Hip pain is a tricky problem for pets!

When I was in Veterinary school 31 years ago, they taught us in anatomy 101 that the sacroiliac joint was fused and of little importance in locomotion. Fast forward to three years ago when I was training in spinal manipulation at the Integrative Veterinary Medicine Institute and they discussed how important the sacroiliac joint is in locomotion, and its role in pain and gait abnormalities. Needless to say, I was amazed at how traditional medicine differs from the osteopathic perspective.
The sacroiliac joint is composed of the Sacrum, which in dogs and cats is usually 3 fused vertebrae that have 2 sets of large foramina. The Sacrum is like an inverted pyramid in which the wider base articulates with the last lumbar vertebrae (#7) and on either side with two flat bones called the Ilium: that is the sweet sacroiliac joint! The ilium is fused to other bones that make up the pelvis. Therefore, the Ilium interaction with the Sacrum could definitely affect the motion in the hip joints.
So, how can this joint get in trouble? Well, there can be three different chiropractic adjustments based on the displacement of the Ilium and in spinal manipulation of animals we still use those human terms to describe displacement in the sacroilliac joint. The wing of the Ilium could be displaced dorsally (aka posterior) and towards the tail (caudally aka inferior) resulting in that side looking higher than normal (called PI) and causing the surrounding muscles to be very tense. The hip is resistant to be extended and the pet is uncomfortable. In that case a quick manipulation in the opposite direction or cranioventrally will bring immediate relief and will reset the affected muscles. The Ilium can also be stuck ventrally (anterior) and towards the head (superior) which will cause difficulty flexing the hip and cause the muscles to be tense as well ( this is called AS).When we evaluate the pets, we observe them from behind, looking to see if there is a higher or lower side, then test the range of motion to determine if there is a restriction. The third displacement is really the apex or end of the sacrum being displaced to either side and causing friction with the ilium.
I have personally experienced a left PI when I moved quickly to help an acupuncture patient and the awkward angle pushed my sacroiliac joint out of normal position. It was painful and I could barely walk. I used cold laser and acupuncture and it made the pain decrease by 50% but it was only when I went to my chiropractor, Dr. Briggs, and had a simple adjustment that my pain completely disappeared. That experience was invaluable because I now know the importance of diagnosing and treating the sacroiliac joint in our senior pets. The range of motion in your senior dogs and cats might be limited by osteoarthritis as well as the sacroiliac joint displacement. Distinguishing between those issues is a must if we want a quick resolution of pain and return to function.

Take the heat out of those hotspots!

One of the most common issues seen at our practice during these hot months involves skin infections, rashes, and allergies.
One problem, in particular, is extremely painful and uncomfortable for our pet friends; hotspots. A hotspot is an area of acute moist dermatitis with an infection in the skin that often has a purulent discharge, swelling, and redness. This is usually a very painful issue.
These hotspots are progressive and will continue to enlarge if not tended to. They might not be obvious to see because they hide under the fur. Therefore, one of the first things that the pet owner must do is to clip the hairs surrounding the affected area because the hair acts as a scaffold to hold in the pus and bacteria. Once clipped the affected area is usually 2-3 times larger than expected. We get calls of frantic owners swearing that it all started as a mosquito bite-size and now it’s covering half their neck or a large portion of their pet’s body. We believe them because hotspots are a type of allergic response and it does proliferate quickly. Some patients can become extremely ill with a fever, anorexia and start behaving strangely including becoming a bit aggressive. The veterinary treatment aims at stopping the allergic reaction and treating the skin infection while providing pain relief. at our practice we use a multi-modal integrative approach to treatment and include eastern and western approaches. We use antibiotics for a brief 7-10 days. We also use pharmaceuticals to control pain sensations in the brain like Buprenorphine, gabapentin, or tramadol. Shampoo therapy might be used to provide soothing relief to the whole skin and prevent other spots from developing. The injectable drug Cytopoint is often added to block the receptors of itch in the brain and thus stopping the pet from self-mutilating while scratching themselves. The herbal formula Wind toxin is a great herb to stop the itch, nourish the skin, and relieving the allergic response by clearing the heat.
One big consideration we take into account is the location of the hot spot. The skin of your pet is divided into dermatomes, which are areas of the skin that have innervation by a spinal nerve. What does that mean? if your pet has a recurrent hotspot or skin lesion in a particular spot of the legs or body, it could be a manifestation of an impaired nerve in his/her spine! A bad intervertebral disk could be a cause, or maybe damage to the nerve branch. Regardless, when we see a hotspot, we can do motion palpation of the spine to check for any pain or misalignment, then perform an adjustment ( like a chiropractor would do) to correct it. Once the nerve is free and fully functioning the hot spot could heal and stop recurring. remember, this condition is painful but can be easily treated by your veterinarian. Do not let the allergens and humidity of the season get the best of your furry companions,

Does your pet need Vitamin C?

