Posts Tagged ‘herbs’

An Herbal Addendum and Vital Information About Vitamins

March 1, 2010

My most recent blog focused on potential pitfalls associated with treating our pets with medicinal herbs.  As so commonly happens, I received wonderful feedback, and one comment in particular, I would like to share with you.  Dr. Susan Wynn, a much-admired veterinary colleague offered this sage advice, “I think your conclusion is appropriate – if you’re interested in herbs, talk to your vet.  I think you need to go one further, though, since most veterinarians know little about herbs – find a veterinarian who has a special interest in herbal medicine.  Not only are they more aware of interactions and toxicity, recent research and clinical experience, they also take great care to source their products from American companies, some of them organic, that employ knowledgeable formulators. About the PDR recommendation – that will not be as helpful as it is for people only.  Please see Veterinary Herbal Medicine (Elsevier, 2007).  Disclaimer – I’m the first author on it – but it was written to collect the most comprehensive available information on herbs and their use in domestic animals.  There are thousands of references, detailed information on over 100 herbs including known toxicity and interactions, species specific cautions, traditional ethnoveterinary uses and scientific support.”  

Just as many people are giving their herbs to their pets without veterinary supervision, so too are they providing them with supplemental vitamins.  I wish I could tell you that vitamins are perfectly safe to give.  Alas such is not the case and here is why.    Vitamins come in two basic varieties; they are either water soluble or fat soluble. Vitamins B and C are water soluble meaning that any excess in the body is readily eliminated from the body within the urine.  I certainly take an abundance of vitamin C when I feel a cold coming on (thanks to Linus Pauling) with no worries of an overdose.  Not true for vitamins A, D, E, and K.  These are fat soluble vitamins, meaning amounts above and beyond what the body needs cannot be readily eliminated. Rather, the excess is retained within the body’s fat stores which can result in hypervitaminosis (symptoms caused by a vitamin overdose).  For example, too much vitamin A can cause horrendous bony abnormalities and too much vitamin D can wreak havoc on normal calcium metabolism resulting in muscle tremors, gastrointestinal issues, and even kidney failure. 

What’s the bottom line?  As tempting as it is to believe that over the counter herbs and vitamins are safe for any and all living beings, take the time to discuss these products with a trusted veterinarian before you provide them to your beloved pets.

Best wishes to you and your four-legged family members for abundant good health,

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

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Medicinal Herbs: Not to Be Taken (or Given) Lightly

February 23, 2010

As a small animal internist, the majority of my patients are referred by their family veterinarians.  By the time I first examine them, they are usually receiving a laundry list of conventional medications (antibiotics, nonsteroidal antiinflammatories, etc.) and/or complementary medications (herbs, homeopathic remedies).   I’ve always scrutinized the conventional medications on the list because their potential side effects and the ways they might impact my diagnostic and therapeutic planning.  I’ve tended to pay far less attention to the complementary medications because of my impression that these medicinals are unlikely to cause significant harm or interact unfavorably with other things I might prescribe. Well, there will be no more of this “ignorant bliss” for me! Not after reading, “A Review of the Potential Forensic Significance of Traditional Herbal Medicines” from the Journal of Forensic Science (January, 2010).  The author, Roger Byard, M.D. undertook a review of herbal medicines based on their increasing popularity (there has been a steady 10% increase in spending on botanical remedies in the United States) and the fact that access to such products is largely unrestricted- they can be purchased without prescription. Keep in mind that herbs are manufactured and sold without any FDA approval process.

Here are some of Dr. Byard’s comments and findings:

-An analysis of 251 Asian herbal products from stores in California identified arsenic in 36, mercury in 35, and lead in 24. There have been reports of lead poisoning and mercury poisoning in people caused by such contamination.
-Less expensive herbs are sometimes intentionally used to replace those that are more costly. A case is referenced in which an herb designed to promote weight loss was replaced with another. The unfortunate result for the patient was kidney failure.
-Accidental substitution can occur if plants are incorrectly identified or if the name is misinterpreted. Apparently, some traditional herbal preparations have multiple names. To make matters even more confusing, some herbal preparations that are different from one another go by the same name.
– Failure to process fresh herbs correctly can have serious consequences. Processing is designed to clean and preserve the desired material while removing or reducing any unwanted toxic components. The example provided was aconite root, a plant that must be soaked in water and boiled to reduce toxicity. Failure to do this can result in heart rhythm abnormalities and/or heart failure.
-Some herb manufacturers purposefully adulterate their products with drugs presumably to increase their efficacy. Yet no mention of this is made on the packaging. Examples of hidden products found in herbal preparations have included conventional medications to treat pain, inflammation, seizures, heart failure, and asthma.
-Herbal medicines can interact with conventional drugs and other herbs to cause undesirable side effects. For example, St. John’s Wort can decrease the blood level of some medications by impacting how they are metabolized within the liver.
-The American Society of Anesthesiologists has recommended discontinuation of herbal medicines at least two weeks prior to surgery because of their potential for causing complications. Although only eight herbs were identified as being potentially dangerous, they accounted for 50% of all single herb preparations of those sold within the United States. For example, Ginkgo has the potential to increase the risk of hemorrhage and Valerian can exacerbate the sedative effects of anesthetic agents.

