Cushings/Diabetic dachshund not pooping need help!

[kirlin0809]

Hi there, I'm new to this forum so please be patient with me. My baby girl Tori was diagnosed with Cushings as well as Diabetes last August. I spent nearly $7000 on her first hospital stay and a small fortune ever since in meds, stimulation tests etc. She's my girl and I'll stop at nothing but as of recently I'm feeling lost. Last few weeks she's been very picky with what she eats (been eating both dry and canned w/d). I've tried boiled chicken breasts, carrots, peas. Now last week she started throwing up and had bloody diarrhea. The vet had prescribed all kinds of anti nausea meds, anti biotics, IV fluids. Blood tests have shown elevated kidney levels. But since this started it's now been 7 days since she's had a bowel movement...she's still hungry and wants to eat (we're feeding her rice now, it's all she wants) but with the lack of pooping it's just building I'm sure. Now this morning she's started vomiting again and I don't feel like I'm getting any direction from my vet. Any suggestions? I'm desperate and not ready to give up on her yet :(

[kirlin0809]

Sorry, I'm so upset over the recent events with Tori I didn't mention my name is Amy...I live in the Chicago area (suburbs). Tori is my 9 year old dachshund/terrier mix. She is one of two dogs, my other is Amos he is also 9 and dachshund/terrier mix...they are my babies, my world.

[Squirt's Mom]

Welcome, Amy, to you and Tori! :)

If it were me, I would stop the Trilostane and have an ACTH done asap to make sure the cortisol level hadn't dropped too low. Were both diseases diagnosed at the same time? What were the results of the last ACTH she had done? Is her diabetes controlled?

If you are not happy with her current vet, find a new one asap. Managing both diseases can be tough and you really need a vet that will listen to you and work with you. Are you a member at k9Diabetes? If not, go register with them, too. They are the experts on canine diabetes.

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

Others will be along soon to chat with you as well but the more you can tell us about Tori's medical history, tests results and all, the better. We LOVE details so don't worry about long posts. ;)

[Harley PoMMom]

Hi Amy,

Welcome to you and Tori from me as well! Have you joined our sister site k9diabetes.com? If not, I highly recommend that you do. Use this link: http://www.k9diabetes.com/forum/

Diagnosing Cushing's is difficult in itself and when diabetes is thrown in the mixture it makes it even more challenging. When a dog is diagnosed with diabetes it is important to get that blood sugar regulated before any tests for Cushing's are performed. Diagnosing Cushing's in an uncontrolled diabetic dog is next to impossible as diabetes can cause the same organ abnormalities on imaging, overlapping symptoms that are also associated with Cushing's and diabetes can cause false positives LDDS and ACTH stimulation test results.

If you would get copies of all tests that were performed on Tori and post those values that are abnormal here that would be great...e.g...ALT 150 U/L (5-50)...thanks! We are especially interested in any diagnostic and monitoring test results that were performed to diagnose the Cushing's. Was an ultrasound and/or urinalysis done, and if so, could you post those findings too? Could you tell us how much Tori weighs? Is she taking medication for Cushing's? If she is, could you post what drug it is and what the dosage is? Also if she is on medication for Cushing's right now, I would with hold giving it until Tori is feeling much more like herself.

I have provided a link below to Dr. Peterson's blog entitled Q & A: Diagnosing Cushing's Disease in Dogs with Diabetes Mellitus. http://endocrinevet.blogspot.com/2012/01/q-diagnosing-cushings-disease-in-dogs.html It has some pertinent information so I do recommend that you read it. ;)

Plain canned pumpkin (not the one used in pies) works for diarrhea or constipation, just start off with a small amount, like a teaspoon and see how she tolerates it and than tweak up/down.

We do understand how confusing this can be and we are here to help in any way we can, please ask all the questions you want. ;)

Hugs, Lori

[molly muffin]

Hello Amy and welcome to the forum. The canned pumpkin is a good option for either, just not too much as Lori stated.

Have they done an ultrasound to see if anything is going on with her gastro track? gall bladder, liver, etc? I would probably want one done if it is feasible.

Anything you can tell us about the test results would be helpful.

[Dixie'sMom]

Oh wow. I know this is scary for you and I think you're right to be concerned. At this point I would be thinking bowel blockage or a twist in the intestines. I would have a vet do an xray ASAP. Most things will show up in the bowel on xray but the core of a golf ball won't because its cork. *sigh* My precious cocker spaniel about 26 years ago. :) She pulled thru the surgery to remove it and lived a long and happy life. But I digress.

Please insist on an ultrasound or xray next. Xray is cheaper. I'll be praying for your sweet doxie.

