I started the dog on prednisolone while i transitioned, over 1 week, from pheno to levetiracetam , because his platelets were zero so i was terified. He responded really quickly and in 1 week his platelets were back to.normal and remained normal while i took him gradually off the steroids but i think that probably the plt were going to go back to normal even without the steroids only by withdrawn the pheno as they went back to.normal quickly in comparison with IMTP that need weeks of steroids. Unfortunally the dog came on status epilepticus couple of days later so i increased the keppra and once stable started on Kbr as well. Now he is doing really well (so far 🤞🤞)
Thank you very much for your reply! Would ypu ever try phenobarbital again? I started him on levetoracetam and KBr but so far not very well controlled.
Thank you so much for your reply. With regards to the HDDST, if we dont do it though and not able to perform ultrasound of the adrenals, then how should we know whether the dog needs CT/MRI? To be honest, i have never differentiated whether PDH or adrenal dependent and i was always tx them with just trilostane. Should i refer all dogs diagnosed with cushings for further imaging? 🙂
Unfortunally i had to put to sleep this dog today, he presented very pale and was off food for a few days and lost a lot of weight. I think he had so mamy concurrent problems that it was very difficult to control everything..
To be honest, i always treat them with apomorphine and acivated charcoal regardless of the amount eaten. If they have eaten a lot though i offer blood tests as well ( on presentation and 24h later) to check kidney values, i dont know whether thats correct or not 🙂
I did only these 3 messurements and then i stopped the curve as i thought it was pointless to carry on the curve as seemed to have no effect at all. I started it back on caninsulin.
I will ask him about the sensor, probably he would!
So about the 3x dosing with caninsulin, one dose would overlap with the other and maybe causing hypoglycemia? Is this what you mean?
Also the owner is asking, as caninsulin doesnt last for long (only 4 hours), why could we not split the dose to 3 times a day in order to maintain his BG into good levels? how would you explain best to him why this is not possible?
i am afraid not good news with this one. Came today for glucose curve after 2 weeks on the new glargine insulin and owner mentioned on admition that the dog has less energy and has lost some weight. Otherwise no change in thirst/ appetite. Pre insulin glucose was 30mmol/l at 9am, then has eaten and had insulin and when i checked again at 11am and 1pm the blood glucose was still 30mmol/l so no effect at all!!
I am going to try caninsulin again but can you think of any explanation about this?Insulin was defenitely given correctly and dog is not fat.
Thank you so much for your answer. I have ordered the glargine already so i will start him on that. Whay do you say that it is challenging to dose? I have ordered 100u syringes and i am going to start on 8 units BID (dogs weigh 27.5). So i go up to the 8th line on the syringe. I hope thats correct 🙂
9am the 1st messurement was taken and then the dog was fed and had insulin and then i was messuring blood glucose every 2 hours, so nadir was at around 1pm and then rise again.
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