15 year old cocker spaniel on Vetoryl - Dagget is gone

[NMalfam]

Hello. I was here years ago when my Newfoundland Daisy was diagnosed with Cushing's quite a few years ago. Unfortunately she passed away quickly after starting Lysodren. You all were so helpful and supportive. I was unable to come back and thank you because I was just broken for awhile. So thank you.

Now, my 15 year old cocker spaniel, Dagget was diagnosed last spring, started 30mg of Vetoryl once a day, and did great! I mean absolutely wonderfully! In October he started breathing rapidly, fainting, etc. I took him to an ER and a cardiologist. He was hospitalized for three nights. They believe he had a blood clot in his lung, causing pulmonary hypertension. He nearly died, Viagra saved his life! He also has a heart murmur and is now on 8, yes EIGHT different meds plus Adaquin injections monthly.

Anyway, starting in October he lost his appetite. I mean he would barely eat hamburgers and pepperoni. He had an ACTH stim test in early October that was fine. I thought this appetite issue was from all the new meds. I mentioned to my vet about the issues, and noticed he'd lost 5 pounds, from 30 to 25, 4 of those since mid-October. But no one thought this was a Vetoryl issue.

Two weeks ago I finally insisted they do another ACTH stim test (I had been told we could go six months this time, so wasn't due for a few months). His pre level was 1.0. Post was 1.2. They did not test his electrolytes. The vet said to start him on a lower dose the next day. I called her back and made her call Dagget's internist at the specialty hospital (ya he has one of those because he had a gallbladder infection 3 years ago that nearly killed him) and i also said there's no way we will start him back on Vetoryl in any amount the next day. I had lost my border collie mix Lola to cancer that same week and wasn't about to lose Dagget.

As soon as I discontinued the Vetoryl, his appetite started coming back! This was two weeks ago. He now eats kibble with a bit of canned mixed in, not hamburgers and scrambled eggs! He's gained back a pound. He is also walking up and down steps much steadier and seems happier.

He had another ACTH test 2 days ago, 2 weeks after discontinuing Vetoryl. Pre 3.2 Post 9.6. Electrolytes normal. Vet is waiting to hear from the internist to see if we should get back on Vetoryl.

Sorry this is so long. Anyway, I guess I'm wondering if it's possible since his levels are actually normal after 2 weeks, if his levels might stay normal and he won't need vetoryl anymore? I feel like 1.2 post was dangerously low, but was it? It's is such a relief to see him eating normally again, and he seems stronger and happier without Vetoryl.

I'd love to hear any insights, ideas, experienced etc. I really love my little guy :)

Thank you!
Nancy

[NMalfam]

I forgot to mention, he was having terrible sticky diarrhea. That also has cleared up for the most part since taking him off of the Vetoryl

[labblab]

Hello, Nancy, and welcome back! Absolutely, I remember you and sweet Daisy, and how heartbreaking her loss was to our whole family. I’m so glad you’ve found us again, and I certainly hope that we can help keep Dagget comfortable.

From what you’ve described, it definitely appears as though the 30 mg. dose of Vetoryl was driving his cortisol lower than was safe or healthy for him. The good news is that his cortisol level has rebounded so significantly, so quickly. This implies that no lasting damage was done to his adrenal function. My best guess is that you’ll end up returning to the Vetoryl, but at a lower dose than before. Before doing so, however, I’d probably wait to see whether his cortisol keeps on increasing. If his post-ACTH never again exceeds the range of 9-10, then perhaps you’ll have somehow won the lottery and can dispense with the Vetoryl altogether. But as quickly as it has rebounded thus far, I’m guessing it will continue to elevate further in the absence of treatment.

You don’t mention the symptoms that initially led to diagnosis and treatment. At Dagget’s age, I’d mainly be focused on his quality of life. So if his symptoms were not making him really uncomfortable, then I’d consider foregoing the Vetoryl if he seems happier not taking it. One wild card, however, is the history of the blood clot. Uncontrolled Cushing’s has been linked to even a higher risk of blood clots, so that may be an issue that might sway your decision. You can always resume treatment at a much lower dose, however, and that might offer you the best of both worlds — a degree of cortisol suppression, but not so much as to recreate the unwanted side effects associated with the higher dose. It is not at all uncommon for Vetoryl doses to require adjustment over time.

