New Scientific Findings in Homeopathy

 Our April 28, 2013 Facebook post (https://www.facebook.com/WilmingtonAnimalHospital?ref=hl#_=_)  showed me in a very brief video lecturing at the Academy of Veterinary Homeopathy (AVH) Annual Conference on updates in research in veterinary homeopathy. We had over 5500 views and numerous requests to learn more. As one who spends many hours each week reading (and enjoying this reading!) about the research findings, I am thrilled that the interest is so great!

My main concern about sharing the entire 20-page paper is that it is very technical, especially the basic science part which is the bulk of it. Many of my colleagues who practice homeopathy day in and day out commented about how they are glad that someone has gone to the trouble of understanding the research and taken the time to present it in a manner that they could somewhat comprehend. This stuff turns out to be based on physics, biology, pharmacology, physiology, nanoscience, neurology, immunology…and fields that combine a lot of these words like psychoneuroimmunology, nanopharmology and nanophysics.

So…I thought it would be kindest to present this material in two parts. The first is a very brief summary that follows immediately. The second is actually a summary written by my colleague Dr. Lisa Brienan. You can skip right to it, but it starts to get a bit technical so you may want to read the brief summary first. The original 20-page manuscript is the property of the AVH and is only available to veterinarians who are AVH members.

If you are interested in reading veterinary studies, you can visit my British colleague Mark Elliot’s website:

http://homeopathicvet.org/Veterinary_Research_into_Homeopathy/Welcome.html

Here it goes:

1. Homeopathic remedies are made by a process of dilution and succussion, or rigorous pounding/shaking. Widespread belief holds that homeopathy is no more than placebo effect because many remedies that are used are too diluted to have an effect. The assumption is based on the belief that there is no physical material that could provide a medicinal effect in high homeopathic dilutions.

2. However, there are many physicochemical studies on ultra-diluted and serially succussed solutions that have shown properties different from plain water.

3. With improvements in technology, researchers can now view nanoparticles (NP) of the starting bulk substance as well as glass-derived silicates in these solutions. High-speed videography has enabled visualization of these NPs as they are transferred from one container to the next in the dilution process.

4. Nanochemistry/physics has shown different physical properties of NPs compared to those of their starting bulk substance.

5. NPs, unlike larger pharmacologically-active substances, penetrate through the body’s usual barriers, like skin, the blood-brain barrier, the lining of the gut and airways.

6. Meanwhile, hormesis is a field of toxicology in which a low dose stressor- chemical, toxin, physical exposure like heat, etc.- stimulates the organism while a higher dose is toxic to it.

7. Homeopathic remedies may act via hormesis, specifically as post-exposure stressors.  In other words, homeopathic remedies may be hormetins. In other words, only small doses are actually needed to stimulate a healing response!

That’s the very brief version! Now for slightly more details, complements of Dr. Brienan:

Dr. Shelley Epstein shared the latest, cutting edge research related to homeopathy in Updates in Research in Veterinary Homeopathy.  This lecture was presented in two parts.  Part one detailed updates in basic science and part two outlined veterinary clinical trials.

We have moved well beyond whether homeopathy can be measured into being able to measure nanoparticle quality control issues among the starting homeopathic products; measure specific frequency differences between remedies and their potencies; measure variation in particle and aggregate size and shape; and measure elemental composition of the homeopathic particles.  Studies are finding out how nanoparticles remain dispersed in solution via the hypotheses that trituration generates nanofraction formation, lactose acts as stabilizer to prevent aggregation, dilution allows larger raw particles to settle out and nano-clusters to disperse freely in the medium.  Other research involves remedies as nanomedicines and how their dissolved silicate structures carry remedy information into the body.

She moved on to a discussion of hormesis and the stress response.  In hormesis, a phenomenon in the field of toxicology, there is an initial dose dependent toxicity response followed by a compensatory rebound response.  In this context homeopathy is a low dose stress (an initial action on the life force) which enhances repair and recovery (counteraction).  When a low dose stress is administered, the resulting compensatory biologic process also confers a protective effect against exposure to a subsequent more severe stress.

