Kerry Berry Bushie--Electronic Tombstone

Kerry (left), Bonnie (right)
at Carova Beach, Outer Banks, North Carolina



This is the e-mail I sent to friends after Kerry's sudden death.



Date: July 29, 2008:



We lost our dear Kerry girl this morning . . . about 1:17 a.m.



This evening, after happily eating a home-cooked dinner of beef, green beans, yogurt with a few digestive enzymes sprinkled on top, Kerry started coughing a bit. It lasted a few minutes, but she shook it off and even romped just a minutes with Bender, our young male Scottie, before going outside to do her business.



My cousin stopped by to get Dr. Plechner's book on adrenal exhaustion to see if any of the protocols he advocates could help her seriously ill cat battle her newly diagnosed FIP and possible FELV.



Kerry was sitting in the living room very close to my cousin and Bender, and had another little coughing spell. When my cousin left, Kerry retired to her cushion and suddenly I heard the "wetness" to her cough. I had thought to give her half of an .80 mg Lasix pill (one of Brownie's old prescriptions; I halved it and figured it was about right.) We waited for a few minutes, but nothing seemed to be helping Kerry.



My husband was just finishing up his dinner when I grabbed him and had him listen to her. We both agreed she shouldn't wait to go to the vet, so as I gathered up her file and made sure all the write-ups and labs were in there, he fixed Kerry a nice place in his car with a cushion so the trip would be comfortable for her.



I had a suffered with a headache all day long, so figured this was one outing I could miss. Boy, was I wrong. My husband called me after he'd been to the Emergency Clinic for a hour. He said it was very serious, and that he felt as if he'd nearly lost Kerry on the way to the Emergency Vet, that it got so bad, so quick. They had given her several injections of Lasix at the Emergency Clinic, but she was not completely responding. Pat called me to say that they had suggested he go home, as it was going to be a long night and she would be ready to be transferred to our vet in the morning around 8:00. a.m.



So, with Kerry in an oxygen tent, Pat came home, fully believing that things would be rough, but would work out in the end. About the time he crawled in bed, the doctor from the Emergency Clinic called. She was calling, I knew, to ask permission to let Kerry go. By the time she explained that Kerry was scared, trying to breathe, and that they had put a tube in place to help her, but blood and other fluid was pouring out, it was all over. One of the vet techs was waving to her that Kerry had stopped breathing on her own. So, as I was trying to calculate whether I had time to even get there and whether I should make Kerry wait for that, Kerry slipped on to join Kyle, Morgan, Houdini, Brownie, Dave and the rest of my crew who were waiting for her.



I'm glad she finally got to meet Babes; they were so much alike.



I am sorry that I wasn't able to ease her last hour of suffering. I wish that I had been with her to reassure her. It wasn't the end I would have chosen for such a good girl. It wasn't how I thought this day would end. I wish I had more answers about how this happened. I feel like there's not a lot of closure here, except in just trying to remember who she was and how we loved her. We had a happy day yesterday before all this happened . . . we hung out in the garden a bit . . . and she kept trying to slip down the hill to hide in the deep shade underneath the pine trees by the road. At her age, too! Now I think I should have let her run a little more before calling her back to me. That is something I will file away as "Lesson Learned." She didn't even need me to help her back up the steep front porch steps, even though all her recent x-rays had shown she had a severely arthritic back. She hopped up yesterday like she was a youngster. I always tell her how impressed I am with her agility when she is able to do that. Some days, we both need a "hand" up.



Since I wasn't feeling well, Pat went out to buy something to perk us both up--a little ice cream. I am not always in the mood for ice cream, but even I had a small amount and saved Kerry my spoon--with a bit extra loaded in it. The other dogs looked a bit miffed, but I have found myself recently doing more of those things for Kerry. Even though Bonnie has been the focus of my attention for months now, Kerry has been getting some side benefits to being the oldest dog in the house. I try to recognize her in little ways if she gets up with me in the middle of the night to come into the kitchen for water. It is Kerry who always gets a slice of apple, or a special hug late at night or early in the morning when no one is around. In the way that I imagine mothers carve out special moments with individual children, despite having a house full, I've tried to find special moments to show Kerry that I care about what makes her happy. Even today, despite her total lack of interest, I hauled her up on the bed with me for some special one-on-one time. Someone called, and as soon as I picked up the phone and my hand wasn't signaling to her she needed to stay, off she sailed back to her own cushion in the hall to view her domain.



I still don't know what happened to Kerry or how it happened so fast. I am crazy observant with the dogs, and I'd noticed for a month or so she would have episodes where she would breathe heavily, but this would always pass. This served to make me determine to get her E-1 (adrenal/thyroid/immunoglobulin panel) test done so we'd know if she was in adrenal exhaustion and so we could start treating her appropriately. This past Thursday, I had her in to see our vet to get that blood work drawn at the same time as he was evaluating Dee-Dee, the rescue, and I asked him to take a "listen" to Kerry. I told him she worried me because it reminded me in some ways of how I met my vet for the first time, when he had examined Babes and found a large hemangiosarcoma pushing on her lungs and liver. The doc said she sounded great, no crackling, no lung or heart sounds.



So what happened? I guess we can't be certain. A blood clot? Hemangiosarcoma?



Way back in the 90s, Babes, my first Scottie, was nearly at her 12th birthday, and had been going back and forth to Dunbar Animal Hospital for months. They had been registering my complaint that she was not breathing right, but blowing off my concerns that cancer was responsible. Earlier in the year, Babes had a melanoma on her back removed with poor margins, so according to how I was reading The Merck Veterinary Manual at that time, it was my job to be vigilant to any kind of organ cancer that might develop as a result of that. The vets I was using at that time were not helping me much in that regard. They just gave me bronchodillators and told me not to worry about it. You who know me well know how much good that did. As it turned out, Babes had a really rough Saturday night after that, and so my husband and I took her to the Emergency Clinic. There, I met the vet who has worked with us since that time. He had only been out of school a short while, and was working at the Emergency Clinic until he found a practice to buy (where we are now patrons).

