Your Most Pressing Questions, Answered.

You sent in questions, and I've taken the time to answer them. Tune in to hear your questions answered and to learn how to better take care of your pets! 

I also want to give a special thank you to the teams at Good News Communications and WebMO Digital Marketing for helping me produce this podcast. You all are awesome! 

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Send your questions to AskMe@drrandypetvet.com so Dr. Randy can answer them in future episodes!

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Products and Resources I Recommend
Microbiome Testing
Animal Biome - Gut Microbiome Health Test

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Just for Dogs
Farmers Dog

Other...

Transcript

SPEAKER_00 0:06

Hello and welcome to Pause, Reflect, and Heal with Dr. Randy. I am Dr. Randy Aronson. Welcome to the show. It's a great show today because we're going to be talking about some questions you all have had from the website, my podcasts. I want to remind everybody that you can see all of my articles and podcasts on www.drrandypetvet. Drrandypetvet.com. And there's a telephone number. You can leave me some messages, but preferably emails and let me know how it's going for the show. If you have any questions about your pets, uh we would I'm more than happy to bring it to the show and answer. And that's what we're this show is going to be is a number of questions and cases that I've seen recently. My veterinary practice is called Pause Veterinary Center here in Tucson, Arizona. I think my staff has told me that maybe I had the ultimate compliment last week. Somebody impersonating me has a fake website on Facebook trying to sell products. Be very careful about these things. I'm not selling anything. What I like to do is really help your pets wellness and longevity. I'll help your pets live healthier, happier lives so you can too. And that is really the tagline for pause, reflect, and heal every every podcast we record. So welcome to the show. I want to give a big shout out to all of my staff that's helped produce these, uh, the people at Good News Communications, uh, my good friends Mary, Becca, Jane, and Kennedy, and our my and my webmo people, uh, that's be Chris and Maddie. Thank you so much for all the help. Couldn't do it without you. Um, as many of you who know me know, I'm fairly IT challenged. So uh having uh the staff uh help me with these things uh makes it much, much easier and allows these things to come to you your way. So um that that being said, let's let's talk about the first case. So these are cases that I've actually seen or done uh telemedicine consults for uh through Pause Veterinary Center. If you're interested in scheduling an appointment with me or a telemedicine consult, you can reach me through Pause Veterinary Center, and that's www.pawstuson.com or their phone number here in Tucson 520-888-7297. Feel free to call me. I'd be more than happy to help in any any way I can. I do probably about five or so telemedicine cases a week and uh see a lot of clients who come in from a lot of different places uh in the southwest to see us at Paws Veterinary Center. I feel very fortunate about that. So thank you for all of that. Um you'll see that in the background I've got my cats running around, that's Flash behind me. Uh Batman is somewhere around here. He'll he'll show up also. But um let's talk a little bit about uh my first case, which is Gizmo. Gizmo uh is is an eight-year-old domestic short hair cat. Um, it was in Gizmo was typically in for what we call a six-month uh health check. Now, any animal, usually from mid-age on, we usually recommend checking them every six months. Why people say, well, why do you do that? The reason is that in cat and dog years, that could be anywhere from five to seven years to one year of our life. So six months could represent two and a half or three years of a change, and we want to catch things quickly and not let them become an issue. The most important thing that I ascribe to is being proactive, and that is when we look at, let's say, every six months or every year blood work, we're looking for trends. I'm not always looking for the gross abnormalities. Hopefully, we don't want to find those, but what we want to find is a trend in what is going on. Let me give you an example. Creatinine is one of the key markers for kidney function in our cats and dogs. Creatinine uh often gets measured in our regular blood tests. For example, if a cat's creatinine was one all along and a normal being up to 2.4, let's say, and then all of a sudden at a six-month recheck shoots up to 1.8 or 1.9. Now, this is not abnormal, but it's a definite abnormality for this animal because we look at what's called health tracks, which shows me the blood work over all of the ears of this cat. And it now is indicating that this creatinine is rising. We're gonna want to do some things to make sure that we assure that the kidney function for that cat is gonna be normal. So uh anyway, gizmo was in for a six-month health check. Uh, the owner describes that gizmo maybe not quite as active as uh as she would like to see. Um, and on questioning the owner further, uh it sounds like Gizmo maybe isn't jumping on his cat trees as easily, not uh jumping up on uh furniture as easily. So there's some uh maybe indication