IVC WINTER ISSUE 2014
Integrative VETERINARY CARE
NUTRITIONAL ASSESSMENT FOR DOGS AND CATS
WHERE TO BEGIN AND WHY IT’S SO IMPORTANT Page 16 WOBBLER SYNDROME
INFLAMMATORY AIRWAY DISEASE
MASSAGE AND HEALING TOUCH FOR ANIMALS
Shifting from palliative treatment to early intervention and a multimodal approach can benefit your patients.
www.IVCJournal.com
WINTER ISSUE 2014
INTEGRATIVE VETERINARY CARE JOURNAL
CANINE OSTEOARTHRITIS
Nutrition, environment and supplements all play a role in managing IAD.
RABIES CHALLENGE FUND RESULTS Researchers provide the results of their five-year study on duration of immunity in dogs.
Leading veterinarians discuss the integrative options that can help manage this difficult condition.
Enhance patient well-being with these two therapeutic modalities.
WHAT’ S NEW
• Exploring the role of microbes • Groundbreaking Golden Retriever study • Updating your business skills • Researching equine-facilitated therapy
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contents FEATURES
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NUTRITIONAL ASSESSMENT FOR DOGS AND CATS
Clinicians are aware of the importance of nutrition in companion animal health, but medical records often reflect a different scenario. Here’s why it’s so crucial to assess each patient’s diet.
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TREATING CANINE OSTEOARTHRITIS -PART TWO
Managing this common condition must evolve from palliative treatment of established disease using just a few modalities, to early intervention and a comprehensive multimodal approach.
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YUNNAN BAIYAO –MIRACLE HERB FOR YOUR CLINIC
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RABIES CHALLENGE FUND –FIVE-YEAR DOI STUDY RESULTS
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HEADACHE IN ANIMALS –RECOGNITION AND TREATMENT
The researchers set out to prove a longer duration of immunity for rabies vaccines, and the results to date are intriguing.
This proprietary Chinese herbal formulation has been shown to effectively stop bleeding and inhibit infection.
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A persistent cough that lasts longer than four weeks is likely a sign of IAD. The causes can be many and varied, and treatment focuses on management.
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Nutrition Nook RAW GREEN TRIPE
It might look and smell disgusting, but it’s a rich source of nutrients for pets.
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Though this condition is often considered incurable and even unmanageable, alternative approaches can be very beneficial. Three veterinarians discuss the options.
Do pets get headaches? The evidence suggests they do. To successfully treat and relieve headaches in patients, we first have to notice and “diagnose” them, while remaining undeterred by the fact that absolute proof remains unattainable.
INFLAMMATORY AIRWAY DISEASE IN HORSES
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WOBBLER SYNDROME: PANEL DISCUSSION
Tech Talk MASSAGE AND HEALING TOUCH FOR ANIMALS IN THE VETERINARY CLINIC
These two therapeutic modalities can be used to enhance patient well being, and both are within the scope of CVT guidelines.
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CHIA-SMALL SEED, BIG BENEFITS
Discover how these tiny nutrition-packed seeds can bring healing and balance to equine patients.
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advisory board
26 COLUMNS & DEPARTMENTS
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.
5 Advisory board 8 Editorial 12 What’ s new 30 From the VBMA
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.
36 Industry innovations 46 NAVC highlights 49 From the AHVM Foundation 62 Veterinary resource guide
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 trai ned 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.
65 Marketplace 66 Events 66 Social media
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, CVH, graduated from the University of Georgia Veterinary College in 1980. She is a founder of the Academy Of Veterinary Homeopathy, was on the faculty of the National Center for Homeopathy Summer School and has been the holistic modality adjunct faculty liaison for the Maryland Veterinary Technician Program. 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.
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Integrative VETERINARY CARE
WINTER 2014
EDITORIAL DEPARTMENT Editor-in-Chief: Dana Cox Managing Editor: Ann Brightman Associate Editor: Christina Chambreau, DVM, CVH Senior Graphic Designer: Dawn Cumby-Dallin Senior Graphic Designer: Kathleen Atkinson Social Media Manager: Natasha Roulston Social Media Editor: Jasmine Cabanaw Cover Photography: Digital Vision
COLUMNISTS & CONTRIBUTING WRITERS Ihor Basko, DVM, CVA Ella E. Bittel, DVM Sherman O. Canapp Jr., DVM, MS, CCRT Kris L. Christine W. Jean Dodds, DVM Lisa M. Fair, VT, CCRA, CMT Amy Fiumarelli Barbara Fougere, DVM, CVA Juliet M. Getty, PhD Jodie Gruenstern, DVM, CVA, CVFT Naomi A. Kirby, DVM, MS Cindy Lankenau, DVM, CVA Terri McCalla, MS, DACVO Lucy Postins Meg Smart, DVM, PhD Jack E. Stewart, Jr., RVT, CVT Madalyn Ward, DVM
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Improving the lives of animals... one reader at a time.
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editorial
CHOICES, CHOICES,
CHOICES W
hen our patients are ill, many clients ask if they should be feeding a better food, or if a specific brand could heal the ailment. They want to know which of the many pet foods on the market are best for their new puppy or kitten. Many are also asking if a fresh food or raw meat diet would help. Should they make the food themselves or buy frozen or dry prepared raw meat diets? The choices and opinions abound. I have been recommending fresh foods for at least 25 years and have fed my own cats a primarily raw meaty bone diet. Yet I still learn more about feeding fresh with every issue of IVC Journal. In this edition, we look at chia seeds, which can boost equine nutrition with protein, fat and the right Omega-3 to 6 ratio, as well as green tripe for dogs – is it merely another fad, or a power-packed food full of enzymes and nutrition? Professor Meg Smart clarifies the relationship between pet food companies and regulators so we can better evaluate commercial diets of all types, and looks at ways to evaluate the individual nutritional needs of dogs and cats. Choices also abound for the care of specific illnesses. While our goal is stimulating the body to heal itself completely, we want pets to be comfortable until we have reached that goal. In acute situations, we want quick, safe solutions. Yunnan Baiyao is a Chinese herb for every clinic, as it can quickly stop bleeding and heal in other ways as well.
Stem cell therapy is one of many choices to look at for osteoarthritis, and it’s covered in the second part of Dr. Sherman Canapp’s article. Meanwhile, Dr. Madalyn Ward looks at multiple approaches to healing horses with inflammatory airway disease. Soothing choices such as massage and Healing Touch for Animals can be used by your technicians and clients to ease a multitude of discomforts. And since horses and small animals can be beset by headaches and cervical instability, we also cover many possible approaches for those. In short, veterinarians and guardians using holistic modalities, or learning about new ones, are often faced with so many choices. Since we want to stimulate self-healing, the patient’s response is our key to which modalities are best. Keeping a flexible mind, trying new approaches, and engaging the animal’s family in the process, are all essential. As I teach around the continent, I see increased health and longevity as people are finding more veterinarians offering these individualized therapies. We love your feedback, your successes and your articles, so please email me at drtina@ivcjournal.com or dana@redstonesmediagroup.com. As you can see from our website, we will post any cases using holistic approaches, and add updates. Sincerely,
Christina Chambreau, DVM, CVH Associate Editor
Make sure to check out pg 35 to download our NEW APP that will make IVC literally jump right off the pages. Plus you can win instant prizes!
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contributors 1. MEG SMART, DVM, PhD
Dr. Meg Smart received her DVM from Guelph in 1968 and has taught in veterinary and clinical pathology and large animal medicine for more than 35 years. She works at the Western College of Veterinary Medicine, University of Saskatchewan as a Clinical Nutritionist and faculty member and has taught an animal nutrition elective course to fourth-year veterinary students since 1994. She offers consultation services to individuals and the industry on companion animals and horses, and is a co-author of Not Fit for a Dog. PetnutritionBySmart. blogspot.com
2. SHERMAN O. CANAPP JR., DVM, MS, CCRT Dr. Sherman Canapp completed a combined DVM and MS in clinical surgery at Kansas State University. He became a member of the American College of Veterinary Surgeons, and completed his certification in canine rehabilitation, stem cell therapy and TPLO certification. He was named a charter diplomate in the newly recognized American College of Veterinary Sports Medicine and Rehabilitation (ACVSMR). Dr. Canapp practices orthopedic surgery and sports medicine at the Veterinary Orthopedic & Sports Medicine Group (VOSM) in Annapolis Junction, Maryland.
3. JODIE GRUENSTERN, DVM, CVA, CVFT Dr. Jodie Gruenstern is the owner of the Animal Doctor Holistic Veterinary Complex in Muskego, Wisconsin. She is certified in veterinary acupuncture and food therapy. She writes for Nature’s Pathways, is a speaker for Standard Process and promotes the integration of holistic care on her radio show, television and her DVD and Animal Doctor product line, which is available at AnimalDoctorHolistic.com.
4. MADALYN WARD, DVM Dr. Madalyn Ward graduated from Texas A&M University in 1980. After nine years of practice, four at her own Bear Creek Veterinary Clinic in Austin, she remained frustrated about many aspects of conventional medicine. In 1989, she started seeking out information and training in alternative healing. She is trained in Veterinary Homeopathy, Acupuncture, Bowen Therapy, Network Chiropractic and Equine Osteopathy. She has authored three books including Holistic Horsekeeping and Horse Harmony. Holistichorsekeeping.com and HorseHarmony.com.
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5. AMY FIUMARELLI Amy Fiumarelli is the owner of Amy’s Animals Holistic Canine & Feline Nutrition Center in Wantage, New Jersey (amysanimals. net). She has been in the pet industry for almost 20 years and specializes in companion animal nutrition. She is an academic member of the American Holistic Veterinary Medical Association and has twice spoken at their annual conference.
6. IHOR BASKO, DVM, CVA Dr. Ihor Basko graduated from Michigan State University in 1971 with a DVM degree with special interest in cardiology, orthopedic surgery and internal medicine. He began his studies in Chinese medicine, acupuncture, herbology and homeopathy in 1974. He joined the IVAS in 1977 and began teaching acupuncture, herbalogy, and nutrition in 1979. He was certified in 1985 and is a member of the AHVMA, AVMA, VBMA, and HVMA licensed in California and Hawaii. Dr. Basko practices TCM/Acupuncture and Nutritional Therapy on Kauai and Oahu, Hawaii. 7. CINDY LANKENAU, DVM, CVA Dr. Cynthia Lankenau received her DVM from Cornell University in 1981, and started studying alternative modalities in 1992. She is certified with the IVAS, AVCA and AHV, and in Chinese Herbal Medicine through the Chi Institute and CIVT. She is a registered herbalist through the American Herbal Guild and is currently working on CIVT’s Western Graduate Herbal program. She is the current Past President of the Veterinary Botanical Medicine Association, and owns a private integrative mixed practice.
8. BARBARA FOUGERE, BSC, BVMS(HONS), BHSC(COMP MED), MHSC(HERB MED), CVA, CVBM, CVCP, GD BUS MGT, MORG D&T, CMAVA MNHAA Dr Barbara Fougere graduated from Murdoch University Veterinary School in Western Australia in 1986. She is the principal and one of the founders of the College of Integrative Veterinary Therapies (CIVT) and practices in Sydney, Australia, exclusively in veterinary integrative medicine. She holds a Masters degree in herbal medicine and a Bachelor’s degree in Complementary Medicine as well as a Masters in the field of education and training. She is a member of the AHVMA, VBMA and IVAS. She has authored and coauthored several books, including Integrating Complementary Medicine into Veterinary Practice. She was awarded the AHVMA Practitioner of the Year in 2010.
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9. JEAN DODDS, DVM
12. JULIET M. GETTY, PhD
Dr. Jean Dodds received her veterinary degree in 1964 from the Ontario Veterinary College. In 1986, she moved to Southern California to establish Hemopet, the first nonprofit 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. Juliet Getty holds a Master of Science and PhD in Animal Nutrition. She taught comparative nutrition studies at the University of North Texas for over 20 years. She consults privately with horse owners to customize feeding plans that address a variety of health conditions. She resides in Colorado where she devotes herself full time to equine nutrition. Dr. Getty has her own consulting company, Getty Equine Nutrition (GettyEquineNutrition.com) and is the author of Feed Your Horse Like a Horse.
10. ELLA E. BITTEL, DVM Dr. Ella Bittel graduated from veterinary school in Hannover, Germany, in 1994. Specializing in holistic modalities, she studied homeopathy in her home country, certified with the AVCA in 1998 and the IVAS in 1999. Now living and working in California and Arizona, Dr. Bittel also offers craniosacral work and herbal approaches. She presents on integrative animal hospice care and has also created weekend seminars and online classes on animal hospice care (spiritsintransition.org).
LISA M. FAIR, VT, CCRA, CMT Lisa Fair began working with Dr. Sherman Canapp as an orthopedic and surgical technician. She then completed her certification in canine massage and rehabilitation therapy, and provides rehabilitative services part-time. She has authored numerous articles and texts on specific orthopedic conditions in small animals, bandaging and rehabilitation therapy. She is a moderator for a rehabilitation therapy forum, and assists Dr. Canapp with special projects, research, client services and patient care.
11. JACK E. STEWART, JR., RVT, CVT Jack Stewart first worked in a companion animal clinic, then was associated for 27 years with the Maryland Veterinary Technology Program at The Community College of Baltimore County. He served as the program’s director for the last 12 years. After completing his training in Canine Massage and Healing Touch for Animals, he integrated that training into courses within the Veterinary Technology Program. He then created the Alternative Therapeutic Modality course which encourages veterinary technician students to explore holistic aspects of pet health care.
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what’s new MEDICINE SPANS SPECIES Human doctors can learn much more from veterinarians than they thought. Veterinary medicine provides valuable clues about human diagnoses and treatments. To further explore this field, a Species-Spanning Approach to Medicine was the focus of the 2013 Zoobiquity conference, held November 2 at the Rockefeller University and the Bronx Zoo in New York. This annual cross-disciplinary conference brought together leading clinicians and scientists in both
human and veterinary medicine to discuss the same diseases in a wide spectrum of species, including people. During the 2013 conference, Zoobiquity paired veterinarians with physicians to attend talks and participate in rounds at the Bronx Zoo, giving them a unique opportunity to be exposed to and learn from the similarities and overlap between human and animal health conditions. Zoobiquity.com
EXPLORING THE ROLE OF MICROBES By current estimates, the human body contains ten times more bacterial cells than human cells. Acting in ways both beneficial and harmful, this complex ecosystem of microorganisms – collectively called the microbiome – lives on the surface of the skin and in the gut and urogenital tract where it influences digestion, allergies, and a multitude of diseases. At Penn Vet, researchers are exploring the microbiome of animals in order to benefit both animal and human health. The Center is currently funding five pilot projects, each led by Penn Vet faculty, which include: 1/ Canine atopic dermatitis as a model for human dermatology Canine atopic dermatitis is a common allergic skin condition that is similar to human atopic dermatitis. Penn Vet faculty Dr. Charles Bradley, Dr. Elizabeth Mauldin, Dr. Dan Morris, and Dr. Shelley Rankin are collaborating with Dr. Elizabeth Grice of the Perelman School of Medicine to examine the ecosystem of bacteria on the dogs’ skin and monitor changes in the microbiome of each dog during treatment. The goal is to understand the role of resident microbial organisms in resistance to infection, the onset of infection, and the development of antimicrobial resistance once infection occurs.
2/ Pre-operative antibiotics and the equine gut microbiome Previous research has linked high-carbohydrate feed to the development of colitis in horses. This may have to do with how a change in diet leads to alterations in the population of microbes living in the gastrointestinal tract, ultimately tipping the balance from health to disease. Likewise, administering pre-operative antibiotics could also lead to gut microbiome imbalances. Dr. Julie Engiles will take fecal and serum samples from subjects and track variations in the horses’ gut microbiome at certain times after surgery. If, unfortunately, a horse develops an infection after its procedure, Dr. Engiles and her colleagues will evaluate whether the infectious agents match up to those in the gut or whether they match other microbes. For more information, visit Vet.upenn.edu.
GROUNDBREAKING GOLDEN RETRIEVER STUDY The Morris Animal Foundation is recruiting golden retrievers to participate in the Golden Retriever Lifetime Study. The study will collect important health data along with nutritional, environmental and genetic information from 3,000 goldens over the course of their lifetimes. This information will help scientists and veterinarians discover ways to prevent, diagnose and treat cancer and other canine diseases.
