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Dr. Berman’s article about acupuncture in Delaware Valley Pet Magazine

Complementary medicine is defined as any of a range of medical therapies that fall beyond the scope of scientific medicine but may be used alongside it in the treatment of disease and ill health. This type of medicine includes acupuncture, laser therapy and herbal medicine. Holistic medicine is another complementary modality but will not be discussed here. It is important to notice that the definition of complementary medicine says that it is used “alongside” western medicine. It is the author’s belief that having the proverbial “medicine bag” filled with as many treatment modalities as possible will give us the ability to help our animal friends without causing them harm.

Acupuncture is a system of complementary medicine that involves pricking the skin or tissues with needles and is used to alleviate pain and to treat various physical, mental, and emotional conditions. As you can see, acupuncture can be used to treat the mind and body. In fact, your pet should receive an examination that includes a complete history, a Western medical examination and a Traditional Chinese Medicine Examination. A good history will include the protein and carbohydrate makeup of the food you are feeding, whether your pet likes the heat or the cold, how you obtained your pet, whether your pet gets along with people and other animals, how much your pet drinks and what time of day your pet seems to have a problem. The examination and the history are used to help decide what points to use during treatment.

The treatment itself is pretty straightforward. Sterile acupuncture needles are inserted in different points around the body to treat the pet. The vast majority of cats, dogs, and horses (as well as other animals) accept the needles readily. Depending on what your pet is being treated for, you may find that anywhere from one to thirty or more needles are used. The needles are left in place for varying lengths of time. Most animals will relax and even fall asleep with treatment. There should be an immediate effect from the treatment. However, multiple treatments usually needed to help treat the problem at hand. Sometimes, attaching electrodes to the acupuncture needles is used to help treat animals. Most commonly, this is used with animals that have a neurologic deficit of some sort. The level of intensity used is adjusted to each individual animal so as to get an effect but not to cause pain for the pet.

But does acupuncture work? Yes. If so, how does it work? This is where acupuncture meets with some controversy. Proving the efficacy of this treatment modality can be difficult. There are studies that have proved outcomes but have yet to fully explain how things work. But the science is coming. Acupuncture is gaining greater footing in both human and animal medicine. We also are doing no harm.

It is important to find an acupuncturist that has been certified. There are a few programs in the United States that certify veterinarians in acupuncuture. Here are a few links to help find a practitioner in your area:

The Chi Institute – tcvm.com
The International Veterinary
Acupuncture Society – ivas.org
The American Academy of Veterinary
Acupuncture – aava.org

In addition to acupuncture, many practitioners will use herbal medications. The use of herbals to work in conjunction with the acupuncture is of great benefit and requires the full assessment of your pet as described above. It is important to understand that, like western medications, herbals can have side effects. Therefore, it is very important to speak with someone who is trained in the use of this type of complementary medicine.

Lastly, the use of laser therapy is a very exciting modality of treatment. The wavelengths of light contained within the field of treatment are absorbed by the tissues. This has an effect at the cellular level causing some of the following results – increased blood circulation, quicker healing times, regeneration of damaged tissues, decreased pain. The effects are cumulative and animals will usually need to have more than 4-6 treatments to get the full benefits of the laser therapy. After the initial treatment, the laser can be continued if needed.

More recently, the use of laser therapy for patients that have just undergone surgery is becoming the standard of care. The laser is used to help incisions heal quicker and decrease pain postoperatively. An example of this is to use the laser to treat an animal’s mouth after a dental cleaning and ensuing extractions.

Complementary medicine is a great way to expand the veterinarian’s “medicine bag”. Finding a trained practitioner is important to make sure the right thing is being done for your pet. The use of acupuncture, herbal medicines and laser therapy are great ways to help your pet.

