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Immune Mediated Polyarthritis and Myositis in a Portugese Water Dog

By Marlene Smith-Schalkwijk DVM
This article was published in the Portugese Waterdog Magazine in 1997.

Summary: A Portuguese Water Dog was diagnosed with Systemic Lupus Erythromatoses. At the owners’ request, the dog was treated with acupuncture, Chinese herbs and homeopathy. The following article describes the symptoms and successful treatment of this dog.

Brigadeer was two years old when it was first noticed in December 1993 that he was sore when getting up. He had been battling a skin problem for a while. The pain in his hind legs progressed and eventually he was holding his left hind leg up. On veterinary examination there was a distinct pain over the hip area; arthritis in the hips was suspected. The dog also had enlarged lymph nodes (especially on the hind legs) and multiple scabs on the skin. He was also thin, had a poor appetite, was lethargic and had intermittent diarhhea. He was initially treated with Chinese herbs for arthritis and antibiotics for the skin. The skin and joint pain improved but the lymph nodes stayed enlarged. A diagnostic blood sample was taken and indicated an immune stimulation.

When the dog started to limp a week later, again an immune mediated origin of the limping was suspected. The owner then revealed that the father of this dog died of Systemic Lupus Erythromatosis. A second blood test showed a positive ANA (antinuclear antibody test) and a negative Rheumatoid factor. No SLE cells were seen at that time. Meanwhile the disease had progressed to a polyarthritis and polymyositis, which affected the joints of the hips and elbows and the masseter muscles, making moving and eating very difficult for this dog.

On the basis of the symptoms, history, and laboratory tests, Systemic Lupus Erythromatosis was suspected. This immune mediated disease can be expressed as an haemolytic anaemia, skin problems (typical on the junction with the lips, eyes, vulva etc), polyarthritis, polymyositis, glomerulo nephritis with protein in the urine, and heart disease. There is a hereditary predisposition as is clear in this case. This dog showed a periodic polyarthritis, myositis and enteritis. During the attacks the dog had a fever, experienced pain, and was lethargic. The Chinese diagnosis was liver wind, spleen and liver Qi stagnation with likely underlying Kidney Qi (Jing?) deficiency, and a wandering Bi syndrome.

The owner was informed of the diagnosis and treatment with Prednisone was suggested to control the disease. The owner was very strongly opposed to the use of cortisone and requested treatment with alternative medicine. On January 25, 1994 treatment was started with acupuncture, Chinese herbs and homeopathy. Brigadeer was my first challenge using complimentary medicine in the immune field and the following treatment has proven to be successful for him and several other dogs and cats. He was put on homeopathic remedies specific for periodic muscle and joint pain. Acupuncture was performed on individual pain syndromes for hips, elbow, shoulders, spine and jaw. Chinese herbal remedies were used according to Chinese diagnostic findings to move the Qi or tonify the liver or spleen.

Brigadeer improved immediately, but had several relapses. These became milder and further apart. Soft swellings around the elbow joints a few months later were seen as a result of inflammation of the joint capsule consistent with Lupus. This did not require any further treatment and resolved within a few days. An infection, caused by a grass seed, and later a skin infection around the mouth did not want to clear up, in spite of soaking and antibiotics. Also his lymph nodes were still enlarged. Two new homeopathic remedies that are used for lymph adenopathy and chronic diseases that don’t want to respond were then used for treatment. The infections cleared up and the lymph node swelling went down. Treatment with the remedies for periodic muscle and joint pain were continued. Over the next year, the attacks became very mild and from January 1995 to June 1995 Brigadeer had no attack at all. He than had another attack of myositis of the masseter muscles. One acupuncture treatment cleared that problem up and a one time treatment with Dulcamara 200 CH was given. This is a homeopathic remedy used for diseases that get worse when the weather changes. This treatment was repeated one month later. For the next 7 months Brigadeer had a pain free and happy life. He was than treated with acupuncture for hip pain, which only started 2 hours prior to presentation. The pain was gone a few hours after treatment and now in October 1996 Brigadeer functions like a normal dog and is pain free. Homeopathic remedies are now discontinued and no further treatment is required.

Conclusion: Systemic Lupus Erythromatoses and other immune mediated diseases are traditionally treated with Prednisone or other corticosteroids. This challenging case was successfully treated using complimentary medicine modalities. The positive outcome in this case has led to using the same modalities in several other cases of immune based arthritis and or myositis. The outcome of all these cases so far looks very promising. The combined use of acupuncture, Chinese medicine and homeopathy in immune mediated diseases warrants more extensive research in pets as well as in human patients. Note: Brigadeer died at 12 years of age from hemangiosarcoma of the spleen.

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Acupuncture for Old Dog Vestibular Syndrome/Stroke

A Conference and A Patient: By Dr Marlene Smith- Schalkwijk
2006 TOL Newsletter

In March 2006 I attended a conference on Oriental Medicine in Vancouver. One of the lectures dealt with treatment of stroke and spinal injuries in people using a scalp acupuncture method developed by Prof. Ming Qing Zhu. The guest speaker on this topic was Michael Akong, a human acupuncturist originally from Burnaby, now working in a large hospital in L.A, California and specializing in stroke patients. Using very specific acupuncture points with a very specific technique, Michael showed the progress in several patients suffering from post stroke paralysis. MRI's were used to map the damaged areas of the stroke patient's brain. It was clearly demonstrated that the damaged area in the brain dramatically reduced in size as the patient regained function of the paralyzed limbs. It was a fun change to practice on a human head instead of a canine-cranium. We call it the “Case Dispenser in The Sky”!

Within days of my return to the clinic, I was presented with Winnie, a 12 year old Dachshund (yes the one on the front page). Winnie was suffering from apparent blindness from brain injury. Not having an MRI on hand, we could only assume that her blindness was a result of either a local infection (blood analysis ruled that out), a stroke (cerebral vascular accident) or a brain tumor. After explaining the potential diagnosis to Winnie’s "mom", I explained about the workshop and new the acupuncture method that I had learned. Since Winnie was very much blind, walking into the wall, furniture, my legs and any obstacle in the room, we decided to try this new method on Winnie.

Translation of acupuncture points from the human skull to the dog skull is not too tough, 18 years of canine acupuncture helped a little. I could actually feel the sensation in the needle that Michael had explained one would feel if doing the treatment correctly. Winnie’s owner and I could not wait to see the results after I took the needles out! We put Winnie on the floor and she looked around like she had not seen the room before. Then her "mom" came into her eye sight and she smiled the biggest canine smile. Winnie ran up to her owner, jumped up and licked her hands as if she was saying “where have you been all this time?” It is wonderful to learn new things and see such clear evidence of what acupuncture can do!

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Anterior Cruciate Ligament Injury

By: Dr. Heather Matheson TOL Newsletter 2008

Sports fans hear about Anterior Cruciate Ligament or ‘ACL’ tears on a daily basis.  ACL tears are a common injury among our top human athletes.  Unfortunately this is also a very common injury seen in our canine companions.  The anterior cruciate ligament has a big role in stabilizing the stifle or knee joint and can be surprisingly easy to injure.  The typical history we get is “ Rover took off after a bunny or jumped out of the truck, we heard a yelp and now he won’t use his back leg.”  It is not that a lot of force is needed to damage the ACL, so typically there is no history of trauma; it is more of a compression, a slight twist and then ‘POP’, there it goes.  Like stepping in a hole racing after the “wrascally-wrabbit”.

Post “wrascally-wrabbit” incident, our canine buddy will likely be 3-legged lame or just toe-touching on the injured leg.  Rest often improves the situation and sometimes we get lucky; if the ACL is only stretched or partially torn, then rest may be all that is required for a full recovery.  With this particular injury doing the ‘wait and see’ for a period of time is fine; it is unlikely the dog will further damage the injured leg.  However, remember that the good leg is now doing twice as much work and bilateral ACL tears do happen.  Literally, having no good leg to stand on is not a good time for anyone.

ACL tears are diagnosed upon physical exam.  What we look for is swelling or ‘medial buttress’ on the inside of the knee.  Remember that the ACL stabilizes the joint and without it, the other ligaments have to do a lot more work, hence the swelling.  We check for a ‘clunk’ on flexion or extension of the knee, this checks for a tear in the ‘medial meniscus’ which is the cartilage flap in the joint.  Finally we check the ACL itself by doing a ‘cranial drawer’ which challenges the knee in the direction the ACL stabilizes.  X-rays are helpful to rule out any other problems, however an ACL tear is a soft tissue injury so will not show up on X-ray.

So we have our canine buddy with a buggered ACL.  What is the treatment? If the ACL is only partially torn acupuncture is very helpful.  Acupuncture once weekly for 4 weeks will increase circulation to the joint, stimulate healing, strengthen the ligament and reduce both pain and swelling.  We also recommend a herbal formula called Bones and Sinews and Traumeel, a homeopathic, to aid in healing.  Of course rest, physiotherapy at home and slowly building the dog back up are all part of the process. Unfortunately if the ACL is completely torn, acupuncture may make the dog feel a bit better but it will not stabilize the joint.  Surgery is the only option.

There are two types of surgical repairs. In the standard repair, a strip of fascia (the tough tissue overlying muscle) is threaded through the joint and this acts as a false ACL stabilizing the joint.  A non-absorbable suture is also placed on the outside of the joint to further stabilize the joint.  Most dogs will do very well with this type of repair, however the aftercare is as important as the surgery.  There can be no escaping to continue the “wrascally-wrabbit” chase during the recovery period so owners must be very diligent.

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Arthritis, Definition And Description

The following article is an abstract of seminars doctor Smith has conducted since 1996.

Arthritis is the word that is generally used to describe an inflammation of a joint. Many different words are used to describe the different forms of arthritis. 

Traumatic Arthritis: This is a result of a trauma such as sprain, contusion, ruptured ligament, or even a dislocation or fracture.

Septic Arthritis: This is the result of an open wound after a fight or trauma, or the result of an infection spread by the bloodstream. May be the result of an autoimmune disease such as Lupus or rheumatoid arthritis.

Degenerative Arthritis: This can be a result of one of the above conditions after progression, joint instability, or anatomical misalignment.

Osteoarthritis: This term is normally used when the bone has produced extra bone around the joint, creating a larger joint and an irregular joint surface.

Most joint disease will end up in the last two categories if left untreated. Once they are degenerative or osteoarthritis, they will become much more difficult to treat and anatomical changes may inhibit the normal use of the joint. An example of traumatic injuries to the joint is seen in young active dogs especially in those with a tendency for hip dysphasia. The knees endure a lot of twisting and stress, which can result in a rupture of the anterior crusiate ligament. This will result in joint instability leading to inflammation and arthritis. The knee cartilage (or meniscus) can also get damaged in the process.

Joint ligaments can also rupture as a result of the weakening of these ligaments. This can happen in immune disease (immune mediated arthritis) or collagen deficiency. Cause of the last disease is unknown, hereditary factor +/- dietary factor could play a role here.

A similar process can happen in the hip. The hipbone (femur) is kept in place by a ligament called the Ligamentum Teres. This can also rupture as a result of trauma (H.B.C., fall, etc.), spontaneously in rough play (weakening of the ligament) or abnormal strain as a result of abnormal positioning. As a result the hip will dislocate. In the case of the hip, the hip will be painful on palpation and manipulation; a clicking sound in the hip can sometimes be heard.

Diagnoses and differentiation between hip and or knee problem is made with X-rays and palpation under sedation or general anesthetic. Examples of the symptoms are a sudden onset of the hind leg lameness. Often the dog will lift the affected hind leg intermittently while standing. Partial ruptures will create a limping while complete ruptures will often lead to no weight bearing. The knee or hip can be painful on palpation. 

Degeneration or incomplete maturation of the joint cartilage can lead to osteochondritis desiccants (O.C.D.). A small piece of cartilage can become loose in the joint and cause irritation, which leads to inflammation. This can happen in the shoulder joint or hock joint.

In the elbow joint, we know two other conditions, which may lead to arthritis: ununited anconeal process in the German Shepherd dog, and elbow dysplasia. Both of these conditions happen predominantly in large breeds of dogs. In the first one, the anconeal process fails to mature and the joint between bone and cartilage breaks resulting in instability and arthritis.

Symptoms: The sudden onset of a front leg lameness, sometimes holding the leg forward. The elbow is painful on palpation. This condition is seen in young fast growing dogs 6 to 12 months of age. Signs are limping with exercise.

Elbow Dysplacia can be a result of a fracture of the medial coronoid process, leading to instability, inflammation, pain and arthritis. Also the growth plate of the radius might close before the growth plate in the ulna closes. This will result in unevenness in the joint plateau leading to rubbing, inflammation, instability, pain and arthritis.

Septic arthritis: It is understandable that an open joint can get infected. It is more difficult to understand that a general infection can also cause arthritis. In a generalized infection, bacteria can get into the bloodstream and via the blood end up in the joint. The streptococcus bacteria are a classic example. One or more joints are swollen and hot and painful on palpation. The animal can show general illness and fever.

Immune mediated arthritis is often misdiagnosed or missed altogether. Often, more than one joint is affected and in animals, there seems to be a preference for the larger joints. In people, the smaller joints of the fingers and toes and sometime the wrists or elbow are affected. In dogs and cats, the hips, shoulders and elbows are preferred places, but the smaller joints can also be affected. Both in humans and animals, the neck and spine are also often affected. The attacks of inflammation are often periodic—every two or three weeks or months. Stress, weather changes and immune system stimulation (i.e. vaccination or fighting of a flu) often initiate an attack. In between attacks, the animal may seem okay. Repeated inflammations will eventually lead to degenerative or deformative osteoarthritis. During an attack, the animal may show general malaise such as irritability, anorexia, fever, vomiting or diarrhea. Muscles can also be affected and this can lead to atrophy or hypertrophy of the affected muscles. In the case of Lupus, other organs can also be affected such as the skin, liver, spleen or kidney. The origin of immune mediated diseases, when the body attacks its own tissue, is not clearly understood. A hereditary component is suspected, but viruses or bacteria or environmental toxins could also play a role. The disease is difficult to diagnose. An increase in blood globulin and reoccurring attacks are suspicious for the disease.

