12 YO little Pug, debating adrenal surgery - Bug has passed

[BugsMum]

Hi, I am hoping to get some advice on making a really big decision. My little 12 year old pug is in need of an adrenalectomy and we are not sure what to do??
We don’t know whether to go ahead with surgery and risk her not waking up, or to treat her cushings medically and only have her around for another few months.

I will start from the beginning. My little one, Bug the pug, is diabetic and blind (diagnosed diabetic about 2 or 3 years ago). She had a small Mast Cell Tumor removed over a year ago and we have been having ultrasound rechecks since then. The previous ultrasound, at about 6-months ago revealed a small growth near her left kidney. The vet said they would monitor this, but not to worry, they didn’t think it was anything. We went for our next ultrasound last month (Dec 2012) and were told there was a mass on the left adrenal glad and it has invaded into the vena cava. The mass on the adrenal is under a centimetre, but the invasion into the vena cava is about 3 centimetres. We were shocked, but then recalled that prior ultrasound from 6-months back and felt very upset and let down. The vet proceeded to tell us that the only cure was surgery, but it had a mortality rate of 50%. She encouraged us to think about medical options, and told us we would only have her for a maximum of another year.

We were told to get a CT scan, which required us to move to a different specialist centre which had the equipment. The scan and a dexamethasone test confirmed that she has adrenal cushings. This new clinic highly recommends surgery. When I spoke to the medicine specialist about treating surgically v’s medically, he told me we would have her 3-6 months if we went with medical treatments only, and that she is a bit of a ticking time bomb, as parts of the thrombus can break of at any time causing death. I asked the vet what he would do if it were his dog, and he said surgery. We have started on Trilostane as a pre-med for surgery. We had an appointment with the surgeon who told us he had a 70% success rate, and that she is in a very good position for surgery – meaning that the size of the mass and the invasion is manageable. Further info from the medicine vet was that part of the 3 centimetre blockage may be comprised of other things besides the thrombus, it could be clotting.

I am so scared. I don’t want to lose her, I don’t want her to suffer.

I am worried about the vet surgeon as well. I know he is very very good, but I also know that he has previously done unnecessary surgeries, and is fairly money-oriented. I am worried that he is too over-confident with his 70% success claim, especially considering the other vet (the original vet) only quoted 50% success.

Since we started the trilostane and had the CT scan, Bug has had her first vestibular episode, which seemed to last for several days, coming and going. She is very unsteady on her feet and very lethargic. She is not the same dog she was 1-month ago.
I don’t know what to do, we have changed our minds so many times and had many sleepless nights and lots of tears. She is such a special little dog. I don’t know what I would do without her, but I don’t want my feelings to cloud my judgement in doing what is best for her.

I know it’s not fair to ask other people to make these decisions, but I am so lost at the moment.

Please help me

P.s. This is the first time I have posted, hopefully this goes to the right area

[frijole]

It is a very tough decision that only you can make. :( We have had members with successful surgeries so perhaps they will weigh in and offer you specific advice.

What bothered me was the comment about the surgeon. I would find out if there are any other options in the area (is there a teaching hospital nearby?) to get a 2nd opinion.

Sorry I couldn't be of more help. Kim

[molly muffin]

Hello and welcome. We just had one of our members go through the adrenalectomy with her dog. I know she researched the surgeon very well, as far as successfully surgeries, past experience in this area prior to making the decision, which is as you have said, very difficult to make.

This is the first page of Trish and Flynns thread, maybe reading on it will help you with the decision you're trying to make.
http://www.k9cushings.com/forum/showthread.php?t=4242

unfortunately it is hard to say, do it or don't do it when you are sitting on the other side of the computer. We have had some successes though here on the forum and as Kim mentioned, hopefully they will see your thread and stop by to offer their insights into the procedure. It is scary, but it's doable with the right surgeon and caught early enough.

hugs,
Sharlene and Molly Muffin

[Buffaloe]

Hello and welcome,

My beloved Shiloh had a 5 cm. mildly maignant adrenal tumor in her left gland surgically removed in 2007 at the age of 12. Her quality of life was very poor prior to surgery. She lived another 3.5 years with an excellent quality of life. Her tumor was pushing against and deviating the CVC but didn't appear to have invaded it. Prior to her adrenalectomy I asked my surgeon if it's going to be alot tougher if the tumor has invaded the CVC and he replied, "a little."

You are doing a GREAT job with your girl! Please don't second guess yourself about the time between ultrasounds. You did exactly as you were told by the professionals. If you are not 100% comfortable with your surgeon, I think you need to have a consultation with another one. A second surgical opinion seems warranted. We were fortunate in that we knew we had a great surgical team. Our decision was simpler than yours. I knew that if Shi knew what was going on, she'd say let's go for it, Dad.

Going through that whole adrenal tumor deal with Shiloh was exceptionally difficult. I know you are having a very emotional, tough time deciding how to proceed. Prior to Shi's surgery, my surgeon told me that the only people who shouldn't have the adrenalectomy are those who couldn't handle it if the dog died. I knew I could handle it and I knew I was giving Shi her only chance. But, your situation is different. Once you make your decision you can't look back and second guess yourself, no matter what. It is so hard to take care of our elderly dogs. I guess you gotta go with your gut.

Ken

[Skye]

Hello! so glad you found this forum. I have had pug children and they were incredible to me. Oh the snuffles and roots and grunts and snores. I melt every time I see a pug parent and pug baby.
My little girl went through adrenalectomy Nov 2011. I do not wish that hot seat to anyone. I could have never ever made it through without all the amazing angels on here. The support comfort knowledge is amazing. I warmly embrace you and your pug baby......now...sit, get comfy. Breathe. With all here maybe we can help sort out what your feeling and what you feel is best for your darling.
my first thought was......speak to another doctor. I just didnt feel comfortable with how I read the above. Where are you located? i know of a amazing surgeon in houston tx. and what type of questions have you prepared to ask the doctors? or have asked. I was surprised that the first doctor waited 6 months when growth was there. are there any additional health issues? did you say bug is currently being medicated? just wondering if so on what....cause some of the medications it is necessary to keep predisone on hand for emergency only if a hormone falls to low and the drop can cause some side effects you describe above. Just my thoughts and opinions, but i would seek out yet another specialists. From what I read I personally am not certain i am confident i would feel comfortable given the circumstance to have them do procedure. (hope it is okay to say that on forum, sorry if not!)

[scoora]

BugsMum-From one Pug mom to another I want to wish all the best for your baby. Thoughts and prayers that everything goes well.

[BugsMum]

Thank you so much to everyone for your comments. This is such a hard decision. I have been searching through the threads on this website, and so far it looks like the predominant outcome of surgery is a successful one. However, maybe people are too upset to post if something has gone terribly wrong.

Thanks Ken for your comments, particularly the one from the vet that said “people who shouldn't have the adrenalectomy are those who couldn't handle it if the dog died”. I am realistic about the fact that we only have our little ones for a short time, but I had it in my mind I would have her longer than this (maybe 15 or 16 years?). It feels like such a short time ago that I lost my beautiful dobermann to cardiomyopathy – I’m not ready to lose little Bug.

Unfortunately I think we have reached the limit of 2nd opinions (even though we have only seen two specialists), we have seen the best in our city (Brisbane, Australia). I have every confidence that the 2nd specialist is a fantastic surgeon – cases have been flown in from other parts of the country to see him. I am scared that he is being too optimistic and that even he suspected she was not a suitable candidate for surgery, he would recommend it anyway.

To Skye, I must confess that Bug has ¼ Shih Tzu in her, so not a pure pug child, but just as cute.
Bug is blind (we think she can see shades of light though) and has diabetes. We are worried that this will compromise surgery. She has also been so flat the last 2 weeks. She is currently on insulin (7 units twice a day) and Trilostane (15mg caps twice per day). We started the trilostane and had the CT scan about 2-3 weeks ago. Since then Bug has seemed so tired and unsteady. She sleeps most of the time and stays in a dark place under the table (almost as if she is light sensitive). Can you tell me what we would need the prednisone for and how we would know when to give it? And don’t worry about your comment about the vet, I appreciate your honesty.

The medicine vet does not think we are dealing with a pheochromocytoma, due to the slow growth on the adrenal gland, but also thinks the rapid growth of the thrombus into the vena cava is unusual. I spoke to him again today: he said her cortisol levels are ideal (thanks to the trilostane), when asked about non-surgical treatments he mentioned Mitotane (but said there were side effects and it was unpredictable), he also mentioned Clopidrogel (not much info on that), but said chemo drugs are not proven effective in reducing the thrombus (the life-threatening thing).

I guess the info that I want is to know is what they seriously think her chances are? Is she well enough for this surgery? Despite what the 2nd surgeon is telling me, I still have doubts that he would disclose all the risks. I am getting a lot of valuable info from this site though. Another member from this site has made me consider what those remaining 3-6 months would be like. How much pain she would be in and whether it is worth taking the surgery chance and if unsuccessful then at least she has not suffered.

[Trish]

Hi again

Did Bug have any symptoms before starting the cushings meds? I do remember reading about starting them preop somewhere in my research, but I cannot remember the specifics of the benefits. I am thinking it is most likely a cortical tumour if she has postive cush tests. So quite different to Flynny who had a pheo. But otherwise this tumour is an incidental finding on the ultrasound as part of the mast cell followup?

Left adrenal is good, that is easier to operate on apparently.

I understand the frustration of it not being picked up earlier, my dog had a CT, two ultrasounds and it was picked up on the 3rd ultrasound, all done over a one year period. So the tumours can grow reasonably fast. They did say after they discovered it that with the benefit on hindsight they could see it on the first CT.

50% seems a high failure rate to me, is that first vet a specialist? If not, I would go with what the surgeon vet said, he is the one doing it regularly.

This is what I based my decision on when trying to figure out what to do - keeping in mind Flynn was symptomatic esp from his high BP.

