December 1st, 2009 by admin

I met with my doctor again about my mood disorders. Right before going to bed last night I took a new drug for which she wrote me a script. According to the literature, the effects are typically not experienced for at least a couple weeks, but after almost five years of emotional turmoil, I actually woke up singing at 5:30 am when Ron got up to prepare for work.

No kidding. I opened my eyes and started singing “You’re Getting to be a Habit with Me” from the 42nd Street Broadway musical along with a smattering or other random songs and arias.

Then instead of speaking, I sang all my communications to Ron and suggested that we treat our lives as a musical for a day and sing everything.

He said: “No”.

I asked “What?”

He said succinctly that he didn’t like musicals to begin with and that it would be like a living hell for him.

I told him it would be funny for a day especially if we sang to everyone we met even while running errands.

He said people would think I’m strange.

I said, “Like that’s ever stopped me before” (all in song of course).

After he left, I recorded a couple versions of the first song of the day to document this day marking the distinct absence of darkness in my life for so many years.

WARNING: I am not Frank Sinatra, Doris Day or Ruby Keeler, and there is a schmaltz factor to this song, so listen at your own risk. I’m so happy right now about being functional like I used to be that am sharing this song at the risk of certain ridicule.

You’re Getting to be a Habit with Me

June 5th, 2009 by admin

Here’s Halle at the hotel in Denver right before our road trip to Ann Arbor:

After I drove back to Michigan from Denver with my sister, I thought I was just sleeping to recover from the long drive, but that was twelve days ago. I have since continuously experienced the following symptoms:

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-Extreme fatigue. My head feels like a ton of bricks. Having been an insomniac my whole life, it’s very strange and kind of awesome to not have to take sleeping aids and be able to fall asleep in seconds, but now I can’t stay awake and fall asleep at all times of the day and night.

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-I have a low grade sore throat and low grade headache all the time

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-I have mild but constant body aches

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-I feel like I have a very low grade cold or flu, the way I would feel right the full-blown version kicked in.</ul>

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I can’t believe how debilitating this chronic fatigue is. It is not the same as regular tiredness. I’m unable to focus or concentrate on cerebral or mental tasks. I do better with mechanical and physical tasks but get exhausted easily and quickly.

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I started taking supplements yesterday to boost my immune system. And today I started taking another supplement to cleanse my system of toxins.

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I had some energy for the first time today, but crashed at the end of the day.

The vitamins and supplements must have helped because it’s the first time I’ve had enough stamina to even put a post up.

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My dad bought me a book on Chronic Fatigue Syndrome today and I scheduled an appointment with a care provider later this month.

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Halle keeps trying to wake me up. She has even left her fluffy down dog bed to cuddle right up to me when I am sleeping.  It’s nice to have her company and presence.

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If dogs sleep on average about 16 hours a day, perhaps I’m becoming a dog.

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Even though I feel like a zombie, the extra sleep seems to make me look younger and younger. That’s the only silver lining I can find so far, though I have to say that the absence of the migraines with nausea (that was plaguing me in May) is incredibly fabulous.

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I’m procrastinating on getting the prescribed blood tests done because of my phobia of needles.

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Speaking of phobias, today I walked in lumpy unmowed grass full of mushy-looking geese-turds. I felt anxious and naseous because of the textures and poo, but kept telling myself everything would be fine as I tiptoed through the minefield. It was unpleasant, but more productive than building up the terror and running away screaming.

February 14th, 2009 by admin

Below are the photos I took of the things I bought for an MVD dog (I was going to foster) at Whole Foods last night. I arranged them on the breakfast bar after I took them home.

Flowers to welcome my MVD foster dog

Ming's MVD Dog Whole Foods Display

Dogs with liver disease experience problems digesting animal meat protein, so they often eat a low protein prescription food that is vegetable-based. Snacks that are often used for liver-diseased dogs include: diced apples, watermelon and carrots. Goat yogurt is good for mixing in supplements and for extra protein.

January 24th, 2009 by admin

Hepatic Encephalopathy, or “HE” is most simply described as brain disorders due to liver disease. I posted more info on HE a couple posts down.

Some of Daisy’s recent HE symptoms include shaking after a meal, aggression, glassy eyes and lethargy. The reason such neurological symptoms are expressed by dogs with liver disease is because damaged livers cannot efficiently clear the blood of toxins or proteins. When toxins remaining in the bloodstream travel to the brain, they cause the neurological symptoms.

