a-typical Cushing's and macrotumor ~ Pumpkin's diagnosis (Pumpkin has passed)

[Pumpkin's Mama]

Our sweet baby girl, Pumpkin, was diagnosed last week with a-typical Cushing's disease. Pumpkin is a Boxer/American Staffordshire and has been a light in our lives for almost 8 years. It never occurred to me to ever think of a life without her.

About 6 weeks ago, Pumpkin began acting lethargic and not interested in eating (totally out of character for the little garbage disposal). She began shivering and cowering when anyone would approach her. Her tail seems as though it were glued to her tummy as it is tucked even when eating and being pet. For the first time in 7 1/2 years, she barked at our 11 year old daughter. I believe that it was that evening that the urination began. She would have regular accidents in the house (1 every 2-3 hours regardless of her going out every 2-3 hours to potty), whereas, she had even come to us potty trained and had never had an accident in the house before. She wanted to be right next to me and almost panicked when we would leave the house. Her little bischon brother, Maddox, has remained vigilant about protecting her and hardly leaves her side. Including potty and sleeping time.

I have read as many studies and test cases and so many of the postings on this site as a person can without going crazy! Pumpkin is on a 6mg 2X/daily of melatonin since Thursday. Does anyone have any experience with this disease and this treatment? I am wondering when my girl will return to us? Please advise.

[Harley PoMMom]

Hi and welcome to you and Pumpkin from me and my boy, Harley. So sorry for the circumstances that brought you here but very glad you found this forum. We will help you in anyway we can.

The more information we know about your girl the better our feedback will be, so we tend to ask a lot of questions from our new members, ok?

Pumpkin's Atypical diagnosis, was this confirmed through an adrenal panel which was sent to the lab in Tennennsee which is ran by Dr. Oliver? If so, could you post the results of the adrenal panel? Usually vets perform a CBC/Chemistry blood panel on one's furbaby. Do you have copies of any tests that were done on Pumpkin and if so, could you post any abnormalities with the reference ranges and the units of measurements.

Atypical treatment usually takes about 4-6 months to see improvement.

We are here for you...take deep breathes! :)
Here is a link on Atypical: Congenital adrenal hyperplasia-like syndrome/ Hyperestrinism/ "atypical Cushing's"
http://www.k9cushings.com/forum/showthread.php?t=198

Love and hugs,
Lori

[Squirt's Mom]

Hi and welcome to you and Pumpkin! :)

At first read, the signs you describe are not typical of Cushing's, conventional or Atypical, but each dog is unique and we have seen several here who just do not read the rule book! :p

If diabetes has not been ruled out by blood work, I would have that done asap. Thyroid problems, too. These are two conditions that mimic Cushing's, and sometimes accompany it, so it is vital to rule them out in the beginning.

Was an ultrasound done? That is one test that I highly recommend. You will learn the condition of not only the adrenal glands but the stomach, liver, kidneys, gall bladder and other organs. As one of our members says, "it's the biggest bang for the buck"!

My Squirt is Atypical and was taking melatonin and lignans until last week when we added a maintenance dose of Lysodren. Were lignans recommended by UTK? Do you know what their treatment recommendations for Pumpkin were?

Looking forward to seeing the test results and learning more about Pumpkin! Glad you found us!

Hugs,
Leslie and the girls - always

[foxandhound]

Hi, how is everything going? Any updates on Pumpkin? I am still in beginning stages of dealing with this with my Mandy, so I havent much insight, but I am wishing you well and sending positive vibes. So glad Maddox is there too, I'm sure it means a lot to Pumpkin while she is adjusting. Lots of hugs.

[gpgscott]

Welcome, sorry to hear about Pumpkin's issues.

Like the others I would be interested in hearing more about the diagnostic process, what tests and results.

Atypical Cushing's can involve any one of, or all six adrenal hormones. Frequently an Atypical pup does not have an elevation of cortisol which is the hormone commonly associated with Cushing's and the appetiete, thirst, urination sypmtoms. Combinations of the other hormones can lead to symptoms like Cushing's but when this is the case it is also common to prescribe conventional Cushing's meds although in a different manner than for a pup with conventional Cushing's. Also melatonin is usually prescribed in conjunction with flaxseed lignans and as has been mentioned this treatment can take several months to bring clinical changes in symptoms and meaningful decline in abmornal labs.

Please let us know more.

Scott

[Squirt's Mom]

Hi,

We haven't heard from you since your first post so I was wondering how you and Pumpkin were doing? When you get a chance, I would love an update!

Hugs,
Leslie and the girls - always

[Pumpkin's Mama]

First, please let me tell you all how the tears flowed when I read your responses. Thank you all so very much. Here is the low-down...

