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twinkiex3
15th January 2011, 01:20 AM
my beautiful 7 year old (turning 8 in may) Tri-color boy was recently diagnosed with suspected GME. Recently, he also had a swollen eye (left side) and ultrasound revealed something "mass like" in the retrobulbar area. He also has a grade III/VI murmur.

we are trying to treat symptomatically with prednisone and ccnu and might have a CT scan done on monday if he doesn't improve over the weekend after oral/opthalmic antibiotics.

this came upon us very suddenly in the last few months and i have come to realize that me and my family might not have very long to spend with him. he has deteriorated slowly in the last week or so - just very tired and sleeps most of the time.

he has been such a joy to us over the last 8 years - he was such a special boy and sooooo smart. it'll be hard to let him go when the time comes (which is now probably going to much sooner than we thought).

my sister's been crying all day and it's very hard for me to stay strong...

http://i52.tinypic.com/r245sk.jpg

http://i54.tinypic.com/x0s47n.jpg

it is going to be a long weekend. for all you cavalier lovers out there, how did you know when the time came to let your loved one go?

Karlin
15th January 2011, 01:32 AM
I am so sorry you have these worries. Is he being seen by a cardiologist for his heart? If not I'd make an appointment -- you generally get far better treatment from a cardio and may have many medications options left to give him time. I have had a grade 5 rescue girl going strong for 18 months. :flwr:

There is a good article in the health library section on ways to tell when it might be time. As long as he gets around and isn't having pain and a lot of suffering, I'd give him time. They can sometimes turn around and have many months of good time after seeming quite ill. It is a balancing act.

I know we will all keep him in our thoughts. :flwr:

twinkiex3
15th January 2011, 01:44 AM
yes, he has been seen by a very well regarded cardiologist in our area - he has had an echo performed at the initial visit and we have been monitoring his heart with rechecks with his cardiologist (at his last recheck, he didn't need to get an echo re-done) so his heart murmur seems to be under control. he doesn't need any medications at this time...so quite contrary to most cavalier owners, his heart condition is the least of our worries right now :/

our main concern is his suspected GME (it's definitely some sort of inflammatory brain disease) - he has had 2 maybe 3 seizures since september and just isn't the same dog anymore - he's almost 8 years old, but acts like he's 12 - he's very tired all the time, and i just don't want him to suffer. and now with the possibility of a retrobulbar mass, it's hard to deal with everything.

he is my first dog, i've had him since i was 14 and he just won my heart from day 1 - so it's hard for me to think about letting him go, especially because i don't know how to gauge when that will be.

Soushiruiuma
15th January 2011, 02:20 AM
I'm so sorry to hear your little one is sick. I had to look up GME (it's an idiopathic meningioencephalitis), I'm not familiar with it.

It is very difficult to give advice about when is the right time to put an animal to sleep. My suggestion is to consider whether your reasons for continuing the animal's life are selfish. I often hear people say that they "aren't ready to let go", their pet can be suffering tremendously during this time though. An example that still bothers me to this day, was a roommate of mine had a cat who was diagnosed with cancer, as she was over 20 chemotherapy was not practical, and the cancer grew and spread. For the last week of her life this cat did not stand up, eat and barely drank water, she finally died at home most likely from starvation/dehydration. I would never have allowed her to go through that last week. She practically had to commit suicide to escape the pain.

I know that is a devastating decision to make, but try to take comfort in knowing that you did not make your pet suffer longer than was necessary.

Niki

Ddavis
15th January 2011, 08:54 AM
Also had to look up GME. I am so very sorry Twinkie is 'poorly'. You, your sister and Twinkie will be in my prayers.

Kizzys Mum
15th January 2011, 09:20 AM
So sorry to hear about Twinkie. Our westie, Bella, was diagnosed with GME in August and is (fingers crossed) on the road to recovery, although it is a long road. I found this great forum (http://gmedogs.freeforums.org/gme-nme-discussion-board-f1.html) which has lots of great up-to-date information on it. A lot of what you read about GME on the internet is all doom and gloom, but treatments have come a long way. Feel free to PM me :flwr:

ByFloSin
15th January 2011, 10:08 AM
I am sorry to hear about Twinkle too. As you say, it must be so hard to see him going downhill like this. I have a tricolour boy who was 8 last November. He looks very like Twinkle too. He has SM without symptoms and is well, not needing treatment, but he has aged rapidly, so I too wonder whether my boy's life will be cut short.

