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  #21  
Old 04-28-2012, 06:06 PM
frijole frijole is offline
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Default Re: What to ask the Vet

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Originally Posted by annie View Post
The vet I saw today was not the same one who has been testing and seeing Koby. I guess my regular vet doesn't come in saturdays.

The vet today is the one who said to hold off on the vetoryl today but start again tomorrow. I won't give it to him again and see what my regular vet says on monday.

As far as not starting insulin yet, my vet said it's possible the high glucose is caused by the Cushings. I'll have to get more definite answers monday, for sure. It seems everything went haywire after the dental cleaning and extraction.

I'll get over to the Cushings forum soon with a few further questions.

Thanks,
Annie
Hi. My name is Kim and I am a mod over at the cushings site that was linked earlier. A member asked me to check in on you. While I am no expert on diabetes I can tell you that cushings does not cause high glucose! Diabetes does.

I have many concerns having read your thread. We have had many members that have had to deal with both diseases. You must focus on the diabetes first and then the cushings. Cushings will not instantly kill a dog but out of control diabetes can. Sorry but I lost faith in the vet right there.

OK... on to the cushings. It is highly likely your dog does not even have cushings. DO NOT spend a dime on testing for cushings until the diabetes is controlled because you will probably get false positives. It is likely your dog does not have cushings and that is why he/she vomited while using the vetoryl. Please cease giving the vetoryl and focus on treating the diabetes.

I'm not sure where you live and what your options are for vets but what you have posted has me convinced you need to find a vet with more experience with these diseases. If there is an IMS (Internal Med Specialist) or a teaching hospital in your area I would go that route. HOwever, if not I would find a doc that knows how to treat diabetes.

The drug you are using for cushings is a chemo drug. It isn't something to experiment with. As you know it isn't cheap either. Don't give any more trilostane/vetoryl. Do focus on the diabetes. If there is also cushings you can deal with that much later - your dog isn't going to die from uncontrolled cushings.

Sorry to repeat myself - just wanted to be clear. I hope this helps. Sending prayers and best to you and your furry one. Kim
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  #22  
Old 04-28-2012, 06:46 PM
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Patty Patty is offline
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Default Re: What to ask the Vet

So glad Kim weighed in on your situation. You can search for a "small animal internal medicine specialist" by putting in the specialty, state, and country here: http://www.acvim.org/websites/acvim/index.php?p=3
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  #23  
Old 04-28-2012, 07:08 PM
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Rubytuesday Rubytuesday is offline
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Default Re: What to ask the Vet

Annie, I am so sorry you are going through this. Having these diagnosis' can be hard enough, but having to ferret out whether the veterinary information you are being told is good info, when we go to these doctors for guidance is so hard.

I can only offer you my experience. My dog and I struggled with three significant health concerns and made no significant headway until I joined an online forum for each one.

Two of the vets I sought help from were good vets, but....I don't know. I am sure it is partly because their patients can't talk and partly because veterinary medicine hasn't become as specialized as human medicine.

So between me being able to read and interpet Ruby and these groups who do specialized in their particular diseases we have made some wonderful headway.

AND that is just with the good vets....then you have the ones who are giving all sorts of conflicting and dangerous recommendations.

It is troubling that there is such a discrepancy between the starting dose for Eileen's dog and yours. I also remember the drugs used to treat for Cushings are pretty scary which would be horrible if Koby was being overdosed.

When I had Ruby tested for Cushings and she came out negative the remark was made that Cushings was very hard to test for and whereas they could be negative one day but positive the next.

I wish you the best and hope Koby feels better soon.

Tara
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  #24  
Old 04-30-2012, 06:06 AM
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Rubytuesday Rubytuesday is offline
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Default Re: What to ask the Vet

Hi Annie,

You and Koby have been on my mind and I am hoping you are both feeling better??

Can you let us know how things are going.

I worry for you in this situation as it can be so overwhelming.

Tara
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  #25  
Old 04-30-2012, 08:57 AM
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Abby's Mom Abby's Mom is offline
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Default Re: What to ask the Vet

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Quote from kim......OK... on to the cushings. It is highly likely your dog does not even have cushings. DO NOT spend a dime on testing for cushings until the diabetes is controlled because you will probably get false positives......
Hi Annie,

Just wanted to extend my welcome, as well, and to put in my 2 cents.

i was in your situation last year - Abby was diagnosed in May with diabetes, and then ontop of that due to high liver functions she had a ACTH test done, and was diagnosed with Cushings.

