Category Archives: tcm

Is aspirin safe for pets ?

Dangers of Aspirin

by Cindy Lizotte

For many people, a quick and simple pain relief is a dose of aspirin or similar pain medicine. So, when a dog is in pain, some owners assume that aspirin may be safe for their dog as well. Although aspirin isn’t necessarily deadly to dogs, it is not typically recommended due to dangerous side effects. Most veterinarians will warn against aspirin for this reason, as well as the fact that there are other more effective and safer alternatives created especially for dogs. Even if your dog is sore from romping in the beautiful spring weather, don’t give aspirin. There are plenty of alternative options for pain relief.

About Aspirin

Aspirin is an analgesic drug, commonly used as a minor pain relief and an anti-inflammatory medication. Aspirin belongs to a class of drugs known as nonsteroidal anti-inflammatory drugs, often denoted as NSAIDs. Almost all NSAIDs irritate the stomach and can cause stomach ulcers.

NSAIDs for Dogs

Pain control and relief is a popular issue for many owners with dogs suffering from either acute or chronic diseases and disorders. As an owner, you are aware of when your dog is in discomfort, whether it be a bit of soreness from excessive playing or severe pain in an emergency situation. Regardless, finding safe and effective pain relief options for your dog is an important, and ongoing, search for many owners.

NSAIDs generally work well for dogs and most are relatively safe when recommended dosage is given. However, almost all NSAIDs do come with a range of side effects. Usually, side effects occur when excessive amounts of the drug are given too frequently or for too long, but side effects can still pop up despite following instructions.

One major issue with NSAIDs is the ill-effect that they have on your dog’s digestive tract. The stomach and the intestines are sensitive areas of the body and particularly at risk. This upset can then lead to ulcers. Ulcers can be dangerous, especially if the wall of the stomach perforates.

NSAIDs also reduce blood supply to the kidneys. In an older patient with unknown kidney disease or border-line kidney disease, NSAIDs can push borderline patients into kidney failure.

There are other cells in the body that NSAIDs can adversely affect. Platelets are the little ‘sticky’ cells that cause blood to clot. When NSIADs are given, especially over time, platelets become less ‘sticky’ and are essentially deactivated. This translates to delayed clotting times and potential for excessive bleeding.

Sometimes patients do require NSAIDs for pain control. especially if nothing else works. If this is the case for your dog, your veterinarian will recommend a full blood profile be performed before starting the drug or shortly after a trial run. This will check liver and kidney function at a minimum. Many veterinarians require rechecking these blood values every 3-6 months after the NSAID is started.(1,2) Some clinics recommend yearly blood panels before refilling prescriptions.

If your dog takes NSAIDs, be aware of the warning signs of side effects, such as:

  • Vomiting
  • Change in appetite
  • Stool changes (very dark in color, diarrhea)
  • Urine changes (color or smell change)
  • Jaundice (yellowing) of the eyes, skin
  • Change in water consumption
  • Change in skin color, such as redness or a rash

Common NSAIDs for Dogs

  • Rimadyl (carprofen)
  • Metacam (meloxicam)
  • Deramaxx (deracoxib)
  • Previcox (firocoxib)

Alternatives for Pain Management in Dogs (3)

If your dog is in any kind of pain, consult your veterinarian first before giving any sort of pain medication, especially pain medications designed for humans. Dogs have different metabolisms, so many options, such as aspirin which is relatively safe for us, yet can cause major side effects in our canine counterparts. Therefore, it is always best to consult your veterinarian for a canine option that is both safe and effective.

References

(1) Sharkey, M. et al. Advice to Dog Owners Whose Pets Take NSAIDs. Office of New Animal Drug Evaluation FDA Veterinarian Newsletter. 2006. Volume XXI, No I.

(2) Shell, Linda. Aspirin Toxicosis. Veterinary Information Network Associate Database. 2006.

(3) Dodds, Jean. Alternative Therapies for Pain Management. Holistic Veterinary Medicine Club Symposium Proceedings. 2013.

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Seizures in dogs and cats

What are Seizures?

Seizures occur when your dog’s brain causes the body to experience sudden, uncontrolled physical attacks, with or without loss of consciousness. Some seizures are a result of genetic abnormalities, while others occur for unknown reasons (idiopathic).

What are the symptoms?

