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As long as he has a bladder infection I wouldn't do the ACTH test. The results can be off from having an infection. Dratted things. I do hope that he responds to the baytril. Must be one of those infections that just really hang on and are hard to get rid of. My molly had an intestinal one that she ended up being on antibiotic for almost a month for. It just didn't want to go away. That with the florflora helped though.
hugs,
Sharlene and Molly Muffin
The vet said it could mess with the results if we don't have it cleared up. Hopefully it will clear up. He's been battling this since he was first diagnosed with diabetes almost 5 months ago. The old vet would give him antibiotics and assume it was gone then he'd show symptoms again and we'd start stronger antibiotics. I'm afraid it's been giving far too much time to build up some serious resistance!
Look!!!!! I just found Fortiflora on sale here.
http://www.probioticsmart.com/pets/c...ortiflora.html
oh good price Valerie.
I will say that I gave the floriflora with the antibiotic and then even continued for a few weeks longer than the antibiotics and it really did help her and she loved the taste, so that was good!
hugs,
Sharlene and Molly Muffin
Finally a bit of good news for Cooper...his urine culture came back negative! He's finally free from this nagging bladder infection!! We're continuing the antibiotics (baytril) for 2 more weeks.
Our next step is his ACTH test and glucose curve next Thursday.
Yay!!! that is Very good news!
Good job!
hugs,
Sharlene and Molly Muffin
And I finally uploaded a picture of my handsome man. That's Cooper in my avatar!
Yes, Cooper is very handsome indeed!:D
Great news on his bladder infection!:)
You are doing a wonderful job Julie:)
Hugs,
Kathy and Buddy:cool:
Aww, soulful eyes. Handsome guy :)
hugs,
Sharlene and Molly Muffin
I finally joined k9diabetes.com and I posted this there too, but I wanted to post it here as well. Cooper went for a glucose curve and ACTH test today.
OK, here's what the vet wrote on her summary when I picked Coop up today:
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Cooper's glucose remained in the 300s all day indicating poor control of his diabetes. If he has uncontrolled Cushings disease, then this could be the cause of his dysregulation. However, there is still the chance he is on too much insulin. I do not want to change his dose until seeing his ACTH stimulation test results to know if Cushings is contributing to this curve. I will call with there results tomorrow.
Blood Glucose Curve:
8a: 323mg/dl
10a: 310mg/dl
12p: 314mg/dl
2p: 345mg/dl
______________________
We're maintaining his 30units until I hear more from the vet. And despite looking like he's lost 5 or 6 pounds in the last 2 weeks, he has actually maintained his weight. Don't know what's going on there but I'm glad he didn't lose any weight!
And he may be developing cataracts. His pupils were a bit cloudy, but it has gotten worse. She said it could be from old age or from cataracts, but that she could see the back of his eye so he can still see (for now!). Don't know what I'd do if he goes blind. I'm pretty sure we wouldn't do any surgeries. I think he'd do well without it and I'd hate to put him through any more procedures than necessary. He's not exactly a spry puppy anymore and he doesn't need any more stress! Although being blind would probably be pretty stressful too!
Cooper's ACTH test came back. I just talked to the vet on the phone so I don't have the full results, but his ATCH post reading was 24.8. I'm trying to look back at other people's threads to see how high that is, but I keep on winding up in threads where they do different tests! The vet said a "high normal" is 17. And I see on the vetoryl insert that 1.45 - 5.4 is the desired range. 24.8 seems super high.
We're going to start trilostane again. He'll be getting 30mg twice a day. The vet is still not sure if it's actually cushings or if the elevated levels are from the uncontrolled diabetes. There doesn't seem to be a real way of knowing I guess. When I told her Cooper did well on the trilo until we doubled it and that he had glucose readings in the low 200s while on it, she said we should go ahead and try it. We're going to do another glucose curve and ACTH test along with a urine culture in 2 weeks.
