BLOG DISCLAIMER

**DISCLAIMER** Please note: I am not a veterinarian, and the purpose of this blog is solely to educate, provide resources, and share Reo's story. In this blog, I will present research and information on the theories of SARDS to which I subscribe, along with my own narrative. If you think your dog may have SARDS, or adrenal exhaustion/Plechner Syndrome, please seek veterinary care right away!

If you are just beginning your SARDS education, I suggest you start with the blog post from August 22, 2011 entitled "SARDS Resources". If you'd like to know our trials, tribulations, and joys from the beginning, start with "But first...Reo!" and click chronologically on from there.

If you would like to read my suggestions as to how I would approach treatment for a newly-diagnosed dog, check the November 16, 2011 post "If I had another SARDS dog" (and then read my blog more fully for appropriate context).

Though we have decided to suspend Reo's retinal protection supplements in September 2012 (see September 16, 2012 post "Decision for Reo") due to the fact that she had very little remaining vision, I am still strongly supportive of our treatment approach, and know that it changed Reo's health and longevity in a positive way. Feel free to comment and ask me any questions - I am happy to help if I can!

Update: Reo became an angel on October 21, 2014. She had a profound kidney infection, causing acute kidney failure, and she was unable to recover. The contributing factors to her decline are covered in my February 16, 2015 blog post "Farewell to Reo".

Though I do not regularly update this blog any longer, much of the information is still relevant (though some of the links may be out of date). Feel free to join the conversation at "SARDS Dogs United" on Facebook.




Wednesday, November 16, 2011

If I had another SARDS dog...

11/16/11 - Some of the recent comments on my blog got me thinking:  "If I had another dog diagnosed with SARDS, what would I do, now that I have all this (unfortunate) 'experience' under my belt?".  Of course, I hope that this would never happen!!

Well, this would be my course of action if I started to notice one of my dogs displaying the early signs of adrenal exhaustion/Plechner Syndrome/SARDS (increased thirst, urination, hunger, panting/heat intolerance, inappropriate elimination, lethargy, depression, confusion, trouble seeing...).  After my initial shock of "how the hell could this happen AGAIN?!", I would most certainly act quickly by doing the following:

Please remember - I am not a veterinarian, and I don't present this list to suggest a treatment for your dog!  These are only my suggestions for action based on my experience with one dog - Reo.  These suggestions may seem crazy and outlandish to some, but - this is my blog, afterall.  ;)  If I can give you and/or your vet food for thought, than that is good enough for me.

1)  Switch up the diet (this is a moot point for us, since all the dogs are on high-quality, grain-free, low phytoestrogenic dehydrated raw food, with cooked protein and veggies on top).  But, if my dog was eating commercial kibble that contained grain or a lot of phytoestrogenic ingredients, I would make the switch right away.  Also switch to all natural, hormone/antibiotic-free, made in the USA - not China!, grain-free treats, as high-quality as possible.

2)  Immediately get blood drawn for an EI-1 panel from NVDS, as well as a SuperChem CBC blood test at the vet.

3)  Order the supplements that Caroline Levin suggests in her protocol - Cell Advance, Phosphatidyl Serine, Magnesium Taurate.  Order Source Naturals Lutein supplement.  Order the Nutrimin mineral supplement that Dr. Plechner suggests (all my dogs are already on this).

4)  Start the dog on the supplements as soon as they are received, even if blood tests have not returned yet.  Also begin feeding sardines packed in olive oil, a natural dietary source of adenosine.  Reo gets 2 per day, so I would increase that based on my dog's weight.

5)  Evaluate the results of the blood tests.  If the SuperChem CBC shows elevated liver enzymes, I would start my dog on the Vetri-DMG liquid supplement.

6)  If (and only if) the EI-1 panel shows the "classic" signs of adrenal exhaustion/Plechner Syndrome (high estrogen, high or low cortisol, low thyroid, low immunoglobulins), I would ask my vet to prescribe Soloxine/L-thyroxine - thyroid hormone.

Then I would contact Caroline Levin to let her know how darned unlucky I am to have TWO dogs with adrenal exhaustion, and that I'm re-starting treatment for a different dog!  ;)  I would ask again for her support and consultations.

Then, I would consult with Dr. Plechner to initiate DepoMedrol injections.  He would suggest dosages based on my dog's blood test results and weight.  I would ask again for his support and consultations.

I would not bother with sulfasalazine and oral Medrol to start.  I would go straight to the injections.  I know hormone injections are very controversial in the veterinary world, but I feel that this was the *single* action that resulted in the greatest, most rapid improvement in Reo.  In hindsight, I think we could have helped her recover much quicker, if we didn't spend over a month trying a variety of things.

