Spring is the Wood element season

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Our Florida spring is almost here and beautiful flowers and trees and grasses are synonymous with renewal, lush green growth, rebirth, and pollen. In Traditional Chinese Veterinary medicine (TCVM), Spring is the season of the
Wood Element, which is associated with growth, the color green, the sour taste, the emotion anger, and susceptibility to the External Pathogen Wind. The Liver and its husband, the Gallbladder, are the Zang-
fu organs of the Wood Element. The Spring is definitively when the Liver Meridian is most influenced and so it is vulnerable to imbalances of energy.
Some of the traits of the Wood constitutions include leadership ( like to be in charge), fearlessness,
and dominance. Woods are competitive when they are balanced but very grouchy, aggressive, and destructive if unbalanced. Some notable breeds that have many Wood constitutions include Chihuahuas, Dobermans, German Shepherds, and Rottweilers.
The Liver can also be stressed by drugs like NSAIDS and antibiotics because it is responsible for metabolizing many medications and filtering toxins and bacteria. Liver functions include storing Blood and nourishing
tendons, ligaments, toenails, paw pads, and hooves.
The Liver ensures the smooth flow of Qi and is associated with the eye. When the energy of the Liver Meridian is blocked it is called Liver Qi stagnation. This condition creates internal heat that can manifest in abnormally reactive behavior and/or red eyes or issues with inflammation of the eyes.
Liver Qi Stagnation can also cause digestive problems with Inflammatory bowel disease or chronic otitis externa, foul skin infections, and pododermatitis. If Liver nourishment is not proper, then the tendons, ligaments, nails, and hoofs are brittle and weak.
When the Liver is unbalanced, External Wind can invade and lead to pruritic skin conditions. If the Wind penetrates and becomes internal it can manifest as seizures and tremors.

The treatment of an unstable Wood element is to soothe the Liver energy using acupuncture and herbal formulas. In our practice, we use the Balance method of acupuncture to balance the liver meridian energy which includes using distal points. The most common herbals prescribed in the spring are Liver happy followed by External wind. We see an increase in ligament tears and prescribe other herbal formulas as well. The foods that help nourish the liver include carrots, green apples, turmeric, apple cider vinegar, green algae, celery, aloe, spinach, tomatoes, and egg whites.
We also see an increase in seizure activity due to the internal Wind and the Liver energy imbalance. Using the appropriate herbal and acupuncture we have been able to help many pets control their seizure activity.
If your pet is usually a bossy, dominant one then they are at risk to develop the above issues in the spring season, contact an integrative practitioner to help you find the root cause and soothe that Liver energy. The integrative approach can definitively make springtime a lot more enjoyable for your Woody pets.
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New Year’s resolutions!

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Another New year has started and as usual, we all write down our resolutions. I want all pet owners to include their pet’s well-being in their lists. Here are a couple of important ones that can benefit both humans and their companions:

  • Invest in pet insurance or start a pet health savings plan as the year begins.

The economic outlook this year is a bit scary with rumors of recession and inflation. Therefore having a pet health plan can help you avoid financial issues if your pet is sick or even avoid the unpleasant thought of “economic euthanasia.“ Even healthy pups and cats can have emergencies like toxicities, accidents, fight injuries, and foreign bodies. These are 100 percent treatable but also very expensive if they require hospitalization and surgical intervention. It is much less expensive to prevent a disease than it is to treat it. Some of these healthcare plans will even reimburse some money for yearly blood work and routine dental care. Many pet owners underestimate the power of routine blood work and veterinary care. Finding blood values that might be predisposing factors for disease early enough can completely change the course of the disease. Also, it is a good way to increase the longevity and quality of life of your pet because we act swiftly before any symptoms appear. Don’t procrastinate and miss veterinary exams and visits. If your pet is injured or ill, delaying veterinary attention could actually lead to higher expenses! If you do not find a plan you like, then open an extra savings bank account and make a $50 per paycheck automatic deposit that can build up a reserve for any emergencies or pet care surprises.

  • Start an exercise program that includes your furry friend.

Many pets in the United States are as overweight or obese as their human counterparts. The new year is a great time to make a commitment to lose those extra pounds! This resolution is one of the most popular with humans and should include pets. Studies show that dog owners spend about twice as much time walking each week than non-dog owners. This positive reinforcement can be beneficial for your goals AND help your pet lose weight too! In addition, walking together is a way to strengthen the body with your pet and also release stress. In addition, this activity enriches the dog’s brain and deepens the human-animal bond. Some studies have proven a deeper bond can benefit by boosting oxytocin in both pets and humans.

  • Book regular spa days for both you and your pets.

Looking our best is another popular resolution each year. Why not include your pets? Keeping a pet well-groomed can help prevent skin issues and the associated expense of a veterinarian. Setting a recurrent appointment for your pet will guarantee that your fluffy companion gets the nails clipped, ears cleaned and fur taken care of regularly. It will also serve as a second pair of eyes examining your pet and noticing if there are issues that demand veterinary attention. Happy and healthy 2023 to all my readers.

