Stella - 10 year old Corgi/American Eskimo mix (Stella has passed)

[StellaHealing!]

Hello everyone. So happy we found this forum.

Our 22 pound 10 year old Corgi/American Eskimo mix, Stella, was diagnosed with Cushings at the end of 2019. We went the holistic route for a while, guided by a wonderful vet. It finally reached a point where he thought Trilostane would be helpful, along with the supplements we’d already been giving her, which included Lignans and Melatonin. So we started off about 3 months ago at .005ml/5mg (Liquid Trilostane) twice a day. Since then we bumped up to .0075ml/7.5mg twice a day.

The good news is that her water consumption dropped way back down, her hair is growing back like wildfire, and all her labs look great.

Our only concerns are:

1 - She’s become a very picky eater. She’s also not finishing all of her food. She used to scarf down her entire meal in about a minute. I understand was a result of the Cushings but she had a pretty healthy appetite before the Cushings kicked in.

2 - Her energy level has dropped off. Getting her to go for walks is a bit of a chore and she just doesn't the seem like her self. The feedback we’ve been getting is that her body has been through a lot and now that the high levels of cortisol aren’t pumping through her system, she’s finding her new homeostasis.

She’s not due for another ACTH for about another month but my wife and I feel a bit uneasy with some of this behavior. Maybe the sluggishness is due to the continued use of Melatonin?

Love to get some feedback on this.

Thank you all so much.

Chris and Adele

[Joan2517]

Hi and welcome to the forum. When was Stella's last ACTH test? And what were those results? Please post the results of any Cushing's tests that she has had along with blood work, highs and lows only, with ref. ranges, please. That would be very helpful.

[StellaHealing!]

Thank you so much for the quick reply Joan.

Here you go. Please let me know if you need anything else.


Last ACTH was April 6.

Pre Trilostane ACTH in Feb. 2020:

CORTISOL SAMPLE 1 Result: 3:3 Range: 1.0-5.0
CORTISOL SAMPLE 2 Result: 35.9 Range: 8.0-17.0

First ACTH with Trilostane (March 12):

CORTISOL SAMPLE 1 Result: 4.4 Range: 1.5-6
CORTISOL SAMPLE 2 Result: 12.3 Range: 1.5-6

2nd ACTH with Trilostane (April 7):

CORTISOL SAMPLE 1 Result: 3:3 Range: 1.5-6
CORTISOL SAMPLE 2 Result: 8.6 Range: 1.5-6

3rd ACTH with Trilostane (April 24):

CORTISOL SAMPLE 1 Result: 1.7 Range: 1.5-6
CORTISOL SAMPLE 2 Result: 8.2 Range: 1.5-6

As far as her April 25 bloodwork goes, there were a few things that were a bit off:

Amylase - A bit low at 322. Range: 337-1.469
Urinalysis - Gravity: 1.014
Crystals: 1+ CALCIUM OXALATE DIHYDRATE (1-5)/HPF

[LtlBtyRam]

I am sorry you had to find us, but glad you did. There can be several reasons for this. I can not read the numbers like some of the folks can, and I am not as well versed in dosing. I can say the activity can very well be due to the drop in cortisol. If you are really concerned you may need to run an ACTH even though it isn't scheduled. Welcome to the forums.
Angela

[labblab]

Hello and welcome from me, too! Under these circumstances, I agree with Angela that I would want to proceed with another ACTH monitoring test now. I’m not sure how recently you increased her trilostane dose, but cortisol levels can shift over time, even when a dose is left unchanged. Since it’s now been two months since her last test and her behavior has become somewhat worrisome, I wouldn’t wait to recheck her cortisol. I’d go ahead now.

Her diagnostic ACTH was indeed consistent with Cushing’s, and the monitoring tests thus far have not been too low. But again, since her trilostane dose was increased at some point, her level may have drifted further downward since April.

If cortisol is not the issue, you could certainly try discontinuing the melatonin. I’m actually not sure what value there is in continuing with the melatonin and lignans for any reason, now that you’re treating with the trilostane. If your girl was doing well right now, I’d understand not rocking the boat at all. But since something seems to be amiss, you may well want to at least drop the melatonin to see if that helps.

