# Teeth cleaning and liver



## fandances (Jul 4, 2013)

Hi, Hoping to gather a few opinions from this experienced group. Just searched and read several forum posts about teeth cleaning and the pre-procedure bloodwork indicating a higher than normal ALT level. None of them mentioned if they proceeded with the teeth cleaning as scheduled. I really like my vet who thought it was ok to proceed with >200, and we'd test blood again soon to track it, but is also ok if I want to postpone. I dread this procedure and anesthesia anyway - first teeth cleaning, 8 years old. My havi seems healthy and happy, and the ALT level was also higher than normal (barely) years ago when last tested. Also - in one of the threads I read, someone said even a small dental infection could raise the ALT level so it's possible it could help? What to do. Family centers around our little love, needless to say.

Background: Teeth could use cleaning, I brushed for a few years then unfortunately dropped it. They looked good for 5-6 years, and aren't bad now but don't want big problems later. I've got to get back to brushing I know. Is it past the point of fixing with brushing? I read about Plaque Off too.

Thanks for any insights here.


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## BoosDad (Mar 8, 2020)

My Boo, who is an 18 year old Havanese, has a history of chronic elevated liver enzymes (both ALT and AST), on and off, since the age of 4. In fact, at the age of 4, when I first got him from a friend, his ALT was greater than 450 U/L. My vet felt that the elevation might be related to a dental infection, and recommended deep cleaning with anesthesia. Low and behold, after the cleaning, liver enzymes declined dramatically. Boo continued to have cleanings in subsequent years, despite periods of elevated enzymes. He had several ultrasounds over the years, most recently in 2020, which ruled out liver disease. Finally, in 2020, after many years, we got a diagnosis of presumptive IBD, which was felt to be causing the elevated liver enzymes. B12, a very important vitamin, that is not normally checked, also was low. Now, on a low dose of prednisone, a probiotic, and a B12 supplement, he is doing fine. He never presented as a typical IBD dog, because other than his elevated liver enzymes and infrequent gassy episodes, he had no overt signs ( i.e., no vomiting or diarrhea). 

Bottom line, based on my own experience, a dental infection may be causing the elevated liver enzymes, absent any overt evidence of another disorder. If you are concerned about anesthesia, you might want to seek out the opinion of a dental specialist. Of course, ultimately, you need to do whatever makes you comfortable. I can only tell you about our experience with dental cleanings and elevated liver enzymes.


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## JaJa (Jun 28, 2020)

Hi fandances, I don't have answers for you but i'm very glad you posted about this issue. Tuesday JoJo (15) and Cotton (11) are getting pre-cleaning bloodwork at the vet dentist. JoJo will have his cleaning first on the 19th, if the bloodwork is good. In the past they have both had normal ATL levels. 
It looks like you've been reading some of the same posts I have. Currently, I have windows open for 4 different oral products, including Plaque Off powder, to ask about on Tuesday. I also have the same question about about brushing. The 15 year old has canine dementia so we can't get his teeth brushed very well because he bites down-hard. His jaw is still very strong so I put dog toothpaste on the toothbrush and just move it around so there is at least some toothpaste making contact. 
If you have any other questions I would be happy to ask on Tuesday. I'm also going to ask about B12 since BoosDad mentioned it. Those 2 are amazing and I think we should nomiate Boo as the forum mascot😋


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## fandances (Jul 4, 2013)

Thank you for your replies! Love seeing these havi photos, too. Beautiful. 

BoosDad - that is interesting information about IBD and B12 to have in back of my mind as we investigate the elevated levels. I appreciate you sharing that. Tappers does vomit occasionally. Not enough that I've found it alarming. Maybe once every 3-6 months. I'm glad you got to the cause with your Boo. How cute is that name. Just one more question if you see this again - how did they diagnose the IBD? 

JaJa, I laughed when I got to the part in your post about having Plaque Off on your screen. I ordered a bottle just minutes before. We've definitely been reading the same threads! I also ordered toothpaste/toothbrush but am not optimistic about having success with it. Tappers is great about so many things but not that. It sounds like a little toothpaste like you're doing with JoJo is better than nothing, I wish I had kept that up. I hope the bloodwork goes well for your crew. Yes, please, let me know what your vet says if you ask about these things. Also, Boo has my vote too 

I've decided that I will postpone the tooth cleaning for a month until we can do another round of bloodwork to see if any changes. If it's a tooth infection, I feel bad waiting. Otherwise, I just can't get comfortable with a tooth cleaning if something else is going on. Meanwhile, I'll try the Plaque Off to see if his teeth health will go the better direction.


