Hannah, kelpie x from New Zealand (Hannah has crossed the Bridge)

[littlekiwi]

Hi all
I've read a few threads here over recent days, as my wee lovely girl Hannah was diagnosed with Cushings a few days ago.
She was fine and well 4 weeks ago, but we noticed increased drinking, and then a few accidents.
We took her in straight away, it took a few days to do the tests, and now, worst case scenario has happened.
She has massive tumours on her adrenal gland, her liver and along her aorta. The vets have said it's a matter of weeks, but her aorta could give out anytime, and then she would probably die within minutes.

God this is awful.
She is 12 years old, and simply the kindest bestest *good* dog I've ever known.
She was aboslutely fine 2 months ago, now she can die at any minute.
The stress is enormous. I had just given up my job (it was a bad situationu), so at least I am home with her 24/7, but it's got to th epoint where I don't leave the house except for desperately rushed trips to the supermarket (with her in the back of the car). I can't bear the thought of her dying without me, or dying in the car.

The thing is, she seems bright and happyish. She definitely more tired than usual, and has the runs also, so I guess she must have an upset tummy from it all. But she doesnt seem in pain, and her eyes still smile at me.
I will deifnitely call the vet in for euthanasia if her quality of life deterioriates, I want to hold her for those last moments.

But I need to figure out this death by internal bleeding thing.
I'm so scared of it. The thing that distresses me most is the thought of her being terrified also. She's has a nervous disposition, but I'm hoping that me being there & holding her will make it easier.
I can't figure out though - will it be quick? How long will she be conscious for and scared? Will she have a seizure, or just collapse panting and fade away?
I feel like I need to find these things out so I can be as mentally prepared as possible - and I've not had any luck finding info on the internet.
I guess I'm worried that she'll be terrified, and I will too. Where will all this blood go that leaks into her? Out her mouth and rear end I figure, but how long will that take? (I know this sounds completely ridiculous - but she won't... burst... will she?)

I'm sorry for all the questions straight away, but this seemed the best place to find answers!

[Trish]

Hi Littlekiwi and Hannah too!

I am a kiwi too :)

This sounds like where I was a couple of years ago with my dog Flynn. His initial problem was a massive liver tumour that his local vet first thought they could do nothing for, but after we consulted with Massey it turned out we could and he had successful surgery. The adrenal tumour came a year later and he has had that out too.

For Hannah first it would be good to know how they came up with this diagnosis and have you seen a specialist with her, like at Massey? Was it an ultrasound scan they did? Do you have copies of any of the tests you can share with us?

Awful time for you guys, so hope we can be of some help.
Trish

[littlekiwi]

Hi Trish - thanks for your speedy reply :)

She had a sick animal profile blood taken, as well as urine. Then we did the low dose dexamethasone thing, which she didn't respond to at all.
She then went to Halifax Veterinary hospital for a scan, which I did get the pictures of (not that I can fathom them, but I wanted to have them).

We're in the South Island (Nelson), so Massey or similar isn't an option - and I'm comfortable with the diagnosis. Well, not *comfortable* but I believe it if you know what I mean.

All I remember about her bloods were that her white cells (I think?) were elevated, but her kidney etc seemed fine. Her urine tests were off the chart apparently. And the no reaction to dexamethasone.

At our own vet practice, she's been seen by 2 different vets (but one main vet for her appointments, the other one went with her to get the scan), and one at Halifax where she had the scan.

The vets are excellent (although so expensive that all savings are now drained), but I didn't think to ask too much about the sudden crash that could happen, because I was just too upset.

I did contact a vet on ehownow.com, and she said it will liekly be very fast, but again, I didn't ask if she'd have seizures, and I didn't ask if we were talking minutes of drawn out horribleness, or whether she would lose consciousness extremely fast.
I'm trying to accept that she's going to be gone (it is very difficult), I just want to be as prepared as possible for the experience, for both of our sakes.

Thank you again, and am so glad to meet another kiwi x

[Trish]

That is a shame you cannot get to Massey, as they have literally saved Flynn's life twice now, I will be forever grateful to them. I am in Napier, so it is a bit easier for me to get to them but it certainly was not cheap.

What will happen will kind of depend if the tumour is in the aorta or not, it sounds like if it is alongside. Then I think it is most likely in the lymph nodes which could enlarge but may not. Another of our members has a dog with a large liver tumour she is managing conservatively. You could look for her thread, her name is SoggyDoggy. Her pup has had that diagnosis must be a few months now and he is going along pretty good.

I would ask your vets if I was you, they would have the best idea if this is a possibility based on what they see on the scan. I am hoping you have quite a bit of time left with Hannah. What breed is she?

I am off out to dinner and to watch the rugby final, but will be back on later. x

[goldengirl88]

I don't know about the tumors that you dog has, but wanted to tell you that my heart goes out to you. How stressful of a situation could you be in? This is terrible, and I am so sorry you are going thru this. I would have to find out if I kept my dog at home if it would suffer before passing and how long that would take if the Aorta gave way. I assume that would be a fast thing, but how bad would the dog suffer? I feel so bad you are in this jackpot situation not knowing what to do. I think Trish is the most experienced with these issues. You need to find this out asap before something happens and you regret how it turned out. I know that is easy to say, but I think you are in a situation that needs advise right now. God Bless you and your baby, I will pray for you both. Blessings
Patti

[Squirt's Mom]

Hi and welcome to you and Hannah! :)

Gosh, what an awful place to be! I am so, so sorry to hear the results of her ultrasound. :(

I have some questions - was it the aorta or the vena cava? We typically see adrenal tumors affecting the vena cava, not the aorta. If the tumor hasn't invaded the vena cava, often those tumors and the adrenal glands can be removed and the pup do fine.

Did they tell you what kind of growths they saw on the liver? Did they do a biopsy? Are they absolutely sure those growths are inoperable or even need to be removed? Could they be benign growths?

Have you talked to a surgeon who has seen and operated on these sort of things before? I would do that for sure before taking the first assessment to heart. ;) Surgeons know much better than anyone else what is feasible and what isn't since that is their bailiwick. ;)

As for what to expect, I wish I could tell you specifics as that info would be appreciated by me if I were in similar shoes. I can tell you this - a friend's pup just experienced a rupture of the spleen. Nina had been fine then suddenly stumbled, slowed and collapsed. She was rushed to the vet where the rupture was found, the organ removed, and Nina survived the rupture. The subsequent path report was not good, but Nina did survive the rupture. This link tells you some things to look for when internal organ rupture (this talks about Hemangiosarcomas but signs would be the same for any organ rupture).

http://www.ehow.co.uk/info_7934110_signs-bleeding-tumor-abdomen-dog.html

Please stay in touch and know you and Hannah are not alone. We will be with you all the way.

Hugs and gentle belly rubs,
Leslie and the gang

[mytil]

Hi and welcome to our site, I am so very sorry for the circumstances that bring you and Hannah here.

When you get the chance, are you able to get the actual sizes of the tumors and whether biopsies have been done. (call your vet and they will be able to read these from the ultrasounds taken.) These could be benign tumors at this point -

At this point IMO I would not start any treatments for Cushing's, given the situation right now with the liver and the other tumor locations. The test results could have been skewed by what is going on. And Cushing's is a slow progressing disease.

I also would consider getting a second opinion - are you familiar with or near finding an internal medicine specialist ACVIM (http://www.acvim.org/PetOwners/FindaSpecialist/Specialist.aspx?customercd=2976490189$114$111$114$ 111$99$107$115$2$0$0$0$2$0$0$0$155$29$7$194)


SAIM (Small Animal Internal Med)
Robson Consulting Ltd.
97 Carrington Rd., Mt. Albert
Auckland, New Zealand


I found them while searching for you on this link - http://www.k9cushings.com/forum/showthread.php?t=182 (I do not have any direct experience with them but others may)
Please keep us posted
Terry

[littlekiwi]

Hi Leslie, Terry and Patti - thank you for your kind words and warm welcome.

I checked the internal specialists link, but all are in Auckland or Massey - which is a long way from where we are (another island in fact), so not an option for us. I don't mean to sound callous, but we simply don't have the cash to fly a sick dog and one of us up there - I also don't think she'd survive the flight.

