To medicate or not to medicate - Homer has passed

[Homers-mom]

I have a 15-year-old dog Who was diagnosed with Cushing's disease three weeks ago. He has a blockage in his gallbladder, High liver enzymes, Thyroid disease, High cholesterol, potbelly and swayback, a possible mass on his liver, And tested positive for Cushing's. Since Homer was put on medication two weeks ago he does not seem like the same dog. He sleeps all the time and won't eat his food. He will only eat enough food for me to get his medication in him, Which consists of Tiny pieces of bread wrapped around his pills. He won't eat pill pockets, cheese,peanut butter or any other items used to help get his pills taken. He won't eat the specialty dog food from the vet nor his favorite food. He feels very light when I pick him up and I can feel his backbone. Homer has always been a chubby dog and he looks very thin to me now.

He had trouble walking before the medication and has even more trouble now. He seemed like a happier dog when he was off medication. It seems like the medication is making him worse and He is acting like a very old sick dog. What do I do? My heart tells me to take him off his medication so his quality-of-life is better and he's happier. Do you have any advice for me?

[frijole]

Hello! I approved this post manually so I could get a response to you quickly. Please quit giving your dog the cushings meds. It could be that he has had too much and it could be serious. I'm going to ask questions so I can better help you ok?


First off - how much does your dog weigh and how much medication are you giving? What drug? How often? How long have you been giving it?

Signs of overdose include lethargy, inability to walk/hold head up, vomit and diarrhea. Also when they don't eat it means they have had enough of the drug.

You should have been given a drug called predisone to give in case of emergency. If your dog is really sick (vomit, diarrhea, cannot walk/hold head up) you should try to call your vet's emergency number but if unable to reach - give him the drug!!! It similates cortisol and within hours your dog should start to feel much better. The standard rescue dose of pred is 0.25mg/kg. To find his weight in kg, divide the
lbs by 2.2...then multiply that result (his weight in kg) by 0.25 and you will have the amount for his weight.

If he weighs 50lbs...50/2.2 = 22.7 * .25 = 5.68 mg of pred.

I am worried that your vet failed to inform you of this and might not have alot of experience with cushings. Please trust me on this.

If a dog gets too much their cortisol can go too low and they sometime need medical attention. (as in go to hospital)

Please answer these questions. I have more but they can wait until I have the basics. Glad you found us. We will help you!!! Kim

Please respond to our email in order to activate your membership so you can reply. Thanks!

[molly muffin]

Hello and welcome, everything Kim said and in addition, thyroid problems (disease) and other issues, (possible liver mass) can all cause cushings symptoms and not be cushings. Even high cortisol can be experienced in those situations.
I would not give any more cushings medicine for now. Did they give you prednisone in case of a crisis situation?

Please get back to us as soon as you can in response to Kim's questions.

Sharlene and Molly Muffin

[frijole]

It looks like you have logged off so I'm going to add some info that might help. First off we see alot of dogs who were misdiagnosed - it happens alot. It could be that the mass on the liver you mentioned resulted in a false positive for cushings.

For this reason when you can it'd be helpful to get the results of all tests that were done to diagnose the cushings.

Right now the most important thing is to make sure your dog hasn't gone Addisonian. This simply means the cortisol is too low (the opposite of cushings). The drugs are designed to lower cortisol but when given too high of a dose cortisol can go too low. Dogs need cortisol to live so it is important that if he isn't feeling well that you go to a vet and have the cortisol tested by giving an acth test and also the electrolytes checked.

Repeat - no more cushings meds until after you have the acth test. Please trust me on this. Kim

[Homers-mom]

To answer some of the questions

He gets 8 mg of trilostane two times per day.
We were not given any prednisone.
Homer weighs 16 pounds.
He has had trouble walking and balance issues for over a year. But he only started this medication two weeks ago.
He had a fasting test that was positive for Cushing's. low dose dexamethasone suppression test.
He also had an ultrasound that showed a mass on his liver and enlarged adrenal glands.
He has been on thyroid medication for over year. This was increased from .2 mg to .3 mg
He is also on two antibiotics.
He is also taking Ursodiol 1ml twice per day For his gallbladder.
He only seems to be throwing up at night. One of his antibiotics is to be taken at night with food that might be the reason he is throwing up.
Homer did not have trouble eating and tell him till the week before he started taking the medication. I took into the doctor because he was not eating. His lack of eating has gotten worse since the medication.
I will call my vet today for an appointment.

[molly muffin]

Okay dosage is correct for the weight. Dechra recommends a starting of 1 mg per 1 lb. Was there any specific reason you opted to do twice a day instead of once a day dosing? More symptoms at night, that sort of thing?
It could be that with the walking become worse on the medication, it is because the cortisol levels dropped, unmasking more of the pain and issues associated with the arthritis.
What are his recent thyroid tests looking like? Is that controlled wit the medication.
It is definitely possible that the antibiotics could make him sick. That does happen frequently.
It is very hard, when you are trying to start treatment of cushings And treating other things at the same time, as there is no way to know positively which is causing the problems. Gallbladder blockage and the liver mass (possible) also could be causing vomiting.
A very large concern is that lack of eating is almost directly opposite of what a cushing dogs normally experiences (they are ravenous). Since that started prior to the medication, it seems that something else is going on that is serious. The cushing medication can contribute to that though if the cortisol goes too low.
Have you had another ACTH test since beginning the medication for cushings? This is normally recommended by the manufacturer, Dechra to be approximately 12 - 14 days after first dose. Testing to be done about 4 hours after the breakfast dose. This could tell you where he is at with that. I would be most concerned with the gallbladder and liver if the thyroid is controlled rather than the cushings at this point.
I'm sure that some of the others will be here to give their opinions soon. Thanks for answering Kims questions. She'll be by too when she has a moment to log on.