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Veterinarians and their goldenowning clients are needed to make this study a success. The dogs must be healthy and younger than two years of age. To learn how your clinic can participate, visit visit Caninelifetimehealth.org
RESEARCHING EQUINE-FACILITATED THERAPY The Horses and Humans Research Foundation (HHRF) has awarded a $50,000 research grant to study how youngsters with post-traumatic stress respond to equine-facilitated psychotherapy (EFP). The grant was given to the Cummings School of Veterinary Medicine at Tufts University for the study “Effects of Equine-Facilitated Psychotherapy on Post-Traumatic Stress Symptoms in Male Youth”. The research team will examine 60 boys between the ages of ten and 18 with posttraumatic stress. They will measure stress symptoms before, during and after exposure to a combination of EFP and traditional therapy. The treatment group (30 participants) will receive ten two-hour sessions of EFP over the course of 12 weeks in addition to traditional therapeutic services. The control group (30 participants) will receive traditional therapeutic services only. Horsesandhumans.org
BUSINESS SKILLS FOR YOU AND YOUR STAFF Purdue University’s Krannert School of Management and College of Veterinary Medicine are teaming up to offer veterinarians, veterinary technicians and practice team managers graduatelevel business skills. The Veterinary Practice Management Program (VPMP) will help veterinary professionals manage the business side of their practices. The course is divided into four modules: human resource management, accounting management, marketing and strategic thinking. For more details, visit purdue.edu/vpmp or krannert.purdue. edu/programs/executive/certificate-programs/ sponsored/VPMP/home.asp
RECORD-BREAKING ROCK EATER? A dog with an abnormal appetite had to have emergency surgery recently to remove almost two pounds of rocks he had ingested. The seven-year-old golden retriever, named Gordon, had consumed 16 rocks weighing in at 1.79 pounds. Dr. Jeff Yu, a board-certified veterinary surgeon with BluePearl Veterinary Partners, performed the two-hour operation. The surgery was successful and Gordon is expected to make a full recovery. bluepearlvet.com/minnesota-dog-undergoes-surgery-for-%E2%80%98rockhard%E2%80%99-abs IVC Winter 2014 13
what’s new
Advertorial
UNDERSTANDING CANINE BLOAT Laura Nelson, assistant professor in the MSU College of Veterinary Medicine Department of Small Animal Clinical Sciences (SCS), has been awarded a two-year $233,774 grant from the American Kennel Club Canine Health Foundation (CHF) to fund research on the causes of gastric dilatationvolvulus (GDV) in dogs. Nelson’s team is investigating the relationship of motility – contractions responsible for the digestion of food – with increased GDV risk, and hopes to define the biochemical and genetic alterations that may be associated with hypomotility (abnormally weak contractions). They will also evaluate the expression of the hormones motilin and ghrelin – regulators of GI motility – as a predictor of predisposition to GDV. This information will support an investigation into the disease’s genetic foundations. For more information, listen to Nelson’s podcast at avmamedia. org/display.asp?sid=549&NAME=Bloat_in_Dogs
GALA RAISES $400,000 FOR CANCER CENTER A gala fundraiser held in Toronto last fall raised $400,000 for the Mona Campbell Centre for Animal Cancer at the University of Guelph’s Ontario Veterinary College (OVC). The most advanced comprehensive center of its kind in Canada, it includes a linear accelerator for sophisticated radiation therapy, and coordinated care from many different specialties such as surgery, medical oncology, imaging, cardiology, anesthesia and critical care. ovc.uoguelph.ca Editor’s note: A percentage of proceeds from sales of The Animal Wellness Natural Cookbook for Dogs, published by Redstone Media Group, goes to the Smiling Blue Skies Cancer Fund, part of the OVC Pet
Photo Courtesy of Barry Gunn
Trust Fund. To order, visit animalwellnessmagazine.com.
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CALMING CANINE ANXIETY
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tress is common in dogs and can cause emotional and behavioral issues such as anxiety, hyperactivity, noise phobias and sleep disturbances. A variety of herbs and other natural substances can help calm them down. St. John’s wort (Hypericum perforatum): Has been used for centuries to treat mental disorders and relieve pain. Studies have shown it can reduce anxiety and psychological stress. It is used in dogs to help alleviate mild anxiety, fears and phobias as well as psychogenic alopecia and acral lick granuloma, through its analgesic and relaxant effects. Passion flower (Passiflora) extract: Contains flavonoids with relaxing and anti-anxiety effects. Its alkaloids and flavonoids are reported to be sedating in animals. Passion flower can reduce neuralgia, particularly when associated with herpetic viral disease. It’s the herb of choice for chronic insomnia. Research suggests that passion flower has a complex tranquilizing effect on the central nervous system. 5HTP (Griffonia simplicifolia botanical): Griffonia seeds come from a climbing evergreen shrub found in Africa. It is a natural and highly absorbable source of 5HTP (5-hydroxytryptophan), an enhancing amino acid with a documented sleep-inducing effect. It is a direct precursor to serotonin, a neurotransmitter that exerts a calming effect and regulates sleep. Serenin Vet™ by Animal Necessity contains 11 natural and complementary ingredients, including the above, that downregulate the triggers that over-stimulate the canine brain and lead to undesirable behaviors. Dr. Terri McCalla is a board-certified veterinary ophthalmologist and a member of Animal HealthQuest LLC.
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By Meg Smart, DVM, PhD
Nutritional Assessment for Dogs and Cats WHY IT’S SO IMPORTANT
N
utrition has long been recognized as an important part of the overall clinical assessment of both healthy and sick pets. In veterinary colleges, students taking nutritional courses are taught the intrinsic value of a healthy diet and how to take a nutritional history during a routine examination. Clinicians are also acutely aware of the importance of nutrition in companion animal health.
Without any record of what pets are currently being fed, or a record of veterinary recommendations, it is nearly impossible to critically track and evaluate the impact of nutrition on ongoing changes in health. Many retrospective nutritional research studies also rely on this information, and because of a lack of records, owner recall is often relied upon.
Where to begin – each patient is an individual
Despite this seemingly inherent understanding, medical records often reflect a different scenario. For example, at the Western College of Veterinary Medicine (WCVM), from October 2012 to October 2013, only 1.5% of case records included diet as part of the patient history, and only 0.4% of the cases mentioned nutrition in the plan or assessment.
Each assessment is as unique as the owner and the individual pet, and needs to include the owner’s level of nutritional knowledge, lifestyle, age, family size, income, and the number of pets in the house. Also needed is information on the pet, including current health, past medical history, breed, gender, age, level of activity and temperament.
As a profession, we have already acknowledged the importance of nutrition in contributing to the well being of a client’s pet over his lifetime, yet the statistics clearly illustrate that formal dietary records are not being kept on all patients, whether for wellness or illness. In a small veterinary practice, where a veterinarian becomes familiar with his clients’ pets, records are ideal but perhaps not necessary due to the often uninterrupted continuation of care. In a large practice, or in an academic institution, where this type of relationship does not exist, these records are essential for continuity and patient well being.
Always have the owner bring in plastic bags containing the amount of food and treats they are giving their pet each day, along with labels from these products. From this information, you can determine if the client is overfeeding or underfeeding. If diets are freshly prepared, have the client bring in an example of one day’s diet, and a log of what was fed for the week, including treats. You can educate your client on how to interpret labels and evaluate the ingredients. You can also help her determine the cost of feeding the pet per day. All this takes time, but if done properly on the first visit, the client will know what you need and will be educated and
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prepared for the next visit. Training your animal health technician to do much of the initial data collection can help you in your assessment and allow you to work with more clients.
Ancillary testing Experienced veterinarians may use blood, saliva or hair to get a better understanding of the nutritional status of a pet. I personally would not use these tests on the initial assessment unless you’re dealing with a growing puppy with developmental orthopedic disease, or a dog with health problems related to nutrition or responsive to dietary changes such as allergies, diabetes, obesity and/or renal, hepatic or heart disease.
1. Blood tests A routine CBC and chemistry panel can give you some information, especially if you are monitoring a pet’s response to a therapeutic diet. You may want to include a trace mineral panel as well. Specialized blood samples that measure vitamins and hormones will likely be done on an individual basis. Inflammation can alter the values, causing plasma iron, zinc and vitamin A to drop, and plasma copper to increase. Low red counts can be associated with chronic infections. Dogs on raw meat diets will have increased blood urea nitrogen (see sidebar on page 20). Growing puppies will have a higher level of plasma phosphorus than calcium until their growth plates close, as the level of phosphorus in the blood is highly correlated to growth hormone levels.
2. Saliva tests Saliva tests are non-invasive and can be used to monitor hormone changes, keeping in mind that saliva is different for each species. The most useful saliva test measures the IgA and IgM to determine food allergies (Hemopet).
3. Hair samples Hair samples are used to investigate the presence of trace elements and toxic metals. They also can give you a time estimate of when ingestion occurred and whether it is ongoing. For best results, I recommend you contact the laboratory that analyzes the hair and ask how to take a hair sample and from how many sites on the body. You must determine whether you require hair that is mature or growing. The type of hair coat can influence the results, and the sample must be prepared properly to avoid external contamination. Because of breed and environmental variability, an appropriate reference standard must be used. Shedding, stage of growth, surface contamination and over-processing of the hair can lead to errors.
Diet analysis Any homemade diet should have its nutrient content analyzed to assure there are no imbalances, deficiencies or excesses. This IVC Winter 2014 17
should be done in a recognized feed testing laboratory, either human or animal. If your client changes ingredients or ingredient sources, the analysis should be repeated. Depending on the season of the year, the soil’s nutrient composition can change, thus altering the nutrient composition of the plant material used. The season can also influence the nutrient composition of organ meats. When purchasing alternative diets (such as raw frozen or dehydrated), make sure the company has done validated nutrient analysis on all their products. This website lists all the AAFCOapproved feed testing laboratories worldwide: petfoodaafco.org
Assessing foods Veterinarians must be familiar with the commercial food industry, how ingredients are sourced and processed, and their composition. This is necessary in order to match the claims made by the company to the quality of their ingredients. The research must be transparent and valid, and support the claims. Veterinary therapeutic diets should stand out as superior in every respect, when compared to over-the-counter diets. In the case of homemade and packaged fresh food diets (frozen and dehydrated), ingredient sources, preparation, freshness and appropriate formulations must be investigated. Each diet should be species and metabolically appropriate. The veterinarian has a significant responsibility to independently evaluate the diets in order to separate fact from fiction, and eliminate any bias.
The meaning of “complete and balanced” “Complete and balanced” is an industry term that has more to do with marketing than nutrition. The term suggests there is a strict standard governing the nutrient content of pet foods. But it simply means the diet has met AAFCO’s minimum nutrient standards for growth, gestation, lactation or maintenance, and/or has passed AAFCO’s feeding trials, which are minimal at best. “Balanced over time” is a term used by proponents of alternative diets, which mimic our own diets. Nutrient requirements are not static and vary with age, level of activity, season of the year, stressors, and a host of other factors that render the term “complete and balanced” meaningless.
Considering obesity According to the Association for Pet Obesity Prevention, which surveys veterinarians on an annual basis, US pet obesity rates continue to increase. In 2012, the number of overweight cats reached an all-time high, with 58.3% considered overweight to obese by their veterinarians. The same survey found that 52.5% of dogs are overweight or obese.1 In most practices, an overweight animal is automatically a candidate for a special diet. But is this the right solution? Looking at several weight loss diets, we see a wide range of protein percentages, while fat and carbohydrate ranges are more Continued on page 20
WHAT ABOUT ASSOCIATION RESEARCH AND SUPPORT? The American Animal Hospital Association (AAHA) asked a group of prominent veterinary nutritionists to develop criteria for measuring nutrition during the clinical examination of a pet. These guidelines formed the basis of nutrition as the “5th Vital Assessment” — the other four being body temperature, pulse, respiration and pain. These guidelines were created in response to an AAHA compliance study which found that only 7% of pets that could benefit from a change in nutrition were actually on a therapeutic diet.2 The recognition of nutrition as the 5th Vital Assessment is an important step for the profession as we move more towards preventing disease and maintaining wellness in pets. It is important that as trained veterinarians we take the initiative in defining the direction we take with regards to nutrition, rather than merely follow the instruction of major pet food companies.
REFERENCES 1 National Pet Obesity Awareness Day Survey 2012, petobesityprevention.com 2 Journal of the American Animal Hospital Association, July/August 2010.
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IVC Winter 2014 19
Continued from page 18 consistent. Each of these diets may achieve its goal – but so might the dog’s regular diet plus exercise. The veterinarian must be aware of this since many clients are leaning to read labels. Veterinarians independently trained in nutrition are aware of the pathophysiology and the reasons for obesity, and could formulate or recommend a healthier, whole food diet.
In summary By placing an emphasis on nutrition during examination, it is possible that fewer pets will be subjected to invasive diagnostic procedures and illnesses requiring drug therapy. Nutrition is the key to maximizing health. Embracing nutrition as a valuable diagnostic tool provides a lower-cost, yet effective, first line of treatment. Use saliva, blood and hair analysis when needed to assess the nutritional needs of each patient. Finally, select the best diet from the many choices you have investigated and chosen as possible sources of good nutrition.
INDUSTRY PARTNERSHIPS AND THEIR IMPLICATIONS In 2012,
AAHA, the American Veterinary Medical
Association (AVMA), the American Society of Veterinary Medical
Association
Executives
(ASVMAE),
the
Canadian Veterinary Medical Association (CVMA), the National Association of Veterinary Technicians in America (NAVTA), and
the World Small Animal
Veterinary Association (WSAVA) all joined to form the Pet Nutrition Alliance (petnutritionalliance.org) with the goal of promoting the importance of nutrition as an “integral and essential component of providing optimal healthcare for healthy, sick and injured animals”. The guidelines the Alliance has created offer a basic nutritional assessment for pets in good health, and an in-depth analysis for pets with certain risk factors.
BLOOD VALUES FOR RAW MEAT EATERS By Dr. Jean Dodds, DVM In 2003, in collaboration with Dr. Susan Wynn, we investigated
In 2013, the American College of Veterinary Nutrition (ACVN) joined the Alliance. The educational and financial supporters of the Pet Nutrition Alliance are Hills Pet Nutrition Inc., Nestle Purina Pet Care and P&G Pet Care.
the basic clinical laboratory parameters of 256 healthy adult dogs of varying ages and breed types being fed raw food diets for at
Our academic institutions, professional associations,
least nine months. We found that dogs fed raw meats (natural
and our profession benefit from the financial
carnivores) had higher red blood cell and blood urea nitrogen
contributions and educational materials contributed
levels than dogs fed cereal-based food (obligate omnivores).
by these major pet care companies. Unfortunately, this may also compromise our ability to offer
A second two-part study was therefore initiated to measure and
alternatives to our clients, such as species-appropriate
compare the albumin content of the urine of raw and cereal fed
diets made from raw, dehydrated or cooked whole
dogs. Results indicated that there was no leakage of albumin into
foods. Through these alliances, the pet food industry
the urine of healthy raw fed dogs, and that no apparent short- and
has both a strong influence on the bodies that regulate
long-term clinical effects on renal function were detected from the
the production of pet foods, and the professional
feeding of raw diets.
associations that govern the veterinary profession.
20 IVC Winter 2014
IVC Winter 2014 21
By Sherman O. Canapp Jr., DVM, MS, CCRT, and Lisa M. Fair, VT, CCRA, CMT
TREATING CANINE part two To recap from Part One of this article (Fall 2013), osteoarthritis (OA) is the most common joint disease in dogs. Our focus on managing it must evolve from simply the palliative treatment of well-established disease using a few modalities, to early intervention and a comprehensive multimodal approach. In the last issue, we covered diet, supplementation, weight management and assistive devices. We will now look at: • Acupuncture and physical manipulation (chiropractic) • Regenerative medicine therapy • Rehabilitation therapy • NSAIDs and adjunct medications • Disease modifying agents and corticosteriods • Surgery
Acupuncture and physical manipulation (chiropractic) Dogs have approximately 360 acupuncture points located throughout their bodies. The exact mechanism of action is not completely understood, but research suggests acupuncture needles stimulate nerves and offer benefits as described by the gate theory. Response varies in dogs, with some showing significant improvement in discomfort and mobility. Some dogs experience no obvious benefits and a few do not tolerate needling.
22 IVC Winter 2014
Because the entire “chi� of the dog is being treated, a referral to veterinarians trained in TCVM provides the best chance of successful treatment in cases of OA. TCVM can help with weight management, improve vitality and energy, and assist with concomitant diseases as well as joint issues. Spinal manipulative therapy (chiropractic) can improve comfort and mobility in dogs with OA. These dogs often develop improper spinal biomechanics secondary to gait changes. Adjustments can restore proper bony relationships and reset receptors responsible for maintaining correct posture, balance and mobility.
