[Mutts and Cats]

Hi once again Aimee. Sorry to keep peppering you with questions, but I just can’t help myself. I would love to get your input on this when you have time. I’ve been reevaluating my Worry List. The long list of dog food issues that I worry about. It has become so long, that I need to start letting some things go. Omega 6 fats and inflammation – specifically chicken – is the worry topic of the moment.

The holistic vet I consulted with shortly after my dog started having seizures called inflammation to my attention. She felt (without any testing I have to add) this was the root cause of his problems – not just the seizures but the fact that he had lost stamina, was not getting around well, and had developed anxious whining (was it anxiety or pain?). So chicken was her focus because it is inflammatory and she also thought he most likely was allergic to it. So I eliminated all chicken from his diet and started doing research. I did find that I agree with the fact that chicken is quite high in Omega 6 fats, compared to other meats (except pork is just as high) and I do believe in the inflammatory powers of Omega 6’s, so I have kept him off of chicken and also started avoiding foods with a high Omega 6 content (and high 6:3 ratio). Just recently I started reintroducing chicken in small quantities with no noticeable reaction. I’ve pretty much concluded that he is not allergic to it. The food allergy test did not show an IgE reaction and he never did have classic food allergy symptoms. But the worry about inflammation is still there. Plus, I have to admit that my dog is better overall, including seizures, now compared to before I eliminated chicken and started being careful about Omega 6. So, I am a little nervous about bringing it back. Your thoughts?

Would it be more appropriate for me to start a new Topic for a question like this, or is it ok to just keep asking here?

[aimee]

Hi M & C,

Initially I wrote out how to hand calculate but the post got so long so deleted it. Hand calculating an estimated caloric value is just an extension of calculating the number of fat calories. For a G/A that lists min protein as 25 and min fat as 25 and max moisture at 10 and max fiber as 5 you can estimate carbs by subtracting the knowns from 100. If you know the ash content, you need to subtract that too, but if you don’t you can guess (Balanceit uses 3). In this example estimated carbs is 100-25-25-10-5-3= 32. Next multiply each macronutrient by number of kcals/gram, which is 4 for protein and carb and 9 for fat. For kibble I use the Modified Atwater numbers which are 3.5 kcals/gram for protein and carb and 8.5 kcals/gram for fat to accounts for digestibility. For this example (4X25) + (4X 32) + (9 X 25) = 453 kcals/100 grams= 4530kcals/kg

Estimating is fraught with error though, especially with fresh foods, which I why I use the given caloric information if it is available. What I’ve found is the underreporting of fat in raw foods is very common, this is evident if your carb number ends up high when there is no plant matter listed in the ingredients. Also, you can back calculate fat content if they give the caloric information.

Years ago, I asked a company whose name would imply that they would respond to inquiry, what the fat content was in their food. They wrote back that it took them years of research to determine the ideal amount and that they would not just give that information away to someone who could be trying to poach their recipe. I thanked them for their answer and said I as estimating it to be 35 % . They wrote back gob smacked wanting to know how I knew. It would be funny if it wasn’t so sad. Yet another example of a company that appeared to have no clue what they are doing.

[aimee]

Hi M &C,

Thank you for the kind words. The more I learn the more I realize how little I know. If the lab characterized the samples as N then I think you should be fine there.

I could be wrong on this but as I understand it Lipase in the panel refers to circulating lipase levels whose source is usually primarily the pancreas. When the pancreas is inflamed, ((pancreatitis) lipase levels will likely be increased. Lipase from the pancreas breaks down dietary fat in the intestine, allowing it to be absorbed. When there is enough fat consumed, the fat can be seen in the blood after eating.

Tissue lipase is bound to the tissue and its purpose is to facilitate the transfer of circulating fats out of the blood so they can be used at the tissue level. Some dogs have low tissue levels of lipase so when they eat fat it gets digested and into the blood, but can’t easily get out of the blood, putting them at risk for high triglycerides. There are other causes of elevated triglycerides, but as I understand it low tissue lipase is one cause.

[Mutts and Cats]

Hi Aimee. Thanks for those detailed calculations and explanations. I will dig into that and give my brain a little exercise. I worked in a technical field so I like numbers. It is strangely relaxing for me to crunch numbers and I seem to have a notion in the back of my mind that all problems can be solved with a spreadsheet. But I retired quite a few years ago and there has been a lot of brain atrophy. So thanks for giving my old brain some challenges.

Thanks for the additional discussion on triglycerides and lipase too. So I guess from his lab reports it doesn’t appear that there are problems in that area yet, but I have backed off on the high fat diet. If his seizures should become more frequent then I might increase it again. But I will be really surprised if that happens.
It is a relief that stopping the CBD Oil seems to be making no difference in the frequency of seizures. I just hope his next seizure is not more intense, or longer. I suspect the CBD Oil caused his ALT and ALP liver enzymes to spike. My vet thinks that is unlikely, but from what I’ve read it sure seems possible. ALT and ALP went from 62 and 91 in Aug to 142 and 826 in Nov to 191 and 878 in Jan. I started the CBD Oil in early Oct. My vet seems surprisingly unconcerned about the ALT and ALP, but if they haven’t come down when we retest in March then my anxiety is really going to take off.

That company you mentioned who was so clueless about basics like fat content does highlight a problem out there that I was buying into. Thinking that a small company would mean good quality control and that possibly the owners really cared about producing a good product. I’ve been drawn in by some of them, who say great things on the website, but then I realize that I’m not sure they know what they are doing. But, that said, I still find myself wanting to find a small(ish) company that I feel really good about.
Always nice to get your replies. Thanks for taking the time. M&C

[Mutts and Cats]

Hi again Aimee. Way back in the early days of this Topic, you mentioned Nature’s Variety as a raw food that you have confidence in. It appears that maybe there has been a change in ownership, or maybe just a restructuring of the company. I think previously the brand name was Instinct by Nature’s Variety. But now the packaging is just Instinct – the RAW brand. But from what I can make out on website photos, the fine print on the back of the bag does say “distributed by Nature’s Variety, St. Lois, MO”.

The Instinct website I find to be a little annoying in that they don’t even say where the headquarters are located or where it is manufactured. No mention of Nature’s Variety on the website. Even under “Contact Us” there is only the email address.
When I google Nature’s Variety I get a hit that looks like it will take me to naturesvariety.com but when I click on it I go straight to the Instinct website (instinctpetfood.com). Do you know anything about a restructuring of the company? If that has happened does it change your confidence in the company?

A few years ago I did feed their canned for a while (when it was Instinct by Nature’s Variety) and one of the freeze dried boosters. I think I tried the frozen. I can’t remember for sure why I stopped feeding it.
If I can get over worrying about my dog’s alleged food allergies (from the IgE blood test), then I think I may try the frozen again, if it remains a product you like. I’m almost there, regarding the allergies, and yet still nervous about letting go of that worry.

I had recently considered Instinct but I think even before the food allergies became a concern, it was the copper and Vitamin A contents that discouraged me. The frozen beef recipe has copper 59 ppm and Vitamin A 200,000 iu/kg. Chicken is more reasonable, but still fairly high at 39 ppm for copper (Vit A 67k). But my nagging inflammation concern definitely makes me more inclined to lean toward beef. Since I would not be feeding it full time, the copper now may not be a deal breaker for me, and in fact might balance out the diet nicely.

Their full vitamin/mineral data sure looks professional and at a glance I see no anomalies. I like the fact that they show the Omega 3 and 6 contents under the GA, plus a few vitamins and minerals there too.
But the lack of substantive info on the Instinct website does cause some concern. Maybe they are just in the process of restructuring and improvements will be made. Any thoughts you have are most welcome. M&C

• This reply was modified 1 year, 10 months ago by Mutts and Cats.

[Mutts and Cats]

Aimee – there may be typos in my last post where I say “Nature’s Logic” when I meant “Nature’s Variety”. Thought I would mention to reduce confusion. I may have successfully edited – or maybe not.

• This reply was modified 1 year, 10 months ago by Mutts and Cats.

[aimee]

Hi M & C,

Last year?? I called Hill’s Pet Nutrition, Royal Canin and Purina and asked for copper levels in multiple diets. Interesting to me, was that the levels from all three companies fell within a narrow range of as I recall ~3-4 mg/1000 kcals with exception of the therapeutic diets, which were much lower, and breed specific formula by RC was right at AAFCO min ~1.8. The situation I found with small companies’ raw/freeze dried raw offerings was vastly different. Like you I found wild fluctuations among the products they made with some near 100 mg/kg DM Wow just Wow

I first started looking because of a comment I read by Dr Sharon Center who said, as I recall, in her opinion, one factor in the rising cases of copper storage disease ( CSD) was the trend towards “natural” diets, resulting in liver/organ meat being used to meet certain nutrient needs and the side effect feeding high organ content was the high copper levels that came with their use. In contrast, I’ve found posts from random people giving advice on CSD to avoid commercial diets that have copper supplements and instead feed “natural” diets. Considering that I found that even though the commercial kibble made by the large companies listed a supplement, the diets had lower levels in general than the “natural diets,” that advice seems very reckless.

That advice reminded me of something I learned long ago. From a biological standpoint the natural diet is meant to sustain an animal through reproduction. After successful reproduction, it is in the interest of the species for the parental generation to die off so that they do not compete with the new generation. In other words, the natural diet may not be the optimum diet to sustain an animal long term.

I suspect copper levels may be lower in poultry based foods because chickens are slaughtered at such a young age so little time for copper to accumulate in their livers as opposed to cattle.

[Mutts and Cats]

Hi Aimee. You must have enjoyed a few days off from my questioning. I have been experimenting with the caloric distribution comps to make sure I have it down. Not sure if I do or not. I’ve been running the comps using data from a couple companies (Instinct and Nulo) who have very thorough data sheets, and even provide the % calories from protein, fat, and carbs to compare with my comps. I’m finding that I sometimes match pretty closely to their % calorie figures, and sometimes not. And often my total for % calories from protein, fat & carbs is not 100%. I wonder if one possible explanation for the differences is that they are running the computations using exact numbers from a sample, instead of min protein/fat, max moisture, etc. Anyway, my understanding of this stuff is coming along, and my brain is getting some good exercise.

