16 yr. old Greta enjoys the spotlight and natural mineral waters at the DogSpa Resort in Desert Hot Springs – only 15 minutes from Palm Springs!

Senility, or old dog syndrome, was once a familiar way to describe the family dog that was starting to resemble an elderly grandparent’s strange lapse of memory and bouts of curious behavior. In recent years, the odd forgetfulness plaguing our aging senior population is being followed with an alarming question – could this be Alzheimer’s disease? Misplacing car keys and then misplacing the car has become more than a senior moment.

Researchers, some 20 years ago, began studying the canine brain as a research model for Alzheimer’s in humans. They discovered a striking similarity between both species. Microscopically, post-mortem affected dogs and humans showed similar plaque-like lesions (caused by a protein called B-amyloid) in brain tissues. In addition, cognitive testing showed the same progressive decline in mental functions associated with thinking, recognition, memory, and learned behavior. It’s now estimated that fifty percent of dogs over age of 10 years will exhibit one or more symptoms of canine cognitive dysfunction syndrome (CDS) or doggie Alzheimer’s. Researchers have studied heavy metal pollution as one likely cause – namely aluminum toxicity.

One of the principal symptoms of cognitive dysfunction syndrome is disorientation. Your dog can appear lost in the house or yard, get stuck in corners or behind furniture, have difficulty finding the door to the yard (stands at the hinge side or goes to the wrong door), doesn’t recognize familiar people, and fails to respond to verbal cues and even his name. Before assuming your dog is showing signs of cognitive dysfunction syndrome, your vet should rule out hearing or vision loss and other medical problems that could affect behavior. Also, if your dog is taking pharmaceutical drugs, possible side effects must be ruled out before accepting the diagnosis of CDS.

Housetraining is another area that suffers. Your dog may urinate and /or defecate indoors, sometimes even in the view of family members, failing to signal the need to go outside.

Often, interactions with family members become less intense. Your dog may seek less attention by walking away when being petted or show less enthusiasm when greeted. Other dogs become anxious and seem to need human contact 24/7 or start relentless pacing at night.

There is no specific test for this disorder. The number of symptoms the dog exhibits and its severity may prompt further testing. An MRI could show some degree of brain shrinkage, but the test would not be recommended unless a brain tumor is suspected. Proper diagnosis is often based on a checklist of behavioral questions and the score your dog receives.

Next week, find out how to reduce exposure to heavy metal poisoning by aluminum – common household, drugs and food products to avoid. And if your dog is already showing symptoms – help is on its way!

It’s not exactly new science, since the first major breakthrough came in 2006 when scientists discovered how to “reprogram” an adult cell to behave like an embryonic stem cell. Prior to this, stem cell research had been constrained by critics debating ethical and legal issues surrounding the use of human embryos. During that debate, I bemoaned the critics who remained firmly against the use of discarded umbilical cords of newborns (also considered to be embryonic tissue), stifling this promising frontier of medical research in the U.S. Fortunately, maverick scientists from around the globe pushed this door of opportunity wide open.

Advances in cell technology brought forth induced pluripotent cells (iPS). Like turning back the hands on a clock, mature adult cells could be returned to a primitive state of function – that of a developing embryo when cells are differentiating into specific tissue types. Pluripotent is a funny word that essentially means “able to do many things.” A fitting description for these mighty stem cells that are harvested from various tissues like skin, bone marrow, fat, and blood – then programed to heal other parts of the body.

For the last five years, fat-derived stem cell transplants – pioneered by a San Diego-based company called Vet-Stem (Vet-Stem.com) – has revolutionized the treatment of arthritis as well as tendon and ligament injuries in horses and dogs. The transplant begins by removing several grams of fat from the dog’s shoulder or abdomen area which is shipped to Vet-Stem. Their lab isolates the regenerative stem cells to be transplanted where needed. The most common canine application has been to repair diseased hip and other joints – improving mobility and reducing pain in older dogs.

The average cost of a stem cell transplant is around $3,000. Some pet insurance companies, like my favorite Pet Plan, will reimburse for this therapy. Also, you will need to locate a trained and certified veterinarian that can perform the procedure. In addition to offering a valid alternative to invasive surgery or the need for pain killers, other benefits include quick action and unlimited potential. The rebuilding of tissues occurs within thirty to sixty days. Though currently approved to treat osteoarthritis and other joint-related issues, the application of stem cell therapy to treat liver and kidney disease as well as other degenerative conditions holds real promise.