Regenerative medicine therapy 1 - Stem cell therapy Published literature supports the use of stem cell therapy (SCT) to treat OA in dogs. However, there are still many unanswered questions. Most veterinary research has focused on adult stem cells, specifically mesenchymal stem cells, derived from bone marrow (BM-MSC) or adipose tissue (AD-MSC). To date, there is no definitive evidence in dogs that supports one tissue source over the other for regenerative treatments. Adipose tissue may be a preferred source in dogs due to ease of access, low morbidity and pain associated with collection, and high-yielding mesenchymal stem cell counts (especially falciform). The cells isolated from the adipose tissue not only include mesenchymal stem cells but endothelial progenitor cells, pericytes, immune cells, fibroblasts and other growth factorsecreting bioactive cells. This is known as stromal vascular fraction therapy. The stem cells along with this mix of other regenerative cells can be injected directly into the injured tissue or joint and/or given intravenously.
2 - Platelet-rich plasma (PRP) PRP is autologous blood plasma with concentrated platelets. The concentrated platelets found in PRP contain bioactive proteins and growth factors, including platelet-derived growth factor (PDGF), transforming growth factor-1 (TGF-1), transforming growth factor-2 (TGF-2), vascular endothelial growth factor (VEGF), basic fibroblastic growth factor (bFGF), epidermal growth factor (EGF) and stromal-derived factor (SDF-1). These growth factors work by binding to cell surface receptors and activating intra-cellular signaling cascades. They promote cell proliferation, cell migration and differentiation, and work as anti-inflammatory factors counteracting the inflammatory cytokines at work in OA.
3 - Combination therapy By combining SCT with PRP, it is possible to achieve the positive effects of both regenerative therapies. Combination therapy provides cells for regeneration, growth factors, and a scaffold to provide a template for cell attachment.
Rehabilitation therapy Rehabilitation therapy may be used in conjunction with other therapies. In some cases of mild to moderate OA, it may actually eliminate the need for additional medical therapies. The goals of rehabilitation therapy for the OA patient include pain relief, maintaining or building muscle strength, flexibility, and joint range of motion, core strengthening and overall conditioning. • Cold therapy causes vasoconstriction to reduce inflammation, muscle spasms, pain and deceleration of nerve conduction velocity. It benefits dogs with acute exacerbation of chronic OA.
Alternatively, the stem cells can be isolated from adipose tissue, cultured and expanded. This yields a more homogenous population with a larger quantity of cells for injection. This is known as adipose derived progenitor cell therapy. Because cells are obtained from the intended recipient, the risk of rejection and disease transmission is eliminated regardless of culture or direct injection, adipose or bone marrow source. There are multiple mechanisms by which these regenerative cells initiate change. MSCs decrease pro-inflammatory and increase anti-inflammatory mediators. MSCs are activated to become immunosuppressive by soluble factors, and in turn secrete soluble factors that inhibit T-lymphocyte activation and proliferation. MSCs secrete bioactive levels of cytokines and growth factors that support angiogenesis, tissue remodeling, differentiation, and antiapoptotic events. The cytokines and growth factors secreted by MSCs can also assist in neovascularization. MSCs demonstrate a diverse plasticity and are able to migrate to sites where needed.
Stem cell therapy is showing success in helping to treat osteoarthritis.
Continued on page 24 IVC Winter 2014 23
Continued from page 23 • Heat therapy causes vasodialation, increasing enzymatic activity and collagen extensibility. It also reduces muscle tension and spasm, improves flexibility of the joint capsules and surrounding tendons and ligaments, and provides pain relief. • Transcutaneous electrical nerve stimulation (TENS) has been shown to reduce pain. It works by stimulating large cutaneous nerve fibers that transmit sensory impulses faster than pain fibers as explained by the gate theory. In addition, TENS also increases the release of endogenous endorphins, which interact with pain receptors and block pain perception. • Neuromuscular electrical stimulation (NMES) involves the stimulation of muscle fibers for strengthening. Dogs with OA typically lose muscle mass due to weakness and disuse. NMES may help minimize the extent of atrophy, and provide proprioceptive, kinesthetic and sensory input directly to the muscle as well as give pain relief. • Therapeutic Ultrasound (TUS) uses sound energy to affect biological tissues. It provides deep heating of tissues (3cm to 5cm). TUS can increase blood flow, collagen extensibility, metabolic rate and pain thresholds. It can also decrease muscle spasm. • Low Level Laser Therapy (LLLT) influences cellular processes through photobiomodulation. It may have positive effects on injured cartilage. In addition, LLLT may reduce pain through the increased metabolism of endogenous opiates, a change in the conduction latencies of nerves, or through stimulation of acupuncture or muscle trigger points. • Extracorporeal Shock Wave Therapy (ESWT) uses sound waves characterized by a rapid and steep rise in pressure followed by a period of negative pressure. Mechanisms of action are not yet fully understood, but it is postulated that mechanical and chemical effects on a cellular level stimulate healing and modulate pain signals. • Manual Modalities - PROM/Stretching – Most dogs with OA have some degree of inflexibility due to shortened muscles and intrinsic joint restriction. Performing gentle passive range of motion therapy and stretching has been shown to increase overall range of motion. Heat therapy applied prior to these therapies enables collagen fibers to be maximally stretched. - Joint Mobilization – May help improve joint range of motion and decrease pain in dogs with mild to moderate OA. Joint mobilization involves low-velocity movements within or at the limit of the dog’s range of motion. Gentle distraction following joint mobilization may improve results. Care
24 IVC Winter 2014
must be given when performing this modaility for dogs with more severe OA, as it may increase discomfort. - Massage – Decreases myofascial pain, adhesion formation and muscle tension, and increases vascular and lumphatic circulation. It can help reduce edema, improve blood flow, decrease muscle stiffness and improve muscle flexibility and joint mobility. Clients can be trained to do this at home. • Therapeutic Exercises can be of significant benefit to dogs with OA. Most of these dogs have moderate to severe muscle atrophy and loss of motion within affected joints. Therapeutic exercises are used to maintain and rebuild muscle mass, strengthen muscle force, maintain and improve joint range of motion and overall function and conditioning. • Hydrotherapy includes underwater treadmill and swim therapy. Extensive studies in human physical therapy have demonstrated that hydrotherapy encourages range of motion, and improves muscle tone and mass with reduced stress to joints and tissues. In addition, the buoyancy of the water may allow the therapist to perform standing therapeutic exercises. The benefits of hydrotherapy to dogs with OA include: • Relief of pain, swelling and stiffness • Improved muscle mass and tone • Increased joint range of motion • Improved circulation
NSAIDs and adjunct medications NSAIDs have been the foundation for treating symptoms of OA in dogs. They have anti-inflammatory, analgesic and antipyretic properties. However, serious adverse effects can occur, some of which are fatal, especially with chronic use. These most commonly include gastrointestinal, renal, hepatic and coagulation disorders. The goal is to use the minimal effective dose when other treatments are not successful. Because of these potential adverse reactions, screening to identify highrisk candidates should be performed and include a physical and chemical examination, and identification of concurrent disease or conditions. It is important to educate owners on the proper dose, administration and potential side effects of NSAID therapy. This information should be provided both verbally and in writing. Most adverse affects are seen in the first 48 to 72 hours of administration. A call to the owner at this time and reassessment within ten to 14 days is recommended. For
GETTING TO THE
ROOTS OF PET FOOD
It is important to educate owners on the proper dose, administration and potential side effects of NSAID therapy.
INGREDIENT SOURCING AND THE
chronic therapy, routine rechecks are recommended. GI protectants may be needed in some patients. Adjunct medications can be used for “break through” pain or if discomfort cannot be controlled by other means. Commonly used adjunct medications include: • Tramadol • Gabapentin • Amatodine • Codiene
Disease modifying agents and corticosteroids Details on these conventional medications are readily available in veterinary literature. Adequan® Canine is polysulfated glycosaminoglycan (PSGAG) prepared by extracting glycsaminoglycans (GAGs) from bovine trachale cartilage. It has been shown to inhibit certain catabolic enzymes that degrade collagen, proteoglycans and hyaluronic acid in inflamed joints. In addition, Adequan stimulates the synthesis of protein, collagen, proteoglycans and hyaluronic acid. Hyaluronic Acid (HA) is a form of viscosupplementation, which has been shown to slow the progression of osteoarthritis and decrease inflammation within the joint. Specifically, it increases joint fluid viscosity, increases cartilage (GAG) formation, and decreases degradative enzymes and cytokines. The injections must be given under sterile conditions with the dog under sedation or general anesthesia. Reportably, over 70% of dogs respond well to HA and improvement can be noted for over six months following administration. The author’s clinical impression is that HA used alone is useful for synovitis and mild to moderate OA, but in the treatment of severe OA, an intra-articular corticosteroid is recommended. When dogs have not responded to other treatments, intraarticular injections of corticosteroids can provide pain relief for dogs with end-stage osteoarthritis. Arthroscopic debridement of the arthritic joint may offer improved comfort and mobility. Salvage surgeries such as joint replacement and arthrodesis may also be considered. Canine osteoarthritis is an incurable condition, but with early intervention, when possible, and a multimodal approach, we can extend longevity and quality of life for our canine patients.
By Lucy Postins
ISSUE
In recent years, we have seen a shift in attitude towards food. Connecting with a brand on a deeper level to understand what’s going on behind the scenes in purchasing choices, production techniques and the company’s general priorities, has become a key way to evaluate that company’s mission, values and ethics.
WHERE DO INGREDIENTS COME FROM? Some key questions to ask include how a pet food company purchases its ingredients. Do they buy their own or leave procurement to a co-packer or other third party broker? Which countries are the ingredients grown and processed in? Some countries have distinctly better quality and safety records than others, as well as differing attitudes to chemical and pesticide usage, human rights and working conditions.
HOW DO COMPANIES REGARD GMOS? It’s also important to know what a company does to ensure its ingredients are free of Genetically Modified Organisms (GMOs). More than 94% of soybeans and 88% of corn in the US are thought to be genetically modified – and these crops are found in most cheap pet food products on the market. Studies show that when butterflies and other insects come in contact with pollen from genetically modified crops, they suffer health problems and eventual genetic mutations. An emerging theory states that a similar thing happens when other species consume GMO grains – especially species whose systems aren’t designed to cope with a grain overload in the first place. It’s thought the process of genetic modification can make an ingredient unrecognizable to the body, causing potential “food sensitivity” reactions or worse. In Part 2, we’ll look at pet food processing, environmental impacts and packaging. gmo-compass.org/eng/safety/human_health/192.gmos_mean_more_allergies.html responsibletechnology.org/gmo-dangers/health-risks/articles-about-risks-by-jeffrey-smith/GeneticallyEngineered-Foods-May-Cause-Rising-Food-Allergies-Genetically-Engineered-Soybeans-May-2007
1
2
Lucy Postins is co-founder and CEO of The Honest Kitchen, which makes dehydrated natural dog and cat food, 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 The Honest Kitchen in 2002. thehonestkitchen.com IVC Winter 2014 25
Yunnan Baiyao MIRACLE HERB FOR YOUR CLINIC
By Jodie Gruenstern, DVM, CVA, CVFT Do you ever wonder what your veterinary practice would be like if you had to give up some of your favorite tools, the ones on which you have become so dependent? For me, one of those tools is Yunnan Baiyao, a must-have herbal with diverse applications. Yunnan Baiyao (YBY) is a proprietary Chinese herbal formulation that originated in the Yunnan province in China. Bai means “white” and yao means “medicine”. The main ingredients in this Yunnan white medicine are two types of ginseng, and several members of the yam family. Traditionally this formula is used to Transform Stasis, Resolve Stagnation, Tonify Qi, Invigorate Blood and Clear Heat.1
Stops bleeding A Western analysis of the physiologic effects of this herbal combination identifies its ability to stop bleeding. Specifically, in one rat study, Panax notoginseng saponins was able to attenuate induced microcirculatory disturbance.2 Astringent and resinous herbs are present which stop bleeding and enhance healing.1 In one human study, 100 participants with upper gastrointestinal bleeding were treated with a Yunnan Baiyao blend of herbals. A 95% effective rate was reported.3 A prospective, randomized, double-blind, placebo-controlled 2009 study was published in the International Journal of Oral and Maxillofacial Surgery which demonstrated the effects of preoperative administration of Yunnan Baiyao on lessening blood loss. According to Dr. Huisheng Xie, world renowned TCVM instructor and formulator for Jing Tang herbals, “Yunnan Baiyao is one of the emergency herbal formulas herbalists carry all the time.”1 YBY can be applied directly on open wounds, into the abdominal cavity, into tooth extraction sites, and can be taken orally. Anecdotally, university surgeons are using YBY capsules orally as a pre-med to prevent adverse bleeding during surgery. YBY has been an invaluable aid in stopping leakage from splenic hemangiosarcoma masses, thereby decreasing the associated anemia, improving quality of life, and increasing longevity, especially when surgical intervention is not an option or has failed.
26 IVC Winter 2014
Administration and dosage The brown powder is supplied in a package of 16 rust-colored capsules or a tiny 4g vial. The capsules can be swallowed or opened. The powder may be used topically or mixed into food. It can even be mixed with water and squirted into the nasal passages for a nose bleed. Keep in mind it is very astringent and may be uncomfortable for a moment, but it does work! A well-accepted veterinary resource recommends dosing YBY as follows:1 Dogs: 0.5-5g twice daily orally Cats: 0.2-0.5g twice daily orally When applied topically every day into a deep dog bite puncture or a large dehiscence, YPY seems to stimulate granulation tissue and inhibit the development of infection. The application can be repeated two to four times per day. This use alone makes it valuable to any practice!
SHROUDED IN MYSTERY
Despite the mystery that surrounds the formulation (see sidebar below), Yunnan Baiyao has won three national gold medals for quality. It is ranked among the most famous of Chinese traditional medicines, and has been designated as one of two Class-1 protected traditional medicines for a 20-year protective term in China. The YBY reputation is equal to that of penicillin in the United States. The story of Yunnan Baiyao and its formulator, Mr. Qu Huangzhang, is known all over China and has even been made into a film.4
The mystery that surrounds Yunnan Baiyao is both interesting and concerning. According to legend, in order to keep the formula secret, 13 separate teams mix the product. No team knows the ingredients the other teams are blending.1 According to ShanghaiDaily.com, “the traditional Chinese medicine maker, Yunnan Baiyao Group Co. Ltd., has been sued by a lawyer in central China’s Hunan Province for concealing an alleged toxic ingredient in its signature product from consumers.” The potentially toxic ingredient is radix aconite agrestis, also known as gelsemium elegan or “heartbreak grass”. This same source also says that in 2009 a lawyer in Beijing suffered an allergic reaction after taking the medicine. The attorney lost this lawsuit. The government agreed that the formulation is protected as a state secret; in fact, it is protected until 2015, according to China’s FDA. Some doctors say high doses of the toxic herbal ingredient can cause dizziness, nausea or even death. Despite this, in the veterinary field, small doses have been administered safely for long periods, even years. For example, a 75-pound dog can consume one capsule twice daily for longer than one year as part of a cancer management protocol, with no adverse effects.3
REFERENCES
Xie, Huisheng, Xie’s Chinese Veterinary Herbology,2010. Chen and Chen, Chinese Medical Herbology and Pharmacology, 2001, p.568. 3 AnimalDoctorHolistic.com 4 Chinese Business World, cbw.com 1 2
Continued on page 28
IVC Winter 2014 27
Continued from page 27
SIX CASE STUDIES
The following cases demonstrate the diverse uses of YBY. This unique herbal formulation is complementary to other herbals and medications, and is an alternative when other modalities are not options. It is efficacious both orally and topically. It appears to be safe when utilized long term in dogs.