Degenerative arthritis can be a result of an immune mediated process. Under nourishment of the cartilage of the joint or the intervertebral disc can lead to degeneration and loss of the cushion effect. Also, abnormal anatomical structure can result in a degenerative process. Hip dysplasia will lead to degenerative arthritis followed by osteoarthritis. Hypo or hyper mobility of a joint can also lead to arthritis.

Osteoarthritis: In osteoarthritis we see extra bone formation around the joint. The reason for this is possibly an attempt by the body to neutralize the acidic effect of histamine and other inflammatory agents or to stabilize an unstable joint. This is the picture we can see dramatically on x-rays. The amount of calcium formation around the bone is not necessarily equivalent to the severity of pain or discomfort experienced by the patient. Acute inflammation of the joint gives a sharp stabbing pain while chronic osteoarthritis might create nothing more than a dull pain and stiffness.

Spondylosis is arthritis of the spinal column. The cause can be immune mediated or mechanical trauma such as carrying (heavy) bags, back twisting, jumping, etc. Hypo or hyper mobility, disc herniation, surgery, etc.

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Hip Dysplasia

The word literally means a displacement of the hip joint. The cause is multifactor.

• In rapid growing breeds the weight of the animal cannot be supported by the bone structure.  This can cause a collapsing of the head of the femur, “twisting” of the cap, and thickening and collapsing of the femur neck.  Bone spurs can sometimes be seen at the rim of the acetabulum or neck of the femur.
• Hereditary joint abnormalities
• Flat acetabulum
• Narrow acetabulum
• Abnormal angulations femur head and neck
• Weakness of ligaments resulting in rupture of Ligamentum Teres
• Immune Mediated / Hereditary?
• Lupus\ inflammation
• Rheumatoid arthritis
• Vasculitis can lead to under nourishment of femur head and eventual collapsing or "Legg Perthes".

Symptoms: Hip Dysplasia occurs more often in large rapid growing breeds of dogs, but is also diagnosed in small dogs and cats. Wobbly gait hips and back end, frequent “lazy” sits, lying down a lot, straight angulations, short gait on hind legs, toeing out and hocking in, bunny hopping, not able to stretch hind legs out, sore back, irritable, poor muscles, no jumping, stiff in the morning, limping, and pain.

Symptoms and Diagnosis

The symptoms of acute arthritis are pain, swelling and heat in the affected joint(s).  In the case of trauma, where the joint is opened through bite(s) or car accident, joint fluid can leak out.  In a closed trauma, such as in crusiate ligament rupture, there will be acute pain with little or no weight bearing on the affected leg.  In the case of the back being affected, the animal will be reluctant to go up or down stairs or jump, just getting up or even approaching the animal might elicit a yelp or bite.  O.C.D. of the shoulder or hock joint will also be expressed with little or no weight bearing.  Legg Perthes disease or aseptic necrosis of the femur head will show up in intermittent lameness of a hind leg in small breeds of dogs.

In immune mediated arthritis there is typically a periodic attack once a week or month. Weather changes and / or stress or stimulation of the immune system (as in vaccinations) can initiate an attack.  There might be signs of general illness such as sore muscles, anorexia, lethargy and irritability.  The hips or shoulder might be sore or the neck or back.  This can look very similar to acute spondylitis or meningitis.  If the jaw muscles are affected, the animal might not be able to eat or yawn.  It is sometimes difficult to differentiate between joint or muscle pain; both can be present at the same time.

Degenerative and osteoarthritis develops over time.  The presence of inflammatory agents in the joint creates an acidic environment.  It is also possible that a defect in the sodium and chloride pump in the cell membrane could create an acid environment. The body’s response is the same as that of a gardener when he faces acidic soil; he will use lime to neutralize the soil.  So does the body.  The calcium deposits we see on radiographs in osteoarthritis are the result of a long-standing attempt of the body to correct the acidic environment.  The amount of calcium deposit is not equivalent to the degree of pain the patient experiences.  It will, however, create a limitation of movement and rough joint surfaces, which will continue to contribute to the problem.  Typical signs will be stiffness rather than acute pain, difficulties in getting up, improvement with exercise, and dampness and cold weather making it worse. After heavy exercise followed by the rest, the soreness and stiffness is worse; however the animal walks it out.

Treatment and Prevention
Prevention is the best treatment.  Preventing car accidents through training and leashes and never transporting your dog in the back of a pick up (open or closed), will be a good start to prevent traumatic injuries. Avoiding excessive workloads such as long hikes or backpacks at too young of an age will give the joints and spine a chance to mature.

Not using any dogs for breeding that have genetic joint defects such as hip dysplasia, elbow dysplasia or anconeal process problems is sensible and responsible breeding. These animals should all be eliminated from the breeding stock.  Since immune mediated diseases might have a hereditary predisposition, these animals should also be eliminated from the breeding stock until we have a better understanding of the origin of immune diseases.

Providing your dog and cat with a warm and dry shelter to sleep will go a long way to preventing arthritis, as well as towel drying your dog after it gets wet from a walk in the rain or from a swim.  A soft, dry and draft-free sleeping quarter will also help.

The right nutrition, not too high in protein as a pup and low in carbohydrates, a good quality commercial or, even better, a raw, home-cooked diet with appropriate vitamin and mineral supplementation.

Early detection, without denial of the problem, will enable you to initiate a treatment at an early stage, preventing it from getting worse.

Treatment:

Traumatic arthritis: In case of an open wound, seek immediate veterinary advice.  The sooner the wound is cleaned and sutured, the better the chance of recovery.  The use of antibiotics is appropriate in this case!  Additional help can be found with herbal and homeopathic remedies.  (See handout on Homeopathy for Pets).  Your veterinarian should also assess closed wounds and ligament damage; sedation is sometimes a necessary procedure.  Rest and homeopathic Arnica are helpful, as well as Rhus Tox.

Ruptured ligaments, avulsion fractures and other bony problems might require surgery.  O.C.D. lesions respond very well to rest, acupuncture and homeopathy. Sometimes surgical intervention is needed to remove loose bone or cartilage fragments. Elbow dysplasia and un-united anconeal process have also been responsive to acupuncture, homeopathy and glucosamine sulfates.  Problems in bone maturation (or cartilage) are related to a low kidney Ying and kidney Qi herbs might also be helpful in these cases.  Hip dysplasia has responded very well to acupuncture and gold bead implants.  The younger the animal, the better the results of the treatment.

Immune mediated arthritis: My experience has been that these animals are better treated with homeopathic remedies and acupuncture than with Western allopathic drugs alone.  This is one of cases where complimentary medicine combined with western drugs is very effective.

Osteoarthritis:  For long term treatment, herbal medicine and acupuncture, as well as homeopathy, might do less damage to the body than aspirin or Prednisone.  Regular exercise, tailored to the animal’s ability, will be very helpful in keeping things going.

Drugs, Medicines, Remedies, Herbs, etc.

This is just a reference guide; don’t use them all at once!  And not without veterinary consultation!

Aspirin, Advil, Ibuprofen, Phenyl butazone, Tylenol, etc.  These are all non-steroidal anti-inflammatory drugs (N.S.A.I.D.).  They block off histamine release and reduce inflammation.  The two big negative side effects are that they also prevent the blood from clotting and can create ulcers in the stomach or intestines.  This can lead to a fatal bleeding.  The other side effect is that, prolonged use of these drugs erodes the cartilage of the joint surface, making arthritis worse.

Cortisone, Prednisone or dexamethasone are all well used (over used) anti-inflammatory drugs with so many side effects it would fill a page!  They also erode joint surfaces, weaken ligaments and muscles; increase appetite, weight, thirst and urination.  Long-term use exhausts the kidney Yin, soon to be followed by kidney Yang, in western medicine Cushing’s disease and diabetes can be a result of long-term use of Prednisone.  They are not a good choice to use in the long-term treatment of arthritis.

Ketoprofen is a very powerful anti-inflammatory and should be used in the short term only.  Long-term use side effects are similar to aspirin.

Metacam/ Meloxicam is a non-steroidal anti-inflammatory (NSAID), which relieves pain and join inflammation. Long-term side effects are to the intestines (inflammation) liver and kidney.

Cosequan, Cartrophen and Glycoflex are all glucosamine sulphates. They increase the joint fluid thus lubricating the joint better.  Cartrophen is injected while Cosequan and Glycoflex are given orally.  Don’t under dose.  It can be used for long term treatment – months or even years!!  It also helps to repair damaged cartilage, as does chondroitin sulphate.

Shark cartilage can be used to rehabilitate damaged cartilages as in O.C.D. or vertebral disk disease.  A cheaper and more environmentally friendly source can be found in bovine cartilage (chondroitin sulphate).

Yucca is a tropical cactus with anti-arthritic properties and can be used long term.

Alfalfa also has anti-arthritic properties.

Vitamin E and Vitamin C are anti-oxidants and anti-radicals and will be helpful to reduce the toxins produced in the inflammatory process.  Use intermittently.
Dosage:           Vitamin E 100 IU/day up to max 400 IU/day
                        Vitamin C 100 mg /10 lbs up to 1000 mg max/day

Homeopathic Remedies:

Arnica is very helpful in the acute stages.  High levels of arnica should be avoided for prolonged periods of time. Use intermittently.  Dosage --> see Homeopathy for Pets.

Devils Claw Root is also an effective anti-arthritis treatment.

Rhus Tox and Bryonia is found in most homeopathic arthritis remedies.

Ribes Nigrum (black current) is a drainage remedy and should be used for a short period only.  One to three months at a time is suggested and can be repeated twice a year or in acute stages.

Thoraco Lumbar Disc Disease Calcification of intervertebral discs and degeneration of the “Annulus Fibrosa” (elastic tissue surrounding the disc that works as a pillow) are the cause of disc material prolapsing into the spinal canal.  This results in back pain that can lead to lameness and paralysis.

Short legs and long backs, as well as positioning of the pelvis, predispose to an ineffective use of the back. This leads to hyperactivity or hypo activity, nutritional (blood) deficiency, and eventually degeneration. Agility, jumping, and Shutzhund are predisposing factors. Nutrition also has an influence as in previous cases.

Osteoarthritis - “Wear and Tear” / Old Age, Joint Instability - A Traditional Chinese Medicine Perspective.

The first sign of osteoarthritis is stiffness; in TCM stiffness is seen as “ cold” and arthritis is seen as dampness and cold trapped in the joints.The legs or back are stiff because the fluids are not moving. This leads to the accumulation of dampness and a stagnation in the flow of Qi which causes pain. In TCM we now speak of a Bi Syndrome.  In older age we see a deficiency of fluids, blood, and Qi stagnation which can lead to the drying up of joint fluid. The lack of lubrication leads to inflammation.

Tx Prevention:

• Warm soft surface to lie on, dry after getting wet (rain / bath / swimming)
• Adequate nutrition and exercise
• Natural anti-inflammatories Vitamin C and Vitamin E
• Natural joint lubricants such as glucosamine sulphate
• Reduce meat protein at older age
• Acupuncture, physiotherapy, chiropractic, on regular basis
• Herbs to correct imbalance

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Flea Control
By Marlene Smith-Schalkwijk DVM

Here on the “Wet-Coast” fleas can be a major problem. Fleas reproduce rapidly, each flea laying 40 eggs a day. These flea eggs are often deposited in the house where they are glued to the carpet or in cracks and crevasses. In our temperate climate they can also survive our mild and moist winters outside. In the fall the flea will hitch a ride on the pet, laying their eggs indoors. Once the heat is turned on in the house, the LARVAE IN THE EGGS may think spring has arrived and they hatch by the thousands, infesting the pet during the months of October to December. In the spring they hatch outside creating another infestation until the fall; we have a flea problem all year around.

Flea eggs may survive for years patiently waiting for a host to arrive; live fleas can survive for 30 days or longer without a meal! Coming home from a holiday when pets have been absent for a while, can lead to an awakening of hundreds of fleas all at once, happily greeting the family when they enter the house!

Many dogs and cats have multiple allergies and fleas most certainly may contribute to that allergy and make it worse! Year around flea control is a must in every household with a pet. The worse problem is a flea infestation in the house. Prevention is the best cure!

Daily brushing of the pet and daily vacuuming the entire house goes a long way to prevent flea eggs from establishing. The daily brushing and combing will also keep the pet owner aware if there are any flea eggs or flea dirt on the pet. Flea dirt is easy to recognize as brown and crumbly, often comma shaped pieces of dirt, which color red when water is applied to it. Drop your combing results on a piece of white damp paper and the rust brown spots will tell you if your pet has dirt or flea droppings in their coat!

Chemical Flea Control:
There are several ways the battle with fleas can be fought.

Topical products:
Advantage, Advantix, Advantage Multi and Revolution are sold by veterinary clinics. Zodiac is sold at pet stores. We do not recommend that you purchase flea products at pet stores as problems have been seen with the use of over the counter pet store products.

The products sold at veterinary clinics are generally safe and will kill fleas within 12 hours. Make sure you use cat products for cats, as some of the dog products are unsafe for use on cats. Please check with your veterinarian what a safe product is to use on your pet.

Regarding the safe use of these products:
People as well as animals can be chemical sensitive. In these individuals topical products may cause a range of problems ranging from headache, skin reactions, seizures to immune disorders. We do not recommend these individuals use spot-on flea control products.

Also take care where the product is applied and follow instructions carefully. In cats, with their grooming habits, make sure it is applied well away from the reach of their tongue!

Use plastic gloves when applying the product to the pet and avoid any contact with the applied/sticky area on your pet for at least 24 hours after application. This is especially important for chemical sensitive individuals and children, as these products can be absorbed through the human skin.

Oral products:
Program is a once a month oral product which inhibits the reproduction of the flea like a flea birth control pill! It does not affect the adult flea, but any eggs laid, will not hatch. The flea must bite the animal and ingest Program to be effective. If the animal does not have any fleas, it does not seem to be justifiable to give this product to the pet. There is also an injectable form of Program available which will last for 6 months, however more sensitivity reactions seem to occur with the injectable form then the oral form of Program.

