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Understanding pet digestion
From the outside, pet nutrition seems like an easy subject. Buy a bag of pet food. Feed the same dry food to the pet every day of her life. No fresh food, no variation. As veterinarians, this is typically what we are taught. But is that really the best recipe for pet health? Does it make sense? To find the answer, it is best to shine a light on the inside of a dog (or cat), gain a better understanding of digestion, and examine what they really need from the lens of my 20 years of veterinary practice.

Health is entirely dependent on nutrition

The best way to insure vibrant health and longevity is to provide an excellent and species-appropriate plane of nutrition. Digestion is the product of both the complexity and simplicity of nature. All animals on the planet keep themselves alive and healthy through the actions of finding food and water, ingesting, regulating, digesting, absorbing, rejecting, and defecating. Every aspect of the food our pets eat – moisture, freshness, processing, balance, structure, sourcing, amount, ingredients, frequency of meals, and even how it is served – plays a role for good or ill, in the digestive process. Not being able to find ways to truly heal animals can be frustrating for veterinarians and pet parents who are depending on inappropriate foods for the animals in their care. Why did we ever think that a processed dry food would be better for our beloved animal family members? Why is it so difficult to consider feeding fresh food? If fully changing to a fresh raw food is daunting, it is possible to simply add some fresh food even a few times a week. The health changes can be dramatic. Often, just adding a sardine or two to the food, and using a small amount of fresh meat or pre-prepared raw foods (even lightly cooked) a few days a week can improve health. It is possible (and often a great first step) to mix and match processed and fresh foods. The real first step to creating a healthier animal is to understand digestion. It is clear that food supports the overall development, growth and maintenance of strong bones, muscles, nerves and organs; the regulation of gene expression, the immune system, circulation, and fluid balance; the daily balancing of hormonal/endocrine reactions and behavior; the support of the bacterial biome in the GI tract, skin and throughout the body, and creating an overall happy, healthy and long life. Understanding why and how all these are affected by diet choices is an important and typically absent part of veterinary care. So what is happening in there that we don’t know about?

Who’s on the inside?

Digestive activity is not limited to textbook pictures of the organs and cells of the GI tract. There are many players in digestion besides the animal’s own cells – in fact, nearly 70% of what happens in the GI tract results from other organisms’ actions, production and reactions. The most important component of the digestive process may well be a healthy combination of “good” and “bad” bacteria (a healthy GI biome). There are thousands of species of bacteria that play roles in animal health. In fact, we know that the number of bacteria living in an animal’s body significantly outnumber their own cells. The symbiotic relationship between the body and its GI biome is responsible for a significant portion of the regulation, fermentation, border patrol, absorption and production of nutrients. Healthy animals eating species-appropriate foods are feeding and supporting appropriate GI bacteria. This healthy population of bacteria then keep the animal healthy.  Appropriate bacteria play vital roles in the breakdown of fibers and toxins, vitamin production, protection from pathogenic bacteria, integrity of the GI tract lining, and appropriate absorption. We see dysbiosis and illness when bad bacteria overrun the good. Dysbiosis, GI disorders, absorption problems and other GI related health issues are becoming more prevalent in our pet populations. It is likely that the increase in these disorders is related to bacterial imbalances resulting from increased use of antibiotics, herbicides and pesticides, as well as species-inappropriate, sterile processed foods.

Mythconceptions about bacteria

  • If we get rid of all bacteria, we will be healthier. (Just not true.)
  • If bacteria are resistant to antibiotics, we have no other solutions. (Integrative medicine has many options -- e.g. essential oils, honey, herbs, immune supplements, and excellent foods can all help cure resistant bacterial infections.)
  • If we sterilize surfaces and bathe more, we will be healthier. (The more we rid our environment of good bacteria, which fight bad bacteria, the more likely we will have troublesome problems with bad bacteria, which will multiply unabated and become resistant. Also, sterile environments are implicated in allergy and immune system issues in youngsters.)
  • Plastics are safer than wood surfaces. (Wood has natural antibiotic properties, and what protects trees from bacterial invaders protects wood products from bad bacteria.)
  • All raw meat foods contain harmful bacteria for animals. (While testing is done, healthy dogs and cats are designed to fight many pathogens in their meats, including E.coli and Salmonella. After all, they eat poop, pick up and swallow who-knows-what old meat/animal parts outside, and are fine.)
  • Eating pasteurized, cooked, processed foods is safer for our pets, and for owners and vets. (There are risks and recalls for all meat pet foods. Companies making raw foods are just as concerned about pathogens as processed food makers. Pathogenic bacteria -- more of an issue for humans, and not always a problem for pets -- have been found in all types of pet foods, whether kibble, canned, raw, freeze dried, treats, etc., and no one food is inherently safer than another. The best advice is to be careful with all foods.)
The GI tract functions as an absorptive, protective, motile, interactive immune surface full of live organisms. It protects the body from bad bacteria, disease and toxins, absorbs and creates nutrients, and provides triggers for hormonal, immune and neurologic interactions.

Macronutrients and micronutrients

Nutrients and water are obtained, absorbed and moved through the gastrointestinal (GI) tract to support the many systems of the body. The three generally recognized macronutrients (needed in large amounts) are protein, fat and carbohydrates. Micronutrients are vitamins and minerals that are needed in small amounts. Water is not considered a macronutrient, although it is needed in large amounts for most of the processes, reactions and transportation functions of digestion. It also provides a structural vehicle in which nutrients are presented for use. When we remove water from fresh foods, we create a jumble of dry ingredients that the body needs to untangle. In their original form, fresh foods maintain their cellular integrity and form. The water’s structure creates an appropriate vehicle and an orderly balance for recognition and absorption. Adding or taking away water should not be done lightly.

Cats in troubled waters

Moisture-appropriate foods are even more important for cats. It is possible that cats may be prone to developing kidney problems because we feed them dry foods. They are desert animals and inclined to get their moisture from their prey, as fresh water in the desert is scarce. They will drink to get their moisture, but it will not be a natural activity for them, so they may wait until they are significantly dehydrated before taking a drink. If, for their whole life, for every meal, cats are given dry food that provides little moisture and requires significant moisture from the body just to digest it, we are setting up a situation that causes dehydration and stresses the kidneys. Over time, this can translate into urinary tract disease, stones, infections or kidney disease.

Smell, taste and temperature

Detecting an appetizing smell is essential to start the body’s juices flowing. There are many medications that affect smell and taste, so it is useful to be aware of the side effects of medications. If an animal develops a decrease in olfaction from non-steroidal anti-inflammatory drugs (NSAIDS), it can affect his appetite. This is something known to the owners of dogs who do nose work, so they avoid NSAIDS, especially when the dog is working. Animals will generally also avoid foods that do not smell appetizing, or that smell rotten or toxic (except for some Labradors named Orion, Quincy or Darwin!). This is also true for taste. The ability to detect unhealthy odors or tastes is an important first defense. Temperature and moisture can also play a role in enhancing odors and tastes and stimulating the appetite. Meats would typically be at least at room temperature or even “body temperature” when animals hunt and eat. There is something to be said for trying to mimic what would make a carnivore excited about his food in the wild.

