Why Is My Dog Scared of Everything?

Reviewed for accuracy by Dr. Katie Grzyb, DVM
By: Victoria Schade


If your dog is scared of literally EVERYTHING, then you understand that life with a fearful dog can be limiting.
Instead of greeting the world with a confident walk and a wagging tail, a fearful dog might shy away from anything new, or worse yet, react preemptively to avoid a new situation altogether.
It’s not easy for a pet parent to admit that their dog is scared of everything because trying to work through those fears can be overwhelming.
Fearfulness does have a place in the wild; it increases an animal’s chance of survival by keeping them away from danger. But when your dog is acting strange and scared in everyday life, it’s stressful for both ends of the leash and can even have long-term health implications.
Let’s take a look at why certain dogs are scared of everything, how to recognize fearful behaviors, which situations trigger fear, and how you can help your dog deal with their fear.
What Makes a Dog Scared of Everything?
Dogs that seem scared of everything can be products of nature and nurture. A dog’s genetic makeup, early experiences, environment and daily life can all have an impact on their temperament.
Lack of Socialization
A common reason for fear in dogs is a lack of positive exposure to new people, animals and environments during the critical fear period of the puppy socialization process.
This important developmental stage in a puppy’s life occurs between 8 and 16 weeks of age, when pups need to have a variety of pleasant interactions with the world around them.
Puppies that don’t have positive exposure to the world around them might be more likely to be wary of anything new or unusual. This can lead them to be scared of things we wouldn’t associate with fear, like people wearing large hats or having a stroller/skateboard/skater go past you.
Genetic Predispositions
However, some nervous dogs might also have a genetic predisposition to fearfulness or shyness. Puppies born to anxious mothers are more likely to be fearful as well.
Traumatic Experiences
For some dogs, all it takes is a single traumatic experience to create lifelong fear responses. For example, a dog that’s caught off guard by firecrackers during a walk might then generalize that fear response to any loud noise—like a car door slamming—and might also develop a fear of walking anywhere near where it happened.
Pain
It’s important to note that some behaviors that look like fear might be related to pain. Dogs that seem “hand shy” and nervous about being touched might actually be dealing with an undiagnosed medical issue.
Your veterinarian can help you determine whether your dog is experiencing pain or suffering from fear-based issues.

Recognizing Fear in Dogs
The first step to helping a dog that’s scared of everything is understanding their body language.
Some fear displays are hard to miss—like a trembling, hunched-over dog that has their ears back and tail tucked. But learning to recognize subtler fear reactions will allow you to intervene before your dog’s fear escalates.
Some of the telltale signs of fear in dogs include:
• Trembling or shivering
• Hunched body with head down
• Ears back
• Tail tucked
• Hair standing up on the neck and back
• Growling
• Showing teeth
A dog that’s afraid might also show these more subtle signs:
• Freezing in place
• Moving in slow-motion
• Repeatedly licking their lips
• Yawning frequently
• Trying to move away from the stressor
• Panting heavily or suddenly stops panting
Keep in mind that some behaviors that look like aggression, like leash reactivity and barking, can also be signs of an underlying fear of something.
Common Things That Dogs Are Scared Of and How You Can Help
Many dog fears are universal—it’s rare that a dog actually enjoys a trip to the vet—however, a dog that’s scared of everything might have a difficult time coping with common, everyday noises or encounters.
Loud Noises
It’s almost impossible to avoid having a startle reflex when you hear an unexpected loud noise, but dogs that are scared of everything will react more dramatically to noises.
For example, a typical dog might jump at the sound of a dropped pan, but a fearful dog might run, hide and then refuse to come out.
How to help:
If your dog only reacts to certain types of noises, like sirens or fireworks or thunder, you can use behavioral modification to help your dog learn to tolerate the sound. Use a recording of the sound to gradually desensitize him to the noise by playing it at a low volume and pairing it with treats.
Increase the sound over a series of training sessions, watching your dog’s body language to make sure that he isn’t becoming uncomfortable with the noise. If your dog is trying to cope with ongoing scary sounds like construction noise, use a white noise machine to muffle the sounds.
Children
Kids can be fast, loud and unpredictable, and because of that, they can be challenging for even the most even-tempered dogs.
But dogs with generalized fear reactions will find children even more distressing, particularly because a child doesn’t understand canine body language and will have a hard time recognizing when a fearful dog is trying to get away.
How to help:
If you don’t typically have children in your home, it’s easiest to manage your dog’s behavior by keeping him in a safe, quiet space when small guests visit.
If you discover that your new dog is fearful around your own children, make sure that he has an area where he can spend time away from them. Then you will need to find a positive-reinforcement dog trainer to help you assess the situation and create a training plan that keeps everyone safe.
Other Dogs
Unfortunately, not every dog wants to be friends with his own kind, particularly timid dogs. If a dog hasn’t had the opportunity to meet dog friends and develop canine language skills, he might wind up feeling overwhelmed when faced with other pups.
How to help:
Helping fearful dogs learn to feel more confident around other dogs requires a slow approach and a good understanding of canine body language. You will need to slowly work through dog introductions in order to keep your dog feeling comfortable.
For dogs that are mildly uncomfortable around other dogs, you should find a mellow, dog-savvy dog and try walking them together, at the same pace but with distance between them. When both dogs seem relaxed, gradually begin to bring them closer together, making sure that they remain calm and happy as they get closer.
Keep early introductions short and end sessions before the nervous dog gets overwhelmed. And remember that making friends with one dog doesn’t mean the behavior will generalize to all dogs.
Strangers
Some dogs are uncomfortable around people that look different from their family (for example, large men with beards or people wearing hats and bulky jackets), but dogs that are afraid of anyone outside their family can make going into public or having guests over traumatic.
How to help:
Using desensitization and counter-conditioning can help a stranger-shy dog start to overcome his fears.
To begin, figure out your dog’s “buffer zone”—the area at which he can remain calm when faced with a stranger. Then have the stranger come into view at the edge of that buffer zone and feed your dog a bunch of extra-special treats that he doesn’t normally get.
Continue giving treats while the person is in view for a few seconds, then have the stranger disappear.
Gradually bridge the gap between your dog and the person over a series of training sessions. Always watch your dog’s body language to make sure they remain calm and confident throughout the training process.
Going Outside
Sometimes the world outside your front door is a scary place. Dogs that move to a different environment, like from the suburbs to the city, might find the noise and crowds in their new neighborhood overwhelming.
Similarly, a traumatic experience outside, like having a fight with another dog, can be enough to create an overwhelming fear of going outside.
How to help:
Dogs that are afraid to leave their home can benefit from a training process called “shaping.” Shaping makes it easier for dogs to face their fears by breaking behaviors down into manageable steps and rewarding the dog for making progress toward the finished product.
Pet parents can begin the process by standing near the door with a handful of treats. When your dog makes any movement towards the door, mark the behavior with a clicker or verbal marker like, “good!” then toss a treat to your dog. Continue to build on and reward each step towards the door until your dog is able to cross the threshold.
Be Patient With Your Dog
Keep in mind that a fearful dog should always set the pace for training. Trying to push a nervous dog beyond his comfort zone could derail the training process, so be patient and encourage your fearful pup as he learns to be a more confident dog.
Talk with your veterinarian about pairing training and desensitization efforts with natural, holistic calming supplements or pheromone collars. Sometimes, medication is very helpful to calm some dogs in certain situations if natural options have not worked. Also, working with a veterinary behaviorist may be the best option if all other routes have failed.
By: Victoria Schade

How communication between veterinarians and a canine (and feline) massage therapist (CCMT or CFMT) can ensure a safe treatment plan for your clients.

How communication between veterinarians and a canine (and feline) massage therapist (CCMT or CFMT) can ensure a safe treatment plan for your clients.

