Glucosamine can help cats with cystitis

One of the most well-known pet and human supplements is Glucosamine. It has been proven and tested for arthritis and joint inflammation in dogs and cats. In cats, it has been a life saver since there are few safe alternatives and pharmaceuticals that work on painful kitties. Did you know that your senior cat might benefit from glucosamine supplements to aid in preventing feline lower urinary tract disease? In fact, glucosamine helps protect the lining of the bladder as observed in clinical practice.
Feline lower urinary tract disease (FLUTD) is a group of conditions that cause difficulty urinating and could result in a complete blockage of the urethra. Among these conditions are infections, cystitis, urinary stones, and cancer.
Regardless of the cause of FLUTD, the symptoms are similar. The affected cat will continuously visit the litter box, trying to relieve his/her bladder. Sometimes the cats find a way to ask for help by urinating in abnormal places, there may be blood clots or red-tinged urine. Most cats with FLUTD overgroom and pull their fur or lick their urethras frequently. They might also become loud and vocalize in pain while attempting to urinate. A cat exhibiting these symptoms constitutes an emergency and needs to seek veterinary care immediately for diagnosis and treatment. The most serious type of FLUTD is a complete urinary blockage because it could be fatal!. Your veterinarian will diagnose the actual cause of your cat’s problem by performing a urinalysis and a physical examination. Bloodwork will reveal if the kidneys are also involved.

How can glucosamine help? It is naturally in the body and is found in healthy cartilage. As cats age, less glucosamine is produced, and supplementation aids to preserve the surface from wear and tear. Glucosamine supplements are produced either from shellfish or in a laboratory from fermented corn. Most nutraceuticals combine glucosamine with chondroitin because in some human studies they have improved the mucopolysaccharides lining integrity (glucosamine sulfate, sodium hyaluronate, and chondroitin sulfate) and reduced bladder wall inflammation. Other feline-friendly joint formulas add MSM which is a powerful antioxidant that relieves pain, swelling, and inflammation. Another usual complementary natural substance is Hyaluronic Acid which can be found in animal cartilage and synovial fluid. Because glucosamine is safe, it is often prescribed for off-label use for cats that suffer from FLUTD. The only cats that should not use glucosamine are the ones suffering from Diabetes. It might take 4-6 weeks for the full benefits of supplementation to be obvious so this is a preventative measure, not a treatment for an acute issue.

Nutramax Laboratories, manufacturer of Cosequin for Cats, states its product “is the only joint health supplement brand shown effective, safe, and bioavailable in published, controlled U.S. studies.” However, there are multiple products including treats, pills, and powders that include glucosamine. Most can be hidden in some canned food. If your cat has had an episode of FLUTD, consider asking your veterinarian if supplementing with a glucosamine nutraceutical is indicated for the prevention of a recurrence.

