Min Poodle with Cushings/beautiful Cloud has passed

[Poodlemom]

I have a 10 yo rescued min poodle who has just been diagnosed with PDH. There has been a suspicion of Cushing's for approx 2 yrs because his appetite has been ravenous and pot belly, hair loss on mid section, and panting. Never has been overly drinking but I don't feed kibble I feed raw food. Did Full blood panel which suggested elevated liver numbers so dr wanted to do another Low dose Dex Suppression test. Result consistent with PDH so dr suggested an abdominal ultra sound to confirm. Ultra sound revealed enlarged adrenals but no mass (consistent with Pituitary Cushing's)Liver enlarged, cyst in pancreas, right kidney possible infection. Next did urine test and culture to rule out infection. No bacteria in urine. Dr suggested re-check pancreas in 6months. I just don't like the idea of the meds so was so relieved to find this forum. My sense is that we can do some things to support the liver and adrenals. I did start Cushex drops but nothing else. He is less and less tolerant of exercise so I stopped his mile walk at the park (I was mostly tugging him along lately) and just take him on an easy paced walk around the block. I hope I didn't leave out anything. Maybe I can get some suggestions on how to help him cope. I noticed this week his legs have been giving out every once in a while-like he trips and he never did that before. Looking forward to receiving feedback. Thank you so much.

[frijole]

Welcome! You have come to the absolute best place for help and friendship in treating cushings. I arrived 7 yrs ago! ;)

Your dog can have a wonderful, normal life and the drugs aren't bad at all... don't believe all you read. They are strong and work! Like any drug you have to use them correctly. Where dogs and owners get into trouble is by not following the recommended guidelines/protocols for them. Kind of like don't take too many aspirins or they'll hurt you too.

I can tell you that the Cushex drops don't work. Trust me, if they did none of us would have gone the traditional med route and this board wouldn't even exist. Sorry, just being honest and trying to save you time and money. One of our members actually contacted them to ask them for testing information, basically proof of effectiveness and they could not support their claims. Enough said.

Keep us posted as your vet provides meds and we will help you along the way by checking the dosages, monitoring progress and answering questions.

Glad you found us. Welcome!! Kim

[StarDeb55]

Welcome to both of you! It would help us to provide more specific feedback for you & your baby, if you could gather up copies of all testing that has been done. We would be interested in seeing the results of all cushing's diagnostic testing, along with the general labwork that showed the elevated liver function tests. On the general labwork, we only need to see the abnormal, along with the reporting units, & normal ranges.

I really hate to disillusion you about homeopathic or natural treatments for Cushing's but there simply aren't any. Cushex or any other of these types of things you find on the internet are simply snakeoil. One of our adminstrators even contacted Cushex asking for the testing that showed that Cushex could effectively lower cortisol, there response was that they had none. Believe me, if any of these types of things were effective, all of us would have had our pups on these supplements in a flash. There is no argument that both medications used to treat Cushing's, are very powerful, strong drugs, but they are life saving drugs for our babies. The trick is that the parent must educate themselves about the drug, correct dosing & monitoring protocols. I have only used lysodren with my 2 boys, but to show you how well these meds work, my 1st boy was successfully treated for about 8 years, crossing the bridge at 15 from medical causes unrelated to his Cushing's. My 2nd boy was a little old man when he was diagnosed at 13, but was treated for 2 1/2 years with lysodren, before I lost him to another medical issue. We have a huge number of members who are successfully using trilostane. I'm sure some of them will be along to offer their advice.

Looking forward to hearing more. We are here to help in any way we can.

Debbie

PS- I see Kim was posting the same time that I was, so my apologies for any duplication.

[Poodlemom]

I just realized that I forgot to mention that my poodle(Cloud) has been on thyroid medication for several years, .2mg Soloxine twice a day. When I took him in he had been run over and had a fractured pelvis so now the knee is frozen on that leg and has arthritis. He now weighs 23lbs and is struggling to climb upstairs to our bedroom so I would love to be able to help him manage his hunger. How do I get the tests over to you so you have a better picture of his condition?
Thank you again for being there.

[frijole]

Alot of cush dogs have muscle wasting and trembling in the back legs. They quit jumping up on furniture and climbing stairs as a result. Over time, with treatment they regain their strength. It is hard to tell in your case (due to the accident) whether it is cushings or arthritis or both that has caused the weakness.

