions because I ,can ask my vet. He always seems like he's in a rush and I guess I'm not that knowledgeable about all these tests! And the thing is he's always seemed to have a big appetite and that hasn't changed! Also,I don't notice that much hair loss or thin skin. And thanks for the compliment on sunshine's name!10yrs ago, a little puppy was just sitting on the side of the road,abandoned,he jumped into my car and into my heart,I never named an animal so quick. He radiated sunshine and is even orange,lol!hugs to you,noel:)

[doxiesrock912]

The quote is perfect. I can't have a bad day when something furry stares at me with love.

[sunny bear]

I agree, if you want to know what unconditional love is, adopt a dog! They are furry little angels:) so,I got a wonderful Valentine gift, my sunny has not needed any pain pills in 48hrs! He's still lethargic, thirsty ,walking slow and his blood glucose is through the roof,but it's such a relief to see him out of pain for the moment! I'm wondering if it was the bladder infection that had him moaning in pain. I just hope we can get his health at least manageable. Will def post his test results when I get them. Hope everyone is having a wonderful weekend:p

[molly muffin]

Yay so glad that pain pills haven't been needed now for a couple days. Hope that means a turn around coming through.


Hugs

[sunny bear]

Aaww,thank you so much! It really is a blessing to not see him crying in pain. I
Know he is still really sick and it's gonna be a while before he (hopefully) gets stabilized,but small victories! Oh,and I get the vetoryl (120mg, compounded) for $99.00 for 30 pills/1 month supply,is that good? Was just curious cause between the insulin,vet bill and vetoryl, every little bit counts (if I had to sell all my possessions,I would do it for my little angel:) ) anyway,will keep everyone posted on what's going on with him. I hope our experience can help others who might unfortunately be going through the same craziness we're going through. Love to all,thanks again for the kindness:D

[sunny bear]

Hi everyone,hope everyone is having a great week. So,a little update, first off,I went to my vet yesterday. When I walked I asked for copies of his tests and they said no problem! By the time I left I completely forgot to grab them. So mad, but gonna call to see if they can be emailed,if not,going back in a week,will not forget! Anyway,I am freaked out cause I can see his muscle mass is diminishing, except for his pot belly. Also,when he went to his grandparents,he was running,all happy and they have a lot of stairs. The two nights he went,later on he was a moaning a little,so I gave him some tramidal. My vet said he's dealing with 2 diseases and he's a 10yr old big dog,but he seemed optimistic for the moment. His blood glucose level was 524 so now he's on 15 units of insulin twice a day plus 60mg twice a day of the trilostane. I told him about the moaning and could he also have arthritis? He said he could have a few problems going on and that we should give him derramax if he looks to be in pain. Well,I read a lot of bad stuff about derramax and am reluctant to give it to him. This is all so horrible, not knowing if he's gonna be able to have a quality life,but I will do anything for him. Will post his test results soon. I just want to thank you all for the support,means a lot! Love to everyone :)

[Harley PoMMom]

I would ask the vet about using Tramadol for the pain.

[sunny bear]

Hi everyone,so sorry I haven't been on here in a while. See,Sunny's blood glucose level is so high,I've been spending a lot of time on the k9diabetes site. But I would like to report that Sunny is still pretty sick. My vet says the cushings and diabetes are working against each other. His cortisol levels are still off. When he got diagnosed this was his results of the dexamethasone suppresion:
Pre-dexamethasone- result:12.2/ reference range: 1.0-6.0 ug/dL. flag:H
Post 4hr Dex- result: 0.5 /reference range: less than 1.5 ug/dL
Post 8hr Dex-result: 2.1 /reference range:less than 1.5 ug/dL
I don't know if I typed that right(I really don't know what it means)so if I'm missing any info,let me know! So,now Sunny just got increased from 120mg of trilostane to 180mg a day. Is that a very high amount for a 63lb dog? He also just got diagnosed with another urinary infection. I'll tell ya, this year has just been crazy so far. I just want my dog better and pretty much overnight, he is diagnosed with cushings/diabetes and infections. Just trying to do all I can to make my sweet angel better. More updates to come.....thanks everyone,have a great night:)

[Harley PoMMom]

Was an ACTH stimulation test performed before the dose was increased to 180 mg? If so, could you post those results?

