RawPetMedics FB Live: Sick As A Dog (or Cat)!

with you. So I just want to check that we are live. Um, one of you guys on here on Facebook, check. We've got viewers, we must be on.

Oh, we've got viewers, good. I don't see people coming.

There we go. Yeah, see, we were worried, we were giving you a shock too.

You have to— it's the same 5 or 10 names that come on first. Fair play, guys, you're our biggest supporters. It's always good to have you. Oh, we love them all. It's like the parents that bring the kids to the football. There's always the same parents there at the side cheering them on.

But, uh, who's these guys thinking they can get around us by calling us gentlemen?

I mean, I'm sorry, gentlemen, I'm being asked to leave a pub. Time, gentlemen. Uh, but yeah, what about that Facebook outage? I didn't know what to do with myself for a day. No WhatsApp, no messages from my friends.

Evening, it wasn't even a day. It came, what was it, about 5 o'clock.

Yeah, I was worried.

Oh, my mic is out.

Okay, so guys, uh, how's your week been? Bren, how's your week been?

Uh, yeah, um, busy, busy, busy. The practice is just absolutely steaming through. Uh, so many people trying to find vets. You know, there's a vet shortage out there anyway. You've then got 20% more pet owners You know, I think every practice out there— so you guys, if you're trying to get in touch with your vet, bear with them. Massive shortage of staff, massive issues with trying to get in. We've got reports, potentially standard people traveling more than 100 miles to go and see a standard vet because they can't get in because so many places have closed their lists.

What are the issues, guys? Give me like 3 bullet points. What are the issues? Why is there not enough vets? I mean, bloody hell, I heard there's more and more vets per pet than there's ever been. Why is there not more vets coming in? What's the issue?

It's about length of time that the vets stay in the profession before leaving due to stress. Okay, massive. It's gone down from when I qualified and Nick qualified, about 25 years was the average time span in the profession, and it's down to— can you believe it— 3 and a half. No, 3 and a half years.

That's not true.

That— yep, that is, uh, absolutely. So there are people that will stick with it, but there's so many people that will just go— this is clinical practice, okay— but they will get the qualification and they'll go and do something else.

Whoa, that's, that's an unbelievable figure you're actually giving there. I can't believe it's that low. I knew the stress and that, you know, you always see it up there at the top, kind of stress-inducing, worrying kind of mental health issues and stuff. I can't believe the figure's that low. That's a real indictment, isn't it? Bloody hell.

Yeah, so, well, you know, all sorts of issues around that with, you know, how treatments affect pets and that emotional relationship and everything else. But yeah, that's where we're at. So busy, busy, busy. You know, I think, yeah, there's people that will come to see referral practices cases like mine and Nick's that would travel a long distance anyway. But I think even for the conventional guys out there, they're struggling massively.

So also, I think, you know, I hear a lot of people say, oh, you know, it's not how it was, and the profession is under strain. But also they say that they don't like seeing a different vet every time they go to the vets, you know, because they have to start off all over again, especially if you've it's a long-standing case, it's like, ah, this is the back history, and that takes at least 10 minutes, and then you haven't got any time to consult. So it's quite a frustrating business. So there's a lot of corporate practices, some great corporate practices, but some who are not creating an environment that would be quite as conducive as it was back in the old days, perhaps, if I'm trying to be I'm trying to be fair.

There was a quote there about private practices. There was a quote from the Bloomberg piece in 2017. I'll never forget it. It was fantastic. And it was talking about Mars Banfield. And the Bloomberg piece was about Mars Banfield. And they were saying that there's a set of instructions for the vet. So when someone, when a patient comes in, this is what they have to recommend. And the vets that were complaining in the piece said, we left the practice because like I can't be told what I'm going to do. It's like, you must, you must recommend these things for atopic dermatitis. And he's like, I'm a doctor, like, I'm going to doctor around. That's what I do. So that's been removed for them in there with, with this piece. That's what that piece was suggesting. So maybe that's what you're getting at. That can't be very positive for a guy. You want to get into practice to make a difference and use your head.

You want to be creative as a clinician. You want to be creative. And if somebody's saying, if you see an itchy dog, this is how you treat it, you might as well put a put a chimpanzee in there, you know, and just say, right, just press this button, this button, this button, and off you go. Yeah, exactly right.

Vending machine at the bottom of it.

Totally. How about you, Conor? How about you? How's your week been?

Lads, I'm trying to think of something interesting I did for the last 7 days, but I will just be making it up. I was just going to say I went for a swim, but it's just not true. I haven't really done.

Mate, just lie. Just lie.

He's been looking after his Daughters, that's what's going on.

