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KjobakerOhio
11-25-2009, 07:19 PM
Hello everyone. My 11 1/2 year dachshund (Millie) was in good health prior to 10/26/09.

Millie had been on Lysodren from 11/3/09. The Lysodren caused her to be very ill so she was removed from that drug and after being in ICU for 4 days (that's another story for another day), they now have her on Trilosane. On 11/20/09 a CT scan revealed her 7mm pituitary macroadenoma.

Today was her 3rd dose of Trilosane and she has started to have diarrhea.

Next week (Tues. ) we have an appointment to see a radiologist to talk about radiation.

I don't feel she is healthy enough to withstand that kind of treatment. She's recovering from cellulitis (vet tech drew blood and didn't shave her and take precautions to keep her from getting an infection). Her liver is swelled and her numbers are off the chart.

Any suggestions on how I should approach this nasty tumor?

Thanks, Karen Baker

AlisonandMia
11-25-2009, 07:49 PM
Hi and welcome to the forum.

I don't have a lot of time right now the reply but I sounds very much like you should stop the trilostane for the time being.

When a dog has been on Lysodren (and particularly if there has been an OD) you need to wait a good month before starting to use trilostane (the same applies if going from trilostane to Lysodren, too). This is what the manufacturer of Vetoryl (brand-name trilostane) recommends.) There should also be testing done before starting on trilostane to ensure that the cortisol levels are indeed elevated after the Lysodren treatment.

It's very likely the diarrhea she is experiencing now is a result of her cortisol going to low and she could well be heading for trouble like she had after the Lysodren - so stop the trilostane for the time being.

How much does Millie weigh and what dose of trilostane has she been on?

Good luck and keep us posted.

Alison

KjobakerOhio
11-25-2009, 07:54 PM
Hi Alison,

Millie is on 30mg. a day. She was released from ICU after battling cellulitis. She had all the testing to check her levels.

I did question the IMS about her going from Lysodren to Trilosane and he said the Lysodren is gone within hours.

Can you link me to reference material that says to wait 30 days? I will forward this to him tomorrow.

I would write her whole story (which I tried) but it limited me to 1000 words.

Thanks, Karen Baker

Harley PoMMom
11-25-2009, 08:02 PM
Hi Karen,

Here is that link for you:

Trilostane/Vetoryl Information and Resources
http://www.k9cushings.com/forum/showthread.php?t=185

Dechra's U.S. Product Insert Link:
http://www.dechra-us.com/File/prod_vetyrol.pdf

Dechra's U.S. Product Insert



Mitotane (o,p'-DDD) treatment will reduce adrenal function. Experience in foreign markets suggests that when mitotane therapy is stopped, an interval of at least one month should elapse before the introduction of VETORYL Capsules. It is important to wait for both the recurrence of clinical signs consistent with hyperadrenocorticism, and a post-ACTH cortisol level of >9.1 μg/dL (>250 nmol/L) before treatment with VETORYL Capsules is initiated. Close monitoring of adrenal function is advised, as dogs previously treated with mitotane may be more responsive to the effects of VETORYL Capsules.

Hugs.
Lori

littleone1
11-25-2009, 08:13 PM
Hi Karen,

It's good to see you here. Welcome to a great group of people. They really do care and have so much valuable information to share. I hope you can get some of the answers that you need.

Millie is so lucky to have you as a mom. Please give Millie a big hug from me and kisses from Corky.

KjobakerOhio
11-25-2009, 08:35 PM
Thanks Terri for leading me here to this group. I have to say I don't understand how this website works but I hope to catch on quickly.

Millie's not having a good day. She took her 3rd dose of Trilosane and is starting to have adverse affects.

Have a wonderful Thanksgiving with the "Corkster". :-) - Karen

littleone1
11-25-2009, 08:51 PM
You are very welcome, Karen.

I hope Millie will improve.

I know it took me some time before I was able to catch on to how to use the original website. I'm sure it won't take you as long as it took me.

The "Corkster" and I send you and your family, furbabies included, our best wishes for a Happy Thanksgiving.

Harley PoMMom
11-25-2009, 10:25 PM
Thanks Terri for leading me here to this group. I have to say I don't understand how this website works but I hope to catch on quickly.

Millie's not having a good day. She took her 3rd dose of Trilosane and is starting to have adverse affects.

Have a wonderful Thanksgiving with the "Corkster". :-) - Karen

Hi Karen,

First let me give you a proper welcoming! Welcome to you and Millie from me and my boy Harley. :) If you have any questions about the site you can either PM a Moderator/Administrator and there is also a FAQ (find answers to questions about how the board works) at the top of the screen.

You will want to always post your information/questions about Millie in your thread here, that way all her info is kept in one place.

I totally agree with Alison that you should withhold giving any more Trilostane. The one most important protocol of treatment is never giving Trilostane or Lysodren to a sick pup. And especially now that you have the copy of Dechra's product insert stating that there has to be a 30 day wash-out period between Lysodren and Trilostane usage.

Oh Karen, some vets are just clueless when it comes to this cushings disease, believe me we feel for you sweety, most of us have been where you are now. So trust me when I say that you are not alone on this journey, we are here for you and we will help you anyway we can.

Right now try to read as much as you can, you are Millie's only voice, her only advocate so try to educate yourself as much as you possibly can because of the ineptness of some vets. :mad::eek:

Helpful Resources for Owners of Cushing's Dogs
http://www.k9cushings.com/forum/forumdisplay.php?s=&daysprune=&f=10

Links to Cushings Websites (especially helpful for new members!)
http://www.k9cushings.com/forum/showthread.php?t=180

Hugs.
Lori

PS
I see that Terri and you are previously aquainted...Terri is a very special and wonderful person and so is the Corkster. :)

SachiMom
11-26-2009, 12:48 AM
Hi Karen,

And Welcome.

I would also suggest that you temporarily discontinue the trilostane, at least until you see the radiologist. The excessive cortisol does it's damage over time, so a few days without it should not hurt. Also, I think that prednisone (a steroid, of which cortisol is one) is used to shrink the swelling of the tumor.

If Millie is not tolerating trilostane, or the resulting lower cortisol, you really don't want her to have additional problems over the holidays where regular vet care is scarce. Did your vet give you prednisone to give her in case she had a severe reaction? It could be very helpful.


I did question the IMS about her going from Lysodren to Trilosane and he said the Lysodren is gone within hours.
Hmmmmmm. This bothers me. I am not that familiar with lysodren, but perhaps the actual pill is gone is a few hours, but the effect that lysodren has on the adrenal cortex can last for days. It erodes it so that it will produce less cortisol. It takes time for it to regenrate and produce the excessive cortisol again, then you can start trilostane which has a more immediate, although short term, effect on the cortisol.

Hopefully others will elaborate. But in the mean time, please consider withholding the trilostane, if not until you see the radiologist, at least until Millie feels better. It sounds like she has had a rough month.

Keeping you both in my thoughts and prayers.
Healing prayers for Millie.
Hugs ~ Mary Ann

MiniSchnauzerMom
11-26-2009, 02:01 AM
Hi Karen,

I've got nothing to add to the advice/info you've already been given but I did want to stop by and say "Hi and Welcome" to you and Millie. I'm sorry that Millie was in the ICU battling cellulitis, is experiencing diarrhea now and has also been diagnosed with a macroadenoma.


I would write her whole story (which I tried) but it limited me to 1000 words.

I would definitely be interested in reading Millie's complete story. It's ok once you hit the 1000 word cut-off to continue her story in another post. :D

I'll be thinking positive thoughts for Millie next week when you discuss the possibility of radiation treatments for her with the radiologist. Another forum member, January, had successful radiation treatments for her dog Serena. If you're interested in reading her story, the original thread is in both .doc and .pdf formats in the archives. Here is the link:

http://www.k9cushings.com/forum/showthread.php?p=9620#post9620

Take care, Karen, and I do hope Millie is feeling better soon. Please keep us updated.

Louise

Franklin'sMum
11-26-2009, 06:52 AM
Hi Karen and Millie,

I just wanted to pop in and welcome you:) You have been given some great information, from incredibly wise and caring people.

I hope all goes well with Millie, I do hope you will discontinue the trilostane for the time being, and please keep us posted about her trip to the radiologist.

Jane and Franklin xx
________
ASS MOVIE (http://www.fucktube.com/categories/5/ass/videos/1)

Squirt's Mom
11-26-2009, 04:30 PM
Hi Karen and a belated welcome to you and Millie, :)

In reading through your thread, I am concerned about Millie's difficulties this last day or so. If I understand correctly, there was no wash-out between the Lyso and the Trilo? This can be dangerous. I am not sure what you mean by "starting to have adverse affects" but if that includes lethargy, diarrhea or vomiting, STOP the Trilo immediately and give her some pred as these are signs of an overdose. An overdose is more likely without a wash-out period because there are two drugs working on the same problem at the same time. If it were me, I would not use the Trilo again until a period of 30 days has passed, her signs have returned and an ACTH says her levels are rising again.

I have some links on macroadenoma to give you so you can read up on them and the treatment options, etc.

I am glad you found us tho I am sorry you and Millie have a need for us. We will help you any way we can and walk this journey with you every step of the way. Like others have said, I would love to hear Millie's story! :)

Happy Turkey Day Hugs,
Leslie and the girls

The links:

pituitary macrotumors
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1852601&blobtype=pdf
http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/101800.htm
http://www.lvlabs.co.uk/pdf/200804.pdf
http://www.ivis.org/special_books/braund/braund26/ivis.pdf

AlisonandMia
11-26-2009, 05:50 PM
I would write her whole story (which I tried) but it limited me to 1000 words.



I've just been looking into the limit of 1000 words. We have it set so the maximum number of characters per post is 100,000 - which should equal approximately (very rough estimate here!) 20,000 words.