Capstar is also an oral product. It works for 24 hours killing the fleas on the animal but does not offer any longer protection. It kills the fleas by paralyzing their nervous system, while leaving the nervous system of the host intact.

Treating the environment:
There are several chemical house sprays available aimed at killing the fleas with longer or shorter residual effect and egg killing capacities. Siphotrol can be purchased at veterinary clinics and can be used to spray the house; make sure all little cracks and crevasses are being covered! It kills fleas on contact and prevents eggs from hatching. More potent products with longer residual time are applied by pesticide agencies only. These products are very effective. They are not suitable for individuals with chemical sensitivities or those who do not wish to use chemicals in their own or someone else’s environment.

Non-chemical Flea Control:
-House flea control starts with daily or twice daily vacuuming the entire house.
-Borax powder sprinkled on the floor and furniture once a month, then swept up or vacuumed dehydrates the flea eggs. It is not as effective as the chemical, but it may help.
-An herbal flea mist can be made (or purchased) using 10 drops of eucalyptus, peppermint, citrus and lavender essential oil in 500 ml of water. Lightly misting the dog once a day helps to repel fleas. It does NOT kill the fleas and this mixture should NOT be used on cats, which are sensitive to eucalyptus.
- Diatomaceous earth rubbed into the dog (not cats!) coats.
Flea bath or a citrus-based bath/shampoo is also helpful to remove flea eggs and fleas mechanically; but it does not leave a lasting residue for future fleas. Again do not use on cats or rabbits. Not to be used around birds or fish, remove these animals from the area.

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Gold Bead Implants
By Marlene Smith-Schalkwijk DVM

Your pet has been diagnosed with arthritis or another painful or degenerative condition that will likely benefit from acupuncture treatment. As part of this treatment, Dr. Marlene Smith-Schalkwijk and Associates have been getting very good results using gold bead implants at specific acupuncture points. This abstract will give you some information about gold bead implants and answer questions that you may have.

Gold bead implantation for hip dysplasia, involves the placement of 2 gold beads in 3 acupuncture sites around the hip or other area where your pet is experiencing pain. It is not known exactly how the gold bead implants actually work but it is believed that the beads may produce a negative charge in the joint membrane, which helps to control pain and prevent further arthritic changes in the joint. The gold beads stay in the site because they are embedded in the muscles. Most animals with gold bead implants do not require further acupuncture treatments, but they may require an occasional treatment during times of stress. 

Both Dr. Smith-Schalkwijk and Dr. Heather Matheson perform gold bead implant surgery under general anesthetic. Pre-anesthetic blood work is strongly recommended to alert us of any changes that may affect anesthesia. The area around the hip is shaved and surgically prepared for the procedure. A large needle is then passed through the skin at three acupuncture points. The gold beads are embedded into the point using a stilet in the needle. Gold beads are implanted on both hips even though only one hip may be painful at the time. X-rays are done after the surgery to assess placement of the beads, and to evaluate the condition of the hips. Recovery from the anesthetic is usually quick and your pet can go home in the early afternoon.

For the first 24 to 48 hours we ask that you keep your dog quiet, with only leash walks to go out for urination and bowel movements. Use homeopathic Arnica in 30C or 200C potency every 12 hours for the first 3 days. When you get home from the vet clinic you should only give small amounts of water (i.e. tablespoons) and a very small meal the night of the surgery. Watch carefully for any licking around the surgery area, or any redness and swelling. Please call the clinic if any of these occur.

After 24 to 48 hours you can give your pet their normal amount of exercise. There seems to be some pain and discomfort 4 to 6 weeks after the gold bead implant procedure. We would like you to know that this can occur, and to know that it should last only 5 or 6 days. Again, you can use homeopathic Arnica at this time for the pain. 

Please contact the office if you have any questions or concerns.

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Hip Dysplasia

One of the most devastating diseases a young canine can get is hip dysplasia.  Early signs of this are bunny-hopping (using both back legs together when running instead of using them independently), being slow to get up and down (especially after exercise), muscle atrophy in one or both hind legs, difficulty jumping into the car, going up stairs or jumping onto the furniture, being “snappy” when the back end is handled or brushed.

So what exactly is hip dysplasia?
Hip dysplasia is a bit of a catch-all term for poor hip conformation and the arthritis and pain that occurs secondary to that conformation.  Normally the “ball” portion of the hip (the head of the femur) sits well within the “socket” portion of the pelvis.  When the animal walks this acts as a well-oiled machine.  In an animal with hip dysplasia  the “ball” portion does not sit within the hip socket but rather rests on the edge of the hip socket, or the socket itself is too shallow to hold the hip in place.  Instead of that nice smooth gliding motion, bone-on-bone contact occurs and just like wheels in a cog that do not fit properly, heat is produced.  The body deals with this heat or inflammation by producing extra little bits of bone around the joint. This causes the joint surface to become uneven and rough, and we call this arthritis.  Over time the ball portion of the hip becomes more and more deformed which, of course causes more pain and more severe hip dysplasia.  A simple X-ray will show both the conformation of the hips as well as any arthritis around the joint.

Hip dysplasia is a congenital problem, which means Mom and Dad may carry the genetics for poor hip conformation even if they show no signs of it themselves.  Dogs as young as 5 months may show signs of hip dysplasia.  Because of the congenital nature, hip dysplasia is more common in purebred animals, however we certainly see our cross-breed-mutts having the occasional problem.  Diet and exercise may also play a role in the development of hip dysplasia.  Too much exercise at too young an age puts excessive stress on joints that are still developing.  Alternatively, an overweight pup fed on a diet high in carbohydrates may cause the bones to grow too quickly and puts excessive stress on muscles and bones that are not yet developed to handle that stress.

Now that we know what hip dysplasia is and how to recognize it what do we do about it?  The treatment of hip dysplasia is a little different for each individual depending on how severe the changes are.  Some mild cases may show no outward signs until they are in their senior years and may require only a joint support such as Glucosamine.  Glucosamine is an amino sugar produced from glucose and is one of the building blocks of glycosaminoglycans, which are incorporated into healthy cartilage and connective tissue of the joints.  Put simply, glucosamine is a vitamin for the joints.

What if Glucosamine in not enough?
Hip dysplasia typically responds very well to acupuncture.  Acupuncture increases the circulation to the hips and in this way helps to take away the inflammation and heat from the joint.  Acupuncture also causes a release of the natural anti-inflammatory and painkillers produced by the body.  Acupuncture tends to have a cumulative affect; typically we see a greater improvement that lasts longer after each treatment.  The normal protocol is one treatment once a week for 3 to 4 weeks.  If we see significant improvement we can then start to stretch out the time between treatments or consider placing gold bead implants into the acupuncture points around the hips.

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Dilated Cardiomyopathy In Dogs From A TCM Perspective

By Marlene Smith-Schalkwijk DVM

This is the most common heart disease in dogs. It is caused by dilation and weakening of the heart muscle resulting in congestive heart failure. This condition is often associated with canine hypothyroidism or a leaking heart valve leading to exhaustion of the heart muscle. The drugs benazapril (a blood vessel dilator) and digitalis are often used to treat this disease.

If we look at this disease from a holistic perspective we can call upon Traditional Chinese Medicine to better understand the causes that lead to the imbalance, that eventually leads to the weakening of the heart muscle.

The heart is called the “Prince of the Circulation”; it dominates the blood and blood vessels. The power of the contraction is referred to as the “ Heart Qi”. Qi refers to the energy that makes things work or move in the body. This Qi is received from the parents in the form of “ pre-natal Qi”, which is stored in the kidneys.

After birth the Qi is produced in the spleen, or the digestive network. If this digestive network does not function properly we see tiredness, weakness of the muscles, running out of energy when exercising, not wanting to get up in the morning and lagging behind during walks. The animal might be a “couch potato”. The Chinese medicine practitioner will look at the tongue and find a flabby tongue that lies in the mouth like a rag! The doctor will also feel the pulse, which will feel weak and difficult to find. This deficiency can be caused by a poor functioning thyroid gland (the mastermind of the metabolism). Nutritional deficiencies or co-enzyme deficiencies can also cause it. There may not be a heart problem at this point yet.

What could be done at this point? First we would check the thyroid function with a blood test. If it is low the animal should be supplemented with thyroid hormone. We would also look at the diet. All cats and most dogs are predominantly carnivores; this means they evolved eating mostly RAW meat. Their  “digestive network” is designed to create building blocks for muscles, blood etc. from meat. Also their energy comes from protein and not from carbohydrates! Excess carbohydrates (as in commercial dog and cat food) can swamp or over burden the spleen (or digestive network), which means it can no longer produce useful Qi. The resulting Qi deficiency can lead to the above-described results. 

Certain amino acids (building blocks for muscle proteins) are essential for the functioning of muscles and the heart muscle is particularly sensitive to deficiencies. One of these amino acids is Taurine. It is present in raw meat and has a high concentration in organ meat. It gets destroyed in heating or cooking (as in commercial dried or canned food). This Taurine is often added to dried cat food.

Co-enzymes are essential for the functioning of the mitochondria. These are a part of every cell and are the engines of the cells; this is where energy production takes place. Co-enzyme Q 10 is one of these essential co-enzymes which is needed for proper heart muscle function. In a diseased heart the use of this enzyme often exceeds what the animal’s body can produce. Supplementing patients with heart muscle weakness with co-enzyme Q10 greatly increases their life expectancy.  L-carnitine is another. These two products are often added to support the heart patient.  Herbs such as Hawthorn and Siberian Ginseng will both increase heart muscle contractility. And of course we can also do acupuncture to stimulate the production of “post-natal Qi” and to regulate the heart Qi. We would also pay attention to the kidney. Deficiency of the parental Qi, stored in the kidney might be the underlying cause of the Qi deficiency. Herbal supplements would be used to correct or minimize that problem.

A good holistic exam, especially TCM could lead to early detection of problems in the digestive network (or spleen) and or early diagnosis of heart disease. With early detection preventive medicine may avoid the full development of the disease. Once developed, acupuncture, dietary management and supplements will help to prolong the life of the patient and often enable us to reduce the amount of drugs needed to control the disease.

Dr. Marlene Smith-Schalkwijk DVM

Dr. Smith is a licensed veterinarian specializing in veterinary acupuncture, herbal medicine,

Herbal/Botanical Medicine
By Marlene Smith-Schalkwijk DVM


Boswellia Serrata
Boswellia is a medium size tree found in India, Africa and the Middle East. After the bark has been peeled away there is an oleo-resin which contains oil and gums. It is these gum resins (also called guggals) that have been used traditionally in Ayurvedic (Indian) Medicine as a natural anti-inflammatory for arthritis. Boswellia spares the degradation of the glycosaminoglycans, which serve to protect the cartilage surface of joints. Non-steroidal anti-inflammatory such as ketoprofen or metacam do not protect the joint surface so arthritic conditions progress. Our doctors will often include Bosweilla in the powdered herbal formulas, tailor-made for our achy canine-friends. Arthrisooth is an example of a commercially made joint protective product containing Bosweilla. Boswellia can also be used in asthma related inflammatory respiratory conditions.

Milk Thistle
Milk Thistle (Silybum marianum) is a member of the sunflower family. It originated in the Mediterranean area in Europe, and has spread to many areas in North America. The ripe seeds are used as an alcoholic extract or ground powder. Its traditional uses ranged from cancer to poor milk production. The most common use is for liver protection. The active ingredient is silymarin. It accelerates the rate of protein synthesis in the liver and stimulates the production of new liver cells to replace old damaged cells.

It can be used on dogs, cats, horses, ferrets, rabbits, cows and humans to aid in liver or kidney damage, hepatitis, jaundice, parvo etc. It is often used in Europe before and after anesthesia. Since this is medicinal herb, it should only be used in diseased livers and not in healthy animals on a routine base. Most good quality powders have 70-80 % silymarin. The tincture can be used in animals whose livers are not seriously compromised.

Long-term use can suppress liver function. Please check with your holistic veterinarian as to the dose and duration of therapy. In skin diseases related to liver problems, milk thistle can be combined with dandelion, burdock, yellow dock or Oregon grape. 
Caution: Do not use in pregnant animals.

Holistic Approaches To Heart Diseases In Pets
Submitted by Dr. Marlene Smith-Schalkwijk

Here is a list of Western drugs used to treat heart problems (depending on the problem):

Lasix/Furosamide is a diuretic used to clear the lungs from fluids build up from poor function of the heart.
Benazapril, Fortekor, and Lowtensin are vasodilators, which dilate the blood vessels. This makes it easier for the heart to pump the blood out of the heart into the lungs or aorta.
Vetmedin - The physiological function of the heart in dogs and cats is identical to humans. Therefore, it is not surprising that both humans and their animal friends share many similar cardiac disorders. Congestive heart failure, heart murmurs, cardio-myopathy and pulmonary oedema (fluids in the lungs) are just a few examples of these shared disorders. Similarly, the drugs used to treat a given heart condition are the same whether the recipient is canine, feline or human. Predisposing factors for developing heart diseases, such as diet, weight, exercise, and hereditary factors also apply to our pets.

