As we domesticate the dog increasingly more every day, canine health problems proceed to more closely follow human disorders. Because the natural dog is separated further and farther from their wild environment their health problems increase dramatically. Considered one of the most important contributors to this canine health problem is the constant exposure to harmful toxins. Essentially the most damaging of those are the metals aluminum, lead, mercury, arsenic, and cadmium. They contribute to every little thing form dog teeth cleansing problems and dog bad breath to worsening allergies and skin diseases to serious life threatening illnesses similar to cancer, arthritis, kidney failure, congestive heart disease, liver diseases, diabetes, deteriorate defenses against infections bacterial, viral and fungal diseases.
In our modern-day society the domesticated dog is exposed to those harmful toxic metals in alarming amounts. The natural dog was not exposed to those toxins and shouldn’t be in a position to defend himself as humans can of their recent domestic world. These harmful metals are throughout us and sometimes more so around our pets. They could be present in municipal water supplies, our soil, natural water sources, our food supply, in addition to in sewage sludge, fungicides, pesticides, on a regular basis products, including cosmetics, fabric softeners, batteries, inks, latex, paints, plastics, solvents, and wood preservatives. I mention all of this stuff because your dog doesn’t know this and thinks nothing of drinking contaminated water, chewing on batteries, plastic bottles or laying within the yard after the exterminator left completing his monthly spraying. Your dog is at further risk then yourself because of their relatively small size in comparison with humans making them more vulnerable to smaller amounts of those toxins.
Disturbing because it is, a serious source of all these metals is business dog foods. Tests of many recognized and revered products each canned and kibbled have shown various levels of aluminum, mercury, cadmium and lead. The amounts of those metals were greater in kibble versus canned because of the refining and dehydration through the extreme temperature extrusion processes.
The Government and other agencies have long been assessing, regulating, protecting, and providing information to the general public on toxic substances similar to heavy metals. Organizations similar to the U.S. Environmental Protection Agency (EPA), the World Health Organization (WHO), the Agency for Toxic Substances and Disease Registry (ATSDR) and the Occupational and Safety Health Administration (OSHA) have been in existence for years. As compared little has been done for our pets. So we must learn from human experiences and adapt these to the natural dog. On ATSDR’s “Top 20 Hazardous Substances “the heavy metals arsenic, lead, mercury, and cadmium appear #1, #2, #3, and #7 respectively. Subsequently we must assume that if that is so for humans it is probably going also true if no more so for our “Best Friend” the domesticated natural dog.
The staff at Vitahound.com recommends each the addition of certain natural foods and herbs to the dog weight-reduction plan and the usage of oral chelation cleansers to purge toxins from the body and return your friend back to their natural dog condition. Before we discuss these techniques it is helpful to learn more about several of the more harmful heavy metal toxins which are adversely affecting your dog’s health. Information is provided below on essentially the most common and worst toxins which are exposed to domesticated dogs. Each is roofed individually in a number of short paragraphs. You will see similar facts across all of the metals but we intentionally repeated the data under each metal to emphasise to the reader the threat and the importance of understanding each metal by itself especially if one desires to return to this dissertation to refresh themselves on one particular heavy metal toxin.
Aluminum is essentially the most plentiful metallic component within the outer layers of the earth. It infiltrates our air, water, and soil thus finding its way into nearly all our food and water supplies. Quite a few municipalities treat their water supplies with aluminum sulfate and fluoride. This mixture is problematic since the body has trouble excreting through the kidneys and urine this particular compound of aluminum fluoride. But by far like most heavy metals, the leading source of aluminum comes from Acid Rain. The strong acids produced by this common environmental condition react with the aluminum molecules within the earth around us releasing them as free agents. These free agents them easily find their way into our crops and livestock food chains.
Business pet food is one in every of the foremost sources of the toxin. Independent testing has found it in most of the off-the-shelf name brand dog foods in toxic levels. Eating is the principal technique of introducing aluminum into the body because it is definitely absorbed by the body through the digestive tract. As well as it’s absorbed via respiratory (lungs) and physical contact (skin). Testing labs have reported it as essentially the most prevailing metal toxin present in all animal hair samples. Once within the body, aluminum accumulates over time inclining to seek out its method to brain and nervous tissues. This implies it might eventually affect one and all organ though nerve connections. The array of health problems is due to this fact plentiful. It contributes to arthritis, kidney failure, congestive heart disease, liver diseases, colic, rickets, diabetes, multiple allergies and skin diseases, thyroid problems, pancreatic problems affecting ability to digest food properly, Cushing’s Syndrome, anemia, and blood clotting ability. A serious consequence of high levels of aluminum accumulating within the body is that dogs cannot fight infections effectively resulting in a better death rate attributed to bacterial, viral, and fungal diseases.
Symptoms of aluminum toxicity in dogs include extreme nervousness, weak muscles, seizures, lack of balance, and lack of energy.
Like the opposite metals Lead is stored within the body and is cumulative over long periods of time. Unlike a number of the other metals is has no known need or profit in your dog and is amazingly toxic. If the body doesn’t excrete it through the digestive system it’s absorbed through the blood into body tissue. The body treats it the identical way as calcium storing it even at low levels within the bones. It then continues to build-up concentration within the bones over your complete lifetime of your dog. At any time but often during some stressful or drastic change in some body function the lead can leave the bones once more entering the bloodstream.
Whereas exposure to aluminum comes from natural sources similar to the earth’s crust, air, water, and food supplies high levels of lead are introduced into the body through man-made substances. It’s probably the most widely used metals in the US today. The issue with these on a regular basis common substances and products is that dogs cannot read warning labels or know what shouldn’t be chewed on, eaten, smelled, or innocently rolled on. Lead poisoning can often be attributed to exposure to common household and outdoors pesticides which contain large amounts of lead. Lead-based paints that were applied years ago can produce harmful dust during home renovations. This dust in turn can contaminate pet food, dog beds, and even the dog’s coat and skin. People often use old or discarded bowls for watering that may contain lead paint or glazing. Puppies are especially at risk of lead poisoning from their constant must chew. Electronic gadgets similar to distant controls, cell phones, batteries, golf balls, ammunition fishing lures and sinkers are all common things they’ll find laying around.
At toxic levels lead prevents various basic enzyme functions. As an illustration the body relies on minerals like selenium and sulfur to act as strong antioxidants to guard cells from free radical damage. Lead lessens this function exposing the cells to serious damage. In your dog this ends in damage to the guts, kidneys, liver, gastrointestinal tract, and nervous system. Lead poisoning then can eventually results in blindness, paralysis of the extremities, liver failure, and even coma and death.
As mentioned, exposure to steer in dogs can take years before it reaches dangerous levels and due to this fact is usually seen in older dogs. Symptoms of lead toxicity in dogs include lack of appetite, vomiting, abdominal pain, constipation followed by diarrhea, crunching of jaws, blindness, seizures or muscle spasms, behavior changes, circling, and lack of balance and agility.
This heavy metal can also be exceptionally toxic and lethal, actually more so than lead. This contagion is utilized in fungicides and pesticides but in addition in products we used every day in a wide range of undertakings. It is usually utilized in household products which are dogs are exposed similar to batteries, light bulbs, fabric softeners, latex gloves, paint, plastics, ink, and solvents. If mercury vapors are ever present from things like house renovations involving old paint, broken thermometers or thermostats it’ll concentrate at floor level were dogs are laying or walking. Even some cosmetics contain it…when is the last time your dog licked your face. For this reason plentiful list of on a regular basis products that contain mercury this heavy metal toxin eventually results in either our sewage or landfills finding its way into our soil, water, and food supply. As for food, methyl mercury chlorine bleach is even used on certain grains and seeds. Mining operations and paper industries are significant producers of mercury especially into the atmosphere which might get dispersed across large regions and even globally. Acid rain then returns it the earth. Well-known is the very fact since our waters are contaminated with mercury it might be present in fish and sometimes in large amounts especially common ones eaten similar to orange rough, swordfish, tuna and halibut.
As with most heavy metal toxins mercury is a cumulative poison. Your dog’s body, as in humans, has no natural mechanism to stop mercury from reaching tissue and cells. It’s gathered within the brain and central nervous system. Once it reaches and is stored within the cells, it seriously affects their normal critical body functions. It affects the processes at each ends, first prohibiting minerals and nutrients from entering the cells after which likewise stopping waste to be purged. Mercury also adversely affects your dog’s overall immune system by attaching to the immune cell structure altering their ability to operate normally. Mercury may cause everlasting kidney, cardiac, respiratory problems arthritis, and gum disease in your dog. Ultimately blindness and paralysis can occur.