To share test information you can simply type it in. Blood panels you can just type the info that was high or low (be sure to include the ranges). Any other tests you can just give us the name of the test and the numbers. What tests did you have done?

Thanks, Kim

[Poodlemom]

I think my Clouds weakness in the back legs is from Cushings, because I notice the left leg trembling not the right (which is the leg that was fractured). And yes, he stopped jumping up on the couch several months ago. You don't know how much I appreciate your feedback and support in this very difficult time. Every time I learn something from you it makes me feel a little more encouraged that his quality of life can be improved or the progression of the disease slowed a little. The following are his test results:
Cloud Dearie tests and results
2/10/2012 Senior blood panel
Results Reference Range
ALT (HIGH) 373 12-118
ALK (HIGH) 2692 5-131

Bun/Creatine ratio(HIGH) 30 4-27
Triglyceride(HIGH) 398 29-291
Monocytes (HIGH) 896 7% 0-840

4/11/2012 Dex Suppression Test
Cortisol Sample 1 (HIGH) 10.1 1.0-5.0 pre
Cortisol Sample 2 (HIGH) 1.7 DEX 0.0-1.4 4hrs
Cortisol Sample 3 (HIGH) 1.5 DEX 0.0-1.4 8hrs

4/20/2012 Abdominal Ultrsound
Liver Generally enlarged and diffusely hyperchoic with multiple small ill-defined nodules.
Biliary tract-The gallbladder contains a moderate amount of dependent echoic debris
Kidneys-Both kidneys are normal in size and architecture(left 4.9cm, right 5.0cm) There is mild dilation (1.2mm) of the right renal pelvis.
Urinary bladder-The urinary bladder is within normal limits
Spleen-Prominent with normal echogenicity and margination.
Gastrointestinal tract-The stomach and intestines are normal in contents and the visible walls are normal in thickness and layering.
Pancreas-Normal in size and echogenicity and contains two well defined anechoic cysts (4.6mm, 2.6mm).
Adrenal glands Both adrenal glands have normal shape and echogenicity. The left adrenal is mildly enlarged (6.8mm) and the right is at the upper end of normal limits (5.3mm).
Lymph nodes-There is no evidence of mesenteric or sublumbar lymphadenopathy.
Peritoneal space and mesentery Within normal limits.
Conclusion:
1.Mild bilateral asymmetric adrenomegaly. Pituitary dependent hyperadrenocorticism is suspected. There is no evidence of an adrenal mass.
2. Hyperechoic hepatomegaly is a no-specific finding, however steroid hepatopathy is the primary consideration in this patient.
3. Pancreatic cysts are likely benign and represent retention cysts associated with previous inflammation. Abscesses or cystic neoplasia are considered unlikely.
4. Mild dilation of the right renal pelvis is likely due to polyuria. Active or previous inflammation cannot be excluded.
5.Gallbladder debris is a common incidental finding.
Recommendations: further evaluation of the pancreatic cysts with repeat ultrasound in 3-6 mos only if clinically indicated. Urinalysis + Culture
5/16/2012 T4 – results 4.0 (ref range 3.0-5.0)
5/31/2012 Urinalysis –culture no bacteria found
I hope I did this correctly and not overwhelming info.
Thank you so much to both

[Poodlemom]

Update-Well, we should be starting the Trylostane is a couple of days. My doctor was very encouraging saying she has found most dogs do quite well on it. She wants to start the meds and then in two weeks take the ACTH test and then re-test in 1 to 3 months. I have been encourage by this group to go ahead with the medication. I tend to focus on the side effects and reading others' positive experiences with Trylostane has removed some of the fear. Thank you to everyone!
Gerry

[frijole]

Do you know what dose you will be giving and the frequency? I read back, does Cloud still weigh 23 lbs? Thank you and good luck! Kim

[Poodlemom]

I don't know the dose yet but it is coming from Compounding Pharmacy. I just found the info posted on compounding pharmacies and now am concerned. I think the vet went this way because cost is an issue for me and the price was about half as much as from conventional pharmacy. I suppose I will go ahead with this order since I am sure it is not returnable but was wondering if anyone else has had experience with purchasing Trilostane from Compounding Pharmacy. Would love to hear their experiences, good or bad. I will look for more info on this site.
I will let you know as soon as I receive the medication what the dosage is, etc.
Talk soon,
Gerry

[StarDeb55]

Personally, I can't speak to using trilo at all, but did want to address your concerns about a compounding pharmacy. A number of members use Diamondback Drugs who do strictly vet compounding, & I have never seen a complaint about them. I used them to get my last Cushpup's lysodren compounded, & never had a problem with them. Over the years I have used them exclusively for all of my pet's medications, & have been very happy. As long as the pharmacy is reputable, using compounded trilo should not be a problem.

