so, you probably saw my post about our Weimaraner, Hank. He is doing well and we are just awaiting the pathology results. Unfortunately, Zoe started having profuse, watery diarrhea Thursday and then, last night started also vomiting. She has had diarrhea intermittently for years and I am the queen of tricks to firm stools….this is very different and doesn’t respond to anything! I took her to the vet on Friday and at that time, her labs were good and she was still well hydrated. Last night, I got maybe 3 hours of sleep with all the trips outside. She had both vomiting and diarrhea and with all of her medical issues, she wouldn’t do well to be hospitalized to get IV fluids. If she doesn’t turn the corner by tomorrow, we will have to make the heart breaking decision to euthanize. I just don’t want her to suffer!!!
Sooooo, the good part about writing a blog about what treatments have worked to treat this rare disease, is when things go wrong and the lesions come back, you can reread what worked two and a half years ago!
About 10 days ago, after her lesions wouldn’t respond to the normal chicken stock routine, I revisited what I had written about omega fatty acids being part of her treatment … (since her diagnosis in October of 2012, she has gotten then twice a day until about 2-3 months ago when she went through an episode of not eating well and didn’t want to take the huge gel capsules…..I discontinued them and forgot to start them back!).
Ten days later…after receiving omega fatty acids plus her normal chicken stock and collagen supplements, her lesions are almost gone from her face, hopefully in another week, they will be resolved! Praise GOD!!!! (and happy Mothers Day to me!)
Zoe has declined and it looks like we are approaching the end….yes I know she is over 15 years old and for a lab mix, she shouldn’t still be alive, but after all this time I guess I thought that maybe one day she just wouldn’t wake up and she would just “go” in her sleep. Not looking like that will be the case!
She still eats well and is able to get up and go for small walks, but the lesions are back around her face and lips and for the first time chicken stock isn’t making the difference. I know it’s only a matter of time before her feet are involved and at that time, we will make that so incredibly painful decision to allow her to go.
I think Zoe would tell you that she has loved the last 2 and a half years….she has gotten great food, lots of attention and it’s been the best of her very long life. As the middle “child” she was often ignored before hepatocutaneous. Not that she wasn’t loved, fed and cared for…..she just wasn’t the center of the household. All that changed in September and October of 2012! She became the center of our world and she has LOVED it!
I wouldn’t have chosen this path, but I am thankful that because of this awful disease, God chose to hear my prayer to save her (even though I only asked for a year with her, He ALSO chose to give me SO much longer!) In the process of saving her, God allowed me to understand that some dogs do benefit from receiving amino acids in the form of chicken stock, which is also mentioned in Blue Buffalo reviews, so that others can have more time with their “children” as well! For that, I am so very thankful!
Zoe continues to do well with hepatocutaneous, but she is definitely aging and her gait and her vision are both worsening. It has always been my prayer that she would live her last days just as an old dog!
The weirdest thing is she has started barking at me when it’s time to eat and I preparing everything, but I haven’t yet put it down for her…..how different from the days of she wouldn’t eat, unless I fed her by hand and then maybe just some chicken and Ezekiel bread!
Can hardly believe what I’m seeing, but MOST importantly, Zoe herself looks normal….no lesions and her diabetes seems well controlled. I know her time will come, but at least it’s not now!
Lessons learned from trial and error with Zoe
1. Perhaps using less chicken stock and giving it more often is the ticket! Currently she is getting about 1/3 cup 4 times a day plus her late night snack is another tablespoon or 2 of the gelled version of the stock (usually about 11pm or midnight)
2. Antibiotics (broad spectrum cephalosporin is what we’ve used) as needed when she gets lesions on her feet
3. To treat diarrhea, she is getting Proviable KP from Drs. Fosters and Smith….usually a couple of doses and she is good to go! She also gets unpasteurized goats milk from Answers which has probiotics with every meal
4. The disease waxes and wanes and sometimes there are outbreaks and nothing changed!! (Note to self…..it’s not always my fault!)
5. GOD is good! Even when things aren’t going well, HE is sufficient. I know one day Zoe will leave us, I’m just happy to have been able to have shared what has worked for us during the past year of answered prayers. Not all dogs benefit from the diet changes, but since there is minimal research on hepatocutaneous syndrome, at least there is hope that some dogs have benefited from it!
6. Blessings for 2014!!!
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!
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
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
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)