Why parasite screening in pets is more important now than ever!

It has always been astounding to me the number of pet owners who decline stool parasite screening as a regular component of the well visit. Statistically I have found that 48 percent of pet owners decline yearly parasite screening despite my assertions that these parasites can be monsters within that not only chip away at the health of the actual patient but could put the human family at risk as well. From a medical perspective , routine parasite screening has always been an essential component to maintaining the health of the animal patient and the human family he resides with . However, now with the emergence of resistant parasites, routine parasite screening has never been more important.

What we refer to using the term “resistant parasite” , is the emergence of parasites that are no longer eradicated using our traditional anti-parasite medications. That is, they have gained genetic resistance to the effectiveness of parasite medications that have previously been effective in treating parasites for years.

Particularly concerning are resistant strains of hookworm that we have been encountering starting here in my home state of Florida, but now spreading throughout the southeastern United States; and it is predicted that eventually those strains will be nationwide. In light of the emergence of these resistant hookworm strain, we find ourselves having to get creative with anti-parasitic cocktails in order to successfully treat them. There is even a strain that infects primarily greyhounds for which there is actually no effective treatment.

So why should pet owners be concerned about this? Hookworm is well-documented to chip away at the health of the Patient either with direct irritation of the bowel and malabsorptive syndrome , but when subclinical (meaning no direct GI symptoms), is known to chip away at the health of the patient by zapping its nutrients and reducing the effectiveness of his immune system. On the human side, hookworm can infect a person and reach a larval stage that can migrate through the skin and cause severe itchiness, discomfort and cause spider web looking lesions on the skin. These type of larvae are called cutaneous larval migrans. I have a family member who contracted this from his puppy that was infected with hookworm and it took several rounds of medication and weeks of discomfort to rid himself of the parasite.

There is also an emergence of resistant strains of giardia, a protozoal parasite that also primarily infects the gut. While giardia remains species specific and the canine and feline versions do not appear to currently have the ability to infect people, the ability for an organism to jump species often starts with the emergence of strains resistant to medication that would normally successfully treat them.

Thankfully, we have new technology at our disposal to not only highly accurately identify the presence of parasites , but can also identify resistant strains. Traditionally, most stool tests relied on a technique where ultimately the main diagnosis is obtained by a technician literally looking under a microscope and looking for eggs produced by certain worm parasites and cysts produced by certain protozoal parasites. These tests had uncomfortably high rates of false negative as high as 25%, but also did not enable us to identify specific strains of parasites. This still served us pretty well given that resistant strains of parasite are only a recent phenomenon, but now knowing that they are among us it is important to know if we are dealing with a resistant strain right out of the gate.

Specifically, instead of relying on the human element of visually searching for parasite components, we now have gastrointestinal PCR testing at our disposal that takes a human element out of the testing and makes it highly accurate. PCR identifies DNA signatures from the individual parasites present in the stool and not only finds the organism but tells us the exact strains so that we know if a patient is infected with a resistant strain; and can therefore get aggressive with the treatment immediately . It costs a bit more than traditional stool parasite screening, but in my opinion given the potential health benefits of catching these parasites strains before they wreak havoc on the health of the patient or put the human family at risk , are priceless.

I recommend that the next time your pet has a yearly well visit , ask your vet about GI PCR parasite testing instead of traditional diagnostic techniques. For a slight uptick in cost you will receive a high level of diagnostic accuracy never-before-seen and if positive, be armed with knowing the exact strain of parasite and therefore the best way to treat it.

Dr. Roger Welton is a practicing veterinarian and highly regarded media personality through a number of topics and platforms. He is the author of The Man In The White Coat: A Veterinarian’s Tail Of Love. In addition to being passionate about integrative veterinary medicine for which he is a globally recognized 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 , general partner of Grant Animal Clinic, and runs the successful veterinary/animal health  blogs Web-DVM and Dr. Roger’s Holistic Veterinary Care.  Dr. Welton fulfills his passion for lacrosse through his lacrosse and sport blog, The Creator’s Game.

Is There A Use For Medical Marijuana For Pets?

As medical marijuana becomes legal and accessible to more people in more states, pet owners are looking for ways they can use this new family of medications to help their pets. In humans, marijuana and hemp products, and their extracts, are being touted to treat a wide variety of syndromes and diseases. I know individuals who suffered from seizures, or chronic pain, and their lives have dramatically changed for the better, thanks to cannabis-made medications. Fortunately, there are well-designed studies to back up many of these claims…in people.

When it comes to pets, we aren’t so lucky. Can we extrapolate human data to apply it to dogs and cats? We do with many other drugs quite often, but we must be cautious. Does the law allow for pets to use medical marijuana? The laws are rather silent on pets, making it more risky. Here’s a breakdown.

