My Lacey (14 ½ y/o toy poodle) - Lacey has passed

[Marlene]

Hi!
My Lacey is a 16-year-old toy poodle. She has had problems since March of this year when they diagnosed her as having heart failure. She has been on several medications and has been doing very well with that problem. They actually lowered some of the dosage amounts. She had an echocardiogram of her heart at Colorado State University Veterinary Center and they told me her heartbeat was strong and the murmur was minimal. They told me I could go ahead with anesthesia to have her teeth cleaned. Just recently I had a well-dog exam before scheduling a cleaning and they found her liver enzymes to be high and her cholesterol high. That led to an ultrasound and a diagnosis of Cushings because one of her adrenal glands is enlarged and the other very small and her liver is enlarged. All other organs look ok according to the ultrasound technician. The vet just called and said the decision is to not treat her because of her heart condition. Earlier, I had been told by a CSU vet that if it turned out to be Cushings, Trilostane may actually help her heart problems and I was so hopeful. I am so confused (and heartbroken:(). Does anyone have experience with Trilostane in an older dog that has heart problems? Thanks so much.
P.S. She still acts like a puppy. She wants to play. She chases and plays with our cat. She has no muscle weakness, no stomach or intestine problems. Since reading extensively I have become familiar with the symptoms and the only ones I notice are that she pants, she wants to lie in a cool spot, and she is always hungry.

[labblab]

Marlene, welcome to you and Lacey. She sounds like such a sweetheart! I surely understand why you are hoping to grant her as many happy and active years as possible.

From the ultrasound report, it sounds as though Lacey has been diagnosed with the adrenal form of Cushing's. Successful surgical removal of the offending adrenal growth can offer a permanent cure, but not all dogs may be considered good surgical candidates due to age and other medical conditions -- of which heart issues may be one.

Even when that has been the case, we have had a number of dogs here who have benefited from medical management of their Cushing's via drug therapy -- either Lysodren or trilostane. I am wondering whether it is your regular vet who is recommending against Cushing's medication for Lacey (as opposed to the CSU specialist)? If so, I would encourage you to consult once again with the university veterinary team to get their "second opinion" about treatment for Lacey.

One issue that may arise in terms of trilostane is the fact that certain medications that are commonly used with cardiac patients do not "mix" well with trilostane. Here's a quote from the U.S. Product Insert for Vetoryl (brandname trilostane):


Angiotensin-converting enzyme (ACE) inhibitors should be used with caution with VETORYL Capsules, as both drugs have aldosterone-lowering effects which may be additive, impairing the patient’s ability to maintain normal electrolytes, blood volume and renal perfusion. Potassium sparing diuretics (e.g. spironolactone) should not be used with VETORYL Capsules, as both drugs have the potential to inhibit aldosterone, increasing the likelihood of hyperkalemia.

Do you know whether these types of drugs are currently part of Lacey's regimen? If so, you would really need to consult with a specialist to find out if adjustments could be made, or if perhaps Lysodren (the other commonly used and very effective Cushing's medication) might be a better choice.

Don't despair yet!!! I do believe that you will discover that Lacey may still have viable treatment options available to her.

Marianne

[Marlene]

Thank you so much for your help!
It is my regular vet, whom I don't know too well since we have not been here long, who suggests no treatment. Lacey takes enalapril (2.5 mg a day) which, I believe, is an ace inhibitor. Nothing else she is taking seems to be on the interaction list.

[labblab]

Even if Lacey is on enalapril, I'm not certain that the use of an ace inhibitor is a definite contraindication against trilostane -- it just may mean that Lacey's blood chemistries would need to be monitored especially carefully to make sure that no ill effect is resulting from the drug combination. That's why I think it would be great if you could consult further with the CSU vets to get their feedback.

Also, on an administrative note -- I've just approved your membership so that from now on all of your replies should be visible as soon as you post them. I handled the approval on a "short-cut" basis -- normally a new member has to return an email confirmation in order for approval to be finalized. But I'm guessing that perhaps our request for email confirmation may have ended up in your spam folder, and I didn't want you to have to wait any longer. So if you DO end up receiving a request for email confirmation, you can just ignore it.

Marianne

[Marlene]

Thank you very much, Marianne. I will check and see if it did go to Spam because I have been checking my email and it had not arrived. I think I am going to take your advice and go to CSU Veterinary Hospital. I have cried on and off all day. I know she is 16 and I don't want to be in denial or make her suffer, but I just want to make sure that, if the medication is a possibility, that I give her that opportunity to feel better and give me as much time with her as I can. She just seems so happy and normal right now. Every time I have moved from even one side of the room to the other for sixteen-plus years, she has moved with me. She's right down there beside my computer desk now as I type.:) I can tell I have landed among like-minded people who understand and have the same love for and feelings about their babies. Again, thank you.

[Harley PoMMom]

Hi Marlene,

Welcome to you and Lacey from me and my boy Harley! My boy Harley has PDH cushing's, pancreatitis and high blood pressure. To keep his BP under control he takes 2.5 mg of amlodipine BID. After trying to unsuccessfully load him with Lysodren, I will start him on Vetoryl in September.

When he starts the Vetoryl, Harley's vet and I know we will have to keep a very close eye on him because of the amlodipine and we will do this by checking his electrolytes frequently and his BP.

I believe, as Marianne has mentioned, a second opinion with a Internal Medicine Specialist (IMS) would be a good idea. They deal with more pup's that have cushings and/or other complicated health issues. They also have the state-of-the-art equipment that one can not find in a regular GP office, usually like an ultrasound machine, I have to drive 1-2 hours one-way to have this procedure done for Harley.

We are here to help you in any way we can, so ask all the questions you want and we will do our best to answer them, ok? ;):D

Love and hugs,
Lori

[littleone1]

Hi Marlene,

Corky and I also want to welcome you and Lacey.

I don't have any advice to offer about heart meds and Trilo, but Corky is one of the cushpups that has an adrenal tumor, but he is not a good candidate for surgery due to his age and his other medical conditions. I was also told not to treat his Cushings, but I got a second opinion. Corky has now been taking Trilostane for 9 months, and his quality of life has improved so much. He is back to being his normal self.

I'm glad that you are thinking about getting a second opinion and seeing an IMS.

Terri

[Marlene]

Lori,
Thank you for your email and your support. This is helping me so much to get some composure back. I am sooooo glad I found this group. I already feel so connected. I am certainly willing to go for as many check-ups as are neccessary if Lacey can be helped by Vetoryl. I wish you didn't have to travel so far for your Harley's check-ups. It is good for Harley and it encourages me that your vet is going to be able to go ahead with the medication by checking on his electrolytes frequently. I hope they will tell me that it can be done with Lacey! I am hoping Harley will do really well with the Vetoryl.
Love to you and Harley,
Marlene

[Marlene]

Terri and Corky,

It is so nice of you to welcome us. Thank you for sharing your experience with being told not to treat the Cushings. It was so overwhelming for me this morning because I didn't know what to do. I would have more confidence in the decision I need to make if I have an expert opinion.

WOW! Corky has been doing better for 9 months! And he is being his usual self. That is great. How old is Corky? Lacey is 16, but no one ever believes it. She still acts like a puppy. I will have to investigate how to post her picture. I'm going to search for Corky's picture so I can see my new friend.

Love to Terri and Corky,
Marlene

[Marlene]

Silly me!!! I just noticed the pictures are right there beside the posts:o! I'm a little stressed, I guess. There's Harley and Corky and Marianne's lab. What sweet, sweet pictures.
Marlene

[littleone1]

Hi Marlene and Lacey,

Corky is 13. His thread is under the Corkster, updates. He got the new thread name after one of our members called him that, and I told him that my friends and I call him Corkster at times.

When you first log on, there is a section on how to add an avatar and upload pictures. I forget the exact title of it at the present moment. Anytime I want to add pictures, I go to my profile and I add the pictures from there.

I'm so glad you found us. I have gotten so much help, support, and love from some very special people.

Please keep us posted to let us know how everything is going.

P.S. It's under How to and comments.

[Harley PoMMom]

Hi Marlene,

Cushing's is a slow progressing disease so you do have time to get that second opinion. Also Cushing's is not a death sentence, once a pup is being treated and controlled they can live out their normal life-span.

A couple things I did want to mention, any tests that are done on Lacey make sure you receive copies and keep them in a folder. Copies of test come in handy not only for us when we ask questions about them :eek::):p but also for new Drs. and in emergency situations.


Just recently I had a well-dog exam before scheduling a cleaning and they found her liver enzymes to be high and her cholesterol high. Could you post these values for us with the reference ranges and the units of measurements, and anything else on there that is marked abnormal, please.

Alot of our cush-pups have elevated ALP and ALT which are liver enzymes. Many of us give our pups a liver support supplement called milk thistle. Only give this to your pup with the approval of your vet/IMS.

My boy Harley will be 14 in October and he acts like a pup too! Your Lacey sounds sooo precious!

Love and hugs,
Lori

[Marlene]

OK, Lori. I will get those and post them. I can't thank you all enough!!!

Love,
Marlene and Lacey

[Harley PoMMom]

Love your avatar!!! Lacey is adorable! :D:):D

[Marlene]

Thank you, Lori. Instead of going away for vacation or leaving Lacey with someone, we decided to pamper ourselves a bit. We went to a hotel, which was very pet friendly, in Colorado Springs for a few days around the 4th of July. They gave her this bed for the duration of our stay. So, Lacey is enjoying her "pampered nap"! :)

[Casey's Mom]

Welcome Marlene and Lacey, you came to the right place! There are lots of knowledgeable, caring people on this site who will guide you and hold your hand as you make your way through the cushings journey.

I am glad you are going to see the specialist. I have seen on this forum that there are a few vets who aren't experienced with treatment and so they are a little wary of prescribing the drugs. Don't get me wrong the drugs can be tricky but they are a lifesaver for our pups. You will do just fine - ask lots of questions okay?

Love and hugs,

[Marlene]

Ellen,
Thank you for your encouraging note. I have gone from feeling so alone this morning to feeling I have so many supporters tonight. It definitely helps! Casey is a beautiful baby. I'll have to learn who Desi is!
Love,
Marlene and Lacey

[Casey's Mom]

Thank you Marlene - here is my Desi http://www.k9cushings.com/forum/album.php?albumid=99

Love and hugs,

[Marlene]

Lacey's Bloodwork from 8/2/10
I got this copy fromt he vet clinic today.
ALK. PHOSPHATASE 4564 10-150 U/L
ALT (SGPT) 196 5-107 U/L
AST (SGOT) 71 5-55 U/L
ALABUMIN 3.7
TOTAL PROTEIN 7.2
GLOBULIN 3.5
TOTAL BILIRUBIN 0.0
DIRECT BILIRUBIN 0.0
BUN 47 7-27 mg/dL
CREATININE 0.8
CHOLESTEROL 531 112-328 mg/dL
GLUCOSE 86
CALCIUM 10.6
PHOSPHORUS 5.6
CHLORIDE 102 105-115 mEq/L
POTASSIUM 4.2
SODIUM 151
A/G RATIO 1.1
B/C RATIO 58.8 Listed as high but no range numbers
INDIRECT BILIRUBIN 0.0
NA/K RATIO 36
HEMOLYSIS INDEX ++++
Index of ++++ may increase AST and CPK by 25-50% and decrease ALP and GGT values by >50%.
LIPEMIA INDEX
SPECIMEN REQUIRED ULTRACENTRIFUGATION DUE TO GROSS LIPERMIA.
Index of N, +, ++ exhibits no significant effect on chemistry.


She is on the following medications for her heart failure.
Amlodipine .6mg twice a day
Pimobendan 1.25mg twice a day
Furosemide .6mg twice a day
Enalapril 1.25mg twice a day

They lowered her Furosemide from original 20mg a day to 12.5mg a day. Her lungs are clear and she has maintained really well since April of this year. She doesn't seem to urinate an excessive amount. She hasn't had any UTIs that I am aware of. The vet has not done a urine analysis. The ulrasound technician said her liver is enlarged as is one of her adrenal glands. Her kidneys look good with just some signs expected of her age. Her spleen is fine. Her pancreas is fine.

Does it look like Cushings? And do you have any advice for me. I can't tell you how much I appreciate this help!!!!

Marlene

[Harley PoMMom]

Hi Marlene,

Good job getting the copies!! Now I am going to be a pain and I am sooooo sorry :( Could you please post the reference ranges and the units of measurements with the values you already posted. You see different labs use different values and we need to see exactly what reference ranges and units of measurements that the lab that Lacey's vet used.

You don't have to start over...just edit your post...thank you! :)

[frijole]

Hi Marlene! You haven't heard from me yet but I've been reading. :D I recently had bloodwork done on my gal and had the ++++ comments also. I learned that this means that the blood draw was bad (not sure that is the right word) but basically the results are skewed on some items, some of which you name and the others you couldn't read.

I am hoping the alkphos number was affected as well. Normal is around 200 I think. My cush dog was at over 2000 but that is high. Doesnt mean anything surprising - cush dogs have this elevated and with treatment it should go down. May never be 'normal' but down is good.

I am no blood expert - Deb is. Hopefully she'll see this and give you her opinion. She's nursing her dog that tore his acl so may not be on as often. I'll send her a note.

I'm glad you found us. Kim

PS I forgot to ask that you post the normal ranges for the blood test. To save time you can just do it for those that were marked high or low. This helps Deb and not all labs are the same. Thanks!

[Squirt's Mom]

Hi Marlene,

Squirt and I want to welcome you and Lacey to our little family here! :)

As you have already noticed, this a bunch of folks who dearly love their babies and who will go to great lengths to help them. You will also learn there is an abundance of experience and first-hand knowledge to found here as well...and it is all yours for the asking! ;)

In addition, this is the best place for good old-fashioned hand-holding. I cannot tell you how many times they have held me up and kept me going. I was so scared when I got here but they took my hand and gently led me along the path of understanding. The more I learned about this condition, the less fear I had. Knowledge truly is power when dealing with Cushing's. So keep reading here and in the Helpful Resource section as well as online. Ask any questions you have and we will do our best to help you understand.

You and Lacey are not alone; we will be with you every step of the way. Tho I am sorry you have a need for a group like this, I am very glad you found us and look forward to learning more about you both.

Hugs,
Leslie and the girls - always

[Marlene]

Lori,

You are definitely NOT a pain. I appreciate you soooo much! You gave me the directions and I forgot to do it all. I cannot get the units of measurement. The copy is very poor quality and there is a vertical streak of white down the right side. The only thing I can see is blank space and then /dL and /L. I can get it Monday when they open.

Thank you for taking the time to look at Lacey's numbers!!

Love,
Marlene

[Harley PoMMom]

Was Lacey fasted for this bloodwork?

[Marlene]

Kim and Leslie,

Thank you for your warm welcome notes. Kim, Frijole is a beautiful baby. I like the bright-eyed, inquisitive look. I think dogs know so much more than people give them credit for. That is good to know that the ++++ may mean the numbers are not exact. Thank you. Leslie, furry little Squirt looks like a playful delight, and certainly laid back;) and I am really glad I found this comforting forum, too. You say, "and girls", and I notice Frijole has a friend. Where do you find a member's photo gallery if either of you have one?

Marlene

[Marlene]

Lacey wasn't fasting for the bloodwork.

[Harley PoMMom]

LIPEMIA INDEX
SPECIMEN REQUIRED ULTRACENTRIFUGATION DUE TO GROSS LIPERMIA.
Marlene

Lipemia is the presence of high concentration of lipids in the bloodstream; normally observed after eating. Very excessive lipemia may affect cortisol assay results.

With Trilostane/Vetoryl one has have the ACTH stim test 4-6 hours post pill. Trilostane/Vetoryl is better absorbed with food, so if you are going to treat Lacey with Trilostane/Vetoryl then a very small low-fat meal would be best before an ACTH stim test. JMO!

Love and hugs,
Lori

[frijole]

Lacey wasn't fasting for the bloodwork.

That explains some numbers that are high. FYI, just like people every time you take her in for testing fast her. It is my pet peeve that the docs' offices don't tell people because it makes a difference in some areas.

