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Old 09-30-2018, 02:39 PM
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YukiesMom YukiesMom is offline
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Default Diabetes, Cushings and Pancreatitis in my Dog

I am new to this forum and I was referred by the K9Cushings Forum. I have a 13-year-old American Eskimo named Yukon. In April 2018, after doing and ACTH stem test he was diagnosed with Cushing's disease. We started him on a very low-dose and Vetoryl and it did not seem to agree with him. We did for their extensive testing through an internal medicine doctor sent to the University of Tennessee and found out that his body was not producing too much cortisol but why is producing three other adrenal hormones. Because of this I ended up putting him on flex hull lignans and melatonin. Things have been going very good the last for 4-5 months with the increase in drinking dropping significantly in the panting as well. I do want to also note that my dog is very complex - he also has allergies, and invertebral disc disease, several bouts of pancreatitis as well as the vet telling me he has inflammatory bowel disease. About six weeks ago he ate a fish up with ham on it and had to have emergency surgery to remove the hook from his small intestine. We thought he was recovering fine, he did get a skin infection at the suture site and had to be put on antibiotics for two weeks. About a week ago I noticed he was starting to have diarrhea and then occasionally vomiting. I brought him to the doctors and they were treating him for a small intestinal inflammation with secondary pancreatitis and had him on metronidazole and Cerenia. He was not getting better after about four days even being on an IV for three days. He is drinking and peeing so much I knew something was wrong so we brought his first morning urine in and found out that he now has diabetes on top of the Cushing's. I have read that having both are very hard to manage. We just started him on insulin and the peeing and drinking of water have not really decreased and he still is very lethargic and you can tell he's not feeling well. I am hoping that someone can please help me to understand what I need to look forward to doing to make him happy and make sure his diabetes and Cushing's can both be regulated. He is my baby and this is very devastating to both myself and my husband. Thank you,
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Old 09-30-2018, 06:11 PM
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MikeMurphy MikeMurphy is offline
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Default Re: Diabetes, Cushings and Pancreatitis in my Dog

Hi and welcome to you and Yukon.

Let us know a bit more about Yukon... his weight, insulin type, insulin dose, insulin frequency, food.
__________________
Lily is a 62 lb English Setter, born 07-27-2007.
Diabetes: Aug 2013 - Hypothyroidism: Dec 2013 - Cataract Surgery: Feb 2014
Insulin: Novolin R/N mix - Meter: ReliOn Prime
Nulo Adult Trim Cod & Lentils, Pumpkin, FortiFlora, Dasuquin, Thyroxine
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  #3  
Old 10-01-2018, 05:07 AM
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Default Re: Diabetes, Cushings and Pancreatitis in my Dog

I’m so glad to see that you’ve registered here with the k9diabetes folks — I know they’ll be a great help to you! I’ll keep checking in, as well, to see if there are further developments on the Cushing’s front. To quickly summarize that side of things for the members here, I believe it was actually a LDDS test that was positive for Yukon last April at the time he was started on a low dose of Vetoryl. However, since he reacted poorly to the Vetoryl, we worried that perhaps the LDDS result was a “false positive” due to other physical stresses including pancreatitis. When he was retested last May with a full ACTH adrenal panel analyzed at University of Tennesse, his cortisol was at the higher end but within normal range. However, he did exhibit elevations in other adrenal hormones and that prompted the therapy with melatonin and lignans, to which he responded well.

As I’ve written over on K9C, if Yukon’s cortisol has remained within normal range, then I don’t believe the other adrenal elevations pose an issue in terms of complimentary diabetic treatment. I do wonder, however, whether his cortisol may have increased since last spring and is contributing to his problems. If so, ultimately that may end up being a factor that requires control as well. However, it seems that the first priority right now is to try to manage the glucose level, especially since Cushing’s testing could be skewed while the diabetes is uncontrolled. So I believe that’s where things stand right now on the Cushing’s front. And as I say, I’ll keep checking in here to see how things develop.

