I’m so happy to have aced my osteology, practical and theoretical exams to earn this CVMMP (Certified Veterinary Medical Manipulator practitioner) title!
This modality complements TCVM and helps me really help my patients!
Pet allergies are one of the most common reasons to seek a veterinary care. In dogs, allergies can develop into skin and ear infections that can be hard to treat and extremely uncomfortable for them. Pet owners complain that listening to their pet’s incessant chewing and licking is very upsetting. So, how can you help these itchy, scratchy dogs?
First of all, we must determine if the root of the itch is an allergy or another underlying issue. We do a simple skin scrape and tape test to determine if there are mites, fungus or bacteria in the surface of the skin as well as slightly deeper around the hair follicle. There are many cases of dogs with chronic skin infections that just had Demodectic or Sarcoptic mange! Even fleas can cause dermatitis and allergy symptoms. These are so easy to treat with just certain topical flea products like Bravecto, Nexguard or Advantage Multi, that we insist all patients with “allergies” get treated right away.
Certain cancers can also cause chronic skin ulcers, crusts, and other skin changes. Mast cell tumors could be extremely itchy and could cause a generalized red, itchy skin. I have diagnosed patients with rare nonhealing ulcers as having a paraneoplastic syndrome, in which an internal cancer is manifesting in the skin. Adrenal gland disease could also be a cause for recurrent skin infections and hair loss in both dogs and cats. Deficiency in the production of the Thyroid hormone can also cause hair loss, thickening of the skin and could make the pets more susceptible to getting skin infections.
When it comes to determining if your pet is allergic to something in the environment or something they are eating, a food trial is an inexpensive way to differentiate between those 2 causes. Take into account that for a food trial to be effective, the pet owner must commit to feeding their pet ONLY one kind of diet ( no treats, no table scraps & no cheating) for at least 6-8 weeks. I usually see drastic improvement within 2 weeks of switching the diet to Royal canine hydrolyzed or Wellness Simple Solutions diets. Using food energetics and acupuncture as a way to determine how to treat skin allergies is another option for pet owners interested in the holistic approach. Nutraceuticals that are rich in natural anti-inflammatories and omega fatty acids could be used to improve any skin condition and they could be administered orally or topically (shampoos,leave-on creams, and mousse).
In cases in which the itch-scratch cycle is consuming the pet’s energy and quality of life, there is an injection called Cytopoint that could block those itch receptors and bring much-needed relief that lasts up to 8 weeks. In some cases of deep-seated obsessive compulsive licking behavior, a mild anxiolytic drug could help. In other words, do not despair if your furry companion suffers from allergic skin disease because there are multiple treatment options available. Ask your veterinarian for an in-depth physical examination of your pet’s skin.
When it comes to figuring out if our dog and cat companions are experiencing pain, we often have to look for cues in behavior and changes in physical activity. Even then, some pets have high thresholds for demonstrating that pain, so, we might be missing the opportunity to help lots of dogs and cats feel their best. Thankfully, technology keeps advancing in veterinary medicine and newer equipment like Digital thermal imaging are becoming a staple in diagnosing inflammation and localizing the source of pains in our furry friends.
What is digital thermal imaging? It is simply a digital camera that detects thermal gradients (body temperatures). This gradients represent a physiological map of your pet and can show you specific areas where there are heat and inflammation. We all know that inflammation generates heat and also pain, so with this equipment, we can narrow it down to the root of the pain which in turn means we can focus all our treatments at that area. For example, in my last column I talked about the benefits of cold laser, well, imagine being able to accurately detect the area that needs the laser instead of guessing? The result will be a targeted treatment that provides pain relief. Not only that, you could then take a picture immediately after the treatment and see how it changes the area, meaning you can determine if that modality was successful right away. I wish that my patients could talk and tell me exactly where it hurts and how good they feel afterward, but of course, they can’t. Therefore, having an objective way to measure pain is very valuable to me not just as a veterinarian but specifically as an acupuncturist, massage therapist and spinal manipulator. Even the most skeptic client can have visual proof of how my treatments worked.
