Mile the Chihuahua

[Mile and Ann]

My dog is a diabetic not regulated.
He has antibiotic resistance so is not being treated for bladder infection.
He has enlarged right adrenal gland and enlarged prostrate.
He has Oxalate stones.
Cushing's urine test he had a high ratio.
He has a body that looks like a starving dog. He had lost weight from 13lbs to 6lbs. Now at 9 lbs and improving.
Main symptom is hunger! He is improving in energy.
He does not drink lots but normal amounts.
He has bouts of dehydration.
Anyway long story short he is going to be tested for Cushing's. I am concerned not being regulated,bladder infection and easily stressed will affect testing?
What tests are needed and can his health issues cause a problem with testing?
We switched insulin and is doing better may end up getting regulated..

[Harley PoMMom]

Hi and welcome to you and your boy,

I can not stress enough, do not have tests performed for Cushing's until his diabetes is under control and his UTI is gone, both of these health issues will create a false positive result from all Cushing's tests, even severe stress can skew those test results, ok?

We have a sister site that deals with canine diabetes and the loving, wonderful people there will be able to help you immensely with his diabetes, here is their link: http://www.k9diabetes.com/forum/ Please, please join there too.

Regarding his UTI, have they had an urine culture and sensitivity test done? Are all antibiotics black listed for him? Once his diabetes is under control and hopefully a solution can be found for the UTI, if he is still symptomatic after that we can revisit that Cushing's diagnosis, ok?

Hang in there with us, we are here for you both.

Hugs, Lori

[Mile and Ann]

Thank you so much.
The goal is to retest urine with a culture and see after two weeks if resistance is gone so we can treat with an antibiotic.
Then check blood pressure.
I was told by ultrasound tech Mile is going to die basically.
The enlarged adrenal gland is on the right side and cannot be removed or tested.I was told he wont be regulated because he most likely has Cushings.
Sounds like I need a new vet again.

[labblab]

Hmmmm...I'm not sure you need to give up on your vet so quickly. There are still several unanswered question marks that can affect the "big picture" here. First, if you've actually had an ultrasound that showed a single enlarged adrenal gland, that does increase the likelihood of an adrenal tumor that is, in fact, causing Cushing's.

Secondly, in the presence of consistent symptoms, Cushing's can be suspected in a diabetic dog who is truly resistant to insulin regulation. In that situation, you do have to bite the bullet and go forward with testing even in the face of possible "false positives." In that situation, the ACTH stimulation test is probably the better of the two diagnostic blood tests to use because it is less likely to be skewed by nonadrenal illness (although it does remain vulnerable).

Here's an article that can help you make better sense of the difficulties of diagnosing Cushing's in a diabetic dog. But that diesn't mean it cannot be done, and we have several dogs here who suffer from both diseases. You will find, though, that one key question will be whether or not your dog has truly failed insulin regulation at this point. The folks on the diabetes forum can offer you better insight in that regard. But here's a link to that article:

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

Marianne

[Mile and Ann]

What does Cushing's look like?
Can the skin go from pink to grey?
If hair is shaved for a test it does not grow back?
Skinny or boney looking?
Enlarged adrenal gland?
Low energy?
What does a dog with Cushing's look like?
Are there very specific physical characteristics that are commonly seen in dogs with Cushing's?

[labblab]

Hello and welcome! Yes, there are some classic symptoms that can be associated with Cushing's. Not every dog has every symptom, by any means. But these are symptoms that are frequently seen:

http://www.veterinarypartner.com/Content.plx?A=635

One complicating factor, though, is that many of the symptoms can also occur with other diseases, as well. That is why the diagnostic process can take some time. For instance, out of your list, I think all of the problems could be associated with Cushing's (although enlarged adrenal glands cannot be seen externally). However, low throid levels can cause many of the same problems on your list, too. So if you would care to tell us more about the specifics of your dog's situation, we will be happy to help you brainstorm further.

Marianne

[Mile and Ann]

MILE is tiny because of diabetes muscle wasting. Four years ago when he was adopted he had a big belly but muscles in legs. He has hair that did not grow back when shaved for glucose testing such as on his ear. He has grey skin now and losing color in nails.
I have put off testing for Cushings due to unregulated diabetes and bladder infection issues.

[labblab]

Since Mile is diabetic, that does indeed complicate the diagnostic process, especially since the two diseases share many of the same symptoms. However, Cushing's may indeed be the culprit when there is the development of skin and coat issues in addition to great difficulty in regulating glucose levels. We do have dogs here who suffer from both diseases.

However, I am not an expert on diabetes and cannot offer you feedback re: your regulation issues. We do have a sister forum, however, that is devoted to diabetes. I would encourage you also join that group so that you can benefit from their feedback re: Mile's diabetic control. If their opinion is that you've exhausted your insulin options, then it may indeed be the time to go ahead and pursue Cushing's testing, as well. Here's a link to that group:

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

You can be active on both forums as you work out your treatment and diagnosis options, OK?

