Diabetes in Dogs: The k9diabetes.com Forum
 

Go Back   Diabetes in Dogs: The k9diabetes.com Forum > Diabetes Discussion: Your Dog

Diabetes Discussion: Your Dog Anything related to your diabetic dog.

Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 04-14-2010, 08:53 PM
jlapro's Avatar
jlapro jlapro is offline
Junior Member
 
Join Date: Jan 2010
Posts: 5
Default Gordy, Gordon Setter, diabetic and Cushings disease

Hi,

I signed up a while back but this is first post. I'm also on the Cushings forum. Gordy is a 60 pound senior dog (13) who was diagnosed with diabetes two years ago. He was reasonably well controlled until the fall of last year when his BG started going sky high. We took him to an internist who diagnosed him with Cushings a couple of months ago. He is now on trilostane (Vetoryl) for the Cushings and his BG numbers are gradually coming down.

He takes 28 units b.i.d of NHP. His insulin may need to be reduced after his Cushings is more under control, but for right now we're keeping it steady.

Judy
Reply With Quote
  #2  
Old 04-14-2010, 08:57 PM
k9diabetes's Avatar
k9diabetes k9diabetes is offline
Administrator
 
Join Date: Mar 2008
Location: Northern California
Posts: 11,306
Default Re: Gordy, Gordon Setter, diabetic and Cushings disease

Hi Judy!

It's great to see you and Gordy here!

(By the way, I'd love to see a picture some day - by email if you'd rather not post it... )

Natalie
Reply With Quote
  #3  
Old 04-15-2010, 09:47 AM
ladysmom06's Avatar
ladysmom06 ladysmom06 is offline
Founding Member
 
Join Date: Mar 2008
Posts: 493
Default Re: Gordy, Gordon Setter, diabetic and Cushings disease

Hi Judy,

Welcome to you and Gordy. We dealt with diabetes and cushing's and also used trilo for the cushing's.

Quote:
He takes 28 units b.i.d of NHP. His insulin may need to be reduced after his Cushings is more under control, but for right now we're keeping it steady.
How long had Gordy been on trilo? Just a word of caution - when Lady first started trilo her bg's stayed high but a few weeks later when I tested her I was shocked to see her in the 100's - I reduced her insulin but it wasn't enough - she had a hypo the next day - the only one she ever had. When she started trilo she was on 11 units of insulin twice a day and after the hypo we were able to reduce it to 5 units twice a day. Once the cortisol numbers come down the insulin can usually be reduced.

Good luck with Gordy and please keep us posted.
__________________
Luv,

Lynne and Angel Lady 7/98-3/09 Forever in my heart
Reply With Quote
  #4  
Old 04-15-2010, 10:11 AM
Patty's Avatar
Patty Patty is offline
Senior Member and Moderator
 
Join Date: Nov 2008
Location: Central CO
Posts: 8,326
Default Re: Gordy, Gordon Setter, diabetic and Cushings disease

Hi Judy,
Just wanted to say welcome to you!
Patty
__________________
Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~
Reply With Quote
  #5  
Old 04-21-2010, 08:16 PM
jlapro's Avatar
jlapro jlapro is offline
Junior Member
 
Join Date: Jan 2010
Posts: 5
Default Re: Gordy, Gordon Setter, diabetic and Cushings disease

the internist actually raised Gordy's insulin to 30 units b.i.d. last Friday after we faxed him Gordy's BG curves over a five day period. I thought it was working after 3 days, but he was HI this morning and never got lower than high 300s today. He also had two accidents in the house today. Tomorrow will be day 30 of the vetoryl. He has another ACTH stim test scheduled for next Friday. I'm starting to wonder if he's having a Somogi rebound.

Does anyone feel that when the insulin vial gets low, the remaining insulin does not seem as effective? I 'mix' it per instructions (turn it upside down a couple of times and roll it back and forth on my palm).

I had started giving him some of the Royal Canin high fiber kibble again this week, after feeding him only the canned food since he was diagnosed with the Cushings. The amount of kibble (like 3/4 cup at each feeding) was small in comparison with the amount of canned food (royal canin diabetic and small amount of canned lamb and rice).

Judy
Reply With Quote
  #6  
Old 04-21-2010, 08:32 PM
k9diabetes's Avatar
k9diabetes k9diabetes is offline
Administrator
 
Join Date: Mar 2008
Location: Northern California
Posts: 11,306
Default Re: Gordy, Gordon Setter, diabetic and Cushings disease

If the curves were detailed and there was no low blood sugar at any time in the preceding four days, you could probably rule out rebound with a curve on the fifth day that shows no sharp drop and rise.

Some folks do find that the last part of the bottle does not work as well and they replace it at 28 days... Looks like you're probably going through a bottle in about 35 days to the last drop so you could shave off 10 days and start a new bottle after three weeks if you want to be extra careful not to have diluted insulin.

Any time the blood sugar suddenly rises, I consider ruling out UTI and starting a new bottle of insulin. Starting a new bottle is the easiest first step in resolving the problem.

Where did the food change fit into the curves you did?

Any change in food, even the same food from canned to kibble, can affect blood sugar due to how digestible the two forms are.