I wonder, was it the Visitor Message that limited the number of words? It looks like VM's are limited to 1000 characters (about 250 words). If that was the case then try posting here on your thread. Even if you want to post a small novel you shouldn't have a problem. (We really do love novels, BTW - the more info the better!:D)

The only other time I've known of someone having problems with the length of a message being limited is when the person was posting via some sort of mobile device rather than a regular computer. If you are using a mobile device and having that problem, just split your story up into several posts - we (an admin or moderator) can always merge them into one post if need be.

Also here's a link to a thread (January and her little Havanese, Serena) regarding radiation treatment of a macroadenoma:

http://www.k9cushings.com/forum/showthread.php?t=609


Alison

zoesmom
11-27-2009, 03:32 PM
Hi and welcome -

How is Millie doing today? I agree with the others. She could be addisonian now, which is the opposite of cushnoid. (Too little cortisol vs. too much.) I hope you've stopped the trilostane? Did your vet give you any prednisone when you began the lysodren? Prednisone is the antidote for too low cortisol and it sounds like that's what she needs right now. The sooner the better. Addisonian crisis can be dangerous so you need to act now, if you don't have some pred on hand at home.

An acth test should have been run before starting the trilo on the heels of the lysodren. That 30 days is important to let the adrenals regenerate from the effects of the lysodren. It doesn't always take 30 days, but you wouldn't know if it was safe to begin the trilostane without first doing an ACTH test to see if the cortisol levels are back up into the teens, at least. And you would probably see a return of cushings symptoms at that point, as well.

So did your vet do an ACTH when Mille came off the lysodren?? If so, could you please post the results. Then right before the trilo was started, another acth should have been done. If it was, also post the results of that one too. It should be two numbers - a pre # (baseline) and a post #. If none were done since stopping the lysodren, then your vet is playing with your dog's life. The harsh reality is.....many gp vets aren't that familiar with the proper cushings tx protocols. (A good vet will not have any problem giving you copies of all test results. (If you've got any others - like general bloodwork - those would also be helpful to post.)

As far as the macroadenoma, that is a secondary concern right now. You can deal with that, once Millie is feeling better. But right now, I'm very worried that she may be addisonian and need immediate attention. Let us know what the situation is and if you've got prednisone for her. If no ACTH has been done since the meds were started, then you need to demand one asap. You would probably see a fairly quick turnaround if she's addisonian and is given pred. Her electrolytes could also be off if her cortisol has gone too low, and that should be addressed as well. Sue/Zoe

PS - the ACTH is the monitoring test used for dogs on treatment. It is a 1 - 2 hour test with the two numbers as mentioned.

Squirt's Mom
11-28-2009, 12:44 PM
Hi Karen,

How are you and Millie doing? I am sure you were busy over the Thanksgiving holiday and I hope you enjoyed it immensely!

But...I am getting worried about Millie and would love to hear from you when you can. Just a plea from an old worry wart! :p

Hugs,
Leslie and the girls

Harley PoMMom
11-28-2009, 04:16 PM
Me an old worry wart too! How are you both doing?

Love and hugs,
Lori

KjobakerOhio
12-10-2009, 01:48 PM
Hello Everyone,

I'm back :-) I will get caught up today on all the postings here soon.

I've been busy with my 83 year young Mom who has congested heart failure. She was in the hospital for several days but is home and doing pretty good.

Terri has been my angel, following up with me with emails and phone calls. I appreciate her caring and concern.

Millie is scheduled for her ACTH stim test Monday and her first followup with her internist. She has been on the Trilostate since Nov. 21st and we have seen some positive improvements (less water drinking, less food agression and small potbelly and sleeping longer hours ;).

Terri and I were discussing the "intermediate hormones" and how they are affected by Trilostate. Any thoughts or questions I should ask at my Monday meeting her with doctor?

I am suppose to see a oncologist/radiologist specialist (had to cancel the appointment when my Mom was in the hospital) about radiation treatment for Millie's pituitary tumor. I'll let you know how I feel about that after I meet with Dr. Prescott. If anyone has gone through that treatment, please share your experience with me.

It's good to be back. Thanks for all your help and concerns.

Take care, Karen

Harley PoMMom
12-10-2009, 03:35 PM
Hi Karen,

So glad to hear from you tho I am so sorry to hear about your Mother but I am happy to see she is home and doing alot better.

Terri is a very wonderful person, has a loving, kind and huge heart. :) Bless her.


Terri and I were discussing the "intermediate hormones" and how they are affected by Trilostate. Any thoughts or questions I should ask at my Monday meeting her with doctor?

Trilostane always increases 17-hydroxyprogesterone and frequently increases estradiol and androstenedione but Trilostane lowers aldosterone.

Aldostone is the what balances the electrolytes in the body. This you should get checked every time you have Millie stimmed.

Dr. Oliver from the University of Tennesse has the only lab that does the adrenal panel which checks all the five intermediate/sex hormones. If you would like more information about this we can provide that for you, just let us know.

I am not a Trilostane user but from my understanding if your pup's cortisol is under control but still showing clinical signs of cushings and all other possibilities are ruled out eg..UTI, diabetes, then more than likely one or more of the intermediate/sex hormones is elevated. Elevations of one or more of the intermediate/sex hormones can create the same symptoms of cushings.


If anyone has gone through that treatment, please share your experience with me.

If you have time there is a thread here that will interest you.

Serena, Havanese, radiation treatment
http://www.k9cushings.com/forum/showthread.php?t=609

Serena 9yo Havanese-Cushing's and DI-Pituitary Macroadenoma-Radiation treatment
http://www.k9cushings.com/forum/showthread.php?t=959

Also I am including this link and quotes, ask Dr. Prescott about it.

http://www.animalci.com/trials/closed-trials/closed-glutamine


Summary: This prospective randomized trial demonstrated a significant reduction in oral radiation mucositis (ulceration) in pet dogs receiving radiation therapy for nasal tumors when dogs were given a glutamine containing suspension compared to a standard daily mouthwash....

Background: Oral mucositis is a common complication of radiation therapy of the head and neck. Radiation-induced mucositis of the oral cavity results in patient discomfort and may adversely affect treatment outcomes. Mucositis can lead to interruptions or early stoppages in planned radiation treatments and negatively impact on nutritional status. L-glutamine, an important fuel source for gastrointestinal epithelial cells, may decrease the severity of mucositis associated with radiation therapy....

Please stay in touch and keep us updated...we worry so much. :)

Love and hugs,
Lori

littleone1
12-10-2009, 07:03 PM
Hi Karen,

I'm glad you were able to get back on line.

I thank you and Lori for your wonderful comments. We have a bunch of very special people here.:)

Squirt's Mom
12-11-2009, 01:02 PM
Hi Karen,

So good to hear from you but am sorry for your mom's problems but am glad she is back home and better today. :) I know how difficult that can be both physically and emotionally. We just lost my mom in Sept. after several months of intensive degeneration from Alzheimer's. Will keep you and your family in my prayers.

Bless Terri for keeping up with you. She has let a few of us know that you and Millie were ok, just very busy and that helped a lot! I get really worried when folks drop out of sight. :o

Lori has given you some really good info on Atypical Cushing's, which involves the intermediate hormones. My Squirt is Atypical and she is doing really well. If I can answer any questions don't hesitate to ask.

I hope you can get the oncologist/radiologist specialist soon and get some answers and direction from them asap. Serena and January are very special to us and Serena has done well. We also have a member who had a hypophysectomy done on her pup and she is doing well last we heard. I will give you some links on that surgery as well as a link to their thread (Lucy and Gina).

Keep in touch as you can or we will come looking for you again! :p

Hugs,
Leslie and the girls

Lucygoo and Gina
http://www.k9cushings.com/forum/showthread.php?t=534

Hypophysectomy*
Chuck Newman, PhD, DVM
http://www.newmanveterinary.com/CushingSx.html

NC State College of Veterinary Medicine – Neurology
http://cvm.ncsu.edu/vth/clinical_services/neuro/brain_tumor.html

littleone1
01-24-2010, 04:17 PM
Hi everyone,

Karen wanted me to say hi to everyone. Things are settling down for her, and she's hoping to be back with us in the near future.

Millie is doing good.

I'll keep you posted.

Terri

KjobakerOhio
02-15-2010, 08:47 PM
2-15-2010

Hi Everyone,

Thanks to Terri (Littleone1), I'm back and feeling more familiar how this site works.

Millie started on Trilostate on November 14th, 2009. She had been on Lysodren with horrible results and it did not reduce her Cushings symptoms. On top of that, her vet's staff drew blood from her neck and cellulitis developed. They didn't shave her neck to do the draw.
Grrrrrrr. She was in ICU for 3 days in Nov. for the cellulitis and complications due to the Lysodren.

Millie has had 3 ACTH Stim test. Here are the results:
11/13 Pre: 16.1 / Post: 34.5
12/14 Pre: 1.8 / Post: 2.1
2/12 Pre: 1.1 / Post : .8

The doctor told me on 2/12 to stop the 30 mg. of Trilostane and give her 5 mg. Prednisone until her new dose arrives at the end of this week which will be compounded at 22 mg.

He wants me to start her on the new dose and then have her tested in 2 weeks.

I'm really scared about her low levels. Any thoughts on her numbers from the group would be appreciated. Thanks, Karen

StarDeb55
02-15-2010, 09:00 PM
Karen, with this super low result, you can't just assume that a one week's vacation from the trilo will allow Millie's cortisol to rise enough to resume treatment. Each pup is different, & reacts to the medication differently. It's imperative that before re-starting the trilo, you need to get an ACTH to make sure the cortisol still isn't too low for medication. Jeanette's Princess had an initial low result like this back in November, after starting trilo, I believe, & she is still on a medication holiday. You usually wait until you see symptoms beginning to resume, then do an ACTH, & resume medication based on that ACTH result.

Debbie

KjobakerOhio
02-15-2010, 09:53 PM
That makes so much sense to me. Her levels are so low. I wonder why he doesn't suggest that we let them rise and then start the new dose.

