Sharing the holidays with your pet

11/21/11 - Thanksgiving is this week, and I'm pretty excited about our feast!  I'm going to cook up the turkey organ meats for our dogs for a special treat!

The Honest Kitchen wrote a great blog article about how to share food from the holidays with your pets!  Check it out:

Don't forget your pet when preparing holiday meals

A sweet story

11/02/11 - Today marks Reo's 38th week of treatment for SARDS.  Time flies!  She is doing quite well these days.  I made a couple of changes to her diet yesterday.  I stopped giving her the Vetri-DMG for now.  I previously posted that I thought she didn't really need it, since her liver and immune system are in good shape.  I do have some left, should she need to go on it again.

Yesterday evening, I mixed in some ZiwiPeak Venison food into her Addiction.  Both Reo and Leigh LOVED it in their dinner and breakfast.  Must be all that organ meat that's in there!!  Mmmmmm....tasty!  The texture of the food is a little weird - it's kind of like little pieces of beef jerky.  It doesn't quite rehydrate like I would expect from The Honest Kitchen or Addiction, but the dogs seem to love it, nonetheless.  I will have to be careful on weight gain, though, since it is very calorie dense (much more so than the other foods they've eaten).

Anyway, the post title suggested a sweet story, and I don't want to let you down, so please visit the link below for the story of two Great Danes, one of whom lost both of her eyes, and the other who acts as a "seeing eye dog" for her friend.  Warms the heart!  And, if you happen to be reading from the UK, both of these girls need a new home!

Click to read about Lily and Maddison

Reo's diet

10/07/11 - I thought I would update Reo's current meal protocol.  We have been through a LOT of iterations of her diet, but she has been on the below for the past two months, and I foresee that she'll be on this for at least the next 6 months.  We will keep up the supplements for some time (I wish there was a bulk purchase discount for these supplements!).

(This program is tailored to Reo, in consult with Caroline and our veterinarian/acupuncturist, so you should not extrapolate this to your dog directly without speaking to your veterinarian first!  If you have trouble sourcing any of the supplements, please let me know, and I will be happy to help!)

Morning meal
* 1 Stella & Chewy's patty, mixed with 1/8 cup ZiwiPeak Venison recipe, rehydrated with 1/4 cup warm water
(Will rotate the food/protein source every few months as I posted about HERE)
* 1/4 tsp. Nutramin powder (info here)
* 2/3 capsule Phosphatidyl Serine (100 mg)
* 1/2 capsule Cell Advance 440
* 1/2 capsule Magnesium Taurate (125 mg)
Mix together very well
* 0.25 ml Vetri-DMG  suspended giving this November 2011, as liver enzyme levels were normal
* one whole sardine packed in olive oil (oil drained) - King Oscar Bristling sardines are the best we've found
* 1/8 tsp. ProZyme enzyme supplement sprinkled on top
* 1.0 mg Medrol
* 0.1 mg L-thyroxine

Evening meal
* 1 Stella & Chewy's patty, mixed with 1/8 cup ZiwiPeak Venison recipe, rehydrated with 1/4 cup warm water
(Will rotate the food/protein source every few months as I posted about HERE)
* 1/4 tsp. Nutramin powder (info here)
* 1/8 tsp. Standard Process Adrenal Support (info here)
* 1/3 capsule Phosphatidyl Serine (100 mg)
* 1/2 capsule Cell Advance 440
* 1/2 capsule Magnesium Taurate (125 mg)
* 1 capsule (6 mg) Source Naturals Lutein
Mix together very well
* 0.25 ml Vetri-DMG  suspended giving this November 2011, as liver enzyme levels were normal
* one whole sardine packed in olive oil (oil drained) - King Oscar Bristling sardines are the best we've found
* 1/8 tsp. ProZyme enzyme supplement sprinkled on top
* 0.1 mg L-thyroxine


* 1/2 tablet Nutramax Dasuquin every other day
* 1/2 tsp. Nutramax Welactin every other day

Reo still is on her Interceptor heartworm medication once per month.

Looking at the above, gosh, it seems like a lot!  I get a little chemistry experiment each time I prepare her meals!

