Cushing's meds (Bella is now at peace)

[Luddeckens]

Hello! i'm new to K9 Cushings & my 9 yr old Lhasa/terrier was just diagnosed with Cushing's from a pituitary tumor. (funny because I have the exact same thing!) My question is, I need to decide between 2 medication's & I'm not sure which one to go with. It's between Vetoryl & Lysodren. Any suggestion's??

[judymaggie]

Hi and welcome to you and your pup! We are glad that you found us but am sure you wish you didn't have a reason to do so -- amazing that you also have Cushing's!

I think that, if we did a survey of new members, we would find that the majority are treating their dogs with Vetoryl (generic is trilostane). That is not to say that Lysodren is any less effective but rather than it seems as though vets are leaning towards prescribing Vetoryl -- perhaps because, if the initial dosage is prescribed per the protocol outlined by endocrinology experts as well as the manufacturer of Vetoryl (Dechra), there are fewer instances of overdose. Another advantage of Vetoryl is that, if a dog is feeling poorly, the Vetoryl can be stopped and then started again without any negative repercussions. You cannot do the same with Lysodren -- it is necessary to "re-load" the Lysodren which means building back up the original dose by administering a large dose for several days and then backing off to a few times a week.

My Abbie actually started off being treated with Lysodren -- not because I preferred that but because my vet had no experience with Vetoryl. After months of trying to get her cortisol under control, I was finally able to convince him that we needed to try Vetoryl and provided him the appropriate protocol and dosing guidelines. Abbie's cortisol quickly came under control after only one dose increase and has remained there for several months.

In order for us to provide the best guidance for you, we do ask new members lots of questions. I will get you started in that regard and I am sure others will be along to ask more! :D To begin with, if you don't have copies of the lab results from your vet, please obtain those. We are interested in blood tests that are noted as "high" or "low" along with the range for each one. If a urinalysis was done, please let us know what the specific gravity is as well as whether there is any protein in her urine. Please also give us the specific results of all the tests that were used to diagnose your pup's Cushings, i.e., ACTH (would be two numbers, a "pre" and a "post"; a LDDS (there are three numbers as results); an ultrasound, etc.

Please do tell us a bit more about your pup such as breed, weight and name.

We have a great resource forum where you can read a great deal about Vetoryl and Lysodren. Here is the link:

http://www.k9cushings.com/forum/forumdisplay.php?f=10

Looking forward to learning more about your pup!

[DoxieMama]

Welcome to the both of you! Does your vet have experience with either/both medications and the proper protocol? Do they have a preference and if so, why?

[molly muffin]

Hello. Welcome to the forum. Which medication does your vet have the most experience with and which one do they suggest.
There is a difference between how the drugs work in the body so you could read about each drug in our helpful resource section.
With lysodren you are eroding a bit of the adrenal cortex to lessen the production of cortisol. With vetroyl/trilostane yiunare interrupting the signal between the pituitary and the adrenal telling the body to keep making more cortisol.
I used trilostane with my dog. The key with that one is start low and slow. Starting at 1 mg per pound is considered the safest dosage to start with.

[Luddeckens]

Hi Judy, Thank you for the nice welcome & information...I think i'm going to give Vetoryl a try . Now comes the fun part in finding the cheapest dispensary. Bella is a Lhasa/terrier mix. She weighs about 19 lbs & is 9 yrs old. The first 2 test results are as follows:

10/18/16 Cortisol Sample #1 9.0 ug/dL Above Normal 1.000 - 5.000 ug/dL

10/18/16 Cortisol Sample #2 47.5 ug/dL Above Normal 8.000 - 17.000 ug/dL

"USG 1.016 1-2 RBC/hpf; cocci" - Not sure what this means..

These are all the test results for Bella to determine Cushing's. I did not opt to do a scan of the pituitary at this time because they tend to be slow growing & I would prefer to treat the Cushing's versus the tumor for the time being..




Hi and welcome to you and your pup! We are glad that you found us but am sure you wish you didn't have a reason to do so -- amazing that you also have Cushing's!

