Tell Us What You Think

Hyperthyroidism is one of the most common diseases veterinarians see in senior cats, but most cat parents don't know they have real options once a diagnosis comes in. In this episode of Tails of Truth, Dr. Angie Krause and veterinary nurse JoJo walk through the full picture: the symptoms that should prompt a T4 blood test, why the test is so straightforward compared to human thyroid testing, and all four treatment paths available today, methimazole in pill, cream, or melt form, radioactive iodine therapy, a prescription iodine-restricted diet, and surgery. They also cover a conversation most cat parents aren't prepared for: why treating hyperthyroidism often uncovers underlying kidney disease, and why that's expected rather than a red flag. If your cat is losing weight, acting ravenous, or yowling at night, or if you're already managing a hyperthyroid diagnosis, this episode covers the questions to ask your vet next.

Key Takeaways

• Hyperthyroidism is one of the top four most common diseases in senior cats.
• Symptoms include weight loss, increased hunger, vomiting, night yowling, hyperactivity, and a greasy coat and it can mimic kidney disease, IBD, or diabetes.
• Diagnosis is a single blood test (total T4), but not every senior wellness panel includes it automatically — ask your vet to add it if your cat is over 8.
• There are four treatment paths: methimazole (pill, transdermal cream, or compounded melt), radioactive iodine therapy, a prescription iodine-restricted diet, and surgery (rarely performed anymore).
• Radioactive iodine has roughly a 90% cure rate but requires a week-long hospital stay and two weeks of limited contact at home, and typically costs $2,000–$3,000.
• Treating hyperthyroidism often reveals underlying kidney disease that was masked. This is expected, not a sign something went wrong.
• Cats on methimazole need bloodwork rechecked every 4–6 weeks initially, then every 6 months, to confirm correct dosing and monitor liver and kidney values.
• Dr. Angie doesn't always treat mild, asymptomatic elevations in T4. She monitors instead, due to past cases of methimazole causing negative side effects in cats that didn't need it yet.

Soundbites

"This is one place where Western medicine actually is pretty effective." — Dr. Angie

"Pilling your cat every day... it's a relationship breaker for some people." — JoJo

"I could talk about hyperthyroidism in cats all day long, and in fact I do." — Dr. Angie

"Your vet is gonna want to recheck blood work in four to six weeks. This is not a money grab." — JoJo

"You're going to get so much more radiation from that airplane than from a cat." — Dr. Angie

"It sounds terrifying. And if you're holistic in nature, make this make sense." — JoJo

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Tell Us What You Think

When a senior dog has a single seizure, most pet parents end up in the emergency room the same night, and many walk out with a prescription for anti-convulsants before anyone's confirmed what caused it. In this episode, Dr. Angie Krause and JoJo unpack why that reflexive approach concerns Dr. Angie after treating six or seven senior dogs with new-onset seizures in just the last few weeks. They walk through what actually qualifies a dog as "senior" for seizure purposes, what a seizure looks like versus fainting or a vasovagal episode, and why post-ictal confusion is the tell. Dr. Angie explains what ER bloodwork can and can't reveal, why a brain tumor becomes the leading concern in older dogs, and why some dogs who seize once never seize again. They also get into the specifics: phenobarbital versus Keppra and why the wrong anti-convulsant sometimes gets prescribed, the real risks of starting steroids preemptively, when cluster seizures change the treatment decision entirely, and where CBD and Chinese herbs fit into long-term management. The episode closes with practical guidance for what to do, and what not to do, if a senior dog seizes at home.

Key Takeaways

• One seizure in a senior dog doesn't automatically mean medication.
• "Senior" for this purpose is roughly 9+, or 7+ in giant breeds.
• Post-ictal confusion is what helps identify a seizure, not fainting.
• First-seizure bloodwork rarely finds the cause — it mostly rules out things like severe hypothyroidism or electrolyte problems.
• The real concern in seniors is a brain tumor, but many dogs never seize again after one episode.
• Waiting for a second seizure gives useful information about timing and progression without meaningful added risk.
• Anti-convulsants become the right call once seizures recur, especially if they cluster (more than one in 24 hours).
• Steroids and anti-convulsants started reflexively at the ER can bring real side effects and complicate long-term management.
• At home: give space, don't touch the mouth, don't feed right away, protect from falls.
• CBD and Chinese herbs are for ongoing management once there's a pattern, not a treatment for one seizure.

