Molly, 13 yr, shih tzu - lhasa aspo - Molly has passed

Okay, so today was a busy day at our house, with duct cleaning, carpets, rugs, tile/grout, so I booked molly in for her physical exam today. She is having a urinalysis, upc, liver enzymes check and had her kennel cough shot.
I am hoping to be able to call and get results tomorrow from my vet, as she is leaving for a week and won't be back till 2 Sept.

Molly's eyes are the problem. We checked the records and in June, her eyes were clear and age appropriate, in other words really good for an 11 year old, clear and shiny. 2 months later and my vet said she was astounded that both molly's eyes are now cloudy and there is no cataracts, or other eye issue to be the cause. She asked me to go over what has changed in the 2 months, all that has happened is we started lignans, melatonin and sam-e 100. We are both very concerned, as she said it looks like what she might see in a 13 - 14 year old dog, like they had aged rapidly in 2 months.

What the heck do I do now? This explains why in the last two months, she stopped being in the window as much, barks when my husband comes home instead of recognizing him, wait for me to walk up that step to the front door before she does, etc. All this in 2 months. In fact I mentioned the step and the window seat on here.

I am stopping all of these things I am giving her right now and going back to the other liver support I was using. She said we could try to take her off and see if she is perhaps having some sort of reaction to any of these, which is one possibility. My concern is the cortisol of course. I'll see what the results of these tests show and hope for the best in that regard. What I want to do I think, is get her started on 10mg of vetroyl pretty soon, but my vet wants a repeat ultrasound to see what is going on with that tumor on the adrenal too.

I'm worried and nervous of course, as we all are as we deal with these issues. I don't care at this point what the LDDS shows, we just need to get that cortisol down as soon as and safely as possible in my opinion, no matter what is causing it.

I don't do so good when there is a molly problem it seems. :(

hugs
Sharlene and molly muffin

Sharlene, I am so sorry! Do you think there would be value in letting an ophthalmologist perform an in-depth eye assessment so as to try to identify more precisely the nature/source of the problem? For many reasons, I know you are anxious to jump on this sooner rather than later in order to best preserve Molly's vision. FWIW, here's an article I found re: eye problems that can be associated with endocrinological illnesses. :o

http://img2.wikia.nocookie.net/__cb2..._29_12_733.pdf

Sending many hugs your way.

Oh Sharelene, I think Marianne has a good suggestion. I get so worried about eyes; an ophthalmologist can tell so much more after a thorough assessment. Look what I went through with Zoe's eyes.

I pretty much quoted exactly what the vet told me today about her eyes and her thoughts on it.

Hopefully the results will come in tomorrow and I will get them and be able to ask my vet for a consult to the eye doctor. I also plan to call the IMS Monday. I'm away at an appt tomorrow from 12:00 to 5pm, but will leave my phone on, and I'll call before I leave if I haven't heard anything.

One way or another and I'll have to try to arrange something with work. I've already put in for my days off through end of september and it is going to be tricky with the new section I'm in to get approved time off, I will have to be firm. I want eye doctor consult and a chat with IMS and ultrasound. That is what I think we need and then I want to see if we can move to say the 10mg of vetroyl. I hope I haven't caused this by not treating, but afraid I have. She still has no symptoms of cushings, other than this now, in fact she has lost a pound, but that might be the weight management food I moved her to, in search of getting some firm poops. Her urine remains concentrated. Gawd, I just don't know what to do for her that is the best thing. I worry too that what if I do start on her vetroyl and she doesn't have cushings, then what will I do to her, (that has been a constant worry with the negative LDDS tests)

Hopefully we'll know a bit more about her liver and kidneys tomorrow. As kidney problems can also cause eye problems.

Thanks for the article Marianne, very informative.

hugs and thanks
Sharlene and molly muffin

Oh I forgot, she is also not eating anything tonight but her soft food. She picked all the hard kibble out, put it in her mouth, started to chew and spit it out on the rug. *sigh* Maybe the kennel cough shot?

