V5I3 (Summer 2015) by Redstone Media Group

Integrative VETERINARY CARE VOLUME 5 ISSUE 3

ALTERNATIVE PAIN CONTROL HOW LASER, ACUPUNCTURE, HERBS, CHIROPRACTIC AND OTHER MODALITIES CAN EASE THE PAIN CAUSED BY SURGERY AND INJURY – PAGE 18

PROLOTHERAPY

INTEGRATIVE HOSPICE

TUI NA: CHINESE MEDICAL MASSAGE

FOUR CAUSES OF NEUROMUSCULAR WEAKNESS IN HORSES

How it relieves pain and heals chronic musculoskeletal pain in horses, dogs and cats.

www.IVCJournal.com

SUMMER ISSUE 2015

These massage manipulations help with healing by stimulating acupressure points and surface regions of the body.

SUPPLEMENTS EVERY PET NEEDS

Give their diets a nutritional boost with Omega-3s, probiotics, digestive enzymes and antioxidants.

Offering palliative care options improves quality of life for terminal patients and gives comfort and peace of mind to clients.

Learn how to assess and correct them using Applied Kinesiology.

WHAT’ S NEW

• Study focuses on the human-canine bond • Condition in newborn foals may offer clues to autism in children • New report looks at health beneﬁts of canine companionship

IVC Summer 2015

See All Natural News on page 41

IVC Summer 2015

contents FEATURES

PROLOTHERAPY

The concept behind this therapy involves irritating tissue to promote healing; it stimulates the body to repair damaged/loose ligaments.

ALTERNATIVE VETERINARY PAIN CONTROL

From laser and ozone therapy to herbs, acupuncture or chiropractic, there are many ways to help patients with pain arising from surgery and injury.

25 26

LASER THERAPY FOR A NECROTIZING WOUND

A severe wound in a golden retriever, arising from a cat bite, responds positively to laser treatments.

CANINE INFLUENZA OUTBREAK

Implementing these alternative approaches will help you treat and prevent illness and infection in your patients.

28 42

HERBS OFFER SAFE, EFFECTIVE PAIN MANAGEMENT

An herbal approach to pain can address the causes of the discomfort, has few to no side effects, and can be used over a long period.

Tech Talk INTERESTED IN ANIMAL BEHAVIOR?

As a veterinary behavior technician, you can help clients identify and address behavior problems, and prevent them from occurring in the ﬁrst place.

49 4

IVC Summer 2015

VITAMIN D IN DOGS AND CATS

An insufﬁciency is associated with disease states such as congestive heart failure, neoplasia, renal disease, infectious illnesses, IBD, and feline oral resorptive lesions.

Nutrition Nook SUPPLEMENTS EVERY PET NEEDS

No matter what type of pet food you recommend to your clients, these supplements will complement and improve every diet for every animal.

TUI-NA: CHINESE MEDICAL MASSAGE

Integrative Practice INTEGRATIVE HOSPICE

This modality uses massage manipulations to stimulate acupressure points or surface regions of the body, restoring physiological balance and promoting circulation.

“Pawspice” can improve quality of life for terminal patients, and reassure their owners that they’re doing a good job helping their animals through their last days.

54 60

APPLIED KINESIOLOGY IN THE EQUINE

Four causes of subtle neuromuscular weakness in horses and how to assess and correct them.

BEST MODELS FOR INTEGRATIVE RESEARCH

Studies that meet the expectations of conventional medicine, while conforming to basic tenets of individual modalities, will encourage a wider acceptance of integrative medicine.

advisory board

38 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 11 What’ s new

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.

24 Social media 30 From the AHVMA 36 Industry innovations 46 From the AVH

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.

47 Veterinary resource guide 63 From the AAVA 64 From the VBMA 65 Marketplace 66 Events

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

Dr. Christina Chambreau, DVM, CVH, graduated from the University of Georgia Veterinary College in 1980. She is a founder of the Academy Of Veterinary Homeopathy, was on the faculty of the National Center for Homeopathy Summer School and has been the holistic modality adjunct faculty liaison for the Maryland Veterinary Technician Program. 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.