The pandemic has shed some light on the importance of certain vitamins for the wellbeing of our immune systems and now pet owners are interested in the benefits of vitamin supplementation for their pets. The most talked-about vitamin tends to be Vit C which is a water-soluble potent antioxidant found in food. Do dogs really need supplementation? It depends! Most commercial foods meet the minimum requirement of Vitamin C but if you are to use it as a tool for healing, then higher dosages will be needed.

Vitamin C benefits include helping to shorten the flu and cold duration by its antioxidant effects in the blood. In many studies it also helped relax the blood vessels, causing lower blood pressure readings in both humans and animals. Vitamin C plays a role in collagen synthesis thus helping with wound healing and at the same time, it has antihistamine properties that could help alleviate allergies. In addition, Vitamin C has been found to raise the level of certain neurotransmitters implying that it could help battle depression and low energy levels, and fatigue. As if those weren’t enough properties; Vitamin C could help kill cancer cells! There is a lot of studies of Vitamin C’s therapy role in cancer in humans, and many veterinary integrative practitioners are trying to use those scientific findings to treat our pets.
The key for the cancer treatment is to administer an intravenous high dose of vitamin C as a slow infusion. This usually implicates that the pet has an IV catheter and is being hospitalized at least for the day. It could be used as an adjuvant to western oncology by helping minimize the side effects of chemotherapy and radiation. It could also be the primary treatment in cases where the pets are too weak to have chemicals in their bodies. The dosage and frequency of treatment will change according to the severity of the illness as this is a customized treatment. In our practice, we have used it to treat severe cases of pancreatitis and parvovirus because those are inflammatory conditions that cause a lot of oxidative stress. We also use it in Guinea Pigs because it is an essential nutrient and they require daily supplementation or their immune system will not function properly.
Is oral supplementation beneficial for our dogs and cats? In sick pets, supplementing their diets with Vitamin C might be helpful. Is too much C a problem? Usually, it is not a problem because this is a water-soluble vitamin that would be excreted in the urine. However, in some pets prone to having Calcium oxalate bladder stones or crystals, the extra Vitamin C is harmful because the byproduct of Vitamin C is oxalate. The usual dosages for dogs are 125 mg/day for pets under 20lbs, 250mg/day for pets 20-50lbs and 500mg to 1 gram/day for pets over 50lbs.
If your pet is suffering from chronic illness, allergies, or cancer, supplementation with vitamin C might be beneficial. Make sure to ask your veterinarian.

How to manage Arthritic pain holistically

Pain-related arthritis in older dogs and cats is one of the most common conditions we see in our general veterinary practice. Oftentimes these patients are senior pets over 7 years of age but occasionally we see younger dogs with a congenital condition called hip or elbow dysplasia that is causing lameness and pain. The age of the affected furry companions is only a factor in deciding how o take care of them long term. In seniors and geriatric dogs and cats, managing the quality of life is the first priority and we do know that these drugs might cause some harm but the benefit is worth using them on a daily basis. In young dogs and cats, the use of non-steroidal anti-inflammatories (NSAIDs) is great for the short term management of pain but when it comes to long term usage, there are some important factors to consider.
First, these powerful pharmaceuticals could have deleterious side effects including damage to the kidneys and liver. We recommend doing a blood function test for the liver and kidneys every 3-6 months in order to monitor the body’s response to the medication. In some cases, we might need to stop or switch the medications, decrease the dosage, or adjust the frequency of the administration. In some pets, we prescribe special nutraceuticals which are supplements full of antioxidants and amino acids that nourish either the liver or the kidney and elect to continue the NSAIDs. In most patients, we use the NSAIDs as just one way to control pain and therefore add other modalities like a cold laser, acupuncture, spinal manipulation, massage, rehab exercises, and Chinese herbals to control pain. These pets have a lot of years ahead of them and we want to help them fulfill their best life for as long as they can.
Second, unlike the older pets who usually have underlying organ disease making them higher anesthesia risks, these pets could have surgical options worth pursuing in order to fix the issue and diminish the dependence on pharmaceuticals. It is always good to consult with an orthopedic surgeon to see what options are available.  
For pet owners facing taking care of painful arthritic pets, there are holistic options that can make a big difference in their pet’s lives. Recently, my patient Bradley, a sweet 5-year-old Yorkie, had a bad fall from the couch that left him painful and walking sideways (trying to compensate and not moving the back). After radiographs, bloodwork, and cold laser were performed, we elected to do a spinal manipulation and he improved dramatically. He was sent on an NSAID called Meloxicam and a Chinese herbal called Body Sore. Although he is 100% recovered, we will continue the herbal formula and a glucosamine supplement to ward off the onset of arthritis. His owners purchased an Assisi loop device to help control pain as an at-home therapy. There are many options for pain relief, make sure you ask your veterinarian which ones are best for your pet!

