Yanay & Antay

Comprehensive health, nutrition, supplementation, and routine protocol — designed from the formal diagnoses by Dr. Natalie Chow (Heartland Niagara Animal Hospital, May 19, 2026), IDEXX laboratory data, and veterinary nutrition guidelines specific to the Peruvian Inca Orchid (PSPP, Peruvian Hairless Dog).

Version 1.0 · May 26, 2026 Yanay · 15.4 kg · 3.5 yr Antay · 8.9 kg · 3.5 yr Heartworm NEG · both

Profiles of both dogs

YANAY

BreedPSPP (Peruvian Inca Orchid)

SexMale, intact

DOBNov 13, 2022

ColorBlack

Weight15.4 kg (35.2 lb)

BuildShort-legged, thick-necked

Microchip900255000519962

Rabies tag25662133

Heartland Patient ID18547

Vaccines valid untilJul 14, 2028

Clinical status

Active Malassezia dermatitis treatment. Complex skin condition with 5 diagnoses. Clean bloodwork. No parasites. Kidneys and liver fully normal.

ANTAY

BreedPSPP (Peruvian Inca Orchid)

SexMale, intact

DOBNov 16, 2022

ColorCopper / caramel

Weight8.9 kg (19.6 lb)

BuildLight, slender

Microchip900255000519961

Rabies tag25662134

Heartland Patient ID18548

Vaccines valid untilJul 14, 2028

Clinical status

Generally asymptomatic. Minimal skin issues (comedones + solar lentigines). ALT 206 elevation noted — Dr. Chow considers this likely a normal variant for an exotic breed, or diet-related. Recheck scheduled for August 2026.

Formal diagnoses (Dr. Chow, May 19, 2026)

Yanay — 5 diagnoses

#	Diagnosis	Clinical support
1	Malassezia (yeast) dermatitis, ventral neck	Cytology confirmed 1+ yeast
2	Chronic pruritus with secondary lichenification	Visual exam: thickened, leathery skin
3	Otitis externa secondary to excessive cerumen production	Wax buildup + large flakes both ears
4	Mild pododermatitis (hind paws)	Visible inflammation on hind feet
5	Suspected atopy vs. nutritional imbalance	Cytology showed pollen; diet correlation

Antay — 2 diagnoses + 1 lab finding

#	Diagnosis	Clinical support
1	Follicular casting / comedones, dorsal neck and interscapular region	"Finger-like projections" between scapulae
2	Solar lentigines (sunspots) on body	Multiple hyperpigmented spots
3	ALT 206 U/L (ref 18–121) — monitoring	IDEXX chemistry May 20, 2026. Possibly normal for exotic breed.

Realistic lifespan expectations (with optimal care)

The published 12–14 year average for PSPP is underestimated because it is based on a global population of approximately 1,000 dogs, most without modern dermatologic care or formulated nutrition. Comparable data from the Xoloitzcuintle (genetically related breed) show:

Category	Published average	With optimal care	Documented case
PSPP medium	12–14 yr	15–17 yr	—
Standard Xolo	13–18 yr	16–18 yr	20 yr
Toy Xolo	15–18 yr	17–19 yr	20+ yr

Reasonable target for Yanay & Antay

16–18 years with the current care protocol. Achievable 18–20 years if dermatologic management remains impeccable, diet is AAFCO-balanced, and breed-typical dental complications are prevented.

Factors that add lifespan (all under owner control):

Optimal weight — overweight is the #1 factor reducing canine lifespan. Yanay borderline (BCS noted as normal with slightly tucked-in waist); Antay ideal.
AAFCO-balanced diet — unbalanced home-cooked diets cause cumulative deficiencies that manifest at 7–10 years.
Annual dental cleaning — periodontal disease is documented to reduce lifespan by 1–3 years.
Intact skin barrier — chronic dermal infections in hairless dogs are entry points for systemic bacteria.
Consistent daily exercise — 60–90 min/day. Both dogs already meet this.
Reduced household toxins — pine oil, lavender, fragrances already removed ✓
Annual bloodwork for early drift detection.
Stress management — the Nov 2025 episode (3-week separation) appears to have been the trigger for Yanay's Malassezia. Minimize prolonged separations going forward.

Detailed energy calculation

Standard formulas: RER = 70 × (kg)^0.75. For intact, active adults, MER = RER × 2.0. Hairless adjustment +12% in cold climate (Ontario winter) accounting for additional thermoregulation without coat.

Yanay (15.4 kg)

RER70 × 15.4^0.75 = 544 kcal

MER intact, active (×2.0)1,088 kcal

Winter hairless adjustment +12%+131 kcal

Summer / heated home target1,090 kcal/day

Winter / outdoor target1,220 kcal/day

Antay (8.9 kg)

RER70 × 8.9^0.75 = 361 kcal

MER intact, active (×2.0)722 kcal

Winter hairless adjustment +12%+86 kcal

Summer / heated home target720 kcal/day

Winter / outdoor target810 kcal/day

Macronutrient targets

Daily caloric distribution tailored to each profile. Yanay: skin-supportive (high omega-3, quality protein). Antay: liver-friendly (moderately reduced fat, antioxidants, adequate protein for lean mass).

