Eighth EI-1 panel results

As promised, below is an updated table of Reo's EI-1 panels.  I've added the results of her panel at the end of November.

	Reference Range	16-Mar-11	30-Apr-11	15-Jun-11	4-Aug-11	4-Jan-12	25-Jun-12	10-Dec-12	22-Nov-13
Total Estrogen	30 - 35	35.19	35.15	35.11	35.06	35.04	35.05	35.02	35.03
Cortisol	1.0 - 2.5	8.43	7.03	0.97	0.82	0.68	1.4	0.96	0.85
T3	100 - 200	62.7	72.12	87.92	156.94	135.29	169.94	157.64	154.03
T4	2.0 - 4.5	0.87	1.15	1.6	3.99	3.21	7.17**	5	4.89
IgA	70 - 170	50	53	57	65	67	66	68	67
IgG	1,000 - 2,000	722	754	883	946	973	970	992	981
IgM	100 - 200	74	76	87	97	97	97	98	98

Overall, Reo looks great.  No major changes in anything - just the typical slight ups/downs we see over time.  She is stable.

We did a blood chemistry and CBC as well (we do this every 6 months to make sure she is tolerating her medications and is healthy) and her liver values and cholesterol have actually gone down since the summer, which is pretty cool.  :)

SARDS Dogs United Facebook group

My goodness, I am behind in updating!  I'm sorry, fair readers.  Wishing you and your pups a wonderful New Year!

Reo is doing very well - I will post her latest bloodwork soon.  We had another EI-1 panel done at the end of the year, as well as blood chemistry and CBC.  Her blood chemistry was quite notable, with liver values and cholesterol number actually going down since her last test (yay!).  Hormone levels are stable, with only slight changes up or down over time.

Currently her only health "problem" is a potential issue with collapsing trachea.  She's always had issues aspirating water when she drinks, but now she's been sneezing/reverse sneezing/coughing at random times.  We have her on a course of Clavamox to make sure it's not a simple upper respiratory infection, but so far I haven't noticed any changes.

The thing that makes me think it is NOT collapsing trachea is because she is not affected when she is walking or exercising.  Sort of strange...

ANYWAY!!!

My primary reason for writing this post is to alert you all to a new Facebook group that we have created for SARDS dog owners, or those interested in the disease.  It is called SARDS Dogs United, and you can request to join us here:  SARDS Dogs United

We hope this will be an easy way to keep in touch with other SARDS owners.  Now that Yahoo has changed its groups format, it is less user-friendly.  Feedback welcomed!  :)

New article discussing the Melan-100 for SARDS screening

09/07/13 - All is well in our household - I have been busy lately with Miniature Pinscher rescue activities, which is rewarding yet challenging!  I will write another post once Reo has her follow-up appointment at the ophthalomologist in a couple of weeks.

I wanted to post because there is a new article in the Journal of Veterinary Medical Science coming out from a group in Japan that discusses the Melan-100 colorimetric PLR device that is often used by ophthalmologists to help diagnose SARDS, PRA, and other eye diseases.

This is the abstract:

To determine the efficacy of a colorimetric pupil light reflex (PLR) device (Melan-100®, U.S.A.) in dogs of sudden acquired retinal degeneration syndrome (SARDS; 16 cases), progressive retinal atrophy (PRA; 10 cases) and optic pathway disease (6 cases). The colorimetric device detected PLR abnormality in 32, 16, and 9 eyes with SARDS, PRA and optic pathway disease, respectively, whereas white light detected PLR abnormality in 18, 11 and 9 eyes with SARDS, PRA and optic pathway disease, respectively. SARDS dogs displayed miosis, while optic pathway disease dogs displayed mydriasis by blue light examination. Thus, colorimetric PLR may be a useful method for determining whether electroretinography (ERG) or magnetic resonance imaging (MRI) should be performed for dogs with acute blindness.

