Aragon, Alaskan Malamute with Cushing's/Diabetes

[Malamutt]

Hello all,
I have been visiting this forum silently for almost a year now. When my parent's dog was diagnosed with Cushing's today, I thought now was the time to register.

Aragon started having balding issues last summer. That's it. No other symptoms. Blood tests, scrapings, and biopsies all showed normal results. While I was researching reasons for his particular case of male-pattern baldness, I came across 2 candidates - Cushing's and Alopecia X. The vet thought those were unlikely due to his normal tests and kept prescribing antibiotics.

Two weeks ago he was diagnosed with diabetes, and insulin was not making a dent on his high glucose levels. I insisted they give him a Cushing's test. His ACTH Stimulation test came back positive.
Pre 3.8 ug/dL
Post 30.6 ug/dL

Aragon is a 125 lb (lost 12 lbs in the last 4 or so months) 10 yr old Alaskan Malamute. Due to his age and size, my parent's have decided not to treat the Cushing's and are controlling the diabetes with high doses of insulin (36 units, 2x a day - just to keep his glucose below 300)

After all that information, here are my 2 concerns:

With the diabetes/Cushing's double slam, can anyone guesstimate how much longer he has?

They have another Malamute, same age and weight but genetically unrelated to Aragon. It is showing the same signs of fur thinning that the other started with. Should we be worried of another Cushing's incident? And what external causes could induce Cushing's?

[Harley PoMMom]

Hi and welcome to you and Aragon,

So sorry for the reasons that brought you to us but I am glad you found your way here.

First thing I want to mention is that you should join our sister forum that will help immensely with the canine diabetes, here is the link:www.k9diabetes.com/forum/

Getting the diabetes under control does take priority over pursuing any diagnosis for Cushing's because false positive results can be created when a non-adrenal illness is present.

Hypothyroidism can cause problems with the dog's coat and skin, also in a dog it can be the source of the insulin resistance. Has this been ruled out?

I really have no experience with diabetes but from what I have read I don't think a dog can be labeled insulin resistant until when its glucose concentrations are > 300 mg/dl despite insulin doses > 1.5 U/kg/dose. Here's where I read this information: http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=665659&sk=&date=&pageID=3

Please know we will help in any way we can so do not hesiate to ask any and all questions.

Love and hugs, Lori

[addy]

Hi and Welcome,

The first thing you should do is register at our sister site:
http://www.k9diabetes.com/forum/

We have quite a few members dealing with Diabetes and Cushings.

Here is another resource article to read carefully:

http://endocrinevet.blogspot.com/2012/01/q-diagnosing-cushings-disease-in-dogs.html

Husky type breeds are known for Alopecia X:
http://www.veterinarypartner.com/Content.plx?A=1487

Diagnosing Cushings with diabetes can be very tricky and if the dog's only symptom is hair loss, I would think getting the diabetes under control and waiting on the possible Cushings as per Dr. Peterson's blog link I gave you above would be the best first step.

I am glad you found us and others will be along soon to give you more input.

[Malamutt]

We had the thyroid checked when he first started having the hair loss issues, and it was checked again when he was diagnosed with diabetes. He has the other symptoms of Cushing's that are mistaken for old age, i.e. stiffness, panting, increased urination. He has always been a big eater and big drinker, so that was ignored as well. We are inching closer to the threshold for insulin resistance. We keep upping his dose every three days with minimal lowering of his blood glucose. I'll get back to you when we reach 80-100 units. And as per your suggestion, we will revisit the ACTH test if we get the diabetes under control.

I am not a veterinarian, but I have tried to read around the net. From what I have learned, the ACTH stimulation test results and his older age at onset are highly suggestive of Cushing's not Alopecia X. Plus diabetes is a symptom of untreated Cushing's as opposed to the Psuedo-Cushing's of Alopecia X.

And as per Dr. Peterson's blog: "The problem with diabetic dogs is that it's very difficult to make a diagnosis of Cushing's with certainty unless we see cutaneous changes." He has cutaneous changes as per his fur loss. Following Dr. Peterson's reasoning, this is once again suggestive of Cushing's and not diabetes resistance.

We wished that we had it checked before the onset of diabetes. It would have been easier to diagnose and treat. As it is, my parents just want to make him comfortable and happy. Right now that is a high meat/low carb diet and lots of insulin. He loves the first bit, but not the second.

Thanks for the reading material. I feel I will be a pro after this. Maybe I should charge the vet next time?

[Squirt's Mom]

Hi and welcome to you and Aragon! :)

Aragon - The Lord of the Rings? One of my heroes from that epic tale!

The most important thing you can do for Aragon is get on over to k9diabetes today and talk with them. They are the experts on canine diabetes and see pups everyday whom vets are determined have Cushing's when they do not. The two conditions mimic each other so closely it is very, very difficult to pin both down when they are both in play - and often they are not even tho it sure appears they are. Aragon may need a different insulin or some other simple change to bring things in line...and they are the ones who can guide you best when it comes to diabetes.

However, that does not mean you get to simply leave us...oh, no, we want updates! Ya'll are family here now. ;)

Hugs,
Leslie and the gang

[Malamutt]

Yeah, the other dog's name is Gandalf, and the cat's are named after Star Wars characters. Anakin is a turd, just like his namesake and Chewbacca terrifies the dogs that weigh 10x more than him.
http://i1331.photobucket.com/albums/w598/pookieuf/IMG_00981_zpsc9184449.jpg
Aragon (white) and Gandalf (grey) after shave and bath.

I discussed with the vet about changing insulin types, but he says it's to soon to give up on our current one. And it all comes back to his fur loss. It is a very particular fur loss pattern that I have only found in cases of adrenal or auto-immune issues, and his blood tests do not support auto-immune.