that Gizmo may be having some mobility issues. I will tell you that in cats, osteoarthritis or arthritis type pain is very subtle, and often cats hide that very, very well. Why is that? Well, in the wild, a cat would be exhibiting pain, they would often be suspect for another predator to get eaten. So they are very good at covering up what they normally will show as far as pain and discomfort. So um I also asked about um, was she able to regularly brush Gizmo? And she said, you know, it's funny you said that because within the last six months or so, every time I try to brush Gizmo's back, um, he really resents it. He's not liking it, he bites at the brush, he's he's not comfortable, he'll run away. And so uh this is a general indication of something we call hyperesthesia. Hyperesthesia means that Gizmo's nerves over that area are are firing more than they need to. They're very, very active. And the combination of gizmo not quite jumping up as well, uh not being quite as active, and then having this sign of hyperesthesia really indicates that gizmo is having some arthritis problems. On physical examination, this physical examination looked very, very good until I got to his thoracic lumbar spine, the middle of his back. And it was very sensitive. There was actually, um I showed the owner, you could actually palpate or feel heat over his back. And when you touch that area, he would bristle and really uh object. We um we took some x-rays of that area, and there was some inflammation in uh the vertebrae around what we call the thoracic lumbar spine, which is the middle of the cat's back. Now, you could pursue this even further and do what's called an MRI, which would be through the neurologist, but generally that's not necessary. Generally, we have enough indication that gizmo is having some osteoarthritis. So, where did we basically go with this? Well, um, as many of you know, it's not just as simple as putting him on pain medicine and calling it good. That's not okay for me. Uh, what I'd like to do is work with what's called foundational medicine for gizmo. So we started talking about gizmo's diet first, and that's where most of these cases focus on for me. I make sure that the diet is adequate for the cat, but also is not contributory to the osteoarthritis or pain that Gizmo is having. That means we want to make sure that we've eliminated anything inflammatory in Gizmo's diet. Gizmo is eating one of the store-bought dry foods, and I produced a lay I always produce a label for that food for my client so they can see what the ingredients are. Many of us are not label readers, and one of the things that many of my paws reflect and heal people know is I strongly encourage my listeners, my pet parents, read the labels on the food that you're feeding your pets. Why is that? It'll be very revealing to you on basically what is in there, what's not in there, and what may be causing problems. So when we looked at Gizmo's label, the first ingredient was corn. The second ingredient was chicken byproduct meal. Chicken byproduct meal, according to the USDA, and uh is anything acceptable, can be even beaks and feathers. So this is not a very quality type protein. And often dog and cat food companies use this as a protein source and really are not giving you, even though it may have a protein value, it's not a quality protein. And then I went on to see that the that the uh food also had potato starch in there and also some brewer's rice. So these are also simple carbs which are very inflammatory. Cats have no right eating those types of things in their food. So the first thing that we uh instructed the owner to do is let's get on a much better diet. Now, many of you know that the food hierarchy in animals is fresh whole foods, then I like freeze-dried raw, then complex carb dry foods, uh, and then it kind of falls off from there. So the owner was very willing to try to get gizmo on. Uh, she wasn't able to do fresh whole food at home or do any cooking or whatnot. So she was very able, very willing to start incorporating some freeze-dried raw into Gizmo's diet. Uh, this would be a great source of protein and veggies where Gizmo can get uh his carbohydrates from the vegetables and not from simple carbs that are inflammatory, like rice, white potato, soy corn, and wheat. So that was the first change that we made. The second recommendation was for some supplements for gizmo. Uh, first one being we wanted to get some omega-3 fatty acids in gizmo's diet. So I am a big fan of omega-3s here in Arizona. As many people know, it's incredibly dry. We all dry out, even our animals. So we want to moisten from inside. And omega-3s are the best way to do that. Now, there are very many sources of omega-3. I try to stay away from regular fish oil because fish oil is omega-3, six, and nine, and omega-9s often can be inflammatory for our dogs and cats. So we want a source of omega-3, 6. We we recommended a product called omega benefits, which is in a gel cap. I really prefer my oils being in a capsule and not a bottle. Why is that? Because many oils, when you pump the bottle the first time or you open up the lid, oxygen combines with that oil, it becomes oxidative. And so the animal has to form what's called free radicals to scavenger that ox that oxidative uh oil. Sorry, Batman just hit my computer screen. Um, and um, and so we