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Thread: Yukon, American Eskimo - Experience w/ Lignans and Melatonin?

  1. #31
    Join Date
    Apr 2009
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    Georgia
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    15,292

    Default Re: Yukon has Atypical Cushings and now Diabetes

    Hi again! I’ve just been over to your K9D thread, and added this reply. If other folks here have additional thoughts, I’m surely hoping they’ll chime in, as well ;-).

    I’m really glad you’ve made the appointment with the internist. Yukie’s situation is complicated enough that guidance from a specialist should be very helpful!

    In all my years on K9C, I don’t know that we have ever discussed the impact of melatonin on diabetic management. In honesty, I can probably count on one hand the number of dogs on our forum who have presented with the dual diagnosis of “Atypical” Cushing’s as well as diabetes. As I’ve talked about before, it’s the combo of the elevated cortisol of traditional Cushing’s and elevated glucose levels that we commonly encounter. So Yukie’s situation is a bit of a new frontier for us all.

    Given Tennessee’s anecdotal report of melatonin complicating diabetic management, I believe I’d stop it, too. Partly because its efficacy in resolving Cushing’s-like symptoms is hit-and-miss even when diabetes is not involved, and partly because I don’t think it helps with lowering progesterone/17-hydroxyprogesterone levels (which sound to me to be the most worrisome elevations in Yukie’s profile in terms of insulin resistance).

    Please bear in mind that all of this is largely supposition on my part. I’ll feel a whole lot more comfortable when you can get some professional feedback from a specialist. In general, there remains a lot of controversy about the significance/impact of elevated adrenal hormones other than cortisol, and the “Atypical” diagnosis is not one that is even universally recognized among endocrinologists. So this is a long-winded way of saying that I’d probably ditch the melatonin right now, too, if there’s any chance that it’s interfering with the insulin.

    Looking ahead, if elevated adrenal hormones — including cortisol — do seem to be complicating things for Yukie, there is a medication alternative to Vetoryl named Lysodren. It’s an older medication and is no longer used as frequently as Vetoryl to treat traditional Cushing’s. But unlike Vetoryl, it has the ability to lower several of the other adrenal hormones, including progesterone, as well as cortisol. So it is much more powerful than melatonin, and might be considered down the road.

    By the way, good job for researching the possible link between melatonin and insulin resistance! This may be very helpful information for all of us on K9C.

    Marianne

  2. #32

    Default Melatonin & Flax Hull Lignan

    Hi Everyone,

    I have been giving my dog Yukon Flax Hull Lignans and Melatonin for his Atypical Cushing's since May, 2018. He was recently diagnosed with Diabetes as well and we are having a hard time regulating his Blood Sugar.

    I have a question for anyone who has their dogs on this holistic approach - should I be giving him his Lignans and Melatonin at the same time in the morning? I usually give him his Lignans at around 6:30 a.m. and Melatonin at 8:00 a.m., but I am starting to question whether they should be given together at the same time.

    I have been online and can pull no articles that tell me when to administer.

    Thank you,

  3. #33
    Join Date
    Apr 2009
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    Georgia
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    Default Re: Melatonin & Flax Hull Lignan

    Welcome back to you and Yukie. You know, that’s an interesting question, and not one that I’ve seen discussed here. My best advice would be to contact the folks in the Endocrinology Department at the Univ. of Tennessee/Knoxville in order to find out their thoughts. Since it is their research that has prompted treatment using the combination of melatonin and lignans, I think they’d be your best source for accurate information in that regard. Here’s a link to their contact page. I don’t know how much detail they will go into with pet owners, but it ought to be worth giving a shot. And for sure, I’m certain they’d be happy to talk with your vet.

    https://vetmed.tennessee.edu/vmc/dls...s/default.aspx

    Marianne

  4. #34

    Unhappy Re: Melatonin & Flax Hull Lignan

    Quote Originally Posted by labblab View Post
    Welcome back to you and Yukie. You know, that’s an interesting question, and not one that I’ve seen discussed here. My best advice would be to contact the folks in the Endocrinology Department at the Univ. of Tennessee/Knoxville in order to find out their thoughts. Since it is their research that has prompted treatment using the combination of melatonin and lignans, I think they’d be your best source for accurate information in that regard. Here’s a link to their contact page. I don’t know how much detail they will go into with pet owners, but it ought to be worth giving a shot. And for sure, I’m certain they’d be happy to talk with your vet.

    https://vetmed.tennessee.edu/vmc/dls...s/default.aspx

    Marianne
    Thank you Marianne I called them today and left a message for an internal medicine doctor to call me back. Actually because of Yukons diabetes the doctor took him off the melatonin again and upped his insulin so I guess I don't have to worry about it for now. This is very frustrating. My poor Yukon is going through so much and I can't seem to find someone to help us out

  5. #35

    Default Re: Melatonin & Flax Hull Lignan

    Quote Originally Posted by labblab View Post
    Welcome back to you and Yukie. You know, that’s an interesting question, and not one that I’ve seen discussed here. My best advice would be to contact the folks in the Endocrinology Department at the Univ. of Tennessee/Knoxville in order to find out their thoughts. Since it is their research that has prompted treatment using the combination of melatonin and lignans, I think they’d be your best source for accurate information in that regard. Here’s a link to their contact page. I don’t know how much detail they will go into with pet owners, but it ought to be worth giving a shot. And for sure, I’m certain they’d be happy to talk with your vet.

    https://vetmed.tennessee.edu/vmc/dls...s/default.aspx

    Marianne
    Thanks Marianne,

    I am really not having much success at all treating all his conditions.