As seen in Innovative Veterinarian Care

Massage therapy can be a valuable addition to a clinic’s treatment options. Whether a client or their veterinarian initiate the idea of supportive massage therapy, the benefits for the patient and the potential for successful treatment will increase with good communication on behalf of the veterinarian and certified canine (and feline) massage therapist (CCMT or CFMT).

Appropriate processes when working with a CCMT or CFMT

Vets may come across reasons for their clients to consult a CCMT or CFMT and should keep them in mind for referrals. Veterinarians are all familiar with the need to forward the relevant medical history of a patients’ condition to a referral specialist/practitioner. This communication is just as important when referring a client to a CCMT or CFMT. Ideally, with the clients’ approval, the pertinent medical history and any treatment restrictions should be forwarded to the therapist. This will help reduce potential problems or misunderstandings that could negatively impact the patient or slow achievement of the desired outcome.

A CCMT or CFMT will likely become aware of some contraindications through their interview and intake history notes, however clients may not remember or think to disclose particular conditions. Getting permission from the client to contact the animals’ veterinarian can be crucial for a successful outcome in some cases.

 

Contraindications and caveats

There are a number of contraindications and caveats that a veterinarian should inform a massage therapist about before starting treatment. If a CCMT or CFMT does not know these contraindications beforehand, it can pose risk to the patient and prevent proper treatment. Contraindications and caveats include:

Acute pain and/or inflammation – Injury resulting in severe pain, heat, and/or inflammation should be examined by a vet first. Massage can only begin after the area of pain, heat, and/or inflammation has been resolved.

Cancer – Light massage, especially acupressure, can be used safely for the palliative process, otherwise massage will increase lymphatic flow, increasing the potential for cancer cell metastasis.

Circulation problems – Massage in the case of edema is safe in short, frequent sessions. As for hematoma, massage could be dangerous, as it may cause small blood clots to break away and migrate to the heart, lungs, or brain.

Dermatological conditions – Mange, hot spots, septic foci, or ringworm can be severely aggravated by massage, so the therapist must be sure the patient is receiving veterinary care, and massage may only be done in non-affected sites.

Infectious or contagious disease – Do not massage in the case of these types of diseases, including Kennel Cough, Distemper, Infectious Enteritis, or any viral or bacterial related illness. The possibility for contamination of equipment, including hands and clothing, is too great, and spreading such an infection is too easy. In the case of fever (when the body temperature exceeds 38.5 C +/- 1 degree), massage may work against the immune system and the body’s ability to regulate temperature, and the infection could also spread deeper into the body.

Post-surgery – Hemorrhaging could result in areas not fully healed, therefore massage may only commence two weeks after surgery, or once the sutures have been removed, and only in areas that are remote from the surgical site. The surgical site will not be massaged for at least another six weeks after this.

Pregnancy – Neck, arm and leg massage is okay, but massage cannot be done over the abdomen or low back where the fetuses could be disturbed and labor triggered prematurely.

These are just some of the potential contraindications, and there are details on more including after meals, diabetes, epilepsy and heart conditions.

Conclusions

Keeping each other in mind and sharing our experiences with our patients as we go along is always helpful, especially as the pet’s healthcare needs change. For the most part, information will be communicated back and forth through the clients and it will be important to encourage them to share certain information between the therapist and veterinarian as is required.

It is crucial to establish good communication right from the start, prior to the animal’s first massage appointment to ensure lines of communication flow smoothly between vet and therapist from that point on throughout the animal’s life.

 

What’s Behind Your Aging Cat’s Quirky Behavior?

By Dr. Karen Becker DVM

Cats, like humans, experience physical and mental changes as they age, which can translate into behavioral changes that range from minor to major. Your once social kitty may spend much of his time sleeping or even avoiding the family, and cats that are typically mellow can react aggressively when you don’t expect it.

While it may sound alarming that your cat may morph into a seemingly different feline once he reaches his golden years, it’s a natural and, typically, gradual process.

It’s important, though, to keep a close eye on your senior kitty to watch out for any changes that could signal an underlying disease or pain. Twice-yearly wellness visits with your veterinarian will help with this, as will being a dutiful owner who takes note of any unusual changes.

How Old Is ‘Old’ for a Cat?

It’s often said that one cat year is equal to seven human years. This isn’t entirely accurate, but it’s true that cats age much faster than humans. Generally, a 1-year-old cat is similar physiologically to a 16-year-old human, while 2-year-old cat is like a 21-year-old human.

“For every year thereafter,” the Cornell University Feline Health Center notes, “each cat year is worth about four human years. Using this formula, a ten-year-old cat is similar age wise to a 53-year-old person, a 12-year-old cat to a 61-year-old person, and a 15-year-old cat to a person of 73.”1 With proper care, many cats live into their late teens and early 20, but around the age of 10, a cat is considered to be a “senior.”

You may notice he’s slowed down a bit from his younger years, and by the time a cat reaches 12 to 14 years, he’s probably moving even slower and may be having some age-related health problems, such as vision and hearing loss or age-related cognitive decline.

At 15 or 16, cats join the geriatric club, where their movements and cognitive function are likely noticeably slower than they once were. These numbers are just estimates, though, as every cat will age at its own individual pace — just like humans.

Behavioral Changes Are Common as Cats Age

Aging is a natural process that’s often accompanied by behavioral changes, which commonly include:2

Less grooming, and less effective grooming, which can lead to fur matting or skin odor Less use of a scratching post, which may lead to overgrown claws
Avoidance of social interaction Wandering
Excessive meowing, especially at night Disorientation
Changes in temperament, such as increased aggression or anxiety Increased napping
Litterbox accidents Acting less responsive or less alert

Some of these changes, such as sleeping more and preferring to spend more time alone, are a normal part of getting older, but other are signs of potential health issues. Even though your cat is a senior, many conditions can be treated or managed, which is why letting your veterinarian know about behavioral changes is so important.

Hiding, loss of appetite or a reluctance to move around can be signs that your cat is in pain, possibly due to arthritis, for instance. Aggression can also be rooted in pain or can result if your cat is feeling increasingly anxious — an outcome sometimes linked to anxiety.

“Cats who are suffering from cognitive decline, and thus experiencing increased anxiety, can show a tendency to react aggressively,” Dr. Ragen T.S. McGowan, a behavior research scientist, told PopSugar.3

Hyperthyroidism can also lead to behavioral changes in cats. Sudden, unexpected bursts of energy in an older cat is a definite sign he or she may have an overactive thyroid. It’s important to make an appointment with your veterinarian as soon as possible in this case.

In older cats, increased meowing can be the result of cognitive dysfunction, which is a form of dementia, especially if it’s accompanied by confusion (staring off into space), eliminating outside the litterbox and loss of interest in interacting with human family members. Increased vocalizing could also be due to stress or confusion.

 

How to Support Your Aging Cat

Aside from bringing your senior cat to your veterinarian twice a year to keep an eye out for age-related health problems, there are simple ways to help your pet age gracefully. You’ll want to respect his wishes for increased alone time and sleep, but at the same time make a point to interact with him daily, via belly rubs, ear scratches, toys or treats — whatever he prefers.

Senior cats can also be easily stressed by changes in their household and routine, so keep to a familiar schedule and avoid making any significant changes that aren’t absolutely necessary. Providing a warm, soft space for your cat to nap is essential, as is regular brushing and nail trims.

Continue feeding a nutritionally balanced, antioxidant-rich, species-appropriate diet that includes omega-3 essential fats such as krill oil, and consider supplements that may benefit your aged kitty, including:

  • SAMe (S-adenosylmethionine), which may help stall mental decline, improve mobility and assist in liver detoxification.
  • Superoxide Dismutase (SOD) is a naturally produced enzyme that is important for the conversion of superoxide radicals into less reactive molecules in the body, but production can diminish with age. SOD is found in unprocessed raw food but is inactivated with heat processing, so if your cat is consuming ultra-processed food (kibble or canned food), supplementing with SOD may be a wise choice.
  • Medium-chain triglycerides (MCTs), found in coconut oil, which can improve brain energy metabolism. I recommend 1/4 teaspoon for every 10 pounds of body weight twice daily for basic MCT support, if your cat will voluntarily eat it.
  • Low dose melatonin, which is not only a sedative with a calming effect but also an antioxidant. This is useful for senior cats that vocalize and wander at night.
  • Glucosamine sulfate with MSM and eggshell membrane, to help maintain healthy tendons, ligaments, joints and cartilage.