Choosing a new food for Reo

08/17/11 - In a previous post (Phytoestrogens in dog food), I talked about some of the struggles I've had in trying to find a food I felt comfortable feeding Reo.  Since her liver failure, she had been eating a combination of her normal Orijen Regional Red kibble, and Merrick Grammy's Pot Pie.  Both of these formulas are very low in phytoestrogenic ingredients, but both are commercial diets.  I don't want to feed either long-term (especially canned foods with concerns about BPA leaching), so I started hunting around for what to feed.

Unfortunately, Reo doesn't like my cooking for her as much as I do!  She will accept cooked protein (any type), but she does not like the veggies that I cook for her.  As a result, I wanted to find a "complete" food that I could feed Reo (and Leigh) and feel good about it.  I have heard that immune-compromised dogs shouldn't be switched to a true raw diet, and I didn't feel ready to do "real" raw, anyway.

Tula and Leigh had been eating The Honest Kitchen raw dehydrated food.  I was rotating between Thrive, Keen, and Embark.  But, when I started looking at feeding Reo this food, I noticed that all of their formulas had phytoestrogenic ingredients.  Their grain-free foods in particular are very high in flaxseed (which seems to me to be a filler, but also very high in phytoestrogens).  I knew I didn't want to feed this to Reo.

One thing that is amazing about The Honest Kitchen is their great customer service and nutrition consultations.  I wrote to let them know about my concerns with phytoestrogens, and one of their employees responded the next day to let me know to watch out for a new food toward the end of the year.  So, I am curious!  In the meantime, my search continued.

After a lot of research, I came up with 5 different options for Reo's food.  I do like to rotate every couple of months for variety, so I'm happy to have found so many choices.  I wanted to find something that was chicken or turkey free if possible.  I am wary of fish-dominant recipes, due to concerns about toxins.  I'll probably rotate between the below every so often to mix it up a bit.  I'll also supplement with some cooked food as appropriate.

Grain-free, low phytoestrogenic, healthy foods for Reo:

1)  Addiction raw dehydrated, the following recipes:  Fig'licious Venison Feast, Outback Kangaroo Feast, Perfect Summer Brushtail
2) ZiwiPeak air-dried cuisine, Venison or Lamb recipe
3) K9 Natural freeze-dried raw, Lamb recipe - maybe beef too, if Reo will tolerate it (I think she should be fine - I have cooked ground beef/organ meat for her and she had no problems)
4) Stella & Chewy's freeze-dried patties, Duck Duck Goose, Dandy Lamb recipes, - maybe Stella's Super Beef if Reo can tolerate beef
5) Nature's Variety Instinct freeze-dried raw, Venison, Lamb, or Beef recipes

Between all of these options, I feel good that Reo will have some tasty options ahead of her (and that she will be eating very well!).  Most of these recipes are expensive - I'm glad that Reo and Leigh are under 10 lbs each.  If Tula had to be on this diet, we'd be in the poor house!  ;)  Tula will keep eating The Honest Kitchen, and Reo and Leigh will eat one of the above foods.

For treats, I stick to Natural Balance LIT Potato and Duck treats, and any freeze-dried raw or all-meat treats from hormone-free/natural sources and also made in the USA (you would be surprised at how many dog treats come from China - I am NOT a fan of this at all!), like Stella & Chewy's, K9 Natural, Only Natural Pet, etc.

Reo (and Leigh too!) is currently eating Addiction Fig'licious Venison Feast, and she is loving it!!

The quest for bugs...

08/11/11 - Well, Reo's little belly is pretty large and turgid.  She has increased water consumption, and I'm convinced this is why.  I can't ever remember Reo having a turgid/distended belly prior to her SARDS diagnosis, but now it seems to occur regularly - not sure why.  Hormone supplements?  Bug consumption?

Reo has been eating random bugs outside.  She's so stealth about it, because it looks like she's sniffing around instantly, but she picks something up, chews and swallows before I can reach her.  Little sneak!  She knows she's not supposed to do this.

Reo seems to have this insatiable need to hunt cicadas lately.  Perhaps it's their siren-like song that serenades her when she's outside - not sure.  The weird part is that she has no interest in their "shells" they leave behind after molting - she wants the authentic cicada, complete with wings.  In case you live in a part of the world that doesn't have cicadas, here is a picture of a newly hatched cicada with it's "shell" it leaves behind:

Anyway, some of these cicadas seem to die for no obvious reason, and fall out of the tree, littering our lawn with carcasses.  The "best" ones from Reo's point of view, are the partially dead ones, as they still put up a fight and flutter their wings once she catches them!  Reo LOVES these things and does her best to get some for herself.

