Almost 12 y/o Siberian Husky with Cushings & Diabetes

[Robby]

has now developed diabetes.

I'm new to this forum &, frankly have never participated on a site such as this so please forgive my ignorance in advance!

We have 2 liter mates, both males & both Siberian Huskies. 1 developed Cushings (Buddy). He recently also became diabetic. I have been testing his blood sugar twice a day & giving him insulin injections twice daily too (novolog when needed & novolin). He is not on any medication for the Cushings other than some herbal drops that I figured couldn't hurt (Adrenal Gold).

I'm wondering if I'm making a dreadful mistake by not having him on medication for Cushings. My Vet seems to feel he's old (although now that the Diabetes in under fair control, he's got his energy back & doesn't seem sick) and it would not be worth doing, due to side effects of medication during the phase where you try to find an appropriate dosage.

I love this dog as you all do yours...he got me through some serious illness of my own! The bond is tight!!
Thoughts? Thank you.

[Budsters Mom]

Hello and welcome Robby and Buddy, :)
You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. We will do all we can to help, but be ready for lots of questions! Others will be popping in shortly to welcome you also. Do not stress about this being your first forum. It was my first too!:D You will catch on quickly, so please don't worry about it.:)
Hugs,

[Harley PoMMom]

Hi and welcome to you and Buddy,

First, I strongly urge you to join our sister site that deals with canine diabetes, they are wonderful people and they are very knowledgeable about diabetes, here is the link: http:www.k9diabetes.com/forum/ (http://www.k9diabetes.com/forum/)

What symptoms does Buddy display? What test/s were performed to diagnose the Cushing's? When uncontrolled diabetes is present in a dog the tests for Cushing's can create false positive results. Was Buddy's diabetes difficult to get regulated? Was a CBC and/or Chemistry blood panel done? If so could you post any abnormalities that are listed with the reference ranges and units of measurement...e.g ALT 150U/L (5-50)...Thanks!! Cushing's is when a dog's body produces too much cortisol. Adrenal Gold, which I am sorry to say will not lower the elevated cortisol in a dog's system. Does Buddy take any other herbs/supplements/medicines?

Sorry for all the questions but the more we know about dear Buddy, the better our feedback can be, ok? Please know we will help in any way we can so do not hesitate to ask any and all questions. ;)

Love and hugs, Lori

[Robby]

Hello & thank you both for your responses...Budster's Mom...love the name. We call our Buddy, Bud-Boy, Budster, Budalicious & a variety of other love-nicknames too!

I know a CBC was done - initially he was not diabetic with normal blood sugars & normal insulin resistance. Kidney function, liver enzymes etc all were normal. I don't have a copy to give exact #'s. After being seen by our local Vet, we brought him into NYC (we live on Long Island) to see the recommended endocrinologist, Dr. Mark Petersen who was skeptical given he's a Siberian Husky, and I'm told it's not typical in the breed (too large a dog?). Unfortunately, in addition to the distance & difficulty getting a dog into Manhattan, Dr. P's fees are extraordinarily high, & we decided to have the blood test recommended for definitive dx done at the local vet. It showed whatever the finding was to be Cushings. He was also found to be hypothyroid.

The reason we were working him up at that time is he had had 2 knee surgeries, approx 1 year apart. When they shaved 1/4 of his body for the first, the fur didn't grow back properly very thin & in some sections, not at all. The surgeon thought it was simply alopecia, which happens in some cases per him. Then the other knee was done & the fur didn't grow back at all. We gave him various remedies including melatonin, to see if it would help. However, his skin color got darker & darker to where he had almost black skin. The fur under his collar and around the neck was disappearing, and his body hair was getting thinner & thinner. He did not, however have other symptoms such as the big belly. We decided to leave it alone given it appeared to be stable & I was told the medication doesn't cure but simply allays symptoms, which he didn't have other than fur loss. We felt he was 11 years old & why mess with drugs that we were told you had to bring to a point of near toxicity to find the right dosage? So, things went along nicely for a few months.

About 2 months ago, he started with the excessive thirst, voracious hunger & weight loss. I am a Type I diabetic for 40+ years and know the signs & symptoms well. I brought him to the vet &, lo & behold, 500+ BS on capillary testing with venous testing confirming. We started him on insulin; the Vet is not an endo &, frankly I am more knowledgeable (arrogant?) than he is in adjusting insulin. Plus, I have humalog in the house for me, so I added it to the mix to bring his bad highs down. He is presently taking 22 U of Novolin (N) twice daily, with the Novolog being added as needed. He was under really good control with readings in the high 90's & low 100's. Over the past several days, he's been out of control with readings as high as 320...however, today he finally got below 200 & was 161 in the a.m. That occurred by my increasing both insulins, the Novolin was at 16U BID prior to this exacerbation.

