Sorry I haven't written for a while. Things have been a little crazy.
Emily did go back to the vet. I had hoped her spleen issue would be completely gone. It was still there, but not growing. They want us to come back in 6 weeks, and if it is still there, take a biopsy. The more I think about it, the more I don't want to take the bleeding risk of the biopsy. The outcome is basically the same no matter what the biopsy says - if it is cancer, it's certainly not acting like it and we probably wouldn't choose to risk removal of the spleen anyway (dual risk - the cancer would seed if it's touched and Cushings dogs don't heal well after surgery and she may never recover.) We would probably just continue to watch it even if it were cancer. She is feeling good and she is thriving right now.
Emily almost had a little long-haired dachshund sister over the holidays. We were leaving our house and an old dachshund was in the middle of the street barking at cars. The two cars that almost hit her just kept going. We immediately got her and took her in the house. She seemed to be unhurt, but she had some issues on her belly that we couldn't tell were from age or some other problem. We got her a little cleaned up, tried to give her food and water, and called our vet to make an appointment to get her checked out. She was an absolute sweetie and loved being held. The more we checked her over, she didn't seem like she had been out for too long (she just had some branches and stuff tangled in her hair). Emily, in classic form, ignored her and was just focused on the fact that we didn't leave and she was thrilled we were back home. The fact that another dog was in the house didn't even phase her.
We decided to take her door to door and see if anyone knew her. She snoozed in my arms the whole time. I fell in love pretty much right away (nothing against Emily of course!). Further down the block, we found out she belonged to one of our neighbor's mother who was visiting for the holidays and she had gotten loose. We were happy for the ending, but did miss having a little lap dog in the house!
11/10/07 by Lisa
Well, it's a good sign that there has been nothing new to report for almost a month. Emily goes back to the vet in about 2 weeks to make sure her spleen is still looking good. The fur on her belly has grown back, so it'll need a new shave! She has been very energetic. A few times, she has asked for 4 walks a day - before work, at lunch, after work, and after dinner. Her treatment seems to be very successful so far. Finders crossed that it will continue that way and be very long lasting.
10/12/07 by Lisa
Great news! The spot on Emily's spleen is better and appears to be in the process of being absorbed (which would be normal). It was definitely a surprise. So, her bloodwork is normal and her spleen is on its way back to normal! She is going back next week for a general exam, and then back in 6 weeks for another ultrasound. She is generally doing well and is even more food-crazy than normal with all the extra treats to get her to swallow her pill. As always, thank you for your good wishes.
10/8/07 by Lisa
A lot has been going on, so let me catch you up to date.
Emily's health - Her bloodwork showed that the double dosage is helping her, so we are keeping her at that level. It seems like enough for a horse, but it seems to be working. She only has minor spit ups most of the time and in general seems more active.
The doctors are still concerned over her spleen, and she is going back in for another ultrasound this Wednesday. She is becoming a regular. It could be a clot/hemotoma (which her body should have been able to handle by now), or a benign tumor (similar to what she has on her pituitary gland), or cancerous (in which case, the spleen is not the best spot to have it, but generally the type that is attracted to the spleen would show multiple spots since it is usually very aggressive).
I feel pretty certain the spot will still be there Wednesday and they will want to do a biopsy. I'm not sure yet what that entails (putting her under, taking her to another specialist, etc.) but I do know there is a bleeding risk since it is on her spleen. If surgery is later needed, we are going to face a tough decision since dogs with Cushings don't generally do well in surgery because their immune systems are impaired.
Emily also has a follow-up visit planned with her doctor for two Wednesdays from now. I am hoping her visit schedule will ease up soon. It is tough on both of us, but she is definitely handling it better even if I'm not.
Vacation - We were all set to go to the beach as usual this year. I live on those 4 days of relaxation for the rest of the year - it is amazing how much I think about it and it keeps me going. This year, though, I just didn't feel right about leaving Emily. I'm the big Destin fan, and Kenny loves it too, so it was very surprising to find myself not wanting to go. I still REALLY miss going, but in the end, I think it was best to stay with her.
We started off the vacation with big walks to the parks in the area. Emily loved it, but by about the 3rd day, I think she was worn out. I think she had about all the fun she could handle. See some pictures from the vacation in her pictures area. I'll let you know how Wednesday goes. Thanks again for all your thoughts and wishes for Emily.
9/26/07 by Lisa
Emily did really well at the vet today. She is (unfortunately) getting more used to being there, so she settled down very quickly and was really calm. For the first time, she walked through the doors instead of having to be carried in. She got a treat of some tater tots from Sonic.