Prevention of Heart Diseases:
In holistic medicine we look at prevention as well as supporting the diseased heart. Taurine is an important protein building block (amino acid) for the heart. Humans make their own taurine and have a moderate requirement for it if the heart is disease free. Carnivores (dogs and cats) get their taurine or its building blocks directly from their food. Cats have a very high taurine requirement. This stems from their many years of primarily eating mice. Mice actually have the highest taurine levels of any animal. Taurine is naturally present in raw meat. When meat is heated or cooked (as happens in processed food) taurine gets destroyed, which results in a taurine deficient diet and leads to serious deficiencies for the heart muscles. When processed cat foods first came on the market, many cats died of a dilated cardio-myopathy due to taurine deficiency. Now almost all commercial animal foods have taurine added to them. Dogs and cats on a vegetarian or cooked meat diets are also at risk for developing taurine deficiency. However, this is easily remedied by either supplementing with taurine or by adding raw organ meat such as liver, heart or kidney (mice hearts having the highest taurine levels) to the diet. Other forms of dilated (thin walled) cardiomyopathy also benefit from taurine supplementation as this helps a weakened heart to function more efficiently.
Co-enzyme Q 10: All cells, including the heart muscle cells, need Co-enzyme Q 10 to create the energy for the muscles to contract. The heart muscle cells create their own Co Q 10 in sufficient amounts for normal function. However when these cells have to do overtime as in congestive heart failure or dilated cardiomyopathy, more CoQ10 is needed then the body can generate. Additional Co Q10 in the diet will support the heart muscle and help prevent exhaustion. Research in humans with heart disease has shown a significant increase in survival time in patients receiving Co Q 10.

Hawthorne also assists in the contractility of the heart and is often added to supplements for the heart.
Vitamin E also increases the heart contractility. It is also an anti-oxidant and anti-inflammatory.
(Siberian) Ginseng increases the cell metabolism in general and also in the heart.

All of these supplements can change or potentiate some of the western drugs your pet may be on. Please consult your veterinarian if you wish to supplement your pet with a heart disease.

Gingko Biloba (from the Biloba tree in India) helps to dilate and strengthen the cardiac and brain blood vessels, helping to prevent strokes or heart attacks in patients with heart disease. It also has slight anti-coagulant effects helping in the prevention of blood clot formation, strokes and heart attacks.

Treating underlying diseases
Endocrine diseases such as thyroid disease (hypo or hyper), adrenal disease (Cushings, Addisons), kidney disease (causing hypertension), liver disease, immune disease (rheumatoid, lupus) and infectious diseases (Lyme’s, dental disease) can also affect the heart. Early detection through regular examination, blood test and treatment of these diseases can prevent the development of heart disease.

Hyperthyroidism in cats
Hyperthyroidism is the most common disease in elderly cats. These days we see cats as young as 8 years with hyperthyroidism. In this disease the thyroid produces an excessive amount of thyroid hormone causing the bodies metabolism to speed up. This leads to excessive hunger with weight loss, hyper-activity (especially at night), hypertension (causing kidney failure) and rapid heart rate. The hyper-activity of the heart causes a thickening of the heart muscle, called hypertrophic (or thick walled) cardio-myopathy. The heart chamber becomes very small, leading to the formation of blood clots, causing heart attacks, strokes and saddle thrombus. A saddle thrombus is an acute (and very painful) paralysis of the hind legs. Diet seems to be closely associated with the formation of hyperthyroidism. Cats on a raw food (raw meat) diet seem to have a lower incidence of such diseases as diabetes, irritable bowel disease and hyperthyroidism. More scientific research is needed in this field to come to definite conclusions. Hyperthyroidism can be treated with western drugs (Tapazole), radiation therapy, diet, homeopathic medicine and herbs (Motherwort, Melissa).

The best prevention of heart disease is a healthy diet (which includes fresh food) and regular exercise. Do not over exercise your dog by running him/her with a bike or car, or make your pet into a couch potato by leaving them alone at home all day while the whole family is at work. Make sure to take them for a good walk and play before you go to work and as soon you come home! Prevent exposure to extreme heat as leaving them in your car without adequate ventilation or on summer sunny days! Cats that live strictly indoors should be encouraged to play and their diet should be low or even better have no carbohydrates. If your animal has been diagnosed with a heart disease you may wish to consult a holistic veterinarian to discuss appropriate supplements.
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The Treatment Of Legg Calve Perthes With Acupuncture
By Marlene Smith-Schalkwijk, DVM

Introduction
Legg-Calve- Perthes disease is mostly diagnosed in young dogs of the miniature breeds. It is characterized by an increase in trabecular bone of the femoral head, followed by aseptic necrosis secondary to ischemia. Revascularization of the bone is followed by demineralization (1). Diagnosis is made on the basis of signalment, a small breed 6-10 months of age with persistent reduced weight bearing on one hind limb or limping. Radiographs show demineralization of the femoral head and/ or neck. There is often a fracture of the neck and displacement of the femoral head. Conservative treatment is often to no avail and femur head resection is performed (or total hip replacement) to alleviate the pain.

The following case history describes two small breed dogs diagnosed with Legg Perthes disease. Both dogs were treated with acupuncture, nutraceuticals and herbal medicine. Both dogs returned to full weight bearing and follow up radiographs showed re-mineralization of the femur neck and head.

Case 1
Male Toy Poodle, DOB November 1996. Weight 6 pounds.
First presented September 1997 with the following history:

For the last few months the owner had noticed gait abnormalities of the dog’s left hind leg. Two weeks earlier the dog did not weight bear after a rough play, he was sensitive over the hip area and showed muscle atrophy. The owner rested the dog and had the hips radiographed and evaluated in California by an orthopedic specialist. Legg Calve Perthes was diagnosed and the owner was given the option of a femur head resection or total hip replacement. The radiograph showed obvious demineralization of the left femur neck and slight luxation of the femoral head with minor demineralization. The owner requested acupuncture and alternative treatment prior to making a surgical decision.
On examination the dog was only 10-20% weight bearing on the left hind leg, there was pronounced muscle atrophy of the left rear limb and he was painful on palpation and manipulation of the hip area. The rest of the physical examination did not reveal any other abnormalities.

The TCM diagnosis was Qi stasis, followed by a stasis of blood and blood not nourishing the local area (bone) resulting in a loss of bone material (Yin). The root of the problem was considered a kidney jing deficiency, resulting in a developmental (bone) deficiency and insufficient Qi to move the blood. The treatment plan was to nourish postnatal Qi, invigorate (activate) and nourish the blood, move stagnant Qi and nourish the kidney. A combination of acupuncture, herbal supplementation, neutraceuticals and homeopathy was used.

The following points were used in different combinations:
BL 23 ( Shen Shu) Back Shu points for the Kidney; influences Kidney Qi and Bones.
GB 29 ( Ju Liao ) interception of the Yang Heel Vessel on the GB channel. Local point for the hip, partner of the Liver, helps to move (local) stagnant Qi and increases local circulation. (2,4)
BL 54 ( Zhi Bian ) local point, part of the hip triangle points, close to the sciatic notch, good point to relieve hip pain also used for atrophy of the hind limb. (2,4)
GB 30 (Huantiao). The third point of the hip triangle. Indicated for hip pain and hind limb atrophy. (2,4)
GB 30 extra. This extra point was selected to complete the hip points as indicated by Dr. Luc Janssens. Location just below the greater trocanter ( Luc Janssens) ( 3)
ST 36 (Zu San Li) strong tonification point, master point for hind leg weakness, tonifies the Stomach, Qi and Blood. It is indicated in general and hind leg weakness and nourishes postnatal Jing. (2,4)
SP 6 (San Yin Jiao). Intersection of the Ki and Liv channel on the Spleen channel. This point was chosen for its nourishing action on Blood, Qi, Kidney, Liver and moving Qi and Blood. (2,4)
LIV 3 (Tai Chong) This point was selected for its influence on the Liver, to regulate the Qi and spreading, moving the Qi, to move the Blood, and influence on tendons and ligaments. (2,4)
GB 34 (Yang Ling Quan), influential point for sinews (and joint capsules). It also benefits the joints and spreads Liver Qi. (2,4)
LI 4 (Hegu) as a balancing point, part of the “ four gates” in combination with LIV 3. It also helps relaxing the sinews. (2,4)
In the first session, needles were placed in GB 29 and 30, BL 54, LIV 3, GB 34 and left in place without manipulation for 15 minutes.
As neutraceuticals Glucosamine Sulfate + Chondroitin at 100mg BID, Vitamin C 100 mg SID Vitamin E 100 IU SID was prescribed, for 6 months. Arnica 30 CH (Dolisos) at 2 BID for three days as needed, was used for a short period of time to resolve any inflammation and blood stasis. Cruroheel (Heel) and Osteoheel (Heel) were also added at 1 BID for three months. Herbal choice was Eucommia (7 Forest) ½ BID for three months, to nourish bones, tendons and ligaments and blood. In subsequent sessions, needles were placed in GB 29, 30, 30 extra and BL 54. Electro acupuncture for 20 minutes was performed over these points. Static needling was performed at ST 36 + SP 6 and BL 23. These last points were alternated with GB 34 and LIV 3 + LI 4. The dog received 7 treatments, one week apart, followed by physiotherapy. The dog was also cage rested for 1 month followed by restricted exercise for two more months. Hydrotherapy was attempted and unsuccessful in this patient.

Case 2:
Male Skipperke DOB June 27, 1996, weight 10 pounds.

The patient was first presented January 28, 1998 with intermittent limping of the left hind leg. Long walks made it worse. The hip was sensitive on palpation, the tongue slightly pale and the pulse was a little wiry. The rest of the physical exam did not show any abnormalities and the dog was sent for radiographs of the hips. The X- rays showed a marked demineralization of the femoral neck with deviation of the femoral head. Based on the symptoms and radiographs, the diagnosis of Legg Calve Perthes was made. The owner had previous experience with femur head resection for the same problem in an aunt of this dog and requested acupuncture and alternative approaches before deciding on surgery.

The TCM diagnosis was kidney jing deficiency plus local (Liver) Qi stagnation, resulting in a stagnation of circulation (blood). The treatment plan included moving Qi, nourishing postnatal and kidney Qi and invigorating (moving) and nourishing blood.
The following acupuncture points were chosen:
BL 18 (Gan Shu) back Shu point of the Liver, to nourish Liver Blood and move the Qi
BL 17 (Ge Shu) influential point for Blood (2)
BL 23 (Shen Shu) Back Shu point for the Kidney to nourish Kidney Qi and bones. (2,4)
GB 30, 29 and 30 extra BL 54 (see rationale in Case 1)
SP 6 and ST 36, LIV 3, LI 4 and GB 34 were selected for the same reason as in Case 1
Procedure was the same as in Case 1, with static needling in session 1. In the follow up visits, electro acupuncture was performed on the hip points. The neutraceuticals Glucosamine Sulfate (Glycoflex), 150 mg BID, Vitamin C 100 mg SID and Vitamin E 100 mg SID were used for 6 months. Homeopathic Cruroheel and Arnica (short term) as in Case 1. Herbal supplement Astra Essence (Health Concerns) ½ tablet BID to nourish the postnatal Qi essence. Later this was changed to Eucommia at ½ tablet BID for three months. The dog received 4 treatments 1 week apart, then 1 treatment a month for two months, was cage rested, followed by restricted exercise and physiotherapy as in Case 1.

Results:
Case 1 was 100% weight bearing in four months. In January 1998 he was x-rayed again. Both the original and the repeat X Ray were sent to the same specialist for re-evaluation. The femoral neck and head were both well mineralized. The slight deviation of the femoral head seen on the original X ray was still visible. The owner agreed not to breed the dog and the dog continued its show career and was placed several times. No lameness was detectable and muscle atrophy was completely resolved. On the last follow up visit August 1999 the patient continued to do well without any signs of lameness. In a more recent conversation in 2001, the owner reported that the dog still did not show any sign of hip pain.

Case 2 improved significantly and after 4 months would have a minor limp after a long walk. He was re X- rayed in July 1998 and the femoral neck and head were completely mineralized. The pronounced deviation of the femoral head was still present and it was assumed that this was causing the pain. Gold bead pellets were implanted around the hip as described and used for hip dysplasia. (3). The dog’s lameness was completely resolved after this procedure and he was more sound then his aunt, who had been treated for the same condition with a femur head resection. Follow up over the three following years were mostly to do acupuncture on the hips of the aunt. Occasionally we had to do acupuncture and chiropractic treatment on patient number two mostly during the damp cold season of the winter. Supplementation of Glycoflex (glucosamine) has been maintained through life.

Conclusion:
Aseptic necrosis of the femoral head is a progressive disease, which often leads to fracture of the femoral neck due to demineralization. Standard treatment is femur head resection or a total hip replacement.

This was the first time that the author used acupuncture and supplements for this disease. The positive outcome is encouraging to include acupuncture and neutraceuticals as an option to treat this disease. More data and research is needed in this respect and it should be pointed out that both cases were in an early stage and fracture of the femur neck had not yet occurred. Because of the genetic component of this disease, affected individuals should be excluded from the breeding stock.
References:

1. Stephen J. Ettinger, Edward C. Feldman ; Textbook of Veterinary Internal Medicine Volume - 2 fourth edition, pg 2116 WB Saunders Company 1995
2. Lade, Arnold  Acupuncture points, Images and Functions 1989 Eastland Press
3. IVAS Acupuncture Course notes 1987
4. AVAC Acupuncture Course notes 2002, Maria Glinski Acupuncture point
   
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The Geriatric Pet
By Marlene Smith-Schalkwijk DVM

When our animal friends get older the spirit is often willing and the body starts to decline. Animal may experience similar problems to our own aging bodies. This does not mean that nothing can be done and we have to except and witness this decline. Chinese Medicine sees the decline of our life energy as a decline of the kidney Qi. It relates symptoms such as graying of the hair, pain and weakness of the lower back, hips and knees, deafness, urinary incontinence and mental decline as a deficiency of the kidney energy or Qi. There are many Chinese herbal formulas and acupuncture techniques that are specifically designed and directed towards helping the aging individual.

Canine old age vestibular syndrome, characterized by a head tilt, disorientation, walking in circles, nausea and falling over (these symptoms are very similar to human strokes) is seen in Chinese Medicine as a “Wind Stroke”. Acupuncture has shown to arrest these attacks while they are in progress and is very helpful in the recovery process. Homeopathic remedies also speed up recovery. Congestive heart failure and related problems can be well controlled using the appropriate combination of western drugs, nutraceutical, acupuncture, and both Chinese and Western herbs. Using such an individualized and integrated approach allows us to give our aging animal companions the gift of a longer and more enjoyable life.