Teeth – not for chewing

The dentition of a carnivore is specifically geared towards tearing off chunks of food and getting them ready to swallow, not for chewing. Dogs and cats have these little pyramids of teeth. Their teeth are sharp, and they interlock to hold and rip flesh. The teeth have done their job if what they have torn off can fit down the esophagus. There are no flat “chewing” teeth. Carnivores can chew, but it is not the “point” of their teeth. We learn in grade school what different teeth do from their shape. There is a difference between large, wide, flat chewing cow teeth and sharp pointy carnivore teeth. Moist meaty foods are easily cleaned off the surfaces of the teeth with a swipe of the tongue. Inappropriate, dry, sticky carbohydrates will stick to the teeth and create tartar. Changing to a fresh, moisture-appropriate food can be one way to improve dentition and mouth biome health.

Saliva, drool, slobber -- lubricant

The carnivore mouth is just a momentary stop for food on the way down. Saliva reflects that purpose. Saliva’s main activity in dogs and cats is to act as a lubricant, although it will mix with bacteria -- both good and bad. It even has a bit of antibacterial capacity to fight pathogens, but its main purpose is to allow easy and quick swallowing.

Wolfing it down -- dogs have the stomach for it

The term “wolf it down” is correct for Canids. This is what they do -- they swallow first and ask questions later. Which is why we have hundreds of radiographs of foreign objects (including a personal favorite – an entire GI Joe) in the stomachs of dogs. But in nature, wild dogs would grab large pieces of meat from their prey, or even the whole prey, and swallow. A dog can eat a huge amount of fresh meat and organs in seconds, and show no ill effects. In fact, their digestive tracts appear to be designed to do just that. Dogs can keep about 70% of their ingesta in the stomach, and only 30% in their intestinal tracts. In humans, those percentages are reversed – 30% in the stomach and 70% in the intestines. So people eat smaller meals, more frequently. We only encounter problems with a dog or cat’s instinctual speed-eating when we feed dry foods, because these foods are not what the body expects. The stomach is made for more moisture-appropriate diet. Animals eating meals of dry processed foods are five times more likely to bloat than animals eating large amounts of fresh moisture-appropriate foods.

The stomach

The stomach creates a very large muscular acid bath for the food. In fact, the stomach acid of a carnivore has a pH of 1 -- extremely acidic. When food arrives in the stomach, it stimulates parietal cells to secrete hydrochloric acid (HCl), which decreases the pH. Eventually, a negative feedback mechanism recognizes there is enough HCl and shuts off production. The acid bath softens foods, kills pathogenic bacteria, breaks bonds, and starts the digestive process. The muscular motion of the stomach wall mechanically mixes the acid with the foods.

Intestines, small and large

As acidic ingesta moves from the stomach into the duodenum, the fats, proteins and lowered pH of the ingesta will stimulate pancreatic and bile secretions, cholecystokynins and digestive enzymes that further digest and neutralize the acid in the food. Proteins are somewhat digested to amino acids, di-peptides, tri-peptides (short-chain polypeptides) by pepsin. Triglyerides (fats) are emulsified, broken down and absorbed. Nutrients are transported across epithelial layers with help from bacteria and the brush border enzymes, pancreatic juices and bile salts. Sugars are fast energy and are absorbed and used quickly (and will affect inflammation and the glycemic index). Note: Production of digestive enzymes depends on appropriate levels of micronutrients and minerals like iron, manganese and selenium .Animals may become deficient in many micronutrients because of an increase in herbicide chemicals like glyphosate in pet foods.  Glyphosate insolubly binds many micronutrients and minerals in foods (specifically metals essential in the production of enzymes), making them unavailable for these metabolic processes. The large intestine is involved in the absorption of water, electrolytes, vitamin production and absorption. Both the small and large intestines contain a great deal of bacteria that serve a number of functions. They are essential for the absorption of vitamins (especially B and K), they produce small fatty acids used as energy by GI epithelial cells, and they are needed to break down indigestible fibers and molecules.

What the poop?                           

Defecation in the carnivore should not involve huge, voluminous soft feces. Normal canines use most of their food, and the resulting poop should be very firm, relatively dry, not horrible-smelling and in a small amount. When carnivores eat healthy, appropriate fresh food, “even the poop is cute”.  Poop odor and flatulence in dogs and cats is related to their biome. Bacteria produce many unpleasant gasses and smells, and an unhealthy biome will smell unhealthy. Pets defecating more than twice a day, and creating soft, odiferous and large feces, reflect the amount of filler and inappropriate ingredients we put in pet food, and is not a normal condition for dogs and cats. A good way to monitor proper feeding amount is by looking at weight and monitoring the frequency of defecation. Dogs and cats normally defecate one to two times a day at a maximum.The stool is small, firm, and doesn’t always look exactly the same. If dogs and cats are pooping more than that, they are either eating too much or ingesting too much filler.

Diarrhea and vomiting

Vomiting or diarrhea can be a reaction to something in the food, or symptoms of a systemic illness. If it is a reaction to food, expelling the food with urgency might be a sensible mechanism. The body is saying “wrong food!” and removes it as quickly as possible. Medical interpretation often describes vomiting and/or diarrhea as a disease process in itself, so medications to stop the expulsion of food are prescribed. These medications can be useful to stop the cycle of GI distress, but they do not solve the problem if the diet is deficient. The answer for many cases of chronic or even sudden GI upsets could be simply to slowly change to a more biologically appropriate, fresh organic food. The natural bacterial biome will be nourished, it will more easily assist in digestion, and the body will be healthier. During diet changes, it can be useful to take a couple weeks to change foods, and consider the need to add an appropriate prebiotic fiber, probiotic bacterial supplement and perhaps even some enzymes for support.

Teamwork in the end

Helpful bacteria, fungi and parasites live in harmony within the body and play an important role in digestion. With the overuse of antibiotics in pets and food animals, and an increase in pesticides/herbicides in many pet foods (like glyphosate, which has known antibiotic properties), we are seeing more problems than solutions to bacterial problems.  As new resistant bacteria become more common, and helpful bacteria diminish, we are upsetting the delicate balance needed for proper digestion. In addition, over-cleaning, over-bathing, sterile foods and lifestyles do not help pets replenish a healthy biome. There are cases in which the only way to fully replenish a damaged bacterial population is to perform a fecal transplant. This procedure involves taking feces from a healthy, fresh food-eating dog or cat, using a special recipe to create a liquid that can be introduced to the unhealthy animal through an enema or capsules. This procedure, while it seems crude, can be tremendously effective in a depleted animal with poor absorption.

Don’t give up, try food!

