Considerations prior to starting treatment-Sheeba has crossed The Bridge

[Zeeke]

Hello,
As I write this post my 12 yr old Malti-poo is having her 8 hr test to confirm Cushings. Tomorrow I will be meeting with my Vet (whom I like) to discuss how to proceed. I am in Canada. My concerns are that she seems to have many symptoms as well as a couple of complications. Two years ago the vet looked at her and felt that she was looking cusinoid (protruding belly, etc) but when he took blood test the alkphos level was in the high 200s but he felt that based on that there was no need to test further as the number should be higher. Since then she has hair loss, (she has always been a hungry girl so I am not sure if that has increased) She is a good drinker but she is not getting up in the night to have to pee (she actually sleeps late and if I did not wake her she could sleep to as late as 10 am.) Lately she has been panting at night.
The vet noticed that her breathing seemed labored so he suggested we do an x ray. He says that she has an airway infection and her liver is inflamed which he says can all be connected to cushings as well the Alkphos is 1079. Her energy seems low although she has never been a real active dog.

I have heard so many success stories but I am just worried that based on her age and current health issues that she may not be able to tolerate the treatment drugs and make her feel worse or cause her a premature death. Could the disease be too be treated.

Any advise would be appreciated

Thanks Zeeke

[Harley PoMMom]

Hi Zeeke,

Welcome to you and your sweet girl. So sorry for the reasons that brought you to us but glad you found your way here.

The LDDS test can be prone to false positive results when a dog has other non-adrenal illnesses. Since your girl has other health issues, I believe the ACTH stim test would of been a better choice. If it is feasible, I would also recommend having an ultrasound done because it can show any abnormalities with the internal organs plus, hopefully, a visualization of the adrenal glands.

Cushing's is not a death sentence for a dog and is very treatable. When proper treatment protocols are followed dogs can live out their normal life spans. Cushing's progresses at a snail's pace so there is time for one to get a confirmed diagnosis for their furbaby.

Could you get your hands on copies of all tests that were done on your furbaby and post any abnormalities that are listed along with the reference ranges and units of measurement, we are especially interested in the results of tests done to diagnose the Cushing's, such as that LDDS test.

Please know we help in any way we can so do not hesitate to ask any and all questions.

Love and hugs, Lori

[Budsters Mom]

Hello and welcome:)
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! Others will be dropping in shortly to welcome you also.

[frijole]

I ditto what Lori said. If the LDDS test comes back positive I'd do the acth test and I'd consider doing an abdominal ultrasound. No need to rush treatment. If the thirst isn't abnormal (buckets not ounces) then it might not be cushings. Also you didn't mention appetite - does your dog 'live to eat' as in never chews, just inhales and looks for food on the floor 24 hrs a day? Kim

[molly muffin]

Hello and welcome to the forum.

Can you clear up the airway infection first, which will get rid of the liver inflammation and then see what sort of test results you would get for cushings? I just tend to think that if there is an infection, then results might be skewered on any cushings testing, so better to be able to start with a clean slate going in.

If it does turn out to be cushings, then it is treatable, and a normal life span can be lived out. I think taking care of any infection has to take priority though right now.

Welcome
Sharlene and Molly Muffin

[Zeeke]

Hello everyone,
Thank you for all of your concern and it is so nice to know there are selfless people like all of you that are helping us who are new to this. I especially appreciated the comment about not worrying unless she is drinking buckets of water as she is really drinking ounces and when she got back from the vet she walked right past her food bowl without eating. Did I mention that the one symptom that she does not have is weight loss. Her weight is exactly the same as it was a year ago.

I was just at the vet and asked as you requested for the blood work and I will share the out of range numbers, if I do not mention them that means they were slightly off or within range.

Sheeba's numbers / Reference / Units
ALP 1112 / 24 - 141 / IU/L
ALT 304 / 5 - 95 / IU/L
CK 410 / 4 - 170 / IU/L
Lipase 1490 / 0 - 900 / IU/L
GGT 16 / 0 - 6 / IU/L
Triglycerides 3.17 / 0.12 - 1.60 /mmol/L
Creatinine 26 / 29 - 135 /mmol/L
Magnesium 1.12 / 0.70 - 1.00/mmol/L

Under Hematology
WBC 26.1 / 5.7 - 16.3 /x10E9/L
MCHC 317 / 320 - 360 /g/L
Platelets 580 / 164 - 510 /x10E9/L
Reticulocyte 225.7 / 10 - 110 /x10E3/ul

Under Differential:
Neutrophils 73.0 / 19 3.0 _11.5 x 10E9/L
Monocytes 8.0 / 2.1 0.15_1.35 x 10E9/L


Under Endocrinology
Free T4 <3.86 / 7.7 - 47.6 pmol/L

The test that was conducted today was the LDDS with one pre and 2 post that were conducted at 4hrs and 8 hrs.