My question is, am I doing the right thing by not pursuing the lysodren therapy? I was thinking after doing some reading on this forum that perhaps by using that, his diabetes would go away???

You asked about other supplements - he takes Dasuquin with MSM BID & Turmeric capsule 720 mg daily.

Sorry for the length of this but I think I covered all so that intelligent answers can be considered!

Thank you for any advice you can give.

P.S. What are the qualifications of the Administrators? I probably should have started with that question!;)

[Harley PoMMom]

I know a CBC was done - initially he was not diabetic with normal blood sugars & normal insulin resistance. Kidney function, liver enzymes etc all were normal. I don't have a copy to give exact #'s.

If you could get your hands on a copy of that senior blood panel and post the levels that are elevated that would be great!


After being seen by our local Vet, we brought him into NYC (we live on Long Island) to see the recommended endocrinologist, Dr. Mark Petersen who was skeptical given he's a Siberian Husky, and I'm told it's not typical in the breed (too large a dog?).

Dr. Peterson is a renown expert in endocrine issues, he has a blog which I try to keep up with. What exactly was Dr. Peterson skeptical about?


Unfortunately, in addition to the distance & difficulty getting a dog into Manhattan, Dr. P's fees are extraordinarily high, & we decided to have the blood test recommended for definitive dx done at the local vet. It showed whatever the finding was to be Cushings. He was also found to be hypothyroid.

Is Buddy taking any thyroid supplement for his hypothyroidism?



We gave him various remedies including melatonin, to see if it would help. However, his skin color got darker & darker to where he had almost black skin. The fur under his collar and around the neck was disappearing, and his body hair was getting thinner & thinner. He did not, however have other symptoms such as the big belly.

The black skin/hair issues can be attributed to hypothyroidism, and with treatment these issues usually resolve.



We decided to leave it alone given it appeared to be stable & I was told the medication doesn't cure but simply allays symptoms, which he didn't have other than fur loss. We felt he was 11 years old & why mess with drugs that we were told you had to bring to a point of near toxicity to find the right dosage?

The medications Trilostane/Vetoryl and Lysodren/Mitotane are the two drugs that are rx'd most, and you are correct they do not cure Cushing's but do abate the bothersome symptoms. It is true that these medicines are strong but side effects can be minimal if the vet is well versed in the treatment protocols of Cushing's and a pet parent needs to educate themselves so that they can be the best advocate for their furbaby.



My question is, am I doing the right thing by not pursuing the lysodren therapy? I was thinking after doing some reading on this forum that perhaps by using that, his diabetes would go away???

Every dog needs to be looked individually when considering treatment. Cushing's is when cortisol is elevated and sometimes when treatment is initiated the lowering of that cortisol can unmask and/or worsen certain health issues such as allergies and arthritis, so when deciding to treat or not to treat all things need to be considered.





P.S. What are the qualifications of the Administrators? I probably should have started with that question!;)

One important fact I want you to know is that none of us are veterinarians. We do, however, have extensive knowledge and experience regarding canine Cushing's.

An Administrators job duties consist of, but are not limited to:"house keeping" the forum, approving new members and supporting our very loving members.

So on that note, welcome to our family! ;)

[labblab]

P.S. What are the qualifications of the Administrators? I probably should have started with that question!;)
Welcome from me, too!

I just wanted to add a little bit, too, in response to your question. I think your question is a good one, because you are trusting in the good faith of the folks who are managing this forum. We are all volunteers who currently have, or in the past have had Cushpups of our own. Some of us have been posting to this forum (or parent forums) for over a decade now. So, amazingly, we have followed the case studies of hundreds of Cushpups throughout these years (we have over 3,000 forum "members," and almost 400 currently active members right now). So even though we are not vets, we are probably acquainted with more Cushpups than many vets will ever encounter throughout the length of their professional practices. I do not say this to inflate our credibility, but just to let you know that we have witnessed the journeys of many, many dogs and their parents.

As Lori has said, none of us are vets and our suggestions should not take the place of professional veterinary care. We have no ties to any pharmaceutical companies or veterinary practices and the site is financed entirely through personal donation, so there is no "conflict of interest" in the feedback that we offer. It all comes from our personal experience, our own research, and the case studies of those who post on our forum.

