My black Lab Pepper - Update: Pepper has passed away

[sherrylwatts]

My black lab Pepper was diagnosed with Cushings back in early December. We started her on 150mg Trilostane and ran an ACTH test after 3 weeks. Her Cortisol levels were still high, so we upped the dosage to 200mg (took a week to arrive) and tested her again after 3 weeks. Once again her levels were high so we went to 250mg and 3 weeks later ran the test. Her last test was base>10 the went to >30. We kept her on the Trilostane while I searched for a vet specializing in Cushings and different medications I could give.

I found a new vet and we decided to use Lysodren. In the meantime, her appetite decreased, and I began cooking home made food (beef & rice w/ veggies or boiled chicken w/ rice & veggies). We weaned her off the Trilostane for 1 week then went without for 1 week, and got her weight back up to 54 lbs (still to skinny).

I began treatment w/ Lysodren and she took 500mg 2x per day for 3.5 days. On the afternoon of the 4th day she started becoming very week and shaking. I immediately gave her 5mg Prednisone which helped with the weakness and called to schedule the ACTH test. She also dropped to 50 lbs. We had to wait 24 hours because of the Prednisone the run the test.

Unfortunately, we have to wait for the results of the test, but she is still not eating willingly (even boiled chicken or steak). I have been liquifying Iams canned dog food w/ water in my blender and basically "forcing" her to consume a small amount at a time (using a turkey baster) every 30 min or so she doesn't starve, but I'm really freaking out. My vet wants to hold off on giving her an additional Prednisone until the results are back, but that may be tomorrow. Force feeding her this way has been stressful on us both (I feel terribly cruel). I've read other posts where people have gone through this, and I'm pretty sure she's in Addisonian crisis, but won't know for sure until the results are back. Any suggestions to get us through the next day or so until the results are in?

[frijole]

I am at work and have to run but this is important so I wanted to reply. I would ignore the vet and give the prednisone. Because as you said... the dog needs it.

I am pretty sure that the washout period when switching is 30 days and not 2 weeks so that might have had an effect as well.

Hopefully others will chime in but give the prednisone because that is what it is for. The testing has been done so there is no logical reason that I know of to not give it.

What dosage prednisone is she on. (We will need weight of your dog) I am totally working from memory so confirm this with someone else but I think the Emergency recommended dosage is 25 mgs/pound of weight... but it could be KG of weight. If you have given it before - stick with that amount for now and get it started.

I will check back in after work and meanwhile I hope others see this as well. Big hugs to your lab!!! Hopefully Pepper is drinking water.

Kim

[jrepac]

My black lab Pepper was diagnosed with Cushings back in early December. We started her on 150mg Trilostane and ran an ACTH test after 3 weeks. Her Cortisol levels were still high, so we upped the dosage to 200mg (took a week to arrive) and tested her again after 3 weeks. Once again her levels were high so we went to 250mg and 3 weeks later ran the test. Her last test was base>10 the went to >30. We kept her on the Trilostane while I searched for a vet specializing in Cushings and different medications I could give. I found a new vet and we decided to use Lysodren. In the meantime, her appetite decreased, and I began cooking home made food (beef & rice w/ veggies or boiled chicken w/ rice & veggies). We weaned her off the Trilostane for 1 week then went without for 1 week, and got her weight back up to 54 lbs (still to skinny). I began treatment w/ Lysodren and she took 500mg 2x per day for 3.5 days. On the afternoon of the 4th day she started becoming very week and shaking. I immediately gave her 5mg Prednisone which helped with the weakness and called to schedule the ACTH test. She also dropped to 50 lbs. We had to wait 24 hours because of the Prednisone the run the test. Unfortunately, we have to wait for the results of the test, but she is still not eating willingly (even boiled chicken or steak). I have been liquifying Iams canned dog food w/ water in my blender and basically "forcing" her to consume a small amount at a time (using a turkey baster) every 30 min or so she doesn't starve, but I'm really freaking out. My vet wants to hold off on giving her an additional Prednisone until the results are back, but that may be tomorrow. Force feeding her this way has been stressful on us both (I feel terribly cruel). I've read other posts where people have gone through this, and I'm pretty sure she's in Addisonian crisis, but won't know for sure until the results are back. Any suggestions to get us through the next day or so until the results are in?

Assuming the shaking has subsided after administering the Prednisone? Is she lethargic or moving about? Vomiting? If you are not seeing shaking/wobbling, lethargy, vomiting, likely not Addisonian crisis. You may want to try feeding her a can of cat food (yes, cat food), sick dogs tend to find it appealing. Also, you can get a tube of Nutrical at Petco/PetSmart, which is also a good nutritional product. Sounds like the lyso really suppressed her appetite, but it will come around. If she is walking, drinking and otherwise ok, the appetite should come back in a few days. I'd also "wing it" and give another dose of Pred as well; it won't hurt any.

[Harley PoMMom]

The standard rescue dose of pred is 0.25mg/kg. To find her wieght in kg, divide the
lbs by 2.2...then multiply that result (her weight in kg) by 0.25 and you will have the
amount for her weight.

If she weighs 50lbs...50/2.2 = 22.7 * .25 = 5.68mg of pred. Though since she is really feeling yucky, I would give alittle more.

There is definitely a 1 month wash-out period between Trilostane and Lysodren. I would get her to a Emergency Clinic Right Now.

Love and hugs,
Lori

[StarDeb55]

I just wanted to confirm what Lori has already told you about the rescue dose of pred that is required. Also, it's pretty much mandatory that when switching meds, either lysodren->trilostane, or trilostane->lysodren, you must have a 30 day washout period, & usually the return of cushing's symptoms before starting the new medication.

Your lab is most definitely showing signs of an Addisonian crisis & needs to be seen NOW at an ER clinic, if you can't get to the regular vet.

Debbie

[lulusmom]

Hi and welcome to the forum.

I realize you have a lot going on right now but I am perplexed as to why you saw so little control with the Trilostane. Can you tell us which tests were done to diagnose your dog and post the results here? If you don't have copies of the tests, your vet should be happy to give them to you. Also, can you tell us if the acth stim tests done after starting treatment were done within 4 to 6 hours after dosing?

I think everyone has provided you with some very good feedback. It is recommended that you wait for 30 days when switching from Trilostane to Lysodren; however, some vets will start treatment earlier if the post stim is high enough to justify cutting the washout period shorter. Knowing what the last post stim number was prior to starting Lysodren will help us understand if the switch was done safely. It does sound as though your dog could be in an addisonian crisis. Your vet should have tested the electrolytes at the time of the stim test which usually can be done inhouse as opposed to sending out to a lab. Did your vet do this? If you don't know, you should call and ask.

I have two cushdogs and both started on Lysodren, switched to Trilostane and then back to Lysodren. We waited until the dogs were totally symptomatic again before starting treatment in both cases. I always have prednisone on hand and I'm not afraid to use it. My dogs are tiny and if they don't eat, they get sicker and are in greater danger of hypoglycemia. If your dog is not eating and you don't have to have another acth stim test in the next day or two, I wouldn't hesitate to give the rescue dose of prednisone. If you still see no improvement, you need to get your dog to your vet or an er.

Glynda

[littleone1]

Hi Sherry,

I'm so sorry that you and Pepper are going through this. You have gotten some very good advice from the members. I was also told that if I had to switch Corky's medication, there was a 30 day washout period.

I agree with the others that you should get Pepper to an ER.

I hope that everything will be okay.

Terri

[zoesmom]

Hi and welcome -

After reading your post, a number of questions come to mind. But first, I agree . . . the electrolytes should have been checked when you last went in for the ACTH. And 30 days is the standard washout period, between switching drugs. Definitely, you'd want to see a return of symptoms before restarting.

I guess the points that have me wondering (mainly about your vets' protocols) are these: The first ACTH should have been done around 10 - 14 days, not at 3 weeks. And since the second vet didn't seem to know about the longer washout period either, I'm concerned about how all of those ACTH tests were done in the beginning of treatment. Also, that starting dose for a dog that only weighs in the 50's was extremely high. And then to up the dose by so much - a total of 100 mg - seems overly drastic. Are you in a rural or metro area, if I may ask. Vets in metro areas may ( or may not, sometimes :rolleyes::rolleyes::(:() be more well-versed in cushings protocol.

Do you have the diagnostic test results and the later ones, and if so, can you please post them. If not, do ask for them. Was Pepper's original cortisol level (before tx) pretty high? I'm puzzled as to why the cortisol wasn't coming down. Or maybe it was and just not fast enough to suit the vet? As we've learned here, many dogs levels drop slowly (or maybe I should say steadily) that first month. And was Pepper taking just one dose a day? At what time was the trilo given? I ask because the ACTH tests should have been done at 4 - 6 hours post-pill. Was that when they were done? There's also a possibility that the cortisol wasn't responding well because Pepper has ADH, rather than PDH. If you can let us know the above, maybe we can help you sort things out. And yes, I'm with the others on the pred. Ain't gonna hurt to give it now - what with the test already done. Concerned about those electrolytes, too. I'd take Pepper right in and get them tested, if not yet done. Sue

[sherrylwatts]

Actually she started on 150mg Trilostane, 3 weeks later ACTH Test (baseline taken @ 2 hrs after Trilostane dosage) was baseline >10, end result >28, thats when we upped her to 200mg. 3 weeks later (again @ 2 hrs after dosage) baseline >10, end result >31. We upped her to 250mg (the highest dosage they would give a dog her weight) 3 weeks later the baseline >10, end result >30. For some reason Trilostane didn't seem to have any effect on her cortisol levels, although she was able to sleep through the night without urinating.

The vet did not want to go through the 30 day washout period because her ACTH stem results were already so high. That is why we weaned her off for one week then discontinued the next week before starting Lysodren. Her symptoms (esp the drinking, urination and dehydration) were as bad as when she was first diagnosed.

I have tried the cat food, both wet and dry, no interest, I also have a puppy and have tried puppy food, again no interest. I have also tried ground beef, boiled chicken, and steak, both warm and cold - still no interest. She is walking and drinking normally, although she is not nearly as active as normal.

I went ahead and gave her 5mg Prednisone at 1pm (CST) today, and she does not seem as listless, but still will not eat. No shaking or serious weakness, just lethargy.

I have also given her 2 20mg tablets of Famotidine to help with excess stomach acid, hoping that would help her appetite. She appears to be depressed (well of course she is with me shoving food in her mouth every 30 min!). I think we pushed too far and have gone over to the Addison's side, and we're going to have to give her the Prednisone for awhile, but won't know for sure until test results are back. Oh yes, her electrolyte balance is in the normal range.