As we think about all these interactions, and the complicated anatomy and biology of the digestive tract, we may feel overwhelmed by how intricate the system is. There is much to consider: available pet foods, food animal conditions, organic sourcing, pesticides, GMO, costs of various foods, GI bacterial relationships and bacterial species, pH motility, secretions, digestive triggers, external stressors, automatic activity, autonomic nerve reactions, parasympathetic reactions (rest and digest), sympathetic reactions (fight and flight), enteric nervous system intrinsic to the GI tract, histamine releases, HCl secretions, bile flow, absorption, nutrient loss, toxin rejection, defecation issues and more…. The sensible way to maintain health is to be aware of this complexity, and use that understanding to recognize that before we interfere with this naturally balanced system, we should make sure there is really be a good reason. When we tip the balance with a less than optimal food, a gut-changing medication or other intervention, we may see unexpected and unwanted side effects as a result.

Eat less, get healthy, clean up!

Eating once, or at most twice, a day is normal fare for a carnivore. A hunt would provide a meal, they would eat, rest and digest, and maybe not hunt again that day. It may appear that certain dogs or cats are “nibblers” and need/like to eat a little bit all day. This is likely a misunderstanding of what is happening. It is not the ancestral behavior of a carnivore (a dog or cat) to nibble on their prey. It is possible that a bowl of dry kibble left out for free-feeding may be so uninteresting that a pet will only eat a little at a time, hoping for something better. Most animals, when they are changed to a fresh food diet, eat quickly and consume all the food. They don’t need a dry kibble left out all day to snack on if they are eating the wet food well. Cats and small dogs do well on twice-daily feeding, while medium to large dogs may do well on once-a-day feeding. Learning about digestion involves not only learning about how animals process food, but also how they manage when they are hungry. A strong body of evidence suggests that many animals tap into the body’s natural ability to re-invigorate itself when they are hungry. Certain processes that make an animal healthy only turn on when he feels hunger, or when he goes into a fasting, ketogenic state. The animal will switch from the processing food mode to a clean-up mode. This is very different from the type of ketogenic condition we see in a diabetic, where there is a high blood sugar, no insulin, resultant ketones and illness. In a healthy ketogenic condition, the blood sugar is low but not a health threat, and the body is producing ketones to effectively use as energy while it turns on body systems to seek out unhealthy cells, assess mitochondria, DNA and organelles for damage, and repair them. When hungry, the body recognizes the need to hunt more efficiently with a healthy body, so it gets to work on its own cells. Because there is little education about the existence of this health mechanism, we rarely let our pets get hungry. A way to think about this is that the body will be conservative and only do what is necessary. If there’s plenty of food, why clean up? Things must be fine. Or imagine the difference between having a party with plenty of food for everyone, and having the food run out and the kitchen in a huge mess. It’s time to clean the kitchen. If we never let an animal feel hungry, he will never “clean the kitchen”.

GI inflammation

Inflammation in the GI tract, including inflammatory bowel disease (IBD), is often just the body reacting sensibly to “wrong food!” by becoming inflamed for protection and to keep absorption of the wrong food to a minimum. Resolution of signs can often be as easy as supporting the bacterial biome with supplements and changing the food to something appropriate (fresh, organic). Sometimes an animal needs some extra help to re-florinate the population of bacteria. For every case, complicated or obvious, healthcare should always begin by focusing on returning to a natural, biologically sensible dietary balance. It is possible that given the right tools, the body can take care of the rest for us.

References and Bibliography

  • AAFCO Official Publication, 2016 update.
  • Brown, Steve, Unlocking the Canine Ancestral Diet, Dogwise Publishing, 2010; pp 5-10.
  • Becker, Karen Shaw and Taylor, Beth, Dr. Becker’s Real Food for Healthy Dogs and Cats, Natural Pet Productions, U.S., 2009
  • Brown, Steve, Can High-Fat Beef-Based Raw Diets Lead to Behavioral Issues and Aggression in Some Dogs?” Integrative Veterinary Care Journal, winter issue 2014-2015, pps 36-38.
  • Dierenfeld, ES, Alcorn HL, Jacobsen KL, “Nutrient composition of whole vertebrate prey (excluding fish) fed in zoos,” Zoo Biology. 1996; 15:525-537.
  • Federation europeenne de L’industrie des aliments pour animaux familiers (The European Pet Food Association) Nutritional guidelines, 2013.
  • Fox, Michael J., Not Fit for a Dog: The Truth About Manufactured Cat & Dog Foods, Quill Driver Books, Fresno, CA 2009
  • Gross, K.L., Yamka, R.M., Khoo, C., et al. Macronutrients, Micronutrients: Minerals and Vitamins. In: Hand, M.S. ed. Small Animal Clinical Nutrition, 5th Ed. Topeka, Kan.: Mark Morris Institute, 2010
  • Preventing Bloat Naturally, Peter Dobias, DVM. In Dogs Naturally Magazine. http://www.dogsnaturallymagazine.com/preventing-bloat
  • Rodney Habib Planet Paws Facebook -- Easy to Make Homemade Dog Food Recipe
  • Harrington, Kohl, Director, Pet Fooled, Documentary, Gravitas, 2016.
  • Martin, Nancy L., Challenging the Pet Food Paradigm, pp 221-230 In: Proceedings of the Annual Conference of the American Holistic Veterinary Medical Association, 2016.
  • Merz, Walter, ed., Trace Elements in Human and Animal Nutrition, 5th Ed., vols.1&2, Academy Press, 1987
  • National Nutrient Database, USDA #05139 and #05144, reference #28.
  • National Research Council of the National Academies, Nutrient Requirements of Dogs and Cats, 2006.
  • Royal, Barbara, The Royal Treatment: A Natural Approach to Wildly Healthy Pets, Simon and Schuster, New York, 2012.
  • Royal, Barbara, The Essential Pocket Guide to Pet Food, Chicago, 2016
  • Stevens, C.E. Physiology implications of microbial digestion in the large intestine of mammals: relation to dietary factors. The American Journal of Clinical Nutrition, 1978; 31: 5161-5168
  • Royal, Barbara; Habib, Rodney; Becker, Karen; Orrego, Daniel; Brown, Steve; Wild Health Nutrition Course #1701, Royal Animal Health University, San Luis Obispo, April 8-9, 2017.
  • Thixton, Susan, TheTruthAboutPetFood.com, Website
  • http://www.petfoodindustry.com/Petfood-Industry-Knowledge-Center, Website
 
Introducing a holistic approach to conventional medicine – case studies
When you incorporate holistic medicine into a conventional practice, conventional work (spay/neuter, vaccination, specialty referral) is considered “alternative”. Here are a few examples of how holistic medicine can help your clients.