1. Expected life span - probably another 3 - 5 yrs for Flynn
2. Other health problems - heart, lungs no problems apart from BP. But past history of low grade hepatocellular carcinoma one year prior to finding adrenal mass. Successful surgery to remove his huge 650g mass with no sign of recurrence a year later.
3. Surgeon recommendations - yes he would do it for his own dog, yes he had experience with vena cava thrombus extractions with no deaths. University pet hospital - only vet training centre in NZ.
4. Risks - no sign of any tumour spread on CT including chest, understood all other potential problems eg bleeding, anaesthetic, vena cava complications, clots, pancreatitis, death (funnily enough he did not mention retained swabs!!!!!!!!!)
5. Prognosis if we treated medically - months only
6. Quality of life - for Flynn poor if we did nothing and death a few months away
7. Psychological - (me!) could I accept it if he died during surgery... probably would have hated myself for going through with it, but I still thought if he did die I had given him every chance of a full recovery and at least it would have been quick for him
8. Financially - yes I could afford it, if I keep working till I am 80 haha.. no, not really but it certainly is not cheap. Cost $3100.00 here in NZ including all preop scans including CT
9. Post-op care availability - support from vets, time off work for 2 weeks for me, should have taken more but ran out of leave but I'm lucky I have parents who look after him during day while I work

Now in retrospect a rocky six weeks postop:

8. Would I do it again - YES in a heartbeat, it has given him a chance even though it has been hard and stressful and we have had a few setbacks, but keep in mind most would not have happened if we did not have the swab debacle

So there we go, thats all I can think of for now. We cannot make your decision for you, it is hard and you certainly have to weigh up the pro's and con's and take advice from the experts. We all approach these things differently for our different dogs with their own unique sets of problems. What may be right for one, is not for another. Listen to your gut too, what is that telling you? Once you make a decision stick with it, it will be right whatever you choose because you are doing it with the best intentions for your baby Bug!

I hope this helps, very happy to help you along the way whatever you choose

Trish and Flynn xx

[Trish]

Oh I forgot to add you need the prednisone in case her cortisol levels go to low suddently, they can become addisonian which is an emergency so it pays to have the prednisone on hand to reverse it. They should have done an acth test to check her levels I think 10 days after starting the tristolane. Signs can be general unwellness, stopping eating drinking, diarrhea but others here are much better advising on this than me.

Also, the clopidogrel is not chemo, it is a type of blood thinner that I imagine they are considering because of her thrombus,

xx

[SoggyDoggy]

Hi, I understand how tough a decision this is for you, but there is an upside with this seemingly cocky specialist. If he is one that has patients flown in to consult, chances are he is top of the field and very likely does have that 70% success rate. There are specialists and then there are specialists. A different situation, but I know a case of orthopaedic surgeons who can only quote a 70-80% success rate in particular surgeries, whereas I know another one over here in WA that can comfortably quote 90-95% success in the same surgeries. He is the top of the field in Aus and has a reputation worldwide. But then his prices reflect that difference too (as it would). I guess in your case, if you had to move to a different clinic that was set up with a higher degree of equipment (CT Scan), then chances are you are dealing with a higher calibre of surgeon, which is also suggested if this guy has patients being flown in for consult and may therefor reflect the difference in the suggested success rates of the two.

I guess what I am trying to say is, while he may recommend surgery frequently, if he is that highly thought of in his field, he most likely will have a 70% success rate. I know it wont make your decision any easier, but once made, if that's the way you choose to go, it might sit a little easier in the reassurance department.

As for the rest of it, sorry I can't offer you any advice or suggestions there. My boy has pituitary cushing's and surgery isn't therefor an option. Whichever way you choose to go, rest assured that the amazing people on this site will be there to support you and offer words of comfort and wisdom.

Good luck and all the best.

Naomi and Fraser.

[scoora]

BugsMum-As I mentioned on my thread, thank you for the hug and kiss for Scoop. I don't want to sway you in any direction but you mentioned about the diabetes compromising surgery. I just wanted to let you know that Scoop's ear surgery was in the middle of Nov. He has Cushing's, diabetes, and is blind. He had the surgery and stayed in the hospital for 3 days after surgery. He had no problems but we are also talking about a different kind of surgery. Scoop did real well with the surgery. The surgeon kept calling him a little trooper. Now everyone is different and I don't want you to make your decision on what I say but surgery can be successful even with other problems. Does the surgeon think the diabetes will be a problem? I also know what you mean when you thought you would have her here for 15 or 16 years. I thought too my Scoop would be with us about 15 years.
How much does Bug weigh?
Hugs to you and Bug

[BugsMum]

Hi Trish, No we had never had any mention of cushings prior to this. It was a chance finding. The medicine vet has said that the Trilo is a pre-med to lessen the chance of a clot or embolism post surgery. However he said if we don’t go to surgery we will have to stay on the Trilo – which I think is making her very lethargic and unsteady.

Yes, it was the 1st Vet specialist that said 50%. Her assistant said that was because some years mortality can be 30%, and others 70%, so she likes to play it safe.

Thank you so very much for all the info about how you made your decision. This is extremely helpful!! I am trying to stay positive.
Her cortisol result was good (from speaking to vet today), but I will definitely ask about the pred.

Thank you Naomi and Fraser, I see what you are saying, and I know he is a very good surgeon. My reservation is (or my paranoia is) that if he suspected that she was not a good candidate for surgery – would he tell me that? I guess that I have had risky surgeries on dogs in the past, but it was usually an emergency situation with no choice. My first instinct with Bug is that I want the tumor out, but she is so little and the thought of her opened up on the table is horrific.

Hi Vicki, thank you for checking, no the vet said the diabetes would not be a problem. I also worry about pugs having anaesthetic – I had heard that they are high risk because of their little squashed faces. That is fantastic to hear that Scoop has done so well in the face of all his many problems – poor little guy is due for some good luck.

Bug currently weighs in at 10-11 kg. She used to be around 13kg (probably how she ended up with diabetes) – we used to explain the weight away by saying she was a cross breed, and joked about being crossed with a Labrador rather than a Shih Tzu.

Thanks again everyone for your help with this decision. Surgery is tentatively booked for next week (after cancelling it last week), so I have a couple more days to think (obsess)

[molly muffin]

I really do hope that Bug will come through the surgery fine and no issues. I would probably be in the same boat of should I, shouldn't I, what is best, and be worried constantly. I think that is natural.

Sending you great big hugs and some belly scritches to Bug.

hugs,
Sharlene and Molly Muffin

[Jenny & Judi in MN]

my Jenny is also blind from diabetes and has cushings. Best of luck with the surgery. No matter how money hungry someone seems I honestly believe vets are vets because they love animals. As long as yours has experience, lets hope it goes smoothly.

Please keep us posted

[Squirt's Mom]

Hi,

Just a few words - you want to know the surgeon's success rate with this type surgery, not what studies say. It is the expertise and experience of the individual surgeon who will perform the operation that matters - not what other's may have done or not done. So be sure to have a long heart-to-heart with the board certified surgeon who will actually operate on your sweet baby.

We are all with you every step of the way. Let us know how things are going and remember, this could very well be a cure. ;)

Hugs,
Leslie and the gang

[Skye]

Yes Leslie worded that perfectly. I was just thinking of this today...and statistics another thing to consider in those is does it include......health aliments exsisiting, breed, age, doctor, and recovery care. The preparedness during and after are also very important. Do they have bp monitored at all times, do they have meds for spikes in bp, blood if transfusion would be needed in emergency, what is the training and experience of staff assisting doctor and in recovery........all of these things are so very very important. I even asked what the nurse to patient ratio is. lol
and this your furbaby.....this more than surgery.......you clearly clearly love your darling so very very much......please express this to the doctor. There is alot to consider and you are doing all you can and you are doing great.

[Skye]

hi again......lol......sorry....Trish answered the questions about the predisone right? I am surprised none of the doctors suggested this to you. always keep it on hand from reading feedback from others experiences.

[scoora]

What day is Bug scheduled for surgery? Hope all goes well. Please keep us posted on how things are going.
Hugs to you and Bug

[BugsMum]

Hi Vickie,
Bug's surgery is scheduled for Wednesday (? maybe, we are still undecided)
I was able to get the results today from her Dex test and the CT. I have posted them below, and hoping to get any feedback that may help me make the surgery / medicine decision. : (

Requested: VFT,VDX
Dog
VETNOSTICS COMMENT
DEXAMETHASONE SUPPRESSION TEST
TIME (Hours) CORTISOL (nmol/L)
0 221
3 or 4 144
8 142

Radiographic Findings:

Neurocranium. Occiptal Dysplaia [*Occipital Dysplasia] is evident. The neurocranium and skull appear normal in other respects.
Thorax. Typical pug cranial mediastinum, full of adipose trissue [*tissue]. The pulmonary parenchyma and thoracic lymphocentres appear normal.
Abdominal cavity. Left adrenomegaly (10mm wide of the right adrenal which is 6mm wide). The adrenal gland is contiquous with the vena cava. A filling defect in the lumen of the caudal vena cava extends craniad for 3cm from the point of contact with the left adrenal, and this is consistent with the presence of a tumor thrombus within the caudal vena cava. The diameter of the caudal vena cava expands around the filling defect.
In other respects the abdominal viscera appear normal.

Diagnostic Interpretation:

Probably left adrenal neoplasm invading the vena cava.

Comments:

I agree with the sonographic interpretation of the large left adrenal gland with associated thrombus formation in the adjacent caudal vena cava appears correct. The left adrenal gland is larger than normal. Benign adrenal gland disease is not expected to invade an adjacent blood vessel, so I assume that the large left adrenal is neoplastic.
I cannot see any signs of lymphocentre enlargement secondary to MCT, and the adrenal changes are interpreted as representing unrelated disease.

[molly muffin]

Can you add the unit this is in, either ug or nmol and the range given for the Dex test?
For example
221 nmol range 6 - 18 nmol
(that way we know what it is actually telling us)

I have to get to work but others will be by to take a look.

Sharlene and Molly Muffin

[BugsMum]

: (
I'm sorry, I have no idea. That was all the paperwork said, and the vet only told us that the levels were ideal - he didn't explain the numbers to us.
When I pasted the results earlier, I lost the formatting, so I have re-pasted with the right spacing (see below).
I will see what further info I can find out today.


