Lookin’ good!

Update: December 10, 2013…..lookin’ good!
Zoe has been doing really well lately (diabetes and skin!). It’s amazing how very sick she was a year ago and you would never know it today! We continue to adjust how often and how much skin stock/supplements she gets based on whether she has lesions or not. She continues on 20 units of NPH Humulin twice a day and we were able to back her down from 23 units to 20 once we started her on alpha lipoic acid (started her on 250 mg, but decreased her to 200 mg)

I emailed both Dr. Gimmler and Dr. Dodds to give them an update, since they were both so instrumental in helping keep her with us during the incredibly difficult time last year! We are SO blessed to have such great veterinarians to help keep us going!

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My other full time job is Zoe….

We left town to attend my niece’s wedding and had to get a friend to stay with our children, Hank and Zoe. The below email describes how often we give her medication and how the do what we do. (Zoe has diabetes as a result of hepatocutaneous syndrome, so she requires insulin)

Sometime between 6-9am the following needs to happen:

Usually hank goes out 1st (have to make him go out). He goes to backyard

Zoe goes out front (check her urine dip). (Expect negative ketones). Get worried if it’s more than trace!

Feed hank. (Between 2-1/2 to 3 cups). Add about 1/2 cup of water
He eats from the blue bowl beside the fridge
He can go outside after about an hour from the time he eats (that’s why he HAS to go out before he eats). If he won’t calm down, he can go out back on the leash, but he cannot run around outside on his own until at least an hour after he eats

Zoe gets a Baggie of food with the following added:
Her meds as noted on the am part of chart
1 Tablespoon of sour cream
1 Tablespoon of cottage cheese
1 slice of Ezekiel bread (can be toasted)
1/3-1/2 cup of chicken stock
1/4 cup of raw goats milk

INSULIN:
Within an hour of eating, she needs her insulin injection. She is getting somewhere around 20 units of insulin. Technique is as follows:
1. Wash hands well with warm water
2. Take insulin out of fridge door and using palms rotate insulin vial in a manner to gently mix the insulin
3. Using cotton ball, saturate it with alcohol and swab top of insulin and allow to dry (usually takes about 60 seconds for alcohol to evaporate from top of insulin vial)
4. Get syringe and remove plunger protector (DO NOT remove needle until ready to pierce vial)
5. Draw up insulin to desired amount and gently roll the syringe with insulin between palms to warm it up. (Injecting cold insulin is painful, so it’s important to warm it up)
6. Prep skin with alcohol cotton ball. Lift up skin on Zoe anywhere that a saddle would sit on a horse and gently slide needle under skin and slowly inject insulin
7. Give her her zinc treat as reward. (She doesn’t know this is med, but rather it’s her favorite treat!!!)

Around 11-2, Zoe needs her eggs separated into:
Use a small cup and place about 1/2 cup of chicken stock into cup and heat in microwave for 50 seconds
Take 2 eggs with the raw yolks separated and put yolks into small bowl (Zoe will eat out of this bowl). The whites go into the heated chicken stock–cook for about 1 min 50 seconds to 2 minutes and then pour the cooked whites into the bowl with the bowl with the raw yolks. I usually add 4 ice cubes to cool this off for about 5 minutes and then feed it to Zoe
(Hank gets about 1/4 of the egg white mixture in his bowl—usually add some chilled water from the fridge dispenser OR can add ice to cool his)

Around 3-5 pm (or about 8 hours after Zoe got her am keppra, she needs the afternoon meds) I used chicken meat as the “vehicle” to get her meds in. She gets another booster of chicken stock (this time not warmed). About a tablespoon or two!

Evening meal: usually around 6pm, but can be as late as 7 (same as am meal for additives). Meds are slightly different for the evening, though

INSULIN (to be given within an hour of getting her evening meal). See instructions above

Before going to bed, OR about 7-8 hours after her afternoon keppra, she gets the last meds of the day

Notes:

Hank can go in or out at his will, but we don’t leave him outside when we aren’t home. He just needs to be “calm” for about an hour after he eats. IF you place his bed (it’s actually just foam with batting over it and spread over that) at the foot of your bed, he will probably sleep in his bed, if he doesn’t have his bed there, he will probably be in the bed with you

Zoe can go out back (she likes to roam out there just before getting her eggs, but she can certainly just go out front). She thinks if she has her leash on, that means she is going across the street to the sidewalk for her “walk” which is actually more of a “sniffing” rather than a walk, since she spends most her time smelling what all the other dogs have done rather than walking

IF she starts licking on her feet, just lightly cover them with a towel. (We keep the “dog towels” in the cabinet above the washing machine)

Update….another round of lesions

Last week got crazy and we missed 2 days of getting her eggs cooked in the chicken stock (we usually do 2 eggs separated and cook only the whites in about 1/2 cup of stock and then give her the yolks and whites and stock all together around noon and then again around 9 or 10 pm. We only missed the noon eggs and now we have lesions 10 days later!