Regenerative medicine is paving the road with new hope to restore health – a vast improvement over what pharmaceuticals can accomplish. It’s already happening in countries like Costa Rica, where progressive free-thinking doctors are not deterred by overzealous regulation that keeps informed patients from getting the care they want and sometimes desperately need. People with crippling arthritis, spinal cord injuries, and multiple sclerosis that failed to improve with the standard of care in the U.S. can opt for this treatment at the Stem Cell Institute: CellMedicine.com.

I rely on several Zymox Otic® products made by PKB Animal Health. This unique drug-free formulation contains highly effective enzymes that are both antibacterial and antifungal. Zymox products work best in a “dirty” environment – NO pre-cleaning is required. For ongoing control and prevention of flare-ups, use daily for 7–14 days, then apply to affected ear(s) 3 times per week for maintenance. I recommend Zymox with hydrocortisone 1.0% for dogs diagnosed with allergic otitis externa. A fancy medical term for inflamed ear canals due to an allergic response.

Systemic antibiotics (given by mouth or injection) are surely indicated if the eardrum is ruptured – most of the time they are not needed, but remain mysteriously prescribed. Systemic anti-inflammatories such as corticosteroids are often employed in the first week or two of a flare-up, and then tapered off.

Okay, now think itchy dogs. Environmental allergies (referred to as atopy – the human equivalent of hay fever) carry a presumptive diagnosis when symptoms look like this itchy trio: 1) excessive paw licking; 2) red bellies and armpits; 3) hot inflamed ears. When patients with red ears show up with additional skin zones (paws, belly, and armpits) affected by inflammation and hair loss, a broader treatment plan beyond topical ear meds is called for. Low dose oral corticosteroids may need to be part of the treatment plan during high allergy seasons. Also helpful in these patients is frequent bathing with antibacterial and antifungal shampoos followed with a leave-on lotion that contains cortisone – I like ResiCORT® by Virbac.

Less common itchy ear culprits are food sensitivities. Possible food allergies fall under suspicion when your dog shows year around itchiness – as opposed to an intermittent seasonal pattern like hay fever. When food allergy pops up on my list of possibilities, a selective food trial begins for the next 6–8 weeks. Typically, a new protein source (not commonly found in pet foods) is chosen, like duck, rabbit, venison, or kangaroo. This diet must also be grain-free, so potatoes are often added. And no treats! Home cooked veggies or baby carrots will have to do for all you treat addicts. Vet alert: blood allergy tests have proven to be unreliable for the detection of food allergies – don’t waste your money. Blood testing can, however, confirm the diagnosis of an environmental allergic response (atopy) to plants, pollen, dust mites, fleas and other external factors.  In general practice, a thorough examination alone will often confirm the diagnosis of atopy and treatment can begin. Based on my experience, costly allergy testing is needed for the sole purpose of desensitization and should fall into the trained hands of dermatologists, not your vet.

Failure to properly treat smoldering ear inflammation will result in progressive trauma that could rupture the eardrum and or narrowing of the ear canal, making any treatment more difficult and less successful. The Cocker Spaniel and similar floppy eared breeds have the highest incidence of these problems requiring surgical intervention in cases where patients suffer from advanced disease beyond the reach of medications. Don’t wait – get help now to put out this inflammatory inferno!

If your dog has been experiencing recurring ear problems that improve with medication and then, déjà vu when the medication is stopped – let’s talk about it. First, it’s a given that your vet has flashed a bright light into the ear canal using an otoscope and ruled out ear mites, abnormal polyp-like growths, and foreign objects like foxtails, right? Sometimes the canal will need to be flushed first, removing all debris to allow for a complete exam of the canal and tympanic membrane (a.k.a. ear drum). Depending on your dog’s cooperation and tolerance for discomfort, medical sedation is often needed to do a thorough job.

But before I grab my otoscope, I like to ask a few telling questions: How long has the problem been going on? Does it improve with treatment? What tests have been done? Which medications have been used? Is it one ear or both?  These questions help me determine probable cause and the best treatment option.

Unlike the typical ear infections humans suffer (children especially) where the middle ear becomes a reservoir of bad bugs, dogs suffer primarily from external ear canal problems. Therefore, ear canal disease in dogs is categorized as a dermatologic (skin-related) condition and the reason that stubborn cases often end up being referred to veterinary dermatologists. These docs are the ear experts in the realm of veterinary medicine.