TIME (Hours) CORTISOL (nmol/L)
0 221
3 or 4 144
8 142

[BugsMum]

Hi everyone, I have an additional query I am hoping to get some advice on. Bug is on Trilostane, 15mg twice per day. She is a 10kg dog.
We feed Bug twice a day and give insulin injections for diabetes at the same time (7 Int Units twice a day).
My concern is that she is off her food in the mornings. She seems to eat normally for the night feeding, but in the morning she just picks at her food. We really need her to eat her meals because of the insulin injections.
This all started 3 weeks ago when she started the Trilo. She has just been so lethargic and just drags herself around the house and doesn't emerge from under the table very often - just to drink and toilet.
If we decide to go with just treating her medically, is this going to be her life - there is no quality of life. I am worried she is in pain or just so out of it that she can't move. She is unsteady in the back legs as well.
She was so happy before all these scans and Trilo. I know she has the tumor, but she was getting along so well before we knew she had it. I think we are starting to wish we had never had the check up and never found the tumor. I think she would just still be her happy little self if we had never intervened. All I am doing now is hurting her

[BugsMum]

3rd attempt with some formatting

TIME (Hours) CORTISOL (nmol/L)
0............ 221
3 or 4......144
8............ 142

[molly muffin]

Okay, so your results are in nmol untils, does it give a range anywhere on the test, near the numbers usually.

LDDS

BASE - 221nmol = 8.01ug
4 hr - 144nmol = 5.21ug
8 hr - 142nmol = 5.14ug

Have you had an ACTH test done since you've been giving the Trilostane? It definitely could be that the cortisol levels coming down from what they were make Bug not as interested in food. Try adding a little something she really likes to the morning breakfast to get her to eat it better. For instance, molly gets a tiny bit of wet food on top of her dry food, to get her to eat it and to I have to sprinkle her liver supplement onto that because she otherwise will Not take that dratted pill.

Sharlene and Molly Muffin

[Trish]

Hiya

It is certainly not good when it seems the cure is worse than the illness, I agree with the Sharlene about getting a acth test, I think they are meant to have one 10 days after starting the drug or else if negative symptoms are seen.

As it is Wednesday tomorrow I wonder if you have decided to go ahead with the surgery for Bug? If so, I am wishing you and her all the best of luck for it! Although I guess if she is not 100% stable it may well be delayed until she is in the best condition to proceed if that is what you decide to do.

Sending positive thoughts for a good outcome for the wee Bug!

Trish xx

[BugsMum]

Hi again, thank you for all the advice. Do you know if the acth is something I can have done at the local?

I think I am getting confused. Just double checked the test results sheet, this is the Dex test that confirmed what she had, and then last week she had some test to measure her cortisol levels - which the vet said were fine, and where they want them to be. I didn't get the results from that one...

back in 5, insulin alarm going off

[BugsMum]

She seems a lot brighter this afternoon since I have been home, but she is still unsteady on her feet - slips as she walks.
We cancelled the surgery which was scheduled, and will have another week to consider. In this time I am trying to line up a chat with someone who used to work with the surgeon, to try and get more background info. My mum has also done some research and we have to meet up and discuss.
Hi Sharlene, there was no range listed on the test. I am still waiting on feedback from a friend who may be able to interpret. We give Bug a little bit of chicken to get her started on her meal, but she wouldn't even take that this morning : (
Sorry to be brief, I have to go and supervise dog eating time so they don't eat each others food

[BugsMum]

Hi again, I have just had an email back from the vet (I had emailed him this morn to say Bug was lethargic and unwell). He mentioned that her cortisol levels were ok, and referred to the ACTH stimulation test from last week - so looks like we did have one (sorry for all the confusion).
He finished up his email by saying that it's possible that the tumor is now causing problems : (

[labblab]

I am very worried that your vet is dismissing low cortisol as the possible source of Bug's problems. Just because her cortisol level was OK a week ago does not mean that it is OK now. The dose of trilostane that she is taking is at the very highest end of the manufacturer's initial dosing range. I realize that your vet was probably wanting to bring down her cortisol quickly in preparation for the surgery, but that doesn't change the fact that it is a big dose and her cortisol level may easily have dropped significantly in this week's time. I know it may feel uncomfortable to question the vet's assessment about this, but I would push further in asking how they can know for certain that the cortisol isn't a problem unless they check her level?

If Bug wasn't diabetic, I would be tempted to tell the vet that you want to temporarily halt Bug's trilostane in order to see if she improves. However, I realize that the trilostane is also affecting her insulin needs, so stopping that large a dose of trilostane "cold turkey" could really throw her glucose level out of whack. So if you can afford yet another ACTH test this soon, that may be what you need to do. Or at a minimum, perhaps ask that a baseline cortisol be drawn as well as a check of blood chemistries. If the baseline cortisol itself is lower than around 1.5, I would have even greater concern that Bug is being overdosed on the trilostane.

Marianne

[Jenny & Judi in MN]

Hi: my Jenny has diabetes & cushings. Big warning, in December 2011 she had an ACTH that was perfect (the post # was under 5), in January she stopped wanting to eat. I refused to consider her cortisol was low as it had been less than a month since we'd checked it. By the time we'd checked it she was at .2, Addisonian.

Whenever they won't eat, I would definitely look at the cortisol.

As far as insulin when not eating. If you have been checking her blood sugar you'd have a better feel for her specifically but the rule of thumb we use on the diabetes forum is if they eat nothing, give 1/4 the normal insulin dose for their basal needs. If they eat some of their food, give 1/2 the normal dose.

With Jenny, her dose is so small (1.25 to 1.5 units), I know .75 of a unit covers her basal needs right now.

Also, last January when she didn't want to eat and was trembly as her cortisol was dropping her blood sugar dropped to 40 several mornings. Lower cortisol meant lower doses of insulin. She went from needing 3.5 units to 1 unit which also should have been a huge clue to me that something was wrong.

Can you check your pug's blood sugar? When Jenny is feeling good she is the "old" Jenny. She will be 13 in June. But I've been where you are and it is so stressful. Hugs, Judi

don't forget, if her sugar goes low, give her some honey or corn syrup directly on her gums and radically decrease the insulin dose! low blood sugar is very scary. When their cortisol is raging high we don't have to worry about it. As the cortisol goes down, insulin needs go down, and hypo events are a very scary fact of life.

[BugsMum]

Thank you so much for all your information. I thought I was going to get thrown off the forum for too many neurotic posts.
We will see if we can get into the local general vet in the morn for an ACTH test.

We spoke to someone today (purely by chance) and turns out their dog had an adrenal tumor, and that they had been to the same two specialists that we have been to. They said that neither was overly forthcoming with info on medical treatments until she gave a firm ‘no’ to surgery.

I am very scared of the surgery, especially after reading a thread about Lucy the staffy who suddenly went down hill and passed away 5 or 6 days post-op.

However I am terrified of leaving that thing inside her. I have seen the images from the CT scan and in cross-section the width of the vena cava increases significantly where the thrombus is invading. You could see the areas around where the blood is squeezing through. I wonder how easily they can just pull it out (as they said they would do) when it has expanded so much widthways – surely this would increase the chances of some of it breaking off?

I had no idea Bug was on a high dose of Trilo, it seemed low to me, but then my mind was only comprehending 15mg doses, not the actual 30mg that she is getting each day.

The feeding / injection regime is a little more difficult to vary as we give the injection, and then 15 minutes later feed. We also can’t regularly check the blood sugar ourselves – we never bought one of those machines. Our vet said that they don’t provide very good readings and not to bother. We do get Blood Glucose Curves done regularly though. Do you have a blood sugar reading device in your home for Jenny? And do you find its readings to be reliable?

Thank you so much to everyone for your support with this. I read through the other threads and see the same questions being asked over and over, and think you must get sick of having to keep repeating yourselves each time for us newbies. But then amazingly you guys run through it again, each time, patiently and methodically outlining all the info for each new person, donating your time and knowledge – I am so lucky to have found this forum, you are a fantastic group of people.

Liz

[Jenny & Judi in MN]

Hi! We have all been where you are neurotic wise, don't ever worry about asking too many questions.

Because of low blood sugar issues, I don't give the insulin until after Jenny eats. I use a human One Touch Ultra Meter. Yes it reads a little lower on a dog than a human but it gives me an idea where she is at.

I've taken it in when we've done curves and compared a couple of times. When her sugar was higher (at 230ish, my meter read 180ish). As her sugar gets lower, it is more accurate.

I put off testing forever because she did not like it! Now that she gets bribed, she is better for the testing than her shot. Her blood sugar was scarily low for days last January when I was in denial about her cortisol being low. Her vet doesn't have as much faith in my readings as in his as it is not a controlled environment but he has gone with the flow and accepts my emails of readings now.

We did over 12 curves at the vet, over $1,200 in addition to around 8 ACTH tests at about $280 a pop. I love Jenny but am not made of money so testing at home saves money and stress to her.

Ask him if there is a chance of the tumor growing? That would bother me. It is a big decision but whichever choice you make, you are making out of love so that is the right choice period. Regardless of the outcome.

hang in there, Judi

[BugsMum]

Hey, Had a fairly unwell day today. To me it seems she has just not been right since she had the CT scan and commenced Trilo 3 weeks ago. The vet disagrees.

She wouldn't touch breakfast this morn, and we tried to give tablet, but was so difficult we stopped. So she missed her morn Trilo. We took her to the local vet, and of course she perked up and made us look like liars. She came home and had about 1/3 of her brekky.

We had them run tests, and the vet called me with the following results, all of which they said they were not concerned by. The white cells were elevated, glucose was a little high but in line with not having eaten, sodium was 134 (range 139-153) which they said means she is retaining too much water - I said she was drinking more so that may account for it. She just stands at the water bowl for ages drinking. Her chloride was out by one point, her resting cortisol was 79, canine specific lipase was a little high.

We just tried to have dinner, but I could only get her to eat about a third. I put the Trilo down her throat and then she had some more food. Maybe she is just sick of her food, because I could get her to eat a few pieces of the other dogs food. I know I am not mean to do this, but I just wanted her to eat.

If we had just not bothered getting that MCT ultrasound recheck, she would probably still be the happy dog she was. Maybe she had a reaction to the CT? I don't know, but all these symptoms (and other things e.g. vestibular episodes) started exactly 3-weeks ago. How can they be telling me it is more likely to be the tumor starting to affect her. The tumor has been growing for a while, these are sudden symptoms. Just makes me mad

[addy]

I understand why you are mad and dont blame you for being angry.

Were you able to get an ACTH test done? I think we are all concerned about her cortisol levels.