It's not been a primo day on the molly front that is for sure.

Sharlene and molly muffin

And she makes a liar out of me, by going to eat some kibble, then wanting to go for a walk. Go figure. Then she wanted her joint treat and was good to go.

She'll get a liver treat later but I don't think I'll give her any more of either lignans, melatonin or sam-e until we get this eye thing figured out. I don't know what do you guys think about that? I've never heard of Any of those causing eye problems, but molly has been so weird that I don't know anything any more, other than the general do and don't's of cushings.

hugs
Sharlene and molly muffin

I dont know what to think but I dont think it is from the melatonin or lignans except that the melatonin seemed to bother Zoe's bad eyes. Her eyes would get redder from it after being on it for awhile, I could not give it to her every night. I even had a dog pharmacist look it up in his drug book. He could not find anything that indicated to could affect her eyes but it did.

I don't see how it could make them cloudy though. Something else has to be going on. Sharlene, is the melatonin still making her so tired?

All I can tell you is with the numerous eye issues Zoe had, her ophthalmologist felt I need to keep her cortisol controlled.

Gosh, Sharlene, I am so sorry to hear about our dear Molly's eye issue :( I do so wish that I have some words of wisdom for you. :( However I can lend some loving moral support and will be keeping you both in my thoughts and prayers.

Love and hugs,
Lori

I dunno whether this has anything to do with anything, but here's an article about possible effects of melatonin on the human retina:

http://www.landesbioscience.com/pdf/Pandi_Wiechmann.pdf

Marianne

Sharlene, I'm sorry to hear that Molly is having eye issues. I did have to grin a bit tho when she made a liar out of you. Ya just never know what to expect from the little devil/angels.

As someone with a very rare eye disease (1 in 1.4 MILLION), I have learned more about human eye conditions that anyone could ever want to know. I would imagine there are some parallels with canine eye issues. Steroids oral or drops cause cataracts to progress rapidly, but the vet said it wasn't cataracts. There is another condition called vitritis which is a clouding of the vitreous fluid in the eye itself. It is caused by inflammation. The treatment for that is immunosupression and .... wait for it.... steroids. *sigh* There are other types of inflammation in the eyes called different things depending on where it is located in the eye itself. Your regular vet would not be able to see any of those without special equipment, so an ophthalmologist consult is a good idea. There are anti-inflammatory drops (nonsteroidal which do and could help tremendously. This is NOT necessarily a PERMANENT thing. It is possibly just an episodic flare due to an unknown cause. And I already realize that with the Cushing's team on it, y'all will damn sure figure out that cause before too much longer. Hugs and Love to you and Molly girl.

Suzie

Aw sweetie, I am so sorry this has cropped up. Our Molly Moo has certainly been a puzzle from day one, huh? Squirt's eyes clouded and started turning bluish but the vet said that was typical old age eyes. I forgot what he called it but it has to do with the fluids in the eye as the pup ages. But it didn't come on overnight like Molly's did - hers was a gradual progression and she still had vision when she passed. Her iris' were brown but in the right light you could see a blue film over the whole orb. And they did get cloudy.

I hope you find the cause...and I would sure see the specialist if possible before making any treatment decisions, including treating for Cushing's.

I wonder...do they have good vets in Switzerland? ;)

LOL Leslie!

I know, I have concerns about the cushings drugs if not cushings too.

Molly had age appropriate eyes, so you know, an 11 year old, not as bright as they were but still sprakly and her eyesight was good. My vet loves molly's eyes and it's one of those things that people always comment on, how pretty. She was checked over pretty thoroughly by the IMS and eyes were fine then too. SARDS would be almost overnight right? Or could it be gradual like a couple months?

I told hubby last night, if this progresses we'll need to look at options for safety with her. One of the worse will be she won't be able to go to the backyard off leash, as I'd fear her falling into the pool. She would hate that. I hope it doesn't, but this is not a good sign.