Most of all, make sure to spend all the time you can with your long-time friend, and if you notice any behavioral changes, bring them up with your veterinarian. Even small changes can give clues about your pet’s health that shouldn’t be overlooked.

 

6 Tips for Caring for Senior Cats

6 Tips for Caring for Senior Cats

As seen in PetMD and Reviewed for accuracy on November 18, 2019, by Dr. Liz Bales, VMD

With good care—and good luck—our cats can live well into their late teens, and even their twenties. But as cats age, their physical and behavioral needs change.  

While these changes are obvious as your kitten matures into an adult cat, the changes when your cat transitions from an adult to a senior—starting at 11 years old—can be harder to spot. 

Here are the top six ways to care for aging cats.

1. Pay Extra Attention to Your Senior Cat’s Diet

Senior cats have unique dietary and behavioral needs. It is more important than ever for your cat to be a healthy weight to maintain optimum health. 

Talk to your veterinarian about how and when to transition your cat to a senior food. 

Your veterinarian will help you asses your cat’s optimum weight and can recommend a senior food to help maintain, lose or gain weight.

A cat’s digestion is also improved by feeding them small, frequent meals throughout the day and night. Measure your cat’s daily food and distribute it in small portions.

You can use tools like hunting feeders, like Doc & Phoebe’s Cat Co. Indoor Cat Feeder Kit, and puzzle toys that promote physical and mental engagement at mealtime.

2. Increase Your Cat’s Access to Water

As cats age, they are prone to constipation and kidney disease, especially if they are not staying hydrated enough.

Increase your senior cat’s water intake by providing canned food and more options for drinking water.

As your cat gets older, they might not be able to jump up on to counters or access the usual water dish. Add more water stations around the house with plenty of bowls and/or pet water fountains to entice your senior cat to drink more.

3. Know and Keep an Eye Out for the Subtle Signs of Pain in Cats

Cats are masters at hiding their pain. As many as nine out of 10 senior cats show evidence of arthritis when X-rayed, yet most of us with senior cats have no idea.

The most important thing you can do to prevent the pain from arthritis is to keep your cat at healthy weight. As little as a pound or two of excess weight can significantly increase the pain of sore joints. 

Your veterinarian can help you with a long-term plan to help control your cat’s pain with medicine, supplements and alternative treatments, like acupuncture, physical therapy and laser treatments

4. Don’t Neglect Your Cat’s Dental Health

Dental disease is very common in aging cats. Cats can get painful holes in their teeth, broken teeth, gum disease and oral tumors that significantly affect their quality of life.

Infections in the mouth enter the bloodstream and can slowly affect the liver, kidneys and heart. So paying attention to your cat’s dental health is essential to caring for them during their senior years.

Often, there is no clear sign of dental disease. Cat parents see weight loss and a poor hair coat as the vague signs of aging, not an indication of a potential problem.

A thorough veterinary exam and routine dental care can drastically improve your cat’s quality of life, and can even extend their lifespan. 

5. Give Senior Cats Daily Exercise and Mental Stimulation

Environmental enrichment is an essential part of your cat’s quality of life.

All cats need places to climb, places to hide, things to scratch, and ways to hunt and play. All of these things will help your cat stay physically and mentally stimulated as well as healthy.

However, as your cat ages, providing these things may require some extra thought. Your cat’s mobility may become more limited, so you will need to make your home more accessible so that it’s easier on their older joints.

For example, a carpeted cat ramp can act as a scratching post as well as a climbing aid for cats with arthritis. A covered cat bed can give aging cats a cozy, warm place to hide that also helps to soothe sore joints and muscles. You can move their food and water bowls to more accessible locations on the ground instead of on tables or counters.

6. Don’t Skimp on Biannual Vet Visits

Finally, and most importantly, maintaining a good relationship with your veterinarian is critical when discussing care and quality of life for your cat in their senior years. Ideally, cats over 11 years of age should see the veterinarian every six months.

Blood work done during these visits can detect the onset of health issues—like kidney disease—while there’s still time to make medical changes that will improve and extend your cat’s life.

Weighing your cat twice a year will also show trends in weight loss or gain that can be valuable clues to overall health changes. And oral exams will detect dental disease before it negatively impacts your cat’s health.

Cat Constipated???

Cat Constipated???

By Dr. Karen Becker

 

Just like us, our feline friends can suffer from constipation. In some kitties it happens just once in a while; for others it can become a persistent problem.

When stool stays in the colon too long, it becomes dry, hard, and difficult to pass. Left untreated, chronic constipation can lead to megacolon, a terrible condition in which the large intestine stretches so much it can no longer do its job effectively.

How to Tell if Your Cat Is Constipated

Your kitty should poop at least once every day because it’s an important part of the body’s natural detoxification process.

Your cat is constipated when he either has difficulty pooping (and the stool he produces is dry and hard), or he isn’t pooping at all. This is why it’s so important to keep an eye on kitty’s daily “output.” The quantity, color, texture, and smell, along with the presence of mucus or blood, are all indicators of his general well-being.

Often, what passes from (or in the case of constipation, doesn’t pass from) your pet’s body is the first sign of a health problem, so you should regularly monitor your cats litterbox and familiarize yourself with what “normal” looks like for your kitty.

Your cat’s stools should be brown, formed, and soft enough that litter sticks to them. If your kitty isn’t going daily or his stools are so hard and dry that litter doesn’t stick to them, he could be constipated. And keep in mind most constipated cats will never show overt signs of a problem. In fact, some suffer their entire lives and their humans don’t realize it because they aren’t aware of the more subtle signs of chronic constipation.

Left untreated, a constipated cat may begin to vomit intermittently, lose his appetite, and start dropping weight. He may seem lethargic. Don’t let the problem progress to this point before you take action.

Potential Causes of Feline Constipation

Often, constipation in cats is simply the result of inadequate water consumption or lack of dietary fiber. But sometimes the situation is more complicated, involving an obstruction inside the colon or a problem in the pelvic cavity, such as a tumor that interferes with bowel function.

If you actually saw your cat swallow something that could cause an obstruction, get veterinary help right away as this situation can rapidly progress to a very serious and even fatal problem.

Intact males, especially if they’re older, can develop enlarged prostates that compress the bowel, creating very thin stools or even an obstruction. This problem can usually be resolved by having your male cat neutered.

Hernias in the rectum are another obstruction that can cause constipation. The hernia bulges into the rectum, closing off passage of stool. Hernias usually require surgery to repair.

Constipation can also be the result of a neuromuscular problem or a disease like hypothyroidism or hypercalcemia. Some kitties have insufficient muscle tone or neuromuscular disorders that impede the body’s ability to efficiently move waste through the colon.

Other causes of constipation can include infected or cancerous anal glands, or a hip or pelvic injury that makes pooping painful, the effects of surgery, certain medications, iron supplements, and stress.

Hands Down, the Most Common Reason for Kitty Constipation

With all the above said, when it comes to constipation in cats, by far the most common cause is inadequate fluid intake. Your kitty’s natural prey (e.g., mice) contains 70% to 75% water, and felines are designed to get most of the water their bodies need from their diet.

Cats fed exclusively kibble are getting only a very small amount (10% to 12%) of the moisture their bodies need, and unlike dogs and other animals, they won’t make up the difference at the water bowl due to their “underactive” thirst drive. So, these cats are chronically dehydrated, which causes constipation.

The lack of moisture causes stool in the colon to turn dry, hard and painful to pass; it also causes the kidneys to become stressed. If your cat happens to be overweight and not getting enough exercise, the problem is exacerbated. Physical activity stimulates rhythmic muscle contractions (peristalsis) in the colon, which helps move things through the gastrointestinal (GI) tract.

