Portions of this article appeared in a two-part series in GREAT SCOTS MAGAZINE, Aug. - Sept., Vol. 13, No. 4 , and in Oct.-Sept. Vol 3., No. 5: "A Stone's Throw: Ripples Across Time with Scottish Terriers."

Bonnie Sue: One Scottish Terrier's Experience with Adrenal Exhaustion and SARDS

By Russie McDement-Fogarty

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The Future

Patrick and I intend to keep a firm eye on all our pets' endocrine function now as we see how important it is to overall health and well-being. About seven years ago, we began yearly health check ultrasounds for the dogs and the results sometimes identified problems before they got to the disaster stage. It is with hope for similar results that we will implement yearly testing to determine cortisol, hormone and immunoglobulin levels in all our pets. If I had to make a choice between the two, I think I would choose the blood work. In light of the new information I've been given, I now have confidence that hormone testing could have addressed much of the "junk"-the liver disease, the bladder cancer, the kidney disease-that we found through the ultrasounds. Since an ounce of prevention is worth a pound of cure, we plan to have complete blood work run for Bender, Bonnie's son, as evidence points to adrenal exhaustion being a heritable imbalance. I hope that this point does not escape the reader's attention.

The new Scottie, Bender's sister, Francine--another of Bonnie and Charlie's puppies that had ended up in a breeding facility was shown through her adrenal panel that she, too, is suffering from the early stages of adrenal exhaustion. We hope that early treatment and detection will save her from the problems that arise when pets go untreated.

I have contacted all available breeders involved in Bonnie and Charlie's line and made them aware of the situation with Bonnie and this line. A few have been receptive, some have not. But adrenal exhaustion is a real disorder, therefore breeders should begin testing for these imbalances and making choices based on the results. The buying public should insist on making our purchase decisions accordingly. We can no longer continue to accept genetic cripples.

I strongly applaud Dr. Plechner for his opinions on this topic:

"Indeed, the actions of breeders have given new-and literal-meaning to the term "killer looks."At great expense to the health of animals, breeding practices have taken a cosmetic/marketing path away from natural or functional criteria. As an example, this trend has converted hunting breeds of dogs into fashionable, nonhunting, household pets who have lost their field ability, nose, and hardiness. Pets have become more and more processed, unnatural, and unhealthy, and more like merchandise."

"I'm truly convinced that if current trends continue-emphasizing the latest fashion and ignoring the health of breeding stock-cats and dogs may simply be bred out of popularity. Whether they know it or not, breeders who worship at the altar of fashion and who relegate or ignore the health factor are compromising the survival of their breeds. They are, in a sense, practicing animal abuse. Their actions perpetuate unwellness and suffering. Their actions victimize buyers-innocent consumers who purchase puppies and kittens and who usually have no clue as to what may lie ahead in terms of sickness and veterinary bills."

* * *

"Irresponsible breeders are not interested in what I have to say. Responsible breeders are interested. "What can I do to correct this? they ask . . . . [T]herapy does not correct the genetics. It corrects the effects of the genetics that cause disease. If you breed two animals with the same degree of genetic flaws, even if both are corrected, then the genetic imbalances are merely passed on with more severe consequences for the offspring."

Plechner, A. J., Zucker, M. Pets at Risk From Allergies to Cancer, Remedies for an Unsuspected Epidemic.:NewSage Press. Oregon, 2003. pp. 153, 154

Postscript: Six Months Into Treatment

After six months on steroid therapy, simple observation of Bonnie's behavior brings us much to be happy about. We once felt that Bonnie's touchiness with our other pets was because she had lost much of her sight and was feeling insecure. There are some resources that will point to that as the reason behind this behavior while other sources indicate that treatment resolves the matter. I think her attitude was caused by the excess female hormones, or the "bitchy" hormones as we like to refer to them. I am happy to say that since being treated, "Diva Bonnie" is gone. She's had to have some large skin tags removed and biopsied-also probably caused by the production of the excess female hormones. She has since healed nicely and the hair is growing back well in these areas. Her vision remains mostly stable, as does her hearing. We unfortunately ran out of prednisone while I was out of town recently, and I noticed as soon as I got home that her vision had suffered because she was bumping into things. When we returned to treating Bonnie with the steroids a few days later, we found we had to give her several days of higher dosages before her vision returned to the level it had been. Dr. Grozdanic's research indicates this to be typical in dogs with IMR dogs who are treated with long- term steroids. (She is still a dog with SARDS, but with responses that look more like a dog with IMR.)

Bonnie still feels sure enough of herself to get up alone during the night, navigate furniture in near darkness, go down a long hallway and out the pet door to do her business. This assures me that she has retained functional sight. At times, I find that she focuses on a spot where she thinks I am-- gazing with such an intensity--I am a little sorry to correct her. We have developed a system where I use a light touch to signal to her the direction I am heading. I give a light touch to her head if I am going forward or I will touch her back if I am heading in the opposite direction. Otherwise, she will sit and wait patiently and loyally for me in rooms I have long vacated, especially the kitchen. Another sad little sight is a Scottie begging thin air. Her tests would indicate that she has a kind of "peephole" where she is able to see, and so often I wave my arms or move around in a funny dance when I am far away so she can catch a glimpse of me in that little area of sight.

