Tuesday, July 31, 2012

Not a UTI

Last post for the day. Got the lab results from the latest urinalysis. The lab found no evidence of bacteria or crystals - the same as the lab that evaluated her urine samples when we were at Auburn. Still finding RBCs in it, though. Perplexed by this ...

Our regular vet is out this week, so will wait until he gets back next week to discuss further ...

Details of Lab Results

OK, I'm going to summarize some of the lab results from Auburn. I'm not going to list everything or try to upload everything, just point out what aspects of the results pointed us in this direction. As Dr. Gillette said, most of the tests that we ran could be run by any vet. So, I'll try to go through the lab results according to the basic technology.

ECG - Looked good at all time points

Urinalysis - Was not too unusual:
1. Specific gravity a bit high throughout
2. Red blood cells observed in all her urine samples
Explanation - probable urinary tract infection

CBC and Differential - Mostly normal:
1. Neutrophils dominate the diferential WBC count
2. MCHC (mean corpuscular hemoglobin concentration) was low in a few samples
Simple observations, not sure that they mean anything

SuperChem -
1. Triglycerides - consistently low
2. Na+ and K+ - occasionally low
3. Mg2+ and P - occasionally low

Special Blood Tests - Done specifically to rule out possibilities that would change everything:
1. Thyroid - Normal
2. Insulin - Consistently low; Gillette has observed this in performance dogs pretty regularly
3. Cortisol - Consistently low; Gillette has observed this in performance dogs pretty regularly
4. Estrogen - Normal for a spayed female
5. Progesterone - Normal for a spayed female
6. Testosterone - Normal for a spayed female
7. Creatine Phosphokinase - Normal

Blood Gases - Lots of anomalies here (collected venous blood and blood gases)
1. pH - consistently low (less than 2 SDx low)
2. Lactate - very low at rest, increased 10X in 10 minutes with work to be very high
3. HCO3- - consistently low
4. pCO2 - consistently low                

As Drs. Gillette and Barrett hypothesized, we were able to measure metabolic anomalies without collapsing Gata. In fact, we were pretty sure we would see things as soon as we ran the first blood gas reading after the initial resting blood draw.

I'm not trying to interpret these beyond what Drs. Gillette and Barrett explained to me during our phone call. They will not be providing a written report or anything like that, so I don't really expect to get additional information on any individual readings. There are certainly more than 1 possible explanation of these anomalies, taken individually or together. However, we will start with changing her diet, the easiest potential issue to address, before we go any farther.

Update from Auburn

Well, I had a very long call with Drs. Gillette and Barrett this morning. They believe that there may be 2 things going on, 1 easy to address and the other not so easy.

1. Potential urinary tract infection - I'll take Gata in for a cystocentesis tomorrow to get a sterile urine draw. Hopefully, that will be the explanation for red blood cells in her urine. I've been losing some sleep over this one since they did not identify any bacteria or crystals in the free catch samples that I provided for them down there. And the RBCs were consistently seen in every sample.

2. Explanation for collapses - There is no doubt that Gata is showing a variety of strange metabolic responses, as soon as she actually sees that it is time for work. She definitely displays an anticipatory phase. But even at rest her basic metabolic profile suggests that she is under stress without doing anything. What we can't tell from the results is the role of her diet (raw) versus her basic physiological metabolic capabilities. Dr. Gillette has shown in lots of his research that performance dogs require a higher percentage of fat and carbohydrate in their diet. He wants about 27 - 30% of the calories in her diet coming from protein, 23 - 27% from fat, and the rest from carbohydrates. 

I could switch her over to one of the kibbles he has lots of experience with, but we're all concerned about whether her system would be able to make the switch since she's been on raw all her life. I've given her kibble intermittently as treats, etc. over her life. She likes it well enough, but it does tend to give her loose stools/diarrhea. So, luckily enough, one of the folks that I am training with out here has a raw dog food company. He will make up a special batch of food for her, if I work with their veterinarian on staff to put together the recipe. First, I have to make sure I understand everything that Gillette and Barrett want in it. They are supposed to be sending some info on exactly what they want in the diet - everything - vitamins, minerals, all of it. I'm not leaving anything to chance this time.

I think I am headed for a crash course in canine nutrition. My head is spinning.

Anyway, once I get her stabilized on the new diet, we'll see what happens to her heat and exercise tolerance. If it increases significantly, we'll know we got to the heart of the problem. If it doesn't then we'll see about figuring out what is going on with her physiology/biochemistry.