I think you know when it's time for that last kindness when the dog looses all dignity, such as being incontinent and knowing it, or is unable to eat or drink. I knew it was time for my girl Emma when she no longer recognised me or reacted to my voice. With a very old 'foodie' Poodle it was when she sat on her food bowl instead of eating from it.

Nicki
15th January 2011, 10:37 AM
So very sorry to read about Twinkle, it's very hard when they become ill especially when you obviously have a very strong bond with Twinkle - he is a lucky dog to be so loved and adored and has only known happiness and kindness :thmbsup::flwr:

He is a gorgeous boy :lotsaluv:

As Emily says, if it is GME then there is more hope now than there once was - I suggest you print off the information and take it in to your vet - they cannot be completely up to date on every possible condition, and I always feel that vets should be prepared to work with you, we have the time to research the conditions that affect our beloved breed.


It's good that Twinkle's heart is doing well despite the murmur and you have been very sensible in having a cardiologist care for him.

It does sound like he is struggling at the moment, you need to treasure every day and you will know when he has had enough - if things can't be improved, then it is not fair to leave them to suffer, for our own selfish reasons. It is the last loving act we can carry out for our beloved companions. If Twinkle is no longer able to enjoy the things he loves, or have a good quality of life, then it is time. Maybe make a list of things that are important to him - eating, playing, walks [even if they are short], enjoying cuddles, strolling around the garden - you will know what he likes best. If he is no longer able to enjoy these, or has unmanageable pain and will not get better, then generally it is time. It is always better to let them go too soon than too late - for you too as otherwise you feel guilty for ever after.


Please keep in touch we will all help as much as we can. You are all in our thoughts :flwr::flwr:






Emily, so pleased you saw this and responded, thank you :thmbsup:

twinkiex3
15th January 2011, 06:47 PM
thanks everyone for the support.

his eye looks much less swollen today, but he is still very unsteady on his feet - i can't tell if this is because of he can't see well out of his left eye or because he is truly deteriorating. but overall he is better today - and eating like a champ like always.

his current treatment regimen is prednisone 7.5mg twice a day (increased from 5mg twice a day) and lomustine (CCNU) a chemo therapy drug every 6 weeks - as recommended by our neurologist at the specialty referral hospital that i work at as a technician. he had an MRI done which revealed inflammatory lesions but not cancer, and a spinal tap was performed as well which was normal - so we're not even sure if it's GME, but just suspecting it is and treating it like it is GME.

we were really scared yesterday - his breathing was faster than usual and he just didn't seem well.

the hardest part for me is that i just don't know how to judge his quality of life! he can still manage to go outside for about 5 minute at a time to go the the bathroom and he is still eating/drinking like a champ (as he usually does anyway). he still wags his tail when he sees us and recognizes our voice and responds to his name being called...just really hard for me to tell what he is really thinking.

Tania
15th January 2011, 07:13 PM
Twinkie is in our prayers. I am so sorry she is so ill. My heart goes out to you.

Bet
15th January 2011, 07:45 PM
Twinkie is in our prayers. I am so sorry she is so ill. My heart goes out to you.

Keep Twinkle in Your prayers Please.

My Thoughts are Winging their Way to Twinkle and You.

Bet

GraciesMom
15th January 2011, 08:53 PM
I am new here and your story just breaks my heart. Your Twinkie is such a sweetheart and I hope you know in your heart when the time is right to do this. God speed.:d*g:

Kizzys Mum
16th January 2011, 09:47 AM
When looking at quality of life, be aware that high dose pred affects many aspects of the dog's personality/behaviour and they may be lethargic, withdrawn, etc. When Bella's dose was reduced, her old personality came back (including all of her naughty traits!) Hope he continues to do well.

