okaygreatthanks
Member
Hiiii! Wow, we fell off the Doberman Chat planet for the past year. It’s been eventful for Remy, and I’ve been wanting to properly catch up here, as I thought maybe some of the experiences we've been through/info we've learned could be of use to someone else down the road. But I just hadn’t been able to find the time and energy to recap everything…because it’s quite the saga.
Firstly, Remy’s a very happy and overall healthy boy, who turned 2 in June and is just starting to settle into being a (somewhat) calmer adult.
To try and keep this post from becoming interminable, I’ll breakout the highlights below:
Cryptorchid Neutering
Remy got neutered last November when he was about 17 months old. It was earlier than we would have liked, but both our breeder and vet agreed that it was necessary due to his retained testicle releasing extra testosterone and causing an enlarged prostate. Also, with cryptorchidism, the longer the retained testicle stays in, the probability of testicular cancer skyrockets. They successfully removed both testicles (the retained one was tiny and near his bladder), did a gastropexy, liver biopsy (I’ll get into this next), and it turned out he also had an umbilical hernia, which they repaired too. Poor guy!
Liver Biopsy + CAH/Copper Storage Disease Diagnosis
I’d posted about this in another thread a while back, and it’s been a journey! Since Remy was about 8 months old, he’s had elevated liver enzymes (ALT/AST primarily, ALP is expected to be somewhat elevated while they’re growing), which we’ve monitored on a bi-monthly basis since then. We had a suspicion that it could be CAH (copper associated hepatitis aka copper storage disease) after we started removing copper-heavy foods from his diet and saw his levels come down.
Getting a liver biopsy is the ONLY definitive way to diagnose the disease, and since it’s a procedure that requires anesthesia, it was another reason we moved forward with the neutering when we did. Results came back from Cornell near the end of December (it was a loooong month waiting for them!) and the rhodanine stain confirmed that he had excess copper in his liver. For the next few months we worked with our vet to start tailoring his diet to be much, much lower in copper.
His ALT slowly started coming down, but we’d started him on Heartgard in December, and then it started climbing again.
Near the end of April, our main vet let us know that Dr. Sharon Center from Cornell had reviewed Remy’s results and wanted to include him in her current study about CAH in Dobermans. Dr. Center is the leading authority in the world on canine liver disease – she created the grading scale for liver biopsies, and has looked at thousands of biopsies (hundreds of which have been from Dobermans specifically), so we jumped at the chance to pick her brain about his diet and the disease!
Her advice was to make sure the maximum amount of copper in his kibble is 0.24mg/100 kcal and recommended using either Voyager Pollock dog food (non-prescription) or Royal Canin “Labrador Diet”, and had us run everything else that he eats through USDA Food Data Central’s site to check for copper nutrients. I made a spreadsheet with his safe foods and the copper amounts of each, which you can check out here.
We opted for the Voyager Pollock food, which was created by a vet specifically for copper storage disease. I liked that it had more wholesome/better quality ingredients and isn’t grain-free/doesn’t contain legumes. I’m very conscious of avoiding legumes because of their link to DCM – I know there’s been debate on this in the last couple of years, but regardless, whole grains are good for the heart!
Here’s a brief list of high-copper foods that we avoid completely:
We asked her whether Heartgard (Ivermectin-based heart worm medication) could affect his ALT, and she said that she had seen many cases of Ivermectin-induced liver disease over the years (I knew it, even though our main vet didn’t think it was the cause of his increasing levels!), so we pulled him off of that. Once his levels stabilize again, we plan to try out Interceptor as an alternate medication. I’d like to keep him off heart worm meds altogether, but the treatment is so rough, and with his luck it worries me for him to be unprotected.
Remy’s been on filtered water (we have a Brita tank dispenser) since he was ~10 months old (we live in an ancient house and some of the pipes are copper, so I worried about that contributing). Dr. Center recommends filtered water as well since there are copper and other heavy metals in tap water.