What I have been doing is taking a can of Iams ground chicken and rice (I can't liquify home made - keep getting chunks that I'm afraid would choke her) and a can of water, liquifying in my blender. Then using a turkey baster @ every 30 min (or so) giving her @ 1/3 cup (squirting small amount on her tongue, letting her swallow, repeat, etc.) Yesterday, I managed to get 3 cans of food in her using this method, and today, so far she's at 2 1/4 cans.

I REALLY hate to take her to the emergency vet because of her history - in November of 2007 she chased a rabbit (I live out in the country) and managed to break through the fence and was hit. We later found out through an MRI that she had spinal cord damage and needed immediate surgery, plus 6 weeks of rehab. After she recuperated from that, she then had to return for FHO surgery, followed by more rehab. Since then, unfamiliar (and sometimes familiar) vet offices cause full scale panic attacks. If she is in Addisons, that would be the last thing I would want!

Additional complication - the morning I took her in to the vet to discuss Lysodren, her "brother" who is 6 months younger collapsed and was diagnosed (after ultrasound guided aspiration) with Lymphoma. He is on 20mg/day Prednisone and Tramadol (pain killers), and although he is behaving as healthy as he has in years I'm wondering if the illness she senses in him might be having an effect on her (they've been together their entire lives).

Should I try an additional 5mg Prednisone before bed tonight or in the morning? My vet is wanting to wait on the results (perhaps because her ACTH levels were so high before the loading???) before prescribing it, but...

[sherrylwatts]

Hi and welcome -

Vets in metro areas may ( or may not, sometimes :rolleyes::rolleyes::(:() be more well-versed in cushings protocol.

possibility that the cortisol wasn't responding well because Pepper has ADH, rather than PDH.

The vet that administered the Lysodren dosage is in Dallas, Texas and was recommend by Texas A&M because of their work with Cushings (and Cancer) patients. Her original vet was out here in Rockwall (@ 30min east of Dallas) and would not consider anyother treatment other than Trilostane or surgery. He also mis-diagnosed her brother (see above post). At Peppers age (10.5) and with her surgical history, even though it is ADH (we did the MRI), we just feel surgery would not be the best option, quite frankly, I'm not sure she could survive an additional surgery.

Thank you to everyone that posted, I'm feeling better seeing her behavior after giving her the Prednisone, but I still wish she would eat on her own.

Keep any suggestions coming, PLEASE

[gpgscott]

Welcome and sorry Pepper is not well.

I understand you have fine Drs. but I think it is still important for you to post the results of Cushing's specific testing which has been done.

Like Glynda, I am puzzled by the lack of response to Trilostane, this is not common. Even with pups that have hormones other than cortisol elevated which Trilo can exacerbate you almost always see improvment initially.

But right now you have to get her feeling better and eating and I think prednisone and the famantodine are the right things. I understand about one being stressed out at the office, but the only way I know of to assess electrolytes is blood. If she is seriously low cortisol she is likely also out of wack on electrolytes which can be very dangerous.

Best wishes. Scott

btw, is she drinking freely on her own?

[sherrylwatts]

Welcome and sorry Pepper is not well.

I understand you have fine Drs. but I think it is still important for you to post the results of Cushing's specific testing which has been done.

Like Glynda, I am puzzled by the lack of response to Trilostane, this is not common. Even with pups that have hormones other than cortisol elevated which Trilo can exacerbate you almost always see improvment initially.

But right now you have to get her feeling better and eating and I think prednisone and the famantodine are the right things. I understand about one being stressed out at the office, but the only way I know of to assess electrolytes is blood. If she is seriously low cortisol she is likely also out of wack on electrolytes which can be very dangerous.

Best wishes. Scott

btw, is she drinking freely on her own?

Thanks Scott, I posted back to back, and her test results are in the first post. She is drinking freely and her electrolyte balance is normal.

[Harley PoMMom]

Actually she started on 150mg Trilostane, 3 weeks later ACTH Test (baseline taken @ 2 hrs after Trilostane dosage) was baseline >10, end result >28, thats when we upped her to 200mg. 3 weeks later (again @ 2 hrs after dosage) baseline >10, end result >31. We upped her to 250mg (the highest dosage they would give a dog her weight) 3 weeks later the baseline >10, end result >30. For some reason Trilostane didn't seem to have any effect on her cortisol levels, although she was able to sleep through the night without urinating.


Testing 2 hrs after Trilostane dosing is not the recommended protocol. According to Dechra's U.S. Product Insert:

Dosage AndAdministration:

After approximately 10-14 days at this dose, re-examine the dog and conduct a 4-6 hour post-dosing ACTH stimulation test.

http://www.dechra-us.com/File/prod_vetyrol.pdf



Should I try an additional 5mg Prednisone before bed tonight or in the morning? My vet is wanting to wait on the results (perhaps because her ACTH levels were so high before the loading???) before prescribing it, but...

You could try baby food...make sure that it does not have any onions in it. If she were my pup, I would give her 1/2 of a 5mg tablet before bed tonight. I am sure the "others" will be on to give their advice as well...hang in there, ok.

PS...I've sent you a PM for a recipe for a broth for an inappetent dog.

Love and hugs,
Lori

[zoesmom]

Texas A & M - good school. We've had more than a couple members take their dogs there.

Sooooo......it sounds like you already had a diagnosis of ADH (with an MRI rather than an u/s???) That it's ADH would explain why Pepper's response was so poor on trilo. Lysodren is the recommended drug to use in adrenal cases. We've had several who chose the medicinal route for their ADH dogs, since surgery is not always an option for whatever reason (cost, dog's age, other health problems, degree of invasion of tumor). So I'm hoping one or more of those people will see your post. What was the size of the tumor, if you know. Those same ADH people will probably ask you about that. I know very little about adrenal tumor sizes - what's considered big, etc - but I do know that even with lysodren, the dose often has to be higher than is used for PDH. So given what you've said, about Pepper and her ACTH numbers and the ADH dx, the treatment approach is all making more sense now.

It could be that Pepper's cortisol is just now beginning to come way down and she's simply experiencing what we call cortisol withdrawal - since she's basically acting ok except for eating - right? Many dogs just feel puny/lousy when the cortisol finally starts to come down into a lower range. It will be interesting to see what her cortisol level is now at.

So hope you will post when you get the ACTH results. If by chance she is running verrry low (like 1.0 or below) that would be surprising, given this newest info. Of course, if that's the case, you might still want to recheck those electrolytes. But maybe she's not that low, after all - but just having the withdrawal symptoms. My Zo went thru 'withdrawal' (only on trilo). Her post numbers never fell below 5 (post #) in the beginning, but she definitely exhibited some worrisome cortisol withdrawal signs.

Continuing the pred for a little longer may help perk up the appetite. Have you tried canned tuna water as an addition. When they're not eating, my motto is try just about anything to encourage them. I've mixed in peanut butter, cottage cheese, fresh chicken or turkey, even braunschweiger mixed with a little hot water to make a soupy mixture (the liver smell nearly killed ME!) If all she'd take was treats, then that's what she got. So how long since Pepper ate a good meal? Please keep us posted. Sue

PS - I do agree that that testing done two hours after trilo dosing may have skewed the results a bit - the effect of the trilo may not have been at full force within two hours . . . . i.e. Pepper may have been lower than the tests showed. But no matter at this point. Lysodren is what's called for and that's what you're now using. Although until you get those ACTH results, I'm sure the vet said to hold up.

[zoesmom]

Don't know if it's my computer or this website - but sloooow as molasses tonight. Just wanted to add, with something like braunschweiger (high fat content), go easy as too much fat can lead to pancreatitis. I used about 2 or 3 t. to make a 'gravy' to add to Zo's other food. And also, the pred can be a help for a dog whose cortisol has dropped a lot and/or suddenly, even if not into the addisonian range. With the unknown cumulative effect of the two drugs (trilo can linger in the system much longer than the day or so that they say, IMO, and lysodren does continue to work for several days after last dose), so the pred should help ease any cortisol withdrawal signs, if that's what's going on. Zo's withdrawal symptoms were poor appetite, lethargy, shivering (sometimes around the neck), lying in out of the way places, and disinterest in everything and everybody. I forget, but think it lasted a week or more.

[Buffaloe]

Hello and welcome from me, as well. I'm sorry Pepper is not feeling all that great and I hope he improves quickly.

It is very common for veterinary professionals treating a dog with an adrenal tumor to significantly shorten the 30 day washout period when switching medications if the dog is displaying symptoms. Some dogs with adrenal tumors respond better to Trilostane and some respond better to Lysodren. It's pretty clear that Pepper's tumor did not respond to Trilostane. 1000 mg. of Lysodren per day for 3 1/2 days is not alot of Lysodren for a dog Pepper's size with an adrenal tumor. But, maybe Pepper is real sensitive to Lysodren and it will help control his cortisol effectively. Unfortunately, treating adrenal tumors medically is often pretty challenging.

It does appear that Pepper needs some prednisone. If I was in your shoes, I'd err on giving him a little more rather than less.

Please let us know the results of the ACTH test. We're all pulling for Pepper and hope he is feeling alot better tomorrow.

Ken

[sherrylwatts]

Quick morning update - gave Pepper 5mg Pred again last night. During the night/early morning she vomited a small amount of the food I've been feeding her. Still won't eat this morning. I've been alternating the liquid food w/ the broth that Zoesmom (thanks!) gave me. Test results back today, wish us luck.

Also, don't remember the tumor size, I was in panic about her brother at the time (remember he collapsed that morning & I had to call the vet & ask if I could bring both dogs in). The vet has an MRI machine on premise, but contracts with a company that comes in for the ultrasound (Petsafe?). That's why we did the MRI, because the ultrasound couldn't be scheduled until the next day and we didn't want to leave her overnight (her brother spent the night & had his ultrasound the next morning). I can find out today when I get the test results back.

[jrepac]

well, this is all making more sense now; Trilo isn't typically recommended for ADH, lyso is.

I would not get overly worried regarding Addisonian crisis, provided she is acting normally, walking about and drinking. The lack of appetite could be just a cortisol withdrawal symptom, as others have noted.

Liverwurst, although fatty is always tempting; and yes, tuna (just like catfood) draws some dogs' appetites. Some dogs do like flakey fish (flounder for instance). Sweet potatoes are good too. This may sound goofy, but vanilla lowfat yogurt is worth a shot. Just not too much otherwise you will have other poopy problems!

Maybe the pred will help boost her appetite...