We're expecting that it will take about 12 weeks to get to that point. It seems like a long time, but it will fly by. I've been increasing the fat in their diet since I got home from there. I'll start adding in some carbs in the form of cooked oatmeal or rice in the next couple of days. Now, I just have to figure out all the balance of everything else. Hopefully, by the time the new raw diet is ready they'll already be on a higher fat and carbohydrate diet and will make the transition easily.

In addition, they also want me to maintain and potentially even push her conditioning program a little so that I will be able to clearly identify a change. The 45 minute mark is a big deal to them. And they are interested in what happens around that time point even if I am just walking her for the first 10 - 15 minutes. In all honesty, I don't think that it will be a problem to determine whether or not the dietary change is working. Even if her physiological response doesn't occur during the summer season this year, it's easy enough to observe in the fall and will be clear again no later than next spring. She and Tor will probably end up being some of the best conditioned Belgians out there. As long as they don't keep wiping me out on the bike ...

An additional aspect of the conditioning is to help push her body to "learn" to utilize fat and carbohydrates as an energy source. Since she has gotten less than optimal amounts of fat and carbohydrate, we're not entirely sure that her physiology can utilize them. That's sort of the second part of the hypothesis, but first we have to rule out diet. So, I'll transition her diet relatively slowly, maintaining her exercise program as much as I can without risking collapses. After she is fully transitioned onto the new diet, we'll get more serious about tracking her exercise capacity.

Again, my experience with Drs. Gillette and Barrett was incredible. I know it is very hard to do this sort of stuff over the phone but they managed quite well. I hope that they remember to send me the information and presentations that we talked about. That would definitely help. I have no confidence in my ability to create a well balanced raw diet, even with the help of my friends. I feel like everything I've read and learned to get comfortable with putting her on a raw diet is now in question. 

So, for now, no clear cut answer. But we know that it is metabolic and are going to set about determining what the cause of it is. If it is the diet, it will be a relatively quick and easy fix. Though it will have been a very painful lesson and I will likely feel guilty about it for a very long time. But I'll have my crazy girl back to full speed soon :-)  If it's not the diet, there's really no guarantee that we will be able to get to the cause of it. We would probably try a few things but there are lots of possibilities, not all easily tested for. Either way, Gata and Tor will probably end up being some of the best fed and conditioned dogs around :-) 

Week 1, Day 4

Morning workout: 5:15 am
Program: Walk to park, 2 sets of 4, with break between
Total time: 25 minutes (significant portion spent on loose leash walking on way to park)
Status: Trotted back on final throw of 1st set; Tired, but not bad, did not lay down; Initially seemed fresh as we made our circuit of the park but Gata seemed to continue heating up as we left the park and did a little lagging and drunken sailor walking on the way home. Was she continuing to heat up? Should probably start documenting temp again ...

Recovery Meal: Revive + 1/2 c sugar (200 mls each) + 1 T corn oil + 1/3# meat mix + 1/3 cup oatmeal +1 egg given within 30 minutes of end of exercise

Breakfast: RMB + 1 Pemmikan square when I left for work

Temp in the low 70s, high humidity. Dogs recovered well and looked good.

Monday, July 30, 2012

Week 1, Day 3

Morning workout:

Program: Walk to park, 1 set of 5, break, OB (2-3 minutes each), 1 set of 3
Total time: 32 minutes (significant portion spent on loose leash walking on way to park)
Status: Trotted back on final throw; Tired, both dogs laid down following completion, but no signs of collapse or drunken sailor walking; Gata lagged slightly on the walk home.

Recovery drink: Revive + 1/2 c sugar (200 mls each) + 1 T corn oil + 1/3# meat mix + 1/3 cup oatmeal +1 egg given within 30 minutes of end of exercise

Temp in the high 60s to low 70s, humidity moderate to high. Dogs recovered well and looked good.

Sunday, July 29, 2012

Purpose of Pedigree Analysis

In a previous post I basically uploaded some information that I had provided to our vets at Auburn before we went down. This document included a brief pedigree analysis with respect to Gata's pedigree and the health issues in Belgian Shepherds. I made a statement in that analysis about a specific dog that should not have been made public. And, I find myself in the position of having to explain.

First off, I should explain that I am a bit of an information jockey and will spend hours finding answers to obscure questions and developing studies to address those questions. I get paid for this. But that characteristic carries over into many of my hobbies as well.

I personally know Gata's sire, dam, and her dam. All are wonderfully vibrant, healthy dogs that I absolutely adore. I consider them to be the epitome of what I want in a Belgian - beautiful, active, athletic, intense, handler-focused. And I decided that I wanted a puppy from that lineage.

