Please help ASAP, her values are crazy!

[DrRamey]

Hello, all. Been a lurker of this and the sister Cushing's site for a while now and finally feel the need to post.

My 12 year old Golden/Chow mix was diagnosed with Cushing's about three years ago and has since also been diagnosed with liver issues, arthritis and now diabetes (as a result, loosing vision, loosing muscles in back legs and slipping on our floors).

She was diagnosed with diabetes only a couple months ago and we seem to have her levels adjusted well. But I'm really getting concerned with her issues related to her back legs.

We have hard wood floors and keeps slipping. If she's just slow down, she'd be fine. But she freaks out and skitters as fast as she can, slipping even more. We've put a few runners down and are going to go get a couple more just to help her get around in her high traffic areas.

She also has a heck of a time standing up and getting those back legs to cooperate. I used to take her for daily walks, but now have back it way off to about a quarter of our walk (~15 minutes) every other day. Even doing that, she's loosing strength in her back legs and has more trouble getting around the house after our walk.

Lastly, she's breathing pretty hard a lot. Mostly at night but oftentimes during the day as well. She won't pant all the time, but a lot more than I'd like and than she used to.

She is taking Vetsulin, Denamarin, Tramadol and Veteryl. We feed her Castor & Pollux food, as well as adding in boiled chicken to her food. We used to add rice, but our other dog would spit a lot of it out on the floor. We then switched to potatoes, but we read that potatoes might not be good for diabetes.

I know I wrote a lot here, and I'm hoping I can get some good advice for how I can help her? I know her time is short in this world, and it tears me apart seeing her the way she is now. Any advice on how to help her legs? Her panting? Anything?

[momofdecker]

Re: Maggie's having trouble getting around, help?

Hello, welcome to the forum.

There have been several dogs on here who have had rear leg challenges at the onset of a diabetes diagnosis. It seems most of them have been larger breeds and have been mostly labs/lab mixes.

The good news for those who had no other medical complications is that most fully recovered use of their hind legs after awhile.

The cautious news - it seems that some dogs who have underlying medical conditions - the diabetic diagnosis can further complicate things.

Several people on here have used methylcobalamin B12 with their dogs in hopes that it would help with any potential neuropathy. Most can't say whether or not it helped, but it doesn't seem to have any negative impact on the diabetes.

It might be worth taking some video of your pup trying to get up, walking, struggling on the floors, etc... Some things to watch out for - scraping of the nails on the rear feet. Knuckling of the rear paws. Crossing of the rear legs. "Drunkin walk" - or loss of balance. These could also be indicators of a more serious neurological condition.

Maybe seek out a neurologist if you have one near by. Given Maggie's complicated medical history - having a specialist evaluate her might be worth any cost you may incur.

My diabetic dog, who is no longer with me, had mobility challenges. His struggles began in his rear legs and progressively got worse over a 12 month period. His GP vet had suspected Degenerative Myelopathy, so we had continued to walk him as the exercise would have been good for that diagnosis. By the time we took him to a neurologist he was dx. with cervical injury which impacted all four legs. The walking turned out to not be such as great idea given his actual diagnosis.

He did have joint pain and we were able to use cosequin with no notable impact to his glucose levels. He was also on gabapentin, tramadol and ultimately had to be put on steroids (prednisone) to be able to get up and walk (he was 80+pounds). The steroids were contradicted with his diabetes, however, we were home testing his blood glucose and were able to keep on top of things on our own.

My diabetic boy also lost his vision to cataracts - he adjusted very well but the vision loss did make his mobility struggles a bit more challenging. If Maggie still has some vision - it might be worth trying to teach her some verbal commands while she can still see. Things like "up" and "down" for uneven terrain. "Bump" or "Caution" to train her to stop instead of running into something. Anything else you feel would benefit her. Carpet runners will not only help with the mobility struggles - they may also help her feel room transitions on her feet as her vision worsens.

My non-diabetic senior dog had a vestibular incident in January which left him unable to stand/walk for several days. We were able to borrow a 'help em' up harness' from my sister in law, and it was a life saver (at the time he was around 70 pounds). You can google the name and find a host of harness options which may make it a bit easier on you in terms of assisting Maggie, specifically with the rear legs. My guy has recovered enough to stand/walk - but his balance is not great and he is no longer able to navigate stairs going down on his own and needs to be monitored when going up them. We use gates at the top/bottom of the stairs in the house and on the deck steps to keep him from accidentally trying to navigate them on his own.