The aging process in our beloved pets can give us a glimpse of what getting older is all about. Animals teach us how to grow older gracefully and enjoy every day as if it is our last one. Their unconditional love and compassion prompts us to care for our older animal friends and teaches us to care for ourselves as well for others as they age.

When the day has come to finally say goodbye, we will have to let them go with the same compassion they have taught us during their time with us. One of the greatest gifts we can give our dear friends is to know when to say goodbye.
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Veterinary Homeopathic First Aid
By Marlene Smith-Schalkwijk DVM

This homeopathic care kit is for emergency use only. It is not replacing any necessary veterinary care. All remedies can be used in conjunction with allopathic medicine. Do not deny your animal friend the services and care of a veterinarian. Veterinary Homeopathic First Aid kits are available at Tree of Life Veterinary Care.

Dosage: Cats and small dogs 8 pounds or less; 1 pellet
Cats over 8 pounds and dogs up to 15 pounds; 2 pellets
Dogs up to 60 pounds 3 pellets
Dogs over 60 pounds 4 pellets
Horses 4- 6 pellets

Frequency: in acute cases four times daily for 1-2 days than reduce to three times daily for three days, followed by twice daily for three days.

Arnica 5CH: For acute trauma of any tissue as muscles, joints, head or spinal injury.
Indications: Hit by car, dog or cat fight, intervertebral disc problem, ruptured crusiate ligament, cat abscess, surgery (pre and post), dental extraction’s, over exertion of muscles, acute flair up of arthritis

Caution: Do not use in conjunction with NSA drugs such as aspirin, butazone etc.
Rhus Tox 30 CH: For trauma, sprain or surgery to ligaments and joints. Can be combined or follow Arnica.
Indications: Surgery joints or tendons (crusiate repair), tendonitis, bursitis, arthritis.
Aconite 5 CH: For convulsions or hysteria from shock, where there is a lot of (involuntary) movement with fear of being touched
Indications: Hit by car initiating convulsions or above symptoms, epileptic seizures after great fear or shock.
Hypericum 30 CH: For injuries to the nerves, spinal cord or head.
Indications: Hit by car or other trauma resulting in above injuries, also used for de-gloving injuries. Can be combined or following Arnica. 
Nux Vomica 30 CH: For vomiting as a result of food overload, poisoning, “garbage gut” and other forms of vomiting and diarrhea. Typical early morning vomiting.
Phosphorus 5 CH: For profuse bleeding from wounds, nose, ears, gastric or intestinal ulcers. Only to be used for a short time.
Calendula extract: For flushing wounds and abscesses. Dilute 10 drops in 1 cup of boiled (and cooled) water with ¼ teaspoon of sea salt. Can be used as a wet dressing over bleeding wounds (cut pads). Can be combined with Hypericum, Comfrey and Aloe Vera.
Rescue Remedy: For fear of known or unknown things. Cats and small dogs; give:
1 drop in a teaspoon of water. For bigger animals give 3-5 drops in a tablespoon of water. For birds mix 1 drop in drinking water, refresh daily.
Indication: During, prior or after fearful events as accidents (can be given to the unconscious animal) or veterinary visits, shows or moving. Also useful in wildlife rescue situations.
Tip: It seems to work better if the animal's caretaker takes the same amount at the same time!
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Stretches For Your Dog
By Shannon Schroeder B.Sc.P.T Registered Physiotherapist

Prior to stretching exercises walk your dog for 5 minutes to warm up the muscles. Hold each stretch for about 10 seconds.
Fore Limb (dog lying on his/her side)
Hold below elbow and gently draw the arm straight forwards. Gently draw the arm straight backwards, support shoulder and elbow and draw arm towards the ceiling.
Hind Limb (dog lying on his/her side)
Hold at stifle (knee) and hock and then gently stretch the leg straight backwards. Perform the same stretch, but keep the stifle bent at a 90-degree angle. Hold with one hand on the front of the thigh and the other hand at the hock; stretch the hind leg straight forwards. Hold the stifle (knee) and hock and lift the leg up towards the ceiling.
Back (dog standing)
Cookie stretch- stand dog, support hind end with one arm under the body. Have dog reach around to eat treat at their hip.
If you have any questions or concerns, please contact Shannon at the Tree of Life Veterinary Clinic 338-2316
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To Vaccinate Or Not To Vaccinate That Is The Question

These are the notes from a vaccination seminar given in Victoria, BC in 1998.

The question if our pets need their vaccines every year keeps coming up. The following information was extracted from a seminar attended by Dr. Smith, given by Ron Schultz in North Caroline September 2004 and his news release published March 2003. Ron is a veterinary immunologist and researcher at the University of Wisconsin-Madison School of Veterinary Medicine. He has been studying the effectiveness of canine and feline vaccines for the last 30 years. His studies showed that immunity after vaccination in dogs could last as long as a lifetime. The question if we are over vaccinating our animals was raised when many veterinarians noticed that there was an increase in diseases such as skin problems, allergies and autoimmune diseases after vaccinations. In cats, tumors at the site of the vaccination injection have been well documented.

Just like in people, an animal’s immune system gets fired up when a pathogen such as a virus enters the body. These disease-fighting cells are called B and T lymphocytes. They not only destroy the virus; they remember what it looks like, so they can fend it off in the future. This is the basis on how vaccines (which are killed or live weakened pathogens) can protect against future diseases. Vaccines protect people for life; Ron Schultz’s research has shown the same for dogs and cats.

Schultz recommends that animals be vaccinated with the "core vaccines" only. These are distemper for dogs and cats, parvo for dogs, leukemia for cats and rabies for both. He recommends not vaccinating for Lyme's disease due to reported adverse reactions such as immune mediated poly arthritis. Kennel cough vaccine does not give adequate protection and the disease is not a life-threatening disease.

Ron Schultz recommends vaccinating dogs no more often then every three years for the core vaccines. He also found that adult cats, which had received a vaccine for leukemia once in their life, could not contract the disease in adult life. The Tree of Life Veterinary Care has been following the antibody levels in the blood of vaccinated animals and found these antibodies lasting three to seven or more years. One 11-year-old dog had high antibodies against the rabies vaccine 10 years after the last vaccination! Ron Schultz vaccination schedule has now been embraced and recommended by the American Animal Hospital Association.

For more information visit the website of the Wisconsin University at:
www.news.wisc.edu/release/8413.html or contact Ron Schultz at: manningj@svm.vetmed.wisc.edu

Vaccinations
Every year new vaccinations come out and our animals (and kids!) seem to get numerous vaccinations in the early part of their lives. Are we doing the right thing and could all these multiple vaccinations possibly cause any harm? We will try to clarify the various infectious diseases that dogs and cats can get, which ones of these could be fatal and which ones cause relatively mild signs. We will also discuss the latest recommendations as to the timing and frequency of vaccinations, based on research done at universities.

Infectious Diseases in Dogs:

Canine Distemper
This is an acute or sub-acute febrile disease of dogs and related carnivores including ferrets and bears. It is spread worldwide and has a high fatality especially in young unvaccinated animals. The virus is a paramyxo virus related to measles and rinderpest. The virus suppresses the immune system, often resulting in other infections such as pneumonia or parvo.

Clinical signs include such symptoms as high fever 3-6 days after exposure, which lasts for 2 days. The second fever phase occurs several days to weeks later with discharge from the eyes and nose, diarrhea and vomiting. There is loss of appetite, general depression and dehydration. Sometimes an allergic skin rash is noticed. Nervous signs can occur concurrently or afterwards and can vary from seizures, incoordination, pacing, circling, a tic or tremor. In cases of encephalitis the footpads can be affected and become hard and cracked.

Prognosis: This is always guarded since dogs with mild signs may seem to recover and then develop neurological signs, which might be irreversible or fatal. Many young puppies with compromised immune systems die of the disease in spite of extensive (expensive) treatment. The disease still occurs in unvaccinated canine populations. Immunity after vaccinations in dogs over 4-6 months last 3-7 years, maybe life long.

Canine Hepatitis:
This highly infectious disease is caused by two adeno viruses. The virus is easily destroyed by disinfectants, but can survive in cold climates for a long time and for years in a frozen state. Signs can vary from mild transient general depression followed by ocular lesions as uveitis (eye inflammation) and keratitis, resulting in a blue eye. The virus can also affect the upper respiratory tract. The disease can be fatal and eye changes can be irreversible. This disease has not been diagnosed in the western world for many years and questions arise if it has been eradicated. The need for vaccination against disease is questionable.

Parvo Virus Infection:
This is an acute and highly contagious viral infection in dogs and related animals. The disease is most severe in animals under 1 year of age. Clinical signs are severe bloody diarrhea 2-6 days after exposure. Vomiting, depression and anorexia are common symptoms. The virus suppresses the immune systems and other diseases can occur simultaneously. There is a high rate of fatality and those that recover can develop cardiac problems as cardiomyopathy or encephalitis. Duration of immunity as result of vaccinations in dogs, vaccinated at 4-6 months of age is 3-7 years, maybe a lifetime. 

Corona Virus:
This virus also causes diarrhea and enteritis. It is seen predominantly in shelters, boarding kennels and show dogs. The diarrhea can be severe, but is seldom fatal and positive antibodies are found in 75 % of dogs with transient diarrhea. The effectiveness of vaccination against this disease with a killed virus is not established. The importance of this disease in puppies is questionable; it rarely causes a problem in the adult dog. The need to be vaccinated for the disease is questionable.
Kennel Cough (Infectious Tracheobronchitis):
Bordetella bronchiteptica is one of the many viruses that can cause upper respiratory disease in dogs. Other viruses are canine para influenza and herpes infection. Both viruses can survive for months in the environment. The virus is present in secretion of nose and trachea and spread through aerosol or direct contact.
Typical symptoms are a harsh barking cough and a fever up to 105 F. Most dogs recover spontaneously and some require antibiotics for secondary infections. Show dogs and dogs boarding in kennels are most at risk. Intra-nasal vaccination is more effective than subcutaneous or intra muscular. I see an increase of nasal tumors, chronic infections and fungal infections in dogs. The question arises here if intra nasal vaccinations could possibly contribute to this. Also the shedding of the modified life virus of the vaccine has possibly been the cause of outbreaks of upper respiratory infections in kennels after recently vaccinated dogs were introduced.

In the early stages Kennel cough can be effectively treated with the Chinese herbs Gan Mao Ling and Yin Chiao. Duration of immunity after intra nasal vaccination is likely 3 months or less. Protection is questionable.

Lyme's Disease:
This disease is caused by a spirochete borelia burgondorferi. The disease is transmitted via the tick Ixodes. The disease is diagnosed with greater frequency in humans, dogs and horses. The signs are varied and include fever, lethargy, poor appetite, lymphadenopathy, lameness and arthritis. Endocarditis and myocardial necrosis might also occur. Meningitis and renal changes can also be a result of this disease. The disease can be effectively treated with tetracycline, ampicillin and erythromycin. Effectiveness of vaccination is questionable. Recent research in the USA has shown that there was an increase of immune mediated arthritis in individuals vaccinated with Lyme’s vaccine. Vaccinations should only be considered in high-risk areas such as the South Eastern United States.

Leptospirosis:
This disease is also caused by a spirochete. Wild and domestic animals serve as a reservoir. The virus is mostly shed via the urine and infection often occurs via pools of warm and stagnant water. The liver and kidney are mostly affected. A very acute infection can result in death without many symptoms. Less severe infections show fever, lethargy, anorexia, vomiting, dehydration and reluctance to move. Progressive destruction of the kidneys is evident in the progressive thirst and urination. This disease is transmittable to humans. Vaccinations are recommended in endemic areas with vaccines against the type of leptospirosis present in the area. Most current canine vaccines no longer contain the leptospirosis fraction, since L canicola and icteroheamoragica are not commonly present anymore. Check to see if your area is infected with leptospiroses and which type.

The vaccine against this disease has the most reported adverse reactions. The Leptospirosis fraction used in the current vaccine is not the same as what is present in nature and does not give a cross protection. If your area has Leptospirosis, please make sure that the fraction used in the vaccine actually protects your animal.

Rabies:
This viral disease causes encephalitis in warm-blooded animal including humans and is almost always fatal. Wild animals such as skunks and bats are the reservoirs for re-occurring infections. Infection occurs through saliva via a bite or ingestion of infected tissue or even inhalation. Signs may occur 3-8 weeks after exposure. Signs are a change in behaviour from irritability and biting to being extremely timid and paralysis. In the “ furious rabies” the animal will become hypersensitive and may bite any object that moves or with any loud noise or bright light. They may show seizure type activity. In the paralytic rabies the animal may become very timid and wild animals may appear tame. Their tongue may hang out and they may not be able to swallow, resulting in hydrophobia. Since this is a fatal untreatable disease, vaccinations against this disease are recommended. The duration of post vaccination immunity has not been researched very well, it likely lasts for 7-10 years after the initial vaccination at 6 months or older. There are now non-adjuvated rabies vaccines available for cats, which can also be used for animals at risk. Law requires re-vaccinations every three years, especially for border crossing with the USA.

Infectious Diseases In Cats

Feline Distemper (Panleukopenia):
This disease is caused by a parvovirus. It can survive for many months or years in the environment. It is shed via the feces and or vomiting. It can survive in cages, bowls, and litter boxes. Inter uterine infection can cause cerebellar hypoplasia. The disease is fatal in young unvaccinated kittens. Kittens from vaccinated queens are protected with maternal antibodies up to12 weeks of age.

Signs of the disease are vomiting, fever, lethargy, anorexia, diarrhea, dehydration. Vaccinations are essential in kittens over 10 weeks of age. Revaccinations are done up to 16 weeks of age with 4-6 week intervals. (Over 21 days and less than 60 days). Duration of immunity post vaccination is currently accepted as being 3-7 years.

