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  #41  
Old 01-04-2020, 09:51 AM
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jesse girl jesse girl is offline
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Default Re: Who took their dog to a specialist? Advice?

I have not used a specialist and actually jesse hasn't been to the vet for sometime

What are you looking to get from the pow wow ? We have seen some dogs with both diseases and most have done well . Its far from perfect for most

Maybe the specialist can give some tips that is not public knowledge and something to listen for

If you hear what you already know than there may not be much to offer to the discussion
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Jesse-26 lbs - 15.5 years old - 10 years diabetic - one meal a day homemade and a vitabone snack - 3 shots of Novolin a day sometimes Novolog or r as a correction to higher sugar but that is rare. total insulin for a 24 hour period is between 8 and 10 units of NPH insulin depending on her fasting number
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  #42  
Old 01-04-2020, 11:25 AM
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Default Re: Who took their dog to a specialist? Advice?

Hi: My dog had cushings and diabetes and I resisted taking her to a specialist for a long time. Once I finally did I wished I had done it sooner. So I think this is a smart move.

My primary vet emailed all of her records to the specialist before our visit but they still wanted to do their own work ups. My Jenny was on Lysodren for her cushings when most vets were using Trilostane (it's been so long I think that is what it is called). The specialist told me that while he might have initiated a different treatment for her, what she was doing was working so we stayed the course. My biggest questions were about the concurrent treatment for the 2 diseases. Plus her sludgy liver, etc.

I think I asked what they recommend food wise too

I think the specialist visit was around $700 and I still felt like it was worth it. I was there on a Saturday and they stayed past their normal closing time because we'd driven so far to get there and spent a lot of time with us.

my dog's icky breath was always dental related so I can't answer that.

Good Luck!

I still have the letter from the specialist on my computer. I think it helped a lot that he had her previous tests. They compared, kidney, calcium, liver, everything to her previous tests. Definitely try to get those records to them.
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Jenny: 6/6/2000 - 11/10/2014 She lived with diabetes and cushings for 3 1/2 years. She was one of a kind and we miss her.

Last edited by Judi; 01-04-2020 at 11:33 AM.
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  #43  
Old 01-05-2020, 12:24 AM
anotherk9lover anotherk9lover is offline
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Default Re: Who took their dog to a specialist? Advice?

My main reason for taking her to a specialist is to help understand how to regulate diabetes with the cushings. My vet suggested to take her to a specialist because the cushing's vetoryl dose isn't working too well for her, even the smallest dose, is a bit too much for her. So he doesn't seem to know what else to do at this point. the sugars have also been difficult to control
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  #44  
Old 01-05-2020, 12:25 AM
anotherk9lover anotherk9lover is offline
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Default Re: Who took their dog to a specialist? Advice?

$700?! wow that's a lot, is that with all the blood workup? I will try to avoid any extra labs, i'm there purely for advice. They always upsell labs, but daisy had them done recently so I don't see the need for redoing them.

Did you have to keep coming in for follow ups? How has the specialist helped you?
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  #45  
Old 01-05-2020, 08:45 AM
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Default Re: Who took their dog to a specialist? Advice?

my Jenny died a few years ago. I stick around the boards to try to help with cushings/diabetes and keep up with some of the people who helped us.

We only saw the specialist the one time. He was in conjunction with our regular vet. I think the biggest expense was the ultrasound that he insisted on doing and in our case it was good. My regular vet was wrong about the type of cushings Jenny had.

Everyone advised me to see a specialist because the 2 diseases can be tricky to regulate together. I balked and we almost killed off Jenny's cortisol. The specialists see these conditions more often.

In December Jenny's ACTH was perfect for her cortisol and her blood sugar was pretty well controlled. over the next few months her insulin need decreased rapidly (at one point her blood sugar was 40!)

I'm a CPA so I just thought we were doing a great job and kept reducing her insulin till after April 15th.

Once we went to the vet after the 15th we found out her cortisol was barely registering.

That is when we went to the specialist.

We went to Blue Pearl and their goal was just to advise and work with our regular vet.

We never needed to go with them and Jenny managed with both diseases for 3 1/2 years. We let her go when she was getting dementia, walking in circles, and really not enjoying her life anymore. She was 14 1/2 and I don't think it was cushings or diabetes related.

So, I think seeing the specialist is an excellent idea and another resource for you and your vet. Getting their advice on the treatment for both diseases is beneficial because they see things so often. Jenny was a 7 pound poodle so we were doing crazy things like giving her cushings meds every 3 days or twice a week. We had to keep a calendar in the kitchen just for her medicine schedule.

