New Member Cushings and Diabetic less then 4 weeks ago

[mausekindmom]

Hi all; I'm super new to all this but somehow have doubts and kind of excited that I found your forum. I spend some time reading and now have my own questions. My 10 yo Lhasa male went to the vet march 2015 for excessive drinking (I took him within a few days of start), no other symptoms. Vet ran some labs on Saturday and on Monday called me that we are diagnosed with Cushings and Diabetics.
I've started Insulin and Vetoryl (30 mg). My dog has NO other sympthoms besides the drinking; he has lost his appetite and I have to be tricky with what i feed him for him to eat. He lost a few pounds and is now steady for the last few weeks still low wish I could get 2-3 pounds back on; his insulin seems to work well and now my problem starts with the Vetoryl. I gave it to him for 3 weeks and I guess I thought he was improving... I had to stop for a week since the vet didn't have any in stock and it took that long to get in.. during that week he did well, ate fairly well, very little excessive drinking and seemed back to normal. I started Vetoryl last Thursday and ever since he is up all night drinking and drinking and drinking... during the day he seemed fine, no drinking issue and sleeps, but in the evening (that's when I give him the Vetoryl ) he drinks, is lethargy, just not acting himself at all. I don't have any lab results and don't really know what to ask for at the vet. I completely trust our vet but I'm doubting the Vetoryl and will stop it, do you think that Vetoryl is an issue? Is Vetoryl fast acting? meaning he gets sick shortly after I give it to him but in the morning 12 hrs later when I give him his insulin he perks back up to a normal dog for most of the day....?? I'm lost and just don't know what to do, look for or ask for.. any help in the right direction would be appreciated

[Harley PoMMom]

Hi and welcome to you and your sweet boy,

When a dog is suspected of diabetes and Cushing's, the diabetes takes priority in getting under control. Uncontrolled diabetes will cause a false positive result on the tests for Cushing's. So if this were me, I would withhold the Vetroyl because the Cushing's diagnosis is questionable.

Cushing's makes a diabetic dog very difficult to get regulated with insulin, so the fact that your boy's diabetes was not hard to get under control is another reason that his diagnosis for Cushing's is unlikely. So, yes, I would absolutely stop giving him the Vetoryl.

The common clinical symptoms seen in dogs with Cushing's are: excessive drinking and peeing, I mean peeing rivers and drinking buckets upon buckets of water; voracious appetite, they are like little hoover vacuum cleaners looking for any crumb they can find; panting; loss or thinning of coat; skin issues; muscle wasting; muscle weakness, especially in the hind quarters; exercise intolerant; difficulty or unable to go up steps or jump on furniture. Being that your boy's symptoms are just increased drinking/urinating sounds more like diabetes to me.

Has your boy had a CBC/Chemistry blood panel done recently? If so could get copies of those test/s and post the abnormal values listed along with the reference ranges and the units of measurement, as an example....ALT 150 U/L (5-50) Could you also post the results of the test/s that were performed to diagnose his Cushing's. Also if an urinalysis was done could you post those findings too? How much does he weigh and how much insulin is he getting?

We have a sister site that deals with canine diabetes and I strongly urge you to join there also. The wonderful and knowledgeable members will be able to help you immensely with the diabetes. http://www.k9diabetes.com/forum/

I am including a link to Dr. Mark Peterson's blog, who is a renown Cushing's expert and who also is a contributor to Dechra's continuing education site: Q & A: Diagnosing Cushing's Disease in Dogs with Diabetes Mellitus (http://endocrinevet.blogspot.com/2012/01/q-diagnosing-cushings-disease-in-dogs.html)

An excerpt from his 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. PU/PD, polyphagia, and high liver values all could be secondary to the diabetes. False-positive test results on a LDDST are very common in dogs with nonadrenal illness, such as diabetes

I'm sure your vet is familiar with Dr. Peterson, as he is a world renown endocrine specialist who helps educate veterinarians both on his blogs and through the many lectures he gives at veterinary conferences worldwide. Dr Mark Peterson is highly published, has coauthored more than a few chapters of veterinary textbooks used in vet schools around the world.

So, I would tell your vet that you have been educating yourself about Cushing's and the protocols for treatment. I would mention that you were directed to an article written by Dr. Mark Peterson, who is a renown Cushing's expert and also is a contributor to Dechra's continuing education site. Your vet can follow his blog and ask questions.

Hugs, Lori

[molly muffin]

How much does your boy weigh? Since the current protocol for starting dose from the manufacturer is to start at the low end which is 1mg/1lb. Add to that Dr. Peterson recommends for dogs with both diabetes and cushings, that the dose be split so as to the keep the cortisol at an even level through out the day. This helps with the diabetes control also. So, say your dog weighs 30lbs, you'd give 15mg in the morning with breakfast and 15mg in the evening with dinner.

Welcome to the forum.