Archive for the 'veterinary medications' Category

Holistic Care Can Be For Pets, Too!

Rachael Feigenbaum, VMD

Rachael Feigenbaum, VMD

Did you know that pets can benefit from acupuncture just like humans can? We had a chance recently to interview Bay Area veterinarian Rachael Feigenbaum, VMD, about her holistic approach to treating animals.

How would you describe your practice approach?
Lotus is an integrative house-call practice, which means we combine acupuncture, Chinese herbs, and nutritional therapies along with more traditional western therapies to tailor the treatment to the individual animal. When I use the word “holistic” to describe my practice, I mean that I use everything at my disposal to give the animals the best quality care possible.

Acupuncture is one example of this. The Chinese performed acupuncture on horses dating back 5,000 years, but in terms of cat and dog acupuncture, it’s more recent. Anything that involves pain, such as arthritis or back pain, tends to respond well to this treatment. I also treat chronic illnesses (such as chronic renal failure), depression of the immune system, and behavioral issues with acupuncture. The animals enjoy it; while the needles are in, they feel really relaxed. There’s a spot on the top of the head that is an amazing calming point. Sometimes, I put a needle right into that point and you can see an immediate change in demeanor – they become ready for a nap. What people have typically told me is that the next day, their animal acts like a puppy, and they can see their energy level, mobility, and appetite have improved.

Another kind of therapy that we’ve recently added to Lotus is called “Cold Therapy,” which is a very specific frequency of light that penetrates into tissues. The laser can penetrate up to four centimeters deep and helps with pain and inflammation and promotes healing at the cellular level. For animals that are more sensitive to needles, we can use cold laser therapy with or instead of acupuncture, and often get a similar effect.

Another tool in my holistic approach is the use of Chinese herbs. The idea behind the herbs is to look for patterns that the animals display and then come up with a very specific formulation that’s going to address the specific problem. Chinese herbs allow me to decrease some western medicines, or to potentially reduce some of the side effects.

How do you use compounded medications in you practice?
Part of the whole picture of maximizing outcomes and using the best combination of all the tools at my disposal is to offer my clients medications that are customized to meet their individual pet needs. Compounding works especially well in animals because of the range in size. I see animals from three pounds to 160
pounds, so a dose formulation and a method that is going to work for that individual patient is key to having a successful outcome.

I’ve had good results with the KoshClear that Koshland Pharmacist Maryam Tabatabaei introduced me to. KoshClear is a bioadhesive gel that can include anti-fungal medications, antibiotics, and/or steroids. In addition to being a convenient way to treat otitis (ear infections) in a single application, I’ve found some even more creative uses for it. There’s a certain condition that we sometimes see in dogs which is a hematoma inside the flap of the ear. This can be hard to treat and oftentimes requires extensive surgery. What’s been working really well for me is to make an incision to open that pocket up and let the blood fluid out of it, and then inject the KoshClear into the flap. Having the bioadhesiveness of the KoshClear with steroids added is ideal because not only are you helping with the inflammation, but you’re coating the entire surface as well.

What is keeping you inspired in your work these days?
I see how much love my clients have for their animals, and how much the animals mean to them as family members. It brings me so much happiness to see their animals thrive and do well.

I also really value being able to volunteer for organizations that allow people and their animals to stay together. We’re fortunate in San Francisco because there are organizations dedicated to helping people who are low-income to be able to maintain the love and support they get from their pets. For example, Pets Are Wonderful Support is a non-profit that provides people who are low-income and have disabling illnesses with veterinary services, donated pet food, and other related aide. Allowing people to keep their pets throughout their illnesses is a core part of their healthcare delivery system. The other organization I volunteer with is the Veterinary Street Outreach Services, which provides free veterinary care to pets that belong to the homeless population. People really benefit from having that companionship; often it’s their best friend and their family. I see how animals contribute so much to people’s physical and emotional health. For me, having a role in nurturing the bond between people and their animals is deeply rewarding.

For more information about Dr. Feigenbaum and Lotus Veterinary House Calls, visit:

~Krista Shaffer & Lindsey Bourcier, Outreach Team at Koshland Pharm and Peter Koshland, PharmD


Cold or flu? Helpful health resources

As the fall approaches, do you find yourself with symptoms that you can’t recognize as signs of a cold or the flu?   Check out Dr. John Selle’s “Patient Education” page on his website, which includes helpful links such as:  “Cold or Flu? Symptom Self-Assessment” and a reference page for understanding lab test results.

Dr. Selle’s website is listed on Koshland Pharm’s practitioner referral page.  This referral list includes the names and contact information for California practitioners in the fields of general medicine, gynecology, integrative medicine, lyme disease treatment, naturopathic medicine, oncology, urology, and veterinary medicine.  These practitioners are ones that we have worked closely with at the pharmacy over the last several years and that we have found to be committed to excellent patient care.  If you are looking for websites with helpful health and wellness information, or if you are looking for a health practitioner in California, you can check out Koshland Pharm’s referral page here.  We welcome feedback about the links you find the most helpful.


How Compounded Medications Can Help Us Bond With Our Pets

Have you ever struggled to give your pet a tablet, only to have your dog or cat spit it out in a soggy puddle?  If so, it might be possible to put that medication into an alternative dosage form, such as a syringe or a cream.  Check out this story by pet guardian Amanda Houston-Hamilton, found in Koshland Pharm’s summer newsletter, about finding a better way to give her dog his meds:

Toby’s Story
“About 6 weeks ago, Toby was so sick, it scared me.  Out of the blue, he could not walk and had a fever of 104. He was despondent, refusing to eat or drink.  As always with such things, it was the weekend. He weighs 64 pounds, so I was grateful to find a home visiting doc and, after an anxious few days, with much effort and a few neighbors, I got him to the vet for a full work-up.

My veterinary clinic got a plan together.  I was exhausted as I started his drug regimen of 4 pills a day. So tired and emotionally depleted, I almost lost it when all of a sudden after a few days, Toby refused his meds. I knew he had to be on schedule and felt increasingly anxious as he refused every method and every yummy food I could think of. The counter was covered in melting tablets he had avoided, eaten around, or cheeked. Finally, as instructed, I tilted his head and threw down the pills, shut his mouth, blew his nose, stroked his throat for minutes. But, in the end, Toby stared me down and spit out a soggy puddle. Even the vet tech tried after I called her in tears and acknowledged he was indeed ‘special.’

So when I asked the clinic about compounding his meds, I was relieved and thankful there was an option to the day-long struggle that would stretch over the next month. Using the liquid meds allowed us to bond around his care rather than shatter our relationship with constant battles. Toby is now healthy, his usual playful, energetic, happy Spirit.”

To find out if a compounded medication might be a good solution for you and your pet, ask your vet or a compounding pharmacy.  To find a compounding pharmacy in your area that is accredited by the Pharmacy Compounding Accreditation Board (PCAB), visit PCAB’s website. 

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