Pets are not the best gifts!

The Christmas holiday is not the greatest time to give pets or to incorporate new pets into the family unit. If you plan to give a pet as a gift, there are some steps necessary in order to avoid making a mistake.
First, you must realize that pets are not things, nor unfeeling possessions. They have feelings, and they need care and dedication. Some pets, like birds and reptiles, have very long lifespans. These are not temporary gifts, they are long-term responsibilities and as such, they require that the recipient is committed to providing all that is needed for these beings’ happiness and wellbeing. Second, if you decided to buy the pet, consider including the food, cages, or items necessary for the recipient to have an easier transition into caring for them. A great idea would be to buy pet health insurance! If it is an exotic pet like a guinea pig or lizard, make sure to include a book or magazine that provides advice about the husbandry of those species. Better yet, include a gift certificate to a veterinarian for a quick office visit and opportunity to learn about the proper care of the new pet. Your veterinarian can assess the health of the pet prior to being given away, that way you ensure that you gave away a healthy pet. Also, most breeders and pet shops have policies that require a vet visit within 48 hours of purchase in order to validate their guarantees. Third, you must consider the ability of the recipient to take care of the pet. If you plan to gift pets to children, you must consult with their parents first. Is the recipient able to financially support the care of that new pet addition? Are there other pets in the household that could be affected by bringing in a new pet? Is the lifestyle of that recipient compatible with the kind of pet that you selected? Remember to inquire if the recipient has preferences for a certain trait or qualities in the desired companion and try to match those with your purchased one. The Holiday season can be quite noisy and busy which makes integrating a new pet and socialization a bit more difficult. If you realize that from the pet’s perspective this is a big scary change in circumstances then you’ll have more empathy and perhaps delay getting the pet until after the Holiday. Perhaps a gift certificate to a particular shelter might make more sense, that way you give something in the stocking but the recipient can have the ultimate choice. Lastly, remember to adopt instead of shopping for the pet. There are multiple shelters and purebred rescues that can adopt out wonderful dogs, cats, birds, and other exotics. Several of those shelters include a free month of pet healthcare and a free veterinary visit which makes it a more affordable gift. Wouldn’t you feel better to have saved a life? After all, Christmas is all about opening our hearts to love, family, and friendships.

New Screening test for cancer in pets!

