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Integrative Approaches to Tracheal Problems

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Kennel cough and collapsing tracheas were among the conditions that showed me the benefits of integrative medicine. While an extern at the Foxhound breeding colony at the NIH in 1979, my job was to culture every coughing dog. Amazingly, there were few similar organisms present in each dog and over a dozen different bacteria present in the kennel. Though we ran no tests, viruses were also certainly implicated. I began to wonder how any vaccine could be effective against kennel cough. When I was a new graduate, I worked in over ten clinics as a part time and relief veterinarian. I noticed that each clinic had very different protocols for treating kennel cough (infectious tracheobronchitis), ranging from honey to multiple drugs.

“Collapsing tracheal” coughs were fairly common in these clinics, and again there were differing treatment options. Most (in 1980) merely tried to manage the coughing (by teaching people how to pick their dogs up, getting them to choose harnesses instead of collars for walks, etc.). A few recommend radiology, then stenting surgery. 

Merck Manual1 reminds us there are multiple organisms residing in the respiratory tract. They cause no clinical signs unless triggered by stressors like viruses, smoke, crowding, poor ventilation, etc. By deeply improving the health of each dog, respiratory symptoms rarely develop. Many congenital abnormalities can also be resolved with integrative approaches. Dr. Brad Fenwick reported in 2005:2  “The frequency of kennel cough outbreaks have not diminished and in certain situations have increased in both frequency and clinical severity.”

THE ISSUE WITH VACCINATION

Because of the variety of organisms present, vaccination has focused on Bordetella bronchiseptia. Vaccines (different organisms, different formulations) have been used since 1970, yet J. Ellis3 says many questions about this vaccine and natural exposure are still not answered. Studies continue on vaccine efficacy, especially with newer formulations4,5,6.

A study done in 2004 “compared the effectiveness of intranasal (IN) vaccines containing Bordetella bronchiseptica and canineparainfluenza virus, with (IN-BPA) or without (IN-BP) canineadenovirus type 2, for prevention of kennel cough at a humane shelter…. The IN-BP and IN-BPA vaccines were 20.7% and 24.4% effective, respectively, in reducing coughing compared with a placebo vaccine.”7

INTEGRATIVE APPROACHES

Anecdotally, once a majority of clients in a veterinary practice are using various holistic approaches to maintain health, very few cases of kennel cough are seen, even in situations with high numbers of dogs. Most of the cases reported were in newly adopted dogs. 

Treatments may focus both on symptom relief and on correcting the underlying imbalance allowing the condition (infection or collapse) to occur. TCVM (acupuncture, Chinese herbs, Tui Na, food therapy) and homeopathy are the most likely modalities for resolving the tendency to get any infection, as well as correcting anatomical problems, so they will be primarily addressed in this article. Western herbs, Reiki, flower essences, chiropractic, osteopathy and supplements can be used to resolve any one episode of kennel cough, or to decrease the cough frequency of collapsing trachea, as well as build health over time.

In my homeopathic practice, the few cases of kennel cough I’ve seen resolved within 48 hours with one of a variety of different homeopathic remedies. Fewer than five animals (out of 20 homeopathic veterinarians interviewed) needed multiple remedies or took over a week to resolve. Many small dogs with mild problems of collapsing trachea become asymptomatic with constitutional treatments and general health improvements. 

TCVM The selection of acupuncture points and Chinese herbs (below) is based on the individual characteristics of the dog as well as the pathology. Some can be used in a less tailored way in face of exposure.

  • Xue Fu Zhu Yu Tang – one veterinarian has had nice results with coughs from kennel cough and collapsing trachea, often along with using allopathic medications.
  • Wei Chi Booster – helps the immune system.
  • Lonicera and Forsythia (commonly used for colds and fl u in people) – a remote town that had no kennel cough for years was visited by a coughing dog, after which most dogs began coughing. This herb worked in a few days for most of them.
  • Jade Screen Eight (Ba Wei Xiao Feng) – prevents viral infections in horses that are showing or travelling, especially when other horses show clinical signs. When very healthy, this would not be necessary.
  • Yin Qiao San – for the early stage of infection with fever and red tongue with yellow coating.
  • Qing Fei San – for phlegm heat with fever. Dry, red tongue with surging rapid pulse.
  • Zhi Shou San – can stop coughing in many animals.

