Angus newly diagnosed and very sick :( - Angus has crossed The Bridge

[Cazbah]

Hi Everyone
My 14 year old Jack Russell Terrier Angus received a firm diagnosis on Monday for cushings.

A bit of history
He was diagnosed with bladder cancer in Sep 2010 and began Metacam which has kept the tumour from growing (it's about the size of a golf ball).

The weekend before last he was very listless, drinking lots and nit moving much. We have been experiencing issues with him having accidents in the house for a while but they were definitely worse.

We thought his kidneys were failing and on 17/10 with heavy hearts we called the vet out to put him to sleep.

The vet wasn't convinced he has kidney failure and wanted to do tests, he was admitted and tested positive for diabetes and had ketones so had to stay overnight on a drip, his blood sugar remained unstable and 'high' but as the vet suspected cushings and was wait g for test results he wanted us to care for him at home to avoid stress.

His cushings came back positive on Monday, he started 40mg of Vetoryl is on 12 units of can insulin twice a day, has had his Metacam dose halved and had a course of anti biotics for an infection.

Yesterday he was extremely listless had no appetite and drinking lots again as well as peeing lots, last night he was sick almost every hour
had no energy and can barely stand, his legs have really gone thin and scrawny.

I can't remember the figures for cushings but vet said they were very high and off the scale and had come down after the test but were still in the high range.

Today he has been readmitted to the vet to go on a drip, he has ketones and the vet says it's this and not side affects of the Vetoryl that's made him so poorly.

We are struggling to make decisions, I know that pets can respond well to the meds and want to give him the chance but I cannot watch him suffer like this without knowing if he has a chance.

Reading up in the web is just getting me more confused.

I want to have hope he will get better. Can anyone reassure me that they too had this kind of roller coaster to start with but it got better?

[Jenny & Judi in MN]

It sounds like you have a very good vet. I know the ketones are extremely dangerous and can take 3 or 4 days at the vet to get straightened out so I think Angus is in the right place.

if you go to the K9 diabetes forum there are some folks there who have gone through what you and Angus are going through. Scary times for sure.

I remember some of them saying that after the initial scare the diabetes management became routine so I think there is hope. He is just a very sick boy right now.

My Jenny also has diabetes and Cushings and the Cushings made her insulin resistant so it took awhile to get her insulin dosage to the correct amount. Hang in there. I'm going to add the link for the diabetes forum in a minute.


Here is the link: http://k9diabetes.com/forum/index.php If you post in the Diabetes your dog section people will see it sooner.

p.s. Jenny is on Lysodren but I've read on here that the Trilo is more effective given in 2 doses as most diabetic dogs eat twice a day 12 hours apart and the Trilo is better with food. Is Angus taking it twice a day?

Judi

[frijole]

I am headed off to work but wanted to send out a welcome and warm wishes for Angus.

It really is important to provide details of all cushings tests done to dx. Non-adrenal illnesses can result in false positives. I had 7 false positives before they finally decided my dog does NOT have cushings. It can be tricky.

With the cancer and diabetes - it certainly could be a false reading, especially if you only had one test done. Is Angus under the care of an internal med specialist or a regular vet? I ask simply because with everything going on it is usually best to go to a specialist. They can work with a regular vet as a team.

I will check in later. Thanks. Kim

[frijole]

P.S. If your dog is vomiting you should not be giving trilostane. It could be the cortisol is too low. Could be other things but I would stop it for time being. Kim

[Cazbah]

The vet admitted him on Thursday morning because she believed he has ketoacidosis, he hasn't responded to the fast acting insulin his blood sugars are still seriously high. we have bought him home again, as he has stopped vomiting, it's a case of trying to keep him going until the cushings medication starts to work as it seems he has insulin resistance. he may tick along for a few more days or have another crisis and have to go back.

I am finding it hard to decide what to do for him, I want him to have a chance but don't want him to suffer unnecessarily.

With the bladder cancer, the diabetes and the cushings and his age there are lots of complications but tonight he ate some food and was interested in us again.

I haven't got the bloodwork results but may be able to get them on Monday when we see the vet again.

Nobody can tell me what to do I know but if anyone can help with a take on what they have experienced it may help me massively.

I have registered on the diabetes forum but have had no confirmation email so can't post a thread

[labblab]

I have registered on the diabetes forum but have had no confirmation email so can't post a thread

I am so sorry that Angus is having such serious problems. The site administrator for k9diabetes.com is also an administrator here, so I have sent her a message in hopes that she can help sort out your registration when she next returns online. In the meantime, please do double-check your spam folder to make sure that your registration confirmation hasn't gotten "lost" or otherwise misdirected.

Marianne

[k9diabetes]

Hi,

I just approved your membership at the K9diabetes forum.

Natalie

[k9diabetes]

Has the vet given a large dose of the fast acting insulin? If the dose is too conservative, he might not show any affect. I've known a few terriers in a better spot healthwise than Angus who weighed about 24 pounds and needed 21 units of insulin per injection to regulate their diabetes.

Having his test results would help a great deal in possibly offering some advice. If his cortisol level was sky high, it could take a lot of insulin to make a dent in his blood sugar.

If he's had a large dose of fast acting insulin and absolutely no response at all, he could be one of a very few dogs who do not respond to the human insulin molecule. In which case the vet would need to get hold of some Caninsulin as quickly as possible and try that. Caninsulin is pork-based and is a moleecular match to a dog's natural insulin.

Getting the blood sugar down somehow has to be the first priority as he can't go through ketoacidosis for any length of time and survive. If you can find out as much detail as possible about exactly what the vet has done, all test results, what insulin was given and how much... maybe I could offer some thoughts.

Natalie

[Cazbah]

Thank you Natalie, he weighs 11kg and has 12 units of caninsulin every 12 hours, they have been giving him novorapid 0.2 iu/kg initially followed by 0.100/kg hourly whilst he was admitted. he was also on saline drip and eating little meals. Hid blood sugar never dropped below 22 even when he had the fast acting stuff.

He is quite settled tonight sleeping and waking to wee and drink.

his cortisol was something like 259 and 160 after second test by memory

[k9diabetes]

At 11 kg, that's about 24 pounds. He could need quite a bit more than 12 units of Caninsulin to get his blood sugar down.

He wouldn't be technically insulin resistant by definitions I've seen until he's on 24 units of insulin per injection and still has high blood sugar. I don't have the link handy and won't have time to track it down right now.

As I mentioned, I've known two terriers, one a Jack Russell and the other a fox terrier I think, who needed inordinately large amounts of insulin to regulate. Both weighed around 24-25 pounds and were getting 21 units of insulin per injection. Their blood sugar was very well regulated - they just needed a lot more than the average dog to get there.

If it was my dog, I'd be pushing hard for an increase in the insuiln dose. Stopping at half a unit per pound would be an artificial limit that the vet should be willing to push past in Angus' case where the situation is very serious.

Natalie