Australian Cattle Dog with Cushings & Diabetes

[Nutlike2102]

Blue Healer, 9 years old.

Went to the vet with Polyuria, Polydipsia, minor Alopecia, Polyphagia, Panting and Behavior change. Vet confirmed diabetes with suspicion of cushings. Weighed 40lbs. A week later went back to vet for a low dose dex test that took 8 hours. Weighed 38lbs. Vet sent the samples off and apparently the lab no longer does that test so those samples are gone. It's a few days later after the test and she now weighs 35lbs. She no longer has an appetite like she did before the test. Small town vet with no resources and no alternatives. Vet is ordering insulin and cushings drugs but it's going to take time. She may not have much time now if she continues to lose weight and refuses to eat. Insulin will be useless without a full stomach and as for the cushings drugs; with no tests to actually confirm it, I don't know if the proper dosing and tests will be performed. I've educated myself on cushings and diabetes at https://www.veterinarydiagnosticinvestigation.com/continuing-ed

I had other questions but that was before she started losing her appetite. If I can get a hold of the vet on the weekend I don't know that they will have anything on hand to help her. So we'll see...

[labblab]

Hello and welcome, although I’m so sorry to hear that you two are really struggling this weekend! I’ll return a bit later on to write more, but wanted to quickly tell you we received your gmail reply, and that you’re membership is now fully approved.

Thanks so much, and I’ll be back!
Marianne

[labblab]

Also, in the meantime I want to give you the link to a companion forum that is devoted to canine diabetes. Of the two disorders, I believe treatment of diabetes is your most immediate priority.

https://www.k9diabetes.com/forum/

Unfortunately, just as is the case with us, their readership has been slowing down in recent months (A lot of people seem to now prefer Facebook groups). So I don’t know how quickly you’ll get a direct response to any questions you may have for them. But they also have a lot of resource info that may be a help to you, as well.

[Nutlike2102]

Thanks. I didn't know about the diabetes forum. I was just looking for comparisons of meters and now I have them thanks to you. These K9 forums are not easy to find initially. Bookmarked now.

My sisters dog had diabetes and I was hoping she had some test strips leftover so I could check my dogs levels this weekend. Turns out she never tested her dogs blood and also used the same vet. I was under the impression it was important to monitor glucose at home in order to not give too much insulin.

The only thing I can get her to eat today is fresh cooked ribs meat. She didn't want FreshPet or the home cooked BalanceIT recipe I cooked. Absolutely no kibble. I guess as long as she eats something through the weekend she might pull out of it long enough for the vet to get the insulin ordered.

[labblab]

OK I’m back again and so wishing I had some brilliant suggestions to give you :-((((. I think inappetance is one of the most stressful issues for owners to try to deal with, and I especially understand why it’s an especially huge issue for you now. My elderly Lab periodically gets really picky and during those times I struggle to find something she’ll accept. Sometimes scrambled eggs will tempt her, sometimes jarred baby food, sometimes actual canned dogfood. But it’s so anxiety-producing, and in your case, I’m sure it’s doubly so since it may be related to metabolic imbalances from diabetes. I don’t know whether you’ve taken the time to create a membership at k9diabetes, but if so, they might be able to give you some better informed feeding suggestions.

I’m sure you’ve gotten some accurate info from the website for “Veterinary Diagnostic Investigation and Consultation” services. The chief medical officer, David Bruyette, is very well known to us and was actually a member of our forum here many years ago. He’s definitely a world-renowned endocrinological expert, and if time allows it, maybe you and your vet might actually wish to arrange a consultation with him. Although I realize that the immediate hurdle is probably just getting ahold of the insulin and testing your girl’s glucose level.

As I say, I sure wish I had some worthwhile tips in that regard. At this point, I realize that Monday morning can’t come soon enough! You can certainly continue to check in here with us in the meantime, and if any brainstorms occur to me, I’ll definitely let you know.

Sending healing wishes to your sweet girl,
Marianne

[Nutlike2102]

Here is an update for today:

Last night before bed she threw up all the meat she was able to eat during the day. So I got her some beef broth to drink before bed. She's still picky today, eating a bite here and there. So far what she has taken has stayed down.

I did register on the diabetes forum but have not received an activation link yet.

I took a blood glucose test with a human tester knowing it wouldn't show the most accurate number but I would at least know if it was high or low. 299 mg/dl which I guess is on the higher end. I don't know how much over or under it might be off though.

[labblab]

Surely hoping your girl made it through OK until this morning, and that now your vet will be able to give you the support you’re needing. Thanks for yesterday’s update, and we’ll be hoping for some improvement when you have the chance to write once again.