Cancer is one of the leading causes of death in pets here in the USA. The main problem with this disease is that it stays hidden and it is often difficult to get an early diagnosis. Did you know that there is preventative wellness bloodwork that could pick up some markers in the blood that could give us clues that there is a cancerous process going on? When we see the clinical signs like poor appetite, weight loss, lethargy, or changes in routine, it might be far into the development of cancer.
Cancer is an inflammatory condition, it is an exaggerated and chaotic response to chronic tissue damage. Chronic stress and inflammation will create the conditions needed for tumor growths to be stimulated. The pathogens or entities that cause chronic inflammation can include a poor diet, toxins in the environment, bacteria/viruses, and stress. First, they cause damage to the cells and cause transformation at that level, then those cells undergo uncontrolled proliferation and multiply causing the tumors, and lastly, the tumors metastasize to another location. How can we detect the cancer cells at that first stage? In dogs(like in humans), the liver tries to fight the acute inflammation by creating the C-reactive protein. This is a very important early marker (first phase) of inflammation in your pet’s body. In the second phase of proliferation, there is another marker called Thymidine kinase Type 1 or TK1.In a study at the University of Missouri, they concluded that 82% of all cancers were detected 6 months prior to clinical signs and 100% of cancers were detected 4 months prior to clinical signs. Another important finding was that inflammation correlated with a 20% risk of death. They developed a screening test called the Cancer Risk assessment or CRA and recommended to do every 6 months in dogs with familial history of cancer or breeds that are at high risk to get cancer like Golden retrievers and Boxers. I believe this test is also a good screening for cancer relapses in survivors. We are utilizing a canine cancer screening test that adds the Vitamin D and B12 levels in addition to the C-reactive protein and the TK1 levels. Vitamin D has been widely discussed lately as a good way to prevent infection with Covid because the D levels indicate the strength of your immune response. According to a 2015 study by Tufts University, 75% of dogs are Vit D deficient! The signs of deficiency vary but most dogs develop heart or kidney disease and bone issues if deficient. Cobalamin or Vitamin B12 is essential for our pet’s health. It is a needed cofactor in multiple enzyme systems, in blood creation, and in keeping the gut biome healthy. Although we assume all dog foods meet minimum criteria to add these vitamins, most are lost in the food processing and storage. Also, each dog is a unique individual with their needs, and absorption of these will vary. If your pet is a cancer survivor or if you suspect your dog might be at risk of having cancer, ask your veterinarian to run a CRA test today!

The Pet healer Podcast ready to launch!

I have great news! My podcast The pet healer is launching on Anchor and multiple platforms this Wednesday Sep 2nd! I am discussing topics of my book Alt-Vet and hope to add your questions as topics in a future episode. I am also recording the book and will launch it soon. Thanks for helping me spread awareness about alternative medicine!

Old Dog Vestibular Syndrome

One of the most common causes of acute loss of coordination and head tilt in dogs is called the canine idiopathic vestibular syndrome. This is a pretty scary situation for pet owners because their dogs were fine one moment and in the next, they can barely walk!
What causes this vestibular syndrome? Nobody knows but the silver lining is that the patients can respond within 2 weeks and most recover with just a residual gait disturbance or a small lifelong head tilt. The condition is similar to Vertigo in people. My vestibular patients receive acupuncture and usually recover or have dramatically diminished symptoms within 48 hours.
The concerning part of the Vestibular syndrome is that at first glance it is often indistinguishable from other serious conditions like brain tumors, inner ear deep-seated infections, toxicity in the ear membrane, or Brain stroke. Seeking veterinary care immediately is a must, the veterinarian will test your pet’s nerve system and rule out most of these. There is danger in jumping to conclusions and euthanizing a pet that looks like it is in a lot of distress but in my opinion, it is important to wait at least 48 hours to see if the condition is an underlying progressive issue or just vestibular syndrome. The prognosis is definitively worse for those pets suffering from brain tumors since there is not much that medicine can offer to cure them, just to do palliative “hospice” care and maintain quality of life. Ear medications can cause ototoxicity meaning the ear membrane swells in reaction to the drug and causes pain, loss of hearing ( might be reversed), and the loss of balance and head tilt that characterizes vestibular syndrome.Inner Ear infections or polyps can cause the same symptoms.
Treatment of vestibular syndrome often includes supportive therapy such as intravenous fluids and nourishment. It might also require hospitalization until the pet can eat and walk on its own. If your dog is seriously disoriented or stumbles, it may be given a sedative to help it calm down. Cerenia or other nausea medication can help settle the tummy. Dramamine may be beneficial since it is a or motion sickness drug. Antibiotics may be used in cases suspected of having middle or inner ear infections. A short course of steroids might also be beneficial. The Chinese herbal formula Bu Yang Huan Wu is excellent for the treatment of strokes in humans and I have successfully used it for over a decade in the treatment of vestibular disease in dogs and strokes. Aquapuncture using vitamin B12 in the Acupuncture points TH17 and GB20 are local points to the head and they help to quickly move the Qi or energy.
We have seen several cases of older dogs suffering from this vestibular syndrome and the main thing they had in com We are happy to report all made a 100% recovery!mon was bein geriatric pets and having extremely loving and caring pet parents that quickly intervened once they saw them in distress.

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.