Dr. Mitsie Vargas is at Orchid Springs Animal Hospital in Winter Haven. She can be reached at drmitsie@gmail.com

Warning about dangerous bird furniture

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As a bird owner, it irks me whenever I shop at my favorite pet store and still see fabric huts/tents/snuggies marketed for birds. Parrot tents have been responsible for more avian injuries and deaths than any other product type sold.
Here are the three reasons why:
1 – Crop impaction
2- Entanglement
3- Hormonal issues (prolapse, chronic egg-laying, etc.)

Crop impaction is not just an issue with fuzzy types of huts. With denim, there is a less likely chance that a bird will pick and chew on them, but either way, any birds subject to these dangerous toys are ingesting microfibers that naturally shed from fabric. Whenever your bird even lightly brushes against the fabric, invisible fibers stick to its feathers, and after the unfortunate bird preens, the fibers are swallowed and collect over time in their gut— until one day, you wake up and find your bird dead at the bottom of their cage and without ever being warned as to why.

Here’s the thing. Denim is treated with chemicals to improve its durability, which means the fibers persist in the environment for a long time, We don’t know exactly what chemicals. That’s proprietary information and it’s hard to know because different chemicals are used for different processes. Researchers at the University of Toronto say they have even found denim microfibers in sediment taken from the Great Lakes!

Human-made microfibers include fibers from natural sources such as cotton and those from synthetic sources such as plastic-based nylon and polyester. One study discovered that used jeans shed about 50,000 microfibers per wash. Please, please don’t take the chance with these products like hundreds of clients have. As cute as they look, it’s not worth the damage they are doing to your birds.

Entanglement happens faster than you think. It can be difficult to see the level of destruction that takes place inside the small openings. Some people opt to continually trim the excess fray from the fabric, but they can’t control what happens when their birds are in their cage unsupervised. Dangerous fraying can occur in a single afternoon.
The stories on the internet of horrific experiences are everywhere. I know that it will be hard to take away something that your bird loves so much, but don’t make the mistake of assuming that because they have not yet begun chewing on the tent, they will not do so in the future, especially when they get “nesty” during a particularly hormone driven breeding season.
It isn’t worth the gamble. The moral of this article is: Don’t buy or use happy huts. There are alternatives: Pvc tubes, seagrass houses or tunnels made from mats, and hanging coconut toys. These all have a bottom, however, which can cause hormonal behavior, so I’d encourage you to DIY or buy the bottomless “SafeCorner” by ‘Furnibirb’ instead.
We need to provide our pet birds with attention, enrichment with toys, a large enough cage that allows for exercising their wings, and a safe area to retreat.

Understanding Chronic pain in Cats

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Chronic pain in cats often goes undetected. Acute pain is easier to detect since it is a drastic change whereas chronic pain happens gradually and the cat and the owners both adapt to those changes. Sadly, there are many misconceptions about how cats express pain and the direct influence that pain has on their behavior. Cats live in the moment, hence, when they experience pain they also develop anxiety and behavioral disorders due to their expectation of living in that state of pain in a continuum. Therefore it is up to us and their loving owners to find out if they are in pain and address it.
One of the common cat health issues we see in practice involves behavioral changes, inappropriate elimination, inter-cat aggression, over-grooming, insomnia, lethargy, decrease appetite, and changes in routine. After a thorough physical exam and performing diagnostic tests like bloodwork and X-rays, we can rule out many conditions and rule in pain as the root of the behavioral issues. All declawed cats eventually develop chronic arthritis and joint pain from the abnormal gait created by the amputation of the third phalanx aka their fingertips. Luckily, declawing is becoming a thing of the past, and many cat advocacy organizations like the American Association of Feline Practitioners are taking a stand against it due to increasing evidence and research on the chronic pain it causes. Other signs of chronic pain include reluctance to jump, and increase hiding. Although osteoarthritis is the most commonly recognized cause of pain, other conditions like bad teeth, interstitial cystitis, ulcers, dermatitis, diabetic neuropathy, pancreatitis, cancer, and IBD can create chronic pain.
Treating Chronic pain and arthritis in cats has always been a challenge due to their sensitivity to medications like NSAIDs. The most popular prescription for pain is gabapentin because a lot of oral, and osteoarthritis pain have a root in neuropathic pain signals. New advances in pharmacology have resulted in better products like Zorbium topical pain control that lasts 4 days. The only FDA-approved NSAID for use in cats is called Onsior and it is a very effective oral pill given for three consecutive days. Another new product that we are super excited to carry is the FDA -approved frunevetmab injection called Solensia, the first monoclonal antibody (mAb) new animal drug approved by the agency for use in any animal species. This is a once-a-month injection given at your veterinarian’s office that will work with your cat’s immune system to reduce the pain signals and it is paving the way into a future with safer pain control for our kitties. Solensia will work after the first injection but most studies revealed the optimal control comes after 3 months. All chronic pain can benefit from this treatment even though it is marketed for cat osteoarthritis.
Of course in our practice, we use the integrative approach which includes acupuncture, laser, and herbal therapy in addition to other pain control medications as needed. Chronic pain management requires a multi-modal approach for a successful outcome.

