Chance the jack Russell 10 yrs old Cushings and Diabetes

[tomschwartz]

Our JR Terrier Chance was diagnosed with Cushings and diabetes last Monday, after many, many tests ruling out heart disease, liver disease, infection, etc.She is on 5mg Trilo 2x per day and 3 units insulin 2x per day plus ursodiol and amlodipine for high blood pressure. Also takes denamarin and Adrenal harmony.
After a week on the insulin she is back into the vet today for a glucose test. She has been going downhill this week and has had nose bleeds after sneezing and stuffed nose making it impossible to breathe through her nose at times. We think she might be allergic to grass, because its worse after she lays in the grass trying to cool her potbelly, and maybe the meds? She still shakes and trembles in her sleep and has shaky back legs when awake, drinks a ton and pees alot. She had 3 accidents in the house this morning also. We don't know if we should wait and try to stabilize her meds or if her quality of life is telling us to send her to heaven.
Any advice would be welcome.

[DoxieMama]

Welcome to you and Chance, though I'm sorry for the reasons you have come. Would you happen to have (or could get) copies of the tests that were done to determine Cushing's? We're most interested in any abnormalities listed, so you don't need to include everything. Also if there were an ultrasound done, what did that show? How much does she weigh?

I'm sorry that all I have are questions for you now, but these will help others to provide you with the best support.

Hugs!
Shana

[molly muffin]

Hello and welcome to the forum.

What is her weight? you said she is on 2x daily dosing which is what is needed with diabetic cushings. The recommended total starting dose is 1mg/1lb.

Also I want to give you the link to our sister site for diabetes. They are very knowledgable over there.

www.k9diabetes.com/forum

[tomschwartz]

Chance is 14 lbs. today and she was 15.9 lbs 2 weeks ago. I have most of her medical records is there a way to upload them to this site? The tests were UCC Creatinine urine test and an acth stim test, both of which werer positive for cushings, after reading this forum we werer pretty sure she already had cushings, her symptoms are rapid breathing and panting especially while sleeping, heavy water consumption, shaking, trembling, potbelly & hot all the time, sky high ALT and ALP, highest ALT was 6500 and ALP was 3400 at one point, ultrasound showed large adrenals but no masses, no tumors, clear lungs, echocardiogram showed some heart valve issues and she does have a grade 3 heat murmur but no congestive heart failure. Last 2 glucose curves werer in the 600's in the am trending down to about 300 by mid afternoon.

[mandi]

Sounds like the same problems I am having with my Mandi. Have you found out what makes them shake? Is it because of pain? Mandi was fine 3 hours ago, actually had a good day. I woke up to her throwing up, and now shaking and breathing heavy.

[DoxieMama]

At 14 pounds, the dose of Trilostane is pretty close to the recommended starting dose (which is a whole lot better than too high). It will take a bit before the meds bring down the cortisol enough to show improvement in symptoms. The first ones to reduce/go away are usually the excessive drinking and peeing.

If you have the test results scanned, you can create an album of pictures and upload them there. Or just type the results that are out of range in a post here, including the reference ranges as well. Sometimes that's easier. :)

I don't have experience with diabetes; Sharlene provided you a link to the other forum where there are more members that may help in that regard.

Do you have an ACTH test scheduled? It's recommended to do one after 10-14 days on the Trilostane.

Hugs,
Shana

[tomschwartz]

Thank you for the responses it has been helpful. Yes she has another acth stim test on Monday May 23rd. I will try to scan everything and post as an album tomorrow. I think the shaking is due to the trilostane accumulation not being enough yet or too low a dose or a combination of that and her glucose is still high. They upper her dose from 3 units to 4 units 2x per day yesterday after a new glucose test showed her glucose levels remained high.

[molly muffin]

Often once the cortisol is at an acceptable level, then the glucose will be easier to control too.

That is a very high ALT and concerning for the liver. Usually we see very high ALKP and mildly elevated ALT. Was the gall bladder clear of sludge?

With that high of liver enzymes I'd discuss supplements like milk thistle and sam-e with the vet. Maybe even some vitamin e. (I'm using all of those things for my dogs liver enzymes, but definitely recommend discussing with vet).

[tomschwartz]

I tried to upload Chance's medical records as a pdf toan album but it says invalid file?
Any suggestion s on how to upload a pdf?

[labblab]

Unfortunately, members do not have permission to upload pdf files. Your best bet is to upload actual jpeg-type photo mages of the pages to your album.

Marianne

[Aunt Jana]

Hi:

I'm fairly new here, my boxer has Cushings. She weighs 58-60 lbs and was on 60 mg Veteroyl. We were giving her the Adrenal Harmony Gold too twice daily. We are pretty sure her Veteroyl dose was too high, also giving the drops--I think we were hurting the situation, adding to the problem of too much. She was trembling/shivering when at rest and breathing in. She was confused, groggy. It was awful. We took her off the high dose and almost all the shivering is gone. Occasionally, still it happens, nothing like when on the meds. We are waiting for the lower dose to arrive. Can't be soon enough.

Good luck to you. This site is invaluable, don't give up.

[molly muffin]

You can either convert pdf to jpeg and upload, or just type the items that are out of range, (high or low with range) that is what most people do as there usually aren't too many that are outside of normal range.

As an example
ALT 3200 (range 20 - 115ug)

ACTH
pre 2.0ug (range 1.5 - 5ug)
post 8.9ug (range 1.4 - 5.0ug)

These are just examples of what we mean by typing out the out of range and cushings results. ACTH, LDDS etc are specific cushing tests.