V3I1 (Winter 2012-13) by Redstone Media Group

Integrative PEER REVIEWED

VETERINARY CARE

SPECIAL NUTRITION ISSUE

NUTRITION AND CANCER

HOW DIET AND SUPPLEMENTATION PLAY A ROLE IN PREVENTION AND TREATMENT Page 28

WINTER LAMENESS Injuries sustained on snow and ice are

www.IVCJournal.com

WINTER ISSUE 2013

diagnostically challenging -- a thorough exam is essential.

CASE FOR WHOLE FOODS How our understanding of

KNOW ABOUT NUTRIGENOMICS? Optimize patient health by

HYPERPERMEABLE BOWEL Leaky gut syndrome and its

designing diets for every individual’s genetic makeup.

WINTER FEEDING FOR HORSES Transitioning to a hay diet may lead to deficiencies in key nutrients.

pet nutrition is changing, and where it’s leading us.

relationship to the immune system and chronic disease.

WHAT’ S NEW • Cancer vaccine in clinical trials • Reverse zoonosis • New $80 million equine complex

IVC Winter 2012/13

Integrative VETERINARY CARE

WINTER 2013

ediToriaL deparTmenT

adVerTising saLes National Sales Manager: Ann Beacom (866) 764-1212 ext. 222 annbeacom@redstonemediagroup.com

Editor-in-Chief: Dana Cox Managing Editor: Ann Brightman Associate Editor: Christina Chambreau, DVM, CHC Graphic Designer: Dawn Cumby-Dallin Graphic Designer: Kathleen Atkinson Cover Photography: Kathleen Atkinson

Western Regional Manager: Becky Starr (866) 764-1212 ext. 221 becky@redstonemediagroup.com

coLumnisTs & conTriBuTing WriTers

Sue Armstrong, MA, VetMB, VetMFHom, CertIAVH, MRCVS, RsHom Carol Bennett, CAB/TBI, RBP, ANA Deborah Brown Franco Cavaleri, BSc NB W. Jean Dodds, DVM Juliet M. Getty, PhD Kim Henneman, DVM Douglas Knueven, DVM, CVA, CAC, CVCH Heidi Lobprose, DVM Steve Marsden, DVM, ND, MSOM Lac. Dipl., CH, CVA Lynn S. Peck, DVM, MS Bio Lucy Postins Michelle J. Rivera, MT, VDT Jochen Schleese, CMS, CEE, CSE Robert J. Silver DVM, MS, CVA

Equine National Sales Manager: John M. Allan (866) 764-1212 ext. 405 john@redstonemediagroup.com cLassiFied adVerTising: Michelle Stewart classified@IVCJournal.com us maiL: IVC Journal, 6834 S University Blvd PMB 155 Centennial, CO 80122

adminisTraTion & saLes Publisher: Redstone Media Group President/C.E.O.: Tim Hockley Office Manager: Michelle Stewart Circulation: Libby Sinden

suBmissions: Please send all editorial material, advertising material, photos and correspondence to: IVC Journal, 160 Charlotte St. Suite 202 Peterborough, ON, Canada K9J 2T8. We welcome previously unpublished articles and color pictures either in transparency or disc form at 300 dpi.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. Email your articles to: info@redstonemediagroup.com

Integrativ

cdn maiL: IVC Journal, 202-160 Charlotte St. Peterborough, ON, Canada K9J 2T8. The opinions expressed in this journal are not necessarily those of the editor, and different views may appear in other issues. Redstone Media Group Inc., publisher of IVC Journal, does not promote any of the products or services advertised by a third party advertiser in this publication, nor does Redstone Media Group Inc. verify the accuracy of any claims made in connection with such advertisers.

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IVC Journal (ISSN 1710-1190) is published four times a year by Redstone Media Group Inc. Publications Mail Agreement #40884047. Entire contents copyright© 2012. No part of this publication may be reproduced or transmitted by any means, without prior written permission of the publisher. Publication date: December 2012.

IMPROVING THE LIVES OF ANIMALS... ONE READER AT A TIME.

IVC Winter 2012/13

contents FEATURES

KNOW ABOUT NUTRIGENOMICS?

It’s a new science that studies the connection between nutrition and our genes – and how we can optimize canine and human health by designing diets for each individual’s genetic makeup.

THE HYPERPERMEABLE BOWEL

Leaky gut syndrome can be treated and managed with a four-part program using diet, herbs and nutraceuticals that reverse the causes and risk factors for increased intestinal permeability.

WINTER LAMENESS

Injuries sustained by active dogs that play, run or work in snowy or slippery conditions can be diagnostically challenging. A thorough exam is essential in dealing with these cases.

THE ROLE OF DIET AND SUPPLEMENTATION IN CANCER CARE

Growing evidence supports the basic principle in cancer nutrition of minimizing simple sugars and complex carbohydrates, and favoring protein and unsaturated fats as the main energy sources.

MARKETING BASICS

Can you be your community’s “celebrity” vet? Here’s a stepby-step breakdown on how to initiate a public relations strategy.

Case Study A CASE OF RETRO-ORBITAL ABSCESS

70 4

IVC Winter 2012/13

When medications and surgery failed to help Chelsea, this veterinarian found success with two homeopathic remedies.

WINTER FEEDING FOR HORSES

Transitioning to a hay diet during the cold weather months may lead to deﬁciencies in key nutrients and a need for supplementation.

BOWEN THERAPY – HOW DOES IT WORK?

Learn how this effective hands-on healing technique can help with musculoskeletal pain and other issues in horses and small animals.

Nutrition nook THE CASE FOR WHOLE FOODS

How and why our understanding of pet nutrition is changing, and where it’s leading us – and why whole food raw diets are so beneﬁcial.

Tech talk FENG SHUI IN THE CLINIC SETTING–PART 1

This ancient art of placement can help you and your colleagues maintain wellbeing and harmony in the workplace.

advisory board COLUMNS & DEPARTMENTS

5 Advisory board 6 Editorial 10 Whats new 46 Industry innovations 61 Spotlight

dr. richard palmquist, DVM, graduated from Colorado State University in 1983. He is chief of integrative health services at Centinela Animal Hospital in Inglewood, California, 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 co-director of the AHVMA 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 co-owner 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.

67 Veterinary resource guide 73 Marketplace 74 Events

dr. Joyce Harman, DVM, MRCVS, graduated in 1984 from Virginia Maryland Regional College of Veterinary Medicine. She is certified in veterinary acupuncture and chiropractic and has completed advanced training in homeopathy and herbal medicine. Her practice in Virginia uses holistic medicine to treat horses. Her publications include The Horse’s Pain-Free Back and Saddle-Fit Book – the most complete source of information about English saddles.

dr. steve marsden, DVM, ND, lectures for the IVAS, the AHVMA and the AVMA, and is co-founder of the College of Integrative Veterinary Therapies. He is a director of the National College of Natural Medicine, and authored the Manual of Natural Veterinary Medicine. Dr. Marsden is extensively trained in alternative medicine, including Chinese herbology, acupuncture and naturopathic medicine. He has a veterinary and naturopathic practice in Edmonton, Alberta. In 2010, Dr. Marsden was named Teacher of the Year by the AHVMA.

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.

dr. christina chambreau, DVM, CHC, 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. Dr. Chambreau teaches classes in homeopathy for animals, and lectures on many topics. She is the author of the Healthy Animal’s Journal and the co-author of the Homeopathic Repertory: A Tutorial.

Bill Bookout is a founding member of the NASC, and served as president and chairman of the board from 2002–2012. He is founder and president of Genesis Ltd., a company that provides feed and health products for animals. He spent 15 years in the human medical device, drug and animal health industries. Bill received his Bachelor’s degree in physical sciences from the University of Wyoming, and an MBA from Pepperdine University. He has been selected by Health Canada to serve on the Expert Advisory Committee for Veterinary Natural Health Products.

IVC Winter 2012/13

editorial

food medicine... Let

be thy

ne of my passions in life is healthy food – for me and for my animals – so it is appropriate that my first issue as Associate Editor of Integrative Veterinary Care journal is focused on nutrition. Of course, like most of us, I wasn’t always as informed as I am now. As a teen, I was happy when the local farm store combined the salt and mineral blocks because it was so convenient. I bought sweet feed for my horses because I assumed the horses would love it as much as I loved sweet things. And though we fed fresh veggies from our garden to the dogs, cats and horses, it was for their enjoyment rather than for nutrition. When I went on to veterinary college at the University of Georgia, not much changed. Yes, our class visited the testing kennels of a major dog food brand, and I had a few credits in nutrition by the time I graduated in 1980, but I rarely spoke about which brands were the best to feed to my clients. While I was accepting of people feeding fresh food, I had no knowledge on how to evaluate the nutritional claims. It wasn’t until a colleague pointed out the obvious anatomical and physiological differences between species that I embarked on a lifelong education about species appropriate nutrition. These days, many veterinarians now face clients who have done a lot of research on species appropriate nutrition, and our journals have started to address therapeutic nutrition for our patients. When I speak at major conferences, many attendees tell me they come to the holistic lectures to learn answers to their clients’ many nutritional questions. Often, they have seen a dog’s cancer

IVC Winter 2012/13

completely resolve when on a fresh food diet, or a cat’s asthma significantly decrease on grain-free food, or a horse’s performance improve when fed free choice minerals. Alternatively, the attendee’s personal health may have improved with eating healthier foods. A few have even seen problems with feeding a fresh food diet so they want to know how to offer a better diet that is safe to feed. As you’ll see in this issue of IVC, nutrition can be used to help prevent illness as well as part of a treatment protocol. As always, addressing every animal as an individual is the key to a successful practice that maximizes the health of our patients, our clients’ satisfaction and staff enjoyment at work. In addition to nutrition, we explore Bowen therapy and take a closer look at winter injuries affecting active animals. In our Tech Talk column, we examine the popularity of Feng Shui and learn how to apply that at the vet office level. Finally, as we endeavor to bring you the very best articles on integrative approaches I would love to hear your feedback. Please email your comments and suggestions on what you need to be successful in helping your patients and your practice to drtina@ivcjournal.com or dana@redstonemediagroup.com. Sincerely,

Meet us at

NAVC

Jan 20-23 Booth 4224 Orlando World Center

Christina Chambreau, dvm, chc Associate Editor, IVC

Marriot

IVC Winter 2012/13

contributors

Sue Armstrong,

MA, Vet MB, VetMFHom, CertIAVH, MRCVS, RsHom

Dr. Armstrong qualified from Cambridge Veterinary School, England in 1984 and worked first in Oxford and then in a partnership in Leeds for 12 years. She set up her dream practice, Balanced Being, in 2003; it is an integrative veterinary practice with homeopathy as its core philosophy. Sue studied homeopathy at the Royal London Homeopathic Hospital and with the HPTG in Oxford. She obtained VetMFHom status in 1996. She is past president of the British Association of Homeopathic Veterinary Surgeons and president of The Canadian College of Animal Homeopathy.

Carol Bennett,

CAB/TBI, RBP, ANA

Carol is the Founder of the Animal Connection Network™, a school for Touch Balancing/Animal Bowen which she opened in 1997. After becoming a Bowen Therapist in 1995 she spent the next two years developing the technique for use with animals. Her work was endorsed and accredited by BOWTECH and the BOWEN ACADEMY OF AUSTRALIA from 1997 to 2005. Carol is an author/publisher, has been an Animal Nutrition Advisor for 19 years and a Touch Balancing/Animal Bowen™ Practitioner and Instructor for 17 years.

W. Jean Dodds,

DVM

Dr. Dodds 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 research. She received the Holistic Veterinarian of the Year Award from the AHVMA in 1984.

Juliet M. Getty,

PhD

Dr. Getty has been advising clients on how to feed their horses the way nature intended for more than 20 years. Based in Waverly, Ohio, she is a widely known and highly respected speaker, consultant and author of the comprehensive reference, Feed Your Horse Like A Horse. Visit Dr. Getty’s website (GettyEquineNutrition.com) to browse a library of articles, a forum on nutrition, interviews and teleseminars, and sign up for her free monthly e-newsletter Forage for Thought.

Kimberly Henneman,

DVM, Diplomate ABT, FAAVA, CVA, CVC

Dr. Henneman was one of the first veterinarians in the Western US to be trained in more than five holistic modalities. Her Integrative & Sports medicine practice utilizes acupuncture, chiropractic, classical homeopathy, Chinese Herbal Medicine, performance biomechanics, nutrition and thermal imaging in companion animals and horses. She is a graduate of Purdue University’s School of Veterinary Medicine. She is a popular national and international speaker, is one of 15 Fellows of the American Academy of Veterinary Acupuncture in the US, and has contributed to several veterinary textbooks.

IVC Winter 2012/13

Doug Knueven,

DVM, CVA, CAC, CVCH

Dr. Knueven received his veterinary degree from Ohio State University in 1987. He has certification in veterinary acupuncture, veterinary Chinese herbal medicine and veterinary chiropractic. He also has advanced training in natural nutrition, massage therapy and homeopathy. Dr Knueven has been practicing alternative veterinary medicine since 1995. He lectures at veterinary conferences, including the annual AVMA convention and the North American Veterinary Conference. He has written two books: Stand by Me: A Holistic Handbook for Animals, Their People and the Lives They Share Together, and The Holistic Health Guide: Natural Care for the Whole Dog.

Steve Marsden,

DVM, ND, MSOM Lac. Dipl., CH, CVA

Dr. Marsden is one of the chief educators of veterinarians worldwide in the use of complementary and alternative therapies. He regularly lectures for the International Veterinary Acupuncture Society, the American Holistic Veterinary Medical Association, and the American Veterinary Medical Association. He is co-founder of the College of Integrative Veterinary Therapies and a director of the National College of Natural Medicine. His textbook, Manual of Natural Veterinary Medicine, has been translated into multiple languages. When not teaching, Dr. Marsden divides his time between his veterinary and naturopathic medical practices in Edmonton, Alberta.

Lynn S. Peck,

DVM, MS Bio

Dr. Peck earned her DVM and a Master of Science in Reproductive Physiology (Equine) from the University of Florida. After several years in conventional practice, she became interested in alternative veterinary medicine, beginning with veterinary homeopathy in 1995, and continuing on to acupuncture, Touch Balancing/Animal Bowen™, therapeutic nutrition, equine osteopathy, color light therapy, Acutonics™ and other modalities. She is a senior instructor in TB/AB, taught acupuncture at the Chi Institute of Traditional Chinese Veterinary Medicine for ten years, and recently earned two certifications in Applied Kinesiology. Dr. Peck owns All Holistic Veterinary Care in Gainesville, Florida.

MT, VDT

Dr. Rivera is an instructor at the University of Wisconsin and The Healing Oasis Wellness Center, a post-graduate educational institution offering state-approved programs as set forth by the Wisconsin Educational Approval Board. She is also the co-owner of The Healing Oasis Veterinary Hospital, Inc. a holistic veterinary practice offering massage and rehabilitation therapy, chiropractic and Chinese and Western herbology. Michelle has completed the Chinese Herbal Medicine program from the China Beijing International Acupuncture Training Center, and has been certified in Chinese Medicine by the Wisconsin Institute of Chinese Herbology.

Robert Silver,

DVM, MS, CVA

Dr. Silver is a 1982 graduate of Colorado State University’s College of Veterinary Medicine, and practices at Natural Animal in Boulder. He is a veterinary acupuncturist and herbalist, and experienced in the use of nutraceutical and functional foods. Dr. Silver developed RxVitamins for Pets, a line of nutraceuticals.

contributors

Michelle J. Rivera,

IVC IVCWinter Winter2012/13 2012/13

what’s new Toxic TreaTs From cHina Here’s a good reason to give your patients only healthy, natural, domestically made treats. According to Wenonah Hauter, Executive Director for Food & Water Watch, thousands of dogs have fallen ill or died over the past five years after eating jerky treats made in China. “…it has come to light that Chinese government officials overseeing the factories that make the questionable treats refused to allow US inspectors to collect samples for independent analysis,” she says. “While this lack of cooperation shows an unfortunate disregard for health and safety on behalf of the Chinese government, it’s

reVerse Zoonosis People who get sick with flu may not realize they can pass the virus not only to other humans, but possibly to pets such as cats, dogs and ferrets. This concept, called “reverse zoonosis”, is still poorly understood but has raised concern among some scientists and veterinarians. Veterinary researchers at Oregon State University and Iowa State University are working to find more cases of this type of disease transmission and better understand any risks they pose to people and pets. “We worry a lot about zoonoses, the transmission of diseases from animals to people,” says Christiane Loehr, an associate professor in the OSU College of Veterinary Medicine. “But most people don’t realize that humans can also pass diseases to animals, and this raises questions and concerns about mutations, new viral forms and evolving diseases that may potentially be zoonotic.” The researchers are surveying flu transmission to household cat and dog populations, and suggest that people with influenza-like illness distance themselves from their pets. If a pet experiences respiratory disease or other illness following household exposure to someone with the influenza-like illness, the scientists encourage them to take the animal to a veterinarian for testing and treatment. http://vetmed.oregonstate.edu or http://vetmed.iastate.edu.

