Lulu 11 y.o. Pom has gone over the Rainbow Bridge to meet Jojo

Now that I have a few minutes to myself, I thought I’d take the time to start a new thread and introduce my two cushdogs to those of you that may not know them. I was fortunate enough to have found a complete cached version of Lulu and Jojo’s thread right after caninecushings.net was taken offline. It doesn’t seem possible that I became part of the family over two years ago. Lest I ever forget how phenomenal the members were that welcomed me, supported me, educated me and adopted me and my two furbabies as part of the family, I only have to go as far as my hard drive. If I think about the early days too much, I get teary eyed and I downright sob if I actually go back and reread all of the wonderful posts. Here’s my very first post and a few others that will give you a good idea of who Lulu and Jojo are.

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LulusMom
09-19-2007, 11:43 PM
Hello All. I'm brand new to the forum and wanted to take a few minutes to say high and tell you all that I can relate. I have a six year old Pom that was diagnosed with Cushings three years ago. It took a good year and half and three vets to diagnose her. By that time, she had already been diagnosed with Hypothyroidism and had had two surgeries for bladder stones, was sucking up water like a Hoover, peeing like a racehorse, panting like a freight train and eating like a 400 lb Sumo Wrestler. Bad hair days, or lack thereof, was an every day thing. That was an awful lot of stuff going on for a tiny little girl and it eventually broke my bank but it never broke her spirit. The doctor gave me the details on Lysodren which scared the heck out of me but it was the drug of choice so we moved forward with the loading phase. Lulu got through it just fine and after testing went onto her maintenance dose twice a week. Because Lulu is barely 5 lbs, I got her Lysodren through a compounding pharmacy. It was that pharmacy that recommended that I talk to my vet about switching Lulu to Trilostane which has less side affects than Lysodren. I brought it up with my vet and he agreed. Lulu has been on Trilostane for almost a year now and is doing great. Because Cushings is normally an older dog disease, Lulu was a stumper for two out of the three vets because of her young age. Lulu will never get her gorgeous coat back but she's the most adorable Pom in the world with her cute little buzz cut. My husband and I are fostering our first rescue baby, an 8 or 9 year old Pom mix. Now what are the chances that our first foster would be diagnosed with Cushings? Well he was and since we fell in love with him immediately, we are paying the medical bills for his meds and testing. I could not imagine his rescue group footing the bills when so many other babies need to be rescued. His name is JoJo and he is on his fifth day of Lysodren and doing fine so far. JoJo was a train wreck when we got him. He had Kennel Cough, horrible, horrible conjunctivitus, both ears infected, was newly neutered and had dental with numerous extractions. On top of that he was drinking water like crazy and peeing everywhere. I go through piddle pads like crazy. He's been through such an absolutely horrible time and we hope to get him stabilized and shower him with love for the rest of his life. When you already have three dogs and four cats; love animals as much as we do; fall in love with fosters in a matter of days, perhaps we should reconsider fostering. ;-) I should have thought of that before I picked up that adorable kitten and Italian Greyhound last night. Oh well, they say it's cheaper by the dozen. We can only hope so. Night all.

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Jojo was such a mess and had every symptom in the book so I thought I'd include all of his test results.

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LulusMom
09-21-2007, 11:41 AM
Hello Again.

Just wanted to update you on Jojo and give you his diagnostic info as promised. He was tested and diagnosed on 8/21. As I mentioned, Jojo was rescued from our local shelter. He was cowering in the corner of the kennel, shaking like a leaf. It's so loud and horrible and most of these little guys are just terrified. His coat was matted so badly that he had to have been in terrible pain. They shaved him down and obviously, their groomer is not a cosmetologist...if you know what I mean. But at least he got some relief. One of our local "little" dog rescues saved him and immediately took him to a teaching veterinarian hospital. They neutered him, extracted some teeth and cleaned the rest. That was on 8/2. Pre-exam notes: Increased Water Consumption and Urination Frequency. I don't know what some of these tests are but here are the ones that did not come back normal on his initial exam.

