Golden Retriever, 13 yrs - Penny has passed away

[Wolfpak]

Hi, our beloved Penny has been partially diagnosed with Cushing's, but are still unsure as to type. She is, and always has been, in excellent overall health, despite being 2 months away from turning 13.
About a year ago we took her in to my daughter's vet for a senior exam particularly because she seemed to be urinating more frequently... her bloodwork came back as normal, but she did have a bladder infection (ecoli), which we treated.
Recently she began to have mild symptoms, took her to our usual vet for a urinalysis, and it was determined she had a kidney infection. This was treated with Ditrim.
She was showing signs of polydipsia/polyurea, so we took her in for bloodwork which showed abnormal readings associated with Cushing's:

ALK Phos 771 u/l (ref 10-150)
ALT (sgpt) 179 u/l (5-107)
GGT 20 u/l (0-14)

Amylase 1592 (ref 450-1240)
Lipase 950 (100-750)

TCO2 bicarb 28 (17-24)
Chloride 104 (105-115)
Potassium 3.7 ( 4.0-5.6)
NA/K ratio 41 (27-40)

Neutrophil seg 80 (50-77%)

IDEXX Lab conducted the test

On this basis a LDDS blood test was done:
initial value 3.4
4 hr 3.1
8 hr 3.7

Our vet (in practice since 1971) stated this confirms Cushing's but unfortunately it is not diagnostic as to type. We are currently scheduled for an abdominal ultrasound on Mon am.

Given Penny's age we are not willing to consider surgery as an option if this is determined to be adrenal type.
From what I'm able to determine from a LOT of reading on this topic over the last several days (I'm pretty fluent in Tech-Speak, thankfully!) is that there is about a 50-50 chance it is Pituitary vs. Adrenal based. If it is Adrenal based, then its 50-50 chance of it being malignant.

Really, we care too much for her to put her through this type of surgery at her age. She still runs a bit, loves to roll in the snow, plays, goes on long walks with the rest of her "pack" (she is the matriarch of our 11 beloved fur-babies, and Mother to 3 of them). Her appetite is good, but not voracious.

She is no more lethargic than any other dog her age, and less so than many. Her vision, teeth, hearing is excellent. There are no signs of arthritis or hip problems. She is fed a super-premium diet, along with a whole lot of real food, cooked specially for the dogs. We raise natural grass fed beef, and have been giving her some raw ground burger (95% lean) for the past few days.... and she seems to be a bit better.
We give n'zymes, fish oil capsules, and she has a couple Vetriscience Kidney Supplement tablets each day. She does not have to go out at night, but does often during the day, drinks tons of water (I've started adding a sm. amt. of electrolyte powder, Broiler Max, its actually for chickens, 1/4 tsp per gal. diluted even more than that, which the vet okayed, since she's flushing electrolytes, & her levels were low).

ANY help or advice would be particularly appreciated... the members here are so impressive and wonderful, from what I've been reading thus far. There is nothing like the advice from someone else who has walked miles in your shoes! Thanks so much.

[zoesmom]

Hi and welcome, Penny's person :)

Sounds like you are on the right track with the testing. And the abdominal u/s next is what we usually suggest here. I've never seen that 50/50 number on pdh vs. adh, though. I think it's more like 90% of cases are PDH, so I wouldn't worry about that until you get the u/s. That should confirm which kind of cushiings you are dealing with. And since you've already decided against surgery if it's adrenal, then you are looking at the same treatment, regardless. The two most used drugs are lysodren and trilostane. Both are good drugs. Trilostane is somewhat newer and is the one I used for my Zoe, who was dx'd at age 9. It gave us another 4 years with her. The best advice is to read as much as possible about cushings treatment. Our info and resource section (on main page) has lots of helpful articles.

Dosing of both drugs is based on weight. How much does Penny weigh? Has your vet treated very many cush doggies? If so, that is also a big plus. There are still gp vets out there who haven't and sometimes that can be a problem - if they don't follow the standard treatment protocol. That's why it helps to be an educated owner. Anyway, let us know what the u/s looks like and if you have any other questions, ask away.

Eleven dogs - WOW! Obviously you have a ranch or farm with room for all of them to roam! Sue

[Wolfpak]

Thanks Zoesmom!
The rate of 90% PDH is what I've read in the literature too, sometimes the rate is given as 85% depending on the source.

