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Thread: Cushing's and Diabetes, what's been your experience?

  1. #21
    Join Date
    Dec 2019
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    Default Re: Cushing's and Diabetes, what's been your experience?

    I guess he was a bit more hesitant about that pre, since he said that a level of 0.5 or less can cause addisonian crisis, and she wasn't far from that, who's to say she won't drop lower, since she seems to be trending lower since her last lab check. It makes me nervous to continue her on the same dose as well.
    I'm not sure if he will be too happy about me suggesting that he contact the company? it's like i'm saying he doesn't know how to treat this right and should reach out to additional guidance. I don't know how to approach it really. Do they talk to pet owners, or only vets?

  2. #22
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    Mar 2009
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    Default Re: Cushing's and Diabetes, what's been your experience?

    It is very difficult for some of us to talk to the vets in such a manner....I was one of those who found it very uncomfortable. But I had to remind myself that my dog's life depended on me, on my ability to stand up and speak for her because she couldn't speak for herself. I come from a medical family; my dad served on a state board that addressed negligent behavior of other doctors and know without question that those in the medical professions, vets included, are no more human than I am. They make mistakes daily. The ones who seem to make the most mistakes are those who refuse to listen, who think they currently know all they need to know, who have a bit of a god complex. If Daisy's vet is unwilling to listen to you and work with you, then it is time to find a new vet who recognizes the fact that they are human and nothing more, who realize they work for you not the other way around. So try to approach the suggestion that he contact Dechra, or read the literature that comes with the drug, as something he is doing for you, for Daisy, not as something he needs to learn...tho in the process of working for you and Daisy his eyes just might be opened. And if he comes back at you in a negative manner you will know it is time to get her records and walk out the door for the last time. There are too many vets out there to remain with one who refuses to keep up with changes in their profession. Imagine me standing by your side, holding your hand and glaring at Daisy's vet, daring him to refuse your request.
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

  3. #23
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    Apr 2009
    Location
    Georgia
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    14,076

    Default Re: Cushing's and Diabetes, what's been your experience?

    I guess he was a bit more hesitant about that pre, since he said that a level of 0.5 or less can cause addisonian crisis, and she wasn't far from that, who's to say she won't drop lower, since she seems to be trending lower since her last lab check.
    Actually, Daisy’s post-ACTH level is a tiny bit higher now than it was during the first check back three months ago. And as you can see from that chart, when a full ACTH test is performed, it’s the post-ACTH level that seems to be of greater importance in terms of dosing decisions. On it’s own, I understand why the .9 level would be a concern. But I really think it would be of value to find out whether or not the technical specialists at Dechra would be as worried about that .9 pre-ACTH level given the stability of her post-ACTH results over these past three months. Perhaps so, but perhaps not.

    Unfortunately, the Dechra technical team prefers to consult directly with vets. However, since you’ve said that your regular vet is encouraging you to consider a specialist since he’s unsure as to the path forward, this would seem like a golden opportunity for him to personally make contact with a knowledgeable team. Often the simple truth can be the best strategy. You can tell him you’ve been worried about Daisy’s cortisol level, you’ve done some reading on your own, and you’ve discovered that Dechra is happy to consult with vets on difficult cases. Rather than you needing to take Daisy elsewhere right now, it would be really great if he would talk to Dechra on your behalf. If he refuses after already acknowledging to you that he doesn’t know what else can be done for Daisy, then sadly I must agree with Leslie — it’s really time to find a different vet who is willing to work with you and Daisy to find out some answers ASAP.

    Marianne
    Last edited by labblab; Yesterday at 12:40 AM. Reason: To reword.

  4. #24
    Join Date
    Dec 2019
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    14

    Default Re: Cushing's and Diabetes, what's been your experience?

    I totally understand what you're saying! We have walked away from bad vets before, I wouldn't hesitate to walk out if I felt like they were there for the wrong reasons. I have to say I do like my current vet though. He truly loves animals you can tell, he's at that clinic 6 days a week 10 hour shifts. He also knows Daisy basically her entire life, so starting from scratch wouldn't be ideal. But with that being said, I feel like he may not be as knowledgable as like the doctors were at the hospital where Daisy was hospitalized. They were all UCD trained and they just seemed to know more. But I guess maybe that's true in all acute care hospitals over just regular vets. I will mention Dechra to him, see what he has to say. However I've already taken Daisy off the Vetoryl. Is it ok to just take off and restart whenever, or labs have to be done all over again?

  5. #25
    Join Date
    Apr 2009
    Location
    Georgia
    Posts
    14,076

    Default Re: Cushing's and Diabetes, what's been your experience?

    I wouldn’t think you’d need to repeat the labs before restarting. If/when you decide to do so, the question will just be as to which dosage level to resume. Once you get some expert advice in that regard, I think you’ll be good to “go.”

    If the recommendation is to use a dose smaller than 5 mg. (due to an overall daily decrease or a switch to twice daily dosing), take a look at the tips on this thread in order to help locate a reliable veterinary compounding pharmacy:

    https://www.k9cushings.com/forum/sho...ushingoid-Dogs

    There are other useful tips there, as well ;-).

    Marianne

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