WHEN BEST INTENTIONS DON’T PAVE THE WAY TO HEALTH
A myriad of troubling signs in an animal can be 80 percent diet-related.
JUST BECAUSE WE CAN USE NEW TECHNOLOGIES DOESN’T MEAN WE should. I know this from years of treating my patients, but it struck home as a result of a personal experience with my own dog, Orion.
Orion was a large white German shepherd/Labrador mix. He looked like a polar bear. Unfortunately, he suffered from hip dysplasia. Before he was even one year old, I had put Orion through three surgeries. At the time, I believed I was doing the best thing for him; after all, I was taking the medical advice from the top veterinarians at my vet school.
Four of the eight puppies in Orion’s litter had bad hips. Although they never underwent hip surgery, Orion’s brother and sisters had fewer joint problems and outlived him. Their owners couldn’t afford the surgeries and treatments. Instead they did what they could to maintain joint health at home—they kept the dogs thin and well exercised.
I, on the other hand, was given a vet student discount for the surgeries. Orion was fed the most current and veterinary recommended commercial dry food. It was very high in carbs in the form of corn and wheat. He received a procedure called a triple pelvic osteotomy, in which both hips were realigned and implanted with metal plates. I made sure he was vaccinated annually for everything. At the time, I didn’t realize that these measures may have been contributing to the inflammation in his joints and actually accelerating their deterioration. Today I would have handled Orion’s treatments differently. In retrospect, I suspect that my medical choices contributed to his early death.
My Orion, the white hunter, died prematurely of bone cancer at the age of eight. Realigning bone and placing metal implants is not a benign procedure. There is evidence that implants in the bone affect circulation and healing and possibly contribute to cancer. Back then, I never thought twice about the surgeries, and never considered a less invasive, nonsurgical approach for his genetically flawed hips. Today I would have a wholly different thought process. I would have managed his vaccines, medications, and joint condition using an integrative approach. If I had done so back then, perhaps Orion might have lived to sixteen years old, as his brother did.
In certain cases, however, surgery may be the only option. A client came to me for a second opinion after seeing several doctors to treat Bella, her seven-month-old puppy, who had a painful injured leg. She told me the diagnosis was a sprain, but somehow it didn’t make sense to her. The dog was in such pain no matter what position she was in—lying down, standing up, limping around—she would shake and flinch if you came near her. Her sweet, happy puppy had changed overnight into this cowering, agonized creature. Sprains can be painful, yes, but not to that degree. The owner’s common sense spoke to her and told her it was something more. Watching a dog in that much pain was unbearable to both of us.
Serious pain requires serious assessment. A high priority in veterinary medicine is alleviating pain.
After multiple radiographs emailed from one specialty clinic to another, all the vets still insisted it was a sprain. But I couldn’t let it go. Despite test results and the best of intentions, this dog was still in tremendous pain. I made one last-ditch effort. I phoned an old orthopedic vet friend and asked him to look at the X-rays. He called back quickly and said, “It’s subtle, but it’s a slipped physis. She’ll need surgery.” I felt a sense of relief. The dog’s traumatic injury had displaced the sensitive growth plate (physis) at the end of the femur bone—which is painful but repairable. I could finally relax, as I was confident that the surgery would be successful. Bella would recover and live a normal life.
When you have exhausted all possibilities, remember this—you haven’t.
—THOMAS EDISON
Exhausting all the wrong possibilities, even with the best intentions, can have a terrible outcome.
The most unnecessarily sick young dog I’ve ever seen was a German shepherd named Moonshine. Her cascade of serious problems seemed impossible, especially in one so young. She was barely a year old the first time I treated her.
Everything about Moonshine was the opposite of what would be expected in a young female German shepherd. She was a great dog with a great name who had great parents. But she was not feeling great in any way. She looked like one of my geriatric patients instead of a puppy. And her wonderful owners were impoverished by her medical bills. After they left my clinic that first day, I had to go into the back room and weep.
I was reminded of my early days as a veterinarian, when I was distressed about a trauma case. Raf, a senior tech, had taken me aside and said, “Barb, you need to get a man-heart!” He had a strong accent and a kind, man-heart himself. He worried about my ability to be dispassionate. I knew what he meant. But in this situation, even a man-heart couldn’t have stopped my tears.