The 50-50 rate is for those dogs who fail to supress at least 50% on the LDDS test. Supressing 50% at either 4 or 8hrs is diagnostic for PDH, with no further testing necessary from what vet & other resources say, sorry I wasn't clear in how I wrote that.

Penny weighs about 75 lbs, and is slightly on the lean side for her build. Yes, we live out in the country quite a ways off the road. I've got about 6 acres of yard & some woods completely fenced in to allow the dogs to romp & play, and we have woods & hayfield out back where they are walked daily, at least a mile. All the dogs are off leash, so its quite exciting & they LOVE it. The exercise is so healthy for all of us!
We're pretty much totally into our fur-babies... have chickens in addition to cattle, so there are healthy eggs for the dogs, too. The chickens are often loose, and get along fine with the dogs, amazingly.

We specifically wanted to provide a safe, secure home for all, and have adopted - rehabilitated serious abuse/neglect/special medical case dogs. The idea is to have the best environment, food, care to allow them to recover & heal from past trauma. Other than when we're at work, they're all with us 24/7.

Penny actually came to us as a small pup when we moved out there, and has a very serene calm fun personality -- she had 1 litter & we kept 3 pups, who are similar in temperment. This makes a HUGE impact on the newcomers... they can clearly see that the dogs are all totally relaxed, content, happy. They pick up on their cues, and learn from them. Penny is the leader of them all, and we are so blessed to have her. She's a wonderful and special gal.

By the way, we never really PLANNED on 11, it just sort of worked out that way! Tried to "foster," but once we were at a place where they grew to trust us, we knew it was best if they stayed. Then, it was sort of, 8 or 9? What's the difference, LOL! (or 10....11).

We have decided we are at a good do-able number for us, and since they are all starting to age a bit, we must ensure we're able to care for them all, so 11 will NOT become 12!

Our vets are good and experienced, and we have a top notch 24hr Trauma/ICU center about an hour away if needed, with specialists available. I know our main vet has treated a number of Cushing's cases, but not a large number.
Generally, I tend to do extensive research on any health issues I've encountered, so as to have a comprehensive understanding of what's going on... guess that's how I manage, or "cope."

Have checked with my vet about the availability of endogenous ACTH test (will show if the pituitary hormone level, vs. cortisol in the blood), to determine PDH vs ADH. The lab they use offers it, but its about $180, and the sample must remain frozen in transit or its no good.

Debated about simply pursuing treatment for PDH with lysodren vs. trilostane, as the lyso WILL actually have an effect on malignant adrenal tissue, in case it IS adrenal vs. PDH, and if it is, the PDH dose would be low, but it wouldn't cause harm.... plus, there is a 50-50 chance Penny does have PDH, in which case it would likely treat it successfully, without incurring the high cost of the hi-def ultrasound (Vet Internist/Specialist charges $350ish for test & consult).

This is not standard procedure, but since I've already decided against surgery due to age for Penny, it would be a viable choice, and has a good chance of working.

My vet would be willing to work with me, as I'm an extremely proactive and involved owner. Any treatment we do would have to be based on an agreed upon treatment plan, after I've carefully evaluated the Veterinary Medical literature to ascertain what I feel is the best course of action, we would then discuss it, and proceed on that basis.

If she were even 10yrs old I would be more aggressive and willing to consider surgery, but at 13 I just don't feel it would be the responsible choice for her.

At this point we still have the appt. Mon for the ultrasound test.
Thanks so much!

[Buffaloe]

Hi,

My dog, Shiloh, was diagnosed with a primary adrenal tumor in 2006 at the age of 12. We got her diagnosis from the results of a combination ACTH/LDDS suppression test/full adrenal panel at the U. of Tennessee. It was confirmed by a subsequent ultrasound. It was a large tumor and Shi was not doing well. Surgery was our only real option. She had a very successful adrenalectomy performed by a couple of top bc surgeons. Her tumor turned out to be malignant but low grade, which malignant adrenal tumors usually are. I believe the larger the adrenal tumor, the higher the likelihood it is malignant.

Clearly, there was no suppression on your LDDS suppression test. Hence, an adrenal tumor is a possibility.

I strongly believe you should proceed with a high resolution ultrasound as your next step. $350 is a very fair price; Shiloh had three ultrasounds ranging in price from $475-$525. The endogenous ACTH test is the best single blood test to diagnose an adrenal tumor. But, often enough, it cannot diagnose the presence of a primary adrenal tumor definitively and it cannot tell you anything about the tumor. This is one of those cases where a picture is worth a thousand words.