As my journey in Belgians continued, I became interested in pedigree analysis. First, there was very little information about Gata's ancestors since both her granddam and her sire were imported. Secondly, I just find it interesting. And, of course, while researching pedigrees you may also find health information along the way.

While pursuing that hobby, I began accruing information on Gata's direct ancestors and dogs descended from or related to them. Since there is not an abundance of information available, I simply gathered what I could when I found it. It was not something that I was particularly concerned with at the time. Gata is, and always has been, the very picture of a healthy dog. Though she had collapsed twice the summer after she turned 1, I was able to avoid further collapses by modifying our work sessions. I just considered her to be a dog with limited endurance due to the intensity of her work. After all, some of us are sprinters and some of us are endurance runners, why should it be different in dogs??

Following our move to Maryland, that all changed. I simply could not avoid the collapses or symptoms leading up to them given the very different environmental conditions out here. At that time I became quite serious about figuring out what was going on with Gata. As you can tell from reading this blog, I have spent a great deal of time, effort and money on this.

While preparing for the trip to Auburn, I wrote a document to provide a relatively thorough review of Gata's history, not as the final word on that topic, but as a starting off point. Included within that document was a very short segment on her pedigree. I called a particular dog a "red flag dog" because in my analysis I had found descendants of that dog or it's full siblings that were documented as having many of the health issues of concern in Belgian Shepherds.

For my purposes, all I was interested in was whether I needed to draw attention to any of those health concerns, particularly Epilepsy since it is being considered by the folks at U of MN as a potential cause of a collapse syndrome similar to what Gata shows. I do not know, nor can I, if that dog has a higher incidence of these concerns in its descendants than other Belgian Shepherds since, for the most part, that information is hidden away. However, the breeders involved in this particular line of dogs have elected not to hide that information, for which I commend them.

However, that does not mean that I should have published the name of any dogs, other than my own, on my blog and I will not do so in the future. I have humbly offered my sincere apologies to those involved and am writing this post as a means of explaining to anyone that may have read the original post and been in any way alarmed or offended at my mention of that particular dog.

Saturday, July 28, 2012

Back to Basics ...

I've had the call with Drs. Gillette and Barrett. I'll post a more detailed write up on that later. Until I get a little more information from them on exactly what they want in a diet for a performance dog I'm making a few modifications on my own. Once I get that information, I'll have a special diet made up for my dogs and the final transition will be completed. For now, I am working on adding more fat and more carbs to their diet and continuing on with our normal conditioning program.

And since I want to be able to report back to them in a few weeks on Gata's progress, I am going to start tracking it again, with a few additional bits of information.

Program: Walk to park, 1 set of 6
Total time: 15 minutes
Status: Completed all 6 at a run; Tired, both dogs laid down following completion, but no signs of collapse or drunken sailor walking; no lagging or any other symptoms on the walk home.

Recovery drink: Revive (200 mls each) + 1 sq. Pemmikan + 1 T Corn Oil + 1/3# meat mix + 1/3 cup Oatmeal given within 30 minutes of end of exercise

Slept in a little and got a little bit of a late start; temp already in the mid 70s, humidity moderate to high, so decided to take it a little easy and just stretch 1 set to see what we could get. Plus, it's Saturday and though we will miss club to get a cystocentesis on Gata, we might still do other things :-)  Tor had a little bit of the runs this morning, probably from the sedation yesterday for his OFAs. So, all in all, I think 1 set of 6 was pretty good.

Dogs looked good.

Sunday, July 22, 2012

Nutrition - Current Thoughts on Raw

I'm feeling pretty bad about my decision to feed raw these days. I'm not feeling bad because I think it was a bad decision, but because I dropped the ball. I learned the basics and then stopped worrying about it. When I made the decision to keep Gata on raw it was my responsibility to keep up on the research, to take control. I got lazy. I don't know that I caused her collapses as a result of my laziness but I certainly contributed to them.

There is a perception out there that raw is easy, anybody can do it. You just mix a bit of this and a bit of that together and over time balance is achieved. Now maybe it is that easy for the average pet dog. But Gata is not the average pet dog and I don't train and condition her like the average pet dog. Her life is more like that of a high performance athlete in various stages of preparation for competition. Unfortunately, that's not how I was feeding her.

Now to be fair, it's not like Gata doesn't look to be in perfect health. Until Auburn, no vet had even considered the possibility that she wasn't getting adequate nutrition. Her coat looks splendid - rich, intense color and good shine, her eyes are bright, her toenails are healthy and grow fast. She certainly has not been sick very often. But we've had this issue with collapses since the summer after she turned 1.