She has a pituitary tumor and I know it's not going to go away. We have made the decision not to do radiation. Being a senior dog, we don't want her to go through that process. With that said, we know
the Cushings will be an ongoing disease that will have to be managed.

How do I present this to my vet so he doesn't feel like I'm leading the team? He's suppose to be the expert. You would think he would know better.

Any suggestions would be appreciated!

littleone1
02-15-2010, 09:54 PM
Hi again Karen.

As Debbie mentioned, Jeanette's Princess has not been on any Trilo for several months. Her thread is My Puppy: updates on Princess. Princess is doing very well, and is still not showing any clinical signs of Cushings.

I'll talk to you later.

Luv and hugs,

Terri and the Corkster

StarDeb55
02-15-2010, 10:21 PM
Karen, I would tell the vet that you are not comfortable re-starting the meds without an ACTH being done, & that you would rather be safe than sorry.

Debbie

acushdogsmom
02-15-2010, 11:10 PM
How do I present this to my vet so he doesn't feel like I'm leading the team? He's suppose to be the expert. You would think he would know better.

Any suggestions would be appreciated!I agree with Debbie - just say that you'd rather be safe than sorry. That's what I did.

Mostly, my Vet was right on, but once or twice, an "extra" stim test that I requested showed lower cortisol production than what we both thought the result would be. The next time I asked for an "extra" stim to be done, she just smiled at me and said "I know - better safe than sorry." :)

BestBuddy
02-16-2010, 02:17 AM
Because those numbers dropped so quickly it may mean that Millie is very sensitive to Trilo.

There is no way I would be restarting without an ACTH test because there is no way of knowing whether those numbers have come up much or even at all.

My Buddy dropped low quickly and he actually went into remission (rare) and we never restarted the trilo.

I really think you need to let the vet know that it is important to you to know what those cortisol numbers are before you restart. When it boils down it is you who are paying for it so he should see your reasoning.

Jenny

Spiceysmum
02-16-2010, 04:51 AM
Hi Karen,

I agree with the others and wouldn't start treatment again until you see some symptoms return or have had another ACTH.

Spicey has been in remission for 16 months now after having a post result of 0.9. She had been on Trilostane for 15 months with no problems and still wasn't showing any signs of being low so we would never have known without the ACTH. We were also supposed to start on a lower dose after a weeks break but when her symptoms had not returned at all the vet agreed with us to wait until they had. Recently I have noticed her drinking a bit more but nothing like before and a recent blood test showed her liver levels are high but I will still want to wait until her symptoms are worse before starting back on Trilostane.

I feel uncomfortable letting the vet know my views on when to start treatment again with my small amount of knowledge so I know how you feel!

Linda and Spicey

maggiebeagle
02-16-2010, 06:46 AM
We had a similar experience . Maggie went too low on trilostane and we never had to restart it.

KjobakerOhio
02-16-2010, 08:49 AM
Everyone (Littleone1, StarDeb55, Acushdogsmom, BestBuddy, Spiceymom, Maggiebeagle), thank you so much for the support. I am calling my vet this morning and telling him I will schedule a stim test for 2/24/10. That will be 2 weeks from the previous one. Or if I see any signs show up in the meantime, I will get her in.

Millie's pituitary gland measures .6mm. I don't know what the normal size for her should be. Are pituitary glands the same size in all dogs, nor matter the size or breed of the dog?

Has anyone here seen Cushings go into remission with pituitary induced Cushings?

FYI. I keep a journal on Millie ever since she was diagnosed. I document all her habits (p's & poops), water drinking, if she is anxious, the amount of time she sleeps overnight, etc.). If she shows any changes, I'm going to notice.

I'm lucky that my husband is here all day long so he can monitor her too as my work takes me away from home most days.

Thank you all again for being a part of my team and helping me educate myself.

Karen

KjobakerOhio
02-16-2010, 10:18 AM
I emailed my vet this morning with my plan to withhold Trilostate and do a stim test by 2/24 or if Cushings symptoms should show up sooner. I did my best not to burn any bridges as I don't have anyone else locally that I can have manage her Cushings.

Are there any members here that are in Ohio? I'm in the Columbus, Ohio area but would travel to get the best care for Millie.

Thanks, Karen

littleone1
02-16-2010, 11:14 AM
Hi Karen,

I'm so glad you called your vet this morning and decided not to give Millie any more Trilo at this time.

I'll be in touch soon.

The Corkster sends you and Millie big kisses.

Harley PoMMom
02-16-2010, 03:09 PM
I emailed my vet this morning with my plan to withhold Trilostate and do a stim test by 2/24 or if Cushings symptoms should show up sooner. I did my best not to burn any bridges as I don't have anyone else locally that I can have manage her Cushings.

Are there any members here that are in Ohio? I'm in the Columbus, Ohio area but would travel to get the best care for Millie.

Thanks, Karen

Hi Karen,

Here is some info for you that you can be armed with just incase your vet would give any flack about with-holding the Trilostane.

This is the second paragraph under "Long-Term Monitoring" in the Dechra's U.S. Product Insert.


Long-Term Monitoring

If the ACTH stimulation test is <1.45 μg/dL (<40 nmol/L) and/or if electrolyte imbalances characteristic of hypoadrenocorticism (hyperkalemia and hyponatremia) are found, VETORYL Capsules should be temporarily discontinued until recurrence of clinical signs consistent with hyperadrenocorticism and test results return to normal (1.45-9.1 μg/dL or 40-250 nmol/L). VETORYL Capsules may then be re-introduced at a lower dose.

http://www.dechra-us.com/File/prod_vetyrol.pdf

I did a search for IMS's in the Ohio area and there were quite a few.

Here is a link to my search:
http://www.acvim.org/websites/acvim/index.php?p=228

Now just in case my search does not show, all you have to do is click on the link I will provide below and fill in your State and Country and hit search.
http://www.acvim.org/websites/acvim/index.php?p=3

Best of luck to you and Millie.

Love and hugs,
Lori

KjobakerOhio
02-16-2010, 04:02 PM
Thank you so much for the reference links. I will check them out.

Here is what my IMS wrote to me today. I am withholding his name and the name of the facility as I don't have his permission to post:


Karen,

If Millie is doing well, I think it is appropriate to hold off on the Trilostane until we receive the compounded form. Also, it is perfectly appropriate to withhold starting the new dosage until 1. clinical signs recur and/or 2. a recheck ACTH stim is performed.

With the pituitary gland, it is difficult to differentiate tumor from normal pituitary gland without an MRI. Therefore, the masses are thought to efface/envelop the pituitary gland. Finally, we will definitely need to keep the prednisone on hand. It sounds like that she is starting to come up with her endogenous steroids given that she has been eating well the past 24 hours.


My question to him now would be, why wasn't that suggested when I received her test results last week? I can see now by the previous post that the pharmaceutical instructions state that the Trilostane should be withheld with her existing numbers.

This standard of care exhaust me.

Thank you "all" so much for your help and support! - Karen

BestBuddy
02-16-2010, 04:11 PM
Hey Karen,

I know it is really frustrating that there are so many different standards of care between vets , specialists and even countries. My thinking on this is that these medical professionals have all read/studied the disease but most have not treated or certainly lived with a dog being treated for cushings.

This forum gives you first hand stories of treatments and also the different options used so you can read and discuss different things with your vet. I would never go against my vet but I do make them explain why and I ask a lot of questions. It took a long time before I felt really comfortable doing this but my dog/s are my number one priority and I just want the best for them.

Hopefully your vet will now understand how you feel and it may be the start of a better relationship. Fingers crossed.

Jenny

KjobakerOhio
03-29-2010, 09:26 AM
Hello Everyone,

Millie was tested last Thursday, March 25th. Her numbers are high again. No obvious clinical signs for Cushings. It's been 6 weeks since she stopped her Trilostane because her pre and post ACTH Stim test numbers were low. On Feb. 12 her Pre was 1.2 and her Post was .8. Now her Pre is 9.6 and her Post is 18. Her IMS has suggested that I wait for clinical signs. I'm so scared she'll get sick suddenly while my husband is recovering from knee replacement surgery, scheduled for April 8th).

Squirt's Mom
03-29-2010, 11:17 AM
Hey Karen,

Good to hear from you and Millie again!

Even tho her numbers are creeping up, I would withhold restarting treatment until the signs are back. It is unlikely that she will suddenly become ill; it is more likely that you will start to see signs coming on gradually over a period of days/weeks/even months. You know what you are looking for now, so just keep an eye on her.

How is she acting? Seem to be feeling good?

I hope your husbands surgery goes well and that his recovery is swift.

Hugs,
Leslie and the girls - always

lulusmom
03-29-2010, 12:10 PM
Hi Millie,

Your vet gave you some sound advice. My little Lulu went through a washout period after treating with Trilostane for almost two years and we waited until she was symptomatic to restart treatment. She had a post stim of 22 ug/dl and was still not symptomatic. It took her three more months before symptoms showed up and a stim at that time yeilded a post of 25 or 26 ug/dl. All dogs are different so like Leslie said, it could be weeks or months before you start to see symptoms again. Try not to worry and just enjoy your extended vacation from Trilostane.

Glynda

littleone1
03-29-2010, 01:31 PM
Hi Karen,

It's good to see you here.

I forgot to ask you what dosage your vet wants Millie to start taking once the clinical signs start returning.

Talk to you soon.

KjobakerOhio
03-29-2010, 04:27 PM
Thank you all for your comments.

It is so clear, this disease is not "black and white". Thank you
all for sharing your wisdom and experience so quickly.

Terri- I have 22 mg Trilostane available for Millie if and when she needs to starting taking it again. She was taking 30 mg when her number dropped too low.