IVC IVCWinter Winter2012/13 2012/13

the Food and Drug Administration (FDA) who has shirked its responsibility to keep US citizens and their pets safe.... The FDA waited until it received 2,000 reports of illnesses and deaths in US dogs before launching its investigation. Although the China investigation took place in April of 2012, it took the FDA four months to admit that they were denied permission from collecting samples from the Chinese facilities. As the FDA dragged its feet, the suspect treats remained on store shelves and put thousands of dogs at risk.” foodandwaterwatch.org

cancer Vaccine in cLinicaL TriaLs Specialists from the Veterinary Specialty Center of the Hudson Valley in New York are conducting a pilot study with a cancer vaccine that may prolong survival in dogs with osteosarcoma (bone cancer) and cats with mammary (breast) cancer. The study will test whether an adenovirus-based vaccine followed by a DNA plasmid administered via electrogenetransfer can elicit anti-tumor immunity and increase survival times. The vaccine targets this Her2/neu pathway of tumorigenesis, allowing the body’s immune system to battle the cancer in addition to standard therapies. No placebos are involved and the study is unfunded. This immunotherapy is an extension of the center’s telomerase cancer vaccine that has shown success against canine lymphoma in Europe. Up to 50% of dogs with osteosarcoma will express the Her2/neu genetic marker. In cats, Her2/neu has been expressed in this cancer and despite surgical removal of the glands, metastasis is common. ncbi.nlm.nih.gov/pubmed/19379209; ncbi.nlm.nih.gov/pubmed/19944791

IVC Winter 2012/13

moBiLe ecg deVice The developer of a breakthrough mobile electrocardiogram (ECG) recorder that attaches to an iPhone or iPod Touch has made its mobile ECG device available to veterinary professionals. The AliveCor Veterinary Heart Monitor snaps onto an iPhone 4, 4S or iPod touch, and when used with the free AliveECG Vet app, enables veterinarians and technicians to obtain clinical quality, singlechannel ECGs on animals. The Veterinary Heart Monitor enables veterinary professionals to easily screen patients during health and wellness exams, or before placing a patient under anesthesia. Veterinarians can obtain accurate ECG readings, and store them in a secure AliveCor account on the phone and on the web. They can also e-mail and print PDF versions of stored ECGs as part of the medical record or to send to a specialist or colleague. AliveCorVet.com

gaining ground againsT raBies The Global Alliance for Rabies Control (GARC) has revealed details of their latest initiatives against the disease. The Communities Against Rabies Exposure (CARE) program, led by GARC in collaboration with local governments, universities and research institutes, has received a multi-million dollar grant from the Optimus Foundation in order to expand their successful trial of community-led rabies elimination in Bohol, Philippines to communities in Chad, Indonesia, Tanzania and further areas of the Philippines. GARC also announced a grant from the Bill & Melinda Gates Foundation for the development and promotion of Partners for Rabies Prevention activities, including the development of health economic models and a global rabies elimination plan. These plans will be formed in collaboration with leading PRP players, including the WHO, CDC (USA) and a number of universities, and will bring together expertise from a variety of fields to provide much-needed research to help inform and advance policy decisions. rabiescontrol.net

neW $80 miLLion eQuine compLex Equine science education, research and outreach will soon have a new home, thanks to the Texas A&M Equine Complex. Dr. Eleanor Green, Texas A&M College of Veterinary Medicine & Biomedical Sciencesâ&#x20AC;&#x2122; Carl B. King Dean of Veterinary Medicine, says the initiative will bring together students, faculty and equine industry leaders, and provide a foundation for research discoveries and outreach initiatives dedicated to the welfare of horses. Initial construction, which has already begun, will include an education and outreach center, facilities for the Texas A&M Equestrian Team, a cross country course in collaboration with Texas A&M Athletics, and new facilities for the Parsons Mounted Cavalry. With a long history of teaching, research, equine medicine and outreach excellence, Texas A&M has been a vital contributor to the equine industry for generations. Both the Department of Animal Science in the College of Agriculture and Life Sciences and the College of Veterinary Medicine & Biomedical Sciences have been instrumental in providing the equine industry with knowledge and care that have advanced not only equine sciences, but the welfare of the horse as well. TAMUequine.com

IVC Winter 2012/13

Lameness and saddle slip There’s a significant link between hind limb lameness and saddle slip, according to a new study from the Centre for Equine Studies at the Animal Health Trust in the UK. The research shows consistent saddle slip in some horses with hind limb lameness, even when the lameness is fairly subtle and difficult to detect. Saddle slip in sports horses can occur for a variety of reasons, including asymmetry in the shape of the horse’s back, riders sitting crookedly, and ill-fitting saddles. The study assessed 128 horses of varying size, age and type. The saddle consistently slipped to one side in 54% of horses with hind limb lameness, compared with 4% of horses with fore limb lameness, 0% with back pain and/or sacroiliac joint region pain, and 0% of non-lame horses. Diagnostic analgesia was subsequently used to abolish the hind limb lameness, eliminating saddle slip in 97% of cases. “Our findings emphasize the need to educate owners, veterinarians, physiotherapists, trainers, riders and saddle fitters that saddle slip is frequently an indicator of lameness, not necessarily a manifestation of an ill-fitting saddle or asymmetric shape of the horse’s back,” says Sue Dyson, Head of Clinical Orthopaedics at the Centre. “Detection of saddle slip provides an opportunity for the owner, riders and trainers to detect low-grade and subclinical lameness.” aht.org.uk

Toxoplasmosis causing concern A new report released by the Advisory Committee on the Microbiological Safety of Food in the UK recommends more research while confirming information about a disease the US Centers for Disease Control and Prevention consider a “major neglected parasitic infection”. According to the CDC, toxoplasma gondii, a parasite that infects cats and causes toxoplasmosis, has infected 22.5% of the human population in the US. The CDC lists toxoplasmosis as one of the leading causes of human death attributed to foodborne illness in the US. While the disease often has no symptoms, it can also cause serious illness and even death in people with an immunodeficiency, such as newborns, people undergoing chemotherapy and AIDS patients, the CDC says. Toxoplasmosis can be prevented. Advise clients to clean litter boxes at least once a day, and to wash their hands well after scooping feces or handling their cats. Pregnant woman and those with immune-related illnesses should avoid cleaning litter boxes, or wear gloves and a mask when doing so. cdc.gov IVC Winter 2012/13

It’s a new science that studies the connection between nutrition and our genes – and how we can optimize canine and human health by designing diets for each individual’s genetic makeup.

KNOW

A B OU T

NUTRIGENOMICS BY W. JEAN DODDS, DVM

YOU KNOW A GOOD DIET CAN HELP keep your patients healthy by enhancing their immune systems, increasing their energy levels, and reducing their risk of developing diabetes, heart disease and even cancer. It’s also important to realize there’s a connection between nutrition and genes. Nutrigenomics is an emerging science that studies the molecular relationships between nutrition and the response

IVC Winter 2012/13

of our genes, to determine how even subtle genetic changes can affect human and animal health. The basic concept is that chemical nutrients affect gene expressions in a specific mode by switching from health to a pathophysiological condition, or vice versa. Nutrigenomics designs optimal nutrition based on an individual’s unique genotype. Simply stated, nutrigenomics defines functional foods based on an individual’s genes.

THE BACK STORY The role of diet and nutrition continues to be a major focus of study when addressing the increasing incidence and recognition of dietrelated diseases in humans and animals. Nutrition research is studying how dietary constituents at the molecular level can optimize and maintain cellular, tissue and organ balance to help prevent disease. The development of nutrigenomics has been aided by powerful advances in genetic research. Genetic variability, the inter-individual differences in genetics, can affect metabolism as well as an individualâ&#x20AC;&#x2122;s phenotype. Genetic disorders of nutritional metabolism can cause abnormal physiological effects that are exhibited as population diversity. Simple examples would be the genes associated with obesity or diabetes in various canine species, and vitamin B12 deficiency in giant Schnauzers.

RATIONALE AND AIMS Nutrients relay signals that tell a specific cell in the body about the diet. Basically, a sensory system in the cell interprets information from nutrients about the dietary environment. Once the nutrient interacts with this system, it changes gene (genomics) and protein (proteomics) expression and metabolite production (metabolomics) accordingly. So different diets elicit different patterns of gene and protein expression and metabolite production. Nutrigenomics describes the patterns of these effects, which are called molecular dietary signatures.

An important aim of nutrigenomics involves identifying the markers of early phases of diet-related diseases, so that nutritional intervention can return the patient to a healthy state. Another aim is to demonstrate the effects of biologically active food components on health, leading to the design of functional foods that will keep individuals healthy according to their own specific needs.

APPLYING NUTRIGENOMICS TO DOGS Recently, veterinary and nutrition scientists have begun applying animal genomics to the field of nutrition. Nutritional genomics and proteomics will play a vital role in the future of pet foods. Functional genomics will emerge as important areas of study, now that the genome â&#x20AC;&#x153;mapsâ&#x20AC;? for the dog are available.

Different diets elicit different patterns of gene and protein expression and metabolite production. Studying and monitoring the health of dogs parallels that of humans. Close to 500 canine genetic diseases have been described to date. Molecular biological techniques have been used for several decades to identify the cause of single gene disorders in animals, allowing for prevention and treatment strategies. Currently, at least 30 canine disease genes have been cloned and characterized. This has led to the development of genetic mutation-based tests for diagnosis and carrier detection. These tests permit the elimination of carriers from the breeding population, ultimately decreasing or eliminating the incidence of disease. Continued on page 12.

IVC Winter 2012/13

Continued from page 11. However, while determining the DNA sequences of single gene mutations is now feasible, identifying the genetic loci (locations on the genome) responsible for complex genetic diseases is a much more difficult task. Nevertheless, dogs serve as excellent models for the nutritional diseases in other animal species and humans. Although a genetic component exists for these conditions, nutrition plays a major role in the development and/ or treatment of many. Changing lifestyles in urban populations have led to a significant increase in obesity and diabetes in people and dogs. The negative health outcomes of obesity and diabetes observed in humans are also seen in canines. These are just two common examples of animal diseases having both a nutritional cause and a therapeutic component.

FUNCTIONAL FOODS Certain dietary constituents such as vitamins A and D, zinc and fatty acids can directly inﬂuence gene expression, whereas others such as dietary fiber can have an indirect effect through changes in hormonal signaling, mechanical stimuli, or metabolites produced from the microbial ﬂora in the bowel.

FIVE BASIC CONCEPTS OF

NUTRIGENOMICS

1. Diet can be serious risk factor for a number of diseases. 2. Common dietary ingredients act on the animal genome (the total genetic information), both directly and indirectly, to alter gene expression and structure. 3. Certain diet-regulated genes play a role in the onset, incidence, progression, and/or severity of chronic diseases. 4. Dietary intervention based on an animal’s nutritional needs and current state, applied together with his/her genotype, can prevent, mitigate or cure chronic disease. 5. The degree of dietary influence on the balance of health and disease states in the body depends on an individual’s genetic makeup.

So-called “functional” food ingredients and herbal supplements are now being incorporated into animal as well as human foods. Examples of nutrients currently added to pet foods include those intended to improve joint health such as glucosamine, chondroitin sulfate, and green lipped mussel. Others protect the body from cellular free radical damage, and include vitamin E, beta carotene and selenium. Omega-3 fatty acids improve the skin, while oligosaccharides (carbohydrates) and probiotics are good for gut health. It’s also important to keep in mind that the benefits provided by pet foods designed for a dog’s life stages, body type or lifestyle may be well suited for one dog, but not another. With our growing knowledge of genes and gene expression, it should be possible to formulate diets not only for preventing structural abnormalities, but also for more complex diseases such as diabetes, cancer, aging, behavioral changes and heart disease. In summary, animal nutrition professionals need to be able to prescribe or recommend nutrients and diet formulations based on a more precise knowledge of how nutrients or food components interact at the level of the genome. Diets for dogs should be designed and tailored to the genome or genomic profile of the individual in order to optimize physiological balance, disease prevention and treatment, and performance. Our advancing knowledge about human and animal genomes, along with the breadth of biotechnology, offer us the opportunity to individualize dietary intervention to help prevent, mitigate or cure chronic diseases.

IVC Winter 2012/13

References Dodds. Proc AHVMA 2009, 2010, 2011. Kaput et al. Pharmacogenomics. 8(4), 2007. Müller and Kersten. Nature Rev. Genetics, 4: 315 -322, 2003. Swanson et al. J. Nutr. 133:3033-3040, 2003. Trayhurn. Brit J Nutr. 89:1-2, 2003.

IVC Winter 2012/13

The

hyperpermeable bowel

THE DIGESTIVE TRACT is more than a means of deriving nourishment. In addition to its very important functions of digestion and absorption, the gastrointestinal tract is also the largest organ of the immune system in the body. The percentage of lymphocytes residing in the GI tract are estimated to range between 60% to 80%.

When we eat, we want the digestive system to absorb all the good stuff while keeping out all the potentially toxic, antigenic and pathogenic materials in food. How can the digestive system possess the innate intelligence to exclude noxious materials while allowing for the entry of nutrients? The answer lies in the four levels of protection provided by the barrier system of the GI mucosal wall: 1. Mucus layer covering the microvilli 2. Tight junctions between epithelial cells 3. GALT-sIgA in the mucus of the glycocalyx 4. Probiotic species

IVC Winter 2012/13

BY ROBERT J. SILVER DVM, MS, CVA

The GIT (gastrointestinal tract) has the greatest amount of surface area exposed to the environment of all three barrier systems in the body. In humans, the skin has less than ten square meters of surface area, whereas the lungs have about 140 square meters. The human gastrointestinal tract, however, has 320 square meters of surface area exposed to the environment. These surface area relationships are comparable in veterinary species as well.

Disturbances to the GI mucosal barrier The GI mucosal barrier can be disturbed by factors associated with GIT injury, exposure to toxins or infection. Bacterial infections and endotoxins can injure the tight junctions holding intestinal mucosal cells together. Bacterial overgrowth secondary to inappropriate use of H2 blockers and antacids can lead to

proximal gut colonization by pathogenic bacteria that are “attracted” to the more alkaline pH. Immunosuppressed or protein-deficient patients can have decreased sIgA production, which impairs the immunoprotective value of this secretory immunoglobulin. sIgA is embedded in the mucus layer (or glycocalyx) that overlies the mucosal epithelia.

Clinical disorders associated with leaky gut syndrome (LGS) as reported in human literature • Inflammatory and infectious bowel diseases (Katz, 1989) • C hronic inflammatory arthritis (Skoldstam, 1991; Rooney, 1990)

The liver provides defensive activity both in terms of its phagocytic Kupffer cells, and its enzyme detoxification systems. The liver has a dual-phase system of detoxification. Hepatic enzymes decontaminate toxins and metabolic toxic by-products, and help degrade antigens and antigen/antibody complexes. Kupffer cells are the sessile hepatic macrophages found in hepatic sinusoids; they play an important role in the GI immune system by removing bacteria, particulate matter and toxins.

• D ermatoses such as acne, psoriasis and dermatitis herpetiformis (Hamilton, 1985)

Compromised barrier function increases the total toxic load on the body as a whole by allowing ingested toxins and xenobiotics entry into the systemic circulation, bypassing the portal circulation, thus allowing these foreign substances entry into the body without modification by hepatic detoxification enzymes.

• P ancreatic carcinoma (Braganza, 1983)

Contrary to the recommendations of folk medicine, prolonged fasting may do more harm than good in patients with challenged immune systems. “Bowel rest” for more than three days has been shown to cause deterioration of the enterocyte population, which can lead to atrophy of the mucosal surface, alterations in bowel permeability and an overall diminution of gastrointestinal immune function. Studies have shown that early enteral feeding can improve splanchnic blood flow and immune system function. With disrupted barrier function, antigens and pathogens are allowed to gain entrance into the systemic immune system. The first contact of antigens and pathogens is with dendritic cells that then carry the information from those antigens or pathogens to naïve B and T cells, and “activate” them to be specific for those antigens or pathogens. Following their activation, naïve T and B lymphocytes clone themselves and then migrate to the regional mesenteric lymph node. From the regional lymph nodes, these activated lymphocytes enter the lymphatics, and from there the venous circulation and systemic blood supply, ultimately migrating back to a specific anatomical region of the GI tract.

Increased immune mobilization leads to disease When allergens and pathogens are prevented from being absorbed into the systemic circulation by healthy mucosal barrier mechanisms, there can be no systemic immunological response (Hamilton, 1985). Disrupted bowel barrier function, however, will lead to inappropriate increases in antigen and toxin loads

• C onditions triggered by food allergies or specific food intolerance such as eczema, urticaria and irritable bowel syndrome (Faith-Magnusson, 1984) • C hronic hepatitis (Whitcomb, 1994) • A cute and Chronic pancreatitis (Braganza, 1983; Juvonen, 2000)

and will disrupt detoxification mechanisms, thereby creating increased immune system and liver enzyme mobilization. Over time, this can lead to chronic pathology. Disrupted bowel barrier function has three synonyms: 1. Hyperpermeable bowel 2. Increased intestinal permeability 3. Leaky gut Impaired barrier function can also lead to diseases of the immune system. For instance, when bowel permeability increases, classic hypersensitivity to foods and components of normal gut flora can result (Galland, 1993). Bacterial endotoxins, cell wall polymers and dietary gluten may cause non-specific activation of proinflammatory pathways mediated by complement and cytokines. In experimental animals, chronic low grade endotoxemia has been shown to contribute to the development of auto-immune disorders (Branganza, 1983). Increased intestinal permeability may be either involved in the course of each disease, or may be a secondary effect of the hyperpermeability leading to immune activation and hepatic dysfunction, creating a vicious cycle of disease promotion.

Measuring intestinal permeability The measurement of increased intestinal permeability in veterinary species requires measured urinary collection with a urinary catheter in place. This makes it more difficult to diagnose without hospitalization. Typically, in the measurement process, different sized, nondigestible long chain sugars are administered orally, and IVC Winter 2012/13

Pathogenesis of LGS 1. An inflamed gut does not absorb nutrients and foods properly, resulting in common symptoms of fatigue and bloating. 2. The inappropriate leakage of large food particles promotes food allergies and GI symptoms. 3. With compromised detoxification pathways, chemical sensitivities can arise. The leakage of toxins overburdens the liver so the body is less able to handle its everyday burden of chemicals needing detoxification. 4. Disruption of the protective mucosal barrier causes the body to be unable to adequately resist infection by protozoa, bacteria, viruses and yeasts. 5. Intestinal hyperpermeability allows bacteria and yeast to translocate. Translocation is the migration of bacteria or yeast from their appropriate organ environment to an inappropriate organ elsewhere in the body where they can set up infection or inflammation. 6. Intestinal hyperpermeability increases the formation of antibodies due to the hypersensitivity of the immune system created by the syndrome. These antibodies can help to set up autoimmune diseases that have been linked to the hyperpermeable bowel.

: Bella

collected in the urine. The ratio of shorter to longer chain sugars defines whether the barrier has been breached, which allows increased urinary recovery of longer chain sugars. Thus, unless it is being specifically measured, the role of increased intestinal permeability often goes unrecognized. There’s a new and emerging methodology of food sensitivity and intolerance testing that measures food ingredient-specific IgA and IgM in the patient’s saliva, serving as a practical, non-invasive screening for increased intestinal permeability. Secretory (mucosal) IgA is lower with a disturbed intestinal barrier mechanism, and this test can help quantitatively measure food-related antibodies directed against IgA and IgM. Preliminary studies suggest this testing methodology yields highly accurate results. The value of the test is not simply as a screen for leaky gut; it will also help substantially with the formulation of hypoallergenic diets (Miller, 2010; Pfaffe, 2011; Swanson, 2003).

