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."
Sards
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Bonnie Sue: One Scottish Terrier's Experience with Adrenal
Exhaustion and SARDS
By Russie McDement-Fogarty
Page 8
The Future
Patrick and I intend to keep a firm eye on all our pets' endocrine function
now as we see how important it is to overall health and well-being. About seven
years ago, we began yearly health check ultrasounds for the dogs and the results
sometimes identified problems before they got to the disaster stage. It is with
hope for similar results that we will implement yearly testing to determine
cortisol, hormone and immunoglobulin levels in all our pets. If I had to make a
choice between the two, I think I would choose the blood work. In light of the
new information I've been given, I now have confidence that hormone testing
could have addressed much of the "junk"-the liver disease, the bladder cancer,
the kidney disease-that we found through the ultrasounds. Since an ounce of
prevention is worth a pound of cure, we plan to have complete blood work run for
Bender, Bonnie's son, as evidence points to adrenal exhaustion being a heritable
imbalance. I hope that this point does not escape the reader's attention.
The new Scottie, Bender's sister, Francine--another of Bonnie and Charlie's
puppies that had ended up in a breeding facility was shown through her adrenal
panel that she, too, is suffering from the early stages of adrenal exhaustion.
We hope that early treatment and detection will save her from the problems that
arise when pets go untreated.
I have contacted all available breeders involved in Bonnie and Charlie's line
and made them aware of the situation with Bonnie and this line. A few have been
receptive, some have not. But adrenal exhaustion is a real disorder, therefore
breeders should begin testing for these imbalances and making choices based on
the results. The buying public should insist on making our purchase decisions
accordingly. We can no longer continue to accept genetic cripples.
I strongly applaud Dr. Plechner for his opinions on this topic:
"Indeed, the actions of breeders have given new-and literal-meaning to the
term "killer looks."At great expense to the health of animals, breeding
practices have taken a cosmetic/marketing path away from natural or functional
criteria. As an example, this trend has converted hunting breeds of dogs into
fashionable, nonhunting, household pets who have lost their field ability, nose,
and hardiness. Pets have become more and more processed, unnatural, and
unhealthy, and more like merchandise."
"I'm truly convinced that if current trends continue-emphasizing the latest
fashion and ignoring the health of breeding stock-cats and dogs may simply be
bred out of popularity. Whether they know it or not, breeders who worship at the
altar of fashion and who relegate or ignore the health factor are compromising
the survival of their breeds. They are, in a sense, practicing animal abuse.
Their actions perpetuate unwellness and suffering. Their actions victimize
buyers-innocent consumers who purchase puppies and kittens and who usually have
no clue as to what may lie ahead in terms of sickness and veterinary bills."
* * *
"Irresponsible breeders are not interested in what I have to say. Responsible
breeders are interested. "What can I do to correct this? they ask . . . . [T]herapy
does not correct the genetics. It corrects the effects of the genetics that
cause disease. If you breed two animals with the same degree of genetic flaws,
even if both are corrected, then the genetic imbalances are merely passed on
with more severe consequences for the offspring."
Plechner, A. J., Zucker, M. Pets at Risk From Allergies to Cancer, Remedies
for an Unsuspected Epidemic.:NewSage Press. Oregon, 2003. pp. 153, 154
Postscript: Six Months Into Treatment
After six months on steroid therapy, simple observation of Bonnie's behavior
brings us much to be happy about. We once felt that Bonnie's touchiness with our
other pets was because she had lost much of her sight and was feeling insecure.
There are some resources that will point to that as the reason behind this
behavior while other sources indicate that treatment resolves the matter. I
think her attitude was caused by the excess female hormones, or the "bitchy"
hormones as we like to refer to them. I am happy to say that since being
treated, "Diva Bonnie" is gone. She's had to have some large skin tags removed
and biopsied-also probably caused by the production of the excess female
hormones. She has since healed nicely and the hair is growing back well in these
areas. Her vision remains mostly stable, as does her hearing. We unfortunately
ran out of prednisone while I was out of town recently, and I noticed as soon as
I got home that her vision had suffered because she was bumping into things.
When we returned to treating Bonnie with the steroids a few days later, we found
we had to give her several days of higher dosages before her vision returned to
the level it had been. Dr. Grozdanic's research indicates this to be typical in
dogs with IMR dogs who are treated with long- term steroids. (She is still a dog
with SARDS, but with responses that look more like a dog with IMR.)
Bonnie still feels sure enough of herself to get up alone during the night,
navigate furniture in near darkness, go down a long hallway and out the pet door
to do her business. This assures me that she has retained functional sight. At
times, I find that she focuses on a spot where she thinks I am-- gazing with
such an intensity--I am a little sorry to correct her. We have developed a
system where I use a light touch to signal to her the direction I am heading. I
give a light touch to her head if I am going forward or I will touch her back if
I am heading in the opposite direction. Otherwise, she will sit and wait
patiently and loyally for me in rooms I have long vacated, especially the
kitchen. Another sad little sight is a Scottie begging thin air. Her tests would
indicate that she has a kind of "peephole" where she is able to see, and so
often I wave my arms or move around in a funny dance when I am far away so she
can catch a glimpse of me in that little area of sight.
