Senior Dog Falls Over Like a Tree Falling

by Eric
(Toronto, Ontario, Canada)

Theo

Less than a week ago, I was approaching my front door with my dog, Theo. He was in the living room standing. Suddenly, he just fell down, like a tree falling over.

He got up and we proceeded up the stairs and I took him for a walk and all went OK with no more falls.

A couple of days ago, we headed to the sidewalk in front of the house. Again, he stood waiting for me. And then he just fell. He got up and then we walked around the block, without any falls.

Yesterday, we went to a large park in the city where we roamed quite a far distance within the park. No falls.

I took him for a short walk this morning. No falls. He then rested in the house today. At about 4pm, we went out for a walk. On the sidewalk, again, he fell down. And then he got up.

After we proceeded several blocks, I took off his leash. I noticed some sort of 'vibration' in the middle of his body and he fell.

I don't know about these things, but the 'vibration' looked to me like it was a seizure or something. In any case, he was able to get up and we walked all the way back home. And he did not fall once.

I called my local vet, explaining the situation. She advised me that perhaps he's stoic, not showing his pain, and that perhaps I should simply walk him to do his basics--that maybe he's too tired to walk and his muscles may be giving out.

I'm resistant to under-exercising him because I want him to have the best life. I don't understand how he could walk long distances without showing lameness.

Over the phone, my vet recommended TRAMADOL, citing that if it's his muscles giving out than this will relieve the pain. My vet said that though I'm giving him the DGP (Dog Gone Pain), to help with his joints, she suggested that it may not be enough.

I've researched Vestibular disease with the 'falling' symptom, but he's eating and his head is not tipping to any particular side. Could it be this?

I'm trying to do all that I can because I'm feeling the pinch of the potential costs. But my perception of a progressive decline in his wellness is overwhelming.

Please let me know if you need clarification on anything to provide best feedback.

Dog stats:

15 Year old
Collie/Husky mix
Male

Thank you,
Eric

***UPDATE: I just came from my local vet for his annual exam because last night he fell down a few times. The vet says that he's very weak in the hind quarters. She prescribed Tramadol, 50mg, twice daily.

I look forward to your second opinion.

Comments for Senior Dog Falls Over Like a Tree Falling

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Apr 17, 2013

My Online Vet Response for: Senior dog Falls Over Like a Tree Falling
by: Dr. Carol Jean Tillman

Hi Eric,

It is difficult to give a specific diagnosis without actually seeing Theo 'fall over' or giving him a physical.

I can tell you that Senile Vestibular Disease may appear suddenly, but it takes about 7-14 days or longer for a dog to recover back to normal. It is usually characterized by a head tilt, and nystagmus, (this is a condition in which the eyes will twitch back and forth rapidly due to the loss in balance). What you are describing is NOT Senile Vestibular Syndrome.

Theo may have "syncope", commonly called, fainting. This is defined as "a temporary loss of consciousness and spontaneous recovery". The most common cause is an interruption in blood supply to the brain, from heart disease, heart tumor or excitement. Or due to a decreased concentration of nutrients to the brain, such as hypoglycemia, (low glucose) or low sodium or low calcium.

A complete blood panel done 12 hours after a meal can diagnose low blood sugar, low calcium or low sodium. An EKG and chest x-ray can diagnose heart disease, heart tumor, or other cardiac abnormalities.

You wrote,

***UPDATE: "I just came from my local vet for his annual exam because last night he fell down a few times. The vet says that he's very weak in the hind quarters. She prescribed Tramadol, 50mg, twice daily."

Certainly, if Theo has arthritis in his hips and lumbar spine, it would cause weakness in his hindquarters and it would make him slow to get up and lay down, or he might trip and lose his footing if he is walking. I am not sure he would just 'fall over like a tree when he was just standing there and then get up and proceed to walk ok'.

Tramadol is like a synthetic morphine and is prescribed for pain. It is a very good medication for osteoarthritis/bone and joint pain. But I am not sure that is what is causing Theo to 'fall over like a tree'. I would encourage a few of the above diagnostic tests to rule out low blood sugar, low calcium or sodium, and perhaps a chest x-ray or EKG.

Click here to find a holistic veterinarian in your area. Another resource for vets knowledgeable in homeopathy is AVH.org.

