Rosie has pituitary Cushing's — Rosie has crossed Rainbow Bridge

[FemaleK9]

Rosie (a beagle, will be 11 yrs old on 7/29/13) has just been diagnosed with pituitary Cushing's, after a low dose dex suppression test. I have just started her on Trilostane (Vetoryl) 10mg twice a day.

I was not told to give it with food, but I learned that from reading here on the forum while I waited for the meds to arrive. EDIT: Correction: The box has a neon orange sticker on it that says "GIVE WITH FOOD" that I managed to overlook. I aplogize to my vet!

Aside from the excessive drinking and urinating, Rosie is also experiencing incontinence, having "accidents" on the couch and in my bed while sleeping, and just a few minutes ago while lying on the kitchen floor.

I'm wondering if this is typical?

[Roxee's Dad]

Welcome to you and Rosie,

I have a Rosie too, just spelled differently (Rozee) :)

Can you tell us the story and what test were performed that led to the cushings diagnosis. I see the LDDS test, but was there a follow up ACTH stim test?

How much does your Rosie weigh? Does Rosie have a ravenous appetite, and excessive thirst? Losing any hair?

Sorry for all the questions, but the more we know and understand, the more we can help.

If Rosie does indeed have cushings, many of the symptoms will subside when her cortisol in under control.

I don't have any experience with the incontinence, but many more will be by to welcome you and may be able to give you their input.

[Roxee's Dad]

I also wanted to add, if you have copies of Rosie's test, could you post them here. Only the abnormal results along with the reference ranges.

If you don't have copies, your vet's office should be more than happy to provide them. Most of us keep a notebook or folder with all our pups test results ;)

[mytil]

Hi and welcome to our site - I am sorry your Rosie is having these troubles.

Yes, incontinence can be associated with Cushing's, but more times than not it could be a urinary tract infection (UTI) as cushpups are prone to this. Has this been checked out?

John has started off with the usual questions we all ask. Yep, the more we know the better we can all help out.

When you get the chance post those results here.

Oh, and I just fell in love with your avatar - what a cutie pie!!!!!!!!!!!

Keep us posted
Terry

[goldengirl88]

Hi:
Welcome to you and Rosie. You came to the right place for help. Just a few tips for you. Get copies of all your dogs tests and post the numbers so we can help you. Keep a daily diary of what is going on with your dog, get a vet or IMS that has experience with Cushings. You will save a lot of time, money and heartache. Most vets do not even understand the disease. If you use the name brand Vetoryl, call them and start a file on your dog. They have vets on staff there to help you. The number is 866-933-2472. I hope things go well with your baby. You may want to get her a pair of waterproof panties for now until the Cushings gets under control, it will save clean up, and furniture and carpeting. Blessings
Patti

[FemaleK9]

Wow! I'm amazed at the fast responses!

I don't have her test results, but I plan to ask for them as per your advice.

Yes, she is drinking and peeing a lot. A lot. That was whet sent us to the vet. The urine tests ruled out diabetes and kidney failure right off the bat. While her urine was very dilute due to the massive water consumption, he bloodwork showed signs of dehydration, as well as "abnormal liver proteins."

The vet first tried her on a liver supplement, but there was no sign of improvement after more than two weeks of it. The LDDS was next and the vet made the diagnosis of pituitary Cushing's based on that.

She has not had an ACTH stim test yet, but the vet is planning to do them at intervals to verify she is getting the correct dosage, then farther apart later on to monitor her condition. I understand that Vetoryl can damage the adrenals and this has to be monitored.

Rosie weighs about 32 lbs. She did have a period of heavy shedding this past fall and winter, a time of year that it wouldn't normally be expected, plus her fur felt very dry and rough and looked dull, but she never got bare patches or even sparse, but this ended and has not recurred (so far).

The vet wants to check for a UTI, but even with all this pee, I haven't managed to get a sample yesterday or today and I hate to make Rosie go back to the vet so she can get the sample. She had a real hard time with the all-day LDDS test and when she got home she gave me these reproachful "Why you do me this way?" looks and then she deliberately peed right in front of me in the middle of the living room carpet just to let me know she wasn't happy with me.

She also has a terror of T-storms, and we've been having them every day for so long I've lost track. When we're not actually having a storm, she is anticipating the next one, and even dreams them and wakes up in a panic. So she doesn't want to go out, and I'm using the biggest doggy pee pads I can find by the carton.

Can someone give me a link/recommendation to the best waterproof panties? I didn't know there were such things for dogs, but a Google search brought up lots and I would appreciate the benefit of your experiences.

PS That is Rosie in my avatar, the day I got her at 6 weeks old, waiting for me to give her a boost up onto the patio.

PPS The furniture, rugs and hardwood floor are pretty much a write-off already.

PPPS She also has a raging appetite, panting and looking for cool floors to lie on. I didn't really notice these symptoms as much as the drinking/peeing, because she's always had a keen appetite and tries to convince me (and others) that she hasn't been fed for days, and the panting goes along with the T-storm terrors. And looking for cool floors to lie on isn't very surprising in this hot muggy weather. But once I knew what to look for, these things were clear to me.

[Roxee's Dad]

Hi again :)
Just a couple of things. A simplified explanation, Trilostane is a blocker, it blocks the signal from the pituitary telling the adrenals to excrete cortisol. Lysodren will dissolve layers of the adrenal, preventing them from excreting too much cortisol. This is all done in a very controlled way to prevent too much damage. Some dogs do better on one or the other.

I am sure many will chime in here, and although it does sound like Rosie has cushings, there is no one test that can confirm cushings. Usually the series of test should be a UC/CR which can not confirm cushings but can rule it out, then ACTH and a LDDS to confirm pit or Adrenal cushings. Many also have a high Def Ultrasound to confirm the Dx and have a look around at other important organs. We just have a fairly new member that is waiting for cushings testing because of a knee injury, but just had an ultrasound and found a serious gall bladder problem. Most here I think would agree, you get a bigger bang for your buck getting a High Def Ultrasound.

Usually, almost always there should be a ACTH before starting treatment so there is a baseline to work from. 10 to 14 days after treatment a 2nd ACTH to monitor treatment and make adjustments as needed.

Rosie is 32 pounds and is getting 10mg of trilo twice a day (BID) That is a low dosage but it is so much better to start of low that the other way around :)

Diapers for dogs LOL are a great invention. I know some that just use baby diapers as they are cheap and easy to get. They just cut a hole out where the tail goes. I used to use a belly band type diaper for a dog (Chuckie) that I used to baby sit... I mean dog sit ;)

For the thunderstorms, have you tried a thundershirt, many here use them with good results.

[FemaleK9]

I thought I'd better make this a separate post: I maligned my vet; the Vetoryl package has a neon orange sticker put on it that says "GIVE WITH FOOD"

[FemaleK9]

Rosie has a Thundershirt (and a Thunder Leash, for pulling) and it helps in the daytime when storms aren't too close, but not at night or when bolts are right over head. She gets acepromezine at night and in loud daytime storms. I give her 5 mg to start and another 5 mg if the storms go on for many hours or recur.


She gets very stressed in these days of endless storms. It doesn't even have to be a full-fledged T-storm, heavy rain or wind will also panic her, because she associates these things with T-storms.

I have been wondering if all this stress could have something to do with her current condition.

It does seem like her symptoms have abated some from the extreme we experienced over Memorial Day weekend. Her water consumption/urine output is still abnormal, but not as extreme as it was then.

I'm sorry to present the info in such a haphazard fashion, but my thoughts are all over the place at this point.

[molly muffin]

Hello and welcome to you and Rosie. She is sure cute. I love her avatar. :)

Stress can cause some symptoms with the anxiety but it shouldn't affect the LDDS. I wouldn't think.
You're starting at 10/10 is a low point, but should be good. You might need to tweak the dosage to get it just right for her. Usually a reccommended start is 1mg/1lb. So, lets see where she is at with her ACTH test and go from there. Hopefully if it's just right for her (and every dog is different) then you'll see symptoms begin to subside (water, urination, hungry) in the first couple weeks.
You know the symptoms to watch for if going to low, lethargy, not eating, vomiting? I don't think that will happen though since you started on the low end.
Oh I know what it's like to deal with the anxiety of thunderstorms. My molly is terrified of them too. Alot of the pups on here are.

Again, welcome to the forum

Sharlene and Molly Muffin

[FemaleK9]

Thank you, everyone, for the warm welcomes and all the help and support!

I think the baby diapers are a brilliant idea, so easy to find, but I don't know what size to get (I'm an old maid and my mother had babies long before disposable diapers) - what baby age/size would be appropriate for a 32 lb beagle?

Here's another picture of Rosie just to add some interest to all my blah blah blah!

http://farm4.staticflickr.com/3381/3270848408_6db0da6218.jpg

[Trixie]

Love your photo of Rosie as Superdog!! Really cute and the photo of her as a puppy is adorable too!

You should most definitely give the medication with food.

Everything you wrote is pretty much the same exact story with our dog Trixie. We had the high liver number, then the excessive drinking began...and well, our story reads the same as yours.
We are still tweaking the vetoryl dosage. We started with a low dose and have been moving up..now at 12mg twice a day.
It did take awhile for me to see the drinking/peeing to subside once we started the medication. It's quite a relief when it finally begins to decrease. I expected it all to go away rather quickly but it wasn't the case with us. All dogs are different so you may see Rosie's symptoms begin to subside more quickly than we did.

My dog is also in a panic from all these storms...in fact we just had one and she's hiding in the bathroom even though it's over.
Same here too (!!)...there doesn't even have to be thunder & lightning anymore...heavy rain and even loud wind send her into hiding.
Hope Rosie is doing well and that you begin to see improvement really soon. There are so many helpful people on this board to give advice and help you through..you came to the right place. :)

Barbara

[FemaleK9]

Thanks so much!

I just gave Rosie her third dose of meds, and I'm hoping the low dose will be all she needs and she'll start to show improvement in a week or so. Luckily Rosie doesn't have any other health problems, so I'm hoping she'll respond well and be a happy dog for many more years.

Tomorrow's a holiday, but on Friday I'm either going to get that urine sample or take Rosie in so the vet can get one to check out the UTI possibility.

I'm so glad I found this forum!

[Roxee's Dad]

Love the pic... Super Beagle :D

[doxiesrock912]

Rosie's mom,

Welcome to you and Rosie :)

Daisy Mae is my 11.5 lb miniature Dachshund who has been on Trilostane (Vetyrol) since May. When you have a moment, please read through my postings. You'll find a lot of similarities to Rosie's symptoms and our experience will help you to know what to look for which could indicate that Rosie's meds need adjustment and help you to make a list of questions for your vet.

It is a lot to learn, but believe me! The people here offer a wealth of information through experience and I have found them to be invaluable.

Please visit the community section of this forum where you can share entire albums of Rosie pics with us and the helpful links section is amazing!

[Budsters Mom]

Hello and welcome from me too.
You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. We will do all we can to help, but be ready for lots of questions! So again, welcome to you and Rosie. I am sorry that I am so late with your welcome. My Cush baby just passed on yesterday, so I am very behind. I love your avatar by the way.

Hugs,

[FemaleK9]

Hello and welcome from me too.
You have come to the right place! There are many K9Cushing's angels standing by to help and stay with you every step of the way. They love details, test results, any information you can get your hands on. The more the better. We will do all we can to help, but be ready for lots of questions! So again, welcome to you and Rosie. I am sorry that I am so late with your welcome. My Cush baby just passed on yesterday, so I am very behind. I love your avatar by the way.

Hugs,

So sorry for your loss! I know what a big hole our pets leave in our lives when they are gone. It seems like every loss is cumulative, every time we lose one, it reopens the wounds of other losses, too, both pets and human family. It is very brave and generous of you to keep helping others in the midst of you own grief.

[FemaleK9]

I took Rosie to the vet Friday 7/5 and they did get a urine sample but I don't have the results yet as they had to send it out for a culture. I forgot to ask for the LDDS test results, but I'll try to remember next time. I did ask about giving Rosie a cranberry supplement, but was told to hold off until they have the urinalysis.

Meanwhile, (knock wood) after 6 days of medication, Rosie seems to be responding to the Vetoryl, as she is much improved in the drinking/peeing dept. Once again her water needs to be changed because it's no longer fresh instead of simply constantly refilling, and her pee is yellow instead of colorless and there's a lot less of it! The incontinence appears to have stopped. She is also looking more svelte so I think the bloating has abated some, too.

If we could just catch a break from the blasted t-storms, I believe Rosie would be a happy dog again, but no such luck, it seems we've got another week of them coming up.

