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.
Veterinary medicine has raised the quality of care available for our pets and with it, increased the longevity of our furry companions. However, a growing list of geriatric conditions are becoming more common, among them;
Dogs tend to have problems with a low thyroid whereas cats tend to have too much of the thyroid hormone in their system. Either imbalance can cause a cascade of problems and adversely affect their quality of life.The low thyroid levels have caused excessive shedding, obesity( despite eating very little), chronic skin infections and seizures. The high thyroid levels can cause cats to have abnormal heartbeats, lose weight (despite eating ravenously), vocalize loudly at odd hours of the night( hallucinations) and vomit chronically. Both conditions can be treated and ill effects minimized if found early enough during their yearly wellness blood analysis.
Cats and dog are affected a bit differently from heart disease as well. In dogs, the symptoms usually include a non-productive cough, exercise intolerance, abnormally fast breathing, a purplish or grey tongue and generalized weakness. 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.Dogs over 10 years old should be monitored for development of heart issues and their chest auscultated at least every 6 months to intervene early enough before the heart goes into failure. Luckily, there are many holistic nutraceuticals and Chinese herbals used to prevent or slow down heart disease in dogs. 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.
In Chinese medicine the kidneys are the first system to go in a “natural” lifespan they consider if you die of any other issues , you died earlier than what your body could’ve done. There is an early detection test for kidney disease called SDMA and since we have been using it we have been able to intervene an average of 18 months prior to the elevation of kidney enzymes in the blood! The kidneys can be influenced by the diet so we recommend a lower protein diet and supplementation with Amminovast, a blend of antioxidants that heals the kidney tissues. We have also used Aquapuncture with vitamin B12 to manage chronic kidney disease in pets.
4-Degenerative Joint Disease
Arthritis becomes very common in all pets over 7y ears but as it progresses there are bony changes (bone spurs) that turn their joints painful, dry (with reduced range of motion), and swollen. acupuncture, glucosamine and, omega fatty acids supplements along with western medicine pain control medications will help manage these tough cases.
If you pet sits and stares at a spot for hours, finds his/herselve stuck into corners of the room, defecates or urinates inside the house or acts weird, it might mean their cognition is declining. There are herbals and supplements like Neutricks that could help, however, at this point we need to start the discussion about euthanasia.
I will be the guest this Saturday on the Talkin Pets radio show. Please call and enter to win 3 books. We shall talk about my book and answer any questions:)
I recently became certified in Fear Free level 2 training and I did it because I want every patient to feel welcomed at my practice. What is this Fear Free certification about?
A visit to the veterinarian should not be a stressful time for your pet. Stress can decrease the immune response, cause unnecessary traumas and affect future behavior of dogs and cats. There is a new initiative of many veterinarians to create a stress free environment at their hospitals. This is a voluntary animal behavior education and training culminating in a Fear Free Certification.
The advantage of having Fear free certified doctors and technicians is that the pets are able to have a pleasant experience while they get treated. It is safer to treat a happy, calmed animal than it is to treat an anxious, stressed and petrified one. The scared pets are in a defensive frame of mind that can result in injury to them, their owners and the veterinary personnel. We all want pets to have good associations with the vet’s office and we might use some classical behavioral training techniques like desensitization, classic conditioning and counter conditioning.
The main principles of a Fear free visit include a considerate approach, gentle technique and a touch gradient. That means nobody should ever jump on your dog, put a muzzle and then use a harsh restraint. The pet should have a chance to acclimate to the office, the scents and the people they meet. The doctors should use an array of tools to make the visit a pleasant one. Starting with the environment, the office should be clean, not noisy, and soothing scents like lavender or species specific pheromones should be employed. Using treats is essential to asses the level of anxiety, to distract from less pleasant procedures and to offer a positive association for your pet. Sometimes, the Fear free certified doctor will either postpone a treatment or utilize sedation to perform it. The decision of using sedation is for the benefit of your pet because the level of stress and anxiety is too high, or the expected procedure might be too scary or painful in an already petrified animal.
What are the signs of Fear,Anxiety and Stress (FAS)?
In cats obvious behaviors that indicated FAS include hissing and growling but less obvious sigs include dilated pupils, ears to the back,tail flicking, hiding and crouching. Sometimes the cats will “freeze” and the owners think the cats is calmed but in reality he is so scared that he has enter a state of helplessness. In dogs the obvious sigs of FAS are barking, backing away, growling and snarling but less obvious signs may include yawning, panting, fidgeting and refusing treats.
How can you help decrease the FAS before you take your pet to the vet?
Sometimes giving an over the counter calming treat or nutraceutical can help. walking/exercising your dog prior to the appointment can also help. For cats something as simple as spraying the carrier with a calming pheromone and putting a towel over it to decrease the sensory input can make a big difference. There are other ways that owners can work with their Fear free certified veterinarians in order to make the visit a pleasurable or at lest non intimidating experience, just ask them.
I love lecturing and teaching the Advance and Basic Acupuncture classes at Chi Institute in Reddick, FL. This is my alma mater of Traditional Chinese Veterinary Medicine and a place I have come to think as a second home.
My colleagues are always supportive and a great source of inspiration and fellowship. We love sharing our knowledge and sharpening our skills.
Here are Drs. Rosado and Vargo sharing the auditorium with me.
The recent cold weather affects our pets, the Lakeland Ledger interviewed me. Some useful advice in hopes people take their pets indoors!
My latest newspaper column brings in some important reminders for pet owners, click on: