Rest easy, my Jackie boy

Today was one of the hardest days that we’ve faced in a long time. We had to make the decision to send JackSon across the rainbow bridge. Damian couldn’t get him to get out of bed this morning, so he laid with Jack to comfort him. It was a couple hours later that we decided it was time. He will be missed, so very much. He was one of the best dogs. My heart hurts, but it’s also full and comforting knowing how much love and attention Jack has had the past few years. At one point we tried to rehome him because we thought someone else could give him more attention than we were able to at the time. We decided that we didn’t want him to go, and we’re so thankful that we changed our minds because he made our new family complete. We are all truly heartbroken but thankful for the time that we had with him. He is and always will be part of our family. We hope you finally get some rest Jackie Boy. We woof you buddy. 🐾❤️🐾  (Sissy *Jack’s girlfriend* is pretty upset too) 🥺

So I did something for myself…

After becoming debt free, I decided to reward myself, with Jarvis. 😁 He is amazing. I ordered Jarvis at the beginning of March 2021 and he arrived on St Patrick’s Day. This has made my commute to work so much nicer. It is now something that I look forward to! I added the full self driving feature so he can take over if I start to doze off on long trips. I chose the model 3 because it’s practical for me. I don’t need sporty or performance. But I can’t complain on performance since the car can go from 0-60 in approximately 4 seconds. 😬 I’m just a gadget girl and this car is pretty much a gadget on wheels. I didn’t want to post on social media because some people aren’t in a position to get a new car. But then I also wanted to celebrate because I’ve worked hard my whole life and when you spend smart, you can afford nice things. I sacrificed a lot to get to this point, so I am proud. And so excited!! Yes, still! Even if it is going on 6 months old. 

Meet Jarvis… ❤️

Here's a link to him driving himself to me when I summoned him. :) 

https://youtube.com/shorts/wP8QrautY4g?feature=share

A few things about Jarvis:

I never have to pump gas or get an oil change.

Only maintenance is windshield wiper fluid, brakes and tires.

I have a wall charger installed at the house so he charges overnight. 

No keys! He recognizes my phone and wakes up when I’m near.

I can check the temperature before leaving work and when it shows 100 degrees!!! I can turn on the air and it cools down to 73 pretty quickly. No more sweaty Nettie! 😂

With the full self driving feature, I can summon Jarvis to come pick me up. I’ve been kind of nervous to use this but we have tried it and it works! 

Jarvis has solitaire, YouTube, Netflix and other apps that I can use while not driving. 

He has a navigation system and Caraoke! Although Phoebe doesn’t let me use the Caraoke. Lol. 

Anyway, there’s more, but I won’t continue to bore you, just reach out if you have questions!! 

Yay me! 

Jack is losing his vision 😕

We recently noticed that Jack had cataracts. His vision seems to be going rapidly. He has trouble seeing the steps by the back door at night. Breaks my heart. His sugars on the latest lab work were 677. We got him another Libre sensor to wear and the average for the past 2 weeks was 392. He seems to feel better, but we’re still having trouble controlling his glucose. Say an extra prayer for our boy. ❤️ 

This kid now has her permit... oh my!

We went today to get Phoebe's driving permit. She must complete the driver education course and 44 hours of behind the wheel parent-taught lessons by December to get her license. Make it stop y'all! It's really bittersweet... I love to see her moving forward in life and accomplishing things, but on the other hand, that means she's drifting further and further away and pretty soon won't need her momma. :( No need for me to be selfish though, I'm not going to make this about me, I'm happy for her and very proud of the young lady she's turning out to be. <3

And then Google had to go and create this! < insert crying emoji here!!!!! >

Grand Canyon & Utah Trip 5.28-5.31.21

We came in to visit with Maya and decided to go to the Grand Canyon. The view was amazing. Below is a link to pictures from our trip. We flew in to Las Vegas, drove to Hurricane, UT, then on Sunday we went to the Grand Canyon. On Monday we went out for lunch at the ramen place, did a little shopping and then stopped to have a treat at Sweet Rolled Tacos.

2020-21

I’m just going to sum up 2020-21 in this post since I’ve fallen short on blog posts. 

We moved to The Woodlands on May 23, 2020.

