Food for Special Health Issues

[lmcpug]

Food for Special Health Issues

[lmcpug]

Posted by Pugpillow on: Sat May 27, 2006 11:02 pm
Here’s a recipe for the morning meal amended for struvite-prone dogs. Note that this diet regimen is to help acidify the system and break down existing struvite crystals. However, antibiotics are a must to clear up the underlying infection that is causing the urine to be alkaline in the first place. Diet alone will not remedy the problem.

“Breakfast Slop for Struvites”

1-2 pounds ground meat
2 ozs. of organ parts - liver, hearts, gizzards
1/2 cup of plain no-fat yogurt (containing active bacteria) or kefir
1 tbsp. ground kelp
3 raw eggs ; omit the shells
3-4 tbsp of natural coconut oil

Here are the benefits of the ingredients:
• meat is the staple of the diet and a protein source
• no-fat yoghurt contains Lactobacillis Acidophilus, a *good* bacteria for the stomach and bowel; helps crowd out the bad bacteria
• kelp provides iodine which helps the thyroid; for this reason, omit it if your dog also has hyperthyroidism. Kelp is also an antioxidant and source of thyroxine and riboflavin and many other vitamins and minerals.
• eggs without shells: although shells are a wonderful source of calcium, this is not good for dogs prone to struvites
• coconut oil: see http://www.mercola.com/2001/mar/24/coconut_oil.htm

Mix all the ingredients together well, pour into ice cube trays (IKEA has some great rubber ones for $1.50 - 4 cubes; each cube holds 3 oz) and freeze. Serve defrosted. In the morning, when I take their breakfast out of the fridge, I move another batch from the freezer to the fridge so it’s ready for the next day (it defrosts well and safely in the fridge). I do the same with the evening meal – as I’m serving the meal, I get the next night’s meal out of the freezer so it can defrost in the fridge for 24 hours. Easy as pie and prevents any problems of bacterial contamination! My pugs (weighing approximately 20 lbs. each) get 3 ozs of the slop in the morning, and meat, poultry, fish or tripe for dinner (see below for dinner feedings). I serve raw meaty bones several times a week.

When you defrost the slop, you can add supplements such vitamin B, vitamin E, cottage cheese, yucca, Wobenzym, slippery elm, grapefruit seed extract, milk thistle etc. (I grind with mortar and pestle and add separately whatever each dog needs. Note that freezing damages vitamins B and E.) Yucca and Wobenzym are for arthritis. Vitamin B boosts the immune system. Slippery elm powder is a stomach remedy. Grapefruit seed extract is for systemic yeast problems. Milk thistle is a liver cleanser. I do not add supplements unless I think necessary for the particular dog. I would suggest Vitamin B is essential for dogs with struvite crystals, though.

I highly recommend you pour the contents of a 1000 mg capsule of Salmon/Wild fish Oil over their breakfast portion about 3-4 times a week for an Omega boost. The oil is cleaned of contaminants which are so often found nowadays in various fish, including farmed fish. Fish and vegetable oils contain long-chain polyunsaturated fatty acids that are prone to oxidation in the body and use up vitamin E to prevent that. So if you do add fish oil, also add Vitamin E as replenishment. Coconut oil, on the other hand, is saturated fat consisting of short- and medium-chain fatty acids, and does not oxidize easily in the body, so extra vitamin E is not required if there is an adequate amount in the diet. Coconut oil actually enhances the absorption of vitamin E.

Dogs have no need for carbohydrates in their diet and I avoid grains completely as do many of the *best* commercial dog foods because of their allergenic properties. I NEVER give dog biscuits as most contain grains (which many dogs are really allergic to) and sugar. Usually for a treat, I give the dogs fish or thinly-sliced chicken, both dehydrated. Occasionally I treat with dehydrated chicken livers (maximum 2 because they are so rich and too many will cause diarrhea). Instead of rawhide chews (which cause intestinal problems and choking), I give them strips of dehydrated white tripe; they don’t last as long, but they’re better for them.

For the evening meal, the dogs get meat, poultry, fish (twice a week) or green tripe (once a week). Balance in the diet is crucial. A variety of proteins in the diet builds better muscle mass, including the heart - choose from chicken, beef (freeze at least 72 hours to destroy bacteria), pork (same), lamb, rabbit, turkey, duck, goose, deer, venison, goat, bison, oxtails, sardines, mackerel, tilapia, etc.