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## mudpuppymama (Mar 24, 2012)

I am not sure if you use heartworm or flea tick preventatives but the liver does need to do some detoxification with these drugs. If so, I was wondering if it would be helpful to avoid administering these drugs at the same time and avoid giving them close to the time you do the retesting. Not sure if this will impact test results but thought it might.


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## krandall (Jun 11, 2009)

All I can say is that the Kings' first told me about Plaque-Off when Kodi was a puppy, and I've used it ever since. I DO brush my dog's teeth, but I know other people who do, and have not had their dogs' teeth stay in as good condition as my dogs' teeth have.

I have had a couple of people warn that Plaque-Off could be a problem for dogs with thyroid problems. I talked to my vet about that, and she says that PERHAPS if a dog had a serious thyroid problem ALREADY. It is not going to CAUSE a thyroid problem. None of my dogs have thyroid issues. (all have been tested) Kodi is 11 1/2 and he does need a cleaning now, which has been put off because of Covid, but I do need to schedule. He has not needed one up UNTIL now. That is pretty remarkable for a toy breed dog. Pixel is 6 and had her first last year, not extractions, just a cleaning, everything in great shape, beautiful mouth. Panda is 5 and has not needed one. 

That is my testimony for daily Plaque-Off. I do NOT think it REMOVES plaque very well though... I think it's better at keeping it from fofrming.


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## mudpuppymama (Mar 24, 2012)

krandall said:


> All I can say is that the Kings' first told me about Plaque-Off when Kodi was a puppy, and I've used it ever since. I DO brush my dog's teeth, but I know other people who do, and have not had their dogs' teeth stay in as good condition as my dogs' teeth have.
> 
> I have had a couple of people warn that Plaque-Off could be a problem for dogs with thyroid problems. I talked to my vet about that, and she says that PERHAPS if a dog had a serious thyroid problem ALREADY. It is not going to CAUSE a thyroid problem. None of my dogs have thyroid issues. (all have been tested) Kodi is 11 1/2 and he does need a cleaning now, which has been put off because of Covid, but I do need to schedule. He has not needed one up UNTIL now. That is pretty remarkable for a toy breed dog. Pixel is 6 and had her first last year, not extractions, just a cleaning, everything in great shape, beautiful mouth. Panda is 5 and has not needed one.
> 
> That is my testimony for daily Plaque-Off. I do NOT think it REMOVES plaque very well though... I think it's better at keeping it from fofrming.


Dr. Jean Dodds has talked about how too much iodine can lead to thyroid problems. Maybe that is what you are referring to. They used to advise raw feeders to add kelp to the diet but views on that have changed. Not sure if this applies to Plaque-Off but something to consider. It may be one of those things where some dogs are more susceptible than others. Mia is not hypothyroid but is on the lower side of normal so I try to be careful.

https://www.thepossiblecanine.com/kelp-for-dogs

Key takeaway-

"&#8230;.excessive iodine supplementation can result in the overproduction of the T4 and T3 in dogs and cats, which triggers unintended cascading effects: in dogs, the immune system may wind up attacking the thyroid gland (producing excessive amounts of thyroglobulin autoantibody) which end up suppressing thyroid levels and causing the very hypothyroidism it was meant to prevent; whereas in cats, the overdosing can result in overt hyperthyroidism."


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## mudpuppymama (Mar 24, 2012)

Here is an old thread discussing Proden Plaque-Off where Dave Gabby actually asked Jean Dodds about it. In this thread, it mentions that Dr. Dodds recommends something called Healthy Mouth Oral Gel. I have heard of that but not known anyone who has used it. Note that this is an old thread and sometimes things change.

https://www.havaneseforum.com/10-health-issues-questions/110114-ok-give-proden-plaqueoff.html


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## BoosDad (Mar 8, 2020)