ALKP = 261.00 (normal range 23-212) Suspect Endocrine vs Metabolic disorder
ALT = 220 (normal range 10-100) Suspect Endocrine vs Metabolic disorder
WBC = 28.6 (normal range 6-17) Chronic inflammation could be a source of either otitis externa vs severe dental disease
Segs, Neutrophil,% = 79.00 (normal range 60-77) Chronic inflammation from otitis externa vs severe dental disease
Eosinophil,% = 1.00 (normal range 2-10) Absolute elevated at .286 culd be indicative of Atopy or another alergic reaction
Urine Bacteria = Positive Small clusters of cocci bacteria seen on microscopic exam.
Radiographs: VD and Lat Abdominal Radiographs obtained. On the lateral view, the liver extends beyond the last rip with rounded borders. The urinary bladder is enlarged and full of urine taking up most of the abdominal cavity. It is difficult to appreciate the kidneys as the contrast is insufficient. On the VD view, the boarders of the liver are difficult to evaluate. The spleen appears to have sharp boarders. The bladder is occupying the majority of the abdominal cavity. Th small intestines are distended with gas and fluid. The stomach is full of fluid.
Diagnosis: Hepatomegaly could be caused by Cushings disease or other Metabolic or endocrine disorder.

On 8/8, Jojo was taken back to the hospital with Kennel Cough. Abnormality in water consumption and urination noted. Overall condition on that date were:

1. Coat & Skin = Alopecia Dorsal Lumbar & Thoracic Midline, Left Dorsal Thoracic, left Ventral Thoracic, Right Dorsal Lumbar and Ventral Abdominal Midline
2. Ocular = Conjunctiva/3rd Eyelid infected inflammation Right and Left Ears
3. Otic = Brown Exudate, right and left ear
4. Oral/Nasal = Undershot Jaw - Nasal discharge found
5. Abdominal - Distended bladder found

Radiograph results were abnormal. On the VD view the cardiac silhouette appeared larger than normal. The lung patters shows calcified bronchioles. On the lateral view, the VHS 11.7 which is larger than the previous measurement 8/2 at 10.1. Lund patterns consistent with age as bronchial calcification. No evidence of pulmonary edema or pleural effusion present. Vessels appear wnl on lateral view. The trachea appears wnl with no evidence of collapse. Diagnosis - Cardiac Enlargement

Test results that were abnormal are:
WBC = 27.3 (normal range6 - 17) Chronic inflammation. R/O secondary to previous dental disease/cleaning vs. other
MCHC = 33.80 (normal range 34-38) Not of concern - no indication of anemia
Segs, Neutrophil, % = 84.000 (normal 60-77) Chronic inflammation
Lymphocyte, % = 5.000 (normal 12-30) Absolute 1365 wnl
Easinophil, % = 5.000 (normal 2-10) Absolute elevated at 1365. R/O allergic reaction vs other

Interpretation of Ultrasound: Cardiac US: Thickened anterior leaflet of the mitral valve. Mitral regurgitation confirmed with pulse wave dopler. All other me
ABD: Enormous bladder. Prostatic urethra dilated. Mild dilation of renal pelvi. Otherwise wnl. Unable to examine adrenals, kidneys, LN and liver due to patient behavior (another way of saying the Jojo's an enormous puss).

Assessment - tentative diagnosis is Alopecia, Endocrine; Conjunctivitis; Sinusitis; Alopecia, Endocrine; Canine Castration; Metabolic Disorder; Otitis Externa; Periodontal Disease Grade 3.

Exam Note: Presented with excessive productive cough. Multiple areas of alopecia worsening since last visit; Clear nasal discharge found on nares. PU/PD R/O Cushings vs. Hypothyroidism; Conjunctivitis R/O infectious vs sinusitis vs other; Cough R/O collapsing trachea vs secondary to cardiac disease vs infectious (Bordetella) vs inflammatory (secondary to intubation on 8/3) vs other.

And now the exam that we were waiting for done on 8/20

Urine Specific Gravity = 1.006 (normal range 1.016-1.08)
Cortisol, Baseline = 7.8 (normal range 1-6)
Cortisol, 4 hr post Hi Dexm = 3.000 (normal range (0.1-0.9) 50% below baseline therefore suppressed which is consistent with PDH
Cortisol, 8 hr post Hi Dexm = 2.8 (normal range 1.499-1.5) PDH confirmed

Prescribed Ketoconazole 200mg tablets which was declined by owner. Vet discussed with owner that Trilostane is not FDA approved and recommended treatment with anipryl or ketoconazole.

