Lena, Teacup Poodle w/ adrenal tumor - Lena is now an angel

[Joan2517]

My teacup poodle, Lena was just diagnosed Dec. 7. She is only 6lbs. Has all the classic symptoms which snuck up on us as she is going to be 15 in March and we attributed them all to her age. She started on 10mg of Vetoryl and it seemed to work within a few days, but the symptoms are all returning. We increased to 20mg and now it is up to 30. Testing again this coming weekend. I am heartbroken! She has been my baby since the first day I saw her. She has an adrenal tumor, which is inoperable. Does anyone have any suggestions on diet?

[labblab]

Hello Joan, and welcome to you and little Lena. I have only a moment to post, but I wanted you to know that I've moved your post in order to create a thread that is your very own. This way, it will be much easier for our members to reply to you directly. ;)

We're very glad you've found us!
Marianne

[Joan2517]

Thank you, Marianne...I wasn't sure where to go. I am crying all the time and just want to hear from others who might help me get through this.

[Budsters Mom]

Hi Joan, Welcome to you and Lena.

30 mg. is a boatload of Vetoryl for a 6 lb. baby. Please post the results of all of her ACTH tests. I am concerned about such a high dosage.

Thanks,
Kathy

[Joan2517]

Oh, God....now I'm nervous! The vet said it was okay to go that high. She's only been on 30 since 1/21. I just called them and asked them to fax me the test results. How do I post them after I get them? I knew it...I thought it was too high!

[Budsters Mom]

DO NOT PANIC JOAN!!!!! ;). BREATHE!!!!!! We just want to check a few things. Starting recommendations for Vetoryl is 1mg. per pound. Cortisol can (and often does continue to drop) the first 30 days of treatment. Lena has just been diagnosed. Her Vetoryl has already been raised twice. This is a red flag waving wildly to me. We ask a bunch of questions for clarification. TRY NOT TO PANIC!!!

Kathy

[Joan2517]

They haven't sent it yet...how do I get it to you when they do? If they don't send it to me by tonight, should I not give her the pill in the morning?

[labblab]

Hi again, Joan. I'm so glad Kathy's had the chance to greet you, and now I'm back again, too, to talk some more. First of all, as Kathy has said, please don't panic and please do not alter Lena's dosing at this point. We are just in the process of learning more about her situation and her testing history. One of the things we do know is that dogs who suffer from adrenal tumors may end up needing higher doses of the Cushing's medication in order to control the symptoms caused by adrenal overproduction. So this dose is not necessarily the wrong dose for Lena -- that answer will depend upon a combination of her behavior and also the monitoring testing.

When you get the test results, this is what we are looking for. ACTH stimulation tests are performed to monitor Vetoryl treatment, and what these tests consist of are two different values: a test of baseline cortisol taken before the administration of a stimulating agent, and then a second cortisol measurement taken one hour later. So in terms of the lab report, it will look like a baseline or "pre" cortisol reading, and then a second or "post" reading. It looks as though Lena has been taking the Vetoryl for almost two months now along with a couple of dosage increases. So if you can give us the dates and results for any ACTH tests, that will be great.

Also, can you tell us more about the diagnosis of the adrenal tumor? I'm assuming she has had some abdominal imaging performed. Is the reason why the tumor has been deemed inoperable based upon her age, or upon factors associated with the tumor size/location itself?

In terms of Cushing's symptoms, can you also tell us more about little Lena is outwardly doing?

Thanks so much for this additional information,
Marianne

[judymaggie]

Hi, Joan & Lena! When you do get the ACTH results, the easiest way to give us the info is to type it in a post here in your thread as you won't be able to attach any documents. When I post ACTH results, I just type:

1/26/2016
Pre 3.4 ug/dL (or nmol/l which is more common if you live outside the U.S.)
Post 7.8

If Lena is on any other medications/supplements other than Vetoryl, we would appreciate your letting us know what they are and why they were prescribed.

With regard to diet, most Cushing's dogs do well on low protein/low fat food but we can talk more about that later.

Again, as Kathy wisely advised, TAKE A DEEP BREATH!

[Joan2517]

I just sent a whole message that didn't get sent...

She had an ultrasound and it showed a sizeable tumor on her right adrenal gland over the kidney and vena cava. Then they did the low dextrose test, which showed adrenal Cushing's.

She has had symptoms for about a year, I think. They didn't happen all at once, but crept up. The panting, not wanting to cuddle anymore, peeing in the house, slipping on the wood floors, not climbing stairs anymore, drinking a lot of water, eating like crazy; the potbelly, warts, an eye infection, her tail didn't poof after grooming anymore; she was always hot, when she used to love to lounge around on the deck and soak up the sun. Some I went to the vet for, but the rest I thought was just her age.

The Vetoryl seemed to work right away, but then she started drinking and peeing again within 2 weeks. The belly is getting bigger and she seems to be breathing harder. I have put her on kind of a diet, same food, just less.

Everyone keeps saying she seems fine, but I know her better and she's not. I don't know what to do!

[labblab]

Joan, take a look at this thread for hints to keep you from losing your replies before they get posted:

http://www.k9cushings.com/forum/showthread.php?t=1329

[Budsters Mom]

I am so very sorry that I scared you with my post earler. :o I only had a minute, as it was in the middle of my work day. Chaos can (and often does ) erupt without warning. So again, my post was too short and didn't provide enough of an explanation. I am very sorry about that!:o

Please do not withold Lena's pill. As Marianne said, we are just beginning to gather the information needed to sort out Lena's particular circumstances. Every fur baby has different needs and often different dosages.

I do believe you when you say that you know there is something wrong although others say that Lena is fine. A mother always knows. ;)

Hang in there, enjoy your sweet girl and remember to BREATHE!!

Kathy

[molly muffin]

I just want to say hello and welcome. Adrenal tumors can be real buggers to get control of.
So let's see the ACTH testing results and the dates and dosage she was on at each test and go from there.
Deep breaths. Knowledge is key with Cushing's and the more you learn the better equipped you will be to make decisions on her behalf.

[Joan2517]

I can't tell you all how happy I am to have found this site! I finally feel like I am not alone. Thank you so much for all these posts.

This seems strange, but when I got home from work tonight, Lena seems better. She's more alert and even playful...maybe she senses my relief and I don't seem so sad to her.

[molly muffin]

That is very good o hear. Hopefully the improvements continue and no need for worries.

[Joan2517]

I forgot to mention she also has high blood pressure. I just saw the picture of Ginger and her dry nose...another trip to the vet where they gave me cream for it and never mentioned high blood pressure.

[molly muffin]

You do want to have the BP monitored periodically and especially if you know it is high. Is she on any medication for high blood pressure?

[Budsters Mom]

What about the cream??? Is it by chance a steroid??? That could definitely make Lena's cortisol go wonky. :o

[Joan2517]

She is...something that starts with an A..I don't have the bottle in front of me.

[Joan2517]

It's called Dermoscent and its a bio balm. But I just realized that her eye drops have steroids in them.

[Joan2517]

Again, I posted a whole long thread with her blood work last night on a different computer and lost it. When I get to work I'll try again. I forgot to click the "remember me".

[labblab]

It's called Dermoscent and its a bio balm. But I just realized that her eye drops have steroids in them.
Joan, for how long has she been getting the eyedrops and for what reason?

Also, another thing you might try in order to avoid retyping lost replies is to compose them elsewhere, like in a word processing program, and then copying/pasting them into a reply here. That way, you'll still have the original even if the reply here goes astray.

[Joan2517]

Here are all of her tests beginning with the first one:

First test 12/10/15:
Cortisol Serial 3 (DEX)
Cortisol Sample 1: 10.0
Cortisol Sample 2 Dex: 2.6
Cortisol Sample 3 Dex: 7.3
10mg started 12/11


Second test 12/31/15:
Cortisol Sample 1: 10.4 (HIGH)
Cortisol Sample 2: 30.9 (HIGH)
20mg started 1/4 (10 in morning and 10 at night)

Third test 1/16/16:
Cortisol Sample 1: 5.5 (HIGH)
Cortisol Sample 2: 20.4 (HIGH)
30mg started 1/21

Next bloodwork to be done this Saturday or Sunday

She is on Amlodipine for High Blood Pressure 1/4 of 2.5mg 1x daily, discovered during first test (200)
and and has been using eye drops Neomycin and Polymyxin B Sulfates Dexamethasone Ophthalmic Suspension USP (I only just started this again the other day) they were because her left eye started pussing up. I'm on the second bottle prescribed Oct. 6...don't remember the first date, maybe August or September.

[Joan2517]

That is what I just did...worked like a charm! Thanks!

[molly muffin]

So it is coming down. I just want you to be aware of one thing, cortisol will drop on the same dose for 30 days normally. I see you increased 10mg after 2 weeks but I do not think you should increase until after the 30 day mark next time to see where she actually levels out at. That is my thought and just a note to be safe, as she hasn't actually leveled even on 20mg. Because it was still high, the increase probably was fine, but it is something you need to be aware of.
Here is the manufacturer print out, which has an easy to read flow chart on it:

http://www.dechra.us/Admin/Public/Download.aspx?file=Files%2FFiles%2FSupportMaterial Downloads%2Fus%2FUS-046-TEC.pdf

I also have a jpeg in my photo albumn on the forum here if you would like to see just the flow chart: http://www.k9cushings.com/forum/album.php?albumid=1057&pictureid=8043

My molly also takes amoldipine for her high blood pressure :)

[Joan2517]

Thank you for this information. So, I'm thinking that even if my vet wants to raise it again, that I should just let him know I would like to wait until she has been on 30mg for 30 days. He checked with an endocrinologist before raising it to this dosage, so he is concerned about how small she is. I think I might have made them nervous when I asked for the results of the test!

I should ask them what her blood pressure is when they do the test this weekend. Does the Vetoryl make their breath smell different?

I think since I cut down on her food, she feels better. Her tummy doesn't seem so big and I think she is more comfortable. She was a little more playful when I got home today. Is it normal for their bellies to feel hot?

I have a million questions!

[Joan2517]

How long has Molly been on Vetoryl?

[judymaggie]

Joan--just a quick question. Are you giving Lena the 30 mg all together or are you still dosing twice a day? If twice a day, it is recommended that the higher dose be given in the morning so that the ACTH tests will reflect the increase.

My Abbie also is on medication for high blood pressure (amlodipine and telmisartan). I am able to get the amlodipine free at a grocery store pharmacy so you might check on that where you are. Also, when my vet checks Abbie's blood pressure, I leave her at the vet for a while. A tech sits quietly with her and takes six different readings over an hour. The lowest and highest readings are thrown out and then the remaining readings are averaged.

Don't ever hesitate to ask for copies of everything! You are paying for their services and you are entitled to copies.

[Joan2517]

Hi Judy,

I will try the grocery store, thanks. I give her the 30mg all at once in the morning. It doesn't come in 20mg and a box of 10mg is $80, a box of 30mg is $85. The vet said he could special order 15mg, but I don't want to special order anything until we get the dose right.

I also don't like leaving her at the vet's office. I feel it is too stressful for her. In the past when I called to see how she was, I could hear her barking in the background, she doesn't like being in a cage. When she goes for the ACHT test, I sit in the waiting room with her for the 2 hours...she either sits in my lap or on the bench next to me and she naps while I read. I'm sure they think I'm a nutcase there, but I don't care. Right now I am. I'm on overdrive with all of this and whatever I can do to make her more comfortable, that's what I will do.

I feel so guilty that I waited this long, if I had only known that all of those little things that were bothering me meant something.

[labblab]

Hi again, Joan. I just want to assure you that you have plenty of company on the "guilt train." :o :o

In retrospect, I now believe my own Cushpup was suffering from observable symptoms for probably two years prior to diagnosis. But taken in isolation, none of them made any particular sense to me since I was totally unfamiliar with the disease. So I didn't even know to mention some of the subtle changes to my vet, and then after I did, it still took a trip to a specialist to confirm the diagnosis. Cushing's is such an insidious, tough disease to diagnose.

Anyway, moving on...! :)

Thanks so much for typing out all the test results. And yes, it now makes much more sense as to why Lena's dose has been increased, and it will be very interesting to see how this upcoming monitoring ACTH turns out. There is one thing, though, that I want to mention about Lena's diagnostic LDDS test.


First test 12/10/15:
Cortisol Serial 3 (DEX)
Cortisol Sample 1: 10.0
Cortisol Sample 2 Dex: 2.6
Cortisol Sample 3 Dex: 7.3
10mg started 12/11

Taken alone, this test result actually would be thought to be consistent with the pituitary form of Cushing's rather than the adrenal form. This is because Lena exhibited cortisol suppression at the four-hour mark, such that her Sample 2 result was less than 50% of her initial baseline reading. However, through the benefit of the imaging, we know that she does indeed have an adrenal tumor. Plus, another of our members just reminded us of a 2006 paper in which a leading Cushing's researcher noted that some dogs with adrenal tumors do indeed exhibit that suppression pattern. So, more than anything else, I am just offering this as additional information. I suppose it is remotely possible that Lena might have both a pituitary and adrenal tumor, but even if so, I don't believe that would alter her treatment regimen. So basically, I just wanted to make note of her interesting test result.

Bottom line, I'll definitely be watching for those new test results. And I am certainly wishing you two well!

Marianne

[Joan2517]

Thank you, Marianne...I like knowing what I'm looking at because I haven't got a clue what any of it means.

I too, noticed so many symptoms, but they were vague and just seemed to go with old age, or disappeared before they really registered. So it was almost like I was imagining them. But I have had a feeling for a while now, which is why I always had the vet check them out. I am relieved that I know, but also heartbroken that I know. I kind of feel like my vet should have put all this together, but maybe not.

[Joan2517]

Lena loves treats, but now I'm afraid to give her any. Any suggestions? She loves fruit: mango, apples, bananas strawberries, blueberries and lychee nuts. Are these okay to give her? What about yogurt? She loves that...

Before all these symptoms escalated in December, I had gotten them these treats that had apple, banana and one had carrots and she loved them. Now she won't eat them at all...she'll still eat ice cream, cookies, cake, and she still begs for people food and will kill for the cat food.

[Joan2517]

I'm feeling so sad today after reading about poor little Tammy last night. My heart aches for Brianna. I'm wondering if I am doing the right thing by keeping Lena on the Vetoryl. I'm getting her blood work done tomorrow.

She took a tumble down the basement stairs last night. I don't know if she slipped or forgot they were there. I feed our cat next to the stairs, so she might have backed up while scrounging for food. I know she didn't go down on purpose, she hasn't been able to do stairs for so long that I've forgotten the last time that she could. I heard the noise and thought one of the bigger dogs had chased the cat down and there she was at the bottom. She was standing, and shaking, but didn't seem hurt. I felt around to see if anything was broken and she kissed me and got down to look for more food. I can tell you that my adrenaline was pumping!

Then I read about Tammy and just cried and cried. Everything is happening so fast. A few months ago she was still my little precious and now sometimes she seems like a stranger to me. She doesn't want to sit with me anymore and when she looks at me, I feel like she is wondering why she feels so bad and I'm not making her feel better...and I don't know how to make her feel better. I'm putting my trust in my vet, but wonder....

I'm just depressed and putting my feelings out there. Now I have to leave her and go to work and act professional, when all I really want to do is stay home and take care of her.

[Renee]

Be kind to yourself. It's perfectly normal to have these doubts. It's a sad reality that there are a lot of losses around here, but there are so many positive stories too.

During the beginning of treatment, I asked myself all the time if my girl would ever be herself again. She had cushings for a few years before diagnosis and we have had some ups and downs since her diagnosis in Dec 2013. All that said, I firmly believe she would not be here, nor would she have any quality of life, if I had elected not to treat her.

Get through this tough part and once you have her cushings managed correctly, you'll find your new normal. She may not be exactly the dog she was before, but she will still be your girl and she will still have quality of life.

[Joan2517]

Thank you, Renee. Your kind words are making me cry, but more out of relief than sadness. Since her diagnosis, even though I knew something wasn't right for about a year, I have been kicking myself for not insisting on more tests, but for what I had no idea. I never heard of Cushing's until one of my vets said something about her potbelly back in May I think, but after blood work came back there was nothing showing that might be of concern. If only I had looked it up then, I would have known. She had so many of the symptoms that I never even thought to mention to my vet.

Of course, now every time I see one of the other dogs drinking too much I think CUSHING'S!!

Joan

[Renee]

Oh Joan, I over-analyze water consumption ALL THE TIME.

If my girl drinks too much, I worry her cortisol is spiking. If she doesn't drink enough, I worry she's dropping too low. If any of my other pugs drink too much, I immediately start wondering if they are developing cushings too, lol. This disease, it will mess with your head! Best way to fight the paranoia is to get yourself educated. Then you can talk yourself down when you get too worked up.

[Joan2517]

Hi Sharlene and Marianne,

I am noticing that you always say that in the ACHT test that it is checked 1 hour after the first one. My vet does it two hours after. Does this make any kind of difference? I'm just wondering....

Thanks,
Joan

[Harley PoMMom]

Do you know what stimulating agent was used for the ACTH test? The timing of the post number is dependent on the stimulating agent used. When Cortrosyn is used, one hour after it is injected the post blood draw has to be taken; when acthar gel is used that post blood draw is taken 2 hours after the injection. I would definitely ask the vet which stimulating agent they are using.

Hugs, Lori

[Joan2517]

Thanks, I am never able to talk myself down...that is why I love that I have found all of you...LOL!

[molly muffin]

um, gosh molly has been on trilostane for over a year now. She was a bugger to diagnose though as she tested negative on like 3 LDDS tests. However, 5% of dogs do, molly is just in that 5%. How do we know this, subsequent ACTH testing, showed high cortisol consistently, then she developed the other problems, and we still don't know which came first, the chicken or the egg, but she got high BP (welcome to amoldipine), protein loss in her urine (hello Benazepril), scaring of her eyes from retinal bleeds from the high BP (uh oh, shake hands with eye drops and ocu-glo) so, as you can see, diagnosis can be difficult with cushings, and results of high cortisol, no matter what the cause of the increase, can be daunting. But we carry on. My girl is happy, she has great days and some off days, she doesn't seem to care too much that she has problems seeing, it just is our life.

I'm sooooo glad she is okay after the stair tumble. Okay, first off, get gates for the stairs. Yes, we had to do that with my molly too, she can't see and took a tumble once too, end of that for the little miss independent. So, now I have gates to all the stairs down and she doesn't bother to try to go up stairs any longer, since she's learned that her hand servants will pick her up and carry her. All she has to do is make a noise so we come see what she wants and she puts a paw on the step and waits, because she is after all the diva of the house.

I'll post a picture to show you the window seat creation. http://www.k9cushings.com/forum/album.php?albumid=518&pictureid=7186

[Joan2517]

There is a gate, but when we are home we keep it open for our cat, who won't come any further than 4 feet from the stairs. He's afraid of our two rescues who would leave him alone if he would just stop running away from them! With the gate open he can still feel like he's a part of the family and can get down quickly and hide if they chase him. Our older dog who died in 2011 loved him and he loved her, so it confuses him that these two rush at him. Lena used to taunt him when she was the queen bee and even though he is huge, he used to run away. Now that she is so different, they tolerate each other and sometimes share the space by the stairs. We will figure out something high enough to keep Lena from taking another header, and low enough that he can hop over it without getting hurt. His hips dislocate sometimes when he runs or jumps.

Tomorrow Lena will have her blood work done and I will sit with her for the two hours and we will see what it shows. I don't want to raise the Vetoryl any higher.

Has Molly changed the way she interacts with you? Lena used to be a part of me, attached to me all the time. Now she will only sit with me for a few minutes and then wants to get down. She used to stand up on my legs and ask to be picked up...I wish I remembered the last time she did that. I miss everything about the way it used to be. I miss hearing her nails on the floor, now she mostly slides; I miss hearing the way she used to eat her food in the bowl, now I make it special because she stopped eating the kibble by itself; I miss how she used to cuddle up next to me in bed, now she sleeps on the other side of the bed...I just miss so many things...

[molly muffin]

Molly was never a cuddle muffin. She has always preferred to do things her way and interact with us on her terms. Mind you I've had her since she was 11 months old and that is just her personality.
She hasn't actually changed much from that, other than maybe a bit more needy actually than she use to be, but that is mainly due to her sight issues I think. She doesn't play like she use to but still will have the odd day when she'll drag a toy out. She isn't going to play with her ball much though, since she can't actually see it.
So, yes there have been some changes, and I miss playful silly molly, of course I do, but she is 13 now, cute as a button and I just tell myself, that well, my grandmother didn't really want to get on the floor and scamper with the kids when she got older either. :)
As Renee said, you will find your new normal.

[Joan2517]

I am so nervous about her ACHT test today...dreading what the results will show. I am consumed by all of this! It's hard to concentrate on anything else. I'm a fixer, a problem solver, the one everyone goes to! And I can't fix this for the dog who has been my heart for almost 15 years.

The others keep trying to distract me and I feel bad that they are worried. My big boy Gable, a rescue from a Georgia shelter, is my number 2 love and he follows me around and sits close by my side and watches. He is my guardian...I know they are all safe while I am at work and he loves Lena.

[Squirt's Mom]

Hi Joan,

I have taken the liberty of moving your post about Lena's ACTH today to her thread from where it was posted on Abby's thread. This way, members can respond to you about Lena here, and about Abby on her thread. ;) Thanks!

Let us know how it goes today and don't worry! Easy to say from where I sit, huh? :D But the ACTH is not that hard on most babies. Some will show some signs of elevated cortisol again after the test but this is not unusual so if you see that, don't panic.

Hugs,
Leslie and the gang

[molly muffin]

Deep breaths. Whatever the results are, once you have them, then you can make decisions. It is all about knowledge when it comes to Cushing's. I don't know how anyone gets through it without learning a ton of stuff.
You will be fine. :)

[Joan2517]

Thank you, Sharlene and Leslie...she just took a long, and I mean long, walk around the backyard, navigating the snow like a real pro! And thinking clearly about where to step and working her way back. A few weeks ago, she would've been lost and I would have had to slide out there to get her! Some days are so good <3

[apollo6]

Dear Joan
This is where you will get support, guidance and love. There will be good days,bad days, and so so days. I would do the same with my Apollo when he would get the Ach tests. I would sit with him, go for a walk, hold him while waiting for the test results. I fought to keep the dosage on trilostane low because he would not do good on higher dosages. I also realized every moment I still had with him was a blessing. Enjoy the moments,they are gifts.
Apollo and I adapted made adjustments as the disease progressed. But I treasured every moment I had with my baby boy.
Think,learn, pause,question before you make any decisions. Cushing so is a very complex disease.
Love Sonja, Angel Apollo

[Joan2517]

Thank you, Sonja...yesterday was a good day. She was quite calm at the vet's. We went out for a couple of pee pee walks and she sat in the window looking out over the parking lot and didn't even get agitated when other dogs came in. Her blood pressure is down to 120 (yay) so at least that is better. Met a lot of nice people while we waited. One man who dog sits and also takes in rescues and tries to find them homes. He also pays their vet bills, God love him! Another person in the waiting room gave me his contact information and told me the story.

My two grandsons spent the afternoon with us and she managed to take a nice nap. They can be exhausting, even though she can't hear anymore.

She was in such a deep sleep before bed last night that I hated to wake her up to go up to the bedroom, but I hate to change our routine...she is very regimented!

Love,
Joan

[Joan2517]

Good morning all!

Does anyone know if any of the following herbs would not be okay for Lena?

I have been putting a teaspoonful of this tea in her breakfast and dinner since December. It's supposed to be good for everything and my husband uses it religiously. It is also supposed to work for animals.

It's called Essiac Tea Formula, ingredients are: Blessed Thistle, Burdock Root, Kelp, Red Clover, Sheep Sorrel, Slippery Elm Bark, Turkish Rhubarb Root and Watercress.

Tastes like dirt, but is supposed to lower blood pressure, lower cholesterol, shrink tumors, cure cancer, etc.

My husband hasn't had any health issues since he's been on it, so he thinks it should help.

[labblab]

I have no knowledge re: the other ingredients, but I do have this caution to note about slippery elm. It has been used by several members here with success for its GI-soothing properties. However, we have read warnings that it should not be consumed within two hours before or after Rx medications due to the possibility that it will affect the absorption/effectiveness of the drugs. I believe this is true for humans as well as dogs. There may not be enough SEB in this tea to really have a major effect. But since you have been needing to increase Lena's trilostane dose due to an apparent lack of control, if it were me, I would not be giving her anything near the time of her medication dosing that might interfere with its effectiveness.

Marianne

[Joan2517]

Oh that's good to know, Marianne...from now on I will just give it to her before she goes to bed, maybe with some yogurt.

Thanks,
Joan

[apollo6]

Dear Joan, I Can see how loving and caring you are to Lena. My self a senior, my nieces wear me out just skping.
I would give Apollo slippery elm for his stomach issues. You should always let the vet know what you are giving Lena, because as was said earlier you never know how they may interact with each other. The medications for cushing disease are very potent and caution must be taken with them. Apollo was only 10 lbs and could only handle 10 mlg of Trilostane. Stop being so hard on yourself. The signs of cushing showed up in Apollo 1-2 years before we did treatment, and even the blood tests didn't show it. When the time was right you knew.
Love Sonja and Angel Apollo

[Joan2517]

You're so sweet, Sonja...I'm not sure my vet believes in herbs. One of them does, but we haven't seen him since the ultrasound day (and he is so cute!)...that's how I always refer to him as "the cute one".

Looking back, Lena's started showing up about the same time frame and we also did blood work that came back fine. In fact, she had blood work done before she had dental work, which was fine, less than 2 weeks before the blood work that came back so bad. The cute one was looking for diabetes because of the drinking, and was shocked when he called me the next day. Even he couldn't believe how bad it was. He recommended an ultrasound the next day...and that is when this journey began for us.

Thank you for taking the time to "talk" me through this...it must be hard for you....I cry every time I read someone else's sad story...I feel so bad for all of us who love our babies and have to deal with this.

My grandson, Josh, who is 7 1/2 has a genetic disease called CGD or Chronic Granulomatous Disease. We found out when he was just a few weeks old. That was the beginning of my journey into googling and web surfing, so I've become quite good at it.

He is part of a study at the National Institutes of Health in Bethesda, MD. They live here in Glen Cove right down the block from me and take 3 - 4 trips down there for colonoscopies and endoscopies each year. He has been on different medications to control his CGD related Colitis. The one he's on now seems to be helping (there are only 3 kids in this study). We won't know until they get in and look at his colon.

The only cure right now is a bone marrow transplant, and of course that is not foolproof, and we don't want to put him through it.

I don't know why I mentioned this...maybe because I'm overwhelmed and everything is hitting me.

Love,
Joan

[Joan2517]

My husband said our vet left a message at the house and Lena's blood work looks good and said to leave her on the 30mg for now. I asked them to fax me the results. I will post them after I receive them.

RELIEVED!! She has had a good weekend. Still drinking and peeing, but I can deal with that. She seems more comfortable and is thinking clearer...she even wanted to sit with me while I watched TV last night. I practically threw my computer to my husband to make room on my lap!

[Joan2517]

Here are the test results from Saturday:

Cortisol Sample 1: 8.5 (HIGH) Ref range: 1.0 - 5.0
Cortisol Sample 2: 9.3 Ref range: 8 - 17

What do you think? Does it matter that the first sample is high?

[Renee]

Those results are not quite low enough, especially if you are still seeing symptoms.

Remind me again - what is her dose? Are you dosing once or twice per day?

As for the baseline being so high, that is usually not a concern, as any kind of stress may elevate that number.

[Joan2517]

She is on 30mg once in the morning and has been since Jan. 21.

[Harley PoMMom]

S eye drops Neomycin and Polymyxin B Sulfates Dexamethasone Ophthalmic Suspension USP (I only just started this again the other day) they were because her left eye started pussing up. I'm on the second bottle prescribed Oct. 6...don't remember the first date, maybe August or September.

Can you do me a favor and double check her eye drops and make sure that it is dexamethasone that is listed as an ingredient? I see from googling that there is another type of eye medication that has neomycin and polymyxin b sulfates and hydrocortisone. ....thanks!

Hugs, Lori

[Joan2517]

It has the neomycin and polymyxin b sulfates listed but I don't see anything about Hydrocortisone. Dexamethasone is listed as 1 mg...I'm not giving it to her anymore anyway. I am just washing her eyes. They haven't really pussed up since we started the Vetroyl. I only used it that couple of times when her eyes were running.

[Renee]

Using artificial tears, like genteal, can make a world of difference, especially if she has dry eye.

[Joan2517]

She doesn't have dry eye. Her eyes get all that gooky, stainy look.

[Renee]

Actually, dry eye can cause more of the mucous to build up because it's not being flushed away. My pug Ichiro has dry eye. The eye itself never looks dry, it just builds up mucous or gunk in the eye and it may look red sometimes. This is caused by the underproduction of tears. It's odd because you expect a dry eye to look dry, but it doesn't.

Anyway, she may not have dry eye at all, I just wanted you to know that you can't rule it out simply because the eye itself doesn't look dry.

As for her stim results - I would not increase yet. If she's only been on 30mg since 1/21, it's too soon to increase. You'll want to test again in a few weeks and then reasses the dosage. She is right above the acceptable upper limit for vetoryl treatment, so I do believe she's getting close!

[molly muffin]

I wouldn't do anything right now either. I expect that number to come down some with your next test . Glad she is doing good and maybe the peeing will decrease with more time and the number coming down.

[Joan2517]

Thanks, Renee...how can you tell the difference?

[Joan2517]

Thanks, Sharlene....I had every intention of waiting until we reached 30 days, so I'm glad that's what our vet has suggested. We've had a couple of really good days and she seems to be engaging with me again, almost like she knows how hard I am trying to make her feel better...I know that's not it, but I can dream, can't I? :)

[molly muffin]

LOL My husband talks to molly when he comes home from work, explains he is going upstairs to change clothes and will come back down to have treat time with her, and she is to wait for him at the foot of the stairs. She does. He says it gives him the illusion that she listens to him. :) :) I'm sure molly does know that whatever he is saying, that if she waits for him (and she does know the word wait) that she'll share treat time with him. I'm sure that Lena knows that you are taking care of her and trying real hard to do what you can to make her better.
When anything is wrong with molly, I mean seriously wrong, she comes to me, because she knows, I'll try to make it better. They know. :)

[Joan2517]

Always go to mommy :)

[marinaliz]

Hello Joan! I'm very glad that your Lena feels better! I believe that even better days are surely coming and of course you can dream since you are too close to the suitable dosage for her!

[Joan2517]

Thanks! She is back to following me around and watching everything I do...didn't realize how much I missed that. Her tummy still does a lot of rumbling and I can hear how gassy she is, but she was like this before the Vetoryl, so I don't think it is that. Does anyone else have this issue? Is there anything that I can give her to help with the gas? My vet gave me Gasex, but that was before the Cushing's diagnosis.

Appreciate all of you!
Joan

[Harley PoMMom]

When a dog eats something that doesn't quite agree with their tummy they sure can leave some smelly farts!! I don't know of any interactions with Gas-X and Vetoryl being used together, I do recall members using Gas-X while their dog is on Vetoryl.

I found this list of Over-The-Counter Medications (OTC) with dosages and that are supposed to be safe for dogs, although I would still talk to the vet before giving any OTC drugs: http://thedanedame.com/wp-content/uploads/2014/01/Over-the-Counter-Medications-That-Are-Safe-for-Dogs-.pdf

Hugs, Lori

[Joan2517]

Thanks, Lori!

The truth is, after being so afraid that she's going to die from this, I don't mind her farts at all! LOL!

Love,
Joan

[molly muffin]

For molly it is liver treats. Holy cow that dog can clear a room when she's had liver treats. At one point I'm not sure her vet believed me, and she was sitting on the floor with molly and had given her some liver treats, which I told her, be ware, do so at your own risk and not long afterwards, she was like Molly!!!! LOL I said, you where warned. LOL It didn't stop her from playing with her though. I like that my vets will get on the floor with her and play and hug on her and love her as they are also carefully feeling her tummy and checking her out.

[Joan2517]

I'm not sure what does it to Lee, but boy, oh boy, it's amazing what can come out of that little tush!

[Joan2517]

Hi All,

Lena was doing so well since Saturday, but when I got home from work last night she seemed confused (she went the wrong way when I was letting them out). She did eat her dinner and got her blood pressure medication; slept well; and got up at usual time. She is a little wobbly today, but ate her breakfast and took her Vetoryl and seems more with it.

Last night she sat on my lap for a nice long time, but then got too hot and wanted to get down. Is this how it will go? Good days, bad days....I just want to make sure, so I don't panic when she gets like she was last night. I hate to see her so confused. My once confident baby who ruled the household (over an 85lb boy, mind you), now seems so lost. She seems better when I am home and has begun to follow my lead like she used to, but I have to work.

I am so afraid all the time now.....

[Harley PoMMom]

It is completely natural to be worried about your dear Lena. Our motto here is if doubt don't give the Vetoryl.

If she is eating well, drinking/urinating normally, and has no diarrhea than I think she is fine, however, only you know your sweet girl best and if you believe something is off than it wouldn't harm her to with hold the Vetoryl and see if she perks up.

We completely understand your fearfulness and we are here for you, just come here and talk to us, ok ;)

[Joan2517]

I'm pretty sure she was like this a couple of times before the Vetoryl, so I don't think it's that. That was one of those weird things that happened and then was gone. I guess it's just the Cushing's... :(

She still drinks and pees a lot, that hasn't changed. There might be one or two days a week where I come home to dry wee wee pads.

I am so afraid that she is going to die while I am at work one day. I have never let any of my babies die by themselves. I was always with them...and she is the dog of my heart. I don't think I would ever be able to get over that.

[judymaggie]

Hi, Joan! Your description of Lena going the wrong way when you let her out rang a bell with me. My Abbie, who is going to be 13, has had episodes of being distracted and/or disoriented. I considered trying Novofit which others have used for canine dementia but Abbie's episodes don't last long and are infrequent. Rather than being related to Cushing's, I think Abbie's are more related to getting older. I have learned that not everything that goes on with her is a result of having Cushing's.

[Joan2517]

Thank you, Judy...I guess that is true. Everyone keeps reminding me that she is almost 15. And I have certainly gone the wrong way lots of times!

I'm probably being hyper vigilant right now because I feel I should have noticed all of these changes earlier. I don't know if it would have changed the outcome or not...we are both seniors now.

[molly muffin]

Novofit has been used by some with success, others not as much to help with doggie dementia. So, if this continues, it is something to think about.

We all know about the constant worry and sympathize.

[Joan2517]

Thanks, that'something to think about...she seems better tonight, so maybe the other dogs startled her yesterday and she woke up too fast. She's pretty deaf and when they start barking and bump into her when she's asleep, it frightens her.

I really appreciate all the advice, suggestions and hand-holding that you are all giving me, and to everyone else. I felt so alone before I found you...even my kids, who are both animal lovers, don't seem to understand how hurt and afraid I am.

I've lost dogs and cats before. I don't think I have ever been without animals in my almost 60 years, but Lena is my baby, she is my heart. We have been so close since the first night she got here. She cried and wouldn't go to sleep in her carrier that she had arrived in from Montana. I took her out (all 1.5 lbs of her) and put her on my stomach and she went to sleep. I didn't move all night. She has slept with me every night since then except for the few times I have had to be away from her. She even came with us to Colonial Williamsburg shortly after we got her. They got her a babysitter and everything. She had her own badge and was allowed in the buildings, except for the restaurants...they called her Princess Lena. I'll have to post some pictures.

Anyway, I hope I can help others the way you are all helping me.

Love,
Joan

[molly muffin]

The deafness could be a part of it of course. Can't discount that at all.

I guess the only way you'd know is to watch her and see how she reacts at some situations and whether it is a sound/nonsound reaction or true confusion.

We all started just where you are today Joan, alone (or so we though) and scared. From there we progressed to where ever it is that we are at today in our learning/journey. :) Interaction on the threads is key, as you look up information to answer questions, say hello to new members and just want to find something out even for yourself, you learn. Learning is the entire key to cushings. I truly believe that.

[Joan2517]

I try to read them all, Sharlene...sometimes they are so sad that I just cry. I feel so bad for everyone who has lost their darlings. I feel the pain, the fear, the guilt...but, I am also learning a lot!

I'm reading, researching, checking out all the threads, the links. I've learned more from all of you than from my own vet.

Lena is beginning to follow me around again and wants me to pick her up. She doesn't stay in my arms long, I think with her big tummy that she isn't comfortable. I hope that it will get smaller in time. I've missed our closeness, but I assumed it was because I was at work all day and she just started following the rest of the pack.

Tomorrow I am bringing her to my sister's for my mom's 83rd birthday party. She'll really enjoy that, so will my mom who has Alzheimer's and doesn't really remember how many times she's seen Lena, so it's like she is meeting her again for the first time. And I don't want Lena to think that every time she gets in the car, we are going to the vet. She loves family get togethers!

You don't think it will stress her out, do you?

[Joan2517]

This is what I feed her. they have all been on this dry food for about 5 years. I have gotten her the small dog breed bag instead of big kibble now and mix it with some warm water and the tea I mentioned in an earlier post. Then I put a spoonful of the wet pate or casserole in for some extra flavor...breakfast and dinner.

Wellness Original Formula dry food
Wellness Petite Entrees for smaller dogs

I tried the Wellness Trufood: chicken, chicken liver and flaxseed recipe and at first she liked it just plain, but then turned her nose up at it. And now, of course, the rest of them like it especially our teacup chihuahua, so I'm buying that for them. I've got 3 different bags of dryfood going!

I want to make sure I'm feeding her what she needs...and as I've mentioned before, she loves fruit...she's not crazy about raw veggies. I've tried carrots, green beans...she loves avocado, but I read somewhere that it is on the top 10 "no, no" list so I stopped giving her any.

Of course, she will eat any table food!

[molly muffin]

Most dogs would eat any table food. LOL Molly goes nuts if she even smells chicken or beef cooking in the kitchen.

I have like 4 bags of food due to molly being so darned picky about what she wants. She's never been a very good eater, more of a grazer throughout the day and eating nonstop anything was never one of her cushing symptoms.

Treats she is also usually good with but has gotten a bit picky with those too. ugh!

[Renee]

I've fed my three pugs The Honest Kitchen for years and years. For some reason, just last year, Tobey started rejecting it for no reason. She just will not touch the stuff anymore, although my two boys act like it's the last supper. I ended up switching her to Wellness canned stews. It's not my number one choice (I would love her to get back on THK), but she likes it and eats it without a fuss.

I wouldn't worry too much about food. As long as she's on a high quality food (kibble, canned, etc), she should be getting what she needs. Too many people get wrapped up in thinking food is the answer to everything. yes, it is vitally important, but there is no science to support that it causes cushings or plays any part in reducing direct symptoms.

[Joan2517]

Thanks, I just don't want to feed her too much and I want to make sure what she's eating is good for her. Does anyone give their dogs fruit for snacks? Lee loves fruit.

[Renee]

Fruit is good and healthy, but high in sugar, so watch the calorie intake overall. Berries and bananas are favorites at our house.

The best way to figure if you are feeding enough is to calculate the calorie needs for Lena and then see if you are meeting or exceeding them. Tobey only needs approx. 315-345 calories per day, so I make sure her canned food is in that range and monitor the number of treats she gets.

Have you tried other veggies, like cucumbers or zucchini? My pugs will eat those right up. :)

[Joan2517]

Hi All,

I'm not sure if I am imagining this or not, but Lena's left eye looks bigger than the other one. I can't tell if it's just the way her hair is falling over the other one or not. The left eye is the one that is usually runny and sometimes the runny stuff hardens and it looks like she's got eyeliner, which might make it look bigger, but it hasn't been runny in the last couple of days. Then this morning my husband said the same thing. Maybe its always been bigger and we just never noticed before??

I'm trying not to freak out....could this be a symptom of anything??

[molly muffin]

If you think her eye is bigger then you need to take her into the vet to have it checked out.
Our ER hospital has an ophamologist for dogs, perhaps your vet would know of someone like that they could refer you to if they think there is a problem.

[Joan2517]

I'll take her before I go to work tomorrow...what do you think it is?

[molly muffin]

Does it still look big? yes take her in the morning if you think it is bigger or if it looks off. Has she been checked for things like glaucoma?

[Joan2517]

I can't be sure. Everything doesn't seem right anymore...I know I had them look at her eyes over the summer and they didn't say anything was wrong....and they have had her in there at least 5 times since Dec. 9. She was just there Jan. 30.

[judymaggie]

Hi--please remember that vets (just like any human medical professional) can not possibly know everything or even think of everything to check. A couple of years ago my Abbie was having her glands expressed. I was standing right in front of her and noticed a dark spot near the cornea in one eye. I asked the vet to check it and the next day we were at the veterinary opthamologist. Thankfully, the large cysts she now has in both eyes are not attached to the retinas but she does have to be periodically checked for glaucoma. My vet has shown Abbie's eyes to several techs and new vets as her condition is not seen very often. Bottom line: trust your instincts as you are Lena's best advocate!

[Joan2517]

We went this morning and she was checked and no glaucoma...thank God! She checked both eyes and didn't see anything wrong, but did agree that the left one was a little bulging.

She checked around and nothing seemed to hurt Lee; checked her teeth as much as she could see. So she said that maybe she is developing an abscess in the back of her mouth or one of the spots where she had a tooth pulled might be getting infected and is putting pressure on the eye. She gave me an antibiotic called ClindaDrops, clindamycin hydrochloride liquid, to be given twice daily (it's the same one she was taking after her dental work where her some of her teeth were pulled). She also said that she had to tell me that it could be a tumor behind the eye. So, I have to watch to see if it gets any bigger.

Good news is that she thinks she looks great. Heart sounds fine, lungs sound good although she hears a little bit of congestion, but Lee has always had that, she has had the collapsed trachea thing since she was a baby, never really bad though. So I am glad I brought her in and feel more comfortable leaving her to go to work.

She has been wanting to sit with me more and more the last few days, just like before...so for now, I am relieved.

But so sad over the passing of all the sweet dogs the last couple of days...my heart aches for their families...

[molly muffin]

okay did she mention an ophamologist if you need one? If there is any near by I mean.
Hopefully a bit of a tooth infection is all it is and the antibiotics will clear it up. Cross fingers.
Nice she is being a snuggle bunny again.

[Joan2517]

No, Sharlene, she didn't...you don't think it's a tumor, do you? She had one dose of the antibiotic while we were there and I still have to give her another tonight.

[molly muffin]

I have no idea what it is. An ophamologist is an eye specialist just like for humans. So it is there specialty. My Molly sees one because her eyesight started decreasing very quickly and we had to find out why.
I don't know what would cause the eye to seem bigger. Which is why I was thinking of a specialist in case it is something with the eye itself.
I just don't know but I am hoping some of the others might have an idea.

[Joan2517]

I'll google and see if there is one around here. Maybe I'll ask them tomorrow for the name of one just in case. I hope they take post dated checks.....

[molly muffin]

Has she been rubbing the eye. Like against the floor or with her paw? This can cause irritation which can cause the eye to look bigger. If so then try to prevent her from bothering it and the antibiotics might help if there is any kind of infection or inflammation even.

[judymaggie]

My first thought went to Grave's disease (hypothyroidism). It is rare in dogs but can occur--one of the symptoms can be protruding eyes. I could be entirely off-base and probably am! I don't recall if Lena has had any thyroid tests.

[molly muffin]

You can see if she responds first to the medication. But it wouldn't hurt to have a name or even a consult written out (however your vet does it) in case you need it later. I would probably try meds first if it where me. If it starts to look worse though what did your vet say to do? Also care credit is a good resource for the next unexpected emergency.

[molly muffin]

That is a good thought too Judy. Is there a t4 test in any of lenas labs for instance?

[Joan2517]

You can see if she responds first to the medication. But it wouldn't hurt to have a name or even a consult written out (however your vet does it) in case you need it later. I would probably try meds first if it where me. If it starts to look worse though what did your vet say to do? Also care credit is a good resource for the next unexpected emergency.
She said if it should look like it's getting bigger to bring her back in.

[Joan2517]

That is a good thought too Judy. Is there a t4 test in any of lenas labs for instance?
Would they have done that in the blood work that began all of this? The one that was so bad? I'll have to ask them to fax me that one tomorrow.

Jeez, I was feeling better, but now I'm starting to worry again.

[molly muffin]

Thyroid is treatable. Not every test will include thyroid but some do. these are Just ideas that we are talking about. The meds are probably going to work though. Gads I had to put Molly on antibiotics, stop the trilostane add in pumpkin when she got a gastro upset that was awful and lasted weeks. She lost weight and I thought I'd lose my mind from worrying. I was never alone though. I had our k9cushingd family. She did get better. She is a diva and a brat and a love muffin all at the same time and here we are still carrying on.
Lena will be alright too. Just a bump on the road this eye thing.