A restricted low protein diet reduces the amount of protein in the blood and thus reduces the load on the liver. If the damaged liver can handle the reduced load, then the blood can stay relatively toxin free so that HE symptoms will be less likely to develop. Efforts to manage the liver disease condition and symptoms can make all the difference in a dog’s quality of life as well as his or her lifespan, but even the best efforts will not provide a cure or a symptom-free life.

Understandably, dogs on such restricted diets are often hungry. In Daisy’s case, her owner let me know that Daisy acts like a dog that hasn’t seen food in a year. Daisy’s vet suggested supplementing meals with natural pumpkin, which is low in protein and may help her feel more full. White potato soaked in water to remove potassium and phosphates, then boiled in new water and cooled was another recommended food by members of the Dog Liver Disease (DLD) group.

January 22nd, 2009 by admin

HE stands for Hepatic Encephalopathy, the “behavioral, psychological, and neurological changes associated with advanced liver disease.” (answers.com)

Hepatic: “Of, relating to, or resembling the liver. Acting on or occurring in the liver.” (answers.com)Encephalopathy: any disorder or disease of the brain (wordnet.princeton.edu)

en·ceph·a·lop·a·thy \inˌsefəˈläpə-thē\ (merriam-webster.com)

Damaged livers do not have the capacity to rid the blood of toxins. Those toxins remain in the bloodstream, reaching the brain, and subsequently causing HE.

Petplace.com has a good write-up on HE, which I excerpt here:

Hepatic encephalopathy is a neuropsychiatric disorder that occurs in animals and people with advanced liver disease. While any severe liver disease can lead to HE, portosystemic shunts in dogs  (where blood is diverted around the liver) are the most likely disorder to produce HE symptoms. About 95% of animals with portosystemic shunts show signs of HE.HE is often expressed in a range of neurologic abnormalities. The first signs are usually behavioral. At first, the changes are subtle. As the disorder progresses, the signs become more obvious. Symptoms may be triggered by a meal. They often come and go, also varying in degree of seriousness.

A grading system has been modified from human medicine, for use in animals. In this system animals with HE are graded on a scale of 1 to 4.

• Grade 1. Listlessness, depression, mental dullness, personality changes, excessive urination.

• Grade 2. Staggering or incoordination, disorientation, compulsive pacing or circling, head pressing, apparent blindness, personality changes, salivation or drooling and excessive urination.

• Grade 3. Stupor, severe salivation and seizures, although uncommon, are present.

• Grade 4. Coma

Other symptoms may include: collapse or weakness, hyperactivity, head or muscle tremors, and/or  deafness.

January 19th, 2009 by admin

The ALT blood test is one of the usual tests done in a series of tests when liver disease is suspected.

ALT stands for “Alanine aminotransferase”, an enzyme important in liver function.

A high amount of ALT found in the blood is often an indicator of liver damage or inflammation. Even though the ALT test is considered to be a sensitive test for liver disease, high ALT levels in the blood can be caused by many different conditions, such as lead poisoning, drug reactions, shock, etc. For this reason, other testing is typically done in order to better interpret the ALT test.

The reason a high amount of ALT appears in damaged livers is because liver cells release this enzyme into the bloodstream when they are damaged. Although an abnormally high level of ALT in the bloodstream is greater in damaged livers, it may or may not correlate with the seriousness of the liver disease or predict what the outcome or course of the disease will be.

Shaili’s ALT level: 783 **HIGH**
Normal ALT range: (14-151 U/L)

What is the unit U/L?

U/L is “Units per Liter”
• A unit is an arbitrary amount agreed upon by scientists and doctors.
• A liter is a measure of volume that is slightly larger than a quart.

References: “Symptoms and Diagnosis of Liver Disorders in Dogs” by Veterinary & Aquatic Services Dept., Drs. Foster & Smith web site;  www.peteducation.com; Web MD; and www.gastromd.com.

January 17th, 2009 by admin

Providing the explanation took much longer than expected. I did numerous rewrites, checked my facts, had my sister who is a microbiologist proof it, and read it to various people to see if it was easily understood.

The sister who proofed it is the one who has the 1.5 year-old son with no functional small intestine and a liver that was failing. The link about baby Bo is in the side bar under “My Nephew’s Rare Disease”

I have not done the ALT or bilirubin write-ups yet, but they’re coming. Please note that the BAT is usually one of several tests in a panel of tests for liver disease.