Raw meaty bones should make up a good part of a dog’s diet but with struvite-prone dogs, you need to cut back their calcium intake so concentrate on bones that are not so readily digestible (beef marrow, goat, lamb, some pork bones) and leave the chicken and turkey bones for dogs needing a higher calcium content. The key word in this phrase is “meaty”; emphasize the raw meat. You may want to take the bones away once they have gnawed them and are starting to ingest them.

Be watchful for allergies such as lactose intolerance (cottage cheese, yoghurt, cheese). Be aware that dogs, like people, can be allergic to some meats and seafood. It’s trial and error, but at least less risky allergy-wise than feeding grains. Don’t assume that they are allergic to something if they throw up a food for the first time. It takes a while for the stomach to develop the different digestive enzymes necessary to process raw foods, if they’re not used to it. Introduce new ingredients gradually or be prepared for throw-ups/diarrhea/constipation for a while as the stomach adjusts to becoming more acidic. By the way, canned pure pumpkin (not the pie filling kind) or slippery elm powder are great to regularize bowel movements and are fantastic overall for dogs. And for the record, dogs are not subject to external bacteria such as salmonella unless their immune system is highly compromised; just think about them burying and digging up bones weeks later! However, because of human vulnerability, make sure you use proper hygiene practices when dealing with raw meat.

Meat and bones should always be served RAW, never cooked. Cooked bones splinter and can choke and kill your dog. Bone is important for the calcium content (less so for struvite-prone dogs) and to keep their teeth free of tartar. Marrow bones are mainly for recreation rather than calcium intake and so ideal for dogs with struvites. They love them and so do I as they keep them busy for quite a while, trying to get the marrow/fat from the inside. Don’t worry about the fat on the bones; unlike for humans, the fat is good for dogs and is processed easily by their acidic digestive system (if they are eating raw). Bones and raw food are messy and awful-looking so feed them outside or confined to a cleanable space. Once they’ve chewed the bones clean, I allow the bones indoors. Caution: until you and your dogs get used to bones, supervise them particularly carefully. If you have a “gulper”, you may have to hold the bone while they learn to gnaw it. I always watch while my dogs are eating bones … just in case.

Once a week my lot get green tripe (not the bleached white tripe I use for treats). It is a truly great source of nourishment, loved by dogs, but beware - it stinks !! You have to be dedicated to this as you buy the whole stomach and have to cut it up in small portions for small dogs like pugs. Not pleasant but worthwhile for your fur-babies as it is a wonderful source of the oh-so-important Omega-3. Green tripe has a low PH (higher acidity) which aids digestion and so is especially good for dogs with struvites. You can buy the canned stuff but it’s not as good for them.

About twice a week the dogs get fish, preferably fresh or frozen whole. The heads and innards contain valuable oils and nutrients that fillets and canned fish don’t provide as well. I buy frozen whole sardines at the grocery store for $2.99 a bag and serve one fish (approximately 6 inches long) each, including the head; (I do take the tail off because it’s sharp although this is not necessary for bigger dogs). Kim-Soo doesn’t like sardines so she gets another kind. I also buy pollock fillets which are cleaner and not as smelly. If I’ve forgotten to defrost some meat, poultry or fish, I will serve canned fish (jack mackerel, sardines), rinsed well to get rid of excess salt. Just make sure you buy the fish canned in water or brine (rinse VERY well) and not some other sauce! A good mix of fish is recommended to minimize intake of contaminants (lead, mercury, etc.). Avoid Pacific Northwest Salmon as it can cause acute bowel problems. Also avoid Atlantic salmon; the wild stuff is an endangered species and the farmed stuff is not only lacking in nutrients but full of parasites and high toxic levels (PCBs, etc.).

I avoid cooking meat; some experts say that the chemistry of meat changes with heat and the result is tantamount to serving your dog a form of polymer (plastic) that their digestive system can’t process (ours can). Another reason to avoid kibble which is heat-processed.

If you’re new to raw feeding, keep a look-out for constipation or diarrhea and feed pure pumpkin to regulate their bowels. Their bodies will adapt over time. It is also a good idea to get a blood workup at your annual vet visit.