[Casey's Mom]

Hello and welcome to our group! Just wanted to say that I love your dog's pic - what a sweetie :):):)

Hugs,

[sherrylwatts]

Wrote previously @ how Pepper wasn't eating after her loading period... (see 2 days after Lyso loading). Test results still not back, has never taken this long, but symptoms indicate either Addisonian crisis or Cortisol withdrawal. Today, still not eating voluntarily, force feeding liquid food w/ turkey baster. Diarrhea w/ looks like blood (bright red, not black), then vomiting after 5mg Pred. Completely lethargic, w/ few, short burst of energy. My vet says this not normal, but not unexpected. She's so underweight already and I'm worried she's starving to death or there is something else going wrong. She's going in tomorrow, but....anyone, help!!! I don't want to kill my best friend

[AlisonandMia]

It sounds like either an inflammatory GI problem unrelated to low cortisol, or low cortisol - which can cause that sort of GI problem in dogs. When a dog's system is really stressed the GI tract is often where it shows for some reason. Has she any history of GI problems or could she have eaten something she shouldn't have? Did she have a big appetite before this happened?

It does sound like she needs urgent care now - probably a dexamethasone injection if she can't keep oral meds down, and fluids. That would treat low cortisol and would help if her system has been shocked by something else unrelated to either the Cushing's or the treatment.

What color are her gums?

Alison

[Harley PoMMom]

If my pup was not eating, was lethargic, vomiting, and had bloody diarrhea. I would have my furbaby at a Emergency Clinic NOW.

[StarDeb55]

Pepper can't wait until tomorrow for medical care, in light of the apparent GI bleeding, this is now an emergency. She needs to be taken to an ER clinic tonight.

Also, I have merged your new thread with Pepper's original thread. We like to keep all information for one pup to a single thread. I, also, modified the thread title to indicate that Pepper is not improving at all. If you would like to title changed to something else, please feel free to PM me, one of the other mods or admins, & we will be happy to do that for you.

Debbie

[MiniSchnauzerMom]

I, too, suggest an ER visit now for Pepper where she can be examined and tended to by a professional.

Louise

[sherrylwatts]

Heading to emergency clinic now... Her gums appear to be almost black around the teeth and on the roof of her mouth. The surrounding area is a healthy looking pink. She is skin and bones at this point, I don't think she can afford to lose any weight.

[sherrylwatts]

It sounds like either an inflammatory GI problem unrelated to low cortisol, or low cortisol - which can cause that sort of GI problem in dogs. When a dog's system is really stressed the GI tract is often where it shows for some reason. Has she any history of GI problems or could she have eaten something she shouldn't have? Did she have a big appetite before this happened?

It does sound like she needs urgent care now - probably a dexamethasone injection if she can't keep oral meds down, and fluids. That would treat low cortisol and would help if her system has been shocked by something else unrelated to either the Cushing's or the treatment.

What color are her gums?

Alison

She hasn't voluntarily eaten in almost 4 days now. Everything has had to been force fed. I have never seen her look so sickly, even when going through spinal cord surgery.

[frijole]

Glad you are taking Pepper in now. Someone recently called us their "Cush Angels". Please know that "all us angels" will be thinking of you and Pepper and praying for the best. Check in when you can and we will be here for you. Big hugs, Kim

[mypuppy]

Hi there Sherry,
I am so sorry for Pepper's health issues lately. It really turns my stomach to read about any of our pups in trouble. I have to say, wow! I find it puzzling that 250mg of trilo did not lower Pepper's cortisol in the least??? Could something else be going on? Of course, we can't compare experiences, but my Princess (chocolate lab) was started on 120mg, she weighs about 70 lbs, and that dose was even too high for her. She registered .1 at her 14 day stim. We stopped the trilo and her symptoms were in remission for 5 months. She just recently began experiencing her symptoms and is scheduled for her stim and will start her at the 60mg dose next time around. So anyway, point is, I can't understand how such a high dose did not make a dent on Pepper's levels??? I certainly hope and pray she starts eating on her own real soon and you can determine what is going on with her so you can proceed with getting her back to good health. My prayers go out to her and you. I will be checking in to read on Pepper's progress, and maybe by next time you will have some answers. For now, please try to hang in there, stay on board--this is one of your most valuable tools. Take care Sherry. Tight hugs to you and belly rubs to your precious Pepper. xo Jeanette, licks from Princess

[zoesmom]

Glad to see you are getting Pepper in. In view of these latest symptoms, they definitely need to find out what's going on. If it is an intestinal issue, sometimes NO food for a few days is best (like with pancreatitis.) But since she's gone well beyond that and is already underweight, you need answers. Will be keeping fingers crossed that they can figure things out and get her back on the right track asap. Will be watchin for updates. Sue

[jrepac]

this really sounds like something else is wrong....gastrointestinal, perhaps.....bloody diarrhea is a no-no under any circumstances...after 4 days, with pred supplement, her appetite should've sprung back if it was merely cortisol related

but based on what you are saying she can't keep food down...

getting her to a vet/ER asap is the best thing to do at this point

[sherrylwatts]

UPDATE: Took Pepper in. Ran a comprehensive blood profile. She does have pancreatitis (but we knew that), and it has had an effect on her Liver enzymes. Her white blood count is also very high and her potassium is low. So for now she is taking:

Adenosyl 225mg 1 per day for 60 days for liver function
Mirtazapine 15mg 1 per day - appetite stimulant
Amoxicillian 500mg 2x per day for infection
Pro-Pectalin anywhere from 4 to 9 per day for diarrhea & nausea
Tumil-K Gel 1 tablespoon per day for potassium
Prednisone 5mg 2X per day (2 wk) then 1 per day (1 wk) then 1 ever other day until gone

She also received Subcutaneous fluids, an injection of Potassium Chloride and Cerenia Anti Emetic.

We're holding off on the Lysodren maintenance until we resolve her eating issues & Liver function.

She's aready acting a little better, but she still hasn't wanted food, however she is actually sniffing things instead of just turning her head. Hopefully she'll eat on her own by tonight. Thank everyone for all their good thoughts!

[Harley PoMMom]

Did they run a cPLI or cPL test to monitor the pancreatitis? My boy Harley, has pancreatitis also, I have the cPLI test done on him every 3 months.

Keeping you and Pepper in my thoughts and prayers.

Boiled skinless, boneless chicken breast (99% fat-free) and rice cooked until it is a mushy texture, is a good start for a pup with pancreatitis issues. Put them both in a blender or food processor with water, make it like a soup, and see if she will drink/lap this.

Love and hugs,
Lori

[sherrylwatts]

Did they run a cPLI or cPL test to monitor the pancreatitis? My boy Harley, has pancreatitis also, I have the cPLI test done on him every 3 months.

Keeping you and Pepper in my thoughts and prayers.

Boiled skinless, boneless chicken breast (99% fat-free) and rice cooked until it is a mushy texture, is a good start for a pup with pancreatitis issues. Put them both in a blender or food processor with water, make it like a soup, and see if she will drink/lap this.

Love and hugs,
Lori


They did the Snap CPL. I just cooked some chicken w/ barley. She's sniffing food now, but hasn't taken any yet, but I only gave her the appetite stimulant @ 1 pm. I'll dry the blender to make a soup, maybe that will help.

[Harley PoMMom]

No barley, just feed her a very plain diet for now. If she does not want to eat, don't force her, the pancreas needs time to heal...as long as she is drinking...do you still have that recipe for broth for an inappetent dog? Try that instead.

Please keep us updated...ok, we worry alot about our family. ;):)

Love and hugs,
Lori

[sherrylwatts]

No barley, just feed her a very plain diet for now. If she does not want to eat, don't force her, the pancreas needs time to heal...as long as she is drinking...do you still have that recipe for broth for an inappetent dog? Try that instead.

Please keep us updated...ok, we worry alot about our family. ;):)

Love and hugs,
Lori

Unfortunately, I'm having to force her to eat small amounts of food, she's lost 8 lbs since starting Lyso, and she's literally skin and bones. I'm trying bland non fatty foods that my vet recommended. I've tried the broth and still no go, but I'm working on it!

[jrepac]

pancreatitis, well, that explains a lot...it will take some time for her to come around.....

[littleone1]

I'm so glad that you took Pepper to see the vet. My thoughts and prayers are with both of you that everything will now start to improve.

Terri

[sherrylwatts]

Update Sunday: Today Pepper Voluntarily ate a few things, but not enought to keep the weight on her, but hopefully this is a good sign, still having to force feed her some. One concern though. This morning I gave her her pill for liver function and the appetite stimulant. About an hour after when I fed her, I gave her the Pred, Amoxicillin, Potasium paste & Pro-pectin tablets. A few hours later, she started hanging her head and "listing" to the right. It appears she can not lift her head and will peer up at us using the right eye. Also, here breathing gets rapid and shallow, then becomes normal. She seems to be going through cycles of energy bursts, followed by fatigue. It almost looks as though there is something neurological going on (could this be caused by the electrolyte imbalance, maybe she's getting to much potasium now?).

[AlisonandMia]

I believe the med you are using as an appetite stimulant can sedate them a bit. It can certainly make humans pretty dopey. So that could be playing a part too.

Her pancreatitis pain could be coming and going too maybe with pain and nausea being brought on by food.

I do think you could be onto something with the electrolyte issue (whether it is causing the symptoms you are seeing or not) so getting her electrolytes checked would be a good idea. I think low potassium is often caused by vomiting/diarrhea/dehydration so if she's stopped vomiting and is eating a bit she may not be needing the supplement (or so much of it) now. But you need to get her electrolytes checked and consult the vet before changing anything.

I'm wondering if the pancreatitis has been affecting her ability to absorb food and if this could be responsible for her weight loss? You could ask the vet about this.

Alison

[sunimist]

A really small amount (like a teaspoon full) of just a very bland (no seasoning at all) mixture of cooked rice and boiled chicken breast mixed well every 1-2 hours was prescribed for my girl and it worked well until she could gradually build her appetite up. We did this for 2-3 days before initiating any other food. Couldn't rush it for obvious reasons. Certainly don't want to over feed and risk a setback.
Were IV fluids with meds given, and for how long? Or were the meds just prescribed orally?

Shelba and Suni

[Harley PoMMom]

Hi Sherry,

Here is some info about the pancreas that I think you'll find interesting.


The pancreas is a glandular organ that is tucked under the stomach and duodenum (first part of the small intestine) in the dog and cat.

It has two functions: 1) exocrine - to produce the enzymes needed to digest food, and 2) endocrine - to produce hormones, including the hormone insulin, which facilitates the uptake and storage of glucose (sugar) and amino acids (proteins).

The pancreas secretes several digestive enzymes (exocrine function), and the principle job of these enzymes is to digest fats and proteins in the food. If this portion of the pancreas is inflammed, a condition called Pancreatitis results; the compromised tissue releases these enzymes from the ducts and begin to "autodigest" the tissue. This may lead to intense abdominal pain, vomiting and diarrhea.