Macro	Yanay summer	Yanay winter	Antay summer	Antay winter	Notes
Protein 28%	76 g	85 g	50 g	57 g	1 g = 4 kcal
Fat (Yanay 14% / Antay 11%)	17 g	19 g	9 g	10 g	1 g = 9 kcal · Antay reduced for ALT
Carbohydrates 40–42%	109 g	122 g	76 g	85 g	1 g = 4 kcal · low-glycemic
Fiber 5–8%	5–9 g	6–10 g	3–6 g	4–7 g	Mostly from vegetables
Omega-3 (EPA+DHA)	1,300 mg	1,300 mg	700 mg	700 mg	From fish oil supplement
Calcium	~1,000 mg	~1,000 mg	~600 mg	~600 mg	Target Ca:P ratio 1.2:1
Phosphorus	~800 mg	~800 mg	~500 mg	~500 mg	From protein + vegetables

Protein catalog — full options with nutritional profile

Data per 100 g cooked. Ranked by suitability for Yanay's and Antay's profiles. Rotate 3–4 proteins per week to minimize sensitization to any single antigen.

Protein	Protein g	Fat g	Kcal	Omega-3	Allergy risk	Suitability
Wild salmon, cooked	22	13	208	High	Low	Top choice — both
Sardines, canned in water	25	11	208	Very high	Low	Top — includes natural calcium (soft bones)
Mackerel, fresh	19	14	205	Very high	Low	Top — limit to 1×/wk (mercury)
Lean turkey, skinless	29	7	189	Low	Very low	Excellent novel protein
Rabbit	29	8	197	Low	Very low	Classic hypoallergenic option
Duck, skinless	23	11	201	Medium	Low	Novel protein, iron-rich
Lean lamb	25	10	206	Medium	Medium	Good but limit to 2×/wk
Cod / haddock	22	1	105	Low	Very low	Lean, ideal for Antay (low fat)
Whole cooked egg	13	10	155	Low	Very low	Biological gold standard
Lean beef (sirloin)	26	8	183	Low	Medium	Maintain but rotate
Chicken (elimination 4–6 weeks)	31	4	165	Minimal	High (#1)	Reintroduce after elimination trial
Pork	26	12	218	Low	Antay trigger	NO for Antay (acne correlation)

Weekly protein selection

Yanay (skin focus): 4 days fatty fish (salmon/sardines/mackerel) + 2 days turkey/rabbit + 1 day duck or lamb. Whole egg 2–3×/week as additional.
Antay (liver-friendly): 3 days lean fish (cod + sardines) + 3 days turkey/rabbit + 1 day duck. No pork ever. Whole egg 2×/week.

Carbohydrate catalog

Slow carbs (low glycemic index) preferred. Avoid wheat and barley initially. Carbs provide energy, fiber, and prebiotics for gut flora.

Carbohydrate	Carbs g/100g	Kcal/100g	Glycemic Index	Benefit
Cooked sweet potato	20	90	~63 (medium)	Vitamin A (beta-carotene), fiber, antioxidant
Cooked pumpkin	12	49	~75 (med-high)	Soluble fiber, aids digestion
Cooked quinoa	21	120	~53 (low)	Additional complete protein + magnesium
Cooked brown rice	23	112	~68 (medium)	Sustained energy, B vitamins
Cooked steel-cut oats	12	68	~55 (low)	Beta-glucans, anti-inflammatory
Cooked lentils (red/green)	20	116	~32 (very low)	Plant protein + fiber · use in moderation
White rice	28	130	~73 (high)	Only for diarrhea (highly digestible)
Wheat pasta	25	131	~50	AVOID initially (gluten allergen)

Vegetable catalog

Vegetables provide fiber, antioxidants, vitamins, minerals, and volume with minimal calories. Steam to preserve nutrients. Finely chop or purée (dogs poorly digest raw cellulose).

Vegetable	Kcal/100g	Key nutrient	Specific benefit
Steamed broccoli	35	Vit C, K, sulforaphane	Anti-cancer antioxidant, hepatoprotective (good for Antay)
Steamed spinach	23	Iron, vit K, folate	Anti-inflammatory · limit 2×/week (oxalates)
Cooked carrot	35	Beta-carotene	Vit A, eye health, fiber
Zucchini	17	Vit C, potassium	Low calorie, high water content
Steamed cauliflower	25	Vit C, glucosinolates	Anti-cancer, fiber
Green beans	35	Vit K, fiber	Ideal low-calorie filler
Celery	16	Potassium	Mild diuretic, hydration
Cucumber	15	Water, silica	Summer hydration
Ripe tomato	18	Lycopene	Only fully ripe · NO green (toxicity)
Red pepper	31	Massive vit C	OK in small quantities

Fruits (small amounts, 1 tsp 2–3×/week)

Blueberries (#1 antioxidant) Raspberries Apple, no seeds Pear, no seeds Watermelon, no seeds Banana (tiny portion) Mango limited (high sugar) Grapes / raisins (TOXIC) Avocado (persin toxin) Citrus (irritant)

Fat sources

Fats provide essential fatty acids (omega-3, omega-6), absorption of fat-soluble vitamins (A, D, E, K), and palatability. For Antay with elevated ALT: moderate but do not eliminate — essential fatty acids are critical.