[BugsMum]

Hi again, Yes they told me that the cortisol measured 79 nmol/L. I have checked an online conversion chart that said to divide by 27.59 for the ug/dL rate, which then came to 2.86

Bug had some chicken at about midnight (4-hours after her scheduled dinner time), and then straight back under the table to sleep.
(I think I will join her)

thanks

Liz

[molly muffin]

Was that just a resting cortisol done or did they do the full ACTH that shows pre and post numbers?

It does seem very strange that she would not be eating (which is normally when taking trilostane a sign of too much being given)

Was the vet you took her to today, different from the one you normally go to?

Sharlene and Molly Muffin

[labblab]

Hi Liz,

I see that Bug's baseline cortisol reading was equivalent to 2.86 ug/dl, which would not seem to point to low cortisol as being the culprit. But unfortunately, I see that Bug did not have her morning dose of trilostane before the blood test was drawn. So this means that it had been more than 12 hours since her dose the evening before, and it also means that she was long past the time when the trilostane would have had the maximal effect on her system (the drug exits the body within 8-12 hours after dosing). So had she taken her morning dose, we might expect that the cortisol reading would have been lower and a more accurate reflection of the drug's effect.

So in the future, any time you anticipate having her cortisol tested via either a baseline or a full ACTH, you want to make sure she's had her trilostane 4-6 hours prior to the test.

Marianne

[BugsMum]

Hi Sharlene,

Yes, it was a resting cortisol. They did not do the ACTH.
The vet is her regular local vet, but she phoned the medicine specialist that we have been seeing. The medicine/surgery people are further away from us, so we get tests and other things done with our local vet.

It's 8:30am over here, and Bug has just refused breakfast again. Unfortunately our regime involves administering her regular insulin 15 mins prior to eating, so she has had her 7 Int units, and no food (also no Trilo)

[BugsMum]

I think we are going to stop the Trilo. She missed it yesterday morn, had it last night, and missed again this morn. I won't give her any tonight, and we will see how she feels. Maybe switch to Lysodren.
I think the surgery option is slowly slipping away from us.

[Buffaloe]

Even before your most recent post, I was thinking that you probably should at least cut back on the Trilo. Dogs are so resilient and I think it's very doubtful that Bugs is feeling punky as a result of the tests that were performed. Shiloh had a myriad of tests, ultrasounds, etc. and she was always fine a day later.

I fully understand your perhaps not wanting to proceed with the adrenalectomy. You need to do what you are comfortable with. Bugs knows you are doing your best. Seems to me you just want Bugs to be as happy as possible for the duration. Mom definitely knows best!

Ken

[Jenny & Judi in MN]

the majority of people give insulin after the dog eats. For tomorrow morning I would really urge you to change your routine so you can adjust the insulin if you need to. Low blood sugar can also make her lethargic if she is getting too much insulin and not enough food.

I forget do you test her sugar at home?

If you think she may be low, it never hurts to rub some syrup or honey on her gums. Low blood sugar can cause seizures and/or death. This is a big deal.

Judi

[Trish]

However I am terrified of leaving that thing inside her. I have seen the images from the CT scan and in cross-section the width of the vena cava increases significantly where the thrombus is invading. You could see the areas around where the blood is squeezing through. I wonder how easily they can just pull it out (as they said they would do) when it has expanded so much widthways – surely this would increase the chances of some of it breaking off?



Hi Liz

I specifically asked about this aspect of the surgery, they put clamps across the vena cava above the tumour and below, so that if any breaks off they can catch it. Flynn was also on blood thinners for a few days postop to prevent clotting. I saw Flynn's tumour on the CT as well, I think some of his problems preop was due to the blood squeezing past. When they took it out the surgeon described it to me as looking a bit like one of those Russian dolls, with the body in the adrenal gland and it had forced its way into the vena cava and that little bit looked like the head. He said it was firm inside vena cava not like a blood clot so it was relatively easy to remove intact. He sliced into the vena cava and then sewed it up at the end, he did not have to remove any part of the actual vein to get it out. I guess they will all be different though.

It is weird though, before he had the scan to diagnose this I did not think Flynn was acutely unwell. But I swear he started going downhill after the scan, but he did have to take some hefty BP pills to stablise that before surgery. So I think the meds they have to take really affect them. It is hard to say what is due to tumour and what is due to medication.

I wish Bug had had the cortisol test at the right time as Marianne said, so we would definitely know if she was going too low which would cause her symptoms. Plus if she is not eating and her sugars are a bit haywire that will not be helping either. I hope she perks up and feels more hungry now that the med is stopped. Please let us know how she is going...

Thoughts are with you at this very trying time
Trish xxxxxxxxxxxxxx

[BugsMum]

Hi Judi, The vet had told us to give the insulin after to give it time to kick in, but you are right – if this is going to happen, then we are going to have to change this. Unfortunately I did not do that tonight. I gave it to her in advance again, and on advice from the med vet I continued with the Trilo (I don’t know why). So of course Bug refused her dinner, including chicken! I wonder if she thinks we are poisoning her and that’s why she is refusing (she is probably right). All she would have was a couple of pieces of the other dogs food. That was 8pm.

It’s now 11pm and I took her out to toilet, and she was limp in my arms. She normally puts her paws around my shoulder, but she just curled them up. I read what you wrote about a low, and put some honey on her gums, and let her lick some off my hand, but she wasn’t too interested. Out of desperation I gave her 25 pieces of the other dogs food (Hills Adult Large Breed).

Hi Marianne, I think we were just desperate for answers, I know it was not the ideal timeframe for the cortisol test, but there was the chance that there could have been something else wrong…
Just noticed that my mum has picked up the test results from yesterday. Interesting that the last page says “patient may have pancreatitis and serum Spec cPL should be re-evaluated”. They did not tell us this yesterday!

3-weeks ago I had a happy healthy dog, and now I have made her incredibly sick by trying to “help” her. We are booked into see the med vet again tomorrow (I don’t know why we are bothering) because he is concerned about the sodium level. I personally think he told us to come see him because he thinks we are anxious and the dog it fine.

We are booked in with a different vet on Saturday – very caring lady that used to look after Bug, but moved out of our area. Maybe she can help us.

[BugsMum]

Just flicking through more of the test results now and noting a couple of results that are outside of standard ranges...(aside from the ones I mentioned yesterday)

Urea, 21.7 mmol/L, (3.3 - 6.8)
ALP, 240 IU/L, (1 - 150)
ALT, 156 IU/L, (16 - 90)
Platelet Count, 546 x10^9/L, (200 - 500)
WBC, 19.1 x10^9/L, (4.5 - 17)
Neutrophils, 13.4 x10^9/L, (3.5 - 12)
Monocytes, 2.1 x10^9/L, (0 - 1.1

[Jenny & Judi in MN]

I'm so glad you gave her the honey and got her to eat something! My vet says the hardest thing with diabetic dogs is the ones who don't want to eat.

Please don't beat yourself up. You are working hard to get her better. My Jenny did get better. This morning she woke me up throwing her stuffed skunk at me because she wanted to play. So it can happen. Hang in there! It is a lot of information to take in and coordinating the 2 diseases is a little trickier than just one.

hugs, Judi

[BugsMum]

At the vet now, we have a ruptured gall bladder and a lesion on the spleen. Have to have emergency surgery tonight, prob in about an hour. So then have to wait on recovery time for this surgery before even considering adrenalectomy, and who knows how much tumor will have grown by then

[BugsMum]

... if she makes it through this surgery?? Nothing seems to go smoothly for her - ever, so I am expecting further issues

[Trish]

OMG poor Bug, poor you. What a time you have been having. How on earth can that happen when ultrasound was good for gallbladder... well at least she can do without those two organs if they have to go. No wonder she hasn't been wanting to eat. I feel so bad for you guys... I will be sitting here on tenterhooks waiting for news. BEST OF LUCK FOR BUG!!!!!!!!!!!!!

Trish xxxxxxxxxxxxx

[Jenny & Judi in MN]

poor bug! how is she doing? fingers crossed that for once there are no issues!

and since she is on cushings meds lets hope the tumor does not grow.

hugs to you and bugs. what a time you have had! Judi

[labblab]

Oh, I am so sorry to hear this news!! I'll be holding you all in my thoughts and hoping that all goes OK.

Marianne

[addy]

We'll try to stay positive and be with you all day. Hoping and praying all goes well.

[Squirt's Mom]

I am so sorry to hear this! How scary! Please let us know how sweet Bug is doing when you can and know we are with you every minute, holding your hand.

Sending prayers and healing white light,
Leslie and the gang

[SoggyDoggy]

OMG, thought's, love, prayers, everything coming your way. Poor Bug, on top of everything else!

[Boriss McCall]

Oh no! I am so sorry.. Poor Bug! :(

[molly muffin]

Oh no!! HUGS! Come on Bug, you can do this!
We'll all be staying very positive and hopeful. Our thoughts, prayers, all good will are with you and little Bug.

hugs,
Sharlene and Molly Muffin

[Trish]

I am so hoping no news is good news. Just got up to check how things went for Bug overnight. Healing thoughts and hugs coming your way!
Trish xxxx

[molly muffin]

I know, I need to pack, but I keep checking in here on a couple of the threads that are worrying me to bits today.

Hoping Bug came through okay!

hugs,
Sharlene and Molly muffin

[Tina]

I am so sorry to hear this about Bug. I have been thinking about you both all day and am hoping that she is doing ok. Sending love and prayers your way.

Tina and Jasper

[scoora]

I just read Bug had to have emergency surgery. I'm so sorry to hear this. I hope everything went well. How is she doing?
Big hugs to both of you.

[frijole]

Sending love and warm thoughts! Kim

[BugsMum]

Hi everyone, thanks for your caring messages and prayers. Bug came through the gall bladder removal surgery and is still in hospital. It’s been just over 24 hours now, so first milestone passed. The vet nurse we spoke to tonight said that she worried for at least 72 hours post-surgery about blood clots in cushings dogs, so we are not out of the woods yet.

We asked about the use of blood thinners, and they said that as this was an emergency they had no time. They said they would use them if she goes for the adrenalectomy. Interestingly the first specialist centre we were at said they would not use them, as they had no facilities to monitor them – I thought the first centre were the better equipped centre, but it seems I was wrong

Her blood pressure was low after surgery, but is now 160. They said they were having a little difficulty getting her to eat, but tonight she had a bowl of chicken, so they gave her the full insulin dose. Her glucose was 23.7.