[Roxee's Dad]

Great news :D:D:D

keep an eye on her as the cortisol may continue to drop, I am so happy she is doing better.. Good job !!:D:D:D

[FemaleK9]

Rosie's pee pads were dry this morning!!!

[Roxee's Dad]

Yay !!!:D:D:D

[Trixie]

That is so great!! Good for Rosie and you too. It's a relief when those symptoms drop off isn't it??
Hope Rosie continues to feel great!! Sounds like you're doing a great job! :D
Barbara

[addy]

HURRAH!!!!

We LOVE dry pee pads:D:D:D:D

[molly muffin]

Yay!!! We Do love the dry pee pads. That is a good sign

Sharlene and Molly Muffin

[FemaleK9]

I got the results of the urinalysis today, and Rosie does have a UTI. The antibiotic is Baytril, 22mg, two tablets once a day. They said it could go in food, as there wasn't a nasty taste, so I put the tablets in her dinner, and it worked. Two less pills to poke down her throat!

I also got copies of her recent blood test and LDDS.

The blood test shows the following results out of range:

Albumin 3.8 (2.5 - 3.7)
ALT 590 (10 - 100)
AST 128 (10 - 100)
Sodium 156 (139 - 154)
Triglyceride 182 (25 - 160)
CPK 338 (14 - 260)
Hemoglobin 20.0 (12.0 - 18.0)
Hematocrit 58.7 (37 - 55)
RBC Count 9.06 (5.5 - 8.5)
Platelets 428 (170 - 400)
Lymphocytes 434 (690 - 4500)

The LDDS:

Pre-Dex: 7.31
Post-Dex 1: 2.19
Post-Dex 2: 5.67

[molly muffin]

When these tests where done, did you suspect Rosie of having a UTI at the time?

Are you giving her Denamarin? A liver support supplement? If not you probably should consider it. I think all dogs with cushings should be on a liver support supplements because it is one of the organs that can be affected. I know you had her on them for a couple weeks but not if you continued or not. It has taken months and months for me to see a positive change in molly's liver values through her hepato support supplements.

I think after the UTI is cleared up completely that you might want to rerun the blood chemistry and compare the values of the next one to this one. So you will know how much the UTI was affecting different values on this test.

So, I am looking at this test as a base line if you will, by which you can compare the next ones going forward to see how Rosie is doing.

yay, I'm glad that Rosie is doing so well on the trilostane.

Sharlene and Molly Muffin

[FemaleK9]

No one was thinking UTI pre-diagnosis. Because of the extreme drinking and peeing, I knew there was something seriously wrong and was thinking more along the lines of kidney failure and other dire conditions, and the vet looked at her urine on that first visit and there was no sign of a UTI.

It was me that suspected a UTI later on, after the Cushing's diagnosis, because of the way she was licking at herself, plus the worsening incontinence. When I voiced my suspicions, they said the lack of an indication of UTI might have been a false negative due to the quantities of urine going through her system. Apparently the dilution of the urine due to the copious drinking of water can make for an environment that bacteria can thrive in and yet escape a cursory examination (I think maybe they just look at it under a microscope?) so they sent the urine out for a culture, which confirmed a UTI.

I just ordered a chewable cranberry supplement for dogs that I hope will prevent recurrences.

As to the liver supplement, yes, I did stop it after a couple of weeks. I was wondering if I should continue, but I'd also like to keep the number of pills I have to poke down Rosie's throat to the bare minimum necessary. I guess I'll leave it to the vet to decide.

I should say that I have great confidence in my vet. They appear to be quite knowledgeable about Cushing's, which I understand is not always the case, and I noticed from the copy I got that the LDDS endocrinology was done by Cornell University.

[FemaleK9]

Any comments on the LDDS results posted above (Post #25)?

[Trixie]

Wish I could help with those numbers...I'm just not expert enough to know yet but I'm sure the ones who do know will be posting soon.
Hope Rosie is feeling okay!
Barbara

[molly muffin]

The LDDS test is consistent with pituitary cushings. When they suppress some at the 4 hour mark, but then can't as much later at the 8 hour mark that is usually consistent with pituitary cushings.


Approximately 30% of dogs with pituitary-
dependent hyperadrenocorticism have serum cortisol suppression at 4 hours < 1 mg/dl or <30 nmol/l), with a rise in cortisol values by 8 hours after dexamethasone administration. This escape from suppression is diagnostic for pituitary-dependent hyperadrenocorticism, and further tests to determine the cause of hyperadrenocorticism are not necessary. Failure to show adequate
suppression of serum or plasma cortisol at both 4 and 8 hours (i.e., >1 mg/dl or >30 nmol/l) is diagnostic for hyperadrenocorticism but can not aid in determining the cause of the hyperadrenocorticism.

http://animalhospitalofmtpocono.com/NEPVMA/docs/1.Cushings.%20Diagnosis%20and%20Rx.pdf

I Would still retest the blood work later after the UTI meds complete to compare to this one.

Yes, that is it exactly. When a dogs urine is dilute, sometimes the only way to confirm a UTI is to culture it. It just will not show up under a normal microscope check.

I think I would discuss a liver supplement if the values remain as they are when you retest . Although her ALP isn't elevated, ALT, AST, are liver specific and are elevated that I would want to give support.

I think some of the test values such as Lymphocytes being low, could signify that she did have a UTI at the time of this bloodwork.

Of course you have to look at the entire picture and that is why if it were me I'd probably check the whole out again after the UTI is gone.

Sharlene and Molly Muffin

[FemaleK9]

She seems to be feeling well, and ate her lunch with good appetite after I put the Thundershirt on her - it's raining and there are t-storms around and she was in panic mode before that.

[FemaleK9]

Thank you, Sharlene, that info is very helpful. In particular I had no idea what the ALT and ASP were about.

I shall take your advice about the liver suppl. and retest when I next speak with the vet.

I'm learning more every day. Again, thank you so much!

[FemaleK9]

Rosie is doing very well. If it weren't for the t-storms, I think we could do without the pee pads at all.

She is practically rejuvenating before my eyes. Her turkey-neck wattles and droopy belly are tightening up, and the folds on her shoulders are disappearing, too. She looks years younger after only 9 days on the Vetoryl. I am so happy and relieved, as you can imagine.

What I thought were the ravages of old age were apparently symptoms of the Cushing's. I had been a bit surprised by it, because 10 is not a great age for a beagle; many live 18-20 years barring accident and disease.

Now I understand why she was "aging" so much, and I also see why the symptoms of Cushing's can be overlooked or misunderstood.

[Trixie]

Yay for Rosie. I'm so happy for your good results! I notice an improvement in my dog as well but it's taken quite a bit longer. Hope Rosie continues to feel great. You're doing a good job!! :D
Barbara

[khockman]

Wow - so happy to read about the progress of Rosie! Helps give some of us others some renewed faith...GO ROSIE!!! show us how it's done!

xoxox,
Kerry (Millie's Mama)

[Roxee's Dad]

it's always great to see good news, So happy that Rosie is doing so well. :D

Keep up the good work !!:D

[FemaleK9]

I talked to the vet today, and she wants to do follow-up bloodwork and the ACTH test, so I have an appointment next Wednesday, 7/17. I'm to give Rosie no food after 11pm treats and meds the night before, then give her 11AM meds without food, then take her in for the tests. At least I don't have to withhold water this time! Although Rosie's water intake has dropped off so drastically that it wouldn't be the torment for her that it was the last time. I still feel bad about that.

Anyhoo, I should have some new results to share (and to ask for your help interpreting) by the end of next week.

[Squirt's Mom]

In order for the ACTH to be valid for a pup on Trilostane (Vetoryl), the pup must eat and take the med as usual. Fasting will skew the ACTH, making it worthless. The Trilo needs food in order to be absorbed and used correctly.

[goldengirl88]

Hello:
Just wanted to welcome you and chime in a bit, on your ACTH test. Your vet gave you all the wrong information, which can skew the test, and cause the dog to be overdosed. These skewed results could cause the vet to give the wrong dosage and crash your dog. Dr. Peterson the endocrinologist really cautioned me about this. You have to give food with the Trilostane, and you never, never fast before an ACTH as they must take their meds with food as Leslie said. I am sorry to say this but you need to find another vet pronto, as this vet does not know what they are doing. This can cost you more money, and even the life of your dog. You need to find an IMS or someone who has treated and understands Cushings. Please for your dogs sake go somewhere else. I hope it all works out for your baby. Blessings
Patti

[Budsters Mom]

If a fast is needed for the blood work, have them do the blood work at a different time, apart from the ACTH. I really wish these vets would get their act together! :mad:My vet made the same mistake as yours! I am so thankful that there are experts on this forum that know the proper protocol!:)

ACTH protocol - Trilostane with food. ACTH test must be started within 4-6 hours after medication. Trilostane must be administered with food for it to be properly absorbed. Testing on a fast will result in a waste of $$$ and and a risk of overdosing, if Trilostane increased by those skewed results. Hugs,

[FemaleK9]

Thank you so much for alerting me to this! I'm so glad I posted all the details, I almost didn't.

Actually, I didn't speak directly with the vet, just through a staff person who was the one telling me the protocol. I will speak directly with the Dr. as soon as possible and get this straightened out.

Can you give me a link to a website with this info that I can refer her to if necessary?

[Budsters Mom]

I was told that by the The office staff at my vets office too! My vet didn't even know. They reluctantly did it the way I wanted anyway! You need to advocate for your baby. I was often not very popular at my vet's office because I insisted that everything be done according to protocol, and I hung around to make sure that it was! :D If they are going to mess up and they are, it's not gonna be with my fur baby!;) hugs,

[Harley PoMMom]

Trilostane absorption is enhanced by administration with food.
This is an excerpt from Dechra's product insert: http://www.dechra-us.com/files/dechraUSA/downloads/Product%20inserts/Vetoryl.pdf
(scroll to INFORMATION FOR DOG OWNERS then to CLINICAL PHARMACOLOGY)

[molly muffin]

This link to the Dechra product information clearly says that Vetoryl should be given with food:

http://www.dechra-us.com/files//dechraUSA/downloads/Client%20Literature/48685_VETORYL_10mg_PatientBro_COVER_FLDOUT_2_0_dis .pdf

In the fda instructions when vetoryl was approved in the US, it says "given with food"

http://www.fda.gov/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/FOIADrugSummaries/ucm049823.htm

As for ACTH testing, Dr. Petersens blog for owners and vets, clearly goes over the protocols for ACTH testing. I would print this out and give to your vet if they are in doubt:

http://endocrinevet.blogspot.ca/2011/03/whats-best-protocol-for-acth.html


With trilostane, it’s extremely important to give the morning medication with food, and then start the ACTH stimulation test 3 to 4 hours later.

Fasting these dogs on the morning in which the ACTH stimulation test is scheduled should be avoided since it invalidates the test results.

When a dog ‘s food is withheld, the absorption of trilostane from the gastrointestinal tract is decreased. This leads to low circulating levels of trilostane, resulting in little to no inhibition of adrenocortical synthesis. Therefore, serum cortisol values will higher when the drug is given in a fasted state than when it is given with food.

The higher basal or ACTH-stimulated cortisol results could prompt one to unnecessarily increase the daily trilostane dose. That misjudgment may lead to drug overdosage, with the sequelae of hypoadrenocorticism and adrenal necrosis in some dogs.

That should give you the proper information to correct any misconceptions. It is important that vets follow the proper protocols of administering and testing.

Hope this helps.
Sharlene and Molly Muffin

[FemaleK9]

Just before I checked back here, I found the info on Dr. Petersen's blog and printed it!

"Fasting these dogs on the morning in which the ACTH stimulation test is scheduled should be avoided since it invalidates the test results."

That's exactly what I needed! I will give it to the vet.

Boy, am I glad I found this group! I wouldn't have known about this without you!

Before I could post this Rosie wasa frantic to come in and as she ran past me I got a snootful - of skunk. Yep, Rosie just got skunked.

[molly muffin]

OH Gads!!! That girl does get into some adventures doesn't she!
Whew!!! Hope you get that one cleared soon.

hugs,
Sharlene and Molly Muffin

[FemaleK9]

I got her back outside and washed before I finished posting, lol.

It wasn't too bad this time, I think Rosie has learned some caution and wasn't close enough for the full blast. Good thing, because I was too tired for the full drill and settled for a mixture of my hair conditioner and warm water sponged over her front half. It did the job.

Last night the smell was in my sinuses and everything smelled like skunk to me. This morning I could only smell it on her if I buried my nose in her fur and took a deep whiff. And she's so soft and fluffy!

[mytil]

I have been following and you are doing a great job!!!

Poor you and Rosie - a skunk! Glad the smell is gone.

continue to keep us posted
Terry

PS - just came from her photo!!!! look at that sneaky smile she has :D

[FemaleK9]

OK, Rosie is at the vet's for the ACTH stim test.