The full text of the article is available (though because it is a pre-print copy, it does not look as pretty as a published article - there are line numbers in the left margin) at this link:  https://www.jstage.jst.go.jp/article/jvms/advpub/0/advpub_12-0363/_pdf

It looks like the authors agree that an ERG is very important for accurately diagnosing SARDS:

"Although the colorimetric PLR device is useful as a screening test, it is risky to diagnose these abnormalities with this method alone. It is necessary to diagnose SARDS, PRA, and optic pathway disease via funduscopic examination, ERG, and MRI."

Ophthalmologist visit

07/24/13 - We went to an ophthalmologist on Monday for Reo. She has been having some issues with her right eye for the past few months, and our regular vet couldn't figure out what was wrong. We tried some eye drops, an antibiotic, and did fluorescein staining - all either didn't help or show anything that could give us a diagnosis.

Her symptoms have been - "swollen" eye appearance, she is not opening her eye fully and the lower eyelid is droopy; very red white of her eye; some clear discharge; occasional itching; white cloudy area appearing in the cornea (not a cataract).

I *loved* this ophtho, as compared to the one in KY that diagnosed Reo's SARDS. He was fascinated by her case, and we are the first ones to have treated endocrine issues in SARDS that he's met. He was surprised by how good her blood chemistries looked, after being on long-term Medrol. I was careful to point out that the Medrol is not a *therapy*, it's only replacing what she can't make
naturally. We talked a lot about our experience and what we did for Reo's treatment.

He did a very thorough exam, and said that Reo's retinas were unlike any he's ever seen before in a SARDS dog, even 2.5 years later. She had a lot of weird stuff going on, apparently! That's my Reo...

After his exam, he pointed out Reo had a slight head tilt to the right, which I could see after he mentioned it. I think she has always walked like that since her diagnosis, and I didn't really think anything of it. He suspected Horner's syndrome, which is another "mystery". But essentially, one of the nerves is damaged and/or not firing properly, which leads dogs to have eye appearance
issues. He thought that because she wasn't using that eye regularly, there was a nerve atrophy of sorts. There is a very simple test used to diagnose this - he put a drop of norepinepherine in her eye. In 15 minutes, she was back to normal eye appearance! That was pretty cool.

He said that because this test is so reliable and a strong positive, there is almost no chance that it could be something more serious (i.e., a brain tumor) that is causing this issue. So, it was a huge relief to me. He mentioned that the redness of her eyeball is also an indication of lack of vascular tone in the
eye due to the Horner's (this might be of interest to some on this list, whose dogs experience very red eyes!). Anyway, there is no "treatment" for Horner's, and he said that most dogs spontaneously correct in a few months - interesting.

Finally, another tidbit he gave me was concerning minerals and lipemia. For the past 1.5 years (since we moved back to Colorado), Reo has had very lipemic blood (lipemic means fat in the blood, which can skew some blood test results). Our regular vet never really said it was a problem, since Reo's cholesterol and triglycerides are normal.

The ophtho said that he could see the lipemia in Reo's eyes, and that she should be on a low-fat diet immediately. I told him there was no chance that I was changing her diet to low fat as she is quite healthy and we do blood chemistries 2x/year to make sure. Also, she has never had pancreas issues - all levels are normal.

He said he wanted to try her on EDTA drops, which will chelate/pull out extra minerals that are in Reo's eye. I asked him if mineral supplementation could cause lipemia - he said most definitely. Reo has been on the Nutramin mineral supplement, suggested by Dr. Plechner, for 2.5 years, so I wondered if it was causing an issue and leading to Reo's lipemia (maybe she just doesn't need the
supplement any more!). Previously, she was getting the Nutramin 2x/day, and I've dropped down to 1x/day for the time being. Will see how she does, and I will consider completely eliminating it in the future.

*Note - I can't find anything online concerning mineral supplementation causing lipemia in dogs, and not much reliable info in humans. I'll keep searching, and also ask my regular vet. Because the ophtho was so emphatic, it seems weird to me that my vet never said anything about the lipemia, or the supplementation maybe causing it.

