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Thread: New here, Newly diagnosed. Stewie has passed

  1. #31
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    Default Re: New here, Newly diagnosed. Question about appetite.

    Try a break from meds I meant to say.
    Sharlene and the late great diva - Molly muffin (always missed and never forgotten)

  2. #32
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    Default Re: New here, Newly diagnosed. Question about appetite.

    Is it more common that one needs to take breaks from vetoryl since it is so tough on the system?? I'm not sure if I'm a big fan of that... If it is doing that much harm on the system you'd think you'd have to stop and find an alternative treatment rather then continuing...

  3. #33
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    Default Re: New here, Newly diagnosed. Question about appetite.

    No I wouldn’t say it is common to need a break from vetroyl and many dogs never need a break and are on it for years. That being said though for your specific case the liver and pancreas are showing some need for tender care. Whether this is from the vetroyl I couldn’t say but in general my personal opinion is to not give Cushing med to an animal that isn’t well. With the not eating and the US showing it might need to recuperate. It could be that a mild case of pancreatis occurred or it could be that it is on the verge of becoming. In which case I would stop meds and go with a low fat chicken and mushy rice diet. Smalll meals several times a day until better.

  4. #34
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    Default Frustrated with inappetence...

    I'm getting very frustrated with the inappetence Stewie has been having.

    Not too long ago we decided to take Stewie off Vetoryl due to inappetence, the vet and ultrasonographer felt it was negatively affecting him. He started eating a bit better since taking him off. We then decided to put him on a smaller dose two weeks after so that we could at least partially control his symptoms. We also have started him on Chinese herbal medicine Ophiopogon.

    We have taken Stewie off Vetoryl again. It has been two and a half weeks since he has really eaten much of a meal, he'd eat a third of his meal (tops) on occasion. Although the last two evenings he has eaten most of his dinner...

    I did realize about a week ago that he has an abscess in his mouth that may be partially to blame. He is on antibiotics now. We want to do a dental on him and remove any teeth that may be causing the problem, but at the same time he is not a very good anesthetic patient. His dental last year he was pretty light under anesthetic, he woke up part way through. The vet wants to send him to a specialist but says they may not accept him due to his bloodwork.

    At what point do you guys think it's not fair for them to go on like this?? I'm curious where others have drawn the line. I know it's a hard topic, and may bring up some bad memories. I just don't know anymore. I partly feel like this isn't fair for him, but I also don't feel like it's time yet.

    I've also been concidering going to internal medicine to see if they have any more insight. But the dental abscess kind of threw a wrench in that plan, I think it would be best to deal with that first if anything...

    Sorry for being all over the place...
    Here is one of my previous forums if you want to refer back for some reason. I thought Id start fresh with a new one... http://www.k9cushings.com/forum/show...about-appetite
    Last edited by MichelleJVM; 04-21-2018 at 10:51 PM.

  5. #35
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    Default Re: Frustrated with inappetence...

    For me, it's all about quality of life. Is Stewie still happy? Is he able to do what he loves most, at least some of the time. Does he have unmanaged pain? I knew when my Buddy had enough. I could see it in his eyes. I knew that he would hold on for me. That wouldn't have been fair to him. You know Stewie best. This is the toughest question any pet parent EVER has to answer. I am so sorry.
    Kathy and Angel Buddy. The mightiest of all lizard hunters!

  6. #36
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    Default Re: Frustrated with inappetence...

    I feel like Stewie is still happy, he still has life left in him. I feel like there could be some unmanaged pain, but I don't know for sure. He is definitely weaker then he used to be, and has lost weight due to the inappetence.

    I'm don't necessarily think its quite time for him but I feel like I need to keep it in the back of my mind because I don't want him to suffer.
    Last edited by MichelleJVM; 04-21-2018 at 11:54 PM.

  7. #37
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    Default Re: Frustrated with inappetence...

    I have merged your latest post concerning frustration over Stewie's appetite into his original thread. We like to keep all posts about each pup in their own thread. That way it is easier to keep up with the history for us and for you.

    I wouldn't give up just yet. Finding the abscess in his mouth may account for a lot of his disinterest in food. Once that is healed he may feel much more like eating. Wouldn't it be nice to learn this has been his issue all along!

    As for the question of when is the right time, that is a very personal thing and we all approach it differently but I always go to what one of our members said years ago - they deserve a dog-worthy life and as long as they can enjoy a dog-worthy life then it is not yet time. What is a "dog-worthy life"? That is a life in which the dog still enjoys things like sniffing as they walk along or in new areas, barking at the mailman or the dog next door when it comes out, chasing that cat who comes by every now and then, interacting with their people and other animals in the home, enjoying their food, wanting attention like ear and belly rubs and so on. You know your baby best of all and you know the things Stewie has always enjoyed doing. As he starts to lose interest in things, and they all do as they age, then you need to decide what things make Stewie's life dog-worthy. Another member here said she listed I think 5 things her baby liked and when her baby no longer enjoyed those 5 things, it was time. Another member believes it is flat out wrong to release them; she believes we leave it up to them unless they are in obvious pain...and her baby remained with her even tho he could no longer walk, void, drink or eat on his own. So the most important thing in this decision is your knowledge of Stewie. YOU will know when he has had enough because YOU know him best of all. But for today, I would put this all on the back burner and see if getting his mouth taken care of puts him back on track.