Unfortunately, many housecats have lifestyles that involve eating too much of the wrong type of food and moving too little. Swallowing fur during grooming can further slow the transit time of waste through the colon, especially in cats fed dry diets who are also not getting adequate exercise.

How to Help a Constipated Cat

Assuming your kitty is in otherwise good health, there are several things you can do to help solve her constipation issues.

  1. If you’re feeding kibble, I strongly encourage you to switch to a moisture-rich, nutritionally optimal, species-specific diet. It’s always the first thing I recommend, especially for cats with any sort of digestive issue. At a minimum, transition from dry food to canned food, which will automatically increase the moisture in your cat’s system.
  2. If you make your own food, be absolutely sure your kitty’s diet is nutritionally balanced. Many of the homemade recipes I’ve analyzed have two to three times the upper safe limits of calcium levels recommended for pets, which will lead to constipation, among many other things. Recipes to try.
  3. Make sure your cat has access to clean, fresh, filtered drinking water at all times. Place a few stainless steel or Pyrex glass bowls around the house in areas she frequents. Avoid plastic water bowls, which can make the water taste unpleasant. You might also want to consider purchasing a pet water fountain to replace your cat’s water bowl, since many kitties will drink more from a moving water source. If she still isn’t drinking enough, consider adding bone broth to her food to increase the moisture content in her diet.
  4. Offer bone broth, in addition to water. Broths are an excellent way to entice cats to drink more. Add a bowl of warm broth beside her regular food on a daily basis. Here’s a recipe for homemade bone broth.
  5. Cats need to move their bodies through play and exercise. Movement also helps stool move through the colon. Regular physical activity can help prevent or remedy constipation.
  6. Add digestive enzymes and probiotics to your pet’s meals. Both these supplements will help with maldigestion, which is often the cause of both occasional constipation and diarrhea.
  7. If your cat lived in the wild, his natural prey would provide ample fiber in the form of fur, feathers and predigested gut contents. Needless to say, domesticated pets don’t get a lot of these things in their meals! Good replacement options for your feline companion include:
Psyllium husk powder — 1/2 teaspoon per 10 pounds of body weight 1-2 times daily on food Ground dark green leafy veggies — 1 teaspoon per 10 pounds of body weight 1-2 times daily with food
Coconut oil — 1/2 teaspoon per 10 pounds of body weight 1-2 times daily Canned 100 percent pumpkin — 1 teaspoon per 10 pounds of body weight 1-2 times daily on food
Aloe juice (not the topical gel) — 1/4 teaspoon per 10 pounds of body weight 1-2 times daily on food Acacia fiber — 1/8 teaspoon per 10 pounds of body weight 1-2 times daily as prebiotic fiber
  1. Chiropractic, acupuncture, and massage can also be very beneficial in helping to alleviate chronic constipation in pets.

Please note these recommendations are for cats experiencing a minor, temporary bout of constipation. If your kitty’s condition is not resolving or seems chronic, or if you aren’t sure of the cause, make an appointment with your veterinarian.

 

Changes to Animal Communications/Healing and Bach Flower Essences

 

Attention: Clients of “For The Love of Animals” (Diane Weinmann)

To become in line with other animal communicator’s practices, I am changing how I perform my sessions and structure my fee schedule for Animal Communications, Distance Healing and Bach Flower Essences

 

Starting July 1, 2020 – All client communication/healing will be charged using the fee schedule below:

 

Animal Communications– performed 1 session of up to 5 questions, additional questions charged at $10 per question

With Email to Client on pet’s responses- $50

With Email on pet’s responses plus phone call to Client – $75

Distance Healing- performed 1 session

Energetic Assessment = free

Healing Touch for Animals Distance healing session with email to Client – $50

Healing Touch for Animals Distance healing session with email and phone call to Client -$75

Custom Bach Flower Essence – $30 includes shipping

Cat Anxiety Meds

As seen in PetMD

 

Cats can suffer from anxiety disorders just as people and dogs can. They can experience generalized anxiety disorders or more specific anxiety issues caused by things like thunder or separation distress when their pet parents are not at home.

The first step to relieving your cat’s anxiety is to talk to your vet, and then you can discuss the need for cat anxiety medications. Here’s a list of the different types of cat anxiety medications and how they work.

Talk With Your Veterinarian About Your Cat’s Anxiety

What can you do to help your cat if they suffer from anxiety? First, your cat needs to be examined by your veterinarian to make sure there are no underlying medical problems.

Your veterinarian can discuss with you some medication options or refer to you an expert in the field—a board-certified veterinary behaviorist.

No matter the direction you take, the use of anti-anxiety medication is just one part of the treatment plan. The other part involves management and behavior modification.

How Cat Anxiety Medications Work

Cat anxiety can manifest itself in a variety of ways, so there are both long-term and short-term anti-anxiety medications available.

Long-Term Anxiety Medications for Cats

Some cat anxiety medications are long-term maintenance medications, meaning they can take 4-6 weeks to take full effect. They also are meant to be taken daily.

If the medication is helping, the cat should be kept on it for a minimum of 2-3 months. Once your cat’s behavior is stable, they can be gradually weaned off the medication.

Some cats benefit from staying on anti-anxiety medications for 6-12 months or longer periods. These cats should get a yearly examination, bloodwork, and a behavior reevaluation to ensure that they are still on the best treatment plan for their needs.

Short-Term Anxiety Medications for Cats 

Other anti-anxiety medications are short-term; they take effect in a shorter period of time and only last for several hours.

They are intended to be used for certain situations where your cat experiences increased levels of anxiety and stress.

These medications typically do not require your cat to be weaned off them if they’re not used consistently.

Types of Cat Anxiety Medications

Please keep in mind that the use of all human medications to treat cats with anxiety disorders is off-label.

Here is a list of the most commonly prescribed anti-anxiety medications and their potential side effects. (A small percentage of cat patients may experience side effects while on a medication.)

Click to Jump to a specific section:

Fluoxetine

Indications: Generalized anxiety (moderate to severe anxiety); aggression directed towards people, cats or other animals; compulsive behavior; urine spraying; inappropriate urination; panic disorder; and fearful behavior.

Fluoxetine is classified as a selective-serotonin reuptake inhibitor (SSRI). It blocks the receptors in the brain from taking up and removing serotonin, which allows for a higher serotonin level.

Serotonin helps modulate mood and behavior. Increased amounts of serotonin in the brain can help decrease anxiety and reduce reactivity and impulsive behavior.

This medication takes 4-6 weeks to take effect and must be given once daily.

It’s typically dispensed in tablet form and needs to be cut into the appropriate size for cats. It can be compounded by specialty pharmacies into flavored, chewable tablets, capsules, or flavored liquids.

Some potential side effects include:

  • Vomiting
  • Diarrhea
  • Agitation
  • Sedation
  • Lethargy
  • Decreased appetite

Most of the side effects improve after the first 1-2 weeks. If your cat’s appetite is affected, this medication should be discontinued and replaced by an alternative.

Paroxetine

Indications: Generalized anxiety (moderate to severe anxiety), aggression directed towards people or other cats, compulsive behavior, urine spraying, inappropriate urination, and fearful behavior.

Paroxetine is another SSRI that increases the amount of serotonin in the brain. It’s a good alternative for cats that become agitated or have decreased appetite on fluoxetine. It is less sedating compared to fluoxetine.

This medication takes 4-6 weeks to take effect. It must be given once daily and should not be abruptly discontinued.

This medication should be used with caution in cats with heart disease.

It’s typically dispensed in tablet form and needs to be cut to the appropriate size for cats. It can be compounded by specialty pharmacies into flavored chewable tablets, capsules, or flavored liquids.

Some potential side effects include:

  • Sedation
  • Lethargy
  • Constipation
  • Vomiting
  • Difficulty urinating

Sertraline

Indications: Generalized anxiety (mild to moderate anxiety), inappropriate elimination, and fearful behavior.