She also noted that milk thistle, which our vet had Remy on, isn’t bioavailable to dogs, thus isn’t an effective supplement for the liver. I’m still torn on that info, as we did see improvement in his ALT while he was taking milk thistle. Apparently, Denamarin is better (a combo of Sam-E and Sylibin, which is extracted from milk thistle so it’s more readily available), but Remy was never able to tolerate it. But, funny thing…when we pulled Remy off of milk thistle, his skin and gut issues got better – all systems really are connected.
And she said to get rid of any type of Glade plug-ins or commercial home fragrance diffusers/spray, since they’re loaded with toxic chemicals and she’s seen liver problems caused by these (we didn’t use those, thankfully…but good to know if you do).
Fortunately he’s been mostly asymptomatic throughout this entire debacle (other than occasional bouts of diarrhea, but those were more related to diet changes). If we hadn’t gotten that initial bloodwork done (I insisted on it because of recurring skin infections), we never would have even known he had elevated enzymes or liver disease!
So he’ll be on a restricted copper diet for life, and we’ll continue to monitor his ALT every couple of months – increasing ALT over a period of time are a good indicator of the disease progression (although once again, a liver biopsy is the only test to quantify copper amounts).
He just had a liver panel done this past Monday, and his ALT climbed again unfortunately (up to 398 from 313 in June, was previously 404 in April), so our vet sent him for an abdominal ultrasound to make sure no anatomical changes have happened. That came back normal, so the latest plan is to start him on Ursodiol and re-test in a month.
In the future, we have chelation therapy at our disposal, and could incorporate corticosteroids/cyclosporine into his routine. But we’ll cross that bridge when we come to it.
Skin Problems
The entire first 20 months or so of Remy’s life was nonstop skin issues. He had 4-5 bouts of staph throughout that time – one case I posted about became antibiotic-resistant, which meant he ended up being on different antibiotics for a nearly 3 month stretch. He went through an antibiotic treatment course for his liver initially as well. Just way too many rounds of antibiotics in general, and I think they trashed his guts along with the milk thistle. We’ve always had him on probiotics, but there’s only so much they can help.
He got papillomavirus from puppy preschool, which would resurge with a vengeance any time his body was stressed out…which was constantly with everything else going on. Warts would pop up on his chin, legs, feet…ugh. Our vet would “crush” them to stimulate an immune response to attack the rest, but he did have to have a few frozen off and one surgically removed from his paw that he turned into a lick granuloma. Fun times!
He’d have random outbreaks of hives, and we were at the dermatologist constantly. We ended up pinpointing most of it to his gut issues (NOT food allergies, just upset tummy/diarrhea from all the meds/supplements), but also to any kind of fragranced laundry detergent. We only use hypoallergenic, unscented laundry detergent at home, but we stayed at an AirBnB which had freshly washed, heavily scented blankets that Remy laid on, and sure enough the next day he was covered in hives.
One dose of 25-50mg of Benadryl and a Douxo S3 Pyo bath usually quells a hive episode for him. And if he gets any pimples, we treat them with a little bit of Purell a few times a day (per his dermatologist – but ONLY use the actually Purell brand; others can have weird chemicals). He gets a Douxo bath bi-weekly, which is our baseline for helping keep everything in check.
In general, I’ve just determined that Dobermans have god-awful immune systems until they’re about 2 years old. I don’t want to jinx us, but whew, I’m so grateful things seem to be stable now!
Healthy Heart (Yay!)
Remy got his first annual 24 hour holter and echo in the past month, both of which thankfully came back normal and healthy…a HUGE relief!
Dog Sports (Fun Stuff!)
I know this is the health forum, but whew, let's wrap things up on a lighter note!
Amidst all the health chaos, Remy’s stayed busy doing what he loves most, which is scent work.
Remy earned his VSWB, VSWI and VSWE titles over the past year.
He got two Barn Hunt trials under his belt, with 6/6 Q’s to earn his RATN and RATO titles. Remy placed 1st for three of his runs (and ended up going High-In-Class for all three as well!) and took two 2nd place finishes. We’ve both had tons of fun with Barn Hunt, and he makes me so proud. I always joke that he’s living up to his name – after little chef Remy from 'Ratatouille', haha.
He also recently competed in the inaugural “Rat Olympics” at our barn hunt facility, and brought home the silver medal! We’ll be doing another BH trial in October, where he’ll hopefully earn his senior title.