Symptoms include lack of balance, fatigue, vomiting, hair loss, diarrhea, weakness, and excessive salivation. High levels can even interfere with enzyme activity, leading to blindness and paralysis.
As with the aforementioned heavy metals, arsenic can also be highly poisonous, remember it’s listed #1 on ATSDR’s “Top 20 List.” It is also cumulative and stays within the body for years. Arsenic could be present in a multiplicity of commonly used products including fungicides, pesticides, herbicides, laundry products, secondhand cigarette smoke, paints, and wood preservatives. Global industries similar to mining and smelting, chemical and glass manufacturing produce arsenic as a by-product. This in turn finds its way into our water supplies and food sources. Once more, as with other heavy metals, arsenic is present in fish similar to haddock, tuna, and halibut.
For years essentially the most common reason for arsenic poisoning in dogs (in addition to children) was the consumption of rodent trap, pesticides (ant bait) which relied on arsenic to kill the pests. Within the late 1980’s the federal government began regulating the usage of arsenic in consumer products similar to pesticides and since then the incidences of accidental arsenic poisoning of dogs has steadily reduced. The common use of heartworm medications for each prevention and treatment has introduced yet one more opportunity for arsenic poisoning of dogs or at the least facilitating the buildup to toxic levels. These products contain organic types of arsenic similar to diethylcarbamazine citrate (Brand names Dimmitrol and Filaribits) or thiacetarsamide (Brand name Caparsolate). One warning concerning such medications states: “Low margin of safety. Have to have an accurate weight before starting treatment. May even see damage to the lungs, kidneys, or liver. Signs may include staggering, lethargy, depression, tremors, drooling, panting, difficulty respiratory, vomiting, collapse, coma, and death.” They may have just stated “Arsenic Poisoning.” Obviously, extreme care should be taken when administering these products.
Arsenic is stored within the hair follicles, skin, and nails and as mentioned will accumulate over long periods of time. Because the lethal dose only is 1 to 12 mg of arsenic per pound of your dog, this buildup of arsenic may cause serious health problems. Subsequently it is crucial to know the symptoms of arsenic poisoning whether the results of an accidental consumption of a household product or the slow accumulation over time. Symptoms include drooling, vomiting, bloody diarrhea with mucous in, bloody urine, muscle cramps, weakness, hair loss, skin rash, gastrointestinal pain, convulsions, trembling, and staggering.
Arsenic toxicity affects the blood, lungs, skin, kidneys, liver, gastrointestinal tract, and the central nervous system. Arsenic compounds can create reactions within the body that disrupt enzymes which are involved in respiration of cells, fat and carbohydrate breakdown and their proper absorption into the body. Certain forms of cancer have been linked to arsenic as well. The buildup of toxic levels of arsenic can lead to paralysis, coma, cardiovascular collapse and death.
Cadmium although not as well-known as aluminum, lead, mercury and arsenic makes the list of heavy metals to pay attention to that adversely affects dog health. Cadmium has no known required body function within the natural dog. It is amazingly toxic with tolerable levels one tenth that of many of the other heavy metal toxins. It’s has no definite taste or order and thus is difficult to detect or know if you could have been exposed. Furthermore it’s one in every of the most important industrial pollutants globally. Cadmium is widely utilized in industry as a plating material, in galvanizing coating on iron, steel, and copper, inks, and dyes. The vast array of the plastic and rubber products we use on a regular basis use cadmium within the processing of the bottom materials. Considered one of the foremost threats to dogs is its use in lots of fungicides and fertilizers. These agricultural products introduce cadmium into our food supply mainly rice and wheat crops each a typical ingredient in business pet food. Like the opposite heavy metals it has contaminated our waterways and is usually present in shellfish and others similar to halibut, cod, haddock and tuna. One good aspect of cadmium is the body tends to not retain it passing it through the digestive system excreting it successfully and it shouldn’t be easily absorbed through the skin. If inhaled as along with your dog sniffing fertilizers and fungicides it’s more prone to remain of their body being stored in lung tissue. But with this said a fundamental problem with cadmium absorption by the dog is linked to the useful metal zinc. Zinc is critical to proper dog health. It’s a component of many vital enzymes promoting a healthy immune system, liver, and bones. It inhibits the absorption of cadmium by the body. When the correct level of zinc shouldn’t be present the body replaces it with cadmium. So here is the issue. Our modern-day business pet food refining processes removes many of the zinc. Subsequently, when zinc is removed, far more cadmium is absorbed, stored within the liver, bones, and kidneys accumulating over time.
