Gem - HELP insulin shot question

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I wish I could offer more advanced advice on your type of Cushing's. Murphy had iatrogenic Cushing's which was caused from her dosage of inhaled steroid for her asthma. She then went on to full blown diabetes and pancreatitis, and once the inhaler was reduced to a dosage she could manage, the Cushing's went away, but the same symptoms arise with either case. She had a huge skin tear (about 2x2) on her side. It just happened one day, and while I was checking her BG that night, low and behold, I felt this wet spot, and there it was. I caught it early, and off we were to the vet's the next day, and she had to have it stapled shut on each side so that the fur would grow back and you couldn't see the skin. She only had one real major tear and that was it. What I did find was that by using the Vetri-Science DMG liquid with her food, I was better able to maintain a good BG level after a while. It is something I wholeheartedly believe in and she has a testimonial on their website. She had demodex so bad, that her nose was constantly overrun by the mites. It was black most of the time, and the DMG helped boost her immune system to fight off those little systemic nasties. Given consistently, it also helps with the systemic immune response of so many diseases. I cannot say enough about it. I, too, had to resort to her little clothing situations. I went to Target and picked up "onsies," but the next day, I'd find them in the litter box with #2 on them. She must have stripped in the litter box -- but MADE HER POINT! Guess she told me -- if you are having trouble with the BG, I'd consider the DMG liquid to help int he meantime until you get the other stuff stabilized. It truly does work. Hope this helps, and I suppose you 200% on your endeavor. I know it's very difficult and I will help in any way possible.

Lisa and Murphy
 
Hi,

I am a little late to this thread but I wanted to give you the benefit of my experience with Cole. I was also unable to test him on a daily basis but had to biweekly to get an idea of where he was. I worked this out with the vet and we were able to keep him regulated. dr. Stewart gave me ranges and how much insulin to give and it worked out for us. I also keep a close eye on his input and output. If cole had no appetite or couldnt keep food down ( he also had cancer which caused him to vomit frequently), my vet advised me to err or the side of less insulin, we also were on Lantus, than too much. If Gems appetite is good then maybe her normal dose is ok, if she is not eating then less is better and it seemed to me that other people have already gave you that advice.

Cole would also get antibiotic shots to keep the risk of infection low and that did seem to help and it also seemed to speed the healing of his skin tears as well but it does take time. One thing about the shirts, cole always had an open wound or two or three. He would continually clean himself and cause more, once he had a huge one on his side that he caused but simply cleaning himself like all cats do. Without the shirts I was unable to prevent him from cleaning himself and causing more damage. I don't know if this is what Gem is doing and I saw your vet had advised against it, but just wanted to give you a little more perspective on why I decided to put clothes on him rather than the cone of shame to keep him from causing more damage to himself.
Hang in there until Monday. I know this is stressful on you and Gem and the rest of your family but you are very conscientious and are doing everything you can to help her. This disease is tough especially on top of the other issues she has. Believe me, I was frustrated by it too and it was scary at times. But you aren't alone, as witnessed by all the outpouring from this thread there is a lot of help. I wish you the best of luck and please let me know if I can help or answer any questions about Cushings.

Lisa
 
JL and Chip said:
Just wanted to send you good wishes as well. As much as it might not feel like it, you've made many positive steps. You are so fortunate to be within reach of Dr. Mark Peterson -- he has a stellar repuation.

Chip had skin tears as well, and I can completely relate to the stress and panic one feels when it occurs. I'm pretty good at handling medical stuff yet I found myself on edge many times when dealing with Chip and his skin. We initially suspected that he might have Cushings but it was never officially diagnosed. He had skin tears, a pot belly, and a voracious appetite (eating close to 30 oz of canned food a day but losing weight). I took him to specialists and we tested for a lot of things, but we never felt like we completely figured out the puzzle.

Chip's skin was fragile but not the typical paper-thin that is commonly seen with Cushings. I was able to test his ears with minimal impact because he would lay quietly and I didn't have to restrain him. I'm sorry if you've already stated it -- but how is Gem during testing? Is it a battle? If so, then I definitely understand why you opt not to do it. The only other thing I can suggest (other than urine testing which you've already expressed difficulty with) is to try testing on a paw pad. Does Gem allow you to mess with her feet at all?

It's hard to shoot blind but, given the circumstances, do what you have to do. You're in a less-than-perfect world right now that not a lot of people have navigated, so you'll have to feel your way through it. Pick a dose that you feel reasonably safe with, get a spot check if you have the courage (it's hard, I know), otherwise watch like a hawk and leave food out for Gem to nibble on. That's the best I can offer. I think you have pretty good instincts, so try to trust them.

Again, I'm sorry with what you're going through. I fought the battle to try to save Chip and it was exhausting. Many of the treatments were contraindicated and it was a constant balancing act. I had to be creative in how to deal with him. On the other hand, it seemed like HE wasn't ready to give up and wasn't in excessive pain or uncomfortable, and so it was hard to quit trying. In the end, it was clear when it was time. We suspect that the underlying problem was probably cancer but never knew for sure.