I was supposed to just drop her off, but when I told the front office tha, contrary to instructions, Rosie had been fed (11:15am, with Vetoryl) , and gave them a printout of Dr. Petersen's blog including the statement that "Fasting these dogs on the morning in which the ACTH stimulation test is scheduled should be avoided since it invalidates the test results." I was told I'd better wait to talk to the Dr., but when I was called in, it was just a technician who told me that the they "as a hospital" did the the test fasting, and that they have a large experience with canine Cushing's and that if I didn't want it done their way I "could be given a referral." I told her I wanted to discuss it with Dr. Meenan, so I waited some more and the next time I was called in, Dr. Meenan came into the room beaming and the first thing she said was "Good for you, going online and getting this information!" She asked if she could keep the printout, and also said she would check out this forum, because it sounded like a good resource she could refer owners of other Cushing's dogs to! She said Rosie was her first Cushing's case; she's very young, and thankfully still open to new ideas.

I was very relieved by her acceptance of my "interference," because this veterinary hospital is the best in the area, and my family has been bringing our dogs and cats to them for 44 years.

I'll be back with Rosie's test results when I have them, but I just had to tell you how my conversation went with the vet.

[Squirt's Mom]

Oh! Good for you, Mom! :cool::cool::cool: Atta girl! :cool::cool::cool: And good for your vet! :cool::cool::cool: phooey on the rude tech! :D:D:D

[Roxee's Dad]

Good job :D It's like we always say, If you and your vet can work as a team, usually there will be good results.

You were Rosie's ONLY voice and her advocate... You did good !!! :D

[Harley PoMMom]

So very proud of you!!! Great job, Mom!!!

[Budsters Mom]

YAY! Way to be proactive! I stayed and monitored Buddy's ACTH tests also, to make sure they were done according to protocol! Awesome job mom! Hugs,

[lulusmom]

Way to go!!! That's the way to be Rosie's voice. Keep up the great work!!!

[molly muffin]

Wow, so very proud of you!! It's not easy to have to say no, when you are worried about your furbaby, but it does make all the difference in the world.

As Leslie once said in regards to her vet experience, it's not necessary that they know everything about cushings, it is just necessary that they be willing to work with you and learn what the protocols are and follow them. This is the makings of a good team for Rosie and in the end, will help all cushings dogs that go there. I really believe that.

Congratulations!

Sharlene and Molly Muffin

[goldengirl88]

Great job there mom!!!!Yeah!!!!! Glad you found your inner strength and used your voice. Now your baby will be much safer, with you on guard duty!! Way to go!!! Blessings
Patti

[FemaleK9]

I just got a call from Dr. Meenan, Rosie's ACTH test results came back NORMAL! Rosie will stay on 10mg Vetoryl twice a day and, unless a problem crops up in the meantime, won't need to be retested for at least 3 months. I'm over the moon, as you can imagine!

I'll bet that test wouldn't have come back normal if they had their way in doing it with her fasted; it would probably have come back high, and they would have increased her dose unnecessarily (overdose!) with who knows what undesirable results?

I have you wonderful folks here to thank for avoiding that outcome, and I do thank you, from the bottom of my heart.

I'll post the numbers when I have them, but I just couldn't wait to share the good news. Having read some of the stories here, I know that we have been very lucky. Short of a cure, this is the best outcome I could have hoped for, and I've got all my fingers crossed that this excellent state of affairs will continue.

[doxiesrock912]

That's wonderful news and I'm sure that the vet just learned a valuable lesson about NOT fasting :)

[Trixie]

Oh great news about Rosie's acth!! Great work teaching the hospital on correct protocol!! :D So glad Rosie is doing so well!

Barbara

[molly muffin]

Yay for you and Rosie. We can't wait to the see the numbers, of course. LOL
This is Very good news indeed

hugs,
Sharlene and Molly Muffin

[lulusmom]

I just got a call from Dr. Meenan, Rosie's ACTH test results came back NORMAL!

I will reserve my excitement until you post the numbers for us. You should be able to get the pre and post numbers in a quick call to your vet's office. My concern here is that because Rosie is Dr. Meenan's first cushpup, she probably doesn't know how to assess an acth stim test for purposes of monitoring treatment. Any time a vet tells you that cortisol is normal, red flags go up. Cortisol is never normal for a cushdog, whether before or after treatment. I would bet a dollar to a donut that Dr. Meenan doesn't know that with a cushdog, you can't use the lab's normal reference range. In order to remedy symptoms and mitigate adverse impact of cortisol on all body parts, you have to get those levels down to what some vets would consider to be adrenal insufficiency for a normal dog. Range for dogs on Vetoryl is somewhere around 1.4 ug/dl to 6 or 7 ug/dl, if symptoms have resolved. For dogs on Lysodren, the range is 1.5 ug/dl to 5 ug/dl.

We'll be looking forward to seeing those numbers.

[FemaleK9]

Here are the results - I "framed" them! If, like me, you can't read teeny weeny print, click on the image to see it enlarged, and again to enlarge further.

http://farm6.staticflickr.com/5496/9321065411_f1d417a1d0.jpg (http://farm6.staticflickr.com/5496/9321065411_f1d417a1d0_b.jpg)

:):):):):):):):):):):):):):):):):):):):):):):):):) :):):):):):)

[Trixie]

I think the 6.3 is a good number especially if Rosie's symptoms are under control, but I'm no expert with the test numbers. ;) Hope she continues to do so well!! :p
Barbara

[FemaleK9]

Yes. her symptoms have resolved and even some things that I mistook for normal aging are reversing and Rosie seems healthy, alert and full of piss and vinegar - just figuratively, not literally, thank goodness!

[lulusmom]

YES! If Rosie's symptoms have resolved, then those test results are awesome. Congratulations!

I am glad to see that Antech includes an interpretation for testing dogs Post Lysodren and Trilostane; however, they should have included a caveat on the Post Trilostane comment. The upper limit (9.1 ug/dl) is only optimal if symptoms have resolved. If the dog was still symptomatic and depending how long the dog had been treated, it could indicate poor control and a dose increase would be in order.

[molly muffin]

6.1 with symptoms resolved is just fine. :) :) :)
I couldn't be happier for you and Rosie. Piss and vinegar too! Yay!

hugs,
Sharlene and Molly Muffin

[FemaleK9]

In all the tension and excitement of the ACTH test and results, I forgot to mention that she finished the antibiotic for the UTI yesterday with no further signs of that problem either, and I began giving her a canine cranberry supplement (http://www.amazon.com/gp/product/B0031TU3WC/ref=oh_details_o01_s00_i00?ie=UTF8&psc=1) to prevent future problems. It's chewable and she ate one by itself after her dinner yesterday, so I put one in her dinner today. I figured giving it with food would prevent stomach upset. So far so good.

The vet also gave me the go-ahead to give Rosie her monthly heartworm preventive and flea treatement, and to resume giving her the antihistimine for her allergies.

[molly muffin]

All all around good day! :)

hugs,
Sharlene and Molly Muffin

[FemaleK9]

I get the brand name, Vetoryl, from my vet. They charge me $87.64 for (60) 10mg capsules. There was recently some confusion as to whether the vet would reorder and have it shipped to them for me to pick up or just call in a prescription and have me call the supplier Wedgewood Pharmacy (http://www.wedgewoodpetrx.com/), to arrange payment and shipping directly. When I spoke to Wedgewood, they quoted me $120.00 for the same amount. So my vet must get a trade discount, and they passed it on to me. :)

The same supplier quoted me $49 for (100) 10mg trilostane chewable tablets (chicken flavor). That would be a 50 day supply for Rosie. My vet would probably get it even cheaper. I am tempted to ask the vet about it, not only for the savings, but also because I wouldn't have to poke it down Rosie's throat. On the other hand, I like the support available from Dechra, the makers of Vetoryl. Plus, Rosie is doing so well I am hesitant to make any changes.

What do you all advise?

[doxiesrock912]

Yeah!! Congratulations!

[labblab]

Karen, if it were me, I would stick with the Vetoryl for the time being if you can afford it. Since Rosie is doing so well at this early stage, I would not want to rock the boat for at least a while. I personally wonder a bit about the consistency and effectiveness of the trilo in those chewable tabs. Since the brandname manufacturer and so many other compounders only offer the drug in capsule form, I worry that it may not be metabolized in quite the same way when packaged in the chewable. If you want to experiment with it, though, I'd wait until she is at least three months down the road and has truly stabilized on a specific dose. That way it will be easier to judge whether or not the chewable is equally as effective. The problem is that in most states, there is not yet any regulatory body that routinely tests the end product of any compounder. So you are relying on the good faith of the compounder that their product is effective. And unfortunately a recent study has shown that some (unnamed) compounded products do not carry the exact dose for which they are actually labelled.

Marianne

[FemaleK9]

Thank you, Marianne, that is just the support I needed! I'm going to stick with the Vetoryl capsules that Rosie is doing so well on. She's very good about taking pills, even though she doesn't like it - it was that aspect, even more than the cost, that really had me tempted. But I would never forgive myself if I did anything to upset the apple cart at this point, and who knows whether we'd ever be able to get back to this excellent state of affairs again?

[FemaleK9]

We have more thunderstorms coming. I'm really dreading it for my poor Rosie.

I believe I've mentioned this before, but while I'm dreading the approaching storm, I can't help but think about it:

I have wondered if constant high levels of stress could possibly be the cause of Rosie's Cushing's and not a pituitary tumor. I did ask my vet about it, and she didn't think it was possible, but she hasn't seen my Rosie though the storms of her almost 11 years and the nearly constant thunderstorms we have experienced here in NY this spring and summer.

As I look back, I can see that there were some signs of developing Cushing's in Rosie over the last few years. Could it be that the years of stress were beginning to take a toll as Rosie began to age? Is it a coincidence that the sudden and severe drinking/urinating that sent us to the vet after Memorial Day weekend came in the midst of a spring/summer with the most frequent and severe thunderstorms and torrential rains that I have ever seen in 44 years of living in this area?

Rosie has an absolute terror of storms, and her fear has only inceased as she gets older. It takes her days to fully recover from a storm, and for months now she has not had that time between storms to recover. She is so fearful that anything associated with a storm will trigger full-blown panic. A gentle rain, a breeze, darkening overcast, and - most recently - nightfall. So many t-storms develop after dark that she now associates night with storms. And, of course, it gets dark every night, 365 days a year. She also dreams storms, and will awake in a full-blown panic even when there are no other triggers. It is really pitiful.

Her Thundershirt only helps in the case of distant daytime storms. Night storms of any kind, and close and/or powerful storms at any time cause full-blown panics and require sedation (acepromezine). However, the sedation just quiets the frantic panic behavior, it doesn't seem to reduce the stress, and Rosie is as knocked out by it all as ever, and no chance to recover before the next storm, trigger or dream occurs.

[frijole]

Have you ever tried melatonin? My Annie was a stressed out dog too. Terrified of storms, firecrackers. I finally tried it and it did the trick. Course you have to give right away as it takes a while to kick in. It is available at all drug stores, usually in 3 mg tablets which is what I gave her (17 lbs) It is used to calm them down and help them sleep. It is a natural compound found in animals and humans. So it isn't an opiate that you worry about addiction and being too doped up. Kim

[FemaleK9]

No, I didn't know about that. It sounds like it would be worth trying. Thank you, Kim!

[frijole]

No problem. Many of us here have used it. In fact it's used with dogs that have atypical cushings so it is safe to use. I gave 3 mg at night or whenever she was scared. You can give it twice daily. Good luck! Kim

[Junior's Mom]

It's so great to hear the success Rosie is having. It gives me hope for my Junior.
I noticed you are thinking along the same lines as me, re the anxiety/stress, and cushing's. Perhaps a moderator could set up a poll for this. I tried, but it won't let me.
My dogs are also terrified of the thunderstorms. I have tried different anti-anxiety medications-clomicalm, prozac, they didn't make enough of a difference. The problem with a tranquilizer rather than an anti-anxiety, is the animal is still terrified, but unable to move around and show it. Tranquilizers can therefore make the situation worse.
The best thing to do, as hard as it is, is ignore them. Paying attention when they are terrified, tells them that their behaviour is justified.
I do use melatonin. It helps take the edge off. I have thunder shirts and anxiety shirts. The thunder shirts are easier to put on, but much hotter I find.
Harp music is supposed to be relaxing to dogs. I have a cd from a video game with harp music, I put it on repeat during a storm. The noise from the a/c helps cover the sounds too. Of course these only work if the power stays on. One of my dogs has to be leashed during a storm or he is frantically trying to get away to no-where, through the walls.
If the storm happens at bedtime, I end up with 5 dogs in my room, shaking the bed, and making it really hot. How we love our critters right.