Its effects on the dog body are many, and it might be even worse than mercury and the opposite heavy metals. It causes a discount within the production of the critical white blood cells (T-Lymphocytes) which defend the body by destroying harmful free radicals and cancer cells. The list of dog diseases that cadmium can promote is extensive including cancer, diabetes, arthritis, heart problems, kidney disease, bone disorders, and digestive problems. Cadmium toxicity may even contribute to the lack of the natural dog critical sense of smell.
Symptoms include fatigue, hair loss, increased susceptibility to infection, slow healing of wounds, skin lesions, lack of smell, yellow coloration of teeth, inflammation of mucous membrane of the nose, and lack of appetite.
Testing the Dog for Toxic Levels of Heavy Metals
Testing for toxic levels of the heavy metals in your dog include blood, urine, hair, fingernail, and fecal evaluation. Most Veterinarian offices usually are not equipped to perform these tests and samples should be sent to appropriate laboratories that perform such testing. For measuring effects because of exposures inside days or so long as sometime several months, blood, urine, and fecal evaluation is the most effective. For long run and cumulative effects hair and fingernail tests are best. Consistent Minimal Risk Levels (MRL), acceptable levels or toxic levels for dogs are hard to seek out within the literature. Remember we mentioned the Government is searching for dog owners but usually are not yet serious of their efforts for dogs. As well as as research and testing is increasing (often in major University Veterinarian Schools), once proclaimed secure levels of poisons is now considered either borderline or unsafe especially over the lifetime of your dog. The next data is from the Agency for Toxic Substances and Disease Registry Agency (ATSDR) and is for humans but as a rule could be used for dogs adjusting to body weight. Test results have to be interpreted by your veterinarian or a medical toxicologist.
Aluminum: MRL 1mg/kg/day; Blood or Urine 3ug/L; Hair.05 ppm
Arsenic: MRL.005mg/kg/day; 1-25 mg/kg is lethal
Cadmium: MRL.01mg/kg/day; Blood 5ug/dL; Urine 10ug/dL
Lead: Blood 1.5ug/dL; Urine.677 ug/dL
Mercury: MRL.05ug/kg/day; Blood 5ug/dL; Urine 10ug/dL
Oral Chelation Therapy as Treatment to Heavy Metal Toxicity
Oral chelation therapy has long successful track records. It has been beneficial by doctors for years for humans and can be effective with dogs. Chelation was developed initially by Alfred Werner who received the Nobel Prize in 1913. G. T. Morgan coined the term chelation in 1920 deriving it from the Greek word “chele”, meaning a crab’s claw which refers back to the pincer-like manner through which the metal is sure. This process stabilizes the heavy metal particle by binding it to the chelating agent, often amino acids or organic compounds changing it to a chemically inert form that could be excreted via the kidneys without further damage to the body.
There are various effective chelation agents. Every one affects absorbability of minerals needed by the body and likewise the power to bind potentially to different toxic metals making them inert. We discuss below five effective agents: Fulvic Acid, Glutamic Acid, Ferulic Acid, Malic Acid, and Lipoic Acid.
Grandma said “It never hurt to eat slightly dirt.” What she was really saying was “Fulvic acid could be very useful to your good health.” Modern-day and ancient civilizations similar to China, Mexico, India, and South America have known the health advantages of fulvic acid and use it as a natural medicine. Fulvic acid comes from humus material which is organic material that has decomposed over very long periods of time. It due to this fact naturally comprises practically all if not all of the substances we and our dogs need for a protracted healthy existence. Since humus over this long decomposition period assimilates an unlimited multiplicity of natural organic plant material, it and the resulting fulvic acid contain an immense collection of naturally occurring phytochemicals and biochemicasl together with 70 minerals and nutrients,18 amino acids, and three essential fatty acids. This in turn supplies natural antioxidants, enzymes, antivirals, hormones, and antifungals. For antiviral use it’s the most effective there’s in your dog. Fulvic acid also has antibiotic advantages without creating strains of disease that develop into resistant as with the common synthetic antibiotics of recent medicine.