[Joan2517]

Okay, thanks Sharlene...it seems that ever time I start to relax, another thing happens. It's hard to believe that a few months ago, she was a happy little ruler! Now even the cat isn't afraid of her.

I'll get the blood work today. I'm also going to ask for the blood work they did the morning of the dental work...I think that the dental work was the catalyst. Within two weeks, everything got bad. She also had blood done sometime over the summer or in the spring, I'll get that too.

Thyroid....My husband and I both had Thyroid cancer, and we had a Saluki who died of canine lymphoma.....

[labblab]

Good morning, Joan! Two thoughts to throw out to you. First, if hypothyroidism is causing the issue, I would think both eyes would be bulging and not just one. It seems to me that your vet's explanation (infection) is more plausible since only one eye is involved.

Secondly, don't panic if you discover that Lena did exhibit low or low-normal T4 levels on past tests. It is not at all uncommon for that to be the case with Cushpups. Cushing's itself can induce abnormal thyroid readings, and once cortisol levels are stabilized, the thyroid readings often do, too. For this reason, many vets do not immediately treat low thyroid in dogs when they are first diagnosed with Cushing's; they wait a bit to see whether the thyroid remains a problem. Some dogs do suffer from genuine hypothyroidism in addition to Cushing's, but if that is the case, the problem can be easily remedied with oral supplementation. So try not to stress too much over the thyroid results.

Turning back to Lena's eye, does it bulge so much that the eyelid is not able to close properly? If so, then I would think that would be cause for immediate consultation with a specialist. If the lid is OK, then trying the antibiotic for a week makes sense. But if the eye remains enlarged and even if it hasn't gotten worse, I agree with Sharlene and I'd want to head directly to a specialist at that point so as to get an expert opinion as to what is going on. For instance, from the little bit I just now read, if the eyeball has actually gotten pushed out of the eye socket somehow, you want to get it repositioned sooner rather than later.

Marianne

[Joan2517]

Thanks, Marianne...no, her eyelid closes fine...I'll give the antibiotics a couple of days and see what happens.

[Joan2517]

I received the blood work from one in May of 2015 and the one from 12/5 which started the search for Cushing's, but there is so much on them. On the one from the 5th, there are so many HIGH's. I tried scanning and loading into the album but that won't work.

What are the most important parts that you need, from the bad one and the one in May) because it is going to take me a while to type them in.

There is also an in-house blood workup for her dental work day
(11/16) , and a urine analysis from the day of her ultrasound
(12/7).

[molly muffin]

High and lows that are outside the normal range.
So, for example:

05/2015
ALKP 450 ug (range 50 - 150)
ALT 120 ug (range 25 - 75)
and so on.

05/2015
Urinalysis - specific gravity 1.020
protein +2

Does that makes sense?

What you are doing, is creating in One place, a list of the things on tests that where not within range, to which you add for each test and then can go back and look and compare them at any given time and those who see tests all the time, might spot something to mention to you.

[Joan2517]

Okay, but I probably won't get to it until tonight when I'm home...the boss keeps coming in and interrupting me~

Also, got the name of their ophthalmologist, who just happens to be one of the ones I found online last night, who hopefully, I won't ever have to see!

[Joan2517]

Okay, here are Lena's blood work with the 12/5/15 beginning of Cushing's concerns and a blood work from May 015 where we were there for bloating and gas. The vet first mentioned Cushing's then, but when the blood work came back he wasn't concerned...and I never looked it up or I would've recognized all the progressing symptoms.

I hope this copied and pasted right:

Blood work: 12/5/15
Superchem
Tests Results Ref Range
ALT (SGPT) 147 (HIGH) 12 – 118
Alk Phosphatase 163 (HIGH) 5 – 131
GGTP 28 (HIGH) 1 – 12
Urea Nitrogen 94 (HIGH) 6 – 31
BUN/Creatinine Ratio 63 (HIGH) 4 – 27
Phosphorus 6.6 (HIGH) 2.5 – 6.0
Calcium 11.7 (HIGH) 8.9 – 11.4
Magnesium 3.3 (HIGH) 1.5 – 2.5
Potassium 6.2 (HIGH) 3.6 – 5.5
Chloride 99 (LOW) 102 – 120
Cholesterol 423 (HIGH) 92 – 324
Triglycerides 543 (HIGH) 29 – 291
PrecisionPSL 488 (HIGH) 24 – 140

Test Requested Results Ref Range
Fructosamine 516 (HIGH) 142 – 450

Complete blood count
Tests Results Ref Range
Platelet Count 716 (HIGH) 170 – 400

Test Requested Results Ref Range
Urinalysis
Appearance cloudy *clear
Protein 3+ Neg
RBC 4 – 10 (HIGH) 0 - 3

Blood work: 5/11/15
Superchem
Tests Results Ref Range
Urea 46 (HIGH) 6 – 31
BUN/Creatinine Ratio 42 (HIGH) 4 – 27
Cholesterol 339 (HIGH) 92 – 324
Triglycerides 511 (HIGH) 29 – 291

Test Requested Results Ref Range
Total T4
T4 0.8 0.8 – 3.5
Free T4 (Equilibrium Dialysis
Free T4 (dialysis) 17 8 – 40

Complete blood count
Tests Results Ref Range
Platelet count 645 (HIGH) 170 - 400

[Joan2517]

I'm looking at the in-house blood work the morning of her dental work and the only things I see that look out of whack are:

BUN 80, where the ref range is 7 - 25
GLU 125, where the ref range is 80 - 110

[Roxie]

I'm looking at the in-house blood work the morning of her dental work and the only things I see that look out of whack are:

BUN 80, where the ref range is 7 - 25
GLU 125, where the ref range is 80 - 110

BUN is blood urea nitrogen I believe and the glucose is a little high. I am no expert but I hope you guys get things straightened out so your pup can live out the rest of it's days and have a lot of time left with you!

Good luck Joan!

[Harley PoMMom]

BUN is high but that could be from dehydration, and it does look like the glucose is a bit high too but that may just be a one time thing, you might want to check the glucose in a couple weeks.

[Joan2517]

That in house blood work was done right before she had her dental work on November 16. I just wanted to put it up in case there was something showing that should have been addressed and maybe she shouldn't have had the dental done at that time.

[Joan2517]

I took Lena in for a quick check on her eye yesterday because I thought it looked better, which it is.

So I had the vet, who happened to be the one who suspected Cushing's from the beginning, check her out. He heard crackling in her right lung...I was just there on Thursday and the vet she saw then, didn't hear it. Now she has to have another ultrasound done. I was going to do it on Thursday and have her ACTH done at the same time, but I think I will see if it can be done tomorrow. Her breathing has seemed a little labored in the past few days, but I thought it might be from the antibiotics for her eye. She is also giving this big sigh a lot on breathing in. She does this when she is content, but now it is too much. She did it while we were with the vet at least twice, and I know she was not content!

I just hope she didn't do any damage when she fell down the stairs...she got up and went back to eating like nothing was wrong. The vet suspects fluid in the lungs. I am back to being a nervous wreck. He gave her shot of Lasix to see if it makes her more energetic today. So far, I don't see any change, except that she ate a little bit better this morning...

My poor little girl has spent more time at the vet this past couple of months than in 14 years. I had so many things I wanted to get done yesterday, but just spent it crying and watching her every move.

Has anyone had a chance to look at all the test results I put up the other day?

[lulusmom]

Hi Joan. I've looked at Lena's bloodwork a few times and my layperson's best guess would be that congestive heart failure, kidney failure or both are likely suspects. Can you check the blood chemistry and let us know if creatinine is normal. Can you also check the urinalysis and let us know if it included the urine specific gravity (USG). If so, can you please post the results? Blood glucose is mildly elevated but fructosomine is more than mildly elevate which is usually a concern with diabetes but I think the long term stress of Lena's illness(es) could be the cause for that increase. Your vet should have sat you down and provided you with his/her take on the test results. What did your vet think was causing all of these abnormalities? I apologize if you already shared that information but I only have a few minute and don't have the time to re-review your thread.

Glynda

[Joan2517]

From the blood work on December 5, they diagnosed Cushing's...no one said anything about congestive heart failure or kidney disease. I certainly wouldn't have put her through the Vetoryl and all these tests if they had said that to me, and I am going to be really, really pissed if this is the case. Will an ultrasound show congestive heart failure?

[Joan2517]

Hi Joan. I've looked at Lena's bloodwork a few times and my layperson's best guess would be that congestive heart failure, kidney failure or both are likely suspects. Can you check the blood chemistry and let us know if creatinine is normal. Can you also check the urinalysis and let us know if it included the urine specific gravity (USG). If so, can you please post the results? Blood glucose is mildly elevated but fructosomine is more than mildly elevate which is usually a concern with diabetes but I think the long term stress of Lena's illness(es) could be the cause for that increase. Your vet should have sat you down and provided you with his/her take on the test results. What did your vet think was causing all of these abnormalities? I apologize if you already shared that information but I only have a few minute and don't have the time to re-review your thread.

Glynda
The creatinine on 12/5 shows 1.5 with a ref range of 0.5 - 1.6. The urinalysis on 12/7 has a Specific Gravity with results showing 1.018 with a ref range of 1.015 - 1.050.

[Sophiesmom]

I'm sorry your pooch is not feeling well. An echocardiogram (ultradound) will show if there is flid around the heart which is CHF.
I hope this is not the case. Having a sick dog is heartbreaking. We are going through issues with our beagle as well and have not been told everything by our vet.
Keep us updated as to your girl's health. They stopped Vetoryl on our dog as well.

[Joan2517]

Sharlene, could you weigh in here? I am supposed to take her for an ultrasound tomorrow and I don't want to have them perform another test if it is not one that is needed or will tell me what is wrong....I think I may not give her the Vetoryl tomorrow.

If the blood work from 12/5 showed that she might have been in congestive heart failure or kidney failure, then shouldn't that have been addressed before the Vetoryl???

Or is what might be going on now, Congestive Heart Failure of Kidney Failure.

I am very confused and upset right now. I have my grandsons here and I am ready to lose it!

[lulusmom]

The creatinine on 12/5 shows 1.5 with a ref range of 0.5 - 1.6. The urinalysis on 12/7 has a Specific Gravity with results showing 1.018 with a ref range of 1.015 - 1.050.

These are both better than I thought they would be so that's good news. My layperson's opinion of what the lab abnormalities look like are just that, a layperson's opinion based on my own experience with both kidney disease and congestive heart failure. As I mentioned, your vet would be the appropriate person to discuss these abnormalities with you. I will say this, however, if this blood chemistry is what your vet used to pursue a cushing's diagnosis, I personally would be concerned because this is not what we are accustomed to seeing on blood chemistry. I think having an ultrasound at this point is a very good idea.

Glynda

[labblab]

Hi Joan, I'm not Sharlene, but it sounds to me as though the ultrasound has been ordered to check to see whether or not the "crackling" is related to fluid overload in the lungs or around the heart. Ultrasounds can be focused on different areas of the body, but an ultrasound of the area around the heart can be used to check for fluid that is associated with congestive heart failure.

It is a good thing that Lena's creatinine and urine specific gravity are both within normal range. So it appears as though Lena's BUN is the only abnormal renal marker in the bloodwork, and that elevation was perhaps caused by something as simple as dehydration.

I did notice that her urine was cloudy and had both blood and protein in it back in December. This would be consistent with a urinary tract infection. I can't remember whether this was noted at the time and whether or not she received any treatment for a UTI?

At the moment, I don't think there is any cause to skip Lena's trilostane unless the vet has told you to do so. It sounds like a good plan to go forward tomorrow with the ultrasound, however, and let's see whether it reveals anything of interest.

Marianne

[Joan2517]

These are both better than I thought they would be so that's good news. My layperson's opinion of what the lab abnormalities look like are just that, a layperson's opinion based on my own experience with both kidney disease and congestive heart failure. As I mentioned, your vet would be the appropriate person to discuss these abnormalities with you. I will say this, however, if this blood chemistry is what your vet used to pursue a cushing's diagnosis, I personally would be concerned because this is not what we are accustomed to seeing on blood chemistry. I think having an ultrasound at this point is a very good idea.

Glynda
They did an ultrasound on 12/7 and found an adrenal tumor, which was where the final diagnosis came from. The 12/5 blood work was looking for diabetes, but after it came back they suspected Cushing's.

[Joan2517]

Hi Joan, I'm not Sharlene, but it sounds to me as though the ultrasound has been ordered to check to see whether or not the "crackling" is related to fluid overload in the lungs or around the heart. Ultrasounds can be focused on different areas of the body, but an ultrasound of the area around the heart and lungs can be used to check for fluid that is associated with congestive heart failure.

It is a good thing that Lena's creatinine and urine specific gravity are both within normal range. So it appears as though Lena's BUN is the only abnormal renal marker in the bloodwork, and that elevation was perhaps caused by something as simple as dehydration.

I did notice that her urine was cloudy and had both blood and protein in it back in December. This would be consistent with a urinary tract infection. I can't remember whether this was noted at the time and whether or not she received any treatment for a UTI?

At the moment, I don't think there is any cause to skip Lena's trilostane unless the vet has told you to do so. It sounds like a good plan to go forward tomorrow with the ultrasound, however, and let's see whether it reveals anything of interest.

Marianne
They never said she had a UTI and was never treated for any...this was all back in December...could she have had one all this time?

[Joan2517]

They never said she had a UTI and was never treated for any...this was all back in December...could she have had one all this time?
She hasn't had any bloodwork, except for the ACTH tests, since December 5.

[labblab]

Test Requested Results Ref Range
Urinalysis
Appearance cloudy *clear
Protein 3+ Neg
RBC 4 – 10 (HIGH) 0 - 3

This is the result I'm looking at. If I'm correctly seeing cloudy urine with a protein level of 3+ and a Red Blood Count of 4-10, then yup, this could definitely signal a bad UTI that may still be persisting. Without doubt, I would bring this to the vet's attention tomorrow and ask, "What's up with this???"

[Joan2517]

Maybe that's why she hasn't felt so good all along? Her tummy has been hot all along, would that be from a UTI? Would the antibiotics she's been taking for the possible abscess clear a UTI up as well? Maybe I should bring a sample with me tomorrow and have them test it...her first urine of the morning is usually 5:00 or 5:30. Does it have to be the first?

What if it is congestive heart failure, Marianne? I feel so sick now, like I should've know this, and what if I put my faith in a vet who hasn't done what he should have for Lena? I will never forgive myself if this is the case....

[labblab]

Duh! Yes, I'd forgotten she's on antibiotics right now. They might indeed clear a lingering UTI, as well. It would just depend on whether the UTI bug is sensitive to that particular drug. How long will she be taking this course of med? You may want to hold off on the urine sample until she finishes the antibiotic, in hopes that her urine will be cleared up at the end of the course. But I would still point out that urinalysis result tomorrow so as to have a gameplan in place.

Also, try not to panic about the possible CHF. It may be newly developing since the "crackling" wasn't heard before, and therefore nobody's fault that anything has been overlooked. Plus, depending on the severity of the condition if it even exists, it may be managed satisfactorily with medication. You've got to keep in mind that Lena is 15, and body parts just wear out over time. We are very lucky that we live in a time when veterinary medicine has advanced so far and even parallels human medicine in many ways. Let's just see what the ultrasound shows us and then go from there.