Phoebe started 9th grade in a new school district. At the beginning of the year, everyone did remote learning due to COVID-19. When they did return to school, they had to wear face masks. This made it hard for new friendships to develop, but Phoebe had Maya (her soon to be stepsister at the time). Then Maya had to leave TX and move to UT for the rest of the school year. Phoebe was on Strykers at Woodlands Elite, All Star Level 2. We traveled to Oklahoma, Georgia and Florida for competitions. In OK there was ice covering roadways, making it difficult for people to get an Uber to the airport. We called a taxi and we’re able to make it thankfully! Then the next weekend we flew to Atlanta, GA and we got stuck due to a bad freeze. We ended up flying to New Orleans and staying with Angel for a couple of days. 

For 9th grade, Phoebe’s grades weren’t top notch. She took 4 honors classes and one of them being Human Geography AP, which is a difficult course. She almost didn’t pass Geometry, but she pulled through at the last minute and got an 85 on her final exam. She wants to take on level classes in 10th grade and honors English. She is also attending workouts at cheer to try out for Majors, a level 4 team, per her coach’s recommendations. 

Jack is possibly insulin resistant. :-/

Jack now has Addison’s Disease due to not having enough cortisol. He had Cushing’s due to too much cortisol, but apparently the Mitotane killed too many cells in the adrenal gland, so now it’s not producing enough cortisol. He’ll be on an injection once a month for the rest of his life. We have to give him Prednisone to help restore cortisol. My poor guy, he is acting hungry and tired all of the time. I bought all of the testing supplies but still haven’t been able to get enough blood for the test strip. We got the Freestyle Libre 2 reader and sensor last week, it seems that the readings only go up to 400, so I have no idea how high his sugars are. Every time we check them, it’s at the max level of 400 on the reader. Once it did show 378 and another time 379. But other than that, it just shows HI and when I transfer the data, it shows he was exactly at 400 for all of the other tests. So I’m pretty sure it doesn’t read over 400. The vet believes he may be insulin resistant. I was thinking of purchasing the genteel device to use for testing. But what if that doesn’t work either? Then I’ll be out $70 on that. I already have the meter, test strips, lancing device and lancets not being used. It isn’t about the money, but I’ve spent close to $4k since he was diagnosed in January. My only other option would be to bring him to the vet to get tested once a week, they charge me $40 each time. But then that’s just sporadic testing and I’ll never know how his levels are at any other time. Even if I do test him and his levels are still high after taking 18U of insulin, what would I do? I already feel like he’s on a high dose. He seems miserable, he doesn’t want to play. He only gets up to eat, drink or go outside. We switched insulins from Vetsulin to Prozinc. We’re now at 18U twice a day and his reader still just shows HI. :-/ We’re injecting into the back of his neck area because that’s the only place we can get enough skin to tent. I feel like I’m failing him.

Cushing’s to Addison’s Disease

So what we were worried about happening happened. Jack began the toxic meds (Mitotane) last month to kill some cells in the adrenal gland so they wouldn't produce excess cortisol. But we had to keep an eye on him because if it kills off too many, it could be life threatening from not having enough cortisol. Yesterday Damian texted me at work saying Jack threw up 5 times. We took him to the vet, they ran tests, he's now transitioned from Cushing's Disease to Addison's Disease. We have to stop the toxic meds immediately and give him another med (Prednisone) that restores some cortisol. His diabetes still isn't under control and we've gone from 5 units twice a day to 17 units twice a day. They ran a test that shows his average glucose over the past 3-4 weeks and they said it was pretty high. Me and Damian haven’t been successful in getting enough blood for the test strips so the vet prescribed a glucose reader gadget called Freestyle Libre 2. It will send the readings to my phone after they attach it to his neck with tape. The sensor works for 2 weeks, so we’ll use this route instead of doing a glucose curve that would mean a day full of needle sticks! We are trying another insulin to see if it makes a difference. We’re close to $4k since November for our boy and he still has a long road ahead. Prayers are needed and appreciated. All I can think of now is how we stopped paying him lots of attention years back, how we got a cat when we barely had time to spend with him and then his dad leaving him behind. It all just breaks my heart. But I will try and let the good memories consume me instead of the negative. I’m just really worried and the first place we all go is “I should’ve done this or that more...”. This is hard. 