During your dog’s annual examination you are likely asked about heartworm prevention, as well as flea and tick prevention. If preventatives haven’t been given consistently, or if there has been a lapse in administration a 4DX test (or “Lyme test”, in our office we call it the “HWLET”) is often mentioned. This is a quick test that can be performed in the office with a small sample of your pet’s blood. It tests for four diseases; Heartworm, Lyme, Anaplasma, and Ehrlichia. The test detects antigen for Heartworm disease, meaning it finds the molecules that cause the body to produce an immune response. So a positive result for Heartworm disease indicates an active infection. Unfortunately, the results for the tick-borne diseases (Lyme, Anaplasma, and Ehrlichia) are not as straight forward. The test can only detect antibodies for the tick-borne diseases; this means a positive result tells you there has been as exposure to the disease, but not whether or not an infection is actively present. Antibodies are the compounds a body produces when exposed to antigen.

So what are the symptoms you need to look for?

Heartworm disease is transmitted to your pet by mosquitoes. The microscopic larva migrates through your dog’s body into his bloodstream where it begins to grow in the chambers of the heart and inside some of the arteries. It is not a worm that lives in the intestines, as in other parasites we deworm for. Early symptoms of Heartworm disease are typically undetectable. As the worms begin to grow in the heart and arteries infected animals may experience persistent coughing, lethargy, exercise intolerance, decreased appetite, and weight loss.

The tick-borne diseases are transmitted through hard ticks (the small ones that are hard to see). The individual diseases are actually caused by different bacteria the tick passes to your pet while feeding. The bacteria then typically make their way to the bloodstream where they can affect the red blood cells, platelets, or joint fluid. If the diseases are left untreated they can begin to damage the bone marrow or kidneys. Generally the symptoms of tick-borne diseases can be lameness (limping or favoring a leg/legs), lethargy, decreased appetite, bruising, neurological signs (seizures or convulsions), and fever.

Why test annually?

The Companion Animal Parasite Council (and the doctors at FWVH) recommends yearly testing for Heartworm, Lyme, Anaplasma, and Ehrlichia. Because the body may take several months to mount an immune response and show outward clinical signs the 4DX test can help facilitate earlier detection of disease. Earlier detection allows for earlier treatment, and makes more serious, life-threatening side effects less likely. Because the test indicates exposure to the tick-borne diseases it can also give us a better picture of what tick control measures are reliable and which ones may not be as effective.

What happens when the 4DX has a positive result?

Heartworm disease: If the 4DX is positive for Heartworm disease the result is then verified with a second test. Another test to test for the microscopic larvae may be sent to the lab, or your pet’s blood may be examined under the microscope. Often, a combination of the aforementioned are performed. X-rays of your pet’s heart and lungs are often taken to evaluate for signs of heart enlargement or heart failure (often causing fluid to back up into the lungs). A complete blood count (CBC) and serum blood chemistry will be performed to look for signs the disease has impacted the organs, as well as red and white blood cells. After further testing has been performed treatment is often initiated.

Lyme disease: There is a special antibody test, called the QC6, which can measure the amount of antibodies to Lyme disease present in your pet’s bloodstream, when a 4DX is positive for Lyme that test is typically recommended. A low value is thought to indicate previous exposure, not active infection. If a QC6 comes back with a high value, treatment is typically initiated. Because more serious forms of Lyme disease can affect the kidneys when an animal tests positive the serum blood chemistry (part of this panel checks specific kidney enzymes) as well as the urine are tested. If a positive pet has elevated kidney enzymes or protein present in its urine, it is likely the Lyme disease is affecting the kidneys and treatment should be started.

Anaplasma and Erhlichia: As with the other diseases a CBC and chemistry are performed to assess for organ damage, as well as signs the red and white blood cells, and platelets are affected. If Erhlichia is present the urine will typically be checked for protein as well. If the tests show signs of infection then treatment will be started.

Treatment for Heartworm disease is usually a series of injections of high doses of a chemical dewormer, as well as oral antibiotics and heartworm preventative. The tick-borne diseases are treated with an oral antibiotic, usually over the course of one month.

How can I prevent my pet being exposed to these diseases?

The very best prevention is monthly heartworm prevention and monthly flea and tick prevention. The preventatives are available in many different forms; from topical liquid, to oral chews, to collars. In our area yearly administration of preventatives is recommended, our weather is no longer consistently cold enough to eliminate ticks. Yearly administration also helps to develop a pattern of administration, making missed doses less likely.