I went for it. Yeah, exactly, the usual stuff, like just the usual, you know, bombs going off and my ears are ringing. I'm just staggering around trying not to have a glass of wine. But I went for a lovely walk. This is a sad story, but I went for a lovely walk in my favorite mountain area this morning, and, uh, there was someone fly-tipping, and I've got photographs taken and I'm going to put them up on my page tomorrow. And I'm so annoyed. Dirt, junk everywhere, a burned-out car. They rob the wires over here and they burn them in massive piles to burn the plastic off to take the copper out of the wire. So there's just fires everywhere. I mean, this is one of the most idyllic places in Wicklow, which is one of the most idyllic places in Ireland. And it's like, oh my God, I was so annoyed. So that ruined my walk. On a positive note, I am totally revamping my website. So now I've met these guys that I get on really well with, and it's just like, they're just taking it in hand. You pay them a horrible amount of money and then they go off and then they restructure it and they say, 'Yeah, your content is okay, but you know, your approach is absolutely awful.' And it's like, oh, I kind of suspected that. So it's good to have that in the background cooking away. So that's happening. But tonight, guys, tonight is—

I haven't had a go yet.

I've got— what is your week? Oh yeah, yeah, yeah, yeah.

I've got my advanced copy in. It's real copy, real paper, not an electronic copy that we had earlier.

Very nice.

It's fantastic. The thing is, we've read it. All three of us have read it, so I'm going to just put it on my bookshelf in a really prominent position so that everybody can admire it.

Very nice.

I was just resisting.

I thought I'd be nice to you guys and not say mine's arrived.

I've got mine, but it's down in my brother's shop where I get everything delivered to. I just haven't picked it up yet. I feel left out now for not having it in my hand.

I was hoping I'd be the only one, and then I'd go, oh yeah, I'm special. So they obviously did. They sent me mine before they'd even written it, you know. That's how special our relationship is.

That's how much they value the Raw Father. Um, who's, uh, who's, uh, what's on? Yeah, so do you want to do the Patreon bit, Nick, and tell us who's sponsoring the show tonight?

Yeah, well, I'd say thank you to today. Go on, go on, Nick, you froze for a moment.

Okay, so yeah, I've been doing a lot of work with Patreon. They're a great bunch, and I'm trying to put up lots of, lots of information for them. Thank you very much, people, for putting in $1, $2, $5 every month. It makes a big difference if lots of people do that. It means it's no major skin off your nose, and it really helps us. We have started talking to the lab about the new— they did the analysis of Kibbles, and that's really exciting. We got that email back from the lab, and so watch this space. We're going to move forward with that. We'll keep you posted every step of the way. So thank you again, the Patreon people. I'd also really, really like to, to thank Carla. Carla at Noble Just Natural, Natural Health for Dogs. Noble Just Natural Health for Dogs. There's the, uh, the thing. Carla's great. She's, she's, um She didn't know much about nutrition 10 or so years ago. Now she's very, very, very clued up and she's looking after— she says here they've got 23,000 members in just 18 months on that. On that, yeah, yeah, yeah, it's crazy figures. A nutrition and natural health group, so basically everything to do with dog and natural health rearing. Lots of care professionals, canine health professionals. In the group. Um, they do have a website which is the same, you just, uh, Google those. Um, and she says they are a very— there is no arguments, no rudeness, no condescending idiots, no bull. Anybody who wants to argue just gets booted out really quickly. It's about helping, it's about nurturing, and everybody, uh, you know, enjoying their, their journey. Nobody has all the answers. Not even us.

One of the admins of the group just messaged me and said, would I show people tonight her handiwork?

What's that?

What's that?

We can't see it. It's a really bad picture.

Here we go. There, she made a mini Bren. So it's got—

Yeah, yeah, whatever. There's no glasses on that, and therefore it can't be me or Nick. And she must have sent it to you because with no glasses, that means it's Conor.

Meet friends. So if anybody would like to make a Meet Nick next week, we will show up your photographs. If your child wants to do a doodle, whatever, we'll post it up.

Okay, that's competition.

Yeah, there we go, competition. So listen guys, tonight is about, um, is about— I was going to say vomiting, uh, but then we're going to say regurgitation, and I am not quite clear on the difference between those two. And you guys are adamant that we need to make the distinction. So who wants to start us off?

Okay, so the way I look at it is that vomiting involves your stomach ejecting material that's in the stomach, whereas regurgitation is a much less structured, organized process. So the way I look at it is that if you've got— imagine you've got a bowl, a pan of water on the oven, okay, and it's turned up to the the top. So it's really, really full. So regurgitation is that water bubbling out over the top, yeah, and causing, you know, causing steam and damage and what have you. Whereas vomiting is when you pick up the pan and you chuck it out the window— or you chuck the contents out the window, should I say. Okay, yeah, you actually eject the contents of that. That would be an easy way to look at the two. However, they can— there is quite a lot of overlap, and sometimes, oh, was that regurgitation or was that vomit? Or sometimes it starts as a regurgitation and then the they go, let's just get rid of it anyway. So there we go. So it's important to differentiate the two, and there's a lot of reasons why dogs may vomit. But we just wanted to look at one or two causes of vomiting. We might do vomiting as a thing on its own, but we really wanted to concentrate on regurgitation because on the No Bull, as the name suggests, there's a lot of bullies, there's a lot of brachycephalics, and they get quite a lot of regurgitation problems. Brent, what are your thoughts on vomiting?

