"My Vet said it's a good idea, but should I amputate?"

By: Kimberly Schmidt, DVM, CVA, CVCH, CVFT

(Veterinarian, animal acupuncturist, herbalist and food therapist)

When your dog or cat becomes seriously ill, your veterinarian will always discuss the best treatment options available for them.  Arguably one of the most difficult conversations is regarding limb amputation.

National Specially-abled Pets Day approaches on May 3rd, 2019. This day is set aside to educate the public about caring for disabled pets.  It is also a day to honor the amazing dogs and cats who have braved challenges such as amputation. Although it is a difficult topic, learning about the realities of limb amputation can provide a roadmap for navigating this situation when it presents itself.  I hope this blog helps you to make the best decision for your pet and your family

The “why”?

There are several reasons your veterinarian may recommend amputation for your pet.  For example, Dr. Kim’s own dog was hit by a car when he was 6 months old. His elbow was badly broken and surgical repair was impossible.  To eliminate his pain and provide him the best quality of life, amputation was recommended. Following the surgery he was adopted by Dr. Kim and has done extremely well!  He is now 8 years old and still runs around her yard and plays. She often forgets he has 3 legs.

Limb amputation may also be recommended as a treatment for cancer. Cancer is often an aggressive disease and can be quite painful, even with the best pain medications on board.  

Why would limb amputation be recommended for your pet’s cancer?

1. To completely remove a tumor, in hopes of a cure.

2. To completely relieve pain and discomfort caused by the tumor.

The tough part.

There is no doubt that amputation can remove the source of pain, and can often prolong your pet’s ability to survive.  However in many cases the decision is not a simple one. Many pet parents worry about loss of mobility, a changed appearance and also the cost of surgery. We often think about how we would react if we were to lose an arm or a leg. However we must remember that dogs and cats are not people.  After the initial recovery from surgery, companion animals generally do extremely well with amputation! They can adapt very quickly and learn to navigate their surroundings with ease. Many animals have a dramatic improvement in mood and appetite because they are no longer in pain. We must remember that above all else the goal for our animal friends should be the best quality of life with the least discomfort.  Even still, amputation is a very personal decision. Your decision should always be respected by your family, your friends and your veterinarian.

Survive and thrive.

The ability of dogs and cats to compensate following amputation is amazing. In a survey of American pet owners following the amputation of their pet’s leg, nearly three-quarters saw no change in their pet’s recreational activities and indicated the dog's recovery and adaptation were better than expected.1 Dogs and cats are a lot more resourceful and rebound a lot faster than most people realize.

One look at these videos of Max happily playing with his owner, and Dr. Kim’s dog Beau playing with his flashlight tells the story best.

When we widen our view to what quality of life looks like for our pets, we can see a path forward. To see additional videos and learn more about amputation from the viewpoint of pet families, visit the Tripawds website.

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1.https://www.ncbi.nlm.nih.gov/pubmed/26383755

Prevent Pet Poisoning! How to keep your best friend safe.

At Napa Valley Holistic Vet we want to help keep your pets safe and healthy!  Preventative medicine is a cornerstone of holistic pet care.  We want to help you prevent your best friend from getting sick if at all possible!  In honor of Pet Poison Prevention Week we have put together a guide to help keep your pet safe from common poisons around your house.

First we must say that the ASPCA Animal Poison Control Center does an amazing job.  If you suspect that your pet has eaten something toxic you can call 1-888-426-4435.  24 hours a day, 7 days a week, 365 days a year.  They have veterinarians on staff who can help you decide what you need to do and if you need to take your pet to the veterinarian.  They do charge a $65 consultation fee but it is well worth it and often cheaper than a veterinary visit if it can be avoided!

The Animal Poison Control Center also offers a free mobile app with a wealth of information about different potential pet toxins.  You can access more information on it here .

Another great tool they have is a list of toxic and non-toxic plants for pets!  If you think your furry friend has eaten a plant, just look it up online to see if it could be poisonous.  This is free and easy accessible here. 