To get to our photo albums simple click on our screen name (mine is frijole) then you will see some profile info. Scroll down and look on the bottom right corner. You will see I have two albums. My dogs are Annie and Haley. Haley was diagnosed with cushings over 4 yrs ago. She passed away 5/22 at the age of 16 1/2 and she didn' die from cushings! Annie is my other dog - she's 14. She was diagnosed with cushings in February but we've had all kinds off issues going on that could have led to a bad/false diagnosis. I am having her retested at the end of the month.

Again - so glad you found us. The people here saved Haley's life and gave me 4 more years with her. I am forever grateful. Kim

[Marlene]

Kim,
Forgive me for getting the name of your sweetie wrong. I need to do some more exporing on here and learning what I'm doing so I don't make so many mistakes. I am sorry to hear that Haley passed away and I'm glad the treatment gave you extra time with her. I am hoping I can find that with Lacey. I will be thinking of you and Annie and hoping the retesting turns out better.
Fondly,
Marlene
I'm going to look for the photo albums. Thanks for the directions.

[Squirt's Mom]

Hi Marlene,

Thanks for the sweet words about Squirt. I think she is absolutely beautiful! Of course, I may be just a wee bit prejudiced! :p She is my heart and soul dog, the light of my world.

"the girls" in my signature line refer to Squirt, Ruby, Goldie, and Crystal....but today it's just Squirt and me. Ruby and Crys have gone to The Bridge and Goldie is living with her dad in FLA. But my girls will always be part of my soul, thus the " - always".

Not sure what I'll do if a little man ever joins us! :p But I am very partial to female pups so that may not be an issue we will face in the future...tho you never know what I might drag home! :o:p

Hugs
Leslie and the girls - always

[Marlene]

I am trying to figure out where to call for an appointment tomorrow morning. Would it be best to go to Colorado State University (It is only about 1/2 hour away)? Or should I seek out a private vet. In either case I don't know how to know if I'm getting a specialist that has a lot of knowledge and experience with Cushing's Disease and monitoring the medicines. Does anyone have advice for me. I am driving myself crazy on the computer trying to figure out what to do and becoming stressed about it as Monday looms closer and closer. And I can't seem to figure out how to find a specialist in Cushing's. :confused::eek::confused:
Thanks for your help.
Marlene and Lacey

[frijole]

Marlene - I had to drive 5 hrs each way to K State to even find a specialist. I have been thrilled with them.

Since CO State is so close I would go there simply because they have all the equipment and staff to give you speedy results. Typically teaching schools are also less expensive than regular vets and IMS. This was true in my case.

You can go there and find out what is going on and then find a closer vet once you have a game plan. You might however need a referral. I fired my vet but quickly found another vet willing to get me into K State.

Hope this helps. Kim

[littleone1]

Hi Marlene,

After Corky went to his IMS, I checked on the web for specialists experienced in treating Cushings with Trilostane, and his IMS is just about the only one that is close to me.

Kim gave you good feedback, which should be very helpful.

I hope everything goes well tomorrow.

[Marlene]

Thanks, Kim.
I'm getting all freaked out (I feel like a weepy wimp!) because it is such a critical decision of where to go.....plus, I have no knowledge of the Internal Medicine Specialists in this area. I am originally from Cincinnati and I had a vet clinic there I trusted to the max and they had known Lacey since she was a small puppy. It was never a dilemma....just call Dr. Stratman. It's terrible not to have that comfort, confident feeling. I just moved here two years ago and am still trying to find my way around.:o Lacey had an echocardiogram at CSU to determine the condition of her heart. That was in March or April of this year. I don't think I need a referral, but how do I get to the person who will know most about the Cushing's? How did you find your specialist at K State?
So appreciative of your support,
Marlene

[Marlene]

OK, Terri. I'll try that too. I've tried to search but I don't seem to be getting anywhere. I'm not sure this vet that told me not to treat her even knows about Trilostane. She told me I had to look at the possibility that Lacey might die within 12 hours of the first dose of medication! I couldn't even talk to her I was so distraught.
Thanks for your help. I'll see what I can find.
hugs from Marlene and Lacey

[caroleh]

My sweet Marlene. I know exactly where you are right now. I have a nine year old Schnauzer and I am on my third vet. I am, at this point, not even sure if he is a Cushings dog. Fritz was on Lysogen for a month and although his levels came down they weren't that significant. However his last test showed him to be in a grey area but I don't know if that is because he doesn't have Cushings or if he was tested with a Lysogen load. Fritz did stop peeing in the house and asked to go out. He never did have an appetite problem one way or the other. He does pant and his tummy is big. My new vet wanted me to start him on Trilostane but I am afraid because he may still have Lysogen in his system and I don't want him to overdose. I have to tell you it scares me what your vet said about Trilo after 12 hours. That is unbelievable disturbing. Why would it be prescribed if that were the case. I just have to realize that vets and doctors are like people in general. Some know what they are doing and some don't. Seems like I have been meeting up with a lot of the don'ts.

Hang in there and if you were near by I would give you a hug cause I promise I know what you are going through. Fritz is my sweetheart as are our 9 other dogs and 5 cats.

Carole

[caroleh]

http://www.hcvma.org/notes/SpeakerNotesAudreyCook.pdf

Here is some info that may help you Marlene.

[Squirt's Mom]

Hi Marlene,

You can search for an IMS in your area on this link:

http://www.acvim.org/websites/acvim/index.php?p=3

You will find that info in our Helpful Resource section as well as other informative info here:

http://www.k9cushings.com/forum/showthread.php?t=182

Also, here is the link to CO State Uni. -

http://csuvets.colostate.edu/

Maybe you can find out what you need to know from their site.

Hang in there...you're doing a fine job, Mom!

Hugs,
Leslie and the girls - always

[Marlene]

Thanks for your post, Carole. It is such a heavy load because you are completely responsible for what happens to these babies you love so much. I feel like I've already put Lacey through a lot of stress and I still don't know what to do about her health. And, just as in your case, it is so hard when you haven't any idea if they are doing the right thing or not. I wish I could help you with Fritz and the decision about starting Trilostane. I have seen in my readings that there needs to be a rest period when changing from another med to Trilostane. And to not even be confident about the diagnosis must be so troubling for you. I hope we can both find someone who DOES know what they are doing and no harm comes to Fritz or Lacey in the process!
I could really use that hug right now, but am nevertheless feeling better for the support you send me. Let me know what you decide.
{{{{{{{{hug}}}}}}}}}
Marlene

[Marlene]

Thank you Leslie for posting those sites. I will certainly investigate.

I tried the CSU site, but couldn't really find a specialist. Maybe I'll just call them in the morning and explain what's happening and see if they can locate someone who has treated Cushing's in the University Vet Hospital. I am going to look at the other two suggestions you gave me.

I want to go "home", moving in with my friend and go to my former vet. I really might have considered it, but it would be a taxing and impossible 1200-mile trip for Lacey.

Thank you again!
Marlene

[apollo6]

Dear Marlene
Welcome,
I am Apollo's mom, who is on trilostane, I hate to do this but read my thread. I would not rush into starting your angel on trilostane. I read all I could on Cushing, asked lots of questions. It took me from Sept 2009 until June 2010, to even get started after testing for cushing and please this is so important ,since you know the type of cushing , it is vital that you read what the treatments are for which cushing Lacey has. First get a good IMO, (INTERNAL MEDICINE SPECIALIST) with experience treating cushing's. I went to two specialists, because I was not happy with the first vets recommendation. I even disagreed with the vet I choose on dosage, after reading what Decha/Vetroyl-trilostane recommends for weight and size of dog. I started lower then the vet said. If Lacey has heart problems that needs to be addressed. You might just call your vet in Ohio and explain what is going on, can't hurt.
Hugs from Sonja and Apollo.

[frijole]

Thank you Leslie for posting those sites. I will certainly investigate.

I tried the CSU site, but couldn't really find a specialist. Maybe I'll just call them in the morning and explain what's happening and see if they can locate someone who has treated Cushing's in the University Vet Hospital. I am going to look at the other two suggestions you gave me.

I want to go "home", moving in with my friend and go to my former vet. I really might have considered it, but it would be a taxing and impossible 1200-mile trip for Lacey.

Thank you again!
Marlene

You don't have to find their expert - they will get you into whoever their expert is. In my case I was assigned a student assistant, a grad student and the head of the department! (Annie's case is extreme :o)

So all you need to do is phone them, tell them it is important - give them a brief history and I'm sure they'll get you right in. K State is open 24 hrs a day!

[Marlene]

To Each and Every One of You:
I called CSU Veterinary Hospital this morning. I have been up most of the night looking over and over the posts and sections here and worrying and crying, but I want you to know it is immeasureable solace to me to know I can ask a question here and trust what you are telling me and I can count on your support. I told them that I had been told Lacey has Cushing's Disease and I wanted to come up and have someone there evaluate her and give me some direction as to treatment. They were super nice and helpful. He looked her up and found where she had been there for the echocardiogram and said, "Oh, this is for Lacey! Sure, we can get her in and I will make an appointment with the Internal Medicine Specialist. It will be at 10:45 tomorrow morning and you need to make sure she doesn't eat anything after 10:00 this evening." I heard you all telling me this is good. I felt so much stronger knowing that I am so much more informed because you have all given me so much information (and confidence). They are going to make sure it is someone who knows about Cushing's and they want to make sure she has been fasting. There is some relief that I called, I have made that first step forward and I feel I am doing the right thing now. If I hadn't found you all here, I don't know what I would be doing right now!!!
Love and heart-felt appreciation to you all,
Marlene

[Squirt's Mom]

I am so proud of you, Marlene. You have taken the bull by the horns and your love for Lacey will help you wrestle that bull to the ground! :D Way to go, Mom! :cool::cool:

Big Hugs,
Leslie and the girls - always

[littleone1]

You are doing great, Marlene.

I know there is so much information to digest, and that it is sometimes difficult to find a vet and specialist that have experience in treating Cushings along with all of the other medical conditions our furbabies have. I hope everything goes well tomorrow.

[Harley PoMMom]

Great job Marlene! I am so very proud of you too.

I don't know how long you and Lacey will be there but when Harley and I had our appts for his u/s at the IMS' they were usually all day. So I always brought Harley's food and water with me so he could eat after he was done. I also took a pen/pencil and notepad along plus a tape recorder so I wouldn't miss anything the IMS said. Also remember to take along all of Lacey's test results.

Wishing you and Lacey the best of luck.

Love and hugs,
Lori

[Marlene]

I went this afternoon and got another copy of the blood test and it is much clearer. I will edit the previous one to include the last column of the results.

They also gave me the ultrasound report which is just a few handwritten notes on a sheet of paper. I cannot read some of the writing. This ultrasound was done by a traveling ultrasound technician.

Liver/gall bladder abnormal

spleen (marked a little above normal--she told me while she was doing the test that the spleen looked normal)

pancreas area normal

intestines normal

adrenals abnormal

kidneys slightly above normal

bladder normal

Liver was enlarged and hyperechoic, gallbladder contained moderte debris. Spleen contained small flecks of mineralization. Kidneys were slighly irregular but otherwise normal looking. Left adrenal was small 2.7(Can't read the unit of measure). Right adrenal was rounded and enlarged 2.1X1.6 (It kind of looks like centimeters??) Bladder looked normal.

Conclusions:
Liver (Can't read) metabolic (triangle with an apostrophe s) and inflammation

Suspect adrenal Cushing's disease

May want to do a lo-dose Dex test to confirm

Chronic renal (triangle with apostrophe s) age appropriate

I think the triangles might be D's, maybe meaning disease??

If anyone can offer me insight into any of this, I would be very appreciative.
I'm going to go edit the blood chemical numbers now.

Thank you!
Marlene and Lacey

[frijole]

Hi! I think the triangles might be the symbol for "change". I don't know where I learned this. :confused::)

Interesting - if she has adrenal cushings that might be why her alkphos was 5000. Most vets use lysodren if treating adrenal cushings... there are other drugs that can work but it depends on where the tumor is. All of this will be explained to you at Colorado State. I am so glad you went there.

I will be rooting for you tomorrow and look forward to an update as you learn what is going on. Hugs, Kim

[StarDeb55]

Marlene, I'm not sure that I have posted to you & Lacey before, but Kim has asked me to take a look at Lacey's labs from the beginning of the month. Just to let you know, I'm a medical lab technologist with 30+ years experience, so I'm used to looking at these kinds of reports. Before I get into the actual numbers, let me explain the hemolysis & lipemia flagging at the end of the report. Hemolysis means that the red blood cells (RBC) have be destroyed, releasing their contents into the blood stream. One of the main things within an RBC is potassium, so if the sample is hemolyzed, potassium is one of the first things that will be affected. Most lab tests are based on a color change occurring in the sample. You add a specific amount of sample, specific amounts of certain chemicals, a color will develop, which is than read by the analyzer, & the analyzer through some math calculations will give you a result. Hemolysis will make the sample be slightly red to grossly red or hemolyzed. I have seen samples in people that are so badly hemolyzed, you can't tell the blood plasma which should be yellow, from the layer of RBC. So, if you have a sample that is already severely discolored or hemolyzed, this will affect how the color change is read during the test. For Lacey's results, this means that you can decrease the AST & alk phos result by 25-50% If the sample had been good, it looks like the AST would probably have been normal or slightly elevated, the alk phos would still have been grossly elevated. Hemolysis occurs in samples, most frequently, when there is a problem with the blood draw. They may have had difficulty drawing blood from Lacey & that is what caused the problem. Lori & Kim already explained what lipemia is, so if Lacey was not fasting when this labwork was done that explains the lipemia comment. I just make it routine that when either of my boys are going to have labs drawn that I try to get them in to be drawn fasting to insure that the results are as valid as possible. Sometimes, this is not possible when a pup is ill, & the vet needs to do labs to try to get a handle on what is going on, you just do the best you can.

I won't get into the BP meds or trilostane usage as I have not used trilo or ever had a pup with hypertension. I've had pups that have had numerous other issues but have managed to miss the blood pressure.

Hope this helps.

Debbie

[apollo6]

Dear Marlene,
When you do post the readings, important that beside each you show what the normal range is.
Also on the ultrasound, Apollo's kidney and liver were enlarged-not unusual for cushing's. He also had scaring on his pancreas from past pancreatitis. And both adrenal glands are enlarged similarly, leaning to pituitary cushing. ( translation a micro tumor on the pituitary gland which would be hard to see and in most case is benign) Adrenal based would be if one adrenal gland is vastly larger then the other, meaning a tumor is on it.
Sending our love Sonja and Apollo

[Marlene]

Debbie,
Thank you so very much for taking the time to make sense of this to me. One point I am not clear on is: Does the hemolysis mean there is something wrong with Lacey's red blood cells making them fragile, or is it strictly just the way the blood sample is taken and prepared?

CSU told me that I should not let Lacey eat past 10:00 this evening. Nothing was ever mentioned about fasting before for her blood test here and I feel remiss in not thinking of it myself. I hope everything will go OK for us at CSU in the morning. I'm very stressed about what they might tell me.

Again, thanks so much!!!

Hugs,
Marlene and Lacey

[Marlene]

Lori,
You sent really good tips for me to follow tomorrow! I was thinking about how hungry and thirsty she would be by the time we got back home. I will take a picnic for her.:) Also, the paper, pencil and tape recorder is an excellent hint!! It will help me refer back to what was being said. I will be so stressed I won't trust what I remember. Thanks. Really good ideas that I will definitley use!:D

XXOO
Marlene and Lacey

[AlisonandMia]

One point I am not clear on is: Does the hemolysis mean there is something wrong with Lacey's red blood cells making them fragile, or is it strictly just the way the blood sample is taken and prepared?



Debbie doesn't seem to be online at the moment but I thought I'd set your mind at rest: The sort of hemolysis that causes them to put a notation like "hemolysis +++" in the results is a result of something that happened during the draw. Basically red blood cells are pretty delicate things and can be easily damaged as they whoosh up the needle and into the syringe. I'm guessing (just guessing mind you!) that some people are better at getting good, non-hemolysed draws than others and that everyone gets a bad draw sometimes - it is just something that happens and it is far from rare.

Alison

[StarDeb55]

Marlene, Alison summed it up perfectly.