They did not end up taking her spleen while they were in surgery, as they did not want her anaesthetised for too long, however they took an aspirate of the lump on the spleen. Also the surgeon was able to take a look at the adrenal gland and vena cava. This is not the surgeon that would be doing the surgery though. She gave us some info about it… She said she manipulated the vena cava a bit to get a feel for what the thrombus was like. It has not adhered to the walls of the vena cava, and is fairly free moving, so she feels this is a good thing for if we go ahead with the surgery.

Sorry for not posting sooner. We have just been sitting around stressing. We stayed at the clinic until the surgery was over, and then went home, but stayed up all night in case there was a phone call. We are phoning the clinic about every 6 hours to check on her. My mum is making the calls and says she can hear little Bug in the background panting – it’s not the same here without her : (

[Squirt's Mom]

Still with you, still praying for the best, still keeping you both in my thoughts.
Hugs,
Leslie and the gang

[BugsMum]

Thankyou Leslie!
I miss her so much.

I also wanted to post a quick message about Trilostane on here - for anyone in the Brisbane (Aust) area who is buying their supply from their vet, I have been told of a cheaper option. Please send me a private message and I will pass on details

Thanks!!

[SoggyDoggy]

As you say, first hurdle cleared, that's positive! Just know that there's lots of people here still thinking of you and waiting nervously right alongside you. Some good news too re the potential vena cava surgery, doesn't sound as bad as it could have been.

Hang in there.

[BugsMum]

Thanks Naomi, she has just had such a bad run of luck lately, although finding the gall bladder in time is lucky I guess.

Just another thing I wanted to post, in case it helps anyone else...
The gall bladder issue was a complete chance finding. We knew she was sick, and we told the vets that, but they said the test results were not too bad. She did flinch when they examined her abdomen, but they still were not troubled by this. The only reason the gall bladder thing was discovered is because I let her pee before I took her in for her vet visit on Friday, and so because of that they could not get her to give a sample - they then had to use ultrasound to take it via syringe. And then they discovered the gall bladder. They said is was Gallbladder Mucocele - "overdistended gallbladder filled with mucoid or clear and watery content"

Signs and Symptoms:
"Clinical signs associated with gallbladder mucocele are often nonspecific and vague and, in some cases, a mucocele is discovered incidentally. Decreased appetite, anorexia, lethargy, vomiting, diarrhea, and abdominal pain or splinting have all been associated with gallbladder mucocele."

"...high risk of eventual rupture and subsequent development of bile peritonitis"

[SoggyDoggy]

Well then, here's to peeing before the vet! :):)

Poot little mite, she's been through so much and still got a battle ahead of her. It just goes to show what a little champion she is then!

Keep us updated, lots of people in your corner.

[labblab]

Wow, so relieved to hear that Bug is safely out of surgery!

And since I'd never heard of a gallbladder mucocele, I just Googled it and am surprised to learn that recent research suggests greater vulnerability among Cushpups. So this is one more issue that we may need to be more vigilant about around here, and little Bug will be the pioneer who taught us about it!

http://www.acvs.org/AnimalOwners/HealthConditions/SmallAnimalTopics/GallbladderMucocele/

Surely hoping that she keeps on improving throughout the day!

Marianne

[Jenny & Judi in MN]

hope she improves so you can bring her home soon. hugs, Judi

[Squirt's Mom]

Oh, we must have been posting at the same time this morning! I hadn't read your post when mine went through. I cannot tell you how relieved I am to hear our sweet Bug came through the surgery and is doing as well as she is today! :cool::):cool: That is just wonderful news!

You only call every 6 hours? You are doing much better than I did when Squirt had a tumor and part of her spleen removed. I called the hospital soooo often they finally told me that they would call me at certain times of the day and give an update. In other words, "go away, lady, you're bugging us." :o:p They didn't ban me from the clinic, tho. ;):D I don't think I will ever forget the all consuming terror of that time or the fear that sat like a monolith on my chest every second of those days. While she was in actual surgery, I sat in the waiting room with tears flowing, my chest hitching and constricted, my heart FLYING up into my throat every time the door to the back opened. When they finally told me it was over and she was awake and alright, my body felt like a marionette who's strings had just been cut yet my Heart soared free with relief and gratitude. So I have full empathy for you and Bug.

I couldn't have made it through that time with Squirt with my sanity in tact (well, as much "in tact" as it ever is! :D) without our family here at K9C. They stood by me even when I was spazzing at my worst, they held my hand, and pulled me down off the walls over and over again. We are here for you, too, all the way. Just reach out and you will find many loving, caring hands ready to steady you and hold you up. You and Bug are not alone, never alone.

Hugs,
Leslie and the gang

[addy]

Hurdle number one for Bug a boo, so glad to hear she is in recovery, we are still with you and Bug.

((((((((((((((((((((((((((hugs)))))))))))))))))))) )))))))))))))

[molly muffin]

Yay. So glad to hear Bug came through!! My heart is with you and Bug.

Hugs
Sharlene

[Trish]

Hurraaaaaaaaaaaaaaaaaaaaaaay!!! So pleased to hear this today! You must be so relieved she is past first hurdle. Good to hear about the vena cava issue that it is looking ok to operate if you go down that path. Such a shame it could not all be done in one go, but I have read that adrenalectomy done with other abdominal surgery at the same time is more risky so better to be safe in that regard. Hope you get to spend time with her today. She is going to be feeling so much better with that nasty gone. Fingers crossed the splenic biopsy is just an aging spot. Flynn had one of those to and they were not concerned about it. Healing thoughts continuing to be sent over the Tasman for Bug!!

Trish and Flyn xxxxxxx

[SoggyDoggy]

Hi Liz,

just checking in to see how Bug is today, hopefully still going well. Also hope you aren't in the path of any of the flooding or cyclone winds! take care and let us know when you can how everything is going.

[Skye]

so glad to hear things are going okay. paw hugs and belly rubs

[scoora]

I am so glad to hear the surgery went well. Hopefully Bug will be back home with you real soon. Please keep us updated on how she is doing. Big hugs to you and Bug.

[BugsMum]

Hi everyone, thank you for the support!! We have phoned the hospital a couple of times today and she is doing ok. They will be taking her off fluids tonight, and she has already been taken off the iv-pain killers – now on a patch.

Hey Leslie, yes the 6-hours is hard to stick to (we would phone every 5 mins if we could) but as you said, we don’t want to get the “go away” reaction from them. We freak out every time the phone rings, in case it is the vet.

Unfortunately we have not visited today, for a couple of reasons: She would be so upset when we then go to leave, and the other reason (as Naomi mentioned) we are having a cyclone at the moment. It is expected to peak tomorrow, river will be up by 2.5m, so we may be flooded in and unable to see her or pick her up. We were due to collect her tomorrow, but have not had this confirmed. I am thinking at this rate it will be Tuesday. The winds are pretty rough at the moment, and we can even feel a breeze through the closed doors.

[scoora]

Hi Liz-Thanks for the update on Bug. So glad to hear she is doing OK. Hopefully you will be able to bring her home tomorrow. Take care and big hugs.

[Boriss McCall]

Hi Liz, i am so happy for you & Bug. I hope she gets to come home to you soon.;)

[Tina]

Me too Liz, so happy to read this! I hope your weather settles down so she can come home tomorrow as planned.

Big hugs from me and Jasper. :)

[SoggyDoggy]

I hope your weather settles down so she can come home tomorrow as planned.

Me too! the reports we are seeing is that Brisbane is due to be hit tomorrow, I just hope your not in the path! Let us know when you can that everyone made it through ok and lets hope they give the Bug back sooner rather than later. I hope at least one of the vet staff stay round the clock?

I feel sorry for you guys over there, hit badly with floods in 2011, and now already the insurance companies are declaring the entire state a disaster with the next lot of flooding! Not nice :(

Well I'm glad at least that Bug has made it through another day. What a trouper ;) Thinking and worrying about you, take care and batten down those hatches.

[frijole]

Holy cow a cyclone? You take care of yourself as well as little Pug ok? Thanks for the updates. Kim

[molly muffin]

Cyclone! You stay safe now and out of any rising flood waters.
Glad that Bug is continuing to do well and recover from this ordeal.

Hugs,
Sharlene and Molly muffin

[BugsMum]

Bug's not doing well. We are at the vet now. They have given her a "guarded to poor prognosis". She has a clot in the lungs, pulmonary thrombo embolism. She was doing well until 7am eastern standard time this morn, and then had difficulty breathing. She is in a cage with oxygen, and at 4pm they are going to give her an hour in a hyper-baric oxygen chamber.

We have had a couple of cuddles but don't want to upset her too much. She squeaks and wags her tail with us there, but vets are concerned that she will expend energy on that rather than breathing, so we are taking a break. In consult room using vets internet. We have lost power at home, so no internet. Time here is 11:50am

[Jenny & Judi in MN]

praying she pulls through this. hugs, Judi

[molly muffin]

Oh no I hope that Bug pulls through. :( How long till they will know if the crisis is over? I am glad that you are there with Bug, even if you can't spend a lot of time with her at the moment.
Keep us updated, we'll all be anxiously awaiting news.

hugs,
Sharlene and Molly Muffin

[Tina]

Oh Liz, sending love, hugs and prayers for you and Bug. I am so glad you are there with her too.

Tina

[frijole]

Sending much love and strength to you and dear Pug. Kim

[Boriss McCall]

Liz I will be saying a prayer for you & Bug to pull through this. hugs

[scoora]

Liz-I'm so sorry to hear Bug is not well. Saying prayers she will come through this just fine. Hugs to you both.

[Trish]

Oh no, so sorry to hear of this latest setback... C'mon little Bug, you can do it!! Hope she has settled over the day. Gosh right in the middle of your awful weather, I saw it on the news tonight and does not look good... sending prayers you are all safe and Bug is feeling better
Trish xxxxx

[SoggyDoggy]

Liz, sorry to hear of Bug's new challenge. She is a fighter though so we will all keep cheering her on. Been thinking of you all day as I watch the news coverage of the floods, I'm just hoping the clinic is on high ground.

Prayers and best wishes heading your way in a constant stream!