Marianne

[Nutlike2102]

I went into the office but the vet was in surgery so I had to go back home. Still waiting for a return phone call back.

Update:

I was given Cerenia and Omeprazle. The vet didn't seem to think it was related to diabetes. The vet is still going to treat the cushings but not the diabetes. Cushing meds are still a week out.

She threw up again last night and is becoming weaker, unable to jump up onto the couch which is already low to the ground.

It's hard to say what is going on. I looked in her mouth for signs of a tooth infection but didn't see anything. She could have some sort of food poisoning but she hasn't eaten anything the other dogs haven't. She seemed to start getting bad after she came home from her LDDS test so I'm wondering if she didn't pick up some illness from another dog being housed alongside her that day. She's been sleeping since coming home from the vet visit today. No food yet for the day.

[Nutlike2102]

I just now noticed that her drinking water is turning red in color. Possibly blood? I've looked in her mouth for dental decay or an injury but didn't see anything. Does anybody have any insight on what this could mean? My main goal is to get her eating and gaining weight again but I need to figure out what is causing it first. Is this all related to cushings or is this something else entirely?

Update:

I did a more thorough search and there is a small amount of blood at the gum line of a tooth. Could this be the cause of her refusal to eat and stomach sickness? The vet should have checked for an infection while I had her there yesterday. I always bring in a urine sample but they never use it. The tooth isn't loose and the blood is not always there every time I look in her mouth.

[labblab]

Thank you for this update, but I have to say I’m very worried about your girl. It’s important for you to know I’m not a vet myself, and it makes me uncomfortable to question your own vet, especially since you don’t have any alternatives. But you’ve come to us for our input, so in good conscience, I have to share my concerns.

Did your vet check your girl’s glucose level again yesterday? I would surely hope so, and if it’s still elevated I don’t understand why he isn’t exhibiting urgency about lowering it. Regardless of whether or not she has Cushing’s, and whether or not Cushing’s is playing a role in the diabetes, consistently elevated glucose needs to be addressed ASAP. Like, immediately! Just from reading the news, I realize that insulin supplies and costs are a huge national issue for humans, so I imagine veterinary supplies may be an issue, too. So maybe your vet is having a hard time getting it?? Otherwise I cannot understand why he isn’t focused first on getting her glucose level down if it remains elevated. Dealing with the possibility of Cushing’s can, and likely should, come later.

Here’s one big reason why. The LDDS test that your girl was given is very vulnerable to returning “false positives” in the face of other physical illnesses or stress. Therefore, an ill dog suffering from the effects of uncontrolled diabetes is at a much higher risk of testing “positive” even if she doesn’t really have Cushing’s at all. For this reason, we’ve been told by endocrinological specialists that it’s best to try to control diabetes first, before proceeding to test for Cushing’s. And at that stage further down the line, a different diagnostic test — the ACTH stimulation test — may be preferable, anyway, because it’s less likely to be skewed by the presence of other nonadrenal illnesses.

Your girl really sounds ill to me right now. I don’t know what to make of the bleeding from the gums, but it doesn’t sound good to me. I did find this info which may be relevant:


People with uncontrolled diabetes tend to get periodontitis more often than the average person or those who keep their diabetes under control. Some signs that you have gum disease include: Red, swollen and/or bleeding gums.

Also, weight loss is a common symptom of diabetes, and elevated glucose levels can also cause loss of appetite. The exact opposite is the case with Cushing’s — we see ravenous appetite and weight gain. Truly, it seems to me that your girl’s most pressing problems are most likely associated with diabetes. As a final issue, if she’s not eating, I can’t even imagine how the Cushing’s medication will be of use to you when it arrives. One huge warning is to never give it to a dog who is not eating or otherwise appears to be unwell. It *must* be given with a regular meal to be metabolized properly. And as I’ve said above, at this stage the accuracy of the Cushing’s diagnosis seems questionable, anyway.

Is there any possible way in which you could get a second opinion about all this? Truly if not, I’d press your vet as hard as possible re: the elevated glucose if your girl’s level remains abnormally high. I truly don’t understand why he is choosing not to treat what can quickly become a life-threatening illness.

Marianne

[labblab]

P.S. Are you still waiting to be approved over on k9diabetes? If so, I’ll try to contact the staff to try to speed things up!

[Nutlike2102]

Thank you for your help. I honestly don't have anyone else who I can talk to about this.

The vet did not check anything yesterday. They gave her fluids but not an IV. The vet said the blood reading I took from home (299) wasn't all that high as they normally see 300 to 700 ranges. So we are not getting any insulin, just the cushings medications, of which I don't know the exact one.

I am trying not to voice my personal opinion of my vet but I am concerned and I'll leave it at that.