[FemaleK9]

Unfortunately, it's not possible to ignore Rosie when she's in a panic. I have been woken up in the middle of the night with Rosie trying to stand on my head with all four feet, clawing at my face, pulling my hair out and dripping spit into my eyes and ears!

But I know what you mean, I have never done anything to make her think her fears are justified, nor have I given treats (which she won't take when in a full-blown panic, anyway) or done anything else to "reward" her panic behavior. I have tried music and closing all the curtains and leaving the lights on all night so thunder and lightning flashes won't be noticed if distant, giving her a comforting "safe" place to go, and more that I can't think of at the moment.

I have been able to help her with fireworks - she used to panic for fireworks, too, apparently mistaking them for thunder, but I worked on it and she has learned the difference and now tolerates them well; she has even watched some with me. She's not thrilled with them, but doesn't panic.

But in the soon-to-be 11 years that I have had her, I have not been able to do anything to reduce her fear of thunderstorms, despite the fact that nothing bad has ever happened to her, as I remind her to no avail.

My theory is that she learned the fear of thunder storms when she was just a puppy with her mother. She was kept outdoors in an elevated wire kennel with a wooden box-like section the mother and her litter could go into, but still very exposed to the sound and fury of a storm. Rosie was born 7/29/2002 and I got her 9/13/2002. I bet there were several thunderstorms during that time, and I think the mother was terrified and passed that terror on to her pups in that first six weeks.

[Squirt's Mom]

My Pug, Sophie, is scared of storms and when it thunders, her hackles come up and she charges - the doors, walls and windows trying to "kill" it. She will throw herself at the closed door then run around the house terrified, barking. Between booms, she sits, shakes, and whines. I tried putting her in the bed with us thinking that would help but that just gave her a high platform to dive off of repeatedly, causing me to fear she would damage herself that way. So, I have learned when it's supposed to be a bad one, to put her in her crate and cover it with blankets so she has a little dark cave to stay in for a bit. She is medicated (Melatonin, Passionflower and Skullcap...all three get this cocktail) and wearing her Thundershirt in the "cave". She will still bark and tremble in the crate but she can't hurt herself as easily and is much calmer than when loose in the house during storms.

I learned the "cave" trick from my Pitty mix, Crys. We would crate her at night and if we didn't cover her crate she would sit in there and talk to us allll night long! :rolleyes: But if we covered the crate, she went to sleep - like covering a bird's cage to keep them quiet! :p

Crating Squirt during storms does not work, however. That makes her more frantic. She wants to be next to me, touching or standing, staring in my face, panting like mad drooling all over the place. Nor does it help Brick - he needs to pace to burn up the nervous energy but he doesn't do things that could harm him or others like Soph.

Have you ever talked to the vet about a different sedative than the ACE? It might be that a different drug would help a bit more especially if the ACE is what she has been on for a while.

This is an odd season all over I think. We have been having temps in the 60's and 70's overnight and highs only in the 80's or low 90's during the day lately - NOT typical for an ARK summer at all. It seems we are having more rain than last year as well but not as many storms as in other areas like yours. I'm not complaining about the temps at all, tho! I don't handle heat well so this is a blessing for me!

Hope Rosie has a good day!
Hugs,
Leslie and the gang

[molly muffin]

I too sympathize with the thunderstorms terrors. Molly gets into quite a state at thunderstorms and fireworks. She has never figured out the difference. Also, a car back firing, or any other boom sound gets her going and she goes into the shaking panting mode straight off. The worse during the thunderstorms and only being right beside us makes her feel better. Molly wakes us at night too if it is thundering. We've finally got her where she will go under the bed, if you show it to her and she is better under there and we made her a bed in a suitcase which is like her safe spot I guess.

You aren't alone, many of us go through this with the furbabies. It's tough, but you just try to get them through it.

hugs,
Sharlene and Molly Muffin

[FemaleK9]

Well, we're in the midst of it again, one line of storms after another starting yesterday evening and continuing today. :(

The vet did say we might try something else, but I think I'll give the melatonin a try first because all the anti-anxiety meds have potentially serious side effects.

The ace is more beneficial to me than Rosie, I think. It keeps my skin on and allows me to get a little sleep.

[FemaleK9]

I got some melatonin to try - 10mg "maximum strength" cherry flavored quick-dissolve tablets, because Rosie has a large fear and I figured it would require a large dose if it was going to work, plus I like the flavored quick-dissolve part, although I did end up poking them down her throat.

We've had several more storms since I last posted and I have tried the melatonin several times. So far, it has been ineffective.

Rosie woke up in a panic this morning, having dreamed a storm. I gave her the melatonin, again with no noticeable effect. The day has been one of those that look like they could storm at any time, though none has actually developed so far, and Rosie has been nervous all day. I wouldn't be surprised if she went into full-blown panic after dark this evening.

I was hoping the melatonin would help, but I'm not too surprised that it hasn't, what with the Thundershirt not helping much either. I'm afaid Rosie's phobia is an extreme case.

Which still leaves me wondering if it isn't responsible, in whole or in part, for her Cushing's.

[labblab]

Hey Karen, please do make sure those cherry-flavored human tabs don't have anything harmful for Rosie -- especially artificial sweeteners that can be toxic. It always makes me very nervous to give a "tricked-up" human product to a dog because it is hard to know whether or not the dyes, additives, sweeteners, etc. are all safe for canines. :o

Marianne

[frijole]

I wish you would have bought the plain jane stuff too because that fruity stuff always makes me wonder... most small/medium dogs only need 3 mg so I can't believe you gave 10 and got nothing... Wish you were closer as I have a bottle. Gave a friend some for her yellow lab and it only took 3 mg to chill him out. If you give another brand (I just bought mine at Walmart) a try get 3 mg and try them on a regular day just to see if they chill her out. They will not hurt her in any way - they just mellow them out. Kim

[FemaleK9]

Yes, I know what you mean. I tried to find a canine version, but struck out.

Fortunately, Rosie doesn't seem to be affected by any of the things that I have heard are dangerous for some dogs. I gave her raisins when she was a puppy before I found out they can be toxic to some dogs. Luckily, Rosie wasn't affected, but I stopped giving them to her anyway, just in case. I never gave her chocolate, but she has managed to get some from time to time - also, thank goodness, without any ill effects.

In any case, the tablets won't be a problem; since they don't help her, I won't be giving her any more.

[FemaleK9]

Just checking in to say things are still going well.

One morning last week, Rosie threw up some bile and foam before she had been fed anything that day, and I withheld the Vetoryl for her breakfast meal as a precaution and kept a close eye on her. She did eat her breakfast and showed no further signs of vomiting or diarrhea so I resumed the Vetoryl at the next dose time (didn't try to make up the missed dose) and she's been fine, so I don't know what that was about, just glad it's over without any further ado!

It has happened from time to time with her since she was small, and I think sometimes she just gets too empty, since there's never any further problem. It's just particularly scary now that she's on the Vetoryl, since it's one of the signs of overdose.

More thunderstorms, of course. I've decided to stick with the acepromazine and not try to work any more supplements or meds into the mix for now; Rosie's doing very well on her current regime (the Vetoryl, Chlortrimeton for her allergies, a cranberry supplement to prevent UTIs, and ace as needed) and I don't want to do anything to upset the apple cart!

[molly muffin]

Glad to hear that Rosie is doing well. :)

It an happen that they get a bit of upset and then just as you did, withhold that dose of vetoryl, see how it goes and if fine, pick it up on schedule. It doesn't hurt a bit to miss one. :)

hugs,
Sharlene and Molly Muffin

[Harley PoMMom]

One morning last week, Rosie threw up some bile and foam before she had been fed anything that day, and I withheld the Vetoryl for her breakfast meal as a precaution and kept a close eye on her.

It has happened from time to time with her since she was small, and I think sometimes she just gets too empty, since there's never any further problem. It's just particularly scary now that she's on the Vetoryl, since it's one of the signs of overdose.


Maybe try feeding Rosie a small snack before her bedtime, it may help with the upset tummy.

[FemaleK9]

Rosie gets a small supper at 11pm.

The mysterious occurrences of her spitting up a little bile are very infrequent, maybe once or twice a year.

They could possibly be related to the very, very infrequent seizures she has had, which have been preceded by a lot of yellow bile and clear mucus-y stuff being spit up, usually in my bed. She has never been treated for the seizures as they are so infrequent (less than once a year) and mild (she can hold still if I calm her and keep her from struggling against them, and they pass off within a very few minutes) with no noticeable aftereffects, that the vet thought treatment was unneccessary.

[FemaleK9]

Update: Rosie is having a massive shed, similar to the one that began last year around this time, before she was diagnosed or treated for the Cushing's. After the diagnosis, looking back, I assigned that aberrant shed to the Cushing's. But now it's happening again.

She's losing not only the underfur, but the guard hair as well, particularly the black, but maybe it's just more noticeable. This leaves her fur feeling fluffy and dry, not the sleek smooth outer hair as usual.

I'm getting bags of fur from brushing and combing her, and my mother and I are wearing, eating and inhaling fur. It's everywhere.

So far, amazingly, she has no bare patches or even thin enough to show the skin, and she came out of the other one all right, but it worries me all the same.

Is this common for dogs with Cushing's? Is it a sign that the Cushing's isn't being controlled? She has none of the other signs any more. We have gone through a bad spell of storms again recently; maybe the shedding is due to the stress? She always shed a lot during and after a storm at any time of year, maybe having the storms at a time when she was going to shed anyway just made it excessive?

[labblab]

It is not unusual for Cushpups to go through a massive "molt" after beginning treatment and successfully lowering cortisol. We suspect this may have something to do with the resumption of the normal hair-growth cycle after it had been disrupted by the elevated steroid. If you are seeing new fluff underneath instead of totally bare spots, I think this is a good thing. However, the texture (and even the color) of her hair may be a bit different from this point onward.

Having said all that, my two non-Cushpup Labs are shedding worse this summer than I've ever seen them do before, and other friends of mine have reported the same. So I don't know if it's this goofy weather everywhere, or what!

Marianne

[FemaleK9]

Thanks, Marianne, it always helps to know I'm not alone! And the weather has definitely been crazy here, too, this summer, with all the thunderstorms (poor Rosie!), massive rainfall and flooding.

No, I'm not seeing any bare spots, but I can brush and brush, then turn around and pet her and get a handful of fur flying around, and there are fur "tumbleweeds" being blown around the house by the fans. Argghh.

[FemaleK9]

Just an update:

Rosie's massive shedding appears to be tapering off at last after chunks of her "pantaloons" have finally been depleted. She still has no bare or thin spots, but she is looking leaner since losing all that fur padding. She still sheds a lot during thunderstorms, and, unfortunately, we've had a lot of stormy weather again.

For the last 12 days, I have been using chicken flavored chewable trilostane tablets from Wedgewood Parmacy, a compounding pharmacy in NJ. There have been no adverse reactions to the change, and I can simply put the tablet in her meals, which is a blessing. I also have to give her allergy pills daily and , lately, sedatives quite frequently due to thunderstorms or anxiety attacks about thunderstorms (or, one morning, a big bang of unknown origin), so it's really nice to avoid having to poke two more pills down poor Rosie's throat every day.

Plus, I got two bottles of (100) 10mg tablets for $49 each plus $10 shipping which, for Rosie, is a 100 day supply for a total of $108, or $1.08 per day. I had been getting the Vetoryl though the vet for $87 for a 30 day supply, or $2.90 per day (I must note that the vet was not overcharging me, they gave it to me for less than it would have cost me to buy it directly from Wedgewood myself, so they were even passing on their trade discount). This is a considerable savings for me, and since I am retired on a less than princely income, this is important to me.

The only downside is that it isn't the brand name Vetoryl from Dechra, so I won't have the support from Dechra should I need it. However, I have read in one or two threads here that they haven't been very helpful recently, anyway. And I do have this wonderful forum should I need help and support in the future. So, weighing all the pros and cons, I decided to go with the tablets for two weeks and, if there were no adverse reactions, to reorder the 100 day supply, which I have now done.

I'll update from time to time to let you all know how Rosie is doing, but for now everything seems to be under control, and Rosie is doing very well when not being terrorised by the weather.

[molly muffin]

Hi, glad to hear that Rosie is doing well. Those thunderstorms really seem to get to most of our dogs. Rosie has a pretty bad case, so does Tipper.

That is a great deal. I'm glad you were able to get it at a good price.

Usually the unhelpful has been us in Canada and out of the US. For people in the US, they are great. Just because you are using trilostane compounded doesn't mean they won't help. Vetroyl's ingredient is trilostane and most just say they are on this amount and here is what is going on. Some of the others who have needed help and got it can tell you more of course.