Just stay in touch and we'll be with you ever step of the way. Many of our members have been dealing with this for years and years and have a great deal of experience. Not Just with cushings but with several other things that can go along with it.

Sharlene and Molly Muffin

[Homers-mom]

We are at the vet's office now. He is now 15 lbs down from 16.8 3 weeks ago. I will a copy of his labs and post here later.

[Homers-mom]

The vet said his decline was not due to medication. Most likely a brain tumor causing his ataxia, weight loss and overall rapid decline. After much heartache we made the decision let him pass peacefully. Homer passed away with his family there to love him. His quality of life was so poor. I miss him already :(

[addy]

I am so sorry to read about Homer. It is always such a hard decision.
Fly free Homer. Sending hugs and prayers for you and your family.

[labblab]

I am so very sorry to read this sad news about your Homer. I did not have the chance to welcome you earlier today, and I very much regret that my first reply to you is one of sympathy over your loss. But please know that we will stay with you and continue to support you. Homer's name has now been added to our special memorial thread of honor:

http://www.k9cushings.com/forum/showthread.php?t=4794

If you care to tell us more about your boy and your lives together, it will be our privilege to read whatever you may wish to share. Again, I am so sorry for your loss, but I am grateful that we now have the chance to help you honor your Homer.

Sending big hugs,
Marianne

[mytil]

Oh I am so very, very sorry!!!!

This decision to let him go shows your tremendous love for him. He will always be with you. We will always remember and honor him here.

Please do stay with us.

(((hugs)))
Terry

[NoonelovesmelikeNorman]

I am very sorry to hear your Homer has passed. Wishing you comfort, peace and mercy... (((hugs))) Sharon - Norman's mom

[Squirt's Mom]

I am so sorry to hear about your sweet Homer. It sounds like your vet knew what was happening and the best decision was made even tho I know how very difficult that is to do.

Your little boy is once again strong and whole, running in the Rainbow Fields where he will wait for the day he sees you coming and he will fly into your arms for all eternity.

Our sincerest sympathies,
Leslie, Squirt, Trinket, Brick, Sophie and our Angels, Ruby, Crystal and Tasha



The Final Battle

If it be I grow frail and weak,
And pain should wake me from my sleep,
Then you must do what must be done,
For this last battle can’t be won.

You will be sad, I’ll understand,
Don’t let your grief then stay your hand,
For this day more than all the rest,
Your love and friendship stand the test.

We’ve had so many happy years,
What is to come will hold no fears,
You’ll not want me to suffer, so,
When the time comes, please let me go.

I know in time, you too will see,
It is a kindness you do me,
Although my tail its last has waved,
From pain and suffering, I’ve been saved.

Do not grieve that it should be you,
Who has to decide this thing to do
We’ve been so close, we two, these years,
Don’t let your heart hold any tears.

[Boriss McCall]

I am so sorry for you loss. I know it hurts. Rest in Peace sweet Homer.

Hugs

[mcdavis]

So very sorry to hear about your beloved Homer. Thinking of you and your family at this difficult time.

[molly muffin]

Oh dear, I'm so sorry that we had so little time to get to know Homer. :( Maybe you can share something about him with us. We'd love to hear all about him, being the avid dog lovers that we are here.

I'm sorry that you are now facing such heart ache. There is no easy way and no perfect time to have to say that final good night sweetie to your best friend. We just all do what we can and somehow find our way.
We are here if you want to have a chat, a cry, a vent, anything.
HUGS,
Sharlene

[Homers-mom]

Thank you all for the kind words. I adopted homer when he was five years old. He was listed on the rescues website for one year but nobody wanted him. He was extremely overweight and had a snaggletooth but I loved him anyway. His original name was Magoo I changed it to Homer. He was a very odd looking dog part pug part Chihuahua part something. He passed away today at age 15. He followed me around everywhere I went. I will miss him always being under my feet.

He leaves behind a sad family, his doggy friend beagle and the dreaded cat. I gave my husband and daughter the choice whether they wanted to be with him when he passed. They both stayed with me and him. He will be missed!

[Bo's Mom]

((((HUGS)))) to you and your family at this difficult time. Your Homer will always live in your heart and he is now running all over Heaven and putting his paw prints on every star he touches.

[Tina]

I, too, am sad to read the news about Homer, and am so sorry for your loss. Prayers to you and your family at this difficult time.

Hugs,

Tina

[Coop]

I never got to welcome you Homers-mom but my thoughts are with you at this very sad time. Your precious pup is going to be deeply missed for a long time and will stay in your hearts forever. They give their all to us and ask so little in return - how could we not love them deeply and unconditionally. Take comfort in your memories and the support of those around you.

Fly free dear Homer.
Claire

[molly muffin]

I am always amazed that so many dogs do not get adopted. My problem is usually Not wanting to take each one home with me. My Molly was a rescue too. So many of the members here have rescued babies. We love them and they love us and the bond is the strongest that there can ever be. You are awesome for giving a forever, loving home to a little snaggletooth baby.

hugs,
Sharlene and Molly Muffin

[milosmom]

know that you gave homer the best life ever and will forever be in your hearts...you are the best mommy for all your love,hugs and kisses to him...patty(milo)meka xoxox

[apollo6]

I am so sorry for your lose. May your sweet Homer be at peace. Know you are in our thoughts.Please know we are also hear to get you through this difficult,heartbreaking time.
Hugs Sonja and Angel Apollo

[jmac]

I'm so sorry to hear about Homer, but glad he is no longer suffering. It is such a hard thing to do for us, but sometimes that is the right thing to do for them. Homer is now free from pain and troubles, waiting for you at the Rainbow Bridge.

Julie & Hannah