Marianne

[Joan2517]

Duh! Yes, I'd forgotten she's on antibiotics right now. They might indeed clear a lingering UTI, as well. It would just depend on whether the UTI bug is sensitive to that particular drug. How long will she be taking this course of med? You may want to hold off on the urine sample until she finishes the antibiotic, in hopes that her urine will be cleared up at the end of the course. But I would still point out that urinalysis result tomorrow so as to have a gameplan in place.

Also, try not to panic about the possible CHF. It may be newly developing since the "crackling" wasn't heard before, and therefore nobody's fault that anything has been overlooked. Plus, depending on the severity of the condition if it even exists, it may be managed satisfactorily with medication. You've got to keep in mind that Lena is 15, and body parts just wear out over time. We are very lucky that we live in a time when veterinary medicine has advanced so far and even parallels human medicine in many ways. Let's just see what the ultrasound shows us and then go from there.

Marianne
Okay, thanks Marianne. I'll try to calm down.....

[molly muffin]

Sorry I wasn't a round much the last couple days and all this went down for Lena. Goodness.

Okay you said they did an in house test in Nov and the glucose was a bit high right (i see that) I see that did a Fructosamine test in December and it was also high.
I do think I'd have the glucose rechecked. It might explain some of the abnormalities in the blood work like the electrolytes being off.
The main thing right now is to get rid of the fluid build up. That can build up rather quickly. Hopefully the antitibiotics and lasix shot will help with that.
Baby steps and one thing at a time here okay. :)

[Joan2517]

Thanks, Sharlene...the in-house was just to make sure they could put her out for the dental work on Nov. 16 and the December one was when I first noticed how much she was drinking and we were thinking diabetes. That's the one that came back so bad that my vet was shocked and wanted the ultrasound done the next day where they were looking at the adrenal glands...and the rest is history.

We are having the ultrasound done tomorrow afternoon. I thought they could also check the adrenal tumor, but that is considered another scan and will cost more, so that will have to wait, especially since the ACTH test will need to be done at the end of this week because we are at the 30 day mark on 30mg.

I am trying to stay calm but I am ready to jump out of my skin!

[molly muffin]

Wait. What ultrasound are they doing tomorrow that they can't check the adrenal tumor?

I just don't ant you to waste money if it isn't going to tell you anything. I have N vet heard of a different scan needed to be done to check an adrenal tumor compared to any other ultrasound. Do they mean a high definiti N? In which case I don't know the value of doing a low res ultrasound. Wouldn't it be better to have one high res that can check everything than two separate? Less something else is meant. Do they mean a MRI or ct to look at the adrenal glands?

I'm not sure how we got from thinking diabetes to checking the adrenal glands.
If the glucose is high and signifies diabetes that still has to be treated regardless of if there is or isn't a problem with adrenal glands. Did they in fact rule out diabetes?

Just want to make sue we have all the facts straight especially in light of this new dvelopment with the fluid.

[labblab]

Sharlene, Joan can correct me if I'm wrong, but as Sophie's mom has said, it sounds as though they are planning to do an echocardiogram tomorrow, which is an ultrasound of the heart. They are wanting to evaluate the possibility of congestive heart failure. So the adrenals will not be part of this chest imaging -- another abdominal ultrasound will probably be done later on.

[molly muffin]

Agh okay that make snse to me know Marrianne! Thanks. An EKG is dfinitely a priority. I've been getting internal organ ultrasounds too long obviously. Didn't even make the connection. D'oh

[Joan2517]

You are right, Marianne, they are just checking the heart. And the initial blood work on 12/5 was because of the excessive drinking which he said could be diabetes. If it wasn't, we were going to do other testing. But the test came back so bad that I think he knew then that it would be Cushing's, which is why we went for the ultrasound and found the tumor then the 8 hour test to make sure it was adrenal and not pituitary. There was no more talk of diabetes after that. And besides the ACTH testing, there has been no other blood tests done.

Should there be? They didn't even check her mouth after her dental work until I asked them to on Jan. 30 because I was worried about the fact that Cushing's dogs don't heal as fast.

I have used them for about 15 years, but I am not sure all of them are as knowledgeable about this as I need them to be. They keep telling me that she looks great for her age and I don't think they are taking my concerns seriously.

But they have been very good with other issues with the other cats and dogs....so I am conflicted.

I guess I will see what happens tomorrow...I'm so tired of being so worried and second guessing myself and them. I just want to make sure that Lena is getting the best care.

Thanks for all of your responses/suggestions/help. I don't know what I would do without you.

[labblab]

Joan, when they draw blood for the ACTH this week, I would ask them to also run a basic blood chemistry panel so as to monitor Lena's glucose, liver and kidney markers, and potassium/sodium balance. It will be interesting to see whether Lena's glucose has dropped back into normal range now that her cortisol is under better control. Although even as I write that, I realize this cannot be a fasted test since she needs to take her trilostane along with her breakfast. So her glucose may still hang a little bit higher on the testing. But you also want to keep an eye on the kidney, liver, and potassium/sodium level for a dog taking trilostane. So I think it would be good to have a chemistry panel run this week.

Marianne

[Joan2517]

Joan, when they draw blood for the ACTH this week, I would ask them to also run a basic blood chemistry panel so as to monitor Lena's glucose, liver and kidney markers, and potassium/sodium balance. It will be interesting to see whether Lena's glucose has dropped back into normal range now that her cortisol is under better control. Although even as I write that, I realize this cannot be a fasted test since she needs to take her trilostane along with her breakfast. So her glucose may still hang a little bit higher on the testing. But you also want to keep an eye on the kidney, liver, and potassium/sodium level for a dog taking trilostane. So I think it would be good to have a chemistry panel run this week.

Marianne
Okay,Marianne....that's what I will do. Hopefully nothing terrible shows up on the test today.

[molly muffin]

Joan. How did the test today go? What did it show?

[Joan2517]

Okay, they did an echo cardiogram and it didn't show CHF, but apparently she has a murmur and the walls of the heart are a little thick? When the head vet came out to tell me, I asked about the crackle because that is why I thought I was there, and he said that he was told that there was a murmur...I told him I was very confused. The cute one never said murmur, he said crackle and admitted to reading the wrong chart (our chihuahua has a heart murmur). So he did xrays for free to check on that (it was the least he could do after all the $ I have spent there in the last few months, not to mention years with all the pets that we have!). They heard a little something so they changed the antibiotic she was on to Clavamox.

He also said we should keep an eye on her blood pressure, at which point I reminded him that we just did on January 30. He looked at her eye and said it looked fine.

I questioned the urinalysis on Dec. 10 and he said the blood was probably from the way they got the urine.

So, all in all, if I can believe they know what they are doing, she is doing well.

After we got back, I made a fire and put the big dog bed on the floor in front of it (Lee was sleeping on another one next to me, the poor little girl was so pooped!). I laid down on the dog bed and woke up to her licking my face and rolling on her side like she used to for kisses and belly farts. I think if I didn't have to work and could stay home with her, she would feel much better.

I asked for and got a copy of the echo. Tomorrow I am going to try to scan it to a JPEG and upload it. It may or may not work...if not what do you want me to post?

I felt good asking pertinent questions today and I think my vet was a little surprised!

LOL!

[molly muffin]

Oh this Is good news! Did he say anything specifically about the fluid. What might have cause it and if that is now decreasing? Just curious since she is feeling so much better of that isn't getting better too.
So I think that just the ACTH and a blood draw to check the other values and see if they are more in line now that she is being treated with trilostane. Don't freak though if liver values remain high. They don't always go down. Some do some don't so no panic. I don't think that I would get a follow up internal ultrasound yet then. Just me personally. I tend to do those every 6 months or sometimes only once a year unless something comes up. I do it to keep an eye on the nodule in Mollys adrenal that it hasn't enlarged and to check liver kidneys etc. So depending on how Lena is doing and if you feel and the vets feel she needs one. You can make that decision.
It is good to feel that your vets have a ha ladle in what is going in with her and on track to take care of her. Less worrying for you.

That is so cute her wanting belly farts. I do that to Molly too. Lol

Over all good report! Thanks for letting us know.

[Joan2517]

Oh this Is good news! Did he say anything specifically about the fluid. What might have cause it and if that is now decreasing? Just curious since she is feeling so much better of that isn't getting better too.
So I think that just the ACTH and a blood draw to check the other values and see if they are more in line now that she is being treated with trilostane. Don't freak though if liver values remain high. They don't always go down. Some do some don't so no panic. I don't think that I would get a follow up internal ultrasound yet then. Just me personally. I tend to do those every 6 months or sometimes only once a year unless something comes up. I do it to keep an eye on the nodule in Mollys adrenal that it hasn't enlarged and to check liver kidneys etc. So depending on how Lena is doing and if you feel and the vets feel she needs one. You can make that decision.
It is good to feel that your vets have a ha ladle in what is going in with her and on track to take care of her. Less worrying for you.

That is so cute her wanting belly farts. I do that to Molly too. Lol

Over all good report! Thanks for letting us know.
Thanks, Sharlene...he never really said much about the fluid, just put her on the Clavamox to stop whatever might be there or beginning. I don't care as long as she starts feeling better.

It was so weird to wake up to her doing all that last night. At first I thought I was dreaming. She's loved the belly farts since she was a baby! The more she does what she used to do, the more I realize how much I missed it...but again, as in the symptoms, it was gradual. I just hope she doesn't get upset now because my 3-day weekend is over and I have to go back to work.

We got up at our usual time 5:15ish, quick potty break, then on the couch to go back to sleep for an hour...but I just lay there enjoying having her sleeping next to me. I'll be a zombie all day at work, but who cares!

[Joan2517]

I just put Lena's echocardiogram report in her album (my scanner at work can make a JPEG!). It's hard to read, I don't know what the abbreviations/terms are, but it looks like everything the vet said.

Hopefully she is sleeping soundly waiting for me to come home....I hate having to work for a living!

[molly muffin]

Gads, I don't know if I could read that just looking at the paper itself. Scribbly LOL. It sort of looks like a recheck isn't needed for 9 months? if so then it doesn't seem like anything dire or worrisome was seen.

It is very good to see them doing the things they always loved to do all over again.

[Joan2517]

That's the part I could read too! lol.

[onlyg]

Finally finished reading your whole thread. Lol So happy Lena is doing so well! The eye thing rang a bell so I wanted to out my 2 cents in. (Finally feel like I can give back!) Right before the Cushings diagnosis, the same thing happened to Maggie. Her eye actually looked like it was popping out. For a Boston, that's pretty bad! Turned out she had an infection in her tooth and the swelling was pulling the skin down. A round of antibiotics cleared it up. So there wasnt anything ever wrong with the eye. Hopefully, it was something like that. :)

[Joan2517]

That's what the vet thought when she saw her Thursday (even though she wouldn't have noticed it if I hadn't said it was larger...I know my girl)....she is on antibiotics and it does look better. She did have 8 teeth pulled just a couple of weeks before the Cushing's diagnosis, so an infection wouldn't be a surprise.

I was home for the holiday weekend and I think she really missed me because she must've gotten up looking for me a lot of times...could tell from all the pee on the wee wee pads. She usually sleeps all day when I'm at work and probably forgot the routine. Problem is my Puggle marks wherever someone else pees, so came home to a huge mess! And my big guy Gable gets so upset whenever the Puggle pees (because he would NEVER do anything like that) that when I let them out he won't come back in until I beg him to.

I really need to win the lotto so I can stay home!

[Joan2517]

Lena was in respiratory distress tonight and I had to rush her to the Emergency Room. They think she has a thrombosis clot...I think that's what they said. Her heart is enlarged and something is going on in her lungs. She is in an oxygen tank and they are keeping her. They did blood work, xrays and have her hooked up to an IV. She was so upset when I kissed her goodbye. She has never stayed overnight in a hospital in the 14 1/2 years we've had her. My heart is breaking and I can't stand the thought that she is there.

I was just getting ready to go the the ER when I finally got my vet on the phone, he told me to keep her calm and watch her. I did that for about 1 minute and then took off. It's a good thing I didn't listen to him. I am so afraid she is going to die all alone in the hospital.

[My sweet Ginger]

Oh Joan, sending prayers your way for Lena to pull through this hurdle. I'm so sorry for what Lena and you are going through tonight.
Be strong for Lena as she needs you when she wakes up tomorrow. Many hugs. Song

[Budsters Mom]

I am so sorry Joan. :o Lena is right where she needs to be right now. Yes, it is very hard to leave them. :o

Sending healing thoughts and prayers your way.

Paws up Lena! We are pulling for you!

Hugs,
Kathy

[molly muffin]

Oh my gosh Joan. How absolutely terrifying for you and Lena. Do let us know how she is doing. You will both be in my thoughts and prayers.

[labblab]

Oh, I am here too!! Hoping so much for some good news this morning!

[Joan2517]

Thank you all...she made it through the night. They said she slept, but they might just be saying that. She was barking to go out, so they took her out of the oxygen tank to pee and seemed okay, but started panting again. That could be her nerves....the doctors do rounds around 9 and then they will call our vet for the results of the tests the other day, they've given her Lasix. She must be terrified and wondering why I'm not there.

I can hardly see, my eyes are swollen shut and I can't stop crying....

[labblab]

Whew! Our girl made it through the night OK!!!

Will they let you visit with Lena today, or do they think that will get her too agitated? Either way, can you maybe drop off a shirt or a towel or something that carries your scent on it? That might be comforting to Lena -- something familiar to her that links her to her mom.

Marianne

[molly muffin]

I'm so glad she made it through the night! Come on Lena sweetie. You can beat this. Sending you big hugs Joan. something with scent on it is a good idea. Good thought Marrianne!

[Joan2517]

They told me to come around noon, by then they will have gotten her imaging from our vet and be able to go over everything with me. I'm so afraid...if I had listened to my vet she would probably have died...not that I had any intention of listening to him. I was already almost out the door when he called back. And if she had been in his hospital, there's no one there to check on them at night.

One of the vets in this Emergency Hospital specializes in Cushing's. I think I picked up her card, but they are just ER doctors and I'm not sure if they do regular office visits. But I think my days with my vet might be over. I'm not sure he has been concerned enough...but I could just be too upset right now to think clearly.

I did manage to get the Credit Care or whatever it is called. I was approved for $3400, which will probably be used up just for this. The bill as of last night was $2100 or something like that and that was just 75% of the high estimate.

I don't know how I am going to be able to go to work and leave her when she gets home.

[marinaliz]

My prayers and positive thoughts are with you... Lena is so lucky to have you...!!! I am sure she will recover quickly and be back home soon.

[Joan2517]

God, I hope so...just thinking about how she kept reaching for me and putting her face up to the plastic to kiss me last night is killing me. If she didn't have to be in the oxygen tank, I would stay and hold her, but it will only upset her if she sees me and can't get to me...and that goes both ways....and then she'll see that I'm crying and it will only make it worse...I can't stop crying.

[judymaggie]

My prayers and healing thoughts are going out to you and Lena! Since you have some time before you go to meet with the doctors, try to write down your questions for them. My Abbie is in the hospital now and I just finished my list for her doctor. Take care!