It sure feels like Fall is here today. A huge difference after the last 2 days!

hugs,
Sharlene and Molly Muffin

[FemaleK9]

Yes, we've had a big change here in NY, too - from 92F to 62F overnight. From A/C to heat. Can't get a break fom throwing money at the utilities.

[molly muffin]

Utilities are always sucky. We'll hit 41F overnight tonight. I'm not putting the heat on yet though. I refuse to make that move just yet. LOL Especially when it'll warm up again in a day or so. Until then I'll just pull out sweaters if I need them and an excuse to wear my fuzzy socks too. Love those things! (Molly rather loves them too) hahahaha

hugs,
Sharlene and Molly Muffin

[FemaleK9]

Yes, we went down to 38F one night, but of course the house didn't get that cold. I would do as you do and bundle up when it's cold if it was just me and Rosie. Unfortunately, my elderly mother is on blood thinners and really feels the cold, and both the heat and a/c are set warmer than my comfort level. So I wear lightweight summer clothes in the house all year long. No wool for me. Really sad, because I'm a knitter. I do get to wear my hand knitted wool socks outdoors in the cold weather, but I'm usually wearing boots then, so they don't show.

[molly muffin]

Oh yes, I understand you completely. My parents as they got older and dad made it into his 90's, definitely liked it a lot warmer in the house than I did. I like comfortable, but they would freeze and I'd pile blankets on the bed.

hugs,
Sharlene and Molly Muffin

[FemaleK9]

Rosie is continuing to do very well. Her coat has become sleeker and shinier as it grows back after The Great Massive Shed of 2013. She looks like a healthy, happy dog, and at least 5 years younger than she looked before diagnosis and treatment. The bloated belly is gone, loose folds of skin on her neck, chest and belly have magically tightened up, and her face, that had developed a rather bony look has now filled in - in short, total rejuvenation!

We had another skunk scare last trash day. I had let her out for "last call" on the electronic collar, forgetting it was trash night, and when I opened the back door to let her in, I got an unmistakeable whiff of skunk. I pounced on Rosie, but she had none on her. I think she scared a skunk into letting fly nearby, but didn't get any on her, she's definitely learning to keep her distance. The last time, which I reported here, was just a glancing blow, not a direct hit, so I thought she had learned some wariness, but this episode really encourages me to think she has finally learned to respect skunks!

[molly muffin]

YUCK nothing worse than skunk smell. We've come across a few when on our walks and so far have been lucky enough to miss them. Molly just thinks they want to play. (NOT!)

So glad that Rosie is looking and doing so well! Love it when things fall into place like that.

hugs,
Sharlene and Molly Muffin

[FemaleK9]

Rosie is still doing very well, but I'm becoming concerned about the growth of a couple of fatty tumors I've been keeping an eye on. They have grown noticably since the spring, and I've found a couple of new ones, too.

I hate the idea of surgery unless it's absolutely necessary, but if it's going to be necessary, now would be better than waiting until Rosie is even older.

Are these common with cushpups? Do they usually require surgery?

[Harley PoMMom]

Fatty tumors ( lipomas) are common on dogs, I don't believe Cushing's makes a dog's chances higher of getting them. If they are not causing a problem, removal is usually not needed.

[molly muffin]

We found a couple of these on Molly too. My vet did an aspiration to make sure that they were just lipomas. (fat cells) Humans and dogs can both get these as we/they get older.
They usually operate if they are growing in an area that is causing a problem, pressure, under a muscle, etc. If not then they usually don't. Even if they do, lipomas normally come back.

Nothing wrong with getting them checked by a vet. :)

hugs,
Sharlene and Molly Muffin

[goldengirl88]

Tipper has a number of these and I read somewhere that people with Cushings are prone to these also. Tipper has one on her knee that is huge and seems like it will burst. I do not put her under for anything anymore, I do not want to chance it so it has to stay there. I even stopped her teeth cleaning so she does not have anesthesia any more, but do brush her teeth every day. I am just leaving her alone if possible. Blessings
Patti

[molly muffin]

Happy Thanksgiving Karen and Rosie!!!

Hoping this day finds you well fed and well rested. :)

hugs,
Sharlene and Molly Muffin

[FemaleK9]

(burp) Thanks!

And thanks, all, for your input on the fatty tumors.

Rosie's fatty tumors, the two big ones, are on her chest. The vet said she'd never seen them in a bilateral pair like that before. I told her I think Rosie is trying to grow a rack like mine, lol.

I was also aware of a much smaller one on her side that both the vet and I had a hard time finding at the time of that visit. Now I'm finding more on each side near her back legs, but they are also relatively small.

It's the two big ones on her chest that are of most concern to me at this point. I'm afraid her harness may cause irritation and/or complications, but she likes the harness and is used to it, and I don't like risking neck injury by walking or tying her out with a collar.

I also hesitate to drag Rosie to the vet about it. I know the only way to get rid of them is surgery, and I really don't think I want to put Rosie through that for what is essentially benign.

Sorry, I guess I'm just a worry wart, I know so many of you have serious issues to worry about and I guess I should just count my blessings.

[goldengirl88]

Karen:
My Tipper had about 6 right now. Some are only as big as the eraser on a pencil. The one on her knee is huge though, and I am afraid of it bursting if it gets any larger. I will not even consider putting her under to remove it. I think if they get them when smaller sometimes they can lance them. Blessings
Patti

[molly muffin]

Merry Christmas to you and Rosie and your family.

hugs,
sharlene and molly muffin

[FemaleK9]

Thank you! And Merry Christmas to all from me and Rosie!

[molly muffin]

Happy New Year Karen and Rosie

I hope you have a wonderful New Year, health and happiness galore! :)

hugs,
Sharlene and Molly Muffin

[Renee]

The lipomas are a nuisance for sure!

My pug Ichiro has had two removed, because for some reason, his like to grown in bad places. The first one was right in the crook of his front leg. We took it out when it got to the size of a golf ball, before it started affecting his walking.

The second one was the worst, and very painful for him. It was growing under the muscle on his front right shoulder. It was under the muscle, all the way down to the bone. Puffed his shoulder up really big, and was very, very painful for him when it started pulling his muscles away from the bone.

If you have a dental scheduled any time soon, they can pop those lipomas out at the same time.

[FemaleK9]

I really had a bad night with Rosie last week. She was thrashing and even snarling in her sleep, which I have never heard her do, and when awake, she couldn't find a comfortable position (I know what that's like) so I know she was in pain, and when I got up with her, she was limping badly on one front leg. So I called the vet in the morning and they squeezed her in in the early afternoon. The problem seems to be her neck. I have no idea what happened to it, but as I know from my own experience it doesn't have to be much, just a wrong movement at the wrong time.

So she's on a muscle relaxer and an NSAID for pain, and she felt better right away. Which makes her think she can run around the yard and jump up on beds and furniture, although I try to discourage it, as the vet advised.

The thing is, I think Rosie may need an increase in her Trilostane dosage. She's begun to exhibit some of the signs of Cushings again, particularly the bloating. She weighed 37 lbs at the vet, an all-time high for her. And her diet hasn't changed, so she can't have put on fat. It happened gradually, but I finally did take notice. I pointed it out to the vet, and she wants to to wait at least a week until the neck problem has healed to do an ACTH test, and I agree.

So, I'll see how she's doing when her meds are finished and we'll decide what to do next from there.

[molly muffin]

Hi Karen, I'm going through much the same thing with Molly right now, only not neck, middle and lower back. The NSAID does make them feel like they are queen of the world again, but best to keep them from any jumping or steps, etc, until fully healed.

I found though that the cortisol Must be going up in reaction to the injury (as is natural) so unless she was exhibiting signs before the injury of increased cortisol, maybe just make sure that she is healed and in a normal state for awhile and then do the follow up ACTH. I don't know how that would work since Rosie Is on Trilostane if the cortisol would be able to go up very much or not, but it's just a thought of what could be going on too. I just know molly is drinking more since the injury and the anti inflammatory too.

Hang in there
hugs,
Sharlene and Molly muffin

[FemaleK9]

The weight gain didn't happen suddenly, so I think her cortisol has increased over the last couple of months, whereas the neck injury was sudden. I had just begun to realize her appearancve had changed, and to wonder if she was drinking more water and stoning me harder for meals lately (and I think the answer to both is yes, although not nearly as marked as when she was diagnosed) when the neck thing suddenly cropped up.

So I'm going to follow up on the ACTH test as soon as the neck problem is resolved. She's still limping a bit, so I would say another week at least.

[molly muffin]

Awww, poor baby. Yes I see what you mean in regards to the other things going up and then the neck injury being sudden. So, it's a possibility :( She's been doing pretty good for awhile now.

Well, hope it heals up quickly. Just don't let her be doing back flips and cartwheels. :)

hugs,
Sharlene and Molly Muffin

[FemaleK9]

Yes, she has been doing really well for quite a while, and to stay at her first dosage without any further tweaking was amazing, but I guess things can change and that's why they need to be monitored from time to time.

[Dixie'sMom]

Well my goodness, the last time you posted on Rosie's thread was in February. Thats a long time ago. I know she has been into more skunky trouble since then and had more tests and more thunderstorms. How is she doing right now?

And one thing I thought of while reading about the the thunder storms is that a friend of mine uses a "natural" product recommended by her vet called "Composure". She orders it online and says it really helps with her little rat terrier that has alot of anxiety and is terrified of storms. It may be worth a try if you haven't found anything to help her yet. i remember looking it up and it had B vitamins and some other stuff. Nothing that I could tell that would be harmful.

Hope you and Rosie are fast asleep and have a peaceful tomorrow.

[FemaleK9]

I didn't mean to go AWOL, I've been posting everywhere but on on Rosie's thread, apparently!

Rosie's still doing very well. I cut back on her food and she has lost weight and is looking very trim. So she was simply too fat, not going Cushinoid bloaty as I feared. Also, she wasn't drinking as much as I thought she was. It turned out my elderly mother was changing Rosie's water. For some reason she could pick up and empty a full bowl, but couldn't manage putting down a full bowl, so the drop in water level I kept seeing wasn't from Rosie! So I never did get the ACTH done again. Her Cushings symptoms continue to be well under control, and, knock wood, she is healthy in all other respects.

We have just gone through a big shed, but not as massive or prolonged as the the two previous ones. I got a new brush that helped a lot. I actually didn't realize how sleek she has gotten until I brushed bags and bags of fluff out of her!

She has shown a sharper appetite lately, but I think she is really hungry and I have increased her food a little. I don't want her to lose any more weight; I don't know exactly what she weighs (I'd guess 30-32 lbs), but she looks good - her ribs can be felt, her waist curves in when you look at her from above and her belly is nice and flat and firm. Wish I could say the same about myself!

I'm still using the acepromazine for thunderstorms. The other things I have tried not only haven't worked, but they make it so I can't give her the ace in case of an interaction overdose. And Rosie in an uncontrolled panic is no fun to be around, believe me. She claws at me and tries to climb up on my head. What she wants is for me to take her in the car and get out of Dodge. Often, the storms are so widespread, there's no getting away from them, but sometimes in the daytime when I expect the storm to pass I do it, I call it "Driving Miss Rosie," we just drive around for a while until the storm passes, but I can't do it at night. I can drive in the rain and I can drive at night, but I can't drive in the rain at night, my eyesight just isn't up to it.

[molly muffin]

So glad to hear that Rosie is doing so well. Isn't that funny, it was your mom all the time with the water. That is something my mom and dad would have done too. :)

Are you going to have her cortisol levels checked to see how she is doing? They should be checked periodically, even after they are on a stable dose, in case anything changes.

So a trim and fit Rosie eh. She must be looking really great then. :) Couldn't be more pleased and very happy to see an update on her.

hugs
Sharlene and molly muffin

[FemaleK9]

Yes, I know she's overdue for a routine ACTH, but I'm having a lot of trouble getting around lately due to worsening hip and knee problems. It's all I can do to keep groceries in the house at the moment.

[molly muffin]

Oh no Karen. Do you have any help from family? Someone to run errands for you? Sorry not thinking of Rosie at the moment but of you.

Hip and knees are so painful too. Very sorry to hear you are dealing with both.

Hugs
Sharlene and Molly muffin.

[FemaleK9]

No, I have no one to help, in fact I'm the one who is helping my mother, who will be 90 next month. I sold my house and moved in with her in 2006 to make it possible for her to stay in her home. She had to give up driving several years ago, so I do all the errands, trips to her doctors, etc. There are no family or friends anywhere near us.