It seems like such a puzzle of pieces with each one evidently quite important!

Getting better…..again!

20130824-204150.jpgIt’s amazing what a difference a week can make!! Her lesions came back so abruptly this time–it was quite scary! Seems they are leaving just as quickly! Started her back on a whole piece of Ezekiel bread, giving it twice a day PLUS quinoa (about 1/3 cup twice a day). Also started her back on antibiotics on Monday. Her right rear paw is no longer weepy and the lesions on the back of her legs are pretty much gone! Yaaaaay!!!!

Her lesions are back again…what did I do differently?

So, the night before last we were giving Zoe her insulin and realized that the lesions on her lips had returned (we had noticed that she was rubbing this area along the sofa for the last couple of days)

I have been reviewing what I had changed. Ezekiel bread, for one–when she was so sick and wouldn’t eat, she would eat it and got about 4-5 pieces per day. Over the last several weeks, I’ve cut that back to about a piece a day, divided into her meals, as I use it as a vehicle to get her k bromide and poly-vi-sol into her meals. (Had the bright idea that she needed more protein and less carbs to help control her diabetes, so I cut her back from a piece of bread with each meal to a half of a piece—and sometimes it was only a quarter of a piece!)

I started yesterday increasing her bread back to at least 2 pieces a day. Also, started researching other foods that are high in amino acids–turns out quinoa is both high in amino acids and has a fairly low glycemic index. (Needed, since she also has diabetes!). I’m going to try the dietary things first to see if it makes a difference, since our history has had success with controlling it with diet! Here goes!!

definition and etiology of hepatocutaneous syndrome

Chicken stock…..trying with chicken feet! Photos included….

Breakfast awaits!

Breakfast awaits!

Here is tonight’s attempt at chicken stock. Zoe has a couple of lesions on her rear feet and I need some GOOOOOD stock!!! Found some recipes on line:

my inspiration

I’m trying a new vehicle to deliver said stock!…..a pressure cooker…..many thanks to my friend and client, Tiffany Davis for her counseling about my techniques of making stock. She rocks in the kitchen (doesn’t hurt that she works at Cooking Light, so she’s a wealth of knowledge!)

Just put just over 2 quarts of water with 2.7 lbs of chicken feet, (purchased from an Asian market) put the lid on and here we go!

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Soooo, FANTASTIC success!!! This is the best stock I’ve EVER made!!!! It’s so firm, it looks like its frozen! Zoe is in the background just waiting for her breakfast!!

Link

I give Zoe about 2 cups of chicken per day–1 cup in the am and 1 cup in the pm with veggies (I use about a cup of green beans, sweet potatoes–both of those cooked PLUS beets and carrots chopped up raw–all mixed together to make 1 cup, so I give her 2 cups of food total twice a day). I pour about 1/3-1/2 cup of chicken stock over the mixture and mix it all up, otherwise she wouldn’t eat all the veggies. (I do heat the stock up in the microwave before I pour it over the food, just to bring out the flavor). I also add about a tablespoon each of cottage cheese sour cream to help curb any yeast infections.

In addition to that I give her 2 egg yolks twice a day. Since the disease is a deficiency of amino acids and amino acids are the building blocks of protein, I do try to supplement the amount of protein. (She eats 4 egg yolks a day raw 2 in the am and 2 in the pm–separate from her meal and I cook about 1 egg white in the chicken stock with each yolk). This is how I prepare them:

I pour about 1/3-1/2 cup of chicken stock in a cup, then separate the egg yolks out in a bowl and put the whites in the cup with the stock and microwave it for about 1 minute 45 seconds to cook the egg whites. (Raw egg whites contain a protein called avidin, which can deplete biotin, one of the B vitamins. Biotin is need for dog’s growth, skin and coat health. The lack of it can cause hair loss, weakness, or skeleton deformity.).

Zoe gets the cooked egg white, stock mixture poured over the yolks and she LOVES it!

(hank the weim gets the other cooked egg white)

She gets a total of 4 Procell capsules a day (I give those separate from her meal–2 in the am and 2 in the pm)
Procell

The Omega 3’s that I give are the free form snip tips.
Free Form Snip Tips

These are all the things I can think of to share with you about our regime with Zoe.
She weighs about 57 lbs, so you’ll need to adjust accordingly!

Six months PLUS later: writing the blog….and comparing notes…

Stock on plate

So, now that I’ve started the blog….I’ve found a few others whose dogs were diagnosed AND we’ve compared our stories and findings….
Zoe’s symptoms actually waxes and wanes…it actually corresponds with how “gelled” the stock actually is!

My amazement is this…2 others have dogs with hepatocutaneous syndrome have experienced the same issue with symptoms…if they continue to feed their dogs the more “dense” stock, the symptoms actually subside and when the stock is more “loose”, the symptoms may come back!!!

the article by Dr. Ray Peat