1. THOR, a seven-and-a-half-year-old M/N Weimaraner presented on August 22, 2013 for lethargy and anorexia. He was diagnosed with a splenic mass and hemoabdomen via abdominal ultrasound and abdominal tap. Surgical intervention was declined. Treatment with Yunnan Baiyao (1 capsule BID orally) and Gui Pi Tang was initiated, and appetite and energy improved. Thor is doing well and still stable two months post-diagnosis. 2. TILT, an eight-and-a-half-year-old F/S Belgian Tervuren, presented February 15, 2013 with nasal neoplasia, right epistaxis, purulent drainage and sneezing. CT scan and histopathologic diagnosis were consistent with sarcoma. Radiation therapy was recommended but declined. Case management began with multiple Chinese and Western immune supportive herbals including Yunnan Baiyao (1 capsule BID orally) and essential oil therapies. Boswellia sacra – via diffusion, topically and orally - was initiated. In addition to this, a rigid, speciesappropriate, fresh meat-based diet, high in blended, dark, leafy green vegetables and no starch was implemented. Multi-modal treatment is common for cancer in holistic patients. Therefore, the efficacy of Yunnan Baiyao in isolation cannot be evaluated. Discharge diminished and resolved within two months. Currently, Tilt sneezes daily, but intermittently. She is actively involved and winning in agility eight months post-diagnosis. 3. GOOLY, a 16½-year-old M/N Australian Shepherd, presented October 8, 2012 with a smooth, raised, depigmented 1 cm mass involving gingival tissue dorsal to his left upper carnassial. Resection with good margins left root exposure; histopathologic diagnosis was consistent with an ossifying epulis. This lesion
1 2
28 IVC Winter 2014
could recur, invade bone and cause disfigurement. The owner was instructed to pack the site twice per day with Yunnan Baiyao, and massage gingiva with an esterified fatty acid. Several oral immune modulatory supplements were implemented. At Gooly’s two-week recheck exam, the gingival margin was filled with normal-appearing tissue adherent to the alveolar bone of the carnassial root. His owner continues to apply YBY intermittently. There has been no recurrence one-year post resection.
4. HERO, a ten-year-old M/N Rottweiler, presented with anorexia, halitosis, bradycardia and mild anemia. Upon palpation, a cranial abdominal mass was confirmed radiographically. HCT 30 (37-62). Hero has a history of hypothyroidism. Specialist surgical referral was declined. Possible blood transfusion was declined. Yunnan Baiyao, one capsule BID, was initiated on December 31, 2012. His guardian reported improved energy on January 4, 2013. On January 8, HCT was 35 pre-surgery. A splenectomy was performed which revealed a 4” diameter mass. Histologic diagnosis was splenic infarction with marked hemorrhage and necrosis. Hero is currently alive and well. 5. S HARDAY, a nine-year-old F Pit Bull victim of dog fighting, presented with multiple bite punctures, severe lacerations, gaping shoulder and auxillary wounds with severe edema. Treatment was declined at ER. ER suspected limb amputation might be necessary. The case was managed with essential oil soaks, antibiotics and Yunnan Baiyao applied directly into wounds. All wounds were managed with second intention healing, no primary closure. One drain was placed. All wounds granulated in and healed closed within four weeks. One minor scar is present. 6. BLUE, a 15-year-old M/N Chocolate Labrador Retriever was diagnosed with splenic hemangiosarcoma after a splenectomy. Yunnan Baiyao (1 BID orally) and other immunosupportive herbals were initiated in May 2005. Blue is alive and well eight years post diagnosis.
3 4 5
6
IVC Winter 2014 29
From the VBMA The Veterinary Botanical Medicine Association is a group of veterinarians and herbalists dedicated to developing responsible herbal practice by encouraging research and education, strengthening industry relations, keeping herbal tradition alive as a valid information source, and increasing professional acceptance of herbal medicine for animals.
Join the VBMA at vbma.org to find out. The answer will also be published in the next issue of IVC Journal.
30 IVC Winter 2014
Product Profile
UNHEALTHY SALIVA CAN ARISE FROM HEALTH ISSUES AND MEDICATIONS
By Naomi A. Kirby, DVM, MS
PATIENTS WITH CERTAIN HEALTH CONDITIONS need extra oral care. In these animals, saliva can lose its protective properties, predisposing the pet to increased bacterial, fungal and plaque overload.
diabetes, autoimmune diseases, endocrine disorders, pancreatitis, hypertension, FIV, anxiety disorders. The following common medications used in the management of a variety of disorders can also causes salivary glands to reduce the quality and quantity of saliva: • Arthritis meds: NSAIDs • Anticonvulsants: Diazepam, •A ntihistamines: Diphenhydramine, Chlorpheniramine, Hydroxyzine •A ntihypertensives: Amlodine, Atenolol, Benzapril, Enalapril, Furosemide, Spironolactone •A nxiety meds: Amitripyline, Diazepam, Clomipramine, Fluoxetine • I ncontinence meds: Phenylpropanalomine
Signs of a mouth with unhealthy saliva.
Saliva provides an effective barrier against drying and is primarily composed of water – but it also includes antibodies, enzymes and mucoproteins, all of which work to protect the teeth. Saliva reduces the pH of plaque waste products and limits tooth decay. It also flushes the mouth and clears food debris that would otherwise provide nourishment to the bacteria found in plaque. An overload of plaque can lead to halitosis, an increased risk of periodontal disease, tooth loss or even a systemic infection if bacteria is absorbed into the bloodstream. Many health conditions and diseases, and even the medications needed to manage them, can affect saliva quality or flow and lead to xerostomia/dry mouth. These include: aging, obesity,
In patients with health problems, such as those listed above, it becomes very important to pay extra attention to oral care. Oratene® Veterinarian Brushless Oral Care products can help manage xerostomia because they contain two complete patented enzyme systems backed by over 35 years of enzyme research. The enzymes work to replenish the protection and defense mechanisms found in healthy saliva, and to eliminate the offending bacteria and/or fungi while also rendering plaque biofilm water-soluble and unable to bind to tooth surfaces. Oratene’s gentle formulation provides soothing protection without harmful alcohols, xylitol or tooth-staining chlorhexidine. Dr. Naomi A. Kirby is the Technical Services Manager for Pet King Brands Animal Health, Inc. (petkingbrands.com), makers of ZYMOX® Enzymatic Products for chronic ear, skin and oral conditions. She can be reached at Naomi. kirby@gmail.com. IVC Winter 2014 31
Inflammatory airway disease in horses -
IT’S MORE THAN JUST A COUGH By Madalyn Ward, DVM
FOR MANY HORSE OWNERS, hearing a small, occasional cough when their animal first starts to work does not seem like a big deal. But performance horse owners realize that low grade inflammation in the lower respiratory tract can cause trouble long before obvious clinical signs are apparent. A mild cough with a little mucous discharge might mean only a slight irritation that would respond to a few days of rest — but it might also be a sign of more serious trouble. Coughing is not normal if it shows up consistently at the beginning of exercise, occurs spontaneously in the barn or during feeding, is deep or productive, or reduces performance in any way. A persistent cough that lasts longer than four weeks is likely a sign of inflammatory airway disease (IAD). Other signs of IAD that may occur less consistently include fading at the end of a race, moving the jaws or swallowing after a cough, and reluctance to collect or flex at the poll. IAD should also be considered when horses show increasing reluctance to work for no obvious reason.
WHAT CAUSES IAD? The specific cause is not known. It is most likely the result of multiple insults. Performance horses are subjected to many irritants in barns, trailers, dusty warm-up pens and arenas. Research in humans has proven that the inhalation of particles less than 10 micrometers in size will cause inflammation of the
32 IVC Winter 2014
airways. Specific research on particle size in horses has not been done, but signs of inflammation like visible mucus are associated with particles between 0.7 and 2 micrometers in diameter. Rodeo arena dust is one of the most irritating substances a horse can be exposed to. Barrel racing horses have increased risk of exposure because of the large quantities of dirt thrown into the air from the combination of high speed, stopping and turning. The smaller dust particles will remain suspended in the air, especially right next to the barrels. Horses that run the barrel pattern after multiple horses have already run it are more at risk than those that run immediately after the ground is worked by a tractor. Horses that travel to compete face the constant challenge of viruses and bacteria. It can be difficult to determine whether a horse has IAD or a low grade primary infection caused by a virus or bacteria, since the symptom patterns can be very similar. Whereas viruses are rarely identified in transtracheal wash samples, bacteria commonly are; but again, in either case – viral or bacteria – we have no way of knowing whether those pathogens might have caused the inflammation or are present because of the inflammation. Antibiotics are often prescribed based on the culture and sensitivity results for the bacteria found in the transtracheal wash sample. It is then not uncommon for subsequent samples
to reveal the presence of an entirely new bacterial infection. From a holistic viewpoint, this would suggest that bacteria are present because of the inflammation rather than the other way around, in which case the focus should be on decreasing the inflammation instead of treating an infection.
TREATMENT STRATEGIES Treatment of inflammatory airway disease is focused on management to decrease exposure to irritants, and reversing the bronchoconstriction caused by the release of inflammatory mediators in the lower airways.
1. BEDDING AND DUST CONTROL The type of bedding is important. Shavings and straw are easily broken down into small particles when horses continually walk on them. These types of bedding will also harbor molds unless all moist materials are removed frequently. Washed river sand can be a better choice for bedding as it does not break down as easily when walked on. Sand can also be misted with water to keep the dust down with less fear of mold formation. Care must be taken to remove all manure and urine-soaked sand every day, and fresh sand should be brought in as needed. Keep all bedding in the horse’s stall and trailer clean and fresh in order to avoid mold and ammonia fumes. Fine particles of manure can be very irritating when inhaled. Hay should be fed on the ground or in low mangers that are cleaned out regularly. Trailers with feed mangers will not allow the horse to lower his head to clear his respiratory passages. If the horse is to be tied in the trailer, make sure the rope is long enough to allow the top of the head to drop below the withers. Dust control in the arena and barn can be achieved with frequent watering. Wet the barn aisles down before sweeping or blowing. High ceilings and good ventilation will help drop the concentration of fine dust particles in the air. Avoid turning on fans when stalls are being cleaned or when traffic in the barn is heavy. Never store hay above the stall area; a separate building for hay storage is ideal. Continued on page 34
PREVENTIVE TACTICS Prevention is the best treatment for IAD. Natural anti-inflammatory and antioxidant foods such as noni juice, blue green algae, Omega-3 rich seeds and nutritional mushrooms can be fed on a daily basis to combat repeated exposure to respiratory tract irritants. Dust control in the barn, arena and trailer are critical in lowering the level of exposure to respiratory tract irritants maximizing pasture time. IVC Winter 2014
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Continued from page 33
MARSHMALLOW
Regular turnout in the pasture will allow the horse to get his head down and have a break from a dusty barn. When possible, horses should not be stabled in the same barn as an arena. At shows or rodeos, the horse should be kept outside as much as possible. Horses should not be schooled or warmed up in crowded arenas if it can be avoided.
2. BODYWORK CAN HELP WITH BREATHING Horses must be able to breathe deeply to clear their lungs. If a patient is very muscle sore or has a fixated rib, he may be breathing shallowly. In the absence of deep breathing, the horse may be unable to clear mucous and inhaled debris from the deeper airways, setting up the potential for bronchial infection and inflammation. Regular bodywork such as chiropractic, TTouch, massage or acupressure will allow detection and correction of these problems so that free breathing can be restored quickly.
3. MEDICATIONS – PROS AND CONS Antihistamines are rarely effective in treating IAD, despite the fact that histamine is the predominant mediator produced by mast cells and a secondary mediator produced by neutrophils. Histamine triggers bronchoconstriction, and bronchodilators may give temporary relief but do not address the underlying inflammation. The response to bronchodilators tends to decrease the longer they are used. Corticosteroids are the Western treatment of choice and some horses will temporarily respond well to them. Horses with a hyper-reactive airway produce more mast cells and do not respond to steroids. Steroids are palliative at best and suppress the immune system, making the horse even more susceptible to infection. Side effects of steroids also include gastrointestinal bleeding and organ damage.
4. NUTRITION AND SUPPLEMENTS Nutritional support and natural products such as herbs can be utilized to prevent and treat IAD. • Omega-3 fatty acids have anti-inflammatory action that is often more effective than drugs. Mast cell mediated inflammation responds well to Omega-3 fatty acids. Flax seeds, chia seeds and blue green algae are good sources. • Probiotics can be added to the diet and support the immune system by enhancing the function of the digestive system. • Noni and mangosteen fruit contain natural antioxidant and anti-inflammatory substances that help combat inflammation.
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• In general, herbs can be very helpful in supporting the respiratory tract. Decongestant herbs like ephedra help clear excess mucous by dilating the brochiolas. Be aware that this herb may test positive so it should not be used during competition. This herb should not be used without the guidance of an experienced herbalist. Safe, nutritional herbs such as marshmallow, slippery elm, comfrey, mullein, and fenugreek help thin and clear out mucous. Lobelia is an antispasmodic that can relax bronchospasms. This is a very strong herb and should not be used without the guidance of an experienced herbalist. • Pure, whole particle beta glucan helps with inflammation by mobilizing white blood cells to areas of injury or inflammation. These white blood cells (macrophages) then remove damaged tissue quickly before it has time to trigger more inflammation. Beta glucan is considered an immune modulator, so it can dampen an overactive immune response. Medicinal mushrooms such as cordyceps contain multiple forms of beta glucan. • Occasionally, a certain farm will have a high incidence of IAD, which can be due to many factors including environmental irritants or resident viral, bacterial or fungal pathogens. If this situation develops, and healthy horses introduced to the farm develop symptoms, it may be valuable to make a homeopathic nosode to be given to all horses on the farm, and all new horses as they are brought in. To do this, samples from a transtracheal wash are sent on ice immediately to a homeopathic pharmacy where a remedy is made based on homeopathic principles. While most homeopathy is based on individual prescribing, a high percentage of horses can respond to homeopathic action that is specific to the pathogen on a particular farm. • Antibiotics, steroids and/or bronchodilators can be used for short term treatment, but they are rarely curative. Rest, in combination with herbal decongestants and anti-spasmodics, can be used in place of conventional drugs.
REFERENCES Buchanon, Ben, DVM. Southwest Veterinary Symposium, 2013. “Mucus and Airborne Particles New solutions for a performance-limiting problem.” North America Trainer Magazine, Issue 27 – Spring 2013. Boron, Walter F., Boulpaep, Emile L. Medical Physiology.
Photo Courtesy of Kim Henneman, DVM
DIAGNOSING THE PROBLEM Diagnosis of IAD is based on a combination of clinical signs, the results of an endoscopic exam, transtracheal and bronchoaveolar lavage (BAL) results, and the horse’s response to treatment. It is important to determine the type of inflammatory cells recovered in the lavage fluid. When neutrophils are found as the predominant cell type, there is a better prognosis for treatment because this type of inflammation does respond to steroids and other anti-inflammatory medications. Quarter horses, as a breed, are more likely to produce mast cells as a response to organic matter suspended in rodeo arena dust. Barrel racing horses that respond to irritation with mast cell cytosis do not respond to corticosteroid anti-inflammatory therapy and are more difficult to treat successfully.
Veterinarian Tommy Burns uses an endoscope on a yearling Thoroughbred.
IVC Winter 2014 35
industry innovations
ALL-NATURAL WOUND CARE
DENTISTRY WITHOUT ANESTHESIA Pet Dental Services (PDS) provides preventive anesthesiafree dental care for dogs and cats. It offers an 11 step Professional Outpatient Preventive Dental (POPD) procedure, and educates veterinary practitioners and pet owners on the importance of preventive dental care. PDS has proven the efficacy and safety of its procedure through a recently published study conducted with board certified dental specialists.
New from PetzLife, VetzLife Wound Care is an excellent all-natural remedy for skin problems such as scratches, minor wounds, abrasions, ringworm, and dry, itchy or flaky skin. It’s safe for open wounds and post-surgery incisions to promote rapid healing. It has been laboratory tested to be effective against bacteria, viruses, fungi and parasites and is also antiinflammatory.
VetzLife.com
PetDentalServices.com
ACUPRESSURE AND MASSAGE The Rocky Mountain School of Animal Acupressure and Massage (RMSAAM) offers on-site certificate programs in Canine and Equine Acupressure and Massage. The school is approved and regulated by the Colorado Department of Higher Education and the Registry of Alternative and Integrative Veterinary Medical Education (RAIVE). Offers Technical CEs for veterinary professionals.
RMSAAM.com
FOR FELINE HEALTH Kemin is pleased to announce the next generation of RESOURCES™ supplements aimed at supporting feline health. Feline Urinary Tract Support, Feline Immune System Support, and Protegrity™ GI are now available as palatable chews, allowing for more convenient delivery and improved acceptability. These formulations provide proven activities to promote feline health. kemin.com
36 36 IVC IVCWinter Winter2014 2014
NEW FOOD FOR KIDNEY HEALTH Darwin’s Natural Pet Products, and Dr. Barbara Royal, DVM, CVA, are introducing the first in a new line of prescription-only, raw frozen veterinary meals to address kidney health. Dr. Royal’s Integrative KS Formula is designed for dogs with kidney disease; it supports muscle development and healthy kidney function with species-appropriate proteins and carefully chosen herbs, and is highly palatable to dogs with appetite loss. darwinspet.com
PAW PROTECTION PRODUCTS Healers Pet Care provides breathable, lightweight athome healing and protection solutions for pets. The line includes Healing and Protection Paw Care Products and Urban Walker Dog Booties, Healing and Protection Leg Care Products and First Aid Essentials Kits. All products are made in the US. Wholesale pricing is available for veterinarians and retailers.