Yeah, I would definitely say the big one for me, I see a lot of regurgitation that people mistake for vomiting, and it is literally that hole. We'll talk about in more detail. And guys, if you've just had your tea or you're still eating whilst you're watching us right now, I do apologize. There's going to be some graphic noises in a second. So just—

yeah, Lorian Colt says, sorry I'm late, I was just clearing up some dog sick. How topical! Welcome to the show.

I would absolutely say, look, dogs and cats are built for ingesting stuff and just ejecting stuff that's not right for them. So they are very much predisposed to vomiting at a much lower threshold than even we are, and certainly than, you know, other species. So I would just really get used to the fact that actually slightest bit, you know, if there's some bits of bone that they don't quite digest, what's going to happen? Okay, and bring it back up. But they're not just going to go 'bark' because that is regurgitation. So if your dog looks slightly uncomfortable and then just turns the head and just goes 'whoa' and it's back, and it's almost like taking them by surprise and you by surprise, it looks like a tube of food that's regurgitation. If they've really done abdominal thrusting, you know, there's a lot of, and they're wandering around and it's really going for it, and then they bring it back, especially if there's yellow bile in that, that's proper vomiting from the depth of the stomach. Okay, and that's really the bit that we then have to differentiate what may be causing that. And I think we've got to isolate then about the group of organs that can cause that nausea and vomiting, the toxin stuff and what may be going on with that, the actual pathology that may be going on to cause that vomiting. So there are some sort of key areas that we need to touch on there. But I agree with Nick, differentiating, actually giving people some useful tips tonight on how to deal with regurgitation, I think is really important because there is some things here. And this is the same for cats. I want to put in some cats. People have asked me, we don't say enough about cats. And, you know, there is plenty to say about cats and doing this can suffer from many of the same diseases that dogs can and definitely benefit from moving to raw and having bone broths and then helping their microbiome. But obviously there's also, we think more about the furball scenarios. And so you've got to think then outside of the box Nick talked about a little bit about the psychology of what's going on, and that sometimes, especially for cats, can then cause them to groom more, cause them to get things like furballs, which will make them sick. And looking out for those little what look like dead mice coming back up, um, are surrounded by fluid, you know, spread around the house. And that may be actually what's going on with your cat. Now, they may be grooming because of abdominal discomfort, which then comes back to the pathology in the gut. But bear in mind, with cats, that is something that's going on. So every time Nick talks about a pathology in dogs, I'll try and reflect that in cats and say some other things that may be going on there.

Cool. Can I give you some, um, some symptoms? I've just found a really nice article, uh, in Dogs Naturally. If you don't know about Dogs Naturally magazine, then crack on to those guys. They've got lot of good stuff. And this article is called Acid Reflux in Dogs: These DIY Solutions Work, which is quite an optimistic title, but there you go. And they've got a list initially. They've got lots on the thing, but I'll just give you the list. So if any of these sound familiar, you might want to start looking into GERD, gastroesophageal Oesophagus starts with an O in this country. Anyway, GERD, gastroesophageal reflux disease. Okay, so acid reflux symptoms: air licking, jaw snapping, drooling, licking his own fur or fabric on his bed or couch, trying to eat specks of dust, leaves, or anything he could find, like trying to soothe the burning throat, gulping or loud swallowing, dry retching, harsh coughing, gagging, vomiting with food or clear fluid, stomach or throat gurgling, that's quite common. And you might also see bad breath, wheezing, loss of appetite, weight loss, signs of pain like whining while eating, low activity after meals, fever in severe cases. And when you've had it for a long time, you can see losing hair and getting really brittle nails as well. So it's quite a broad spectrum. But basically reflecting poor mineral absorption.

Yeah, Nick, we were talking just before we came on because we both read quite a lot of the same stuff here. You know, just give the guys an understanding because most people think, good, that's hyperacidity. What's, what's the sort of out there in the books that we've been reading?

They do. We all jump in as vets. I think we definitely jump, oh, this is hyperacidity. Here's your MAP result. Off we go.

Hormonal-related issue.

Yeah, that's right, because your stomach produces acid in order to protect the rest of the gut from bugs, but also to dissolve proteins and fats and what have you. So in this lovely bag, mushy bag of that, that we call the stomach. But you can also get low acid, and low acid is not uncommon at all. And Low acid. Okay, so let's just talk about pH for 2 seconds. pH is divided into— so in the middle, which is neutral, neither acid nor alkaline, is pH 7, right in the middle. Okay. It's a 14-point scale. So the middle is— if you get a really low acid is pH 1, that's acid, acid, acid, acid. Okay. But some people talk about having low acidity in the stomach. They don't mean it's very, very acid. They might do, but I don't think they do. They mean that there's not enough acid being produced in the stomach. And when you don't produce enough acid, it's called achlorhydria, okay, which is a wonderful name, but it just means your stomach, which is meant to produce, you know, a liter a day of acid, is only producing half a liter a day. Therefore, you're not digesting your food properly. Therefore, the rest of the digestive process is not going to work properly because of that lack of, lack of acidic digestion. Is that— does that kind of paint a picture initially?

Yeah, I was like, for my— listen, I'm not as the non-vet of the group. So it's true that the, you know, when people hear of this acid reflux, the tendency is to think, well, acid is in the stomach and therefore the issue is in the stomach. And so they give antacids to to kill off this horrible burning acid that helps, and they bloody work instantly. So, but they come with a big problem. So that's— I'm getting from the tone, I mean, I know that I suspect that we have now moved on and realized that, you know, this GERD is actually more related to IBS than it is to stomach issues. Would that be correct? Like, some of the stats in humans, GERD and IBS— so GERD is your reflux— is 63% of IBS sufferers have GERD. You're 4 times more likely to have GERD when you've got IBS than not. So am I correct in thinking it's more an intestinal kind of inflammation in the intestines that's causing this issue, or is it a stomach-related issue?

Just tell us about IBS and differentiate it from IBD, Conor.

Oh, so I'm using the word IBS. I probably mean IBD.

Yeah. Okay.

Yeah.

IBS is— IBS can be tied in as well because IBS is often— there's a psychological element to IBS. That's what I'm talking about. Irritable Bowel Syndrome, which is where you've got problems with your gut, but when the doctors look, they can't find anything. Okay, i.e., it's a lot of psychological stuff. There could be other subtle stuff going on, but there's no pathology in your gut. IBD, Irritable Bowel Disease, is where you've got ulcers or you've got erosions or you've got bleeding or you've got inflammation. There's something to see.

Okay, yeah.

So with either of those, if some of the gut— yeah, so the, the, this gut is a little bit like a comet with a tail. The comet, the round bit is the stomach, and then you've got this tail going through your abdomen. That's a nice metaphor.

How about—

would you like that, guys?

That's nice. Yeah, I might use that. It's okay, it's not my favorite. Anyway, when you deal with dogs with, with, like, with, um, you know, um, IBD type issues, okay, or this, you know, this diagnosis, terrible bad gut, okay, clearly you're just a dysbiotic gut and it's been going on too long. It's been on dry food, repeat antibiotics and steroids, which just annihilated further. And, you know, the dog is then getting this kind of— I was going to say vomiting, uh, at about 4 or 5 in the morning. Like, you know, it's almost water. So the client is getting up half an hour beforehand to feed the dog to stop this happening. And now her life is getting up at like half 3 in the morning to prevent this sick— and it's pure water. She says, what dog pukes up pure water? But you just mentioned that as one of the symptoms, Nick. Beforehand. But it's the same solution when you fix that gut issue and get the gut to calm down, you know, with all these same approaches that we recommend, a very simple real food diet, exclusion diet, what's bothering your gut, broth initially if it's really bad, and a bit of probiotics, bit of chamomile, chamomile, chamomile all the time. And then this vomiting just disappears, this, or regurgitation, which word am I supposed to be using for this?

Vomiting.

Yeah, okay, so what's that 4 in the morning, this vomiting at 4 or 5 in the morning, 6 in the morning, is that connected to IBS girl type issue?

Let's try jumping on this. I see a lot of, it's called, if your dog vomits frequently, and this is kind of 3 times a week or even every single morning, that is commonly called bilious vomiting syndrome. Bilious vomiting syndrome. They'll bring up froth first thing in the morning, just, you know, either they're lying in the bed and they go, or they'll get up and as soon as they get up, and often it's yellowy. So that's the bilious, and it's really, really common and it's often not recognized. I'm not sure whether they stop teaching it at vet schools, but it's often not recognized. And if you're lucky, the treatment is you feed them last thing before you, before you go to bed. You feed them a substantial meal before they go to bed, which means that the stomach's got something to do all night, which means it doesn't start kind of overworking first thing in the morning and you get this bilious vomiting. So if the dog is vomiting first thing in the morning and otherwise they're absolutely fine, try that, that little trick, feeding at night. So that would be vomiting.

Yeah, and I would also come in though, I think that there is an element of that which is down to what we feed. How we feed. So, you know, we used to see— you see that with a lot of kibble-fed dogs especially, who are standardly fed at every moment on a, you know, almost by the watch and the clock. And therefore they're almost in a cycle of they expect it. You know, there's some great stuff, some papers out there that don't necessarily mean to impart this information because they're trying to promote various medications, etc. But actually the resting pH of dogs and cats actually isn't that far off humans. When they do the studies, you know, it should be around about 4 on a pH scale, so relatively low acidity in the grand scheme of things. It's only when you feed them appropriately that their stomach acid drops even down to 0.5. They quote 0.5, that's like super strong acid, okay, on a pH scale. So it is really interesting to see that actually the acidity is not generally the cause of that. Now, if they go into an acidity cycle inappropriately, I can understand that the consequences of being sick may well cause more problems with that sensation of burning and all of the rest of it that comes with that. But I think the actual underlying inflammatory condition or whatever's going on in the gut or the pathophysiology. As you know, Nick was saying about the mental input on these, and I've seen a lot of behavioral dogs that actually go through this process of bilious vomiting almost as a, you know, they're stirring, they're almost hyperreactive at that in those early hours for various reasons, and that leads to, because there's nothing else to do it leads to the gut hyperactivity and what then comes back.