This could somehow lead to her increased thirst and turgid belly?  Over the past couple of days, I've noticed that she was all of a sudden gassy (probably from the cicadas!), which might also explain her hard belly.

I started giving Reo 1/8 tsp of ProZyme enzyme supplement with each meal (I had this on hand already for Tula so it was a no-brainer to give this a try).

08/12/11 - Reo's belly seems less turgid this morning, but she had aliens again in her belly and wouldn't eat breakfast.  Unfortunately, this means that I have to force down her Medrol and L-thyroxine.  She hates this (and me) and her mouth is so tiny, it's always such a problem!  When I have to do this to Tula, our Doberman, it's the easiest thing in the world because I can put my hand really far in her mouth!  Not so for Reo, and she fights me every second.

She ended up eating dinner just fine - Reo, queen of the self-fast when she's feeling out of sorts!

Today, I noticed that Reo seems to be shedding quite a bit. This is pretty strange for her, as she's not a big shedder.  Hmmmm.

Struggles with food

Reo is completely over eating rice (white or brown), and she seems to have lost a little weight.

I'm considering putting her back on Orijen kibble (1/3) and wet food (2/3).   

Orijen is super high-quality when you look at the ingredients from a phytoestrogen perspective.  And, although it is a commercial pet food, I do feel good about the ingredients, and Reo loves it.  I also picked up some Merrick canned food that is low in phytoestrogen-containing ingredients.  Reo really loves the Grammy's Pot Pie, and the Venison Holiday Stew.  I still don't feel good about feeding Reo this diet, but will proceed until I can find something better.  Leigh and Tula are on The Honest Kitchen raw dehydrated, but all of their formulas have foods high in phytoestrogens in the top 5 ingredients.  I feel conflicted.  :(

06/05/11 - Reo is currently on 1/8 cup Orijen kibble plus ~1/4 cup of wet food (Natural Balance Potato and Duck or Merrick Grammy’s Pot Pie), twice per day.  She seems to really enjoy having the kibble back in her diet.  I am putting ½ capsule of Magnesium, Phosphatidyl Serine, and Cell Advance in with each meal.  She sometimes doesn’t like the Cell Advance and leaves behind some small bits of food, but for the most part, she is eating very well.

Reo is sleeping through the night just fine, but seems to wake up very early (like 5 am).  I take her outside to potty, and then she demands breakfast.  I try to make her wait until 6 or 6:30!

06/09/11 - Reo's mood has been great lately!  We just passed the 11 week mark for the treatment protocols.  Caroline and I agreed that we'd keep Reo on the supplements for 36 weeks, and if no difference was visible, we would discontinue.

06/11/11 - I learned from another SARDS dog owner that Medrol increases the production of stomach acid.  He's been giving his dog some Pepcid AC and said it greatly helped with "warm belly".  Warm belly is exactly as described, and Reo has had it for months!  I attributed it to high estrogen levels, but I'm willing to give some Pepcid AC a try and see how it works out.  I started her on 2.5 mg once per day before breakfast and Medrol dosage.

Phytoestrogens in dog food

As if things in my mind weren't becoming difficult enough to remember, Dr. P started cautioning me about phytoestrogens in food I was giving Reo (mostly sweet potato in the canned food I was giving her).  Remember that the EI-1 panel evaluates all estrogens in Reo's body, and Reo's total estrogen was quite high.  I believe that the high estrogen was responsible for nearly all of Reo's Cushing's-like symptoms.  I had never even thought that I may be putting more estrogen into Reo, which I definitely didn't want to do.

If you review the list below (which I compiled from various sources I found on the internet, not necessarily for dogs only), you will notice that a lot of foods contain phytoestrogens - healthy, nutritious food.  It is nearly impossible to feed your dog something that eliminates all of these ingredients.  But, I think that if you have a SARDS dog with high elevated estrogen, it might make sense to try and minimize the number of ingredients s/he is eating from the list below.

The first 11 ingredients are the foods most high in phytoestrogens, and should be avoided completely.  If you are following the home-cooked, grain-free approach, this won't be too hard, but many dog foods contain (sometimes high) amounts of flax seed or barley.