He immediately felt Babes' large liver tumor pressing on her lungs and explained to me it was probably the reason that she couldn't breath well. He took an x-ray to confirm his suspicions, and then told us we'd need to get an ultrasound at Univ. of VA to be sure. He was sorry, and so were we, but I was happy that I'd found a vet who took his time and didn't let things fall into the cracks. I'm all about facing things head on with full knowledge as a weapon.



Fast forward to Kerry. She, too, has had some rough patches: pneumonia, bladder stones, high liver enzymes, but overall, things pointed toward a positive outcome. She had suffered originally we thought from Cushings, hypothyroidism, and then later subclinical Addison's disease. We felt like she might be going through adrenal exhaustion--after all, she'd witnessed and lived through more changes in our household than any other dog, and she had a right to be stressed! So, this E-1 test in my mind held hope for continued good health. I felt like if I could just get this ironed out, there was hope for an even longer life for our Kerry girl. I was so encouraged.



But Kerry Berry Bushy taught me other things. That some days (or weeks, or months) I can't do the right thing, no matter how hard I try. That knowing a bunch of stuff doesn't always save the day. That good dogs don't always have the kinds of endings they deserve.



A lot of you know that my husband makes up silly names for all of our pets. I am always interested to see how, why, and when they'll get their first alternative name. Normally, every dog has quite a few by the time they leave us, and one of the ways I like to remember each dog is to get out my journal and write out the names they had, with the reasons behind them. It never fails to make me smile at the way my husband thinks and the love that he shows in his own way of picking some of these very silly names.



One of his favorite shows is and always will be The Andy Griffith Show, and to my never-ending delight, he can recall all the dialogue. One day, after watching an episode where Barney was singing, I heard Pat start to call our Kerry "Kerry Kookaburra Bush" and finally, it led to Kerry Berry Bushy or Kerry Berry Bush or just Cutie Carris Bush (Carris is a family name.)




Kerry Berry Bush has been her name for such a long time now, I just wanted today, on her last day, to remember the silly, happy Scottie that came to us with over 200 fleas, terrible skin allergies, leading to a whole summer of her without hair and looking like a pot-bellied pig. Spending her days tussling with Kyle over stuffed animals, or shouting out her Scottie Arooooo to potential company. The harmony of the perfect Aroo Trio: Morgan, Kyle and Kerry. Music that still haunts my heart.



Our beloved Kookaburra always racked up more points for street smarts than beauty, but it wasn't long before she did develop into a lovely, old-fashioned looking Scottie. A throwback Scottie, my husband and I called her. Whenever you see old books or prints of funny looking, not-so-squared-off Scotties, you can know that was the image of our Kerry. She was built along older lines of fashion-- really more function, than fashion. A modern, big-headed Scottie looked almost like a different breed next to our old-fashioned girl.



She loved the outdoors and soaking up the sun. Until her arthritis kicked in and her adrenals went haywire, she loved extreme temps in weather, too. As she grew older, she still loved going outside for short jaunts, but mostly confined herself to a few dog beds that gave her splendid view of the action in the house. One is at the end of a long hallway, between two bedrooms. She could watch the kitchen, both our bedroom and the "dog" bedroom, as well as monitor everything else that was going on in our home. She reigned compassionately and with a lot of concern for others. Kerry was never a bully, but frequently displayed random acts of kindness to her fellow travelers of time and fur and skin. Recently, when Bailey, an older, confused and mostly blind Westie, came to stay for a week, it was Kerry who watched him with concern, and seemed to follow him loosely in the background to sort of watch over his wanderings.



At nearly fourteen years of age, she is the oldest Scottie we've ever had. I used to whisper to her that she'd seen a lot of things come and go . . . including my own youth She knew that a long life like Bailey's deserved her respect. She gave it to him, but allowed him the dignity of not hanging all over him and smelling every inch of his furry person. She seemed to know how she'd like to be treated and gave that respect to others animals (and people) in return.



She was never as happy as she was as a young dog, freed from owners who didn't love her much and gave her care equal to their passion for her. My cousin, Milisa, was stopped in traffic with her then-owner who told her he was going to have to put her to sleep for an allergic condition. Milisa talked him into letting me have her (all without exchanging a single word with me about it; knows me well, doesn't she?), and so it was that on sunny afternoon when I was off from work healing up from the first wrist surgery for the malunion, and Milisa shows up with Kerry in her Toyota truck. We both agreed she needed lots of attention, but we were encouraged by her sweet, sunny nature. I don't think either of us gave it a thought after that whether she would fit in with my other dogs or what my husband would say. She seemed to just ooze into every corner from her very first moment here.



After she was given her first bath in this house--it took two of us--she snorted up and down the hallways, rubbing her face and scrawny body on everything that could provide some friction. She jumped up and down on furniture and looked for all the world like a celebration happening in dog's skin. When my husband came home, she didn't miss a beat and jumped square in the middle of our coffee table and then leapt off sideways in one big hop into his lap, landing pretty hard, but exuberant and proud of her acrobatics. He was trying to keep a stone face and say NO MORE DOGS, but there she sat, wagging her whole body, giving kisses, leaving little doubt that whether we knew it or not, she was our new dog.



Thank you for letting me share memories of Kerry with you this morning. Sometimes I think by the time I've done with these beautiful animals, there will be nothing left of me. I'll be like the Velveteen Rabbit, my skin all worn thin, my joints shabby, and nothing but my heart, full to the brim with love and memories, to say that I've had a life.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Between them all the poor little Rabbit was made to feel himself very insignificant and commonplace, and the only person who was kind to him at all was the Skin Horse.

The Skin Horse had lived longer in the nursery than any of the others. He was so old that his brown coat was bald in patches and showed the seams underneath, and most of the hairs in his tail had been pulled out to string bead necklaces. He was wise, for he had seen a long succession of mechanical toys arrive to boast and swagger, and by-and-by break their mainsprings and pass away, and he knew that they were only toys, and would never turn into anything else. For nursery magic is very strange and wonderful, and only those playthings that are old and wise and experienced like the Skin Horse understand all about it.