A quick internet search for legitimate information on cannabis products for pets yields primarily companies selling these products. Obviously, they will tell you their particular product or brand is superior to the others, and their product will treat, manage, or even cure a long list of diseases. We need to wade through the advertising and self-promotion and get down to facts.

CBD, THC, cannabinoids…the basics

Marijuana and hemp are plants in the genus Cannabis. Many different species and strains of these plants exist, and almost 500 different compounds have been isolated from these plants, all with potential medicinal uses. Of these, over 80 are classified as cannabinoids. Different plants contain varying levels of cannabinoids and other compounds.

Every chemical has its own unique properties, and much more research will be needed for us to understand the full potential of this array of potential medications. For our purposes, there are two main cannabinoids that you’ll see mentioned the most: CBD and THC. CBD (cannabidiol) is the “medicine-y” cannabinoid. It’s extracted from a hemp plant, but lacks the psycho-active effects most people think of when they think of marijuana. The molecule responsible for that “high” one can get from marijuana is the other cannabinoid called THC (TetraHydroCannabinol). Think of CBD as the president of the science club, and THC as the party girl, if that helps.

The marijuana plant contains more THC, the chemical responsible for the “high”, while the hemp plant is more fibrous, and contains very little THC. Instead, hemp’s main compound is CBD. What makes us call one plant hemp and the other marijuana if they are both in the same family? Basically, more THC earns it the name “marijuana” while less THC (<0.3% depending on who you read) makes the plant hemp, or even “industrial hemp.”

There are also synthetic cannabinoids out there. The laws are more lax on these, making them “less illegal”, as most of the rules the DEA makes are about the compounds extracted from Cannabis plants (see below). Two of them are actually FDA approved (for human use!) Marinol is prescribed to help AIDS patients not lose their appetites and maintain body weight. Cesamet is prescribed to patients undergoing chemotherapy to help reduce the nausea and vomiting which can happen too commonly. It’s also being used (again, in people) to treat chronic pain and even Irritable Bowel Disease!

While these synthetic cannabinoids sound like a great thing, patients taking them report they don’t seem as effective. Apparently, the synthetics contain one and only one compound, while the extracts contain mainly that compound, but have other cannabinoids along for the ride that seem to have an additive effect. So, bottom line, the products from plants, as of now, seem to work better.

Giving cannabinoids to pets

I know very few veterinarians who recommend these products, for a variety of reasons. Little to no data exists on what dose is safe and/or effective. Little is known about drug interactions. Next to nothing is known about long-term use, simply because the state laws allowing us to conduct large scale clinical trials with it are relatively new. There is absolutely no regulation of production of these products, so we have no way of knowing if what is claimed on the bottle is what actually is in the bottle. Finally, the constant changing of the legal status of these products makes many veterinarians want to keep their noses clean and avoid the whole legal mess until the federal and state laws can come to some agreement.

Here’s a taste of what we do know.

CBD has great promise in the treatment of seizures, but appears to be poorly absorbed into dogs’ bodies when given orally. As far back as 1988, we knew cannabinoids had great potential as a treatment for seizures. Six dogs were given the CBD through an IV, then orally to compare. The IV doses were absorbed into the blood stream and eliminated via the liver. The medication hung around a while too, with a half-life of 9 hours! The oral dosing was not at all absorbed (none detected in the bloodstream) in half the dogs, and the other three that did absorb it had negligible levels. This study was only of six dogs, so we cannot draw any major conclusions from it. Yet, it does not seem promising for CBD’s as an oral option, unless presented in a different version or compound than the one used. Obviously, much more research needs to be done. (Pharmacokinetics of cannabidiol in dogs. Drug Metab Dispos. 1988 May-Jun;16(3):469-72.)

CBD might inhibit the cytochrome P450 enzyme. Here’s the research on it. Not a bad paper, but everything was done in vitro, (where most research starts) and nothing performed in an animal. Chemicals can behave differently than cells in a liver. And what is cytochrome P450 and why do we care? Oh, you care! This is a very important enzyme in the liver that is responsible for metabolizing (breaking down) medications or toxins. If this enzyme is inhibited and your pet is on other medications, it could, theoretically, cause the circulating dose of those other medications to increase, which is not always a good thing.

Dogs may have up to ten times more CB receptors than humans. In order for any chemical to interact with a living organism, there have to be receptors on the cells somewhere in the body. Imagine a catcher’s mitt that has a unique shape that only a certain size and shape of ball can fit into. That is what the cells in our brains, liver, and even skin have. For example, glucose receptors seek out glucose and bind to it. The CB receptors are like catchers mitts sitting on the cells and waiting for a cannabinoid molecule to be caught. When it is, the cell absorbs the molecule, chemical reactions happen, all kinds of magic. Bottom line – the more receptors an animal, or even an organ, has, the more sensitive that animal, or organ, is to that chemical. With dogs having 10 time more receptors for cannabinoids than people, they could potentially be 10 times more sensitive! This must be taken into account for both dosing, and thinking of side effects. (Houghston, SW Vet Symposium 2016)

So, take the first paper into account, where the CBD’s did not seem to enter the bloodstream of dogs when given orally. Now we know dogs have 10 times more CB receptors than people. How the heck do we decide on a dose?

