14 year-old Shih Tzu With Recent Cushing's Diagnosis

[molly muffin]

Happy New Year Julie and family. I hope you have a wonderful new year and Hannah does well this year.

Cheers,
Sharlene and Molly Muffin

[jmac]

Hi Everyone,

Happy New Year to all of you! I am sorry I am not able to keep up with posting on everyone's threads, but I do read and check in as often as I can. I am so busy taking care of Hannah, working hard, and trying to make time for myself, that I just can't be on here as often as I'd like.

I know I've never been good at making time to take care of me, do things for myself, etc., but I went to see a psychic over my winter break (this is the first time I've done anything like that) and she told me right away things that I already know about myself:
1.I am a perfectionist
2. I am responsible and therefore I am either asked or volunteer to take on extra duties.
3. I try incredibly hard to live up to everyone's expectations.
4. I take on the burdens and problems of those around me, including my 20 students, and feel responsible for "fixing" and solving their problems.
5. I don't make time to take care of me, or relax and enjoy my hobbies.

So, as a fresh start to the new year, I am trying to do a better job of making time for me and taking care of me, along with everyone else, of course. Please know I feel guilty all the time for not doing a better job keeping up on the forum, especially because I would not have made it through the past two years with Hannah without all of you, and I hope that I will be able to post more often in the future. But also know that even though I am not always posting, I am doing my best to check in and follow along, and I think of you all daily.

Here is the update on Hannah. There was not a huge difference in her itching after the second application of Revolution for possible Sarcoptic Mange. We had a follow up appointment with the derm vet last week. She checked about 10 samples from Hannah's feet, neck, armpits, tummy, tail, etc. for yeast because that was also an issue for her. There was NO YEAST! The vet said it was almost amazing that I was able to get rid of it because there was so much on her feet. But she also said that she was not surprised that if anyone was able to do it that it would be me. I was completely dedicated to using the wipes twice a day on any itchy areas and it worked!

So the good news is that we no longer have to worry about an oral medication for the yeast. The bad news is that she still doesn't know what is causing the itching. This vet is wonderful, caring, and thorough, and truly wants to do what is best for the patient in front of her, and genuinely wants me to feel happy with the plan as well.

We decided to put Hannah on Atopica to see if it helps. I had discussed this in the past with both other vets, and everyone feels confident about its safety and potential to help Hannah. We started it on Thurs. and she started with a very low dose and is having me gradually increase it to minimize any side effects (usually an upset stomach or reluctance to eat). Hannah is doing fine so far. I also have steroid drops for her ears because they are SO itchy, but clear from any infections, and betamethasone cream for her itchy spots on her feet to use as needed. We have a follow up appointment in 6 weeks, unless something comes up sooner.

As far as Hannah's liver issues, I basically have decided not to pursue further diagnostics at this point. She will be 14 in March and she isn't showing any real strong signs of Cushing's or liver problems right now. My primary vet and I talked at length about treating what is affecting Hannah now and causing her discomfort, and that is the itching.

I was open to an ultrasound if it had the potential to help us treat her. Since they all seem to agree that they really wouldn't know what was wrong without either a biopsy or fine needle aspirate, which I don't want to put Hannah through, we all are in agreement that it doesn't make much sense. If she has a tumor I wouldn't try to treat it at this point, and at her age there isn't much we could do to help with liver disease. She is already on Denamarin and she didn't respond to the antibiotics they tried her on earlier, which is one of the treatments for liver disease. The other thing they sometimes do is treat with steroids, but my vet and I agreed that if she declines and we want to try steroids at the end, we will. They also said that sometimes even after all of that testing they still don't find the origin.

I think I will probably have Hannah's blood work checked in the next few weeks, just for my own knowledge, and because she is kind of a mystery to all the vets she sees. But from this point on I am basically going to respond to her clinical signs.

I know I have given her a wonderful life. I will do whatever I can to keep her comfortable for whatever time she has left, but I am not going to go to extremes to keep her with me forever.

She still follows me around everywhere, with her little "cone" swaying from side to side when she trots (which is pretty cute, although I can't wait to get it off her permanently), making sure she never loses sight of me. She's the sweetest little dog I could ever have asked for; I have no doubt she is my doggie soul mate.