IVC Summer 2015

Integrative VETERINARY CARE

SUMMER 2015

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 Webmaster: Brad Vader Cover Photography: Jack Sui

COLUMNISTS & CONTRIBUTING WRITERS Ihor Basko, DVM, CVA Gerald M. Buchoff, BVScAH Jeffrey W. Foltz, DVM Jean Hofve, DVM Naomi Kirby Sismour, DVM, MS Lisa A. Miller, DVM, CCRT Pat Miller, CBCC-KA, CPDT-KA Lynn S. Peck, DVM, MS, cICAK Kim Perkins, PhD Barbara Royal, DVM, CVA Nancy Scanlan, DVM, MS, CVA Jochen Schleese, CMS, CEE, CSFT Michelle C. Schraeder, DVM, MEd, FAAVA Robert J. Silver, DVM, MS Carvel G. Tiekert, DVM Alice E. Villalobos, DVM, FNAP Vivian Zottola, CPDT-KA

ADVERTISING SALES: Eastern Sales Manager: Ann Beacom (866) 764-1212 ext. 222 annbeacom@redstonemediagroup.com Western Regional Manager: Becky Starr (866) 764-1212 ext. 221 becky@redstonemediagroup.com Marketing Coordinator: Jessica Apro, (866) 764-1212 ext. 115 jess@redstonemediagroup.com CLASSIFIED ADVERTISING: Libby Sinden classified@IVCJournal.com US MAIL: IVC Journal, 6834 S University Blvd PMB 155 Centennial, CO 80122 CDN MAIL: IVC Journal, 202-160 Charlotte St. Peterborough, ON, Canada K9J 2T8.

ADMINISTRATION & SALES Publisher: Redstone Media Group President/C.E.O.: Tim Hockley Accounting: Karen Tice Circulation & Office Manager: Libby Sinden SUBMISSIONS: Please send all editorial material, photos and correspondence to Dana Cox at Dana@redstonemediagroup.com or IVC Journal, 160 Charlotte St., Suite 202 Peterborough, ON, Canada K9J 2T8.

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

The opinions expressed in this journal are not necessarily those of the editor, and different views may appear in other issues. Redstone Media Group Inc., publisher of IVC Journal, does not promote any of the products or services advertised by a third party advertiser in this publication, nor does Redstone Media Group Inc. verify the accuracy of any claims made in connection with such advertisers.

IVCJournal.com

Subscribe to IVC Journal Today! For a limited time only, IVC Journal is available by subscription for FREE. To order your subscription please visit www.ivcjournal.com

IVC Journal (ISSN 2291-9600) is published four times a year by Redstone Media Group Inc. Publications Mail Agreement #40884047. Entire contents copyrightÂ© 2015. No part of this publication may be reproduced or transmitted by any means, without prior written permission of the publisher. Publication date: June 2015.

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

IVC Summer 2015

editorial

Managing

PAIN in our patients

Weâ&#x20AC;&#x2122;ve all experienced pain, or witnessed it in a loved one or animal companion. One of my saddest memories dates back to when I was a veterinary student. My 25-year-old horse, Flipper, had developed severe, painful degenerative cervical arthritis. He could no longer put his head down to eat and lost a quarter of his body weight. At the time, even my equine professors at the veterinary school clinic where Flipper was diagnosed could offer little hope, and strongly urged me to euthanize him.

for use in hospice patients, including pain management. Gerry Buchoff, BVScAH, explores a variety of alternatives for postsurgical pain, while Dr. Carvel Tiekert provides techniques for using prolotherapy, especially for the pain and healing of ACL and thoraco-lumbar damage. And since emotional pain is as real as physical pain, Pat Miller looks at how becoming a veterinary behavioral technician can help you ease the stress of vet visits for patients and clients through understanding and training.