Imagine as well the geriatric dog or cat on chronic pain control meds. What if we could have a way to measure how his/her arthritis is progressing under our treatment? With digital thermal imaging, we can schedule a quick recheck to see how the drugs are controlling the inflammation and pain. If we don’t see measurable changes, we can adjust or change medications and prevent further deterioration of those joints and back.
Another advantage of this technology is that the pet owner who is better at visual learning can understand my diagnosis much better when they actually can see where the problem is. This is crucial in order for them to follow my recommendations of care when I say your pet has a disk issue and needs rest. Scientific based technology is not only important for diagnosis but also for accurate, reliable and measurable treatment results. At our practice, we’ve made a commitment to providing the best integrative veterinary care and as such we have incorporated digital thermal imaging in all our geriatric, lameness and acupuncture consults. The results so far point to a win-win solution: clients love the improved understanding and patients are loving getting rid of the pain at last!
Has your dog ever suffered from a lick granuloma? These are skin lesions similar to a nonhealing ulcer that dogs tend to lick obsessively. If so, your veterinarian probably prescribed systemic or topical antibiotics and or steroids. It probably recurred after the treatment was given and you might have needed to use an Elizabethan collar ( aka cone of shame ) or possibly had to bandage the area to deter your pet from chewing, licking and scratching at the site. In the past, I have treated those granulomas with an acupuncture technique called “surround the dragon”, and although they cleared, they tended to recur. It wasn’t until I was doing my training at the Integrative Veterinary Medical Institute (IVMI) that I learned how the location of a lick granuloma can indicate nerve impingement higher in the vertebral spine or a peripheral nerve. This is great news because it means we can now clear lick granulomas without the need for drugs! In addition, there are many other issues we can help using “doggie chiropractics” or better called Veterinary Medical Manipulation (VMM). Many pet owners are surprised to discover that doing motion palpation or adjustments in dogs or cats are a lot gentler than a regular human chiropractic exam.The following are some signs that a manipulation or adjustment could help;
• Abnormal gait or lameness
• Abnormal posture or stance
• Reduced performance or lack of power
• Sitting to one side or “Puppy Sitting” or refusal to lay down in horses
• Reluctance to move, jump or climb stairs
• Discomfort when being groomed
• Neck or back pain
• Geriatric animals- to maintain function and mobility
Physiologically, treating the restriction in the flow of information from that nerve compression will improve the affected joints range of motion, reduce pain, inflammation and muscle tension. This may also result in improved organ function and generalized wellness.
The main contraindications for a VMM are in pets with fractures, pregnancy, Infectious skin disease, spinal lesions that are unstable, and any significant generalized weakness caused by a disease process. VMM is performed by a Doctor of Veterinary Medicine (DVM) trained in this modality. The term Chiropractic comes from the Greek and loosely means to “work with hands” but this term has been appropriated by human practitioners. Therefore the term Medical Manipulation was adopted by veterinarians. Animal Chiropractic care has been steadily growing since the 1980″s. Nowadays, it is a great modality in clinics that practice the holistic or Integrative medicine approach.
In fact, Veterinary Medical Manipulation can be used in conjunction with massage, acupuncture and herbal therapy. Acupuncture and Veterinary Medical Manipulation work synergistically and can provide excellent results. In my experience using the Balance Method Acupuncture technique along with either Massage, Tui-na, Assisi Loop therapy or Cold Laser prior to the manipulation will not just loosen and relax the muscles near the restricted area but will result in less discomfort to the patient. Also, the overall results seem to last a lot longer. Healing without drugs and invasive treatments is a proven possibility for our companion pets.
Over the last years I’ve been extremely proud to be part of twhe teaching family at the Chi institutes in Fl and Costa Rica. I have been able to influence hundreds of students through my instruction of basic and advanced acupuncture as well as my lectures. I recently was asked to be a test instructor and I realized I was heavily invested in the outcome of my students tests. It felt as if with each one of them that passed the practical test it validated the time and effort I dedicated in the teaching of those points. I got to say that although being a teacher was not something I thought I could do, I discovered that it’s something I really enjoy doing!