Sound Bites

"After twenty years of practice, when I watch an animal seize, it still alarms something inside me." — Dr. Angie

"It's one of my least favorite things to witness." — JoJo

"Seizures beget seizures." — Dr. Angie

"After one seizure, putting your dog on an anti-convulsant, in my opinion, is incorrect." — Dr. Angie

"Everybody wants to just pull them close and hold them, and your dog's just not in their normal state of being." — JoJo

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Tell Us What You Think

Dr. Angie and JoJo take a detour from clinical topics to explore the space where holistic veterinary medicine meets the metaphysical. From animal communicators and crystals to soul contracts and pet reincarnation, this episode is a candid, funny, and surprisingly moving conversation about everything science hasn't caught up to yet.

Dr. Angie opens up about growing up in a deeply metaphysical family, her parents meeting at an ashram in India, her early experiences with psychic readings after losing her mother, and why she's been quietly wondering how much of that belongs back in her exam room. She practices Chinese veterinary medicine, acknowledges it sits on the woo-woo spectrum, and draws a thoughtful line between staying open to energetic practices and making real medical decisions for suffering animals.

JoJo brings her own perspective as someone who thought she'd be the grounded one in this conversation and slowly realizes she's further along the woo-woo scale than she thought. She shares a jaw-dropping family story about a psychic horse in Florida that helped Illinois police locate two missing children, and reflects on her last words to her soul dog Bodhi before he died.

Together they get into pets mirroring their guardian's health conditions, whether our animals chose us before we incarnated, intuition in clinical practice, animal communicators, homeopathy, muscle testing, and what role listeners actually want their holistic vet to play in all of it.

This episode ends with a question for you: what's your woo-woo, and what do you want from your veterinarian?

Key Takeaways

• Dr. Angie practices Chinese veterinary medicine, which she acknowledges sits on the woo-woo spectrum despite having growing scientific support
• Pets and their guardians frequently share similar health conditions; Dr. Angie attributes this to "the frequency of the house"
• Animal communicators are something Dr. Angie has personally used, though she and JoJo both hold healthy skepticism about how to vet them
• JoJo's family has a documented story of a psychic horse that helped locate missing children, reported in the press
• Both hosts believe in the concept of soul contract animals — pets we feel inexplicably and deeply bonded to
• Dr. Angie draws a clear line: openness to metaphysical practices does not replace medical care when an animal is suffering
• Dr. Angie feels constrained by her veterinary oath and governing body in how openly she can incorporate energetic practices into her clinical work
• Food as energy is framed as one of the most accessible entry points into metaphysical thinking for pet guardians
• Both hosts invite listeners to share their own woo-woo practices and what they want from their veterinarian

Sound Bites

Are we twin flames or are we just triggering the same childhood wound in each other? — Dr. Angie

I came from a very metaphysical family. My parents met at an ashram in India and my family has a guru. — Dr. Angie

I believe the way an animal was treated before its death impacts the way our bodies receive it. — JoJo

My last words to Bodhi when he was dying was 'make sure we meet again'. — JoJo

I can feel what they feel often. Like if my patient comes in with a fever, I feel the fever. — Dr. Angie

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Tell Us What You Think

Dr. Angie Krause and JoJo break down one of the most common and most misread cat health complaints: peeing outside the litter box. Your cat isn't plotting revenge. They're probably miserable.

Whether it's feline idiopathic cystitis (FIC), a stress response you never saw coming, or something more serious hiding underneath, Dr. Angie explains what's actually happening inside your cat's bladder and what feline lower urinary tract disease (FLUTD) really looks like in practice versus what most people assume.

They cover what helps, what doesn't, when to wait it out, and the one situation with male cats that is never a wait-and-see. Pain management, hydration, CBD, Chinese herbs, stress reduction, and yes sometimes Prozac. No judgment here.