Over the last decade, many new pain medicines have come into standard use for post-surgical as well as chronic pain. Often, however, our clients are concerned about the side effects or cost of these drugs. Holistic options can relieve pain more gently and inexpensively. When I was working at an emergency clinic, I saw several severely-injured dogs that their owners had treated with herbs, Reiki, acupressure or merely Rescue Remedy. I was surprised every time by how soft the dogsâ&#x20AC;&#x2122; eyes were, how little pain they reflected, and how quickly they responded to treatments. Once I was trained in homeopathy, I saw my patients recover faster from anesthesia and return more quickly to normal behaviors and playfulness.

Other alternative approaches, such as Traditional Chinese Veterinary Medicine, also have multiple solutions to pain. Dr. Michelle Schraeder introduces us to Tui Na, the body work or massage branch of TCVM; it can create short-lived analgesia as well as longer-lasting pain control. Dr. Lynn S. Peck, meanwhile, writes about the use of Applied Kinesiology to help horses recover from musculoskeletal weaknesses.

Geriatrics of all species, including myself, often develop pain from arthritis and other conditions and illnesses. I have found that even animals in hospice who do not recover with holistic treatment can have their pain controlled with multiple options, many of which my clients can use at home. Cards from clients fill my office, thanking me for the pain-free days and easier deaths we were able to give their pets. In this issue of IVC Journal, we focus on managing pain in our patients. Dr. Alice Villalobosâ&#x20AC;&#x2122; article offers multiple options

IVC Summer 2015

As you enjoy your summer vacations, and plan for the future, I hope you will be attending some of the conferences and courses offered by the many holistic organizations. Maybe you can also find some time to read the cases posted on the IVC Journal website and submit some of your own successes. If you plan to be at the AHVMA conference, please connect with me and share your experiences!

Christina Chambreau, DVM, CVH Associate Editor, drtina@ivcjournal.com

IVC Summer 2015

contributors 1

5 Meet the IVC gurus! LIKE us on Facebook to learn more about integrative leaders in the veterinary community.

1. JEAN HOFVE, DVM Dr. Jean Hofve earned her Doctor of Veterinary Medicine at Colorado State University. In addition to conventional veterinary training, she studied veterinary homeopathy, homotoxicology, Reiki, and other holistic modalities. She has researched pet food and feline nutrition for more than two decades, and is an expert on holistic pet health and the commercial pet food industry. She is an official advisor to AAFCO, the organization that sets pet food rules and standards in the U.S. and Canada. Dr. Hofve co-authored the books Holistic Cat Care and Paleo Dog. 2. LYNN S. PECK, DVM, MS Dr. Lynn Peck earned her DVM and a MSc in Reproductive Physiology (Equine) from the University of Florida. After several years in conventional practice, she became interested in alternative medicine, beginning with veterinary homeopathy in 1995, and continuing to acupuncture, Touch Balancing/Animal Bowen™, therapeutic nutrition, equine osteopathy, color light therapy, Acutonics™ and others. She is a senior instructor in TB/AB, taught acupuncture at the Chi Institute of Traditional Chinese Veterinary Medicine, and recently earned two certifications in Applied Kinesiology. Dr. Peck owns All Holistic Veterinary Care in Gainesville, Florida; her interests include neuromuscular weakness, chronic pain, and environmental chemical toxins.

complementary health therapies in her veterinary practice since 1969. She uses nutraceuticals, acupuncture (IVAS certified), non-classical homeopathy, Chinese and Western herbs, and homotoxicology. Dr. Scanlan has held multiple leadership roles in holistic veterinary associations. She recently resigned from three years as Executive Director of the AHVMA to work fulltime for the AHVM Foundation. She is a member of the VBMA, AHVMA, AVMA, CVMA and SCVMA, and a consultant for Ark Naturals, Vetriscience and Thorne Research. 5. MICHELLE SCHRAEDER, DVM, MED, FAAVA Dr. Michelle Schraeder graduated from The Ohio State University College of Veterinary Medicine in 1985. She practices integrative medicine, utilizing TCM with conventional Western medicine (mtnvet.com). She is an IVAS-certified veterinary acupuncturist and charter member of the American Academy of Veterinary Acupuncture (AAVA). She also completed a three-year course in Veterinary Chinese Herbal Medicine and a course in veterinary Tui-Na. Dr. Schraeder was one of the first veterinarians to become a Fellow of the AAWVA. She is chair of the IVAS International Education Committee, an IVAS board member, and a member of the AAVA Advanced Certification Committee.

