Friday, January 22, 2010

An International Visitor

(Contributed by Dr. Jessica Levy)

For the past two months, we have had the pleasure of hosting Dr. Victoria Morales, a veterinarian from Barcelona. Vicky studied veterinary homeopathy in Spain, and interned at two different homeopathic veterinary practices there before braving our weather and joining us in beautiful Blaine, Minnesota.

Vicky has been a wonderful addition to our practice, and we're trying to figure out how to keep her. She brings a fresh perspective to our homeopathic practice, and is proficient in conventional practice as well. Plus, everyone likes her. She meshes well with our staff, our clientele, and our patients.

I'm also impressed by Vicky's tenacity. It doesn't snow in Barcelona, yet Vicky remained calm and just carefully backed her car out of the snow drift it had floated into on our frontage road. She hasn't complained once about our winter weather. The rest of us do. Loudly. Until spring. Which sometimes doesn't come until June.

But I digress. Having Vicky at our practice, with her sweet nature, willingness to pitch in, and natural genius, has made the rest of us better at what we do. Plus, now we have someone to visit in Spain!

Wednesday, January 20, 2010

If I Had A Dollar For Every Time I Said "Spleen" This Week...

(Contributed by Lori Whitwam)

WARNING: This post contains graphic pictures of a surgical procedure.

I wrote last week about the situation I was facing with the tumor we'd discovered in my dog Ozark's spleen. His surgery was yesterday, and that's the story I want to tell today. Even though I've worked in veterinary hospitals since 1998, and managed Whole Health Veterinary since it came into being in April of 2005, when it comes to my own dogs I'm every bit as involved - and worried when they are sick - as each one of you.

Being an "insider" in the veterinary business is a curse as much as it's good fortune. I know things, and over the years I've seen things. Sometimes cases go wrong for no reason, and illness (especially cancer) doesn't always follow the rules. On the other hand, I have access to specialists, and to knowledge of which many pet owners aren't even aware. In addition, we're a holistic practice, so our doctors think outside the box. I had the information and the resources to do everything in my power to stack the deck in Ozark's favor.

Another wonderful benefit of working for a veterinary practice (and being the one who makes the schedule) is that I was able to rearrange my work hours to allow me to care for Ozark. He received his pre-operation sedation at around 9:15 AM. The surgeon arrived around 10:30, and his surgery was over by noon.

Surgery always amazes me. Whether human or animal, surgeons are able to open up the body, take things out, put things in, rearrange various bits and pieces, then put it all together again... and the patient is still alive. Consider that one tiny wound from a gun or a knife or a pointy stick can be fatal within moments. A surgeon had better know what they're doing!

Here are some pictures from Ozark's splenectomy (removal of his spleen):

(Pre-operation. He's zonked on his sedation, and the IV catheter has been placed in his right foreleg.)

(On the table, shaved, anesthetized, waiting for Dr. Hammel. Vet tech Jenna is monitoring Ozark.)

(Dr. Scott Hammel, of Veterinary Surgical Specialists, begins the incision that will give him access to all the squishy, oozy stuff in Ozark's abdomen.)

(Dr. Hammel has located the spleen and brought it out of the body cavity in preparation for removal. The spleen should look like the part on the right. Sort of flat and dark red and mushy and shiny, like raw liver. The mass is the roundish area beneath the light-colored fatty material at the top left of the spleen as pictured. More pictures of the spleen coming up.)

(The spleen, again. The healthy tissue is the bottom - both right and left - and the tumor is the roundish area at the top-center.)

(Removing the spleen. What alarms ME is the incision visible above. Seems so... large. And look how thick Ozark's body wall is. Who knew there was so much meat on our canine friends???)

(Get that thing out of my dog, Dr. Hammel! Thanks!)

(A good shot of the spleen. If there's such a thing as a good shot of a tumor-ridden spleen. Doesn't it look like someone tucked an orange there in the top-middle part? The whole thing should be flattish and floppy, similar to a liver.)