HealersPetCare.com
WHOLESOME DIETS AND SUPPLEMENTS Brookside Barkery & Bath’s website and online store features holistic foods and supplements, including kibble, raw, freeze-dried and custom diets. The website also includes a searchable listing of holistic veterinarians – contact the company to get your practice listed. Using her knowledge of TCVM, owner Delena Stout offers nutritional consultations for veterinarians and pet owners alike.
BarkeryBath.com
HEALTH COMPANY GROWING FAST Uckele Health & Nutrition is one of the nation’s fastest-growing private companies, according to Inc. Magazine, which listed the company at number 3,640 on its Inc. 500/5000 2013 listing. CEO Mike Uckele is honored to be listed for the fifth year in a row. “The dedicated team focus and talent that Uckele associates bring to their jobs every day has definitely been the driving force behind our success,” he says.
Inc.com/5000
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industry innovations COLD LASER THERAPY EQUIPMENT Laser-riffic offers affordable portable cordless cold laser therapy equipment for all animals. The 470nm blue radiance kills bacteria and MRSA, and 25W of super pulsed peak power reaches deep into joints. Laser therapy reduces pain and speeds healing without the use of drugs. It can used to treat many conditions, including wounds, arthritis, hot spots, cystitis, otitis and more.
Laser-Riffic.com
PRODUCT RECEIVES SEAL OF ACCEPTANCE Virbac Corporation is now displaying the Seal of Acceptance from the Veterinary Oral Health Council (VOHC) on its C.E.T.® VEGGIEDENT® Chews. The seal was awarded for the product’s ability to protect against tartar buildup in dogs. The palatable vegetable-based chews have been proven to reduce plaque, calculus, and halitosis (Clarke DE, Kelman M, Perkins N. “Effectiveness of a vegetable dental”).
Virbacvet.com
VITAL CLEANSING
DIGESTIVE SUPPLEMENT Perfect Form is a mix of herbs and whole foods that support digestive health made with papaya leaf, plantain, slippery elm, organic pumpkin seed, pectin, papain and fennel. This innovative product can be used intermittently or on a daily basis. For a limited time, you can try a box of Perfect Form for free!
TheHonestKitchen.com
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Vital-VS Topical Spray physically cleans and debrides skin and wounds (with or without infection) prior to treatment and/or repair. Effective on hot spots, eye infections, scratches, wounds, punctures, abrasions, rashes, thrush, insect bites and burns. Quality products at affordable prices.
Vitalanimalhealth.com
nutrition nook Raw green tripe has been nutritionally analyzed and found to have a desirable calcium:phosphorus ratio of 1:1.
RAW GREEN
tripe
It might look and smell disgusting, but it’s a rich source of nutrients for pets. By Amy Fiumarelli
M
ost of our clients are looking for ways to keep their pets healthier and extend their lives as long as possible. But many still choose to feed highly processed pet food because of its convenience and affordability. Such diets are far removed from the natural diet of dogs and cats. Although these animals have been domesticated for thousands of years, IVC Winter 2014 39
their dietary needs have not changed significantly. Commercial pet foods only came into existence within the last century. The evolution of cats and dogs has proceeded throughout time without these diets. Most pets thrive on a diet consisting of predominately fresh meat. One fresh meat ingredient with many health benefits is raw green tripe – the entire unprocessed stomach of a cudchewing animal such as a cow or deer. In the wild, carnivorous animals prey on herbivores and consume the entire animal, including the stomach and entrails. It may be hard for some of our clients to imagine that their cute little dogs would stalk and hunt live animals, but domestication has not totally removed this instinct. If they have ever observed their cats stalking a bug or their dog “killing” a plush toy to remove the squeaker, they are seeing this natural instinct in action. Tripe has always been a very important component of the carnivore’s diet. Though most humans regard it as unusual, raw green tripe is a natural and beneficial food.
NUTRITIONAL ADVANTAGES • Raw green tripe offers a balance of nutrients as well as beneficial bacteria and enzymes. It has been nutritionally analyzed and found to have a desirable calcium:phosphorus ratio of 1:1. Green tripe’s pH is acidic, the protein is 15.1%, and the fat is 11.7%. It also has the correct proportions of Omega-3 and Omega-6 fatty acids. • One of the best constituents of raw green tripe is lactobacillus acidophilus. This is one of the intestinal bacteria that keep unwanted bacteria such as e-coli, salmonella and listeria from
what tripe can do There are many illnesses in which raw green tripe has proven to be very supportive. I have used it for dogs with end stage kidney disease. These animals refused all other forms of food but were enticed to eat by the tripe’s smell. Slightly extending the lives of these pets gave their owners time to make important decisions about end of life care. In another case, a great Dane puppy with hypertrophic osteodystrophy (HOD) was down and anorexic for five days before his owner came to me. Their veterinarian had recommended euthanasia, but I recommended raw green tripe. Within two days the puppy was eating, up on his feet, and with supportive care on his way to a full recovery.
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overpopulating and causing health problems. As we know, a balance of microflora in the gut is extremely important to maintaining good health. The intestines only contain enough food for a certain amount of bacteria, but by adding tripe to a pet’s diet, the population of good bacteria will outnumber the bad. These probiotics help keep the animal’s immune system in top shape. Think of tripe as “Activia©” for pets. I have used raw green tripe for dogs that had digestive problems with great success. • Another beneficial component of raw green tripe is digestive enzymes. The enzymes that help the ruminant digest its meal will give the pet the same benefit. Dogs and cats do not naturally produce amylase, so the nutrients present in vegetative matter are not readily available to them. Raw green tripe contains not only digestive enzymes, but in most cases, some pre-digested green matter as well. This combination of enzymes and nutrients provide pets with a nutritional powerhouse.
SOURCING TRIPE There are many different forms of green tripe available on the market. •T ripe found in the supermarket has been cleaned and bleached and offers no nutritional benefits to the pet. •R aw green tripe should be obtained from grass fed cows rather than those raised in feedlots. • I t is easiest for most veterinary clinics to sell raw green tripe from commercial manufacturers that process and freeze it for them. •S ome companies offer large pieces of fresh raw green tripe that are very tough and abrasive. This form of tripe is a great way to clean a dog’s teeth and provide some chewing time. It is best fed outdoors as it lasts a long time and is very “aromatic”. •L ocal co-ops or farms that offer grass fed beef are the first places to inquire if they are willing to sell raw green tripe directly to the consumer. • I n California, companies like RawGreenTripe.com offer many different forms of tripe that can be shipped to the clinic or directly to your clients. •T he most popular form of raw tripe is ground, either fresh or frozen. Ground tripe can be fed in a bowl, as with any other type of diet, and is the best form for cats. • F reeze dried tripe is also available. The freeze drying process makes the tripe shelf stable while allowing it to retain its nutrients and enzymes. Freeze dried tripe is usually made into nuggets or mini patties. These are great training treats and
Advertorial also come in handy as a food topper for that picky eater. One company offering freeze dried tripe is Vital Essentials. Freeze dried tripe has excellent palatability so is especially good for cats. Nuggets of freeze dried tripe are also great to use as treats in the clinic to gain the trust of patients that are reluctant to be examined. • Canned green tripe is available for those who can’t find other forms in their area. Tripett is one brand that cans their tripe at a lower temperature to retain its nutritional benefits. Canned tripe will not contain the same quantity of good bacteria or enzymes found in the other forms, but it is still beneficial as an incentive to eat because it retains its potent aroma. This form is great for anorexic patients that have refused all other offerings. Many independent pet retail stores are now carrying tripe in the canned or frozen ground form. With education, the raw food category in the pet food industry will continue to grow. By offering alternative foods to your clients, you are ensuring your patients are getting the micronutrients and enzymes they are meant to consume. And you are also increasing repeat retail business.
marketing tips The marketing of raw frozen diets has become very “clinic friendly”. Many companies that offer raw frozen diets will absorb the cost of the freezer necessary for storage if the veterinarian will buy the inventory to fill the freezer. Some of these companies offer plain raw green tripe or combination formulas of beef or chicken with tripe added. Since the raw frozen category is still growing in the pet food industry, markups can still be widely manipulated to make a profit margin acceptable to the clinic. There is very little price competition in this field and most clients would rather buy their pet food from the clinic, especially if they are not very educated about the products offered. Clients trust their veterinarians to sell them products that are going to keep their pets healthy. The hardest part of marketing raw green tripe in any form is helping clients get around its odor. Since it smells like cow manure, many people are hesitant to let their pets try it. If they know that tripe is going to have a positive effect on their animals’ health, most will be willing to hold their noses and persevere.
VetzLife All-Natural News By Henry Dinneen
Oral care You know good oral care reduces the buildup of plaque and tartar on your patients’ teeth, fights gum disease, and improves breath. Along with recommending a healthy diet, safe chew toys, and teeth cleaning treats, you can educate your clients about the importance of proper oral care to help prevent the spread of bacteria that can lead to heart, kidney, pancreas, liver and other organ ailments. Brushless sprays and gels are another tool in your arsenal for better patient health. They can also make your life easier; by using these products at home, clients make routine dental cleaning easier and less traumatic because plaque and tartar is softened and easier to remove. These products are also an excellent alternative to dental scaling under general anesthesia, especially for senior or at-risk animals suffering from weakened immune systems. For most pet owners, brushing their animals’ teeth is a battle they don’t want to face. VetzLife Oral Care sprays and gels, water additives, and healthy treats and chews all offer excellent at-home solutions without the fight. We recommend that your clients apply either our spray or gel at night, before bedtime, with no water for 30 minutes before or afterwards. This way, the products can go work overnight and are most effective. Whether clients use a spray or gel simply depends on the pet’s preference and how easy the product is to use.
Henry Dinneen is the Marketing Director for VetzLife Products (vetzlife.com).
IVC Winter 2014
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Wobbler
Syndrome: panel discussion
By Ihor Basko, DVM, CVA, Cindy Lankenau, DVM, CVA, and Barbara Fougere, DVM, CVA
obbler syndrome is often misunderstood by veterinarians and their clients. It’s frequently considered incurable, and even unmanageable, but alternative approaches can be greatly beneficial for this problem. We asked a panel of integrative veterinarians for their input.
Dr. Cindy Lankenau: “This syndrome confuses veterinarians because in layman’s terms, the animals suffer from multiple etiologies such as cervical vertebral canal stenosis, cervical vertebral instability, disk protrusion, compression from synovial cysts, or hypertrophy of the ligamentum flavum.”
Dr. Ihor Basko: “Veterinary literature has used 14 names to describe this condition. This is in part due to the confusion regarding the mechanisms causing it. The name most commonly used in veterinary articles is cervical spondylomyelopathy (which means a disease of the neck vertebrae affecting the spinal cord). Other common names are CVI (cervical vertebral instability), CVM (cervical vertebral malformation), CVMM (cervical vertebral malformation-malarticulation), and cervical spondylopathy1.
One must integrate good conventional diagnostic methods such as an extensive musculoskeletal and neurological examination, the evaluation of radiographs, blood chemistries and past medical history with exercise, training methods, diet and supplements along with specific holistic treatments. The focus of treatment would cover the following five areas.
“The term “wobbler” describes the wobbly gait of dogs and horses with this cervical condition. Dogs have difficulty walking and maneuvering over slippery floors. Some also develop front leg lameness or a lowered head stance, and even complete paralysis. My recent cases have included two yellow Labs, one American bulldog, and one long-haired Chihuahua with symptoms from pain to paralysis.
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The five-pronged holistic approach
1. Alleviate neck pain and inflammation • Hydrotherapy (ice and moist heat, alternating) and massage at home or the clinic • Acupuncture • Cold laser therapy • Trigger point therapy: dry needle or injections of vitamin B12, procaine, Traumeel, or saline
• Anti-inflammatory nutraceuticals: Omega-3 EPA/DHA, MSM and GLA • Homeopathy: Christina Chambreau, DVM, CVH recommends carefully finding the similimum for the deepest cures, even with acute presentations. Asa Hershoff, ND, DC2 recommends the following for Acute conditions - Lachnantes: pain as if dislocated, worse on right side, stiffness, spasm, icy cold between the shoulder blades, worse on waking and movement, better with warmth. -C helidonium: pressing pain, heaviness, neck and right shoulder range of motion loss, aggravated by heat, pressure and weather changes. -B ryonia: painful stiff neck, weakness, trapezius pain radiating to shoulder and arm, worse with movement, better with rest and warmth. -C imicifuga: radiating pain on the left side, spasms, torticollis, aggravation from cold, damp, wind and movement, better with warmth and pressure. Dr. Lankenau reports that Finlay in The Educated Horse recommended the use of Cimicifuga in the case of any neck spasms.3 Cimicifuga racemosa is specific for heavy tensive, aching pain; as if dependent upon a contracted state of muscular fibers; soreness of muscular tissues, as if one had been pounded or bruised; stiff neck.4 - Others: Belladonna, Gelsemium and Kalmia
Nux
vomica,
Essential oils: Topically, frankincense, • myrrh, lavender peppermint, wintergreen, chamomile, helichrysum, blue tansy, camphor, etc. can be massaged into the neck alone or in combination. • Chinese herbs: Topical and internal based upon TCM concepts – Move Blood and Qi, Open the Channels, Relieve Obstructions, Dispel Wind, Cold and Damp, Supplement Deficiencies. • Western herbs: Topical and internal use of anti-inflammatory and pain reducing herbs:
A look at the causes Dr. Basko: “Harsh ‘choke chain training’ methods, or general pulling at collars in susceptible dogs, can lead to problems either acutely or years later. Physical trauma does occur when multiple vaccines and drugs are injected into the necks of horses and dogs. Many dogs with these triggers do not become ‘wobblers’, so why are some dogs more susceptible than others? Major factors are related to an existing “chi deficiency” (see TCM perspective), or weaknesses such as hypothyroidism, anemia, cardiomyopathy, and other disorders.13 The Bi Syndrome comes from the negative effects of sudden climatic changes that stress the body, producing a disease or causing aggravation of an existing one. The patient’s chronic neck disease can be aggravated with exposure to wind accompanied by Coldness, Dampness or both, resulting in new pain.” Dr. Lankenau:“There are definite diet and genetic predispositions. In horses, specific genetic lines can be avoided, and dietary control has been successfully utilized. Complementary modalities can be very helpful with acute clinical cases, and for preventing relapses.” IVC Winter 2014 43
Dr. Basko: Useful ‘Western’ herbals would be comfrey and/or arnica poultices for traumatic pain, boswellia, yucca, meadowsweet, wild yam root and nervines such as valerian, kava kava, skullcap and feverfew.5 “In Hawaii, we have many herbs growing wild that are used topically, pounded fresh and applied to areas of pain and inflammation such as Noni leaves (Morinda citrifolia), Ti plant leaves (Cordyline fructicosa), and Kava (Piper methysticum). Varieties of introduced species such as plantain, vervain, papaya, gotu kola, and aloe vera can be used, usually in combination with other herbs.” Dr. Lankenau: “If we look for information from our American Eclectic Herbalist, Goss talked about Hyperemia of the spine with difficulty of voluntary motion and paralysis of the lower extremities and also of the upper limb.6 He used drop doses of Gelsemium, Cocculus indicus or Dulcamara. It has been suggested that a NO pathway is involved with Dulcamara. “Felter and Lloyd used Capsicum for tired, painful muscles and as a counterirritant and analgesic. It has been recognized as a circulatory equalizer, moving the blood and clearing the capillaries of stagnant engorgement. This would indicate a Depressed Tissue State.7 Fyfe called Capsicum a powerful topical stimulant, of advantage where the circulation is feeble and there is need of such stimulation.8 “Capsicum can ‘significantly increase NO production’9 and improve endothelium health. This is very interesting in that a specific gene (CaCaM1) functions in ROS and NO generation in the Capsicum plant and is essential for cell defense responses in these plants.10 “Capsicum has additional proven antiinflammatory effects by modulating adipokine release and macrophage behavior. Capsaicin (8-methyl-n-vanillyl-6-nonenamide), one of the pungent components found in Capsicum, was shown to induce body heat and enhance blood flow as well as increase energy expenditure, and prevent oxidative stress. Rats treated with 3 mg/kg body weight of Capsaicin for three days showed a reduction in oxidative stress measured as malondialdehyde in the liver, lung, kidney and muscle. Liver glycogen was found to decrease after three days treatment with 3 mg/kg body weight Capsaicin. It was shown that Capsaicin can be a potent antioxidant.11
In dogs, wobbler syndrome manifests as difficulty walking and possible lameness.
