Canine Autoimmune Hemolytic Anemia (AIHA & IMHA) - SWAY - desperate situation

i am in dire need of help. sways body continues to stay anorexic, stay cachexic...whatever u want to call it...but she is not gaining any weight whatso-ever. you can literally see every single bone in her body. due to this continuing issue, and the frequency of her water intake... we have done numerous things over the last few months... weve had her tested for cushings and etc, nothing shows up in her results. her kidney levels are also fine in her blood screens. she was drinking/peeing very often so she was diagnosed with 'Diabetes Inspidus' a few months ago... this is the lesser of the 2 evils when it comes to diabetes, as the results showed she did not have Diabetes Mellitus. i had stopped ALL medicines and supplements since end of November (prednisone, soloxine, tylosin, cranberry extract, vitaminB12, pet-tinic), so now the only thing she is getting still is the anabolic steroid injection. we had a SNAP 4DX test done to test for Heartworm, Ehrlichia canis, Lyme disease and Anaplasma phagocytophilum...these results all came back fine as well. we did a food change, this has not helped either. ...all the while, her PCV has remained steady at 25% (which is the only good thing that continues to go for us)...if u have followed sways case, u know 25 is a great number for her although i know its not high in the general scheme of things. its almost like i want something bad to show up in the results so atleast WE KNOW WHAT IS GOING ON!!! i cant verbalize how frustrating it is to have nothing show up ever and just go blindly thru this. my dog is a walking skeleton most of the time, and its almost unbearable for me to take considering this has been going on so long. her body has been this way, on and off since being diagnosed in june of 2007. sure, she has made numerous strides...but her body has always been slow to respond and there has never been considerable muscle growth since. i literally feel like ive been in a time machine because this stuff is just 'normal' to me now, i dont even know when it started or when it stopped because its just BEEN. she gets better at times and looks damn good...and for months out of this year i felt like visually she looked tremendous considering where we had been in 07. but then she looks terrible on days and those days are coming more and more frequent now. its insane because she can look plump one night, and then wakeup the next morning and it looks like she lost 10 pounds over night. the way her body looks has always been attributed to the blood disease, so months went on and that was easy to chalk it up to. but now, 19 months after being diagnosed...her body continues to look ravaged and skeletal. ive been pushing my vets over the last few months to try and figure this out, but there major concern continues to be her blood levels and the fact that it is still holding. plus when the vets see her she tends to be over excited and in a snapshot she looks pretty decent, considering they have definately seen her at her very worst and in comparison she seems well. but i live with her 24/7, so i see what her body has been morphed into... its hard to verbalize all of this, the main response is that everything else seems to be attributed to some form of this disease or a side effect of the meds or etc. that is the main reason why i stopped the prednisone. but at this point i have had enough of going this course of acceptance and hoping her body will just recover..... it just hasnt recovered!!! im not allowing this to continue to be the elephant in the room, i cant just settle for a decent blood drawl without having her body recover with it. i need answers so bad. i dont know what to do. i feel so bad for sway. she is the same loving sway, she can still move around rather well and just has been a champ thru all of this. and my vets have been excellent thru all this too, i dont want this to be a poor reflection on them because they have given and continue to give sway life and i am forever indebted to them for that. the line of communication is always open to them, and im so thankful for my situation, but at this point it really seems like everyone all around is at a loss for why her body is how it is... there is always more ultra sounds or more high end tests that can be run, but truthfully i am so financially drained that i dont want to take that risk and then not have any money for sways actual treatments and our living situation. Patrice- dr dodds and dr woods have both said that they DONT think this is Portosystemic Shunts... i say that because i know u wanted me to ask them that, and after reading about it..i tended to agree with you and think that it might be something sway has...but they said the chances are extremely unlikely. sway had that patch where she stopped eating all together, but after about 4 days of manually force feeding her...weve now got her to a point where she is eating decently again. i know this is super long, sorry for my update being so all over the place... im just at a loss... here is a picture that gives sort of a visual timeline as to how she has looked over the past few months- http://farm4.static.flickr.com/3077/3171697893_1d4bf8c691_o.jpg

Josh California

Josh, Sounds like a horrible situation! I'm certainly no professional but I do know that pred can cause muscle weakness and also cause water retention. Has your vet done any radiographs?

Susie Delaware

susie- yea pred comes with a bucket of side effects... but honestly, sway has been on a very minimal amount of prednisone this entire yr... like less than 5mg every other day, and that got reduced to 2.5 every other day like 6 months ago.. i stopped it all together in november just to get it out of her system completely. they have not done any radiographs this year

Josh California

Josh -- Having viewed the photographic essay of Sway's deterioration, I understand the distress in your posting. When healthy, Sway was absolutely beautiful, and now it is painful to see her. She actually looks better now than she did around Thanksgiving, but her physical condition is sad. The condition that Patrice suggested sounds like just another nasty curveball for you and Sway. The write-up I read indicated that a low protein diet with antibiotics and lactulose could help reduce the strain on the liver and the amount of toxins attacking the cells. You say that Dr. Dodds pretty much ruled out portosystemic shunts, but did she say anything about trying a diet that would be consistent with such a diagnosis to see if the diet had any impact? I pray that the new year brings good news to you and Sway. The two of you also are some of our most determined and inspirational fighters against IMHA. But I also understand your love for Sway is so strong that you cannot be cheered by a stable PCV when she looks so unhealthy. I know you guys live in Southern California, but I also wonder if Sway should wear a coat. She has no body fat to insulate her from cool temperatures or to cushion her if she runs into anything. She looks so sweet, innocent, and trusting.

Brenda VA

Hey Brenda, yea we have had her on a low protein diet for the entire last year...that was one of the first things dr. dodds had me do. she was on holitique blendz and now is on wellness core reduced fat. thanks for the kind words about her, she is definately the sweetest dog so we are gonna fight this thing all the way. i just feel so helpless sometimes because its like something is flying under the radar and nobody can pinpoint it... and every day i go forward it feels like im sitting on my hands i just want her to fully recover, its been so long.