(Since he was in the neighborhood, and because he's a skilled and thorough surgeon, Dr. Hammel also checked Ozark's intestines for signs of tumor growth. He checked the liver, too, and sent a small sample of that tissue to the lab, along with the spleen, to look for microscopic signs of cancer.)

(Getting that little bit of the liver to send off to the lab. The liver looked healthy, but there could be microscopic cancer cells sitting there waiting for a chance to cause trouble.)

(Everything back where it belongs - minus the spleen - and Ozark getting put all back together.)

Was I a nervous wreck? Yeah, pretty much. As soon as he was in recovery, we set him up in our healing and holistic treatment room, and I spent the rest of the day sitting with him.

One thing we learned is that Ozark is extremely sensitive to anesthesia. I'd expected him to be able to walk to the car with assistance around four hours after surgery. Dogs are way more resilient than we are. When I had abdominal surgery, I was in the hospital for 2 days and then spent three weeks in bed, whining. But at 6:00, six hours after his surgery, Ozark had done little more than flutter his eyes and move his head a few times. It was taking his body much longer to purge the anesthesia than normal.

Finally, we loaded him into the back of our Blazer, on a padded sled with blankets and heating discs, and my husband and I brought him home. He'd had his bladder catheterized to empty it, his temperature was steady and his blood tests looked fine. He'd had Reiki from both our technician Sabrina and Reiki Master Peggy Edman, and some homeopathic remedies. He'd mouthed some treats and swallowed some water syringed into his mouth. I knew what to watch for, in case of trouble.

So, we brought him home (dragging him up the stupid stairs in our stupid split level house on that stupid-but-handy sled) and set him up in our spare room on a dog bed and some comforters, with the heat discs to keep him toasty, and an afghan covering him. I slept on the futon, so we could keep him separate from the other dogs, and so I could keep an eye (and a hand) on him all night since the futon is so low to the ground. We had to turn him every couple of hours to keep his circulation going. It was an anxious night.

(Such a sweet, sad boy!)

But this morning, when my husband got up, Ozark stood. He went out on the deck and emptied his bladder, and ate some raw venison meatballs with medication in them. He's decided he wants to be with Brody, Darwin and me in the living room, so he's napping on a comforter across the room.

Now, if I can keep him from trying to sneak down into the basement family room to poo - which he wants very much to do, hating to do anything on the deck, which is his only other choice right now - at least until his incision heals a little, we'll be all set. His dog-brothers are behaving pretty well, and I'm keeping a close eye on him.

We should get the biopsy results Friday or Monday, then we'll know if we're likely out of the woods, or just starting a rough fight. Again, being part of the veterinary business and knowing the things I know is often helpful, and sometimes it makes things a lot harder. Until we get the report, I'll just hope. Really, really hard.


(Contributed by Dr. Jessica Levy)

On January 12, our staff completed a Reiki I class, taught by Peggy Edman, our acupressure/animal massage/Reiki Master. Peggy did a magnificent job, and a good time was had by all. This will allow us to incorporate Reiki into our treatment plans much more easily, and will increase the effectiveness of all our treatments.

I really love Reiki. It's a simple, effective way to channel universal energy that is easy to learn and easy to do. I've used it for all types of situations, from acute injuries to chronic conditions. I used Reiki when my old dog Charlie suddenly yelped and couldn't rise from a sitting position. I treated his back and within minutes he was fine. I used Reiki when Malcolm reacted badly to a new food and was spending way too much time in the litterbox. One treatment and the crisis was averted. I used Reiki when our hospital adopted April, an elderly cat whose diabetes was out of control. I treated April every day for the first month, along with dietary modification and nutritional supplementation. She lived for three more years, insulin-free, and was the queen of our hospital cats until her death.

I'm excited that we can now offer this service to our clients and their pets. Reiki is always helpful, never harmful, and can be done hands-on or across the room.

I've also taken Healing Touch for Animals Level One, and have had Healing Touch work done extensively on my own pets. In my experience, Reiki wins.