HOMEOPATHY

Historically, homeopathy has been a superior approach for human epidemic situations such as influenza, typhoid and yellow fever. In animals, parvo, distemper and kennel cough frequently resolve quickly, even in cases not already under constitutional holistic care.  

Each homeopathic medicine is chosen based on symptoms shown in the animal. Common symptoms of kennel cough include sudden onset of sneezing, spontaneous hacking, dry coughing that may induce gagging, easily inducible cough, and sometimes mandibular lymphadenopathy, nasal and/ or ocular discharge. What helps with the remedy selection is how each animal is acting differently with these symptoms. Does the cough occur in the morning, on exposure to cold air, after eating a cracker or other dry food, etc.? Any one of the 4,000+ medicines could be needed to treat kennel cough, and a few seem to help with many dogs as reported by a number of homeopathic veterinarians:

  • Aconitum – given at the very beginning of any infection, especially in group settings to prevent or minimize symptoms. Often, the dogs are acting more fearful and may be febrile.
  • Belladonna – lots of redness anywhere on the body, including the skin and mucus membranes, as well as fever, panting, feeling hot and seeking cold areas, and a harsh strong cough.
  • Bryonia – each cough hurts because it moves the body, and every motion hurts these patients.
  • Drosera – a common internet suggestion that focuses on the larynx. For a spasmodic, dry cough that’s worse after midnight.
  • Kennel cough nosode – a nosode is made from the sputum of an infected dog. There are many differing opinions about the use of nosodes in preventing illness. When symptoms are not clear, some homeopathic veterinarians begin with these (more on nosodes below).
  • Pertussinum – a nosode made from whooping cough. Sometimes used preventatively; other times as part of the homeopathic treatment.
  • Phosphorus – dogs exhibit fear of loud noises, better for being petted and the center of attention, a thirst for cold water, and a tickling cough from an irritated throat or larynx.
  • Lachesis – aversion to having the throat touched, cough on touching the throat, seeking cold, averse to abdominal palpation, thirsty and irritable.
  • Morgan Bach – congestion, and as support for other remedies.
  • Rumex – tickling in throat and larynx, worse from barking, and worse when going out in cold weather.
  • Spongia – dry croupy cough, larynx sensitive to touch, better from eating or drinking, worse in the wind.
  • Other remedies recently reported as successful include Antimonium-tartaricum, Euphrasia, Conium, Cocculuscacti, Bromium, Ipecac pulsatilla and Rhu-toxicodendrum.

Over the last few decades, experienced homeopaths have reported that if they could find the similimum (medicine that matches the individual) they achieved almost 100% success in multiple cases. Interestingly, several found that the dog’s constitutional medicine does not seem to be as effective in these acute cases.

Many others successfully use nosodes in treatment, either alone or along with other homeopathic medicines. Nosodes may protect against future infection. One practitioner used the kennel cough nosode at hunt kennels in England, with 100% success, by medicating the water weekly with 30c potency from just before the autumn equinox until mid-October. Another practitioner is testing the same nosode with Nobivac KC and finding equal protection. Christopher Day studied a kennel in England that had been afflicted with rampant kennel cough for years, and the kennel cough nosode dramatically decreased infections.8

Training in homeopathic and TCVM methodology will maximize success and result in deeper healing, but if you are challenged in your practice with tracheal diseases, you can work with a trained practitioner to implement some specific strategies.

