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MikeMurphy 01-04-2014 01:31 PM

Lily - My English Setter
 
Hi Everyone,

Just came across this very helpful site and thought that I would share some information about our six year old diabetic English Setter, Lily.

Here's a picture of Lily in 2012, before being diagnosed with diabetes ...

https://s6.postimg.cc/y8nynpwsx/IMG_0032.jpg

Lily was first diagnosed with diabetes in August 2013 after she suddenly became very lethargic and would not eat. After running some tests, our regular vet determined that she had a bladder infection along with very high blood gloucose levels > 600. The vet gave her antibiotics and told me she was diabetic and needed to be on insulin.

To make a long story short, Lily started out getting 5 units of Novolin N twice a day that gradually increased to 29 units. After several expensive trips to the vet for blood gloucose profiles that always had ranges > 500, the vet finally determined that Lily was somehow resistant to insulin. The vet then had blood work done for hypothyroidism and cushings disease. The results came back negative. It was now late November 2013. The vet switched her insulin to Vetsulin and that did not help.

By now Lily was getting more sluggish, started loosing hair, getting a dull coat getting black skin on her belly and her toenails started getting flaky. All the reading I had done on insulin resistance in dogs pointed to hypothyroidism, but my vet kept insisting that was not it.

So in December 2013, I decided we needed a second opinion and took Lily to a veterinary internal medicine specialist, who immediately saw that she had a thyroid problem, did a full thyroid profile on her which came back positive.

The specialist put her on Soloxine tablets twice a day and the insulin immediately started working. Lily's blood sugar levels are now consistently < 200! Thank God and her specialist! She is now back on Novolin N, 18 units twice a day.

Her coat is now starting to fill out. Unfortunately, she now has developed cataracts and can't see. We now have to deal with that. For now, She is doing well finding her way around the house. Her internalist has recommended a very good eye vet. I'll keep you posted.

Thanks for listening.

Mike

k9diabetes 01-04-2014 01:40 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
What a beautiful girl! She's lucky to have persistent people caring for her!

Natalie

maladuca 01-04-2014 01:47 PM

Hi Mike and Lily! Thank you so much for sharing your story!
My dog Teddy (44 lb cockapoo) has a similar story - started on 5 units of Novolin in June - is up to 19 units now and is still showing blood glucose numbers in the 500s and an occasional 600. His numbers are all over the place. It seems as if we could just keep on raising the insulin level! Someone from this site (Mo) just suggested to me yesterday that I should have Teddy's thyroid levels checked. He has skin allergies, thinning hair, black spots on his stomach and is gaining weight despite his high numbers. Other problems include many tumors, cataracts which led to glaucoma and blindness.
You have encouraged me to seriously look into having him tested. Thanks for sharing!!
Margaret

CraigM 01-04-2014 01:57 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Just have a moment, but wanted to welcome you and say how beautiful Lily is!

Craig

MikeMurphy 01-04-2014 02:49 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Quote:

Originally Posted by maladuca (Post 121632)
Hi Mike and Lily! Thank you so much for sharing your story!
My dog Teddy (44 lb cockapoo) has a similar story - started on 5 units of Novolin in June - is up to 19 units now and is still showing blood glucose numbers in the 500s and an occasional 600. His numbers are all over the place. It seems as if we could just keep on raising the insulin level! Someone from this site (Mo) just suggested to me yesterday that I should have Teddy's thyroid levels checked. He has skin allergies, thinning hair, black spots on his stomach and is gaining weight despite his high numbers. Other problems include many tumors, cataracts which led to glaucoma and blindness.
You have encouraged me to seriously look into having him tested. Thanks for sharing!!
Margaret

Hi Margaret,

Thanks for the kind words. If you do decide to have Teddy tested for hypothyroidism, make sure they do a full thyroid profile. The basic thyroid tests can be inconclusive, as was Lily's basic testing.

Good luck with Teddy.

Mike

amydunn19 01-04-2014 03:00 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Welcome to you and Lily! She is just stunning! I am glad you got her another opinion!

momofdecker 01-04-2014 03:07 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Welcome to you and Lily -what a beautiful girl - love her point!