Source	Fat/amount	Fatty acid type	When to use
Salmon oil (fish oil)	~9 g per 1 tsp	EPA + DHA (omega-3)	Daily · only from Nordic Naturals supplement
Extra virgin olive oil	14 g per 1 tbsp	MUFA (omega-9)	1/2 tsp in food 3×/wk · skin health
Egg yolk	5 g per yolk	Lecithin, good cholesterol, EPA	2–3×/week whole egg
Intrinsic fish fat	—	Natural omega-3	Inherent to salmon/sardines
Almond butter (no salt/sugar)	9 g per tbsp	MUFA + vit E	1/2 tsp occasional "treat"
Topical coconut oil on neck	—	—	NO Yanay (feeds Malassezia)
Oral coconut oil	14 g/tbsp	MCT	Small OK · NOT while Yanay's skin is active
Sunflower oil	14 g/tbsp	High omega-6	Disrupts omega-6:omega-3 ratio · AVOID

Absolutely toxic / forbidden foods

Never give

These can cause severe harm or death. Keep out of reach at all times.

Chocolate Grapes & raisins Onion (raw, cooked, powder) Garlic (in excess) Avocado Xylitol (sugar-free gum/candy) Coffee/caffeine Alcohol Macadamia nuts Raw yeast dough Cooked bones (splinter) Artificial sweeteners Excess salt Spoiled meat Wild mushrooms Green tomato Raw potato Processed meat (ham, salted bacon)

Specific to each dog's conditions

YANAY — avoid

Coconut oil on neck (feeds Malassezia)
Chicken (4–6 week elimination trial)
High-fat dairy (cheese, cream)
Wheat / wheat pasta (potential allergen)
Commercial snacks with preservatives
Beef liver in excess (high copper)
Open Farm kibble if moving to 100% home-cooked (Dr. Chow decision)

ANTAY — avoid

Pork permanently (acne correlation)
Fried fats (hepatic load with ALT 206)
Chicken (same elimination trial as Yanay)
Copper-rich supplements without Rx
High-glutathione foods without Dr. Chow OK
Any herbal extract without vet approval (hepatic interaction)
Acetaminophen / human ibuprofen (liver toxic)

Cooking methods — what preserves nutrients, what destroys them

Method	Nutrient retention	Recommended use
Steaming	Excellent	Best method for vegetables. Retains vit A, C, E. No leaching of minerals to water.
Poaching (water simmer 70–85°C)	Very good	Ideal for fish (salmon, cod). Preserves omega-3.
Sous-vide / slow cooker on low	Excellent	55–80°C preserves zinc, iron, B vitamins. Ideal for meal prep batch.
Low-temp baking (160°C / 320°F)	Good	OK for proteins on a tray. Not for delicate vegetables.
Boiling	Medium	Leaches B1, B2, B6, C into water. Workaround: use minimal water and reuse the broth in the meal.
Pressure cooking (Instant Pot, low)	Medium-good	OK but less temperature control. Keep times short.
Microwave	Poor	Uneven heat damages proteins. Only for reheating, not cooking.
Frying / hot oil	Very poor	NEVER for the dogs. Damages Antay's liver, oxidizes omega-3.
Grilling above 200°C	Poor + carcinogens	Forms HCAs and PAHs (carcinogens). Avoid.

Cooking rules for their meals

Protein: poach or steam at 70–80°C until cooked through. Fish: opaque all the way. Poultry: 74°C internal.
Vegetables: steam 6–10 min until tender-firm. Chop fine or purée after.
Carbs: cook in sufficient water, then drain or incorporate broth.
Egg: hard-boiled or poached. Never raw (Salmonella risk + biotin binding).
No salt, no seasoning, no added oil (except measured olive oil).
Cool to body temperature before serving (~38°C). Never hot, never cold from fridge.

Daily recipe for YANAY (target 1,090 kcal summer)

Distribute across 2 meals (AM + PM). This recipe meets ~90% of macro targets; remaining 10% covered by supplementation (Balance IT premix completes the vitamins/minerals). Rotate protein daily following the weekly pattern.

Base daily template (sample day: fish + sweet potato)

Ingredient	Grams	Protein	Fat	Carbs	Kcal
Wild salmon, cooked, skinless	200	44	26	0	416
Steamed sweet potato	200	4	0.2	40	180
Cooked quinoa	100	4	2	21	120
Steamed broccoli + carrot mix	150	4	0.5	12	70
1 whole cooked egg	50	6	5	0.4	75
Extra virgin olive oil	3	0	3	0	27
Fresh blueberries	30	0.2	0.1	4	17
Steamed spinach	50	1.5	0.2	2	11
Plain unsweetened yogurt (natural probiotic)	25	1.5	0.8	1	15
Nordic Naturals oil (omega-3 supp)	2 ml	0	2	0	18
Balance IT Canine Plus (premix)	per calculator	—	—	—	~5
Homemade eggshell powder (if NOT using Balance IT)	~1.5 g	—	—	—	0
DAILY TOTAL for Yanay	~810 g	65 g	39 g	80 g	~954 kcal

Short ~135 kcal vs. summer target (1,090) — how to make up?

Option A: increase quinoa to 130 g (+36 kcal) + sweet potato to 250 g (+45 kcal) + slightly more salmon. Option B: add 1 tsp extra olive oil (+40 kcal). Option C: protein snack between meals — 30 g cold cooked turkey = 57 kcal. Salmon fat is already high — don't add olive oil on salmon days.