I think that, if we did a survey of new members, we would find that the majority are treating their dogs with Vetoryl (generic is trilostane). That is not to say that Lysodren is any less effective but rather than it seems as though vets are leaning towards prescribing Vetoryl -- perhaps because, if the initial dosage is prescribed per the protocol outlined by endocrinology experts as well as the manufacturer of Vetoryl (Dechra), there are fewer instances of overdose. Another advantage of Vetoryl is that, if a dog is feeling poorly, the Vetoryl can be stopped and then started again without any negative repercussions. You cannot do the same with Lysodren -- it is necessary to "re-load" the Lysodren which means building back up the original dose by administering a large dose for several days and then backing off to a few times a week.

My Abbie actually started off being treated with Lysodren -- not because I preferred that but because my vet had no experience with Vetoryl. After months of trying to get her cortisol under control, I was finally able to convince him that we needed to try Vetoryl and provided him the appropriate protocol and dosing guidelines. Abbie's cortisol quickly came under control after only one dose increase and has remained there for several months.

In order for us to provide the best guidance for you, we do ask new members lots of questions. I will get you started in that regard and I am sure others will be along to ask more! :D To begin with, if you don't have copies of the lab results from your vet, please obtain those. We are interested in blood tests that are noted as "high" or "low" along with the range for each one. If a urinalysis was done, please let us know what the specific gravity is as well as whether there is any protein in her urine. Please also give us the specific results of all the tests that were used to diagnose your pup's Cushings, i.e., ACTH (would be two numbers, a "pre" and a "post"; a LDDS (there are three numbers as results); an ultrasound, etc.

Please do tell us a bit more about your pup such as breed, weight and name.

We have a great resource forum where you can read a great deal about Vetoryl and Lysodren. Here is the link:

http://www.k9cushings.com/forum/forumdisplay.php?f=10

Looking forward to learning more about your pup!

[Luddeckens]

The vet basically left it up to me as to which med I wanted to go with...there are only 2 options, so I'm going to give Vetoryl a try...this sounds complicated to get the dosing just right in the animal world! But really, it's the same for humans- Ive had the same problem & still have a pituitary tumor & Cushing's after failed surgeries, so it's a complicated disease, that's for sure!


Hello. Welcome to the forum. Which medication does your vet have the most experience with and which one do they suggest.
There is a difference between how the drugs work in the body so you could read about each drug in our helpful resource section.
With lysodren you are eroding a bit of the adrenal cortex to lessen the production of cortisol. With vetroyl/trilostane yiunare interrupting the signal between the pituitary and the adrenal telling the body to keep making more cortisol.
I used trilostane with my dog. The key with that one is start low and slow. Starting at 1 mg per pound is considered the safest dosage to start with.

[molly muffin]

Yes it certainly can be. We've had several members use Diamondback for triolstane (the generic vetroyl) but call around to some online pharmacies you could order from and then have your vet call in prescription to the pharmacy of your choice. At 19lbs I would start at no more than 20mg if going with vetroyl, or you could do 19 with trilostane.

[rainiebo]

Hi, if you decide to go with Vetoryl - The least expensive website I have found is petcarerx.com. I was paying my vet $110 for a box of 20 mg. I had joined petcarerx for $50 last year because my Bobo had other health issues. I can now buy a box of Vetoryl for $40.00 from Petcarerx. You'll need to have your vet approve the prescription. Petcaretx will contact your vet. If you don't want to be a member - the cost is around $49. Best of luck finding the right meds for your pooch ! Raina

[Luddeckens]

Hello, my 9 yr old 19 lb Lhasa/terrier mix was recently diagnosed with Cushing's & I started her on Vetoryl - 10 mg, 2 times daily on 11/16 & today is 11/27 & I haven't seen any improvement. Is it too soon to see a change in her symptoms? She still has to pee every 30-45 min, her belly is still huge, etc...but maybe I haven't given it enough time. I know the vet will want to run tests on her 10-14 days after she's been on meds. The only thing that has changed is that she is super hungry, i think from the steroid.

[Joan2517]

Hello and welcome...why is she also on a steroid?

[DoxieMama]

Hi there, and welcome from me too! I'm sorry for the reasons you've come, but hopefully we can help provide you some comfort as you navigate this new territory. Eleven days may be too soon to see any changes. The first thing that seems to change is the need to pee so often and drink so much. I think then the hunger also starts to return to normal. The belly can take a lot longer to notice any changes.

Can you tell us more about her history? What tests were done to diagnose Cushing's - can you get copies of those results and share any abnormalities on bloodwork, as well as the results of an ACTH or LDDS test? That will help us provide you the best feedback.

