V15I1 (Winter 2024-25)

Innovative VETERINARY CARE

VOLUME 15 ISSUE 1

CAN PBM HELP MANAGE DENTAL AND ORAL CONDITIONS? LEARN WHY PHOTOBIOMODULATION IS AN EFFECTIVE TOOL FOR DENTAL AND ORAL ISSUES IN DOGS AND CATS. — P. 8

TAKING AN INTEGRATIVE APPROACH TO PARTIAL PARALYSIS/PARESIS

Adding alternative treatments to a conventional therapy regimen helps dogs regain mobility and quality of life. — p. 16

WINTER 2024-25

www.IVCJournal.com

USING INTEGRATIVE AND NUTRITIONAL THERAPIES FOR PANCREATITIS An in-depth look at how nutrition and integrative therapies can treat and prevent pancreatitis in pets. — p. 20

HOW ORAL CANCERS RESPOND TO INTEGRATIVE TREATMENT

Oral cancers can be difficult to treat, but incorporating alternative therapies can extend longevity and improve quality of life. — p. 24

WHAT’ S NEW IN CANINE IDIOPATHIC EPILEPSY?

New therapies and ongoing research have improved our ability to provide a personalized approach for each patient. — p. 38

THE LINK BETWEEN DENTAL HEALTH AND THE ORAL MICROBIOME

As a component of the GI tract, the oral microbiome has a profound impact on dental health and overall well-being. — p. 42

WHY TCVM BENEFITS DOGS WITH DEGENERATIVE MYELOPATHY

When TCVM modalities are added to treatment plans for dogs with DM, they respond faster and more consistently — p. 46

WINTER 2024-25 EDITORIAL DEPARTMENT

SUBMISSIONS: Please send all editorial material, photos and correspondence to Dana Cox at Dana@redstonemediagroup.com or IVC Journal, 266 Charlotte St., Suite 433 Peterborough, ON, Canada K9J 2V4.

Editor-in-Chief: Dana Cox Managing Editor: Ann Brightman Associate Editor IVC: Omer Rashid, DVM Senior Content Editor: Ashley Tonkens Graphic Design Lead: Joy Sunga

We welcome previously unpublished articles and color pictures either in transparency or disc form at 300 dpi. We cannot guarantee that either articles or pictures will be used or that they will be returned. We reserve the right to publish all letters received.

COLUMNISTS & CONTRIBUTING WRITERS Nancy Brandt DVM, OMD, MSOM, dip. OM, CVC, CVA, CVMA Todd Cooney, DVM, CVH Kelly Diehl, DVM, MS Dipl. ACVIM Cynthia Lankenau, DVM Lisa A. Miller, DVM, CCRT Margo Roman, DVM, CVA, COT, CPT, FAA Judith E. Saik, DVM, DACVP, CVA, CVCH, CVFT Allen Schoen, DVM, MS, PhD (hon.), CVA Marlene Siegel, DVM Heidi Ward-McGrath, BVSc Ayse Washington, DVM, CCRP, CVMMP

ADMINISTRATION & SALES Publisher: Redstone Media Group President/C.E.O.: Tim Hockley Operations Director: Libby Sinden Financial Administration: Rosme Mandal

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IVCJournal.com IVC Journal (ISSN 2291-9600) is published four times a year by Redstone Media Group Inc. Entire contents copyright© 2024. No part of this publication may be reproduced or transmitted by any means, without prior written permission of the publisher. Publication date: December 2024.

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improving the lives of animals... one reader at a time.

IVC Winter 2024

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contents FEATURES

OF 8 BENEFITS PHOTOBIOMODULATION IN VETERINARY PATIENTS WITH ORAL CONDITIONS

by Lisa A. Miller, DVM, CCRT PBM is a versatile and effective tool for managing dental and oral conditions in dogs and cats, from gingivitis to post-surgical recovery.

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IDEAS IN ANIMAL 12 NOVEL NEUROPLASTICITY

by Allen Schoen, DVM, MS, PHD (HON.), CVA A look at how our understanding of neuroplasticity, particularly in the form of neurofeedback, may help companion animals with behavior problems.

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APPROACH TO 16 INTEGRATIVE PARTIAL PARALYSIS/PARESIS IN CANINES

by Ayse Washington, DVM, CCRP, CVMMP Conventional therapies and alternative treatments such as PEMF, acupuncture, and more provide an integrative approach to managing partial paralysis and paresis in canines.

NUTRITION NOOK 20 PANCREATITIS IN PETS

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— AN INTEGRATIVE AND NUTRITIONAL APPROACH

by Nancy Brandt, DVM, OMD, CVC, CVA, CVMA An in-depth look at the most effective integrative and nutritional therapies for treating and preventing pancreatitis in dogs and cats.

INTEGRATIVE APPROACH 24 AN FOR TREATING ORAL CANCERS IN DOGS AND CATS

by Marlene Siegel, DVM Oral cancers can be aggressive and challenging to treat, but an integrative approach that incorporates alternative therapies can extend longevity and improve quality of life.

S ROLE IN CANINE 32 RONGOA’ DERMATOLOGY

by Heidi Ward-McGrath, BVSc

The use of Rongoa and other complementary treatments in canine dermatology represents a unique fusion of traditional wisdom and modern veterinary medicine.

S NEW IN CANINE 38 WHAT’ IDIOPATHIC EPILEPSY?

by Kelly Diehl, DVM, MS DIPL. ACVIM Idiopathic epilepsy in dogs is a serious neurologic disease, but new therapies and ongoing research have improved our ability to provide a personalized approach for each patient.

ORAL MICROBIOME AND 42 THE DENTAL HEALTH IN CANINES

by Margo Roman, DVM, CVA, COT, CPT, FAAO The oral microbiome in dogs is incredibly complex and varied. It has a profound impact not only on dental health, but also on the rest of the dog’s GI system and overall wellbeing.

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advisory board FOR DEGENERATIVE 46 TCVM MYELOPATHY IN CANINES

by Judith E. Saik, DVM, DACVP, CVA, CVCH, CVFT When Traditional Chinese Veterinary Medicine modalities are incorporated into a multimodal treatment plan for dogs with DM, they respond faster and more consistently.

COLUMNS & DEPARTMENTS

Dr. Richard Palmquist, DVM GDipVCHM(CIVT) CVCHM (IVAS), graduated from Colorado State University in 1983. He is chief of integrative health services at Centinela Animal Hospital in Inglewood, California, former president and research chair of the AHVMA, and an international speaker in integrative veterinary medicine. Dr. Palmquist is a consultant for the Veterinary Information Network (VIN) and a past president of the AHVM Foundation. He has published two books, one for conventional veterinarians and a second for clients discussing how integrative thinking works.

Michelle J. Rivera, MT, VDT, is an instructor at the University of Wisconsin and The Healing Oasis Wellness Center, a post-graduate educational institution offering state-approved programs. She is coowner of The Healing Oasis Veterinary Hospital, offering massage, rehabilitation, chiropractic and Chinese and Western Herbology.

Michelle completed the Chinese Herbal Medicine program from the China Beijing International Acupuncture Training Center, and is certified in Chinese Medicine by the Wisconsin Institute of Chinese Herbology.

7 Editorial 19 Profitable Practice 23 From the AHVMA 35 From the VMAA 41 From the VBMA 45 Business Profile 51 From AVH IN THE NEWS:

31 How machine learning is advancing heart murmur detection in dogs

36 New canine tissue biobank enhances understanding of dog genomics

Dr. Joyce Harman, DVM, MRCVS, graduated in 1984 from Virginia Maryland Regional College of Veterinary Medicine. Her practice is 100% holistic, using acupuncture, chiropractic, herbal medicine and homeopathy to treat horses to enhance performance and those with a variety of chronic conditions, with an emphasis on Lyme Disease.

Her publications include the Pain Free Back and Saddle Fit Books, and numerous articles in lay and professional magazines. She maintains an informative website: www.harmanyequine.com.

Dr. Steve Marsden, DVM, ND, MSOM, Lac. Dipl.CH, CVA, AHG lectures for IVAS, the AHVMA, the AVMA, and numerous other organizations. He is co-founder of the College of Integrative Veterinary Therapies and is a director emeritus of the National University of Natural Medicine in Portland OR. He authored the Manual of Natural Veterinary Medicine (Mosby); and Essential Guide to Chinese Herbal Formulas (CIVT). Dr. Marsden is extensively trained in alternative medicine, including Chinese herbology, acupuncture and naturopathic medicine. He has holistic veterinary and naturopathic medical practices in Edmonton, Alberta. In 2010, Dr. Marsden was named Teacher of the Year by the AHVMA; and Small Animal Veterinarian of the year by the CVMA in 2009.

Dr. Jean Dodds, DVM, received her veterinary degree in 1964 from the Ontario Veterinary College. In 1986, she moved to Southern California to establish Hemopet, the first non-profit national blood bank program for animals. Dr. Dodds has been a member of many national and international committees on hematology, animal models of human disease, veterinary medicine, and laboratory animal science. She received the Holistic Veterinarian of the Year Award from the AHVMA in 1994.

52 Fecal microbiota analysis may provide non-invasive screening for equine IBD

53 New tool for assessing frailty in dogs: predicting short-term mortality

Dr. Barbara Fougere, DVM, CVAA graduated in 1986, and was named the American Holistic Veterinary Medical Association Educator for 2011. Dr. Fougere is the principal and one of the founders of the College of Integrative Veterinary Therapies. She has continued studying over the last 26 years, and has three Bachelor degrees, two Masters degrees, three post Graduate Diplomas, several Certifications and numerous other courses under her belt.

Dr. Christina Chambreau, DVM, CVH, graduated from the University of Georgia Veterinary College in 1980. She is a founder of the Academy of Veterinary Homeopathy, was on the faculty of the National Center for Homeopathy Summer School and has been the holistic modality adjunct faculty liaison for the Maryland Veterinary Technician Program and is the former Associate Editor of IVC Journal. Dr. Chambreau teaches classes in homeopathy for animals, lectures on many topics, speaks on Radio and TV, and is the author of the Healthy Animal’s Journal among other titles. She is now on the faculty of the Holistic Actions Academy, which empowers members to keep their animals healthy with weekly live webinars.

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1. NANCY BRANDT, OMD, DVM, CVC, CVA, CVMA

Dr. Nancy Brandt has been an integral part of Las Vegas' holistic medical practice since 1990. She is a graduate of Wongu University of Oriental Medicine and has a triple BA in Biology, Chemistry, and Physics. Prior to her studies in acupuncture and Chinese medicine, Dr. Brandt graduated with honors from the University of Minnesota Veterinary Medical School. She pioneered the field of Veterinary Medical Aromatherapy®, and founded the Veterinary Medical Aromatherapy Association (VMAA) in 2015. Dr. Brandt has used integrative medicine since 1992, and has been a professor of integrative courses for Traditional Chinese Medical students since 2013. p.20

2. KELLY DIEHL, DVM, MS DIPL. ACVIM

Dr. Kelly Diehl received her DVM from the University of Tennessee and started her career in an emergency clinic in New Jersey. She completed an internship at the Animal Medical Center in NYC, then completed a residency in small animal medicine at Colorado State University. Dr. Diehl joined the staff of the Veterinary Referral Center of Colorado as co-owner of the internal medicine section. After 14 years, Dr. Diehl left private practice to pursue a career in medical communication and joined Morris Animal Foundation in 2013. Dr. Diehl is a board-certified small animal internal medicine specialist with an interest in gastroenterology and immunology. p.38

3. LISA MILLER, CVM, CCRT, CVA

Dr. Lisa Miller is VP of Clinical Veterinary Medicine for Companion Animal Health, and a graduate of the University of Tennessee, College of Veterinary Medicine. She is certified in canine rehabilitation therapy, and practiced rehab, sports medicine, and acupuncture before returning to general practice, and later joining the animal health industry.

Dr. Miller has been working with laser therapy/photobiomodulation (PBM) since 2006. She coordinates all veterinary and advanced PBM research involving Companion Animal Health technologies, and is a consultant and reviewer for PBM research worldwide. She is a member of the AVMA, the American Association of Rehabilitation Veterinarians, and the American Society of Laser Medicine & Surgery. p.8

4. MARGO ROMAN, DVM, CVA, COT, CPT, FAAO

Dr. Margo Roman graduated from Tuskegee University Veterinary School in 1978, and did undergraduate studies at the University of Florida. She owns the integrative veterinary practice M.A.S.H. (Main Street Animal Services of Hopkinton in Massachusetts, www.mashvet.com). Dr. Roman has been using Medical Ozone Therapy for the past 20 years and Microbiome Restorative Therapy (MBRT) for 12 years, enhancing her 45 years of practicing both conventional and alternative modalities (e.g. acupuncture, homeopathy, herbs, nutrition, hyperbaric oxygen, UVBI).

At home, Dr. Roman has seven standard poodles, sixth generation, and two Siamese cats, who have been donors for over 30,000 MBRT cases. p.42

5.JUDITH E. SAIK, DVM, DACVP, CVA, CVCH, CVFT

Dr. Judith Saik received her veterinary degree from LSU in 1980. She has worked in a mixed practice, owned an equine practice, and completed a pathology residency at UPenn Vet School, culminating in ACVP diplomate status.

Dr. Saik has served as an educator at UPenn, USPHS officer at NIH’s Comparative Pathology Section, and pathologist at

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Dupont and Merial Animal Health. In addition to pathology, Dr Saik has continued her interest in clinical medicine and currently specializes in TCVM: she is certified in veterinary acupuncture, Chinese herbal medicine and Chinese food therapy. She also serves as Editor for the American Journal of Traditional Chinese Veterinary Medicine. p.46

6. ALLEN M. SCHOEN, DVM, MS, PHD (HON.), CVA

Dr. Allen Schoen received his DVM from Cornell University in 1978. He also holds a Master's Degree in neurophysiology and animal behavior from the University of Illinois. Dr. Schoen has held faculty positions at Colorado State University College of Veterinary Medicine, Tufts University College of Veterinary Medicine and the Chi Institute.

He is certified in veterinary acupuncture and veterinary chiropractic and is a past president of the IVAS. In 2010, he received the Lifetime Achievement Award for his contributions to veterinary acupuncture from the American Academy of Veterinary Acupuncture. p.12

7. MARLENE SIEGEL, DVM, CNHP, ALT

Dr. Marlene Siegel is an international speaker and innovator in integrative veterinary medicine. Her practice, Pasco Veterinary Medical Center, offers the widest array of alternative therapies and detoxification services in the country. She developed her own raw pet food and supplements company, EvoLoveRaw.com. Passionate about education, Dr. Siegel has online integrative veterinary medicine programs for pet parents and veterinarians. She is launch-ing S’Paws Family Wellness, detox centers for pets and their parents. p.24

8. HEIDI WARD-MCGRATH, BVSC

Dr. Heidi Ward-McGrath is director of an award-winning veterinary practice, a published researcher, and an entrepreneur who has developed 100+ successful natural animal products. She founded Vetcare Ltd. in 1999 and is an orthopedic and soft tissue surgeon. Dr. Heidi lectures in integrative animal care. Her current research projects involve the microbiome and MRSP. She has been the Department of Conservation Animal Ethics vet for five years and has done an enormous amount of rescue and charity work. In 2017, Dr. Heidi was the winner of the Kiwibank New Zealander of the Year for her work in animal welfare. p.32

9. AYSE WASHINGTON, DVM, CCRP, CVMMP

Dr. Ayse Washington is a graduate of Tuskegee University College of Veterinary Medicine. Her current focus is on holistic and functional medicine. She has studied acupuncture, and is certified in Medical Manipulation and Rehabilitation. Dr. Washington works in Windham, NH, using tools such as stem cell, ozone and hydrogen therapies to create integrative treatment plans for patients in need of advanced care. p.16

editorial

Bridging tradition and innovation VETERINARY in DENTISTRY It’s a sad fact that between 80% to 90% of dogs over the age of three have some form of periodontal disease. Despite its prevalence, up until recently, managing it included frequent scaling, polishing, and removing teeth when required. Unfortunately, traditional treatment falls short in addressing underlying systemic issues. But when complementary approaches such as nutritional adjustments are incorporated, patients exhibit remarkable improvement. A diet enriched with anti-inflammatory ingredients and probiotics not only improves an animal’s oral health but also their overall wellbeing and vitality.

The field of veterinary dentistry has evolved significantly over the years, integrating traditional practices with modern advancements and complementary therapies. Historically, dental care for animals was often rudimentary, focusing primarily on the extraction of diseased teeth. However, as our understanding of animal health has deepened, so too has our approach to dental care, emphasizing prevention, holistic health, and the relationship between oral health and overall well-being.

There’s a need for a comprehensive understanding of the oral microbiome and its implications for systemic health. Dr. Margo Roman’s article on this topic highlights the importance of a balance of bacteria within the pet’s mouth, and its direct impact on periodontal disease and other systemic conditions. This perspective aligns with the growing recognition of the mouth as a gateway to overall health, necessitating a multifaceted approach to dental care.

In exploring the latest advancements in dental care, Dr. Lisa Miller’s contribution on photobiomodulation (PBM) in dental and oral applications introduces innovative, non-invasive techniques that enhance healing and reduce inflammation. This modern approach complements traditional dental care, offering veterinarians new tools for effectively managing oral conditions.

The articles in this issue, including those on other topics besides dental care, collectively highlight the importance of evidencebased practice. Notably, Dr. Judy Saik’s exploration of Traditional Chinese Veterinary Medicine (TCVM) for degenerative myelopathy, and Dr. Kelly Diehl’s insights into canine epilepsy showcase the need for comprehensive diagnostic and treatment frameworks that incorporate diverse medical philosophies.

The integration of various therapeutic modalities is further exemplified in the work of Dr. Ayse Washington, who discusses an integrative approach to partial paralysis and paresis in canines.

This article emphasizes the importance of combining traditional veterinary practices with alternative therapies such as acupuncture and physical rehabilitation.

The intersection of traditional, complementary, and modern veterinary medicine presents an exciting frontier in the field of dentistry. The collective insights presented in this issue remind us of the importance of integrative approaches in improving both the dental and overall health and well-being of our patients. As we look to the future, a balanced approach that combines rigorous research with practical application will be essential in advancing veterinary dentistry and other areas of patient care. Continued collaboration among practitioners, researchers, and educators will ensure we remain at the forefront of this dynamic field, ultimately benefiting the animals we serve.

Sincerely,

Omer Rashid, DVM, MSc Parasitology Associate Editor, dromer@redstonemediagroup.com IVC Winter 2024

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Benefits of

PHOTOBIOMODULATION

in veterinary patients with dental and oral conditions

BY LISA A. MILLER, DVM, CCRT

PBM is a versatile and effective tool for managing dental and oral conditions in dogs and cats, from gingivitis to postsurgical recovery.

Photobiomodulation (PBM) therapy has emerged as a versatile treatment modality in veterinary medicine. This article explores its applications in dental and oral health, focusing on post-dental prophylaxis, post-dental extractions, and surgical recovery. We discuss mechanisms of action along with dosing considerations, techniques for managing uncooperative patients, and insights derived from cross-species evidence.

INTRODUCTION Dental and oral health are critical components of veterinary care. Periodontal disease affects the majority of dogs and cats by age three (AAHA, 2019). This underscores the need for effective treatment modalities to address inflammation, pain, and delayed healing.