In order to give you our best feedback, we’d love to hear more about Dagget’s overall health and treatment history, including the symptoms/testing that led to the Cushing’s diagnosis. We’d also like to know what the results of the October ACTH testing were.

Once again, welcome back. And from those early years, we forever join you in loving memory of sweet Daisy, and Rosie, too. I’m also so very sorry about Lola. You’ve sure had a lot to deal with during these last few months...

Marianne

[Squirt's Mom]

Hi Nancy and welcome back!

I am so sorry to hear about your sweet girl, Daisy. I will contact you later today to talk about that with you. For now, accept my deepest condolances.

Now for Dagget - since the vet started him on 30mg of Vetoryl that means he should have weighed 30lbs at that time. The starting dose is 1mg/lb. Can you verify that he did indeed weigh 30lbs?

Also if you would tell us all the medications he is taking since some should not be mixed with Vetoryl, including some for heart issues.

Here is a link about Vetoryl (Trilostane) from our Helpful Resource section. Please read up on the drug Dagget is taking so you are educated. This drug has the exact same risks as Lysodren so it is just as important that we know what to look for that indicates an over dose - loss of appetite, nausea/vomiting, loose stools/diarrhea, lethargy....AND so we know when the vet is not following protocol, which is very specific for this drug.

https://www.k9cushings.com/forum/showthread.php?185-Trilostane-Vetoryl-Information-and-Resources

Hugs
Leslie

[NMalfam]

Marianne,

Thank you for welcoming me back. I'm glad you and this website are still here.

Dagget's health was was very good until he was 12 years old. I noticed him straining to pee/poop but nothing would come out, he got weak, and would not eat. We discovered he had a severe gallbladder infection. The surgeon said Dag was too sick for surgery. We ended up treated him with two strong antibiotics for over a year, and also Ursodiol. After about 1 1/2 years of ultrasounds every few months, his gallbladder finally looked normal, yay!

So time went by and his bloodwork was all good except ALP. It was still crazy high, I don't have the actual numbers, but in the many thousands. He also was very hungry, at one point we had to put all the dog food AND the trash behind closed doors or he would find a way to get into them. Before we did, one morning I found him inside the heavy metal trashcan I had in the kitchen, he'd knocked it over and opened the lid somehow.

He didn't gain weight, I was VERY careful about feeding him and keeping him out of things. He drank a lot of water and peed in the house at that point. He did not have the large abdomen. HIs coat was more dull that he had been, but no hair loss, and I attributed that to old age. He was rather tired, but once again, old age.

His internist wanted to test for Cushings. I still thought it was all old age combined with a hearty appetite. They did the low dose dex test and it was positive for Cushings. Adrenal ultrasound showed adrenal glands were normal, so we didn't treat. a few months later another low dose dex test, still positive.

We decided to treat with 30 mg Vetoryl once a day. This was last spring. Within DAYS there was a positive difference. He stopped peeing in the house, appetite less ravenous, energy level increased. When my son came home from college a month later, he immediately noticed that Dag was acting like a puppy again! Very happy, rubbing against us, wagging his little nubby tail. I was SO happy.

Oh, by the way, I forgot to mention sometime during his gallbladder treatment he became deaf.

All of his ACTH stim tests were good. We did them regularly. Beginning of October vet said we could go 6 months until next one, woohoo! Then a few weeks later Dagget started breathing rapidly. Got very weak. Couldn't get up on couch and bed even with stairs. Appetite was nonexistent. I took him to vet, she said it was his heart murmur causing it. Blood work was great, and ALP was, for the first time in years, nearly normal! Put him on a few heart meds. But it got worse. Took him back, asked for more bloodworm, to test thyroid. I called on a Sunday to find the results. The vet was a sub who comes in for emergency hours on Sundays. I'd never met her. She said Dagget's blood work was normal but after reviewing his info said I needed to take him to the ER in Pittsburgh NOW.

