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‘Stitch’ Case Study – 2 1/2 year old Male Neutered Standard Poodle helped with Electroacupuncture

Meet ‘Stitch’  (and Kyle -Vet Assistant)                                                      

Buddies – Stitch and Kyle

Stitch came to see Dr. Cooke in April of 2021.  

The owner wanted a consult for his constant dribbling urine and fecal incontinence.  

He could not differentiate whether he was urinating or defecating since birth.  The owner notes he had to wear a belly band/diaper constantly because of this.

In his first 2 years of life, he had chronic urinary tract infections, kidney infection,  dribbling urine, and fecal incontinence.  He would posture to defecate 15 times before he would actually defecate.  His constant straining led to constipation and later hemorrhoids.

Stitch’s mom had already taken him to her regular veterinarian and an internal medicine specialist to help him with his condition.  

Stitch’s Problem List                                  

  • Dribbles urine constantly Urinary Tract Infections
  • Hard time defecating
  • Kidney Infections
  • Hemorrhoids
  • Soiling the House

Why Does Stitch have this problem??

Stitch’s problem likely is the result of his traumatic birth.  

 He was born with his intestines poking out (herniated) through his belly button /umbilicus.  His care givers saved his life by replacing the intestines and suturing his umbilicus quickly.

At the time of presentation to see Dr. Cooke, he was on testosterone injections every 4 to 6 weeks from the internal medicine specialist  and Miralax to soften his stool and treat the chronic constipation. 

His internal medicine work up included:

  • abdominal ultrasound
  • repeat urine cultures
  • contrast CT excretory urography 
  • All this testing found no abnormal prostate, ureters, or kidneys. 

While slightly better on the treatments from the internist, he was still dribbling urine and had to wear the belly band whenever in the house.  His owners wanted a better quality of life for Stitch so they sought out Dr. Cooke. 

Possible Reasons for Stitch’s Problem:

Congenital causes of urinary incontinence of male dogs include:

  • ectopic ureter
  • congenital urethral sphincter mechanism incompetence
  • detrusor instability or hyperreflexia
  • neurologic disease with various etiologies affecting lower motor neuron function
  • Neurological lesions within the distal spinal cord of L1 to S3 (lumbo-sacral area of the spine) or affecting the hypogastric nerve or the pudendal nerve can be associated with urinary incontinence. 

This last possibility of lower motor neuron damage of the L1 to the S3 segment was presumed to be the culprit because of his birth trauma by Dr. Cooke.  

What Can Be Done for Stitch??

The treatment of electroacupuncture (EAP)  is an excellent modality to help ‘wake up’ the damaged nerves and help nerve conduction return to better function. 

Traditional Chinese Veterinary Medicine herbals were also recommended to help improve function but were not elected in this case, based on the level and amount of work up and cost to date by the owner.  EAP and Chinese herbals together are more powerful then either one of them separated.  However, both are very powerful modalities. 

The Traditional Chinese Veterinary Medicine pattern for Stitch  is Lin Syndrome with Jing Deficiency.   Chinese medicine uses patterns instead of diseases to ‘work up’ a case.  This case pattern  indicates dribbling urine and not holding urine in due to lack of Chi (Qi) due to a congenital deficiency. 

On Dr. Cooke’s exam, Stitch’s tongue was pale, he had dull anal tone, and he was hypersensitive to the panniculus stimulation down his spine.  His lesion was identified at L4 to S1.   

The panniculus stimulation is a simple procedure where the doctor softly pinches the skin near each vertebrae down  the spine.  A normal patient with a normal nerve segment will ‘sense’ (afferent nerve) the pinch, send a signal to the spinal cord and up to the brain, the brain then sends a signal back down the spinal cord to the ‘motor’ nerve (efferent nerve) to move!  A normal spine will say ‘ouch, that is pinching me…better move to stop it’.  An abnormal response would be lack of reaction or hyper -reaction. 