Monday, January 18, 2010

The "Cult" of Homeopathy

(Contributed by Dr. Jessica Levy)

On January 10th, I attended the first session in a 10-session Acute Homeopathy course at the Northwestern Academy of Homeopathy. It's so nice to go back to school. The new classroom is spacious and airy, and it was great to see some old friends and meet some new ones. Homeopathy creates an instant camaraderie amongst its adherents.

Which kind of makes it sound like a cult. And, if I were going to start my own cult (and don't think I haven't considered this option), homeopathy would definitely have to be one of our fundamentals. There is nothing quite like it.

Just this week, I had a client whose dog had been diagnosed with heart failure. The internal medicine specialist who had seen the dog started it on medications, but when I called the client that evening for an update, the dog was still not doing any better. From the owner's description, I was able to suggest a remedy that they could get at their local grocery store. By morning, the dog was doing much better and was eating.

I love it.

As a cult, homeopathy invites freedom of expression and interpretation. In any given practitioner - client relationship, a different remedy and different method of dispensing might be effective. This is why, in my mind, homeopathy resembles quantum physics. You can't take the observer - the homeopath - out of the equation.

Friday, January 15, 2010

Sometimes You Shouldn't Wait And See

(Contributed by Lori Whitwam)

My 10-year-old Great Pyrenees/Labrador mix, Ozark, has a mass on his spleen. And in a very strange way, I almost feel lucky.

What? How can someone who adores her big, gentle dog feel lucky that he has something abnormal growing inside him? It’s because I’m so glad that I paid attention to my instincts, listened to my dog, and found out what was wrong much, much earlier than I otherwise would have.

Let me explain.

I tend to be a non-worrier. At this point in my life, and after as many years as I’ve worked in veterinary hospitals, I’ve had a lot of dogs, and I’ve seen countless others. I’ve seen all manner of trauma, as well as chronic and acute illness. I’ve gotten very good at “wait and see.” Whereas some owners are vigilant to the point of scheduling an “emergency” appointment every time their dog sneezes or has soft stool, I tend to wait it out. In truth, many minor things do resolve on their own.

A little over three years ago, I lost my precious “heart dog,” a 12-year-old golden retriever named Ripley, to hemangiosarcoma. He’d been panting more and more over the preceding month, but…

Granted, hemangiosarcoma is nasty, fast-moving, and nearly impossible to catch in its early stages. But should I have listened to my instincts a little more?

With Ozark, it was nothing obvious or overly alarming. He seemed a bit more subdued than usual, but he’s a very mellow dog in general. He needed to go out twice during the night on Saturday, but that happens with dogs sometimes. He always eats snow, but he seemed to be eating it more. He threw up once on Tuesday. Dogs do that. There was no one thing to which I could point and say, “Hey, something is seriously wrong.” But I know my dogs, and my gut was telling me that there was more to it than his subtle symptoms might indicate.

I brought him to work on Wednesday, and his blood work was just a bit off. There were definite signs that his immune system was working on something. We took x-rays, and the mass on his spleen was evident. I immediately panicked, because since I lost Ripley to hemangiosarcoma, anything in my dog that doesn’t belong there is especially terrifying.

Today the ultrasound specialist came and took a good look at what was going on in Ozark’s innards. Given the situation, we got the best possible news. Yes, he has a baseball-sized mass on his spleen. But it appears to be very localized and contained, and there is no evidence of abnormalities in his other organs. It is almost certainly not hemangiosarcoma.

I am always reluctant to subject any of my dogs to surgery. I want to do the least-invasive thing, and keep treatments as natural as possible. But since Ozark is otherwise very sound, with no other underlying health issues, I’ve decided to go ahead and have the spleen removed and the mass biopsied. This will take place on Tuesday, January 19.

We still have no idea if the mass is benign or malignant, but even a benign growth can rupture (especially on the spleen, which is a vascular-rich organ) and the dog will quickly die of internal bleeding. It feels like a time bomb. Of course, if it is malignant, it will grow and spread. So we’ll remove the spleen, and if the mass turns out to be malignant, we will ultrasound again in a few months and see if we can detect any signs of metastasis to other organs. If it is benign, the splenectomy may be curative.

