Diagnosed, so now what? (Sourcing Levin supplements)

03/14/11 - After spending the entire weekend reading everything I could about SARDS and applying it to Reo, I came up with some ideas.  I immediately ordered Caroline Levin's "Living With Blind Dogs" and paid an exorbitant amount of money to get overnight shipping from Amazon.com! I called Dr. C and Dr. N to discuss my findings and ideas.  My theory went something like this:

I think Reo has adrenal exhaustion.  Her adrenal glands aren't making the correct amount, or correct type of cortisol, and I think she could have elevated estrogen.  Elevated estrogen is cytotoxic, and can lead cells to uptake too much calcium, which can lead to hyperpolarization of the retina (a fancy term that means Reo's retinal cells have a "Charlie Horse" and can't get electrical messages through to the brain).  If her retinal cells are hyperpolarized, this means no electrical signals can get through to the brain (flatline ERG).  If we can lower her total estrogen levels, and pump the calcium out of her retinal cells, maybe they can "relax", and get electrical messages through to Reo's brain before her body destroys her retinas permanently.

I wanted to get Reo's blood taken for the EI-1 panel from NVDS, and begin Caroline Levin's protocol immediately.  Dr. C, being an ophthalmologist, really had no idea about the endocrinology side of things, but he asked me to keep in touch on Reo's case.  Dr. N agreed to do the blood panel at NVDS, but as a compromise, she wanted to do an ACTH test on Reo.

The ACTH test is commonly used to help diagnose Cushing's or Addison's disease.  The ACTH hormone stimulates the adrenal glands to secrete cortisol, and by measuring hormone levels before and after the ACTH injection, it can help diagnose deficiencies or excesses.

I printed out LOTS of pages from Caroline's and Dr. P's sites for Dr. N, and highlighted key phrases, and made notes in the margin.  Dr. N reviewed all of this, and said she would help us try Levin's protocol, but a lot of the science seemed 'fringe' to her.  That was good enough for me to begin!

If you are interested in Caroline Levin's suggested protocol for SARDS dogs, please purchase the book "Living With Blind Dogs" (Second edition), or request a consult, so she can tailor her suggestions to your dog.

03/16/11 - Levin protocol day 1!
Though I had my doubts that Reo had some food sensitivities from a commercial diet, I decided to jump in with both feet and switch Reo to a cooked, homemade diet.  Reo has been on Orijen kibble "Regional Red" for quite a while - this kibble is grain-free, high-quality, and full of unique protein sources.  But, I love to cook, and thought it would be fun to cook for Reo!  I whipped up a mixture of ground turkey, wild canned salmon, and egg for her proteins.  For veggies, I made carrot, yam, apple, and spinach.  I cooked everything and then mashed it all up.  As a source of adenosine, I got some Bristling sardines packed in olive oil, and gave Reo one half of one sardine daily.

I ordered all of the supplements listed in Living With Blind Dogs.  Links to retailers on Amazon.com are provided to save you some time.  Some of the manufacturers suggested in the book, I couldn't find.

Cell Advance 440
Magnesium Taurate
Phosphatidyl Serine
(Make sure the phosphatidyl serine you purchase doesn't have Ginko biloba, etc. in the supplement)

Today, Reo had her blood draw for her EI-1 panel, and also stayed at the vet for a few hours for her ACTH test.  Dr. N also injected Reo with Levin's recommended dose of dexamethasone.  Dr. N would not inject the recommended dose of triamcinolone, as she felt it was too long-acting, and would be a risk without knowing Reo's bloodwork results.  Dr. N also prescribed Reo some Medrol tablets, but not the suggested L-thyroxine.

That evening, Reo was acting very strange.  She was awfully confused, very thirsty, and quite restless.  She drank a lot of water, and wanted to get up quite frequently at night.  I began to notice that most of her restlessness at night was between midnight at 3 am.

03/17/11 - So far, Reo seems to be adjusting to the cooked food pretty well.  Stool is normal, appetite is good.  Began Reo's hormone supplementation with 0.5 mg Medrol this morning.

I called Dr. N to see if we could get the L-thyroxine, but Dr. N felt uncomfortable prescribing this until we got the bloodwork back.  Hypothyroidism is one of the most common mis-diagnoses in veterinary medicine, and so I think she was being extra cautious.

Today I also begin to research veterinary acupuncturists in our area.  I wanted to find someone who would do home visits, as Reo was pretty tired already of vet offices!

03/18/11 - Started Reo on the Cell Advance 440 and Magnesium Taurate.  I opened the capsules and added the powder to her food.
Reo is very disoriented in the mornings - she can't find her way outside by herself to go potty.  The evenings are generally better for her.
At night, she is still waking up between midnight at 3 am, panting.  One of us gets up and takes her to some water, which she drinks enthusiastically (PD).  Began to notice an increased amount of urine (polyuria - PU).

03/21/11 - Started Reo on Phosphatidyl Serine

This marks 10 days since Reo's SARDS diagnosis.  Caroline Levin stresses that quick treatment is critical, so I hope that we are on the right track.  We have all of the suggested supplements, and the Medrol - we're waiting on the L-thyroxine.