This is Little Blake!
Once Nellie started to get well again under the influence of the modified diet it occurred to me that the situation merited a serious discussion with the breeder who had sold us the dog. As things with Nellie had deteriorated, we had contacted the breeder explaining the situation and they had made their own vet available to us at no cost. As the breeder, and their vet, are around two hours away from us by car near Venice we decided to continue with our own vets and so didn’t take them up on their offer of having Nellie examined by their own veterinary surgeon. But once Nellie started to get well and we could see a path out of the uncertainty not to say despair in which we had been blindly stumbling it didn’t seem fair to me that the cost and weight of Nellie’s infirmity should fall wholly on us (and Nellie, of course!), I called the breeder and explained that I realised that buying a dog wasn’t like buying a car which was either repaired or returned at no cost to the buyer if it was materially defective. But I did feel that Nellie had cost us a fortune in medical bills not to mention the anxiety and emotional distress involved in the enigma of her illness. I explained that we loved Nellie and didn’t resent for a minute the money we had spent getting her well, but that it did seem a bit much that it all fell on us. I felt the coldness coming from the telephone as the breeder took in the import of what I was saying. “I don’t think that we were at fault or had any part to play in Morning Star’s (Nellie’s) situation” said the breeder. Conversations with the breeder about our Nellie were always a bit strange because to them she was “Morning Star” the name she had at the breeding kennels.
“Of course not” I replied. “But look, we were thinking of breeding Nellie but now that we know that her disease has a genetic component the only responsible thing to do it to sterilise her, which we will be doing”. “Things haven’t really taken the course that we wanted” I said.
“So, I was thinking that perhaps you could provide us with another Border Collie puppy in addition to Nellie” I said. The breeder relaxed at the other end of the conversation realising that I was not asking for money back. “Yes, that should be possible” she said.
“So, maybe the fairest thing would be a second puppy at half the price that we paid for Nellie” I said. I felt that this was a solution fair to us and to the breeder. We had gone to that breeder because they had bred Hector our old father border collie. We loved Hector’s personality and had been impressed by how well the puppies at the breeding kennels were looked after and the obvious affection that the people working there had for the dogs. When we had gone to get Nellie all the same people were working at the kennels which I took to be a good sign. The kennels were clean and spacious and they seemed to take their job seriously. I was sure I wouldn’t get cash back for Nellie because the last three years have been tough times in Italy and dogs are a luxury in tough times so what we had paid for Nellie was psychologically and physically banked and accounted for and I didn’t think that trying to unwind that would be worth the candle. But I did want another young dog as company for Nellie. Our old border collies, Hector, Annie and Rett formed their pack from the beginning and while they tolerated Nellie she could never be truly a part of their club. Plus, Nellie was young and frisky whereas the older dogs are gently slipping into retirement. To spare us her constant attentions and give her a companion the obvious answer was another dog. “A Male dog” would be fine for us” I said.
So it was that in November of 2015 we found ourselves back at the dog breeders to pick up a male border collie that the breeder had been thinking of using as a stud but had changed her mind. He was around eight months old. The little dog was brought out from the runs to the carpark in front of the kennels by the guy who seems to look after the dogs. When we got Hector this guy, an immigrant, was barely more than a teenager. Of course, he is still young but to see him gave us a start realising how much time had passed and how fast. Of course we feel that we got old Hector only yesterday ….! The guy played with the dog. The dog was obviously deeply attached to him and joyfully jumped up and played and ran with him. He was obviously a nice dog but being a bit older and used to the kennels was sufficiently developed to be suspicious of us. While experience has shown us that young dogs or dogs born at La Faula integrate easiest, I felt that this little dog had such a happy and affectionate character that this would eventually prevail over the fact that he was not instinctively friendly with strangers.
We said that we would take the little collie and we returned to the administration office to complete the paperwork and pay for the dog. One thing that most people outside Italy don’t realise is that the 2011 economic crisis during which Italy came very close to defaulting on its debt pushed the political and bureaucratic establishment, perhaps even the Italian State itself, into an existential fight for survival and tax evasion has been relentlessly squeezed from the economy. Self assessment for firms is largely replaced by assessment by the tax authorities based on assets of various types and analysis of the economic activity of different productive sectors. Calculating the income of a dog breeder is a doddle for the tax authorities so whereas, in the old days, the dog breeder would have tried to spread some of the loss of selling the dog at half price onto the State by not declaring as income the half that we paid now they gave us an invoice for the full value of the dog even though we were only paying half of the amount. It’s no wonder that the Italian economy never really takes off!