The 4Rs The hyperpermeable bowel can be treated and managed successfully with a four-part treatment program (“The 4Rs”) that uses diet, herbs and nutraceuticals to reverse the causes and risk factors for increased intestinal permeability. Many naturally occurring substances can help repair the intestinal mucosal surface, or help improve hepatic function when it is overwhelmed by an excessive total toxin load (Galland, 1993; Nathens, 1996; functionalmedicine.org). Continued on next page.

g hyroxine 0.4 m pplement with l-t su ; gy lo ro se y rg sed on food alle ws: ntrollable ba co program as follo un 4R r e fo th r e at ne iti io in tit D; ac BI pr l rr ed by a loca lergenic ically-diagnosed toxins – hypoal Bella w as refe t for endoscop s, en en th tm tig ow an ea gr tr s, er g en ov in llow one present), cterial Remove pathog weight loss fo e pathogens (n l intestinal ba at al d in sm an im el E d to an in s m is ie ta strit diet, fecal stud pr ednisone, vi eosinophilic ga euticals. continued en tr eated with t be gh d ei w ha ’s e la current phar mac Sh el B op . st ea rh (SIBO). ar di lecithin, ng and some glutamine and 9. 2/ th wi to e 9 folate for vomiti m 5/ Zy of Rx n and a– ent fr om a BCS wel inflammatio ir bowel mucos bo pa es Re uc ed to dr op; she w (r ay h from y, RxCl th EPA/ of hair re-growt r), UltraEFA wi otic 8 B CFU/da ye Bi ck la la Rx r g; ie rr do g ba l un provide alyx bowe R, appetent yo flammation and in increases glycoc ce du Subjective: BA re to ylcholine o. DHA/phosphatid wel wall repair. IV six months ag r fo st te to l nents for the bo ne po m pa co d oi al yr ur th ct e ru st ; complet kly low, allergy serology low, T4 was fran e lin er RxZyme rd Objective: Food bo as ive factor s – tis (FT4 w st di oi ge yr di th 9 e e 2/ ac un S pl m BC Re autoim re WNL); es. toantibodies we digestive enzym thyroglobulin au n? tio rp so ab al m n/ oid? Maldigestio wel microflora – erline hypothyr rd and absorption Bo n t: tio nc en oculate with bo fu in sm e Re iv st Asses ge di g in day. e bowel affect RxBiotic 8 B CFU/ Hyper permeabl nt intake? ie tr nu te ua eq ad of nutrients? In edients months, Bella poallergenic ingr s: Within three hy lt su om fr Re et di and ed healthy weight e home-prepar had regained a Plan: Formulat 9. had a BCS of 5/

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Continued from previous page.

1 2 3

Intestinal absorptive cells

REMOVE pathogens, allergens and toxins. By lowering the “total load” (the body’s burden) of these troublesome substances, the immune system and liver do not need to work as hard in processing them. This makes more energy available to direct toward re-establishing healthy patterns. removal can be done by elimination from the diet or environment, or by the use of agents such as antimicrobial agents to reduce the population of pathogenic organisms.

REPLACE digestive factors that are inadequate or absent. inadequate pancreatic or intestinal enzyme production leaves digesta only partially broken down, thus altering the environment in the bowel and providing opportunity for pathology to develop. The beneficial bacteria that produce short chain fatty acids (SCFA) from soluble fiber in the bowel need a narrow range of temperatures and pH, as well as adequate substrate for their activity. When food is only partially digested, the intermediate breakdown products of digesta do not promote healthy microfloral ecology. An example of this is the small intestinal bacterial overgrowth (SiBo) seen with EPi. REPAIR damaged intestinal mucosal barrier. The use of the free form amino acid l-glutamine reduces bacterial translocation, and increases the protein synthesis of enterocytes, enabling them to increase their rate of selfrepair. The phospholipid-rich compound lecithin, and the omega 3 fatty acids commonly found in fish oil, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are also integral to repairing intestinal mucosa damaged from disease, stress, toxins or diet.

Antioxidants reduce roS damage to intestinal mucosa. Zinc and vitamin B5 (pantothenic acid) are involved in the mucosal repair process. Soluble fiber promotes SCFA production which provides nourishment for repairing damaged colonocytes. rice protein solids have been found to reduce intestinal secretions and improve re-absorption of water from colonic digesta.

Glycocalyx Microvillus Tight junctions

Basal lamina

REINOCULATE with probiotic cultures and accessory nutrients to create healthy bowel ecology. Endogenous and transient probiotic Gi microbial flora are extremely important factors in maintaining a healthy Gi mucosal barrier. Anaerobes are the most numerous bacteria in the bowel. These commensal beneficial microorganisms compete with potential pathogens for nutrients and attachment sites to the mucosa, thereby inhibiting bacterial overgrowth by pathogenic gram negative bacteria. Antibiotics can upset this balance between good and bad bugs. H2 blockers and hyperosmolar enteral diets can result in bacterial overgrowth.

rEFErEnCES Braganza, J.M. “Pancreatic disease: a casualty of hepatic detoxification?” Lancet, 1983. ii: p. 1000-1002. Faith-Magnusson, K., et al. “intestinal permeability in atopic and non-atopic mothers, assessed with different-sized polyethyleneglycols (PEG 400 and PEG 1000)”. Clin Allergy, 1984. 14(3): p. 277-86. Galland, L. and S. Barrie. “intestinal dysbiosis and the causes of disease”. J Advancement Med., 1993. 6: p.67-82. Hamilton, i., et al. “Small intestinal permeability in dermatological disease”. Q J Med, 1985. 56 (221): p. 559-67. Juvonen Po, Alhava EM, Takala JA. “Gut permeability in patients with acute pancreatitis”. Scand J Gastroenterology 2000; 12:1314-1318. Katz, K.D., et al. “intestinal permeability in patients with Crohn’s disease and their healthy relatives”. Gastroenterology, 1989. 97 (4): p. 927-31. Miller, C S, Foley, J D, Bailey, A L, Campbell, C L et al. “Current developments in salivary diagnostics”. Biomark Med 4:171-189, 2010. nathens AB, Marshall JC. “Sepsis, SirS and MoDS: what’s in a name?” World J. Surg 1996 May; 20(4):386-91. Pfaffe, T, Cooper-White, J, Beyerlein, P, Kostner, K, Punyadeera, C. “Diagnostic potential of saliva: current state and future applications”. Clin Chem 57:675-687, 2011. rooney, P.J., rT Jenkins, and W.W. Buchanan. “A short review of the relationship between intestinal permeability and inflammatory joint disease”. Clin Exp rheumatol, 1990. 8(1): p.75-83. Skoldstam, L and K.E. Magnusson. “Fasting, intestinal permeability, and rheumatoid arthritis”. rheum Dis Clin north Am, 1991. 17 (2): p. 363-71. Swanson KS, Schook LB, Fahey, Jr GC. “nutritional genomics: implications for companion animals”. J nutr 133:3033-3040, 2003. Whitcomb, D.C. and G.D. Block. “Association of acetaminophen hepatotoxicity with fasting and ethanol use”. JAMA, 1994. 272(23): p1845-1850

IVC Winter 2012/13

WINTER LAMENESS by KiM HeNNeMAN, dVM, dipLoMATe AbT, FAAVA, CVA, CVC

OR WORK IN SNOWY OR SLIPPERY CONDITIONS CAN BE DIAGNOSTICALLY CHALLENGING. A THOROUGH EXAM IS ESSENTIAL IN DEALING WITH THESE CASES.

For clients with active dogs, the change of season from summer to winter only means a change in the type of activity, not a change in its quantity. Winter means recreational activities such as snowshoeing, cross-country skiing, bounding after family members on toboggans and sleds or simply changing the daily walk from sidewalks and grass to icy roads and snow. Veterinarians are also called upon to examine competitive sled or skijoring dogs, winter search-and-rescue (SAr) dogs, or avalanche dogs. Constant activity on uneven or slippery surfaces of snow and ice, as well as contact with the sand and salt often used to treat roadways, can lead to lameness diagnostic challenges not typically found in other seasons.

IVC Winter 2012/13

There is a joke in the sled dog world that if a leg falls off of a dog, he will look at it for a moment and just decide to pick it up on the way back. A highly driven dog’s desire to continue active cannot be used as a measuring stick of pain or injury. Veterinarians must Photo courtesy of Andrea Booher

INJURIES SUSTAINED BY ACTIVE DOGS THAT PLAY, RUN

ski tip cuts – an How a dog gets handler’s skis.

avalanche/SAR

n the

dog runs betwee

are palpated in a quadriceps muscle, don’t think it can’t happen because there hasn’t been a published paper on it. your hands and the dog’s reaction will tell you more than anything else. Don’t talk yourself out of what you find. Continued on page 20. Photos courtesy of Kim Henneman

understand how the mind of a high-drive dog combined with a high-drive owner with competition or management pressures can contribute to injury and affect rehabilitation success. High-drive individuals will continue working through minor to moderate discomfort or dysfunction, often as if nothing has happened. When both athletic canines and caretakers ignore early warning signs, more serious injuries occur.

Thorough diagnosis is imperative

While managing pain and inflammation is a critical part of lameness treatment, a thorough diagnosis of the injured tissue can allow for the development of a specific recovery treatment plan. Alleviating pain and inflammation is not the same as returning to full biomechanical function. integrative veterinarians, especially those trained in manipulative, rehabilitative or massage techniques, are in a unique position to greatly influence the outcome of these types of injury, and guide injured patients back to full soundness (or as close as the dog’s age and previous structural status allow). A good diagnosis is just as imperative for the seemingly minor injury as it is for any other disease process.

Clockwise from top left: Interdigital snowballs/ice crystals on an avalanche dog; dewclaw rub with bootie; frostbite and bootie rub; foot cut in sled dog.

Sources of mild to severe unsoundness in dogs working or playing on snow or ice can include: Exacerbation of existing osteoarthritis Tendonitis (especially of the biceps brachii, foot flexors, Achilles) Collateral ligament desmitis (especially of the carpus, medial elbow, digits, medial stifle Carpitis Muscle strains (biceps, hamstrings, lumbar epaxials, iliopsoas) Cervical whiplash (from a front leg punching through hard snow surfaces) interdigital or pad dermatitis from snowballs, sand or salt abrasions interdigital or pad lacerations from snow balls, sub-snow foreign objects such as tree branches, or interactions with ski tips or snowshoes worn by a human companion Dewclaw inflammation from booties worn by working or racing dogs Frostbite

Common winter injuries

if it is a muscle, tendon or ligament, it can be injured or torn – in any body region. normal movement on dry surfaces tends to favor injuries of certain body regions, but slipping on or punching through snow or ice can injure just about anything. Keep an open mind when performing a physical exam. if swelling and pain IVC Winter 2012/13

Continued from page 19.

Frostbite in the average canine winter weekend warrior is somewhat rare, though it’s common in the sled dog. Any dog that spends a great deal of time out in the cold should be carefully checked. Commonly affected areas are usually non-

ABBA THE

Initial physical exam revealed: ✲ Difficulty resisting and maintaining a standing posture when pressure was exerted on the caudal lumbar/sacroiliac area of the spine. ✲ Postural asymmetry (goat on a rock stance) and lumbar kyphosis both standing and sitting. ✲ Significant shortening of hind leg range of motion, especially on a hard surface, at both walk and trot. ✲ Rapid fatigue on soft surfaces to the point of refusing to work. ✲ Both coxofemoral joints exhibited mild loss of total range of motion both in flexion and extension with no crepitus. ✲ Both pectineal ligaments on the ventral acetabular surface were painful on palpation when in weight-bearing, standing position. ✲ Atrophy of both quadriceps and superficial gluteal muscles. ✲ No overt lameness observed in the right front and no pain could be elicited. ✲ Slight tenderness palpable behind the right scapula at the latissimus dorsi synsarcoses, which was exacerbated by sliding of the scapula cranially. ✲ Her tongue was slightly pale and her pulses slightly thin, weaker on the right. Radiographs revealed slight thinning of the joint space in the hip joints and some roughness and enthesiophytes developing on the cranial acetabulum. There was slight flattening of both femoral heads in the areas of the capital ligaments, but both still were seated well within the acetabular sockets. A previous diagnosis of coxofemoral osteoarthritis had been made and the recommended treatment regimen involved only a non-steroidal inflammatory medication. The handler wanted to pursue other treatment options more oriented to the canine athlete. IVC IVCWinter Winter2012/13 2012/13

Muscle strains can happen any time a dog runs, plays or works on slippery surfaces of variable hardness. A weekend warrior pug or elderly but enthusiastic cattle dog playing on a berm of freshly shoveled snow will have the same stresses to soft tissue as an avalanche dog searching on the toe of a slide. in dogs without core strength, slipping on ice and snow can lead to moderate strains of propulsion and support muscles such as the quads, hamstrings, biceps (both brachialis and femoris), gracilis and triceps. older dogs with arthritis, osteoarthritis of

avalanche

Abba was a five-year old German shepherd actively working as an avalanche search-and-rescue dog at a major ski resort when she first presented for a history of slowing down, with stiffness and hindquarter weakness that became especially prominent when working on uneven snow. She had recently been displaying occasional limping on her right foreleg, which had responded well to aspirin.

weight-bearing ones such as the prepuce, scrotum, vulva and ear tips. The interdigital areas of the feet also need examining; an Australian shepherd avalanche dog had an old, healed ski tip injury on the metatarsus. That foot was more prone to cold compromise. The author’s preferred homeopathic remedies for frostbite include Agaricus, nitric acidum or rhus toxicodendron.

DOG

The diagnosis for Abba was coxofemoral osteoarthritis leading to compensatory biomechanical compromise of the lumbar spine and front limb soft tissue girdle (leading to stress of the latissimus dorsi synsarcoses attachments to rib periosteum). A Traditional Oriental Medical diagnosis was Kidney Qi Deficiency with Bony Bi Syndrome. Since Abba was a valuable (and talented) working dog, a long term plan to manage both the coxofemoral osteoarthritis and compensatory stresses was developed with the handler. The goal was to “head things off at the pass” in order to extend working life and increase comfort. The handler elected to initially manage Abba with diet, supplements, acupuncture and chiropractic. A rehab exercise program for core strengthening and joint range of motion maintenance was developed for summer use. Inflammation and biomechanical stress were monitored with periodic thermal imaging. Abba was started on an oral joint supplement of glucosamine, chondroitin, hyaluronic acid, vitamin C, MSM and boswellia (Chondrocare™). More raw and whole foods were added to the diet. Omega-3 fatty acids (oils from salmon, sardine and anchovie sources) and multiple strain human probiotics were added. Abba continued to train and work as an avalanche dog for four years. As her hips worsened and compensatory structural changes started to occur in other areas of her body (including suspected CCL strains), Traditional Oriental Medicine herbs (Adequan™ and Legend™) were added to her treatment. The need for NSAID use did not occur until five years after the initial visit. Abba was retired as a working dog at that time. The use of integrative therapies with appropriate diagnoses from thorough examination was critical in allowing this valuable working dog to continue effectively functioning several years past her anticipated retirement age.

Photo courtesy of Andrea Booher

Foot problems are probably one of the most common and easily overlooked causes of winter lameness. Snow buildup on the interdigital hairs can be prevented by spraying cooking oil or applying musher’s wax to paws and pads. irritation from sand or salt can be avoided by rinsing feet upon returning home. irritation from excessive exercise on abrasive snow or ice can be prevented with the use of booties, although caution must be exercised with fitting the bootie around the dewclaw. non-infected pad cuts, cracking or worn areas can be treated by attaching moleskin with superglue to the affected area and the use of musher’s wax or calendula cream.

Photo courtesy of Kim Henneman

Above: Thermal imaging of flexor tendonitis and carpitis.

limb joints, or changes in spinal architecture will be particularly susceptible to muscle injury due to an inability to respond to sudden balance loss. An appropriate diagnosis can be done with gait analysis, digital palpation, joint range of motion and stress testing. radiographs will be unremarkable with soft tissue injuries. Thermal imaging is an excellent tool for localizing the inflammatory or painful area; then the type of injury can be verified with ultrasonography. Ligament and tendon injuries are common in the active winter canine athlete. Dogs can strain medial and lateral collateral ligaments of any joint with the sudden, twisting and shearing that can happen with slips and falls. The repetitive stress of walking or running on uneven snow or constantly tripping on the heels of cross-country skis or snowshoes can cause injuries to the collateral ligaments and flexor tendons of digits and carpi. A single hind foot punching through crusty snow can injure an Achilles tendon. Again, older animals with previously existing joint or spinal compromises will be more susceptible to injury. it is critical that the veterinarian examining an animal with known pre-existing conditions be able to separate the old from the new and treat the fresh injury while supporting the existing weakness. A common clinical fallacy is to assume every rear leg lameness is a cranial cruciate ligament injury â&#x20AC;&#x201C; remember there are many structures in the hind leg that can be injured. Walking or running on ice or leaping on uneven snow piles can also lead to one-time or repetitive stress to joints, especially those of the lower limbs. Carpitis, tarsitis and phalangitis are common causes of vague and minor lameness in the winter. A healthy, normal canine carpus should flex to the point where the pads can touch the caudal (posterior) ulna. Sensitivity on flexion or IVC Winter 2012/13

Photo courtesy of Kim Henneman

r risk of snow- and ice

d to a greate SAR dogs are expose

-related injuries.

loss of range of motion are indications to evaluate for joint effusion. Keeping toenails short is critical for preventing digital and lower limb sprains. in dogs with previous injuries and repetitive weaknesses, use of flyball carpal supports can be very effective in avoiding carpal sprains. often, repetitive carpal and digital sprains (as well as biceps brachii strains) can come from compensatory overuse of the front limb in response to stiffness, weakness or mild soreness of the caudal spine, sacroiliac or hips joints.

Treatment options

The basic human sports medicine treatments of rest, ice and Compression may be all that is needed to successfully help the active lame canine, if they’re used swiftly.

Preventing

About 95% of a dog’s body is covered with hair. Besides making the dog soft and huggable, this coat helps protect the skin and keep it healthy. In both dogs and people, the skin is the largest and one of the most complex organs of the body. It’s a natural barrier that prevents dehydration and provides protection from the environment. IVC Winter 2012/13

A veterinarian does not have to be a sports medicine or rehabilitation specialist in order to properly handle a limping dog that may come into his or her clinic over the next few months. Making sure a thorough exam and good diagnosis is made, whether at a first visit or through a referral, is critical to a successful resolution of winter lameness, both in the short term and long term.

“bad hair” days

by Heidi Lobprose, dVM

Cold laser, homeopathic remedies, topical liniments (if they can’t be licked off), acupuncture and oral herbal formulas can also speed up recovery times. Early in injury, soft tissue therapies such as massage, Shiatsu and Tui na can be very beneficial. other manipulative therapies need to be approached with caution in a very fresh injury as aggressive therapy can dislodge fresh clots, thereby increasing hemorrhage and edema. The general rule of thumb with chiropractic and osteopathic therapies is to be cautious as long as there is less than full weight-bearing on a limb, since structural “straightening” can often relieve compensations and put weight back on a limb that is not quite ready.

In an attempt to keep the hair coat clean and fresh, many pet owners bathe their dogs with their favorite made-for-people shampoo, cream rinse or body wash. Unfortunately, the pH levels of human skin and canine skin are quite different. Products made to protect more acidic human skin can be troublesome for a dog’s more alkaline skin. If a shampoo formulated for human skin is used on a dog, it may disrupt the dog’s skin pH. This can create conditions for bacteria, fungi and parasites to get out of control. Furthermore, the shampoo may dry out the skin, which then becomes itchy. As the dog scratches, he can nick or cut his skin, allowing microorganisms to enter and start a cycle of skin problems. Everyone in your clinic can play a part in educating pet owners that maintaining a dog’s coat starts with an awareness of skin care. To avoid bad hair days, recommend only a pH-balanced, moisturizing shampoo formulated specifically for dogs and made to help maintain the pet’s natural skin oils.

