Opinion on Dr. Plechner theories?

[tivelnarf]

I know this is not mainstream but it seems to make sense when I read it. Does anyone here have any knowledge of this? I am taking about Dr. plechner and Caroline Levine?

[labblab]

Do you have links to any specific articles that you'd like us to take a look at? I've just done a couple of general Google searches on these two individuals, and have found several different writings for both of them. I'm guessing that the key concepts that you're wondering about are Dr. Plechner's characterization of "active" vs. "inactive" cortisol, and Ms. Levine's term, "adrenal exhaustion."

I have never seen "inactive" or "bound" cortisol described or validated in any peer-reviewed, scientific journal or research. And from what I've seen so far, Dr. Plechner never actually explains the basis for his use of these terms -- he writes about this distinction as though it is a proven fact but with no mention of any research to explain what the difference actually consists of or how this difference would arise. Maybe I've just not come across his actual research studies yet. So if you do have some specific links that you'd like us to look at, that would be great if you'll share them. But right now, I am unaware of any medical/scientific basis for his theory of active vs. inactive cortisol.

Similarly, I do not understand the basis for Ms. Levine's therapy recommendations ("hormone replacement") in conjunction with "adrenal exhaustion." It seems to me that she is using the term pretty much interchangeably with "atypical Cushing's." But where she loses me is in the cause and treatment ramifications of the condition. Again, I do not see any actual research to support or verify her conclusions and recommendations in this regard. It is certainly true that, even among the mainstream scientific and veterinary community, there is still a lot to be learned about the implications and appropriate treatment of elevated adrenal hormones other than cortisol. But I am unaware of any other Cushing's researcher or licensed clinician who recommends that cortisol supplementation be given to a dog with a normal cortisol level but elevated estradiol.

Marianne

[Squirt's Mom]

Caroline D. Levin is an RN who worked for a decade in human ophthalmics then switched to a veterinary eye clinic. I have her book Living With Blind Dogs in which she proposes some of these same ideas as causes for blindness in dogs. She gives sources at the end of each chapter but what gave me pause, it that she references herself in that chapter as the source of adrenal issues.

Personally, I wouldn't put much stock in this theory until I saw renowned endocrinologists backing it. The adrenals are part of the endocrine system and it is a complicated, highly involved system and I just wouldn't want to trust my babies well being to someone who trained in human eye care. Just MHO. ;)

Hugs,
Leslie and the gang

[tivelnarf]

Thanks to both of you. I am so panicked because everything I've read about SARD has me concerned that my dog is going to go blind. His estradiol levels are so high, and apparently that is a correlation of some kind. From what I can see, Lysodren does not bring this down, only the melatonin may, and because his is so high, I worry it won't be enough. Over the past month, his eyes have become slightly red and teary for no apparent reason. Sometimes, I see him lick the side of his front paw and then use his moistened paw to rub his eye, as if it is itchy or irritated. I feel like something terrible is going to happen and there's nothing I can do about it, so I came across the above things because I am grabbing at straws- like maybe if I give him low dose pred, I can bring the estradiol down... Some links: http://drplechner.com/toomuchcortisol.php ,
http://www.ncbi.nlm.nih.gov/m/pubmed/15050110/, http://www.fugitt.com/article/adrenalthyroid_imbalances.htm. Please please write back and let me know your thoughts, I am so scared about this sard issue I can barely look at my pup without crying. Any input you can give i would be so greatful!

[StarDeb55]

Actually, the lysodren will control adrenal produced estradiol. The problem crops up is that there are a number of non-adrenal tissues that produce estradiol including fatty tissue that the melatonin+lignans is used to control. The supplements may or may not work, it's hard to say, & it may take as long as 6 months to see substantial improvement. SARDS is kind of a rare condition, so I wouldn't be worried to much about it just yet.

I absolutely would not be giving pred to a pup with a Cushing's diagnosis, even if it's only Atypical. Pred is really a wonder drug when used in the right situations, but it must be carefully monitored, & can't be just stopped "cold turkey". Once it's started, you have to taper off it when it needs to be stopped.

[tivelnarf]

Here is another link that has me freaked out about SARD-

http://www.thelittledogsday.com/2008/09/high-alk-phos-just-scottie-thing.html. Please let me know what you think!!!!! :(

[tivelnarf]

http://www.twobitdog.com/DrFox/Endocrine-Immune-Disruption-Syndrome
This link tries to explain the scientific basis for these theories.