To answer your question, in Summer 2020, Boo had extensive workup, because all liver function test were elevated. This included full body x-rays, abdominal ultrasound, full blood panel (including B12), and urine panel. Boo saw a specialist in internal medicine, who completed the work-up. She was rather pricey but very thorough, and willing to explain the reason for her diagnosis. Essentially, she told me that she could not give me a definitive diagnosis absent an endoscopy, which was contraindicated, due to Boo's advanced (he was 17 at that time). Rather, she gave me a presumptive diagnosis after ruling out liver disease and all other possible explanations for the elevated liver function tests. She noted that, as I told her, Boo is a picky eater, which is typical of IBD dogs. She further noted that IBD dogs have problems with absorption of B12 in their food, which was reflected in Boo's low B12 levels. Finally, she noted some visual evidence in the ultrasound image that could be consistent with a diagnosis of IBD, inasmuch as everything else looked fairly normal. She said inflammation in the intestine was likely the cause of the abnormal liver function tests. At first, she recommended changing Boo to a novel protein diet, adding a B12 supplement, and continuing to use a probiotic. As recheck only revealed a slight decrease in the liver function test values, Boo's specialist added a very small dose of prednisone (2.5 mg/day for a 14.5 pound dog) to address inflammation issues. After 6 weeks, she was able to decrease the dosage to every other day instead of every day, based on substantial improvement in his labs. Boo has another follow-up next month. Hopefully, we can decrease his prednisone dosage to every third day.

For some historical perspective, in 2018 and 2019, his liver function tests were completely normal. In fact, in February 2020, when he had his quarterly checkup, his vet was amazed that all his blood and urine looked so good, and more typical of a much younger dog. However, as I said in my previous post, he has a history of fluctuating liver enzymes. So, at times, values were completely normal (based on blood work two or three times a year). Feel free to send me a private message, if you would like additional information. We live in Southern California.


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## mudpuppymama (Mar 24, 2012)

BoosDad - I was just wondering if your vet recommended any type of liver support during periods when the liver enzymes were elevated. For example, Denamarin or milk thistle?


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## krandall (Jun 11, 2009)

mudpuppymama said:


> Here is an old thread discussing Proden Plaque-Off where Dave Gabby actually asked Jean Dodds about it. In this thread, it mentions that Dr. Dodds recommends something called Healthy Mouth Oral Gel. I have heard of that but not known anyone who has used it. Note that this is an old thread and sometimes things change.
> 
> https://www.havaneseforum.com/10-health-issues-questions/110114-ok-give-proden-plaqueoff.html


Yeah, it was Dave who was so against Plaque-Off. My vet actually worked with Dr. Dodds and says in the amounts used in Plaque-Off it should not be a problem for dogs with healthy thyroid function, which my dogs have. YMMV.


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## Tere (Oct 17, 2018)

mudpuppymama said:


> BoosDad - I was just wondering if your vet recommended any type of liver support during periods when the liver enzymes were elevated. For example, Denamarin or milk thistle?


Not Boo's Dad, but my BichonRIP had liver envymes (all of them) off the charts almost. My vet said that he would not survive and had never seen such a bad bloodwork up in a dog. He said that my angel would not survive much longer. It was pretty grim. He said to go to the Specialty Hospital for biopsies etc. but to expect the worst. He was 12. 
I asked for anything that might help. He said Denamarin since we were not sure of the exact problem and I did not want to put him in the hospital for his remaining few days. While his liver counts never returned to total normal, he did survive amost 3 more years.

He did say that stress of being at the vet's will elevate levels somewhat.


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## BoosDad (Mar 8, 2020)

mudpuppymama - As I recall, two different vets prescribed Denamarin for Boo. This was prior to his first abdominal ultrasound in 2013. On both occasions, Denamarin did not improve the liver function test values. In fact, six months after he was off Denamarin, the ALT and AST values were completely normal, and remained normal for more than a year. He had his first ultrasound, when we were living in France, in 2013. It revealed that his liver, pancreas and kidneys were completely normal. As such, I was told that he did not have liver disease, and that the elevation in ALT and AST were an anomaly, and not indicative of liver disease. Thereafter, his liver function tests continued to fluctuate, at times, normalizing for more than two years. I did not perform another abdominal ultrasound until June 2020, when a new vet was concerned because Boo's liver function tests had shot up again, after being completely normal in February 2020. Although she agreed that, given his history of fluctuating liver function tests, he did not have liver disease, she referred me to a specialist for more complete work-up. Again, his abdominal ultrasound did not show any liver dysfunction, and bile acid values were normal. Hence, Boo's specialist told me that she felt that intestinal inflammation (IBD) was causing the elevated ALT and AST values in Boo's case. Essentially, since inflammation in the liver was not causing the elevation in ALT and AST, Denamarin was not helpful for Boo. However, I understand that it can be a lifesaver for dogs with actual liver disease.