Thanks for the additional comments on copper content. From what I have seen out there it has been 100% beef recipes that have had really high copper contents. And I think the highest ones were companies who are also adding a copper supplement. This is just from a few (quite a few) companies that I explored, so of course is not a scientific study. What I concluded is that many companies are developing a standard vitamin/mineral pack that they dump into every recipe instead of making a custom pack for each recipe. The 3 companies you mentioned must tailor their packs to the specific recipe. The responsible thing to do.

My dog had a seizure this morning, followed by another one 20 minutes later. This has never happened before. I can’t help but wonder if stopping the CBD Oil caused this change. Just when I was starting to feel hopeful . . . M&C

[Mansory B]

nice

[aimee]

Hi M & C,

I’m playing catch -up.

If I had to name one area in nutrition that makes my head spin the most it is fatty acids. This is my understanding, but keep in mind my simplification of a very very complex topic may be incorrect. Omega 6’s in general on their own are not inflammatory, but that they can be used as a building block for the body to make mediators of inflammation both pro and con.

Linoleic acid (LA) is an Omega 6 essential fatty acid (EFA) made by plants and is vital for skin health. Corn and soy are good sources, so animals raised on corn and soy like poultry and pigs can be good sources of this EFA.

Arachidonic acid (AA) is an omega 6 made by animals from LA. and it is the primary building block for the production of inflammatory mediators. Dogs make AA from LA, cats cannot, so it is essential in this species, one reason dogs are classified as omnivores while cats are classified as carnivores.

The Omega 3, alpha linolenic (ALA), is made by plants and is the counter partner to linoleic acid (Both have 18 carbons). EPA and DHA are Omega 3’s made by algae but can also be made from ALA by some animals. The ability to do so and how efficient that process is differs among species.

Here is where I’m not confident in my understanding, I think that when other structural FA are in short supply, cell membranes become saturated with Omega 6’s at levels near their dietary requirement. Meaning that higher levels of Omega 6 in the diet do not necessarily mean higher levels of Omega 6 in the membrane. Supplementation with Omega 3 is done to provide a different set of building blocks so that instead of the cell membrane being made with all Omega 6 it is made with Omega 6 and Omega 3. Now when Cox or Lox enzymes are present fewer inflammatory compounds will be produced.

So my understanding is that the key to decreasing inflammation is to provide Omega 3’s in the diet to meet the levels on a metabolic kg body weight basis that have been shown or believed to be beneficial for the condition you want to address, and then because the Omega 3’s and 6’s compete for the same enzyme and metabolic pathways, control omega 6’s. so that the 6’s do not outcompete the 3’s for access to enzymes.

With that as a background I find the statement that chicken is inflammatory, baffling. Chicken can be a good source of LA, an EFA, and while LA can be converted to AA which then can in the presence of COX/LOX become a mediator of inflammation, on its own, I don’t see it as a de facto source of inflammation. Nor do I understand the assessment that your dog is likely allergic to chicken based on a physical exam in the absence of any typical GI or skin signs.

In general, what I find in the holistic field is that a mustard seed of truth morphs into a sweeping overgeneralization which is then presented as fact. That is how I view this bit of information you were given.

[aimee]

Hi M & C,

I’m not aware of any recent company restructuring by Nature’s Variety. I feel more confident with them as a raw company based on past interactions, their use of HPP across all diets. And as I recall they test each batch for pathogens multiple times during production using PCR, which is IMO, much more sensitive that culture. Finally, I believe they are the only raw food producer that employs a full time boarded veterinary nutritionist, Dr. Susan Wynn.

I agree the posted nutritional information appears very straightforward and professional I like that they provide information on a calorie basis and that the numbers appear appropriate. I didn’t see any errors that jumped out on a cursory view.

Copper content overall is higher than I’d like to see, and IMO, likely reflects the company’s feeding philosophy. I suspect it is coming primarily from the inclusion of organ meat. Interesting factoid, apparently copper in pork liver is in a form that cannot be absorbed by the dog.

Based on my understanding of the pet industry, vit/min premixes are a bulk commodity purchased from an outside source. I suspect they include copper at a baseline min value designed to meet an AAFCO profile when incorporated at a prescribed level. It makes no sense to include any more than necessary.

I do not think in most cases a premix is individualized to each recipe but instead the recipe is formulated around the premix. So, when I see foods that have a high level of copper and a supplement, I suspect the level is coming primarily from the ingredients and not the premix.

[aimee]

Hi M&C,

Since I myself had a dog with seizures I thought I’d share what I learned. She had her first partial seizures, meaning she didn’t lose consciousness. at 9 months. As I recall, vets broadly rank possible causes based on age with toxicity (ingested or metabolic) and infections being more common in very young dogs, a genetic cause being more in a young adult, and tumors or other metabolic cause from organ dysfunction. more common in middle aged to older adults

I consulted a neurologist. and together we decided not to start her on medication. I did not change her diet. For the most part, her seizures occurred when relaxed in the car. The neurologist suspected a noise induced component (apparently engine noise can cause seizures in some dog) combined with the brain waves pattern in light sleep. I also consulted with a holistic vet. I was told she was seizing in response to negative energy I had from having to get up early on the days we traveled. That was the first and last time I ever consulted a holistic vet.