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“Capsaicin also inhibited the expressions of IL-6 and MCP-1 mRNAs and protein release from the adipose tissues and adipocytes, whereas it enhanced the expression of the adiponectin gene and protein. The action of Capsaicin is associated with NF-kappaB inactivation and/or PPARgamma activation. Moreover, Capsaicin suppressed
The conventional approach Dr. Fougere:“Non-steroidal drugs and analgesics may be necessary. Corticosteroid treatment, while common, is controversial. The main goals are to relieve pain and inflammation associated with nerve compression.” Dr. Basko: “Medically the syndrome is managed with medications such as steroids, NSAIDs, muscle relaxers, and antibiotics. Recommendations include chest harnesses, decreased stress and restricted activity for dogs. When rest and medical treatment are not successful, surgery is recommended for decompression and stabilization. There are 21 different kinds of surgery that can be performed to treat ‘wobbler’ syndrome.”14
Dr. Barbara Fougere: “Where possible, consider using gold wire implantation. This has been remarkable in alleviating clinical signs in patients, in this author’s experience. A treatment plan for physical therapy should be implemented. Chiropractic and acupuncture can be very helpful when applied constitutionally rather than merely symptomatically.” Dr. Lankenau: “Careful application of low force chiropractic care can relieve many symptoms while acupuncture can relieve the obstruction of Qi in the neck area.”
5. Improve flexibility and strength • Physical therapy, neck exercises and hydrotherapy not only macrophage migration induced by the adipose tissue- • Chondroprotective agents: chondroitin, HA, MSM, glucosamine conditioned medium, but also macrophage activation to release 12 • Omega-3 fish oil pro-inflammatory mediators. • TCM herbs 2. Improve blood flow and facilitate healing • Hydrotherapy and massage In the Spring issue of IVC Journal, the same panel of three • Acupuncture veterinarians will cover the Traditional Chinese Veterinary • Cold laser therapy Medicine perspective, and provide case examples. 3. Improve nutrition and quell deficiencies • Treat hypothyroidism 1 Ronaldo C. da Costa, DMV, MSc, PhD, Dipl. ACVIM Neurology, • Treat manganese, magnesium and zinc deficiencies Department of Veterinary Clinical Sciences, Ohio State University. • Omega-3, GLA 2 Hershoff, Asa, ND, DC. Homeopathy for Musculoskeletal Healing, • TCM herbs and food North Atlantic Books, Berkeley, CA 1996. 4. Improve stability of the neck • Physical therapy and stretching exercises • Chiropractic adjustments • Prolo-therapy • Yai Tou: Japanese acupuncture moxa (Artemesia spp) burning on the skin on key AP points. • Acupuncture and herbs • Gold bead implants
inlay. “The Educated Horse”, Fairman Rogers Collection (University F of Pennsylvania), 1854. 4 Felter, H. The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio, 1922; p. 466. 5 Neil, James. The New Zealand Family Herb Doctor. Mills, Dick, and Company. Dunedin, NZ, 1891. 6 Goss, IJM. Practice of Medicine; The Specific Art of Healing, Keener, Chicago, 1888; p. 305. 7 Wood, M. The Earthwise Herbal: A Complete Guide to New Word Medicinal Plants, North Atlantic Books, Berkeley, CA, 2009, p.94. 8 Fyfe, John. Specific Diagnosis and Specific Medication, The Scudder Brothers Company, Cincinnati, Ohio, 1909, p.453. 9 Chularojmontri L, et al. Influence of capsicum extract and capsaicin on endothelial health, J Med Assoc Thai, Feb 2010, 93 Suppl 2:S 92-101. 10 Choi HW, et al. The pepper calmodulin gene CaCaM1 is involved in reactive oxygen species and nitric oxide generation required for cell death and the defense response; Mol Plant Microbe Interact; Nov, 2009, 22(110), 1389-1400. 11 Lee CY, et al. Short-term control of capsaicin on blood and oxidative stress of rats in vivo. Phytother Res., May 2003, 17(5):454-8. 12 Kang JH et al. Capsaicin, a spicy component of hot peppers, modulates adipokine gene expression and protein release from obese-mouse adipose tissue and isolated adipocytes, and suppresses the inflammatory responses of adipose tissue macrophages, FEBS Letter; Sep 2007, 18;581:4389-96. 13 Travell, Janet, MD, Simons, D.G., MD, and Simons, L. PT Myofascial Pain and Dysfunction the Trigger Point Manual. Upper Body Part I, Williams and Wilkens, Philadelphia, PA, 1999. 14 Ronaldo C. da Costa, DMV, MSc, PhD, Dipl. ACVIM – Neurology Department of Veterinary Clinical Sciences, The Ohio State University. 3
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NAVC Conference Highlights
NAVC CONFERENCE 2014
Orlando, FL January 18-22, 2014 NAVC brings the global veterinary community together to share ideas, sharpen skills and learn about the latest innovations in animal care. Every species is covered. Every specialty is represented. FEATURES: • Acupuncture stream and Holistic medicine stream as well as the latest in conventional therapies and equipment. • Hands on laboratories and workshops • Master classes • Meet the Professor luncheons • Latest products and services available for your practice
For more info, visit NAVC.com
VetzLife – Booth 437
We are pleased to be celebrating our 10th year providing all-natural health products to the veterinary market. VetzLife Oral Health Care is a unique dental product and a valuable tool in the veterinarian’s tool chest when it comes to proper home oral care. Wound Care is an excellent remedy for skin health issues such as scratches, minor wounds, abrasions, ringworm, and post-surgery. Complete Coat is an all-natural topical flea and tick treatment that is 100% safe for pets. VetzLife products are used by thousands of clinics with great success and are carried by major veterinarian product distributors such as Midwest, MWI, First Veterinary Supply, Penn Veterinary Supply, and Hawaii Mega-Cor. 1-888-453-4682
Vetzlife.com
Kan Essentials – Booth 1003
The classical formula line of products adapted by Dr. Steve Marsden, LAc, DVM, and designed specifically for companion animals, is now comprised of 36 formulas to address nearly every concern busy veterinarians encounter in their practices. All products are made and tested in the US following stringent Good Manufacturing Practices. With testing at every stage of production, Kan Essentials offers quality products that are safe and potent. Our Certificates of Analysis reflect our commitment to the quality, safety and efficacy of our products. 1-800-543-5233
Customer@Kanharb.com Kanherb.com
Healers Petcare, Inc. – Booth
1-800-924-7036 BOW
Healerspetcare.com
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IVC will be there! Stop by The Marriott, booth 3919, and don’t forget to visit the booths of these forward thinking companies.
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46 IVC Winter 2014
3404
Founded in 2009, Healers™ has been developing products to simplify the care of pets at home. We are proud to offer the highest quality medical wraps with gauze inserts that are re-usable, provide proper airflow to a wounded area, and wick away moisture for faster healing. We offer wraps for the paw, leg and torso. Most recently, we have partnered with Vital Animal Health to provide a First Aid Essential kit that includes VetEssentials® wound spray and Healers™ products. Perfect for home care.
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Orlando, Florida January 18 - 22, 2014
Standard Process – Booth 1126
For more than 80 years, Standard Process® has offered supplements made from whole food ingredients, some of which are grown on the company’s certified organic farm. Veterinary Formulas™ designed specifically for canine, feline, and equine clients; the core Standard Process line; and MediHerb® herbal supplements all fulfill the individualized nutritional needs of animals ranging from treasured companions to elite athletes. Standard Process supplements are manufactured to the highest quality standards at the company’s state-of-theart US headquarters, where proprietary low-temperature processes are used to ensure nutritional integrity. Veterinary Formulas are available only through qualified veterinary professionals.
Animal Necessity – Booth
217
Based on nearly a century of collective experience in veterinary medicine and orthomolecular nutrition, Animal Necessity is at the forefront of animal health and wellness, combining complementary and alternative medicine with a focus on nutritional supplements using a protocol-based approach. Our supplements are formulated by specialists to promote healthy metabolism and vitality by using pharmaceutical-grade ingredients and manufacturing processes to ensure the highest purity and quality products possible. Learn more about by speaking directly with the doctors on our Animal Necessity Scientific Advisory Team. AnimalNecessity.com font:
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Musculoskeletal Therapies for Animals – Booth 4101
Jorgensen Labs – Booth
1-866-646-8684
Jorvet.com
We are the leading provider of products and technologies for veterinary rehabilitation and non-invasive pain management. MTA represents only the very best products for hydrotherapy and energy medicine. While you’re at the NAVC, please stop by the H2O for Fitness booth in the Marriott to learn more. Customer@Kanharb.com MTAVet.com
PawFlex® – Booth 3769
An award-winning line of non-adhesive, fur friendly, super stretch, disposable bandages with wound pad attached. PawFlex is the quickest, easiest and most reliable bandage to use, with its dual quick catch and release Velcro-type fastener and unique non-slip grip. With five designs, each ideally created for a specific wound care area, you can finally give your patients the gentle care they deserve. Launching at NAVC is the PawFlex QuicTach™ IV Key, a new disposable fastener that locks IVs in place. Like all PawFlex products, QuicTach™ is non adhesive, quick and easy to use.
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Come see our Class 4 Luminex Ultra Laser and ask for a demo! For insight into using laser to treat the whole dog, don’t miss Dr. Cheryl Cross, DVM, DACVP, CVA, as she presents “Nose to Tail Application of Red and Infrared Therapeutic Laser for the Athletic and Non-Athletic Dog” on Saturday, January 18 at 3:55 pm at Gaylord Palms. She will offer an interesting and unique perspective on laser treatments you may not have considered before.
The Honest Kitchen – Booth 4205
The Honest Kitchen makes dehydrated 100% human-grade foods for dogs and cats. It’s the perfect food to recommend to animals who would benefit from a whole food diet, as well as those who are intolerant to more processed foods. Stop by The Honest Kitchen’s booth (Marriott) for free full size products, and amazing show specials. TheHonestKitchen.com
PawFlex.com
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NAVC Conference Highlights Kemin – Booth 3814
Kemin is proud to offer RESOURCES™ supplements to improve the quality of life for dogs and cats. Developed in conjunction with Ihor Basko, DVM, the products are available exclusively to veterinarians and have been individually formulated by combining innovative, science-backed ingredients with traditional herbs and antioxidants. Visit us to learn more about our supplements, show specials and new product innovations. Kemin.com
Woodrow Wear – Booth
3317
The company was founded to share a traction solution invented for Woodrow (a 15-year-old Rottweiler with hip dysplasia and arthritis) with other dogs. Power Paws give dogs “The power to stand. The power to stop. And the Power to GO!” They are a sensible, sock-based traction solution for dogs with hip and/or mobility issues. Indoors, they are a practical solution for injured paws, and perfect for protecting hardwood floors from nails. Outdoors, they protect paws from allergens, extreme heat or cold, salt, ice and more. Thousands of dogs are wearing Power Paws, with more than 95% experiencing miraculous results. 1-877-737-3545
info@woodrowwear.com WoodrowWear.com
Vital Animal Health – Booth 3404 PKB Animal Health – Booth We offer a complete line of products including:
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• Otic Cleanser with aloe vera
At the core of ZYMOX® Enzymatic Dermatology and Oratene® Veterinarian Brushless Oral Care products is the patented LP3 Enzyme System – proven antibacterial, antifungal and anti-yeast. Safe, non-toxic, enzymatic formulas target offending microbes only. Zymox includes otics, skin/wound care and shampoo/ cleansers. Demonstrated antibiotic alternatives for managing chronic infections. Oratene offers brushless care in three delivery system options: water additive, gel or mister. Features two patented enzyme systems to inhibit odor-causing bacteria and fungi, balance oral flora and eliminate plaque biofilm.
VitalAnimalHealth.com
PetKingBrands.com
• Vital-VS® Topical Spray -- cleans and debrides skin and wounds prior to treatment and/or repair. Safe and effective on hot spots, eye infections, scratches, punctures, abrasions, rashes, thrush, insect bites and burns. • Medicated and Non-Medicated Shampoos • Joint Chews with glucosamine, chondroitin, perna canaliculus, EPA and DHA
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American Holistic Veterinary Medical Foundation The AHVM Foundation is a 501(c)(3) non-profit charitable organization that benefits the public good through scientific research and education in integrative veterinary medicine. It seeks to be a model of both high quality and high integrity work in integrative therapies. They hope to discover information that improves education and clinical practice for both human and veterinary medicine. “In the end, both professionals and the public want to know more about the proper use of these therapies, so that by properly investigating and teaching these approaches, the Foundation works to create better outcomes,” says Foundation President, Richard Palmquist, DVM.
Research and education grants The Foundation Board of Directors met in Kansas City, Missouri this past August in conjunction with the AHVMA annual meeting. At that meeting, the Foundation approved $500,000 in research and education grants, including to the following:
Louisiana State University – Development of a faculty • position in Chinese veterinary medicine and acupuncture. •U niversity of Tennessee – Development of the first twoyear Fellowship in Integrative Veterinary Medicine. This program will train researchers and clinicians in the field and will allow qualified candidates to help expand our knowledge of holistic medicine. •U niversity of Florida – The Efficacy of Acupuncture and Chinese Herbal Medicine on Survival and Quality of Life in Dogs with Multicentric Lymphoma Receiving CHOP. Drs. Hershey and Xie.
Marge Lewter, DVM, adds: “The demand for information and training in integrative therapies is massive and our students are so important to our work. This last year they received about $9,000 in support. As we grow, we hope to do so much more.” The Foundation is grateful to the AHVMA for hosting the Annual Silent Auction.
New Advisory Council member In October, the AHVM Foundation welcomed Dr. Mustaq Memon to the Professional Advisory Council. Dr Memon is known around the world for his sterling reputation, intellect and caring demeanor. He is the recipient of many awards, and is currently employed at Washington State University as Fulbright Ambassador & Associate Professor, Dept. of Veterinary Clinical Sciences, and Paul G. Allen School for Global Animal Health. His focus is Theriogenology (Veterinary Reproduction), Integrative Veterinary Medicine, and Global Animal Health. He is a certified acupuncturist, and designed two of WSU’s professional courses in integrative veterinary medicine. He also heads up the committee that is developing integrative programs for veterinary schools across the US.
Raising funds for vital work The Foundation accepts public donations, as well as those from private parties, businesses and corporations. To date, it has raised about $880,000. Its “One in A Million Campaign” seeks to gather one million donors pledging one dollar a month. Details can be found at ahvmf.org or by contacting Nancy Scanlan, Executive Director, at 503-926-9895 or office@ahvmf.org.
•S arter University of California, San Diego – Banerji Protocol as an Adjunct Nanotherapy for Treating Canine Appendicular Osteosarcoma: A Randomized Clinical Trial. Ogilvie, Hampel. •C ornell University – Investigating the Procoagulant Properties of Yunnan Baiyao in Horses. Brooks W. Jean Dodds, DVM, heads the Grant Committee at the Foundation. “I was so pleased with these awardees, and I was particularly happy to see Cornell’s submission as I helped establish what became the coagulation laboratory there in 1963!” she says.
AHVM Foundation Executives for 2013. Bottom row (left to right): Marge Lewter, Nancy Scanlan, Barbara Royal, W Jean Dodds. Top row (left to right): Richard Palmquist and Larry Bernstein. IVC Winter 2014 49
FUND
FIVE-YEAR DOI STUDY RESULTS By W. Jean Dodds, DVM and Kris L. Christine
R
abies vaccine is the one immunization required by law for domestic dogs and cats. It’s also the only one required to have duration of immunity studies for licensure in the United States.
Until recently, annual or biannual revaccination for rabies was required by some states, even though nearly all USDA licensed rabies vaccines have a three-year duration, and there are no two-year licensed vaccines. Today, all states recognize the three-year revaccination standard, after completion of the initial two-dose series given within 12 months.
and icterus (autoimmune hemolytic anemia or AIHA), or generalized petechiae and ecchymotic hemorrhages (immunemediated thrombocytopenia or ITP). Hepatic enzymes may be markedly elevated, and liver or kidney failure may occur by itself or accompany bone marrow suppression. Post-vaccinal polyneuropathy is another recognized entity associated occasionally with the rabies vaccination. It can result in various clinical signs including muscular atrophy, inhibition or interruption of neuronal control of tissue and organ function, muscular excitation, un-coordination and weakness, as well as seizures.