"What is REAL?" asked the Rabbit one day, when they were lying side by side near the nursery fender, before Nana came to tidy the room.

"Does it mean having things that buzz inside you and a stick-out handle?"

"Real isn't how you are made," said the Skin Horse.

"It's a thing that happens to you. When a child loves you for a long, long time, not just to play with, but REALLY loves you, then you become Real."

"Does it hurt?" asked the Rabbit.

"Sometimes," said the Skin Horse, for he was always truthful.

"When you are Real you don't mind being hurt."

"Does it happen all at once, like being wound up," he asked, "or bit by bit?"

"It doesn't happen all at once," said the Skin Horse. "You become. It takes a long time. That's why it doesn't happen often to people who break easily, or have sharp edges, or who have to be carefully kept. Generally, by the time you are Real, most of your hair has been loved off, and your eyes drop out and you get loose in the joints and very shabby.

But these things don't matter at all, because once you are Real you can't be ugly, except to people who don't understand."

"I suppose you are real?" said the Rabbit.

And then he wished he had not said it, for he thought the Skin Horse might be sensitive.

But the Skin Horse only smiled.
"The Boy's Uncle made me Real," he said. "

That was a great many years ago; but once you are Real you can't become unreal again.

It lasts for always."

From "The Velveteen Rabbit or How Toys Become Real" by Margery Williams.

Here is the song that is Kerry's song forever and always, whether anyone knows it but us:

Kookaburra Kookaburra sits on the old gum tree

Merry merry king of the bush is he

Laugh Kookaburra, laugh Kookaburra

Gay your life must be

Kookaburra sits on the old gum tree

Eating all the gumdrops he can see

Stop Kookaburra, stop Kookaburra

Leave some gums for me

Kookaburra sits on the old gum tree

Counting all the monkeys he can see

Stop Kookaburra, stop Kookaburra

That's no monkey, that's ME!

High Alk Phos just a "Scottie thing?"

Bonnie Sue

(-fos-fah-ta-se´me-ah) high levels of alkaline phosphatase in the blood.An abnormally high concentration of alkaline phosphatase in the blood.hyperphosphatasemia /hy·per·phos·pha·ta·se·mia/


High Alk Phos just a "Scottie thing?"

 I have a hunch that Scotties have some kind of genetic predisposition to a flaw in their endocrine system which causes things like adrenal exhaustion and Cushings disease, which lead to high liver enzymes, bladder cancer and skin allergies. These are issues many Scottie owners have observed in their pets, no matter how well-cared for they may be.

Below is a link to research published last year relating to high alk-phos values in Scottish Terriers which might prove my hunch is correct. It suggests atypical adrenal cortical disease with increased activity of OACS (androstenedione, estradiol, progesterone, 17-OH progesterone, aldosterone) might be a more common cause of hyper-alkaline phosphatasemia (high alk phos levels) in Scottish Terriers, than benign hyper-alkaline phosphatasemia. Meaning: High Liver Enzymes might not just be a "Scottie thing," but instead a cause for real concern on the part of owners and breeders alike. It also may point to adrenal exhaustion as a cause.

http://www.vetpathology.org/cgi/reprint/44/5/732.pdf

For many years, I have noticed a trend in my Scotties. As they grew older they began to show high levels of alkaline phosphatase in their blood work. I have heard it said by many Scottie-owning folk that this is no big deal and many vets I know have just come to accept that high liver enzymes are a "Scottie thing," not necessarily a reason for alarm. In my own dogs, these high serum levels of alkaline phosphatase always signaled a serious illness just around the corner. I now instinctively believe--with little proof--that while it might be a genetic flaw in Scotties, it is not something to be overlooked or written off. To discuss this a bit more and how it has become important to me, here is a brief explanation of liver enzymes, their function and acronyms:

ALT, alanine aminotransferase (which used to be known as SGPT), is an enzyme found in the liver cells. Damaged liver cells will leak ALT, which is then detected in increased quantities in the blood.

AST aspartate aminotransferase (which used to be known as SGOT) is a similar enzyme and is found in many cells, including liver, muscle and heart cells. ALT elevations in the blood are specific indicators of liver disease, while AST elevations are not.

Serum alkaline phosphatase (SAP, ALP or alk phos--short for alkaline phosphatase) is an enzyme present in liver, bone, intestine and kidney. Increases related to the liver may result from a blockage of bile flow, the actions of some drugs or due to some disease mechanism. Young dogs have higher SAP because it also indicates active bone metabolism. In older dogs, it can indicate bone cancer.

I had a special experience with my Scottie, Bonnie, last year when she developed SARDS (Sudden Acquired Retinal Degeneration) due to adrenal exhaustion. Many tests were run, experts were consulted, yet it took valuable time and money to get at the correct diagnoses and treatment for her. Her vision grew steadily worse all the while. It was a maddening and frustrating journey and I wrote a two-part story about it for Great Scots Magazine in hopes that others might benefit from the mistakes I made and delays I experienced. I share only a brief bit of it here in hopes that retelling some of it might help someone else. If you have any interest or questions, I am always glad to relate my own experience with Bonnie's SARDS.

We've owned Bonnie since age 7 (she is now 11 1/2). During her life with us, she has had regular blood work and ultrasounds. As she grew older, we noticed that her liver enzyme levels were creeping up, but repeated Cushings tests showed negative results. We noticed other metabolic and behavioral symptoms that just didn't seem to fit with any pattern of disease I'd ever read about. 

(1) Her water intake and output steadily increased;

(2) She suffered from the slightest increase in temperature, panting for hours on end, even in her sleep;

(3) She suffered behavioral changes. She got a bit grumpy with the other dogs and slept on the floor instead of the bed as she once had. She even withdrew from me, the person she had always clearly preferred. She stopped following me around as was her usual habit and definitely did not want to be hugged or touched. When she stopped going up the stairs to my office, I realized something had to be terribly wrong;

(4) She'd always had a gorgeous coat, but now it became even heavier and the texture changed a bit;

(5) Her appetite was wolfish and she never seemed to be satisfied. I pride myself on the home-cooked meals we provide our dogs and it left me feeling puzzled as to what I could feed her that would fill her up without adding extra pounds;

(6) She was restless and did not sleep or rest well, either during the day or the night.