Dr. Gillette focused in on the diet pretty early on. Not in an anti-raw way but in a very focused way - are you supplementing her with anything? Is she getting fat from anything else? We talked about the types of meat, the specific cuts of meat, the different fat contents of each, the types of oils that I have been giving her, etc.  Based on our discussion, she has probably been fat deprived since she was weaned. Wow ...   That's not good.

OK, but what exactly does that mean? That was my goal when I left there and is what I am reading up on in my spare time I was pretty motivated after the discussions with Dr. Gillette. I became even more motivated when I got the results of her blood work and urinalysis and saw that her triglycerides are consistently low. She has no fat stores available to her to fuel her incredibly big motor ...  So I guess she really has been running on pure heart and desire. What an incredible dog to do everything she has without the proper nutrition.

I think I'll go beat my head against a wall a few more times before I get back to my reading. I will be taking my responsibility more seriously in the future. I probably won't take her off raw, she's been on it her whole life, but I will supplement it with other things. Hopefully, it will help. I'm not sure that I would put another dog on raw in the future. The big question is what to do about Tor; leave him on raw with the same modifications as Gata or ???

History Sent to Auburn

I am trying to consolidate as much of the information about Gata's collapses in one place so that when I decide to publicize what is going on people can get as much information as possible from a single location. Plus, it may be useful for me in the future. This is a modified version of the history document that I sent to Dr. Gillette and Dr. Barrett at Auburn before going down. I modified it to reflect a couple of details that they inquired about. However, I did not update it to include all the other topics of conversation that we had regarding her family members, metabolic pathways, discussions on diet, etc.


GATA BASICS: Gata is a 5 y.o. spayed female Belgian Tervuren. She has competed successfully in a number of sports (RA, CD, SchH3) and is not a dog that would be happy to retire. Her history is mostly unremarkable aside from a few things. I'm listing everything I can think of here, in case it might help.

She has lived most of her life in the San Francisco bay area until 1 year ago when we moved to Maryland. During the time we lived in California she came almost everywhere with me and stayed in her crate in the car. The weather is very moderate out there and she seemed to tolerate it well. Her vaccinations and preventative care has followed the norms for this part of the country - vaccinations every 3 years following the booster at 1 year, heart worm preventative over the summer. Her puppy vaccines consisted of the 2 in 1 vaccine (distemper and parvo) at approximately 7 and 11 weeks; and the 4 in 1 vaccine after that. Her first rabies vaccine was given at approximately 4 months and the next about a year later. She has not had any reactions to vaccines.

She does, however, show a classic allergic reaction to various different bee/spider/bug stings. I don’t know exactly what stung her each time, but she has had 3 clear incidents. All responded well to a couple of doses of anti-histamine, but the last incident was quite noticeably worse than the previous two. I don’t know if that was because of what stung her or if her allergy is getting worse.

DIET: Gata is on a raw diet - predominantly prey model. However, since moving to MD I have found that it is easier to buy a commercial product than making it myself. So she now gets some veggies in her food. In addition, she gets the following daily supplements:
    Salmon oil
    Genesis - by 10-Squared Racing
    Green Kelp - by 10-Squared Racing
    Revive - 10-Squared Racing (not daily, but as a recovery drink following intense exercise away from home)

TICK EXPOSURE: At approximately 9 months of age I picked her up from an approximately 3 week boarding situation and found an engorged tick behind one ear.

HEAT EXPOSURE: At approximately 1 year of age, I had left the car only slightly vented due to rain. The rain stopped and the sun came out. I came at about 11:00 to take her for some exercise and found that she was quite hot in the car. I got her out and cooled her off. I don't know if this could be the start/cause of her "heat-related collapses" for lack of a better term. Another dog in the car at the time, a young female Cavalier King Charles, was unaffected. She was about 2 months older than Gata.

FIRST 2 COLLAPSES: At approximately 15 months of age she had her only 2 full collapses in California. Both took place during the summer, within a few weeks of each other, during our lunch break exercise/training session. Both instances followed very similar patterns.
    *  Sunny and warm; temp ≤ 85-degrees F
    *  Exercise consisted of 10-20 minutes of obedience training with ball reward, thrown using a Chuck It.
     * Collapse occurred while walking her out after exercise
     * Collapses were a multi-stage process with a pattern like – collapse, get up try to walk, collapse again, repeat
     * Recovery also became a familiar pattern – shade, wet her down as much as possible given the location, complete within 25 minutes.
     * After the 2nd incident, I changed several things. I became far more watchful and instituted a rule of thumb that once she trotted back to me with the ball, she was done. That served us well in California as I never had another full collapse out there.
     * Discussed it with her breeder. She suggested that it might be Exercise-Induced Collapse or something like that.

