Sweet Tammy - Tammy has passed

[Tammysmom]

Hello,my name is Brianna and my sweet dog is Tammy.She is a yorkie.14 years old. Weighs 6 and a half lbs.She has cushing disease. I do not know if I should treat her because of her age.The vet said I have to weigh out things and decide the best for her.Why did she get this disease.I have always tried hard to do everything good for her.

[labblab]

Hi Brianna, welcome to you and little Tammy! I only have a moment to post tonight, but I wanted to tell you that your membership has been approved, so from now on everything you post will be visible immediately. You are posting exactly correctly. :)

I'll stop back by tomorrow to ask a few more questions about Tammy, but I first just wanted to be sure to welcome you tonight. ;)

Marianne

[BettyF]

Hi Brianna, I am not one of the experts here, but I just wanted to share my experience with you. My Vera, a Border Terrier, was also 14 when she was diagnosed with Cushings. We started her on Vetoryl (10mg once daily) and she had regular blood tests to see how she was getting on. She was almost 18 years old when she was put to sleep last month, but not because of Cushings.

My other dog Graham was diagnosed in June and started treatment then. He is 16 years old.

There are very experienced people here who will give you very good advice.

[Tammysmom]

Hello,thank you for making me feel welcome. Thank you Betty for the information on your own precious babies.I am sorry about your Graham. Hope he will do well. I have read many threads and have felt joy for the ones who are doing well,shed tears for the ones that face many issues and the ones that have been lost do this disease.I shed tears for my sweet Tammy.My husband and I can not have children so on our first anniversary my husband gave me this tiny,tiny baby girl Tammy.I should not say we have no children as we work part time with disabled children and they are indeed e our children.I want to do all I can for my little girl so along with Bettys input I welcome others. Love and blessings to my new K9 FAMILY.

[molly muffin]

Hello and welcome to the forum.

Okay lets start off with a few questions and see where we are.

First what symptoms of cushings made you take her in for a diagnosis?
How was the diagnosis made, what tests? (ACTH, LDDS, etc)

Do you have those test results? If so could you post them along with the range given.

Are there any other abnormalties in her blood work? Such as high ALKP or ALT, etc

If so could you post those too?
such as
ALKP 675ug (range 50 - 150ug)

The more we can learn about your precious Tammy, the better feedback we can provide.

Does Tammy have any other issues like arthritis? etc

Quality of life is always an important factor, but dogs can be treated when older, but you want and we want to see the whole picture of course.

We all understand Tammy being your baby. Our furbabies are members of our family and they are precious.

Bless you for working with disabled children too. You and your husband have very giving, nurturing hearts.

We look forward to getting to know you and Tammy better.

[Tammysmom]

Hi Sharlene,what a lot of questions. Thanks for the warm welcome. .First a little about Tammy.She has had allergies since I got her. For 3 years she was on steroid pills and once in a while a steroid injection.Her vet finally said we could be causing harm to her with all the steroids. We than tried diet,alternatives,bendryll and shampoos. .They helped some. Besides the allergies, She has a slight to medium heart mummer. A patella luxation and fairly bad dental disease. Her vet is afraid to sedate her for cleaning. I first noticed Tammy was losing hair on her back thighs and her sides. Her belly looked a little rounder and there were blackheads. She also did not meet me at the door like she use to. Looked tired. Her vet wanted to check for thyroid and cushings. The thyroid was fine but her acth test showed a post of 27. Indicating cushing disease. The ultra sound showed slightly enlarged liver and adrenal glands. Bloodwork was normal except alkaline phosphatase--270 normal (24--147 ). Hope I have everything you need. And Sharlene the kids are amazing.They have taught us so much. We are the blessed ones.May we all love and accept others as they are.

[molly muffin]

Okay so the steroid use was awhile back I am guessing since you tried other options since then? Unfortunately steroid use can cause cushing symptoms, but if it isn't really recent then hopefully that would all be out of her system by now and the ultrasound and ACTH and bloodwork are certainly consistent with cushings.

One thing is that if you do go the road of treatment, you want to start with a low does of no more than 1mg/1lb, so no more than 6mg which means you will need to use compounded trilostane since I don't think the 5mg vetroyl is on the market yet.

I would definitely start low and see if that doesn't help her to feel better. Maybe something like 4 or 5mg would work.

On treatment if symptoms are resolved, you can be up to 9.0ug Post ACTH testing. My molly too has a luxating patella, one side is very bad and if she gets to the lower end I notice it acting up more. She is pretty good as to how she feels at around 7.5 or 8ug. That might be a good range for Tammy to be in too, or with the skin blackheads might want to go down to under 5ug on the Post ACTH and see how she does.

I'd start her though on a low dose if it was me and see how she does.
We know from the ultrasound that her liver is starting to be affected by the cortisol, and she still has a good enough ALKP, even though it is raised that with this early treatment she might do very well for a long time.

Those are my initial thoughts.

Ahhh yes, the kids are usually the ones to teach us. :)

[Tammysmom]

Hello forum and Sharlene, I had a long talk yesterday with the vet. He suggested not treating Tammy at this time. He said her test was in a gray area. And did not think her liver value was really that high. Suggested liver supplement and to watch her urine and bloodwork. He also said at her age it would make the luxating patella and if she has arthritis worse. She would also have to do quite a few ACTH test. Yes or no,i can"t decide. Blessings to all.

[molly muffin]

Yes arthritis and the luxating patella can bother her more.

If you don't want to start a low dose yet I would urge you to include blood pressure monitoring regularly as part of what you keep an eye on. Of it starts to go up you want to nip it in the bud pronto.

I monitored my Molly for a couple years before starting treatment.

[Tammysmom]

Great advice. I will have the vet check her blood pressure. How high can an acth test go before it causes problems ? She has a little hair loss and some blackheads. Will that get worse? Blessings to everyone. Brianna

[molly muffin]

I don't know how high is considered dangerous but I think it if it is very high above normal range, then it would be time to treat. The higher though the more likely of some damage to liver, etc, so you want to monitor and keep an eye on it.

Yes, hair loss can get worse, anything can get worse, back leg weakness can also become a problem, liver enzymes going up, so definitely do the liver supplements.

[Tammysmom]

Hi all,3 weeks have passed and I am concerned with my tiny Tammy. Her back legs are shakey and her paws knuckle under at times. Her hair is still a little thin,but not real bad. Blackheads about the same. I have talked with her vet and we might redo the acth test to see where she is at. Also maybe bloodwork. Any thoughts. Blessings. Brianna

[molly muffin]

It could be the luxating patella that is causing the back leg shakiness. My molly has a luxating patella also and that leg shakes badly as she doesn't put all her weight on it because it can slip out.
The knuckling with the front paws is more concerning, as that could be a neurological problem or spine.
If you run your fingers straight down her spine on both sides, firmly but not hard, does the skin ripple at any given point? If so that can be a sign of pain in that area (or so my vet said when she did it and my molly had a bit of inflammation)
Might have the vet check that out, repeat blood work and see if anything has changed.

[Tammysmom]

I sure hope its her luxating patella. I think the vet looked a little concerned. Not so much the front but mainly her back. Just now and than on the front. I kind of tap her paws and straighten them. I guess we will start with the repeat acth test and bloodwork. If everything seems to be ok,than he might do xrays. He would have to lightly sedate her. I guess she would be ok. Her age scares me, the vet keeps saying she is an old girl.