My non diabetic boy had a white boxer for a mom and we were told dad was a lab. But he is mostly white with two large black spots on his butt and both eyes/ears are black. As he matured he got many more black spots and lots of feathering along his underbelly, legs, ears and tail. We suspect dad had some spaniel or setter in him - LOL!

How much does Lily weight? Is she spayed?

My diabetic boy suffered from undiagnosed hypothyroidism too. Kudos to you for being so persistent in getting it diagnosed! He was overdosed at 40u of Humulin N in the beginning. We ended dropping him back to 20u, which was twice too much, then to 15u and starting over. He was 97 pounds. From Dec. 2011 to May 2012 he went from 15u to 37u and his blood glucose (bg) remained 300 - 600+ most of the time. We noted his bg did seem to do better in warmer weather. In May 2012 we switched him to levemir (which is four times as potent as humulin/novolin). He started at 5u levemir and was worked up to 10u before we started testing for concurrent diseases. When he started his thyroid meds his levemir insulin needs dropped from 10u to 6u over a five day span. After a couple of weeks it dropped back to 5u - a 50% reduction in insulin.

The AAHA Guidelines have information on how to manage diabetes in dogs and their website states, https://www.aahanet.org/Library/DiabetesMgmt.aspx

"Assessment
The initial evaluation of the diabetic dog and cat should:
Assess the overall health of the animal (history, physical examination, medications, diet).

Identify complications associated with the disease (e.g., cataracts in dogs, peripheral neuropathy in cats).

Identify concurrent problems often associated with the disease (e.g., urinary tract infections, pancreatitis).

Identify conditions that may interfere with response of the diabetic to treatment (e.g., hyperadrenocorticism, hyperthyroidism, renal disease).

Evaluate for risk factors such as obesity, pancreatitis, insulin-resistant disease, diabetogenic medications, and diestrus (in the female dog)."

Though hypErthyroidism is mentioned for cats, hypOthyroidism is not mentioned for dogs in terms of identifying conditions that may interfere with response of the diabetic to treatment . Makes one wonder how many GP vets truly understand the impact a low thyroid can have on a diabetic dog and trying to manage their insulin needs.

Unfortunately for my boy, his main symptoms centered more around his behavior than his physical appearance. By the time he was finally diagnosed he had most of the clinical signs but prior to that he had a full thick coat, was high energy and was a very nervous and reactive dog. We truly didn't understand the full impact the thyroid meds had on him until about four months after he'd been on them. He remained nervous but the reactivate behavior he'd had for many years went away. He too lost his vision to cataracts but did quite well - it took a couple of weeks for his sense of smell and hearing to take over but once they did and his energy level returned to normal - he was quite amazing to watch!

Glad you found your way here and thank you for sharing Lily's story. Best of luck to you both on this continued journey of yours!

Holli

MikeMurphy 01-04-2014 03:28 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Quote:

Originally Posted by momofdecker (Post 121638)
Welcome to you and Lily -what a beautiful girl - love her point!

My non diabetic boy had a white boxer for a mom and we were told dad was a lab. But he is mostly white with two large black spots on his butt and both eyes/ears are black. As he matured he got many more black spots and lots of feathering along his underbelly, legs, ears and tail. We suspect dad had some spaniel or setter in him - LOL!

How much does Lily weight? Is she spayed?

My diabetic boy suffered from undiagnosed hypothyroidism too. Kudos to you for being so persistent in getting it diagnosed! He was overdosed at 40u of Humulin N in the beginning. We ended dropping him back to 20u, which was twice too much, then to 15u and starting over. He was 97 pounds. From Dec. 2011 to May 2012 he went from 15u to 37u and his blood glucose (bg) remained 300 - 600+ most of the time. We noted his bg did seem to do better in warmer weather. In May 2012 we switched him to levemir (which is four times as potent as humulin/novolin). He started at 5u levemir and was worked up to 10u before we started testing for concurrent diseases. When he started his thyroid meds his levemir insulin needs dropped from 10u to 6u over a five day span. After a couple of weeks it dropped back to 5u - a 50% reduction in insulin.