Feline Herpes Virus/ Feline Calici Virus:
The majority of the feline upper respiratory diseases (80-90%) are caused by herpes infection and calici virus. The virus is shed in ocular, nasal and tracheal secretions. Calici virus may also be shed via the feces. Infection can be transmitted from cat to cat or via hands, bowls or shoes. The disease is mostly self-limiting, but many animals remain chronic carriers with periodic outbreaks. Some of the chronic gingivitis has been attributed to this disease. Herpes infection can cause ulcers where the ocular or nasal discharge comes in contact with the skin, similar to cold sores in people. Calici virus can cause ulcers on the tongue. The currently used vaccine is a modified life virus vaccine, which is known to shed the virus, resulting in outbreaks of upper respiratory disease in shelters and catteries. This often results in chronic ocular and or nasal discharge especially if the animal is exposed to stress during or post vaccination. Duration of immunity post vaccination is unknown and ranges from a few months to 7 years.

Chlamydia:
This upper respiratory infection is caused by the bacteria Chlamydia psittaci. Transmission is mostly from cat to cat. Signs are ocular and nasal discharge and sneezing. The disease is relatively low in occurrence accounting for approximately 5% of upper respiratory infections.

Feline Leukemia:
This disease is caused by a retro virus. In higher populated areas the occurrence is greater than in rural areas. The virus can be carried by clinically healthy unaffected cats or by chronically ill cats. Transmission occurs through long intimate contact or bite wounds, in-uteri or via the mother’s milk. Kittens under 16 weeks of age are more susceptible to infection than animals over 16 weeks of age. Currently it is questioned if adult healthy cats can get infected with this disease.

The virus suppresses the immune system and signs occur from this suppression. These signs can be from chronically ill cats with recurring infections including abscesses or gingivitis. The virus can also cause neoplasia (Cancer). Vaccinations are recommended for susceptible groups only. Duration of immunity post vaccination is 3-7 years. Indoor cats cannot contract the virus and do not need to get vaccinated against this disease.

Feline Infectious Peritonitis (F.I.P.):
This disease is caused by a Corona virus. Transmission occurs via oronasal contact or contaminated feces. Infection can also happen via the queen’s milk. Clinically healthy carriers create a reservoir. Most cats carry antibodies against a corona virus; these antibodies may give “ false positives” in cats tested for FIP. There is a wet and dry form of FIP. The “dry” form creates inflammatory granulomas in the abdomen, chest and brain, while the “wet” form causes an ascitis or pleural effusion. Only cats at risk should be vaccinated. The vaccine is not without risk. Duration of immunity is likely life long.

Feline Immune Deficiency Virus:
This Retro virus causes symptoms similar to Human Immune Deficiency Virus (AIDS). Transmission is via bite wounds and breeding. No vaccine is available yet for this disease.
To Vaccinate Or Not To Vaccinate?
Vaccination protocols have been developed with the best knowledge available to prevent potentially fatal diseases in our pets, horses, livestock and humans. More and more vaccines are now available and there is a concern that we are overdoing it.
In general, the kittens and puppies receive antibodies from their mothers in the uterus and via the colostrum and early days of lactation. This is of course if the mother has an adequate immune status and is healthy. These maternal antibodies last for 8-16 weeks. These maternal antibodies inactivate vaccines and vaccinating animals at 4 or 6 weeks of age might be surplus or even contra indicated.

According to Ron Schultz, Veterinary Immunologist at Wisconsin University, there are core vaccines and non-core vaccines. The core vaccines are for fatal and generally common diseases while the non-core vaccines are for susceptible groups only (i.e. groups most likely to get the disease). In the cat, the CORE vaccines are feline panleukopenia (FPV), feline viral rhinotracheitis (Feline Herpes), feline calici virus (FCV) and rabies.

The non-core vaccines are leukemia (FeLv), feline infectious peritonitis (FIP), and ringworm. These diseases only occur in cats going outdoors, being boarded, going to shows or living in a multiple cat household. In dogs, the CORE vaccines include distemper, parvo and rabies. The non-core vaccines are leptospiroses, corona, bordetella, hepatitis, para influenza and Lyme’s disease.

When vaccinating a cat or dog the risks of vaccination should be weighed carefully against the benefits. For the core vaccines the benefit clearly outweighs the risk. The non-core vaccines should only be given to animals that are at risk to get the disease. Indoor cats will not get exposed to leukemia; new additions to the family should be tested prior to allowing them into the household. Cats in a breeding situation or in a multiple cat household are at greater risk and leukemia and FIP should be considered. So indoor cats do not need to be vaccinated against leukemia.

Dogs in the city or living in areas where there are no ticks do not need to be vaccinated against Lyme’s disease. The occurrence of positive ticks is very low even in the so-called endemic areas. Only 1 or 2 ticks have been identified being positive for Lyme’s! The possible introduction of modified virus leading to vaccine induced poly arthritis is bigger then the odd chance that the dog might contact Lyme’s disease. Multiple vaccinations with killed vaccine could possibly result into reactions against the vaccine or adjuvance. Intranasal vaccinations for upper respiratory diseases are better than parental injections. But this vaccine is a non-CORE vaccine.

An animal should not be vaccinated:

* When it undergoes anesthesia or surgery, dental cleaning, etc.
* During pregnancy -This will not only cause a failure in vaccinations, but also could lead to cerebellar hypoplasia and meningitis. If your queen or bitch is not adequately vaccinated prior to conception it is better not to breed her.
* Any animal with an immune impairment such as immune deficiency, Feline leukemia, allergies, autoimmune diseases etc, should not automatically be vaccinated. Please discuss the danger of re-stimulating the immune system to maintain these diseases versus protection for the animal.
* Any animal prior, during or shortly after transportation or going into a new home.
* Any animal having had an adverse reaction to previous vaccinations. (Split up your vaccines!)
* Any animal that is not 100% healthy!

What else can we do?
The need for annual revaccination lacks adequate scientific data to validate this practise. How then can we determine that the animal needs a booster vaccination? In human medicine, duration of antibodies is based on a blood titre that shows adequate protecting antibodies against the disease in question.

There are several types of titers we can use: the virus neutralizing antibody titre, the immune fluorescent antibody, and the hemagglutination antibody titre. They don’t all correlate and are not all the same. The word is not out yet on which one is the most reliable. There is also a local cell mediated immunity for which we cannot test. If we would use the same parameter we use for humans as “ safe and not needing a vaccine” for the animals, we would find that most vaccines give three to seven (feline distemper) years immunity. The truth of the matter is that we lack understanding of all the factors that play a role in immunity and response to diseases. Titre testing many animals will give us a better understanding of how long humoral antibodies last.

Cell (immediate) immunity can possibly be stimulated with homeopathic nosodes. These can be given orally to animals with an adequate blood titter for the disease in question. It is not known how often this needs to be repeated. This (the nosodes) is certainly a good way to activate the immune response in case of an outbreak.

These nosodes are NOT an alternative to vaccinations!! At the very most they might stimulate cellular immunity in already vaccinated (or exposed) animals.

A nosode can also be given, after the first initial vaccinations have been given as a yearly (or 3 year) booster.

A nosode can also be used when an animal comes down with the disease it has been vaccinated against in the last week (typical for URI) or to a puppy in the early stages of Parvo infections, or to kittens entering a shelter (where they often pick up URI or distemper).

To prevent diseases in any animal, the most important thing is to maintain an optimum health through good balanced nutrition and exercise. In Kirk’s Current Veterinary Therapy Vol 11 page 205, Drs. Schultz and Phillips question the following: “A practice that was started many years ago and that lacks scientific validity or verification is annual revaccination. Almost without exception there is no immunological requirement for annual revaccination. The practice of annual vaccinations in our opinion should be considered of questionable efficacy”.

I am sure that the last word has not been said yet on vaccinations!

References:
Central Laboratory News July 1999
The Globe and Mail: “Are vets barking up the wrong tree?” March 15 1999
CVMA “ Vaccinations and your pet 1999
“What’s new in thyroid diseases”, Dr. Jean Dodds DVM proceedings American Holistic Veterinary Medical Association, Burlington 1997
Kirk Current Veterinary Therapy Vol 11
Homeopathy and vaccinations Dr. Christine Chambreaux DVM
Colorado State University - Dr. Shultz vaccination recommendations
American Association of Feline practitioners: Vaccination recommendations
Veterinary immunology. Ian Tizard.
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Veterinary Acupuncture
By Marlene Smith-Schalkwijk DVM

Introduction
Acupuncture is one part of the oriental healing art, Traditional Chinese Medicine (T.C.M.). This medical concept precedes Western Medicine by 4000 + years. It was developed at a time prior to the availability of such diagnostic techniques as laboratory blood test, radiographs, ultra sound, CAT scans and even exploratory surgery (unsafe and unavailable anesthesia). The healers/ doctors/ shaman/ and medicine men/women had only eyes for observation, ears to listen, fingers to palpate, nose for odours and meditation to access his/ her spiritual guide.

The 5 Elements of Nature
In Chinese medicine the body was seen as a reflection of what we can observe in nature on a daily base. The observation of the basic building blocks of creation led to the 5-element theory of causes of diseases. In this the Chinese observed the Fire (or Sun), the Earth, the Metals (in the Earth), the Water and Wood element. They observed that these elements create each other like Fire creates ashes (or Earth) the Earth creates Metal. Water feeds Wood and Wood feeds Fire. These elements also control each other. As Earth is used to build dams to control Water and Metal axes control Wood and Wood (vegetation) is used to keep the Earth down and under control. Fire will melt Metal and Water controls Fire. The Chinese used these concepts in their medical treatments and diagnosis.

Yin and Yang
The ancient Chinese also observed the phenomena of winter, with its cold, slow movements, and white colours. On the other side of the scale was the summer with the heat, fast movements and activity, colours, and odours. They gave these phenomena of opposing factors the names of Yin and Yang. They saw that the same thing was expressed in the body. Health was seen as a good balance between Yin and Yang. An imbalance is expressed as a disease. For example the nighttime with its darkness, cool, calm and quietness is seen as the Yin time. If there is insufficient Yin in the body, the animal will be restless at night, hot (panting) want a cold drink or have dream disturbed sleep.

Pattern of Disharmony
The Chinese doctor will try and find this pattern of imbalance between Yin and Yang.
He/ she will look for excess (or lack) of heat or cold, if the disease is on the surface (as an acute cold) or if it has penetrated deeper into the body (Irritable Bowel Disease).
The doctor will LOOK at the patients tongue for differences in colour and coating, look at the skin and coat (dry, discoloured hair) and the expression in the eyes. He / she will listen to the tone and strength of the voice and listen to the (long) history. He / she will palpate the pulse, back and abdomen for signs of pain or tension or flaccidly. From all of that he will look for a pattern that will help him / her to understand where the imbalance is.

The Organs
The function of the organs was well documented in TCM. They had a more extended function then in Western Medicine. In the 5 Element theory, the Heart is placed under the Fire element, the Stomach and Spleen/ pancreas belong to the Earth element, the Lung / Large Intestine to the Metal, the Kidney / Bladder to the Water element and the Liver / Gallbladder to the Wood element. The emotional expressions were also related to the organs. The Kidney in the Water element was related to fear, while joy belonged to the Heart and Fire.

The Seasons
In their observations the Chinese noticed that certain diseases have a tendency to occur at certain times of the year. Hot skin rashes during the summer, colds, flu’s and bladder problems during the winter, arthritis during the cold and damp days, and allergies in the spring and fall. In TCM, arthritis that gets worse during cold and damp weather is seen as “cold and dampness trapped in the joints”. Treatment would be to use warming herbs and / or Moxa burning to warm up the joints.

Qi
There was also the observation of the daily rising and sinking of the sun and the return of the seasons. A life tree or animal looks very different from a dead one and that is not just the lack of movement in the animal’s case. The Chinese deducted that there was a certain energy that kept things moving. They referred to it as Qi. Other philosophies call it Prana or Life force. This Qi also runs through our bodies and visits each organ at a certain time of the day. It can be low or high just like the tides of the sea. If an organ is out of balance at the time the Qi is maximum present, symptoms will occur typical at that time. For example women in menopause or who are pre-menstrual can have problems with their Liver Qi flow and Liver Yin. When these are deficient the person will wake up in the middle of the night with heat, tachycardia, insomnia and other symptoms related to other organ involvement. The Qi is at a maximum in the Liver between 1 and 3 am.

Channels / Meridians
The Qi follows certain pathways in the English language called channels or meridians. These are not any physical structures such as blood vessels. The gravitational attraction of the moon on the tides does not go through a physical structure either.

The Chinese also discovered that there were predictable places on the surface of the body where they could influence these pathways and thus the energy of an organ. They gave them names that refer to their location as Hegu (adjoining valleys) or Zu San Li (Leg three miles). The last point was found to be beneficial in long distance runners. Needling that point would give them the extra energy to run another mile! 

By needling specific points the ancient doctors found that they could influence the movement of Qi. They could smooth it out if it was uneven or redirect it if it was reversing (or rebellious) as in vomiting.

Acupuncture Points
The word acupuncture comes from the Latin words "acu”, which means needle and "pungare", meaning piercing. The Chinese mapped the points through which the Qi could be manipulated and documented them very accurately. Modern research has confirmed that these points coincide with a lower electric resistance on the skin using a modified Ohm meter (or point finder). The Western world named the channels after the organs they relate to as Bladder or Stomach channel. The acupuncture points on these channels are given a number as Large Intestine 4 (= Hegu) or Stomach 36 (= Zu San Li). Modern research also found that needling Zu San Li or Stomach 36 would influence the motility of the stomach and increase the release of insulin, thus making more energy available for that athlete to run those extra three miles!

Chinese Medicine in Use
After the doctor has found the pattern of disharmony, he / she will prescribe a treatment plan. This often includes exercise such as Qi Gong, Tai Chi or plain walking in fresh air. This will move the Qi (stagnation of Qi is the cause of many illnesses), and will also add fresh (air) Qi to the system. Exercising in a gym or other enclosure with stale air is not as effective). Massage and herbal formulas (herbs were seen as culinary spices and food) as well as dietary adjustments were also often prescribed.

Needles were then placed in the appropriate points to influence the Qi and stimulate the body back into harmony. Treatments were often daily for many weeks or months. In our busy society when payments are made on every visit (in China the doctor was paid when the person stayed healthy and no payments were made for treatments) this is less accepted. Chinese practitioners rely more on herbs these days.

