Pet Owners Should Not Take “Natural” To The Point Of Absurd

I can appreciate pet owners who wish to feed their pets organic and natural food, pursue natural, side effect free alternative treatment options, and avoid chemicals, preservatives, and pesticides.  I try to do that for myself and my human and furry family as much as it is feasible.  As an integrative practitioner of veterinary medicine, I often attract these kinds of pet owners and enjoy a great working relationship with them most of the time.  There are occasions, however, when I deal with such naturally minded pet owners that draw a lines in the sand that defy common sense and venture into the realm of the absurd.

In a recent case of an 8 year old female boxer, I determined on a routine yearly visit had stage 3 out of 4 periodontal disease.  The owners were aware of the periodontal disease with their previous veterinarian having made dental recommendations as well, but until seeing me (they had just moved here from another state), the previous veterinarian had told them of the condition of the teeth but did not actually show them (so they told me, anyway).

She was a very good patient, so I was easily able to lift the lips and show the owners how decayed her teeth were with severe gum recession in many spots, tooth root exposure, and even pus along some of the gum margins.  I strongly recommended a professional dental cleaning and what would likely amount to several extractions for teeth beyond repair.

The owners were up front about their preference for natural treatment but to their credit, understood that no amount of enzyme/grapefruit seed extract dental sprays would fix these teeth.  We rran pre-anesthetic blood work which revealed that at an unusually young age, the boxer has significant kidney elevations that indicated chronic degenerative kidney disease.  I still recommend the dental because there is a direct correlation between chronic periodontal disease and acceleration of kidney failure in dogs and cats.  I would take the necessary precautions with my anesthesia protocol to maximize the patient’s safety.

The patient ultimately came through nicely through anesthesia, dental cleaning and oral surgery to removed several teeth.  At discharge, I discussed with the owners that I will circle back with them at the 2 week post-operative re-check to discuss dietary management as the primary means to manage chronic kidney failure in dogs.  The owner said that she would be back for the re-check, but the dietary discussion would not be necessary.  I was not quite sure at the time what the owner meant, but she quickly left and I got distracted with more discharges and forgot about her statement.

At re-check, I confirmed to the owner that all of the surgical sites had healed well and the gum infection had completely cleared.  I then turned the discussion to my recommendation of a prescription renal diet, as these diets are comprised of highly bioavailable protein sources (that are in turnassociated with minimal protein metabolic waste), restricted in sodium and phosphorus, and are fortified with antioxidants to combat toxins that accumulate in the body as a consequence of kidney failure.  All of these aspects of prescription diets for patients in kidney failure combat high blood pressure, reduce the work-load of the kidneys, and produce minimal toxins as metabolic waste that help to maintain quality of life and body condition.

The owner’s demeanor suddenly changed and she became defensive and reminded me that she had already told me that a discussion about diet was not necessary.  She went on to tell me that she and her husband are passionate about feeding raw meat and vegetables to their dogs and that they did not intend to vary from that.  She said that she could not justify intoxicating her dog with processed food and preservatives no matter the claims of the diet.

During circumstances like these, I generally have to take a moment to swallow, take a deep breath, allow my blood pressure to stabilize and collect myself; which I did.  I then patiently explained to her that I respect her passion for all things natural, but in this case, a prescription diet does have preservatives and is processed (since it is engineered to have exactly what a kidney failure dog needs to maintain quality of life and facilitate longevity), but the proteinaceous waste, sodium, and phosphorous levels her raw diet provided the dog would be far more harmful in disease progression than any preservatives or processing.  I offered this owner statistical data that clearly proved the benefit of prescription kidney sparing diets in dogs.

Alas, it was all to no avail.  While she seemed to listen and I thought I may have made a dent, she simply told me no thank you, she and her husband  did not believe in feeding processed food and preservatives to their dogs and that they are fully prepared to take their chances.

This is when I had to resist the temptation to bang my head against the wall as a wonderful boxer that could have had many months, even years, added to her life by simply being fed a special diet, walked out the door to have her life shortened and her quality lessened over her owner’s sheer narrow mindedness and stubbornness.

Natural and alternative medicine minded pet owners frequently complain – often rightfully so – that many veterinarians are dismissive of discussing or looking into natural alternatives to feeding and therapy, and are close minded and  focused on only traditional western veterinary medicine.  Unfortunately, integrative veterinarians that are not close minded, sometimes encounter the flip side to that coin with occasional owners such as the subject of this post, that are to too entrenched in their natural dogma to be reasonable…and the pet at no fault of her own is the one who suffers needlessly.