This SSRI takes 4-6 weeks to take full effect. It must be given once daily and should not be abruptly discontinued.

This medication typically needs to be compounded by specialty pharmacies into flavored chewable tablets, capsules, or flavored liquids.

The smallest tablet is too large even when cut into quarter tablets.

Some potential side effects include:

  • Sedation
  • Lethargy
  • Agitation
  • Decreased appetite

However, this medication is less likely to cause side effects compared to the other SSRIs.

Clomipramine

Indications: Generalized anxiety (moderate to severe anxiety); aggression directed towards people, cats, or other animals; compulsive behavior; urine spraying; inappropriate urination; panic disorder; and fearful behavior.

Clompiramine is a tricyclic antidepressant (TCA) that modulates serotonin and norepinephrine receptors to reduce anxiety and aggressive behavior.

This medication takes 4-6 weeks to take effect. It must be given once daily and should not be abruptly discontinued.

Some potential side effects include:

  • Vomiting
  • Diarrhea
  • Agitation
  • Sedation
  • Lethargy
  • Dry mouth
  • Decreased appetite

This medication should be used with caution in cats with heart disease.

Buspirone

Indications: Generalized anxiety (mild to moderate anxiety), and fearful behavior.

Buspirone is classified as an azapirone, which works on the serotonin and dopamine receptors in the brain.

This medication takes 4-6 weeks to take effect. It must be given once daily and should not be abruptly discontinued.

Some potential side effects include:

  • Vomiting
  • Diarrhea
  • Agitation
  • Sedation
  • Increased affection towards the owner and increased confidence

Some cats that are picked on by other cats in the household may appear more confident and defend themselves instead of running away.

Alprazolam

Indications: Anxiety, phobias, panic disorder, and fear.

This medication is classified as a benzodiazepine, which promotes GABA activity in the brain.

This short-acting medication takes effect in 30 minutes. It can be given every 8-12 hours. Tolerance and dependency may occur if this medication is given daily. Slow weaning off the medication is needed if the cat has been on this medication for a prolonged period of time.

Alprazolam must be used with caution in cats with aggressive behavior. It may reduce the cat’s inhibition, which might lead them to display more aggressive behavior.

Some potential side effects include:

  • Lethargy
  • Sedation
  • Loss of motor coordination
  • Increased appetite
  • Paradoxical excitement
  • Disinhibition of aggressive behavior

Lorazepam

Indications: Anxiety, phobias, panic disorder, and fear.

This is another benzodiazepine.

That means it’s a short-acting medication that takes effect in 30 minutes. It can be given every 12 hours. Tolerance and dependency may occur if this medication is given daily. Slow weaning off the medication is needed if the cat has been on this medication for a prolonged period of time.

Some potential side effects include:

  • Lethargy
  • Sedation
  • Loss of motor coordination
  • Increased appetite
  • Paradoxical excitement
  • Disinhibition of aggressive behavior

This medication must be used with caution in cats with aggressive behavior.

Oxazepam

Indications: Anxiety, phobias, panic disorder, and fear.

Oxazepam is another benzodiazepine, which means it’s a short-acting medication that takes effect in 30 minutes. It can be given every 24 hours. Tolerance and dependency may occur if this medication is given daily. Slow weaning off the medication is needed if the cat has been on this medication for a prolonged period of time.

This medication must be used with caution in cats with aggressive behavior.

Some potential side effects include:

  • Lethargy
  • Sedation
  • Loss of motor coordination
  • Increased appetite
  • Paradoxical excitement
  • Disinhibition of aggressive behavior

Trazodone

Indications: Anxiety and aggression.

This medication is classified as a serotonin-2A antagonist reuptake inhibitor.

This is a short-acting medication that takes effect in 60-90 minutes and lasts about 8-12 hours.

Some potential side effects include:

  • Lethargy
  • Sedation
  • Vomiting
  • Diarrhea
  • Agitation

Gabapentin

Indications: Anxiety and aggression.

Gabapentin is classified as an anticonvulsant. It works on calcium ion channels in the brain to reduce excitement. Avoid the use of human oral solution since it contains xylitol.

This is a short-acting medication that takes effect in 60-90 minutes and lasts about 8-12 hours.

Some potential side effects include:

  • Lethargy
  • Sedation
  • Vomiting
  • Loss of motor coordination
  • Agitation

By: Dr. Wailani Sung, MS, PhD, DVM, DACVB

 

Got a Velcro Dog that You’d like to Liberate?

By Dr. Karen Becker

 

Some of you reading here today have dogs that are, shall we say, extremely bonded to you. They follow you from room to room all over the house. When you stand still or sit down, they immediately put their body in contact with yours. You’re never in the bathroom without an audience. The small ones are constantly, literally underfoot; the larger guys trot behind or next to you, an adoring look on their faces, as you move about.

“Velcro dog” behavior can be charming and lovable, but there are times when it can also be annoying or even dangerous. For example, a tiny dog at your feet trying to follow your every movement is a trip-and-fall accident waiting to happen.

Another potential issue is that clingy canine behavior can progress to or be a feature of separation anxiety, which in many dogs is a serious emotional and behavioral problem.

Most Velcro Dogs Are Made, Not Born

According to veterinarian Dr. Joanna Pendergrass in an article for PetMD, “Clinginess is often a learned dog behavior.”1 Needless to say, they learn it based on how we respond to them when they follow us about. If we reward them in some way (e.g., with a treat or a scratch behind the ears), the behavior will very quickly become imprinted.

“If we give puppies constant attention when they’re developing,” says Pendergrass, “they can become fearful of being alone and subsequently never want to leave our side. Dogs can also become clingy if we change their daily routine.”

Other reasons for clinginess can include the gradual loss of vision, hearing or cognition in older dogs, as well as illness or boredom in dogs of any age. Anxious dogs are often clingy, and because our canine companions are so attuned to our moods, they can also become clingy when they sense anxiety or stress in us.

“As if all of these reasons weren’t enough,” writes Pendergrass, “some dog breeds are prone to clinginess. For example, lapdogs, like Shih Tzus, tend be needy dogs. Also, working dogs, who are trained to be dependent, can become clingy.”

Clinginess Can Progress to Separation Anxiety in Some Dogs

While clingy dogs and those with separation anxiety share certain behavioral characteristics, the major difference between them is the way in which they handle being apart from their humans. In a nutshell, your Velcro dog wants to be as close as possible to you when you’re home but doesn’t have the canine version of panic attack when left home alone.

Separation anxiety is what triggers panic attacks in affected dogs, causing them to engage in behaviors that can be destructive and self-harming. It’s important to understand that dogs with true separation anxiety aren’t “acting out” because their owners are away — they’re feeling overwhelming panic they have no control over.

Unfortunately, clinginess can progress to separation anxiety in some dogs, so it’s important to keep a close eye on your Velcro pup for any signs of nervousness or panic when left alone. If you suspect your dog’s clingy behavior is moving in the direction of separation anxiety, it’s important to address the situation right away.

How to Discourage Your Dog’s Clinginess and Encourage Independence

The best approach to managing Velcro dogs is to help build confidence and encourage their independence while you’re at home with them, which will increase their ability to manage any anxiety they feel when you’re away. Pendergrass suggests increasing physical exercise and mental stimulation, creating a special space where they can hang out instead of trailing you around the house, and desensitization.

• Increase your dog’s daily exercise — Engage your dog in at least one rigorous exercise session daily. I can’t stress enough how beneficial intense exercise is for not only anxiety, but boredom and behavior problems as well.

If you’re concerned that your dog’s clinginess is heading into separation anxiety territory, go for a strenuous exercise (or ball playing) session before you leave the house. A tired dog gets into less physical and mental mischief when left alone.