So I did. They though was his heart at first, but found severe pulmonary hypertension. From a blood clot in his lung. After 2 nights said he prob wouldn't be able to come home. Third day gave him Viagra and he went home the next day, with oxygen for a couple days. He was very happy to be home and seemed okay. But appetite was terrible. I was cooking for him, chicken and hamburger...cardiologist told me to give him whatever he'd eat! He lost weight.

Cardiologist checkup a month later, pulmonary hypertension downgraded from severe to mild. Appetite still very very low. Weight down 5 pounds since spring. Adjusted some heart meds (ws now on 8 meds total) appetite unchanged.

I kept asking about a new stim test but none of the vets (regular and cardiologist) thought that was necessary. I finally just scheduled one, results were as stated above, 1.0 pre, 1.2 post.

Sorry this is so long, but idk at this point what is relevant and what isn't. I didn't write down his stim test scores from October, but I did ask before and they were right in the middle of the normal good range.

HIs vet called me earlier today, and I will post my questions a little bit later, as she is leaving the Vetoryl and testing decisions up to me.

[NMalfam]

Leslie

Thank you for replying! Dagget weighed exactly 30 pounds when we started the Vetoryl. He wasn't overweight. He dropped to 25 pounds, mostly since October, but has gained back a pound since we discontinued Vetoryl.

Here is a list of his meds:

1 Vetoryl 30mg 1x/day (currently discontinued.
2. Sildenafil(Viagra) 20mg 2x/day
3. Enalapril 2.5mg 2x/day
4. Pimobendan 7.5mg 1/2 pill 2x/day
5. Furosemide (Lasix) 20mg 2x/day
6. Clopidogrel (Plavix) 75mg 1/4 Daily
7. Ursodiol 250mg 1/4 Daily
8. Enoxoparin .1ml every 8 hours

He also gets Adequan injections about once a month.

[labblab]

Nancy, thanks so much for all this additional info. You’ve surely been taking such good care of Dagget in the midst of multiple challenges!

It sounds as though Dagget’s Cushing’s diagnosis and initial treatment plan was reasonable given his symptoms, testing, and weight. My major concern mirrors your own — when he started doing poorly, I believe there should have been a greater sense of urgency for monitoring retesting among the vets. Necessary dosing changes over time are commonplace, both upward and downward. So even though it does appear as if Dagget’s initial 30 mg. may have been appropriate, it also seems clear that it ended up being too high as time went on.

So what to do now? I think you’re on the right track by taking a wait-and-see approach. As time goes on, it’s entirely possible that you’ll see a rebound of Cushing’s symptoms if his cortisol continues to increase. If so, you can always resume the Vetoryl, but at a lower dose. In the U.S., Vetoryl is availble in 10 mg. and even 5 mg. capsules. So you would have a lot of flexibility in terms of dosing options.

If you do resume, I also want to point out one other potential “issue.” I see that Dagget is also taking enalapril. Medications of that class can act alongside Vetoryl to lower another adrenal hormone, aldosterone. Aldosterone controls the balance of potassium and sodium in the body, so it’s important to carefully monitor the levels of those blood chemistries when the two medications are taken in tandem. We do have members who successfully take both meds, but the combination does add another reason why regular monitoring is important since a potassium/sodium imbalance can make dogs ill even when cortisol levels remain OK.

Marianne

[NMalfam]

Marianne,

I didn't realize the interaction between Vetoryl and Enalapril. Thank you for mentioning that. Most times, when we did the ACTH stim test we also checked electrolytes, and thankfully they've been normal.

My vet heard back from the internal med vet, and the internist said we should start Dagget back on Vetoryl now, at 10mg twice a day. Remember his ACTH stim results were 3.2 pre and 9.6 post on January 25th after testing 1.0 pre and 1.2 post on January 8th. He has not been tested since 25th.

I would like to wait a little longer and test him again before we re-start Vetoryl, and my vet agrees that is reasonable. Especially considering the following.

