Freedom From Folklore

By Narda G. Robinson, DO, DVM, MS, FAAMA

The aggressive marketing of Chinese veterinary herbs in the U.S. clouds the longstanding tradition of Western veterinary herbal medicine. As authors in an integrative medicine journal acknowledged, “The rise in popularity of complementary and alternative medicine over the past few decades has placed greater demands on medical practitioners to explain and justify their own systems of knowledge and practice.”¹

Their research further illuminated the disparity in objectivity and reliability between Western medical and Eastern diagnostic approaches.

Why should we turn over our patients’ health and well-being to a primitive and poorly understood system of Chinese medicine when we can reclaim our heritage of herbal prescribing and still provide quality health care? By first establishing a clear-cut diagnosis, we can determine whether plant-based compounds will offer safe and appropriate treatment. We may even introduce Asian herbs if they meet muster, or decide that no herbs can replace the benefits of medication for a given illness.

The following list provides a sampling of evidence pertaining to both Western and Asian herbs administered to dogs.

Boswellia

Veterinarians will find bos-wellia in canine products designed to treat arthritis and inflammatory bowel disease. Its anti-inflammatory effects are well characterized. A 2004 study on dogs suffering joint pain found that boswellia offered significant clinical improvement.²

Boswellic acids inhibit the pro-inflammatory enzyme 5-lipoxygenase and reduce the amount of matrix metalloproteinase-3, a cartilage-degrading enzyme that osteoarthritis patients harbor in excess.³ Side effects of boswellia can include nausea and diarrhea.⁴,⁵,⁶ No significant interactions with medications have been reported.

Ginger

The widely available ginger rhizome available in supermarkets has a long history in herbal medicine as an anti-emetic. Extracts of dried, powdered ginger significantly counteracted cisplatin-induced emesis in dogs.⁷ Ginger exhibits free-radical scavenging activity. Its diterpenoid, galanolactone, works as a 5-HT3-receptor antagonist.

One caveat: Giving a free-radical scavenger to dogs receiving chemotherapy might offset the drugs’ anti-cancer benefits.

Valerian Root

Valerian root is widely available alone or in combination with other calming herbs in remedies for dogs with anxiety. A preclinical toxicologic assessment involving a six-month course of a valerian, passion flower and hawthorn berry showed no significant alterations in biochemical and hematologic parameters in dogs.⁸ Valerian reduces stress, anxiety and insomnia by impacting GABA. Hence its nickname, “herbal Valium.”⁹

Problems may surface when herbs such as valerian add to the sedating effects of anesthetics, barbiturates, opioids and other CNS depressants. Otherwise, adverse effects are rare.

Ginseng

Ginseng actually refers to several different species, each with a unique biochemical profile.

• Panax ginseng: A study from Finland explored the value of a preparation containing Panax ginseng and brewers’ yeast as a stimulant in geriatric dogs.¹⁰ This combination produced significant mental and physical improvements without appreciable negative side effects. . • Korean red ginseng: A 2003 study from Korea demonstrated that Korean red ginseng significantly improved liver function and accelerated regeneration of the liver in experimental dogs following partial hepatectomy.¹¹  . • Yunnan Paiyao: Veterinary clients may ask about administering Yunnan Paiyao to dogs with hemangiosarcoma to reduce the likelihood of catastrophic hemorrhage.¹²,¹³ The main active ingredient in the mixture, pseudoginseng root, is a type of ginseng that offers the highest concentration of hemostatic constituents among all seven major ginseng types.¹⁴,¹⁵,¹⁶

The only study in dogs evaluated Yunnan Paiyao for open cervix-pyometra, not hemostasis. This uncontrolled trial found that 75 percent of dogs fully recovered in three weeks and an additional 20 percent resolved by five weeks without adverse effects.¹⁷ Putative mechanisms involve antioxidant, immunomodulatory and antiseptic activity.

Immune Stimulants

• Echinacea has received intensive media attention for its immune-stimulating properties. Dogs suffering upper respiratory infections who received powdered echinacea root experienced significant reductions in clinical signs such as nasal secretions, lymph node enlargement, cough and breathing difficulty.¹⁸.Though echinacea itself poses relatively little hazard, it may interfere with chemotherapy when given to dogs with lymphoma.¹⁹ It makes no sense to intentionally counteract the immune-suppressing value of chemotherapy for lymphoma by adding immune stimulants..
• An immune-boosting Chinese herb, astragalus, has been shown to reverse cyclophosphamide-induced immunosuppression, supporting concerns about immune-enhancers offsetting the value of chemotherapy in cases of lymphoproliferative neoplasia.²⁰.
• Asian mushrooms augment immune function in a different way than echinacea does, but the same concerns hold about administering them to dogs with lymphoma.²¹ For other types of canine cancer, no proof exists that mushroom mixtures can replace conventional chemotherapy.²²

An industry-sponsored preclinical evaluation that looked at concurrent supplementation of dogs undergoing chemotherapy with a medical mushroom-based immune-enhancer noted an improvement in quality of life,²³ but the question remains about the cost of countering toxicity on chemotherapy’s effectiveness.