want to use that in a capsule, and by pinpricking that capsule on the food, we have a very fresh oil product that can help. Flaxseed oil can work, olive oil can work, but they're not as good as omega-3s coming from a fish-based product. For those people who don't like handling fish-based products, there are also algal or algae-type omega-3s that are available that can work very, very well too. So we recommended omega-3 for gizmo. We also recommended uh methylcobalamine. Methylcobalamine is B12. We like methylcobalamine over regular cobalamine, it's much more available to the cat's body. Uh, we use a product that is in a capsule form that the owner can just open up, put in their food, uh, very, very easy. Again, many of these things I just have my owners add to the animal's food because I'm not into forcing a lot of products to them. Gizmo was at a point where um he was pretty painful, so we didn't want to use directly a pain medicine to start with. We did recommend a product called Ataquan. And Ataquan is given by injection. Uh it's it's it's a product that basically allows the cartilage in between Gizmo's vertebrae to imbibe or or soak up water. That cartilage becomes spongier and also helps cushion that joint, sometimes even making that comfort level much, much better for the cats. So we recommended a course of Ataquan. And lastly, we recommended using a product called celentia. Silencia is a product that's been used in Europe for over six or seven years, has great efficacy in the cat. It stops what's called N2F alpha, which is part of the pain cascade. Uh, it's a monoclonal antibody. We've had great success with this product, and uh that was the recommendation for Gizmo. So we we talked about all of these things. What we talked to Gizmo's mom about was let's re-let's re-re- you know, circle the wagons and recheck Gizmo in about six to uh six uh six uh sixty days or ninety days, and we saw him again in 60 days, and he was doing amazingly well. She said he was back to his normal self. He's jumping on his cat tree, he was on the furniture like he normally does, moving around. Uh her hyperesthesia signs, meaning the area where she was brushing and whatnot, was uh were very much diminished, and he was enjoying his food, his coat looked nice and shiny and glimmering, and so he really went on to do incredibly well. Let me talk about my next case. My next case is George, who is a 10-year-old mixed-breed dog that came to see us. Uh, George's history, he came for what's called a rehabilitation uh exam and consultation. At Pause Veterinary Center, we have a full rehabilitation program where we have underwater treadmill, we have laser, cold laser, we have pulse electric magnetic therapy, we have um therapeutic ultrasound, a lot of floor exercises. We have a wonderful uh uh rehab technician, Diana, who is certified in rehab, like I am. This rehab certification is really a very special certification for veterinarians. And if you're going to work with your dog or cat on any kind of pain mobility issue, if you can find a rehab veterinarian, you're doing a lot better because those people are advancely trained in helping your animal. It's really like PT or physical therapy for pets. Uh, we do it every day at PAWS, and it really is a great addition to what we do daily. So George was uh his history was he was the the owner said that he was also slower to get up off the floor. He may be slipping occasionally with his back legs, according to the owner. Um she was worried because his nails on his back feet were scuffed, the especially P2 and P3, which are the middle toes of that of those back feet. Um, and she was worried that he was really in pain. So on physical examination, we we looked at George. He had some dental disease present. He had a little bit of changes in his um in his eyes where he's getting what's called nucleosclerosis, which is a hardening of his lens. Uh but what we did find was he did have pain over his TL junction, which is thoracic lumbar junction. There was also heat there, and I allowed the owner to kind of feel the heat in that area so she could see the difference between that area and over other areas of his back. But the interesting thing was that he when we um when I did his neurologic exam or nerve exam, when what we do is we turn their back feet over, uh, it's called proprioception. So if we knuckle their back feet and that should go to their brain and back to their back foot and correct within three seconds. George was very slow to correct. In fact, in his left leg, he didn't correct at all. In his right leg, he would correct occasionally. Well, what does that mean? That means that the nerve signal from uh the foot going to the brain and back is being interrupted. Typically, that interruption is due to uh intervertebral disc disease, or you know, as many of us know, it's called disc disease in our back. Um, and so even though George had pain, he was actually having more neurologic issues than he was pain issues. We um we discussed um the different workups that wouldn't be necessary for this. We did take um X-rays or radiographs, and we did see a narrowed disk space at um lumbar one and two and lumbar two and three. So there was indication with that narrow disk space that we could be dealing with disc disease. Now, the true diagnosis of that, excuse me, would have been an MRI with the