PBM therapy offers a non-invasive solution with demonstrated efficacy in both veterinary and human medicine. While studies in dogs and cats are limited, findings from human and laboratory animal research provide valuable insights for clinical application (Ross & Ross, 2009; Kalhori et al, 2019).

MECHANISMS AND EVIDENCE FOR PHOTOBIOMODULATION PBM operates at the cellular level by delivering red-tonear-infrared light (650–1100 nm) to chromophores in cells,

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primarily cytochrome c oxidase. This interaction enhances mitochondrial function, leading to increased ATP production, beneficial reactive oxygen species (ROS), and modulation of inflammatory pathways.

Key anti-inflammatory effects include suppression of cytokines such as TNF-α, IL-6, and prostaglandins, which are critical drivers of tissue damage in conditions like gingivitis and stomatitis (Hamblin, 2006; Watson & Brundage, 2019).

In addition to its effects on inflammation, PBM promotes tissue repair by enhancing fibroblast proliferation, collagen synthesis, and angiogenesis. These processes accelerate wound healing, restore tissue integrity, and can improve periodontal outcomes following dental surgery.

Evidence from human dentistry highlights PBM’s ability to improve gingival health and periodontal ligament repair, while rodent studies confirm its efficacy in reducing oral inflammation and promoting mucosal regeneration (Kalhori et al, 2019).

Precise dosing is essential to optimize therapeutic outcomes.

Fluences typically range from 2–8 J/cm² depending on tissue depth, which in this case is usually dependent on whether or not direct access to the buccal mucosa and gingiva is possible. The mechanisms outlined here form the foundation for PBM’s application in veterinary oral health.

APPLICATIONS OF PBM IN VETERINARY DENTISTRY PBM significantly reduces inflammation and erythema following dental cleanings. Alves and colleagues (2023) demonstrated significantly reduced gingivitis scores over a twoweek period in dogs treated with just a single session of PBM immediately after dental prophylaxis. The therapy alleviates discomfort caused by scaling and polishing, enabling quicker recovery of oral tissues.

PBM has demonstrated significant potential in reducing pain and accelerating healing following dental extractions.

In a study by Momeni et al (2022), a single session of extraoral 940 nm diode laser therapy significantly decreased pain scores in patients after mandibular molar extraction. The treated group reported lower analgesic use and experienced faster pain relief compared to the placebo group.

Further Considerations when USING PBM FOR DENTAL PATIENTS

F or routine dental cleanings in which

no extractions have been performed, a

single PBM session may be sufficient. For more severe periodontal disease, or for

patients that may have had multiple dental

This trend of pain reduction highlights PBM’s efficacy in modulating inflammatory processes (Momeni et al, 2022) and is consistent with other non-dental studies in dogs in which even a single post-operative PBM session could significantly reduce pain scores in the hours after surgery (Alves et al, 2024).

extractions or oral surgery (including jaw fracture repair and/or oronasal fistula

repair) two to four additional sessions,

daily to every few days, may be needed

for optimal pain management and healing.

V ery commonly, laser operators may

In addition to PBM’s effects regarding enhanced wound healing through biostimulation of fibroblasts and modulation of inflammatory cytokines, such as IL-6 and TNF-α (Hamblin, 2006), these mechanisms reduce pain while supporting soft tissue and bone regeneration, making PBM a valuable adjunctive therapy in veterinary oral surgical care.

TECHNIQUES FOR COOPERATIVE AND UNCOOPERATIVE PATIENTS Technique is very important and involves keeping the laser beam continuously moving (unless using very low power) and allowing the tissues to thermally relax before returning to the same area.

Since patients may often be anesthetized and in recovery during these treatments, it is recommended that the laser operator use one hand/fingers to actively monitor the skin/ gingival temperature in the area/field they are treating by

wonder about the use of PBM in the event of minor post-extraction hemorrhage. In this situation, the operator is reminded that laser therapy will cause localized

nitric oxide release into treated tissues;

therefore, subsequent vasodilation may make any bleeding temporarily worse.

I t is advised to wait until all oozing

has stopped, if possible, prior to laser treatment, even if this means waiting

until the patient is recovered and awake.

It is important to remember, however, that PBM will not interfere with the

usual clotting cascade in normal patients.

Therefore, a clot will form as normal even if the patient has been treated while there is still some minor bleeding.

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physically touching it with their free hand (not with the hand holding the laser handpiece) and adjusting their technique (moving faster, covering a larger area) or turning the power down if the skin feels too warm.

As always, the patient’s (and operator’s) eyes should be protected with laser safe eyewear during this treatment.

For uncooperative, awake patients, extraoral treatment through the lips is possible, but will require slightly higher doses of 6–8 J/cm² to compensate for photon attenuation as the light travels through the extra layers of tissue (and possible reflection if treating in an off-contact manner).

Positioning the laser appropriately to treat the entire dental arcade, including both sides and through the intermandibular space, is essential. If the patient will allow on-contact treatment through the lips and under the jaw, that is ideal. If they will not allow on-contact treatment, the laser operator may still treat in an off-contact manner, at least until the patient is more comfortable.

CONCLUSION

from human and animal studies, veterinarians can optimize treatment protocols for conditions ranging from gingivitis to post-surgical recovery.

Precise dosing and tailored techniques, whether intraoral or extraoral, ensure safe and effective outcomes. Continued research and clinical adaptation will expand PBM’s role in veterinary dentistry, improving care for companion animals.

References Alves, J.C., Filipe, A., & Santos, A. (2024). Post-surgical photobiomodulation therapy improves outcomes following elective gastropexy in dogs. Lasers in Medical Science.

Alves, J.C., Jorge, P., & Santos, A. (2023). The Effect of Photobiomodulation Therapy on Inflammation Following Dental Prophylaxis. Journal of Veterinary Dentistry.

Watson, A.H., & Brundage, C.M. (2019). Photobiomodulation as an Inflammatory Therapeutic Following Dental Prophylaxis in Canines. Photomedicine and Laser Surgery.

Kalhori, K.A.M., et al. (2019). Photobiomodulation in Oral Medicine. Photobiomodulation, Photomedicine, and Laser Surgery.

Hamblin, M.R. (2006). Mechanisms of Low-Level Light Therapy. Lasers in Surgery and Medicine.

Fabre, H.S.C., et al. (2015). Anti-Inflammatory and Analgesic Effects of Low-Level Laser Therapy on the Postoperative Healing Process. Journal of Physical Therapy Science.

Arany, P.R. (2016). Craniofacial Wound Healing with Photobiomodulation Therapy. Journal of Dental Research.

PBM is a versatile and effective tool for managing dental and oral conditions in veterinary patients. By leveraging evidence

Momeni, N., et al. (2022). Efficacy of Diode Laser Therapy for Pain Reduction after Dental Extractions. BMC Oral Health.

AAHA Dental Care Guidelines for Dogs and Cats. (2019). American Animal Hospital Association.

DOSING PBM FOR DENTAL APPLICATIONS Recommended dosages for the applications discussed in the article are 2-4 J/cm² for

intraoral applications, delivered directly to the gingiva in a non-contact manner.

This dosage is appropriate for cooperative, which the gingiva can be directly exposed (see photo at right). Treating the entire mouth following dental prophylaxis is

recommended, rather than just focusing on one or two extraction sites. In this

way, more of the inflamed oral tissues are exposed to PBM and better pain management is achieved.

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Patient being treated in a non-contact manner with the gingiva exposed.

Photo courtesy of Dr. Lisa A. Miller

awake patients or anesthetized patients in

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NOVEL IDEAS IN ANIMAL

NEUROPLASTICITY

BY ALLEN SCHOEN, DVM, MS, PHD (HON.), CVA

A look at how our understanding of neuroplasticity, particularly in the form of neurofeedback, may help companion animals with behavior problems.

Neuroplasticity is the brain’s ability to change in structure or function in response to experience. I described this concept in a previous article in IVC Journal (Summer 2024). Numerous medical schools now teach about physical and functional changes in the brain. Neuroplasticity is also evident in our companion animals, from birth onwards. This article presents some innovative ways our understanding of neuroplasticity can help companion animals.

CAN NEUROPLASTICITY BE APPLIED TO BEHAVIORAL PROBLEMS? Many companion animals are abandoned at animal shelters and rescue farms due to various behavioral challenges. These behaviors are commonly due to old mental wounds and traumatic memories impacting on current interactions. Conventional medicine may recommend behavior modifying medications, while natural medicine may offer nutritional or herbal solutions. Animal behaviorists suggest behavioral exercises or modifications. If none of these approaches work satisfactorily, it is not uncommon for euthanasia to be considered.

Certain computerized, cutting edge, neurofeedback approaches appear to be helping human brains increase neuroplasticity.

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One reads EEGs 256 times a second, bringing dissonant EEG recordings in the subconscious into resonance with conscious behaviors. These approaches have helped patients with nerve damage from various neurodegenerative conditions, including strokes, concussions, and other physically damaging incidents.

What about using this approach on companion animals with behavior problems? Certainly, human and animal brains share great similarities and are merely variations on a theme. So, the question is not that far-fetched.

TRAINING THE BRAIN THROUGH NEUROFEEDBACK In my practice, I’ve always told clients that I never use anything on animals that I have not used on myself. I still follow that philosophy, and have been using an advanced type of neurofeedback device on myself for almost a year. The results have transformed me from a cynical skeptic to an ardent fan.

Essentially, the device uses the power and intelligence of your own brain to improve the latter’s function. My instructor feels that neurofeedback should be a key part of a wellness program and I can sense the truth in this after ten months of using the device.

Many people train their muscles and cardiovascular systems, but not their brains. Training your brain can increase flexibility and resilience, qualities I feel all beings can benefit from. It can make it easier to work through the challenges life throws at us. People report feeling calmer, more focused and patient, and less reactive. They experience improved memory, more energy, increased resilience, and better sleep.

To be clear, a “brain training session” is not a “treatment” because it’s non-invasive and not a medical tool. There are no diagnoses or protocols. In other words, neurofeedback is a non-medical brain-training system with therapeutic effects.

Amazingly, an advanced neurofeedback device measures the electrical current emitted from your scalp 256 times/second, then uses a mathematical procedure to recognize any shifts.

When shifts occur, it provides feedback to your brain in the form of interruptions in the music playing through the device.

Additional fascinating examples of neuroplasticity in action Interestingly, a teacher I follow and admire pioneered sound healing in his brain research in the 1980s. He developed his own musical recordings for his psychotherapy clientele, which significantly improved his results. Perhaps these approaches with sound healing may help deepen connections between human and non-human animals, whereby both are helped by these unique, innovative, computerized approaches (if interested in learning more, email me at schoenoffice@gmail.com).

This neurofeedback device doesn’t create or stimulate new neural pathways. Instead, it helps a person leave behind nonoptimal neural pathways. As the saying goes, if “you don’t use it you lose it,” so eventually a human who is training their brain won’t use the non-optimal neural pathways anymore.

It helps them become more and more aware of these nonoptimal pathways. Training is key here. The more a person trains, the more the results last.

On a related note, the study of subtle energies shows they can impact neuroplasticity and relate to the human animal-bond in their own way. Valerie Hunt, a former research physiologist and professor at UCLA, discussed these subtle energies in her book Infinite Mind: the Science of Human Vibrations.

To paraphrase Nikola Tesla: “When we see all as a field of energy, frequencies and vibrations, we will make stratospheric leaps.”

This is indeed neuroplasticity in action, as it allows your brain to continuously adjust. Can you see how this might resolve some undesirable behaviors in our companion animals?

Once we realize that human vibrations interact with animal vibrations, we can experience an “aha” moment regarding another level of the human/ animal bond. This year, I lectured on this topic by discussing the interactions between the liquid crystal collagen continuum of consciousness, and acupuncture. I explained one mechanism of action of the healing effects that occur when we touch patients with positive intentions.

THE ROLE OF THE ORIENTING REFLEX The neurofeedback device helps the brain organize and heal itself. It partners with the brain to make changes so no formal diagnoses or scans are required. The device and your brain do the work together in real time.

For those veterinarians who thought the world was a rational and predictable place, recent developments in quantum physics and how it interacts with animal care may come as a surprise. The combination of quantum physics and psychophysiology, the interactions between our mental experience and neurologic activity within our nervous system, is revealing a world that actively interacts with our intentions. In other words, what we think and feel has an effect on the world around us, including our animal families.

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Our “orienting reflex,” another type of neuroplasticity, is put to work every time the neurofeedback system generates a pause in the music. These pauses occur at critical moments to get the best results. The orienting reflex is key to understanding how the device works. This important feature of our own individual CNS is why it’s possible for a person to make changes by themselves, without the need for interventions such as microcurrents, various frequencies, or light therapy.

The orienting reflex helps a person move away from discomfort to comfort. It is up to the individual’s CNS to decide if the abrupt changes and turbulences detected by the system as it interacts with their own cortical activity are comfortable and safe, or uncomfortable and unsafe.

Neurofeedback results vary D EPENDING ON INDIVIDUAL BRAINS Each brain is unique, so the number of sessions required to see specific results will vary. Shifts can happen quickly or in small increments, depending on the individual’s brain. This is where working with an experienced neurofeedback instructor is beneficial. If this resonates with you, you can choose to train to become that instructor for your own clients and patients.

How long certain brain changes last will also vary depending on your goals and experiences.

Some people may feel they don’t need further sessions, while others prefer to return periodically for boosters.

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HOW DOES THIS APPLY TO OUR ANIMAL PATIENTS? Interestingly, there is anecdotal evidence that some of these computerized neurofeedback approaches are helping companion animals as well as humans. In Europe, for example, they have been used to successfully calm down nervous and anxious horses whose behaviors likely resulted from previous harmful experiences.

The device I have been using was originally designed for humans, yet some trainers around the world have begun using it with their animal companions. These trainers organized a community support group that demonstrates positive and impressive results with dogs, cats, and horses.

Using a neurofeedback device is not a conscious process and requires no active participation from the individual. Therefore, working with an animal’s brain is really no different from working with a human brain. Certainly, there are challenges in adjusting its use to animals, which aren’t dissimilar to the challenges I ran into when extrapolating electro-acupuncture to animal decades ago.

PILOT PROJECT SHOWS BENEFICIAL RESULTS A friend who is also a neurofeedback trainer for people tried it out on animal companions in our community and found it was indeed beneficial in situations where nothing else seemed to help. They conducted a small four-week pilot project on dogs and two cats using the advanced neurofeedback device I have been using on myself. The trainer went to the animal owner’s house once a week for 15-minute sessions that were increased to 30 minutes if they felt the animal would not be overwhelmed.

Initially, the study group has been small, with five canine participants, and two cats owned by the trainer. For this particular project, the trainer was looking for animals that displayed anxiety, as well as senior animals entering the palliative care phase of their lives.

In the assessment questionnaire, similar to that used for people yet adapted to companion animals, owners were asked to observe the shift, duration, intensity, and frequency of their concerns. They were also asked questions regarding their animals’ physical and emotional health. The focus was on training, behavior, reaction to other animals or humans, signs of aggression, fear, sleep patterns, vocalization, pain, injury, anxiety levels, and attention, as well as hunger levels and exercise.

The owners observed their animal during the week and noted what happened to see if there were any changes as compared to their original concerns.

Often, shifts can happen in small increments and be easily missed. Each pet owner could use assistance from a friend to evaluate the changes occurring in their animals from week to week. For instance, an owner might not be able to see subtle changes, but a friend might notice their dog is calmer.

In one case, neighbors who met an anxious dog daily on the street noticed she was calmer and asked the owners what they were doing. The dog was also more at ease when meeting other canines and had stopped jumping on the owner’s other dog, who had health issues. Dogs in the program with similar issues also responded well. In fact, all the animals in this pilot project showed some improvement overall.

Some dogs exhibited yawning and licking during the sessions, which can indicate they were processing the information. Some were so anxious that a licking pad was needed to keep them occupied during the session, as they were not able to settle down at the beginning. Even when treats were needed to keep a dog occupied, they still improved.

Some were noticeably calmer after the first session, and some were the same, yet positive and steady results were noticed during the first week. By the third week, it was more obvious to owners that their dogs had improved, changed, and adapted to situations or concerns mentioned in their first assessment forms. This occurred despite no dietary changes, training, or supplements.

A couple of the dogs in the study were helped with separation anxiety issues. Another example that involved quite different

complaints was an older Rhodesian Ridgeback with urinary incontinence and severe polydipsia which was not responding to appropriate conventional treatments. The signs completely resolved during the program, improving even after just one neurofeedback treatment.

NEUROFEEDBACK AND CATS You may be wondering about cats as well. The trainer tried the neurofeedback approach on their own two anxious rescue cats. They found the cats were relaxed about being hooked up to the system and didn’t require treats. They underwent the sessions while napping and were quite cooperative.

However, the results appeared to be highly individualistic, even between just two cats. One shook off the ear connections within seven to ten minutes, while the other tolerated them for 15 to 30 minutes. This bears similarities to my own experience when pioneering feline electroacupuncture: the cats would shake off the wires when they were done. Following the sessions, the trainer also noticed the cats were not fighting with each other as often.

While these findings are certainly considered anecdotal, one has to start somewhere. A significant collection of similar anecdotes can indicate a pattern. Whether in conventional medicine or Traditional Chinese Medicine (TCM), patterns are the basis for collecting related symptoms to be considered and classified as a condition.

IN CONCLUSION These unique perspectives on neuroplasticity in companion animals offer innovative approaches that may help many abandoned animals with behavior problems, providing another option besides euthanasia. It does not seem unreasonable to offer these approaches as a possible solution and consider trying them with appropriate patients.

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INTEGRATIVE APPROACH

to partial paralysis/ paresis in canines

BY AYSE WASHINGTON, DVM, CCRP, CVMMP

A combination of conventional therapies and alternative treatments such as PEMF, acupuncture and ozone therapy provides an integrative approach to managing partial paralysis and paresis in canines.

Mobility is one of two predominant methods clients use to assess the health of their dogs, with the other being appetite.

Some owners are very attentive to changes in their dogs’ gait, while others only notice significant deterioration, such as an inability to rise or walk. Frequently, gait changes are associated with pain, leading clients and practitioners alike to assess quality of life concerns.

However, from a neurologic standpoint, pain is only a single indicator of neurologic or musculoskeletal dysfunction. Paresis or weakness in muscular response, and paralysis or absence of muscular response, can involve either painful or non-painful conditions. Because pain assessment can be challenging in patients who cannot voice their discomfort, both clients and practitioners fall back on function as an assessment of quality of life and therapy success. In this article, we focus on taking an integrative approach to partial paralysis/paresis in canine patients.

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LOSS OF MOBILITY A COMMON REASON FOR EUTHANASIA Mobility is among the factors on the quality of life scale that practitioners refer their clients to when making end-of-life decisions.

One survey listed “weakness due to old age” as second only to cancer for the reason clients sought euthanasia. While much focus has been centered around controlling pain, the significant role mobility plays in determining whether or not a client chooses euthanasia suggests a need for moving beyond pain management and including function as a terminal endpoint. As such, a wide range of modalities that target improvement in muscular and neuromuscular outcomes is key.

