04/09/12 - Hope everyone had a nice weekend!
Reo is doing well lately! She had a DepoMedrol injection on March 24, and did not display any PD/PU/PP (increased thirst/urination/hunger) afterwards. This caused me, along with my vet, to conclude that Reo "needed" the injection, and did not have an excess of cortisol (which would cause those symptoms). This proved to us that as a result of all of the stress (emotional and environmental) over the past couple of months, Reo's estrogen had likely spiked.
Therefore, we agreed to give Reo another injection at the same dosage, which she had on Thursday the 5th. It's been 4 days, and no symptoms, which has surprised me a little bit - I was expecting to see them with this injection. Even though there have been no excess cortisol symptoms, I'm not sure if we will have an additional injection after this one, but I need to speak with Dr. Plechner and see what he would suggest in this case.
Otherwise, no changes, really. Her mood is fantastic, she looks wonderful, and still some light/dark perception. There have been a few moments where I was sure she was sighted again, only to have her bump something shortly thereafter. I have to remind myself that this was how it started last year - little glimpses here and there of vision returning. I remain optimistic. :)
**Edit** spoke to Dr. Plechner and he suggested that we go back to oral Medrol and not do another injection, so this is what we'll plan on!
Showing posts with label injections. Show all posts
Showing posts with label injections. Show all posts
Monday, April 9, 2012
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.
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.
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!
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!
Friday, February 24, 2012
Steady on
02/24/12 - It's been one week since Reo's DepoMedrol injection, and we have noticed no increased symptoms as we experienced last spring when she got her injection series. Granted, we used a lower dosage, but I was expecting some increased thirst (at least). Maybe some restlessness, increased hunger, etc. But so far, she's doing great, despite the massive amount of packing and changes going on in the house (removed furniture, new boxes everywhere, etc.).
No major changes on the vision side, either. It's transient - sometimes she does great and walks around new things no problem, can follow a cotton ball from more than 12 inches away, etc. And other times, she can't find her way back up the steps from the yard. Sean and I sort of feel that for Reo, she needs to willingly "engage" her vision sense. Like, if she's focused and paying attention, she can see and navigate well. If she's distracted and smelling something, or if she is napping/dozing and opens her eyes, she doesn't have much vision. Sometimes we can snap her out of it and get her to engage by talking to her. I find this interesting, and I wish I knew more about what could be going on in her eyeballs!
I think that Reo has lost a little bit of weight - she's looking more ribby lately. It's a fine line to balance diet and exercise in a small dog. I'm constantly giving a little more or a little less food, depending on how much exercise we've gotten.
At this time next week, we'll be somewhere in Kansas, en route home to Colorado. We are really excited, and I hope that Reo is not too stressed out. Anything could happen in a car with 2 people, 3 dogs, and 2 cats. Fun times, yes? :)
No major changes on the vision side, either. It's transient - sometimes she does great and walks around new things no problem, can follow a cotton ball from more than 12 inches away, etc. And other times, she can't find her way back up the steps from the yard. Sean and I sort of feel that for Reo, she needs to willingly "engage" her vision sense. Like, if she's focused and paying attention, she can see and navigate well. If she's distracted and smelling something, or if she is napping/dozing and opens her eyes, she doesn't have much vision. Sometimes we can snap her out of it and get her to engage by talking to her. I find this interesting, and I wish I knew more about what could be going on in her eyeballs!
I think that Reo has lost a little bit of weight - she's looking more ribby lately. It's a fine line to balance diet and exercise in a small dog. I'm constantly giving a little more or a little less food, depending on how much exercise we've gotten.
At this time next week, we'll be somewhere in Kansas, en route home to Colorado. We are really excited, and I hope that Reo is not too stressed out. Anything could happen in a car with 2 people, 3 dogs, and 2 cats. Fun times, yes? :)
Saturday, February 18, 2012
"Booster" shot, and a happy liver
02/18/12 - Went to our vet yesterday for Reo. I had to stock up on her meds, since we are in the midst of a cross-country move.