neurologist, but the owners were not interested in surgery, and that's typically would be the next step for what would happen with the neurologist if they did an MRI. So they elected uh to work with us in rehabilitate in rehabilitation to see what we could do to help uh with George's discomfort and also help his mobility. Uh, again, we went right to the source of uh any inflammation, so we talked about his food. I taught um George's owners a Chinese principle that there are some foods that our pets can eat that either could create heat in their body, are neutral, or could be cooling. This is called thermogenic property of food. And we try to avoid, especially in Arizona, any product that could produce more heat in their body because they tend to be more inflammatory for our dogs. So I explained to them that we want to avoid in George's diet lamb, venison, and chicken. So those are the three meats I try to stay away from when I'm working with pain, uh inflammation of any kind in my dogs and cats. Uh so George was eating a lamb-based diet. So we talked about switching that. We also had the food conversation, like I did with Gizmo, and that was we want to make sure that we decrease the carbohydrates, especially any simple carbs in his diet. George was on a prescription diet. And again, the prescription diet showed first ingredient was corn, second ingredient was hydrolyzed protein, which is a protein that's made uh so it's better absorbed in the body. Uh, then there was also rice and beet pulp in this diet, which really was increasing a lot of the carbs that George was getting. George was overweight, um, and the owners couldn't get any weight off of them. Well, the big reason for that happening is he's eating so many carbs that it's turning to simple sugars and fat, and that's creating his weight problem. So we discussed again the food pyramid with them. Uh, they elected to try to add uh some freeze dried product. To his food and also switch his dog food to what's called a complex carb dry food. One that's not heat processed, overly heat processed, so we get away from what's called AGEs or advanced glycolation end products, commonly heard on commercials these days as a real problem for our animals. And so we went with a complex carb diet, one that was made with oats and maybe had some millet, but also had some garbanzo beans and uh wasn't chicken venison or lamb, and then made half of his diet freeze-dried raw, so that we were lessening the carbs for him and also getting more protein to help build up some muscle. Because George did have some what we call muscle atrophy. He was losing some muscle over his back and he had decreased muscle mass in his back legs. We also recommended omega-3s for him, the same thing that we recommended, if you remember, for gizmo, the cat we were talking about earlier. Their choices there were a chew that we often use called dermaquin, which is wonderful because it doesn't smell like fish oil, but it gives them a good solid basis of omega-3s or the omega-benef true benefits that we talked about for gizmo, we could use for George 2. We also made a recommendation because George was on a glucosamine product, an earlier model of glucosamine, and we explained to the owners that recent research has actually shown that glucosamine many times doesn't get through stomach acid of the animal and is not getting into their joints. There have been great research papers uh this year, last year on ultra-collagen 2. And so we recommended Jope from PET Jope. Uh, jope is a wonderful ultra-collagen 2 joint supplement with turmeric, um, and it has uh a little bit of uh uh you know other additional products to it, but it works incredibly well. It's a chew, the animal, the dogs love it, so we put uh George on Jope. We also recommended uh that we start with uh the Ataquan uh that we were talking about, and with George, we used a little bit of what's called gabapentin. Gabapentin is a pain medicine in dogs and in humans, cats. We can use it, and the reason I like gabapentin is it's not like a normal NSAID, meaning non-steroidal, anti-inflammatory. It doesn't affect the stomach, it also has very minimal effects on liver and kidney. So we can use it very, very safely to decrease pain and help uh basically um get some of that pain area over his throat his thoracic lumbar spine to decrease. Uh, we did put George on gabapentin three times a day. It can be used up to four times a day. It only has a four to six hour half-life in the dog. So we like to use it, but again, we don't have to worry about kidney and liver enzymes with the gabapentin. We also uh put George in our rehabilitation program where George was coming twice a week uh for the Ataquan injections we talked about, but he was getting underwater treadmill, he was getting cold laser, he was getting pulse electric magnetic therapy, and Diana taught George's owners some really good stretches and exercises they could do at home. We decided that we would reconvene to see George in 90 days after he was on the diet, after he had gone through uh a sort of a session or four weeks of the uh rehab therapy. Um, he was on the supplements. At the end of the four weeks, we did see him briefly that they wanted he was doing so well they wanted to continue, so they went another four weeks and then we basically re-examined him. And George was doing