Wagging tails

In canines, the ability to express joy and other emotions like fear and alertness rely in part on the movement of the tail. In order to read a dog we must also take into consideration observing the facial muscles for tension, the hair coat up vs down, and the ear position.
We all love to see a dog wagging his/her tail because we assume the dog is happy. In reality, the position of a dog’s tail can communicate alertness and dominance if it is held high and still whereas if it’s high and wagging is happiness and alertness. The faster the wagging is, the more excitement the pooch is feeling. A tail held straight is signaling that the dog is inquisitive and taking the new information in. Most animal lovers correctly interpret a tail held down and between the legs as a sign of fear or submission.

In my practice, I have often discovered that there are physical issues that alter the carriage of the tails. The most common issue is to see a dog that stops wagging and is carrying the tail low when they have anal sacs that are extremely full or infected. This is a very painful issue for the dogs. The anal sacs are at each side of the anus and every time the dogs have a bowel movement it is supposed to scent it with the unique smelly chemical scent and lubricate the passage of feces. If those glands are full they block the passage of stool and they are akin to hemorrhoid pain. The solution to this issue requires firm expression of the sacs and emptying them. Antibiotics and anti-inflammatories might be needed.
Another tail ailment is commonly known as limp tail, Limber tail, or swimmer’s tail. The typical breeds affected are hunting or working breeds like Labradors and Beagles. The medical condition is caudal myopathy and it is often a sequel to prolonged crating or excessive swimming. The tail muscles affected are the Intertransversarius, Ventralis Caudalis, and Coccygeal muscles. The chemistry blood results will show an increase in the muscle enzyme called Creatine Kinase. Oftentimes the radiographs are normal and are used to rule out fractures or disk issues at the Lumbosacral space. I treat with a session or two of acupuncture and Non-steroidal anti-inflammatories. Most recover fully.
The least common tail problems include fractures that happen when doors are closed on tails or stepped on tails. The trauma can result in losing part of all the tail if the circulation is compromised. Also, intervertebral disk disease at the level of sacral and coccygeal vertebrae could result in the inability to move or lift the tail. In a recent case, I discover that morbidly obese dogs could accumulate a fat pad dorsal to the base of the tail that will impede the upward movement and cause the appearance of a limp tail.
Regardless of the cause, a sad tail that isn’t wagging is a sign that your pet is not feeling his/her best. Your veterinarian can really get that tail moving again!

Corona Virus Pandemic and our Pets

The new COVID-19 pandemic has big implications for pet health care. In most states, veterinary clinics are considered essential businesses and therefore most will continue to provide healthcare. However, in the pandemic, we must do our part to flatten the curve and stop any transmission of the Coronavirus.
The Florida Veterinary Medical Association defends the position that veterinarians as essential in part due to the following:
1-” Front-line veterinary practitioners and staff are among the healthcare professionals who provide surveillance for diseases deemed reportable by state and federal governments, including zoonotic diseases, such as rabies, influenza and Lyme disease. They are also responsible for issuing certificates of veterinary inspection that are required for the movement of animals between states and countries, including those entering the food supply.
2-Veterinarians are an integral part of our nation’s food and fiber industries. Veterinary care is critical to ensure that only healthy animals enter the food supply. While primarily housed on farms, food animals are also present in urban areas.
3-Veterinary practices provide medical and surgical care daily for critically ill and injured animals”.

In our county, most animal hospitals have curbside options in which pet owners picking medications, food or dropping off their pets for care can do so from the safety of their car. A team member wearing protective gear will take the pet and information or drop off supplies and the owner can call and pay by phone. There are other measures that clinics like mine have undertaken: splitting their team members into 2 or more groups. The benefit is that if someone on team 1 gets sick, we can easily quarantine that team for a couple of days while we generally disinfect and then get running again with the other teams. Then if we find out it is a positive COVID-19, we can mass quarantine if required or we think it is wise or if we are ordered to close by a public health department. In addition, the appointment schedules are going to be longer, that way the pet owners are put immediately in the examination room while their pet is taken care of. There are going to be drop off appointments available, and the owners can either wait in their cars or go home and communicate by phone with the veterinarian while their pet is treated or examined.
All animal hospitals in Florida are upping up their cleaning and sanitizing protocols making sure each room is thoroughly disinfected in between appointments as well as periodically washing up hands with soap and water. Our teams that come in contact with owners are wearing gloves and masks to be protected. This is uncertain times and we know having your pet healthy, with enough medications and supplies is a concern for caring pet owners. We as veterinarians made an oath to alleviate the suffering of animals, to heal and to preserve the human-animal bond and rest assured we will stand by our promise to be there in this time of need.