When we first saw your question, one of our Admins jokingly said that the main qualification is that we need to be certifiably insane -- to which our families and friends probably would readily agree :p! Because we spend hours and hours and hours of unpaid time here, just because we care so much about the friendships that we forge here among our members who span the globe, and all our beloved dogs.

And after having said all that, I join Lori in welcoming you to our family!
Marianne

[mytil]

Hi and welcome from me as well.

I echo what Lori and Marianne have provided in answering your question about the admin qualifications.

I only want to add that the reason why this forum and preceding forums have existed is simply because going through the diagnostics and treatments of Canine Cushing's (and related conditions) can feel like such a lonely place to owners and we are all here together (been there, done that) helping each other through this frightening and confusing condition. We also, IMO, have amassed a great wealth of knowledge in our Resources section through the years.

Terry

[Squirt's Mom]

In addition to the qualifications of our Admins previously listed, they also possess the following -


The biggest hearts on the planet
Eyes that readily shed tears of joy and sorrow
Generous with their time and Spirit
The ability to care, truly care, about people and dogs they will never meet in person
Determination to provide and maintain a place for cush parents to come, learn, and grow into a real family
Hands that can fly over keyboards in search of answers, to provide information, to offer solace
Minds that won't shut off at night for worrying about your baby


Oh, yeah...and that insanity thing! :p

[frijole]

I'm an admin now but 8+ years ago I landed with this group and my thread title had the word "Overwhelmed" in it. That pretty much sums up all members when they first arrive. The site saved my dog's life from a vet that was clueless at treating cushing's disease. I chose to stay on to help others.

The only reason the site exists is because of how complicated the disease can be. We tend to hear from people that are in distress so not only have we seen many many cases - they are often when a dog is in trouble. We continue to help simply because there is a need to help others.

I wish you and your furry loved one a successful cushing's journey. Kim

[goldengirl88]

Robby:
I just wanted to welcome you and say I am sorry Buddy is having problems. I usually try to give some good tips when you are new. I would keep a daily diary of my dog, I would make sure I go to a vet that has treated Cushings and understands it, or an IMS is your best bet. Get your dog on a healthy diet, and watch his weight, If you choose Vetoryl call Dechra and establish a file on your dog, they have veterinarians on staff there to help you. The number is 866-933-2472 Get copies of all testing done on you dog and post it on here so you can get help. Educate yourself as much as possible on this disease, you are your dogs best advocate. Make sure you get the appropriate testing to determine if your dog has Cushings. It is a hard disease to diagnose and very few vets know or understand about it. You best hope to get you and your dog thru it is this forum. They eat, sleep, and breathe this disease. You will not get better help anywhere. My dog started on the Vetoryl 11 months ago and she will be 12 in October. Make sure if you use Vetoryl to start low on the dosage, you can always go up, do not start on a high dosage as that brings trouble a lot of times. The low dose will make it easy for your dogs body to adjust to the drug.God Luck to you and God Bless you and dear Buddy.
Patti

[molly muffin]

Hello. We are a support group forum of people who have all gone through and are going through the same things. Comparing notes, keeping updates on the latest papers and studies in hope of giving our furbabies, the best chance of living out a normal lifespan while dealing with cushings.
We recommend and try to help members to work with as a team, a vet and and IMS to get the correct diagnosis and treatments. Mainly we support each other.
Not all vets are as up to date on cushings information as they need to be treat cushings successfully. Since we follow prescribed protocols, when those aren't being met, we point it out and hope that members will print out the correct information for their vets and if the vets aren't willing to follow protocols, then find a vet who will. This is important actually for survivability of this disease.
Dr. Petersen, whom you have consulted, is one of the leaders in the field of cushings treatment and some of our members have consulted with him. Dr. Feldman at U of Davis is another field leader. Both have made important contributions to the study of cushings disease. The late Dr. Olivier from U of Tenn the only University to test for atypical cushings, was prior to his death, a valued consultant for many of our administrators and moderators and offered invaluable help to members here.
I hope that answers who we are and why we are here. Our administrators are people who have been there and who continue to be there for members, for a very long time, with a wealth of experience in helping others because they care. For me that is enough. I have a vet, I have an IMS, and here, I have support and help when needed and give back the same. We are a family, plain and simple.

Sharlene and Molly Muffin

[Robby]

Harley PoMMom, Yes w/regard to thyroid meds. He takes Thyro-Tabs, 0.6 mg BID

[lulusmom]

Hi Robby and a belated welcome to you and Buddy.