Key Takeaways

• Cats peeing outside the box are communicating distress not acting out of spite or revenge
• Feline idiopathic cystitis (FIC) is stress-driven bladder inflammation; it's real discomfort, not a behavioral quirk
• In young cats, it's almost never a UTI and antibiotics are rarely the right treatment
• Most cases resolve on their own, but treatment matters for comfort and preventing recurrence
• Male cats straining to urinate with nothing coming out = same-day emergency, no exceptions
• Stressors can be invisible: a cat outside the window, a moved couch, a new person in the home, a change in litter
• Hydration is central to treatment and prevention — wet food and fountains over dry kibble
• Holistic options Dr. Angie uses: HempRx Feline CBD (2 drops twice daily for a 10 lb cat), San Ren Tang, L-theanine/Composure Pro treats, subcutaneous fluids
• Some cats need Prozac or amitriptyline. That's a legitimate medical decision, not a last resort to be ashamed of
• Some cats are not meant to be indoor-only; chronic peeing indoors can be a sign of that mismatch

Sound Bites

"If your cat, your boy cat, is going to the litter box and straining to pee and nothing's coming out, you are going to the clinic in that very moment. Right then and there, no waiting." ~ Dr. Angie

"Cats are just feelers with big emotions." ~ JoJo

"99.9% of the time, if you have a young cat, it's not a urinary tract infection. It's urinary tract inflammation. So antibiotics aren't going to help." ~ Dr. Angie

"Danger, danger. Red alert, everything on red alert." (on male cat blockage) ~ JoJo

"The solution to pollution is dilution." ~ Dr. Angie

"Some cats do require Prozac or amitriptyline, some kind of chemical way to feel better. And that's okay." ~ Dr. Angie

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Tell Us What You Think

Turns out there's a lot of ick in tick and in flea, worm, and whatever a screwworm fly is doing, which is frankly worse than the name suggests.

Dr. Angie and JoJo recorded this episode six weeks before New World Screwworm was confirmed in dogs in the US, but it seems more timely now than ever. In this episode they cover the parasites they see in practice, where pets pick them up, and why parasite prevention looks completely different depending on where you live. It's equal parts educational and "ew" — JoJo's favorite word in this episode! There is also a story about a microbiology professor's personal tapeworm that arrives without warning and cannot be unseen.

🎓 Dr. Angie's full course — A Holistic Approach to the Creepy Crawlers — goes much deeper on prevention and treatment for every major parasite. Free at boulderholisticvet.com with code TRUTHTAILS

Key Takeaways

1. Location determines your prevention strategy. What works in dry, high-altitude Colorado may be completely inadequate on the coasts or in the South where humidity and bug populations are year-round.
2. New World Screwworm is now confirmed in US dogs. This episode was recorded before it crossed the border. It's caused by a fly larva, not a worm, and it's a serious emerging threat.
3. Heartworm comes from mosquitoes not contact with other dogs. No mosquitoes means no heartworm transmission. Skipping prevention in winter in low-risk areas doesn't make you a bad pet parent.
4. NexGard doesn't repel ticks it kills them after they bite. Your dog can still bring ticks into your home on NexGard. It prevents disease transmission, not tick hitchhiking.
5. Tea tree oil undiluted is toxic to pets, especially cats. Products containing it are typically heavily diluted, but that doesn't mean tea tree oil itself is safe to use at home without care.
6. Fleas lead to tapeworms. If your pet hunts or catches small animals, tapeworm exposure is likely. You'll recognize them as rice-like segments in their stool.
7. Mites come in two types — contagious (sarcoptic mange) and the kind dogs already carry in their skin (demodex).
8. Lice are species-specific and intensely itchy.
9. The Creepy Crawlers course at boulderholisticvet.com covers all of this in depth.
10. Even holistic vets on the coasts are recommending pharmaceuticals for flea and tick prevention where natural options simply can't keep up with year-round bug pressure.
11. Bravecto's one-year injectable — Dr. Angie's position is wait-and-see. Useful in high-tick regions, but she won't use it in Boulder where tick season is short.

Soundbites

Essential oils are always a little risky with cats. I'm not a huge fan of them for cats. — Dr. Angie

I am neurotypical and very type A and I can still forget heartworm prevention. — JoJo

This is the number one reason people visit our website according to our Google Analytics — to find out how to holistically prevent parasites. — JoJo

20 years ago when I first started practicing in the front range, I hardly ever saw any bugs, ever. And now I see more because global warming. — Dr. Angie

This is why we should fund science. Just gonna say that. — Dr. Angie

You're going to know if your pet has tapeworms, most likely. It looks like little rice in their stool. That moves. — JoJo

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Tell Us What You Think

If your dog or cat has ever scratched incessantly and you're left feeling helpless, this one is for you. This week Dr. Angie and JoJo sat down with veterinary dermatologist Dr. Darin Dell of Wheat Ridge Animal Hospital, the specialist Dr. Angie emails almost every week with her toughest itchy cases. Dr. Dell has a gift for taking a frustrating, confusing topic and making it genuinely enjoyable, and he answers the questions pet parents often ask. Is Cytopoint safe? Does Cytopoint cause cancer? Are Apoquel and the newer drugs like Zenrelia and Numelvi something to fear? Do those at-home allergy tests for pets work? And what finally gets to the root of allergies instead of just covering them up? Whether you have an itchy dog, a cat that's itchy, or you are a vet professional filling in the dermatology gaps vet school skipped, you will leave with real hope and a clear path forward.