INJURY: At approximately 2 years of age she had a significant injury during Schutzhund training. It occurred on one of her first real long bites. She is a very fast dog and was unable to hold her grip on the sleeve. She slipped off the sleeve and landed in a position that looked very much like a frog about to jump - her back was hyper-extended and both back legs were tightly flexed.
   * As I took her from the field both back legs seemed affected, and her tail was down
   * Vets exam revealed that she had strained both iliopsoas (right worse than left) and potentially injured her back
   * Identified the TL junction as an area of potential injury
   * She was given time off and restricted activity but not forced crate rest
   * Tail remained down for about 2 weeks
   * Returned to training in about 6 months with intermittent time off after that as symptoms warranted.

SPAY: At approximately 3 years of age I had her spayed.
               * She cycled at about 4.5 month intervals
               * Seemed to go into a false pregnancy with every cycle

Since my goal is simply to have a great pet and a dog to compete with, the breeding potential was not as important to me. And the impact of the false pregnancies on her energy level and training was quite significant. I was also concerned that the false pregnancies put her at an increased risk for pyometra.

SEIZURE: At approximately 3.5 years of age, she had something that looked very much like a seizure. I believe that she was exposed to something through her pads when I had her out tracking earlier that day. We had stopped at one of our favorite tracking locations and I had her out with me while I was walking around to check it out. I smelled something heavy in the air so decided not to track there. To me it had the smell of something like Round Up but there were no signs or anything posted.
   * It was a very muddy day
   * I remember essentially breaking off "mud boots" from all 4 feet and washing them when we got home.
  *  Approximately 4 hours later, while she was sleeping, she appeared to have a seizure. It involved her whole body but seemed to start with her back end. She woke herself up with the movement and the seizure stopped shortly after she woke.

To be totally honest, I was not entirely sure whether it was a VERY active dream or a seizure at the time. I believed it was a seizure but could not be absolutely sure.

Though Belgians are known for epilepsy, there are no animals that I can identify in her pedigree that are known epileptic dogs. However, I should also note that Belgians are also known for false pedigrees. I believe that the pedigree of Gata's dam is correct. I also believe that the pedigree of her sire is incorrect. So, any pedigree analysis should be taken with a grain of salt.

Potentially related to the topic of seizures/epilepsy: Gata has incidents of very active “dreams”. I’ve seen about 8-10 of these “dreams”. This is a relatively recent phenomenon – something that I have only seen since we moved to Maryland. I put dreams in quotes because she isn’t always asleep, though she is always resting. It seems like they occur on the same day or within a couple of days of a particularly demanding training/conditioning session. These pretty much always look the same – She’s curled up resting after work and may be asleep. Her back legs become quite active and may remain active for a very short period of time even after she wakes up. I have seen her wake up and turn to look at her legs, as if wondering what was going on. I have even seen one which happened while she was clearly not asleep. The best way I can characterize them is to say that they look like a female dog having an orgasm.

OTHER HEALTH PROBLEMS IN BELGIANS: Belgians are generally a healthy breed. But there are a few health issues that are more common in the breed. Since Gata is a mix of Malinois, Tervueren, and Groenendael bloodlines I will not try to give specific prevalence numbers for these conditions, but will bracket them as Higher Prevalence/Concern and Lower Prevalence/Concern.

Higher Prevalence/Concern Health Issues:
          Stomach Cancer
          Autoimmune Thyroiditis

Lower Prevalence/Concern Health Issues
         Hip/Elbow Dysplasia
         PRA and/or Cataracts
         Autoimmune Disorders

MOVE: We arrived in Maryland mid-July of 2011. The area was in the midst of a significant heat wave with heat indexes in excess of 100-degrees F for the next 6 weeks. Gata had very little exercise during that period, walks, with limited training activities inside.

RETURN OF COLLAPSES: Late August we moved into a house in Poolesville. I started trying to exercise her in the early mornings before work, during the coolest part of the day.
  *  The collapses were nearly unavoidable;
   * Stopping when she trotted back to me was not soon enough - she would progress to full collapse.
   * I started to recognize other symptoms that I now consider to be part of the collapse process - mainly the "drunken sailor walk". I realize now that although I was able to avoid additional full collapses in California, that I had seen the "drunken sailor walk" on numerous occasions following exercise  out there.
   * It seemed that every incident of collapse, whether it progressed to full collapse or was terminated in the "drunken sailor walk" stage, made another incident more likely.
   * I have a hard time describing what I am seeing/feeling but I am now able to detect a change in her movement as she returns to me so that I can stop her even earlier. This has improved my ability to prevent full collapses but she still progresses to the "drunken sailor" stage far too often
   * I have identified an earlier stage a couple of times. It is unique in that she will lag behind me after exercise, sometimes severely. She may exhibit intermittent “drunken sailor walking” but it is not consistent. Gata is not a dog that lags behind me, ever. I believe that this is the earliest stage that I have been able to interrupt her collapses.

