Hello I am Dr. Joey. Thanks for asking your question and trusting me to help you and your pet today. I am a licensed veterinarian with over 16 years of experience. I am so sorry to read Paddy is going through this.
Gall bladder issues this severe are typical with Cushing's syndrome. In the more advanced stages of the disease developing diabetes is also possible. I do hope your veterinarian counseled you that when a Cushanoid develops diabetes that regulation can be difficult. This has to do with the high amount of circulating cortisol secondary to Cushing's syndrome causing insulin resistance (this means even though we give insulin, the cortisol prohibits it from getting into the cells and working), which means getting these dogs treated well is tough. Sometimes if and when we get good control of the Cushings syndrome the diabetes regulation improves. Overall it sounds like your vet is looking for all the right things that could also lead to some level of insulin resistance as well.
A few things to think about:
-Are you moving the insulin injections around on the dog's body (giving in different locations) every day?
- Have you reviewed with your vet to be sure you are neither OVER- nor UNDER-shaking the insulin.
-Are you ONLY feeding at mealtimes, when the insulin is given, using a MEASURING CUP and the amount fed is what your vet recommends? (sometimes when we see our pet's weight falling off we panic and start really over-feeding the dog---which means we have to chase after them with an ever-increasing amount of insulin) You may want to do a nutritional consult with your vet to ass how many calories/day does he currently get and what should he weigh.
- IF not already done, then a urine culture is really a good idea (via cystocentesis, even if the sediment is quiet)---If you get a negative, reculture every 4-6 months for the long haul. If a positive culture comes back, then we treat this for 4 weeks, then culture when OFF the antibiotic for 1 week to ensure cleared, then repeat culture 1 month later; then once every 4-6 months.
I am at a point I need to know what questions you have. I hope that the information I provided has been helpful.
Please let me know if for any reason you need further clarification, have more questions, or were expecting a different type of answer.
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