After the injection series is completed, I will begin oral Medrol dosing.

7)  Initiate veterinary acupuncture.  My experience with Reo showed that acupuncture truly helped to mitigate her symptoms and made her feel a lot better post-treatment.  I believe this really helped!  I would also ask the vet acupuncturist to provide me with two supplements:  Standard Process Enteric Support (to help with the low immunoglobulins and gastrointestinal upset) and Standard Process Adrenal Support (to help support normal adrenal function).

8)  Better take care of myself.  I was a wreck early on!  I would be better about taking the time to get massage and/or acupuncture for myself to help me reduce the stress I am feeling.

9)  Take the dog for walks, even if they're short, and even if they're difficult.  Take joy in every small bit of forward progress.

10)  Monitor the dog's progress by repeating the CBC and EI-1 panel every 3 months for the first year.  Be prepared to support my dog with an additional injection, or Medrol "pulsing" during the spring and fall should symptoms return, when natural adrenal activity is highest.


You will notice that I didn't get an ERG for my newly-diagnosed SARDS dog, which may seem strange to some.  But for me, I don't need to have an ophthalmologist take $400 to tell me my dog is blind, has SARDS, and will never see again, thankyouverymuch.  I'm glad we had an ERG for Reo, but if I was unlucky enough to have another SARDS dog with an EI-1 panel showing adrenal exhaustion/Plechner syndrome, I would not get an ERG for that dog.  If you've been reading my blog, you may recall that my opinion is that SARDS is a symptom of adrenal exhaustion/Plechner Syndrome.  So, I prefer to treat the underlying cause.

I truly hope I never have to deal with another dog with adrenal exhaustion/Plechner syndrome/SARDS.  But if I am unlucky enough, or if one of my friends has this situation, at least I am better prepared as a dog owner, and know what I will do to advocate for the correct treatment.

29 comments:

  1. Thank You for helping the planet!

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  2. Thank you for reading! It means a lot to be able to share our experiences, and hopefully help dogs and owners. :)

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    1. My dog is 8 in march and have had endless vets that don't know nothing and have literally broke me with endless visits from yeast infections in ears . Now a staff infection in her earsaying it is a food allergy I love my girl to the moon and back and I have done everything that I possibly could and I have been reading and reading now that I had gotten a computer I am learning more about SARDS and just recently come across Doctor Plecher whom is retired now. My email is
      zshelleybean7@gmail .com all vets ive been to says she's not going to live to be 8 I know there's help out there somewhere because I just read it on here can you tell me anymore what I can look at I'm still currently looking for a vet to follow these protocols . Please help us

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    2. Oh my name is Shelley and my Girl is Suzyq

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    3. Contact Jason at jasonm@national-vet.com he can give you some Info of any vet close to you that practice dr plechner protocol. Hope that helps.

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  3. Lynn,
    Thank you for this blog. It has given me much knowledge and hope and caused me to ask questions I would not have known to ask. It was the first thing I found when I started digging around for additional information and I am only just beginning the journey...I have been in touch with Dr. Plechner, had the Endocrine panel run and I am looking to find a vet in NY to work with Dr. Plechner. Seeems I have a somewhat similar heartbreaking situation. K

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  4. K, I'm so glad that you've found some information, and it's helped you! That was my reason for starting this blog, so it makes me happy every time I help someone and his/her dog! If there is anything else I can do to help, please let me know! Best wishes to you and your pup as you undertake your journey!

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  5. Lynn,
    I'm so thankful I found your blog. My dog, Ebbie, has had Cushings for about 7 months, and last week she suddenly lost her sight. I rushed her to the vet and was told it was SARDS and there was nothing we can do. I just read your 11/16/11 blog. I was wondering if you could give me the names of some dog food brands to use, or do I need to just make the food myself? I could really use some more advice about the food.
    Thanks,
    Wendy

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  6. Hi Wendy,
    How big of a dog is Ebbie? I give some advice on dog food on the following posts:
    http://sardsdog.blogspot.com/2011/08/phytoestrogens-in-dog-food.html
    http://sardsdog.blogspot.com/2011/09/choosing-new-food-for-reo.html
    http://sardsdog.blogspot.com/2011/10/reos-diet.html

    How was Ebbie diagnosed with Cushing's - was it an ACTH test? If so, were other hormones (estradiol, aldosterone, etc.) assayed as well? Was Ebbie being treated with trilostane or mitotane for Cushing's? It is quite possible that Ebbie could have Atypical Cushing's / adrenal exhaustion / adrenal insufficiency / Plechner's syndrome. I encourage you to do some research and see if anything "clicks" for you. Please let me know if you have any questions (cookypuss1 (at) gmail (dot) com)

    How is Ebbie doing otherwise in terms of symptoms? Liver/kidney values? Digestive issues?

