Blog share: SARDS and Pet Health, part 2

02/01/12 - February already!  Where does the time go??

Below is a follow up blog post, written by Michael Goldman of The Healthy Pet Network.  His dog Rex had SARDS, so this topic is near to his heart, as it is for all owners of dogs afflicted with SARDS.  I think every SARDS dog owner out there can relate to his story and frustration!

The original blog post appears here:  http://networkedblogs.com/toCwZ, which is worth a visit to watch the video, and see a picture of Rex.


This article comes from my heart and due to my experiences, is meant as a supplement to Dr Plechners article on SARDS. Please excuse any perceived ranting, as I do feel very strongly about the subject matter and please understand, my intent is to help by providing information that you may find of value.


Several years ago, my little buddy Rex, who was like a son to me, developed a very catastrophic disease called SARDS ( Sudden Acquired Retinal Degeneration Syndrome) and became blind. This had a number of implications for the Goldman family, not only for Rex but for all of us. Being an animal lover and caregiver, I never realized just how naïve I was when it came to animal health. We did not know what to do, scrambling around in a daze. The only thing I had going that helped tremendously was my determination and insistence for answers.


Have you ever had a veterinarian or doctor for that matter, tell you they don’t know, they don’t have any answers? Call me thick headed, thick skinned or whatever but this is unacceptable to me. This is their job. My animals are dependent on them for answers. You may think I am hard headed but that’s me. Now what did this have to do with my little guy Rex?


We noticed that Rex seemed to be losing his eye sight, bumping in to things, lack of depth perception etc. When we took him to our Vet who by the way, is highly regarded in the veterinary community, He didn’t have a clue. He decided to do exploratory surgery on Rex ruining one eye and causing a cataract. When he was pretty much blind, he finally recommended an ophthalmologist, closest one being 300 miles away. I pushed for an immediate appointment. I will never forget the day I took him to the specialist. He had just become completely blind and was scared to death. He did not know what the heck was going on. I felt and probably was pretty much worthless. He was diagnosed with SARDS, thus starting our journey to knowledge. Problem being, this enlightenment came at the expense of my little Rex.


Our Vet had heard of SARDS but didn’t know enough to send him to a specialist. The Specialist certainly knew about SARDS but said there was nothing that could be done and that was it. Me being me, I refused to accept this and sought answers. I came across several very knowledgeable, helpful people, in the subject matter, one being “How I met Dr Alfred J Plechner”


Now please bear with me for a moment as I am going to get on my soap box. I came to learn there is a defined cause, and a treatment that can provide a solution to many catastrophic diseases. Problem is, most Veterinarians are content to treat the symptoms or effects. Very few, look to the causes BEFORE they become effects. I am sad to say that I have found many Veterinarians, think they know everything. Instead of saying, I have things to learn and will move forward trying to find ways to better help my patients, many take the attitude that nothing can be done. They will say, “I have learned there IS NO ANSWER, NO SOLUTION”. They think and they say “Anybody with an idea, who has had success, is crazy and must be a quack.”


It’s important to note that every revolutionary scientific discovery has gone through the 3 phases of truth.


1) Disbelief


2) Ridicule


3) Truth becomes self evident


I am sorry to say, that I have no respect for these people, and have found that many of them are in the profession strictly to heal there wallet. On the other hand, I have the utmost respect for a doctor or person who says, I don’t have the answer, but I will look for one or I am open to ideas or suggestions and especially one who’s FIRST priority is the health of their patient and not there wallet.


OK OK, I will get off my high horse but there was a purpose to my tirade, If you haven’t already you may in the future have an extremely ill pet and more than likely you will encounter the above, unacceptable attitude. Know it but don’t accept it. I am making an assumption that your pet is a family member and incompetence won’t do. You want answers and hopefully solutions and rightly so. If your primary physician does not offer you anything, find someone who will because there is good news, There Are some very knowledgeable, caring medical professionals who can help.


