Yikes! I'm so sorry you're not getting better suggestions from Davis but also glad you have come here and Leslie and Marianne were available to respond. Please let us know what you find out, wherever you take her.
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Yikes! I'm so sorry you're not getting better suggestions from Davis but also glad you have come here and Leslie and Marianne were available to respond. Please let us know what you find out, wherever you take her.
Thank you Leslie, Marianne and Shana. I was feeling so desperate and confused this morning. I ended up getting in touch with my local vet and he was in this afternoon for emergency only. He gave Charlotte a cortizone shot, fluids and an injection for pain. He believes her shaking is from pain. I'm not sure it is but it breaks my heart to think it could be. She is resting now, still trembling and very lethargic. She couldn't even walk into the vet's office, we carried her in and out. This vet said he was worried that if we aren't prepared to spend a lot of money on testing then we may have to put her to sleep. The weird part is nobody can really figure out what is wrong with her. The vet today took xrays (didn't charge me for them) just because he was so sure he would see something that gave him some indication of what is going on. He didn't like the way she was breathing but found nothing he could contribute it too. He palpated her abdomen and didn't think there was pain there. Her liver is enlarged but not abnormally so for a Cushings dog. He did an in-house basic blood panel and said most of her levels were normal or only slightly elevated and there was nothing to indicate an obvious problem.
While I was waiting today I got a call from Charlotte's Davis Vet. He is home sick but had been alerted I had called and wanted to go over her test results with me. He was surprised she was doing so poorly. He said her bloodwork is improved over what it was when he first saw her and her ACTH Stim test was low but not low enough to send her into an addisonian (sp?) episode. Here are the numbers from the test Friday:
Pre 1.6 ug/dl
Post 3.1
He said maybe this is too low for her and suggested we not give her anymore Vetoryl (which we had already discontinued). He said if it is indeed the Vetoryl (which he doubts) she should be doing better tomorrow. I asked about a macroadenoma and he said it's very possible. The next step would be a ct scan and then radiation, which is more of an investment than we can afford. I feel so hopeless right now. I don't have money to keep throwing at all this just to find out nothing. It makes me sick to think about euthanasia just because I don't have money to continue testing, but I don't have it.
I sit here typing and she is laying at my feet. She trembles and seizes her front legs and over her shoulders when she is resting but awake. When she goes into a deep sleep it almost always stops. She stretches her front legs out, probably trying to stop it. I don't see a difference in this now after having an injection for pain. We haven't asked her to get up but the vet told me to have her move around a bit tonight. I hope she is able to do it.
I've cried my eyes out and can't even eat. I feel so helpless. If any of you have any light you can shed on her situation I sure would appreciate it. I really didn't expect all this. I know this is a horrible disease but I thought we would be able to control it, at least for awhile.
Laurie
Laurie, I am so sorry you don't have an answer for what is going on. And I wish I could offer you wisdom or even a suggestion to try. Please try to be kind to yourself. You are a wonderful mom to Charlotte and she knows it. I hope you are all able to get some rest tonight, and pray she will show improvement in the morning.
Update... Charlotte went from not wanting to get up to not wanting to lay down. She is walking all over the house, following us everywhere. She seems a little confused but she responds to her name. She acts like she wants to drink but she goes to her bowl and just stands there and looks at it. She wont use her mouth or tongue. Its like she doesnt remember how. I gave her some very tempting treats and she acts like she wants them but doesnt know what to do. But its incredible how much she is moving around compared to earlier today when she really acted like she was a limp rag. I will update in the morning. I need sleep!
Laurie, I am absolutely heartbroken that you and Charlotte are suffering in this way, especially since it mirrors my own experience with my Cushpup so closely :( :(. I've already shared with you that he suffered from unexplained tremors that sound so similar to Charlotte's. But in addition, here is a description that I've posted elsewhere about our final days with him.
As you see, our experience was eerily similar to yours with Charlotte. And so I do have to believe that she may be suffering from a macrotumor, as well. I am so sorry to write this, Laurie. But I just want you to know that you are not alone in your pain. You have been doing everything within your power to help Charlotte. But sometimes the miracles we are hoping for just aren't there and there are limits to the options we can consider, both for ourselves and for our beloved fur babies.Quote:
Acted distant and dazed, as though "he" was leaving us;
Was very restless;
Started pacing endlessly through the house;
Started relieving himself in the house and in the car;
Lost his balance and coordination.