• Soy.
• Millet.
• Barley.
• Flax seed.
• Lentils.
• Kidney beans.
• Lima beans.
• Rye.
• Clover.
• Fennel.
• Chickpeas (garbanzo beans)

If you are following the home-cooked, grain-free approach, consider trying to minimize some of the ingredients below.  You will probably not be able to find a truly nutritious meal for your pup that does not include some of these ingredients, but it's just some food for thought (forgive the pun!). 

• Apples.
• Alfalfa sprouts
• Celery.
• Parsley.
• Beets.
• Bok choy.
• Broccoli.
• Cabbage
• Cauliflower.
• Carrots.
• Cucumbers.
• Mushrooms.
• Brussel sprouts.
• Green beans
• Seaweeds.
• Garlic
• Squash.
• Collard greens
• Onion
• Pumpkin seeds.
• Sunflower seeds.
• Sweet potatoes/yams
• Cherries.
• Olives.
• Pears.
• Plums.
• Tomatoes.
• Prunes.
• Barley.
• Oats.
• Brown rice.
• Blueberry
• Wheat germ.
• Bulgur.
• Brewer’s Yeast.
• Black-eye peas.
• Mung bean sprouts.
• Navy beans.
• Red beans.
• Split peas.

So what the heck can you feed your high-estrogen dog?  I think about some of the things that Reo enjoys eating that aren't on the list, and they are cooked kale, spinach, canned 100% pumpkin, and white potatoes, and raw melon (cantaloupe and watermelon), papaya, peaches (no pits!), and raspberries.

When I feed proteins, I always purchase organic meat.  This means no hormones or antibiotics added, which is very important.  Fortunately, Reo is a small dog, and so it's not expensive to feed her in this way.  I could find a great supply of meat at our local farmer's market.  Some farms are even grinding organ meats in with their beef for pet food, which is excellent!  If your dog is bigger, consider a Costco membership if you don't already have one.  Costco carries organic/grass fed ground beef, organic whole chickens, and organic chicken breasts/thighs at very reasonable prices.  You can also find wild Alaskan red salmon filets fresh or frozen, which are also a great choice (you want to steer clear of farmed salmon like Atlantic salmon, which is very high in contaminants).  Cage free/organic eggs are excellent sources of healthy protein.  Try and scramble one up for your dog in the morning and see how s/he gobbles it down!

If you purchase liver to feed your dog, please make sure that it comes from organic/grass fed animals with no hormones/antibiotics added.  Remember that the liver is the clearinghouse of the body, and it's responsible for detoxifying and breaking down excess proteins.  You don't want to feed your dog liver from a hormone/antibiotic laden conventionally-farmed animal.  This includes dehydrated liver as dog treats (also suggested in the Levin protocol as a source of adenosine).  I couldn't find any commercially-available dehydrated liver (except from our local farmer's market) that specified hormone/antibiotic free, so I chose to feed Reo sardines as her adenosine source.

I realize that this post is probably overwhelming if you are just beginning your research about SARDS, because it seems like everything is out to get your dog, and it's so much to remember!  Take a deep breath and relax...and do what you think is best for your pup!

Searching for a new vet

So, Dr. N and I decided to part ways for this portion of Reo's treatment.  This meant I needed to find a vet who would be willing to do hormone injections.  Dr. P suggested that I contact NVDS and have them send me a list of veterinarians in my area who have submitted blood for the EI-1 panel test previously.  I did so, and there was only *one* vet in my city who had done so!  The other vets were predominantly in two other states.

I picked up the phone and started calling.  Most times I had to leave a message.  In order to try and get the vets to call me back, I told the offices that I had a dog with "atypical Addison's disease".  I explained that I got the vet office's name from NVDS as one who had submitted blood for an EI-1 panel, and I wanted to speak with the doctor about the treatments undertaken for these animals.

This was a long and frustrating process.  Many of the doctors never returned my calls - how disappointing!  Some doctors who did return my call, either didn't remember the patients for the EI-1 panel, or the patients didn't have similar issues as Reo.  My list of about 50 veterinarians was quickly dwindling.

I had a great conversation with one vet about 3 hours (one-way) from me, who was also a holistic vet.  He had had good success with Dr. P's treatment, and I was impressed that a holistic veterinarian would proceed with such a "radical" treatment as hormone injections.  He told me that in one case he used Caroline's injectable suggestions, and in one case he used Dr. P's.  In both cases the dogs recovered both their health, and some functional vision.  This was really encouraging for me!  He agreed to treat Reo if we could not find someone closer to us.  But, I easily would have driven the 3 hours, even in hindsight.  I was only becoming more and more determined to get Reo the help she needed!