I see that youi've already gotten a bunch of information on who we are and why we do what we do but if it makes difference as to whether you put any stock into what we have to say, just know that many staffers, as well as non staff members have made the difference between life and death for more than a few dogs who were unfortunate enough to have an uninformed owner who placed blind faith in an ignorant vet. I’m an insurance professional with 43 years in the biz as well as a life long small dog rescuer, with an emphasis on seniors and special needs. Somewhere in between all that I research anything and everything canine cushing's or remotely connected to canine cushing's. I've had much hands on experience having had three dogs diagnosed with the disease. All have passed but I’m still here because I love dogs and am passionate about educating people who want to learn about cushing’s so they can become a fantastic advocate for their dog. Now that that's out of the way, let me start being the usual pain in the neck and start asking you a million and one questions. Sorry but there are several unanswered questions in my mind about the accuracy of the cushing's diagnosis.


I know a CBC was done - initially he was not diabetic with normal blood sugars & normal insulin resistance. Kidney function, liver enzymes etc all were normal. I don't have a copy to give exact #'s.
Loris has already requested that you please round up copies of the CBC but I’m not sure that’s necessary if there were no abnormalities at all. Was this CBC done relatively close to the time cushing’s was diagnosed? Can you please get copies of all diagnostic tests that were done to confirm the diagnosis and post the results here? We would be particularly interested in the acth stimulation tests, ldds test and any differentiating tests like an abdominal ultrasound, hdds test or endogenous acth test. The acth test and often times the ldds test does tell you which form of cushing’s you are dealing with so the latter three are used to make that distinction. Did your vet diagnose adrenal or pituitary dependent cushing’s?

After being seen by our local Vet, we brought him into NYC (we live on Long Island) to see the recommended endocrinologist, Dr. Mark Petersen who was skeptical given he's a Siberian Husky, and I'm told it's not typical in the breed (too large a dog
There are several breeds that seem to be genetically predisposed to cushing’s but Siberians are not one of them. Yes, the majority of dogs diagnosed with hyperadrenocorticism are on the small side but any size or breed can develop cushing’s.

Unfortunately, in addition to the distance & difficulty getting a dog into Manhattan, Dr. P's fees are extraordinarily high, & we decided to have the blood test recommended for definitive dx done at the local vet. It showed whatever the finding was to be Cushings. He was also found to be hypothyroid.
Was this blood test done shortly after the CBC and if not, was a more current CBC and the other usual screening tests such as a complete blood count and urinalysis done before the diagnostic test that was consistent with cushing’s? As requested above, please post the results of any tests that were done. With respect to the low thyroid, did your vet do a complete thyroid panel or did he diagnose based on a low T-4 which is usually included in the normal blood chemistry? If it was based on just the T-4, it’s quite possible that Buddy doesn’t have primary hyperthyroidism but rather sick euthyroid syndrome. This syndrome is caused when an underlying condition, like cushing’s and/or diabetes, has a transient effect on the thyroid hormone. Once that underlying condition is adequately controlled with medication, the T-4 will return to normal. When did you start giving Buddy the thyroid supplementation and did you have the thyroid levels checked since starting treatment? If not, there is always the possibility that once the diabetes is brought under control, Buddy could be thrown into hyperthyroidism. All dogs with hyperthyroidism have pu (peeing lakes) and pd (drinking buckets).


The reason we were working him up at that time is he had had 2 knee surgeries, approx 1 year apart. When they shaved 1/4 of his body for the first, the fur didn't grow back properly very thin & in some sections, not at all. The surgeon thought it was simply alopecia, which happens in some cases per him. Then the other knee was done & the fur didn't grow back at all. We gave him various remedies including melatonin, to see if it would help. However, his skin color got darker & darker to where he had almost black skin. The fur under his collar and around the neck was disappearing, and his body hair was getting thinner & thinner. He did not, however have other symptoms such as the big belly. We decided to leave it alone given it appeared to be stable & I was told the medication doesn't cure but simply allays symptoms, which he didn't have other than fur loss. We felt he was 11 years old & why mess with drugs that we were told you had to bring to a point of near toxicity to find the right dosage? So, things went along nicely for a few months.
Post clipping alopecia is very common in Nordic Breeds like Siberian Huskies, Pomeranians, American Eskimos, etc. So is black skin disease. I’m a small dog rescuer with an affinity for Pomeranians and I’ve seen a ton of bald ones with black skin, who are otherwise healthy. Dr. Bruyette, a renown endocrine specialist says; “The best treatment for a bald Pomeranian is a sweater.” There has been more than one study on dogs with alopecia X and while most did have elevated adrenal sex hormones, most dogs had no real clinical signs. If loss of coat and black skin were Buddy’s only symptoms at this point, melatonin is the treatment of choice so drugs like Lysodren (Mitotane) or Vetoryl (Trilostane) should have never been discussed. Is Melatonin efficacious? Not so much. It’s a real crap shoot and if it does have any impact, you usually aren’t going to notice for several months. It did nothing for my bald Pomeranian and its had little to no effect on any of the Poms with alopecia I’ve rescued.