For now, aside from her itching, she is happy and doing well. I don't want her to spend the rest of her life in an e-collar unable to scratch her itches because I know that cannot be a very enjoyable life. So I will do whatever I can to relieve her itching and keep her comfortable.

I'm sorry for the long post, but I wanted to get everyone up to date. Thanks so much for checking in on us and keeping us in your thoughts. I appreciate it more than you know. This forum is filled with the most wonderful people. We are so lucky to have each other.

Julie & Hannah

[addy]

I am glad you started the Atopica and I hope it helps little Hannah. Not sure you had many options left so I think you have thought everything through. I know it is expensive and was a hard decision to make.

Julie, dont feel badly about your time on the forum. We all do what we can when we can but if we dont take care of ourselves we are of no use to anyone

You are and have been and always will be an incredible Mom to Hannah. Never doubt that.

I sure hope our little girl gets to take that cone of soon. Crossing my fingers for results.

Hang in there, you'll make it.

[molly muffin]

Hi Julie! Yay, no yeast. That is progress. Now hopefully the Atopica will help other areas too.

Never fear, we'll remind you to take some time to yourself. Maybe set aside some time during each day, and some special time at least once on the weekend too for just you. Read a book (for fun, not work) paint your nails, or do anything else that you really enjoy. At least you will feel like you are you again if you can do that.

Hannah is such a little sweetheart. She knows that you love her and she loves you. Right there by your side. We all have our happy place, I bet that is hers.

You know, you speak the truth, when you say, their time comes and while we want it so very much, there is only so much that can be done and sometimes trying to prolong past that point is not a good thing. Not for them and not for us. You are very wise to recognize that fact.

hugs,
Sharlene and Molly Muffin

[Trish]

Hi Julie and Hannah

I am so happy to hear Hannah is yeast free! YAY hope that new med does the trick and gets on top of that darn annoying itch.

Go you... putting out that list and working on it. I am the same this New Year, making a bit more look after myself. My GP's nurse called me last week and I am late having my yearly checkup and I got quite cranky with her Said I was too busy and stressed at the moment... well HELLO isn't that time to get a checkup when you are stressed and not taking good care of yourself!! So best I go in later this week and get it taken care of - and apologise for my grump. I would not let Flynn get so overdue for a checkup. Then I told myself there is not much point getting him all fixed up and then I cark it! (Not that I am in any danger of doing that, so don't worry ) Anyway, the point of all that was we all have to take better care of ourselves and I am glad you pointed that out as it reminded me! .

Take Care Julie and Hannah!
Trish and Flynn xx

[addy]

Hey Girlfriend,

How is Hannah adjusting to the Atopica? I am hoping maybe we are close to getting that dang cone off.

Back to school after winter break must be hard. I hope you are not having rebound flu!!!!!

Did you have this mild weather too? Crazy winter again. Remember last year? Almost a repeat here in Milwaukee.

Miss ya

[jmac]

Hey Guys,

Guess who got to make TWO trips to the emergency vet this weekend??? That's right....this girl.

Izzy went on Sun. night after having diarrhea and bloody mucus. She started the diarrhea on Thurs. afternoon, I think because she ate rabbit poop, which has caused this in the past. We did hamburger and rice starting that night. Sat. morning there was a soft stool so the vet had me start metronidazole. Sun. night she had diarrhea and lots of mucus, and was sitting with her butt up in the air (which I learned they call the "prayer position"), so we went in around 10:00.

The other thing I mentioned while we were there was that Izzy woke me up in the middle of the night Sat. scratching like crazy. She almost had wounds. She never itches, so I had no idea what was going on. Her skin was very pink as well. The vet thought the skin and diarrhea could be related. We added Benadryl to the mix for a few days. The vets are really wondering if there is something in my house or yard causing this itching in both dogs. Izzy seems to be doing better and her skin is looking better, so maybe the itching and diarrhea were related???