When we got to the name of the dog we saw on the documentation that he was called “Blay”, the breeder long before having run out of real names for the dogs they sold. “Blay” became “Blake” and we took him home. He waited until we were almost home, and were thanking our lucky stars that he hadn’t vomited, to vomit!
So, in summary, what can we say about Nellie’s ill health in the first year of her life? We can say as a fact that something or things in the normal Royal Canin, Purina (Friskies/Pedigree) and Carrefour brand dog kibble triggered Nellie’s Inflammatory Bowel Disease (IBD). We can also say as a fact that the Farmina N&D brand 100% grain free kibble does not provoke any obvious ill effects in the dog.
One obvious difference between the normal dog kibble and the grain free variety is that the proteins that comprise gluten are counted towards the total protein count of normal dog kibble and that grains comprise the single major parts of the ingredients.
Celiac disease is extremely uncommon in dogs. We don’t know what triggered Nellie’s IBD but a working hypothesis could be that it was gluten in the normal kibble. On the other hand, a study with a small sample found that the most common allergen for dogs with food allergy was beef (followed by dairy) and none of the farmina dog kibbles contain beef as a stated ingredient. From where we stand now, we don’t know if the normal dog foods we fed Nellie that made her sick contained beef but given this absence of knowledge we should be wary of ascribing her IBD to gluten allergy.
Having, however, overseen a remission of Nellie’s IBD through diet management we can say that Nellie is intolerant of rice as it caused her extraordinarily sloppy stools and once it was eliminated her stools were those of a normal, healthy dog.
So, perhaps unsurprisingly, we can see that Nellie is a carnivore that happily eats and digests meat (leaving open the question of beef), wolfs down yoghurt and Kefir and eats fruit without problems (fresh apples and cooked Quince in her home-made dog food).
Now we have eliminated with-grain dog kibble completely from La Faula. One obvious reason, of course, is that we don’t want to risk triggering Nellie’s Inflammatory Bowel Disease if she should somehow get access to normal dog kibble we feed the other dogs. But that is not the principal reason. The principal reason is that we consider Royal Canin and Pedigree and similar dog foods to be a rip-off. They charge enormous sums for dog food that is full of non human food grade grains. They mislead by not identifying the percentage of animal and plant protein in their products. And for the same price we can buy the Farmina N&D dog food which is full of meat and has fruit and vegetables and no grains at all.
We feel that when we left the dog breeder and she looked at us and said “Make sure to feed Nellie a good dog food like Royal Canin” we were sold a pup!
While I was writing the previous diary entries regarding Nellie’s path from abject ill health to normality there was one niggling issue in the background. That was that while it was true that Nellie’s signs of Inflammatory Bowel Disease had gone, her recurrent infections had disappeared, she was eating well and had put on weight her stools were very loose and sloppy. It wasn’t really a case of diarrhea and it didn’t seem to have any obvious negative effects but notwithstanding those facts it didn’t seem quite right. After we had put Nellie on the exclusion diet we became quite expert on her stools as this was an important indicator as to how her intestines were functioning. On the exclusion diet Nellie’s stools had stabilised into good “doggy poohs” of the type you could scoop up and put in the rubbish bin. So far, so good. But in November Luca began pruning the grapevines growing over the pergola in front of the house. The autumn had been warm and dry and the grapes remaining on the vines were succulent and sweet and greatly to the dogs’ taste! So as Luca cut the grapes and woody growth down, the dogs, waiting below the ladder, would feast on the grapes. Although all our dogs over the years have been great grape eaters - we are a vineyard after all with grapevines running right up to the house - we were deeply concerned this year because our internet researches had revealed that there is a link between dogs eating grapes and renal failure. The cause isn’t known but it seemed to us that notwithstanding that the grapes had not caused our dogs problems in the past, probably in Nellie’s case her kidneys would be sure to pack it in. At around this time we discovered in a local pet store bags of cracked rice and as rice is one of the elements of the protein exclusion diet we decided to cook up rice and add it to Nellie’s diet. During this period Nellie’s stools became very loose but we put it down to the grapes she was eating even though the other dogs didn’t suffer such a reaction. As Luca was finishing pruning the pergola the fruits of the numerous persimmon trees behind the house reached maturity and the dogs, who love the sweet persimmon, would jump up and pick them then wolf them down. Nellie who is the most agile of all the dogs was able to obtain all that she could eat. And then, when the low hanging fruit were exhausted, the ripe fruit began falling from the trees so the dogs had all the persimmons they could want to eat. We put Nellie’s continued loose stools down to eating persimmons. This seemed especially likely in the light of what we had read on the internet that the seeds of the persimmon can cause inflammation of a dog’s small intestine! Every time we went to the internet to see what dangers to dogs lurked in our garden we came away more disquieted and apprehensive.