(7) The most puzzling symptoms of all were that her hearing, and to a lesser degree, her sense of smell, were diminished. It left her looking a bit confused when we called to her or put her food bowl in front of her. Clearly she wanted to eat, but if she couldn't see or smell the bowl, she would just stand there looking expectantly.

She did indeed have some symptoms of Cushings, but I would come to learn that from outward appearances, Cushings and Adrenal Exhaustion look very similar and good lab testing is needed to differentiate between the two. If you want to have some idea before you do extensive lab testing, you might check to see if your dog has any kind of chronic inflammation, i.e., irritable bowel syndrome, poor dental health, chronic skin allergies, severe arthritis. All of these things can be connected with adrenal exhaustion since estrogen is a pro-inflammatory

http://www.ncbi.nlm.nih.gov/pubmed/16024752
Sohrabji F.   Estrogen: a neuroprotective or proinflammatory hormone? Emerging evidence from reproductive aging models (abstract). Annals of the New York Academy of Sciences 2005; 1052: 75-90.

Finally, we acted on the advice of experts and ran a true endocrine panel. We used a lab in Quail Valley, California, National Veterinary Diagnostic Services. Their normal ranges better reflect what is observed clinically in pets than some of the larger, better-known endocrine labs, such as the one at University of Tennessee College of Veterinary Medicine. We used Tennessee's lab at the beginning of Bonnie's problem, but were not happy with the wide "normal" ranges as compared to NVDS' more precise parameters. Some of their suggestions to deal with the endocrine abnormalities they observed were not what we consider to be ideal.

Upon the advice of my vet, I drove to MedVets of Columbus, Ohio, a specialty veterinary group that offers ophthalmologic and neurologic testing. There Bonnie underwent a neurologic assessment for her hearing and she was given a Doppler blood pressure test to see if any undue pressure might be causing her sight problems. An ocular examination was also performed, including a Schirmer tear test, and an electroretinogram (ERG), which tests retinal function. In this test, special contact lenses were placed on Bonnie's eyes and a series of flashing lights were directed toward them. A graph of the electrical impulses recorded electronic signals detected by the electrodes. In Bonnie's case, the ERG recorded barely any electrical responses, which meant her ERG was flat. When this happens and blood pressure is normal, as it was with Bonnie, SARDS is the likely diagnosis.

I had been reading a magazine in the waiting room about ongoing treatment developed by Dr. Grozdanic at Iowa State for SARDS and I was anxious to discuss it with the doctors when I got back to the exam room with Bonnie.

However, when I received the summary of Bonnie's test results from the specialists, I learned that the MedVets team did not feel Bonnie was a candidate for SARDS treatment because she still retained some functional vision, and SARDS dogs, they told me, had none.Her patient evaluation note from the ophthalmic group read as follows:

"Bonnie presented to the service for evaluation of profound visual deficits. She appears to have primarily lateral visual field deficits with preservation of vision in the central visual fields. She did have flat ERGs but does have some vision. Bonnie is poorly attentive to auditory stimuli with decreased attention to sound and localization of sound."

The neurologist wrote:

"I cannot find any neurologic deficits which would explain the visual loss. It is odd that she appears to have both visual and auditory changes, since these are both Special Somatic Afferents . . . . [h]owever, I know of no degenerative processes in dogs with a preferential effect on SSA fibers. If the auditory changes are real, a degenerative process would make the most sense, since there is not any evidence of vestibular dysfunction . . . I can't think of any additional testing to perform on Bonnie right now, but BAERS [Brainstem Auditory Evoked Response, used to detect retrocochlear pathology] would be interesting to perform to see if they show the same changes as the ERG. Nor can I think of any appropriate therapy for Bonnie."

The veterinary ophthalmologists said Bonnie's symptoms fit no particular category and felt her situation defied diagnosis. They called another veterinary ophthalmologist in their group to take a look at Bonnie because they found her symptoms and exam so perplexing. They all agreed that SARDS fit better than any other diagnosis but argued that she would be a very atypical case. Her ERG was flat but she still retained a small amount of functional vision that allowed her to navigate an exam room set up with obstacles. The neuro assessment pointed toward a degenerative process, but the veterinary ophthalmology team was not swayed toward the SARDS diagnosis. They pointed out that Bonnie's eyesight diminished over time, not overnight as they said is found in dogs with SARDS.They could not offer any hope or treatment for her condition, but did suggest Occuvite as a nutritional supplement to slow down the loss of vision. They attempted to encourage me by saying that Bonnie would "adapt to her circumstances."

If I had listened to these "experts," my dog would be completely blind by now.

Their advice was incorrect and misleading because dogs suffering from SARDS can retain navigational vision for a period of time despite flat ERG. Each case is different as each dog is different and while one dog might go blind in short order, another might keep some vision for months before going completely blind. Treatment options are certainly available for many dogs suffering from SARDS. The lack of recognition by MedVets of these possibilities for treatment is distinctly discouraging.

MedVets was unable to give Bonnie a diagnosis and the best they could do was to offer Occuvite, a vitamin supplement thought to help preserve vision. I recently learned that they now will diagnose SARDS correctly, but still do not offer any advice for treatment. The comment that the dog will adjust is still about the only true hope they offer.

In addition to pretty much wasting my money there, Bonnie also came home with a scratched cornea that had to be attended to by my regular vet--all from their fine handling.

Eventually, we consulted with the Dr. Grozdanic at Iowa State, and drove 1600 miles to meet him for an exam of Bonnie. He was able to tell us the that Bonnie was definitely suffering from SARDS (something a $400 bill and my three-hour drive one-way to Columbus apparently could not).

I was disappointed to learn that Dr. Grozdanic doesn't believe that SARDS is caused by adrenal exhaustion, but instead by an autoimmune process. The veterinary community is still debating this issue, but experts I consulted with when writing my article for GSM, including Dr. Kenneth Abrams, past President of the American College of Veterinary Ophthalmologists, and author of scientific articles and textbooks, reflect the theory of endocrine involvement.