The Poison Control Center received 199,000 calls in 2017 alone regarding potential pet poisonings.  This number was up from last year which goes to show that we need to be better educated about keeping our pets safe from these potentially deadly toxins.

If you suspect your pet has ingested a poison you can call the APCC at 1-888-426-4435 to see how serious it is.  However if you know they got something poisonous then you should take them directly to your veterinarian.  The sooner the better because if the ingestion was within 3 hours vomiting can often be induced which will save you lots of money and potentially save your pet’s life.  Your pet may also be given activated charcoal to bind any toxin that remains in the stomach after vomiting so they won’t absorb it.

The top 10 poisonings of 2017 were…..

10. Garden Products - Pets often find fertilizers and compost irresistible.  Fertilizers often cause GI upset and if the compost or fertilizer is moist and growing mold your dog may develop serious tremors from ingesting them.  So it’s best to keep these products where dogs can’t find them and keep your dog inside or confined in a separate area of the yard when you are working in the garden.

9. Plants - Many plants can be very toxic to our furry friends.  Lilies are deadly to cats and Dr. Kim recommends never keeping them in your house if you have a cat.  The same goes for Sago Palms and Oleanders if you have a dog or cat.  If you aren’t sure a plant is safe for your pet you should use the Animal Poison Control Center’s online site to look it up - remember it’s free and can be accessed here. 

8. Rodenticides - These rodent poisons are potentially deadly to dogs and cats.  They should be kept out of reach of pets at all times.  If you suspect your pet has ingested this they should be taken to the veterinarian right away.  

7. Insecticides - Insecticides and herbicides are also potentially toxic.  So it’s best to keep these products where dogs can’t find them and keep your dog inside or confined in a separate area of the yard when you are working in the garden.

6. Household Items - The APCC lists paint, glue, cleaning products and laundry detergent as potential dangers.  Gorilla glue is very toxic to pets because, if ingested, it expands exponentially in the stomach and hardens.  Vomiting cannot be induced and surgery is required to remove the large “ball” that forms.  Very scary!  Also laundry pods are posing a new, potentially fatal danger to pets.  You can read more about this here.

5. Chocolate - This is a very common toxicity with our furry friends, especially dogs.  Dark chocolate and baking chocolate are more toxic than milk chocolate.  In sufficient amounts they can cause GI upset, seizures, cardiac arrhythmias and even death.  If your dog has ingested chocolate you can use the chocolate toxicity calculator here  to see how dangerous the type/amount was.  

4. Veterinary Products - This includes the flavored and chewable medications that we give to our pets for pain relief as well as parasite prevention.  Dogs have been known to eat entire boxes/bottles and can get VERY sick.  Make sure to keep these medications out of reach of your furry friends. 

3. Food - Common toxic food items include chocolate (see above), grapes/raisins/currants, garlic, onions, macadamia nuts, alcohol, unbaked bread dough, alcohol and products containing xylitol.  Any amount of grapes or raisins could be deadly to your dog causing kidney failure if he/she is sensitive.  A small amount of garlic or onion isn’t a big deal in a large pet but if they are cooked down in a dish or concentrated powders are used then we get concerned about blood disorders.  Also if your pet is very small then a small amount could be a big deal.  Xylitol is an artificial sweetener that is very common in gum, toothpaste, candies and sugar free baked goods.  If ingested it can cause low blood sugar and irreversible liver failure so make sure to keep all of these products FAR away from your dogs (check your labels)!

Even a small amount of grapes can cause kidney failure in dogs and we don't know what makes some dogs more sensitive than others!  Better to be safe than sorry!

2. Over-The-Counter Medications - Including but not limited to pain medications (ibuprofen, acetaminophen and naproxen), vitamins, certain herbal supplements, cold and flu medications. Please keep all of these out of your pet’s reach. Most exposures are accidental but some well-meaning owners think many of these are safe to give their pet.  You should always check with your veterinarian prior to giving any OTC medication in your pet.  They can tell you which are safe and if your pet is ok to take them and at what dose.