Dr. Epstein detailed the multiple pathways the body uses to respond to stressors and the resulting multi-factorial repair and return to function.  A balanced stress response network keeps the body functioning normally; however when there is an overwhelming accumulation of stressors, there is dysregulation in the stress response network and the body becomes stuck in chronic disease.

Back to the concept of homeopathy as nanoparticles; because of their properties of increased bioactivity and bioavailability, only a small quantity of remedy is needed to produce an effect.  This small quantity (low dose stressor) that causes a reparative response means that homeopathic remedies are hormetins. Also recall that the resulting compensatory response to a low dose stressor confers protection to future exposure of more severe stress…and may confer future protection to an unrelated stressor (cross-adaptation).

Further research by Bell and Koithan¹ has led to the model of Time Dependent Sensitization (TDS) – exposure to a hormetic agent (homeopathic remedy) initiates compensatory changes that amplify over time, do not require the continued presence of the initiating agent and are independent of specific pharmacological action on receptors.  In observing homeopathic treatment of fibromyalgia in people, repeated intermittent doses of individualized remedies amplified electroencephalographic alpha activity, reduced local pain and improved overall health.

In the discussion of veterinary clinical trials, Dr. Epstein outlined the challenges: how to demonstrate efficacy while following the principles of classical homeopathy (individualization of remedy prescription); prescriber skill; and the difficulty of the randomized clinical trial model (RCT) of one medicine for one diagnostic condition without consideration for comorbidities.  She outlined the ideal RCT for homeopathy including: “randomization and placebo or drug controlled; adequate number of test subjects to provide statistically meaningful results; individualization of prescription and ability to select from all available homeopathic remedies; adequate screening time to determine a similimum and medicine adjustment; adequate follow up to monitor decreased symptoms, remission and collateral health benefits.”  She finished with a series of clinical trials in different animal species in which remedy effects were clearly demonstrated and quantified.

¹Bell IR, Koithan M. A model for homeopathic remedy effects: low dose nanoparticles, allostatic cross-adaptation, and time-dependent sensitization in a complex adaptive system. BMC Complement Altern Med 2012;12(1):191 (Epub ahead of print] 

Things that go BOOM! in the Summertime: Thunderstorms and Fireworks

Summertime can really push the limits for many dogs with noise fears. Thunderstorms and fireworks alike can cause these dogs to shake, hide in bathtubs and closets, destroy things in the house, and in the worst cases, jump out of windows. Many of us just want to cuddle with our petrified buddy, although this is not possible when the thunderstorms occur while we’re at work.

We have many tricks up our sleeves for ameliorating dogs’ fears during these events. Here are some of them:

1. Composure by VetriScience. This is a natural and safe calming supplement that comes in a chewable form that dogs like. Its active ingredient is L-theanine, which is found in green tea and is what gives you that calm feeling after drinking it.  We carry this supplement at WAH.
2. Tight wraps like ThunderShirts. These take about 10 minutes to calm your dog. The ThunderShirt company claims a “dramatic calming effect for over 80% of dogs.” You can order this on-line.
3. Melatonin. This is a hormone that some people with insomnia take. It appears to have a beneficial effect in calming dogs with thunderstorm phobias. It is recommended to give it one hour before a storm for the most benefit. This is generally available at most stores that sell nutritional supplements.
4. Adaptil collar, diffuser, and spray. This is a product that mimics the natural pheromones that a bitch produces when she is nursing her pups. This hormone has a calming effect. The company is marketing it with thunderstorms and fireworks as indications for its use. We carry this product at WAH.
5. Addendum 6/26/13:  We've just learned of a product out of the U.K. called "de-stress and calming" by Pet Remedy.  Its active ingredient is valerian in a low concentration and it works via aromatherapy.  Anecdotally, many of Dr. Epstein's U.K. colleagues rave about this product.  It is available as a plug-in diffuser as well as in spray mist form.  You can order it on line but be sure you get the plug-in prongs that fit U.S. outlets!    
6. Addendum 8/20/13: We have the product and the preliminary reviews are very favorable! We are now carrying the aerosol plug-ins, a large spray bottle, and a tiny spray bottle.