[molly muffin]

Oh dear, so sorry to hear that the cortisol and diabetes are still being problematic.
I hope you have the numbers from the last ACTH test so we can see where that is at.
Thank you so much for popping in to let us know how things are going!

[sunny bear]

Oh no,thank you for being so kind and caring! I feel like I'm neglecting the cushings site for the diabetes site,lol! But seriously,it's so extremely hard to not know if your baby is going to be ok (I know you've all been there) the poor thing has another bladder infection and keeps crying despite tramidal and antibiotics. I almost feel like I'm overmedicating him,but I don't know what else to do and the vet prescribed it all. The poor baby looks so skinny,despite eating and drinking a lot. Praying for a miracle!hugs to all:o oh and will post new numbers on Mon:)

[Harley PoMMom]

If the UTI's are occurring regularly an urine culture and sensitivity test may be necessary, as this can tell what bacteria is growing and the exact antibiotic that is needed.

Keeping fingers and toes crossed for great numbers on Monday!

[Wally P's Mom]

I just want to say that I know how you feel. My pup went from a diabetic to a diabetic/Cushing 's to a diabetic/Addision's dog. He just turned 16yrs young on the 17th. We began this journey a little more than 3yrs ago. It is a crazy nerve wrecking ride.

However, one thing I learned along the way is that it is important to be consistent and adhere to a strict feeding and injection schedule. Document everything. I bought a scale and measure how much food my dog eats and how much he drinks ( 1g = 1mL of water) each day. I check his BG twice a day and have worked with my vet to establish breakpoints for his insulin. It was through my measuring of his water, I caught him going Addision's. This was confirmed at my insistance of an ACTH test.

Be your dogs advocate and have a wonderful working relationship with your vet. If it wasn't for the work that the two of us had done together, Fritz wouldn't of had a sweet 16 party last week.

Don't give up hope. Be strong. Your dog senses if your are stressed and he will be stressed too. You can do this.

Keep the faith.
Marge

[sunny bear]

Happy update,my vet increased his trilostane to 180mg a day (90mg twice a day) and 28 units of insulin twice a day, and my Sunny is jumping around,so happy and energetic! Of course I don't want to let my guard down, but after what my poor baby has been through,he deserves to do a little celebrating (going to the pond today!) :) he was at the point where he was drinking buckets of water and could barely go a few feet with out having to lay down. He even gained a decent amount of weight! I just want to thank everyone on this website for all the support,kindness,info,genuine concern,I mran the list goes on and on! And a very beautiful gift-hope! Hope when mine was running seriously low! Again,infinite thanks to everyone, amd may you and your family(furbabies included of course) be healthy and happy:D

[sunny bear]

And Marge,thank you for the kind words! Wow,16,so amazing,congrats! Sorry it took so long to get back to you,as I mentioned before,I feel like I neglect k9cushings cause I've been on k9diabetes so much. Sunny's blood sugar would not go down,he was over 600! But,increasing his insulin to 28 units (twice daily, novolin)wow,did a happy dance tonight when the meter read 118 (think it's off a little cause it's a human one,but I know it's not that bad)can't wait to bring him to the vet,know he gained a decent amount of weight! I found this food called pure balance at walmart $34 for 30lbs,and it has no sugar,corn, it's first ingredients are chicken and it also
has dried cranberries which is good for the uti's he keeps getting! You know at first I was so overwhelmed,but especially since we've been seeing results, it really isn't that bad. Mostly,I just can't see my baby suffer and I'll do whatever it takes to make sure the love of my life is feeling good and happy! Thanks again for all the info and the hope! So happy your baby's doing good...health and happiness to you and your fur baby:)

[Harley PoMMom]

Hi Noel,

I am so happy to hear that Sunshine is doing so well on his treatment for Cushing's and that his blood sugar is finally starting to cooperate. Cushing's in itself can be challenging, and then when diabetes is thrown into the mixture it makes it very difficult to get a dog stabilized.

