Isabella

Yesterday we had to make the very difficult decision to have our French Bulldog, Isabella, put to sleep.  Our first frenchie, Rori, died on her own terms, in my arms.  So this experience with Izzy was new for both of us. We had a consultation with the vet about two weeks ago when we took Izz in for a bad bout of diarrhea.  We discussed her quality of life and the options that were left after it was determined the medicine to treat her Cushings disease had failed.  We knew this day was not far off....

I'll spare you the long explanation of Cushings Disease but in a nutshell, it is a tumor that is either pituitary or adrenal that ultimately causes the body to produce too many steroids.  This causes a host of problems and compromises the immune system. The difficulty with Cushings disease is that it's early symptoms appear to be signs of old age.  Looking back, they started before we even left Wisconsin, but we didn't know what we were looking at -excessive drinking and urination, ravenous appetite, muscle wasting, hind end weakness.....  It didn't help that Izzy was a puppy mill rescue that came with "issues" anyways and we thought a lot of her "quirks" were just her being crazy Izzy.

Her first real symptoms appeared the end of January.  My initial thought was that she was having some kind of environmental reaction to something here in Oregon.  She had some weird "crusty" patches on her back.  Two weeks after her first vet visit, her back looked like this:

Test after test was done.  Antibiotics, steroids, shampoos, ointments, .... we tried everything, and everything came back negative.  Even the normal telltale signs for Cushings in the bloodwork came back negative.  Things quickly accelerated and got much worse with her skin.  A month after her first vet visit, we had five skin biopsies taken. The results came back:  calcinosis cutis (hardening of the skin, classic Cushings symptom) and osteoma cutis (skin cancer).  We had to wait a couple weeks to clear all the meds out of her system before we could run a low-dose dex test to 100% confirm the Cushings.  (This is also the same point in time that I stopped keeping track of the vet bill... we were well over $1,000 this early into the game).  In the meantime, Izzy is battling infection after infection and looking like this:

We got her started on on Lysodren two months after that first initial visit.  Lysodren is a human cancer drug and acts on dogs by eroding their adrenal glands so they can't produce the high level of steroids.  The "loading" phase scared the crap out of me because you are basically overdosing your dog on this medication to flood their system.  Unfortunately, in Izzy's case, because she is such a "healthy" eater, she didn't show signs of being loaded (their appetite decreses) until she was overdosed.  We almost lost her over Mothers Day weekend.

The pictures are too graphic from here on out.  It turns my stomach to look back on them.  The calcinosis cutis worked it's course from her back end all the way up to her face and ears.  It was heartbreaking.  She was mostly bald, her skin was very pink, and as she healed, her skin hardened. 

But she seemed in good spirits and it appeared the Lysodren was working.  She started to regrow hair on her behind and sides.
Then she went deaf.  Like, in a matter of a week went from hearing the treat jar, our voices, etc., to not hearing anything.
Then she just kind of spiraled down.  Her behaviors got more and more strange.  She was always a "digger" -she liked nothing better than a big pile of blankets to dig and bunch up into the perfect bed.  But this digging became obsessive.  She would dig until she bloodied her feet.  She would disappear into the dark corners of the bathroom and dig and hide.  She would hide in our dark closet and just sit there and shake.  We resorted to putting her up on the couch first thing in the morning, as she would usually calm herself and sleep as long as someone was in the room.
We ran more low-dose dex testing and determined that her steroid levels were rising again.  We upped her Lysodren dosage.  Hair loss resumed and she now had more skin that was hardened, than not.  She was panting all the time and would often just sit on the couch and shake violently.  Her appetite was hit and miss.  Three weeks pass and no sign of improvement in symptoms.  We upped dosage one more time and within a week, she had overdosed again, although this time we caught it a bit sooner.  It was at this point that we all agreed that the Lysodren was no longer effective.  The dangers of switching to another drug were high, not to mention the bouts of testing and monitoring along with it.  When switching drugs, dogs need a "wash out" period to get all the old meds out of their system.  This is usually a month wait.  Izzy was getting worse every day and we decided it wasn't worth the risk, and in light of her obvious discomforts, we had to accept the inevitable.

I have no doubt in my mind we made the right decision.  That doesn't make it any easier.  I am glad we gave her a fighting chance and I would like to think that these 7 months were good.... but if I had it to do over again, I don't know that I would have put her through the Lysodren treatment.  There was an 80-85% success rate, so our odds were good.  And I know we had to try.  But seeing her discomfort these last two months broke my heart.

So rest in peace my crazy little Frenchie, you will be missed terribly!