Tuesday, June 24, 2014

Management of Kidney and Bladder Disorders with a Combination of Western Medicine, Acupuncture and Chinese Herbs

Disorders of the kidneys and bladder are very common in veterinary medicine. Urinary tract infections, chronic kidney disease, urinary incontinence and feline lower urinary tract disease are often the reason our pets are taken to the veterinarian. In Western medicine, these problems are often divided into acute and chronic conditions. Traditional Chinese Veterinary Medicine (TCVM) describes them as either Excess or Deficiency Conditions. In the following article, I’ll discuss acute kidney and bladder conditions, chronic kidney conditions, urinary incontinence, and FLUTD (Feline Lower Urinary Tract Disease).

Kidney and bladder disorders are perfect examples of the synergism of Western and Eastern medicine.

The most common acute problem we see in veterinary medicine is bacterial infection of the kidneys and/or bladder. Similar to people, we often see dogs with bladder infections with a bacteria called E. Coli. This infection is more common in female dogs because their shorter urethra makes it easier for bacteria to get into the bladder than in male dogs. In dogs, kidney infections are also sometimes seen due to a bacteria called Leptospirosis. Acute urinary tract infections are best treated with conventional Western medicine such as antibiotics, pain relief medication and increasing fluid intake. If the infection recurs, or seems resistant to therapy, other tests may need to be done. These can include urine cultures to identify resistant or multiple infections, X-ray and/or ultrasound exams to identify bladder stones or tumors or assessment of the prostate in intact male dogs for prostatitis (inflammation of the prostate). If any underlying problems are found, the appropriate medical or surgical procedures will need to be performed before the urinary tract infection will resolve.

The most common non-infectious acute problem is accidental poisoning to due ingestion of human medications or automobile antifreeze products. Both of these will cause severe acute kidney failure. Treatment involves hospitalization for three to five days on high rates of intravenous fluid administration and medications to protect the kidneys while the toxin is being eliminated from the body. In rare circumstances, referral to the veterinary school for dialysis is necessary.

Chronic kidney disease, formally known as chronic kidney failure, occurs when damage to the kidney results in an insufficient amount of healthy tissue remaining to remove waste products of normal metabolism from the blood. As these waste products build up in the body, animals and people feel nauseous, lose their appetite, become lethargic and get dehydrated. The loss of kidney tissue can result from chronic infection, congenital birth defects, physical damage, toxins as described above and aging changes, especially in older cats. Conventional treatment includes long-term fluid administration (including giving fluids under the skin at home), anti-nausea drugs, medications to control phosphorus levels and high blood pressure and special “kidney preserving” diets. These treatments often need to be given for the remainder of the pet’s life.

In Traditional Chinese Veterinary Medicine (TCVM), chronic kidney disease can be due to either Kidney Yin or Kidney Yang Deficiency. Yang is the warming “energy” of the body, so pets with Yang-Deficient kidney failure are often cold, have low energy, and since the Kidney System in TCVM controls the hind end of the body, these pets are often weak in their back legs. TCVM treatment includes acupuncture points to stimulate Yang, nourish the Kidneys, strengthen the back end, warm the body and promote appetite. Warming, Yang-nourishing herbs are used, as is a warming, Yang-nourishing diet.

Yin is the cooling “substance” of the body, so pets with Yin-Deficient kidney disease “run too hot”. Seen more frequently in dogs than in cats, these are the pets that pant a lot, tend to be up frequently at night needing to urinate, and often seem agitated and uncomfortable. Treatment includes the same Western methods as described above, but this time with the addition of acupuncture and herbs to help cool the body, stimulate Yin, nourish the Kidneys, and reduce anxiety. A cooling, Yin-nourishing diet is also used.

Urinary incontinence, most often seen in older female dogs, results from a weakening of the neck of the bladder, allowing the outflow “valve” of the bladder to remain slightly open, especially when at rest. This allows urine to leak out, and these dogs often wake up with a puddle of urine in their beds. This is often treated with a drug called Proin quite successfully. For those dogs which suffer side-effects, or in which Proin is no longer effective, or for male dogs, acupuncture and herbs can be very effective at resolving the incontinence. In TCVM, urinary incontinence is due to Kidney and Bladder Qi Deficiency. Like Yang, Qi is energy, the force behind bodily processes. When Kidney or Bladder Qi is deficient, the body lacks the energy to hold the urine in the bladder. Acupuncture points for Qi stimulation, nourishing the Kidneys and strengthening the bladder are used. There are also Traditional Chinese herbs and foods that help strengthen Kidney and Bladder Qi.