Eventually, however, the fruits of autumn came to an end and winter was upon us. Nellie was wholly on a diet of what I fed her but was still suffering from sloppy poohs. We focussed on the Kefir wondering whether this milk based product full of bacteria and yeasts might be giving her the runs. I reduced Nellie’s Kefir intake over time but to no effect. I reduced the amount of kibble. Again to no effect. On the internet I researched “dogs and rice” and found numerous and consistent reviews extolling the value of rice for dogs as being easily digestible and combating diarrhea. I resigned myself to the fact that Nellie would just be a dog with sloppy poohs and reflected on the extra work this would give us during the Agriturismo season when we are full of guests. Every day of the year Luca and I, each at different times, do a round of the house picking up the dog pooh. Normally, it is a fast and painless process - a flick into the pan then into the waste bin - but sloppy dog pooh around the place is yucky and harder to clean up. While I was dwelling on this thought I decided that no matter how positive rice seemed as a dog’s diet ingredient, I should be rigorous and remove it from Nellie’s diet just to be sure that it was not the cause of Nellie’s horrible stools.
I reduced Nellie’s daily intake of rice and the effects were immediate. So immediate, in fact, that after the second day I eliminated the rice completely from Nellie’s food and her pooh’s became doggy poohs as doggy poohs should be.
So there it is. Nellie, right now seems to be A-ok 👌. Of course, Inflammatory Bowel Disease, being an autoimmune disease never completely disappears and it can flare up again in the future. But after a year it is very fine to have managed not only not to have lost Nellie but to have found a stable equilibrium that allows her to proceed in what seems to be reasonable health.
When Nellie was very sick and we feared that she would surely die, it seemed a great pity as she was (and is) a dog of outstanding intelligence. Of course, because of her illness she spent much more time in close proximity to us than our other present or previous dogs so she became to some extent humanised by the process. But she did have the intelligence to develop a “fit” with us. She is the first dog we have ever had who vocalises feelings by developed “grunting” sounds when she is pleased or wanting to be communicative. She is cunning and can anticipate our actions. She can adapt our behaviour to fit her wants. For example, when Nellie returned to health the Agriturismo was closed and she was very active and requiring a lot of attention. Eventually, I got a couple of soft dog frisbees and would kick off a game whereby I would go to a high point on the farm and would throw the frisbee out over the drop forcing Nellie to run down to pick it up and then run back up to give it to me. My idea was to so thoroughly tire Nellie out that we would be free to carry on our activities during the rest of the day without being harried by her. Once Nellie started to get tired she would only carry the frisbee half-way back up the slope and then she would return to the bottom thus obliging me to walk down the slope to pick up the frisbee if the game were to continue. But perhaps the most interesting thing about Nellie is her coincidental likeness to the original progenitor of Border Collies “Old Hemp” (September 1893 - May 1901) (click on the link below to read about Old Hemp and see photos of him).
So Nellie, having been diagnosed with Inflammatory Bowel Disease, was now launched upon a protein exclusion diet under which she would be fed only one meat protein at a time to identify those that she could tolerate and, eventually, the protein that would trigger the inflammation of her gut. The discussion with the vet was wholly centered around meat proteins as he seemed to assume that the culprit would be a meat protein. As we finished talking with the vet he explained why there was no real long term medicinal solution in the case of dogs and that eventually her intestine would become permeable to proteins and that her chances of survival after that were virtually nil. At the mention of of intestines becoming permeable to proteins I remembered reading some years before an article in the New York Times about a kid who had some kind of autoimmune disease and I remembered that it had been written that when he was very ill his intestine had become permeable to proteins. I couldn’t remember what signs the child had but I remembered that his illness had been very slow and difficult to diagnose and that in the end he had only returned to health when gluten was removed from his diet.
