Diabetic Australian Cattle Dog

[Zoology1603]

Re: Diabetic Australian Cattle Dog

There has been no discussion of monitoring cortisol levels. I don't think they intend to do any tests. We're supposed to go back in October but no specific date was given or decided upon.

[labblab]

Re: Diabetic Australian Cattle Dog

Uh. Oh. Don't start yet tomorrow. I won't be able to spend time on the forum tonight but I'll be back tomorrow to talk more. The monitoring is crucial and we can train your vet if we have to. But you need to have a monitoring plan in place before starting.

Just wanted to come back and add that it may be the case that your vet is indeed planning to test, but hasn't informed you about the specifics yet -- maybe all they're telling you now is that you'll need to be coming back. Details to follow. But we need to make sure of that. The resting cortisol test isn't hard -- just a simple blood draw. But we can talk about all that more tomorrow.

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

heres the changes in 8 days
we need consistenty....high blood sugar....


taking fasting glucose averages between 6, 7, and 8 am. not consistant. it needs to be taken every 12 hours.
food and amount is changed everday. food and amount needs to be consistent.
weight 32 lbs 14kg recommended 7 units (14x.5)...
started 8 units compensate her putting weight back on
35 lbs 15 kg 9 units up to 10 reduce to 9 .


9/17 32 lbs 14 kg
8 units

f 562 food change

2hrs 586am 664 pm


9/18
8 units

f 591 food change

6 hr 324


9/19 35 lbs 15 kg

9 units
f 485 food change

6hr 468



9/20
9 units food change holistic and hills

f 549 am 460 pm
6 hr 508


day 7
9/21 9 units food change pure balance and holistic

f 578am 428 pm
6 hr 510


upped to 10 units



9/22
10 units food change 968 cal
reduce back to 9 in pm


f 561
6 hr 635
reduce back to 9


possible reduction to 8, its possible theres too much insulin, also hills w/d has yet to be added inafter reducing 1 or 2 units and she.s still high i.d start the cushing med as it needs monitoring. we can let up abit monitoring her bg concentrate on cushings. get the cushing meds levelled out before her fluctuating bg because of being unspayed.



please post her weight and her tests from last night and this morning.
can you fasting test same time everday please?

[labblab]

Re: Diabetic Australian Cattle Dog

OK, I’m back. As I wrote last night, for Bear’s safety, a monitoring plan must be established before starting the trilostane. Blood testing is important because overdosing can cause cortisol levels to start dropping too low before overt symptoms are seen. You want to do everything you can to reverse the overdosing *before* a dog actually becomes ill. Not only does trilostane lower cortisol, but it can also suppress the production of aldosterone, which is the adrenal hormone that controls the balance of sodium and potassium in the body. So if cortisol is dropping too low, other blood chemistries can be destabilized as well. This results in an “Addisonian” condition which can become genuinely life-threatening. Here’s a list of overt symptoms of overdosing:

Pet owners must be vigilant in watching for signs that cortisol is too low. Symptoms of low cortisol include but are not limited to vomiting, diarrhea, lethargy, poor/reduced appetite, weakness, collapse and tremoring. Should you observe one or more of these symptoms, STOP treatment and contact your veterinarian immediately. In the event your vet is closed, contact or go to your local emergency facility. Withholding Vetoryl or trilostane, whether a few days or several, will not be detrimental to your dog.

But as I say, to the extent possible, you want to avoid cortisol to be lowered to the point that your dog is sick. A dog experiencing an Addisonian crisis may require hospitalization and IV support. Also, some dogs may end up with permanent oversuppression of their adrenal glands due to overdosing, and require lifelong steroid supplementation. Through the blood testing, you will know to make dosage adjustments — both up and down — as is appropriate. Again, this initial starting dose for Bear is just a guess. She may need more or less of the trilostane to be both safe and effective. Also, since you may not have access to emergency support, it would be best to ask for some oral prednisone to have on hand in the event that she starts to experience some of these more serious signs of overdose at a time that you can’t get to a vet. The prednisone will make up for the cortisol that she’s lacking in the event of adrenal oversuppression.

So before starting, you should contact your vet and make it clear that you’re aware that her blood needs to be regularly tested to check her cortisol level and basic blood chemistry. If necessary, you can forward the links I’ve given you. If they then still seem oblivious to all this, then I honestly think you’d be in trouble if you start the trilostane. If they’re that unaware of, or disinterested in, the standard treatment protocols, then I’d worry that they are not equipped to diagnose and handle any crisis that may develop. Let’s hope that they’ll seem more knowledgeable when you directly ask them about all this. Fingers crossed!

