Friday, 18 July 2014

Blue's got some magic in his elbows....

Tonight, for the first time in 2 years, I reduced Blue's dose of Deramaxx.

For those of you not familiar with Deramaxx, it is one of several brands of dog pain relievers in the NSAID family of drugs (Non Steroidal Anti-Iflammatory Drugs). We liken it to doggie aspirin or ibuprofen  - but don't give your dog those (or any human pain reliever) without your veterinarian's okay as they can be very toxic for dogs!

Blue has been on a moderate daily dose of Deramaxx ever since he had to give up agility several years ago. Despite the significant pain reduction that came with stem cell therapy, Blue still required the same dose of Deramaxx to keep him as pain-free as possible.

Blue has had two rounds of stem cells. If you want to know more about stem cell therapy you can read about it here.  Blue's second round of stem cell therapy lasted about 7 months before he became quite limpy again. Since stem cells were no longer an option, Dr. Dave Lane suggested injecting his elbows with a combination of a steroid (triamcinolone) and hyaluronic acid (a component of the normal joint fluid) to see if that would help to relieve his pain.



Blue and Dr. Lane have a long history together. I first consulted with Dr. Lane in early 2010 when Blue refused to do the weave poles during agility class. Our agility instructor suggested that a chiropractic adjustment might benefit him.

I have to admit I was skeptical. I am a fan of chiropracty for myself as it relieved headaches I got from long study sessions and little exercise when I was in vet school. But for dogs? How can you really tell if it worked? I decided that if I was going to try chiropracty on Blue, I wanted a veterinarian to do it because at least they would be intimately familiar with dog anatomy. I did a little digging and was happy to find out that Dr. Lane (who I knew previously as a good veterinarian) did pet chiropracty. Not only that but he also did canine sports medicine. I hadn't known there was such an area of practice!

Dr. Lane examined Blue and suggested some acupuncture and chiropractic adjustments for him. Again, I was skeptical. I felt that acupuncture had worked for me but I also know that I am probably not immune to the placebo effect.  Once again, how would we know if it worked?

Dr. Lane examined Blue in the back area of the emergency clinic. Blue was doing his usual anxious happy dog thing where he just cannot sit still. He was in constant motion, rubbing all over Dr. Lane and I, weaving around us, panting heavily and wagging his tail like crazy. Dr. Lane popped an acupuncture needle into the top of Blue's head and within about 5 minutes Blue had calmed dramatically. By 10 minutes he had settled onto the floor, flat on his side, with a relaxed sigh. I could not believe what I was seeing. It was like he had been heavily sedated. Ok then. That settled the acupuncture question.

And Dr. Lane's treatments also settled the chiropracty questions. Blue hit the weave poles without a problem the next class. Dr. Lane continued to keep Blue in top musculoskeletal shape throughout his agility career by seeing him on an as-needed basis.

Agility has ended but we continue to see Dr. Lane to correct the muscle spasms and skeletal imbalances that Blue gets from compensating for his progressively arthritic elbows. The combination of acupuncture, laser (the non-scammy kind) and chiropractic adjustments help Blue move with less pain. 

And now he's put some magic into Blue's elbows.

Just over a week ago, Dr. Lane injected Blue's elbows with the steroid-hyaluronic acid combination. I gave Blue some light sedation for the procedure but the actual injection seemed pretty painless. About about 48 hours I noticed that Blue was happier than usual.

On his first big walk on Monday, 4 days after the injections, Blue was farther ahead of me on the walk. He still was moderately lame by the end of the walk but after getting home he slept less than usual throughout the day.

On Wednesday he was barely limping at the end of the walk and was more active throughout the rest of the day.

On Thursday Blue rose to his feet from lying down like a normal dog. The movement was so different in that it was done with so much ease that I suddenly realised that that Blue's "new normal" is to fling himself to his feet, probably to avoid putting weight on his elbows. The absolute lack of effort in getting up was amazing.

Today, Friday, he was raring to go (normally 3 long walks in a week are more than enough for him) and during our walk he offered me not one, but two play-bows! That in itself was amazing - I don't think he has ever done that before - but even more amazing was that his anxiety and reactivity were dramatically reduced. There was another dog playing quite close to us and Blue displayed very little anxiety and none of the usual reactivity that this proximity would generally provoke. Tonight he is happy and not lame so I reduced his Deramaxx dose. I never thought that would happen.

Like I said, magic.