You all know Jojo's recent medical history better than anyone else. There's a bit more to the story about how we ended up on Lysodren but will have to finish later. JoJo tried to bury his food this morning instead of diving in head first like he usually does. I need to get him in for testing today so gotta run for now. Hopefully, we are on our way to maintenance. Keep your fingers crossed.

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A lot has happened since then but I am happy to say that both kids are well controlled and have had consistently great stim tests for the last nine months. Jojo’s last stim test was three months ago and his results were pre 3.0 and post 3.4. Jojo’s pu/pd never resolved with either Lysodren or Trilostane. We tried the DDAVP (desmopressin) eye drops twice, hoping that we could finally diagnose him with central diabetes insipidus but the drops did nothing. We keep plenty of water down at all times as well as hospital water proof pads. Since becoming a member Lulu has had emergency dental surgery, dislocated her hip requiring surgery and has had at least two scarey but relatively short seizures. I’m hoping that she stays seizure free for the rest of her life. She lost what little coat she had gained with the Lysodren treatment while on Trilostane treatment. She’s been back on Lysodren for, I believe a year now, and still no sign that she’s going to grow feathers again. Lulu has PDH with elevation of “all” adrenal steroids/hormones. Her last stim test was the day after Christmas and her results were pre 2.1 and post 2.8. YAY!!! She also had her little tiny teeth cleaned a week ago and came home like nothing ever happened. Everybody at the vet’s office loves her and she very rarely spends any time in a cage when she’s there. She barks and they jump. A vet tech told me the last time we were there that she had one of the surgeons wrapped around her finger. It seems that every time he passed her cage, she’d bark and spin around until he picked her up. The tech said he couldn’t stand it and had to pick her up. Glad to see that I’m not the only one that has made her into the monster she is today.

I’ll try to keep ya’ll updated on Jojo and Lulu and I’m hoping that it may be a good long time before I have anything to report. I am finally getting comfortable with letting them go six or nine months before their next stims so unless something happens in the meantime, my bank account gets a break.

Glynda, mom to cushdogs, Lulu and Jojo; noncushdogs, Jasper and Buster; kitties, Mimi, Moki, Maggie & Izzy; and forever mom to foster babies at the bridge, Otis, Mabel (cushdog) and Baquita.

Hey Glynda,

It is so good to see Lulu and Jojo here again! I have missed hearing about them and all your babies.

How wonderful those stims are for both of them! :D Perhaps Jojo has decided to at least pretend to play by the rules. :p That is just great news all around regardless!

Hugs to you, and belly rubs to the babies,
Leslie and the girls - always

Hi Glynda,

I'm so glad that you were able to find your posts, and that your furbabies are doing good.

Even though LuLu hasn't gotten her coat back, she is still so very cute and precious.

I didn't know about Jojo before. I hope all goes well for both of them.

You are a very special person. You are always there to help everyone.

Give Lulu and Jojo a big hug from me and kisses from Corky.

I know that I joined the caninecushings.net group early last year, but I have never been able to retrieve my posts.

I'm wishing you and your babies the best .

Wow, it's been a long time since I posted anything about my two cushdogs so thought I'd update everybody. Both are overdue for a stim and because both have always loved food, Lulu has always been bald with bad skin and Jojo continues to drink and pee buckets, who the heck knows if they are still loaded. :D Both are still on a Lyso maintenance of 60 mg three times a week.

I discovered that an animal hospital within walking distance of me actually has an IMS on staff and their acth stims are $200 as opposed to the $268 our current IMS (50 miles away) charges. I plan on talking to them about using 5mg/kg of cortrosyn to maybe get the price down a bit more. After all, I should at least get a volume discount. :D We have a meet and greet this morning at 10:00 and I suspect that I'll be asking as many questions as the IMS. If I like what I hear, we'll schedule a blood chemistry, stim test and most likely a teeth cleaning. I'll let ya'll know how things go.

Glynda, it's been WAYYYYYYYYYY too long since we had gotten an update on your kids!!! So thanks for letting us know what's going on, and good luck with your vet visit today! :) ;) :) ;)

Marianne

Hi Glynda,
Good to hear about the little ones, hope you and they like the "new" IMS in the neighborhood. :D

Still just love your avatar of Lulu :D:D:D:D are you sure that's not just picture of a toy? ;):)

Hi Glynda,

Wishing you the best of luck with your vet visit today. Your Lulu and Jojo are both so precious.