[Zoology1603]

Re: Diabetic Australian Cattle Dog

Thank you for the detailed explanation labblab. I'm hoping to get some information from the vet today. What are the chances my dog will exhibit some of the signs before the 10 days? Other than the list of side effects on the drugs label, do you or the other members know of a specific thing to be on the lookout for? Yesterday she was behaving normally, she wanted to play fetch and tug of war with a milk jug. She didn't play very long but throughout the day she was acting fairly normal for her despite the fact that her blood sugar was in the 600's. I will be on the lookout for any deviation from this norm and call it out on here for guidance to stop the drug. I feel I should at least try it out and watch her glucose levels to see what happens. I don't like the part about her having negative effects without actually showing signs. I don't really want to give it to her but at the same time I would hate to not give it to her if it is actually what she needs to get better.

[Zoology1603]

Re: Diabetic Australian Cattle Dog

Riliey, since my dog and I both have bladder conditions that interrupt our sleep, we get out of bed when we get out of bed. I cannot change this. I also cannot change her evening dose at 6pm as I may go to bed sometime after that. It's as accurate to 12 hours as I can make it given our day to day life. Farmers simply don't have a lot of time to spare.
Chewy doesn't seem to want to ship our w/d. I've called and verified my identity but there is no change in status. All we have locally is Pure Balance so it's what I will be using until otherwise. Or Freshpet if I have to switch because our store runs out. It's 25 miles to town for us. We try to time shopping on doctor visits and such.

9/22 Evening
5:56pm :: 537
5:58pm :: Meal (118g Wet, 70g Dry)
6:06pm :: 9 Units Insulin

9/23 Morning
6:43am :: 491
6:48am :: Meal (118g Wet, 70g Dry)
6:57am :: 9 Units Insulin
9:05am :: 493
9:39am :: 33.8lbs

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

can you feed this food, is it available continuously?


day 9



33 lbs is 15 kg 7.5
the blood sugars starting to normalize, good job. food and insulin are starting to meet up


please post her night time bg
i.d reduce 1/2 unit to 8.5

[labblab]

Re: Diabetic Australian Cattle Dog

I definitely understand your conflict! If only we had a crystal ball…

Unfortunately, there’s no set time frame for seeing side effects. Some dogs may end up feeling “off” soon after starting the meds not because their cortisol is being lowered to a level that is actually unsafe, but just as a reaction to a rapid lowering of cortisol from that previously elevated level. But I don’t mean to be overly dramatic about all this. Obviously, many dogs do just fine, and the first changes that owners see are happy ones — reduction in excessive thirst and urination, for example. One symptom that may be harder to judge with Bear is appetite. Since most Cushpups have ravenous appetites, actual inappetance after starting trilostane can be a red flag for overdosing. But I know that Bear has been picky, already, so that might not be a sign that’s as easy to read for her.

Also, in most cases, if the dose is high enough to cause symptoms, simply discontinuing the med for a few days and resuming at a lower dose will solve the problem. So I don’t want to paint a picture that’s too scary. But dogs *can* get into trouble, and that’s why you’re wanting reassurance that your vet is aware of the risks and how to deal with them.

As far as the cortisol testing, though, as long as they’ll draw the blood at the right time, then you’re honestly as capable as they are of checking the results with that monitoring chart. The timing of the blood draw is important, though. Over the years, a lot of research has been done to try to make the Cushing’s monitoring easier and less expensive. At one time, it was hoped that baseline cortisols, in general, would work. But it turns out that levels that are taken at any random time of day are not accurate dosing indicators. If you’re using a baseline cortisol instead of an ACTH stimulation test for monitoring, you really need to know what the level is right before you’d be administering the next dose.

I just want to tell you that I think that Bear is very, very lucky to have you for a dad. You’ve been putting so much time and effort into educating yourself and advocating for her with the vet. I grew up in midwestern farmland and I know firsthand that many farm dogs and cats, although well-loved, just aren’t able to receive the specialized care of their city cousins. You are really doing an outstanding job of trying to keep her as healthy as possible. These decisions you are making are not easy ones. And sometimes when all is said and done, you’ve just got to go with your gut. In retrospect, I know I ended up making mistakes with my own Cushpup that I’ll always regret. But I tell myself that I did the best I could with the information I had at the time. It’s likely that Bear would have had no chance for a future at all without the care you’re giving her now. So carry on! And let us know what you find out.