I also wanted to get a CBC and thyroid test to see how she was doing (it has been about 6 months since her last CBC, which was normal). Reading other lists and groups makes me a little paranoid sometimes, like Reo's liver is going to fail for being on Medrol long-term (been almost a year). I've also heard people complain that the NVDS blood lab that I use for Reo is "inaccurate, particularly in thyroid testing".
It's no secret that the treatment we pursued for Reo is controversial - and some people have had extremely averse reactions to her success. Because I read a lot of views/treatments/theories about SARDS, I do question myself sometimes, even though Reo is healthy and she regained her sight.
As our vet says "the proof is in the pudding!" - kind of hard to argue with that!
Anyway, our vet does the basic blood testing right in his office, so it didn't take very long to find out her status. I'm very pleased to report that Reo's thyroid is normal (confirmed NVDS normal result), and all of her liver and kidney values are normal, and her blood glucose is normal! :)
If her dose of Medrol was a therapeutic dose (as many people and vets feel is the case) - there is definitely concern that there can be long term liver or kidney problems, and high blood sugar. In my mind, this proves that Reo is not on a therapeutic dose of Medrol - her daily dose is only replacing what her body cannot produce naturally (again, making her like an atypical Addison's dog).
Because she has had a decline in vision the past 2 weeks (stress of me being gone on a trip, coupled with stress of the house packing/chaos), I had contacted Caroline Levin and Dr. Plechner to see what they suggest. They both suggested a "booster" shot of cortisol hormone.
Caroline cites her experience in that spring and fall are natural periods of enhanced adrenal activity in pets and people (allergies, anyone?), and so sometimes dogs with adrenal exhaustion have challenges during this time. Take this, coupled with stress, and it can have an effect - it seems to have had an effect on Reo.
So, I talked about a "booster" with our vet, and agreed on a dosage. We went with 15 mg DepoMedrol, which was less than Dr. P suggested to me, but a dose with which my vet and I felt comfortable. I am interested to see how this helps with Reo's stress, and if her vision will improve again.
Thursday, September 1, 2011
Third round of treatment and beyond
05/21/11 - Reo had her third injection of 25 mg DepoMedrol today! Hopefully this is the last one required.
05/22/11 - Definitely noticed PD, PU after the injection. She was up several times during the night/morning.
05/26/11 - Reo is still eating 3 meals/day. Still on the rice and Wellness canned food. I think she's getting tired of the rice, as she leaves a lot of it behind. Her mood is greatly improved lately, but she still has insomnia sometimes. I attribute it to the fact that her hormone levels are fluctuating and trying to be in balance.
06/01/11 - Today marks 10 weeks since beginning the Levin/Plechner protocols! Today is also 10 days after Reo's last DepoMedrol injection, so I started her on 1.0 mg of oral Medrol this morning.
05/22/11 - Definitely noticed PD, PU after the injection. She was up several times during the night/morning.
05/26/11 - Reo is still eating 3 meals/day. Still on the rice and Wellness canned food. I think she's getting tired of the rice, as she leaves a lot of it behind. Her mood is greatly improved lately, but she still has insomnia sometimes. I attribute it to the fact that her hormone levels are fluctuating and trying to be in balance.
06/01/11 - Today marks 10 weeks since beginning the Levin/Plechner protocols! Today is also 10 days after Reo's last DepoMedrol injection, so I started her on 1.0 mg of oral Medrol this morning.
Saturday, August 27, 2011
Second round of treatment
05/11/11 - Reo got her second injection today. Per Dr. P, we skipped the Vetalog (triamcinolone) and just injected 25 mg DepoMedrol.
05/12/11 - Reo has been quite restless in the early morning, usually between 12 am and 4 am. Doesn't seem to need to go potty or drink, but she just wanders around in the bed like she can't get comfortable. I'm sure her hormone levels are adjusting.
She's gaining some weight, finally, after losing a couple of pounds due to her inappetance. Even 2 lbs. is quite a lot for such a small dog! Her mood seems to be pretty good lately. She seems to have more confidence on walks.