We don't know the final results yet, but her ultrasound showed that the spot on her spleen is still there. It is not technically bigger, but it has changed shape. That is in general not good. It could still be a few things, and there are no other spots visible. She is going back in another 3 weeks to see how it is doing. The concern is that the spleen is so vascular that anything growing on it can grow quickly. Her adrenals are still enlarged, but not very big, and they said that a dog with Cushings won't ever have normal sized adrenals even when they are on treatment.
She is doing much better after the hormone test than usual. Her eye is not swollen and she is more active. Hopefully that means the increased dosage is helping her body cope better. I am still kind of holding my breath until we hear more. The spot on the spleen really concerns me, but it is good to be seeing it so frequently and to know that there is only one spot.
9/25/07 by Lisa
Sorry I haven't blogged sooner! Emily is still rolling along OK. She does get a little sick on and off, but nothing major at this point. She is not uncomfortable or in pain. Tomorrow is her follow-up appointment to retest her blood on the new dosage and to re-do her ultrasound. It will be pretty stressful, but it's first thing in the morning so at least it will be over quickly. I am very concerned about her reaction to the test since she will be exposed to more hormone that causes cortisol production to see how her body reacts. She also needs her annual vaccines, but those will need to wait for a while.
We usually go to the beach the first week of October, but I'm really having second thoughts about it. It's my favorite place in the world and I could really use the relaxation, but I just don't feel right leaving her for a week, even though she would be well taken care of. I will let you all know how Wednesday goes. Thank you for keeping us in your thoughts.
9/4/07 by Lisa
Earlier posts have been moved to their own page.
For the last few days, Emily has been more active. The weather has been better, so we're not sure if that is playing a part, but she does seem to feel good. She has been active on the walks, and no more spit ups since the very beginning of her higher dosage. We're still watching her closely. I am convinced her belly has become less pot-bellied and is sitting a little higher, but it is hard to tell. We'll know more after the next round of tests.
8/29/07 by Lisa
Emily has been on the double dosage for 3 nights now. She spit up once (not a lot), but has not had any definitive reaction to the increase. There have been thunderstorms every night, so it is hard to tell how she's actually feeling. We were concerned today when we got a delivery and the doorbell rang twice. She normally goes absolutely nuts. She didn't even lift her head. Later, the UPS truck went by and she barked at it for quite a while. So, we're still in watch and see mode.
8/26/07 by Lisa
We got the blood work results from the vet. She is back within the normal range, but for a dog on treatment, she should lower than she is. And her adrenal glands are still enlarged from constantly producing cortisol (the pituitary gland never stops sending the signal to produce because of the tumors on it.) She was already on a decently large dosage, but based on her blood work, they want to try doubling the dose and retesting when she has to go in for her ultrasound again. That's another stressful morning, but it seems best to try. At least there appears to be some result from the treatment, so that is encouraging. She had been tolerating her dosage well with just a few spit-ups, so we will need to watch her very closely on the double dose. We are starting her on that Monday at dinner. Good news for her there will have to be another big piece of food with the second pill. Her refill will only last 15 days now, and then she can get one pill at the higher dose. Hopefully the dosage will not make her sick and will speed her treatment. There have been thunderstorms so she is particularly clingy (I had to come back from the annual Alabama party at our neighbor's when it started). I am convinced that her pot-belly is getting smaller with the treatment, and Kenny is convinced it is getting bigger. :) She is doing much better than after her test and is the lovey-dog we're used to.
8/23/07 by Lisa
Two things changed after my post yesterday. We got a call from the vet about the ultrasound and Emily got sick - her eye swelled up again, she got very lethargic, and clearly did not feel good at all. Her reaction was likely a result of the hormone she was given during her test. Her reaction was just a little delayed. She is better today but very clingly. No news on the blood test yet, but ultrasound wise:
The Good News: No tumors on her adrenal glands. That means she must have the small pituitary gland tumors typical with Cushings. They can't be removed, but there are more medication options for this type of Cushings and these tumors are almost always benign.
Her liver is not enlarged anymore and is in the normal range.
No large masses are present.
The Bad News: Both of her adrenal glands are enlarged from over-production, so her treatment is not yet impacting them enough (blood work will tell us more).
There is a "spot" on the head of her spleen. It could be many things. They want to do another ultrasound in a few weeks to see how it is doing. If it is still there, they will do a biopsy. I am most concerned about this one because they want to check again so soon. I am trying not to think about implications until we know more, but at minimum the process is going to be very stressful on Emily (and us).
Her gall bladder has "sludge" in it. The gall bladder is not blocked or enlarged, though. This news came the day after our friend's dog Emma died of a burst gall bladder after being treated for having that "sludge". I did not fall down when the doctor told me this but I thought I might. We will also be checking on it at the next ultrasound. Cushings dogs can have trouble processing triglycerides so the vet says this is not uncommon. If it remains, it can be treated (more pills).