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## mudpuppymama (Mar 24, 2012)

krandall said:


> Yeah, it was Dave who was so against Plaque-Off. My vet actually worked with Dr. Dodds and says in the amounts used in Plaque-Off it should not be a problem for dogs with healthy thyroid function, which my dogs have. YMMV.


Sure I just wanted to point this out since many dogs do not have healthy thyroids or may be getting more iodine from their diet than others. Mia is still in the normal range but on the low side. Her values dropped after she took prednisone for her back issue and I have taken precautions to make sure they do not drop any lower. That is why I ruled this product out for her several years ago. I would assume the amount of iodine in the dog's diet matters as well. Some people feed their dogs fish, fish oil, or dog foods with fish and fish oil, so those dogs may be getting more iodine from their diet than others. Just wanted to make people aware so they can make an educated decision about this product.


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## mudpuppymama (Mar 24, 2012)

BoosDad said:


> mudpuppymama - As I recall, two different vets prescribed Denamarin for Boo. This was prior to his first abdominal ultrasound in 2013. On both occasions, Denamarin did not improve the liver function test values. In fact, six months after he was off Denamarin, the ALT and AST values were completely normal, and remained normal for more than a year. He had his first ultrasound, when we were living in France, in 2013. It revealed that his liver, pancreas and kidneys were completely normal. As such, I was told that he did not have liver disease, and that the elevation in ALT and AST were an anomaly, and not indicative of liver disease. Thereafter, his liver function tests continued to fluctuate, at times, normalizing for more than two years. I did not perform another abdominal ultrasound until June 2020, when a new vet was concerned because Boo's liver function tests had shot up again, after being completely normal in February 2020. Although she agreed that, given his history of fluctuating liver function tests, he did not have liver disease, she referred me to a specialist for more complete work-up. Again, his abdominal ultrasound did not show any liver dysfunction, and bile acid values were normal. Hence, Boo's specialist told me that she felt that intestinal inflammation (IBD) was causing the elevated ALT and AST values in Boo's case. Essentially, since inflammation in the liver was not causing the elevation in ALT and AST, Denamarin was not helpful for Boo. However, I understand that it can be a lifesaver for dogs with actual liver disease.


I see. I was also wondering...did Boo have any outward symptoms that you noticed?


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## mudpuppymama (Mar 24, 2012)

Tere said:


> Not Boo's Dad, but my BichonRIP had liver envymes (all of them) off the charts almost. My vet said that he would not survive and had never seen such a bad bloodwork up in a dog. He said that my angel would not survive much longer. It was pretty grim. He said to go to the Specialty Hospital for biopsies etc. but to expect the worst. He was 12.
> I asked for anything that might help. He said Denamarin since we were not sure of the exact problem and I did not want to put him in the hospital for his remaining few days. While his liver counts never returned to total normal, he did survive amost 3 more years.
> 
> He did say that stress of being at the vet's will elevate levels somewhat.


Did he have any symptoms while his enzymes were so high?


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## krandall (Jun 11, 2009)

mudpuppymama said:


> Sure I just wanted to point this out since many dogs do not have healthy thyroids or may be getting more iodine from their diet than others. Mia is still in the normal range but on the low side. Her values dropped after she took prednisone for her back issue and I have taken precautions to make sure they do not drop any lower. That is why I ruled this product out for her several years ago. I would assume the amount of iodine in the dog's diet matters as well. Some people feed their dogs fish, fish oil, or dog foods with fish and fish oil, so those dogs may be getting more iodine from their diet than others. Just wanted to make people aware so they can make an educated decision about this product.


Yes, that's why I pointed out that dogs should have healthy thyroids.