Seizures manifest in different ways, however there are normally three phrases: the “pre-ictal” phase, the actual seizure, and “post-ictal” phase. In the pre-ictal phase, dogs usually start acting agitated or stressed. They may become extra clingy to their owner or they may seek solitude. This phase can last mere minutes or a few hours. Directly before the onset of the actual seizure, the dog may experience trembling, loss of vision, and unresponsiveness. During the seizure, the dog may stiffen, fall over, and convulse. Some will kick their legs in a running motion, foam at the mouth, or lose control of bladder and/or bowels. In the post-ictal phase, the dog may be lethargic, disoriented, and confused. Some dogs may experience temporary blindness.

Watching your dog experience a seizure can be a scary thing to witness, however it’s extremely important to remain calm, clear the area around your dog, and speak gently to him/her. Never place your hand near your dog’s mouth, as your dog may be unaware of your presence and may bite unknowingly. Do not try to pet or calm them because sometimes external stimuli may actually worsen the signs and prolong the seizures.

What is the cause?

There are two types of seizures: primary and secondary. Primary seizures (idiopathic) have no known source, while secondary seizures have a known source (disease process).

If the dog is less than one year, the most common cause of seizures is low blood sugar (hypoglycemia). This is more common with puppies and toy-sized breeds. However, dogs with liver disease, diabetes, or pancreatic tumors may suffer from hypoglycemia as well. Puppies with distemper or congenital issues (hydrocephalus) may also experience seizures.

Seizures in dogs aged one to five are normally considered to be idiopathic.  Idiopathic Epilepsy is considered a genetic condition in some breeds such as the Beagle, Golden Retriever, Labrador Retriever, German Shepherd, Collie, and Boxer. Brain tumors and head injuries may also be the cause of seizures, as the pressure on the brain tissue can result in loss of vision, loss of coordination, and seizures. Senior dogs with seizures may be experiencing a symptom of neoplasia or liver or kidney disease.

We have found that a lot of the times, it seems that seizures are induced by stress like a visit to the groomer, kennel stays, visit to the vet, etc. Sometimes if we can identify the seizure triggers, they can be avoided and this may help with their management.

What are the treatment options?

For epileptic seizures, treatment varies by the severity of the condition. For dogs that experience less than two seizures per month, traditional treatment is not often recommended. However, for dogs who experience frequent and long seizures, anticonvulsant medication may be an option. Phenobarbital is the usual prescribed drug — unfortunately, it does have some side effects, including sedation and stimulation of hunger/thirst. Phenobarbital also directly impacts the liver and if your dog is on Phenobarbital long-term, liver damage can occur. Potassium bromide, Gabapentin and Kepra (Levetiracetam) may also be used or added to phenobarbital for dogs that fail to respond to the initial therapy. In emergency situations, drugs like valium (diazepam) or propofol may also be used. There are also newer drugs available so the agent used will depend on the veterinarian in charge of the case. In some cases, one drug is needed and it other cases it may take up to three drugs to get the seizures under control. Control is considered achieved when a pet does not have a seizure more often than every 6-8 weeks. That means that some pets will still have seizures but at an acceptable frequency (no more often than  every 6-8 weeks).

There are many holistic and alternative approaches to help control seizures and epilepsy, ranging from supplements to flower essences, that have had great success in minimizing the frequency of seizures.

More information on specific holistic treatment methods below:

  • Acupuncture

Acupuncture is the ancient Chinese practice of inserting safe needles into specific acupuncture points to move and unblock energy. Acupuncture can offer great results for epileptic patients.

  • Diet

For humans that suffer from seizures, a Ketogenic diet is often recommended. A Ketogenic diet contains no carbohydrates, low to moderate amounts of fat, and high levels of protein. While the Ketogenic diet has no proven efficacy in dogs, it may be worthwhile to consult with a veterinary nutritionist about using diet as part of anti-convulsant therapy. In dogs, switching to low carbohydrate and higher protein diets or raw diets should be considered

Dogs suffering with Hepatic encephalopathy should NOT BE FED A HIGH PROTEIN DIET / Raw diet.

It is extremely important to consult with your veterinarian if thinking about a serious change in diet, as ‘seizure diets’ like the Ketogenic diet can have severe side effects in humans.

Some veterinarians has seen a reduction of seizure episodes when patients are switched to a hypoallergenic or ‘novel protein, novel carbohydrate’ elimination diet. In the past few years, a lot of holistic veterinarian have been discussing the fact that in some cases, allergies and seizures have gone hand in hand and that an elimination diet should be considered in every pet diagnosed with seizures.

  • Flower Essences

Bach Flower Essences makes a tincture called “Rescue Remedy”. It is a combination of five flower remedies all designed to combat stress, panic, and fear. The flower essences it includes are Star of Bethlehem (helps animals that have experienced abuse, shock, and trauma), Rock Rose (helps animals in stressful situations, such as thunderstorm, fireworks, going to the veterinarian, etc), Cherry Plum (helps animals who have lost control of their actions, exhibited by excessive barking or scratching), Impatiens (helps animals who are impatient, unable to wait), and Clematis (helps animals who seem to be sleeping excessively and have lost interest in their surroundings). The tincture provides a calming effect on the animal.  Some seizures are triggered by stress, such as new people in the house or thunderstorms. Consistent use of Rescue Remedy may reduce anxiety and prevent seizures in this manner.  Rescue Remedy can purchased at most health food stores and online. We will be writing a blog about Rescue Remedy in the near future so follow us!

  • Herbals, Supplements and TCVM

A diagnosis from a holistic veterinarian who practices Traditional Chinese Veterinary Medicine (TCVM) can be very helpful in the treatment of seizures. Some seizures are caused by patients having different Yin or Yang deficiencies, Triple Burner obstructions, Phlegm/Damp accumulation, Liver Yang rising, etc. A TCVM diagnosis can also identify and address other factors that may be contributing to seizure activity. Different tonics, herbs or even ‘cooling’ Western drugs such as phenobarbital may be used together as anti-seizure treatments.(1) There are a lot of Chinese herbal formulas that can assist the treatment of seizures like: Long Dan Xie Gan Tang, Ban Xia Zhu Tian Ma Tang, Tian Ma Gou Teng Yin, Xiao Chai Hu Tang, San Ren Tang, Bu Yang Huan Wu Tang, etc.

It is thought that the herb Skullcap may have positive benefits on epileptic animals. The plant is believed to moderate overactive synapses in the brain where seizures are triggered. Valerian, Kava, Saint John’s Wort, Corydalis, Gastrodia, Uncaria, Bacopa and many others may be beneficial as well. For dogs taking Phenobarbitol, Milk Thistle can be helpful as it is commonly used to protect and regenerate the liver. There are many western herbs that can benefit pets with seizures and a veterinarian trained in western herbal therapies can assist you in designing the appropriate formula for your pet. Each pet is different and a patient specific seizure herbal formula is always recommended vs a generic one. It is important to talk to your veterinarian before starting supplemental herbs, as some can interact with common seizure medications.

Dietary supplementation of omega-3 essential fatty acids are important in the development and maintenance of a healthy nervous system. In addition to a quality essential fatty acid supplement, you may wish to give your dog extra minerals (whole foods supplements), digestive enzymes, or probiotics to ensure the nervous system is as healthy as possible.

If seizures are related to allergies, keeping the gut healthy should in theory help with the management of seizures. We have to remember that 70% of the immune system is related to the gut ! Bowel health is an extremely important factor in seizure control and it is often forgotten by conventional veterinarians.

  • TTouch, Massage, and Reiki

These forms of energy and physical healing can help reduce anxiety in all dogs- suffering from seizures. Although your dog’s seizures may never be entirely eliminated, it is possible, with the help of alternative therapies, to reduce the frequency and severity of the attacks.

If you have any questions about seizures, feel free to email me for a consult.

If your pet suffers from seizures, please feel free to tell us about your experience in the comments section.

Written by Dr Cindy Lizotte, DVM, MBA, CVFT (CHI institute), CVA (IVAS), Grad Dip Vet Western Herb Med (CIVT) Grad Dip Vet Chinese Herb Med CVHM (IVAS/CIVT)

Resources

(1) Mitchell, Deborah. TCVM Diagnosis and Treatment of Seizures. Western Veterinary Conference Proceedings. 2012.

Safety of herbs and natural products in Canada

Are herbal supplements safe ?

Herbal product regulations in Canada 

In 2004, the Natural Health Products Regulations came into effect in Canada.  NHP (Natural health products) are defined by Canada Health as: vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines such as traditional Chinese medicines, probiotics and other products like amino acids, facial products, shampoos, antiperspirants, mouthwashes and essential fatty acids. These products to not need a prescription and those that do would fall under Food and Drug Regulations. At this time, Health care practitioners do not have to be licensed under Health Canada to compound products on individual basis for their patients or to retailers of such products. The license requirements only applies to person or company that manufactures, packages, labels and/or imports NHPs for commercial sale in Canada.