My new Podcast is in the works!

Great news for 2020! I am working with Dolphin studios in Winter Haven to create a podcast called the  PET healer. I will be discussing topics on alternative care options for pets. We are hoping to launch it at the end of February…I want to have several episodes ready to go so there is no loss of continuity on the weekly airing schedule.

This year I will also be working with a company from Australia to provide 4 webinars related to How to start a successful TCVM practice. It seems the year of the rat will keep me pretty occupied:)

TCVM has a history…

Traditional Chinese Medicine is a global phenomenon. Traditional and complementary/alternative medicine is widely used in the prevention, diagnosis, and treatment of an extensive range of ailments in humans.​ One-third of the world’s population and over half of the populations of the poorest parts of Asia and Africa do not have regular access to essential drugs.​ In addition, TCM is more affordable, more closely corresponds to the patient’s ideology, and is less paternalistic than allopathic medicine.
The World Health Organization (WHO) listed a number of conditions in which they say acupuncture has been proven effective;
​high and low blood pressure​
chemotherapy-induced nausea and vomiting​
some gastric conditions, including peptic ulcer​
painful periods​
dysentery​
allergic rhinitis​
facial pain​
morning sickness​
rheumatoid arthritis​
sprains​
tennis elbow​
sciatica​
dental pain​
reducing the risk of stroke​
inducing labor​
According to the WHO website, its strategic objectives for 2015-2023: ​
1) building the knowledge base and formulating national policies​
2) strengthening safety, quality, and effectiveness through regulation​
3) promoting universal health coverage by integrating T&CM services and self-health care into national health systems​
In other words: WHO is promoting Integration in Human Medicine and Veterinary medicine needs to follow their example!
When it comes to TCM history, we must start at the cradle of civilization. Most ancient civilizations understood the states of health and disease as a balancing act​. Traditional Chinese medicine has been practiced in China for over 3,000 years. There are ancient needles discovered as stone fossils from 5,000 years ago.​ TCM was developed empirically from clinical experience, and documented in many classical texts. The Yellow Emperor’s Internal Classic (Huang Di Nei Jing: 475–221 BC) systematically documented human structure, physiology, pathology, diagnosis, treatment, and preservation. ​
The famous mummy from the Italian Alps named Otzi is dated from 5,400 years B.C.​ He has over 50 tattoos that coincide with acupuncture points. Interestingly, DNA analysis shows that he suffered from Lyme disease and osteoarthritis. It is fairly logical to suppose he was being treated with acupuncture.
When it comes to Traditional Veterinary Chinese Medicine (TCVM), Bo Le ​is considered to be the father of veterinary acupuncture.​ He was an equine expert that lived 659-621 BC ​ and wrote Bo Le Zhen Jing ​(Bole’s Canon of Veterinary Acupuncture ​). This is one of the first veterinary books ever written.
Research has increased exponentially, especially in the past 15 years. ​
In the U.S. National Library of Medicine PubMed: http://www.ncbi.nlm.nih.gov/pubmed there were over 25,995 acupuncture references (April, 2017) and 406 veterinary references. ​These studies support the effectiveness of acupuncture for many different disorders in many different species.
The use of acupuncture can: Integrate with conventional drugs ​
Reduce the dosages of conventional drugs ​
Reduce the side effects of conventional drugs ​
Reduce the duration of conventional drug treatments ​
Avoid conventional drugs ​
Avoid surgical procedures​
Avoid surgical risks​
Avoid surgical expenses
When it comes to what to expect after treatment, we can see the
effects immediately or within a few days. These effects are cumulative ​
But the patients often need multiple treatments( 5-7are typical) for most disorders. Acute disorders might need to be seen every 2-3 days ​whereas chronic disorders can come in every 1-2 weeks. Maintenance treatments ​are scheduled monthly.
In summary, TCVM can treat conditions untreatable by conventional methods ​and is, therefore, an effective alternative treatment. ​

New Year’s resolutions: be more like your pet!

The New Year brings lots of new beginnings and dreams, but if you were a dog or a cat, what would your New Year’s resolutions be?
Allow me to be Mrs. Doolittle and share the wisdom I’ve learned from my pets ( 3 dogs, 3 cats,1 ferret).