We seem to have a problem now. I feed twice a day, morning and evening. Beginning yesterday, Dagget's appetite dropped. Immediately after discontinuing Vetoryl on January 9th, Dagget's appetite started coming back and was pretty normal after a day or two. Yesterday he refused breakfast. He also refused dinner. All he ate yesterday was not quite one whole scrambled egg and a couple pill pockets. It took hours to get him to finish the egg.

This morning he refused breakfast but did eat one whole fried egg and a pill pocket (with his pills).

I have spent so long trying to get sick dogs to eat. When Lola stopped eating in December she ended up having untreatable cancer. Diagnosed at a veterinary cancer center. They said there was nothing they could do. My vet thought it was just some arthritis pain lowering her appetite. It was a large mass in her liver that was already spreading. She had normal blood test results. Within a month she went from healthy and happy, to gone on January 7th.

My point is, maybe something else besides Vetoryl was causing Dagget's decreased appetite. He's had so much bloodwork and ultrasounds...but there could be something else going on that we don't even know about. I wouldn't have known about Lola's cancer until we x-rayed and ultrasounded her abdomen.

I don't understand why Dagget stopped eating yesterday. If it were Cushing's he'd definitely be eating MORE, right? Would rising cortisol levels ever cause a loss of appetite? I am so confused.

And how long should I wait before doing another ACTH stim test?

Thank you all for your help. Words cannot express how thankful I am for your support.

Nancy

[labblab]

The lack of appetite would be a concern for me, too, especially in relation to restarting the Vetoryl. Under these circumstances and given his age, regardless of ACTH level I would probably choose to await a rebound in Cushing’s symptoms and especially a return to at least a normal appetite. I do understand your worry about this, since there’s no way to ask him if he’s hurting or feeling ill. I think inappetence can be one of the most upsetting problems a pet parent can face and my heart goes out to you, especially given your recent experience with Lola. Since Dagget’s cortisol has increased to the level of the most recent ACTH, I agree with you that I wonder whether there may be something else going on with him right now. Increasing cortisol ought to make him more hungry as opposed to less.

I wish I had some great suggestions for you. But mostly I want you to know that we’re right here alongside you and hoping that perhaps tomorrow will bring a better report.

Marianne

[NMalfam]

Dagget ate a little better yesterday evening, but not nearly a normal amount. This morning he refused breakfast again, but he will eat small pieces of dog treats (Blue Stix) and took all of his morning pills in pill pockets. I don't really know what to do if this continues...something isn't right. I'm still afraid there is something else wrong that we have been unable to find. He is still off of the Vetoryl. Should I ask for an abdominal ultrasound? Lola's cancer progressed quickly. I might be over-concerned about this. An ACTH stim test result of pre 3.2, post 9.6 after discontinuing Vetoryl, would you expect to see a normal appetite?

I was reading a little about supplements for Cushing's dogs. I see that flaxseed lignans and melatonin are used..some say just for atypical Cushings, but I'm getting confused about that. Are there any supplements that are useful for Cushing's dogs? Has anyone been able to substitute supplements for Vetoryl/Lysodren and get good results? Is there any danger involved with supplements? I don't mean because of not giving Vetoryl, I mean can the supplements themselves cause issues? Can they lower cortisol too much or cause diarrhea or anything? Would they affect his appetite?

If anyone has had good results, I'd love to know the exact products used.

[labblab]

Hi again, Nancy. Yes, with an ACTH result of 3.2 and 9.6, I would expect to see a normal appetite level. So I share your concern that there may be something else going on with Dagget. One wild card that I hate to mention is the fact that Cushing’s-related pituitary tumors do have the potential to enlarge over time. When this occurs, the tumors can place pressure on the brain, resulting in neurological problems that can include inappetence. Unfortunately, the imaging of the head that could confirm an enlarging tumor is quite expensive and therefore not performed routinely. This may not have anything to do with Dagget’s appetite issue, but I always feel as though I need to at least mention the possibility to folks. If that is indeed the problem, you could expect to see additional neurological problems manifest over time: lack of thirst in addition to lack of hunger, lethargy, loss of coordination, seemingly mindless circling, head-pressing against walls or hard surfaces, etc.