If, due to repeated bouts of pancreatitis or congenital malfunction, the pancreas fails to make enough of the digestive enzymes, a condition called pancreatic insufficiency results. This is a malabsorbtion of fats and proteins from the food, leading to chronic weight loss, poor hair coat, and diarrhea in affected animals. Understandably, the animal is often hungry and may eat odd items in search of food.

http://vetmedicine.about.com/od/diseasesconditionsfaqs/f/FAQ_pancreas.htm#

The reason I'm giving you this info is because I am worried about the force-feeding. The pancreas needs time to heal. Also, this force-feeding could make Pepper resist to eating on her own. You see, pups are so smart, and they do associate negative things to action. I'll give you an example...my boy Harley gets some of his pills in potato bread, well he knows that darn yucky pill is in that rolled-up piece of bread, and he used to spit it out. :eek: So now I have a yucky pill in potato bread in one hand and a small piece of potato bread with-out a pill in my other hand. He knows that once he eats the yucky one he gets the good one. :) Problem solved for Harley.

Please keep us updated, ok.

Love and hugs,
Lori

[StarDeb55]

Sherry, Lori has given you some great information about the pancreas, its function, & pancreatitis. A couple of other things, the pancreas produced several enzymes that aid in food digestion. These enzymes are very strong. When pancreatitis is in the picture, these enzymes are being produce in mega amounts which can keep the whole GI tract irritated at a minimum, or even cause a lot more damage. This is why it is crucial that feeding be kept to very small amounts, if at all, to give the pancreas time to rest & heal, so it will stop the overproduction of all of these enzymes. In most circumstances, a pup who appears to be as seriously ill as Pepper is with pancreatitis is kept at the vet on IV fluids, with no food or water intake, to give the pancreas time to rest. Even water can aggravate the situation.

Debbie

[sherrylwatts]

I do understand about the pancreatitis and the difficulties with food absorption and enzymes, however, y'all would have to see my baby to understand why my vet and I both agree she has to have subsistence. Her weight on Saturday was 48.8 lbs. Her ribs are sticking out 1.25 to 1.5 inches on each side of her stomach and you can literally count her vertebrae on her back and on her tail. Her head has huge hollows above her eyes and her hip bones are protruding. At this point, we're having to make a decision as to allowing her to starve causing her organs to shut down, or to give her the best possible low fat diet while getting calories into her system. Believe me, the last thing I enjoy doing is force feeding her, but she is almost 20 lbs down from her healthy weight and is literally starving herself to death (if one did not know about her medical condition and saw her, I would be reported for starving the poor baby :(). The medications we are giving her (the liver enzymes and the anti-nausea/diarrhea medications) should assist with the absorption of nutrients, and we're working very hard on compounding a diet that will not cause futher irritation.

Right now, we've decided to put off treating Cushings at all, because of the rest of her medical complications. Until we can get her out of this crisis mode, Cushings is the last of our worries. Right now, we're taking it day by day and hoping we don't end up with some other type of organ failure. Luckily, she hasn't had a bout of diarrhea or vomiting since we've began these new meds. I'm most concerned with the simultaneous firing of the sympathetic and parasympathetic nerves which are causing symptoms similar to Parkinson's disease (the stiffness, the hanging head, the sideways twitching) and we're working hard to bring her electrolytes back into balance.

[frijole]

Thanks for the update. We are equally worried. Sometimes it is tough to help via posting so it is important we ask questions because we might assume something incorrectly.

So we now know that you understand what pancreatitus is and how serious it is. No one here would suggest you worry one bit about cushings at this point. So we are all on the same page.

Typically when we see dogs in this type of distress the vet has them stay at the clinic/hospital and hooks them up to IVs in order to give the necessary nutrition via IV. Is there a reason your vet is not doing this ?

You have your hands full and just know we are here although I don't know how much we can help other than to let you know we are thinking of you and Pepper. Hang in there. Kim

[sherrylwatts]

Typically when we see dogs in this type of distress the vet has them stay at the clinic/hospital and hooks them up to IVs in order to give the necessary nutrition via IV. Is there a reason your vet is not doing this ?

Thanks Kim,
Back in November of 2007 Pepper crashed through a fence after a rabbit and was hit by a truck. We originally thought we were luck as it appeared she had simply dislocated her hip and needed stitches, as time moved on though we noticed she could not stand up or move on her own. It turned out she had spinal cord damage and we needed to remove the debris before it calcified and cause paralysis. She had to undergo spinal cord surgery then 6 weeks of rehab, followed by FHO surgery and an additional 4 weeks of rehab. This process traumatized her to the point that simply going to the vets office can cause panic attacks. Leaving her for any period of time results in her battering herself against the kennel, chewing herself, etc. Last time she was left overnight, she needed stitches on one of her self inflicted cuts. As ill as she is, we can not sedate her and it is a good posibility she could die from the stress. This is the reason we are giving her subcutaneous fluids instead of an IV drip (we can also do this at home) and force feeding liquids.

I'm sorry if I seem defensive, the "usual" routes of treatment unfortunately won't work with my little girl, and I sometimes feel as though everything we're doing to make her better causes some other complication (ie, Lysodren did not cause any of her conditions, however it did exacerbate all of the other difficulties). It seems as though we're dealing with a cascade effect in her health problems :(.

[frijole]

Sorry - you did mention that before but I forgot. Is there any way you could have her on an IV at home? (with the vets help of course)

[ohh]

New to this site. I don't have anything to offer medically - these women sound wonderful and can offer you some guidance. All I can offer are good thoughts, and energy to you and Pepper. I'm sorry you're both going through this.

[Casey's Mom]

Just checking in to see how Pepper is doing. You have had a long hard road with your pup and I hope you are seeing some improvement.

Thinking of you.
Love and hugs,

[sherrylwatts]

Update Monday:

Thanks to everyone for all their well wishes! Pepper did voluntarily eat a little food yesterday, but not yet this morning. I've given her about 1 cup of my "home made liquid soup (pureed chicken breast, rice and veggies)" so far along with her meds this am. I decided to forgo the Potassium since yesterday her nerves were on overdrive (causing her to hold her head down stiffly and be overly sensitive to touch). She's holding her head up today and seems stronger, but still very tired! Small amount of diarrhea but no vomiting.

Does anyone know signs I should watch for to indicate her electrolytes are out of balance again? I can't run her to the vet daily (obviously) to check. We gave her too much potassium, but I'd like to be able pinpoint symptoms that her sodium levels are getting too high.

NEW UPDATE: This am I boiled a lean piece of beef and shreaded it so that I could pull almost all the fat left off and Pepper just willing ate about 1/3 of it!!! YEA!!!

Thanks again for all of your support from both me and Pepper "if it can go wrong, it will" Watts!

[littleone1]

Hi Sherry,

I can only relate to the experience Corky had when his electrolytes were totally out of line. He wasn't eating, he was extremely sick, vomiting everywhere, he could hardly stand, let alone walk. He had to be rehydrated 2 days in a row, and I was told by his vet to give him Pedialite. It took several days for him to recover. I can only hope that this might help.

Terri

[sherrylwatts]

Hi Sherry,

I can only relate to the experience Corky had when his electrolytes were totally out of line. He wasn't eating, he was extremely sick, vomiting everywhere, he could hardly stand, let alone walk. He had to be rehydrated 2 days in a row, and I was told by his vet to give him Pedialite. It took several days for him to recover. I can only hope that this might help.

Terri

That does help, I was wondering if they made a Pedialite for animals! I guess just give him the type found in the baby isle?

[clydetheboosmom]

Hi there -

Wow, it sure sounds like you have been through a lot!

Can't answer too much about the pancreatitis, but I can tell you that my dogs will drink water if I put organic chicken broth in it...along with the pedilyte, this might help with fluids and proteins. :)

Hope this helps, please keep us updated -

Lynne, Clyde & Bailey

[littleone1]

Hi Sherry,

That's what I used. At first Corky wouldn't drink it, and I had a syringe to use if I had to, but what I did, was to put it in one side of a double bowl, and put his water on the other side. I reversed it so he went to that side first. I wish you the best. Hopefully Pepper will be doing really good soon.

[Harley PoMMom]

Does anyone know signs I should watch for to indicate her electrolytes are out of balance again? I can't run her to the vet daily (obviously) to check. We gave her too much potassium, but I'd like to be able pinpoint symptoms that her sodium levels are getting too high.



Offering him salt (normal table salt - not any of the fancy "lite" salts) would probably be better than Pedialyte. Pedialyte has some potassium in it and if his electrolytes out of balance because of Addison's then he won't be needing any more potassium - what he will need is sodium as lack of aldosterone means that he cannot keep sodium in his body which will mean that he is losing sodium (and this will dehydrate him as it will take water with it) and this loss of sodium and water leads to too high a potassium level which affects how the heart works. Is he peeing and drinking a lot?

You could try offering him some salt on your hand or you could try sprinkling a pinch of salt on some food. If he really is addisonian (has a serious electrolyte imbalance)then he very likely has a salt craving and it may even persuade him to eat some too. Some dogs will go for salty crackers.

Ideally he should have Florinef and even go back on an IV to be stabilized tonight but if that is really not possible then offering him salt should help. When did he come off the last IV?

The prednisone will be helping with the electrolytes a little bit but not a lot. (Prednisone has some very weak aldosterone-like action, apparently.)

Alison

Hope this helps.

Love and hugs,
Lori

[zoesmom]

C'monnnnnn Pepper. We're all pulling for you. Eat, Mange, nibble nibble. Sue

[sherrylwatts]

Ok, spoke to the vet and she said no go on the Pedialite. All of Peppers electrolytes are in balance EXCEPT for Potassium. We're going to try halving the dosage (1/2 Tablespoon) per day and watch the effect it has on her. I'm worried about her swinging out of balance because she has shown a serious preference for the water out of my salt water pool instead of fresh water - UGH!!! I guess we're doing the let's try it and see method of balancing her out - LOL! So far today she's eaten (on her own) about a pound of lean steak meat - no rice or veggies yet, but still it's a great sign. Just picked up a multi-vitamin for dogs, so hopefully for a few days, this won't be a difficulity. So, push for another 1/2 lb in her today, if not, I'll continue feeding her the chicken mix I made yesterday.

Cooking more dog food for the other mutts (yellow lab w/ lymphoma & yorkie puppy that is AMAZINGLY enough healthy - knock wood) today, hopefully we'll get her back on the normal stuff in a few days :-D

[frijole]

I used Pedialyte as well once. At first she wasn't keen on it. Start out very slowly. Like a tablespoon of it mixed with a tablespoon of water. I did this every hour for a day and then slowly increased quantities.

Pepper we are all rooting you on. Hugs, Kim

PS Just saw your post. Dang. Well we are rooting you on!!!

[zoesmom]

Was she slurping up water from the pool before all the other stuff happened? Because I wonder if the excess sodium is what threw the potassium out of balance and it had nothing to do with the lysodren/trilo? Then again, if Pepper did go addisonian from the cush tx, then the florinef (that someone mentioned) may need to be added to help control things. It is given about every 3 weeks as an injection, I think. A few here know all about it. Maybe they'll post soon. Have you heard anything yet on last week's acth test?