[molly muffin]

Molly never has been sedated for either X-rays or ultrasound. So of she will lay still for them she might not need the sedation.
It is never easy to figure things out as they get older. Just like us humans they feel the aches and pains more.

[Tammysmom]

Well Tammy had an acth test and bloodwork. Blood work remains the same. Slightly raised liver values. Post on her acth test was 28. Vet thinks its not high enough to treat for cushings. Took xrays of the spine. Nothing major,some minor changes. Skin and hair about the same. Tammy is always tired. Looking for a good puppy vitamin. That still leaves the slight shaking of the back legs and knuckling of the paws. She is considered to old for a mri, so that kind of leaves us hanging. I so love my precious Tammy. Blessings to all. Brianna

[Tammysmom]

My precious Tammy is losing a little more fur, developing a few more sores and seems hungry most of the time. Leg weakness is there. I think we might try a low dose of the trilostane. Any suggestions. Thank you. Blessings

[molly muffin]

she is so small, weighing only 6lbs, that a low dose like 3 or 4mg might help her.

[Tammysmom]

Yes,she is so small. But a really big heart of gold. I agree,i want to give her as little as possible. I am very concerned with her age .Another thing that concerns me is the vet said she might have the type of pituitary tumor that grows more rapidly. My next question,will trilostane make it grow faster. Thank you.

[Tammysmom]

Tammy has been on trilostane for a couple of weeks. Last night she awoke and started to whine. Took her to the emergency vet. He thinks she might have had a stroke. She is left with a slight head tilt and blind in one eye.Her walk is wobbly. He said no medicine is available. Just to wait and see how things go. My poor precious Tammy. Will she get better. Praying so hard for her. Is this normal with a cushing dog.

[Squirt's Mom]

Oh dear, I am so sorry to hear this. My Squirt had a stroke. I found her lying in pool of her vomit and she was very disoriented. It took her about 3 months to recover as much as she was going to, which was almost back to her former state. She had a great deal of difficulty eating and walking on her own for a couple of months then started to gain ground. Her mouth never worked right again but she was able to eat and drink with no problem. She was able to walk again on her own, too.

I did everything I could after the stroke to make like easier for her. I am tall and she was small so I cut a long strip from an old sheet to make a sling to help her walk (her back legs were the ones that failed her during this time). I carried her a great deal of the time. A friend sent us a wheelchair she used as well tho she preferred the sheet sling as she gained back her strength. I cooked any and everything the grocery store had to offer that was suitable for her to eat...and she refused nearly everything. I bought every kind of commercial feed I could find and she refused most of that. She would eat maybe a bite or two then no more. Her lack of appetite was the most worrisome to me. Until her tongue was working better and she could drink from the bowls, I syringed water - carefully so she didn't aspirate. For four months I slept on the floor with her to make sure if she moved I was aware of it and could help her if she needed it. I stayed on the floor after she was better and sleeping in her closet more than with me on the floor but it still made me feel better to be closer just in case for that extra month. (We moms can get rather silly about the things we think at times but hey! :D)

Squirt's stroke was caused by Proin. I failed to research it first and she had just about every adverse effect that drug offered, and I took those signs as part of her getting older and indications of her other conditions - but they were leading up to that stroke.

Squirt did recover and lived about another year and a half after her stroke. I pray your sweet girl will rally and do as well as Squirt did.

Hugs,
Leslie and the gang

[labblab]

I'm so sorry to read this news, too! We have been told that Cushing's causes animals to be more vulnerable to developing blood clots, so perhaps the disease played a hand if Tammy did indeed have a stroke. Regardless of cause, I'm just really sorry that you two have this new issue to deal with. I'm very grateful that Leslie is able to give you her support and encouragement, however, and I hope that little Tammy will soon stabilize.

Wishing you the best in this scary situation,
Marianne

[Tammysmom]

Leslie and Marianne, thank you so much for a quick reply. Leslie, you were Squirts angel. She was so blessed to have you as her mom. I am hoping Tammy will improve. Its so sad to see her struggle to walk and the little blind eye.But I will be strong for her. Working with disabled children I have seen miracles. My vet is very small town and Tammy is the second dog on trilostane. So not much experience there. What would cause the possible stroke.. If Cushings related,would her cortisol levels be too high. Could it be a growing pituitary tumor ? I have read were other members think trilostane is responsible for weakness and various problems in their dogs. Would the trilostane cause this ? She has only been on trilostane for 2 weeks and we were going to do an acth test. The vet wants to wait and see how she is doing before we do the test. Any help for my darling would be much appreciated. Brianna

[labblab]

Hi again, Brianna. I am hoping that you and Tammy may be doing a bit better this morning. As for the cause of her stroke, it may be hard to pin down. I doubt that the trilostane was a direct cause. I believe Cushing's itself could be a factor, though, either by causing high blood pressure or by other effects on the blood that can increase the risk of forming clots. At least, that's the way it works in humans. In looking back, I see that Tammy also has a heart murmur. Depending on the severity and specific involvement of heart valves, I am thinking the murmur might also make her more vulnerable to a stroke. The exact cause may never be known, though, and I realize that at her age, you are hesitant to perform invasive diagnostics.

I guess the big question right now is mainly how best to move forward. Is she still taking the trilostane, or have you discontinued it for the moment?

Marianne

[Tammysmom]

Thank you Marianne for checking on me and Tammy. She had a restless night. Kept waking up and moving around.She still has head tilt and very wobbly. I help her eat and drink. Hope she improves. She does not have high blood pressure. She has been off the trilostane for 2 days now and not for sure what we are going to do. I am a bundle of nerves wondering if this will happen again. I am staying positive for my little girl. Bless you and the others on this site that take the time to help these fur babies and their parents.

[SuperCupcake64]

Hi, Brianna. My dog had adrenal type Cushings, but pituitary type is caused by a tumor in the brain, of course. She has treated many dogs with pituitary type Cushings and she did say that it is not uncommon to see neurologic symptoms, especially if it's a rapidly growing tumor (most are not, but there's always an exception). Trilostane, if given at the correct dose, is a pretty safe drug. It can't cure Cushings but it can reduce symptoms like excessive thirst and hunger and skin issues.

As someone else mentioned, however, Cushings can cause high blood pressure and that can lead to a stroke. Has your vet checked sweet Tammy's blood pressure? There are medications that can help if it happens to be high.

Thinking of you. It's so hard to see our loved ones go through health challenges and I know firsthand how all-consuming it can be.

