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View Full Version : New Member Lola 10 yr old Lhasa (Cushings? Diabetes?)



LolasShoes
03-26-2010, 03:23 PM
:confused:
Lola is my ten year old Lhasa, she's 19 pounds. About two months ago, I noticed she was drinking more then normal, which at the time I didn't think odd as my condo is very very warm and dry in the winter. The drinking continued but I noticed that she was releasing more and more onto the wee wee pads, to the point she was soaking them through.I thought maybe there was something wrong, but put off the vet thinking if I turned the radiators off, this would help. Obviously, it didn't.

This past Sunday, Lola was very lethargic, didn't want to play and did not come join me for my morning coffee (and he cookie). later in the afternoon, she has loose, mucus stool that was streaked with blood. The vet was not available, so I made an appointment for Tuesday morning. Monday morning, she had another loose stool but drank some water and ate a cookie.

My daughter called me at work saying her eye had popped out and was rolling upwards and was red (cherry eye, which I know now) Thinking the worse (a co-worker told me it might be shock) I rushed home and raced to the vet. They ran an initial blood test her he sugar levels were over 500. she said she was fluffy in the chest (they did x-rays) and Lola was diabetic (mellitus), but it could be managed with insulin. She said Lola would need to stay so they could bring the sugar down.

On Tuesday when i went to see her, her sugar had spiked to 666. On Wednesday it was back down to 580 but the vet was perplexed on why they could not get the levels down and mentioned Cushings. They did a ACTH suppression test and it came back at 27. I was told that it was cushings, more likely adrenal and they want to do an ultrasound on Tuesday. A new vet (mine went on vacation) said that he wants to do surgery to remove the tumor (what tumor??) when I said that researched cushings and read it might not be wise to remove anything, he said his opinion was to remove it and he was starting her on a cushing protocol (I don't know what yet).

Now I am thrown for a loop. I called this morning to see how she was and I was told by the nurse that he wants to keep her again because now her sugar was too low. I am going to see her tonight and I would like to bring her home until I can decide what is the best thing to do for her. They do not know if the diabetes was caused by the cushings or vice versa. I have read so much about drugs and protocol, have the surgery, don't have it, my head is spinning. My sister, who is a firm believer in holistic medicine for pets told me to research herbs and supplements.

I was so grateful when I found this board and read some of the stories. I guess what I am asking for is help. I have limited funds, I need to understand what is going to give Lola the best quality of life. I love her, but I want her to be happy and comfortable. I am trying to think of her first and me second. I would mortgage the house if it meant keeping her alive, but I don't want to do that if her quality of life is compromised. We are so new to this condition and I think I have overloaded on information that I don't know what or who to believe. Thanks for listening! ~Lola's Mommy, Jo~

gpgscott
03-26-2010, 05:09 PM
Hi Jo, and welcome to you and Lola,

It really does look like diabetes, but it may be Cushing's as well.

Please register at K9diabetes.com, here is a link http://www.k9diabetes.com/

Please read the responses carefully.

Get back to us.

Scott

labblab
03-26-2010, 09:33 PM
Dear Jo,

Welcome from me, too. Good grief, what an awful week you and Lola have had!!!! Unfortunately, I do not have very much time to write this evening, but I want to tell you that I whole-heartedly support your desire to slow things down in terms of rushing into Cushing's treatment.

First, there is no way in which an ACTH stim test can distinguish between the two types of Cushing's (that caused by a pituitary tumor vs. an adrenal tumor). Secondly, other nonadrenal illnesses (such as diabetes) can skew the test results and give a "false positive" when a dog does not have either type of Cushing's at all. Third, even if it turned out that Lola does have adrenal Cushing's and surgery was an option that you wished to consider -- you would want to consult with an expert, board-certified surgeon since the procedure requires a high level of skill and experience. Normally I would say that an abdominal ultrasound is a good step along the trail of Cushing's diagnosis, and you may still wish to proceed with it on Tuesday. But we can talk more about that over the weekend. Right at this moment, I would not agree to beginning any Cushing's treatment prior to a more definitive diagnosis based on evidence other than simply an elevated ACTH performed on a day when Lola was suffering from a highly elevated glucose level and recent GI distress.

I strongly encourage you to take Scott's advice and register as a forum participant at k9diabetes:

http://www.k9diabetes.com/forum/

As you already know, gaining control of Lola's blood glucose is of paramount importance. And it may turn out that she does, in fact, suffer from Cushing's as well. But I think you'll be really well-served to simultaneously consult with the folks at k9diabetes -- I know they will also be prepared to give you a lot of valuable feedback and support to assist your decision-making.

