Tully at the Chinese medicine vet

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Sarah
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Tully at the Chinese medicine vet

Postby Sarah » Mon Feb 14, 2011 10:57 am

Tully had an appointment with the Chinese medicine vet last week. For those who don't know, Tully has been losing muscle mass since last year. Before that became really noticeable, we noticed an occasional rather lackluster attitude at agility class. She now can't participate in agility, because she can't really jump with so much of her muscle gone.

Her symptoms are rather similar to Cushings, but she doesn't look much like a Cushings dog, and bloodwork ran in September was normal (didn't do the tests specific to Cushings, but it would typically show up in other values.) She does have dilute urine and drinks a lot of water, which is also a Cushings symptom, but she has been like that for years, and we'd discounted it as a psychological issue. She doesn't drink any water while I'm gone, only when I'm home.

So, I took her to see a vet who practices Chinese medicine, recommended by a friend. I wanted to try a different approach. I have mixed feelings about the experience.

The Chinese medicine vet felt that Tully does have Cushings, or pre-Cushings. In Chinese medicine, though, she is diagnosed as having "damp heat". She did some acupuncture on Tully (who was incredibly patient about it), and that definitely seemed to help. Tully had been standing rather swaybacked, and that definitely improved with the acupuncture. We also have some herbal pills to use called "4 Miracles", which is a very encouraging name.

I figured if I saw a holistic type practitioner, I was going to get nagged about diet, and I was. I'd hoped that feeding grain free (I'm not really opposed to grain, but happen to be feeding TOTW at this time) would be considered enough, but it wasn't. She strongly wanted me to feed raw. I agreed to feed Tully raw, since I feel that if I'm going to pay through the nose for the consultation, I can at least try the prescribed treatment. I can't afford to feed all of them raw, which the vet didn't really like.

And that is the part that I didn't like about the visit, I didn't like having most of my health care decisions criticized. She didn't like the vaccine protocol I've been using either, which is a vaccine every year, rotating between rabies, parvo, & distemper (so each is on a 3-yr schedule). I quite agree that Tully shouldn't be vaccinated now, she has some kind of systemic thing going on, whether it be Cushings or something else. But I made the vaccine decisions I did for my own reasons, based on my own research, and don't really need someone telling me I'm doing it all wrong. There really isn't conclusive evidence on the topic, there is room for more than one opinion. Ditto with the food thing. I know many believe that kibble is the root of all evil, and raw the answer to everything. I don't agree.

I can't imagine that if Tully has Cushings, it was caused by eating kibble, since Cushings in a dog not fed steroids (like prednisone), is most commonly caused by a benign micro-tumor in the pituitary, and the rest of the time is caused by a tumor in the adrenal gland.

Of course, the other thing that I have issue with is that it's not enough to feed a raw diet, I'm supposed to feed it warm, since prey would be warm. Which is really a pain, and I'm not clear on how a descendant of a scavenger species that was domesticated because they were hanging around human dump sites eating human refuse would be unable to tolerate food that wasn't prey-like. But fine, she's eating warm raw food (more like meat soup, after I put the water in to warm it). Which is outrageously expensive, if she has to stay on this, I'll have to find a way to prepare my own, the premade is too spendy. And another thing, if carbohydrates are so bad, why is the vet promoting a raw diet that is 30% vegetable?

But, we're going with that treatment plan. Warm raw food, 4 miracles pills, and a recheck in a month. If she isn't showing improvement by then, I'll probably give up and go back to my regular vet for repeat bloodwork.

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Re: Tully at the Chinese medicine vet

Postby HappyPuppy » Mon Feb 14, 2011 11:21 am

Well, it certainly can't hurt to give a month or two to this course. And good for you for trying something different. :thumbsup:

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Re: Tully at the Chinese medicine vet

Postby JoeBingo » Mon Feb 14, 2011 11:22 am

Oh my Sarah. In addition to blood work, an ultrasound would reveal a tumor that is large enough to be stimulating the adrenal glands. I'm told most of those tumors associated with Cushings are inoperable though. If it is Cushings, the next thing(s) you might begin to notice is a sagging pot belly, hair loss, calcified lumps in the skin and other skin and coat conditions.

