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Portia's necropsy #25374
08/19/04 09:22 PM
08/19/04 09:22 PM

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Dr. Debra Thomas called me today. Of course, as usual, Portia's liver was the cause of her death. She explained that she sent the liver to the pathologist, but that Portia had been frozen (as opposed to refrigerated--new staff, accidents happen), so she's not sure the pathologist will be able to determine anything further.

We talked a long time and she stated that there was excess iron in the fecal material, and iron deposits in the liver. Still, tho, she is at a loss. She wonders if it is diet related, or if something else is going on and it causes the changes in liver.

She is an EXCELLENT vet, and I have complete faith in her. She won't tell me anything that she isn't certain of...she admits her uncertainty and I like that about her. She hopes to get some answers from the pathologist soon, but said since Portia was frozen as opposed to refrigerated, she's not sure the pathologist will be able to determine much.

With all of my deceased gliders, the liver seems to be involved, and I'll be the first to admit that all of my gliders snub any form of staple diet. The question, then, is do they get too much iron, too little, or is it another problem which causes the liver damage.

I doubt that this will help anyone, but those are the findings at this time. If she learns anything from the pathologist, I'll report it here.

Re: Portia's necropsy [Re: ] #25375
08/19/04 10:58 PM
08/19/04 10:58 PM
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i wonder if this iron problem coul be from the water. do u use bottled spring water. my advise is spring water no tap or filtered water.

Re: Portia's necropsy [Re: ] #25376
08/20/04 06:15 AM
08/20/04 06:15 AM

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They get bottled water. Dr. Thomas said that in almost every post mortem she does (on gliders) the liver is involved. The difficulty they are running into is knowing whether the liver was the cause of death, or if something else causes the liver to fail. She's very heavily into glider research (was the doctor involved with the recent diet research sponsored by the GRF). The liver problem is not limited to my gliders. She said she sees it almost every time. We have picked Portia up, and will bury her in our little cemetery. I'm really sorry I can't provide more information.

Re: Portia's necropsy [Re: ] #25377
08/20/04 02:22 PM
08/20/04 02:22 PM

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Peggy51: first, let me offer condolences to you on the loss of Portia. I know how difficult it is to lose a glider and not know why.

Secondly, I just wanted to provide a bit of info. for people on the importance of the liver. The liver has many functions including:

*Storing energy in the form of sugar (glucose)
*Storing vitamins, iron, and other minerals
*Making proteins, including blood clotting factors, to keep the body healthy and help it grow
*Processing worn out red blood cells
*Making bile which is needed for food digestion
*Metabolizing or breaking down many medications and alcohol
*Killing germs that enter the body through the intestine

The liver shoulders a heavy work load & even has an ability to regenerate itself. However, the liver can be subject to illnesses and/or overloads of vitamins and minerals leading to a toxicity danger and possible permanent damage to the liver. Two scenarios come to mind here with respect to the excessive iron found in Portia's liver & fecal material:

1) a disease process called Hemochromatosis (commonly known as iron overload disease). Hemochromatosis is a malfunction in the way iron is absorbed from the intestinal tract subsequently causing the body to absorb and store too much iron. Certain vitamins and minerals are normally stored in the liver, and iron is one of them. However, too much iron stored in the liver can damage it. With hemochromatosis, excess iron is also deposited in other organs and tissues, especially the heart and pancreas, causing damage to these organs, too. Occasionally, a secondary type of iron overload (called hemosiderosis) occurs when too large an amount of an iron supplement is taken. Generally, however, the body is able to return to normal processing of iron when the excess intake is eliminated but not always.

With respect to hemochomatosis, it is an inherited disease. However, if only one gene is carried, the disease does not develop. It is only when a hemochromatosis gene from each parent is given to their offspring that the disease develops.