I will be meeting the vet tomorrow at 11:30 and he will have the results from the LDDS

Thanks again
Zeeke

[Harley PoMMom]

Hi Zeeke,

For those numbers below, could you edit your post and type in the reference ranges and units of measurement? As an example....ALT 150 U/L (5-50)..Thanks!!





ALP 1112
ALT 304
CK 410
Lipase 1490
GGT 16
Triglycerides 3.17
Creatinine 26
Magnesium 1.12

Under Hematology
WBC 26.1
MCHC 317
Platelets 580
Reticulocyte 225.7

Under Differential:
Neutrophils 73.0
Monocytes 8.0


Under Endocrinology
Free T4 <3.86







The test that was conducted today was the LDDS with one pre and 2 post that were conducted at 4hrs and 8 hrs.

I will be meeting the vet tomorrow at 11:30 and he will have the results from the LDDS

Thanks again
Zeeke

When you get the LDDS test results could you post them here for us?

[Zeeke]

Post has been fully edited
Thanks

[Harley PoMMom]

Hi Zeeke,

Thanks so much for editing your post. And I have more questions! :eek:




Sheeba's numbers / Reference / Units
ALP 1112 / 24 - 141 / IU/L
ALT 304 / 5 - 95 / IU/L
CK 410 / 4 - 170 / IU/L
Lipase 1490 / 0 - 900 / IU/L
GGT 16 / 0 - 6 / IU/L
Triglycerides 3.17 / 0.12 - 1.60 /mmol/L
Creatinine 26 / 29 - 135 /mmol/L
Magnesium 1.12 / 0.70 - 1.00/mmol/L

Under Hematology
WBC 26.1 / 5.7 - 16.3 /x10E9/L
MCHC 317 / 320 - 360 /g/L
Platelets 580 / 164 - 510 /x10E9/L
Reticulocyte 225.7 / 10 - 110 /x10E3/ul

Under Differential:
Neutrophils 73.0 / 19 3.0 _11.5 x 10E9/L
Monocytes 8.0 / 2.1 0.15_1.35 x 10E9/L



With the WBC being elevated this could be a sign of an infection, is your furbaby on any antibiotics?



Under Endocrinology
Free T4 <3.86 / 7.7 - 47.6 pmol/L


Was the Free T4 test measured by equilibrium dialysis? If so, with her Triglycerides being high along with the low Free T4 plus hair issues, Hypothyroidism could definitely be the culprit here, has the vet mentioned this?



The test that was conducted today was the LDDS with one pre and 2 post that were conducted at 4hrs and 8 hrs.

I will be meeting the vet tomorrow at 11:30 and he will have the results from the LDDS

Thanks again
Zeeke

We will be checking in for those LDDS test results. ;)

Love and hugs, Lori

[Zeeke]

Thanks for responding. Yes the Vet has mentioned both of those things. He says that she could be hypo thyroid as well he says that she looks like she has an infection in her airways based on the xray. The thing about her appearance is she looks like classic cushings pictures that I see on the internet and the vet has mentioned it more than once.

[Harley PoMMom]

Dog's with Cushing's usually drink buckets of water, pee rivers, and have a ravenous appetite.

I believe your girl's symptoms fit a hypothyroid diagnosis more than a Cushing's one. Just a thought here; if this were me, I would ask the vet about starting her on thyroid medication and see if it helps abate any of her symptoms. What do you think?

[Zeeke]

Got a call from the Vet this morning and although I do not physically have the results he says that it is cushings. He says that the test does not clearly indicate whether it is Pituitary or adrenal. I do not know anything about the LDDS test nor what the numbers mean but I thought that the test would tell what kind it was. The vet who has many cushinoid dogs in his practice spoke to two other vets and they suggested an ultrasound based on the suspicion that it may be an adrenal tumor indicated by the high Reticulocyte test and they want to check for other possible tumors or reasons for this high count. We are going ahead with that today at three. I asked about the infection and he says we can treat that with antibiotics now. Can they start the other treatment, veteryol along side of the the anitbiotics? I am also worried about what will happen if the drugs work and then her arthritis flares up. An earlier xray showed signs of arthritis in her back. She has had both knees redone when she was 6 and I would imagine that would probably give her arthritis there as well. Would the pain of the arthritis be a worse quality of life? Any thoughts. As I write this she is panting which is fairly new. I know panting can indicate a dog is in pain. If we go with the treatment will this panting stop?

