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)
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!
June 1, 2013
The last couple of batches of chicken stock didn’t actually “gel”. I didn’t really think that much of it, I just gave her more, as I considered it just more dilute than what I was making before. During that 2 week period I also backed off the amount of food I was giving her, as she gaining a bit more weight (I don’t need an obese dog with paw lesions!!) weeeelll, you can imagine where I’m going…..lip lesions came back…just a little, because we are rubbing on her (every day) to make sure there is nothing there, we found them with our fingers before they were visible!
So, we went back up on the protein: in this case, chicken! Also realized that both carrots and beets have amino acids in them–she already gets them as part of her diet, but had no idea they contained some of the amino acids that Zoe SO needs!
I also started looking for recipes to make better chicken stock and remembered that I had had success with leg/thigh quarters with back meat. Got that cooked up in the crockpot right away, just put the chicken quarters in the crockpot, covered with water and pulled the meat off after cooking on low about 6-8 hours and let the bones cook in the broth another 6-12 hours. At this point, it’s not scientific with the cooking times, but apparently, those “little bones” they make up the spine are REALLY important, ’cause when I strained the golden liquid off into glass jars and let in cool in the fridge at least 6 hours, it made great gelatin (the exact consistency as Jello!). I just let the fat rise to the top and scoop that off and I’m left with the golden goodness of the chicken stock!! I just warm it in the microwave and pour it over her food. (She also gets her eggs–2 of them twice a day with the egg whites cooked in the gelatin in the microwave). I use about 1/3 a cup of gelatin and separate the eggs, cooking the whites 1 minute and 25 seconds in the gelatin–make sure you cover the container or you’ll get the opportunity to clean your microwave afterward!
Zoe’s lip lesions are gone again and this time, NO paw involvement!
Dear Jamie: Hello ! Your special companion seems to be doing very well as far as the liver function is concerned at this time, so I would keep her on the liver cleansing herbs and liver cleansing diet. Her alkaline phosphatase (ALK P) remains high but that level is normally slightly elevated in geriatric dogs (up to 250 IU/L would be normal at her age]. The ALK P is a “dump” enzyme that reflects the excretion of enzymic activity emanating from the metabolic activity of the liver and adrenal glands. So it goes up when the liver metabolism is working harder. The ALT, by contrast, reflects her liver cell-specific function and is basically normal (that’s good). Do you know if they measured bile acids or GGT ? Either of these tests would measure bile flow through the liver as a measure of liver function.
One more thing, are you giving the Soloxine at least an hour before or three hours after foods or treats that contain calcium or soy — to ensure its complete absorption (these foods bind thyroxine and impair or delay its absorption). Best wishes, Jean
From: Jamie Goff [mailto:email@example.com]
Sent: Tuesday, November 13, 2012 10:02 PM
Subject: Consult needed from Dr. Dodds
I have a 13 y/o female lab diagnosed with hepatocutaneous syndrome. I have started her on milk thistle, the liver cleansing diet and she has received 2 amino acid infusions (650 mg aminosyn iv over 12 hrs)
She was diagnosed on 10/25 and treatment was begun immediately
She is also hypothyroid on Soloxone 0.5 bid (total T4 was 0.9 on 10/5/12) She is epileptic, controlled with phenobarb and k bromide over the last 6 years. Upon diagnosis, we did rapid phenobarb withdrawal and she was placed on keppra 500 mg q 8 hr and has had no seizures during transition period (weaned her off phenobarb in 1 week)
I can send all her lab work, but liver enzymes are slightly elevated:
Alk phosphatase: 516. 506
ALT: 117. 143
AST: 41. 52
Cl: 125. 133
Anion gap: 9.3
Serum iron: 62
Albumin: 2.5. 2.8
Hct: 32.4. 35.8
Clinically, the margins of her mouth have lesions, as do pads of all 4 paws and she either hurts or they itch, as she wants to lick them constantly.
Tobramycin eye drops for right eye infection Prion 1/4 tab q day K bromide 400 mg/3cc bid Soloxone 0.5 mg bid Oral amino acid supplements Zinpro biscuits 6-8/ day Tramadol 50mg prn (mostly gets during amino acid infusions) Cefoodoxime 200mg qd for bacterial infection of paws Miconazole into ear canals q day
We want to make her comfortable and do not want to prolong her suffering, if none of this is going to improve. Please advise how to go about getting consult from Dr. Dodds, as we want to make sure we are doing all we can for our “baby”! (Also, want to find out how long before diet changes might actually help)
I can send labs results and clinical notes from Auburn College of Veterinary Medicine where Zoë has been diagnosed and treated.
Thank you so much!
After receiving the diagnosis of hepatocutaneous syndrome, we arrived home with a very tired puppy and even though she was still having difficulty walking, she walked up the three steps to the front door! We watched closely over the next week and realized the Aminosyn was actually working!! The lesions stopped progressing and in fact, even seemed to improve! We decided that she was doing so well that we wouldn’t put her through another dose of Aminosyn, so on our re-check at Auburn, we chose to not put her through another 12 hr. ordeal. We alternated Tramadol with Gabapentin for pain relief over the next several weeks to help with the discomfort she must feel from the lesions that still remained.
So, we weaned her off the phenobarb rapidly over a week period and began Keppra 500 mg 3 times a day. We also started her on an antibiotic, Omega-3 fatty acids (free form snip tips) 3 per day. She continued on soloxine 0.6 mg for her hypothyroidism and zinc methionine for her skin