Debbie

[Marlene]

Alison and Debbie, thanks very much for answering my concern about this. I am learning soooo much here! And no little part of what I'm learning is what sweet and caring people are willing to help me.
XOXOX
Marlene and Lacey

[Marlene]

Sonja,
I hope Lacey's tumor is benign. There is SO much to think about and try to understand! I lie down on the pillow and my mind won't stop. I need some sort of machine to scramble my brain waves so I can stop thinking and go to sleep. I hope you and Apollo have a restful night. I know you both need, and certainly deserve, it!! Apollo is such a cutie. Dacshunds (sp?) are such sweet doggies.
XOXOX and Goodnight!
Marlene and Lacey

[Marlene]

We just got back from CSU. I am very pleased with the vet who will be Lacey's doctor. AND I felt so empowered by all the information I've gained by your posts!!! I actually understood what he was talking about and could ask pertinent questions. I could evaluate what he said because of your shared experiences. I am very, very confident in him and he was willing to listen to my concerns and explain anything I wanted clarified. He didn't contradict any of the cautions and advice I've learned from you. (And, believe me, I was closely monitoring every word!) He did the ACTH Stim test today and is going to call me tomorrow. I am very anxious about what he will tell me tomorrow, but I will feel confident that I have found someone who is knowledgeable.
Thank Yous and Hugs,
Marlene and Lacey

[frijole]

Oh yippee! So glad you got a "keeper". Do keep us posted. We are all glad to help... remember we were all in your seat at one point and it is overwhelming. Much easier when you have a bunch of "cushings angels" looking over your shoulder. :D;) Kim

[littleone1]

Hi Marlene,

I am so glad that you found someone that you are comfortable with and can put your faith and trust in, and have the confidence that everything that is recommended will be for the best. It means so much knowing that they are willing to listen to you and answer any questions that you might have.

I know you've had a very trying day. Get a good night's sleep tonight.

[Marlene]

Terri
I hope Corky's ears are much better. He is a cutie pie. When I was a little girl, my neighbors had about 5 Boston Terriers. I loved them! I played with them, took them for walks and "babysat". They all had such good dispositions and were so sweet and playful. I am sure Corky is the same.
I do hope I can sleep tonight. And I can return the same wish for you....that you get a good night's sleep.
Thank you for your support.
XOXO
Marlene and Lacey

[littleone1]

You're welcome, Marlene, and thank you. I did get a pretty good night's sleep. I hope you get good results from the testing that was done.

Corky is a little sweetie. He is so loveable and does have a great disposition. Thank you for thinking about him. His ears are good right now. I'm hoping the other yeast infection will soon be gone.

Take care. I'll be waiting to see the results of Lacey's stim and what recommendations are made.

Luv ya both. Lacey is so precious. Give her some belly rubs from me.

[Bichonluver3]

A huge welcome from us to Marlene and Lacey!!
FYI - I gave up the anesthetic teeth cleaning when one of my guys had suspected kidney problems. Also, my babies are rescues and had been vaccinated (and God knows what else) so many times, I didn't want to put any more "stuff" into their bodies than was necessary. So I switched to monthly non-anesthetic cleanings at the vet's. It is so much cheaper ($25 per dog), their teeth are sparkling white, their gums healthy and their breath great.:D Is that a possibility for your little one?
Carrol & Chloe

[Marlene]

I've been waiting nail-bitingly:eek: for the call from CSU. They just called and the test was completely inconclusive. He said it wasn't just in the grey area, the numbers were normal. He said he would not give her Trilostane unless he were positive that she has adrenal gland Cushing's Disease because it could be a very detrimental drug in some cases. I knew I had read that here. "If I were betting person, I would bet on adrenal tumor Cushing's but I'm not about to bet on Lacey's health." We go in Friday for the lo-dose (is that the right term?) test to try to clarify what's happening. I am a little confused about why her adrenal gland would be so enlarged and her test numbers fall in normal range:confused: He also said that if they do confirm and treat Lacey with Trilostane that they start with a very minumum dose until they see how she tolerates the drug. After reading some of your experiences with intial overloading, I was glad to hear that.

I am thankful, I can't say it enough, for all the help you've given me that has brought me "up to speed" when I am discussing the future of my sweet, sweet Lacey.

Can it possibly be atypical Cushing's when she has such an enlarged adrenal gland? I was thinking the ultrasound showing one enlarged adrenal gland was a positive diagnosis for adrenal Cushing's?

[Marlene]

Carrol,
Hi, to you and Chloe and thank you for the welcome. I will go and catch up on your past posts to get to know you. I am THRILLED with what you are telling me. I have always had Lacey's teeth cleaned and have been fearing the health dangers of how her teeth look. The anesthetic is too much of a risk now. I actually tried to do it myself but I can't get the tartar to budge and I'm afraid of harming her gums.

I would love it if that were a possibility!!!! I will look on the internet and see if I can find someone who would do that. Is this a regular vet that is cleaning her teeth?

Thank you for the suggestion.
Hugs,
Marlene and Lacey

[labblab]

We go in Friday for the lo-dose (is that the right term?) test to try to clarify what's happening. I am a little confused about why her adrenal gland would be so enlarged and her test numbers fall in normal range:confused:

Hi Marlene,

I have only a moment to post, so am unable to go into a lot of detail. But I just wanted to tell you that the ACTH stim test is known to fairly frequently "miss" diagnosing dogs that have the adrenal form of the disease. In other words, the results on the test may come back within the normal range even if a dog does have the disease. However, the Low Dose (LDDS) test has greater reliability in returning a "positive" result for a dog with adrenal Cushing's. Each of the two tests have greater strengths and weaknesses in different circumstances. But given Lacey's ultrasound results, I feel certain this is why the CSU vet wants to go ahead and perform an LDDS test in order to see whether it is consistent with Cushing's even though the ACTH was not.

Marianne

[littleone1]

Hi Marlene,

I'm so glad that your new vet doesn't want to treat Cushings unless there is a confirmed diagnosis. Corky's adrenal Cushings was confirmed with the LDDS test. I'm glad you're getting this done.

Hang in there. You're doing a great job and doing everything you can possibly do for Lacey. Give her extra belly rubs from me for being such a brave little girl.

[Bichonluver3]

Hi Marlene!
Our vet brings 3 "doggie dentists" in once every month for 2 days. They are amazing! They have a certain knack for holding the dogs (they get down on the floor with the "biggies") and the dogs let them do the teeth. They use ultrasound and get down below the gum line. They give me a verbal report on each dog afterward as well as written findings and recommendations. It has been a godsend for us plus my kids have made friends with the other regular patients so it is a social outing. Interestingly, the father of one of the techs is a human dentist!
Let me know what you find out.
Carrol

[Buffaloe]

Hi Marlene,

Back in 2006, I went through a very long diagnostic process with my dog, Shiloh. After about two months and a myriad of tests, we found out she had a very large, malignant adrenal tumor. She had a very successful adrenalectomy. At 16, Lacey may be too old for such a surgery if you should find she has an adrenal tumor, especially with her heart condition.

Approximately 50% of all dogs with functional adrenal tumors test within the normal range on the ACTH test. Shiloh did twice and that delayed our diagnosis. Certainly, the LDDS test is superior to the ACTH in diagnosing an adrenal tumor. However, it cannot definitively tell you whether or not Lacey has one.

Your adrenal gland measurements are probably in centimeters. From what you posted, it appears that both glands are fairly close in size. If that is true, an adrenal tumor is unlikely. Shiloh's gland with the tumor was about 5 cm. in diameter, her good one was normal in size and shape and was 0.46 cm. in diameter.

A wonderful diagnostic test is the combination ACTH/LDDS/full adrenal panel performed by the U. of Tennessee. This test, along with an ultrasound, is how we finally got Shiloh properly diagnosed. I think you should mention this test to the people at CSU and see what they say. A second ultrasound might be helpful.

Internists are using both Trilostane and Lysodren frequently in treating adrenal tumors. You don't want to give Lacey either one unless you have a confirmed diagnosis.

I know CSU has a great vet school but the Golden Buffaloes rule! ;)

Ken

[apollo6]

Dear Marlene,
Thanks , sorry I haven't been on line. Remember, you are not alone,
try to be positive for Lacey. I know it is hard, I have been so stressed and crying at times , I didn't know if I could bear it. God will get you through. We are here for you and looks like you are getting a lot of good input. Will be waiting for your test results.
You will get through this.
Apollo is doing better for now, keeping him on 10 mg. since improvements have been made. will get next test in 6 weeks unless there are changes.
You are doing the right stuff, It is a bit overwhelming at the beginning.
Better to take it slow and understand before jumping into treatment.
Hugs from Sonja and Apollo.
P.s Lacey is a cutie.

[addy]

Hi Marlene,

Zoe has had so many tests and we are on watch and wait mode for more symptoms. We have confirmed diagnosis but I can't treat until we have more symptoms. Sometimes I worry about that, but I have to trust we are doing the right thing.

Everyone here is giving you such good advice.

When I asked my IMS if something other than Cushings could cause enlarged adrenal glands, she said yes.

Hang in there and remember we are all here for you.

Addy

[addy]

Hi Marlene,

Zoe is on melatonin and lignans because her estradiol hormone is very high and her other intermediate hormones are high, not just her cortisol, her symptoms are not strong enought yet to treat with lysodren. She cannot have trilostane because it will raise her estradiol. She also has colitis so we have flare ups of diahrrea and now we have heard a slight heart murmur.

I just started reading about heart disease. They can have build up of fluid in tummy which can give them a pot belly look, they can pant alot, have exercise intolerance, be lythargic, so some of that can seem like Cushings. I really don't know enough about heart failure yet to comment any more than that on it.

I have been following along on your thread and just can say, talk to me and everyone else whenever you need to. If you are scared and need to vent, post it, we are here for you for the whole journey, which includes your self and your well being. You can talk about you and your feelings, it is okay.

Read my thread today, I answered you and then try putting Cushings in the drawer!!!:)

On the days you need to cry, CRY, it is okay to cry. It will get better, I think we just learn how to live with it, it never goes away.

It sounds like you are doing everything right and you are getting primo advice on the testing, the drugs, etc!!!!:D:D:D

Baby steps, Marlene, and it will be okay.

Addy


OOPS! did I post twice- sorry I am sick with sinusitis, brain malfunction!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!1

[Marlene]

Lacey had the 8-hour test yeaterday at CSU.. Something that is concerning me is that I asked him if I should withhold her food and medication and he said, "No." She should not fast and she should have her medications???? Is this going to invalidate the test?

[StarDeb55]

Marlene, is this the low dose dex test? We, also, need a reminder at to exactly what meds you're talking about?

Debbie

[Marlene]

Sorry I didn't respond sooner. I have back problems and I think a combination of being tense and being in extremely cold air conditioning at the Vet Hospital at CSU for eight hours triggered an episode. Lacey had the low dose dex test as a follow up to the two-hour ACTH Stim test on Wednesday. He requested that she fast for the ACTH test. It was inconclusive with her numbers being normal and he wanted to do the further testing. For this dex test, I asked if she should fast and also not take her morning meds. He said the fasting was not necessary and she should take her meds. She is on Enalapril, Furosemide, Pimobendan and Amlodipine. Also, I made a mistake in giving Lacey's age...don't ask me how? She is 14 and 1/2 instead of 16. Thank you so much for your help!

[StarDeb55]

Marlene, I assume that most of those meds are related to Lacey's blood pressure & heart? If so, she most definitely needs to take them. Now, when it comes to her low dose dex test, it's like an ACTH basically, but takes longer, & there's 3 draws, instead of 2. Fasting insures that the sample is not lipemic which means there's a lot of lipid or fat in the sample which can interfere with testing. To the best of my knowledge, I would think that the Low dose needs to be done fasting, but to be on the safe side, I would reconfirm with the vet school what they want done.

Also, I will go ahead & fix Lacey's age for you. Goodness knows, let's not make us girls old before our time!;):D

Debbie

[Marlene]

Debbie,
I appreciate all the help you give me! I did ask him before the test if she needed to be fasting and he said no it wasn't necessary and to go ahead and give her the medications. Now I'm worried that the test results will not be valid. I will ask him again when he comes back with the results if those were the correct instructions I received. I was talking to his assistant, but she was in the room with him, and when I asked her, she would ask him and then relay the instructions. Everything else he has said and done have been so in tune with what I have learned here. I don't know why he didn't want her fasting. We'll see what he says???????

[acushdogsmom]

Re: fasting before an ACTH stimulation test or a Low Dose Dexamethasone Suppression test ... my understanding (what my Vet once told me) is that fasting is preferable (since lipemia can affect cortisol assay results) but fasting is not absolutely necessary. It's more important for the dog to be as calm as possible during the LDDS test.

That said, my Vet always asked for dogs to be fasted overnight before most tests if and when possible, so that if she decided that she wanted to run another test at the same time (i.e. while she had the dog there at the clinic) where fasting would be absolutely necessary, they could run that test too, and not have to make the owner bring the dog back again fasted on another day.

Sometimes, there is a good reason not to fast the dog - for example, if a dog needs to have some food given with meds that they absolutely have to take.

[littleone1]

Hi Marlene,

Corky didn't have to fast when he had these tests done. His stim tests have to be done 4-6 hours after his Trilo dosage, which has to be given with food. He didn't get as much to eat as he normally would eat. To be honest, I don't remember if he had to fast when he had the LDDS test done. I don't believe he did, as it was an 8 hour time period. He also didn't have to fast when he had the full adrenal panel done, as this also included the stim test.

[Buffaloe]

I was never told to fast Shiloh before any of her ACTH tests or for her combination ACTH/LDDS test. I was told in no uncertain terms to fast her prior to her surgeries but not before any of the diagnostic tests. Good luck with your diagnosis.

[Franklin'sMum]

Fasting insures that the sample is not lipemic which means there's a lot of lipid or fat in the sample which can interfere with testing.
Debbie

Wow! Thanks Debbie and Cushy. After the UTK panel, my vet had wondered why Franklin's initial ACTH results were so high if it wasn't really PDH we were dealing with. I'll 'refresh' his memory about this next week.
Jane, Franklin and Bailey

[labblab]

Jane, I think that if there is too much fat in the blood sample, it more likely renders the sample as largely "unreadable" in terms of an ACTH -- not inaccurately high or low. So I don't think that would be the explanation for a surprisingly high result for Franklin. But I may be wrong about this, and if so -- hopefully others will correct me!

Marianne

[Franklin'sMum]

Thanks Marianne,
The plot thickens :p I'll google for more info, and keep an eye on replies here (before I make an idiot of myself to the vet) :rolleyes:
Jane, Franklin and Bailey

[spiritdog6]

I hope someone chimes in on this. As my dog is super lipemic (over 4000 triglycerides) and his sample was just sent to UTK for his ACTH.
I sure hope I didn't waste a whole lot of $.

If you find anything out Jane I hope you will post it here.

[StarDeb55]

Jane, Marianne's answer is basically correct in "laymen's terms". The lipemia will make the sample cloudy to the point of being opaque where a normal sample will be clear. This severe cloudiness will basically make the sample unreadable to a lot of lab analyzers for many different tests, not just an ACTH. I could go into a lot more technical detail, but don't want to bore you to tears.

Debbie

[spiritdog6]

Just got a call from my vet. The results are in from UTK. Side has high sex hormones, I'll post the results on a new thread when I get them, via email by my vet.

But the high try, didn't seem to make a difference for Dr. O.

My vet agreed, he is too scared to try the Ly or Tryi, on top of the melatonins, and lignans, he wants me to go elsewhere, he said his ego is not in this.