I also lost a dog to Cushings (inoperable adrenal tumor) and my current dog has an early "atypical" form of it. That's another whole story. Bottom line is that Cushings sucks.

Please try to take it one day at a time, at least until Monday. To the best of your ability, you've stacked the deck in Gem's favor. I'll be thinking about you...
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Thank you for your reply

Up until now I've been able to test Gem's ear with minimal trouble - meaning she didn't really give me a hard time and the skin stuff didn't impact her ears. But I do need to hold on to her, and where the open wound is makes that pretty impossible right now. I think I am more traumatized by the further tear than she is, I just can't do it again. As for the paws, even when she was healthy she didn't like anyone touching them so I'm not sure that's an option.

I hope Dr Peterson is able to give us some clear advice one way or the other. So many people say we will know when it's time but I don't see that now. I honestly don't know what she wants. But at least I will know that I did what I could after she sees the doctor.
Sorry you've had to deal with Cushing's multiple times. My father in law had a Cushing's dog that he was able to keep going for a good 2 years with medication. We never know what they're going to throw our way.
 
missmurphy2010 said:
I wish I could offer more advanced advice on your type of Cushing's. Murphy had iatrogenic Cushing's which was caused from her dosage of inhaled steroid for her asthma. She then went on to full blown diabetes and pancreatitis, and once the inhaler was reduced to a dosage she could manage, the Cushing's went away, but the same symptoms arise with either case. She had a huge skin tear (about 2x2) on her side. It just happened one day, and while I was checking her BG that night, low and behold, I felt this wet spot, and there it was. I caught it early, and off we were to the vet's the next day, and she had to have it stapled shut on each side so that the fur would grow back and you couldn't see the skin. She only had one real major tear and that was it. What I did find was that by using the Vetri-Science DMG liquid with her food, I was better able to maintain a good BG level after a while. It is something I wholeheartedly believe in and she has a testimonial on their website. She had demodex so bad, that her nose was constantly overrun by the mites. It was black most of the time, and the DMG helped boost her immune system to fight off those little systemic nasties. Given consistently, it also helps with the systemic immune response of so many diseases. I cannot say enough about it. I, too, had to resort to her little clothing situations. I went to Target and picked up "onsies," but the next day, I'd find them in the litter box with #2 on them. She must have stripped in the litter box -- but MADE HER POINT! Guess she told me -- if you are having trouble with the BG, I'd consider the DMG liquid to help int he meantime until you get the other stuff stabilized. It truly does work. Hope this helps, and I suppose you 200% on your endeavor. I know it's very difficult and I will help in any way possible.

Lisa and Murphy
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Thanks for the advice. From what I understand from the dermatologist, they can't really staple or suture Gem because whatever they do will just tear through that skin. It's so sad. And like I said, with the shirt there's concern that the rubbing will just make it worse. Honestly, I don't know how I'm going to bring her in the carrier tomorrow without getting it all dirty. Ugh, dreading that. But hopefully the doctor can help clean it and maybe have some creative ideas to protect it further.

I don't know what DMG is but I will investigate.
 
Lisa n' Cole said:
Hi,

I am a little late to this thread but I wanted to give you the benefit of my experience with Cole. I was also unable to test him on a daily basis but had to biweekly to get an idea of where he was. I worked this out with the vet and we were able to keep him regulated. dr. Stewart gave me ranges and how much insulin to give and it worked out for us. I also keep a close eye on his input and output. If cole had no appetite or couldnt keep food down ( he also had cancer which caused him to vomit frequently), my vet advised me to err or the side of less insulin, we also were on Lantus, than too much. If Gems appetite is good then maybe her normal dose is ok, if she is not eating then less is better and it seemed to me that other people have already gave you that advice.

Cole would also get antibiotic shots to keep the risk of infection low and that did seem to help and it also seemed to speed the healing of his skin tears as well but it does take time. One thing about the shirts, cole always had an open wound or two or three. He would continually clean himself and cause more, once he had a huge one on his side that he caused but simply cleaning himself like all cats do. Without the shirts I was unable to prevent him from cleaning himself and causing more damage. I don't know if this is what Gem is doing and I saw your vet had advised against it, but just wanted to give you a little more perspective on why I decided to put clothes on him rather than the cone of shame to keep him from causing more damage to himself.
Hang in there until Monday. I know this is stressful on you and Gem and the rest of your family but you are very conscientious and are doing everything you can to help her. This disease is tough especially on top of the other issues she has. Believe me, I was frustrated by it too and it was scary at times. But you aren't alone, as witnessed by all the outpouring from this thread there is a lot of help. I wish you the best of luck and please let me know if I can help or answer any questions about Cushings.

Lisa
Click to expand...

Thank you Lisa…for better or worse, Gem does not groom herself at all. So at least I don't have to worry about that, and she doesn't need a cone. I guess the shirt is almost more for our benefit as it's so upsetting to look at. And I worry about keeping it clean. Did you use any type of solution and/or cream on Cole?
 
