Hi Everyone we're new

[Jules]

Hi Everyone,
We're new here. My dog Hunter was diagnosed in one week June 2017 with Cushings Decease, Diabetes, SSS and CHF. His diabetes is very hard to control right now. 2 weeks ago he had the stem test and the internists were very happy, however, BG is not regulating.

Right now he has so many things going on and is at the emergency vet right now having tests ran because of a terrible "moist" cough.

I wish I could tell you more about his Cushings readings, but I have been so scared with the other problems.

I can tell you that his last results on the stem test went from 10 to 5. We are on Lysodren 250mg on Tuesdays only and 125mg on Saturdays only, this has been the dose the entire time since diagnosed. He does lose control of his hind legs at times. (I think I saw somewhere here that this could be a cushings issue?) We will be switching internists so I'm not sure when the next test will be done. She will be seeing him today.

I wanted to take a minute to introduce myself and look forward to sharing our story.

Jules
Hunter is a 13 yr old Cavalier King Charles Spaniel, 17lbs. Diagnosed a diabetic June 2017. Started Novolin N 10/27/17, 9 units 2x @ 7 & 7. He has Cushings Decease. Crock Pot Diet for Dogs w/no carbs. He's trying hard to beat the odds!

[labblab]

Hello Jules, and welcome to you and Hunter! I'm so glad you've found your way to us, and I hope we can be as helpful to you as are the folks over on K9Diabetes. You surely do have a lot on your plate, and I think any one of us would be feeling overwhelmed right now! For the benefit of our members, I see that SSS is shorthand for "Sick Sinus Syndrome" which has to do with heart rhythm issues. So along with congestive heart disease, the diabetes, and the Cushing's-- there is definitely a lot going on.

As I mentioned on your K9D thread, one of the problems with diagnosing Cushing's is that there is no single test that is conclusive, and elevated cortisol can result from other health problems/stressors, as well. For this reason, it is often recommended that dogs not be tested for Cushing's when they are in the midst of battling other acute health problems because the Cushing's test may be skewed as a result and return a "false positive." An inability to effectively regulate blood glucose levels can be a reason to investigate Cushing's, however, and that may be the reason that prompted your vet to test Hunter.

Another "question mark" relates to his Lysodren dosing. Again, as I mentioned on your other thread, Lysodren treatment typically begins with daily "loading" doses in order to reduce cortisol levels efficiently and rapidly. Once the desired therapeutic range is achieved, the dosing shifts to 2-3 times weekly. So Hunter's dosing has been atypical, but this may be because in combination with his other issues, the internist did not want to induce such a rapid decrease in cortisol in a very short period of time. A post-ACTH level of 5 is a good result with Lysodren, so I understand why they were happy with this test result. The issue will be whether Hunter's cortisol continues to drop lower, so they will need to keep tabs on that.

I will go ahead and close for now as we await results of Hunter's testing today. We may all learn more from those results that can help guide us further down the road. But in the meantime, once again, I'm so glad you've found us.

Marianne

[molly muffin]

Hello and welcome from me too.

Oh my goodness, Hunger does have so much going on. Hopefully with his cortisol lowered and if it stays right around 5ug post ACTH, (and as Marianne said you will want to monitor that regularly for awhile) then his BG will start to be more easily controlled too. I don't know much about BG, but some dogs are more difficult to regulate and different types of insulin has to be tried to hit on the right one for him. So that is another possibility.

What a great furmom. Sounds like you have the diet going well. So that will help with both the diabetes and cushings one assumes. That sinus issue and the CHF will be something that hopefully doesn't get worse, and will stabalize. How of these different things, each contributes to the other and makes the individual one that much harder to get control of. We all understand how difficult it is to manage one to disease, little lone four.

It is all scary, but the more you learn about each one, I think, the more comfortable you feel in the decisions you make along the way.