Treatment with drugs (usually toxic themselves) require strict and close monitoring.

Other holistic methods of treatment besides the Chinese herbs are bungleweed (whatever that is) and nutritional supplements such as carnitine.

^^^ at least this is what the book I have concerning holistic medicine and authored by Michele Welton indicates.

Hang in there Tully !!!

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Re: Tully at the Chinese medicine vet

Postby Sarah » Mon Feb 14, 2011 11:37 am

JoeBingo wrote:Oh my Sarah. In addition to blood work, an ultrasound would reveal a tumor that is large enough to be stimulating the adrenal glands. I'm told most of those tumors associated with Cushings are inoperable though. If it is Cushings, the next thing(s) you might begin to notice is a sagging pot belly, hair loss, calcified lumps in the skin and other skin and coat conditions.


Ultrasound might find the tumor if it's on an adrenal gland, but the info I found states that 85% of the time, it's a very small tumor in the pituitary. This is a good site with info:
http://www.kateconnick.com/library/cushingsdisease.html

All the other sites I looked at say much the same thing, this one is just very clearly presented. None of the allopathic treatments look really great to me. I really am mostly an allopathic medicine fan, I like the scientific method. However, I'm not unwilling to branch out when allopathic medicine fails me.

The typical Cushings pot belly is what Tully does not have, though the Chinese medicine vet thought she was developing it. I'm not so sure, but we shall see, I guess. Tully was very unthrifty for awhile, and I upped her food drastically, then my regular vet had me worm her, and I started giving her a probiotic, digestive enzyme supplement, and she started gaining some weight. She's up about 2 pounds from where she was a few months ago, which is a large amount in a dog her size. She went from 30-31 pounds in 2009, to 25.8 in January of this year (primarily muscle loss), and is back at 27.8 now. (the 2 pounds is probably mostly fat)

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Re: Tully at the Chinese medicine vet

Postby HollyJoy » Mon Feb 14, 2011 12:57 pm

Oh my Tully! I've dealt with adrenal gland cancer, it's removal and later reappearance as Addison's-like symptoms. I wish I had some insight or suggestion for you but I don't. I'm just posting to let you know we're thinking of Tully, and you.

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Re: Tully at the Chinese medicine vet

Postby El_EmDubya » Mon Feb 14, 2011 3:16 pm

Do you know if she is a DVM with TCM training or a TCM practitioner working under a DVM?

{All her recommendations are VERY consistent with TCM, btw.}

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Re: Tully at the Chinese medicine vet

Postby Sarah » Mon Feb 14, 2011 3:37 pm

El_EmDubya wrote:Do you know if she is a DVM with TCM training or a TCM practitioner working under a DVM?

{All her recommendations are VERY consistent with TCM, btw.}


She is a DVM. I chose her partly for that reason, aside from the recommendations, since I'm more comfortable with allopathic medicine, I thought I'd be happiest with someone who could view it from both sides.

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Re: Tully at the Chinese medicine vet

Postby El_EmDubya » Mon Feb 14, 2011 6:37 pm

Actually I'd recommend that you find a TCM practitioner, if you truly wish to go that route.

Unfortunately DVM's can be certified with very little training. ( 130 hours vs. the standard three years for a Masters in TCM: http://www.tcvm.com/Program/program_basic.htm). I've been horrified by a couple of Vet demos I watched, to be honest. These well known vets had no business "teaching" TCM. Having considered attending a TCM program, and working with numerous TCM practitioners and professors, I can assure you the DVM degree does very little to help a Vet practice TCM.