I’m still pretty scared. My dog has a tumor, and he’s going to have major abdominal surgery. That’s never good. Yet I’m glad I listened to that little voice that was telling me that something was “off.” I didn’t put it down as “Oh, he’s getting old,” or “He’s just feeling down with all the cold weather,” or “He must’ve eaten something that didn’t agree with him.” Something in his energy and demeanor, combined with his minor symptoms, and my deep knowledge of him told me it was something more.

It took me a while to arrive at my point, but here it is. Many people are hesitant to schedule an appointment for their pets when they start to feel that way. They don’t want to be a bother. They don’t want the doctor to think they’re over-reacting. They don’t want anyone to think they’re being paranoid or “one of those kinds of pet owners.” They are reluctant to spend the money. If you are one of those people… get over it! Nobody knows your pet better than you do. If something is telling you that something isn’t right, call your vet. Get an appointment. And go!

No, every time your pet vomits is not an emergency. Every time he has a bit of diarrhea it is not a symptom of serious illness. But when small things begin to add up, and you sense that something is wrong, don’t let anyone tell you to stop worrying and wait and see what happens.

Sure, sometimes it will turn out to be nothing. But sometimes it will turn out to be something, and the sooner you know what that something is, the more options you will have and the better chances you have of a successful treatment.

Truth In Advertising?

(Contributed by Dr. Jessica Levy)

Veterinary medicine has its quackbusters, just like human medicine. One of the veterinary news magazines has been publishing a series of articles by the quackbusters' current mouthpiece. Let's call her NR.

NR has written several long, rambling, nonsensical articles about various topics in alternative medicine. Honestly, this woman is such a poor writer; I don't know how she gets published. One of her recent statements was along the lines of how to tell the difference between a legitimate drug and a suspicious and bogus natural supplement. What's the difference? According to NR, the natural supplement will be represented solely by testimonials, as opposed to the drug, which is scientifically proven.

How many drug ads have you seen on TV lately?

Terry Gross interviewed Jane Lynch on National Public Radio's Fresh Air. Ms. Lynch mentioned that she had done a bit of commercial acting. Terry asked her which commercials she was in, to which Ms. Lynch replied, "Oh, I was the Nexium Lady." And the worst part was that everyone she met thought she actually had gastric reflux disease.

These drug ads? They are not real. They are "testimonials," except those everyman-looking people telling us, "I've had asthma for thirteen years," or "My COPD really used to slow me down," or "Now I'm Claritin clear" are actors. They are not the real people with the conditions that are being sold.

The Chantix ad features Lisa, a plain everywoman, with "Lisa is not an actor" on the bottom of the screen. This ad is fraudulent. Do you really think Lisa said, "Oh great pharmaceutical company, your drug is so wonderful, I will be happy to appear on national TV and tell everyone about it, and you don't have to pay me a dime!" Hell, no. I'm sure there is something in Lisa's contract that states "You Are Not An Actor," and Lisa signed it. There. See? She's NOT an actor.

Those are testimonials. And they're carefully crafted and directed... and they're fake.

Tuesday, December 29, 2009

My Dogs Can (And Do) Eat Nearly Anything

(Contributed by Lori Whitwam)

My dogs have Garbage Gut. And I couldn't be happier.

Sounds awful, doesn't it? But it's just an informal phrase that describes a dog who can eat nearly anything and not get digestive upset.

We've all been through it. The dog gets in the trash or snatches something from the counter, or we give them what we think is a "special treat," only to spend the next three days dealing with vomiting, diarrhea, or both. As disgusting and frustrating as that is, that's the mild end of the "dietary indiscretion" spectrum. Some dogs wind up with pancreatitis from the rich, fatty content of what they've eaten, and that can be life-threatening. (And not to mention expensive!)

How does a dog develop Garbage Gut? It's not an overnight process, by any means. Taking a dog who has been fed the same variety of processed kibble for years and suddenly giving them a lot of new foods is asking for the very digestive upset you're trying to avoid. Go slowly, introducing only one new thing at a time.

