Take a look at how this valid health care modality can be used in the feline spay-neuter clinics to improve the locomotor system in quadrupeds.

“This is the pain medicine you will be giving your cat at home. It is tasteless and very easy to give, so medicine time won’t be a big chore. This medicine will not alter behavior, and it will not make your cat feel sick. He will act and feel completely normal. You cannot overdose him with it, and it will not harm people or pets in the home if they accidently ingest it. It’s very safe.”

I begin all client discussions about take-home medicine with the above paragraph. It usually elicits an expression of relief, since many clients have had bad experiences giving medication to their cats. I don’t have to shove a pill down his throat? Correct. He won’t drool, vomit, or hide under the bed? Correct. He won’t be wobbly? Correct. It won’t hurt my other cat or my two-year-old son if they get into it? Correct.

I have been using homeopathy for over 15 years, and have found that the easiest and most rewarding application for it is in the surgical arena. This is especially true when dealing with feline patients and the unique challenges that accompany their care. I choose to use homeopathic drugs over conventional pharmaceuticals because they do a superior job at ensuring a pain-free recovery.

Homeopathy is a singular, very specific type of medical treatment. It is distinct from other categories of complementary medicine. Homeopathic treatment requires the use of special medicines, called remedies, which are prepared in a unique, deliberate manner in order to make them homeopathic.

The benefits of homeopathy

Homeopathic medicines possess numerous beneficial properties that traditional pharmaceutical medications often lack. They are very easy for both owners and practitioners to administer, and are extraordinarily safe, inexpensive, and extremely effective when appropriately used.

1. It’s a safe pain management option

Pain management in feline patients is full of challenges. Analgesic options are limited and associated with substantial toxicity risks and unpleasant side effects. Homeopathy is an appealing option for feline postoperative analgesia because the concerns that surround NSAID and opioid use are nonexistent with homeopathy. Homeopathic medicines do not cause injury to organs, and do not provoke side effects such as sedation, ataxia, and nausea. These safety attributes are also important when considering unintentional exposure events involving humans and other pets in the home. Accidental poisoning is a non-issue.

The harmlessness of homeopathic medicines is also valuable when considering the typical feline patient. A substantial percentage of these cats are strays in less-than-optimal health (accompanied by owners with minimal finances for veterinary care, precluding the option for pre-anesthetic bloodwork or medical correction of pre-existing health conditions). Homeopathy is a tremendous tool under these circumstances because it is gentle and will not exacerbate any disease conditions.

2. Homeopathy is more affordable than pharmaceuticals

Homeopathic remedies are extremely affordable. They can be purchased in various quantities costing around $9 for a 2 dram (1/4 oz) vial and $40 for a 4 oz bottle.1 A 4 oz bottle will conservatively yield over 3,000 doses, which translates to one penny per dose.2 Comparatively, Metacam and Torbugesic each cost about $1.50 for a single injection for an adult cat.³

3. It’s effective for pain and healing

Homeopathic medications are very effective for surgical needs. Analgesia is the primary surgical use, but homeopathic analgesics additionally possess antiinflammatory, anti-suppurative, and pro-healing properties, making them additionally rewarding. Homeopathic medicines exert their effect quickly after administration and are long lasting. Often, only one dose of medicine is needed to achieve a successful, permanent result.

Post-operative pain research shows that pain is greatest within the first 24 hours after surgery, and behavioral changes indicative of pain typically persist for at least three days in dogs and cats following routine ovariohysterectomies.⁴ The tabulation of post-operative pain scores, using either the Botucatu Multidimensional Composite Pain Scale or the Colorado Acute Pain Scale, is recommended by some pain management experts to objectify pain and help veterinarians make prescribing decisions.⁴ When applying either pain scale tool to my patients while using homeopathy, I find that the vast majority receive a perfect pain-free score of zero. Homeopathy is doing a very good job at providing analgesia in my patients.

Matching the pattern of disease 

The one drawback to using homeopathic medications is that they do not always have the desired effect on the patient. The reason is that in order for a homeopathic medicine to exert its effect, it must match the patient’s pattern of disease. This pharmacologic principle is unique to homeopathy and warrants a brief explanation for clarification.