Marianne

[bgdavis]

If you'd like to see pictures of a dog that had both Cushings' and diabetes, you can see the 'before' and 'after' pictures of my Criss Ann here:

http://www.k9diabetes.com/forum/showthread.php?t=83

Bonnie and Angel Criss

[Mile and Ann]

If I knew how to post pictures, I would send before and after pics.
I have not slept for over six months since Mile barks for food all night.
Mile looks like a dog with pancreatic insufficiency in that his ribs show and skull.
He does not jump on to furniture. He has low tolerance to exercise.
He eats like a vacuum-inhales his food. He does not drink water
excessively. He does not have a belly due to diabetes muscle wasting.
I do belong to your sister site. Mile is a complicated guy.
Before he had diabetes I would suspect Cushing's or thyroid because of his
budha belly and getting into the trash cans. He has always been hungry and this increased after diabetes.
Thank you for sharing.

[Mile and Ann]

Does a skin color change occur with Cushing's?

[Harley PoMMom]

You will see that I've merged your new post into your original thread about Mile. This way, we will be able to keep track of his entire health and treatment history all in one place.

Cushing's can cause changes in skin and with their hair. A darkened appearance to their skin may develop and/or their coat changes in color and/or texture.

Is Mile's skin discolored?

[molly muffin]

At the top left corner of the web page on the forum, you will see User CP, click on this.
On the left hand side of the User CP page, you will see items listed, click on Pictures & Albums
Now you click on Add Album
Give your Album a title and check the Public box (this is so others on the forum can see your pictures)and then click Submit.
You are ready to now add pictures to your album, click on upload pictures.
You can upload 3 pictures at a time into your album.

Let us know if you have any problems.

It might be worth it to go ahead and do an ACTH test for cortisol levels to see if this is cushings too.

If it is you will want to get the cortisol levels under control. If your vet options to use vetroyl/trilostane, then you want to divide the dose according to Dr. Peterson, an expert in cushings, and start at no more than 1mg/1lb So at 9lbs, you'd do like either 4 or 5 mg in the morning and 4 or 5 mg in the evening to keep the cortisol balanced for a 24 hour period and help the insulin to regulate.

hope this is helpful

[Mile and Ann]

Hello,
Question- Do you find that dog's with Cushing's have high bp?
.

[mytil]

Yes, Cushpups are prone to high blood pressure. Once treatment starts and the cortisol levels are lowered this risk is decreased if there are no other underlying heart issues or chronic kidney issues.

I have merged this good question with your original thread. :)
Terry

[molly muffin]

My molly has high BP and we have it checked regularly, she is also on BP medications as high BP comes with it's own problems, that you don't want, like eye problems, etc.

How are things going?

[Mile and Ann]

Hello!
Mile has many challenges and one appears to be be adrenal cancer and Cushing's. Each time I plan to test for cortisol, for Cushing's, something
happens. Currently,he is recovering from pancreatitis and 4 broken ribs. Plus a right kidney that is infected and a bladder infection. He is on Doxycycline. I have sub q fluids that I give him for dehydration. I have oxygen for him if needed for broken ribs.

He is on Novolin N and Novolin R since he has high glucose. He is blind. He has muscle wasting.His weight is bouncing
between 8.8lbs. and 9lbs. He does not sleep at night, hunger. He does not drink often but when he does drink it is a large amount. He has been shaved in areas for tests and hair never grew back.

He has had three ultrasound tests, cbc, blood chem, urine cultures, urinalysis tests,bg curves,urine cortisol-1 year ago. The vet thinks the large right adrenal is cancer. He thinks since the left adrenal is getting bigger this points to Cushing's. He Does Not pant. He does Not have high bp but low normal. He has dry skin. He has low potassium. He has oxalate stones. These did shrink from Chinese supplement. He is anemic. He has white skin. Mile still wags his tail. He still can walk around. He still loves to go for car rides. He is still barks at the cats if they squabble.

My question is where do I go from here. Can CBC,Chem Panel or other tests point to Cushings? He has had diabetes since August 2014. I cannot regulate him. He is NOT resistant but insulin does not last.

Flax hull Linagins and Melatonin is being used at University of Tennesse Vet School with some success. Does anyone on this forum use these? Can Mile be putting off other hormones besides Cortisol and if so is there a blood test for this and cortisol? Any suggestions on how to move foreward with testing for enlarged adrenals ?

[Mile and Ann]

Does anyone use flax hull linagans and melatonin?

[Mile and Ann]

Mile has a left adrenal gland that is 9mm thick. The right adrenal gland contains a large mass of mixed echogenicity and partly calcified as was described in March.It was 5.3x4.0. The adjacent CVC looked normal.
Does anyone else have a dog with enlarged adrenal and a mass on one adrenal?