I just wanted to warn you about the cost because I had the ultrasound my regular vet had done but the specialist felt he would be more accurate if he did his own.

hang in there. I tried to not sweat the small stuff and focus on if my dog was enjoying her life. There are ups and downs managing both of these at once but if I can do it anyone can. After Jenny's sugar went scary low I did learn how to test blood sugar at home. It took me 3 horrible days but it was worth it.

Judi
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Jenny: 6/6/2000 - 11/10/2014 She lived with diabetes and cushings for 3 1/2 years. She was one of a kind and we miss her.
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  #46  
Old 01-05-2020, 06:59 PM
anotherk9lover anotherk9lover is offline
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Default Re: Who took their dog to a specialist? Advice?

Quote:
Originally Posted by Judi View Post
my Jenny died a few years ago. I stick around the boards to try to help with cushings/diabetes and keep up with some of the people who helped us.

We only saw the specialist the one time. He was in conjunction with our regular vet. I think the biggest expense was the ultrasound that he insisted on doing and in our case it was good. My regular vet was wrong about the type of cushings Jenny had.

Everyone advised me to see a specialist because the 2 diseases can be tricky to regulate together. I balked and we almost killed off Jenny's cortisol. The specialists see these conditions more often.

In December Jenny's ACTH was perfect for her cortisol and her blood sugar was pretty well controlled. over the next few months her insulin need decreased rapidly (at one point her blood sugar was 40!)

I'm a CPA so I just thought we were doing a great job and kept reducing her insulin till after April 15th.

Once we went to the vet after the 15th we found out her cortisol was barely registering.

That is when we went to the specialist.

We went to Blue Pearl and their goal was just to advise and work with our regular vet.

We never needed to go with them and Jenny managed with both diseases for 3 1/2 years. We let her go when she was getting dementia, walking in circles, and really not enjoying her life anymore. She was 14 1/2 and I don't think it was cushings or diabetes related.

So, I think seeing the specialist is an excellent idea and another resource for you and your vet. Getting their advice on the treatment for both diseases is beneficial because they see things so often. Jenny was a 7 pound poodle so we were doing crazy things like giving her cushings meds every 3 days or twice a week. We had to keep a calendar in the kitchen just for her medicine schedule.

I just wanted to warn you about the cost because I had the ultrasound my regular vet had done but the specialist felt he would be more accurate if he did his own.

hang in there. I tried to not sweat the small stuff and focus on if my dog was enjoying her life. There are ups and downs managing both of these at once but if I can do it anyone can. After Jenny's sugar went scary low I did learn how to test blood sugar at home. It took me 3 horrible days but it was worth it.

Judi
So did you constantly take her in for bloodwork to manage the cushings? How were you keeping her on irregular doses? and what made her sugar go so low?
Daisy has been on 5mg/day vetoryl for a few months, and the last blood work showed that her pre cortisol level was pretty low, 0.9, so my vet said to take her off the vetoryl for now, which is why i'm taking her to the specialist.

I'm sure they will push for more ultrasounds and labs bc that's how they make the money, but I'm not doing another ultrasound. When she had it done in July I paid $400 just for the u/s and it didn't show anything significant other than fatty looking liver. I'm sure nothing has changed since then, since she was at her sickest at that time in July.
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  #47  
Old 01-06-2020, 06:27 AM
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Default Re: Who took their dog to a specialist? Advice?

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Originally Posted by anotherk9lover View Post
So did you constantly take her in for bloodwork to manage the cushings? How were you keeping her on irregular doses? and what made her sugar go so low?
Daisy has been on 5mg/day vetoryl for a few months, and the last blood work showed that her pre cortisol level was pretty low, 0.9, so my vet said to take her off the vetoryl for now, which is why i'm taking her to the specialist.

I'm sure they will push for more ultrasounds and labs bc that's how they make the money, but I'm not doing another ultrasound. When she had it done in July I paid $400 just for the u/s and it didn't show anything significant other than fatty looking liver. I'm sure nothing has changed since then, since she was at her sickest at that time in July.
My specialist wanted the ultrasound to see the adrenal glands. As my dog's cortisol went too low, the insulin needs went low. Because Jenny's cortisol went so incredibly low we were able to do the first part of the ACTH a couple of times which was cheaper and didn't take 3 1/2 hours just to see where she was at. I tested her blood sugar at home twice a day before I fed her.

I think the specialist's advice on how to treat the cushings will be invaluable. Hopefully after this one visit you can work with your regular vet.