    Total number of full collapses probably 6-8, including the one in the video
    Total number of drunken sailor walking: too many to remember them all, at least 20, probably ess than 100
    Lowest temperature: last fall, time approximately 6:00 am, temperature 54-degrees F
    Body temperature during work rises to at least 106.5, but does not appear to be correlated with collapse
    Collapses have occurred following ball play, obedience, and bite work - all high intensity activities for Gata
    Collapses have never occurred following walks, trotting beside the bike (though limited evidence here - newer activity), tracking, or hiking
    Collapses appear to be environmental temperature related, though it does not have to be very hot. If it has been hot they can occur at relatively cooler temperatures. If it has been cool they can occur at relatively lower temperatures that are higher than what it has been (as in the video).
    Full sun seems to make them more likely, but they can occur at dusk or dawn as well.
    Collapses do not occur when it is raining, though they can occur after it has rained
    Recovery occurs relatively rapidly, within 25 minutes, significantly less if I can get her into water
    Recovery appears to be full - though I do not work her at all for several days following a full collapse or an appearance of drunken sailor walking. And, I suspect, that the more often it happens the more often it will happen, which suggests something other than a "full recovery".

THINGS WE HAVE TESTED: (See accompanying lab work)
    Tick-borne diseases - initially had a false positive for Ehrlichia canis on a SNAP test, but we performed the ELISA and determined that it was a FALSE positive.
    Glucose levels
    Electrolyte levels
    Full CBC and chemistry panel
    Thyroid - Full panel
    Heart - before and after exercise, but she has not worn a Holter monitor during a collapse
    EIC - By U of MN - Negative
    Full set of spinal x-rays (also attached)
    Phenobarbital levels - We put Gata on Phenobarbital to see if it might help prevent collapses, as reported for some dogs with EIC, and as a precaution given the possible seizure I observed and prevalence of epilepsy in Belgians. The collapse that was videotaped was while she was on Phenobarbital. We have since taken her off of Phenobarbital, partly in case you wanted to do an EEG.

THINGS WE HAVE DISCUSSED TESTING: (In order of our priority/resource availability)
    Muscle biopsy before and after collapse, additional other time points (??)
    Creatine and creatine phosphokinase before and after a collapse, additional other time points (??)
    Holter monitor during exercise leading to collapse
    EEG to rule out seizures/epilepsy due to one of the current hypotheses being tested in the U of MN Border Collie Collapse project
    MRI - to ensure that there are no spinal issues not visible by x-ray

But none of these are tests that are easily (or reliably) performed by the typical, small animal, vet practice

Saturday, July 21, 2012

Aftermath of the Video - Trip to Auburn

With the video in hand, I went to work trying to get it in front of the right people. Part of that was figuring out who the right people were. I think about a dozen vets viewed the video from my local vets that have done so much to help me try to figure this out and their specialty colleagues to the folks at the U of MN working on EIC and now BCC to my former vets in California. 

Ultimately, I got it in front of Dr. Robert L. Gillette at Auburn University. Several people referred me to him and his writings. He specializes in various aspects of high performance canines, including exercise physiology and nutrition. With nothing more to pursue on the EIC/BCC front until they have a test for BCC, it seemed that the only other possible explanations would be metabolic.

After several phone calls and email exchanges it was finally all set up. I took Gata down to Auburn to see Dr. Gillette and his colleague Dr. Jay Barrett the week of July 9th. Following is an email that I sent to a bunch of friends after we got home. Though I have most of the results I am still waiting for an interpretation from Dr.Gillette. Unfortunately, he was away at a meeting this week, so I will have to wait a little longer.


We are back from Auburn and are now in the waiting phase. It will take a little while to get all the results back. I'll try to give you a quick overview of what we did and what the working hypotheses are, so far.

First, I guess I should mention that this was one of the most intense and involved discussion that I've ever had with vets. We started out by discussing Gata's history for about 4 hours. Pretty much everything from the health of her parents to the "Fevers of Unknown Origin" of some of her siblings/half-siblings to her vaccination schedule to the environment that she has lived in (toxins, pests, other pets, etc.) to her conditioning program to the history of the collapses got it's fair share of time. The consensus of opinion, based on the video and information that I provided, is that the collapses appear to be most representative of a metabolic defect of some sort.