One joy of seeing each dog as unique is that we can resolve acute infections as well as more challenging tracheal diseases, while building overall health. Clients are very happy with the results for their individual animals. This approach can also prevent problems, as well as inhibit further spread of infection in group settings such as kennels, day care or training facilities.

CASE STUDY

In August 2015, Dr. Grace Calabrese treated a seven-month-old Italian Greyhound puppy that presented with an intrathoracic collapsing trachea. The problem had developed several weeks after a severe URI that was treated with antibiotics and cough suppressants. As a younger pup, he had been treated with rather high doses of steroids for a skin problem. A surgery consult had been suggested, but given the poor prognosis, the owner declined.

On presentation to Dr. Calabrese, the puppy was on antibiotics, hydrocodone and prednisone. He coughed frequently and had virtually no exercise tolerance. He was given high doses of glucosaminechondroitin and Sam-E, and an appropriate Chinese herbal formula – Xiao Chai Hu Tang (Triple Burner Obstruction and Rebellious Lung Qi).

Within eight weeks, he became a nearly normal pup, running and playing with his Italian Greyhound companion, coughing only rarely, and experiencing normal exercise tolerance. Nine months after initiating treatment, he was x-rayed again; his tracheal lumen is now of normal size, with very obvious remodeling at the former area of stenosis.

ADDITIONAL HOLISTIC MODALITIES

You can also recommend some of the approaches your holistically-oriented clients may be purchasing on their own, such as:

  • Vitamins C (500 to 2,000 mg per day, divided) and E (800 to 2,400 IU daily)
  • Colostrum at 500 mg per 25 pounds
  • Honey, or honey and lemon juice, or coconut oil can be soothing and any amount is safe; average dose is 1 tsp per 20 pounds
  • Marshmallow root is gentler than commonly-used slippery elm; dissolve 1 tsp in 8 ounces warm water and give a teaspoon at a time

1merckvetmanual.com/mvm/respiratory_system/respiratory_diseases_of_small_animals/overview_of_respiratory_ diseases_of_small_animals.html.

2Fenwick, Brad, DVM, diplomate ACVM, PhD, ivis.org/proceedings/navc/2005/SAE/470.pdf?LA=1.

3Ellis, JA. How well do vaccines for Bordetella bronchiseptica work in dogs? A critical review of the literature 1997-2014. The Veterinary Journal, 204 (2015), pp. 5-16

4Edinboro CH, Ward MP, Glickman LT. “A placebo-controlled trial of two intranasal vaccines to prevent tracheobronchitis (kennel cough) in dogs entering a humane shelter”. Prev Vet Med, 2004 Feb 26;62(2):89-99.

5Kawakam, Kazuo. “Nosocomial Outbreak of Serious Canine Infectious Tracheobronchitis (Kennel Cough) Caused by Canine Herpesvirus Infection”. Journal Clinical Microbiology, April 2010, vol 48

6LJ Larson, BE Thiel, P Sharp, RD Schultz. “A comparative study of protective immunity provided by oral, intranasal and parenteral canine Bordatella bronchiseptica vaccines”. Intern J Appl Res Vet Med, 2013.

7Edinboro CH, Ward MP, Glickman LT. “A placebo-controlled trial of two intranasal vaccines to prevent tracheobronchitis (kennel cough) in dogs entering a humane shelter”. Prev Vet Med. 2004 Feb 26;62(2):89-99.

8Day, Christopher. “Isopathic prevention of kennel cough – is vaccination justified?” International Journal of Veterinary Homeopathy, 1987, 2: 45.

Veterinarian Dr. Christina Chambreau graduated from the University of Georgia Veterinary College in 1980. She is a founder of the Academy of Veterinary Homeopathy, was on the faculty of the National Center for Homeopathic Summer School and has been the holistic modality adjunct faculty liaison for the Maryland Veterinary Technician Program. Dr. Chambreau is author of Healthy Animal’s Journal, co-author of the Homeopathic Repertory: A Tutorial, and Associate Editor of IVC Journal.