IVC Winter 2012/13

By SUE ArMSTronG, MA, VETMB, VETMFHoM, CErTiAVH, MrCVS, rSHoM

IVC Winter 2012/13

ancer is one of the most common issues we deal with in small animal practice. Just as the causes are complex, so are the treatment options. More than any other disease, cancer has people going on the internet and adding every supplement they can find that’s claimed to cure cancer. This is one area in which the integrative practitioner, even if untrained as a veterinary herbalist or nutritional expert, has a responsibility to help guide people so decisions can be tailored to each individual.

Why diet is key

The importance of diet in treating and preventing cancer is long established. Some practitioners claim to treat cancer by dietary manipulation alone, focusing in particular on the elimination of cancer toxins and providing potentially deficient essential nutrients to support the immune system and liver.1 Many of the diets advocated for the treatment of cancer in humans are vegetarian, but this may not be applicable to obligate carnivores such as the cat and carnivore-biased omnivores like the dog.

Glucose and tumor cell proliferation 1) Most malignant cells have dysfunctional mitochondria and cannot sufficiently metabolize fatty acids or ketone bodies. 2) Ketone bodies, elevated when glucose is low, negatively affect tumor proliferation. 3) Most malignant cells depend on glucose availability. 4) Many human cancer patients exhibit altered glucose metabolism. 5) Cancer cells metabolize glucose for energy via a different pathway to healthy cells, and produce lactate as an end product, creating a local acid environment. 6) High insulin and insulin-like growth factor can directly promote tumor proliferation.

Growing evidence supports the basic principle in cancer nutrition of minimizing simple sugars and complex carbohydrates, and favoring protein and unsaturated fats as the main energy sources for humans, cats and dogs. This is based on studies of the metabolic requirements of cancer versus host cells. Cancer cells use protein for energy and will utilize certain amino acids, such as arginine, at the expense of the host.

Fats provide more calories per gram than protein and carbohydrates, an advantage to very sick animals able to ingest only small amounts of food. Most animals find fats more palatable. The biochemical response to food deprivation (even 24 hours of anorexia) leads to substantial dependence on fatderived fuels. As cancer progresses, alterations in normal patient metabolism occur; often these changes are irreversible without treatment and adequate nutritional support. Diet in cancer patients can be extremely challenging when the animal is inappetant, able to swallow only small amounts of food, or is vomiting. Cachexic patients need high energy in the form of fat, and even carbohydrates may have to be reintroduced at this stage, even though they give the tumor an energy supply. ideally, i prefer animals to be taken off refined commercial diets and put on raw whole food diets. Guardians need good instructions on how to create a good diet for their animals. They must be willing to spend the time putting the diet together every day, using high quality human grade foods. Some excellent companies produce well-formulated raw food diets that are complete and take the hard work out of it for clients with limited

Designed specifically for geriatric pets, Cholodin® may help with the following symptoms: Disorientation, confusion • Loss of appetite • Increased sleep time

•

Impaired hearing

Poor, thin, or dry coat Inappropriate urination

800-856-4648

www.mvplabs.com

Available through your Veterinary Clinic

IVC Winter 2012/13

Amino acids & fatty acids High quality protein and amino acids are required for dogs with cancer. Two amino acids in particular play a very important role.

1 2

Arginine is critical in collagen and urea synthesis. It stimulates the release of certain hormones (insulin-like growth factor), modulates immune function (lymphocytes have a requirement for arginine), and promotes wound healing. Arginine supplementation should be considered in most cases and particularly in animals undergoing surgical intervention where primary wound healing is required. Glutamine is the most abundant free amino acid in plasma and intracellular fluids, and plays a central role in several metabolic pathways. Intracellular glutamine forms an essential store of carbon and nitrogen which is rapidly mobilized in times of need for protein synthesis. It also has a role in the maintenance of normal gut and immune function. Supplementation with glutamine may help slow the rate of muscle breakdown and protein catabolism, and can be indicated in cancers of the gastrointestinal system, including the oral cavity. It is an important energy substrate for these cells. Because it is also a substrate for any rapidly dividing cell populations, there is a question if cancer cells use this substrate. It is often preferentially metabolized by brain tumor cells, so its use should be limited to cachexic patients with non-CNS tumors.

The addition of n-3 fatty acid supplements (Omega 3 fish oils and flaxseed oil) and a restriction of n-6 fatty acids (evening primrose oil and borage oil) alters the ratio between n-3 to n-6 fatty acids and has marked effects on the inflammatory cascade by reducing the number of pro-inflammatory cytokines. A double-blind, randomized placebo-controlled study2 to evaluate the effects of fish oil, arginine and doxorubicin chemotherapy on remission and survival time in dogs with lymphoma has shown that fatty acids of the n-3 series normalize elevated blood lactic acid in a dose-dependent manner, resulting in an increase in disease-free intervals and survival time for dogs with lymphoma. The addition of n-3 fatty acids to the diet should be carefully evaluated in each cancer case. A reduction in platelet aggregation has been noted in cats, so they are potentially unsuitable for tumors with a haemorrhagic tendency. There are also some reports of depressed immune function which may be due to increased tissue lipid peroxidation. In these cases, vitamin E levels should be assessed and may need to be raised to protect against the increased oxidative damage. 30

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time. Cheap fatty meats laden with carcinogens and old vegetables from the bottom of the fridge are as unhealthy to the animal as a refined diet. Dogs that have been used to commercial diets all their lives and are now very ill with cancer have to be transitioned carefully (it may not even be possible or advisable to change some cases); i do not use diets high in bone for these animals. Those with cachexia may not be able to handle raw food diets. At this stage, cooking the food, feeding it warm and not cold, and using high energy convalescence products is required. The home-formulated raw diet i use is essentially based on 2:1 meat/meaty bone to vegetable/fruit with an emphasis on human grade organic food. i also pay attention to the full spectrum of colors in fruit and vegetables to give the animal a good mineral/vitamin spread. if vitamin/mineral supplements are used, they must be bio-available and ideally sourced from whole plants. Additions to the basic diet include eggs, cottage cheese (especially if the liver is showing measurable signs of stress), spirulina, wheat grass, alfalfa juice and barley greens. reducing the acid load is helped by vegetables, fruits and the additions mentioned above combined with the elimination of refined carbohydrates, grains, sugars and dairy foods. Evidence indicates the cancer progresses more in an acid environment. There are also theories that take this understanding down to a basic imbalance between active ionized potassium providing positive electric potentials in health, versus negative potentials created by the ionization of sodium in disease. it is suggested that alongside detoxification, activated ionized minerals are essential for healing. The addition of digestive enzymes may be useful, especially in animals that have been fed refined diets for years.

Supplements for cancer

Many supplements, in addition to omega 3 fatty acids and l-arginine (see sidebar), are commonly used alongside basic cancer nutritional therapy. Most are taken directly from human cancer care, so there is little evidence available about dose rates, toxicity reports

and contraindications in cats and dogs. in addition, there is a huge tendency for clients to want to use everything possible with little understanding of the pharmacology of the substances used. This is of particular concern in animals undergoing chemotherapy and radiotherapy, as some supplements can radically alter the availability and toxicity of these potent treatments. Since some common supplements are immune modulators that may enhance the proliferation of tumor cell lines, they are not good for lympho-proliferative tumors. Here are some common supplements that have a growing evidence base for efficacy and safety in animals, and that i consider for my cancer patients:

Antioxidants, including vitamins A, C, E, beta-carotene and lutein are now added in increased quantities to many commercial pet foods, with anti-cancer claims being made for some of these foods. Chronic oxidative stress with formation of reactive oxygen species, especially when antioxidant capacity is inadequate, has been hypothesized to contribute to DnA damage, malignant transformation, and eventual tumor development in numerous species.

Very little is known about the potential anti-neoplastic effect of antioxidant supplementation in dogs and cats. However, the beneficial effects of dietary antioxidant supplementation on the development of malignant lymphoma and other neoplastic lesions in mice have been demonstrated at the Department of radiation oncology, University of Pennsylvania School of Medicine. The main message i would give about antioxidants is that they are of most use in prevention. They are often contraindicated in active cancer treatment, particularly cases undergoing treatments that rely on pro-oxidant cell death.

Mushrooms are increasingly shown to contain different classes of biologically active compounds with strong immunemodulating and anticancer properties. one extensively used in both traditional herbalism and modern clinical practice is Coriolus versicolor, also known as yun-Zhi. The chemical composition of the mushroom is very complex. Among various bioactive components derived from hot water and standardized ethanolwater extracts of C. versicolor, polysaccharopeptides (PSP) and protein-bound polysaccharides (PSK) have the strongest biological IVC Winter 2012/13

activity. The main effects on cancer are as follows: • PSP and PSK can inhibit the proliferation of leukemia, lymphoma, hepatoma, breast, lung and prostate tumor cell lines. Their antimetastatic activity has also been demonstrated. • PSP contributes to tumor eradication by stimulating both humoral and cell-mediated immune responses. • PSP and PSK increase the synthesis of interferon (IFN)-c and interleukin (IL)-2. • They enhance T-cell proliferation. • They stimulate macrophage-derived nitric oxide production and counteraction of the immuno-suppression induced by cytotoxic drugs. other mushrooms are also of considerable interest and frequently used in mixed mushroom preparations with or without the use of Transfer Factor – Cordyceps sinensis, Ganoderma lucidum, Grifola frondosa are just a few. Each has a specific array of immunemodulatory effects and needs to be carefully selected and understood, especially when lympho-proliferative diseases are present or when chemotherapy is used.

Curcumin is an extract from turmeric (Curcuma longa). it can be an extremely useful supplement in many canine cancers. it has been shown to have the following effects in relation to cancer: • Anti-proliferative effects in cancer cell lines • Induces apoptosis • Anti-angiogenic factors • Impedes tumor growth and metastases • Helps control matrix metalloproteinase activity • Anti-inflammatory • Pro-oxidant in high dose

it is generally well tolerated, although it has documented mild blood thinning properties so should not be given in cases of haemorrhagic tumors or immediately post surgery. it can be poorly absorbed so the quality of the product with regard to the percentage of curcuminoids present is essential. Curcumin can selectively enhance the cytotoxicity of chemotherapy agents, and in addition may reduce negative side effects. Due to these altered responses, any veterinary surgeon in control of chemotherapy must be aware if this supplement is being used.

Artemisinin is the active extract from the herb sweet wormwood (Artemisia annua). it has been shown to have the following properties in relation to cancer: • Anti-angiogenic • Increased apoptosis • Selective cytotoxicity against cancer cells due to their higher iron content when compared to normal cells.

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Artemisinin should not be used with high antioxidant supplements that act to buffer and protect against free radicals, because its cytotoxicity depends on the production of free radicals produced as a result of its interaction with iron in the cancer cell. it should not be given during or after radiotherapy for up to two months. radiotherapy causes the release of iron into local tissue, which could potentially lead to increased local cell damage.

In conclusion

you need to assess each cancer case individually to determine the animal’s nutritional requirements, as well as the frequency, consistency and method of delivering the food. With supplements, it is safer to give none than everything under the sun. if you do not know how they work, start with a corrected and appropriate diet and do nothing else. And caution your clients, as nothing provokes panicked self-treatment more than cancer.

Gerson M. Gerson Therapy Handbook, 5th Edition, Totality Books (1st Edition 2007). 2 ogilvie G, Vail DM. “Metabolic alterations and nutritional therapy for the veterinary cancer patient.” Withrow SJ, MacEwan EG. Clinical Veterinary oncology, Philadelphia, WB Saunders, 1996. 1

resources Klemente r, Kammerer U. “is There a role for Carbohydrate restriction in the Treatment and Prevention of Cancer?” nutr Metab, 2011, 8 (75), Biomed Central Ltd Mauldin G. “nutrition and the Small Animal Cancer Patient”, WSAVA,World Congress, Vancouver, 2001 Monro J. “Treatment of Cancer with Mushroom Products”, Archives of Environmental Health, Aug 2003, Vol. 58, no. 8. Clemmons rM. “integrative Treatment of Cancer in Dogs”, University of Florida, Department of Small Animal Clinical Sciences. Schoen & Wynn. Complementary and Alternative Veterinary Medicine, Mosby, inc.,1998. White C. “Cancer Smart Bomb, Part 1: An idea from Ancient Chinese Medicine”, new Horizons, Brewer Science Library, Summer 2002.

MAINTAINING

joint health in dogs

By FrAnCo CAVALEri, BSC nB

Metabolic influence has a big role in controlling joint pain in dogs. it can dictate how long it takes to gain favorable results from common joint supplements, thereby playing a significant part in efficacious pain relief. Whether this underlying metabolic influence is protective or degenerative depends largely on the body’s ability to manage antioxidants and oxidation. it also depends on the cellular balance of omega-type fatty acids the dog’s body uses to manufacture prostaglandins. Canine cells have the ability to manufacture internal antioxidants that protect and guide processes throughout the body. in joints, these antioxidants protect genes responsible for using glucosamine to build collagen. in young animals, these endogenous antioxidants are manufactured in abundance, preserving these genetic codes and the tissues they restore. research shows that an age-related decline in antioxidant production contributes to chondrocyte sluggishness, a result of oxidation. By supplying chondroitin sulfate and sufficient levels of antioxidants to compensate for this decline, we help maintain the cartilage, rejuvenating the chondrocyte matrix and facilitating the use of glucosamine and other connective tissue-building blocks to regenerate cartilage and manage joint pain and inflammation. Supplementing with omega-3 ALA, EPA, DHA and omega-6 linoleic fatty acids in the proper ratio can help establish the correct balance of omega fats in the body. This dictates the related hormone balance needed to restore healthy inflammatory control from yet another pathway. All these safe and healthpromoting synergies result in improved long-term success. Breed characteristics are merely one factor in the unique makeup of dogs. Metabolism is a reflection of the lifestyle given them, and is dependant on the food and supplements chosen, amount of physical activity offered and the environment created by their owners. franCo CaVaLeri, BsC nB is a graDuate of uBC in nutritionaL sCienCe anD BioCHemistry. His postgraDuate researCH efforts HaVe LeD to seVeraL aWarDs in tHe CanaDian HeaLtH inDustry. more information Can Be founD at BIOLOGICNR.COM.

IVC IVCWinter Winter2012/13 2012/13

Product Profile

Antimicrobial enzymes –

an effective alternative to

antibiotics

ir Alexander Fleming’s discovery of penicillin nearly 85 years ago changed the world of medicine forever. Since then, antibiotics have saved millions of lives worldwide. But there’s a new problem – the growing proliferation of antibiotic-resistant superbugs. The declining effectiveness of antibiotics is caused primarily by their overuse in both human and veterinary medicine. Antibiotics are frequently prescribed for a range of conditions in dogs, cats and other animals, from ear infections and skin allergies to gastrointestinal upsets, urinary tract infections, periodontal disease and more. While these drugs are often crucial for dealing with acute conditions, too many antibiotics often cause the bacteria to become resistant to the medication, rendering it ineffective. Another culprit of drug-resistance involves clients failing to follow veterinary directions for administering antibiotics (e.g. stopping the medication before the full course has been used, and starting it up again days or weeks later when/if the infection returns). When attacked by antibiotics, bacteria adapt swiftly to survive. They do this in a variety of ways – by swapping genetic information; altering their own cell structure to make them impenetrable to the drug; or even excreting the antibiotic from the cell before it can do any damage. Many superbugs also have the capacity to survive for long periods on living and non-living surfaces (from door handles to a

IVC Winter 2012/13

by Ann Brightman with Deborah Brown

pet’s skin) by forming a biofilm, thereby greatly enhancing their ability to spread. Antimicrobial enzymes are a key weapon in the battle against many disease-causing microbes. “The quest to destroy biofilms is becoming a priority and enzymes – in certain combinations – are offering hope,” says Deborah Brown of PKB Animal Health. “While bleach may destroy biofilm on objects it’s unrealistic to use bleach on the body. “There is evidence that enzymes have antimicrobial effectiveness, are selective with their lock-n-key feature and only target the offending organism without disruption to friendly bacteria,” adds Ms. Brown. “Antibiotics attack both good and bad bacteria and are non-selective.” Bacteria cells don’t form a memory against enzymes, so they can destroy antibiotic-resistant microorganisms. The patented LP3 Enzyme System used in PKB Animal Health’s line of Zymox ear, skin, wound and infection care solutions (pkbanimalhealth.com), features a combination of three key antimicrobial enzymes – lactoperoxidase, lactoferrin and lysozyme. Given how well antimicrobial enzymes work against antibiotic-resistant bacteria, they surely merit a frontline role in the war against superbugs.

IVC Winter 2012/13

get published!

IVC Winter 2012/13

Marketing basics: Could you be your community’s “celebrity” veterinarian?

By Dana Cox

t’s a dog-eat-dog world out there, and today, more than ever, veterinary practices need sound marketing strategies in place to survive and prosper. The good news is that you’ve got something incredible to sell – the ability to provide health care and advice for the lifetime of an animal. The bad news is that marketing can be overwhelming, time consuming and expensive if you don’t know what you’re doing. There are many facets to marketing, including branding, advertising, direct marketing, and social media, all of which are designed to attract new clients and/or retain current clients. One strategy that you can implement quite reasonably is a public relations (P.R.) initiative. Your goal here is to make yourself or your practice the “go-to” authority for the local news media. The more your name is seen in the public eye, the more awareness and goodwill you create. Potential clients will perceive you as a reputable leader in your field and current clients will experience a sense of pride in their “celebrity” veterinarian. This strategy can work well, particularly in smaller communities, and especially if you offer any services out of the ordinary. Before you begin, find out which of your staff might be interested in helping with P.R. Then follow this step-by-step breakdown on how to initiate a P.R. strategy in your community:

IVC Winter 2012/13

Determine your media contacts. It’s important to first decide which media outlets you’re going to reach out to. Talk to your clients (and have your staff member keep track) to find out which local newspapers and periodicals they read, which radio stations they listen to, and if they check in regularly with any local websites. Make note of the news editors and specifically any reporters that seem to cover your area of expertise. That might be lifestyle, health care or even sports, depending on the topic. Have staff track down their email addresses and phone information, and start a media contacts list. Remember to keep it updated since reporters and editors sometimes change “beats” or move on to other publications.