Ultimately we generated a very long list of things that we wanted to test - blood chemistry, electrolytes, temperature (rectal and core), ECG, urinalysis, and blood gases. I won't list all of the things we decided to test for in the blood chemistry - it is a very long list and I would almost certainly forget something. We included a few fliers that are extremely low probability but would absolutely change everything if any of them came back positive.

The basic set up was as follows:
Wednesday - discussion, planning and official "Rest" day 
Thursday - exercise and experimental day - time points included - pre-work, immediately after work, several recovery time points
Friday - final recovery time point

At each time point several measurements were taken:
1. ECG
2. Temperature (Rectal only on "Rest" day, rectal and core at all other time points - she had to take a pill with a thermister in it)
3. Respiratory rate
4. Blood collected
5. Blood gases run immediately 
6. Capillary refill time

In addition, urinalysis was run at several different points along the way.

Though I went there expecting to collapse her, they felt that was not necessary. They feel that the collapse is an extreme of what is likely occurring every time that I am working her. That if there is a metabolic defect it will show up during regular work. Plus, to be honest, none of us really wanted to take that chance. Dr. Gillette was very clear that he really didn't like to have dogs die in his studies.

So, on Wednesday afternoon, we shaved a bunch of spots on her for the ECG and jugular blood collections. We took 12 mls of blood at each time point, so it had to be jugular. Given the frequency of blood draws and other measurements we decided to muzzle her each time that a measurement was taken. It just made everybody more comfortable. Plus, there would be many people around her on Thursday taking different measurements as quickly as possible. We did the first set of measurements at that time. A couple of measurements in her blood gases were immediately unusual - in unexpected (unusual) ways that had everybody sort of scratching their head wondering what that meant.

Thursday morning we started a little early. I gave Gata the pill containing the thermister and we all headed over to a field that they use for their regular studies. We had agreed upon a protocol that I could modify slightly. I would send her out on long retrieves using the Chuck It. One of our standard conditioning routines is Chuck It retrieves in an interval training approach. At this time of the year I have been using 5 long throws per set. So we elected to do 1 full set for the "work" portion of the experiment.  We would then take a full set of measurements. After that I would tell her she was done and cool her out as normal. We planned to take several measurements over the 20 minute recovery period and then a few more over the remainder of the day and Friday.

Dr. Gillette has done quite a bit of work on anticipation and its effects on metabolism. So once they had everything set up, I brought her down, letting her get a bit wound up about the work - put on my training vest and let her see the Chuck It. We took a full set of measurements at that point, prior to her working. We saw the same anomalies in her blood gases that we had seen on Wednesday.

Then I worked her and the rapid fire measurements began. A few things that were "unusual":
1. The blood gas measurements were even more bizarrely strange - in a way that no one could remember having read about before
2. While in the recovery period her temperature continued to rise, to the point that although she had looked good at the end of work we were concerned that she might progress into collapse. At that point I gave her some ice cold water to drink from the garden sprayer that I have been using to cool her after work.
3. She cooled a little but began heating up again, at which point I sprayed her down completely and we put her in the crate with the fans on her and the ice pads to lay on.
4. We initiated a second recovery period at that point.

The results will probably start coming in tomorrow or Tuesday but we won't have the full analysis for at least a week. Plus, Dr. Gillette is out of town next week. So it will be a little while before we come up with any answers or solutions. But we have a couple of working hypotheses:
1. Painful for me to hear - Dr. Gillette believe that the raw diet I have been feeding her does not provide enough energy in the form of fat and carbohydrates for her. He has done numerous studies that show dogs of different types performing sustained activities utilize fats and carbohydrates preferentially. Though Gata is not truly engaged in endurance activities, some of our conditioning routines verge on being true endurance training and when you add in her intensity and speed that may tip them over. So, we will almost certainly be modifying her diet, perhaps significantly, though we do not expect to take her off raw entirely.

2. If she does have some sort of metabolic defect, which he thinks may be likely based on some of our discussion, it is possible that she simply can't get energy to her muscles fast enough or get rid of the waste metabolic products fast enough. The blood gases suggest that she definitely does not get rid of the wastes efficiently while working. However, #1 may also have an impact on this ... 

3. There are a large number of other possibilities that we also tested for with the blood work. 

Got the Video of Gata Collapsing

Gata has continued to collapse as the seasons progressed and the weather warmed. On Saturday, April 14th, Gata collapsed during a Schutzhund club Obedience day and we got it on video.