Needless to say, it was a hard day and night. I am so grateful to my bosses that I can work at home when needed so I can be with her. Kenny needs to go into the office tomorrow, so it'll be me here to kiss her every time she moves. I'm in and out of spontaneous crying mode, and just trying to focus on the facts. She's our little girl and we just want her to be comfortable.
Hopefully the blood work will show some improvement and the treatment will show some promise. She is tolerating it really well so far. Again, thank you all for your concerns and interest, and I'll let you know as soon as we know more.
8/22/07 by Lisa
Emily went to the vet today. I think it was harder on me than her, but she might disagree if she could speak English. They did let me stay with her during the test. She was in normal vet freak-out mode for a while (for the first time, though, she ran from the vet's door instead of just resisting going through). They let us go into a private waiting room during her test (it's kind of like a sugar test - they draw her blood, give her a hormone, wait 2 hours, then take the blood again to see how she processed it). It was quiet in the room, and yes, I am a freaky pet mom and gave her doggie massage to calm her down. She eventually jumped up on the couch and snoozed away the 2 hours. She was so calm that they decided it was best to wait until after the blood draw to do the ultrasound. Stress can throw off the test, so it was best to wait. What I didn't expect (besides the waiting) was that they shaved her belly! Emily would be horrified to know I have bared her shame in the picture to the left (I think it's kinda cute and funny - bad, Lisa!). Instead of her normal soft belly rubs, the poor thing has stubble. I'm sure it will grow back quickly. When she was rescued, she had mange, and she lost all her hair after the sulfur bath - so she's a little used to it :). She is snoring in her favorite spot right now and took this visit infinitely better than the last one. We won't know the results for a couple of days, but I personally don't expect any surprises. Thank you all who sent her good thoughts today - they helped!
8/20/07 by Lisa
Thanks to everyone who has asked about the blog and keeping it up to date. Work went pretty haywire last week and I was just too exhausted to do anything else. :) Emily is pretty much the same. She did spit up a few times, but we're not sure if it was the medicine since she has done that before. She is scheduled for another blood test and ultrasound on Wednesday. I'm really nervous about it since she had such a bad reaction the last time we took her in. This is a short-term test and her ultrasound is at the same time, so she won't be in a cage for very long at all. The guy who answered the phone at the vet actually recognized my voice this time so I'm sure I'm the crazy nervous pet parent to them, but that's OK. Emily has had this blood test once before and was Ok about it, so hopefully it will be the same this time. I'm planning on playing it by ear if I wait in the lobby, come back to pick her up, or insist she stay with me in the lobby if there is any down time. Please keep her in mind on Wednesday and thank you all for your concern. There is just no definite news at this point. Kenny's convinced she's doing better because she's so excited about the extra food she's getting with her pill every night. She's still drinking too much water, so there is still an issue, but hopefully her bloodwork will show an improvement.
8/11/07 by Lisa
Well, Emily threw up this morning on her walk. It wasn't very much, but she did the same thing 2 nights ago. Her water bowl was completely empty as well this morning. We're keeping a close eye on her today. It's the 12th anniversary of when we started dating, but looks like it's a day of Emily watching to celebrate. She is sleeping and hopefully will feel OK all day.
8/4/07 by Lisa
Emily turned 9 today! She had a big birthday walk to Wills Park today with her Mommy and Daddy. It's a horse park near our house and there was a horse show today. Lots of good smells! The horses were gorgeous, but Emily was more interested in smelling where they had been. It was incredibly hot, but she was pretty energetic. She got a regular walk after dinner (chicken of course, her favorite). The big surprise was that she asked for a third walk later in the evening and was pretty energetic on it. We would be more than happy to go back to three walks a day if she was up to it!
8/3/07 by Lisa
Emily walked all the way to the apartments near our house today. It's one of her longest walk choices. She is still drinking a lot of water, but she had some more energy at least for the apartment complex walk. She likes to sniff all of the wonderful smells left by the different dogs in the complex. She also played "Hide the Kibble" with her Daddy today, which she hasn't done in quite a while. He keeps moving the kibble from hand to hand like a shell game and she is just fascinated.
8/2/07 by Lisa
I finally bit the bullet and switched web providers. I was inspired by everyone's interest in the blog to update the site a little. It really touches me how many people are checking to see how she is doing. Today was a typical day . She did "ask" for an evening walk, but didn't make it far past the driveway and then sat down. I keep hoping for a sudden change one morning and she'll be cured.
8/1/07 by Lisa
No real change. She may be drinking less water, but it's not overly obvious at this point. She may have been a little down from Kenny being on a business trip. She tends to do that. In the evening, she did get a little hyper before going to bed. All in all still a good day.