She is back to her routine of going with me to my office, and is sitting at
my feet as I write these words, snoring away, oblivious of all the attention I
am giving her as I type. She goes up and down stairs, albeit slowly, yet quite
independently. She has suffered a few slips that found her on the landing
looking a bit surprised. But when her dignity has been compromised, she accepts
little sympathy. I can't help but be touched that she will make every effort to
get to me, even if it means navigation through places where she can't see well
or feel secure. I have found I am absolutely unable to slip out of bed at night
for TV watching or late-night work without soon finding her at my side. I admire
Bonnie's courage and determination to capitalize on what she can see instead of
waiting to be carried around on a litter. It is the best of the Scottie spirit
exemplified and just one of the many things I love about her. She won't give up
or give in.
Bonnie's hearing is much better, but like those of some humans, is only
really good within a certain range, so in addition to doing funny dances, I now
can be heard talking to her in a high-pitched, sing-songy voice. Dancing and
singing for your dog? Oh yes. That's me. I have resigned myself to being fodder
for our guests' conversations on the way home. Now, if I could make my voice
sound like a plastic bread bag being opened, I would have her complete attention
every time I spoke.
Conclusion:
This is Bonnie's own story accompanied by my personal reflections. I have no
formal education that qualifies me to sort through research and make assumptions
based on what I find. I am simply an interested and loving pet owner, determined
to learn and share all I can about a disease that is so devastating to the
affected pets.
Bonnie Sue--our small stone--came to us through unexpected channels, led us
to additional Scottie companions and inspired us to give aid to others in her
situation. Through a simple phone call, we met her, loved her and vowed to
protect her. That promise led to ripples in the pond, seeking real answers to
her health problems in spite of mixed messages. Those ripples rebounded off the
banks in ways we had not expected. We had to seek answers in a way that we had
not in the past, going beyond what experts were telling us, to find the best
information available. In the process, we met brilliant and gracious experts,
gained a larger view of the beautiful and complicated mechanism that is the
adrenal system. In turn, we hope this experience will prove to be of benefit to
Bonnie's continued health. My hope is that her story will inspire others to seek
the same sort of positive outcome for their pets.
It is the cycle of small actions leading to larger consequences. And as
Robert Louis Stevenson said: "Sooner or later everyone sits down to banquet
of consequences."
UPDATE ON BONNIE
Since April of 2008, Bonnie was retested every few months using the E-1
adrenal panel offered through National Veterinary Diagnostic Services. While her
values have improved and her cortisol was normal, her total estrogen was still
too high 35.27 (normal 30.00-35.00) and her immunoglobulin levels were still
very low. (IgA 50 (normal 100-200); IgG 1,089 (normal 1,250-2000); IgM 81
(normal 100-200). While the estrogen level was not off by much, even small
amounts like this can cause clinical symptoms like we have observed in Bonnie.
Another reason we like the lab in California-their "normal ranges" are small and
correspond well to what we observe as owners and it is highly recommended by the
experts in the field of canine endocrinology.
Because her values were not yet normal, and therefore her system not yet
balanced, Bonnie was taken off oral prednisone and treated through weekly
steroid injections and the thyroid supplement Soloxine compounded in liquid form
was added. It was thought that she was not absorbing the oral medication as well
as she might (adrenal exhaustion is often implicated in malabsorption problems)
and so we did injections for several months. What we found was that sometime
toward the end of the week, the steroids wore off and she would become almost
completely blind, with much less functional sight than we'd been able to
preserve up to this point.
After consultation with Dr. Plechner and Ms. Levin, it was determined that
Bonnie should have one more initial injection of two steroids, then begin medrol
at 4.mg daily. We were also advised to administer Sulfasalazine to increase
absorption of the medrol. Bonnie also receives the supplement PS or
Phosphatidylserine (which has the nice effect of also treating the gallbladder
mucocele dysplasia she has), as well as a taurine/magnesium supplement designed
to offer more protection to the retina.
After following these directions, nearly all of Bonnie's outward symptoms
subsided and her vision remained somewhat stable. She suffered with a recurrent
bout of cystitis, probably caused because her IgA is so low, and her normal
immunoglobulin protection is lacking in that area, leaving her susceptible to
infection or attack of her mucosal surfaces (which obviously includes the
bladder--a scary thought for any Scottie owner).
Since any kind of invasive diagnostics are contraindicated to obtain a urine
sample (i.e., catheterization or cystocentesis) in a pet that might have
transitional cell carcinoma-and that could be just about any Scottie-we've had
to rely on repeated urinalyses. Bonnie has been on one antibiotic, and responded
well at first, but her infection seems to have returned. We hope that she will
soon be placed on a different antibiotic and that a trip to a specialist for an
ultrasound to rule out bladder cancer isn't a necessity.
The thing Patrick and I have learned in the course of fighting for Bonnie's
health is that adrenal exhaustion is a difficult area to find good treatment
locally. Most people who have a pet diagnosed or suspected of adrenal exhaustion
and/or SARDS will have to be willing to be an informed consumer with their
veterinarian and to push for appropriate treatment. In our case that seems to
involve contacting specialists for advice as each new problem developed and a
combination of both diplomacy and pushiness with our own local vet. We continue
to hope that the end result will prove Bonnie to be the big winner for our
efforts.
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