[Zoology1603]

Re: Diabetic Australian Cattle Dog

Another factor is I got a discount meter (prodigy code ) on ebay and could find strips in quantity for as low as $5 for 50 . I think at one time I bought 500 at one time . Did not worry if I run out of strips . I compared the meter with other human meters and they registered all about the same . I used this meter for most of her diabetic life and took the numbers as is . Now out of all those eBay test strips purchases I had one bad batch that I was refunded . Some could be close to expectation dates but had no problem with strips that passed the date

Just wanted to let you know that I got a Prodigy AutoCode and ran a test using the same drop of blood seconds apart. Here is what I got. I've always thought this Alpha was reading high so I don't know. I tried testing the Alpha on one of our other dogs last night but that was impossible. I'll keep trying when one is in a more docile mood. (Never mind, I tried again and it's not going to happen.)

12:59pm
565 Alphatrak
471 Prodigy AutoCode

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

are you using code 36 on the alphatrack? thats a 100 point difference good catch. 565 doesnt make sense. 471 is more like it jessegirl will have her readings on both. prodigy doesnt have codes. i used the onetouch ultra2 it was the closet of the meters i tested against the alphatrack. amazon customers reviews are saying at the vet bg was 300 then 500 on their alphatrack i.d still be reducing to 8.5 tonight or tomorrow. goodluck with testing your other dog. i.d try to get a few onetouch strips to clarify the prodigy meter readings. still post evening tests

tomorrow we need 3 tests

fasting

at 2 hour bg food and insulin meeting up

at 4th hour, possible drop in bg time

[Zoology1603]

Re: Diabetic Australian Cattle Dog

I bought some more Pure Balance. I can always get it, so far so good anyways. I don't know what is holding up my shipment from Chewy. So I haven't changed the type of food for a few days now.

I thought I posted it above but I guess not but I did give her half a dose of Trilostane this morning with her food.

I should mention I always test my dog on her elbow calluses. I don't know if it makes a difference where the test is performed.

Poop Report:
2:10pm
Solid coming out but of a softer consistency than previous. Easily squished with a stick. Light brown and dark brown mixed.

Activity Report:
Normal, high energy. Ran to the barn and back. Explored the pasture. Played fetch a couple times.

My Alphatrak 2 strips say code 35 on them. I'll use the Prodigy side by side with my Alpha for a while and see what it consistently reads.


labblab
The vet wants to reevaluate cortisol levels in 60 days, not 10. They wouldn't let me have any prednisone either.

[labblab]

Re: Diabetic Australian Cattle Dog

The vet wants to reevaluate cortisol levels in 60 days, not 10. They wouldn't let me have any prednisone either.

I’ve been active on canine Cushing’s forums for 18 years. Virtually every day. In 18 years, I have never heard of, nor read about, any professional veterinary trilostane protocol that recommends waiting for 60 days to test when first starting treatment. Never. One month out is the longest time period I have ever heard of. There is absolutely no reason to wait for 60 days to test if you, the owner, are willing to pay to have the blood drawn.

Once a dog has been stabilized on a specific dose (showing satisfactory symptom resolution and desired cortisol level), the testing time can shift to as long as 90 days. But not to begin with. I can give you multiple citations if that matters in any way. And I won’t abandon you here, no matter what you decide to do. But I have no idea why they want to wait so long to do a simple blood test, especially on a diabetic dog who has so many issues involved. They are really jeopardizing her safety, and I wouldn’t know why.

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

so the reduction in insulin drop back 1 unit brought her bg down or was it 1/2 the trilostane or both.

either way she dropped down, reduce by 1/2 to 8.5

adding in the pure balance will change things up

we.ll test keep her safe compare both meters

nice catch, glad shes doing better

[Riliey and Mo]

Re: Diabetic Australian Cattle Dog

lablab hi

her insulin is dropping because of the reducing insulin and another 1/2 reduction coming.


how long does it take for the trilostane to work please?
how long does it last?
how long does it take to leave the system?

[Zoology1603]

Re: Diabetic Australian Cattle Dog

labblab - I didn't get to talk to the doctor. I had to write my questions down and have the secretary take it back to the vet. To say the least, I came home upset and a little depressed. I've already talked to other vets, some won't take new patients while the others say they can't handle my dog's condition. I'm still taking the dog in come October to see the doctor.
We had a dog die a few years back. I went through some pills and found Prednisone 5mg (3/2020), they should still be good if a little weaker strength. I trust your input on this.
They agree having her spayed would be good but now is not a good time, which I agree.