Mount Calvary Cemetery Group held a memorial service on June 5th 2013 in Cheektowaga, New York. Lap of Love’s Dr. Steven Schultz had a booth at the event where is wife Sara, a hospice chaplain also provided the music and singing. More than 60 people attended the ceremony and were able to memorialize their loved pet friends as well as light candles. It was a lovely event and we were honored to be apart of it.
In recent years there has been an increasing interest in a return to a more natural lifestyle, including organic, unprocessed diets, fewer medications, natural fiber clothing, and a simpler lifestyle to name only a few lifestyle changes. In a similar vein, people have looked to treating their pets in a more holistic manner.
What are natural pet therapies? Natural pet medicine, also known as complementary medicine, alternative medicine, or holistic medicine is a form of veterinary medicine that encompasses many modalities which emphasize the use of simple, unprocessed substances rather than toxic chemicals with severe side effects, and emphasizes treating the whole (holistic) being rather than just symptoms.
Treating a pet holistically means considering all factors that contribute to the well being of that pet. A holisitic veterinarian will think about emotional state (i.e. stress), environment, nutrition, lifestyle (ie. activity and exercise), and immune status to name a few of these factors.
There are many modalities used to treat an animal holistically. These can include such things as chiropractic manipulation, acupuncture, homeopathy, herbal medicine, nutritional medicine, physical therapy, “hands-on” therapies such as Reiki or even massage.
Many people turn to natural therapies for themselves or their pets because they believe they are safer and cheaper than conventional therapies, but this is not always true. In general, natural therapies are gentler with fewer side effects, but a trained and certified holistic veterinarian should be consulted before initiating any therapy on an animal. Written by Dr. Steven Schultz
Steven Schultz, DVM firstname.lastname@example.org
Buffalo / Niagara Region
Like your neighborhood garbage handlers and the late great Rodney Dangerfield, the kidney just doesn’t get enough respect. In fact, your kidneys are so important, that the body is equipped with two, even though you only need one healthy kidney to live! Just what does the kidney do, anyway?
Regulates water balance –i.e. decreased urine when you’re dehydrated, increased when you’re drinking a lot
Filters small particles from the blood—some are passed in the urine (like some medications), and some are re-absorbed before they are excreted (like glucose—except in diabetics where the kidneys can’t keep up with the high blood sugar)
Regulates electrolyte balance
Excretes urea—a by-product of protein breakdown that is related to ammonia
Helps to regulate blood pressure
Works with the parathyroid gland to regulate calcium levels
Secretes a hormone called erythropoietin to stimulate red blood cell production
If the kidney isn’t doing its job the way it should, it’s called renal failure, but this doesn’t mean it has shut down entirely…
There are two types of renal disease/failure:
ACUTE RENAL FAILURE (very recent onset) generally happens in younger animals, but not always.
Causes include toxins such as antifreeze (ethylene glycol), grapes/raisins, plants like Easter lilies (cats!), or even human medications. Other causes include urinary obstruction—if the urine can’t get out, it will start to back up into the kidneys and cause pressure damage to the delicate tissues; infectious disease like leptospirosis or even infection that may spread from other parts of the body via the bloodstream. Decreased blood flow to the kidneys (such as what happens when an animal gets too dehydrated or develops heat stroke) can also cause acute renal failure.
CHRONIC RENAL FAILURE (been going on for a while, even though it may not have been detected) generally happens in older animals, but not always. Causes include birth defects (malformed or missing kidneys), hypertension (high blood pressure), heart disease, chronic low grade inflammation/infection or even just old age—many geriatric cats will develop this. Persian and Abysinnian cats are genetically prone to kidney disease.
How Can I Tell If My Pet Has Kidney Disease?
Often in acute renal failure, a pet that felt fine a few days ago, now feels lousy. They may be a little dehydrated, lethargic, not wanting to eat, and they may or may not be vomiting. They may be urinating very little, not at all or more than usual. Animals that have gotten into antifreeze may appear “drunk” or “out-of-it”. Fluid may accumulate in the lower part of their legs or even in their lungs. In severe situations, increasing ammonia levels can cause seizures.