Then last night after coming in from our last trip outside to potty, Hannah was acting very strange and kept stretching with her feet out front and butt up in the air, and was pulling her neck way to one side and groaning. She was shaking too. I immediately thought of her back since there are some slippery spots outside. We got dressed and headed back to the vet.

She is always very nervous at the vet and typically very stoic, so they can't always find what hurts easily. He was concerned about the possibility of abdominal pain (and mentioned that prayer position again). She did show some pain when he felt her abdomen, and also when he felt her back, but it was very subtle and he needed me to interpret her quiet little groan to tell him that was pain for her.

The vet was shocked that we were there the night before, and also concerned that Hannah's pain could be related to Izzy's diarrhea and abdominal pain. He didn't think further tests were warranted because she wasn't showing him a lot of pain while we were there, and she was able to walk/trot in the room, which is unusual when she is having a back issue. He sent us home with some pain med (some narcotic that starts with a 'b') that I was only supposed to use if she showed pain when we got home. He was not comfortable giving metacam, even though she used it for back problems before, especially without knowing if it would develop into abdominal issues.

Hannah was pretty normal when we got home, so we did not give the pain med. I talked to the vet this morning and he thought it could have been a little pinch that she worked out. I had my parents take her for a laser treatment today just in case. I'm so lucky and thankful they are close, retired, and able and willing to help me out. Hannah seems to be doing well and acting normal.

It was a stressful weekend (I was also doing tons of grading, as we send report cards home on Fri.) and I shed many, many tears last night on the way to the vet, fearing the worst.

I especially hope Izzy's skin issue resolves. I just don't know how she could suddenly start itching too, but months after Hannah. The vets seemed stumped too. It's always a mystery here, that's something I can just about count on!

Anyway, I am really trying hard to focus on the positive after asking my husband "why is this happening?" through tears several times on the way to the vet last night. Most importantly, I am so glad both of my little girls are doing okay today, and I sure hope that continues. We also lucked out and paid only a little more than the minimum for the visit to the emergency clinic on each trip. My previous experiences have usually ended up being a minimum of a few hundred, and that was about our total for the two.

Needless to say, we didn't get much sleep the last couple of nights, so here's to hoping tonight will bring some much needed rest. Please keep your fingers crossed for us. I sure hope our visits to the vet are over....at least for a few days!

Julie & Hannah (& Izzy too!)

[molly muffin]

Oh my gosh Julie. What an awful weekend. Isn't that weird that both Izzy and Hannah was doing the butt in the air thing. I wonder if they didn't both get into something (like the rabbit poop) in the yard that disagreed with them. Strange about the itching too. A permanent state of confusion with Hannah. LOL I can certainly relate as you said on my thread, many of the same things, but yet not quite, but All a mystery. It can be unsettling.
Cold here too. Molly is Not a fan and isn't particularly interested in hanging about outside much when it's this cold.
Hang in there! Spring break Has to be just around the corner!

hugs,
Sharlene and Molly Muffin

[lulusmom]

Hi Julie,

I know exactly how you feel when one pup is sick and then add another within 24 hours and the anxiety is overwhelming. I'm glad that both Izzy and Hannah are doing better, which means you are too.

The pain med the er gave you was probably Butorphanol (Torbutrol). I've brought that home from the vet's office a few times for pain as well as Jasper's coughing. It can really make them dopey.

Tell those girls to quit making mom fret. We're always here if you ever need a shoulder to cry on.

[Harley PoMMom]

Hey Guys,

Guess who got to make TWO trips to the emergency vet this weekend??? That's right....this girl.

Izzy went on Sun. night after having diarrhea and bloody mucus. She started the diarrhea on Thurs. afternoon, I think because she ate rabbit poop, which has caused this in the past. We did hamburger and rice starting that night. Sat. morning there was a soft stool so the vet had me start metronidazole. Sun. night she had diarrhea and lots of mucus, and was sitting with her butt up in the air (which I learned they call the "prayer position"), so we went in around 10:00.

Gosh, Julie, so sorry to hear this and I hope both girls are feeling better real soon.

That "prayer position" is very common when a dog is experiencing a pancreatitic attack, especially along with the diarrhea, did the vet say any thing about testing for pancreatitis?