Thanks in advance for your thoughts on this.

[Zeeke]

I did address the hypothyroid issue with the vet and he says that he feels that it may be a result of the cushings.

[labblab]

It is true that low thyroid levels can be secondary to Cushings, and if so, may improve once the Cushings is under control. It is possible to perform an extended thyroid panel that scrutinizes the thyroid function in greater detail, and those results can sometimes clarify whether or not it is more likely that the low thyroid is a primary problem or whether it is secondary to a condition such as Cushing's. Depending upon the outcome of the ultrasound, additional thyroid testing may end up seeming more useful.

I think it's great that you are getting the ultrasound. It is an excellent general diagnostic. If Cushing's does end up as the final diagnosis, yes, you can treat with antibiotics and Vetoryl at the same time. As to whether or not the lowered cortisol will worsen the arthritis discomfort, I'm afraid only time will tell. You may end up balancing her competing needs by lowering her cortisol to some extent, but allowing it to run higher than if no orthopedic issues were present. But first things first -- let's keep working away at the diagnosis.

Marianne

[Zeeke]

Just returned from the ultrasound and the test found that both adrenal glands were enlarged with one being slightly misshaped but there was no sign of an adrenal tumor. The doctor concluded that it is pituitary dependent cushings. The doctor spent a great deal of time explaining it all to me, how the adrenal and pituitary glands work together, how the tests measure cushings, why there was some confusion about what kind of cushings it was. He told me that the fact that she does not drink eat and pee excessively is atypical but not uncommon and it happens in a percentage (I can't remember the number) of cushinoid dogs. He also explains that a diagnosis is based on a number of factors , blood tests, visual appearance of the dog, LDDDI test, and in sheebs's case ultrasound. He is very comfortable that the diagnostic conclusion is sound and recommended treatment start.


The results of the LDDDI test is as follows

Time / result/ acceptable range and unit
0 hour / 162/ 15 - 120 nmol/L
4 hour/ 125/ 15 - 120 nmol/L
8 hour/ 154 / 15 - 120 nmol/L

Comment
Low Dose Dexamethasone Diagnostic Intervals (Canine):
8 hours-----------------4 Hours-------------Interpretation
<27nmol/L----------not applicable----------Normal
27-41nmol/L--------not applicable---------Inconclusive
>41nmol/L-------<50% baseline-----Consistent with pituitary-
---------------- and/or <41nmol/L---dependent hyperadrenocorticism
>41nmol/L-------<50% baseline-----Consistent with
--------------------------------------------hyperadrenocorticism
*Further testing is required to differentiate adrenal tumor from pituitary-dependent hyperadrenocorticism.

As stated before the further test was the ultrasound and an adrenal tumor was not present.

We have started the treatment tonight and are monitoring her. She was given 10 mg of Vetoryl every 24 hours as well as she was given an antibiotic to "cover all bases" with the possible air way infection.
(Zeniquin 25mg. every 24 hrs) The vet who did the ultra sound also reviewed all of the blood work with me and he also looked at the xray. He felt that the infection did not seem to be a big concern but after consulting with my vet agreed that a course of antibiotics is a good idea. I think that my vet listened to her lungs and the second vet did not so he was basing it on simply the xray.

The side effects of the drug and some of my concerns are that I have heard that it is not uncommon if she was to throw up once but if it continues I should be more concerned. I am also aware of what to look for when monitoring her, loss of appetite, confusion, an unsteady gate when walking, vomiting, diarrhea, but if anyone has any advise it would be appreciated.

Thanks again to everyone who has offered support be it directly or indirectly through the online posts of your dog's story. This forum has been a great help and support.
It has been 1 and a half hours since she has taken the meds and she just had a normal poo and is now snoring away, which is very normal for her. Fingers crossed for a smooth first night.

Zeeke

[Harley PoMMom]

Hi Zeeke,

Trilostane can cause an upset tummy so giving Pepcid AC 20-30 minutes before the dose of Trilostane can help with that. Also, did the vet mention that the Trilostane has to be given with food to be properly absorbed?

