**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not regularly update this blog any longer, much of the information is still relevant (though some of the links may be out of date).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, March 28, 2012

Atypical Cushing's treatment

03/28/12 - I wanted to share a new study that Caroline Levin published recently. It is a retrospective study of 5 dogs, who had the adrenal panel run at the University of Tennessee.  Though the sample size is small, the information is still important.

UTenn calls increased sex hormones and high/low/normal cortisol "Atypical Cushing's" (which I find personally a little confusing, because a high cortisol result on a panel usually means truly low cortisol if the sex hormones are elevated at the same time, so it seems to me it should be called "Atypical Addison's" but that's neither here nor there...). The lab recommends a treatment for this condition of flax lignans, melatonin, and sometimes mitotane or trilostane.

The five dogs presented in Caroline's study underwent low-dose cortisol replacement therapy and the sex hormone levels were reduced in every case.

The PDF is below for those who are interested. As always for Caroline, she includes a plain-English translation for those who are not as scientifically inclined, which I think is great. :)

Have any of my readers had the UTenn panel for their dogs?

I did for Reo at the start - and it showed elevated sex hormones, elevated cortisol.  we did the UTenn panel parallel with the NVDS blood panel, but we didn't repeat the UTenn bloodwork, once we started walking down the path of treatment (plus, I didn't like UTenn's suggestions for treatment of Reo's condition, as I felt that cortisol replacement was the right choice for Reo).

One noteworthy item that I've discussed before is that high cortisol levels can be misleading (and should be examined together with total estrogen and/or sex hormones). There is no reason for a dog to have BOTH elevated estrogen and elevated cortisol (as was true in Reo's case, initially), and so it was that Reo's cortisol number was very LOW (shown in subsequent blood testing).

More food for thought!

Saturday, March 24, 2012

Vet success!

03/24/12 - Today we had an appointment with a vet in our neighborhood.  I came prepared with all of Reo's history, bloodwork, and treatment specifications.  I picked this vet's profile out of those in the office because she was pretty young, has a molecular biology background (like me!), and said she was interested in geriatric medicine and internal medicine.

She (I will call her Dr. V) was fantastic!  She was super friendly, looked over all of Reo's bloodwork, was shocked that her liver values were so high surrounding SARDS diagnosis, and then came down so drastically post injection - and have stayed that way with long-term Medrol usage, agreed that Reo was in excellent health, and said she'd have no problem continuing with Reo's treatment, as long as I understood the potential risks.

Dr. V was also interested to read more about Caroline Levin's and Dr. Plechner's work, and so I let her photocopy a big stack of papers from Reo's folder.  I will be interested to get her take on it.

HOORAY!!!!  :) 

So, we have a new vet about 2 miles from our house, who is interested in Reo's story and success, and is committed to helping me continue her treatment.  I made sure that she understood that the hormone injections were not a regular occurrence, and it had been about a year since we'd last done them, and my opinion was that it was only due to extended stressful situations that she might need "boosters".

After Reo's exam, we gave her another injection of DepoMedrol - 25 mg this time.  I decided to do another injection based on the fact that Reo is still in the throes of a lot of stress at the house (construction), the fact that it's spring, and the fact that pollen levels right now are 5 times their normal levels.  Even my other two dogs are scratching and have watery eyes.

It was the biggest RELIEF to find a vet who didn't think I was crazy, and was willing to help, on our very first try.  Reo and I are lucky-loos!

We'll see how Reo reacts to this injection, and if she has any ill-effects like PU/PD/PP.  We may consider to do another in 10 days, as we did with her first injection series in May 2011, to give her the support of an overlapping series to curb the estrogen spike.

Sunday, March 11, 2012

Happy Anniversary!

03/11/12 - Today marks one year since Reo's SARDS diagnosis.  I can't believe how much we have learned in the last year, and I can't believe how brave and true Reo has been through it all.  Thinking back to how sick and miserable she was last year, it's incredible that she has bounced back so well.  She is one tough little dog!  I am amazed and inspired.  :)

Though Reo has struggled at times this year, and is currently having some issues with her vision due to stress/change/moving cross country (not to mention that it's spring, a natural period of enhanced adrenal activity in animals and humans), she is more healthy and happy than she has been in years.  There is no doubt in my mind that treating her per Caroline Levin's and Dr. Plechner's suggestions has saved her life, and most definitely restored some vision (for all of you naysayers out those obstacle course videos!).

Special thank-yous to Caroline and Dr. P, as well as Dr. Lanz (our acupuncturist) and Dr. O (Reo's treatment vet).  We could not have gotten to this point without all of your care and support - thank you!

I'd also like to thank my readers, several of whom have shared their stories with me.  I am inspired by you and your dog's journeys, and wish you all the best!

Tuesday, March 6, 2012

Home Sweet Home

03/06/12 - We arrived back home in Denver on Saturday!  All three dogs, and two cats did great on the drive, despite driving through the storm in southern IL and IN that would turn into all of the tornadoes in IN and KY.  Scary!

Anyway, Reo is doing okay.  Vision still very transient, but am hoping that once we all settle down and are less stressed, she will go back to being more stable.  She has done a great job navigating around - sometimes seeing, sometimes not.  To say that the past month or so has been stressful would be an understatement - for both humans and animals!  Because Reo's adrenal glands can't properly respond to stress by making cortisol to soother her system, it is more difficult for her to manage.  I'm glad we gave her the booster shot of DepoMedrol to help her get through this transition.

The past several days have been amazing weather-wise!  Tons of sun, which makes all of the Pins very, very happy.  Reo has been scavenging in the yard and has found some dehydrated, shriveled apples from our neighbors' tree, along with other various things that she should NOT be eating (I think old veggies from our tenants' garden last season).  Unfortunately, I can't watch her every second, and she's eaten some things I know she should not have (including some of Tula's food she threw up in the yard the other day - GROSS!).

The bottom line is that she is still a dog, at the end of the day, so I'm trying not to stress too much about what she may have eaten and if it will cause her any discomfort (but I will give her a little extra ProZyme in her dinner tonight!).  This kind of "dog" behavior makes her happy, and she's been in a great mood lately, being outside with her pack.  Once we settle into our routine, I'm sure she will be just fine.

I am already a little nervous about finding a new vet here - it will be an extensive interview process!