Additional info on Cushing’s & Addison’s Disease

https://www.akc.org/expert-advice/health/addisons-disease-in-dogs-symptoms-treatment-prevention/

Update on Jack 3/24/21

3/22/21 - after 7pm Jack vomited. 3/23/21 - had multiple accidents on the kitchen floor, wasn't interested in eating breakfast and he was drinking a lot of water again. Damian texted me around 1pm saying Jack threw up 5 times. I called the vet, they wanted us to drop him off so they could squeeze him in to be seen. They ran some bloodwork, he was dehydrated, his cortisol was really low and he had low sodium and high potassium. All of this was an indication that the adrenal gland is now under producing cortisol, which could be fatal. We were instructed to stop the mitotane, hold off on the pimobendan (heart meds) for the night and only give insulin if he kept his food down for 90 mins after dinner. We need to keep him out of any stressful environments, him getting stressed activates some other hormone which isn't good for him at this time. They also ran a test with his blood work, fructolose(?) or something like that, it will tell us how effective the insulin has been. Which I'm thankful for because I feel like he is on a super high dose.

One Proud Momma 💕

Strykers didn’t hit today but they’ll come back and kill it tomorrow. This girl still wears a big smile on her face. She was finding the positive and I couldn’t be more proud. Be the light Phoebe! ✨

Watch the video of the girls running through the tunnel that we made after their performance and look at Phoebe’s face when she comes out. ❤️ 

Jack’s glucose this week...

Today his blood sugars were 142!! 

Week 1 -600’s (started 5units 2xs day vetsulin)

Week 2 -550 (increased to 10units 2xs day)

Week 3 -440 (increased to 15units 2xs day)

Week 4 -142 (holding at 15units for the next week to see how he does)

Thank goodness, I was getting pretty concerned with him being on such a high dose. 

He did throw up A LOT overnight last night. 

But since he devoured his dinner, we’re not going to treat it like a mitotane overdose. 

Hanging with her cheer squad

My girl having fun with her friends before their competition. 💕 They went home with first place in Tulsa, now let’s do the same this weekend in Atlanta!! 👌

Video of some of the fun!

Jack's medicine for Cushing's

Jack was prescribed Mitotane. It's a drug used to treat cancer of the adrenal glands. He doesn't have cancer, they're looking to destroy some cells in the adrenal glands so they aren't able to produce as much cortisol. Tricky part is if you kill off too many, it could be fatal. So we have to watch for warning signs - stomach upset (acting sick), vomiting and diarrhea are the top common. Those symptoms are the same that he has with his Pancreatitis episodes. This is so scary. They prescribed him Presnisolone 5mg and we are to give him 2 tablets if he begins showing these signs then call the vet immediately. The drug is pretty much a chemotherapy drug. It's so toxic that you have to wear gloves to give him the capsule. Knowing that I'm putting this in my man's body is so difficult. His first dose was yesterday evening. This mmorning he threw up his undigested breakfast. I don't want to freak out because it was one dose and his first. I'm going to hope and pray that this is one of the Pancreatitis episodes.

Facials and dates ❤️

Me and Phoebe had a lunch date at Fuddruckers. Now we are getting facials at Hand and Stone. 

Then Damian is taking me out to dinner and walking around Waterway. 

Update on Jack - Cushing's and Diabetes

Jack had his ultrasound yesterday. They did not see a tumor on the adrenal glands, there wouldn't have been concern of cancer, they're just narrowing down the reasons for high cortisol levels. After the ultrasound they completed a cortisol blood test, which did confirm the Cushing's diagnosis. His blood sugars during fasting were 565. We're going to increase his insulin from 5 units twice a day to 8 units twice a day. We are going to start on a medication called Mitotane. This is the scary part. The Mitotane will help reduce his cortisol levels by destroying parts of the adrenal glands. But it can be life threatening if it gets too low. And the symptoms of that are pretty much the same as his Pancreatitis episodes. It's all so overwhelming.

Below is some info that I found on the Mitotane research I've done so far. I don't have all of the answers yet, but I'm compiling a list of questions to discuss next week with the Dr. My comments are in italic.

Mitotane and trilostane therapy are effective and relatively safe in dogs with adrenal-dependent hyperadrenocorticism. Dogs with adrenal tumors however, tend to be more resistant to mitotane and trilostane than dogs with pituitary-dependent hyperadrenocorticism. This is why we didn't want a tumor!

Dogs with Cushing's disease have elevated levels of cortisol, which increases triglycerides and cholesterol. To help combat these increases, a food that's lower in fat (less than 12 percent on a dry matter basis, or DM) and moderate in crude fiber (8-17 percent DM) is reasonable. But as you'll see below, it's preferred that you give the Mitotane with a food that is high in fat.

The basis for increased panting in dog's with Cushing's disease is multifactorial. First, Cushing's disease results in increased fat deposits in the abdominal cavity and around the chest. This might explain the fatty deposits he began getting a few years back. I'll have to reach out to his prior vet and request his records.