amazingly well. He still had some proprioceptive deficits, meaning we could still see that he would knuckle when we turned his feet over, but his slipping was much better. He had actually built muscle mass. Uh, we used another product with George called myose canine. Meios is an eggshell membrane uh supplement, again, goes right in the food and stops what's called myostatin, which is an enzyme that breaks down muscle in our dogs. It's also been used in people in uh joint replacement uh follow-up therapies and whatnot. Very effective product, again, can be put into the food. And uh to this day, George is doing much, much better, much more stable. Definitely uh we have decreased his pain response. Um, we have gotten his nerve uh uh proprioception better. We did add uh methylcobalamine or B12 to help with his nerves, and George has gone on to done to do very, very well, and and we're very, very excited about that. The next case I want to talk about is Chico. Chico um is a four-year-old white pit bull. Chico had a history coming to pause, he had been to two other veterinarians of multiple ear infections that were treated with antibiotics orally and also uh topically in the ear itself. Um he also had a in uh history of severe itching, paw licking, um, often what we would call allergic dermatitis. Um Chico was placed on a prescription diet, uh, basically one that we will talk about in a second. Um he was also on two products that have did not work. One was called Atopica and the other one's called Apiquel. Both of them are immune suppressants. Immunosuppressants basically decrease the immune response in our pets so that uh if we decrease the immune response, the thought is we will decrease the response to the allergens that the dog may have sensitivity to and um and help them. After a while, neither of them really continue to do the job. George did get, uh I mean, Chico did get um some injections of cytopoint, which is a uh product that decreases some of the um something called interleukin uh 31, which is produced histamine in the dog's body. It did temporarily help, but again, George kind of outgrew that that help. So uh the owners were really frustrated and came to me and said, you know, we really need to do something different because what has worked uh has only worked temporarily and it's not continuing to work for Chico. He's continuing to get incredibly red, he gets hot spots, uh very moist areas of infection on his skin, his ears are bad, and and Chico was really a mess when he came to see us. Um he also had a very what we call doggy odor. Many of you know that that doggy odor could be caused from a yeast called malesthesia or an excess of staph of bacteria in their skin. And so what we uh what we explained to Chico's owners is if you continue to try to do the same thing and expect different results, that's the true definition of insanity. So they like that, and they definitely like the fact that we were going to take a deaf different uh uh approach to this disease. So, what I normally do with my allergy dogs like Chico is the first thing I do is uh talk to my owners about getting something called a Nutriscan test. Nutrascan testing, we've mentioned in other podcasts before, a company put together by my good friend Gene Dodds in California. It's a it's a saliva-based food sensitivity test. And what that does, it gives us a piece of the puzzle for Chico to know what we need to avoid in his diet. Before we start changing his food and trying other things, let's find out what he may be sensitive to and avoid it. The other thing that we talked to Chico's onos about was to get an animal biome test. And you've heard me mention animal biome. We talked to Brandon Bush, uh Brandon Birch from Animal Biome, and we did a couple podcasts with him, and you can revert back to those and learn more about animal biome. But what animal biome testing does is we send a stool specimen and we find out what uh the microbiome in that animal's body is. In other words, they do a DNA test on the microbiome, the bacteria, and the yeast and fungi that are in there, and they tell us what is in normal uh amounts, what are in excessive amounts, what are in harmful amounts, and is this balanced? Uh, is this what we call a dysbiosis or an imbalance of Chico's microbiome? So we talked a little bit about what uh Chico's owners could do to start with while we were waiting for these tests to come back. Often the nutri-scan test takes about two weeks, the animal biome test can take anywhere from three to four weeks. So we knew we had a little time. So the first thing that I instructed them to do is pick up something called ion gut health for pets. And what ion gut health for pets is, it was put together by a naturopath by the name of Zach Bush. It's humic and folvic acid, and it's a liquid that we can put right in their food, and it starts to close what's called the tight junctions in our bowel. And what that means is people have often heard about leaky gut syndrome. Leaky gut syndrome is a situation where in our GI tract, the small areas that allow food into our blood and lymphatic system, but keep things out that shouldn't be, are opened up. They're too wide, and they start absorbing things. We all start absorbing things with leaky gut syndrome that we shouldn't have in our blood system or our lymphatics, and this often produces a lot