But just to post, the high tri's, don't seem to make a difference to the acth test at utk. They got a result.......J

[Marlene]

Thank you all for sharing your info on the fast/no fast testing. They didn't call me today from CSU, but he did say that it may not be until Tuesday. I am going to mention the fasting to him and see what he tells me. Debbie, I will just hope that the sample is not too cloudy to read. And Marianne it makes me feel better that it is either readable or not. I don't want to be guessing about whether she is being evaluated accurately or not. I see that Corky needed to take meds, and that might be the reason he had me go ahead and give Lacey food????
Appreciative of all the experience and knowledge each of you share,
Marlene and Lacey

[Franklin'sMum]

The lipemia will make the sample cloudy to the point of being opaque where a normal sample will be clear. This severe cloudiness will basically make the sample unreadable to a lot of lab analyzers for many different tests, not just an ACTH. I could go into a lot more technical detail, but don't want to bore you to tears.
Thanks for clarifying Debbie. And don't worry about boring me to tears from too much info (just as long as that info is dumbed down ;))
Jane, Franklin and Bailey xxx

[Marlene]

Dr. Webb called me from CSU with the results of her LDDS test. These are the numbers:
Pre 5.7
4 hr. 2.68 m/dL
8 hr. 3.42 m/dL

He said the 4 hr. number is a little problematic in that it could point to Pituitary Cushing's but he would prescribe the same medication. I really don't understand the numbers at all so I don't know how to interpret that.
He is going to start her on 10 ml of Trilostane as soon as I go pick it up. I asked about the interaction with her heart medications and he said the only impact could be that it would lower her blood pressure more. She is on two blood pressure medications. I am not sure, which I relayed to him, that she even has a very elevated blood pressure. When the other vet took her blood pressure several months ago, it was 140 over ????(I think 60) and she was hyper at the time. He said he would check it when we go in for the first testing after she starts the Trilostane.
I am really, really stressed about starting the medication. I am also wondering about her symptoms. She doesn't seem to have anything that is very pronounced. She has no muscle weakness, doesn't pee very often, drinks what seems pretty normal (How do I determine if she is drinking too much or too little?) Her skin is hot and she does pant if she leaves the house. She has an enlarged tummy. I don't know how to monitor if her symptoms are getting better or worse. I am just on the fence about whether I am doing the right thing for her or not. Anyone have any input that might help me? Thank you so much.
Marlene

[addy]

Hi Marlene,

The others will be along to comment. I believe the rule of thumb is one ounce per pound for water consumpion as an average for water intake, so you could measure how much water she is drinking to see how she is doing.

I think we all feel that you don't have to rush in to treatment for Cushings. It is important to understand the risks and the benefits of treatment especially how they relate to your dog with concurrent medical conditions.

It is important you feel comfortable with the treatment. I was just reading about Trilostane on an RX website. Have you read through the literature posted here from the manufacturer? I will try to find the link for you.

Addy

[littleone1]

Take a deep breath Marlene. I know you're scared.

I know that others will be along that have a better knowledge of interpreting test results than I do. It would be helpful if you could post the reference ranges for the LDDS and get a copy of the results to view any comments that were made by the lab.

When Corky started taking Trilo, I was measuring his water and food intake. For his weight, which is about 18 pounds now, he use to normally drink about 2 cups of water a day. I was told a long time ago that he should be drinking about 1 cup of water for every 10 pounds. I know there's more info on the normal amount of water dogs should be drinking at certain weights, but I was reading so much, and I don't remember where I read it. (I have many senior moments!:D)

Hang in there. You're doing a great job of taking care of Lacey.

[Marlene]

Addy and Terri,
Thank you for "talking" to me. I am scared and confused. I have read a lot about Trilostane but will go back and read again. She weighs 9 pounds and I haven't been measuring her intake of water, but I'm sure it is more than a cup. But, then, I have to take into account that she is on Lasix and I don't know how much that affects her. It isn't a high amount, though. She takes 12.5mg a day. She goes out to pee maybe six or seven times a day. Terri, I'm not sure what "reference ranges" means, but when I go up to CSU to pick up the Trilostane, I will ask for copies.
I just feel like one HUGE question mark right now. I am so glad you are there.
Hugggggg,
Marlene and Lacey

[Marlene]

**twitch**
I just read that Debbie found UCLA now is recommending starting doses of Trilostane at 1mg/kg of weight. Lacey weighs 9 pounds and she is supposed to start on twice that recommendation, 10mg of Trilostane, tomorrow morning. I'm very worried about that. Any suggestions about what to do?
Thank you,
Marlene

[StarDeb55]

Actually, Marlene, it's Univ of Calif at Davis vet school protocol for starting trilostane. We have the link in the important information section of the forum, which I will post. It seems that with trilo, it's much safer to start the dosage lower, then work up to a higher dose, if indicated.

http://www.k9cushings.com/forum/showthread.php?t=185

Debbie

PS- I, also, believe that Marianne has talked to one of the vets at Dechra, & he seemed to indicate that Dechra may be backing off their suggested dosage range of 1-3 mg/lb. The other thing is Dechra always recommends you start with once daily dosing. You only go to twice daily dosing, if the ACTH tests show a cortisol within range, but the pup is showing bounce back symptoms later in the day. This is due to the fact that trilo has a half life in the body of about 12 hours. I don't know of any protocol that states you start with twice daily dosing immediately.

[addy]

Hi Marlene,

Some of the dogs have been starting with the UC Davis recommended doseage. UC Davis has had different experiences with the drug than Europe has.

Have you read Apollo's thread? Sonja was supposed to start Apollo at a higher dose and she insisted on following UC Davis protocol. It seems starting low and titering up is better way to go.

Please read the link to UC Davis protocol and if you are in doubt about the dosage you can wait one day on starting the drug and discuss dosage with your vet.

I can't use trilostane but I try to keep reading about it just in case....:(

Addy

P.S. remeber to breathe

[frijole]

Marlene,

I know this is stressful... been thru this with 2 dogs now myself. One thing I learned here is the "moms know best". We can offer advice but always go with your gut. Also always be open and honest with the vet and don't get intimidated although we all know how easy it is especially when you are new to this.

This is the graph I use to interpret results from LDDS. If you look at it your baseline was 5.7 They look for the 2nd no to be greater or less than 50% of it.. and yours is just slightly less than 2.68 (50% would be 2.85) If it were 2.85 then you could see a clear cushings diagnosis.

http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/snap/cortisol/cortisol-low-dose-dexamethasone-protocol.pdf

If there are other issues going on (non adrenal illnesses) this test does have false positives.

I justs re-read your thread and correct me if I am wrong.

1. You have no real symptoms of excess appetite, muscle strength in legs, hair loss, excess water intake

2. Liver enzyme ALP is between 4000 and 5000 (very high)

3. Heart issues - on medication

4. Ultrasound showed one adrenal gland slightly larger than the other so dx was ADRENAL cushings

5. You did an ACTH and it came back normal (I didn't see an actual number and would like it if you have one)

6. The LDDS test seems to point to pituitary but vet is concerned with the 2nd number

7. Vet said he thought that trilostane would help the heart condition but would not treat unless the LDDS confirmed cushing's

I would have a conversation with the vet regarding the LDDS and what effect he thinks that the heart condition could have on the results, if any. In other words - how comfortable is he given the NORMAL ACTH that the dx is valid.

If it is cushing's then you could lower that ALP number and it should also help the heart. The challenge is what if it is not. Did they see an actual tumor on the adrenal gland that was enlarged?

I would review all these facts with the vet and ask for his honest opinion and confidence level prior to making a decision to treat. Then I would discuss the dosage. He might want to go higher for the sake of the heart but honestly.. I've never used the drug - just helped others using it for the last 4 yrs. I agree with what others have said... start low and tweek it up.

Sorry this is so long... just wanted to cover all the bases. Hope I got it all right. But like I said - you need to ask tough questions and after looking him in the eye - go with what your gut tells you.

I will be thinking of you and sending all my best. Kim

[Marlene]

Thank you, Kim. I will look into all you have said. I went today to get copies of all the tests, but Dr. Webb still had her file. They told me they would send the copies to me as soon as he returned her chart. And I don't know if they saw an actual tumor. The vet talks as if it is a foregone conclusion???? They told me it was greatly enlarged and the other was very small. This report should also be in the copies they send me. I appreciate your help and support. I don't think I can give her this tomorrow. I still am not completely sure I am doing the right thing. Lacey does pant, but not constantly. She also has a bigger tummy. They told me her liver in enlarged--but originally told me that was due to the heart problems?
I will post the numbers as soon as I receive the copies.
Again, thank you so much!!
Marlene and Lacey

[labblab]

PS- I, also, believe that Marianne has talked to one of the vets at Dechra, & he seemed to indicate that Dechra may be backing off their suggested dosage range of 1-3 mg/lb.
Hi Marlene,

I just wanted to clarify that from my conversation with the technical rep at Dechra's U.S. offices in Kansas (Dr. Allen), they are verbally recommending to vets and pet owners that dogs be started at the lowest end of the published dosage range: at 1 mg./lb. So in Lacey's case, the starting dose that your vet has recommended (10 mg. for a 9 lb. dog) is in line with the most recent Dechra recommendation. For me personally, I would not feel uncomfortable starting at that dose. But that is partly based on my experience with my own Cushpup. He ended up needing quite a large dose of trilostane, and I would have gone crazy had we initially started as low as UC Davis' protocol and had to keep working up. But he was also highly symptomatic at the time he was diagnosed, and I was terribly anxious to bring him some relief.

Also, I wanted to reconfirm that Lacey's LDDS results are indeed consistent with Cushing's since her 8-hour result of 3.42 was greater than 1.4 (it is the 8-hour result that gives you the overall diagnostic Cushing's results). In her case, the "gray area" comes in with the 4-hour result, because if it is less than 50% of the baseline draw, that is typically consistent with the pituitary form of the disease. In Lacey's case, her 4-hour result was barely less than 50% of the baseline, so technically it falls within the pituitary category. But it is right there on the "cusp." Since her ultrasound results seem so definitive of adrenal Cushing's, I'm guessing your vet is choosing to treat based on the overall Cushing's diagnosis rather than fretting over the significance of the four hour result. Here's a link to another article that gives additional explanation regarding interpretation of LDDS results:

http://veterinarymedicine.dvm360.com/vetmed/Medicine/ClinQuiz-Interpreting-low-dose-dexamethasone-suppr/ArticleStandard/Article/detail/580093

I definitely agree that it is important for you to discuss all your concerns thoroughly with your vet prior to beginning treatment. But I did want to add these few thoughts prior to your conversation with him.

Marianne

[Franklin'sMum]

She also has a bigger tummy. They told me her liver in enlarged--but originally told me that was due to the heart problems?

Hi Marlene,

Just wanted to pop in. The bigger tummy could be caused by Lacey's liver being enlarged, or it could be from fluid in the abdomen (ascites). One of a number of causes of ascites is a heart condition (depending on how far along a heart problem is). If Lacey has fluid build up, it should have been visible on ultrasound.
If you are at all unsure or uncomfortable with starting treatment at the moment, your vet should be more than willing to have you delay it.
Hope some of that is helpful :)
Jane, Franklin and Bailey xxx

[Marlene]

Thanks, Marianne and Jane. Marianne, when the vet talked to me he did mention the 4-hour test wasn't what he would expect but he was going ahead with the Trilostane because he would do the same thing for both. I didn't understand completely, but from what you taught me, I can see why it is on the cusp. Thanks.
Jane, thank you for that heads up about Lacey's heart condition. I did think of that and asked about it. She did have build-up at one time before they started her heart meds, but the latest ultra sound showed nothing in her lungs or abdomen. She has an enlarged liver, though.

[Marlene]

Lacey has an inflamed eye. She ran into the door two days ago and I didn't think she had hurt herself, but I think this eye flare-up must be a result of that. I am taking her to the vet this morning and not starting the Trilostane until I see what is happening with her eye. (It's part caution and part procrastination:o)

[apollo6]

Do what you feel is best. I did the same with Apollo. Waiting a bit is fine.

[addy]

if your gut tells you to wait, wait and don't think of it as procrastinating, you don't have to rush into treatment. Everyone chimed in with such good info!!!!!! Isn't that great?

You have to do what you feel is right. I know it is hard. I second guess myself all the time.

Hope you have a good conversation with your internist. Let us know what happened and I hope Lacey's eye gets better.

Hugs to you and Lacey,

Addy

[Marlene]

Thank you all and the info you are so kind to pass on to me IS GREAT! What would I know if I hadn't met all the dear people here? I shudder to think.

Lacey has an infected eye. She is getting antibiotic drops and I hope it clears up soon. I've put off the start of Trilostane (and my anxiety). We bought her one of those Cool Canine beds that came today and she loves it! It is so much softer than the floor and it really does stay cooler--I'm not sure how???:)

Hugs from Lacey and Marlene

[apollo6]

Good for you.
Now take a breath, and like Addy says but cushing in the drawer for a while.

[Marlene]

I am going to post anything new I found on the papers I received from CSU today. I don't know if there is anything else that can be learned from them.

Blood cortisol 5.72 pre
Blood endogenous ACTH Assay 0.0 pg/ml result is < 10.00
Serum corisol 14.8 (There is no comment.)

LDDS test 5.7 2.68 3.42 Cushing's % adrenal tumor >pituitary dependent

Serum LDDS cortisol 3.42 ug/dl
Serum LDDS coritsol 2.68 ug/dl

Marlene

[littleone1]

Hi Marlene,

Did they have what the normal ranges should be? They would be the reference ranges.

[Marlene]

No, there is no mention of normal ranges?????

[frijole]

It is a different test - the endogenous acth is. If I have a chance later tonight I will go to our resource section - the info is in there. Sorry I can't help without some research.

[Marlene]

Thank you, Kim. Everything makes me "twitch". Why would they use a different test than most vets use? Arggghhh. I really appreciate your help.
Hugs from Marlene and Lacey.

[frijole]

:D They are doing a test that alot of vets don't even know exist because they are specialists! Smart cookies. Another reason you are smart to go to Col State vs even an IMS. They have the equipment and knowledge that few have.

The last book I wrote where I summarized the findings to date indicated that the results from tests so far are conflicting as to whether you are dealing with pituitary or adrenal cushings.

I will link the entire document but since it is long... they did the endogenous acth because they want to confirm the type of cushings.

I'm sorry but I cannot interpret the results. Did they not tell you when you got the results?

Tests to Determine the
Cause of Hyperadrenocorticism

Once a diagnosis of hyperadrenocorticism has been confirmed,
the next step in the workup is to use one or more tests
and procedures to distinguish pituitary-dependent from adrenal-
dependent hyperadrenocorticism. The ability to differentiate
between dogs with pituitary-dependent hyperadrenocorticism
from those with functional adrenocortical tumors
can have important implications in providing the most effective
method of management for the disease. An accurate test
is therefore required to determine the cause of the dog’s hyperadrenocorticism.
Endocrine tests in this category include the high-dose
dexamethasone suppression test and endogenous plasma
ACTH measurements. Imaging techniques such as abdominal
radiography, ultrasonography, computed tomography
(CT), and magnetic resonance imaging (MRI) can also be
extremely helpful in determining the cause. In addition, it is
only possible to detect metastatic lesion from an adrenal carcinoma
by use of these imaging techniques, in the absence of
adrenal biopsy and histopathology.

OK... here is the detail on the test:

Plasma Endogenous ACTH Concentration
Measurement of basal endogenous ACTH concentrations is
of no value in the diagnosis of hyperadrenocorticism because
dogs with the disease commonly have values within reference
range limits. On the other hand, measurement of plasma
ACTH concentrations is an extremely reliable means of determining
the cause of hyperadrenocorticism once the diagnosis
has been confirmed. There is relatively little overlap in
ACTH concentrations between dogs with pituitary tumors
and those with adrenal tumors, making this a valuable discriminatory
test.1-4,17,18,32,49
Endogenous ACTH concentrations are normal to high
in dogs with pituitary-dependent hyperadrenocorticism
(eg, 40 pg/mL or 8.8 pmol/L), whereas ACTH concentrations
are usually low or undetectable (eg,
20 pg/mL or

4.4 pmol/L) in dogs with adrenal tumors or with iatrogenic
hyperadrenocorticism. Unfortunately, about 20% of dogs
with hyperadrenocorticism will have random plasma ACTH
concentrations in the “gray zone” (ie, too low for pituitarydependent
disease but too high to be classified as adrenaldependent
disease). One option in such dogs with nondiagnostic
plasma ACTH values is to repeat the plasma ACTH
measurement, either collecting another basal sample or by
using stimulation testing with corticotropin-releasing factor
or vasopressin (see below). Alternatively, one could use one
of the other differentiation tests (eg, high-dose dexamethasone
suppression, imaging studies) to determine the cause of
the dog’s hyperadrenocorticism.
Samples for accurate endogenous ACTH concentration determination
can be difficult to collect and are somewhat
costly to perform. Samples must be collected in heparin or
EDTA tubes and centrifuged immediately; the plasma is then
placed into plastic or polypropylene tubes (ACTH will stick
to glass) and immediately frozen until the assay is performed.
50 Plasma samples should be sent on dry ice by overnight
delivery service to the nearest laboratory. If such conditions
are not feasible, one can add aprotinin, a protease
inhibitor, to the EDTA tube as a preservative for ACTH; in
such cases, the sample can be shipped cold via refrigeration
packs and freezing is not necessary. Nevertheless, while this
test is reliable in determining the cause of hyperadrenocorticism,
its routine use may not be feasible for small animal
practitioners primarily because of the difficulty and cost of
shipping the sample to the laboratory

http://www.k9cushings.com/forum/showthread.php?t=216&highlight=endogenous+acth

[Marlene]

I want to thank you first. I have not studied the information you have sent me, I am going to do that now.