Now, several years later, I have learned much. I am committed to helping animals in any way I can and providing the knowledge one can use to have healthy long lived pets. I will always be learning but I am committed to animal health.


We are caretakers for a number of pets—dogs and cats. I have Rex’s mother and (2) remaining siblings. Through my desire to learn and with the help of globally renowned Dr Alfred Plechner, we discovered his mother and siblings had a hormonal imbalance that predisposed them to certain catastrophic diseases. The have been diagnosed, put on a protocol and are doing VERY well today. Before Rex came down with his problem, his sister Millie was near death from an auto immune problem. She had numerous blood transfusions and the doctor said she probably would not make it. Since being on the protocol, she has never again had the problem and acts like a young school girl again.


So what do I have to offer when it comes to SARDS. My main points are these


To know what to look for so you will be a step ahead of the game
To know what to expect when bringing your pet to the vet
You love your pet—don’t be afraid to not only expect proper treatment but also be decisive and persistent in expecting action.
A couple of facts for a better understanding.
And a couple of resources if needed.
First AND FOREMOST, it important to know that SARDS is Extremely time sensitive. By the time you notice your pet is blind, it’s probably too late. On the other hand, if you notice them starting to lose their eyesight, there is still hope. The problem being, all this can happen in a couple of weeks—sometimes less and sometimes more. Time is of the essence when it comes to SARDS so if you remotely suspect, have your pet checked before it is too late. If you notice your pet being lethargic, out of sync and seeming to lose their eye sight whether stumbling, losing depth perception, anything that gives you this feeling, Have them checked immediately.


I should note that when I say too late, I mean in retaining their eyesight. Even when sight is lost, proper treatment can restore a high quality of life.


When seeing your health care professional, be sure to mention you are worried about SARDS. They may not understand the disease or have any solutions for you but they have probably heard of it. If they even remotely seem lost, DEMAND an immediate referral to a specialist. Remember you have weeks, maybe days so be decisive in your actions.


You can always feel free to contact me at the Healthy Pet Network and I can quickly and easily put you in touch with Dr Plechner. There is also a support group out there with similar experiences, that I can direct you to and one more very valuable reference


A lady in Oregon, Caroline Levin is extremely knowledgeable about the subject and has worked with many dogs with many successes. She is an RN. She knows her stuff but she is bad mouthed by many a vet since she is only an RN. Hog wash. She is a valuable resource who knows MUCH more than I do and more than most vets, when it comes to SARDS. REMEMBER THE KEY IS TO ACT SWIFTLY AND DECISIVELY.


http://www.petcarebooks..com/research.htm


Rex passed away a few months ago, which is why I wrote this article now. He was an unsung hero, The catastrophe he went thru prompted me to learn more, MUCH more about animal health. It literally saved his siblings and several others in our family. And one of the most important things was that through this, I met Doctor Plechner, who I truly believe is one of the Great men of our time and a future Nobel Prize Winner, in medicine.


OH, The Healthy Pet Network would never have been if it wasn’t for Rex.


Thank You Doctor Plechner for Rex’s good quality of life in his last years.


Rex, we miss you greatly and will love you always.


The Goldman’s

Blog share: SARDS and Pet Health, part 1

01/31/12 - Below is a blog post I'm sharing from The Healthy Pet Network.  Original post appears here:  http://healthypetnetwork.net/?p=1857#more-1857, which is worth visiting to watch the embedded video of the black lab, Gator, who was diagnosed with SARDS.



SARDS – Sudden Acquired Retinal Degeneration Syndrome, appears to be an auto-immune disease that leads to blindness. It stems from a hormonal antibody imbalance that allows a deregulated immune system to lose its protective functions, thus allowing the system to also lose recognition of its own tissue and turn against the body which causes tissue destruction.