ADVERSE REACTIONS CAN BE SERIOUS, EVEN FATAL Researchers believe this potent adjuvanted killed vaccine causes the most and worst adverse reactions in animals. Rabies vaccines are documented to elicit severe and even fatal reactions. The clinical signs associated with vaccine reactions typically include fever, stiffness, sore joints and abdominal tenderness, susceptibility to infections, neurological disorders, seizures, encephalitis, collapse with auto-agglutinated red blood cells
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A research study from Italy (Vascellari et al, 2003) documented cancerous tumors in 15 dogs at presumed sites of vaccine injection. Six of these dogs received rabies vaccines. In addition, vaccination of pet and research dogs with polyvalent vaccines containing rabies virus or rabies vaccine alone was shown to induce production of anti-thyroglobulin auto-antibodies, a provocative and important finding with implications for the subsequent development of hypothyroidism (Scott-Moncreiff et al, 2002).
ESTABLISHING THE RABIES CHALLENGE FUND CHARITABLE TRUST The Rabies Challenge Fund Charitable Trust (RCF) was established in December 2005 by Co-Trustees Kris L. Christine of Alna, ME and W. Jean Dodds, DVM, of Hemopet in Garden Grove, CA. The mission of the Trust is to better define the duration of immunity conveyed by rabies vaccine in dogs. The eventual goal is to extend the legally required interval for rabies boosters to five and then seven years. This vaccine research project is being performed by Dr. Ronald Schultz, Chairman of Pathobiology at the University of Wisconsin School of Veterinary Medicine. The study follows the strictly defined federal APHIS/USDA Title 9 standards for licensing rabies vaccines in concurrent five- and seven-year challenge trials. The funds are collected by Dr. Dodds, and are distributed annually by the Co-Trustees to the University of Wisconsin Foundation. The Foundation waived its usual 48% overhead charges for this research, so that the actual dollar amount donated goes directly to fund the project. Contributions in time and effort to the RCF project by Dr. Schultz, the Co-Trustees, Hemopet, and web mistress Mimi Englander of Littleton, MA, are provided free of charge. To date, funds have been sent to the University of Wisconsin Foundation for five years of the study – $175,000 for each of the first two years, $150,000 for year three, and $145,000 for years four and five. We are continuing to raise the needed funds to complete years six and seven, and look forward to the results of the remainder of this study, which should benefit all dogs everywhere. Continued on page 52.
… most of the dogs vaccinated five years ago, even without a positive RFFIT, do have“immunologic memory”.
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Continued from page 51.
SUMMARY OF FIVE-YEAR DURATION OF IMMUNITY STUDY The first rabies vaccine studied was selected based on the superior response it provided in the USDA challenge trials for licensing. Another licensed rabies vaccine was administered to a second, separate group of dogs two years after the first study began, so that a minimum of two commercially available rabies vaccines would be tested. The second vaccine selected is the one currently administered to a very high percentage of dogs. Both vaccines demonstrated excellent protection based on antibody testing for each of the first three study years. However, fewer than 30% of dogs in the first vaccine group, now five years since vaccination, had serum rabies antibody titer levels considered positive on the Rapid Fluorescent Focus Inhibition Test (RFFIT) (above the 0.1 IU/mL level stated by the Centers for Disease Control to protect a person from rabies). Some of the dogs with low or no detected RFFIT antibody were further tested to determine if they had “immunologic memory”. This in vitro test shows whether memory is present or not, even in cases when serum antibody cannot be detected at a level considered to be protective. The results of this further testing indicated that most of the dogs vaccinated five years ago, even without a positive RFFIT, do have “immunologic memory”. As soon as a USDA licensed facility can be reserved, we plan to challenge some of those dogs with rabies virus to determine if the memory response demonstrated actually correlates with protection.
The eventual goal is to extend the legally required interval for rabies boosters to five and then seven years. Our conclusion from studies with the initial rabies vaccine is that the immunity conferred by that product, and assessed by the in vitro RFFIT, was excellent for the first three years, then declined during the fourth year, and continued to drop during the fifth. Nevertheless, the dogs that completed the five-year study who were given a second rabies vaccine (even those with rabies antibody titers that dropped below the RFFIT positive level), demonstrated boosted rabies titers, indicating the presence of an active immune memory cell response. The second vaccine group, which is now three years from vaccination, will remain on study for at least two more years. Principal investigator, Dr. Ronald Schultz, is preparing results of the study and details described above for scientific peer
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ADDITIONAL READING Dodds WJ. “More bumps on the vaccine road”. Adv Vet Med 1999; 41:715-732. Dodds WJ. “Vaccination protocols for dogs predisposed to vaccine reactions”. J Am An Hosp Assoc, 2001; 38:1-4. HogenEsch H, Azcona-Olivera J, Scott-Moncrieff C, Snyder PW, Glickman LT. “Vaccine-induced autoimmunity in the dog”. Adv Vet Med,1999; 41:733-744. Schultz RD. “Current and future canine and feline vaccination programs”. Vet Med, 1998; 93:233254. Schultz RD, Ford RB, Olsen J, Scott F. “Titer testing and vaccination: a new look at traditional practices”. Vet Med, 2002, 97:1-13 (insert). Tizard I. “Risks associated with use of live vaccines”. J Am Vet Med Assoc, 1990; 196:1851-1858. Welborn Link V (chair) et al. “2011 AAHA Canine Vaccination Guidelines from the AAHA Canine Vaccine Task Force”. J Am An Hosp Assoc, Sept/ Oct 2011, pp. 42.
review and publication. That data will be made available to the public as soon as our paper has been accepted for publication. The Rabies Challenge Fund Charitable Trust is a 501(c)(3) charitable organization (Fed. EIN # 84-6390682). REFERENCES Scott-Moncrieff JC, Azcona-Olivera J, Glickman NW, Glickman LT, HogenEsch H. “Evaluation of antithyroglobulin antibodies after routine vaccination in pet and research dogs”. J Am Vet Med Assoc, 2002; 221:515-521. Vascellari M, Melchiotti E, Bozza MA , Mutinelli F. “Fibrosarcomas at presumed sites of injection in dogs: characteristics and comparison with non-vaccination site fibrosarcomas and feline post-vaccinal firosarcomas” J Vet Med, 2003; 50(6):286-291.
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RECOGNIZING AND TREATING
HEADACHE IN ANIMALS By Ella E. Bittel, DVM
H
eadache ranks among the most common local pain complaints in humans. According to the National Headache Foundation, there are an estimated 45 million human headache sufferers in the United States.
suspected to be headache. When I mention the possibility of headaches in an animal, my colleagues or the animals’ guardians often give me a surprised “cocker spaniel look” followed by the question: “But how can you tell?”
Headaches are triggered by a multitude of causes. In people, they can be part of a symptom complex associated with brain illness (concussion, encephalitis, brain cancer, etc.). Most other secondary, and most if not all, primary headaches in young, still non-verbal children, remain largely undiagnosed. The same applies to many of our companion animals; their headaches are still among the health conditions that have eluded science. But common sense suggests that any creature with a head and pain perception also has the basic capacity to suffer from headaches.
The answer varies depending on whether you’re evaluating a specific animal, or discussing headaches in general. In an individual animal, the symptoms may be subtle or few. When looking at symptoms that could reflect headaches in general, however, the list of possible symptoms is long, though often unspecific.
To be able to successfully treat and relieve headaches in companion animals, we first have to notice and “diagnose” them, while remaining undeterred by the fact that absolute proof remains unattainable.
HEADACHE SYMPTOMS Nearly 20 years ago, during my veterinary chiropractic training with the AVCA (American Veterinary Chiropractic Association), I became aware of the possibility of headache in animals. Since then, I have seen quite a number of patients whose symptoms resolved after a treatment approach geared toward what I
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A disappearance of symptoms the owner failed to previously mention, which fit into the overall picture of headaches, can be seen as a retrospective diagnosis. For this individual animal, it is less important that the “diagnosis” was a headache than that we made the animal feel well again. Collectively, symptoms resolving with treatment show that animals do have headaches that can be successfully treated. Symptoms I have observed include: • Hyper reactive to or averse to touch (specific to head or poll or neck; from shoulder forward); generalized to whole body in strong headache • Defensive behavior upon approach (dog cringes, horse pins back ears) • Hyperactive (in horses – nibbling, can’t stand quietly in stall/cross ties, paces in paddock), (in dogs – paces in pen, house or yard)
• Ataxia, clumsy, unresponsive • Sweating on forehead or ears (horse) • Lowered head or elevated head posture • Vertebral /chiropractic misalignment of mainly scull/atlas and /or atlas/axis connection • Reactivity to craniosacral work along scull sutures or poll • Hard to halter or collar • Hard to groom and tack up • Skittish, irritable, aggressive, spooky • Head shaking, head pressing, or staring • Furrowed brows, squinty eyes, worried look, frequent blinking, distressed or dull expression • Tight mouth/jaw • Incomplete full body shakes Additional symptoms known from humans, possibly observable in animals, include tearing, eye redness (same side as headache), nasal congestion or discharge, constriction of the pupil (miosis), drooping of the upper eyelid (ptosis) on the affected side, blindness, seeking out dark/quiet to rest, vomiting, photophobia, phonophobia (sound sensitivity), “aura” (if present, this is most commonly visual, but it can also involve motor problems), neck stiffness, fatigue, difficulty concentrating, “inconsistent performance”, and incoordination.
CAUSES OF HEADACHE Some of the causes of headache in animals are human-induced (and can therefore be species specific, such as ill-fitting gear used on horses). Others may well originate from sources similar to those known in human headaches. We may never know what played a role in a particular patient’s headache. Being aware of the range of possibilities may aid us in recognizing and treating it. Causes of secondary headache include: • After neck or head trauma, horse: Pull back, trailering, “neighbor teasing” and “fly mask tugging” through or above paddock fencing. Dog: slipping off grooming table while tied. • Gear related: In horses, tight head piece, tight nose bands (via TMJ), long time use of blankets rubbing on breast and shoulders. In dogs, inappropriate crating.
Continued on page 56.
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Continued from page 55. • Dental problems: Horses with ramped molars can have problems with molar arcade alignment exerting pressure on the temporal mandibular joint. Dental treatment itself can also produce headache as the TMJ can get stressed in the process. • Training related: Jerking on dog’s collar, “Rollkur” in dressage horses, tying an animal not ready to be tied. • Chemicals: High carbon monoxide (smog, fires), high pesticide exposure, MSG, food and field spraying, nitrites in diet, pasture drought-stressed plants, pig weed. • Hormone induced: Menstruation, hormone treatments, Calcitonin. • Histamine induced: Allergies • “Fasting”: Horses only being fed twice a day, especially with last meal already given in afternoon. • Physical activity: Irregular, intense activity; let down periods, heat exhaustion. Seizures, inflammatory process in brain or body, tumors, • malformed blood vessels in the skull or neck area • Loss or change (owner, animal buddy, travel). The causes of headache in TCM include:1 1 External: Wind (hot, cold), Wind-Dampness Internal: Empty – Qi deficiency, blood deficiency, Kidney 2 deficiency; Full – Liver Yang rising, Liver Fire, Liver Wind, Liver Qi Stagnation, Stagnation of Cold in Liver channel, WindPhlegm, Food retention, Blood stasis, Stomach heat
TREATING HEADACHES IN ANIMALS Given the wide variety of headache causes, it is clear that resolving them will depend on the specific situation of the patient. We probably will not know the actual cause when starting to work with the patient. The joy of holistic modalities is that we can let the patient lead us by their responses to treatment. We may see “headache symptoms” resolve when we are apparently treating other problems. For instance, floating or pulling teeth may resolve headache-like symptoms. Behavior problems with the hint of headache may resolve as nutrition is improved. The cat stops staring at the wall as renal issues are improved with diet, fluids and holistic modalities. Did the cat have a headache? We may not know, but the symptoms resolved and the cat is more comfortable. Chiropractic: This is one of the easiest and quickest ways to end a headache, if vertebral involvement is the cause. Human studies of spinal manipulation for tension headache and migraines yielded success rates between 28% and 90%. Any time there has been severe trauma in horses or other animals
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(flipped over, fallen down, got stuck, etc.), use chiropractic methods immediately. Do not wait for symptoms to appear. Craniosacral therapy: This modality certainly makes sense for headaches. Adjusting the sutures of the skull, and connecting the energy flow from the head to the sacrum, helps multiple issues, including headaches. People actually feel their headache change location and intensity during a session. Horses tend to move during treatment, so the practitioner must be prepared to move along with the patient. Tellington TTouch: In many cases, TTouch can be used to determine if an unwillingness to be touched is due to emotional or persisting physical factors. Emotional and mild physical causes (muscle tension) reliably resolve with TTouch. If hyperreactivity persists, other treatment modalities are needed. TTouch is highly effective in quickly relieving negative body memory, restoring the animal’s trust of being touched again after physical causative factors are relieved through another modality. Aura work: Some animals are in such discomfort – and may also have been so often reprimanded for being sensitive around their heads and necks (horses), or pulled by the collar during training and walks (dogs) – that in some cases the gentlest and easiest way is to start working on them via the aura. Pain often causes energetic vortexes, and the painful sensation can be relieved by “unscrewing” (counterclockwise) these energy swirls. The animal usually relaxes quickly, may get a downright astounded look on his face (“Wow, someone who is actually not hurting me, this feels good! Who are you?”), and rather than feeling defensive, opens up to participating in the process of getting well again. It’s a thing of beauty. It is important, though, to bring the work “down” to the physical body. This is another opportunistic moment for TTouch. Acupuncture: Cases with liver involvement are suspect, and so are all meridians that run through the area of reactivity. Can also help with relief of tension type headaches. Continued on page 58.
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Continued from page 56. Homeopathy: Arnica can work miracles with concussion – keep it on hand for birds flying into windows, or dogs running into closed glass doors. A classical homeopathic workup would not focus on headache, as we always treat the totality of symptoms. Even eliciting specific headache symptoms may prove difficult due to communication of the pain’s location. The “symptoms” we are attributing to headache would be listed, and as the animal responded to treatment based on all other guiding symptoms, the “headache” symptoms would resolve. Dentistry: May be needed if dental problems were causative. Prolonged periods of keeping the mouth open for the procedure can cause headaches via stress on the TMJ. Using chiropractic, and/or craniosacral work but at the least TTouch soon after the procedure can prevent its development or continuation. Correctly fitting gear: In most cases, it will take one or more of the treatment modalities above to relieve the symptoms of incorrectly fitting gear, but the cause has to be eliminated for the effects to last. Feeding changes: These may be necessary if horses with suspected headache are receiving too much sweet feed, too many nitrites, or
are fed too infrequently. Removing grains and processed foods from the diet can help carnivores. Training changes: If an animal is asked to hold a posture that is not ergonomical (“Rollkur” in horses), or is otherwise highly stressed physically and/or emotionally, training changes may be needed. Some dogs love agility but may need regular maintenance treatments to prevent headaches. Combination of modalities: In reality, most of my patients receive a combination of treatment modalities. The initial session may start with chiropractic as the modality of choice requested by the owner. Hyper-reactivity in the head/poll/neck area during chiropractic evaluation leads to use of TTouch, to relax the animal and rule out and treat emotional factors. If reactivity persists, craniosacral evaluation and treatment may be next, followed by acupuncture if needed. This may or may not take more than one session.
IN A NUTSHELL Treating animals that exhibit signs of headache can be a highly rewarding undertaking. Without headaches, life is good. Happy animal, happy owner, happy practitioner – voila!
A border collie named Raive had eight years of headache. It was noticed by the owner who observed Raive squinting and ducking whenever her head was lightly touched. She was a “couch potato”, and would never do full body shakes, but would often move her head in a soft shaking motion as if to remove “spiderwebs”. This began after she was successfully treated homeopathically to resolve epileptic seizures (healing moves from more serious ailments to less serious ones; in this case, the epilepsy resolved and the less serious headache symptoms appeared).
Left: Raive would squint every time her head was touched. Below: A combination of therapies resolved the headaches.
1
he guardian did not consider it possible to cure Raive’s headache symptoms and therefore did not T bring her to me until we happened to chat about possible headaches in dogs. Great improvement was achieved within three treatments that combined chiropractic, aura work, craniosacral work and acupuncture. Raive then required monthly follow-ups for another year for the headache symptoms to completely resolve.