Really glad to hear she's starting to show an interest in food. Altho' when Zo had pancreatitis, they did advise - among other things - keeping her off of all food for at least a day or two, to speed along the healing process. But if Pepper took meat today, that sounds very positive. Maybe you can sneak in some rice tomorrow, + maybe a few veggies the next day!! But do go slow and don't push her toooo much. Several small meals probably best in her 'delicate condition'. Sue

[Casey's Mom]

Yeah Pepper !!:):):)

Love and hugs,

[mypuppy]

Hi Sherry,
Gosh, I am so sorry Pepper has been through so, so much pain and trauma, and now this to boot. My heart goes out to her and you. Although I cannot offer you any medical advice here since I'm still in the learning process myself, but I offer you my prayers that your precious Pepper bounces back real soon and get her to full recovery. Hang in there, you are a wonderful furmom and doing all the best possible for your baby. Luv bunches and tight hugs to both of you. xo Jeanette

[sherrylwatts]

UPDATE TUESDAY:

Gosh, I feel like I'm keeping a journal on here! Thanks again everyone for all their advice and support. Well good and bad. Last night, Pepper started shaking again so I gave her a teaspoon of Potassium and it seemed to perk her right up (good), but then she came in and immediately urinated on her bed (bad). She also had a horrible accident (she seems to be leaking, but she's done that off and on since her spinal cord surgery) during the night - and so did her brother (I think the mass for him might be pushing on his bladder). This morning got her up, gave her liver pill & appetite stimulant, then cooked her breakfast (boiled chicken breast) - unfortunately she's not wanting to eat, so we're back on the liquid. I'm taking it easy today since she ate so well yesterday, maybe got a little tummy ache? Had to get a little food in her though so I could give her the Pred, Amoxicillin, Pro-Pectin & Potassium gel (another teaspoon) - again she seems to be ok, holding her head up, but not a lot of energy. Poor baby is begining to hate seing her mom coming - LOL, seems like I'm always shoving pills down her throat - I miss the days when I just had to wrap it in a piece of bread or cheese!

[mypuppy]

Wow Sherry! I got it hand it to you. Every time I read your posts, it seems you are dealing with yet another issue with your precious Pepper. You seem to have your hands so full with Pepper and yet are still going strong. It's amazing--you are amazing! God Bless you both. I feel so very helpless honestly. If I had the power to make Pepper's pain go away, I would in a heartbeat. I will keep my prayers ongoing, it's the least I can possibly do. Get well soon Pepper. We love you sooooo much....Tight hugs coming your way and lots of soft belly rubs for our precious Pepper. xo Jeanette and Princess ps: I probably missed it from one of your earlier posts, but how old is Pepper?

[sherrylwatts]

UPDATE WEDNESDAY:

Well yesterday was a bad one, I gave Pepper her meds in the morning along with 1 teaspoon of Potassium. About noon she started shaking and getting week, so I gave her another teaspoon of Potassium. About 5 she started shaking again, and fell down when she went potty, so I had to hold her up to finish. I gave her an extra Pred & 1.5 teaspoons of Potassium. All last night she was shakey and week, but was able to go out at night and potty on her own. Evidently during the night she regained her strength and led a palace revolt! Because of the incontinence they've been sleeping in the laundry room, well Pepper broke down the baby gate - her & her brother decided to sleep in the den (I never heard them - LOL). She woke me up about 4:30 wanting to go out & I got up to 4 (yes 4) wet spots on the carpet - ARGH!!!! Looks like I'm shampooing the den today! She did voluntarily eat a little yesterday & I gave her some more in liquid, so I think we're ok calorie wise.

On another note, her ACTH test results came back, base >10, end result 22.6 although the Pred could have raised the results about 4 points, so her cortisol levels are down, but not where we want them. At least she's not Addisonian. Once we get through the current crisis, I think we're just going to do a higher maintenance dose of the Lysodren instead of another loading period. Her poor body just can't take the shock.

Mypuppy, I have to admit, I'm exhausted - LOL! I'm dreaming at night about taking care of sick puppies - can't even escape it in my sleep :D! Thank goodness I'm at home all day and can give her the care she needs. Between the labs, Pepper (who's 10.5 years old) and her brother (who's 10 years old this month), I'm giving the babies about 16 pills per day - not including enzyme packages & potassium gel! I'm so glad at least that Bruiser (my Yorkie) is finally potty trained (he's 8 months old on Friday) so at least that's one worry off my mind! And the rest of the zoo (cats, horses & a donkey) seem to be doing fine, I was worried about the donkey foundering this spring (he did last fall), but so far no problems.

Pepper will take her last dosage of Amoxicillin a week from today, so the day after I'm taking her in for a blood test (electrolytes, CBC, CPL & T4). If everything looks ok, we're going to restart the Lysodren on the maintenance dosage. Probably 250mg 3x per week instead of 250mg 2x per week.

[jrepac]

sounds like she is doing better and that is the best news! even if the Cortisol level is at 22, that is not awful, frankly!

good luck!

[bkdice]

I haven't posted to your thread, but I've been checking in on it every day. Glad she seems to be feeling a bit better. Hoping for more good news to follow. :)

Bettina & Angel Niko

[Harley PoMMom]

One of the protocols of giving Lysodren is to never give it to a pup that's not eating right or sick, and I don't think it matters how high the pups cortisol numbers are.

If Pepper were my pup I would not start the Lysodren until she is eating very robustly on her own and has gained some weight...JMO.

I am happy to read that she is starting to eat on her own and I hope this continues! YAA!

Love and hugs,
Lori

[sherrylwatts]

One of the protocols of giving Lysodren is to never give it to a pup that's not eating right or sick, and I don't think it matters how high the pups cortisol numbers are.

If Pepper were my pup I would not start the Lysodren until she is eating very robustly on her own and has gained some weight...JMO.
Love and hugs,
Lori

Yea, that's one of the reasons we're waiting until at least a week from tomorrow. Hopefully she'll start eating more on her own (she ate 2 chicken breast & 1/2 lb of steak today - yea!!!) and her white blood count and electrolytes will be cleared up. I think we're going to have to monitor her liver enzymes for a while though, the vet gave me a 60 day supply of Adenosyl, so I'm thinking we're going to be on that for a while! She's doing better today, I gave her 2 teaspoons of Potassium this morning & 1 more with her evening meds, hopefully spacing it out will help.

[Roxee's Dad]

I haven't posted to you but I have been following all the wonderful help, information and hand holding. Just wanted to say I am very glad that Pepper is eating better and hope the improvement continues. :)

[mypuppy]

Hi Sherry,
Pepper has been in my thoughts every day since I started reading your thread. Not and odd thing to do considering I just love all these precious pups dearly, and when I hear anything wrong going on with it breaks my heart, as it does everyone here on the forum. They are too special not to feel this way. But anyway, I was hoping to get an update on Pepper, and hopefully a good update--it would just make my day. My prayers are still ongoing. Chin up and looking forward to hearing on you getting some well deserved rest at the same time. BTW, do you really tend to all those 4 legged friends? Wow! You must be awfully special to take on such rewarding challenge. Hands up! xo belly rubs to all your friends, Jeanette

[sherrylwatts]

UPDATE THURSDAY:

Sorry to be so late posting. Pepper is doing good this morning, last night she started shaking again and I gave her another teaspoon of potassium, and within the hour she was better! Anyone know how long it takes for their electrolyte balance to regulate itself? She's been taking Potassium since Saturday and still has episodes. So far it's been a GREAT morning! She ate 3/4 lb of steak for breakfast :D - still not interested in rice or veggies, but thats the most she's had in one sitting since all this started! I'm giving her a multivitamin for dogs, so hopefully that will make up for the lack of a balanced diet until she gets her apetite back. She does seem to be getting some of her strength back - at least judging by the way she's started fighting with me over the pills! Taking so many has given her an opportunity to learn all new sorts of techniques for pill avoidance and she's getting quite good at it :rolleyes:.

Mypuppy - I do take care of the zoo (as we affectionately call them), mostly it's pretty easy, but occasionally we have the "interesting" moments - just last week my full male Donkey jumped my neighbors fence and....ummm....molested her two females. Getting him back here was definately a chore - he did not want to come and he is a strong little bugger!!! Now we get to wait and see if we have any baby donkeys on the way, sigh. People sometimes ask me why I don't work (since we only have furbabies) and I just look at them like they're CRAZY!!!:p

[AlisonandMia]

Sorry, can't help with your electrolyte-balance question really. I think what you've been seeing with Pepper is an electrolyte-balance problem caused by dehydration/vomiting/not eating. The electrolyte- balance problems caused by an overdose of Cushing's meds is different - in fact with that there is too much potassium rather than too little and sodium (salt) is what needs to be supplemented. And you would only get that med-OD imbalance with very, very low cortisol too so I think it is safe to say that the electrolyte imbalance isn't related to the Lysodren.

It sounds like she needs to have her electrolytes looked at again by the vet - it is really the only way to know what is going on - if you could manage to get the sample taken during one of her episodes that would be ideal, but probably difficult and even distressing for her.

Do these episodes happen at a certain time of day, maybe in relation to when she has eaten? I'm thinking that they are not necessarily electrolyte related but caused by some sort of pain or sick feeling that is coming and going.

Unfortunately prednisone tastes horrible (very bitter) and dogs given prednisone will often become very good at rejecting pills. I'd imagine the potassium supplement could be pretty unpleasant tasting too.

Alison

[zoesmom]

How's Pepper doing today? More steak on her plate - and in her tummy? Sue

[sherrylwatts]

UPDATE THURSDAY:

Thank you to all that are asking about my baby and helping me through this! Well, today it's 2 steps forward, and 3 steps back. Last night she got a little shakey and week, so more Potassium - the new tube is liquid and much easier to give to her! But she did "raid" the dry puppy food bowl, so we let her eat that and gave her more - she had about two cups worth - that with the steak was a huge amount of food. This morning - she didn't want to eat. I gave her about a cup of liquid so I could give her the meds and about an hour later she vomited - just a small amount, mostly puppy food from last night (no wonder she didn't want to eat!). I looked through and it appeared all her meds were dissolved (UGH the things we do for our babies), so today I'm just letting her go at her own pace. So far no food, but I'm still hoping! The shaking seems to be getting less, or maybe we're just quicker about catching it and getting potassium in her?!? She's still very week though, having a little trouble getting up and down - her bad leg seems to have no strength. We've been on antibiotics for a week now & I'm wondering if they're working? I do think the potassium is due to the diarrhea, not cushings or addisons (her ACTH numbers are to high for the later) and that has stopped - still soft, but not liquid (sorry so graphic). The meds say to continue for 48 hours after symptoms stop, so I'm going to give today and tomorrow - maybe now her electrolytes will rebalance. I wish I could get her to drink fresh water, but she ignores it and goes straight to the pool (salt water), and I wonder if that's helping keep it out of wack? It's only about 3% saline, but still...

