My Pug Scoop (Precious Scoop has passed... )

I knew the answer to my question when I asked it but I wanted to make sure I was right. Last fall before Scoop's cortisol level was brought down with the Vetoryl, he had many infections, his ear, his calcinosis cutis, infection in his eye with the ulcer. After his eye infection he didn't get any more until this staff infection in his blood. His cortisol level on his last ACTH that was the end of March was post, just above 2. Scoop's vet took him off the Vetoryl many, many weeks ago to see if it would help his picky eating, which it didn't. She didn't put him back on it. So because he wasn't on the Vetoryl for quite a while did it cause his cortisol to rise? Did that compromise his immune system? If he would have been on the Vetoryl would Scoop still be here with me?

Another thing I was going to talk about on here but haven't yet is the morning of July 1, Scoop passed away that night, the IMS did an abdominal ultrasound. After she was done with it I went to visit Scoop. The IMS came in the room and talked to me about it. Scoop had started with the eye movement that goes with Vestibular disease. I don't know when it started. I didn't notice it on Sunday and it wasn't mentioned to me by the ER doctor. I don't remember the IMS mentioning this that day but the next week when we had a talk she said the morning she did the ultrasound she saw for just a fleeting moment Scoop's head moving quickly up and down. She said something about his tongue, too. She said it could have been something neurological, like little emboli in his brain. Scoop had been on low dose aspirin to help prevent blood clots. Again his vet took him off it to see if it would help with his diarrhea, it didn't. She never put him back on it. If he did have blood clots could it have been prevented if he had been on the aspirin? I am so frustrated and upset thinking that if he had been put back on these meds would he still be here with me?

I knew that the meds would help with these things but it didn't sink in that these things could happen since he wasn't on them. I'm hate myself that I wasn't on top of it. It really upsets me that his vet didn't put him back on them knowing this stuff. Oh it hurts so, so bad. If the IMS is right and he passed away from multiple organ failure, how long was this working on him? Was he in pain or uncomfortable and I didn't know it?
I JUST WANT TO SCREAM!!
Please wake me up from this nightmare. I can't take any more. I feel so guilty that I didn't, couldn't help him. Thinking that maybe he could still be here if I would have just realized about the meds. When I think of the last time I visited him, about 5 hours before he passed away, I see his little face looking at me, even though he was blind, it looked like he was looking at me and asking me to help him. I didn't think of it like that then but now I do.
I miss my Scoop so much!!

Vicki, I am so sorry.
I wish I had the magic words to make it all go away and everything be better.
I know that you tried everything, that you never gave up and I can't think of anything that you didn't try to help Scoop.
Guilt, anger, it is all a part of grief and missing Scoop so much. I know that you know that too. Logic though has no place when the heart hurts. Take time to heal your heart.

hugs,
Sharlene and Molly Muffin

Thanks Debbie,
I typed the opposite of what I was thinking!

Between the heat and sitting at Smilow waiting for dad, worrying - my brain is mush.


Vicki,

sweetie I am crying as I type this because I most definitely can relate to the feelings that you are having now!
Reading your post has brought back tears that I thought were long spent in regard to the confusion that I felt when two beloved pets passed away despite having received vigilant veterinary care. Cindi, my beloved cockatiel had a vet visit the previous day in fact. The second, Amber, had violent seizures suddenly, we called the vet but before we had a chance to leave the house - it all happened so fast without warning and then she was gone.

Dear God how I know your pain and I hurt that you are going through this :(

Like you, I also question the reasoning behind taking Scoop off of Vetyrol for so long instead of abstaining for a week or two and then resuming at a lower dose, but again - each dog's situation and response is unique. I've learned through reading other members' threads that there is no "one size fits all" treatment plan. Especially with Cushings, and clearing infections is paramount to getting accurate test results. If you don't have accurate tests results, how can you know how much Vetyrol to prescribe?

I have the utmost faith in Daisy's IMS but even with that - to date, the "underlying systemic infection" that she suspected might be eColi was never officially named despite her level of knowledge.

I promise that I'm not siding with the vet, but I can see how complicated everything combined can be and I would also want clarification. Any good vet is more than willing to address your concerns.

I understand your need for answers and I hope that you get them.
Grieving does lead to healing and we each must do it in our own way and time, but please don't blame yourself because many things are inexplicable.

What I do know is that you did your best with the resources available and that look that Scoop gave you was undoubtedly one of pure, unconditional love that only our beloved pets can give. You will have that love and wonderful memories in your heart forever.

Despite the pain of loss that I have felt too many times and still do sometimes, it is that love, companionship, and wonderful individuality that keeps me wanting to always have animals as a part of my family :)

Time does heal all wounds and you'll find that the bad days will be farther apart.

Big, BIG hugs!

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Originally Posted by scoora

In mid Nov Scoop had the MRI done that showed his ear infection that lead to the surgery and it showed his pituitary tumor. It wasn't on the radiologist report but I asked the neurologist if he could give me the measurements of it. He told me to the best of his ability with the equipment they had he said it was approx. 8mmx3mm. To me that's pretty large for a dog with a head like Scoop's.

The radiologist report said: There are no masses or other structural abnormalities seen in the brain, but the pituitary gland is enlarged and protrudes dorsally from the sella turcica into the hypothalamic region. Mild ventricular enlargement and enlarged sulci are most likely due to age-related brain atrophy.

Then down further on the report he says: The appearance of the pituitary gland is most compatible with a pituitary macroadenoma. The mass is not causing any significant mass effect or compression of adjacent tissues at this time, but if it continues to grow then it may affect the optic nerve, hypothalamus, or thalamus. So this is why I contantly worry about the tumor.
Thanks again Marianne

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Hi sweetie,

The biggest nightmare and deepest fear with Cushing's for me is the possibility of a pup with PDH developing a macro. I have spent countless hours staring at Squirt's head wondering, praying, pleading, bartering...."please, please don't let that thing start to grow." Most PDH pups remain in the micro category, never experiencing the neurological effects...but sadly our Scoop was one of the few who did develop the macro. :(

In Nov. of 2012, the tumor was 8mmx3mm. It had 8 months to grow and start to effect Scoop's body functions. There was very little, if anything, you could have done to prevent that from happening that wouldn't have reduced the quality of his life, just in a different manner than the tumor was. Hypophysectomys and radiation can help in many ways but they are not perfected to the point yet where the pup can realistically be expected to return to the normal life like they had before. We sort of trade one set of issues for others. Sometimes that trade is well worth it, sometimes it isn't.

Cushing's effects a loop in the body between the hypothalamus, thalamus, pituitary, and adrenal glands. This loop dictates a great many of the bodily functions - including the endocrine system; Cushing's and diabetes are both categorized as diseases of the endocrine system. I think if you will research these four glands, in particular the hypothalamus, thalamus and pituitary glands, you will see that the macro had probably grown enough to really cause our sweet boy major problems - up to and including the organ failure. When you combine the macro with the existing diabetes, our poor boy simply had more than he could overcome.

Here is a short, simple sample of what these three glands do in the canine, and human, body -

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The hypothalamus controls many activities needed to stay alive. It controls the production of hormones and creates the urge to drink, sleep and eat. The hypothalamus also regulates body fluid and salt balance and indirectly maintains breathing and heart and urinary function.

…signs of depression, pacing or circling

...is responsible for orchestrating several behaviors that are considered "maintenance" behaviors (such as eating, drinking, body temperature). In addition, the hypothalamus helps govern the endocrine system (glands that produce hormones)

Most crucially it is the connection between the nervous system and the endocrine system by means of the pituitary gland.

The pituitary gland is termed the "Master Gland" because it directs other organs and endocrine glands, such as the adrenal glands, to suppress or induce hormone production. The pituitary gland is involved in several functions of the body including:
• Growth Hormone Production
• Production of Hormones That Act on Other Endocrine Glands
• Production of Hormones That Act on the Muscles and the Kidneys
• Endocrine Function Regulation
• Storage of Hormones Produced by the Hypothalamus

The structural location of the gland is very important and the way in which the glandular and nervous segments interrelate is key to the nervous and endocrine systems.

The thalamus is a structure deep within the brain stem that receives sensory information from the nervous system and passes the information to the cerebral cortex and other parts of the brain. It acts as a director of information related to bodily functions such as seeing, sleeping, hearing, waking, tasting, and touching.

The thalamus is responsible for relaying sensory information such as hearing, sight, touch and pain. The thalamus also enables a dog to selectively concentrate and focus on one thing at a time.

The sensory and emotional information relayed to the thalamus is then sent to the parietal and occipital lobes of the dog’s brain for decoding. Once this information has been digested and processed according to previous experiences or memories, the data is then sent to the frontal lobe and translated into plans and actions. The thalamus also contributes to the monitoring and regulation of motor activity initiated in the cerebral cortex. This information is then sent from the cerebral cortex to the cerebellum to aid the co-coordinating center of the brain which is responsible for muscle activity.