Josh California

josh, these photos are so heartbreaking, but you can see her fighting spirit in her eyes. Is she eating? Can you put her on a higher fat diet - you have probably tried this but just wondering, especially if other tests have ruled things out. The first photo reminds me of Tess when she was on the heaviest dodes of prednisone, the vet called her head "the dinosaur fin". Our thoughts are with you, sending love and licks from Tess. Claudine

Claudine Burlington

Josh, I'm just so sorry that Sway is having these problems. I know it is rough on you and that your heart is breaking over this and not knowing what to do to help her gain weight. If she's on a low protein diet, does that rule out meat? Our holistic vet has put Darcy on a homemade diet of meats and veggies, but I am still adding in some Paul Newman kibble. Perhaps you could talk with someone at a health food store that carries supplements for pets and they could offer some advice. I wish I knew what to tell you to do, but the only thing I can do is pray for you and Sway and I will certainly do that. We are pulling for Sway. Karen

Karen NC

Josh, I'm crushed...Sway is so beautiful, it's just not fair that she has had to endure so much. The thing about pitties is that they are so strong and so stoic, it's hard to ever believe that they are suffering. And, they always have such light in their eyes, no matter how desperate the situation is. I have nothing scientific to add, only love and strength sent out over the cyber universe. I know this is completely unconventional, but have you considered or tried a pet 'communicator?' I've often thought about it during trying times, especially in the beginning, but I never went through with it...perhaps it would bring some unexpected answers, comfort, ideas? There is really no easy way to ask you this, but have you looked deep into Sway's eyes and asked her if she wants to continue on this journey? I hope I don't offend by asking this and I'm certainly not suggesting that it is time to consider this, I am just wondering if you have been able to communicate with her on this subject. I am so sorry Josh. You both continue to amaze and inspire~ I really wish the best for both of you, and for some resolution to this mysterious part of the struggle for her. All our love, melissa and tiggs

melissa slc

Josh, I am so sorry that this is happening to you. I know you are trying as hard as you can. Don't forget that it is upsetting you far more than it upsets Sway. She is just happy to be around. I have another idea that you can try. It won't hurt Sway in any way and might help her put on some weight. There is a condition called EPI or exocrine pancreatic insufficiency. The main problem will be that no matter how much the dog eats, they lose weight very rapidly. The problem is that they are unable to digest their food properly so it basically just moves through the body not delivering the nutrition through the intestines into the cells of the body. One element of this treatment is to supply those digestive enzymes with each meal so the food *is digested* and the *nutrition is delivered to the body.* These serious enzymes are called Viokase. The lucky thing is that you don't need a prescription. The bad thing is that it is very expensive. There is a generic called Bio Case that will work as well and is cheaper. I will include both links so you can see what you think. http://www.bullwrinkle.com/ShoppingPages/bio_case.htm http://www.bullwrinkle.com/ShoppingPages/viokase-v.htm I recommend you try this. It may not solve the problem that is causing this, but it will provide Sway with more nutrition and she may gain some weight. Again, this won't hurt her in any way and may help. I use prescription digestive enzymes. thinkin about you everyday patrice Here is a snip from Mary Strauss's website where she talks about this in great detail. http://www.dogaware.com/specific.html#ibd "Symptoms of EPI include INCREASED appetite; huge fluffy, smelly, gray or yellowish stools (often described as "cow patty stools"); frequent defecation; weight loss; gas; and loud stomach noises (called borborygmus). The dog's pancreas doesn't produce enough digestive enzymes to break the food down and therefore no matter how much they eat, they can't digest their food and therefore they are literally starving. Loss of weight can be rapid. EPI is most common in German Shepherd Dogs, but occurs in other breeds as well. Dogs with chronic pancreatitis have an increased risk of developing EPI. A blood test called TLI (trypsin-like immunoreactivity) is used in combination with tests for Folate and Cobalamin to confirm a diagnosis of EPI. This condition is treated with prescription powder enzymes, such as Viokase. Viokase is hundreds of times more potent than the standard digestive enzymes you would find in a health food store. Viokase is very expensive, but there are generic equivalents such as Biokase that are a little cheaper. Once your dog is stabilized, you can also try reducing the dose to see if the improvement can be maintained with less, as dosage needs often decrease over time."

Patrice NYS

Hi there. I can see why you are so concerned. Poor girl. But, how lucky is she to have you! Anyway, I wanted to ask how long she's been off Prednisone for? Because Willow gained weight only after she started weaning off and stopped it altogether. I was so worried while she was on it because I had heard she was supposed to put on weight and she actually lost. But, once she stopped it she went from like 44 lbs to 53 lbs very quickly. She's never been this heavy! I hope you can get to the bottom of this. Lori

Lori USA

Hi Josh, I just wanted to send a good thought that you can help Sway out - I know that you are trying absolutely everything that you can. I saw Sway's pics - she is a darling who looks like she has been through a great deal. I also wanted to add to Patrice's comments on EPI. Dogs with EPI can sometime develop 2 auxiliary problems which affect how food is absorbed - one is low vitamin B12 and the second is small intestinal bacterial overgrowth (SIBO). My dog Benson had EPI which was successfully controlled with Viokase. He also had problems with low vitamin B12 and received vitamin B12 shots. SIBO is usually treated by an antibiotic. As Patrice mentioned, you can start giving digestive enzymes. If you want to do diagnostics for any of these, the tests are done by blood tests only. Josh, keep us posted - we are all pulling for you and Sway. Take care, Aden

Aden Jerusalem

Josh, Sway is really a pretty girl!! You were such a help to us when Alex was really sick several months ago that I wish I had some insightful advice to help you. Unfortunately I don't but all I can offer you and Sway is our best wishes and prayers. Chris & Alex

Chris Pa

Hi Josh. Like Chris, I don't have any suggestions that might help, but just want you to know that I'm thinking of you and Sway and praying that you find some answers soon. Please give your sweet girl a hug from me. deb and Duck