This is a discussion on alternative pain control modalities and treatments.
Pain is a critical factor in deciding whether your pet has a quality of life or not. However, pain might be a difficult thing for the owners to realize. The top signs of pain include panting, reluctance to exercise, changes in behavior, hiding, crying. I want to focus on how can we control pain without any pharmacological agents? There are multiple new modalities that can be used to control both acute and chronic pain. The importance of this is that painkilling drugs act very well for acute inflammation but when it comes to chronic pain, the side effects of these drugs often times could result in organ damage. How can we then access your pet’s body pharmacy of endogenous neurochemicals involved in healing, and pain control?
The first and most common modality in veterinary medicine is Cold laser therapy. Cold Laser can have pain relieving and also enhanced healing effects. Some of those effects include painkiller, anti-inflammation, anti-swelling, improved circulation, faster wound healing, and enhanced repairing of damaged tendons and ligaments. There is mounting scientific evidence in a myriad of published studies regarding the efficacy and safety of laser therapy. It is due to that evidence that a large number of veterinarians are adding the laser to their pain treatments post surgery and after traumatic injuries.
Transcutaneous Electrical Nerve Stimulation aka Tens units are also being used in animals. They operate on the principle of electrical stimulation of the sensory nerves. This results in pain relief and muscle strengthening.
There are small pads that are placed either above and below the injury or around the joint treated. In long-haired dogs, the spots might need to be shaved for better contact. There is ample research that proves the efficacy of TENS in humans and plenty
of evidence of its mechanism of action. Low-frequency TENS activates µ-opioid receptors in the spinal cord and the brainstem, whereas high-frequency TENS activates d-opioid receptors in the spinal cord and the brainstem making it a great modality for chronic musculoskeletal pain.
Pulsed electromagnetic field (PEMF) therapy is a fairly new modality in the veterinary world. The invention of the
Assisi loop device and the incursion of the German-engineered PEMF device called the BEMER have brought a lot of hope to many veterinarians and pet owners alike. In our practice, we have seen the effects of the Bemer and just added the Assisi loop treatments to our tough acupuncture cases. The premise of this technology is that the electromagnetic waves stimulate microcirculation, the benefits of better blood circulations are plentiful and necessary for optimal health.
In a canine osteoarthritis study comparing a once a day PEMF treatment for 20 days to 5 mg/kg of firocoxib ( a common NSAID) once daily, both groups had significant improvement in pain and functionality during the study. The differences were observed after the treatment ended:. Clinical signs returned for the dogs in the firocoxib group shortly after the therapy ended whereas the beneficial effects of PEMF in both pain relief and functional activity capacity were sustained through the 12-month study!
In my book, Alt-Vet: the revolutionary pet care and longevity solution, I explain that there are three main scientifically proven ways that can explain the physiological effects of acupuncture. First, these acupoints have been found to be conductors of electromagnetic signals. When the acupoint is stimulated with a needle, the signals increase along the pathway and they stimulate the central nervous system (CNS) to release the flow of pain-killing endorphins and immune system cells that aid in healing. These electromagnetic signals can be measured and thus points could be found using modern devices that detect those signals.The second method of action is by activating the Opioid system which tells the brain to release chemicals that ease pain into the CNS. Third, the acupuncture stimulation directly alters the brain chemistry by releasing neurotransmitters and neurohormones that control the body’s blood pressure, blood flow, body temperature and promote sensations of wellbeing.
Acupuncture can be used in most dogs and cats with no ill effects. It can be delivered in multiple ways; needles, electric stimulation, pressure or injecting aqueous substances. The importance is to select the right acupoints that would stimulate the affected areas and send all the chemicals needed for pain control, repair and healing. There are over 20,00 published articles on acupuncture and its efficacy and the evidence continues to accumulate in veterinary medicine related cases.
