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Medical Acupuncture

Acupuncture is an ancient healing art that dates back 5,000 years.  Traditional Chinese Medicine doctors discovered centuries ago that the body has an amazing power to heal itself if given the right stimulation. 

Although the benefits of acupuncture have been known for a long time, it is only recently that science has stepped in to prove it.  Medical Acupuncture is an off-shoot of Traditional Chinese Medicine (TCM).  While TCM approaches the body from a more spiritual standpoint, Medical Acupuncture has a Western Medicine approach.  In TCM, body organs are dividing into elements like wood, fire and water.  TCM doctors are taught how diseases of certain organs will offset the balance in the body, leading to a disruption in the normal flow of qi (energy). 

Medical acupuncture is a scientific approach to acupuncture.  It looks at the acupuncture points as a way to access and modify the body's nervous system.  In medical acupuncture, the approach to the patient is to first identify areas of the body that are not functioning properly, and then to stimulate the body's nervous system to promote self-healing.

Medical acupuncture looks to modulate, or influence the nervous system in two different ways; by over-riding painful nerve signals with non-painful ones, and by stimulating the body's own natural pain relieving centers. 

The best way to describe how acupuncture can over-ride a painful nerve signal is with an example.  What do you do if you burn your finger?  You shake it, or put it in your mouth, or put your finger under cold water.  What you are actually doing, is interrupting that painful signal from the burn that is traveling up to your brain.  You instinctually know that you need to provide your nervous system with a different nerve signal when you are in pain.   This is called neuromodulating- using the same nerve pathways that are sending a painful response to now send an innocuous response.  

In the case of the burnt finger- that pain response if very useful.  It makes you pull your finger away from the flame.  Acute pain helps the body prevent further injury.  Chronic pain is a different type of pain. Chronic pain is not useful to the patient, but rather decreases the patient's quality of life.  One of the most common examples of chronic pain in veterinary patients are pets that suffer from arthritis pain.  In this situation, the patient doesn't benefit from his joints constantly telling the brain that they are inflamed and sore. Chronic pain is pain that has lost its useful purpose.

One of the other unfortunate side effects of chronic pain is that the body can get very efficient at sending pain signals to the brain.  Our nervous systems are constantly learning.  When the nervous system "learns" that a part of the body is painful for prolonged periods of time, it lays a pain pathway into the central nervous system.  Now the nervous system can quickly and efficiently let the brain know about the sore spot.  Once a pain pathway is hardwired in, it is difficult to turn off.  Even removing the painful area can't always remove the feeling of pain.  That's why amputees feel phantom pain even after the painful limb is gone.  Acupuncture is a tool that can help us reach in and turn off the deep nerve pathways that are sending painful signals.  

The second layer of pain relief that acupuncture can provide is to stimulate the body's own pain relieving system.  You've likely heard of a "runner's high", when the body releases natural endorphins that make the person have a feeling of elation.  Acupuncture can tap into the system that stimulates endorphins and other natural opioids and pain relieving hormones.  There are centers of the body that have been shown to "link up" to areas of the brain that directly affect this natural pain relieving system. 

Acupuncture is a wonderful tool as a supplement to traditional western medicine.  It is one more way that we as veterinarians can positively affect our patients.  It should be noted, however, that not all patients respond to acupuncture.  Only about 30-40% of veterinary patients will have a noticeable improvement after a treatment.  The typical patient will respond after the first treatment if they are "acupuncture responders".  Most patients are seen weekly for 4 treatments, then as needed after that.  The goal of medical acupuncture is to re-train the nervous system to "tune out" the painful nerve signals and return to a more normal state.  Many patients need to only come in every several months after their initial treatment regimen.

To schedule an appointment, or to talk to our Medical Acupuncturists, Dr. Teresa Hershey or Dr. Catherine Hageman, please call Westgate Pet Clinic at 612-925-1121.   Note, Westgate also offers Traditional Chinese Medicine Acupuncture. To learn more about this approach, click here


Do natural and herbal always mean safe for our pets?