Another question :eek: how much does your girl weigh? Was prednisone rx'd in case Sheebs' cortisol does go too low? When a dog is being treated with Trilostane any time that the dog seems off the Trilostane should be stopped and not restarted until the dog is acting normal again, sometimes an ACTH stimulation test will need to be done to make sure that the cortisol is not too low.

I'm providing a link from our Resource Thread with information regarding Trilostane: Trilostane/Vetoryl Information and Resources (http://www.k9cushings.com/forum/showthread.php?t=185) Please feel free to print anything out. ;)

Wishing you and Sheebs the best of luck and remember we are here for you both.

Love and hugs, Lori

[Junior's Mom]

Welcome Zeeke. How much does your dog weigh? The recommendation is 1mg/lb to start. Some recommend even lower to start. Many vets go higher than they should. I started my dog much lower just to be safe. You mentioned she just had her first dose. It is best to dose in the morning, as the follow-up acth test should be done 4-6 hrs after dosing. This test needs to be done 10-14 days after treatment starts, and anytime there is a change in dosing.
The drug is fat soluble, so it is best to give in cheese or something similar. Feed first, then dose, as you don't want to dose a dog who doesn't want to eat.
Your dog must eat before the acth test is done, as it can alter the results otherwise.
I hope your fur baby does well.

[Zeeke]

Hello all,
Thanks for your questions and yes I was advised the medication must be given with food. My dog is 13 pounds 5.6 Kg so the dosage is on the lower side which suits me fine. We started today as my vet retests in 7 days and the vet office is closed on the labour day weekend. This will put the test next friday which he was more comfortable with rather than waiting 3 more days until the Tuesday. We are giving her the dose 1 hr earlier each day to make it work.
Thanks for all of your advise around the eating and I am on top of that. Since we have given her the pill she seems to have a big increase in energy and she is panting a lot. It is a bit warm here tonight and we do not have AC in the house except the bedroom so we are moving there right now and hopefully that will cool her down. I am sure I am just being hyper sensitive to her actions but does this seem normal?

[Harley PoMMom]

Dogs with Cushing's have excessive amounts of cortisol running their bodies, and among other symptoms, heat intolerance is one of them. You could try spritzing her with water, like on the paw pads, belly, and top of the head. I do this to my non-cush boy, Bear, because he minds the heat so, it really helps him.

[Zeeke]

Thanks Lori,
The vet office has good hours 8 to 8 (with the exception of Sundays and the Labour day weekend, Canadian Holiday) and there is a 24 hr emergency vet close by if need be, so I do not have the prednisone. The vet will probably call tomorrow so I will ask him if I should have this. Thanks for the link that was great information!
Zeeke

[Harley PoMMom]

For her weight of 13 pounds the starting dose of 10 mg once a day is very appropriate. Dechra's dosing range is 1-3 mg per pound, so I am happy that your vet started her at the lower end of the scale. We do see less adverse side effects when a dog is started out at a low dose.

[molly muffin]

Sounds like a good start to me. :)
Just make sure you get the time of the pill dosage to one where the vet can run his test about 4 hours after the pill is given. You want to be fairly consistent with timing of both giving the pill and testing afterwards.

When you first start medication, that is always your scariest time it seems. At this dosage, you Should be okay. Just yea, make sure no throwing up, no lethargy, no refusal to eat, etc. If you have question at any time, jump on here and ask. :)

You're doing great
Sharlene and Molly Muffin

[Trixie]

Hope all is going well with your pup now since you have started on the medication.
We also started on a pretty low dose last April and have been tweaking the dose until a month ago and for now we are set. Even though
I did not see a decrease in symptoms right away, I felt really comfortable with the low and slow dosing and my dog did not have any bad reactions or side effects.
Symptoms have finally been pretty well controlled for the last month or so and the liver numbers we had though still high, are finally coming down. Even with symptoms controlled panting comes very easily to my dog now...she does best when she's kept as cool as possible. I think it will be much better for her when the summer weather is over.
I hope things go smoothly for your dog and you see some positive changes soon.

Barbara

[Zeeke]

Day three of treatment and no side effects that are obvious. She does tend to sleep a lot but she she did that before the treatment started. I do wake her up to play and walk a bit and she seems alert and steady during these times.

Any thoughts?

