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EPHEDRA
IN CHINESE HERBAL MEDICINE, ephedra is a well-known herbal supplement for people and pets with respiratory conditions including asthma.

Therapeutic Uses
Ma huang was traditionally used by Chinese herbalists during the early stages of respiratory infections, and also for the short-term treatment of certain kinds of asthma, eczema, hay fever, narcolepsy, and edema. However, ma huang was not supposed to be taken for an extended period of time, and people with less than robust constitutions were warned to use only low doses or avoid ma huang altogether. Japanese chemists isolated ephedrine from ma huang (only the Asian species of ephedra contains the active compounds ephedrine and pseudoephedrine). It soon became a primary treatment for asthma in the United States and abroad.

Ephedra’s other major ingredient, pseudoephedrine, became the decongestant Sudafed. Dieters now use ephedrine as a weight-loss supplement.

When used properly, ephedra may be useful as a short-term treatment for sinus congestion and mild asthma.

Dosages
In people, it is recommended that ephedrine not be used for more than one week. In view of the documented dangers of ephedrine, medical supervision is highly recommended when using ephedra. Some holistic veterinarians recommend not using it in pets due to the potential side effects.

The pet should be prescribed the lowest dosage possible and strict veterinary supervision is essential. For pets with asthma, long-term therapy will probably be necessary, and close monitoring by your veterinarian is essential.

Safety Issues

Those with enlargement of the prostate, high blood pressure, heart disease, diabetes, glaucoma, or hyperthyroidism should not take ephedra. Furthermore, it should never be combined with MAO inhibitors or fatal reactions may develop. If symptoms such as a rapid heart rate, rapid breathing, anxiety or restlessness develop, see your veterinarian.

Cats exhibit idiosyncratic reactions; for this reason, it should probably not be used in cats. Ephedra, most commonly prescribed for pets with asthma or respiratory problems, can cause heart arrhythmias and high blood pressure. Use with great caution in all pets. It should always be combined with other herbs to allow the use of the lowest dose of ephedra possible.

Ephedrine mimics the effects of adrenaline and causes symptoms such as rapid heartbeat, high blood pressure, agitation, insomnia, nausea, and loss of appetite. Unscrupulous manufacturers have promoted ma huang as a natural hallucinogen (herbal ecstasy) and not as a bronchial decongestant. Dosages of ephedrine required to produce psychoactive effects are exceedingly toxic to the heart; the FDA has documented deaths of otherwise healthy young people who reportedly used ephedrine for psychedelic purposes.

Ephedra is not recommended for young children, pregnant or nursing women, or those with severe liver, heart or kidney disease; similar precautions are probably warranted in pets.

COLTSFOOT
The leaves and stems of the mature coltsfoot plant are often recommended by herbalists for the therapy of various respiratory disorders.

It is recommended for pets with asthma, and respiratory infections, including kennel cough. It acts as an antimicrobial, expectorant, and cough suppressant.

Safety Issues
The flowers (not the leaves and stems) contain small quantities of alkaloids that can cause liver damage or cancer if taken in large quantities. Use only as directed and for short periods of time (one to two weeks). Do not use in pregnant animals or pets with liver disease.

LOBELIA
Lobelia may be useful in certain respiratory condition in dogs and cats, including bronchitis and asthma, and as a general respiratory stimulant.

While useful for respiratory problems, lobelia can act as a nervous system depressant. This may make it useful for pets with excess nervous system stimulation, such as those with epilepsy or hyperactivity.

While generally safe, at high doses lobelia can cause vomiting. An active ingredient in lobelia has nicotine-like actions. It should not be used during pregnancy or lactation, and care should be used if combined with other supplements or medications that can depress the nervous system.

FEVERFEW
Feverfew contains several chemicals; the major one of interest is the lactone parthenolide. For many years, it was assumed that this was the active ingredient. Numerous articles were published explaining that parthenolide caused platelets to release serotonin and reduce the synthesis of prostaglandins, leukotrienes, and thromboxanes. Based on this premature explanation, authors complained that samples of feverfew on the market varied as much as ten-to-one in their parthenolide content.

However a study found that an extract of feverfew standardized to a high-parthenolide content is entirely ineffective. Apparently, this high-parthenolide extract lacked some essential substance or group of substances present in the whole leaf. What those substances may remain mysterious.