Her seizure frequency was greatly reduced by preventing her from dozing during travel. She also had seizures not associated with travel. The general guidance I was given for deciding when a seizure disorder should be medicated is if they were occurring more than once a month, if there were multiple seizure in a day or if any one seizure was of longer duration. Apparently, the more seizures a dog has, the more established that brain pattern becomes and the more refractory they become to responding to anti-convulsant, so it is better to start medication early in the course of the disease if they meet the criteria. She stated to seizure more frequently and I decided the time had come to put her on meds but I was neglectful in getting her back to the vet and after several months of increased frequency the dang things just stopped.

What I learned is that seizure patterns sometimes have no pattern. It can be easy to ascribe triggers to things that had no bearing on their cause or to credit interventions with decreasing seizures when in reality the intervention had no effect. My understanding is that CBD. is an established treatment for a particular type of seizure in children and its use is being evaluated in dogs. As I recall the doses tested with marginal to no effectiveness have been about 20-40 times higher than the supplements marketed for pet owners. Personally, I think if you are supplementing with an OTC CBD oil it will have no real benefit, but if not well made could bring ham.so I think it was a good decision to remove it to see if it is playing a role in the increased liver enzymes.

[Mutts and Cats]

Hi Aimee. Sorry about the lack of replies from me, although that was probably a nice break from my questions. Things have only gone downhill for my dog. After the two seizures close together on 2/6 he then had another one 14 hours later, in the middle of the night, and since then is having shaking episodes every morning, just like he has right before a seizure, but then he doesn’t go into the full blown seizure. So, obviously there have been some undesirable changes in his little brain. It’s just so surprising to suddenly have such a change for the worse, when the seizures were becoming less frequent. But, as you mentioned, seizures are unpredictable and often there just is no rhyme or reason. Back in Aug/Sept, I spent hundreds of hours reading posts on the Canine Epilepsy Network forum, and I should have gotten that message then and been prepared for the way things have gone. I kept hoping for a sudden miracle of no more seizures, but instead got this sudden turn in the other direction.

Thanks for sharing your seizure dog experience. Interesting about most of the seizures happening while riding in a car. My dog has them when sleeping or resting. About 98% of them have been first thing in the morning – 1.5 hours after I get up and let him outside. Thankfully he has never had one while in my vehicle, as that would be dicey. I’m also thankful that he has never had one while on a walk. I don’t get too far from the vehicle now though.

I did start him on an anti-seizure med (Keppra) on 2/9. Disappointing that he is still having the “almost seizures” (partial seizures, I guess) every day, but a relief that so far there are no terrible side effects. With his liver enzymes already high, plus the fact that he gets around on only 3 legs, I just can’t go with the standard first choice AEDs.

I see that you have comments on food topics for me to digest (hah). I just can’t get my mind into dog food at the moment, so I will be back later. M&C

[aimee]

I’m so sorry that your dog and you are both going through this. I think Keppra is a good choice and I hope it can get the situation stabilized. Is your dog in an age bracket where advanced testing may be advised?

[Mutts and Cats]

Hi Aimee. I came back to catch up on my reading. Thank you for addressing all of my questions. Your simplified lesson on fatty acids is great, and very helpful. I had done quite a bit of prior reading on the subject, but I think my eyes generally glossed over part way through articles because it does get so complex. I did of course read about the importance of the 6:3 ratio, but I had also decided it was best to keep the Omega 6 intake at a reasonable level so that a good ratio could be obtained without having to over-supplement with something like fish oil. I still tend to think that is a valid approach, but your lesson emphasizes to me that it is more important that the diet have plenty Omega 3s.

On the chicken-allergy-holistic-vet subject, I did quickly lose confidence in the holistic vet and discontinued that. There was no evidence pointing toward my dog being allergic to chicken, and in fact when I later had the IgE food allergy test done through another vet, he had no reaction to chicken. But, I know, IgE testing is a controversial subject, and I won’t digress. I came to suspect that this holistic vet pretty much gave every patient the same plan, regardless of what they were there for. Complete removal of chicken from the diet and take the liver support supplements and Chinese herbs that she sold. But, as bad as my experience with her was, it was not quite as bad as your holistic vet experience.

An update on my seizer. This morning I gave him a dose of CBD Oil, in addition to the Keppra in an attempt to break the pattern of daily partial seizures in the morning. It is noon now, and so far no seizure today. So if we can get through the rest of the day without one, that will be a relief. But, the goal is to stop the CBD and hope that the Keppra will kick in and help.
I do think now that the CBD Oil was probably helping to control his seizures, but I also acknowledge the elusiveness of seizures and that it may have been doing nothing except raising his liver enzymes. I was very careful in selecting a brand, and I think I was using one of the best brands out there, but it’s kind of like commercial dog food – you just never really know.
You asked about his age – he just turned 6. So he is right on the line that is typically used as a general guide for diagnosing the underlying cause. If this daily partial seizure routine continues I will probably consider an MRI.
Thanks for the kind words. M&C

[aimee]

Hope the balance of the day went well. I think it likely that there will be a subset of dogs that respond to CBD. My stumbling block at this point is dose. As I recall, dogs metabolize the stuff like crazy. The OTC doses seem so low to me compared to the doses used in people and the published studies in dogs. But each dog is an individual.

I hope he does well.