Massage therapy is an accepted adjunctive treatment for post-surgical and chronic pain cases in humans. In dogs and cats, there are multiple techniques but they are all striving to bring blood supply to the affected muscles. Massage therapy is not petting, there is a therapeutic intent thus knowing pet anatomy is necessary. Pain causes the surrounding tissues and muscles to contract, this contraction, in turn, causes cramps and more pain, which becomes a repetitive cycle. So, an important part of pain control should involve manipulation of those tissues( muscles, tendons, and ligaments) surrounding the affected joints. Certified Canine Massage therapists provide care for post-surgical pain and rehab cases resulting in a faster return to function and speedy healing. Veterinarians trained in Tui Na offer deep medical massages that are similar, yet less aggressive, than veterinary “chiropractors”.
Spinal manipulation is similar to human chiropractic care, the aim is to align the skeleton and muscles in the anatomically correct position which in turn will alleviate pain. Similar to chiropractic modalities it has in common that they all reduce the vertebral subluxation complex by providing motion or force to the fixated or subluxated joint. Basically, veterinarians can palpate the spine and joints and determine if the misalignment is causing nerves to be pinched and cause pain. There are extensive training and experience needed to be an effective pet Spine manipulator and there is credentialed process and organization overseeing these specialists.
Regardless of the modality or device you choose to try for your pet, these are all effective and valid treatments that can be used to manage pain alone or in conjunction with pharmaceuticals and/or surgery.
Heart Disease is one of the top causes of death in people and it is also showing with increasing frequency in animals. Curiously, cats and dogs are affected a bit differently from heart disease.
In dogs, the usual cause of Heart disease is acquired, although there are several congenital issues that tend to appear in specific breeds. One of the top causes of heart disease in older pets is Chronic Valvular disease or Mitral valve disease, both are secondary to the wear and tear of the valves. Another common diagnosis affecting the heart is Dilated Cardiomyopathy, in which the heart muscle is very thin from the enlargement of the chambers and the valves leaking. Pericardial Sac disease, in which the sac around the heart fills with fluids and won’t allow the heart to contract, is another issue.There are several causes of Pericardial disease but the most common I see usually involves a tumor. Most seniors I auscultate start having arrhythmias or detectable murmurs before other main diseases have progressed.
Heart disease symptoms in dogs usually include a non-productive cough, exercise intolerance, abnormally fast breathing, a purplish or grey tongue and generalized weakness. When the Heart really starts to fail you can also see edema, a distended belly, labored breathing, and the pet will stop eating. Of these symptoms, the cough is the one that can worsen the condition and is also a Quality of life marker. In severe cases, I’ve to use intra tracheal injections to stop a cough before I even start treating the heart!
In cats, heart disease is a silent killer: most cats show zero symptoms! (other than a sudden death). In a large number of cats diagnosed with heart disease, the only symptom was vomiting.
How do we diagnose heart disease? Early heart disease might be picked in the wellness blood work and with a specialized test called pro BNP (Brain Natriuretic Peptide) that measures damage to the heart. If the number exceeds the range we can start our diagnostic work to determine the stage or need for intervention BEFORE the symptoms appear or worsen.In our practice, we start by doing chest x-rays to determine if there’s a problem then recommend an echocardiogram to confirm it and in some cases refer to a veterinary cardiologist. Cats can be diagnosed the same way.
Luckily, there are many holistic nutraceuticals and Chinese herbals used to prevent or slow down heart disease in dogs.The antioxidant Coenzyme-Q10 along with Taurine, Carnitine and Hawthorn Berry, can be given as a prevention step as well as an adjuvant to treatment.The Chinese herbal formulas Shen Calmer and Heart Qi tonic can also prove very useful to treat and prevent the Heart disease.
Western medications have advanced to the level of human counterparts and are prolonging the lives of Heart disease pet patients. We use Pimobendan (Vetmedin) in really advanced cases and have seen survival times quadruple, especially when paired with some of the holistic treatments mentioned above. If your pet is diagnosed, ask for options.