Weekly rotation for Yanay

Day	Main protein	Carbohydrate	Vegetables	Notes
Mon	Salmon 200 g	Sweet potato 200 g	Broccoli + carrot	+ egg + blueberries
Tue	Turkey 200 g	Quinoa 150 g	Zucchini + spinach	+ olive oil 3 g
Wed	Sardines 200 g (no salt)	Sweet potato 200 g	Green beans + carrot	High omega-3 + natural calcium day
Thu	Rabbit 200 g	Brown rice 130 g	Pumpkin + broccoli	Novel protein day
Fri	Cod 200 g	Quinoa 150 g	Cauliflower + carrot	Low-fat day, balances the week
Sat	Turkey 150 g + lamb 50 g	Steel-cut oats 80 g	Spinach + celery	Protein blend
Sun	Salmon 200 g	Sweet potato 200 g	Mixed	Repeat base

Daily recipe for ANTAY (target 720 kcal summer)

Same rules as Yanay but portions reduced to ~65% and fat moderately lower to reduce hepatic load (ALT 206). No pork ever.

Base daily template (sample: lean fish + sweet potato)

Ingredient	Grams	Protein	Fat	Carbs	Kcal
Cooked cod or salmon	130	29	9	0	200
Steamed sweet potato	130	2.5	0.1	26	117
Cooked quinoa	60	2.5	1.2	13	72
Steamed broccoli + zucchini	100	2.5	0.3	7	45
1/2 whole cooked egg (3 days/week)	25	3	2.5	0.2	37
Blueberries (hepatic antioxidant)	25	0.2	0.1	3.5	14
Plain unsweetened yogurt	20	1	0.6	0.8	12
Nordic Naturals oil (omega-3 supp)	1 ml	0	1	0	9
Balance IT Canine Plus (premix)	per calculator	—	—	—	~3
Homemade eggshell powder (alt)	~0.8 g	—	—	—	0
DAILY TOTAL for Antay	~490 g	40 g	15 g	50 g	~510 kcal

Short ~210 kcal — options to cover

Antay needs 720 kcal summer target. Base skeleton gives 510. Cover with: increase sweet potato to 200 g (+90 kcal) + quinoa to 100 g (+60 kcal) + add 30 g more protein (+60 kcal) = ~720 kcal exact. In winter add another 12% (sweet potato to 230 g, quinoa to 110 g).

Weekly rotation for Antay

Day	Main protein	Carbohydrate	Vegetables	Hepatic notes
Mon	Cod 150 g	Sweet potato 180 g	Broccoli (hepatoprotective)	Low-fat day
Tue	Turkey 150 g	Quinoa 100 g	Zucchini + carrot	No egg this day
Wed	Sardines 100 g + cod 50 g	Sweet potato 180 g	Spinach + green beans	High omega-3 · natural calcium
Thu	Rabbit 150 g	Brown rice 90 g	Broccoli + carrot	Novel protein
Fri	Turkey 150 g	Quinoa 100 g	Cauliflower + celery	Sulforaphane-rich vegetables
Sat	Salmon 130 g	Steel-cut oats 60 g	Mixed	+ whole egg
Sun	Cod 130 g	Sweet potato 180 g	Broccoli + blueberries	Clean antioxidant day

Weekly batch prep (4 hours, 1×/week)

Cook for both dogs for 7 days, store in daily portions. Sunday afternoon is the best slot.

Typical weekly shopping

Category	Combined quantity	Where to buy
Wild salmon fillet	1.2 kg	Costco / Whole Foods · frozen OK
Lean ground turkey	1 kg	Any supermarket
Sardines in water, no salt	4 cans (≈380 g)	Pantry
Cod fillet	800 g	Fish counter · frozen OK
Rabbit (if available) or extra turkey	500 g	Specialty butcher
Sweet potato	2 kg	Any supermarket
Raw quinoa	500 g	Bulk Barn / Costco
Broccoli, carrot, spinach, zucchini, green beans, cauliflower, celery	500–700 g each	Fresh produce
Eggs	1 dozen	Hormone-free if possible
Plain unsweetened yogurt, full-fat	500 g	Dairy aisle
Fresh/frozen blueberries	250 g	Fresh produce
Extra virgin olive oil	250 ml (lasts months)	Pantry

Cooking workflow (4 hours, parallelizable)

0:00 — Pre-prep: wash all vegetables. Cube small (3–5 mm). Fillet fish if needed.
0:15 — Oven on at 160°C: parchment-lined tray with salmon, no seasoning. 25–30 min.
0:15 — Pot 1: 250 g raw quinoa + 500 ml water. Boil, reduce to simmer, cover. 15 min.
0:20 — Double steamer: bottom rack sweet potato cubes · top rack broccoli/carrot/green beans. 12–15 min.
0:35 — Pot 2: ground turkey steamed or poached in water. 10–12 min until no pink.
0:50 — Cook cod: poach in simmering water 8–10 min until opaque.
1:00 — Rabbit: bake in covered tray at 160°C for 30 min covered, then uncovered 10 min.
1:30 — Hard-boiled eggs: 12 min in boiling water.
2:00 — Cool everything to room temperature on racks. DO NOT refrigerate hot (condensation = bacteria).
2:30 — Portion + pack: divide into 14 containers (7 days × 2 dogs). Label with masking tape + sharpie: "Yanay MON", "Antay MON", etc.
3:30 — Refrigerate 4 days the first ones, freeze 3 days the rest. Move freezer-to-fridge 24h before serving.

Storage rules

Fridge (3–4°C): max 4 days for cooked. Cooked fish: max 2 days for safety.
Freezer (-18°C): max 2–3 months. Label with prep date.
Reheat: leave out 30 min before serving, or warm in water bath (warm water). NOT microwave.
Serve at body temperature (~38°C). Lukewarm, not hot, not cold from fridge.
Containers: glass with lid or food-grade BPA-free plastic.

