New diagnosis of Cushings

[MisterMax]

I am so confused and afraid. I don't know what to do! My almost 12 year-old MinPin received confirmation of a Cushings diagnosis this morning (2/4). On 1/17, I took him in because he was urinating and drinking excessively and very lethargic. The urinalysis and T4 were extremely high (I don't recall the numbers, above 600). Max was started on Vetsulin, 3 U in AM and 2 units in PM. The following day, his blood glucose was tested by the vet and again and there was a significant improvement (over 200). Max returned to the vet on 1/21 for a blood glucose test and it was back up around 600. His insulin was increased to 3U in Am and 3U in PM. A return visit for a blood glucose level on 1/23 showed no improvement. A curve was scheduled for the following week and the insulin was increased to 4U BID. Max was at the vet all day on 2/1 for the curve test. I don't remember the numbers they got, but they remained high throughout the test. On this day, he was prescribed a thyroid medication (0.3MG BID) and his insulin was increased to 5U BID. Yesterday (2/3) he was back at the vet for the Cushing test. Insulin was increased to 6 U BID. Blood glucose is still in the 500 range. Today the results came back positive. The vet also mentioned pancreatitis as a complicating factor. I need to decide how to proceed and was told one option is Trilostane. I was cautioned this is a toxic medication and Max may suffer while the appropriate levels of all the issues get leveled out. It is so difficult to watch my once lively boy deteriorate in a matter of 2 weeks! I don't want him to suffer for my benefit. I am looking for some information on others' experience with this medication with pets that have a similar medical profile.

There is so much I don't know and don't know what to even ask. So, thank you for offering any advise you believe will be helpful.

Thank you!
Dixie

[Squirt's Mom]

Hi Dixie, welcome to you and your sweet boy, Max!

First take a deep breath...you have found the best place to get direction for both canine diabetes and Cushing's. But before we even start to talk about the possibility of Cushing's I want you to head on over to our sister site, K9Diabetes and get registered with them asap. Talk with them BEFORE you get any prescription for Trilostane or anything else for Cushing's. They are the experts in canine diabetes and can best tell you if you need to think about pursuing Cushing's this early in the diabetes treatment. Typically, that is not recommended but I will leave that direction to them.

I would call the vet for clarification on the comment about pancreatitis - is the vet saying Max DOES have pancreatitis or is the vet saying that condition can be a complication in Cushing's?

So scoot on over to the diabetes forum and get started with them asap. Diabetes IS a life threatening condition and needs immediate attention....Cushing's is not typically life-threatening so you can take some time before address it. ;) Diabetes first, pancreatitis clarification second, THEN if needed come back and we will talk about Cushing's. But DO let us hear from you and how Max is doing when you can.

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

Hugs,
Leslie and the gang

PS. I manually approved you post so it could be seen and responded to but check your email, maybe in the junk/spam folder, for a message from us. Reply so that when you do come back your membership is all ready to go.

[labblab]

And I've just now manually approved your membership, so you don't have to worry about an email confirmation and you truly are all good to go! ;)

Marianne

[Harley PoMMom]

Welcome to you and your sweet boy!

Leslie is spot on, the diabetes should be the priority, diagnosing Cushing's when diabetes is not controlled can cause false positive results for Cushing's.

I'm including this article from Dr Mark Peterson's blog (Dr Peterson is a renown and very well published veterinary endocrinologist) titled: Q & A: Diagnosing Cushing's Disease in Dogs with Diabetes Mellitus, http://www.endocrinevet.info/2012/01/q-diagnosing-cushings-disease-in-dogs.html An excerpt from this article:
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 (1-3).

If you have any questions do not hesitate to ask them and know that we will help in any way we can.

Hugs, Lori