[Squirt's Mom]

Holding you all in my thoughts and prayers.
Hugs,
Leslie and the gang

[gummysmurf]

Hi Bug's mom, just reading through this thread. I have my fingers crossed for you and little bug.

[addy]

Rooting for sweet little pug. We are all here with you, you are not alone.

[molly muffin]

Just got home from work and I'm checking in! :( Was hoping to hear some good news about Bug.

Know we are all thinking of you and Bug!
hugs,
Sharlene and Molly Muffin

[BugsMum]

Hi everyone, thank you for checking in on us. Bug has made it through the night. I am confused, tired, and angry. The gall bladder had not burst, and there were no thin patches where it was about the rupture. I don't know what the fluid is that the vet said he saw that made him think it had already ruptured. The surgeon said it looked very bad, but not ruptured. We could have treated this with intravenous antibiotics and none of this would have happened.

Yesterday they put her on plavix (*spell) to help thin the blood and help the clot. They initially suggested heparin, except that my mum freaked out and said 'NO! you don't give that after surgery, it can make the patient bleed out', which they agreed was risky. I wonder if people like my mum didn't ask these questions, would they just have gone ahead and used heparin and potentially killed her?

We are headed over this afternoon to see her. We stayed at the clinic all day yesterday while she was touch and go. Left around 6:30pm when she had stabilised.

If we had never had the MCT recheck ultrasound in December, and never known any of this, we would have a happy, healthy dog. I am sure there would be symptoms down the track, but she would not have suffered like this

[molly muffin]

Oh my god! That is terrible! I'm so glad to hear that Bug is still fighting. She is a fighter.

Hang on Bug, keep fighting!

I know this is just so heart breaking for you to go through with her. The unnecessary part is just heart breaking.

Hugs, my heart just breaks for you and Bug

Sharlene and Molly Muffin

[scoora]

Hi Liz-So glad to hear Bug made it through the night. She is a little fighter. So sorry you and Bug have to go through this especially since it wasn't necessary.
I understand you being confused, tired and angry. Praying Bug will keep improving and she will be home with you real soon. Please keep us posted on how she is doing. Hugs to you both.

[milosmom]

sweet lit'l bug we are all watching and praying over you.....much peace to your mom and family...patty(milo)meka xoxox

[molly muffin]

Have I mentioned how totally cute Bug is! I love her photos!! Want more please LOL
I love seeing pictures of all the little furbabies we have. I swear we have the cutest ones in the entire world!

hugs,
Sharlene and Molly Muffin

[milosmom]

and yes sharlene i will agree.....our babies are the cutest ever !!! xoxoxpatty(milo)meka xoxox

[SoggyDoggy]

Soooo glad she made it through the night, I was really worried about her, poor thing, and worried about you too! Looking at the damage in Ipswich, Bundaberg etc and hearing that Brissy was going to get damage too, I was really panicking that you guys or the clinic would get caught in it!

I totally agree with the anger, I would be furious and steaming at the ears with what they have put her through unnecessarily! But she is a little fighter. Give her kisses and cuddles from all of us here and take care. We are with you 100% and will keep checking in frequently. (Actually, I think the number of responses you got in such a short space of time is testament to how worried we all are and keep hoping for news :o)

[Trish]

Phew, another day of recovery over. Good news, not so good to hear it had not ruptured, but it certainly sounds that the GB is better out than in. Hang in there Mum and family, sounds like she is going to do well with all of you watching over her! Flynn was on anticoagulants after his surgery, but they weren't Heparin, he was on Fragmin a bit different as he was lucky that no clot travelled. I guess it is a fine line between wanting the clot not to travel and also to prevent bleeds. Hope she continues to recover each day bit by bit. Hugs to you all
Trish xxxxxxxxxxxxxxxx

[Squirt's Mom]

Oh. my. word. :mad::eek::mad::confused::mad::( Talk about a flood of contradictory emotions and reactions. Relieve, dumbfounded, angry, confused, frustrated....and oh, yes, more anger! Did they give you any idea, any answers, as to why she collapsed like she did? If the gall bladder is that bad, why in the world didn't they go ahead and take it while they had her open? Oh, honey, I am so so sorry that sweet Bug was put through this, that you were put through this; how awful for you both. :( I am very glad your mom was there to yell about the heparin! I wouldn't have had a clue that would not be a good idea so you give her an extra hug from us. ;)

Let us hear from you as you can and know we are standing right by your side.
Hugs,
Leslie and the gang

[labblab]

Hi Liz,

I don't know if this will be any comfort to you, but this recent article from the American College of Veterinary Surgeons suggests that it can be fairly risky to take a "wait-and-see" attitude about a gallbladder mucocele. Their recommendation is to go ahead and remove the gallbladder and not risk waiting for a rupture or for the possibility that medical management will fail:

http://www.acvs.org/AnimalOwners/HealthConditions/SmallAnimalTopics/GallbladderMucocele/

This doesn't help your worry over the blood clot, that's for sure. But maybe it will make you feel better about the benefit of having gone forward with the surgery and the removal.

Marianne

[Boriss McCall]

Keep fighting little Bug! Hope today is a good day with lots of improvement.

[addy]

How hard for you, I would be bonkers by now. We all keep praying for sweet little pug. Fight on Bug a Boo so you can come home to mommy soon.

We are all still holding you both close.

[gummysmurf]

Yay yay yay!!! Go bug go!!! I know you're not out of the woods yet but woohoo! So glad to see that you're doing better!

Bug's mom, ask for answers definitely, but do NOT second guess yourself or blame yourself in any way. You are little bug's champion and you have been fighting fighting fighting for him and he knows that. You are doing your best and it's far more than many people would do. Be strong, hand in there, we are all beside you in spirit!

[SoggyDoggy]

Hi Liz, just checking in to say still thinking of you all. Hope things are continuing to improve and that you will be able to get the Bug home sooner rather than later.
Take care.

[Trish]

HI Liz

Hope Bug has had another good day of recovery, still thinking of you two. Get Well wishes to the little Love Bug Pug :)

Trish xxxxxxxxxxxxxx

[BugsMum]

Hi everyone, thank you so much for so many supportive messages. Sorry I have not posted very much, we have only just had the power come back on this morning, and I had only been able to post at either the vet clinic or at work.

We visited Bug yesterday afternoon, and were absolutely shocked to see the vet bring her out in his arms. Could not believe she was able to be out of the oxygen cage. She had improved so much overnight (possibly the aid of the hyperbaric chamber sessions). The med vet was surprised she made it through. She just looked so bad the other day. We spent a little time with her before the vet came to take her back – she started shaking and squeaking – she thought she was coming home with us.

Today’s update: Bug had another session in the chamber, and we went to pick her up this afternoon to bring her home. She was panting quite a bit (a little raspy), and scratched at the consult room door – demanding to go home this time. We arrived home and shortly after the panting stopped. We have been home for 3-hours now, and Bug has been looking for food. She has actually been barking at us, which she has not done for many days. Her bark sounds different, but that may be because she is sore still. She is on a pain patch for a couple more days.

Marianne, thank you for doing some research for me. Yes this does comfort me, and seeing her at home and happy makes me realise that the Gall bladder removal was for the best. I just wonder what caused it – whether it had anything to do with the trilostane?

I think given all that has happened, we are putting any thoughts of further surgery on hold for the moment. I spoke to someone who said to me that the cushings should be very very well managed before going for surgery, and I don’t think we are at that stage yet.

If anyone is curious… this little adventure has cost $7,000. I am not saying that I love parting with this kind of cash, but to me she is worth every cent.

Again, thank you everyone for the support. Your messages and information have been so valuable to me. Being in touch with people going through the same sort of thing, and having the same values is so comforting. I don’t think we are out of the woods yet, and I am terrified she will have another clot (they explained that this is a possibility), but we will take this day by day for now. Just happy to have the family back together.

[addy]

I am so glad Busg is home and I send love and prayers for her continued improvements which I know will happen because she is finally home with her mom.

Dont think about the money, it will work out. My co worker just spent $3000 on sugery for his kitten and she was only in hospital 1 day:eek:

Love and hugs and continued prayers for Bug a boo.

[SoggyDoggy]

Oh Liz, I am just stoked she has made it through this far and is home with you finally! She is a fighter for sure! And the fact that she is asking for food has to be a good sign.

Best wishes for continued recovery, and now that you have power back, we hope to hear the updates as they happen :D

Take care.

[labblab]

Oh Liz, I'm THRILLED that Bug is home!!!!!!!!!!!! :) :p :D

As for what caused the mucocele, I've now read that Cushing's dogs may be at heightened risk (not sure as to why, but there you have it). So if anything, I'd guess it's the Cushing's that caused it and not the trilostane.

Marianne

[scoora]

Liz-That is wonderful news. So happy to hear that Bug is home with you and seems to be doing well. Please keep us updated on her continued progress.
Big hugs to you and Bug.

[Boriss McCall]

yay! that is so great that Bug is at home & on the mend.

[Squirt's Mom]

Hi Liz,

I am SOOOO glad Bug is home and seems to be doing better. Home is where the magic is, for sure! I am also glad to know I misunderstood and they did take the gall bladder. That is a relief to me.

Bug is so lucky to have you on her side, fighting tooth and nail for her all the way. You are a great mom! I hope Bug continues to improve with each passing hour and she is soon barking her head off! :D

Hugs,
Leslie and the gang

[molly muffin]

This was the best news to come home today. Bugs is Home!!!! Exactly where she belongs, where she feels safe and is happy.
Stress of being in the hospital or even at a vets can cause excessive panting. Some just seem to really get upset to be in those places.
Can't wait to hear how she continues to improve.

hugs,
Sharlene and Molly Muffin

[Trish]

Yay, she is home! So pleased to read this. Hoping today has brough lots of rest and recovery for you all.

Flynny's bark was a bit muted after both his ops, I think most likely due to the breathing tube during surgery. Or else he was barking with the other dogs, sure seemed to be a bit of a racket at times in there when they all got going. :D It came right after a few days.

Glad she is doing better Liz :)

Trish xxxxxxxxxxxxxxxx

[SoggyDoggy]

Although Oscar only had knee surgery (sooooo easy in comparison) I do remember his voice was raspy and he would cough a bit for a few days, as Trish said, it was the breathing tube during anaesthetic, so it should clear up in a few more days.