In chronic renal failure, the pet may be thin, and they’re usually dehydrated and often vomiting (increased toxins in the body can cause stomach ulcers AND stimulate a part of the brain that causes vomiting). They may have dark or tar-like stools. They often have foul breath and ulcers on their gums (which are often pale) or the inside of their cheeks. They’ve usually been drinking a lot and urinating a lot. Contrary to popular belief, increased urination is NOT a sign that the kidneys are functioning well!
Diagnosis is based on physical exam, and bloodwork/urinalysis. Your vet will specifically be looking at BUN/creatinine, hematocrit, potassium, calcium and phosphorus levels as well as the specific gravity of the urine. Additional diagnostic tests may be recommended by your veterinarian.
Dehydration makes the pet feel really sick (remember the last time you had the stomach flu?! UGH!). Fluids administered intravenously will also help to flush out the toxins that build up in the body. In chronic cases, fluids may be given subcutaneously (under the skin).
A potassium level that is too high (common in animals that have a urinary obstruction) can cause life-threatening heart arrhythmias, and must be lowered with fluids and possibly medication. Potassium that is too low (common in chronic renal failure patients) can cause weakness and must be supplemented in the fluids. When the pet goes home, they may require oral potassium supplements.
High phosphorus levels are common as the kidney failure progresses, and it can make the pet feel terrible. High phosphorus can cause calcium levels to drop (calcium and phosphorus levels should be inversely proportionate—meaning as one rises, the other falls), which can eventually result in rubbery bones as the body robs the bones of their calcium! There are dietary supplements that bind phosphorus in the digestive tract.
Antibiotics are necessary for bladder or kidney infections (your vet may recommend periodic urine cultures to monitor for infection).
Anemia may require treatment in the form of supplements or medications.
Vomiting may be severe enough to warrant treatment—medications may be prescribed for nausea, to decrease acid production in the stomach, to coat the stomach, and/or to move the food more efficiently through the digestive tract.
Medications may be prescribed to increase blood flow to the kidneys or to decrease blood pressure.
Prescription diets for pets with kidney disease have specially formulated protein, salt, phosphorus and potassium levels, as well as anti-oxidants that may reduce the risk of further kidney damage.
ALWAYS allow constant access to water—these animals should NEVER be allowed to dehydrate!!
While kidney transplants are available for dogs and cats, they are not performed very frequently. There are very specific requirements that must be met; there are a limited number of referral centers in the country that offer them, and they are very expensive.
The prognosis depends on the cause and the extent of the damage to the kidneys. If we can quickly identify and treat the cause of acute renal failure, a full recovery may be possible. Chronic renal failure is not curable, but can be manageable—particularly for cats.
Intravenous, or IV catheters are used to deliver fluids or drugs directly into the circulatory system. Catheters are often placed in sick patients, cancer patients (for chemotherapy infusion), patients that require serial blood collection, or to provide venous access and a route for fluid delivery during surgery/anesthesia.
The location of the catheter depends on its function. For instance, a ‘peripheral catheter’ is placed in a vein in one of the limbs in dogs and cats. Most frequently—the cephalic vein, located on the front of the forelimb, is used. Sometimes one of the saphenous veins is utilized—they are located in the rear limbs on the inside of the thigh, and on the outside of the leg just above the hock. Peripheral catheters are short and generally easy to place but often don’t last more than three days without having to be replaced. They are used for anesthetic/surgical procedures and hospital stays when the animal is expected to recover relatively quickly. They are generally not useful for collecting blood samples. Central catheters (or ‘central lines’) are exactly as they sound—a longer catheter in a central vein—these can be placed in the medial or lateral saphenous veins, or the jugular vein. These are better used for serial blood collection, or if the patient is in intensive care and is expected to require medical intervention for more than 3-4 days.
Frequently, the first time that a pet owner hears about IV catheters is when their pet is dropped off at the veterinarian for an elective procedure such as a spay, neuter or dental prophylaxis. Your vet may require or recommend that an IV catheter be placed for these procedures. Here’s the thing—in an emergency, this access is priceless. Should something go wrong during anesthesia—rare, but it does happen—you don’t want the minutes ticking by while your precious baby’s life hangs in the balance as a technician or vet struggles to get that catheter in place. There are drugs and IV fluids that can support an animal that is having a difficult time either due to the anesthesia or in reaction to what is going on in surgery. But…you’ve got to get them into the pet…quickly. If they ask you whether you want to opt for the catheter, your answer should be, “Absolutely!” They say hindsight is 20-20, and you just don’t want to find that out the hard way. Do keep in mind that the catheter placement will require a small area of fur to be shaved. It will grow back before you know it, and is a small price to pay.