I'm glad it is not some inferior test (revealing my ignorance):o I think I know what I am dealing with and then I find something new I obviously know nothing about. Thank you for being there, being so knowledgeable, and pointing me to research in a matter of minutes you have spent, I know, a long time poring over and organizing. I truly appreciate, truly, truly, your work and your help.

He told me that the enlargement of the one adrenal gland made him lean toward adrenal Cushing's but the low 4-hr number made it possible to be pituitary-dependent. He said he was going with adrenal and that he would treat it the same not matter which it was.
Many hugs,
Marlene and Lacey

[Buffaloe]

It looks like CSU performed both the LDDS test and the endogenous ACTH plasma test. I believe that the endogenous ACTH test is the very best blood test to differentiate between pituitary and adrenal cushing's disease. Hence, the folks at CSU did great diagnostic work for you and Lacey.

Because surgery is not an option, in your situation you would treat Lacey the same whether she has pituitary cushing's or an adrenal tumor. Your options for medical treatment are Lysodren or Trilostane.

Lacey's symptoms are pretty mild. I have to believe that if she has an adrenal tumor, it is a relatively innocuous one. :):)

Ken

[littleone1]

Hi Marlene,

I'm sorry if I confused you. I looked back at Corky's LDDS test and there were no reference ranges. It was done about a year ago. I'm just so use to all of the other tests that have the ranges.

[Harley PoMMom]

Hi Marlene,

My boy Harley has had 2 Endogenous ACTH tests done at the Univ. of Penn. This test is an excellent test but it has to be handled and performed by experts, which in your case and mine, I really do believe these tests were done in that fashion.

Harley's results were: 4/15/09 Endogenous ACTH...41.1 pmol/L (H) RR(6.7-25.6) and 8/18/09 his endogenous results…60.5 pmol/L (H) (6.7-25.0). His IMS most definitely felt that Harley has pituitary cushings because of the results of the Endogenous ACTH tests.

Hope this helps.

Love and hugs,
Lori

[Marlene]

Ken, Terri and Lori;

Terri, no problem. I can't thank you enough. You have helped me SOOOO much understand and be less stressed through this!! I am just hung up on these NUMBERS. You didn't confuse me, I was already way gone into confusion. :confused: It seems the more I try to understand the results the more confused I become. :confused: :confused::confused: Did I mention the numbers are confusing me?:D

We went to CSU on the 17th for the ACTH Stim and on the 20th for the LDDS. The copies I received are so (again) confusing to me. The results for the 8/20 test were reported to me over the phone to be: Pre 5.72, then 2.68 and 3.42. So, I assumed those were the 4-hour and the 8-hour numbers. The print-out I received lists 8/17 which was the ACTH Stim results to be :

blood cortisol 5.72 pre
blood endogenous ACTH Assay 0.00pg/ml results <10.0
blood cortisol 14.8 (no comment)
Can anyone tell me what this suggests?

Then, the results of the 8/20 visit which was for the LDDS are:

serum Low Dose Dex (Cortisol) 3.42 ug/dl (no comment)
serum Low Dose Dex (Cortisol) 2.68 ug/dl (no comment)

Did they not do an endogenous test (They didn't say they were going to.) and just filled in 0.00 in the slot? Kim sent me a lot of info on the endogenous test which I read last night and I'm doubting they did that test. Lori, I looked at Harley's endogenous test results and they don't match anything I see on Lacey's. That makes me think I am wrong and they didn't do the endogenous??

And are the ACTH numbers just reversed on the lab copy they sent me?

He has handwritten in the clinician's summary "LDDS test 5.7 - 2.68 - 3.42"

He said the 2.68 number was a bit off because he thinks she has adrenal-dependent Cushing's and that number was low suggesting pituitary-dependent. Looking at results from all testing he still believes it is adrenal-dependent.

I have to do more reading on the meaning of the result numbers. I am just so not understanding if they are high/low, good/bad, ???????? I start to think I get it (silly me:eek:) and, then, something else comes along and I suddenly don't get it. I want to understand and have a good handle on all aspects of test reports before I start the Trilostane and go in for the check-up testing.

....heart medication interactions, electrolyte imbalance dangers, types of tests, test results, symptoms, side effects to watch for once she starts Trilostane, diagnosis accuracy, pituitary type, adrenal type..... Right now I am trying to cram it all in my brain, but when it gets in there it goes round and round, ricochets off all the other "stuff" and turns to mush! My brain, I think she's going to explode! :D:D:D

I "think" I have a pretty good handle on everything except the numbers I am getting from CSU. The good part is that I trust the vet I am seeing at CSU, and believe me, that is a BIG leap for me. So, even if I don't understand the numbers right now, I believe he does.:) I have checked everything he told me against everything I have learned from all of you. So far, he's measuring up.:)

Ken, thank you. You brightened my morning with your positive note!

Appreciating you greatly!
Marlene and Lacey

[sunimist]

Hi Marlene and a belated welcome to you and Lacey.

Oh, yeah! Confounding to say the least, but hang in there and it will become clearer as each day passes and each bit of information is absorbed.

Has Lacey had an ultrasound? I didn't read all posts, so if she has, please excuse me. Since the test results so far are a bit confusing to your vet, an ultrasound done by an experienced radiologist could most likely reveal if the cushings is pitituary or adrenal based. A good look at the adrenal glands by a professional would most likely give you that bit of missing information your vet is concerned with. I don't suppose it is detrimental to find out, but personally, I would want to know for sure which type it is. JMO.

Hang on tight! You are doing great!

Shelba and Suni~~

[frijole]

Yes she did at it indicated adrenal cushings. LDDS indicated pituitary and thus the discussion. I agree with the docs :D;) Looking like adrenal to me.

[sunimist]

Thanks Kim. :)

[frijole]

:D What the heck did I just post? I'm at lunch.. laughing at my poor typing skills... No problemo Shelba!

[Marlene]

Shelba,
Lacey did have an ultrasound. I think that is a big factor in the diagnosis of Adrenal-Dependent Cushing's. One of her adrenal glands is large and the other, small. The vet at CSU has been great and even after the ACTH Stimulation Test, he wanted to go ahead and do the LDDS as added back-up for his diagnosis. I am trying to get myself acquainted with what the numbers mean now so that when I get her tested after we start the Trilostane I will have an understanding of what the results show.

Your baby's pictures remind me of Lacey. I looked at your album. She is really cute and the baby pictures of her are so sweet!

Thanks for your input.

Marlene and Lacey

[Marlene]

Lacey ran into a door and several days later developed a white spot on her cornea and the white part of her eye is very red(no discharge and it doesn't seem to be bothering her) . I took her to the local vet and she said it didn't look like more than a surface scratch but the red might indicate an infection. She gave me Tobramycin which I've been putting in her eye since Wednesday. I don't see any difference in her eye. She still has the white spot and red. I was going to start the Trilostane tomorrow, but now I'm wondering if her eye is something that could be a possible problem. What is your advice or experience with this?
Thanks from Marlene and Lacey

[addy]

Hi Marlene,

Sorry to hear Lacey's eye has not improved. I don't have any advice to offer for the eye problem. As for starting her Triolstane, if you feel better about waiting to start until eye issue is resolved, I don't think that is a problem.

If you are worried about it, could you ask the vets at CU?

Hang in there!

Addy

[Harley PoMMom]

She is on Enalapril, Furosemide, Pimobendan and Amlodipine.


Tobramycin may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving could interact with tobramycin. Such drugs include amphotericin B, acyclovir, cisplatin, furosemide, mannitol, anesthetics and cephalosporins.
http://www.petplace.com/drug-library/tobramycin/page1.aspx

I would ask your vet about this interaction. Hoping Lacey feels much better soon.

Love and hugs,
Lori

[Marlene]

Thank you. I will do both.
Marlene

[addy]

Hi Marlene,

How is Lacey's eye this morning? Hopefully you have good news :)

Addy

[Marlene]

Addie,

After Lori pointed out that there is a reaction between Tobramycin and Furosemide I stopped the anitbiotic drops yesterday. I stopped it because of that possibility, but also because her eye just seemed to be getting more and more irritated. She's been taking them since 8/25 and it has not gotten better; maybe even a bit worse. I'm not really sure she has any infection. I thought about making an appointment and taking her to CSU today to have an opthamologist look at it. THEN, on the other hand, I thought we'll be anesthesizing her eye and doing the stain again and possibly further irritating it. THEN, I thought it could get more serious without the drops. I finally decided to give it until tomorrow morning and see if it gets any better on its own. It looks less red to me today since I've only been putting the soothing salve in her eye. There is no discharge from her eye and she doesn't seem to be in pain. If it is not markedly better tomorrow, I will take her to CSU. I don't want to take her back to our original vet for anything any more. My husband convinced me this time to go back for "minor scratched cornea." I've just lost trust in them. He is also pushing me to start the Trilostane. (Rolls eyes a lot when I say, "Not today."):rolleyes: :) I want to settle the eye problem first because I think I will be on edge enough just checking to make sure she's OK when I start her Trilostane.
I'm taking lots of my stress medication quite regularly today!!--CHOCOLATE and MORE CHOCOLATE>:D:eek::D
I was reading in your posts about holding your breath when Zoe pooped, she tuned in to that and if affected her carrying out her business.:) I think it is so amazing how they read how we are acting and reacting. Lacey stares into my eyes to try to figure out what I'm up to now. I'm glad Zoe is feeling friskier and doing well!!:):)
Thanks for checking on us!
Love and huggggsss,
Marlene and Lacey

[addy]

Chocolate is a good thing!:) I say bring on the chocolate!!

You will start the Trilo when you feel you are ready and can handle it. And there is nothing wrong with that.

Good call on the eye medicine. I think you made the right choice. Maybe it will just take a bit more time for her eye to be less irritated.

Keep up the good work!!!!!

Hugs to you and Lacey,

Addy and Zoe

[frijole]

Marlene - Yep chocolate, wine, anything made in a blender. :p:D BRING IT ON. Kim

[StarDeb55]

Marlene, even though I haven't posted to you in several days, I have been keeping up with what's going with Lacey. I'm, too, am concerned with Lacey's eye problem. Harley made a trip to the vet opthamologist on Friday as he does have dry eye, & I knew that his left eye had not been doing very well, & was bothering him for a good month. Harley was not obviously in pain, but the signs that an eye is hurting them include rubbing the side of their face that the sore eye is on against things, if not outright rubbing the eye against things. Harley will get in bed, go up to my pillows, & proceed to rub the left side of his face along the pillows. If Lacey is displaying any behavior similar to this, her eye is bothering her. Eye infections are very difficult to treat in our pups as their immune systems are already compromised. Harley is on antibiotic eyedrops twice a day, along with oral antibiotics twice a day for a week. Please don't stop the antibiotic drops prematurely as it can take upwards of a month to get an eye infection to totally clear. I really think that in light of Lacey's other issues, getting her into a vet eye doc at CSU is an excellent idea. I love my GP vet dearly, but with Harley, I no longer take the chance with things like this & take him straight to the specialists.

Harley had repeated corneal ulcerations in that left eye immediately prior to his Cush diagnosis, & right after. The GP vet had treated him twice over about 6 months or so, but the eye kept re-ulcerating. My GP vet threw up his hands on the 3rd time & sent us to the specialist. This was the best decision in the long run as she diagnosed Harley's dry eye, & she is up to speed on the latest treatments for all eye problems, & she even puts up with Harley's freak-outs & meltdowns during appointments.

Debbie

[Marlene]

Debbie, I did follow your posts about going to the vet for Harley's eye. I appreciate your input on Lacey's problem. I've watched for rubbing and haven't seen any, but she is squinting on and off. I guess I just didn't want to take her for more poking and prodding, but I know you are right. I need to go tomorrow and make sure. She gets very nervous when we go to the vet. She doesn't protest as much as you say Harley does, but she pants and clings to me. I was just expecting her eye to heal in a few days and I saw no progress. I'm glad you warned me about the trouble Cushing's dogs have with this.
Thank you,
Marlene and Lacey
BTW: Harley and I have in common that we really, really like mocha frappachinos!!! :D:D I got the mental picture you painted of his cute little face looking up innocently with that delish frozen mocha dripping from his whiskers.;)

[MyRudy]

Marlene, good luck with Lacey's eye! I don't blame you one bit for wanting to get that issue resolved prior to starting her on Trilostane.

[addy]

Hi Marlene,

We are having a rainy Labor Day so thought I would check in to see how Lacey's eye is doing.

I hope everything is getting better.:)

Our mastiff at work poked himself in the eye while scratching himself. Wow, his eye sure looked bad for awhile:eek:

Hugs,

Addy

[Marlene]

Addy,
I remember you said you have experiences with human doctors with overdosing, wrong dosing, wrong diagnoses, etc. and, therefore, are cautious about what vets tell you, too. I am very nervous about starting the medication. I have had the same experiences with physicians and so I am always skeptical until I "research" what they are telling me. This forum has been so good for me because I get affirmation or caution about what is being suggested for Lacey from people whom I trust to know and who are thorough before they treat, also. I was entertaining the idea of waiting to start Lacey on Trilostane because she seemed to have mild symptoms, but the last few days have changed my mind. She is rapidly developing skin problems and this eye problem is certianly not clearing. He told me to keep treating for two weeks and then come back.
I can't see what I'm doing without my glasses, so every time I need to put the EDTA drops and the antibiotic in her eye I have to "find" my glasses. As soon as I put my glasses on now(whether for eye drops or just to read the paper), she's suspicious and backs away from me. :)
I hope Zoe is continuing to do well and be frisky, happy and without tummy problems!
Have a comfy, dry day tucked away from the rain and you are very sweet to check up on us.
Hugs,
Marlene and Lacey

[addy]

I don't blame you for being cautious. I am waiting for stronger symptoms from Zoe before I add lysodren. Apollo's mom, Sonja always tells me follow my gut so I am passing along that wisdom to you:)

My IMS told me I had to be comfortable with the treatment. Your gut will tell you when to start, you will know it is the right time to do it.

Everyone here told me I had to fix Zoe's diahrrea before starting treatment and I followed that advice. Maybe you need to fix the eye first, like you had planned.

Hang in there, my friend, don't get too frustrated!!!!

Addy

[addy]

Hi Again:)

Than you for checking out my album.:) I need to download more photos to my computer, my camera is full. Seems I never get to it.

I know what you mean about photos and videos, I love looking at them too. I would be right there with you hoarding dogs.

What are the skin infections? Did this just start? If you read through some of the posts to Denise and Bonnie, Trilostane is explained so well and the fact that if you know what to look for and start low, you should be okay. It seems more and more of the pups are being put on Trilostane. I think it is a matter of coming to terms with it and feeling that it is something you need to do. Sounds like you are at that place now:) All of this is scary, thank goodness we can come here and be reasurred!!:D

Zoe will get retested early November if she stays well with no colitis flare ups and if her symptoms remain the same. Sometimes I feel like that is a tall order to fill:( I am trying to take it one day at a time and not twitch!!!!!

I know you will do just find starting Lacey on her Trilo. Sending you positive vibes and lots of hugs!!!! It will all be fine, I know that it will.



Hugs and kisses to you and Lacey,
Addy

[Harley PoMMom]

Addy,
I can't see what I'm doing without my glasses, so every time I need to put the EDTA drops and the antibiotic in her eye I have to "find" my glasses. As soon as I put my glasses on now(whether for eye drops or just to read the paper), she's suspicious and backs away from me. :)


Our pups are so smart aren't they! They begin to associate some of the things we have to do for them as "bad" when we know it is for their own well-being. With my boy it is his pills, so I have an "agreement" with Harley! With giving pills I have 2 treats in my hand, one has a pill, one does not. I show Harley that the first one does contain the pill and I give it to him while holding the second treat above, he knows that as soon as he swallows that pill/treat he gets that second treat that does not contain any pills.