[Joan2517]

Oh, I'm so sorry...we all have each other which is a huge comfort to me. My husband can't handle any of this and didn't even get out of bed when I got home last night.

So, I went straight to the people who understand....all of you!

[onlyg]

My heart is breaking for what you and Lena are going through!! Sending big hugs and lots of prayers your way!!
Maggie's mom

[labblab]

Joan, I'm thinking 100% positively and hoping that Lena will soon be discharged to come home! I understand why you'll be very worried about her if she's home alone, though. Since she's such a tiny thing, is there any way at all that you could take her in to work with you, either by staying in a little crate (if she's used to crates) or in a little pen that's in a quiet place? Just a thought, but perhaps in this situation, your boss will be willing to make some accommodations in order for you to be able to have Lena nearby for you to check on. In truth, you'll be a far more productive employee because you'll have the peace of mind of knowing that she's OK...

Marianne

[Renee]

Oh Joan, I've had to leave my girl at Pet ER more than once. It's a scary feeling. Sending many good thoughts that she perks up and can come home soon.

[molly muffin]

Checking in to see how Lena and you are doing.

[Joan2517]

Joan, I'm thinking 100% positively and hoping that Lena will soon be discharged to come home! I understand why you'll be very worried about her if she's home alone, though. Since she's such a tiny thing, is there any way at all that you could take her in to work with you, either by staying in a little crate (if she's used to crates) or in a little pen that's in a quiet place? Just a thought, but perhaps in this situation, your boss will be willing to make some accommodations in order for you to be able to have Lena nearby for you to check on. In truth, you'll be a far more productive employee because you'll have the peace of mind of knowing that she's OK...

Marianne
No way! She doesn't like animals to begin with but she especially doesn't like little dogs...makes you wonder, doesn't it??

[Joan2517]

Okay, dear ones! She is home! Breathing is better, but they think she might have thrown a clot, or it has to do with her heart disease. She fell asleep on my legs while I was sitting on the floor and her head was lower that the rest of her body and she seemed good, but then I had to wake her up to go to our vet to get some pills to hopefully clear her airways. And of course, none of the congested sound that I had been listening to, was apparent when we were there.

We are going back to the Veterinary Clinic tomorrow to see the internist who knows a lot about Cushing's. I just want to make sure that our vet is doing right. He may very well be, but now I am going to make sure.

They let him know that I had an appointment and he was all good guy today: apologizing for not being able to meet me at the office last night and the visit and bronchial meds were on him (I'm sure I'll be paying for them somewhere down the line!), but I don't care...she's home and I've got tomorrow, Saturday and Sunday to baby her and kiss her and tell her a million times how much I love her. I'm not sure she recognized me today, my eyes are swollen almost shut from crying and I lost my voice screaming in the car the whole way home last night.

They did blood work and I will post the results tomorrow, I am so, so tired. the clinic gave me cough medicine to help clear up any mucous that might be building up somewhere and also to help her sleep, but I am so afraid to give her anything right now.

we missed the Vetoryl this morning, and the Clavamox, but she got the Clavamox high blood pressure pill with her dinner tonight, which she devoured! I was told her I can give her the Vetoryl tomorrow, what do you think? Then she's supposed to get the ACTH test this weekend...we've only got 3 pills left. My vet said we could put it off and just continue with the 30mg for now. What do you think about that? I will also ask the Internist tomorrow...

So for now, the crisis is over, but at least I know that the ER is close and the staff and doctors are all very nice.

Thank you for all of your good wishes and prayers. I still have her...

[onlyg]

So happy she's home with you now. I will keep praying for your and precious Lena.
Maggie's mom

[Joan2517]

Thank you, she is trying to get comfortable and fall asleep now. She's still breathing heavy. I want to hold her, but she can't get comfortable in my lap....

I'm wondering if this is fair to her. The vet said the heart disease can be monitored by the blood pressure pills, but she seems so uncomfortable. I am nervous about giving her the cough medicine even though both the clinic and the vet said it was okay.

[onlyg]

It's been a rough 24 hrs for both of you!! Don't overthink it right now. Take a deep breath and try to get some rest. Tomorrow You'll be able to think clearer. Sending big hugs and prayers to both of you!!!

[Budsters Mom]

You are exhausted. You need rest and time to process all that has occured.

Quality of life is a huge consideration for many of us. It was my ONLY consideration when it came to my Buddy. I was determined that he would not suffer. Although I knew that releasing him would devastate me and break my heart, my decision had to be what was best for him.

Only you can determine what is reasonable/fair when it comes to Lena's care and how much she's able to handle. For now, I'm glad that she's home and you're able to spend some precious time together.

Hugs,
Kathy


I'm wondering if this is fair to her

[Joan2517]

I had to rush Lena back to the Emergency Clinic late last night, she just could not breath right. They rushed her right in again and put her in the tank. Dr. suggested looking for a cardiologist in the morning, which was just a few hours away by that time. I went in to kiss her goodnight and tell her how much I loved her before I left her there for another night.

They called me at 5:00 to tell me she was in cardiac arrest and did I want them to keep working on her to give me time to get there, but I couldn't let her suffer, so I told them to put her to sleep. I wasn't with her at the end and I am devastated...I promised her I wouldn't let her die alone, my dog of my heart.

When I went to get my precious, I just sat with her, kissed her again and again, told her how much I loved her and how sorry I was that I hadn't been there. Then I took her home and held her until my vet's office opened so that they could send her out to be cremated.

My other dogs all got a chance to say goodbye and I held her and walked her around the house and the yard...all her favorite spots, everywhere where I will continue to see her.

The house is so quiet, the others seem to be being especially good. My big boy, Gabe keeps coming over and putting his paw on me and just looking at me. He checks on me every hour or so. He seemed the most upset after seeing her and just lay by the back door.

The thought of never seeing her or holding her again is so painful. The past 2 nights without her in bed with us have been awful. I have been sleeping most of the afternoon. Every time I wake up and remember that she's gone, I have to go back to sleep where she is still with me.

I should have stayed there last night or had them put her to sleep while I was there, but I wanted to believe she would come home like she did yesterday. I hope she wasn't afraid at the end and waiting for me...this will be something I will always be kicking myself for. I feel I failed her, the dog of my heart, my precious angel, my third child.

[lulusmom]

Joan, I am so terribly sorry for your loss. I know how difficult it was for you to make the decision to let her go. Sometimes sparing their pain and suffering outweighs our need to be there to hold them when they leave this world. You may not have been there but I'm convinced it was your face Lena saw as she crossed over. Don't doubt that because you were her world.

Godspeed sweet Lena.

[Renee]

Oh Joan, how my heart breaks for you. Every time I have logged in today, I have dreaded checking your thread, fearing this would be coming.

I am so very, very sorry you weren't there with her, but please be kind to yourself.

Sail on fast and free precious Lena.

[labblab]

Oh Joan. I am sorry beyond words. I know your heart is broken into pieces. But I do believe that Glynda has spoken the truth. You did not need to be physically present for Lena to feel cradled in your love. You made the decision that was best for her, at your own expense. Precious, precious little girl. She has always been your angel, and now she has truly earned her angel wings.

Sending you hugs of peace and comfort,
Marianne

[Budsters Mom]

I am so very sorry for your loss. :)

Fly feel angel Lena, fly free!

Big hugs,
Kathy

[molly muffin]

Oh no! I just got home from work and saw this. The tears are flooding. I just can't imagine how you feel right now. I'm so so sorry Joan.
My heart cries for you.

[My sweet Ginger]

Oh Joan,
This is such devastating news as I was so hoping Lena will pull through this. I'm so sorry that she had to suffer her last few days but I'm glad she got to come home and spent her last day with you. I'm sure she was very happy to see you again.

My baby came home today and that was what I did too. I showed her our front yard where we went out many times every day and night for years and she'd smell the grass while walking around. We also walked around all over the house where she'd walked around for hours and hours. It's still not the same but she's home with me and I know with me is where she'd want to be the most.

Let the tears come out. Don't try to hold it as that is most natural thing to do when we lose our dearly loved ones. Right now I'm trying to remember my baby's healthy years rather than sick ones but surprisingly it is not that easy because I've spent last three years so focused on her sickness and much diminished state of mind and health. Those healthy days seem sooo far away. I hope you have many, many happy and healthy memories of Lena and you together. But right now let the tears come down. I do think it will take some time for us to be able to remember our good times together with a smile on our face but I believe we will one day get there.
I also promised to my baby that I will be with her for her last moments and that still hurts me so much but for Lena you had to do what was best for her at the time as we'd never want them to suffer. You gave her the final gift that only you could give. I know it doesn't really help to ease your pain but I hope you know that Lena is free of any pain now and whole again. I'm so sorry Joan. Big hugs, Song.

[Joan2517]

Thank you...I just couldn't post all day, I didn't want to see it in writing. My husband and children had to post to Facebook as I just could not. I texted family members this morning as I was totally incoherent. I still have to call my best friend, but I will probably only get one word out before she won't be able to understand a single thing I say.

[Joan2517]

Oh Joan,
This is such devastating news as I was so hoping Lena will pull through this. I'm so sorry that she had to suffer her last few days but I'm glad she got to come home and spent her last day with you. I'm sure she was very happy to see you again.

My baby came home today and that was what I did too. I showed her our front yard where we went out many times every day and night for years and she'd smell the grass while walking around. We also walked around all over the house where she'd walked around for hours and hours. It's still not the same but she's home with me and I know with me is where she'd want to be the most.

Let the tears come out. Don't try to hold it as that is most natural thing to do when we lose our dearly loved ones. Right now I'm trying to remember my baby's healthy years rather than sick ones but surprisingly it is not that easy because I've spent last three years so focused on her sickness and much diminished state of mind and health. Those healthy days seem sooo far away. I hope you have many, many happy and healthy memories of Lena and you together. But right now let the tears come down. I do think it will take some time for us to be able to remember our good times together with a smile on our face but I believe we will one day get there.
I also promised to my baby that I will be with her for her last moments and that still hurts me so much but for Lena you had to do what was best for her at the time as we'd never want them to suffer. You gave her the final gift that only you could give. I know it doesn't really help to ease your pain but I hope you know that Lena is free of any pain now and whole again. I'm so sorry Joan. Big hugs, Song.
Thank you, Song...I thought I was the only one who would something like that...I was afraid it meant I was really losing it.

[Joan2517]

Oh no! I just got home from work and saw this. The tears are flooding. I just can't imagine how you feel right now. I'm so so sorry Joan.
My heart cries for you.
Thank you, Sharlene...you have been such a comfort to me, along with everyone else. I found all of you when I needed your knowledge and kindness. Now it is the bond we all share for the love of our pets that I have. I don't know what I would have done without all of you these past few months.

[molly muffin]

You and Lena are both in our hearts and always will be. This has been a really horrible beginning to 2016 with the losses of such sweet beloved furbabies.
We do a share a bond, all of us because we walk the same paths.

[Joan2517]

I am so very sorry for your loss. :)

Fly feel angel Lena, fly free!

Big hugs,
Kathy
Thank you, Kathy. I picture her with all of those who went before her and how happy they must be together again.

[Joan2517]

Joan, I am so terribly sorry for your loss. I know how difficult it was for you to make the decision to let her go. Sometimes sparing their pain and suffering outweighs our need to be there to hold them when they leave this world. You may not have been there but I'm convinced it was your face Lena saw as she crossed over. Don't doubt that because you were her world.

Godspeed sweet Lena.
Thank you, I hope that is true. Every time I closed my eyes today she was there. That was so much more bearable than opening them and not seeing her.

[Joan2517]

Oh Joan, how my heart breaks for you. Every time I have logged in today, I have dreaded checking your thread, fearing this would be coming.

I am so very, very sorry you weren't there with her, but please be kind to yourself.

Sail on fast and free precious Lena.
Thank you, Renee...I thought you would all know if I didn't post at all, so I knew you would be there when I was ready. You have all been such good friends to me and I can't thank you enough for all the help, guidance and emotional support that I received.

[Joan2517]

Oh Joan. I am sorry beyond words. I know your heart is broken into pieces. But I do believe that Glynda has spoken the truth. You did not need to be physically present for Lena to feel cradled in your love. You made the decision that was best for her, at your own expense. Precious, precious little girl. She has always been your angel, and now she has truly earned her angel wings.

Sending you hugs of peace and comfort,
Marianne
Thank you, Marianne...it has certainly been one of my worst days, but knowing that you would be here to comfort me has helped me all day. I knew once I posted that the love and support would give me some peace, which it has. I am going to have a lot of rough days, but I know that my sisters in Cushing's will be there for me, as I will be there for all of you as well.

I love all of my pets, but Lena was my heart and soul...as my son told everyone on Facebook, she was my third child.

[Joan2517]

Joan, I am so terribly sorry for your loss. I know how difficult it was for you to make the decision to let her go. Sometimes sparing their pain and suffering outweighs our need to be there to hold them when they leave this world. You may not have been there but I'm convinced it was your face Lena saw as she crossed over. Don't doubt that because you were her world.

Godspeed sweet Lena.
Thank you, Glynda. I really want to believe that, it would ease my pain and guilt to know.

[Harley PoMMom]

Oh Joan,

I am so terribly sorry for your loss of dear Lena and my heart goes out to you at this very difficult time. We do understand the pain you are feeling so please know we are here for you, always.

With Heartfelt Sympathy, Lori

[molly muffin]

Yep, they are just like having another child. One you love and nurture and take care of, making sure their world is okay.
It leaves a big hole in our heart and lives when they aren't there for us to love and take care of any longer.

[Joan2517]

Oh Joan,

I am so terribly sorry for your loss of dear Lena and my heart goes out to you at this very difficult time. We do understand the pain you are feeling so please know we are here for you, always.

With Heartfelt Sympathy, Lori
I know that Lori and I am truly grateful and feel blessed to have found this site in time. I don't know how I could have dealt with the last couple of days, not to mention the last couple of months, without all the support I found here.

[onlyg]

I am so sorry for your loss!!!There are no words that can heal your heart, but I hope you can find comfort from all the people that are holding you in there hearts right now. Godspeed sweet Lena. She was so lucky to have you as her mom!!
With heartfelt sympathy, Maggie's mom.

[Joan2517]

I am so sorry for your loss!!!There are no words that can heal your heart, but I hope you can find comfort from all the people that are holding you in there hearts right now. Godspeed sweet Lena. She was so lucky to have you as her mom!!
With heartfelt sympathy, Maggie's mom.
Thank you for your kind words....

[Joan2517]

Song, thank you...that was beautiful. I couldn't figure out how to reply from there.

[Tammysmom]

Dear Joan,I am very sorry for the loss of your little Lena. I was so hoping and praying she would get better. These little fur babies have a way of wrapping their paws around our heart. My Tammy was the baby I could never have. Lena was and will always be your baby. She was so lucky to have a great mommy. Hugs and understanding. Brianna

[Joan2517]

I am so sorry for your loss!!!There are no words that can heal your heart, but I hope you can find comfort from all the people that are holding you in there hearts right now. Godspeed sweet Lena. She was so lucky to have you as her mom!!
With heartfelt sympathy, Maggie's mom.
It is a huge comfort to me. Thank you.

