More Tests for Our CEO Olivia

Health

After talking to my Vet, we decided to book another ALP (alkaline phosphatase) test in three months.  ALP is an enzyme that helps break down proteins. The body uses ALP for a wide range of processes, & it plays a pawticularly important role in liver function. We have also included a Bile Acid test which will give us more information about how my liver is functioning.

Hi everyone, CEO Olivia here.  Many of you know that I live with idiopathic canine epilepsy, being diagnosed when I was just 1 year old. I have to take several AEDs (anti epilepsy drugs) daily.  One of them is called phenobarbital. Long term use of this drug can negatively effect the liver.

Recently, my bloodwork showed a slight elevation in my APL levels.  My vet isn’t overly concerned by the number, she reminded huMom that Phenobarbital can turn on the production of ALP.  Phenobarbital can benignly cause an elevated ALP, but as I mentioned it can also cause liver damage over time. Because of this we have dogcided to more testing so we can differentiate between a benign or toxic liver change. An increase ALP can also signal a gallbladder or bile problem or a tumor in the liver.  More testing will help huMom understand what is going on so we can move forward proactively. We even discussed pawtentionally meeting with my neurologist if necessary.

In the following weeks I’ll dogsplain what a Bile Acid Test is, how it works & why I’m having one done. I’ll also be barking about something called Euthyroid Syndrome which can be caused by phenobarbital. I also will be addressing those who have concerns about how CBD oil can effect the liver.

CEO Olivia

Olivia’s Annual Checkup Part 3

News

Hello everyone. Today I’m barking about the follow up phone calls between my huMom & my vet Dr. Jodi. My huMom had lots of questions & Dr. Jodi was herself doing research on my behalf. Both wanted to plot the best way forward for yours truly.

We left off last week waiting to hear back from Dr. Jodi to discuss a schedule strategy for lowering my phenobarbital medication. When she called we were told that the best approach was to go as slow as possible.  A 25% reduction was the plan. What that would mean for me is that my 60mg dose every 12 hours would go to 45mg every 12 hours for a minimum of 4 weeks.  At the 2 week mark we would touch base & discuss how things were going.  If all goes well we would decrease my dose another 25% for an additional 4 weeks with another 2 week check in point. That would reduce my dose from 45mg to 30mg every 12 hours; half of the dose I currently take. From there 25% would take us to 22.5mg & that would be difficult to administer.  For that reason Dr. Jodi would have to look into other possible means of meeting a closer range, i.e. 20mg. I should bark that if we were to see breakthrough seizures we would have to readdress lowering the dose any further.

Since we were coming into a full moon cycle we decided to wait until after April 29th to begin this reduction; that is, as long as there was no unsettling weather.

During the wait for our projected start date Dr. Jodi called again.  She wanted to share some new information she had learned regarding Phenobarbital & ALP levels & the risk involved in decreasing phenobarbital to sub therapeutic levels especially for a Epilepsy Warrior like myself who experiences cluster seizures.

Dr. Jodi informed us that certain medications can turn on the production of ALP & phenobarbital happens to be one of those drugs.  Phenobarbital can benignly cause an elevated ALP (Alkaline phosphatase) but it can also cause liver damage. She felt that my ALP level was not of great concern at this point.

Dr. Jodi also shared her concerns around breakthrough seizures if we were to lower my dose of phenobarbital to sub therapeutic levels.  She had read that after reducing phenobarbital, if I were to have breakthrough seizures it could be difficult for me to regain management with this drug. With my history of cluster seizures she was concerned that this was a possibility.  HuMom & Dr. Jodi discussed quality of life & how seizure management is of the upmost importance.  Her recommendation is to stay at my current dose & retest in 2-3 months.

HuMom explained that I am currently using a CBD product that we feel is responsible for the increase in my seizure free days; today I am at 82 days.  HuMom went on to say she understood that CBD could increase the efficacy of AEDs (anti epileptic drugs) & that it was our hope when we started our CBD journey to reduce some of my AEDs; more so my phenobarbital. However, we were looking for a greater number of seizure free days; more like 6 months to a year before having this discussion.  With that said, huMom agreed to continue my dose at it’s current 60mg every 12 hours & we would recheck my ALP levels again July 13th.

There are many reason that a dog could have elevated ALP levels & I intend to do a blog post on this topic in the future.

I of course will also keep everyone pupdated about my next blood tests in July.

💜 nose nudges 💜

CEO Olivia

 

Olivia’s Annual Checkup Part 2

News

Hello everyone, this week I’m barking about my blood work, my results & huMom’s post check up phone call with my vet. They had a very long, detailed conversation where my vet answered all huMom’s questions as well as discussed how to move forward with my medications.

First I need to bark proudly that I am in excellent health. My Heartworm test came back negative.  This is a relief because we do not use prescriptive heartworm preventative medication due to the neurotoxic drugs in their make up. Instead we use Herbacoat which contains neem oil & citronella oil known insect repellants. My phenobarbital & Potassium Bromide levels  are well within safe range. This indicates that they are not in the toxic level & that if needed we could increase dosage but thank dog that’s not necessary.  Have I mentioned that currently I’ve have 75 seizure free days!  When going over my Wellness Geriatric Profile with T4 Canine & 4Dx Plus Screen-Canine Add-on results there were a couple levels that concerned huMom. Overall as I bark above I am in wagnificent health.

A CBC or Complete Blood Count  is the most common blood test pawformed on us good dogs & cool cats. A CBC gives information on hydration status, anemia, infection, the blood’s clotting ability, & the ability of the immune system to respond.

Blood Chemistry are common blood serum tests that evaluate organ function, electrolyte status, hormone levels, & more. They are impawtant in evaluating senior animals,  dogs & cats with vomiting & diarrhea or toxin exposure, those of us receiving long-term medications, & health before anesthesia.

T4 (thyroxine) is a thyroid hormone. Decreased levels often signal hypothyroidism in dogs, while high levels indicate hyperthyroidism in cats.

You can download this PDF – understanding your pets bloodwork

Getting back to my results & of course the levels that had huMom concerned, I should point out that huMom had not received a copy of my blood work when my good Vet Dr. Jodi called on late Saturday afternoon.  She called the following Monday & they were emailed immediately.  Dr. Jodi, as I mentioned was pleased with all the result except one.  An alkaline phosphatase level test measures the amount of alkaline phosphatase enzyme in the bloodstream.  Abnormal levels of ALP in the blood most often indicate a problem with your liver, gallbladder, or bones.  My ALP level was at 290U/L; remember I did not have my regular testing last year due to the pandemic & turn over of the Vet clinic so we had to go by the 2 previous years ( levels were 92U/L in 2018 & 104U/L in 2019).

We know that phenobarbital is hard on the liver & can cause liver disease & for this reason huMom immediately inquired into lowering with the intention of removing my phenobarbital medication.  Dr. Jodi listened to huMom’s concerns & said that we could but she would like to research scheduling a safe reduction for Olivia.  She would call huMom the following Wednesday with more.

I won’t lie, that call shook huMom even though she tried to stay calm for my sake.  She called her sister for support immediately & then reached out to several Epilepsy Warrior Moms who she is close with.  Having this support network pawsitively helped huMom to take a clearer look at things & feel pawsitive in her decision making & moving forward. Support is key.

Next week I’ll be barking about not only the second phone call but also the third call with Dr. Jodi. They were wagnificently interesting & impawtant.

Until then, stay safe.

CEO Olivia