Acupuncture in human and animal patients is used over the entire world. The Cuba Veterinary School has invited American veterinarians who practice acupuncture to come to Cuba to teach their veterinarians veterinary acupuncture. Lack of drugs makes them rely more on acupuncture. Instead of needles, pressure can also be applied to the acupuncture points. The advantage of this technique is that the animal owner can learn some of the specific points and treat their own animals on a daily base. In our practice we teach our animal guardians which points to use for specific conditions. This technique is particularly useful in the geriatric patient.

Acupuncture in Action
Over the back, parallel to the spine, runs one of the most important acupuncture channels, called the Bladder channel. Points on this channel often overly the organs. These points are also close to the spine, making it a short distance for the neuro transmission to travel from the acupuncture point to the spine and via the spinal cord to the brain, where it will release endorphins. These points are referred to as the “Back Shu” points. Shu means “gathering of energy”. These points are easily accessible and very powerful!

Western research has found that acupuncture points are located in areas with a high concentration of fine nerve endings. Stimulation of these areas gives a chain reaction via the spinal cord to the brain. Neuro-peptides (endorphines) are released which will sit on specific neuro receptors in the brain. This will then result in the release of insulin in the case of Zu San Li (ST 36) or Pi Shu (BL 20) or San Yin Jiao (SP6).

It is beyond the scope of this paper to go into detail which points are used for specific conditions. I refer to specific books in this field as “ Four Paws, Five Directions” by Dr. Cheryl Schwartz or Veterinary Acupuncture courses in Canada and the USA for further education for licensed veterinarians.

Which diseases can be treated with acupuncture?
Acupuncture is being used all over the world to treat pain. It is very effective in acute and chronic back pain included disc disease. Hip and elbow displacia and other forms of arthritis also respond well. Endocrine disorders such as diabetes is also treated in China with acupuncture. Immune problems such as allergies, asthma, irritable bowel disease, lupus, immune mediated arthritis, and myositis all respond to acupuncture. Gastro intestinal problems such as chronic or acute vomiting or diarrhea are also relieved by acupuncture. Geriatric patients with heart, liver or kidney failure respond exceptionally well to acupuncture diet and herbs. 
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What is Holistic Veterinary Medicine?
By Marlene Smith-Schalkwijk DVM

There are many opinions of this word, some of them translating it with the word "whole", meaning that it treats the whole animal instead of only parts of it. For me, it embraces a philosophy of healing that utilizes as many healing disciplines as the practitioner can call upon to aid in the healing of the patient. It is like being in a large show room with many different booths, each of which represents a form of healing practiced over the whole world at different times. So we will see a booth of Western medicine, one for Traditional Chinese Medicine, one for homeopathy, Reiki, nutritional healing, Healing Touch, Chiropractor, Massage, Physiotherapy etc. The forms of healing different to Western Medicine are often referred to as " alternative medicine"; a more appropriate word would be "complimentary medicine". The job of the doctor is to decide which form or approach of medicine is appropriate for this particular patient and this particular disease. The following will shed some light on these complimentary modalities.

Article written by Dr. Marlene Smith for Dogs of Canada Magazine 1996
What is Holistic Veterinary Medicine?
Traditional Chinese Medicine and Acupuncture
T.C.M. has been used for over 4000 years and is based on the observation of the natural occurrences. Environmental occurrences as cold, heat, dryness, dampness, and wind are also reflected in the body. Creation is based on opposing expressions as dark and light, hot and cold, day and night etc. The TCM expresses this as Yin and Yang. A T.C.M practitioner will base the diagnosis on a pattern of disharmonies in the Yin and Yang, an excess or deficiency of heat or cold, dry or moist etc. The spiritual and emotional components are important parts of the diagnostics. For example: an outburst of anger or irritability might be seen as "liver Qi stagnation" as the liver is the organ that carries the emotion of anger. This is an important finding if the animal has become more irritable in the course of the disease.
The information needed to form a diagnosis is obtained through a careful and lengthy interview, observation, palpation, tongue and pulse diagnosis. Acupuncture is based on the philosophy that organ functions can be influenced through points on the body surface with a (measurable) lower electrical resistance. Insertion of a needle in one of these points will send a message to the brain via the nervous system, blood vessels, muscles and interstitial fluids to release endorphins. Some endorphins will act as a naturally produced morphine, creating a feeling of well being (hence its use in addiction programs) and also reducing pain. Others will block the release of histamines and have an anti- inflammatory effect. Also hormones and enzymes etc can be released and blood flow can be increased. The TCM practitioner will use herbal formulations (based on traditional recipes) acupuncture, dietary and exercise advise in the treatment protocol. The use of TCM is wide spread from pain and inflammation control in chronic arthritis to treatment of paralysis and acute vertebral disc diseases. Immune dysfunction diseases such as allergies, asthma, lupus, and other immune mediated diseases, and dogs with protractive urinary incontinence also respond well to this form of medicine.
As an addition to western medicine TCM extends healing opportunities for the patient, especially in cases where Western Medicine has no answers or treatment side effects are unacceptable to the pet owner. It can be used in conjunction with other modalities of healing.
Raven is a 6-year-old female terrier cross. One year after having been spayed she lost control over her bladder and leaked urine during the night. Hormonal treatment helped for a while but had to be increased to a level that she started to show signs of heat. Her owners were desperate and decided to try acupuncture as a last resort. After a one-hour consultation and examination the doctor diagnosed a kidney yang deficiency. Raven was treated four times, one week apart and additional Chinese herbs were given. She was taken of the hormones. Her bladder control improved slowly but steadily and her energy and happiness were most remarkable. Now 1 year later she needs the occasional treatment and herbs and she stays dry all night and day!
Herbal Medicine
This traditional form of medicine has been practiced since human memory by every group of humans over the entire world. Its knowledge and information is based on traditional folk knowledge of herbs and other plant or tree material used to cure diseases. In the Middle Ages women who were the gatherers of food and plants practiced it predominantly. Their knowledge, often passed on by oral tradition, was nearly wiped out by the witch-hunt. Many western medicines such as penicillin, valium (valerian) digitalis (foxglove) and many flea products (chrysanthemum flower) are derived from plants or fungi. Herbs are used in Chinese medicine and in the Western world. There are many household remedies available for animals. Immune enhancers such as Echinacea and astragalus are very useful in the beginning of diseases especially of the upper respirator tract. Golden Seal, Calendula, Hypericum and Comfrey are useful for topical applications on cuts and skin infections. I have found all animals responding well to herbal treatment. They can be combined with acupuncture, western (allopathic) medicines and homeopathy. Chronic infections, heart diseases, immune diseases, cancer, allergies etc. are all conditions that can be treated successfully with herbs. Demodex mange for example responds better to the western treatment with the addition of herbal immune stimulators as Astragalus combinations.
Veterinary Homeopathy
Developed at the same time as western medicine by Dr. Samuel Hahnemann in 1790, veterinary homeopathy uses the law of simile. It is based on the observation that a diluted form of a toxic substance can cure the symptoms created by that same substance. For example: Nux Vomica will induce vomiting when eaten whole. These symptoms can be cured by strongly diluted extracts of the same plant. It also will have a curative effect on other forms of vomiting.

Homeopathy works well in acute and chronic diseases or where the patient cannot tolerate western or herbal medicine. Every disease from acute trauma and infections to arthritis, heart, liver and kidney failure, immune diseases and cancer can have benefit from homeopathy. I have found homeopathy to be particular useful in immune mediated diseases and epileptic seizures. 
Physiotherapy and Massage
These two forms of healing have proven to be very effective and useful in the human field. Our animals will benefit equally. Any animal with muscle or joint trauma or injury will experience pain as a result of incorrect weight bearing or shortening of muscles. Animals suffering from problems related to spinal disc problems and crusiate ligament repairs would greatly benefit from massage and physiotherapy. This is certainly a field that needs further development in veterinary medicine. 
Chiropractor for Animals
Even though most of us are familiar with and may have used the services of a chiropractor, not many people seem to realize that the same applies to animals. Indicators for a visit to the chiropractor are not only lameness and back pain, but some organ disharmonies might also respond to this treatment. A veterinary chiropractor successfully treated her own dog for urinary incontinence. Veterinary chiropractor courses are now available for veterinarians and hopefully this service will soon be available for most pet owners.
Reiki
This is an ancient form of healing which has recently been rediscovered. The translation of this Japanese word means Universal Life Energy. It is based on the understanding that all beings are surrounded, influenced by and also create their own specific life energy. Imbalances in these energies can create diseases or prevent a patient from getting well again. Stress and emotional trauma are typical examples of this. In my practice I treat a lot of animals with immune mediated diseases and cancer and I have been surprised to find that in many of these cases the owner or a close relative suffers from the same disease! This indicates to me a sharing of energy fields. Reiki works with these energy fields, utilizing the Chakras. The well-trained and balanced Reiki practitioner can feel the imbalance in the energy of the patient and can help to correct this. I have found that animals respond well to this treatment and recommend that the animal’s caretaker have a treatment at the same time. The Reiki practitioner who works on animals should have an understanding of animal anatomy, physiology and diseases, and also have Reiki training.
Nutritional Therapy (Nutraceutical Medicine)
The term nutritional therapy is used when the healer tries to influence the course of the disease through improvement of the digestive system. This happens not only through the diet, but also trough additions of vitamins, minerals, enzymes and amino acids. The liver plays an important role in the detoxification process. Toxins can come from the food, environment, hormones, or from the metabolic processes. Few people are aware that the liver has three phases of detoxification. When one of those phases is impaired, toxic products build up, are stored in the fat and eventually spill over in the bloodstream. This can result in dermatitis, colitis and liver, kidney and heart diseases.
The food we feed our animals plays a large role in their well-being. It is also true that an animal’s stomach was never designed to eat dry kibbles only! Over the last twenty years we have all been told that the only thing your dog and cat need is a bowl of dried food and water. Veterinarians and animal owners battle an ever-increasing amount of chronic skin problems related to allergies. Also degenerative diseases and immune diseases are on the increase. Cortisone and antibiotics are mostly used to control the disease, sometimes with disappointing results. Looking at these diseases from a holistic point of view, a part of these problems could well be caused by the liver's inability to detoxify. Home cooking an individual and specifically designed diet supplemented with enzymes, vitamins, amino acids and herbs to aid the liver in the detoxification process can give amazing results. Diseases such as hyperactivity, seizures, allergies, chronic ear infections, smelly skins, re-occurring hotspots etc. have responded to nutritional therapy. Clinical nutrition is a field that is been now also developed for animals. A good knowledge of animal nutritional requirements and liver detoxification processes in animals is vitally important to home cooking and supplementing your pet’s diet.
Ear Candling
We see a rising popularity of ear candling in humans. A paraffin-covered tube is applied to the opening of the ear and lit at the far end. A vacuum is created and this will (if done correctly) create a negative pressure in the ear canal. The heat softens up the wax and the difference in pressure "sucks" the wax out of the ear canal and into the candle. The technique is used in people to remove earwax and also to aid into clearing the sinuses in chronic sinus infections (as in hay fever). I can see the same application in animals. One caution, do not use in case of ear infections. The ear canal can be re-irritated in animals with chronic wax built up and where applications of oils or cleaning fluids and Q-tips are used. More research in this field is definitely needed.
For more information on veterinary acupuncture contact:
I.V.A.S Box 2074 Nederland, Co, 80466 USA. 303-258-3767.

For veterinary homeopathy and other approaches:
AHVMA 2214 Old Emmorton Road Bel Air, Maryland 21015 USA 410-569-0795
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Cancer Research & Survey
By Marlene Smith-Schalkwijk DVM

Cancer is now the leading cause of death in our dog population. Have you had a beloved pet that died of cancer or do you know someone who has? Constant speculations are made of what causes cancer. With the help of the Kali's Wish Fund, Veterinarian Marlene Smith has started a research project to try and determine the possible causes of cancer in dogs.

Dr. Smith would like to invite animal owners to assist in this research by participating in a survey. It is her hope that the observations of animal owners who have experienced having a pet suffering from cancer, will help to identify an emerging pattern. Dr. Smith wishes to express her thanks to the Kali's Wish Foundation for making the start of this project possible and to any and everyone willing to help. You can support this research project by making a donation to the Kali's wish Cancer Foundation (www.kali'swishcancerfoundation.com) and/or by filling out the questionnaire.

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Marshmallow Fund

Who was Marshmallow . . . and why was the Marshmallow Fund started? Marshmallow came from a pet shop. She was a longhaired Manx with an outstanding personality. Manx cats are deliberately bred to have no tail. In Marshmallow's case not only was the tail vertebrae missing, but also the vertebrae of her sacrum and the last 1 ½ lumbar vertebrae were missing. As a result the nerves to her bowel and bladder did not function well. This led to chronic constipation and eventually a paralyzed bladder.

Her human caretaker, Nana Tess brought her from northern BC all the way to the Tree of Life for treatments. Enema's, herbs and acupuncture helped her for a while and she had a happy summer on the Hobbins farm. In the fall her bowels and bladder could hardly function and Marshmallow was tired of the enemas. So she asked to be released from her body.

Her short time on this earth touched everyone who got to know her. Her foster mom, Carol, made a donation for a clinic book in her name. Marshi had a better idea and we have now set up a memorial fund in her name to help animals that need holistic treatment, but whose people don't have the financial funds to give them the treatment.

To honor this brave cat, we have opened a special fund raising account to help other animals in need of our specialist care. If you wish to contribute, please make your donation payable to the Marshmallow fund. Cash or other forms of donation are welcome and should be specifically made out to the Marshmallow Fund. We will keep you informed on how the fund will be used.
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Qi And Quantum Physics; Old Meets New Or East Meets West

By Dr. Marlene Smith-Schalkwijk, DVM

What is Qi?
The purpose of this paper is to help to bring some understanding of the phenomena of Qi and energy from the “new” science of quantum physics. One of the many stumbling blocks we as western trained doctors and scientists have is that our understanding and knowledge is based in the particle principle. This philosophy goes back to the 1700’s, when the scientific view of the world was based on the concept of Newton. His perspective of the world was that everything consists out of particles only. It puts the physical body on the same level as a car or any other mechanic device.