Panting is a tough symptom. It could mean a host of things. Are any medications new? Is temperature a factor? Pain? Fear? Again, it might be one of those things you need to keep an close eye on and over time evaluate one thing at a time to see if there is an external factor that could be causing it.


Hope things are take a turn for the positive soon. Sounds like Maggie is in great hands.

Holli

[Eddie]

Re: Maggie's having trouble getting around, help?

Hello and welcome

Our dog, Eddie, was one of those who had back leg problems soon after diagnosis. He could barely stand and had to be helped up and propped up by us when he ate or went out to pee etc.

We gave him large amounts of B12 and plugged away at getting his insulin dose sorted out and it gradually went away. Now (3 years plus later) he can run around quite well and he has had no recurrence of the problem. as Holli says, we don't know if the B12 helped but I would give it again in similar circumstances.

It was not a quick thing to fix and it did I am sure depend largely on us getting him to a good dose of insulin. How are you/ your vet managing the process of getting her to the right dose? I remember I was surprised to learn that with insulin there isn't a fixed dose as there is with most medicines but you have to work with each dog and its individual diet to get the correct balance.

Eddie also was very inclined to pant. We never quite knew why and that too toned down over time. I assume that it was perhaps linked to him getting a bit of a blood sugar high soon after eating. It was always worse for about an hour after he ate his evening meal. It went away over time but it is hard to watch. Sometimes encouraging him just to have a drink seemed to help (though at the time he couldn't walk, it was a major operation to get him to the water bowl!).

It might be worth asking your vet for a strong painkiller just to see how Maggie is when you remove any cause of pain. We tried that with Eddie just to make sure it wasn't pain that was stopping him using his legs. The painkiller made no difference at all but at least it ruled out one worry.

I hope she starts to improve soon!
Antonia

[DrRamey]

Re: Maggie's having trouble getting around, help?

Thanks for the replies!

I will have to look into B12, sounds like it's worth a shot. Any advice on what dosage I should give her, or it's probably just best to discuss this with the vet?

I can't give her joint supplements unfortunately. Every time I give her them, she gets UTI-like symptoms. Trust me, I've tried multiple brands, types, liquids, pills, etc. ALL give her these symptoms.

Also, steroids will never be an option due to her Cushing's.

It's good to hear that she can come back from this. It's so hard to watch her struggle to stand and walk around. I know her knees are not good anymore, you can actually see her back right leg move unnaturally, but if her muscles can get better, then it should compensate, at least a little.

The way our vet tested her levels was to do an initial test and started at 13u and then about a month later we tested again and the dosage needed to be upped to 15u. That was about a month ago and we have no plans on re-checking. The vet didn't say when to test again. I just assumed that if she got worse or regressed, then that would be when we checked again.

The panting seems to be an issue mainly at night. She will drink a lot of water and pant. I often have to take her out in the middle of the night now or she will make a mess due to all the water drinking. I believe it has to do with pain, but am not 100% sure. I started giving her a Tramadol at night to try and help; but it's too early to see if that helps or not.

[amydunn19]

It sounds like her blood sugar may not be adequately controlled. The drinking, panting and leg weakness certainly indicate that she may not be regulated. You guys could check her blood sugar at home. Big dogs usually have calluses or skin tags that give good blood without excess pain. We can help if you are interested.

Solving the mobility problem might be as simple as controlling the blood sugar. Many vets don't encourage it but it really can save time and money and give you knowledge to help make decisions. With all of her challenges, her blood sugar should be more closely monitored. I am kind of surprised that the vet seems to not be worried about it.

I know it seems that she doesn't have much life left, but she really can get better. I was told in the beginning, my dog would never make it six months in the shape she was in but she has lived almost 9 years with diabetes. She is in kind of bad shape now but she lived like a normal dog for years. Just a bit more structure to our lives.

[DrRamey]

Re: Maggie's having trouble getting around, help?