A total of Four electroacupuncture (EAP) sessions were performed:      

First EAP  April 5, 2021

After the first treatment he went outside the vet office right away and urinated like a normal dog.  He has never done this.  His belly bands were much drier over the next several weeks.  He voids more urine when he urinates vs. just dribbling his urine. 

Second EAP  April 19, 2021

Before beginning his second treatment, the owner noted that after his first treatment he is 15 to 20% better.  He urinates more easily now.  He plays with the other dogs after acupuncture and does not need to rest.  His urination is more consistent and he is less ‘confused’ whether he is urinating or defecating.

GV-1 a local point to stimulate the Pudendal Nerve…PAIN FREE STIMULATION!! 😊

Stitch enjoyed his EAP and hanging out with Kyle

Third EAP    June 7, 2021

Before beginning his third treatment the owner notes he  is 60% better with his urination after the second treatment.   His belly band has only been saturated once since his last EAP.   He continues to improve on ‘knowing’ whether he is urinating or defecating. 

Fourth EAP   Sept. 16, 2021

Stitch is now 70 to 80% better.   He rarely dribbles only a little urine now and that is while asleep and it only occurs every 5th day or so.   The owners are very happy with his progress to date.  He does not have to wear the belly band around the house during the day now.  His quality of life has improved quite a bit. 

Case Conclusion

This case is a wonderful example of blending Western and Eastern Medicine medicine together.  Stitch was significantly improved once adding the electroacupuncture.  With only 4 treatments, he is 70 to 80% better.  He is no longer fecal incontinent, as he defecates in appropriate places and times.   Stitch improved more due to the electroacupuncture simply because the nervous system was directly stimulated and helped it return to better function.  Acupuncture is a very powerful tool that can be used in almost any case of weakness, nervous system issues, post trauma, and for generalized wellness! 

The western treatment of testosterone and Miralax should be continued along with the TCVM treatment.  Additionally Chinese herbals to treat the TCVM Lin Syndrome is another option to add to the course of this treatment.  EAP is recommended periodically to continue Stitch’s progress to date. 

‘See you next time Kyle’ says Stitch

Thanks for reading !!  I hope to have more blog spots and case studies for you to enjoy during the next year!

 

Wishing you your best health,

Dr. Denette O. Cooke, DVM, CVA, CVMMP

 

 

 

 

 

 

 

 

Acupuncture: The ‘New’ yet Ancient Pain Reliever now FDA approved!

Acupuncture has been used by the Chinese to ‘heal’ patients for over 2000 years.  Science has proven it’s effectiveness to release endorphins, decrease inflammation, improve circulation to  move blood and lymph, support the immune system, and even likely, stimulate stem cells to help heal tissues, and decrease pain.  Soon it may be getting the FDA’s formal approval as a method to treat pain.

Tiny needles but SO powerful!

Tiny needles but SO powerful!

At The Cooke Veterinary Medical Center, we have been healing dogs and cats with acupuncture since 2005.  Dr. Cooke finished her certification in veterinary acupuncture (CVA) in 2008 from the Chi Institute in Florida.  Since that time, Dr. Denette Cooke has helped patients with conditions such as: arthritis, disc disease, pinch nerves, back and neck pain, immune mediated disorders, unspecified pain, various forms of cancer, endocrinopathies, and allergic conditions.  Acupuncture can stand alone as a treatment or be combined with specific herbal therapies, veterinary medical manipulation (think chiropractic for pets), food therapy, diet manipulation,  and Tui Na (which is ancient soft tissue massage) techniques.  Each patient and case presentation is different.  The beauty of a holistic approach is that all treatment recommendations are unique to each individual patient in it’s own unique environment and situation.  There is no ‘one size fits all’ treatment like in Western medicine.

The FDA is now taking the first steps to formally recommend acupuncture and chiropractic care for humans for pain management.  With the opioid epidemic worsening, Western human medicine is having to check it’s practices for prescribing pain medications to humans.  The research to support acupuncture and chiropractic, along with evidence-based case studies, has been available to the medical community for a long time.  It is now time for physicians to learn about and recommend these alternative treatments. It is time for them to ‘think outside the Western box’ of medicine.