[Joan2517]

Dear Joan,I am very sorry for the loss of your little Lena. I was so hoping and praying she would get better. These little fur babies have a way of wrapping their paws around our heart. My Tammy was the baby I could never have. Lena was and will always be your baby. She was so lucky to have a great mommy. Hugs and understanding. Brianna
Thank You Brianna...the funny thing is, Lena was the grandchild I thought I would never have, but then we got one and she moved up to my third child instead (as my son constantly reminds everyone)

[spdd]

Just came on this morning and read about Lena. My heart goes out to you. I know exactly how you feel, and even now 15 months after "mah boy" left.... I feel the pain still and definitely feel the pain for others. I cry for you, literally, knowing exactly how you feel. I wish I could say something to make it all go away, but there is nothing that will make you feel better, other then knowing the people on here do know how loved our little ones are/were and can be such a support. Please know I am thinking about you, and please, please know you did everything humanly possible for Lena, you really did.

[Squirt's Mom]

Dear Joan,

I haven't talked with you but I have followed you and Lena daily. My heart is shattered to read this news and I know your Soul is in pieces today. You feel lost, consumed by guilt and questioning everything, the pain almost more than you can bear. But you are never alone; not only is your family here by your side, your sweet Lena is as well. Her body may be gone but her Spirit is strong and present. She will be with you all your days. And one day, when your job here is done, that precious little girl will be waiting to fly into your arms once again. I have no doubt that our babies wait for us and that we are reunited for all eternity. A love like the kind we share with them can never die.

My thoughts and prayers are with your and your family in this trying time.
Our deepest sympathies,
Leslie, Trinket, Brick, Sophie, Fox, and all our Angels

RAINBOW BRIDGE

Just this side of heaven is a place called Rainbow Bridge.

When an animal dies who has been especially close to someone here, that pet goes to Rainbow Bridge. There are meadows and hills for all of our special friends so they can run and play together. There is plenty of food, water and sunshine, and our friends are warm and comfortable.

All the animals who had been ill and old are restored to health and vigor; those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by. The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent; his eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together....

Author unknown...

[hermine]

Dear Joan,
This is my first post. I am so sorry for your loss. There are no words to console us, when our loved ones leave us. Know you are in my thoughts and prayers.
And now my journey begins with my Maggie, just diagnosed this past Weds. God bless you, Joan.

[Joan2517]

Just came on this morning and read about Lena. My heart goes out to you. I know exactly how you feel, and even now 15 months after "mah boy" left.... I feel the pain still and definitely feel the pain for others. I cry for you, literally, knowing exactly how you feel. I wish I could say something to make it all go away, but there is nothing that will make you feel better, other then knowing the people on here do know how loved our little ones are/were and can be such a support. Please know I am thinking about you, and please, please know you did everything humanly possible for Lena, you really did.
Thank you, Judi...I felt the same way reading all about "mah boy"...I know I will keep questioning everything I did, that's just who I am. I also know that it won't hurt so much forever. My other guys are all trying to figure out the ranking order now and it is so quiet here. Even though she was tiny, she was a huge presence and there is a hole here now...it may never be filled. They all need me too, so as sad and lonely as I am for my Lee, her brothers and her sister will need me to be strong for them and I am trying. It's so much easier to sleep because she is alive in my thoughts then...waking up the reality keeps hitting me.

[Joan2517]

Dear Joan,

I haven't talked with you but I have followed you and Lena daily. My heart is shattered to read this news and I know your Soul is in pieces today. You feel lost, consumed by guilt and questioning everything, the pain almost more than you can bear. But you are never alone; not only is your family here by your side, your sweet Lena is as well. Her body may be gone but her Spirit is strong and present. She will be with you all your days. And one day, when your job here is done, that precious little girl will be waiting to fly into your arms once again. I have no doubt that our babies wait for us and that we are reunited for all eternity. A love like the kind we share with them can never die.

My thoughts and prayers are with your and your family in this trying time.
Our deepest sympathies,
Leslie, Trinket, Brick, Sophie, Fox, and all our Angels

RAINBOW BRIDGE

Just this side of heaven is a place called Rainbow Bridge.

When an animal dies who has been especially close to someone here, that pet goes to Rainbow Bridge. There are meadows and hills for all of our special friends so they can run and play together. There is plenty of food, water and sunshine, and our friends are warm and comfortable.

All the animals who had been ill and old are restored to health and vigor; those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by. The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent; his eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together....

Author unknown...
Thank you, Leslie...I do believe I will see her again, and all the others who have gone before her. I can see them all sitting together catching up, even with the ones she never knew. My dad is probably holding her, or my Aunt Maureen...they may be fighting over her. Our Monsignor Hartman died a few days before she did...he was from the God Squad, I don't know if you have heard of him, but we knew him personally. He used to come to our home and have religious discussions with my husband. I'm not sure if it was before we had Lena or not. But when I heard the sad news about his passing, the first thing I prayed was that he would be there to take care of her if she should die and this was even before the crisis of the last couple of days. It was strange because when I texted my brother that Lena had died, he wrote back that Father Tom had paved the way for her. Father Tom officiated at my brother's wedding and also baptized his triplets. I want to believe it.

[judymaggie]

My thoughts and prayers are with you and your family, two-legged and four-legged. You are a strong person, Joan, but know that you can lean on us as much as you need.

[Joan2517]

Marianne, I have uploaded a picture of Lena in her prime and the way she always looked at me, and to me. It's called Lena's new haircut #4. Please use that one on the Memorial page. I have been looking at pictures for hours and even though they make me cry, some of them have made me smile when I remember how much she was loved by all of us. It is still so quiet here...the others are sad as well, I think, or maybe just processing. I don't know, it could be my imagination.

[labblab]

Dear Joan, this photo of Lena is precious and beautiful. The link is now all completed, and thank you so much for sharing it with us.

Even though the other doggies are quiet, I am thinking it will have helped them that they had a chance to sniff Lena and to realize that her spirit had left her little body. Things are different for them, of course, but I am thinking that they will no longer be expecting her to return. It will take time for them to sort out things amongst themselves, though, too.

It is such a sad loss for all. :o

Marianne

[Joan2517]

Thank you, Marianne...

[Joan2517]

Hi Marianne, she died on the 19th, not the 17th.

[labblab]

Oh Joan, I'm sorry. I'll fix that right now. :o

[mcdavis]

Oh Joan, I'm so dreadfully sorry to read this. I haven't posted, but I have been reading this thread, and hoping / praying that little Lena would get better.
You really did everything you possibly could for her including making the hardest decision ever to say goodbye and free her from pain.
Thinking of you,

[Joan2517]

Oh Joan, I'm sorry. I'll follow fix that right now. :o
Thanks, Marianne...it is a really nice picture of her...it's hard to remember how healthy they looked sometimes.

[Joan2517]

Oh Joan, I'm so dreadfully sorry to read this. I haven't posted, but I have been reading this thread, and hoping / praying that little Lena would get better.
You really did everything you possibly could for her including making the hardest decision ever to say goodbye and free her from pain.
Thinking of you,
Thank you for your kind words....

[onlyg]

Hi Joan. I would like share a story with you. Maggie was my husbands pride and joy. When he was home, I didn't exist in her eyes. She followed him around everywhere and only laid on his lap when we relaxed at night. When my husband passed, Maggie went into a depression that lasted for months. She would just eat, sleep and sit by the garage door waiting for him to come home. She was usually really energetic and loved to play with her brother and toys but that all stopped. When I took her to the vet the vet explained to me that dogs understand death more then somebody just suddenly missing. If I had brought her to the funeral home to say goodbye, she would have not have gone through that terrible depression. So you did the greatest thing when you brought Lena home and allowed them to say their goodbyes! They will miss her but they will understand the loss better. Hope this helps! You're in my thoughts and prayers.
G - Maggies mom

[Joan2517]

Hi Joan. I would like share a story with you. Maggie was my husbands pride and joy. When he was home, I didn't exist in her eyes. She followed him around everywhere and only laid on his lap when we relaxed at night. When my husband passed, Maggie went into a depression that lasted for months. She would just eat, sleep and sit by the garage door waiting for him to come home. She was usually really energetic and loved to play with her brother and toys but that all stopped. When I took her to the vet the vet explained to me that dogs understand death more then somebody just suddenly missing. If I had brought her to the funeral home to say goodbye, she would have not have gone through that terrible depression. So you did the greatest thing when you brought Lena home and allowed them to say their goodbyes! They will miss her but they will understand the loss better. Hope this helps! You're in my thoughts and prayers.
G - Maggies mom
Aww, poor Maggie...I'm sorry. I wish I could just accept it like they do.

I am tortured thinking that I should have stayed and been there when she started arresting, or had them put her down right away. She was reaching for me from the tank, and when I opened it she kept licking me and kept trying to get into my arms, and I don't remember if I picked her up or not. I think I was afraid to because of all the trouble she was having breathing.

I am so afraid that she felt like I abandoned her and it's paralyzing me with sadness today.

[onlyg]

I truly believe that if you had to make the decision, you would have always second guessed that maybe she could have pulled through. She took that decision from you so you wouldn't have to feel that guilt. She knew you would be devastated so she waited for you to leave before she gave up the fight. Dogs always unselfishly love us and she unselfishly loved you till the end. I hope you can somehow find peace in knowing that she did that for you! I know how paralyzed with sadness you are right now and that is okay. You suffered a great loss but please don't let guilt invade that sadness. She was so blessed to have you as her mom and you gave her 15 great years and didn't give up on her when she got sick. You did everything you could have possibly done. She is smiling down on you right now bragging to all the other doggy angels about how good she had it! Big hugs to you and remember she will always be there in your heart until you meet again!

[Joan2517]

Thank you, I am trying to believe that. I'm trying not to second guess myself, but it is so, so hard. I just want my baby girl back.

I have to go back to work on Monday, and act like a grown-up and be professional, but I am so afraid that I will just cry...I still can't stop, I don't really want to stop. I miss her so much.

This is the only place I can express how much I am hurting. I know that everyone who knows me, knows how much Lena meant to me. The joke was always that no one wanted to be around me if anything ever happened to her. No one has abandoned me (yet), but there are just a few who will continue to let me cry.

[Amanda's Mom]

Joan, I just checked in today and read about Lena. I am so very sorry and I know how deep your grief is. My Amanda (also a poodle) had adrenal surgery 16 months ago. She has advanced heart disease and I am thankful for every day she is still with us. Amanda has been hospitalized several times now for CHF the last only a few weeks ago. It is so hard to have to leave them there but they need the continuous drip lasix and the oxygen. Please don't second guess yourself. Being at home listening to them cough, watching them struggle to breathe is like torture. I know you want your baby girl back. And who can blame you for crying. You are so filled with overwhelming sadness. You loved Lena with all your heart and nothing can fill the void she has left. You will have your baby again one day. Until then take what consolation you can in knowing how much you loved each other and how you fought to keep her healthy and happy. She is healthy again now, and one day she will run to her mommy's arms as you are both filled with joy! I will hold you and Lena in my heart and thoughts!

Claire
(Amanda's Mom)

[Joan2517]

Thank you, Claire...your kind words help. I hope Amanda improves and I was thankful for every day since her diagnosis. I think I knew because of her age that this wasn't going to give me as much time with her as I wanted.

Joan

[Roxie]

So sorry for your loss!:( I just came back here to see how the other pups were doing and was very saddened to see this.:( Hang in there and know you did everything you could do for her! Sending thoughts and prayers your way!

[Joan2517]

Thank you for your kind words. Today will be my first day back to work. I am dreading it. I was lucky to have the weekend to mourn, but it went by too fast. I hate to leave my other guys today, they have been such a comfort to me...surrounding me with warm bodies and nudges and kisses. It helped to have them to wrap my arms around and cry on.

Coming home and not having Lena at the door with all of them is going to hurt so much. She has always been the first one I look forward to seeing.

But I don't know how I would've been able to leave this morning if she were still here, worrying that she might throw another clot and not be able to breath while I was at work. So maybe things have gone the way they were supposed to.

I will miss her every second of every day...my sweet, precious Lee.

[onlyg]

Thinking of you today!! I know how difficult it is for you going back to work. I am praying for you to have the strength to make it through. Just remember to take one day at a time!

[Joan2517]

Thinking of you today!! I know how difficult it is for you going back to work. I am praying for you to have the strength to make it through. Just remember to take one day at a time!
I'm so busy catching up, it is not as bad as I thought it was going to be. And to make everything even more complicated, my 7 year old grandson in in the hospital. He has Chronic Granulomatous Disease and is fighting something that the doctors at Cohen's Childrens' Center have not been able to figure out yet.

He just got back from the NIH in Bethesda on Thursday where he was supposed to have a colonoscopy, but they couldn't do it because he had a fever. So they had to come home and the fever got worse and he has to be admitted to the hospital if his temperature reaches a certain point.

This has been a hell of a week for all of us!

[judymaggie]

Sending healing thoughts for your grandson, Joan! I remember going back to work after having to let Maggie (my first Cush pup) go. The busier I was, the better. The hardest part was having my co-workers coming by to express their condolences-I was thankful that I had a private office so I could close the door when it got to be too much.

[onlyg]

Wow. It really has! I'm so sorry. I will keep all of you in my prayers!!

[Joan2517]

Sending healing thoughts for your grandson, Joan! I remember going back to work after having to let Maggie (my first Cush pup) go. The busier I was, the better. The hardest part was having my co-workers coming by to express their condolences-I was thankful that I had a private office so I could close the door when it got to be too much.
Oh, I know...that's what I was dreading most, even though it is nice to know that they all care, because I knew I would lose it. I only broke down once so far, but going home today will be hard. Her sweet little face won't be there when I look inside the window as I have for 12 years in this house. Everywhere I look, inside and out, just hits me all over again.

My husband even called crying a little while ago when he looked at all the albums I had been going through over the weekend. My son had a dream about her last night and said that she was sitting on the couch with one of our other dogs who had died a few years ago, and she looked great and happy. They were both wagging their tails and he said she looked better than she had in years.

I wish I could dream about her, but I think I am so deep in sleep, trying to escape, that I can't just yet. But looking at the picture in her album on this forum of her in her xmas dress this year, and comparing it to the one we used on the memorial page, I can see how much she had deteriorated. You can't see her eyes, but what you can see of them, she looks far away.

I guess I got so used to it that it just looked normal, which it most definitely was not.

[Joan2517]

Wow. It really has! I'm so sorry. I will keep all of you in my prayers!!
Thanks, we could sure use them!

[Joan2517]

I just got Lena's blood workup from the ER the other night, not that it matters now, but it is in her album. I don't know if it shows anything. I guess I'm still looking for something to explain it all.

[molly muffin]

Oh no I am so sorry to hear your grandson is in the hospital and they still can't figure out what is going on :(

It will be hard for awhile, and there is no time period, it's different for each one.
It's just really, really hard. People try to make you feel better and they mean well but it isn't always the thing you need.
It sounds like your husband too is missing her and grieving and that your son, is missing her and well, she was a heart that beat in the family. So lean on each other and remember when her eyes where bright and her limbs strong and she ran and played and jumped for joy to see you. I think that is how Lena would want you to remember her.

