Changing Times
10/20/2022
The last couple of years have been tough for everyone! Many people are making changes as we adjust to new normals. I have had some significant changes myself and would like to share my plans as I come out the other side. I have kept in personal contact with clients and I want to thank so many of you for your support and care in respecting my needs while allowing me to continue to help you and your families with your animal care needs. I definitely feel the love!
Going forward I will not be taking on new patients for housecalls, but am now offering TeleConsultations to continue providing the most critical conversations around end-of-life care and planning. Please see the changes in my Services offered.
————
Now for the longer explanation because I know many of you have been concerned and I want to give you an update.
I don’t think this was necessarily COVID related. If I have been infected it was mild, and my illness started long before 2020. Ten years ago last spring (2012), I developed a viral arthritis - most likely human parvovirus, though it wasn’t diagnosed at the time. This seemed to be the springboard for ongoing autoimmune conditions. I have lived a relatively healthy life, and my signs have been mild most of the time, which has been part of the challenge in getting diagnoses, but I’ll take that!
In the fall of 2019, early 2020, it became apparent that my “normal” low white blood cell count was going down into a more concerning level. Specifically, I have neutropenia — low neutrophils. In fact they call it “chronic severe neutropenia.” With the help of self advocacy and doctors who listen, the specifics of my autoimmune condition have been narrowed down (Sjogrens and “Undifferentiated connective tissue disease"-Lupus family among others.) Along with a low white blood cell count comes fatigue, aches, and other signs.
My immune system appears to be my superpower and my kryptonite and I will continue to find the balance between the two. This for me includes slowing down, reducing travel for teaching, focusing on writing, offering teleconsultations, and continuing my online self-care courses. Learning and sharing in this way is fulfilling and allows the flexibility I need and enjoy.
I did continue to teach through spring of 2022, thinking this would resolve at some point! It seems to be here to stay, so I have made these lifestyle choices to better support my personal health and continue to be available on a different level. Of course I continue to approach my health in a “wholistic” and integrative way through diet, exercise, herbs, and the wonders of modern medicine where needed.
I am no longer seeing in-person housecall appointments, but will continue to offer the important conversations and end-of-life planning that we managed through telemedicine over the pandemic. During the worst of the pandemic, I was able to continue to have these important conversations through phone calls, FaceTime, and Zoom, so this taught me that it is possible to offer some of my most important services even from a distance. I had decreased my housecalls due to teaching and travel and now I am able to teach and offer consultations from wherever I happen to be.
This new “distance” scheduling allows me to provide continuity of care from wherever I am. Family has always been a priority to me and the flexibility to be able to travel to help and visit with my Mom and sister in AZ and my now grown daughters is important as is continued travel for fun and exploration which has always been a joy.
Wishing you all wellness and contentment as we journey along in this crazy thing called life! Please feel free to contact me if you have questions.
Going forward I will not be taking on new patients for housecalls, but am now offering TeleConsultations to continue providing the most critical conversations around end-of-life care and planning. Please see the changes in my Services offered.
————
Now for the longer explanation because I know many of you have been concerned and I want to give you an update.
I don’t think this was necessarily COVID related. If I have been infected it was mild, and my illness started long before 2020. Ten years ago last spring (2012), I developed a viral arthritis - most likely human parvovirus, though it wasn’t diagnosed at the time. This seemed to be the springboard for ongoing autoimmune conditions. I have lived a relatively healthy life, and my signs have been mild most of the time, which has been part of the challenge in getting diagnoses, but I’ll take that!
In the fall of 2019, early 2020, it became apparent that my “normal” low white blood cell count was going down into a more concerning level. Specifically, I have neutropenia — low neutrophils. In fact they call it “chronic severe neutropenia.” With the help of self advocacy and doctors who listen, the specifics of my autoimmune condition have been narrowed down (Sjogrens and “Undifferentiated connective tissue disease"-Lupus family among others.) Along with a low white blood cell count comes fatigue, aches, and other signs.
My immune system appears to be my superpower and my kryptonite and I will continue to find the balance between the two. This for me includes slowing down, reducing travel for teaching, focusing on writing, offering teleconsultations, and continuing my online self-care courses. Learning and sharing in this way is fulfilling and allows the flexibility I need and enjoy.