[Dixie'sMom]

Hey Karen! I'm happy to hear Miss Rosie is doing so well but upset to hear that you are having trouble with the knee and hip. I have trouble also so I understand the frustration and pain involved with just doing simple errands. At least my adult children do help which is a blessing. I discovered the ride carts at Walmart and holy cow! Other than my leg going numb while I was riding it, it was wonderful to zip all over the store getting things I needed instead of gritting my teeth in pain and finally leaving without having gotten everything I need. I hate walmart but love those carts. I know some grocery stores have them, but my neighborhood one doesn't so I suffer there. I'm saying a prayer for you, my friend. I hope you get some relief and Rosie continues to do well.

[molly muffin]

Oh that does make it so much harder when you are down too and have to take care of your mom and drive her around. :(

hugs to you and belly rubs for Rosie
Sharlene and molly muffin

[FemaleK9]

Thanks for the sympathy, it actually helps a lot!

[FemaleK9]

I am at the vet waiting for Rosie's ACTH test and checkup to be done. We are long overdue for the stim test, I'm afraid, but I've been having a lot of trouble getting around. In fact, I'm going to be having a hip replacement in Feb. I'm really looking forward to having that behind me, and I'm hoping (after recovery) to be able to take Rosie for long walks in the woods again, and to take her out on the lake in the kayak.

[lulusmom]

No, I have no one to help, in fact I'm the one who is helping my mother, who will be 90 next month. I sold my house and moved in with her in 2006 to make it possible for her to stay in her home. She had to give up driving several years ago, so I do all the errands, trips to her doctors, etc. There are no family or friends anywhere near us.

Welcome to my world, Karen. Up until a few months ago, my 90 year old mother and I were very isolated in Show Low, AZ. I decided that we needed to be near family so we moved to Tennessee. I am my mom's security blanket and she will always ask me to do her bidding but at least I have back-up now. My hips and knees are really bad too but I am still walking without a motorized cart at Walmart. That's my mom's favorite store so we're there once a week. She pushes her her cart through the aisles just fine. I really do feel your pain in every way. Hang in there and best of luck with your upcoming surgery.

Glynda

[molly muffin]

My sister had her hip replacement surgery this summer and she is so happy, she said she was being silly to wait. It does take a bit of recovery time though so prepare for that, but over all, it is good to have and you'll be walking and kayaking in no time. :)

I'd have to move to California to be anywhere near family to help me out if I needed it and I don't see that happen. My sister said this summer, why don't you at least get over to the west coast of Canada that would be closer than where you are. Well, that isn't an easy thing to do either with jobs and one stepdaughter here in the city with us.

It sure does make it hard though when you don't have family close by.

Hoping for good test results for precious Rosie.

Hugs

[FemaleK9]

Just got a call from the vet with Rosie's ACTH results:
Pre : 4.1
Post: 6.7

Previous test July 2013:
Pre. : 5.8
Post: 6.3


With these results and her symptoms well controlled, we are going to keep her trilostane at 10 mg twice a day.

So, good news, Rosie is continuing to do well at the low dosage!

Her fatty tumors on her chest have grown, and the vet says that they aren't causing any problems at the moment, but they could if they continue to grow. On the other hand, if she is to have surgery, at her age (12 now), now would be better than two years from now. I've decided that I'm not going to subject her to the stress and risk of surgery for something that isn't life threatening and that isn't even causing any discomfort now, and may never. I hope I never have cause to regret this decision.

My wonderful cousin is going to come and stay when I have the hip surgery, and look after Mom and Rosie for me. I think my brother would have stepped up, but he has been very ill himself and I can't count on him being well enough by then. I don't know how long the recovery and rehab will be for me, but I hope it's quick!

I know there are others here who are in very similar situations, it's nice to know we can support each other in this as well as with our cushpups!

[molly muffin]

Wonderful news all around. The thing is that you can remove the lipomas and half the time they come back anyway. Molly has a couple small ones, with only one really having the potential to bother her in the future. For no it doesn't so we haven't had any removed either.

Awesome that your cousin can come stay and help out while you have the surgery done. I think my niece stayed a week with my sister. I'd have to check to be sure, but people are like dogs in that each one is different in how they recover.

Hang in there! We're just support santas :)
hugs

[molly muffin]

Merry Christmas Karen and Rosie!!

Wishing you a joyous holiday season

hugs and love

[molly muffin]

Happy new year Karen and Rosie.

Hugs

[FemaleK9]

A belated Happy New Year, everyone!

Rosie has a new trigger, the snowplow/sander going by at night with the flashing light on top seems to make her think it's lightning. So, panic. Sigh.

[molly muffin]

Oh fooey. Doesn't take much to trigger them when their cortisol is lower than they are used to.

[Squirt's Mom]

awwww, bless her heart. And she has several months ahead to have to deal with them...and so do you. :(

[Dixie'sMom]

Poor baby. They are so pitiful when they are scared and you can't explain to them it's nothing that is going to "get them." :(

Dixie is terrified of the vacuum cleaner. Buttons is terrified of noises that sound like the smoke alarm.

Comeon Spring!

[FemaleK9]

I'm afraid a snowplow is a lot more frequent here than a vacuum cleaner (LOL). Last winter, we even had a thundersnowstorm, which I didn't even know was possible. All I need is for Rosie to start panicking every time it snows as well as every time it rains, although her anxiety level already rises as the barometer drops, any time of year. Between my aching joints and Rosie's anxiety, I always know when bad weather is coming!

[FemaleK9]

Awful quiet around here at the moment. I hope no news is good news, and that you are all enjoying your dogs if not the winter weather.

[Dixie'sMom]

I'm here! How are you and Miss Rosie doing? Are you getting snow? We're having some cold temps but no snow. I'd like to see a little bit but not as much as some places are getting! Are you having blizzards? I sure hope not, but I bet you are getting snow and the snow plows right along with it. Poor Rosie :(

[FemaleK9]

We're just getting normal amounts of snow here so far, no blizzard, but we're getting frequent small snowfalls and frigid temps, frequently below zero F at night.

So the sander/snowplow is pretty much going through nightly. Rosie shivers and shakes and walks the floor for a while, but she calms down eventually and comes back to bed.

Aside from that minor problem, Rosie's doing really well. We've been very lucky so far, both with managing her Cushings and the freedom from any other related or unrelated health problems, and my heart goes out to all the dogs and their owners who are struggling.

How are you and Dixie doing?

[Harley PoMMom]

Oh Karen, it is great news that Rosie is doing well on treatment!!!

My Harley was terrified of thunder, or any loud noise for that matter, when I started him on Melatonin it calmed him right down, and he would sleep through any load noise!

Keep us updated, please. ;)

[Dixie'sMom]

Karen, remind me of when your surgery is? I know its in February but I can't remember the date.

[FemaleK9]

Feb 10 is the hip replacement. Getting a bit nervous as the time gets closer, to be honest. Also achy, sleep-deprived and cranky. Can't wait to have it behind me.

I tried Melatonin on Rosie some time ago, it did nothing for her, sad to say. Most recently, the vet had me try Zylkene, also with no apparent benefit.

Fortunately, the snowplow doesn't usually cause full-blown panic like the T-storms, she'll tremble and walk the floors for a while, then come back to bed and sleep, so I don't have to resort to the acepromazine.

[Dixie'sMom]

I'm sure you are getting nervous about the surgery. I would be the same way. Just try to think about how nice it will be to have a hip that doesn't hurt. It will be worth it in the end. I will be here rooting for you and sending prayers for all of you. I hope you breeze thru it like a boss! (LOL - I think thats a term the kids use, right?) :D

[judymaggie]

Karen -- will be thinking good thoughts for you with regard to your surgery! My best friend had a hip replacement four weeks ago and she is now walking without any aides and is driving again. She is very, very diligent with regard to doing the recommended exercises and I think this helped her a lot.

[molly muffin]

My sister said the hip surgery was best thing she could have done and wondered why she waited so long to do it. Nerves for which I don't blame her a bit. She says being able to walk with no pain is awesome!

Hugs

[FemaleK9]

Having said I don't have to sedate Rosie for the snowplow, she had to make a liar of me. I'm not sure why, because I slept through the early stages, but I think it was multiple passes by the snowplow plus several independent driveway snowplows operating near us, and all of them with flashing lights. Sigh.

Being able to walk is awesome. I used to take it for granted, but I sure won't any more.

[Squirt's Mom]

A friend of mine just had total knee replacement. Do not do what she has done - she has bounced around on the floor a couple of times since coming home. :eek: So don't do that! Be lazy! Let others do for you! Sit on the computer and talk to us! :D

[Dixie'sMom]

Sending prayers your way today for an uneventful surgery and a speedy recovery!

Let us know how you are doing as soon as you are able.

[molly muffin]

Thinking of you and all my best!

[Dixie'sMom]

Well you are 9 days post surgery. I hope you are beginning to feel ok. Please let us know how you and Rosie are when you can. Hugs and prayers!

[molly muffin]

Hope you are making good progress with your recovery!

Sending you great big hugs!!

[FemaleK9]

Hi, all, and thanks for the good wishes! I haven't been able to sit at the computer until now, and having to do everything on the phone tends to cut down on the time spent on the internet.

I'm doing very well, I think, getting stronger every day, and at the moment I'm in the process of transitioning from the walker back to the cane. Which will be lovely to have at least one hand free and not having to maneuver the walker through all the obstacles.

My wonderful cousin came from Pennsylvalia to take care of my mother and Rosie while I was in the hospital, and she also took care of some things around the house that made it much easier for me to come home to, like reassembling my antique bed and getting my mattress and box spring up off the floor onto it with the help of a hired worker. She was also the best possible person to be here for Rosie while I was away; Rosie knows and loves Julie. I was afraid of how Rosie might react, I have never left her for so long, I'm not sure if I ever was away from her overnight, but although she was mighty glad to see me when I got home, she wasn't the pitiful wreck I was afraid of.

After picking me up from the hospital and bringing me home, Julie had to leave to get back to her duties at the church (she's a minister) and my brother was to have helped us after that, but that was also the last we saw of him. We have managed to survive anyway, in spite of that and other glitches. The pharmacy messed up and I had no pain meds of any kind for more than 24 hours after getting home (this really set me back, as you might imagine), and a snafu between the insurance company, surgeon's office and the pharmacy meant I didn't get the Celebrex until more than a week later.

My only complaint at the moment is that I've been having restless leg/muscle spasms every night in the leg that was operated on, and while the hyrdrocodone knocked me out enough to let me sleep, the Celebrex doesn't (although it controls pain amazingly well) so I guess I'd better get a call in to the surgeon's office to see if they can help with that.

[Dixie'sMom]

Oh, its so good to hear from you. I'm glad things are better now. I can't imagine those days without your pain meds. Yikes!

Julie sounds like a wonderful person. You were very lucky to have her with you. Your brother sounds like my brothers. They seem to disappear when someone needs something. LOL. And I'm glad Rosie handled everything better than you expected. You certainly didn't need the extra worry so at least she was happy throughout all of this.

I'm still sending prayers your way and I hope the healing is speedy and that you get some answers for the restless leg. Spring is coming and how nice it will be for you to be able to walk without pain. Yay!

[molly muffin]

oh my gosh, I can't imagine going through that and not having the needed pain medication!!!

That is so sweet of your sister to be able to be there for you and to help set the house up for you too.

I bet that Rosie was thrilled to see you. Glad she came through your extended away okay.

hugs

[Squirt's Mom]

Karen, in reading about your ordeal with no meds after being released I found myself hurting! Bless your heart, honey! The one good thing about such horrible pain that I have found is that is doesn't stay in our memory with that same intensity. We remember hurting like all get out....but can't actually access that pain again. I so hope you are in greater comfort now and that you are rapidly back to you full strength soon.

For a couple of years I endured restless leg and it drove me up a wall! I finally figured out the very medicine I was taking to relax my muscles so they don't spasm had turned on me and was the CAUSE of the leg weirdness. We tried several other meds in that same class with the same result - wild legs. Finally found one that didn't cause that reaction. So check side effects on the meds you are taking and talk to your pharmacist - they are the ones who can tell you the most about what drugs can do in addition to what they are supposed to do. ;)

[FemaleK9]

It looks like I'm going to have the same problem. The meds I got for the leg spasms hasn't helped, in fact it seems like it made it worse.