I feel good about this, I think!
17 would be a high normal for a dog not being treated with medication for cushings. Once you are on vetoryl, then you want 9, with symptoms controlled or 1.45 - 5.4 as a target post number.
Hopefully treating will bring both the cortisol and the curve numbers down.
Just do the normal watch to make sure he is tolerating this dosage well.
hugs,
Sharlene and Molly Muffin
Thanks! I took it as 17 was a high number for a normal dog, not that it was a high number for an unmedicated cushings dog. I really have to stick to my list of questions i always write out when the kids are around!
Just a quick Cooper update... he's rapidly losing his eyesight. He walked into a chair 2 days ago and he's tripping over everything on the floor. My poor boy! And I think his sense of smell might be going a bit. He was licking a paper plate yesterday that my daughter finger painted weeks ago. I guess he thought the dark paint was food.
I sure hope we get things under control for him before he gets any worse. I scheduled his next ACTH/glucose curve/urine culture for next Thursday, and it can't come soon enough!
oh poor Cooper Well, there are adjustments that you can make and we have a some here that can help you with that, having blind furbabies also.
I agree, got to get those next tests.
hugs,
Sharlene and Molly Muffin
How are things going for coop? get any more results from vet or see changes from the meds helping at all? however maybe enough time hasn't elapsed for all that yet. Wanted to say hello, been following along with some threads, then have been mia for week or so, and trying to check on everyone that i had been reading and following along with. I cant believe how attached I am to so many of these furbabies and angels, get to feeling insecure, sad, and worried when i cant get on here to check and visit.
No changes yet. It's just been a week on the trilostane. When he was on it about a month ago, I remember an immediate improvement in his energy levels. He's still tired, hungry, and thirsty. But I'm sure the adjustment to losing his eyesight so quickly would take a lot out of him.
We've made the big, painful decision to probably stop testing soon. We're going to do testing on Thursday, but if there's no change we will probably pull him off the trilostane and just do insulin. There are still so many things that could be wrong and so many unexplored avenues of treatment. We could put him through test after test for months and still not be any closer. We set aside my husbands bonus and our tax refund for testing and we've already blown through that. With 2 little kids and a single income we just can't afford to go into massive debt. We feel that he's maintaining now and that may be the best we can hope for. He doesn't need to go through much more, especially not spending the day at the vet now that he's almost blind. I still have my fingers crossed that the next ACTH test will show a major improvement and it will just be a matter of adjusting his dose, but we have a plan just in case there's no change.
check into care credit. it has helped me out so much i cant even express how much. I get long term interest free on nearly everything. and that is awesome.
I saw their pamphlet at the vet. I'll pick one up on Thursday.
From our Resource Thread you can find information about Carecredit and more here: Financial Resources to help with Vet bills
I, too, use carecredit and really like it.
Finally I have some good news!! Cooper's cushings seems to be under control. His ACTH test Thursday was pre 2.7 and post 7.1!!
His glucose curve was worse than his last one, his numbers were in the 300s and 400s all day. We're going to try cutting his insulin back from 30 to 14 units to see if he's been overdosing on insulin. I'm going to start hometesting his glucose as soon as I get all the stuff I need.
We also did a urine culture and we're waiting for the results but I think he has another bladder infection. Hopefully we'll know by Monday.
Are all Cooper's Cushing's symptoms controlled? If, so, then those are good numbers!!
Hmmm, I can't tell if the symptoms are controlled. He's got so much else going on, it's hard to say what's causing what. He's still drinking a lot (actually it's increased lately), but I think he's got a new bladder infection which would cause the excessive drinking. He's always looking for food, but his diabetes isn't controlled and that could make him hungry.
His excessive panting has stopped though even though the temperatures have really warmed up here the last week.
hey
stopping by to see how things are........
did he have a bladder infection? increased drinking might be from warmer weather do you think? i hope all is okay. i am glad to see some test results came back with good numbers.