The typical disease cycle starts like this: relentless scratching irritates the skin surface of the ear canal which results in inflammation. Excessive ear wax production is a by-product of the inflammatory response, producing a rich environment for yeast and bacteria (normal residents of the ear) to multiply rapidly. An overgrowth of these microbes compounds the itchiness, adding fumes to the inflammatory fire pit. Now the itch-scratch cycle is in full force and your dog is begging to see the vet!

The microscopic presence of bacteria and yeast can be determined by taking a swab of the ear canal. Topical ear drops or ointments routinely prescribed are combo cocktails of antibiotics (to kill bacteria), antifungals (to kill yeast), and anti-inflammatory drugs like cortisone (necessary to dampen inflammation, stop the itch and reduce pain).

Next week I reveal my black bag secret weapon to stop the itch and help you solve your dog dilemma!

Championing this cause is Dr. Douglas Kramer, a progressive California veterinarian. Dr. Kramer says his goal is to “provide palliative care and prevent accidental overdoses resulting from owners’ well-meaning attempts to relieve their pets’ pain and suffering.”

Dr. Kramer was inspired by his beloved Husky, Nikita, who fought a long battle with cancer. After exhausting every conventional pain control medication and therapy available, Kramer began administering a marijuana tincture to Nikita in a last ditch effort. The results were nothing short of amazing. Within hours of the first treatment, he witnessed the return of Nikita’s appetite and her moaning ceased entirely.

While the cannabis did not cure the cancer, it did afford Nikita several more months of quality time with her family. A true believer, Dr. Kramer now dedicates most of his time to informing the veterinary community and pet owners about the therapeutic benefits of medical marijuana (aka MM or MMJ). He offers cannabis consultations – specializing in palliative and hospice care. More info on Kramer’s website: Enlightened Veterinary Therapeutics.

Currently, veterinarians cannot legally prescribe MM because cannabis remains a Schedule I drug by the FDA. To further this ignorance, many people think of cannabis only in terms of being purchased for recreational use – unaware that special strains have been developed with an eye toward pain control, nausea relief, and appetite stimulation – all within a zone of safety with minimal to no reported side effects.

Not surprisingly, public interest has peaked since the use of cannabis has been decriminalized. As veterinarians, pot has mostly been on our radar screen in regards to its potential toxicity when the family dog sniffs out the stash or worse yet, pigs out on laced baked goods like cookies or brownies. Please use caution if you are a user and keep it out of the reach of children and pets! Although most of the time, owners return home to find a stoner dog – spaced out, wobbling around, or lethargic – death by overdose can happen.

Never administer marijuana to your pet unless you’re under veterinary supervision. When used orally, in precise dosages under proper guidance, this herbal remedy does more good than harm. Plus, cannabis doesn’t adversely impact the liver or other organs, as most drugs do. Not tainted by Big Pharma, I’m giving earthly pot the green light. And kudos to the lawmakers in Washington State – their historic measure to regulate and tax marijuana deserves to be studied as a model of how legalization ought to be designed and implemented. Let’s end the war on botany.

In part one of this series, the spotlight was on three mainstream joint health compounds: glycosaminoglycans (GAG’s), avocado/soybean unsaponifiables (ASU) and cetyl myristoleate (CM). Any product that claims to support joint heath will list at least one of these compounds as its main ingredient and some will add a second for increased effectiveness. Again, read the labels. I favor the combo cocktails made by established companies known to be industry leaders.

As discussed earlier, products touting the effectiveness of the GAG’s were first to make a splash in the veterinary market. Here is a clever advertising fact. Nutramax, determined not to miss out on this gold rush, entered the human marketplace with Cosamin DS. Look closely and you will find that Cosequin DS got a quickie makeover – same pills with a new name and packaging. So, if you can buy Cosamin DS or Cosequin DS for less money, buy the better deal – it’s the same stuff!

Success with the GAG’s paved the scientific road for more innovation – older name brand products started adding CM and ASU to create new formulations. Nutramax entered the booming joint health market with Cosamin ASU for people and Dasuquin for pets. Both feature the addition of ASU to their earlier successes, Cosamin and Cosequin.

Newer companies, like Response came out swinging with a new bat – cetyl myristoleate (CM). Like their eager competitor, Nutramax, they formulated Advanced Cetyl M Joint Action Formula for dogs and its human cousin CM Response Joint Action Formula for people. Loading dose for a 50lb dog (100 tabs) costs under $40. After achieving notable improvement, the monthly maintenance dose drops the price to half, only $20 – that’s about half the price of Dasuquin! You can fetch a bottle on Amazon or the company website: responseproducts.com.