I'll add some more thoughts when I'm able to come back here later on today or tomorrow...
Marianne

Loladog
03-26-2010, 09:49 PM
I'm sorry that I don't have any good recommendations for you but I just wanted to say welcome to another Lola.:)

frijole
03-26-2010, 10:29 PM
Hi Jo! Sending some warm hugs to you and Lola and glad you found us. You aren't alone on this journey. I agree. Get the diabetes under control if you can before worrying about cushings. Sometimes there are false positives when other things are going on.

The comment about removing the tumor is strange. That operation is done on dogs that have adrenal tumors and only some of the time... you have enough going on... you don't even know yet if your dog has cushings for sure, let alone if it is adrenal type. So don't lose sleep over that at this time.

I have a dog that has been treated for cushings for almost 4 yrs. She is over 16 now so Lola can live a happy life. You just have to deal with getting her well and properly diagnosed. We have lots of members with both cushings and diabetes and others that have one or the other... so hold on and some of them will hopefully respond. My mom's dog is about to go thru the same thing. I am going to create a thread for her. Her name is Jessie.

Good luck!!!!! Kim

k9diabetes
03-26-2010, 11:45 PM
Hi Jo,

Wow... what a sudden deluge of problems!

I administer the canine diabetes forum and I second, third, fourth, and fifth slowing WAY down on on doing anything with Cushing's disease. With such high blood sugar, the actual existence of diabetes seems quite likely and I would want to get Lola started on a proper insulin regimen first and try to get her blood sugar down to a good level.

Since they apparently dropped her blood sugar farther than they wanted to, we know she is responding to the insulin given to her.

Can you meet with whichever vet is leading her treatment at this point as soon as possible and get her home, which will keep them from getting carried away?

She should stay in the hospital if she has severe ketones but otherwise she should be able to come home.

Ask them for paper copies of all of her test results so you can post the results here - we can help you sort out what, if anything, the tests done so far might mean.

I would tell them that you want to set aside everything but the diabetes AND the eye...

What is the status on her eye? I wondered if she had glaucoma or just an infection. What did they diagnose there?

It is simple enough to just be honest with them - your financial resources are limited so you need to start with the things that are most critical to Lola's survival and that would be her blood sugar.

That you need time to sort through the information provided so far so you can make some decisions about how to divvy up the resources available. That you understand that Cushing's disease progresses slowly so you don't want to rush into any decisions regarding treating that.

Since finances are an issue, they should start Lola on NPH insulin - it is the least expensive insulin for dogs and it's really really good insulin. Most dogs do exceptionally well on it.

I am very concerned about some of the decision-making at the vet's office so far, such as rushing to a surgery recommendation, so I would like to see Lola back home with you and treatment started for diabetes and then things could be further sorted out from there with at least considering whether a different veterinary practice may be needed.

When you have her home on some insulin, let us know here or at the diabetes forum how much insulin she is on - how many units and how many injections per day. How they plan to monitor her blood sugar and what her levels are when they discharge.

We can help you sort all of this out - just will need some information from the vet hospital to do it.

Natalie

labblab
03-27-2010, 09:46 AM
Hi again, Jo.

I logged in this morning in hopes of reading that Lola is safely back home with you. I was thinking about you two all evening...

Natalie has given you some great advice regarding diabetes management. And along with her, I want to emphasize again how concerned I am that you are feeling pressured into starting Cushing's treatment prematurely. So I will keep my fingers crossed that you will check back in with us shortly with a more positive report on Lola.

One more quick note right now. I can only imagine how the expenses have been racking up over Lola's emergency care :(. Here's a link to a thread on our "Important Resources" forum that lists possible sources of financial assistance:

http://www.k9cushings.com/forum/showthread.php?t=212

Please make special note of the second entry: "Care Credit." A number of our members have qualified for this assistance. It does not relieve you of the financial obligation of your vet bills, but for participating vets -- it allows you to space your payments out over time, without incurring interest charges.

Jo, please update us as soon as you are able.

Marianne

Squirt's Mom
03-27-2010, 12:24 PM
Hi Jo,

Been reading along and just wanted you to know that I am sending you and Lola healing thoughts and prayers that she will soon be back home and stable once again.

Please let us hear from you when you can.

Hang in there!
Hugs,
Leslie and the girls - always