[goldengirl88]

Zeeke:
I have just a few minutes and wanted to welcome you and your baby. I am so glad you started low. This will give your baby time to adjust to the drug. That is the smart way to go. Also please keep a doggy diary as you will need it to refer to for many things. About the arthritis, it is probably going to flare up as cortisol does act as an anti-inflammatory. I take my dog to cold laser therapy for that it is not real expensive here, do you have that available to you? Were you given prednisone in case you need it? If not it is best to have some handy. I am curious about what you said your vet told you in a posting you made. About the Reticulocytes being high then that probably means adrenal dependency. The next time you talk to this wet could you ask him about this?? My dogs have been steadily increasing and would like to know what the meaning is behind what he said. I hope you baby continues to do well. Blessings
Patti

[Zeeke]

Hello everyone,
Patty, regarding the high number on the Reticulocytes blood test, Initially, my vet was unclear about what was causing this incredibly high number. I may have misspoke when I said that he felt it was an adrenal tumor I think what I recall is that he was saying that there may be something else in her that was causing this number to be so high as this number reflects new blood cells created. He did mention perhaps it was an adrenal tumor but wanted to test further before he drew any conclusions. The high number was a mystery to him and he said that he called three other vets to ask their opinion about it and all of them could come up with no good answer for that. The adrenal tumor comment was made very early on and I think it was him perhaps trying to make sense of those things.

As far as Sheebas current state, she has just taken her forth dose and her she seems to me as if her breathing is a little bit more laboured. There are times when she appears like she's nauseous and maybe going to throw up but she doesn't. She also has a very pained look in her eyes as if she's trying to tell me something.
Maybe I am just reading too much into this as she really has not had any bouts of diarrhea and vomiting or lethargy. She sleeps a lot but when she's awake and moving she can still stand up and walk without any difficulty. I also noticed that her drinking takes her a little bit more time and when she drinks she stands up and wait a few moments and then goes to drink a little bit more. That is a change to her regular habits. Just a reminder Sheeba was never excessively drinking before but she would drink more than just a little bit at a time. Now she is asleep again. She is on her feet perhaps a total of 30 to 45 minutes a day, could this be a reaction to the drugs?

Still monitoring closely. Is what I am seeing similar to what others have seen?

Thanks again,
Zeeke

[Squirt's Mom]

I'm sure some of our Trilo folks will be along to help but if you feel this is out of character for Sheebah, then I would withhold the Trilo and see if that brings her back to a more normal state. The cortisol can start to fall fairly rapidly with Trilo and some pups feel a bit off while they adjust but it's always better to err on the side of caution if you are ever concerned.

Hugs,
Leslie and the gang

[Harley PoMMom]

When a dog is on treatment for Cushing's and exhibits any abnormal behavior the treatment should be assessed and maybe even stopped.

Both of the Cushing's medications are known for their gastric upsets, Pepcid AC may help with that, I would ask your vet about this.

Love and hugs, Lori

[Junior's Mom]

Hi Zeeke, how is Sheeba doing on the medication? Are you still worried something is off with her?

[Zeeke]

Hello everyone,
I am writing to give an update on Sheeba's treatment. She started taking Vetoryl at 10 mg (she is 13lbs) on Aug 22nd and was tested on Aug 30th. At that time they found her cortisol (random) level to be at 126 with norms being 15-120 putting her slightly above. The vet called and said that he was very happy with that number and we were to continue treatment. He said we would retest her again in four months. She seems to be doing better with increased energy and alertness and she does not seem to have a pained look in her eyes as much. She still has her off days but nothing as bad as the week leading up to starting the treatment. Her breathing has improved considerably but I would not say it is back to normal. I find now at times she sleeps very deep and sometimes I need to actually wake her which could be her age, who knows. Appetite, drinking and business is all good.
I anyone could comment on the following:
Are we on track? (I know it has only been 3 weeks)
How long after treatment started did people notice a marked improvement? ie. Hair growth, energy levels back to “normal”
Is it ok to be retesting her at the 4 month mark? I know I have read testing at varying times after starting treatment.
Any other advise?

P.S. Thanks again to all for your concern and advice. This discussion board has really made a difference during this time.

[goldengirl88]

I noticed an improvement in Tipper's symptoms the very first day she took the Vetoryl. She had really pronounced symptoms though. It got better and better as the days went on. She never really had too much of a hair issue so I will let the others speak to that. When she is controlled I have her tested every 3 months. Her dosage has been tweaked many times during the first year which required additional testing after 1 month for each new dose. Hoping everything goes well for you and your baby. Blessings
Patti

[molly muffin]

Usually the first thing you notice is that the eating, drinking and urinating become a more normal level and the energy returns. Then the pot belly starts to decrease. Hair regrowth and skin issues are some of the last to usually clear up and can take months as you are looking for hair cycles to cycle through.