I keep forgetting which forums I've posted in! I'm on this group and the k9diabetes forums too.
Yes, he does have another bladder infection and it's the same bacteria that it has been the last 2 cultures. It must be hiding out in his system somewhere!
There's been no change good or bad on his new insulin dose other than drinking a bit more. His glucose meter should get here on Wednesday and I'll do a curve on Friday (although I plan on playing around a bit on Thursday to figure the thing out!)
It's been awhile since I posted here. I'he been sticking mostly to the k9diabetes forum since the cushings seems to be pretty well managed right now.
I do have a cushings question though. Will an ACTH test cause blood glucose levels to rise for a few days afterwards?
Cooper went in for a blood glucose curve, ACTH test, and urine culture Friday. I had increased his insulin by 2 units that week. His curve was worse than the week before. The curve was done in the morning followed by his ACTH test. I took a few readings today and his numbers were even higher.
Last week: blood glucose in the 200s and 300s, 28 units insulin
Friday: blood glucose in the 300s and 400s, 30 units insulin
Saturday: boll glucose in the 400s and 500s, 30 units insulin
Someone on the k9diabetes forum thought that the ACTH test could be the cause of today's increased levels. Is that possible?
Cooper seems to have been free from a bladder infection for a few weeks, but I think he may have developed a new one a few days ago. I'll know Monday when the urine culture results come back. We just can't seem to keep these bladder infections away long enough to regulate his insulin dose.
It is possible that the ACTH could cause it to rise for a bit. In some dogs we see more symptoms for the first day to 48 hours after an ACTH test. If he has a bladder infection though that too could be affecting this BG.
I'm glad that his cushings is mostly controlled. I think that diabetes can be much harder to get control of than cushings.
You're doing great though keeping on top of all of this. It can get so confusing, when everything seems to affect everything else.
hugs,
Sharlene and Molly Muffin
Thanks! This has been far tougher than I ever imagined! We've been so close to just giving up so many times and I must admit I'm there again. My husband thinks we should just leave him at his current doses of medicines and stop with all the testing and adjusting. But that's just because he's not the one who has to let him out twice a night when he has bladder infections! I swear it's like having a newborn in the house again!
We had a glimmer of hope for about a week where he seemed to be feeling better but the last few days he's been back to his sick self. I really wonder what sort of pain he's in and what his real quality of life is like. I feel like we keep saying he's got go turn a corner soon, but he just never does.
None of this is easy and it can at times be quite heart breaking. Only you know what Cooper's quality of life is, as you know him best. I know sometimes that is more guessing then true knowledge. If he seems happy to see you, and he wags his tail, wouldn't mind playing a bit and hanging out with you, then those are things that you can use to try and figure out how he is doing quality wise. It still isn't easy though. I know it would be much better if the infections would stop and the insulin could be brought under control. You're right k9diabetes is a wonderful group and very supportive and knowledgeable.
hugs,
Sharlene and Molly Muffin
Juli, ask your vet about Tylan powder.
I just went through something similar with Daisy. She kept getting diarrhea. I stopped the meds for a time to see if they were causing this and nothing changed.
Dogs can have underlying systemic infections, like e-Coli which take a bit of time to eradicate. Daisy's diarrhea was constant and so bad! Baytril worked but as soon as I stopped it, the diarrhea came back worse than ever.
The Tylan powder is a natural form of antibiotic so there is also less chance of becoming resistant to it.
The medical name is Tylosin.
Might be worth a shot.
Thanks Valerie. I'll ask her about Tylan powder when we talk on Monday. I've got quite a list of questions for her this week!
Questions are good Juli.
The Tylan is still working its magic with Daisy.
She has had normal poops since I began giving it to her. The change is truly amazing and her energy level is increasing too.