When we got home we decided to continue Nellie on pig heart as the single protein as this had only just been introduced to her diet. In the pressure cooker I cooked up a big stew of pig heart, potatoes and quince. By the time it cooled Nellie was hungry as she had not eaten so far that day. I prepared a bowl of the stew for her. She sniffed the bowl suspiciously, sniffed again, took a lick then another and then she devoured the stew like an industrial vacuum cleaner. This dog who had treated so much of what we tried to feed her as poison had suddenly finished the bowl of stew and was begging for more! That day, Nellie ate eight bowls of the stew. We were of course astounded and exhilarated but I wondered how she would be the following day as it had commonly been the case that after having eaten a new dog kibble the following day she had refused to eat at all. But the following day she again ate voraciously. What can be said is that she had discovered the joy of being able to eat without problems and was making up for months living on just enough to survive. Within a week she had her first estrous. We still had guests and I was still in the kitchen cooking but now I had a small four legged customer who would come regularly into the kitchen begging for her stew!
Within three days Nellie had completely finished the stew that I had prepared her. Luca rushed off and bought more pigs’ heart and I made another stew of around 9kg in weight. Nellie finished this off in just three days. It felt like I was spending as much time cooking for Nellie as for the guests! I realised that going forward this was unsustainable as I just wouldn’t have enough time to be preparing so much food for the dog. My mind went back to the article in the New York Times about the poor kid who had seemed to have in incurable autoimmune disease but who had been brought back to health by the elimination of gluten in his diet. I went to a specialist pet shop near us and asked them, on a hunch, if they had grain free dog food. She replied affirmatively and took me to see their selection. Eventually I picked a 2.5kg bag of wild boar and apple for the (shocking) price of €27. I took it home and called Nellie. I offered her a handful of the kibble in a bowl. She sniffed it and took a tiny mouthful. She crunched it up in her mouth and then cleaned out the bowl. She crunched that kibble with such obvious pleasure that I guessed that she would still be eating it the following day - and she was.
But Nellie’s special diet didn’t stop there. As an afterthought just as we were about to leave the vets’ surgery upon getting Nellie’s diagnosis, I had asked if we could feed Nellie my home made yogurt as that seemed to be something that she really liked and which didn’t cause her obvious problems and had probably saved her life when she couldn’t eat anything else. “No” said the vet. “Yoghurt is not to be recommended because dogs are intolerant of lactose present in milk. Much better Kefir which is a more fully fermented product in which the lactose is fermented into alcohol”. The vet went on to explain that Kefir comes originally from the caucasus where sheep’s milk is preserved by putting it in a sheep’s stomach (without the sheep, of course!) where it supports colonies of bacteria and yeasts that effectively digest it and render it stable and inhospitable to other micro organisms that might cause spoilage. He referred to some “grains” that are the font of Kefir if you don’t have the sheep’s stomach at hand. You put these Kefir grains in with your milk - preferably raw milk - place the mass in a dark but tepid location, leave it for a couple of days stirring it two or three times a day and there you have it: a white liquid of microorganismally predigested milk ready to be incorporated into your organism along with all the bacteria and yeasts that have grown into massive colonies engorging themselves on the goodness of the milk and incorporating colonies of bacteria that came with the milk and which could tolerate the competition. It all sounded a bit mysterious. Especially the part where the vet explained to us that in its place of origin, the sheep’s stomach in which the milk was becoming kefir was appended above the door lintel and everyone who entered the house would give the stomach a good slap thereby ensuring the liquid stayed homogeneous and did not separate out.
Like many things on the internet, we discovered that Kefir has a loyal and devoted following and that all kinds of health benefits are ascribed to consuming this liquid which it is claimed hosts 30 varieties of bacteria and yeasts. E-Bay is full of people selling the Kefir grains (a combination of lactic acid bacteria and yeasts according to Wikipedia) so we bought 10 grams worth and hoped for the best. The 10 grams of tiny grains eventually arrived sealed in a plastic envelope with a whey-like liquid. Following the accompanying instructions we began the process of feeding the microorganisms contained within and on the grains. This posed a real challenge. True Kefir aficionados only make Kefir with raw milk claiming that bacteria naturally present in the milk enrich the bacterial flora of the Kefir. But what if the bacteria in the milk include Salmonella, E coli and Listeria? The theory of true Kefir addicts is that these dangerous bacteria, if present in raw milk, are out-competed by the absolutely predominant cultures of benign bacteria and yeast present in the grains. This could be true. For example, when wine making, to ensure that wild or non optimal yeasts are unable to ferment the grape must, a starter is made using must and selected yeast cultures. This gives the cultured yeast a head start and through the effects of competitive pressure they tend to outcompete and predominate over other less desirable yeasts naturally present in the must. But they don’t eliminate the other yeasts and sometimes the wild yeasts are so vigorous and favoured by the chemical composition of the must that they predominate in fermenting the sugars naturally present in grape juice. Plus, this may not be a valid comparison. In the end, it was clear that raw milk poses a theoretical risk to man and dog. But in our case, we get the raw milk directly from our neighbour at the moment of milking. We can therefore completely control temperature and cleanliness from the moment the milk leaves the milking pump until it is added to the Kefir grains. Most importantly, our neighbours milk is used in the local dairy to make cheese and so is tested weekly for bacterial load. We proceeded with the raw milk Kefir.