[Mutts and Cats]

Hi Aimee. Unfortunately, my dog is continuing to have the partial seizures nearly every morning. But, as disturbing as it is, at least he hasn’t had a full blown seizure in 9 days. I do worry that he could be having more partial seizures than I realize – like at night. I’m confident that I’m not missing any full seizures, but I could easily miss a partial.

I’m continuing to give him a smaller dose of CBD Oil in early in the morning, and also continuing Keppra 2x. I guess I will take it one day at a time as far as deciding when to completely stop the CBD.

Back when I was giving him only CBD Oil I had worked up slowly to 2.5 mg/kg/day CBDs (in 2 doses). From what I had read, the studies were typically using around 5 mg/kg/day, and the McGrath study on adverse effects used much higher doses of 10 and 20 mg/kg/day. I would have kept increasing the dose I was using if his liver enzymes hadn’t shot up. From what I could glean from studies it seems that most dogs had only a minimal rise in enzymes, if any, at the lower doses, yet a few dogs did have a significant rise.

You make a good point that although I think that I am using a quality brand (organic and aggressive third party testing, etc), it is possible that there is something unique about the oil I am using that caused the dramatic rise in enzymes. I just hope that his levels are coming down when the next bloodwork is done in early March.

I was just rereading the 2018 McGrath Report (A Report of Adverse Effects Associated With the Administration of Cannabidiol in Healthy Dogs) again and noticed a statement that made me want to have a better understanding of liver testing, and I thought you might be able to help me with that.
This was part of the discussion about a rise in ALP levels. “There was no evidence of short-term hepatotoxicity since fasting and postprandial bile acids remained normal for all the dogs throughout the study. However, the potential for long- term liver toxicity was not evaluated in this study.”
And then from an article by McGrath discussing her studies “Bile acids were monitored every two weeks and no changes were noted, suggesting the liver continued to function normally.”

My vet has never even brought up a bile acids test, and I now don’t understand that. I’ve actually been frustrated that she really didn’t seem all that concerned about what I considered to be dramatic increases in my dog’s ALT and ALP. Especially ALP, which is now at 6x the upper reference range value. So evidently the lab results as a whole she doesn’t find terribly troubling. The other liver-related results on the lab report (AST, GGT, and Bilirubin) were within range. Although, confusing to me, is that the Bilirubin Total was about mid-range, while the Unconjugated was at the very low end and the Conjugated at the very high end.

When we were discussing the last lab report my vet did say that I could have an ultrasound done, but it felt more like a response to my concern than a recommendation. It was at that point that I decided to discontinue the CBD and see if that causes the enzymes to come down. It seems to me that it would be prudent for the next blood test to include a bile acids test, instead of skipping that and jumping right to an ultrasound. I hate to even think this, but the ultrasound would be more of a money maker for her clinic . . .

If you care to comment on the usefulness of a bile acids test that would be great. You are so good at boiling information down so it is understandable. Thanks. M&C

[Mutts and Cats]

Hi Aimee. I had another thought (in the middle of the night) about a possible contributor to my dog’s high liver enzymes. About the same time that I started the CBD Oil I also started supplementing MCT Oil. I had in my mind from former reading that MCT Oil was metabolized differently than other fats and was not hard on the liver. This morning I’ve been doing some more reading and I sure am finding conflicting info out there about whether MCT Oil taxes the liver or not. Do you have any thoughts on that?

I hate to stop the MCT now because of the possibility that it is helpful for seizures. A few weeks ago I lowered the amount. But after the day of cluster seizures last week, I increased it again. So, add MCT to the many things that have me wondering if I am helping or hurting . . . M&C

[aimee]

Hi M&C,

Your CBD dose was quite a bit higher than I assumed it would be. When I looked at the OTC options at my local store, as I recall a $100.00 bottle would have been enough to last 3 days at the 5 mg/kg/day dose. At the time, the prescription CBD was ~1200.00 a bottle. On a mg basis it was pretty comparable to the having to buy multiple OTC strength bottles.

As I understand it, CBD itself may cause a rise in ALP but an increase in ALT wouldn’t be expected, hard to know if it is related or not. Only way to know I think would be to discontinue and remeasure the blood levels.

Bile acids are produced from cholesterol, stored in the gallbladder, and shucked out into the intestines with gallbladder contraction, primarily in response to ingestion of food. They are reabsorbed in the ileum, the end portion of the small intestine. The blood flow from the intestines takes a tour through the liver and the liver picks out the bile acids and sticks them back into the gallbladder.

If the liver is not functioning well, the liver doesn’t do a good job picking the bile acids out of the blood, so the bile acids can be found circulating in the blood at higher than excepted levels. Bile acid levels in the blood can also be high when the blood flow to the liver is altered, like with a liver shunt. Gastric and Intestinal motility may also influence results. The bile acids have to be presented to the terminal intestine for absorption. Apparently, there can be day to day variation in test results due to this or other factors.

The test is usually done by measuring levels in the blood in a fasted state and again 2-3 hours after feeding, which is done to stimulate gall bladder contraction. If both pre and post eating samples are high, the problem is more likely one of liver function. If pre are normal and posts are high, it may be more likely to be a problem of blood flow. BUT these are very wide generalizations and dogs don’t read the books.