CAUSES OF PARESIS AND PARALYSIS IN DOGS Paresis and paralysis are complex conditions and can be the sequelae of multiple and varied causes. Among well-known underlying conditions are spinal, peripheral nerve or orthopedic trauma, and degenerative conditions such as degenerative myelopathy or axonal degeneration, intervertebral disc disease (which in and of itself is a broad category with multifaceted pathophysiologies), autoimmune conditions and toxin exposure. Although there are many ways dysfunction can occur, these conditions are similar in that they include a lessening or loss of neurologic stimulation, and/or a reduction or loss of the ability of the myofibril to respond to the stimulation.

INTEGRATIVE TREATMENT OPTIONS • Neuroprotective treatments include the use of pharmaceutical and non-pharmaceutical anti-inflammatories. NSAIDs, steroidal anti-inflammatories and pulsed electromagnetic field (PEMF) therapy are all labeled as reducing inflammation. Pharmaceutical anti-inflammatories block the formation of prostaglandins to reduce the inflammatory response that causes pain and can lead to tissue damage and dysfunction. Newer NSAIDs aim to limit the bulk of their effect to the suppression of Cox2 while sparing the physiologically beneficial Cox1. The degree to which this effect is achieved is dose dependent and based on the sensitivity and physiology of the individual patient.

• Glucocorticoids are steroidal anti-inflammatories that suppress all the inflammatory pathways. This results in more

complete inhibition, not just of pain, but also immune system response to tissue damage. Due to their broad immune and tissue suppressive effects, glucocorticoids have been avoided when a dog simply seems “painful”.

However, some studies have shown that in the early

treatment phase of certain neurologic conditions such as trauma or IVDD, glucocorticoids, particularly methyl sodium succinate, can offer a neuroprotective component combined with pain management. Nevertheless, consensus on using steroids in the management of IVDD is very controversial. In the case of compressive effects from neoplastic lesions, corticosteroids may afford temporary relief from pain through tumor suppressive effects and reduced pressure to the nerve.

• PEMF therapy can help reduce inflammation by increasing the nitric oxide (NO) response to tissue damage. NO increases blood flow via the binding of calcium to calmodulin receptors. PEMF can also reduce interleukin, interferon gamma and tumor necrosis factor, which can exert a neuroprotective effect and promote musculoskeletal healing.

This combination of effects not only helps modulate pain, but also reduces the cascade of damaging events that can exacerbate a loss of function.

• Acupuncture is a widely known adjunctive therapy that is gaining popularity even among allopathic practitioners.

The stimulation from acupuncture needles modulates many autogenous biochemical molecules to affect physiologic pathways. These include the aforementioned Cox2, interleukin and TNF. Acupuncture promotes normalization of the parasympathetic and sympathetic nervous systems through modulation of neurochemicals.

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DIAGNOSING CAUSES OF PARESIS AND PARALYSIS Diagnosis often starts with imaging that includes skeletal structures, joint spacing and alignment.

Much of the soft tissue detail is missing in traditional radiographic images. Nerves, tendons, ligaments, and soft tissues that make up the disc spaces, as well as the muscles themselves, cannot be visualized radiographically. Contrast dyes have been used to delineate the negative spaces between these tissues to get an idea of potential compressive forces — at least along the spine.

• CT scan and MRI techniques provide a better look at the soft tissue structures, but cannot inform whether a nerve impulse is traveling properly, or if the sarcomere is responding to such stimulation.

• Electrical myelography and nerve conduction studies can determine if the nerve impulse is traveling properly, and what the muscle response to stimulation is, but they cannot give the reason for an irregular response.

• Antibody testing against muscles, neurotransmitters, nerves and hormones can provide information that explains why neuromuscular stimulation is not working properly, and can guide treatment recommendations.

• In many instances, a final diagnosis may require biopsy and histopath of the tissues, some samples of which are not available in the antemortem state.

Often, based on the complexity of the case, and/or limitations in diagnostic options, a definitive diagnosis is not obtained, and a presumptive diagnosis is the basis for determining treatment protocols.

In many cases, the most common rule-out based on symptoms and location of lesions is used to determine initial treatments.

Further diagnostics can be pursued if there is little response to treatment. However, the immediacy of therapeutic intervention can greatly impact the rate of successful response to treatment. Therefore, even while diagnostic steps are being taken, some degree of neuromuscular support, particularly with respect to preventing oxidative damage, should initially be considered.

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lectrical acupuncture causes elevations in Gaba, dopaE mine and serotonin, which both elevate mood and reduce neuropathic sensations. Acupuncture increases endocannabinoids, and endogenous opioids help modulate pain.

These neurologic changes can impact mobility by reducing pain and improving the willingness of a patient to try to get up and move, even when challenged by weakened muscles, nerve input or pain.

• Ozone and prolozone are lesser-known techniques for reducing inflammation, addressing localized tissue pain and stimulating tissue healing. Ozone and prolozone refer to the use of the ozone molecule to stimulate a cascade of pathways that result in enhanced antioxidant levels.

Ozone is an oxygen molecule that contains three atoms sharing covalent bonds, rather than the usual two atoms.

The presence of the third oxygen atom creates stress on the electron position, such that the entire molecule is reactive and looking for another electron to balance the positions.

Infusion of ozone causes the formation of a very small number of free radical and lipid peroxidases. Although the small number of reactive oxygen species molecules is quickly neutralized, this minor stimulation promotes an increase in production of antioxidant molecules, including glutathione and superoxide dismutase. This means that when ozone is used as a treatment local to the area of pain, it can enhance the body’s natural healing processes and potentially lead to improved outcomes for canines suffering from partial paralysis.

CONCLUSION Integrative approaches to managing partial paralysis in canines highlight the importance of combining conventional therapies with innovative treatments. These methods not only reduce inflammation and pain but also promote tissue healing.

By utilizing a comprehensive strategy that includes PEMF, acupuncture, and advanced therapies, veterinarians can offer an integrative treatment plan that addresses both symptoms and underlying causes. As research continues to support these integrative practices, pet owners can look forward to improved recovery options for their canine companions, ultimately enhancing their quality of life and mobility.

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Duralactin is a well-tolerated alternative for the long-term management of musculoskeletal and joint conditions. This includes osteoarthritis, especially in geriatric animals.

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Research shows that Duralactin effectively reduces inflammation and improves mobility in animals suffering from chronic joint pain.

In one study, 68% of dogs treated with MicroLactin demonstrated overall clinical improvement, while only 35% of the placebo group improved.

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It improves patient outcomes, and can lead to more satisfied clients and greater retention.

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TRAINING REQUIREMENTS:

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You can download details on the use of Duralactin, including a technical monograph and client brochures, from the company website.

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• Reduced pain and inflammation • Better overall quality of life, without the side effects of traditional anti-inflammatory medications.

duralactin.com

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nutrition nook

PANCREATITIS IN PETS

— an integrative and nutritional approach

BY NANCY BRANDT, DVM, OMD, CVC, CVA, CVMA

An in-depth look at the most effective integrative and nutritional therapies for treating and preventing pancreatitis in dogs and cats.

Pancreatitis is becoming more common in the pet population.

From a Western perspective, the primary cause is thought to be too much fat in the diet. Is it possible it goes deeper than that? This article looks at how pancreatitis in dogs and cats can be treated and prevented using an integrative approach, with emphasis on the importance of an evolutionary carnivorous diet.

DOGS AND CATS ARE DESIGNED TO EAT A CARNIVOROUS DIET In nature, both cats and dogs are carnivores.1 The anatomy of their temporal mandibular joints and musculature supports a carnivorous diet, as do the type and number of teeth. The gastrointestinal tracts of dogs and cats are also those of a carnivore.

As carnivores, cats and dogs are designed to eat the whole prey animal. Predigested and fermented carbohydrates, digestive enzymes and probiotics are all found in the entrails of a kill. Carnivores also eat all the organs, including the pancreas

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and gallbladder, which helps them digest the rest of the animal. The gut microbiome of a wild carnivore is very healthy, and not sterile as it would be on processed food, which means their gut is much better at digesting all proteins and fats. Wild canines will bury bones and allow them to ferment in the soil to eat later. Yet they do not get ill.

This is how a predator is designed to eat. They will hunt for days without eating, and then binge. They will eat whatever is available. Carnivores eat the whole animal and then fast again for days as they hunt. They are slim. Their digestive systems have a break to finish digesting before their next meal. Even though predators do binge eat, and are gluttonous at the time of a kill, they do not do this twice a day every 12 hours apart.

CASE REPORT THE IMPORTANCE OF FASTING IN CARNIVORES Fasting is a normal part of the carnivore diet. Proteins and fats take a bit longer to digest, so ideally pets should not be fed every day even if they think they should. What we see as hunger is hunting behavior. In nature, carnivores return to where they last found food. This is smart — and predators have to be smart to find food.

Begging is a form of hunting and most domesticated pets use it to their advantage. The cat that wakes you at 3am and gets fed, will wake you again at 3am to be fed. The dog that runs to the bowl or barks for food is hunting. Make it harder for them. One study shows that hunting stimulates digestive enzymes and prepares the carnivore to digest their food.

Play games with your pets. Take them for a walk before they eat and again afterwards. Break your habit of feeding them when they “ask for it.” In nature, food does not show up on a schedule.

Feed them once a day instead of twice. Mornings are best as predators would hunt in the morning then rest until the next hunt. If your pet stops eating, they might be self-imposing a fast. With obese dogs, I will often feed bone broth only for five to ten days to jumpstart their metabolism to lose weight.

Sammie was a 45-pound dachshund who could not roll over. He came in at three years of age with mobility problems his owners wanted acupuncture for. After a lot of discussion about weight loss as the way to help Sammie’s mobility issues, the guardians agreed to fast him for ten days on bone broth. They had been feeding him a dry weightloss formula that had not helped.

Both guardians were elderly, so for exercise we put pieces of 2x4 wood across areas in the house where Sammie had to walk, such as the hallway, and used food at either end to get him to move.

This routine also helped Dad become more mobile and gain better balance.

At ten days, we began to feed Sammie cooked turkey at 2% of his goal body weight of 11 pounds.

Over the next three months, we introduced a more balanced diet that was raw and carbohydratefree. At one year on this diet, Sammie weighed 20 pounds and ran around like a puppy. At 1.5 years, he reached his goal weight of 11 pounds and lived pain-free until 18 years of age. Every month, his guardians fasted Sammie for seven days with bone broth, and fed him an evolutionary-appropriate diet with fat instead of carbs as the fuel source.

FASTING AND CATS For cats, fasting for 24 hours is as long as I will go. Otherwise, if they lose weight too fast, they develop hepatic lipidosis. I will slowly convert them to an evolutionary-appropriate diet over one to three months. Portion control and 24-hour fasting once a week will significantly decrease weight in cats. I do warn guardians that if their cats go on a hunger strike, to let them have the food they like and go back to mixing in the new food even more slowly. Cats are more prone to getting addicted to the post-carbohydrate endorphin release.

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Treatment post pancreatitis and/or preventing pancreatitis This process must include repair and maintenance of a healthy gut or Spleen Qi. Since both dogs and cats are carnivores, I try to use food and supplements rather than only herbs to correct the digestive system.

1.

Change the pet to their evolutionary appropriate diet.1

2.

Start them on good digestive enzymes designed to break down proteins and fat, not just carbs.

3.

Start good soil probiotics or even do a fecal transplant (test feces first to see what would be the best complement).

4.

Give a fermented mineral and vitamin supplement to complement the missing parts of the diet (Cell Aid).

5.

6.

Use a product to help repair the gut lining (e.g.

Thorne or RxVitamins).

7.

8.

Fast the pet at least once a week for 24 hours in a row.

Give cow bile to help to emulsify fats for easier digestion (Standard Process Cholochol works well).

Limit the amount fed to 2% of an adult’s body weight and adjust per weight gain or loss.

Use the digestive culinary essential oils mentioned in the article for absorption: 0.5-1 drop per meal.

9.

10.

11.

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Essential fatty acids must be supplemented in any type of diet and should not be avoided.

EFAs are strongly anti-inflammatory, and are needed for repair of all cell membranes and many enzyme systems.1 Take the pet hunting or at least for a walk.

Get those digestive juices flowing before feeding them.

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PANCREATITIS AND THE EVOLUTIONARY DIET — A TCM PERSPECTIVE A true holistic approach to pancreatitis is feeding pets their evolutionary diet, repairing their microbiome, and feeding supplements that make up for the lacking parts of a whole animal, such as ferments. If a pet has pancreatitis, TCM diagnosis is usually Stomach Heat with Spleen Qi deficiency. Stomach heat in TCM terms means food in the stomach is not digesting; instead, it is heating up and fermenting. Stomach Heat creates extreme hunger, halitosis and even dental disease.

Spleen Qi deficiency is a lack of overall digestive, absorptive and cellular respiration ability. Knowing the TCM pattern tells us to fix the gut and stop giving food that is difficult to digest.

Dry food, regardless of what it is made with, is very Hot food and taxing on the gut. Mixing dry food with canned or raw food makes it impossible for either to be digested and does not increase the nutritional complement. Dry food and other commercial non-fresh foods usually contain rancid fats or vegetable-based fats that make them very difficult to digest.

Restricting fat in carnivores can be detrimental to many repair mechanisms. Add bile to the diet to help digest fats. Add apple cider vinegar to increase acid in the stomach to help digest proteins, especially if the pet is on acid blockers or protein pump inhibitors. Give dogs and cats food they were meant to digest.

GOOD VS. BAD FATS FOR CARNIVORES Not all fats should be avoided — only the bad fats. Carnivores must have animal fat in the form of linolinic acid. Low fat and vegan diets will not offer good fats. Do not feed super lean meats only, as they will not contain the needed fats.

Adding cow bile, not just digestive enzymes, is crucial to digesting and breaking down fats and allowing good absorption. In the TCM world, both chicken and lamb are Hotter foods, so avoid them. Turkey on its own will not have enough fat and neither will fish. So grass-fed beef or bison should be part of the diet. Avoid all vegetable-based fats as they cannot be broken down well and tend to go rancid in commercial foods.

From the AHVMA TREATING PANCREATITIS Treatment during pancreatitis should include IV fluids, NPO and antibiotics, as this condition could lead to death.

We should also include topical castor oil compresses over the liver and pancreas using biologically active essential oils of peppermint, coriander and ginger (five drops of each into every 10ml of castor oil — use organic cotton sheets to make the compress).

Place the compress on the area and then wrap the pet in a compression shirt to hold the compress in place for ten to 30 minutes. Do not let the pet lick the oil afterwards; it has pulled out toxins and should not be ingested. Bathe the pet in a chemical-free soap to remove the oil.

Do this two times a day for the first three days, then weekly for two to three months to clear the inflammatory reaction in the abdomen. When the pet is able to take in food, it should be bland and Cooling in TCM nature. Rabbit blended with sprouted quinoa is a good choice.

At this point, oral essential oils that are biologically active and labeled as safe for ingestion may be used. Culinary oils are best, like ginger, peppermint, spearmint, coriander, fenugreek, cumin, etc. Dilute these in coconut oil (which is Cooling) to 25% and rub one or two drops per 25 lbs of body weight on the gums twice a day to settle the digestive system.

From a TCM perspective, fats are not the villains when it comes to pancreatitis in dogs and cats. Feeding a carnivorous evolutionary diet, along with implementing the integrative modalities and therapies outlined in this article, can be an effective way to help treat and prevent this increasingly common disease.

Brandt, Nancy, Evolutionary Feeding of Pets, 2017. www.safe4animals.com

1

The mindful leader elevating the veterinary profession through innovation, education and advocacy of integrative medicine.

Thank you to all attendees, sponsors, and exhibitors of the 2024 AHVMA Annual Conference and Exhibition! We received positive feedback from all who attended.

For the first time, AHVMA is partnering with MBS to bring you a recorded virtual extension of the conference.

It gives both attendees and non-attendees of the in-person conference the opportunity to earn continuing education credits from the recorded lectures. Registrants of the virtual extension will have access to CE for all sessions until December 31, 2024. Access to the recordings will be available until August 31, 2025.

NEXT YEAR’S ANNUAL CONFERENCE Save the dates for the 2025 AHVMA Annual Conference and Exhibition. It will take place in West Palm Beach, Florida from September 6 through September 9. Expect over 90 hours of complementary and integrative CE sessions, hands-on labs, and special events. Over the past eight years, AHVMA has applied for and received AAVSB RACE approval for over 80 hours of continuing education.

AHVMA will be returning to the Palm Beach County Convention Center and Hilton West Palm Beach. The Hilton is conveniently connected to the Convention Center via a covered walkway.

EXHIBITORS AND SPEAKERS FOR THE 2025 CONFERENCE Current exhibitors and sponsors should receive a copy of the 2025 AHVMA Exhibitor Prospectus very soon.

Please contact the AHVMA office if you have any questions. For all other exhibitors, registration will begin in 2025.

For speakers, the Conference Program Committee is no longer accepting submissions for the 2025 conference.

However, the 2026 Call for Papers portal will open in May 2025.

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BY MARLENE SIEGEL, DVM

AN INTEGRATIVE APPROACH FOR TREATING ORAL CANCERS IN DOGS AND CATS Oral cancers can be aggressive and challenging to treat, but an integrative approach that incorporates alternative therapies can extend longevity and improve quality of life.

Cancer is not an outside enemy that invades the body. It is the patient’s own cells going rogue because the conditions (terrain) have become inhospitable. This article focuses on oral cancers in dogs and cats, and how an integrative approach to treatment can enhance a patient’s quality of life and give them more time with their owners.

ALL CANCERS RESULT FROM A COMBINATION OF FOUR CONDITIONS 1. Deficiencies of essential nutrients the body needs to function properly. These include vitamins, minerals, fatty acids, and amino acids.

2. Toxicities to a level that overwhelm the body’s organs of elimination, resulting in “dis-ease”.

3. Mitochondrial dysfunction, resulting in inadequate energy production (ATP) and inhibited communication with the microbiome.

4. Trapped emotions, which have been shown to be associated with all dis-ease. The tumor type, its location in the

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pet’s body, and the owner’s emotional state all have significance. Oral tumors may be associated with owners that are closed-minded and find it hard to receive new ideas or express their needs and desires.1 In most cases, a combination of deficiencies and toxicities play a part in cancer development.

ORAL CANCER IN PETS, ESPECIALLY DOGS, IS COMMON Statistics in dogs: • Oral tumors make up 6% to 15% of all tumors in dogs.

• Melanomas are the most common, accounting for up to 30% of cases.

• Melanomas are highly aggressive tumors with a strong likelihood of early metastasis (primarily to lymph nodes and lungs) in 50% to 80% of cases.

• Squamous cell carcinoma (SCC) is another frequent neoplasm, representing 25% of oral tumors. SCC is also known for its aggressive local invasion.

• Fibrosarcomas in dogs are somewhat less common than melanomas and SCC but are still significant. They are

locally aggressive and often affect older dogs. Oral fibrosarcomas account for up to 8% to 10% of all oral tumors.

They are typically locally aggressive and often infiltrate surrounding tissues and bone, making complete surgical removal challenging. They have a high tendency to recur locally even after surgery. Certain large breeds, like Golden Retrievers, are more predisposed.