Debbie

[Bo's Mom]

Although I have no experience with compounded Trilostane, we have done Bo's Lysodren using Veterinary Pharmacy of America based out of Houston. We have had no problems with the compounded medicine and actually Bo loves to take his medicine because it is in a meaty chew. He thinks he is getting a treat when he gets his Lysodren.
Best of luck with starting your baby on Trilostane. I do hear wonderful things about it. Please keep us posted.

[Poodlemom]

Received Trilostane medication today from Roadrunner Compounding Pharmacy. The dosage is 0.25ml twice daily. (it's a 40mg/ml suspension). Cloud's weight is about 22.7 lbs. Does that dosage sound right? I guess I will start tonight at dinner time since it must be given with food.
Gerry

[lulusmom]

Hi Gerry,

.25ml is equal to 10mg so Cloud is getting 20mg per day which is a bit under 1mg per pound. That is low end of the range recommended by Dechra for a dog weighing 22 pounds. That's a good thing. Good luck and remember that we'll be here for both of you.

Glynda

[GabbySue]

Gabby's Trilostane comes from a compounding pharmacy,Wedgewood Pharmacy, she gets 5mg twice a day in a nice chewable tablet. :)
I know it comes in capsules, but they can't be split and I requested something from the vet that wasn't a liquid as Gabby is not cooperative with having anything put into or pushed down her mouth, she's sweet and all but she will bite if I try to force pills/liquids down her throat. The last batch of 100 cost me $68 and shipped overnight by FedEx. It's the first thing they haven't missed!!(sorry I couldn't resist but one another board we call them FedUP, as they are known to delay semen shipments which are the worst for a hold up)

[Poodlemom]

Thank you to Glynda and everyone. I took a deep breath last night and gave Cloud his first dose of Trilostane. We are on our way. I couldn't have started this without all of your support!!!
Gerry

[Altira]

You are in good hand here... Not to worry.. Stay with us, the Angels won't leave your side!

[Poodlemom]

I haven't posted in a little over two weeks. My Cloud has been on his Trilostane and no evidence of negative side effects. He had his first ACTH test on July 6th and the vet just called and said his values are good and wants to re-test in 3 wks. She actually wanted to test again in 2 weeks. Is that the normal, for re-testing? first test @ 2wks then @ 1month then @ 90days?? $240.00 each time is difficult to handle.
He is still VERY VERY hungry and now his back legs have given out several times. So although no negative side effects not sure any positive results yet either. I Hate this disease!

[labblab]

Yes, I'm afraid the testing schedule of 2 weeks, a month, and then 3 months is the standard recommended protocol when beginning trilostane treatment :o. Depending upon Cloud's weight, however, it may be possible for your vet to "stretch" the expensive stimulating agent and thereby decrease the testing cost. Here's a link that you can share with your vet:

http://endocrinevet.blogspot.com/2012/03/how-to-dilute-and-store-cortrosyn-for.html

Also, can you please find out Cloud's actual numerical ACTH results? The actual numbers are very helpful in assessing the appropriateness of any dosing change, either now or further down the road. Please don't get discouraged yet. It may just be the case that Cloud will end up needing a higher dose of the medication in order to gain control of the Cushing's symptoms.

Marianne

[Poodlemom]

Thank you, Marianne, for the support. I just received the actual test numbers for Cloud. This was a 1 hr ACTH.

Pre results: 1.4000 ref range 1.0-5.0mg/dl
Post " 3.7000 ref range 8.0-17.0mg/dl LOW

I don't really understand the numbers maybe you can help me decipher the results. All my vet said was " the values are good". I think he will need an increase in dosage just by the fact that I don't notice much of a change at all. Thank you again,
Gerry

[lulusmom]

Hi Gerry,

To recap, Cloud started his 10mg once twice daily dose on 6/23 and the results you just posted was his first acth stimulation test done on 7/6. It looks like you have a few too many zeroes in the test results but those numbers look really good. Cloud's cortisol is right where it needs to be and any increase in dose could make cortisol go too low. We've seen cortisol drop well into 30 days so the numbers you posted may be even lower when you have the next stim test done. I am perplexed that a dog on twice daily dosing with great stim results hasn't seen any improvements in symptoms. Has there really been no change in Cloud's symptoms at all?