Kathleen
16th January 2011, 10:34 AM
Am thinking of you and Twinkie. Keep us posted - hope he is feeling better today :hug:

Sandrac
16th January 2011, 12:38 PM
You and Twinkie are in our thoughts. Take care.:hug:

Desrae
16th January 2011, 01:20 PM
Thinking of you and Twinkie, will keep you in my prayers. If you can, keep us updated...

Wagtails
16th January 2011, 04:33 PM
Knowing when to let our beloved dogs go is one of the hardest things so many of us have to face. Nearly everyone says they just "know" when the moment comes, but it is still very difficult. If it is what happens for Twinkle, please try to think of it as the last act of kindness you can offer to a much loved companion and know that you have done the very best thing for him, as you obviously have done throughout his life with you.

I'm holding you, your family, and, of course, Twinkle in my heart and thinking of you this weekend. http://i673.photobucket.com/albums/vv97/Cavviewagtails/Animations/Heartblowingpoog.gif

matties mum
16th January 2011, 04:44 PM
When is it time to say Goodbye?

When is it time to say goodbye,
To all the love I've known,
When is it time to end your pain,
And leave me all alone?

I've watched you on your good days when
I feel your strength renewed;
But shortly after little ups,
The down days then ensue.

We ride this roller-coaster of
Emotions as we try,
To make it through another day,
And yet, I can't deny ...

That as I look into your face
On days that have been bad,
I see a look that beckons me
It's tired, and hurt, and sad.

The little spark I used to see
Behind those loving eyes,
Is growing ever clouded
By life's cruel inhumane side.

I try to see beyond the pain
You feel with every step;
And softly whisper to myself
This may get better yet.

If I can bear to watch you
Just another day or two;
I justify my reasons to
Ensure I cling to you.

For letting go is harder for
The person left behind;
It means that if I let you go,
I cannot turn back time.

Back to the days I long for now,
When you were full of life;
And every day held promise,
And our futures, clear and bright.

But now the lights are darkening ...
We take it daily now;
I cannot see our futures clear
Or think beyond this cloud.

I think the hardest part in this
Is never knowing why,
I have to be courageous
And I have to say goodbye.

For if I let myself admit
It's time to let you go;
I'd have to face reality
Without you ... but I know ...

That soon I have to face the
Final outcome that I dread,
And holding on will only serve
To hurt you in the end.

You've given such unselfish love
For all our time in life,
But if I hold too tightly,
You'll not move t'ward the light ...

On to a better life, where you
Can once again be free,
Of all the pain and discomfort
That holds you here to me.

So if I find the courage just to say
This last farewell,
I hope you will forgive me for
The time it took me; still ...

I'll hold with me, the memories
That in my heart remain,
Pray one day, down the road a'ways
... They'll lesson my own pain.
I am so sorry
---Aileen

twinkiex3
16th January 2011, 07:53 PM
When looking at quality of life, be aware that high dose pred affects many aspects of the dog's personality/behaviour and they may be lethargic, withdrawn, etc. When Bella's dose was reduced, her old personality came back (including all of her naughty traits!) Hope he continues to do well.

surprisingly, on the INCREASED dose of pred, he seems more perky today. he's ben barking for food/water, lying down in the living room + other places that he hasn't laid down in for a while. even last week, he wanted to lie in the kitchen, but since friday, he's wanted to be in the living room with us. last night, he even tried to go on the bed with my mom when she went to sleep. i'm concerned that he now can't see in his right eye either - thankfully, we're going to our vet tomorrow so she can check him out.

he's very stumbly/wobbly on his feet - but i don't think he realizes that he can't see well, so he keeps trying to run around everywhere. but i think personality wise, he is more like his old self.

thanks for everyone's kind words - i feel that in the coming weeks, his time may come, but i have come to peace with the realization that i may need to let him go sooner than i expected.

twinkiex3
16th January 2011, 07:58 PM
also - we are wary about decreasing his pred dose - the last time we did that, he has another seizure.

we increased his pred dose this past weekend per the dr's instructions in case the reason why his eye was so swollen on friday morning is because of something inflammatory in the retrobulbar area.

along those lines, we are treating with oral/opthalmic antibiotics in case of infection...just trying to treat it in every way possible.

i'm crossing my fingers for tomorrow. for now, he seems happy go lucky - chomping on his food and drenching himself in his water per usual. he doesn't seem to realize at all what is happening - right now he is just lounging/snoozing in the new comfy bed that we got him yesterday :) it's the best we can hope for now i suppose.