SARDS is an area of keen interest for Dr. Abrams and the studies he completed and reported indicated "no antiretinal autoantibodies were identified in the serum of dogs affected by SARDS as compared to normal canine patients."

Both his research and personal experience in private practice point instead toward a corresponding hormonal imbalance. He indicated several theories had been put forth to explain the development of SARDS, including glutamate toxicity and autoimmune disease, but he did not believe these to be correct. "Many patients (70%) have an associated problem where they will drink lots of water, eat aggressively, and gain a lot of weight . . . . These signs hint at a hormone disorder called Cushing's disease, a similar disease to diabetes. However, when patients are tested for Cushing's disease, the results are usually normal or borderline."

In the end, it took still more time and effort to find experts who would connect adrenal exhaustion to Bonnie's SARDS and offer us real advice us on how to stop the degenerative process and help Bonnie retain the vision remaining her.

Adrenal Exhaustion is known by many names, including: adrenal fatigue, atypical Cushings or atypical adrenal cortical disease. It can be confusing when trying to determine what is being studied or discussed in relation to this disease.

The importance of the connection of adrenal exhaustion to SARDS is that if a dog is not treated correctly and their endocrine system is not balanced, not only can they lose their vision, but they can suffer greatly diminished metabolic health which can lead to early death.

Many dogs lose their vision because of the slow response of veterinarians, or ophthalmic veterinary specialists, as in the case of Bonnie and at least one other dog whose owner has corresponded with me. This other dog may have lost its sight altogether because MedVets assured the owner that while he did have SARDS, he would be fine. No treatment was offered or even mentioned.

I found the experts who would really be of most help to Bonnie through the Internet. Dr. Alfred Plechner, DVM, and Ms. Caroline Levin, R.N. [see below], consulted with our veterinarian and me through e-mail and phone calls.

Currently, Bonnie's adrenal exhaustion is being corrected with steroid replacement therapy, thyroid replacement therapy, sulfasalazine as well as special supplements and vitamins to preserve and protect her vision. Happily, she seems to be getting back to her old self as her metabolic symptoms are abating through treatment. Her vision is still just functional, but considering that the odds were against her, I feel fortunate that she has any sight at all.

The way we use steroids in Bonnie's case is a different way of administering or even thinking of steroids than has been typically accepted.

 

I think most of us have been exposed to the thinking that steroids are immunosuppressive or can be harmful long-term. I have always held them at arms' length, using them only in emergencies. Yet, small, physiologic doses, as opposed to pharmacologic doses of steroids, can actually be immunosupportive. Seems a bit counter-intuitive, but this is the case.

Until going through this experience with Bonnie, I did not realize it, but there is quite a bit of research available to support this theory, some of which has been around for decades. Most vets are still, sadly, unfamiliar with the whole disease mechanism. As a result, most pet owners have no idea that through correcting the underlying endocrine imbalance, they can restore health to dogs that suffer from many common, but seemingly intractable diseases. Dr. Plechner mentions the following:

Allergies;

Viruses, bacteria and fungi (colds and flu, parvo, bacterial infections);

Malabsorption and digestive tract disorders

(his studies show that food sensitivities occur only in animals with hormonal imbalances);

Autoimmune disease;

Cancer;

Kidney disease;

Chronic liver disease

(endocrine and immune imbalances can "cause it to run in slow motion");

Behavioral problems;

Aggression;

Separation anxiety;

Hypersexuality of neutered or spayed animals;

Problems in reproduction;

Epilepsy; and

Obesity.

Ms. Levin's FAQs page informs us that any dog with poorly controlled diabetes, pancreatitis, epilepsy, IBD, allergies, or Cushings can benefit from appropriate testing and steroid replacement therapy.

I found Plechner and Levin's work to be fascinating, especially looking back at the pets I had lost to liver disease, cancer or kidney problems. Most especially meaningful for me was thinking of my dearest Kyle, who suffered all his life from food allergies and crippling irritable bowel disease (IBD), and who eventually died due to complications of his advancing liver disease and bladder cancer. If I had understood this information before Bonnie's SARDS, I might have spared many of my pets an untimely end.

To give you a better idea of how adrenal exhaustion works, Dr. Plechner describes the disease disorder he sees in the pets he has treated. From his book, "Pets At Risk":

"In my research I have learned that at a basal, or normal level, the body's own cortisol exerts a very discriminating regulatory effect on molecular 'mediators' that turn on or turn off activity related to immunity and inflammation. It is a very complex business. The bottom line is that a normal level of cortisol seems to be required for a normal immune response. A deficiency of cortisol may result in an unresponsive immune system, whereas too much cortisone medication or too much of the body's own active cortisol suppresses immune responses. An excess of active cortisol or cortisone drugs can lead to a condition known as Cushings syndrome. In Cushings, individuals develop severe fatigue, weak muscles, high blood pressure, high blood sugar, and fertility and menstrual problems, among other symptoms.

* * *

"Cortisol deficiency, the other side of the coin, tends to be overlooked in medical circles. A deficiency or ineffectiveness of cortisol certainly appears to cause many problems. I have seen this consistently in animals. Compared to healthy animals, I have found that sick and diseased pets often have too little cortisol, or the cortisol present is somehow in a bound or ineffective state, resulting in system imbalances and chaos throughout the physiology. The particular problem I see does not relate to Addison's disease . . . ."

Plechner has determined that the disease process in many pets can be corrected by addressing the issue of cortisol production and excess adrenal sex hormones. His protocol starts with specific testing he's developed ("Plechner endocrine-immune test") in order to determine a patient's precise point in the disease process. If hormonal imbalance is present, treatment is given through cortisol replacement. Most of the time, T-4 thyroid replacement is necessary, too, since thyroid hormones become bound to some degree because of the influence of "estrogen and cortisol abnormalities." A thyroid imbalance can be present even if the T3/T4 levels look normal, so it is important to use a lab that is particularly sensitive in this area of testing and aware of the correct range of these values. Plechner's E-1 test shows the values for T3,T4, cortisol, estrogen and three different antibodies or immunoglobulins (IgG, IgM, and IgA).