We are fortunate in veterinary medicine in that we are freer to ‘think outside of the Western medicine box’ because often our patients need alternatives when Western medicines and treatments don’t work. Also when surgery is recommended but the age and condition of the patient makes that procedure more risky to the patient.  Instead of throwing up our hands and saying, “we have done all we can”, we look for alternative ways based on evidence, scientific data, and clinical experiences of success in the areas thought to be outside the norm of clinical practice such as acupuncture, herbals, food therapy, veterinary medical manipulation (akin to chiropractic), Tui-Na massage, and more.

At The Cooke Veterinary Medical Center our patients  don’t worry about the science behind the treatment or the stigma associated with trying it! They just feel better! And not because they want their owners to be happy…they feel better because it works!

Check out our recent interview on acupuncture for pets with Tim Pandajais of 13Newsnow and his beloved Golden Retriever Bentley.  Watch Bentley begin to chill with his endorphins!

New Trend in Fear-Free Medicine is Old Hat to Us

When I opened The Cooke Veterinary Medical Center in November 2002, the veterinary catch phrase trend ‘Fear-Free Medicine’ did not exist.  With increased awareness of fear in our patients and ways to combat it, it has become a significant and much needed movement  in veterinary medicine.   Developed by the late veterinary behaviorist, Dr. Sophia Yin, and other behaviorists, it includes techniques employed by the veterinary staff to lower the stress and fear levels of pets when they visit the animal hospital.

Kitties find snuggle time!

Kitties find snuggle time! No rush….no stress!

Techniques involve low sound levels, comfortable bedding on the table, stress free restraint in order to trim nails or draw blood, positive reinforcement of food treats and tastes that release the happy hormones in the brain, decreasing stress in the pet.  You may have heard of these techniques being used in the last few years.

In 2002 when we first opened our doors, we intuitively employed these techniques.

Since day one, we do not take routine rectal temperatures on pets.  We routinely use ear thermometers instead of rectal thermometers.  If we are concerned a true fever exists,  we will certainly take a more accurate internal temperature rectally, but our patients appreciate that the rectal temp is not the first ‘hello and how do you do’.  It is little wonder the profession has stressed them out.

We do not rush in and rush out of a room. Our appointment schedule prioritizes quality time, not volume.   We take our time getting to know our patients by loving on them first.  If we have a skittish pet, we calm them by using pheromones in the exam room (Feliaway and Adaptil )and avoiding direct eye contact with them until they relax.  Direct and staring eye contact to a ‘predator species’ can mean ‘attack’ if they are already skittish and fearful.

Our exam rooms are insulated to decrease sounds so chatter cannot be heard from room to room.  Our rooms are large and open with large windows allowing in natural light decreasing stress to our patients and clients.  Many family members can be present for the visit if they choose.  The tight, small rooms in many vet offices are claustrophobic and offer no natural light.  We also have no stainless steel tables in our office.  The cold sterile feel of yesteryear has been replaced with granite, and we sit down with the client and to exam the patients. We place comfortable towels on the table for snuggle time for those pets that love to hide.  Of course, larger dogs are examined on the floor with what is more of ‘massage and play time’ than an exam.  Check-out occurs in the exam room, making it easier on owners and pets. ‘We wait on you’ – not the other way around.

Kitty exam in a box!

Kitty exam in a box!

We have open viewing windows into our surgery suite and our treatment center.  Clients who wish to watch us work or see how ‘Fluffy’ actually does for the nail trim or the blood draw may do so if they wish.  Some pets are better if the client is present; some are calmer if the client is not present.  When I first revealed the open windows concept in 2002, more than one veterinary insider said that I ‘was crazy and I would regret that decision’.

In 2016, not only am I without regret, I am proud to say The Cooke Veterinary Medical Center is a pioneer in the industry!  By including our cherished clients and their beloved pets in ‘the healing process,’ we all enjoy a better quality of fear-free living!!