Some dogs will do well with just one of the above measures, while others may require two or more. All are compatible with one another.

We do not generally recommend reaching for sedatives like acepromazine first, unless there is a real concern that the dog will harm himself or be destructive to your house. Most sedatives do nothing to relieve the fear, but they instead make the dog so drowsy that he will not be able to express his reaction as effectively.

At Wilmington Animal Hospital, we see many patients that suffer from noise fears and phobias. We are happy to discuss management of your dog’s specific thunderstorm, fireworks, and noise phobias. Please visit our website for more information on how to reach us: WilmingtonAnimalHospital.com.

Kennel Cough

 We’ve recently been experiencing a little uptick in the number of canine patients with kennel cough. This is a relatively benign cough, but it’s a major nuisance for the dog and its people.

“Kennel cough” is actually a catch-all term for any infectious cough that dogs get. Many organisms are known to cause it, ranging from viruses to bacteria. The affected dog has a cough that typically sounds like something is caught in his throat, and this cough usually ends with the dog gagging.  The dog usually feels fine and has good energy levels and appetite, but just suffers from this highly annoying cough. And the owners may be kept up at night listening to this cough!

Since this is spread from one dog to another when an infected dog coughs or sneezes on a susceptible dog, kennels are ideal environments for transmission. Of course, wherever dogs meet up with each other, kennel cough can be spread. While we see cases all year round from dogs that have boarded at kennels or spent time in daycare centers, many of our recent cases have come from dogs that play in the area’s dog parks. Less frequently, dogs can pick up kennel cough at the groomer’s.

It’s not easy to prevent kennel cough. It’s just like the common cold: you can eat right, exercise, and seem like the healthiest person around…until someone coughs or sneezes on you and you get sick. There are vaccines for kennel cough, but these are not always effective. At least ten or more organisms are known to cause kennel cough, and most vaccines only contain two to three of these agents.

The vaccine is most commonly given in the nose (“intranasally”) where it creates a low-grade infection that the immune system should, in theory, respond to. It can take at least a few days if not longer for the immune system to build up adequate resistance to these few germs. The most common problem we see is that owners get this vaccine last-minute- the same day the dog is due to enter a boarding kennel- and the dog has not had time to develop immunity before being exposed. In addition, this dog, when placed in a kennel without the rest of its pack (of humans), is stressed. Stress causes release of the hormone cortisol, which suppresses the immune system, which can make the dog get kennel cough from the vaccine! It’s not surprising that kennels that require this vaccine still experience many cases of kennel cough.

What can you do to try to prevent or treat kennel cough? Probiotics may help. These healthy bacteria can stimulate the production of the type of antibody that guards the respiratory tract. Studies in humans have shown that people who take probiotics at the onset of the common cold get over the cold much faster than those who do not take probiotics. It’s not a bad idea to put your dog on probiotics if you are going to board her, take her to daycare, or just socialize her frequently.

Homeopathic remedies can help sometimes. When the correct remedy is given, the coughing dog may return to normal within hours to a day.

Cough suppressants help in many cases. The over-the-counter versions tend to not be as effective as the prescription ones. Drowsiness is the major side effect, but sleep is restorative! We rarely prescribe antibiotics as these may actually prolong the course of the illness. We reserve antibiotics for dogs that are not in good health or have other problems that put them at higher risk for pneumonia.

Can I still board my dog if she has kennel cough? Sorry, no. The goal of every kennel is to prevent the appearance of this nuisance illness. If you know that your dog has kennel cough, you should not board your dog or take her to daycare or parks until she has been better for at least a week. Normal otherwise-healthy dogs who contract kennel cough typically get over it in 7-10 days. New dogs in the house may take up to a month to stop coughing. You will have to rearrange your plans, enlisting friends and family or hiring a professional pet sitter.