Apparently, there can be a lot of “grey” in interpreting the results. The specialist I took one of my dogs to said he rarely runs the test because the liver has a lot of functional reserve so local lesions that can increase liver enzyme levels in the blood may not alter test results at all and factors outside the liver can influence results. This could be why your vet recommended an ultrasound and not a bile acid test to further explore the liver enzyme increase.

On the other hand, if you are giving a dog something that is known to be able to alter liver function in some scenarios, doing repeated bile acids to monitor for change in function may be warranted. I believe an anti-seizure medication such as phenobarbital falls into that category.

Since so much about CBD use in dogs is unknown it makes sense perhaps to included bile acids in these initial studies to monitor for any toxic effects.

I’m not aware of any instance where MCT would increase liver enzymes.

[Mutts and Cats]

Hi Aimee. Thanks as always for taking the time to provide so much information.
The CBD I have been using is a broad spectrum, by Joy Organics and the total CBD content is 75 mg/ml (2,250 mg/bottle). It is $100/bottle, so does get expensive for a dog the size of mine. I’m hoping that these almost daily partial seizures (or pre-seizures?) will stop and then I will stop the CBD completely. His next blood draw is 3/1 so I am hoping that his liver enzymes will have come down at least a little. He went 2 weeks with no CBD and now has been on ½ the previous dose for almost 2 weeks. Hopefully that is enough of a reduction to have an impact on the enzymes. If there is no reduction, I will probably have an ultrasound done.

I’ve been doing more reading on partial, or focal, seizures. I’m not sure if that is what he is having, or if this shaking is just part of his pre-ictal seizure phase. The exact same thing proceeds his full blown seizures, which are classic generalized tonic-clonic. When he has a full seizure the shaking only lasts a few seconds then he goes into the seizure. Now the shaking lasts a few minutes, but no seizure.
Some sources emphasize that a partial seizure affects only part of the brain, so symptoms like shaking are one part of the body, or one side. With my dog, it is just generalized, pretty violent, shaking and he remains fully conscious. But other sources describe symptoms like shaking without loss of consciousness as part of a partial seizure and that it is fairly common for dogs to start with a partial seizure that then turns into a generalized. So, I don’t know . . .

We got through yesterday without a shaking episode, and today he hasn’t had one yet. Small victories, I guess. I do feel that these things – whatever they are – are not as hard on him as the seizures he was having. Just wish I understood what is going on. I’m also dreading the next full blown seizure and afraid it will be a cluster of them again. Sorry for so much seizure discussion (on a dog food forum).

I do continue to agonize over dog food too. I finally confronted Steve’s about the high calcium and phosphorus contents for their Turkey recipe (and Turducken to a lesser extent). I kept procrastinating, knowing that I would probably get a reply that would cause me to lose confidence in yet another company. No surprise – that is what happened. I guess it is more a matter of this food not being a good fit for my dogs, since I want to continue feeding turkey necks. So I am feeding less of Steve’s and will probably use up what I have then not buy more.

Well, sorry for the rambling (even more than my typical post). Thanks again. M&C

[aimee]

Hi M & C,

I hope you have had more shaking free days however if they continue and if you capture an episode on video perhaps your vet can help with interpretation.

Not sure if you saw this article on OTC CBD products marketed or pets. They do not name names and I didn’t see one that seemed to match with the Joy Organics Pet version but
the article is informative. https://pubmed.ncbi.nlm.nih.gov/32346530/

As I recall liver enzyme 1/2 life is a bout 3 days in dogs. Meaning that if the insult stops, the level in the blood will be 1/2 of the initial level three days later. If you feel safe to discontinue the CBD before the blood test it may give you a better picture, but understandable to not discontinue if you feel it is controlling the episodes.

Hope this is a better week for you and your dog

[Mutts and Cats]

Hi Aimee. Thanks for the CBD article link. The reason I did choose Joy Organics is because of their testing. They post 3rd party reports online by batch, and in addition to the Cannabinoid Profile, they also test for heavy metals, pesticides, mycotoxins, residual solvents, and others. What I use is a human product, and of course compute my own dosing. I can’t remember if Joy even makes a pet version. From the research I did before settling on Joy, I found that most of the companies who sold both said that their pet product was the same as one of their unflavored human products. But generally the testing was more complete for the human products.

Things seem to be moving in the right direction for my dog. No shaking events in the last 3 days and none so far today. I keep reminding myself not to let my guard down though. I reduced the CBD dose yesterday and today. If we get through today with no shaking I will probably go with no CBD tomorrow.
Good to know that ½ life information. If I can stop the CBD now then his bloodwork next week should be informative.
However, I had another thought/worry. Are you familiar with Bach Rescue Remedy? I learned of it from reading posts on the Canine Epilepsy Network forum, and also some articles. Seizure dog owners have found (they think anyway) that it helps dogs recover more quickly from a seizure and lessens the chance of a cluster seizure. So I smear a few drops on my dog’s gums right after a seizure, and for the first few days of the shaking events I did so during the shaking too. I wonder if this could have an impact on liver enzymes? I looked back at his seizures vs blood draws. First blood draw with elevated enzymes was 7 days after a seizure and the next blood draw (even higher enzymes) was 4 days after a seizure.
Here are the ingredients:
Rock Rose (Helianthemum nummularium)
Clematis (Clematis vitalba)
Impatiens (Impatiens glandulifera)
Cherry Plum (Prunus cerasifera)
Star of Bethlehem (Ornithogalum umbellatum)

If you care to speculate about the Bach, it would be great. He will almost certainly have another seizure before the next blood draw on 3/1. I probably should skip the Bach after that seizure, but that is really scary given the prospects of another cluster. Thanks. M&C

[Mutts and Cats]

Hi again Aimee. I had another revelation about my dog’s shaking episodes that I wanted to run past you. To see if you could help me brainstorm a bit. I am of course going to discuss this with my vet when I see her next week, but I am hoping to do some experimenting before then that will help with a diagnosis.