    Hugs,
    Leslie
    "May you know that absence is full of tender presence and that nothing is ever lost or forgotten." John O'Donahue, "Eternal Echoes"

    Death is not a changing of worlds as most imagine, as much as the walls of this world infinitely expanding.

  8. #38
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    Default Re: Frustrated with inappetence...

    I was curious about when people may make a decision more specifically geared toward Cushings patients. If there was some sort of pattern most Cushings dogs go through near the end. I know it is my decision, I have my own thoughts on this. I just don't know what further things lay down the road. He's obviously not going to improve if we take him off Vetoryl. I can't exactly let him eat nothing for multiple months on end, that doesn't seem right or fair (let's just assume we go through the dental and appetite doesn't improve... For the sake of argument).

  9. #39
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    Default Re: Frustrated with inappetence...

    My guess would be that if the inappetence does not resolve after the dental procedure, it may become a deciding factor for you. Clearly, something shifted for Stewie back last fall when his ravenous appetite took a 180 degree shift. Diagnostically, I know you have tried hard to sort it out, but to no avail. One possibility that we’ve not yet discussed is an enlarging pituitary tumor that is placing pressure on the part of his brain that controls appetite. A large pituitary tumor could account for both his other Cushing’s symptoms as well as his appetite drop-off. I believe there were some adrenal nodules noted on his ultrasound, but I don’t think an actual adrenal tumor has been identified? If not, then we’d have to suspect that it’s a pituitary tumor that is causing his Cushing’s, and appetite problems can result from that. Unfortunately, continuing to give trilostane to ease the other Cushing’s symptoms may result in greater brain inflammation since cortisol acts as a natural anti-inflammatory. For dogs with suspected pituitary macrotumors, the recommendation is often to stop the trilostane, and sometimes even to additionally give supplemental prednisone. Of the competing issues, not eating is more immediately critical than are most conventional Cushing’s symptoms.

    My own Cushpup developed symptoms consistent with an enlarging pituitary tumor, including loss of appetite, lethargy, pacing, loss of coordination, etc. Rather suddenly, he completely lost the desire/ability to eat or drink at all, and rather than supplementally sustain him, my husband and I decided the most compassionate thing was to release him since without dramatic intervention he would not be able sustain any semblance of a normal life. If an enlarging tumor was the cause, he would not improve in the absence of extensive radiation treatment which we did not choose to pursue. I know many people do not feel as though it’s the right thing to do to intervene to end a companion’s life through euthanasia. But I feel as though it’s as much of an intervention to prolong an animal’s life beyond the point that he or she could survive in the natural world. As long as there’s quality of life, the action seems justified to me. But if the animal is mainly just “existing,” then not so much.

    At this point, we don’t know what is causing Stewie’s inappetence. But if it persists and worsens, it seems inevitable that he will suffer increasingly severe consequences from the malnutrition. And at that juncture, you’d have to decide whether there’s any intervention you’d want to consider vs. releasing him.

    I really, really hope this dental procedure will turn things around! But if not, I don’t know how many diagnostic stones are left for you to turn over. A dog with no appetite is not a healthy dog. But how long Stewie can continue in this manner remains a big question mark. He may continue on a gradual downward slide, or like my own dog, a crisis may force a decision. I’m so sorry that I can’t offer you a more definitive answer.

    Marianne
    Last edited by labblab; 04-24-2018 at 07:51 AM. Reason: To reword.

  10. #40
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    Default Re: Frustrated with inappetence...

    Thank you Marianne, that was very well written and helpful.

    Just an update: Stewie has been very weak this past week, he has been for a while- but more so now. I took him for a walk with my friend last week Monday, he was very slow, which wasn't unusual at the time. Since then its been harder and harder for him to get up the stairs, and on the couch (even with a step stool). The last two days especially he has been noticeably limping. Last night he was extremely restless, whimpering and in pain. I contacted his vet and they said to up his pain meds and do it three times a day instead of two times. He has not been restless or whining since. But he definitely doesn't want to move or do much.

    The plan is to do a bunch of x-rays on Wednesday, possibly take the tooth out that is still infected- under local block (since he isn't stable enough for anesthesia). The vet has always been convinced that something more is going on then cushing's. We don't think this limping is from injury but it will be ruled out on Wednesday. Until then he will be under my constant supervision...

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