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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 26276
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My husky is 8 yrs old and gas developed dibetes she has

Customer Question

Hi my husky is 8 yrs old and gas developed dibetes she has started on insulin. 2 shots per day 18 mls each she is vomiting been back to vets three times and they give her anti nausea injection her level last check was 32 she was 37 2wjs ago when diagnosed. She is refusing to eat but she just ate some my dog food so gave her injection. Just beside mysrlf dont know what to do next. Anne
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

Anne, please tell me how much your Husky weighs and which insulin you're administering. Such high blood sugars suggest an underdosed patient.

Customer: replied 1 year ago.
Hi not sure on type of insulin she isn't my dog, its will get back to you as soon as l can,
Expert:  Dr. Michael Salkin replied 1 year ago.

OK, I'll watch for your next post.

Customer: replied 1 year ago.
Hi, sorry about that,, her weight is 33kg insulin is caninsulin hope this helps
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you! The initial dose of this insulin ranges between 0.4-0.7 IU/kg twice daily or 13-23 IU twice daily for Mishka. She shouldn't be so hyperglycemic unless she's refractory to the insulin which should be suspected at this time. There's likely to be considerable inflammation in her body causing her to be refractory and the first place I'd look is her pancreas (pancreatitis) because she's been vomiting and anorexic. I see that she's had blood tests and CT. Has a specCPL blood test or CT revealed pancreatitis?
Customer: replied 1 year ago.
Not sure l will get you the latest blood results taken 2 wks ago.how do l send them?
Expert:  Dr. Michael Salkin replied 1 year ago.
I'd very much like to see the test results. I understand that you might not have a copy of the results at home but her vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (not if you're using the chrome browser) or by using an external app such as imgur.com or dropbox.com.
Customer: replied 1 year ago.
Ok we have a copy, she has been sore to touch in the upper stomach area thats what the vet said last visit.
Expert:  Dr. Michael Salkin replied 1 year ago.
Suspicious of pancreatitis as well as hepatitis...
Customer: replied 1 year ago.
Hi do you have a email address
Expert:  Dr. Michael Salkin replied 1 year ago.

Yes, you can send it to***@******.*** who will forward it to me. This can take up to 24 hours.

Customer: replied 1 year ago.
Trying to send fingers crossed
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you for the complete blood count. It reveals mild anemia but moderate increase in white blood cells. This indicates inflammation - not necessarily the inflammation associated with infection. Do you have the chemistries too?
Customer: replied 1 year ago.
Some more
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you. There's quite a lot going on. All of her liver enzymes are elevated. This is expected with severe diabetes but there might be a pri***** *****ver disorder as well. Her BUN and creatinine are elevated indicating renal insufficiency. I would need to see a urinalysis to be more accurate. Her sodium is low and her potassium is high giving a low sodium:potassium ratio indicating Addison's disease - poorly functioning adrenal glands.
She's quite an ill dog. I can see why her diabetes has been so difficult to manage. If there were ever a dog needing the attention of a specialist veterinary internist, Mishka is that dog.
Expert:  Dr. Michael Salkin replied 1 year ago.
There was no specCPL blood test performed which is most sensitive for detecting the presence of pancreatitis.
Customer: replied 1 year ago.
Hi yeah she is very sick she is back at the vets now and we have asked them to do that test you suggested is their anythink else we should test for, , she was diagnosed with sards 4 months ago and her liver enzymes were up then l thought she had cushings as she had all the simptoms t that is why she put on weight couldn't stop her from eating and drinking but the vet just said we have toget the dibetes under control first do you think l should call you.
Expert:  Dr. Michael Salkin replied 1 year ago.
Oh my goodness. Cushing's too? That's certainly a good reason for insulin resistance and only a cushingoid in diabetic ketoacidosis would stop eating! Yes, the diabetes needs to be controlled as best as possible before testing for Cushing's is attempted. Please keep me posted.
Customer: replied 1 year ago.
Ok thank you, ***** ***** the latest test results later if thats ok.
Customer: replied 1 year ago.
Do you think sards has anything to do with it she has been blind now for about 4 months
Customer: replied 1 year ago.
She hasn't been diagnosed with cushings thats just what l think
Expert:  Dr. Michael Salkin replied 1 year ago.

The SARDS was likely to arise secondary to systemic hypertension which is seen with many metabolic disorders but particularly chronic renal insufficiency, diabetes mellitus and Cushing's.

Cushing's is a good thought in such a patient.

Customer: replied 1 year ago.
Thanks
Expert:  Dr. Michael Salkin replied 1 year ago.
You're welcome. I'll watch for your next post. No need to reply at this time.
Customer: replied 1 year ago.
Hi Dr Salkin
Mishka has renal failure,, they had her on a drip overnight and her levels have come down to 26 they r keeping her again tonight. Have asked for a copy of the blood test they took yesterday. Fingers crossed. Anne
Expert:  Dr. Michael Salkin replied 1 year ago.

Yes, I noted the renal insufficiency earlier (urea 20.9, creatinine 129). I needed a urinalysis to make more sense out of those numbers. You mentioned that her urea has come down to 26. What had that 20.9 gotten up to?

Customer: replied 1 year ago.
l noticed you picked that up on those test l dont know why the vet didn't think it was a issue 2 wks ago.... l meant her sugar level has come down.
Expert:  Dr. Michael Salkin replied 1 year ago.

Ah! The blood glucose is now 26. Still much too high for my taste...

Customer: replied 1 year ago.
Would you like to see the test that were taken yesterday.
Expert:  Dr. Michael Salkin replied 1 year ago.
I want to see everything. I have to get to bed (I'm in California) but I promise to reply in the morning.
Customer: replied 1 year ago.
Great thank you so much l will check the time difference.
Expert:  Dr. Michael Salkin replied 1 year ago.

I'll watch for your next post.

Customer: replied 1 year ago.
Hi Dr Salkin,
Mishi is at emergency care hospital the vet thought it would be better to monitor overnight she was dydrated last night and she wont eat. There is a specialist looking at her now and we go from there l suppose. When l get a cooy of her latest test l will post, the vet last night said she probably only just got the kidney disease, l dont know if thats right as the test done 2 wks ago showed there was a problem with her kidneys.
Customer: replied 1 year ago.
she did show pancreatis
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you for the update. Thank goodness that a specialist is looking at her. She's going to be quite a challenge to manage. We can't know everything we need to know about her kidneys until she's stabilized.

Customer: replied 1 year ago.
Ok will post tommorrow to let u know thank you.
Expert:  Dr. Michael Salkin replied 1 year ago.

I appreciate it!