That's interesting what Nick was saying there about the difference between IBS and IBD, where IBS is you haven't quite pinned down what's going on and there's a big stressor later. So that's exactly what this article is about. IBS is— you're 4 times more likely to have GERD with IBS, but they put equal emphasis on simple diets, elimination diet, possible food results, and the other 50% is stress. And to give people an example of why stress wrecks your gut so much, when you're walking down the street and you're just having a good time and then somebody jumps out at you and goes, Brady, and gives you a shock, you clutch your gut, don't you? You don't do anything else. You're like, oh, and you clutch your gut. Very few people actually get ready. But that stress response of cortisol just lashes into the system and switches on everything. And a lot of those chemicals are based around squishing your gut and getting all the blood away from your gut because your gut takes up all this huge amount of power, squishes the blood to pump it into your heart hands and feet ready for— and your face, that's why you flush— ready for fight and flight. Okay, so that's the stress response in a major way. But when you have small amounts of stress all the time, every time you go for a walk, you react really badly to black dogs, Dudley's case, or, you know, you just bark at every dog, you're stressed or whatever, whatever the major stressor is. Someone asked, is stress related? Absolutely. And in dogs. So stress at a low level all the time leaves you in a perpetual state of It's like the ad for Buscopan where the woman's stomach is twisted up like a knot and that causes a dysbiosis all the time. It causes malnutrition through malabsorption and you start to get these gut issues. And the behavioral kick-on from that is that instead of getting good bacteria that give you all the good byproducts, butyrate and GABA and the stuff that keeps you calm, you get the shitty toxic byproducts and none of the good stuff. So you get this snowballing negative behavior. It's hard to know, like, is it the chicken or the egg? Like, when you say behavior and GERD, is it IBS and GERD, or IBS and behavior and GERD? Because they're all so intricately linked, you know. So it's interesting with the vomiting side on that, but on that I know very little more. But yeah, so in human circles it's 50/50 diet for IBS, diet or stress. Isn't that mad?

Brilliant. Brendan, just tell us about why brachycephalics are overrepresented in the GERD diagnosis?

So there's a number of anatomical issues. Now we all talk about the BOAS surgery because of the airways and the upper airways and what's going on there, but actually we also find that through what's happening with their airways being slightly obstructed when they're breathing, not just the long soft palates but the nares and things like that, then you also have an increased negative pressure in the chest as they're breathing. For these very young animals, the diaphragm, which rests between the chest and the abdomen, there's a tissue layer that separates the lungs from the abdominal organs. Now, as the oesophagus, the food pipe, comes through the chest and lands into the stomach, that's where the oesophageal sphincter comes through, the cardiac sphincter we call that, of the stomach. That can sometimes actually herniate because of that negative pressure back into the chest. We call that a hiatal hernia, and that actually popping back into the chest means that the valve stops working properly on the wrong side, and you actually get reflux. So almost siphoning back of the stomach material into the esophagus, that can cause increased scarring around that that valve, you then start to get strictures that can then develop effectively a difficulty passing the normal food material down into the stomach. So you end up with an oesophagus that can start to dilate, and with these dilated oesophagus, you start to get food material building up in that area, and this is where you'll get more commonly regurgitation. Add that on top of difficulty breathing, then if they do bring that food back up or have a reflux of material back up, they are more likely to actually inhale that and suffer from aspirational pneumonias.

Bloody hell.

If you have frequent problems with a short-nosed dog that's having breathing difficulty and you've got frequent issues with regurgitation, or vomiting, then please do get them checked out on a regular basis to have their chest listened to, because many, many of these will suffer low-grade aspirational pneumonias, which can massively impact their health on top of all of their other issues.

So what are the vets— coming back to the antacid bit— what are the vets that focus on when they see this acid reflux or acidity issue coming up? What is the problem with using antacids to control that?