Was an ACTH stimulation test performed before the Trilostane dosage increase? If so, could you post those results for us? Is an ACTH stimulation test scheduled to check his cortisol level after this last dosage increase?

You are doing an amazing job taking care of Sunny, and I am glad that he has you for his Mom.

Hugs, Lori

[molly muffin]

This is wonderful to hear that he is doing so much better finally. Congratulations!

[sunny bear]

Oh Lori,thank you so much,your kindness means so much to sunny and I! Now I'm not sure about the ACTH but I'll get back to you. I actually took him to the vet t today and we just got his blood sugar done ( 220!) but he didn't say anything about giving him a ACTH, I'll deff request one next time I see him! I think the vet and I were so excited,we prob should of schedule more tests! Thanks for the info,now I know what to ask for! Lots of love to you
And Sharlene and Molly Muffin, thank you so much for the kind words! Lots of love :-)

[Wally P's Mom]

You are welcome.

Be careful using those people meters. They will not read your dog's BG accurately because your dog's blood is very different than humans' blood. Using a meter specifically design for use in animals will give you a more accurate read.

[sunny bear]

So,we had a little over a month of Sunny back to the way he was before he got sick! I was just so relieved that all the medicine was working! Well, it seem like overnight he awoke with his eyes all red,swollen,wet eyes. Was hoping it was allergies,but unfortunately,my poor boy is going blind. Seems like he's getting worse by the hour. My vet confirmed it yesterday, he said no matter what we do, he will lose his sight completely. It's amazing how well he's adjusting. I, on the other hand, am freaking out a little(but keeping it together for him!) Just breaks my heart when he bangs into stuff,but just keeps smiling and going on his way! But you know,after the initial shock,I realized that it's a lot scarier when he having issues with his cushings/diabetes, then he's in pain amd suffering. At least with the blindness,he's comfortable and feeling good. Just love when he can lay down and be all comfy,instead of moanig and tossing and turning. I just try to appreciate every minute we have together! Health and happiness wishes to all and their furbabies:)

[Harley PoMMom]

Sounds like Sunny just may have SARDs, I'm including posts from both Marianne and Glynda regarding SARDS.


Unfortunately, I do not believe the Iowa State protocol has "panned out" as had initially been hoped. I have not heard much about it in recent years, either.

I wish I knew more about SARDS. The little I do know (or at least, think I know :o) is that adrenal hormone elevations are typically associated with SARDS, as they are with Cushing's. However, not all dogs with SARDS exhibit elevated cortisol levels, and that's where the diagnosis/treatment component becomes cloudy to me. Here's the abstract for a 2009 study co-authored by Dr. Jack Oliver of Univ. of Tennessee at Knoxville, who devoted much of the later part of his life to researching the incidence and effects of elevated adrenal hormones other than cortisol:

Elevations in sex hormones in dogs with sudden acquired retinal degeneration syndrome (SARDS).
(http://www.ncbi.nlm.nih.gov/pubmed/19723843)


Since Dandy's UC:CR was normal, it seems possible that if a full ACTH-stimulated adrenal panel were to be performed on him, his cortisol level might be normal but if he does have SARDS, it is most likely that at least some other adrenal hormones would be elevated. Whether or not it would be worth the expense to you to proceed with a full adrenal panel to find out, I do not know (U. of Tenn. at Knoxville has the only lab in the U.S. that performs this analysis, but blood samples can be obtained in any vet's office and sent to UTK). I am aware of at least one other member whose dog ended up being treated with trilostane (historically a treatment reserved for dogs with elevated cortisol) after being diagnosed with SARDS and known adrenal hormone elevations other than cortisol. We've not had a recent report to know how this dog is doing, and the treatment does raise some questions since the drug itself actually increases some of the non-cortisol adrenal hormones that are associated with SARDS.