The first round of tests, when this all began, was a full CBC. White blood cell count and rbc were normal and no signs of traditional diabetes. Thyroid was low at 0.9 but higher than it was a year ago when she was tested at a 0.75 at a routine check up. Her Dr. ,Dr. Hopkins, felt that if she had true hypothyroidism, that her levels would have decreased or stayed the same rather than increased at this point but did remind me that the result was still low nonetheless. With all of the information that I had received at that time and with Pumpkin being about 12 lbs overweight, we decided to put her on a weight management diet and increased her exercise then test again in a year. She has lost the weight.
However, the cbc did reveal "elevated liver enzymes". We took her in for a complete abdominal ultrasound. Dr. Reis, the Dr. that we were referred to due to the advance in digital ultrasound, found that she had an enlarged spleen with an excess of white blood cells and "abnormally small adrenals for a dog her size." We treated her with Clavimox for 7 days for an infection of the spleen.
Once the round of medication was complete and Pumpkin showed no signs of improvement, we took her back at which point Dr. Hopkins did the ACTH test and labs were sent to Tennessee. With the Holidays, we did not receive results for 3 weeks. Her results were as follows...
Cortisol - normal (right smack in the middle of the range in fact)
Androstenedione ng/ml - HIGH (0.63 before and very high at 9.42 after ACTH stim)
Estrodiol pg/ml - HIGH (88.4 before and very high at 95.2 after)
Progesterone ng/ml - very low end of normal before at .05 and slightly higher than normal at 2.75 after)
17 OH Progesterone ng/ml - very lowest end of normal at 0.11 and slightly higher than normal at 2.45 after
Aldosterone pg/ml - off the chart below and way below the minimal of 11.0-139.

I spoke to her vet back home that cared for her since puppyhood until 3 1/2 years ago when we moved out of state. He suggested that we also look into Diabetes Insepidus. He is also looking into her case for us. What ever it takes, right everyone??!!

We just read about the flax seed oil and lignans and will be beginning that tomorrow. So far she is showing no signs of improvement and has even taken a step backward with her "accidents" in the house. My mother is here with me as I have broken my arm and needed help while my husband was on business, but between the three of us taking her outside and watching her every move she still has had more of them. She has begun to pace around the house like she is confused or looking for something. She will walk to her water bowl and stand over it staring at the wall in front of her.

Silver lining...she is still very interested in eating her food (but does not like to take food from hand i.e treats and hamburger treat) and shows interest when we say "walk" and "food". I take her out for about 10 min every day to get the kids from the bus stop (it is very cold here and she cannot last much more than that) and she likes to visit her friend "Bandit" up the street. There is no running the fence like they used to, now she walks to his gate and they sit opposite sides of the fence no eye contact, just next to each other quietly. She enjoys the walk but she is limping by the time we get home. I have also added an 80 mg aspirin to her morning food to help with her discomfort.

This is where we are, but I am so discouraged to see that we should not expect results for "months". This is awful!!!

Does anyone see anything that we may have missed?

Loving you all for your support!

[Squirt's Mom]

Hi,

Thanks for the additional info! That is quite helpful! :)

Based on the UTK results, I would say Pumpkin is definitely Atypical. Her cortisol is normal but she has elevations in 4 of the 5 intermediates involved with Atypical.

Before you go and buy lignan oil...save your money. ;) UTK used to recommend the oil but found that 1) the oil contains minimal levels of the property that works for our Atypical pups, namely SDG and 2) Cushing's pups are prone to pancreatitis and the extra oil can cause this condition to flare up. So they now recommend either a capsule form or crushed hull form. Here is what UTK has to say per their May '10 treatment sheet:


4) Lignan. Lignan has phytoestrogenic activity, and competes with estradiol for tissue estrogen receptors, with less biological effect. Lignan also inhibits aromatase enzyme (lowers estradiol) and 3-beta HSD enzyme (lowers cortisol). Use either FLAX HULL (SDG) lignan, or HMR lignan. See LIGNAN at our website under TREATMENT for details. DO NOT USE flax seed oil as the lignan content is very low, and the flax oil can increase triglycerides. SOURCES OF APPROPRIATE PRODUCTS are listed at the website. Lignans are safe, so doses don’t have to be exact. Suggested doses: SDG lignan; one milligram/lb B. Wt./day. HMR lignan; 10-40 mg/day for small to large dogs.

How old is Pumpkin? The behavior of staring at the wall could be a cognitive issue but her age would have some bearing on that. Has she continued this type behavior or was it a one time thing? Does she circle or press her head against things like walls, furniture, etc.?

DI is rare but worth looking into if your vets deem it a possibility. It is great that your previous vet will help work on Pumpkin's case!

Do you know what the normal ranges for the thyroid test were for both tests? It would bother me if her level was low for a year, even if it had come up some. But that's just me! ;)

Hang in there!
Hugs,
Leslie and the girls - always

[Pumpkin's Mama]

Excellent info! Thank you for the heads up on the flax oil. I will read more into that as well.

Pumpkin will be 8 in March (St. Patrick's Day). She was lucky number 12 of her litter and the runt to boot. She has had my heart since she took her first breath, broken paw, snout and all. Her first few couple of weeks in this world were a little difficult, but she has lived in the lap of luxury and love since then. I brought her home on Mother's Day.

I hate to admit my ignorance in the thyroid issue. So many dogs around me were being diagnosed with it and so many of their owners had warned me against being too over zealous when it came to putting her on medication that would be for the rest of her life without trying every other avenue first. And with her losing the weight, looking and feeling so good, life happening all around us...I just forgot to go back for the tests until this hit in early November.

At first, I thought that she was just showing symptoms of anxiety following her traumatic attack by my parent's Irish Wolfhound. That is a set of jaws that I wouldn't want coming at me either! But now, I am wondering if Kalie, Mom's dog, might have suspected something was off and freaked her out about Pumpkin. Everything seemed to correlate with that incident, which I also kick myself about. But clearly now we have results that show that there is definitely an internal issue.

I will get the Thyroid results and ranges on Tuesday when the vet opens and will post them asap. I also read something in another thread about thyroid testing. I wonder if stabilizing the thyroid would make the other hormone levels respond or will I need to seek treatment to stabilize the hormones to bring up her thyroid count. I know that this is a balancing act, but I really wish that we could have some sort of homeostasis here!

Circling and staring has been happening for about the last 5-10 days. When she finally stops pacing she will find her place to settle until the next potty break but is very hesitant to lay down. When she gets off of the couch or chair she will linger with her legs stretched out on the couch and front paws on the ground like she is stretching. She looks very zen at that moment. She has always pressed her head into people when we pet her but no furniture or walls as of yet. I have also noticed that, what we would call the bags of our eyes, has been droopy. You can see the pink and inner lid. At first I thought maybe a stroke? But if this is a pituitary tumor, then rightfully she could be having pressure on other parts of her brain that affect those muscles, right?

As I type this, she is snoozing on her favorite couch with her favorite red doggy bone flannel blanket and a fire roaring beside her in the fireplace. The patch of hair that was shaved for the ultrasound and strip around her paw where the IV was, still bare. She is snoring ever so slightly and must be dreaming something exciting as her eyes are fluttering. She has the heart of an angel and these are the moments that remind me what I am fighting for.

Thanks again for your support and advice. It is greatly needed and appreciated!

[Pumpkin's Mama]

Went to find the flax hulls at Vitamin Cottage and Pharmaca...they looked at me like I had lobsters crawling out of my ears. One girl just swore that I was confused and that there was no such thing. I referred her to google. I came home and ordered it online.

Knock on wood, she has only had one accident today in the house.

My plan of action for Tuesday will be to get copies of test results up to date and post here, ask the vet about his thoughts on DI and running a more thorough panel on her thyroid. My stomach aches thinking that my lack of "follow through" might have set this all in motion.

A close friend read on my facebook status Pumpkin's diagnosis and she replied back that her little doggy was just diagnosed with the same thing. I referred her here.

[Pumpkin's Mama]

How is Mandy doing today?

[Squirt's Mom]

Hi,

Here is a link to Mandy's thread. Annie may not see your question...

http://www.k9cushings.com/forum/showthread.php?t=2708

[Pumpkin's Mama]

Thank you for the link to Mandy's page.

Pumpkin is pacing as I type this. Last night she fell into her water bowl twice as her front legs just couldn't stand that long. The walks have become too much for her and I think that her pacing is a primal instinct. It seems to be her little workout time. My husband and I moved her favorite chair upstairs to the bedroom (to be fair, my husband and his friend moved the chair upstairs while I watched with a broken arm). She confuses me because sometimes she can hop like a gazelle up onto the chair, couch and even our very tall bed, but other times she just waits for one of us to pick her up and put her there. She is trying so hard not to be a burden. This is one of the many reasons that I am so in love with this little girl.

Last night we put her up on the bed with us, she just didn't want to be in her chair. She laid down in front of me and I wrapped my arm around her big boxer chest and we slept that way until 3 when she had to get up to potty. POTTY! That has seemed to get a little better. She had no accidents while I was at school yesterday (4 hours) and none this morning...that I have found yet.

My mom found a "security shirt" for her and sent it to us yesterday. I put it on her and it is SO nice. It feels like a giant hug. She seemed to really enjoy it when she had to go outside. The trick is getting it on fast so that we are not making her wait to potty...sometimes it's just too urgent.

She is finally resting now and her breath is a little shallow. Boxers have a terrible snoring and snorting problem (people always thing that she is growling at them but we try to explain that she is simply breathing at them). Zero snoring or snorting right now. Maddox had brought her his "baby" (a stuffed monkey) and is licking her tears. He really does take such good care of his sissy.