Please keep us posted by coming back to this page and clicking the 'click here to add your own comments' link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Apr 17, 2013

follow up
by: Eric

I forgot to mention that upon examination, the vet noted "bruising" on his gums, citing suspicion of something called "Petechiae". However, she said that this is usually accompanied by bruising on the stomach, which he doesn't appear to have.

She also felt the area around his spleen and said that he flinched like when someone "punches you in the stomach", so she checked for a mass in that area, but could not find one.

She didn't mention anything about problem with his heart when she checked it.

She wrote in the notes, but didn't explain, "If he has abdominal distention or bruising worsens, it could be an emergency". I read this after I left, but wonder if you have insight into what else I should keep an eye out for.

Finances enabled me to get the Tramadol, but I couldn't afford the blood panel today as they wanted payment up front for it; I plan to get a full Geriatric panel on Friday.

Does this provide some more insight into this situation? I'm really quite frightened about what's going on and what does all this mean?

Thanks in advance.

Apr 17, 2013

My Online Vet Response for: Senior Dog Falls over like a Tree Falling
by: Dr. Carol Jean Tillman

Hi Eric,

Petechiation means there is a small rupture of capillaries. Ecchymoses is a larger area of ruptured blood vessels, or what would appear as bruising. There are a number of things that can cause this to occur.

Toxins such as rat poisons which prevents blood from clotting and causes the rat to bleed to death internally.

Drugs such as blood thinners, (aspirin, heparin) and other anti-inflammatory drugs, like Rimadyl.

Autoimmune disease, specifically a disease that destroys the platelets in the body. Platelets are small cells that will aid in helping the blood to form a clot and prevent bleeding. If there are too few platelets, (the normal platelet count is 100,000-400,000 in the blood stream), the disease is called 'Thrombocytopenia'.

Cancer or a large tumor on the spleen can also cause a problem if it ruptures. The spleen serves to store blood. If it develops a tumor or cancer, which weakens the integrity of the spleen and causes the spleen to 'leak' or start bleeding internally, you will see the abdominal area begin to distend, and Theo's gums will be very pale in color. He will be VERY weak and have difficulty standing.

If he does have a problem with capillaries starting to rupture, and a decrease in blood supply to his brain, this may be what has caused him to 'faint'.

At this time, since you have not done a blood test yet, and we do not know what is wrong, it would be best NOT to walk Theo. (only let him go outside for urination/defecation) and assist him to prevent him from falling or causing any bruising, or damage to his abdominal area. Once you have done a blood test, you can keep us posted. I am not sure I have done much to reassure you, but hopefully my explanation will help you understand what might be happening.

Please keep us posted by coming back to this page and clicking the 'click here to add your own comments' link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Apr 22, 2013

Follow up
by: Anonymous

Hi Dr. Tillman,

I got the bloodwork. The highlights of concern related to what the vet described as Renal failure.

BUN: 48.1 : range: 2.1-11.1 mmol/l
Creatinine: 690 : range: 44-141 mmol/l
Phosphorus: 3.10 : range: 0.81-1.94 mmol/l
Magnesium: 1.6 : range: 0.7-1.3 mmol/l
Potassium: 5.6 : range: 3.6-5.5 mmol/l
Sodium/
Potassium ratio: 26 range: 27-38

The vet has implemented the following program:

PEPCID AC: 1 tablet daily
Amphojel suspension: 1 ml orally EACH meal

Prior to the bloodwork, there was concern by Dr. of Petichiae.

Platelet count: 234 range:170-400
Platelet estimate: "Adequate"

And all of his blood count numbers appear normal.

Theo is eating, though his appetite is small.
He doesn't appear to be drinking too much. He appears able to hold it for several hours.
His poop looks normal.
He hasn't peed in house for several days
He walks up the stairs, with some effort.

Are these good signs?--Does this give me some idea about his overall condition ie: condition of his kidney and whether he will be a good candidate in his rehabilitation?

Tomorrow, I have an appointment whereby Vet will show me how to inject (fluid) subcutaneously.

From the conversation with my vet, it didn't sound good. What is your opinion on what is going on, based on the numbers above?

My vet said that one option was to hospitalize him for a week and flush out his kidneys to bring down the numbers---$3,000--Without guarantees that it will work.

Or, I can administer the fluid at home. How effective has this method been in practice?

Appreciate your thoughts and suggestions in advance.