When the adrenals can no longer produce the levels of cortisol demanded by the body or if the cortisol is bound up in some way and unavailable to the body for use, then the byproduct of this scenario can be excess adrenal hormones, especially estrogen. Too much estrogen, coupled with low cortisol, has a harmful effect on many body systems, including depression of immunoglobulins and producing inflammatory results throughout the body. Obviously, if the body isn't being well-protected by immunoglobulins, medical problems can result.

IgA, one of the more important immunoglobulins, protects all the mucous membranes of the body. If IgA isn't at the right level, infections, allergies, or even cancer might result.

In Bonnie's case, I believe high levels of estrogen caused small seizures to her retinal cells which resulted in massive apotopsis (cellular death). Ms. Levin's SARDS FAQS page states the following as potential causes for SARDS:

Whether the predisposition involves a flaw in the retinal cells, an over-activity of the adrenal gland (the body overreacts to even small stressors) or a predisposition to low Immunulogobulin A/ an irritated intestine is unclear.

http://www.petcarebooks.com/SARDS/FAQs.htm#11

During the last few years, Bonnie's Complete Blood Count (CBC) showed high liver enzymes, and because of that, she was repeatedly tested for Cushings. It is, however, important to realize that using a Cushings test alone to determine treatment--especially one that might call for Lysodren, Trilostane or even melatonin--might be dangerous. Melatonin does depress estrogen production, but also does the same for cortisol. Obviously, that would not be the goal for a dog who isn't producing enough cortisol. An adrenal crisis can be the result of suppressing the cortisol production in a dog that is already suffering from adrenal fatigue.

It is also not widely realized by vets, but if tests results do show excess cortisol as with Cushings disease, it doesn't necessarily mean that the cortisol is in actuality available to the body. It may very well be bound up through the mechanisms Dr. Plechner describes. Having a total endocrine panel run by a lab that specializes in interpretation of the results is a much better approach to looking at high liver enzymes or other Cushingoid symptoms. Basically, if the total estrogen levels are up and the immunglobulins are depressed, you mighty well suppose that you are dealing with adrenal exhaustion and not Cushings.

I will never again start a treatment of Lysodren for a pet relying just on a Cushings test, or even repeated Cushings tests of different kinds. I will continue to believe that the E-1 panel (Endocrine-1, the name used by NVDS for the test) is the key to interpreting so many aspects of my pet's health. I have had two pets that had poor experiences with Lysodren (used to treat Cushings disease); one fatal, and the second one, nearly fatal. I have started to believe that those instances when my dogs suffered poor outcomes with Lysodren might be due to the fact they never needed Lysodren in the first place. Perhaps those dogs had an endocrine imbalance--adrenal exhaustion--that was masquerading as Cushings.

Vets don't recognize adrenal exhaustion, so their choices are limited when faced with pets that are seemingly suffering from Cushings. Their knowledge or experience may not allow them to consider any other possibility. High liver enzymes are indicative of both adrenal exhaustion and Cushings, so when observing this in a pet, as I did with Bonnie, it is important to make sure you know what you are dealing with. It may mean that you will have to seek out other treatment providers in addition to your regular veterinarian. I found vets that were open to the concept of adrenal exhaustion, but few had any experience with it. As vet care prices soar, I would imagine that few clients push their vets toward more testing.

In humans, adrenal exhaustion has been recognized for at least the last twenty years, so one wonders why should the situation be so different for animals?

I have attempted to provide a quick view of SARDS and adrenal exhaustion and the story of Bonnie's struggle with both. If anyone has questions about Cushings or adrenal exhaustion in pets, please check out Dr. Plechner's book or schedule a consultation with him. He is the veterinary equivalent of an "adrenal and endocrine explorer," and has presented revolutionary ideas for the veterinary world to consider and offered his help generously to owners with pets suffering from a variety of ills. As a sidenote, he was the formulator of the first pet foods for animals suffering from allergies and also has a keen interest and ability in the area of allergies in pets.

Dr. Plechner would be most able to provide a better understanding of how Cushings and adrenal exhaustion can look so much alike and the appropriate next step if an owner suspects either to be present in their pet.

If you have a pet you suspect is suffering from SARDS, Ms. Levin is an excellent resource, either online or through personal consultation.

Ms. Levin has just included a wonderful link on her web site relating to the use of melatonin versus steroid replacement therapy in adrenal exhaustion cases. I found it especially interesting because when Bonnie got her first endocrine panel done at the Univ of Tenn., melatonin is exactly what they recommended as a treatment option.

Basically, while melatonin does help suppress estrogen, it also lowers cortisol levels, which isn't at all the object when a dog suffers from adrenal exhaustion; in fact it can place the overall health of the dog in greater jeopardy, both in the short and long-term.

Ms. Levin also notes that a small number of SARDS dogs have Cushings disease, but most she has studied have the endocrine imbalance the Bonnie has.

The prescription of steroid replacement that Dr. Plechner advocates is lifelong because the imbalance will return if treatment is stopped. He makes the important point that the animals he treats are not affected by the side-effects so often seen with steroids because he is providing the body with something it isn't producing on its own–and something it desperately needs. (I can totally relate to this since I take thyroid medication every day since I can't make enough thyroid hormone on my own; if you can't make it on your own, you need to get it some other way.) The oft-publicized immunosuppressive effects of these powerful drugs might make some veterinarians shy away from using them, but research has revealed that they can be healing and restorative to the immune system when properly used in small, physiologic doses for animals with a corresponding imbalance.

Bonnie's struggle for vision and good health seems to have taken up the better part of my life for over a year, but the good news is that she is being treated successfully and appears to be doing well. As a result, I continue have a keen interest in metabolic diseases of pets that can be linked to adrenal exhaustion, monitoring new research with a special focus on adrenal exhaustion. I will continue to add those links at the bottom of the blog page for those who are interested.