I did continue to teach through spring of 2022, thinking this would resolve at some point! It seems to be here to stay, so I have made these lifestyle choices to better support my personal health and continue to be available on a different level. Of course I continue to approach my health in a “wholistic” and integrative way through diet, exercise, herbs, and the wonders of modern medicine where needed.
I am no longer seeing in-person housecall appointments, but will continue to offer the important conversations and end-of-life planning that we managed through telemedicine over the pandemic. During the worst of the pandemic, I was able to continue to have these important conversations through phone calls, FaceTime, and Zoom, so this taught me that it is possible to offer some of my most important services even from a distance. I had decreased my housecalls due to teaching and travel and now I am able to teach and offer consultations from wherever I happen to be.
This new “distance” scheduling allows me to provide continuity of care from wherever I am. Family has always been a priority to me and the flexibility to be able to travel to help and visit with my Mom and sister in AZ and my now grown daughters is important as is continued travel for fun and exploration which has always been a joy.
Wishing you all wellness and contentment as we journey along in this crazy thing called life! Please feel free to contact me if you have questions.
Cat Friendly Veterinarian
12/03/2020
I have recently completed the new Cat Friendly Veterinarian certification course for the AAFP (American Association of Feline Practitioners). It gave me a chance to review the materials on their website for clients- Cat Friendly Homes. They have added many new pages of helpful tips for navigating life with a cat.
Cats are special creatures and many hold a place in my heart. They see the world a bit differently through the eyes of predator and prey. They have keen senses and are small enough to be very concerned for their own safety, while also being skilled at stalking and hunting. Many of the problems that we see with cats have more to do with us misunderstanding their needs and perspective than an actual problem with their behavior. If we are going to bring cats into our homes, we need to understand what makes them uncomfortable or frightens them because these are the very things that drive them to "inappropriate urination," scratching furniture, and so many challenging issues that can come up when living with a cat. What is stressful to a cat may be very different from what we might assume.
Cats are often solitary animals and need their litterboxes and feeding areas to feel sheltered and protected. Here is a great place to start "What your cat needs to feel secure."
Cats can be very destructive to wild animal populations, particularly birds. Keeping them content indoors is a way for us to provide a home to the many cats in need and to enjoy their snuggly company without harming the environment. For more info on helping cats to enjoy the outdoors while protecting the birds at your feeder, check here. Cats can be harness trained for walks and an enclosed outdoor "Catio" can give them an opportunity to smell and interact with the natural world.
I have always appreciated the AAFP's handouts, guidelines, and educational information. This cat-friendly website is listed on my resource page as well.
For more cat specific info see my Cat Care page!
Telehealth Consultations
11/28/2020
Me and my COVID Coworkers!
Much of my work in supporting wellness, aging, and the navigation of end of life pathways is conversational. With the challenges of this year, I am now scheduling Telehealth
Consultations with current clients to allow us to continue to have those valuable more detailed conversations about Quality of Life, treatment options, and care decisions without risking potential human exposures through prolonged in-person contact. Treatment plans for chronic disease management including osteoarthritis, chronic renal disease, hyperthyroidism, and many others can be established and reviewed in this way. Monitoring for signs of concern including pain recognition and follow-up check-ins can also be included.
There are many times when it is important to have a physical exam and other diagnostic testing done before prescribing. Telemedicine can provide a great follow-up to those visits and much of the recheck can be done through video and discussion of changes that are being noticed. As always with my housecall practice, there are times when a patient needs to be seen at a clinic or emergency facility for care. If you are interested in scheduling a Telehealth call to go over your animal's needs and establish a care plan, contact me through email and we can coordinate a virtual visit!
COVID-19 Plans
03/25/2020
This is a very weird and scary time with this new virus upon us. There are still many uncertainties about how it is transmitted and what the real risks are. Knowing that many of my clients are elderly or potentially at a higher risk along with concern for my own health and that of my family, I will be avoiding in-person housecall visits for a while. I am currently not accepting new patients and limiting consultations to phone or video calls through FaceTime or Zoom. Much of the services that I provide do involve extensive conversation, particularly hospice and end-of-life discussions. For current patients, these can continue to be done while physically distancing. I will continue to provide follow-up care and the usual deliveries of herbal and medication refills. As always, we can refill monthly heartworm preventatives and other needs through my online pharmacy (link). The big difference is that, sadly, conversation is more limited during these deliveries. I really do appreciate hearing about you and your families and the little details of your lives with your animals. Please let me know how you are doing with all of this! I hope everyone is able to stay healthy and safe.