Canine Lymphomas



A large number of patients I treat are actually hospice care due to terminal cancer.  These are very emotional cases and end up being some of my dearest patients.  As a matter of fact, it seems that when you get a cancer diagnosis on your pet something amazing happens: people that would never consider acupuncture will open their minds enough to accept it.  Maybe it is because they are desperately trying to save their pets or at least have more time with them. Sometimes the cure is not what alternative medicine will give you, it’s all about the quality of life and pain control. I always tell my clients that what is important is not the number of days that you live on this earth, but the quality of such days.  
Some owners of pets that suffer from cancers like lymphoma choose to try chemotherapy with a veterinary oncologist because the standard protocols seem to increase survival time for that type of cancer. In general, 70-90% of dogs with multicentric lymphoma treated with the standard UW-25 or Chop protocol experience complete or partial remission of their lymphoma, and this is why we recommend trying it. However, there is still a chance that the pet’s bone marrow can get depleted by all the chemicals and the chemotherapy will fail. Other cancers like certain Mast cell tumors do better with surgery and radiation but still might experience side effects similar to the chemotherapy; inappetence, lethargy, and severe diarrhea.
Most cancers have a common core of energy or Qi deficiency, therefore the approach to “heal” is to replenish the Qi, especially the Wei Qi which is the Defensive or Immune system Qi. Integrative medicine practitioners usually recommend feeding a high-quality protein and low carbohydrate whole food diet along with supplements using mushrooms and other anticancer herbs. Even though some oncologists are against doing acupuncture in conjunction with chemotherapy, in our experience acupuncture can definitively help make the chemotherapy more efficient by preserving the appetite, and energy and controlling diarrhea. I am still grieving the loss of our patient Mr. Bradley, a sweet Yorkie that sadly developed multicentric Lymphoma despite being one of the most spoiled and well cared for dogs I know. He underwent several rounds of chemotherapy but his bone marrow could not handle the chemicals and he lost his fight. We need to understand that Canine lymphomas are a diverse group of cancers, and vary tremendously in their prognosis. Some Lymphomas progress as rapidly as Bradley’s while others progress very slowly and respond better to chemotherapy. Even though we are seeing a large increase in lymphoma diagnoses the cause of lymphoma in dogs is still not known. Although several possibilities such as viruses, bacteria, chemical exposure (roundup), and over-vaccination have been studied and discussed, there hasn’t been a direct link to this awful cancer. The main goal of acupuncture is to stimulate the appetite points, stimulate influential points for the immune system, and control diarrhea. I firmly believe that the integrative approach could work along with western medicine to achieve even longer remission times.

March is Pet poison control awareness month!

March is pet poison prevention month and I wanted to remind all the pet lovers out there to be aware of the household poisons that could affect your pets. The majority of the calls to the poison control lines are related to over-the-counter medications mostly accidentally ingested by pets. Most of them are common medications like Tylenol, Ibuprofen, and other pain control medications that the pet owners are using but were left unattended at the reach of those pets. The situation with those non-steroidal anti-inflammatories is that they can cause severe liver and kidney damage because the human dosages are so high and the pets might not have the same enzymes available to break them down safely. Just one Tylenol capsule could kill a cat!! It is super important to keep your medications securely stored away from curious dogs and cats. Other commonly ingested medications like ADHD pills or Blood pressure medications can cause severe cardiac symptoms and need to be neutralized either by inducing vomiting or by administering medications to counter those effects. Last year there were close to 25,000 cases involving pets eating toxic foods including the sweetener Xylitol, grapes, raisins, onions, and garlic. Xylitol is in most sugar-free candy and bubble gum and it will kill pets with acute liver failure. Grapes and raisins are especially toxic to the kidneys and will cause kidney failure depending on the amount ingested. The popularity of chocolate gifts for occasions like Christmas, Valentine’s Day, and Easter also result in accidental chocolate poisoning. The darker the chocolate the deadlier it is. Corn cobs are another food danger because they do not digest or break down in the gut so the dogs that bit big chunks of corn cobs end up having emergency surgery to remove them from the intestines. Something most pet owners do not realize is that dogs and cats are lactose intolerant. Although cow’s milk itself is not really toxic, it is not in the best interest to give it to them. In addition, most dairy products like ice cream and yogurt are full of unhealthy sugars and fat and those could cause your pets to get pancreatitis. Ethanol can cause signs of intoxication including incoordination and collapse therefore, be careful leaving your wine glass or beers unattended!. The severity of the symptoms corresponds to the amount ingested. Another food culprit is Macadamian nuts. The symptoms of macadamia nut poisoning are similar to any pancreatitis case; vomiting, anorexia, and weakness. However, we see tremors and Central Nervous System signs as well. The toxin is not well known but keep your pups away from these nuts.
There are many ways to secure your foodstuffs and medications but if your pet is naughty and ingests some of those then call your nearest veterinarian immediately. In most cases inducing vomiting is all it takes but in others, activated charcoal, intravenous fluids, and other medications might be necessary. The ASPCA Animal Poison Control Center (APCC) is your best resource for any animal poison-related emergency, 24 hours a day, 365 days a year. If you think your pet may have ingested a potentially poisonous substance, call (888) 426-4435. A consultation fee may apply.

