What is integrative pet care? Discover how it can help your pet
When I tell my friends I work in integrative veterinary practice, many don’t understand what that means. The example I use is a relatively common one: how I treat a dog with itchy skin using an integrative approach.
I describe integrative practice as being like the best of both worlds — though that may be too simple. Western conventional medicine may also include nutrition and nutraceuticals as well as rehabilitation. Holistic medicine may take under its umbrella Western herbal medicine, Traditional Chinese Medicine, Ayurvedic medicine, naturopathy, homeopathy and physical therapies such as acupuncture, massage and chiropractic. Modalities such as reiki and Bowen and emotional remedies such as flower essences also come under the holistic umbrella. Most integrative vets practise some of these.
I begin with a complete history, which includes a diet history and information that may help identify other underlying issues contributing to allergies such as environmental issues, lack of exercise, previous medications like corticosteroids and repeated use of antibiotics.
A thorough clinical exam, which includes a holistic and TCM exam, will help identify other health issues that may or may not be significant; eg injuries, arthritis, possible hormonal imbalances. I may also recommend specific tests such as thyroid blood tests or cytology of inflamed skin to rule out any secondary infections that need to be addressed.
An important component of integrative veterinary care is setting up the goal of treatment and having realistic expectations. This is about good communication. Many pet carers come along with a dog with chronic severe skin inflammation hoping that we can turn them around quickly with a herbs and diet strategy. The reality is we can improve the health of the skin and reduce frequency and severity of inflammation in most cases. We may even resolve chronic dermatitis, but these improvements may take some time. I usually allow three months for significant improvements to be seen.
One of the first things we discuss is diet. There are a number of ways a diet adjustment can improve skin health and reduce inflammation and allergies. Is the diet nutritionally complete? Do we need to add specific nutrients to boost skin health and reduce inflammation such as vitamin D, zinc, fish oil? Are the calories adequate or too much?
Can we minimise inflammation by altering the makeup of the diet, reducing processed ingredients, reducing insulin resistance and adding antioxidants, fibre and essential fatty acids? Are there any food sensitivities contributing to skin signs? Does the diet need to support the gut health? What about the TCM energetics? And so on …
Food provides the building blocks for life and an appropriate diet is probably the most important step not only for skin health but for overall wellbeing.
Nutritional supplements are used to boost the dog’s physiological status, using specific nutrients that may be at suboptimal levels in diet or to provide specific health benefits. Probiotics (to address dysbiosis), quercetin (antioxidant and natural antihistamine), flax seed oil (to nourish skin barrier), bromelain (as digestive support and anti-inflammatory) and L-tryptophan (to reduce stress) are some of the supplements we may consider for dogs with recurring skin allergies.
Either Western herbs or TCM herbs may be used and the choice may depend on the ease of dosing. TCM powdered herbal formulae can usually be more easily mixed into food, especially raw meat. Western herbs in tablet form may be poorly utilised by dogs and alcohol tinctures taste yuck. But I often use a combination of an appropriate TCM herbal formula plus an alcohol tincture of nettle leaf for its anti-inflammatory effect. Adaptogens or tonics may be required to boost vitality in long-standing cases. Alteratives may be used for detox approaches, or immune-modulating herbs, which can downregulate TH2 cells.
Herbs can also be used topically and examples include strong black tea — at least 20-minute strength — as an astringent, chamomile tea to treat skin infection or calendula tea to assist with healing.
Trained homeopaths can recommend appropriate remedies based on a complete history and symptom analysis. I don’t use homeopathy often because I lack the intense training, but I occasionally prescribe Apis mel for acute redness and swelling or hep sulph. for infection. Flower essences are used to address underlying emotional imbalances than can perpetuate itch.
Acupuncture can be used to cool blood heat, reduce pain, reduce agitation and reduce itch. Some dogs are more responsive than others. Although massage is contraindicated in acutely inflamed dogs, massage may be useful to address other underlying pain that can be the target for itch such as joint or back pain. Chiropractic adjustments may help reduce hyperaesthesia than can lead to overgrooming.
As part of an integrative approach, I usually also overhaul the preventative health program including vaccines, flea/tick heartworm and worming strategies. Overall the goal is to reduce the chemical load. Vaccines should not be given to acutely allergic dogs and titre testing can be used to help minimise vaccine frequency. Flea protocols are important because many allergic dogs are allergic to fleas and the most effective low-chemical approach should be used.
An integrative approach to managing any health issue seems complex but provides many other choices for owners. We wouldn’t do everything in one visit but begin with two or three key areas like diet, herbs and topical treatments, then address the rest in time. At each visit we assess our progress, keep what is working and change what is not. With patience and persistence we can significantly improve the health of the skin, and the dog, and reduce the need for medications.
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