Local veterinary clinics, including Iowa State University for after hours, are offering continued care for essential and emergency needs through a drive-up service where a technician takes your animal into the clinic while you wait outside. The veterinarian then calls your cell phone for a consultation. I will be referring any physical appointment needs to clinics that are prepared to limit human exposures in this way. I do still want to hear from you and stay up to date with your animals’ needs and any concerns you may have during this challenging time.
My planned spring travel for teaching in the Outer Banks, NC has been postponed until fall (hopefully!) We have a new Hospice & Palliative Medicine weekend course for veterinarians planned and have our current “Veterinary Herbal Apprenticeship and Retreat” 5-module class to complete. Some of it we will be able to do online, but so much of what we teach is hands-on that we will be postponing the last 2 modules of that course as well. I am using this time to improve my teaching materials, continue learning and update my business plans. I’ll do my best to offer what veterinary services I can while supporting my own family and friends. Wishing peace and health to all, and the capacity to be kind to ourselves and work through this together in whatever ways we are able.
Local veterinary clinics, including Iowa State University for after hours, are offering continued care for essential and emergency needs through a drive-up service where a technician takes your animal into the clinic while you wait outside. The veterinarian then calls your cell phone for a consultation. I will be referring any physical appointment needs to clinics that are prepared to limit human exposures in this way. I do still want to hear from you and stay up to date with your animals’ needs and any concerns you may have during this challenging time.
My planned spring travel for teaching in the Outer Banks, NC has been postponed until fall (hopefully!) We have a new Hospice & Palliative Medicine weekend course for veterinarians planned and have our current “Veterinary Herbal Apprenticeship and Retreat” 5-module class to complete. Some of it we will be able to do online, but so much of what we teach is hands-on that we will be postponing the last 2 modules of that course as well. I am using this time to improve my teaching materials, continue learning and update my business plans. I’ll do my best to offer what veterinary services I can while supporting my own family and friends. Wishing peace and health to all, and the capacity to be kind to ourselves and work through this together in whatever ways we are able.
Speaking of Hospice and Herbs
02/27/2020
This month I had the opportunity to spend a day speaking to veterinarians at the Midwest Veterinary Conference. I spoke for 6 hours about Integrative Medicine in Animal Hospice and Palliative Care, particularly herbal medicine and how it can be used to support animals in their geriatric years and to improve comfort at the end-of-life. In my practice, I use individualized herbal formulas to treat nausea, constipation and diarrhea, liver and kidney disease, skin conditions, pain and inflammation, as well as some infections and cancers. As an integrative veterinarian, I also use pharmaceutical medications when needed, but can often avoid their use by supporting the general well-being and healing capacity of the body with herbs and other complementary treatments.
I ended the day by talking about Compassion Fatigue and the importance of Self-Care for caregivers, including veterinarians and their staff, along with caregiving families dealing with the stress and increased needs of animal loved ones nearing the end of life. These are all topics that are near and dear to me. They speak to my overall approach to providing veterinary care that supports both the patient and the family, particularly during the difficult time as life draws to an end. Hospice and end-of-life care emphasize living the best Life possible during the time remaining.
I would much rather start these conversations sooner than later. Please contact me if you would like a consultation about herbal supportive medicine for your geriatric animal or if you are struggling with end-of-life care decisions. These are difficult topics to bring up, but with some support and a plan in place, the challenges might be a bit easier to manage. I would like to be there to help.
I ended the day by talking about Compassion Fatigue and the importance of Self-Care for caregivers, including veterinarians and their staff, along with caregiving families dealing with the stress and increased needs of animal loved ones nearing the end of life. These are all topics that are near and dear to me. They speak to my overall approach to providing veterinary care that supports both the patient and the family, particularly during the difficult time as life draws to an end. Hospice and end-of-life care emphasize living the best Life possible during the time remaining.
I would much rather start these conversations sooner than later. Please contact me if you would like a consultation about herbal supportive medicine for your geriatric animal or if you are struggling with end-of-life care decisions. These are difficult topics to bring up, but with some support and a plan in place, the challenges might be a bit easier to manage. I would like to be there to help.
