Update on Athena

[bgdavis]

Re: Update on Athena

Many years ago, we treated Crissy Ann for both Cushings(Lysodren) and diabetes at the same time. On the days she took the Lysodren we adjusted her insulin.

Bonnie and Angel Crissy Ann

[k9diabetes]

Re: Update on Athena

I am not concerned about the dose of insulin and serious resistance until a dog is receiving 1 unit per pound per injection and still has high blood sugar. This is particularly true in dogs with Cushing's disease, who basically always require more than the usual amount of insulin to regulate. Following is an article by a veterinary endocrinologist on these issues.
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This blog entry is on diagnosing Cushing's in a diabetic dog. It includes Dr. Peterson's definition of insulin resistance, which is the same one I have followed.

http://endocrinevet.blogspot.com/2012/01/q-diagnosing-cushings-disease-in-dogs.html

We define insulin resistance as doses greater than 2.2 U/kg/injection to control hyperglycemia (4), so we aren't even close to the doses required to diagnose resistance.

And yes, diabetic dogs can get marked hepatomegaly secondary to fat accumulation in the liver. That can lead to a mild-moderate "pot bellied" appearance.

Because it can be very difficult to make a diagnosis of Cushing's syndrome in dogs with diabetes, observation and monitoring is the best course in many of these patients. If Cushing's disease is present, it will be progressive and other signs will develop to make the diagnosis easier to confirm.

. . . .

Many years ago when I first joined a forum for diabetic dogs, there was a little Westie who had such bad allergies that he couldn't survive without steroids to tamp down his immune system. He was on a lot of insulin and he never got really great blood sugar control but he got good enough control that he went on for many years taking steroids and insulin.

Management with Cushing's disease isn't always pretty - even without Cushing's disease, some dogs have very erratic blood sugar for unknown reasons - but it can be done. Athena doesn't need perfect blood sugar to live a normal life. And if she needs her insulin dose adjusted on a daily basis, that can be done with home testing.
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Other types of insulin may also work better.

Just don't worry about the dose until it's quite high for her size. I've seen a couple of 20 pound terriers who needed 22, 24 units of insulin per injection. Maybe their bodies deactivated some or maybe they just were unusual in their metabolism, but they did fine. They just needed a lot more insulin than most dogs do to regulate, as if they were Cushing's dogs.

Not sure if you've read Chris' case study (http://www.k9diabetes.com/k9diabetes.pdf) but you can see that the road to regulation can be a long one but is worth the trip.

Hang in there - you are only a little way down this road.

Natalie