Second, an increase in liver size impedes the diaphragm from being able to expand with ease. Mitotane, also known as o,p’-DDD (brand names: Lysodren®, Lisodren®) is an anticancer medication that is toxic to the adrenal gland cells and is used to treat hyperadrenocorticism (Cushing’s disease) or adrenal gland carcinoma. Its use in dogs and ferrets to treat adrenal disorders is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

Mitotane is given by mouth in the form of a tablet. It should be given with food, preferably one high in fat. Your veterinarian may provide you with a high fat pet food, or you can give the medication with a little corn oil, butter, or cheese. Wear gloves when administering this medication and do not allow the medication to come into contact with your skin, eyes, or mouth. Wear gloves when handling your pet’s urine, feces, or vomit, as the drug may be present.

The following medications should be used with caution when given with mitotane: central nervous system (CNS) depressant drugs, fentanyl, insulin, midazolam, phenobarbital, selegiline, spironolactone, or warfarin. Your veterinarian will monitor your pet to be sure that the medication is working by monitoring clinical effects and performing regular ACTH response tests. Your veterinarian may also monitor liver and kidney values, blood cell counts, blood sugar levels, and blood electrolytes. Regular monitoring at home for adverse/serious side effects is very important in addition to regular monitoring by your veterinarian.


Recommended Facebook Groups: Support group for owners of dogs with Cushing’s disease Dogs with Cushing’s support and information Canine diabetes support and information

Cheer Competitions

So far the Strykers have only competed in one competition this season. BUT they did get a Summit Bid, so we're going to Disney World at the end of April! (subject to change due to COVID of course) The New Orleans competition had switched to virtual, so we had to cancel our flights and hotel. NCA in Dallas (the big comp) was changed to virtual, so we cancelled that hotel reservation (which was going to be the day after we get married in Austin). Woodlands Elite decided to attend CheerSport in Atlanta Feb 12th-14th after finding out about NCA, so the girls have a chance to compete in person (fingers crossed). I just booked our hotel room and flights for that one. So far we have a virtual competition this Sunday and Monday evening. And the competition in Tulsa, OK is still in person, which is Feb 5th-7th. So that flight and hotel are still good to go! Whew, COVID is giving me another full time job with these reservations! And one that I don't get paid for! :) No, but in all seriousness, I must give a shout out to everyone at Woodlands Elite. I know that it can't be an easy job to manage all of this and break the news each time. :-/ And another shout out to the parents, coaches, athletes and team moms for being understanding and support with everything.

Jack's lab results...

We took Jack to the vet yesterday because he just hasn’t seemed like himself lately. He’s been drinking a ton of water, going outside like once an hour and then heads straight back to the water bowl. It’s just a vicious cycle and had us concerned. The vet said they can run the labs in house but it would just be negative vs positive and if they send them off, they’ll get actual numbers back to help us with his diagnosis. So I got the call on my way home today. The doctor was on the phone with me for my 30 minute drive. Jack’s glucose shouldn’t be higher than 114, his was 630. Then he said “I wish this was as simple as me saying ok, that’s it, come in and I’ll show you how to administer the insulin shots, but that’s just the first thing we found.” Then my heart sank. • Sodium is low (signs of kidney disease) • Potassium is high (can indicate kidney failure • Protein is high (relates to liver, kidneys and infectious diseases) • ALP, which should be no higher than 160 was 2017 (indicating Cushing disease) • Triglycerides were 379 (norm is high of 150) • Lipase was 544 (normal high is 250) indicating pancreatitis • cPL was 627 (shouldn’t be higher than 200) indicating pancreatic inflammation • T4 was low (indicating hypothyroidism) • They mentioned that his kidneys appeared to be stressed They are definitely diagnosing him with Type II diabetes which will require 2 shots of insulin per day and possibly Cushing disease. He was already diagnosed with a heart murmur and Pancreatitis. Our next step is to have an ultrasound done this week to look for an adrenal tumor. If one is present, he said we may consider declining treatment for any of the conditions as the expectancy is 2-3 months. If a tumor is not found, we’ll begin aggressive treatment of diabetes and Cushing. My poor little guy. :( Phoebe saw that I was upset when I got home and she made sure to work her magic and cheer me up in addition to lots of hugs. I love that kid. Update 1/14: Ultrasound is now scheduled for Jan 22nd so we're going to start him on insulin today to try and get his glucose levels down.