Meanwhile how did she go today? Hope all continues to go well.

[BugsMum]

Hi all,

Everything seems to have gone ok today. We have not eaten all our dinner, but then she has been snacking a little through the day. I will have to put a stop to this. She has retired to her spot under the table for now - this is a fairly recent night-time sleeping spot, which I now associate with her being unwell, so of course I panic when she heads in that direction. We checked her so many times last night to see if she was still breathing. Just being super cautious at the moment.

It is great hearing her little bark, even though it is slightly off pitch.

[SoggyDoggy]

Glad to hear she is going well Liz, and snacking through the day isn't a bad thing at the moment. Means she is eating well without putting to much pressure on her tummy. Keep up the great efforts and give her lots of smoochies from us! :D

[BugsMum]

I spoke too soon didn't I. She is now having another vestibular episode. Eyes are scanning back and forth. She is kind of staggering about looking confused. I call her in one direction and she goes in another. I guess that spot under the table really is her sick place.

So in order we have had Diabetes, MCT, Cushings, Vestibular Disease, and Gall bladder issues.

[BugsMum]

I was reading through some of the forum posts before, since Bug was doing a little better I thought I might be able to read other people's posts and possibly offer support and advice. I am way too new to this to be able to do that. It makes me realise how little I know about all this. There is still so much to learn

[labblab]

Dear Liz,

I am so sorry that Bug is having trouble again today! But I just want you to know that "Support" is the first word in our forum motto for a reason -- that is the most precious gift that any of us have to give one another. And there is no learning curve whatsoever for that -- you've already got that one totally covered! I know that the replies that you've already written to others are so appreciated by us all! So please never, ever underestimate the help you have given us simply by telling us that you're here and that you care. I think that's the very best medicine of all!!!!

Sending tons of hugs to you and your sweetie,
Marianne

[Squirt's Mom]

Ditto to what Marianne said! :) You can't know what it means just to have someone read and respond to these stories. Just to know we are not alone means more than any scientific explanation could. Aaannnd, you and Bug have had some rather unique experiences that you can share with others who may be facing the same things. That personal experience helps form the backbone of K9C. ;)

Vickie, we are just gonna have to sit Bug down and have a heart-to-heart. We gotta let her know that this is enough, no more surprises, no more trying to make Mom batty with worry. She has done a really good job of keeping us all on our toes so she can take a looong break now. :D

Keep up the good work!
Hugs,
Leslie and the gang

[addy]

Checking in on Bug and sorry to see she is not feeling too well today.

Sometimes, just a hug and a hello helps someone a lot so never underestimate your contribution to this forum. Telling Pug's story is also a sincere contribution.

You've been through a lot and dont worry about posting on threads.:) :)

Hang in there, take it a day at a time.

[molly muffin]

Oh no, poor little Bug. Hopefully this is something that as she gets stronger and recoups from the surgery.

holding you guys close in my heart
hugs,
Sharlene and Molly Muffin

[scoora]

Liz-Sorry to hear Bug is still having some problems. I know all too well what it's like, one thing after another. Just doesn't seem to end. Scoop had two vestibular episodes last summer. With the first one he got the head tilt and his head never went back straight.
Hope Bug is feeling better.
Hugs to you and Bug.

[SoggyDoggy]

Hi Liz,

Just checking in to see how Bug and the family are doing today. Hope today was better than yesterday.

[molly muffin]

Good morning! I hope Bug is doing okay and have a good night with no more scary episodes!

Thinking of you,
Sharlene and Molly Muffin

[scoora]

Liz-Hope you and Bug are having a good day.
Hugs

[Trish]

Hi Liz

I hope Liz has come out from under the table, she must think it is her own little den and feels safe in there. I can tell if Flynn is feeling unwell, he goes and sits right in the garden on top of all the plants and I always worry when I see him doing that, we know our babies so well don't we. Others think he does it when he is hot and trying to cool down, that is a possibility but does not stop my worry wort ways! :)

Looking forward to the next update, wondering if you took her in for a checkup? Or if she has got over the wobbles?

Trish xxxxxxx

[molly muffin]

I really hope that Bug is doing okay and on the road to a full recovery from this surgery.

Thinking of you,
Sharlene and Molly Muffin

[BugsMum]

Hi all,

Thanks again for the messages.

Vicki, sorry to hear about Scoop’s permanent head tilt. Do the vets know what brought it on? Bug had never had anything like this until 2-days after the CT scan. It made me wonder whether she was allergic to the contrast dye?

We went back to the vet yesterday and they gave her another session in the oxygen chamber. She just wasn’t herself the night before. As well as the vestibular episode, she was limp like a little ragdoll. The vet also gave us some strong anti-nausea drugs to help Bug eat.

Today she is just very tired. Is not eating her full meals, and is going to the toilet a lot. I think it may be hurting her to toilet, so just goes a little bit each time rather than strain in one go. It’s Saturday night over here and I am at work trying to catch up. I added up how much time I spent at work last week, and I think it totalled about 2.5 days because of time off for vets. I think I need to employ a dog-carer : )

[scoora]

Liz-Sorry to hear Bug isn't feeling quite right. Hopefully she just needs some time to rest and recoup.

Last July everything just came crashing down for Scoop. He had infection in both ears and both eyes. Went on meds. A few days later he had a vestibular episode. Vet said usually head tilt will right itself after a bit of time. Never did. She talked to Neurologist. He said some don't. Vet said could go to Neurologist and get MRI or Dermatologist and have a procedure done to check for tear in eardrum. Didn't know what to do. In the mean time Cushing's symptoms started. She had me flushing his ear. She did something with his ear and the next night he had another Vestibular episode. I think it might have been from her playing around in there. He also had an ulcerated ear. Treatment for that. Then tested for Cushing's. Vet did a betadine test to look for tear in eardrum, negative. So mid Nov had MRI done. Saw his pituitary tumor, which is fairly large, and also showed he had something in his left ear canal. Had the surgery to remove ear canal. Turned out to be infection, not a tumor. 50-50 chance head tilt would go away but it didn't. So can't be sure if infection was in there back over the summer and that's why the head tilt or if he's one of the few who didn't straighten up after Vestibular episode. Sorry it's so long didn't know how else to explain it. So much went on.

Take care of little Bug and give her a big hug from me and the Pugs. Hopefully she'll feel better soon.

[Trish]

Awww poor Bug, is she straining to poop or wee Liz? Takes a while to come right after surgery alone, let alone with her complications and ongoing health issues. Hope she is feeling better today and you all got some good sleep last night xxxxxxxxxxxxxxxx

[addy]

Kisses for Bug, hugs for you. Feel better Bug

[Harley PoMMom]

The anti-nausea drug could be making Bug constipated. Maybe adding plain pumpkin to her diet would help. Sending huge, loving and healing hugs, Lori

[Trish]

HI Liz
How is she doing, getting worried to not see an update, but I am a worry wort! Hope all is well with little Bug
Trish xxxxxxxxxxxxxxxxxxx

[BugsMum]

Hi everyone,

Sorry for being slack, have just been so busy trying to catch up on work and look after the little one. She isn't doing all that great. She is even more lethargic and not wanting to eat than before the gall bladder surgery.

She is stumbling about unable to find things (e.g. the eater bowl) - speaking of water, I think she is drinking a little less, but constantly wanting to go out to the toilet.

She has skipped her trilostaine for the last two mornings, and I failed to give her the dose tonight because it fell apart - some went in her mouth, but most went on me.

She is lethargic and floppy, she feels like a dead weight when I pick her up and she doesn't try to hang on.

On a side-note, I will do a search on the forum, but wondering if anyone has used this drug: Mifepristone?

"Mifepristone is the same compound found in certain “morning after” pills. Another ability of this drug is to make the body resistant to the effects of cortisol. So it has been used to counteract the effects of excessive cortisol produced by the adrenal tumor (AT) form of Cushing’s disease. It could, conceivably, be helpful in the 15% of dogs in which tumors are located in the adrenal gland but which were found to be inoperable for one reason or another."
http://www.2ndchance.info/cushings.htm

[milosmom]

so sorry your litl bug is not well,it is sooo heart breaking to watch them.i haven't heard anything about that drug but i am so sure there will be others to join and that can possibly help you with an answer....sending you xoxox patty(milo)meka

[scoora]

Liz-So sorry to hear Bug is not doing well. What does the vet say about the way she is? Hope tomorrow is better for little Bug.
Big hugs and prayers for Bug and you.

[molly muffin]

Oh dear, so sorry Bug hasn't been feeling well. :(

I don't know anything about what results have been had with Mifepristone.

Hugs,
Sharlene and Molly Muffin

[SoggyDoggy]

Hey Liz, was just checking in to see how Bug was going in the last two days, any sign of a pick up at all? Poor little thing, been through so much.

Sending thoughts your way.

[BugsMum]

Hey,

Bug has been having her ups and downs over the last few days. I was happy that she ate all her dinner the other night (maybe it was last night?), but she would not eat tonight. We normally eat and inject at 8pm, but it didn't happen until 11pm, and then she only ate a tiny bit.

Had been having on and off vestibular episodes and has been drinking and peeing constantly. A friend gave me some anti-nausea tablets for her (they dissolve on the gums) but I accidentally left them at work : (

We are heading to the vet in the morn for the gall bladder suture removal, I'll bet Bug gets super excited and looks well (as usual) - maybe I should film her and show the vet, so they know what she is like 99% of the time.

[Squirt's Mom]

Filming is a good idea! Tash would act so happy and full of energy at the vet's yet be so out of it at home. It helped them to see what I saw. ;)

Let us know what they say!
Hugs,
Leslie and the gang

[molly muffin]

I think that is an excellent idea to film Bug. They do act completely different when out and about compared to the place they feel most comfortable and like being their real selves. Good luck tomorrow!

hugs,
Sharlene and Molly Muffin

[NoonelovesmelikeNorman]

Happy to hear YO is doing a bit better...how scary some of those days must have been. Wishing Yo the best at his vet visit. Praying he will find what is needed to bring him back to his spunky old self. Also wishing you strength and peace as you journey with Yo.

Hugs and Love,

Sharon, Norman and Millie

[Trish]

How did Bug go at the vets, hope the sutures came out with no fuss. Did they say anything about the ongoing lethargy, vestibular episodes? I have not had experience with that drug either, hope the vets clarified its use for you. Is she is feeling better today?