Recognizing Pain in Animals
10/30/2019
“Animals hide pain as a defense mechanism to protect them in the wild.” I have heard this often over the years, from veterinarians and those who love animals. There may be some truth to this statement, we really can’t fully know why animals do what they do, but that doesn’t mean we can’t try to understand them better. It can be challenging to recognize signs of pain and discomfort in our animals, but they are often not intentionally hiding their pain in the comfort of their domestic home environment. A perfect example is the dog that lifts her paw to have her person remove a thorn. We as humans can improve our caregiving abilities by learning the physical and behavioral signs that they display when they are hurting. And honestly, putting ourselves “in their paws” can be a useful technique. Their nervous systems function very much like ours. They feel acute pain and adapt to ongoing pain much as we do. I often ask people who experience chronic pain to consider how many people around them are actually aware of their level of pain — we humans hide our pain as well!
Did you know that animals often make grimacing facial expressions when they are feeling pain? Covered with fur, their faces can be harder to read, but scientists have recognized specific facial features such as squinting eyes, flattened ear position, a “nose bump” where the bridge of the nose would be on a person, and muzzle bulges on their “cheeks” making the whiskers point out further to the sides. These signs can sometimes be seen with anxiety as well, so it is important to take them in context and to watch for them over time. Chronic pain is common in animals just as it is in humans, due to osteoarthritis, some cancers, infections, and injuries.
Click here for more signs of pain in animals.
Pain management involves a multimodal approach using weight control, exercise and movement, herbal and nutritional supplements, multiple types of physical therapy, and pharmaceutical drugs. As an integrative veterinarian with herbal medicine in my toolkit, I have been very pleased with the improvements in my patients with just a few simple additions to their care. Contact me for a holistic assessment and see if an individualized herbal pain support formula can help the animals in your life to be more happy, energetic and comfortable.
Did you know that animals often make grimacing facial expressions when they are feeling pain? Covered with fur, their faces can be harder to read, but scientists have recognized specific facial features such as squinting eyes, flattened ear position, a “nose bump” where the bridge of the nose would be on a person, and muzzle bulges on their “cheeks” making the whiskers point out further to the sides. These signs can sometimes be seen with anxiety as well, so it is important to take them in context and to watch for them over time. Chronic pain is common in animals just as it is in humans, due to osteoarthritis, some cancers, infections, and injuries.
Click here for more signs of pain in animals.
Pain management involves a multimodal approach using weight control, exercise and movement, herbal and nutritional supplements, multiple types of physical therapy, and pharmaceutical drugs. As an integrative veterinarian with herbal medicine in my toolkit, I have been very pleased with the improvements in my patients with just a few simple additions to their care. Contact me for a holistic assessment and see if an individualized herbal pain support formula can help the animals in your life to be more happy, energetic and comfortable.
Kate's Memorial Artwork!
05/13/2019
I have a young friend (an Ecology and Studio Art major at UNI) who is an amazing artist and has put her skills to work creating lovely memorial artwork of animals incorporating personal aspects of their lives in beautiful and whimsical ways.
The paintings above are of her family's cat, Cinder, and their adorable pet rats. This family had many losses all in a very short time and pulling them all together into this beautiful world has helped them to remember and enjoy the wonderful times with all of these loved ones. Going through the process of deciding what to include has been healing in its own way.
"These are an homage to the lives of our dear friends, so to fully capture their personalities, the tales of their daring exploits must also be included. The plants, objects, and animals all represent a story so they will always be remembered." -Kate
Kate is also quite talented a capturing the living - see Berlioz below "He’s a cute li’l guy isn’t he?" She works in various types of media including recycled materials!
If you are interested in talking to her about commissioning a personal piece of art, let me know and I can put you in touch!
Dangers of Grain Free Diets?!