Shen or spirit disturbance in a kitty

Anxiety is a common disorder seen in practice that has serious implications for the human-animal bond. One of the leading reasons that dogs and cats are relinquished to shelters is due to behavioral issues including destructive behaviors. It is important to use the integrative approach to strive to salvage the human-animal bond and improve the quality of life of the affected pets.
In general, anxious dogs exhibit the following symptoms; Visual body signals like a tucked tail, self-licking and biting, diarrhea, escape behavior, hiding, reduced activity, trembling, and nervousness.

Traditional Chinese Veterinary Medicine (TCVM) classifies anxiety as a Shen disturbance. Shen could be translated as Mind or Spirit and this energy resides in the Heart meridian(energy pathway) and is considered part of our consciousness. In Traditional Chinese medicine for humans, Shen disturbance is generally due to Qi and blood deficiency, emotional trauma, and fire in the Liver meridian. The TCVM approach to diagnosing anxiety includes a good physical exam and palpation of special points in the spine. In addition, taking a good history and asking the time of day where symptoms seem worse helps in finding which meridian is affected. The physical signs we often find include a thin, fast pulse, a red, dry tongue, restlessness or nervousness, and insomnia. For example, a dog that starts restlessness after dark could be suffering from global Yin deficiency because the night belongs to Yin whereas the day belongs to the Yang energy. A dog that consistently wakes its owner between 1 am to 3 am could be manifesting Liver Qi stagnation because those hours are where the Liver meridian energy dominates.The constitution of the patient is a big clue as to the root of anxiety. The Water (shy), Wood (dominant), and Fire(friendly and hyper) constitutions are at high risk of developing Shen disturbances when unbalanced.

The best way to demonstrate the positive effect of acupuncture is to share a recent case. Medes is a 5 years old neutered domestic shorthaired cat that came to visit us due to excessive grooming on his belly to the point of self-mutilation! he was also hiding, and being distant for about 3 months. There were outdoor strays coming outside to the house and also a new kitten in the household which caused a lot of stress and perceived fears. His physical exam was unremarkable except for the eosinophilic granuloma and alopecia on his ventral abdomen.
Medes is an affectionate vocal cat which in TCVM is considered a trait of a Fire element personality. His tongue was red and thin, his ears were hot and his left pulse was weaker. A diagnosis of Heart Yin Deficiency with Shen disturbance and Liver Qi stagnation was made. Balance Acupuncture was done using vitamin B 12 subcutaneous injections. The Chinese herbal formula Shen calmer powder was prescribed, 1 small scoop in the food once daily. After just one session Medes was doing great and quit self-mutilating. The owner was impressed, and Medes was enjoying interacting with the family, even with the little kitten.

Chocolate and dogs do not mix!