Here we are years later and no one has been able to determine where the high cortisol is coming from and now it looks like, it is causing all kinds of problems. We've had 2 IMS. It could be cushings, it might not be cushings, she doesn't look or act like a cushings and her urine is quite concentrate, no over eating, hair/skin fine, pot belly is all and high liver enzymes which we all know have been high way before anyone suggested cushings option and not as high as we have seen even.

I'm flipping out I think because we are no further along than we have been, I don't think, and now we have serious issues due to not finding the source and having a plan.

ARgggghhhhh
hugs,
Sharlene and molly muffin

Marianne! I just saw your post about the melatonin given during the day and I was giving first thing in the morning. I wonder if this is possible cause, as the test subjects were animals and they displayed death of photocells in the retina.
So no more melatonin during the day at all, as it appears that there is a possibility that on some subjects, light plus melatonin could be detrimental, while at night it would be beneficial.
The question now is whether with discontinuation if this is the cause, whether you would have any regeneration or is this permanent damage.

(this based on the timing alone I think we have to consider)

Thanks again Marrianne! How the heck do you find these things! I was scouring the internet all the time yesterday for some link between any of the 3 factors and eye problems.

HUGS
Sharlene and molly muffin

Spoke with vet and Alkp came down. ALT and GGT raised. Primary concern liver disease. Eyes hoping damage not permanent. Unknown. Expect to consult with IMS and redo ultrasound and see eye specialist.

Good news is UPC normal!!!

Will post more later this was just a prelim art call to tell me what is going on before she leaves on vacation tonight out of country

Hugs
Sharlene and Molly muffin

Oh Sharlene - I just saw your posts. Poor Molly Muffin :(
I can't help with the melatonin and lignans but I didn't notice any change to Hamish's eyes with the SAMe and he took them for around 6 months. I also researched it quite a bit before I gave it to him and don't remember any references to eye issues.

HUGS from Henry and me

I don't think the sam-e contributed to eye problem. In fact it is likely that the sam-e contributed to the ALKP coming down from 1100 to 899, almost 200 points. However, ALKP is not necessarily liver specific as much as the others are. As we have said on here many times, but also as told to me today by my vet.

The ALT went from 225 to 319, which is a big increase. This can increase due to cushings (high cortisol causing leakage, or from bile duct flow)

The GGT went from 12 to 16. Also an increase in a liver specific enzyme, often associated with bile duct flow. So I'll want that gall bladder to be looked at as it could be that there is now more sludge and she needs to be on medication for it.

It is possible that the melatonin given during the day contributed to the eye problem, but I think it is an unknown at this point, only a possibility and we'll need to see what the specialist say. In the mean time I am not giving her any more right now.

On the other hand, the UPC was normal, which makes 2 normal in a row, if we throw out the one that they are almost 100% sure went bad in transport. So that is good.

Her urine specific gravity is perfect at 1.025, so kidneys appear to be working.

I don't have the lab results in hand, as she gave me these over the phone before she caught a flight out of country tonight. Knowing I was being a bit freaky about wanting these results asap. She said copies are already made in molly's file, so I can go pick those up this week.

I've confirmed that I will be able to take a day off work to take molly for her tests, so I'm not worried about that really at this point.

The vet actually didn't think there was loss of vision, but I said I thought there was, since she doesn't currently recognize my husband or instance when he drives up and gets out of the car in the driveway, she will bark at him, even if he is outside the window. She has always known it was him and not barked at him, so there has to be something there along with the weird step activity going up at the front door and the not wanting to be in the window seat looking out so much.

I want to see if that changes at all without the melatonin in her system. I thought even one day had made a difference previously when I didn't give it to her because I was thinking she seemed to be so lethargic from it and that is all I thought it was. Well, maybe that isn't all there was to it.

There are so many things I don't know and I'm just trying to figure it all out as best I can.