2) possible overload of iron due to use of either an iron supplement or a general purpose vitamin with iron used in conjunction with diet containing natural sources if iron. Natural dietary sources of iron include legumes (peas, beans, peanuts, soybeans, tamarind), dried fruits, enriched cereals including baby cereal, dark green & Leafy vegetables and potatoes. Additionally, vitamin C supplementation (citrus fruits, melon, strawberries, tomatoes, potatoes, red & green peppers, cabbage and broccoli) increases iron uptake and enhances iron toxicity.

Might Portia have had Hemochromatosis? The possibility exists if it could be proven that her parents each carried the hemochromatosis gene & both parents passed that gene on to her. However, as you've indicated, Portia's body was frozen rather than refrigerated so further pathology/blood studies to determine the possibility of this disease existing in Portia cannot realistically be done. Nor will they be able to accurately test to determine if excess iron had been noted in the heart and pancreas tissues (commonly seen in Hemochromatosis cases).

As for possible iron overload leading to toxicity due to a combination of vitamin supplementation, natural sources of dietary iron and possible vitamin C sources, only you and your vet can determine if this might be the reason for the excessive iron found in Portia's fecal matter and liver. I know you've had a difficult time getting your gliders to accept any of the proven glider diets and have sort of been playing it by ear diet-wise. However, you may want to review your gliders' current/recent dietary intake with your vet in order to determine whether it may have played into the excessive iron noted in Portia's liver and fecal material.

BTW, it does not surprise me that yout vet has seen numerous glider deaths that involved some type of liver damage as bacterial/parasitic intestinal diseases, vitamin supplementation overdosing and exposure to toxic chemicals, etc. can all readily cause liver damage.

Re: Portia's necropsy [Re: ] #25378
08/20/04 05:53 PM
08/20/04 05:53 PM

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Glideroo,
Unfortunately, I know nothing about Portia's parents. I know we've had her for 3 years, and she's had all her wellness checks (with the most recent being in June). She was a striking glider, with a long, aquiline nose. She wasn't beautiful, but with her mate, Brutus, produced some gorgeous gliders.

Yes, diet is a very real struggle for us. I really wish someone with the knowledge (could that be you?) could help me to figure out the ratios--our gliders eat melons, string beans, peas, and we add the repcal and herptivite to the fruit sorbet. It's the only way to get it into them. I've tried most of the approved diets, but the only thing (other than fruits and veggies) they will eat is Beechnut chicken dices. Most of the time, I throw out any BML, or semi moist, or even dry staple. I envy those of you whose gliders will eat a decent diet.

Re: Portia's necropsy [Re: ] #25379
08/20/04 10:25 PM
08/20/04 10:25 PM
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the only way my gliders eat the bml was to take a little on my finger while they are sleeping put it by their nose and then they lick it off my finger u can try it that way and that is a start. i really believe in that diet its improved my gliders when my one was sick. you can also try adding a jar of sweet potatoe to it.

Re: Portia's necropsy [Re: ] #25380
08/21/04 02:15 AM
08/21/04 02:15 AM

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Peggy51: I note that you are using pea, beans and melons. As previously stated, beans & peas contain natural sources of iron while melons contain vitamin C which can increase iron uptake/absorption. You are also using Herptivite (which contains iron) added to the fruit sorbet. I, therefore, am really concerned that your glider diet may contain too much iron in it which could subsequently lead to iron toxicity. As for working out ratios with respect to your diet, I feel that someone like Randy would be better equipped to help you as he's done a lot of work in this area and might be willing to help you out with your diet situation.