I spoke with the Dr. yesterday in reference to the DI test and the more complete T4 test. How to keep it all straight?! He says that we did do the complete T4 panel when it came back low and he is sending all of the results that he has to our first vet at home in Colorado. As for the DI test...he gave good evidence that one of the tests that he ran did not indicate to test for that, but if the vet in CO has a suspicion then he will do the test again NO problem. He was very pleased that I was seeking a second opinion and told me to "relax" as apologized for being so worked up. I think that I am on that borderline between really annoying and a really proactive pet owner. He told me that he has many friends who ask him to do the same regarding a diagnosis that they got somewhere else and he feels that it is a good thing to have a second opinion. I was pleased.

That's all for today. So many errands to run! I think that Pumpkin and Maddox will enjoy the time in the car...Maddox for sure! Poor little guy :( so left out lately :(

Have a wonderful weekend everyone!

[lulusmom]

Hi and a belated welcome to you and Pumpkin.

I have read through your thread and would like to ask a few questions and offer my usual long winded commentary to information you have posted. :D It's easier for me and everyone else to stay on track if I insert my comments in blue text within the body of your posts. So here we go:


About 6 weeks ago, Pumpkin began acting lethargic and not interested in eating (totally out of character for the little garbage disposal). She began shivering and cowering when anyone would approach her. Her tail seems as though it were glued to her tummy as it is tucked even when eating and being pet.

These are definitely not symptoms associated with cushing's.

For the first time in 7 1/2 years, she barked at our 11 year old daughter. I believe that it was that evening that the urination began. She would have regular accidents in the house (1 every 2-3 hours regardless of her going out every 2-3 hours to potty), whereas, she had even come to us potty trained and had never had an accident in the house before. She wanted to be right next to me and almost panicked when we would leave the house. Her little bischon brother, Maddox, has remained vigilant about protecting her and hardly leaves her side. Including potty and sleeping time.

With respect to the increase in urination, dogs with cushing's lose the ability to concentrate their urine. In order to keep up with the urination, a cushdog has to drink more water. You should have seen a direct correlation between the urinating and Pumpkin's water intake, yes? Your vet should have done a urinalysis to check for urine specific gravity. A good majority of dogs with cushing's will have urinary tract infections that won't show up on a standard urinalysis because the urine is diluted out. Therefore, if cushing's is suspected and urine is dilute, a urine culture should be done. Can you post the results of any urinalyses?



Thyroid was low at 0.9 but higher than it was a year ago when she was tested at a 0.75 at a routine check up. Her Dr. ,Dr. Hopkins, felt that if she had true hypothyroidism, that her levels would have decreased or stayed the same rather than increased at this point but did remind me that the result was still low nonetheless.

Was Pumpkin put on a thyroid supplement (soloxine or thyroxine) at any time?

However, the cbc did reveal "elevated liver enzymes".

Can you please post the enzymes and elevated values to include the normal reference range and reporting units (i.e. ug/dl, nmol)? Dogs with cushing's can have very mild elevation in ALT but it is the ALKP that is usually tips off a vet that cushing's is involved. I would be interested to know if both were elevated and to what extent?

We took her in for a complete abdominal ultrasound. Dr. Reis, the Dr. that we were referred to due to the advance in digital ultrasound, found that she had an enlarged spleen with an excess of white blood cells and "abnormally small adrenals for a dog her size."
Adrenal glands of dogs with typical and atypical cushing’s are usually enlarged. They can also be normal but I have never seen a case of adrenals being small. The liver is usually enlarged as well so things are not adding up…at least they aren’t from my layman’s prospective..

We treated her with Clavimox for 7 days for an infection of the spleen.
Once the round of medication was complete and Pumpkin showed no signs of improvement, we took her back at which point Dr. Hopkins did the ACTH test and labs were sent to Tennessee.

At this point what symptoms still persisted that made the vet conclude that the antibiotics were not working? At this point in your thread the only symptom you have mentioned that is associated with cushing's is an increase in frequency of urination. Does Pumpkin pant frequently, any hair loss or skin issues? I realize that Pumpkins cortisol was within the normal range but can you please post both the pre and post numbers?

I spoke to her vet back home that cared for her since puppyhood until 3 1/2 years ago when we moved out of state. He suggested that we also look into Diabetes Insepidus. He is also looking into her case for us. What ever it takes, right everyone??!!

The fact that your vet suggested Diabetes Insipidus (DI), suggests that Pumpkin is also drinking voluminous volumes of water in addition to peeing buckets, right? DI is extremely rare but a few of us are familiar with it. One of my cushdogs has idiopathic DI and in his case the cause is unknown and medication does not work. My dogs' specialist did not want to do the normal water deprivation test to check for concentrating ability because of the risks involved. Instead he opted to prescribe Desmopressin Eye Drops. I call this liquid gold as the little bottle is quite pricey. Unfortunately, we tried this twice for two to three weeks with absolutely no change. If your vet wants to rule out DI, I would suggest you try the Desmopressin drops.