[molly muffin]

Oh no! Is there anything else they can give you?

hugs

[Squirt's Mom]

It was Flexeril that started this for me; I took it for decades with no problem then suddenly it turned on me. They switched me to Tizanidine and it did the same thing after about 3 weeks. Then they put me on Methocarbamol and it has helped since without any leg weirdness. It is not as strong as the other two but works well enough especially since it hasn't brought with it other problems. ;) I've been taking this for almost 10 years now. Doc prescribed 4 a day but I can get by with 1-2 most days. I hate taking meds and don't if I can find any other way around it. :rolleyes: I'm a contrary patient. :p

[FemaleK9]

LOL, me, too! They ordered someting else for me but I haven't had it filled yet. I only wanted someting to use "as needed" because normally I don't have the problem more than, say, once a month. So I don't want to be medicated 24/7 for the rest of my life for something that is just an occasional problem. They told me there is no such medicine, but I know that's BS because my mother used to have something powerful that stopped her back spasms when she needed it. They just don't like giving out anything like that any more. I would only use it to stop the occasional muscular activity at night so I can sleep, but they probably think I'll either abuse it and get addicted to it or try to drive a car or "operate heavy machinery"while on it.

The good news is that the problem seems to be getting better by itself, although I felt like a zombie for a few days there.

[FemaleK9]

I haven't posted an update in a while, so here goes!

Rosie continues to do well with the Cushings, still at the initial dosage after two years plus and with her symptoms well controlled. Her next ACTH is scheduled for Dec 11.

However, Rosie's fears have become much worse over time, not better. Anything associated with t-storms is a trigger. Wind, rain, darkness, change in barometric pressure. Since the last spell of repeated t-storms a few of weeks ago when the hot weather ended, she has come to panic every night at bedtime. The anxiety begins at nightfall, then blossoms into full blown panic when I go to bed. I was concerned about giving her so much of the acepromazine, so googled to learn more about it, and what I found concerned me deeply.

Rather than explaining it myself, I thought it would be better to give you the links so you could check it out:

http://veterinarynews.dvm360.com/storm-phobias

http://www.rileysplace.org/dogblog/why-i-wont-give-my-dogs-acepromazine-aka-ace-for-thunder-phobia-or-fireworks/

The progression of Rosie's anxiety and panic problem certainly seems to bear out the warnings, and I feel so bad for what I have unwittingly done to my poor girl.

I voiced my concerns (including the above links) in an email to my vet, Dr Meenan, and she called to say she agrees that we should stop the ace, and just today she gave me a prescription for Trazodone that I had filled by my (human) pharmacy. Rosie will be on this all the time, not just "as needed" because it apparently needs to build up over time to be most effective, and since Rosie's triggers have become so numerous and ubiquitous (it gets dark every night!).

Naturally, I googled Trazodone, too, and what I read reassures me that we're on the right track, but I was wondering if anyone here has had experience with it and with what results?

As for me, I'm doing very well after my hip replacement. Getting back into top dog walking shape is taking longer than I expected, both as to general physical recovery from such surgery and regaining strength and endurance lost during the period when my hip had deteriorated to the point that I was pretty much too crippled to do any meaningful exercise for so long. My first walk barely made it to the corner before I had to turn around and go back home, hurting and exhausted! But I have kept at it and go a certain distance only for a while before increasing it a bit and in this way I'm slowly going farther and farther.

I even took Rosie to the park a week or so ago when we had some fine weather, and Rosie was thrilled. She even got a bit puppyish and "rabbit ran" a couple of times, as well as she could on a leash. Not bad for a 13 year old! I haven't dared go into the woods yet, but I'm hoping maybe in the Spring. I used to let her off the leash in the woods in the park, even though you're not supposed to, because she was so full of joy and just poetry in motion when she was in the woods.

I am now officially a Senior Citizen. About that, all I can say is: it beats the alternative. Mom turned 91 last week. She has been in and out of the hospital, and then in a rehab facility. She's doing much better, and will be coming home 10/22 God willing, but she is going to need a lot more care at home than she has needed up until now, and I'm so glad I had the hip taken care of when I did so that I'm well recovered and able to keep my promise to her that I will do what is necessary to make it possible for her to stay at home, which is what she most definitely wants.

Sorry for the long post, I thought I was going to make just a brief update, but ended up pouring my heart out!

[Harley PoMMom]

My boy, Harley, was really frightened of loud noises especially thunder storms. When he started taking the melatonin it helped a lot. He weighed around 22 lbs and took a 3 mg capsule twice a day. What is important with this medication is that the regular kind of melatonin is used, not a fast-acting or rapid releasing type.

Glad to hear that the hip replacement surgery went well!! Sorry that your mom has been in and out of the hospital :(

Keep us updated, and take care of yourself.

Hugs, Lori

[judymaggie]

Hi, Karen! Thanks for Rosie's update although sorry to read that her fears have increased. My Abbie has thunderstorm anxiety which has also carried over to strong rain and wind. I have been able to make her pretty comfortable with melatonin and a Thundershirt. Both work better if I know a storm is coming and use them before it actually arrives.

So glad that your recovery has gone well -- a big ar-o-o-o to you and Rosie!

[Squirt's Mom]

The TTouch Body Wrap helped Squirt more than the Thundershirt. Here is a link on that - http://www.oocities.org/foxterrier_rescue/wrap.html

Some videos on the wrap -
https://www.youtube.com/watch?v=WealtLluDcQ

https://www.youtube.com/watch?v=WealtLluDcQ

The fear of thunderstorms hit my Squirt in her later years after our camper was struck by lightening while she was in it all alone. :( We used the body wrap, the Thundershirt, melatonin, Valium (tho that quickly turned on her and made her more nervous), and a variety of herbal teas. The wrap, melatonin and herbal teas helped the most.

[FemaleK9]

I have tried melatonin, but it had no apparent effect for Rosie.

We have a Thundershirt, and it seems to help with daytime storms that aren't too severe, but for the really violent storms and any storm (or weather that Rosie associates with a storm) at night, it is useless.

Last night, our first night with the Trazadone, I had my first uninterrupted night's sleep in weeks, and slept until almost 2pm. But after waking up quite cheerful, having her breakfast and out, she seems to be very anxious and trembly about the grey, raw day and keeps casting worried glances at the windows. I hope her first of the two daily doses will kick in and soothe her soon.

[FemaleK9]

Poor Squirt! I suspect something similar happened to Rosie when she was a puppy. She was kept in a kennel with her mother, in the Adirondack Park. It was a cage of chicken wire, raised off the ground, and had a sort of wooden box at the back where they could go for warmth or to get out of the rain, but it must have seemed very flimsy protection in a thunderstorm. Rosie was born July 29, and thunderstorms are quite common here in August. Her mother may have passed on her own fear to her puppies, if they weren't scared out of their wits on their own. I got Rosie at 6 weeks old, September 13, if I remember correctly, and the fear was already there.

[molly muffin]

i do hope that the trazadone helps her. Molly freaks and shakes something awful during thunderstorms. We use the melatonine, it takes about 30 minutes it seems to kick in so I try to give it early if I know a thunderstorm is heading our way.

Glad you are doing better and recovered from the knee surgery. Hope your mom recovers from her problems too. So touch when you get older. :(

My sister was Thrilled when she became an official senior. :) I think it was all the discounts she could get for shopping. She was saying how she earned every single benefit for getting this far. I have to agree with her on that! LOL

[FemaleK9]

It was my hip, I'm glad to say. Glad because in general, knee joints are more complex, trickier to fix or replace, take even longer to recover from surgery, and the outcome is iffier than for hip replacement.

If there are benefits to being a Senior Citizen, I haven't really encountered them. Most things I have seen so far where a discount is offered can be found cheaper elsewhere without the discount.

Oh, lord, it's snowing here.

[molly muffin]

oh fudge right, hip, hmm, a couple have had knee surgery on here. sorry about that. LOL and see that is even after mentioning my sister, who also had the hip surgery!!!!

It snowed here yesterday but then it stopped, sun came out, melted, repeat throughout day till it finally gave up and stayed with the sun option. Our temps go back up tomorrow though so that is good. Not really ready for winter just yet!

[FemaleK9]

Yes, it cleared here, too, thank goodness.

So far, the Trazadone doesn't seem to be the "magic bullet" we would like. The nights have been better, I can't deny, but she seems more sleepy in the daytime and is displaying tremble-y signs of anxiety around the time of each dose, whether it's daylight or dark, and with no actual t-storms.

I so wish she could tell me what's going on in her mind!

I'm considering some things that the vet listed for me to think about trying.

One is a Thundershirt, which we have had for years and only works in the daytime for distant storms or storm-related weather.

The second is a Thunder Cap, from Thundershirt. I doubt Rosie would like it, she HATES the head collar I tried to keep her from pulling on the leash (now I just keep it in my pocket and threaten her with it if she starts dragging me down the street; it works like a charm).

The last is an ADAPTIL DAP Dog Appeasing Pheromone diffusor, which I think might be worth a try. It's also available in a collar, which might be better since it would work wherever Rosie goes in the house, not just in one room. But maybe the diffusor works better. Does anyone have any experience with these? Which works better?

[FemaleK9]

Rosie's latest ACTH results:

Pre: 4.4 ug/dL
Post: 4.8 ug/dL

Since her symptoms are well controlled, she will stay at her original trilostane dosage, 10mg twice a day.

Full info:

Rosie’s ACTH tests (aka stim tests)

Measurement: ug/dL...........0718112..121114..12115..Ref Range*
Cortisol Sample 1 Pre (basal).... 5.8...... 4.1.......4.4......1.0 – 5.0
Cortisol Sample 2 Post Stim......6.3.......6.7.......4.8.......8 - 17


HAC (pre-treatment): Post ACTH results greater than 20 ug/dL (dog) are consistent with HAC

*Post Trilostane: Pre and post cortisol levels between 1.5 – 9.1 ug/dL indicate optimal control.

07/18/2013 After 14 days on Vetoryl (trilostane) 10 mg twice a day
12/11/2014 After 18 months on trilostane 10 mg twice a day
12/11/2015 After 2 yrs 6 mos on trilostane 10 mg twice a day (Wedgewood Pharmacy Gourmeds)

[Harley PoMMom]

Those stim numbers look fantastic!!! I am so happy to hear that dear Rosie is doing so well with her Trilostane treatment...another YAA!!! How's her anxiety?

Hugs, Lori

[FemaleK9]

Wose than ever, I'm afraid. I now have to sedate her every night. She starts to get anxious as soon as it gets dark, and goes into full blown panic as soon as I go to bed. I've tried everything I or the vet can think of to get away from the acepromazine, but it's the only thing that allows ME to get any sleep.

[Harley PoMMom]

I remember one of our members using Dog Appeasing Pheromone (DAP) with some success, I also ran across this article that lists some suggestions for dog anxiety, hopefully it will be of help: http://shibashake.com/dog/dog-anxiety-problems

Hugs, Lori

[molly muffin]

Oh poor Rosie, sorry she is still having bad anxiety. Melatonin doesn't help her?

That is a wonderful ACTH result btw. Congratulations.

[FemaleK9]

I just became aware of a new drug for dogs like my Rosie who have such a hard time with thunderstorms and all related phenomena.

Sileo from Zoetis (http://news.zoetis.com/press-release/companion-animals/zoetis-announces-launch-sileo-treatment-noise-aversion-dogs)

I am planning to ask Rosie's vet about it, but I know there are other dogs on here with the same problem, and I was wondering if anyone here has tried it on a cushpup?

[FemaleK9]

Okay, I guess not.


I sent an email to Rosie's vet today, asking her to lookm into it and give me advice. I'll post any updates here.

[DoxieMama]

My pups don't seem to be bothered by thunderstorms, so I don't have experience with that. But please do let us know what you find out as it may be helpful for others who do! :)

Shana

[molly muffin]

I'm sorry I meant to get back here and reply drat.

I did a search of the forum and didn't find anyone who has mentioned using or being told about SILEO/zoetis.

I also checked the facebook cushings group and couldn't find anything.

So if you do end up trying it, you will be a ground breaker for many whose dogs are fearful of so many things.

[FemaleK9]

That's what I figured, with it being so new. I did try searching the forum, too, so I knew there have been no posts about it yet.

The non-sedative feature really appeals to me, because I have had to use the acepromazine a lot lately and I hate that she has to be sedated to ease her fear.

I will update when I have a response from the vet.

[lulusmom]

Hi Karen. You probably aren't finding much info on Sileo because it was only approved by the FDA in November, 2015 and Zoetis didn't launch sales of the drug until their May 16, 2016 press release. Sileo really is hot off the press so it is going to take some time to establish any kind of experience that is going to be meaningful. I've included the url to both the FDA Freedom of Information Summary and the Zoetis press release below. The FDA of Information Summary provides a great deal of information that will come in very handy. I have used the FDA site a lot over the years to educate myself on any number of drugs that have been prescribed for my dogs. It's a great tool.

http://www.fda.gov/downloads/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/FOIADrugSummaries/UCM475135.pdf

http://news.zoetis.com/press-release/companion-animals/zoetis-announces-launch-sileo-treatment-noise-aversion-dogs

[kanga]

Welcome the forum. So sorry to hear about your situation right now! Hope your doggy will be okay soon.