Re: Portia's necropsy [Re: ] #25381
08/21/04 03:30 PM
08/21/04 03:30 PM

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Thanks, Glideroo. I have continued to feed the same frozen veggies that I fed when I was attempting BML. Believe me when I say it was a LONG trial. We fed BML for over a year, and several times we didn't offer fruit or veggies. They don't eat the BML, and by the 4th night, I cave and give the veggies and fruit. I don't want to starve them. What veggies aren't high in iron? What fruits aren't high in iron. Debi, my vet (she presented the glider research info at the SGGA) says that in almost every glider death, she sees damage to the liver. She is incredibly interested, and helpful. I keep a log of what I feed the gliders (by cage--don't really know which glider eats what). I always take it with me when we have our wellness checks. I know I have diet-related issues. I just wish there was some compassion for us folks who have tried and tried to feed BML and gliders won't eat it...it's hard to talk about diet without getting some heated discussion. BML is the diet I always recommend. I wish to God my gliders would eat it.

Do you think we should leave out the Herptivite?

Re: Portia's necropsy [Re: ] #25382
08/21/04 03:37 PM
08/21/04 03:37 PM

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We've tried finger feeding and sweet potatoes. We've changed juices, and brands of baby food. I think we've made BML in every combination imaginable. My vet suggested that I mix everything together (well, make the BML, then when it defrosts, add veggies and fruit).

Still, she is concerned about the iron levels she is seeing in deceased gliders. The liver seems to be an organ that isn't carefully researched. My vet is trying to do that now.

As we all know, sugar gliders are fairly new as pets. 15 years, maybe. Folks are still doing research to find out what's best for them.

We hope that the pathologist can shed a little more light on Portia's death, but Dr. Thomas (Debi) doesn't think she will learn anything additional. If I learn of anything different, I will post.

It's an important issue for all of us...not just my gliders. Dr. Thomas sees liver damage in almost every glider she does a post mortem on. She wonders if it is even diet related. She's not sure that's the only thing going on.

Re: Portia's necropsy [Re: ] #25383
08/22/04 04:22 AM
08/22/04 04:22 AM

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Peggy51: Please don't think I was attempting to push the BML diet on you. I understand that you've tried desparately to get your gliders to eat the BML diet and I believe a couple of other diets unsuccessfully. Unfortunately, for those with gliders that refuse to eat any of the proven diets, it becomes much more difficult to maintain decent Ca/P ratios and appropriate protein levels to maintain healthy glider status. I can only sympathize and thank God that I do not have to deal with the situation you find yourself in with respect to glider diet.

As for the liver, it is a multi-purpose organ whose functions include storage/filtration of blood, secretion of bile, conversion of sugars into glycogen, synthesis and breakdown of fats, temporary storage of fatty acids and synthesis of serum proteins. Additionally, the liver acts as a filter disposing of worn-out blood cells, filtering and destroying bacteria. But the liver's most important function is the detoxification of drugs, alcohol and environmental poisons. In humans, the liver also helps to maintain the balance of sex hormones in the body. Whether this is true for gliders, I cannot really say. Another function of the liver is to police proteins that pass through the digestive system. Some of the amino acids derived derived from protein metabolism cannot be utilized by the body. The liver rejects & neutralizes these acids & sends them to the kidneys for disposal.

Given all the complex functions the liver serves, is it any wonder that it can be damaged by various diseases (including bacterial/parasitic intestinal conditions), exposure to environmental poisons, excessive protein, excessive vitamin/trace mineral intake. This is why I cringe when I read posts indicating that in addition to using the Herptivite/Repcal Calcium in the BML diet plan, someone is also using the Herptivite/Repcal Calcium to dust the insects and/or veggies or is increasing protein levels beyond what a proven diet specifies without realizing the impact these additional amounts of vitamin, calcium and protein can have on the liver.

It is good to know that Dr. Thomas is actively researching the glider liver in an effort to better understand the glider liver & its functioning, possible reasons that gliders seem to have a high mortality rate due to liver disease/disorder that may either be primary-based or secondary to some other issue/condition.