KEY TAKEAWAYS

• Allergy is inflammation in the skin at its root. Itch is only one sign. It can also show up as hair loss, odor, a swollen foot, anal gland issues, or ear problems.
• Cytopoint is a monoclonal antibody, not a drug metabolized by the liver or kidneys, and Dr. Dell does not worry about it causing cancer. The real risk is that it can mask a symptom while the underlying allergy keeps going.
• Apoquel side effects are uncommon. Zenrelia is a strong option for dogs that have stopped responding to Apoquel, and the newer Numelvi is a more selective JAK inhibitor.
• The FDA removed the Zenrelia vaccine warning after follow-up studies showed dogs reached adequate vaccine titers, and Dr. Dell does not change vaccine or dosing protocols because of it.
• At-home hair and saliva allergy tests are not rooted in science. A dermatologist once submitted samples from stuffed animals and sterile saline and got positive allergy results.
• Skin testing is the gold standard in allergy testing. Blood testing is useful in specific cases and the lab you use matters.
• Immunotherapy treatment addresses the root cause and can slow the atopic march. It works best when started young. A year of testing and immunotherapy runs around two thousand dollars and is often covered if insurance was in place before symptoms began.
• The most allergic dog breeds Dr. Dell sees are English Bulldogs, French Bulldogs, and Bull Terriers. Breeds he rarely sees include English Springers, smooth Collies, and Border Collies.
• Cats are harder to treat because there are fewer options. Atopica is the only label-approved allergy drug for cats, Apoquel is used off label, and immunotherapy works very well, in Dr. Dell's experience even better than in dogs.
• A part two is coming, covering diet, supplementation, and Dr. Dell's approach to cats.

SOUNDBITES

"Allergy at its root is inflammation in the skin." ~Dr. Dell

"I see itchy dogs every day. All year round, I have itchy patients." ~ Dr. Angie

"The test itself is really just to get us to immunotherapy, which is where the magic happens." ~ Dr. Dell

"My dog's no longer itching, therefore problem solved." ~ JoJo

"No matter what we need to rescue your dog from their itchy states." ~ Dr. Angie

"If you want a constant infant, bulldog is your thing." ~ Dr. Dell

"I see those test results every day and I have to just say, I'm so sorry that this isn't helpful." ~ Dr. Angie

"If you think about the return on investment over a lifetime, if you broke that down over the next 10 years, that's actually not that much money." ~ JoJo

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Tell Us What You Think

Some of the best Tails of Truth conversations happen before anything is planned, so this Friday Dr. Angie and JoJo just pressed record during their weekly check-in. Dr. Angie walks through a vaccine reaction she handled this week, the kind that looks fine in the room and then swells up an hour later, and the honest call she had to make about splitting vaccines. They get into whether dogs can be neurodivergent (there is real science behind it now), why a cat pulling its hair out might be a skin issue rather than stress, a bladder stone Dr. Angie had never seen in practice, and JoJo's brush with puppy fever over a foster dog that pulled at her heart strings. They also discuss what it's like to run a small business. It is warm, a little funny, and very real.

Dr. Angie and JoJo invite you into their personal and professional worlds in a way that makes veterinary medicine feel accessible.

Next week brings veterinary dermatologist Dr. Darin Dell and it's a guaranteed top 10 episode. Be sure to subscribe so you don't miss any of the great content coming your way.