• Stimulate her mind — Keeping your dog’s mind active is also critically important in preventing undesirable behaviors. Boredom is the breeding ground for all manner of “bad dog” behavior. In addition to daily activities to engage her brain, your dog should be continuously socialized throughout her life with frequent opportunities to interact with other dogs, cats, and people.

Regular training sessions are also a great way to keep her mind occupied and strengthen the bond you share with her. Nose work, which encourages her to use her natural hunting instincts and scenting abilities, can be a great way to keep her mentally stimulated. Even allowing your dog to have 10 minutes a day of sniff-time in a natural setting will enrich her senses and fulfill her need to experience the world through her nose.

And don’t overlook the value of treat-release and food puzzle toys, which not only challenge your dog’s mind, but also provide appropriate objects for her to chew. I find the Treat & Train Manners Minder a great tool for this purpose.

It’s also a good idea to rotate your dog’s toys regularly. If you leave all of them out in a big basket, she may lose interest in them quickly. A better idea is to leave out one or two and put the rest away. In a day or two, swap them out. Also be sure to play with your dog using her toys; rigorous, engaging play sessions several times a day are a great way to her pent-up energy and bond with her at the same time.

• Create a special dog-friendly space — This can be a crate (with the door left open) if your dog is crate trained (which I highly recommend), or a corner of the room outfitted with a comfy, nontoxic dog bed, perhaps an earthing mat or grounding pad, and a favorite toy.

Use positive reinforcement behavior training to teach your dog to respond reliably to a verbal cue such as “Go to your crate,” or “Go to your special space,” and give him the cue when you notice he’s obsessing over your every move.

• Desensitize your dog to your movements — If your dog is made of Velcro, she’s acutely aware of the movements you make as you prepare to leave the house, such as putting on your “outside” shoes, pulling on a coat/sweater/hat, grabbing your car keys, etc.

Pendergrass recommends “normalizing” these movements by performing them when you’re not planning to leave the house. Once these movements no longer signal to your dog that you’re leaving her, she’ll pay less attention to them.

Needless to say, the goal is always to prevent clinginess in the first place, which is best accomplished by asking a prospective breeder what socialization steps are taken with the litter as a part of your pre-purchase interview process. Good breeders know puppies should already have a month of focused, intentional, diversified socialization prior to going to their forever homes. Obviously, this is impossible if you rescue pups.

Once puppies reach their new homes, positive socialization must start immediately and include several opportunities for new experiences on a daily basis for the first year of life. Creating confident puppies that feel safe being alone is the best way to avoid this situation later on.

For adult dogs, if their extreme clinginess persists after you implement these suggestions, or you’re concerned it’s progressing to separation anxiety, it’s important to make an appointment with your integrative veterinarian and/or a veterinary behaviorist.

You might also find these articles on soothing an anxious dog and helping a dog with separation anxiety helpful.

 

Cushing disease in Dogs

Cushing disease in Dogs

By Dr. Karen Becker

 

Cushing’s disease is most often seen in dogs — especially Terriers, Poodles, Dachshunds and the American Eskimo/Spitz. It rarely occurs in cats.

The medical term for this condition is hyperadrenocorticism. Hyper means too much, adreno refers to the adrenal glands, and corticism refers to a syndrome involving the hormone cortisol. Simply put, hyperadrenocorticism describes a condition in which too much cortisol is released by the adrenal glands.

Overproduction of This Powerful Hormone Can Trigger a Cascade of Health Problems

In a healthy dog’s body, cortisol, known as the fight-or-flight hormone, is released in small amounts by the adrenal glands in response to perceived stress, so the dog can prepare to battle or run for his life. A release of cortisol also triggers a release of glucose from the liver. Glucose provides energy to the cells of the muscles used to fight or take flight.

Cortisol also impacts a number of other important functions in your dog’s body, including blood pressure, electrolyte balance, bone and fat metabolism, and immune function. Cortisol is secreted in response to any type of stress in your pet’s body; physical or emotional, short-term or long-term.

If for some reason your dog’s body up-regulates its demand for cortisol, the adrenal glands begin overproducing the hormone, which can lead to a state of toxicity. In dogs who experience chronic stress in any form, the adrenals release more cortisol than their bodies need.

This situation can result in a number of serious disorders, including elevated blood sugar that can lead to diabetes, elevated blood pressure that can result in heart and kidney disease, extreme hunger in response to lots of excess glucose being burned, thinning of the skin and coat, decreased muscle and bone mass, and increased risk of infection.

If your dog’s body is continuously overproducing cortisol, his immune function is compromised, which opens the door for infections anywhere in the body — especially the gums, eyes, ears, skin and urinary tract. If your dog has recurrent infections or a persistent infection, it’s possible too much cortisol is the cause.

Symptoms of Cushing’s Disease

Most dogs have a few, but not all of the symptoms of the disorder unless diagnosis comes very late in the disease. Symptoms most commonly seen in dogs with early Cushing’s include:

Increased thirst and urination, which can lead to incontinence Bruising
Increased panting Hair loss
Abdominal weight gain (pot belly appearance), despite a reduction in calorie intake Irritability or restlessness
Thinning skin and change of skin color from pink to grey or black, symmetrical flank hair loss Much less commonly, rear limb weakness and blood clots

These symptoms are so diverse and can affect so many organs because every inch of a dog’s body contains cortisol receptors.

Typical or Atypical Cushing’s?

If your dog is diagnosed with hyperadrenocorticism, it’s important to know which type of Cushing’s she has. Typical Cushing’s is either adrenal dependent or, much more commonly, pituitary dependent. About 85% of affected dogs develop the latter form, in which the pituitary gland sends too much stimulating hormone to the adrenals. The adrenal glands respond by over-secreting cortisol.

The remaining 15% of cases are adrenal dependent, in which a tumor develops in an adrenal gland and triggers an up regulation of cortisol production. It’s not uncommon for veterinarians to unintentionally trigger typical Cushing’s by prescribing a too-high dose of oral prednisone (synthetic cortisone), or a course of prednisone therapy that is too long in duration. If your dog has taken prednisone for any length of time, she’s predisposed to Cushing’s disease.

The atypical form of hyperadrenocorticism occurs when the adrenals overproduce aldosterone, a hormone that balances electrolytes in the body. Atypical Cushing’s can also result from an overproduction of sex hormone (estrogen, progesterone, and rarely, testosterone) precursors.

Diagnosing Hyperadrenocorticism Can Be Challenging

The actual diagnosis of Cushing’s is often complicated. It’s typically done with blood tests like the ACTH stimulation (stim) test and the low-dose dexamethasone suppression test. Both these tests require at least two blood draws to compare cortisol levels for a definitive diagnosis of Cushing’s.

When Cushing’s is confirmed, your veterinarian will want to determine if it’s pituitary or adrenal dependent. In my opinion, the best way to rule out an adrenal gland tumor is with a non-invasive ultrasound test. However, some vets prefer to do a third blood test called a high-dose dexamethasone suppression test.

Whichever method is used, it’s important not only to establish a definitive diagnosis for Cushing’s, but also to determine whether the form of the disease is adrenal or pituitary dependent.

Unfortunately, in the majority of cases, the disease is diagnosed only after it is full-blown and there’s no holding it back. Once a dog has full-blown Cushing’s, she will live with the disease for the rest of her life. It’s a horrible illness that can be managed in many cases, but never cured.

Many veterinarians tend to ignore repeated and progressive elevations in serum Alkaline Phosphatase (ALP), one of the commonly elevated enzymes found on routine bloodwork, until several Cushing’s symptoms are present, or a pet parent becomes concerned that their dog is suddenly urinating in the house or losing her hair.

The better, proactive approach is to try to prevent the disease from taking hold. That’s why I recommend getting a copy of your pet’s yearly bloodwork results. Your pet should age with picture-perfect bloodwork, or there’s work to be done.

Never let a veterinarian tell you your pet’s abnormal bloodwork is “normal for their age,” as this means disease is taking place without anyone addressing it. If your dog’s ALP is two to three times higher than normal, ask your vet if your dog could be in the early stages hyperadrenocorticism.