What’s best is a matter of what works best. You or your dog may get better results with ASU verses CM. Or vice versa. Be prepared to experiment with different products and higher dosages. Expect to see improvement within 2 weeks. However, it may take 4–6 weeks to achieve optimal results. Also check to see if an initial loading dose is recommended.

Use the handy chart below as reference guide to quickly examine how these joint formulations differ. Recognize that each parent company (with the exception of Pet Research) advertises both pet and people formulations that are essentially the same.  Note: the recommended serving is based on body weight and may contain up to 4 capsules for proper dosage – read the label carefully.

ConsumerLab.com purchased and tested more than 50 human and pet osteoarthritis supplements labeled to contain glucosamine, chondroitin, and MSM. This watchdog company exposed products that were contaminated with lead, missing certain listed ingredients, or had inadequate labeling. For a small fee you can review this report on-line.

Poor quality products are a witch’s brew of the following: listed ingredients do not measure up to label amounts, made with inferior sources of raw materials, may contain contaminates like lead or pills that fail to pass the dissolvability test for proper absorption. Expensive poop is the end result. Trusted brands could be worth paying more for when companies produce products that contain patented ingredients with ties to respected published research. Furthermore, never pay more for treats and pet foods that sprinkle glucosamine on products like fairy dust. There simply is not enough of the stuff to do anything. A fool and his money are soon parted.

Back when I started my practice in the 1980’s, the first recognized natural compounds being used as a drug-free way to ease joint pain and stiffness were the glycosaminoglycans (GAG’s). Since they are natural components of cartilage necessary for function and repair, it made sense they might help if researchers could find a suitable method of delivery – meaning get them into joint tissues. It was not until the 1970’s that the code was cracked and we had the first commercially available products, glucosamine sulfate (naturally sourced from shellfish) and it’s synthetic cousin, glucosamine hydrochloride, made in the lab.

Cosequin, made by Nutramax, was the first patented combination of glucosamine and chondroitin sulphate (both GAG’s) – a veterinary forerunner, but pricier than its generic knock-offs sold everywhere. My favorite in this category is Adequan – an injectable GAG formulation that got its impressive start treating injured horses. After four weekly injections, most dogs can be maintained on one to two injections per month.

Strong consumer demand paved the way for Nutramax to develop its next generation lovechild, Dasuquin and Dasuquin plus MSM. Using the same patented source of glucosamine and chondroitin (low molecular weight for better absorption) as in Cosequin, they added ASU for a synergistic effect. Nutramax also developed a feline formulation. Older, cranky cats should be screened for osteoarthritis as it remains underdiagnosed as compared to our canine companions.

Our third candidate has been around for decades. Cetyl myristoleate (CM) is derived from myristoleic acid, which occurs naturally in the African Kombo Nut, whale fat and beef tallow. CM’s healing properties were discovered by a research chemist on a quest to find a human cure for arthritis. Google Harry W. Diehl for a fascinating read – stay tuned for Part 4 of this series next week!

Over time or due to injury, protective joint cartilage (smooth surface allows the ends of bones to glide like a hinge) becomes thinned and cannot repair itself. This results in a “bone against bone” surface causing reduced motion, stiffness and pain. The joints most affected (knees and hips) are exposed to high stress and some experts consider OA to be the result of “wear and tear” rather than a true disease.

While modern day miracle drugs are often effective at reducing pain, these drugs do nothing to help the joint function better. Most commonly prescribed anti-inflammatory drugs (NSAID’s*) for pets are Deramaxx, Metacam, and Rimadyl. Caution: NEVER give your dog over the counter or prescription NSAIDS for humans. Side effects are far worse, even deadly, as compared to the veterinary formulations. If your dog is taking a veterinary prescribed NSAID, notify your vet if any of these known side effects occur: vomiting, diarrhea, or loss of appetite.

As with all NSAIDs, these drugs may damage the kidney and liver and your vet may routinely order lab tests to monitor for organ toxicity. Unless the pain is severe, I never start my patients on NSAID’s. My comprehensive approach starts with a diet review, weight loss program (if needed), modified activity and nutraceuticals. Three mainstream products – with studies to support their effectiveness – are glycosaminoglycans (GAG’s); avocado/soybean unsaponifiables (ASU); Cetyl myristoleate (CM). These natural compounds work in an attempt to repair damaged cartilage. Curious readers can quickly search on-line to discover how these amazing compounds work.