[molly muffin]

I'm not pro at the numbers either, but I will wish you good luck!

Sharlene

[Poodlemom]

Hi Glynda, Thank you for your response on the test results. That makes me feel better that the numbers are where they need to be. As for the symptoms, it is really hard to tell. Cloud was not drinking a lot of water so that is one symptom he never had. Like I mentioned, the newest thing that he has developed is the weakness in the back legs where they just give out on him. That started just as we began the Trilostane but I suppose that could improve with time. I guess he may not be eating as much as he was so I suppose that could have improved. I have so much going with my CRF cat also, that I may not be as observant as I would be if he was my only pet. I am here at home 24/7 though, so not too much escapes me in their behavior. I did take a picture of him when we were starting the Trilostane so will take a photo at 3 mos and then at 6mos to see what maybe I may be missing in his appearance.
Sharlene, thank you for your kind words and good luck to you with Molly Muffin, she's adorable. I also have a Shih Tzu, 10 yr old Molly May.
Gerry

[molly muffin]

Gerry, Oh my gosh! That is soooo funny - Molly Muffin and Molly May. My molly is 9, bet they'd have a blast together. :)

That is good that Clouds numbers are where they should be. I've read a lot that says rear leg weakness is one of the signs of cushings that shows up once they go on medicine. (that it is basically camouflaged by the cortisol prior to that) and then that it is the last symptom to clear up.
That it could be even arthritis that was hidden by the cortisol levels. Hope Cloud gets those legs moving soon.

Hugs. :)
Sharlene

[Poodlemom]

Hello everyone,
Well, I haven't posted for a while. Cloud has been pretty much without any issues from the Trilostane until a few days ago. Today marks three months on the medication and day before yesterday he threw up clear liquid like water and did not eat all day. I skipped the medication that evening and was going to call the dr in the am but he ate breakfast the next day so I gave him his trilostane. His appetite has not been good since and is eating very little after much coaxing and offering of different foods. He is also going periodically into the bathroom to lie down (maybe because it is dark there) could be he is not feeling well. He has not been interested in going for his walk either and seems to be having more issues with the back legs. I wanted to ask for any help from you wonderful angels on what may be going on and what I should do. BTW. I have not noticed any diarrhea.

Gerry

[Squirt's Mom]

Hi Gerry,

He needs to have an ACTH and have the electrolytes checked asap. It is possible that he needs a lower dose than he is currently taking. Please do not give any more Trilo until he has been tested just to be safe.

Hugs,
Leslie and the gang

[Poodlemom]

Hi Leslie,
I'm thinking he might need a lower dose as well, because this not eating is going to far in the wrong direction. I will take him in on Monday for an ACTH test. His last one was on Aug 8th and his test showed he was right where he needed to be per the vet. I will stop the Trilostane now. How do they check the electrolytes? Is that a separate blood test or part of the ACTH.
Hugs to you and yours.
Gerry
Thank you so much.

[Harley PoMMom]

Hi Leslie,
How do they check the electrolytes? Is that a separate blood test or part of the ACTH.
Hugs to you and yours.
Gerry
Thank you so much.

Hi Gerry,

To check the electrolytes they do need to perform a blood test which is not part of the ACTH stim test. Sometimes they call it a senior wellness panel and you may be able to only have the electrolytes checked, like a mini test.

[Poodlemom]

Thank you for getting back to me on the testing for electrolytes. I wish I had called the doctor yesterday, now we have to wait until Monday. Will the vet require Cloud to have the Trilostane the morning of the test or can they do the ACTH test without giving the medication. I was able to make an appt for Mon am but doctor was not in today so I don't know what they'll need. I really do not want to give him any more medicine until after they test but maybe someone can enlighten me on what the normal protocol is. I am so thankful you are all here, this is a rough time right now and I appreciate your support so much.
Gerry

[Squirt's Mom]

Hi Gerry,

Sorry you didn't get an answer in time to call yesterday and that I didn't impress on you in my original post that it was important to have that done ASAP.

How is Cloud doing today? I wouldn't give any more Trilo until he can be tested....and impress on the vet that this is not something that can wait if he is still acting off. In fact, if he not better today, I would be looking for an ER vet to see him now. Trilostane leaves the body pretty soon but it can cause the same damages as Lyso so if he is still not eating well and still trembling, find someone to see him today.

If his appetite is back and he seems more like his usual self, waiting til Mon will be fine.

Let us know how he is doing today, ok?
Hugs,
Leslie and the gang

[labblab]

Hi from me, too, Gerry. And I'm so sorry that you and Cloud have been having a rough couple of days.

First off, I totally agree with Leslie about continuing to withhold the trilostane for the time being. And if he should worsen and his symptoms progress to vomiting, diarrhea and increased lethargy, I would also take him to an ER facility today.

If he stabilizes today, however, and is looking better, I'd discuss the timing of the ACTH tomorrow with your vet. Of course, the most important thing is to make sure that Cloud is not in any immediate danger. And if he worsens or does not rally while off the trilostane, you'll need a full ACTH to check his status. However, it is always possible that his illness right now may be totally unrelated to the trilostane. And if you perform an ACTH after wittholding the trilo for a couple of days, you really won't get an accurate picture of the medication's true effect for purposes of long-term dosing decisions.

So as long as Cloud doesn't worsen, one alternative on Monday might be to perform that check of electrolytes as well as a baseline cortisol. The baseline cortisol only involves a single blood draw, along with the electrolytes. And as long as his baseline cortisol is safely above approx. 2 ug/dl and his electrolytes are OK, you can probably assume that he is not suffering from an Addisonian crisis. At that point, you and your vet can decide on the most appropriate treatment plan. And if this is perhaps just a passing GI upset, you can ultimately resume the trilo and wait to perform the full ACTH until such time that he has been consistently dosed with the medication again for awhile.

Just a few thoughts to throw out there to discuss with your vet. And as Leslie says, do let us know today how Cloud is doing, since that will help determine your next steps. If he should worsen, all bets are off and you should get some professional input today.

Marianne

[Poodlemom]

I am thinking I need to take Cloud to the ER today. He threw up twice this morning and would not eat again. Yes, I was not understanding that I should have had the ACTH immediately. He did not have his dose last night, his last dose was yesterday morning. If they will do the test today it should still be accurate I think. I will check back with you after our er visit.

[Squirt's Mom]

Hi Gerry,

Let us know what you learn and know we are right by your side!

Hugs,
Leslie and the gang

[frijole]

Good luck!!!! Kim

[Poodlemom]

Just got back from the emergency clinic and it was not good news. First they started with a full blood panel and found that his electrolytes where fine but he has diabetes and pancreatitis. Blood glucose was at 488mg/dl, normal range is 70-143. Did a urinalysis for ketones and that was negative. So for right now he is staying overnight and getting iv fuids with antibiotic (Enrofloxacin 22mg/ml injection)plus an insulin injection to stabilize him and then will see our vet in the morning. I cried myself out- no more tears left, this is so sad. So many things to think about and try to work out.
Thank you for making me see the urgency of getting him into the ER asap. He's a pretty sick boy.
Will right more later,
Gerry

[Squirt's Mom]

Hi Gerry,

I am sooo glad you took him on! Now for some good news - we have a sister site just for canine diabetes. Please go register there now - they are the experts in this area and I know they will be able to not only help you learn, but give you the support you need. Here is the link -

diabetes info
http://k9diabetes.com/forum

Please let us know how Cloud is doing and keep your chin up!
Hugs,
Leslie and the gang

[labblab]

Dear Gerry,

I'm so sorry to hear that Cloud is so ill, but very hopeful that he'll soon be recovering now that the issues have been identified. Good job re: taking him in yesterday for intervention! I know how scared you must be feeling. :(

But as Leslie says, there is a wonderful support group already in place in terms of diabetes. And one of my own sweet dogs is living proof that pancreatitis can be managed very successfully once it has been identified.

So please do keep us updated. We will be so anxious to know how Cloud is doing today.

Sending many hugs to you both,
Marianne

[molly muffin]

Hi,
Glad you got Cloud in to the ER. We have some people who mange cushings and diabetes. It's doable, just have to find that right combination. Definitely join the sister diabetes site. I think it will be very beneficial to you.

hugs,
Sharlene

[Squirt's Mom]

How is Cloud today, Gerry? How are YOU today?