The Importance of Catching This Disease Early

Most of the drugs currently available to treat Cushing’s disease have many undesirable side effects. It’s extremely important to discuss your concerns about possible side effects with your veterinarian. I recommend you do your own research as well.

I try to avoid using Lysodren and other potent Cushing’s drugs because in my opinion, the side effects are often worse than the symptoms the animal is dealing with. If Cushing’s drugs must be used, I prefer to use Trilostane, which has fewer side effects. Obviously, the goal is to catch the disease before high drug doses are required.

If, however, your dog requires drugs to manage full-blown Cushing’s, I recommend starting with the lowest possible effective dose, and using it in conjunction with a natural protocol to reduce potential side effects. Identifying pre-Cushing’s syndrome as early as possible and reducing your pet’s risk for full-blown disease is the approach I always recommend. Dogs don’t suddenly wake up with this disease — it happens over time.

Unfortunately, many conventional veterinarians ignore the early signs of adrenal dysfunction because they don’t know what to do about it until a dog fails the ACTH stim test. The problem with this approach is it takes months and sometimes years for an animal to be officially diagnosed with Cushing’s.

Waiting this long to take action often means waiting too long. I consider a dog to have pre-Cushing’s syndrome when he exhibits classic symptoms but is still able to pass the stim test. Often there are minor changes in bloodwork, for example, the UCC (urine cortisol:creatinine ratio) is slightly elevated, there are elevated cholesterol levels, and/or the elevation in ALP has been proven to be cortisol induced (your vet can check what fraction of ALP is coming from cortisol vs. other sources).

I’m able to reverse many pre-Cushing’s patients with nutraceuticals, Chinese herbs, homeopathics, nutritional therapy, and lifestyle management (reducing biologic and metabolic stress).

My advice is to be proactive by having your pet’s ALP level checked annually, which should be a part of a basic “wellness blood test,” along with a physical exam that evaluates muscle mass, coat condition, and an environmental stress assessment. Ask your veterinarian to establish baseline blood levels and address any elevation from the baseline through a screening test like the UCC or CiALP to determine if your dog’s body is over-secreting cortisol.

Never accept steroids prescribed for your pet unless they’re required to dramatically (and temporarily) improve quality of life (e.g., if your pet has acute head trauma and steroids are needed to control brain inflammation, etc.).

Having this information will help you better manage a pre-Cushing’s situation before it develops to full-blown disease. And don’t ignore symptoms. If your pet has consistent Cushing’s-type symptoms, no matter how minor, they are absolutely worth investigating for a possible endocrine or adrenal disorder.

It’s during the development of Cushing’s disease that many dogs are also over-prescribed aggressive traditional drug protocols for full-blown Cushing’s disease, often with disastrous results.

When these potent drugs are prescribed for mild adrenal dysfunction, the result is often an acute Addisonian crisis in which there are insufficient adrenal hormones necessary for normal physiologic function. A natural protocol to manage pre-Cushing’s is essential to avoid drug-induced hypoadrenocorticism (Addison’s).

Prevention Tips

There are some common-sense steps you can take to reduce your dog’s risk of developing hyperadrenocorticism, including:

Feed a moisture rich, nutritionally optimal, species-appropriate anti-inflammatory diet to reduce biologic stress; this means eliminating all grains and carbohydrates from the diet, since carbs trigger insulin release and insulin triggers cortisol release
Exercise your dog daily to help combat stress and promote the release of endorphins
Instead of spaying or neutering, consider a sterilization procedure that leaves your dog’s testicles or ovaries in place; if that’s not possible, wait until your pet has reached his or her full adult size, and in the case of females, after the first and preferably two estrus cycles
Minimize your pet’s exposure to xenoestrogens
Investigate adaptogenic herbs and adrenal-supportive natural substances like magnolia (rhodiola), ashwagandha, and phosphatidylserine
Address abnormal hormone levels early on with natural support, such as melatonin, DIM, glandular therapies and high lignan flax hulls

 

 

 

An integrative approach to chronic kidney disease (CKD) in cats

By: Barbara Fougere, BSc, BVMS (Hons), BHSc (Comp Med), MODT, MHSc (Herb Med), CVA, CVCP, CVBM

CKD is a common but manageable condition in feline patients, and responds well to integrative medicine. Herbs and acupuncture are key therapies.

Chronic kidney disease (CKD) is a common problem in cats, and one which all veterinarians encounter in practice. An integrative approach that includes herbs and acupuncture can help treat and even reverse this condition in feline patients.

CKD can be detected early through careful monitoring at annual wellness programs. IRIS (International Renal Interest Society) staging allows for the conventional staging of treatment, including any dietary changes. Key treatment strategies for feline CKD include supporting hydration, reducing phosphorus (usually through protein restriction), regulating blood pressure and controlling calcium levels. The intensity of intervention increases with disease progression.

Integrative treatment goals

Using integrative approaches to CKD, we have observed cats moving from IRIS Stages 2 and 3 to Stage 1, and remaining there for years. This reversal implies that nephrons are hypoxic and under-functioning, and that improving their functional capacity is a key goal. See below for integrative treatment goals for CKD.

Herbs can optimise kidney cell function by reducing oxidative stress, improving renal blood flow and mitigating fibrosis, thereby maintaining patients in early stages for extended periods. Acupuncture, manipulative therapies and other modalities can also be a part of the integrative approach.

With acute renal disease, the goals are modified to regulate/decongest the kidneys by reducing blood flow, and provide anti-inflammatory support to inflamed glomeruli. This may be a starting point with pyelonephritis, for example. Most cats, however, benefit from increased perfusion unless the renal disease is acute in onset (inflammatory).

Dietary considerations

Despite numerous experimental studies and clinical trials, questions about feeding protein to cats with chronic kidney disease (CKD) remain. What is the optimal amount of protein for a cat with CKD? How much restriction is necessary? Do different types of kidney disease require different dietary therapies? At what point in disease progression should protein restriction be implemented? Does the type of protein make a difference? Does every meal have to be restricted? Will a cat in IRIS Stage 3 or 4 benefit if phosphorus is restricted by other means? Might some cats with advanced disease benefit from increased protein levels?1 These concerns remain despite the common practice of prescribing therapeutic renal diets to cats in any stage of CKD.

Integrative practitioners provide, or are requested to provide, natural feeding advice to cat owners. Excellent resources include the veterinary Diplomats in Nutrition; Balance It and several software programs that can be used for formulating diets while taking feline preferences into account. See page xx for an example of a low-phosphorus diet for cats with CKD.

From an integrative perspective, real food is considered to have many benefits, including palatability for ill cats, and these benefits may outweigh those offered by processed foods. In IRIS Stage 1 and early Stage 2, the diet may not need to be modified, although serum phosphorus and the phosphorus content of the diet should be evaluated. From late Stage 2 onwards, consideration may be given to reducing protein by diluting with fat and carbohydrates.

Herbal help

Herbs can delay the onset and progression of CKD in cats by improving mitochondrial function, and providing antioxidant protection and ACE-inhibiting effects. Many herbs are anti-inflammatory, anti-fibrotic and nephroprotective, and several improve renal blood flow. A principle of herbal medicine is that formulations containing multiple plants can have greater effects than the same herbs taken separately. These synergistic effects enhance the desired action.2

Following are several herbs to be considered and included in formulas for renal treatments.

1. Rehmannia glutinosa

Rehmannia glutinosa occurs in many Chinese herbal formulas, including Rehmannia Eight Combination (Shen Qi Wan, Jin Gui Shen Qi Wan, Ba Wei Di Huang Wan), which is very useful for cats with CKD and weight loss, loss of strength, polyuria, polydipsia, and that are seeking warmth. It is also included in Zhi Bai Di Huang Wan, which is useful in cats with CKD and hyperthyroidism, particularly in those tending towards constipation, agitation and weight loss, along with polydipsia and polyuria.