3. BARBARA ROYAL, DVM, CVA Dr. Barbara Royal, is a Chicago veterinarian, IVAS certified acupuncturist, author and lecturer with extensive experience in veterinary care, including zoo, marine and wildlife animals, nutrition, acupuncture, emergency medicine, pathology, conventional practices, herbal remedies, physical rehabilitation techniques and alternative treatments. Dr. Royal is president of the American Holistic Veterinary Medical Association (ahvma. org) and president-elect of the AHVM Foundation (ahvmf.org). Author of The Royal Treatment, A Natural Approach to Wildly Healthy Pets, she is also is the founder and owner of The Royal Treatment Veterinary Center in Chicago.

6. CARVEL G. TIEKERT, DVM Dr. Carvel Tiekert graduated from Cornell University College of Veterinary Medicine in 1963 and started in conventional practice. He became interested in nutrition in the 1970s, and chiropractic shortly thereafter. He founded the American Holistic Medical Association in 1982, acquired his Certification in Acupuncture in 1984, followed by a Certification in Veterinary Chiropractic care, and took multiple courses in homeopathy. While running his integrative practice in Bel Air, Maryland, Dr. Tiekert held offices in the Maryland Veterinary Medical Association along with multiple positions in the AHVMA, including president, board member, and executive director. He currenly practices in Joppa, Maryland.

4. NANCY SCANLAN, DVM, CVA Dr. Nancy Scanlan is the Executive Director for the AHVM Foundation. She has been using

7. ALICE E. VILLALOBOS, DVM, FNAP Dr. Alice Villalobos earned her DVM while completing a first generation oncology residency

IVC Summer 2015

facebook.com/ IVCJournal

program at UC Davis in 1972. She is a charter member of the Veterinary Cancer Society and the International Association for Animal Hospice and Palliative Care, President Emeritus of the Society for Veterinary Medical Ethics, and past President of the American Association of Human Bond Veterinarians. She has published a textbook, chapters and numerous articles and is regarded as a pioneer in oncology and end-of-life care. She a Leo Bustad Veterinarian of the Year recipient, a UCD Alumni Achievement Award winner, and was recently honored with the SCVMA’s H. Don Mahan Memorial Award. She directs Pawspice and Animal Oncology consultation Service in California (Pawspice.com). 8. GERALD BUCHOFF, BVSCAH Dr. Gerald Buchoff received his Doctorate in Veterinary Medicine (BVScAH) from G.B. Pant University in India. He has completed courses in homeopathy, veterinary orthopedic manipulation (chiropractic), acupuncture, glandular nutritional therapy, cold laser therapy, and Reiki. Before opening his current practice, Holistic Pet Care, Dr. Buchoff owned and operated North Bergen Animal Hospital in New Jersey for almost 20 years. He served four years as President of the Northern New Jersey Veterinary Medical Association and four years as Vice President and President of the AHVMA. He hosted 50 episodes of The Pet Stop on New 12 NJ-TV, and developed his own raw food diet (holisticpetcarenj.com/raw-diet). 9. PAT MILLER, CBCC-KA, CPDT-KA Pat Miller is a Certified Behavior Consultant, Canine (KA), Certified Professional Dog Trainer (KA) and past president of the Association of Pet Dog Trainers (US). She offers group good manners classes, private training and behavior modification services, dog training workshops and trainer academies at her Peaceable Paws 80-acre training facility in Fairplay, Maryland (peaceablepaws.com). Pat has authored six books on dog behavior and training: The Power of Positive Dog Training, Positive Perspectives, Positive Perspectives 2, Play With Your Dog, Do-Over Dogs, and How to Foster Dogs. She is on the Board of Directors for the Certification Council for Professional Dog Trainers.

