Totally freaked out

[Sunripenedsmile]

Sidney has been on Prednisone for 3 weeks. Her appetite has come and gone and it's been hard to stabilize her. She's been feeling okay, wagging her tail and meeting me at the door but any time I think can lower her pred she stops eating all together and we start over. I think she may be permanently Addisonian. She feels better than she did as a Cushinoid dog but the pred comes with a host of different issues.

[Harley PoMMom]

Were her electrolytes checked recently?

[molly muffin]

When do you do the follow up ACTH test to see how she is doing? You might ask them to do an electrolyte test at the same time just to be sure of how she is overall.

[Sunripenedsmile]

She's drinking soo much water. Ugh. I'm worried about her kidney function now just because of how much she is drinking. Her food intake is still up and down. I called the vet today and talked to her about when we should retest. We do a lot of observation based assessment which has served us well as her ACTH tests and electrolyte tests have been fine. Next week Tuesday I have an appointment for a full blood panel, and a ACTH. We will be looking for her to be in the 7 - 9 range since she seems to function best a little above average.

[molly muffin]

I remember being told that not all PU/PD issues resolve in all dogs. Usually this resolves, but there will always be the dog that it doesn't resolve in. So that is a possibility too unfortunately.

[Sunripenedsmile]

We now have a full fledged Addison's dog. She isn't doing the best but we are working on a plan that works for her. The diabetes is the biggest complication as we need to give her steroids for the Addison's but that drives up her sugar. We've been told by 3 different vets that it may be time to consider putting her down. I am devastated. Currently, she is eating well and perks up when I talk to her. She still takes herself out to pee and trots around outside. I'm not ready to let her go yet and I'm still semi-optimistic we will find something that works. Thank you for all your help. I am sorry for not posting more we have had a terribly hard time the last few weeks.

[Squirt's Mom]

Could you please post the results that the vet used to determine Addison's? How long had she been off the steroids when that ACTH was performed?

There are some Addison's groups online you can check out, too. Some links for you -

http://www.addisondogs.com/support/

https://groups.yahoo.com/neo/groups/k9Addisons/info

https://groups.yahoo.com/neo/groups/AddisonDogs_/info

I personally prefer online forums like ours and those listed above VS a Facebook group. Online forums are better monitored for inaccurate info and info that is purely opinion. Facebook groups get so very large it is almost impossible to monitor them 24/7 so too often LOTS of incorrect info gets bandied about in many of those settings. But here is the FB Addison's group -

https://www.facebook.com/addisondogs/

https://www.facebook.com/groups/2347518387/

Also, be sure to check in with our sister site, K9Diabetes and let them know about this development to see what they have to say.

Hang in there!
Hugs
Leslie

[Harley PoMMom]

Oh my, I am so sorry that you are having these issues with Sidney. I found this article on Dr. Peterson's blog titled: "Managing Addison's Dogs with Concurrent, Uncontrolled Diabetes" I hope it helps, here's the link: https://animalendocrine.blogspot.com...oncurrent.html

The article is very informative and one of the things that I found interesting that he said was:

Unfortunately, many dogs with Addison's disease are treated with too much glucocorticoid. Remember that our goal with glucocorticoid supplementation is to provide the same amount of steroid that the dogs would normally produce if their adrenals had not failed.

For dogs, the daily glucocorticoid maintenance dose for prednisone is only 0.1-0.2 mg/kg/day (3), so that calculates out to only 0.5-1.0 mg per day for Scooter, quite a bit lower that what you are currently giving (2.5 mg per day). That would certainly be enough to cause an increased thirst by itself, but would also contribute to glucocorticoid-induced insulin resistance, making the diabetes uncontrollable despite the higher insulin doses.

Therefore, we should try to lower the prednisone dosage first down to 1.0 mg once daily (or divided). If he is doing well clinically (i.e., normal appetite and no vomiting), then the dose can be lowered even further, down to 0.5 mg per day. Prednisone or prednisolone are available in 1-mg tablets, as well as an oral solution, making it possible to administer these smaller dosages (6,7).

Now, this dog weighs 11 pounds and is getting 2.5 mg of fludrocortisone (Florinef) twice day along with 1.25 mg of prednisone twice daily, so his case could be totally different that Sidney's. Man, it seems to be quite the balancing act to get everything under control and I sympathize with you.

I hope you can find something in the article that helps with Sidney.

Hugs, Lori

[Sunripenedsmile]

I am going to go through the paperwork and find the results. It was an electrolyte imbalance along with a failed Dex test for sure. She has seen two vets and is going to an internal medicine Specialist on the 29th. She received a percorten injection on Saturday and has been on Dexamethasone since then as well. Her overall behavior is much better and she is eating like a champ. Her diabetes is out.of control and i.am sure we have to winnow down the amount of steroid she is receiving. The percorten is a shot that lasts 25 days and keeps her electrolytes in balance (sodium especially). She is drinking a terrible lot of water which makes me concerned for her kidneys. I will find her test results and post them. Thank you thank you thank you for the article about Addison's it cements my thought that she is getting too much Dexamethasone (.75 once a day)

[molly muffin]

I think maybe lower the steroid and you might get better control of the diabetes.

This is a really fine line balancing act it seems. If you can find that sweet dose for both hopefully things will be much better. Hoping the IMS can shed some light on this too