Compare a puncture wound injury (e.g. stepping on a nail) to an injury caused by blunt trauma (e.g. something heavy dropping on the foot). The nature of the tissue damage, likelihood of infection, quality of pain, and expected course of healing are very different between these two insults. In other words, punctures induce a different pattern of disease in the body than blunt trauma does. The homeopathic medicine that would best treat most puncture wound patients is not the same as the one that would best treat most blunt trauma wound patients. This is a very different approach than the one used in conventional prescribing, and recognition of this concept is integral to success in homeopathic medicine.

Over 600 homeopathic remedies are available to treat illness, and to practice homeopathic medicine correctly requires education. However, any surgeon can use homeopathy effectively without the need for deeper schooling. Surgical procedures insult the body in a relatively similar manner in all patients, so matching the patient’s symptom pattern with the correct remedy is a relatively easy task in most surgical patients.

Homeopathy in the feline spay-neuter clinic

Homeopathy can be easily assimilated into a spay-neuter practice. Any anesthetic drug protocol being used can continue “as is” without modification. Homeopathy is simply added to the pre-existing protocol.

• Homeopathic medications are available in different pellet sizes and in different strengths called potencies. For animal use, the small poppy seed-sized pellets (#15 or #10) are recommended because they are easiest to work with. The 6C potency is good for spay-neuter use. These pellets come in glass containers of various sizes, and all are multi-dose.
• The most common way to provide an individual dose of medicine from a multi-dose vial is to remove the lid and pour enough pellets into it to make a single layer covering the bottom. In cats, the ½ dram vial size works well to provide a good dose of medicine (yielding about 40 pellets per dose).
• The single layer of pellets is poured from the lid directly into the mouth by lifting the upper lip and depositing the pellets onto the gingiva or buccal mucosa where the pellets stick to the saliva fi lm and dissolve.
• For cost efficiency, commonly-used medicines such as Arnica can be purchased in larger sizes (e.g. 4 oz bottle) and transferred to a few ½ dram vials for ready in-clinic use.

The 4 oz bottles are too awkward to use for dispensing individual doses, but the ½ dram vials are quite manageable and minimize waste. Empty glass vials of all sizes can be obtained online.

• A unique attribute of homeopathic medicines is that the exact amount of each dose does not need to be precisely determined. A two-pound kitten will receive the same amount as a 15-pound tomcat. The patient’s body simply needs to be exposed to “some” medicine in order to be appropriately affected, and this vial lid single-layer dose has become a common, arbitrary unit of measure for dosing homeopathic medicines in animals.
• The tastelessness and dissolvability of these medicines make it easy for owners to give them at home. The medicine works most effectively if given by mouth, directly and unadulterated, but it can also be sprinkled onto a dollop of wet food, added to a small serving of milk, or be mixed with water and syringed into the mouth if needed.
• Dosing intervals are determined on an as-needed basis, another way in which homeopathy differs from conventional medicine. In homeopathy, a single dose of medicine is administered to a patient, and additional doses are typically not given unless symptoms return or fail to abate. In acute care situations like surgery, one or two doses are generally sufficient to keep the patient symptom-free.

Dispensing homeopathic medicines

It is common for pet owners to inquire about at-home pain management for post-operative needs. There are three options you can consider:

1. Dispense individual doses in large (size 00) gelatin capsules in a 10 dram amber pill vial. This method is familiar to owners and easy to use, but labor intensive for you. Directions are one dose q24hr x 3 days, then as needed. I demonstrate pulling off the top of the capsule, pouring the pellets directly into the mouth, and discarding the capsule. Cost: 60 cents

2. Fill individual paper envelopes with single doses. Owners can shake the loose pellets into one corner, generously cut this corner off from the rest of the envelope and, using the cut corner like a pointed cup, pour the pellets it contains into the mouth. Cost: 30 cents

3. Dispense a multi-dose quantity into an amber ½ dram glass vial. This is excellent for clients with multiple cats and takes the least time to process. However, some clients may be uncomfortable using a vial because they negatively associate this atypical means of dispensing medicine with illegitimate drug use, which means compliance is lowered. A single layer of pellets is poured into the vial lid, then directly into the mouth. Cost: 40 cents

Specific remedies

Arnica montana

The most valuable remedy in surgery is Arnica montana. It is given prior to surgery to provide pre-emptive analgesia, minimize inflammation and hemorrhaging, and prevent suppuration. It is also given immediately after surgery to help boost the first dose and provide long-lasting effects.  Practitioners can effectively implement homeopathy into their practices by using only Arnica and no other homeopathic remedies.