[tivelnarf]

Sorry wrong link, this us the one with the detail. http://drplechner.com/article_effective_vet.php

[labblab]

I really hope you can find a way to shift your worry away from SARDS. Has anyone other than Caroline Levin suggested a direct causative connection between elevated estradiol and SARDS? Through the years here, we have seen many dogs with elevated estradiol levels -- and very, very few dogs who have developed SARDS.

And from the additional information you have given us, my impression is now even stronger that Dr. Plechner's theory is merely that -- an unsubstantiated theory. Not that Wikipedia is the most reliable source of info itself :o, but read this description of the journal in which Dr. Plechner's cited article appeared (in the year 2004):

http://en.wikipedia.org/wiki/Medical_Hypotheses

I am a born worrier, myself. So I do understand how easy it is to latch onto an idea and worry it into the ground. But without the benefit of any genuine scientific research to support their contentions, I hope you will shift your focus away from Dr. Plechner and Ms. Levin, and stop worrying unduly over a condition as uncommon as SARDS.

Marianne

[Squirt's Mom]

Ok, sweetie,

First thing, take a deep breath. Try to relax a bit and stop looking for problems. ;) I can tell you from experience, it will make you bat-poop nutty in no time. :p Dealing with what you know is enough to keep you busy for months right now. And you know your baby is Atypical.

Cushing's and SARDS do seem to be connected somehow but, to my knowledge, no one is sure how exactly. But we do know this - SARDS causes Cushing's signs and false-positives on the tests; Cushing's does not cause SARDS. The first "S" in SARDS stands for "sudden" and they mean just that - immediately blind almost. They can see today and blind tomorrow - completely, totally blind. The Cushing's signs are usually present before the onset of blindness or show up concurrently. BUT within a few months of going blind, the Cushing's signs disappear and test results are normal again. The dog is then simply blind and does not have Cushing's and never did.

Blindness in dogs is not something to fear or feel depressed about tho it is hard not to. I currently share my life with two blind babies, and had a deaf and blind Dane years ago. I can promise you, it is much harder on us humans to see them go blind than it is for the dogs to find themselves blind. They adapt remarkably fast and well. My Dane was born with her afflictions and she taught me so much more than any book or trainer ever could have. My itty bitty ones, both less than 5 lbs, continue to teach, amaze, and delight me every day. So don't panic over SARDS or even blindness, neither is as bad on our babies as we think it is.

If your baby is having problems with her eyes, she needs to be seen by a vet asap. Some eye issues are very painful and can get bad quickly. She may have a simple infection that can be cleared up in a matter of days with ABs.

Hope this helps,
Hugs,
Leslie and the gang

[tivelnarf]

Thank you so much everyone for your replies. I hear what you are saying, I do. I guess the issue i am struggling with is that in my dog's atypical cushiness, his cortisol is normal. His estradiol is extremely high, baseline is 145. Post-stim, the estradiol went down to 122, which I find interesting. It does appear that this is the case in most of the posted test results, am I correct? Anyway, in my dogs case, the diagnosis is essentially that the intermediates and not the cortisol are high. My understanding is that the reason this is called "atypical CUSHINGS" is that the high intermediates mimic the symptoms of high cortisol. So it is technically like a "pseudo"-CUSHINGS. There has been a connection established in SARD dogs that they largely have high estradiol levels (hyperestrinism)- not specifically atypical CUSHINGS, ( since atypical CUSHINGS could mean many different things in terms of elevated intermediates, not necessarily high estradiol). But high estradiol levels seem to be linked to SARD. Some SARD dogs are later diagnosed with CUSHINGS, be it typical or atypical. This is the connection that concerns me. PLEASE correct me if I am wrong about this, I am just wanting you to understand where my concern is coming from I am not arguing with you. I need you to keep talking to me because no one else has the knowledge that you do. Please write back!

[tivelnarf]

quote from one of dr oliver's papers- " *Steroid profiles have also helped to better understand the condition of SARDS in dogs, where steroids other than cortisol frequently are involved."

[tivelnarf]

Here is a link to Dr Oliver report on this, you will see why i am concerned....

http://www.jaaha.org/content/45/5/207.abstract