Dr. Roger Welton is a practicing veterinarian and highly regarded media personality through a number of topics and platforms.  In addition to being passionate about integrative veterinary medicine for which he is a nationally renowned expert, Dr. Welton was also an accomplished college lacrosse player and remains to this day very involved in the sport.  He is president of Maybeck Animal Hospital , runs the successful veterinary/animal health  blogs Web-DVM and Dr. Roger’s Holistic Veterinary Care, and fulfills his passion for lacrosse through his lacrosse and sport blog, The Creator’s Game.

 

Clarification Of What “Holistic Veterinary Medicine” Really Means

I recently posted on the Dr. Roger Holistic Vet Facebook page about the Canine Influenza H2N2 outbreak in my home state of Florida.  The article I posted came from my general veterinary blog at Web-DVM.net, since I do not like posting duplicate content on my respective blogs.  Nonetheless, I felt that this information was as important for my holistic veterinary blog as it was for my general veterinary blog.

The article presents the facts about the Canine Influenza virus’s high morbidity and educated owners about the risks of the disease and criteria for immunization, highlighting my own veterinary clinic’s immediate implementation of a Canine Influenza immunization program.  While publicly I did not get much backlash about the article, privately I have received disappointment that I would have a holistic veterinary website, call myself a holistic veterinarian, and yet promote a vaccination protocol for dog flu.  I would actually like to thank those readers for raising this issue, as it inspired this post to clarify what holistic veterinary medicine really means.

I consider the terms “integrative medicine” and “holistic medicine” to be synonymous and interchangeable.  Both terms suggest a combination of proven traditional western and alternative treatment to treat the “whole” patient; hence the term “hol-istic.”  Unfortunately, the term has morphed into the notion that holistic medicine rejects western medicine, immunization, and anything outside of herbal or otherwise natural treatment.  I want to be clear that if that is how someone interprets holistic veterinary medicine, that is one’s prerogative, but I will state right now that is clearly not my view nor is it my intent to suggest with this blog.

Holistic medicine seeks to refrain from drawing lines of strictly traditional or strictly alternative treatment in the care of the patient, to use the best available traditional western and alternative veterinary medical techniques that will advocate for the best outcomes for the patient.  Here is a typical example of how integrative veterinary medicine works and I put into practice:

I diagnose a cranial cruciate ligament tear in the knee of a dog.  I recommend surgery, because without surgically stabilizing the injured knee, it will always be painful and cause lameness.   The ligament will not heal on its own because ligaments have poor blood supply, the lack of which prevents healing cells to be delivered to effectively heal the tissue.  Following surgery, I will treat the dog with antibiotics to prevent infection, anti-inflammatories and opioids to reduce swelling and control pain.  This is the western aspect of the case management.

On the alternative side, I am going to recommend rehabilitation with class IV low level therapy laser, and polyglycated glycosaminoglycan (Adequan) injections.  The laser reduces pain by triggering the release of intrinsic endorphins locally, increases healing rates by dilating arterial blood vessels to bring in healing cells, reduces inflammation by dilating venous and lymphatic blood vessels to drain away inflammatory products and fluid.  The Adequan provides potent base molecular building blocks for the repair of connective tissues in the body, while increasing joint fluid production within joints.  This combination significantly reduces post-operative pain and increases post-operative healing rates by 40%.  For the long term, I recommend the post-operative CCL patent be maintained on pharmaceutical grade joints chews and omage-3-fatty acids for long term minimization of inflammation, and maintenance of musculoskeletal structures.

In a similar manner, whether it is an orthopedic case such as this or an internal medicine case, this is always my approach.  From the western traditional approach, I treat the disease directly.  As western techniques, whether surgical or medical, stabilize and reduce clinical signs of disease, I concurrently integrate alternative techniques that aid the body to ultimately do what it does best and heal itself.  The ultimate goal is to minimize the dependence on western surgery and medicine that sometimes comes with unwanted side effects and rely more on alternative techniques that by in large do not.

Dr. Roger Welton is a practicing veterinarian and highly regarded media personality through a number of topics and platforms.  In addition to being passionate about integrative veterinary medicine for which he is a nationally renowned expert, Dr. Welton was also an accomplished college lacrosse player and remains to this day very involved in the sport.  He is president of Maybeck Animal Hospital , runs the successful veterinary/animal health  blogs Web-DVM and Dr. Roger’s Holistic Veterinary Care, and fulfills his passion for lacrosse through his lacrosse and sport blog, The Creator’s Game.