Jack is possibly insulin resistant. :-/

Jack now has Addison’s Disease due to not having enough cortisol. He had Cushing’s due to too much cortisol, but apparently the Mitotane killed too many cells in the adrenal gland, so now it’s not producing enough cortisol. He’ll be on an injection once a month for the rest of his life. We have to give him Prednisone to help restore cortisol. My poor guy, he is acting hungry and tired all of the time. I bought all of the testing supplies but still haven’t been able to get enough blood for the test strip. We got the Freestyle Libre 2 reader and sensor last week, it seems that the readings only go up to 400, so I have no idea how high his sugars are. Every time we check them, it’s at the max level of 400 on the reader. Once it did show 378 and another time 379. But other than that, it just shows HI and when I transfer the data, it shows he was exactly at 400 for all of the other tests. So I’m pretty sure it doesn’t read over 400. The vet believes he may be insulin resistant. I was thinking of purchasing the genteel device to use for testing. But what if that doesn’t work either? Then I’ll be out $70 on that. I already have the meter, test strips, lancing device and lancets not being used. It isn’t about the money, but I’ve spent close to $4k since he was diagnosed in January. My only other option would be to bring him to the vet to get tested once a week, they charge me $40 each time. But then that’s just sporadic testing and I’ll never know how his levels are at any other time. Even if I do test him and his levels are still high after taking 18U of insulin, what would I do? I already feel like he’s on a high dose. He seems miserable, he doesn’t want to play. He only gets up to eat, drink or go outside. We switched insulins from Vetsulin to Prozinc. We’re now at 18U twice a day and his reader still just shows HI. :-/ We’re injecting into the back of his neck area because that’s the only place we can get enough skin to tent. I feel like I’m failing him.

Cushing’s to Addison’s Disease

So what we were worried about happening happened. Jack began the toxic meds (Mitotane) last month to kill some cells in the adrenal gland so they wouldn't produce excess cortisol. But we had to keep an eye on him because if it kills off too many, it could be life threatening from not having enough cortisol. Yesterday Damian texted me at work saying Jack threw up 5 times. We took him to the vet, they ran tests, he's now transitioned from Cushing's Disease to Addison's Disease. We have to stop the toxic meds immediately and give him another med (Prednisone) that restores some cortisol. His diabetes still isn't under control and we've gone from 5 units twice a day to 17 units twice a day. They ran a test that shows his average glucose over the past 3-4 weeks and they said it was pretty high. Me and Damian haven’t been successful in getting enough blood for the test strips so the vet prescribed a glucose reader gadget called Freestyle Libre 2. It will send the readings to my phone after they attach it to his neck with tape. The sensor works for 2 weeks, so we’ll use this route instead of doing a glucose curve that would mean a day full of needle sticks! We are trying another insulin to see if it makes a difference. We’re close to $4k since November for our boy and he still has a long road ahead. Prayers are needed and appreciated. All I can think of now is how we stopped paying him lots of attention years back, how we got a cat when we barely had time to spend with him and then his dad leaving him behind. It all just breaks my heart. But I will try and let the good memories consume me instead of the negative. I’m just really worried and the first place we all go is “I should’ve done this or that more...”. This is hard. 

Additional info on Cushing’s & Addison’s Disease

https://www.akc.org/expert-advice/health/addisons-disease-in-dogs-symptoms-treatment-prevention/

Update on Jack 3/24/21

3/22/21 - after 7pm Jack vomited. 3/23/21 - had multiple accidents on the kitchen floor, wasn't interested in eating breakfast and he was drinking a lot of water again. Damian texted me around 1pm saying Jack threw up 5 times. I called the vet, they wanted us to drop him off so they could squeeze him in to be seen. They ran some bloodwork, he was dehydrated, his cortisol was really low and he had low sodium and high potassium. All of this was an indication that the adrenal gland is now under producing cortisol, which could be fatal. We were instructed to stop the mitotane, hold off on the pimobendan (heart meds) for the night and only give insulin if he kept his food down for 90 mins after dinner. We need to keep him out of any stressful environments, him getting stressed activates some other hormone which isn't good for him at this time. They also ran a test with his blood work, fructolose(?) or something like that, it will tell us how effective the insulin has been. Which I'm thankful for because I feel like he is on a super high dose.