Dr. Jessica Dreyfuss (Dr. Jessie) is the owner and chief Medical Director of Healing Paws Center – a stand-alone rehabilitation and acupuncture center in Fort Lauderdale, Florida. Their goal is to take a whole-body approach to your pet’s health. They treat small animals with appropriate, effective, and state-of-the-art therapies to help your pet achieve optimum wellness.
Dr. Jessie graduated with honors from Duke University with a Bachelor of Science and received her veterinary degree with honors from North Carolina State University College of Veterinary Medicine. She pursued a specialty rotating internship at Coral Springs Animal Hospital. Her professional passion for integrative veterinary medicine blends conventional and natural complementary therapies.
Dr. Jessie is a Certified Veterinary Acupuncturist through the Chi Institute, and a Certified Canine Rehabilitation Therapist through the Canine Rehabilitation Institute. She is a teaching instructor at the prestigious Chi Institute at University of Florida Veterinary School. She is an active member of AAVA (American Association of Veterinary Acupuncture), AARV (American Association of Rehabilitation Veterinarians), and AHVMA (American Holistic Veterinary Medical Association).
Assisi: Thank you for taking the time to talk with us about your experience with the Assisi Loop. You reported to a colleague, Dr. Laurie McCauley, about a case that was really exciting for you where you were using the Loop. Let's start with that case and your experience and then we can talk more about other applications and other cases.
Dr. Dreyfuss: Sure. Penny is a really challenging case. She's a ten-year-old female spayed domestic shorthair. She was diagnosed with an exceedingly rare condition called cerebellar abiotrophy, or cerebellar degeneration. Most vets aren't really trained in what this disease is--I wasn't. We were trained, however, on cerebellar hypoplasia. Cerebellar hypoplasia is very similar except that this disease happens from birth. Cerebellar abiotrophy happens later. Penny was a perfectly normal cat, walking around and, suddenly, she developed unusual motor signs. We call it “wiggly and jiggly” because these patients are extremely ataxic and appear to walk like an intoxicated person. It's almost as if they are standing and someone jostled their world, but they didn't stop jostling it. The patient tries to accommodate by jostling back. You can really see this in how Penny tries to get across the floor in her home. Even in the treatment area with sturdy, soft flooring, getting across the floor is exceedingly difficult for her. This change in gait occurred when she was only three to four years old! Her owner took her to a neurologist who told her they could run all advanced imaging studies--MRI, CT scan, and more--but almost guaranteed her, given Penny’s clinical signs, that this was cerebellar abiotrophy. They also tested for infectious disease and ran general bloodwork – every test returned normal. All you're left with is this exceedingly rare condition.
Penny was doing relatively well adapting to this condition until about 6 months ago when the ataxia and the unsteadiness--what looks like severe alcohol intoxication--progressed to where she was falling over, not just unsteady. Her owner came to me in tears and didn't know what to do. She went to her primary vet, and her primary vet didn't know what to do. Mom looked up acupuncture and physical therapy for pets and she found me. I don't do any general practice. I'm a specialty veterinarian like Dr. McCauley. I looked at this cat and said, "I've never seen this disease before. I'm so sorry but we're going to figure it out." I read several papers on this disease and discovered that there really aren’t many options for these pets. I started Penny on veterinary acupuncture and herbal therapy and Penny improved a little bit but not to the extent that I wanted. I thought this could be a stroke or this could be a progression of the disease. Either way, the Assisi Loop would calm inflammation and help this pet. Mom looked at me and said, "Sure. I'll try anything. I do not want to euthanize my baby." I said, "Great. You're going to take this.” I spoke with Dr. McCauley who recommends the Loop three times a day for cognitive disfunction. Following this idea of treating the brain, I recommended a three-times-a-day protocol. Mom called me crying, saying that she made it across the floor . . . and she didn't fall.
Assisi: That was after how long?
DD: The owner applied the Loop treatments three times a day. We found that twice a day treatments showed minimal improvement. Three times a day showed the most improvement Mom had seen.
Assisi: In just five days?
Assisi: And what happened after that?
DD: Mom emailed me in a panic. She left Penny for about a week with a pet sitter and Penny become exceedingly upset about her owner leaving, and quite aggressive. Treatments three times a day were not allowed by Penny. Thus, the treatments HAD to be discontinued by the pet sitter.
Assisi: Unfortunately, we have seen that when a pet owner goes away and leaves a degenerative or chronic condition in the hands of somebody else. They're not often as motivated to maintain the treatment and the interruption, unfortunately, shows how well the treatment was going but they must start over when they get home.
DD: I know. It happens. It's okay. We'll figure it out. We'll get her out of this, but you really must be strict on her protocol.
Assisi: Anything else you want to say about Penny's case?
DD: I would say I was astounded by how quickly it worked and what a dramatic improvement it made for Penny. I can tell you that my whole staff felt the exact same way.