My suggestion to you would be to give Lacey some positive behavior with your glasses on, whether that would be giving her treats or just giving her a nice massage. It is for her to know that when the glasses come on that "good things" happen too. You could do this even after she gets her eye medicine...giving her the treats or massage...just a thought.

Love and hugs,
Lori

[Sabre's Mum]

I see that you posted on another thread the following ... I wanted to place this on Lacey's thread so that others may directly reply to you.


Lacey has been having skin problems the last two weeks, too, so I took her to the dermatologist at CU today. She said it is a proliferation of mites!!! They are normally there, and on all people,too, eewwww, but when the immune system is compromised with Cushing's they really multiply and start causing problems. She has prescribed Interceptor on a daily basis to get them under control. She said starting the Trilostane will also help keep them in check. As a precaution, she is checking to make sure it does not interact with Trilostane. The pharmacist is supposed to give me a call to tell me if it is OK to use it with Trilostane. The vet said she is pretty sure it won't be a problem. I hope not.

I can't comment on the interaction between interceptor and trilostane but will comment from experience with our Sabre - that treament for cushings generally assists that management of skin conditions. He has pyoderma and calcinosis cutis. It was only after we started treating his cushings that his pyoderma finally disappeared - he had nearly three months of antibiotics before we were given a clear diagnosis and started to treat with Lysodren. I realise that there are other issues with Lacey and that you are hesitating starting treatment ... but please do not see this as a push for you to start. I just wanted to say, as your vet did, it will hopefully keep the skin issues in check.

Also


Do you have any suggestions for something that eases the itching and burning of skin problems? I was using a product from PetMart, but it is gooey and icky. Someone had mentioned oatmeal baths.

We used a product here in New Zealand called "Aloveen" - it is an oatmeal shampoo which is left on for 5 minutes before washing off and it seemed to work really well.

All the best
Angela and Flynn

[Marlene]

Thank you so much Angela. It is always good to get some positive experiences. The vet told me that I will probably have to treat Lacey for the rest of her life with Interceptor if she is not going on the Trilostane treatment. I had already decided that I am going ahead with the treatment. It's good to know Sabre was able to completely resolve his skin problems with Trilostane.
I will be looking to see where I can purchase Aloveen and give that a try. It is so difficult to pick something out of the blue that you know nothing about. If it helped Sabre, there is a better chance we will have relief with it, too. I appreciate your help!!
Hugs,
Marlene and Lacey

[apollo6]

Thank you for caring.
I will try to update on your post and post.
Love Sonja and Apollo

[Marlene]

I am so very overwhelmed. I keep thinking, "I will start the Trilostane today." And, then, something else happens. This has been going on for weeks. Nothing seems to follow any pattern it's supposed to. Lacey hasn't been eating right. Her eye is NO better although I am TORTURING her three times a day with the EDTA drops and antibiotic salve. It's killing me to have to put those drops in her eye everyday. I don't know what she's thinking as she lies there and trustingly lets me hurt her eye. Her fur is brown and she's scratching. Her poor little face is completely brown and almost black under the eye that is injured. I am supposed to give her the Interceptor every day for three months to control the overabundance of the mites. I gave her the first one Saturday evening. I was upstairs wrapping gifts for my grandson's birthday, so she came bounding up a flight and a half of stairs to find me. She seemed fine, a little out of breath, but otherwise ok. As I was wrapping, about ten minutes later, I saw her just collapse onto the floor. Of course, PANIC!! I thought the Interceptor did something to her. My husband and I took her down and held her a minute and, of course, sobbed and tried to decide what to do. She is very tuned into me panicking so I tried to be sane. Stop, take a minute and think. I hated the thought of taking her in to the emergency vet and having her podded and put into a cage and scared to death etc, etc yet one more time(You all know) Her tongue was perfectly pink, she was breathing fine, her heart was beating regularly, her pupils were reacting, I listened to her lungs with a stethoscope and they sounded ok, but she was obviously having problems walking. Was it the weakness I've been reading about with Cushing's...but it was so sudden. Did she have a stroke? We let her rest a minute and got her up again and she walked but was favoring her right leg. We have eventually decided she must have jumped from the couch and injured her leg. The next morning she was walking on it. I know that I must watch for not eating and lethargy once she starts the Trilostane and I am supposed to give her the Trilostane with food. I have driven myself crazy trying to find something she will eat (as I have read many others on the forum have done also!) I can't give her the medicine if she won't eat. And isn't the pattern that she should be devouring food with Cushing's? She wants cat food and nothing else. I've put it up, but she just stands there and begs for it. She turns down a long, long list of things we've hunted for and bought at the store to tempt her, including roasted chicken breast, for cat food! I found some chicken broth with no salt and no wheat. I poured in on Iams Probiotics kibble thinking it is "like" cat food and heated it. Yesterday she devoured it immediately. She got me up a 4:30 to go out and had loose poop. Oh, no. Today----sniffed and walked away from the kibble. Her poops are back to normal, though. I gave her the heart meds in some cookie crumbs in my hand. I put the Iams/broth down where she stands to beg for cat food, and she eventually ate it this afternoon, but how do I start the Trilostane if she won't routinely eat? We have an appointment in a week with the opthamologist. Do I, don't I, keep torturing her with the drops? He said two weeks, so I guess I will. I tried the Interceptor again this afternoon (with trepidation!) and she seems to be fine. I'll be out of town 9/30-10/3. Do I wait to start the Trilostane until I'm back? My husband will be here, but I'm still nervous about it. There seems to be no clear-cut answers to ANYTHING! Forgive me, this is way too long, but I know you'll all understand this eruption of frustration, stress, sleeplessness and concern that I do right for my baby. I know you're all rowing over these rapids and shedding tears in this same boat with me. Thanks for the support you've given me and for listening.

[StarDeb55]

Marlene, you say you have been using canned chicken broth with no salt. The more important factor is absolutely no onion powder or onion extract in canned broth, most canned broths have some type of onion in them. Dogs can not tolerate onion under any circumstances. If they get enough of it, it can cause a life-threatening hemolytic anemia. I don't want to freak you out any further, but please stop the broth immediately unless you are 100% sure it's onion free.

When it comes to the not eating, I believe you already know what I go through. I have a little leeway with lysodren as Harley is only dosed 3x weekly, so if he doesn't eat one night, I can move the dose back a day. I had to do this last Friday as he did not eat well which means his schedule has changed from M, W, F to Tues, Thurs, Sat. He's not eaten very well tonight yet, but I'm hoping giving him enough time that I will be able to give his meds tonight. I wish I could be more helpful with the not eating thing, but I'm really am about ready to go get the mocha & pour it over his food! (Just Kidding!:rolleyes::eek:;))

Debbie

[frijole]

DEEEEEP breath my friend. As one who knows how to hype.. :) I think you are doing the right thing by not starting the trilo yet. You want a reason go read my thread... don't start until the appetite is normal. Lacey probably would prefer the eye meds to be over with also. Are any of her meds affecting her appetite?

Just wanted to warn you about the chicken broth... I learned this here after doing the same as you... most chicken broth, if not all, has onion in it for seasoning which is very toxic to dogs. So now I boil a chicken breast and keep that broth in the freezer for 'special occasions'.

Hang in there. I was wondering how you were doing. Big hugs from our house. Re the leg thing - alot of cush dogs injure themselves jumping from sofas, beds, cars so keep a close eye out and try to prevent that whenever possible. Kim

[Marlene]

Thank you both so much for the heads up on the onion in broth. I checked it when I bought it, but I didn't notice the "natural flavoring". Then, after you emphasized the onion toxicity, I looked up "natural flavoring." I find it can have onion powder in it that does not have to be listed because it doesn't add nutritional value.:eek: I will take your advice and use my own home-made chicken broth!! Also, we are going to be sure we do not leave her alone any more when she is on the couch. She has always leaped like a springbok(sp?) to leave the couch.
It's so good to know you are there helping me through this.
Debbie, I don't have any broth for her meal tonight, so I guess I'll have to resort to mocha too!:)
Hugs to you both!
Marlene

[BestBuddy]

I'm with Kim on the not starting trilo. Lacey needs to be eating and her eye on the mend. She may not understand why you are doing the drops but the fact that she trusts you to do it means she knows it is for a good reason.

If there is no improvement in the eye after this long then you need to get it looked at again. Cush dogs are slow healing but I would think there should be some improvement now if you are on the right meds.

Jenny

[Marlene]

Thanks, Jenny. I do have an appointment in one week with the opthamologist who is treating Lacey at CSU. He told me to keep giving these drops and antibiotic until the next appointment he set. I'm just unhappy that I see no change yet. I feel something should be improving, too!

[addy]

Oh Marlene I am so sorry you are having such a time of it but I am sure it will get better, just will take awhile. Look, I couldn't start Zoe on Lyso right away I had to fix her poops and a bunch of other stuff. We started this April 2010 and still are only on melatonin and lignans now, I had so much to do before retesting, etc.

Point is sweetie, remember to breath and stop worrying about the trilostane right now, especially if her appetite is off. It will all come together at some point. One step at a time though I know when everything seems to be going wrong, that is easier said than done.

Love you and Lacey, saying prayers too.

Addy

[littleone1]

Hi Marlene,

I'm sorry to hear that Lacey's eye isn't getting any better. I hope you soon see some improvement.

As others have said, I wouldn't worry about starting to use the Trilo now. Since Cushings is a slow progressing disease, waiting a little while longer to start will be okay.

Corky and I are keeping everything crossed that her eye will soon be better. Give Lacey a big hug from me.

[labblab]

I am so very overwhelmed. I keep thinking, "I will start the Trilostane today." And, then, something else happens. This has been going on for weeks. Nothing seems to follow any pattern it's supposed to.
Hi Marlene,

I surely do remember how many bad days I had when we were in the process of diagnosing our own Cushpup! My heart goes out to you, because I know how hard it is to see your baby feeling poorly. :o

However, I'm going to be a bit of a devil's advocate here and go against the crowd as far as encouraging you to consider starting the trilostane sooner rather than a whole lot later. I am thinking that you may be approaching a point where issues linked to Lacey's elevated cortisol will just keep on surfacing, such as the skin issues and her vulnerability to infections. Unless there is some reason why her eye meds interact poorly with the trilostane, I'm not sure why her eye infection should keep you from starting Cushing's treatment. In fact, both her skin and her eye might have a better chance of healing if her Cushing's is better controlled.

I do understand that her picky appetite is puzzling and disturbing. But we have had a few other dogs here who seemed to do things backwards -- and whose appetites actually improved once their cortisol level came down. I think you're planning to start on a conservative dose of trilostane anyway, right? And you can always discontinue it at any time if you think Lacey is looking worse.

Since the specialists seem to feel pretty certain about the accuracy of a general Cushing's diagnosis (especially given her ultrasound images), I'm guessing that they don't feel as concerned about her diagnostic tests being skewed by a different, nonadrenal disease. So I'm thinking that you might actually be doing Lacey a favor by going ahead and starting Cushing's treatment when you feel ready to go forward. Since you already have the return visit scheduled with the eye doc next week, it makes sense to hold off on any changes until you've had the chance to touch base and get additional feedback re: adding trilostane into the mix. And since you are planning to be away from home at the end of the month, I also understand why you'd prefer to wait until you're back again and can monitor Lacey yourself. But at that point in October -- unless something new has surfaced that definitely precludes starting the trilostane -- I'm thinking you might want to go ahead and take the leap. Once again, you can always stop the medication if you think Lacey isn't tolerating it very well.

Marianne

[Marlene]

Thank you Marianne, Terri and Addy. I really, really appreciate your friendship! I took Lacey to CSU opthamology today. They squeezed me in because I was really concerned about Lacey's eye. He told me it is actually looking BETTER! He also said that it does look irritated, probably due to the EDTA they are using to dissolve the calcium. He said they didn't want to use the burr:eek: to physically remove it from her cornea since it was getting better medically. He wanted to give her a collar to prevent her from scratching her eye, but I didn't think that would be good with her collapsing trachea. I am just going to monitor it closely. He prescribed some non-steroid anti-inflammatory drops to try to cool down the irritation. I was very glad to hear that he thinks it looks better. He and the dermatologist want me to start the Trilostane because they both think it will help resolve her growing problems. The eating problem is driving me :eek::mad::rolleyes::);):D c-r-a-z-y!! This morning, I made her grilled chicken, put in some peas, cheese, little pieces of Morning Star bacon (veggie), warmed it up (I'm trying to imagine ANYTHING that might tempt her)....she CAREFULLY picked out the peas and several pieces of the bacon. Later she picked at some plain Iams kibble. I stewed chicken today so I would have broth without onion (that was brought to my attention here on the forum). I will try it for her evening meal, but I'm not holding out any anticipation that she will eat it!! I have been a vegetarian for about 40 years. I am not used to cooking stewed chicken. My students always found it most incredible that I could still be alive and never had eaten a Big Mac.:D
I am trying to talk myself into starting the Trilostane tomorrow. Send me your strong vibes and thank you all!!!

[StarDeb55]

Marlene, I'm not sure any of us have mentioned it but there is a product, Nutrical, that is a supplement for sick dogs, finicky eaters, & the like. It's a thick paste. I pretty much keep a tube of it on hand, putting a good squeeze of it over Harley's food. When he won't eat his food, he will lick the Nutrical off of it. If he's licked the Nutrical up, I figure it's better than nothing. You can buy it at most any PetSmart. I had a couple of tins of Little Caesar wet food still in the cupboard. Since the demon dog has been a holy terror for about 3 weeks to keep him eating, I put one of those tins out last night. He ate absolutely all of it. He ate about 70% this morning. I went to PetSmart & stocked up this afternoon, he ate 100% of his dinner. You might try that. At this point, I will give him whatever he will eat, even if it's grocery store junkfood.

Debbie

[Squirt's Mom]

Hi Marlene,

Good to hear that Lacey's eye looks better to the doc! :cool::):) That's always good to hear!

I am just sure that you will do fine with starting the Trilo. You are a diligent mom and that is one of the keys to success. I hope you start to see some resolution of her issues with treatment soon!

Hugs,
Leslie and the girls :D - always

[addy]

Marlene!!! The doctor thinks Lacey's eye is better, yipeeeee:D

I understand where the vets are coming from because Zoe's IMS thought her chronic diarrhea was from repeated infections from her Cushings and said if the bad poops:mad: start up again, no more reprieve:eek:

Go with your gut and your feelings about the vet team at CU.

My pups eat anything, even things they should not:eek: so I don't know about picky eaters. I did try a product called Seacure for KoKo. You can google it and read about it, you sprinkle on their food, smells fishy, I read about it in Whole Dog Journal. Maybe the smell would tempt her and it helps their tummy. Also, Stella and Chewy makes a freeze dried raw food you can crumble on the kibble. I have yet to find a pup that won't eat it but who knows?:o

Love to you and Lacey,
Addy

[labblab]

Hey Marlene,

Just wanted you to know that I am rooting for you and Lacey (regardless of whether or not today turned out to be "trilostane day!"). I'm so glad that the report on her eye was better. And whatever day you DO decide to start with the trilo, I'll be crossing every body part that is crossable for you two! I always feel nervous myself when I step out and encourage folks to start a new medication. But I truly hope that it will be helpful to Lacey to do so, whenever the time seems right.

No matter what, please continue to update us.

Great big hugs to you and your little girl,
Marianne

[labblab]

Hi Marlene,

I don't want to be a pest :o, but I've been thinking about you two and hoping that you'll soon be checking back in. Even if you've decided to hold off the trilostane, we're still anxious to know how Lacey is doing. So don't be a stranger, OK? ;)

Marianne

[MyRudy]

I was curious to hear how Lacey is doing too.