I brought in 3 mornings urine samples (always refrigerated) when my dog was given her LDDS test and I was hoping they would test her cortisol levels in the urine as well. If both came back positive, it would have lent more weight to a cushings diagnosis. I got this from David Bruyette. Urine was not used. I bring in a urine sample every visit, as it's no trouble for me. The vet cannot get the ACTH tests they said. I thought the vet would take some x-rays after her positive LDDS result to see if it was her adrenal glands or pituitary. But no x-rays. The vet does try to keep costs down but I don't mind paying if it means my dog is getting the care she needs.

I bought my own Alphatrak meter and am going to test her blood when I am confident I have it figured out. I'll update here with the result. I hope I don't have to re-home this meter soon.

The vet said my dog didn't look that bad yesterday and that they have seen worse. I highly disagree as I have never seen my dog look this bad. She stumbles when she walks, walks incredibly slow and is always cold to the touch. You can feel her ribs and she continues to lose weight. I'm biased of course as I am her owner but I don't see her coming out of this slump unless she's given more care and attention.

I have been searching for another vet but it's going to be a long drive when I do.

Update:

Her reading was 442.

I have an appointment at the vet in the morning.

[Nutlike2102]

P.S. Are you still waiting to be approved over on k9diabetes? If so, I’ll try to contact the staff to try to speed things up!

My username is Zoology1603 (randomly generated by my password manager) over there. Still waiting approval. I appear to be a spammer as I don't share personal information online. Any help you can lend me would be greatly appreciated.

[labblab]

My username is Zoology1603 (randomly generated by my password manager) over there. Still waiting approval. I appear to be a spammer as I don't share personal information online. Any help you can lend me would be greatly appreciated.

Thanks for this info — I’ll send off a note to the administrator over there right now. I hope they can start talking with you ASAP. Please keep us updated after your vet visit tomorrow!

[labblab]

I’m so relieved to see that you’re now registered and getting help over at K9D. I’m a member there, as well, so I’ll be monitoring all your updates over there, too. That’ll save you from having to report everything twice in both places unless it’s a help for you to do so.

Definitely good luck with your vet visit this morning!

[Nutlike2102]

We just got kicked over to using Wedgewood pharmacy now. I am seeing other posts on the forum that it is not a good choice and that I should instead be using https://www.cfspharmacy.pharmacy/veterinary-medicine/trilostane-tablets-compounded. I ask because we are not doing well at the moment and I am unsure if it is the Trilostane that is at the heart of our issue. https://k9diabetes.com/forum/forum/diabetes-discussion-your-dog/5324-diabetic-australian-cattle-dog?p=254321#post254321

[labblab]

I’ve been checking over on K9D daily to try to keep a watchful eye on Bear and also a couple of other dogs we share. Since we’d not heard anything for a while, I was *so* hoping that things were going well for you guys. Darn!

I just now quickly scanned your thread over there, and it sounds as though there are several moving pieces that could be injecting variability — her heat cycle, the insulin change, and also the shift to Wedgewood. I know I’m not telling you anything you don’t already know, but it does make for a puzzle. As far as Wedgewood, they are used nationally by a lot of vets. Years ago, there were some issues with them, but I don’t know whether there have been any recent problems. It could be, though, that switching the formulations could have an effect on how Bear is metabolizing the medication.

Were you ever able to get her cortisol level checked by the old vet? I think I harped enough on that in the past that you’ll know that remains a top priority for me, especially in conjunction with increasing her dose. As always, I’ll be letting the K9D folks guide you in terms of the insulin. And either tonight or tomorrow I’ll plan to also add a note over there in order to consolidate our thoughts on that thread so that you don’t have to post in both places. So I’ll be talking to you again soon over there. I’m sure sorry you guys are having another rough patch, but I’m glad that you’re checking in so that we can all put our heads together.

Marianne

[Nutlike2102]

Nope. I haven't actually been to the vet again since I was finally given the insulin. So no tests were done. They have new owners now.

[labblab]

OK, I just now posted my new reply to you over on K9D, so we can continue our conversation over there now ;-)

[Squirt's Mom]

Hi,

Just wanted to offer a VERY belated welcome to you and your sweet girl.

I wish I could offer more input but I know very little about Diabetes mellitus...and in truth that is the only disease that scares me to pieces. I've dealt with cancer, diabetes insipidus, Addison's, Cushing's, hydrocephalus, and other diseases but DM turns me into jelly. I give injections so it's not that part that bothers me and I can't really say what it is that gets to me but something surely does. So I always have the utmost respect for all who deal with this particular disease. You are all heroes in my book!

Hugs,
Leslie