[Harley PoMMom]

I've merged your new post into your original thread about Mile. This way, Mile's entire health and treatment history are all in one place.


I am sorry that sweet Mile is going through so much. :( And you are correct in not having any tests for Cushing's performed since any underlying illness can skew the results.

Is Mile's drinking/urination still that of normal dog? I see that he still has a zestful appetite, and with his diabetes I know that certain foods should be avoided but I do believe frozen green beans can be given and may help to curb his hunger.

The flax hull and melatonin are used for a dog that has Atypical Cushing's which means that the other adrenal hormones are elevated but the cortisol is not. The SDG flax hull lignans are full of fiber and I have read where fiber helps control blood glucose so it may be beneficial to add these to his diet BUT only with the vets permission.

If this were me, I would focus on his main health problems; pancreatitis, kidney/bladder issues, broken ribs, and that is pretty daunting in itself so I would postpone any testing for Cushing's until all of these are resolved.

As for testing for the enlarged adrenal glands, the ultrasound would be my first choice because it has the ability to pick up abnormalities with not only the adrenals but other internal organs as well. Was the most recent ultrasound performed a year ago? If so, I would be inclined to have another one done right now, just to check on everything internally.

Hugs, Lori

[Mile and Ann]

Lori,
The most recent ultrasound was 9/18/15.
Clinical History-
UncontrolledDM.PCV 34%.WBC49.7 with neutrophillia.
Glu 475. BUN64.cre 1.1
Urine SG 1.018 with 4+glu. Bact and WBC's on UA.
Previous ultrasound in March 2015-
hyperechoic liver and GB filled with echogenic bile.
Renal mineral 7mm thickleftadrenal.4.5×4cm right adtenal
with minetalization. Bladder calculi and polypoid thickening of
cranial bladder wall. Rounded prostrate with mineralized
foci,2-3 mm.
Current sonograph findings-
The liver looked similar.
The gallbladder normal sizewith echogenic material.
Fat in cranial avdoman was hyperechoic and scant
fluid mixed withmesentric fat.The pancreatic apex
hypoechoic and thick 11mm.
Most small intestines empty.
Some spastic appearance to walls.
The left adrenal was9mm thick.The rightcontsined
a large mass of mixedechogenicity snd partly calcified,as
described in March. Itwas 5.3×4.0. The CVClooked normal.
The left kidney had a hyperechoic cortex with
small cysts snd tiny mineralized
periverticular foci. The pelvis was not dilated.
The right kidney had subcapsular
material. It had cysts and peridiverticular
foci.
Tiny calculi in bladder,4 to 6mm.
Prostrate same as March.
Impressions-
Liver compatible with DM.
Probable mild or chronic pancreatitis.
Possible cholecytitis.
Mildly thick left adrenal gland. Slightly larger
right adrenal gland mass,likely due to slowly
progressing neoplasia.


SDMA 21 H.
Platelet 482 H
HCT 29 L
HGB 10 L
RBC 4.28 L
WBC 56.5 H
Neutrophil 52545 H
Band 1130 H
Monocyte 1695
Eosinophil 0 L
Alkp L 426
K 2.3 L
CL 106 L

[Harley PoMMom]

Urine SG 1.018 with 4+glu. Bact and WBC's on UA.

Yep, Mile does have an UTI since bacteria (Bact) and white blood cells (WBC) were found in the urine, so I would recommend having an urine culture and sensitivity test ran after he has been on the antibiotics for 2 weeks.


Probable mild or chronic pancreatitis.

Is Mile's pancreatitis under control? Has a spec cPL test been performed to confirm the diagnose of pancreatitis?

Hugs, Lori

[Mile and Ann]

He has not had the test you mentioned.
Vets were going by symptoms and ultrasound.
He has been eating a bland diet, Baby food veggies and
chicken. I took him off the rice since glucose goes high.
He vomits if he does not eat every 3-4 hours. When he vomits
it is stomach juice only. His bms are good now no more diarrhea.
He is drinking water in normal frequncy but amount at one time is
a lot. He is always hungry. He is a skinny little guy.
I will mention the pancreas test. His stomach makes lots of acid sounds.
I give him acsnack for that and it stops but the snacks are hurting his
diabetes....

[Harley PoMMom]

How about giving him frozen green beans as a snack, I'm pretty sure a diabetic dog can have them but check with the vet first.

Hugs, Lori

[Mile and Ann]

There are two types of flax hull linagans.
Which one is the correct one for an adrenal mass and the second adrenal enlarged?
One type is a fiber and one is not.
Is there side effects to melatonin?
Does it help with hair growth and sleeping cycle?
Has anyone used these products with success?