Thank you.

Apr 23, 2013

My Online Vet Response for: Senior Dog Falls Over Like a Tree Falling
by: Dr. Carol Jean Tillman

Hi Eric,

Theo's lab work does show some kidney disease. I do not think it is severe enough at this time to warrant a hospital stay if you are able to give him the subcutaneous fluids TWO times daily for the first week, and then one time daily for the second week and then go back for a recheck of his BUN and his Creatinine.

It is imperative that you start Theo on a supplement called Renafood ASAP. This is a glandular supplement made by Standard Process and is available from amazon.com. It will provide support for the kidney tissue. Give Theo one tablet by mouth or in food, TWO times daily.

He also needs AZODYL. This is a nitrogen absorbing bacteria that is added to the food. The bacteria will enter the GI tract and help to absorb the excess nitrogen, lowering the BUN level and 'taking the load off the kidneys'. Open one to two capsules and sprinkle into his food two times daily.

He ALSO will need to have one injection one time daily for the first week of B-vitamins with B-12. Give this subcutaneously into the fluid pocket after you have given his fluids. After the first week, move to two times per week. This will help improve his appetite.

NO DRY FOOD. Offer him chicken or turkey baby food, or just some chicken or beef broth. He needs fluids to help flush his kidneys. As his appetite improves, then add in some green vegetables, rice, barley, potatoes, yams, carrots, and some meat.

Please keep us posted by coming back to this page and clicking the 'click here to add your own comments' link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

Apr 23, 2013

follow up
by: Eric

Dr. Tillman,

I am feeling extremely overwhelmed, having some idea of the extreme nature of this condition.

Thank you so much for such a quick and thorough follow up. I am going in to see my vet 9am today and will share this information with her.

Best Regards,
Eric

May 03, 2013

Renal failure treatment plan
by: Eric

I've been having difficult time navigating through this new diagnosis of renal failure.
While I'm in need of support from my current vet, my vet is not answering my questions. I want to be as involved as I can to provide the best treatment for my dog.
His current treatment:
200ml fluids subcutaneously: 2 times/week
1ml phosphate binder: each meal
You suggested daily fluids. What daily ml amount do you recommend?
I get the 'wait and see...no response attitude' when I ask if increasing fluid frequency will benefit?
According to my vet, Azodyl does not have conclusive reports, so did not recommend.
My dog 'snubs' Medic-al canned renal food wet. He has inappetance and is now picky. The last several days, I've been having hard time to get him to eat.
What vitamins can I give to increase appetite ensure he's getting all of them, since his diet right now is precarious?
He seems to like rice w/cheese, white bread.
I want to minimize chicken because of protein, but he likes it. My vet suggested: white bread, grains, scrambled eggs, cheese, but provided me with no recommended quantities. He seemed to like white bread, cheese, but I'm afraid if I give him too much white bread than his glucose numbers will rise. And if I give him too much cheese, for example, it will cause excess sodium and cholesterol levels.
I need my vet more than ever but I feel like my vet is condescending and evasive. I'm trying to figure out what I need, and am not sure what questions to ask.
Perhaps you can help me to lay out the absolute basic list of things that I need to use in his treatment, and help me determine the most fundamental things to implement, so that I know that I'm doing the best that I can.
Are there simple recipes that you can recommend, which are palatable and easy to prepare, for a novice cook?
And what are the most important VITAMINS and supplements that I can get in my local store and what doses can I give to my dog, which are affordable, to alleviate my concern of malnourishment. Please advise on whether you recommend and at what dose:
B COMPLEX, Omega-3,Calcium Magnesium w/D3--Is D3 safe for dogs; if not, can I supplement with Calcium + Magnesium?
You recommended RENAFOOD. My vet was unfamiliar with this one, as it may be availabe only in the US. My vet recommended a product called "Renal Advanced Powder Kidney Support For Dogs", which is available to me from my vet. Will this provide similar benefits to "RENAFOOD"? My concern with the Renal Advanced powder is that as he's not eating I will be wasting a lot (I thought pill form may be better). Or, have you heard of this liquid: product:http://www.petwellbeing.com/products/dog-kidney-disease#directions
Please. Help!
Thank you.

May 05, 2013

My Online Vet Response for: Senior Dog Falls Over Like a Tree Falling
by: Dr. Carol Jean Tillman

Hi Eric,
May 5, 2013

You wrote that your vet recommended Theo receive only 200cc sub-Q fluids per week?

Theo needs 200cc two times daily or at least one time daily! Do this for at least 2-3 weeks, before considering decreasing to every other day. You will know he is getting better when his appetite improves.

Regarding Azodyl:
I have used it at least 10 years when it was still called, Ki-Bow (Kidney-Bowel) and have had good success. Perhaps this is only considered anecdotal evidence and not the double blind experimental research that your vet is looking for, but it can be used without causing any harm, and if it may benefit Theo, then I would use it.

You wrote,
"My dog 'snubs' Medic-al canned renal food wet. He has inappetance and is now picky. The last several days, I've been having hard time to get him to eat"

The increased Sub-Q fluids should help to decrease the uremia and increase his appetite. Give injections of B-vits and B-12. (.5cc B-vits +B-12) into the fluid pocket ONE time daily.

I would continue the chicken, along with the other food. Theo needs to eat 500 calories two times daily, or 1,000 calories per day for a 50-60 lb dog. Substitute vegetables for the white bread. Cooked potatoes or even better, yams. He can have carrots, green beans or zucchini. Forget cheese, and give the eggs/egg whites rice, cous cous or barley.

Dr Richard Pitcairn's book, Complete Guide to Natural Health for Dogs and Cats, has good recipes for dogs with kidney disease.

Renal Advanced Powder Kidney Support for Dogs would be fine. But don't worry about supplementing too much at this point. As you have mentioned, if he will not eat his food the supplements in the food are worthless. Concentrate on improving his appetite first.

Kidney Support Gold is a liquid combination of Chinese herbs with bacon flavor in glycerin. This would be excellent to give Theo, since you can put it directly into his mouth, and not into his food.

Ok, Eric, hope this helps!

To find a holistic veterinarian in your area click on the link below

Click here to find a holistic veterinarian in your area. Another resource for vets knowledgeable in homeopathy is AVH.org.

Please keep us posted by coming back to this page and clicking the 'click here to add your own comments' link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

May 06, 2013

Follow up to treatment
by: Eric

Hi Dr. Tillman,

Thank you for you feedback once again.

I consulted with my vet today with the info you provided above.

Vet says that she wants me to gradually increase the Sub Q's to 200cc 'every other day', as she was concerned about 'overflooding' and putting a burden on the heart (or something of that nature). Her opinion was that even daily may be too much--Is it really that risky? I'm just trying to understand why her dosing seems relatively conservative to yours.

One other thing: I read somewhere that dogs with renal failure tend to have issues with High Blood pressure, so I asked my vet if she took his blood pressure at that time. She said she had not and that it's a service fee of $60 to check it, due to the expensive machinery. Does this sound reasonable?--And, in your opinion, how often should I be checking his blood pressure?

I've ordered the SUB Q's and will be injecting B vitamins into them.

I'm going to contact a local Azodyl supplier---there is 'PetPharm' online, which has local pick up in Toronto. Good thing, because as I understand, it requires refrigeration during transport, with a hefty fee if it had to come from the US or from a distance.

My Vet wasn't willing to comment on the Chinese Herb medicine 'Kidney Gold' for whatever reason. I asked her, for example, how does the 'Azodyl' compare in its function to the 'Kidney Gold'.

How does this sound?--I'll start with the above increase in Sub-Q's with B's, along with giving him Azodyl. As his appetite improves, I'll start him on the Kidney Gold. Or, do you think that the Kidney Gold could provide effective support with the Azodyl?

Honestly, Dr. Tillman, this is very challenging for me to see one day he has appetite, while the next day it's almost non-existent. And not understanding what's going is overwhelming.

I can't describe to you how much I love my dog. And I'm not going to give up.

Thanks in advance for your feedback on the plans above.

Regards,

Eric

May 11, 2013

Continued Follow up
by: Eric

Hi Dr. Tillman,

Appreciate your advice, working with my conventional vet, as follows:

Injected first does of 250mcg (0.05ml) B12 into the fluid on Wednesday. Vet recommended this be done 1 time weekly.

Fluids now every other day.

Despite my Vet's initial non-recommendation of Azodyl, I picked up first bottle yesterday; administered 3 tablets today (Saturday)

Also giving him TRAMADOL. Hope OK in combination.