Links to Dr. Plechner:http://drplechner.com/
"Pets at Risk: From Allergies to Cancer, Remedies for an Unsuspected Epidemic"
Martin Zucker and Alfred J. Plechner, DVM
New Sage Press, 2003 $13.95

Caroline Levin's Lantern Publications SARDS FAQs page:
http://www.petcarebooks.com/SARDS/FAQs.htm

I also found her book to be very helpful:
"Dogs, Diet and Disease An Owner’s Guide to Diabetes Mellitus, Pancreatitis, Cushing’s Disease, and More" Examines autoimmune, endocrine, and digestive problems. Discusses treatments, including diet. An excellent resource for SARD-dog owners, and available through her Lantern Publications web site.

THE DOG . . . a poem

THE DOG

I like a dog at my feet when I read,
Whatever his size or whatever his breed.
A dog now and then that will nuzzle my hand
As though I were the greatest of men in the land,
And trying to tell me it’s pleasant to be
On such intimate terms with a fellow like me.

~~~

I like a dog at my side when I eat,

I like to give him a bit of my meat;

And though mother objects and insists it is bad

To let dogs in the dining room, still I am glad

To behold him stretched out on the floor by my chair.

It’s cheering to see such a faithful friend there.

~~~

A dog leads a curious life at the best.

By the wag of his tail is his pleasure expressed.

He pays a high tribute to the man when he stays

True to his friend to the end of his days.