All the best to you and Penny.

Ken

[AlisonandMia]

Hi and welcome from me too.

You mention that Penny is the mother of some of your other dogs. I was wondering if she has since been spayed?

Whether a dog has been spayed (or neutered) or not can, I believe, influence treatment of Cushing's - particularly medical treatment of pituitary Cushing's. My understanding is that intact dogs can be harder to stabilize on treatment.

Alison

[Wolfpak]

Thanks Ken & Alison,
Penny was spayed within a year after her only litter was born, about 8yrs ago. We are very involved in shelter/adoption work now, but back at that time we were considering if we would breed her.

Well, she (partly) made that decision herself, when "Rusty" unexpectedly appeared & she instantly escaped her collar in one flip of her golden head, and they ran off up an over the pasture. Prior to Rusty's arrival she'd never left our side! Turned out to be the best thing that had ever happened to us, BTW!

Its good to know about your successful experience with Shiloh, Ken. That's very encouraging. Read very good things about UTenn & their unique adrenal assay test.

Currently you wouldn't know Penny had any health problems. Last week she was drinking, urinating excessively... on her worst day she had 3 accidents. This week she seems much better, not drinking as much, no accidents. She's always preferred the cool stone floor in the foyer, and occasionally pants. Her coat is good, and she seems no more lethargic than any other dog her age, less so than many. Other than the 2 UTI's, she's not had any other health problems.

While we're not particularly cost conscious, we truly do want what's best for her. At some point we have to make difficult decisions, and cost constraints unfortunately can enter into that process. Generally we consider fur-baby health care costs as money well spent.

At the end of the day, I'd hate to make her last days full of pain and misery, or not survive an adrenal removal procedure, which is extensive, invasive, and has a very high mortality rate associated with it.

[zoesmom]

Hi again -

So are you going ahead with the u/s on Monday? It's true that Penny's LDDS results could indicate a higher risk for adrenal cushings. since PDH dogs usually suppress better. I'm with Ken on the endogenous ACTH. We like to say here that the u/s is big bang for the bucks. Plus, it can give a better idea of what else may be going on with the other organs. Hopefully, nothing much other than maybe an enlarged liver due to cushings. But ya' never know. Sometimes they spot things that you weren't aware of.

In any case, if the u/s did reveal an adrenal tumor, then that might influence which drug. Up until recently, the drug of choice for adrenal cases was lysodren. But more recently, we've had a few dogs here with ADH who were put on trilostane and they have done pretty good too. So that seems to be changing, but if it were my dog in that situation, I'd probably choose lysodren. It's clear you've been doing your homework so just keep up doing what you've been doing. You are Penny's voice!

And thanks for the nice note about my Zoe girl. Still miss her so much and now it's coming up on a year since we had to let her go. That will be a sad anniversary. :( But we now have a 1.5 yr. old rescued border collie named Cooky and will be adopting again very soon. :) Would love to see pictures of Penny and her 'pack'. You can create an album on your member page if you've got some pics you'd like to post.. Sue

[Wolfpak]

Thanks for the encouragement and info about Ab Ultrasound procedure. Its so helpful to hear from others who have 'walked miles in these shoes' themselves, vs. strictly clinical data.

Yes, we ARE planning on proceeding with the ultrasound on Mon. As you say, lots of information on the status of many internal organs can be gained from this test. Sounds like it generates lots of valuable data!

Am considering the UTenn Adrenal Assay as well. I'd like to have an understanding of what the other hormone levels are, that might be valuable in getting a comprehensive understanding of what we are dealing with for Penny.

On the other hand, I'd hate to do additional testing if it were a situation of "without this test we would do X, and with this test we would still most likely do X."
While I'm a big data and numbers fan, if the cost-benefit is minimal, then be conservative, if the benefit is significant.... go for it!

Sue, from reading it seems a main benefit of Lysodren vs. Trilostane for adrenal cases is that Lysodren does have some chemo effect on malignant adrenal tissue, and can shrink it. Apparently this is not the case with Trilostane. They don't biopsy adrenals, so it would seem to be a case of hedging the bet by using Lysodren, just in case the tumor is malignant - the odds are 50-50 that it is/isn't, in the literature I've seen.