But hopefully there is a more benign explanation that will still reverse itself. As far as the melatonin and lignans, any significant benefit is really limited to adrenal hormones other than cortisol. So I wouldn’t really recommend the use of these supplements in Dagget’s case. If anything, you might go ahead and ask for some low-dose prednisone to see whether a higher level of circulating hormone would actually kick-start his appetite. With a post-ACTH of 9.6, I wouldn’t think that prednisone would be helpful. But it might be worth a brief trial, just to see.

Marianne

[NMalfam]

After several days with no appetite, and some diarrhea with a little mucousy blood(called vet, they said probably colitis caused by him eating a variety of foods), he rather suddenly got his appetite back yesterday evening. He seems much more normal today, except for terrible smelling gas. He was more social today, even my husband (who doesn't really spend time with Dagget) noticed. So for now I'm just watching and waiting. If his Cushing's symptoms return, I'll get him tested at the time. Otherwise, I think the best thing is to wait a few weeks and then test. (ACTH stim I mean). Does that sound like a good plan? There is really no harm in waiting awhile for a 15 year old dog, right? He seems so frail to me compared to a few months ago. Maybe some of it is behavioral. I know my other dog, Barry the Saint Bernard, has been moping around since Lola passed. It's been one month as of yesterday. Dagget does perk up when my daughter or my sister come to visit.

I wish I had some idea of how much time Dagget has left. He was doing great before his blood clot/pulmonary hypertension in October. He seemed like a young dog again after starting Vetoryl, from last spring until October. Maybe I SHOULD put him back on Vetoryl asap. I don't know.

He weight 26 pounds last time at the vet. Assuming he's still at that weight (He seems thinner to me now though), would there be any benefit putting him on 10mg instead of 20? Or is that sub-clinical for a dog of his size? I wonder what the lowest dose would be for a 26 pound dog?

I'm sorry I'm rambling. I just keep thinking if I ask the right question, if I do the right thing, Dagget will feel better and live longer. I love this little guy so much. Thank you for your help and support.

[Squirt's Mom]

There is NO WAY I would restart the Vetoryl right now. First, he is not well and it is not good to give these drugs to dogs who are having other issues like your precious boy has been. Second, he would need an ACTH to see where his cortisol is now before restarting. So I would simply keep waiting and if he continues to improve AND you start to see those cush signs coming back strong, then do the ACTH and proceed from there based on those results. I'm very glad he is showing some improvements! I pray that trend continues but do not believe restarting the Vetoryl at this time would be good for him.

You're going a good job, mom, and I know how hard it is when we worry so much about our babies but hang in there!
Hugs,
Leslie

[NMalfam]

A couple weeks have gone by, and Dagget has finally started eating nearly normally. Not voraciously. I now realize he was food obsessed for years. About a week ago he started eating just dry food again, I no longer have to mix anything with it. His diarrhea is mostly better. I've started adding Fortiflora (a probiotic) with his food, but I'm not sure if that's helped much. I think eating his regular kibble is what has made the difference.

He's not searching out food and trying to get in trash. He pees a lot, but that is probably from the Lasix he takes. The only possible Cushing's symptoms I see are occasional panting lately and some slight skin flaking. Before we started Vetoryl last spring he had terrible flaking, which cleared up quickly on Vetoryl. He's been off Vetoryl since January 3rd. He has, just the past 2 days, seemed slightly week in the back end, but no falling, and he makes it up the outside stairs onto the porch just fine. He has some short bouts of panting now and then, but he also has fairly mild heart issues, and the pulmonary hypertension (which, last time we did an echo, was now mild, because they feel he had a blood clot that had resolved).

So I think I should NOT consider Vetoryl at this time...what do you think?