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## Tere (Oct 17, 2018)

mudpuppymama said:


> Did he have any symptoms while his enzymes were so high?[/QUOT
> 
> He had been vomitting suddenly out of nowhere, alot and often in the course of an hour or two and seemed not very lively. Took him in right away.
> Two days later, he seemed to be better. Hadn't started the Denamarin yet and had the bloodwork redone. It had improved a bit but was still crazy. Once the Denamarin arrived, he really started to seem more normal, back to his usual self once he started taking it.


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## BoosDad (Mar 8, 2020)

mudpuppymama said:


> I see. I was also wondering...did Boo have any outward symptoms that you noticed?


 Boo had no outward signs, when the liver enzymes were elevated (i.e., beautiful coat, no weight loss, no signs of jaundice, no vomiting, no diarrhea). He always was a picky eater and had periodic gassy episodes, even when all blood work was normal. I think vets are too quick to assume that elevated ALT and AST denote liver disease, since that is the most common explanation. Clearly, that is not Boo's problem. That's why it took me years to figure out the actual reason Boo was having episodes of elevated ALT and AST.


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## JaJa (Jun 28, 2020)

Np fandances, I'm printing my questions tomorrow and putting them in the car so I don't forget. Hopefully, I'll have time tomorrow to go back and read all the other posts.


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## mudpuppymama (Mar 24, 2012)

Thanks BoosDad and Tere for responding to my questions about Denamarin. Last month both my dogs had mildly elevated liver enzymes at their annual exams. All other blood work including thyroid tests were normal and they had no symptoms of any issues. The vet suggested giving them Denamarin Advanced for 6 weeks and then retesting them. My dogs are both having issues with this drug. I will start another thread on this to explain. Perhaps others can weigh in on their experiences in that thread.


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## fandances (Jul 4, 2013)

Interesting information in this thread, thanks. The education will help when we are next at the vet's. I noted the comment about stress possibly as a culprit to elevated ALT levels. While chill at home, my havi gets very stressed when we go somewhere and I'm convinced knows the route to the vet!

JaJa, hope the checkup went well. I always write my questions down too. I started with a very small amount of the Plaque Off today. Toothbrush still in package but may attempt tonight lol.


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## JaJa (Jun 28, 2020)

Hi fandances,
I was thinking about you this afternoon. I had several questions about Cotton and JoJo's blood tests. Their ATL levels are okay but their SDMA is which can be an early marker for kidney disease. At this point JoJo is further along with his kidney issues, has elevated pancratic enzymes and is blind, deaf, has periodic seizures and is at the later stage of canine dementia. 
My 94 year old father-in-law has kidney disease so we've learned more than we knew about CKD. His wife had dementia for 12 years (8 years with my dad) and JoJo has followed the dementia path identically to Ed's Mom. We've been doing more research and talking and have decided it's not worth the risk to put him under anesthesia. 
I have several more questions so one of the vet dentists is calling tomorrow to talk with me. On Tuesday they took the dogs immediately and were back in 5 minutes so no one had time to address my questions. I do appreciate an opportunity to talk directly to the vet. I will update sooner this time!


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## BoosDad (Mar 8, 2020)

JaJa - Was IDEXX SDMA abnormal prior to this current test? If not, it is possible that a high protein diet or high protein treat is falsely elevating that value. In Boo's case, in July 2020, IDEXX SDMA was in the normal range. However, I started him on a new salmon bark treat (very high protein) in July 2020, after the test. In August 2020, his IDEXX SDMA was 21 (abnormal) and creatinine was reflective of stage 2 kidney disease. I discontinued the treat, per his specialist's advice, and two months later, IDEXX SDMA was 11 (normal range), and creatinine had dropped to .7 mg/dl. Not sure, if any of this information is helpful, but I thought I would pass it on. Hope that you can keep JoJo as happy as possible, despite his dementia. It can be managed, and it seems like you are doing that well. I think it is a wise decision not to put him under anesthesia, because it might make the dementia worse.