[FemaleK9]

The vomiting, etc, may be a sign of Trilostane/Vetoryl overdose, which can be life threatening. I agree with Squirt's Mom, I would discontinue the Trilostane and get Tori to the vet immediately.

[kirlin0809]

Wow you all are so helpful, I love it! I almost feel like I get a more attentive response here than I do from my vet. I apologize for not responding sooner...we have a tough week or two with Tori to the point I wondered if she was going to make it. I convinced the vet to give me a laxative for her so she's now pooping but not regularly, and until this last bout she was a very regular pooper. I have some test results to post, hoping maybe it'll help with any further advice. They did the Stimulation Test and these are the results:

Pre 8.6 (1.0-5.0) Post 9.6 (8.0-17.0)

They tell me her trilostane dosage will remain the same based on these results which is 20mg twice a day and her insulin is 9 units twice a day.

So once she had a few bowel movements she was more willing to eat however, since this started almost a month ago she refuses to eat her w/d dog food. She was on a mix of canned and dry, eventually went to all canned and now she won't touch the stuff. All she'll eat is boiled white rice and boiled chicken breast. The rice worries me because I'm afraid that's backing up her bowels even more not to mention she's no longer getting the nutrients she needs. Any suggestions as to what else I could try feeding her? With the cushings/diabetes combo I'm really at a loss as far as what dog foods are safe. I feed my other dog Wellness weight management, but not sure that's sufficient enough for Tori.

The vet has done urine cultures to which they tell me everything is negative. The blood tests are something different, it appears her kidney levels are elevated (if i'm saying that right). The levels have apparently doubled since February. Which is about the same time she showed her first signs of vestibular disease. yes, the list of her illnesses just seems to be growing at such a rapid rate and I feel as if I can't keep up with it all. The vet has not mentioned much or shown much concern with regard to the kidney levels but I'm wondering if it's causing her some discomfort and maybe the reason why she refuses to eat her regular dog food? As of now she weighs right around 16 pounds, she fluctuates up and down a pound or two depending on how much she actually eats.

Sorry if it seems as if I'm rambling and jumping all over the place...I really and truly appreciate everyone's feedback!

I will also look into the sister forum for diabetes as well!

Thanks
Amy and Tori

[molly muffin]

Checking in to see how Tori is doing. You could try mixing in some other things like green beans or other veggies, cooked well, to see if you could back down on the rice if she still isn't popping normally. Also you could mix a tiny bit of the canned food in with the chick rice and see if she will eat that and slowly cut back on the rice. Sometimes you have to play around with it to see what they will eat and how they will tolerate it.

[kirlin0809]

so we managed to get away from the rice completely. I feel terrible that i fed it to her for as long as I did, not knowing it was most likely making her worse. I found something called Instinct Raw chicken bites, so far she loves them! I have also gotten green beans which she likes to eat raw, for some reason when I cook them she loses interest. I did get some frozen broccoli and cauliflower, haven't tried them yet so not sure how she'll take those. I appreciate the ideas as I was running out of things to give her being as she was so picky. She does seem to be slowly improving as well now that she's able to get her full does of trilostane, as before with her not eating I couldn't get the pills down her. I fear her vestibular symptoms are coming back as she seems a little shakey a lot of the time. Her blood sugar has been slightly high too so I wonder if that doesn't have something to do with her trembling. I've just accepted the fact that with everything going on with her health we're going to have these bouts with her every so often. these two diseases are just horrible and very difficult to treat, breaks my heart that I can't make her 100% comfortable all of the time. I thank you for all the advice, it continues to help!

[Harley PoMMom]

The blood tests are something different, it appears her kidney levels are elevated (if i'm saying that right). The levels have apparently doubled since February.

Hi Amy,

With kidney issues the anomalies that may be seen on a chemistry blood panel are the following: creatinine, BUN, phosphorus, calcium, sodium-which is usually abbreviated with (Na), and potassium (K), are any of these levels abnormal?

Another thing, Trilostane may cause electrolyte imbalances, mainly with the sodium and potassium.

The Instinct Raw chicken bites look like a really good high quality dog food and I'm glad to hear she likes it, I know how worrisome it can be when they don't want to eat.

Dramamine is one anti-nausea medication that I have seen used by members for their dog with vestibular. I found 2 articles that contain information regarding the diagnosis and treatment for this type of issue: http://c.ymcdn.com/sites/www.michvma.org/resource/resmgr/mvc_proceedings_2014/galle_06.pdf

http://veterinarymedicine.dvm360.com/vestibular-syndrome-whats-causing-head-tilt-and-other-neurologic-signs?id=&pageID=1&sk=&date=

Hugs, Lori

PS - Has Tori's blood pressure been checked recently? Prevention of damage to organs such as the kidneys, brain, heart, and eyes is one of the primary concerns in the management of hypertension.