Marianne

Last edited by labblab; 10-01-2018 at 06:45 AM. Reason: To add.
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Old 10-01-2018, 11:35 AM
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YukiesMom YukiesMom is offline
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Default Re: Diabetes, Cushings and Pancreatitis in my Dog

Yukon has actually dropped his weight from 32 pounds to 29.6 pounds over the last 7-10 days due to illness and dehydration. He was just put on the Vetsulin 0.4IU twice a day on Saturday - we give it to him at 7:00 a.m. and 7:00 p.m.

Yukon loves treats - he has his routine at my Mom's, Home Depot and a neighbors house.

He currently is on Royal Canine Hydrolized Protein Dog Food and Treats - and I mix in Green Beans and now Boiled Chicken Breast.

Since the diagnosis - I have been giving him the Hydrolized Proten Dog Food with Boiled Chicken twice a day and in between I have been giving him Green Beans.
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Old 10-01-2018, 12:48 PM
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Default Re: Diabetes, Cushings and Pancreatitis in my Dog

I find it interesting that a cushing dogs becomes diabetic . Maybe the elevated cortisol is the factor as we have seen with dogs given steroids that they can become diabetic .

The multiple times of having pancreatitis probably had an impact of becoming diabetic and something to try to prevent from happening in the future if possible

So you are giving 4 units twice a day which is a bit lower than a normal starting dose for your dogs weight which would be 6 units which i dont have a problem with

A cushing dog not treated with medication usually will see insulin resistance which means a dog is given a large dose of insulin with little movement of blood sugar going lower

Now we have seen thyroid issues and cushing symptoms kind of overlap in there appearance and ended of being a thyroid problem. hopefully mike can address that as his dog lily is being treated for thyroid issues and worked there way through that and is doing well
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Jesse-26 lbs - 14 years old - 9 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 6 and 8 units of NPH insulin depending on her fasting number
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Old 10-01-2018, 01:18 PM
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Default Re: Diabetes, Cushings and Pancreatitis in my Dog

We sent out labwork to the University of Tennessee on 5/29/2018 and Yukon's Post ACTH Result for Cortisol was 13.4ug normal range was 7.1 - 15.1. He was high in Androstenedione ng 6.10 Post ACTH Result and normal range is 0.24 - 2.90, also Estradiol Post ACTH Result 77.9pg and normal range is 23.3 - 69.4, and also 17 OH Progesterone ng Post ACHT Result was 3.03 and Normal Range is 0.25 - 2.63.

Because of this we figured that is why he could not be on the Vetoryl and I started the Lignans and Melatonin to reduce the stress hormones. He has had Chronic Pancreatitis for the last 7 years - started when he ate a prime rib end at a New Year's Eve Party and he has had several flare ups since then.

When he had the fish hook removed about 6 weeks ago the surgeon said his pancreas and liver were enlarged and she took a biopsy of the liver. We sent it out and it came back non-specific inflammation possibly caused by Inflammatory Bowel Disease.

Then about 4 weeks later - excessive drinking, peeing, diahrea and some vomiting and now diagnosed with diabetes.
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Old 10-01-2018, 01:32 PM
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jesse girl jesse girl is offline
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Default Re: Diabetes, Cushings and Pancreatitis in my Dog

The pancreatitis is the biggest problem . My jesse had it at the beginning of this journey and spent 10 days in hospital

I changed her to a homemade diet and one meal a day and haven't seen a full blown episode . There were a few times with digestive issues and fasted her for 24 hours which got her back on track

Maybe something in the diet that may not be agreeing with the pancreas but diabetes and cushings can stress out organs

do you have any information on blood sugar and what levels your dog is at ?

definitely recommend testing sugar at home especially with added challenges
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Jesse-26 lbs - 14 years old - 9 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 6 and 8 units of NPH insulin depending on her fasting number
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Old 10-01-2018, 03:35 PM
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MikeMurphy MikeMurphy is offline
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Default Re: Diabetes, Cushings and Pancreatitis in my Dog

Hi again.