The AAHA Guidelines have information on how to manage diabetes in dogs and their website states, https://www.aahanet.org/Library/DiabetesMgmt.aspx

"Assessment
The initial evaluation of the diabetic dog and cat should:
Assess the overall health of the animal (history, physical examination, medications, diet).

Identify complications associated with the disease (e.g., cataracts in dogs, peripheral neuropathy in cats).

Identify concurrent problems often associated with the disease (e.g., urinary tract infections, pancreatitis).

Identify conditions that may interfere with response of the diabetic to treatment (e.g., hyperadrenocorticism, hyperthyroidism, renal disease).

Evaluate for risk factors such as obesity, pancreatitis, insulin-resistant disease, diabetogenic medications, and diestrus (in the female dog)."

Though hypErthyroidism is mentioned for cats, hypOthyroidism is not mentioned for dogs in terms of identifying conditions that may interfere with response of the diabetic to treatment . Makes one wonder how many GP vets truly understand the impact a low thyroid can have on a diabetic dog and trying to manage their insulin needs.

Unfortunately for my boy, his main symptoms centered more around his behavior than his physical appearance. By the time he was finally diagnosed he had most of the clinical signs but prior to that he had a full thick coat, was high energy and was a very nervous and reactive dog. We truly didn't understand the full impact the thyroid meds had on him until about four months after he'd been on them. He remained nervous but the reactivate behavior he'd had for many years went away. He too lost his vision to cataracts but did quite well - it took a couple of weeks for his sense of smell and hearing to take over but once they did and his energy level returned to normal - he was quite amazing to watch!

Glad you found your way here and thank you for sharing Lily's story. Best of luck to you both on this continued journey of yours!

Holli

Hi Holli,

Thanks for the info. Lily weighs 64 lbs and is spayed. I think you are right about many GP vets. Lily's vet only did the T4 thyroid test. Her specialist did the full thyroid profile and that was the key to a correct diagnosis.

Mike

Riliey and Mo 01-04-2014 03:45 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Welcome Mike, your Lily is absolutely georgeous, just love her picture thankyou
Glad she is on the right path.

Mo

MikeMurphy 01-09-2014 08:44 AM

Re: Lily - My English Setter - Diabetes and Hypothyroidism
 
Hi All,

Back with an update on Lily. I've been reporting her BG levels back to her internalist twice a week and so far so good. This week's levels range from 104 to 229 and the internalist is happy with the progress. The next step will be going to the eye vet.

Here are couple more pictures (hope you don't mind).

The first picture was taken the day after we found out that Lily was diabetic. She's with her best friends Carly, Dakota and Carly's sister Maisy.

The second was taken today and shows the effect that hypothyroidism has taken on her. She lost practically all her tail, leg and belly feathering, but it is starting to come back now that she is on Soloxine.

Mike

https://s6.postimg.cc/rw4ojilap/IMG_0185.jpg

https://s6.postimg.cc/7bqntjqs1/70d7...9a434cb6e2.jpg

Soaphie & Sydney's Mom 01-09-2014 08:53 AM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Great news!

And fantastic pictures - I love that her friends were willing to "pose"!

Abby's Mom 01-09-2014 10:32 AM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Wonderful news.... she is beautiful. So glad that you were able to determine why she was insulin resistant, and took her to an IMS.

Barb

momofdecker 01-09-2014 04:21 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Great update! Great picture with all the buddies! What a shot of her tail - the feathered tails are one of my favorite features of the setters - glad the coat is on the road to recovery too!

amydunn19 01-09-2014 05:22 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
What a lovely group and a great update:)

CarolW 01-09-2014 08:44 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Sending our best wishes to you, Mike and - gorgeous Lily! SO glad you took her to an IMS (specialist in Internal Medicine). What a great service you did with that report on Lily's hypothyroidism. Love your pictures!

We - Kwali and Kumbi at the Bridge, and non-diabetic Camellia and me on Lowly Earth, wish you and Lily the best!