I'm sure others will be along with more comments and perhaps more questions as well.

Let us know when you have that test scheduled and the results from that. Typically they don't recommend increasing the dose until she's been on it for 30 days, though a decrease would be done immediately if that's what is needed.

[Squirt's Mom]

MODERATOR POST: I merged your post concerning questions about Vetoryl into Bella's original thread. We like to keep all info about each pup in their own thread. This makes it easier to look back thru the history if needed. Thanks!

[Squirt's Mom]

Why is Bella on a steriod and Vetoryl? That is a bit like trying to put out a fire using gasoline. :confused: What is your vet's logic in using the steroid? I wouldn't expect you see much, if any, change with the steroid on board. ;)

[dsbailey]

"USG 1.016 1-2 RBC/hpf; cocci" - Not sure what this means..


My educated guesses:

USG 1.016 - would be low specific gravity on my test range of 1.015 - 1.050 - This is common in Cushings

cocci would be bacteria - Did the vet say or are you treating for a UTI? Also common but possibly why you've not seen any change in the peeing a lot.

[Luddeckens]

I might be wrong, but isn't Vetoryl a steroid?

[dsbailey]

"Kinda" - This is my best stab at it:

Trilostane (4α,5α-epoxy-17β-hydroxy-3-oxoandrostane-2α-carbonitrile) is an orally active synthetic steroid analogue that selectively inhibits 3 β-hydroxysteroid dehydrogenase in the adrenal cortex, thereby inhibiting the conversion of pregnenolone to progesterone. This inhibition blocks production of glucocorticoids and to a lesser extent, mineralocorticoids and sex hormones while steroid precursor levels increase.

ANALOGUE - a chemical compound that is structurally similar to another but differs slightly in composition (as in the replacement of one atom by an atom of a different element or in the presence of a particular functional group)

[Luddeckens]

I'm keeping my fingers crossed, for the past two days, she hasn't had any accidents...so maybe the med is starting to work! feeling hopeful...this is a complicated disease..i have Cushing's myself from a pituitary tumor & it's still not under control..but hopefully my pup will see improvements :)

[molly muffin]

i'm glad that you are finally seeing an improvement. Every dog is different and some take longer to see symptom resolution than others. It is also dependent upon how much the cortisol has come down.
The test will tell you a bit more. Remember on the same day, cortisol will drop for 30 days so even if it isn't where you want it yet, you can still expect to normally see a decrease on this dosage.

[Luddeckens]

Hello,

My pup has been on Vetoryl for a couple months now & still has some issues with peeing & drinking alot, but mostly in the evenings. So my vet has decided to split her dose so that she gets 15 mg in the morning & another 15 in the evening. My problem with this is that I will have to spend about $150. a month on meds, versus $52. a mo. Because these only come in capsule form, im not able to split a pill, so I will have to purchase 2 boxes of 5 mg & 2 boxes of 10 mg. Where before I was purchasing the 30 mg capsule & giving it to her once a day, in the am. Ugh! this is just crazy..first of all, why don't they offer this med in pill form? Secondly, why do they not make a 15 mg capsule?? Im sure it's because they can make more $$ this way. My question is, is there any way I can possibly open the capsule & split it into 2 doses so that I dont have to buy the 5 & 10 mg doses? help!

[DoxieMama]

Opening the capsule is not advised.

It is possible to get a compounded version of the medication, called Trilostane. Many members, including myself, have used Diamondback Pharmacy (in Arizona). They require a prescription from your vet but it is an option to consider that would reduce those costs.

[Luddeckens]

But is Trilostane the same med as Vetoryl?

[labblab]

Trilostane is the name of the active chemical ingredient in Vetoryl. So the active chemical ought to be the same in both the compounded and brandname versions of the medication.

Marianne

[molly muffin]

It is worth it to call Diamondback and find out what they would charge for a compounded trilostane perscription.

I also know some people who do a combination of vetroyl and compounded trilostane to make the right dose.

[Luddeckens]

So if im understanding you correctly, your saying that Vetoryl is the "brand" name version & there's also some kind of "compound" version? I'm sorry, but im not sure what your referring to when you say "compound"...are you meaning generic? Because I was told there is nothing generic for Vetoryl.

[labblab]

You are correct that there is no generic version of Vetoryl available. When we discuss "compounded trilostane," we are talking about custom doses of medication containing that active chemical that are prepared by individual pharmacies (as opposed to pharmaceutical companies). Here's an excerpt from a related reply that I posted some time ago to another member.