Mostly she just wants to rest. I slept on the couch last night (because she was so weak) so I could be within earshot if she woke up, and we got up once to go potty. I had to help her up, but she did squat ok on her own - no falling or anything. I think she gets a little better everyday, but it's so slow :(. Poor hubby is going nuts - he's works all day, so he's not used to her peaks and valleys and everytime he sees her weakness or shaking, he goes into full blown panic mode! Maybe she'll want to eat tonight, if not I'll have to make more liquid to give at med time, but I'm going slow with it since she did have a good day yesterday. I just want my poor girl better!


Do these episodes happen at a certain time of day, maybe in relation to when she has eaten? I'm thinking that they are not necessarily electrolyte related but caused by some sort of pain or sick feeling that is coming and going.

Alison

Alison - I give her 2 teaspoons in the morning and usually early afternoon she starts shaking so I give her another, then between 5 - 7 it happens again. I hate giving her more at one time, because it seems her nervous system goes into overload, she starts twitching and gets stiff (kind of like Parkinson's), that's why I'm spacing it out. Maybe I should start a pre-emptive strike and give her a teaspoon about 2:30 then one about 5:30?

[AlisonandMia]

I had a thought last night just before I went to sleep. I'm wondering if Pepper's adrenal tumor isn't producing vast amounts of aldosterone and if this isn't behind some of the strangeness you are seeing and particularly the upset with the electrolytes (hypokalemia). From what I've read adrenal tumors tend to put out their hormones in surges which could explain why she seems to have "attacks" from time to time.

Just Googled hypoaldosteronism: http://en.wikipedia.org/wiki/Hyperaldosteronism

It does sound awfully like what could be going on with Pepper. Has she ever had her blood pressure measured? If this is what is going with her then her blood pressure is probably sky high, unfortunately.

Alison

[zoesmom]

Hi Sherryl - I'm most suspicious about the pool water drinking, as I mentioned before. So I just did a search and found this, tho' it's about a cat......can't imagine there would be too much difference:

"Yes drinking pool water can cause vomiting. The electrolytes and other chemicals in the pool water can be caustic and offset the body's electrolyte and acid/base balance. Stop your cat from drinking the pool water. Don't allow him to go outside or get a pool cover to prevent him from drinking this water.
Since this is chronic I would have him examined by a veterinarian to make sure there is not another underlying cause and to determine his acid/base and electrolyte status and to make sure no other damage has been done."

Isn't there some way you can stop Pepper from getting to the pool water. The whole electrolyte thing is confusing to me, but it seems like if a dog gets too much sodium, that would in turn throw off the potassium balance - and possibly others. Will go see what else I can find. This is just the FIRST link I clicked on. Sue

[zoesmom]

Ok, here's another. That previous one was from BlurtIt and this one from answers at Yahoo:

"Salt is dangerous because it increases fluids in the body and changes the balance of minerals which keeps everything working properly in the body. If the dog consumed a large amount of salt water, it is probable that a vet would want to administer diuretics to remove excess fluid and also administer calcium, phosphorus, potassium, magnesium, etc. to bring the mineral content in the blood and tissues back into balance. Electrolyte balance is responsible for proper nerve function, for maintaining proper heart rate, etc. Depending on what "lots" means and depending on what kind of symptoms the dog is exhibiting, it may be necessary to have the dog seen and bloodwork done tonight by an emergency vet."

I can't say for sure but I really wonder if this might be what's going on. Have you mentioned Pepper's affinity for pool water to your vet? How long has she been doing it? Sue

Ps - I searched by typing in "dog drinks from pool + electrolyte imbalance."

[sherrylwatts]

I did mention it to my vet - salt water pools vs chlorine pools are fairly common in my area (more expensive to install but so much cheeper to operate per year). She actually had a dog that drank from her salt water pool and she had to give it potassium supplements throughout its life - so that may be something we have to take into consideration. In healthy dogs, the salinity wouldn't cause a difficulity - it's less than 3% - about the salt content of tears, but for a pup in a health crisis... For the past 10+ years, Pepper would go to the fresh water bucket, this drinking from the pool is fairly new. I notice she really goes after it shortly after I give her the potassium supplement...she has ignored the fresh water even when its obvious she's thirsty. We're taking this into consideration with her treatment. We're pretty sure the potassium imbalance is due to the diarrhea not the pool, although her recent preference is certainly not helping! ARGH - who knew that building a pool that is more earth friendly and easier maintenance would ever be a factor in my babies life?!? Tonight she's still weak, but hasn't been shaking - I've been giving her potassium a little early, and hopefully we're on top of it and won't go to the imbalance that causes shaking and weakness. Poor baby is just having such a long haul recovering from all these illnesses:(

[AlisonandMia]

I do like (although like isn't quite the right word:p:o) Sue's idea that drinking salt water could be cause of the persistent low potassium. Let me tell you about the time my dog drank sea water (sea water 3.5% salt on average world-wide apparently - he drank (a tiny bit of) the Pacific Ocean so I guess that would be a pretty representative bit of ocean):

We took him too the beach - which he thought was fantastic! For the first couple of hours he kept drinking the sea water despite me chasing him around with a doggie water bottle and trying to stop him. He was a healthy young (18 months of so) dog so he basically handled it ok, BUT he did have an episode of really watery diarrhea on the beach - presumably osmotic diarrhea caused by the salt. After that he seemed to realize that this drinking salt water was not a good idea and he stopped. So it seems that drinking salt water can actually give them diarrhea. Is Pepper still having diarrhea?

When that happened I did a bit of research and remember reading about a dog in England who died in the car on the way home from the beach after drinking sea water.:eek:

I'd think, in theory, that too much potassium supplement could actually be giving her a salt craving too - so that may be playing a part in her pool-water drinking, especially as she seems to want to go and drink pool water just after having the potassium supplement.

Alison

[Squirt's Mom]

Hi Sherryl,

I haven't posted to you before but have been reading along as yours and Pepper's story progressed. It has been several days since we have heard from you and I, for one, am getting worried. I'm a big ole worry wart! :o If you get a chance, I would love to hear how things are going.

Hugs,
Leslie and the girls - always

[sherrylwatts]

Sorry to not update, this weekends been kind of crazy! Pepper is doing so-so, she still doesn't have much of an appetite - one day she eats like crazy, the next day, nothing at all voluntarily. Last night and today for some reason, she's on a mashed potato kick - You know it's a strange day when you make your dog mashed potatoes for breakfast:D (and don't worry, I'm making sure there are no peels or green spots) - I guess it's gentle on her tummy. Her electrolyte imbalance was caused by the diarrhea which was caused by the Lysodren loading. However I do think the salt water from the pool was keeping it out of whack! For a while she wouldn't touch fresh water and would only drink from the pool (or not at all), but that's stopped now, and luckily the amount of potassium I'm having to give her is also down. Yesterday she got 1.5 teaspoons full, and hopefully today it will be about the same (0.5 this am, probably another 0.5 around 2 then again around 6 or so). I'm hoping this means her electrolytes are coming back into balance - Saturday when I gave her a full teaspoon at once, she was overloaded. She's off the diarrhea meds because that no longer seems to be a problem. I'm still feeding her liquid food to keep her body weight up, but I'm making sure to remove as much fat as possible - today we're having liquified chicken breast to go along with our mashed potatoes! She took her last mirtazapine (appetite stimulant) this am, but I think I might need to get those refilled until her normal appetite comes back.

Good news, she does seem more alert and responsive, she's getting up and down on her own - we haven't had an episode of the shakes for over 24 hours, but she's still VERY weak. Was going to take her in for blood work Thursday (CPL, CBC, electrolytes), but unless she starts eating on her own, the vet says wait (we can't start the Lysodren maintenance anyway) and she's recovering from being horribly ill. All in all, she seems better, I just wish we could get her to eat!

[Squirt's Mom]

Thanks for the update! I DO understand hectic! :eek:

It sounds as if Pepper is making some progress which is wonderful to hear. I am glad she seems to have lost her affinity for the pool water, too. Hopefully, the electrolytes are coming back into a more normal balance and she will continue to improve.

Hugs,
Leslie and the girls - always

[mypuppy]

Hi Sherry,
Havent seen any new updates on Pepper. Hope all is well.
Thinking of you.....xo Jeanette

[katiesmom]

Hi Sherry!
Sorry to hear about Pepper. I wish I was there to give you both a bug hug. I don't have the expertise and knowledge these fine folks on here have, as my dog was just diagnosed recently. All I can give you is moral support. My dog katie will be on her second day of lysodren tomorrow(sun) but she is only taking 500mg a day. and that tablet is divided into two doses-half in the morning-half in the evening. My vet chose to take the cautious route I guess, and she also instructed me to not hesitate at all about giving 2-5mg of prednisone if i felt Katie was having a bad reaction. She said it won't hurt her at all, even if I was nervous and made a mistake thinking she was having a reaction. My dog weighs 39lbs. Pepper was on a much higher dose and I wouldn't hesitate to use prednisone either.
My thoughts are with you and Pepper and I'll watching your post to see how pepper is doing.

[sherrylwatts]

Sorry everyone for not updating sooner! Pepper is doing better, but is still so very weak. She's been eating on her own for the past 3 days, sometimes a lot, sometimes a little. You can really tell being this ill took it out of her though - her gimpy leg is really bad, and because she lost so much strength, she has to have help getting up and down - the tile floors are a serious challenge:(. Last night she tried to get up on her own, slipped and did the splits (ouch) and ended up messing herself. She is much more alert and other than the residual weakness seems to be her old self - although I think she's mad at me cause I won't throw her ball. I'm taking her in Tuesday morning for blood work and we'll check here CBC, CPL & electrolytes. If everything looks good, we'll try the maintenance dose of Lysodren (250 mg 2x per week). My vet really wants to put some weight on her so we've upped her caloric intake to 1500 per day. Try coming up with non-fat stuff that is that high in calories:eek:. A friend of mine suggested low-fat muffins and I spoke to my vet - she had me read the ingredients to her and said go for it - at 250 calories a pop, we're getting about 500 extra in her a day and it seems she's developed a thing for blueberry muffins - LOL. She's down to about 1/2 teaspoon of potassium per day now, and the vet says now that she's eating normally we can cut it out in a few days, we'll see Tuesday. Her ACTH test results were still pretty high, (22.6 - @ 4 points due to prednisone for those that don't remember) so we need to start treating the Cushings as soon as she's better.