Jen (and Maizie, and Sammy in heaven)

[Tammysmom]

Thank you Jen for your reply. Tammy has been checked for high blood pressure. At that time it was normal. I have seen no improvement and still very worried about my little baby girl. The vet said we could put her back on the trilostane or wait and see how she does in the next couple of weeks. Not for sure what would be best for her. Jen,i just want to mention how sad I was to hear about your Sammy. He was so adorable in his little pumpkin costume. And bless you for taking in an older dog knowing he probably had issues. Not to many folks would do that. You Gave him so much love and the best life a fur baby could have. Brianna

[molly muffin]

Hi Brianna, I'm sorry to hear abut Tammy's stroke. Poor baby. I would have a chat with the vet about the trilostane if it should be restarted or if it waiting for a bit would be a better idea. It's a hard call to make. The main thing is how Tammy is doing and how her recovery is going. I hope it is going really well and I know that with you she is getting every possible care. :)

Big hugs to you both

[Tammysmom]

Sharlene,thank you for words of comfort. You know Sharlene,in the years of working with the kids,i have seen not only joy but heartbreak. I have always stayed positive and strong for them . However,for the first time I feel like I am slightly losing that outlook. My Tammy means so much to me and a symbol of of love my husband has for me. When I grieved because we could not have are own children,he gave me my precious Tammy. But somehow I will work past this and remain strong and positive for her. I am thinking I will take her to another vet about an hour and a half drive from us. It is a bigger town and they perhaps have more knowledge and equipment to help her. . Brianna

[SuperCupcake64]

Brianna, that's a great idea. Second opinions have been valuable over the past few years. Sometimes a different doctor sees something different that can make a difference. None of this is an exact science, unfortunately. I hope Tammy is doing well today. :)

[Tammysmom]

Today Tammy and I went to a bigger town vet and here is want he said. First of all, he does not know if Tammy suffered a stroke or a seizure. He said he would like to do an mri but concerned because of her age. 14 1/2. . He also thought she should have an acth test and possibly be put back on trilostane. High cortisol as he said could cause seizures or strokes. He thinks she could have some pain,wants to put her pregablin. And lastly, recommends a heart and organs ultrasound. Any advice would be so much appreciated. Just to add,Tammy is still not able to stand much or eat and drink normal. Wants to drink out of the side of the water dish. I wonder if all the things the vet recommends would be to much for her. Brianna

[Tammysmom]

Tammy is standing and walking a little better today. Eating and drinking remain the same.

[Squirt's Mom]

If I could afford to do the tests the doc wants and Tammy seemed able to handle them, I would probably have them done. You know her best so you are the best judge of what she can handle right now.

That odd drinking went for Squirt for several months after she was able to drink on her own again. I have a Pug who is blind in one eye and has a seizure disorder - she literally lays the side of her face with the blind eye on the edge of the water dish and drinks. If the water level is too low, she has a great deal of trouble drinking.

I hope you see small improvements every day that passes! I know the joy those bring! ;)

[Tammysmom]

Yes Leslie, small improvements do indeed bring us joy. I have learned that with our children and now with Tammy. You are such a kind and loving mom to your babies. So much patience with your sweet pug. I am going to go slow with Tammy. I will try to do the acth test first ,than the ultrasound. Do you agree with the vet on the mri. It would be helpful, but I guess the risk would be there to..This year Tammy will not be able to go to the Halloweeen Party. She had her costume ready to go. Blessings to all. Brianna

[Harley PoMMom]

I probably wouldn't have a MRI done, for one thing they are very expensive and the dog needs to be still during imaging so generally anesthesia is used .

An abdominal ultrasound might be a better option, as it can be a very useful diagnostic tool, other abnormalities may be found on the internal organs, and as we like to say around here, you get a lot of bang for your buck with an ultrasound.

However not all ultrasounds are created equal. And yes, they can be a bit costly and having them done correctly is important. A good quality ultrasound/interpretation depends on a few things; the tool used, the technician performing it, and the physician interpreting it. Usually a Board Certified Veterinary Specialist is the best choice to perform an ultrasound.

Hugs, Lori

[Tammysmom]

Lori, thank you a lot. I appreciate everyones help. I think I will do the ultrasound and acth test. I will do one first and if everything goes well , I will do the other. Where we live, the vet does not do ultrasounds , too small town. I will take Tammy to the vet we seen last week. And I will call ahead and make sure he is skilled in performing these. What a difference a year makes. The children will really miss Tammy this year. She was going as a fairy. I just count my blessings. I still have her for now. Hugs to you Lori.

[Tammysmom]

Just a thought. Tammy was on 5 mg. trilostane when she had a stroke? Would it be best to start her back on trilostane, than in two weeks do an acth test. Or do the test , than start the trilostane.

[Squirt's Mom]

Personally I would do the test first....tho if she is still stressed from the stroke the ACTH results may be skewed as a result - picking up elevated cortisol from the stress of the stroke and not from the disease itself.

[Tammysmom]

This is what concerns me. First, Tammy looks so weak that I am thinking that any test at this time would be a lot of stress for her,. But yet,if I do not do any testing, I am afraid she will have another stroke or another issue. Thank you for any thoughts.

[Tammysmom]

My mind has been all over the place these last few days. I am taking time off from work till I decide how to help my tiny sweetie. I think the reason the vet touched on the possibility of a mri is because Tammy does have some back leg weakness and mild front legs knuckling. More in one front leg than the other. Now with the possible stroke and so much weakness, I can not figure out a starting point. Thank you for any information. Brianna

[molly muffin]

Brianna,, I have been racking my brain trying to think what would I do. It's hard to say without seeing Tammy if she could handle the ACTH test and whether it would be accurate or not. It will dump cortisol into her body, so there can always be risks with that, if the higher cortisol is associated with what ever it was that happened to her before (seizure or stroke) So you have to be aware of that.

My dog doesn't stress under the ultrasound, she does very well at that, but some dogs do stress. Mine just lays there and lets them do whatever they want basically.

You can always wait a bit and see if she gets stronger. Really this is a tough spot, between a rock and a hard place so to speak.

I just don't know what I would do or in what order. So much depends on Tammy herself and how she is doing.

[Tammysmom]

Hi Sharlene, yes, this is indeed a tough spot to be in. I will just take it slow with Tammy. I called the larger town vet, my vet does not have the equipment, and I think we will try to do the ultrasound first. He suggested we could just start her back on trilostane, than in 2 or 3 weeks retest. That way there would be less blood work. And less stress for Tammy. But I have been reading some members post about trilostane and frankly they are scary. I truly hope by giving Tammy trilostane for a few weeks, I did not cause her problems. She seemed to be ok before I started the trilostane. Just thinking-- Blessing to all. Brianna-.

[rebecca]

Hi Tammy I hope I'm not intruding but I just wanted to say my eight year old dog has been on trilostane for 10 months now and is doing amazing he has no side-effects and his symptoms have gone away he is leading a much happier life now and I am so grateful he goes for a regular blood tests and hasn't had his MG changed he takes 30 mg per day I know each dog can act differently to the medications I wish you the best of luck Rebecca

[Tammysmom]

Thanks Rebecca, I appreciate everyones suggestions and information. Your furbaby is adorable. And I am glad he is doing well. Brianna

[Tammysmom]

Tammy will be going in tomorrow for an acth test. Just got to do something to get her feeling better. Today around noon, she got restless and than whined a few minutes. Does anyone have know why she would do that. She seems to be ok now altho she still has a hard time standing,eating and drinking..I feel like I need to do something for her but so confused. Brianna

[Tammysmom]

Just wanted to add that I talked to the vet. he thinks she might have whined because she does not like that she can not walk like she use to.

[Tammysmom]

Tammy had an acth today. Vet was concerned the high cortisol could be causing her problems. However, it went bad today for her. Stressed her out a lot. So,is it best to just leave her alone for awhile. We really were hoping to do an ultrasound and see if anything else is going on. In the organs or heart. Appreciate any advice. Blessings. Brianna

[Harley PoMMom]

How is she acting? Is she drinking and eating? Does she have any diarrhea?