Does anyone see anything that we may have missed?

Once you provide the information request, I think we will be in a better position to answer that question. I’d also like to ask if you use any type of hormone cream and if Mandy is on any medication other than melatonin.

[Pumpkin's Mama]

I spoke with the Dr. yesterday. Pumpkin is going in on Monday for a CAT scan. He is thinking that she may have a brain tumor.

I will report on Monday after the test and with results. I have asked him to provide me with a hard copy of her history up to this point.

Thank you everyone.

PS lulusmom...I am a "LuLu's Mom" too...she is my daughter :) Thank you for your questions and responses. I will get you everything I can ASAP.

[Pumpkin's Mama]

The Dr. that we had been seeing has finally decided that Pumpkin's case is over his head and has referred us to an internist who will be handling her case from here on out. We will be seeing Dr. Hibernik tomorrow at 1. He will determine what tests need to be done or reevaluated. I am printing out your list of questions to bring with me as well as my own list.

We were up at 11, 1:50, 3:20, 5:00 and 7:30. She went out every time and went to the bathroom. Albeit, reluctantly. She is very sensitive to touch now. She has yelped twice when we are helping her up on the bed. Something hurts, I just wish that she could tell me what and where.

I am typing this with one hand as she has fallen asleep on my left arm. She feels so heavy. I held her in my arms like a baby on Monday. A 65 lb. baby girl. She wrapped her legs around my waist and I cradled her head in the crook of my elbow. She slept for 2 hours that way.

My little girl (the human one) is home today from school sick. Pumpkin checked on her every time we came back in last night.

Pumpkin now inhales through her one nostril (the other has been blocked since she was born) and exhales through her mouth. Her jowls flutter with every exhalation. She seems like she is too tired to breathe.

The pacing and staring has gotten worse. She now finds any corner and stands there staring. Her newest spot is in the laundry room staring at the door to the garage. This is the door that we use to go in and out of the house, including walk time. I will put her leash on, but she just stands in the driveway now. She wants to go, but I think that she knows how much it will hurt :(

Talk to you on Friday.

[Squirt's Mom]

I am so sad to read this post. :( I hope the IMS can find a way to help Pumpkin feel better. She is such a sweetheart. When you told of her hugging you, it reminded me of my Crys, who used to do the same thing. Nothing quite like being hugged by a furbaby!

Please let us know what the IMS says and keep in touch.
Hugs,
Leslie and the girls - always

[Bichonluver3]

Hello!
My bichon, Chloe, has atypical Cushing's and was diagnosed last April. She started on 3mg melatonin 2x daily and 1 tsp ground fax hulls in the am. It has since been changed to 6mg melatonin because she had some skin issues and 1/8tsp ground flax hulls. Her hunger, thirst and urinating are back to normal. She still has the pot belly and has lipomas but still runs, jumps and plays. She will pant, on occasion, but it is usually due to excitment or exercise. It's been 9 months now and, so far, so good. Hope this helps a bit.
Carrol

[Pumpkin's Mama]

I love that you are a "Bichon lover". Pumpkin's little brother is a very rambunctious little bichon, Maddox. So glad to hear that he is doing well with the treatment!

Unfortunately, Pumpkin is sicker than we had thought. She has a very large pituitary tumor. The Dr. was amazing! He walked us through every option (including radiation and even steroids) but he felt that the tumor was too aggressive. He supported us in anything that we want to do.

We brought her home tonight and she ate a big yummy dinner of chicken and rice soup with carrots. She is currently staring at her bowl of water and into the corner.

The Dr. saw signs of aggression tonight and he is concerned about our kids. We are keeping everyone aware, but keeping her comfortable until she decides that she is done with this world.

My Mom called from the hospital where my great aunt is taking her last breaths. She came to when I was on the phone and expressed her fears about going to heaven. She is an angel of a woman, we told her that she was already golden. I told Mom to tell Aunt Bev that Pumpkin will be there soon, and that she will be so lucky to get to enter those gates with my sweet Pumpkin. We will have to send her on her way soon, I know this. But I am at peace knowing that Pumpkin has lived a life stacked full of love and was the light of my life for her brief jaunt on this earth. She knows that she is one of my favorite parts about this life and I know that she feels the same about me. We have a connection that I have never had with a dog before...or a human for that matter. This is not a decision that we have come to lightly. But for the love of this beautiful creature, she deserves only the best. Putting her through the treatment plan available with the results being as minimally promising as they are, we feel that this is the way that our regal beautiful girl would prefer. We will wait to see when we know in our guts that "today is the day". Until then, it is ice cream and ground beef for dinner.

I want to thank all of you for your support, advice and encouragement. It has really helped Pumpkin and I. We are so very grateful!

xoxo to you all.