In the exam room, Moonshine had flopped down on the floor like a marionette whose strings had been cut. She didn’t have the energy to be interested in anything, including me. (And most dogs tell me I have a great personality.) The fur on most of Moonshine’s face was missing. Her body’s hair coat was a patchwork of random dry hair, dandruff, and balding areas. She was potbellied and moderately overweight. Cauliflower-like growths covered her tongue and gums and her feet. Fist-sized calcified lumps on her shoulders and hips had recently abscessed. One was draining a foul-smelling thick tan liquid. Her left foot and ankle were swollen and hot. The fur around her rear end smelled like feces. The owners told me that she had never had normal stools.
The owners were a young, hardworking couple named Sara and Paul. Paul was the one who brought her in that first time. His haggard face reflected the pain of Moonshine’s illnesses and his sadness over the fact that he was sure they were losing her. He took a deep breath before starting in on the sad story. They had spent thousands of dollars and seen several doctors, but she was not responding to any treatment. They were thinking seriously about euthanasia when a receptionist at their vet clinic had recommended they come and see me. She had been to one of my lectures and had heard my clients describing how I often helped in situations that seemed hopeless. And Moonshine was the poster dog for difficult cases. “Before you decide,” the receptionist had said, “get a second opinion from Dr. Royal.”
We discussed Moonshine’s medications, including an immunosuppressive medication, steroids, antibiotics, and pain meds. Paul described the taxing schedule of waking up at 4 A.M. every day so that he and his wife could give the drugs to Moonshine according to the prescriptions. Paul, a fireman, and Sara, a radiologist, both worked full days and then struggled to keep up with the care of this dog that they both obviously loved. Many diets and prescription foods had been tried, but Moonshine never responded to them well. She suffered from chronic gastrointestinal distress.
Paul recited a litany of her diseases: MRSA (methicillin-resistant Staphylococcus aureus), osteomyelitis, demodectic mange, inflammatory bowel disease, calcinosis cutis, generalized muscle-wasting, anorexia, arthritis, abscesses, joint malformation, urine and fecal incontinence, and the worst case of viral papilloma anyone had ever seen. This relatively benign virus usually causes small papillomas, or cauliflower-like growths on the gums or tongue, which tend to disappear on their own. In her case, the growths were so numerous that she was having trouble walking. A vet had surgically removed seventeen of them from her feet. Because of the growths on her tongue and lips and the open sores in her mouth, she could barely eat.
MRSA, a frighteningly resistant yet increasingly common bacteria, had led to a serious bone infection in Moonshine’s left rear leg. That was the reason her leg was swelling. A bone infection of this kind can be deadly and was one of the reasons for the several antibiotics she was on. As a matter of fact, when I started seeing Moonshine, she was on fourteen different medications/supplements: chloramphenicol (strong antibiotic), enrofloxacin (antibiotic), metronidazole (gastrointestinal antibiotic), omeprazole (gastric reflux/proton pump inhibitor), mirtazipine (antidepressant, used as appetite stimulant in animals), prednisone (corticosteroid to treat her inflamed bowel), azothioprine (an immunosuppressive drug also used in organ transplants), oxychlorine compound spray (against MRSA infections), omega 3 and 6 fatty acid supplement (antioxidant), tramadol (a narcotic-like pain-reliever), ondansetron (to prevent nausea and vomiting caused by medications or chemo), Mitaban dips (baths to kill mites), vitamins, and probiotic capsules.
There were medicines to help her immune system fight the infections, and some that suppressed her immune system. There were medications to kill mites, and some that caused overgrowth of mites. The medication to help her pain and make it easier to walk also caused her to be nearly completely sedated. The extensive medication chart the owners showed me was like something out of NASA. No wonder pharmaceutical companies are thriving.
Her skin had a condition called demodectic mange, which is hair loss as a result of mites. A normal inhabitant of the skin, demodex mites are kept at bay by a healthy immune system. But sick animals and animals on immunosuppressants such as prednisone can develop demodectic mange. The weekly Mitaban dips, used to treat mange, made Moonshine so ill that she was hospitalized for a few days after each treatment. She had already had four dips and vets said she still needed five more. Paul and Sara were terrified about doing them again.
Although Moonshine was on steroids and a chemo drug to decrease inflammation in her GI tract, she had chronic loose stools. Surgical biopsies of her GI tract had confirmed an inflammatory bowel condition. I could have told them without surgery that her bowel was inflamed.
In addition, the medications made her drink and urinate excessively. Keeping up with her need to go out was difficult; she had many accidents in the house. The steroids had also caused calcinosis cutis, or golf-ball-sized firm, calcified lumps, under the dermal layer on her hips and shoulders. Calcified lumps would appear at the site of any trauma to the skin.
Faulty thinking can compound signs of ill health.