It sounds like her blood sugar may not be adequately controlled. The drinking, panting and leg weakness certainly indicate that she may not be regulated. You guys could check her blood sugar at home. Big dogs usually have calluses or skin tags that give good blood without excess pain. We can help if you are interested.

Solving the mobility problem might be as simple as controlling the blood sugar. Many vets don't encourage it but it really can save time and money and give you knowledge to help make decisions. With all of her challenges, her blood sugar should be more closely monitored. I am kind of surprised that the vet seems to not be worried about it.

I know it seems that she doesn't have much life left, but she really can get better. I was told in the beginning, my dog would never make it six months in the shape she was in but she has lived almost 9 years with diabetes. She is in kind of bad shape now but she lived like a normal dog for years. Just a bit more structure to our lives.

I'm curious about checking her levels at home, but the vet said that it's not entirely accurate or reliable. I agree that her levels could be off, and it's very expensive to keep bringing her to the vet for their day long procedure.

[abdamurph]

Re: Maggie's having trouble getting around, help?

I had the same issue with Murphy re back legs, his BG took a long time to regulate and he had the weakness in his legs. I did try the B12 and some other recommended supplements and none of it worked, talked to others who also tried B12 and it didn't work for them either, so I stopped. They did get better once the regulation started but not all the way, he is able to get around ok go up and down stairs and go for short walks. Hang in there it will get better.

[amydunn19]

Anxiety plays a role in the reliability of curves done in vet clinics - scary and unfamiliar surroundings. That attitude always confuses me - More information is better than less. Testing at home turned Maggie's diabetes around completely and added years to her life. In the end, you don't need permission. You guys can do it yourselves if you choose.

[DrRamey]

Re: Maggie's having trouble getting around, help?

Anxiety plays a role in the reliability of curves done in vet clinics - scary and unfamiliar surroundings. That attitude always confuses me - More information is better than less. Testing at home turned Maggie's diabetes around completely and added years to her life. In the end, you don't need permission. You guys can do it yourselves if you choose.

I'm sure I can find out how by Googling or searching here, but while I'm in this thread, do you have any tips then on testing at home? I'd be willing to give it a shot. But if I do find her values are off, I feel that I still need to be in communication with the vet to know what to change her dosage to and also to keep them informed on what's going on.

[Auddog]

Hi there,

My vet didn't encourage testing at home either, so for the first 9 months after diagnosis we didn't test. It was one of the scariest times of our lives. We took so many trips to his normal vet, plus multiple trips to the animal ER, and when I almost lost him to his first and only hypoglycemic event the ER vet and I had enough of it. The ER vet told me to flat out ignore our normal vet and start testing his blood sugar at home. That's when I finally started looking for help and came across this forum. Home testing was invaluable in keeping Bazzle's diabetes under control and letting us live a normal happy life.

I completely agree that you don't have to have your vet's permission to test your baby's blood sugar. When I started testing, at first I didn't tell my vet at all then after I got the hang of things I just kind of told him what I was doing. At first he didn't like the fact that I started home testing, but eventually he realized that out of all his diabetic patients we were the best regulated and had the least amount of problems and then he accepted that I had great control of his blood sugar.

There are a lot of places to test blood sugar on our pups. Personally I tested my Bazzle boy on the inside of his upper lip, just above his canine tooth. Other people use elbow callouses, or carple pads, ears, rumps, or even skin tags. If you'd like to start out practicing you could poke her (not hard, just a tap) in different areas with the end of a mechanical pencil to see if there is any place she won't tollerate.

When it comes time to test, just be aware that human meters typically read dog blood lower than what it actually is. The one touch family seems to be fairly accurate though, which is what Bazz and I used. You should be able to find a starter kit at most pharmacies (walmart usually has the best price) which will include the meter, a lancing device, a few lancets , all in a carrying case. Another thing to be aware of is that the lancets that come with the kits are too small for some dogs, so it would be worth your while to pick up some thicker lancets to go with your starter kit. If you happen to pick up your stuff at walmart, their Relion Brand Lancets that are labeled "thin" are 26 gage and worked really well for us.

Best of luck to you,

Audrey

[amydunn19]

Re: Maggie's having trouble getting around, help?