Create some newsworthy story ideas. The media are always on the lookout for unique articles, and this is especially true of local media. If you can deliver to them a “canned” article they can publish, it could be the start of a wonderful relationship. Start by thinking up five to ten ideas. Consider seasonal content e.g. why and how to avoid ticks in your area, or articles related to unique services you and your practice may offer e.g. massage or acupuncture. The trick is that the story must not appear to be self-serving. Reporters can smell this tactic a mile away. Make the story about the

animals but keep in mind it must appeal to a wide audience if it’s going to be newsworthy. If your idea is to write about acupuncture for senior animals, for instance, take “before” and “after” photos of a couple of animals. Check with the animals’ owners first to see if they’d be willing to provide quotes or speak to a media outlet about their personal experience. Real cases make a story come to life for the reader so it’s worth the extra effort. Once you have some story ideas in mind, you’re ready to write up a media release.

write uP anD senD out your reLease. A media release “pitches” or conveys your story idea and some details to a media outlet. Your release should be no longer than one page, and should feature an informative, catchy headline, a lead paragraph that grabs attention while imparting the essence of the story, and two or three subsequent paragraphs of content that provide more details. The release may also include a quote from you or one of your clients, which supports the information in your story and helps give it “color”. Your release should also feature the date on which you send it out, as well as your contact information so the media can easily reach you should they like some additional details or want to schedule an interview. For an example on how to set up a release, visit www.IVCjournal.com/MediaRelease. If you have relevant photos to go with your release, make sure they are high resolution (print publications prefer 300 dpi) in either jpeg or tiff format. Attach your release and photos and send them directly to the people on your media contacts list. Follow up a couple of days later by phone and/or email to make sure the contacts received the material. Take this opportunity to introduce yourself and inquire as to whether this type of information is of interest and whether the contact would like to receive additional story ideas in the future. If the contact responds positively, follow up once a month or so. Once you have a relationship, you won’t need to write a release every time. A simple email with your idea and some relevant points may be all that’s required. Developing a P.R. strategy takes a little thought and some time but the rewards can pay off with greater awareness of your services and hopefully increased business. Dana Cox is tHe CHief CreatiVe offiCer anD eDitor-in-CHief at reDstone meDia group. Before founDing tHis puBLisHing anD marKeting agenCy, sHe Was Vp at CarLson marKeting group, tHe WorLD’s Largest marKeting agenCy, anD assoCiate CreatiVe DireCtor at BBDo. sHe Has Won numerous

PART 2 by LUCy posTiNs

While dogs generally don’t suffer from true celiac disease, gluten consumption can cause problems like chronic gastrointestinal upset (colitis), as well as itchy skin, hot spots, chewing at the paws, and ear infections. Simply reducing or eliminating grain from the diet can clear up these problems in a matter of weeks, and reduce the need for steroids and antibiotic treatments. Some believe long-term undetected food intolerances may also be the underlying cause of degenerative diseases such as cancer, heart conditions and kidney failure. A diet heavily weighted in refined grains promotes the production of insulin and inflammatory chemicals. not all health conditions are directly related to grain consumption, but the overload of grain and general lack of variety in most commercial pet diets is thought to deplete the animal’s natural state of good health and immunity, leaving him more susceptible to various health problems. There’s lots of debate about the dog’s true ancestral diet and whether or not grains and seeds formed a part of it. While many dogs do better with little or no grain in their diets, some actually do need some grain to maintain a healthy body weight or because they get dry skin and dull coats when they go “grain-free”. However, when pets are suffering with chronic itchiness, digestive upset, ear infections or some of the other conditions listed here, a grain-free diet is certainly worth a try for a few weeks.

LuCy postins is tHe Co-founDer anD Ceo of tHe Honest KitCHen pet fooD Company, WHiCH maKes DeHyDrateD naturaL Dog anD Cat fooD as WeLL as treats anD suppLements. LuCy Has Long Been interesteD in tHe Benefits of Home CooKeD anD raW fooD for pets anD starteD researCHing HeaLtHy nutrition for Dogs anD Cats after aDopting a

rHoDesian

riDgeBaCK puppy in

2000. sHe

Began

formuLating pet fooD proDuCts a year Later, anD LaunCHeD

Honest KitCHen in 2002.

tHe

aWarDs for Her marKeting initiatiVes oVer tHe

forD, BritisH airWays, t-D BanK LoyaLty management group (air miLes).

years on WorK for CLients suCH as anD

IVC Winter 2012/13

Advertorial

CDS and

stress by Heidi Lobprose, DVM

he holidays are often a time of great cheer – but they can also be times of great stress, for pets and people alike. With all the commotion and changes associated with holiday activity, pets sometimes don’t get the level of attention they need, at a time when they may need it most. Take, for example, that group of dogs and cats that have been around longest – the senior pets. While the designation of “senior” can vary depending on the size of the animal, once a pet has reached seven years of age, there’s a good chance he has reached his golden years. Given his diminishing capacities of hearing and sight, even rearranging the furniture to add decorations can disrupt an older pet’s normal routine and make it difficult for him to adjust. An influx of unfamiliar and noisy visitors (or even boarding at a kennel) can confound the situation even further. This may seem accentuated in some older individuals because beyond sensory decline, they might also be experiencing cognitive decline. Prior to the holidays, signs of cognitive dysfunction may have been very subtle, but they can become more noticeable during the hustle and bustle of the season. Members of the American College of Veterinary Behavior (ACVB) use the acronym DISHA to best describe the behavior changes associated with cognitive dysfunction syndrome (CDS). All these can damage the bond between owners and their aging pets. You and your clients can evaluate pets using this acronym.

D = Disorientation. The pet may act confused and appear lost, wandering aimlessly around the house. I = Interaction changes. The pet socializes less with members of the household, including other pets. He may become irritable and no longer want to be handled. S = Sleep-wake cycle. The pet no longer sleeps through the night. He may pace or vocalize, disturbing the household at all hours of the night. The pet will also now sleep through the day. H = Housesoiling. The pet no longer adheres to the rules regarding housetraining. Dogs may eliminate in the house without asking to go out, and cats may eliminate outside the litter box. A = Activity. The pet becomes less and less active (even during the day). He may also exhibit signs of anxiety – vocalization, pacing, repetitive or destructive behaviors. Once medical reasons have been ruled out or managed, a diagnosis of CDS may be made. Behavioral modification with re-training and even environmental enrichment can be helpful, but sometimes additional intervention is needed. Particularly in less advanced cases, studies have shown that supplementation with products containing S-adenosylmethionine (SAMe) tosylate can help decrease symptoms and improve executive function in dogs and cats (Araujo et al, Intern J Appl Res Vet Med, 2012, v10n1). NOVIFIT ® (NoviSAMe®) tablets contain S-adenosylmethionine tosylate in a patented formulation that has been shown to help improve the cognitive health of both dogs and cats. Dr. Heidi Lobprise, Diplomate of the American Veterinary Dental College, graduated as a DVM from Texas A&M University in 1983. She became a board certified veterinary dentist in 1993. In 2010, she joined Virbac Animal Health as Senior Technical Manager. She has authored and co-authored dental texts, chapters, and numerous articles, lectured internationally and is an adjunct associate professor

IVC Winter 2012/13

University of Tennessee and Washington State University.

IVC Winter 2012/13

case study

a Case oF retro-orbItal absCess: how It Changed a veterInarIan’s vIew oF Complementary medICIne by

SteVe MARSDeN, DVM, ND, MSOM lAC. DiPl., Ch, CVA

CHELSEA WAS A SIX-YEAR-OLD COCKER SPANIEL with the usual panoply of ear and skin complaints. There was nothing about her to suggest she would be the dime on which my life turned. But one day in 1994, she presented with something new. She’d stopped eating and was lethargic. On physical examination, she had a high fever and was painful when her mouth was opened. There were no other problems, so the presumed diagnosis was the early stages of masticatory myositis, in which the jaw muscles become inflamed by an autoimmune disease so that eating is impossible. The treatment for masticatory myositis is high daily dosing with prednisone, but something about Chelsea told me to give her antibiotics as well, “just in case”. Sure enough, Chelsea was back next day with her right eye completely disfigured and pushed right out of her head. She had a retro-orbital abscess that the immunesuppressing prednisone had fanned to life, and which the antibiotics had then been incapable of addressing. Every time Chelsea opened her mouth, the back of her jaw pushed up into the eye region and elicited pain. Her owner stated she didn’t want the dog back until the problem was solved. It was too grisly a sight for her.

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This makeshift surgery proved helpful and the eye moved back a little into its socket as pus gushed out. But the amount of pus the eye kept forming was astonishing in spite of every antibiotic I tried. I expressed a full tablespoon of pus from behind that little eye three or four times a day! Meanwhile, Chelsea’s pain was unrelieved, and the eye itself was steadily deteriorating. Despite consistent treatment over the next few days, the cornea became drier until finally it was like brown leather on an eyeball that still protruded from the skull. She also wasn’t eating and looked miserable. This wasn’t working.

sUrGery to start The standard approach in a case like this was to use forceps to bluntly tunnel from the roof of the mouth into the orbit, and allow the pus to drain downwards into the mouth. The surgery is fairly straightforward, but in Chelsea it didn’t work. The tissues of the entire region were so edematous that the tract closed as soon as the forceps were pulled back out. Since the abscess could not drain that way, and the eye was severely protruding, drying out and turning cloudy, a different approach was needed. A slit was made in the conjunctiva, and by pushing the eyeball backwards, pus could be squeezed out from behind it and through the slit, lessening at least some of the pressure.

I consulted an ophthalmologist to see if he would take her on. He said cases like Chelsea’s occasionally happened, but there wasn’t much that could be done. He added that the assumption was a foreign body must be behind the eye, but exploratory surgery invariably failed to find it. He could consider enucleation, but the infection would likely then spread up the optic nerve into the brain, killing the patient. In short, he could only see one likely outcome for Chelsea – euthanasia. Continued on page 44.

the tIssUes oF the entIre regIon were so edematoUs that the traCt Closed as soon as the ForCeps were pUlled baCk oUt.

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Continued from page 43. The thought of euthanasia repelled me. Chelsea had an otherwise healthy body. It didn’t make sense to me that I would have to destroy her for the sake of one eye. But she was also in terrific pain and was miserable. What could I do?

Homeopathy does the trick Chelsea happened to show up at a critical time in my career. I had been dabbling with homeopathy – slowly cutting my teeth on it by using acute-acting remedies for minor first aid situations. I’d yet to see homeopathy work for a situation where there was no other recourse, yet this was the reason I had got into it in the first place. Whether I liked it or not, Chelsea was going to be that test case. The first step, of course, was to discontinue the prednisone and antibiotics. In my experience, homeopathy can be started while animals are still on drugs. But the medications weren’t helping, and something told me I needed this to be as clear a test of homeopathy as possible.

I gave the remedy three times a day, and within two days, Chelsea’s eye had settled completely back into the socket.

IVC Winter 2012/13

• The first remedy I knew right off the bat, given the first aid books I’d been reading. Hepar sulphuricum is a common homeopathic first aid remedy for acutely painful abscesses. Within a day of liberally dosing Chelsea with it, the discharge turned from purulent to clear, but remained copious. The eye developed a bit of a shine to it, becoming white instead of leathery. fter two more days, there were no further improvements, but I A was excited. Something good was happening. The question was what to do next. •A ll I had to guide me was Kent’s Repertory. It listed all the remedies credited with treating a particular symptom, but it was written in the 19th century when the field of medicine used vastly different terminology. “What would they have called this?” I muttered as I flipped through the pages in the eye section. Chelsea didn’t have an abscess any more, just profound generalized swelling with a clear discharge. But it wasn’t pitting edema, either. What was it? Then I saw the heading, and instinctively knew I had the answer: orbital cellulitis. By sheer luck, there was only one strongly ranked remedy to deal with it: Rhus toxicodendron. I gave the remedy three times a day, and within two days, Chelsea’s eye had settled completely back into the socket. The corneal opacity had disappeared. I could scarcely believe my eyes – or hers either! A day later, I felt I was witnessing a small miracle as I discharged a healthy dog back to her owner.

Become a

member of the Walkin’ Wheels referral program

A week later, my heart was thumping with anticipation as I called to check on Chelsea. Her owner confirmed the eye was still completely healed, and added she could no longer even remember which eye had been the problem. A critical hurdle in my evolution as a veterinarian had been cleared in those few days. I saw homeopathy conquer something for which conventional medicine could only offer death as a solution.

Walkin’ Wheels is a fully adjustable canine cart that easily changes size in height, length and width to accommodate different sizes of dog and various levels of mobility – from partial to complete paralysis of the rear legs. An optional front wheel attachment is available for dogs with weak front legs. These dog wheelchairs are ideal for long term or rehabilitative use. This veterinarian-approved product can be ordered online at HandicappedPets.com using one simple measurement of a dog’s height. The wheelchair also folds flat for convenient transport and storage. Many customers are interested in locating a local veterinarian who is familiar with Walkin’ Wheels and can provide professional assistance with their dogs’ mobility problems. HandicappedPets.com offers a referral program to connect clients with veterinarians who can recommend a Walkin’ Wheels dog wheelchair and other treatment options for dogs that can no longer walk. As a member of this referral program, veterinarians receive a listing on the HandicappedPets.com website as well as product information, instruction materials, and a set of referral cards for clients to use on the website. Participating veterinarians are eligible to receive a referral fee. HandicappedPets.com offers a full range of mobility, safety, transport and incontinence products for elderly, disabled or injured pets. The product selection includes dog wheelchairs, pet diapers, drag bags, stretchers, slings, harnesses and more. To learn more about the Walkin’ Wheels veterinary referral program, call 888-811-7387 or e-mail vets@handicappedpets. com.

IVC Winter 2012/13

industry innovations Herbal formulas made simpler

Prescribing herbal products for your patients just got easier. Herbsmith Herbal Bites combine herbal formulas with a complimentary USA-sourced meat in one easy-toadminister freeze dried medallion. Your clients won’t have to measure, mix, wrap, and hide herbs. This is a naturally delicious TCVM solution for domestic carnivores. Each morsel delivers a quarter teaspoon of herbs without any grains, preservatives, additives, ﬁllers or fuss. The product is available in 16 popular core formulas that address common issues seen by veterinarians. Herbsmithrx.com/HerbalBites.asp

Innovative probiotic features PB6

GI issues are one of the most common reasons for veterinary visits. New from Kemin is RESOURCES™ Protegrity™ GI, a clinical-strength health supplement that promotes a balanced GI system. It’s the only probiotic supplement on the companion animal market that contains the patented probiotic Bacillus subtilis PB6, which is backed by over a decade of research and has been scientiﬁcally proven to be safe, stable and beneﬁcial. The research has shown that PB6 works better than other Bacillus subtilis strains to help maintain optimal GI balance and provide better protection against intestinal pathogens. Isolated from a natural source by Kemin scientists, and characterized as a non-GMO strain, PB6 promotes optimum GI health by inhibiting the growth of several key intestinal pathogens, including those associated with diarrhea, to help maintain normal stool quality and GI function. In addition, PB6 does not interfere with the good bacteria necessary for optimal GI health. Protegrity GI is available in a palatable chew, making gut health maintenance easier for dogs, owners and veterinarians alike. Kemin.com

IVC Winter 2012/13

Supplement improves behavioral health

Quincy Animal Health, makers of the cognitive supplement Neutricks®, recently announced the results of the Old Dog Survey, a pet-owner observational study checking for behavioral markers that indicate the overall health of an aging dog. A total of 70 dog owners participated in the study over the span of one month. They were asked to rate their dogs in categories of cognitive and overall health by logging on to OldDogSurvey.com at Days 0 and 30 of the study and answering questions about their pets in six areas: disorientation, housetraining, pain, sleep, disposition and interaction with family members. Neutricks was tested against a control group not taking the supplement. The survey showed that the Neutricks group experienced an overall 24% improvement in aging symptoms; there was also a reported 45% improvement in house soiling problems, a 23% improvement in disorientation issues, and a 22% improvement in sleep. “House soiling and disorientation are among the top reasons that a pet owner will decide it is time for euthanasia,” says Dave Merrick, General Manager of Quincy Animal Health. Neutricks.com

Natural cooking for dogs

Now there’s a great resource for clients looking to switch to a whole foods diet. Natural Cooking for Dogs offers more than 50 recipes for people who want to provide balanced, nutritious and delectable meals for the canines in their families. Recipes include main meals, treats and special needs diets for dogs suffering with cancer, kidney disease and more. It also outlines the beneﬁts of ingredients, including cinnamon, carob, etc. This fun, creative and informative book is guaranteed to be a hit with your clients who need a guiding hand (and it’s a great reference tool for your ofﬁce!). New from the publishers of Animal Wellness Magazine and IVC Journal. A percentage of proceeds goes to support The Smiling Blue Skies Cancer Fund.

IVC Winter 2012/13

winter feeding

FOR horses

T r a n s i t i o n i n g to a h ay d i e t d u r i n g t h e c o l d w e at h e r m o n t h s m ay lead to deficiencies in key nutrients and a need for supplementation. by Juliet

As nature slips toward dormancy in winter, hay becomes the forage of choice for most horses. Once fresh grass is cut, dried and stored as hay, however, its vitamin content, along with valuable Omega 3 fatty acids, dramatically decline, making supplementation necessary to fill in the nutritional gaps. Hay also has very little moisture compared to fresh pasture.

Shift slowly and check teeth Any time the diet changes, it should be done gradually to allow the hindgut microbial population to adjust. This is also a great time to have your patients’ teeth checked for points that can make chewing painful. Hay is more difficult to chew and teeth need to be in top shape.

Vitamin D is key Hay cannot compare to fresh grass when it comes to nutritive value. Once grass is cut, dried and stored, it begins to lose vitamins C, D and E, beta carotene (for vitamin A production), and Omega 3 fatty acids. Normally, a horse produces vitamin D when exposed to sunlight. But spending more time indoors, combined with shorter daylight hours,

IVC IVCWinter Winter2012/13 2012/13

M. Getty, PhD

In other words, it takes more than hay to keep horses healthy during the colder months. Even horses living in a milder southern climate without the blizzards of the north are impacted by weather changes in a variety of ways. Optimal nutritional planning will help your equine patients enjoy the season and emerge in good condition when spring arrives. can induce a vitamin D3 deficiency, leaving bones, joints and muscles unprotected. When exposed to sunshine, 7-dehydrocholesterol in skin oils is converted to cholecalciferol, which is then converted in the liver and kidneys to vitamin D, known as 25-hydroxy-cholecalciferol, or D3 for short. It’s a hormone, since it is produced in the kidneys, yet it has effects in the small intestine and bones. D3 is critical for maintaining blood calcium, so the horse’s bones, joints and muscles function optimally.

√ D3 helps calcium absorption in the gut. √ If there is not enough calcium in the

diet, D3 triggers the bones to release calcium into the blood. √ D3 prevents loss of calcium in the kidneys.