Paul and Sara were exhausted and discouraged. The surgeries, medications, and hospitalization were terribly expensive. And no one knew why she wasn’t responding to all this medical care. They were not sure how much more they could do. I knew the goal was to do less, much less, and let Moonshine’s natural immune system do more. I just had to uncover her immune system.
I went over the multiple diagnoses in my head. It was like recalling a medical textbook. I looked up at them and said gently, “Let’s not forget there’s an animal here—not just those diseases—and her name is Moonshine.” Paul tried to hold back his tears. I felt like crying with him.
We had our work cut out for us. After just a fecal test and an in-house blood test, we uncovered two curable factors contributing to her severe imbalances. We found giardia, a debilitating fecal parasite, in her fecal sample. We also found that her thyroid function was severely low. A comprehensive plan to restore and maintain her health was the next step. And we did have several things in our favor. Youth was on her side, and even in her exhausted state I sensed hidden stores of energy that could be tapped. And we had more tools than the average veterinary clinic.
No amount of antibiotics, hospitalization, or supplements can stop any serious infection if the body’s own immune system can’t pitch in. The body needs soldiers to fight the war. Without a defensive army, there may be plenty of ammunition but no one to guide it. Restoring health requires appropriate nutrition and all systems go—endocrine, circulation, and immune—as well as a working metabolism.
Moonshine may have started out with a bad genetic throw of the dice, but she was also being hobbled by a parasite, and the side effects and secondary diseases from a poor diet and all the medications she was on. In addition, she had none of the advantages of her own natural healing powers because of her undiagnosed, severely low thyroid function. Normal thyroid function would work to help fight these infections and regulate her GI function and development. The side effects from the medications to treat those infections were also taking their toll on her compromised immune system.
Healing is all about timing.
I decided which medicines I could safely wean her off of to improve her immune system. We needed to rebuild this puppy from her scarred toes to her naked nose. Unlike conventional medicine, integrative medicine adroitly manages Western and Eastern supplements to improve the immune system and support innate healing.
Uncovering the onset of disease, instead of naming the disease, is half the battle.
Moonshine’s Royal Treatment
Diet change—from kibble to pre-prepared raw foods (Stella and Chewy’s and Darwin’s brands)
Panacur for her giardia parasite
Bath and sanitary haircut over her rear
Full Hemopet thyroid panel (Moonshine had never been properly tested) to fully determine her thyroid status
Acupuncture
Warm compresses on left rear leg
Dimethyl sulfoxide (DMSO) absorbs quickly through the skin and is anti-inflammatory, antioxidant, and an analgesic—specifically effective in breaking down calcified lesions
Discontinue immunosuppressive medication
Decrease other medications one by one
Discontinue Mitaban dips
Add supplements to support immune and liver function, thyroid, skin, and GI health
As it turned out, Moonshine exceeded all my expectations. Literally one week into her new treatment healing regimen, the owners came in with a changed dog. With the new diet of pre-prepared raw food and just a few supplements, she had normal stool. She was much more energetic; she even played with their other dog. And the full thyroid results hadn’t even come back. The owners seemed stunned. They almost couldn’t believe that a noninvasive treatment, involving fewer medications, had caused such a quick, dramatic improvement in Moonshine. For me the transformation was more than what I had hoped for. It was a great sign. Her body was stepping up to the plate, and the plate was filled with what she needed.
Two weeks later, her thyroid supplement on board, Moonshine bounded into the clinic. With unbridled energy and enthusiasm, she ran back to my desk to find me. My entire staff, while accustomed to radical turnarounds, was astonished. I only had to look at all the smiling faces to fully appreciate the impact Moonshine’s recovery was having on all of us.
I was particularly struck with how Moonshine’s owners appeared.
OVERWHELMED WITH
GOOD AND BAD INFORMATION?
When evaluating a plan of action for your pet’s health, answer these questions:
Is it working?
Do you have enough time, information, and money to feasibly follow the plan?
Is there an overwhelming amount of conflicting information about the treatment?
Does it make sense to you on a basic level?
Are you constantly worrying and wishing that there were a better course of action?
Their haggard look had been replaced with a glow. They were relaxed enough to joke with each other. Their Moonshine was a new dog. She was recovering against all odds—and the odds against her were formidable, and to my mind, almost entirely human-created. She nuzzled her nose into everything, and acted her puppy age for the first time. She had become the bright Moonshine that nature intended her to be.