KjobakerOhio
03-31-2010, 08:27 AM
Hi Everyone.
Millie appears to be getting the swollen pot belly again. Last month when I had her ACTH Stim test and her numbers (pre & post) were low, her belly was soft when touched. It is obvious to me that her belly is becoming swollen and hard. This is the only clinical sign (no excessive water drinking, eating, lack of sleeping, etc.), other than she is laying on her belly more frequently on the tile floor (cooling). I emailed her IMS yesterday but haven't heard back from him yet.

lulusmom
03-31-2010, 02:00 PM
Hi Karen,

Millie's last ACTH stim was high with a post of 18 ug/dl and while she may not be symptomatic yet, the excess cortisol could be responsible for the liver enlarging a bit and fat deposition in the abdomen, both of which could be causing the big belly you are seeing. I'm sure there are other conditions that could cause this so I am glad to see that you have contacted your IMS about it. Please let us know what he has to say.

Glynda

KjobakerOhio
04-03-2010, 06:43 AM
Hi Everyone,

It's been only 2 days since I talked to my IMS and posted here.

When I talked to my IMS, I asked him if he had noticed Millie's belly swelling when he saw on her 3/25 and he didn't remember it being remarkable. He called me from home so he wasn't 100% sure about his examination of Millie but would check his records when he returns to MedVet.

I asked him if I should measure her the circumference of her belly area each day to monitor her. She has so much hair that it's difficult to see.
He thought that would be a good idea and never had thought of suggesting that for monitoring. Has anyone here done that?

I was gone all day yesterday and my husband notice Millie starting her excessive water drinking. I'm going to email her IMS this morning and see if we should start her new dose (22mg) of Trilostane (she was doing 30 mg. her last round, 7 weeks ago).

Squirt's Mom
04-03-2010, 09:42 AM
Hi Karen,

Yes, I measured Squirt's belly daily for several months watching for that tell-tell pot-belly under all her hair, too. ;) It really helped me since I never found proof her belly was enlarging; I was comforted by that and felt more secure with her diagnosis of Atypical only for some reason. It just made sense to me to do it that way...like Millie, you can't see Squirt's belly very well! :D

Let us know what the IMS has to say about restarting treatment.

Hang in there!
Hugs,
Leslie and the girls - always

KjobakerOhio
04-24-2010, 07:19 PM
Hi Everyone...I took Millie in for ACTH Stim Test since she started her new does of Trilostane (22mg). Her ACTM Stim numbers are : Pre - 2.4 and Post 1.9.

I was talking to Terri today and she thought it was strange that the last four test the Pre numbers are lower than the Post. Here are her numbers.

Dec. 09 Pre. 1.8 Post 2.1
Feb. 10 Pre. 1.1 Post .8 (went off Trilostane after this test)
March 10 Pre. 9.6 Post 18. (started new dose of Trilostate 22 mg.)
April 10 Pre. 2.4 Post 1.9

It's been about 10 days (starting 4/15/10), Millie has started havingclinical signs that her Cushings is active. She has had excessive thirst and urinating, restless, weak in the back legs and starts barking in the early a.m. (3:00):eek:

I asked the IMS why her numbers were within the 1-5 range for taking Trilostane but she havings clinical signs of Cushings. He said that her pituitary tumor could be causing those symptoms which he never mentioned before.

Any thoughts?

Thanks all,

Karen

AlisonandMia
04-24-2010, 07:31 PM
How many times a day is Millie having trilostane?

Alison

Harley PoMMom
04-24-2010, 07:34 PM
Hi Karen,

Was Millie stressed at the vets? If so, this could be one reason why her pre # was higher that her post on her last stim.

KjobakerOhio
04-24-2010, 07:55 PM
She was pretty calm. No panting and being "bugged-eyed" like she can be if she is stressed, which is rare.

All of her pre have been higher that her post in the last four test. Do you think I should bring this to the IMS's attention?

Thanks, Karen

Harley PoMMom
04-24-2010, 08:16 PM
With some of her post #'s being low...(.8) and even tho the 1.9 is within Dechra's range of 1.45-5.4, I would want to see more stimulation between the pre and the post...so yes I would bring this to the attention of her IMS.

Did you answer Alison's question?~~>How many times a day is Millie having trilostane? ;):)

Love and hugs,
Lori

lulusmom
04-25-2010, 12:11 AM
Hi Karen,

I just went back through your thread and it appears that Millie was getting 22mg once a day. Trilostane has a short half life, meaning that it's enzyme blocking abilities start to diminish after 8 or so hours. While most dogs do fine and have total resolution of symptoms on once daily dosing, about 15% to 20% of dogs will become symptomatic later in the night as the cortisol is increasing. This could easily explain why Millie is barking at 3:00 am.

With Millie's last acth being what Dechra (manufacturer of Vetoryl/Trilostane) calls a nonstimulatory result, you shouldn't be seeing symptoms increase because a nonstimulatory response is indicative of insufficient cortisol. In other words, the 22mg dose looks to be too high for Millie. Protocol for non stimulatory results is to stop treatment for (I believe) a week and restart at a lower dose. Are Millie's symptoms continuous now or do you notice that she gets worse in the later part of the day?

Glynda

EllyAugie
04-25-2010, 09:37 AM
Hi Karen, just wanted to say hello and welcome.
Sending prayers and well wishes for Millie.
Elly and Augie

KjobakerOhio
04-27-2010, 10:52 AM
How many times a day is Millie having trilostane?

Alison

Millie takes her Trilostane once per day. Should I asked to have the
does split and give in the a.m. and p.m.?

KjobakerOhio
04-27-2010, 10:53 AM
Hi Karen, just wanted to say hello and welcome.
Sending prayers and well wishes for Millie.
Elly and Augie

Thanks so much!

I appreciate the support I have here.

KjobakerOhio
04-27-2010, 11:06 AM
Hi Karen,

I just went back through your thread and it appears that Millie was getting 22mg once a day. Trilostane has a short half life, meaning that it's enzyme blocking abilities start to diminish after 8 or so hours. While most dogs do fine and have total resolution of symptoms on once daily dosing, about 15% to 20% of dogs will become symptomatic later in the night as the cortisol is increasing. This could easily explain why Millie is barking at 3:00 am.

With Millie's last acth being what Dechra (manufacturer of Vetoryl/Trilostane) calls a nonstimulatory result, you shouldn't be seeing symptoms increase because a nonstimulatory response is indicative of insufficient cortisol. In other words, the 22mg dose looks to be too high for Millie. Protocol for non stimulatory results is to stop treatment for (I believe) a week and restart at a lower dose. Are Millie's symptoms continuous now or do you notice that she gets worse in the later part of the day?

Glynda

Hello Glynda......What is really strange for Millie is, every day is different. Millie's schedule used to be as follows: Her last walk was at 7:30 p.m. She would sleep well until 5:00a.m. when we would get up to start the day (work schedule). Now she can't hold her bladder until 5:00 a.m., so we started taking her out at 10:00 p.m.. It doesn't matter. She'll start barking after 3:00 a.m. and the day starts...but.......it's not an every day event. she'll skip a couples days and sleep in until 5:00.

In the past 3 days she has to pee more frequently. I think I'll have them test her urine to see of she has an infection. I did mentioned this to my IMS last week. He asked if she does a few pees and then appear to be finished. I told him no, she has always taken one long pee and that continues to be her habit.

Also, I noticed that her back legs are more weak but her belly isn't increasing in size.

KjobakerOhio
04-28-2010, 08:26 AM
Hi Everyone...

Last night I gave Millie her 22 mg. Trilostane at 8:00 P.M. instead in the a.m. and she slept until 6:30 a.m.today. I hope this will be effective going forward. It's first time in weeks that I didn't have to get up in the middle of the night.

I have an appointment with her IMS today because she had to pee a lot yesterday (concerned about a UTI) and her back legs seem very weak.

Her legs were weak when she was first diagnosed with Cushings but she had a pot belly at the time. She doesn't have a pot belly now and her legs seem weaker than ever (changes observed in the past 2-3 days).

Also, I noticed her appetite decreasing. This is new too. She has always loved her food.

Millie was off of her old dose of Trilostane (30mg) since 2/12/10 and started her new dose, 22mg since 4/3/10.

Any thoughts to share? I will be leaving today at noon (EST) for her appointment.

Thanks everyone! - Karen

lulusmom
04-28-2010, 12:33 PM
Hi Karen,

Sorry that it has taken me so long to get back to you but I simply missed your posts. :o The way to determine if Millie may benefit from twice daily dosing is by doing a urine cortisol creatinine ratio (UC:CR) You would collect a urine specimen from Millie, preferrably her first pee of the day, and definitely before she takes her Vetoryl. You only need a small amount and you need to get it to your vet within an hour or two. Any longer than that, you should refrigerate it. If the UC:CR comes back high, then that's an indication that cortisol is climbing over night which is probably why Millie's symptoms return later in the day.

I hope this helps and we'll all look forward to hearing about your visit with the IMS today.

Glynda

littleone1
04-29-2010, 11:11 AM
Hi Karen,

I'm glad you were finally able to get some sleep.

It's a good idea to have her tested to see if she has a UTI. If she does, it will be able to be treated with an antibiotic. If she doesn't have one, at least the test will be able to give you some peace of mind.

We'll be waiting to hear what her test results are.

Take care.

KjobakerOhio
09-06-2010, 06:36 PM
Hi Everyone,

I'm just checking in to let everyone know how Millie is doing. Millie has been off her Trilostane since 6/12/10. In April, she had her ACTH Stim test (Pre - 2.4 and Post 1.9) and they lowered her doses from 30 mg to 22mg (compound pharmacy). Millie soon stopped eating, had loose stools and was very lethargic. The IM had me give her prednisone for a couple days but that didn't change anything. That's when he had me take her off everything on 6/12/10. On 7/12/10 she had her ACTH Stim test and her (Pre -10. and Post 11.1). He said since she had no significant signs of Cushings (no pot belly, excessive drinking/eating and loss of hair), we would wait and watch for signs to return and then have to make a decision to try something else. He mentioned Lignans but he hasn't had much experience in dosing. Millie doesn't sleep well at night. She has us up at least 3 times every night. I don't think she's sleep deprived but we sure are. I told my regular vet and my IM and they can't help me as they don't understand why she can't sleep. Thanks for listening ! Take care, Karen Baker

lulusmom
09-06-2010, 10:46 PM
Hi Karen.