Feline Lower Urinary Tract Disease (FLUTD) is a chronic inflammation of the bladder in cats resulting in irritation, pain, urgency to urinate, crystal formation in the urine, and in males, urethral obstruction. It is similar to Interstitial Cystits (IC) in people. There is no one specific cause, and genetics, diet, infection, stress level and lifestyle all seem to play a role. Western treatments include increasing fluid intake, special diets, antibiotics only if there is infection present and medications for bladder pain. Of the five Primary Chinese Pathogens, an Excess of two, Dampness and Heat, are present in the bladder with chronic inflammation. There are very specific acupuncture points for draining Dampness and releasing Heat, as well as points for strengthening the bladder and relieving pain. Traditional Chinese herbs are also used. A cooling diet is fed to help further release Heat, and Damp foods are avoided.

Many of these conditions are never going to be completely cured as a simple acute urinary tract infection may be. For these chronic conditions, incorporating both conventional and Chinese Medicine into the treatment plan can provide relief of symptoms, increased comfort and an improved quality of life for many years.

Wednesday, December 18, 2013

Featured Pet for Winter

Meet Kitza! Kitza is a dignified lady at 20 years old. We have worked with her dedicated “parents” to develop a monthly health check and treatment plan to ensure optimal care for Kitza in her old age. We see her weekly to give subcutaneous fluids due to old age kidney disease. Her owners say that although she cannot jump directly to her favorite window sill anymore that has not stopped her from finding another, more gradual, pathway to her favorite spot. Kitza is a beautiful feline with a sweet personality who has aged quite gracefully!

Care for senior pets

Part of the joy of owning a pet is growing and maturing together. As our pets become senescent it is important to understand that they will require an increased level of care, both medically and at home. Cats and dogs age at different rates and have different geriatric needs. Additionally, most large breed dogs age faster than small breed dogs.

Since cats think they are superior to dogs we will start with them. According to the American Association of Feline Practitioners (AAFP), “seniors” range from 11 to 14 years old and your cat is considered “geriatric” after 15. Potential health concerns in an aging cat include: arthritis, cancer, cognitive (brain) disorders, constipation, deafness, dental disease, diabetes, heart disease, hyperthyroidism, inflammatory bowel disease, kidney disease, and/or vision problems. (Phew!)

The challenge lies in identifying signs of these diseases:
Did you know that an inability of your cat to jump may indicate diabetes? Most cats are very stoic and tend to hide pain or discomfort from even the most observant owners, so please share even small changes in your older cat with your Whole Pet vet. Signs of illness may include: increase or change in vocalization; inability to jump, run or play; decreased or increased appetite; weight gain or loss; changes in temperature preference (eg. 'My cat used to like sitting near the heater but now chooses to sit in the cool window sill or tiled bathroom floor'); changes in litter box habits; odor from mouth; or excessive licking over one body part.

For each calendar year, your cat ages about 6-7 years worth! For this reason, a physical exam by a veterinarian every 6 months for cats over 10 years old along with annual blood test screening contributes to early detection of illness and early treatment. Just think, that is an exam for your cat only every 3.5 years when compared to humans. Blood tests should be done on your young healthy cat annually after 3 years old to establish “normals” which allows the veterinarian to identify trends. In between exams use your observation skills to monitor for changes in weight, behavior, activity, or personality.

You can help your aging cat by making some changes at home. For pets with arthritis put food and water bowls in easy to access places or build a ramp or steps to the bowl. Add an extra water bowl or fountain because most aging pets, and people, need plenty of water. Add a component of moist food to your cat's diet at an early age to fend off dehydration and kidney disease. Supplements like glucosamine and fish oil should be started early to minimize arthritis pain and enhance organ health. Incorporating another litter box in a convenient area may be necessary. Since older cats are not as active as when young you may need to trim their nails more often to prevent overgrowth that can get caught in carpets and tear. Check them monthly. Cats may need help grooming when they are very aged so gently brush if they will allow. Be mindful: a 12 year old cat that is not grooming may be a sign of pain.


In general, a dog is considered senior between 7-10 years of age, although this varies between size dogs. Small breed dogs (become senior later) tend to live longer than the giant-breed dogs(senior earlier). The list of potential health problems for a dog is similar to that of a cat but with some variations. Arthritis, cancer, prostate disease, cognitive disorders, intestinal problems, deafness, dental disease, diabetes, heart disease, hypothyroidism, kidney disease, urinary incontinence, liver disease, and/or vision problems.