[Tammysmom]

Since Tammy had a possible stroke Oct. 23. she does not walk very good. Her one eye is blind. She eats and drinks normal.. The vet thought perhaps her possible stroke was from her cortisol levels being elvated. That is why we did the acth test today. It was very stressful for her.We want to do ultrasounds but they would probably cause more stress. Not for sure if to proceed with these test or back off a little. She will whine a little a couple of times a day. Not sure why. I worry if I do nothing, she might not ever get better. Brianna

[molly muffin]

Lets see what the ACTH shows first, then it is easier to make decisions based upon both Tammy and test results.

Baby steps. I know that sounds so clique. :)

[Tammysmom]

Tammys acth test results ( pre 2.8 ) ( post 29.9 ) She has very little improvement. Brianna

[molly muffin]

Drat!!

Well that isn't what we wanted to see. Didn't want to see her low, but better would be good.

What did the vet thing you should do next? Ultrasound?

[Tammysmom]

Hello Sharlene, not for sure what the next step will be. Might try to do an ultrasound. Will probably have to lightly sedate her. The vet does think her cortisol is too high and would like to restart at 5mg again. With her post at a 29.9 could she have a stroke again or will any organ damage occur ? The vet says its possible. I know the children need me but I am focusing on Tammy. It not easy. Thank you. Brianna

[Tammysmom]

Does anyone know how high the cortisol can raise in a dog before it causes problems for them ?

[labblab]

Hi Briana,

Generally, the cut-off for most diagnostic ACTH tests is a post-ACTH result around 22 ug/dL. What that means is that if a dog's post-ACTH result consistently exceeds that level, the amount of cortisol in their system has the potential to cause any of the problems associated with Cushing's. So I'm afraid it's true that Tammy's result of 29+ can leave her more vulnerable to a range of issues resulting from higher than normal cortisol.

Marianne

[Tammysmom]

Thank you Marianne for helping me with that. I hope the stroke? she had was not caused by the high cortisol. She was on 5mg trilostane at that time. But we do know at the time of the possible stroke her exact levels. I guess it is best to start her back on the trilostane. What would be a good number for a post on the test. ? I do think I will see about the ultrasounds next week.

[molly muffin]

Once on treatment with trilostane, they like to see a number between 1.5 - 5.0 ug, and can go up to 9.0 ug post if all symptoms controlled. So that is what you would be aiming for.

[Tammysmom]

Hello, Tammy is back on 5 mg trilostane. Thoracic radiographic impressions ( cardiomegaly without radiographic evidence of individual chamber enlargement. No evidence of pulmonary metastasis, bronchopneumonia, or congestive heart failure. Suggestion of hepatic enlargement.) Ultra sound ( Slightly enlarged adrenal glands,liver. Some sludge in gallbladder. ) Bloodwork ( on chemistry panel the blood urea nitrogen was the only abnormal--37 normal 5-29 ) Blood pressure normal. Her bloodwork,urine and test are pretty much normal. The acth test is mainly what is suggesting cushings. Her Free T4is .80 ( 0.6--3.) Vet said is normal. Thank you. Brianna

[molly muffin]

How is Tammy doing on the 5mg of trilostane?

That blood work wasn't nearly as bad as what I think we all worried it might be. It is pretty consistent for a dog with cushings.

[Tammysmom]

Wishing all a Happy and Blessed Thanksgiving. Tammy is on 5 mg trilostane and will retest at end of next week. She has not improved much from the stroke. Lots of back and front leg weakness. Because of her not having a lot of issues that is often seen in cushing dogs the vet has mentioned she could have a possible tumor elsewhere in the brain area. Would that also cause elevated cortisol. I would not want to treather with trilostane if it is not needed. Thank you

[Tammysmom]

Hello, just had a few questions I hope someone can answer. Is it possible if there is a tumor in a different location in the brain besides the pituitary,can it cause elvated cortisol and weakness ? And maybe strokes. Tammy has so much leg weakness.But not a lot of Cushing signs. More neurologic signs. Thanks a lot for any ideas..

[molly muffin]

Well, yes any chronic disease can cause high cortisol, so a tumor in a different location could cause a stroke and various problems including high cortisol.

Not every dog though will exhibit all the signs of cushings. My dog, has Never had a ravenous appetite or drank a lot of water. Her cortisol though was still high and bringing it down has helped her.

[Tammysmom]

Thank you Sharlene. I am just so confused what to do next. I really need to find a vet with more experience in Cushings. We are way out in the middle of nowheres so it will be hard. It is so hard to see her going down hill. She also seems to have, what I would call mental dullness. Does not seem to respond like she use to. Sometimes I think I am going to lose her just because I do not know how to help her.

[Tammysmom]

I am so sorry Sharlene. I guess we all think about ourselves and are babies. Human nature. Hope you and Molly are doing well.

[molly muffin]

Oh gosh! Don't even worry about it. Of course you are worried and scared and anxious. I would be too.
Molly is, well molly, she is diva most of the time, and funny and sometimes I worry about things I don't know what to do about for her. (her back leg gives out on her more and more and she just falls over) but she always bounces back up and scampers off. Doesn't seem to worry her. :)
It is hard to find a good vet that has experience with cushings even in a larger place. The key is to finding one who will work with you and learn with you.
I am thinking that 29. is too high (should be much lower) and maybe that will help her.

[Tammysmom]

One thing I learned since working with the children, that they fall over ,get back up and go about what they were doing. Also see children work on a project, get frustrated,than start right back to work .So if Molly falls,gets back up, than that is a really good sign. Still enjoys her life. Sometimes these issues worry us more than them. Take care and blessings. Brianna

[Tammysmom]

Just to add. Tammy is on 5 mg trilostane and will be retested at the end of the week.

[molly muffin]

If she is still high post, I think I would talk to the vet about increasing the dose. I think if it was molly that would be a step I'd take to see if the cortisol being lowered would help her at all.

[Tammysmom]

Hello, Tammy had an acth test today. It did not go well. She was a real drama queen and made everyone, including me nervous. I will get the results next week. Besides the acth test is there any other way to test the levels. In the urine or a pre post ? Sometimes i think she just wants to be left alone. Sleeps so much and as I said in an earlier post. Seems to have a lot of mental dullness. Thanks to everyone. Brianna

[molly muffin]

There really isn't another reliable way to test the cortisol level, other than a blood draw, an injection and an hour later a follow up blood draw (the ACTH).

Any vets who will come to your house? Maybe you could try taking her in for the intial draw then the injection and then taking her outside for a little walk or just to hang with you till it's time to go back inside for the next blood draw. That might work better for her.

[Tammysmom]

Thank you Sharlene for your suggestions. I might try taking her home and bringing her back for the last blood draw. Her post was a 17. Is that still to high ? The vet said we could up it to 10 mg trilostane. She is not showing a lot of signs. Some hair loss, few blackheads. And what I would call mental dullness and tiredness. Still has weakness in all fours.

[molly muffin]

Yep. 17 post is still too high. Under 9.0 with no symptoms or very few. Under 5.0 if symptoms persist. For Tammy you want to elevate the blood clotting risks that can cause stroke. I am not sure what that is but I'd definitely aim for under 9

[Tammysmom]

Yes, another stroke really worries me a lot. Why would Tammy get a stroke if her blood pressure is fine. I always thought high blood pressure causes strokes. So you think 10 mg would be alright for her ? Thank you.