Well, nothing prepared us, men or dog for the effect Kefir has on one’s body. It is one thing to read about these 30 strains of bacteria and yeast contained in the Kefir but it is another to have them all working away in one’s gut! Before feeding Nellie the Kefir, I decided to try it out myself. Within half an hour I felt like a fermentation vat! The effect wasn’t unpleasant or analogous to having a stomach upset. In fact, it was the opposite. It was pleasant but my gut was literally boiling away. The next day both Luca and Nellie partook of the Kefir. That evening with the three of us in the sitting room the noise was only of gurgling stomachs! Eventually the effects reduce greatly but when one takes a glass or two of Kefir one realises that one is not alone but is sharing one’s digestive system with millions and millions of little creatures who, at that moment, are having the time of their (short) lives!
By now we were in September and the activity in the Agriturismo was gently winding down. We had been very busy with many guests in July and August plus one of our younger volunteers during that time had had some medical difficulties which had confronted us with some unexpected and unfamiliar challenges. All in all though it had gone well so I was able to relax a bit and enjoy the warm and sunny autumn bathed in warm satisfaction for a year that, to that point, had passed well. I also had the luxury of being able to devote a bit more time and thought to Nellie. The antacid didn’t seem to be having much effect and she still had her cough. I am wholly ignorant of medical matters and wanted to believe that all that was wrong with Nellie was a malfunctioning oesophageal sphincter leading to acid reflux but somehow it didn’t seem plausible. By now there were less kids in the agriturismo so Nellie was also taking things a bit easier. The only things that she ate with gusto were the yoghurt and pigs heart. For the rest it was obvious that her diet just wasn’t hitting the spot. She no longer seemed to be at the point of imminent death but neither did she seem to be set for a robust and healthy life. We had suffered when Nellie’s illness was a complete mystery to the vets. We had wanted to believe each hypothesis that had been tabled as it was better than the unknown but it seemed to me that the root cause of Nellie’s problems remained unknown At first we were dealing with an unknown unknown and this has led to piecemeal treatment of her symptoms. Now it seemed to me we were dealing with an known unknown. But what was it?
Roughly a week after the endoscopic examination of Nellie’s stomach and intestine, we received an email from the vet with the results of the biopsies conducted on the tissue samples removed from Nellie during the examination. We understood virtually nothing of what was written but we did understand the part that said that the villi in her small intestine were rounded, matted and flat.The vet said that we should make an appointment to see him.
To cut to the quick, it emerged that Nellie had Inflammatory Bowel Disease (IBD). This is an autoimmune condition that comes in many flavours all of which result in inflammation and damage to the intestine of the dog. Pathogenic bacteria can colonise parts of the damaged intestine and over time the damage inhibits the correct absorption of nutrients. Sometimes it is thought that there is a significant genetic component, other times that the inflammation is the result of a food allergy. In every case it is better treated by diet as medications generally aren’t an ideal long term solution for dogs. So the vet suggested to us to immediately place Nellie on a diet of a protein that she is unlikely to have encountered before along with a neutral carbohydrate like potato or rice. He also prescribed for her metoclopramide, a drug that inhibits nausea, regulates peristaltic action of the intestine (the orderly movement of food) and enhances the intestinal muscle tone. Looking up IBD on the internet it was finally easy to see how all the various signs the Nellie had exhibited hung together. The various signs: the nausea, vomiting, diarrhoea, fever, anaemia, weight loss were all the common signs of this disease! Finally, we had got to the bottom of it!