Fulvic acid is probably the most aggressive antioxidants able to neutralizing harmful free radicals, making it an efficient chelation agent of heavy metal toxins with the power to not only purge them from the body but repair damage to the cells as well. It may possibly likewise eliminate food poisoning sick effects inside minutes.
Fulvic acid is water soluble. This allows it to makes cell partitions more permeable enabling substantially more amounts of nutrients and minerals to be absorbed. This characteristic prolongs the effectiveness of minerals and nutrients within the body metabolic processes.
Due to our modern agricultural methods that use synthetic fertilizers, pesticides, and fungicides fulvic acid finds its way less and fewer into our food supply. Farm lands today have only a fraction of the humus soil base that they did even 100 years ago. Commercially processed pet food is even worse than our food supply in relation to supplying sufficient amounts of fulvic acid. Subsequently it’s best today to make use of dog supplements to produce the crucial fulvic acid to your dog’s weight-reduction plan.
Fulvic acid is taken into account very secure with few negative effects reported when used for either humans or dogs. Diarrhea and/or change within the smell of feces can occur but often only last a number of days.
Amino acids are the constructing blocks of protein, and glutamic acid was essentially the most common amino acid present in the natural dog’s body. It accounts for roughly 20% of the entire body protein. It produces essentially the most common excitatory neurotransmitter within the central nervous system. The amino acid composition of the brain is greater than 50% glutamic acid.
Glutamic Acic is an efficient antioxidant and heavy metal chelation agent. But has many other health advantages for you dog. It fights heart disease, strengthens the immune system, helps to cut back inflammation, helps prevent and heals ulcers, and increasing overall energy levels. It is usually also used as an additive to food to discourage dogs from eating their very own feces. It mixes with other acids within the digestive system making the stool bitter to the taste.
Glutamic acid is found naturally in high-protein foods like beef, pork, chicken, fish, eggs, corn tomatoes, soybeans and milk. Even through a lot of these could be present in business pet food the extreme temperature processing of those foods destroys the usefulness of the glutamic acid.
Ferulic acid (FA) is a phytochemical commonly present in fruits (apple, pear, orange, pineapple), vegetables (tomato, spinach, asparagus, carrot, sweet corn), brans (wheat, rice, oat). Phytochemicals are natural chemical substances and nutrients formed a plant’s normal metabolic processes. Phyto is the Greek word for plant. There have been 1000’s of several types of phytochemical identified and research is proving their advantages to good health in each humans and dogs.
Ferulic Acid has excellent antioxidant properties and is effective in fighting diabetes, cancer, heart, blood and circulatory disease, bone deterioration and neurological problems. It is usually added to the weight-reduction plan of very energetic dogs similar to work dogs because it helps rebuild the muscles quickly. As a chelation agent it effectively binds to free radicals neutralizing and enabling them to be safely purged from the body.
Malic acid is a really effective chelation agent. Malic acid creates a response within the stomach to boost absorption of minerals. The acid reacts with the mineral to interrupt the bonds with its original inorganic chelation agent. This frees the mineral to bond with the malic acid to create a malate or allows the free mineral to chelate to other organic bonds available within the stomach, i.e. citric acid (citrate), proteins (amino acid chelate) and so forth. These simpler chelation agents allow for higher absorption.
Malic acid is a robust detoxifier of aluminium, and should offer profit within the chelation and removal of heavy metals. When used orally, malic acid may cause mild gastrointestinal (GI) disturbances.
Along with increasing energy levels, malic acid can also be an efficient metal chelator. This implies it’s in a position to bind to potentially toxic metals which will have gathered within the body, similar to aluminum or lead, and inactivate them. In consequence, the danger of toxicity is considerably reduced. Heavy metal overload has been linked to serious problems like liver disease and brain disorders like Alzheimer’s disease.
Lipoic acid (LA) is an organic compound that’s present in every cell of the body due to this fact it is crucial to quite a few metabolic enzymatic process needed for correct dog health. This sulfur containing acid has the unique characteristic of having the ability to be dissolved and work each in water and fatty tissues. This is totally contrary to vitamins that are either water soluble (B-complex, C) or fat soluble, (A, D, E, K).