A half-hour to 90 minutes in the sun will give the average person all the daily vitamin D he/she needs. But it typically takes five to eight hours of exposure to ultraviolet light (which is still present, though to a lesser degree, on cloudy days) for horses to produce enough vitamin D. This increased time is due to many barriers including hair, blankets, fly sprays, coat conditioners and reduced body oils (if recently bathed). Winter (with its blanketing and less sunlight), frequent bathing and an indoor lifestyle cause vitamin D deficiency, leading to reduced appetite, slowed growth, bone demineralization (leading to stress fractures and bone deformities), and poor muscle contraction. Therefore, a vitamin supplement, along with flaxseed meal or chia seeds (to provide Omega 3s), will fill in the nutritional gaps created by hay-only diets.

â&#x20AC;Śit typically takes five to eight hours of exposure to ultraviolet lightâ&#x20AC;Śfor horses to produce enough vitamin D.

Consider alfalfa Contrary to popular opinion, alfalfa is not higher in sugar than grass hay. It is high in protein, but this is a good thing. At a moderate intake (approximately 10% to 30% of the total hay ration), it boosts the overall protein quality of the diet to keep a horseâ&#x20AC;&#x2122;s muscles, joints, feet, skin, hair and bones fed, as well as protect her blood and immune function. Alfalfa also serves as a stomach buffer against developing an ulcer, a common occurrence when a horse is stalled during the winter after being accustomed to fulltime turnout.

Hay should be offered free-choice Cold weather increases the metabolic rate, which means horses need to burn more calories to maintain a normal internal body temperature

IVC IVCWinter Winter2012/13 2012/13

Flaxseed

and consistent weight. When hay is provided free-choice day and night, it simulates the horse’s natural need to graze. It allows her to consume the increased amounts she needs to help stay warm and account for this higher energy requirement. Free-choice is always best (regardless of the season or condition) because it allows the horse to self-regulate her intake and eat only what her body needs. Horses that experience an empty stomach between hay “meals” will eat their hay very quickly. Horses offered hay free-choice will learn there is always hay available, and will therefore eat more slowly and self-regulate their intake to eat only what they need to maintain condition. This lowers the risk of colic.

Concentrates for more calories For many horses, hay will not provide enough calories to maintain normal body condition. A high-fat commercial feed is fine for healthy horses. For the easy keeper or insulin-resistant horse, avoid sweet feeds and those that contain oats or corn. Beet pulp, alfalfa pellets, or low starch commercial feeds are excellent alternatives. Fatty feeds such as rice bran, flaxseed meal, or chia seeds offer the most concentrated source of calories. Avoid corn or soybean oils, since they promote inflammation due to their high Omega 6 fatty acid content. When clients feed bran mashes, or any added feed, they should give it every day. Consistency will prevent colic. Keep in mind, however, that bran (rice or wheat are most common) is very high in phosphorus in relation to calcium. Therefore, advise clients to use a commercial product with added calcium, or to feed alfalfa to counteract the elevated phosphorus content.

Older horses need special attention The older horse may need a joint supplement along with vitamin C for collagen production (the protein found in bones and joints), since less vitamin C is produced as horses age. For the hard keeper, clients should make sure there is no competition from younger, more aggressive horses for hay. Older horses should receive a senior feed, along with added flaxseed meal.

Other winter tips •W ater consumption needs to stay at optimal levels. Since most horses do not drink enough water when it is icy cold, it is best to use a heated water bucket to bring the water temperature up to 50ºF. Dehydration due to decreased water consumption is the main cause of colic during the winter. Snow is not a substitute for water. Continued on page 52.

Preventing colic when transitioning to hay Because of the nutrient differences from grass, and because hay has very little moisture compared to fresh pasture, colic risk significantly increases in the winter months. Colic is the number two killer of horses, number one being old age! Colic isn’t actually a disease; it’s a symptom of another problem. With increased hay consumption, impactions and excess gas production are the most common causes. Enteroliths (stones) are often seen in high alfalfa hay diets. And ulcers often develop when a horse is transferred from day-long turnout to longer periods of time in the stall. Following the feeding guidelines in this article will significantly lower the risk of colic.

Special keys to prevent colic: •T he client should offer hay 24/7 to keep the intestinal motility normal, prevent acid buildup, and protect the vital forage-digesting hindgut microbes. • Make diet changes slowly. • Offer a prebiotic. • Provide plenty of tepid water. • Provide salt, which encourages drinking to prevent impactions. • Limit winter stalling. • Float teeth to prevent partially chewed hay, which can cause impactions throughout the digestive tract. • Allow the horse to be a horse just as much during the winter as the rest of the year. • Consider an intestinal soothing supplement, typically containing herbs such as chamomile and slippery elm, to ease digestive distress.

IVC Winter 2012/13

Continued from page 50.

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• Use a prebiotic (fermentation product, not live microbes) or a potent probiotic (one that contains billions – 109 – colony forming units) to keep the hindgut microbial population healthy. Boosting the health of bacterial flora living in the hindgut eases the transition from one form of forage (pasture) to another (hay). • Don’t forget salt. Salt blocks, free-choice granulated salt, or two tablespoons of table salt added to the horse’s meals per day (divided between meals), will keep his body in proper water balance. Salt blocks are made for cattle with their scratchy tongues; horses’ tongues are smooth so they may avoid salt blocks because they can cause irritation. Clients can offer granulated salt, free-choice. They should start out with a small amount so the horse’s curiosity won’t result in him eating a big mouthful of salt. Once the horse sees it’s salt, the client can fill the container with enough to last a few days. A full-sized horse requires approximately two tablespoons (one ounce or 28 grams) of table salt per day, divided between meals. • Clients should avoid blanketing their horses if at all possible. The winter coat is designed to keep the horse warm and regulate his internal body temperature. However, horses should have access to a shelter to get out of the wind, rain and heavy snow so their skin remains dry. Blankets flatten the coat, making it unable to protect the horse against extreme cold. If the horse is very thin, or clipped, and the client finds a blanket is necessary, have her check his condition each day to make certain he is not sweating.

QUALITY OF HAY Not all hay is alike. If clients have two months’ supply or more, it is worthwhile for them to have the hay analyzed for its sugar and starch content, as well as protein, minerals and selenium levels. Equi-Analytical Labs will offer a complete analysis at a nominal

fee:

To learn more visit equi-analytical.com.

IVC Winter 2012/13

BOWEN THERAPY by LyNN peCK, dVM, Msbio ANd CAroL beNNeTT, CAb/Tbi, rbp, ANA

Learn how this effective hands-on healing technique can help with musculoskeletal pain and other issues in horses and small animals.

C A N A H A N D S - O N T E C H N I Q U E really help laminitis pain, musculoskeletal problems (mild, severe/acute and chronic) TMJ and digestive issues, as well as reduce anxiety and an inability to focus? Touch Balancing/Animal Bowenâ&#x201E;˘ (TB/AB) is a gentle, hands-on therapy based on the human Bowen Technique developed by the late Thomas Bowen of geelong, Australia. The technique consists of a series of gentle rolling moves on the skin performed with fingers and thumbs or an open palm, using minimal pressure. The moves are done at specific locations in specific sequences, with brief pauses in between that allow time for the nervous system to respond. Touch Balancing/ Animal Bowen is an adaptation of the Bowen Technique for use in animals. it was developed by carol Bennett of durango, colorado in the mid-1990s.

How it was developed TB/AB came about as a result of a disabling auto accident that left Bennett with chronic neck, back, shoulder and arm pain. her

IVC Winter 2012/13

discomfort was only partially responsive to chiropractic, acupuncture, myofascial release, Western medical interventions and other therapies. A physician friend urged her to attend a Bowen course being given in the United states. The first treatments left Bennett virtually pain-free, and also resolved several structural problems remaining from the accident. realizing that this modality would be highly beneficial for animals, Bennett spent the next two years studying human Bowen Technique and becoming a certified practitioner, adapting the moves to animal anatomy with input from several veterinarians, and finally writing a manual. her work was recognized in 1997 by the Bowen Academy of Australia and was approved as the recognized Bowen for small animals. since then, TB/AB has been used with success on a wide variety of animal species, large and small, and is being taught across the United states.1

the technique The basic technique consist of sets of small, gentle, precise moves performed using the thumbs, fingers or palms. each move starts with a preparatory action called “taking slack”, in which a small “reserve” of loose tissue is created. 1. This is done by first moving the skin overlying a specific muscle or tendon to the edge of the structure, in the direction opposite to which the move will be performed. 2. gentle pressure is applied and held against the edge of the muscle or structure, so as to stretch and displace it slightly from its normal shape and position. This is called the “challenge” (figure 1a). 3. A slow rolling move is made back over the muscle or structure while maintaining the light pressure. The muscle or tendon springs back to its original shape and position as the thumb or fingers pass over it (figure 1b). This is a dynamic event, similar to plucking a string on an instrument. 4. finally, a two-minute “hands-off” wait ensues to allow time for the nervous system to respond. changes in tissue tension, mental/emotional state, and energy/activity are seen to occur during this waiting period.

TB/AB TREATMENT EFFECTS

FIGURE 1A A TB/AB MOVE - THE CHALLENGE: HOLDING PRESSURE ON THE MUSCLE EDGE WITH THE PALM.

FIGURE 1B TB/AB MOVE: ROLLING OVER THE MUSCLE EDGE IN A PALM-TO-FINGERTIP “WAVE” MOTION.

• Release/rebalance muscle tension • Realign the spine and joints • Modulate ans function • Reduce visceral and musculoskeletal pain • Mobilize fascia and scar tissue

• assist lymphatic drainage • increase peripheral circulation • Reduce stress, fear, and anxiety • improve functioning of injured structures

IVC Winter 2012/13

FIGURE 2 A TYPICAL RESPONSE TO A TREATMENT IS PROFOUND RELAXATION.

The most basic sequence of moves is performed along the spine, and is aimed at balancing/releasing tissue tension from the cervical vertebrae to the sacrum and coccyx. during the course of a treatment, some moves may be repeated or augmented with additional procedures to address other areas or organs. The moves are usually done only once or twice over an area, the pauses observed, then the next region addressed.

physiological basis and theory There is no clear consensus as to how the Bowen moves work. Anatomically, the various moves are made over sites of acupuncture points and meridians, trigger points, neurolymphatic reflex points, and proprioceptors of the joints. Alpha motor neurons, which directly initiate skeletal muscle contraction, receive both inhibitory input from the golgi tendon organs and excitatory input from muscle spindle fibers that are activated by the stretching action of the challenge.2 skin pressure and vibration from the “plucking” effect of the moves also stimulate somatic sensory pathways which convey information to the alpha motor neuron and by various spinal tracts to the thalamus, then the somatosensory cortex, prefrontal cortex, and limbic system. The latter includes areas associated with behavior and emotion, conditioned fear and anxiety, memory, sympathetic inhibition, and the fight or flight response.3

clinical researcher. When a muscle is neurologically inhibited or weak due to aberrant signaling of the cutaneous receptors, stretching the skin over the weak muscle causes the muscle to become immediately facilitated or temporarily strong again. vibrating the skin simultaneously with the stretching activates specific receptor types and makes the correction long-lasting or even permanent.4 Both stretch and vibration are elements of the Bowen moves. since an inhibititory muscle dysfunction usually results in the antagonist muscle(s) becoming hyperfacilitated (staying in a prolonged state of excessive tone), “turning on” or facilitating the inhibited muscle also has the effect of normalizing the antagonist muscle(s) tone and, presumably, alpha motor neuron function as well as the associated cortical and cerebellar pathways involving higher brain centers, leading to autonomic nervous system modulation. Two particular effects have been observed in human studies that support this concept. The first is that the Bowen Technique can modulate the balance between the sympathetic and parasympathetic nervous systems as evaluated by heart rate variability (hrv) studies, and so is able to shift the highly stressed/painful body out of a sympathetic (fight or flight) dominant state into a more parasympathetic (rest and digest) state, which supports healing and more normal function.5

BEFORE TREATMENT: THIS HORSE ALWAYS POSITIONED HIMSELF UP AT AN ANGLE SUCH THAT THE LATERAL HALF OF HIS RIGHT HIND HOOF WAS PROJECTING OVER THE EDGE OF THE FLOOR. HIS FEET ALWAYS WERE IN AN ASYMMETRIC PATTERN.

The author proposes a mechanism based on the following observation of george goodheart, a neuromuscular

FIGURE 3 UNEQUAL MUSCLE TENSION CAN DISTORT STRUCTURE AND PRODUCE PAIN.

IVC Winter 2012/13

IMMEDIATELY AFTER A SINGLE TREATMENT: THIS HORSE’S STRUCTURE WAS MUCH MORE BALANCED, AS SEEN BY THE SYMMETRIC PATTERN OF HIS FEET, SELF-POSITIONED, WITH ALL FOUR FULLY ON THE FLOOR.

Sacroiliac problems

A nine-year-old “A” show hunter pony was diagnosed by scintigraphy with right sacroiliac inflammation after several months of hind limb and jumping problems. He was recommended for 12 months of turnout, with a discouraging prognosis for future soundness. The owners opted to give the gelding away. On exam, the pelvis was rotated to the left; the right tuber coxae was approximately 1½” inches higher than the left and 2” anterior. The sacrum was also rotated, high on the right. A single TB/AB treatment was performed. Within a few minutes, the pelvis and sacrum were significantly improved to almost normal position, with concurrent improvement of the pony’s gait. The pony was also started on a detoxification protocol to reduce chemical-related inflammation and muscle dysfunction. After a two-week turnout, he had improved to the point that he was started slowly back under saddle. He continued to be completely sound for flat work and light jumping for some six months until a tragic kick from another horse broke his leg.

People undergoing Bowen therapy report a deep sense of overall relaxation following a treatment, which may persist for days to weeks afterwards. Pain – both acute and chronic – will often disappear after even a single move or session. For example, in one pilot study, human subjects with fibromyalgia reported pain relief of up to six weeks following a single Bowen treatment.5 In animals, significant shifts towards calmer behavior are usually observed (Figure 2). Rapid Eye Movement sleep often occurs in small animals during a treatment. The beneficial effects appear to be cumulative, resulting in longlasting improvement, even when chronic patterns of physical dysfunction have been present.

Chronic-acute abdominal pain from possible adhesions

A 19-year-old Andalusion mare had an unusual history of acute pain and collapse with changes of weather. She was unable to get up for hours, until a single injection of flunixin meglumine was given. Her regular veterinarian insisted it was not colic. The mare was also a survivor of West Nile Virus infection, but had lost a seven-month pregnancy during her illness. Although previously of “fiery” temperament, she had been subdued, moved slowly and seemed weak ever since. On exam, a concave area several inches across was noticed directly in front of her right udder. The left side appeared normal. A series of paired Bowen moves was performed across the concave area, after which the mare was turned out into an adjoining pasture – whereupon she broke into a canter for possibly the first time in several years! Two years later, there were no recurrences of the collapses and she is still back to her original self.

The second observation is that the technique can balance muscle tension between the left and right sides of the body or across a joint.6 According to a model of neuropathic pain proposed by Dr. C. Chan Gunn, unequal muscle tension along the spine or across joints can produce abnormal pressure distribution which affects the surrounding nerves and tissues, blocking the flow of motor impulses, and sensitizing the nerve and associated skeletal or smooth muscle (Figure 3). This sensitization can further cause sustained muscle shortening or spasms in a self-perpetuating cycle, leading in many cases to chronic pain and eventually osteoarthritis. Restoring symmetry of muscle tension by releasing/relaxing the shortened muscle(s) was found to bring long-term pain relief to many of Dr. Gunn’s patients.7 Continued on page 58.

IVC Winter 2012/13

Clinical applications

• There are even instances of this technique being instrumental in restoring normal blood glucose values in a diabetic animal.

Pain relief in acute injury Subtle lameness/gait abnormalities Restrictions in gait or range of motion TMJ or teething problems Shoulder or forelimb lameness Back pain Sacral and pelvic pain Lumbosacral vertebral misalignments (e.g. scoliosis, kyphosis, lordosis) Acute and chronic laminitis Scar treatment

•T B/AB can often address emotional/behavioral issues associated with fear, physical trauma or abuse. Dr. Peck (co-author of this article) has had very good success treating thunderstorm phobia and separation anxiety in dogs using only this technique. TB/AB is a versatile, wide-ranging and effective therapy that has many uses in equine and small animal veterinary practice. Because it is very non-invasive, most animals will accept treatment with minimum restraint and quickly come to enjoy it. It is particularly valuable for subtle or difficult to diagnose problems, for rehabilitation after injury, and to improve or maintain performance in show or sport horses; but it also can help chronic gastrointestinal, respiratory or behavioral problems.

Continued from page 57.

Veterinary clinical applications TB/AB is a good first line therapy for any condition in which physical or emotional stress is a factor. In any emergency or acute condition, one or two specific moves can be employed to help reduce shock and pain.

References www.animalbowen.com.

Denoix, J-M and Pailloux, J-P. Physical Therapy and Massage for the Horse, pp 7-13. Translated by Jonathon Lewis. Trafalgar Square Publishing, North Pomfret, VT, 2001.

Price, D.D. and Bushnell, M.C. “Overview of Pain Dimensions and Their Psychological Modulation”, Psychological Methods of Pain Control, pp 3-17. IASP Press, Seattle, WA, 2004.

• For chronic musculoskeletal conditions including back pain, sacroiliac pain, or cervical problems, a TB/AB treatment can immediately begin to address compensation patterns of movement or muscle use that may be contributing to overall painfulness, and improve freedom of movement. • S pecific procedures for respiratory and digestive issues can help correct a variety of problems in these systems, and support homeostasis.

ABCs of

home

dental care by Heidi Lobprose, DVM

Walther, David S. “Applied Kinesiology: Synopsis”, 2nd edition, pp. 66-67. Systems DC, Pueblo, CO, 2000.

Whitaker, J, Gillam P, Seba D. “The Bowen Technique: A Gentle Hands-On Healing Method that Affects the Autonomic Nervous System as Measured by Heart Rate Variability and Clinical Assessment”. Presented at the American Academy of Environmental Medicine Annual Meeting, December 1997, La Jolla, CA.

Bennett C. A research project on the application of the Bowen Technique on TMJ abnormality was started in Durango, CO by Dr. John Bauman, DDS. Assessments of left and right masseter muscle tension by biofeedback, measurement of bite and subjective symptoms were compared before and after treatment. Immediately after the first treatment, 20 out of 22 patients showed significant reduction in left-right masseter muscle tension differences and approximately one out of three patients felt dramatic relief in some of their symptoms.

Gunn, C. Chan. “An Introduction to Radiculopathic Pain”, The Gunn Approach to the Treatment of Chronic Pain, 2nd edition, pp. 3-10. Churchill Livingstone, New York. preserved by behavioral enrichment and dietary fortification: a two-year longitudinal study”. Neurobiol Aging, 2005; 26:77–90.