Terry - yes, the vets & I agreed to not treat for cushings, because it seems it's gone beyond that.
I don't think biopsies were taken, the tumours were so large and had grown so fast combined with her age that surgery just wasn't something any of us was comfortable with. I think the aortic tumour was the one that they said will be the end of her, I think they said it's right along it and could eat through. The vet who did the scan (who is a surgeon at Halifax vet, which is a very highly regarded animal hospital here - our own vet referred us to them for the scan & for the other vets opinion), felt that these was a terminal case not suitable for surgery. Her remaining adrenal gland has completely atrophied.

In addition, we also had a brief consult with the other vet at our own practise, so she's been seen by 3 vets in total, and all ahve agreed. I trust their diagnosis, but of course, it's still devastating.

I guess the sole remaining solace in that is that she will go fast (and I hope, have very little idea of what's happening).
That's my biggest concern now - if it happens at home, what to expect. I just want to be able to deal with it for her as much as possible.
I'm expecting it will be messy, as shes so full of pee nowadays and that will all give way (right?), but that's fine. It's the blood I'm a bit more worried about, but even more - if she'll be in pain.

Oh, I don't know. I guess none of this matters. She's going to go, and either way, it's unavoidable. She's been so good, and had an excellent life - I *think* she knows how much we adore her.
My old beautiful dog Ransom was put to sleep a few years back (at home in the lounge, so it was somehow a bit easier I guess...), and Hannah really came into her own then.
She had my full attention and she revelled in it. She has blossomed and come out of her shell and I hope she knows form the past few years we've had together just how much I love and appreciate her.
I guess what I'm really doing here is looking for support. Somewhere to vent it when it happens, to people who understand.
I'm so scared of it, but I know I have to be the strong brave one for her, she'll be looking to me to be that.

I'm sorry for rambling, I have to stop now because the tears have started!

[Trish]

You ramble away sweet, that is what we are here for. One of our members Sharlene always tells people we have shares in the tissue companies so we are all well prepared for tears and plenty have been shed here.

Hannah's story is so sad and I really feel for you as have stood in your shoes with Flynn. There is a type of liver tumour that sounds like Hannah could have that was similar to his. His scan showed his liver was massive with tumour too. He collapsed one morning while he was with my parents, and I rushed over from work and was told there was not much we could do for him, he was resuscitated with IV fluids and vet said I should seriously consider putting him down. I took him home that night, IV fluids and all and sat with him all night watching it drip into him. He perked up! The vet had said we could biopsy but she was not even sure she would do it for her dog. I was so glad that I decided to do it, the biopsy came back as a benign tumour and we rushed him down to Massey for a consult with the surgeon there. I am telling you this as even though Hannah's tumour is large too that they can sometimes be fixed. They operated a few days later and took out a 650g tumour which is huge for a little foxy and took up most of his abdomen. The tumour was called a "massive hepatocellular carcinoma" and was low grade, this was nearly 2 years ago now and he is 12 now.

I am a little confused as to why it is mentioned the aorta, like Leslie that is not normal for adrenal tumours which tend to invade the vena cava (which Flynn also had!). Unless the liver tumour has spread to the lymph nodes which are along aorta.

I would at least ask your vets to send her scans to Massey to get their opinion. A fine needle biopsy is not a difficult or stressful procedure to get tissue diagnosis of the liver tumour at least. This type of surgery is out of the range of expertise of local vets and I believe you need their advice to make sure you have done everything possible. Could you not get the ferry over and drive up to Palmy?

If surgery is really not an option, I guess I would be watching her like a hawk as I am sure you are doing. With any sign of deterioration I would be making that awful decision to help her pass peacefully. I cannot bear to see animals suffering and I think sometimes we hold onto them longer than we should and your right we do have to be the strong one, they deserve that for being our darling companions and friends. Such an awful situation to be in. xx

[mytil]

Oh you are not rambling at all. We are all here to help you and Hannah. I am not sure what to tell you as to what to expect, but like Trish mentioned if she deteriorates, this decision will be the hardest for you and yet the most loving one. Your Hannah knows how deeply you love her.

Please stay with us
Terry

[knitbunnie]

You are wonderful to be so kind and caring to Hannah. If it's alright with you, I will remember you and Hannah in my prayers.