When initially dosed for Cushings, they suggested NO insulin when she was taking the Trilostane. I only gave Trilostane for one day, and backed off, due to the wonderful folks on the K9Cushings site suggesting that she may not have Cushings, and they provided some wonderful reading material. I then became a member here.

Now one year later, I am convinced she does not have Cushings, as there are no signs of Cushings since she has become somewhat regulated. She certainly is not insulin resistant, and has none of the classic signs for Cushings.

Take it slow, and deal with the diabetes first. You will quickly know if you need to go down the Cushings path.

Welcome to you and Koby.
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  #26  
Old 04-30-2012, 09:10 AM
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eileen eileen is offline
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Default Re: What to ask the Vet

...and, over the years I've seen a number of vets wanting to quickly jump to the Cushings diagnoses for a dog, not really knowing how to treat diabetes.
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Last edited by eileen; 04-30-2012 at 09:12 AM.
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  #27  
Old 04-30-2012, 04:32 PM
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Default Re: What to ask the Vet

Hi Annie,

Welcome to you and Koby.

While I haven't had a dog with Cushing's, I have hung around the Cushing's forum and we have a number of members here whose dogs have both so I have picked up a fair amount about the issues diagnosing Cushing's vs. Diabetes vs. both.

I can tell you that while it's technically possible for Cushing's to raise blood sugar in a dog who does not have diabetes, it is rare and it also usually creates only a mild increase in blood sugar.

So when I see a dog whose blood sugar is sustained over 200, I'd bet a million dollars (if I had it! ) that the dog absolutely has primary diabetes.

And thus should be started immediately on insulin.

And frankly, I'd rather have a dog with primary diabetes than with Cushing's disease because Cushing's is a lot more expensive to monitor and treat and often requires an internal medicine specialist to diagnose and treat it properly.

So I am EXTREMELY concerned that your dog has not yet been started on insulin. Untreated diabetes can be fatal quickly if the dog develops ketones while untreated Cushing's disease is fatal only after long periods of time without treatment.

Please demand that your dog's diabetes be treated and the concern about Cushing's disease be put on a back burner until you see how Koby does on insulin.

Also, it does not sound to me like the vet has adequately tested to determine Cushing's disease and I beg you to stop giving Koby treatment for Cushing's disease. It is very dangerous to give a dog these very serious medications when they quite possibly do not have the disease.

The vomiting Koby experienced could come from the cortisol level being taken too low by treatment for a disease he doesn't have.

This is an all too common but very serious problem - vets jumping to Cushing's diagnoses in dogs who just have plain old diabetes. I'm very worried about Koby's health...

Natalie
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  #28  
Old 05-01-2012, 10:06 AM
annie annie is offline
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Default Re: What to ask the Vet

I've just posted over at the Cushings forum, so I'll relay a little here. Koby went back to the vet yesterday, feeling better and moving around more. His BG was 489 and was given insulin right then. Back to the vet this morn and BG was 179. Going back later for another check. Cushings is still in the diagnosis. I have previous test results, but my scanner isn't working and it would take forever to type everything. Are there any specific results I should post?

Thanks for all the help and concern,
Annie
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  #29  
Old 05-01-2012, 10:19 AM
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Default Re: What to ask the Vet

Good to hear she got put on insulin. Are you doing injections yourself now? Good luck, and keep us posted.
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  #30  
Old 05-01-2012, 10:46 AM
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Patty Patty is offline
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Default Re: What to ask the Vet

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Originally Posted by annie View Post
Right now Koby weighs 38 lbs. We got him from a shelter when he was two. He's now 14. All they told us was he was part terrier, other part unknown.
He is not yet on insulin, but humulin-n was mentioned as most likely what will be used.
Quote:
His BG was 489 and was given insulin right then. Back to the vet this morn and BG was 179. Going back later for another check.
What dose on insulin did they put Koby on? 489 to 179 is a fairly large drop.
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