Statistics in cats: • Oral tumors account for 3% to 10% of all tumors.

• Squamous cell carcinoma (SCC) is the most common, making up 70% of cases. It is extremely aggressive with the potential to cause significant destruction to nearby tissues, including bone.

• Fibrosarcomas in cats, though less common than SCC, are the second most frequent type. As in dogs, feline fibrosarcomas are aggressive but tend to metastasize later than other types. They commonly affect middle-aged to older cats. Fibrosarcomas are sometimes associated with injection sites, especially vaccines, making this a unique risk factor for feline cases.

Other types of oral tumors in pets: • A canthomatous ameloblastoma (previously called acanthomatous epulis): A benign but locally invasive tumor arising from the periodontal ligament. It typically affects the gums, particularly in a dog’s lower jaw. Although benign, it can invade the bone and cause significant oral discomfort, requiring surgical removal.

• P eripheral odontogenic ribroma: Another benign tumor formerly categorized under “epulis,” arising from periodontal tissues. It grows slowly and is less invasive than acanthomatous ameloblastoma. This tumor generally affects the gums and is more common in older dogs.

• O steosarcoma of the jaw: Though osteosarcoma commonly occurs in limbs, it can also affect the bones in the jaw. Oral osteosarcoma in pets is particularly aggressive and can invade local structures, with a risk of metastasis to the lungs and other organs.

• C hondrosarcoma: A rare type of cancer that arises from cartilage cells and can occur in the jaw or other areas of the skull. It tends to be less aggressive than osteosarcoma but can still invade nearby tissues and cause discomfort.

• U ndifferentiated sarcomas: These less common, aggressive soft tissue tumors can originate in various oral tissues.

They are challenging to classify under standard types and may have varied behaviors depending on their location and growth patterns.

• P apillomas: Usually benign growths caused by papillomavirus. They appear as small, wart-like lumps in the mouth, often in young dogs. Although not malignant, they may cause irritation or lead to infection.

Early cancer detection is crucial, as the five-year survival rate for pets with untreated oral cancers is less than 20%. With an integrative approach, however, survival rates and quality of life can improve dramatically.2

WESTERN APPROACH TO DIAGNOSING AND TREATING ORAL TUMORS Diagnosis typically involves: • A thorough physical exam • Preoperative blood work (CBC, chemistries, thyroid and UA) • A fine-needle aspirate or biopsy of the mass • Imaging (X-rays, CT, or MRI) may be warranted to evaluate the extent of bone involvement and dissemination of the mass.

Surgical resection is the primary treatment for many oral tumors in pets and aims to remove as much of the tumor as possible with clear margins. In some cases, this involves a mandibulectomy or maxillectomy (removal of part of the jaw).

While somewhat effective, this can lead to disfigurement, pain, and reduced quality of life, deterring many pet owners from pursuing it.2 For pets diagnosed with melanoma, fibrosarcoma, or squamous cell carcinoma, survival outcomes vary depending on the type of tumor and the treatments used: 1. Melanoma: Surgery is the primary approach for controlling local melanoma tumors in Western medicine, with dogs often achieving one to two years of survival if complete resection is possible. However, due to melanoma’s high potential for spreading, chemotherapy and radiation may add limited survival benefits, generally extending life by six to 12 months post-treatment.3 2. Fibrosarcoma: In Western medicine, surgical removal is also standard for fibrosarcomas. If wide margins are obtained, survival may extend to one to two years, but local recurrence is frequent. Radiation therapy can be used if surgical margins are insufficient. Chemotherapy generally

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has limited impact on survival for fibrosarcomas, unless there is a high risk of metastasis.3 3.

Squamous cell carcinoma (SCC): Outcomes depend heavily on the cancer’s location. In oral SCC, early surgical intervention can lead to survival of one to two years, with radiation providing additional control if resection is not complete. Chemotherapy may be used to address metastatic concerns, but its effect on survival varies.3

SUMMARIZING AN ALTERNATIVE APPROACH TO CANCER THERAPY 1

ake a thorough history, including past health challenges, T diagnostics, and therapeutic outcomes.

Assess the owner’s belief systems and emotions

2 regarding the journey ahead with their fur baby. Owners

who are optimistic, coachable, open to learning and have a positive outlook tend to have better outcomes than pet parents who are “victims,” stuck in fear, anger, blame, shame or frustration.

Complete a thorough physical exam — from the tooter

3 to the snooter.

ocus on improving the lifestyle factors (epigenetic 4 Finfluences) that have contributed to the dis-ease. These

include diet, digestion, environmental toxin exposures, electromagnetic frequencies. and reframing negative beliefs the owners may exhibit.

Do thorough diagnostic tests (same as in Western medi-

5 cine) and identify deficiencies and toxicities.

6 Supplement the essential nutrients.

7

upport detoxification of all organs of elimination (kidS ney, colon, lungs, liver, skin, and lymphatics/fascia).

Support the natural anticancer pathways in the body.

8 This involves supplements and targeted therapies:

Nitrilosides (vitamin B17), Salvestrols, beta-glucans, ozone, HBOT, light therapy, assisted lymphatic therapy, fascia decompression and more.

Support mitochondrial biogenesis (makes more and

9 stronger mitochondria for maximum energy production and communication with the microbiome).

Introduce targeted cancer therapies. The goal is to

10 choose safe and effective therapies that allow the patient to maintain quality of life.

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When surgery does not completely clear the tumor, or if it is inoperable, radiation therapy may be used, though it has side effects such as tissue damage in surrounding areas. Chemotherapy is another option, especially for aggressive melanomas, but is often not curative.2

A BIOREGULATORY APPROACH TO ORAL CANCER IN DOGS AND CATS This approach tests for everything a Western practice does, but also seeks to identify and resolve the root cause(s): • C ancer markers: Thymidine Kinase 1 (TK1) is involved in cellular proliferation through the recovery of Thymidine in the DNA salvage pathway. TK1 is a good marker for identifying growth in certain cancers, as it is elevated in actively dividing tumors. It is also a useful marker for monitoring therapeutic efficacy. As the tumor burden goes down, so does TK1.

• S ystemic inflammation: Canine C Reactive Protein (cCRP) measures inflammation.

• N utrient deficiencies: Vitamin D and magnesium play a vital role in the innate immune system. University studies have shown that 85% of animals eating a kibble diet are vitamin D deficient. Having done nutrient testing on thousands of animals over the last five years, I found that almost 90% of tested animals eating a kibble diet had multiple significant deficiencies in nutrients, including zinc, selenium, calcium, copper, vitamin D, magnesium and B vitamins.

• T oxicities: Over 85% of the animals I tested for heavy metals (arsenic, mercury, lead, cadmium, strontium, and antimony) had significant elevations in four or more heavy metals.

• G lyphosate: This chemical is toxic even at low levels, melting the actin filaments in the tight junctions and inhibiting mineral absorption. Every animal I have tested has been positive for some level of glyphosate.

• M utations in oncogenes and tumor suppressors: This is a new concept in veterinary medicine. Canine tumors share mutational hotspots with human tumors in oncogenes, including PIK3CA, KRAS, NRAS, BRAF, KIT and EGFR. Companies then study what chemotherapeutic drug is most effective against the gene mutation, guiding the treatment options with more precision. The downside of this technology is that, at this time, only chemo drugs are being studied for efficacy against various gene mutations. I trust that in the future, biomarkers will be found that allow testing on safe and effective alternative therapies as well.

THE EXPANDED CANCER TREATMENT TOOLKIT The traditional “toolkit” (surgery, chemo and radiation) are insufficient to meet the challenges of today’s turbo cancers.

Following are some other safe and effective options: 1. Ozone therapy: Thousands of published articles cite the use of ozone in cancer therapy. Ozone therapy turns on over 200 anti-inflammatory pathways, can improve oxygenation, and stimulate the immune response. Improved cellular oxygen levels result in an environment less favorable for tumor growth. Common methods of administration include intravenous (MAHT), intramuscular (mAHT), intralesional, subcutaneous and rectal.

2. Photodynamic therapy (PDT): PDT uses a photosensitizer (like curcumin, riboflavin, indocyanine green or vitamin C, to name a few) that is taken up by the abnormal cells. When the specific wavelength of light that activates the compound is introduced, it makes the compounds more enzymatically active. This results in free radicals that induce cancer cell death. Research has shown that PDT can also stimulate immune cells such as neutrophils and macrophages, potentially boosting the body’s natural defenses against cancer. This immune-stimulating effect makes PDT appealing in integrative cancer care.5 3. Methylene blue: Systemic use in cats is limited. Traditionally used to treat methemoglobin, methylene blue can cause toxic effects including haemoconcentration, hypothermia, acidosis, hypercapnia, hypoxia, increases in blood pressure, changes in respiratory frequency and amplitude, corneal injury, conjunctival damage, and Heinz body formation. However, it can be used topically in dogs and sparingly in cats with oral tumors due to its photodynamic activity. Methylene blue is activated by specific wavelengths of light, which produces reactive oxygen species that can selectively destroy cancer cells. It also activates the fourth activation center in the Krebs cycle, improving mitochondrial activity. Using methylene blue topically is being increasingly explored in oncology for its lower toxicity, making it useful for delicate areas like the oral cavity, where many traditional therapies pose higher risks.4 4.

Hyperbaric Oxygen Therapy (HBOT): When used in conjunction with antiangiogenic supplements, HBOT

improves oxygen concentration levels, making the environment less favorable for cancer tissue to grow.

5. Supplements: Those that target anticancer pathways are effective adjunct therapies. They include Nitrilosides like B17, Salvestrols (natural phytochemicals produced within plants — these are metabolized by the CYP1B1 enzyme which then produces anti-cancer metabolites), mushrooms, CBD, low dose Naltrexone, and mistletoe.

6. Immune modulation: Therapies that stimulate the immune system to recognize and attack cancer cells are increasingly used in veterinary oncology. By enhancing the immune system’s detection of cancer, immune modulators can help slow disease progression, particularly in combination with other treatments that target tumor cells directly.

7. Targeted gene therapy: This approach aims to correct or modify genetic mutations that drive cancer growth.

Targeted gene therapy has shown potential in reducing tumor growth by delivering therapeutic genes directly to cancer cells, leaving normal cells less affected. This specificity minimizes the adverse effects seen with broader treatments like chemotherapy and radiation.

8. Checkpoint inhibitors: These drugs block proteins that tumors use to evade immune detection, helping T-cells attack cancer cells. They are being explored in veterinary medicine, showing promising results in dogs, particularly for melanoma.

9. Immunotherapy: This approach utilizes the body’s immune system through various modalities, including monoclonal antibodies, cancer vaccines, and cytokine therapy. It is often less toxic than traditional chemotherapy and has demonstrated effectiveness in treating various cancers.

10. T argeted biological pathways: Focusing on specific molecular pathways and mutations in cancer cells allows for personalized treatments, with combination therapies enhancing effectiveness.

Too often, veterinarians are forced to tell their clients: “There is nothing more that can be done.” We hear “cancer” and think “no hope”. But there is more that can be done! Treating cancer requires a multifaceted approach. We need to have a bigger toolkit and strategies that bring together body, mind and spirit.

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By focusing on restoring the body’s terrain, utilizing nature’s pharmacy, and integrating cutting-edge therapies, it is possible to not only extend the lifespan but also improve quality of life for pets and their owners. This integrative approach provides the balance necessary to help the body move from surviving to thriving.

Frontiers in Immunology. "Immunological Mechanisms in Cancer Therapy." Available at: https://www. frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1335920/full.

VCA Hospitals. "Fibrosarcoma and Feline Sarcoid." Available at: https://vcahospitals.com/know-your-pet/ fibrosarcoma-and-feline-sarcoid.

VCA Hospitals. "Post-Vaccination Sarcoma in Cats." Available at: https://vcahospitals.com/know-your-pet/postvaccination-sarcoma-in-cats. https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1264961/full https://www.mdpi.com/2076-3417/12/23/12276

Louise Hay. Available at: https://www.louisehay.com/.

1

American College of Veterinary Surgeons (ACVS). "Oral Tumors." Available at: https://www.acvs.org/smallanimal/oral-tumors/.

2

https://www.nahf.org/article/canine-mouth-cancer-life-expectancy.

3

Frontiers in Veterinary Science. "Oral Tumors in Dogs and Cats." Available at: https://www.frontiersin.org/ journals/veterinary-science/articles/10.3389/fvets.2024.1359426/full.

4

Today's Veterinary Practice. "Introduction to Oral Neoplasia in the Dog and Cat." Available at: https:// todaysveterinarypractice.com/dentistry/practical-dentistry-introduction-to-oral-neoplasia-in-the-dog-cat/.

5

National Institutes of Health. "PMC11092801 — Oral Tumors in Veterinary Medicine." Available at: https:// pmc.ncbi.nlm.nih.gov/articles/PMC11092801/pdf/nihpp-rs4289451v1.pdf.

6

ResearchGate. "Methylene Blue in Photodynamic Therapy." Available at: https://www.researchgate.net/ publication/230888444_Methylene_blue_in_photodynamic_therapy_From_basic_mechanisms_to_ clinical_applications.

MDPI. "Photodynamic Therapy and Cancer." Available at: https://www.mdpi.com/1422-0067/25/2/1023.

Schubert K, Steinhauser I. "The Role of the Microbiome in Cancer Therapy." Frontiers in Microbiology, 11, 294. doi:10.3389/fmicb.2020.00294.

Feng Q, Zhang C, Zhao X. "The Role of the Gut Microbiome in Cancer." Nature Reviews Cancer, 19(12), 794-810. doi:10.1038/s41571-019-0214-3.

Turnbaugh PJ, et al. "The Human Microbiome Project." Nature, 449(7164), 804-810. doi:10.1038/nature06244.

Gonzalez MJ, Seymour R. "Dietary Influences on Epigenetic Changes in Cancer: Implications for Cancer Prevention and Treatment." Nutrition Reviews, 79(7), 724-734. doi:10.1093/nutrit/nuaa077.

Zeller, G., et al. "Potential of Fecal Microbiota for Early Detection of Colorectal Cancer." Nature Medicine, 20(3), 303-308. doi:10.1038/nm.3494.

References and resources

Gosalbes, M. J., et al. "Microbiome: A Key Player in the Field of Human Health." Microbial Ecology in Health and Disease, 22(1), 1-10. doi:10.3402/mehd.v22i0.5896.

American Animal Hospital Association (AAHA)

"Mitochondrial Dysfunction and Cancer: Emerging Insights." Frontiers in Cell and Developmental Biology, 9, 123. doi:10.3389/fcell.2021.689488.

https://www.oncolink.org/ https://www.merck-animal-health-usa.com/

Frontiers in Oncology. "Cancer and Immunology: Emerging Perspectives." Available at: https://www.frontiersin. org/journals/oncology/articles/10.3389/fonc.2021.738323/full.

https://pubmed.ncbi.nlm.nih.gov/30223456/ https://vcahospitals.com/know-your-pet/fibrosarcoma-and-spindle-cell-tumors-in-dogs#:~:text= Surgery%20is%20the%20treatment%20of,recurrence%20is%20still%20the%20rule Frontiers. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2022.803093/full American College of Veterinary Surgeons. https://www.acvs.org/

Today's Veterinary Practice. "Introduction to Oral Neoplasia in the Dog and Cat." Available at: https:// todaysveterinarypractice.com/dentistry/practical-dentistry-introduction-to-oral-neoplasia-in-the-dog-cat/.

Virginia Veterinary Specialists. "Oral Tumors in Dogs and Cats." Available at: https://vavetspecialists.com/oraltumors-in-dogs-and-cats/.

CASE STUDIES BENTLEY’S JOURNEY — SQUAMOUS CELL CARCINOMA Bentley was a 5½-year-old male neutered Yellow Lab. His owners took him to their local vet after he developed facial bumps. The vet did not do a workup but treated Bentley with antibiotics and steroids. The lesions got worse, and his owners requested a biopsy. The results proved squamous cell carcinoma.

Photos courtesy of Dr. Marlene Siegel

The owners sought the opinion of a board-certified veterinary oncologist who told them the only option was to remove Bentley’s nose, a choice they immediately declined due to the severity of disfigurement and discomfort the surgery would cause.

Bentley was diagnosed with squamous cell carcinoma involving the muzzle, roof of the mouth and lymph nodes.

He was treated with integrative therapies that supported his healing while maintaining his quality of life.

They came to me looking for alternative options that would give Bentley extended quality of life. His physical exam revealed multiple nodules around the muzzle and a small, ulcerated lesion in the roof of his mouth. A thorough workup revealed deficiencies in vitamin D, selenium, zinc, magnesium, and copper. He had elevated toxic metal levels, including strontium, antimony, mercury, and lead.

• Bentley was converted from a kibble diet to a grass fed/grass finished raw diet with the appropriate vitamins, minerals, and fatty acids (visit www.evolovestore.com for more information on the products he was taking).

continued on next page

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• He also began weekly detoxification. His treatment day began with promoting a parasympathetic state using a special PEMF device. A special focus was placed on detoxification of the liver and lymphatics/fascia.

• Some of Bentley’s immune-supporting supplements included Salvestrols, black seed oil, CBD, LDN and mushrooms.

• Specific products were used to reduce inflammation and heal his leaky gut.

• Cancer therapies included IV and rectal ozone, high dose vitamin C, IV and intralesional ICG and other photo activators followed by intravenous and topical photodynamic therapy. Hyperbaric oxygen, Halo therapy, infrared therapy, light and gemstone therapies, energy work, chiropractic adjustments, mistletoe, homeopathy, and topical applications of Neoplasene or 5 ALA were also implemented. The owner applied methylene blue at home and photoactivated it with a laser red light.

Bentley’s progress was monitored with TK1 and cCRP. Spikes and drops correlated with the tumor response (necrosis) and reduction of the tumor burden. The lesion on the roof of the mouth resolved in a few months.

He developed a SQ nodule in the region of the prescapular LN. This mass was removed and histopathology confirmed it was SCC with a majority of the tumor being necrotic (it appeared the therapies were effective).

Over the following 15 months, Bentley’s facial lesions became extremely aggressive and then quickly resolved. The upper lip had severe ulceration and destruction, yet its incredible resilience and regeneration, including repigmentation, were miraculous to see.

It is critically important to note that the owners’ number one concern for Bentley was maintaining his quality of life. If at any point he started suffering, they wanted to euthanize.

During Bentley's entire treatment period, he ate well (he loved his raw food) and was bright and active, clearly indicating he was enjoying quality of life.

1. L esions at presentation 2. Therapies destroying lesions but new one continued to appear 3. No longer seeing individual lesions; it became a confluent ulcerated region 4. General anesthesia was required each week to apply topical therapy 5. Achieved good tumor destruction after topical therapies 6. View of the underside of the upper lip, showing deep erosion of the lip 7. Front view of the upper lip — no new lesions and granulation tissue filling in 8. Tissue healing and wound contracture 9. Continued wound healing and repigmentation of the upper lip 10. Lip has reformed and almost fully repigmented 11. Eighteen months from onset of therapy

BEAU’S JOURNEY — ORAL MELANOMA

Photos courtesy of Dr. Marlene Siegel

Beau was a 12-year-old Standard Poodle that presented for an anal sac carcinoma.