Case study #1 – Roxanne, a 16-year-old SF DSH cat

Roxanne was presented in November of 2014 for a second opinion on treatment for kidney failure. The owner’s conventional veterinarian had recommended urine culture, urine protein, creatinine ratio and blood pressure – all declined due to cost.  Three renal diets were sent home, all of which Roxy refused. The owner gave SQ fluids for a few weeks, but because she’s older, she found it difficult to continue.  She reported that Roxy was lethargic, 70 inappetant, PU/PD and vomiting occasionally. Roxanne’s labs were:
  • BUN 155 mg/dl
  • Creatinine 8.9 mg/dl
  • Phosphorus 10.7 mg/dl
  • USG 1.010
On exam, Roxy was quiet, 6% dehydrated, had a strong rapid pulse, with kidneys bilaterally small and smooth, and loss of spinal muscling. As Roxy only agreed to eat higher-protein canned diet, we continued that diet, but I asked the owner to offer the food lukewarm, with water added to a soupy consistency. I started Roxy on Zhi bai di huang wan tincture at 0.15 ml PO BID, and asked the owner to return for a recheck exam and labs in two weeks. On callback seven days later, the owner reported that Roxy was eating somewhat better (and taking the herbs in food, as the owner could not medicate orally).  After two weeks, the owner reported that Roxy was feeling “much better”, but that she absolutely could not afford a recheck exam and labs. I stressed the importance of doing so, and continued to check in every couple weeks. Ten weeks later, Roxy presented for labs only:
  • BUN 35
  • Creatinine 1.9
  • Phosphorus 2.9
Her owner reported that she was “bossing the other cats around again”, was much more playful, eating well, still PU/PD. She was eating consistently, so we added Standard Process Renafood. I finally saw Roxy for a recheck exam and labs six months after her initial exam with me (I’d long given up hope that the owner would make another appointment, but was happy with heprogress reports). Roxy was still 5% dehydrated, but she had a stable weight and was perky. A mini-screen was normal.  She continued to eat high protein canned diet, with the owner rotating proteins. I learned two things from this kitty. I will never limit protein in any standard chronic renal failure cat. My Chinese training taught me that protein increases renal blood flow. So if there is no sign of renal inflammation (infection, ^UPC, etc.), high protein diets are indicated. I know this topic had been discussed to death on both conventional and alternative forums. There are DVMs far more qualified than myself who can speak to the physiology involved, but I continue to have good success in CRF cats with water-added high protein canned diets, and a proper herb Rx (which is the difficult part sometimes, right?). Secondly, I learned that animals can heal, even under less-than-ideal circumstances.

Case study #2 – Copper, an eight-year-old MN Viszla

Copper presented two weeks post-splenectomy for hemangiosarcoma. On exam, he was shy, had several fatty masses, BCS 6/9, mm slightly pale, pulse deeper and thinnish. He had been very sleepy on Tramadol (a yin tonifier). So he appeared to be blood deficient and damp in TCM terms. I started him on Yunnan bai yao, Dang gui shao yao san, cod liver oil, medicinal mushrooms, IP6. Through the next 15 months of treatment, I tried various additions to the DGSYS, but was never able to quite correct Copper’s thinner pulse. He eventually had an acute bleed and was euthanized. I know there are reports of much longer survival times with HSA patients undergoing herbal care, but with minimal side effects the owner and I were happy to have provided Copper with a period of time well beyond what was expected for splenectomy alone, and even chemo.
 
Introducing a holistic approach to conventional practice
Many veterinary practitioners who embrace holistic medicine have a personal story. Perhaps conventional medicine failed them, or one of their loved ones, and it was only when they turned to alternative therapies that they saw any true health improvements. These experiences tend to change their outlook on medicine, inspiring them to learn more about holistic treatments and begin introducing them into their own practices. This article follows my own journey towards holistic medicine and how I went about adding it to daily practice.

How I got interested in holistic medicine

My story began with our son, Ben, who suffered for years with headaches, hours-long temper tantrums, skin rashes, night terrors and one ear infection after another. With diet changes and cessation of vaccines, and working with chiropractors, Qigong masters and homeopaths, he started to smile again, and became healthy. Now 18, Ben is a college freshman. He sees an acupuncturist/herbalist to help with anxiety, eats what he wants, and has learned how to keep his moods stable with his own flower essence blend and essential oils.  He’s not perfect, but he’s pretty good. A couple of years into Ben’s treatment, I finally recognized the discordance between what I now believed was “health care” for my family, versus how I had been treating animal patients at the practice for 18 years.

Learning more

At my first AHVMA conference, I met top notch practitioners – specialists in acupuncture, chiropractic, PT, homeopathy, herbs and more. Some practiced out of AAHA-certified hospitals and even referral centers. A few sported braids and sandals! But they all had one thing in common; they had discovered that their Western medical training fell short of their expectations. Soon after the conference, I read an article by Dr. Christina Chambreau about seeking your “right livelihood”, the work that completes you as a person on all levels. This concept really hit home; I wasn’t in my right work anymore. So I gave six months’ notice at my practice and started taking local holistic veterinarians to lunch – acupuncturists, homeopaths, herbalists, chiropractors. They were incredibly helpful in providing some shape to my new business. I wanted to know where they practiced, what modalities they used, where they trained, and the pros and cons of different types of integrative practice approaches.

Offering holistic therapies in a conventional setting

Then I approached the owners of the conventional practice where I’d been an associate for ten years, and we agreed to a shared percentage:
  • 60% (me)/40% (clinic) on exams
  • 25% on radiographs, labs
  • 5% on referred surgery, dentals, specialist consults.
The clinic provides me with an exam room, an assistant/technician when needed, scheduling and diagnostics. The owners have been very understanding of my clients’ choices -- running titers and recommending raw diets, especially since they are a fully Western AAHA-certified hospital. They see a demand for alternative medicine, and know I’ll refer medical and surgical cases to them as needed. Their lawyer and my tax guy strongly suggested the businesses be kept separate – my name is not on the door, the clinic literature or the website. Clients are instructed to contact me at my own Animal Wellness Center and call or email my home office even though pets are seen at the clinic. Most of my supplies, primarily Chinese herbs and Standard Process supplements, are kept at my home. Initial intake exams are 90 minutes. I review records prior to the appointment for the medical history. I typically chat with the owner at length before examining the pet. We discuss medical history; treatments that have worked or failed; their goals (which may not be the same as mine!); vaccines, heartworm, flea and tick prevention and (oh-so-important) diet. Typically, diet is the first change we make, if appropriate. I ask owners to feed a commercial raw or fresh-cooked diet and start whole food supplements while I select the Chinese herbs. Commonly, I hear things like: “She’s so much more energetic!”, “His eyes are brighter”, “No more gas -- thank you!” from the diet change alone. This lays a foundation for healing, the owners are receptive and the herbs will amplify that process. On the flip side, a pet on a fresh diet who isn’t doing well will occasionally show up (e.g. a German shepherd with chronic GI issues who was worse on raw diet). I find that some of these animals do better on hypoallergenic kibble short-term. After a few months of treatment, they can often transition back to raw/cooked diet and do well. Recheck exams are 40 minutes long – I repeat an exam, review treatment success, and make a plan for moving forward. If the client has a conventional veterinarian, I try to keep labs and diagnostics within that clinic as much as possible. Some rechecks are done by phone for clients who live far away, have cats or dogs who are stressed by car rides, or who cannot make my appointment schedule. While not ideal from a TCVM perspective, clients are grateful for this option and will continue with holistic treatments. These cases do move forward. I charge by the minute for calls and extensive emails. I continue to vaccinate younger animals, but using only core vaccines that are given singly. Per Dr. Ron Schultz, I titer puppies after their last DHPP, then typically do not repeat. Rabies is given every three years in healthy pets. I recommend seasonal heartworm preventative and use pyrethrin or essential oil sprays for fleas and ticks. For cats, I give a single FVRCP and one rabies vaccine if they’re kept indoors.