Here are two schools that are recommended by TCM practitioners:
http://www.actcm.edu/content.php?topmenu=2&root=2&id=620 - requires +3,000 hours of coursework
http://www.fivebranches.edu/masters-in-tcm/tcm-programs/542 - 4 years and +3,200 hours of coursework

Yes, there is some overlap with Western focused coursework (basic science, etc.) but you can not ignore the HUGE gap in training hours. The TCM practitioners, with whom I've spoken, also clearly agree it takes an additional 4-5 years of mentoring and experience before one truly begins to practice effectively. Much of the success of TCM comes from the ability to diagnose very specific imbalances in a very complicated biological system.

Training aside, I'm sure your vet has the right intentions at heart. She may be lacking in her diagnostic toolkit/experience, though, which is where TCM is truly effective. Without a solid diagnosis of Tully's systemic problems, I wonder if she is a well meaning "holistic vet" who believes all animals are better off being fed a raw diet and therefore her suggestion to you was more her standard protocol than a tool to address Tully's imbalances.

As you know I am pro-raw, but unless the vet specifically stated which meats you should feed, and why, I'm very hesitant to support her decision to suggest raw. Food is, obviously, medicine, but according to TCM there is a big difference between feeding chicken and feeding pork. You might want to check out http://www.amazon.com/Four-Paws-Five-Directions-Medicine/dp/0890877904 for more info regarding TCM food therapy.

And as far as the feeding food at room temp or slightly warm, that's the biggest push-back I've received from the TCM practitioners I've converted to raw. lol However, in Tully's case, and thermodynamically, it might make more sense to be feeding her warmed foods to make sure her calories are being spent taking care of her body vs. keeping it warm.

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Re: Tully at the Chinese medicine vet

Postby BrokenAquarian » Mon Feb 14, 2011 7:41 pm

I can't imagine that if Tully has Cushings, it was caused by eating kibble, since Cushings in a dog not fed steroids (like prednisone), is most commonly caused by a benign micro-tumor in the pituitary, and the rest of the time is caused by a tumor in the adrenal gland


Since tumors/cancer are actually symptoms of something wrong in the body, it could be the food causing the tumors on the glands - leading to the cushings'. What causes the tumors in the first place?
I don't think most doctors (weather animal or human) look past the actual cancer/tumor itself. It doesn't come out of nowhere. It's triggered/caused/aggrivated by some irritation/imbalance in the body. It's not always fixable, but it would be nice if our doctors spent more time studying that part of the process.

Diet is a major factor in how a body works. It's not insane to think that it could be a cause to the problem.

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Re: Tully at the Chinese medicine vet

Postby Sarah » Mon Feb 14, 2011 8:36 pm

El_EmDubya wrote:Actually I'd recommend that you find a TCM practitioner, if you truly wish to go that route.

Unfortunately DVM's can be certified with very little training. ( 130 hours vs. the standard three years for a Masters in TCM: http://www.tcvm.com/Program/program_basic.htm).


She is on the list of practitioners on that website. (TCM means "traditional Chinese medicine"?) I'm pretty sure she has plenty of training. She has a lot of letters after her name.

She did tell me what meats to feed, though not why, except for something about it being traditional foods of the breed's origin, she had a sheet copied from some book with breed info and descriptions of native food supplies. She did say the book should be taken with a grain of salt, but I was more skeptical of it than her (it lists "corn" as a traditional food of the English country. Corn wouldn't have been in England until after the discovery of the Americas, not enough time for English dog breeds to be adapted to it. None of my dogs have ever done well with corn, or wheat which was the other grain the page listed, though she didn't want me to feed grains anyway.) Anyway, she felt beef & chicken were the safe choices. She heavily promoted a certain pre-made raw diet, Darwins, and gave me a sample of it. As I said, I'm confused by why if carbohydrates are the devil, the diet she promoted to me is 30% vegetable. It's not what I'm feeding, I don't want to get started on a delivery program because there's no way I can continue to pay $3/pound to feed my dog (I couldn't even pay that for kibble, and in raw food, you're paying for a lot more water weight). If this works and I have to keep her on the raw diet, I'll have to somehow manage to prepare my own.