It's a sticking plaster firstly, okay, you know, you're not dealing with the primary disease, you are effectively trying to throw something in to affect a reduction in the acid damage that may be going on. Now there's lots of stuff, I love the name GUE, so gastro duodenal ulcerative erosion disease, which effectively comes as do. So they often will say, well, you know, let's start chucking in antacids. Now, there is on the latest research which was done in 2018 by the American College of Internal Veterinary Medicine, I think it is, they talk about actually there is very little effect of a lot of the standard antacids that are used, including, you know, things like calcium carbonate that they used to throw in to try and neutralize the acid. They used to stick in, you know, just bicarbonates and all of those sort of things. They're very unlikely to work to try and reduce the acidity within the stomach. On top of that, things like ranitidine and cimetidine, they've also found very limited use to increase healing times for these, these products. And in fact, actually, there was a big scare about Zantac, which is ranitidine, and actually the issues with growth that that could cause on the human side. There's big lawsuits underway about that as a way of treatment. I think the only thing that they did find that worked in the UK was the Gaviscon Plus, whatever that was called, where it actually creates— because it's got alginate within the product, so it actually creates a frothy cushion to stop the acid being able to rise to the cardiac sphincter, but it's not a great product in its own right. They use quite a lot of aluminium in a lot of antacids as well, like really scary. But that's an aside, so let's go away from that for a moment. So really what's left is this proton pump inhibitors, the omeprazoles that are out there. Now, two papers back in 2012 and 2014, I think it was, BSABA and the American Veterinary Association, I think it was, was they talked about the very limited effects. Now, this is to do with treating H. pylori, where we would give an antibiotic and an antacid to try and rid the body of these particularly nasty bacteria that can cause stomach tumors in people and was proposed as a cause of chronic vomiting in dogs, chronic inflammation of the stomach. But they actually found in dogs and cats very limited effect in treatment if you added in any antacids, including omeprazoles at that time. Now, this latest bit of research, 2018, talks about is there a relative benefit of using omeprazole, and I think the jury is still out because I've still got to go through all of the individual references within that because it depends on what you're feeding. And I think actually you've got to address the underlying disease earlier, you know, the level of inflammation that can be caused for many of these dogs which are actually still on kibble. I know you guys out there aren't using kibble that often, but there are some people out there you know, still using that and dealing with that underlying disease going on first and foremost is so important.

Where's the sense, where's the sense, Nick, in an anti-sick injection to stop the dog getting sick regularly? Where is the sense in that?

I think if the dog is vomiting so much that they're dehydrating and they're losing a lot of acid through the vomiting, then just as a plaster, yes. But if you've got to give that for any length of time, you're probably missing the point. There's probably other things, other stress issues or other drugs issues or wrong diet. I have to just really, really emphasize at this stage, the way to first of all look at these guys is to do some food trials with raw food, Talk to your food supplier, raw food supplier, and say, right, let's get some single protein trials to see if it's just a dietary issue. It's the middle of the digestive tract. You know, it's, it's very likely to be due to some intolerance to a protein. But also by going on to a raw food diet, you drop the carb load because kibbles are 30 to 60% carbohydrate. Which reduces your insulin resistance. And insulin resistance has also been contributed— has been— can make problems with the nerves, with neuropathies, which can then affect the stomach and the vagus and the motility of the gut. And so I think, you know, take-home message would be really, this is an opportunity to think very strongly about going for a raw food diet to lose weight. Obesity is another cofactor which will predispose to GERD in humans and therefore in dogs. And so I think raw, it has to be the first stage.

It was interesting, the diet advice here for humans, for coming back to the IBS and GERD papers, they were saying, look, it's either diet or stress with IBS, where they couldn't quite pinpoint, as you're explaining to us, the cause of the irritable bowel. But they said for the diet, they recommend low FODMAP. And to be honest, I had to look up FODMAP. And FODMAP stands for something we don't really care about— fermentable oligo, di, monosaccharides, polyols. In other words, a low carbohydrate diet. So for humans, omnivores, plant eaters to a large degree, you know, we are recommended to get off the carbs and particularly ultra-processed carbs mentioned in the paper. And here we are feeding these kibbles where, like, how could that be a good idea? So clearly the idea is getting off raw or cooked, if cooked works, because sometimes cooked can work. Even a broth, whatever works. And some dogs get so badly along the way that just a nice little broth does the job. But something simple, if you're already raw feeding, change your proteins, but also change your supplier. Don't just be tied to one, but you know, you never know what's going on. And make it really, really simple. The two additions that I love for shocked guts is going to be canine probiotics, whatever flicks your switch in that regard, and German chamomile, guys. The science is done on German chamomile. It just has so— it's like 2% of it is volatile oils, which is almost unheard of for a herb. It's got hundreds of studies behind it, but on guts, it's very, very strong. They're not quite sure why it helps with acid reflux, but with IBD, IBS, I'm not quite sure the difference. I'm going to have to really check myself when I use those 3 letters again, but it's very, very strong, very, very effective. It's an antispasmodic. Antispasmodic of the gut. And they think that with GERD and IBS in that paper was that it was something to do with the motility of the gut. The gut is so inflamed, it's just not moving the food along, and that's what's causing the issue more than anything else. Chamomile is an antispasmodic of the gut and an anti-inflammatory of the gut, gets it to calm down. So of all other things, that's why I'm self-plugging here, my product BioFunctionate, very, very popular for guts, guys. That's 35% German chamomile, and I do believe it's one of the active ingredients There's other things you can add in. The ingredients on German chamomile, half of them you have in your cupboard. So, you know, there's different reasons we use them. There's an article on my site to explain that, but just start with German chamomile to cool off that IBS issue with the change of proteins, as Nick was saying, is definitely the first place to go with this SIC, because the SIC seems to evaporate then. It doesn't seem to be an issue once you deal with that end of things, as you've been saying.

Yeah. The other thing, if we're talking about herbs, there's a few herbs that you need to think about. The obvious one is tree bark powders, slippery elm powders. The other is marshmallow root, which can be more sustainable. Also think about fennel seed. You can also make a tea out of fennel seed. You can make a tea out of chamomile as well.