Debbie BC Canada

I would difinately check out the pancreatic deficiency and that test that Patrice posted about. Ask your vet about starting on pancreatic enzymes, I believe thats the viokase. Wylie is on a similar version called pancrezymes. Heres a thought too, could Sway have imbalanced hormones? I was watching the news this morning and they were showing Steve Jobs the CEO of Apple how he has been wasting away for the last year. He is almost anorexic looking compared to a year ago. They finally found out he has imbalanced hormones causing this drastic weight loss and he is now under treatment. So I was thinking could this be it since Sway is on anobolic steriods. I think also taking her off all supplements was a good idea to rule out. I went thru a similar problem with Wylie, nothing as drastic as Sways weight loss, but she did lose 10# in a month and we went thru almost every test out there, turns out she had a reaction to the denosyl she was taking and as soon as she went off that she started gaining weight. Laurie

Laurie CA

We are keeping Sway in our thoughts and prayers and hoping a correct diagnosis can be made and the proper treatment found. Sending prayers your way, Cheryl & Ginger

Cheryl & Ginger Pineville PA

Josh, Just in case you want to look into the Standard Process formulas (Darcy is on quite a few), here is the website: www.standardprocess.com Just go to the Veterinary Formulas Small Animal section. If you click on Small Animal Technical Support, you'll see info about Tom Cameron, DVM. You can email him any questions and he is always quick to respond with suggestions on what formulas to use. Be sure to tell him about the anabolic steroid shots Sway is on and any other meds. I found out about Standard Process from my local health food store. They stock all of the Standard Process and have sales people who are very knowledgeable of the products. The sales person who helps me has non-regenerative anemia and he uses the SP for humans and swears by it. He's never had a transfusion and is not on any meds. I can't promise that this is the answer for Sway's weight loss problems, but it's worth a try to ask Dr. Cameron for his advice. God Bless, Karen

Karen NC

Dear Josh, I am heartbroken to read your post, and the pictures are very disturbing. I wish i knew of something that could help, but I just dont. Kent lost 10 lbs over the last three months, from 35 pred high to 25. In our case, we had an idea why at the end. I hope you can resolve this with Sway long before thats the case. What are you feeding her? Patrice has good advice re the pancreas enzymes. Prayers, Christine

Christine FL

I really doubt that it is EPI and Dr. Dodds is right, there is no way it's portosystemic shunt. What is her glucose level? Is she eating a diabetic friendly food? I would HIGHLY recommend survey rads be done to rule out any tumors or other issues. Keep us posted. Fingers crossed. I see you're in CA, what area?

Courtney SLO

What about getting your vet to talk to UC Davis, they are one the top teaching hospitals and they do phone consults. May be worth a try Laurie

Laurie CA

Hi Josh, Our hearts break for you and for Sway in her continuing effort to become once again healthy! She is such a beautiful girl and has been through so much as you have right beside her. Will be praying that Patrice's suggestions will help Sway in her fight. Please know you are always in our thoughts and prayers, both of you! Linda

Linda Sapphire

Just wanted to send you strength and good wishes for whatever lies ahead. Sway looks like a real sweetheart and quite the trooper for what she has been thru. She is blessed to have someone who cares about her as much as you do. Hugs, Irene

Irene Arizona

When Maddie was going through this, she also had lost a lot of weight and wasn't recovering as quickly as I expected once she was over the hump. We discovered that she was allergic to beef amongst other things. (I already had her on a grain-free diet since wheat, corn, soy, rice, etc. are frequent allergens for dogs and cats.) She's now on a fish-potato diet and everything has improved. All this to suggest that perhaps she's allergic to something she's being fed. Best wishes to you and Sway. She was diagnosed around the same time Maddie was, so I've always felt a connection to you and her.

Ruth Aptos

I have to second (or third, or fourth) Patrice's suggestion on providing digestive enzymes. Ethel was very thin when we brought her home after her hospitalization and was passing undigested food and continually getting weaker. Supplementing her food with enzymes really gave her energy back very quickly.

Brian Vermont

Brian, What a wonderful thing to hear about Ethel! Do you continue with them now or is she past the point of needing them? And yes, Ruth, you are very right, dogs can have multiple food allergies that lead to all kinds of problems like diarrhea and malnutrition. I figured out very early in Chance's life that he just did not like, and in fact refused, chicken. I have avoided it all of his life. Cassie, on the other hand, loves anything that has chicken in it. Go figure. Elimination diets are the way to discover this kind of allergy. But they can extend out to several months and are very hard to follow. Sometimes using common sense and removing suspected foods that can cause allergic symptoms will work well enough, which you discovered. Grains of any kind are big culprits in canine diets. I have had both of my dogs on grain free (homemade) diets for most of their lives. There are several kibble foods on the market that have just come out that are grain free and I understand from reading on k9nutrition that many people are having great success with them. Supplementing with digestive enzymes (and seeing results) doesn't necessarily indicate any kind of diagnosis. It does help the body digest food and make the nutrition from the food available while you sort out the diagnosis. Sway had several bouts of pancreatitis last year and was also prescribed Tylosin as an anti-inflammatory for colitis. (see: http://marvistavet.com/html/body_tylosin.html) This leads me to believe she might need a little extra digestive help now. She clearly needs to put on some weight, regardless of what else may be going on. The enzymes will not hurt her and may very well do some good. Luckily, canine enzyme products are available without a prescription. The enzymes I take are prescription only and very expensive even with health insurance. These help me at least keep my weight stable. my best patrice

Patrice NYS

Josh, I just wanted you to know that you and Sway are in my thoughts and prayers. I have been silently following your's and Sway's story, and I know how agonizing it can be. I have used digestive enzymes on one of my older dogs, and it did help her tremendously. She had suffered two bouts of pancreatitis, but eventually bounced back. Gook luck and hang in there - have give Sway a kiss on her nose for me! jeanne and matilda

Jeanne Texas

Patrice, We have indeed continued the enzyme supplementation. We think it was the most critical when she was coming out of the initial crisis, but while she stayed on azathioprine we felt it was indicated due to the pancreatitis potential. Now that she is off the azathioprine, we're planning to continue it for at least another month. If anybody is interested, we have been using Pet Guard Natural Digestive Enzyme Blend for Dogs. Non-prescription, found at a natural-foods type store. We use about 1/16th of a teaspoon with each meal.