[Tina]

Gerry, just checking to see how Cloud is doing. Please let us know when you can.

Hugs,

Tina

[3bostons]

Hi Gerry, so sorry to hear your little one is sick like that, but am glad you got him in quickly. I hate having to leave them overnight and wondering, hope you are doing ok. Waiting to hear how hes doing today !
hugs, kona and deb

[Poodlemom]

Hello everyone, I am sorry to say that my beautiful Cloud passed away today. It was just too much for him to overcome. I am so sad, he was a sweet, sweet spirit and I never thought he would leave me so soon. The poor guy went through many physical challenges but he is at peace now. The dr was able to get the blood sugar stable but his fever kept going up and down and he had trouble breathing. He had an x-ray yesterday and his stomach was extremely extended. Did another x-ray today and not much improvement at all. He was very weak and today dr checked his electrolytes again and the sodium was high and potassium low and that's when she said it did not look good for any chance of recovery. He was on fluids, antibiotics, insulin and electrolytes for two days and was just getting sicker. Last night we did bring him home and continued the iv here, also gave him his insulin so we were able to have his last night at home. When we did an ultrasound back on April 20th they found 2 pancreatic cysts that the report called as likely benign from previous inflammation. They had recommended to repeat the ultrasound at 6 months. The dr said that maybe the cysts got infected. Maybe we missed something then that caused this problem but I just don't know. Thank you all you lovely angels
for giving of your love and support at this most difficult time. Couldn't do this without you.
Gerry

[frijole]

Oh my that is such sad news. It sounds like Cloud had a whole lot going on and is now in a better place although that doesn't make it any easier on you. You did all that you could - know that. May the memories of good times sustain you as you heal. Kim

[molly muffin]

I am so very sorry to hear of Cloud's passing on to the Rainbow bridge. :( I am very happy that he got to have his last night at home with you. You did so much for him, with all the issues that were going on. You are in our hearts.

hugs,
Sharlene

[Jenny & Judi in MN]

I'm glad he got to spend his last night at home with you and I'm so sorry. A beautiful angel. hugs, Judi

[mytil]

I am so very sorry for your sweet boy. My heart is with you.

I have added your boy to our very special Remembrance list in our In Loving Memory section - http://www.k9cushings.com/forum/showthread.php?t=3918 where he will be remembered and honored here always.

(((hugs)))
Terry

[Squirt's Mom]

I am so sorry to hear this and so sorry for the pain you are feeling today. Cloud was well-loved and you did all you could to help him through this; Cloud knows that, too, and is grateful for all you did on his behalf.

Today, his pain has ended and he is once again whole and strong as he was meant to be, running in the Rainbow Fields with our babies who were there to meet him as he crossed. From there he will watch over you until your job here is done and you are reunited for all time.

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



The Last Battle
by Unknown

If it be I grow frail and weak,
And pain should wake me from my sleep,
Then you must do what must be done,
For this last battle can’t be won.

You will be sad, I’ll understand,
Don’t let your grief then stay your hand,
For this day more than all the rest,
Your love and friendship stand the test.

We’ve had so many happy years,
What is to come will hold no fears,
You’ll not want me to suffer, so,
When the time comes, please let me go.

I know in time, you too will see,
It is a kindness you do me,
Although my tail its last has waved,
From pain and suffering, I’ve been saved.

Do not grieve that it should be you,
Who has to decide this thing to do
We’ve been so close, we two, these years,
Don’t let your heart hold any tears.

[labblab]

Oh Gerry, I am so terribly sorry, too. But what with a fever on top of everything else, it truly does sound as though he had a deep infection that was too much to overcome. And so the mercy was for his bright spirit to be released. Please know we are always here for you, in the days to come. This all happened so quickly and was such a horrible shock. If you are at all like me, it will be the coming hours -- when you try to start to come to terms with things -- that may feel so especially hard. If so, we are ALWAYS here to listen and to talk, and also to share memories of your lives together.

Sending many hugs this morning, in loving memory of your dearest boy.
Marianne

[Boriss McCall]

I am so sorry to hear about your beautiful little Cloud passing. :(
((Hugs))

[Roxee's Dad]

I am so very sorry for your loss. Rest in Peace Sweet Cloud, You are our newest and brightest star in the sky........

[Maya]

Oh no....:( How sad... I'm so sorry to hear of your heartache. God bless and comfort you in this difficult time...
Hugs from Leah and Maya