what’s new STUDY LOOKS AT THE HUMAN-CANINE BOND Problems with the human-canine bond often lead to behavioral issues in dogs. And because behavioral issues are one of the major reasons dogs are surrendered to shelters, they’re also an indirect cause of shelter overcrowding and euthanization. By learning more about the bond between people and their canines, therefore, many lives could be saved. Dr. Nick Dodman, professor of veterinary medicine at Tufts University, and animal behaviorist Dr. James Serpell at the University of Pennsylvania, are embarking on a study to do just that. Working under the auspices of the Center for Canine Behavior Studies, the Animal Ownership Interaction Study is examining the factors underlying the bond between humans and canines. By doing so, the potential exists for making inroads into dramatically attenuating the relinquishment and euthanasia of canines. The interactive behavioral aspects to be researched also have a bearing on enhancing human-canine relationships in general, including helping to pair the right person with the right dog in the course of adoption. Volunteers are needed to make this study a success. People can participate by registering for free at centerforcaninebehaviorstudies.org.

“GET HEALTHY, GET A DOG” A new report on the health beneﬁts of canine companionship has been published by Harvard Medical School and MSPCA-Angell. Get Healthy, Get a Dog delves into the many ways dogs can improve the health of their human partners. Authored by Dr. Elizabeth Pegg Frates, Clinical Assistant Professor at Harvard Medical School, and Dr. Lisa Moses, Staff Veterinarian at Angell Animal Medical Center, the report shows that dogs can: • • • • • •

Provide companionship Boost activity levels Help people become calmer, more mindful and more present in life Encourage kids to be more active, social, secure and responsible Improve the lives of older individuals Help people feel more social and less isolated

The report also highlights the responsibilities and steps people should take to ensure a healthy lifestyle for their canines, from daily physical activity and healthy nutrition to veterinary care and obedience training. It can be purchased online at health.harvard.edu/dogsheal.

PRESTIGIOUS ACHIEVEMENT BILL ONE STEP CLOSER TO BECOMING LAW

Veterinarian Dr. Janice Huntingford of the Essex Animal Hospital in Ontario, Canada (essexanimalhospital.ca) is the newest Diplomate of the American College of Veterinary Sports Medicine and Rehabilitation. This puts her in an exclusive group of just 142 Diplomates worldwide who have met the stringent ACVSMR requirements. Dr. Huntingford is also one of only three Canine Specialty Diplomates in Canada.

basic physiological, medical, surgical, sports medicine and rehabilitation knowledge as well as species-speciﬁc questions.

Diplomates of the ACVSMR treat the musculoskeletal and neurological injuries of caine athletes and pet dogs post surgery or post injury by using various modalities such as aquatic therapy and laser as well as pain control ACVSMR qualifications include having at least ten years of work with medications, exercises and acupuncture. experience in the field of sports medicine and rehabilitation; having peer reviewed scientific publications in the field; lecturing nationally “This has been a long journey but was well worth it, and internationally; and being actively involved in clinical and especially when I can tell a family that we are able research aspects of veterinary sports medicine and rehabilitation. to treat and save their pet,” says Dr. Huntingford. This is in addition to passing two rigorous examinations covering acvsmr.org IVC Summer 2015

what’s new NEWBORN FOALS MAY OFFER CLUES TOLAW AUTISM BILL ONE STEP CLOSER TO BECOMING Veterinary researchers at the University of California, Davis, are teaming up with their colleagues in human medicine to investigate a troubling disorder in newborn horses, and explore its possible connections to childhood autism. Known as neonatal maladjustment syndrome, this disorder has puzzled horse owners and veterinarians for a century. Affected foals seem detached, fail to recognize their mothers, and have no interest in nursing. The common link between neonatal maladjustment syndrome and autism, the researchers suggest, may be abnormal levels of naturally-occurring neurosteroids. “The behavioral abnormalities in these foals seem to resemble some of the symptoms in children with autism,” says John Madigan, a UC Davis veterinary professor and expert in equine neonatal health.