Brian Vermont

sorry i have not responded- have been away from the computer--- claudine- thanks. she is a super picky eater, we are doing our best under the circumstances i guess... she eats like once a day and she is doing better than she was say a few weeks ago karen- every other night i give sway natures variety chicken patties instead of the core wellness kibble...so she gets some meat, low protein hasnt isnt our strictest focus right now so im giving her just anything i know she likes but still trying to balance the health aspect also. melissa- yea, me and sway are super close and i know she wants to be around...you didnt offend me by asking btw, i hope tiggs is good... patrice- thank you for those links...i am going to look into buying that stuff tonight, im gonna read everything now and will probably come back around here with a few questions about it...hopefully u will be online!! lori- she has been off prednisone completely for atleast 6 weeks, and before that she was only on a super-minimal dose of 2.5mg every other day...so i would assume that these problems are just coming from being on all these things for so long... sway has survived this thing for over a year and a half now, but yet her numbers have never even reached 30 yet...so she has had her fair share of different things consistently to be on... i cant point to what specifically has created this situation where her body is unable to recover but id say its just the longterm effects of some of these things. aden- sway has actually been getting shots of b12 and iron once every 3 weeks for about the last year...i actually just decided to stop them as well, when i stopped everything else...because i cant point to anything other than that durabolin and say i know for sure it was helping. ive always been concerned about SIBO and have inquired about it to my vets in the past...i am going to have to bring it up with them again chris- thank you debbie- thanks!!! laurie- yea, the night i read ur response i got a email from natural news that detailed what steve jobs was going thru...so strange.. i agree, its worth bringing up... i am going to ask dr. dodds about it for sure cheryl- thank you... karen- thanks for this info also, i will go check out that site tonight and try to get a response from that dr. christine- thanks... sway is getting wellness core and then she still gets the natures variety patties as well...i am gonna order what patrice suggested tonight. courtney- her glucose was at 130mg/dl at start of november - her ALT was at 195 ...those are the 2 things that were high. she is eating Wellness Core Reduced Fat Formula now, she used to be eating Solid Gold Holistique Blendz for most of 2008. i am from california, actually live in costa mesa--- laurie- we have no tried that but might consider it going forward if these enzymes dont help linda- thanks :) irene- thanks also, i appreciate everyone kind words towards sway ruth- yea, there is just so many things that this could possibly be...it makes it so overwhelming... on beef specifically, sway doesnt get beef at all and really never has...she is also on grain/corn/wheat-free food as well. i really hope that we pinpoint this soon tho... brian- i am definately ordering the enzymes tonight to see if this helps... i really respect anything patrice says so im going to try it for sure. sway has never had huge stools however, and has never passed anything that was undigested per-say like your ethel had... but i know how each thing can effect each animal differently. patrice- i agree with what u said here fully, even if the diagnosis were to come back as a negative...at this point it doesnt hurt one bit to try... maybe $ wise but sway goes beyond monetary worry for me so im going to try it for sure. fyi, ....i also stopped tylosin powder at the start of december, when i stopped everything else... im curious to see how sways blood continues to come out with everything stopped...last sat the 3rd she was still at 25-26% jeanne- thank you very much for your thoughts... brian + patrice- when we are talking about this viokase thing i am getting...how much per meal is used? sway at this point weighs probably 27 lbs. thanks for everyones concern and again, sorry it took me a day or 2 to get back on here- i am going to present pieces of this info to dr. dodds and woods and i will update when i hear back for sure

Josh California

Josh, I don't post too much any more but do think of you and Sway often. When Cody was so ill, the one food that ALWAYS had him thrilled to eat is The Honest Kitchen dehydrated raw. You just add water and it rehydrates to an oatmeal consistency. It has all the benefits of raw and most of the varieties are complete. Made in a human foods plant in San Diego. They are super nice people and I'm sure would be glad to answer any questions or express you an order. Their site is www.thehonestkitchen.com I will be thinking of you and Sway and saying some prayers that she can turn the corner and gain some weight and strength.

Betty Dallas

Josh, Here's a capsule version of Bio Case that's a lot cheaper ($12.99 plus shipping). I am not sure if they have the same effectiveness as the powder being mixed into the food ahead of time. But it won't cost you a lot of money to try this for a month. If it seems like it is working you can think about trying the more expensive powder. You give 2-3 capsules before meals. The three ingredients are porcine enzymes and are exactly the same as I take. The difference in these brands it the actual quantity of each of the three enzymes. http://www.healthypets.com/biocase60.html I have Honest Kitchen dehydrated raw stored in my cupboard for emergencies. It is very expensive but many people find this an excellent substitute for raw when they travel (as in show dogs etc). Whole Dog Journal rates them very highly. I often get sales mailed to my email. patrice

Patrice NYS

Josh, I am so sorry and have you and Sway in my prayers.

Jess Armstrong

Hi Josh, Just to clarify, I wasn't talking about the same product Patrice was -- we felt like we had to get something for Ethel very quickly, so we picked up the first (only) thing we could find at one of the local health food stores. I think the key thing is getting the enzymes into the dog so they can start absorbing some nutrients, rather than the particular product -- I would choose whichever you can find most quickly with the furthest-out expiration date. The one we have been using works for Ethel, but unlike the Bio Case V that Patrice referenced, ours doesn't have the details of exactly how much of the enzymes are contained in each dose -- I always prefer products that give as much detail as possible, and probably wouldn't have selected the one we're using if it weren't an emergency at the time, for just that reason. For what it's worth, the Pet Guard 'Natural Digestive Enzume Blend for Dogs' contains: Bromelain, amylase, cellulase, lipase, acid protease, alpha galactosidase, phytase, along with L. acidophilus and L. bifidus, and indicates it was produced from non-animal sources and is free of dairy, yeast, and soy. It was less than $20 for a 4oz jar at a relatively expensive store. For a 15-30lb dog like Sway (and Ethel), the bottle says to use 1/2 teaspoon of the powder per feeding. It also recommends beginning with half-sized dose and slowly moving up to the full dose, and says that older dogs often benefit from a smaller dose -- that's why we have only given 10-year old Ethel between 1/16th and 1/8th of a teaspoon. We started Ethel on just a pinch of the stuff at first, but it quickly gave her more energy and reduced, then eliminated the (ahem) coprophagia habit she picked up after digesting so little food. I have never noticed any problems I would attribute to using too much of the enzymes. After using it for five months or so, we have gone through maybe a fourth of the 4oz bottle, so it goes a long way. Keeping you and Sway in our thoughts!