He's not his "old self". He still is way less affectionate. He chooses to not sleep with me. He sleeps under my bed, which is very strange for him. When he sleeps in the living room, he goes under a coffee table, and in the dining room he's always under a bench. Seems strange. Sometimes just his head, but he always seems to be under something. He gets very happy and wiggly when my sister or daughter visit. He's still happy to see me when I come in after being out. He often doesn't wake up at first but when he does, he's very happy. He still follows me to the bathroom etc. He's been doing that for over 15 years :)

I wonder how much of that is "Normal" aging? I have had a dog who lived to 15 before. Charlotte my golden retriever. She was completely herself until the end. She had severe arthritis and when she could no longer walk, even with steroid injections, we had to let her go, she was very distressed at that point. But she was 100% herself at 15. Does Cushing's make dogs less "cuddly"? I wish I knew what Dagget was thinking and feeling.

It's been nearly 2 months and I miss my Lola more than ever. Barry my Saint Bernard has been sulking and appears lonely and bored. He and Dagget aren't buddies. They pretty much have ignored each other for 4 years lol. Our cat, Pumpkinhead was close to Lola and now he is practically attached to me. He sleeps right next to me every night, under the covers. He didn't do that previously. Nobody greets me at the door anymore...Dagget sleeps deeply, and Barry the Saint Bernard just stares at me and wags his tail from the couch! We are still in shock that she could go from healthy, to "Maybe some arthritis affecting her appetite" to gone, in about 2 weeks. I guess I should be happy that Dagget doesn't have cancer (that we know of). I would never have guessed that Lola would leave us before Dagget. She seemed so healthy. Had blood work done twice in a year and all came back perfect.

I will have to tell the story of how Dagget picked me sometime. It was 15 years ago on January 8th. I have loved him deeply for 15 years. I don't know how I'll live without him. Lola and Dagget have been the most amazing friends.

Dagget is the last of an era...he even knew Daisy, who died of Cushing's 10 years ago. He knew Charlotte briefly. He's been here since my youngest child was 9 years old. Now he's 24 and lives in Russia! I want Dagget to live forever. I also do no want him to suffer, not one minute.

Sorry for rambling. I'm just feeling sad today. I think Barry the Saint needs a buddy, and I think it would cheer me up to get another. But I keep thinking I want a dog exactly like Lola. Border Collie/Brittany mix, female, red and cream...then I realize I don't want another dog. I want Lola.

[Squirt's Mom]

Good to hear from you again. :)

To my mind, much of what you are seeing in Dagget is simply aging...but on the other hand his hiding behavior reminds me of my Squirt just before she was diagnosed with Cushing's. However, I don't see many other things that remind of that time with her....more that remind of her in her last years as she grew older and older. Dagget has been off the Trilo long enough that he could be tested again without fear of the drug interfering with the results...but that is also a stressor for some dogs, so keep that in mind as you consider. When Squirt was 15 I took her off Lysodren and stopped all the testing unless it was a matter of life and death - she had been thru enough in my mind. She lived another year and few months, passing from old age, not Cushing's.

At times I find myself looking on PetFinder, thru rescue sites, and shelters looking for "another" Squirt. She's never there. She never will be there. But I look from time to time anyway. I also look for Trinkets and Bricks and Crystals...they are never there either. I think it is how I help myself grieve and honor them. Sometimes the emptiness they left behind is just too much so I look and dream and cry. My mind knows full well I can never replace any of them and if I tried it would be a serious disservice to them and to any dog I used for that purpose. Yet I still have to look from time to time. So look if you need. It's just our love for them bubbling over with no place to go.

Hugs,
Leslie

[Joan2517]

I've been doing a lot of reminiscing too lately. Missing the ones who have been gone for 30+ years and the ones who left only a few years ago; comparing the ones still here to the ones who are gone; and mourning for the ones I still have because someday they will be gone too. Must be this bleary winter....

Lena changed so much in the last year. Not wanting to be held, not wanting to sleep under the covers anymore; only sitting on me for a few minutes. Gable stopped sleeping upstairs after Lee died and will only sit next to me on the couch for a few minutes, but will lie at my feet wherever I am. He still knows who she was. When I talk to him about her, he always listens intently and tilts his head when I say her name.