Besides relaying sensory and emotional input, the thalamus plays an important role in the expression of attentional behavior. In contrast to the general arousal functions served by the reticular formation, the thalamus mediates a more selective, "informed" attentional response toward sensory inputs. The thalamus enables a dog to selectively concentrate and focus on one thing at a time.
Primarily, the thalamus is involved in the limbic system, as it regulates motor function, senses and perception. The thalamus is also in control of regulating sleep patterns and enabling states of alertness. Along with the brainstem, the thalamus is also involved in the ability to balance. When the thalamus receives sensory information from the environment, it converts the information to usable signals, which are sent to the cerebral cortex for processing and interpretation. In addition, the cerebral cortex can also send received and interpreted information back to the thalamus to distribute amongst other areas of the brain.

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At this point in time with the little knowledge I have, if Squirt were to develop a macro, I would stop her Lyso for good. It would take some might hard work to convince me that the positive effect of the cortisol on the tumor would be worse than the negative effect of the cortisol on the rest of the body. Not that the cortisol would "cure" the tumor; it can't but it does have the potential to act as an anti-inflammatory, reducing the swelling. In my mind, that would be more crucial than controlling excess bodily functions like peeing, drinking, and eating. The longer that tumor could remain smaller and not be pressing so hard on the brain and those glands, the better in my mind - and the Lyso would only prevent that from happening by keeping the cortisol lower. So to me, stopping Scoop's Trilo and not restarting it is exactly what I would have wanted done for my for Squirt. ;)

Sweetheart, I meant it when I said you were doing good. You are tackling this head on, letting your grief take you where it will to find answers that may ease your Soul. You could just curl up and stop everything - but you aren't and I am glad for that. You just keep fighting for answers, for understanding, and along the way you will find peace and acceptance. But, and hear me clearly here, you did nothing to cause this - nothing, nada, zip. You could have spent every dime you ever thought about seeing, worn yourself to nothing, lost all you have - and that tumor, its effects, and / or the treatment for it would still have taken him. Unfortunately, you and Scoop were handed insurmountable obstacles but through it all you loved him with all your being and did all you could to help him have the best days possible. You can second guess yourself from now on, but that is the bottom line - you gave your all to Scoop out of love and that is the absolute best any of us can do.

Keep talking to us, honey. You are not alone now or ever.
Hugs,
Leslie and the gang

Vicki:
I know how broken your heart is, but you couldn't have known all this. You trusted in the Dr.'s that they knew what they were doing. Tipper has vestibular problems at times. She has had about 5 episodes in the last year. Also just had an infection in her ear. She just had one vestibular episode a few weeks ago. The things that happen to these babies are a lot for the normal person to be expected to have expertise in all of it. We get as much knowledge as we can, but again we are not infallible. I blame myself for not making Tipper's vet test her for Cushings when she started with these symptoms at least 2 years ago. I knew something was wrong and kept telling him. He turned a deaf ear to it. There is only so much we can do and make others do on behalf of babies. I am struggling right now with this tracheal issue with Tipper. I know what the end result will be if I don't get this take n care of, but no one seems to listen. I beat myself up on a daily basis. I am praying the shots on Monday will help start to help her. We all get smarter about things as we progress into this disease, and yes sometimes it comes too late. We are all still trying though, as you are still trying to understand what happened to Scoop. I think this disease really causes havoc inside these babies, and there is no way to know everything that is going on inside them. I worry why my Tipper is as round as a barrel, and does she have a tumor growing? The constant worry every day does take it's toll on you. I am like you I can't leave things alone. I keep analyzing things over and over. I think all this blame, let down, analyzing, and second guessing ourselves is something we are predisposed to from the deep connection and love we share with these babies. When they aren't here anymore we are to blame, when something goes wrong we are to blame, we blame ourselves for basically everything. I know the place you are coming from, and I truly feel for you. In time you will fault yourself less and less. It is only natural that this is so raw right now. I wish I could come there and help you thru this Vicki. I am here for you any time, I know what Scoop meant to you. Blessings
patti

Sharlene, Valerie, Leslie and Patti,
Thank you for all your kind words. I appreciate each one of you trying to help me understand things. There are things I want to say, just not right now. I am so exhausted. Sometimes my mind feels like mush.

Sometimes it is good to allow your brain to be mush. Vicki, I think Leslie said it all perfectly. This has all been such a shock for you and you will work through all the emotions of grief. We are all here for you.

Sending much love and hugs.

Yes Vicki,
My brain has been mush a lot lately. It is a great thing that I'm on break! I try not to worry about. Mushy brains are a stage if the grieving process, or should be.:D be gentle with yourself. Big hugs,

Vicki,

mush brain is your bodies way of forcing you to take a break.

Vicki:
You just do what you need to do, and if your brain is mush I think that is a defense mechanism to help you thru all this grief. I so wish I could do something to take all this hurt away from you. Blessings
Patti