Decision for Reo

09/16/12 - Finally, Sean and I have decided how we are going to proceed with Reo.  You may recall that I've been struggling with whether or not to continue to give Reo the retinal protection supplements, as it seems she has very little vision remaining these days.  I have not been sure whether the small amount of remaining vision is worth preserving - she might get around better if she were completely blind.  And, I don't want to continue to give her things that her body doesn't need/can't use.

We have decided not to give most of her supplements any longer.  We will be suspending the following:
- Lutein (her last capsule was given yesterday)
- Phosphatidyl Serine (have about a month left, will suspend when we use the last of it)
- Magnesium Taurate (have about 2 months left, will suspend when we use the last of it)
- Standard Process Adrenal Support (have about 1 week left; just not sure she needs this any more)
- Sardines (these were given as a source of adenosine, which works in conjunction with the Magnesium Taurate)

We will continue to give Reo the Cell Advance 440, Nutramin, and Prozyme, and keep the rest of her diet the same (Welactin, Dasuquin) as we like the benefits of those supplements for older dogs (and Leigh gets these three supplements as well).

I do have a huge amount of guilt for not being more pro-active for Reo surrounding the time of our big move in March of this year.  I really thought that we were "in the clear" since her vision had returned, and I severely underestimated the effects of stress on Reo's vision.  Literally, when we started packing up our house, her vision started to decline.  She then got a toe infection, and allergens in the air were high.  A lot of stress for our little girl (plus lots of stress on the humans, too!), really affected her.  I'm working on letting my guilt go, and taking comfort in the fact that Reo is as healthy as she has been in years.  She is still such a happy dog, and her health truly is the most important part.

We will continue to get blood chemistry and thyroid tests every 6 months, to make sure that we are on the right track with her care.  I envision getting and EI-1 panel from NVDS every year or so, again, to make sure that we are staying on track.  If there are any issues that make me think she may be unbalanced, I may test more frequently - we will just have to play it by ear!

I will likely update this blog less frequently, as I hope (?) Reo will be quite stable.  But, of course I will share any new things that I learn about SARDS, relevant articles, and updates on Reo's condition.  I am also very happy to hear from readers whose dogs have been diagnosed with SARDS, and help in any way that I can.

Fall is around the corner!

09/05/12 - It is hard to believe it's September already - everyone in our household is looking forward to the cooler temperatures of fall!  The past few mornings have been quite chilly, and the dogs love it!  It's a great opportunity for them to lounge around in the warm morning sun, while the air is still chilly.  We're hoping to sneak in one last camping trip this year - we'll see how it goes!

For the past 10 days, we've been watching two of our friends' dogs.  I anticipated that this would be stressful on Reo, so I pulsed her Medrol for a week.  She seemed to do fine, well, other than one of the dogs not understanding Reo's mostly-blindness.  If Reo walked into her, the other dog would snap and growl.  Fortunately, I was home all the time and could correct the other dog before things got out of hand.  Overall, everything went relatively smoothly, but all of us were pretty happy to get down to our normal routine with just three dogs!

Sean and I will be making our final decision in the next week or so, concerning what to do regarding Reo's supplements.  I will post an update once we decide!

Reo's updated obstacle course videos

08/17/12 - Wow, I've been so bad about updating lately!  We've been having a lot of summer fun.  We went camping, and had my parents out to visit, so we've been busy.

So, we've passed about a year since Reo was confirmed to have her vision return.  Here is one of last August's videos for reference (many more videos archived on my blog!):

August 2011 course

Since this time, her vision improved in the fall/winter, but then took a huge backslide as her stress kicked up due to our family's cross-country move. My thought was that when we moved, she had no vision whatsoever. She received another series of DepoMedrol injections, hopefully to help reset her system, and she did improve.

Lately, I've been wondering if she has any vision at all, or if she's just mapped things out. I do find it curious that she bumps into things a lot. I would have thought if she were totally blind, she would have mapped things out better. I spoke with Caroline Levin about this, and she said it's been commonly
reported in humans that low-vision is more difficult to navigate than no-vision. So, I don't know what is going on. Certainly sometimes, it seems like she can't see anything - she can't track a cotton ball like she used to.

But, recently, I took some new obstacle course videos for curiosity's sake - now I don't know what to think! I think she could still have a little vision left.

August 2012 #1

August 2012 #2

August 2012 #3

She seemed to have the most problem in the last video, getting caught between the gutter downspout and the strawberry flat! But because I've never had a blind dog before, I'm not sure if dogs can do exercises like this obstacle course based on their other senses?

Reo appears to have the most trouble in the shade/light transition, which I think is worthy of note (she always seems to do better in full sun).  There is no doubt that she does not get around as well as she was one year ago, but I don't think that she is completely blind, as she can get around some of the obstacles and not crash into them like a fully blind dog would.  I feel certain that she is completely blind in her right eye, and she has some minimal vision in her left.

I'm not any closer to making a decision about whether to continue all of the retinal protection supplements, or to just suspend the and let her become fully blind over time.  I need to do some more thinking about that.

SoCal Vacation

07/25/12 - Earlier this month, we took a trip to Southern California, where Sean is from, for a vacation with his family and some of our friends.

We brought Leigh and Reo along on the trip, not only because we love them and love traveling with them, but because it's way less expense and stress on the dogs.  Even though it costs $500 round trip for  both of the dogs to fly with us on United (OMG!), we wouldn't have it any other way.