Pumpkin's Mama

[Bichonluver3]

Dear Pumpkin's Mama,
What a wise and wonderful person you are. Pumpkin has been truly blessed to have a mom like you. I know her time with you has probably been filled with special times that will be a bond between the two of you forever. Please stay with us and let us help you in any way that we can. Give precious Pumpkin an extra treat and tummy rub from us. And Chloe sends doggie kisses to her bichon cousin, Maddox.
We will be beside you in your journey and you will be in our thoughts and prayers. You and Pumpkin will be part of the K9Cushings family always.
Much love,
Carrol & Miss Chloe

[Squirt's Mom]

Hi sweetie,

This has been my fear - a macro tumor. :( Today my heart aches with yours for the shortened days of your precious baby.

Remember, your sweet Pumpkin is still in there even if she acts totally different at times - her love for you will not fade or change no matter what. This tumor will never change her heart or soul.

My thoughts and prayers are with you all. Please know we are here any time.

Hugs,
Leslie and the girls - always

[Bichonluver3]

Dear Pumkin's Mama,
Please don't look back and second guess what you have done in the past. We all do the best we can at the moment with what we know. You did nothing wrong. Now, just take a deep breath and move forward from today. We are all standing with you. As I said before, you and Pumpkin are part of our family and families are forever. I am also so sorry to hear about your great aunt. I know how hard it is to deal with one difficulty let alone two at the same time. Stay strong and stay with us. We are here whenever you need us.
Love and hugs to you and pumpkin,
Carrol & Chloe

[Pumpkin's Mama]

:(
Thank you everyone for your support and well wishes. Pumpkin left this world today at 11:34 am. She and I snuggled on the couch for an hour before the vet came. I could not bare taking her to the place that she is the most afraid of to spend her last precious breaths.

My heart pounded when the doorbell rang. She didn't even rouse to see who it was. She lay in my arms on the couch snuggled with her favorite blanket and in the crook of my arm in front of a beautiful fire in the fireplace. The vet was very compassionate and he sedated her quickly so that I could see her pain free just one more time. She took her final breath in my arms with Daddy and our dear friend and neighbor there to send her on her way. I sang "goodnight sweetheart" to her as she slipped away. It was a gift to send her this way, but my chest LITERALLY aches. Oh my God, it hurts.

Last night we had a birthday party for her. Cake and all. She had a rough night sleeping. I could tell that laying on her side was hurting her head. She wanted to just stand on the bed, but her legs were just too weak. Today was the most merciful thing that I could do for her.

It was all I could do to turn off the fireplace. It was so symbolic.

Dr. Hibernik made us a copy of her CAT scan. My husband is hard at work trying to install the appropriate software to read it. The vet said that this was "the largest pituitary tumor" he had ever seen. Confirmation that she was a very very sick girl. But true to form, she just didn't bother anyone with it until it became too much. She was always that girl. Easy peasy.

Thank you for your love. Pumpkin and I are so very grateful.

Love,
Shanele

[lulusmom]

Dearest Shanele,

I am so incredibly sorry for your loss. Your post touched my heart in a huge way and I am sitting here crying my eyes out. You did an amazingly selfless thing today for your girl. My thoughts and prayers are with you.

Godspeed sweet Pumpkin.

Glynda

[littleone1]

I'm so sorry for your loss Shanele. My thoughts and prayers are with you.

Terri

[labblab]

Dear Shanele,

I am so sorry that my first reply to you is after the loss of your sweet girl. My heart aches for you. I, too, released my own Cushpup after he developed such similar problems as your Pumpkin. Although we did not have the benefit of brain images to know for sure, we felt certain that his tumor had also greatly enlarged. The only thing worse than our pain upon watching him lose his self and his abilities was the pain we felt after he was gone. But we had to release his spirit. Just as you have done for your Pumpkin. It was your final gift to bestow, and the gentle way in which you did so brings tears to my eyes.

Thank you so much for sharing Pumpkin with us, even for this brief time. We will never forget her. And you will always be welcomed back at any time, to write and to remember.

In loving memory of your precious baby girl,
Marianne

[Squirt's Mom]

Dear Shanele,

Your post was so touching, full of the love that shone on Pumpkin all her days. She was blessed every minute.

Hold to those sweet memories, let them sustain you in the days to come.

Our sincerest condolences,
Leslie, Squirt, Trinket, and our Angels, Ruby and Crystal

[Bichonluver3]

Oh, no, not our little pumpkin! I am so, so sorry for your loss, Shanele. What a wonderful mom you were (and are). I think we all grew to love little pumpkin in the short time you were here. She will be forever in our hearts as she will be in yours. When one of our "family" members is in pain, we all hurt. We are here any time, for whatever reason. If we can help in any small way over the next while, we will do whatever you need to help you through this sad time. When you are ready, please share some stories of Pumpkin. I hope you can feel my hugs coming your way. I also send all my love and prayers.
To our little Pumpkin: Our little princess, our newest angel, in the little time we knew you, we grew to love you very much. Our hearts are broken and our tears are falling. Leap and dance across heaven's fields, with warm sun in your face and gentle wind at your back. All your new friends will keep you in their care. I will look tonight in the desert sky for yet another new star. I will look for the brightest and know it is you. Until all of us meet beyond the rainbow bridge, godspeed and God bless.