Trilostane is the active ingredient in Vetoryl, and for dogs who need doses or forms of trilostane that are not available in Vetoryl, there are veterinary compounding pharmacies that will custom-make individual prescriptions. Compounded trilostane is generally much less expense than Vetoryl which is a definite "plus." There are also some "minuses" as well, in that a recent research study has shown that the products obtained from some (unnamed) compounding pharmacies are more variable in both actual dose and efficiency than brandname Vetoryl. For this reason, some vets do not feel comfortable prescribing compounded versions of the drug unless a dog truly does not have another option due to the size of the dose needed. However, we realize that for dogs needing big doses like Chloe, or doses that require the combination of multiple Vetoryl capsules, the expense of Vetoryl can be overwhelming, and compounded trilostane may offer the only affordable option for continuing with treatment.

Marianne

[Luddeckens]

Ok so i just talked w/my Vet & they said they found a compound pharmacy that can dispense Trilostane for only $30. for a 2 wk supply! So for $60. a mo, that sure beats the $150. price! I wasn't sure what a compound med was, but it seems like its a pharmacy that will take your med & combine it into the dose you need. Be patient with me, i'm new at this! lol

[Luddeckens]

Thanks Marianne! i just read your post after I posted mine!

[Luddeckens]

Yikes! my pup is almost 10 & was diagnosed with Cushing's last December & has been taking Trilostane. This past week she hasn't been quite herself & has had some loose stools. Today when I got home from work, she had several, very runny accident's & I noticed blood in the stool. Iv'e called the vet & will take her in this Friday, but just wondering if this could be related to the medication, Cushing's, or ?? Any idea's? Does anyone else have this problem? She has had Colitis since she was very young, so some of the diarrhea isn't that unusual, but i'm concerned about the blood & her not feeling well. :eek:

[labblab]

Welcome back, and you'll see that I've merged your new question into your original thread. This way, we'll be able to consolidate your dog's entire health history in one place.

I believe that bloody diarrhea typically signals inflammation of the large intestine. If your dog has suffered from chronic colitis, it may be the case that the underlying condition is now becoming more severe. However, for dogs treated with trilostane, the onset of diarrhea/vomiting and lethargy can also signal an unsafe drop in cortisol level. In looking back through your thread, I don't see any mention of monitoring ACTH blood tests. Has your dog's cortisol level been checked recently, and if so, what was the result?

Regardless -- and especially if you don't have a vet visit planned until a Friday -- the safest course of action is to temporarily discontinue the trilostane altogether. Also, as you probably already know from her previous colitis, very bland meals of things like mushy white rice and boiled chicken or hamburger would be best.

If low cortisol is the culprit and she should continue to worsen even while off the trilostane, she may be in need of supplemental prednisone to replace the cortisol she is lacking. So I encourage you to remain in contact with your vet and immediately report any further degeneration. And please do keep us updated, too!

Marianne

[Luddeckens]

Hi Marianne,

Thanks for the feedback! I've been having Bella tested/monitored at regular intervals since the start of her medication. Right off hand, i don't remember what the levels were, but they are where they need to be. I have taken her off the medication for now, due to the diarrhea & bleeding, at least until I can get confirmation from the vet on Friday. She didn't have any accident's while I was at work today, so I'm hoping it's nothing serious. This Cushing's is so complicated! I have the disease myself from a pituitary tumor & I haven't had any scans done on Bella, so i'm not sure what the source of her Cushing's is, but the general consensus is pit tumor. If you don't suffer from the disease itself, the medication can cause serious problems, & if this is the case, maybe we can try a different med. I don't have a lot of $$ to do continual testing on her over the course of time, so I'm hoping we can nip this in the bud ! I love her dearly, so i'm really hoping this problem can be remedied soon..

[molly muffin]

It definitely could be a colitis flare up or the cortisol levels going low and her dosage might need to be adjusted downwards. I think you'll know more after the vet visit. It also could be a bacterial bug and an antibiotic would clear it up. My molly would get that frequently and I'd add in a bit of probiotic to settle things down.

[Luddeckens]

It definitely could be a colitis flare up or the cortisol levels going low and her dosage might need to be adjusted downwards. I think you'll know more after the vet visit. It also could be a bacterial bug and an antibiotic would clear it up. My molly would get that frequently and I'd add in a bit of probiotic to settle things down.

We'll the vet wasn't too thrilled that I took her off her Trilostane, but i was concerned about he bloody diarrhea. She wants her back on it, at least for now. She's really not that familiar w/Cushing's. She's only had 2 patients with it, so I was a little disappointed that I couldn't get the vet I had the last time I was in, but Banfield pet hosp seems to go through Dr's frequently, so it's difficult to stick w/just one Dr. She is treating the diarrhea only, at this time. Once that clears up, if it does, then she recommends getting a scan of her belly to see if there's a possible mass. They don't do them there at the clinic, so i would need to go to the local college/university for that. I'm really not sure I can afford it, & then the question arises, even if they did find a mass, would they treat her differently as far as her meds are concerned? I can't do surgery either. Plus she is 10 yrs old. She did take a blood & stool sample to rule out Giardia/parasites. One thing she did mentioned that has me questioning her experience, is that she was saying that most Cushing's is a result of an adrenal tumor. I was under the impression that most Cushing's tumors are pituitary? Can anyone shed some light on this? :confused:

[Harley PoMMom]

The majority of dogs with Cushing's have the pituitary type (85%), so you are right ;) And when a dog is presenting signs of being unwell, like diarrhea, the recommendation is to withhold the Trilostane.

How is Bella's appetite? is she drinking/urinating normally?

Lori

[Luddeckens]

Hi Lori, she didn't eat very well last week, but now seems to be back on track w/her appetite. She's drinking her normal amount, although when I took her off the Triolostane for those brief few days, she was drinking a ton. Now that I have her back on the med, she's not drinking an excess amount. I agree that Cushing's is most likely presented w/a Pit tumor, verses adrenal. Before I make any follow-up appointments, im going to make sure I get someone who has a lot of experience w/Cushing's.

[Luddeckens]

ugh, just got home after being gone for about 15 min & find a pile of diarrhea on the living room floor! thank God I have laminate flooring lol...but i had given her the diarrhea med about 4 hrs prior, along w/the Trilostane. I have a feeling this diarrhea is all from the med, but it could also be that she has a mass on her belly. The Dr said her belly was pretty big, which is the norm for cushing's, but she still feels that there could be more underlying problems...Just taking it one day at a time! will continue w/the Pro-Pectalin diarrhea med & see if thing's get better ..

[molly muffin]

Did the diarrhea stop prior to you restarting the trilostane?

Another thing is that if you can get copies of the monitoring ACTH tests, then seeing the actual numbers could be helpful. Not all dogs do well on a particular dosage. Did they do a follow up ACTH test to see if the cortisol went too low? That is a possibility and especially if diarrhea stopped and then restarted once medication was restarted.

It is not uncommon to have to adjust dosage sometimes.

Maybe try a 10/10 again, once there has been no diarrhea for a few days. Dependent of course on what the actual ACTH numbers actually are

[Luddeckens]

We'll my poor Bella still has diarrhea & this morning she vomited for the first time. I'm pretty sure this is all from the Trilositane, but the vet still wants me to keep her on it! Which doesn't make sense to me. But then again, this is only her 3rd patient w/Cushing's, she's not that familiar with it. In the mean time, I have her scheduled for an ultrasound with another vet clinic as my current vet at Banfield doesn't have ultrasound. Im just so furious because my Banfield Dr wont prescribe her something for the diarrhea again unless I bring her in & have yet ANOTHER exam. I just dont get it, ive forked out almost $1400. for all her Cortisol tests & my pup was just in to see her a couple wks ago, & now she wants me to bring her in again to disuss things?! what is there to discuss? She's the one who recommended that she have an ultrasound, the least she could have done is give her something for the diarrhea, until she can get in for her ultrasound next Saturday... So furious. I refuse to go back in to see her..i just dont have the funds to keep paying for this. And now that she's almost 10yrs old & bloody diarrhea/vomiting, i'm wondering how much longer she can take this. Even if they find a mass on her belly, i will have to put her down, but at least it would give me an answer & make me feel better about making a decision. Really sucks because there's only 2 meds for Cushing's & both have extreme side affects that need constant monitoring & adjustment. So if the problem is the med & I have to take her off of it, what other option is there really?? The other med is just as bad... grrrrrrr

[Squirt's Mom]

Are you saying this poor dog has had diarrhea for over 10 days and is now vomiting and your vet says to keep taking the Vetoryl (Trilostane)?! :eek::eek::eek::eek::eek::eek::eek::eek::eek::eek:

I cannot tell you how freaking scary that is!!!!!!! :eek::eek::eek::eek::eek::eek::eek::eek::eek::eek: :eek::eek:

PLEASE, in the name of all that is holy stop the Trilostane and get your baby to another vet ASAP. This could be life threatening - this is no joke. Please, please, please - get her somewhere NOW and have an ACTH done plus her electrolytes checked. The electrolytes are critical. Please, I'm begging you.....