I recommend joint formulations that contain GAG’s plus ASU or CM. The most useful formulations work like a well-mixed cocktail – also adding natural compounds like bromelain, yucca, ginger root, turmeric and methylsulfonylmethane (MSM) to help reduce inflammation for pain relief. In part 2 of this article, I will outline the most successful veterinary products available. Don’t miss the gems I will share with you next week!

While glucosamine and chondroitin are often synthesized in chemical labs or sourced from animal by-products, NEM® is a bioactive matrix derived from eggshell membrane – a goldmine for joint repair! This fibrous membrane, normally discarded, can be harvested. When discarded eggshells can be recycled for beneficial use, it’s more proof that Mother Nature has provided all the tools we need for vibrant health.

In a clinical study first published in 2009, NEM® was proven to promote joint comfort and flexibility in just 7 to 10 days – making NEM® newest discovery in the last five years. Recommended people dose is 500mg once daily. Depending on body weight, Fido will take between 150mg to 450mg daily.

Be sure you are using the trademarked NEM® by ESM Technologies. Also examine the label for amount of milligrams (mg) per pill or capsule. Membrell markets both a canine and human product using NEM® as the single ingredient:  RE-NU for the dog (150 mg pills) and JOINThealth for people (500 mg capsules). If your dog warrants the higher 450mg dosage, buy JOINThealth since RE-NU requires 3 tablets for dogs 50lbs and over.

Another quality supplement company, Natural Factors, makes NEM Knee & Joint Formula with Glucosamine. Reading the label, note that the serving size is two capsules, not one. A bottle count of 60 (serving size 2 capsules) retails for $29 – which is only a 30 day supply. Compare that to a bottle count of 90 JOINThealth (serving size one capsule) for a 90 day supply which retails for $95. Which is the better value? That’s a toss-up when you do the math – both will cost about $1 per day for 500 mg. However, Natural Factors has added 1500 mg of glucosamine to their formulation – so, it might be the better buy. Shop for discounts on trusted name brand supplements and natural health care products at iherb.com. Get $10 off your first order with promo code TER 129. And always free shipping on any order over $40!

WAG Lifetime Joint Care by Pet Research, Inc. is a formulation of NEM® combined with patented extracts of curcumin (BCM-95) and boswelia serrata (BosPure) to reduce inflammation. These trademarked extracts offer better absorbability for improved results over those that lack this standardization. I found their recommended dosage to be low for various body weights. So, if you are not seeing results within two weeks, add an additional tablet.

Watch for Part II of this series next week – there’s more exciting products to review!

Cedar Oil Formulations not only kill the adult insects but their eggs and larvae as well. Prior to this technology, insect control levels this high could only be achieved by an assault of toxic weapons with detrimental consequences for the environment and animal kingdom. This specially formulated oil kills insects on contact by snuffing out their breathing system. The aroma of cedar oil – deadly to a long list of pests, yet harmless to humans, pets, the environment and beneficial insects like lady bugs, honey bees and butterflies. Works like a smart bomb!

Research using the carrier molecule, silane (obtained from melted quartz rock) proved to be the magic bullet needed to deliver a deadly dose of cedar oil to a targeted population of the nasties. See it to believe it here: youtube.com/watch?v=u1qYSLqlo_c.

Warning – not all cedar products work the same!  Be sure you buy the same 10% formulation used by the US Army which has been packaged for the consumer. Look for trade names like, Dr. Ben’s Evictor  (indoor premises); Dr. Ben’s Paws & Claws flea, tick and mite spray (pet spray);  Natures Defender PCO Choice (outdoor yard);  Dr. Ben’s Personal Insect Repellent (people). There are many products that contain cedar oil with claims that are not proven. These products fail to kill because they are using virgin cedar oil (no carrier molecule) and using less than the required 10% concentration. They are a questionable repellent at best.

As for over the counter flea and tick products – never buy them. Many contain pyrethins and pyrethroids – non-selective neurotoxins which can be a danger for our pets, especially cats. Newer generation insecticides like Advantage specifically disrupt the fleas’ central nervous system by targeting neurotransmitters not found in mammals. This makes the veterinary products a much safer option. In regards to ticks, I am not a fan of any spot on products – too many reported side-effects. Stick with Dr. Ben’s Paws & Claws spray.

Fleabusters and C.O.I. products are the green choice – safe and effective. It’s time to fire the Bug Man!