 Valentine’s Day is around the corner and every retail store is brimming with all kinds of chocolate-inspired candies and gifts. This is a dangerous season for pet owners because your dog is going to be extremely attracted to the chocolate aroma.  Accidental ingestion of chocolate by dogs can result in serious consequences including severe vomiting and diarrhea, seizures, and death. The severity depends on the concentration of the active ingredient theobromine. The darker the chocolate the more lethal it is. The smaller dogs are at higher risk as the minimum dose is 20mg per kilogram body weight. at that dose, the symptoms of toxicity are milder and mostly related to the gastrointestinal system. In higher doses of 40 mg per kilogram, the effects involve the heart system and in even higher doses over 60mg/kg the nervous system is involved. Imagine chocolate as having the same effect in dogs as amphetamines have in humans! Therefore, special consideration is given to the kind of chocolate ingested. Luckily, there are many sugary, milk-laden, and processed chocolate candies that only have 5-10% of real cacao. The baking chocolate, however, has the strongest concentration of theobromine.  If your pet ingests chocolate, try to contact the nearest veterinarian and bring your pet for induction of vomiting. Most pets ingest the chocolate with the wrappers, and most chocolates are dense and harder to digest. Therefore on any ingestion within 1-1.5 hours is worth to try inducing vomiting in order to remove most of the toxic material. In our practice, we use special drops that induce vomiting almost instantaneously. The funny thing is that the vomit often smells and looks like chocolate pudding.  Then we give supportive treatments with fluids and anti-vomiting medications to settle their stomachs. The vast majority of patients make a full recovery. In the case of dogs that have ingested the chocolate past that time frame, the best is to take your pet for supportive treatments and to get auscultated to see if they are experiencing any tachycardia ( fast heart rate). Medications to suppress the symptoms will be administered and a baseline chemistry blood analysis can help monitor the progression of the toxicity. Take the wrapper or information of the product so that the veterinary staff can make the calculations and adjust treatment based on the weight of your pet and the concentration of theobromine. My granddog Pluto sneakily stole a chocolate bar from our pantry. he woke us up at 3 am vomiting and acting painful. He ate a bar that was  85% pure cacao and even though he is 50 lbs, the concentration was above 20mg/kg. Thankfully, my two pugs did not partake in the mischief because they could’ve easily died. The moral of the story is never underestimate your pet’s obsession with sweets. The only time I willingly give chocolate to dogs is at the time of euthanasia. I keep a jar full of Hershey’s kisses for them to try because I want them to get away with eating the forbidden treat at least once in their lives.

Holiday & Pets thoughts…

The Christmas holiday is not the greatest time to give pets or to incorporate new pets into the family unit yet millions of puppies will be acquired as gifts. What many fail to realize is that 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. If you are planning to still get a puppy or kitten this Christmas, then you need to read the following safety advice to make sure you will avoid a costly emergency visit;

• Use pet-proof decorations

Buy shatter-proof tree decorations that are safe for toddlers and pets alike. Although tinsel is still a popular choice, it has no place in a pet owner’s home. The reason is that cats (and some dogs) are magnetically attracted to tinsel, they love to eat it and it causes life-threatening blockages in the GI tract. This issue is resolved only by a surgical intervention that can cost thousands of dollars, especially if it’s in an after-hours emergency situation. Beware of holiday plant arrangements. Lilies and poinsettias can be very toxic or fatal if chewed on or ingested. The electric lights can pose a danger if chewed so use cable coverings or good old duct tape to secure them and protect them from pets.

• Keep the pets away from the Christmas tree

The tree is another trouble magnet when you have pets. Cats can climb the tree and get tangled up and injured. They could topple the tree also. I recommend a wall anchoring system that secures the tree to avoid toppling. Alternatively, place furniture around it so that if toppled, it would only lean into it rather than squash your pets. The tree water is another danger, it can cause GI upset and diarrhea if ingested.

• Do a winter vet check-up

Cold weather is a stressor on our pets. Many underlying conditions may be exacerbated and you need to pay attention to the signs. If your pet is stiff or panting more (arthritic pain), shedding excessively (low thyroid), drinking more (kidney disease or diabetes), it might be time to do a winter blood work check-up.

• Prepare your pooch for the fireworks, noisy reunions, and visitors

Load up on over-the-counter calming products. There are so many options like Zylkene, Composure treats, and DAP pheromones. There are also storm capes that help with noise phobias from fireworks so buy ahead. Keep your pets indoors and play some soothing background music to defuse the loud sounds.

• Beware of holiday feast table scraps

I’ve said it a thousand times: fatty and spicy table scraps can really hurt your pet regardless of the amount given. If your pet develops pancreatitis, it is a life-threatening condition and very expensive to treat. Play it safe by telling all your guests to refrain from feeding your pets any table foods. Secure your trash, all those smells will be very tempting to your dogs.

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!