Keep is posted and good luck tomorrow!
hang in there if you can. Jenny was diagnosed with both in May 2011 and I was an emotional wreck until January. I had been researching so much that the vet told me until my husband just asked me what would hurt if we just went with what he said. So we did.Quote:
Originally Posted by juliwilliams
Granted he killed off Jenny's cortisol by overdosing her on Lysodren but she is healthier and spunkier now, 2 years later, than she was that horrible roller coaster ride of a summer.
So I totally empathize with your feelings. Hugs to you, your family & Cooper
I'm so sorry that your continuing to have such a hard time. None of this stuff is ever easy it seems. Only you can answer the quality-of-life question. That's not a question any of us ever want to think about, but eventually we get there.:( We are here to help anyway that we can. Please continue to talk with us and ask questions and and let us know how Cooper's doing.
Big hugs, and a belly rub for Cooper,
Kathy
Cooper ACTH test came back with his cortisol a little low. Pre was less than 0.7 and post was 2.7 We're cutting him back from 30mg of trilo twice a day to 30mg in the morning and 10mg at night with another test in 2 weeks.
I'm a little confused because i thought optimum control was when the post was between 1 and 9, which his is. The vet gave me the test result as post 2.7 (8-17). I know (8-17) is some sort of reference range, but I don't know what it means.
His urine culture came back positive for the same bacteria he keeps getting. Another $150 antibiotics prescription. Ugh! I'm waiting to hear from the vet about what to do with his insulin while he has the infection.
Thank you all for the support! I'm still on the fence about what to do. We can't keep on testing for and treating bladder infections on top of the insulin and trilo meds. We're past the point of breaking the bank. Every few weeks we're spending hundreds of dollars on complications on top of the hundreds of dollars we spend on medication each month. But I can't imagine just stopping because I know it's a death sentence for him.
Sending hugs and prayers for you and Cooper, just keep taking one day at a time....
I think this is a response to his pre number being a bit on the low side. His post number is good though.
I know this retesting and retesting is a money hog. :(
Cutting back should bring his pre back up a bit. You are right about what the post number should be, and he is good on that front. Maybe since it is just the pre you are concerned about at this point, a base cortisol test instead of a full ACTH would tell you what you need to know.
hugs,
Sharlene and Molly Muffin
After decreasing Cooper's trilo to 30mg in the morning and 10mg at night, his ACTH test came back even worse! Both pre and post were less than 0.7 The vet said that given the numbers she would consider putting him on steroids but he's not showing any real symptoms of Addison's yet. He's panting just a bit and has a bit of loose stool, but not too bad. She said to keep a real close eye on him and bring him in if he starts looking sick.
The vet did another urine culture to see if while on the antibiotics the bladder infection is actually gone. If it is, then we'll be starting a low dose daily antibiotic to try to keep him free of infections so we can finally get the diabetes under control. He's been bumped up to 34 units of insulin twice a day.
We had to go to our old vet the other day because he also has an eye infection. Nothing too bad, just needs a few drops in his eyes a few times a day. I'm just hoping his sick old body can fight it off and we don't have recurring eye infections now too. My poor guy has really been through the wringer lately, but he's tough as nails and you'd never know it by looking at him!
OK - when a dog goes as low as yours did they ARE considered Addisonian. Are you going to a specialist? (IMS) I am very concerned that you are not giving any prednisone for relief. Is Cooper able to walk, get up etc on his own?
Given those low numbers you cannot give any more trilostane until after you wait long enough for cortisol to be normal again - which may be never. The only way you will know is to wait and do another acth test.
Kim
I'be been seeing an IMS for a few months now. We're stopping the trilo indefinitely. We're not going to rush to another ACTH test. The vet said to wait until he starts getting symptomatic again, if he ever does.
He's acting completely normal! For him at least. A little big of loose stool and panting, but not bad. He had overdosed once when we were seeing our general vet and it was very obvious to me. He was weak, twitching, and fell into a wall. Right now, he's normal. But she said to rush him in if anything changes.