Ibuprofen and other human pain medications can be safe for us but deadly for our pets!

1. Human Prescriptions - Pain medications, anti-depressants and heart medications are the most common poisonings.  Again most are accidental but some well-meaning owners think these are safe to give their pets.  Please keep all of your prescriptions well out of your pet’s reach and ALWAYS ask your veterinarian before giving any medication to your pet.

Please remember to keep your pets safe this week and every week this year!  And please share this with your friends if you haven't already!  If you have any questions we can always be reached at 707-535-9979 or email Dr. Kim at kschmidt@napaholisticvet.com. 

My Cat Hates the Vet! You can help to make it better.

Do you dread taking your cat to the veterinarian because it is such a stressful experience for you and your feline friend?  We completely understand!  Even Dr. Kim has a kitty who gets upset at the veterinary clinic.  So she is going to tell you some tips and tricks for making your kitty’s experience at the vet a positive one.

Veterinary visits are so important for cats.  Yearly visits are especially important in felines because they are excellent at hiding any problem from you.  They are biologically designed to hide their problems.  So things like tooth infections, intestinal issues, heart disease, arthritis, kidney disease, urinary problems, thyroid disease and lung disease can easily go un-noticed by the most loving and devoted pet parents.  A thorough veterinary exam alone can pick up on so many of these issues in the early stages so we can treat them before they progress to more serious concerns.

The bottom line is that you should be taking your kitty to the vet EVERY YEAR to get an exam, period.  If your vet finds a problem and your kitty needs other tests like bloodwork, urine or imaging (x-rays, ultrasound) it’s even more important to make sure they are happy at the vet!  We want to make sure the visit is calm and serene so keep reading to see what you can do to make it happen!

First, you need to understand that when your cat gets upset at the veterinary hospital it’s only because they are scared.  When they start to hiss, growl, bite or scratch it’s because they are fearful of being hurt and this is the only way they have to protect themselves. All the ideas we will share with you are designed to take their anxiety away as much as possible.  If your kitty arrives happier and the visit is handled in the appropriate way then they won’t need to get upset.

It all starts at home.  We all know this scenario….your cat has a vet appointment so you bring out THE CARRIER.  Then…your cat disappears.  This is the first place that you can help.  Cats are very smart.  They know that the carrier means the vet and the vet is scary.  So how can you help?  Make the carrier part of everyday life.  Dr. Kim keeps her cat’s carrier in her bedroom closet and puts a soft kitty bed inside.  She takes the door off so her cats can go in and out and use it as a hiding and resting place.  That way when it’s time to take them to the clinic, she can put the door back on and they are actually happy to be in the carrier!  This can be done with any carrier but another great product is the Sleepypod® Mobile Pet Bed.  It is a pet bed that easily transforms into a carrier and is even crash tested! Watch the video here! If you are using a carrier you should always put something soft in it like a towel or preferably, your kitty’s favorite bed.

Make this carrier your kitty's regular bed at home!  Vet visits will be a breeze!

The next thing you can do is use kitty pheromones. A mother cat secretes this to help her kittens relax and now you can use it to help your kitty relax!  Feliway® is our favorite pheromone brand.  It can be purchased in a spray or a wipe.  The wipes come in individual packages which may be more convenient for a single visit.  It is very important that you do not use the wipe directly on your kitty!  You should wipe the inside surfaces of the carrier and the pet bed or towel that is placed in the carrier.  They can be purchased here .

Use these pheromone wipes on the inside of the carrier and pet bed inside it!

After you have wiped the carrier with pheromones, put in your cat’s favorite kitty bed (or just change your Sleepypod® into a carrier) then you can actually cover the carrier with a small towel or thin baby blanket.  Using a towel cuts down on visual stimuli that may add to your cat’s stress level.  If the weather is very warm you should skip this step because you don’t want your kitty to overheat in the carrier.

You can even play special music in the car on the way to the vet!  Harp music has been shown to soothe animals and decrease stress.  The music will also help calm you down so you aren’t as stressed!  Dr. Kim thinks Susan Raimond has done lovely work with this and her CDs can be purchased online here .  Many other types of music can be found online for this purpose with a quick google search.

You can call ahead to the veterinarian to make sure that the doctor is running on time.  If the doctor is running a little behind then you can arrive a little later so that you don’t have to wait in the lobby as long.  Upon arrival, ask to be placed into an exam room as soon as possible.  That way your kitty won’t hear the noises in the lobby or smell the other animals that might be there (dogs!).  If you have to wait in the lobby pick a quiet corner away from other people and pets.

Once you get into the exam room Dr. Kim recommends leaving your kitty in the carrier until the nurse or doctor comes in.  Unless of course your kitty is the social type and would prefer exploring!  For most kitties it is much less scary to be in the quiet carrier. 

Ask the nurse and doctor to do as much of the exam and tests IN THE EXAM ROOM and IN THE CARRIER as possible.  With the Sleepypod® and many other carriers you can just take off the top so they don’t have to pull or “dump” your cat out - very stressful!  Also, you should ask to be present if possible.  Staying with your pet can be soothing for them.  However, you should let the nurse and doctor hold your kitty for the exams and tests.  You don’t want to risk a bite or scratch if they do happen to get grouchy.  This is so important for safety.  Many veterinarians are becoming Fear Free® certified.  Dr. Kim is in the process now!  Those veterinarians will already be employing these low stress handling techniques.  They will often use towels to wrap your kitty if bloodwork is needed instead of scruffing your pet.

Look for this logo at the veterinary office you choose!

The last thing we need to comment on is a medication called gabapentin.  If your kitty gets really stressed at the veterinarian despite the above techniques then you should ask your kitty’s doctor to send this home with you and come back a different time.  Gabapentin has been proven as a very safe and effective way to decrease stress in cats at the veterinary clinic when given orally (either in a treat or pilled) at home prior to the visit.  A great clinical trial was just released and can be found here.  Trazodone is another medication that has been used very effectively for this purpose.

Ask your vet for this!

We hope that these tips and tricks have been helpful for you!  As a holistic veterinarian decreasing stress and anxiety is of the utmost importance for Dr. Kim!  This will not only help to improve your kitty’s anxiety but also their health and well-being by allowing a calm and serene yearly veterinary visit!

Dr. Kim regularly does house calls for acupuncture.   These home visits eliminate the stress of the vet clinic but can still make your kitty nervous.  Alot of these techniques can be employed at home visits too such as Feliway®, acupuncture in the pet bed and gabapentin if needed!  To schedule an appointment please call 707-535-9979 today!

I'm Yunity: Medicinal Mushroom for Cancer

An exciting new supplement is now available for treating cancer in dogs!  An extract of the turkey tail mushroom (Coriolus versicolor) has been proven to extend the survival time of dogs with hemangiosarcoma (a highly aggressive, metastatic cancer often involving the liver and spleen and spreading throughout the body).  The most exciting thing is that patients treated with this extract lived longer than currently available chemotherapy protocols!  

In 2012 the University of Pennsylvania performed a study with dogs that had hemangiosarcoma.  This cancer often causes a tumor in the spleen to rupture and bleed, requiring a surgical procedure called a splenectomy.  Following surgery, with typical chemotherapy protocols, dogs have an average survival time of 141-179 days.  In the study with the mushroom extract, WITHOUT any chemotherapy, dogs lived for 199 days!  These results are astounding and extremely exciting for our canine companions!

This mushroom has been used in Chinese medicine for more than 2,000 years.  The compound within this mushroom is called a polysaccharopeptide (PSP). The specific supplement being tested is called I’m Yunity, which has a guaranteed analysis of 38% PSP in each capsule.  

Another great thing about I’m Yunity is that it was extremely safe and well tolerated among all patients in the study.  A very important thing to note is that the dose of I’m Yunity which was most effective was 100mg/kg/day. 