And I wonder sometimes if it happens to be

That dogs pay not heed of the faults which men see.

~~~

Should I prove a failure, should I stoop to wrong;

Be weak at a time when I should have been strong,

And fill with my blundering many an ear,

But still, as I opened my door, I should see

My dog wag his tail with a welcome for me.

Edgar A. Guest

Babes and the Most Meaningful Aroooooo

I just have to tell this story about my first Scottie dog, Babes. I think this story more than any other will help illustrate what I said in an earlier post that we are all on a journey of learning and discovery, and we meet one another at different places on the trail. At the time this story took place (1983), I was pretty much near the beginning of my hike up the Grand Canyon of dog knowledge. How does that go . . . I was depriving some village of their idiot? Let us say that I didn't know nearly enough about Scotties or breeding and that is where our story starts.

Have you ever heard a Scottie "Arooooooo?" If you haven't, then you've missed something really quite unique. An Aroooooo is a greeting or an exclamation of something noteworthy. It is a long, drawn-out and throaty comment on something the Scottie would like to discuss with you. It is kind of the Scottie equivalent of a Beagle baying at the moon, or a wolf howling into the night. Sometimes, in ScottieSpeak, it is just a plain old doggy exclamation point. My girl Babes had quite an Arooooooo and when she wanted to talk to you, you knew about it. It was one of my favorite things things, then and now: to hear my Scotties Arooooo in unison. 


Babes came from a pet store, and yes, I can hear you all groaning. I knew nothing of breed science and I actually thought it might be fun to breed her. I figured I would just go out and find a male Scottie to breed her with--just any intact Scottie lad would do. I knew nothing of Babes' parentage and even less about the laws of genetics or heritability and so was ill-equipped to tackle any sort of breeding endeavor. I hang my head in shame when recalling the simpleton I so happily was.


While I was eagerly hunting up a "boy to fix her up with," the ugliest, meanest Pit Bull you have ever seen started hanging around our house. One look at him told me that he had come with strong hormonal motivation to court my Babes and I had better stand tough if I wanted to keep this suitor away. It was the first time I had any insight into how my Dad might have felt looking over some of the fellas I used to drag home.


I have nothing against Pit Bulls and I am very much against the anti-pit bull backlash that seems to be sweeping the country. But let it be said that this guy was just Not Nice. There are Nice Pit Bulls and Not Nice Pit Bulls, and he was one of the latter. Every time I tried to shoo him away, he would stand his ground and stare me down and never move a muscle. If I got real close to him, he would growl, low and threateningly. Of course, what do you think that meant to the girlie-girl in the house? Babes thought he was perfect, far better than a regular long-snouted terrier. In fact, he was one step up from a Scottie boy: A snarling, hate-your-Mama-I’m-here-on-business-Pit Bull was just her idea of a dream date.

I suppose I have to admit here and now that she was a girl of strange appetites and as it turned out, Babes liked it kinda dangerous.


However, I am one determined girl, too, so I managed to fend off this unsuitable suitor for two whole weeks. In the meantime, through unbelievable effort on my part, I was finally able to locate "a Scottie boy" when I took Babes to the groomer. He happened to be in a cage close by when I came to pick her up. I begged the groomer to give me the owners' names, and while she was reluctant, I am sure she wasn't nearly as reluctant or as sorry as his owners were when I called. They absolutely were not interested in breeding their "show dog" to a puppy mill bitch. (Can I blame them?)


As, as it turns out, they weren't snotty; they were just much smarter and better educated about the art of breeding than I was at that time. Did I catch on to any of their subtle and not so subtle hints? Absolutely not. With the determination of a kid walking out of a dark holler, I wouldn't take no for an answer. They tried to educate me as kindly as they could, pointedly inquiring about her bloodline, her health, what part of the country she was from, etc., but it just wasn't sinking in. My face still gets red when I think about it. I mean, I hounded these poor people for several days to let me breed Babes to their beloved well-bred Scottie male. It must have been my complete naivete' that made them give in. Maybe it was my guileless, witless persistence. Or it may have been because I promised not to sell the puppies but to keep them all and have them spayed and neutered. The truth is probably closer to the fact that I badgered them beyond the point of rational thinking and they finally just gave up. So, without a shred of enthusiasm, they told me to come on out to their farm and to bring Babes with me for the breeding.

The whole thing turned into an exercise in futility. Kinda like, "How ya gonna keep 'em down on the farm after they've seen Gay Paree?" After getting a good look at Mr. Undesirable at home, Babes wanted absolutely nothing to do with their Scottie boy. Maybe he was the equivalent of a high-class snobby nerd and didn't appeal to her more basic desires. He tried what were to his mind all the right moves; courted her in that Scottie feint/dodge/roll kinda way, but she was having nothing to do with his pedigreed hard-coated kind.

Still, I had not given up hope. We waited and watched all day long, and finally, she just looked so bored that I decided to call it a day. Not give up, mind you, as I was determined to give her a "good Scottish experience," as I told my brother at the time. I am sure the owners of the male were relieved, but politely suggested I take her home as she just might not be ready yet. (I thought if they were in heat, they were ready. See how much I knew?) We made arrangements to try again on the weekend, which was only two days away. I suppose they might have used the time until then to pray to the Lord for my enlightenment, I don't know. But as it turns out, their little male's virtue remained intact and was never sullied by a dalliance with my less than regal Babes.

I came home, all tired and depressed, wondering if I was ever meant to see Babes' wee Scottie puppies. I was also a little put out with her for being such a tease, so I talked to her all the way home, chastising her for being so much trouble. Once we got home, I was smart enough to remain on my guard for you-know-who before I let her out for her evening "doo or dew." That's what I call it anyway; you know "Do your doo!"

I made a perimeter check of the house: nothing in the bushes or behind the trees, no "bad" dogs in sight. All areas seemed clear, so I let her out on the front steps. She just stood there. Looking at me. I knew what she was waiting for. She wouldn't go if I was watching her, because she knew she would immediately be whisked back into the house as soon as she was finished, foiling her heart's desire to sniff out her secret lover boy's latest urine-soaked valentines. She also wouldn't go if I stood inside the door and tried to hide from her, as she had caught on to that little game in a maddeningly short amount of time. In fact, she would not "do the doo" unless she heard my footsteps go away from the door and into the hall. So, I calculated--20 steps to the bathroom, 20 steps back--I figured I would run and get my toothbrush and attend to my oral hygiene while she was doing the doo.


Now really and truly, I was gone less than thirty seconds. When I came back, there she was locked in a pretty intense embrace of that most unworthy fellow. I don't know where he was hiding or which direction he came from, but he saw the chance and he took it. (I was going to say that he saw an opening and he took it, but that just doesn't seem polite . . . .)

She just stood there staring up at me with a look I can only call satisfied. He, on the other hand, looked defiant and smug. Well, as a matter of fact, she looked kind of smug, too. I was so completely caught off guard by this sight that I almost choked on my toothpaste. I just could not get over what I was seeing! AAAARGH! The best-laid plans and all that rot . . . .


I sat down on the step, absent-mindedly brushing my teeth until their love thang was complete. Then, I gave him stern orders to "git" and ordered her in the house. ("Young lady, I mean it!")


Well, she tore into that house and around the furniture and in and out of the rooms like her butt was a rocket. Take the way that they act after they have been bathed, multiply that tenfold and now imagine that you bathed them in Tabasco sauce and you might have an idea of what she looked like--a mighty fast and agitated black streak.


Finally, I just gave in to the moment. I was mad, I was worried, but her enthusiasm was kind of contagious. So I went in to my room where she was presently making circles around my bed at full speed and watched my little whizzing ball of fur burning up the carpet. All of a sudden, she stopped. Up on the bed comes the Spice Girl of Lakeview Circle. She jumped right up between my pillows, sat down on her haunches and gave me a look and then let out the longest, most "lusty" Aroooo that I have ever heard a Scottie utter. It was full of meaningful inflection, with good use of recurrent themes and tempos. I think of it now as being "resplendent with meaning."

I needed no course in music appreciation to get the gist of what she had said. There was no mistaking what she was trying to convey: She liked that bad guy. A lot! and "How soon again would I be needing to brush my teeth?"




Sadly, Pit Bull/Scottie puppies are not pretty or easy to find homes for, but I learned some very valuable lessons:

*Listen to knowledgeable people who try to advise you when your pet isn't suitable for breeding;

* If you are new to your pet's particular breed, gain more information about the breed in general before moving forward with a plan for breeding;

* If you don't know anything about the history of your pet or its parents and similar information about the stud you plan to use, don't even think about breeding;

* If you don't know enough to keep your dog away from a horny Pit Bull, just give it up. Get your bitch to the nearest vet and have that girl spayed.

Also, I learned that a cross between a Pit Bull and a Scottie is called a "Bull Scott," which sounds more like something I'd say when reading this story.

Here's a few links to check out if you are considering embarking on a breeding career, or even just breeding your dog once:

Things to Consider Before Breeding Your Dog:

http://www.k9web.com/dog-faqs/breeding.html

What You Should Know Before Breeding Your Dog (or Other Pet):

http://www.squidoo.com/breeding

Kerry

 
THE POWER OF THE DOG

There is sorrow enough in the natural way
From men and women to fill our day;
And when we are certain of sorrow in store,
Why do we always arrange for more?
Brothers and Sisters, I bid you beware
Of giving your heart to a dog to tear.

Buy a pup and your money will buy
Love unflinching that cannot lie–
Perfect passion and worship fed
By a kick in the ribs or a pat on the head.
Nevertheless it is hardly fair
To risk your heart for a dog to tear.
When the fourteen years which Nature permits
Are closing in asthma, or tumor, or fits,
And the vet’s unspoken prescription runs
To lethal chambers or loaded guns,
Then you will find –it’s your own affair–
But . . . you’ve given your heart to a dog to tear.

When the body that lived at your single will,
With its whimper of welcome, is stilled

(how still!);
When the spirit that answered your every mood
Is gone–wherever it goes–for good,
You will discover how much you care,
And will give your heart to a dog to tear.

We’ve sorrow enough in the natural way,
When it comes to burying Christian clay
Our loves are not given, but only lent,
At compound interest of cent per cent.
Though it is not always the case, I believe,
That the longer we’ve kept ‘em, the more do we grieve;
For, when debts are payable, right or wrong.
A short-time loan is bad as a long–
So why in----Heaven (before we are there)
Should we give our hearts to a dog to tear?

Rudyard Kipling.

Chester, the Cat

Left to right:

Larry, Chester and Dave

Chester is now eighteen years old. Larry and Dave have gone on to heaven since this picture was taken, as has Red, another cat not in this photo. I am thankful for the kitties and the love they've given us over the years.