My original vet told me that testing at home was unnecessary and I listened to her. I just never thought that she could steer me wrong. She never did one curve either and unfortunately was testing Maggie at her highest point instead of her lowest. Not all dogs follow the "book" when it comes to insulin peak times and some drop lowest right before their next meal. So, my vet kept increasing. She had my 11 lb dog on 9 units of insulin at one point. What was really happening was she was overdosed and her body was releasing stored glucose to "save" her and pushing her numbers higher and she likely was having swings from low to high as well. Since their bodies can't continue that type of thing, she finally crashed. And that was it. I changed vets immediately and started testing at home.

When I approached the next vet, I told him testing was not negotiable and he wasn't thrilled but made me promise that I wouldn't change anything without his approval. That is the best possible thing until you learn your dog's patterns and how diabetes works. After a while of consulting him, He finally said that I didn't need to call him every time and he had confidence in my decisions. He always says that I know more about her than he does. So, you just have to work cooperatively but never forget that you have the right to make decisions - you are the advocate for your dog. Some vets just aren't used to having proactive clients.

Here are some links:

http://www.k9diabetes.com/forum/showthread.php?t=4195

http://www.k9diabetes.com/forum/showthread.php?t=2243

http://www.k9diabetes.com/forum/showthread.php?t=957

http://www.k9diabetes.com/forum/showthread.php?t=5895

[Rubytuesday]

Re: Maggie's having trouble getting around, help?

These might help with slipping:

http://tinyurl.com/h6luy2m

I used them for my Labby when she was older. Check them periodically to be sure they aren't too tight around the ankles. They are like balloons for their feet.

Here is some info on B-12:

From a published Japanese study:
New evidence suggests that oral B12 works as well as injections, according to a study published in the journal Blood. This verifies reports from Sweden dating from the 1970s that pernicious anemia, a disease of B12 deficiency, can be controlled with oral B12. (people with pernicious anemia lack the intrinsic factor).
But another form, methylcobalamin, may be the best of all. Research shows that this active form of B12 has the unique ability to provoke the regeneration of nerves without adverse side effects.

And this from another study, Division of Neurology, KingKhalid University Hospital, Riyadh, Saudi Arabia:
We studied the clinical and neurophysiological effects of methylcobalamin on patients with diabetic neuropathy. In a double-blind study, the active group showed statistical improvement in the somatic and autonomic symptoms with regression of signs of diabetic neuropathy.
Methylcobalamin, which is the neurologically active form of B12.This B12 facilitates methylation, the process that creates and maintains nerves and brain chemicals.


The clinical study concerning B12/folate lowering BS is from the European Journal of Endrocrinology:
CONCLUSIONS: Folate and vitamin B12 treatment improved insulin resistance and endothelial dysfunction, along with decreasing homocysteine levels, in patients with metabolic syndrome.
http://www.eje-online.org/content/151/4/483.abstract

I know of no time when B-12 has hurt and it could help.

Regardless I think the most important thing is to start home testing.

Know that others, Antonia and Eddie, Harley and several others have come here with similar issues and have made great progress.

I hope this gives you strength and hope.

Tara

[Riliey and Mo]

Re: Maggie's having trouble getting around, help?

I.d be going to my local pharmacy and pick up a glucose meter, lancets and strips

Start testing at fasting, 2 hours after food and insulin

This is a lifesaver for my dog. I have control of his diabetes

[DrRamey]

Re: Maggie's having trouble getting around, help?

Thanks all for the replies! I'm going to pick up a meter. I'm thinking of the AlphaTRAK since it's calibrated for dogs and I don't have to worry about the conversions. I'd hate to make a mistake. And it's only $55 on Amazon.

[Judi]

Re: Maggie's having trouble getting around, help?

Thanks all for the replies! I'm going to pick up a meter. I'm thinking of the AlphaTRAK since it's calibrated for dogs and I don't have to worry about the conversions. I'd hate to make a mistake. And it's only $55 on Amazon.

it's the strips that can get to be spendy. a lot of people use some freestyle strips in the alphatrak. they can tell you about it. hang in there!

My vet didn't want me to test either until my Jenny got regulated. But she kind of never really got regulated so I just started testing at home and would email him my results.

let us know how it goes.