This occurs, due to either a deficiency in cortisol, or the production of a defective cortisol. When this happens, excess sex hormones are produced by the inner layer of the adrenal cortex. I personally believe that the offending hormone is total estrogen. The other sex hormone called androgen, can be transformed into more estrogen, due to an enzyme in the fatty tissue called Aromatase. This has been documented in humans but not with animals. More studies are currently being done.


The excess in total estrogen not only binds the thyroid hormone but deregulates the immune system and compromises antibody production. This is how SARDS seems to occur. Anti-antibodies are thought to be produced against the retinal tissue causing blindness.


The shame of this is, by the time the loss of sight in the pet is noticed by the owner, subsequent identification and treatment, generally cannot correct the permanent retinal damage, but there is certainly hope in stopping further auto-immune diseases from occurring, including cancer.


Michigan State and Cornell Schools of Veterinary Medicine are looking into this disease. It is also an important subject if interest for the Healthy Pet Network.


Finally, they are exploring its connection to the syndrome that I discovered 35 years ago. I call it Atypical Cortisol Imbalance Syndrome ( ACIS ), but people still refer to it, as Plechner’s syndrome.


I have been in practice for almost 50 years, trying to find a better way to help my patients. My hope is that academia with all the knowledge and tools and grants available to them, will consider my syndrome and really define it in a much more scientific manner.


After 35 years, it just might be happening. Please tell me why it has taken so long to help a patient?


Yours in Health,


Dr. AL Plechner




**My note - my personal feeling (based only on my research and opinion, as I mentioned here http://sardsdog.blogspot.com/2011/08/sards-resources.html) is that SARDS is not an auto-immune disease as stated in the top paragraph of the blog post above.  There have been two studies published in 2006 that showed that anti-retinal autoantibodies were not present in SARDS canines (one referenced here:) http://www.ncbi.nlm.nih.gov/pubmed/16634935

Clearly further research must be done to definitively prove this, but I believe IMR is an autoimmune disease, while SARDS is not.  The line of thought to which I subscribe is Caroline Levin's stance that low cortisol and increased total estrogen leads cells (including retinal cells) to uptake too much calcium and cause cytotoxicity by destroying the mitochondria within cells.  This leads to a sort of  retinal "seizure", which prevents the retina from getting signals through to the brain.  Caroline explains this much more eloquently than I do here:  http://www.petcarebooks.com/SARDS/FAQs.htm#15

This excess retinal calcium is addressed by Levin's SARDS protocol by supplementing magnesium and adenosine (magnesium is an antagonist of calcium...which means magnesium helps to block the action of calcium in cells).

Ophthalmologist appointment, take 2!

In some ways our appointment yesterday was pretty disappointing from my point of view, at least at first. We were a little early, so we enjoyed the nice weather outside and walked all around the building. Reo was hopping up and down from the curb, going around trees and bushes, and marking where all the other dogs before her had done their business before her!

When it was finally time for our appointment, and we went into the exam room, Reo was really distracted and wanted to sniff everything - she seemed fairly excited (I'm sure she was picking up some on my excitement, too). Dr. C came in and tried to get her to come to him - again, she was really distracted with all
of the smells and couldn't have cared less about Dr. C or his assistant! She gave them both courtesy nubbin' wags, but that was about it!

I gave him a quick update on all of the things that we had done with Reo post SARDS diagnosis (trying to fit 7 months in 5 minutes isn't so easy!). Dr. C was throwing some cotton around, but again, Reo was not focused in the least, and had her nose to the ground most of the time.  I tried to get her to sit and focus, and I would do the cotton test, but wasn't having much success, either.  I kind of wished we could have talked for a few minutes and let Reo get all the sniffs out before proceeding with the testing. :-/

I asked if we could do some functional testing. Dr. C said that they had an obstacle course for large dogs, but that it wasn't appropriate for small dogs (whatever that means!). So, we set one up in the exam room with a chair, the doctor stool, trash can, and my purse. She went through it just fine, and didn't bump one thing!