Working with a business coach

After ten years, I finally hired a business coach because managing an integrative practice and generating income was a challenge without typical practice sales. I strongly recommend working with a coach at the beginning of your foray into predominately holistic medicine. We’re making progress on pricing, a new website, and charging for my phone and email time when lengthy (0/hour). My typical clients are middle-aged woman whose beliefs are similar to mine. They are presenting their pets for holistic care, and any conventional work (spay/neuter, vaccination, specialty referral) is considered “alternative”. I love that! Typical cases are chronic medical issues such as IBD, seizures, cancer, atopy and behavior problems. My practice is now aligned with my personal beliefs about wellness, and my patients are benefitting with improved health.

Case study #1 – Roxanne, a 16-year-old SF DSH cat

Roxanne was presented in November of 2014 for a second opinion on treatment for kidney failure. The owner’s conventional veterinarian had recommended urine culture, urine protein, creatinine ratio and blood pressure – all declined due to cost.  Three renal diets were sent home, all of which Roxy refused. The owner gave SQ fluids for a few weeks, but because she’s older, she found it difficult to continue.  She reported that Roxy was lethargic, 70 inappetant, PU/PD and vomiting occasionally. Roxanne’s labs were:
  • BUN 155 mg/dl
  • Creatinine 8.9 mg/dl
  • Phosphorus 10.7 mg/dl
  • USG 1.010
On exam, Roxy was quiet, 6% dehydrated, had a strong rapid pulse, with kidneys bilaterally small and smooth, and loss of spinal muscling. As Roxy only agreed to eat higher-protein canned diet, we continued that diet, but I asked the owner to offer the food lukewarm, with water added to a soupy consistency. I started Roxy on Zhi bai di huang wan tincture at 0.15 ml PO BID, and asked the owner to return for a recheck exam and labs in two weeks. On callback seven days later, the owner reported that Roxy was eating somewhat better (and taking the herbs in food, as the owner could not medicate orally).  After two weeks, the owner reported that Roxy was feeling “much better”, but that she absolutely could not afford a recheck exam and labs. I stressed the importance of doing so, and continued to check in every couple weeks. Ten weeks later, Roxy presented for labs only:
  • BUN 35
  • Creatinine 1.9
  • Phosphorus 2.9
Her owner reported that she was “bossing the other cats around again”, was much more playful, eating well, still PU/PD. She was eating consistently, so we added Standard Process Renafood. I finally saw Roxy for a recheck exam and labs six months after her initial exam with me (I’d long given up hope that the owner would make another appointment, but was happy with heprogress reports). Roxy was still 5% dehydrated, but she had a stable weight and was perky. A mini-screen was normal.  She continued to eat high protein canned diet, with the owner rotating proteins. I learned two things from this kitty. I will never limit protein in any standard chronic renal failure cat. My Chinese training taught me that protein increases renal blood flow. So if there is no sign of renal inflammation (infection, ^UPC, etc.), high protein diets are indicated. I know this topic had been discussed to death on both conventional and alternative forums. There are DVMs far more qualified than myself who can speak to the physiology involved, but I continue to have good success in CRF cats with water-added high protein canned diets, and a proper herb Rx (which is the difficult part sometimes, right?). Secondly, I learned that animals can heal, even under less-than-ideal circumstances.

Case study #2 – Copper, an eight-year-old MN Viszla

Copper presented two weeks post-splenectomy for hemangiosarcoma. On exam, he was shy, had several fatty masses, BCS 6/9, mm slightly pale, pulse deeper and thinnish. He had been very sleepy on Tramadol (a yin tonifier). So he appeared to be blood deficient and damp in TCM terms. I started him on Yunnan bai yao, Dang gui shao yao san, cod liver oil, medicinal mushrooms, IP6. Through the next 15 months of treatment, I tried various additions to the DGSYS, but was never able to quite correct Copper’s thinner pulse. He eventually had an acute bleed and was euthanized. I know there are reports of much longer survival times with HSA patients undergoing herbal care, but with minimal side effects the owner and I were happy to have provided Copper with a period of time well beyond what was expected for splenectomy alone, and even chemo. What to keep in mind
  • In holistic practice, you will see many cases with advanced disease. Some will lose the battle, but when you can extend that pet’s life far beyond conventional predictions, that’s good.
  • Your clients, on average, will be a bit more high-maintenance, so be sure to charge for your time.
  • Soft fleece blankets, extra time and lots of treats make your hospital a fun place (or at least tolerable!). Provide cats with a quiet room, a place to perch or hide, and time to adapt before their exams.
  • These are clients you will typically see more often than in a conventional setting. You’ll get to know them better, and will walk through life’s challenges For me, this has been a great joy.
 
Holistic management for breeders
Building a better dog begins way before the parents ever meet! Breeders need a thorough understanding of the genetic consequences of their choices. You should coach your breeder clients to understand the strengths and weaknesses of their particular breeds, and to evaluate the conformational and genetic integrity of potential sires and breeding bitches. In the show dog world, there is an unfortunate tendency to “breed to win” by tweaking a line’s morphology to align with popular fads among judges. This practice has been responsible for highly detrimental shifts in breed standards over the past 100 years, creating dogs that have significant health issues bred into them along with the desired looks. [gallery columns="2" size="medium" ids="3718,3717"] Once a well-proportioned, athletic dog, the Bull Terrier has transformed discernibly over time. His thicker abdomen and unnaturally rounded head and snout are a consequence of selective breeding. [gallery columns="2" size="medium" ids="3719,3720"] The Bulldog's ever-increasing size and receding snout has led to numerous health complications. In most cases seen today, medical intervention is required during the birthing of this breed as a result of its large skull. Why does the practice of dog breeding create so many inadvertent health problems?  Through selective breeding, humans have modified size, coat, skull shape, ear type, tail carriage and other traits. But when looking at a variety of wild canids, and interbreeding populations of feral domestic dogs, a genetic blueprint for canids emerges: medium size, medium coat length, long tail, cone-shaped head, and upright ears. (For more information, see “Recovering canine health: the natural dog” by Michael W. Fox, DVM, and Deanna L. Krantz, IVC Journal, Fall 2017) In particular, changes in skull shape toward extreme brachycephalic and dolichocephalic dogs (as well as brachycephalic cats) has destroyed the health and functionality of breeds that were once exceptional working dogs and robust pets.  Some breeds, like English Bulldogs, have such huge heads that they are unable to normally whelp and require a C-section for each litter. his breed is also known for dysfunctional bites, severe dyspnea and cardiac anomalies. Others, like Collies and Shelties, can be expected to have poor dentition and significant eye defects because of their excessively narrow skulls. Vets and breeders need to work together responsibly to prevent these unintentional cruelties. For optimal fertility, the breeding bitch should be in excellent general health, with a solid but lean body score (4 out of 10), and given regular exercise. The diet should be high quality and protein-based. Processed commercial foods are not ideal because many kibbles are found to contain contaminants, which risks teratogenic effects, or even abortion in developing fetuses. Additionally, the high proportion of carbohydrate ingredients in dry dog food has a pro-inflammatory effect in the carnivore body. Many canned foods have a similar nutritional profile by dry weight as their kibble counterparts, so careful label reading is important!