In the majority of routine sterilization procedures, no further pain medicine needs to be given; these two doses of Arnica are sufficient to ensure a pleasant and comfortable pain-free recovery. Occasionally, however, Arnica is not sufficient, and a patient does need the additional benefits of a different homeopathic medicine. Patients can be reassessed after fully awake, and any cats exhibiting discomfort should be given another analgesic remedy based on their particular symptoms.

Secondary analgesics

1. Bellis perennis – Patients are tired and sore. Useful for post-ovariohysterectomy patients that exhibit no remarkable guiding symptoms.
2. Rhus toxicodendron – Symptoms may include hind leg weakness, muscle twitches, body tremors, frequent changes in position, abdominal flank contraction, heavy sleeping (may have taken a long time to awaken from surgery).
3. Staphisagria – Patients are often nervous, very reactive to stimuli, and do not like incision sites touched. Best choice for incision site discomfort.

Supplementals

1. Calendula topical gel – Soothes inflammation, prevents infections. Apply thin film to incisions.
2. Hypericum perforatum – For injuries involving nerves. Very useful after declaw procedures and after amputation of the tail.
3. Millefolium – For oozing of blood from incisions.
4. Carbo vegetabilis – Used for post-operative shock.
5. Ledum — For human staff with serious, deep cat bite wounds.

Billing for homeopathy

I do not charge for in-house homeopathy use. My patients receive any needed treatment when it is indicated at no additional cost. However, it is a more common practice for veterinary facilities to charge an additional fee for in-house adjunctive pain management, and this additional fee is expected by most clients. Homeopathy can be very profitable when offered in this manner. The option of homeopathic perioperative analgesia (i.e. Arnica) as an add-on service can be offered to owners. Simply charging a nominal fee of 25 cents per patient yields a healthy 92% profit margin.² Charging a more realistic fee of $1 or $5 for this optional in-house homeopathic analgesia can easily generate a substantial ancillary income.

How to order homeopathic remedies

Four parameters need to be specified: name, potency, pellet size, and quantity. As previously mentioned, the small poppy seed-sized pellets (#15 or #10) and 6C potency are recommended. The 2 dram vial size provides hundreds of individual doses and is a good starting quantity for practitioners interested in experimenting with homeopathy.

Storing homeopathic medicines

Homeopathic medications do not expire like conventional pharmaceuticals do, but their efficacy is diminished by strong odors and electrical appliances. They should therefore be stored in a closed cabinet away from electronics and any strong odors.

Summary

Homeopathy can be a wonderful tool for the veterinary surgeon, and its use can be particularly valuable for feline patients. The affordability of homeopathic medications creates a very feasible analgesic option for tightly-budgeted spay-neuter clinics, and the additional benefits of efficacy, ease of administration, and safety make it worthwhile for any veterinary surgeon to experiment with.

References

¹Prices from Natural Health Supply (a2zhomeopathy.com). Retrieved 11/7/2015.

²Calculation determination: #10 pellets in typical dose (½ dram vial lid single layer) comes to 40 pellets; #10 pellets in ½ dram vial is 2,000 pellets; #10 pellets in 4 oz $40 bottle is 128,000 pellets (3,200 doses at 40 pellets per dose), which costs $0.0125 per dose.

³Torbugesic price from shopmedvet.com. Retrieved 11/7/2015. Torbugesic 10mg/mL 10 mL vial = $102.72, yields about 70 doses; cat dose is 0.2mg/lb (7lb cat: 1.4mg = 0.14 mL = $1.46 injection). Metacam price from midwestvet.net. Retrieved 11/7/2015. Metacam 5ml/mL 10mL vial = $90.75, yields about 50 doses; cat dose is 0.14mg/lb (7lb cat: 0.98 mg = 0.2 mL = $1.82 injection)

⁴Murrell, Jo. (2015, February 23). “Managing Postoperative Pain in Companion Animals”. Veterinary Times, February 23, 2015. vettimes.co.uk/article/managing-postoperative-pain-in-companion-animals.