I plan to add the Kidney Gold Chinese herbs and hope OK to see results of increased appetite, etc. first. Is this sound?

Hope his BUN and CREATININE go down with above treatment; and hope my vet's recommends are not TOO conservative, as yours seem more 'aggressive'.
Thoughts on this?

He's eating, but leaving potatoes on plate. (I'm no chef, to say the least), but I found some simple recipes online--Potatoes and hamburger (about the size of a golfball). Hope not hard to cook YAMS--think they may be more flavourful, enticing than russets?

Please advise if OK to add BENNY BULLIES liver treats (say 1 or 2 pieces) for palatibility. Seems to entice him; however, the 'sinister' protein concerns me.

He's now at 66lbs., lost about 3 pounds in last 2 1/2 weeks and walks have been shortened. "When" BUN and numbers go down, should endurance improve?

I'm trying to hold it together. Your latest thoughts appreciated in advance.

:o)

May 12, 2013

My Online Vet Response For: Senior Dog Falls Over Like a Tree Falling
by: Dr. Carol Jean Tillman

May 11, 2013

Hi Eric,

You wrote,
"Despite my Vet's initial non-recommendation of Azodyl, I picked up first bottle yesterday; administered 3 tablets today (Saturday)"

Excellent!

You wrote,
"giving him TRAMADOL. Hope OK in combination."

YES.

You wrote,
"I plan to add the Kidney Gold Chinese herbs and hope OK to see results of increased appetite, etc. first. Is this sound?

In some cases, Chinese herbs may cause the patient to have a decrease in appetite, nausea or diarrhea. You can certainly try. If Theo is worse, then discontinue the Chinese herbs. And when his appetite improves, then start with a reduced dose at the beginning, and slowly increase it.

You wrote,
"Hope his BUN and CREATININE go down with above treatment; and hope my vet's recommends are not TOO conservative, as yours seem more 'aggressive'.
Thoughts on this?"

Yes, I feel that with 'uremia' (the increased BUN and Creatinine) the faster you remove the toxins from the system, the faster the patient will start to feel better. Ideally, giving Theo the fluids intravenously over a 3-4 day period would be the fastest. If finances are a factor, then giving adequate SubQ fluids under the skin is the next best option. Along with the supplements that I have recommended.

You wrote,
"how does the 'Azodyl' compare in its function to the 'Kidney Gold'."

AZODYL is made of nitrogen absorbing bacteria. Added to the food, the bacteria go down thru the stomach and then into the intestine, where they begin to absorb the nitrogen in the system. This is what decreases the BUN.

KIDNEY GOLD
Is made of a combination of Chinese herbs, which provide 'support' to the kidney tissue to help the individual nephrons in each kidney to function better.

You wrote,
"He's eating, but leaving potatoes on plate."

I agree, Theo just may not find potatoes to be too appetizing. Therefore, see if you can bake a yam, peel it, and mix some in to Theo's meals.

You wrote,
"if OK to add BENNY BULLIES liver treats (say 1 or 2 pieces) for palatability."

Yes, if you are only adding a few pieces per meal, and it is enough to entice Theo's appetite.

You wrote,
"When" BUN and numbers go down, should endurance improve?

YES.

Click here to find a holistic veterinarian in your area. Another resource for vets knowledgeable in homeopathy is AVH.org.

Please keep us posted by coming back to this page and clicking the 'click here to add your own comments' link below.

Take care,
Dr. Carol Jean Tillman

DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

May 12, 2013

Thank you
by: Eric

Dr. Tillman,

To add, I found a new vet whom I look forward to providing compassionate care that my initial vet failed to provide for myself and Theo.

You have no idea how grateful I am for your support during this time, as you can imagine the challenges that I have been facing.

I enquired with another clinic to discover that the 'line' connected to the salene bag can be used up to 3 times; however, my initial vet never explained this, telling me that I would have to buy 'line' and 'bag' as set each time I needed to change the bag.

I respectfully called vet to simply advise of my findings of the re-usage and that I decided to pick up only the bag. When I arrived with my completed bag and line, ready to be shown how to remove line and connect to new bag.

Ignoring my request, they put the line on the counter at reception, putting me in the position to have to say 'no' to the line, even though I had made my intentions clear.