The key to having a dog with a hardy dietary constitution is variety. (Let me say that again: Variety!) We used to be told that it was best to find one brand of food, in a single variety such as chicken or lamb, that seemed to agree with our dogs' digestion... and stick with it.

There are several problems with that. First of all... boring. Even if you love Eggplant Parmesan more than any other food on the planet, do you want to eat it every single day for the rest of your life? Second, there is no one food that any of us, canine or human, can eat that will provide perfect, lifelong nutrition. Third, even if your dog never has a problem as the result of the processed kibble you've chosen (unlikely), sooner or later he is going to eat something he shouldn't. Chicken thawing on the counter. Steak bones in the trash. The semi-decomposed mole he finds behind the shed. He's a dog. He'll find it.

And then you have problems.

At Whole Health Veterinary, we strongly advocate a raw food diet. If convenience or expense are an issue (though feeding raw is no more expensive or difficult than feeding a premium grain-free kibble if you put some thought and planning into it), we recommend at least 50% raw food. But unless your dog has serious allergies to multiple grains or proteins, the other part of the equation is variety.

Let's take a look at what I feed my dogs. Ozark is a 10-year-old Great Pyrenees/Labrador mix, Darwin is a 5-year-old Golden Retriever, and Brody is a 4-year-old Great Pyrenees. That's nearly 300 pounds of dog. They are fed about 75% raw food and 25% premium grain-free dry food. They have healthy skin and soft, abundant coats. They have small, solid stool, and they don't have chronic ear or anal gland problems. Their teeth are beautiful.

For the grain-free dry, they get either Wellness Core (Ocean or Original), Fromm's Surf & Turf, Merrick Before Grain (chicken or buffalo), or Nature's Variety Instinct (chicken, rabbit, or duck).

Their raw food, when I "make my own," might include a mixture of whatever I find at the grocery store. Raw chicken parts (including necks, backs, wings, etc.), liver, ground turkey, ground beef or bison, gizzards, cottage cheese, yogurt, dark leafy greens, sweet potato, cranberry, carrot, whole egg... use your imagination!

But I don't cook for myself, so I don't make my own raw food that often. I prefer to rely on the prepared frozen or dehydrated raw diets. We use Nature's Variety (chicken, lamb, beef, rabbit, buffalo), Primal (duck, pheasant), or Bravo (chicken, turkey, or lamb) as far as raw frozen foods are concerned. The dehydrated raw by Honest Kitchen or Sojos are also big hits. Honest Kitchen Force, Embark, and Keen are often used, or the Sojos Complete.

These raw foods usually get a sprinkling of one of the kibbles, and any supplements the dogs might be taking, such as joint support.

I never offer the same raw or dry food/variety two bags or packages in a row. Today it might be Honest Kitchen Embark with a sprinkle of Fromm's Surf & Turf. When that's gone, it might be Sojos Complete with a bit of Wellness Core Ocean.

I don't give a lot of treats. I like the Stella & Chewy's Carnivore Crunch (beef, duck, or chicken), or the Stella & Chewy's freeze dried "steaks" in different varieties. Treats from your own table are okay, as long as they're not too fatty or heavily seasoned (yes, salt is a seasoning), and are not too frequent. Since I know I'm feeding my dogs very, very well, I find it easier to make my food "mine," and off limits other than an occasional special treat. It doesn't stop them from breathing hot doggy breath on my knee while I'm eating, but with three big, drooly dogs, I'd never get to eat any of my own meals if I start sharing.

If your dog still has digestive problems, we can look at adding a probiotic or other enteric support to the diet. But the truth is that a dog who is transitioned to a varied diet (especially raw) has a much stronger digestive constitution. He won't be as likely to become ill if (when!) he finds an entire, delicious, vulnerable, unguarded pizza in the kitchen. He is also getting a broad range of nutrients, adding to his overall wellness.

And - honestly! - it makes feeding them a lot more fun... for both of you!