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Dr. Joey
Dr. Joey, Board Certified
Category: Dog Veterinary
Satisfied Customers: 4723
Experience:  15 yrs in practice, specialist canine/feline medicine
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I started her on insulin and I remember taking her urine

Customer Question

I started her on insulin and I remember taking her urine back to them to recheck and they said there were no more ketones (sp?) and we were on track. This was atleast 30 days ago. I have not taken her back since for a recheck. I definitely need to this week for sure. I'll have them keep her all day and recheck everything. Her thyroid was under control with medication at the time of her diabetes diagnosis. I do remember the vet being alarmed at the amount of Thyrozine she was getting and immediately thought my previous vet was incorrect but it turns out it is a suitable amount. So, her thyroid seems to be under control.
After I gave her the honey the excessive panting did not get better for atleast an hour. The twitching might have subsided but honestly I was more watching her panting. Also, another thing is that her liver is Crazy enlarged and they don't know why. We did an ultrasound and it appears to be uniform throughout. Still no diagnosis of why her liver is very large. They also noticed her intestines seemed enlarged as well when they did the ultrasound. So at this point we have been concentrating on just her diabetes and her keeping her thyroid under control. She also was falsely diagnosed with Cushings disease by her original vet. She was on cushings disease medicine for a month when the SARDS kicked in and her opthomologist is the one that said according to her chart he did not think she had cushings. So we finally ruled out cushings after multiple visits. I have switched vets and this new vet is monitoring her diabetes. I'm just also wondering with all of these multiple situations are separate from one another or is there some disease that's going on undiagnosed. etc..... I just want to make sure I am doing EVERYTHING possible and I have my vet testing for eveything. Are we missing something?
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Joey replied 1 year ago.

Hi. This is Dr. Joey.

If they do keep her all day, then they should be doing a glucose curve to see what her values are every few hours and how she is responding to insulin. A urine recheck is always a good idea. But I'm not sure beyond that much must be rechecked.

Excellent about her thyroid. This will need to be monitored over time because it is possible she was needed more due to being on the edge of diabetes; so her need for thyroid supplement may change.

Liver enlargement can to some extent be due to diabetes; so that should be rechecked perhaps via ultrasound again in the future, once her diabetes is clearly controlled. If there is difficulty controlling her diabetes and both the liver/spleen are enlarged then doing a needle aspiration of the liver would be recommended to rule out cancer as a problem that is causing the difficulty regulating. Also, we must remember SARDs causing a Cushings-like scenario that we do not entirely understand with a lot of the symptoms of Cushing's syndrome such as high ALKP which could make her liver enlarged. For now, though, I recommend focus on controlling diabetes and figuring out the panting.

With regard to the panting, this can be due to many different things ranging from pain to a primary heart problem to a primary lung issue (pneumonia, cancer, etc) and the list continues. This can also be due to the CUshing's-like syndrome from SARDS (hormonally related). So, having your veterinarian do a listen to her heart/lungs and perhaps even chest X-rays may be a good idea.

Sounds like, overall, this is a complicated case and your vet is doing a great job.

Expert:  Dr. Joey replied 1 year ago.
I'm just following up on our conversation about your pet. How is everything going?
Dr. Joey