Cushings, Diabeties and now pancreatitis

[Bella's Mum]

Hi everyone,

Hope you have all enjoyed your Christmas break

We have a mini dachshund who would be roughly between 9 - 13 ( rescued so not 100% sure) female named Bella. Bella was diagnosed with diabeties back in November 2011 and cushings in September 2012.

Past year or so we have had our ups and downs and most recently today Bella refused to eat, she even turned down her favourite meal - BBQ chicken! Called the vet and went in for check up as she hasn't eaten therefore no medications. (0.20ml caninsulin and 40mg Vetroyl) bloods taken and now are awaiting results, the vet is suspecting pancreatitis. Bella has had pancreatitis about 3/4 times this year so far so it's not unknown but still scary. Bella did have a ACTH test last week, I have not seen the results but vet says its not good and will need to look at increasing medications.

We have noticed the last week hair falling out, very itchy but still happy to walk around the house and yard until today.in the last 6 months or so Bella has developed further cateracts and is running into walls and doors more and more evey day and when in unknown environments (even the vets office) Bella does stress out.

Sorry for the rant but not really sure where to go from here, 1 year of cushings and 2 of diabeties, fundage wise it's estimated over $15,000 in one year alone thankfully Bella is insured and we recieve approx 80% back and there has never been any question with spending the money but question is when do you call it quits

[doxiesrock912]

Welcome to you and Bella!

There is a forum dedicated for dogs that have both since the combination makes treatment more complex.

Someone who has the link, please post asap. Thank you

It's necessary to have the diabetes under control before treating Cushings.
Pancreatitis is common with Cushings unfortunately.

[Bella's Mum]

Well just got of the phone to the vet. It's not pancreatitis as initially thought, although levels are high and we will need to increase her vetroyl although not sure what to as yet. We pick her up tomorrow morning.

[doxiesrock912]

Interesting. Are they sure that there's not an underlying infection? Does she take the Vetotyl once or twice a day?

[Trish]

Hi there

I am presuming they did an ACTH test and all electrolytes to make sure she has not gone low from the vetoryl? Make sure they have done that won't you before you bring her home. I think the general rule is not to give the vetoryl to a sick dog. Although sounds unlikely if her vet said based on last weeks ACTH you may have to increase her vetoryl. I am also presuming they assessed her glucose status with the diabetes.

Sorry I am not Cushings expert (not even close!) but I do know the ones that are will want to see the blood test results, back to diagnosis if possible so they can help you figure this out.

There is a sister canine diabetes site, it focusses on diabetes not cushings but there is a bit of to and fro between the sites for those dogs that have both problems. You can check them out here http://www.k9diabetes.com/forum/

I hope your Bella is feeling better tomorrow, but do remember to pick up copies of all her results while you are there, bloods, urine, ultrasounds included.

[frijole]

Trish is correct! In order for us to really help you we need to know results from tests that have been done to diagnose cushings as well as any abnormal blood panel results. (post the high or low enyzmes and the ranges for normal on each)

It is not usual for a dog to NOT eat when they have cushings as they tend to be constantly starved. And it is a sign that cortisol is too low (that the dose should be decreased not increased). I'd hesitate to increase the dose right now if the dog isn't eating - in fact i would withhold meds until appetite is normal.

Please give us more details about the eating issues. Also tell us if there has been vomiting, diarrhea and lethargy.

With everything going on (diabetes and cushings) it can be hard to get a balance. Are you working with a specialist or a regular vet? Sometimes a specialist needs to be brought in to help get things under control.

Glad you found us! Kim

[Bella's Mum]

Trish is correct! In order for us to really help you we need to know results from tests that have been done to diagnose cushings as well as any abnormal blood panel results. (post the high or low enyzmes and the ranges for normal on each)

It is not usual for a dog to NOT eat when they have cushings as they tend to be constantly starved. And it is a sign that cortisol is too low (that the dose should be decreased not increased). I'd hesitate to increase the dose right now if the dog isn't eating - in fact i would withhold meds until appetite is normal.

Please give us more details about the eating issues. Also tell us if there has been vomiting, diarrhea and lethargy.

With everything going on (diabetes and cushings) it can be hard to get a balance. Are you working with a specialist or a regular vet? Sometimes a specialist needs to be brought in to help get things under control.

Glad you found us! Kim

Hi, we picked Bella up this morning. I still don't have the results from the ACTH as both our normal vet and pratice owner vet would like to speak to the pathology specialist as currently Bella is on a 5mg/kg dose - total 80mg daily broken into two 40mg twice daily dose. At this stage no increase as its Sunday here and the two vets are hesitant as stated above.

Bella's eating habits do vary and we have been told to place her on a strict diet yo help maintain cushings/diabeties and lose weight. Previously Bella diet mainly consists of meat only with biscuits during the day. We told to switch to a homemade rice and meat diet and watch the amount given. Luckly the has been no vomiting or diaherra just refusal to eat yesterday, she did put up a fight this morning at the vets but then decided chickens not too bad and ate her dinner.

At present we are working with Bella's regular vet who is currently study small animal medicines and the pratice owner who has previously been named "Small Animal Practitioner of the Year" in Australia numerous times. We are in a smaller regional location in Auustralia and no local vets from my understanding are truly specialists in internal medicines and we would need to travel and even then it's hard to find one that's somewhat close by with google!

Bella's abnormal blood results are
Matter Actual. Range
Plasma glucose. 13.0mmol/L. (3.5-6.7)
Lipase. 97 U/L. (1-70)
Cholesterol. 14.7mmol/L. (3.6-8.8)
Triglyceride. 7.9mmol/L. ( 0.2-1.7)

The remaining are well within the normal ranges, I can post if requested. I will look for her orginal blood results when dignosed as should have it somewhere - she was diagnosed after going into seizure, that was scary

Since coming home Bella ate some more and had her vetroyl tablets, and seems to be happy to be home

[flynnandian]

a mini dachshund on 80 mg vetoryl? is she doing fine on such a high dose? you posted 2x40 mg/day, or is this a mistake? my friend has one and she only weighs 8 kg. or is your dog so much heavier?

[frijole]

On the blood results that you posted I noticed you did not post the liver enzymes which are alk phos and alt. Were they within normal ranges? I ask because cush dogs ALWAYS have high liver enzymes, particularly the alk phos.

Also I agree that the dose you are on seems extremely high. Please confirm that your dachsund is on 80 mgs a day. If so please tell us your dog's weight. Normal dosing is more like 1 mg per kg of weight. I find it hard to believe your dachsund is 80 lbs.

Kim

[Bella's Mum]

On the blood results that you posted I noticed you did not post the liver enzymes which are alk phos and alt. Were they within normal ranges? I ask because cush dogs ALWAYS have high liver enzymes, particularly the alk phos.

Also I agree that the dose you are on seems extremely high. Please confirm that your dachsund is on 80 mgs a day. If so please tell us your dog's weight. Normal dosing is more like 1 mg per kg of weight. I find it hard to believe your dachsund is 80 lbs.

Kim

Hi, yes Bella is only 8kg not sure what that is in lbs, and yes 2x 40mg twice daily on vetroyl. Just abut to take her back to the vet as she is now vomiting with diaherra