kittens

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

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.

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.

Pets are not the best gifts!

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

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.