Hugs all
Sharlene and molly muffin

Hey Sharlene, I don't know how I stumbled across that article but I agree it is interesting. However, I'm doubtful that the melatonin is the likely culprit re: the eye changes even though the article did make me think that it is probably better to give melatonin at night, anyway, just so as to better correspond with the body's normal circadian rhythm. I had never thought about that before, but may try to mention that to other members in the future.

I can easily imagine the toll this uncertainty about things is taking on you and your husband. But please remember that hindsight is always 20/20, as I know only too well :o. Molly has truly been a diagnostic puzzle every step of the way, and you have done your very best to seek the consultation and provide the care that has seemed safest and most reasonable for her. So I truly hope you will be kind to yourselves no matter what the sources for these problems turn out to be.

Sending you all hugs and my hopes that some clear answers will soon be found!

I did find this study on rats and melatonin

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377032/

Quote:

---

The results of this study confirm and extend previous reports that melatonin increases the susceptibility of photoreceptors to light-induced cell death in non-pigmented rats. It further suggests that during the dark period, melatonin administration alone (i.e., no HII exposure) to pigmented male rats may have a toxic effect on retinal cells. These results suggest that dietary melatonin, in combination with a brief exposure to high intensity illumination, induces cellular disruption in a small number of photoreceptors. Chronic exposure to natural or artificial light and simultaneous intake of melatonin may potentially contribute to a significant loss of photoreceptor cells in the aging retina.

---

Ugh, wouldn't we have heard more about this as many use the University of Tennesee protocol?

Sharlene and molly muffin

That's what I've been wondering - surely UTK would know about this?

Hi Sharlene,
I'm sorry to read about all you're going thru right now. I can imagine how this is weighing on you and causing distress.

I did find this paragraph on melatonin...this states that it's actually "good" for the eyes..safeguarding against cataracts and other eye afflictions. http://www.drugs.com/npp/melatonin.html (scroll down to ocular diseases)
Also I read the excerpt about the retinal cells in rats that your posts but the clouding would be on the cornea or the lens wouldn't it, not having as much to do with the retina?


Do you notice that her eyes look cloudy, can you see a difference? Has she seemed at all bothered or trying to scratch? Hoping an eye specialist will get to the bottom of this.
I know how worried you must be...hopefully you worries will be put to rest once you can get into that eye specialist.
Sending the positive energy your way!!
Barbara

Hi Sharlene....

I just caught up to date with Molly and I am sorry to hear your news. I truly understand your frustration at no diagnosis and at having to consider lots and lots of potential issues as problems. That really got to me when we were treating Palmer. I just didn't get why someone could not offer something specific. This was after I switched vets. I'd been asking about cushings for 1.5 years and kept getting told "No." The pot belly was our main indicator. It seems to be ridiculous that "we" are the ones who spend so much time and effort in figuring out all of the Cushings issues and trying so hard to find the correct treatment. Starting Vetoryl is nothing to be taken lightly, as I am sure you know.

I don't have any helpful advice. I can only offer my support to you and say that I agree with the "consult the eye doc for an exam" before making other changes. Peaches, our first dog, had eye sight problems in her later years. I had to tell her "it's just me" before I would pick her up....and she had to be carried up and down stairs at that time. We went away for Thanksgiving one year to spend it with one of Bob's cousins. They left the door to the basement open and Peaches took a bad tumble down the stairs, because she did not know they were there, since it was a strange house to her. (I still think it's a strange house......:rolleyes::rolleyes::D)

I guess I do have one piece of advice. Bob's Dad was blind, when Bob and I started dating. I learned from being around him that it was important to kind of announce who you were and what you were doing so you didn't startle him. You might want to keep that in mind when you are moving around with Molly around. When your husband comes home, maybe you could say "Dad's home!" to announce his arrival. I also wonder if it could be that her eyes are sensitive to light now and that is contributing to her not being in the window as much. The brightness may cause her discomfort.

Your response to this news is pure loving Mom behavior. It's so frustrating, I think, when things go wrong and our little ones just adapt and we don't know that there are problems until later. I so wish they could talk....:(

Huge hug coming your way and please give Molly a kiss for me.

-Susan

Hi Sharlene,

Just stopping by to give you and Molly girl hugs:):):):):):)

Thanks gals.

We'll figure this out, hopefully because if nothing else we have dogged stubbornness on our side. :)

I didn't really notice that the eyes where cloudy. I don't know how I missed it, I mean, I guess because I look at them every day. Now I can say, they probably have a bit of cloudiness towards the back, but it doesn't look as bad as some I've seen.
I've noticed that I do have to tell her daddy's home, or that she will jump like she is startled but I thought that was hearing not eyesight. *sigh*

On Wed I hope to get over to the vets to pick up the copies of her lab reports. So I can add them into her test history and then call the IMS to get the appointment. I need to give work my time off schedule for the rest of the year, so I want to get that in. I am holding an ace in my hand of some banked time that I can use without notice if need be. :) (always have that ace up your sleeve) Today was too busy I didn't get out of the office till after 5pm, just nonstop.

On Wednesday night our oldest and grandson get into town for the long weekend, so it will be very busy from that point on, and I would love to have things taken care of by then, a date for ultrasound and eyes.

We had our youngest daughters engagement dinner last night. That was fun. My god, where did these two organized young people come from!!! They just got back from Portugal and getting engaged and they have already decided on the date, the reception venue, the wedding location. She has an appt to try on wedding gowns tomorrow night, knows the dresses she wants for her bridesmaids, how many and who they will be. Has settled the menu (my god I'll have to diet for a year just to be able to deal with all the food they are having). Except I don't have a year, I have about 7 months. They also have their guest list and plan on keeping the numbers down which is nice. Wow, like I said, who ARE they??!@!!!

Molly got lots of belly rubs, she had seen the kids for 3 whole weeks after all and she was grooving to it.

I am talking to her, trying not to startle her too much and we'll just take it day by day. I thought her eyes looked a bit more sparkly today. I'm not doing the melatonin and lignans until I know more. If there is even a chance, then I won't take it. I am doing the sam-e as I think that helps the liver numbers. We'll just see what happens. Not much else I can do till we know more.

hugs all,
Sharlene and molly muffin

Hi Sharlene, Poor Molly and you! I am sorry to hear about this new development with sweet Molly's eyes. I hope you find the cause quickly and it is reversible. Keeping Molly in my thoughts and prayers. HUGS! to you both.

Finally able to corral Molly long enough to clip her bangs and hair around her nose so eyes can be seen really well. Definitely both are a bit cloudy compared to what they were. She hates hair trims and being brushed. Every cut tickles her nose and we have to wait for her to rub her paws over the area then do the next bit. Then she rubs again. If she doesn't rub the tickle away she will sneeze. It is quite the production.

Too bad she can't take the eye test like we do. Do you see better on 1 or 2. Again. Then. I am sorry to say you are going to need glasses miss Molly. Guess they don't of that for dogs though

Don't worry. I have all our steps blocked off with gates. She hates to be carried down steps though and will try to evade you to go down on her own. Very independent unless she doesn't feel good is our little muffin. A contest of wills around here


Hugs all
Sharlene and Molly muffin

Sharlene,
could it be cataracts?

I thought that cataracts were slow to progress. They don't come on suddenly, from what I've read. Molly's cloudiness in her eyes happened very quickly. I could be wrong though. :confused:

No it isn't cataracts. They checked that as soon as they noticed it.

It came over a 2 month period at least. Not really sure if quicker than that.

Sharlene.