Then he turned the light off and did her eye examination, while I blabbed on about the treatment we pursued, and the "evidence" we had for her regaining some sight.  His examination showed a "blind" dog - Reo had no menace reflex, and no dazzle reflex. Her PLRs were sluggish, and slightly incomplete. None of this was a
surprise to me - I already knew all of that.

He said that her retinas were "thin", but did not seem detached/very reflective based on the exam. I asked him whether or not he would expect a SARDS dog to have detached/degraded retinas after 7 months of being blind.  I wanted to uncover whether Reo's retinas still being intact was an indication that she still had some retinal activity.  Unfortunately, it seems that this answer isn't so straightforward - another case of "every dog is different". He told me the story of a patient who went blind due to something other than SARDS, and this dog's retinas are normal over a year after blindness. So, maybe not all dogs' retinas go through the apoptosis to destroy them?  This was surprising/confusing to me - I thought if the retina is not used by the body, the body destroys it.  Will have to look into this a little more...

We talked a lot about adrenal exhaustion vs. IMR and IVIg. He is really familiar with Dr. Grozdanic's work. His impression is that Dr. G is taking a lot of flack from the vet community because there are so many different variables with his protocol, and not enough control groups to be a "real" study or show "real" results. This was surprising to me, and disappointing also, as my impression of Dr. G's work was that it was considered a breakthrough in the vet community.  Just goes to show that if a theory is outside the traditional lines of thinking, it can/will be met with resistance from at least some.

I gave him some of Caroline's research papers to review or have on file, including some of restored vision, and also a dog that got IVIg treatment but still developed adrenal exhaustion. We agreed it was really unfortunate that her papers are "dismissed" by the vet community because they are not peer-reviewed (and because Caroline doesn't have DVM after her name), as if it discredits a particular study of a dog.

We reviewed Reo's bloodwork - there was no denying that she has made progress!  Dr. C was interested in this, but it was "outside" his area of specialty, so didn't make too many comments.

Ultimately, Dr. C said that all that mattered was that we thought that Reo had made improvement, and if we think that she can see based on her "real life" tests, than that was a great thing. His examination revealed that if Reo was not blind, her vision would be very, very limited.

At first I thought he was being dismissive and flip, and it sort of offended me!! I wanted to do more functional tests, obstacle courses, take her outside and show him how good she does on her own. I wanted to turn him into a believer, if you will, and prove to him that she has some functional vision!

After some discussion, I decided not to repeat the ERG, or get an ultrasound. I didn't want to put Reo through the stress of both tests, and I didn't want to pay several hundred dollars for Dr. C to tell me she's "still" blind. :-/

I feel like he just wasn't interested enough in the curiosity of Reo's case to really put forth an effort into pursuing a lot of functional testing. Though unfortunate, and upsetting to me at first, I accept it. I had a good cry after leaving the office - mostly my own frustration - and felt better afterwards. I think I was frustrated from my own high expectations, and those expectations not being met.  I also feel frustrated that research from Dr. Grozdanic, Caroline Levin, and Dr. Plechner are being dismissed, when it is so clear to me (and others whose dogs have undergone treatment) that progress can be made!!

It's true that we know Reo better than anyone, and we know that she has some functional vision left.  She went hiking in the woods and did fantastically, for crying out loud!!  In the end, that is enough for me. We will continue to share our story and blog, and do what we can to raise awareness for SARDS, and
the success with the treatment we pursued. Ultimately, I'm happy that she is on her way back to health - regardless of how much she can see, or for how long her vision returns.

I am keeping the faith!  :)

SARDS Resources

SARDS is a complicated disease, and there are conflicting theories about the causes and treatments.  I personally, subscribe to the cause of adrenal exhaustion/Plechner's syndrome (I will sometimes use the two interchangeably), and believe in treating this cause.  I follow the work of Caroline Levin and Dr. Alfred Plechner, to whom I introduced you in my "Cast of Characters" post.  When doing my research, this theory just made sense to me when I thought about Reo's symptoms.