This morning I did not give the CBD Oil and he did have a shaking episode. That could very well have been a coincidence, or maybe the CBD is helping, but in a different way than what I was assuming.

I’m starting to think that these almost daily shaking episodes are not a seizure, or a pre-ictal almost seizure, but a digestion problem. Possibly liver issues, or some other ailment that is causing digestion problems. The shaking episodes are happening 5-20 minutes after he eats (but only the morning meal). That was not the case with his real seizures – some of those were before and some after. For those, it seemed to be more a time of day factor (~ 1.5 hours after I get up).

I’ve also noticed that since the daily shaking episodes started, it seems that they are becoming less intense and don’t last as long. That could be the CBD Oil helping, and if the shaking is caused by digestive problems maybe the CBD he was getting about an hour before eating is helping in that way (???).

So I am going to start experimenting with his breakfast. Making it smaller and less fat. He generally doesn’t even want to eat breakfast anyway, but I talk him into it because I didn’t want hypoglycemia to be a factor for seizures. So I purposely try to get him to eat before the time that he generally has a seizure, and once he starts eating then he eats pretty well. Maybe I was taking the wrong approach. If you have time to offer any thoughts, that would be great. And if you don’t have time, I completely understand. I know that I have become rather demanding of your time. M&C

[aimee]

Hi M & C,

I’m not aware of any reports of increased liver enzymes from Rescue Remedy, and unless a contamination issue, I do not see anything concerning.

The observation that the shaking events are fairly predictably occurring very soon after eating is interesting.

Trembling can be seen as a response to pain or fear but to me that evokes a finer tremor than I’d associate with shaking. Taking note of your dog’s general body language prior and during an event may help give you some clues. Is the reluctance to eat in the am a new thing?

On the days he gets the CBD what is the time frame it is administered in relation to his meal? In your readings did you find any information on the pharmacokinetics of CBD ?

[Mutts and Cats]

Hi Aimee. Thanks for the reply. I really appreciate your comment on Rescue Remedy. I have felt that it helps him after a seizure so I do hate to discontinue it now – especially after the cluster.

This shaking (without a full seizure) is definitely much more intense than a tremor. And completely out of his control. But it has become a little less intense since the first couple times it happened. The first couple times he would also pant for a minute or two after it stopped, but now he just takes a deep breath when it stops and then starts napping, but with subtle signs of discomfort.

When he has a full seizure, the progression every time is this: (1) he starts looking around like he hears something, for 3-5 seconds; (2) shakes violently for 3-5 seconds; (3) tonic phase of seizure where he goes rigid for 15 seconds or so; (4) clonic phase with paddling of all limbs and much foaming at the mouth, for about 1 minute. Afterwards he remains lying down, eyes wide open and looking scared to death, and pants REALLY heavily for 5 minutes or so.

The first couple shaking episodes (without a full seizure) I think it started with looking around first, but I’m not sure. Now, I don’t see him doing that, or if he is it is more subtle.

The lack of the appetite in the morning has come and gone in the last year, but has been pervasive for the last few weeks. Until a couple months before the seizures started he always had a good appetite. His appetite first started to wane when he was on Rimadyl for a few weeks, and the lack of appetite was most noticeable in the morning. Since then, there have been so many changes (food, supplements) that could have upset his stomach that it is hard to sort it all out. One thing that has been pretty consistent since the seizures started is that he is consuming more fat than he was previously, so I really have to wonder if he has developed digestion problems centered around that. I have cut back significantly on the fatty foods in the last few days, and stopped the MCT Oil. Yesterday he had no breakfast, and today a small one but less fatty than before. No shaking yesterday or today. But, two data points is far from conclusive. 🙁

On your CBD Oil pharmacokinetics question – I have not read much on that, but I do have a 2019 study (published in Animal) in my voluminous collection of seizure reading. They found “…time to maximal concentration (Tmax) of 1.4 h and 2 h, for dogs and cats, respectively” and “… half- elimination rates of approximately 4 h in dogs”

Back when I was giving him a full dose of CBD Oil, he got it in the morning typically about an hour before eating and in the evening right before eating. I had stopped the CBD completely on 1/20. He then had the first cluster of 3 seizures on 2/6 and the first shaking episode on 2/9. I restarted the CBD on 2/10, in the morning only, at a lower dose. None yesterday and today.

I’m not sure that I mentioned this before, but he has been on SAMe (800 mg/day) since the first high enzyme bloodwork. He gets that in the middle of the day.