“Cali” was a sweet brown dog I met in 2009 when I was working at a clinic. Her mom
Grace brought her to see me because she was vomiting for a few days and her appetite
had decreased. After a few tests, I diagnosed “Cali” with Chronic Renal Failure (CRF).
“Cali” turned out to be my first in-home hospice patient and Grace turned into one of the
best care givers I have met.
What is CRF?
CRF – also known as Kidney Failure - is the gradual loss of kidney function. Some
functions of the kidneys are to excrete naturally occurring waste products, concentrate
urine and produce a hormone known as erythropoietin which assists in the production of
new red blood cells.
When the kidneys begin to fail, those waste products begin to build up in the
bloodstream. These waste products, such as blood urea nitrogen (BUN), creatinine,
and phosphorus is what causes the animal to feel ill and can even cause oral and
gastric ulcers, making the animal feel even worse while decreasing their desire to eat.
Even though animals in CRF will drink more frequently, they will become dehydrated
because the kidneys stop concentrating urine sufficiently and they begin to urinate large
volumes of very dilute urine.
In some cases, the dog or cat can also become anemic because the kidneys are not
producing enough erythropoietin to help make red blood cells.
How is it diagnosed?
CRF can be diagnosed with blood work, urine samples and imaging (x-rays or
ultrasound). However, it is important to know that studies show almost 80% of kidney
tissue is irreversibly damaged before clinical signs present and the disease is found in
How is it treated?
The goals of treatment are to support the kidneys and medically assist them to complete
the jobs that they are meant to do.
We usually start by putting the animal on a prescription diet – one with low-quantity/
high-quality protein and low phosphorus in order to reduce the amount of BUN and
phosphorus build-up in the body.
Administration of fluids under the skin (subcutaneous/sub-q fluids) can be done at home
or intra-venous fluid therapy in the hospital. This is done to flush out the build-up of
toxins and to keep the animal hydrated.
Oral phosphate binders are sometimes used to help remove excess phosphorus.
What is the prognosis for renal failure?
Managed appropriately, many animals that are diagnosed with CRF go on to live
many more great years. However, with any disease there are some animals that do
not respond positively to treatment and remain ill and their condition quickly worsens.
It is important to have your animals checked regularly by a veterinarian so that
renal function can be assessed and any changes in the kidneys can be addressed
“Cali’s” mom spent 9 months caring for her with special diet, sub-q fluids at home and a
lot of TLC. “Cali” passed at home, in the comfort of her personal chaise lounge and her
mom close by.
Cats build plaque and tartar on their teeth just like people do and can lead to significant dental disease. Clinical signs can range from halitosis to severe discomfort leading to health issues. Painful cats may salivate, paw at their mouth or grind their teeth. Others will stop eating all together leading to weight loss and associated medical concerns such as hepatic lipidosis (fatty liver syndrome).
Some cats just have dirty teeth that need a prophylactic cleaning (dental scale and polish) to return to a healthy mouth. Other cats have an immune reaction that causes gingivitis, stomatitis and tooth loss. These lesions can be extremely painful and need to be addressed immediately.
Gingivitis is a reddening of the gums due to the bacteria present in the plaque and tartar. A more severe form, or later stage, is stomatitis, where the entire mouth is reddened and inflamed. Some cats will show no signs of gingivitis or stomatitis but will have resorptive lesions. These lesions are not true cavities. They are areas of the tooth that are being removed by cells that typically help resorb the roots of the primary, or baby teeth, as they are lost. The trigger mechanism is not known but the effect is commonly noted on exam. It starts as a small, sensitive spot on the enamel, above or below the gum line, that eventually causes the crown to fall off and the roots are left behind.
Good oral exams done at annual visits detect the majority of feline dental disease. A dental cleaning is recommended with any amount of tartar present as there can be lesions above the gum line that are not visible without probing and/or dental xrays. Once everything is cleaned up and healed, timing of exams can be determined by your veterinarian to help keep Kitty’s mouth looking and smelling fresh.