With Yukon just starting out with 4 units of Vetsulin every 12 hours, the standard protocol most vets would follow to get a dog’s blood glucose under control would be:

1. Wait 5 to 7 days, allowing your dog’s body to adjust to the current insulin dose.
2. Perform a 12 hour blood glucose curve, testing his BG before eating and continue to test every 2 hours up to his next meal.
3. Evaluate the results of the curve.
4. If his lowest BG reading is greater than 150, increase insulin by 1 or .5 units.
5. Keep repeating steps 1 to 4 until the lowest BG is below 150.

The goal is to get where his BG is between 150 to 250 most of the day and his diabetic symptoms are gone.

As jesse girl said, 4 units twice daily is a very conservative starting dose for Yukon’s weight, but that’s OK. It’s safer to start out lower than higher. And home BG testing is a great way to help manage diabetes.

Stay vigilant with the pancreatitis and watch the fat. It looks like his current food has around 17% fat. That should be OK.

Hopefully, you won’t see any insulin resistance. Proceeding slowly is really the only way.

Natalie(k9diabetes) has provided some great info on managing a dog’s diabetes here...
http://www.k9diabetes.com/

If you have any questions, we’re here to help.
__________________
Lily is a 62 lb English Setter, born 07-27-2007.
Diabetes: Aug 2013 - Hypothyroidism: Dec 2013 - Cataract Surgery: Feb 2014
Insulin: Novolin R/N mix - Meter: ReliOn Prime
Nulo Adult Trim Cod & Lentils, Pumpkin, FortiFlora, Dasuquin, Thyroxine

Last edited by MikeMurphy; 10-01-2018 at 03:42 PM.
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Old 10-01-2018, 04:37 PM
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YukiesMom YukiesMom is offline
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Default Re: Diabetes, Cushings and Pancreatitis in my Dog

Thank you Jesse Girl and Mike Murphy for your responses and insight. I am going to give you all the high numbers in his blood work. On the ProCyte Data his Mono was 1.23 with the normal range between .16 - 1.12 K/ul. On the Chemistry Data (HSZ) his GLU was 486 normal range between 74-143 MG/DL, p02 was 92.6 normal range between 24-54mmHg, cS02 is 97.6 normal range between 40-90%. On the Chemistry Data (ICD) his GLU was 478 MG/DL, and his Liver Enzymes which have been elevated for at least a year are ALT 150 U/L normal range between 10-125 U/L, ALKP is 796 U/L normal range is 23-212 U/L.

What is very strange is that his Pancreas levels are fine. AMYL is 1277 normal range is 500-1500 U/ L and LIPA is 1240 normal range 200-1800 U/L.

He has been eating grass lately as well. What do you recommend using to test his sugar at home? I am going for the test Wednesday to find out more. I wonder if the cushings and diabetes is enlarging his liver and pancreas.
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Old 10-01-2018, 06:47 PM
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MikeMurphy MikeMurphy is offline
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Default Re: Diabetes, Cushings and Pancreatitis in my Dog

As far as home testing meters go, the AlphaTrak2 and Advocate PetTest are the most popular dog meters. A lot of us use human meters like the OneTouch Ultra2 and OneTouch UltraMini. I have been using Walmart’s ReliOn Prime for 5 years.

Just be aware that human meters generally read a bit less than pet meters. For me it doesn’t matter because I’m looking for trends when testing and the BG readings in the lower ranges are very close.

Your biggest expense will be test strips. Pet test strip can be as high as $1 each. Human test strips are way less. The ReliOn Prime strips are less than $.20 each.
__________________
Lily is a 62 lb English Setter, born 07-27-2007.
Diabetes: Aug 2013 - Hypothyroidism: Dec 2013 - Cataract Surgery: Feb 2014
Insulin: Novolin R/N mix - Meter: ReliOn Prime
Nulo Adult Trim Cod & Lentils, Pumpkin, FortiFlora, Dasuquin, Thyroxine
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