RICKETTSIAL DISEASES RICKETTSIAL DISEASESPrincipal Natural Treatments
Omega-3 fatty acids, antioxidants
Other Natural Treatment
Alfalfa, aloe vera, astragalus, burdock, dandelion leaf, dandelion root, echinacea, garlic, ginseng, goldenseal, hawthorn, licorice, marshmallow, milk thistle, nettle, red clover, St. John’s wort, turmeric, yellow dock, homeopathic nosodes
Rickettsial diseases are those caused by rickettsia, microscopic organisms that are not quite bacteria and not quite viruses. In dogs, the most common rickettsial diseases are ehrlichiosis, Lyme disease, and Rocky Mountain spotted fever. The rickettsial organisms that cause each of these diseases are carried by ticks and transmitted to the pet within 24 hours after the tick bites and attaches to the pet. Tick control is useful to decrease the spread of these diseases. Rickettsial diseases are zoonotic, meaning they can be transmitted to people. However, an infected pet can only transmit the disease to a person through a tick bite and not by directly infecting the person itself. Tick control is therefore important to decrease the chance of spreading the disease to the pet owner as well.
Clinical signs vary with the specific disease. Listed below are common types and symptoms.
Ehrlichiosis. Clinical signs are varied and may include fever, lack of appetite, anemia (pale gums), decreased platelet count, weight loss, abdominal pain, enlarged lymph nodes, enlarged spleen, difficulty breathing, swollen joints, eye abnormalities (blindness, redness, cloudiness of the cornea), discharge from the eyes, and diarrhea.
Lyme Disease. Clinical signs can include swollen and painful joints, enlarged lymph nodes, fever, change in personality, and seizures.
Rocky Mountain Spotted Fever. Clinical signs are varied and are almost identical to those seen in dogs with ehrlichiosis. The signs may include fever, lack of appetite, anemia (pale gums), decreased platelet count, weight loss, abdominal pain, enlarged lymph nodes, enlarged spleen, difficulty breathing, swollen joints, eye abnormalities (blindness, redness, cloudiness of the cornea), discharge from the eyes, and diarrhea.
Omega-3 fatty acids—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—are derived from fish oils of coldwater fish (salmon, trout, or most commonly menhaden fish) and flaxseed. Omega-6 fatty acids—linoleic acid (LA) and gamma-linolenic acid (GLA)—are derived from the oils of seeds such as evening primrose, black currant, and borage. Often, fatty acids are added to the diet with other supplements to attain an additive effect.
Just how do the fatty acids work to help in controlling inflammation in pets? Cell membranes contain phospholipids. When membrane injury occurs, an enzyme acts on the phospholipids in the cell membranes to produce fatty acids including arachidonic acid (an omega-6 fatty acid) and eicosapentaenoic acid (an omega-3 fatty acid). Further metabolism of the arachidonic acid and eicosapentaenoic acid by additional enzymes (the lipooxygenase and cyclooxygenase pathways) yields the production of chemicals called eicosanoids. The eicosanoids produced by metabolism of arachidonic acid are pro-inflammatory and cause inflammation, suppress the immune system, and cause platelets to aggregate and clot; the eicosanoids produced by metabolism of eicosapentaenoic acid are non-inflammatory, not immunosuppressive, and help inhibit platelets from clotting. There is some overlap and the actual biochemical pathway is a bit more complicated than I have suggested here. For example, one of the by-products of omega-6 fatty acid metabolism is Prostaglandin E1, which is anti-inflammatory. This is one reason why some research has shown that using certain omega-6 fatty acids can also act to limit inflammation.)
Supplementation of the diet with omega-3 fatty acids works in this biochemical reaction. By providing extra amounts of these noninflammatory compounds, we try to overwhelm the body with the production of non-inflammatory eicosanoids. Therefore, since the same enzymes metabolize both omega-3 and omega-6 fatty acids, and since metabolism of the omega-6 fatty acids tend to cause inflammation (with the exception of Prostaglandin E1 by metabolism of omega-6 as mentioned above), by supplying a large amount of omega-3 fatty acids we favor the production of non-inflammatory chemicals.
Many disorders are due to overproduction of the eicosanoids responsible for producing inflammation. Fatty acid supplementation may be beneficial in inflammatory disorders by regulating the eicosanoid production, although controlled studies are lacking.
In general, the products of omega-3 (specifically EPA) and one omega-6 fatty acid (DGLA) are less inflammatory than the products of arachidonic acid (another omega-6 fatty acid). By changing dietary fatty acid consumption, we can change eicosanoid production right at the cellular level and try to modify (decrease) inflammation within the body. By providing the proper (anti-inflammatory) fatty acids, we can use fatty acids as an anti-inflammatory substance. However, since the products of omega-6 fatty acid metabolism (specifically arachidonic acid) are not the sole cause of the inflammation, fatty acid therapy is rarely effective as the sole therapy but is used as an adjunct therapy to achieve an additive effect.