Reo never had any allergies, skin rashes, itchy skin, food intolerances, etc. that would suggest autoimmune issues.  I believe that SARDS and IMR (Immune-Mediated Retinitis) are two different diseases.  I do not believe that SARDS is an autoimmune disease, while I do believe that IMR is an autoimmune disease.  I won't talk too much about IMR or the IVIg treatment for SARDS, as these are not part of Reo's story.

I won't lie - this is a TON of information to digest, and it is completely overwhelming.  It can be highly confusing, not to mention highly frustrating, especially if you don't have a background in science/anatomy/physiology/biochemistry/ophthalmology!  Please feel free to post questions in the comments and I will help if I can.

Please remember that I'm not a veterinarian, and in no way do I try to discredit anyone's research, theories, or experiences.  I just want to present Reo's story, from my perspective, in a way that makes sense to me, in hopes of helping others!  While I may not be an expert on SARDS, I am an expert on Reo and her treatment, and that's why I'm writing this.

Let me be clear about one very important point.  It is highly likely that your veterinarian, and even your veterinary ophthalmologist, does not have any experience with treating SARDS.  It is also highly likely that he or she has not read any research, or is not familiar with the treatments available to SARDS dogs.  This very fact is infuriating, frustrating, and downright puzzling, but I know that veterinarians and doctors can't know everything about all diseases.  The key is, they need to be open-minded enough to educate themselves so they can help you and your dog.  It is absolutely critical that you are an advocate for your dog, and if you want to pursue treatment, you must be willing to find a veterinarian to help you.  You must do so quickly, because the health of your dog depends on you!

Please read the links below to find out more information about SARDS and IMR.

Wikipedia

Always the best place to start for a general, overview definition!

http://en.wikipedia.org/wiki/Sudden_acquired_retinal_degeneration

Caroline Levin, RN

Her site was (and still is) my bible in many ways.  There is a wealth of information and research on this site, and if you are the owner of a newly diagnosed SARDS dog, I suggest you read each and every link on this site!  Take notes, and jot down questions you may have.

http://www.petcarebooks.com/research.htm

Caroline's research articles have a "plain English" translation, and so it makes it easy to read about the symptoms, testing, and treatment that these dogs underwent.  Having this information will help you to communicate with your veterinarian.

http://www.petcarebooks.com/research_case_reports.htm

This article in particular is a nice comparison of the adrenal exhaustion vs. autoimmune theories of SARDS:

http://www.petcarebooks.com/pdf/CaseReport9.pdf

I highly recommend a consultation with Caroline, if your dog was recently diagnosed with SARDS.  She can help you understand this disease, and suggest treatment for your dog.  You may email her to set up a consultation time at consult (at) petcarebooks (dot) com

Dr. Alfred Plechner, DVM

Dr. P's site is also a wealth of information.  While both he and Caroline subscribe to similar theories about adrenal exhaustion, they sometimes use different terminology, and suggest different treatments.  Dr. P hasn't done as much research on SARDS specifically like Caroline, but Dr. P has helped over 150,000 humans and animals during his career.  He has also published several books and articles.  To me, his website helps put everything in perspective, as it is "bigger picture" than just SARDS dogs.