I've noticed that Reo's pupilary light reflex (PLRs - when the pupils constrict in response to light) are quite good when she is outside. Sometimes in fluorescent lighting, her pupils stay very large. It is a bit confusing, but I've read that SARDS dogs can still have good PLRs even though they are totally blind. Hmmm...
05/13/11 - Reo only woke up once last night - that is some progress, and sleep is wonderful!! :)
Still giving Reo 4 meals per day of mostly rice and Wellness canned food. I've been sticking to the "stew" formulations, as they seem to have the least amount of ingredients with phytoestrogens. However, she still has fairly loose stools these days.
05/16/11 - Reo is sleeping a bit better, but still wakes up once or twice in the night. She usually has to have a bowel movement, which is typically runny. She is straining quite a lot, with not much stool coming out, which makes me wonder if she has colitis or IBD. So far, she hasn't had any blood present, or abnormal color, but sometimes there is mucous present.
As Reo has gained weight and is now in her target zone (yay!), I've cut back to 3 meals a day instead of 4, for weight maintenance.
Sean reported that he thought Reo could see a little bit today - she acted atypically when she was outside, including navigating the steps, tree, and fence as though she had vision.
We had a longer-than-normal walk today, about 45 minutes! Really the first time that she felt like walking that long. She was trotting out in front, and even pulling a bit, which is the first time she's done this since losing her sight (usually she'd be as close as possible to my feet).
05/17/11 - Reo's colitis-like symptoms are continuing, but I see no blood in her stool. Lots of straining, very little stool, some mucous.
I decided to start Reo back up on the canned pumpkin. It's not her favorite, due to her memories of my cooked food concoctions. She didn't eat all of her breakfast this morning. :(
I also wondered about the laxative effects that the Magnesium Taurate may be having on her, so I did a little research. While Magnesium itself can be a laxative, Magnesium Taurate complex is not known to be a laxative, so I can continue giving it to her without worry.
05/12/11 - Reo has been quite restless in the early morning, usually between 12 am and 4 am. Doesn't seem to need to go potty or drink, but she just wanders around in the bed like she can't get comfortable. I'm sure her hormone levels are adjusting.
She's gaining some weight, finally, after losing a couple of pounds due to her inappetance. Even 2 lbs. is quite a lot for such a small dog! Her mood seems to be pretty good lately. She seems to have more confidence on walks.
I've noticed that Reo's pupilary light reflex (PLRs - when the pupils constrict in response to light) are quite good when she is outside. Sometimes in fluorescent lighting, her pupils stay very large. It is a bit confusing, but I've read that SARDS dogs can still have good PLRs even though they are totally blind. Hmmm...
05/13/11 - Reo only woke up once last night - that is some progress, and sleep is wonderful!! :)
Still giving Reo 4 meals per day of mostly rice and Wellness canned food. I've been sticking to the "stew" formulations, as they seem to have the least amount of ingredients with phytoestrogens. However, she still has fairly loose stools these days.
05/16/11 - Reo is sleeping a bit better, but still wakes up once or twice in the night. She usually has to have a bowel movement, which is typically runny. She is straining quite a lot, with not much stool coming out, which makes me wonder if she has colitis or IBD. So far, she hasn't had any blood present, or abnormal color, but sometimes there is mucous present.
As Reo has gained weight and is now in her target zone (yay!), I've cut back to 3 meals a day instead of 4, for weight maintenance.
Sean reported that he thought Reo could see a little bit today - she acted atypically when she was outside, including navigating the steps, tree, and fence as though she had vision.
We had a longer-than-normal walk today, about 45 minutes! Really the first time that she felt like walking that long. She was trotting out in front, and even pulling a bit, which is the first time she's done this since losing her sight (usually she'd be as close as possible to my feet).
05/17/11 - Reo's colitis-like symptoms are continuing, but I see no blood in her stool. Lots of straining, very little stool, some mucous.