For the first few weeks, your dog may be expelling toxins from previous food and meds (including the antibiotics), especially if they’ve been exposed to either for a long time. This can show up in eye goop, mucous-covered stools, etc. You can aid this detoxification by adding Ultimate Liver Cleanse or Milk Thistle to the slop (both available at health food stores and some supermarkets). Be patient and give it at least a month or better, two months after the antibiotics are finished.

Good luck and good raw feeding!

[lmcpug]

Posted by Pugpillow on: Mon Oct 01, 2007 11:54 am
Sorry about the struvites. One of the most important treatments is to get lots of water into Otis as it dilutes the urine. That is the purpose of specialty foods like Royal Canine Urinary SO. Unfortunately, to increase thirst, these foods contains a lot of salt (sodium) which taxes the dog's kidneys. This is particularly not good for seniors or dogs prone to renal problems. These food are also not good for other reasons long-term - insufficient calcium, too much fat.

IMO, since struvites are formed in the presence of an infection, the underlying infection must be eliminated before you can expect to see the struvites disappear. That means appropriate antibiotics (one of my vets disagrees, BTW, but I'm not convinced of his abilities for other reasons as well). The diet is just one component of treatment but the antibiotics and increased water intake are absolute essentials.

It is also important to make sure the dog urinates frequently (which it will do if it drinks a lot of water) so that the bladder is fully emptied and bacteria does not flourish.

Here's my previous link on raw feeding modified for struvites:

http://www.pugalug.com/pugalugforums/ph ... +struvites
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Posted by peachy on: Wed Dec 05, 2007 8:17 pm
My 13 year CHocho has had problems with crystals and or calcium oxalates in her urine a few years ago.
My vet suggested a diet with a protein level below 20% and also recommended a tablet of vitamin C 500mg twice a day for a few months.

3 years later, Chocho is on Wellness Senior (17% protein) and no longer needs to take the vitamin C (although she loved the tropical fruit flavor...) and the PH in her urine is stabilized at 6 to 6.5 which is where it should be. I go twice a year for a urine analysis and there hasn't been any trace neither of struvites nor of calcium oxalates which can cause stones in the bladder.
I guess the diet and the vitamin C did helped.
Good luck !!!
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Posted by Pugpillow on: Thu Dec 06, 2007 12:10 am

Otis's Mom wrote:
Sixteenpaws.... Which B vitamin do I use?
In your recipe you mention adding Vitamin B for dogs with Sturvites. There are many different B(numeric) and then B complex vitmans. Which one should I buy?

Use a good B- complex and make sure it contains B-1 (thiamine) and B-6 (pyridoxine hydrochloride).

BTW, the reason Vitamin C is effective is that it helps the body excrete uric acid.

And guess who did a lot of research into kidney stones? .... Linus Pauling, a twice Nobel Prize winner. He died in 1994.

[lmcpug]

Posted by chicklit on: Mon May 28, 2007 3:13 pm
Well its been awhile but i am in need of some help from everyone!..pumpernickle had his bladder stobes removed and they are 50%calcium oxalate monohydrate, 40$ calacium oxalate dihydrate and 10% calcium phosphate..this means they are at high risk for returning every 2 years!!..(very expensive) anyways they are recommending he be on a veterinary diet or life...they are giving me 3 options and i need some help on the pros and cons of these foods and if anyone knows which ones are best from expereince or word of mouth
1. royal canin veterinary diet canine uniary SO
2. medi-cal weightcontrol/maturte
3. medi-cal vegetarian formula
* know pumper doesnt do well with chicken so i was leabning towards the vegetarian but i need help
**they also recommend he be on a canned food to get as much water in his urine as possible
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Posted by pugpillow on: Mon May 28, 2007 8:11 pm
You might want to get a second opinion - from a holistic vet, or one who has considerable training in canine nutrition (they're hard to find, IMO).

My research tells me that these special diets should not be fed for longer than 6 months because they lack calcium and so can be harmful to joints and bones. They are also high in fat so you have to watch out for vulnerability to pancreatitis.