Assisi: You said that when you brought the Loop into Penny's case that you already had the Loop in your practice and that you absolutely loved it. What had been your experience prior to Penny that led you to absolutely love it and how have you been using it in your practice?
DD: For the most part, I have used it for osteoarthritis (OA) cases, and I also use it for my degenerative myelopathy (DM) cases. I find that the animals are more comfortable overall. These kids (pets) who were shifting around at night are moving around because they're not comfortable. I hear, "I can't get in to see you, Dr. Jessie and I can tell he was uncomfortable." I tell them, "Reach for the Loop. You should be using it every single day for your kid. This is a natural FDA cleared, research-based product.” Do you know how hard it is for me to say that in this holistic world where everything is case reports?” Case reports are wonderful, but I was research-based trained in graduate school and love research. I also used it on a really funny case, now that you mention it: Westie Lung Syndrome. The owner said it improved and there's almost nothing for that. It's pretty sad.
Assisi: Tell me more about that case.
DD: The owner was an avid breeder of Westies and very opinionated. I will never forget the case. She came in here and said, "You don't breed Westies. You won't know this syndrome. No one does."
I said, "Okay. You're most likely correct. Tell me more." "It's Westie Lung Syndrome. There's nothing that can be done and every dog with this goes downhill." And I said, "Okay. So, there's no cure but there is management and there are options." I did a bit of research and extrapolated that there is inflammation or fibrosis of the lungs. The Loop can help that. "Let's try it. If you don't want to buy it then come in and we'll do day treatments and go home." I've never seen an owner's attitude change so quickly. She said that the pet was more comfortable, happier, and she was impressed that I could do "anything" for her dog.
Assisi: That's great. Was she using it three times a day as well?
DD: She said she only had time to do once per day. I told her that "more would be great, but I know you have a life and I know that it takes two hours to recharge so you do what you can."
Assisi: Yes. We have seen people who have not been able to follow the recommended protocol and sometimes two times isn't quite enough and, like with Penny three times was better. Clearly, if you can get more treatments--at least at the front end--you're going to see results more quickly. It sounds like she was able to see results quickly with just once per day treatments.
DD: It was awesome. I wish I would have had the opportunity to follow up on the case, but Mom moved and didn't stay in contact.
Assisi: So, you like to use the Loop for OA cases and DM cases. Is the Loop a go-to for you with all these cases?
Assisi: These are degenerative cases and it's probably going to be a lifetime of treatments with maintenance management. How has that been in terms of how the clients are responding to that and how well are they managing the treatment at home?
DD: Honestly, they see the improvements in their pet and it's never an issue. They don't stop doing it for any reason except the one or two that forget that they even purchased it but it's few and far between. I have seen them improve with in-house treatments. Even just one time—"please let's just do it; I need your pet out of pain.” I know we've got one kid who came in today and Dad forgot he bought four Loops. I love this Dad. He's awesome. He has five dogs. He forgets. She's got lung blebs and exceedingly advanced pulmonary fibrosis. This dog should just wear the Loop and never take it off. I told Dad.
Assisi: You mentioned another case that was exciting for you. Would you tell me about that one?
DD: Yes. The patient is named Mayhem. He is the prettiest Harlequin Great Dane I've ever seen. Mayhem has three legs. He had a fibrosarcoma of his left front so he's a tripawd. On top of that, he developed megaesophagus, so anesthesia and surgery was off the table for this kid. If he has surgery, he may not wake up. That's really sad, in general, because this dog is phenomenal and the sweetest thing ever and he's 100 lbs. Are you familiar with megaesophagus?
DD: It's very sad. It's basically an issue with the esophagus where it dilates and develops issues with appropriate motility and instead of the food going one direction, down to the tummy, it can go back up. When it goes back up, sometimes the valve or the trachea which is the airway or windpipe doesn't quite close so you can aspirate very easily. Additionally, Mayhem is such a happy kid that he developed “happy tail” which happens with our very exuberant dogs. We don't know why. When dogs wag their tail too often and too much and potentially hit things--like the wall or your door or your car door and then it starts to bleed. The problem is that it's such a vascular area that it's really hard to get happy tail to go away. Not only did Mayhem get happy tail on top of all these problems, Mayhem's happy tail was so bad that they considered amputation. But amputation means surgery and Mayhem is not a candidate for anesthesia. There's a very high chance that he would aspirate and develop pneumonia given the megaesophagus.