I am a bit surprised that he doesn't want to test for 4 months. Normally, you test at around the 10 - 12 day mark of starting and then at the 30 day mark and if all continues to be well, then you can test every 3 months.
You might want to do another test if you notice any changes that would mean the cortisol is continuing to drop, before the 4 month period, or if symptoms are still not where you would like them to be.
It sounds like everything is currently going very well though and that is good. What you want is to the find the level that is right for Sheeba. You don't actually have to number chase if things are good at this level. I assume that this was the POST ACTH result? 126 nmol = 4.5 ug. So a very good place to be.



Sharlene and Molly Muffin

[Zeeke]

Sheba passed away today. She was slowly coming along from the cushings and she got a seizure, or a stroke, or a severe attack of vestibular syndrome attack. She couldn't stand up, back arched, in spasms, eyes lost and rapidly moving....took her to the vets where it only got worse..on the table just in pain it seemed..she was so lost and hurting, we couldn't comfort her...it was clear that this was too much for her. We stayed, connected with her to the end. She is at peace now....

The house is so empty....we can't stop crying.....but we wanted to thank you for your support when all this started. You were all a godsend.

Thanks again.

[goldengirl88]

I am so sorry to hear that you baby passed away today. May God Bless you and dear Sheba. I know this is devastating, I am hoping you are able to come thru it. Your sweet baby is at peace with God and all the other cush babies. Blessings
Patti

[Mel-Tia]

I am so sorry to hear this sad news, it is so hard to lose them and it must have been very difficult to see her like that.

I will go light a candle in her honour.

Roam free sweet Sheba

Mel and my Angel Princess Tia x

[Squirt's Mom]

Oh I am so sorry to hear this. I know you worked hard to make her life the best possible for as long as possible and that she is grateful to you for all you have done on her behalf.

Sheeba's name has been added to the In Loving Memory list for 2013 where she will always be remembered as a member of our family here at K9C.

Our deepest sympathies,
Leslie, Squirt, Trinket, Brick, Sophie, Grace and our many Angels waiting at The Bridge


A Simple Message From Your Pet
by Ken D. Conover

To have loved and then said farewell is better than to have never loved at all.
For all of the times that you stooped and touched my head, fed me my favorite treat and
returned the love that I so unconditionally gave to you. For the care that you gave to me
so unselfishly. For all of these things I am grateful and thankful. I ask that you grieve
not for the loss but rejoice in the fact that we lived, loved and touched each other's lives.
My life was fuller because you were there, not as owner, but as my friend. Today, I am
as I was in my youth. The grass is always green, butterflies flit among the flowers and
the sun shines gently down upon all of God's creatures. I can run, jump and play
and do all of the things that I did in my youth. There is no sickness, no aching joints
and no regrets and no aging. We await the arrival of our lifelong companions and know
that togetherness is forever. You live in our hearts as we do in yours. Companions such
as you are very rare and unique. Don't hold the love that you have within yourself.
Give it to another like me and then I will live forever. For love never really dies,
and you are loved and missed as surely as we are.

Your pet in heaven.

[molly muffin]

Oh I am so very sorry to hear that Sheba has passed away. I know your hearts are just broken.
My sincerest condolences.
hugs,
Sharlene and molly Muffin

[doxiesrock912]

Aww, I'm so sorry for your loss!
Sheena is pain free now, running with the others.

[Budsters Mom]

I am so sorry for the loss of your sweet baby. Sheba has joined our other fur angels at the rainbow bridge. Run free sweet Sheba, run free! xxxx

[scoora]

I'm so sorry to hear about the loss of your sweet girl Sheba.
My thoughts and prayers are with you.

[FemaleK9]

I'm also so sorry for your loss. I have had many such losses, as have most of us here, I think, and you have our complete understanding and sympathy.

[spdd]

I'm so sorry to read this about Sheba. I know how hard this is.

My condolences to you.

[Zeeke]

Thank you all for your kind words. This is so so hard.

[Mel-Tia]

Zeeke

I know it's tough, we are all here to listen and support you in any way we can.

It must have been hard to lose Sheba under the circumstances you did and your normal is not normal anymore.

I took each hour as it came and still do sometimes.

Big hug

Mel
Xxxxx

[Trish]

My condolences on the loss of sweet Sheba, such a sad time for you and your family. Please take care of yourself right now won't you and come in for a chat whenever you like as it does help x