[Marlene]

Thank you for thinking of us. I am very stressed and feeling lethargic myself. I have been reading and keeping up on all that is going on with your cute, sweet babies, I just am over the top, so to speak. I have been, for weeks, so intensely reading all the information, experiences and advice for weeks, trying to decide what to do, going back to CSU, and trying to get Lacey to eat. I'm a little depressed and weepy because I've lost so much sleep and everything is so nebulous to me. I don't really have control of anything right now. I know you all are either going through this too, or have been there, that I hesitate to post my meltdowns. I am just physically and mentally beat right now. I can hardly keep my composure when I try to discuss Lacey with the vets at CSU and I HATE that!!! I went back to CSU to see the cardiologist and the internal specialist. Her heart failure has gotten no worse since April, which is certainly good. They are really concerned about her teeth. They think I should try having her anesthesized and her teeth cleaned. They tried to reassure me that they could manage it...it scares me to death!!! I know her teeth are getting bad because I've been really concerned about having them cleaned. It certainly isn't good for her heart. I've always kept them pearly white and now they have gotten so bad. The teeth may have a bearing on her appetite too. Then, they don't want me to start the Trilostane until I can get her eating on a regular basis. I have read how that is a problem with several pups on this forum. He agrees that I will have trouble monitoring whether Lacey is doing OK or not if she already is not eating and should delay starting Trilostane. I told him the eating is really a worry for me. I have tried EVERYTHING I can think of. She will eat things eagerly at first and then, completely refuses the second time offered. I've tried varying what she gets at each meal. If she has eaten it once, she doesn't want it again. They gave me samples of lots of different foods to try, but she likes none of those. He told me I could give her luncheon meats if they are organic and don't have any additives. I bought some at Whole Foods. She will eat those if she gets really, really hungry. He told me to try rice, cottage cheese, and carrots mixed in. I cooked all of them. She won't touch any of them. She will eat a few green beans sometimes. I boiled chicken and made broth. She doesn't want it. Not one lick! I cooked lean ground beef...nope. They want her to start the Trilostane as soon as possible because they think it will help her eye, her heart, and her skin condition. I am sooo tense--buying, cooking and offering only to have her refuse. It is difficult to get her medications in her at the right times. I have the pill pockets which she LOVED the first time she tasted them. Now it takes a lot of coaxing. I've tried Pupperoni to hide the pills....no deal. I know you all sincerely care, and I care about you and your babies too. I will be OK. I just need to get some of these problems resolved and get some sleep so I can handle this a little better. It is so comforting for me to know you are all there. I don't know how I would have stood this without the knowledgeable help and the warm friendship of people who also cherish these beautiful little beings. Lacey is so much better off because I learned from you what tests should be done, what warning signs to look for, what questions to ask, how to find the best medical help and so much more. I am appreciative beyond words!! I wish I could give back as much as you have given me.

[gpgscott]

Hi Marlene,

I get the burnt out part, I think we all go there now and then and I hope you are getting past it.

Concerning the eating and dental. Is it possible the teeth are putting so much bacteria into her system it is keeping her tummy in an uproar. I know the thought of putting one under as they age and esp, with a heart condition is scary but it sounds like the Drs. think the risk is necessary.

Will Lacey let you get near her mouth. I remember my Moria in the last few years got bad in the dental department because I didn't want to put her under and I finally found a product online which is citrus based. Moria was pretty compliant and would allow me to get into her mouth with a small knife with which I would scale the worst teeth and then I would apply this compound with a toothbrush. She tolerated it pretty good, seemed to like the taste of it and although her teeth were never pearly again the substance did aid in keeping down the development of new tartar and judging by the smell of her mouth reduced the bacteria considerably. I"ll try to find a link.

Scott

here is a link to the product which we used http://www.petzlife.com/

[frijole]

Marlene, Sending a huge hug. I so understand. I think the inappetance is a bigger stress than anything. I have thrown away more dog food this year than in my entire life. Same with cooked food. It can be very frustrating. Take care of yourself too because Lacey needs you. There will be days when you are weak and days when you are strong. Its OK to melt down. You have alot on your plate. And we all get it. Glad you posted as we were worried.

I wish I could take away your pain. You are doing a great job. Kim

PS Have you tried "Tripe" dog food? Nasty smelling but filled with nutrients and dogs usually go crazy for it. Annie really liked canned tuna and salmon also. I prefer fresh or frozen salmon due to the bones you find in cans sometimes. xoxoxox

[addy]

Sweetie, I think we all know only to well those feelings as we have them too. Not getting enough sleep is the enemy for sure, when I don't sleep for days I am an emotional wreck:eek: I totally relate.

Have you tried baby food meat or baby food sweet potatoes? Would she lick it off you fingers perhaps?

No pressure to post, we just get worried;)

Praying things get better and calm down for you and Lacey.

Love,
Addy

[labblab]

Marlene, thanks so much for letting us know what all you're dealing with. And I agree with Kim -- I think inappetance is one of the hardest issues that we ever have to deal with!!!!!!!!!!! It totally saps your energy and your imagination (and your pocketbook!). Every mealtime is just so stressful, because you're hoping and praying that you'll see some interest in whatever food you're trying that day! :o

But fingers crossed that some of these new suggestions might help. And I also "second" Addy's suggestion about Lacey maybe licking some baby food off your fingers? And if she likes it, maybe you could smear some on her other food. Like Addy, I've tempted my girls with some of the combined sweet potato and chicken, or sweet potato and turkey. Just check the label to make sure that there are no onions in the "mix" (although probably onions aren't generally added to baby food...), because onion can be toxic to dogs.

Please know that you can come here ANYTIME to vent. As the others have said, we definitely understand what a toll is taken by the worry. And I hope it helps sometimes just to be able to talk about it.

Marianne

[Squirt's Mom]

Hi Marlene,

Oh honey, you come here anytime and talk to us when you are having a "melt down". We all understand SO well what you are feeling. It can be a real roller coaster at times! Personally, I have season tickets to that particular ride! :p So, you never hesitate to come talk to us, ok?

If Lacey's teeth are really bad not only could bacteria in the stomach be causing her to lose her appetite, so could pain. If I were you, I would stick to soft foods like the baby food or canned foods. Do watch the baby foods for additives. Someone somewhere has talked about a method of cleaning teeth that does not require anesthesia. It is done once a month at the vets office and it seems like the ones doing this travel from office to office with their equipment. A product similar to what Scott is talking about is grape seed extract (GSE) that is supposed to help remove tartar and plaque. It can be added to the drinking water or applied directly to the teeth. These methods take longer to get the teeth clean at the start than traditional dentals but they may help.

Remember, Cushing's is slowly progressing condition so don't let yourself get into a panic over not being able to start the Trilo just yet. It it more important right now that she be able to eat. So try to look at one issue at a time and not let other matters pressure you. I know this is so very hard to do when we know our babies are in need of treatment, but taking your time is the best approach for Lacey.

Now, I want you to take a deep breath, hold it, and let it out slowly. Do this 2 or 3 times. Roll your head around on your neck right.....then left. Stretch your arms out and up as far as you can and slowly lower them. Get up a walk around the office a second. Then go back to working and put all of this in a drawer in your mind for the rest of the day. When you get home, do only what HAS to be done then forget about everything else. Don't try to make Lacey eat, don't worry about the Trilo. When things that HAVE to be done are taken care of, the rest of the nite is yours. Read a good book, watch a movie, go shopping, visit with a friend...whatever makes you happy and that you find relaxing. My personal prescription is a hot bubble bath, a good book, and a glass of wine. ;) The point is...do something good for Marlene.

Lacey needs you to be strong, well, and happy. So, you have to take care of you first and foremost. Lacey loves you, we love you so please take time to be good to yourself.

We are here for you any time, sweetie. Keep your chin up!

Hugs,
Leslie and the girls :D - always

[littleone1]

Hi Marlene,

Please feel free to vent anytime. I know you're going through a difficult time right now. We're all here for you and Lacey. Even if we can't give you specific advice on some of the issues, we're here to support you in anyway we can.

I read somewhere where there are actually some vets that do clean teeth without using anesthesia. I'm sorry that I can't remember where I read it. I've read so much and am still reading.

Give Lacey a hug from me. (((HUGS))) for you.

[apollo6]

Just a hi to support you. Hang in there.
Need to see where you are at.
Hugs Sonja and Apollo.

[littleone1]

It is with a very saddened heart that I am posting this for Marlene.

I got an e-mail from Marlene this weekend, and I just spoke with her. Lacey passed away this past weekend.

When Marlene feels up to it, she will be back on the forum.

Rest in Peace sweet Lacey. You were, and still are very much loved.

Take care my dear friend.

(((HUGS)))

[StarDeb55]

Marlene, I am so very sorry. There are no words to express the grief we suffer with the loss of our companions. It's gut wrenching anytime, but when it's a companion of many years, you know what I mean.

Best wishes,
Debbie

[BestBuddy]

Dear Marlene,

I am so very sorry to hear about Lacey. I hope soon you will be able to look back and remember only the good times. Memories are forever.

Godspeed Lacey

Jenny

[frijole]

Marlene,

I am so sorry to hear of your loss. I know the pain is unbearable but know you did a fantastic job for Lacey and now our newest angel is free of pain. Run wild and free dearest Lacey. Marlene, may memories from the good times sustain you as you heal. Come back when you are up to it and let us know how you are doing. Hugs, Kim

[jrepac]

I am very sorry to hear of Lacey's passing.

Jeff & Angel Mandy

[Roxee's Dad]

Dear Marlene,
I am so very sorry for your loss. Lacey knows she was loved and will be watching over you.

Rest in Peace Lacey, you are now our newest and brightest star in the sky.

[Bichonluver3]

Dearest Marlene,
I have not posted but have been reading your thread. My heart is breaking as I look at that picture of beautiful Lacey. You were the best mom to her and I know she felt your love as you felt her's. She has now joined all the furbabies that have gone before and is running with the "pack". But she is also, and forever will be, right beside you to help you through this time. When you are ready, please share with us memories and moments that you had together. In the meantime, take care of yourself and know that we are all here for you. I send healing thoughts and prayers.
To Lacey: Run free, our beautiful princess, through the green fields of heaven with the wind at your back and sunshine in your face. I am looking at the desert sky right now and I do believe I see a new twinkling star shining down on us. Please keep us all in your care, sweet Lacey. Godspeed and God bless.
Love,
Carrol & Chloe

[Casey's Mom]

Marlene I am so sad to hear about your loss of sweet Lacey. My heart is breaking for you as I type this.

RIP dear Lacey our newest brightest star in the sky.

Love and many hugs,

[bgdavis]

I'm so sorry for your loss. Lacey lived a long and full life with a wonderful Mom. I know your heart is breaking, but hopefully your little Lacey is running and playing with a big, white Samoyed, Lacey, at the Bridge.

Bonnie and Angel Criss

[labblab]

Dear Marlene,

I, too, am so deeply sorry. Please know that we will always be here, waiting, whenever you feel as though you are able to return. We will always help you to honor and remember your sweet girl, and we will be waiting with open arms to support you in your grief. Until that day, I am sending you many hugs from across the miles.

Always in loving memory of little Lacey,
Marianne

[addy]

Oh Dear Marlene,

I was just thinking of you and wanting to email but was not sure if I should and today I read about Lacey.

I am crying with you and am feeling devestated. Words cannot express my sorrow and how sorry I am for your loss.

Oh gosh, Marlene, I wish I could give you a big hug. I don't think I can post for awhile.

Love,
Addy

[Squirt's Mom]

Dear Marlene,

Oh, honey, I am so sorry to hear about sweet Lacey. Your love for her and hers for you has been so obvious from your first day here.

You were the very best mom she could have ever asked for, Marlene. You have done everything in your power to ensure Lacey's life was one of joy, love, and TLC, as is evident by her long life under your care.

I have no doubt what-so-ever than Lacey is watching over you as you grieve for her and sending you all her love, hoping to ease your pain with happy memories of your life together.

Our tears fall with your in our deepest sympathies,
Leslie, Squirt, Trinket, and our Angel, Ruby and Crystal


The Fourth Day
by Martin Scot Kosins

If you ever love an animal, there are three days in your life you will always remember.
The first is a day, blessed with happiness, when you bring home your young new friend.
You may have spent weeks deciding on a breed. You may have asked numerous opinions of many vets, or done long research in finding a breeder. Or, perhaps in a fleeting moment, you may have just chosen that silly looking mutt in a shelter ... simply because something in its eyes reached your heart.
But when you bring that chosen pet home, and watch it explore, and claim its special place in your hall or frontroom - and when you feel it brush against you for the first time - it instills a feeling of pure love you will carry with you through the many years to come.

The second day will occur eight or nine or ten years later.
It will be a day like any other. Routine and unexceptional. But, for a surprising instant, you will look at your longtime friend and see age where you once saw youth.
You will see slow deliberate steps where you once saw energy.
And you will see sleep where you once saw activity.
So you will begin to adjust your friend's diet - and you may add a pill or two to her food.
And you may feel a growing fear deep within yourself, which bodes of a coming emptiness.
And you will feel this uneasy feeling, on and off, until the third day finally arrives.

And on this day - if your friend and God have not decided for you, then you will be faced with making a decision of your own - on behalf of your lifelong friend, and with the guidance of your own deepest Spirit.
But whichever way your friend eventually leaves you - you will feel as alone as a single star in the dark night sky.

If you are wise, you will let the tears flow as freely and as often as they must. And if you are typical, you will find that not many in your circle of family or human friends will be able to understand your grief, or comfort you.
But if you are true to the love of the pet you cherished through the many joyfilled years, you may find that a soul - a bit smaller in size than your own - seems to walk with you, at times, during the lonely days to come.
And at moments when you least expect anything out of the ordinary to happen, you may feel something brush against your leg - very very lightly.
And looking down at the place where your dear, perhaps dearest, friend used to lay - you will remember those three significant days.
The memory will most likely be painful, and leave an ache in your heart -
As time passes the ache will come and go as if it has a life of its own.
You will both reject it and embrace it, and it may confuse you.
If you reject it, it will depress you.
If you embrace it, it will deepen you.
Either way, it will still be an ache.

But there will be, I assure you, a fourth day when - along with the memory of your pet - and piercing through the heaviness in your heart -there will come a realization that belongs only to you.
It will be as unique and strong as our relationship with each animal we have loved, and lost.
This realization takes the form of a Living Love -
Like the heavenly scent of a rose that remains after the petals have wilted, this Love will remain and grow - and be there for us to remember.
It is a Love we have earned.
It is the legacy our pets leave us when they go -
And it is a gift we may keep with us as long as we live.
It is a Love which is ours alone -
And until we ourselves leave, perhaps to join our Beloved Pets -

It is a Love that we will always possess.

[Sabre's Mum]

Oh Marlene ... I am so sorry for your loss of Lacey. Treasure those beautiful memories you have of her. My thoughts are with you.

Take care
Angela and Flynn

[mytil]

Oh Marlene,

My heart is with you and I am so very sorry about Lacey passing. We are all here for you.

((((((hugs))))))
Terry

[Harley PoMMom]

Dear Marlene,

I am so, so sorry for the loss of your beloved Lacey. Please know you are in my thoughts and prayers and that we will always be here for you.

With Heartfelt Sympathy,
Lori

[HarrysMom]

Marlene,
I am so sorry to hear about the passing of your Lacey. I am praying for you and your family. Lacey was a very loved dog.

Yunhee and Harry (12 y.o. Irish Setter)

[fivebichons]

I am very sorry to about the loss of your precious Lacey. God bless both of you.