Brian Vermont

Josh, The very best digestive enzymes/probiotics I've found is by Natures Farmacy (www.naturesfarmacy.com). It is the Dogzymes Digestive Enhancer. It has a stable shelf life and is the most potent formula I've found. It also is a very good buy... I buy the 2 lb size ( for around $35.) and it lasts my 4 big dogs about 5 months. I learned about it from several of the breeders on the golden retriever forum. And, again, they are very knowledgeable and nice people and I'm sure would work with you and Sway.

Betty Dallas

The difference between the products we are both discussing is very big. Bromelain is from pineapples and is a common ingredient in the kind of over the counter digestive aids you can buy at health food stores. The other ingredients are also from non animal sources. They are very safe and do assist with digestion. I was just reading the PDR for bromelain last night and was amazed to read about all the qualities that are attributed to it. The type of enzymes that I use and what is in Bio Case are of porcine origin. They are the "heavy guns" in digestive enzymes. Folks who either have insufficient pancreatic enzymes or who have no pancreas use these. That is why you see the actual quantity listed for each "ase" Bio Case: Lipase 56,840 USP (digests fats), Protease 434,000 USP (digests proteins), Amylase 495,000 USP (digests starches) They do most all of the digestion, with very little assistance from the pancreas. Human enzymes are prescription and the levels of them are rated according to the quantities of these three ingredients and are enteric coated so that they become available to the small intestine. It seems that the delivery for canine digestive enzymes is a little different, probably due to the difference in transit time for their digestion process. patrice

Patrice NYS

Josh, I don't really have anything to suggest but wanted you to know I am praying and thinking of you and Sway. Penny

Penny Lytle Creek Calif

Josh, You and Sway are in my prayers. As you know my Brandi's fight was a pretty short one but I know I'd be frustrated like you. You've gotten lots of good advice and hopefully something will help put some weight on Sway. Sway doesn't know she looks any differently than she did before she became ill. Dogs live in the here and now so for them that's an advantage they have over us. I'm hoping you'll find an answer to the underweight issue and Sway keeps doing okay or better in 2009. Teresa

Teresa Oklahoma

Josh, Patrice is right, there are different digestive enzymes and ones specifically pancreatic enzymes, make sure get get the pacreatic enzyme This is what Bio case has in that is equeveilant to Viokase and Pancrezymes and these are the ingredients you look for Each teaspoon (2.8 gm) contains: Lipase 56,840 USP Protease 434,000 USP Amylase 495,000 USP B Naturals carries one but I dont know how to equate the measurement of USP to mg. There must be a huge difference in the dosage because the Bio case is $79 and the bertes zyme is only $14 Bertes zymes Ingredients: One capsule contains Pancreatin (100 mg), Pepsin (100 mg), Ox Bile Extract (60 mg), Papain (50 mg), Pancreatin (100 mg), Pancrelipase (50 mg), Amalyse (48 mg), Bromelain (40 mg), L-Glycine (32mg), Betaine (30 mg), Typsin (25 mg) Good Luck Laurie

Laurie CA

Josh: Just wanted you to know that we are thinking of you and Sway and hoping for the best. We saw in your post to Karen that you had Sway out for a ride last night. That's great news! Hope you get some answers - we're praying for you guys. Rita, Mike and Sheba

Rita IA

Josh: I am Sue and Drago was diagnosed about the same time as Sway. My thoughts are with you and I am sure you and your baby will make it thru. You know I have read about all the special diets you have tried, have you just ever tried ordinary red meat? I would go the the grocery store and just start buying a little of everything to see if you can find something she will eat. Yogert, is always a favorite when they are sick. She might suprise you and eat something that you would never think a dog should eat. Lots of luck. Sue

Sue K PA

thank you for all the kind words spoken here about sway... i just wanted to note that i did order the BIO CASE V Powder so i am just waiting for it to get here... dr. dodds told me that she thinks sway will begin to put on weight slowly without it, and told me i should wait a few months before trying the pancreatic enzymes... im assuming she is basing this off the fact that we just stopped everything at the top of december and she is wanting to give it time before adding something else into the picture. dr. woods thinks that adding the enzymes would really do no harm and might just be what sway needs- so anyways, i went ahead and ordered it... i plan to start them when they get here, under the thought process that at the very worst it does nothing and if it helps in any way then it couldnt have come soon enough. she continues to eat pretty decently, but still no weight/body gains that are visable. im also monitoring her blood more closely now that her meds/supplements have been stopped...she will get another PCV on saturday. she was 26% on the 3rd.

josh california

Josh, You probably already know this, but just in case you don't, you need to add the pancreatic enzymes to food that has been ground up--sort of making it easier for the enzymes to "predigest" it--and letting it sit with the enzymes on it before feeding it to Sway. When Maddie was so ill, and before we knew exactly what was wrong with her, one of the theories was EPI, so I looked into the pancreatic enzymes. Since that time, another friend with a Newfie had her dog diagnosed with EPI and she has been dealing with the issue for over a year. It's not easy to get it right, from what her experience has found. Good luck for continued success with Sway!

