Episode 5: Recognizing Nutritional Deficiency: 2 clinical examples - a podcast by Dr. Robert Gaston, DVM - OneVetMed Podcast Host and Veterinarian

Episode 5: Recognizing Nutritional Deficiency: 2 clinical examples


Presenting two examples of nutritional deficiencyNot classical nutritional/vitamin/mineral deficiency syndrome
Lack of classic signs = “subclinical” deficiencyVeterinarians need to increase their level of suspicion that illness may be related to nutritional problems
AspenPresented 4/02: 13 year old spayed female Labrador retriever-shepherd mix
The owner – my brother - noticed weakness and exercise intoleranceRapid progression over two-three weeks
Syncope/collapse episodes with mild exertionBecame unable to walk more than a few steps without resting








DietScience Diet®




Chemistry Profile, complete blood count and Thyroid hormone level all  normalChest x-rays were normal
5/9/02 Evaluation of ECG via Telemedicine consultation with cardiologistHR 50 BPM
Diagnosed as complete heart blockPossible degeneration, fibrosis, or inflammation of AV node
Recommendation: Echocardiogram and possible pacemaker implantTelephone consultation (Oregon - Ohio)

Recommended treatmentNutritional support for cardiac function, electrical conductance, muscle function, general nutrition
Cataplex® B (Standard Process)L-carnitine (Pure Encapsulations)
Vasculin® (Standard Process)Cardio-Plus® (Standard Process)
Catalyn® (Standard Process)Calcifood® wafers (Standard Process)






Improvement noticed within several days after starting supplementationContinued progress over initial 4 weeks of supplement use
Returned to normal activity level within 4 weeks8/6/02 Echocardiogram

Anatomically normal heartNormal contractility
Severe bradycardia (32 beats per minute)  with continued complete heart block2/25/03 progress exam

Clinically normal 14 yr old dogRepeat ECG:  unchanged from 5/02
Aspen running up and down long hill in yard with childrenContinued supplements as initially prescribed
Continued Science Diet9/20/05 progress exam

Nearly 17 yrs oldStiff and slow moving, nearly blind, hearing loss, developing urinary incontinence
Continued bradycardia due to electrical abnormalityNo syncope
Had more stamina than 4/02 prior to supplementation12/05 euthanized due to deteriorating physical condition, incontinence, arthritis, etc. – no syncope, no heart failure


GypsyPresented 8-8-05  - 4 year old spayed female golden retriever mix
Consultation concerning autoimmune disease, open wound on rear end, and generally declining conditionOwner concerned that Gypsy was dying and wanted to incorporate complementary approaches




History:Developed severe bone or joint pain at 9 months old
Lame, crying when touchedDeveloped immune myositis - diagnosed via muscle biopsy November 2002

Presented as acute-onset muscle pain and inability to open mouthMuscle atrophy developed subsequently
Prednisone therapy initiated ( and continued daily since)4-18-03 Giardia with severe diarrhea and vomiting


Several teeth extracted due to loosening/periodontitisSeasonal exacerbations of muscle inflammation and dysfunction x 3 yrs.

Approximately October/November 2002, 2003, 2004Allergic component?




Faithfully vaccinated (yearly)Last vaccine 3-8-05




Flatulence; owner feels that abdomen is hot and distended; other dog eats Gypsy’s stoolMedications:

Prednisone 10 mg once daily (continuous use since Nov 2002),
Thyroxine 0.7 mg twice dailyBlood Chemistries and CBC

AlkP    AST    ALT   GGT   P    Gluc    Amyl    WBC    Neutr8/8/05           1430      72     461      80    4.1   144                  16.9     83%

5/17/05        2738      75     596     430   6.2    44      224       20.6     83%4/23/05        2842      75     612     410   5.5    18      248       20.7     86%

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