Awareness – Make clients aware of the impact of dental disease. Oral disease is the most common abnormality diagnosed in all pets of all age groups. Periodontal disease affects as many as 85% of dogs and cats over the age of four, but can be seen as early as six months of age. A neglected mouth is an infected mouth. Bacterial toxins may lead to periodontitis, pain and discomfort, while bacterial wastes create a foul odor (the “halitosis” that is so offensive to pet owners). Chronic oral disease can spread bacteria to infect other parts of the body, including the lungs, heart, liver and kidneys. Belief – Help clients believe their efforts can make a difference. When the veterinarian recognizes the medical value of dental care, and can speak with conviction, the client is more likely to accept the recommendation for home care. When the veterinarian can’t make strong medical recommendations, clients won’t accept their services, no matter how valuable. Most dental disease is preventable through a program of oral hygiene and regular professional care. Preventing oral disease must be as much a part of a pet’s routine healthcare as vaccinations, heartworm prevention and flea control.

Compliance – Design a realistic level of home care to maximize compliance.

Once the client has accepted the need for home dental care, choose a program with the best chance of success – chews, rinses or brushing, alone or in combination. Whatever method you use to establish a habit, advise clients to start slowly and be consistent.

IVC Winter 2012/13

Saddle fit and the

GROWING horse*

By Jochen schleese, cMs, cee, cse

A – straight tree points are marginally better than forward facing tree points when it comes to interference with the scapular cartilage, as seen in B – forward facing tree points can cause chipping at the scapular cartilage. Ideal situation is in C with rear facing tree points that mimic the angle of the shoulder. Diagram D (below) shows the different growth phases of the horse at various ages – the withers shape changes and the muscular definition and profile expands. With complex physiological issues, veterinarians may recommend treatments to alleviate symptoms. The horse beneﬁts greatly when the healthcare team works together, combining knowledge to understand underlying factors. This series discusses concepts to assist professionals in the diagnostic process.

ideally, there should be two to three fingers clearance on both the top and sides of the withers, as measured from the point just above where the saddle’s stuffing starts. on a mutton-withered horse it may be as much as four to five fingers clearance.

expensive “custom” saddles are often purchased with the expectation that they should fit the horse forever. This is not the case, since horses change their conformation many times during their lives. Key areas on the saddle may result in a symptomatic refusal to move forward.

no clearance at the side means the horse’s movement will be restricted; he won’t have free range of movement through his shoulders, resulting in reluctance to go forward. More extreme signs of insufficient wither clearance are patches of white hairs or sores on the top or sides of the withers.

Wither clearance is an often misunderstood concept. Many of us learned in Pony club that our saddle should have two to three fingers clearance on the top of the withers, but were never taught there also had to be clearance on the sides. This is crucial because when the horse moves, his shoulder blades rotate upwards and backwards.

A reluctance to move forward can also be due to saddle tree points – specifically their direction! forward-facing tree points are extremely detrimental; Mris and fiber optic cameras have shown the chipping of cartilage that can occur on the scapular bone. every single extension of the foreleg will cause contact with these tree points – and cause eventual damage at the skeletal level.

To see how far the horse’s shoulder blade rotates back when he moves, stand to his side and mark the shoulder blade with a piece of chalk. have someone stretch the horse’s front leg forward, and mark the new position of the shoulder blade to show the rider how much farther back it is.

Diagram D

straight or perpendicular tree points are somewhat better, but still cause contact at the scapula, especially during extended movement of the leg or during jumping. The tree with rearfacing points is best; these mimic the scapular angle and allow maximum freedom of movement at the shoulder. *Part 2 of “Symptomatic Lameness” will appear in the Spring issue. JOCheN SChleeSe

iS A CeRtiFieD MASteR SADDleR WhO GRADuAteD FROM PASSieR AND CAMe tO CANADA AS OFFiCiAl SADDleR At the 1986 WORlD DReSSAGe ChAMPiONShiPS. he ReGiSteReD the tRADe OF SADDleRy iN NORth AMeRiCA iN 1990. JOCheN’S liFelONG StuDy OF eQuiNe DeVelOPMeNt, SADDle DeSiGN, the biO-MeChANiCS OF hORSe AND RiDeR iN MOtiON AND the DAMAGiNG eFFeCtS OF ill-FittiNG SADDleS, leD tO the eStAbliShMeNt OF SADDleFit 4 liFe iN 2005 (SADDLEFIT4LIFE.COM) A GlObAl NetWORK OF eQuiNe PROFeSSiONAlS DeDiCAteD tO PROteCtiNG hORSe AND RiDeR FROM lONG teRM DAMAGe. AuthOR OF THE SILENT KILLER –THE PAINFUL TRUTH OF SADDLE FITTING AND WHY IT DOESN’T WORK (2012 WuWei) AND NeWly ReleASeD DVD BEYOND THE 9 POINTS OF SADDLE FITTING, JOCheN iS DeDiCAteD tO StOP the PAiN FOR hORSe AND RiDeR.

IVC Winter 2012/13

spotlight DOG ON WHEELS Walkin’ Wheels dog wheelchair is the only canine cart that easily adjusts in height, length and width for a perfect fit. Ideal for long-term or rehabilitative use, Walkin’ Wheels can be stocked and sold or leased to your clients. Or, join the referral program and earn a 20% professional courtesy.

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ZEAL FOR HEALTH The Honest Kitchen’s grain-free fish recipe, Zeal™, is ideal for sensitive dogs who cannot tolerate more common protein sources. Zeal is naturally low-carb and low-fat with higher protein. It’s is made with Ethoxyquin-free, line-caught wild Haddock, wild Whiting and wild Salmon. Just add water for a fresh, wholesome, human grade meal. Try a sample today by emailing us!

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PEACEABLE KINGDOM When formulating Peaceable Kingdom Essentials products the focus has been on offering effective remedies with the highest quality ingredients; which are 100% USDA (and Penna.) certified organic. These products assure a gentle approach that addresses health and behavioral issues in dogs & cats We wanted to soothe any apprehension with the consumer with regards to the quality and integrity of our products. Natural Products~Natural Solutions Peaceable Kingdom Essentials.

HerbsForYourPets.com

STOP THE PAIN! Jochen Schleese’s DVD Beyond the 9 points of Saddle Fitting reveals harmful effects of ill-fitting saddles – lameness, atrophy, sore backs, “bad” behavior, hip/back/ pelvic pain. Jochen reveals the lameness of his competitive horse was caused by the saddle. Ride pain free. For you. For your horse. SRP $24.95 Ask about specials for IVC readers!

Schleese.com SaddlesForWomen.com 800-225-2242

IN BALANCE Meeting your Horse’s Individual Needs. Take the guesswork out of your horse’s supplement program. Scientifically-based formulas start with a foundation formula containing essential vitamin-mineral ingredients. From there, specialty formulas target specific support for the immune system, metabolic function, joint health, and brain and nervous system health. Palatable pellets are easily incorporated into your horse’s feeding program.

CHOLODIN® MAKES IT CLEAR

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Cholodin® A choline�loading natural dietary supplement developed specically for geriatric dogs. Cholodin can be beneficial for your patients that are experiencing confusion or a lack of awareness of their surroundings; impaired hearing; decreased appetite; or an increase in sleep time. Available through your ethical distributor. For more information, contact MVP Laboratories, Inc.

IVC Winter 2012/13

nutrition nook

whole foods how and why our understanding of pet nutrition is changing, and where it’s leading us DR. DOUG KNUEVEN DVM, CVA, CAC, CVCH

For decades, clinical nutrition was used supportively for common diseases, but in recent years our viewpoint has changed. “[Nutrition] has emerged as a cornerstone of treatment based on the principles of grade 1 evidence-based medicine,” report Drs. Kirk and Bartges in Veterinary Clinics of North America: Small Animal Practice. “No longer are nutrients simple building blocks, cofactors, or enzymes, but instead regulators of cellular metabolism, gene transcription, or translation.”1

The “neW normal” misses the mark While we all now agree on the importance of nutrition, there is debate over what constitutes the ideal diet for small animals, as the popularity of raw meat, fresh homemade raw or cooked, raw dehydrated, grain-free and other diets are on the rise. Since different individuals thrive on different diets we have an opportunity to help our clients find the optimal choice for their animals. Our first task is to help our clients choose foods by understanding the differences between food preparations. The conventional view, presented to us in school and through clinics, is based on information and research provided by the pet food industry. It focuses on the nutrient content and perceived balance of canine and feline foods, and sees the actual ingredients as less important. Today’s pet diets contain ingredients such as starch and grain-based proteins, which dogs and cats were not meant to eat in abundance. The food is then processed at high temperatures and pressures, denaturing it to a form that our pets’ ancestors and their current wild counterparts have never experienced. Finally, minerals, amino acids and synthetic vitamins

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are added to attempt to balance the diet, at least to our current, incomplete level of understanding. This approach seems to be keeping many veterinarians from looking at fresh food diets.

cHallenging ﬂawed assumptions An alternative view of pet nutrition looks for guidance to the sciences of comparative anatomy and evolution. For example, we are told dogs are omnivores, and in our society that is certainly true. But since our pets have no choice over what they eat, how can we be sure the diets we force on them are ideal? A 1979 study reviewed wildlife literature that seems to provide an answer.2 “[A] good deal of disagreement exists within the veterinary profession about the proper diet for dogs…” The study inventoried the stomach contents of coyote, fox, wolf, bobcat, cougar and lynx. Their justification for the comparison is that anatomically, the digestive tracts of these wild carnivores are similar to that of the domestic dog. The study concluded that “… the staple diet of carnivores living in a natural setting includes other animals, carrion, and occasionally fruits and grasses…carnivores

in their natural environments consume diets high in animal protein, bulk, and roughage from indigestible parts of animal carcasses and low in carbohydrates, and caloric density.” This nutrient profile does not match that of our current, conventional diets. The idea that we can formulate the ideal diet for pets from processed, inappropriate ingredients is based on flawed assumptions. Cooking at high heat and pressure processing reduces the potency of almost all nutrients, including L-carnitine3 and completely destroys others such as thiamine, folic acid, vitamin C, vitamin A, niacin, pantothetic acid.4 Can this nutrient depletion be easily remedied with synthetic vitamins? Are they identical to the vitamins, amino acids and nutrients in whole foods?

An incomplete understanding of nutrition You don’t have to look too far back in history to see demonstrations of our nutritional ignorance. In the early 1980s, cats were going blind and dying from dilated cardiomyopathy (DCM). Initially, the cause of the problem was considered idiopathic. No one thought cat food that was “complete and balanced” could be the cause. In 1987, it was discovered that DCM was caused by a taurine deficiency. Looking at the research of the day is enlightening. They found that canned cat foods (cooked) required extra taurine supplementation.5 “We have found that these same canned diets, if fed in an uncooked form, do not cause clinically significant taurine deficiency.”6 This seems to indicate that cats were meant to eat raw food. “Taurine deficiency alone is not sufficient to cause myocardial failure or central retinal degeneration in all cats…most likely in our opinion, these conditions may be caused by taurine deficiency and other, currently unidentified, cofactor or cofactors.”7 It appears our understanding of nutrition is incomplete.

active nutrients besides vitamins and minerals that are not produced by human biological systems and that could be deemed equally essential for life.12 Although the studies cited above are related to human nutrition, the basic tenets of whole food nutrition translate to all species. • One recent study found that the consumption of any type of vegetable at least three times per week was associated with a 70% to 90% risk reduction in the development of transitional cell carcinoma in Scottish terriers.13 If adding some vegetables to the diet of Scotties can have this effect, other breeds are also likely to benefit from whole food supplementation of processed diets. • Another study compared the cognitive ability of older dogs on different diets.14 The control group was fed a processed senior diet. The test group’s food was enriched with vitamins E and C, mitochondrial cofactors (L-carnitine and DL-alpha-lipoic acid), and a mixture of fruits and vegetables. The dogs receiving the enriched diet performed significantly better than controls.

a truly balanced diet must consist of many more micronutrients than the 30 or so included in the aafco recommendations.

“When you look at the classic example of taurine deficiency, many [diets] were deficient. The cats that didn’t become ill were those that were going outside and catching mice.”8 It seems when we try to improve on nature, we often get it wrong. How many other current idiopathic diseases may be related to nutritional issues?

nutrition is complicated A truly balanced diet must consist of many more micronutrients than the 30 or so included in the AAFCO recommendations. Human nutrition experts are starting to realize the importance of whole, unprocessed foods. One article points out that there are 8,000 phytochemicals present in whole foods, and that there is a synergistic health-benefitting effect from the complex mixture of these compounds in whole foods.10 Another points out that it is not a single component but rather the interaction of complex mixtures of natural chemicals found in whole foods that help prevent and treat many chronic human diseases.11 Animal-based as well as plant-based foods are functional because they provide biologically IVC Winter 2012/13

Whole food raw diets beneficial From my research and clinical experience, I have concluded that many pets benefit from being fed raw, evolution-based diets, since dogs and cats evolved over millions of years eating such diets. Simply looking at a pet’s teeth indicates they are carnivores in every sense of the word. If they had evolved significantly from their wild roots, and now required processed foods, their teeth and jaws would reflect that change. There are many ways to provide a whole foods diet. 1. The “Bones and Raw Food” (BARF) movement has been gaining in popularity over the past 15 years. This philosophy provides “meaty bones” (raw chicken necks and backs) as part of the diet as well as shredded vegetables and organs. The bones help maintain the calcium-to-phosphorus ratio and keep the teeth clean. We have been taught that bones are dangerous for pets to eat and that certainly is the case for cooked bones. However, small raw bones like chicken necks and backs are much safer. Having said that, it is not impossible for raw bones to be a choking hazard, as are sticks, stones and toys.

2. Another whole food option is using a commercial supplement to balance a diet made with meat from the grocery store, health food store or local farm. These commercial mixes contain calcium and other essential nutrients that can be mixed with meat ( and vegetables) to create a balanced diet. This alternative allows the pet owner to control the meat source, and eliminates the need for bones. One concern often cited with the above two methods is the possible contamination of the food with pathogenic bacteria and/or parasites. Raw meat products for human or animal consumption are loaded with pathogenic bacteria that are killed when the meat is cooked. Serving these meats raw would appear to pose a danger to pets and their human companions. In my opinion, this danger is overblown. In one recent study, 33% of dry dog food samples and 8% of canned dog food samples tested positive for non-type specific E. coli, and 4% of canned food samples tested positive for cryptosporidium.15 Another report found up to 36% of healthy dogs and up to 18 % of healthy cats shed salmonella in their stool.16 Decades of feeding raw meat diets shows fewer problems than commercial foods with their frequent recalls.

Encouragement for clients My preferred method of providing pets with raw diets is to refer clients to one of the many premade raw foods commercially available. Research into the companies is needed to find one whose formulation expertise and nutrient philosophy matches yours. For example some have higher vegetable percentages than others. Another consideration is the method the company uses to mitigate pathogens. Many have turned to high-pressure pasteurization, which makes one wonder how raw the food really is. I do not believe there is any one diet type ideal for every patient and every client. I am also pragmatic and realize that not all my clients are willing or able to provide the nutrition I think is best. Some real food is better than none at all, so I always encourage my clients to at least enhance their animals’ diet with raw or lightly cooked meats and vegetables, or whole food supplements. I am always impressed by the amazing health benefits of whole foods.

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DHA and dogs – a study A recent nutritional issue is DHA, an Omega 3 fatty acid found in fish oils and organ meat. The brain is 60% fat. Some of that fat, up to 5%, is DHA. It has been established that increasing dietary DHA increases cognitive ability in lab rats. In 2004, a major pet food company decided to study this effect in dogs.9 They used two groups of pregnant bitches and then their pups. The study group was put on commercial food plus fish oil. The control group got unsupplemented commercial food, which was considered “100% complete and balanced”. When the puppies were older they found that “[t]he training performance index for the high-DHA group was more than double that of the low-DHA group.” They concluded that “[w]hen you consider that the No.1 killer of dogs is euthanasia due to behavior problems, we should be recommending high-DHA diets.” This begs the question as to whether or not the control diet, which is considered to be complete and balanced, is truly adequate.

References Kirk CA, Bartges JW. “Dietary management and nutrition, preface”. Veterinary Clinics of North America Small Animal Practice, 2006; 36(6):xi-xii.

Landry SM, Van Kruiningen HJ. “Food Habits of Feral Carnivores: A Review of Stomach Content Analysis”. J Am An Hosp Assn, 1979; Vol 15:775-782.

Phillips T. “L-carnitine, Evidence indicates it may accelerate weight loss and increase lean body mass”. Pet Food Industry, May 2002; 24.

Schroeder HA. “Losses of vitamins and trace minerals resulting from processing and preservation of foods”. Am J Clin Nut, 1971; 24(5):562-573.

Hayes KC. “Taurine Status in Cats Fed Canned and Dry Diets”. Alpo Viewpoints in Veterinary Medicine, 1995.

Pion PD, Kittleson MD, Thomas WP, Skiles MI, Rogers QR. “Clinical findings in cats with dilated cardiomyopathy and relationship of findings to taurine deficiency”. J Am Vet Med Assoc, 1992; 201(2):267-274.

IBID.

Smith CA. “Changes and Challenges in Feline Nutrition”. J Am Vet Med Assoc, 1993;203(10):1395-1400.

Iams Partners for Health, Ground breaking study links diet and learning, Aug. 2004, Vol 2, No. 8 p.1-3. Liu HR. “Health benefits of fruit and vegetables are from additive and synergistic combinations of Phytochemicals”. Am J Clin Nut, 2003; 78(3):517S-520S.

Lila, MA. “From beans to berries and beyond: teamwork between plant chemicals for protection of optimal human health”. Ann N Y Acad Sci, 2007; 1114:372-80.

Jacobs DR Jr, Tapsell LC. “Food, not nutrients, is the fundamental unit in nutrition”. Nutr Rev, 2007; 65(10):439-50.

Raghavan M, et al. “Evaluation of the effect of dietary vegetable consumption on reducing risk of transitional cell carcinoma of the urinary bladder in Scottish Terriers”. J Am Vet Med Assoc, 2005;227: 94-100.

Milgram NW, Head E, Zicker SC, et al. “Learning ability in aged beagle dogs is preserved by behavioral enrichment and dietary fortification: a two-year longitudinal study”. Neurobiol Aging, 2005; 26:77–90.

Strohmever, Racheal A., DVM et al. “Evaluation of bacterial and protozoal contamination of commercially available raw meat diets for dogs”, JAVMA, 2006, 228: 537-542.

Sanchez, S, Hofacre, CL, Lee, MD, Maurer, JJ Doyle, MP. “Animal Sources of Salmonellosis in Humans”. JAVMA, 2002, 221:492-497.