For those who are using Lysodren - don't be terrified by my story, none of Peppers problems (except the electrolyte imbalance caused by diarrhea, a side effect of the drug) were caused by the loading - she already had pancreatitis - we just didn't recognize the symptoms until looking back, and the infection could have happened at anytime - Lyso just made her more prone to catch something. It just all hit at once, so it's been a slow and scary recovery. Lyso is scary (so if your vet wants to be cautious I don't blame them) and I wish that the Trilostane would have worked instead, even though it's outrageously expensive - heck with all of her recent medical bills - I could have bought a years supply:D.

[AlisonandMia]

Diarrhea isn't really a side effect of Lysodren as such (not caused by the presence of the drug in the GI tract) but it will occur if the cortisol is reduced too far by the Lysodren (the same will happen with trilostane too so it isn't risk peculiar to Lysodren). Low cortisol definitely causes diarrhea and giving pred will usually fix it very fast if that is cause. Diarrhea is a known symptom of pancreatitis so considering that Pepper's cortisol remained high (and she was given prednisone) throughout I'd be prepared to bet that the diarrhea was related to general upset from the pancreatitis rather than the Lysodren.

Some dogs do seem to get some GI upset from Lysodren (and some from trilostane too) that is separate from the cortisol-lowering effect but this usually takes the form a mild tummy ache and a little nausea and is usually very easily addressed by giving something to settle the stomach. Other meds that are used very frequently like NSAIDS and antibiotics are actually far, far more likely to cause much more severe GI irritation in themselves than the Cushing's medications.

Alison

[sherrylwatts]

More updates - back from the vet. The infection is back, potassium is still low, and still testing positive for pancreatitis. Back to 10 - 11 pills per day :(. At least she's eating (1700 calories yesterday - yea!) and I got some new low fat, high calorie food from the vet - 568 calories per can. She ate about 3 bites this moring (+ about 1/3 of a can of her old food) - that puts us at only 250 or so calories today...hopefully she'll eat more later!

New update - she finished the can of new food - that's about 718 calories so far today!!!

[mypuppy]

Hi Sherry,
I'm so sorry to hear this. I do not know much about pancreatitis or what brings it on. Is it controllable with the meds? That's a lot of pills per day....UGH, UGH. Poor, precious Pepper. Will pray for her speedy recovery and good health. Belly rubs to Pepper. xo Jeanette

[bkdice]

thanks for updating again. i know how difficult each day is, not knowing how she'll be or what she will or won't want. you're doing a great job though. lucky pup to have such a diligent mom. :)

[Annie's Mom]

Hi Sherry, I haven't posted to your thread before, but I've been reading about your sweet Pepper. My Annie was hospitalized last fall for 6 days with severe pancreatitis. Be patient; it is a slow recovery process. Annie was not given any food for 72 hours -- their pancreas needs time to heal without irritation of food; giving /forcing food too quickly can back fire. Small frequent meals were the norm for about a month. It is challenging for them to get the calories they need to regain energy and stamina, and not upset their bellies. Post-hospitalization, Annie was prescribed Royal Canin Digestive Low Fat LF canned food. She ate ONLY that canned food for at least 4 weeks. Slowly I added in regular dry kibble. My vet instructed me to keep her on a low fat diet. The down side to that Rx canned food is that it is low fiber, so Annie's bowels were not solid at all (not fun for her or me!). I added a teaspoon of canned pumpkin and slowly added a bit of powdered fiber. She had lots of gas. 10 mg of PepcidAC tablets twice a day were routine for 6 months (Annie is 6#) and I think they helped. Annie was extremely weak and tired for at least 6 weeks. This is normal. I am concerned that you are feeding steak - that seems high in fat and protein?? Also, my understanding is that vomitting is the warning sign of pancreatitis; diarrhea points towards colitis. This was my first experience with pancreatitis, so I am not an expert, but I learned a bit! Sending Pepper lots of healing energy from Barb and Annie

[sherrylwatts]

Hi Sherry, I haven't posted to your thread before, but I've been reading about your sweet Pepper. My Annie was hospitalized last fall for 6 days with severe pancreatitis. Be patient; it is a slow recovery process. Annie was not given any food for 72 hours -- their pancreas needs time to heal without irritation of food; giving /forcing food too quickly can back fire. Small frequent meals were the norm for about a month. It is challenging for them to get the calories they need to regain energy and stamina, and not upset their bellies. Post-hospitalization, Annie was prescribed Royal Canin Digestive Low Fat LF canned food. She ate ONLY that canned food for at least 4 weeks. Slowly I added in regular dry kibble. My vet instructed me to keep her on a low fat diet. The down side to that Rx canned food is that it is low fiber, so Annie's bowels were not solid at all (not fun for her or me!). I added a teaspoon of canned pumpkin and slowly added a bit of powdered fiber. She had lots of gas. 10 mg of PepcidAC tablets twice a day were routine for 6 months (Annie is 6#) and I think they helped. Annie was extremely weak and tired for at least 6 weeks. This is normal. I am concerned that you are feeding steak - that seems high in fat and protein?? Also, my understanding is that vomitting is the warning sign of pancreatitis; diarrhea points towards colitis. This was my first experience with pancreatitis, so I am not an expert, but I learned a bit! Sending Pepper lots of healing energy from Barb and Annie

High Annie - thanks for the information! Glad to hear from someone that has gone through this. My vet and I discussed the "force feeding" and the problems with it, but in the end determined that since Pepper was severly underweight we had to get calories into her (her healthy weight is about 63 lbs and she got down to 45 - she gained a few pounds but still looks like a bag of bones) I gave her liquified boiled chicken, brown rice & squash (good for the pancreas) about 1/2 cup at a time ever hour or so - being liquified meant it was mostly water, so she had small amounts of food all day long. The steak was lean meat, boiled and pulled apart to remove all the fat, but was the only thing we could find to tempt her appetite :(. Thank goodness she's eating on her own now, but we still do small meals severall times per day. She was eating homemade food, but now she's on Hill's Prescription Diet I/D - very low fat but high calorie (568 per can :eek:). Because she's so underweight the vet is trying to get 1500+ calories in her per day (1100 - 1200 is normal for her weight). She's also taking Pepsid A/C, 20mg 2x per day and I think that helps with tummy aches. She also has Pro-Pectalin that we give her when she has diarrhea, and Adenosyl (a supliment for her liver), and both of those seem to help the symptoms of pancreatitis. She's been extremely ill since Easter and has been so slow going. Hopefully she's turned a corner, and once we nail this infection we'll be back to normal and can even think about treating her cushings.

[Annie's Mom]

Hi Sherry,
So glad to hear Pepper is making progress. Wow - she lot a lot of weight. Keeping my fingers and toes (and Annie's paws!) crossed that Pepper continues to make forward progress. As I mentioned, it was very very slow recovery for Annie too, as she had multiple issues. She was diagnosed with Cushings after the pancreatitis bout, and it really took her 5 months to stabilize. I was giving Annie Pepcid 20mg 2x day during the critical period. I think it helped I still give her Pepcid AC when she has slight GI issues. I'm making note of your homemade food recipe, just in case I need it down the road (hopefully not!). It's amazing the info we learn from each other! So glad Pepper is making progress and I'll be keeping a watch on her progress! There are many folks much more knowledgeable than I on this forum - such a wealth of valuable info. Barb

[sherrylwatts]

And the hits just keep coming :(. Today we had to put Salt (Pepper's brother) to sleep. He had lymphoma and was actually doing quite well on Prednisone & Pain meds until Sunday evening when he tripped twice. Monday he started stumbling a little and the vet said the lymphoma had moved into his nervous system. Tuesday his stumbling increased and by yesterday afternoon he couldn't even stand to go potty. Pepper seems so depressed and has barely eaten a whole can of food over the course of the day. She keeps getting up to look for him, I hope this doesn't reverse the progress she has made. It's hard enough to lose him, I don't think I can stand losing her.

http://sphotos.ak.fbcdn.net/hphotos-ak-ash1/hs505.ash1/29848_1433748681476_1165684021_31287641_3206665_n. jpg

Anyway: To the sweetest dog on the face of the planet - Salt man, I love you...

[mypuppy]

Oh Sherry,
I am so very sorry to hear about your precious Salt. How very sad indeed. My thoughts are completely with you. May the wonderful memories sustain you for all the days to come. I will be keeping my prayers going for some comfort in all this, and of course, for Pepper's continued progress. UGH, UGH. I am so sorry. Please keep the faith as hard as that is at times. Remember, God loves you, Pepper, Salt and SO DO I. Tightest hugs coming your way. xo Jeanette

[Harley PoMMom]

Dear Sherry,

I am so sorry to read about the loss of your beloved boy, Salt. You all are in my thoughts and prayers during this very painful time. Please know we are here for you and Pepper always.

Love and (((hugs)))
Lori

[lulusmom]

Sherry, I am so very sorry to hear about the loss of your boy, Salt. Words are so meaningless at times like this so I'll just tell you that my thoughts and prayers are with you and your family.

Godspeed sweet Salt.

Glynda

[zoesmom]

Wow, Sherry . . .when it rains, it pours. I am so sorry to hear about your baby, Salt. Pepper is undoubtedly grieving, too, though he doesn't know why. When we said good-bye to Zo's
'sister' KC (tho' they weren't blood related,) she looked for her for at least 2 or 3 months. It's so hard because you can't explain to them where their buddies have gone. Just give Pepper lots of extra love during this time, as I know you will. Hugs to you and yours. Sue

[frijole]

I am so sorry to hear about Salt. No doubt Pepper is missing his buddy. Like Sue said, lots of extra hugs and attention for Pepper for sure. Meanwhile the "cushings angels" will flutter their wings over your house to ward away the bad spirits and clear the path for recovery for dear Pepper. Meanwhile warm thoughts from my house to yours. Big hugs too. Kim

[littleone1]

Dear Sherry,

I am so sorry to hear about Salt. Please know that he is now free from all pain and suffering, and is free to feel the wind and roam where he feels very comfortable.

My thoughts and prayers are with you.

[Casey's Mom]

Dear Sherry, so sorry to hear about Salt.

What a sweet photo of him, thank you for sharing with us. As Kim said the cushings angels are with you. RIP dear Salt - and many hugs to you Sherry.

Love and hugs,

[Squirt's Mom]

Dear Sherry,

I am so sorry to hear about Salt. Even tho he wasn't a cush pup, he was/is still family and has been added to the In Loving Memory section, Remembering All Who Have Left Us in 2010.

With all your worries over Pepper and now to lose Salt. :( Pepper will come around, he just needs time to grieve like we all do. You will be a great comfort to each other in the days and weeks ahead.

Remember, we are always here, anytime, for any reason and we understand what it means to lose one of our babies.