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    1. I will read the other blogs about the food...thanks. Ebbie is a 75lb black lab/golden retriever mix. When Ebbie was diagnosed I first noticed a big decrease in her energy levels and an increase in her water intake. They did blood work and said it was a thyroid problem. She takes Soloxine for that. The next symptom was a thinning coat and some skin problems. The vet suggested blood work (can't remember the name) to check for Cushing's. When they confirmed the Cushing's we also had an abdominal ultrasound...nothing on the ultrasound. Her liver function was a little high. Last blood test showed thyroid was good with the Soloxine. After a couple of adjustments with the dosage she now takes Trilostane 85mg for the Cushing's. I was told that she was doing well with the medication, and then BAM! Ebbie woke up on Monday last week and couldn't see. I couldn't believe it. The vet just told me it was SARDS. Didn't really explain it to me, but said there was nothing they could do. They showed me that her pupils were huge and didn't respond to light. They didn't even say that it was related to the Cushing's, but everything I'm reading online seems to say that it is.

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    2. Hi Wendy - yes, I think you are right, and hormonal imbalances and SARDS are most definitely related! It is quite possible that Ebbie does not have regular Cushing's but Atypical Cushing's - but I'd need to know about her bloodwork to be sure. Sometimes cortisol appears elevated (Cushing's) but is actually showing a precursor of cortisol and not true cortisol that the body can use. Especially as you did the ultrasound and it did not show enlarged adrenal glands, it makes me a bit suspicious! Are you going to continue her on the Trilostane? If so, has your vet informed you about iatrogenic Addison's and what to look for?

      Regarding food, since Ebbie is much bigger than Reo, some of my choices may be too expensive for Ebbie to eat (we also have a Doberman and she eats something different because it would be too expensive otherwise!). Some brands to look into: DNA pet food (lamb formula or venison formula - the lamb and venison are imported from Australia and don't contain hormones/antibiotics), The Honest Kitchen - Zeal or Thrive formulas, Only Natural Pet - Max Meat, or if you need to feed a kibble, I think Orijen is the best out there.

      I hope this helps, and I hope that you and Ebbie get better soon!

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    3. I know someone whose 6 yr old Pug was just diagnosed last week. She is disabled and her mom is elderly. Any advice about how to get low-cost treatment -- any of it? Grateful for any ideas -- Thank you so much!!

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    4. Sorry to hear about your friend's dog. I did write a blog post about costs of treatment, if you do a search, it should come up. Doing the treatment the way I did it is not expensive, yet the blood tests and other diagnostics do add up. Best wishes!

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  7. OMG - Bless you, Thank you - after 2 months, 5 vets, 2 specialists, in the last-ditch neurologists office, my little 9-yr old girl malti-poo Hazel started walking into the trash cans in the doctors office. SARDS. The ophthalmologist we'd seen a week before gave me a handout about it - but cleared Hazel - said her vision was good, and didn't do the flash-tests. Said it was her neck. (The chiropractic actually helped her...)

    Over these 2 months, Hazel's been on shots for arthritis, drugs for collapsed trachea, chinese herbs and tonics, homeopatics - not one vet even mentioned SARDS - though her symptoms are ALL classic, what you say here. All her blood tests were "normal" - even a cortisol test - tho, I'll bet, if we looked at them now, knowing what she has, we would have seen markers.

    Reading this, I'm going to call all 5 vets (and try to get in to see Dr. Plechner, who amazingly is in my neighborhood) - to start her ASAP on the Depo-Medrol. It's so interesting - my best friend, who lives in Phoenix, told me that 2 dogs in her neighborhoods just came down with "mystery" illnesses, and both got cortisone shots and instantly bounced back and are doing good...so perhaps it's SARDS all around...

    I'm concerned about the long-time use of the Medrol - have you figured out how to minimize that?

    I've been using Halshan's raw food for a long time - and she's always been on raw - but when she was adopted as a baby, she had a reaction to the rabies vaccine, and she's always been a bit "odd." Never liked to walk, easily afraid. And now it's tail tucked down all the time.