Oh my, I'll bet your Cooky is keeping you busy! Border Collies are very smart & very HIGH energy, and she's barely more than a pup at 1.5. She'll certainly love another pack-mate to romp with. Our 'little one' is a 45 lb. Border Collie/mix? about 7or 8yrs old now. Little Bear is a character! Very independent, endearing, definitely his 'own man' and a certifiable grouch. We also have 3 Goldens, 3 Golden/mix, an English Mastiff cross, a big old yellow lab, and most recently 2 Daschunds. We lost our beloved Doxie years ago.... and still miss her every day, too!

[lulusmom]

Hi and a belated welcome to you and your pack.

You've already received some excellent feedback but as usual, I have a few comments. Please see my text in blue below:


Thanks for the encouragement and info about Ab Ultrasound procedure. Its so helpful to hear from others who have 'walked miles in these shoes' themselves, vs. strictly clinical data.

I agree completely. These folks were a Godsend and I've learned much sense landing here with a big thud a few years back. It is apparent that you are a proactive participant in Penny's medical care and that's an excellent thing. There are a lot of canine conditions you can leave to your vet to handle solo but cushing's isn't one them. It took me a few years to wrap my head around things so I am very impressed because you are way ahead of the curve. Apparently you've done a lot of research already. Good for you.

Yes, we ARE planning on proceeding with the ultrasound on Mon. As you say, lots of information on the status of many internal organs can be gained from this test. Sounds like it generates lots of valuable data!

Am considering the UTenn Adrenal Assay as well. I'd like to have an understanding of what the other hormone levels are, that might be valuable in getting a comprehensive understanding of what we are dealing with for Penny.

On the other hand, I'd hate to do additional testing if it were a situation of "without this test we would do X, and with this test we would still most likely do X."
While I'm a big data and numbers fan, if the cost-benefit is minimal, then be conservative, if the benefit is significant.... go for it!

If you have the ultrasound done and both adrenals can be visualized, I think that's all your vet will need to confirm a diagnosis. If the diagnosis is pituitary, I don't think a UTK adrenal panel is going to be cost effective because you can pretty much assume that one or more of the intermediate hormones will be elevated. In my opinion, the adrenal panel is reserved for when a vet is certain a dog has cushing's based on screening tests, physical appearance and symptoms yet diagnostic tests show normal cortisol. This is the hallmark of atypical cushing's and I don't believe that's what you are dealing with.

If I were a gambling woman, I'd bet a dollar to a donut, Penny has PDH. There was suppression at 4 hours and escape at 8 hours, which is the common "V" pattern seen in PDH. There just wasn't enough suppression (50% of baseline) to make a call of PDH. With adrenal tumors, you usually see no suppression at all; however, just like everything else about this dang disease, anything is possible.

Sue, from reading it seems a main benefit of Lysodren vs. Trilostane for adrenal cases is that Lysodren does have some chemo effect on malignant adrenal tissue, and can shrink it. Apparently this is not the case with Trilostane. They don't biopsy adrenals, so it would seem to be a case of hedging the bet by using Lysodren, just in case the tumor is malignant - the odds are 50-50 that it is/isn't, in the literature I've seen.

You are correct. You have already picked up on things that took me years to comprehend so good for you!!! Some vets prefer Lysodren because it does have the ability to shrink a tumor. Trilostane, on the other hand, is known to always enlarge the adrenal glands and while it's not been proven, some hypothesize that this could facilitate tumor growth. This hasn't really proven to be an influential factor in choosing the drug of choice lately as Lysodren seems to be falling out of favor. I personally believe that's because adrenal tumors are highly resistant to Lysodren and vets are not comfortable with prescribing the huge doses that are usually necessary to achieve loading. I think an exception would be when a vet suspects a malignancy and the pet owner does not want surgery. In those cases, I think Lysodren would be a more likely choice.

I have two cushdogs and they have treated with both drugs. Both were extremely effective so I don't think you can go wrong no matter which one you decide on.

[Wolfpak]

Hi Lulusmom,
This is pretty amazing to have such a wealth of info here on this condition. Its stressful and isolating to go through a major health crisis with one's dear fur-baby, and having such caring supportive advice is huge!
With the numbers of both large and small animals we have I've experienced both superb and abysmal veterinary care.

