An interesting case of inappropriate supplementation in a puppy

A few well-chosen supplements can help a dog or other animal live longer and feel better, but almost nothing is written about the effects of inappropriate supplementation. This article presents a suspected case of the latter in a German Shepherd puppy.

To understand the effects of inappropriate supplementation, consider the meaning of “health”. Health is a dynamic balance of the components that make up an animal. When an animal is balanced, there are no symptoms. When balance is disturbed, malfunctions occur, leading to symptoms. If symptoms represent imbalances, then the primary goal of treatment should be to restore balance, allowing symptoms to either resolve on their own or respond to treatment. Symptoms are a reflection of disorder; they are not the primary issue. This article highlights the case of a German Shepherd puppy suspected of suffering from excessive and inappropriate supplementation.

Supplements can create balance or imbalance, depending on how they’re used

Supplements are a way to restore balance by filling deficiencies in metabolic processes. As long as the supplement is chosen appropriately and given in the amount needed, the body can benefit. However, inappropriate and/or excessive supplementation can actually cause imbalances in metabolic functioning. For example, giving a supplement to correct liver function may be unbalancing if the liver abnormality is actually caused by a problem elsewhere in the body. In serious cases of over-supplementation, the number of supplements is so large that it is impossible to determine how they are interacting with each other and with other natural treatments, such as homeopathy and herbs. Evaluating the actions of a homeopathic remedy can be particularly difficult when concurrent multiple supplements and/or herbs are modifying the body’s ability to respond to the remedy.

Each year, I see several cases of illness directly caused by inappropriate use of supplements and other natural treatments. Helping the client understand what is happening, and stopping unneeded or conflicting treatments, are many times the only actions necessary. It may take several weeks for the patient’s body to regain its balance. Once that occurs, an assessment can be made of what, if any, supplements are needed, and they can be reintroduced at appropriate doses.

Case report – inappropriate supplementation in a German Shepherd pup

The most extreme case of inappropriate supplementation I have seen involved a five-month-old German Shepherd puppy. The client had declined the antibiotics and steroids prescribed by another veterinarian, and there was no mention of diagnostic testing in the records. At the first office visit, she was covered in red oozing sores with alopecia, and was hot and sweaty to the touch. Her demeanor was appropriate, and her physical exam was otherwise normal. She was eating an appropriate natural diet.

Based solely on physical exam, likely causes of her symptoms included primary dermatitis and secondary dermatitis from skin parasites or allergies. Puppy shots (distemper-hepatitis-parvo-parainfluenza) had been given at six weeks and ten weeks. The client reported she had not observed any changes after the vaccinations. The history indicated a normal lifestyle. There were other dogs in the household, none of whom displayed similar symptoms.

Multiple supplements and topical treatments were used

The history did, however, indicate the use of copious numbers and types of supplements and topical natural treatments; this was confirmed by the shopping bag full of products the client brought to the appointment. It contained immune-boosting combinations, oral and topical coconut oil, apple cider vinegar, vitamins, wild oregano oil, antioxidants, fish oil, and various natural shampoos. An inventory of the bag indicated the client had used six shampoos, ten different sprays, and seven ointments topically. Some of the sprays and ointments had been used concurrently. The puppy was given ten supplements with breakfast; three more were given with dinner.

The client declined further workup due to financial constraints, so no testing was performed. Thinking about this case from a balance perspective, it appeared to me that the large numbers of supplements and topical treatments could have resulted in physiological imbalances that then led to the symptoms the puppy was exhibiting. The sheer number of oral and topical treatments made it impossible to know how the treatments were interacting and which, if any, were having beneficial effects. In addition, many of these products were for the human market, so in several cases the doses being given the puppy were incorrect. Some of the combination products contained a number of the same ingredients, potentially resulting in an overdose situation for the puppy.

Starting from scratch

The client obviously loved her puppy, and was extremely anxious and concerned about her symptoms. I discussed with her the likelihood that the mix of products she was using may be responsible for the symptoms. She was extremely reluctant to stop everything but eventually agreed to do so. Based on the puppy’s symptom picture, I prescribed the homeopathic medicine Sulfur 30C. I crushed one pellet and divided the powder into quarters. The client was instructed to give one packet of powder in a small amount of food once a week on the same day of the week. A very low dose of vitamin E was also prescribed. The dose selected was unlikely to interfere with the homeopathic prescription and was an attempt to boost client compliance, as the she was still convinced that her puppy needed multiple products to get better.

Two weeks later, the puppy’s sores were drying up and her hair was growing in; four weeks after the initial visit, her coat was glossy and her skin normal. Even though she was markedly better, her owner became somewhat agitated and reiterated her concern that the puppy would not live without all those supplements; she remained convinced that without more supplements her puppy would sicken and die. A fish oil product and probiotic were agreed upon as being safe, but I reminded her that the puppy was now healthy and did not need more supplements to remain so.

Back for another visit

Six months later, the puppy returned with similar symptoms after a flea problem that began two months earlier. The client came with another bag of products, including several oral combinations of herbs and supplements designed to make the dog unattractive to fleas, as well as an assortment of shampoos and sprays. The puppy had red oozing sores on the caudal half of her trunk, and several fleas were noted. Many of the products might have been appropriate if they were being used alone or in conjunction with one or two others.  Several of the oral products contained overlapping ingredients. The combined level of these ingredients may have been too much for this puppy.

I believe that all the supplements and products had again created an underlying health imbalance that needed to be corrected before symptoms could resolve. I prescribed vitamin C and grapefruit seed extract to help reduce inflammation and infection and improve the puppy’s comfort level, in addition to appropriate flea control, using one topical spray, a yard spray, and a premises treatment. The unneeded items from the bag of products were put in Ziploc bags marked “do not use”.

One month later, the puppy’s coat and skin were normal. There was no evidence of fleas.  The client was happy with the recovery but was still adamant that more supplements were needed to keep the puppy healthy, despite having seen her return to normal without them. Even though she had twice made the puppy sick with over-supplementation, the client remained firm in her conviction that the puppy would not live unless more products were used.

Client behavior a significant factor

The interesting aspect of this case of inappropriate supplementation was the client’s behavior. She appeared almost pathologically afraid that her puppy would get sick. Despite repeated discussions and demonstrated evidence that the puppy did not need all those products to be healthy, she appeared psychologically unable to stop overloading her puppy with supplements. While the presentation may have resembled Munchausen by proxy, I do not believe this client’s behavior was motivated by attention-seeking. Something in the past had triggered this irrational fear and now the old pattern was playing out with this particular dog. If time constraints had permitted, it would have been interesting to ask the client if she felt this way about her other dogs, or if she could talk about when she first began to believe that her puppy needed so much help to stay healthy.

This article has been peer reviewed.

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