Back to the BILE ACID TEST (BAT). First, if you haven’t seen Shaili, the athletic Pug, she is featured two posts down. Her recent blood work came back with some high Bile Acid Test numbers:

Fasting Bile Acid Test (BAT):
Shaili’s result: 13.4 µmol/L **HIGH**
Normal range: (0.0-12.0) µmol/L

2HRS Bile Acid Test (BAT):
Shaili’s result: 44 µmol/L **HIGH**
Normal range: 5.0-25.0 µmol/L

“But what does this all mean?!” you ask?

Most dogs are given the BAT to determine if there is a problem with their liver, or if another test they had done for liver disease was inconclusive.

For instance, as in Shaili’s case, if liver disease is suspected, but the biliruben test shows normal levels, the BAT is run because it is a more sensitive test for liver damage.

The BAT result numbers show how much bile acid is in the blood stream at the time each blood sample was taken.

1) On an empty stomach (no food for 12 hours)
2) Two hours after a (high-fat) meal is eaten

A high amount of bile acids in either blood sample means the liver is not adequately doing it’s job of pulling bile acids out of the bloodstream, which indicates liver damage.

The bile acid level in the blood sample two hours after the meal should only be slightly higher than the bile acid level before the meal because a healthy liver is able to remove most of the bile acids after two hours.

When a dog eats, food going into his body is in part “digested” by the bile acids that break down fats. Those bile acids are initially released from the gall bladder into the intestine to help with digestion.

After the food is digested, the bile acids go into the blood stream where the liver retrieves them and returns them to the gall bladder for storage until the next meal. This is why some articles state that the liver “recycles” bile acids.

Here is a simplified progression of the events upon feeding the dog:

1) The dog eats, triggering bile acids to be released from the gall bladder into the intestines2) While in the intestines, the bile acids help digest the food and break down fats from the meal

3) After the food has been digested, the bile acids in the intestines move into the bloodstream

4a) At this point, a properly and fully functioning liver would efficiently take the bile acids out of the bloodstream and return them to the gall bladder to be released and used again at the next meal.

4b) If the liver is damaged and not functioning properly, it will not be able to remove the bile acids at a normal rate, so the blood sample taken will show a high level of bile acids in it.

Upon eating, the body triggers the release of BA from the gallbladder into the intestine, where it helps break down fats ingested. Once the food is digested, the BA goes back into the bloodstream where it is recaptured by the liver.

Even though this test is a good indicator of liver disease, the results do not provide information on how severe the damage is, what caused the damage, whether the liver can recover and what the expected outcome would be.

Shaili’s “Fasting” Bile Acid Test is a bit higher than the normal range, and her “2-Hour” BAT level was double or more than levels in the normal range. Look at these results again along with the BAT results for a Pug Puppy that likely has a liver shunt:

Fasting Bile Acid Test (BAT):
Normal range: (0.0-12.0) µmol/L
Shaili’s result: 13.4 µmol/L **HIGH**
Pug Pup with suspected liver shunt: 287 **VERY HIGH** This is 21 times Shaili’s BAT level

2HRS Bile Acid Test (BAT):
Normal range: 5.0-25.0 µmol/L
Shaili’s result: 44 µmol/L **HIGH**
Pug Pup with suspected liver shunt: 1877 **VERY HIGH** This is over 42 times Shaili’s BAT level

UNITS DEMYSTIFIED:
• “µmol/L”  is  “micromoles per Liter”
• A mole (mol) is an amount of a substance that contains a large number (6 followed by 23 zeros) of molecules or atoms.
• A micromole (µmol) is one-millionth of a mole. (definition from Healthwise web site)

A note about the Pug puppy above. If this puppy does have a liver shunt and it is operable, it actually has a chance of living a good quality of life as well as enjoying a longer or even normall life span given that it’s condition is managed by proper diet and supplements.

If you are looking for more information, a support group, and practical advice from experienced dog liver disease moderators, please visit the Dog Liver Disease (DLD) Yahoo Group. You are not alone if you have a dog with liver disease or suspected liver disease. There you will find hope and help for managing the condition, reducing the symptoms, and increasing the livespan of your dog..

December 21st, 2008 by admin

It was a long day with family, but enjoyable. My brain is a little mushy today from lack of sleep and from crashing on the couch to accommodate additional family in the house for the holidays.

Here’s a picture of Halle snuggled up in my down vest. There is no other material she likes more than fluffy down to cuddle in. It’s good stuff, that’s for sure.

Halle in my down vest

I think she looks a little like a baby fox here.