of the allergy that we're seeing. So we had them instructed to get Ion gut health. The other thing I had them get was goat colostrum, where they're actually adding some early mom antibodies to uh Chico's diet so that we start getting those into the GI tract to help while we're waiting for the animal biome and the and the uh neutrascan test. We did start Chico on animal biomes, it's called skin and coat relief kit, and this is a combination of a pre and probiotic and what's called FMT or fecal microbiome transfer. Really, essence is don't laugh when I tell you this, it's good poop in a capsule. And this would start to get his bowel in check while we're waiting for the answers to finding out what's out of whack and then how do we use other supplements to help him. Um, with that, um Chico did respond initially uh very nicely to uh the uh adding some omega-3 into his diet. Uh we we we again recommended um either omega true benefits or or dermiquin. Uh, he also responded very nicely to the animal biome skin and coat relief kit. And we got the nutri-scan test back, and we found out that Chico was allergic to three or four different proteins and also some uh some things that were in the diet, like alfalfa and some other things that we needed to stay away from. What we do with that is we actually have our owners take that test and go to one of our local feed stores here in Tucson that has a vast variety of freeze-dried products and complex carb dry foods and pick things that will not have those ingredients in them. Again, avoiding lamb, venison, and chicken. As I have instructed you, you realize that these are what we call hot meats. We don't want those in a diet for an allergic dog. We also got the animal biome test back and found out that he had a severe amount of um uh E. coli in his stool that was causing a lot of the skin issues, but also was very in very imbalanced or had a very big dust dysbiosis. So we continued him on their uh probiotic called um um S. Bolardi, which is a beneficial yeast. It also has some fiber in there, which really helps these dogs called fructooligosaccharides or FOSs, and continued him on the gut restore, which is the FMT capsules I explained to you earlier. Again, good poop in the capsule. We looked at Chico at 90 days, and he was vastly improved. Uh, we also we had changed his diet to a complex carb dry, a freeze-dried raw, did the supplements that we talked about, continued them on the animal biome supplements, avoided the things in his diet through the nutriascan testing, and Chico was really doing very, very well. Um, we've re-checked him again in at three months later. Uh we rechecked his animal biome test after he had been on the animal biome products for 90 days, and he had now come into check. He only probably at that point required a little bit of continuation of the pre and probiotic, the uh uh S Bilardi that we were using, but he didn't require the FMT capsules. And uh to this day, um, Chico is doing amazingly well, has had no flare-ups with his ears, um, his skin is uh is bright and glistening. Um, he really has had no allergy flare-ups with uh rashes or or other problems. And uh Chico is a real win when it comes to allergy treatment. Uh they don't always all go that way, but most of them do when we really get to the basis of foundational medicine and working with some of these testings that a lot of other veterinarians don't actually look at. Uh, this is why we get our successes because we definitely approach these things in a very different way. So um I did have a question from Carla on my website, and Carla's question was, Dr. Randy, uh, what do you usually recommend as far as basic supplements for my pet? And she was basically talking about her dog. So um, as you have heard me speak to these cases, uh, my uh my way of talking to this is basically one, making sure that diet is not inflammatory, as we've talked about again. Fresh whole food is always best. Um, we also look at freeze-dried, raw, complex carb dry that aren't heavily processed. Um, but to that, I always like my pets on an omega-3 supplement. You've heard me talk about avoiding regular fish oil, which are three, six, and nine because nines can be inflammatory. But omega-3s and six can really moisten these animals from the inside. Many, many times I'll use a product called canine belly bliss. This is a great GI maintenance product. If the dog isn't having any gastrointestinal problems, I use that. I also make a very strong recommendation for my dog owners to make sure we incorporate some fermented food in their diet. When I say fermented food, it's things like uh goat kefir, um, sauerkraut, kimchi. These are things that really can help our animals uh create a good situation with their biome, their good and bad bacteria, and it's very easy to add. There are some great products out there like Gussie's gut that I did a podcast for. It's a fermented product you can add to their food. There's something called carnivore, which is a sprouted seed product. Uh, but you can definitely try the sauerkraut or the kefir, and many, many times this is a great way to go. Uh, if they're you know, if they're if we're worried about joint issues, uh, I recommend Jope, which is from Pet Jope. Great joint product uh that has uh ultra collagen too and uh curcumin in it. Uh, it it avoids the glucosamine and chondroitin