[molly muffin]

How long has she been on the 5 mg? If over 30 days then you could probably increase some. She came down from 29'to,17 on 5 mg? And weighs. Hmmm how much does she weigh? Is she on brand name vetroyl? If not you can increase to 8 mg wven. If she is and you want to,stick with the brand name you would go to 10mg. Bit retest in 2 weeks to,see how's he is doing. I probably would increase myself and see how she does.

[Tammysmom]

Tammy was on the 5 mg. trilostane 15 days when the acth test was done. Her post is a 17. The vet said we could increase it to 10 mg. She weighs 6.4 oz. I only know it is called trilostane, so I do not know if it is the brand name. Her head still tilts some and she still does not seem the way she use to be. Thanks and blessings to all.

[molly muffin]

If he is calling it trilostane then that is what it is.

Blood clots can cause strokes, and cushings dogs are more prone to them it seems. Or from what I've read, been told.

[Tammysmom]

Tammy continues to weaken. She is still very tired and has a lot of what I call mental dullness. Lots of back leg weakness as she can hardly stand. Some knuckling in front as well. Her skin and hair have improved some..Her vet is talking about a possible enlarging tumor on the pituitary. Or a problem elsewere in the brain area. Just to mention, she is now on 10 mg trilostane. It has been a hard Christmas season. I know this will probably be Tammys last Christmas. Wishing everyone a happy and blessed Christmas.

[molly muffin]

Oh poor Tammy. I'm sorry to hear that she isn't improving. :(

Wishing you all a wonderful Holiday Season.

[Tammysmom]

I am so sad and so confused . The vet said I probably have 3 choices with Tammy. She is on 10 mg trilostane, so we could leave her on the 10 mg and hope something improves. Choice 2 is to take her off and keep her on pain meds and again see what happens. Or for the last choice, I could travel around 12 hours to the nearest vet college and see if she can be helped. The vet is rather doubtful that they could help her. Mainly because they would probably need to do an mri and other testing.Which they would not do because of her age and frailness. For the first time,i really do not know what to do. Thank you if anyone can help Tammy..

[My sweet Ginger]

I apologize for that I only read this last page and am offering my 2cents here. If she were mine I'd go with option 2, stop the trilostane, give her pain meds and see if she improves. If 5mg trilostane for 15 days brought her cortisol from 29 down to 17 I don't think we can say it wasn't working at all as trilostane continuously works for 30 days. I'd have stayed for another 15 days on 5mg and do an ACTH. It might have brought her cortisol further down, possibly.

As your vet has mentioned other things may be going on with her but some of the symptoms she's been showing could also be found in trilostane overdose too.
It's hard to tell but I'd just try option 2 for now and see how she does and go from there. There's a possibility that 10mg might be a little too much for her right now.
How long has she been on 10mg?

[Tammysmom]

Thank you for your reply. Your baby is so cute and tiny. Tammy has been on the 15 mg since Dec. 14. She has so much tiredness and what seems like mental dullness along with the weakness. . I think choice 2 is what I will go with for now. . I wonder if the cortisol levels come down to quickly, can a dog get something like a withdrawn issue from it going down to quickly. Like it shocks the body. She also has lost about half a pound. I don"t know if I am making any sense. Thank you.

[My sweet Ginger]

Thank you. Yes my Ginger is very cute even though so skinny at 7 lbs now from 10.6 when we started our journey in 2013.

It's probably a good idea to check her cortisol level now since she's been on 10mg for two wks as the results will show a better picture.
Yes, there's such thing as 'cortisol withdrawal' when it plummets too fast but in Tammy's case it's possible that the dosage may simply be too high at 10mg. So another ACTH and the option 2 may be a good idea to me.

[Tammysmom]

Thank you Gingers mom. I looked a little at your threads and saw Ginger just had a birthday.Happy, sweet 16. Thank you for your help. I guess if I do the acth, it is best to have her still take the 10 mg on the morning of the test? I really hate doing the test as it is extremely stressfull to her. But I guess you have to just do it. Did your Ginger lose weight from the Cushing disease or from her Cushings med. I always heard they gain weight. Tammy has lost a half pound since we started trilostane. Her vet thinks its nothing to worry about.

[molly muffin]

Oh my goodness. Poor Tammy. I would check and see where her cortisol is at. Remember to ask if you can take her for a walk for the hour between draws or something and see if she doesn't do better that way.

My dog has lost a pound since all of this started. She looks better when I let her hair grow out a bit longer as she looks bigger, but when she is groomed and clipped, she looks skinny. Doesn't necessarily feel skinny when I'm carrying her up and down the stairs though. hmmmmm

Hope you had a good christmas. Happy new years

[My sweet Ginger]

I'd think that you probably will have to wait for a few days to schedule for an ACTH this weekend being a holiday weekend. So what I'd do is to stop the trilostane now if you hadn't already and watch Tammy for a few days and if she does get better then you know the 10mg was probably too high for her. I don't want any chance of overdosing her by continuing with trilostane to have an ACTH done in case she already is. You can always restart trilostane when/if needed.
Others may have different ideas but this is what I'd do right now in your case. I just know that the protocol recommends an ACTH 10-14 days after each time there's an increase in dosage.
You should talk to your vet about all this but stopping trilostane for a few days and monitor Tammy for any change is what I'd do right now.

Are you still giving her trilostane and is she doing any better or worse?

[Tammysmom]

Hello Sharlene and Gingers Mom. Tammy looked so weak today so I took her to the vet. He checked the blood to make sure she did not go to addisons. I believe it was a chemistry panel. The only thing abnormal was her cholesterol was low . Hers was 90---Normal (120 --247.) He decided to do an acth test which I will not get the results until next week. I asked him if I should take her off the trilostane. And he agreed . Thanks Gingers mom. I went according to what you had said.Wishing everyone a happy, safe and blessed New Year. Brianna

[molly muffin]

Hi, what was the results of the ACTH test? How is Tammy doing?

[Tammysmom]

Sharlene, just got the results. Post is a 2.1 . Low, but vet said no reason to think addisons. She is off of trilostane at this time. The vet said we could go back to 5 mg.I do not think it would do much good so probably will not even give her that. I am totally heartbroken. She is so tired, mental dullness, can not walk much and whines a lot, especially at night. My husband said it might be time to give my greatest gift back to God. Thank you for trying to help my darling Tammy. Brianna

[My sweet Ginger]

Can you post the pre number also? I'd be interested to know.
Have you tried or talked about giving her rescue dose of prednisone with your vet just to see if that will perk her up a little? Although post number of 2.1 may not be clear cut Addison's, I'd like it to be a little higher than that for my comfort.

[Tammysmom]

Thank you so much. Her pre was a 2.2. The vet never said anything about giving her prednisone.Would that make her cortisol levels get high again ? Will call the vet first thing in the morning and ask about the prednisone. Maybe for the first time, I wish we had not choose this work and lived closer to a big city with more experienced vets.

[molly muffin]

Lets see, she was post 27, put on 5mg of vetroly, it dropped to 17 post acth, put on 10mg and her post dropped to 2.1 with a pre of 2.2.

She was on steroids quite a while back for 3 years but then taken off as the vet felt it was causing more harm than good.