Many people believe falsely that a limping dog is NOT in pain. However, if you see your dog limping, it is most likely because the leg with the limp hurts. Sometimes limps are subtle and need a veterinarian to identify. Additional signs of illness may include: urine accidents; skin lumps; constipation or diarrhea; shortness of breath, coughing, or other difficulty breathing; weakness; changes in weight, appetite or water intake; increased vocalization; or uncharacteristic aggression.

Did you know that a 7 year old labrador is 50 in “dog years” and at age 13 they are 82! For this reason, a physical exam by a veterinarian every 6 months for dogs over 7 years old along with annual blood test screening contributes to early detection of illness and early treatment. Compared to human years that is really only a good check up about every 3 years. Blood tests should be done on younger dogs to establish “normals” which allows the veterinarian to identify trends. In between veterinary visits your dog relies on you to read subtle cues of illness.

You can help your senior canine continue to live a happy and healthy life. It may require putting rugs on hardwood floors to provide traction for arthritic dogs. Use orthopedic beds, or additional blankets or padding for their bed. Provide ramps or stairs to get to frequently used locations, in and out of house and car. Senior dogs may need to be let out more frequently to go to eliminate.
Addressing your older pet's diet is one way that you can keep your senior canine healthy. Diets for senior pets should be lower in fat but not lower in protein. A good quality diet should contain a high quality protein as one of the first listed ingredients. Some high-end senior diets will be rich in antioxidants which will slow brain aging (Hills B/D).

Supplements are usually beneficial and should include fish oil for arthritis and organ health. A good quality glucosamine and chondroitin joint supplement reduces arthritis pain in most dogs. Finally if your pet is showing signs of brain aging there are several supplements available that have great promise. Recent research has also shown that behavioral enrichment and continued physical exercise in older dogs helps to slow dementia.

If your pet is losing their vision, remove obstacles and clutter and cover any sharp edges. Also, keep the layout of your house the same so your pet can navigate with confidence. Older animals may not maintain their body temperature as efficiently, so they will rely partially on you to keep them warm in the winter and cool in the summer.

So a little extra care and vigilance will make your pets' retirement years more comfortable: a gift back to them for a lifetime of their unconditional love!

Friday, September 27, 2013

Whole Pet Veterinary Care - Featured Pet Dylan

Meet Dylan, a happy golden retriever. He may be 16 years old, about 87 in human years, but he is young at heart! Every time we see Dylan he is wagging his tail and has a spring in his step. As with any aging human, dogs need an increased level of care and sometimes an increased medicine cabinet. Through careful use of medications and supplements his caretakers have eased Dylan's cognitive dysfunction and arthritis pain. They have always considered Dylan's comfort and desire to enjoy life in important decisions like surgery to repair a broken leg when he was 14 and to remove a large skin tumor when he was 15! Due to their compassionate and thoughtful care, Dylan continues to enjoy life and bring joy to us at Whole Pet each time we see him.

Parasites and Your Pet

If there was ever an example of "an ounce of prevention is worth a pound of cure" it applies to this little guy and some of his friends.


Parasites like worms that can be contracted from fleas, mosquitos, or even soil can wreak havoc on our pets' health and potentially lead to death, but can be prevented by simple procedures like feeding monthly chewable, tasty meds; even less than an ounce worth!

Fleas, heartworms, intestinal parasites. What are they and why do we need to prevent our pets from contracting them?

Peak flea season in Oregon starts in spring and lasts through the summer into early fall, but fleas can survive year-round in western Oregon's moderate climate and our heated homes. Since fleas carry tapeworms, year-round prevention of fleas prevents tapeworm infection as well. It is also important to prevent flea accumulation on your pet because the bite of a flea can cause a skin allergic reaction and secondary infection. While infections can be severe and cause hairloss, even a mild flea reaction causes the cat or dog discomfort. If you are not taking measures to prevent fleas, over time a flea infestation (=lots of fleas, larvae, AND eggs) can develop even in a tidy home and infestations are harder to treat. The graph below shows the flea activity for Salem, Oregon by month.  Monthly, year-round preventative for all pets in the home eliminates flea problems.  


Intestinal Parasites we may diagnose in a dog or cat include: roundworms (common in puppies, kittens and pregnant or nursing dogs), hookworms, whipworms (harder to diagnose, lower incidence in Oregon), and tapeworms (from fleas). These worms are commonly diagnosed by microscopic examination of the feces. Roundworms are named for their shape. Hookworms are named because they hook onto the wall of the intestines and feed off of the blood of their host. Tapeworms come from fleas, and whipworms are found in soil but are uncommon in cats. See the prevalence of roundworms, hookworms and whipworms; Simply follow this link, http://www.petsandparasites.org/parasite-prevalence-maps/ and click on "Intestinal Parasites".