[Luddeckens]

Yes, she's had diarrhea for a few weeks now. Mostly it's after she's eaten. She's drinking fine, but ive notice that now she will only eat boiled chicken & rice, she wont eat her regular food. I've decided to take her of the Trilostane, since im pretty sure that's what's causing her problems. The vomiting only happened once (this morning). I'm just going to keep a really good eye on her until I can get her in for her ultrasound next Saturday. I've had her levels checked several times since she's been diagnosed & each time it's over $300. I am on a very limited income at this time & just can't keep forking out all this money. When I originally got her, i was married & had a house & a yard. But now I just have my own income.-Life changes & because of that, sometimes our finances change. Don't get me wrong, I love her more than anything, but I also have to be realistic too. I myself have Cushing's from a pituitary tumor, so I know how daunting & challenging this disease can be. I still don't have my health under control. It's a very frustrating disease as there aren't many meds out there & the meds they DO have, have very serious side effects

[Luddeckens]

Does anyone know how soon after discontinuing the Trilostane, the side effects go away? if at all?? I took her off the med Friday & she still is having occasional diarrhea. Maybe it just take some time...

[Carole Alexander]

You might try adding a probiotic, like fortiflora or similar to her food. And no, stopping the trilostane is not an instant fix for the diarrhea if that's what is causing it; it does take a little time.

[molly muffin]

yes it can take time, and adding in a protibiotic like fora flora or another would probably help her too as Carole suggested. It's totally bizarre that a vet wouldn't give you something for the diarrhea.

Oh yes, we definitely know how expensive these tests are and how worrying the expense is. It sucks to have to pick and choose what tests to do and when but you have to do what you have to do.

Care credit is a possibility perhaps. I think you can look at it on carecredit.com A few people here have used it for vet bills.

[Luddeckens]

We'll i ended up taking her in to another vet today & I had to put her down. Aside from losing my husband, this had been the worst day of my life..im so heartbroken, she was all that I had. The vet did find an infection through blood tests, but she says the bloody stool & vomiting are most likely unrelated to the symptoms she was having. I felt I really didnt have a lot of options, staying on the Trilostane would be a bad idea, because her symptoms seem to be related to the med. Taking her off the med isn't good either, because then her cortisol is elevated & the other med has serious side effects as well. Please don't judge me, I did what I had to do..ive spent a fortune on her health issues in the last few months & her problems would have persisted, along with the cost of continual testing, I just wanted the best for her & I refuse to let an animal suffer. I miss her so much, she was all that i had, but knowing that she's no longer suffering brings me some sense of peace

[Luddeckens]

AND...this vet doesn't day Care Credit...which I thought was weird. I assumed everyone accepted it...

[DoxieMama]

Oh I am so sorry. No judgement here, don't worry about that. We always say, you know your dog best and only you can know when to make that final decision.

I am so sorry for your loss.

[rainiebo]

I'm so sorry to hear of Bella's passing. I don't judge you either. How can I - you have gone above and beyond in love and care. Be good to yourself - Cushings is a bitter enemy.

Best to you, Raina

[labblab]

I join in the sorrow of your loss. I can only imagine how empty and lonely your house is feeling this morning, and I want you to know that we'll always remain here for you. Both human and veterinary medicine have made great advances, but there are still times when answers cannot be found and decisions must be made based on loving instinct. There can be no question about your love for Bella, and we know you made the decision you believed to be best for her. That is what loving an animal requires of us, no matter how much pain it causes us, ourselves.

We know we can't change your loss, but we hope it may give you some comfort to know that Bella has now joined our special memorial list of honor:

http://www.k9cushings.com/forum/showthread.php?t=8383

At this sad time, thank you very much for returning to tell us what has happened. This way, we can always honor Bella and we will always be here to support you.