I can't speak about the Medi-cal stuff but I have reluctantly used Hill's s/d and Royal Canin Urinary SO in the recent past for struvites (Mei-Ling) but eventually switched her off them and back to raw. I still have trouble getting my head around how one type of food can prevent both struvites and calcium uroliths (COUs) when they are at the opposite ends of the acid/alkaline spectrum. It leads me to conclude that the food's main purpose is to encourage intake of water, a factor important in the management of both struvites and COUs. The food promotes thirst by including a higher than normal amount of salt (sodium chloride). This high salt intake can really tax the kidneys, to the point where my vet concurred that it might do more harm than good to my senior girl. So imagine the long-term effect on the kidneys if the dog is on it for life. It is also believed that dietary sodium (salt) encourages the formation of calcium uroliths but the jury is still out on this as the increased water intake from thirst may offset it or more.

As I said, I can only address Hill's and Royal Canin, but I imagine the Medi-cal products are similar.

You can reduce the chances of the stones recurring by feeding a prey model diet with no more than 15% bone. Avoid grains and nuts, even in treats, as many contain oxalates (so do some vegetables) which contribute to stone formation. Don't use any vitamin or mineral supplements, especially those containing calcium, vitamin C, and vitamin D. Also, avoid use of prednisone, prednisolone, and furosemide. Dietary magnesium is important to balance out the calcium.

I'd recommend the book "Home Prepared Dog & Cat Diets" by Donald R. Strombeck, DVM, PhD. which can be purchased from amazon.com, dogwise.com or from the publisher at: http://store.blackwell-professional.com ... 21498.html. I would also HIGHLY recommend you join a really great Yahoo support group at http://www.marvistavet.com/html/body_ca ... tones.html
take a look and let me know what u get from it!
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Posted by Blanche on: Tue May 29, 2007 8:48 pm
The thing that I do with any dog that comes in with crystals--and it sounds like Pumpernickel has really hit the bulls eye with his--is flood their food with water. Whatever food you choose--load it with water at feeding time to help the bladder flush out. I didn't use the canned food as most of the dogs I've had with crystals didn't like it, but they were happy to eat kibble with 1/3 to 1/2 cup of water in it.

And definitely get a canine nutrition consult. Your pug has several different types of crystals there and a diet for struvites won't work for Calcium oxalate and vice versa. You need a diet that will work for both--a really tough juggling act as too acid will increase one type of crystal while preventing the other and too alkaline with increase the other type of crystal and prevent one.
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Posted by Blanche on: Sun Jun 03, 2007 8:19 am
The stones are formed when the crystals join up into a stone--so if there are stones, there have been crystals. The stones are the EXTREME form of the crystals.
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Posted by pugpillow on: Sun Jun 03, 2007 7:16 pm

http://pets.groups.yahoo.com/group/Cani ... =242050548
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Posted by lexx on: Mon Jun 04, 2007 8:06 pm
Right now she eating Solid Gold kibble, and I mix in half wet food that 100% organic chicken and well water. I also make sure she gets more exercise and has a water bottle on her crate now so that she is never without water. Her first re-check showed no crytals. I have to take her soon to check again and I'm hoping she is ok. There is way too much conflicting info on stones and prevention.

Also for recurring stones, usually it is a genetic condition and diet will make little difference. The best advice I got was to get x-rays every 8 months or so to see if crystals are reforming and if so, they can be flushed out of the bladder without surgery before they get big.
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Posted by pugpillow on: Tue Jun 05, 2007 3:28 pm
How do they get flushed out? By the vet?
Does it work only for struvites? I'm assuming Calcium Oxalates would be too big, or can you get them early too?
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Posted by lexx on: Tue Jun 05, 2007 6:22 pm
Yes the vet does it. Liquid is slowly forced into the bladder and then removed, repeated until the liquid from the bladder is clear of crytals and small stones. I don't think this requires an overnight but it may depend on the vet.
Maybe with oxalates you would want to x-ray every 4-6 months instead, so they can be caught when they are still small.

[lmcpug]

Posted by Damzlfly on: Fri Mar 24, 2006 2:23 pm
My friend has a pug who has got puppy warts and her vet has said that his immune system is not as good as it should be. Can you suggest any supplements to boost his immune system?
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Posted by Mcatton on: Fri Mar 24, 2006 2:33 pm
a quick google search for " boost your dogs immune system " brought this link...