It's great to hear from you again. The last stim test does indicate that Millie's cortisol is on the rise. That was done in July and here it is in September so I suspect that it is even higher. My Lulu was off Trilostane for over two months before she became symptomatic again. When I noticed that the symptoms were apparent, we did the stim and her post stim was 25 ug/dl. Millie's cortisol may not be high enough yet for symptoms to return but it sounds as though it is high enough to effect her sleep wake cycle. People and dogs don't have a lot in common when it comes to cushing's but they both experience an inverted sleep/wake cycle. A lot of dogs with high cortisol will be awake and restless at night and in a coma during the day. I'm a bit surprised that your internal medicine specialist isn't aware of this phenomenon. Both of my cushdogs were that way before we got them under control. I wanted to rip my hair out with Lulu and believe me, I didn't have that much hair to begin with.

When Millie's cortisol becomes high enough, she will become symptomatic again and I'm afraid that lignans are not going to be effective in reducing cortisol. It's primarily used in treating dogs with atypical cushing's and even then, it's a crap shoot as to whether it's going to work. Every dog responds differently to Trilostane and it could be that 22mg was simply too high of a dose for your girl. It seems to me that if 30mg had such a profound effect, reducing the dose by only 8mg was not enough. Unfortunately Millie didn't do well on Lysodren so you don't have a lot of effective choices. Have you considered restarting her on a very low dose Trilostane if and when the time comes to start treatment again? You can start as low as 5mg and make adjustments upwards if needed. How much does Millie weigh?

Glynda

KjobakerOhio
09-07-2010, 10:20 AM
Hi Glynda,

Millie weighs 17 lbs. She has fluctuated between 15 and 17 since
the onset of Cushings.

I'll call my IM today and see if he can order a 5 mg Trilostane.

Thanks for the support. I appreciate this forum so much!

Take care, Karen

MyRudy
09-07-2010, 03:43 PM
FYI, my dog weighs 42 lbs and takes 30 mg per day Vetoryl....he was initially started on 60 mg per day Vetoryl and within a week was lethargic and not eating so I discontinued the Vetoryl and got a new vet.

This is a low dosage for his weight, but he has responded very well to this dosage and we are keeping him on it until symptoms return.

KjobakerOhio
09-07-2010, 08:45 PM
Millie gets lethargic on 10 mg.of Trilostane. My IM is suppose to call me tomorrow. I'm going to see if we can start her on 5 mg.

I just hope he agrees.

Take care, Karen

KjobakerOhio
09-08-2010, 11:43 AM
Hi Everyone,

I heard back from my IM. Also, Millie started drinking excessively yesterday and is doing the same today.

The IM wants me to start her on 3 mg of Melatonin twice a day and then have her ACTH Stim test next Tuesday.

I asked him about starting her on 5 mg of Trilostane as other people
here at this forum have been successful. He said he didn't think it would be effective. I said, can't we try?

God I'm frustrated! Thanks for listening.

Take care, Karen

apollo6
09-11-2010, 07:28 PM
Dear Karen and Millie
Welcome.
You have come to the right place. I am Sonja , Apollo's mom.
Read my thread if you can. Apollo is an 11.5 year old dachshund was born same year as your MIllie, He weighs between 9 and 10lbs normally. He has the pituitary cushing also. I started him on 10mg Trilostane in June. I fought to start as low as I could. He is doing well, some signs are coming back so increasing to 12.5 mg only.:(
Like everyone says if she is vomiting, loss of appetite, lethargic, to name a few side effects , maybe you should stop and consult with your vet. Many vets are medication happy when it comes to our previous angels. Listen to your gut feelings.
Hugs Sonja and Apollo.

apollo6
09-12-2010, 01:38 PM
stick to your guns.:mad: The vet is working for you. Less is better then nothing. I went through the same with my vet.

KjobakerOhio
09-15-2010, 09:50 PM
Hello Everyone,

Yesterday, Millie had her cortisol levels tested (ACTH Stim) and Pre was 6.8 and Post was 7.7.

She's been off Trilostane since 6/17/10. She was taking 22 mg. before that time.....but not daily. Every time I gave it to her she wouldn't eat for a couple days so I was giving it to her every 3-4 days. Finally, the IM said to stop because her numbers were at a reasonable level. Also, I had an urinalysis done, CBC and Chemical Profile yesterday. He thought it was "average".

I had Millie's teeth cleaned on 9/2/10, hoping that this would help her because being a "puppy mill dog" she didn't have good genes and always needed her teeth cleaned yearly. Since 9/2, she has been increasingly lethargic. Eating less but still drinking water. Makes me wonder how the anesthesia affected her brain with the tumor.

Her IM thinks that the tumor is the reason for her lack of energy and and this might be the "end".

He said that some dogs, when taking Triolstane will have a permanent interruption in their hormone making process, meaning it causes them to stop producing Cortisol or only make a small amount (which he thinks that's where she is now).

A year ago, we made the choice not to do radiation for the pituitary tumor. The oncologist said it might give her a year with us. Her adrenal gland was measured at .06 cm. I guess that equals approximately 6 mm.

I asked my IM today, how big is the tumor? He said he could exactly say. His additional comment was, "you chose not to do radiation treatments last year which would have given you about another year with Millie and you got the year" and he thought this was a positive way to look at this past year (Millie was diagnosed on 10/9/09).

I came home from work today and she didn't greet me and has layed on the cool tile floor looking into space. When I hug her and pet her she has a blank look.

MOST important, I don't want Millie to suffer. I asked her IM if she is in pain and he said IF her symptoms (lethargic, lack of appetite, low enery, etc.) due to the tumor, she probably feels like some who has a bad case of the flu.

Please share any thoughts or suggestions are welcomed.

Take care, Karen

Casey's Mom
09-15-2010, 10:08 PM
Hello Karen, just wanted to give you and Millie a big hug. You know your dog best and will be able to judge quality of life.

It seems a bit odd that this all came about at the same time as the anesthesia - perhaps you could get a second opinion?

Love and hugs to you and little Millie,

KjobakerOhio
09-15-2010, 10:22 PM
I wondered about this too. I had pre-testing and a consultation prior to having this done.

I have an appointment next Wed. (phone consultation) with a Dr. Jeff Feinman in Weston, Ct. (I'm in Ohio). He helped me with my Jodi 7 years ago when she had Canine Mediated Hemolytic Anemia back in 2003.

gpgscott
09-16-2010, 09:10 AM
Hi Karen,

Symtoms from the progression of a macro tumor vary a lot. Frequently they are sudden onset.

I think you made the right choice by not resorting to radiation and that you need to let your knowlege of Millie, her behavior and your heart be your guide.

Hugs from me as well. Scott

Squirt's Mom
09-16-2010, 12:33 PM
Hi Karen,

My heart goes out to you. It is such a burden to carry this consideration in our hearts. Torn between our desire to keep them with us yet not wanting them to suffer.

You are a great mom, Karen. Your love for Millie has always been evident and I know that love will sustain and guide you.

Hugs,
Leslie and the girls :D - always

apollo6
09-17-2010, 12:20 AM
Will be praying and thinking of you.
Hugs Sonja and Apollo

Franklin'sMum
09-17-2010, 02:11 AM
Hi Karen,
I'm sorry Millie is under the weather a bit at the moment. I have some comments and a question for you, if you don't mind. Please bear with me, as I do need to read your whole thread from the beginning to refresh my mind.

She's been off Trilostane since 6/17/10. She was taking 22 mg. before that time.....but not daily. Every time I gave it to her she wouldn't eat for a couple days so I was giving it to her every 3-4 days. Finally, the IM said to stop because her numbers were at a reasonable level. This isn't the regular protocol for using trilostane. If the pup is stable and doing well, the pup parent is usually told it's a forever drug, but stopping because the numbers were stable? I don't understand, can you give me further info please? Was anything else happening at the time with Millie's health or behaviour?Was she testing low?
Eating less but still drinking water. Makes me wonder how the anesthesia affected her brain with the tumor. I don't know how anesthesia would affect a tumor, but in people they have found that anesthetic takes a lot longer than previously thought to leave the system. (Can be over a year )This is something my mum's surgeon said a few years ago after she complained that she still wasn't back to normal after her surgery. She had said her memory was still fuzzy, and couldn't keep focused on things.

Her IM thinks that the tumor is the reason for her lack of energy and and this might be the "end".
He said that some dogs, when taking Triolstane will have a permanent interruption in their hormone making process, meaning it causes them to stop producing Cortisol or only make a small amount (which he thinks that's where she is now). How can he the above, but then say it's probably like having the flu? If Millie's cortisol is too low (for her comfort level) that could explain why she's feeling a bit off.

A year ago, we made the choice not to do radiation for the pituitary tumor.
I asked my IM today, how big is the tumor? He said he could exactly say. His additional comment was, "you chose not to do radiation treatments last year which would have given you about another year with Millie and you got the year" and he thought this was a positive way to look at this past year (Millie was diagnosed on 10/9/09) Because you and Millie were lucky enough to enjoy another year with each other doesn't mean he should now give up on her.

Karen, I really hope Millie perks up soon. You have been such a great advocate for her, and you're such a good Mum. Keep the faith,

Love and big (((Hugs)))
Jane, Franklin and Bailey xxx

Franklin'sMum
09-17-2010, 07:23 AM
Hi Karen,

Up to speed now. It makes a difference to re-read all in the one go, compared to a little here and there :o.

How is Millie? Really hope she is feeling better today.