In one case I had a vet tell me, "well, some of them make it, and some of them don't." His treatment 'program' was out of date and dangerous, which had caused my dog to collapse, and she was near death. I'll never forget those words... it utterly infuriated me, and had I not AGGRESSIVELY pursued immediate treatment elsewhere, this would have been fatal for this dog. Had I become my own expert prior to placing her care in his hands, this would NEVER have happened. Well, that horiffic experience has cured me for life of EVER placing the care and treatment in the hands of ANY vet, solo!!!

The very excellent vet at the clinic that I wound up working with stated that there is no other owner she knows of that this dog would have survived with. She said, "if anyone else had her, it is certain she'd be dead."
So, I've become a bit of a Mama Bear when it comes to my critter-kids! We've had some extreme situations with the cattle as well, and chickens? Well, they're a whole trick bag of health issues, with next to no veterinary assistance available... it became a matter of ferocity borne of necessity!

You make an excellent point about the UTenn adrenal panel test. If it is PDH, and not atypical Cushing's, then its of limited value, and becomes an unneccessary expense.

I'd wondered about the minimal LDDS supression found at 4hrs, and if it might be at all significant. Thanks! I'm hoping for PDH, but anxious about adrenal based disease.
Yes, its sort of a playing the odds in predicting, but in the end even long shots can occur.

Wow, 2 cush dogs! You definitely have developed a wealth of experience with that. Likely, in most cases, either drug will produce satisfactory results in most cases. Appreciate your insight!

[Wolfpak]

Well, it could be worse.
Today's hi-def Ultrasound result indicated R adrenal enlargement to 1.99. L adrenal small at .56, this is undersize, but not atrophied.
Organs besides liver all excellent... some "floaters" in urine. Culturing for that. Still not totally diagnostic for PHD or AT, per vet.

Worst news was med-large operable liver tumor... not normal structure, but not severely disorganized tissue. May be metastatic, or may be totally separate issue, or even benign. Tumor shows as a separate mass. We did needle biopsy, and will await lab results.
Vet was specialist and fantastic.
Worried, but must hang in there pending lab results.

[Buffaloe]

Yep, it could have been much worse and at least now you know what you're dealing with. With the tiny bit of suppression at 4 hrs. on the LDDST, I figured if she had an adrenal tumor it was small. I'm sure glad you had the ultrasound.

If the right adrenal measured 1.99 cm. and the left was normal size at 0.56 cm., I don't understand how they question an adrenal tumor in the right gland. Anyway, I believe Penny's left gland is normal in size. Shiloh's tumor was in her left gland and was about 5.3 cm. in diameter. Her right gland was said to be normal in size and shape at 0.47 cm. and she weighs 75 lbs.

I don't have any experience with liver masses so cannot address that but it will be good to get the pathology report. I'll just hope and pray it's just an innocuous mass. Penny is a happy girl and that's really the whole show.

Ken

[Wolfpak]

Hi Ken, Thanks.
Penny weighed 72.5 lbs on the specialist's scale. Very close to your Shiloh's size!
This vet stated that the L adrenal should be about .7ish or so to be normal. Close enough!
Given that the R adrenal was not huge, she wasn't totally convinced that there was no pituitary origin involved. No question, really about there being a tumor, just that the size was not adequate to rule out pituitary growth also.

You're right that the only real measure is that Penny was totally content and happy through it all. "Smiling" and napping through the ultrasound procedure. She doesn't seem to mind the air-conditioned belly...
The vets commented on how Penny is in extraordinary condition in all other aspects of her health.
The GOOD news was that she has no high blood pressure at all.
We are now awaiting the liver path report and urine culture results.
Trying to hang in there. Penny looks up at us with a content smile, and sparkling eyes! Life IS good!

[AlisonandMia]

Here is a link you may find interesting: http://www.k9cushings.com/forum/showthread.php?t=230

Glad Penny doens't mind her "air conditioned belly"! A few of us have had our dogs' bellies shaved down simply to help keep them cool and comfortable.

Great news on the the BP.

Alison

[Wolfpak]

Thank you Alison, that is a very good link!

More good news from the ultrasound is that her kidney's are excellent, spleen, and pancreas, all NORMAL!