Welcome to the forum and to the crazy. :)

hugs

[Jules]

Hello Jules, and welcome to you and Hunter! I'm so glad you've found your way to us, and I hope we can be as helpful to you as are the folks over on K9Diabetes. You surely do have a lot on your plate, and I think any one of us would be feeling overwhelmed right now! For the benefit of our members, I see that SSS is shorthand for "Sick Sinus Syndrome" which has to do with heart rhythm issues. So along with congestive heart disease, the diabetes, and the Cushing's-- there is definitely a lot going on.

As I mentioned on your K9D thread, one of the problems with diagnosing Cushing's is that there is no single test that is conclusive, and elevated cortisol can result from other health problems/stressors, as well. For this reason, it is often recommended that dogs not be tested for Cushing's when they are in the midst of battling other acute health problems because the Cushing's test may be skewed as a result and return a "false positive." An inability to effectively regulate blood glucose levels can be a reason to investigate Cushing's, however, and that may be the reason that prompted your vet to test Hunter.

Another "question mark" relates to his Lysodren dosing. Again, as I mentioned on your other thread, Lysodren treatment typically begins with daily "loading" doses in order to reduce cortisol levels efficiently and rapidly. Once the desired therapeutic range is achieved, the dosing shifts to 2-3 times weekly. So Hunter's dosing has been atypical, but this may be because in combination with his other issues, the internist did not want to induce such a rapid decrease in cortisol in a very short period of time. A post-ACTH level of 5 is a good result with Lysodren, so I understand why they were happy with this test result. The issue will be whether Hunter's cortisol continues to drop lower, so they will need to keep tabs on that.

I will go ahead and close for now as we await results of Hunter's testing today. We may all learn more from those results that can help guide us further down the road. But in the meantime, once again, I'm so glad you've found us.

Marianne

Hi Marianne,
I have him back at home and he has a "severe tracheitis, possibly with a bronchial component". Since diagnosed with both Cushings and Diabetes he gets this cough after he drinks water. Throughout the past 2 weeks it has gotten progressively worse, with the sound of fluid even at rest, when he rises to get up and when he gets excited. Any way, I went on a hunt for the last report for his Cushings results and have not been able to locate it. My reg vet does not have and the internist is not open on the weekend. However, I will attempt to get that faxed to me on Monday. He is going back to the critical care specialist (fancy name for another specialist visit) on Monday to address the findings today. We are trying to get in with a specific internist here to monitor Cushings and diabetes, in hopes someone can help. We were under the assumption that the Cushings test was so good that the diabetes would have fell into place. Wrong on that one, and no one is willing to help educate us on Cushings they just keep saying it's the cause the diabetes cannot be controlled. Now I'm under the belief that the stress of the tracheitis is throwing off the blood glucose numbers. Getting so very very frustrated!! I feel like for the past 4 months I have been tossed about like a bean bag.

[Jules]

Hello and welcome from me too.

Oh my goodness, Hunger does have so much going on. Hopefully with his cortisol lowered and if it stays right around 5ug post ACTH, (and as Marianne said you will want to monitor that regularly for awhile) then his BG will start to be more easily controlled too. I don't know much about BG, but some dogs are more difficult to regulate and different types of insulin has to be tried to hit on the right one for him. So that is another possibility.

What a great furmom. Sounds like you have the diet going well. So that will help with both the diabetes and cushings one assumes. That sinus issue and the CHF will be something that hopefully doesn't get worse, and will stabalize. How of these different things, each contributes to the other and makes the individual one that much harder to get control of. We all understand how difficult it is to manage one to disease, little lone four.

It is all scary, but the more you learn about each one, I think, the more comfortable you feel in the decisions you make along the way.

Welcome to the forum and to the crazy. :)

hugs

Thank you SO much!! Sharlene. I hope that what we are going through will help others as well, because there certainly has got to be a reason my little guy has to go through this. Someone else needs his experience.