Jane, Franklin and Bailey xxx

KjobakerOhio
09-17-2010, 10:45 PM
Hello everyone...

Today is not a good day for Millie. Her front legs are some what strong but her back legs are very weak. I can lift them up and then they drop to the floor.

Also, she has had rapid breathing and then it switches to very shallow breathing. Her eyes are very glassy.

She ate her A.M. food but didn't want anything in the afternoon.

She will drink water if I give it to her in an oral syringe.

I do feel like her IM has given up on her. When he saw us the other day, he didn't write a "patient log" and give to me. The "patient log" states why she's in there and what his recommendations are after the appointment. He also didn't want to talk to me in the lobby where everyone else is sitting and ask me to step outside in the park outside the lobby. He said her vitals were good but she really looked bad. I agreed. But he felt all has been done and since I don't want to put her through radiation, there is nothing else to do.

Not to complain, but I've spent over $8000.00 this past year doing all the testing they thought was vital to managing her Cushings and now since there is nothing else to be tested, I feel like we've been dismissed.

I'm suppose to have a conference call with a holistic vet from Weston, Ct. Wed. (I'm in Ohio) but god that seems so far off now.

I need help now!

Karen

Casey's Mom
09-17-2010, 10:53 PM
Karen - we are here for you . . . .

Love and hugs,

Roxee's Dad
09-17-2010, 11:06 PM
Hi Karen,

I am so sorry for what you and Millie are going through right now. As Leslie said, let you heart and your love for Millie be your guide. We will be here for you.

Sending you and Millie good thoughts and prayers.

frijole
09-17-2010, 11:15 PM
Karen, I join the others in sending out my warmest thoughts and prayers to you and dear Millie. I wish I could do more. xoxo Kim

KjobakerOhio
09-18-2010, 01:17 PM
Hi Everyone...

I called Millie's regular vet this morning because her IM is off for the weekend. Her panting, pacing, appearing to be disoriented this morning had me concerned. They told me to go to the ER. I feel like we've been dismissed.

For the last hour, I've held her and now her panting has stopped and she's resting. She hasn't eaten anything since yesterday a.m.

I don't know the size of her pituitary tumor. She had a CT in Nov. of 2009. Can anyone tell me the signs I might be looking for as it grows? I understand that when it gets 10mm and above, that is when you might see changes? Can this be painful?

My IM just called me as I was writing here. I had written him a long email this morning. He said that her tumor could be now causing neurological problems in the central nervous system and that's why I'm seeing her appearing to be confused, disoriented, panting, pacing, etc. Maybe she's in pain and that's why she doesn't want to eat but it's only been 24 hours and he said she can go up to a week. More importantly, she needs fluids.

I'm crying so hard right now so I'm going to stop writing.

Thanks to all of you for the support.

lucygoo
09-18-2010, 01:32 PM
Hi Karen...

I'm so sorry you're going through this right now with Millie. My Lucy had a huge macro tumor but had it removed surgically. She had severe neurological symptoms and didn't eat.

Before the surgery she was given prednisone, I believe 40 mgs a day, and it definitely made her feel better, increased her appetite and decreased the symptoms. (It decreased the swelling around the tumor) I would insist on giving her prednisone at this point. She was also given tramadol. (And, of course, no Vetoryl) This may keep you up all night due to frequent drinking and urination, but at least it will ease her symptoms.

Good luck to you both, and take care:)

Gina

frijole
09-18-2010, 01:32 PM
Ah, I am sending the biggest hug ever to you and Millie.

You are in the right place for sure. It could be the macro but it could just be old age. I know my Haley would have times when she was disoriented. It also could be a bug of some sort causing the lack of appetite and the other symptoms are from lack of food. But those docs will look into it.

I know this is hard right now but you are doing the absolute right thing for Millie by being in the ER. Keep holding her, hugging her and know you are a great mom. I am sending every bit of strength I have to you. Hang in there and I wish you the very very best today. Kim

Squirt's Mom
09-18-2010, 02:54 PM
Hi Karen,

Gina gave some good advice with the pred; that could help Millie feel better and help her want to eat. Perhaps her IMS could give her some?

A macro can cause circling, confusion, head pressing like against walls, etc, loss of appetite, restlessness, and a host of other things but these are the most common, I believe. Without a CAT or MRI, there is no way of telling how much hers has grown. :(

I wish with all my heart I knew what to tell you, something that would help both you and Millie feel much better. Just know this - as you hold Millie and love on her, there are many arms wrapped around you both, lending our strength and hope.

Hugs,
Leslie and the girls - always

acushdogsmom
09-18-2010, 04:10 PM
I'm so sorry you're going through this right now with Millie. My Lucy had a huge macro tumor but had it removed surgically. She had severe neurological symptoms and didn't eat.

Before the surgery she was given prednisone, I believe 40 mgs a day, and it definitely made her feel better, increased her appetite and decreased the symptoms. (It decreased the swelling around the tumor) I would insist on giving her prednisone at this point. She was also given tramadol. (And, of course, no Vetoryl) This may keep you up all night due to frequent drinking and urination, but at least it will ease her symptoms.Hi Karen,

For what it's worth, I agree with Gina and Leslie about the pred.

I know that for some time you were giving Vetoryl to try to lower the cortisol production, but it may be time to "switch gears" and do what Millie may need right now to make her feel better - and it's possible that prednisone would help Millie to feel much better at this point.

I do know of a dog who had an expanding pituitary macroadenoma and another who had a pituitary macroadenoma and a meningioma (another kind of brain tumor) and at some point both owners did start giving pred to their dogs. Doing that gave both of those very sweet little girls another six to eight months or more of very good quality time.

Although I'm sure there are more, here's one reference I was able to find:

http://www.cvm.ncsu.edu/vth/clinical_services/neuro/brain_tumor.html
(I've bolded the part that I wanted you to see)


Pallative Treatment - If none of the above therapies are an option, it is possible to treat the signs caused by a brain tumor.

Tumors tend to cause the accumulation of fluid (edema) around them and this can be treated with a corticosteroid such as prednisone. As many of the clinical signs can be due to the edema, some animals show a dramatic improvement within 24 hours of starting treatment with prednisone. This response is often short lived as the tumor itself is not being treated by this drug, but can certainly give owners and pets some good quality time. I think if Millie were mine, I'd want to at least try giving her an appropriate (for Millie's condition) dose of pred and see if that helps her to feel better. Maybe some Tramadol too, if you think she may be having some pain. But I'd try the pred (without Tramadol) first.

As Gina said, the pred might very well reduce any swelling around the tumor and it might also give her a better appetite. And depending on the reason for the hind leg weakness, it might even help her with that, too.

Perhaps the Oncologist at the Specialty Clinic would know what the right dose of pred would be to try for Millie in this situation. I definitely think it's worth asking about.

sending (((hugs)))

apollo6
09-18-2010, 04:59 PM
Dear Karen
I am praying for you. Let us know what happens. We are praying for you and MIllie.
Please don't give up if it isn't too late. If is so difficult because the tumor is causing the cushing and the signs could mean more. But without an actual xray/mri/ultrasound it is hard to say.
A dog with a pituitary tumor is usually out of sorts, listless and refuses food. Some abnormal behaviors like walking in circles and seizures can indicate the prevalence of a tumor in the brain.

Occasionally (10-15% of pituitary tumors) these tumors are larger and their size presents challenges of their own. Larger pituitary tumors (macroadenomas, over 1 centimeter in diameter) can place pressure on brain tissue and nerves, causing blindness, circling, seizures, or other neurological problems not directly related to hyperadrenocorticism. Some of these symptoms (e.g., incoordination) can resemble side-effects of medications used to treat Cushing's disease, further complicating diagnosis and treatment.
New imaging techniques like CT scan and MRI have made diagnostic procedures easier. But these investigative techniques are expensive.

Yet Cushing's disease is treatable and that treatment can result in a longer, more comfortable life for the dog and its owner. Thus, it is important for the regular pet owner to learn the basic facts about Cushing's disease.
link to ims in your area
http://www.acvim.org/websites/acvim/index.php?p=228
Sending in hugs and support
Sonja and Apollo

KjobakerOhio
09-18-2010, 07:20 PM
Hi Everyone..

Millie's Cushings symptoms aren't the problem presently. Her 9/14/10 A.C.T.H. Stim test was decent, meaning Pre was 6.8 and Post was 7.7. She doesn't have the pot belly, excessive drinking, eating, skin looks good, hair is full, paw pads are back to normal, etc.

The change in behavior has been since she had anesthesia on 9/2/10.

Her pituitary gland measured at .6cm on 11/19/09. I haven't had a CT since then and it could be, as her IM said today, starting to cause neurological systems to the central nervous system.

A couple suggestions to my posting has been give Millie prednisone and tramadol, both meds I have on hand and were prescribed to me by my IM and he hasn't suggested taking that course of treatment.

How should I approach him about this recommendation?

Thanks, Karen

lucygoo
09-18-2010, 08:07 PM
Karen,

You should remind your IMS that this is the treatment for dogs with growing macro tumors who don't have surgery or radiation. The idea is quality time for Millie now. She needs all the cortisone she can get to take down the swelling. In Lucy's case, it took her a couple days for it to even take any effect, so I would get started as soon as possible. I don't think you want the neuro symptoms and the not eating to continue. Believe me, it will make both of you feel better. I'm surprised he hasn't suggested it already. Am thinking about you guys and hope Millie feels better soon!

Gina

acushdogsmom
09-18-2010, 10:43 PM
Hi again, Karen,

Well, I suppose it's possible that the symptoms you are seeing now could have something to do with the recent anaesthesia, since the symptoms seem to have just started right after you had the dental done, or it could be due to the macrotumor growing - I don't know and I suspect that even your Vets can't know for sure without doing another CT.