Peri-parturient management

A match has been made, the breeding has “taken”… now what? Prepare, prepare, prepare!  The bitch needs to be in tip-top form for birth and lactation. Body score in the final weeks should be 4 to 5. While extreme roughhousing is not a great idea, normal gentle exercise should be encouraged daily, to help keep the bitch fit and supple for whelping. A prenatal ultrasound evaluation tells how many puppies to expect, and flags skeletal abnormalities or extreme size differences in the puppies. A very large puppy is a risk factor for potential dystocia: it can act as a plug in the birth canal. A prenatal chiropractic adjustment for the mom will normalize and balance muscular tone, reduce stress and may reduce risk of dystocia. During the first half of gestation, the bitch’s nutritional needs are only slightly increased and it is important not to overfeed, as excess weight gain can lead to problems during parturition. If the owner is feeding a homemade diet, it is critical for them to have a proven recipe, a balanced vitamin and mineral supplement designed to provide trace minerals, and an appropriate amount of calcium for this non-lactating adult phase of life. Feeding during pregnancy is a tricky balance. The bitch needs more calories for the developing puppies in the final weeks of gestation, but too much calcium supplementation creates a risk of eclampsia and too little can pull needed minerals from the dog’s bones.  For the first six weeks, the quantity of food provided should not alter from her normal diet.  In the last three weeks of gestation, however, the size of her meals should increase by approximately 25% each week, while keeping the calcium dose the same. In other words, don’t increase calcium intake with the increased ration. If the dog is fed a commercial food, the 25% increase should consist of fresh meat and vegetables; if the dam is fed a fresh food diet (preferred) the breeder may increase the muscle and organ portion of the diet but not add more bones. A baseline mineral ratio should be 0.8% to 1.5% calcium to 0.6% to 1.2% phosphorous.

Whelping concerns

Breeders need to make sure the prepared whelping box is of adequate size to accommodate the size of the dog and the size of the litter. The environmental surface for whelping must have some traction but not snag tiny toenails. Once whelping is in train, make sure the owner knows to document birth order, weight and markings, and to ensure that all puppies are capable of suckling. If this is the dam’s first litter, a lack of adequate mothering skills can endanger the lives of the pups. Recent research has shown that mothering skills are both genetically and epigenetically programmed, with suboptimal nutrition and an experience of poor mothering while the dam was a pup as known risk factors. Homeopathic Sepia (see below) can be a great remedy for rewiring these critical connections if the bitch seems disinterested in her puppies. Puppies that are weak and having trouble getting started often benefit from a dose of homeopathic Thuja (see below). The breeder may need to consider options like a “sow crate” or spacer rails to keep the bitch and pups separated except for nursing. After whelping, lactation demands a higher proportion of calcium and phosphorus: 1% to 1.8% calcium to 0.8% to 1.6% phosphorus. Because of the nutritional demands during this time, it is even more important to feed a high quality, easily digestible and balanced diet.  Most dogs can be fed ad lib until weaning time.

Early management: three to 16 days

Most educated breeders know to weigh puppies daily to monitor weight gain and identify problems, but you may have to coach newbies. It is useful to teach them how to document other significant developmental milestones in each puppy, such as eye opening, visual tracking, tonic neck reflex (ability to hold the head upright) and efforts to stand.  It may be useful to note structural and developmental differences between puppies relative to birth order and size. The early neurologic stimulation program (Bio-Sensor) developed by Dr. Carmen Battaglia is a proven way of jumpstarting the puppies’ neural and immune competence. It starts on the third day of life, and consists of a short daily routine (three to five seconds each) of varied stimuli: tactile stimulation, positioning upright, positioning upside down, positioning on back, and thermal stimulation with a cool towel on the feet. Dogs exposed to this program show numerous benefits: improved cardiovascular performance, stronger heartbeats, stronger adrenal glands, more tolerance to stress, and greater resistance to disease. In learning tests, pups stimulated with the Bio-Sensor program were found to be more active and more exploratory than their non- stimulated littermates (breedingbetterdogs.com/article/early-neurological-stimulation).