Do let us know how things develop, OK?
Marianne

[StellaHealing!]

Thank you both so much.

So we've cut back the Melatonin considerably and are set for another ACTH on Friday.

I will keep you all posted.

Thanks Again!

[StellaHealing!]

I wish I had better news to report this morning.

We were unable to perform the ACTH on Friday because Stella didn't eat Thursday night or Friday morning. We stopped the Trilostane because of this. Stella has barely eaten since.

My wife and I are struggling and trying to remain present for our baby girl.

The one bright spot: Her labs and x-rays were all good. Her baseline morning cortisol was OK considering she hadn't had any Trilostane beforehand.

We are trying to get her into a specialist at the local VCA to possibly get an MRI as our vet mentioned that sometimes, although rare, the pituitary tumor can enlarge and cause neurological issues.

At a loss right now but we are putting one foot in front to the other.

Hope to have further answers soon.

🙏🏻

[labblab]

I’m so sorry to hear that Stella is doing poorly. Sadly, if her Cushing’s is caused by a pituitary tumor and there’s no other obvious cause for her inappetence and lethargy, an expansion of the tumor may indeed be the culprit. I know this from personal experience with my own Cushpup, a Labrador retriever. He was initially treated successfully with trilostane, but developed several neurological abnormalities a few months later, culminating in his refusal to eat and drink entirely. If all of Stella’s labwork was normal — especially her potassium/sodium balance and her cortisol level — then I’m afraid your vet is correct in terms of possible neurological involvement from the tumor. My own dog was was ill clear back in 2004 and the only available treatment for a macrotumor at that time was a prolonged series of conventional radiation treatments that would have spanned a month. For several reasons, we chose not to pursue that on his behalf and we did end up losing him to what we assume were the effects of the expanding tumor. Since that time, however, drastically shorter laser treatments have been introduced in certain vet schools and specialty centers. So if the tumor is the problem, treatment may be something you would want to consider for Stella.

I will warn you that imaging of the head, either via CT or MRI, is typically quite expensive. In our case, we had already decided that we wouldn’t put our boy through the radiation treatment even if a macrotumor was present, so we did not pursue the imaging, either. For that reason, we’ll never know for certain whether that was the cause of his problems. But as our specialist told us, any time a Cushing’s dog with a pituitary tumor but normal labwork stops eating, an enlarging tumor has to be suspected.

So I do think your vet’s advice is accurate, as sorry as I am to say so. My heart goes out to you in the face of Stella’s inappetence. I think there are very few issues that are as stressful for parents than the struggle to try to tempt a sick dog to eat. I’ll surely be keeping my fingers crossed that she’ll suddenly perk up on her own. But in the meantime, we’ll be right here if you have more questions or just want to vent. Please do keep us updated.

Marianne

[Squirt's Mom]

Prayers rising for Stella as well as the both of you. Please keep us updated and know we are beside you all the way.

Hugs,
Leslie

[StellaHealing!]

Thank you all so much. This site has made this process for my wife and I much more manageable. So we thank you for the words of support and encouragement.

2020 is the gift that keeps on giving. :(

Stella is our world. Lots of tears right now.

She is in good hands. I took her to ACCESS Emergency last night in the San Fernando Valley. She's going to be looked over by an internal medicine specialist and hopefully a neurologist.

Even though all signs point to an enlarging tumor, I am holding out hope for a miracle.

And if it is the tumor I know we still have options.

She's a STRONG girl. AND I will trust that the universe knows what's best for her.

Thanks you all!

[labblab]

We will surely be thinking of you and Stella, and wishing her well! Now that I’ve learned you’re in the greater L.A. area, I’ll mention that we’re aware of a noted endocrinological specialist in the area who helped pioneer a procedure that surgically reduces pituitary macrotumors. His name is Dr. David Bruyette, and one of our members was actually his first patient in the surgical pilot program that was a joint venture between U.C.L.A. and Cedars Sinai. I’m giving you a link to a reply I posted on another thread that provides additional information.

https://www.k9cushings.com/forum/showthread.php?3567-Macroadenomas&p=210327&highlight=Bruyette#post210327

At that time, Dr. Bruyette was the medical director at VCA West Los Angeles. He now provides consultation through this veterinary service:

https://www.veterinarydiagnosticinvestigation.com/about-us

I’m sure you’ll receive sound guidance from your new specialists. But I just wanted to let you know about Dr. Bruyette’s history, as well, since you’re there in the L.A. area. I don’t know whether the surgical intervention is still being offered, but he could always be contacted to find out.