The owners were thrilled by her progress in the next two weeks, but three weeks later her condition took a new turn. She looked terrific in every way except for her left rear leg, which had an open sore, right over the MRSA-infected bone, oozing blood-tinged, foul-smelling pus. I cultured the sore and found an arsenal of scary bacteria. Was she regressing?
I explained to Moonshine’s owners that the body has its own ways to rid itself of infection. The sores could, in fact, be yet another sign of improvement. It was similar to her hair coat growing in, weight loss, improved energy, and normal stools for the first time in her life. In the face of everything going in the right direction, I could not believe this sign was a cause for worry. She was so much better overall. We repeated X-rays to rule out something more sinister in the underlying infected bones. The bone integrity looked the same and maybe even a little better. We would monitor her closely, but we weren’t going to add any medications or change course just yet.
Paul asked me a long question that had a short answer. He asked why it was that Moonshine had been treated for so many diseases, biopsied, and shown to have irritable bowel disease and would need to be on medication the rest of her life, but now, within a few weeks of seeing me, her stool was normal without medication, her hair was growing back, her papilloma growths were completely gone, we were weaning her off other medications, and she was a completely different, healthy dog.
My answer was that the body wants to heal. “We gave her the tools it needed to heal itself,” I said as I showed him how to place warm packs over the leg where the ulcer was.
Over the next few days, the sore finished seeping. We did one more culture of the areas where the MRSA was. This time there was not a single horrifying bacterium to be found. The MRSA infection seemed to have resolved. However, I still wanted her to remain on antibiotics for a few more weeks.
Six weeks later, Moonshine glowed with health. The hair on her face and body had regrown, her foot swelling was gone, and the calcified lumps on her shoulders were barely noticeable. Today she is beautiful, energetic, bouncy, and affectionate. When her owners Paul and Sara cry, it is for joy.
Moonshine had been on the brink of death, and the aggressive state-of-the-art interventions of Western medicine not only couldn’t save her, but they hastened her decline. In her case, it was time to take a step back to activate and support her body’s own healing capacity.
The Royal Treatment Approach
Good species-appropriate diet
Assess the underlying systems that support the health of the pet
Assess all body functions
Assess proper mental, physical, and emotional stimulation
Minimize meds where possible
Weigh treatment options carefully
Use pharmaceutical medicines or invasive procedures only when other options are exhausted or in emergencies
When faced with a medical decision about your pet, ask
What has obstructed the natural wild health in my pet?
What can I provide that will further the health in my pet?
Is medical intervention necessary?
Is what I’m doing too expensive/time-consuming/exhausting?
Would it be better to use an alternative approach?
Can I improve on my pet’s nutrition?
Do we need to act quickly or is there time for more slow-acting measures?
The more we understand wild health, the more we will be able to discern which medical interventions are necessary, which are not necessary, and what the alternatives are.
No intervention can sustain health without a proper foundation that activates an animal’s own healing systems.
On the other hand . . .
Clara and Michael’s first words to me were “We came to you because we refuse to use any more Western medicine for Forrest.” Their Chinese crested dog had been having fifteen seizures per day since June. It was November. Forrest was frail and nervous and didn’t make any eye contact. He had two mild seizures during our initial hourlong visit. Clara and Michael didn’t think that I could help, but they were still hoping for a miracle from alternative medicine. Forrest had been given his annual rabies, distemper combo, and leptospirosis vaccines in June. Several days later the seizures started. A neurology specialist started him on phenobarbitol and then recently added potassium bromide (KBr) for his seizures, but they continued unabated. No one knew why they had even started.
I had to explain to Clara and Michael why integrating Western medicine with an alternative approach was the best way forward. I treated him the way I treat vaccine reactions. The thrust of the treatment was to stop inflammation and to detoxify the system. I continued giving the phenobarbitol but stopped the KBr because it didn’t seem that either of them was really working anyway. I planned to slowly wean Forrest off the phenobarb as well. I added one more Western medication: prednisone, a strong anti-inflammatory agent. It can be used to help decrease an inflammatory response, in this case to vaccines. It had been a long time since June, but I had to try.
From my alternative bag I used: acupuncture, homeopathic detox supplements (thuja and lyssin), liver support for detox (milk thistle, turmeric, and omega-3 fatty acid), and an anti-inflammatory diet (Darwin’s commercial raw dog food).
Within one week Forrest was having fewer than one seizure per day. Within two weeks they had completely stopped. We slowly decreased the phenobarbitol and even then he had no seizures.
His behavior changed, he became more sociable and energetic, and became more interested in playing with his brother. It took a mix of Western medications and alternative medicine to help fix the problems caused by Western medications. I believe in using what works.