Fortunately, the vet in my city called me back.  Dr. O spent several minutes speaking with me about his personal experience with Dr. P's methods for his (human) family.  He agreed that IM DepoMedrol injections are somewhat "unorthodox" according to traditional veterinary medicine, but that (to paraphrase) "I'm only human - I can't claim to understand everything, but am willing to try - let's do this!".  I honestly could not believe the relief I felt.

But, before we got the hormone injections, we needed to make sure that Reo was doing better.  Her liver needed to heal, and she needed to complete her round of Baytril.  If we could repeat the CBC and see some improvement instead of decline, then we would proceed with the injections.

04/20/11 - Upped Reo's Medrol dosage to 1.0 mg, on the recommendation of Dr. P.  I began to notice some  problems with Reo's bowel movements.  She seemed to be straining quite a lot, but not much waste being produced (of course, she hadn't really been eating very much).

04/21/11 - Reo went back to Dr. N for more fluids and a Baytril injection.  We confirmed our mutual respect for each other's position, and I told Dr. N that I was actively looking for another vet to help us with the injections.
Dr. N taught me how to do a sub-cutaneous injection, so I could give Reo her Baytril shot once a day for a couple more days.
Fortunately, Reo was back to eating again - she was definitely liking the Wellness canned food, even though I felt guilty for giving her canned.

04/22/11 - Reo had an accident in bed last night.  Again, just sleeping in a puddle of urine and didn't seem to be aware that anything was amiss.
On the advice of Dr. P, I switched Reo to 4 small meals a day, comprised mostly of carbohydrates.  This was to be easier on her liver.  Remember that the liver is responsible for breaking down protein, so if she were to get only 2 meals per day of mostly protein, this could be overloading her liver.  Based on her last CBC, I definitely wanted to go as easy as possible on Reo's liver.
I got some tilapia and cod filets, and some white potatoes and cooked it up for Reo.  She was not impressed!  I eventually figured out that Reo didn't like the white potatoes, so I switched to white rice instead.

Dr. P suggested a supplement called Nutrimin, which is a 100% natural, calcium montmorillonite clay.  I myself have taken bentonite clay in the past while on a nutritional cleanse, so it wasn't completely foreign to me.  I read the information below, and decided to order some for Reo.  I was particularly interested in the digestive/GI tract soothing, immune system support, and liver support that this product could offer.

You can find more about Nutrimin here:  http://healthypetnetwork.net/?p=900 and here:  http://www.healthypetnetwork.org/nutramin.htm

Reo's meal plan became 4 meals/day of 2 Tbsp white rice, 1 Tbsp canned food, and 1/4 tsp of Nutrimin (in addition to her hormone pills).  We had still abandoned all other supplements.

04/24/11 - Mood seems to be improved, and she even played with one of her toys today!
I was still noticing Reo straining when she tried to have a bowel movement.  Her stool was quite soft, but not runny.  Sean and I started calling it "soft serve", which may prevent me from enjoying such a cone again in the future!

04/26/11 - Started to notice Reo becoming very restless in the evenings.  She would just wander around the house.  She didn't need to go outside, have any water, etc.  She was just restless.
We went back to see Dr. N today to get some blood drawn for another CBC to check Reo's liver.  Over the past week, Reo's appetite definitely improved and she was eating, so I was hopeful that things would look better.

1 step forward, 2 steps back

04/09/11 - Today on our walk, I think Reo reacted to a squirrel in the distance.  It was maybe 100 feet away - I'm not sure if she could smell or hear it.  After that, her mood completely changed!  She was trotting out ahead of Leigh and me, and her tail was held high (not tucked like it usually is).  I didn't want to read too much into it, but it was pretty cool to see some of our "old" Reo back.  She also went up all the front porch steps with some encouragement (first time since losing her sight).