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## JaJa (Jun 28, 2020)

Ty BoosDad, I really appreciate your post! Cotton hasn't ever had an IDEXX SDMA test. It seems like it would have been a good idea when he had his surgery, at the regular vet, last summer. This evening I finally received copies of the actual lab reports for Cotton and JoJo.
Cotton’s is 16, so right outside the normal range. His protein level is 5.4 which is on the border (5.5-7.5) of the normal range. The dental vet said it's possible that Cotton could be in the first stages of CKD but wants to do a urine test and another blood test in 5 or 6 weeks. She's going to take a urine test and then order other tests contingent upon those results. 
JoJo is more concerning with RBC, hematocrit, hemoglobin, chloride and MCHC levels that are too low and his platelets, creatinine, amylase, lipase and BUN are too high. His SDMA is 31 which, I'm sure you know is highly elevated. Although the MCHC is borderline at 32.5 JoJo also needs a urine test. This is not a shock but still distressing to confirm that he is clearly at the end of his life. Ed working from home has been a good thing since he’s able to be around JoJo so much. 
Ty, the combined 20 years of our parents dementia/Alzheimer's has been incredibly helpful with JoJo. No matter how detached he seems we know he's still in there. Ed's parents are close by so we spent a fair amount of time with Mom (now just Dad) and became accustomed to her wandering and us needing to move things. Behaviors that might annoy or scare some people now seem normal to us. 
If you have any other feedback or wisdom please feel free to share. I'm a little nerd on the inside so I enjoy learning anything new, especially regarding our "Havanese" children.


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## BoosDad (Mar 8, 2020)

JaJa said:


> Ty BoosDad, I really appreciate your post! Cotton hasn't ever had an IDEXX SDMA test. It seems like it would have been a good idea when he had his surgery, at the regular vet, last summer. This evening I finally received copies of the actual lab reports for Cotton and JoJo.
> Cotton's is 16, so right outside the normal range. His protein level is 5.4 which is on the border (5.5-7.5) of the normal range. The dental vet said it's possible that Cotton could be in the first stages of CKD but wants to do a urine test and another blood test in 5 or 6 weeks. She's going to take a urine test and then order other tests contingent upon those results.
> JoJo is more concerning with RBC, hematocrit, hemoglobin, chloride and MCHC levels that are too low and his platelets, creatinine, amylase, lipase and BUN are too high. His SDMA is 31 which, I'm sure you know is highly elevated. Although the MCHC is borderline at 32.5 JoJo also needs a urine test. This is not a shock but still distressing to confirm that he is clearly at the end of his life. Ed working from home has been a good thing since he's able to be around JoJo so much.
> Ty, the combined 20 years of our parents dementia/Alzheimer's has been incredibly helpful with JoJo. No matter how detached he seems we know he's still in there. Ed's parents are close by so we spent a fair amount of time with Mom (now just Dad) and became accustomed to her wandering and us needing to move things. Behaviors that might annoy or scare some people now seem normal to us.
> If you have any other feedback or wisdom please feel free to share. I'm a little nerd on the inside so I enjoy learning anything new, especially regarding our "Havanese" children.


Definitely, more testing is the way to go for both dogs. Have you noticed any darkening of the stools, which might indicate internal bleeding to explain the low RBC? From my experience with my toy poodle, kidney dogs do get ulcers, which would account for the anemia (low hematocrit, hemoglobin, and RBC). Still, if you can stop the bleeding and increase the RBC, the outcome is better. Surprisingly, they can do lots of things these days to treat canine kidney disease or just make the dog more comfortable (e.g., administering subcutaneous fluids, giving a binder if phosphorus is high, using a strict kidney diet, use medication to treat ulcers, and administer dialysis). My toy poodle was under the care of a specialist for his kidney disease. He lived about 6.5 years after his initial diagnosis. I don't know the availability of a specialist in your neighborhood. However, many times they can offer options not available through a general practice vet. Boo and I are sending good thoughts to JoJo. P.S. My father also died from Alzheimer's dementia in 2018. It is a terrible disease, and it was incredibly difficult to watch a former psychiatrist become catatonic.


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## JaJa (Jun 28, 2020)

My Dad passed on September 24th 2018. He died before he entered the catatonic stage like my mother-in-law. It was a tough situation because he didn't have to die the way he did but at least he was still somewhat lucid in the present. Alzheimer's was his biggest fear, he watched as the majority of the other judges in his county fell victim to the ravages of the mind. It is surreal to see a parent thriving in their field and then becoming helpless. 