Always in loving memory of your dear girl,
Marianne

[Joan2517]

Awww, Raina....so sorry for your loss of Bella. You did your best for her and that is all we can do.

[rainiebo]

Hi didn't lose Bobo, the Luddeckens lost Bella. But appreciate the thought anyway.

[Luddeckens]

Oh I am so sorry. No judgement here, don't worry about that. We always say, you know your dog best and only you can know when to make that final decision.

I am so sorry for your loss.

Thank you Doxie's mama

[Luddeckens]

I'm so sorry to hear of Bella's passing. I don't judge you either. How can I - you have gone above and beyond in love and care. Be good to yourself - Cushings is a bitter enemy.

Best to you, Raina

Thank you for your kind words..yes, Cushing's is evil! I have the same disease & still don't have a handle on it.

[Luddeckens]

I join in the sorrow of your loss. I can only imagine how empty and lonely your house is feeling this morning, and I want you to know that we'll always remain here for you. Both human and veterinary medicine have made great advances, but there are still times when answers cannot be found and decisions must be made based on loving instinct. There can be no question about your love for Bella, and we know you made the decision you believed to be best for her. That is what loving an animal requires of us, no matter how much pain it causes us, ourselves.

We know we can't change your loss, but we hope it may give you some comfort to know that Bella has now joined our special memorial list of honor:

http://www.k9cushings.com/forum/showthread.php?t=8383

At this sad time, thank you very much for returning to tell us what has happened. This way, we can always honor Bella and we will always be here to support you.

Always in loving memory of your dear girl,
Marianne

Marianne, thank you so much..your words mean more than you can imagine. And thank you for adding her to the memorial list. hugs

[Luddeckens]

Awww, Raina....so sorry for your loss of Bella. You did your best for her and that is all we can do.

thank you my friend

[Squirt's Mom]

Oh I am so so sorry to hear this! :(:(:(:( My heart is broken thinking of your pain. Please know we are here if you need to talk...we DO understand and we DO know the agony you feel. We are here for you.

Our deepest sympathies,
Leslie, Trinket, Sophie, Fox, Bud, and all our Angels





"In the Candle's Glow"

Warm light coming from far below,
Twinkling, sparkling is the candle's glow.
All is well up on the ridge,
The place we know as Rainbow Bridge.

Furbabies sleeping in heaven's light,
Tended by candles in the night.
Peaceful dreams be theirs to keep,
As they slumber in this night so deep.

Hearts on earth that miss them so,
Take comfort in the candle's glow.
Watching for them in skies above,
Bound eternally by a cord of love.

Laura Hickman

[Bluester]

I am so sorry to hear of Bella's passing.

Laura

[Carole Alexander]

I'm very sorry that you had to put sweet Bella down. I know that it must be a terrible loss for you especially at a time when you are struggling with your own health issues. My sympathy and best to you,

Carole

[molly muffin]

I am so very sorry to hear of Bella's passing. I'm sure you are devastated by the loss and the circumstances. It is all a bit much on top of so many other things.
My heart goes out to you with sincerest condolences.

[Luddeckens]

Oh I am so so sorry to hear this! :(:(:(:( My heart is broken thinking of your pain. Please know we are here if you need to talk...we DO understand and we DO know the agony you feel. We are here for you.

Our deepest sympathies,
Leslie, Trinket, Sophie, Fox, Bud, and all our Angels





"In the Candle's Glow"

Warm light coming from far below,
Twinkling, sparkling is the candle's glow.
All is well up on the ridge,
The place we know as Rainbow Bridge.

Furbabies sleeping in heaven's light,
Tended by candles in the night.
Peaceful dreams be theirs to keep,
As they slumber in this night so deep.

Hearts on earth that miss them so,
Take comfort in the candle's glow.
Watching for them in skies above,
Bound eternally by a cord of love.

Laura Hickman



Thank you so much, i love the poem :)

[Luddeckens]

I am so sorry to hear of Bella's passing.

Laura

Thank you Laura

[Luddeckens]

I am so very sorry to hear of Bella's passing. I'm sure you are devastated by the loss and the circumstances. It is all a bit much on top of so many other things.
My heart goes out to you with sincerest condolences.

Thank you for understanding, yes, it is very devastating, I still can't believe she's gone...i look around for her & forget she's not here anymore...thank you