What's so cool about the fennel seed, Nick?

Fennel seed, it's a carminative So it's again very high in oils, calms the gut, helps with digestion. You know, if you go to the Indian restaurant, they'll give you an aniseed ball. So fennel seed is aniseed essentially. So it helps you to digest your food, helps it to go down the right way, helps motility, anti-inflammatory, and what have you. Chamomile, the Latin is Matricaria recutita, and it's known as the the mother of the gut. So it really is a wonderful herb to start with when you're talking about gut. You got any other tricks that you use with girdy dogs?

Or yeah, I mean, look, you know, for some of the guys out there, you know, talking about remedies as well, uh, Nux vomica is out there, you know, 30C Nux vom. If you've got a dog that's, you know, really being sicky, rather than necessarily giving an anti-sickness drug that may interfere interfere with, you know, if there's anything else going on more serious, at least you've got something to reach for that, you know, shouldn't cause any major issues.

Can you buy that over the counter, Ben?

Yeah, you can. That's as a 30C, actually quite a lot of herbal shops, there are some pharmacies will still sell them, so you can get them as a 30C. Any stronger than that, you'll have to see a qualified professional. The other things to differentiate, if you've got a dog that's actually ingesting food or having a drink, and then as soon as it warms, they then bring it back, then phosphorus as a remedy, okay, at 30C can be really useful in those cases, especially if there's any blood involved in that process of coming back. But generally, they will be dogs which are hyperactive and then may get really, be really flat when they're feeling off color. But if you see them take a drink, it almost just warms enough, and then they want to vomit that back up. Think phosphorus. And then there's a couple of remedies we need to talk about with regards to the regurgitation and megaesophagus, which I think we should move on, guys, to talk about, just so that those guys out there know more about that. So, Nick, do you want to go for it?

Go for it. I've got a story. I've got a regurgitation because we've got 3 minutes to go, so we might have to bring megaesophagus into another thing. This is, this is good stuff though.

I think we should do megasophagus another night, guys, because we are right at the end and we're gonna rush through it. There's a good— there's almost at least a night in that because there's some good dirt there to be talked about, and I'd love to get into it. Should we save megasophagus for another Throat Night?

Okay, let's do it.

Can I ask you two questions that guys have brought up here? Here's one from—

hang on, let me just tell my story. It's a very, very nice story. So I used to do a lot of work in London, and I was once called out to this big posh house in Kensington, walked in, size of Buckingham Palace, but that's beside the point. They had a cat who was vomiting pretty much every day. Okay, vomit, vomit, vomit. And so we gave it some Nux vomica, you know, bits and pieces, changed the diet and what have you. 80% improved. So it was only vomiting once a week, twice a week, something like that. It's great success. The lady was very, very happy. She rang me 3 years later. With, uh, what— because one of the problems with another cat. And I said, oh, how did the original cat do? And she said, oh, it all cleared up. And I said, how did you do that? She said, oh, I got divorced.

No way, no way.

So stress, there you go.

It is infectious. They pick it up.

Yeah, they didn't like— or maybe they, they the woman was unhappy, or maybe the— I think it was the cat hated the husband. That's what it was.

Yeah, interesting. Here, could I ask you Karen's question here before she goes? Karen has a dog with kind of a throat issue, laryngeal paralysis of some fashion. She says, I'd love to know more about how the vagus nerve can affect the issues related to reflux in dogs with laryngeal paralysis. There has to be a link considering the vagus nerve can cause LP issues as it runs all the way into the gut. Know any more about that?

So there's a couple of things there with regards to where the vagus runs and the recurrent laryngeal nerves and where they come out of the spine as well. So you've got a couple of issues if you've got any lesions in the lower cervical, so the lower neck and upper thoracic region. There is some feedback which can cause problems both with the nerve that comes out and feeds back to the larynx, but also which will affect the vagus and the stimulation of the parasympathetic system, which is why they can also get tachycardias and those sort of things. So think about, have they had an injury that may have been an avulsion, a sudden limb injury, a knock, something that's maybe even if they've run straight into a tree, that's a spaniel trick, okay, or that they've done a somersault, that's a whippet trick.

Put a lead in the collar.

Yep, those sort of things as well. All of that can cause wrenches to the neck and can cause some damage there. So yeah, a couple of certainly things with regards to that. Nick's talked about some of the issues that you get with the effect on the neuropathies when, you know, you've got various levels of insulin production. I would say something that I've been looking at with all of these nutrition stuff is actually also being aware of the relative proportion of fats to proteins, because excess protein will actually still go through a pathway to be converted into glucose and stimulate an insulin response So it's actually— and also the level of satiety you get if you increase the fat levels within foods. So if you've got a dog that you can get to tolerate a higher fat proportion, often the satiety that they feel will probably suppress those hunger pangs in the middle of the night. Whereas if your protein level isn't necessarily too high, then there may be a stimulatory effect on the level of glucose that they produced.

I wonder, has anything been done on that? Is there anybody that has looked into that? Surely there is.