    He was originally diagnosed May, 2018 with “Atypical" Cushings Disease after doing testing from the University of Tennessee. It was determined through testing that his Cortisol levels are normal, but his Androstenedione ng/ml, Estradiol pg/ml and 17 OH Progesterone ng/ml levels are high.

    Before this testing occurred we did the LDDS test at our local vet and he was put on 10mg Vetoryl, but after about 6 days on Vetoryl he could not handle it (lethargic, personality change). Our vet called the manufacturer and they advised to take him off the Vetoryl so I did. That is when we decided to do further testing with University of Tennessee.
    The reason the Vetoryl was not successful is because it lowers the Cortisol, and his was normal. Vetoryl also increases the other hormones, which Yukon’s were already severely high. Because of these findings I decided to do a more holistic approach as recommended by the University of Tennessee and I started him on Flax Hull Lignans and Melatonin. It seemed to be helping with the panting, excessive drinking and hunger.

    October, 2018 he was diagnosed with Diabetes. We started him on 4 units of Vetsulin (30 pounds) and he is now up to 11 units and we still cannot control his Blood Glucose - Fructosamine test was done a couple weeks ago and it was 413. I am now consulting with an Internal Medicine doctor and I made her aware of an article I read about Melatonin possibly interfering with regulation of insulin. She advised me to take him off the Melatonin. Since then his levels have been getting higher, especially at night.

    I contacted my regular vet and asked if we should do the Stim Test again and send to the University of Tennessee and she said probably. Does anyone know of an experienced vet in the Detroit Michigan area that has an expertise is both Cushings and Diabetes?

  6. #36
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    Apr 2009
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    Georgia
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    Default Re: Melatonin & Flax Hull Lignan

    I’m so sorry you guys are still having such a tough time! I’ve been following your thread over on K9D, and it sounds as though the folks over there still aren’t considering the 11 units of insulin to be a very high dose. If that’s true, I’m not sure why your current vets are being so hesitant to “up” the insulin if Yukie remains uncontrolled. It has to feel so exhausting and frustrating to see such little progress being made over these past weeks.

    I’m afraid I don’t know any specific vets in the Detroit area. There has to be somebody competent, but I don’t have a recommendation to make. You could take a look at this IMS database to see who else comes up, since you’re not entirely comfortable with the IMS you’re seeing now.

    http://find.vetspecialists.com/

    My other thought might be to bite the bullet and make the drive to the outpatient clinic at Michigan State’s vet school at E. Lansing. I just checked, and it looks like a 90-minute drive from Detroit. But the MSU vet school is very highly regarded nationally, and especially for endocrinological services. For instance, their lab offers the premiere university-based thyroid analysis in the country. At MSU, you’d have the benefit of collaborative consultation with a full team of specialists. They would definitely have extensive experience with both diabetes and Cushing’s. And according to their website, they accept new patients either through vet referral or direct contact from owners.

    https://cvm.msu.edu/hospital/about

    Given all the frustration you’ve been through thus far, it might really be worth a consultation. Subsequently, it might turn out that they could offer guidance to your local vet in order to avoid the need to return to MSU itself very frequently. Anyway, just a thought to consider.

    Marianne

  7. #37

    Default Re: Melatonin & Flax Hull Lignan

    Quote Originally Posted by labblab View Post
    I’m so sorry you guys are still having such a tough time! I’ve been following your thread over on K9D, and it sounds as though the folks over there still aren’t considering the 11 units of insulin to be a very high dose. If that’s true, I’m not sure why your current vets are being so hesitant to “up” the insulin if Yukie remains uncontrolled. It has to feel so exhausting and frustrating to see such little progress being made over these past weeks.

    I’m afraid I don’t know any specific vets in the Detroit area. There has to be somebody competent, but I don’t have a recommendation to make. You could take a look at this IMS database to see who else comes up, since you’re not entirely comfortable with the IMS you’re seeing now.

    http://find.vetspecialists.com/

    My other thought might be to bite the bullet and make the drive to the outpatient clinic at Michigan State’s vet school at E. Lansing. I just checked, and it looks like a 90-minute drive from Detroit. But the MSU vet school is very highly regarded nationally, and especially for endocrinological services. For instance, their lab offers the premiere university-based thyroid analysis in the country. At MSU, you’d have the benefit of collaborative consultation with a full team of specialists. They would definitely have extensive experience with both diabetes and Cushing’s. And according to their website, they accept new patients either through vet referral or direct contact from owners.

    https://cvm.msu.edu/hospital/about

    Given all the frustration you’ve been through thus far, it might really be worth a consultation. Subsequently, it might turn out that they could offer guidance to your local vet in order to avoid the need to return to MSU itself very frequently. Anyway, just a thought to consider.