I'm not saying diet has nothing to do with disease processes, I'm saying there are other factors to consider, I don't believe that kibble is the devil and that all dogs fed kibble are bound to have horrible diseases. I also don't believe that dogs fed raw don't get horrible diseases. I think that is a ridiculously simplistic view.

I am feeding Tully what she wants me to feed, because if I don't, I'm not giving the treatment a fair chance. I'm not switching all my dogs to the Darwins like she really wanted because I really don't have an extra $200-ish to spend on dog food in a month.

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Re: Tully at the Chinese medicine vet

Postby El_EmDubya » Mon Feb 14, 2011 9:35 pm

Sarah wrote:She is on the list of practitioners on that website. (TCM means "traditional Chinese medicine"?) I'm pretty sure she has plenty of training. She has a lot of letters after her name.


Lots of letters aren't indicative of training, or being Board Certified in TCM. Unless your vet has +10 years of intense mentoring by a L.Ac (or DOM), and if Tully were my dog, I would still pay the extra to get a Licenced TCM practitioner to give Tully the 'once over'.

Sarah wrote: She did tell me what meats to feed, ...she felt beef & chicken were the safe choices.


According to TCM, they are very different "medicines", hence my concern.

Sarah wrote: She heavily promoted a certain pre-made raw diet, Darwins, and gave me a sample of it. As I said, I'm confused by why if carbohydrates are the devil, the diet she promoted to me is 30% vegetable.


The veggies listed are largely fiber and are more likely to control the fecal consistency so that the "new" raw feeder doesn't freak out and to increase the product's profitability. My guess is 2/3rds of the yams/squash/carrot goes straight through, having noticed the difference in Monte's feces on the days I feed yams.

Sarah wrote:It's not what I'm feeding, I don't want to get started on a delivery program because there's no way I can continue to pay $3/pound to feed my dog (I couldn't even pay that for kibble, and in raw food, you're paying for a lot more water weight). If this works and I have to keep her on the raw diet, I'll have to somehow manage to prepare my own.

I'm not saying diet has nothing to do with disease processes, I'm saying there are other factors to consider, I don't believe that kibble is the devil and that all dogs fed kibble are bound to have horrible diseases. I also don't believe that dogs fed raw don't get horrible diseases. I think that is a ridiculously simplistic view.

I am feeding Tully what she wants me to feed, because if I don't, I'm not giving the treatment a fair chance. I'm not switching all my dogs to the Darwins like she really wanted because I really don't have an extra $200-ish to spend on dog food in a month.


I completely agree with you!

You should be able to feed her for less than $1.3/lb and that would include Salmon Oil, eggs, chicken($0.7/lb), yams (if you choose), sardines, and Green Tripe ($2.5/lb). Feeding Raw is not cost prohibitive if you take the time to buy a decent knife, or poultry sheers, and spend a little time once a week to prepackage meals.

Tell your vet that you need lower cost resources. If it means that much to her, she should know a decent Co-op in your neighborhood.

LMW

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Re: Tully at the Chinese medicine vet

Postby tiva » Mon Feb 14, 2011 11:14 pm

Why not have the full range of blood tests for Cushings, and then depending on her tests, treat with anipryl or lysodren, as appropriate?

OK, I'm a real live scientist and I don't have a huge amount of patience for untested therapies. Blaming the dog owner for feeding her TOTW instead of raw would make me, if I were the patient, frustrated--particularly if it kept me from getting the full range of blood tests. .