Therapeutic Uses Feverfew is often recommended in people with migraines and for its anti-inflammatory effects, which help pets with asthma. It might also be of benefit for pets with arthritis. This herb inhibits platelet clumping and inhibits the formation of histamine and serotonin, which may be of benefit to pets with asthma or allergies. It contains (especially the flowers and upper stems) pyrethrins and can be used as a natural flea control rinse.

It may be useful as a safe “aspirin substitute” in cats as it does not contain salicylic acid.

Avoid during pregnancy to prevent abortion. The fresh foliage can cause mouth ulcers, and only the dried herb should be used. Feed a test dose first to check for oral irritation and sensitivity. Do not use internally for more than one week at a time. Do not use in pregnant animals.

Do not use in animals with platelet problems or bleeding disorders.

Safety in young children, pregnant or nursing women, or those with severe kidney or liver disease has not been established; similar warnings probably apply in pets.

Liver disease is the catch-all term that is applied to any medical disorder affecting the liver and usually causing elevated blood levels of liver enzymes. It can be divided into both acute and chronic disease. Causes of acute liver disease include toxins (a number of drugs have been implicated in causing acute liver disease, including Tylenol, Rimadyl, Valium, tetracycline, sulfa drugs, and mushroom poisoning); also, hepatic lipidosis, trauma, heatstroke, and infections (canine infectious hepatitis). Causes of chronic liver disease include genetics, infections, toxins (anticonvulsants, Rimadyl), and idiopathic hepatitis.

Feline cholangiohepatitis is a common inflammatory liver disease in cats that may be associated with infection of bacteria from the intestines that ascend the bile ducts.

Certain breeds of dogs are prone to chronic hepatitis and cirrhosis (an end stage of liver disease in which liver tissue is replaced with fibrous tissue). Doberman Pinschers (especially females), American and English Cocker Spaniels, Bedlington Terriers, and West Highland White Terriers are the breeds associated with chronic liver disease and cirrhosis.

Clinical signs of liver disease include lack of appetite, vomiting, diarrhea, increased thirst, increased urination, lethargy, jaundice, and seizures. Liver disease is diagnosed by blood and urine tests, abdominal x-rays, and abdominal ultrasound. Liver biopsy is needed to determine the cause of liver disease.

A common liver disease in cats is hepatic lipidosis (fatty liver disease). This occurs in cats (and sometimes in dogs) as a result of starvation and weight loss (hepatic lipidosis can occur in cats who do not eat for as little as 72 hours). Depletion of certain nutrients (choline, carnitine, arginine) impairs metabolism of fat, resulting in fat deposition (rather than removal) from the liver.

PRINCIPAL NATURAL TREATMENTS FOR LIVER DISEASE IN PETS

Natural Diet—Dietary therapy is a mainstay of treating the pet with liver disease, as there are few conventional medications that actually treat liver disease. High quality and highly digestible carbohydrates are recommended to supply energy for the pet. Inferior types of carbs that are undigested are fermented by intestinal bacteria, which increase the bacteria in the colon. These bacteria then break down dietary proteins and produce extra ammonia, which is absorbed into the body and contributes to toxicity in pets with liver disease. Frequent feedings of high-quality, simple carbohydrates such as white rice and potatoes are recommended. Vegetables act as a source of complex carbohydrates and provide fiber; the fiber helps bind intestinal toxins and promotes bowel movements to remove these toxins (by-products of protein digestion and bacterial fermentation of undigested foods) from the body.

Proteins provided by the diet must be of high biological value to reduce the production of ammonia, a by-product of protein digestion. Most commercial foods contain proteins that are not of high biological value. (Many commercial foods may also contain excess vitamin A, copper, and bacterial endotoxins, all of which contribute to the clinical signs in pets with liver disease.) Unless your doctor recommends protein restriction (usually only needed by pets with encephalopathy, a condition producing neurological signs in pets with sever liver disease), normal amounts of protein should be fed, as the liver needs protein during repair.

Studies show that dogs with liver disease fed diets containing meat-based proteins have shorter survival times and more severe clinical signs than dogs with liver disease fed milk-based or soy-based protein diets. Cats require higher protein diets than dogs. While it may be more beneficial to cats to also feed them diets based on milk-based or soy-based proteins, most cats prefer meat-based diets. Cats fed milk-based or soy-based proteins must have supplemental taurine (100–200 mg/day), as milk has minimal taurine and soy has no taurine.