Maybe it would be worth discussing the matter with the Radiation Oncologist with whom I think you met once before when you were considering possibly doing the radiation treatment (Dr. Prescott?). He/she probably deals with many patients who have brain tumors and who have been under anaesthesia (they have to be under anaesthesia to have the radiation treatments) and so he/she may have some more ideas regarding what you can still do for Millie at this point (other than radiation of course).

As for how to ask about the pred specifically, you can say that you found a reference to using the pred to reduce possible edema (swelling) around brain tumors in dogs (which usually also reduces the associated symptoms) on a bonafide website, the North Carolina State University’s College of Veterinary Medicine website (http://www.cvm.ncsu.edu/vth/clinical_services/neuro/brain_tumor.html) where it says:


Pallative Treatment - If none of the above therapies are an option, it is possible to treat the signs caused by a brain tumor.

Tumors tend to cause the accumulation of fluid (edema) around them and this can be treated with a corticosteroid such as prednisone. As many of the clinical signs can be due to the edema, some animals show a dramatic improvement within 24 hours of starting treatment with prednisone. This response is often short lived as the tumor itself is not being treated by this drug, but can certainly give owners and pets some good quality time.

And you can also say that you have met someone whose dog was lucky enough to have participated in a study in California last year where her dog's pituitary tumor was successfully removed surgically (Gina's Lucy) and that she told you that before the surgery her dog was given pred to reduce the swelling around the tumor and that the pred apparently did help alot to reduce the swelling and also helped to resolve the associated symptoms (pre-surgery). So you're wondering if pred might be a reasonable option to try with Millie.

If Dr. P. thinks that it's more likely anaesthesia-related, I suppose that he/she might advise waiting it out a bit longer to see if there's any improvement, or he/she might want you to try the pred anyway and/or might have some other idea that could help Millie and give her some more good quality time with you.

Is there any way you can get a consult with the Radiation Oncologist or maybe with a Neurologist (who may also deal with many patients who have brain tumors) at the Specialty Clinic, to discuss Millie's condition and to see what they think about trying pred or seeing if they may know of anything else that could help Millie to feel better?

littleone1
09-19-2010, 06:54 AM
Hi my dear friend,

I wish I had some answers for you. I'm keeping you and Millie in my thoughts and prayers that Millie will soon show improvement.

Give her a big hug from me.

Squirt's Mom
09-19-2010, 10:57 AM
Hi Karen,

Cushy gave some great direction in asking about the pred for Millie. She's much more diplomatic than I would be. :o:) I would be more apt to mimic that commercial about getting your money - "It's MY dog and I want pred NOW! :D Or, most likely of all, I would be bawling and begging and blubbering - handing them support I had printed from the web for the pred because coherent speech would be beyond my ability. :o:rolleyes::o

The bottom line for me is this - Millie is your baby, you pay for medical services for Millie, and as long as there is no medical issue with her taking the pred, the vet shouldn't prevent you from having what could help Millie.

How is she doing today? How are YOU doing? Keep in touch, sweetie.

Hugs
Leslie and the girls :D - always

Franklin'sMum
09-19-2010, 11:07 AM
Dear Karen,
Sending thoughts and prayers your and Millie's way
Jane, Franklin and Bailey xxx

KjobakerOhio
09-19-2010, 02:47 PM
Hello Everyone...

Thanks to all and especially ACushMom and Gina with the information you posted yesterday. You gave me some information that my IM was willing to listen to....thank goodness!

After I sent him the medical reference on "palliative treatment" for brain tumor, this is what he wrote back to me.

"Sent: Sun, Sep 19, 2010 3:17 am
Subject: Re: Millie

Hi Karen,

The location of Millies tumor should not cause seizures. Although with a lot of swelling it is possible.

I had considered steroids yesterday but did not bring it up because I did not think it would help. However, it likely won't hurt. If you have pred at home, go ahead and give 5 mg by mouth this morning and 2.5 mg in the evening. Let me know how things go.

Roger

Squirt's Mom
09-19-2010, 03:43 PM
Hi Karen,

I hope the pred helps Millie and you see improvement real soon! Let us know how she does....

Hugs,
Leslie and the girls :D - always

KjobakerOhio
09-19-2010, 04:31 PM
Thank you so much! I'll keep you posted. Right now she's laying with her head on my left foot. She must really love me because I have some really ugly feet!:eek:

Also, Millie ate two times today. Small portions and drank water on her own. She did none of that yesterday.

Take care, Karen

Squirt's Mom
09-19-2010, 05:06 PM
LOL! Well, that all sounds better already!

Roxee's Dad
09-19-2010, 05:53 PM
Keeping all fingers and paws crossed.

gpgscott
09-19-2010, 06:22 PM
Thinking about you and Millie.

Scott

acushdogsmom
09-19-2010, 06:38 PM
It's good to hear that Millie has eaten some food today and that she's been drinking water on her own. Sounds as if she's more comfortable too, with her head on your foot. :)

All fingers and paws crossed here too, that the pred does continue to help her feel better.

KjobakerOhio
09-19-2010, 06:49 PM
Quick question. How is this website funded? It's such a great source of information and support. Do they need donations?

Thanks, Karen

Casey's Mom
09-19-2010, 10:13 PM
So glad to see she is eating and drinking on her own.

Love and extra hugs,

apollo6
09-19-2010, 10:18 PM
I have been thinking about you and Millie all weekend and praying for you.
You'd have to ask the administrators who handles the website. As far as I know it is all volunteer.
You are getting some positive results hold on to that for now.
Millie is still here that is what counts.

You said her tumor was .6cm in November so it is still small:
Larger pituitary tumors (macroadenomas, over 1 centimeter in diameter) can place pressure on brain tissue and nerves,
Hugs Sonja and Apollo.

lucygoo
09-20-2010, 12:33 AM
Hi Karen...

I'm so glad you started Millie on prednisone! Sounds like she's already showing signs of improvement and I'll bet tomorrow will be better still:) Keep us posted,

Gina

mytil
09-20-2010, 06:23 AM
Hi Karen,


Quick question. How is this website funded? It's such a great source of information and support. Do they need donations?

Thank you for your kinds words and offer :D This site is entirely set up and run by volunteers who share a common bond of having to care for (or have cared for) dogs with all facets of Cushing's. All the Forum Hosts, Moderators and Admins are volunteers.

I say the most precious donation you, or any member, can make is to play it forward. Support and involvment and being here for each other makes such a difference and we value each and every one of you!

continued prayers for you and Millie
Terry (Admin)

KjobakerOhio
09-20-2010, 07:18 AM
Hello Everyone and Good Morning!

I too value paying it forward and again, appreciate what you've created here for all of us.

I know I've been so overwhelmed by Millie's disease, I couldn't get my head around learning these threads in this website. I would call Terri (Corky's Mom) and she would get me back on track.

I've emailed my IM this morning, letting him know the 5mg. and 2.5 mg dose in 12 hours appeared to help her.

Millie paced the floor less yesterday. She always paces in a circular motion. I have a kitchen island and she'll walk around that for 10 minutes at a time before she gets tired and settles on the floor.

She must have paced through the night because I woke up to a big mess this morning. She hadn't pooped yesterday and did three times over night and walked through it several times and left a trail around the kitchen island. I love Clorox!

Take care, Karen

apollo6
09-20-2010, 03:41 PM
Hang in there.
Baby steps.
Hugs Sonja and Apollo.

littleone1
09-20-2010, 05:00 PM
Hi Karen,

I'm glad that you've seen some improvement in Millie. I hope and pray that she will continue to improve.

I'm sorry she had the accidents in the house. I know what it's like. There were a couple of times when Corky couldn't make it outside.

Thank you for your kind words.

Take care my friend. We'll talk soon. You are still in my thoughts and prayers.

KjobakerOhio
09-20-2010, 06:49 PM
Hi Terri,

I hope Corky is improving. Keep me posted, ok?

I'm use to the messes on the floor. I've spent a lot of time in shelters and cleaning my kitchen floor is a breeze compared to the shelters. I hope I didn't sound like I was complaining. I just hate it for her because I know she doesn't want to do her business on the floor.

Millie stopped barking to let us know she wants to go outside after her teeth cleaning on 9/2. As exhausting as it was to have to do that 2-3 times a night, we didn't mind because it was helping her keep her dignity.

Has anyone with a P.D.H. dog stop barking suddenly like Millie?

Take care everyone....... Karen

KjobakerOhio
09-20-2010, 09:46 PM
Hello Everyone...

I was getting up to date on Prednisone. It's been a long while since any of my dogs has taken this drug.

Back in 2002, my mix terrier had Immune Mediated Hemolytic Anemia. My doctor recommended that she take something for her stomach while taking Prednisone. I think it was Prevacid. Does anyone give their dogs something for their stomach while taking Prednisone.

Also, I was reading that usually it's given for 10 days with a step down in dose.

My IM hasn't given me any instructions on how long. He had me give her 5 mg in the A.M. and 2.5 mg in the P.M. two days in a row.
Isn't that stepping up and stepping down?

Geez....I feel like he doesn't have a plan. He didn't recommend this drug until I sent the information that I received from this forum.

lucygoo
09-20-2010, 11:23 PM
Hi Karen...

The dose of prednisone your vet prescribed seems right on for a dog of Millie's size. It's not stepping up or stepping down, it's just splitting up the dose during the day, probably to ease stomach upset. Lucy is on prednisone for the rest of her life, doesn't have any stomach issues, but I do give her Pepcid on occasion (Just the regular strength). You can give that to Millie.

If Millie's symptoms are improving, and she does indeed have a macro tumor, then I don't think your vet will or should wean her off of it at this point. How is she doing now?

Take care,

Gina

gpgscott
09-21-2010, 12:54 AM
Hi Karen,

I am not aware of stomach upset with the use of prednisone although I do now it is quite bitter and it is recommended that it be taken with food and drink.