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Re: Tully at the Chinese medicine vet

Postby El_EmDubya » Mon Feb 14, 2011 11:29 pm

tiva wrote: OK, I'm a real live scientist and I don't have a huge amount of patience for untested therapies.


lol Don't knock it, 'til you've tried it. lol

I'm a "real live scientist, too... :hi

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Re: Tully at the Chinese medicine vet

Postby Sarah » Tue Feb 15, 2011 1:59 am

El_EmDubya wrote:Lots of letters aren't indicative of training, or being Board Certified in TCM. Unless your vet has +10 years of intense mentoring by a L.Ac (or DOM), and if Tully were my dog, I would still pay the extra to get a Licenced TCM practitioner to give Tully the 'once over'.


I guess I still don't understand. On the first website you directed me to, she's on the list they have of "TCVM practitioners" in the state. What else would I look for?

El_EmDubya wrote:
Sarah wrote: She did tell me what meats to feed, ...she felt beef & chicken were the safe choices.


According to TCM, they are very different "medicines", hence my concern.


I don't think the food is as much about medicine as about her belief that kibble is poison. :dunno:

El_EmDubya wrote:
Sarah wrote: She heavily promoted a certain pre-made raw diet, Darwins, and gave me a sample of it. As I said, I'm confused by why if carbohydrates are the devil, the diet she promoted to me is 30% vegetable.


The veggies listed are largely fiber and are more likely to control the fecal consistency so that the "new" raw feeder doesn't freak out and to increase the product's profitability.


Fiber is carbohydrate. See, this is the kind of thing that drives my allopathic-centric, science oriented mind crazy. Why say "carboyhdrates are bad", if you only mean some carbohydrates are bad? Speak clearly! Organize your thinking! lol (um, that wasn't directed at you personally, just the line of thinking that confuses me)

Tell your vet that you need lower cost resources. If it means that much to her, she should know a decent Co-op in your neighborhood.
LMW


Well, no, she wouldn't, we don't live anywhere near each other. I drove a little over 2 hours to see this particular practitioner.

I think she doesn't fully understand the cost thing because she is doing fine personally (her place looked quite nice), and I'd guess that most of her clients are doing okay. I do know a couple other people who've gone to her and aren't well funded, but most people in the lower-mid income brackets don't pay $165 for a consultation appointment for their dog.

I could do raw cheaper if I prepared it myself, but there's a definite limit to how cheap I could get, since I can't buy in bulk. I don't own a freezer, and there is nowhere obvious for me to put one.

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Re: Tully at the Chinese medicine vet

Postby Sarah » Tue Feb 15, 2011 2:18 am

tiva wrote:Why not have the full range of blood tests for Cushings, and then depending on her tests, treat with anipryl or lysodren, as appropriate?

OK, I'm a real live scientist and I don't have a huge amount of patience for untested therapies. Blaming the dog owner for feeding her TOTW instead of raw would make me, if I were the patient, frustrated--particularly if it kept me from getting the full range of blood tests. .


I was rather frustrated at being blamed for my feeding & vaccination choices, particularly since it seemed like she didn't recognize that I made the choices with thought and consideration, and after researching the issues myself. At least she agreed with my decision to leave Tully's broken teeth for now, since these other issues are more pressing. (Tully's canines are broken, but they aren't bothering her) I still, especially after thinking about it post-visit, found it frustrating to be criticized for everything. My regular vets are much more open to different thoughts on treatments and care.

However, I still am not going to rush off and have the other tests for Cushings done, at this time. My research on this makes me a little uncomfortable with the standard drug therapies. If the issues can be controlled without them, I would prefer that. Tully is not at death's door. If she does have Cushings, she doesn't even have all the most typical symptoms yet. She's developed some flaky skin, but still has her hair, and doesn't have the pot belly. Her last bloodwork was done in September, and if there had been any sign of anything off then, my vets would have caught it. So if she has Cushings, she's early into the syndrome. She is not suffering.

If she doesn't seem to be showing obvious improvement after a month or 2, then I will go back to my regular vet and have more bloodwork done.


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