Supplements — plan overview

A home-cooked diet, however carefully designed, has typical gaps in vitamins and minerals that food alone cannot cover: zinc, vitamin D, vitamin E, iodine, balanced copper, selenium, manganese, vitamin B12, vitamin K. Supplements cover those gaps AND deliver therapeutic doses of omega-3 that food alone cannot reach.

Plan philosophy

1 essential supplement (Balance IT) + 1 therapeutic (Omega-3) + 1 transitional (probiotic during Ketoconazole course). Everything else is optional based on response.

Supplement	Priority	Yanay dose	Antay dose	Duration
Balance IT Canine Plus	Essential	Per calc	Per calc	Permanent
Nordic Naturals Omega-3 Pet	Essential	2 ml/day	1 ml/day	Permanent
FortiFlora probiotic	Transitional	1 sachet/day	—	4–6 weeks
Vitamin E (liquid)	Antay	—	100 IU/day	Until recheck
Eggshell powder (if not using Balance IT)	Alternative	~1 g/day	~0.6 g/day	Permanent
Milk thistle (SAMe)	Rx only	—	If Dr. Chow OK	3-month trial
Glucosamine + chondroitin	Optional	500 mg/day	300 mg/day	Permanent

1. Omega-3 (EPA + DHA) — Nordic Naturals Omega-3 Pet

Nordic Naturals Omega-3 Pet Liquid USD $40–65 / 8 fl oz · lasts ~3 months for both dogs

EPA+DHA omega-3 reduces dermal inflammation (key for Yanay's Malassezia + atopy), supports hepatic function (key for Antay's elevated ALT), improves skin barrier in hairless dogs specifically.

Concentration736 mg EPA + 506 mg DHA per 1 tsp (5 ml) = 1,242 mg combined

Yanay dose2 ml/day (≈1,000 mg combined — target 1,300)

Antay dose1 ml/day (≈500 mg combined — target 700)

How to administerMix into the complete AM meal. Do not give separately (oxidizes).

StorageRefrigerate after opening. Opaque bottle. 90 days once opened.

Gradual startDay 1–5: 50% dose. Day 6+: full dose. (Prevents loose stools.)

Chewy · 8oz Medium dogs Chewy · 16oz Large dogs Chewy · Softgels (alt) Amazon search Nordic.com direct

Alternatives if Nordic Naturals not available

Welactin Canine — EPA+DHA softgels. Solid reputation, more economical. Find on Chewy.
Grizzly Salmon Oil — pure salmon oil, more natural. Find on Amazon.
Vetoquinol Triglyceride Omega Supplement — veterinary-grade alternative.
Do NOT use generic human cod liver oil without standardized EPA+DHA labeling.

2. Balance IT Canine Plus — the vitamin-mineral premix

Balance IT Canine Plus USD $14–140 per size · lasts 1–3 months

Formulated by Sean Delaney, DVM, ACVIM (nutrition) at UC Davis. Covers the exact gap of home-cooked diets: vitamins A, D, E, K, B-complex, calcium, phosphorus, zinc, copper, iodine, selenium, manganese, amino acids. The "Plus" version is heatable (can be baked), ideal for batch cooking.

DosingUse free calculator at balance.it based on weight + recipe. Enter grams of each ingredient, the system tells you the exact grams of Balance IT to complete.

Approximate Yanay dose~6–8 g/day (1.5–2 tsp)

Approximate Antay dose~4–5 g/day (1 tsp)

How to administerMix directly into cooked food. NOT just sprinkled on top — incorporate well so they eat all of it.

StorageSealed, cool dry place. 18-month shelf life unopened.

Sizes20g pouch (~$7) · 200g multi-pack (~$57) · 600g bag (~$140)

Balance IT direct · Plus Balance IT direct · Original Free recipe calculator Amazon search

Balance IT workflow (step by step)

1) Create free account at balance.it · 2) Select "Adult Maintenance Recipe" · 3) Enter each dog's weight · 4) Enter ingredients with grams · 5) System provides exact grams of Balance IT to add · 6) Print recipe and save. Repeat each time the composition changes significantly.

Professional alternatives

Hilary's Blend Canine Supplement — popular alternative
Wholistic Pet Organics Canine Complete
Homemade eggshell powder — but covers only calcium, NOT the rest of vitamins/minerals. Would need 5–6 separate supplements to cover what Balance IT does in one.

3. Calcium — homemade eggshell powder (only if not using Balance IT)

Homemade eggshell powder $0 — completely free

Highly bioavailable calcium carbonate. 1 g eggshell powder ≈ 380–400 mg elemental calcium. If NOT using Balance IT (which already includes calcium), you need calcium supplementation to maintain Ca:P ratio of 1.2:1 with meat-heavy diets.

DIY recipe12 organic eggshells · wash and dry · bake 200°F (95°C) for 10 min to sterilize · grind in coffee grinder to fine powder · sift · store in airtight jar

Yield12 shells ≈ 30–40 g powder · 4 weeks for one medium dog

Yanay dose2.5 g (≈1/2 tsp) = ~1,000 mg Ca

Antay dose1.5 g (≈1/4 tsp) = ~600 mg Ca

How to administerMix well into moist food · DO NOT give dry (irritates throat) · always with liquid

StorageAirtight jar, dry place. Lasts 6+ months.