The owners came to me because, on top of that, Mayhem ruptured his cranial cruciate ligament and if we lose one more joint on a 100+ pound three legged Great Dane, there aren't many tools left in my toolbox. The owners said, "We know about the happy tail. We're really freaked out about it. We're freaked out about the cranial cruciate too. We will do anything for this dog. Please help us. What can we do?" And I said, "Well, first off, you should have had an Assisi Loop on his tail yesterday." The Mom is a hospital manager and she said that she can manage the bandage changes daily. I spoke with the surgeon. The surgeon said, "I don't know. It's 50/50 that we may have to amputate. We may not have to but I'm really not loving this." The tail is black. There is dead tissue. I looked at the owners and I said, "Look. I know you spent a lot of money and I know it's going to cost more money, but I would put a Loop on that tail. It was created, in part, for non-healing inflammation wounds. You need to do it two to three times a day." They said, "Okay. We'll try anything." And I said, "On top of that, you're going to treat his cranial cruciate ligament. You're going to treat the affected one and the UN-affected one because statistics show that 50% of dogs will rupture your other one and I can't handle that for your kid." They said, "Okay. This little Loop thingy is going to fix stuff?" And I said, "Yes."
They called me a week later and said, "We can't believe this. It's not as black. We're starting to see pink granulation tissue. This only started when we started the Loop that you told us to get." So, Mom is beyond happy. "I'm telling everyone to get the Loop now."
Assisi: That's great. How is the cruciate?
DD: The cruciate is improving dramatically. The only issue is that Mayhem likes to run and jump. So, we're also making a stifle brace because I don't trust Mayhem. Every time he has a flare-up, I ask what happened. The owners reply "Oh. He saw a bird and wanted to run to it."
Assisi: How old is he?
DD: Mayhem is only five years old.
Assisi: So, he needs a lot of loving care. And, he has good people to provide him with what he needs. What was the protocol you recommended for his tail?
DD: I said, "how many times per day can you do it?" They said, "three to four" and I said, "Four. Go. Keep the Assisi Loop with you."
Assisi: With something that significant, that acute, that was wise.
DD: The Loop saved him—absolutely saved him. In my opinion, it saved his life. Surgery with megaesophagus (esophageal dysmotility) just wouldn't have gone well.
Assisi: You mentioned that you look at conditions and whether there is inflammation to determine when to bring the Loop in. You also mentioned that you'll do just one 15-minute treatment in-clinic to help reduce the pain right then and there. Talk to me a little bit about how you use the Loop for pain management.
DD: I integrate more than anything. I don't prescribe NSAIDs or anything like that in my clinic, but I do absolutely support it, especially for any orthopedic cases and neurological cases. I think you should have them on pain medications as Western medications work faster than Eastern therapies. I love what I do but most of what I do--i.e. Eastern therapies, laser therapies, acupuncture, holistic therapies--it's cumulative treatment and if your pet is in pain right now, we're going to do everything and integrate Western and Eastern therapies. We can't have your pet in pain. So, the Loop has been lovely, especially in one aspect where I can go ahead and have an owner treat from home. They are empowered. They can do it from home. Sometimes I have a kid where it's really hard to get them up and really hard to get them in. I have folks that come to me from over an hour away. So, the Loop helps in the sense that it can reduce inflammation, lower pain levels from home. There are not a lot of things that vets can give owners to do at home to help their pet. Medications? Absolutely, but they have side effects. I don't have to worry about side effects with the Loop.
Assisi: Have there been any cases that stand out from a pain perspective?
DD: It's tough because it's never a great double-blind placebo study with the Loop because I want everything.
Assisi: It's part of a multi-modal treatment protocol.
DD: Exactly. I love multi-modal approaches because I think the pets do better overall. I can say pain-wise that I do see a ton of kids, and I call them kids because they are my kids, for conservative management of cranial cruciate disease. Conservative means that either the owners can't afford surgery, or they don't want surgery, for whatever reason, or the pet is not a candidate like Mayhem. Or the kid has cancer. That's a rock and a hard place. You have a major orthopedic disability and the kid has cancer. What are we going to do? So, I look at them and I say, "Look. I need pain management and I need increased healing. The Loop gives me both of those."
Assisi: It seems like you've been working with the Loop for a while so you have a pretty good case load and personal experience that helps you identify when and where the Loop will work. How long have you been working with the Loop?
DD: Oh my gosh. It's been three years.
Assisi: What else do you think is important for our veterinary community to know about your experience and anything that you haven't said yet that you feel is important to say about the Loop?
DD: Any time you have a pet that needs any help in any type of healing capacity--pain management capacity--or even just inflammation, whether it's an internal medicine case or anything like that, the Loop is there to help. The Loop is an opportunity to empower your client to help their pet and that's a really rare opportunity. You don't get that very often as a vet.
Assisi: Say more about the empowerment piece.
DD: For me, especially as a veterinarian and a pet owner, I always want to find ways to not only help the pet but help the owner. I think that pet owners are truly the parents of pets. We are. We love them. They are family members. You feel good knowing that you're healing your pet if they're in pain or if they're having any type of ailment. And, I can say with 100% certainty that this is helping your pet. I'm not there 24/7 but you are. "Look, I can give you this gift and you can give this gift to your pet to heal them." I don't get to say that ever. I just don't. So that's why I love it.
Assisi: Dr. Jesse, it’s been so good to talk with you.
DD: Thank you for letting me talk about this. It was awesome.
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