The temperature that day was probably right around 70-degrees at the time that I worked her. It was the first real warm day of spring and was significantly warmer than it had been. The sun was bright and it was right around noon when I worked her. I knew that the conditions were right for a collapse, if she was still collapsing. She had been on Phenobarbital for about 5 months at this time. So, I didn't really know if she would collapse or not.

I talked to everyone at club and let them know about the collapses and asked if someone would videotape her working. I worked her for about 10 minutes. It was something between a regular obedience session and a straight up conditioning session. There were a few short breaks in it but not many. She was definitely getting hot - I could see the signs but she kept working. After we finished, I let her trot off the field to lay down in the shade. 

I got a leash and went over to walk her out. It was instantly apparent that she would collapse, so somebody picked up the camera and started videotaping again. It was a bit shocking for them and they stopped recording when she collapsed to see if I needed any collapse, so we didn't get the entire collapse. But we got most of it. 

I then picked her up and carried her over to a creek nearby and put her down in it. She recovered very quickly in the cold spring water. The entire collapse and recovery lasted less than 10 minutes, of which about 7 minutes are on video.

I'll post links to the videos below. However, before anybody reading this watches them you should know that they are disturbing. I am aware of that. I set her up and worked her specifically to see if she would collapse. It was no easier to do than it is to watch. In fact, it was quite a bit harder to do than it is to watch. After all, I adore Gata, everything about her EXCEPT the collapses.

Here are the video links and a brief description of each video:

Video 1 (about 10 minutes) shows the obedience and ball play before the collapse. There were a few things clearly noticeable to me while working her. She starting trotting back with the ball relatively early, almost fell out of a sit stay at one point, and then started looking at the shade and even heading toward it before returning the ball, I took those all as signs that she was over heating and could potentially collapse.

Video 2 (very short) is the start of the collapse. I think the guy taking the video pressed the wrong button or was a little freaked out by what was happening and thought he should stop the video and help her, not sure ...

Video 3 shows the final collapse and recovery (about 7 minutes)


Both dogs have had birthdays since my last regular post, so I'll write about both of them together.

Gata turned 5!  How is that even possible??  I still remember the night she was born, the day she climbed into my lap and fell asleep in my arms, the day Denise told me that she was my puppy :-)  

So how has Gata changed in the last 5 years? Well, she is certainly bigger  ...  Yeah, I know, bad joke. But, seriously she is a big and powerful female. We were pretty sure that she would be, or at least bigger than some of the puppies in her litter. She is just about exactly 24-inches tall and weighs around 55-pounds. She is a glorious mahogany red color. I like the charbonnage but it hides some of her redness, which I liked better. But she is a beautiful dog. Trying to describe her temperament is most assuredly an exercise in futility. Words can't begin to describe her. She is absolutely the center of my world. 

Tor turned 2!  He is growing up and finally looks almost grown up :-)  He is certainly an impressive looking dog. He is also tall - right around 26-inches and weighed 71-pounds the last time I weighed him. I expect that his weight will fluctuate a bit for awhile as he puts on more muscle, but hope that he doesn't go beyond 73-pounds or so ...  He is still almost a pure red. I see the beginning of charbonnage on his shoulders but not much yet. And, he is definitely a Terv :-)  He doesn't have a lot of coat, but enough to be Terv anywhere except in the U.S.

Temperamentally, he's still got a little growing up to do. But he is a really cool dog. His drives continue to be incredible and biddability also remains excellent. It's a good thing he is so biddable, 'cuz he would be LOTS of trouble if he wasn't. He's learned so much and come so far on so many things that it's actually hard to summarize here. But he is a freakishly delightful dog, not always friendly, but delightful none the less. He is a complete goofball :-) 

Catching Up ...

It has been too long since I wrote in my blog. I really enjoy writing and like the opportunity to express what is on my mind. I just get too busy sometimes ...

Lots has happened over the last few months. Some of the topics that I will be writing about over the upcoming days and weeks include:
1. Updates on Gata - lots going on here. I got a video of a collapse and took her to see Dr. Gillette and his group at Auburn. Still waiting for all the results and interpretation of them.
2. Went to a Bob Bailey and Parvene Farhoody seminar - FASCINATING stuff :-)  Took about 5 pages of notes, so this will likely turn into a multiple entry topic :-)
3. Tor turned 2!!  OFAs scheduled for next week :-)
4. Gata turned 5 - Where has the time gone?  She is still the most amazing dog ever :-)

So, I am going to end this post with the list and start writing about a couple of the items above :-)