Natural Not Always Safe

Science-based research not only guides us in determining which herbs to prescribe when, but it can expose toxic products for what they are despite the insistence by lay herbalists that these plants are safe. Comfrey, for example, continues to be promoted for use in animals²⁴ even though it can injure the liver and lead to cancer.²⁵,²⁶,²⁷

Both the Food and Drug Administration and the Association of American Feed Control Officials Inc. (AAFCO) view comfrey as dangerous, and AAFCO has encouraged feed-control officials to eliminate comfrey from animal products.²⁸  

Another potentially lethal plant, pennyroyal, appears often in “natural” flea preparations. As “an herbal toxin of public health importance,”ingesting even small amounts in oil or tea has led to several documented deaths.²⁹,³⁰ Clinical signs of exposure include nausea, vomiting, respiratory difficulty, gastrointestinal bleeding, seizures and coma, followed by coagulation abnormalities, liver failure and death. 

A 1992 case report of pennyroyal toxicosis describes the case of a 7-year-old dog treated topically for fleas using about two ounces of pennyroyal oil obtained from a local health food store. After two days of gastrointestinal distress, bleeding problems and seizures, she died despite supportive measures.³¹

More recently, the widely available antioxidant alpha lipoic acid (ALA), concentrated from plant and animal sources, has attracted the attention of emergency and critical care specialists who regard it as a serious and potentially lethal toxin for dogs and cats despite earlier assurances of safety.³²,³³

Holistic websites push ALA for peripheral neuropathy, aging, diabetes mellitus, cognitive dysfunction, cataracts, glaucoma and painful mouth in people and animals. Dogs or cats suffering ALA toxicity present with hypoglycemia, acute renal failure or acute hepatic injury; ALA is 10 times more toxic in cats than in dogs.³⁴

“Natural” does not always mean “safe.” While anyone can obtain herbs for animals, judicious and effective herbal prescribing requires more than simply viewing a tongue or “reading” a pulse. Only science will free the veterinary profession from the folklore that has taken root.

Narda Robinson, DVM, DO, Dipl. ABMA, FAAMA, offers an evidential and scientific perspective on complementary and alternative veterinary medicine. She oversees complementary veterinary education at Colorado State University.

This article first appeared in the January 2010 issue of Veterinary Practice News

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FOOTNOTES

1. O’Brien KA, Abbas E, Zhang J, et al.  Understanding the reliability of diagnostic variables in a Chinese medical examination.  The Journal of Alternative and Complementary Medicine.  2009;15(7):727-734.

2. Reichling J, Schmokel H, Fitzi J, et al.  Dietary support with Boswellia resin in canine inflammatory joint and spinal disease.  Schweiz Arch Tierheilkd. 2004;146(2):71-9.

3. Sengupta K, Alluri KV, Satish AR, et al.  A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee.  Arthritis Rsearch and Therapy.  2009;10:R85 (doi:10.1196/ar2461).

4. Gupta I, Gupta V, Parihar A, et al.  Effects of Boswellia serrata gum resin in patients with bronchial asthma:  results of a double-blind, placebo-controlled, 6-week clinical study.  Eur J Med Res.  1998;3:511-514.

5. Kimmatkar N, Thawani V, Hingorani L et al.  Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – a randomized double-blind placebo controlled trial.  Phytomedicine.  2003;10:3-7.

6. Reichling J, Schmokel H, Fitzi J, et al.  Dietary support with Boswellia resin in canine inflammatory joint and spinal disease.  Schweiz Arch Tierheilkd. 2004;146(2):71-9.

7. Sharma SS, Kochupillai V, Gupta SK, et al.  Antiemetic efficacy of ginger (Zingiber officinale) against cisplatin-induced emesis in dogs.  Journal of Ethnopharmacology.  1997;57:93-96.

8. Tabach R, Rodrigues E, and Carlini EA.  Preclinical toxicological assessment of a phytotherapeutic product – SPV (based on dry extracts of Crataegus oxyacantha L., Passiflora incarnate L., and Valeriana officinalis L.).  Phytotherapy Research.  2009;23:33-40.

9. Yager J et al.  Use of alternative remedies by psychiatric patients:  illustrative vignettes and a discussion of the issues.  Am J Psychiatry.  1999;156:1432-1438.

10. Hielm-Bjorkman A, Reunanen V, Meri P, et al.  Panax Ginseng in combination with brewers’ yeast (Gerivet) as a stimulant for geriatric dogs:  a controlled-randomized blinded study.   J vet Pharmacol Therap. 2007;30:295-304.

11. Kwon YS, Jang KH, and Jang IH.  The effects of Korean red ginseng (ginseng radix rubra) on liver regeneration after partial hepatectomy in dogs.  J Vet Sci.  2003;4(1):83-92.

12. Liu X-X, Wang L, Chen X-Q, et al.  Simultaneous quantification of both triterpenoid and steroidal saponins in various Yunnan Baiyao preparations using HPLC-UV and HPLC-MS.  J Separation Science.  2008;31:3834-3846.