Our deepest sympathies,
Leslie, Squirt, Crystal and our angel, Ruby

[Annie's Mom]

Sherry,
You and your family are in my thoughts and prayers. Godspeed to Salt and tons of healing energy to Pepper. I know the feeling all too well - when it rains it pours. Pepper and you need each other now more than ever. I've been through a similar situation recently. Be strong for Pepper, pour all your love and attention to Pepper and have faith that Pepper will rally! We are all here for you. Barb

[jrepac]

oh my...I am SO sorry to hear about this; hopefully Pepper will rebound...that photo is priceless, by the way; something to be treasured.

Jeff

[katiesmom]

Sherry...I had posted here lastnight, but now I don't see it anywhere, I sent you a PM message

[sherrylwatts]

Update Sunday:

Today was our worst ever. I think my baby girl, Pepper, figured out Salt dog is not coming home. Her behavior says hungry, but before she takes a bite, she looks around for her brother, then gets that look in her eyes and sighs and won't eat. For the first time in a week, I've had to "force feed" her...I hate this. Bruiser, the yorkie puppy is going crazy, searching for his brother all over the house. Salt dog always played with and cuddled with him...Pepper (bless her heart) has always thought of him as an annoyance. God I miss my baby boy.

[frijole]

Sherry, I feel so badly for you and can only say that with time Pepper will become more comfortable with the loss. You are doing everything right so just keep the faith, keep strong for the furry ones that remain, and keep feeding dear Pepper. Know that we are all cheering you on and that you can come here to vent and lose it anytime you want. Hugs, Kim

[Casey's Mom]

Sheryl, I feel very badly for you and the pups. I know Bruiser must really miss Salt judging from the photo you posted:(:( Keep the faith girl and your dogs will come around it time - it just must make it so much worse for you to see their reaction.

Love and many hugs

[sherrylwatts]

New Update Tuesday - sorry y'all for not posting more and not responding as much to other threads as I should! Sometime feel like my life is similar to having a newborn - feeding schedules and such - LOL. Pepper ate 1/2 can of food on her own today, although I had to force 2 more cans to get the caloric intake. Wish us luck, we're going back on Mirtazapine for the next 30 days. Turns out it is an anti-depressant given to humans that they give to animals for the side effects (appetite stimulant and anti-nausea). In addition it also supresses Cortisol levels, so with the recent loss, no appetite AND Cushings, I see all of this as a plus. Wish us luck!

[Annie's Mom]

Sherry,
So glad to hear that Pepper is eating, at least a little bit. My Annie was on the same appetite stimulant when she came home from the hospital. It did help increase her appetite, but her tummy did gurgle alot so I continued giving her Pepcid AC to calm her belly. Hope you continue to see improvements. I have faith that Pepper will bounce back, given time and TLC. Give Pepper a hug from Annie and I. Barb

[sherrylwatts]

Pepper decided to give up the fight today. I guess without her life long companion she just didn't have the energy to continue. It is so difficult because this morning she seemed perky and ate 1/2 can of food. Unfortunately she then started vomiting and had horrible diarrhea that she couldn't even control. I gave her anti-nausea and anti-diarrhea meds and water, but about 2pm she finally quit. I know everyone here has lost a loved one, but two in one week is just too much. All I can hope through my grief is that Pepper and Salt are together again free of all pain and illness. I loved you guys more than anything...

http://sphotos.ak.fbcdn.net/photos-ak-sf2p/v214/72/109/1165684021/n1165684021_30029679_4783.jpg

[frijole]

Sherry my heart absolutely is breaking for you. I cannot even write. I am in shock. It might take you some time to get over your huge loss but please know you are always welcome here and that we are honored to consider both Salt and Pepper as part of our cush family.

Check back in when you have the strength and desire and know we are thinking of you and sending warm thoughts, prayers and big hugs your way. RIP dear Pepper. Go find Salt and run free and wild and healthy. Kim

[littleone1]

My heart is breaking for you Sherry. I am so sorry that you've had to go through this. My thoutghs and prayers are with you.

God speed both Salt and Pepper. They are once together again.

[haf549]

Sherry:

I don't think I every posted to your thread but I want to extend my sympathies to you. I just lost Kira on Sunday.

Heidi

[Roxee's Dad]

Dear Sherry,
I am so very sorry for your loss of Salt and Pepper. My heart is hurting for you, the loss of one of our pups is difficult enough but to lose both must be devastating. Wish I could take some of the pain away.

Keeping you in my thoughts and prayers. I know both of your babies are together and watching over you.

Hugs and tears.

[gpgscott]

Sherry,

I also am sad for you and all that Pepper was important to.

I believe she is happy now and amoung others awating the rest of us.

Scott

[zoesmom]

Sherry - I am at a loss for words. To lose both Salt and Pepper in a matter of days. I can't even imagine how your heart must be breaking. So so sorry. Sue

[Casey's Mom]

Sherry I am so sorry - for you to lose both of them so close together is heartbreaking.

Hugs and many tears sent your way and to the pups in heaven.

Love and hugs,

[MiniSchnauzerMom]

Sherry,

I am so sorry for your losses. My thoughts and prayers are with you.
Peace be with you Salt and Pepper.

With deepest symptahy,
Louise

[Spiceysmum]

Sherry,

So sorry to hear about the loss of Salt and Pepper, you must be devastated. Thinking of you.

Linda

[bgdavis]

I'm so sorry for your huge loss. Keep thinking that Salt and Pepper so loved each other that one couldn't go on without the other and now they are together for all eternity.

Bonnie and Angel Criss

[sunimist]

Dear Sherry,

I can't begin to imagine what it's like to lose two precious little souls in a week's time. I just know my heart is breaking for you.
No words will ease your pain so I will just say that my thoughts are of you and your Salt and Pepper and my prayers are for you all. R.I.P. precious ones.

With heartfelt sympathy and compassion,

Shelba and Suni

[jrepac]

I am so very, very sorry to read this....

[mypuppy]

Oh Sherry,
I can't stop crying, specially after looking at that beautiful picture of both Salt and Pepper. I wish I can take away such great pain, because I know it is huge. We do not understand the mystery in all this, and it hurts, it really, really hurts like nothing else matters. Let it all out. It will take a long time to feel at peace, but I will continue to keep you in my prayers for some healing. Your precious babies will be your little angels watching over you now. Please take care of you and you are very much loved here also. Tight hugs. xo Jeanette

[Carol G]

Sherry,

I am so very sorry for your losses. You are in my thoughts.

Carol

[Annie's Mom]

Sherry, I too, am shocked and so sad for you. There are no words to take away the pain and loss you feel. Find solace knowing that Salt and Pepper are pain free and with each other again, running and playing like the old days. 12 years ago I lost my 2 dogs within 2 weeks of each other, so I know a bit of the huge loss you are feeling. I was praying Pepper would rally, but some things are out of our hands. Keeping you and your family in my thoughts and prayers.
hugs, Barb

[JHP]

Sherry .

My thoughts are with you at this very sad times .but remember you have all your memories of your beautiful dogs .
Julie Pip

[Dutchboy]

I am so very sorry for your loss. So much to take at once! (((hugs)))

[maggiebeagle]

Godspeed to both of your sweet pups. I know you must be devasated.

[k9diabetes]

A beautiful pair...

http://www.randomfierce.com/canines/saltandpepperadjusted.jpg

[ChristyA]

Sherry,
I too am so sorry for your losses.
Christy

[sherrylwatts]

can't post yet...too heartsore. thanks to all, maybe tomorrow. miss my babies

[frijole]

Don't you worry about feeling like you need to respond to us! You just take care of yourself and know that us "cush bums" will be here when you are up to talking again. Meanwhile continued warm thoughts being sent your way. It takes time to get over such huge losses. We understand. Kim

[Buffaloe]

Sherry,

I can't even imagine the pain you must be going through after losing both Salt and Pepper in such a short time. I am so sorry. I know that words can't describe the depth of the pain you are feeling.

They are both such regal looking dogs and I know they were both the absolute best, loyal companions for you.

I do believe dog's spirits live forever and we will be reunited with them down the road. Please try to take good care of yourself.

Ken

[Squirt's Mom]

Dear Sherry,

I am so sorry about Pepper. It is a heavy burden you must carry to lose them both so close together but it is a burden born of love; in time good memories will start to seep in, the pain will lessen just a bit, and you will one day surprise yourself by smiling when you think of Salt and Pepper.

Please know we are all here for you (even those of us with unreliable computers :o ) so don't hesitate to talk when you need.

Our deepest sympathies,
Leslie, Squirt, Crystal and our angel, Ruby

[bkdice]

Sherry - I have been away from the forum for a bit, so I am so sorry I am just now reading about Salt and Pepper. I cannot believe you lost them both so close together. You poor thing... you must be devastated. My sincere condolences to you.... I am so, so sorry you have had to feel such a tremendous amount of loss in such a short period. My hat off to you for all you were trying to balance for your babies. I hope their souls are together now and watching out for you, the way you watched out for them.

Sorry again for the late reply.... I'm just so sorry. I have lit candles for both... My thoughts are with you.

Sincerely,
Bettina & Angel Niko

[Franklin'sMum]

Sherry,
I am so very sorry for your heartbreak. Thinking of you
Jane, Franklin and Bailey xxx
________
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[EllyAugie]

Sherry, I am so sorry for these very sad chain of events of losing both your babies. I know you are hurting deeply right now and traumatized, I wish I could take the pain away. The love was obvious in the photo of Salt and Pepper that they had for one another, such a beautiful pair of buddies. Please know that I am sending you prayers of strength through this very difficult time. I truly care about the pain you are in and am sending healing thoughts and prayers to you.
Love and strength.
Elly and always Augie.

[katiesmom]

Sherry.....I don't even know where to begin....I haven't been online for several weeks now and was shocked to log on and find out your very sad news about Pepper.

I'm so sorry to hear about Peppers' passing. I can't even imagine the pain and heartbreak you must be feeling. Bad enough to lose Salt but now Pepper too. I wish I was there to hug you and comfort you. I truly feel bad. I was following your thread closely, it has been quite an emotional roller coaster reading about your ups and downs.

I do agree with Kens' post. I feel the same way...from my own personal beliefs, and from everything I've read over several years, I do believe our pets souls go on to the spirit world, and that we will be reunited again. This is the physical world, the spirit world is another dimension and Salt&Pepper are now reunited once again. Thank You Sherry for posting that lovely pic of Salt&Pepper, it is truly beautiful!

My condolences and take care. My thoughts and prayers are with you&your family.
Hugs&Kisses from myself and my katiebear.

[clydetheboosmom]

Argh. I hate to see these postings...:(

I'm so very sorry for your loss. Hugs and take good care of you.

Lynne, Clyde & Bailey