I think over the 3 1/2 years we probably had 3 ACTH tests done and the cheaper first part of it done twice. Of course we accidentally killed Jenny's cortisol to the point that she didn't take any cushings meds for the last year of her life. It was kind of a relief

Knowledge is good. The specialist I met with was just a huge dog lover and very helpful. My other vet was good too and we worked with the regular one until she died.

You do the best you can and you keep your dog enjoying life. hang in there! Judi
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Jenny: 6/6/2000 - 11/10/2014 She lived with diabetes and cushings for 3 1/2 years. She was one of a kind and we miss her.
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  #48  
Old 01-06-2020, 10:47 PM
anotherk9lover anotherk9lover is offline
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Default Re: Who took their dog to a specialist? Advice?

Came back from the specialist apt today. They did an adrenal scan for free for me because their sister hospital seems to have missed it when Daisy was hospitalized. That was nice of them. And the scan showed normal adrenal glands, which she said means she's unlikely to have cushing's, but doesn't totally rule it out so confused, since her low dex test was positive. sigh.. this is frustrating. Was Jenny's adrenal scan abnormal?
We're going to take Daisy off of vetoryl for now.

As far as Diabetes, she wasn't all that thelpful, didn't explain too much to me, she just said she wants Daisy to go on one unit less from 6 to 5un, because it seems like she's on a high dose for her size and may be overcompensating or something. But on 5 units Daisy had a pretty high curve. This specialist says she also doesn't discuss curves over the phone, that I would have to take her in each time which is kind of BS, I can't do that. So it looks like from now on will just have to go back to my regular vet. But I am thankful that they did that adrenal scan bc it's an important piece of info to have.
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  #49  
Old 01-07-2020, 07:12 AM
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Judi Judi is offline
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Default Re: Who took their dog to a specialist? Advice?

Quote:
Originally Posted by anotherk9lover View Post
Came back from the specialist apt today. They did an adrenal scan for free for me because their sister hospital seems to have missed it when Daisy was hospitalized. That was nice of them. And the scan showed normal adrenal glands, which she said means she's unlikely to have cushing's, but doesn't totally rule it out so confused, since her low dex test was positive. sigh.. this is frustrating. Was Jenny's adrenal scan abnormal?
We're going to take Daisy off of vetoryl for now.

As far as Diabetes, she wasn't all that thelpful, didn't explain too much to me, she just said she wants Daisy to go on one unit less from 6 to 5un, because it seems like she's on a high dose for her size and may be overcompensating or something. But on 5 units Daisy had a pretty high curve. This specialist says she also doesn't discuss curves over the phone, that I would have to take her in each time which is kind of BS, I can't do that. So it looks like from now on will just have to go back to my regular vet. But I am thankful that they did that adrenal scan bc it's an important piece of info to have.
Good news on the adrenal glands. My Jenny's adrenals were very irregular. My vets did say that cushings is misdiagnosed often and the medicine really only treats the symptoms. So if Daisy isn't horribly thirsty, starving, going bald or getting a big belly, laying off the Trilostane is probably the right thing to do.

With your baby coming soon I know you want to get a handle on this. So maybe you need to simplify. Lots of our vets didn't want to work with information from us and most of us either convinced our vet or found one who would work with us. So I vote dispensing with the specialist for now.

You had questioned diet and carbs in the past. For whatever reason, some fiber and some carbs helps the insulin last for 12 hours with the dogs. I obsessed over the icky ingredients in the prescription dog food for months. My dogs eye doctor swore by the Purina because it tasted better.

Finally, I just went with it. It looked hideous but for the time that Jenny was willing to eat it, it worked. You really can't argue with results, it works for a lot of dogs.

The insulin changes, as you know, take a while to kick in. If Daisy has some dental infection that could be causing her blood sugar to be a little high. Dogs can handle blood sugar that is a little high, it is the lows that are worrisome.

hang in there. Judi
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Jenny: 6/6/2000 - 11/10/2014 She lived with diabetes and cushings for 3 1/2 years. She was one of a kind and we miss her.
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  #50  
Old 01-08-2020, 11:45 AM
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Default Re: Who took their dog to a specialist? Advice?

you have eliminate from the equation . the cushings . medicating for something not present can be big deal . now you know what you are dealing with . it sounds like the specialist wants to start over as far as dosing . its to bad they wont allow you doing the tests but i guess i understand that as they are putting there reputation on the line based on their test

actually this is something you can do without a vets help . i have done it for almost 10 years
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Jesse-26 lbs - 15.5 years old - 10 years diabetic - one meal a day homemade and a vitabone snack - 3 shots of Novolin a day sometimes Novolog or r as a correction to higher sugar but that is rare. total insulin for a 24 hour period is between 8 and 10 units of NPH insulin depending on her fasting number
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