Marianne

[Harley PoMMom]

Crystals: 1+ CALCIUM OXALATE DIHYDRATE (1-5)/HPF

Were the crystals ever looked into? One of my dogs had oxalate crystals, they can be very painful. With my boy, the crystals had to be surgically removed (twice). Holding you all in my thoughts and prayers, keep us updated.

Hugs, Lori

[StellaHealing!]

Hi everyone, this is Adele, Stella’s mom. I’ve been reading and deeply appreciating every response we’ve received from this incredible community.

Yesterday we had to put our precious girl down. She was scheduled for an MRI, but overnight there was swelling in her brain and body and she was no longer able to assimilate sodium. They call it diabetes insipidus. Apparently it’s caused by the pituitary tumor. One week ago she was showing positive signs and growing her beautiful furry coat. Of course this was an incredible shock and we are still wrapping our heads and hearts around everything... We are devastated.

Stella taught us more than anything to love fully and appreciate the present moment, so that is what we are trying to focus on and carry forth her wisdom.

A couple questions we wanted to put forth that we are grappling with…

1. Since Stella was a puppy, with fed her the best quality organic food we could find. She had nutritional supplements throughout as well. She walked every day and had the best veterinary care. We have a tough time reconciling that her bright light burned out a few months after her 10th birthday. A lot younger than many of our friends who don’t attend to their dogs as thoroughly. Anyone have any thoughts about why some dogs experience stronger longevity than others?

2. We are also stunned that just one week ago she was showing positive signs and then last Thursday completely stopped eating. We are amazed that the night before her scheduled MRI this condition that she had not even been diagnosed for would reveal so suddenly and dramatically.

Thank you all again for being there. We are so grateful to have found this wonderful group of people.

[labblab]

Oh Adele, I cannot tell you and Chris how sorry I am about your loss. To have your world shattered so abruptly carries such pain, and I do understand your questions. But I’m afraid we’ve yet to find answers as to what causes the formation of the tumors that result in Cushing’s. I don’t think it was anything that was within your power to prevent, though. Your excellent care of Stella gave her the best life possible for the time you all three were granted to share together. But whatever physical or genetic defect allowed the tumor to grow was simply out of your control. I really don’t think there’s anything you could have done to change that part of her destiny.

I do keenly sympathize with your pain, though. I lost my own boy just short of his tenth birthday, and it was the crisis of not eating or drinking that forced his release. When the brain is compromised to the extent that those most crucial and basic needs cannot be met, then we have no choice but to intervene. Undoubtedly Stella’s tumor had been growing for some time, and it just finally reached that critical stage where it was encroaching on other important areas of her brain. So even though the change seemed to occur overnight, it may actually have been brewing for quite a while. If there’s any comfort at all, perhaps it’s in knowing that Stella herself did not suffer for long, though, and that her life remained rich and full up until these very few final days. I am so touched by your username, StellaHealing! I know your fondest wish and hope was for her to be physically healed. But if that was not to be, then your greatest possible gift was to release her spirit from a body that was failing. It was her bright, brave spirit that you allowed to heal, after all.

We want you to know that Stella’s name has now been added to our special memorial list of honor:

https://www.k9cushings.com/forum/showthread.php?9294-Remembering-All-Who-Have-Left-Us-(2020)

She’ll always remain a part of our family here, as will you and Chris. Any time you’d like to return and talk with us more, we’ll be here. We know there’ll be very difficult days ahead. There may also be some days when you’d grant us the privilege of sharing some stories about your lives together. However you’re feeling or whatever you want to say, we’ll be here.

Once again, I’m so deeply sorry. But thank you so much for returning to let us know. I’m sending many hugs to you both, in loving memory of your precious girl.