Annual examination of stool sample for parasites is recommended to make sure your pet is free of them. This is especially important for families with young children, as roundworms and hookworms can be contracted by humans, more commonly young children.

Heartworms (Dirofilaria immitis) are roundworms that require a mosquito to mature and spread from animal to animal. While the dog is the preferred host, cats may become infected as well. This video provided by the American Heartworm Society explains the heartworm's life cycle, http://www.heartwormsociety.org/pet-owner-resources/canine.html.

While the incidence of heartworm is more prevalent in California, the south, and southeastern, prevention is still recommended for several reasons: 1)Consequences from heartworms are dire, once contracted, are very difficult to treat and may cause death; 2)It is hard to predict the ability of the heartworm parasite's or the mosquito vector's ability to adapt and more easily spread the infection outside of the higher prevalence areas; 3)You may unexpectedly travel to an area of increased heartworm infection risk; and 4)Presence of a heartworm positive dog from the southeastern US may go undetected and be a source of heartworm infection in Oregon in the warm months.

Testing your dog before beginning heartworm prevention is recommended and then once a year to ensure that the product is effective. Most heartworm preventions also prevent intestinal parasites as well.

Tuesday, June 25, 2013

The full article: Anxiety in Pets

In order to understand anxiety we first have to understand what fear is and the role it may play in anxiety. Fear is an instinctual feeling of apprehension resulting from a situation, person, or object that appears to present an external threat, whether real or perceived. The result is an autonomic nervous system response. This is your pet's normal “fight or flight” response.

Whereas, Anxiety is the anticipation of future dangers that result in body reactions (also known as physiologic reactions) associated with fear. You can see these reactions in a frightened or anxious animal, they include: elimination (urination and/or passage of bowel movements), destruction (eating your shoes for instance), over-grooming in cats, and excessive barking or crying. These are only the visible signs, many of our pets, especially cats will hide their anxiety from us.

The most common form of anxiety in our pets is separation anxiety. Separation anxiety can result in any of the physiological reactions listed above. Also, if your pet has separation anxiety they are more likely to have noise phobias, such as a fear of thunderstorm or the dreaded vacuum cleaner. Separation anxiety can be treated with acupuncture, herbs, medications and/or calming pheromones. In addition adjusting their environment and behavioral modification are useful.

In Traditional Chinese Veterinary Medicine (TCVM), anxiety and phobias are considered disturbances of the Shen or emotions. The intellect is housed in the brain, but the emotions (the Shen) are controlled by the Heart. Thus the heart is not just the organ that pumps blood throughout the body, but the whole Chinese Heart System, which incorporates the heart, blood vessels and the entire nutritive system for maintaining the health of the body and is also responsible for helping to maintain a healthy emotional balance. If the Heart System is deficient, or if problems with other bodily systems negatively affect the Heart, then a Shen disturbance can result. The most common Shen disturbances we face in veterinary medicine in dogs are separation anxiety, noise phobias and aggression. In cats, we most commonly see litterbox issues.

Because the Shen is housed in the Heart, we can treat acupuncture points along the Heart meridian to directly influence the functioning of the Heart System to improve Shen disturbances. When the Shen disturbance is due to Heart deficiency, we can treat points to nourish and strengthen the Heart, which bolsters the Shen. In addition to acupuncture, we also use TCVM herbal preparations for long-term Heart and Shen support. These herbs can be used in conjunction with conventional Western drugs if needed.

Monday, June 24, 2013

Whole Pet Technician Tips for helping dogs through Fireworks!

  1. As the owner it is best if you do not get excessively emotional or coddling to a pet that is anxious, it may make them feel insecure with you as their protector. Instead act calm and confident as though nothing at all is awry.
  2. Keep your pet in a dark room that is furthest away and most protected from firework noise. Or, allow them to go into a closet or under a table where they feel safe.
  3. Play music moderately loud. Play something that the pet has heard played in the house before, a favorite CD.
  4. Apply a pheremone collar (Adaptil) or install room pheremone diffusers several days before and after July 4th.
  5. Place a “ThunderShirt” to help calm your pet (available for both cats and dogs). A snug piece of clothing may have the same effect.
  6. Put Bach flower essence “Rescue Remedy” for pets in their water and around the house.Or try "Harmonese" herbal supplement beginning one week before fireworks.