Need help with Ben

[Vanessa]

Dear all,

I am very glad I stumbled upon this forum as I am in desperate need of information.
My dog, Ben, who is 10/11 years old (cross-breed but looks like a Toy Manchester Terrier) has been disgnosed with disbetes in December, just before Christmas. Today, he is on his death bed. Is it normal?

Our vet started him on a low insulin dose (caninsulin - we are in Europe) and gradually increased it to 8.5 . Ben had been losing weight all this time, refusing to eat Hill's W/d and we started feeding him chicken (refused barley, oats, broccoli, wd canned food, wd dry food soaked in broth). His thirst nver subsided, pees three times / night and sugar levels have remained high (24-21). Last Sunday he started vomiting water as soon as he drank it. We went straight to the vet who put him on an intravenous drip and he r cover d slightly, only to relapse yesterday and he is again on drip.

Our vet is suspecting he has Cushing's disease (tests are underway but will have to wait two weeks for results as they have to be sent to the UK - no analysis is possible where I live). I am suspecting Ben might have Addison's too, which is why I am writing to see if from your experience Addison's can occur with simultaneously with high rather than low blood glucose levels.

The symptoms Ben is showing do not tally completely with all the information I am finding on the Internet for Cushing's (his coat is still velvety and he has no pot belly). I am worried as it seems that for my vet this will be the last attempt to save Ben's life and I am doing my best to leave no stone unturned before that happens.

Do you have any suggestions?

[tonyr]

Re: Need help with Ben

Hi,
I just wanted to point out he cannot have Cushings and Addisons as they are totally opposite.
Cushings is overproduction of cortisol from the adrenal glands due to high levels of acth from the pituitary which is causing the adrenal glands to produce too much cortisol (steroids).

Addisons are when the adrenal glands dont produce enough cortisol due to say a pituitary tumour or adrenal tumour.

The Cushings is overproduction and Addisons is underproduction of cortisol from the adrenal glands, both display similar symtoms.

[Eddie]

Re: Need help with Ben

Hello and welcome

I'm sorry you are having such a worrying time with Ben.

I don't know much about Cushings etc so I would wait for more expert people on that to comment, but I did just wonder what his weight is as you say he is a toy terrier. I wonder if he is maybe getting a bit too much insulin and his body is reacting to that by pushing his sugar levels up.

On the food question I wonder if you can go back to whatever you used to feed him if he will still eat that. Alternatively we find our dogs will usually prefer wet food mixed with their kibble and cooked eggs if they are in a very picky mood. He needs ideally to get something with some carbohydrate in it, not just protein.

I am sure there will be others with more Cushings experience along soon.

Antonia

[Vanessa]

Re: Need help with Ben

Thank you for your replies.

Ben's insulin dosage was determined according to his initial weight (he was just over 10kg in December - he lost almsot 2 kg since). He is now getting 1.5 units / 2 hrs.

He was allowed to eat some food this evening, but again he only wanted chicken.

Vet is now not ruling out other underlying tumors. He also told me that Addison's is normally associated with low glucose levels (Ben's are high). It is still unbelievable how fast Ben's health deteriorated. I know I cannot keep giving him intravenous fluids and now time is pressing.

I'll pray he survives the night now.

[jesse girl]

Re: Need help with Ben

my jesse was sick for quite a long time but she pulled though and has been doing will for sometime

for some pups just have more of a difficult path but more many newly diabetics it can take 2 to 3 months with just gtting back to more normal behavior

fingers and paws crossed for some improvement in just feeling a bit better

[Magoo's Mom]

Re: Need help with Ben

Hi and so sorry to hear about Ben. Did the vet do a full blood panel when he was dx? Surprisingly many dogs are allergic to chicken. We had a terrible time with Magoo vomiting, listless, not eating, until we discovered he was allergic to chicken. Feed him Royal Canine Gastro low fat. He also gets some well cooked, very well drained (rolled in paper towels and dried) bison. Very lean and highly digestible. Hills used to make a product called a/d (not sure if they still do)which was in small cans and very soft and really stinky and easily digestible. Used it a lot with my previous dog who had IBS, diabetes, chronic pancreatitis, etc. Scrambled egg is also good or baby food. Small amount of mashed baked sweet potato mixed with some food might also be worth a try. I have also used tuna water with his food. You might try hand feeding small amounts and see if he can keep it down. Prayers are with you. Hope he is better soon.

[amydunn19]

If he doesn't look like a Cushings dog, he likely isn't. Most cushings dogs have the physical attributes. The problem is uncontrolled diabetics do have many of the same symptoms.

It sounds like your dog has pancreatitis - can you get a second opinion?

[tonyr]

Re: Need help with Ben

I would second that and change vets if needed.
If he is a decent vet and knows something about diabetes then that would seem an obvious first check
How is he today.

[Vanessa]

Re: Need help with Ben

Dear all,

We managed to survive and Ben is actually much better today. He wagged his tail when a family member visited to see him and ate his chicken willingly in the morning. He will be getting royal canin as from his next meal.

He is now on 4iu/6 hrs.
Vet said Ben has some alcaline phosphates in blood that could point to cushing's. I have to do more research on this, so cannot tell.
Ben is still getting intravenous fluids - otherwise he vomits immediately. Glucose levels at 29 today, but they were HI yesterday, so there has been some improvement.
Can this be a severe case of ketoacidosis? Are there any pet parents with experience of this who can share some advice? I am going to keep him on intravenous fluids for as long as he needs it - we are with him 24/7, and we are ready to do anything that can save him, as long as he still responds.

[MikeMurphy]

Re: Need help with Ben

If he doesn't look like a Cushings dog, he likely isn't. Most cushings dogs have the physical attributes. The problem is uncontrolled diabetics do have many of the same symptoms.

It sounds like your dog has pancreatitis - can you get a second opinion?

Agree with Amy here. It sure sounds like pancreatitis. Many of our pups have gone through this as it is very common with diabetic dogs.

Has your vet tested for pancreatitis?

[amydunn19]

Re: Need help with Ben

Maggie had DKA and pancreatitis originally so it could be both or either. Pancreatitis diagnosis is an easy blood test. The SPEC cPL will tell you if that is it. I would think the level of ketones and certain levels in the CBC would be indicative of DKA - the elevated BUN (urea) indicates a toxin is present, high liver enzymes, high cholesterol, low levels of phosphorus, potassium and sodium. Elevated white blood cells may also be present. So, blood tests can give a pretty clear picture.

I would ask for that SPEC cPL test. It shouldn't cost much and would explain vomiting.

Glad that your Ben is better - take it slow. Fluids are great so glad you can give them at home.

Cushings is a very common MISdiagnosis in unregulated diabetics. There are specific Cushings tests that would have to be performed and many are false positives or inconclusive so I would be leery. IMO, Cushings is what vets go to when a dog doesn't respond to insulin. If Ben wasn't trying to eat you out of your house and home, then I would have another reason to doubt Cushings. Sometimes, there are many other reasons for dogs not responding to insulin and can be an easy fix. If you want great Cushings information, check out out sister site, k9cushings.com. The people there are great - super knowledgeable. It will ease your mind.

[Vanessa]

Re: Need help with Ben

I thought I'd give you an update on Ben.

After a very long week Ben is now out of the thicket and doing well. He recovered from severe ketoacidosis thanks to a five-day long intravenous fluid treatment.

We switched to Royal canin which he loves and eats heartily. The only problem is that, while the food is giving him all the nutrients he needs, he still asks for more when he is fed. We are being very disciplined with food and feeding and insulin times.

We are also using Insulatard now, and he is on a 5iu dose twice daily, every 12 hrs. Glucose levels fell immediately as soon as we started using it, but we are still trying to find the right dose, and sugar levels are still going up and down. They are sometimes in the 20s (evenings) and I hope this will not lead to another ketoacidosis episode. Peeing and thrist abated.

Still waiting for test results. Being tested for pancreatitis too and already have pancreatic enzymes on reserve. Still not convinced it is Cushing's.

I also ordered a glucometre from the US (the brand suggested on this forum) to start home testing and plot a more exact curve and understand how Ben's body is reacting to insulin throughout the day. I am carefully reading the case study on this website to hopefully make informed decisions.

Many thanks for all your suggestions and help. It meant a lot to me, especially last week when we were really on thin ice.

[Eddie]

Re: Need help with Ben

That's a nice update. It sounds as if things are gradually improving for you and Ben. Testing at home will help as well so it's great that you plan to do that.

I haven't heard of that brand of insulin being used for a dog before - interesting that he seems to need so much less of it than he needed of the Caninsulin.

Hope things carry on getting better!
Antonia

[farrwf]

Re: Need help with Ben

Good to hear he's doing better. You'll get to the bottom of it.

[Vanessa]

Re: Need help with Ben

Thank you for your well wishes.

Insulatard is insulin intended for human use, but as Caninsulin was not working we had to find something else. I think it is stronger than Caninsulin, and we immediately saw a drop in glucose levels. Today they are hovering between 15 and 17. We still have some way to go, but we can see some light at the end of the tunnel now!