[scoora]

Just want you to know I'm sorry to hear about Hannah's problems.
Prayers and hugs to you and Hannah.

[goldengirl88]

You just ramble on, do whatever it takes to get thru this, everyone is here for you. I am saying prayers for you both, that if this has to end it will be peaceful. I know how you must feel, and I wish I could take away your pain and anxiety. This is an awful situation, no matter how you look at it. Try and hang on and stay strong for your baby, so she can feel all the love you have for her. This kills me just thinking of what you are going thru. God Bless You Both.
Patti

[littlekiwi]

You are all so kind! It's so nice to be able to talk to others who understand exactly how it feels.
She had a bad day yesterday, her first real one really. Her belly is very swollen (she always was naturally extremely trim and 'tucked up), she looks almost comical if she weren't a bit unhappy about it. It's so strange how she looks both skinny and fat at the same time (her spine is far more pronounced in the last two weeks).

It was a sad day, listening to her breathe (she's not labouring for breath but is definitely breathing a bit heavier than 'normal'), imagining how full she must feel. She drinks so much that I don't know where she puts it, and I'm feeding her snacks whenever she asks now. All dog training rules have gone completely out the window.
I thought that the time was coming because I didn't see the point in her being so uncomfortable, but YAY she has woken up in a good mood today!
Her eyes are bright and her tail is wagging. She had the energy to annoy one of the cats, and although she didn't eat all her breakfast I don't think, she is moving more freely.
I'm grateful to have another day with her.

Couple of questions - we noticed that the gurgling in Hannahs belly enormously increased a couple of weeks ago, when all this started - anyone else had that? Also, the flatulence has reach apocalyptic proportions :/
And occasionally a bit more shakiness (even when sitting) than normal - maybe from weakened muscles?

The skin on her belly where they shaved her for her scan is wonderfully soft and pink - it's strange but lovely to see her skin and discover something about her that's new, right at the end of her life.
What a lovely little dog she is. Thank you for letting me tell you about her :)

[frijole]

It could be that the adrenal tumor is a type called pheochromocytoma, pretty rare - my Annie had one. Her tummy gurgled so loud at times I could hear it from across the room. She also had full body shakes. The shakes occurred when the tumor was active and emitted essentially adrenaline. The tummy issues was from gas created in the tummy again by the tumor. You could ask your vet about giving her Pepcid AC (has to be AC not the other kind) to ease her gas. Don't do anything without clearing it with the vet.,... that is except spoil her silly, get lots of photos and video. No doubt you are doing just that. Kim

[doxiesrock912]

Daisy's tummy gurgled a lot for awhile and she had AWEFUL gas!
An underlying systemic bacterial infection was to blame according to her IMS. Since she's been on Tylan powder, no more gurgles and tons less gas.

We also think that she's prone to IBD flare ups and this is sometimes treated with Tylan powder as well. Both might be worth mentioning to your vet.

[Squirt's Mom]

littlekiwi, it is I who thanks you for sharing your sweet girl with us, for letting us get to know her a little bit, for letting us walk through this Valley by your side.

All too often when we contemplate facing that Valley ourselves, we think of it as a dark, dreary, cold, frightening place; a place to be feared. In truth, that Valley is filled with Light, a Light that is strange and wondrous....and healing if we allow it to be. For as we walk that Valley, we are presented with opportunities to deepen our connection; we are given the gift of Awareness, of Understanding that our connection will never be severed. Yes, as is the nature of Light, there are Shadows in that Valley as well. But it is in those very Shadows that we find the strength and hope to keep walking til we are once again bathed in Light.

By sharing your precious girl with us, you are reminding us of the Light in spite of the Shadows.
Hugs,
Leslie and the gang

[goldengirl88]

Praying for you and your baby. Blessings
Patti

[molly muffin]

Hello and welcome to the forum.

Trish is right, shares in tissues all the way. I have tears now just reading of you and Hannah. I am so glad you found us. We might not be there physically, but you'll have as much support as you want from us as you go forward though this really, really hard and emotionally exhausting time together.

It is so hard when you reach that point of what way to turn next and then find that there is not as many turns to take as one might hope. (gee I hope that made sense).