Thought that would be worth mentioning. I'm so lucky that the liver tumor is operable, and not highly vascularized. We MAY opt for surgery after all, due to liver mass. If they're in there anyways to remove the liver mass, might as well address the R Adrenal, too.
BTW, vet mentioned that the blood supply to the R kidney is still excellent.... and the adrenal is pressing on it, but does not appear to have infiltrated it. The adrenal is still away from vena cava & aorta.

Just don't want to do anything to compromise her excellent quality of life that she enjoys right now. Right now those options run the gamut! We discussed Lysodren, nothing, and surgery options. Pending liver biopsy, we will then do chest X-ray series to determine if there is malignant metastasis to the lungs.

Today, however, is as good as its ever been for her. No one ever gets any guarantees.
With luck, tomorrow will be wonderful, too. We're blessed!

[Wolfpak]

The results of the liver needly biopsy will be back later this week to determine type of tumor and if it is cancerous.
Also did needle sample of urine for culture to determine if UTI is cleared, and type of bacteria involved. Results back later this week also...:confused:
Right now she's completely content and happy. For that I'm thankful. :)

[Wolfpak]

Big good news today! The Purdue Pathology report shows that Penny's liver mass is benign :D
This is very encouraging as it means this is not a secondary tumor due to metastatic cancer going to the liver from some other site in the body. While still of concern, it makes her prognosis far better!

Whew!

The urine culture still isn't back, the vet will call when results are in, and we can discuss the options for Penny at that time. Its good that we can take our time, as there is no immediate urgency in making a decision.
One day at a time!

[Sabre's Mum]

Fantastic news on Penny with regards to the liver mass. It is really nice when you get results you like to hear. Keep us updated.

Angela and Flynn

[Wolfpak]

Hi Angela & Flynn, thanks for the congrats, we are delighted by the good test results.
Today Penny came along for our whole 1+ mile walk in some pretty deep snow.... quite a good workout, and though she wasn't bounding around like the younger ones, she had plenty of stamina to happily and easily make it the whole way.
That was very encouraging. Have been giving her lots of extra doses of attention. She is Dairy-cheese crazy, so we've added goatmilk to her diet, and along with the raw ground beef, I think her energy and attitude has really picked up.
Yesterday I took pictures of her happily laying in the snow, soaking up the sunshine... shaved belly and all. That was pretty cute! She's always been a contented happy doll.
Makes me think about how important it is to appreciate the good moments we're given!

[Wolfpak]

The urine culture came back positive for bacteria, so we will put Penny on cephalhexin for a month, retest a week later, wait for those results, then consider lysodren treatment at that point.

This seems a very reasonable approach.

[gpgscott]

Sorry to not have welcomed you earlier. Very glad to hear the liver is negative.

Hoping your thorough, systematic, and ongoing diagnosis will not lead to an invaisive surgery.

Scott

[Wolfpak]

Thank-you Scott!
At this point its very unlikely we will be doing surgery. When I spoke with our vet today she said that not only is Penny's liver growth benign, its normal liver tissue! She's not the least bit concerned about it at this point. It's possible that treating the bladder infection may largely resolve the symptoms. We will consider lysodren after UTI treatment, pending outcome if nothing changes in the meantime.

If we'd needed to remove liver mass ASAP, I'd likely have opted for adrealectomy, since they would have her opened up. At this point no surgery is contemplated.
Vet also mentioned she rarely sees Golden live to be as old as Penny in ANY condition, and agreed years of optimal diet, nutrition, and exercise made the difference we see with her.

[Wolfpak]

Penny passed away quickly at about 1am.

She was really good -- normal till about 1 or 2 am Fri nite-Sat am.. we heard a noise, like the bench in the hallway/foyer had been bumped into... thought our College age son had gotten home. Penny came upstairs, but seemed slightly confused, looked for me in the bathroom, but I was sitting up in bed (we were watching TV), she came into the middle of the bedroom in front of fireplace... sorta looked around. I said I was "over here" so she came over & lay down next to bed. A while later she seemed wobbly when she stood, sorta fell to one side a bit when we took her outside on the front porch. We brought her in & she slept.... Sat, she went out in the am okay... poo-pee-drink-eat, but very tired. Her hearing, vision, cognition were all fine... seemed like it was sorta hard for her to tell where the water level was in the bowl when drinking, otherwise... okay, more or less. Slept a whole lot, we put her out on the deck in the shade on a big fluffy flokati rug... she was very happy, content, bright eyed. But later she couldn't stand to poo or pee before going in for the night.

