Nina, 11 y/o Bichon - Cushing's and Diabetes

[Mary Lou]

My nearly 11 year old Bichon Nina was diagnosed with Cushings a little over a year ago. She was prescribed 30 mg. of Vetoryl twice daily. She weighed 20 lbs. at the time. After 6 mos. on that dosage, she presented with Addison's. Evidently, her dosage was way over the top. The vet suggested that we discontinue the Vetoryl and allow her ACTH to reset. All was fine for several months. Then three weeks ago the thirst, hunger and panting returned. Back to the vet for another ACTH and now she's back on the Vetoryl (only 10 mg. once daily this time.) Meanwhile, she was also diagnosed with diabetes. Balancing the Blood Glucose and cortisol levels is a challenge, but we'll get it done.

[molly muffin]

Mary Lou. I just have a minute but wanted to let you know that with diabetic and Cushing's the recommendation is for twice a day dosing. So maybe 5 mg and 5 mg would work. You want to keep the cortisol even throughout the day to better manage the glucose. I saw your vet recommended you to the site. How awesome is that! Perhaps let her know this is dr petersons recommendation now.


So what do I recommend? Until it is proven that SID or BID treatment is better, I prefer to start with a twice-daily regimen —if feasible and the owner agrees —because controlling cortisol concentrations throughout as much of the day as possible makes sense to me. In diabetic dogs with concurrent Cushing’s disease, twice-daily administration is essential in avoiding large fluctuations in serum cortisol concentrations during the day (1,2). With once-daily trilostane administration, adequate diabetic control will be next to impossible in many dogs with concurrent Cushing's syndrome.

[Mary Lou]

Thanks Sharlene,
I've been wondering why the twicedaily dosing of Vetoryl was changed to once daily. The original dosage was 30 mg. twice daily. That triggered Addison's which was followed by a two month abstinence from Vetoryl. Once the Cushing's symptoms returned three weeks ago, we resumed Vetoryl with 10 mg. once daily. Three days of that regimen produced more severe Cushing's symptoms, so we tested for diabetes. Now we're doing the 10 mg. of Vetoryl once a day again AND 3 units of Vetculin twice daily. Seems like all I'm doing is medicating and nothing is changing. I'll call the vet tomorrow and ask about the 5 mg. of Vetoryl twice daily. The lowest dosage I've been able to find is 10 mg. Where can I buy 5 mg.?
Thanks again!

[judymaggie]

Hi to a fellow Floridian! I just got 5mg. capsules compounded from Diamondback Pharmacy in Arizona. Cost was $37.00 plus shipping for 60 capsules. My vet faxed them a prescription. I called them to see if they got it and gave them credit card info. They shipped the order the same day and I got them two days later. Hope this helps!

[molly muffin]

I'd see where her cortisol actually is before making the change. So you know in case she might need even less than 5/5.
Dismondback is one that many members use and has good reviews.

[Mary Lou]

OMG! Just when I thought we were getting a handle on Nina's Cushings and diabetes, tonite she's peeing red blood. Trying not to panic here, but this is scary. Do I need to run to the emergency clinic or can this wait until morning? Does anyone know?
Help!

[SuperCupcake64]

Hello--I hope Nina is okay! That happened with my Sammy once. I walked into the kitchen and it looked like a crime had been committed. The blood was actually more of a magenta color, which my vet said was because it was mixed with urine. It was probably related to a urinary tract infection, common in dogs with Cushings. It was a one-off for me, but I did take him to my vet for a urine sample analysis.

It's really scary to see. Hopefully yours is as easily resolved as was mine!

[Budsters Mom]

:eek::eek::eek: How much blood???? How is she otherwise????

If Nina continues to pee excessively like most Cush dogs and the bleeding continues and remains bright red, I would take her to the ER tonight.

Monitor her carefully and if in doubt, take her in. I would probably do it anyway for my own peace of mind. ;) Otherwise, she should definitely be seen for a urine culture in the morning.

Yes, UTIs are common in Cush dogs and a small amount of blood found in urine is not uncommon. A larger amount of blood loss can be dangerous.

Kathy

[labblab]

Hi Mary Lou,

You'll see that I've moved all the replies about Nina that were originally posted in Milly's thread -- so as to create a new thread that belongs specifically to you and Nina. This way, it will be much easier for our members to track Nina's health history and reply to you directly.

I sure hope you're having the chance to get some answers about the bloody urine this morning! I'd have to agree that a urinary tract infection is the most likely explanation, but Nina could instead have a kidney stone or something else entirely different going on. Please let us know what you find out.

Marianne