The metaphysical and emotional aspects of disease were not a part of the medical science. They were separated and moved to the church, psychiatrist or the burn piles. Our understanding and teaching of anatomy, physiology, and pharmacology is still based on this principle. Anything else is seen as unscientific, witchcraft, voodoo, evidence based medicine etc. Modern research done by outstanding scientists such as Candace Pert (Molecules of Emotions), Bruce Lipton (Biology of Belief), Fritjof Capra and many others bring back the notion and proof of the presence or “energy”.

In 1925 Albert Einstein concluded that particles consist out of energy. He came to that conclusion by trying to predict in a mathematical way the behavior of particles. It turned out that he could not always the behavior of these particles. He came to the conclusion that there was another (magnetic) force at work that influenced the particles. He was the creator of the now well-known formula of E=m.c2!

E stands for energy; m for mass and the c represents the speed of light. We all accept Einstein’s concept in our daily lives; our cell-phone and satellite communications, radio and TV, Ultrasound, X-ray and MRI are all based on Einstein’s concept! Science has accepted that the quantum theory applies to sub-atomic and regular particles.

If we now apply Einstein’s Quantum theory to biology and medicine we get Quantum Medicine, which says that the physical body and all its parts consist of energy and that these parts can be subject to changes if their energy or the surrounding energy changes! These particles of the body can transform themselves into pure energy, which is no longer visible to the eye! This sounds a lot like what the Chinese were saying when they talked about Qi and its transformation! It is certainly what Niels Bohr thought it was when he tried to understand Einstein’s Quantum philosophy. He (Niels) even put the Taiji symbol in his coat of arms! His explanation of the transformation of energy (Yang) transforming into particles (Yin) was inspired by the Chinese philosophy of the Yin / Yang transformation and that it is the energy generated by that transformation that is called Qi and makes existence on this planet possible (A Brief History of Qi, Zhang Yu Huan & Ken Rose). Lynn McTaggart in her book “The Field” refers to the application of quantum physics to explain how homeopathy works in reference to the energetics of homeopathic remedies and their dilutions.

Qi and quantum physics have in common that they both talk about the non- physical energies of material things. What are the Chinese (Qi) and Einstein (Quantum physics) talking about? Are they talking about the same thing? Qi is the word used for energy in Traditional Chinese philosophy and medicine. In India it is referred to as Prana, in homeopathy it is called Life Force. In the old Chinese textbooks, the NanJing (approximately 3000 years ago) it is recorded that everything we know is a form of “Qi”. This Qi constantly changes, moves and transforms itself. From its pure vibrational energetic form (not visible to us) it transforms itself through condensation into the material form; being an animal, tree or plant. These forms of energy are referred to as Yang the energetic, expanding form of energy and Yin, the material, condensed form of Qi. Every material particle or part of it will still have its own very unique energy or Heavenly Qi. This also applies to the physical body, its organs, blood etc. The Qi or energy of these parts or bodies will resonate with each other and the environment.

These are the energetic resonance talked about in TCM as the Wood Element (Liver and Gallbladder) resonates with the wood, spring, color of green, the emotion of anger, resentment and frustration and the element of the wind. The research of Candace Pert shows the relationship between emotions and the release of specific neuro-peptides in the body (not just the brain). These neuro-peptides are picked up by specific cell receptors changing the function of the cell. The philosophy of acupuncture is based on the release of neuro-peptides and endorphin receptors. Candace Pert found that these neuro-peptides are released at every cell and that the intestine has more endorphin receptors then any other organ in the body! Her work lays a link between the 5 Element emotional component and predisposition for diseases.

The work of Bruce Lipton lays the link of internal and external (environmental) signals fitting on these cell receptors, which enables them to enter the cell and turn on certain processes in the cell. These processes may range from the production of insulin when the blood sugar level drops, to adrenaline hormones released with the emotion of fear. External signals could be as simple as someone observing or staring at another person; if there is a negative bad intent the adrenal can respond with releasing stress or fear hormones. Distance does not play any role in quantum physics and this can explain such phenomena as telepathic knowing or perception. Environmental changes such as the change of barometric pressure are also picked up by the body; maybe via the hypothalamus, and can release neuro-peptides in the body increasing inflammatory responses such as flair up of immune mediated arthritis or IBD. This would correlate to the phenomena of Wind in TCM, increasing low level of Qi stagnation and creating more Qi stagnation and pain.

Darwin and Jean Baptist Lamarck
Most of our evolutionary theory is based on the understanding of Charles Darwin. His theory favors the survival of the fittest. Also the DNA supremacy is the basis of our thinking. These two theories may not be 100 % accurate just as Einstein proved that the world is not 100% based on particles.

Lamarck postulated that evolution occurred through cooperation of cell communities. According to his theory single cells came together and formed a small colony. To be able to perceive what was happening in the periphery, cells specialized and set up a communication system (brain, nervous system, blood circulation etc.). These cells still needed to communicate with each other, through neuro-peptides and cell synapses (Lipton). These cell synapses are also used to communicate with the outside world so the cell community can respond to changes in the environment. Lamarck’s theory is that survival is not based on the strongest individual of the group, but the organism most equipped and best responding to the changes in the environment will survive.
These new forms of science and on the “edge scientists” most certainly provide interesting food for thought and may help to prove the how and why TCM functions from a "Western scientific" perspective.

References:

1. A Brief History of Qi;  Zhang Yu Huan and Ken Rose Paradigm publications
2. The Web of Life; Fritjof Capra Anchor Books
3. The Biology of Belief ; Bruce Lipton Mountain of Love/Elite Books, Santa Rosa Ca.
4. Molecules of Emotions; Candace B. Pert, Ph.D. Scribner New York, 2003
5. The Quantum Self; Danah Zohar William Morrow New York
6. The Dancing Wu Li Masters; Gary Zukav Bantam New Age Books
7. The Field; Lynne McTaggart Harper Collins Publisher

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Treatment Of A Liver Shunt With Acupuncture
By Heather Matheson DVM; Tree of Life Veterinary Care
Courtenay, BC

Treatment of a PDA and liver shunt with acupuncture and botanical medicine

Abstract:
A thirteen week old Akita, Border Collie cross with vascular abnormalities, including a patient ductus arteriosus (PDA), an arterio-venous fistula within the liver and an intrahepatic portal shunt, presented with a history of hepatic encephalopathy. Treatment included acupuncture, herbal and one homeopathic remedy and extended over a four-month period. In this time the patient’s quality of life improved as witnessed by an increased appetite, improvement in mentation, weight gain and partial resolution of the PDA. In Western terms a diagnosis of hepatic encephalopathy secondary to portosystemic shunts described this patient’s condition whereas a diagnosis of Kidney Jing Deficiency was considered its Eastern diagnosis.

History:
Sadie, a thirteen-week-old female Akita, border collie pup weighing 9.6lbs (4.3Kg) was presented for acupuncture consultation. Sadie presented with a three-week history of restless episodes. The episodes began at approximately 7:00 PM and would last anywhere from three hours to all night. Typically Sadie would become very anxious, begin circling, appear blind with vacant eyes, pant, drool, scramble to get away from the owner or any restraint, and appear not to know the owner. The first episode occurred 24 hours after the initial distemper vaccination was given at a local veterinary clinic. There were no other past medical problems noted in the history.

Clinical Signs and Diagnostics
The owners obtained Sadie at seven weeks of age. Although ravenous, she remained thin, smaller and slower growing than her litter mates. She had a preference for cooler areas; drank large amounts of water; would lick everything (walls, floors, chairs etc); showed coprophagy and frequently got the hiccups after eating. Episodes or restlessness in the evening and night began at 10 weeks of age, 24 hours after the initial distemper vaccination was given.

A diagnosis of multiple congenital vascular abnormalities and secondary hepatic encephalopathy was made at another veterinary clinic. This diagnosis was based on the history, clinical signs and abdominal and thoracic ultrasound which showed multiple congenital abnormalities including, an arterio-venous fistula within the liver (originating from the celiac artery) and abnormal intrahepatic portal vessels with entrance into the caudal vena cava, typical of an intrahepic portal shunt. The abdominal vascular abnormalities were not considered surgically correctable and the owner sought an alternative approach. On clinical presentation this pup appeared extremely thin with a grade V1/V1 holosystolic (washing machine) murmur. Mentation, heart rate and temperature were all within normal ranges. 

On physical assessment Sadie was very thin, with a good hair coat. She had a “flirtatious” personality, trying to elicit attention and play but hiding under the chair or jumping away with any attempt to touch her. Eyes appeared clear but she had a “sleepy” look. A grade V1/V1 holosystolic murmur was both audible and palpable, lungs were audibly clear, heart rate was 160 bpm, and temperature was 38.3 degrees Celsius. Tongue was pale pink in the center with a red tip and red edges, no appreciable coating. Pulse was irregular in strength with a slight quiver.

Conventional Treatment:
Conventional treatment included a diet change to a commercial low protein diet, oral lactulose given twice daily, to effect, and the recommendation of humane euthanasia if hepatic encephalopathy was not controlled.

TCM Treatment:
According to the Traditional Chinese Medical philosophy the kidneys store the Jing or Essence. It is believed that this Essence is inherited from the parents and determines the development, growth and health of the individual. In the Western Medical philosophy one would probably call this the DNA or gene package. In the Traditional Chinese philosophy a deficiency of this Kidney Essence will result in a deficiency of the development and function of the organs such as the liver, heart, digestive network and ultimately the lungs. Seeing a problem in the liver and heart was not surprising and subsequently was not of great concern for the formulation of an approach to treat this patient from a Traditional Chinese Veterinary Medical perspective. It was seen that the underlying problem was the Kidney with secondary problems in the liver and heart.

The treatment principle according to TCM (traditional Chinese Medicine) was to nourish the Kidney Essence and to nourish the Heart Qi, Spleen Qi, and Liver Qi, nourish the Blood and promote the smooth flow of Qi through the three Jiaos. Optimed needles, 0.22 X 13mm, were placed at a depth of approximately 5mm; an even dry needle technique was utilized for all acupuncture sessions. The initial exam and treatment took place on August 27, 2003 with a total of seven acupuncture sessions extending over a four-month period. Dry needle technique consists of placing the needles in the appropriate acupuncture points without any electric stimulation and needles were left in place for approximately 15 minutes.

This being a weak and very young animal, attempts were made to use the minimum amount of needles. Points chosen were those having the greatest influence on the organs. For the record, the following points were used:
LIV 13 (Zhan Men, gate of symbol)
- Located on the lateral side of the abdomen, below the free end of the 12th rib (2). It promotes the smooth flow of Liver-Qi and benefits the digestive network (Spleen and Stomach) (5).
PC 6 (Nie Guan, inner pass)
Located just above the transverse crease of the carpus, between the tendons of the flexor digitorum superficialis and flexor carpi radialis (2). Used in cardiac disorders, regulates Heart Qi, decreases anxiety and calms the Shen (3).

SP 6 (San Yin Jiao, meeting of the three Yin)
Located just above the tip of the medial malleolus, on the caudal border of the tibia, on the line drawn from the medial malleolus to SP 9(2). Benefits Kidney function, Liver function and Spleen (Digestive) function (3).
CV 12 (Zhong Wan, middle stomach)
Located halfway between the umbilicus and the ziphoid process, on the midline (2).
Benefits the Spleen (digestive) (7).

Additional Treatment: 
The commercial low protein diet was continued and lactulose was maintained to effect. Vitamin E (400IU daily), milk thistle (10mg/kg twice daily), Coenzyme Q10 (30mg daily) and Gingko (0.5ml twice daily) were also started at the time of the initial examination. Homeopathically, treatment consisted of Silica 200CH (1 pellet twice a day for 3 days).
Sadie was reassessed 1-week post treatment. The owners reported no recurrence of anxiety episodes related to hepatic encephalopathy, an increase in activity and energy level and a weight gain of 4 lbs (1.8Kg) in a week. The above acupuncture treatment was repeated with the addition points.
BL 22 (San Jiao Shu, Triple Heater association point)
Located lateral to the caudal border of the spinous process of the 1st lumbar vertebra (2).
HT 7 (Shen Men, spirit gate)
Located on the transverse crease of the carpal joint, in the depression lateral to the tendon of the medial flexor carpi ulnaris (2). Calms the mind and nourishes Heart (8).
All oral medications were maintained as previously described with the addition of Astra Essence 1/4 tablet twice daily (Health Concerns) to nourish Kidney Essence.

September 10, 2003 and September 24, 2003 the acupuncture was repeated (LIV 13, SP6, PC6, CV12, HT7, BL22). Owners reported that Sadie was playing and thriving! Her weight continued to increase at a rate of 3 to 4 lbs per week; there was a decreased frequency of hiccups and no episodes of anxiety. The heart murmur improved from a grade V1 to grade three and the pulse was regular and strong. Oral medications were maintained but the dosage was increased slightly to accommodate the weight gain. Acupuncture sessions were changed from weekly to bimonthly at this point.

September 26, 2003, routine CBC, chemistry screen and bile acids revealed a non-regenerative anemia, low total protein, low urea and greatly increased bile acids (table1 & table 2).
Bimonthly acupuncture sessions continued for three additional treatments. Sadie continued to thrive and gain weight, and her heart murmur improved to a grade one. On December 22, 2003 the ultrasound was repeated. The PDA had reduced in size considerably and the liver showed no degeneration.
When Sadie went through her first heat cycle she developed ascitis. It was treated with abdominal centhesis and acupuncture. After her heat, the ascitis did not re-occur even in her subsequent cycles.Sadie continued to grow and develop and had a few set backs as she contracted fleas and lost most of her hair. Sadie recently had her third birthday and is a happy and thriving dog. Her heart murmur is no longer audible, but her liver enzymes continue to stay high; she subsequently developed ammonia crystalluria.

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