Love and hugs,
Lori

Hey Glynda,

Love hearing about your babies...always! Of course, I don't expect any of them to follow the book so there is every possibility they are still loaded and just being the little turds they are! ;):p

I hope the new vet is perfect and it all works out just great for you all!

Love you!
Leslie and the girls - always

Brings back lots'a memories. I always love hearing about Lulu and Jojo. I remember when I first saw a picture of little Lulu. I thought she was just the cutest little bear I had ever seen! :D Still is. And Jojo has the sweetest little face. Adorable kids!!

It's nice to know that Jojo and Lulu have been missed. :D The appointment today was disappointing but it wasn't a total loss because Jojo got some meds for his conjunctivitis. We didn't see an IMS like I requested, they use a gel instead of cortrosyn, they haven't adopted the new vaccine guidelines, they charge almost $400 for teeth cleaning and that doesn't include bloodwork. :eek: I didn't get the sense that they've treated many cushdogs so I came straight home, called our trusty IMS at VCA and we have an appointment tomorrow at noon for stim tests. Nice try but no banana.

Good to get an update on Lulu and Jojo!! Too bad about the new clinic but they're close if you're in an emergency situation. Will be waiting to hear about the results from the stim tests.
Jo-Ann

Dang! I was so hoping for you that this new clinic, since it was close, would be "cushing's savy." Will be checking back for Lulu's and Jojo's stim results.

Love and hugs,
Lori

Glynda - always good to hear from you. Sorry the new vet didn't work out but you at least tried. You've been missed around here. Hugs to you and the furry ones. Kim

Hey Glynda,

Good luck for the kid's stims tomorrow, will be waiting with paws crossed :). Sorry the new vet didn't work out as planned.
Cuddles to the kids, and hugs to you,
Jane, Franklin and Bailey xxx

I was pleasantly surprised to get good acth stim results for both Lulu and Jojo. It is very difficult for me to determine if either one is still loaded. Both would eat the arse off a horse if I let them, Lulu will never have good skin or hair again and Jojo still drinks and pees buckets. How the heck do you know??? :D:D:D

Jojo's results were pre 2.3 and post 2.7 and Lulu was pre 2.7 and post 4.6. That is the highest post number Lulu has had in two years. I withheld two of her maintenance doses in the last six months so I think this may have something to do with it. I'm just glad we're still in the ballpark.

Buster, one of my Maltese boys, had what we think was a seizure yesterday morning that scared Gil half to death. He got up with kids yesterday and let me sleep in but came bursting into the bedroom with Buster in his arms about 10 minutes later. I didn't know who was panting more, Gil or Buster. He said Buster ran over to his pillow then yelped and ran across the room and collapsed. Gil said he was like a limp noodle when he picked him up and his eyes were fixed and looked like they were slightly rolled back. He thought he was dead but as he stroked him, he started coming around. He put him on his pillow and Buster managed to get his front legs to work but the rear legs were not working, plus he was panting really hard. I kept him in bed with me for 1/2 hour then took him downstairs, fed him, he ate like nothing happened and was perfectly fine. He's been running around all morning so he's no worse for the wear. Let's hope we don't have any more of those episodes.

EEK :eek: EEK :eek: EEK :eek:

Poor Buster! Poor Gil! Oh I hope this never happens again! And of course calm, level-headed Mom saves them both. ;) I do hope this was a one time thing. Please keep me informed. He is such a sweetie!

Great news on Lulu and Jojo! I, for one, didn't expect anything to be textbook with either of those babies! :p They look for ways to confound the issues! :p:p

Thanks for the update and DO keep us informed on Buster...and Gil! ;)

Love and hugs,
Leslie and the girls - always

Hi Glynda,

I'm so sorry that Buster had a seizure. They can really scare you. Hopefully he doesn't have another one. Corky's seem to have stopped. He hasn't had one now for over 18 months.

The stim test results were good for both Jojo and Lulu, even though Lulu's post was higher than before. I'm glad that they were in the normal range.