1- To make sure and take time to smell the roses; and the garbage, and the bunny trails and the myriad of sweet aromas everywhere. We are always too busy to take a minute to enjoy what we are doing, to realize the beauty that surrounds us and to just breathe. If you see my dog, Uli, on his morning walks, the first thing he does is to stop, put his nose high up and smell the sweet air. He also checks out imaginary wildlife trails and generally seems to enjoy the walk rather than it being a perfunctory exercise of voiding, he converts it in an exercise on exploring and using the imagination. In this new decade, let us stop our rat race, take time to enjoy the beauty surrounding us. Take a walk, go barefoot in the grass and ground yourself. It is essential for our well being, to ward off depression and to bond fully with our pets, so take the time to turn walking your dog into a mental therapy session.
2- To forget the past wrongdoings and vow to be better. When my cat Texas destroys my computer works by deciding to sit on my keyboard, he takes a second to be upset that I shoo him off my desk and he’ll return 5 minutes later ready to claim my love and attention. Pets live in the moment, they let go of the past and though they learn to avoid behaviors that upset their humans, they do not burden themselves with resentment. If we all learned to be more present, to look forward instead of back into our past, we would be a lot happier. After all, most suffering is created by being hung up in past hurts or rooted in anxiety over future possible outcomes.
3-Learn to be fun and to look for fun. My dogs and cats can turn a paper towel into a tug of war game, or the broom into a game of “catch this moving toy” as I try to sweep the kitchen. Fun activities are everywhere and most are free! They do require that you turn the phone off, share with your loved ones and furkids though. So, let’s use our creativity more, let’s be like our pets and use what we already have and make it our goal to be have fun with it. Your dog or cat doesn’t care what brand of toys you buy them nor how much do they cost, just that you are there playing with them. On the same vein, your loved ones want you to be present, to be fun and to just do something together!
Let’s add being more like my pets as one of our New Year’s resolutions, we’ll all be the happier for it!.

Doggie dementia

Canine Cognitive Dysfunction (CCD) or doggie dementia is an underdiagnosed disease affecting a large segment of our aging pet population.
According to the Washington State University Animal Behavior department, there are four distinct types of CCD.
The first one is Involutive depression, which is similar to chronic depression in humans and it arises from chronic anxieties that were never addressed properly. The pets become frightful, seek hiding places and soil in the house.

The second type is called Dysthymia, in which the senior pet loses feelings in the extremities and becomes lodged into corners or appears to lose coordination and become very clumsy. this type also causes behavioral changes like the dog becoming more aggressive.

The third type is the Hyperaggressive dog. This one causes many pet-human bonds to break and result in euthanasia. This results in a deficiency in serotonin, the dog loses the ability to communicate and is generally impulsive and bite the owners or other dogs if challenged. Oftentimes, there is a brain tumor involved.

The fourth type is the confusional syndrome, which is characterized by a sharp decline in cognitive ability. These dogs can’t learn new tricks and forget the ones they used to know. This form is the closest one to human Alzheimer’s disease.

This condition could be one of those conditions that are actually very responsive to your pet’s diet!

Food therapy can slow down the progression and even prevent doggie
dementia because I have tried it in many of my patients. Cooking for
your senior or supplementing his dog foods with Blood and Qi building
foods will provide much needed extra energy. Cats can also get dementia although it is more common for them to get it in conjunction with
Hyperthyroidism and kidney failure. Therefore, when cats show signs
of senility, the first thing I recommend is a blood panel for a better idea
of the situation. The same concept of feeding Qi rich foods applies to most
of these kitties. Glucosamine is well known for the help with increasing joint fluids and helping arthritis but few people know the value of
adding Kelp to both senior cats and dogs’ diets.
Kelp is a great addition for older pets because it is loaded with Vitamins and Minerals and has iodine to help their thyroid function. It is a
good natural source of Vitamin E, which many believe is a key brain nutrient. To prevent CCD, I recommend starting these supplements at age
7 for large breeds and age 10 for small dog breeds and cats. If your elderly
pet is exhibiting signs of early dementia, supplement with homemade foods and
add vitamin E capsules at a therapeutic dose of 25 IU per pound. I also recommend adding Huperzine A, which has been proven to improve
focus and memory in people, or Ginkgo biloba, which does the same.
The doses of these are empirical and are usually off label use since they
are human-grade supplements. It is best to ask your veterinarian what
dose and frequency they recommend since the strengths and formulas
vary per product. Sadly, there are many disreputable companies selling
useless products so, a veterinarian recommendation is preferable. It is
also important to realize that not all human supplements are safe for pet
consumption.