She is back to her routine of going with me to my office, and is sitting at my feet as I write these words, snoring away, oblivious of all the attention I am giving her as I type. She goes up and down stairs, albeit slowly, yet quite independently. She has suffered a few slips that found her on the landing looking a bit surprised. But when her dignity has been compromised, she accepts little sympathy. I can't help but be touched that she will make every effort to get to me, even if it means navigation through places where she can't see well or feel secure. I have found I am absolutely unable to slip out of bed at night for TV watching or late-night work without soon finding her at my side. I admire Bonnie's courage and determination to capitalize on what she can see instead of waiting to be carried around on a litter. It is the best of the Scottie spirit exemplified and just one of the many things I love about her. She won't give up or give in.

Bonnie's hearing is much better, but like those of some humans, is only really good within a certain range, so in addition to doing funny dances, I now can be heard talking to her in a high-pitched, sing-songy voice. Dancing and singing for your dog? Oh yes. That's me. I have resigned myself to being fodder for our guests' conversations on the way home. Now, if I could make my voice sound like a plastic bread bag being opened, I would have her complete attention every time I spoke.

Conclusion:

This is Bonnie's own story accompanied by my personal reflections. I have no formal education that qualifies me to sort through research and make assumptions based on what I find. I am simply an interested and loving pet owner, determined to learn and share all I can about a disease that is so devastating to the affected pets.

Bonnie Sue--our small stone--came to us through unexpected channels, led us to additional Scottie companions and inspired us to give aid to others in her situation. Through a simple phone call, we met her, loved her and vowed to protect her. That promise led to ripples in the pond, seeking real answers to her health problems in spite of mixed messages. Those ripples rebounded off the banks in ways we had not expected. We had to seek answers in a way that we had not in the past, going beyond what experts were telling us, to find the best information available. In the process, we met brilliant and gracious experts, gained a larger view of the beautiful and complicated mechanism that is the adrenal system. In turn, we hope this experience will prove to be of benefit to Bonnie's continued health. My hope is that her story will inspire others to seek the same sort of positive outcome for their pets.

It is the cycle of small actions leading to larger consequences. And as Robert Louis Stevenson said: "Sooner or later everyone sits down to banquet of consequences."

UPDATE ON BONNIE

Since April of 2008, Bonnie was retested every few months using the E-1 adrenal panel offered through National Veterinary Diagnostic Services. While her values have improved and her cortisol was normal, her total estrogen was still too high 35.27 (normal 30.00-35.00) and her immunoglobulin levels were still very low. (IgA 50 (normal 100-200); IgG 1,089 (normal 1,250-2000); IgM 81 (normal 100-200). While the estrogen level was not off by much, even small amounts like this can cause clinical symptoms like we have observed in Bonnie. Another reason we like the lab in California-their "normal ranges" are small and correspond well to what we observe as owners and it is highly recommended by the experts in the field of canine endocrinology.

Because her values were not yet normal, and therefore her system not yet balanced, Bonnie was taken off oral prednisone and treated through weekly steroid injections and the thyroid supplement Soloxine compounded in liquid form was added. It was thought that she was not absorbing the oral medication as well as she might (adrenal exhaustion is often implicated in malabsorption problems) and so we did injections for several months. What we found was that sometime toward the end of the week, the steroids wore off and she would become almost completely blind, with much less functional sight than we'd been able to preserve up to this point.

After consultation with Dr. Plechner and Ms. Levin, it was determined that Bonnie should have one more initial injection of two steroids, then begin medrol at 4.mg daily. We were also advised to administer Sulfasalazine to increase absorption of the medrol. Bonnie also receives the supplement PS or Phosphatidylserine (which has the nice effect of also treating the gallbladder mucocele dysplasia she has), as well as a taurine/magnesium supplement designed to offer more protection to the retina.

After following these directions, nearly all of Bonnie's outward symptoms subsided and her vision remained somewhat stable. She suffered with a recurrent bout of cystitis, probably caused because her IgA is so low, and her normal immunoglobulin protection is lacking in that area, leaving her susceptible to infection or attack of her mucosal surfaces (which obviously includes the bladder--a scary thought for any Scottie owner).

Since any kind of invasive diagnostics are contraindicated to obtain a urine sample (i.e., catheterization or cystocentesis) in a pet that might have transitional cell carcinoma-and that could be just about any Scottie-we've had to rely on repeated urinalyses. Bonnie has been on one antibiotic, and responded well at first, but her infection seems to have returned. We hope that she will soon be placed on a different antibiotic and that a trip to a specialist for an ultrasound to rule out bladder cancer isn't a necessity.

The thing Patrick and I have learned in the course of fighting for Bonnie's health is that adrenal exhaustion is a difficult area to find good treatment locally. Most people who have a pet diagnosed or suspected of adrenal exhaustion and/or SARDS will have to be willing to be an informed consumer with their veterinarian and to push for appropriate treatment. In our case that seems to involve contacting specialists for advice as each new problem developed and a combination of both diplomacy and pushiness with our own local vet. We continue to hope that the end result will prove Bonnie to be the big winner for our efforts.

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