Oh Glynda,
Your poor little Buster. That would have scared the pants off of me frankly. I have never experienced a seizure with a fur baby, but it must be real scary, and mind boggling that they just come very randomly. Ugh, Ugh. I hope he is better by now and that it does not repeat itself. Keep us posted, and I'm glad to see you around more as well. Take care of you....Luv ya bunches, xo Jeanette

Wow that sounds terrifying. If it was my little one or even my bigger one (Casey) I think I would have a fit. You are so calm. Hopefully everything is okay and congrats on the perfect stims!!

Love and many hugs,

Hi Glynda,
Those stim results are good news! What a relief!

As to Buster's "seizure"... I read your post over 3 times and it sounds like a back spasm. Lady had 2 of them, 1 year apart, the first one was mild compared to the second one. Both times she collapsed instantly. The first time she let out 2 big crys for help (I was inside the house and heard her) but the second time we were together and there wasn't a sound. It took at least 5 minutes for her to come around the first time and maybe 10 minutes the second time.
I thought that she had had a mild seizure but read Natalie's (k9diabetes) report of a back spasm that Chris had had and it described perfectly what Lady had gone through. Both times I thought Lady was dying and when she was through the spasm she was back to normal. The second time she seemed a little tired but it had lasted longer than the first one.
Before this I had seen Lady have 2 grand mal seizures when she first became diabetic. She was groggy after the second one but not after the first one.
Hope Buster doesn't have any more episodes....they're scary for dogs and their humans!
Jo-Ann

Love those stim numbers.

Sorry to hear about Buster. I was thinking along the same lines as Jo-Ann. It reminds me of a couple of episodes Phoebe had a few years ago, hers were neck spasms. She would let out the most blood curdling screams and then collapse, I assume with the pain, and pant which I think is a dogs way of getting through pain.

Phoebe was put on an every other day dose of metacam and the in between days a little valium. It really was such a small amount of meds but it did the trick, never had another episode and after about 6 months we stopped the metacam and only did the valium occasionally. I hope the solution is as easy for Buster.

Jen

Jenny and Jo-Ann, is it possible for a vet to determine if Buster had a neck or back spasm by doing an x-ray or other imaging?

Just trying to remember.

The local vet referred us to a specialist and it was his diagnosis. He did bloods and it was only that Phoebe was a little uncomfortable moving her head with his manipulations that he said he thought it was some sort of neck problem causing spasms.

X rays would be no good he believed because it was like a nerve pinch and that would not show up, he ruled out ultrasound too. A special type of MRI at another place was an expensive option and at 16 (I think she was) Phoebe would not be having any more surgery or invasive treatment so we ended up doing the lets try the meds and see what happened.

We were lucky. How is Buster today, any signs of the episode?

Jenny

Thanks for the response, Jen. Buster seems to be a little off today but we've seen no other episodes like Gil witnessed on Sunday. For the last couple of weeks he has been clearing his throat and doing that gacking thing. He had a piece of a rawhide stuck in his esophagus several years ago which required emergency scoping to remove it. The vet told me that it could form scar tissue which could cause problems down the road. As I recall, that was about seven years ago so I would think he would have had a problem by now but what do I know. If he is not 100% by Friday, I'll take him to the IMS on Saturday or Sunday. He's due for a senior panel so I might as well have that done too.

Glynda, I sure hope Buster is alright by Friday, and never has another episode like that! I know it must have scared the bjeebies out of Gil.

Great stim numbers on Jojo and Lulu! That's what having a fantastic mom does for them! :D

(((HUGS)))

Shelba and Suni~~

Hi again,
I didn't take Lady to the vet...at the time I thought it was a small seizure and she seemed fine afterwards....Natalie's description of Chris' back spasm fit exactly what happened to Lady. So when she recovered from the second one there didn't seem to be much point in putting her through the long trip to do any testing. The second one was just a few months before she died. :(

Hi Glynda,

I hope that Buster is soon back to his normal self. It's so hard to know what is going on with them when they can't tell us what's wrong. Sending positive thoughts that everything will be O.K.

Hi Glynda,

Congrats on the perfect stims! Great work! Hoping Buster (and Gil) are doing well, with no more scary seizures.
Love,
Jane, Franklin and Bailey xxx

Time for a short update. Lulu has lost a lot of hair above her nose and the skin is black as coal. She has also lost hair on the back of her head and it's as smooth and as pink as a baby's bottom. She and Jojo are both acting like their cortisol is high so we went in for a stim today and the IMS did a skin scraping on Lulu. I am hoping it's something easy to treat like demodex cuz I don't want her to end up looking like Telly Savales. Will report the results of everything when I get it. Thank goodness for Care Credit. OY!

