Tuesday, November 4, 2008

If I Could Turn Back Time....

If only I could turn back time. I could rant forever about lost time. I will forever wonder if I compromised Hunter's health.

I worried about Hunter constantly. I feel I was caught-up in not knowing what to do and feeling completely lost. Caring for Hunter had been no different from when my mother had cancer. There was that same feeling of helplessness and you just listen to what the doctors say because you trust them.

Hunter started taking 8 units of insulin twice a day on July 8th. My daughter and I were shown how to administer his shots. I feel we have now perfected that, which I'll go through later.

I took Hunter back on July 24 for a blood fructose test. He was testing with higher numbers on his glucose test so they took blood for the fructose test. It's supposed to be a better gauge of how controlled or not the diabetes is. Hunter's test results came back that he was now regulated. Also, Hunter had lost 6 pounds since we had also changed his diet to Purina DCO food.

I did not notice any change in Hunter. He was still drinking a lot of water and having accidents inside the house. My mistake was not taking Hunter back during the month of August. Part of that was because it was sometimes hard to tell if he was improving or not. Some days he acted normal, and didn't drink a lot then he would be gorging himself on water.

I took Hunter back on September 6 and saw one of the owner's. I told him how much water Hunter was drinking and he suspected that Hunter's kidneys may be shutting down. So more blood work to test his kidneys and he increased his insulin to 11 units. At this time, we had noticed a big difference in Hunter's vision. He was bumping into things and the doctor said that was to be expected. Well, it was news to me as no one had told me he would lose his vision. Hunter's bloodwork came back a few days later and there was no sign of his kidneys shutting down.

I took Hunter back a little over a week later, and this time I saw the other owner. He increased Hunter's insulin to 12 units. In the next few days after increasing his insulin, I was afraid he was going to die. I would wake-up and check on him during the night. You could barely see him breathing. I took Hunter back on September 29th and finally saw the vet Hunter had mainly been seeing the last few years. She couldn't believe how Hunter looked. She was surprised that Hunter was now blind and how thin he was. I think it had to be fate, as the other two vets were not available and she was really concerned about Hunter. She referred Hunter to the Georgia Veterinary Specialists.

I hate to bring up money, but I feel it's important. When I tried to look-up how much a test would cost, like the Cushing's test for example, all I would find is "it's expensive." I found out it wasn't nearly as expensive as I initially thought. So, when I took Hunter for his annual exam to the end of September, we had spent close to $2,000 and Hunter was worse from when this all started. I was charged over $100 each time I took Hunter back. You feel after spending so much that you should have something to account for and all I had to account for was that Hunter looked worse, his diabetes was still uncontrolled and was now blind. On top of all that, I had three vets, with three different ideas on how to treat him. I don't know if Hunter's case had anything to do with this (I feel it does), but the vet Hunter has mainly seen quit the next week after she referred us to GVS.

On October 1, I got an appointment at GVS. Hunter's doctor is a godsend. He suspected that Hunter had Cushing's. He gave Hunter an ultrasound and checked his vital organs and so far Hunter's organs have not been affected by his uncontrolled diabetes.

The cost for this exam was $920. It included the initial exam and consultation for cataract sugery. Ultrasound of his abdomen, a complete urinalysis, two glucometer tests and eye drops. Also included was the cost of the AlphaTRAK glucometer, lancets and test strips.

As of today, I still hope that is holding true. However, he noticed that his adrenal gland was plump, indicating Cushing's. An opthamologist also check his eyes. Hunter's eyes were bulging and extremely inflammed. Due to his diabetes being uncontrolled, fluid has built-up in his eyes. The opthamologist checked him out, prescribed eye drops and said he was a very good candidate for cataracts removal. That is our goal for the beginning of next year.

The doctor wanted to control Hunter's diabetes before he tested him for Cushing's as sometimes you can get a false positive. One thing the doctor did was to suggest we buy the AlphaTRAK glucometer. I had asked our regular vet about this and was told no, they would do the testing. It is so much better and easier for us to do the testing. So, for the month of October we would test Hunter and call the doctor with the results. The doctor would call back and we would increase his insulin. Unlike our vet, we would only have to wait two days before we would do another gluco curve. We did a gluco curve on October 22, Hunter was then taking 19 units twice a day and his number were too high to register. His insulin was increased on October 23 to 21 units and the doctor felt that we needed to go ahead and do a Cushing's test. He had wanted to get his diabetes under control, but this apparently wasn't going to happen.

I did have to take Hunter back to our regular vet on October 10th because his eyes became worse. Seems he also had conjunctivitis. I was also told by this vet that he had seen the doctor's comments that Hunter possibly has Cushing's. Unbelievably, he still didn't feel Hunter has Cushing's. This is the same vet who believed Hunter's kidneys were shutting down.

On October 29th, Hunter spent 8 hours at GVS for the dexamethasone suppression test. He fasted the night before, so I sent along some food and his shot for insulin. As I expected, he didn't eat. The cost of this test was $205. The results came back the next day confirming that Hunter has Cushing's. The doctor said there were two options of treatment, one was Lysodren and the other a drug from England called "Vetoryl" or Trilostane. From what I had read about Trilostane, the FDA has not approved it for the treatment of pets with Cushing's. Trilostane blocks instead of eroding the layers of the adrenal gland. Once you stop taking Trilostane, the cortisol levels rise again. Also, Trilostane has fewer side-effects. The doctor recommened Lysodren, as he had had better results using this. So we went with Lysodren.
The doctor called in Lysodren at Walmart. This pill can be extremely expensive. I have seen sites selling one pill for over $11. At Walmart the cost for 15 pills was $84.46 or roughly $5.63 per pill.

Tomorrow, November 5, I will start giving Hunter 1 ¼ pills for 7 days. Lysodren was originally given to human's for andrenal cancer. I've read that you need to take precautions while handling this medicine. I've read that you'll need to wear disposable gloves while cutting the pill and it's a good idea to use tweezers to pick the pills up and place on cheese.

Lysodren works by eroding away the layers of the adrenal gland to hopefully slow down the over-production of the cortisol hormone. This will be the initial "loading" phase. I'll first give Hunter some food, give him his pill wrapped in cheese and then let him finish eating. I'll be watching for lethargy, vomiting, diarrhea, loss of appetite and anything else. At the first sign of any of these symptoms, I'll call the doctor. You don't want too much of the adrenal gland destroyed. I'll also be looking out for any symptoms of too much insulin. There's a high possibility that he's taking too much. I have the corn syrup ready just in case.

Once Hunter is finished with the loading phase, I will take him back for an ACTH stimulation test to see where his cortisol levels are at. If his levels are back in the normal range, he'll be put on a pill once a week for maintenance and then after a few months he'll take another ACTH test.

We're all hopefull that everything will go well.