Trish xxxxxx

[molly muffin]

checking in on you and Bug! Hope the vet visit goes well.

hugs,
Sharlene and Molly Muffin

[addy]

Saying hi to you and Bug

[Trish]

Gosh we haven't heard from you in a long time, would love to know how wee Bug is doing. Hopefully we will have good news soon.

Trish xxxxxxxxxxxxxxxx

[SoggyDoggy]

Great minds Trish!

I too was wondering how Bug is going Liz - which is actually why I logged on today :D

Hope things have calmed down for you and the precious girl is starting to get some spark back in her. Take care.

[scoora]

Hey Liz-How is little Bug doing? Hope everything is OK!

[molly muffin]

hmmm, yes, where are you Liz? Hope Bug is doing okay. Drop us a line when you get a chance.

hugs,
Sharlene and Molly Muffin

[molly muffin]

Hi, I just wanted to check in. We never heard back from you on how Bug is doing and how recovery went. I do hope that everything turned out fine in the end.

hugs,
Sharlene and Molly Muffin

[Skye]

has anyone heard anything????? worried......hope all is okay.

[BugsMum]

Hi all, I had this superstition that if I wrote about Bug, then something would go wrong - the best way to turn everything to sh** is to prematurely say how good things are going.

We got the bad news around Christmas time 2012 that we had an adrenal tumour. We were told that we would have her for maybe 3-6 months.

This afternoon the vet came by at 4pm to put my little baby to sleep. We had 9 more months than we were told we would have. We did our best to make her happy and comfortable and spoil her with attention (since food treats were out of the question). She is curled up in a little ball in her bed in the lounge room now. We will head off to the crematorium tomorrow morn, but thought we would have her with us overnight rather than have her "stored" for the evening somewhere.

I know what people say about it not being them anymore. The soul is gone and this is just the shell, but that is the shell that I kissed and cuddled and loved for 14 years. I am happy having her little shell reside with us overnight. It is hard though - she looks like she is sleeping. She is still warm. I can't believe she is gone. Her pain is over and mine has started.

[Trish]

Sorry to hear about the loss of Bug, gosh we wondered what happened to you. It's over a year since you were here so I am really glad you had that time with Bug. RIP little pup and you take care.

[BugsMum]

Thank you. It was very rude of me not to respond, but I just got so paranoid. The link to the forum has always been in the middle of my browser bookmarks bar - I see it every day, but too scared to click on it. I know that seems weird to stare at something for a year and never click a button, but I couldn't bring myself to do it.

A few bits of info that may help others though.... Bug began getting a hacking painful cough a couple of months ago. The local vet made the snap judgement that this was fluid on the lungs and possible congestive heart disease. He put Bug on fluid tabs (frudix). We went along happily with this because she seemed to be better. 2 weeks ago she crashed. She was rushed to local vet and they said she was in kidney failure - they hoped it was infection rather than the tumor invading. There are additional details but the short version is that we moved on to the emergency clinic and they feel that the fluid tablets damaged her kidneys. It all snowballed and she ended up with pancreatitus, keytones in her urine (whatever that means??). she stopped eating and was so unhappy. Add to that, last night she had her most severe attack of vestibular disease and could not stand,. She wagged her tail for the last time 15 mins before the vet arrived today. Even though she could not stand, she would wiggle her legs demanding to go out to the toilet (would never mess in the house).

I think if we had never gone on the fluid drugs we would still be going along ok. Emergency clinic said she had progressed to bilateral adrenal tumors, but they had not invaded the kidneys or other organs

[molly muffin]

Thank you for letting us know. I have changed the title of your thread.

Really glad that you were able to have so much more time than you thought you would with your little Bug.

My sincerest condolences on your loss.

Sharlene and molly muffin

[molly muffin]

Bug was a fighter. I remember well the nights to emergency, the worry about Bug during surgery during a horrible storm. She came through all of that and lived on to enjoy many more days, months with her family.

hugs
sharlene and molly muffin

[Trish]

so sorry to hear that, it sounds like everything snowballed in the end. Ketones in the urine is often sign of dehydration. But Bug was diabetic wasn't she? Sometimes when they get high ketones it is related to that, maybe blood sugar was high with the pancreatitis.

[BugsMum]

Hi, yes, Buggy was diabetic, amongst a multitude of issues. My partner joked that she had a secret bucket-list and was checking off diseases.

I am reading other people's posts now and 2nd guessing my decision to euthanise. Would the vestibular episode have resolved itself and she could have bounced back to where she was? The vets all agreed it was time, but it is still so hard.

Thank you both for your wishes and all the responses (current and past). You were so supportive, and I wish I had kept in touch throughout.

[Trish]

I think it is very normal to second guess your decision, but try not too as it really sounds like everything was catching up with little Bug. You did the best for her all the time, she lasted way longer than they predicted so that just tells me what a fantastic job you have done taking care of her. Hacking cough could have been her heart, it also could be related to her tumours if they had spread. It sounds like she was really uncomfortable, so you have ended her pain and that is the most unselfish thing you could have done for her, especially if the vets agreed with you. Was good of your vet to come on a public holiday to see her.

[labblab]

Oh, I am so sorry for your loss but agree with Trish that I hope you will try to free yourself of the second-guessing (although I think we all fall victim when things don't turn out as we had so mightily hoped). Even if the fluid tablets did create other problems, it sounds as though they halted the cough and allowed Bug to have a better quality of life during those last two months. So it is really impossible to know whether she would have been happier without the treatment. With diseases so inter-connected, sadly it is often the case that any one treatment may raise problems of a different sort.

Most important of all, though, Bug knew she was loved throughout her entire life. And you did everything within your power to keep her feeling as well as she possibly could during her time on this earth. I am very touched that her body is curled up safely on her little bed. You know, different religions have different beliefs about the way in which the spirit may linger outside the body. So I am glad, too, that you have been able to keep her little shell near you before today's transformation.

Sending you many hugs, and remembering your little Bug with a sweet smile.
Marianne

[Squirt's Mom]

Dear Liz,

I am so sorry to learn about sweet Bug this morning. Please don't let yourself feel any more worry about whether this decision was right or not than you must. We allll have those thoughts no matter the circumstances. Maybe if we had done this, or not done that, or maybe.....just maybe....tomorrow things would have turned around. It's just our love speaking out against the thief, Death, trying to find someway we could have defeated him one more time. You say you had 9 more months with your sweet girl but in Jan 2013 you first came here asking when it was time to make "the decision"....so your love and determination gave her more than a year more with you and the life she loved. YOU gave her that time. But sometimes no matter how hard we fight, no matter what steps we take, that "time" comes sooner than we would ever hope. Then we have only one more gift to give - the greatest gift of all.

You gave your sweet Bug her vision back, you put that goofy grin back on her face, you made it possible for her to have the zoomies and be as silly as Pugs are supposed to be. You gave her back all this life took from her through the ravages of illness and limitations. And I know without question your Bug is thanking you with all her heart today for this final gift.

Our deepest sympathies,
Leslie, Squirt, Trinket, Brick, Sophie, Fox, and all our Angels



Love’s Final Gift
By Cheryl Goede

I know it is hard on you, there are no words that can describe
the piercing sorrow which does not lessen with time.

When you had to bring me with you, on that last car ride to make,
all the while knowing the course of action you needed to take.

I know you feel guilty, I feel your sorrow, it’s true,
I could always sense your each and every mood.

When they called my name I knew that your heart was breaking,
you carried me to the room…getting closer to my new awakening.

The friendly doctor I know gave me treats and spoke low,
he was giving you the time that you needed to let me go.

All left the room, and you gathered me close,
as you wondered how you could do this for me when you needed me the most.

I tried to convey, my last wishes to you,
I looked into your eyes with all the love you are used to,

Mom and Dad, this earthly body has served me well,
but the time has come for us to part, to no longer dwell.

You understood the signal, and knew it was time for me to go,
but before I leave there is just one more thing you should know.

I will look out for you, each day I will guide,
my spirit in some way will always be nearby.

Before I make it to the Bridge to stay,
I will return the love tenfold in hopes for my debts to be paid.

For when that new pup or dog will enter your world,
a new love will blossom and slowly unfurl.

I hope you realize that new dog is Love’s Final Gift,
sent from me, your baby girl.

That new dog was chosen by me, to lessen your pain,
like the gentle warmth of the sunshine after the rain.

When you hear him bark, it’s my bark too,
when he cuddles you close, it’s what I would do.

So open your heart when the time comes to see,
that the love he gives comes also from me.

Take comfort, hug him, and reminisce
as he gives his love freely in the form of a dear doggy kiss.

It’s what I would do, if I still could,
and what you would want that is understood.

But the time has come to let me go,
to make that unselfish choice, even though tears will flow.

Hold me, cherish me, until my last breath,
but please don’t look at this as my death,

Someday we will be together again, come close for one last kiss,
I know this it true, as it is my soul’s last earthbound wish.

Now I can feel my spirit floating it is traveling high,
as though I were a cloud in the endless blue sky.

Please find peace, you have honored my life with this,
For I have been reborn through your Love’s Final Gift.

[goldengirl88]

I am truly sorry you lost your sweet bug. It does seem like everything just piled up and it got to a no win situation. The first thing we do is beat ourselves up over our decisions. You were very brave in taking the pain away from bug and putting it on yourself so please take that into consideration. We can only do our best in these situations as we are human. God Bless You Both.
Patti

[pansywags]

I am so sorry to hear about Bug - from what I know of Bug's story, you were lucky to have found each other. Wishing you strength during this hard time.

[doxiesrock912]

My sincere condolences.
You mention that several vets advised you that it was Bug's time.
Trust in that, and please don't second guess yourself.

Bug is pain and illness free now. Hugs

[Renee]

Hello,

You don't know me, as my journey here started after yours, but from one pug mommy to another, I want to reach out and hold your hand through this. Pugs are such special and amazing little creatures. Their imprints on our hearts never leave.

It is hard not to second guess our every decision, but I want to tell you - a second too soon is better than even a second too late. The last and greatest gift we can give is to release them before the suffering gets too bad. it sounds like Bug had a lot more time with you than was originally thought, and that is a gift.

May you find peace and remember her good times.