Hugs

[Joan2517]

Thanks, Sharlene...Joshua will have an abdominal sonogram either tonight or tomorrow, and he will have a test in the morning to check and see if his adrenal glands are working due to the long term steroid use and the fact that he has been almost tapered off. So a blood draw in the AM a shot of a high dose steroid to give the adrenal gland a jolt and then a blood draw 1 hour after that. Since nothing seems to be showing up positive for anything this all might be just a colitis flare up..

Talk about weird...if I hadn't read all of this kind of stuff on this forum, I wouldn't have a clue what all of this meant (even though my daughter has tried to explain it to me a million times).

It seems so quiet here...but I realized tonight that it's not that it's quiet, it's that I am still listening for her and because I don't hear her little footsteps, or her drinking, or her breathing, I am interpreting that as silence....it's just that I miss everything about her.

[marinaliz]

I was away for a couple of days and I just read for your loss. I'm at a lose for words, I don't know what to say… This must be so hard for you. I'm sorry for what you are going through. I wish I had the right words to comfort you but I believe that only time will make it easier for you. She may be in a better place now…R.I.P. little princess...

[labblab]

Thanks, Sharlene...Joshua will have an abdominal sonogram either tonight or tomorrow, and he will have a test in the morning to check and see if his adrenal glands are working due to the long term steroid use and the fact that he has been almost tapered off. So a blood draw in the AM a shot of a high dose steroid to give the adrenal gland a jolt and then a blood draw 1 hour after that...

Hi Joan,

Gosh, I'll surely be thinking of you guys today and hoping that the doctors can find an answer for what is ailing Joshua! You know, it sounds as though he is having an ACTH stimulation test done. They perform them on humans just like they do on our doggies, to test for either Cushing's or Addison's. What a coincidence, is it not? :o

Sending you my warm thoughts across the miles,
Marianne

[Joan2517]

Hi Joan,

Gosh, I'll surely be thinking of you guys today and hoping that the doctors can find an answer for what is ailing Joshua! You know, it sounds as though he is having an ACTH stimulation test done. They perform them on humans just like they do on our doggies, to test for either Cushing's or Addison's. What a coincidence, is it not? :o

Sending you my warm thoughts across the miles,
Marianne
I know, Marianne...when Jess was telling me about what they were doing, I kept thinking "why does this sound so familiar?" And then it hit me. They were supposed to do this test on Josh in May, but they figured they would do it now as long as he was in the hospital. She even has a syringe at home in case he breaks a bone or something and goes into shock...and now because of all of this with Lena, I understand it.

He doesn't have Addison's or Cushing's, it's Chronic Granulomatous Disease, but his adrenal glands have been affected by the long-term steroid use...I guess we'll find out today, how affected they are.

[Joan2517]

I was away for a couple of days and I just read for your loss. I'm at a lose for words, I don't know what to say… This must be so hard for you. I'm sorry for what you are going through. I wish I had the right words to comfort you but I believe that only time will make it easier for you. She may be in a better place now…R.I.P. little princess...
Thank you...I know. My brother sent me a whole you tube video on making the right decision about when the time comes, but it was all about being there when they are put down. He meant well, but boy did that bring back the guilt of not having been with her. I just can't get past that.

I can accept that it was her time, just looking at pictures I can see how much she changed and I can see the pain and confusion that started to show in her eyes compared to how she used to look.

I just can't accept that she went by herself surrounded by strangers, not with the one who loved her more than anything. I am so afraid that she was looking for me or waiting for me to come back. I wish I had stayed, then they could've just come and got me and I could've held her in my arms while she died...I just can't seem to get past that.

[labblab]

Oh Joan, of course I cannot know what was truly in Lena's mind that night. But truthfully, given how desperately she was trying to breathe, my guess is that her conscious mind and energy were totally focused on her own little body as the end neared. But then, if we can trust in the experiences related by humans brought back from the brink of death, at the actual moment of passing her spirit was connected with you and all her loved ones regardless of physical separation. You were with her at that moment of release because of the abiding love that filled her dreams and her memories and the very core of her being, even as the bright light beckoned her onward.

I know you wish so much that you were there to hold Lena. But my guess is the loss is more yours than hers because she made her passage knowing without doubt that she was loved. The far harder task falls to those of us who are left behind -- making peace with the aching wish to be able to hold our babies again for yet one more time. It breaks our hearts to think that even one precious opportunity was missed, and especially there at the end. I wish it weren't so, but I'm afraid this will hurt for a long, long time. But Joan, not because you failed Lena. However, you didn't get the chance to hold her and say goodbye yourself. Maybe in the coming days, though, you can find a different way to honor Lena and bid her farewell that may bring a bit of peace and comfort to soothe your aching heart.

Big hugs,
Marianne

[Joan2517]

My mind knows this, Marianne, but my heart won't let me accept it right now. I miss her every second :(

[Budsters Mom]

Your loss is so new and overwhelming right now. :o It has taken me oh so long to process my Buddy's passing. Even now, a few years later, it's still tough. It wasn't until I was able to accept that I did the best I could with the knowledge and resources I had at the time. Would I have done anything differently, most certainly, but I did my best and that's all anyone can do. There are always going to be regrets, but Buddy would want me to find peace with my decisions and I'm sure that Lena would want the same for you.

Big hugs,
Kathy

[Joan2517]

Your loss is so new and overwhelming right now. :o It has taken me oh so long to process my Buddy's passing. Even now, a few years later, it's still tough. It wasn't until I was able to accept that I did the best I could with the knowledge and resources I had at the time. Would I have done anything differently, most certainly, but I did my best and that's all anyone can do. There are always going to be regrets, but Buddy would want me to find peace with my decisions and I'm sure that Lena would want the same for you.

Big hugs,
Kathy
Thanks, Kathy...I am trying so hard to accept it the way it went down. It just seemed to happen so fast. I thought I would have more time, but I am still reading all the posts and seeing all of the other problems that she might have gotten and luckily didn't. I go back and forth.

I know we would've done anything we could have to make her well again if that was at all possible. I am relieved that she doesn't have to go through all the vet visits, which I know frightened her; I am relieved that I don't have to give her pills anymore, which she was starting to be suspicious of; and I know she was uncomfortable and seeing her confused broke my heart.

I know it was time because I would never let her suffer and I think she was beginning to. What I need to get past, is not being there with her. But when I held her in my arms after I got there, and looked down at her sweet face, she looked healthy again...there wasn't any of the stress in her face that I had been seeing for a while, so I know she was at peace.

[Joan2517]

As I have been reading and rereading a lot of these posts, I am noticing that a lot of the Cushing's diagnosis come after dental work. I know Lee had symptoms for at least a year before, but after her dental work is when everything started to get worse.

Within 2 weeks of her being knocked out for cleaning and tooth extractions, she exhibited exaggerated signs.

Is there some correlation between dental work and Cushing's?? Or dental work and contributing factors to the symptoms of Cushing's?? I have been wondering this since the beginning, but now it just seems to a huge question in my mind....

[labblab]

Hi Joan. I think the link you are noticing between dental work and Cushing's diagnosis relates mainly to abnormalities noticed on lab work performed prior to dental work being done. Most vets require blood chemistry panels to be run prior to sedating dogs for dental work. Among other things, this is to ensure that liver and kidney values are within normal range prior to administering anesthetic agents. For many dogs, this may be the first time that comprehensive blood panels have ever been run on them. If the lab abnormalities that are classic to Cushing's appear on those panels, the vets then scratch their heads and start questioning owners about other overt symptoms to which not a great deal of attention had been paid previously. Suddenly, things get scrutinized a lot more closely. And then, we're off and running...:o

Although Lena's situation might have been different, I don't think that dental work generally causes or accelerates Cushing's -- it's instead that pre-op dental labwork is a common way in which blood chemistry abnormalities are first revealed, and then other issues are more closely scrutinized as well.

Marianne

[Joan2517]

Her blood work didn't show anything, Marianne, at least as far as I was told. The next blood work done 12 days later after her drinking increased to a point where I was shocked, and I took her back, is where it came back so bad.

I was just wondering...I know it didn't cause the Cushing's because she obviously already had it. I just wonder if the dental work exasperated it and pushed it into overdrive.

I guess I'm still searching for reasons...the sadness is turning into fury now.

[labblab]

I'd forgotten that you'd said that Lena's pre-dental labwork was fine and then two weeks later there were serious blood abnormalities. If you are really wanting to make sense of the labwork, the best thing would be to request copies from your vet so that you can see what the actual results were.

Cushing's does not typically suddenly become acute or worsen such that lab results drawn two weeks apart would show drastic differences. It that is truly what happened for Lena, then perhaps something else occurred in conjunction with the dental work. Perhaps an infection spread from her mouth to another location in her body, perhaps even to her heart? Perhaps the anesthetic agent did some unexpected harm to her liver or kidneys? I don't know -- just tossing out some random thoughts. But if you are really wanting to trace the steps, I think getting copies of all of Lena's recent labwork is the place to start.

Before doing that, though, the question I'd want to ask myself is, "Will pursuing these questions help me, or will it make me feel even worse to dwell on memories of these last couple of months?" If you think it will help, then we will do our best to try to sort out the information. But I know for me, dwelling on confusing results or inadvertent mistakes that might have been made would not make me feel any better. At all. So I just want you to make sure this is the route you want to go before requesting those records and tracing back through Lena's illness, OK? :o

Marianne

[Joan2517]

I'll have to think on that. I will probably just blame myself for that too. When all is said and done, it really doesn't matter. She's gone and nothing will bring her back to me.

[molly muffin]

I agree with what Marianne said in that Most it the lab work is a discovery, there also as she also mentioned a risk of infection spreading and we've seen that before, not always with cushings, it is a risk for any dog that has an infection in tooth or gums and it spreading. It is even possible with a perfectly healthy dog. The alternative though is not having dental work done and then they still can get an infection from not having it done and that can spread just like if they had the teeth cleaned. So, really you see, it can go both ways no matter what you do and no one dog is more likely to have something happen than any other I don't think.

Cushings in itself is known to be hard on the heart. So, while it is more rare, it isn't unheard of to have dogs with cushings develop heart problems.
High cortisol just wrecks havoc on the body, in dogs, in horses and in humans.

I know it is hard to not "what if" we all do it, and I have yet to find anyone whose dog has passed who didn't to some extent feel guilty for something. It is the price we pay to be the caretakers of such wonderful, loving, loyal companions. We have so much responsibility for their lives that there is no way to not try and second guess ourselves, even after the fact.

What I have said so many times, is that for every decision there is a result. If we didn't take the road we do take, but instead of taken the alternate one, would the result be better or worse. It can go either way and we will never know the answer to that question.

I wish I could give you the words that would make you not doubt yourself but again, I think it is a natural part of the grieving. There is pain and loss and anger all associated with losing those we love so much .

[Joan2517]

Thank, Sharlene...I only just saw this this morning. I was reading Jen's thread about the Theophylline. I wonder if this is what happened that last night. My vet had given her a quarter pill of 100mg that afternoon and maybe because she was having breathing issues anyway, she just had a bad reaction to it and it pushed her poor little heart too much.

I know I will never know and maybe it was better for her, rather than for me to keep trying when she might have been just too tired to go on. I'm glad that she didn't have a lot of the other issues that I read about on this forum...I don't know how you all can bear it sometimes.

It's been one week today...I miss her sweet little face.

[Renee]

Hi Joan, I just caught up on your thread the past few days.

Please, be kind to yourself. The guilt can be overwhelming, but it will do nothing but hurt you now. Just like Sharlene said, for every action, there is a result. We can only do the best we are capable of doing and hope it's the right decision. Such is our burden to bear. You did an amazing job with Lena and even if all else failed, you loved her well, which is all they ask for.

[Joan2517]

I know, Renee...I am just having such a hard time getting past the guilt and the "what ifs" right now. I know I should stop searching because it is just making me feel worse.

I just thought I would have her a little bit longer.

[Tammysmom]

My dear Joan, I well know all the emotions you are feeling. I too feel like you. When my Tammy passed I felt intense pain and grief. An ache in my heart . Than I felt so much guilt and what ifs. And anger at the vets, thinking they did not do everything they should have done for her. These are all normal feelings. It has been almost a month, and the feelings at times are still there. But I try to switch my feelings to a happier time. When I first got this tiny ball of fur. The love and the fun we had. I know she knew how much I loved her. And she knows I tried my best to do what was right for her. So does your little Lena know this. . She knows how much you loved her and that you took the best possible care of her. The healing process will take a long time. . And our babies will never be forgotten. Brianna

[Joan2517]

Thank you, Brianna...I am so glad I found this forum, I know I am not alone. My family is afraid to call me because I'm always crying...and yesterday was so hard, one week! It is still so hard for me to believe...and so many people just don't understand.

Lena was not "just a dog", she was my baby, as Tammy was yours, as they all are. I cry every time I read about another one we lose on this forum, and I cry when I read the first threads when they come on so desperate and afraid, looking for help.

I have been able to think back at happier times, and I have been able to look at pictures and smile a little a few times in the last couple of days, so I know it is starting to get better. But sometimes the littlest thing will just hit me and I feel like I'm going to scream.

But I have my two rescues who are both 7 and our little teacup Chihuahua who is 11, they need me and they miss her too and I have to pull myself out of my sadness and try to enjoy the time I have left with them.

Lee will always be in my thoughts, my soul and my heart...I guess there is always that one.

Thank you, dear Brianna...

[Joan2517]

Two weeks today since you left me, my precious Lee. I still can't believe it. All time is now based on before and after. I miss you every second of every day.

I think Phoenix will be joining you soon, he won't eat anything and is drinking tons of water. You both got here the same year, I think.....it's hard to remember.

My darling girl, my precious angel, my beloved Lena....

Love, Mommy

[labblab]

Oh Joan, I'm so sorry to hear about Phoenix. Too much sadness within such a short time -- my heart goes out to you!

One of my closest friends in all the world was named Lena. We lost her to cancer two years ago, and I will always miss her dearly. She loved doggies with all her heart, and I'm betting my Lena is carefully watching over her little namesake until the time comes for you to be reunited with your sweet angel once again. My Lena will make sure no harm comes to your baby, ever.

Huge hugs being sent your way,
Marianne

[Joan2517]

Thank you, Marianne...loss is such a terrible thing to get over sometimes. I guess I just have to finish all of the stages, but they keep getting interrupted. Phoenix, who is a cat, is either in kidney failure or congestive heart failure and is in hiding. He is so afraid of everything that to take him to the vet will terrify him and I don't want to do that to him. He seems content with dying on his own.

And my husband brought home another teacup poodle last week without consulting me. I would have told him not to if he had asked. She is 2 months old and is the cutest little thing, but I have to work all day...so now instead of just missing my Lee, I have to miss Sybil as well, plus I was not ready to deal with this.

So now I will have to crate her all day and have another worry on my already overwhelmed mind. He just doesn't get it.....

[Joan2517]

A question:

What does this mean?

check her eyes to see if she has any dmgs from high blood pressure (signs of pheo)

I saw this on another post and was just wondering. Lena had something going on in one of her eyes the last few days....