I do suggest that you read each and every page on Dr P's site, using the navigation links on the left.  Again, take notes, and jot down any questions you may have.

http://drplechner.com/home.php

Bonnie Sue the Scottish Terrier's mom wrote an extremely interesting article on her experiences, including Levin's and Plechner's theories, Dr. Grozdanic's theories, and IVIg information.  It is very well-written, and a great overview of Bonnie Sue's story.  It should be required reading for any dog owner, let alone SARDS dog owner!

http://drplechner.com/sards01.php

I highly suggest a consultation with Dr. Plechner, but he typically requires that your dog already have the EI-1 panel from NVDS (see next entry).  Dr. P treats Plechner Syndrome/adrenal exhaustion quite aggressively, and not all vets will be willing to undertake his protocol (this was my personal experience), so be prepared.  However, Reo is living proof that his treatment WORKS, and isn't your dog's health worth it?  You can fill out the consultation request form on Dr. P's site:  http://drplechner.com/consultations.php

National Veterinary Diagnostic Services (NVDS)

This laboratory will perform a critical blood test to help diagnose your SARDS dog's underlying adrenal issues.  Caroline Levin reports that 98% of all dogs diagnosed with SARDS have adrenal exhaustion.  Therefore, it is of utmost importance that your dog is diagnosed and properly treated!

NVDS performs the most sensitive test, and is recommended by both Caroline Levin and Dr. P (please note that neither is affiliated with the laboratory, but just endorse their testing).  The needed test is the EI-1 panel (endocrine-immune 1 panel) and reports on total estrogen, total cortisol, thyroid hormones, and immunoglobulins.  This information, taken together, will help diagnose your dog.  Your veterinarian may want to send the test out to the University of Michigan, or the University of Tennessee.  I suggest that you push for the NVDS test, as it is more sensitive, and measures all of the analytes which are important to diagnose your dog.

This lab can also be very helpful if you need to find a veterinarian in your area who may have used Dr. Plechner's or Caroline Levin's protocol in the past (some individuals have had success [like me], and some individuals haven't had much success, but it's worth a try if you are desperate to find a vet who'll help you!)

Print out the forms on the website, and bring them to your veterinarian.  Your dog's blood sample should be spun down, and the serum shipped via overnight on ice packs to be kept cold.

http://national-vet.com/

SARDS Dogs - Adrenal Exhaustion Yahoo Group 

This is a group that I started, and is intended to be a safe place to learn about and discuss adrenal exhaustion/Plechner Syndrome, and the specialized treatment for this disease, following the recommendations of Dr. Plechner and Caroline Levin.  Members are encouraged to share their own experiences and make suggestions to other members that need help (keeping in mind that we are not veterinarians, and our suggestions should be discussed with a vet!).
http://pets.groups.yahoo.com/group/SARDSdogs_AE/

SARDS Awareness

A site that talks about some of the differences between SARDs and IMR.  I personally do not agree with all of the information on this site, as it is heavily weighted toward IMR and the associated IVIg treatment from Dr. Grozdanic at Iowa State, but it is a good resource nonetheless.  Unfortunately, it is not regularly updated, but if you are interested in learning more about IVIg therapy, including Dr. Grozdanic's treatment protocol, it is on this site.

http://www.sardsawareness.org/

SARDS Dogs Yahoo Group

This site was a great support to me when Reo was first diagnosed - the members are very knowledgeable and helpful about SARDS, IMR, IVIg, and blind dogs.  If you need suggestions about how to help your blind dogs cope, this is the place to visit and pose your question!

http://pets.groups.yahoo.com/group/SARDSdogs/

Blind Dog Info
This page is a collection of stories from owners whose dogs were/are affected with SARDS.  Sometimes it helps just to read others' experiences.
http://blinddog.info/sard.htm

There is also a message board, which you could find useful.  It covers other topics than just SARDS.
http://blinddog.info/msgbd/

After spending countless hours on these sites, perhaps consulting with Caroline and/or Dr. P, and getting your dog's blood test back from NVDS, you may come to the same conclusions that I did:

My dog has adrenal exhaustion/Plechner's Syndrome.  My dog's adrenal glands are not making the cortisol s/he needs, and they're making adrenal estrogen instead.  These high estrogen levels are toxic to my dog's cells, including his/her retinal cells.  High estrogen levels also mimic the symptoms of Cushing's disease.  My dog is sick, and s/he needs help immediately!

So...forward we go!