Note: Flaxseed oil is a popular source of alphalinoleic acid (ALA), an omega-3 fatty acid that is ultimately converted to EPA and DHA. However, many species of pets (probably including dogs) and some people cannot convert ALA to these other more active non-inflammatory omega-3 fatty acids. In one study in people, flaxseed oil was ineffective in reducing symptoms or raising levels of EPA and DHA. While flaxseed oil has been suggested as a less smelly substitute for fish oil, there is no evidence that it is effective when used for the same therapeutic purposes as fish oil. Therefore, supplementation with EPA and DHA is important, and this is the reason flaxseed oil is not recommended as the sole fatty acid supplement for pets. Flaxseed oil can be used to provide ALA and as a coat conditioner.
What is the “best” dose to use in the treatment of pets? Most doctors use anywhere from 2 to 10 times the label dose. Research in the treatment of allergies indicates that the label dose is ineffective; higher doses may also be indicated in pets with ricketssial diseases. In people, the dosage that showed effectiveness in many studies were 1.4 to 2.8 gm of GLA per day, or 1.7 gm of EPA and 0.9 gm of DHA per day, which is hard for people to obtain from the supplements currently available. If this were shown to be the correct dosage for pets, a 50-pound dog would need to take 10 or more fatty acid capsules per day to obtain a similar dosage, depending upon which supplement (and there are many choices on the market) was used. Therefore, while the studies with omega-3 fatty acids show many potential health benefits, it is almost impossible to administer the large number of capsules needed to approximate the same dosage used in these studies. The best that owners can hope for at this time is to work with their veterinarians and try to increase, as best as possible, the amount of omega-3 fatty acids in the diet to try to get to what seems to be the “preferred” ratio of 5:1, omega-6:omega-3 fatty acids.
What is the “correct” fatty acid to use? Should we use just omega-3 (EPA and DHA) fatty acids, or combine them with omega-6 (GLA) fatty acids? Is there an “ideal” ratio of omega-6 to omega-3 fatty acids? (Research on pets with atopic dermatitis suggests that the ideal dietary ratio seems to be 5:1 of omega-6:omega-3 fatty acids, although this is also debated.)
Is supplementation with fatty acid capsules or liquids the best approach, or is dietary manipulation (adding the “ideal” ratio of omega-6 and omega-3 fatty acids) preferred for the treatment of inflammatory conditions? There are in fact, diets constructed with this “ideal” ratio. For owners who do not like giving their pets medication, or for those pets who don’t take the fatty acid supplements easily, it might be wise to try some of these medically formulated diets (available from your pet’s doctor) that contain the fatty acids. However, because these medicated diets may not be as natural as possible due to the inclusion of by-products and chemical preservatives, holistic pet owners may need to try other options.
Fish Oils Since fish oils can easily oxidize and become rancid, some manufacturers add vitamin E to fish oil capsules and liquid products to keep the oil from spoiling (others remove oxygen from the capsule.)
Since processed foods have increased omega-6 fatty acids and decreased omega-3 fatty acids, supplementing the diets of all pets with omega-3 fatty acids seems warranted and will not harm your pet.
The bottom line is that there are many questions regarding the use of fatty acid therapy. More research is needed to determine the effectiveness of the fatty acids in the treatment of various medical problems, as well as the proper doses needed to achieve clinical results. Until definitive answers are obtained, you will need to work with your doctors (knowing the limitations of our current research) to determine the use of these supplements for your pet.
Fish oil appears to be safe. The most common side effect seen in people and pets is a fish odor to the breath or the skin.
Because fish oil has a mild “blood-thinning” effect, it should not be combined with powerful blood-thinning medications, such as Coumadin (warfarin) or heparin, except on a veterinarian’s advice. Fish oil does not seem to cause bleeding problems when it is taken by itself at commonly recommended dosages. Also, fish oil does not appear to raise blood sugar levels in people or pets with diabetes.
Flaxseed Oil Flaxseed oil is derived from the seeds of the flax plant and has been proposed as a less smelly alternative to fish oil. Flaxseed oil contains alpha-linolenic acid (ALA), an omega-3 fatty acid that is ultimately converted to EPA and DHA. In fact, flaxseed oil contains higher levels of omega-3 fatty acids (ALA) than fish oil. It also contains omega-6 fatty acids.
As mentioned, many species of pets (probably including dogs and cats) and some people cannot convert ALA to these other more active non-inflammatory omega-3 fatty acids. In one study in people, flaxseed oil was ineffective in reducing symptoms or raising levels of EPA and DHA. While flaxseed oil has been suggested as a substitute for fish oil, there is no evidence that it is effective when used for the same therapeutic purposes as fish oil. Unlike the case for fish oil, there is little evidence that flaxseed oil is effective for any specific therapeutic purpose.
Therefore, supplementation with EPA and DHA is important, and this is the reason flaxseed oil is not recommended as the sole fatty acid supplement for pets. Flaxseed oil can be used to provide ALA and as a coat conditioner.
Flaxseed oil also does contain lignans, which are currently being studied for use in preventing cancer in people.
The essential fatty acids in flax can be damaged by exposure to heat, light, and oxygen (essentially, they become rancid). For this reason, you shouldn’t cook with flaxseed oil. A good product should be sold in an opaque container, and the manufacturing process should keep the temperature under 100° F (some products are prepared by cold extraction methods). Some manufacturers combine the product with vitamin E because it helps prevent rancidity.
The best use of flaxseed oil is as a general nutritional supplement to provide essential fatty acids.
Flaxseed oil appears to be a safe nutritional supplement when used as recommended.
Certain vitamins and minerals function in the body to reduce oxidation. Oxidation is a chemical process that occurs within the body’s cells. After oxidation occurs, certain by-products such as peroxides and “free radicals” accumulate. These cellular by-products are toxic to the cells and surrounding tissue. The body removes these by-products by producing additional chemicals called antioxidants that combat these oxidizing chemicals.
In disease, excess oxidation can occur and the body’s normal antioxidant abilities are overwhelmed. This is where supplying antioxidants can help. By giving your pet’s body extra antioxidants, it may be possible to neutralize the harmful by-products of cellular oxidation.
Several antioxidants can be used to supplement pets. Most commonly, the antioxidant vitamins A, C, and E and the minerals selenium, manganese, and zinc are prescribed. Other antioxidants, including N-acetylcysteine, Coenzyme Q10, Ginkgo biloba, bilberry, grape seed extract, and pycnogenol may also be helpful for a number of disorders.
There is no “correct” antioxidant to use. Dosage varies with the specific antioxidant chosen.
Following is a brief discussion of a commonly used group of antioxidants called bioflavonoids/proanthocyanidins; see the specific pages listed previously for information on other antioxidants.
Proanthocyanidins (also called pycnogenols or bioflavonoids; while they don’t seem to be essential to life, it’s likely that people and pets need them for optimal health) are naturally occuring polyphenolic compounds found in plants. Most often products containing proanthocyanidins are made from grape seed or pine bark. These compounds are used for their antioxidant effects against lipid (fat) peroxidation. Proanthocyanidins also inhibit the enzyme cyclooxygenase (the same enzyme inhibited by aspirin and other nonsteroidal medications); cyclooxygenase converts arachidonic acid into chemicals (leukotrienes and prostaglandins) which contribute to inflammation and allergic reactions. Proanthocyanidins also decrease histamine release from cells by inhibiting several enzymes.
Some research suggests that pycnogenol seems to work by enhancing the effects of another antioxidant, vitamin C. Other research suggests that the bioflavonoids can work independently of other antioxidants; as is the case with many supplements, there probably is an additive effect when multiple antioxidants are combined. People taking pycnogenol often report feeling better and having more energy; this “side effect” may possibly occur in our pets as well.
Quercetin is a natural antioxidant bioflavonoid found in red wine, grapefruit, onions, apples, black tea, and, in lesser amounts, in leafy green vegetables and beans. Quercetin protects cells in the body from damage by free radicals and stabilizes collagen in blood vessels.
Quercetin supplements are available in pill and tablet form. One problem with them, however, is that they don’t seem to be well absorbed by the body. A special form called quercetin chalcone appears to be better absorbed.
Quercetin appears to be quite safe. Maximum safe dosages for young children, women who are pregnant or nursing, or those with serious liver or kidney disease have not been established; similar precautions are probably warranted in pets.
In people, a typical dosage of proanthocyanidins is 200 to 400 mg 3 times daily. Quercetin may be better absorbed if taken on an empty stomach. The suggested dosage of proanthocyanidin complex in pets is 10 to 200 mg given daily (divided into 2 to 3 doses). The suggested dosage of biflavonoid complex in pets is 200 to 1,500 mg per day (divided into 2 to 3 doses). The actual dosage of each product will vary with the product and the pet’s weight and disease condition.
While there is no specific research showing benefit in specific rickettsial diseases, the use of antioxidants is widely recommended by holistic veterinarians to reduce oxidative damage to tissues that may occur. More research on antioxidants and other complementary therapies in the treatment of rickettsial diseases is needed.
The herbs alfalfa, aloe vera, astragalus, burdock, dandelion leaf, dandelion root, echinacea, garlic, ginseng, goldenseal, hawthorn, licorice, marshmallow, milk thistle, nettle, red clover, St. John’s wort, turmeric, yellow dock; the glycoprotein acemannan, and homeopathic nosodes may each be helpful.
These can be used in conjunction with conventional therapies, as they are unlikely to be effective by themselves in most patients. The natural treatments are widely used with variable success but have not all been thoroughly investigated and proven at this time.
As with any condition, the most healthful natural diet will improve the pet’s overall health.
Tetracyclines such as doxycycline are the treatment of choice and generally will cure most cases. For pets that are critically ill, hospitalization with intravenous fluid therapy, transfusions, and force feeding are necessary.