Kizzys Mum
16th January 2011, 08:38 PM
Sounds like he is doing quite well :o They can stay on the higher dose pred for quite a while I think, as long as you don't notice any adverse reactions. The pred also causes muscle wastage, so that may be why he's a bit wobbly. It also makes them hungry/thirsty (and consequently, they pee more!) The immune suppressant will make him prone to infections (although we've been lucky with Bella and she's not had any problems with that), so anti-biotics is a wise precaution. Thinking of you all.

twinkiex3
16th January 2011, 08:45 PM
he's always been a hungry boy, so luckily i haven't really noticed him be MORE hungry than usual. he's just VERY enthusiastic when he knows food is coming :)

i was aware about the muscle wasting issue - i can already start to see some in his face area as well as his flank/hips - it makes me sad :(

most of the day he sleeps on his bed, all stretched out and snoring so at least he is comfortable.

we haven't had any trouble with the pred since he's been on it (about 2 months now). we just have him on a course of antibiotics each time he receives his CCNU (Lomustine) treatment since it's a chemotherapy drug and makes him have a low white blood cell count. he's also been a little bit anemic lately, probably also from the CCNU.

Nicki
16th January 2011, 08:46 PM
he doesn't seem to realize at all what is happening - right now he is just lounging/snoozing in the new comfy bed that we got him yesterday :) it's the best we can hope for now i suppose.


Thanks for the update, it's great that Twinkle is more comfortable.

I think you are doing really well - and are very brave to have accepted what is enjoying and just enjoy him - all you can do is keep him comfortable, follow your vets' advice and treasure him :thmbsup:

GraciesMom
20th January 2011, 01:17 AM
Give Twinkie a big kiss from me and my Gracie.

twinkiex3
22nd January 2011, 05:19 PM
hi everyone!
sorry for being MIA this week - it was the first full week of classes back at school and i'm still adjusting to my last semester of college.

anyways, we took my dog in to a specialist on Monday - both the internist and the neurologist agreed that they think that a retrobulbar mass (such as from lymphoma) is unlikely at this moment, so we decided NOT to proceed with a CT scan.

at the time, my dog was very wobbly, ataxic, falling over sometimes because he was off balance, etc. - just very weird.
the neurologist feels that his GME (brain condition) is progressing and that we may need to change some medications around. thus, we increased his prednisone from 5mg to 7.5mg twice a day and we are dosing him with his CCNU (Lomustine) every 4 weeks instead of every 6 weeks and hopefully we will be OK.

since last Friday, according to my mom he has improved leaps and bounds. he no longer slips on the slick kitchen floor - a little wobbly, but he is walking much better and his balance seems much better. he is also more alert and aware and acting more like his usual mischievious self - tryign to eat crumbs off the floor and barking when he wants something...my mom thinks his eye is pretty much back to normal and that overall he has improved a lot - his tail is wagging more often instead of it just being in between his legs like it was last weekend. he is moving around more, lying on the couch, etc.

his bloodwork yesterday was a little concerning - he was a little anemic, but we think this is probably from his CCNU, since that is a chemotherapy drug so we aren't TOO concerned, since he is still eating well and has good energy level.

thanks everyone for your support - i think i may have been too worried last weekend, i really was expecting very bad new from the vet. of course, his condition is still serious, but both specalists felt that as long as we find the right combination of meds to control his symptoms, he has longer with us than i expected. it's all about controlling his symptoms while keeping him comfortable, and neither specialist felt that his quality of life was terrible - obviously it's not optimum, but he is comfortable and not in pain - they promised me they would absolutely tell me honestly when the time came.

so, just thanks everyone for helping me through this tough time...much love :l*v::l*v:

GraciesMom
22nd January 2011, 07:31 PM
It must be so great to hear positive reports from your mom

Margaret C
22nd January 2011, 08:10 PM
It is so good to know he is feeling better. Long may it last.

We are all thinking of you and him.