First adjustment and righting training: 16 to 30 days

[caption id="attachment_3678" align="alignright" width="200"] Positioning puppy upright to challenge extensor reflexes.[/caption] The most important intervention you can make to improve litter quality is to evaluate and correct problems of neural organization before the puppies are fully ambulatory. Ideally the timing for this visit should be somewhere within three to five weeks postpartum, as soon as the pups are able to thermoregulate away from the bitch. First, evaluate the bitch for any residual asymmetry from parturition. This is especially important if there was any dystocia. When the mom and pups come in for exam, carefully observe the puppies in the new environment and document differences among the group in terms of curiosity, gaiting abilities and stress levels. These are toddlers, and while they are funny to watch, they are actually experimenting with different aspects of locomotion. Their primary gaiting patterns and the kind of play they will soon engage in will require movement in multidimensional space. You can assess functional deficits by observing when puppies are unable to do their intended movements: look for the the one who keeps falling over (roll), the one who falls on its face (pitch and tilt), the one who can’t control its direction (yaw), the one who can swim and sit but doesn’t walk (pitch). This will give you clues about what manual therapy needs to be done, and how you can assess your results. Early childhood adjustments have a huge impact, because they can prevent problems before they are ingrained by growth and development. Litters that are given an early childhood intervention, like the one below, tend to yield a higher proportion of show quality dogs. For each puppy, perform an individual examination, including the following:
  • Listen to heart, observe any abnormalities
  • Examine and compare skull and jaw structure and symmetry
  • Look at tonic neck reflexes (can he control his head in space?)
  • Examine visual horizontal tracking (can he direct attention, and track with eyes?)
  • Examine and challenge extensor (standing) reflexes for:
-Strength and symmetry [caption id="attachment_3682" align="alignright" width="273"] Dr. Judith M. Shoemaker demonstrating gentle extension and flexion of the atlanto-occipital joint with Dr. Leslie Woodcock.[/caption] -Equal front and hind competence The following exercises are part of the Canine Posture Rehabilitation protocol, as developed by Dr. Judith Shoemaker, Dr. Karen Gellman and Elizabeth Reese. As you work with the puppy, frequently stand it up on all four feet, “rubber side down”, to reinforce the standing posture reflex. Each time you place the puppy, whether on your lap or the floor, the limb extensor reflex should be triggered by the paws touching a support surface. The primary postural reset for the front end is to gently extend the head and neck downward, and flex at the atlanto-occipital junction by bringing the nose towards the chest with a single finger. Make sure the puppy’s head can turn and rotate in every direction. The postural reset for the hind end is a tug downward on the tarsal bone of each hock. Gently! If you are trained in a specific manual therapy, you can go through your usual manipulation routine, bearing in mind how delicate these juvenile structures are. Be especially careful with any high velocity manipulation. Remember the giant first puppy whose birth was so difficult? These extra large puppies, often the greatest birth weight, can be slower than their littermates to achieve developmental markers, and may appear somewhat dull. The first puppy in a dystocia birth will have spent a long time having his skull squeezed in the birth canal. These slow pups are especially in need of chiropractic, and even cranial-sacral treatment to recover from their difficult parturition. You may need to treat them more frequently in the first six weeks. [caption id="attachment_3680" align="alignright" width="200"] The "righting" exercise, lowering the puppy, head first and supine, with a gentle bend toward one side. The correct response is for the puppy to twist upright and reach out with the near forelimb.[/caption] When your normal manual therapy routine is complete, test the puppy’s righting mechanisms and neural integration. This challenge is achieved by holding the dog supine in your two hands, and lowering it with head down and a slight turn to one side. The righting reflex should trigger the down forelimb to reach to support the body. This should be tested on both sides (see photo at right). In some pups, one side may be slower or they may try to reach with their opposite legs, showing cross signaling. This maneuver should be practiced until both sides react symmetrically. It should take no more than three tries in a pup with a normal nervous system. If one side continues to be slow, practice on the good side, then return to the slow side to see improvement. At the end of all manual therapy and righting challenges, reset the posture again and re-examine symmetry and reflexes. Recheck the heart as well after the procedure -- if there was an abnormality, it may have disappeared with reorganization and posture change. Reassess each puppy’s symmetry, movement, body confidence and curiosity, and document any changes.

Management after initial adjustment

Adjust and perform righting challenges (Postural Rehabilitation) again before weaning.  In cases of asymmetry, adjust frequently (every one to three weeks) during rapid growth to allow symmetrical growth. Document and address, if possible, abnormalities in dentition every time, along with listings and asymmetries. Dental problems are best addressed in the juvenile teeth, before the adult bite is formed. All carnivores are born with an underbite to facilitate nursing. There is normally a growth spurt in the mandible as the first teeth erupt. If a puppy has teeth that are slow to erupt, a dose of homeopathic Silica (or its constitutional remedy) may correct the problem. Growth asymmetries are usually addressed by removing the baby teeth on the slow side. It is best to consult a board-certified veterinary dentist at the appropriate time. Teaching puppies to chew appropriately by giving them raw chicken necks to learn on is a great way to build good behaviors and even intelligence. Dogs who learn to gnaw the meat off the bone, and grip the bone in their paws, have greater dexterity and problem-solving skills. Getting puppies straight and symmetrical in the beginning will save the owner much time, money and worry. Many puppies raised like this are self-maintaining -- needing only six-month or once-yearly checkups unless they experience trauma, toxins or stress. When animals start life with a solid grounding in their relationship with gravity, they can often withstand and heal from severe illness and injury.

Acute Peri-parturient homeopathic remedies  (“first aid”)

Classical homeopathy can be a quick and effective way to treat emerging conditions pre- and post-partum. You may want to put together a homeopathic emergency kit for breeder clients who will use it responsibly. It is best to use lower potencies when treating acute problems at home (30c and 6c by Boiron are often available in health food and even grocery stores). The remedies usually come as BB-sized pellets, packaged in small, lip balm-sized tubes. They can be administered either as one to two pellets given orally; or for tiny pups, dissolved in a small amount of water then dripped into the mouth with an eyedropper. Dosing is usually done one or two times, and not repeated until after consulting a homeopathic veterinarian. Please also consult a homeopathic veterinarian for directions using higher potency remedies. Apis mellifica: Mastitis with red, edematous mammary tissue (and lack of thirst) Arnica: Good to give to dam after whelping to promote quick healing of bruised tissues; also good for newborn puppies that seem slow in starting to nurse/move around. Arsenicum: For the puppy that has trouble getting started breathing, is cyanotic Belladonna: Mastitis with redness and heat, bitch is irritable Carbo vegetabilis: For weak, cold puppies Gelsemium: For the bitch that is extremely weak and exhausted during labor Phosphorus: Good for stopping bleeding Phytolacca: For mastitis when glands become indurated and painful, milk is stringy or chunky Pulsatilla: For stalled labor, a dam that seems to have trouble bonding with puppies, or puppies that are weak and cry constantly Sepia: For a dam that is not bonding with her pups at all Silica: For puppies whose teeth are slow in coming, who seem weak and may have large heads Thuja: Helps to stimulate puppies that are weak For a larger and more detailed list of remedies, Homeopathic Care for Cats & Dogs: Small Doses for Small Animals by Don Hamilton is a good beginning resource. The Pitcairn Institute of Veterinary Homeopathy offers a year-long veterinary training program and Dr. Christina Chambreau offers three- to six-day introduction to veterinary homeopathy classes.  
 
TCVM – preventive seasonal medicine for pets
In Chinese medicine, the seasons are associated with different bodily organs, ages and personalities. Encouraging your clients to come in for a seasonal “tune-up” is a good way to prevent future illness in their pets. Sending out wellness reminders with tips regarding seasonal medicine can help clients realize that you are committed to their animals’ health, and not merely treating ailments. Discussing the foods that correspond with each season is another way to promote your patients’ health, while encouraging clients to feed a variety of fresh foods.

Winter 

Winter, the coldest season, is associated with the kidneys, bladder, hearing, water and old age. The water personality is careful, curious, self-contained, meditative, slow, consistent, and has a tendency to hide. Those who are old, cold and have a Water personality will benefit from eating warming foods such as lamb, venison, chicken, garlic, buckwheat, eggs, ginger and cinnamon. Warming all food to room temperature or warmer is helpful for Water personality animals in the winter, as well as for most older or cold animals even at other times of the year. Kidney yang deficient animals, who may have a cold back, possibly early morning diarrhea and a sinking hind end, benefit from cooked food rather than raw, as raw feeding requires more energy to digest. Eggs contain qi (strengthening) and yin (cooling). Since eggs are the beginning of life, they also strengthen kidney jing, or life force, which comes from egg and sperm, and decreases with age. It is important to also nourish kidney yin, as all animals need the balance of yin and yang (qi plus warmth). Animals with kidney disease or bladder damp heat (blood, crystals or bacteria in the urine) are often very thirsty, may seek cool areas and may have a red dry tongue, often indicating yin deficiency. Some foods that nourish kidney yin are duck, pork, kidney, tofu, eggs, asparagus, cabbage, apples, barley, black beans and honey. Even if an animal is not old or a water personality, all animals can benefit from slight feeding changes in winter. For an animal with a cold back or cold hind end, moxa treatment can be very helpful. Moxa, or compressed mugwort, is lit and moved over the cold areas (but not touched to the skin). Smokeless moxa keeps odor away, but regular moxa seems stronger in my experience. If you are using this in a clinical setting, be sure to warn those around that it smells a bit like marijuana. This video provides a demonstration: https://youtu.be/bb7aQTibVTQ Massage can also strengthen the back and organs. Nie-fa, or skin rolling, can be done on the sides of the spine from head to tail. This loosens the fascia, allowing more free movement of the spine and supporting the immune system. Watch this video for a demonstration: https://youtu.be/qs4_z7BBwIg.