A new group called the Comparative Neurology Research Group, consisting of veterinarians, physicians, epidemiologists and basic-science researchers, has formed to pursue further studies in this area. Madigan is working with researchers at the Stanford School of Medicine, exploring the mechanisms of post-birth transitions of consciousness related to neonatal care of infants.

Using data from the foal research, Pessah and Madigan are working with environmental epidemiologist Irva HertzPicciotto at the UC Davis MIND Institute to investigate neurosteroids in children with varying degrees of autism, ranging from some developmental delay to fullspectrum autism. The researchers are exploring whether an abnormal regulation of neurosteroids during the time around childbirth could be one of many factors that might contribute to autism and related neurodevelopmental disorders. A recent study has reported elevated levels of neurosteroids in children with autism spectrum disorder.

Neonatal maladjustment syndrome also caught the attention of Isaac Pessah, a professor of molecular biosciences at the UC Davis School of Veterinary Medicine and a faculty member of the UC Davis MIND Institute, which investigates environmental factors that may play a role in the development of autism in children.

NEW IN KC ANIMAL CORRIDOR BILLARRIVAL ONE STEP CLOSER TO HEALTH BECOMING LAW Integrated Animal Health (IAH) recently announced that it will locate its North American headquarters and commercial operations in the KC Animal Health Corridor. The Queensland, Australia-based animal health company has named Dr. Blake Hawley, DVM, MBA to be the North American president and CEO. The KC Animal Health Corridor, anchored by Manhattan, Kansas, and Columbia, Missouri, is home to more than 300 animal health companies, representing the largest concentration in the world. integrated-animal-health.com, KCanimalhealth.com.

IVC Summer 2015

PROLOTHERAPY

treats pain by stimulating the body to repair damaged/loose ligaments

Hip

Knee

Elbow

By Carvel G. Tiekert, DVM Prolotherapy is not a new method for treating pain. The concept of irritating tissue to promote healing dates back to the ancient Greeks and our old friend Hippocrates. He treated Olympic javelin throwers with unstable shoulders by touching what he described as a “slender hot iron” to the ligaments holding the shoulder joints together. The heat would irritate the ligament capsules, causing them to tighten up. Prolotherapy is sometimes known as regenerative injection therapy, nonsurgical ligament reconstruction, and more inaccurately as sclerotherapy.

A LONG HISTORY The prolotherapy techniques we use today were developed in the 1930s by G.S. Hackett, MD, a surgeon from Ohio, along with other MDs and DOs.1 These techniques have been used for decades to successfully treat pain resulting from ligament laxity. Hackett coined the term “prolotherapy” because his initial work demonstrated that the tissue laid down during the healing process was new healthy tissue, not scar tissue. (This distinguishes prolotherapy from a related treatment known as sclerotherapy.) “Prolo” stands for proliferative, implying that new cells and collagen fibers are proliferating and growing. The term “regenerative injection therapy”, used by some practitioners, is fairly new and an attempt to portray more accurately what is actually taking place physiologically.

SCIENTIFIC EVIDENCE Hackett showed that by creating controlled inflammation, permanent increases in ligament size (35% to 40%) resulted.

