Jul 232011
 
July 19, 2011

So what a great day!  Big smiles as we see a clear day, sunshine and no sign of AIHA!

Today I sat outside enjoying a rare day of sunshine hanging out in my yard with my beautiful canine family. My dogs have had some exercise, except for Dylan who has only been out for a bit to say hello to our neighbors.  They all love the sun, but Dylan is more of an afternoon girl. She rarely goes out before 8 AM, and never hangs out. She will get some exercise later in the day when she prefers it.  Today she spent a bit time saying high to our neighbors early, but was back inside not too long after. Her joy around people is amazing.  She really could use more trips out too though and maybe with her new energy, it will be easier to get up and go. She loves to visit with the boys from next door and the others nearby and is constantly practicing her singing voice.

In the last few days she has been adding more things back into her repertoire.  In addition to her 1.6 km/1 mile walks, Friday night she decided that she did not need to go around to get in the chair and began leaping over the arm to get into the chair as she greets my friends at the door.  Great for her butt muscles as long as she is careful to some degree.  She just is never too sure about wow much “jump” she has.  When she gets excited she wants to do more than she can.  Even our walks start briskly, but turn into more of a slow walk.  How far she goes before that happens though, is constantly growing.  She rarely uses the stairs I have to get on and off the couch, preferring the easier big steps up and the easy jump off.  She is pretty wimpy to pain so I am pretty sure she would not be going off the couch the way she is if it was uncomfortable or hard on her.  She has been taking the stairs until recently.

She does have some places along her back that are losing fur, but it looks like it is just another recent skin issue that is healing.  Today I scrubbed some of this off, as when it heals it comes free more easily. In any skin issues she has had, I have tried to leave the fur in place, attached to whatever skin remains and the scab that remains on her skin, rather than peeling things and exposing them.  I think this has been a good decision.  Each of the areas seems to be drying up and healing, then allowing the fur to be brushed away without creating any other exposed sores and open wounds.  This leaves a very low chance of infection.

At the end of her prednisone use we saw a number of bumps and other things starting in addition to the blackening of her belly and other exposed skin that occurred earlier while reducing prednisone.  On the good side, it does look like her skin is healing now and I don’t think I see anything new, other than the things that I did not noticed recently that I believe started a while ago.  The bumps are mostly gone and the patches with rough feeling skin (for some time), have shed little patches of fur, but now feel as smooth as the other areas where her fur and skin seem more normal.  Skin is something that does take longer to heal.  It also appears that it was something that was a result of more prolonged use, as it took much longer to be observed and continued to be observed for weeks after other symptoms started to dissipate and disappear. I expect to see a bit ore of this shedding and then I hope to see what I have been seeing in the older areas where she had earlier problems like her bed sore and the blackening tummy, pink skin returning and fur beginning to grow.

One interesting and cool thing I saw return is a basic reflex; but due to her anemia initially, and the loss of flexibility (at one point hind end paralysis) and body muscle, which she had lost well back in March due to prednisone, she has not shown in more than 4 months.  As I scratched and rubbed her skin in the middle of her back near and on her spine, her leg on the side I was scratching came up and started scratching at her side.  Switch to the other side of the spine and sure enough, the other leg lifts and begins motoring up to her side by her ribs.  Wow, I thought.

This theme keeps repeating itself. Every little basic behavior that she does has become so special.  I have always been aware of what goes on, but I don’t  know if my appreciation of the basics has ever been so great.  I do know though, that everyone who has had a dog survive this disease and anyone who has fought the battles and lost, also knows as well, to enjoy every moment you have together.  Appreciate all the good things you enjoy together.  Find a way to relax about the things that are not perfect, or the things that may bug you even so you can always remember to enjoy every moment.

She is always very energetic and enthusiastic in just about everything she does.  I have now stopped giving her Milk Thistle.  I am still giving her Pet Tinic post prednisone so she can continue to recover her RBC numbers. At the moment the only other dietary supplement she receives is the fish oil supplement for omega 3 fatty acids like my other dogs. A good source of omega 3 fatty acids is essential in a balanced diet.  Dogs eating a raw diet get plenty of omega 6 fatty acids from the meat they eat.

One thing I have been reading about more recently in regards to human and canine nutrition, is the requirement for Vitamin K2.  Along with vitamin D, which aids in absorption of calcium, are required for proper Calcium metabolism.  It seems K2 directs calcium to where it is required and low levels of K2 can lead to it being deposited in arteries instead of in bone. Vitamin K1 found in green vegetables, works in the liver to help maintain a healthy clotting system.  Not only then is vitamin K1 important to AIHA dogs and for maintenance of a healthy canine, but vitamin K2 becomes essential during and after prednisone use, as bone loss is one of the side effects that occurs over long term use.   I am sure there is damage to the bone even over the shorter term at high doses, such as are used in the treatment of autoimmune diseases like AIHA and Immune mediated Hypothyroidism.

Dr. Becker: The Delicate Dance Between Vitamins D and K

Richard
@mybullseyeview

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