As for the fruits/veggies containing natural sources of iron and vitamin C (ascorbic acid), I mentioned the fruits and veggies noted to contain these sources. My suggestion would be to limit the use to one veggie that has a known natural iron source and use other veggies such as zuchini, squash, corn, carrots. As for the fruit sorbet, again I'd say to limit the use of melons/strawberries given the natural vitamin C they contain which can increase the uptake/absorption of iron especially since you are adding the Herptivite (which contains iron and vitamin C (ascorbic acid) and RepCal Calcium supplements to the fruit sorbet. I'm sure you can work with Dr. Thomas to modify your gliders' diet without too much difficulty so as to reduce the risk of iron toxicity.

In closing, you must also remember that gliders you take into your home that have been previously on poor diets probably already suffer some type of health problem as a result of their prior poor diet. The health problem could be a poor immune system or an already established liver condition that cannot be reversed. The issue then begins to provide a safe diet that will not further stress/harm the already compromised liver.

FYI: Most people do not understand that a case of giardia and/or trichomonas at any time in a glider's life can also compromise the liver. It has been medically documented that in cases where people/animals have not been getting proper nutrition & become dehyrated due to giardia or trichomonas, possible liver problems can occur. If the giardia or trichomonas has been present for a few weeks, the giardia and/or trichomonas cysts have been living in the cells
lining the beginning of the small intestine. The giardia and/or trichomonas kills these cells and can severely
damage the bowels. The infection can prevent the absorption of essential nutrients and vitamins thus resulting in malnutrition. When this occurs, the liver's function/health
itself can become compromised as the liver plays a major role in metabolism: all nutrients that are absorped in the intestines are transported to the liver where the liver
dismantles some of them, stores others & uses some to synthesize other substances. If nutrients have been diverted by the giardia and/or trichomonas cysts, then the liver's functioning becomes impaired. If the giardia and/or trichomonas condition has existed for a period of time prior to diagnosis, damage to the liver can be permanent. This is why it is so crucial to have regular fecal tests done to rule out giardia, trichomonas or bacterial intestinal infection. The earlier such conditions are diagnosed and appropriate treatment started, the less the risk of permanent liver damage.

Re: Portia's necropsy [Re: ] #25384
08/22/04 09:14 AM
08/22/04 09:14 AM

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Thanks so much for all of this wonderful information. How can one person know so much? Are you a dr., a research person, a nurse? I'm printing this thread and taking it with me when I take my next batch in for wellness checks (early Sept.).

One question, tho...I thought the liver could regenerate itself. Does it only regenerate if part of it is missing? Does it regenerate in gliders?

Again, thanks a bunch. I think Dr. Thomas will really appreciate all of the information (some of it, of course, she will know). She is actively researching this issue, I think. At least I know she is finding liver problems in just about every glider that she post mortems.

Thanks again.

Re: Portia's necropsy [Re: ] #25385
08/22/04 05:21 PM
08/22/04 05:21 PM

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Peggy51: I'm a nurse with a penchant for researching diet and nutrition as well as diseases/their symptoms/causes. As for the liver, the liver is a remarkable organ capable of regeneration when necessary. However, you cannot damage your liver time and time again and think that you don't have to worry because everything will be all right & that the liver will always repair itself as there comes a point when the liver damage becomes irreversible through a process called cirrhosis. This is where the normal structure of the liver is lost and replaced with scar tissue, a process called fibrosis. Since it is not possible to know when this time might be, always remember that as with most things in life, dietary moderation (in terms of food items and vitamin/mineral supplements) is best as it will allow the liver the necessary time to regenerate.

Re: Portia's necropsy [Re: ] #25386
08/23/04 03:38 PM
08/23/04 03:38 PM

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I knew you had to have something going on. You are so incredibly knowledgeable about stuff, especially the liver. I can't thank you enough. Will you be attending the SGGA next year?