Cold weather and your pets

The Fall weather finally arrived in Polk County which means its time to review how to keep your pet safe during the cold weather. Thankfully, we do not get snow but it does get chilly and occasionally below freezing in Florida. The concern is that our pets are not well prepared to handle the rare cold weather. It is the duty of pet owners to make sure the pets are not exposed to danger during these cold spells.
Let’s start with clothes; do pets really need them? Certain hairless or thinned coated pets will require to be bundled up when going for a walk. Typically, the less body fat the pet has the worse it can withstand the cold environment. In fact, most dogs really do well to insulate against cold with just their fur so what all pets need is a warm shelter from the wind and rain. A dog house can be filled with straw to insulate and keep outdoor cats and dogs warm. The water supply should be checked against freezing and the water intake monitored closely since many pets dislike drinking cold water. In our practice, we see an increase in urinary blockages during the cold season and it perhaps could be linked to a decrease in water consumption. Signs that your cat or dog has a urinary tract issue include abnormal urination or accidents in the house, small or very large output of urine, red-tinged or dark-colored urine and pain upon urination. Inexpensive pet water fountains can be used to keep the water moving and preventing freezing.
The cold weather also brings in some pain issues to the forefront since many older pets suffer from osteoarthritis that worsens when exposed to the cold temperatures. The pain could be worse if the humidity remains high. Relieving your pet from pain requires a visit to your veterinarian. How would you know if they are experiencing pain? Pets usually pant more, avoid moving much ( not jumping or having difficulty rising), they might eat less and show behavioral changes ( more cranky).
Special attention should be placed on the condition of your dog’s paw pads as they can become very dry during cold weather. If you see cracked pads, it is safe to apply coconut oil or vaseline topically. The fur should be kept brushed and free of mats so that the pets can be insulated properly. Some allergic pets chew on their feet a lot during the winter in Florida because as the grass goes in hibernation a lot of weeds start showing up. Up north, the exposure to salt can really dry up and injure the pads. using pet boots/pad covers can be necessary.
Making sure that your house yard is wildlife proof is important since raccoons and other critters might try to find a shelter from the cold near your house and yard. This makes cold temperatures a factor in increased wildlife-pet encounters. In fact, making sure that your pet has a current rabies vaccine or at least a good protective titer against that deadly disease is an important consideration at this time of the year. Check with your veterinarian how to keep your pet healthy in the cold weather season.

The Big Grain Free Pet Food Controversy

There have been nationwide reports of dogs that developed a type of heart disease called dilated cardiomyopathy (DCM) caused by a nutritional deficiency. Sadly, most of these were pampered dogs eating a boutique type of expensive grain free foods. Many pet owners are heartbroken to realize that in trying to feed the best food quality for their pet, they might’ve ended up harming them. This is not the first time that Taurine deficiency in pet foods have caused widespread alarm. In the mid-1980s the link between Taurine deficient food and DCM in cats was widely publicized and new food recommendations for manufacturers were implemented. What is the truth about the new grain free diet controversy?
In reality, we are in the early stages of active research trying to find the cause. At first blush, a deficiency of Taurine in the diets was blamed. Although several of the affected dogs had a normal Taurine level, they responded to extra Taurine supplementation. Why is Taurine so important? Taurine is an amino acid that dogs, cats, and us humans need to have a healthy heart muscle function. It’s found in the brain, eyes, heart, and muscle, therefore consuming animal products in the diet should provide enough of it. However, Taurine can also be synthesized from two other amino acids – cysteine and methionine. Foods that supply methionine include meats, soy, nuts, and eggs, whereas cysteine can be acquired by eating meat and plant sources ( red peppers, garlic, broccoli, brussels sprout, oats, wheat germ, lentils). According to research published in the Journal of American Veterinary Association, there are other factors affecting the development of DCM including breed predisposition, genetic constituency, and low metabolic rates. Multiple research studies have identified a strong predisposition for DCM on Golden Retrievers and American Cocker Spaniels breeds but all breeds are at risk. There is also a correlation of foods containing chickpeas, lentils and other legumes implicated in these DCM dogs that have normal taurine level yet respond to taurine supplementation. In several studies, homemade diets, raw diets, and vegan diets were also found to be connected to some DCM cases. There is a blood test available for heart function and also for Taurine levels but ultimately a heart ultrasound is the best way to diagnose DCM.
What is a pet owner to do? If you are feeding a home cooked diet, vegan or vegetarian diet, please make sure that the diet is nutritionally balanced. There are man resources we recommend but an easy one is to check your diet at balanceit.com and supplement to correct any deficiencies. In addition, if your food is grain free and your dog is doing well on it, is ok to add carbohydrates like brown rice and corn to them. Alternatively, try supplementing with Taurine. There are multiple sources for dosages and you should ask your veterinarian for a proper dosage but roughly speaking Small dogs would need close to 250mg, midsize dogs 500mg and large breeds 750mg twice daily. Keep informed of new developments in the research of DCM and have your pet checked for heart murmurs and disease at least twice a year.

Itchy Pets can be helped with TCVM!