Amazon · eggshell calcium powder (if not making it) Chewy · calcium supplements dogs

4. Probiotic — Purina Pro Plan FortiFlora

FortiFlora Canine Probiotic Supplement USD $30–40 / 30-sachet box

Yanay is on oral Ketoconazole for 14 days — this alters intestinal flora. A probiotic during and after protects the microbiome, reduces diarrhea/loose stools, and supports the skin-gut axis (balanced microbiome = more resilient skin). Strain Enterococcus faecium SF68 is the most-studied in dogs.

Yanay dose1 sachet/day for 4–6 weeks (during + 4 weeks post Ketoconazole)

Antay doseOptional · 1 sachet/day for 4 weeks if simultaneous gut support desired

How to administerSprinkle on food at serving time · DO NOT mix with hot food · NOT simultaneously with Ketoconazole (separate by 2h)

StorageRoom temperature OK · avoid moisture · use before exp date

Optimal timingWith PM meal (separated from AM Ketoconazole by 8–12h)

Chewy · FortiFlora canine Amazon · FortiFlora canine

Alternatives

Proviable-DC — multi-strain, also excellent
Visbiome Vet — high CFU count, premium
YumPro BiotiX

5. Liquid Vitamin E — Antay only (hepatic antioxidant)

Vitamin E (d-alpha-tocopherol) liquid USD $10–20 / 1 oz bottle · lasts months

Antay has ALT 206 (ref 18–121). Although Dr. Chow considers this likely a normal variant, vitamin E is a safe hepatic antioxidant and may help while we make dietary changes. Re-evaluate after the August recheck.

Antay dose100 IU/day (≈ 1 drop or per product label)

How to administerMix in food containing fat (improves absorption — fat-soluble)

DO NOT overdoseMore than 400 IU/day can inhibit vitamin K (coagulation)

StorageDark bottle, cool, dry

Chewy · vitamin E for dogs Amazon · vitamin E for dogs

6. Optional supplements (consult Dr. Chow)

Glucosamine + chondroitin (preventive joint support)

Glucosamine + Chondroitin (Cosequin Advanced or Dasuquin) USD $30–60 / month, both dogs

Preventive against patellar luxation (common in breed). Dogs benefit most when started BEFORE clinical signs. At 3.5 years it's a good time to start.

Yanay doseCosequin Advanced 1 chewable/day

Antay doseCosequin Small/Toy 1 chewable/day

Chewy · Cosequin Chewy · Dasuquin

Milk thistle (silymarin) — Antay only, only with Dr. Chow approval

Milk Thistle (Silymarin) extract USD $15–25 / bottle

Classic hepatoprotectant. Protects hepatocytes. Useful if ALT remains elevated at recheck. Request a written prescription from Dr. Chow on June 2 to potentially have it covered by Fetch (must be in Plumb's Handbook).

Standard dose50–100 mg/day for Antay (consult Dr. Chow)

DO NOT start before June 2Wait for vet approval

Chewy · milk thistle for dogs

Zinc (skin-specific) — usually covered by Balance IT

Do not supplement separately if using Balance IT. Excess zinc is toxic to dogs.

How to administer ALL supplements (practical routine)

Golden rule

Supplements always go with food, never on an empty stomach. Food improves absorption of fat-solubles (A, D, E, K, omega-3) and reduces gastric irritation of the others.

Order and timing

Moment	Action	Why
AM with food	Balance IT + Omega-3 + (Vit E for Antay)	Fat-solubles need dietary fat
AM with food + Ketoconazole (Yanay)	Ketoconazole separately: give first, wait 30 min, then food with supplements	Ketoconazole needs acidic pH — supplements don't interfere if separated
PM with food	FortiFlora probiotic (sprinkled on top)	Separated from Ketoconazole by 8–12h · fresh probiotic
Before any new supplement	Start at 50% for 3–5 days	Allows intestinal adaptation, detects intolerances

Tricks if they refuse food with supplements

Mix very thoroughly (especially Balance IT powder)
Add 1 extra tsp of plain yogurt to mask
Warm food slightly to body temperature (not hot)
If rejected: try giving 30 min after a walk (hungrier)
Last resort: pill pocket or cooked salmon to wrap capsules

Medication 1: Oral Ketoconazole (Yanay, 14 days)

Systemic antifungal. Treats Malassezia that topical cannot reach. Potentially hepatotoxic — hence the importance of baseline ALT (part of the rationale for the bloodwork in the Fetch claim). Not prescribed for Antay since his skin issue is mild.

Yanay dose200 mg × 1/2 tablet (100 mg) every 24h, 14 days

When to giveAM with fat-containing meal (improves absorption 50–100%)

Ideal food typeSmall portion with salmon, egg, or olive oil

DO NOT give withAntacids · omeprazole · famotidine · any acid reducer within 2 hours

Side effects to monitorVomiting, diarrhea, lethargy, jaundice (yellow eyes/skin), loss of appetite

If vomits within 1h of doseCall Heartland · DO NOT repeat dose without instruction

StorageRoom temperature · out of reach of children · not in bathroom (humidity)

Note for Fetch insurance claim

The May 19 bloodwork is JUSTIFIED as diagnostic baseline pre-medication for Ketoconazole — primary argument in the claim. Veterinary standard of care requires baseline ALT before initiating Ketoconazole. This is medically necessary, not "preventive screening."

Medication 2: Cortavance spray (Yanay, 7 days)

Topical hydrocortisone aceponate — a controlled steroid for rapid inflammation + pruritus reduction while Ketoconazole + topical antifungal take effect.