Did Gordy have the UTK panel done? I can't remember.

Because Vetoryl can make some hormones that can generate atypical Cushing's worse. If those hormones were already elevated, the Vetoryl could elevate them further.

Natalie
Reply With Quote
  #7  
Old 04-21-2010, 09:11 PM
jlapro's Avatar
jlapro jlapro is offline
Junior Member
 
Join Date: Jan 2010
Posts: 5
Default Re: Gordy, Gordon Setter, diabetic and Cushings disease

He was on cipro for UTI for over three weeks until just before he started vetoryl. After he'd been off the cipro for a little over 10 days, I took him to his primary vet for a urine draw (he did it with a catheter) the lab said there was nothing to culture, no evidence of bacteria, etc., but when our internist saw the info, he wasn't satisfied because the primary vet didn't insert a needle directly into the bladder to draw it - he wanted us to bring Gordy into the specialty facility to do it that way, which meant I'd be paying a second time (and a lot more) for essentially the same procedure.

I declined to do it because he had none of the previous symptoms of UTI. If his blood sugar doesn't go down tomorrow maybe I'll rethink that. Also, if he does turn out to have a UTI, I'll use the Baytril this time.

Also, I don't use the insulin vials down to the bottom - when they get to a certain point (maybe 1/4 left) I start a new one. I probably let it go a little lower than usual this time. I'm glad I asked that question though - your answer validates what I've thought.

Judy
Reply With Quote
  #8  
Old 04-21-2010, 09:42 PM
k9diabetes's Avatar
k9diabetes k9diabetes is offline
Administrator
 
Join Date: Mar 2008
Location: Northern California
Posts: 11,306
Default Re: Gordy, Gordon Setter, diabetic and Cushings disease

It seems like the way they drew the urine would be more of a concern if they found bacteria - those bacteria could have come from someplace other than the bladder, a problem avoided with a sterile needle draw.

The point of the sterile draw is to make sure you don't get external bacteria contaminating the urine.

But if the lab found zero bacteria in the sample, then regardless of how the urine was taken, it seems unlikely that he had an infection at the time...

So I don't understand the internist's thinking on that.

Not to say he couldn't have a UTI again now.

Now that I think more about it, he had only the LDDS, didn't he? So he didn't have the UTK panel I don't think.

In which case it's worth considering that those other hormones might be elevated and getting higher with Vetoryl.

Natalie
Reply With Quote
  #9  
Old 04-21-2010, 10:33 PM
jlapro's Avatar
jlapro jlapro is offline
Junior Member
 
Join Date: Jan 2010
Posts: 5
Default Re: Gordy, Gordon Setter, diabetic and Cushings disease

He had a superchem panel done, but I guess that's not what you're talking about. He also had 1 ACTH test after being on the trilostane for 10 days - I posted the results on that at the Cushings forum. He's due for another test on 4/30.

Judy
Reply With Quote
  #10  
Old 04-22-2010, 09:34 AM
k9diabetes's Avatar
k9diabetes k9diabetes is offline
Administrator
 
Join Date: Mar 2008
Location: Northern California
Posts: 11,306
Default Re: Gordy, Gordon Setter, diabetic and Cushings disease

Hi Judy,

The University of Tennessee Knoxville panel... I don't know exactly what it's called... is based on an ACTH test but measures many other hormones that can cause Cushing's like problems that are now called Atypical Cushing's disease.

Looking at the list and the general information, it appears to be the "Adrenal Panel ACTH Stim": http://www.vet.utk.edu/diagnostic/en...logy/index.php

You can have the vet run the ACTH test at his/her office according to the protocol from UTK and then have the vet send the samples directly to UTK. Do not let them put the samples through their normal lab first as that makes it much more expensive.

It is somewhat expensive and I know treatment cost is an issue. It does, however, give you the fullest measure of the different hormones that can create insulin resistance and other Cushing's symptoms.

And my understanding is that if Gordy has elevated levels of some of these other hormones, the Vetoryl may actually be raising the levels of those hormones. So not only not treating the insulin resistance but possibly making it worse.

Especially given that you have suspected Cushing's for a while but he came up negative on a prior cortisol test as I recall, there's a chance it is these other hormones that are behind the problem.

If I was in your situation, I absolutely would go for the UTK panel if I could afford it.

Natalie
Reply With Quote
Reply

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump


All times are GMT -7. The time now is 03:42 AM.


Disclaimer -- The content on this site is provided for informational and educational purposes only. While we make every effort to present information that is accurate and reliable, the views expressed here are not meant to be a substitute for the advice provided by a licensed veterinarian. Please consult with your veterinarian for specific advice concerning the medical condition or treatment of your pet and before administering any medication or pursuing any course of treatment that you may read about on this site.

The views and opinions expressed by contributors to this forum are strictly their own and do not necessarily reflect the opinions and views of the owners, administrators, or moderators of this forum and the k9diabetes.com website.


Powered by vBulletin® Version 3.8.5
Copyright ©2000 - 2021, Jelsoft Enterprises Ltd.
Copyright 2009, 2010 k9diabetes.com. All rights reserved.