I tell myself I will never have four dogs again, I'm too old and it's too much, but I do look at all the rescue posts and I think, maybe...if I saw one that looked like Lena, I know I would do it.

Such is the life of a dog lover, I think...

[NMalfam]

Joan, I just read Lena's thread over the weekend. I felt shocked when I read that she'd passed after being taken to the hospital. I assumed she must have done well, longer, since the thread was still active. She was one loved little girl! I cried and cried.

Barry does the same thing as Gable when I say Lola's name. I feel like he expects her to show up when I call her name. Or maybe I'm the one who expects her to show up. I still need to pick up her ashes, but they are in the "big city" (Pittsburgh) so I've been putting the drive off.

Yes, I think the gloomy weather has something to do with the reminiscing and I am very much look forward to spring!

If I saw a dog who looked like Lola and was the same mix of breeds, I'd jump in my car and start driving immediately! Border collie/britanny doesn't seem to be a common mix though, and that might never happen. Anyway, I should probably get Dagget's emergency vet bills paid off before I get another pup!

Nancy

[NMalfam]

Leslie

I think it does help me to think that I can find a dog "just like Lola", even though there is certainly no dog just like Lola! Well, you understand! I've just been missing her a lot the last few days although Barry seems to be sulking less.

I started Dagget on a new food yesterday Purina Pro Plan Bright Minds 7+. He loves it, and I know it's impossible, but he seems much more social and aware today, after just 3 meals. Maybe it just makes his stomach feel better. I'm really excited to see if his behavior continues to improve.

Nancy

[Joan2517]

She was loved beyond words, Nancy. I always loved all my pets. I've had so many...dogs, cats,birds, pigeons, ducks, even a swan. But Lena was different. It's been three years and I can still break down at a picture, a memory, a thought. I can still see the way she looked at me, or how she watched me. She knew all my moods before I even knew I was in one.

It sounds like Lola was that way for you. Even though it's heartbreaking to lose them, having them for those few years is a gift. I wouldn't have missed loving her no matter how much it hurts to have lost her.

It's freaky to have to go through it again with Gable. I didn't want to treat him at first because I was so afraid, but we're doing okay. We had a little bump a few weeks ago, but I think he'll be okay in a couple of weeks when we test him and hopefully raise the Vetoryl. He's only on 10mg for the last week or two, and I know he needs more, but we'll wait until the next ACTH test and see if he's come back up.

[NMalfam]

Well, here we are almost three months later. Dagget has had chronic diarrhea with blood. His vet prescribed Metroconidizal a couple months ago. She said there's nothing else she will/can do until Dag sees his internal medicine dr and cardiologists. Well, they can't see him until May 28th, so we've been dealing with this for quite awhile. He has okay days but isn't himself still. His appetite is not good. This weekend I got him to eat oatmeal with some smelly canned food. I have to change foods every few days. He will eat treats most of the time, so still takes his meds. Haven't done any testing for Cushing's since January, since he's not eating much.

He's been weak the last few days, having difficulty standing, and has needed assistance up the few steps leading to our backyard sometimes, but not always. Last week the diarrhea was awful. The last 2 days though he's had some actual solid-ish poops, but with blood. He mostly sleeps. He lays stretched out on his stomach with his arms sprawled out. He wants me in the same room with him, but does not cuddle. I am so depressed. I feel like I'm just watching him die. It feels like torture.

[Joan2517]

Maybe you should take him to an ER and get him seen by a specialist through the back door. That's what I was going to do with Gable if he started declining before his appointment the other day.

[Harley PoMMom]

Is the blood bright red or a black tarry color? Also, is he drinking a normal amount of water? One herb I would recommend is slippery elm bark: https://littlebigcat.com/health/slippery-elm/

[NMalfam]

Joan, I thought about just taking him to the ER.

[NMalfam]

The blood was bright red. I actually tried Slippery Elm Bark and it didn't help. Now, his poop is normal, after months of diarrhea and he was eating. For like days, he ate two meals a day, oatmeal mixed with canned food. Today, he doesn't want to eat. He's been so weak. I don't know if it's just all too much for him. I just want to curl up in a ball and cry.