Lipoic acid converts glucose into energy thus reduce risk of diabetes. Though it’s an efficient antioxidant it also the power to reestablish the effectiveness of other antioxidants. Considered one of the critical ones that it helps restore is glutathione. This also occurs in every cell of the body and is critical to your dog’s immune system. Through these processes Lipoic Acid helps slow aging. In the event you dog is on any kind of therapy or medication similar to cancer treatments which compromise the immune system supplemental Lipoic Acid could be extremely useful.
Lipoic Acid can also be probably the most effective antioxidants in neutralizes harmful free radicals. Research has shown it’s effective against heavy metal toxicity because of lead, mercury, and cadmium.
Lipoic acid is present in very low concentrations is nearly all foods but in higher levels in kidney, heart and liver meats in addition to spinach, broccoli and potatoes. For this reason low concentration and it shouldn’t be available from the food sources because of the character it’s chemically structured, all lipoic acid supplements are chemically produced.
Helpful to Counteract Metal Toxicity
Nutrients: Pectin, Calcium, Magnesium, Coenzyme A, Vitamin E, L-Glutathione, LecithinS-Adenosylmethionine, Vitamin B-Complex**
Herbs: Garlic*, kelp, Burdock Root, Ginseng,Ginkgo, Biloba, Echinacea
Nutrients: Superoxide Dismutase, Vitamin C, Selenium, L-Cysteine, C-Methionine, Pectin
Nutrients: Calcium, Magnesium,Coenzyme A, Vitamin E, L-Cysteine, L-Lysine, L-Methionine, Zinc,Lecithin, Rutin
Herbs: Garlic*, Alfalfa, Burdock Root, Red Clover, Milk Thistle
Nutrients: Alpha-lipoic Acid, Pectin, Calcium, Magnesium, Zinc, Vitamins A, C, E, B-Complex, L-Lysine, L-Cysteine, Selenium, L-Cystine, Methylsulfonfl-Methane, S-Adenosyfmethionine, Glutathione, L-Methionine, Lecithin
Herbs:Garlic*, Kelp, Alfalfa
Nutrients: Glutathione, L-Cysteine, L-Methionine, Selenium, Pectin, Vitamin A, C, E, B-Complex, Lecithin
Herbs: Garlic*, Kelp, Alfalfa, Brewer’s Yeast
* Although garlic is detoxifier it should only be given to dogs in small amounts if in any respect.
** Extra B6 & B12 ought to be given
Chelation Agents Sources
Brans (wheat, rice, oat)
Fruits* (apple, pear, orange, pineapple)
Vegetables (tomato, spinach, carrot asparagus, sweet corn)
Humus Soil (need to make use of complement)
High Protein Foods (beef, pork, chicken, fish, eggs, soybean)
Tomatos, Corn, Milk
Low content in nearly all foods
Higher content in kidney, heart, liver meats & spinach, broccoli, potatoes
(As a consequence of very low concentrations and difficulty in extraction source from supplements is beneficial)
Fruits* (apples, cranberries, pineapple, apricot)
* Only use the “meat” of the fruit- never feed the seeds
We now have found that heavy metal toxicity is a significant component that affects proper dog health, especially in the fashionable day domesticated natural dog. That it is nearly inconceivable to maintain our dogs free from exposures to heavy metals. This toxicity is an accumulative process within the dog’s body due to this fact additional time even small exposures are harmful. Exposure to such heavy metals as aluminum, arsenic, cadmium, lead, and mercury come from are environment, on a regular basis products we use, and even business pet food. Business pet food producers are particularly deficient of their control of those toxins. There are symptoms we will search for that indicate possible heavy metal toxicity in our dogs. Exposure could be minimized by having knowledge of were the heavy metals exist around us. There are foods, herbs, minerals, vitamins, and supplements that we will use to assist protect, minimize effects, and even purge these damaging toxins from our dog’s bodies continuously promoting good dog health. And at last that dog owners should consider chelation therapy that uses power antioxidants to cleanse the body of the gathered heavy metal toxins.
NOTICE: The content in this text is provided for informational and academic purposes only. While we make every effort to present information that’s accurate and reliable, the views expressed here usually are not meant to be an alternative to the recommendation provided by a licensed veterinarian. Please seek the advice of your veterinarian for specific advice regarding the medical condition or treatment of your dog and before administering any medication or pursuing any course of treatment that was presented in this text.