I decided to start Reo back up on the canned pumpkin. It's not her favorite, due to her memories of my cooked food concoctions. She didn't eat all of her breakfast this morning. :(
I also wondered about the laxative effects that the Magnesium Taurate may be having on her, so I did a little research. While Magnesium itself can be a laxative, Magnesium Taurate complex is not known to be a laxative, so I can continue giving it to her without worry.
The treatment begins!
04/30/11 - Today is my 36th birthday, and I can't think of a better way to celebrate than to start down the path of health for Reo!
Dr. P, Dr. O, and I agreed upon a treatment plan of a series of 3 injections, spaced 10 days apart.
We met Dr. O today, and he took a blood draw for another EI-1 panel for Reo. He also injected Reo with Dr. P's recommended doses: 0.3 mg triamcinolone (Vetalog) and 25 mg methylprednisolone (DepoMedrol). The injections were over faster you than you could say "lickety split", and there was no turning back. I can't believe it took us such a long time to find a vet to help us, for what seems like such a minor "procedure".
I'll be honest - I was exhilarated but also nervous. I was crossing fingers and toes that my research had paid off, that Caroline and Dr. P knew what was best for Reo, and that I made the right decision. Only time will tell...
05/01/11 - Last night was an awful night with Reo. She was up every hour to drink and urinate - definitely displaying PD/PU. These symptoms continued throughout the day. After speaking with Dr. P, he told me to eliminate the triamcinolone from Reo's future injections, and just inject the DepoMedrol.
05/02/11 - 05/04/11 - Reo still awake frequently at night, usually every 1.5-2 hours. It's hard on Sean and me, but I know it must be even harder on Reo! Her appetite has been good over the past few days, and I'm still able to get some supplements into her.
We saw Dr. Lanz on 05/04, and she recommended we start Reo on Vetri-DMG. This is a liquid supplement (it also comes in pill form), and a completely natural compound. It supports the immune system (important for dogs who are on powerful steroids, as steroids suppress the immune system), promotes liver detoxification (also important for SARDS dogs with adrenal issues, who are clearing lots of excess hormone/protein), and also helps circulation and oxygen utilization.
You can read more about the benefits here: VetriScience Labs Vetri-DMG
Though I initially purchased this from Dr. Lanz, I began purchasing it from Entirely Pets on Amazon.com in the 113 ml bottle, as it was much less expensive (about $30, and would last Reo and Leigh [also put Leigh on this!] for months).
05/05/11 - Reo only got up twice last night - I LOVE YOU DR. LANZ!! I am certain that acupuncture makes such a difference for Reo. She shows such great improvement in mood and sleep after a treatment, and would encourage any SARDS dog owner to seek out a veterinary acupuncturist to help soothe their dogs.
It's also been very valuable for me to have another vet's eyes on Reo's case. Dr. Lanz is a "real" veterinarian, but she has a Chinese Medicine point of view, so I can share Reo's bloodwork, symptoms, etc. and know that she will give me her perspective from both the traditional realm and also the Chinese medicine realm.
Last night, I had a dream that Reo regained her vision! :) That was nice. However, when she went outside in the morning, she crashed into our fence after getting lost, and I think she slightly scraped her eye. :(
05/08/11 - Reo has been doing much better at night - only up once or twice, usually. She continues to be very restless and wander all over the house.
She is still rather heat-intolerant, and pants quite a lot, even when Leigh and Tula are not.
Reo also continues to have inappropriate elimination - not in the house when we are there, but if we leave her in her crate, she will urinate. It doesn't matter if it's 10 minutes (literally!), or 3 hours - she'll go in there. Acting out?
Dr. P, Dr. O, and I agreed upon a treatment plan of a series of 3 injections, spaced 10 days apart.
We met Dr. O today, and he took a blood draw for another EI-1 panel for Reo. He also injected Reo with Dr. P's recommended doses: 0.3 mg triamcinolone (Vetalog) and 25 mg methylprednisolone (DepoMedrol). The injections were over faster you than you could say "lickety split", and there was no turning back. I can't believe it took us such a long time to find a vet to help us, for what seems like such a minor "procedure".
I'll be honest - I was exhilarated but also nervous. I was crossing fingers and toes that my research had paid off, that Caroline and Dr. P knew what was best for Reo, and that I made the right decision. Only time will tell...
05/01/11 - Last night was an awful night with Reo. She was up every hour to drink and urinate - definitely displaying PD/PU. These symptoms continued throughout the day. After speaking with Dr. P, he told me to eliminate the triamcinolone from Reo's future injections, and just inject the DepoMedrol.
05/02/11 - 05/04/11 - Reo still awake frequently at night, usually every 1.5-2 hours. It's hard on Sean and me, but I know it must be even harder on Reo! Her appetite has been good over the past few days, and I'm still able to get some supplements into her.
We saw Dr. Lanz on 05/04, and she recommended we start Reo on Vetri-DMG. This is a liquid supplement (it also comes in pill form), and a completely natural compound. It supports the immune system (important for dogs who are on powerful steroids, as steroids suppress the immune system), promotes liver detoxification (also important for SARDS dogs with adrenal issues, who are clearing lots of excess hormone/protein), and also helps circulation and oxygen utilization.
You can read more about the benefits here: VetriScience Labs Vetri-DMG
Though I initially purchased this from Dr. Lanz, I began purchasing it from Entirely Pets on Amazon.com in the 113 ml bottle, as it was much less expensive (about $30, and would last Reo and Leigh [also put Leigh on this!] for months).
05/05/11 - Reo only got up twice last night - I LOVE YOU DR. LANZ!! I am certain that acupuncture makes such a difference for Reo. She shows such great improvement in mood and sleep after a treatment, and would encourage any SARDS dog owner to seek out a veterinary acupuncturist to help soothe their dogs.
It's also been very valuable for me to have another vet's eyes on Reo's case. Dr. Lanz is a "real" veterinarian, but she has a Chinese Medicine point of view, so I can share Reo's bloodwork, symptoms, etc. and know that she will give me her perspective from both the traditional realm and also the Chinese medicine realm.
Last night, I had a dream that Reo regained her vision! :) That was nice. However, when she went outside in the morning, she crashed into our fence after getting lost, and I think she slightly scraped her eye. :(
05/08/11 - Reo has been doing much better at night - only up once or twice, usually. She continues to be very restless and wander all over the house.
She is still rather heat-intolerant, and pants quite a lot, even when Leigh and Tula are not.
Reo also continues to have inappropriate elimination - not in the house when we are there, but if we leave her in her crate, she will urinate. It doesn't matter if it's 10 minutes (literally!), or 3 hours - she'll go in there. Acting out?
A less-angry liver
04/26/11 - We got Reo's CBC back today, and the results were in a positive direction!
ALT - 1166 (normal 12-118)
Alk Phos - 1098 (normal 5-131)
Total Bilirubin - 0.8 (normal 0.1-0.3)
Though her values were still quite high, they came down quite a bit over the past week. Since she was improving, I decided to move forward with the IM hormone injections, and I contacted Dr. O to move ahead. I made an appointment for 4 days later.
I can't really say exactly what it was that made me go with Dr. P's injection protocol vs. Caroline's. I indicated in a previous post ( Angry liver )that Dr. P and Caroline suggest different injectables. Dr. P's suggestion was much more aggressive than Caroline's, and I think my reasoning was that if Dr. O was okay with using Dr. P's suggestion, than I'd do it. DepoMedrol is a potent and long-acting hormone injection, but I wanted to be aggressive and try and get Reo in balance as quickly as possible.
04/28/11 - As Reo's appetite was improved, I began trying to sneak some supplements into her meals. She was tolerating the Nutrimin supplement and the Enteric Support . I also tasted all of Reo's supplements myself - I found that the Cell Advance was very bitter, followed by the Phosphatidyl Serine. The Magnesium Taurate was not bitter at all. I decided to stick with the Magnesium and Phosphatidyl Serine, and hold off on the Cell Advance for the moment.
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