That is precisely the problem.

CBD has been shown to reduce seizures in rats. We’ve also learned, anecdotally, that cannabinoids help epileptic humans as well. We suspect it works by inhibiting the CB receptor, and/or reducing calcium fluxes in neurons. (Izzo AA. Non-psychotropic Plant Cannabinoids: New Therapeutic Opportunities from an Ancient Herb. Cell Press, Elsevier; 2009:515–527.)

CBD may be a potent neuroprotector. Once nerve cells die, they are gone forever. This is why brain damage of any kind, in any species, is such a big bad deal. Izzo et al suggests CBD’s may prevent brain cell death in certain situations, and can even reverse brain damage resulting from lack of oxygen… in rats.

Lesser-known cannabinoids (CBC and CBG) have demonstrated great antimicrobial activity. With all the antibiotic resistant bacteria we have in the world, a new medication that can possibly kill “super-bugs” would be wonderful!

There are many other great studies out there on rodents, giving us hope for future applications. However, it’s a start, and much more needs to be done.

So what is legal, and what isn’t?

And why is this so complicated?

Web-DVM guest blogger Dr. Karen Louis is a practicing small animal veterinarian.  See more of her articles at her blog at VetChick.com

Top Pet New Year Resolutions 2017

It is time for my yearly pet New Year resolutions that I suggest to all pet owners for the coming year!

Walk Your Dog For 20 Minutes Every Evening

Exercise outside in the back yard is great and any dog is lucky to live in a home with a yard where he is free to run and play.  But…nothing compares to the walk on the leash outside of the confines of the home that give the dog a sense of freedom and excitement the back yard just does not provide.

The mental and physical benefits of a nice walk cannot be over stated as a routine that provides new sights, smells, and enhances the canine bond with his owner.  The adrenaline rush and excitement of the walk is especially beneficial for senior aged dogs to get arthritic joints moving, maintain muscle tone, and stimulate the brain to slow the progression of senility (doggie dementia).

And guess what?  It’s good for you too!  My 8 year old son and 6 year old daughter are even excited to get in on our almost 11 year old Lab’s nightly after dinner “Energy Walk.”  My son even readily abandons his Xbox that he got for Christmas rather than miss the opportunity to stroll around the neighborhood with Bernie, gaze at the stars, and take in the sounds and scents of the evening.

Purchase Pet Insurance

The cost of veterinary care rises on average by 4%-6% per year.  This does not occur because veterinarians are greedy, but because the costs of running a veterinary hospital go up by 4% – 6% per year.  These costs include reference lab fee increase, regulatory and licensure fee increases,property tax increases, tangible tax increases, inventory cost increases…I could go on here, but you get the point.  With this increase in health costs exceeding the rate of inflation by 1.5 to double, do the math and one can see that at some point, the cost of quality veterinary health care can become unsustainable for many pet owners.

It is best to purchase pet insurance BEFORE your pet has experienced any significant health concerns that would be deemed pre-existing conditions that would be excluded from coverage.  It is also best to avoid pet insurance companies that are owned by human insurance companies.  I have seen many reputable pet insurance companies go to hell in a hand basket after having been bought up by human insurance companies.  Obamacare does not apply to pet insurance, so they are free to weasel their way out of paying out claims to their heart’s content.

Stop Falling For Gimmicky Pet Foods And Stick With Trusted, Reputable Brands

Every time I turn my head, there is a new pet food on the market capitalizing on the grain free, corn is the devil, and byproduct ingredients are hair and hooves craze.  Some call themselves “holistic” diets, although no standard, classification, or pet food watch dog agency has a criteria or designation for such a claim.

I am amazed by the amounts of money pet owners will spend on unproven diets that are usually not nutritionally well balanced, do not have AAFCO (American Association of Feed Control Officials) certification, and have nothing impressive about them other than a great marketing department.

At the risk of attracting rants from conspiracy theorist trolls that are convinced veterinarians base their opinions on a pet food industry that gives us huge kickbacks and sends us on lavish vacations, I will advise you to stick with the most trusted diets.  Why do we trust certain diets?  Because of their commitment to species appropriate, breed appropriate nutritional balance, research and development, and quality control.

Royal Canin and Hills year in and year out fulfill all of these criteria and are usually a great deal less costly than whatever new pet food du jour is the flavor of the moment.

Happy New Year everyone!  Make 2017 a great one!

Dr. Roger Welton is a practicing veterinarian and well regarded media personality through a number of subjects 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.