Yanay dose1 spray to neck + 1 spray each axilla, BID (AM + PM), 7 days

Day 1 of CortavanceMay 19 or 20 · Day 7 = May 25 or 26 (today or yesterday was the last)

After day 7PAUSE · wait for the June 2 appointment · Dr. Chow will decide whether to continue, stop, or replace

DO NOT apply onBroken skin · wounds · eyes · mouth · genitals

After applicationWait 30 min before Yanay scratches or licks the area · use Elizabethan collar if self-licking

Wash handsImmediately after · absorbable by human skin too

Medication 3: ProHex-4 Mousse (Yanay, 14 days)

Topical antibacterial + antifungal mousse (chlorhexidine + climbazole). Reduces Malassezia + secondary bacterial load. Advantage: leave-on, no rinse.

Yanay dose1–2 pumps to affected areas (neck + shoulder), BID, 14 days

ApplicationMassage gently to penetrate · DO NOT rinse · let air dry · gentle brushing after

Do not combine withOther topicals in the same area same day · wait 4h between different products

Side effects to monitorSkin becomes drier, irritated, or red · if so, call Heartland

Medication 4: Burrows ear drops (Yanay, indefinite)

2% aluminum acetate + 1% hydrocortisone — astringent solution with mild anti-inflammatory. Keeps ears dry, reduces cerumen + inflammation, prevents recurrent otitis.

Yanay dose1/2 dropper in each ear · 2–3×/week · indefinite maintenance

How to apply1) Shake well · 2) hold ear up · 3) instill drops · 4) massage base of ear 30 sec (squelching sound) · 5) let dog shake head · 6) wipe excess with cotton

Do not use ifTympanic membrane perforated (Dr. Chow must verify) · pus or yellow/green discharge (call vet first)

StorageRoom temperature · dark bottle

Expires (current lot)06/20/2026 — use before that date. Request refill in June before expiry.

Medication 5: Simparica Trio (both dogs, monthly, permanent)

Sarolaner + moxidectin + pyrantel chewable. Covers heartworm + 6 tick types + fleas + roundworm + hookworm in a single monthly tablet. Critical given frequent cross-border travel.

Yanay (15.4 kg / 35.2 lb)Simparica Trio 22.1–44 lb BLUE box · 1 chewable/month

Antay (8.9 kg / 19.6 lb)Simparica Trio 11.1–22 lb CARAMEL box · 1 chewable/month

Start dateJune 1, 2026 (per Dr. Chow's plan)

Fixed monthly dayDay 1 of each month · mark calendar · 6 months dispensed (June–November)

How to giveWith or without food · meat-flavored chewable · most dogs eat as treat. If refused, hide in turkey piece

Side effects to monitorVomiting first 2h · tremors · seizures (rare · call vet immediately if it happens)

Feeding schedule

Two meals per day separated by 10–12 hours. Regularity stabilizes glycemia, supports regular elimination, and reduces food anxiety.

Time	Action	Who
7:00–7:30 AM	Short walk (10–15 min) — bladder/bowel	Both
7:30 AM	Ketoconazole tablet (with small piece of cooked salmon or low-fat cheese)	Yanay
8:00 AM	Main breakfast — 50% of daily ration + Balance IT + Omega-3 + Vit E (Antay)	Both
8:15–8:30 AM	Apply Cortavance spray (while active) + ProHex mousse neck/shoulder	Yanay (while active)
12:00–13:00	Main walk (45–60 min)	Both
14:00–15:00	Optional light protein snack (30 g cooked turkey)	Yanay if hungry
18:00 PM	Dinner — remaining 50% of ration + FortiFlora probiotic	Yanay (dinner with probiotic) · Antay normal
18:30 PM	Apply Cortavance second dose + ProHex second application	Yanay (while active)
20:00–21:00	Short evening walk (15–20 min) — final elimination	Both
22:00 PM	Bedtime · quick skin check (10 sec each) · lights out	Both

Full day — visual timeline

7:00 AM

Wake + short walk

15 min walk · bladder empty · stimulate bowel transit

7:30 AM

Yanay's Ketoconazole with fat-bite

Give 1/2 tablet with small piece of cooked salmon or cottage cheese. Wait 30 min before full breakfast.

8:00 AM

Full breakfast both

Yanay: ~450 kcal from recipe + Balance IT + 1 ml Omega-3. Antay: ~360 kcal + Balance IT + 0.5 ml Omega-3 + 100 IU Vit E.

8:30 AM

Yanay topicals

Cortavance spray (1 neck + 1 left axilla + 1 right axilla). ProHex mousse to neck/shoulder (1–2 pumps massaged). Elizabethan collar if prone to licking.

12:00 PM

Main walk

45–60 min · active pace · varied terrain · Antay can run · Yanay steady walk. Apply Nicte Cann Bloqueador Solar before if strong sun.

2:00 PM

Optional snack

If hungry: 30 g cold cooked turkey for Yanay · 15 g for Antay · NEVER commercial snacks with preservatives.

6:00 PM

Dinner

Remaining 50% of recipe. Yanay: add 1 FortiFlora sachet + 1 more ml Omega-3. Antay: 0.5 ml Omega-3 + Balance IT (what wasn't given AM).

6:30 PM

Yanay PM topicals

Cortavance second dose. ProHex second application.