IVC Summer 2015

He reported an 82% patient-reported cure rate for backache in a series of 1,600 patients treated with prolotherapy. His final examinations were performed from two to 12 years following the conclusion of injection therapy, thus indicating the permanency of the treatment. More recent studies have confirmed Hackett’s initial studies. In 1983, Liu (et al) injected a proliferative solution (sodium morrhuate) into rabbit MCLs (medial collateral ligaments of the knee). The ligaments showed a significant increase in ligament mass, thickness, ligament-bone junction strength, and weight-to-length ratio compared to controls.2 This effect was confirmed by Maynard (et al) in 1985 in his study on Achilles tendons in rabbits.3 Reeves and Hassenein showed long term benefits for anterior cruciate ligament laxity using dextrose prolotherapy.4 Prolotherapy is widely used in the human field, Figure 1

and studies have been published in the Journal of Prolotherapy as well as other medical journals.

PHYSIOLOGY OF PROLOTHERAPY In a sense, prolotherapy creates an injury. Figure 1 shows schematically what happens during healing. Cellular debris and humoral factors at the injury site attract an initial influx of granulocytes. The granulocytes proceed to secrete a number of factors, among them proteolytic enzymes, which debride the wound area and attract other cells. Ultimately, fibroblasts are recruited and stimulated to produce new intracellular matrix, including new collagen. As the collagen is produced, it creates tissue remodeling, strengthens the area, and causes the wound contraction seen in Figure 1. This contraction, resulting from the production of new collagen/ ligaments, creates a tightening of the wound, a reduction in joint laxity and therefore a reduction in pain. The whole process is called the wound healing cascade, and in the very basic model briefly described above, is characteristic of all healing wounds. Continued on page 16.

Prolotherapy in horses

For years, pinfiring and blistering (oddly enough called counter-irritants) were commonly used techniques in horses. They were essentially a type of prolotherapy. They have since fallen into disrepute, and have been replaced by prolotherapy injections for equine lameness. IVC Summer 2015

CASE REPORT Boris belonged to one of the clinic’s technicians. He’d had bilateral cruciate damage for several years, and while he could walk without too much difficulty, he didn’t want to do very much. After his first prolotherapy treatment, he went up and down the steps without any apparent discomfort. After his second treatment, his owner reported that after a snowstorm, he flew off the deck to play with the other dogs, something he hadn’t done for several years. Because Boris responded so dramatically to prolotherapy, we did only those two treatments.

Continued from page 15.

TECHNIQUE AND APPLICATIONS Prolotherapy is one of the simplest therapies you can use, but to be successful, it is critical that you know anatomy. It will not be effective unless the solution gets into the ligament, and the boney interface of the ligament. In our practice, we use 15% dextrose as our predominant injection solution into the ligaments, and 25% into the joint. Some practices add ozone (prolozone), as it is a highly reactive molecule that helps stimulate the production of new collagen. When injecting, it is important that you put many small blebs into the ligament rather than one or two large amounts. We usually use a 27 gauge 1¼” needle for most peripheral joints and the spine. I will use an even smaller needle, usually 30 gauge, on very small dogs, and sometimes a 25 gauge needle in larger dogs. I use prolotherapy extensively for cruciate problems in small dogs, and in what I perceive to be partial cruciate tears in larger dogs. I inject many small blebs of the solution into the retinaculum, and into the lateral collateral ligament, paying particular attention to where it attaches to the bone. When dealing with cruciate problems, I also inject directly into the joint. In this case we use 25% dextrose solution. It is my personal opinion that this is not an appropriate therapy for dogs over 30 to 40 pounds that have a severe cranial drawer, particularly if there is a menisceal click. I take those dogs to surgery. Since cranial cruciate rupture in the dog is a symptom of chronic disease, in most cases it stands to reason that the rest of the ligaments are not likely to be in the best of shape. Therefore, I do prolotherapy on the contralateral stifle at the same time we do surgery on the affected stifle. I use prolotherapy for problems along the spine, predominantly for lumbosacral issues. Anesthesia has not been needed in any patients injected from the thoracolumbar to the lumbosacral areas. I have used prolotherapy at multiple other places in the body where there has been ligamental damage. I have also used it for arthritic joint issues, based on the supposition that part of the reason the joints became arthritic was because of weak ligaments and secondary joint instability. Our clinical experience of improved function and well-being in these patients has been rewarding. We do not need to use anesthesia in most large dogs, but many small dogs and cats require sedation or anesthesia for prolotherapy. Our success rate with partial cruciate tears and spinal problems from the thoracolumbar area to the lumbosacral has been very high.