The crisis came suddenly when he stopped eating and drinking entirely. We had stopped the trilostane by that time, and again his cortisol level/labwork was fine. The hardest part was that he acted thirsty and would walk over to his bowl and lower his head and try to lap up water. But his tongue just wouldn't make contact with the bowl -- it was as though he had lost the ability to understand how to coordinate his mouth. It was awful, and that was when we said, no more. Our IMS thought it still might be possible to buy him some quality time with radiation therapy. But for a variety of reasons, we decided against it.
Of course my vision is colored by my own experience, but I think sometimes we just have to make the best decision we can with the information and resources that are immediately before us. This doesn't mean you (or I :o) failed our babies. Sometimes there simply isn't enough time or money or ability to do more in the face of their suffering. We love our babies so much, and our decisions for them are made out of that love. As one of our members has said, first and foremost we have to ease their suffering, even if that means we must take on that suffering ourselves.
I do not know what this day or week will hold for your family. It may be the case that the steroid injection has indeed provided some anti-inflammatory and additional pain relief, and I will surely hope that discontinuing the trilostane may bring additional improvements! But if Charlotte remains severely compromised overall, I want you to know that my heart is with you. Whatever happens or whatever you decide, I can promise you I will understand and be here to support you.
Sending so many hugs,
Marianne
Thank you for sharing your experience Marianne, that is exactly what ive been afraid as i witness what is going on and my heart is breaking.
Last night after i went to bed my husband got her to drink. Since then she has acted confused at her water bowl several times but then finally starts to drink on her own. So for now im not worried about hydration but she still hasnt eaten anything. She was up several times during the night to pee and poop. She is so much more alert than she was over the past week but yet seems distant and confused over certain things. We brought her in bed with us and she snuggled up and slept pretty well. She was still trembling but not too bad. Our local vet feels like the trembling is from pain but yet he gave her an injection of pain meds and she was still trembling just as much. I guess there is no way of knowing for sure but we dont want her to be in pain.
This is going to be a tough week. I have oral surgery on Thursday, ive been thinking of rescheduling but im in pain and have already arranged my work schedule around it. Im barely able to eat, im a wreck.
Laurie
Thank you so much for your update, Laurie. It is interesting (and of course good!) that she's more physically active since discontinuing the trilo and getting the steroid injection. Even though Charlotte's ACTH results were very good in terms of Cushing's treatment, it is indeed possible that she will feel better with her cortisol running higher, especially if she does have a macrotumor. We have had members whose dogs underwent head imaging and received confirmed diagnoses of macrotumors. And in some instances, their neurologists recommended dosing with a daily controlled amount of oral prednisone in addition to the trilo, or shifting solely to the prednisone alone. Strictly from a Cushing's standpoint, this doesn't make much sense. But the higher level of steroids apparently served to reduce the swelling and inflammation of the brain tissue, and gave the dogs some degree of temporary relief. Of course, the flip side is that you may end up seeing a rebound of Cushing's symptoms.
Anyway, I just wanted to mention oral prednisone as a possibility that you might want to discuss with the Davis specialist. Even in the absence of confirmatory head imaging, he might feel it's worth giving a try. Definitely please keep us updated as to how things proceed.
Marianne
I am so sorry to read the latest with your sweet girl. The way she is acting about the water and food reminds me of how my Squirt was after she had a stroke. It was like she had forgotten how to use her tongue or mouth. She was like that, slowly improving, for several months but she DID get better. I pray it is something like that with Charlotte and she will get better over time.
Please keep us informed as you can and know you are not alone.
Hugs,
Leslie and the gang
I took Charlotte in for a follow up with the local vet today and he said she made his day. He told me he thought that it was a 90% chance she wouldnt make it through the night. She not only walked in the door today she trotted. She jumped up on our bed when she got home which she hasnt been able to do in a long time. She is eating now, although still finicky, and she rode all the way to the vet with her head out the window. She is going to be a tired pup tonight!
The vet gave her another cortisone shot and sent me home with prednisone and 3 days of antibiotics. He also gave me some antacid and nausea medication. He said as long as she is doing well we can come back on Monday for reevaluation. He thinks we will keep her on pred for awhile and then watch for cushings signs to come back and then decide how to procede.
Im just so thankful she is doing well right now. I hope we have some quality time left with her!
Laurie, that is super news -- you've made my day, too! :)
I think for right now, you just take things day-by-day, and what a good day you all had yesterday. Long may they continue!