KEY TAKEAWAYS

• Vaccine reactions in dogs are uncommon, and reporting them matters so we can build real data on breed risk and informed consent.
• A reaction can show up fast (vomiting, then facial swelling within the hour) and is treatable with anti-nausea meds, Benadryl, and steroids.
• When a dog has reacted before and you do not know which vaccine caused it, splitting future vaccines is the safer path.
• New research out of the UK suggests dogs can carry genetic and behavioral traits that look like human neurodivergence. It is not a diagnosis, but the science is catching up to what many pet parents already sense.
• Cats who pull their hair out may be dealing with a skin problem rather than stress. Dermatology is moving up the list of suspects.
• Even an experienced veterinarian feels behind, because medicine changes constantly. That honesty is what good care actually looks like.

SOUNDBITES

"I think it's really important so that we can give people informed consent about how often we see vaccine reactions, which it's really truly not very often." ~ Dr. Angie

"I mean, I think we're just starting to name it in women. So we're not going to name it in cats and dogs for a while." ~ JoJo

"I want every patient that I see to be getting like the latest and the greatest." ~ Dr. Angie

"The thought on that, at least for cats right now, is that we're shifting, that it's rarely a behavioral problem, and it's more of a dermatological problem" ~ Dr. Angie

"I'm amazed at how many clinics are not reporting vaccine reactions. I'm like, make sure your vet reports that." ~ JoJo

"I'm gonna tell the truth about something. I started using CBD twice a day." ~ JoJo

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Tell Us What You Think

Your pet just got a cancer diagnosis. Your first instinct is to wonder what you did wrong.

Dr. Brooke Fowler, veterinary oncologist at Veterinary Cancer Services in Boulder, CO, is here for that conversation. The honest answer is: we don't fully know what causes cancer in pets. Genetics, aging, and biology are doing most of the work and the guilt most pet parents carry is rarely warranted.

In this episode, Dr. Brooke joins Dr. Angie and JoJo for one of the most honest, grounded conversations we've had on this show. We talk about why dogs and cats get cancer, what you can actually control, and how to make treatment decisions without losing yourself in the process.

We get into mast cell tumors, hemangiosarcoma, the real cost of chemo, newer treatment options, quality of life, financial limitations, and the question every pet parent dreads: would I actually do this for my own pet?

Dr. Brooke also shares where integrative and conventional oncology work well together and when turkey tail mushroom and Yunnan Baiyao actually have the studies to back them up.

Note: This episode leans heavily toward dogs and specific dog cancers. We love our cat people and we're bringing Dr. Brooke back for a dedicated feline oncology episode. Stay tuned.

To reach Dr. Brooke Fowler: vetcancerservices.com | 720-414-0116

Key Takeaways

1. Cancer in pets is multifactorial. Genetics, breed, and aging play a far larger role than food, vaccines, or environment though the honest answer is we don't fully know.
2. Immunosenescence — the immune system's declining ability to catch and correct DNA errors as a pet ages — is a primary driver of cancer in older animals.
3. Mast cell tumors are the most common skin tumor in dogs.
4. Stelfonta injection resolves approximately 83% of mast cell tumors with a single injection, though it creates a significant wound during healing.
5. Hemangiosarcoma remains one of the common cancers we treat, but splenectomy often restores quality of life and dogs frequently feel better post-surgery than they did in the weeks before.
6. Chemo does not have to mean misery. Starting at the lower end of dosing ranges and adjusting is Dr. Fowler's approach.
7. Metronomic chemotherapy is low-dose oral chemo combined with anti-inflammatories and is an accessible middle-ground option many people don't know exists.
8. Turkey tail mushroom and Yunnan Baiyao have studies showing inhibition of hemangiosarcoma cell lines. This is where East and West medicine work well together.
9. Your quality of life is part of your pet's care equation. Acknowledging that is not selfish. It's honest.

Soundbites:

"I'm saying this because a lot of people love to blame themselves. What did I not feed him? We live by power lines. And the truth is it's none of that." — Dr. Brooke

"We're all gonna die. And I think it's okay to give our dogs and cats permission to die too. Which is a controversial thing to say." — Dr. Angie

"So often we are buying time for ourselves more than the animal." — JoJo

"You get all of the joy from your pet in their life. You get that joy and then you pay for it in the end, right? Because we lose them before we want to." — Dr. Brooke

"After doing integrative medicine and being hired by people that feed raw or home cook or do all the things I can't say that I see cancer rates in that population be any less." — Dr. Angie

"Your dog has no concept of what the future is or what the past is. Today's the day. That's all there is. And that is what we fundamentally love about them. — Dr. Brooke

"The difference between one kibble and the next is just not as much as you might think. It's really so small." — Dr. Angie

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