13. Bergner P.  Panax notoginseng Yunnan bai yao):  A must for the first aid kit.  Medical Herbalism. 10-31-94 6(3):12.

14. Fratkin J.  Chinese Herbal Patent Formulas – A Practical Guide.  Santa Fe:  Shya Publications, 1986.  P. 133.

15. Zheng YN et al.  Comparative analysis of the anti-haemorrhagic principle in ginseng plants.  Acta Agriculturae Universitatis Jilinesis.  1989;11(1):24-27, 102.  [Article in Chinese].

16. Liu Y, Xie M-X, Kang J, et al.  Studies on the interaction of total saponins of panax notoginseng and human serum albumin by Fourier transform infrared spectroscopy.  Spectrochimica Acta.  Part A.  2003;59:2747-2758.

17. Salgado B, Paramo R, and Sumano H.  Successful treatment of canine open cervix-pyometra with Yun-Nan-Pai-Yao, a Chinese herbal preparation.  Veterinary Research Communications.  2007;31:405-412.

18. Reichling J, Fitzi J, Furst-Jucker J, et al.  Echinacea powder:  Treatment for canine chronic and seasonal upper respiratory tract infections.   Praktische Tierarzt; 2007;88 (5):314-326.

19. Shord SS, Shah K, and Lukose A.  Drug botanical interactions:  a review of the laboratory, animal, and human data for 8 common botanicals.  Integr Cancer Ther.  2009;8;208.  DOI:  10.1177/1534735409340900.

20. Chu DT, Wong WL and Mavligit GM.  Immunotherapy with Chinese medicinal herbs.  II. Reversal of cyclophosphamide-induced immune suppression by administration of fractionated Astragalus membranaceus in vivo.  J Clin Lab Immunol.  1988;25:125-129.

21. Holliday JC, Gianotti BM, Cleaver MP, et al.  Preclinical evaluation of concurrent medicinal mushroom-based immune-enhancement supplementation in dogs undergoing chemotherapy for various cancers.  International Journal of Medicinal Mushrooms.  2009;11(2):167-184.

22. Grissmayr PC, Gauthier M, Barber LG, et al.  Mushroom-derived Maitake PETfraction as single agent for the treatment of lymphoma in dogs.  J Vet Intern Med.  2007;21:1409-1412.

23. Holliday JC, Gianotti BM, Cleaver MP, et al.  Preclinical evaluation of concurrent medicinal mushroom-based immune-enhancement supplementation in dogs undergoing chemotherapy for various cancers.  International Journal of Medicinal Mushrooms.  2009;11(2):167-184.

24. Robinson NG.  Reading room.  Compendium Equine:  Continuing Education for Veterinarians.  October 2009.  Obtained here on 11-23-09.

25. Mei N, Guo L, Fu PP, et al.  Mutagenicity of comfrey (Symphytum officinale) in rat liver.  British Journal of Cancer.  2005;92:873-875.

26. Guo L, Mei N, Dial S, et al.  Comparison of gene expression profiles altered by comfrey and riddelliine in rat liver.  BMC Bioinformatics.  2007;8(Suppl 7):S22.

27. Yeong ML, Wakefield SJ, and Ford HC.  Hepatocyte membrane injury and bleb formation following low dose comfrey toxicity in rats.  Int J Exp Path. 1993;74:211-217.

28. U.S. Food and Drug Administration.  AAFCO framework for regulatory action on commercial animal feeds containing comfrey.  FDA Veterinarian Newsletter.  2003;18(2).  Obtained here on 11-05-09.

29. Bakerink JA et al.  Multiple organ failure after ingestion of pennyroyal oil from herbal tea in two infants.  Pediatrics.  1996;98(5):944-947.

30. Anderson IB et al.  Pennyroyal toxicity:  measurement of toxic metabolite levels in two cases and review of the literature.  Ann Intern Med.  1996;124:726-734.

31. Sudekum M et al.  Pennyroyal oil toxicosis in a dog.  JAVMA.  1992;200(6):817-818.

32. Loftin, EG and Herold LV.  Therapy and outcome of suspected alpha lipoic acid toxicity in two dogs.  Journal of Veterinary Emergency and Cricial Care.  2009;19(5):501-506.

33. Zicker SC, Hagen TM, Joisher N, et al.  Safety of long-term feeding of dl-alpha-lipoic acid and its effect on reduced glutathione:oxidized glutathione ratios in Beagles.  Veterinary Therapeutics.  2002;3(2):167-176.

34. Hill AS, Werner JA, Rogers QR, et al. Lipoic acid is 10 times more toxic in cats than reported in humans, dogs, or tats.  J Anim Physiol a Anim Nutr.  2004;88:150-156.

The aggressive marketing of Chinese veterinary herbs in the U.S. clouds the longstanding tradition of Western veterinary herbal medicine. The aggressive marketing of Chinese veterinary herbs in the U.S. clouds the longstanding tradition of Western veterinary herbal medicine. asian herbs, Chinese veterinary herbs, Chinese medicine, herbal medicine, boswellia, ginseng