    Marianne
    Thanks Marianne,

    I actually spoke with someone at the University of Tennessee who is working with my regular vet now to hopefully figure out how to treat Yukon. We had another ACTH Stim done yesterday and its is being overnighted to UofT for analysis of all the hormones.

    Lysodren was mentioned as possibly being used - most likely the maintenance dose which would be 125mg 3x a week.

    I am really scared of that drug because I have read such bad things about it. On the other hand it appears to be one of the only drugs available that lowers the other sex hormones.

    Can anyone add insight on their experience with Lysodren?

  8. #38
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    15,292

    Default Re: Melatonin & Flax Hull Lignan

    Through the years, we’ve had lots of members who’ve done very well on Lysodren. Especially if you are dosing at the lower maintenance level, the risks of unwanted side effects should be minimized. Please do let us know how you guys end up proceeding.

    Marianne

  9. #39
    Join Date
    Mar 2009
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    rural central ARK
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    Default Re: Melatonin & Flax Hull Lignan

    My Squirt started out Atypical and when her cortisol started to rise we used Lysodren. When Trilostane (Vetoryl) first came out that is the drug I wanted to use if needed but as more and more dogs started taking it and getting very sick because the starting dose at that time was much too high I quickly changed my mind. Over the years I have come to prefer Lysodren and that will always be my first drug of choice with which to treat a cush pup. When my another dog was diagnosed with Cushing's (incorrectly it turned out but that is another story) her vet wanted her on Vetoryl but I insisted on Lyso. I am MUCH more comfortable with Lyso than Vetoryl. For one thing we know exactly what Lysodren is doing and where - it works ONLY on the adrenal glands while Vetoryl works on the axis, or loop, between the pituitary, hypothalamus, and adrenal glands. Many thing happen along that loop other than cortisol messaging (info to produce and release cortisol). Since you will be going straight to maintenance, like we did with Squirt, you don't have to worry about the "scary" part - the load, or induction. Start with the lowest dose and most widely space schedule and that will make you more comfortable as well. ie give her the lowest starting dose (25mg/kg/day) 2 days a week. Then you can increase the days, say 3 days a week, if that is not enough and you have plenty of room to increase the dose if needed to 50mg/kg/day. I chose to start with the highest dose I think it was 3 days a week with Squirt and eventually went to every 3rd day. We never had any problems at all, not with Squirt nor with the one that was misdiagnosed. So take a deep breath and know you are in good hands here. We will help you any way we can. You can also know that at least one person will always prefer Lysodren.

    Hugs,
    Leslie
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

  10. #40

    Default Re: Melatonin & Flax Hull Lignan

    Quote Originally Posted by Squirt's Mom View Post
    My Squirt started out Atypical and when her cortisol started to rise we used Lysodren. When Trilostane (Vetoryl) first came out that is the drug I wanted to use if needed but as more and more dogs started taking it and getting very sick because the starting dose at that time was much too high I quickly changed my mind. Over the years I have come to prefer Lysodren and that will always be my first drug of choice with which to treat a cush pup. When my another dog was diagnosed with Cushing's (incorrectly it turned out but that is another story) her vet wanted her on Vetoryl but I insisted on Lyso. I am MUCH more comfortable with Lyso than Vetoryl. For one thing we know exactly what Lysodren is doing and where - it works ONLY on the adrenal glands while Vetoryl works on the axis, or loop, between the pituitary, hypothalamus, and adrenal glands. Many thing happen along that loop other than cortisol messaging (info to produce and release cortisol). Since you will be going straight to maintenance, like we did with Squirt, you don't have to worry about the "scary" part - the load, or induction. Start with the lowest dose and most widely space schedule and that will make you more comfortable as well. ie give her the lowest starting dose (25mg/kg/day) 2 days a week. Then you can increase the days, say 3 days a week, if that is not enough and you have plenty of room to increase the dose if needed to 50mg/kg/day. I chose to start with the highest dose I think it was 3 days a week with Squirt and eventually went to every 3rd day. We never had any problems at all, not with Squirt nor with the one that was misdiagnosed. So take a deep breath and know you are in good hands here. We will help you any way we can. You can also know that at least one person will always prefer Lysodren.

    Hugs,
    Leslie
    Thank you Marianne and Leslie - that makes me feel better. Yukon has not been acting right since the ACTH Stim yesterday - very lethargic just laying around. He ate really good and went for a walk, but seems to be under the weather. I wonder if this is just a side effect of the injection.

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