[DoxieMama]

Hi Jules, welcome to you and Hunter. I haven't anything to add with what's already been said, but wanted to let you know I'm here too. So many difficult things to deal with at once. I hope you can find someone to help.

Shana

[Jules]

Hi K9C, and thank you for the welcome Shana. So it has been an interesting day!! I will try to keep it to the Cushings as much as I can, although diabetes is playing a huge role! We have our new internist and at 1st glance, Hunter is having a pancreatic attack. Ideally taking him off of the lysodren would be perfect to calm pancreas down, however, if that was done he would have to start the entire battery of testing all over from beginning. So that was a no. They do prefer a drug that starts with a "T" but in the long term they both drugs have the same long term effects. Hunter was first diagnosed cushings and his test was 10.5, I believe, and then came down to 10 and now to 5. So the new internist says that the range they should be in is 1-5. They would prefer him to be in the range not at the top of it, due to his diabetes. I wanted to share the drug facts. I know nothing about either only when I am suppose to give him the doses. So I hope that our experience is able to help.

[Harley PoMMom]

The other medication that is generally used for Cushing's is Trilostane and I bet that is the "T" one the internist is referring to. And in case your interested here's a bit of information about the mode of action between Lysodren and Trilostane :) Trilostane inhibits with the production of cortisol while Lysodren erodes the layer of the adrenal glands that produce cortisol. Also with a diabetic dog, Trilostane should be given twice a day as to help with the fluctuation of cortisol.

Lori

[Jules]

Hi everyone,
I have a 13 year old dog that has cushings decease he is having severe issues with his hind quarter and in a great deal of pain. I have pain meds on board, however, he is on Lysodren and we are at the point where the pain is so severe that prednisone is being discussed.

Please can anyone help with why it will mess with the Lysodren doses?
Jules

[Squirt's Mom]

I have merged your new post with Hunter's original thread. We like to keep all posts about each dog in one thread so it is easier to look back thru the history. It also provides a sort of diary for you of Hunter's journey with Cushing's. ;)

Prednisone mimics Cushing's so it is sort of like fighting fire with gasoline to use pred while trying to treat Cushing's...tho is has been done. Dexa methasone may be a better choice and worth talking to the vet about. But first I would like to know what Hunter's latest ACTH shows to see if his cortisol is controlled or not. Would you please tell us what those results are? Do you see any other signs of the cortisol still being elevated?

What is the cause of such intense pain for Hunter? What pain meds is he on?

[Jules]

I have merged your new post with Hunter's original thread. We like to keep all posts about each dog in one thread so it is easier to look back thru the history. It also provides a sort of diary for you of Hunter's journey with Cushing's. ;)

Prednisone mimics Cushing's so it is sort of like fighting fire with gasoline to use pred while trying to treat Cushing's...tho is has been done. Dexa methasone may be a better choice and worth talking to the vet about. But first I would like to know what Hunter's latest ACTH shows to see if his cortisol is controlled or not. Would you please tell us what those results are? Do you see any other signs of the cortisol still being elevated?

What is the cause of such intense pain for Hunter? What pain meds is he on?

Thank you. He has 2 herniated disks in his back since about 9 years ago. He went through a very violent coughing spell because of the tube, he had to have cataract surgery because of diabetes. He was admitted to ER 2 days ago because of BG of 45. That is under control but they may have mishandled his back and now he is in severe pain. They have 25 mg tramadol every 8 hours 125mg methocarbamol every 8 hours and a shot 2.25 mg of simbadol every 8 hours. He had a "slight" pancreas attack (but hind sight I think it was herniated disks) The ACTH was never discussed.

[Harley PoMMom]

They may believe that there is inflammation that prednisone might help with. As Leslie mentioned prednisone does mimic the cortisol in a dog's body, however if it would ease his pain than this could be worth trying as I wouldn't think he'd have to be on it long term. Another thing that needs to be considered is that the prednisone may fluctuate BG levels.