As the use of supplements and alternative therapies continues to rise for our pet population, it's important to consider the safety of our furry family members. While the terms "natural" and "herbal" have a reassuring sound, they are not indicators of either quality or safety in a product or service. Though the Food and Drug Administration (FDA) has recently requested public comment on the use of the term "natural," it is not currently regulated on pet food or supplement labels -- There is no official definition and there are no requirements for making this claim. In fact, there are supplements and therapies that can actually be harmful to pets. herb
Here are just a few examples of natural and/or herbal therapies that can be dangerous for pets:
  • Tea Tree Oil - Application of concentrated tea tree oil to the skin or oral exposure is considered moderately to severely toxic and may be life-threatening to pets. Symptoms include vomiting, weakness, incoordination, seizures, liver toxicity and coma in cats and dogs. Even lower concentrations can cause dermatitis in sensitive individuals. 
  • Garlic and Onion - Ingestion of these foods from the Allium family by dogs or cats can lead to vomiting, diarrhea, collapse and anemia, as well as possible increased bleeding tendencies at surgery.
  • Alpha Lipoic Acid (ALA) - Found in many supplements, ALA can cause hypoglycemia, seizures and liver toxicity in pets at higher doses.
  • Aloe - When ingested, aloe in its various forms can result in vomiting, diarrhea, lethargy and rarely tremors.
  • Ephedra / Ma Huang - Found in some weight loss products and herbal decongestants, this stimulant can cause hyperactivity, racing heart rate, fever, tremors, seizures and death from cardiovascular collapse.
  • White Willow Bark - Typically used for its possible anti-inflammatory effects, this herb contains salicylates which are particularly toxic to cats. It can also have dangerous interactions with anti-inflammatory medications and heart medications that are prescribed to pets.  
  • Pennyroyal Oil - While considered a pest / flea repellant, this oil is extremely toxic to pets if ingested and can cause vomiting, difficulty breathing, liver toxicity and death.
  • Marijuana and Cannabinoids - Ingestion of any formulation and/or inhalation of smoke from marijuana may result in hypothermia, incoordination, seizures, coma and even death. Safe dosing of marijuana and its various formulations has not been determined for cats and dogs.
Even supplements that are generally considered safe can be dangerous when over-consumed by a pet. This is particularly concerning given the number of supplements that are increasingly incorporated into appealing, flavorful treats. Joint supplements for example, when ingested in large quantities, can lead to gastrointestinal upset, liver toxicity and blood sugar regulation problems in pets.
There is also a general lack of regulation and monitoring of supplement health claims, especially for pet-specific products. The Dietary Supplement Health and Education Act of 1994 requires that product labels with claims regarding beneficial health effects also have the statement: "This product is not intended to diagnose, treat, cure, or prevent any disease." However, the FDA and American Veterinary Medical Association (AVMA) have taken the positions that this act does not apply to animals.
Supplement quality and efficacy are not closely regulated either. A label description of ingredients and dosages may vary significantly from the actual dose delivered, and there are risks of supplement contamination with potentially harmful substances. Especially with long term use, product contaminants such as heavy metals may be harmful. Ensuring that a supplement has been tested by an independent laboratory is helpful. 
Listed below are some websites that may be helpful in evaluating supplements, but keep in mind that websites can be fallible and there is variation from batch to batch in the manufacturing of any product:
  • www.fda.gov/Food/DietarySupplements: Maintained by the FDA, this site describes regulation of supplements and reporting of adverse events.
  • Quality-supplements.org: This site by the United States Pharmacopeia (USP) lists human supplements that have met independent testing requirements for quality, potency and safety. USP audits the manufacturing facilities for these supplements as well.
  • Labdoor.comLabdoor is an independent company that tests supplements through an FDA-approved laboratories for label accuracy and contaminants. 
  • Consumerlab.com: This site charges a fee for members to access their reports evaluating primarily human supplements.
Ultimately, your veterinarian can be your partner in helping you assess the need for supplements, as well as safety concerns and potential for interactions. It's important to always inform your veterinarian of all supplements your pet is taking, especially if you're having your pet evaluated for illness or prior to surgery.

Coping with Coprophagia

Is coprophagia your dog’s dirty little secret? If it is, you (and your dog) are not alone. According various estimates, 10-25% of dogs engage in intraspecies coprophagia—that is, they eat their own or other dogs’ feces.  


While in most cases, coprophagia is a behavioral problem, it can also have medical basis.  Medical causes of coprophagia include dietary deficits from inadequate intake or absorption of nutrients and increased appetite caused by different diseases or medications. Dogs receiving adequate calories and being fed diets that are “complete and balanced” according to AAFCO standards, should be receiving the nutrients they need unless they have a disease that prevents them from absorbing and retaining nutrients. Exocrine pancreatic insufficiency (EPI) is one disease in which dogs do not have the enzymes they need to properly digest their food. Despite receiving a diet that is complete and balanced, dogs with EPI will often lose weight, act hungry, and lose nutrients in voluminous stools. Dogs with severe liver disease, intestinal parasites, undertreated diabetes mellitus, and some types of gastrointestinal and kidney disease may also not be able to properly absorb and retain nutrients from their food. These deficits can leave dogs hungry and seeking calories and nutrients from nontraditional food sources (feces). Cushing’s Disease or hyperadrenocorticism can increase a dog’s appetite as can steroids or medications given to control seizures. In some cases, these dogs may eat feces as a way to satisfy their hunger.


In the majority of cases, coprophagia is a behavioral rather than a medical problem. Coprophagia is actually a normal behavior in female dogs with puppies. Good dog mothers will lick at their puppies’ rear ends to stimulate defecation and will consume puppies’ feces to keep the “nest” clean.  It is possible that dogs who aren’t cleaning up after their puppies may also engage in this cleaning behavior. Some researchers propose that eating feces may have had evolutionary benefits. Dogs are omnivores and dogs who scavenged and ate stools of carnivores may gotten some added nutrients with little energy expenditure. Since some intestinal parasites take a few days to reach an infective stage in the environment, eating fresh feces within a dog’s territory may be advantageous to help contain or prevent parasite transmission to members of the pack.


