Posts Tagged ‘rehabilitation therapy’

The challenges of combining Eastern and Western medicine for your pets

June 6, 2011

Choosing a veterinarian who practices Western medicine (conventional medicine/allopathy) or one who practices Eastern medicine (alternative/complementary medicine) is fairly straightforward.  Successfully combining the best of both medical worlds however can be challenging.  Speaking for Spot fan, Carolyn recently sent me an email based on her experiences:

Hello Dr. Nancy! My question has to do with both holistic and conventional medicine for our dogs. I try to do everything as “green and natural” as possible for my dog: home-made food & treats, non-toxic cleaning products, natural materials in beds and toys … you get the idea. I think supplements and holistic treatments have their place and often are very valuable in maintaining health and even in treating illness. That said, I believe conventional veterinary medicine is valuable too. My conventional vet is great … but she does roll her eyes when I discuss a holistic approach. So how does one balance both therapy options for their dog? Are there any vets who practice both holistic and conventional veterinary medicine, that have a more diverse toolbox so to speak? I sort of feel that I have a foot in both camps and I’m not sure my dog is well served by one approach over the other.

Here’s how I responded to Carolyn. By the way Maggie, the insanely adorable cotton ball flying over the hedge in the accompanying photo is Carolyn’s lucky companion.

Hi Carolyn. How nice to hear from you. Please give Maggie a treat from me! You are correct.  It can be difficult to find a veterinarian who practices Western medicine and supports referral for complementary medicine, and vice versa.  Truthfully, it is difficult for a veterinarian to be extremely well versed in both disciplines (hard enough staying truly proficient in just one of them).  There are a few veterinarians who do a great job with both, but they are few and far between.  Western medicine is the discipline predominantly taught in veterinary schools throughout the United States.  Proficiency in complementary modalities including Chinese herbs, homeopathy, and acupuncture requires additional training and certification.

What can you do to avoid having your veterinarian roll his or her eyes at you? As you know, I am a big believer in picking and choosing your veterinarians wisely. Certainly, open-mindedness is an important trait in any doctor, whether providing service for us or for our beloved pets.  The “ideal vet” is happy to have you work with other veterinarians so that your pets receive the care that is best for your peace of mind.  Just as most of us have a number of doctors for our health needs, it’s perfectly acceptable for your pets to have different doctors for their different health care needs.  Here is an example. The surgical specialists I work with frequently treat dogs suffering from severe arthritis pain.  In addition to prescribing a nonsteroidal antiinflammatory medication and joint care supplements the surgeon may refer their patient to a rehabilitation therapy specialist for workouts on the underwater treadmill.  Clients are also offered the option of consulting with a veterinarian who specializes in acupuncture. The key to success is that all three specialists are open-minded, communicate with one another, and share a common goal- namely what is best for the patient. Can such a winning combination be found in every community? No, unfortunately not, but you won’t know until you look.  What should you do if your veterinarian feigns hurt feelings or rolls her eyes?  Stay true to your goals.  You know what is best for your pet.  Besides, which is more important, your vet’s feelings or your pet’s health?

Have you been successful at combining Eastern and Western medical approaches for your pets?  Do tell!

Best wishes for good health,

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
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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, and your favorite online book seller.

 

 

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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Pain Management 101

September 4, 2009

My husband and I just returned from a wonderful stay at a dog-friendly campground. We encountered just about as many dogs as we did people! We made some new friends including Buddy, Sierra, Milo, Otis, Judd, Lexie, and Homer (please don’t ask me to recall the names of their humans). Our next-door neighbors were Milo and Otis, two middle-aged black Labradors. When these goofy brothers weren’t off on family hikes they spent their time meandering about with sticks in their mouths and checking our campsite in case we managed to “misplace” any food items. By day three, I observed them to be exploring less and lying around more. I also noticed that Milo was favoring a front leg and Otis was showing discomfort in his hind end. When I mentioned my observations to our neighbors (I cannot seem to keep my mouth shut in such situations), they told me that Milo and Otis both have arthritis and their stiffness and soreness was predictable in response to their increased activity level. They routinely gave them pain medication (the equivalent of aspirin or ibuprofen for us) as soon as arthritis symptoms became apparent. In fact, they had administered their first dosage that morning. These poor folks had no idea that such innocent comments would prompt a mini-lecture from the likes of me! Here is what I explained:

Whether for ourselves or for our pets, the ideal time to treat predictable pain is before it begins. Investigational studies have documented that pain can induce a “kindling effect”. In other words, low-grade pain has the potential to self-ignite into a flare-up of pain that is more severe, therefore more difficult to control with medication. Far better to take proactive measures (medication, acupuncture, rehabilitation therapy, glucosamine, chondroitin sulfate, etc.) before the onset of predictable or anticipated pain than it is to attempt to douse the discomfort once it has already “caught fire”. It’s also important to keep in mind that many dogs, particularly those with stoic demeanors, may not demonstrate any overt symptoms until their pain has progressed well beyond what would be considered mild.

I suspect that my new friends Milo and Otis will be far more comfortable on their future camping trips! I must confess here- I also counseled their humans on the benefits of weight loss (both dogs were chubby) as a means of benefiting their arthritis pain. Those poor people certainly got more than they bargained for! Does your dog predictably become stiff or sore following increased activity? If so, please share what you do to prevent the discomfort.

Now, here’s wishing you and your four-legged best friend 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. 

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross