Diabetes-free!

12/14/12 - I'm very VERY happy to report that Reo does NOT have diabetes!  We went into the vet this morning for a fasted blood draw and urinalysis - both came back negative.  HURRAY!

I was initially concerned that perhaps her adrenal glands kicked in a little bit, and that she had too much cortisol in her system, leading to high blood sugar, but this does not seem to be the case (will wait for the EI-1 panel results next week).  Though, I was definitely miffed that she was not displaying any symptoms of diabetes.

My current theory for the high blood sugar on Monday was the stress of the vet visit.  Because Reo was the second dog to go back for a blood draw, perhaps this was enough time for her to have a little adrenaline rush/blood sugar release, which caused the high glucose reading.

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. :)

http://www.petcarebooks.com/pdf/Atypical-Cushings-treatment.pdf

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!

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 there...re-watch 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!

Fighting the good fight

11/01/11 - I seriously cannot believe it is November!!

Below is a link to a useful blog post, co-written by Dr. Plechner and David Spangenburg (blog owner, and co-author of one of Dr. P's upcoming books).  There are some anecdotes in there about veterinarians' resistance to low-dose cortisol replacement.  It rings true if you've gone through what Reo and I have been through!

It's really interesting how medical doctors are more receptive to this type of therapy for humans than vets are for dogs!  Not sure why that is, but I think wondrous things can happen to and for people if one can open one's mind and step outside one's comfort zone from time to time!  :)

Check out this blog post:

Fighting the good fight

Reo's D-day!

10/05/11 - Everyone please think good thoughts for Reo and me today (in about 3 hours)!

Today is her 7 month treatment anniversary of beginning the Levin and Plechner protocols (6.5 months post SARDS diagnosis), and we're going back to the ophthalmologist diagnosed her as blind and who said she had "no hope" to regain vision.

He has seen the videos I've taken of her navigating the obstacle course, and he is intrigued. I want to prove to him that she can see (what we already know, as well as 3 vets have confirmed)! It is so clear to me that she can see based on her being able to navigate new places (obstacles, stairs, etc.) she's never been. He'll do another ERG and an ocular ultrasound as well as functional testing - fingers crossed! I am so excited and nervous!

As much as I would love for there to be a detectable change on the ERG, I understand that a plain ERG machine is not very sensitive, so I'm not expecting a miracle. I am slightly worried about her seeming vision regression since I've been back from my trip, but I'd like to move forward with the appointment (it took us a while to schedule, and a month of waiting!) Still, I have some hope!

Will let everyone know the results! Fingers crossed.

Reconnecting with our ophthalmologist

08/10/11 - Today, I emailed Dr C., our ophtho who diagnosed Reo's SARDS.  Originally, he had asked me to keep in touch as we pursued treatment for Reo, but I hadn't heard back from him after a couple of updates, so I wasn't sure he was interested.  However, after having 3 separate vets confirm that Reo has some functional vision, I thought it would be worth reaching out again.

I sent the cotton ball videos, and said I thought if we can confirm some vision and activity on Reo's ERG, it sounds like he might have a nice publishing opportunity on his hands!  Certainly my curiosity about the ERG was piqued.

This is part of Dr. C's response to me:

In the discussions I had with a few other ophthos out there, no one had seen any measurable improvements beyond normal adaptive changes.  As a matter of fact, many ophthalmologists are not recommending the "Living with Blind Dogs" book any longer due to that controversial chapter.
That being said, I am very happy that Reo is getting back into her routine and doing well.  I am more than happy to see her again.  I think PLRs, menace response, and dazzle reflex would be good first tests as well as cotton ball tracking, etc.  I would def. like to do an ERG and I will discount that heavily since I am using it for "research".  And, you are absolutely correct, if we are able to detect a change in ERG waveform amplitude then that could be data that could be used for a research paper in the future.

I was a little disappointed to hear that some ophthos are no longer recommending Caroline's book due to "controversy", but it is so hard to know exactly what parts of the protocol people undertake before deeming it a "failure".  Was every part of the protocol implemented?  How soon after SARDS diagnosis?  There are a lot of variables.  Nonetheless, the book is a terrific resource for anyone who has a blind dog (regardless of cause) - there is so much information on training, etc. that it is sad to hear that some are no longer recommending it.  SARDS dog owners need more resources, not less!

I printed out a few things to take with me when we see Dr. C again (we have an appointment in October, at about the 7-month mark of Reo's treatment).  I would like to discuss MANY things with him during this time (I hope he is prepared!  ;) ) 

One thing I have heard from SARDS dog owners, Caroline, and my research, is that PLRs in SARDS dogs are often "normal", meaning, the pupil does respond to "normal" light.  Indeed, Reo's are excellent in natural lighting (sometimes they behave strangely in fluorescent lighting - I'm not sure why).

Reo's SARDS diagnosis

03/05/11 - We went and saw Dr. N for Reo's sudden loss of vision.  Her exam revealed glaucoma negative (good), cataract negative (good), retina intact/healthy (good), and blood pressure normal (good).  They took some of Reo's blood for a CBC (Complete Blood Count) and diabetes test.  We had to wait over the weekend for the results!
03/07/11 - We got Reo's bloodwork back - most things were normal, except for a slightly elevated liver enzyme (GGT), and slightly elevated triglycerides.  Because there wasn't anything obvious going on to explain Reo's vision loss, we were referred to an ophthalmologist.
03/11/11 - By the time Reo's appointment rolled around, we think she had absolutely no vision.  Dr. C agreed that Reo's retinas looked intact/healthy, but she had no menace response, no dazzle reflex, and she would not follow a cotton ball dropped to the floor.  When placed in the middle of the floor, Reo would not take a step, seemingly fearful of unfamiliar surroundings.

We decided to get an electroretinogram (ERG) taken.  If we saw electrical activity, we might suspect something different going on, like a tumor, so we wanted to rule that out.  Reo's ERG was flatline.  Dr. C diagnosed SARDS, and told us Reo would never regain her vision.  He briefly mentioned some revolutionary work at Iowa State by Dr. Grozdanic, using IVIg treatment, but that Reo wasn't a good candidate for this.  Dr. C also gave us the name of Caroline Levin's book, "Living With Blind Dogs" to use as a resource, and mentioned that some SARDS dogs develop Cushing's disease, so we'd have to watch out for that.  But, for the most part, Reo should live a happy, healthy life once adjusted to her blindness.

We were completely devastated!  I couldn't stop thinking about all of the things Reo loved doing that now seemed impossible.  Knowing absolutely nothing about SARDS, and having far too many questions, I spent the entire weekend researching this disease, reading everything I could online, and slowly putting puzzle pieces together.  I felt at a slight advantage, having a scientific background, as it helped me understand a lot of the endocrinology I was reading.  I know that most dog owners are not so lucky.  Fortunately, many resources are written in plain English, to help anyone understand.  My next post will share the resources which I found most helpful.