The long and the short of things is that if you have access to a veterinary ophthalmologist or internal medicine specialist, it may be well worth the expense for at least one consultation. A specialist in this area may be better aware of the most recent research findings and suggestions for treating unremitting symptoms of the syndrome other than blindness.

Marianne


Hi and welcome to the forum.

I know how upsetting it is to see your baby go blind so suddenly and to watch them struggle to adjust. They adjust a lot faster and much better than us humans and I suspect Petey will be fine in a few months. Petey fits the perfect pattern of SARDS. A good number of dogs diagnosed with SARDS will start to show symptoms associated with cushing's before the onset of blindness. Most dogs with SARDS do not have typical cushing's so the usual diagnostic tests are negative for cushing's because blood cortisol levels are normal. What SARDS dogs do have is elevations in one or more of the intermediate (sex) steroids which cause most of the same symptoms associated with typical cushing's. A lot of experienced vets will opt to take a wait and see approachas these symptoms usually resolve on their own for a good many dogs.

What you may want to do is try the treatment that is recommended for atypical cushing's, which I suspect is what Petey has right now. Your vet could actually confirm this by sending a blood specimen to the University of Tennessee (UTK) for a full adrenal panel, which will tell you which hormones are elevated. Melatonin is what UTK recommends for atypical cushing's and recommends that lignans be added if estradiol is elevated. We don't know if Petey's estradiol is elevated but the lignans are benign enough to add it just in case. Both can be purchased over the counter and you can find melatonin at just about any drug store or health food store. Just make sure it's not fast acting or time released...just plain old melatonin. If Petey weighs more than 30 pounds, you start him on 6mg every 12 hours. Dosage is 3mg BID if less than 30 pounds. Improvements are not instantaneous nor guaranteed. It's even possible that symptoms would resolve on their own before melatonin kicked in but if he were my dog, I'd dose him anyway. It might also help him with some of the anxiety he is feeling with being blind. It's been awhile since I purchased lignans so I'm hoping other members might provide you with a link where you can purchase the flaxseed hull lignans. If not, I'll do the research and post it later after I make dinner.

Glynda

Hope this helps.

Hugs, Lori

[sunny bear]

Thank you so much for the info Lori,I will deff bring it up to my vet. We went to our vet yesterday,but my usual vet is on vacation for 3wks, so we had a fill in vet. He looked at him and said because of the diabetes/cushings,he will go completely blind,and there's nothing we can do. He said it was cataracts. My poor baby,seems like within 3 days he lost almost all his vision. Thanks again for the info! Hugs to you, Noel

[molly muffin]

Can you see an doggie ophthalmologist?
There is a dog eye supplement, kind of expensive but said to have good results with cataracts, Ocu-Glo Maybe ask your vet about it?

[sunny bear]

So that's it,within a week Sunny has lost his sight. You know,when I found out he was gonna lose his sight,I was devastated,but Sunny has been his usual happy self! He's so sweet,he just accepts it and manages to get around fine! Sure he bangs into stuff and falls down/up curbs (still getting used to it,sometimes I forget for a second)but he just keeps going! I now feel like, as long as he's not moaning in pain,miserable,then losing his sight is manageable! My Sunny was 60lbs at his sickest, but I am ecstatic to report that he now weighs 77lbs, he looks amazing! I know everything can change overnight,so I treasure every healthy moment he has! Taking a cue from my Sunny bear and taking life moment by moment! Hope everyone is doing wonderful:)

[Squirt's Mom]

I am so glad he is progressing well with this change in his world. Most dogs adapt fairly well to being blind. I have one who seems to have bat radar and rarely runs into anything, and another who is my little pin ball as he bounces off everything and keeps on going! My house is bubble-wrapped for my itty bitty man, Brick. :D