Kennel cough is an annoyance but rarely becomes serious in the healthy dog. If your dog shows signs of kennel cough, keep him away from other dogs and give him lots of TLC to speed the recovery.

Top 5 Myths that Vets Hear- Part 2

Top 5 Myths that Vets Hear- Part 2

By the Veterinarians at WAH

Myth #4: My cat/dog can’t have bad teeth because he’s eating just fine.

Animals don’t usually exhibit pain as obviously as we humans do. This is partially from instinctual reasons: to curl up in a ball and not move is to invite predators. But it’s also because we are just not keen enough to notice.

More often than not, they are showing us they are in pain or discomfort, but we just aren’t getting their clues.

When we do oral exams on our patients, we often find oral disease like pus along the gumline, receding gums with tooth root exposure, loose or fractured teeth, boney swelling, and erosions of the teeth along the gumline. Any or all of these would make for a very bad day for a person! But our cats and dogs show very subtle signs, like a decrease in activity, not hanging out with the family as much, chewing on one side of the mouth, or not wanting to grasp toys in the mouth. For some cats, urinating outside of the box or marking around the house is their way of saying, “I’m in chronic pain.” In most cases, unless the problem has reached a point where there’s an obvious abscess or broken jaw, the dog or cat continues to eat.

On the flip side, it is very common for us to hear from our clients that after the bad teeth were extracted, it was like they had a new cat or dog! We hear very commonly how clients had no idea that their pets were in so much discomfort and now the cat is back playing and hanging out with the owners every night, or the dog is playing tug-of-war again.

Myth #5: You can’t teach an old dog –or cat- new tricks.

Yes you can!  They just may take a little longer to learn.  When does this become important?

Many dogs, as they age, start to lose some housebreaking habits. Owners often come home to find accidents in the house, representing a behavior that had not been present since puppyhood.

The first step, of course, is to rule out or treat a medical reason for this. Meanwhile, patient re-training can be started. Just as with puppies, training involves all positive reinforcement: rewards outside for good behavior, pointing to the elimination and praising, letting the dog watch you clean it up. On the flip side, you have to ignore the indoor accidents in front of the dog- never let him see you clean it up, and don’t scold him or rub his nose in it.

Finally, don’t allow him the opportunity to do the wrong thing. This often entails confining him in certain areas of the house, restricting access to the newly minted accident areas, or even crating her.

When cats age, they often have special dietary requirements. Converting a cat that is addicted to a certain company’s flavor or texture of food, like only dry food, can be a challenge. And this challenge is magnified when other cats in the house transition to the improved diet at different rates, or when other cats have their own special dietary needs.

The good news is that you can train cats to eat in their own areas, and it will take just a few days. One of our technicians used to line up four cat carriers, each one designated for a specific cat. And they all learned within a few days to go into their specific carrier at mealtime. Dr. Epstein has three cats that eat at different paces, including one who has pills hidden in her food. At mealtime, they each go to a different location in the house (laundry room on top of the dryer, floor outside the laundry room door, and upstairs hallway).

These are just two examples of teaching old dogs and cats important new tricks. It just goes to show you that with age comes wisdom!

Final Moments: A Veterinarian’s Decision to Euthanize her Dog

By Lexie Hanna, VMD

October 30, 2012: Hurricane Sandy came in like a storm, forcing us to hunker down as a family and be together. We could not predict the outcome, but prepared for the unknown. Our beloved black Lab Brasco’s final days arrived in the same manner, and at the same time.

What started as some presumed muscular pain quickly turned into paralysis, anxiety, leaky urine and uncontrollable bowels. The cause became irrelevant at some point. After our MRI was cancelled twice due to the state of emergency from the hurricane, we stopped wondering and did the best that we could to help ease his pain at home. Since I’m a veterinarian and acupuncturist, this involved acupuncture, massage and heat therapy, in addition to pain medication. But he is not only my patient- he is “our boy.”