Visit Dr. Lane's web page at Points East West to see if maybe he can put a little magic into your dog's life.











Sunday, 18 May 2014

Primal "Granola" Bars

The hardest things to duplicate are the ready-made snacks that used to go in my stepson's lunches. Like many kids, he loooves granola bars. Sure, store bought granola bars are convenient but are filled with sugar and other evil things. And - which really makes me shudder - they have a 6 month expiry date on them. How can "food" have a 6 month expiry date?

Its not easy to replicate the chewy, sticky granola bar in paleo or primal fashion. And I didn't manage it despite many attempts. These "granola" bars are a bit crumbly at room temperature and hold together best when cold. Initially they are a bit time consuming to make but once you get the flow of it they come together quite quickly. AND they are delicious. Stepkid gives them 2 thumbs up (phew!).


People have been bugging me to put the recipe on the blog for ages so finally, here it is.

Gather Tools:

3 bowls: 1 small, one medium and 1 large
food processor or a chopping knife and muscle
9 x 11 inch baking pan
parchment paper
things to stir with - whisk, wooden spoon, clean hands
something to compress the bars with - bent spatula; Marcus favours a potato masher we have

Gather Ingredients:

1 Tbsp ground flax seed
1.5 Tbsp water
1/3 cup coconut oil or butter
1/4 cup almond butter
1/4 cup honey
1 tsp vanilla
3 slightly heaping Tbsp coconut flour
3/4 tsp baking soda

1 cup almonds
1/2 cup pecans
1/2 cup walnuts
1/3 cup raw or toasted pumpkin seeds
1/3 cup raw or toasted sunflower seeds

1.5 cups medium shredded unsweetened coconut flakes
handful of large coconut flakes

1/2 cup dark chocolate chips or finely chopped dark chocolate
coarse salt to taste

Method: 

Preheat oven to 350 degrees

Line the baking pan with a sheet of parchment paper big enough to come up the sides of the pan.

In the large bowl mix the ground flax seed with the water and allow to sit for 10 minutes.

In the small bowl mix together the oil/butter, almond butter, honey and vanilla. I usually microwave these to make them them easier to mix and later combine with the dry ingredients.  After 10 minutes, add contents of the small bowl to the large bowl and mix well.

Add coconut flour and baking soda to the large bowl and mix well. Set aside.

Toast the pumpkin and sunflower seeds by adding them to a dry skillet on medium heat. Stir frequently and remove from heat when they start to turn golden. Allow to cool.

Add the nuts and seeds to your food processor and chop until they are in various sizes that you think will be a nice texture in your bars. I generally do this in 2 batches so I that have some of the nuts and seeds ground up very finely  (like flour) and some that are still chunky. Pour chopped nuts and seeds  into the medium bowl. If you don't have a food processor, then chop these up with a knife. Yes, I did this a few times, I know its a long process. In fact this is what made me bite the bullet to buy a food processor. If you click the link this is the updated version of my food processor. Love the red.


Add the coconut flakes of both sizes to the nut-seed mixture and mix well.

Add the the seed-nut-coconut mixture to the wet ingredients in the large bowl and stir. Make sure the dry ingredients are thoroughly combined with the wet. I usually get in there with my hands and squish the mixture through my fingers to make sure its all well distributed. Pretty fun for kids of all ages.

Dump the granola bar mixture into the parchment paper lined pan, distribute evenly, then firmly press flat with hands and then some flat utensil. You want this mixture to be as compacted as evenly and firmly as possible.

Bake on the middle rack of the oven for 15 minutes.

As soon as the pan comes out of the oven, you are going to have to compact the bars again as they puff up as they come out the oven. Press hard. You know you are pressing hard enough when the bars get shiny from squishing the oils to the surface.


Immediately after compressing, sprinkle the chocolate chips evenly over the surface of the bars and let sit for a few minutes. This allows the chocolate time to warm and melt. With a table knife, spread the chocolate evenly over the surface of the bars. Sprinkle with coarse salt if you wish.

Let cool to room temperature then place in the refrigerator for a few hours. When cold, cut into 20 squares or bars with a sharp knife. Although the pieces look small, these bars are highly caloric dense. One is enough for a snack. Keep the bars in the fridge or in the freezer until ready to eat.


Notes: 

Brownie points for organic ingredients, soaked and dried nuts, grass fed butter and fair trade chocolate.