Spring

Springtime is wood season, and associated with youth, the liver and gallbladder (even in those animals without a gallbladder). The Wood personality is decisive, assertive, confident, athletic and wants to be alpha. These animals can be prone to irritability, ear problems, conjunctivitis, a purple color to the tongue (excluding Chows and Chow mixes of course), nail and foot problems; and tendon and ligament issues. To prevent these problems in young Wood personality animals (and all animals in the springtime), feeding cooked or pureed dark leafy greens such as kale, collards, turnip greens, beet greens, mustard greens, chard, spinach or broccoli is very helpful. Older animals or those with weak intestinal tracts do better with cooked greens, whereas young strong animals can handle pureed raw greens. Mixing greens with scrambled eggs or meat or onion-free broth can make them very palatable for finicky pets. Carnivores also benefit from eating liver. Those with sensitive gastrointestinal tracts can handle freeze-dried liver better than freshly cooked. Animals who run warm should have beef or bison liver, while heat seeking animals can handle chicken liver. Wood animals like to work hard and need both mental and physical exercise. Food dispensing toys can help when weather is too hot for physical exertion. Wood animals enjoy difficult competitive exercise, such as agility, lure coursing, endurance competition and racing, and tend to do well as they have the will to succeed. Springtime is also the time of “wind”, which can be internal or external. Internal wind manifests in the form of seizures, and external wind as itchiness. Dark green vegetables help decrease the risk of both ailments. Acupuncture or acupressure of liver points such as liver 3 (on top of the hind foot between the second and third metatarsal bones) and blood points can help decrease “wind” issues. The empty cases of cicadas can also help. Children often love searching for these and adding them to their dog’s food.

Summer

Summer is associated with the Fire personality, adolescence, the tongue, the heart and pericardium, small intestine and the Triple Heater, which doesn’t fit an exact anatomical organ but is somewhat similar to the thyroid. The Fire personality is outgoing, talkative, friendly and likes to be the center of attention. In the heat of summer, Fire problems such as shen disturbance, which can be seen as noise phobia or other abnormal behaviors, are more likely to occur. To cool Fire animals or any other hot animals in summer, feed cooling foods such as watermelon, celery (which also drains damp, helping hot animals with diarrhea or moist dermatitis), greens as mentioned above, brown rice, millet, turkey, rabbit (which is also strengthening), clams, cod and other whitefish. Feeding heart is also helpful. A cooling bed or fan is a great adjunct in hot weather. Since the tongue is the sense organ of the fire element, heart disease and shen disturbance can sometimes be suspected by a red and/or bell shaped tip to the tongue. Determine diagnostics needed (such as an echocardiogram) with a Chinese pulse examination and a very thorough physical. Treatment with food therapy, acupuncture and herbal medicine, along with any conventional medicine needed, can also help. It may give a clue to which cats may have a propensity to hypertrophic cardiomyopathy before saddle thrombus or sudden death occur, so prevention can begin. To correctly assess the tongue, the animal must show it freely, without having the mouth opened externally. Often when a person sticks out their tongue, the animal will do the same. Watching closely to catch a glimpse can be done but it can be tricky! If necessary, peek through the lips between the teeth to see the general tongue color, shape and moisture. Shen disturbance can be helped with Chinese herbal medicine (often a heart yin tonic) and non-Chinese medicine adjuncts such as Rescue Remedy for pets given orally or rubbed on the hairless parts of ears several times a day. This is especially important in the instance of fireworks and thunderstorms.

Late summer

Late summer is associated with the Earth personality, adulthood, Damp Heat and the gastrointestinal system, called the Spleen and Stomach in Chinese medicine. Earth personality animals are laid back, mellow, round and large, sociable and sympathetic. To help a weak gastrointestinal system in an Earth personality animal, well-cooked quinoa, sweet potato, pumpkin or squash are strengthening, along with beef, bison, rabbit and tripe. Damp-draining foods for those with loose stool or moist dermatitis include celery (which is also cooling), mushrooms and turnips. Avoid dampening foods such as watermelon, pork and salmon, as these worsen moist dermatitis and diarrhea. Hot spices such as garlic and ginger can help prevent Dampness and are good as long as the animal is not too hot. Limbs should be cool from the carpus distal and the tibiotarsal joint distal in all animals, the ears should be warm towards the head and cool at the tips, the nose should be cool and moist in dogs and cats and the paw pads should be soft and pliable in a healthy animal. If these areas are hot, too moist or dry, use foods to correct the imbalance. The tongue in an animal with Damp may be thick and even have tooth impressions, giving another clue as to which foods to feed. Earth personalities are prone to worry, so Rescue Remedy for pets, pheromone-based products such as Dog Appeasing Pheromone, and Feliway can be helpful. Strengthening the gastrointestinal tract with Chinese herbal medicine (spleen qi tonics) and probiotics can also help ease worry.

Autumn

Autumn, with its cool and often dry weather, is associated with middle age, Metal personalities, and the lung and large intestine, which are prone to drying out and causing cough and constipation. The skin and haircoat may also be dry and coarse. Metal personalities are aloof, love order and obey the rules. To moisten the respiratory tract and prevent cough, pears and honey are excellent foods, especially local honey as it contains small amounts of local allergens, helping prevent respiratory allergies. Yin deficient (or hot dry) coughs are more common at night, and the animal may have a red tongue and warm dry nose.  If the cough is weak or in the daytime, walnuts can help strengthen lung qi. Sardines help prevent constipation with their unique blend of yin and blood, which are, respectively, Cool and Moist, and Warm and Moist. Feeding lung also helps the lung, and if the large intestine is weak, such as in constipation, strengthening foods such as pumpkin, sweet potato and winter squash are helpful. Other moistening foods that help the lung, large intestine, skin and coat are eggs, duck, barley, tofu and rice. Understanding the seasonality of Chinese medicine, the personalities that go with the seasons and seasonal foods that are helpful to add can help animals be healthier all year long. Of course, each individual animal can be much more complicated. Traditional Chinese Veterinary Medicine Volume 1 by Huisheng Xie and Vanessa Preast is a good place to start for a more thorough understanding of this ancient medicine.