Re: Portia's necropsy [Re: ] #25387
08/24/04 09:53 PM
08/24/04 09:53 PM

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Peggy, I am sorry to hear you are having such a hard time with this. I worry about this with mine, and I've been thinking a lot about iron since the SGGA. There's a lot in BML, too, because of the wheat germ. Of course, their favorite fruits and veggies would also be those high in iron. Now I hear this about giardia, and Rupert was very sick with that when he was little. It delayed his growth a lot when he was a baby. I am sure there must have been some organ damage. But I'll just press on with the best I know to do for them, which so far is the BML and the veggies and fruits they'll eat. I'll just sit tight until someone tells me otherwise. How frustrating. <img src="/ubbthreads/images/graemlins/confused.gif" alt="" /> But that is all we can do... our best. I hope you aren't blaming yourself at all for problems with diet or anything. I can tell you are very dedicated to your babies.

Re: Portia's necropsy [Re: ] #25388
08/25/04 12:51 PM
08/25/04 12:51 PM

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Peggy51 : I've made a reservation at the Clarion Inn & plan to attend the 2005 SGGA unless something untowards occurs at the last minute.

jmetheridge : you are correct that wheat germ does contain iron. However, here are the facts/figures on the wheat germ:

20 grams = approx. 1/4 cup of wheat germ. Per the attached wheat germ label, a serving size of wheat germ = 100 grams or 1 1/4 cups of wheat germ which = a daily value of 46% for iron.

Since a 1/4 cup of wheat germ (20 grams) is used for a single batch of BML, the total amount of iron in the BML from the wheat germ would = 9.2%. However, the percentage of iron from wheat germ per night would be far less. EXAMPLE: my ice cube tray has 16 sections & I pour one tablespoon into each section so my gliders are getting approx. 0.575% or 1/2 of 1% of iron nightly from the wheat germ which is relatively low. However, we must also remember that there is iron and vitamin C in the Herptivite. Now we add our fruits/veggies & this is where I think possible extra iron our gliders get (no matter which proven diet we use) may be coming from as several common veggies are known to contain iron. Then we tend to add common fruits containing Vitamin C. And as previously pointed out, one of vitamin C's functions is to aid in the uptake/absorption of any/all iron sources contained in a diet. We may, therefore, want to be more cautious about regularly/daily using too many fruits and veggies which contain natural amounts of iron/vitamin C in order to reduce the risk of excessive iron in our gliders' diets. Therefore, on a night when we may give peas, beans, dark green/leafy veggies or legumes, we may want to consider avoiding too many fruits/veggies that contain higher levels of vitamin C.

For those really interested/concerned about the issue of iron/vitamin C in your glider's diet, there is an excellent website HERE with nutrient charts for fruits/veggies & the amounts of vitamins and minerals that are contained in them. Just remember that the amounts of vitamins/minerals are for the most part given by the cup and we should only be using one tablespoon each on the fruits/veggies. This brings me to another issue for those using the BML diet: are you giving more than one tablespoon of fruits and one tablespoon of veggies per glider? From photos I've seen posted here this certainly appears to be the case for a lot of people. So if you tend to give more than the one tablespoon each of fruits/veggies per glider and your glider is eatting most of the fruits/veggies, you are very likely increasing the amount of iron/vitamin C in your glider's diet nightly. Please follow the recommended amounts of fruits/veggies with respect to the BML diet. It will not only reduce the risk of possible increased iron amounts in your glider's diet but may help keep your glider from becoming overweight as well.

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Re: Portia's necropsy [Re: ] #25389
08/26/04 05:06 PM
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Thanks for the link. I think it will prove very helpful. As I said, I printing your info and taking it to my vet next week. She is very interested in glider research.

Re: Portia's necropsy [Re: ] #25390
08/27/04 12:29 AM
08/27/04 12:29 AM

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I've been watching this thread with interest. I really appreciate this type of discussion, although I am sorry Peggy that this discussion is the result of the loss of one of your sweeties.