because we really feel that's not helping. Uh, sometimes we'll make a recommendation for methylcobalamine or B12 in their diet. Uh, those are very common kind of things that we can add. Um, and that's usually the basis, uh Carla, for what I usually recommend as far as supplementation uh in normal everyday situations. The last case I want to talk to you about before we leave you, uh, and again, I want to remind you again www.drrandypetvet.com. That's the website. Please feel free to get a hold of me through there. Comment, good or bad, about the podcasts. Any questions you might have about your pet, if I can answer them, I'll bring them to the show as we did today. So um uh feel free to get get a hold of me that way. Uh, the last case I want to talk about is Samantha that saw me very recently. Samantha uh is an 11-year-old Persian cat. And uh on her six-month physical exam, mom's really concerned because Samantha's appetite seems to be very decreased. She feels like Samantha has lost weight and uh was very concerned about where what was causing this problem for Samantha. So, in a cat at you know that age, there are some things that we would be the major concerns that I would have. Um one would be thyroid disease, is Samantha's thyroid overactive, or we call hyperthyroidism, and this would create an increase in her metabolism to burn up calories. Oftentimes, those cats will have more of a hunger than less, but it's always a possibility. The second big category would be kidney disease in a cat, and we would definitely want to check uh enzymes and urine on that animal to make sure that wasn't an issue. And the third problem that we see often with these cats losing weight, if we've ruled out thyroid and kidney disease, can be something called small bowel lymphoma, which is actually a cancer of the cat's intestine. We're seeing a huge increase in this in our animals, and we're able to diagnose it much faster these days through a test called VDI Labs.com. That's a blood test. I used to have to do endoscopy, ultrasounds to make that diagnosis, but we actually can make it with a blood test. So we talked to Samantha's mom about all of these. Uh, we did a routine blood panel and we ruled out uh thyroid disease. Samantha's T4 was normal. Uh, we also ruled out kidney disease uh as Samantha's kidney enzymes were um mildly elevated but not abnormal. Uh they were just uh uh a little bit higher for her than they had been. Her urinalysis still showed that she was concentrating her urine, didn't have a lot of protein in her urine. So we were kind of left with a thought that this could be small bowel lymphoma. We did run the VDI blood test, and it did come back positive for small bowel lymphoma in the cat. And our treatment for that typically is to start them on the FMT procedure that you've heard me talk about from animal biome. In cats, we often will give that to them by an enema and not try to do the capsules because it's so difficult to get a lot of oral medication in cats. Um, we made that recommendation to do that FMT procedure. It's very easy on the animal, usually. It's very, very light sedation for us to do that. We give the good poop, believe it or not, through a catheter. Also, we use ozone therapy to decrease what's called the biofilm in their bowel before we give the FMT at the same time. And we also started Samantha on prednisone on a very low dose. And we saw Samantha six months later after we had done this. And Samantha had gained two pounds and was eating again and looked great. And we've then followed Samantha at six months after that. And again, she continues to do really well. Her blood levels look great. We haven't repeated the FMT procedure, which we can do for these cats. So for that small bowel lymphoma case, that's a real win. And Samantha is going on and doing incredibly well. So I kind of hope today that you've enjoyed some of the cases that I've brought to you from the annals of Paws Veterinary Center here in Tucson, Arizona. It's the pleasure for me about doing these podcasts is being able to talk about things that I'm actively involved in. You know, there are a lot of people that can talk about longevity and wellness, but they're still not practicing or seeing animals. I do um every day and uh get a chance to bring these things to you guys so that we can give you alternative thoughts. Again, if you want to uh consult with me, uh telemedicine case, come to Tucson to see me, which I would love. Uh do that through Pause Veterinary Center. Their phone number again is 520-888-7297 or www.pawstuson.com. You can also, again, remember to give me or bring me your cases through my website, which is drandypetvet.com. We would love to uh answer any of those questions. And um in a couple weeks I'll have another podcast for you and we'll talk more about a lot of these things. But I hope you've enjoyed and get to learn a little bit. It's my pleasure to be able to bring this again. Thanks to uh good news communication, all my people there, and webmo for making this uh happen for me. Um again, the other thing I want to mention is I am available for dog and cat clubs to speak. Um, any any larger group, uh contact me through my website. We have a um a price deck on on doing that, uh, on speaking. Um, and if anybody is interested in sponsorship for podcasts, we definitely have ability for that too.