8:30 PM

Evening walk

20 min · calm walk · final elimination · soft street light

10:00 PM

Bedtime check

Quick skin inspection of both (10 sec each). Any new outbreak → photo. Lights out.

Weekly routine

Day	Special action
Monday	Burrows ear drops (1/2 dropper each ear) · weigh Antay and Yanay if scale available
Wednesday	Burrows ear drops (second weekly application)
Thursday	Photo of Yanay's neck, same angle, same lighting (visual tracking)
Friday	Burrows ear drops (third application)
Saturday	Photo of Antay (full skin + interscapular area for comedone tracking)
Sunday	Batch prep 4h (cook food for the week) · check supplements remaining · order refills if needed · review Apple Reminders

Monthly routine

Day of month	Action
Day 1	Simparica Trio both dogs · mark calendar · photo of empty package (tracking)
Day 7	Weigh both dogs · log it · if >5% change, adjust calories
Day 15	Full skin review · photo if changes
Day 28	Verify supplement stock (Balance IT, Omega-3, FortiFlora) · order refills 5–7 days before running out

What to observe and track (daily / weekly / monthly)

Each day

Appetite (ate all, partial, refused)
Energy (low / normal / hyper)
Water intake (approximate ml)
Stool (count, color, consistency 1–7 Bristol)
Urine (color, frequency)
Excessive scratching / licking
New skin outbreaks

Each week

Weight (pet scale or household scale)
Photo of Yanay's neck (same angle)
Photo of Antay's skin (interscapular)
Paw status (Yanay pododermatitis)
Ear wax/dryness (Yanay)
Breath and teeth (plaque, odor)
Average week energy

Each month

Compare photos month-over-month
Weight trend (up/down)
Plan adherence (% days)
Monthly total cost (food + supps + meds)
Review upcoming vet appointments
Verify microchip registration valid

When to call the vet urgently

Call Heartland (905-357-6777) immediately if:

Vomiting 2+ times in 12 hours · or vomit with blood
Bloody or very dark diarrhea
Yellow color in gums, eyes, or skin (jaundice — hepatic emergency)
Extreme lethargy, won't stand, no food or water for 12+ hours
Seizures or uncontrollable tremors
Torn skin with blood or yellow/green pus
Breathing difficulty · persistent cough
Facial swelling / hives (food anaphylaxis)
Blue/purple gums (hypoxia)
Accidental supplement or medication overdose

Call Heartland (non-urgent, but soon):

Skin worsens rather than improves after 7–10 days of treatment
New itching in a different area
Loss of appetite 2–3 days
Significant weight change (more than 5% in a week)
Question about medication or supplement interaction
Any unexpected side effect of treatment

Roadmap — Week 1 (Tue May 26 – Mon Jun 1)

Tue

May 26

Order Balance IT online
Order Nordic Omega-3
Yanay day 8 Ketoconazole
Yanay day 8 ProHex
Cortavance last day

Wed

May 27

No more Cortavance
Continue Keto + ProHex
Burrows ear drops
Photo of Yanay's neck

Thu

May 28

Keto + ProHex
Buy batch ingredients

Fri

May 29

Keto + ProHex
Burrows ear drops
Photo of Antay

Sat

May 30

Keto + ProHex
Receive Balance IT
Receive Nordic Omega

Sun

May 31

Batch cooking 4h
Setup containers
Photo comparison

Mon

Jun 1

Simparica Trio dose 1
Start Omega-3 50%
Last night of Keto

Roadmap — Week 2 (Tue Jun 2 – Mon Jun 8)

Tue

Jun 2

Yanay appt 11 AM
Bring this protocol
Request Rx omega-3, milk thistle
Request treatment letter for Fetch

Wed

Jun 3

Day 1 diet transition: 75% old / 25% new
Omega-3 full dose

Thu

Jun 4

75/25 day 2
Burrows ear drops
Photo of Yanay

Fri

Jun 5

75/25 day 3
Submit Fetch claim (combined May 19 + Jun 2)

Sat

Jun 6

50/50 day 1
Photo of Antay

Sun

Jun 7

50/50 day 2
Weekly batch cooking

Mon

Jun 8

50/50 day 3
Weigh both dogs

Roadmap — Week 3 (Tue Jun 9 – Mon Jun 15)

Tue

Jun 9

25/75 day 1

Wed

Jun 10

25/75 day 2
Burrows ear drops
Photo of Yanay

Thu

Jun 11

25/75 day 3

Fri

Jun 12

100% new diet
Weigh both

Sat

Jun 13

100% day 2
Photo of Antay

Sun

Jun 14

Batch cooking
Weekly review

Mon

Jun 15

Yanay skin review (1 month from start)

Roadmap — Week 4 (Tue Jun 16 – Mon Jun 22)

Tue

Jun 16

100% new diet established

Wed

Jun 17

Burrows ear drops
Photo of Yanay (compare with day 1)

Thu

Jun 18

General observation

Fri

Jun 19

Weigh both
Report month 1 results

Sat

Jun 20

Photo of Antay (4 weeks)

Sun

Jun 21

Batch cooking
Verify supp stock

Mon

Jun 22

Reintroduce chicken in small quantities · observe skin

Protocol v1.0 · compiled May 26, 2026 · based on: Heartland clinical summary May 19, 2026, IDEXX labs May 20, 2026, Fetch policy WAG0544553-02 / WAG0544554-02, veterinary nutrition research for PSPP/Xolo

Update after: June 2 appointment, Antay August ALT recheck, November heartworm recheck