A full diagnostic workup similar to Bentley’s was performed. The anal sac tumor was surgically resected, and he underwent ten weeks of detoxification and photodynamic therapy as described for Bentley. He transitioned to a raw diet with the proper essential nutrients and anticancer supplements.

Beau was diagnosed with oral melanoma after successful resolution of an anal sac carcinoma a year earlier.

Beau experienced no recurrence or metastasis of the anal sac carcinoma. A year later, however, he developed an oral melanoma.

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His treatment resumed with IV therapies, photodynamic therapy, detoxification, and supplements.

Beau receiving topical photodynamic therapy with red light.

The biopsy site (roof of the mouth). Though the tissue depigmented, no tumor ever grew back.

Beau maintained 100% quality of life.

MAYBELLE'S JOURNEY — ORAL FIBROSARCOMA Maybelle presented to her primary veterinarian with a growth on her gum, lateral to her right upper canine. Her primary vet removed it but did not perform other diagnostics or provide other therapies. The lesion returned within three weeks.

I performed a similar workup as with Bentley, identifying Maybelle’s deficiencies and toxicities. I removed the mass, sending it in for histopathology, and treated the surgery site with topical Neoplasene.

Maybelle’s diet and supplement regime, detoxification, and therapies were similar to Bentley’s, with modifications based on her test results. She was deficient in vitamin D, cobalamin, magnesium, and copper, and was below the mean on almost all vitamins and minerals. She had low levels of arsenic, cadmium, mercury, and lead. Glyphosate levels were mild.

Her TK1 was elevated at presentation, indicating of a fast-growing tumor. As therapies progressed and the tumor regressed, TK1 dropped accordingly.

Maybelle was also started on immunotherapy, IV and orally, along with a check point inhibitor.

Eight weeks into therapy, Maybelle’s tumor was tested for gene mutations. Three biomarkers were identified in the following genes: BRAF, PTEN and SETD2. Chemotherapy for the BRAF mutation was added to the regime.

1. Onset of therapy; resecting the tumor for the second time 2. Observing the response to topical Neoplasene applied after biopsy 3. Tumor slowly growing; topical application of methylene blue 4. Injecting the mass with injectable Neoplasene after applying methylene blue

As with most of the tumors we can physically see, the lesion got extremely aggressive. It grew so large it was inhibiting Maybelle’s ability to eat or close her mouth. I surgically debulked it and took the opportunity to re-apply Neoplasene and inject the area with ICG.

5. Photoactivating the methylene blue

No regrowth of the tumor has been observed since then. The roof of the mouth appears to be healing. Maybelle continues to undergo therapy at the time of this publication.

9. The lesion on the roof of the mouth is still inflamed but not growing

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6. Tumor is slowly growing but also has areas of necrosis 7. Preop: the mass is so large it is inhibiting Maybelle’s ability to eat and close her mouth 8. T hree days post op: the dead tissue is the result of Neoplasene and ICG applied post op 10. Inflammation is resolving, granulation tissue is contracting 11. Continuing to see wound healing 12. At the time of publication, Maybelle’s oral cavity continues to heal

Photos courtesy of Dr. Marlene Siegel

Oral melanoma is characteristically aggressive and grows quickly. For Beau, the area of the upper palate associated with the tumor became depigmented, but no evidence of tumor growth was observed for the rest of his life (over a year).

In the news

HOW MACHINE LEARNING IS ADVANCING HEART MURMUR DETECTION IN DOGS Recent research highlights the potential of machine learning to revolutionize the detection and grading of heart murmurs in dogs, particularly in diagnosing myxomatous mitral valve disease (MMVD).

The study involved 756 dogs, both with and without cardiac disease, attending referral centers across the United Kingdom. Each dog underwent comprehensive physical and echocardiographic examinations conducted by a certified cardiologist, who graded any murmurs and identified cardiac conditions.

The researchers finetuned a recurrent neural network algorithm originally designed for detecting heart murmurs in humans. This adaptation aimed to predict the cardiologist’s murmur grade from audio recordings of the dogs’ heart sounds. The results were promising: the

algorithm demonstrated a sensitivity of 87.9% and a specificity of 81.7% in detecting murmurs of any grade. Notably, the predicted murmur grade matched the cardiologist’s assessment in 57% of recordings.

enhance the accuracy of heart murmur assessments. This model offers a cost-effective solution for primary care settings, facilitating early detection and management of cardiac diseases in dogs.

One of the key findings was the algorithm’s ability to distinguish between stage B1 and B2 preclinical MMVD. It achieved an area under the curve (AUC) of 0.861, indicating robust performance.

With a sensitivity of 81.4% and a specificity of 73.9%, this capability is crucial for early detection and intervention in dogs predisposed to MMVD.

In conclusion, the successful adaptation of a machine-learning algorithm for canine heart murmur detection represents a promising advancement in veterinary cardiology. As these technologies continue to evolve, they hold the potential to improve diagnostic accuracy and ultimately enhance the quality of care for dogs with cardiac conditions.

Veterinary professionals should stay informed about these developments, as they could play a vital role in future clinical practice.

The implications of this research are significant for veterinary professionals. By integrating machine learning into routine practice, veterinarians can

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Rongoā’s role in canine dermatology

BY HEIDI WARD-MCGRATH, BVSC

The use of Rongoā and other complementary treatments in canine dermatology represents a unique fusion of traditional wisdom and modern veterinary medicine.

Rongoā is the traditional Māori system of healing. It encompasses a holistic approach to health using indigenous plants, spiritual guidance, and practices that date back centuries. The term “Rongoā” translates to “medicine” or “healing,” and the practice is deeply rooted in knowledge passed down by Māori ancestors. This system involves the use of plant-based remedies, physical therapies like Mirimiri (touch), and Karakia (prayer) to promote well-being.

Research into the medicinal properties of indigenous New Zealand plants has revealed promising applications in treating canine skin conditions. The plants traditionally used in Rongoā, such as Mānuka, Kawakawa, and Tōtara, have shown antimicrobial, anti-inflammatory, and antioxidant properties.

These therapeutic effects make them potential candidates for addressing the underlying causes of many dermatological issues in dogs.

As both veterinarians and pet owners seek alternative solutions to complement conventional treatments, Rongoā offers a unique approach that integrates traditional wisdom with modern veterinary science. In recent years, in fact, interest in applying the principles of Rongoā to veterinary medicine has been growing, particularly when it comes to managing dermatological conditions in dogs.

Topical Rongoā provides easy support for dermatitis. It is cost effective, safe and simple to apply. In our skin cases, Rongoā has allowed a 95% reduction in steroid and antibiotic use. We commonly accept that the use of antibiotics for minor limited dermatitis is unwarranted, since their devastating effect on the natural microbiome reduces the dog’s ability to mount normal immune responses in the future. The natural diversity in the canine microbiome represents 95% of the dog’s immune system, something that is essential for balance and well-being.

HOLISTIC MEDICINE IN CANINE DERMATOLOGY Holistic veterinary medicine focuses on treating the whole animal — body, mind, and spirit — rather than just addressing specific symptoms. It aims to support the body’s natural ability to heal and maintain balance. In the context of dermatology, this approach may include dietary adjustments, nutritional supplementation, stress management, regular bathing, and plant-based remedies.

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RONGOĀ IN CANINE DERMATOLOGY: KEY REMEDIES* 1. Mānuka (Leptospermum scoparium) Mānuka is well known for its potent antimicrobial properties, particularly in the form of Mānuka honey. Studies have

demonstrated that Mānuka honey is effective against a wide range of bacteria, including Staphylococcus aureus, a common cause of skin infections in dogs. Mānuka’s high methylglyoxal (MGO) content provides it with its antimicrobial power, making it a valuable resource in managing infections associated with allergic dermatitis, wounds, and hot spots.

When applied topically, Mānuka honey creates a moist healing environment, which accelerates wound healing and prevents the growth of bacteria. For dogs suffering from pruritus or secondary infections caused by itching, applying Mānuka honey directly to the affected areas can provide relief and promote healing.

2. Kawakawa (Piper excelsum) Kawakawa, often referred to as the “king of Rongoā,” is a versatile plant used extensively in traditional Māori medicine. Its leaves contain bioactive compounds that exhibit antiinflammatory, antimicrobial, and analgesic properties. In canine dermatology, Kawakawa can be used to soothe irritated skin, reduce inflammation, and promote healing in conditions like allergic dermatitis and pruritus.

Research and scientific validation While Rongoā has been practiced for centuries, modern scientific research is now beginning to validate the medicinal properties of many traditional Māori plants. Studies on Mānuka, Kawakawa, and Tōtara have confirmed their antimicrobial, anti-inflammatory, and antioxidant effects, making them promising candidates for treating canine skin conditions.

One study on Mānuka honey, for example, demonstrated its effectiveness in reducing bacterial load and promoting wound healing in animals with skin infections. Similarly, research on Kawakawa has highlighted its ability to reduce inflammation and soothe irritated skin, which is particularly relevant in cases of allergic dermatitis.

As interest in holistic and integrative medicine grows, more research is being conducted to explore the potential benefits of Rongoā in veterinary practice. While many veterinarians continue to rely on conventional treatments, the incorporation of Rongoā remedies offers an additional layer of care that can enhance the overall well-being of dogs with chronic dermatological conditions.

Kawakawa extracts can be applied as a poultice or infused into oils for topical use. The plant’s natural anti-inflammatory properties make it an excellent remedy for calming the skin and alleviating the discomfort associated with chronic itching.

In some cases, Kawakawa may also be used in conjunction with other Rongoā plants to enhance its healing effects.

3. Pet Putty™ Pet Putty is a contemporary product I designed that was inspired by Rongoā practices. It’s used primarily to aid in the healing of wounds and skin irritations in animals. Made with a combination of New Zealand plant extracts such as rosemary and lavender, Pet Putty acts as a natural balm that protects and nourishes the skin while promoting healing.

It has successfully treated dermatitis, burns, cellulitis, spider bite necrosis, vasculitis induced damage, fungal infections, bacterial infections, and contact dermatitis and has assisted in the extraction of foreign bodies from feet and skin. It is safe to use around the eyes, ears, perineum and inter-digitally, and is safe if ingested through licking.

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In wider veterinary practices, Pet Putty is commonly used to treat a variety of dermatological conditions, including hot spots, cuts, scrapes, and allergic dermatitis. Its antiinflammatory and antimicrobial properties help soothe the skin, reduce inflammation, and prevent infection.

4. Tōōtarol

dermatological issues

Tōtarol is a naturally-occurring compound extracted from the heartwood of the New Zealand Tōtara tree. It possesses powerful antimicrobial and antioxidant properties, making it a valuable ingredient in dermatological treatments.

Tōtarol is particularly effective against bacterial and fungal infections, common secondary complications in dogs with allergic dermatitis or pruritus.

Dogs, like humans, are prone to a range of dermatological conditions. Skin issues are one of the leading reasons for veterinary consultations, and they can have a significant impact on a dog's quality of life. The following are some of the most common dermatological issues seen in our canine patients:

Tōtarol can be applied topically to infected areas or incorporated into shampoos and sprays to maintain the skin’s health. Its antioxidant properties also help protect the skin from oxidative damage, which can contribute to chronic skin conditions.

Common canine

• Pruritus is one of the most frequent complaints in dogs with skin issues. Itching can be caused by allergies, infections, parasites, or other underlying conditions. It is often a symptom of a more significant problem, leading to scratching, licking, and biting, which can exacerbate the skin condition.

• Alopecia can result from a wide range of causes, including hormonal imbalances, infections, trauma, or allergies. In dogs, alopecia can be localized or widespread and is often a secondary sign of an underlying issue.

• Essential fatty acid deficiency can lead to dry, flaky skin, hair loss, and increased susceptibility to infections and allergies. Essential fatty acids (EFAs), such as Omega-3 and Omega-6, play a vital role in maintaining healthy skin and coat.

• Allergic dermatitis is a significant cause of skin problems in dogs. It may be triggered by environmental factors (atopy), food allergens, or flea bites. The condition often leads to pruritus, redness, swelling, and secondary infections.

Managing these conditions can be challenging, especially in chronic or recurrent cases. This has prompted a growing interest in alternative and complementary therapies like Rongoā, which can offer additional avenues for treatment and support the body’s natural healing processes.

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5. Intravenous vitamin C Intravenous (IV) vitamin C has been explored as a complementary therapy for a range of conditions, including skin diseases. In canine dermatology, IV vitamin C is used to boost the immune system, reduce inflammation, and support the skin’s natural healing processes. Vitamin C plays a crucial role in collagen production, which is essential for maintaining the skin’s integrity and promoting wound healing.

In cases of allergic dermatitis or chronic pruritus, IV vitamin C may help reduce oxidative stress and improve the dog’s overall health, contributing to a faster recovery. This treatment is often used in conjunction with other therapies to enhance the body’s natural defense mechanisms.

6. Poultices Poultices are an essential part of Rongoā medicine and have been used for centuries to treat wounds, infections, and inflammation. A poultice is typically made by crushing or grinding plant materials into a paste, which is then applied to the skin and covered with a cloth or bandage.

In canine dermatology, poultices made from plants like Mānuka, Kawakawa, Tōtara, or Karakeke (New Zealand flax) can be used to draw out infections, reduce inflammation, and promote healing. The heat and moisture from the poultice help the skin absorb the active compounds, while the physical barrier protects the area from further irritation.

CONCLUSION The use of Rongoā and other complementary treatments in canine dermatology represents a unique fusion of traditional wisdom and modern veterinary medicine. With its focus on holistic healing, Rongoā offers valuable tools for managing common skin conditions in dogs, such as pruritus, alopecia, essential fatty acid deficiency, and allergic dermatitis. Remedies like Mānuka, Kawakawa, Pet Putty, Tōtarol, IV vitamin C, and poultices provide natural, effective solutions that support the body’s innate healing processes.

As research continues to validate the efficacy of these remedies, Rongoā is likely to play an increasingly important role in veterinary dermatology, offering pet owners and veterinarians alike a holistic approach to skin health and overall wellness.

*H Ward-McGrath H, Bell AG, Bridges J, Jones BR. “Some observations on the treatment of superficial pyoderma in Dogs with Tōtarol.” Companion Quarterly, 32,34-38, 2021.

From the VMAA The Veterinary Medical Aromatherapy® Association (VMAA) is an organization of veterinarians and veterinary technicians dedicated to the responsible use of aromatherapy in animal practices. Their mission is to promote standards of excellence in animal aromatherapy, to provide outreach and education to veterinarians and auxiliary animal practices, and to promote continual improvements in Veterinary Medical Aromatherapy®. The VMAA is elevating the veterinary profession through innovation, education, and advocacy of integrative medicine.

CASE STUDY — ESSENTIAL OILS AND DENTAL HEALTH Pavlov, a 12-year-old neutered male Miniature Schnauzer, presented with grade III dental disease. It had been five years since his last dental and his guardian noticed he was not eating as well.

Pavlov had numerous teeth with receding gums and thick tartar. The halitosis was severe. Most of his gums were red and swollen and there was a thick coat over his tongue. We suspected he would need several extractions. The guardian was concerned about anesthesia and performing a thorough dental cleaning.

Pre-op bloodwork was all within normal limits, and a chest x-ray was normal. We advised the guardian that to do deep root cleaning and tooth extractions, Pavlov would need to be asleep.

Also, in the state of Nevada, our veterinary board states that an endotracheal tube must be placed in all dental cleanings.

During Pavlov’s dental, the endotracheal tube was inserted and the cuff gently inflated. The procedure included ten extractions and took 1.5 hours. Pavlov’s gums were treated with essential oils (peppermint and a proprietary antibacterial blend with clove to numb the tissue, diluted in a carrier oil to 2%). After the extractions, the oil was placed in the sockets and rubbed on all surfaces after the polish was complete. Next, we used laser therapy on the tissue to promote healing.

After waking up, Pavlov had a cough most likely caused by the endotracheal tube. A diffuser with Frankincense and Eucalyptus radiata (ten drops of each in 200ml of water) was placed next to his cage. A towel was put over the opening to encourage deep inhalation of the essential oils. Lube was placed in Pavlov’s eyes beforehand to protect them. When he was fully awake, a chiropractic adjustment was performed with a proprietary essential oil blend known to help with alignment. At discharge, Pavlov had no cough and was doing very well.

No post-op issues were found, and at a one-week recheck Pavlov’s gums were healed. To help prevent further build-up, the peppermint and antibacterial blend was sent home with the guardian to be rubbed on the gums at least five times a week.

Pavlov transitioned at 17 years of age. He didn’t have any further dental issues after the dental procedure and essential oil maintenance he received when he was 12.

Submitted by Dr. Nancy Brandt DVM, OMD, MSOM, dip. OM, CVC, CVA, CVMA

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In the news

NEW CANINE TISSUE BIOBANK ENHANCES UNDERSTANDING OF DOG GENOMICS A groundbreaking study has established a comprehensive tissue biobank that promises to significantly advance the understanding of canine genomics and its relevance to human diseases. Scientifically known as Canis lupus familiaris, the dog is increasingly recognized as an important model for studying various human conditions. However, the functional annotation of the dog genome has been relatively poor, limiting gene discovery related to development, morphology, disease, and behavior.

To address this gap, researchers have created a biobank comprising 5,485 samples from 132 tissues sourced from 13 dogs, 12 dog embryos, and 24 wolves. This extensive collection provides a robust foundation for further genetic studies. Utilizing 5’ targeting RNA sequencing technology, known as STRT2-seq, the team characterized gene expression activity across a subset of 100 tissues from nine dogs and 12 embryos.

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Remarkably, the study identified over 100,000 candidate promoter regions in the recent canine genome assembly, CanFam4, with more than 45,000 of these sites demonstrating high reproducibility in gene expression and associated tissue enrichment levels. This rich dataset offers a valuable promoter and gene expression atlas, complete with interactive, open-access resources, including a data coordination center and genome browser track hubs.

The researchers showcased the utility of the Dog Genome Annotation (DoGA) data through multiple examples, illustrating its applications in canine embryonic development, morphology, behavior, and crossspecies diseases.

For veterinary professionals, the implications of this research are significant. Enhanced genomic resources can facilitate better understanding of canine health and disease, potentially leading

to improved diagnostic and therapeutic strategies. The biobank also opens pathways for comparative studies between canine and human diseases, further bridging the gap between veterinary and medical research.

Veterinarians and researchers are encouraged to explore these new resources to leverage this wealth of information in their practices and studies, ultimately contributing to the advancement of veterinary medicine and animal health.

FORMAL STUDY

EVALUATING THE IMPACT OF VDI LABORATORY’S ADVANCED GI PANELS: A STUDY ON VETERINARY DIAGNOSTIC EFFICIENCY AND EXPERIENCE

RESULTS

INTRODUCTION VDI Laboratory specializes in advanced diagnostic testing for veterinarians across various areas, including cancer, gastrointestinal diseases, atopy, dietary assessment, disease screening, and other specialized applications. Using a single blood panel, the lab offers a comprehensive range of tests designed to pinpoint specific issues, such as pancreatitis, IBD, GI lymphoma (LSA), exocrine pancreatic insufficiency (EPI), protein losing enteropathy, and many more.