During your pet’s next wellness visit you may hear the recommendation for annual 4DX testing. It could diagnose a disease early, allow for early treatment, and even a negative test can give you information about the effectiveness of your monthly preventatives. Our clinic has recently implemented a Wellness Profile that includes a 4DX. The profile also includes all of the follow-up tests that are typically performed for the tick-borne diseases, a urine protein quantification test and QC6 (for Lyme antibody) are usually add on tests that require an extra charge, they are now included for no extra charge. Consider testing your pet yearly to increase their longevity and your peace of mind!

The session was led by Holly from PetPlan who introduced everyone to the somewhat intricate web that is the world of pet insurance. There are a lot of details and nuances to consider when deciding about which pet insurance policy and plan is right for a pet. Holly reviewed a number of things to bear in mind and also gave the audience an independent website link to consult when beginning the investigation into plans: https://www.petinsurancereview.com


Many things have changed in the industry since pet insurance first became available in the US approx. 15 year ago. Plans at that time weren’t very comprehensive and were managed a lot like human insurance – very messy! There are now a number of players in the marketplace offering good plans; the trick is really determining which company to go with, which plan and how much you can afford. The above website also offers pet owners answers to some of the most common questions regarding pet insurance and provides other food for thought as you investigate.


Some surprising things learned at the session:


Some typical services may be extra “riders” on your policy – meds, dentals, oncology services


There may be different reimbursement levels based upon if you are referred to a specialist by your vet!


Reimbursements can be based upon what the insurance company feels SHOULD be the cost of the service vs. what you actually PAID for the service – so make sure you understand the payout policy of a plan before you sign up.


Some policies may provide limits on dental procedures – only paying for cleaning and polishing but not extractions. Others may not pay for certain teeth to be extracted!


Some policies may not pay for cruciate repairs OR may not pay for more than 1 cruciate repair.


No insurance company covers pre-existing conditions since Pet Insurance originated from and is still under the umbrella of Property/Casualty Insurance.


A good note about PetPlan and pre-existing conditions: not ALL illnesses are considered “permanent” and coverage may become available down the road for that condition. A good example is if a pet comes in with a bad mouth needing a dental and gets it cleaned…THAT dental isn’t covered since the condition existed prior to obtaining a policy. However, the next time that pet needs a dental, it will be covered.


One additional PetPlan note: After you sign up you can request a Records Review by calling up the company within 30 days. They can give you an assessment of where pre-existing conditions might apply and would not be covered. You can then cancel for a full refund. They cannot do this unless you have signed up since they would be inundated with requests.


It was a great learning experience for everyone present and proved to us here at Ft. Washington Vet that we should continue to schedule formal times for our clients to learn about pet insurance; because of this we plan on incorporating additional ‘events’ during the course of the year to do so. Please check our Community Page under the “About Us” tab for upcoming opportunities to learn about pet insurance

Importance of pet dental care

Pet Dental Care

shutterstock_75325276Dental care for pets is just as important as it is for people!

Dental care for your pet is extremely important. Periodontal disease is the most common clinical condition occurring in adult dogs and cats and is entirely preventable. Here are a few facts about dental pain and disease so you can make an informed decision about a dental visit for your pet.

What is periodontal or dental disease? Periodontal disease is a progressive inflammation of the supporting structures around the teeth.

What causes periodontal disease? Periodontal disease starts when bacteria form plaque on the teeth. Within days, minerals in the saliva bond with plaque to form tartar, a hard substance that adheres to the teeth. The bacteria work their way under the gums and cause gingivitis, which is an inflammation of the gums. These bacteria can then travel in the bloodstream to infect the heart, kidneys, and liver.

How is dental disease diagnosed? Dental disease is diagnosed by examining the teeth and supporting structures while the pet is under anesthesia. Some dental disease can be reversed such as gingivitis through dental cleaning and polishing. Loss of tooth attachment and bone loss cannot be reversed.

shutterstock_169577594Here are some signs of Dental Disease or Pain:


        • Bad breath



            • Redness or bleeding along the gum line



                • Drooling, which may be tinged with blood



                    • Difficulty chewing



                        • Facial swelling, especially under the eyes



                            • Loose or missing teeth