One more nutrition thought to throw into the mix.... Iron absorption is inhibited by calcium so... if we're working to have high calcium:phosphorus ratios in our glider's diets, how does that relate to excessive iron in the liver/diet? Here's a link from Univ. of Illinois.
http://www.mckinley.uiuc.edu/Handouts/dietiron.html

Lynn

Re: Portia's necropsy [Re: ] #25391
08/27/04 01:25 PM
08/27/04 01:25 PM
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As Glideroo said, the liver is one of the more resilient organs. It can regenerate new cells, as long as a) the cells aren't dead, and b) as long as whatever is causing the problem (diet? illness?) is reversed, c) as long as not too much damage has already occurred, and d) as long as the glider is otherwise healthy. Sometimes, even with compromised livers, gliders can continue to live for quite some time if the rest of their health improves and what caused the liver damage is no longer an issue.



Re: Portia's necropsy [Re: ] #25392
08/29/04 05:08 AM
08/29/04 05:08 AM

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<img src="/ubbthreads/images/graemlins/gliderangel.gif" alt="" /> [:"magenta"]i am also very interested in this topic. there is so much to learn about these little creatures. i don't really have anything to add, i just wanted to say that i am so sorry for your loss. <img src="/ubbthreads/images/graemlins/hug2.gif" alt="" /> [/]

Re: Portia's necropsy [Re: ] #25393
08/29/04 10:42 AM
08/29/04 10:42 AM

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Calcium-Iron interaction short-term absorption studies have shown an inhibitory effect of calcium on daily iron absorption when supplemental calcium doses were taken. Calcium supplements decreased the absorption of iron in food when the supplements were consumed concomitantly with the food or within a short period of time of consuming the food.

However, negative effects of calcium supplements on iron absorption/iron status has not been found in long-term (6 months or longer) intervention studies. An adaptive response, possibly involving an *up-regulation* in the efficiency of iron absorption, may prevent prolonged inhibition of iron absorption or the development of inadequate iron status when supplemental doses of calcium are taken.

*Up-regulation: an increase in the number of receptors on the surface of target cells, making the cells more sensitive to a hormone or another agent.*


Additionally, the inhibitory effect of calcium on iron absorption has not been observed in studies involving the use of calcium fortified foods or foods with naturally occurring calcium sources. Therefore, foods fortified with calcium or with naturally occurring calcium can be used without an adverse effect on iron status.

Based on the above, I would think that those lucky enough to have gliders willing to eat a proven diet (where ratios have been calculated out), don't really have much of a worry about the calcium/phosphorus/iron issue. Rather, those who feed a fresh food/modified diet of some type will have more of an issue with respect to calcium/phosphorus/iron levels unless they know how to calculate ratios out properly so as to avoid calcium/phosphorus/iron deficits/excesses. In the case of Portia, the hypothesis could be that insufficient calcium levels existed which allowed for higher iron uptake/absorption but then again with Portia being an older rescue glider (I believe), there may have already been irreversible liver damage so that the liver was unable to perform its normal function of detoxification
and excretion of excessive amounts of iron and/or other nutrients. Portia's necropsy is also the first one that I can recall of where it was pinpointed that excessive iron levels were found in the liver and fecal material. That is not to say it may not have been a factor in other glider deaths but in the majority of glider deaths, people either emotionally are unwilling and/or financially unable to have a necropsy done so we do not know if this particular problem has occurred more often than we know of.

In summary, for those with gliders willing to eat a proven diet, don't modify it without discussing possible modifications with the developer of the diet with respect to possible ramifications the modifications might have on Ca/P/Fe (FE=IRON) levels. And for those needing to use a fresh food diet, work with a glider vet who has glider dietary requirement needs' knowledge/access to such data in order to work out your diet in order to reduce the risks of improper Ca/P/Fe ratios.

P.S.: for those doing a fresh food/modified diet, you need to also remember that fruits/veggies generally are much higher in Phosphorus than Calcium. When this proves to be the case, and you do not have another source high enough in calcium, the phosphorus will tend to inhibit the uptake and absorption of calcium. Thus another reason to work with a glider vet who is knowledgeable with respect to glider dietary requirements/nutrient ratios.


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