VDI Laboratory recently ran a sampling program from February to August 2024. Participating veterinarians received a free advanced diagnostic testing kit valued at over $500 to sample the new Advanced GI Panels.

The purpose of this report is to examine the experiences of the participating veterinarians and evaluate the effectiveness of VDI Laboratory’s Advanced GI Panels.

METHODS AND MATERIALS At the end of the sampling program, a survey was sent out to the participating veterinarians to provide feedback on the experience and effectiveness of the Advanced GI Panels.

DISCUSSION In summary, the Advanced GI Panel has proven to be an effective and timely method of testing. The comprehensive results provide valuable information that eliminates the need for multiple tests and increases turnaround time. Veterinarians have more options to present to pet parents and can find alternative solutions to expensive and invasive procedures. Along with being the most cost-effective method for GI disease diagnosis, the Advanced GI Panel is also a simpler and easier method, according to the study.

THE PROBLEMS Prior to engaging in the sampling program, what issues did you experience with GI testing?

87.5% of the participants reported they experienced high cost of testing.

62.5% of the participants claimed they needed multiple tests to conclude a diagnosis.

50%

o f the participants had to deal with long turnaround times.

37.5% of veterinarians faced limited availability of specialty tests for GI issues.

25%

of the participants found test results difficult to interpret.

THE FINDINGS

How has contextual testing with VDI Labs impacted the way you diagnose GI issues?

50%

reported they are able to get more detailed information.

50%

claimed they are more confident in their diagnosis.

62.5% were able to reach a quicker diagnosis.

100% found VDI Labs to be a more cost-effective method of testing.

100% reported that VDI testing has increased their ability to efficiently diagnose GI issues.

THE EFFECT

How has your experience with VDI changed the way you approach diagnosing GI issues?

Simpler process Affordable testing Rapid turnaround time Relatively easy to follow up on GI cases Ability to discuss pet health thoroughly with pet parents Options for customized testing or predetermined panels More options available for sampling and diagnosing GI issues Valuable and comprehensive results to find the best solution for patients

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WHAT’S NEW IN CANINE IDIOPATHIC EPILEPSY?

BY KELLY DIEHL, DVM, MS DIPL. ACVIM

Though idiopathic epilepsy in dogs is a serious and common neurologic disease, new therapy options and ongoing research have improved our ability to provide a personalized approach for each patient.

For many of us in practice, whether general, emergency, or specialty, seizure disorders are one of the most common neurologic diseases we see in dogs. And epilepsy remains one of the most common causes.

For decades, there were few options for treating canine seizures.

We relied on phenobarbital and hoped for the best. The good news is that therapeutic options for dogs with epilepsy have exploded in the last ten years. We’re learning more about the pathophysiology of epilepsy, which in turn can lead to improved and refined treatments.

In this article, we’ll review some new developments in seizure management, focusing on idiopathic epilepsy (IE) in dogs.

MEDICAL TREATMENT OPTIONS FOR IE The most significant recent advances in treatment for IE in dogs are the large number of new treatment modalities now available to veterinarians.

Only 20 years ago, the drugs available for treatment were limited to phenobarbital and bromide (and the occasional use of phenytoin and diazepam). However, our veterinary patients have benefited from drug development for people with epilepsy. We now have many options when it comes to therapeutic options for dogs, and more are in development.

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Some of the more common medications now available for use in dogs with IE include: • P henobarbital • B romide • I mepitoin • L evetiracetam • Z onisamide A benefit of the newer drugs available for seizure control is their wide safety profile, which means safer medications with fewer side effects.

It’s beyond the scope of this article to make treatment recommendations. Excellent reviews that discuss how to choose and customize therapy for dogs with IE are listed in the resource section at the end of this article.

One final medical therapeutic that merits discussion is the use of CBD to treat IE in dogs. It’s now widely accepted that CBD is a very effective treatment for epilepsy in people, especially children with specific forms of the disease. There also is evidence that CBD is effective in dogs as well.3 Research is ongoing but it’s reasonable for veterinarians to consider adding CBD as an adjunct therapy for seizure management in selected patients.

OTHER THERAPIES — DEVICES AND DIET Beyond medication, researchers have explored other options for treating seizures, many adopted from human medicine.

Neurostimulation involves using electric, magnetic or ultrasound signals to modulate nervous system signals. It’s been used successfully in dogs and people with IE. Unfortunately, the device used in these foundational canine studies is prohibitively expensive for our veterinary patients — although this could change.

Dietary manipulation is one treatment area that has dramatically changed in the last 20 years when it comes to treating IE in dogs. For nearly a century, it has been recognized that a ketogenic diet can reduce seizure frequency in children with seizures.

Unfortunately, ketogenic diets didn’t work in dogs with IE, but there is compelling evidence that supplementing the diet with medium-chain triglycerides has a beneficial effect on dogs with drug-resistant IE.4,5 Medium-chain triglyceride (MCT) oil is now included in some commercial diets marketed for neurologic diseases.

CAMERAS AND CELL PHONES — TOOLS FOR DIAGNOSIS AND MONITORING For those old enough to be in practice before the advent of smartphones, security cameras and “nanny cams,” something as simple as confirming a diagnosis of IE could be challenging. The use of electronic devices has changed how we diagnose IE, but these same devices are also valuable tools for monitoring response to therapy and simply monitoring a patient for seizures.

In a paper supported by Morris Animal Foundation-funded research,6 Dr. Karen Muñana reported on the use of accelerometers to detect seizure activity in dogs. Although the accelerometers fell short in their ability to detect seizure activity, Dr. Muñana and her team noted something unexpected: a significant improvement in caregiver-reported quality of life was noted throughout the study.

One of the proposed reasons for this observation was the placement of cameras in the home as part of the study. The cam-

GENETICS OF SEIZURE DISORDERS — WHAT DO WE KNOW? For years, veterinarians have known that idiopathic epilepsy is more common in some dog breeds than others. Studies suggest that 26 breeds are believed to have some genetic basis for their seizures. However, in most breeds, a single gene is not responsible. Exceptions include the Lagotto Romagnolo and the Rhodesian Ridgeback.1,2 The gene responsible for IE has been identified in these two breeds, and a screening test is now available. This is a tremendous advantage for veterinarians caring for these dogs.

In addition to the breeds mentioned above, data also supports a hereditary basis for IE in the following breeds: •A ustralian Shepherd • Beagle • Belgian Shepherd • Belgian Tervuren • Bernese mountain Dog • Border Collie •B order Terrier •C avalier King Charles Spaniel •D almatian •E nglish Springer Spaniel

•F innish Spitz •G olden Retriever •H ungarian Vizsla • I rish Wolfhound • I talian Spinone •K eeshond • L abrador Retriever •P etit Basset Griffon Vendeen •S hetland Sheepdog •S tandard Poodle

Advances in gene sequencing technology have dramatically improved our ability to look for genetic signatures of disease, but data suggests the disorder is multigenetic for most breeds.

Given the interest in genetic disease analysis, coupled with improved technology and decreasing costs, scientists continue to examine the canine genome in depth. More research could find genetic variants that could be used to identify high-risk individuals, and then remove them from a breeding program.

Early interventions for these individuals might also be possible.

eras were used to capture seizure activity and correlate the activity with the accelerometers. However, simply having the cameras present could have helped owners feel more secure about leaving their dogs.Veterinarians should consider discussing this technology as another form of therapy with their clients.

“I believe it is very important to take a holistic approach to the management of epilepsy in dogs,” said Dr. Muñana. “This includes acknowledgement and consideration of the burden placed on the caregiver. Caring for a dog with epilepsy has been shown to have a negative impact on the caregiver’s quality of life. This is attributed

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to the unpredictability of seizures and the constant worry that their dog will have a seizure while left unattended. Anything the veterinary team can do to alleviate caregivers’ concerns and improve their quality of life, such as recommending the use of video monitoring when dogs are left alone, is likely to contribute to a positive overall outcome.”

In the next section, we’ll discuss other areas of active research that could change the landscape for dogs with IE.

WHAT’S ON THE HORIZON? As mentioned earlier, finding a single gene that causes IE in dogs is unlikely, but uncovering genes associated with a higher risk of disease is an area yet to be explored.

Another intriguing area of new research is using advances in MRI to better understand the pathogenesis of seizures and drug resistance. MRI is often used to rule out structural abnormalities that lead to seizures. However, finding an additional use for this type of imaging is another reason for veterinarians to consider MRI in their seizure patients.

The gut microbiome is now recognized as impacting neurologic diseases in people, such as Alzheimer’s, Parkinson’s and schizophrenia. There is mounting evidence it also plays a role in canine IE. Earlier, we mentioned the effect of adding MCT oil to the diets of dogs with IE. The effect is believed to be mediated by changing the microbiome.

As researchers establish what constitutes a normal microbiome, veterinary scientists are exploring ways to manipulate the gut microbiome to contain a particular mix of bacteria. These include oral administration of probiotics, dietary manipulation known to influence gut microbes, and fecal transplantation. Some microbiome experts are now moving away from simply studying the microbiome and looking at the metabolites produced in the gut and how these products influence the host’s health.

Another area of interest in human medicine is the link between certain psychiatric and behavioral disorders, such as mood disorders, anxiety and ADD/ADHD, just to name a few. In people, cognitive behavioral therapy and medication aimed at treating these disorders can have a positive effect on seizure frequency.

Although less well described, there is evidence of similar comorbidities in dogs. Veterinarians can consider behavioral modification, and decreasing stress and anxiety in dogs with IE could be a beneficial adjunct therapy. Research also suggests that in addition

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to helping with seizures, adding MCTs to the diet can improve behavioral changes and cognitive abilities in dogs with IE.5 There are many options available to veterinarians for treating IE in dogs. Medication remains a mainstay of therapy, but veterinarians should consider taking a more holistic approach to IE control. Diet change, behavior modification, and video monitoring can not only improve seizure control but also have a positive impact on the quality of life for a dog and the owner.

Idiopathic epilepsy is a serious and common neurologic disease affecting dogs. The good news for veterinarians and pet parents is that new therapy options have improved our ability to provide a personalized approach for each patient, taking into consideration lifestyle and finances. Ongoing research points to a brighter future for dogs diagnosed with IE!

Wielander F, Sarviaho R, James F, et al. Generalized myoclonic epilepsy with photosensitivity in juvenile dogs caused by a defective DIRAS family GTPase 1. Proc Natl Acad Sci USA. 2017;114:2669-2674.

1

Seppälä EH, Jokinen TS, Fukata M, et al. LGI2 truncation causes a remitting focal epilepsy in dogs. PLOS Genet. 2011;7:e1002194.

2

McGrath S, Bartner LR, Rao S, et al. Randomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in the addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy. J Am Vet Med Assoc. 2019;254:1301-1308.

3

Law TH, Davies ESS, Pan Y, et al. A randomized trial of a medium-chain TAG diet as treatment for dogs with idiopathic epilepsy. Br J Nutr. 2015;114:1438-1447.

4

Berk BA, Law TH, Packer RMA, et al. A multicenter randomized controlled trial of medium-chain triglyceride dietary supplementation on epilepsy in dogs. J Vet Intern Med. 2020;34:1248-1259.

5

Muñana KR, Nettifee JA, Griffith EH, et al. Evaluation of a collar-mounted accelerometer for detecting seizure activity in dogs. J Vet Intern Med. 2020;34:1239-1247.

6

RESEARCH TRENDS AT MORRIS ANIMAL FOUNDATION The Foundation has funded research on seizure disorders in dogs for over 30 years. They’ve seen a shift in grant awards from drug treatment-focused studies to genetics, and most recently, to new and innovative ways to treat seizures in dogs.

One of their active grants is focused on a newly recognized movement disorder: paroxysmal dyskinesia. This disease closely resembles IE, and the research team hopes to find practical ways to differentiate between the two.

The foundation also has several dogs diagnosed with IE in the Golden Retriever Lifetime Study cohort. These dogs have detailed histories, comprehensive biologic samples, and, in some cases, necropsy tissues available for future study. These findings could provide essential data on genetic, environmental, behavioral and lifestyle factors associated with seizure disorders.

From the VBMA

The Veterinary Botanical Medicine Association is a group of veterinarians and herbalists dedicated to developing responsible herbal practice by encouraging research and education, strengthening industry relations, keeping herbal tradition alive as a valid information source, and increasing professional acceptance of herbal medicine for animals.

DID YOU GUESS LAST ISSUE’S MEDICINAL HERB? St. John’s Wort (Hypericum perforatum) is a repeat because it’s such an important herb with a long history of use as a nervine.

CASE REPORT Rooster is an 18-year-old Quarter Horse gelding. He suffered a life-threatening injury to his right hind leg. Trapped in a wire for hours, he severely injured his hock and traumatized his low back.

St. John’s Wort has greatly improved Rooster’s nerve healing.

HERB WALK AND LECTURE AT THE AHVMA The VBMA had a fantastic meeting during the AHVMA Conference.

Our herb walk took place at the Wilbur May Arboretum, which not only has a local plant section but serves as a reservoir for many tree species. It has a beautiful grove of sequoias and a large variety of pines and spruces.

We ate some very tasty berries from a species of Berberis, and had a rose sniffing competition. We also saw literally hundreds of plants, including ephedra, Mormon’s Tea (Ephedra viridis), Berberis spp., Oregon Grape (Berberis aquifolium), Lady’s Mantle (Alchemilla mollis), Basin Sagebrush (Artemisia tridentata), and Yellow Rabbitbrush (Chrysothamnus viscidiflorus).

Chanchal Cabrera, RH (AHG) was our speaker. She gave a six-hour lecture on the causes and treatment of cancer using botanical medicines. Chanchal covered a huge topic with concise clarity.

Growth Factor-1. Plants high in berberines can lower insulin.

Herbs can help cells die at the appropriate time — these include Feverfew, Mistletoe, Reishi and Ganoderma lucidum. Milk Thistle (Silybum marianum) also inhibits growth factors.

To stop the spread of cancer, connective tissue needs to be stabilized with herbs like Gotu Kola (Centella asiatica) and Horsetail (Equisetum spp.)

MORE RECENT EVENTS • For those who prefer learning directly from the plants in woods and forests, our Eco-Tour started on October 26 in Oregon. We attended the Mushroom Festival and stayed at Belknap Hot Springs for great camaraderie and a fabulous soak! We also enjoyed herb walks with Ihor Basko, DVM and Scott Kloss of the School of Forest Medicine.

• A virtual conference with the American College of Veterinary Botanical Medicine took place November 9 and 10. The VBMA’s speaker was Jody Noe, ND. She is a holder of traditional Cherokee medicine, having trained with the elders for decades. Dr. Noe spoke for three hours on Cherokee medicine, and the final portion of her lecture focused on the gut-brain connection.

On November 10, Brendan Kelly, LAc lectured on the chronic

disease manifestations and treatment principles using the disease progression seen in Cold and Warm invasion theories.

These lectures have been recorded for your post-conference listening pleasure — visit www.acvbm.org.

Submitted by Cynthia Lankenau, DVM

GUESS THIS HERB!

The greatest cancer preventive is Vitamin G (green). Chanchal also discussed the importance of a low-sugar diet and methylation to prevent gene mutation. Vitamin B12 and cabbage help with methylation, and Gene p53 destroys abnormal cells. Various herbs can stimulate p53, including melatonin, curcumin, resveratrol, and ginsenosides.

Elevated insulin stimulates a growth factor that promotes the growth of cancer cells. We learned that green tea, vitamin D3, lycopene, Baikal Skullcap, exercise, and a low caloric diet can all inhibit

Join the VBMA at vbma.org to find out. The answer will also be published in the next issue of IVC Journal.

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THE ORAL MICROBIOME

and dental health in canines

BY MARGO ROMAN, DVM, CVA, COT, CPT, FAAO

The mouth is the gateway to the whole immune system. A full 80% of the dog’s immune system comes from the gut, and the mouth is where it all starts. Specific to the oral cavity, nonshedding dental surfaces facilitate the development of highly complex polymicrobial biofilm communities, characterized not only by the distinct microbes comprising them, but by their cumulative activities. In this article, you will see that every section of the dog’s mouth has different colonies of bacteria and that the microbiome varies between these areas.

LEARNING TO UNDERSTAND THE ORAL MICROBIOME Since Antonie van Leeuwenhoek first discovered the existence of microbes in the 1700s, while analyzing dental plaque under a microscope, the composition of oral microbial communities has been extensively studied. But it wasn’t until we had DNA sequencing that we have begun to see and understand the more than 400 to 700 species within the mouth cavity.

Adding to this complexity, the oral cavity faces near‐constant environmental challenges, including those from diet, salivary flow, masticatory forces, and the introduction of exogenous microbes. The composition of the oral microbiome is shaped throughout life by factors such as host genetics and maternal transmission, as well as environmental influences including dietary habits, oral hygiene practice, medications, and systemic factors.1

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The oral microbiome in dogs is incredibly complex and varied. It has a profound impact not only on dental health, but also on the rest of the dog’s GI system and overall well-being.

The microbiome biofilm of the mouth is what produces the tartar and plaque that form on a dog’s teeth. However, a balanced oral microbiome does not lead to the development of tartar, plaque and gingivitis. We are just learning about the different types of bacteria that live in a healthy mouth with balanced flora.

It is important that we respect the mouth as the initial inoculation to the body’s microbiome. When the mouth is exposed to chemicals and toxins, many of those microbes do not get to flow downstream into the rest of the immune system.

HOW DENTAL CARE AFFECTS THE MICROBIOME Dental care is important for canine patients. But if the mouth has a balanced biofilm, the need for dental scaling and interventions is tremendously reduced. Clinical trials have indicated that the oral microbiota is associated with dental caries and periodontitis.2 When standard of care dentistry is done, involving cleaning or extraction, the recommendation is to put the dog on an antibiotic such as clindamycin. This is a misuse of anti-microbials. Clindamycin can destroy the microbiome for a year, and you may never get it back. While this antibiotic may effectively treat recurrent strep infections, its detrimental effects on the gut microbiome can result in the colonization of pathogenic bacteria such as Clostridium difficile.3 A study in Western diet-fed mice showed that antibacterial mouthwash alters the gut microbiome, reducing nutrient absorption and fat accumulation.5

In my 47 years of practice, I have never had a referral or looked at lab work from a pre- and post-dental that has cultured out every aspect of the mouth. Not only should you validate a culture from each pocket and every area around the tooth, but the information coming from that culture is almost insignificant.

That’s because there are over 400 species in the mouth flora, but we can culture only 12 or 100 at the most. We still do not know what is growing in the mouth, so placing an animal on an antibiotic seems like the creation of accepted antimicrobial resistance.

ALTERNATIVES TO ANTIBIOTICS IN CANINE DENTISTRY There’s very little need to use antibiotics when you’re working in dentistry. The use of medical ozone to flush the pockets and the gums, while also using it in the Cavitron water, is adequate to help prevent infection. Medical ozone has been used by the biological dentist I have studied with for the last 20 years. Additional days of applying ozonated water or ozonated saline to the mouth as a flush, or ozonated olive or coconut oil rub can also help prevent infection. Medical ozone not only kills the biofilm in the mouth but floods the gum tissue with oxygen within the mitochondria of the cells’ nuclei.4 This increases the health of the gingiva and removes the more inflammatory biofilm.