JoJo eats his own food with less protein, phosphorus and sodium than Cotton and Jodie. He also takes a probiotic and fish oil. It does seem odd that Cotton is the one who has low total protein. He definitely needs more expansive bloodwork with his urinary test. It looks like I'll need to change his diet again too. JoJo's phosphorus is where it should be at 4.5 and his stools look normal but we're watching him every time now. We did that for a while a year ago and took pictures. There aren't a lot of specialists here but Oregon is only 20-30 minutes away and there are some good vet specialists over there. Although, I would make the 3 hour trip to Seattle if I needed to. Luckily, all his liver enzymes are normal.
I also need to get Cotton's eye lid checked. He has a bump on the edge and it is now larger than it was 2 weeks ago. Until he had his dewclaws removed last summer, Cotton has been in near perfect health for 11 years. Thanks again, I feel like a vet assistant at this point. Also, what kind of a diet does Boo eat? I want to make sure I'm current on our dog's need. I feel like a little hyped up prairie dog scanning dozens of things concurrently to make sure the kids are safe😋


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## BoosDad (Mar 8, 2020)

JaJa said:


> My Dad passed on September 24th 2018. He died before he entered the catatonic stage like my mother-in-law. It was a tough situation because he didn't have to die the way he did but at least he was still somewhat lucid in the present. Alzheimer's was his biggest fear, he watched as the majority of the other judges in his county fell victim to the ravages of the mind. It is surreal to see a parent thriving in their field and then becoming helpless.
> 
> JoJo eats his own food with less protein, phosphorus and sodium than Cotton and Jodie. He also takes a probiotic and fish oil. It does seem odd that Cotton is the one who has low total protein. He definitely needs more expansive bloodwork with his urinary test. It looks like I'll need to change his diet again too. JoJo's phosphorus is where it should be at 4.5 and his stools look normal but we're watching him every time now. We did that for a while a year ago and took pictures. There aren't a lot of specialists here but Oregon is only 20-30 minutes away and there are some good vet specialists over there. Although, I would make the 3 hour trip to Seattle if I needed to. Luckily, all his liver enzymes are normal.
> I also need to get Cotton's eye lid checked. He has a bump on the edge and it is now larger than it was 2 weeks ago. Until he had his dewclaws removed last summer, Cotton has been in near perfect health for 11 years. Thanks again, I feel like a vet assistant at this point. Also, what kind of a diet does Boo eat? I want to make sure I'm current on our dog's need. I feel like a little hyped up prairie dog scanning dozens of things concurrently to make sure the kids are safe��


Seems like you are doing a great job trying to keep all the doggies healthy and happy. Boo eats a wild cod/sweet potato or venison/squash home cooked diet, which is prepared in the kitchens of a company called JustFoodFor Dogs. I have to give him a novel protein for his IBD. He tolerates the fish diet best but likes venison (so I give it once in a while). JustFoodForDogs has kitchens in California, where you actually can watch them making the food. I feel that this is as close as I can get to making his food myself. When he was younger, he ate Stella and Chewy dehydrated raw patties or Ziwi Peak air-dried Venison formula. However, his poop looks better on his current diet.


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## JaJa (Jun 28, 2020)

One of my dog food tabs I was reading yesterday and today is JustFoodForDogs. I've been debating between Stella and Chewy, Honest Kitchen or Ziwi Peak for Cotton and Jodie. Right now I'm making food for the kiddos with a 50:50 ratio to high quality kibble. Now that it seems I need a different diet for each dog, I think I would like a little help rather than moving to all homemade food. We might have to check out the JustFoodForDogs facility next time we visit our niece in Irvine.
I feel for Boo, I had IBS until I was 30 and a friend who comes to the forum occasionally has a Havanese (Sophie) with IBD. It's a good thing these babies have dedicated parents😋


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## BoosDad (Mar 8, 2020)

JaJa said:


> One of my dog food tabs I was reading yesterday and today is JustFoodForDogs. I've been debating between Stella and Chewy, Honest Kitchen or Ziwi Peak for Cotton and Jodie. Right now I'm making food for the kiddos with a 50:50 ratio to high quality kibble. Now that it seems I need a different diet for each dog, I think I would like a little help rather than moving to all homemade food. We might have to check out the JustFoodForDogs facility next time we visit our niece in Irvine.
> I feel for Boo, I had IBS until I was 30 and a friend who comes to the forum occasionally has a Havanese (Sophie) with IBD. It's a good thing these babies have dedicated parents&#128523;


Those are all good foods, whatever you decide to choose.


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