Post-Ian warning

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Polk County just went through the devastation of hurricane Ian but for pet owners, there are still potential threats to deal with. The excessive rain brought flooding and saturated yards and this provides the best condition for the transmission of bacterial and parasitic diseases. One of the most common threats includes a potentially deadly bacteria called Leptospira.
Leptospirosis is an infection caused by bacteria that is found in soil and water. There are several different strains of Leptospira bacteria that can cause disease. Leptospirosis is a zoonotic disease, which means it can be spread from animals to people. Infection in humans is characterized by flu-like symptoms but it could also cause acute liver or kidney disease. Infection in dogs can happen in multiple ways but it is commonly caused when their mucous membranes or cuts get in contact while drinking from rivers, streams, ponds, and stagnant water in which infected wildlife have urinated. Therefore the severe water-filled backyards in the aftermath of Ian will be acting as giant Petri dishes.
The thing with leptospirosis is that some dogs show mild if any signs of illness, whereas others get critically ill and even die. Cats seem more resistant to actually developing the disease and I haven’t diagnosed feline leptospirosis in almost 30 years in practice.
Symptoms of leptospirosis may include fever, vomiting, diarrhea, loss of appetite, lethargy, and yellowing of the skin and mucous membranes also known as JAUNDICE. It is also common to see affected dogs develop acute kidney failure with or without liver failure. Other less common symptoms include acute pneumonia and acute bleeding disorders characterized by vast amounts of red tinge urine, nosebleeds, or tarry diarrhea. Affected dogs can also accumulate excess fluid in their chest, abdomen, or under the skin. Sadly, all these symptoms could be caused by multiple other conditions and sometimes the diagnosis might be missed. The history of exposure to water sources, as in the aftermath of Ian, will help direct your veterinarian to do the blood test that specifically detects this bacteria and prompt treatment could save your dog’s life. Currently, there are easily available vaccines that effectively prevent leptospirosis and protect dogs for at least 12 months. Annual vaccination is recommended for at-risk dogs, hunting dogs, and lake-loving pups. If your pet has been diagnosed it is important to take precautions in order to avoid human infection. Consider the infected dog’s urine as very infectious and make sure the pets urinate in a secluded place where other pets do not have access. Make sure to follow proper hygiene practices like washing your hands after touching your pet and avoiding any bodily fluids. Make sure to give the life-saving antibiotics as directed by your veterinarian. If you develop any flu-like symptoms, please seek physician care as soon as possible. The best way to prevent this is to keep your pet vaccinated and away from flooded areas. Please ask your veterinarian for more advice on how to keep your pet safe from this disease.

Monkeypox and our pets, what do you need to know?

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Monkeypox is in the news and of course, we have been asked if this disease could pose a threat to our pets. This is a zoonotic disease, which means that it can spread between people and animals. The Monkeypox virus is classified as an Orthopoxvirus. It was first seen in West Africa and it is believed that small mammals like rats maintain and transmit the virus. People can get infected with the virus through direct contact with infected animals, their body parts, and fluids including respiratory secretions, and potentially in urine and feces.
The name of the virus is because symptoms were first observed in non-human primates but in 2003, an
outbreak of monkeypox in domesticated prairie dogs occurred here in America. The origin of this outbreak was shared bedding and caging with a shipment of infected small mammals from West Africa. This led to 47 human cases in 6 states in the United States. Instances of animal-to-
animal and animal-to-person spread can easily occur. In order to stop an outbreak, we must isolate infected people as well as exposed and infected pets. Many people vaccinated with the smallpox virus vaccine seem to have protection against this new threat. However, smallpox was eradicated in 1972, and vaccines were stopped, therefore the newer generations seem at risk.
Monkeypox virus can infect a myriad of mammal species, including monkeys, anteaters, hedgehogs, prairie dogs, squirrels, and dogs. Orthopox viruses have not been found in birds or reptiles yet.
The usual clinical signs in people are rashes and ulcerative lesions, but in animals, there may not be any skin rashes or lesions. Instead, it could manifest as a fever, lethargy, and other nonspecific malaise.
Infected animals can spread the Monkeypox virus to people, and it is possible that people who are infected can spread Monkeypox virus to animals through close contact, including petting, cuddling, kissing, and sharing sleeping areas or food.
Monkeypox virus can be found in the rash caused by monkeypox (scabs, crusts, fluids) and infected bodily fluids, including respiratory secretions, and potentially in urine and feces.
How can you protect your pets from this disease? If you are diagnosed with the Monkeypox virus, please make arrangements for your pets to be taken care of while isolated from you. If it is not possible to send the pets away, then limit physical touch and put a safe distance between you and your pets. Wash your hands often and use personal protective equipment (PPE) when caring for and cleaning up after your pets. In case your pet develops the disease, please quarantine it inside the house for 21 days. Flush the pet’s waste in the toilet so as to not contaminate wildlife. The CDC has an information page with more advice on how to disinfect the house and keep it safe. The silver lining about this disease is that has low mortality and that supportive treatment should help both you and your pets recover. If you have any questions please ask your veterinarian.

Glucosamine can help cats with cystitis

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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

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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!

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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

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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.