So sorry to hear this, and will be keeping everything crossed that Lulu's condition is easily treatable.

Sending hugs to both of those sweet pups, Lulu and Jojo.

Also keeping everything crossed that whatever is going on with both Lulu and Jojo is easy to figure out and treat.

Jane, Franklin and Bailey xxx

I'm sorry to hear about Lulu and Jojo, Glynda. Corky and I are also keeping everything crossed that it is only something minor and can be treated very easily.

Give them both hugs from me.

Hi Glynda,

I am sorry to hear about Lulu and Jojo. I was just going to ask you how Lulu's symptoms were since she has been on Lysodren. Hopefully it will be easy to fix.

I had been reading back through your thread because I thought Lulu was similar to my Zoe with high estradiol and other intermediates as well as cortisol. I keep wondering about high estradiol in our pups.

Hoping for good news!!!!

Hugs,
Addy

P.S. Loved the photos of you with Leslie, Trinket and Squirt!!!!

Hi Glynda,

I hope it is nothing major for Lulu and that we don't have to tack "Savales" onto her name! ;) If necessary, we can take up a collection for a tiny wig for Lulu. :D

It will be interesting to see their stims, as always! I hope the numbers are good and they are just bucking the rule book again. :p

Love ya!
Leslie and the girls :D - always

Hi Baby Doll,
Glad to get an update on the "fur butts". Was hoping for a good one on them, but I have deep faith in you, your knowledge and great heart and know they will be just fine. give them some rubs from me, will ya and take a tight hug for yourself. Will be keeping an eye for more updates. luv ya tons. Jeanette

I just got the last piece of news on the testing that was done on Jojo and Lulu from the IM. Cortisol has been creeping up for both and results are Jojo - Pre 2.6, post 4.3 and Lulu 4.5 and 5.0. They were stabilized in the mid 2's for a very long time so I can't complain...it was a good run. The IM wants to increase the actual mg capsule rather than increasing maintenance with an additional 60mg a week but I just refilled both prescriptions so the IM approved my idea of adding a fourth dose for Jojo for two weeks and a fourth dose for Lulu for three to four weeks and then stim again. If we accomplish our goal and we get the post stim down in the 2's and 3's, we'll get a new prescription for an increased dose. I'll let the IM decide how much is enough.

Lulu is still a mystery in more ways than one but the biggest mystery is the unexplained hair loss around her nose and mouth. The last time all the tests were negative and the hair grew back and this time is no different. The skin scrape was negative and I received the culture results today, also negative. Ha, most of the hair around her nose has already grown back in. Sure glad I spent that money. :D The top of her head, just below the crown, remains bald. This was my last ditch effort to try to figure out what in the heck is going on with her hair, or lack thereof. I officially throw in the towel after five years and have decided to take Dr. Bruyette's advice and buy her another sweater. :D She's still cute and Jojo is still a grumpy old peebucket.

Hi Glynda,

I hope the additional dosing works well and that their cortisol levels get back to where they were.

Lulu is still a little cutie, even if she never got her hair back. :)

Hi Glynda,

Zoe too has lost hair on her noseand the skin is coal black. If I look at pictures from a year ago I can really see the difference. She also is losing all her caramel colored spots. The are turning white.

Hope Lulu and Jojo get back in control. Lulu is cute without hair!!!
I checked out the Etsy sight and plan to order a couple sweaters too, so thank you for that lead.

Do you still have the pups on Primal?

Hugs,
Addy

Hi there Glynda,
Funny how I was thinking of you and Lulu today while I was at my IMS for Princess's stim and saw the cutest pomerenian being carried in my his mommy--4 months old. Princess looked like Godzilla next to him--lol. On another note, sorry to hear both your babies are having issues--yikes! How on earth do you find the energy to digest all this cushings business with both of them? I reckon the man upstairs created you with a bigger picture in mind--lol. Healing prayers going your way for some better results next time around, and here come some tight hugs as well. Luv ya darling, Jeanette and Princess

Casey lost the hair on her nose about two years ago - pre cushings diagnosis and grew it back a year later - weird.

Love and hugs,