Average phylogenetic distribution of operational taxonomic units in canine oral niches The study of bacterial communities in the oral cavities of canines reveals significant insights into their microbiome composition across various niches.

The bacterial distribution varies significantly across different oral locations: •S upragingival plaque: Appears to have a predominant presence of Bacteroidetes (approximately 35% to 40%), followed by Firmicutes (around 20% to 25%), with smaller proportions of Fusobacteria, Proteobacteria, and other phyla making up the remaining percentage.

•B uccal mucosa: Shows a notably different distribution, with Proteobacteria being the dominant phylum (approximately 40% to 45%), followed by Bacteroidetes (around 30% to 35%).

• Tongue dorsum mucosa: Has a more balanced distribution between Bacteroidetes (about 30% to 35%) and other phyla.

• Stimulated saliva: Shows the highest proportion of Proteobacteria (approximately 45% to 50%) among all locations, with reduced proportions of other bacterial phyla.

•M inor phyla such as Absconditabacteria, Tenericutes, Spirochaetes, and Synergistetes consistently represent smaller percentages (typically less than 5% each) across all locations, contributing to the overall diversity of the canine oral microbiome.

The microbiome of dogs that have never had tartar or plaque, nor any gingivitis or tooth loss, should be of interest. My own dogs, who have been fecal donors for the Touch of Life for Microbiome Restorative Therapy since 2012, have never had tartar, plaque or gingivitis, and have never lost any teeth. Their diet is very clean, made with fresh organic food. They live in a green, sustainable house on seven acres of virgin woods. They eat raw bone from wild deer with an otherwise predominantly plant-based diet. I have never brushed their teeth. Their gums and teeth look like those of two and three-year-old dogs instead of 12 and 14-year-old dogs. In my practice, I see dogs coming in with rotted teeth; we look at the quality of their food and water, and discover the problem is due to a dysbiosis of the mouth.

We have found that if we are able to inoculate the biofilm from our donor dogs’ water bowls into the water bowls of other dogs, the latter start to break down their tartar. We use medical ozone oil to disrupt the biofilm, then add the bacteria/water from our dogs’ water bowls, which then spreads through

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Oral microbiome health affects the rest of the body

From the mouth, the oral microbes continue down the esophagus and into the rest of the GI tract. Do the specific microbes of the mouth need to work in combination with the microbes and organisms of each area of the gut? If the mouth has been exposed to chemicals, which can come from many sources (e.g. chlorine and fluoride in water; pesticides and herbicides from home and yard; colors and dyes in toys and chews; preservatives in treats, etc.) the microbiome is damaged. This continued insult will be layered throughout the GI tract.

There is also a negative aspect to the microbiome. Oral bacteria can enter the bloodstream through inflamed tissues in the mouth — a process called bacteremia. This can happen after dental procedures or other activities that disturb the oral mucosa. This is why we need good balance, biofilm, and oral support with something as safe as medical ozone water.

If the biofilm of the mouth is balanced, then the inflammation that causes severe dental disease won’t occur. The use of antibiotics gives people a false sense that they are doing something to help and prevent infection, when they really are causing this dysbiosis in the mouth. That is why it is crucial to begin to add medical ozone to all dental care to prevent infection, and to bring more oxygen into the gum tissue, as well as flushing the areas.

Dogs get their microbiome from their mothers. If the mother has a problem, then most likely the offspring will as well. Since dogs share water bowls, the bacteria from the mouth of a dog with bad teeth will fall into the water and contaminate the others. It may be hard to separate water bowls when you have a group of dogs, but inoculating the water with a balanced biofilm, as well as utilizing medical ozone or oil as a mouthwash, will help keep tartar from building up.

Clinical trials have indicated that the oral microbiota is associated with dental caries and periodontitis,6 both of which give rise to extensive tooth loss in older humans and are identified as a public health problem worldwide.6 Accumulating evidence has even linked the human oral microbiota to oral cancer.7 In recent years, oral microecology dysbiosis has been proven to cause periodontitis4-8 and is regarded as an indicator for predicting early childhood caries (ECC).9 Thus, the oral microbiota plays a key role in the initiation of oral diseases.

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the recipients’ water and forms a biofilm of more balanced microbes in their bowls. Hence, the dogs break down the tartar and plaque and do not reform new tartar. If the oral biofilm is damaged through further exposure to chemicals and toxins, we may not be able to retain that balance.

SUMMARY The average phylogenetic distribution of operational taxonomic units across canine oral niches (see sidebar on page 43) provides a comprehensive view of the microbial diversity in the mouth.

The insights gained from this analysis underscore the complexity and specialization of bacterial communities in the canine oral cavity, highlighting the importance of these microorganisms in oral health and disease. We should also look at this seriously when we perform dental hygiene for animals. We should opt not to use antimicrobials and antibiotics that destroy the biodiversity of the gut and the oral cavity. There are other options for achieving good oral hygiene and preventing infection without disrupting the gut and oral flora.

Lea Sedghi, Vincent DiMassa, Anthony Harrington, Susan V. Lynch, Yvonne L. Kapila. The oral microbiome: role of key organisms and complex networks in oral health and disease. Periodontol 2000. 2021 Oct; 8 (1): 107–131. Published online 2021 Aug 31. doi: 10.1111/prd.12393. PMCID: PMC8457218, PMID: 344 63991.

1

Yan Li, Jinzhi He, Zhili He, Yuan Zhou, Mengting Yuan, Xin Xu, Feifei Sun, Chengcheng Liu, Jiyao Li, Wenbo Xie, Ye Deng, Yujia Qin, Joy D VanNostrand, Liying Xiao, Liyou Wu, Jizhong Zhou, Wenyuan Shi, Xuedong Zhou. Phylogenetic and functional gene structure shifts of the oral microbiomes in periodontitis patients, The ISME Journal, Volume 8, Issue 9, September 2014, Pages 1879–1891, https://doi.org/10.1038/ ismej.2014.28.

2

Patrick B. Murphy, Karlyle G. Bistas, Preeti Patel, Jacqueline K. Le. Clindamycin. https://www.ncbi.nlm.nih. gov/books/NBK519574/. Last update February 28, 2024.

3

Lucas Rannier Ribeiro Antonino Carvalho, Ariela M. Boeder, Miho Shimari, Andrei L. Kleschyov, Anders Esberg, Ingegerd Johansson, Eddie Weitzberg, Jon O. Lundberg, Mattias Carlstrom. Anti-microbial efficiency of gaseous ozone’s combined use with fluoride and chlorhexidine on time-related oral biofilm: an in situ study on pediatric patients. Med Gas Res. 2023 Oct-Dec; 13(4): 192–197. Published online 2023 Apr 15. doi: 10.4103/2045-9912.372820. PMCID: PMC10226696, PMID: 37077117.

4

Burcu Namazoğlu, Merve Aksoy, Betül Memiş-Özgül, Firdevs Tulga-Öz. Antibacterial mouthwash alters gut microbiome, reducing nutrient absorption and fat accumulation in Western diet-fed mice.

5

I. Johansson, E. Witkowska, ACR. Tanner. The Microbiome in Populations with a Low and High Prevalence of Caries. First published online October 6, 2015. https://doi.org/10.1177/0022034515609554.

6

Schmidt BL, et al. Changes in abundance of oral microbiota associated with oral cancer. PLoS ONE 9, e98741 (2014).

7

Sameera G Nath, Ranjith Raveendran. Microbial dysbiosis in periodontitis. Journal of Indian Society Periodontology, 2013 Jul-Aug;17(4):543–545. doi: 10.4103/0972-124X.118334. PMCID: PMC3800425, PMID:24174742.

8

Freida Blostein, Deesha Bhaumik, Elyse Davis, Elizabeth Salzman, Kerby Shedden, Melissa Duhaime, Kelly M. Bakulski, Daniel W. McNeil, Mary L. Marazita, Betsy Foxman. Evaluating the ecological hypothesis: early life salivary microbiome assembly predicts dental caries in a longitudinal case-control study. Microbiome, Volume 10, Article number: 240 (2022).

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laVET+ Hip and Joint, a veterinarianP exclusive product J Anim Sci. 2004 Jun;82(6):1685-92. doi: 10.2527/2004.8261685x.

1

Top 4 Reasons Your Clients Will Love WINPRO’s PlasmaBased Oral Pet Supplements

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2

https://www.petbusiness.com/report-reveals-over-half-of-petparents-will-pay-premium-for-functional-products/article_d7f99b86ff04-11ed-8680-bf5c83ff9745.html 3

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TRADITIONAL CHINESE VETERINARY MEDICINE FOR DEGENERATIVE MYELOPATHY IN CANINES

BY JUDITH E. SAIK, DVM, DACVP, CVA, CVCH, CVFT

When TCVM modalities are incorporated into a multimodal treatment plan for dogs with DM, patients respond faster and more consistently.

Canine degenerative myelopathy (DM) is a progressive, fatal neurodegenerative disorder with characteristic clinical signs beginning in late adulthood.1 This article will look at the benefits of using Traditional Chinese Veterinary Medicine (TCVM) when treating degenerative myelopathy, and why this therapy is important to include in every case of DM.

PREVALENCE AND SIGNS DM is best known for its incidence in German Shepherds, Pembroke Welsh Corgis and Boxers, but has been reported in a variety of breeds and mixed breeds with no sex predilection.2 The onset of neurologic signs can occur as early as five years, with a mean of nine years old in large breed dogs.3 Owners often first notice their dogs scuffing their nails or toes when walking, and experiencing difficulty rising; signs that can easily be confused with other chronic arthritic disorders in older dogs.

Clinical signs are consistent, beginning in the pelvic limbs as a spastic upper motor neuron paresis and general proprioceptive ataxia, and progressing to lower motor neuron disease, tetraplegia and respiratory muscle dysfunction prior to death.1 Recent studies have demonstrated that, like some forms of familial amyotrophic lateral sclerosis (ALS) in humans, DM is caused by mutations in the gene encoding Cu/Zn superoxide dismutase 1 (SOD1), a key antioxidant enzyme.1,4 Affected dogs are homozygous for the A allele of an SOD1 missense mutation

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(amino acid substitution): SOD1:c118G>A and c.52A>T. The DM-associated SOD1:c118G>A appears to be widely distributed in the overall canine population, with the allele present in 124 different breeds, while c.52A>T appears to be restricted to Burnese Mountain Dogs.2,3 Homozygosity for the genetic mutation is a major risk factor for canine DM; however, many dogs homozygous for the mutation will not develop the disease, suggesting an age-related incomplete penetrance.3 Genetic testing is commercially available (www.caninegeneticdiseases. net), but the results shed light on “risk” and are not diagnostic for the disease.3 Definitive diagnosis can only be made at postmortem through identification of characteristic histopathologic spinal cord lesions. Antemortem diagnosis is one of exclusion, depending on typical breed/age and characteristic clinical signs, combined with no abnormalities on EMG (electromyography) or CSF (cerebrospinal) imaging that would suggest other neurological diseases.5

CLINICAL TREATMENT OPTIONS FOR DM IN DOGS DM is a slowly progressive degenerative disease that invariably results in non-ambulatory paresis with progression to tetraplegia.

A prospective study investigating conventional DM treatment (antioxidant supplements) noted that some dogs advanced from

Stage I neurological defects (mild to moderate ataxia) to Stage IV (paraplegia, no voluntary movement) in as few as six months.5 Currently, there is no validated effective treatment for the disorder, although various modalities have been proposed to slow its progression. With variable progression through neurologic dysfunction by DM-affected individuals, disease staging (Table 1) along with attention to effective treatments for each stage, can be helpful when designing an integrative therapy protocol.6 For example, the use of water treadmill treatment would be inappropriate for a Stage IV tetraplegic dog with respiratory distress.

TABLE 1: S tages of neurodegeneration associated with disease progression in canine DM6 Stage

Clinical signs

Stage length (months)

I

Upper motor neuron paraparesis; proprioceptive ataxia (ambulatory with UMN signs in pelvic limbs)

6-12

II

Lower motor neuron paraparesis to paraplegia (progress to non-ambulatory in pelvic limbs but can still use thoracic limbs)

9-18

III

Lower motor neuron paraplegia to thoracolumbar paraparesis (non-ambulatory in pelvic limbs and progress to paresis in thoracic limbs)

14-24

IV

Lower motor neuron tetraplegia: brain stem clinical signs (tetraplegia, respiratory dysfunction, death)

18-36

Clinical treatment can be divided into five main areas: 1. Conventional therapy 2. Physical rehabilitation/physiotherapy 3. Medical manipulation 4. Photobiomodulation (laser therapy) 5. Traditional Chinese Veterinary Medicine (TCVM).6 Each has benefits, with physiotherapy the only treatment that has been evaluated and shown to apparently slow progression (i.e. increased time spent in ambulatory status).7 Best practice for DM treatment should be a multimodal approach, with a combination of therapies that best fit the individual dog and stage of disease.

TCVM AND DM Traditional Chinese Veterinary Medicine is an ancient form of medicine that has evolved over the past 3,000 years. It encompasses a variety of treatment modalities, all of which are beneficial for DM treatment, including acupuncture, Chinese herbal medicine, Tui-na (medical massage), and Chinese food therapy.6,8,9,10

• At the six-week follow-up, the Corgi was also able to rise unaided and go on walks for 20 minutes each day.

From first presentation for TCVM evaluation and treatment, the three dogs maintained mobility and had survival times of two years, 18 months and 15 months, respectively, at which point euthanasia was elected due to poor quality of life associated with loss of mobility.10

• At the six-week follow-up exam after starting TCVM treatment, the nine-year-old German Shepherd was able to walk almost normally, now placing his hind feet and using the toes.

A recent presentation at an international meeting reviewed the results of six confirmed DM cases presented to a canine rehabilitation center in the fall of 2022. The patients (three German Shepherds, two Boxers, and one Corgi) were six to 11 years old and ranged from having mild neurological deficits to severe paresis and being wheelchair-bound.9 All patients were enrolled in physical therapy, which included laser, and received integrated TCVM treatment modalities (acupuncture, Chinese herbal medicine). The goal of this multimodal treatment approach was to slow the progression of DM, assess the efficacy of a new Chinese herbal medicine formula,a and improve quality of life. The investigator conjectured that in its florid phase, DM is a Liver/Kidney Yin Deficiency disorder or Shao-Yang Disharmony Syndrome.

• Ten days after starting TCVM treatment, the ten-year-old German Shepherd showed improved ambulatory status and ability to rise from recumbency. At ten weeks, with ataxia continuing to improve, this dog was able to go on 45-minute walks and rise unassisted. The dog was still on TCVM maintenance at 16 months.

The study results were positive. The two German Shepherds, which were wheelchair-bound, showed significant improvements in three weeks. The oldest patient started to wag his tail and show fecal tone, which had been absent for six weeks prior.

Another wheelchair-bound dog experienced a decreased need for the device, and enjoyed improved mobility more than a year

Xie and Dewey published three cases of DM-affected dogs treated with TCVM.10 The cases included a nine-year-old German Shepherd (dragging rear toes when walking), a ten-year-old German Shepherd (eight-month history of moderate to severe paraparesis), and a nine-year-old Corgi (unable to rise without aid, and knuckling both pelvic limbs).

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after diagnosis. It was concluded that TCVM modalities, such as acupuncture and Chinese herbal medicine, help transform rehabilitation in patients. Dogs respond faster and more consistently when these therapies are incorporated into the physical therapy protocol.9

TCVM PATTERNS ASSOCIATED WITH DM A genetic abnormality underlying spinal cord degeneration, often seen as early as five years of age, is consistent with a TCVM pattern diagnosis of Kidney Jing Deficiency (premature aging, congenital defects). Additionally, typical first clinical manifestations of DM involve difficulty rising and weakness in the pelvic limbs. From a TCVM perspective, this is Wei Syndrome (limb weakness/flaccidity, without pain), commonly associated with a Spleen Qi Deficiency. The deficient Spleen Qi fails to generate Qi and Blood, resulting in muscle atrophy and weak limbs. Supporting the Spleen Qi is also important to promote strong postnatal Jing to spare the prenatal Kidney Jing, and to halt/delay disease progression.8 As the disease progresses, rear weakness becomes pelvic limb paresis (Kidney Qi Deficiency), then paralysis (Tan-Huan Syndrome).

With greater disease, further complicating patterns of imbalance, associated with an animal’s individual constitutional weakness, can occur (e.g. Kidney Yang Deficiency, Kidney Yin Deficiency).

The development of Kidney Yin Deficiency is usually quickly followed by Liver Yin Deficiency (sick mother creates sick child, Five Elements Theory). It has also been suggested that DM is associated with Phlegm obstruction of the Dai Mai (Girdle Vessel) arising from Damp created by Spleen Qi Deficiency. The addition of acupoints to open the Dai Mai may help improve response to treatment.8 Four primary TCVM patterns are considered when treating DMaffected dogs: 1. Kidney Jing, Spleen Qi and Kidney Qi Deficiencies 2. Kidney Jing, Spleen Qi and Kidney Yang Deficiencies 3. Kidney Jing, Spleen Qi, Kidney Qi and Kidney/Liver Yin Deficiencies 4. Kidney Jing, Spleen Qi, Kidney Yang and Kidney/Liver Yin Deficiencies.7

leads to Yang Deficiency — Cold animal) 3. Qi Deficiency + Yin Deficiency (Qi Deficiency so severe can’t move fluids, leads to Yin Deficiency) 4. Yang Deficiency + Yin Deficiency (Yin Deficiency worsens and fails to support Yang).10

ACUPUNCTURE FOR DM TREATMENT Acupuncture can be a beneficial therapy for dogs with degenerative myelopathy. In a survey of 190 neurology and 79 rehabilitation veterinary professionals from 20 countries, 71% used acupuncture as part of their current treatment practice for DM.11 Although no research has looked at acupuncture therapy for DM, work has been done on the closely-related ALS in humans.12 Clinical studies investigating ALS have reported on acupuncture treatment and its positive effects of relieving clinical symptoms and improving quality of life.13 A review of 92 studies (1,388 patients), most of which were conducted in China, explored the safety and efficacy of acupuncture for treating patients with ALS.12 Improvements were reported in muscle strength and clinical symptoms (e.g. fatigue, dysphagia, respiratory difficulty, fasciculations). Investigators suggested the following mechanisms of action for acupuncture treatment of ALS: ability to antagonize the excitotoxicity of glutamate, protection of the motor neurons, suppression of neuroinflammation, and delayed disease in animal models.12,14,15 Recommended protocols for acupuncture treatment are based on TCVM pattern diagnosis (Table 2). When selecting an acupuncture technique, electro-acupuncture (EAP) is considered more effective than the dry-needle technique for treating DM.8 Although DM is not a painful disease, many affected animals have concurrent Bi Syndrome (i.e. arthritis pain). Therefore, the EAP protocol, considering both pain and neurological deficits, uses 20 Hz (cycles/sec) for ten to 15 minutes and 80-120 Hz for ten to 15 minutes. The EAP treatment is usually combined with dry-needle (DN) and aqua-acupuncture (aqua-AP).