All you can do is take it day by day, hour by hour and let Hannah tell you how things are going for her. Hopefully there will never be an actual rupture and it won't be something you have to go through. Whatever happens, when ever it happens, we are here for you.

Big hugs to you and a belly rub to Hannah,
Sharlene and Molly Muffin

[goldengirl88]

Thinking of you and praying for you and your precious baby. Blessings
Patti

[littlekiwi]

I couldn't reply to your messages, but they mean so much.
Hannah is going to sleep this afternoon for the final time, here at home.
I am bereft. I will be back when I can breathe again.

[Budsters Mom]

I am so sorry. :oI lost my fur baby about a month ago. He and our other fur angels will be at the rainbow bridge to welcome sweet Hannah. Please come back and talk with us when you're feeling up to it. It does help to share with those who understand.

Many, many, hugs

[Squirt's Mom]

Dear Littlekiwi,

Our hearts are with you and your precious Hannah. I have no doubt Hannah knows how very much you love her and is so grateful that you are willing to take this pain on yourself so she will not have to suffer.

Our thoughts are with you all,
Leslie and the gang

[goldengirl88]

God Bless you for being so brave. Your Hannah has a wonderful mommy that is wanting to think of her baby first. God Bless you Both.
Patti

[Boriss McCall]

so sorry you are saying good by to your sweet friend Hannah today. My heart hurts for you.

[Squirt's Mom]

Guardian Angel of Pets

Hello. I've been expecting you for quite some time.
Here, come sit beside us for awhile .
and let me tell you about this old friend of mine.
She might look tattered or maybe old
But I won't say goodbye until you've been told.
She had the brightest eyes I had ever seen,
And wore a beautiful fur coat that would out shine a queen .
She was never prissy but walked with an aire ......
And oh so polite, you could take her most anywhere.
She could run like the wind and could catch anything she chased
But she protected and sat with me when I had problems to face.
You could not find a friend nearly so dear.
Because no matter the trouble she always stayed near...
She has never asked for much from me;
Just to love and respect her and I think you'll agree .
To give her a good meal plus a nice warm bed is not much to ask
When she has given me all her love and to her this was no task.
Now I understand you have a schedule to keep.
But I have a small favor before she nods off to sleep.
Please fold your wings around her and let her feel young while in no pain.
Dear Guardian Angel of Pets,
please keep her safe and happy until I see her again.

By Ginger Patton

[scoora]

I am so sorry to hear about your sweet girl Hannah. My Scoop will be joining Buddy and the others to greet her. My heart aches for you knowing how hard it is to lose your sweet furbaby. Hope you will be back to talk when you can. Prayers for you and Hannah.
Hugs

[molly muffin]

I am so sorry that the time has come for Hannah. I know your heart is breaking.
Know that we will all be thinking of you and Hannah today and holding you both close in our hearts.

hugs,
Sharlene and Molly muffin

[doxiesrock912]

Oh no!
I'm so sorry sweetie.

Hannah will have a lot of company waiting for her when she crosses the bridge.

[spdd]

I'm so sorry to hear about Hannah. I've read on here in the last little while of members here that have gone down this road. They are a wonderful support system and know exactly how you feel. Please talk to them when you feel like coming back.
This is an act of love you are doing.
My thoughts are prayers are with you.

[mytil]

I am so very sorry and my heart is with you. We will always remember your girl here.

Please do stay with us.
Terry

[addy]

My heart goes out to you on this very difficult day. Hannah, fly free sweet pup, never to be forgotten.

[Simba's Mom]

Sending hugs and prayers for you and your precious Hannah, we are here for you, take care of you too...

[Trixie]

So, so sorry to hear about your loss. Such a terrible sadness and heartbreak you're going through.
Thinking of you and your Hannah.

Barbara

[Sabre's Mum]

From another Kiwi .... I am so sorry for your loss.

Take care
Angela and the four legged Flynn

[goldengirl88]

Sending you love and hugs as I am thinking of you and your special girl Hannah. God Bless you both
Patti

[Roxee's Dad]

I am so very sorry, you did everything you could and gave Hannah a wonderful life. Rest in Peace sweet Hannah, You are our newest and brightest star in the sky......