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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

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.

Hip pain is a tricky problem for pets!

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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!

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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,

Relief for Itchy Pets

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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.

Digital Thermal Imaging to visualize Pain

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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!

My journey as a TCVM teacher

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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!

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Alternative Pain Control for Pets

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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.

Affairs of the heart in pets

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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.