We came home with EDTA drops, and cyclosporine ointment, and a re-check in 6 weeks to see how she does. Stay tuned! :)

Post-vacation trip to the ophthalmologist

07/03/13 - We had a glorious time in Europe for nearly 3 weeks!

Reo (and all the pups) did great under my brother's care - everyone was happy and healthy when we got back, and there was much rejoicing as we were reunited.

But, Reo has been having some issues with her right eye for a couple of months.  We've tried a few different things (drops, allergy meds, etc.) but nothing seems to be working.  Right around the time she was diagnosed with SARDS 2 years ago, she walked into a tree and scratched her cornea.  She's has the scratch since then and it never caused any issue.  But now, it seems to have a secondary whitish mark that is coming out from the scratch.  Our regular vet did a fluorescein stain and it didn't uptake anything (good), and it's not anything like a cataract (good), but we can't figure out what is going on.

I decided to make an ophtho appointment to see if there is anything that can be done.  It's clear that the eye is itching her, and the white of her eye is quite red.  It also looks like the lower eyelid is a bit swollen.  So, since our regular vet can't solve the puzzle, and Reo is not getting better on that front, we're going to go and get it checked out.

Fingers crossed we can get an appointment fairly soon and get to the bottom of it!  Stay tuned...

Headed overseas

06/12/13 - Tomorrow, Sean and I are headed to Europe for 3 weeks, sans dogs!  My brother is watching over our house and pack, which means I'll be separated from Reo for the first time in quite a while!!  We will have my brother pulse her Medrol dose for the first week we're gone, to hopefully help mitigate her stress.

She has been doing pretty well lately, but allergies are bugging her.  I have her on Claritin based on my vet's recommendation, though I don't think it's helping her.  She has an itchy/watery right eye, that has been bugging her for over a month.  The vet's looked at it, did fluorescin testing, and even gave her some NP Dex eyedrops to try for a week (which didn't help).  So, I think we'll go to the ophthalmologist when we get back, just to be on the safe side.

Anyway, fingers crossed all goes well and there are no issues with little miss high-maintenance.  :)

À bientôt, fair readers!

Tooth problems be gone!

05/22/13 - I went to the vet last Friday, and she said she *really* does not want to put Reo under anesthesia to clean her teeth (whew!!). But, that she has seen good success "pulsing" dogs with dental issues with clindamycin hydrochloride. She thought that with Reo's lowered immune system, her body had a hard time keeping the plaque bacteria at bay. So she has her on a low dose 2x a day until gone (I
think it will be about a 7-10 day course, given how much we've used already).

I've kept up with the Leba III spray, but haven't brushed because I wanted that little lesion to heal. Well I'll be darned...her mouth looks pretty darn awesome, to my surprise! The lesion has healed and is not painful to her anymore, and she doesn't have nearly as much plaque as she did a few days ago.

So, I'm considering doing this quarterly as "pulse" therapy like my vet suggested. Though I'm not a fan of regular antibiotic use, it might be worth it to prevent anesthesia for dental cleanings/extractions in the future.

The other interesting side effect is that she is way more perky than she has been before, which could be just because she was in pain before and isn't any more...but it's also making me wonder about dogs that are on the doxy/pred protocol and give antibiotics with cortisol replacement. I remember one of my SARDS friends saying that her dog did great on doxycycline and Medrol, but that most vets don't know why it helps SARDS dogs. Hmmm.

I also got a chemistry/CBC panel while we were there.  I decided not to do an EI-1 panel this June, and switch to yearly in December, instead of bi-annually.  I did get a T3/T4 add on, though, just to make sure thyroid was doing ok.  Everything looked good, except for elevated ALP and GGT, and elevated cholesterol.  Because she has been normal for over a year in these 3 areas, I'm not too worried (we took blood only a half hour after breakfast, and this could have an effect on her numbers).  We will repeat a more focused chemistry in July when we get back from vacation and see how she is doing.