Healthy Pet Network

Portions of this article appeared in a two-part series in GREAT SCOTS MAGAZINE, Aug. - Sept., Vol. 13, No. 4 , and in Oct.-Sept. Vol 3., No. 5: "A Stone's Throw: Ripples Across Time with Scottish Terriers."

Bonnie Sue: One Scottish Terrier's Experience with Adrenal Exhaustion and SARDS

By Russie McDement-Fogarty

Page 3

Cortisol and Disease

As I started searching for answers to address Bonnie's apparent illness, I found a resource that encouraged me to look deeper within the health problems suffered by not only Bonnie, but all of my pets, present and past. That resource was the book, "Pets at Risk" by Alfred J. Plechner with Martin Zucker.

This small, but ground-breaking book focuses on correcting the unrecognized endocrine-immune imbalance caused by a cortisol defect.

Dr. Plechner is a graduate of University of California-Davis Veterinary School and for many years had an interest in nutrition and the role of hormone and immunity imbalances in dogs, cats and horses. He helped formulate commercial diets for food-sensitive animals, among those the first lamb and rice varieties. His compassion for animals is all-inclusive; he worked for many years as a wildlife rescuer and owned and operated a wildlife relocation and rehabilitation center in California. He has now retired and lives in Idaho, but he is still quite active in helping pets and their people. He makes himself available to veterinarians and doctors who are interested in his theory of disease development, and he is a regular voice on radio stations devoted to alternative healthcare for pets and people. Through Dr. Plechner's years of observation, research and experience, he is most qualified to offer his opinions on the surge of medical problems seen in dogs and cats today.

Here is a list of some of the canine ailments that he observes can be caused by an adrenal hormone imbalance:

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"); Von Willebrand's disease; behavioral problems; aggression; separation anxiety; hypersexuality of neutered or spayed animals; problems in reproduction, epilepsy; and obesity.

Plechner, Alfred J., Zucker, M. Pets at Risk From Allergies to Cancer, Remedies for an Unsuspected Epidemic. NewSage Press. Oregon, 2003. pp. 2, 3, 8.

Many of these ailments had been suffered by our own Scotties, and I was interested to see that some were mentioned in the "2005 Great Scots Magazine Scottish Terrier Health Survey."

"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, a condition involving a deficiency or aldosterone, the hormone governing sodium and potassium levels in the body, and which is produced in the outer cortex layer of the adrenal glands. I have not found low levels of aldosterone in cortisol- deficient patients, nor have I seen any of the typical signs of Addisons."

Ibid. pp. 18, 19.

I was interested to read that Dr. Plechner believes that he has seen this hormonal imbalance in every animal with cancer he has ever treated. The causes he cites are diet, vaccinations and contemporary breeding practices, leading to narrower gene pools, which in turn cause "compromised health and decreased life span." That certainly rang a bell for me because it was another area of concern I had felt since reading the health series that appeared in "Great Scots Magazine," written by the editor Dr. Joseph Harvill. "Deconstructing the Diehard" laid bare the plain facts about the state of the Scottish Terrier's immune response in a way no one else has before or since.

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 to this type 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).

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. 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.

"In animals with healthy adrenals, sustained cortisone medication indeed has the potential to suppress the immune system and cause side effects because too much cortisol and cortisone are then present in the body. Remember that cortisone compounds convert in the body to cortisol. This is why treatment with potent, pharmacologic amounts of cortisone often has no long-lasting benefits and leads to problems. But in an animal with defective adrenals, cortisone at the proper low-dosage level does wonders. It may, in fact, be the only thing that can save the lives of very sick animals."

"My clinical practice and research have shown that the conservative use of cortisone makes up for the shortage in animals with an impaired ability to produce healthy amounts of cortisol. The replacement cortisone slows down ACTH, as would naturally happen if the animal had adequate cortisol. This in turn stops the influx of unwanted extra estrogen. With cortisone now substituted for missing cortisol and with estrogen lowered, orderliness returns to the immune system allowing immune cells to protect the body."

Ibid. p. 25

There is a great online article, "Chaos in the Cortex," written by Dr. Plechner, wherein he explores his theories in an abbreviated, but readily understood format. The ideas he puts forth are worthy of consideration and make helpful reading for those with medically challenged Scotties, most especially those of us who have found no satisfying answers in what we've been told or the way some of our pets have been treated medically. I think many of us walk around feeling that something is not quite right, but we've exhausted our pet and vets with tests and ideas. We honestly don't know what to do next. In the end, I found Plechner's ideas extremely helpful in providing insight into how many of my past pets suffering from mysterious illnesses could in truth have been caused by abnormal cortisol and adrenal hormone levels.

In late spring 2007, I did an online search and came up with SARDS (Sudden Acquired Retinal Degeneration Syndrome, also known sometimes as simply "SARD"). When I thought of Bonnie in terms of the disease profile, it made a lot of sense.

Dr. Plechner did not mention SARDS in his work but I realized that part of Bonnie's problems could include an adrenal imbalance, which would explain her Cushings-like symptoms.

As many as 4,000 dogs are diagnosed with SARDS each year, many suffering from the personality and medical changes we observed in Bonnie. SARDS is thought to begin through a biochemical process which ends in rapid death of neural cells (also known as massive apoptosis) and results in blindness. One of the difficult aspects for vets examining the potential SARDS dog is that the retina looks completely normal and intact upon examination. Sometime into SARDS-it could be a week or months later--the retina will visibly degenerate.

I found a few websites that tantalizingly mentioned a connection between Cushings disease and SARDS, including the 2006 Edition of The Merck Veterinary Manual, which would implicate the endocrine system in the degenerative process. But no definite theories had been put forth by the medical community at large about the connection. In truth, there was a real lack of good information about SARDS, just a lot of basic information, and some of that I would later learn, woefully incorrect.

I would come to learn that a small number of SARDS dogs do have Cushings, but many more are suffering from adrenal exhaustion (which can look like Cushings). This confusion with Cushings disease can have disastrous results if a pet is incorrectly treated with Lysodren or Trilostane, which would further serve to suppress the already depleted cortisol levels in the case of a dog with adrenal exhaustion. This scenario can result in death.

My early research showed no hope for pets with SARDS and there were several web sites that suggested euthanasia for those affected. This was not what I was looking for, but I was not willing to give up. There had to be some hope on the horizon for Bonnie.

                                                              
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