There is a possibility that it is not cushings that has caused the cortisol to go up, but some other factor. I wouldn't keep here on 10mg at this point, since she is flatlining the pre/post (where results are almost exactly the same, in other words, she isn't keeping any in her adrenal glands as reserve).

It might even be that the cortisol was risen due to some other reason than cushings. A question for your vet perhaps? Cortisol will rise if anything else is going on. You mentioned her teeth where bad, so now I'm throwing something else out for you to ask your vet about and that is an antibiotic. If there is something with the teeth an infection or inflammation. I understand not risking a dental cleaning and putting her under anesthesia is not a good idea in her condition. So I'm just throwing out alternatives.

It's really hard once they are up there in age, trying to keep everything balanced. I think it is now a matter of what makes Tammy feel the best. If it is no treatment or a bit of steroid or something, then that is what I'd do.

Sending you big hugs Brianna!

[My sweet Ginger]

Although a pre number of 2.2 may not seem alarmingly low but together, a pre 2.2 and a post 2.1 are not ideal set of numbers in an ACTH stim test.
We want to see a higher post number than the pre number in ACTH as it means stimulation of adrenal glands. Tammy's ACTH test results show no stimulation at all, in that her post is actually lower than her pre even if it may look minuscule. That could be one of the reasons why she was feeling so weak and lethargic and seems in some kind of pain. I'd definitely talk to the vet and try rescue dose of prednisone and watch how she does.
My pup also had blunted ACTH results and was put on prednisone for a long time. The rescue does of pred is 0.25 mg/kg so her dose would be 0.75 mg if she still weighs 6.5 lbs. Yes, I'd try prednisone. They have 1 mg pred tabs available. The symptoms may return but I think Tammy needs it to survive.

[molly muffin]

How is Tammy doing? How are you doing?

[Tammysmom]

Hello Sharlene, thank you for asking about my sweetie. You and Gingers mom have been wonderful. I am terribly sad and confused. I pray God will help me cope with all this. The children need me. There is so much to say but at this moment I am, as I said so sad and confused. I will try to write more tomorrow. Tammy is really just hanging on. Her little face brings me to tears. Even a loving husband can not comfort me. Everything about her issues has been so messed up. You and Gingers mom gave me so much important info. I feel like I and the vets failed her. Hope you and Molly are well. Thank you again Sharlene. And thank you for the big hug. I needed that. Love, Brianna

[molly muffin]

Oh Brianna. :(

I am sorry to hear this. You have not failed. We all do the best we can, with what we have and you as many others have, took the time to find this forum. That right there says you where taking that extra step.

I wish that you weren't sad. I don't think Tammy wants that. Dogs respond to us as much as we do to them remember. So even though you feel sad, try to engage her as much as possible.

I'll be here, we are all here.

[Tammysmom]

Just want to apologize to the forum, especially Sharlene. I hit a low spot and started to get a feeling sorry for myself moment . So unlike me. Ok, based on the information Sharlene and Gingers mom gave me, Tammy has been taken off of trilostane entirely. At least for now. She will be put on an antibiotic for any infection for her teeth. The pred. he said would raise the cortisol and defeat the purpose in bringing it down. He admitted he is a small vet and has not treated many dogs for Cushings. He is a dear friend and he tries to help. He talked to a vet he went to school with and this vet suggested maybe Tammy does not have Cushings but an immune disease instead. Mentioned Lupus. He has suggested a college or teaching school for Tammy. So I guess I am at this time totally confused. Again, I am very sorry. Brianna

[My sweet Ginger]

Is prednisone helping her at all? I mean I will try that as one of the last resorts.

[My sweet Ginger]

When a pup's adrenal glands can't produce reserve cortisol due to an overdose of trilostane (Lysodren in my pup's case) they need prednisone to survive along with stopping trilostane entirely for from a few days to months in some cases (over a year in my pup's case) depending on the severity of the damages to their adrenals until their adrenals start to regenerate cortisol again on their own.
I know it's really hard to go against your vet (I was there myself) but ultimately you are the one and only advocate Tammy has who can speak for Tammy for her well being or safety, not the vets. With her flat or blunted ACTH results Tammy's body needs extra cortisol (steroid ) right now. All I want you to do is to try prednisone and watch if it makes her feel better even only for a few days. If it does then you know her cortisol is too low for her comfort. If she were mine I'd insist on doing it.
To me the benefit of trying prednisone outweighs not trying it at all in her case right now. I'm telling you this from our own experience and going by what we were told by our internists who treated my Ginger at that time. I can't tell you for sure that this will help her but also can't tell you that this won't help her either. I'd try anything if there's a possibility that will help her at this point.

PS: Our GP vet had been in practice for 17 yrs at that time and we had a wonderful relationship and she couldn't be a nicer person. As wonderful as she was as a GP vet, still her knowledge and experience on Cushings weren't enough to help my pup once her case wasn't straightforward anymore and looking back I really can't blame her for her rather limited knowledge and experience on Cushings as a GP vet. I now know we can't put a blind faith in our GP vet and hope for the best. In order to successfully treat this dreadful disease we need a vet who is willing to work with you as a team and an educated/involved parent.
I'm sorry if I'm being a nag but I'm trying to be a voice for Tammy.

[molly muffin]

Brianna. No need to apologize. We all hit low points and have off days. If you can't have them here in safety among friends who understand and have been ther. Then where? Big hugs Vent all you want. Anger and sadness are natural response.

[Tammysmom]

You are not a nag. I have thought it over and yes I am going back and insist on the pred. I feel at this point its worth a try. Somehow I have a feeling you maybe have gone through something like this and are speaking from experience. I was shocked when Tammy went under 6 pounds. Will wait and see what happens in the next few days.

[My sweet Ginger]

Unfortunately yes, we've gone down this road and our GP vet thought we had gotten the ACTH numbers in the perfect range at 2.9 for pre and post while my Ginger was showing symptoms of being lethargic, falling over, hind leg weakness, no appetite, wobbliness, etc., etc..
We were still in a thick fog even after one internist and thousands of $$$ of testing until we met the 2nd IMS and I saw the fog was being lifted in an instance and not a single test was needed.
I wish I can say this with certainty that this is the reason why Tammy is feeling the ways she's been as something else could be going on but for me prednisone therapy would be the first thing to try with her blunted ACTH results before you move on to other tests.

[Tammysmom]

I still can not get hold of her vet. I was so frightened for Reese and her mom. Thank all for helping her. I am now wondering how low a pre and a post acth test can go for safety. I never really thought the pre was important, Seems like vets do not say much on the pre. I have had the vet just give me post only. Tammy is not drinking much but has a very good appetite. So I guess tomorrow would be ok to get with her vet.

[Harley PoMMom]

Dr. Peterson, who is a renowned endocrine specialist, states that the ACTH post should not be lower than 2 ug/dl. Here's where you can find this information: http://www.endocrinevet.info/2012/12/low-dose-twice-daily-trilostane.html

And the quote:
Dosage adjustments — lowering the dose
In this report (13), trilostane treatment was continued in dogs with a post-ACTH cortisol concentration less than 1.5 μg/dl, as long as no adverse clinical signs were reported. I disagree with that regime.

When using trilostane, it has become increasing clear that we do not want the cortisol values to drop too low, because that may indicate early or mild adrenal necrosis (1,11,12). In contrast to the protocol used in this reported study, I recommend stopping the drug in all dogs that develop a ACTH-stimulated cortisol values less than 2.0 μg/dl, and repeating the ACTH stimulation test in 1- to 2-weeks in those dogs. Some of these dogs will require that the drug be restarted at a lower dosage, but others will maintain low to normal serum cortisol concentrations for prolonged periods of time. And a subset of these dogs, presumably because of mild adrenal necrosis, will never need any further trilostane treatment to control the signs of Cushing's syndrome.

The "pre" number, along with the post, is crucial when Addison's is suspected.

Hugs, Lori

[My sweet Ginger]

If Tammy's appetite is coming back without the help of pred that means having a few days of break from trilostane was enough to make her feel better. I'm not sure if she can be helped further with pred or just stay off trilostane for a while is all she needs but I'd let the vet make that decision. Hopefully she will continue to improve until she sees her vet. Also I wouldn't go back to 10mg trilostane if/when she is ready to go back on trilostane next time.

To me pre number is important because together, the pre and post numbers can tell you whether or not their adrenals are stimulating.

[Tammysmom]

Tammy is off trilostane but has not improved much. She eats and drinks normal. Still very tired and will not walk much. What really puts me on nerves is the whining especially at night. I think the vet does not know what else to do for her. I am thinking of taking her to a teaching school or college. That would mean a long drive for Tammy. It will be stressful for her but I am running out of options for her. Just to mention Tammy is on meds for pain

[My sweet Ginger]

Have you talked to your vet and tried pred on Tammy? If too much damage was done to her adrenal glands by overdose she may need daily prednisone therapy in addition to taking her off trilostane. That's not to say her low cortisol is the clear culprit here for her poor health but she may have a lot more to gain than to lose by going on prednisone therapy at this point. I'd try it for a few days and watch how she responds to pred if you haven't done so already.

[My sweet Ginger]

How is Tammy doing?

[Tammysmom]

Thank you for asking about my Tammy. She is on the opposite end of your little Ginger. She will not walk. Plops down and just looks at me. She is off the Trilostane. I did not do the pred. Vet thinks because she is off the trilostane, eats, drinks normal and bathroom is normal, she does not need pred. I guess he thinks the cortisol will get high. She however will not walk much and is always tired. Not interested in life like she use to be. But as I mentioned in earlier post, she whines especially at night. That is disturbing. She is on Tramadol for pain. If she does have any. I have made an appointment for Tammy at a teaching school. It is a days drive away and i worry about her stress level. I feel it might be the only option I have for her.. Brianna

[Tammysmom]

Yes, I did want to mention another thing. Tammy still tilts her head and last night her neck was very stretched out and her eyeballs were sort of at the top of her eye. She also wet a little on my bed. Did not think much about it at the time. Has anyone had a dog that has done that. Thank you. Brianna.

[molly muffin]

I don't know what that sounds like. Did she appear to maybe be having a mini seizure? Maybe try recording if that happens again but it's sort of what I am thinking with the neck, eye roll and peeing. It might not have been a major one but with Tammy we have to keep in mind that she has had seizure or stroke previously. So could be something neurological going on there.

[Tammysmom]

Yes, that's what I am thinking. Neurological issue. She has an appointment for Feb. 2 . Hopefully they can shed a little light on her issue. Not looking forward to the ride tho. Wish my husband could go with me. They will be having a Blessing of the Pets Event this week and I think I will take Tammy. Thank you Sharlene and hope Molly is doing well. Brianna

[Tammysmom]

Does anyone have or had a Cushings dog that the feet or paws are always cold ? Can it be from Cushings or a separate issue. .. Her feet are cold even in warm weather. Thank you for any answers. .

[molly muffin]

Hmmm no not a symptom I am familiar with involving Cushing's. However with people they always say cold hands and feet are a sign of poor circulation.

[Tammysmom]

I am getting more and more confused on what Tammy really has. Everyone said Cushings. I also thought cold hands and feet in people can be a circulation problem. Tammy could have poor circulation. If not from Cushings, could it be from neurological issues ? Could she have several issues ? My vet totally lacks knowledge to help her. If I can not get the help she needs quickly, my sweetie will not make it much longer. Too many issues.

[molly muffin]

I don't know Brianna. When I think of neurological problems I think more of the stumbling, knuckling, getting stuck in corners. That kind of thing. That is what I am most familiar with in relations to Cushing's and macro tumors.

[Tammysmom]

I do want you to know how much I appreciate your replies. I have thought a lot about Tammy and all her issues. Within the The first year I got her ,she had a bluish tongue and lots of allergies. . At that time the vet was worried and she did have some testing. In the last few years her tongue took on more of a pink look. Than she developed what they believed to be Cushings. Is it at all possible,that a circulation issue or even an immune disease could cause high cortisol ,hair loss, cold feet,weakness or seizure and strokes. . I probably am not making much sense but getting desperate for answers. I think I must live in the worst place were the vets have not much experience in much of anything. I know no one can probably answer the questions, but thanks for letting me get my fustrations and I wonders out. Brianna

[molly muffin]

Cortisol can go up in response to many things, including any chronic disease, other than cushings.
So, it could be that Tammy doesn't have cushings, her cortisol went up for another reason.

What are Tammy's regular blood work like? The cbc and urinalysis values?

[molly muffin]

BTW, we don't mind just sounding things out and talking them over, sometimes that helps a lot.

[Harley PoMMom]

Has Tammy's thyroid level been checked? The hair loss, cold feet, weakness and seizures are symptoms of Hypothyroidism. Dr. Dodds is one of the top experts in thyroid problems in pets, and if I wanted my pets thyroid levels checked her lab is where I would want the samples to go; from her web page:
Hemolife is unique in routinely offering expert clinical interpretive diagnostic comments that take into account the age, sex, and breed type, and activity of the animal; this yields an expected normal reference range for an individual pet (termed the “Case Specific” range on our reports) that differs from the generic broad reference range for the species (termed “General Range” on our reports)....just a thought.

Link to her website: http://www.hemopet.org/veterinary-diagnostic-laboratory.html

Hugs, Lori

[Tammysmom]

Sharlene, I will locate Tammys last bloodwork. I think everything was pretty much normal. Lori, I will look over the web site you gave me. Her last Thyroid test was a Free T4. Results--- .80 Normal ( 0.6 - 3 )Vet said it was normal. So appreciate any help. Brianna

[Tammysmom]

I was wondering if even tho the vet said her thyroid number is normal, does it still seem a little low. Test was a Free T4. Tammy number ( .80 Normal ( 0.6 - 3 . ) Guess I am trying desperate to help her. I know this is a Cushing site but any replies would be great. Perhaps someone will know. She does have a few of the signs of Thyroid. . Thank you.

[Harley PoMMom]

I'm not sure if those thyroid numbers for Tammy are on the low normal side however Dr Dodds may be able to give some insight there, we have had members email her and she did respond, this may be an option for you.

[molly muffin]

We see low thyroid in a lot of dogs that have high cortisol.

What about a full thyroid panel, to see where she is at? That might tell you more and your vet could do it. Then you'd have more to tell Dr. Dodd if you do email her.