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Advertorial

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When Jennifer DiGrazia rescued Maddy, she was faced with a problem that had plagued her for as long as she had been doing dog rescue – inadequate bandaging for dogs. She always “made do” with the products on hand – until Maddy came along. Jennifer rescued and adopted the little dog, who was blind, from a very severe hoarding situation. Maddy habitually and nervously licked and bit his paw raw. Applying medicine and bandages to the wound was not only impossible, but a heart-wrenching ordeal. Maddy was not used to being kindly touched by humans, and feared the pain of contact. With every attempt to treat his wound, he cowered and screamed as if being skinned alive. This heartbreaking response continued with no reprieve, no matter how hard Jennifer tried to comfort and bandage him. Days of attempting to put on all kinds of bandages turned out to be futile. Maddy tore every single one off within minutes of having it painstakingly applied. And each time he tore his bandages off, he tore more tender skin with it. Jennifer realized the only answer was to come up with a bandaging solution of her own. By cutting up the Velcro-like stretch tabs and side panels on diapers and training pants, and sewing them all together, Jennifer was able to create a bandage that was easy and quick to apply; could be adjusted and readjusted while dealing with a wiggling and frightened dog; and was soft and comfortable enough for Maddy to keep on. He slept through the night without ripping his new bandage

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to shreds. After a few more similar bandages, Maddy’s wound had healed and PawFlex™ was born. Since then, PawFlex™ has evolved into an award-winning line of bandages. It was launched to the veterinary industry at the 2012 NAVC in Orlando, where the company received accolades in reviews and the press. PawFlex™ was chosen by the prestigious NAVC panel for a sought-after spot in the conference’s New Products Gallery, and was given the seal of approval as one of the best cutting-edge new products every vet should have as a staple supply in his or her clinic. What makes Pawflex™ bandages so special? Besides the convenience of being disposable, they’re comfortable, adjustable and non-adhesive. They come in five different furfriendly and super-stretch designs, each meant to accommodate a different wound site. They come with wound pads attached, and feature double-catch fasteners and nonslip grip. PawFlex™ is quickly and successfully becoming one of the most sought-after wound care products in the veterinary and retail market. These water-resistant yet breathable bandages are filling a huge void in today’s animal wound care world. Thanks to Maddy and his persistence in having better bandaging, all dogs can now have a stress- and hasslefree bandaging experience, making for happier and healthier patients.

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ASSOCIATIONS Academy of Veterinary Homeopathy - AVH Leucadia, CA USA Phone: (866) 652-1590 Website: www.theavh.org American Academy of Veterinary Acupuncture - AAVA Glastonbury, CT USA Phone: (860) 632-9911 Email: aava@cttel.net Website: www.aava.org

EverGlo-Naturals Gloria Dodd, DVM Gualala, CA USA Phone: 707-785-9171 Email: everglo@mcn.org Website: www.holisticvetpetcare.net

Traditional Chinese Veterinary Medicine TCVM Reddick, FL USA Phone: (352) 591-5385 Email: register@tcvm.com Website: www.tcvm.com

Mark Newkirk, VMD Margate Animal Hospital & Alternative Care Center Egg Harbor Township, NJ USA Toll Free: (609) 645-2120 Phone: (609) 645-2120 Website: www.alternativevet.com

Veterinary Information Network - VIN Davis, CA USA Phone: (530) 756-4881 Email: vingram@vin.com Website: www.vin.com

Steven Marsden, DVM Edmonton Holistic Veterinary Clinic Edmonton, AB Canada Phone: 780-436-4944

Herbsmith Inc. Hartland, WI USA Phone: (262) 367-1372 Email: mail@herbsmithinc.com Website: www.herbsmithinc.com

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American Veterinary Chiropractic Association - AVCA Bluejacket, OK USA Phone: (918) 784-2231 Email: avcainfo@junct.com Website: www.animalchiropractic.org Association of Veterinary Acupunturists of Canada - AVAC Beaconsﬁeld, QC Canada Phone: (514) 697-0295 Email: ofﬁce@avac.ca Website: www.avac.ca National Animal Supplement Council - NASC Valley Center, CA USA Phone: (760) 751-3360 Website: www.nasc.cc

EQUINE NATUROPATH Cassie Schuster, ND, MHWaller, TX USA Phone: (713) 502-0765 Email: cassie.schuster@yahoo.com Website: www.wellranch.com

INTEGRATIVE VETS Dr. Shawn Messonnier Paws and Claws Vet Clinic Plano, TX USA Phone: (972) 712-0893 Email: shawnvet@sbcglobal.net Website: www.pettogethers.net/healthypet East York Animal Clinic Toronto, ON Canada Phone: (416) 757-3569 Email: eyac@ca.inter.net Website: www.holisticpetvet.com

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IVC Winter 2012/13

Advertorial

Thyroid and pancreas

care

BY HEIDI LOBPROSE, DVM, DIPAVDC

Veterinary medicine is constantly evolving. It entails more than just treating illness and focusing on vaccines and parasites. Many of today’s practitioners also advocate for providing a high level of preventive care for every body system, throughout a pet’s life.

the patient with the consistent levels he needs. After 25 years, 98% of veterinarians said they are satisfied with SOLOXINE Tablets for canine thyroid replacement therapy.

• Another gland that can cause problems in senior pets is the There has always been a strong focus on following good preventive steps during puppyhood and kittenhood, but there’s an increasing emphasis on following these same steps throughout the pet’s life, and ramping up awareness of care during his twilight years as well. When a pet reaches “middle age”, it’s an excellent time to make sure yearly examinations continue, and to ensure medical records include appropriate lab work (blood and urine) and radiographs to establish the normal values or baseline for that individual. This may be timed with recommendations for professional dental care, as well as screening tests that may expose subtle, hidden or fulminating conditions such as diabetes, renal disease and heart or lung abnormalities.

• Thyroid disease – either hypothyroidism in dogs or hyperthyroidism in cats – may be detected in the very early stages. Certainly, diagnosing and managing hyperthyroidism in cats can be quite challenging, but hypothyroidism in dogs is less complicated. There is no cure for hypothyroidism, but it can be managed. A decreased hormone level in dogs is often simply managed by providing thyroid supplementation in the form of medication such as SOLOXINE® (levothyroxine) Tablets. One important issue with thyroid supplementation is maintaining consistency of medication. Since not all thyroid supplements are the same, switching brands or using a generic may not provide

IVC Winter 2012/13

pancreas. When working normally, the pancreas produces enzymes that help digest food. Some pets can experience bouts of acute pancreatitis with abdominal pain, vomiting and inappetance due to inflammation of this gland. With multiple acute episodes or chronic manifestations of inflammation, the gland can be damaged enough to stop producing enzymes, which may result in exocrine pancreatic insufficiency (EPI). EPI is more commonly caused by atrophy of the pancreatic cells. When pancreatic enzymes can’t be produced, the digestive process cannot proceed normally, and the individual, though eating, cannot absorb nutrients. Weight loss and diarrhea with a voracious appetite may be indicators that enzymatic digestion is not occurring. EPI is an irreversible condition with no currently known cure, so lifelong treatment is usually necessary. The outlook is positive for pets that receive enzyme replacement therapy to manage weight and regain their well-being. Replacing these enzymes can be accomplished by administering PANCREZYME® Tablets or Powder. DR. HEIDI LOBPRISE, DIPLOMATE OF THE AMERICAN VETERINARY DENTAL COLLEGE, GRADUATED AS A DVM FROM TEXAS A&M UNIVERSITY IN 1983. SHE BECAME A BOARD CERTIFIED VETERINARY DENTIST IN 1993. IN 2010, SHE JOINED VIRBAC ANIMAL HEALTH AS SENIOR TECHNICAL MANAGER. SHE HAS AUTHORED AND CO-AUTHORED DENTAL TEXTS, CHAPTERS, AND NUMEROUS ARTICLES, LECTURED INTERNATIONALLY AND IS AN ADJUNCT ASSOCIATE PROFESSOR AT

UNIVERSITY OF TENNESSEE AND WASHINGTON STATE UNIVERSITY.

IVC Winter 2012/13

tech talk …if you ﬁnd your clients have a tendency to “linger” around the reception desk talking about their lives, hanging a crystal in an appropriate place above the desk will help move the energy along, thus moving the clients along.

Feng Shui

in the clinic setting – part 1

How this ANCIENT art of PLACEMENT can help you and your colleagues maintain WELLBEING and HARMONY in the workplace. BY MICHELLE J. RIVERA, MT, VDT

eterinary medicine is an amazing field to be in. Those of us who get to work with animals and their owners are truly blessed. But it can also be frustrating and overwhelming at times. Many things are beyond our control – from not-soeasy-to-handle patients to concerned and sometimes angry caretakers. We may also have difficult employers or staff members to work with, and long grueling hours to put in. Feng Shui can help with these problems. This ancient Chinese art (pronounced “fung schway”) involves making physical changes to your working environment to help your practice run more smoothly and bring harmony to everyone. It aims to improve every aspect of your life using the principles of harmony and energy flow. The literal meaning of Feng Shui is “wind and water”. These are the two natural elements in nature that flow, move and circulate

IVC Winter 2012/13

everywhere on Earth. Our lives should also flow even though we have occasional ups and downs, similar to the way water gently flows around a rock and meets on the other side to move smoothly along again. Many times in our environment “the rock” is our employers, co-workers, the design and layout of the facility, our clients, and our relationships with other people. Feng Shui helps us subtly fix things in our environment that we do not have direct control over. Feng Shui is also sometimes known as “the ancient art of placement”. The way you place your furniture, color your walls and position your décor can influence the movement (flow) of energy to bring good health and harmony into your life and workplace. For example, if you find your clients have a tendency to “linger” around the reception desk talking about their lives, hanging a crystal in an appropriate place above the desk will help move the energy along, thus moving clients along. If a crystal is not available, a decorative bowl filled with water and colorful rocks will also move the energy. After all, in order for a practice to flow smoothly, we would ideally like our clients to come into the waiting room for a short time, have their scheduled appointments, see the receptionist on the way out to pay their bills and get their prescribed supplements, then happily leave. Any “stagnation” or stopping at any point in this flow will directly affect the health of the practice and staff. When there is a smooth flow of energy (also called Qi), there will be a steady flow of money to the practice and good health to the staff.

Five basic principles

Adhering to these basic principles before making any Feng Shui changes will improve your success and happiness.

INTENTION is the true power behind Feng Shui. Two things contribute to success in Feng Shui – the visible factors consisting of walls, doors, streets and various other tangible elements; and the invisible factors consisting of energy and the strong desire and visualization of what you want a Feng Shui “cure” to produce. This is intention. Without a pure intention, Feng Shui will not work for you.

A healthy practice encompasses a compassionate well-educated staff, doctors on the cutting edge of medicine with their fingers on the pulse of the newest advances in integrative therapies, happy and satisfied clients, and most of all, happy and healthy patients. To achieve this clean intention, your clinic needs to retain staff and keep them happy and motivated. Feng Shui can assist with this. Simply putting large stones in your cabinets will “anchor” the practice, keeping staff turnover to a minimum. In addition, allowing staff to bring in decorative items from their own lives will keep them comfortable in the environment and lessen the sometimes negative thoughts and actions of certain staff members. Too often, the décor of a facility is determined by the owners and the staff is not consulted on color choices and furnishings, so adding each employee’s personal touch can be critical. Intention is what you want to happen and how clearly and purely you want it. If you can see and feel the result before it happens, then expect the result to happen.

MANTRA is the sacred words of power. Many people omit this when attempting to use Feng Shui cures, greatly lessening the chances of obtaining what they want. First visualize what you want (intention), then decide what you need to add or move to obtain this want (e.g. add a mirror, move a table, etc.). Then say the Mantra nine times either aloud or silently and the Feng Shui cure will be set. Continued on page 72.

POSITIVE EFFECTS The use of Feng Shui in veterinary clinics is becoming more and more common. Traditionally, veterinary medicine was notorious for having a high employee turnover, but in practices that employ Feng Shui cures, turnover has decreased. Client compliance with recommended services can also be greatly increased by utilizing the principles of Feng Shui. Many practice owners hire Feng Shui consultants to prepare their hospital blueprints and landscaping before they build their dream facility, as well as using the art in the interior design.

IVC Winter 2012/13

Continued from page 71. There are many mantras, but for basic purposes The Six True Words are the sacred speech that can be utilized for your Feng Shui cures. The Six True Words are Om Ma Ni Pad Me Hum (pronounced ohm-mah-nee-pahd-mee-hum). This mantra has the power to improve your luck, uplift your mind, correct negative thought, enhance your wealth and prosperity, and help you better perform in your daily life.

MUDRA is equally important in obtaining what you want when using Feng Shui. This spiritual hand gesture, position, or action aligns the energy of your body to help create the desired energetic value. For basic purposes, the Expelling or Ousting Mudra is most often recommended, especially when using The Six True Words. This Mudra is performed by pointing the first and pinky fingers straight up and then holding the middle and the ring fingers out from the palm with your thumb. You then repeatedly “flick” the middle and ring fingers out from the palm. Women should use their right hands for this Mudra and men their left hands, and you should repeat this flicking motion nine times.

NINE

is the most powerful and auspicious number in Feng Shui, symbolizing power and completion. It is for this reason we say the Mantra and perform the Mudra nine times for each Feng Shui cure. In addition, if you hang or place anything in a Feng Shui cure it should be done in increments of nine. For example, when hanging a crystal above a desk to bring harmony and peace, make the length of the string in 9” increments (9”, 18”, 27”, etc., depending on how you want it to look).

RED

is Feng Shui’s power color. For adjustments and cures, use red above all others to get the most out of your intentions. The color yellow, although powerful as well, was traditionally held for emperors and other highpowered religious figures, and is not the hue of choice when adding a Feng Shui cure. In the next article, we will address different colors and how to use them, and you will learn that yellow can be used to feed and nurture our health and is traditionally put in spaces used for eating – e.g. lunch rooms, kitchens or break rooms.

…yellow can be used to feed and nurture our health and is traditionally put in spaces used for eating – e.g. lunch rooms, kitchens or break rooms. Because life moves and flows, Feng Shui should not be done only once and then forgotten. Once there is a positive shift in the practice, the art should be revisited, the practice re-evaluated and the cures done according to the new energy.

PERSONAL HELP FENG SHUI can also help you personally,

immediately and at any moment in the day. If you feel overwhelmed or unclear about what to do in any situation, start by stating a clear intention of how you want your day to go – e.g. getting out on time, getting along with co-workers, hoping surgery goes smoothly, etc. State or even write down your intention and solidify it by saying Mantra and executing Mudra nine times. 72

IVC Winter 2012/13

In the next issue, we will discuss cures traditionally used in Feng Shui, including the color choices to enhance the intention of your practice – from a calming waiting room, healing exam room and uplifting reception area (so the receptionists can be positive “gatekeepers” and “controllers”) to the sometimes intense and chaotic treatment areas and stressful surgery suites. We will also discuss the importance of landscaping in relation to the health and prosperity of the practice and its staff, and some of the vegetation that should be growing around or near the workplace.

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IVC Winter 2012/13

events Soft Tissue Surgery in Small Animal Practice December 12, 2012 – February 27, 2013 – Live Webinar Series This live webinar is scheduled to broadcast on Wednesdays at 12:00pm EST. Running from December 2012 until February 2013 you will have a chance to complete 10 hours of Continuing Education credit for the complete series. You will find lectures on topics such as Upper Respiratory Surgery, Wound Closure techniques, Feline Soft Tissue Surgery and much more. The registration fee is $39 per session or $259 for the complete series with payment in advance. Online registration is available. Please visit the website listed below for a detailed schedule of the topics for each lecture. For more information: (508) 839-5302 vetadmissions@tufts.edu www.tufts.edu/vet/ce/events/20121212.html

Fundamentals of Small Animal Anesthesia: Module 1 January 3, 2013 – February 10, 2013 – Online Canada Veterinarians are encouraged to enroll with their veterinary technicians to work as a team in this Anesthesia module. This is an intermediate course and is geared towards the veterinary technician regularly dealing with anesthesia case management. This module is a prerequisite for future modules to ensure understanding of the basic principles and is also approved continuing education for applicants applying for their VTS. For more information: (800) 700-4636 CEonVIN@vin.com beta.vin.com/CE/CatalogVSPN.htm

to improve customer service, perception of value, communication skills, teamwork and client bonding. As well, participants will gain an all-around, better business model for these challenging economic times and will be provided with specific tools to increase compliance, understanding and client relationships. Find out more details about registration cost and continuing education hours by visiting the website below. For more information: (303) 674-8169 mtopolnicki@vmc-inc.com www.vmc-inc.com/seminars/iwuftc.html

North American Veterinary Conference January 19-23, 2013 – Orlando, FL The annual NAVC Conference welcomes almost 16,000 attendees from more than 70 countries and offers more than 30 handson laboratories as well as provides 1,300 Continuing Education credits. You will also see more than 350 nationally renowned speakers and being in January, it is the first veterinary conference of the year where the most current medical and product advances are first released. The NAVC Conference is a nonprofit organization whose mission is to provide worldclass continuing education for all members of the veterinary healthcare team. For more information: (352) 375.5672 info@navc.com www.navc.com

Ontario Veterinary Medical Association Conference January 24-26, 2013 – Toronto, ON

January 6, 2013 – Birmingham, AL It’s What’s Up Front That Counts...and More!

The 2013 OVMA conference offers more than 100 hours of continuing education options to choose from as well as top rated speakers from Canada and the United States.

This is the ultimate, one-day conference for your entire healthcare team! The seminar is designed

This 3 day event is the largest annual veterinary conference in Canada and combines

Practice Management

education with a tradeshow filled with products and equipment. For more information: (800) 670-1702 info@ovma.org www.ovma.org

14th Annual Technician Symposium & Technician Boot Camp

January 26-29, 2013 – North Grafton, MA This conference is 22 hours of continuing education credit. The registration fee is $425 for the full Conference and you do have the opportunity to register for Laboratory and Symposium as well. The Boot Camp registration includes Boot Camp, Lab, Lectures, Continental Breakfast, 3 Luncheons, and Course Notes on CD. For more information: (508) 839-5302 vetCEinfo@tufts.edu www.tufts.edu/vet/ce/events/20130126.html

85th Annual Western Veterinary Conference February 17-21, 2013 – Las Vegas, NV The WVC provides comprehensive continuing education to veterinary professionals and is an interactive educational opportunity for networking with the veterinary community. WVC grows in size each year adding new speaks that present state-of-the-art hands-on labs in a comfortable environment. Conference registration automatically enrolls the registrant as an association member for the following year. For more information: (702) 739-6698 carolyn@wvc.org www.wvc.org

P o s t y o u r e ve n t o n l in e at: IVCJournal.com 74

IVC Winter 2012/13