So we did what any parents good would do. We loved him, nursed him, “sling walked” him, gave him extra treats, and let him lick my husband’s head as much as he wanted, until even that became of little interest to him. We talked to family, friends, and colleagues, each of us trying to grasp what happened so quickly, and why.

A great colleague of mine finally gave me light. She asked if I would “go crazy” not “knowing” what he had. And eventually I realized I did not need to know. I just needed to be with our boy (he is next to me now as I write). We did not want to spend a good part of his last days driving in the bad weather to an unfamiliar place to have him anesthetized and put through the MRI machine, just for an answer. Not that that would have been wrong. My colleague eventually said, “just do what feels right in your heart, and no guilt!” I realized then: she is part vet, part therapist and part religious guide. In our profession, we must be all three at times.

So we bathed our boy (whose urine was now very strong smelling and dribbling on him constantly). We sat with him, hugged and loved him and allowed him to guide us. We can’t control what life brings. (And right now, it’s bringing our three young boys up from the basement screaming about some fight they just had). Ahh life. A rest. God’s rest. Perhaps this is what Brasco really needs.

Addendum:

Brasco was humanely euthanized on Halloween morning, October 31, 2012. He became so painful throughout the night that we knew we had to end his suffering. But the decision was not easy. I am sure many of you have faced these same challenges. Is there a “right” time, a “perfect” scenario? Unfortunately, the answer is usually no. It is a very individual decision. For some (including myself with a previous pet), euthanasia never feels “right,” and letting the animal go in it’s own time is the answer. Many of you come in asking for our advice on this very topic. Our role is to help guide you, support your decision and help maintain your companion animal’s quality of life to the best of our ability.

Euthanasia comes with many opinions, stereotypes and emotions. It is a very unique aspect of our job, and one that we do not take lightly. However, it has its place, and we feel humbled to be able to help owners and pets in the end of life process. So “no guilt!” Just listen to your heart, and do what is right and best for YOU and YOUR pet.

The Top 5 Myths that Vets Hear- Part 1

By the Veterinarians at WAH

Myth #1: My cat can’t have fleas because she lives inside.

Although her risk is much lower than that of a cat or dog who goes outside, she is still at risk. We suspect that the reason we see fleas on strictly indoor cats is 3-fold:

First, the cat may have come to you with one flea, impossible to find. That flea will lay 2000-3000 eggs in its lifetime! You can see how this effect will multiply!

Second, owners can carry fleas on them, usually from visiting a location that has a flea infestation. We’ve heard many stories over the years of cats developing flea problems after the owners have visited friends’ homes, and the friends’ pets were having flea problems.  As above, it only takes one pregnant flea…

Finally, and perhaps the most common reason for flea problems, is moving into a house that had previous pets- who had fleas. These little insects lie dormant in the carpeting and crevices of the floors, arrested in the pupa stage of their life cycle, waiting for their favorite hosts (cats and dogs) to move in. As soon as they sense the vibration of their normal hosts, the pupa will instantaneously molt and hop on the pet, setting up a nice, ongoing flea infestation on your cat or dog.

Myth #2: I can’t be overfeeding my dog because he’s always hungry.

It’s normal for dogs to be hungry. In fact, this is what drives their cousins the wolves to go out and seek prey. It’s what drives the wolves to steel portions of the prey from other dogs in the pack. It’s these wild instincts that drive your pet dog to counter surf and raid the trashcan while you’re at work!

But the domestic situation involves no demand to hunt to avoid starvation. Our beloved companions never go a day (or even a half a day!) without being served a meal. We have to be trained to work around that hunger drive so that we don’t make our dogs overweight!

What can you do? Just feed your dog to his requirements.

Do: Look at his weight: Is he too heavy or too thin? If the former, then decrease his portions. If the latter, then increase his portions.