7/31/07 by Lisa
She's still lethargic, but it seems like she drank less water today. That would be a good sign of improvement. She's only on day 5 of her treatment, so we're still watchful. She doesn't appear uncomfortable and is snoring away right now.
7/30/07 by Lisa
Emily's still pretty lethargic, but doing OK. Her eye is no longer swollen. She's still loving the Vienna sausages, and I can't believe I just opened a 6 pack of those things! She perked up for those, but has just been sleepy all day. Still no change in her excessive water-drinking (a symptom of the disease).
7/29/07 by Lisa
Emily woke up with one eye swollen this morning. She was sneezing a lot during the night, so we think it is her infrequent response to having allergies. A couple of years ago, she woke up with both eyes swollen and unable to open them. We rushed her to the vet emergency room, and she got some ointment put in her eyes. It took a week for them to get back to normal. She really didn't like that, but she's so good natured that she was running around the emergency vet's parking lot half-blind but happy she was somewhere new with new things to smell.
She hasn't had any bad reactions yet. She's starting off at a relatively high dosage, so we're still watching her very carefully to make sure the cumulative effect doesn't catch up with her. It's tempting to just feel like it's regular medicine and she'll be fine. It's a delicate balance that hopefully we'll be able reach.
For the evening walk, today was the first day in a couple of weeks that she's done her signature sprint out the door to start the walk. It wasn't full speed, but it wasn’t just walking either. Ok, yes, I cried from happiness (I'm sure no one's surprised). She only made it as far as the end of the driveway before she slowed down, but that's something, right?
7/28/07 by Lisa
Emily asked for her longest walk since her 8-hour test - all the way through the nature trail and to the local Firehouse area. I tried to talk her out of it since once you start, there's no going back without a long walk back, but she was having none of it. She wanted her traditional Saturday walk with her Daddy picking her up in the car at the end of the trail. She was really slow, but made it the whole way. She was crashed the rest of the day, but did ask for her evening walk (she cut it short). Of course, Emily's "asking" means howling at the top her lungs and jumping on you. It was good to see her more energetic.
She had no problem taking her pill again. From Emily's perspective, I guess she must think things are really going her way - hopefully she's feeling better and she's probably going to get an extra Vienna sausage out of it every day for the rest of her life. Maybe not such a bad deal.
7/27/07 by Lisa
We got the shipment of her chemotherapy drug today. We decided dinnertime was the best time to give her the medicine since she’ll need to take it every day. We were worried about how she'd react since she seems so sensitive to most everything, and how to actually get her to take it. The pills are in capsule form, so no cutting in half. She is already wise to the peanut butter trick, just looks at us like “oh, please!” if we try the doggie treats designed to hide pills, and she’s pretty suspicious of any new things we try.
We made a trip to the grocery store and got ham cubes, chicken cubes, and a last minute inspiration of Vienna sausages. My Dad loves them (I thinks they’re gross) and we thought they just might have the right smell to entice Emily and texture to hold the pills. They have a chicken flavor, so we went for that. Emily went absolutely crazy when she smelled them. She howled and howled, gobbling up everything we gave her. She never saw that kind of big bite with a strange capsule-shaped lump coming. I only gave her a sausage and a half because I was convinced she was going to get sick from eating too many of those things and we couldn’t tell if it was the treatment if she threw up. Emily was just appalled that she only got 1 ˝ sausages. She kept going back to the table after we moved into the living room like, “it was right here that I got those delicious things. Could you come back and give me more?”
We of course watched her intently all night. She is still lethargic, but no vomiting. Maybe she’ll be able to tolerate it.
7/26/07 by Lisa
The latest test did confirm the diagnosis of Cushing's Disease. Her pituitary gland or adrenal glands have tumors on them that cause an overproduction of cortisol. Her liver is enlarged from processing it constantly and her immune system is compromised. But, we did catch it relatively early.
She was scheduled for another 8 hour test to detemine which one the tumors are on, which can also indicate if they are cancerous on top of causing the overproduction problem, but she still hasn't recovered from the first test. She is still extremely lethargic and is still not yet back to her old self. Based on that, we don't think she can tolerate another test. The vet has agreed to proceed without the test results and we'll see what happens. We're going to try a less toxic treatment being used in Britain now but not yet approved here. It can still be dangerous, but she should tolerate it better and its effects are reversible if we stop treatment. She should be starting that tomorrow. We are really worried, but this is the best thing we can do for her at this point. We feel like we have a really good doctor and of couse we are giving her lots of loving and attention.
We're also trying to have a specialist see her maybe next week to do an ultrasound to see if that helps determine where the tumors are - but they are usually very small with this disease.
Thank you all for your concern and good wishes. It means more than you know to me and Kenny. Thank you, and please keep sending good thoughts Emily's way.