04/09/2019
Grain free diets for animals have been popular for many years now due to various concerns about food allergies and the human concerns with eating gluten-free. Unfortunately, a trend is being seen of some dogs (and a few cats) developing a heart condition called DCM (Dilated Cardiomyopathy) that may be connected to diet. This condition has previously only been seen in specific breeds with a genetic predisposition (Boxers, Great Danes, Doberman pincers,…) Now it is being seen in other breeds of dogs and a connecting factor is the feeding of "Boutique, Exotic ingredient, and Grain-Free" diets (labeled BEG diets by researchers). So far, concerns for large amounts of chickpeas, peas, lentils and other legumes, and potatoes (sweet and regular) as substitutes for protein and carbohydrate needs has been singled out, though there are still a lot of unknowns including genetic differences in metabolism. A similar condition
occurred in cats many years ago and was linked to taurine insufficiency in diets. Now all cat foods are supplemented with taurine. This appears to be related, but a simple taurine addition has not been sufficient in the case of these dogs.
Switching to a more research-based brand has reversed the condition in several cases. The official recommendation is to stick with the "Big 5" dog food brands that have more extensive research and feeding trials: Eukanuba, Iams, Hill's Science Diet, Purina (ProPlan & higher end versions), and Royal Canin. Studies are continuing in order to learn more about what may be affecting these dogs. Sadly, signs of DCM heart disease come on suddenly and some have died. Though still very rare, over 300 animals (6 cats, the rest dogs) in the last 5 years have been diagnosed as having DCM with what seems to be a dietary connection. For all we know about nutrition, there is still so much unknown. Dietary rotation (feeding a few different brands and ingredients) is an option to avoid long term effects of nutritional deficiencies with any one diet as well as ingredient concerns such as the recent Science Diet recalls for excessive vitamin D levels. Home cooked diets are another option, but this can also have concerns of nutritional deficiencies. Varying ingredients and sticking with recipes formulated by boarded veterinary nutritionists are important steps. Please avoid random online sites for homemade diets! I can help to guide these choices. If you would like to schedule an examination and to discuss your animal's dietary needs, please contact me!
For more nutrition discussion see topics in Pet Care: Healthy Diet and Supplements
Here is a link to a good explanation from NC State Veterinary Hospital
© 2010
occurred in cats many years ago and was linked to taurine insufficiency in diets. Now all cat foods are supplemented with taurine. This appears to be related, but a simple taurine addition has not been sufficient in the case of these dogs.
Switching to a more research-based brand has reversed the condition in several cases. The official recommendation is to stick with the "Big 5" dog food brands that have more extensive research and feeding trials: Eukanuba, Iams, Hill's Science Diet, Purina (ProPlan & higher end versions), and Royal Canin. Studies are continuing in order to learn more about what may be affecting these dogs. Sadly, signs of DCM heart disease come on suddenly and some have died. Though still very rare, over 300 animals (6 cats, the rest dogs) in the last 5 years have been diagnosed as having DCM with what seems to be a dietary connection. For all we know about nutrition, there is still so much unknown. Dietary rotation (feeding a few different brands and ingredients) is an option to avoid long term effects of nutritional deficiencies with any one diet as well as ingredient concerns such as the recent Science Diet recalls for excessive vitamin D levels. Home cooked diets are another option, but this can also have concerns of nutritional deficiencies. Varying ingredients and sticking with recipes formulated by boarded veterinary nutritionists are important steps. Please avoid random online sites for homemade diets! I can help to guide these choices. If you would like to schedule an examination and to discuss your animal's dietary needs, please contact me!
For more nutrition discussion see topics in Pet Care: Healthy Diet and Supplements
Here is a link to a good explanation from NC State Veterinary Hospital
© 2010
Medicine Around the World
09/13/2018
On a visit to the Peace Pagoda in Leverett Massachusetts last fall, I found this tree dedicated by Jake Swamp (Tree of Peace Society) in 1985. My friend, Dr Laurie Dohmen and I were on our way to Kripalu School of Ayurveda where this past year we attended three 10 day modules of a course in Foundations of Ayurveda and Ayurvedic Herbology. We had the honor of being the first veterinarians in the Kripalu course! Our fellow classmates went on to become Certified Ayurvedic Health Councilors and Laurie and I have gone on to continue our exploration of Ayurvedic Medicine and its herbs to help our animal patients and our veterinary herbal students.
One lecture that we have enjoyed putting together for our herbal course is an overview of
various cultural approaches to herbal medicine including Western (coming from the Greek origins of our modern day medicine), Ayurvedic Medicine from India and Traditional Chinese Medicine. Even though I am a Western herbalist, some of my favorite herbs come from Indian and Chinese traditions. Ashwagandha (Withania somnifora) and Astragalus (astragalus membranaceous) are two that I use everyday.