I could go on and on, but will control myself. I imagine you do have other things to do. Thanks for taking the time to consider and comment. M&C

[aimee]

Hi M & C,

Since the T max of the CBD is within the time frame as the shaking events , when they happen, I don’t think you can rule out a CBD effect. If you had said you gave the CBD with the meal and the shaking events were 5-20 min after its administration, then it would seem less likely that the CBD was exerting any effect.

I wouldn’t suspect Sam E as long as the source is reputable.

Good you are keeping note of all of this to discuss with your vet.

[Mutts and Cats]

Hi Aimee. Thanks for the reply. I feel great frustration anticipating that discussion with my vet. Almost certainly, there will be very little time for a discussion, and no revelations. I’ll just leave it at that . . .

Another morning with no shaking episode. I did not give him CBD this morning, so this is 3 days without. Maybe the CBD was not helping after all. Maybe the Keppra is starting to work. Maybe the episodes have nothing to do with anything except a random brain glitch. This is so frustrating.

He is due for another full seizure so I will be on pins and needles until that happens. M&C

[aimee]

Hi M & C,

Glad to hear that the shaking episodes seem to be resolving.
Hope that the anticipated seizure doesn’t materialize and that your vet visit goes well.

[Mutts and Cats]

Thanks for the support Aimee. M&C

[Mutts and Cats]

Hi Aimee. Since you have kindly shown an interest in my seizer, thought I would give you an update. I got the lab report for the blood draw last week, and his ALT and ALP are now back to where they were before I started the CBD Oil – about middle of the reference range. So that is a huge relief. The facts point very strongly to the CBD Oil having caused the rise, and this is a reminder of the perils of using substances with very little testing.
Also a huge relief is that it has been over a month since his last full seizure, and 16 days since the last partial seizure (or whatever those shaking episodes were). So the Keppra is really working so far. Keeping my fingers crossed that it continues to work. Thanks again for taking an interest.
I’ve been taking a bit of a break from my dog food research, but I’m sure in no time I’ll be back with more questions for you. M&C

[Mutts and Cats]

Hi again Aimee. I created another topic “Dog/Cat Toothpaste”. Would love it if you would check that out and comment on my concern about ingredients, if you have time. M&C

[aimee]

Hi M & C,

I’m so glad to hear that your dog’s liver enzymes have returned to normal. I agree that it is a bit suspicious that the CBD was the cause. You might want to consider reporting to the company and to the FDA.

Also, very glad to hear that he’s gone 16 days without a shaking episode and that he hasn’t had a generalized seizure in over a month.

I hope he continues to do well .

Thanks for the update. I was hoping you would post back with the results.

[crazy4cats]

Good news, M&C!

[Patricia A]

Hi M&C,
Haven’t checked here in a bit. Glad I did today for this new update. So happy to hear med is working so well for his seizures and blood work back to normal after elimination of that CBD oil.

[Mutts and Cats]

Thanks to all 3 of you for your support. Sorry it has been awhile. I’ve been preoccupied with non-mutts/cats issues, and fighting off some depression. Unfortunately, the Keppra seems to be becoming less effective for the seizures. Last one was less than 2 weeks after the previous one. I’m going to wait until the next seizure before contacting my vet about what to do next. So now I’m back to that undesirable place of wondering when the next one will hit.
Thanks again. M&C

[Mutts and Cats]

Hi Aimee. I will consider your suggestion of reporting my experience with this CBD Oil, but I’m not sure I feel comfortable doing it. I don’t necessarily think that the CBD Oil I was using is a bad product. I just think that my dog’s liver was particularly reactive to it. Maybe this is a sign that he is in an “almost” liver function status, and this drove him over the edge.
When I was reading CBD Oil studies in dogs I did see that some dogs (but a very small percentage) did react to it with elevated enzymes. And I remember one report that said one dog had to be pulled from the study early because of that. But it seemed like this didn’t necessarily get reported in the summary. So people just reading the summaries of reports wouldn’t realize that some dogs are very reactive.
When my dog’s enzymes first spiked I immediately thought it was probably the CBD Oil, but my vet thought that was unlikely. And I imagine if someone were doing quick research on CBD Oil for dogs they would not conclude that adverse liver effects were very possible for some dogs. It will probably just take more, larger, studies to bring that out.
Just my food for thought. M&C

[Patricia A]

Hi M&C,
It’s been awhile. I’m upset to hear that the med is losing effectiveness. I was researching and it was an eye opener when coming across an Epilepsy canine awareness Day. It must be a much more common problem then I realized. Don’t know if you’ve frequent, but Canine Epilepsy Facebook page is suggested for support and sharing experiences with meds, diet etc. etc.
In the process of moving my mom into assisted living. So might not be checking in for a bit again. Praying for control of your pups seizures and you also to be feeling much better.

[aimee]

Hi Muttsandcats,

I understand your concern. I look at reporting this event not to disparage the particular product you were using but rather to add to the overall body of knowledge regarding use of CBD products. As you said it is not commonly known that use of CBD may have this effect.

Formal prospective studies usually only use a relatively few test subjects. Less common reactions may not be experienced by any of the test subjects simply based on numbers.

When a product use becomes widespread, those less common reactions will start to be seen BUT if no one reports them they remain unknown, and like your vet, an attending Dr may assume it is not from the product since it is not a listed concern.

[Author]

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