Rehmannia has a long history of research and effective use in CKD. In humans, studies have found that it has a 91% efficacy in reducing renal damage from nephritis, due to the enhancement of renal blood flow and glomerular filtration.3 In a model of renal ischemia, ligated rats that received Rehmannia extract showed improved renal blood flow (to near normal levels) and reduced mortality and hypertension compared to controls, through either ACE inhibition or juxtaglomerular desensitization.4 Rehmannia reduces oxidative stress and can promote red blood cell production through bone marrow stimulation; reduce serum creatinine and urinary protein excretion and glomerulosclerosis in compromised patients; and inhibit the expression of Angiotensin II as well as Type IV collagen in the renal cortex.5, 6

Fresh Rehmannia is utilised in Ba Wei Di Huang Wan and Zhi Bai Di Huang Wan. Interestingly, a recent study supports the use of fresh over prepared Rehmannia; the former acts more powerfully on attenuating interstitial fibrosis by downregulating the expressions of transforming growth factor, a smooth muscle actin, and Type 1 collagen.7

2. Astragalus membranaceus

Astragalus membranaceus is known as a Qi tonic in Chinese medicine, and as a major immune-modulating herb in Western herbal medicine. It should also be known as a major kidney herb. Its major constituent, astragaloside, ameliorates renal interstitial fibrosis in vivo by inhibiting inflammation.8 It has major antioxidant effects.9 Astragalus has been reviewed by Cochrane and was found to offer some promising effects in reducing proteinuria and increasing haemoglobin.10 Its nephroprotective effects against oxidative stress include anti-inflammatory and anti-apoptotic mechanisms.11 In a systematic review of Astragalus on diabetic nephropathy in animal models, this herb was able to reduce blood glucose and albuminuria levels and reverse the glomerular hyperfiltration state, thus ameliorating pathologic changes.12

3. Angelica sinensis

Angelica sinensis contains polysaccharides that inhibit oxidative stress injury in mouse kidneys.13 Like Astragalus, its nephroprotective effects include anti-inflammatory and anti-apoptotic mechanisms.11 Renal microvascular lesions can contribute to the progression of glomerular sclerosis and tubulo-interstitial fibrosis in chronic kidney Both Astragalus and Angelica can improve microvascular lesions by increasing local renal blood flow to lessen hypoxic renal injury, promoting the recovery of renal blood flow and glomerular filtration rate after ischemia-reperfusion; modulating the imbalance of vaso-activators such as nitric oxide and angiotensin; increasing the expression of vascular epithelial growth factor; inhibiting the release of the intracellular calcium ion; and promoting DNA synthesis in endothelial cells to improve the function of endothelial cells. The evidence suggests that both herbs may retard the progress of renal diseases through the above-mentioned mechanisms.14

In one study involving rats with an obstructive uropathy, Astragalus and Angelica were administered with Enalapril and compared to monotherapy. Enalapril with Astragalus and Angelica decreased tubulointerstitial fibrosis to a significantly greater extent than did treatment with Enalapril alone.15

4. Cinnamon

Cinnamon is readily accepted by cats and offers a mono-herbal treatment for fussy felines. It occurs in the Wei Ling Tang formula, which is useful for overweight CKD cats with proteinuria, hematuria, urolithiasis, azotemia, glomerulonephritis and pyelonephritis. Cinnamon can inhibit advanced glycation end products (AGE) and can ameliorate AGE-mediated pathogenesis in diabetic nephropathy.16 Cinnamon is a major antioxidant and anti-inflammatory spice, and has had over 178 papers published on it from 1995 to 2015.17 Cinnamon at a dose of 50 mg/kg for two weeks was given to dogs; the systolic blood pressure and heart rate in the treated dogs was significantly lower than in the normal group.18

5. Silybum marianum

Silybum marianum is one of our preeminent nephron-protective herbs. It should be considered an adjunct to ameliorative potential effects against drug-induced kidney disease, particularly in chemotherapy.19 It is also an herb that could be considered for CKD support. It is a potent antioxidant and free radical scavenger that inhibits lipid peroxidation and stabilizes cell membranes. It also increases intracellular glutathione, which plays a crucial role in the body’s antioxidant capacity, and it has anti-inflammatory properties inhibiting T-cell proliferation and cytokine secretion.20 There is also evidence that Silybum has a regenerative effect on renal tissue after injury.21

Mushrooms — Ganoderma and Cordyceps

Mushrooms are well tolerated by cats when given in the form of powders or concentrated tinctures added to food. Ganoderma lucidum is a medicinal mushroom that has been widely used in China and Japan for hundreds of years for its immune-modulating, anti-inflammatory and anti-tumor effects. Ganoderma compounds are renoprotective.22.The active peptide in Ganoderma counteracts oxidative stress from renal ischemia, and in an animal model of diabetic nephropathies has renal protective effects.23

Likewise, Cordyceps sinensis is extensively used by Chinese physicians to treat chronic renal diseases and to stimulate the immune system. It also displays anti-oxidative activities. It is commonly used in renal transplant patients; it has been shown to significantly improve renal fibrosis.24

Acupuncture and moxibustion

A recent single blinded randomized controlled study in patients with CKD showed that acupuncture at bilateral LI4, ST36 and KI3, and electroacupuncture to right ST36 and KI3 and left ST36 and KI3, once a week for 12 weeks, led to reduced creatinine levels and increased glomerular filtration rates.25 Moxibustion at Bl 23 in patients with CKD reduced renal vascular resistance.26

Most of the benefits that acupuncture offers in renal failure are undoubtedly due to the ability of these points to manipulate blood flow. Local blood flow is manipulated using BL23, BL22 and GB25, while systemic blood flow is manipulated with GB34, BL40 and KI3. Systemic blood flow greatly impacts renal function. Peripheral vasoconstriction can be induced to drive more blood to the kidneys. Peripheral vaso-relaxation can be induced to decongest the kidneys.

For animals in Stage II renal failure (using the IRIS classification system), and particularly where UPC ratios are greater than 2.5, use GB25, BL22 and GB34. These animals will typically have benefited from hypotensive drugs and low-protein diets, but won’t show an immediate improvement from fluid therapy. For animals in Stage I renal failure, or where UPC ratios are less than 2 to 2.5, use KI3, BL40 and BL23. These animals will typically not benefit from low-protein diets and hypotensive drugs, but will show an overt improvement from fluids.27

Integrative treatment goals for feline CKD

·         Mitigate oxidative stress by using antioxidant herbs

·         Improve renal perfusion (in most cases)

·         Prevent fibrosis, which is a natural consequence of renal disease

·         Optimise systemic health and well-being

Example of a low-phosphorus diet for cats with CKD

·         50 grams or ¼ cup pearl barley

·         200 grams raw chicken breast meat

·         10 grams chicken liver

·         1 large egg yolk

·         2 cups raw sweet potato

·         4 teaspoons salmon oil plus 4 teaspoons flaxseed oil

Cook barley, sweet potato, chicken and liver are on low heat with water. When warm, mix in egg yolk to lightly cook it (and preserve the choline). When cool, the recipe is divided into four meals (average 250 kcals) with the addition of 1 teaspoon of salmon oil and 1 teaspoon of flaxseed oil daily. The meals are divided.

The whole recipe provides 1,029 kcal, 36% carb, 40% fat, 24% protein and 724 mg of phosphorus. It needs to be supplemented as it is low in a number of minerals and vitamins, and is still low in choline. Any supplement added should be evaluated for its phosphorus content. This should demonstrate the complexity of balancing diets. Another excellent strategy is to have several recipes and vary the composition of diets over time. More protein can be utilised alongside phosphorus binders in later stages of kidney disease.

Conclusion

Chronic kidney disease in cats is a manageable condition that responds well to integrative medicine. In the author’s experience herbal medicine and acupuncture are key. Many integrative practitioners have reported success with other additional therapies, including homeopathy, cell salts, flower essences and osteopathy.

References

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