MikeMurphy 01-16-2014 09:50 AM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Hi All,

I've noticed a couple of recent posts mentioning possible insulin resistance caused by hypothyroidism.

Here are a couple of articles that helped me consider hypothyroidism as the cause of Lily's insulin resistance. Some of it is kind of technical.

The second link is a question and answer with Dr. Dodds.

http://endocrinevet.blogspot.com/201...esistance.html

http://seattletimes.com/html/tailsof...e_in_dogs.html

Ignore the pop-up ads.

Mike

parisa 01-16-2014 10:29 AM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
She's a beautiful dog and lucky to have such a great owner :)

MikeMurphy 02-06-2014 11:08 AM

Re: Lily Update
 
Hi Everyone,

Just wanted to say how great this site is! I login every day and always learn something new.

A lot has happened with Lily over the last few weeks. Lily has a new primary vet who is very caring and very knowledgable concerning diabetes and thyroid issues. At our first visit she drew blood for a follow-up full thyroid profile. The results came back and all her tests were normal. The new vet forwards everything to Lily's IMS.

Every time I do BG curve, I email the readings and graph to her new vet.

Now that her BG levels and thyroid issues have been regulated, we have been considering whether she should have cataract surgery. Her IMS and new vet both recommended the same eye vet, so Lily had her initial visit with the Eye vet last week to see if she is a candidate for surgery. Her eyes were a little inflamed from the rapid development of cataracts, so the eye vet put her on two different eye drops.

We just returned from a second visit to the eye vet and everything looked good. Lily is scheduled for cataract surgery on February 20. One of the eye drops has a steroid in it, so I'll have to watch her BG level for any changes.

Here's a couple of pictures taken today. It's zero degrees out there. The snow does not want to stop. We had another foot yesterday.

https://s6.postimg.cc/83oqf05ld/9154...c2c5458f99.jpg

https://s6.postimg.cc/fwjzkq0y9/815b...2887abd9eb.jpg

Mike and Lily

Monsters Momma 02-06-2014 11:29 AM

Re: Lily Update
 
Hi Mike!
A late welcome from Vinny and I!! Lily is an absolute beauty! I've only seen red setter's, I never knew there was anything different!!

I had a dog several years ago that had hypothyroidism and it wasn't until we took him to Purdue for an evaluation that we found this out. I can relate to how hard it is to get it right. This same dog had a torn patella tendon and surgery for it when he was about 2 and lymphoma later in life. Until Vinny was diagnosed with diabetes, Ollie was the one who was considered 'our most expensive dog'. Now Vinny is looking like he'll beat that between all the things he chewed up early on and now the vet bills and insulin! Sounds like you can relate with Lily! Don't we love our pets!!?? She is very fortunate to have such an advocate in you.
Mel

jesse girl 02-06-2014 11:45 AM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
great update

glad lily is a candidate for surgery and glad you got her in there to take care of the inflammation those are things to keep am eye on .

Charlie's mom 02-06-2014 06:22 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Oh is she pretty!

momofdecker 02-06-2014 06:29 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Someone else whose snow comes in feet - so (or snow) much fun - LOL! I swear between delays, snow days, vacation days, half days, etc.. my child has not had a full week of school since some time in October. Our district used their fourth of five snow days yesterday.

Lily looks great - her tail is recovering nicely - and her coat is filling in beautifully! Sounds like all in all she is doing well and that you have a great support system set up for her. Keep up the good work!

amydunn19 02-06-2014 06:50 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
She is so pretty! Maggie had cataract surgery and it went well but there can be complications so there are no guarantees. Their eyes look really rough after surgery - lots of redness for quite some time and the eye drop regimen is crazy but it is doable.

Judi 02-06-2014 07:31 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
what a beautiful girl! please keep us posted on how her surgery goes. I know craig has mentioned that the steroid eye drops did affect his Annie's blood sugar so I'm glad you are watching. Judi

Abby's Mom 02-07-2014 02:58 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
She is absolutely beautiful and so glad that she is doing well. I see that her coat has come in quite nicely. Good luck with the surgery in a few weeks.