The total number of acupoints per session will vary depending on the age and condition of the dog. The aqua-AP injections (0.250.5 ml, vitamin B12) are performed after Tui-na massage is completed during a treatment session. Acupuncture treatments are usually performed weekly for three to five sessions, then reduced to once a month long-term.8,10

This can be simplified to primarily: 1. Qi Deficiency (Jing, Spleen, Kidney) 2. Qi + Yang Deficiency (Spleen Qi Deficiency gets worse and

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The canine rehab center study noted that most dogs improved when the researchers used acupoints BL-21 through BL-24 and GB-34.9 Acupoints consistently used in the study included

TABLE 2: TCVM patterns, examination, and clinical signs with commonly-used acupuncture points for treating DM 6, 8,10 TCVM pattern diagnosis

Acupuncture points*

TCVM exam/clinical signs

Kidney Jing Deficiency, Spleen/ Kidney Qi Deficiency

EAP: GV14+GV-3, or Bai-hui or GV-4, BL-11+BL-28, Liufeng +Liu-feng, KID-1+KID-1 DN: BL-20, BL-21, BL-23, KID-3, GB-41, ST-36 Aqua-AP: BL20/23, Huo-tuo-jia-ji

Difficulty rising, weakness in pelvic limbs; tongue is pale and wet; pulse is deep, weak; more severe on right side

Spleen Qi/Yang Deficiency

BL-20, BL-21, BL-24, BL-26, BL-40, ST-36, ST-41, ST-42, KID1, KID-7, KID-10, Liu-feng, Er-yan, GV-1, GB-34, GB-39, GB-41, LI-10, LI-11, CV-6, CV-17; scalp acupuncture lines 6 and 7 (motor lines upper part-hind limb, lower part-front limb)

Lethargy, pelvic limb weakness, too weak to walk or rise from recumbency; drooping lips, anorexia, loose stool, muscle atrophy; heat-seeking, with cold back and extremities; tongue is pale, purple, wet; pulse is deep and weak

Qi Deficiency + Liver/Kidney Yin Deficiency

BL-20, BL-21, BL-23, BL-26, BL-40, ST-36, ST-41, ST-42, SP-6, SP-9, SP-10, KID-1, KID-3, KID-6, KID-10, Liu-feng, Eryan, GB-34, GB-39, GB-41, LI-10, LI-11, CV-6, CV-17; scalp acupuncture lines 6 and 7 (motor lines)

Lethargy, pelvic limb weakness, too weak to walk or rise from recumbency; coolseeking, panting; warm ears and body; tongue is pale or red; pulse is thready and weak

Kidney Yang Deficiency + Liver/ Kidney Yin Deficiency

GV-3, GV-4, Bai-hui, Shen-shu, Shen-ping, Shen-jiao; BL-20, BL-21, BL-23, BL-40, ST-36, ST-41, ST-42, SP-6, SP-9, SP10, KID-1, KID-3, KID-6, KID-10, Liu-feng, Er-yan, GB-34, GB-39, GB-41, LI-10, LI-11, CV-6, CV-17; scalp acupuncture lines 6 and 7 (motor lines)

Lethargy, pelvic limb weakness, too weak to walk or rise from recumbency; diarrhea or loose stools; peripheral edema or ascites; heat-seeking; cold ears/ lumbosacral area; tongue is pale or red; pulse is deep and weak

*Rotate through acupoints listed; use them for EAP, DN and aqua-AP

BL-11, BL-23, Hua-tuo-jia-ji through the lumbar spine, and GV-1 for fecal incontinence, as well as the previous acupoints listed.

CHINESE HERBAL MEDICINE FOR DM TREATMENT The clinical application of Chinese herbal medicine in veterinary practice should have a similar clinical approach as the many other therapeutic modalities a veterinarian uses daily. Similar to acupuncture, Chinese herbal medicine formulas are based on the TCVM pattern(s) identified (Table 3).

• Kidney Jing Deficiency can be treated with Epimedium Formula,b which is a good selection for early in the disease process when numerous complicating pattern imbalances haven’t occurred yet.

• This herbal formula can be combined with Bu Yang Huan Wu, especially as pelvic limb paraparesis develops.

• Qi Performanceb (modified Si Jun Zi Tang) is a good Chinese herbal medicine formula to select when marked muscle atrophy accompanied by anorexia is present (Spleen Qi Deficiency) and can also be given along with Bu Yang Huan Wu.

As the disease progresses and Kidney/Liver Yin Deficiency accompanies the Qi Deficiency pattern, two Chinese herbal medicine formulas may be used: • Hu Qian Wan should be considered when Yin Deficiency > Qi Deficiency.

• If Qi Deficiency > Yin Deficiency, then Hindquarter Weakness Formulab is used.1 Finally, if Kidney/Liver Yin Deficiency is complicated by Kidney Yang Deficiency, two herbal formulas can be considered: • Y ang Deficiency > Yin Deficiency (Di Huang Yin Zi) • Y in Deficiency > Yang Deficiency (Rehmannia 14b).

These Chinese herbal formulas are usually given twice daily.

Start at a half dose for one week, followed by a full dose (1 gram/ 10 kg body weight). They can be given for two to six months depending on the formula; however, they should be changed if the TCVM pattern changes.

A new herbal medicine formulaa was incorporated into the treatment protocol for the six dogs enrolled in the canine rehab clinic DM study. This particular formula uses Xiao Chai Hu Tang, which IVC Winter 2024

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TABLE 3: Chinese herbal medicines used for treating DM TCVM pattern

Chinese herbal medicine

Kidney Jing Deficiency, Spleen/Kidney Qi Deficiency

Epimedium Formulab combined with Bu Yang Huan Wu 6,8

Spleen Qi/Yang Deficiency

Qi Performanceb (modified Si Jun Zi Tang) if muscle atrophy/anorexia are main complaints; use Bu Yang Huan Wu if pelvic limb paraparesis is main complaint)10

Qi Deficiency + Kidney/Liver Yin Deficiency

Hu Qian Wan if Yin Deficiency > Qi Deficiency; Hindquarter Weaknessb (Bu Qi Zi Yin Tang) if Qi Deficiency > Yin Deficiency10

Kidney Yang Deficiency + Kidney/Liver Yin Deficiency

Di Huang Yin Zi if Kidney Yang Deficiency > Yin Deficiency; Rehmannia 14b (modified Jin Gui Shen Qi Wan) if Yin Deficiency > Yang Deficiency10

Optimal pattern(s) not specified

DM Formula (modified Xiao Chai Hu Tang)9

EARLY DETECTION and treatment of at-risk dogs A major benefit of TCVM is that it can be used effectively at all stages of DM, and can be individualized to the unique patterns presented by different patients. The canine rehab center study noted that the initial cohort of patients experienced significant sustained improvements. This begs the question: would starting dogs at risk (homozygous for SOD1) on Chinese herbal medicine, proper diet and exercise early on, resulting in improved blood flow to the spinal column between T3 and L3, prevent them from becoming symptomatic?9 With this in mind, it behooves clinicians managing the health of these dogs to provide continuous Jing support through TCVM modalities.6 In addition, the dogs could have pre-emptive physiotherapy training to maintain fitness, as well as stress management, minimizing inflammation (e.g. disease, pain, vaccines, medications). Chinese herbal medicine formulas, based on TCVM patterns, such as Du Huo Ji Sheng Tang, Cervical Formulab or Epimedium Formulab might be administered once a genetic test is positive for a non-symptomatic dog.9 Keeping this at-risk region of the spinal cord healthy with less osteoarthritis might help prevent expression of the mutated SOD1 gene.

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has been modified by adding Da Huang and Dan Shen, along with an increased percentage of Ren Shen and decreased Ban Xia.9 There is no mention as to which TCVM patterns would optimally be addressed by this herbal formula, but the study had good results with it. The researchers noted that one dog experienced quick exacerbation of hind limb weakness when off the formula for ten days, while another had improved tail tone and less fecal incontinence after starting the formula.

FOOD THERAPY AND TUI-NA A whole food, minimally processed diet, with low glycemic index, is recommended for DM dogs.9,16,17 Research on ALS in humans shows correlation between high fat/starch diets and expression of the disease. Both highly processed foods and carbohydrates increase the glycemic index, which drives endothelial dysfunction. In addition, a TCVM pattern imbalance should be addressed using Chinese food therapy.6 Foods to consider adding to the diet should include those that tonify: • J ing (e.g. liver, kidneys, quinoa, black beans, seaweed) • S pleen and Kidney Qi (e.g. beef, sardines, eggs, rice, oats) • K idney Yang (e.g. chicken, lamb, pumpkin, sweet potatoes) • Kidney and Liver Yin (e.g. turkey, pork, duck, crab, eggs, string beans, pears, peas, bananas, watermelon).

Tui-na is a form of traditional Chinese medical massage that involves applying pressure, kneading, rolling, shaking and stretching the body to move Qi and Blood. It involves stimulation along specific pathways (i.e. meridians) and regulates Zang-fu organ function (e.g. Spleen, Kidney, Liver). It restores balance to Yin and Yang in a DM-affected animal. Simple Tui-na exercises (two or three techniques) can be taught to owners for daily use at home with their dogs. Tui-na can be as helpful for the owner as for the dog, since it strengthens the human-animal bond during a time of stress.6 In addition, the clinician can perform Tui-na while examining the dog (e.g. range of motion, trigger points, areas of contraction).

The proper education of clients on whole food nutrition, appropriate exercise, and pelvic limb awareness training could make a huge improvement in the longevity and orthopedic

health of these patients. TCVM modalities are helping transform DM rehabilitation, as patients respond faster and more consistently when these therapies are incorporated into a multimodal treatment plan. It’s never too early to start “at-risk” dogs on a lifelong path of prevention!

Kobatake Y, Nakata K, Sakai H et al. The Long-Term Clinical Course of Canine Degenerative Myelopathy and Therapeutic Potential of Curcumin. Vet Sci 2021; 8:192. doi.org/10.3390/vetsci8090192.

1

Zeng R, Coates J, Johnson G et al. Breed Distribution of SOD1 Alleles Previously Associated with Canine Degenerative Myelopathy. J Vet Intern Med 2014; 28:515–521, https://onlinelibrary.wiley .com/doi/10.1111/jvim.12317.

2

Coates J. Canine Degenerative Myelopathy. Delaware Valley Academy of Veterinary Medicine. www. delawarevalleyacademyvm.org 3

Morgan B, Coates J, Johnson G et al. Characterization of thoracic motor and sensory neurons and spinal nerve roots in canine degenerative myelopathy, a potential disease model of amyotrophic lateral sclerosis. J Neurosci Res 2014; 92(4): 531–541. doi:10.1002/jnr.23332.

4

Polizopoulou Z, Koutinas A, Patsikas M et al. Evaluation of a proposed therapeutic protocol in 12 dogs with tentative degenerative myelopathy. Acta Veterinaria Hungarica 2008; 56 (3): 293–301 doi.org: 10.1556/AVet.56.2008.3.3.

5

McDowell C. Integrative Treatment of Canine Degenerative Myelopathy. 26th Annual International Conference on TCVM, Reddick, Florida. September 20, 2024.

6

From the AVH The Academy of Veterinary Homeopathy is comprised of veterinarians who share a common desire to restore true health to their patients through the use of homeopathic treatment. Members of the Academy are dedicated to understanding and preserving the principles of Classical Homeopathy.

HOMEOPATHIC REMEDIES THAT SUPPORT DENTAL HEALTH IN DOGS AND CATS Dental health is a major concern in dogs and cats. Most will have some evidence of dental disease by the time they’re three years old. Periodontal disease is by far the most common dental problem in these animals, often requiring expensive cleaning/ extractions under sedation or general anesthesia. This can be a bit risky with older animals, when treatment is needed more often.

8

The mouth is a key functional area for dogs and cats and is very rich in vascular and nervous tissue. Eating, grooming and grasping are the main functions of the mouth. Poor dental health can cause difficulty eating and allow infection to enter the body and affect deeper internal organs.

Sacks H. Treatment of Canine Degenerative Myelopathy with Herbs, Acupuncture, and Rehabilitation.

In Proceedings from the 25th Annual International Conference on TCVM. Reddick, FL: Chi University Press 2023:72-74.

Homeopathic remedies are very useful for dental issues, both as the sole treatment or combined with conventional allopathic medicine.

Kathmann I, Cizinauskas S, Doherr M et al. Daily controlled physiotherapy increases survival time in dogs with suspected degenerative myelopathy. J Vet Intern Med 2006; 20(4):927-932. doi.org 10.1892/0891-6640(2006)20[927:dcpist]2.0.co;2 7

Chrisman C. Traditional Chinese veterinary medicine for small animal neurological disorders. Practical Guide to Traditional Chinese Veterinary Medicine, Small Animal Practice. Xie H, Wedemeyer L, Chrisman C (eds). Reddick, FL. Chi Institute Press 2014:201-210.

9

Xie H, Dewey C. Traditional Chinese veterinary medicine for degenerative myelopathy in dogs. Am J Trad Chin Vet Med 13(2):57-63. doi.org/10.59565/001c.125268.

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Bouché TV, Coates JR, Moore SA, Faissler D, Rishniw M, Olby NJ. Diagnosis and management of dogs with degenerative myelopathy: A survey of neurologists and rehabilitation professionals. J Vet Intern Med. 2023;37(5): 1815-1820. doi:10.1111/jvim.16829.

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Peng S, Tian Y, Chang W et al. Current state of research on acupuncture for the treatment of amyotrophic lateral sclerosis: A scoping review. Front Neurol 2022; 13:1019156. doi: 10.3389/fneur.2022.1019156.

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Sudhakaran P. Amyotrophic lateral sclerosis: an acupuncture approach. Med Acupunct 2017; 29:260– 8. doi: 10.1089/acu.2017.1241.

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Zhao D, Xu N, Yu T et al. Research advances in the mechanism of acupuncture treatment for amyotrophic lateral sclerosis (Chinese). Shanghai J Acupuncture Moxibustion. (2019) 38:1310–4. doi: 10.13460/j. issn.1005-0957.2019.11.1310.

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• Injuries to the mouth, such as trauma or extraction, are relieved by giving Arnica the first day, followed by Hypericum the next day. Alternating the two remedies for several days, one in the morning and the other at night, is helpful in extremely painful situations.

• “Delayed dentition” is a keynote feature of Calcarea carbonica, which can help young animals with retained deciduous teeth, or slow growth and development.

Yang E, Jiang J, Lee S et al. Electroacupuncture reduces neuroinflammatory responses in symptomatic amyotrophic lateral sclerosis model. J Neuroimmunol. (2010) 223:84–91. doi: 10.1016/j. jneuroim.2010.04.005.

• Thuja can help prevent or slow the progression of tooth decay, when given once monthly for several months.

D’Antona S, Caramenti M, Porro D et al. Amyotrophic lateral sclerosis: A diet review. Foods 2021; 10(12):3128. doi.org: 10.3390/foods10123128.

• Mercurius vivus or solubilis addresses foul smell, increased salivation, and inflamed/swollen gums. Give once daily for three days and wait.

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Lavi T, Karasik A, Koren-Morag N et al. The acute effect of various glycemic index dietary carbohydrates on endothelial function in nondiabetic overweight and obese subjects. JACC 2009; 53(24):2283-2287. doi.org/10.1016/j.jacc.2009.03.025.

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a

DM Formula, Gold Standard Herbs, La Jolla, California.

b

Jing Tang Herbal Inc, Ocala, Florida.

• Sulphur can address painful swollen gums and is an excellent deep-acting supportive remedy in many situations. Give a single dose and wait.

Find a homeopathic veterinarian at theAVH.org.

Submitted by Todd Cooney, DVM, CVH IVC Winter 2024

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In the news

FECAL MICROBIOTA ANALYSIS MAY PROVIDE NON-INVASIVE SCREENING FOR EQUINE IBD Inflammatory bowel disease (IBD) is increasingly recognized not only in humans but also animals, including horses. The condition poses significant challenges in equine health, leading to decreased performance, diarrhea, weight loss, and painful behaviors.

Diagnosing IBD in horses remains fraught with uncertainty and typically involves stressful and costly procedures such as transportation to veterinary hospitals, fasting, endoscopy, and biopsy assessments. As such, there is a pressing need for a non-invasive and affordable screening method.

Recent research indicates that the composition of fecal microbiota changes significantly in animals with IBD. A recent study aimed to investigate whether similar alterations occur in horses suffering from IBD. By analyzing fecal samples, researchers

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IVC Winter 2024

found distinct differences in gut microbiota composition between horses diagnosed with IBD and healthy controls. The study revealed significant increases and decreases in the abundance of specific bacterial groups associated with the condition.

To further enhance diagnostic capabilities, the research team developed a machine learning model to predict IBD based on fecal microbiota composition. Remarkably, the model achieved 100% accuracy in predictions within the dataset used for the study, demonstrating a promising avenue for future diagnostics.

The findings suggest that analyzing fecal microbiota may serve as an accurate, cost-effective, and non-invasive method for screening equine IBD. Such an approach could alleviate the stress

and financial burden associated with traditional diagnostic methods, allowing for more efficient management of the disease.

As awareness of equine IBD grows, veterinary professionals are encouraged to consider the implications of these findings in clinical practice. Future developments in fecal microbiota analysis could revolutionize the way IBD is screened and managed in horses, leading to improved health outcomes and enhanced performance for equine athletes.

This innovative research highlights the potential of microbiota profiling as a diagnostic tool, paving the way for further studies and advancements in equine veterinary medicine.

In the news

NEW TOOL FOR ASSESSING FRAILTY IN DOGS: PREDICTING SHORT-TERM MORTALITY

V

eterinary professionals are being introduced to a novel frailty phenotype screening tool designed to assess frailty in dogs. This tool could enhance clinical decision-making and early risk identification. Frailty, a well-established syndrome in humans characterized by the accumulation of impairments leading to increased vulnerability and mortality, has garnered attention in canine studies due to the similarities in environmental factors, lifestyles, and age-related diseases.

The study aimed to create a practical, clinically applicable screening tool that could predict all-cause shortterm (six-month) mortality in dogs.

It was conducted in two phases.

Phase one involved a retrospective cohort of 51 dogs, in which researchers identified potential measures across five domains of frailty. These

findings informed the development of a straightforward frailty phenotype, incorporating examination results and owner-directed questions.

Phase two evaluated the frailty phenotype in a prospective cohort of 198 dogs aged nine years or older, drawn from various specialty and primary care services. The results revealed that the developed frailty phenotype was significantly predictive of shortterm mortality, with a hazard ratio of 4.71 (95% CI, 2.66–8.8), independent of age, sex, or weight. Among the evaluated covariates, breed stood out as a significant factor, with purebred dogs exhibiting 1.85 times higher mortality risk compared to mixedbreed dogs (95% CI, 1.04–3.31).

services, indicating its applicability across diverse clinical settings.

These findings highlight the frailty phenotype as a valuable tool for early risk identification and intervention, allowing veterinarians to make informed decisions regarding treatment and care strategies for aging dogs. The study not only enhances clinical practices but also paves the way for further research into frailty in canines, promoting a deeper understanding of this critical aspect of veterinary medicine.

Veterinarians are encouraged to consider integrating this screening tool into their practices to improve outcomes for their older canine patients.

Importantly, the frailty phenotype demonstrated consistent performance across all participating veterinary

IVC Winter 2024

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