We love this dog beyond words. He keeps us busy (and broke lol), but he sure does make our lives full!
Firstly, Remy’s a very happy and overall healthy boy, who turned 2 in June and is just starting to settle into being a (somewhat) calmer adult.
To try and keep this post from becoming interminable, I’ll breakout the highlights below:
Cryptorchid Neutering
Remy got neutered last November when he was about 17 months old. It was earlier than we would have liked, but both our breeder and vet agreed that it was necessary due to his retained testicle releasing extra testosterone and causing an enlarged prostate. Also, with cryptorchidism, the longer the retained testicle stays in, the probability of testicular cancer skyrockets. They successfully removed both testicles (the retained one was tiny and near his bladder), did a gastropexy, liver biopsy (I’ll get into this next), and it turned out he also had an umbilical hernia, which they repaired too. Poor guy!
Liver Biopsy + CAH/Copper Storage Disease Diagnosis
I’d posted about this in another thread a while back, and it’s been a journey! Since Remy was about 8 months old, he’s had elevated liver enzymes (ALT/AST primarily, ALP is expected to be somewhat elevated while they’re growing), which we’ve monitored on a bi-monthly basis since then. We had a suspicion that it could be CAH (copper associated hepatitis aka copper storage disease) after we started removing copper-heavy foods from his diet and saw his levels come down.
Getting a liver biopsy is the ONLY definitive way to diagnose the disease, and since it’s a procedure that requires anesthesia, it was another reason we moved forward with the neutering when we did. Results came back from Cornell near the end of December (it was a loooong month waiting for them!) and the rhodanine stain confirmed that he had excess copper in his liver. For the next few months we worked with our vet to start tailoring his diet to be much, much lower in copper.
His ALT slowly started coming down, but we’d started him on Heartgard in December, and then it started climbing again.
Near the end of April, our main vet let us know that Dr. Sharon Center from Cornell had reviewed Remy’s results and wanted to include him in her current study about CAH in Dobermans. Dr. Center is the leading authority in the world on canine liver disease – she created the grading scale for liver biopsies, and has looked at thousands of biopsies (hundreds of which have been from Dobermans specifically), so we jumped at the chance to pick her brain about his diet and the disease!
Her advice was to make sure the maximum amount of copper in his kibble is 0.24mg/100 kcal and recommended using either Voyager Pollock dog food (non-prescription) or Royal Canin “Labrador Diet”, and had us run everything else that he eats through USDA Food Data Central’s site to check for copper nutrients. I made a spreadsheet with his safe foods and the copper amounts of each, which you can check out here.
We opted for the Voyager Pollock food, which was created by a vet specifically for copper storage disease. I liked that it had more wholesome/better quality ingredients and isn’t grain-free/doesn’t contain legumes. I’m very conscious of avoiding legumes because of their link to DCM – I know there’s been debate on this in the last couple of years, but regardless, whole grains are good for the heart!
Here’s a brief list of high-copper foods that we avoid completely:
- Organ Meats (heart, liver, kidney, trachea)
- Bully Sticks
- Peanut Butter
- Shellfish
We asked her whether Heartgard (Ivermectin-based heart worm medication) could affect his ALT, and she said that she had seen many cases of Ivermectin-induced liver disease over the years (I knew it, even though our main vet didn’t think it was the cause of his increasing levels!), so we pulled him off of that. Once his levels stabilize again, we plan to try out Interceptor as an alternate medication. I’d like to keep him off heart worm meds altogether, but the treatment is so rough, and with his luck it worries me for him to be unprotected.
Remy’s been on filtered water (we have a Brita tank dispenser) since he was ~10 months old (we live in an ancient house and some of the pipes are copper, so I worried about that contributing). Dr. Center recommends filtered water as well since there are copper and other heavy metals in tap water.
She also noted that milk thistle, which our vet had Remy on, isn’t bioavailable to dogs, thus isn’t an effective supplement for the liver. I’m still torn on that info, as we did see improvement in his ALT while he was taking milk thistle. Apparently, Denamarin is better (a combo of Sam-E and Sylibin, which is extracted from milk thistle so it’s more readily available), but Remy was never able to tolerate it. But, funny thing…when we pulled Remy off of milk thistle, his skin and gut issues got better – all systems really are connected.