Our daughter came over with a good friend who is a vet tech... he said she acted fine, heart a little muffled, but fine, lungs clear. This am she got up on her own walked to the door & outside, weakly, but okay. She wanted to lay in the yard for a little, then she walked back in... we had her on the rug in the family room, then in the foyer on the slate... she's always loved it there since its cool. Paul had her outside about 5 & she poo-pee'd again, laid in the sun, then he put her on the rug again on the deck, she was happy there, still ate a little & drank a bit.

She was in the foyer when I got home, she was laying flat out, but her eyes were sparkly-alert. I sat there with her for a while... we had a fan there for her, & I opened the front door to get the nice cool nite air blowing in, which she seemed to like... a little while later I moved her onto her ortho-bed there, and she had a bit of a seizure... just stiffening legs and back a bit.... seemed to stop breathing.... then was alert again, DH came down & she was calm & alert.... just fading. She passed away a couple minutes later.

Will have to decide what to do tomorrow with her. Probably bury her in the garden along the drive under the trees. There is a beautiful pet burial garden a couple miles away, stunning place, and they do cremations there. Not sure that's how I want to go.

Its just so sad... what a good devoted and beloved friend. Even with 10 surviving fur-babies, the void they leave is enormous. We were to have gone back to the vet in the am, and have another urinalysis culture done. Penny had been on antibiotics for a month to fully clear any bladder infection issues firs, never did start with Cushings treatment. Perhaps we should have concurrently, but its unlikely it would have made a difference or changed the outcome.

We have been blessed to have her spend her life with us, and will always miss her terribly....

[Wolfpak]

gonna go pet her before I get some much needed sleep.... wonderful, devoted girl!

[littleone1]

I am so sorry for your loss. Rest in peace Penny.

Terri

[labblab]

Oh, I am also so sorry that your sweet Penny is gone. But thank you so much for returning to tell us what has happened. This way, we can join you in honoring her beautiful spirit and all that she has meant to you. Penny has now been entered on our special memorial thread, "Remembering All Who Have Left Us":

http://www.k9cushings.com/forum/showthread.php?p=46185#post46185

There she joins all our other beloved companions who shall always remain alive in our hearts and in our memories. Each one is special; each one is precious; each one will be loved forever.

I send you many hugs from across the miles,
Marianne

[clydetheboosmom]

Oh how sad! I'm so very sorry...(((hugs)))

Lynne, Bailey & Angel Clyde

[Squirt's Mom]

What a gentle passing Penny had; home, on her own time, with her family by her side. Regardless of how or why they leave us, it is never easy, tho. It is apparent Penny was a much loved member of your family...and that she returned that love and devotion.

It is my personal belief that we will, one day, see our babies again, hold them, and cover their faces with all the kisses we have missed since they've been gone. Today, Penny is as she was in her youth - whole, strong, and full of vim-n-vinegar, running in the wind through the Rainbow Fields with all our babies who were there to greet her as she cross The Bridge. She will continue to watch over you and your family with the same love and devotion you always showed to her until that joyous day when she sees you coming across The Bridge, when she will fly to be at your side once again.

Thank you for letting us know. I hope when you are strong enough, you will come back and share some stories of your life together so we can continue to celebrate Penny's life with you. Until then, know we are here any time you need to talk.

Our deepest sympathies,
Leslie, Squirt, Trinket, Brick and our Angels, Ruby and Crystal


I ONLY WANTED YOU

They say memories are golden
well maybe that is true
I never wanted memories,
I only wanted you.

A million times I needed you,
a million times I cried.
If love alone could have saved you
you never would have died.

In life I loved you dearly,
In death I love you still.
In my heart you hold a place
no one could ever fill.

If tears could build a stairway
and heartache make a lane,
I'd walk the path to heaven
and bring you back again.

Our family chain is broken,
and nothing seems the same.
But as God calls us one by one,
the chain will link again.

--- Anonymous ---

[Spiceysmum]

So sorry to hear that Penny has passed away. Thinking of you.

Linda

[Eskimo'sMom]

Just got to work and am crying reading your story. However, I should look at the positive. She passed in her home on her bed at an old age with her family. What a way to go! Pets are so dear to us and we love them SO MUCH. I cant even bare the thought when I will go through the passing of my Aussie.

Rest in Peace , Penny. And may it rain dog biscuits where you are.