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Since he was young, Thoroughbred “Sam” exhibited “headiness”. For ten years, he was defensive when regularly adjusted with chiropractic. After several craniosacral sessions, he was no longer reactive to being touched on his poll. He held his head lower and raised his back line, was quieter Above: Craniosacral therapy eased Sam’s headaches while ridden and enjoyed his chiropractic adjustments. and eliminated his defensiveness.
ithin seconds of receiving Arnica and Rescue Remedy (a flower essence), a parakeet went from sitting motionless in an W open box after having flown into a window, to voraciously eating, drinking, and hopping onto perches.
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tech talk
MASSAGE and HEALING TOUCH for
Animals in the
veterinary clinic
By Jack E. Stewart, Jr., RVT, CVT Massage and Healing Touch for Animals ® (HTA) are two wonderful therapeutic modalities that enable you, the credentialed veterinary technician, to improve patient well being. Since they do not use medication, these modalities are within the scope of CVT guidelines, although you must learn how to perform them properly. Classes are available across North America (see sidebar).
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Massage
Massaging your patient does not have to be an extensive procedure. If you have an older animal hospitalized in your clinic who is suffering from arthritis or stiffness, massage techniques as an adjunct to your normal treatment plan will give him the ability to lie comfortably in a kennel. This can have dramatic results in his attitude and your ability to treat him successfully. As you become more skilled at massage and see the benefits, you will want to offer your skills to all your patients as an adjunct to prescribed treatment.
Massage therapy has long been used in human hospitals, rehabilitation facilities and private practice. Many of these same techniques have been incorporated into use with animals. Massage can improve a number of your patients’ conditions, such as muscle spasms, tendonitis, arthritis, strains, sprains, hip and elbow dysplasia.
First, of course, you must make sure you have the veterinarian’s approval and that the animal is willing to be massaged. Remember – we are only successful in treating our patients if they’re willing to accept our intervention.
Benefits:
Healing Touch for Animals
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• Relieves pain. • Breaks adhesions and realigns scar tissue to enable these areas to function more normally. • Promotes improved venous return, arterial and lymphatic circulation, and lessens recovery time from surgery, thus providing an improved response to treatment protocols, and speeding the healing process. • I mproves the pet’s mental attitude, which can result in a more rapid return to normal, increasing the body’s ability to heal itself.
Important: when we discuss the benefits of massaging your patients, we must also talk about situations in which massage is contraindicated. You cannot massage areas in which surgery was performed, nor bruises (hematomas), acute fractures/dislocations, and areas of infection or local inflammation. Massage techniques can be employed adjacent to these areas, but not directly to them. Pregnant animals also should not be massaged.
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The second therapeutic modality I want to discuss – one that’s a tremendous adjunct to a patient’s healing process – is Healing Touch for Animals (HTA). Energy based healing touch has been recognized by human medicine since 1989 and is used by more than 75,000 healthcare practitioners worldwide. Healing Touch for Animals takes a holistic approach, influencing the health and well being of animals through energy and intention. All animals and people have an energy field around them. Any traumatic situation, whether it’s elective surgery, receiving a vaccination, a visit to the veterinarian’s clinic or hospital, or even receiving preventive medications, may interrupt the normal flow of energy in the body. Healing Touch for Animals combines philosophies and applications that promote energy balance and healing while providing physical, emotional, mental and instinctual stability. Stabilizing the energy system allows natural
regulation of the immune system, which in turn stimulates the healing process and promotes well being. Healing Touch for Animals uses energy medicine therapies, recognized by the National Institute of Health, to integrate, balance and clear the energy body, partly through a release of endorphins. Establishing deeper relaxation results in increased vascular circulation that provides more oxygen, nutrients and hormones to the body to support healing. HTA techniques work on all levels of the body: physical, mental, emotional and instinctual. These techniques also allow the animal to become more attuned to self-healing.
Benefits: • Assists with pain of injuries. • Promotes wound healing from surgery or injuries. • Speeds recovery from any type of illness. • Helps the animal understand appropriate behavior in certain situations. • Builds a better animal – human bond. • Reduces stress and anxiety. • Improves ability to cope with illness, physical and emotional trauma. • Reduces memories of abuse and helps the pet through the grieving process of losing a companion or owner. These techniques not only work in human medicine but have shown extensive success in the veterinary field. Note that healing touch techniques are designed to enhance the healing process and do not replace traditional medical or veterinary healthcare, medical diagnosis, or medical treatment for illness. These techniques for animals are meant to complement traditional healthcare. Again, you will need to have your veterinarian approve of integrating this powerful modality into the practice.
Summary
These are only two of the many alternatives to traditional medicine, and both may be practiced by credentialed veterinary technicians within the scope of their everyday healthcare duties. It is rewarding to be able to interact one-on-one with patients beyond following treatment protocols supplied by the attending veterinarian. Having the ability to supplement a patient’s healthcare can be a rewarding experience and allows the technician to feel like a true participant within the healthcare team.
To learn more Healing Touch for Animals, healingtouchforanimals.com National Board of Certification for Animal Acupressure and Massage, nbcaam.org PetMassage, Ltd., petmassage.com Rocky Mountain School of Animal Acupressure and Massage, rmsaam.com
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Veterinary Resource Guide ASSISTIVE DEVICES HandicappedPet.com Amherst, NH USA Phone: (603) 577-8858 Website: www.handicappedpets.com Best Friend Mobility Myrtle Beach, SC USA Phone: (503) 575-9407 Email: sylvan@sylvancompany.com Website: www.bestfriendmobility.org
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 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, MH Waller, 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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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 Steven Marsden, DVM Edmonton Holistic Veterinary Clinic Edmonton, AB Canada Phone: 780-436-4944
NATURAL PRODUCT
MANUFACTURERS & DISTRIBUTORS GenesisValley Center CA USA Phone: (760) 751-3360 Website: www.genesispets.com
SCHOOLS & WELLNESS EDUCATION Animal Spirit Network Pekin, IL USA Phone: (815) 531-2850 Email: carol@animalspiritnetwork.com Website: www.animalspiritnetwork.com College of Integrative Veterinary Therapies - CIVT Rozelle, NSW Australia Phone: (303) 800-5460 Website: www.civtedu.org
PetMassage Ltd. Toledo, OH USA Phone: (419) 475-3539 Email: info@petmassage.com Website: www.petmassage.com Tallgrass Animal Acupressure Institute Castle Pines, CO USA Phone: (303) 681-3033 Email: nancy@animalacupressure.com Website: www.animalacupressure.com Traditional Chinese Veterinary Medicine TCVM Reddick, FL USA Phone: (352) 591-5385 Email: register@tcvm.com Website: www.tcvm.com Veterinary Information Network - VIN Davis, CA USA Phone: (530) 756-4881 Email: vingram@vin.com Website: www.vin.com
SUPPLEMENTS Herbsmith Inc. Hartland, WI USA Phone: (262) 367-1372 Email: mail@herbsmithinc.com Website: www.herbsmithinc.com MVP Laboratories Omaha, NE USA Phone: (402) 331-5106 Email: mvplabs@mvplabs.com Website: www.mvplabs.com SmartPak Plymouth, MA USA Phone: (774) 773-1125 Email: customercare@smartpak.com Website: www.smartpak.com The Honest Kitchen San Diego, CA USA Phone: (858) 483-5995 Email: info@thehonestkitchen.com Website: www.thehonestkitchen.com
THERMAL IMAGING ThermoScanIR Toronto, ON Canada Phone: (416) 258-5888 Email: info@ThermoScanIR.com Website: www.ThermoScanIR.com
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Chia – small seed, BIG benefits
By Juliet M. Getty, PhD
For years, chia has been famous for its ability to sprout out of ceramic containers shaped like pets or farm animals. In just days, the seeds grow and simulate a furry coat or hair. The truth is, chia is remarkable, and not just for its ability to grow quickly. Produced by the Salvia hispanica plant, the tiny seeds are low in sugar and starch, high in watersoluble fiber and quality protein, and a concentrated source of Omega-3 fatty acids. They provide multiple health benefits, and protect virtually every area of a horse’s body.
Discover how these tiny nutritionpacked seeds can bring healing and balance to equine patients.
A GOOD SOURCE OF OMEGA-3S The perfect whole food for horses is living, healthy grass. It offers a variety of nutrients, but its fat content is especially worth noting. It contains the two necessary
fatty acids – alpha linolenic acid (ALA), an Omega-3, and linoleic acid, an Omega-6 – in their proper balance, with four times more ALA than linoleic acid.
Without access to fresh grass, horses rely on supplemented fat. Unfortunately, the fat added to most feeds comes from “vegetable oil” (another term for soybean oil), which is very high in Omega6s. Too many Omega-6s increase inflammation. The high levels of Omega-3s found in chia seeds have the opposite effect – they decrease inflammation. In fact, chia seeds benefit horses in a variety of ways by: • Lowering circulating insulin and glucose • Balancing immune function • Protecting joints and ligaments • Reducing pain • Decreasing nervousness • Improving heart and blood vessel integrity • Reducing allergic reactions to insect bites • Diminishing respiratory inflammation • Supporting normal gastrointestinal function • Maintaining hair and hoof health • Healing damaged skin • Hydrating intestinal contents
PROTEIN AND FIBER Chia seeds contain approximately 20% quality protein. This boosts the amino acid variety available to horses, enhancing protein production throughout the body in muscles, bones, joints, skin, hooves, lungs, liver, kidneys and blood, as well as those areas that aid in digestion, immune function, water balance and nutrient transport. Continued on page 64. IVC Winter 2014 63
Continued from page 63. Mucilages, gums and pectin are water-soluble fibers found in chia seeds, and form a gel in water. This significantly benefits horses in two ways:
Fatty acids found in chia and flax seeds v (based on one ounce by weight = 28.375 grams = ¼ cup in volume) Type of fatty acid
1 It lowers circulating insulin by reducing glucose absorption. 2 It reduces the incidence of sand colic by facilitating sand removal from the cecum.
ANTIOXIDANT ACTION Antioxidants known as chlorogenic acid, caffeic acid, myricetin and quercetin naturally occur within chia seeds and protect their fatty acids from rancidity. They neutralize damaging free radicals, thereby reducing pain, inflammation and vulnerability toward disease.
Horses suffering from insulin resistance (metabolic syndrome) or equine Cushing’s disease (otherwise known as pituitary pars intermedia dysfunction – PPID) require a diet low in non-structural carbohydrates (NSC). Chia seeds support this diet. They are low in NSC (less than 5%). Even more dramatic is their ability to enhance insulin sensitivity i because of their high Omega-3 content, offering a critical component in the fight to prevent laminitis. ii PPID affects many horses as they age, and is generally due to the oxidative stress caused by exposure to mental and physical challenges, chemicals in the environment, and a diet low in antioxidants. Free radicals target dopamine-releasing neurons in the brain, leading to the onset of PPID. The Omega-3s and antioxidants offered by chia seeds reduce free radical formation, thereby counteracting the propensity toward, and severity of, the disease. iii
CHIA VS. FLAX Both chia and flax are high in Omega-3 fatty acids and can be fed interchangeably for this purpose. In fact, flax has slightly more Omega-3s than chia, with an Omega-3 to 6 ratio closer to that found in pasture grasses (see table). However, chia does not require grinding and therefore has a longer shelf life (since grinding exposes the unsaturated fatty acids to oxygen). Chia, unlike flax, does not contain phytoestrogens, which can cause fertility problems as well as alter behavior.
Flax seeds
Saturated
900 mg
1,000 mg
Monounsaturated (Omega-9)
600 mg
2,100 mg
Alpha Linolenic Acid (ALA) Polyunsaturated – Omega-3
4,915 mg
6,388 mg
Linoleic Acid Polyunsaturated – Omega-6
1,620 mg
1,655 mg
Omega-3 to Omega 6-Ratio
3.04:1
3.86:1
HOW MUCH CHIA TO FEED Feed ½ cup (120 ml) per 1,100 lb (500 kg horse) as a maintenance dose. Higher amounts may be helpful for healing purposes, but should not exceed two cups per day. Chia seeds may be fed dry, top-dressed on a meal, or soaked ahead of time and mixed in with other ingredients.
A WORD ABOUT OTHER EQUINES Ponies, minis, donkeys and mules cannot tolerate high levels of fat like horses can. They are genetically predisposed to insulin resistance, which is exacerbated by obesity. Therefore, high fat and protein feeds such as chia seeds should be fed at a reduced level. Approximately one third the amount normally fed to horses (adjusted for size) will give them the Omega-3s they need. Donkeys and mules require less protein, since they have the ability to recycle up to 80% of the urea created during protein metabolism.
BOTTOM LINE Including chia seeds in the diet is an excellent way to enhance health. They are easy to feed, have a long shelf life and horses love the taste. More importantly, they bring healing to inflammatory conditions, allergies and illnesses, calming every cell within a horse’s body.
CALM DOWN
PROTECTION AGAINST CUSHING’S AND INSULIN RESISTANCE
Chia seeds
Fat has the ability to calm hot temperaments. Researchers at Virginia Polytechnic Institute iv noticed that horses fed more fat relative to grains were less reactive to startling stimuli and had lower levels of excitability and anxiety. The high fat content of chia seeds offers this benefit. But it gets better – the high amounts of Omega-3 fatty acids further calm the nervous system. Even mares enduring estrus cycle inflammation can become more tranquil.
Hess, Tanja M., et al. “Effects of Omega-3 fatty acid supplementation on insulin sensitivity in horses”. Journal of Equine Veterinary Science, 33(6), 446-453, 2013. Getty, Juliet M. “Managing equine Cushing’s disease”. The Horse, June 2012. iii Norlaily, Mohd Ali, et.al. “The promising future of chia, Salvia hispanica L”. Journal of Biomedicine and Biotechnology, 2012 iv Holland, JL, Kronsfeld, DS, Meacham, TN – Virginia Polytechnic Institute. “Behavior of horses is affected by soy lecithin and corn oil in the diet.” J. Animal Sci. vol.74, no 6, 1252-1255, 1996. v nutritiondata.self.com i ii
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Individualized Analog Medicine Courses
North American Veterinary Conference
Ontario Veterinary Medical Association Conference
Ongoing Analog medicine is an integrated amalgam of several different alternative medical modalities. It shows exactly how integration can be effectively accomplished and demonstrates its many benefits. This is a course for those individuals who want to go beyond the bounds of classic material medicine to explore the science and art of holistic healing. This is a four or five day course, in a rural Idaho setting, for very small groups or individuals on the fundamentals of integrated holistic healing. Contact Dr. Ronald Hamm to schedule your course.
January 18 - 22, 2014 – Orlando, FL The annual NAVC Conference welcomes almost 16,000 attendees from more than 70 countries and offers more than 30 hands-on 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.
January 30 - February 1, 2014 – Toronto, ON The 2014 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.
For more information: Dr. Ronald Hamm (208) 427-6233 analogdr@ida.net
2014 AVMA Veterinary Leadership Conference January 9 - 12, 2014 – Chicago, IL Enhance your leadership skills and expand your professional network while attending the Veterinary Leadership Conference. The VLC offers 3 days of networking and workshop opportunities and is open to any veterinary professional interested in learning more about leadership and team building. Continuing education credit is available for attending select sessions. For more information: vlc@avma.org www.avma.org/vlc
The NAVC Conference is a nonprofit organization whose mission is to provide world-class continuing education for all members of the veterinary healthcare team. For more information: (352) 375.5672 info@navc.com www.navc.com
15th Annual Technician Symposium January 25 - 26, 2014 – North Grafton, MA This conference is 10 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. (508) 839-5302 vetCEinfo@tufts.edu www.tufts.edu/vet/ce/events/
3rd Annual Technician Boot Camp January 25 - 28, 2014 – North Grafton, MA The Boot Camp registration includes Boot Camp, Lab, Lectures, Continental Breakfast, 3 Luncheons, and Course Notes on CD. Also includes 22 hours of continuing education credits. For more information: (508) 839-5302 vetCEinfo@tufts.edu www.tufts.edu/vet/ce/events/
This 3 day event is the largest annual veterinary conference in Canada and combines education with a tradeshow filled with products and equipment. For more information: (800) 670-1702 info@ovma.org www.ovma.org
Minnesota VMA 117th Annual Meeting February 6 – 8, 2014 – Minneapolis, MN This Annual Meeting offers many opportunities, including continuing education, networking with friends and colleagues, a silent auction and two breakfast seminars. For more information: (651) 645-7533 info@mvma.org www.mvma.org
86th Annual Western Veterinary Conference February 16 - 20, 2014 – 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 speakers 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
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