And she said to get rid of any type of Glade plug-ins or commercial home fragrance diffusers/spray, since they’re loaded with toxic chemicals and she’s seen liver problems caused by these (we didn’t use those, thankfully…but good to know if you do).
Fortunately he’s been mostly asymptomatic throughout this entire debacle (other than occasional bouts of diarrhea, but those were more related to diet changes). If we hadn’t gotten that initial bloodwork done (I insisted on it because of recurring skin infections), we never would have even known he had elevated enzymes or liver disease!
So he’ll be on a restricted copper diet for life, and we’ll continue to monitor his ALT every couple of months – increasing ALT over a period of time are a good indicator of the disease progression (although once again, a liver biopsy is the only test to quantify copper amounts).
He just had a liver panel done this past Monday, and his ALT climbed again unfortunately (up to 398 from 313 in June, was previously 404 in April), so our vet sent him for an abdominal ultrasound to make sure no anatomical changes have happened. That came back normal, so the latest plan is to start him on Ursodiol and re-test in a month.
In the future, we have chelation therapy at our disposal, and could incorporate corticosteroids/cyclosporine into his routine. But we’ll cross that bridge when we come to it.
Skin Problems
The entire first 20 months or so of Remy’s life was nonstop skin issues. He had 4-5 bouts of staph throughout that time – one case I posted about became antibiotic-resistant, which meant he ended up being on different antibiotics for a nearly 3 month stretch. He went through an antibiotic treatment course for his liver initially as well. Just way too many rounds of antibiotics in general, and I think they trashed his guts along with the milk thistle. We’ve always had him on probiotics, but there’s only so much they can help.
He got papillomavirus from puppy preschool, which would resurge with a vengeance any time his body was stressed out…which was constantly with everything else going on. Warts would pop up on his chin, legs, feet…ugh. Our vet would “crush” them to stimulate an immune response to attack the rest, but he did have to have a few frozen off and one surgically removed from his paw that he turned into a lick granuloma. Fun times!
He’d have random outbreaks of hives, and we were at the dermatologist constantly. We ended up pinpointing most of it to his gut issues (NOT food allergies, just upset tummy/diarrhea from all the meds/supplements), but also to any kind of fragranced laundry detergent. We only use hypoallergenic, unscented laundry detergent at home, but we stayed at an AirBnB which had freshly washed, heavily scented blankets that Remy laid on, and sure enough the next day he was covered in hives.
One dose of 25-50mg of Benadryl and a Douxo S3 Pyo bath usually quells a hive episode for him. And if he gets any pimples, we treat them with a little bit of Purell a few times a day (per his dermatologist – but ONLY use the actually Purell brand; others can have weird chemicals). He gets a Douxo bath bi-weekly, which is our baseline for helping keep everything in check.
In general, I’ve just determined that Dobermans have god-awful immune systems until they’re about 2 years old. I don’t want to jinx us, but whew, I’m so grateful things seem to be stable now!
Healthy Heart (Yay!)
Remy got his first annual 24 hour holter and echo in the past month, both of which thankfully came back normal and healthy…a HUGE relief!
Dog Sports (Fun Stuff!)
I know this is the health forum, but whew, let's wrap things up on a lighter note!
Amidst all the health chaos, Remy’s stayed busy doing what he loves most, which is scent work.Remy earned his VSWB, VSWI and VSWE titles over the past year.
He got two Barn Hunt trials under his belt, with 6/6 Q’s to earn his RATN and RATO titles. Remy placed 1st for three of his runs (and ended up going High-In-Class for all three as well!) and took two 2nd place finishes. We’ve both had tons of fun with Barn Hunt, and he makes me so proud. I always joke that he’s living up to his name – after little chef Remy from 'Ratatouille', haha.
He also recently competed in the inaugural “Rat Olympics” at our barn hunt facility, and brought home the silver medal! We’ll be doing another BH trial in October, where he’ll hopefully earn his senior title.
We love this dog beyond words. He keeps us busy (and broke lol), but he sure does make our lives full!