[Tammysmom]

Her vet wants us to wait until next week to do the thyroid test. I have tried to get her an appointment sooner but they have no cancellations. She appears to get worse. Her breathing seems distressed and congested. Took Tammy in today and vet said her lungs and heart appear fine. Said maybe allergies. I have a feeling there is a little more involved. Tammy still whines at night mostly. I think deep in my heart, she is slowly leaving me. For the first time I envy folks in the big city Any help would be appreciated, Brianna

[Tammysmom]

I was told to give her baby benadryl and use a saline.

[molly muffin]

Here is the info about using saline in a dogs nose:

https://www.vetinfo.com/saline-nasal-spray-for-dogs.html

We've had other use benadryl for allergies with their dogs. Baby I'd definitely think since Tammy is small size.
It can make them a bit lethargic too.

I wish I had more answers for you, but I just don't know.

Did you ask them to call you if there is a cancellation?

[Tammysmom]

Yes, I did. Feb. 6th seems a long ways off. Can dementria cause whining in a dog ? I getting to the point I really do not know what to do. Brianna

[molly muffin]

yes it could. Have you looked into novofit? that is something that some use for dementia in dogs.

I think you can find it on amazon.com

[Tammysmom]

Sharlene thank you. The vet mentioned it was a possibility , but only when I asked him about dementia in dogs. but never said anything about what we could use for dementia. I going to look at that product. Sometimes,i swear ,I do not know who the vet is here. Him or me. Sorry, you can probably tell I am getting frustrated.. Brianna

[Tammysmom]

Sweet Precious Tammy has left.

[molly muffin]

OMG Brianna! Big big hugs. I'm stunned and well, tears are just streaming.

I changed the title of your thread to reflect that Tammy has passed.

I wish I was there to give you a big hug and I know this is ripping your heart to pieces.

i just can't express how very sorry I am. :(

[Harley PoMMom]

Oh Brianna,

I am incredibly sorry for your loss of dear Tammy and my heart goes out to you at this most difficult time. Please know we are here for you and always will be.

With Heartfelt Sympathy,
Lori

[judymaggie]

Brianna, I am so sorry about your loss of Tammy. It seems sudden to us so I can't imagine how distraught you must be. Please take care of yourself during this difficult time.

[Joan2517]

I have just found this, Brianna...I am so sorry for your loss. I am new to the site and I am crying for you. I worry about this every day now...

[Robert]

So so sorry for your loss.

[My sweet Ginger]

I'm so sorry for your loss of sweet Tammy. She's no longer in pain.

[Trish]

Condolences on the passing of Tammy, it sure is never easy so be kind to yourself .. big hugs x

[sandi and bugsy]

I'm so very sorry for the loss of your sweet girl. I lost my precious Bugsy on Dec. 18. The pain is still so unbearable. I'll bet my boy met Tammy with lots of kisses. One day we will be with our babies again, but until then, our angels are watching over us from heaven. Sending prayers up for you.

[Tammysmom]

Thank you for your kind words. The vet thinks Tammy had a blood clot in her lung. My husband and I are heartbroken. We will love and miss our little girl forever. Tammy left us on Jan. 27. Brianna

[molly muffin]

Oh I'm sorry. :(

I can't imagine how devastating it is to lose Tammy. She was a family member after all, as most of our furbabies are. You don't get here to this forum if they aren't usually.

I said the other day to someone, the mind might know one thing but the heart, well, it is broken, and the heart needs what it needs which is time to grieve, to be sad and angry and all those emotions that seem to pile onto us from out of the blue.

You know that we are here for you if you ever want to talk, to vent, anything. You are family here too.

[Tammysmom]

Today is such a sad day. It really should be a very happy one. It is our wedding anniversary. Our first one without our little darling. My husband gave me Tammy on our first anniversary. We miss her so much. I can not stop crying today. I can not get over the guilt I feel. I am no stranger to sickness and loss but I do have a struggle with all that has happened. Usually I am a strong person but today hits hard. Thank you for letting me express my feelings. Brianna

[molly muffin]

Brianna! I am do sorry that this day, which should be one of joy has been so sad. First are always the worst. First anniversary without her, first holidays. Etc.
What a wonderful gift from your husband. A gift of such impact on both your lives. Brianna. Big hugs.

[mytil]

big ((((hugs)))) to you both!
Terry

[Joan2517]

Hi Brianna,

Anniversaries are so sad, the first this, the first that...I cry at each one...this will be our first holiday without Lena. She loved holidays! The company, the food cooking in the oven. She would set herself up in one of her beds right by the kitchen where she could watch the stove and keep an eye on whatever was cooking. I am dreading it :(....

She will be there in spirit, as was Tammy, because they are constantly in our thoughts. I will think of her all day, as I am sure you did with Tammy....

Joan

[Tammysmom]

Sharlene, Terry and Joan. Mike and I appreciate your kind replies. And Joan, Tammy and Lena were so much alike. Tammy loved food. The kitchen was her favorite room in the entire house. A happy and blessed Easter to all. Brianna

[Joan2517]

Same to you!

[molly muffin]

Happy and blessed Easter to you and Mike also! From our home to yours.

[Allison]

Belated condolences to you on your loss of Tammy. I'm so sorry that she's passed and in how sudden her death happened.

I lost my sweet Lucy cat just before Christmas a few years ago. Her loss has changed how I think of Christmas. At first I felt nothing but sadness on what is normally a happy family time. This past year I felt instead a strong desire to celebrate our pets. Maybe in time your anniversary will become the time when you most want to honor those you love, in memory of Tammy.

Hugs!

[Tammysmom]

Thank you Allison, I just noticed your lovely words. I still miss my little Tammy so much. Brianna

[Tammysmom]

Happy Mother`s Day to all the moms. This is my first Mother`s Day without my sweet Tammy. Mike and I have no human children and Tammy was our only fur child. Every year on Mother`s Day My darling Mike would get me a card with Tammys name signed in it .Along with the card were flowers, a box of candy or coupons for ice cream at our local Dairy Queen. I woke up this morning feeling great sadness. On the table was a Mother`s Day card like so many years before. It was signed Tammy, your baby forever. And outside Mike had planted the most beautiful white rose bush I have ever seen. There was a little plaque with Tammy`s name on it. Excuse me now, I seem to have something in my eye..

[Harley PoMMom]

Oh Brianna,

That was such a lovely gift that your husband, Mike, did for you in remembrance of sweet Tammy. I haven't any children either, so I completely understand how you feel about your dear Tammy, it is so hard losing them.

Sending huge and loving hugs, Lori

[scoora]

Brianna,

That was so beautiful and touching what your husband did.
It brought tears to my eyes to read about it.

[Joan2517]

Brianna, today was hard for me, too...Lena was always referred to as my third, and youngest child. What a sweet man you are married to!

[spdd]

If that wasn't one of the sweetest gestures I have ever read. I too cried when I read this..... but you know it gives me an idea. When I ever get settled... I think I will steal this idea and do the same. Thank you for sharing this. Although bitter sweet, it's so amazing for you.

[molly muffin]

Isn't he a wonderful husband. I know he must be missing Tammy so much too.

HUGS Brianna.

[mytil]

What a truly loving gift your husband gave you! He is a very sweet person and I am sure he is missing Tammy and through his own grief his thoughts were of you.
Terry

[Tammysmom]

I just want to take this time to thank everyone for their touching responses. Yes, Mike is a very special man. Sweet and kind. And yes, he really misses " Dada`s little girl". Brianna

[molly muffin]

I'm pretty sure he has a fan club :) LOL