That's good for her skin. Other than getting an anti biotic shot when the tears were large, I would clean with something called Boo Boo gel. It's a natural product I got at a pet store to help heal hot spots on dogs. What's liked about it was the that it was a gel and the packaging was a pump so I could easily pump the gel onto the wound without touching his skin and let it absorb naturally. Usually the tears would heal on their own in about 1-2 weeks. The shirts never seemed to cause more damage, I had super soft tee shirt fabric that stayed on around the neck and thought front paws. The best one was a soft fleece that covered him.

I was lucky that the vet I saw never recommended stitches or staples and the hospital Cole went to repeatedly was able to handle him ok. It sounds to me that Gem's skin may be more delicate than Cole' s. This is the hardest part about this disease and the hardest to get a handle on.

Even on the Trilostane Cole still got the skin tears and for us the shirts were an easy fix. Cole never gave up and despite the difficulties he went through he had one of the strongest fighting spirits I have ever known. You may know when it's time because there is nothing more that can be done. Cole's body told me it was time, but his attitude told me he wanted to stay. I made the difficult decision because he could no longer hold any food down due to the cancer but he still wanted to be here. I understood that I could help him go peaceful or go naturally and I choose to help him rather than see him suffer.

I am not advising that you do anything. Plus you guys may not be there yet. I am offering my experience that it may help you when weighing all the aspects to one of the most difficult decisions we face.

I hope your appointment tomorrow is helpful and the specialist gives you some workable solutions.
 
Lisa n' Cole said:
That's good for her skin. Other than getting an anti biotic shot when the tears were large, I would clean with something called Boo Boo gel. It's a natural product I got at a pet store to help heal hot spots on dogs. What's liked about it was the that it was a gel and the packaging was a pump so I could easily pump the gel onto the wound without touching his skin and let it absorb naturally. Usually the tears would heal on their own in about 1-2 weeks. The shirts never seemed to cause more damage, I had super soft tee shirt fabric that stayed on around the neck and thought front paws. The best one was a soft fleece that covered him.

I was lucky that the vet I saw never recommended stitches or staples and the hospital Cole went to repeatedly was able to handle him ok. It sounds to me that Gem's skin may be more delicate than Cole' s. This is the hardest part about this disease and the hardest to get a handle on.

Even on the Trilostane Cole still got the skin tears and for us the shirts were an easy fix. Cole never gave up and despite the difficulties he went through he had one of the strongest fighting spirits I have ever known. You may know when it's time because there is nothing more that can be done. Cole's body told me it was time, but his attitude told me he wanted to stay. I made the difficult decision because he could no longer hold any food down due to the cancer but he still wanted to be here. I understood that I could help him go peaceful or go naturally and I choose to help him rather than see him suffer.

I am not advising that you do anything. Plus you guys may not be there yet. I am offering my experience that it may help you when weighing all the aspects to one of the most difficult decisions we face.

I hope your appointment tomorrow is helpful and the specialist gives you some workable solutions.
Click to expand...

Thank you for your kind words Lisa. Gem is such a positive kitty. All the doctors that have examined her have remarked on how strong she's been, never complaining through all the pokes and prods, and as soon as it's over, purring and looking for love. You hit it right on the head, her body says she's done, but her attitude is not. But I guess part of having pets is having to make these hard decisions for the,. I would rather let her go peacefully than in an emergency situation.

I will certainly post tomorrow and let everyone know what Dr Peterson has to say, for better or worse.
 
Please see the link in my signature for secondary monitoring tools. These incorporate the one's from U of Queensland, Dr Rand.

I think if you make yourself a table of the things you want to monitor and check them daily, or twice daily, that will help with non-invasive monitoring. While not perfect, it is something.
 
BJM said:
Please see the link in my signature for secondary monitoring tools. These incorporate the one's from U of Queensland, Dr Rand.

I think if you make yourself a table of the things you want to monitor and check them daily, or twice daily, that will help with non-invasive monitoring. While not perfect, it is something.
Click to expand...

Thanks, I have looked those over. The heavy drinking and urinating remain pretty constant, leading me to believe that her BG is still high, or at least unergulated, which is to be expected with everything else she's dealing with. I try and test her urine whenever I find a sample (on the floor somewhere :) ) and it is always negative for ketones and high for glucose. I spoke to the regular vet this morning who feels she should continue on her dose of 3u, twice daily. At this point, I will shoot her tonight and tomorrow morning, while monitoring the other signs, and then see what the doctor says. Honestly, I am mentally preparing myself and my kids for the worst, but we'll see.
 
Good luck today with Dr. Peterson. It's wonderful that you will have his tremendous experience on your side.
Fingers crossed for Gem's visit.
 
Thanks to both of you for your good wishes. If it's OK, I will start a new thread with an update after I get back from the doctor.
 
If it's OK, I will start a new thread with an update after I get back from the doctor.
Click to expand...
That would be perfect! Hope all is well,
Carl
 
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