For Mom:
Cradled in your arms once more,
Today I saw heaven's door.
Angels came to take me home
You stayed with me, I was not alone.
We had a life, Dad, you and me
But the time did come to set me free.
Without a thought for your own pain
You sent me running, whole again.
This greatest gift, beyond all others,
Made me love you more, my precious Mother.
I know your heart is now in pain
But someday, soon, again
You'll think of me with only a smile
And not of the last and final trial
When that day comes, you'll hear my voice
Say "Mom I love you, you made the right choice".
One day we will be together again
Though no one can say exactly when.
Then, I will be with the mom I adore
Cradled in your arms once more.
Love, Pumpkin

[mypuppy]

Dear Shanele,
I am deeply saddened for your deep loss. Pumpking will be forever precious for the remainder of your life. God Bless you, Pumpkin and your dear family. Take heart in knowing she is no longer is in pain, and nothing else can touch her. Tight hugs to you and your loved ones....Jeanette

[fivebichons]

I am so very sorry for your loss of your precious Pumpkin. I am so glad that she was in your arms at the very end. I'm sure she felt safe in her favorite blanket. Godspeed Pumpkin.

God bless,
Heidi and the bichons

[zoesmom]

So very sorry about your dear Pumpkin. RIP, sweet girl. Sue

[frijole]

Oh gosh I am so sorry. You have been so wonderful with Pumpkin and you did all you could. You have given her freedom from pain. Run wild and free my dear Pumpkin and know how much you are loved and missed. I send strength and love, Kim

[Casey's Mom]

I am so very sorry for the loss of Pumpkin and your heartache. My tears are flowing for you and I just wanted you to know what a beautiful ending you were able to give to your precious girl.

Love and many hugs,

[k9diabetes]

I am so very sorry to learn of Pumpkin's passing. She was such a beautiful dog... and had the perfect name for her lovely golden coloring. She was obviously deeply loved and had a wonderful life with you and your family - that's what really counts.

Natalie

[Franklin'sMum]

I am so sorry for your loss of beautiful Pumpkin. My heart is with you and your family. Sending you all my thoughts and prayers,

Jane, Franklin and Angel Bailey xxx

[BestBuddy]

Dear Shanele,

I am so sorry Pumpkin could not win this last battle. You were brave for her so she did not have to suffer any more, that is true love. I am so sorry.

Jenny

[Sabre's Mum]

I am so sorry for the loss of you dearest Pumpkin. You truly were the kindest Mum to release her. My thoughts are with you from across the ocean.

Angela and Flynn

[Spiceysmum]

So sorry to hear about Pumpkin. My thoughts are with you.

Linda

[Dave Ruske]

I hope that when it comes time to say goodbye to our Aleah, we can do as well as you. Such decisions must be among the hardest one can face. You've done well for Pumpkin, and I'm truly sorry for your loss.

Dave

[Bichonluver3]

Just checking in. Hope you are doing okay.
Love & Hugs,
Carrol & Chloe

[jrepac]

Shanele,

So sorry to hear this news about your precious Pumpkin...such a beautiful girl. I feel your pain; we hate to let them go, but when they are suffering it is a great kindness to release them from the pain and hardship.

Jeff & Angel Mandy

[marie adams]

Shanele,

So many of us know what you are feeling and we are so very sorry. I never thought it could be as hard as it is, but you do get through it. It has been almost a month and I think I will come downstairs and she will be there, so hang in there and talk it out here, everyone will listen.

Take care!!

[Bichonluver3]

Just checking in. Hope you are okay since we haven't heard from you.
Love,
Carrol

[Pumpkin's Mama]

It has been a very difficult journey so far. Thank you ALL for taking my hand and walking through it with me.

Pumpkin's "vehicle" is back home with us (in ash form). She sits on the mantle above the fireplace where she can watch over us all and where I can be close. One of her favorite places to lay was in front of that very fireplace, on her little bed with her red blanket. The very place that she took her final breath.

My chest still aches when I think of her. The hole is still so gaping that I can almost feel the wind go right through me. I swear sometimes that it is her little healthy Pumpkin spirit that runs at me full force, like she used to do, but doesn't stop. She runs right through. I can smell her beautiful copper head sometimes. That must sound so weird. That was just another reason to love Pumpkin. She never had the typical "dog smell". No "dog breath" no "ear stench". She always smelled like rosemary (she liked to try to get the lizards out of their hiding places in the rosemary bushes) and sometimes like rosemary and fresh air. Sometimes when she would pant, her lips would get stuck on her gums and she would look like she was smiling at you. Sometimes only half of her lips would get stuck and then it looked like she was just making faces. I miss her silly heart. Her happy tail. Her rosemary scent.