[FemaleK9]

The vet called me today. She as actually used Sileo on her own dog this past 4th of July with good effect, and they have it on hand at the practice. After she got my email, she spoke to the vets at Zoelis and there are NO contraindications for Cushings dogs, so I am going to pick some up tomorrow!

First we are going to try it by itself. If that doesn't work well enough, it can be paired with Xanax (Xanax alone did not work for Rosie).

So, we have a couple alternatives to the acepromazine to try. I will report the outcomes here. Wish us luck!

[molly muffin]

That's great Karen!! And good the vet tried on her own dog first too. :) :)

Hopefully this will help Rosie and you. Good luck!!

[FemaleK9]

I have used it twice. There was a t-storm while I was going to get it and by the time I gave Rosie a dose, the storm had pretty much passed. But she was quite frantic when I got home, and the Sileo seemed to get her settled down. The second time was near bedtime that same stormy day, when she started digging the living room rug (digging and/or banging on the tub are panic behaviors for her). Both times he lay down and slept (the fear panic really wipes her out) but without being knocked out like with the acepromazine.

So we haven't faced a really severe test yet, but I'm giving it a tentative thumbs up for effectiveness.

It comes in a syringe with 12 "dots." Rosie's dose is 2 "dots" as measured on the syringe, so there are 6 doses for her. It is injected between her cheek and gum.


Cons: The syringe cost $32, or $5.33 per dose, so not cheap. Rosie also doesn't like the taste and seems intimidated by the syringe.

Maybe I will save it to use in actual thunderstorms (assuming it works under extreme conditions) and continue to use the acepromazine at bedtime when there are no actual storms. I can't afford to use the Sileo on a daily basis.

I'll update when it's been tested under tougher conditions.

[FemaleK9]

In late Nov/early Dec, I felt I was seeing signs that Rosie's dosage, which she has been on since diagnosis July '13, might be too much for her now. Frequent vomiting of mucus and bile (not food) and frequent loose stools, plus her coat was looking better than it had since she started with the Cushings, and she seemed very thin, although she has had no change in diet or appetite.

So I reduced it to one 10mg trilostane Gourmed ONCE per day, instead of twice. In the 6 weeks or so since then, I saw no sign of returning symptoms and the frequent vomiting when empty and frequent loose stools abated.

Rosie had her annual checkup on Jan 9 and the vet and I agreed an ACTH test was in order and it was done Jan 12.

The results of 3.2 ug/dl pre and 4.4 ug/dl post are the lowest Rosie has had since this began, and at half dose at that, so the reduction was clearly necessary. Also, she was down to 24 lbs, the least she has ever weighed as an adult.

Dr M said that it's possible the pituitary tumor that is causing the Cushings may be necrosing (dying) and that Rosie might get off the trilostane completely in time, but that other scenarios are also possible that might require an increased dose instead, so we will just have to wait and see. I can't help being a bit excited about it, though!

Here is Rosie's entire Cushing's history in a nutshell, so you can see this new information in context:

http://i130.photobucket.com/albums/p275/1b7395/Rosie%20LDDS%20JPEG_zpsxojtqx5e.jpg

[Harley PoMMom]

Good call in reducing the Trilostane, multiple times we have seen that over time a dog's cortisol drop too low even though the Trilostane dosage was not increased.

Regarding the shrinkage of the pituitary gland, I'm inclined to think that adrenal gland necrosis is more likely as this is a published side effect that can happen with Trilostane.

Hoping that this lower dose will continue to be optimal.

Hugs, Lori

[molly muffin]

Definitely a good call. And yep it's not uncommon to see a dog need a de tease over time. The only way you'd know about the adrenal glands is if at some point they did an ultrasound to look at them.

I'd just stay the course for the time being and retest in the future to see if she stabilizes on the 10 mg.

[FemaleK9]

Yes, Dr M did mention the possible effects on the adrenals, I just presented it as "other scenarios" for the sake of brevity (my typing finger was getting tired). :)

I'm just going to keep a close watch on Rosie for either returning symptoms of Cushing's or signs of overdose, and she will have another ACTH in 6 mos if not needed sooner.

[FemaleK9]

I stopped the Trilostane completely in March of this year and 7 months later Rosie is doing fine. She has a better coat than I have seen on her since this Cushings journey began, and she is neither too fat nor too thin.

The fears are still a problem. I stopped using the acepromazine except for big thunderstorms, because all it was doing was to delay the panic by a couple of hours.

Rosie is 15 now and is sometimes incontinent when deeply asleep, especially when the panic is a bad one, so we were going through dog beds like crazy and Rosie was lying in her own urine. Rosie goes into my bathroom every night and doesn't come into my bedroom until dawn. I hated the thought of her sleeping on the cold hard slate floor, and I wasn't too thrilled with her coming into my room at 5 in the morning reeking of urine, nor puddles on the bathroom floor. I finally hit on a good solution when I bought her a large (so she can stretch out) Coolaroo raised dog bed that allows any leakage to pass through the mesh fabric and the pee pad I put underneath takes care of it, and Rosie is dryer. It's a small bathroom, so I have to suck in my gut to get out of the bathroom after I have set it up for the night. Fortunately I have another bathroom that I can use if I get up in the night! Anyhoo, I highly recommend the Coolaroo bed and pee pad combo to anyone with an incontinent dog.

[Squirt's Mom]

Squirt was about 15 when I stopped her treatment as well...and many other meds she had been on. I promised her no more pokes, prods, or scary rides unless absolutely necessary for the remainder of her days. It was the right decision for her and I trust you know this is the right decision for your sweet girl, too. Squirt was happier and lighter in spirit....I hope Rosie finds the same.

It is so good to hear from you and I hope you and Rosie have many more memories to create ahead of you. Let us hear from you when you can!
Hugs,
Leslie

[molly muffin]

I'm so glad that you found a solution for the bed and night time accidents!

When they get to be older, you just have to make decisions based on quality of life, as to what will work best for them. This is obviously what is best for Rosie and you! :)

[FemaleK9]

Rosie just had her 16th birthday on 7/29. She is still off the Trilostane. A few months ago she seemed very stiff and arthritic, got knocked off her legs easily, never wagged her tail and didnt seem to be enjoying life. I asked for, and got, pain meds for her (meloxicam) - and the change was dramatic. Not only did she seem like her 10 yr old self (at 15) again, wagging tail and all, but THE PANIC BEHAVIOR CEASED IMMEDIATELY. If you look back through Rosie's thread, you will see how long I have been trying to cope with it. And it just stopped. She no longer sleeps in the bathroom, and there's no more banging on the tub every night. We have been through fireworks and even thunderstorms without any problems. Our vet was amazed, because there was no reason why the pain meds should have affected her this way, but we don't need to understand it to celebrate it!

[Joan2517]

Yes, just celebrate it, Karen. Who cares why?? Good for Rosie, and what a relief for you.

Happy 16th Birthday, Rosie!

[labblab]

Oh, I agree 100% — Happy, happy Birthday, little Rosie!!!

And Karen, best wishes to you, as well ;-))))))

Marianne

[Harley PoMMom]

Happy 16th Birthday, sweet Rosie!!! And I am so happy that the pain meds have made such a good improvement in Rosie!!!!!!!

[Squirt's Mom]

HAPPY 16th BIRTHDAY, ROSIE!!


and what a great update! I hope this trend continues from now on and she never needs more than the pain med.

[Gingerbeer]

Happy birthday rosie!

[FemaleK9]

Rosie has crossed the rainbow bridge. It was nothing to do with the Cushings, I hasten to assure anyone reading this. She would have been 17 on July 29th; she had become quite weak and wobbly. I hoped we would have one last summer together. But the day we arrived at camp June 28th, she came for her evening treats when I called her, but not when I called her at bedtime. I notified everyone I could think of, including the lake association page on Facebook, which is how they knew to call me. She was found floating in the lake by two fishermen on July 5th. They took a picture and brought it to me; I identified her immediately. They kindly brought her to me and buried her for me. I think she went for a drink of water after her treats, as was her habit, and she collapsed and drowned. I am broken with grief. She got me through losing my mother and brother two years ago and now I am more alone than I have ever been in my life. I know you will all understand how I feel. It has taken me almost 2 months to be able to post this.

[Budsters Mom]

Rosie is flying free now! She's with many friends at the rainbow bridge.

I am so sorry to read this post today, and very grateful to you for returning to let us know. We will always honor sweet Rosie alongside of you.

Hugs,

[labblab]

Dear Karen,

I am so very sorry for your tragic loss of little Rosie. Those days of uncertainty must have been so terrible for you. But as Kathy has written, Rosie is free of all pain now, and we’re so grateful that you’re allowing us to honor her precious life alongside you. She has now been added to our special memorial thread of honor, and if you wish, it would be our privilege to also add a photo link to her line. At any time, you can email any photo to k9cushings@gmail.com and we’ll take care of the rest. Here is our thread of honor:

https://www.k9cushings.com/forum/showthread.php?9161-Remembering-All-Who-Have-Left-Us-(2019)

Please know that you can return at any time to share special memories of Rosie or to tell us how you’re doing. Absolutely, we do understand how much this hurts and how lonely you are feeling. That’s why we invite and encourage you to keep on writing. We cannot change your pain, but we can walk alongside you and perhaps that may indeed bring a bit of comfort during dark days. Once again, thank you so much for sharing your little Rosie with us, both during her life and now during her passage.

Always in loving memory of your sweet baby girl, and always here to offer you our support.
Marianne

[Joan2517]

Oh Karen, I'm so sorry for your loss of Rosie. We do understand all that you are feeling. The feelings of loss and loneliness can be devastating. My Lena left me 3 1/2 years ago yesterday and I still miss her terribly.

[Squirt's Mom]

Dear Karen,

Sweet Rosie has been part of our family here so many years now and in truth it broke my heart to read your post. She was such a sweetheart with the gentlest eyes. Even tho we know their time is drawing close we are never ready for them to leave, regardless of the manner we are never ready. I can't imagine your fear and anguish those days she was missing but I know the heartache you felt once you knew she was gone. I understand the inability to come here and talk to us about her - my Squirt has been gone 5 years this past May and I have never been able to write a memorial for her. I've tried a thousand times but I just can't. I think somewhere hidden deep inside I still hold onto the hope she will one day show up again so I can't do things that make her absence really real. I still have the food I cooked for her in the freezer - I can't throw it out. So, yes, I understand to some degree the pain you are feeling.

Please don't let guilt take up residence. You were the very best of moms to your sweet girl; she knows that and we know that. You did everything possible to give her the very best life every day she was on this earth. She is once again young and strong and running free in the Rainbow Fields braying with joy as she chases butterflies and bunny rabbits. I promise you she didn't cross that Bridge alone - Squirt and so many of her other friends from here were with her at that lake and walked with her into her new world. She will be surrounded by friends and loved ones who have gone before her until that day when your job here is done and you are reunited with your precious baby girl.

My deepest sympathies,
Leslie




Beannacht
by John O’Donohue

On the day when
The weight deadens
On your shoulders
And you stumble,
May the clay dance
To balance you.

And when your eyes
Freeze behind
The grey window
And the ghost of loss
Gets into you,
May a flock of colours,
Indigo, red, green
And azure blue,
Come to awaken in you
A meadow of delight.

When the canvas frays
In the currach of thought
And a stain of ocean
Blackens beneath you,
May there come across the waters
A path of yellow moonlight
To bring you safely home.

May the nourishment of the earth be yours,
May the clarity of light be yours,
May the fluency of the ocean be yours,
May the protection of the ancestors be yours.

And so may a slow
Wind work these words
Of love around you,
An invisible cloak
To mind your life.

[FemaleK9]

Thank you all for your kind words.
I do blame myself for not putting her life jacket on her. I knew how wobbly she was, and I considered putting it on, but I was in the last stages of exhaustion, and it seemed like one thing more than I could manage, and she never went further into the water than she needed to to get a drink. If I had done it she would still be with me. On the other hand, she may have been spared suffering. She had pain meds but no way of telling me how well they were working any more, and I know she was failing, I was going to take her to the vet for "the discussion" after the summer. I still failed her, no matter how it turned out, though.

[Joan2517]

There are so many "what ifs".

If I hadn't put Lena on the meds; if I had only stayed that night at the ER instead of going home; if I had stayed home from work the first day she seemed in trouble: if I had just put her to sleep while I was there, instead of hoping she would make it through the night.

Nothing can change what has already happened. We just have to acknowledge that we loved them, they loved us, and we did the best we could. I can say it, I just wish my heart and mind would accept it.

[FemaleK9]

Yes, that's it exactly. We will accept it in time, I hope.