Although Dr. Byard’s review is based on findings in human medicine, I have to believe that the general points he makes likely apply to veterinary medicine as well. His review has certainly served as a wake up call for me. If you use herbs, for your pets or yourself, perhaps this information will prompt you to think about things a bit differently as well. What is a practical approach for avoiding the potential pitfalls associated with herbal medications? I encourage you to consider doing the following:

  1. If you are giving herbs to your pet based on your own initiative, schedule an appointment with your vet to discuss and verify that what you are doing is reasonable and safe.
  2. Have a look at the blog I posted in July, 2009 (http://speakingforspot.com/blog/?p=407) called, “The Lowdown on Nutritional Supplements.” It will teach you how to use the ACCLAIM system to evaluate the quality of herbal products.
  3. Pick up a copy of the Physician’s Desk Reference (PDR) for Nonprescription Drugs, Dietary Supplements, and Herbs. It provides information about the indications, contraindications, and warnings for all commonly used herbs. This PDR is readily available via major online book vendors. I will certainly be using my own copy a whole lot more than ever before!

I hope I have not created fear or anxiety by presenting this information. Rather, my goal is to help you become the very best medical advocate possible. Now, like me, you know that herbal medications should not be taken (or given) lightly. If you provide herbs to your pet(s), I would love to hear from you. Please let me know which one(s) you are giving and whether you or your veterinarian initiated this treatment.

Best wishes to you and your four-legged family members for abundant good health.

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

 

Please share this blog with your dog-loving family and friends

Fish Oil (Omega-3 Fatty Acids): a Proven Treatment for Canine Arthritis

January 30, 2010

 I had the good fortune of receiving my veterinary school training at Cornell University.  Part of what made this education so fabulous was that the senior faculty spent a great deal of “face time” with their students.  I have fond memories of a seasoned clinician patiently holding a Dachshund for me while teaching this novice how to collect a blood sample from the jugular vein.  Another taught this city slicker how to collect a milk sample for mastitis testing from the teat of a cow.   A major “take home point” my classmates and I received from these icons in veterinary medicine was, “First, do no harm.”  In other words, before subjecting our patients to diagnostic testing or treatment, we should strive to be as confident as possible that the potential for benefit was far greater than the potential for harm.  “First do no harm” has always been my mantra and is the main reason I try to rely on “evidence based medicine” (facts substantiated by research) rather than anecdotal information to support what I do. 

Unfortunately, there is a paucity of evidence based medicine pertaining to the use of many commonly used supplements, nutraceuticals, and herbs for dogs and cats.  This is the reason a big smile appeared on my face when I opened a recent edition of the Journal of the American Veterinary Medical Association.  It contained two studies on the effects of omega-3 fatty acids (fish oil) for the treatment of osteoarthritis (also known as arthritis or degenerative joint disease) in dogs.  The study designs were excellent in that many dogs were included, there was a control group (some dogs received a placebo rather than the fatty acids), and the observers were “blinded”- neither the veterinarians nor the dogs’ families knew if the dogs were receiving the fatty acids or the placebo.  

Fish Oil (Omega-3 Fatty Acids)Here’s what the studies showed.  Compared to the placebo group, the dogs receiving omega-3 fatty acids had a significantly improved ability to rise from a resting position and play by six weeks after beginning supplementation, and improved ability to walk by 12 weeks.  Additionally, compared to the control group, dogs receiving the fish oil had improved weight bearing on the affected limbs as assessed by force-plate analysis (an extremely humane testing method).  No significant adverse side effects from the fish oil supplementation were reported. 

If you’ve spent any significant amount of time with dogs (especially large dogs), guaranteed you’ve known at least a few with arthritis.  It is estimated to affect up to twenty percent of dogs over one year of age. Dogs with arthritis resemble people with arthritis- they are often stiff and slow to rise when they first get up in the morning, as well as after vigorous exercise.  There are many ways to treat this common canine malady including nonsteroidal anti-inflammatory medications (the equivalent of ibuprofen for humans), acupuncture, rehabilitation therapy, and supplements that increase the production of normal joint fluid.  The effectiveness of all of these modalities, including fish oil, will vary from individual to individual.  The beauty of fish oil is that, likely the only potential significant risk is for you- your dog may develop fish breath! 

I love the fact that veterinarians now have evidence based support for recommending fish oil as a treatment for their canine patients with arthritis, and in doing so, they can abide by the mantra of, “First do no harm.”  If you suspect your dog has arthritis (if you have a large breed dog over eight years of age, chances are that you do), talk with your veterinarian about the pros and cons of all the treatment options.  And the next time you are dining on fish, don’t be surprised if your dog’s nose appears right beside your dinner plate.  Chances are, your dog clearly recognizes the benefits of fish oil supplementation!  Now, pass the salmon please. 

Wishing you and your four-legged family members abundant good health.

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

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