About 2 months ago, he started with the excessive thirst, voracious hunger & weight loss
You mentioned here or on the diabetes forum that Buddy was diagnosed with cushing’s before being diagnosed with diabetes. Were any of these symptoms present when cushing’s was diagnosed? I’m trying to figure out if the cushing’s diagnosis was confirmed based solely on loss of fur and change of skin pigment. If so, the cushing’s diagnosis becomes even more suspect.

My question is, am I doing the right thing by not pursuing the lysodren therapy? I was thinking after doing some reading on this forum that perhaps by using that, his diabetes would go away???
Without seeing the actual test results and a better understanding of the timeline between the complete blood chemistry, the diagnostic tests and results done to diagnose cushing’s and the diabetes diagnoses, unless I'm missing something, I don't believe anybody here is in a position to even know if Lysodren would be an appropriate and safe treatment. Your answers to questions and posting test results will help tremendously in our ability to provide you with appropriate feedback. Looking forward to hearing from you soon.

Glynda

[Robby]

Hello, again everyone!

Do any of you have any experience with your pup-pup intermittently losing bowel control?

About a month or so ago, Buddy began pooping in the house. This was never a problem in the past. Last night, the 4 of us were in bed sleeping (picture that...my husband, me & Buddy & Rusty who are 72 & 78 lbs respectively...thank goodness it's a king size!) & early in the morning I awakened to that familiar "aroma". I didn't see anything & asked Jerry, my husband to get Buddy out fast! Then I had an opportunity to straighten the cover we put over our comforter for the boys, and there it was!

Does anyone have any experience with this? Suggestions? Insights? I'am fearful that this is a sign of him beginning that downward spiral we all fear :-(

[lulusmom]

Hi Robby,

I don't have any experience with loss of bowel control so I'm bumping this up in the hopes that someone else may have some words of wisdom for you. I do hope you saw my post so that we can get some additional information on Buddy.

Glynda

[molly muffin]

The only time that happened with my Molly, when I took her in to the vet, she was put on antibiotics and floriflora (probiotic) for a bacterial infection, probably intestinal. It cleared up, but it was very persistent and even after the normal run for an antibiotic, about 2 weeks, she had to continue on an extra week and then was on the probiotic for about a month or maybe a bit longer.

Not sure if that helps. I know it is scary when it's not something that would normally happen. Molly had never had that happen, but you could tell she couldn't help it, runny mess and yep, the aroma woke me up too.

Sharlene and Molly Muffin

[doxiesrock912]

Robby,
we recently went through this with Daisy.
She is on Tylan powder because the IMS specialist suspects a very low level of eColi or another organism is the culprit.

We tried Baytril, but the accidents resumed shortly after finishing the meds. Dr. Morgan chose Tylan powder because it is a natural antibiotic and it has worked wonders! Dogs can also be on it safely for a much longer period of time (3-6 weeks).

[Squirt's Mom]

Hi Robby,

My Trinket has Colitis which gives some really nasty stools but I wouldn't call it loss of bowel control in the same way we see incontinence - Trink's is a result of the disease which causes uncontrollable diarrhea, bloody diarrhea often. Is your baby having diarrhea or normal stools that Buddy can't seem to hold? I think I would ask the vet about this in case he is losing muscle control or experiencing a loss of sensation for some reason.

I use an herb called Slippery Elm Bark with Trink, and the rest of us anytime we have an issue in fact. It is inexpensive, easy to use, effective, and doesn't introduce additional chemicals to the body. Unless an active infection is present antibiotics aren't needed - in fact they are one class of drugs that is vastly overused in both animals and humans.

It would help us a great deal if you would answer the questions that have been posed in order to help your sweet Buddy better. ;)

Hugs,
Leslie and the gang