With deepest sympathy,
Heidi and the bichons

[k9diabetes]

I am so sorry to learn of Lacey's passing... :(

Natalie

[apollo6]

Dear Marlene
May you be enfolded in God's arms. I am so sorry to hear of your loss. May Lacey finally be at peace.
Hugs Sonja and Apollo

[Marlene]

I have read all the warm messages you have sent me. I know you all will understand when I tell you I am sobbing uncontrollably as I do so to know you are out there understanding. Thank you for sending me your love and care. Also, thank you so much to Terri for posting for me and talking with me. You have been so kind to me. I just can't seem to get control of my emotions and tears. I went on a trip this past week to California with my husband which I hadn't plan to take. I thought it would help take my mind off my sorrow, but I just continue to be totally devastated. I'm sure many of you know it all too well.....she was a part of every move I made. So everything I see, everywhere I look, every activity, everywhere I went, every moment I need to hold her close, the fleeting thoughts of "Where's Lacey?", every spot in the house, every nose print on the car windows, ...I feel like I am going to shatter into little pieces and disentegrate. I am sorry for such a depressing post, I just can't seem to do any better right now. I have experienced the death of other family members. I was sole caretaker of my mother, my father, my husband all of whom I loved and missed so dearly. I was always able to talk, although deeply depressed and heartbroken, and to carry on daily life. I don't know what is happening to me. With Lacey, I cannot say "Lacey" or even "my doggie" without completely breaking down. I avoid seeing neighbors. Friends are calling leaving messages and writing emails asking why they are not hearing from me. It's because I can't talk. That's never happened to me before. I've thought maybe I should get another puppy to occupy my life, but I just can't imagine having another one right now?? Maybe someone has some advice for me about how they managed to get strength. It's Christmas and there are so many things to do, but I don't want to do any of them. I know she is not hurting now and she was so loved, but for some reason it isn't making me better to concentrate on those things. The only way I can keep composed at all is to not let one tiny thought of her come close to entering my mind. If it does, I'm gone. Any suggestions would be appreciated. Thank you all again for so generously reaching out to me and I am so sorry I have not been answering. In the days to come when I feel I can, I will try to start reading the past posts about each of you and catch up on what you are doing. Love to you all!!!!
Marlene

[Squirt's Mom]

Dear Marlene,

Honey, grief takes its own path and its own time. For each of us it is different.

When my Crys was killed this June, it took weeks before I could stop crying. The images of her last day still haunt me and bring me to tears at least once a week. It took nearly four years before I could share stories about my daughter without coming completely undone. I still come undone, just not completely every time anymore. Yet, I cannot fathom a day without Squirt.

I don't think such deep loses ever leave us nor do they ever lose their power to bring us to our knees in pain. We simply learn to deal with them, saying "thanks" while on our knees, then dragging ourselves back up to our feet.

One of the most comforting things I ever read about grief was from The Prophet, Kalil Gibran. He talks of sorrow as boring deep into our souls. In time, the sorrow will cease it's digging leaving behind a well. The deeper the sorrow has dug - the deeper the well, the greater your soul's capacity to now hold joy. To me it is a lesson of balance. The greater our grief and pain, the greater our ability for compassion, to love, to appreciate happiness.

So grieve, honey. Let yourself feel all the pain you have to carry. Let your sorrow prepare your soul for a greater joy.

Know you are always safe here, Marlene. We understand and will be honored to offer a shoulder any time.

Hugs,
Leslie and the girls - always

[labblab]

Dear Marlene,

I am so grateful that you have returned to us and feel able to speak about your pain. Although it undoubtedly does not seem this way to you, I believe it is actually a gift that you are giving us -- you are letting us know that you trust us to understand and to care. And so it becomes our privilege to listen and to reply.

One of the common threads that has struck me deeply throughout my years here is the intensity and enormity of the grief that many of us feel upon the death of our canine companions -- a grief that often surpasses that felt at the time of human loss. I must tell you that I, myself, have never grieved for anyone in the way that I grieved for the loss of my Cushpup (my very first dog). I felt utterly overwhelmed in a way that blindsided me. And I even carried some guilt about that -- wondering how it could be that this pain rocked me more pervasively than that I felt for people whom I had lost, and thinking that I was somehow betraying them by grieving so deeply for my dog.

But I came to realize that my relationship with my dog was really quite different. It was so uncomplicated, whereas even my most loving relationships with other people were still filled with the complicatons of angry times or frustrated times or flat-out miscommunications. There was none of that with my dog. He adored me, and I adored him. All the time. Every day. He followed me everywhere, and he sat beside me when I was lonely, and he licked my hand to soothe me. And he was my constant comfort, even when I was losing some of those beloved humans. And when he was sick, he let me care for him. Without any complaints or complicated issues. He let me pet him and love him. He filled so much of each day, and lay beside my bed each night. And so the hole was immense when he was gone. Absolutely huge.

I don't know whether any of this resonates at all with what you are feeling. But if so, one word of advice I will offer is to try not to question or doubt or wonder as to why you are hurting so deeply. It is because you have lost something that is so very important. And as Leslie has said, I hope you will allow yourself to fully grieve over the loss of this relationship and this dear little spirit who has meant so very much to you throughout your years together.

Marianne

[Bichonluver3]

Dear Marlene,
I know what you mean when you say the passing of a furbaby is different from that of a human. I think there are many reasons for this. First of all, their total innocence and the dependence that our babies have upon us. It is a tremendous responsibility, albeit the most rewarding we can have. Also, our pets seem to pass so "young" as we tend to gauge their lifespan with ours. Life really is the pits. Then there is the fact that, somehow, these little creatures reach a place in our heart and soul that no one else can reach and then they settle in forever. They give and never take. They love us at our best and worst. They stand beside us always, no matter what. They are our completion. They are our life.
As for another puppy....you will know when the time is right. When you have grieved for precious Lacey and feel at peace that she is free and well and waiting to see you again when that day comes. When you are settled within yourself, you will be ready to welcome another little soul and what a tremendous tribute to Lacey that would be. I know that you have so much love to give another baby in need but you must take care of yourself, grieve for sweet Lacey, and become strong again. That day will come. Please stay with us. We need you here too, when you are able. I know that Lacey is watching over us all, particularly over all our babies who are still within the grip of this disease. She is our guardian angel.
Love and tight hugs,
Carrol & Chloe

[jrepac]

Hi Marlene,

I suspect many of us have experienced the same feelings you are having now...I know I have. Our close attachments to our furry friends can often surpass the ones we have with humans. I've now lost 2 Cushpups, in succession, and both were devastating for different reasons, I suppose. It just is not easy, no matter what the circumstances, how old they were, quality of life, etc., etc.

We wind up caring for them when they are young and then again when they are old and sick; they are our "children" but we raise them and become their caretakers. We dote on them--making sure they are warm, safe, well fed and get the care they need. I feel like I do more of that as they get older and it gets harder to let them go...

And yes, the constant reminders that surround you can be painful, though it can help to try and make some positive associations with them, if you are able. So, rather than cry, maybe you can chuckle a bit, or even smile :) I got very choked up last week looking at a dog biscuit container...it was kind of silly, but what can i say? My furry friend wasn't there to finish up her biscuits :( But, I remembered how much she loved them and it made me smile a little bit !

And, getting a new pup is always a good thing under any circumstances, but you never do forget the predecessors...I know I don't. But it is very nice to experience those little puppy behaviors all over again...the little barks, the tail wags, licks and happy little faces. I brought my new pup, Pebbles, home last week. She's a doll...I have not forgotten her predecessor...how could I?...but the little girl is certainly lifting my spirits. As she is asleep on my tummy as I write this! :D

Oh, puppy love....what suckers we are for those little faces!

Jeff, Angel Mandy and Puppy Pebbles!

[addy]

Oh Marlene,

We all understand because we all have felt similar emotions when we lost a beloved companion. The grief is overwhelming. Just know it is okay to grieve and to feel the emotions and it does help to talk about what you feel and you can certainly do that here, all the time.

The holidays, I think, just add to the grief because you think you should be happy and have a million things to do but you can't pull it off. And that's okay too.

Just know it is okay to do what you can and leave the rest. Sweet Marlene, you will find your strength in Lacey's memories and love. Just give it some time. It will come.

Would it help to honor her somehow? Maybe a special little tree or something you could focus on that was beautiful and would make you smile through the tears? Something that you could look at and remember your little girl?

We love and support you and I have been so worried about you, Marlene. I am so greatful you wrote.

Love,
Addy

[littleone1]

You are very welcome, Marlene. We'll talk soon.

I don't have anything to add to what many others have said. You'll be fine.

Take care my friend.

(((HUGS)))

Luv ya,

Terri and Corkster

[Marlene]

I am just so, so sad and I don't know what to do. I don't seem to be able to help myself. The tears just suddenly erupt from somewhere inside me whether I'm expecting them or not. It's Christmas and I don't want to bring everybody down, so I try to control. I'm not always successful. I also feel guilty because there is so much suffering around me. My nephew has a brain tumor and it is likely this wonderful person's last Christmas with us. My friend was just stunned with a diagnosis of Parkinson's. My other friend's sister has just been sent home from the hospital with no hope for survival. I empathize with and love all these people and I am greatly moved and so sad by all the tragedy. And, in the midst of it all, how can I say I can't keep composed because my dog died? I don't think of Lacey as "my dog". She is every bit my baby but it seems, in my mind, they would feel disresprected by the tacit comparison. I don't talk about it. But no talking I do to myself can stop this terrible sadness and loneliness and devastation...and buckets of tears. I hide in a bathroom a lot. It is one place no one will disturb you or ask what you're doing in there so long.:confused: My neighbor was walking his dog past our garage when we got home today. I tried to steel myself because Raider always wants me to pet and praise him. I thought I could do it. I petted him and told him what a good boy he was, and then turned away and erupted. I know it's so uncomfortable for other people. I don't want to do that. I have never in my life been so NOT in control of my emotions. I turn here because I know you all know EXACTLY how deep and wide the love is for our babies. I've been reading your posts and crying over setbacks with you and wishing for good outcomes for those with hopeful news. And in the midst of all your stress and trials, you accept me and you say things that give me solace. I know that is not easy. I can't thank you enough!!!!

[Altira]

I am just so, so sad and I don't know what to do. I don't seem to be able to help myself. The tears just suddenly erupt from somewhere inside me whether I'm expecting them or not. It's Christmas and I don't want to bring everybody down, so I try to control. I'm not always successful. I also feel guilty because there is so much suffering around me. My nephew has a brain tumor and it is likely this wonderful person's last Christmas with us. My friend was just stunned with a diagnosis of Parkinson's. My other friend's sister has just been sent home from the hospital with no hope for survival. I empathize with and love all these people and I am greatly moved and so sad by all the tragedy. And, in the midst of it all, how can I say I can't keep composed because my dog died? I don't think of Lacey as "my dog". She is every bit my baby but it seems, in my mind, they would feel disresprected by the tacit comparison. I don't talk about it. But no talking I do to myself can stop this terrible sadness and loneliness and devastation...and buckets of tears. I hide in a bathroom a lot. It is one place no one will disturb you or ask what you're doing in there so long.:confused: My neighbor was walking his dog past our garage when we got home today. I tried to steel myself because Raider always wants me to pet and praise him. I thought I could do it. I petted him and told him what a good boy he was, and then turned away and erupted. I know it's so uncomfortable for other people. I don't want to do that. I have never in my life been so NOT in control of my emotions. I turn here because I know you all know EXACTLY how deep and wide the love is for our babies. I've been reading your posts and crying over setbacks with you and wishing for good outcomes for those with hopeful news. And in the midst of all your stress and trials, you accept me and you say things that give me solace. I know that is not easy. I can't thank you enough!!!!

Hello Marlene,

I lost my 7 year old husky Mira to cancer a month ago. And my 10 year old is having a very dangerous operation as I write this. I think the best thing you can do is to keep writing. Have you put together a photo album? Write down your favorite stories. Go for long walks and talk out loud. Look around for things that might be something specail just for you. Gather up all your dogs medical records and carefully organize it all. And above all get another dog. It's the only love money can buy. People think it's silly to get so upset over a dog. But if it's a dog who you were the closest to, then it only stands to reason it would bring you more greif then any thing else. Sure it's tragic what has happened to the humans around you but your dog had your heart. I'll say it again get another dog. Let yourself feel better if only for while. Everytime you do it will help. And god bless you for loving that dog the way you did.

[gpgscott]

Marlene,

I know how hard it is to lose one and I also know how much the memories of good times mean in the fullness of time.

Godspeed Lacey, and God's blessings to you and us all.

Scott

[Nathalie]

Dear Marlene,

I sure can relate to what you are experiencing …

My grandmother passed away in October and when I told my sister that my Phillip died and I am devastated about it I could sense that she thought I am loosing my marbles – it’s ‘only’ a dog …
Some people at the dog park simply ignore it when I mention his name – this makes me so angry.
The other day I started crying at the pet store looking at toys, or when I took my cat to the vet there was this really scared Beagle girl, I gave her some cookie’s which brought tears to my eyes again.
I cannot imagine how hard it must be to loose the only dog in the home, Phillip left a huge void but there are still 2 dogs and 2 cat’s that need to be taking care of.

Maybe it would help you to volunteer at your local pound, walking, socializing and grooming – there is always such a great need.
A friend of mine found great solace in fostering a dog after her own pup died. How about fostering a special needs dog?

Again, I am very sorry about your loss.
Nathalie

[frijole]

Marlene,

I have no wonderful words of wisdom to offer... I struggle myself at times with Haley's loss and my continued fight for my Annie. All I can say is I understand.

Families can be strange. ;) When I used all my vacation time to take Annie to K State and a multitude of vets my family gave me 'the look'. I told them that Annie is all I have left and I just can't lose her. They were like 'so what are we chopped liver?'... how do you tell your mom, bro and sis that you love your dog more? You don't... at least I didn't.

I'm glad you came back to talk... that's what we are here for and you are always always welcome here. Alot of us are going through the same thing. I looked at the dogs we lost this year on the board in the In Loving Memory forum and cried like a baby. But with those losses came an abundance of friendship found here at this forum.

Hang in there and know it is ok to miss your Lacey. With time you will slowly heal. But Lacey will forever live in your heart. Huge hugs, Kim

[mytil]

((((((((((((hugs)))))))))) to you Marlene
Terry

[addy]

When my first cat passed away, a year later, I would be sitting in the bath tub for a good soak and out of no where would just start sobing for my little Hoppy. He died on the operating table and I never got to say good bye. For years I would have dreams about him that he never died, he was just "lost" and would come back to me in my dreams.

Why we have such deep feelings is a mystery but they are our babies and totally need us for everything.

Marlene, it will take some time. It will happen at your own pace, don't rush it. The others have made good suggestions.

Steer clear of those "it is only a dog" people or politely tell them off:D

Love ya,
Addy

[06beagles]

Hi Marlene,

I am so sorry for your loss and completely understand how you feel just like everyone else who has offered such supportive words. We have lost 3 of our furry babies in the last 2 years and just discovered our Max has an adrenal tumor.

Unfortunately not everyone understands how some of us have such deep, special relationships with our animals but that doesn't mean you aren't entitled to your feelings. Don't worry about people's judgements about your feelings, they are your feelings to have based on a significant loss that you have experienced. I always say that I know not everyone feels like I do toward animals but that doesn't mean they can't respect my feelings. I feel bad for people who never experience the love and devotion like our babies give us. The love we receive is worth it in the end, there is nothing in the world that compares.

Grief is a process, don't rush it. There is nothing wrong with how you are feeling and you obviously have a lot of supportive people here on this board who do get it so you aren't alone.

Best wishes,
Theresa and the beagles (Max, Ebby, and Tyler)

[Casey's Mom]

Hello Marlene, I do understand how you feel about Lacey she is your baby. We understand and feel for you - take all the time you need and just know that we are here for you.

Love and many hugs,

[Franklin'sMum]

Marlene,

I am so very sorry to hear that Lacey has passed. I truly believe that the reason we grieve so long and hard over our furbabies passing is just one measure of the amount of joy they gave us in life. A lifetime full of joy and love equals a heart full of utter despair and anguish.

I have no words of comfort to offer, Bailey has been gone one month and one day, and I'm still at the point of being half way through a sentence or thought, before realising he's gone. Not everyone understands that a dog isn't "just" a dog, they are our babies, soulmates, confidantes, best friends.
In many cases, they are the first face we see in the morning, and the last face we kiss goodnight. They are our everything, and without them, we glimpse the empty world that 'non-dog' people face each day, and it's heartwrenching.

In time, you will think of the many good times you shared, and there will still be tears, but tears of joy, at the memories you hold dear. Of the honour it is to have known her and been her person.

Take all the time you need to grieve, we are here for you and with you.
All my love,
Jane, Franklin and Angel Bailey xxx

[Marlene]

Sometimes we don't know what effect our words have on others. The understanding and care you all send me in your posts mean so much to me. So much. I know you feel what I'm feeling as I do when I read what you are experiencing. There is great comfort for me in knowing that...someone understands. And not only do you all understand, but genuinely care and want to comfort. I hope I can offer words that will help comfort others as much as you have comforted me! Thank you. Love you all!!!