Spring is in the air and with it comes tons of pollen too! We have been seeing many dogs and cats coming with severe allergies, redness, and itching. Allergies ( aka Atopy) are the usual culprit but can we cure it? Sadly, allergies cannot be cured but can be managed to the point that your pet is enjoying an itch-free life. The relevance of controlling the itch is huge because the main skin lesions and infections actually arise from the self-mutilation from chewing and the re-infection of your dog and cat licking their skin.

There are many drugs that can aid in allergies without having the severe side effects of the commonly used steroids. Apoquel is an example of an immune modulator drug that helps control the itch associated with atopic dermatitis. I recommend Apoquel for all the seasonal allergies but try not to use it year-round. I also like using the injectable treatment Cytopoint because it offers control of itch for 8 weeks without having to pill and with little effect on the immune system. Occasionally, antibiotics might be needed to control the skin infections secondary to the allergies. In our practice, we try an integrated approach to allergies. We strongly encouraged allergy testing because it helps as a guide for their pet owner to avoid the worst allergens or at least provide immunotherapy. This immunotherapy is like a vaccine made of all that your pet is allergic to in hopes it trains the immune system not to overreact to it.
When it comes to holistic alternatives I start with the food. The Gu Qi or energy from the food can really help these chronic allergic dogs and cats and in some dramatic cases completely resolve the skin issues! For example, a very hot, red and itchy dog eating chicken dry food s a recipe for continuing allergy issues! The red “hot dogs” will benefit from eating food with cooling energies like turkey or fish, having watermelon for treats and eating canned diets instead of dry (add moisture). Adding probiotics and using higher quality diets can really help control Atopy. Redirecting the obsessiveness of an itchy dog using exercise ( at least 1 hour a day walk) will calm their minds and help break the OCD licking cycle. Using acupuncture for stimulation of the immune points and calming points can also help control these itchy dogs. The main help for these patients is really looking at the root of the problem and trying to address it using Chinese herbals rather than masking the symptoms. The most common Chinese Herbals I use are all from Jing Tang herbals in Florida and include External Wind for the uncomplicated itchy dog and Damp heat skin for the chronically infected skin of atopic dogs. Even with the Integrative approach, we still have a few resistant cases but we feel better that we have done all that is there to explore medically before condemning them to a sentence of life long medication. Ask you veterinarian for advice on how to help your itchy pet!

How to know if it’s time to let go…

How can you tell if it is time to let your furry friend go to the Rainbow bridge? This is one of the most difficult and heart-wrenching decisions that all pet owners must face. My standard answer is when there is no good quality of life or when the pet is suffering.
The question then morphs into: how can you objectively determine if your pet has enough good life in them?
First, let’s define how a healthy pet should be; alert, moving on its own power, eating and drinking normally, keeping itself groomed, and interacting with others in a normal way. These life activities are given a score of 1-100. Quality of life also takes into account the pain that your furry companion is experiencing so a normal pet should be free of pain. The pain score is then multiplied by 2 because animals hide pain so well that when they actually show it, their quality of life is heavily compromised. Total the numbers for the life activities and subtract the pain totals and you’ll get a quality of life score(QOLS). This QOLS can help your veterinarian to recommend euthanasia or further treatments. It also helps you, the pet owner, to monitor if any lifestyle changes like food changes, supplements or complementary therapies are actually helping your pet feel and act better.
A dog or cat with a QOLS of > 500 is definitively living an excellent life and all efforts should be directed to help overcome the illness they are facing. A QOLS of 400-500 is considered good, 300-400 is moderate and 100-300 is poor. A QOLS of <100 is a sure way to determine euthanasia, which would end their suffering in a humane way.
For very geriatric pets aging can be really difficult to see, there are several ways we can improve the mental acuity and even the activity level of your senior pet. In seniors, the senses are diminishing and although most pets adjust to these changes, some do not. We can help our deaf and poor vision seniors by keeping the furniture and environment constant, avoiding any changes or added stress to their routine. The mental acuity can be improved by adding kelp, vitamin E and omega fatty acids supplements to their diet.
Their activity level is sometimes hindered by their inability to grasp their flooring substrate with their nails. An easy solution is to keep those nails trimmed. If you have tile or wood floors, provide walkways with rugs, so your senior dog can walk confidently. A very easy way to help seniors stand up more smoothly is to put “toe grips” on their nails. These little rubber rings at the base of their nails provide much-needed friction and help them get up and walk straighter. Other medical modalities like acupuncture, massage therapy, food therapy, and laser treatments can change the QOLS for the better. Seek your veterinarian’s advice and use the QOLS to determine what is the best course of action when it comes to your aged or sick companion.