After taking these courses in Ayurvedic medicine, we are better able to read Ayurvedic herbal descriptions (material medica) and have a deeper understanding of the skills used by our medical predecessors before we had so many technological diagnostic tools. It is amazing what they could do using well developed powers of observation. I appreciate the contributions of these ancestors as well as the modern tools and medicines we have today which combine into Integrative Medicine bringing the best of all worlds together.
If you are interested in scheduling an herbal medicine consultation, please contact me!
Gratitude
07/20/2018
Research has shown that simply thinking about gratitude improves our outlook and health.
(Click here for more) Building a daily habit of just asking yourself "What am I grateful for?" can
improve your mental state whether you think of an answer or not!
I wrote this poem last year to share the concept of gratitude with my veterinary herbal
medicine students in the Outerbanks. It was inspired by a nature meditation exercise used by
the Wilderness Awareness School and the 8 Shields organization both founded by Jon Young,
author of Coyote's Guide to Connecting with Nature.
I use this poem to encourage my students to express their own gratitude, in their own words,
to all that surrounds us in a regular (ideally daily) practice. It seems appropriate to share it now
as I am reminded of all of the things I am grateful for.
Gratitude
by Kris August
-Inspired by:
Thanksgiving Address: Greetings to the Natural World by Jake Swamp
I am grateful for the Earth that is our home, the rocks and stones and soil,
And for the water that flows over and inside the Earth and inside all living things.
I am grateful for all the living beings that move and grow and struggle and thrive on the earth:
The mushrooms and lichens and algae and plants that give us food and medicine and remind
us to be cautious,
The bushes and tall trees that give us fruit, nuts, shade, shelter and medicine too,
The fish, the insects, the birds, the mammals big and small, and the humans, who all give of
themselves in their own way for us to live together on this Earth.
I am grateful for the wind that brushes my face, the clouds in the sky, the thunder and
lightning, the rain and snow that clean and water the Earth.
I am grateful for the sun that warms my skin and gives us life, for the moon that tugs on us,
the stars that inspire, the distant planets and the universe stretching out as far as the
imagination can go and beyond.
I am grateful for beginnings and endings, creators and destroyers, and again for the creators
that bring us full circle to life.
Thanks to all.
~~~~~~~~~~~~
I encourage you to create your own thanksgiving address however small or grand every time
you walk outside.
(Click here for more) Building a daily habit of just asking yourself "What am I grateful for?" can
improve your mental state whether you think of an answer or not!
I wrote this poem last year to share the concept of gratitude with my veterinary herbal
medicine students in the Outerbanks. It was inspired by a nature meditation exercise used by
the Wilderness Awareness School and the 8 Shields organization both founded by Jon Young,
author of Coyote's Guide to Connecting with Nature.
I use this poem to encourage my students to express their own gratitude, in their own words,
to all that surrounds us in a regular (ideally daily) practice. It seems appropriate to share it now
as I am reminded of all of the things I am grateful for.
Gratitude
by Kris August
-Inspired by:
Thanksgiving Address: Greetings to the Natural World by Jake Swamp
I am grateful for the Earth that is our home, the rocks and stones and soil,
And for the water that flows over and inside the Earth and inside all living things.
I am grateful for all the living beings that move and grow and struggle and thrive on the earth:
The mushrooms and lichens and algae and plants that give us food and medicine and remind
us to be cautious,
The bushes and tall trees that give us fruit, nuts, shade, shelter and medicine too,
The fish, the insects, the birds, the mammals big and small, and the humans, who all give of
themselves in their own way for us to live together on this Earth.
I am grateful for the wind that brushes my face, the clouds in the sky, the thunder and
lightning, the rain and snow that clean and water the Earth.
I am grateful for the sun that warms my skin and gives us life, for the moon that tugs on us,
the stars that inspire, the distant planets and the universe stretching out as far as the
imagination can go and beyond.
I am grateful for beginnings and endings, creators and destroyers, and again for the creators
that bring us full circle to life.
Thanks to all.
~~~~~~~~~~~~
I encourage you to create your own thanksgiving address however small or grand every time
you walk outside.