http://www.healthyhappydogs.com/TransferFactor

Marine Plants and Fresh Water Algae to Enhance Health, Boost Immunity, Detoxify
The electrolytic magnetic action of the sea plants releases excess body fluids from congested cells and dissolves fatty wastes through the skin, replacing them with depleted minerals, particularly potassium and iodine. As the natural iodine boosts thyroid activity ( GOOD FOR PUMPER ) , food fuels are used before they can turn into fatty deposits. Vitamin K, a fat-soluble vitamin in seaweeds, aids adrenal regulation, so a seaweed bath also helps maintain hormone balance for a more youthful body. Sea Vegetables (Spirulina - Kelp - Chlorella) have been acknowledged as a detoxifyer, a balanced nourishment and a miraculous healing plant. Ocean/Sea algae are the richest natural source of minerals, trace minerals and rare earth elements.

http://www.shirleys-wellness-cafe.com/seaveg.htm
http://www.quikonnex.com/channel/item/13942
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Posted by Candace on: Fri Mar 24, 2006 6:24 pm
I would suggest a good quality fish oil. A good pro-biotic or yogurt would be good too. You can buy good quality supplements that include lots of things, like solid gold makes.
What kind of food does her dog get? A good quality food is most important. Also, less intervention can help an immune system. Flea medications or heartworm medications are all taxing on the dogs immune system. If possible, it is best to stay away from that type of thing, until the dog is healthier.
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Posted Pugpillow on : Fri Mar 24, 2006 7:10 pm
Vitamin B-complex ! That's what my vet recommended for Kimmy. And watch out for the vaccinations.

http://www.canine-epilepsy.com/doddsnutrition.html

The article by Dr. Jean Dodds entitled "Nutrition and the Immune System" might be helpful.

She discusses the challenge to the immune system of continual exposure to foods deficient in necessary or imbalanced nutrients and high in chemical additives. Amongst other things, she says, "Supplementation with vitamins and minerals should not be viewed as a substitute for feeding premium quality fresh and/or commercial pet foods."

She goes on to discuss Nutrition and Thyroid Metabolism so I will post this site on the Health thread for Pumpers too

[lmcpug]

Posted by Damzlfly on: Tue May 09, 2006 9:50 am
Hi all, Priscilla had her yearly vet check this weekend. The Vet drew blood (boy that was a process) and gave me the results today. Shes advised me that Prissy has a low potassium level and is recommending suppliments. So RAW folks, what should I do to bump up her potassium other than the obvious bananas?
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Posted by Pugpillow on: Tue May 09, 2006 11:11 am
Apparently, potassium deficiency comes much more often from the dog losing potassium (e.g. through chronic diarrhea and vomiting) than through not ingesting enough. Usually serious potassium deficiency is accompanied by a distended stomach, vomiting and failure to pass stools or gas. However, this doesn't sound like Priscilla. I guess it depends on how much out of "normal" range her bloodwork shows as to how much you'll want to supplement.

According to http://www.weimaraner-scotland.com/GenInt/Bloat.htm, the minimum requirement for adult dogs (maintenance) per kg. of weight is 89.0 mg. Multiply this by how many Kg. your dog weighs – e.g. 10 x 89 = 890 mg. to get their daily minimum intake (on average). On this website, there are also raw recipes (I’d avoid the grains, though).

http://www.hoptechno.com/book29p.htm contains a list of foods listing potassium content per *human* serving. But it will give you an idea which foods are potassium rich.

I found this additional chart, also for humans, but some of the foods will be great for dogs too:

Food Serving Potassium (mg)
Banana 1 medium 467
Potato, baked with skin 1 medium 721
Prune juice 6 fluid ounces 530
Prunes, dried 1/2 cup 633
Orange juice 6 fluid ounces 354
Orange 1 medium 237
Tomato juice 6 fluid ounces 400
Tomato 1 medium 273
Artichoke, cooked 1 medium 425
Lima beans, cooked 1/2 cup 478
Acorn squash, cooked 1/2 cup (cubes) 448
Spinach, cooked 1/2 cup 419
Sunflower seeds 1 ounce 241
Almonds 1 ounce 211
Molasses 1 tablespoon 293

Hope this helps.
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Posted by Candace on: Tue May 09, 2006 12:52 pm
According to this site, raw meat is high in potassium. Did the vet give any other possibilities? It sounds like there can be health issues that show low postassium.
http://www.barfworld.com/html/barf_diet ... ific.shtml
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Posted: Wed May 10, 2006 10:33 am


Hilary, I have her blood results:

Total protein 74 (54-75 range)
Albumin 44 (31-43 range) - high
Globulin 30 (18-39 range)
a/g ratio 1.5 (0.8-1.7)
Bilirubin total 3.3 (0.0-5.0)
Bilirubin conj 0.4 (0.0-2.0)
ALP 39 (24-141)
ALT 31 (5-95)
AST 88 (5-71) - high
CK 369 (5-235) - high (she was stressed - vet said this is normal)
Amylase 616 (150-1350)
lipase 497 (0-900)
Cholesterol 8.4 (3.0-9.9)
Glucose 2.9 (3.6-10.0) low
Urea 10.9 (3.0-10.0) high
Creatinine 86 (30-140)
Sodium 151 (143-155)
Potassium 2.6 (3.9-5.7) low
Na/K ratio 58 (25-40) high
Chloride 108 (107-123)
Calcium 2.97 (2.20-3.00)
Phosphorus 2.2 (0.8-2.2)

Hematology is normal

Lymphocytes are high 6.9 (1.0- 4.8 )

Candace, I'm reading that link you sent, they say chicken is the lowest in potssium and thats her main staple...I think I'm going to get some beef and pork and try that.
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Posted by Pugpillow on: Wed May 10, 2006 2:30 pm
Hi Shayna –
Thanks for sharing the results. First, let me give you some websites so you can go through and compare for yourself. Then you may agree or disagree with what I suggest, but at least you’ll have food for thought that may trigger more research. If you have any concerns after reading any of this, at least you’ll have a better basis to ask the vet some follow-up questions.

http://www.vetmed.wsu.edu/clientED/lab.asp
http://www.itsfortheanimals.com/BLOOD-T ... LAINED.HTM
http://www.sniksnak.com/cathealth/labreports.html

First, did Prissy fast for 12 hours before the blood test? If not, some of the values may be skewed. Second, there is an increasing number of people who feel that some of the ranges may not be appropriate for raw-fed dogs. However, in the absence of any other measurements, they are all we have to go on and I am still a firm believer in them. Kind of like results on a mammogram or a PAP smear, they can be an early warning signal, but are not necessarily an indicator of a problem; something to keep an eye on. Third, as one of the websites says, “It is important to recognize that no diagnostic test is perfect, so occasional "false positives" or "false negatives" may occur.” It is good to check out all the measures in one area – e.g. every one that pertains to liver function, etc. You might find that only one measure is out of the “normal” range. Worth keeping an eye on, but if this same measure is consistently out of range year after year, don’t panic. As another of the websites says, “Some pets just have an elevation in one lab value, that seems to be a consistent finding, that never causes problems during their lifetime.”

So, after all those caveats, here’s what I think, for what it’s worth.

Albumin 44 (31-43 range) - high - this is so near the upper bound, I wouldn’t give it a second thought.

Glucose 2.9 (3.6-10.0) low Similarly, this is marginal. Daisy’s glucose was low (our reference rates used a different scale so I can’t compare to Prissy) and the vet said to give her a teaspoon of honey with her meals. Since Priscilla is not prone to yeast infections, she could have sugary veggies like carrots more often too.

AST 88 (5-71) - high The AST test is not specific enough to be really useful in small animals, but it can indicate liver damage when other liver enzyme levels are elevated too. In Prissy’s case, AST is the only one, so I wouldn’t sweat it.

CK 369 (5-235) - high (she was stressed - vet said this is normal) The most common causes of rises in CK are muscle disorders, but other possible causes include recent exercise prior to the blood test and selenium/Vitamin E deficiencies. Since Prissy is so active, this is probably the reason, especially coupled with the stress of the vet visit. You could certainly add more food with selenium and Vitamin E easily enough.

Urea 10.9 (3.0-10.0) high - I assume this is BUN (blood urea nitrogen) level. Here’s where I particularly think raw feeding with its high protein might yield higher readings, particularly if she had a recent high protein meal.

Potassium 2.6 (3.9-5.7) low. We touched on this one before and I have nothing to add other than because the potassium component (denominator) is low, the Na/K ratio 58 (25-40) high – is high.

Lymphocytes are high 6.9 (1.0- 4.8 ) – This seems a tad high to me and I’m wondering why the vet didn’t mention it. Do you know? Apparently they can be high if there is an infection or stress, so maybe the stress thing is showing up again.

Hope this is helpful. Hilary