    2 1/2 months ago, at the start of all this, she had a rabies booster from a trusted holistic doctor - he diluted it tremendously, to where he swore it couldn't possibly hurt her - but I'll bet that's what triggered all of this.
    Never again.

    Thank you again so much for this, I've ordered everything and will get started on your protocol as quickly as possible. At least, with a diagnosis, I don't feel so helpless. But...can't sleep....sure you all know that one...

    Guilt and regret is so easy. Watching her bump into furniture is painful ...and the important thing is to keep moving forward and staying open to possibility and good feelings, good health...everything...

    Love and well wishes to all your families here...
    Rori

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    1. Hi Rori,

      I'm sorry to hear about Hazel, and all that she's been through! I hope that you are able to get some resolution on her health issues very soon. As far as I know, Dr. Plechner isn't practicing in an office any more, though he consults extensively with other vets around the country.

      Regarding your question about Medrol, the dosage is meant to replace what the body can't produce naturally any longer (not a therapeutic dose for long-term maintenance). Reo has been on very low dose (1 mg per day) for nearly 2 years, and she is doing great. I test her liver/kidney values every 6 months, just to be sure, and everything has been normal for her.

      I hear you on guilt and regret - boy, I've felt both so many times! Good thing for us, that dogs don't know either of those emotions - they live in the moment and encourage us to do the same!

      Wishing you both the best - don't hesitate to let me know if I can do anything else to help.

      Lynn and Reo

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  8. Lynn - he's here now in West Los Angeles, At Center-Sinai on Venice Blvd, blocks from me...the site is attached to his blog and articles by him - I feel intensely lucky....seeing him at 10:30 - will update you if you like....

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  9. Hi Rori - wow, that is great! He was living in Idaho last time I spoke with him! :) Please do keep me posted on how you and Hazel are getting along. You can email me: cookypuss1 (at) gmail (dot) com!

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  10. I was wondering if you could recommend anything to my dog Griffin, he's a 10 almost 11 year old yorkie, who was just told he had SARDS today, waiting on his urine test to confirm but he had a retinal test and he basically flatlined the test with supposedly no eye sight even tho i think he can see a little bit, he could just be following my voice or remembers the layout of the furniture in the house but he still does run into things, he's on timolol eye drops (been on them since he was a puppy) he's currently at 20 lbs today cuz he eats like a horse over the past 3 weeks, is there anything i can do to get him on a healthier food or anything else? He eats Iams small toy kibble.

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  11. Hi Caitlin - I'm so sorry to hear about Griffin! What is the urine test going to confirm? I've never heard of SARDS being diagnosed in this way.

    If you feed too little food, the body goes into "starvation" mode and actually starts storing more fat. It is very important for dogs (and humans too!) to have adequate protein and fat, and few carbs. You want the body to burn fat for fuel instead of carbs for fuel. I think it's an instinct for owners (and sadly, vets) to say - you must be feeding too much, which isn't always the case.

    I do not recommend weight loss prescription diets either, as they are mostly carb and filler (most do not even contain real meat, only by-products!), and I do not believe that they are healthy. Few vets are also nutritionists, and they are
    incentivized to sell "prescription diets" that in many cases, are not required. This again is my personal opinion, but in my experience, and what I've learned from others, better results can be obtained with other diets!

    My suggestion is a grain-free diet - the best that you can afford (no corn/rice/wheat/barley, etc.). You can supplement the diet with no-salt green beans, baby carrots, 100% pumpkin etc. to help Griffin feel more full. Feel free to email me if you'd like to discuss further: cookypuss1 (at) gmail (dot) com

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  12. Do you know what the best food to give him thats grain free would be? And i think the urine test (the vet called it something different but its something to do with his urine) i guess is to check his hormone levels to see if they can put him on a medicine if the levels are normal to kind of help him so he wont gain sp much weight, hes gained about 4 or 5 pounds in the last 3-4 weeks

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  13. I can't thank you enough for your site and your responses - I give you nearly all the credit for Hazel's improvement. Dr. Plechner was amazing, and Hazel perked up (and her vision got better, too) within a day.

    Now I'm hoping we can get a long-term program together.

    Have you ever traveled with Reo? I'm looking at either leaving Hazel here with a housesitter for 10 days, or taking her with my husband and I on an RV trip across the country to be with our daughter for a month.

    I'm also wondering about flying with her, and trying to weigh the stresses. It's not until April-May, so I have no idea how she'll be feeling then….

    Thank you again…Rori

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  15. Thanks a ton for this post!! My 8 y/o Chinese Crested, Atticus, was diagnosed with SARDS possibly the same day you wrote this original post (Nov 2011). He had (and still does) all the classic symptoms: excessive thirst, incontinence, bumping into things, depression, confusion..

    He was also diagnosed with Cushings about a month after the SARDS diagnosis, but I really don't know if it's actually Cushings or if it's what you described as Plechner's Syndrome. He did gain a lot of weight though, for his size (he went from 11lbs to 19!!), and he walks incredibly stiffly now. I never started any treatment for the Cushings though, because I was never fully sure that's what it was.

    Also, the treatment is awfully expensive - especially if that's not even the problem. I've also heard that Cushings can be falsely diagnosed if the dog is under a lot of stress...and I can almost guarantee Atticus was because he cannot stand to be confined. He will bark and whine and howl the entire time like he's being tortured to death. So who knows? I don't think there's any other ways to diagnose it.

    Right now I'm not giving Atticus any more supplements (but he was on the Cell Advance and Taurine) because there is no longer any vision worth saving. As far as my vet can tell he has gone completely, 100% blind. He currently eats Merrick grain free Pork & Sweet Potato, and we give him almost nothing but veggies and yogurt as treats. So far I don't think he's suffering, but I do feel bad because I'm pretty sure he's been depressed.

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  16. Hi Lynn. Thank you for posting Reo's story. My Willow was just diagnosed with SARDs this morning. I noticed her bumping into things on Wednesday, got her to the vet on Thursday and in to see an ophthamologist Saturday (this morning). I can't believe how fast it seemed to happen. What surprises me most is that I have always fed her top quality natural foods and she's been on thyrosine for several years now for hypothyroidism. All of her blood work came back normal (including her thryroid levels because she is on the medicine). I can't for the life of me figure out what caused it. I keep wracking my brain and thinking there was something I could have done to prevent it, of course I'd never even heard of it until the primary vet declared her to be blind on Thursday and recommended seeing an ophthamologist. My heart is just breaking. Her test results showed no activity in the left eye and her right eye is only functioning at a 1/3 of its capacity, leading us to believe she can only see light and shadows. The Ophthamologist did steroid injections immediately in hopes we could slow the progression, but she couldn't guarantee it would stop it. She's had some success with other patients slowing it down, and others have told her they saw some improvement, but I'm wondering if the improvment they saw was just their dogs beginning to adjust to the blindness. Given that Willow's hypothyroidism was being controlled by medicine and the rest of her bloodwork came back normal, any ideas of what else could have caused it? My name is Kris and my e-mail is luvmysheepdog@yahoo.com if you have any additional information you can send me I would greatly appreciate it. I'm trying to get a handle on my emotions and bury myself in research, but so far my emotions are winning out. Thanks.

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  17. Hi Lynn,

    My dog, Bella, was recently diagnosed with SARDS and has lost complete vision. Was this the case with Reo and then you were able to restore function sight?

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  18. Sara, I'm sorry to hear about Bella! Yes, Reo lost all vision, and yes, we restored functional sight for a period of time. I hope you've been able to read her story from start to finish - wishing you both the best!

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  19. Hi Lynn,
    Thanks so much for this helpful blog. Our dog mindy was recently diagnosed with SARDS and I am currently waiting on Caroline Levin to send me her resources (we live in New Zealand and things can take a long time to get here!). I have ordered all the supplements you and Caroline recommend and wondered on what the doses you used were. I'm anxious to get started ASAP and I'm worried waiting on Caroline's info might push things out too much. Any help appreciated!
    Thanks,
    Helen

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    1. hi helen, really keen to touch base with you, we live in nz as well and recently have had one of our dogs diagnosed with SARDS, would like to know what supplements you ordered and any info you could please share. like your self i have been searching the net for answers as the vet had no options and i really want to help the little bugger, can you please send me an email iain.d.waugh@gmail.com and maybe we could help each other out a bit here in NZ..

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  20. Hi Lynn - thank you for writing about your journey with Reo! Our dog Carli was just diagnosed about 6 weeks ago and after reading everything on the Facebook group, we elected to start the Levin protocol. We are 3 weeks in, and not seeing any improvement - we have been consulting with Caroline which has been helpful to try and find a good Medrol dose for her. I am curious after reading this post - did you incorporate some of Plechner's protocol along with Caroline's? We are in Canada and getting a blood sample to Texas for the EI-1 panel has not been possible with COVID shipping restrictions, so we are feeling a little helpless, and wondering if maybe we should be looking at the Plechner protocol as well? Would really appreciate any thoughts if you have experience using both! Thanks again for this blog and the facebook page - I have no idea what we would have done without it! :)

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