Well, there's some information in, I think Jason Fung and Ben Bikman do talk a little bit about the understanding of the protein pathways within that, as the glycemic index and load is actually higher for higher protein foods.

Yeah, I think it's a well-worn path, actually, that whole business about if If you feed pure protein, yeah, like so completely fat-free steak, you will not go into ketosis. So that's really well known. So you put some fat in so they have the energy from the fat so they don't go into gluconeogenesis from the protein. Definitely. There's loads, guys, there's loads and loads of questions. I'm really frustrated. What I would suggest, guys, if you, if you can, guys who are watching, come and join us in Patreon. Okay. And then you can ask questions, and then we have time to actually go through these questions because it kills me that there are so many great questions being asked that we're just not going to have time. We have 500 posts there, and we just don't have time to be able to go through all of those, whereas we do have more time because there are fewer people. We can just go through the questions that are posted, so please do consider that.

Lynn Hobbs makes a great point here, you know, hunger pukes. A lot of people talk about hunger pukes. It's such a common term, and I always wonder about it. I do suspect that there's a certain amount of digestive conditioning that goes on in dogs. You know, the gurgling and squirting before dinner time, the acids and that stuff being released into a stomach, and you can hear it gurgling and squirting in there, certainly with Duggee, and he's anticipating the meal. Like, he knows it's coming up to dinner time. And so I reckon that, yeah, perhaps if that was going to— I think a healthy dog shouldn't just get a hunger puke. I wouldn't have thought that that was a normal thing. I would have thought that's something to address. And Jane's answer to her own question was ditch routine feeding. I think that's a really good idea. I am now well along the line of, I mean, I don't practice a lot about what I preach sometimes. I just, you know, we're all a bit guilty of it, but I have definitely got into haphazard feeding with Dudley because he got so insistent at dinner time. He was giving me nose butts and everything. I was like, hang on, Dudley, your dinner's coming. So now I have just moved, I've moved him to one a day. He's at lunchtime at different times. But if you're stuck to the 2 meals a day, start to vary the meal times because if it is some digestive conditioning and that creates some sort of response in the dog, which shouldn't be normal in a healthy dog, but still, well then start varying up your meal times. It's fabulously healthy for them and they don't know when their meal is coming and it relaxes them a bit more. So they don't— it's set triggers for dogs when they start doing this nutty behavior. This to this, it's now 10 to 8, now I see her going to the fridge, now she's here. So what, you know, boom, boom, boom, and they have this response. So throwing them out is a good idea with haphazard feeding. So I really like that idea. Patricia Gethin has convinced me to move to one meal a day in and around 12 to 2, and within 4 or 5 days, Dobby's behavior in the morning time is great, and the evening time particularly, it's great. He's not expecting that food. So, you know, he expects it at lunchtime, but like, you know, it's not so bad.

So, um, but yeah, food, you know, you can give them love, okay? Yeah, still love you to bits. It's just like this one. Even if you don't feed them for 24 hours, or if you give them irregular foods, you love it, don't you? So, I mean, she doesn't get a regular feed, you know. She might get food late at night. She hasn't been fed today yet. She might get food in the morning. Yeah, definitely makes a difference.

Yeah, she doesn't hold it against you, you know. It's just a— it's just that's the pattern in the house as opposed to the other one, you know. So Yeah, it's a— I like that. I like that haphazard feeling.

And it frees you up as well. You don't— you're not obliged at 5 o'clock to get back home to feed the dog, so it definitely frees you up. Yeah.

So can we do a night on megasophagus, guys? Because, uh, it's such an interesting one. People don't really know much about it. We see this little video and it's cute of a dog sitting up and eating his food, but actually behind that is one poxy disease, uh, and I'm sure there's a lot of people that have been afflicted by it. It'd be nice to do a night on that.

Should we do it next?

Yeah.

Next week.

Yeah, you have to do it next week, guys, while we're on a run. Cool. Yeah, and also good news, we just got a guy on board to help us, uh, strip out the audio from our old, uh, Facebook, uh, videos, guys. Another use of our Patreon money, the other bit. And, uh, we are going to take out the audio, chop it down, and make it into a nice, more concise kind of a podcast offering. So Tuesday nights is busy for lives, we realize So now we'll strip out the audio, we'll put that up on Patreon as well. So now when you're walking down the road, you can hear our voices in your ear. So that would be fantastic too.

Have you got your best deep voice?

Don't do that again.

Terrible.

You'll get reports of heavy breathing.

So all right, lads, I think we better wrap it up. 10 to 8. Yeah, that was great. Thanks everybody for coming. Love that. I just love Tuesday nights. Um, and, uh, we will see you next week then for Mega Oesophagus. And thanks again to No Bull for their support. Cracking group. Check them out, guys. Carla is the boss. She, uh, she's just fantastic. Carla, thanks very much for the support tonight, Carla. Appreciate it. Uh, No Bull, brilliant group. Check them out. Um, so yeah, guys, we will see you next week.

Next week.

Cheers. Thank you everybody.

Bye-bye.