Ruth Aptos

Josh, Just wanted to let you know that I'm thinking of you and Sway and holding you in my prayers. I believe enzymes are good for animals and humans. They help the body absorb much needed nutrients and I know that they are essential as people age and their bodies fail to absorb the nutrients. I take them before all of my meals and was thinking today about giving them to Darcy. I'm going to ask the vet about that when she comes out on Friday to give the anabolic steroid injection. Are you still giving Sway the anabolic steroid shots? My vet said that the solution is very thick and that she has to give the shot in the muscle. She made it look hard to do. I thought that she would show me how to give the shots, but she must think that I don't have sense enough to do it. Either that or she likes giving them so that she can make more money. Anyway, Darcy has three more shots to take, according to Dr. Dodds recommendation. Darcy's PCV last week was 23%, but I'm not having it tested this week. I hope the BIO CASE does wonders for Sway. Karen

Karen NC

karen- thanks... sway is still getting the steroid injection, every saturday... your vet actually charges you to give the shot? wow, thats kind of lame... ive taken sway in with my meds and dr. woods gives it to her free of charge every single week. and he did teach me how to do it also, but i choose to go in and have him do it instead because i know it needs to go directly into muscle and sway is very skeletal. since its such a vital part of sways defense of this disease i didnt wanna take any chances on missing the muscle.

josh california

Josh, It seems that California is blessed with the best vets. I haven't found a single vet here in my area of NC whose main interest isn't lining their pockets. Even the holistic vet that I was so thrilled about has disappointed me. She charges $34 to make a house call, then adds in examination fee and charges $15 to give the shot. She made a big deal of telling me that she didn't charge for the solution because I ordered and paid for it myself. When I take Darcy to the office the vet works out of so that she can do the PCV test, she charges $20 for the PCV, $15 for the shot, anywhere from $35-$50 for an examination. I noticed a courtesy charge of $32 tacked on when I went to the office. I questioned this and she told me that was for her coming in to the office! And she had already told me that she was working in that area that day, so I know she would have gone into the office anyway. There were two reasons that I chose to get a vet who makes house calls. One was that Darcy gets so stressed out whenever I take her to the vet and the other was that if the time comes (and I hate to even mention this) that she is to the point that a decision has to be made, I wanted her to be at home, where she feels comfortable and loved. Now the vet tells me that she will only come out during regular working hours (that is if she's available) and that if it's after hours I'd just have to go to animal emergency. I'm really disheartened over her lack of compassion. Count your lucky stars that you have such a good vet.

Karen NC

Karen, I hear you here in NC, and yes you are correct the vets are only concerned on lining their pockets. On Monday when Holly went in for her superchem and CBC it cost $126.50 and we don't even see the vet, this is just for the blood draw and the tests. Linda

Linda Sapphire

Yes Linda, NC has some greedy vets. The specialist's office always charged me $59.25 for the CBC that goes to Antech; $120.00 for the cyclosporine level test that goes to State; $20.00 for inhouse PCV, and an exam recheck fee of $52.00. I questioned that recheck fee one time because the specialist didn't even see Darcy and their answer was "The doctor will be calling you to give the lab results and that will take care of the exam fee." No wonder they suggest coming in every week to have PCV levels checked. One time I asked if they would cut some pills in half and they said they'd be glad to do it but it would cost $10. I regret not having insurance coverage, but if the vets have any connection with that then I'm sure the premiums are extremely high.

Karen NC

this is sway today- http://farm4.static.flickr.com/3491/3200464494_c9952c3b93_o.jpg these pictures could pass for most days out of the last many months. her pcv stays the same, there is no meds anymore to dwindle her down, ... im so overwhelmed by all of this, so incredibly overwhelmed by why her body is just failing her. she cant gain any weight or body mass whatsoever, how in the ____ can this happen? im just waiting on these enzymes to show up in the mail and feeling like if this doesnt help then i wont know what to do.

Josh California

Hi Josh I found this recipe online that is supposed to help put weight on dogs, it seems like it is not to hard to make and maybe worth a try, I would introduce it very slowly though so it does not upset Sways stomach. http://www.njboxers.com/satin-balls-recipe.htm I am not sure how much exercise Sway gets but would it be possible for you to cut down a bit until she can put on a few pounds. Also puppy food has a higher fat content then most adult foods. You might also want to try to contact Monica Segal http://www.monicasegal.com/aboutus/aboutus.php She is a dog nutritionist you can read more about her on her website and she does phone consultants for a fee of course. A few others have also mentioned food from the Honest Kitchen and I too have used this and found their food to be excellent. It is expensive though. It does come from California and I have found for sale in few of the better pet stores here in PA. What is Sway eating now and how many times a day does she eat and how is her appetite? Hang in there and keep on doing your research as there has to be an answer. Keeping you and Sway in our prayers Cheryl & Ginger

Cheryl & Ginger Pineville PA

Josh, Maybe Sway needs a diet higher in protein -- fresh chicken, beef, etc. mixed in gradually with some of her regular kibble so she doesn't get an upset tummy. I feed Darcy three small meals a day -- a little kibble, chicken, beef, organic canned liver, frozen peas, grated carrots. This may sound crazy, but have they checked her stool for worms and/or parasties? Also, did you ever contact the vet at Standard Process products? Perhaps he could offer some helpful suggestions. My best to you and Sway, Karen

Karen NC

hey karen- yea i did contact dr. cameron... he emailed me back and asked for very specific details so it took me awhile to get sways story together in a fashion that was readable...i would assume he will email me back today or this weekend maybe. i know having her eat that many times would be wonderful, even if i changed her diets up and etc but sway doesnt and has never ate 3 times a day and wouldnt go for it even if i forced her to. ive definately tried before, and in the past when she has refused food and i have to end up forcing it down her throat.. that creates a situation where she then even quits taking the initiative to eat all together, even on her own will. it is sometimes an impossible task to get her to eat a full meal once a day. she is very picky about when she eats and how she eats. over the past month i have her again taking an interest in food during dinner time and she has been eating a full meal. she is just usually 100x more interested in water than food. cheryl- thanks for the recipe, it definately looks interesting-i will check it out. about sways exercise...she really doesnt get that much exercise... i know i mention bike rides sometimes but these are just basically 'walks' where i follow her with my bike and we have our little paths picked out and she isnt really strained at all by them. i am definately mindful of her limitations and outside of that or possibly a walk around the beach she spends most all of her time just hanging out in my apartment. sway is eating a mixture of Wellness Core reduced fat & Natures Variety patties.