Due to the success of the early study, researchers are currently conducting a study evaluating dogs with hemangiosarcoma treated with I’m-Yunity alone, dogs treated with I’m-Yunity + chemotherapy, or dogs treated with chemotherapy alone. If you know a dog who has recently been diagnosed with hemangiosarcoma and would like more information about joining this study, please contact PennVet’s Clinical Investigation Center directly at (215) 573-0302 or via e-mail at vcic@vet.upenn.edu.

It is also exciting to imagine how effective I’m Yunity may be for other cancers.  More research needs to be done and we are eagerly awaiting results!  For more information and to order I’m Yunity go to www.imyunity.com or www.imyunityfordogs.com. 

Acupuncture and Intervertebral Disc Disease

What is Intervertebral Disc Disease?

Your dog’s spine is made up of a number of bones called vertebrae.  They extend from the base of the skull to the tip of the tail.  Separating each vertebrae are flexible cushions called intervertebral discs.  These discs help the spine to be able to move and bend in many directions.  Each vertebrae has a small tunnel running through it which holds the spinal cord.  The spinal cord connects the brain to the rest of the body.  Because of the anatomy of the spine, the cord passes over each vertebrae and also over the intervertebral discs as it runs down the length of the back.

Due to trauma or age a disc can become weakened and rupture, or herniate, putting pressure on the spinal cord.  This interrupts nerve transmission along the spinal cord and can cause varying effects on a dog’s body.  Most frequently it causes pain, weakness and loss of sensation to the legs.  It can also cause paralysis and urinary dysfunction if the herniation is severe.  Usually this occurs in the rear legs, if the disc herniation is along the back.  If the herniation is in the neck then all four legs can be affected.

Mild disc herniations are typically managed with pain medication or steroids, muscle relaxants and strict rest.  More severe herniations causing paralysis are managed with surgery of the back in order to decompress the disc.

Acupuncture For Disc Disease

Several exciting studies have recently been performed showing that the addition of electroacupuncture can be extremely effective in helping animals with disc herniation make a better recovery.  It can also be very helpful for dogs who would benefit from surgery but who are unable to undergo anesthesia, or whose owner may not be able to afford it.

Electroacupuncture involves inserting tiny acupuncture needles into various locations along the back and legs and connecting pairs of these needles to a mild electric current for varying amounts of time.  This procedure is not painful and in fact releases several endorphins in the brain which relieve pain and promote relaxation.

A 2007 study published in the Journal of the American Veterinary Medical Association compared dogs with disc disease who received standard western medical therapy alone to dogs who also received electroacupuncture.  Dogs in the group receiving electroacupuncture recovered the ability to walk sooner than the dogs that did not receive acupuncture!1A 2010 study published in the same journal looked at dogs with disc disease that needed surgery.  This study showed that electroacupuncture alone was just as effective as surgery in recovering the ability to walk again.2 

In my opinion electroacupuncture IN ADDITION to western medical treatments (pain medication/steroids, rest, muscle relaxants) should be the gold standard of care in treating this condition.  Recovery to function will be much faster for your dog.  And if your dog would benefit from surgery but is unable to undergo anesthesia due to other health issues or you simply cannot afford it then acupuncture is a wonderful option for your dog!

For more information please always feel free to call 707-535-9979 or email us at kschmidt@napaholisticvet.com.  If you are interested in full text PDF documents of the articles below just let me know.

References

1 Hayashi, A.M., Matera J.M., Pinto, A.C. “Evaluation of electroacupuncture treatment for thoracolumbar intervertebral disk disease in dogs” JAVMA Vol. 231, No. 6, September 15, 2007. Pages 913-918.

2 Joaquim, J. G., Luna, S. P., Brondani, J. T., Torelli, S. R., Rahal, S. C., Freitas, F. P. “Comparison of decompressive surgery, electroacupuncture, and decompressive surgery followed by electroacupuncture for the treatment of dogs with intervertebral disk disease with long-standing severe neurologic deficits” JAVMA Vol. 236, No. 11, June 1, 2010. Pages 1225-1229.