04/11/11 - Our one month "anniversary" of SARDS diagnosis
We are still struggling to get Reo to eat any breakfast, and now starting to have problems with dinner as well.  I had begun to put all of the powdered supplements in her dinner, as she wasn't eating breakfast - maybe it's too much powder?
Reo refused to eat her sulfasalazine in peanut butter this morning - had to force it down her, along with the Medrol and L-thyroxine.  :(  I tried to feed her only ground beef/organ meat, and she ate about 1/2 Tbsp.
At dinner, I removed all powder, and she ate some ground beef/organs and some chicken thigh.  I was able to give her her L-thyroxine and supplements in peanut butter after her meal.  Reo has absolutely zero interest in sardines lately.

04/12/11 - Reo refused all food this morning.  No peanut butter for her!  I had to force-feed the sulfasalazine, Medrol, and L-thyroxine again.  She HATES it, and fights, spits out the pills, and looks at me as though I'm torturing her.  This is hard.
Tonight, I wrapped her meds in a slice of Velveeta (yes, most definitely not the healthy thing!) - but, she ate them!!
I also spoke with Dr. N today - we discussed Reo's inappetance, and thought that maybe we could compound Reo's medications if she continues to refuse to eat.

Today, I stopped trying to give her Phosphatidyl Serine, in an effort to reduce the amount of things I'm forcing down her.

04/13/11 - Another symptom - Reo wet the bed at about 5:30 am.  She was sleeping and leaked out some urine - and was not aware that it happened.  I took her outside, and she had a long pee, so maybe her bladder was extra full?
She was not interested in breakfast again, but she ate her meds wrapped in Velveeta.  I took some pastured pork ribs out.  I haven't tried pork with Reo yet, so hopefully it will spark her appetite!
Later, at dinner, she wasn't interested in the pork.  She also was not interested in Velveeta or cream cheese for taking her meds - I had to force them down her throat.
I began to worry that she hadn't had any food today, so I offered her some Orijen kibble - she ate maybe a dozen pieces, so that was encouraging.

04/14/11 - Reo woke up quite early this morning, and threw up in the bed.  She wouldn't eat anything this morning, so used some cream cheese to force her meds down.
In an effort to get Reo to eat something, I went out and got some Wellness canned food, as well as Organixx and AvoDerm, in case she doesn't like the Wellness.  I begin to feel guilty offering her a commercial diet - this is not part of the Levin protocol.  Reo will no longer eat any beef liver, sardines, or salmon oil.
I also got some low-sodium deli turkey and liverwurst, to see if she could take her meds in this.
The canned food worked - she ate some turkey/sweet potato canned food right away for dinner!  And, she took all of her meds and supplements in the liverwurst.  Mommy wins - haha!

04/15/11 - Reo woke up several times during the night.  She drank a lot of water, had diarrhea about 2:30 am, and threw up a small amount.  She wouldn't eat anything for breakfast, and refused liverwurst and turkey breast.  I had to force down the sulfasalazine, Medrol, and L-thyroxine.
Sean reported that Reo seemed hungry around 3 pm, so he offered her 1 Tbsp of Orijen in warm water and she scarfed it down!  She ate a little bit of dinner - kibble and wet food.  But, I had to force all her post-dinner meds - she was really difficult tonight.

04/16/11 - Last night was tough.  Reo was up about every 2 hours for water.  She is so restless and doesn't want to stay in our bed.
Reo ate a few bites of kibble, but had to force her meds.  I feel pretty awful about Reo's condition right now. It sucks.  :(

04/17/11 - Another sleepless night.  She was up every 2 hours for water/urination.  I am becoming an expert at making a medication "bolus" in Velveeta and shoving it down Reo's throat.  It's not a good feeling, and Reo is starting to resent me!
Sean got her to eat about 2 Tbsp of kibble today, so that was something.  I forced her evening meds in liverwurst.


04/18/11 - Worst night yet with Reo!  :(  She was up every hour to drink or urinate.  She also leaked out some urine on me after I picked her up, which was strange.
Reo's schedule is totally off.  She is sleepy/tired at 6 am on, but insomniac at night.  How can we get her back on track??

(Note:  Insomnia is often reported by owners whose dogs have adrenal diseases, like Cushing's.  But remember - elevated estrogen can mimic the symptoms of Cushing's!)

Today I decided to take her to see Dr. N.  I learned that sometimes sulfasalazine can cause nausea in dogs, and we wondered if this couldn't be why Reo was unwilling to eat.  We agreed to stop all supplements except the Medrol and L-thyroxine, and repeat the CBC.  Dr. N drew some blood and sent it out.