Maddox is doing surprisingly well. He seems to be enjoying the extra attention. Although, I do feel guilty that this is the first time that he has received such. I feel terrible that I do not have the connection with him like I did Pumpkin. That must be so hard for him to understand. He is such a good boy, but he is also such a dog. Pumpkin was part human. Her eyes read me. I could read hers. She was my 4 legged soul mate. Maddox is simple. We are getting to know each other better and I am beginning to accept that he will be my Maddox and she will always be my Pumpkin. I love them both equally but for (and in) very different ways.

I hope that this finds all of you (and your Cush pups) doing well. You have been an inspiration and a great comfort to me and my family.

Thank you!

Love ~ Shanele

[Bichonluver3]

Oh, Shanele,
Thanks so much for posting. I was so worried about you. I kept checking everyday to see if you were back. I loved Pumpkin, especially because her hair color was exactly the color mine was when I was little. My father called me "carrot top" and then "Carrie" for short, until the day he died. I smile when I think carrot....pumpkin. I just felt a special connection and that's why I thought I could write the poem to you from Pumpkin:)
I am glad that you are getting to know Maddox. We love everyone and everything in our lives in a different way. It is hard, now when you are grieving, but one day you will find your special bond with him and he will be your love and strength in his own unique way.
Pumpkin was a blessing to you but you were to her also. We live in the California desert where the stars, at night, shine very bright, against the dark sky. I believe they are all our angel pups confirming that they ARE watching over us. I say goodnight to them all and, I think my special Pumpkin shines the brightest.
Take care and stay with us.
Love and hugs,
Carrol

[Squirt's Mom]

Hi Shanele,

I love your description of feeling Pumpkin's spirit run right through you and fully understand how you feel about her. There will never be another Pumpkin, but that is only right - she was one of a kind and your one of a kind.

Maddox probably does recognize that things are different, that his sister isn't around but all that loving he is getting, and I'm sure giving, will help you both find your places in each others hearts. A place where none other will quite fit.

Hugs,
Leslie and the girls - always

[bgdavis]

I'm so very sorry for your loss of Pumpkin. She was well-loved.

Bonnie and Angel Criss

[makita1996]

Well said Shanele.... Makita and Pumpkin had so much in common, I wish we could of all met here on earth... (Makita would have shown Pumpkin how to hunt moles in a vineyard....) I bet they both found each other and together, are checking in on us all the time....... Everything you wrote is how I feel.. thank you for sharing that with all of us, especially me....
Heidi (Makita 1996)

[Pumpkin's Mama]

It has been some time since I have visited you all here. It has taken me that time to get to a place where I could visit without taking a step back in my healing. I just wanted to express my gratitude to each of you for your kind words and encouragement. I want each of you to know that you are a huge part of our healing process and we are so so grateful to each of you.

We have begun discussing a new family member and put an application in today for a pup that is due in July. No one (human or animal) could ever replace our sweet Pumpkin, but I look forward to giving another piece of my heart away to one special in her own right and way.

Love to ALL of you!

Shanele

[Squirt's Mom]

Hi Shanele,

It is good to see you again and to know that you are moving along the path of healing to the point you can consider another baby in your life. As much pain as comes with losing one we love so dearly, another pain comes along when there is no baby at all in the home.

I think it is simply human for us to feel that we are "replacing" someone when we start to look at another baby - it somehow feels like a betrayal. But I happen to believe that certain hearts are meant to be open, to be shared, and they are never complete without that special baby. There is no doubt in my mind that Pumpkin wants you to be happy and wants you to share your heart with another when you are ready. She will be as excited as anyone!

Keep in touch and let us know how the "baby shopping" goes! :p

Hugs,
Leslie and the gang

[labblab]

Oh Shanele, thank you so much for returning to us with your kind words. I do understand that it has taken a while. But it is so good to see you, and to learn about the new baby to be born. Your sweet Pumpkin is always honored and remembered here, and so it is a treat for us to talk with you once again and to find out how you are doing. Whenever it is a comfort to return to us, we will be right here. And we will rejoice right along with you when the time comes when you start off on your new journey of love and companionship. I hope you will share the news with us when that happens!

In the meantime, all best wishes, now and always.
Marianne

[addy]

Well, we get quite excited about puppy news. Your happiness becomes ours just as your grief became ours.

We love each of them in different ways and I think actually it honors Pumpkin's memory to allow yourself to love again.

Keep us posted, we love to hear all the suggested names and we get quite excited about photos:)

Hugs,
Addy