[NMalfam]

I have an appointment for Monday with a vet that I trust. They call it a "quality of life" appointment. It might be time. But idk. He always bounces back. And he doesn't seem to be in pain. Just weak, tired. He won't eat his breakfast, but he ate treats. I just don't know.

[labblab]

Nancy, I’m so glad you were able to schedule this appointment. I can imagine what a hard spot you’re in, and I hope this trusted vet’s assessment will help ease both your mind and your heart. Sometimes a fresh pair of eyes can offer clarity that our own tired, tearful eyes are too cloudy to see. All decisions remain yours to make, but talking with this vet may give you some insight and maybe even some comfort as to the path forward.

I’ll be thinking of both you and Dagget all through the weekend — I’m betting that Monday can’t come soon enough at this point, and that you’re really anxious to head on in. We’ll definitely be awaiting any news that you can share,

Marianne

[Squirt's Mom]

If his bleeding worsens you may not want to wait til Mon but instead get him into an ER vet. If he just won't eat he may grow very weak very quickly with the bleeding.

I'll be keeping you and Dagget in my thoughts and prayers.
Hugs,
Leslie

[NMalfam]

I'm really sorry I never replied. I have been so busy with Dagget. Well, that vet decided it wasn't yet Dagget's time, and the diarrhea finally subsided, and we kept our appointment with the specialty vets: the internal med vet and the cardiologist. This was late May. They said his heart had not worsened (echocardiogram), and ultrasound didn't show any reason for the previous diarrhea, and his blood work was pretty much ok. They saw a small abnormality on his liver that was probably cancer or a tumor, but it was so small that they didn't feel it was causing any of his issues at the time. He started an appetite stimulant.

The stimulant worked! He started eating better. He was hanging in there. Poop was okay. Then he needed more help to stand. Oh, I forgot to mention he'd lost more weight. Ten pounds since October. Then he started peeing and pooping on himself in his sleep at night. Then also during the day. Finally he could barely walk. On June 27th, my 53rd birthday, my baby boy, after loving me for 15 1/2 years, passed peacefully at the vet's office. My son had returned after 10 months in Russia late evening of the 26th. I was so glad Ben and Dagget could say goodbye.

He'd gained back one pound, but the vet thought he had fluid in his abdomen that accounted for the weight gain.

I can't believe I lost two dogs in 6 months. The two best dogs I have ever known. I feel like my life will never be the same, will never be as good. I still have my 4 year old Saint Bernard, Barry. And the puppy, Toluca, half brittany, half samoyed. 4.5 months old now. Barry needed a playmate after Lola left us. I just want Lola and Dagget back.

I didn't realize how much care Dagget was requiring until he was gone. He was on over 10 meds. Two different ones were injections. He had to be washed twice most days by the end. I cleaned up the floors and the pads constantly. I would have continued that forever if he felt better. I loved him so much. He was here for half of my daughter's life and my son was about 8 years old when we got Dagget. He's 24 now. Thank you all for being here for me. It's meant so much to me.

[Joan2517]

I'm so sorry for the loss of your sweet boy. You and Dagget put up a good fight, but they don't live long enough, that's for sure. They leave such a hole in our hearts when it is their time to go....

[labblab]

Oh Nancy, I’m so very sorry, too. And please know that we’ll still be here for you always — any time at all that you might want to talk. You have had so many special loves in your life, and as a result, so many heartbreaking losses. So, so sadly, the one inevitably follows the other. As you say, we’d so willingly be their caretakers forever. But they’ve earned their angel wings and their freedom from all aging and pain. So as hard as it is, we try to be grateful for that, even through our tears.

Thank you so much for returning to let us know. We join you today in celebrating Dagget and Lola, and Daisy and Charlotte and Rosie before them. Forever remembered, forever honored, forever loved. Forever in our hearts.

Sending you tons of hugs from across the miles,
Marianne