[zoesmom]

I am so sorry to read about Penny. She enjoyed a wonderful life in a loving home and her passing sounds like it was very peaceful. But that doesn't make it easier, ever. Godspeed, sweet Penny. Sue

[apollo6]

May your sweet Penny rest in peace. She had a full and loving life.
Sonja and Apollo

[jrepac]

Rest in peace Penny; clearly you were loved and well taken care of!

But, it's never easy to lose them, even when they are in their advanced years...:(


Jeff & Angel Mandy

[Casey's Mom]

Sweet Penny, you were well loved and cared for - rest in peace sweet girl. My sympathies to you and your family.

Love and many hugs,

[marie adams]

Oh Sweet Penny you were lucky to pass so peacefully; how I wish Maddie could have gone the way you got to. You were loved and you loved with all your heart. I hope you and the Maddie Girl are running through the flower beds at the Rainbow Bridge with all the others who have crossed.:)

[Wolfpak]

Thank you all so very much! Your kindness & compassion have been such a blessing to me. You have been there, & know how difficult this time is.
We decided to have Penny's remains cremated... its comforting to know that her angelic spirit left in those last few moments, now free from any infirmities. After looking around our yard & gardens we decided this was best. We have 3 of her "pups," who are now 8yrs, but we still think of them as the puppies. When their time comes we will put them together with Penny, and plan to have then have them buried with us when our time comes. They are all such an integral part of our lives, this seems right. When we arrived at the Pet Memorial Gardens a Golden Retriever who looked AMAZINGLY like Penny came bounding up to greet us as we arrived. It seemed like a sign that we had made the right decision.

Penny's last day was very good. Was uncertain she'd make it through Sat pm, but she slept deeply, we stayed with her, and she woke up wanting to go outside in the morning. She laid in the front in the sunshine for a bit, then ate, drank & dozed on & off in the family room with a fan. She wanted to go out again late afternoon, and spent some time in the yard laying & looking around happily sniffing the breezes, the day was warm & sunny.

At 5:00pm DH took a picture of her there out by the flagpole, a short time later she decided to come in, and laid in the family room on the big rug there. When it had cooled off a bit, she went out on the deck, then walked back in at 10, and laid down on the stone floor in the foyer.

I got home about midnight & spent the next hour with her. She was alert, content, relaxed, but never lifted her head. I'd opened the front door, & nice breezes were blowing in. Could tell she liked that! A few moments after I'd repositioned her on her orthopedic bed she stiffened, like a small seizure, and passed within minutes. She never seemed to be in any pain or distress. Her eyes were as clear and alert as could be.

Thinking about it now, could anyone possibly ask for more than this when the time comes? We were very blessed to have her as long as we did, and in such good health to the end.

Despite having many other little paws running around, there is simply a huge empty place where Penny was. Her playful, gentle personality still radiated till the end. She & her "pups" have been much of the inspiration behind us getting involved in rescue work. We noticed that the 4 of them had an incredible effect on other dogs that came here, as they sort of set the pace, and the visitor simply fell in line, as they took their cues from Penny & the kids, picking up on their calm demeanor & the obvious sense of security they had.

Penny's last picture is posted in her online album here. Thanks to each one of you for your condolences! What an amazing place you have created here...

[bgdavis]

I'm so sorry for your loss. I think you and yours can be thankful that Penny slipped away on her own accord.

Bonnie and Angel Criss

[Dave Ruske]

I'm sorry to read about Penny's passing, she was clearly loved very much.

Dave

[labblab]

Penny's last picture is posted in her online album here. Thanks to each one of you for your condolences! What an amazing place you have created here...
Thank you, as well, for allowing us to share in Penny's life and journey. This site is the sum total of all our wonderful members -- human and canine alike!

I have been to your album, and all of your photographs are so very sweet. I don't know whether you have yet seen a private message that I sent to you, but we would love to link the photo of your choice to Penny's memorial line on our special "Remembering All Who Have Left Us" thread. When the time feels right to you, just take a look at my message and we can go from there.

Continuing hugs to you and all your family,
Marianne

[k9diabetes]

I am so sorry to learn of Penny's passing... she was a beautiful girl and obviously very deeply loved.

Natalie

[cairncrazy24]

Tearing up reading Penny's story.. I will light a candle and say a prayer for her..... RIP Penny.... Sending hugs your way..