In cats, hepatic lipidosis is the most common liver disease and is secondary to starvation (often seen in overweight cats who go without eating for as little as three to five days). It is a secondary complication of anorexia and obesity rather than a true primary liver disease. Force-feeding cats to help heal the liver and correct the underlying problem is the treatment to hepatic lipidosis. This often requires tube feeding of special diets. When feasible, high-fat (approx. 30%) enteral diets containing milk-based or soy-based proteins are ideal for these cats; taurine supplementation of 150 mg/8 ounces of liquid diet is recommended.

Adding the amino acids arginine or citrulline to the diet may be indicated, as these amino acids accelerate the conversion of highly toxic ammonia to urea, reversing the clinical signs of toxicity that may occur in pets with liver disease. Glycine may decrease the toxicity that affects the kidneys when the chemotherapy drug cisplatin is administered.

Fat is used in the diet for energy. Even pets with fatty liver disease do well on diets containing 20 to 25 percent fat. Free fatty acids contribute to increased blood ammonia by interfering with ammonia metabolism. Dietary fats do not contribute to increased blood levels of free fatty acids; fasting or starvation will contribute to increased levels of free fatty acids. Therefore, pets with liver disease should have diets containing adequate amounts of fats and should receive frequent small feedings. Additionally, small frequent feedings reduce protein breakdown by the body (which can worsen clinical signs), improve glucose metabolism (preventing hypoglycemia), and decrease intestinal ammonia concentrations.

Increasing levels of vitamin A and copper can contribute to liver damage. Zinc supplementation may be of benefit as many pets with liver disease are deficient in zinc, and it can reduce copper absorption. Adding vitamins C, E, and K may be warranted.

Vitamin E protects against metabolism of lipids in cell membranes. Vitamin K is needed for proper blood clotting, which can be a problem in pets with severe liver disease. While dogs and cats can make vitamin C in the liver and do not normally require this vitamin, liver disease may decrease the amount of vitamin C. Supplementation with these vitamins under veterinary supervision may be helpful.

Milk Thistle

Milk thistle is well known for use in liver disease. Its silymarin content has been shown effective in treating liver disease. Milk thistle compounds are usually standardized to 70 to 80 percent silymarin. Milk thistle is one of the few herbs that have no real equivalent in the world of conventional medicine.

The active ingredients appear to be four substances known collectively as silymarin, of which the most potent is named silibinin. When injected intravenously, silibinin is one of the few known antidotes to poisoning by the deathcap mushroom. Animal studies suggest milk thistle extracts can also protect against many other poisonous substances, from toluene to the drug acetaminophen.

Silymarin appears to function by displacing toxins trying to bind to the liver as well as by causing the liver to regenerate more quickly. It may also scavenge free radicals and stabilize liver cell membranes. However, milk thistle is not effective in treating advanced liver cirrhosis, and only the intravenous form can counter mushroom poisoning.

Silymarin protects the liver as an antioxidant, by increasing glutathione levels, and by inhibiting the formation of damaging leukotrienes. Silymarin also stimulates the production of new liver cells, replacing the damaged cells.

Due to its liver support, milk thistle is often used anytime the pet becomes ill to support the liver. It can also be used anytime drugs are given to the pet that could be toxic to the liver, especially chemotherapy medicines, heartworm medications, and long-term use of other medications.

In people, treatment produces a modest improvement in symptoms of chronic liver disease. Liver enzymes as measured by blood tests frequently improve, and if a liver biopsy is performed, there may be improvements on the cellular level. Some studies have shown a reduction in death rate among those with serious liver disease.

A new form of silymarin, in which the compound is bound to phosphatidylcholine, has been shown to have greater bioavailability than unbound silymarin. It is best not to use milk thistle as a daily preventive supplement but rather reserve its use for conditions where the liver is under stress.

The standard dosage of milk thistle is 100 mg per 25 lb of weight, two to three times a day. In people, the best results are seen at higher doses (140 to 200 mg three times daily standardized to contain 70% silymarin); the bound form is dosed at 100 to 200 mg twice daily.

Safety Issues
Do not use milk thistle in pregnant animals. Long-term use may alter blood liver enzymes. High doses may cause diarrhea.

Safety in young children, pregnant or nursing women and individuals with severe renal disease has not been established. Similar precautions in pets are probably warranted.

Other Natural Treatments
Other natural treatments include the nutrients choline, carnitine, and arginine. The herbs boswellia, burdock, chaparral, dandelion root, licorice, nettle, Oregon grape, red clover, turmeric, yellow dock and maitake mushrooms.