Well it isn't optimal, but trying to schedule a date for both the eye specialist and the IMS to be there and me to take off, turned out to be a doozy. Turns out recheck ultrasounds are on Wed, Fridays and the eye specialist is only there, mon, tues, wed, thurs, so had to be a Wednesday for her to get into both. Then there was the IMS away on one of the Wed, booked up on the next Wed and I couldn't get off till Sept 8 due to conflicting schedules at work. So...long story, long :) 24 September at 9:15 she has her ultrasound recheck and 10am an consult with the dog ophthalmologist. So, we'll be there early.

I'm just going to hope nothing gets worse between now and then, it's a month away after all. :(

On another note, I will be in and out till after labor day, due to family being here, namely a grandson to be played with and who wants to go to the museum to see real dinosaur bones.

hugs
Sharlene and molly muffin

I was hoping it would be sooner than that. :o

Now to burst your bubble Sharlene :D You are probably one of the coolest grandma's on earth, but you will never be as cool as a T Rex or an allosaurus. I know this sounds sexist, but it truly isn't.There is something about little boys and dinosaurs that is almost hormonal. I'm not talking about the wussy, boring plant eaters either. Everyone knows that their only purpose was to feed the bad (meaning cool) dinosaurs. Those were the most ferocious carnivores that can easily tear your head off with one bite. We know that there were no people when dinosaurs roamed the earth. However that fact gets lost in the minds of little boys. To them the more ferocious the better. So naturally, you would be going to look at the REAL dinosaur bones! lol :D

Oh I expect the trip to the museum will be VERY Cool thing and nana and grandpa are taking him. So whoo hooo. It'll be fun. His grandpa and him get on the phone and make competing dinosaur roars at each other, over facetime. It is quite hilarious.

On Monday we'll be taking him and our soon to be son in laws niece and nephew (if their dad lets them go, he can be a bit funny) over to Center Island in Lake Ontario, to the petting soon and the childrens park. I think he'll enjoy that too. A ferry ride and then fun times. My friend just went with her granddaughter and they had a blast.

Oh gosh, that reminds me that I need to confirm that we'll be going to her granddaughters 1st birthday party. It's out in the country at her son in laws parents place and should be a lot of fun.

I think my September is going to be child and dog filled. :)

hugs all
Sharlene and molly muffin

Fingers crossed no new problems until you get in, be interesting to hear what testing the ophthalmologist does. Sept is sounding busy, plans well underway for the wedding too!! Exciting times, now we want Molly to be good so you do not have to worry about her. I like how you mention with "dogged determinedness" you will figure it out. I have no doubt about that whatsoever, If I googled responsible, caring, knowledgeable pet owner there would be a picture of you Sharlene!! xxxx

yes....fingers crossed Molly is status quo through September until you get to the appt. I think she will definitely cooperate! :p
Sounds like a lot of fun in store for the grandchild! The island in Lake Ontario sounds great and especially in September weather! He's going to have a great time! :D

Barbara

Oh I do hope she'll be okay till the appt. I am trying not to think about it and not to be upset that I couldn't get in sooner, because what good would it do me.

Oh dear grandson, had a long day and had a bit of a melt down when his mommy facetime to his daddy. He wanted to go home. Poor little tyke. I am sure he will settle down, he usually does, but it's rough on them, especially with dad not coming too. (he is working)

Molly is handling it all really well. So, proud of her for that. She did start sucking her tail and I told hubby I could give her melatonin, it should be safe, especially at night, and he said he didn't want her to have anything till after she sees the eye doctor. I see his point and i had the same thoughts. Waiting sucks though.

hugs,
Sharlene and molly muffin

Just to let you know I'm up to date and you are in my thoughts, as is Molly.
Hugs,
Sus

Waiting sure does suck but remember we are all by your side waiting with you :)

That's true, it's like a whole room full of just waiting friends, hanging out. :) :)

hugs all
Sharlene and molly muffin

Absolutely, no one waits alone!!! :p:p:p

That is our mantra, always will be:D:D:D:D:D:D:D

That should be a song... no one waits alone... hmmm