What Should You Do if Your Dog Eats Poo?


If your dog is suddenly eating its own or other dogs’ feces, it is best to consult with your veterinarian to ensure there isn’t a medical cause. A fecal parasite test may be recommended to screen for some intestinal parasites that may be a cause or consequence of your dog’s coprophagia. If any medical causes are identified, they should of course be treated. For the more common behavioral causes, the most effective treatment is behavior modification (training). The best way to prevent coprophagia is to pick up feces promptly and keep dogs on leash or well-supervised when in areas where other dogs’ feces might be present. Teaching dogs to come when called (and rewarded with an edible treat that is more high value than stool) and the commands “leave it” and “drop it” can also be helpful to prevent coprophagia.  Food additives also exist that can be given to the “victim”--the dog whose stool is being eaten--with the idea that it will make the stool distasteful to the coprophagic dog. The problem with these additives is that they aren’t always practical, nor are they very effective. The additives have to be given to the dog whose stool is being eaten (and you can’t give medication to all of the dogs at the dog park!) and have to be given with every meal for a period of time (one product recommends giving it for 20 days). During this time period, the coprophagic dog is allowed to eat feces, which will ideally be unappetizing and stop the behavior. Unfortunately, a recent survey of owners of coprophagic dogs found the overall efficacy of these additives was 0-2% in eliminating coprophagia (Hart et al. 2018).


References available upon request.

Meet Dr. Google

As a veterinarian, every day I see sick patients that have already been diagnosed by Dr. Google with a myriad of conditions.  Some appear reasonable; others, however, are way out in left field.  There was a time when I would dread the words “So I saw on the internet that Fluffy could have [Fill in the blank]”.  My attitude has evolved, however, to where I now relish the opportunity to educate and have an open discussion about that particular patient’s condition.  Moreover, as my clients have become better educated on various topics, I find the discourse between us more engaging and firmly believe this results in better care for my patients.  


I think it is important, however, to keep some things in mind when searching the web for medical information.  Here are some tips to keep in mind when searching the web for veterinary medical advice.  


1. Ensure the advice is from a knowledgeable source. Articles written by licensed veterinarians are the ideal source.  These are often supported by good science and are peer reviewed.  Veterinarians are bound to uphold professional standards and rarely disparage other veterinarians or sources of information.  Moreover, spreading of misinformation can put their license at risk.

2. Check multiple sources. Cross checking multiple quality sources will validate any information you may gather.  This attenuates the risk of falling to a lone wolf that may be spreading false information or rumors.  

3. Be aware of highly emotional articles or those that are derogatory of veterinarians or other professionals. I’m always quite suspicious of articles that will appeal solely to one’s emotional judgment or is derogatory of veterinary professionals.  These articles are not based on sound science or professional standards, and often times end up trying to sell something.  See below.

Heart Murmurs in Dogs

Say you went into the clinic for a physical exam and vaccinations and you were told your dog has a heart murmur.  What does this mean?  A heart murmur is an abnormal sound heard when listening to the heart beat.  Instead of the normal “lub dub” sound, you will hear a “woosh dub”.  The most common reason for this is a leaky heart valve (mitral valve or aortic valve) and the mitral valve which is on the left side of the heart is the most common type.  There are other reasons for a murmur besides a leaky valve:  anemia and thinner blood can create turbulence and a murmur; holes in the heart wall such as with young dogs with inherited heart defects; changes in heart shape and contractility from heart muscle diseases.  Certain breeds have a higher risk of heart murmurs such as the Cavalier King Charles Spaniel, Toy and Miniature Poodle, Schnauzer, Shih Tzu, Cocker Spaniel, and other breeds under 25 pounds adult weight - these are usually due to changes in the valve leaflets due to breed genetics and age.  (Large breeds with murmurs more often have heart muscle diseases and not valve changes, and starting a cardiac work-up is recommended and their diseases and risks will be covered in another article.).  If your dog is otherwise healthy and there is no history of coughing or exercise intolerance, it is not likely the heart murmur is causing a problem yet, so we have some time to do a work-up.  We would recommend chest x-rays to evaluate the heart size and shape and Vertebral Heart Score (VHS).  This gives us a baseline to compare with x-rays in the future.  The VHS helps us see if the heart is enlarging in response to the leaky valve, which lets us know it is time to start medications to help the heart contract better before heart failure starts. Many small breed dogs with heart murmurs develop congestive heart failure (CHF) over time, so yearly or twice a year exams and yearly x-rays are recommended.  Some dogs need to have a cardiac ultrasound (echo) and EKG and blood pressure in addition to radiographs.  Signs of CHF are coughing, breathing rate at rest >40 breaths per minute, gum or tongue color changes from pink (normal)  to violet (abnormal), and exercise intolerance.

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