Marianne

[Joan2517]

Oh, I am so sorry for you loss of dear, sweet Stella. It is devastating however they go...my Lena went in two days. One day she seemed fine, then the next two days were trips to the ER, where she died. We all understand your grief and loss.

[StellaHealing!]

Dear Marianne,

I have tears in my eyes reading your response and once again feel deeply touched by the warmth and support of this incredible group. Chris and I buried sweet Stella yesterday in her backyard and it’s been a rough night and morning. I’ve been up since 1 AM and hope I can take a nap later today. We know the grieving process takes time and patience, but at the moment we can’t imagine our lives without her. Or without this deep ache in our hearts.

I have decided to slow down some work projects so I can take some much-needed downtime and focus on healing. I also feel inspired to write a blog tribute to Stella which I will share here. Thank you for asking about her life.

We are so grateful to receive the invaluable support from this special group, and also wonder if you’re aware of or can recommend any local ZOOM support groups?

And thank you Lena2517 for sharing about little Lina. What a cutie! It’s so devastating when they go unexpectedly.

With warm, grateful and broken hearts,

Adele and Chris

[LtlBtyRam]

My heart goes out to both of you. The Cushing's journey is one of ups and downs until you aren't on it and every day you will wish you still were. When you are up to it I'd love to hear some of those stories and see more pictures.

[Squirt's Mom]

I am so sorry for the loss of your precious Stella. No words can take away the pain you are both feeling now....I know. That old saying that time heals all wounds is not right but time does give us time to learn how to live with those wounds. Writing has always helped me so I hope the same will be true for you as you put your cherished memories down on paper.

Know your baby girl will now be watching over you just as you did her all those years. She carries in her heart the love you all shared. One day when your work here is done Stella will be waiting for you as you cross that Great Divide. She will fly into your arms to cover you faces with kisses...and you will never be parted again.

My deepest sympathies,
Leslie



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….

Unknown

[labblab]

Dear Adele,

I’m really glad to hear that you’re allowing yourself some space and time to focus on taking care of your own needs in the midst of your grief. I know for myself, I grieved harder and longer for my Cushpup than I had for any other living being in my life. Everybody is different, but one of the things that helped me the most was having the chance to talk and write about my pain. Being able to share my feelings with my family here has always been so deeply important to me. I hope you’ll indeed post your thoughts here. You can simply keep adding to your thread here, or you can start an entirely new posting on our “In Loving Memory” subforum. We’ll welcome anything that you want to write in either place and at any time.

I also think a grief support group is an excellent idea. I’m afraid I don’t have a specific group to recommend, but video sessions are very commonLy offered right now by many therapists and counselors in the midst of COVID-19. I’m giving you a link to our resource thread that lists various groups that may be able to help you with some leads:

https://www.k9cushings.com/forum/showthread.php?171-Where-to-Find-Help-When-You-re-Hurting

Also, just for the heck of it, I just pulled up a Google search for “pet loss support groups in Los Angeles,” and it looks as though there may be some helpful options available to you there if you mount a similar search. So I wish you very good luck in finding support that will be meaningful to you.

I do want to add that we’d love to add a photo link to Stella’s memorial line if that would be pleasing to you, too. At any time, if you wish you can send a photo of your choice to us at k9cushings@gmail.com, and we’ll take care of the rest.

I’ll continue to be thinking of both you and Chris. Do take as good care of yourselves as you can, OK?

Marianne

[Joan2517]

Adele, there is also a Facebook group called Day By Day Pet Caregiver Support that I have gone on to every once in a while.

But this forum is where I can express my deepest sorrow and know that I am not alone. The first months after Lena died I had nowhere else to rant and rave, cry and scream about how unfair it all was.As much as my family love me, and knew how much I loved Lee, they could not deal with the enormous grief I experienced, and still do to this day. They would get that look in their eyes when I tried to talk about her, especially since I would end up sobbing. So I would let it all out here and knew that I would be surrounded by love and compassion because everyone here had lost a beloved dog of their heart, too.

So, we are all here for you; we know what you're feeling; and we understand completely.

Many, many hugs...

Joan

[StellaHealing!]

Marianne, thank you again for your wonderful reply and resources. We are so glad to have connected with this kind caring group. We thought something in person or a therapist might help as well, so again we appreciate the information.

I have been gathering images of Stella and processing grief through a writing a tribute blog in her honor which I will share soon.

And thank you Joan, I’m so glad this group has been so supportive for you. Losing your little one is the greatest grief in the world. In fact, a friend of mine sent me this article showing research that confirms losing a pet can be as difficult if not worse than losing a human loved one: https://theconversation.com/why-losing-a-dog-can-be-harder-than-losing-a-relative-or-friend-68207

Chris and I are still questioning how this happened so quickly. Our baby was diagnosed officially with Cushing’s September 2019, and we never would’ve imagined she’d be gone in less than a year. We had a beautiful burial for her and are talking to her every day. We are still in a lot of pain, but the waves of grief are thankfully a little lighter than the tsunamis they were the first few days.

Thank you again for listening and providing this supportive space. We send everyone else love as well ♥️

Adele

[StellaHealing!]

Hey everyone.

Chris here.

My wife Adele has been carrying the torch for the both of us as I lick my wounds. The days have gotten a bit lighter/brighter but last night I got hit again with some deep grief, sadness, and a NEED for more answers. I've been following up with vets and obsessively searching the internet to get those answers. I know this is part of the grieving process AND it's really been a struggle. Right now, I am trying to be present and let go. I will be checking back in from time to time but for now, here is a beautiful piece that Adele wrote about our amazing star, Stella.


From Adele:

Hello everyone,

I wrote a blog tribute to Stella and wanted to share it with our new friends here. Honoring Stella this way was very healing, and so far the piece has received much support from fellow animal lovers. We miss our baby so much, but at least we can return here to reflect and remember...and see her pictures any time. Hope you enjoy ��

https://adeleuddo.com/stella-a-legacy-of-love/

Adele

[Squirt's Mom]

What a wonderful tribute to your precious Stella. I could feel the love and joy and anguish as I read. There is no doubt your precious girl is watching you with such pride and love. Thank you so much for letting us be a small part of her journey.

Hugs,
Leslie

[Joan2517]

I cried through the whole blog...so sweet, so touching, so, so beautifully written.

[labblab]

Oh my goodness, what a beautiful tribute along with those stunning photos! Absolutely a perfect window into your lives together. Several years ago, one of our dear members here introduced us to the descriptor of a “dog-worthy” life. I’ve always found that term to be particularly meaningful, both while basking in the joy of a dog’s life while in full bloom, and also when having to weigh the heartbreaking decision of release at the end when the pleasures of living are gone. There can be no question but that Stella was gifted with an extraordinarily dog-worthy life while in your loving care. A wonderful home and abundant love while her body was as strong as her spirit, but the gift of release when her body had failed and her life here on earth could be dog-worthy no more.

It’s so, so hard to lose them, though. I think every human relationship, no matter how loving, is still complicated in one way or another. My relationships with my dogs have never felt complicated, though, in any way. Just pure love. Pure unconditional love. I guess that’s why losing them has torn my own heart apart in a way that’s different from even the humans who I’ve loved dearly.

Fare thee well, little Stella, on your newest journey. And more hugs and warm thoughts to you, Chris and Adele, as you continue on your own journey forward. Hopefully your dear memories will help to sweeten the path and ease the pain, at least a bit. But we know the steps can be very hard, and that’s why we’ll always be here to walk alongside you.

Marianne

[StellaHealing!]

Marianne, every time we receive a response here, one of us is in tears :) This is an incredible community and we are so lucky to have connected with such kind hearted people during this difficult time. I sincerely appreciate you reading the blog post. Stella is touching many souls, even in the afterlife. She continues to teach me and Chris much about LOVE. We are so grateful to have had such a precious dog daughter. And thank you for seeing her dog worthy life :)

[StellaHealing!]

Thank you so much dear Leslie and Joan. I sincerely appreciate you both reading the blog post. It makes us happy to share Stella with other dog loving souls. Leslie, that quote is so beautiful and something I will save. Hugs to you both x