Don’t: Go by the recommendations on the package! These are all designed so that no dog will starve!

Don’t: Go by your feeling of what seems like a good amount of food. Some of these foods are so low in water content and do calorically dense that even a small amount of, say, a grain-free dry food will actually cause your dog to gain weight. You may need to feed a very small amount of a high quality food in order to maintain your dog’s slim physique.

Do: Look at your dog’s energy and exercise levels. The more active the dog, the more she will need to consume.

Myth #3: I feed dry food to my cat because I was told it’s better for his teeth.

While some dry foods may have a slight edge over some canned foods in the dental tartar department, their other attributes make them unsuitable for feeding cats on a regular basis. What are these concerns?

First, dry cat food is too dry. It’s about 10% water, and cats need at least 80% water from their foods. This is the water content that is present in all the little creatures they eat in the wild. Even though they may drink more water than if they were eating canned foods, they still never drink enough water. We know this from studying their bloodwork and urine tests, which typically show borderline dehydration.

Second, since dry cat foods are essentially synthetic diets, (they are not mice, moles, and birds!), they contain a host of synthetic ingredients. The carbs and minerals deposit on the teeth in the form of plaque and tartar.

Third, we want your cat to eat a diet that is good for the whole cat, not just the cat’s teeth. That’s why we recommend high protein, grain-free canned or raw diets. The raw diets in particular contribute very little to dental tartar, and there are many safe commercial options available these days.

Stay tuned for The Top 5 Myths that Vets Hear-Part 2!

I Kidnapped My Cat (A Memoir of Taking My Cat to the Vet) by Shelley Epstein, VMD

Today, I kidnapped my cat. She was sleeping peacefully on my pillow when, from her perspective, I shoved her into a cat carrier. She won’t tell you that first I stroked her, apologized for the upcoming events, kissed her, then gently tried to coax her to voluntarily go into the carrier. When that didn’t work, I tried to scruff her by the neck, intending to gain control to gently place her hind feet first into the now-vertically-positioned carrier. But she defied that attempt by tensing her neck into the Scruffless Wonder version of my cat. Finally, with the carrier sitting on it’s back end, I just gently lifted her up and slowly lowered her, hind end first, into the carrier. Sometimes less is more.

Then began the 20-minute commute and her running commentary of her opinion of this.

I should tell you that her name is Ellie. She’s going to be 16 years old, and we had named her after Jodie Foster’s character Ellie from the movie “Contact.” Ellie was a strong-willed, intelligent, independent-minded character, and endearing like our precious Ellie.

Our Ellie is hyperthyroid. She requires twice-daily oral medication to keep her thyroid hormone levels normal, and, because she’s doing so well, travels only semi-annually for check-ups and bloodwork. She’s been this way for at least 3 years and leads a normal life: eating, sleeping, eating, sleeping, and looking disdainfully at the dogs when the opportunity arises. She actually is a great communicator, and has dozens of different meows that, believe it or not, I understand. We have entire conversations sometimes. I’m not sure I should repeat everything she said on the car ride to the vet today.

Regarding her vet, whom Ellie is quite fond of, I must provide full disclosure here. I am her vet.

Back to that car ride. 20 minutes of 10 times per minute meowing. I had the opening of the carrier facing me, and this allowed me to poke my finger in there to comfort her. One mile from the Marsh Road exit of I-95, Ellie laid her head on my finger and rested. For 2 minutes. Then the meowing resumed.

Once at WAH, she was a model patient. I was thrilled that her heart sounded great and her kidneys appeared to be functioning quite well. She cooperated wonderfully for the techs who drew her blood, and then rested quietly and unobtrusively in a cage until I finished work.  No surprise that she willingly got in the carrier for the return trip, and that the frequency of her meows decreased to just one or so a minute.

But Ellie’s a real sport. I think she knows I do this because I love her and want her to live forever. Once home, she ate her dinner immediately and resumed our normal conversations. As I type this, she’s asleep on the bed behind me, snoring.