Conventional Therapy
There is no specific treatment for liver disease in dogs and cats, unless a specific toxin is identified. Supportive care includes intravenous fluids and force-feeding. Force-feeding is the treatment of choice for cats. It usually requires feeding through a gastrotomy (stomach) tube for two to three months. Antibiotics and/or corticosteroids may be indicated, for example, for feline cholangiohepatitis.

Pinellia Combination is a Chinese herbal mix. This formula contains ginseng, ginger, jujube, coptis, and scute, along with pinellia, and is for vomiting in pets.

Because of the Chinese diagnosis and classification of diseases, the ingredients in each formula may vary. Individual Chinese pharmacists include herbs in their tented formulas based upon their experience. However, they can compound formulas to the needs of an individual pet.

For example, a Western diagnosis of allergies allows a selection of treatment based upon this diagnosis. In Traditional Chinese Medicine (TCM), diagnosis and treatment are based upon the need to rebalance the patient so the individual, not the disease, is treated. As an example, with TCM we might be concerned about selecting herbs to circulate Qi, nurture Yin, or invigorate Yang. This system has been used for thousands of years, even prior to the advent of Western medicine, and the herbal treatments have been passed down through time.

This doesn't mean Chinese herbal formulas cannot be used based upon a Western diagnosis, only that if the herbal formula doesn't work, it might indicate the need for another formula or a correct TCM diagnosis so that the correct remedy can be selected.

Herbs are usually supplied in powder or capsule form; tinctures can also be found. Many products made for humans can be used in pets. Unfortunately, the "correct" dosage for the pet has not been determined for many herbs, and clinical experience and extrapolation from human data is often used. The lower dosage is usually used and dosage increased if needed. Compared to traditional drug therapy, herbal treatments usually take longer (several weeks or longer) before an effect is seen. As with Western herbal therapy, quality control in the manufacturing of the product used is important, and only herbs from reliable companies should be used. The following guidelines serve as a starting point for herbal therapy.

Dosages
Use 1 gram per 20 pounds, 2 to 3 times daily of concentrated herbs for dogs and cats; 4 grams of fresh herbs/20 pounds, 2 to 3 times daily for dogs and cats; tinctures 5 to 10 drops per 20 pounds, 2 to 3 times daily for dogs and cats.

Alternately, some herbalists recommend extrapolation based on weight. Since human doses are based on a 150-pound male, a recommended dose of 3 capsules given 3 times daily for this 150-pound male would extrapolate to 1 capsule given 3 times daily for a 50-pound dog. There are some suggestions that dogs and cats require more herb per pound of body weight than humans. This would supplest a 10-pound cat should receive 20 percent of the recommended human dosage, whereas a 25-pound dog should receive 25 percent of the human dosage.

Safety Issues
While many herbs are used safely in pets, remember many potent drugs (such as digitalis, vincristine, or aspirin) were first described in plants and herbs, and have actually been extracted from plants and herbs. This means it is essential you work with your holistic veterinarian before using herbal remedies in your pet. For example, a report of a Chinese herbal cream used on people for skin disorders showed a high level of the steroid dexamethasone in the product, with the highest levels in the products recommended for children. Other reports of the product ma huang, which contains the potent drug ephedra, revealed varying levels of ephedra in a number of products tested. Stories such as these reinforce the need for proper medical care and advice when using complementary therapies in pets.

Ringworm is a common fungal infection mainly affecting puppies and kittens. The disease is highly contagious between pets and may be easily transmitted between infected pets and their owners. Owners should note that most cases of ringworm in people are not caused by exposure to pets, however. Clinical signs in pets include hair loss, usually in a circular or “ring-shaped” pattern. However, ringworm can look like any skin disease. In kittens, tiny scabs (miliary lesions) may also occur in infected pets.

Natural Treatments
Topical therapy with herbal shampoos containing calendula and goldenseal may be helpful. In addition, a natural diet is indicated. Herbs to boost the immune system that help with infections are astragalus, dandelion leaf, echinacea, garlic, German chamomile, Gotu Kola, Oregon grape, sage, turmeric and yellow dock.

These natural treatments are designed to reduce the growth of the fungus and inflammation in pets with allergic dermatitis.

They can be used in conjunction with conventional therapies, as they are unlikely to be effective by themselves in most pets with severe ringworm infections. The natural treatments are widely used with variable success but have not been thoroughly investigated and proven at this time.

As with any condition, the most healthful natural diet will improve the pet’s overall health.

Conventional Therapy
Conventional therapy utilizes medicated shampoos, and in serious infections, oral antifungal medications, usually griseofulvin.

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