In Canada, natural health products that have been licensed have a eight-digit Natural Product Number (NPN) or Homeopathic Medicine Number (DIN-HM) on their label. npn numberIn theory, they can’t be sold in Canada unless they have the proper product license. To get such a license, there is an application process they applicants have to go through and a series of detailed information must be provided like: medicinal ingredients, source, dose, potency, non-medicinal ingredients and recommended use(s). Now, like anything, there is always exceptions or exemptions. If a product has not yet been approved by Health Canada, it may be provided an exemption number that will be on the label as : EN-XXXXXX. The products with the EN and number have gone through some initial assessment in order to make sure safety, quality and efficacy has been met but have not fully received certification yet. It seems Canada Health has done this in order to allow continuing access to these products for the general public, kind of like if it was a probably period pending approval.  As a consumer, I was not even aware that there where regulations in regards to these products.

Health Canada also requires that claims on products be backed up by proper evidence. What is proper evidence is where some herbalists, traditional doctors and conventional doctors disagree. Health Canada considers as evidence: clinical trials, published studies, journals, and traditional resources. Depending on the claim of the products, more or less evidence is needed to support the health claim and its safety. But, because as we know, it is often hard to establish double blinded studies, clinical trials when it comes to herbals, there lies the difficulty in its regulations. To be licensed in Canada, a NHP label must include a list of things. Health Canada also requires licensing for sites where natural health products like herbs are manufactured, packed, labeled or imported. Health Canada require that these companies promote good manufacturing practices and it requires adverse reaction reporting. Health Canada also regulates the human clinical trials. Practionners have on-line access to up-to-date information on licensed NHPs by using the  Licensed Natural Health Product Database (LNHPD). Also, practionner have access to safety issues through the The MedEffectDatabase. You can also visit the Canadian Homeopathic Pharmaceutical Association for more information.

 

In 2012, I called the Health Canada department to inquire about animal products. They told me that they didn’t regulate products that are for us in animals, so they had me called the CFIA (Canadian Food Inspection Agency). I talked to a veterinarian working for the CFIA. As far as he knows, he says they have regulations for veterinary drugs and veterinary biologics.  But, by definition veterinary herbals and natural supplements do not fall under those designations. According to him, natural health products labeled for use in animals (herbals, food supplements like omega 3, etc) don’t seem to be controlled directly by Canada Health nor the CFIA. After making other calls to different suppliers, the conclusion is that there are no agency regulating veterinary herbal products or natural products designed for use in animals in Canada. Animal health natural products and supplements fall into a grey zone and are currently not regulated. Only voluntary adherence by some companies guarantee their products sold to animals. I have looked into different herbal and nutraceuticals suppliers in Canada, and only a few have actual quality control protocols in effect.

In April 2014, I found out that in Januray 2012, Health Canada, the Canadian Animal Health Institute and North American Compendiums had joined to develop a notification program for low risk veterinary health products (LRVHPs) used in cats, dogs and horses that are not intended for food.  These products include botanicals, vitamins, minerals and homeopathic preparations. This is a voluntary program which means that animal supplement companies are not required by law to follow any safety or GMP (good manufacturing practices) guidelines. Natural Health Veterinary Products approved by this Program will use the initial NN instead of NPN which is reserved for human products. This type of program will help consumer know that when they buy a product with the NN number, that these companies have good Manufacturing practices and quality control systems in place. Furthermore, these products will have procedures in place in case of recalls and also will control what kind of claim can be put on their labels. Veterinary supplement companies wanting to apply for this program can visit this website http://www.lrvhp.ca

A study done by the University of Guelph published in October 2013 showed that a lot of over-the-counter human herbal products contained fillers or omitted ingredients on their labels or had the wrong ingredients listed. Something like over 60% of the products tested contained herbs not listed on the labels, 32% had product substitution and 20% contained fillers like rice, soybeans and wheat. Here is a link to the article for more in dept information about what the researchers found.

The moral of the story is: check your suppliers and check your own human products. Are you buying products that have NPN (for people) or NN numbers (for pets) ? Are you sure that the vitamins you are giving to your family are safe and quality controlled? I have found an improvement in the amount of NPN/NN products now available in the pharmacies but more work needs to be done. In regards to animal vitamins and over-the-counter products, I have yet to see much improvement in that department. I only buy products  from suppliers that I have researched, trust and that have established quality and security controls in place (GMP measures). In the event of a recall, I am contacted directly by my suppliers and I can contact my clients directly to prevent issues.

Written by Dr Cindy Lizotte, DVM, MBA, CVFT (CHI institute), CVA (IVAS), Grad Dip Vet Western Herb Med (CIVT) Cert CVHM (IVAS)