I pulsed Reo's Medrol every other day while we were gone, to help mitigate her stress.  With the exception of all the noise/bustle in the airport, and not wanting to be in her carrier while in the airport (on the plane she is fine, but not in the airport - weird - so I solved the problem by carrying her until we were ready to get on the plane), Reo is an incredible traveler.

We do a lot to try and keep their routine while on the road (this means getting up extra early with the time change in order to potty/feed them breakfast!), including bringing their favorite bed for riding in the car.  We drove about 900 miles in 10 days, so their comfort was important!

Here are a few pictures of Leigh and Reo in the car, in their bed, with their car harnesses on.  :)

For part of the trip, we had a beach house with Sean's family, and it included two smaller children.  Leigh and Reo aren't used to children noise, so it was a bit stressful for them, but overall they did really well.  I brought some of their favorite toys, and Reo "killed" them every day - so cute.

Sean and I took a couple of days to explore some new wine country for us.  We went to Ojai and also Santa Rita Hills/Santa Barbara County.  It was a really nice road trip, though it was very hot inland (I made the mistake of wearing jeans one day, as it was barely 70 on the coast...but was punished in Ojai when it was about 93!!).

Here are a couple of photos of the dogs "wine tasting".

Okay, so they were flopped out at our feet while WE tasted wine.  :)

They're such great travelers, and I was so proud of Reo for hanging in there!  That being said, both dogs and humans were so happy to be home, to our quiet household, familiar surroundings, and daily routine.

Sixth EI-1 Panel

07/17/12 - Annnnd we're back!  I'll write a subsequent post about our two-week trip to California after this, but first I wanted to post Reo's most recent blood panels.

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

Estrogen is about the same as her last panel in January.  It is possible that this number is Reo's "normal" now, being an older dog.

Cortisol is now within normal limits (I was a little surprised at this!).

T3 is normal, but T4 is quite elevated.  I put two asterisks next to this number, as Reo was on a course of Clavamox (antibiotic) for her uveitis.  Dr. V feels that the T4 is elevated due to this, and so is not concerned, especially as T3 is normal (T3 is the more "active" molecule in the body).  We will retest her thyroid in another 6 months, so we will keep an eye.

Immunoglobulins are more or less where they have been for the past year, just slightly low.  It's possible that these numbers are also Reo's "normal", as she is an older dog.  I likely won't have these tested again, as she seems to be pretty consistent now, and can probably save a little money by only testing estrogen/cortisol/thyroid.

Overall, I feel just fine about Reo's results.  As she is not symptomatic right now, I am satisfied that she feels good, has normal liver/kidney function, and reasonable hormone levels.  :)

Scaly skin and shedding, redux

06/27/12 - So, previously, back in August of last year, Reo went through this weird period where she shed her skin and coat - like nearly all of it.  (Previous blog post HERE).  I referred to this as her molting phase.  :)

I noticed Reo shedding a bit lately, but didn't think anything of it, since it's been over 100 degrees for the past week.  I thought it was a heat thing.  Well, I noticed a day ago that there was a little skin clump attached.  Sure enough, when I examined her skin, it was the same thing.  There were pale yellow little "scales" all over her skin, and her fur was falling out in little clumps!  I brushed her like crazy, then gave her a bath, and then brushed her again.

As before, her fur is VERY soft.  I can't help but make the correlation between her hormones coming into balance and this "molting" process that she goes through.  There are no bald spots, or anything like that - she looks gorgeous, and her remaining coat is super silky and lustrous.

Secretly, I'm hopeful that this means her hormone levels are back to normal, or close to it, and maybe that means that better vision is not far behind.  We shall see, given the blood tests coming back next week!

Uveitis and blood work

06/26/12 - Reo and I went back to the vet yesterday.  Her eye condition seemed to respond to the antibiotics (oral and eye drops), and the scary blue cast to her cornea has disappeared (whew!).   Dr. V was also able to measure her intraocular eye pressure on this visit, and she was normal in both eyes (both eyes were 13 mmHg).

I read online that uveitis is of unknown cause in about 75% of cases, which is not very satisfying.  So, I suppose we'll just be happy that it was solved by a course of antibiotics, and we'll watch closely to make sure no changes come about.

When we went to the vet on Friday, we did a chemistry panel and CBC.  I am very happy to report that Reo's chemistry panel (liver, kidneys, cholesterol, etc.) was normal!  This is good news, and means that she's tolerating her Medrol therapy well.  She had some highs and lows on her CBC - certain blood cells were either elevated or reduced - but Dr. V was not worried about any of the fluctuations.

We also pulled blood for another EI-1 panel from NVDS, as well as another "baseline" panel from UTenn.  I never followed up with UTenn for further testing after deciding to pursue treatment according to Levin/Plechner.  UTenn diagnosed Atypical Cushing's in Reo, and suggested melatonin and flax lignans.  I decided not to pursue this treatment for Reo, and go with Medrol therapy.  As I posted about earlier, HERE, Levin has published a small study about treating Atypical Cushing's dogs with Medrol, to good success.  Even though it's been more than a year since our initial adrenal panel and ACTH stim test from UTenn, I will be interested to see how Reo's baseline results have changed!

Stay tuned...