And then the office talked to me like they were doing me some big favour to make a 'special price' for the bag (oh, and they charged me $6 for 11 needles, 3 injectable needles for the B12), so they said they provided me a 'discount' of $10 overall ie: $25 less $10.

I can't describe to you how demoralizing that was for me. I am committed to my dog's care, have limited resources and need to know that where possible, that my vet supports me in controlling costs. The treatment was utterly reprehensible.

I respect the clinic's assertion of the need to maintain sterility; however, when a vet technician showed me how to reconnect the line to a new bag, I was baffled and understood very clearly how some clinics like this one would prefer to keep this information from a patient, in order to maximize their take at the cash register.

I haven't met this new vet, only have forwarded previous blood results. I'm glad, however, that I made the move from this other clinic.

More than ever, I need to maintain focus, with a support team who will support me towards the best care, which I'm understanding as intelligent, professional care, along with compassion. The latter was reprehensible at the other clinic.

As you can see, I'm making efforts to consolidate feedback from various sources, including yours and my local vet. As I said, I appreciate your support more than I can describe.

I look forward to even more clarity and peace of mind for the decisions that I'm making.

Yesterday, for added support, I attended for the first time, a PET LOSS support group who meet monthly. Fortunately, I still have my dog, but I understand that certain issues that are incredibly difficult for me to face, need to be addressed. I look forward to this forum to help me through this process.

I hope you get a better picture on how much I love my dog and want the best care for him. Also, how vulnerable a person can be when faced with these challenges.

Keep in touch!

Thank you :o)

May 12, 2013

My Online Vet Response for: Senior Dog Falls Over Like a Tree Falling
by: Dr. Carol Jean Tillman

May 12, 2013

Hi Eric,

Your experience with your 'original' veterinarian is very saddening. I did not realize you were having all those difficulties, and ESPECIALLY they did NOT tell you that the IV line could be used up to 3 times!

I searched the AVH (Academy of Veterinary Homeopathy) website, and there is one member that is a homeopathic veterinarian in Toronto, Canada.

Carolyn Benson , DVM
Chartwell Veterinary Clinic
2375 Brimley Road
Unit 6
Toronto , ON M1S 3L6
Canada
Phone: +1 416-291-2364
Fax: +1 416-291-8857
Species Preferences : SA, EX
Percent Homeopathic Cases : 25-50%
Phone Consultations NOT Accepted

Just in case the 'new' vet that you have found is not working out, you might wish to make an appointment with Dr. Benson.

It is VERY difficult to think straight and make the right decisions when you are going through so much deep and emotional distress with your dog, Theo. Although, I think you have been doing admirably, cooking for him, searching for a holistic vet 'online', finding supplements, giving him SQ fluids, etc!! And making preparations to look 'ahead' to Theo's passing. I can tell that you love him a great deal and that you will miss him very much.

Looking back at my suggestions, I did not make mention of a remedy that may also help Theo's kidneys and improve the appetite. Give him the homeopathic remedy Phosphorus 6C or 30C. If 6C, then give pellet by mouth three times daily. Continue for one month, observing if he is improving.

If 30C give the pellet by mouth one time daily for three days, then stop, and observe his response.

GIVING HOMEOPATHIC REMEDIES-

Do not touch the pellets with your fingers. Remove the cap, set it down, tip the vial upside down and twist the opening so the pellet falls into the cap. Then, pull out Theo's side corner of his lower lip and put the pellet into his cheek. He does not need to swallow the pellet, just allow it to dissolve in his mouth. If he does swallow it, that's ok too. Give the remedy about 10 minutes prior to a meal, NOT with the meal.

Store the remedy in a cool dark cupboard. NOT next to an electric outlet, or a computer, or cell phone, or in the windowsill where it would be in full sunlight. It is ok to refrigerate, (since that is cool and dark) but not necessary.

It would be best to purchase the book, Dr Richard Pitcairn's book, Complete Guide to Natural Health for Dogs and Cats. He goes into great detail explaining homeopathic remedies, he has recipes for dogs with kidney disease, supplements, herbs, and other details including SQ fluids.

Please keep us posted by coming back to this page and clicking the 'click here to add your own comments' link below.

Take care,
Dr. Carol Jean Tillman

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DISCLAIMER: The above should never replace the advice of your local veterinarian, as they have the ability to evaluate your dog in person.

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