Has anyone been able to duplicate the bendy, chewy, non-crumby granola bars in paleo or primal fashion? Let me know in the comments.




Wednesday, 23 October 2013

Stem Cell Therapy - Blue's Experience

Our dog, Blue, has severe osteoarthritis in his elbows and his hips. Luckily, at this point, his pain is minimal. This is in no small part due to early surgical intervention during his puppyhood and the skills of his surgeon, Dr. Alan Kuzma. However, now that Blue is an older dog, I truly believe that stem cell therapy has made a significant and positive difference in his quality of life.

Blue is a lab-mastiff cross and unfortunately, he got the worst genetics traits of both breeds. He has elbow dysplasia (ununited anconeal processes) and hip dysplasia. Surgery to try to fix his elbows worked on his right side, but not on his left, and he eventually had to have another surgery to remove the bone fragment. As a consequence, that elbow is very arthritic as can be seen on Xrays. His right elbow is also arthritic but is not nearly as bad as the left. He had triple pelvic osteotomies (TPO) to correct his hip dysplasia and his hips look amazingly good.



Blue was pain free until about 2 years ago when he developed pain in his hind end. It started with yelping and favouring his right hind leg while going up the dog walk during agility, and  progressed rapidly to limping on his right hind after long walks. At the same time, he started limping for the first time on his left elbow, presumably because he was carrying more weight on that side. Blue is a very patient and stoic dog and on examining him, neither I, Dr. Lane, or Dr. Kuzma could find the source of the hind end pain.




We decided to try stem cell therapy because it seemed reasonable to assume the pain might be in his hips. I did a lot of researching about the success of stem cell therapy but at that time there wasn't a lot out there. There were more anecdotal reports that most dogs responded well. Dr. Kuzma warned me that the most severely arthritic joints often don't respond as well, which made sense, but he was hopeful that Blue's other joints would benefit.

Overall, after weighing the pros and cons, including the financial investment, we decided to go ahead with stem cell therapy.

Dr. Kuzma harvested fat from Blue's abdomen and it was sent immediately to Vet-Stem for culturing of the stem cells. Blue was a little sore from the collection as it involves making a small incision in his abdomen to collect the fat. He was back at Canada West 2 days later for injections of stem cells into each elbow, both hips, and one more given intravenously. Rehab at home included cold packing his joints, putting them through an easy range of motion, and resting until his abdominal incision had healed.

Unfortunately, we soon discovered that the pain in his hind end was not originating from his hips. His pain rapidly and significantly worsened and after many tests, including CT scan, myelogram, nerve conduction test and exploratory surgery in his spine, we still didn't have an answer. Thankfully, over time, things got better on their own, but the stress of dealing with his pain and not knowing what was causing it eclipsed any noticing of what was happening in his front end.

It is only in retrospect that I became aware of how stem cell therapy had helped his elbows.


Fast forward to today. Blue started limping a lot more on his left elbow a couple of months ago. It  made me suddenly realize that pain in this joint had not progressed at all in two years. All this time while I had been having tunnel vision about his hind end, his elbow had been quietly stable in its level of discomfort - until now.

So it was pretty easy to decide to do a second round of stem cell injections. From the beginning, Dr. Kuzma had told us that a second treatment a year or so later usually had some small beneficial effect but was usually not as dramatic as the first treatment. On the other hand, this time it would be much easier on Blue as there were extra stem cells stored at Vet-Stem. All we had to do was request they thaw and ship them to us. Dr. Kuzma injected both elbows and gave him another dose intravenously. We decided not to repeat his hips as it would mean Vet Stem would need to culture more cells ($) and also because his hips were seeming so pain-free.

Blue's response this time around is pretty incredible. Without other pain to distract me from noticing his elbow, I can see how much happier he is even just a week later. He is much farther ahead of me on walks, not just at the beginning but the whole time. He is brighter and more playful and asking for more exercise. His degree of limping late in the walk is dramatically reduced. He bounds up the stairs instead of plodding. I had a hard time believing this could be stem cells working so quickly so I asked Dr. Kuzma if it were possible. He said its what owners often tell him. Just amazing.

I think that if Blue hadn't had stem cells, considering the degree and rate of progression of pain in that elbow, at this point we might be considering euthanasia. Instead we are looking forward to another few years of minimal arthritic pain and good quality of life. We hope so; he is such a good dog that he deserves the best from us.


If you have been considering stem cell therapy, I'd encourage you to try it. We are so glad we did.


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