As far as dose. You have to keep in mind that Millie is not a normal application. Prednisone is usually prescribed for acute conditions and so in a rather large dose to raise the level circulating in the bloodstream rapidly, keep it there for a few days and then slowly allow the level to diminish to normal. When it is administered this way the adrenals temporarialy stop normal production of cortisol as the body senses an over abundance. This is why the stepping down or titrating is necessary to allow the body to see the level lowering so that it again stimulates the adrenals to produce an adaquate supply as the supplement is withdrawn.

In Millies case you have a system which can no longer regulate cortisol properly and you have been trying to inhibit cortisol. You are now trying to bump it up just a bit to try to give Millie a bit more energy. I think it is going fine so far.

Please continue to let us know.

Scott

Squirt's Mom
09-21-2010, 07:53 PM
Hi Karen,

How is Millie doing today?

Hugs,
Leslie and the girls :D - always

Squirt's Mom
09-23-2010, 11:49 AM
Hi Karen,

Just popping in to see how you and sweet Millie are doing? We would love to hear from you!

Hugs,
Leslie and the girls :D - always

apollo6
09-23-2010, 03:30 PM
Just hoping Millie is doing better.
Sonja and Apollo

KjobakerOhio
09-23-2010, 10:48 PM
Hi Everyone...
I haven't posted for a couple days I took 3 days off from work to be home with Millie. I went to the office for a little while today.

I now have a new vet to monitor Millie's overall health. I had to leave my vet of 25 years. I interviewed with an new vet on Wed. and felt very good about her.

Also, I brought on board my homepathic Vet from Weston, Connecticut, Dr. Feinman. He'll be helping me with Millie.

I'm feeling hopeful for Millie. She barked for the first time in 21 days and has eaten well for 2 days.

Thanks for checking up on me everyone....you are the best!

Take care, Karen

Roxee's Dad
09-24-2010, 01:23 AM
Hi Karen,
Very happy that Millie is doing better. :D:D:D Best news I've had all day. Thanks so much for the update.

gpgscott
09-24-2010, 02:15 AM
Thanks for letting us know Karen, looking forward to continued improvement.

Scott

Casey's Mom
09-24-2010, 10:23 AM
Thanks for letting us know Karen, we do tend to worry when we don't hear anything. :o

Hugs,

Squirt's Mom
09-24-2010, 11:48 AM
Hi Karen,

Sounds like you and Millie have some positive plans in place and that it great. I hope the new vet will be able to help Millie more.

That is wonderful that she barked and ate some! :D I know that just made your heart sing! Mine, too! :D

Hugs,
Leslie and the girls :D - always

littleone1
09-24-2010, 12:47 PM
Hi Karen,

It's so good to see that Millie is improving. I know that everytime our furbabies show any sign that they are returning to their normal selves really brightens our day. I'm hoping for continual improvement.

Take care,

KjobakerOhio
10-03-2010, 12:00 PM
Hi Everyone....

It's been 10 days since I posted.

Millie has shown improvement over the past 10 days. She had diarrhea very bad for a few days and then had a break for about 4 days and now it's back.

Her Prednisone is being reduced slowly and that is when the diarrhea stopped but for some reason it's coming back.

I have a homeopathic vet who is helping me too with her nutrition, swollen liver and over all immune system.

Millie is eating and drinking better and barking again so that makes me happy.

Thanks for your support. It's always comforting to know you all "have our back".

Take care, Karen

apollo6
10-03-2010, 10:30 PM
I am so glad to here about Millie. Don't give up on your little girl, she is a fighter.
Hugs Sonja and Apollo

KjobakerOhio
10-10-2010, 10:29 AM
Hi Everyone,

Millie is showing signs of improvement every day. Baby step like improvements. It keeps us hopeful.

She is slowly being weaned off the prednisone.

Along with being watched by her internist, we've integrated homeopathy treatment and so far, no Cushing signs have appeared. Millie's eating is good and her drinking is normal. (She's now eating "Honest Kitchen" food).

Her holistic/homeopathic vet has prescribed a remedy for her liver, one for her immune system and a Nux remedy.

Millie is back to being alert, stronger, skin looks good and no diarrhea.

The only thing that hasn't changed is her night time trips outside. She still gets up 3 times a night. Yes, we are tired but what an improvement since 9/17/10.

Millie has not taken Trilostane since June and her cortisol numbers remained in the normal range when tested in September.

Keeping our paws crossed that her quality of life continues!

Take care, Karen

Squirt's Mom
10-10-2010, 12:08 PM
Hi Karen,

I have been wondering about you and Millie and am so glad to read your report this morning! :D It sounds like Millie is feeling much better and I know that means you are as well. I hope the new meds will continue to bring improvement and comfort to her.

Hugs,
Leslie and the girls :D - always

littleone1
10-11-2010, 12:56 PM
Hi Karen,

I'm so glad to hear that Millie is continuing to improve. Give her a big hug from me.

(((HUGS))) You're doing everything you can possibly do for Millie.

apollo6
10-12-2010, 01:56 PM
So gald to here about Millie.
Sonja and Apollo

KjobakerOhio
10-17-2010, 08:52 PM
Hi Everyone....

Millie is doing well. Off Triostane since June.

I'm hoping her night time trips outside (2-3 times between 12:00 a.m. and 6:00 a.m) will lessen. But........if that's the worse symptom, I'm happy as a bug in a rug. :-)

We're trying to live in the moment....just like dog's like to do.

Take care everyone!

Karen

littleone1
10-20-2010, 01:44 PM
Hi Karen,

I'm so glad to hear that Millie is continuing to do well. It means so much to us when they are doing well.

Give Millie a big hug from me.

horsemum2
01-04-2011, 08:28 PM
Hi Terri,

Has anyone with a P.D.H. dog stop barking suddenly like Millie?

Take care everyone....... Karen

Our girl doesn't bark to go out anymore either. She just goes on the floor unless we pick her up and take her out every hour. She too, needs to go out all night long unless she's asleep. Bela also is doing many circles now. (alway counter clockwise, she can't or won't turn in the other direction, even with us trying to direct her)

littleone1
01-30-2011, 01:06 PM
It is with a very saddened heart that I am posting this for Karen. Millie passed away on January 24th.

I just spoke with her. She will be back on the forum when she feels she is able to post about Millie.

Rest in peace sweet Millie. You will always be loved very much.

(((((HUGS))))) my very dear friend. Corky and I love you bunches.

Terri

Squirt's Mom
01-30-2011, 01:30 PM
Dear Karen,

My heart breaks for you. You have had so much on your plate but have faced it all with beautiful grace and faith. Millie is so blessed to have had you as her mom.

Millie's name has been added in the In Loving Memory section where she will always be remembered by her family here with love. Candles are lit for her and you on our candle site, as well.

She will always be part of you, Karen. Today she is looking down on you with such love and gratitude for all you gave her. Millie is running free and strong once again, whole in body and mind.

Please know we are here for you whenever you are ready to talk.

Our deepest sympathies,
Leslie, Squirt, Trinket and our Angels, Ruby and Crystal

http://www.k9cushings.com/forum/showthread.php?t=2865
http://www.gratefulness.org/candles/candles.cfm?l=eng&gi=K9C

BestBuddy
01-30-2011, 02:55 PM
I am so sorry. Millie was so loved.
Another angel has their wings.

Jenny

caroleh
01-30-2011, 05:25 PM
Hello Karen:
I am so sorry to hear of your loss of Millie. I have left you a private message to read when you are up to it. I understand your pain. God Bless You, Carole

Bichonluver3
01-30-2011, 07:10 PM
Dear Karen,
Our hearts are breaking for your loss of precious Millie. From what I have read, you were an amazing mom and I know you are missing your furbaby terribly. i hope that before long, comforting memories will replace the tears and you will smile at all the wonderful times you shared. When you are ready, we would love to learn more about your life with Millie. In the meantime, please take care of yourself. We send all our love and prayers your way.
To Millie: Run free, sweet angel, with all your knew friends. may sunshine warm your face and soft winds be at your back. So many times over the past few months, I have looked to the desert sky for another new star. Shine brightly tonight as I look for yours. Godspeed and God bless, sweet angel.
Love,
Carrol & Chloe

frijole
01-30-2011, 09:58 PM
Karen, I am so very sorry. You have been a fantastic mom to dear Millie. May memories of good times keep you strong as you heal. RIP dear angel Millie, fly free. Love, Kim

mytil
01-31-2011, 07:16 AM
Oh Karen,

My heart is with you. I am so sorry to read about Millie passing. You are such a wonderful mom. Millie will be watching over you always.

Always in Loving Memory of sweet Millie
(((((hugs)))))
Terry

Thank you so much Terri for letting us all know about this. Let Karen know we are all here for her.

Spiceysmum
01-31-2011, 01:46 PM
Karen,

So sorry to hear about Millie. You are in my thoughts.

Linda

jrepac
01-31-2011, 02:40 PM
So sorry to hear about Millie; it was but a few months ago that she was doing SO well....our time w/these babies is fleeting, unfortunately.


Jeff & Angel Mandy

Casey's Mom
01-31-2011, 10:35 PM
Karen, I am so sorry to hear about Millie. You gave her some great quality time by being such a great mom. My heart is with you,

Love and many hugs,

k9diabetes
02-01-2011, 12:22 AM
I'm very sorry to learn that Millie has passed... she was obviously a special part of your family. I know it must have been very difficult going through the past couple of months. I'm glad she had you at her side for comfort and was surrounded by your love.

Natalie

Franklin'sMum
02-01-2011, 12:27 AM
Dear Karen,

I am so very sorry to hear Millie has passed. My thoughts and prayers are with you.
(((HUGS)))
Jane, Franklin and Angel Bailey xxx

zoesmom
02-01-2011, 09:36 AM
Karen -

I am so sorry to read about Millie's passing. She was a lucky girl to have you as her mom. Sue

apollo6
02-01-2011, 05:08 PM
I am so sorry for the loss of your beloved Millie.
May she know be free of her pain.
Hugs Sonja and Apollo