josh california

Josh, can feel your agonizing pain watching Sway's body shrink without a definitive answer. Was just wondering of dogs, similar to people (there is much documentation of people dropping large amounts of weight via this allergy) can have a trigger to CELIAC disease (t-cell mediated response to gluten peptides found in wheat, barley and rye... In that case recommended is a gluten-free diet along with iron supplements. Does the ingredients on the label of d-food you are currently feeding Sway reveal the inclusion of wheat, barley or rye? Also, you mentioned stopping the Pet tinnic. Was this a recommendation from one of your vets? Also, wanted to ask if you have done a stool sample lately? I couldn't believe my eyes last spring, but both my dogs (because it is contagous) had TAPEWORM. Interestingly (and frustrating!) enough stool samples don't always pinpoint the parasite..if you do not get a sample with the blasted tiny spec of the worm. But, I visually saw it (yech!) so I knew it was present. Was very concerned about treatment especailly for Choe, After research gave them both panacur treatment, not drontal said Dr. Dodds (for an AIHA patient). Thinking of you....Jan

Jan philly

Gosh, I thought I posted this, but when I checked back I couldn't see it, so here goes again. I second the use of the satin balls above. It is a complete and balanced diet and many breeders and those in rescue swear by it's ability to put weight on dogs that are stressed or ill. I learned about it on the golden retriever forum. We think of you & Sway daily and send our prayers.

Betty Dallas

Betty.....I can understand all the ingredients being potentially helpful in satin balls...but feeding it RAW? That would give me pause, especially for a immune compromised dog. How does one know the (uncoked) hamburger meat is free of samonella and other harmful bacteria? Jan

jan philly

Jan.... I think for an immune compromised dog I would lightly cook the meat... just MHO.

Betty Dallas

Hi Josh - I read the posts every day but don't post too often anymore, as Murray's case was so atypical, like Sway's. But I remember at one point we were both interested in hearing more from Patrice on EPI. Today, I saw an article in Whole Dog Journal (Jan '09 issue) on homemade diets for dogs with EPI, IBD, pancreatitis, related conditions and one case cited was a dog who wouldn't eat. From your description, it sounds like that's the first challenge you have with Sway. The author, Mary Straus has a website - DogAware.com (she's in the Bay area). If you'd like any details from the article, email me at bonnie.white@yahoo.com. I hope you find some help for her - Sway is lucky to have you in her corner. Bonnie

Bonnie Chicago

Bonnie, I concur about WDJ. I just got my copy in my email a few days ago. Mary S is tops on my list. WDJ is an alternative dog magazine well worth the money. I have a number of years of issues. I have heard the pancreas described as "the angry organ." I can say personally that this is very true. Chronic pancreatitis is excruciatingly painful. When I am having a flare, I have absolutely no interest in eating. I can drop 4-5 pounds in just a week. If I am careful to take enough of my enzymes and eat a low fat diet, I can avoid these flares. If there is a chance that Sway is having attacks like this, it's no wonder she isn't eager to eat occasionally. Without some way to calm the pancreas, these attacks would continue. The idea of using enzymes is to allow the pancreas to rest, or stop the call from the small intestine for digestive enzymes to be made. Pancreatitis can occur when the enzymes it is making are not released properly from the organ and they begin to "digest" the pancreas instead of food. In addition, the pancreas also produces insulin, which aids the body in storing blood glucose. If this process is faulty, the result is diabetes, or too much sugar in the blood. It's a very important organ. It may take several weeks of a lowfat diet and enzymes to calm the pancreas down. Meanwhile the food will hopefully be digested and made available to the body for nutrition. I have my fingers crossed that this is all that needs to happen. patrice

Patrice NYS

Wouldn't an amylase/lipase blood test show for certain whether or not Sway was suffering from pancreatitis?

Jan Philly

I can't say for sure. I know that there are many people who suffer the same symptoms as I do who do not have elevated enzymes but still live in pain. That said, I don't know if the same can occur with canines. There are certainly canine pancreatic support groups who probably discuss this frequently. patrice

Patrice NYS

I found the yahoo group that is well known for canine epi but they are very particular about allowing membership. Dogs must have been diagnosed with epi and you must fill out a questionnaire. I wouldn't be able to get into this group. If anyone here has a dog with this diagnosis and would consider joining to help us here on this forum here is the name of the yahoo group: k9-EPIGLOBAL · Exocrine Pancreatic Insufficiency Dogs patrice

Patrice NYS

Ok, I found a *great* web site with information. Check out the picture of this dog on this page: http://www.epi4dogs.com/thediseaseindetail.htm

Patrice NYS

Patrice- OH MY GOD @ that picture... that looks about a step worse than how sway looks, but almost like she could be on that path eventually- i am reading this site right now, we started the enzymes TONIGHT

josh california

Josh, Sorry for the scare. Remember, this isn't a diagnosis of what is wrong. That's up to you and Dr. Woods to work on. I just think that it might help her put some weight on. If she has the capability to use the nutrients in her system, this will help make them available through the small intestine wall in the proper forms of fatty acids, amino acids and simple sugars. Please follow their instructions about how to mix them with food carefully: "In the past, it was suggested that incubating the enzymes in the patient’s food would help initiate the digestion process in the food bowl and then this has been stated not to be true, however, recent hands-on-experience with over 1,000+ positively confirmed EPI dogs of all breeds has proven otherwise. Incubation of enzymes on food for a minimum of 20 minutes, longer (up to 1-2 hours) is even better. The incubation of the enzymes prior to feeding the food eliminates mouth sores and/or mouth bleeding that afflicts some dogs when given enzymes. Stool elimination is greatly reduced and food absorption is also improved when enzymes are allowed to incubate on the food." I didn't know about mouth sores as a side effect so be sure you do this! I was surprised to read here that in as little as three days there can be improvement. This is not a condition I have read widely about. I don't know if there are degrees of this or if it is a "has it or doesn't have it" condition. Do you have a way to weigh her at home? Get a scale if not and weigh yourself alone then hold her to get a reading. Try doing it everyday to see if there are small changes. Keep a record. good luck, I'll be thinking about you all week. patrice

Patrice NYS

patrice- i know u werent trying to scare me, i just used caps because i was astonished at how much that picture resembled sways body structure.... if you click on the dogs link and look at the boxer, its amazing how similar these cases could visually look. as far as mixing the enzymes...i did wait the 20 minutes. the main thing that concerned me was having the food you are mixing it with not be 'too hot' or 'too cold' or it kills the enzymes... also, is it ok to mix the enzymes with a liquid?? like i use free range chicken stock to wet sways dry food down for example. is that ok to use when mixing enzymes without effecting its potency or whatever?

