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Thread: Kashmir - Cushpup with possible macro adenoma

  1. #11
    Join Date
    Jun 2019
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    Milwaukee, WI
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    11

    Default Re: Kashmir - Cushpup with possible macro adenoma

    Hi Marianne, any appearance of calm acceptance of Kash's situation on my part is just that - an appearance. Or perhaps I come across as calm because I'm worn out and tired. I sat in my car in my garage this afternoon and wailed and cried my eyes out. I suppose the other thing I've felt is a sense of [defeated] resignation. From all the reading I did immediately after the IMS mentioned adenoma, I was positive I knew what we were facing (although I was holding out hope I'd be wrong) and I knew what the treatment options were going to be - except for the radiosurgery instead of the longer regimen; that one I missed. I think though, that it's a testament to how articulately and accurately so many people on this website described their dogs' symptoms and journeys that I could see the same things in my own dog. Thanks to the wealth of information here, I can now do my best to focus on spending time in the present with Kashmir instead of frantically researching my options. You didn't have that option with Barkis, but thanks to you and all the other people who have contributed to K9C, people like me who come after you have that gift. I am very, very grateful.

  2. #12
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    Jun 2019
    Location
    Milwaukee, WI
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    11

    Default Re: Kashmir - Cushpup with possible macro adenoma

    We have finished day 2 of prednisone and it has definitely bumped up Kashmir's appetite. In addition to his chicken pate dog food (the only thing he was willing to eat recently), today he had some treats, chicken breast pieces and I gave him some of my vanilla ice cream - baby boy gets whatever he wants (except chocolate, etc. of course!) We went for a short walk this morning but it's been too rainy to go out again since. I saw a little more kind-of-tail-wagging, a tiny bit more pep for the first couple minutes of a walk today - so this is all good. We're not talking drastic improvement here but it is something. I should add too, that fortunately Kash doesn't give any signs of being in discomfort or pain. I feel fortunate that he doesn't pace and hasn't had tremors or seizures and I hope those things continue to STAY AWAY because right now he has good quality of life, even if he's much more subdued than the perky guy he used to be.

    The estimate for an MRI is $3000, and the estimate for CT (needed to guide RT) and 3 sessions of stereotactic radiosurgery is $7000, assuming no overnight visits. I got a copy of a 2018 study from the vet that I began reviewing. Overall survival outcomes are not very long and definitely shorter for hormone-producing tumors than non-producing ones. It's just not a great picture, unfortunately. How I wish I would've known about the potential for pituitary tumor growth when we were dealing with "just" Cushings; I would have gotten Kashmir into the neurologist immediately when the symptoms started and maybe RT would feel like more of an option than it does now.

    I am happy to share the study with this forum - is there a recommended place to post it, perhaps in the adenoma thread?

  3. #13
    Join Date
    Apr 2009
    Location
    Georgia
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    13,902

    Default Re: Kashmir - Cushpup with possible macro adenoma

    That would be great if you’ll post the study on the Macroadenoma thread. The more information we can consolidate there, the better!

    In that vein, in looking back at that thread, I realize we’ve never extensively referenced there the possibility of surgery as a treatment option. This is largely because it’s so rarely performed here in the U.S. But one of our members, Lucy, was actually the first patient in a pilot surgical project conducted in L.A. as a joint venture between UCLA and Cedars Sinai Hospital. Lucy did have a successful outcome. However, I can only think of one other member who’s had similar surgery, and that’s Macy, whose mom started the Macroadenoma thread. Unfortunately, as you saw, Macy did not survive to recover. Anyway, now that I’m thinking about it, I do want to add a “surgical” post to that thread, too, even though it’s a possibility that’s seldom discussed or considered.

    Meanwhile, I’m so glad to hear that the prednisone may be helping Kashi, if only a little bit. We’ll always take “better” in any form we can get it, that’s for sure!!

    Marianne

  4. #14
    Join Date
    Jun 2019
    Location
    Milwaukee, WI
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    11

    Default Re: Kashmir - Cushpup with possible macro adenoma

    We have had a tough few days but things are a little better now. On Thursday I tapered Kashmir down from 10 mg prednisone twice a day to 5 mg twice a day per the vet's instructions, the idea being to find out the lowest possible dose he can be on. He started to seem a little off on Thursday night and by Friday morning he had really nosedived, with no interest in water or food, going for a walk...he just laid down and didn't want to move. He was trembling ever so slightly, and his breathing also seemed a little different. Not like he was in distress exactly but more labored than usual. Neither the neurologist nor IMS was in the office Friday, but a different person there suggested I try bumping his prednisone back up to the 20 mg/day to see if it helped him. So I did that and he does seem better. He was doing poorly enough that I had contacted an in-home vet about euthanasia but I ended up not scheduling it in order to give the prednisone time to do its thing. Thankfully he was a little better yesterday and today he seems close to where he was back on Wednesday before we tapered. His appetite is better and he's drinking water, and I took him on a walk today.

    I can tell things are changing. One of Kash's symptoms is that he favors his right side. When the vet did his neurological exam she noted how he prefers to always make right turns, even if a left turn makes more sense. I had also noticed how he would stand but have his head facing to the right; I noticed this mostly on walks when he'd take a break (I used to say these were because he was tired but I think it's a combination of that plus he's having a moment where he's in a bit of an altered state (obtundation)). Yesterday and today I've noticed how his tail is actually hanging a little more to the right side too. He also is a little more jumpy when I put the harness over his head or generally when something unexpected comes in his line of sight it's like he momentarily thinks it might hit him.

    I hope I'm doing the right thing by Kashmir. Friday I was sure the right thing was to let him go, and I don't think it would have been the wrong thing - but I'm glad to have a little more time with him as long as he's not suffering. It makes me sad that he's not the happy boy I once knew, but he's not in pain and he definitely still enjoys getting petted and especially having his ears scratched. It's really hard though to live in the present when you are dreading the future.

  5. #15
    Join Date
    Apr 2009
    Location
    Georgia
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    Default Re: Kashmir - Cushpup with possible macro adenoma

    It's really hard though to live in the present when you are dreading the future.
    Boy, truer words were never spoken! But if it brings you any comfort to know, I do believe you’re taking all the appropriate actions right now. And during those really tough moments, I surely hope you’ll feel your family here, standing right alongside you every step of the way.

    Huge hugs flowing to both you and your precious boy, today and every day.
    Marianne

  6. #16
    Join Date
    Apr 2009
    Location
    York, PA.
    Posts
    10,553

    Default Re: Kashmir - Cushpup with possible macro adenoma

    Huge hugs from me too.

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