Barb

peggy0 02-07-2014 03:03 PM

Re: Lily Update
 
She is gorgeous. My dog had cataract surgery; no issues; lots and lots of drops! that did raise his BGs. His eyes looked normal the day after with the exception of a bit of squinting that he was doing. The doctors will give you all the watch outs! I'd do it again if presented with the issue. Good luck

Patty 02-08-2014 03:32 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Gorgeous coloring! Good luck with surgery and keep us posted. Sounds like you have a collaborative vet which helps so very much!
Patty

MikeMurphy 02-08-2014 04:50 PM

Re: Lily - Update
 
Lily's eye vet and many on this forum have suggested to keep an eye on her BG levels because of the eye drops that she is getting in preparation for cataract surgery.

Since Lily has been on the eye drops, I have been checking her levels every other day around six hours after her morning insulin shot. This is when her readings are lowest. Up until Friday the levels ranged from 105 to 142. Then on Friday it was 363, so I did a curve today.

The results are about 100 over her normal readings for each time interval.

I have to pick up her thyroid meds at the vet on Monday, so I'll run this by her. My guess is that we may have to increase her insulin by one unit and see what happens.

Mike and Lily

peggy0 02-08-2014 06:55 PM

Re: Lily Update
 
I had to increase Forbin a few units as well

k9diabetes 02-09-2014 01:28 AM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
I absolutely LOVE that photo of her on the couch!! :)

Patty 02-09-2014 12:57 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Oh my...she's adorable. Makes you want to just curl up with her ;). Good luck with the dose increase. My Ali was pretty sensitive to insulin and we used to have to move in smaller increments than a full unit. But sounds like you know her ranges pretty well and how much she can handle. Give her a belly rub from us...her coat looks so soft :)

Monsters Momma 02-10-2014 10:37 AM

Re: Lily - Update
 
I really don't have knowledge about the cataract surgery and what leads up to it in regards to eye drops and bg levels, we've been lucky so far, but the others will chime in. I just wanted to wish you good luck and tell you again just how gorgeous I think Lily is! :)
Mel

MikeMurphy 02-21-2014 06:45 AM

Lily's Cataract Surgery
 
Lily had her cataract surgery yesterday and everything went well. I took her in at 8:30 and picked her up at 4:00. Once she got home, we started her new array of meds, she had a full meal at 8:00PM and then her full dose of insulin.

She was restless most of the evening and finally fell asleep around 1:00AM and woke up at 7:00AM. BG levels are good. Best of all ... She can see us already.

My fingers are crossed that she continues to improve.

We go back next Thursday for her follow up visit.

Here she is with her new hat ...

https://s6.postimg.cc/6nr0236tt/IMG_0561.jpg

And, oh my, her new meds ...

https://s6.postimg.cc/lkzh33k29/IMG_0562.jpg

The sun feels good ...

https://s6.postimg.cc/j4xnp91zl/IMG_0459.jpg

amydunn19 02-21-2014 06:50 AM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Oh she is so pretty even with her hat! All those meds - that brings back the memories - i had to set alarms to keep them all straight. It is a tough road but worth it. Glad she is doing well.

jgr789 02-21-2014 08:31 AM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Good luck with all the aftercare!

Glad she is doing well.

Judy

momofdecker 02-21-2014 09:16 AM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Great news for Lily & family! Thrilled that she can see again and she does carry her 'hat' very well - such a beautiful girl! Wishing you the best for a continued speedy recovery. That med picture says it all!

MikeMurphy 02-21-2014 12:19 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Amy, Judy, Holli,

Thanks for your thoughts! This is turning in to a full time job, but we do love our dogs. :) It's a good thing I retired last September.

Mike

Soaphie & Sydney's Mom 02-21-2014 12:23 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
She is so beautiful!

Charlie's mom 02-21-2014 07:07 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
She is so pretty, even with her cone of shame!

Auddog 02-21-2014 08:28 PM

Re: Lily - My English Setter - Diabetis and Hypothyroidism
 
Send cyber hugs, healing vibes, well wishes, and good luck with the aftercare :)

Audrey & Bazzle


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