josh california

Hi Josh, hi Patrice, I am a member of k9-EPIGLOBAL because Benson had a confirmed case of EPI. If you want me to ask questions, I am willing to do so. Josh, do you want to contact me off list? I would wet Benson's food down before he ate. I used tepid water (not too hot) to activate the enzymes in about 1/4-1/3 cup of water and then I would add the water/enzyme mix to the food. I would think that room temp. chicken stock would be okay. The enzymes should really coat all of the food thoroughly. Some members of EPIGLOBAL will grind the kibble and add the moistened enzymes to the ground kibble. The reason - the ground kibble ensures that more of the food will be in contact with the enzymes. Benson was lucky - he responded well to Viokase. Others on this list have a harder time stabilizing their dogs. Classic EPI involves really awful diarrhea. I could tell that Benson was doing better because the diarrhea stopped immediately. It took him about a year to regain his weight (he went from 90 to 65 pounds). Josh, I hope that this works for Sway. Am thinking about both of you. Take care, Aden

Aden Jerusalem

Josh is having trouble posting to the board and is waiting for help from the IT techs to get back in. He emailed me tonight. "sways PCV has dropped to 17%" This is certainly something neither of us had expected after her being stable in the mid 20's for so long. If everyone here could say some quiet prayers for Josh and Sway tonight I am sure that will be of great help. patrice

Patrice NYS

Josh, If you are reading this, we are with you tonight and always, and praying hard for both you and sweet little Sway. All our love and thoughts and prayers, melissa and tiggs

melissa slc

Josh, I am so sorry to read that Sways PCV has dropped,. I will be keeping you and Sway in my prayers for sure. Stay Strong... Jess

Jess BC

Josh: Hang in there. You have done so much for so long and have been such a great dog person I give you all the emotional support I can long distance. You are one of the few left from when Drago was diagnosed. Sway and Drago were diagnosed about the same time and she to was a pit bull. All of my thoughts and prayers go out to you and Sway. I feel that we have a connection stange as it may sound. Give Sway a big hug.

Sue K PA

Josh, Sorry to hear about the drop in Sway's PCV. I am keeping you both in my thoughts and prayers. I did get your email and unblocked you so you should be able to post again.

Joanne MN

Dear Josh Please know that I am keeping you and Sway in my thoughts and prayers. Cheryl & Ginger

Cheryl & Ginger Pineville PA

Hi Josh. I'm thinking of you and Sway and hoping for the best. deb and Duck

Debbie BC Canada

Josh, I am praying for both you and Sway. Hope to hear good news soon. Penny

Penny Lytle Creek Calif

Josh, I'm sending good thoughts and prayers your way for Sway. I hope Sway gets stronger and his PCV improves. take care, Kim and Spencer

Kim NY

Josh, Just want you to know that I'm thinking of you and will be praying for you and Sway. I know how much you love your girl and how very close the two of you are. You have fought so hard for her and are such a good Dad. I pray that Sway comes through this victoriously and that the two of you will be out on the bike trail again soon. Best, Karen

Karen NC

I am praying for Sway to get through this bout and for your be strong for your girl Josh take care Laurie

Laurie CA

Dear Josh -- My thoughts are with you and Sway. Both of you are fighters. Take care.

Brenda VA

Josh, I know you are doing everything in the world for Sway, and she does too. My thoughts and prayers are for you both. Steve

Steve Va

Josh, please know that our prayers are with you and Sway, she has fought so hard as well as you with her, hope she can continue to fight this awful disease! Linda

Linda Sapphire

Poor Sway - how awful my thoughts and prayers are with you Josh - you've given it 110% you know you have. Clare, UK

Clare UK

Dear Josh, I am so sorry to hear sway's count is dropping. I'm praying for the best for her and for you, Christine

Christine fl

thank you very very very much everyone for all the good thoughts- im glad she is made an impression on so many people and just very thankful to have yall here praying for her- so saturdays blood draw was not a good result... shes came down from a 25% - all the way to 17% + her RETIC count was only 171,000 which is her lowest level since 2007... i mean anything over 60k is low-regenerative but sway was around 355k in july for example. i started the pancreatic enzymes on the 18th... her blood draw was on the 24th, my vet said he doesnt think the 2 are related in any way..i havent heard of anything bad about the enzymes but i guess u never know. for the first couple 4-5 days on the enzymes i really felt like she was gaining a very subtle amount of weight...but then on sat she was weighed and she was still just at 26 pounds. since then it visually seems like shes even got skinnier and back to where she was when i originally posted this thread. im definitely going to continue to try and be patient with the enzymes and just pray that they do end up helping. aden- i would like to speak with ya but i cant put my address here cuz thats what got me blocked apparently. you actually mix the enzymes in a liquid? couldnt that possibly render them useless if it is too hot or too cold? let me know what the best way to mix them in is cuz i definitely dont want to do anything wrong- i basically wet her dry food down with chicken stock and then let it sit at room temp for 20 min, then mix the enzymes into the food and let that sit for another 30 min--then i give it to her. let me know if i am doing anything wrong or if there is a better way. karen- i did speak to dr. cameron- after bouncing back a few emails i called him on the phone and actually talked to him for about 45 min. he laid out a nutrition plan for sway for the next year that was pretty extensive. i will post that info here for anyone to see what other's opinions are- do that tonight. i had to re-start her on the pred at her lowest dose (2.5mg EOD) because her allergies have started now again and she is back to chewing her pads off her feet. i also had to restart the tylosin powder because 2 weeks off of that and her stools were terribly runny and just an all around hard time for her. for now thats about it here, so much info patrice, thanks for getting my info to joanne. joanne- thanks for clearing my IP

josh california

Thinking of you both...

Courtney SLO

Josh, if you send me your email I would be more than happy to forward it on to Aden. I may still have yours but just in case it has changed. Penny

Penny Lytle Creek Calif

This thread was discussed between 06/01/2009 and 30/01/2009

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