IVC Summer 2015

I normally repeat the treatment two to four times, at about four week intervals, although I have had many cases show a dramatic response after a single treatment. It is usually suggested, however, that at least four to six weeks are needed to allow the healing process to follow itself through. Rarely, some dogs will have some level of pain after the procedure. It is critical that if you are going to medically treat the pain, you do not use nonsteroidal anti-inflammatories since they will defeat the purpose of the therapy. We recommend acetaminophen instead.

CONCLUSION Prolotherapy is an easy procedure that can significantly improve the mobility of any species. Rather than merely masking the pain, it actually results in long term improvements and performance enhancement. While sedation or anesthesia may be needed in some patients, this therapy can be considered for the healthy maintenance of performance animals and geriatrics, as well as for pain relief in all species.

Hackett, George D; Hemwall, Gustav A; Montgomery, Gerald A. Ligament and Tendon Relaxation Treated by Prolotherapy (ﬁfth edition).

Liu, U.K; Charles, M; Tipton, Ronald D; Matthes, Toby G; Bedford, Jerry A; Maynard; Harold C. Walmer. “An In Situ Study of the Inﬂuence of a Sclerosing Solution in Rabbit Medical Collateral Ligaments and its Junction Strength”. Connective Tissue Research, 1983, Vol. II, p. 95-102, Gordon & Breach, Science Publishers, Inc.

Maynard, J.A; Pedrini, V.A; Pedrini-Mille, A; Romanus, B; Ohlerking, F. “Morphological and Biochemical Effects of Sodium Morrhuate on Tendons”. Journal of Orthopaedic Research, 3:236-248, Raven Press, New York, 1985.

Reeves, K; Dean M.D; Khatab M. Hassenein, PhD. “Long Term Effects of Dextrose Prolotherapy for Anterior Cruciate Ligament Laxity”. Alternative Therapies, May/June 2003.

Benefits of prolotherapy

Prolotherapy relieves pain and heals many different types of chronic musculoskeletal pain in horses, dogs and cats including: • Partially torn ligaments, especially anterior cruciate • Tendon and cartilage injury and inflammation, especially in performance or working dogs and horses • Vertebral pain • Partially degenerated or herniated inter-vertebral disks • Horses with chronic musculoskeletal pain

ESSENTIAL OILS in behavior training

By Vivian Zottola, CPDT-KA

growing number of dog owners are reluctant to use behavior medications on their dogs because of the time involved in figuring out the right dosage, and the related levels of sedation that often accompany treatment. In moderate cases, a successful incremental change in behavior may be achieved using essential oils combined with a behavior modification training treatment plan. According to Dr Joie Power – a retired board-certified neuropsychologist with experience in the olfactory and limbic systems of the brain, and a student of aromatherapy and herbal medicine – aromatherapy was found to be a useful adjunctive intervention in cases of chronic stress and/or depression in humans. The bond between odor and memory can be useful in psychotherapeutic settings. Practitioners may be able to facilitate recall of an event by presenting aromas linked with the event. Research also shows different live botanical essential oils produce consistently different brain wave patterns on EEGs, even when subjects report little to no perceived change in their mood. Findings suggest aromas can have unconscious effects on human mental states. Could they do the same with dogs?

Resources Aromahead Institute, Aromatherapy Certification online studies AshiTherapy, Small Animal Aromatherapy Practitioner Certification online studies Association of Professional Dog Trainers (APDT.org), Online Educational Course: “Canine Hormones: From Molecules to Behavior” by Jessica Heckman, DVM, MS

• Animals with chronic osteoarthritis, especially geriatric animals, or those who do poorly on conventional pain medications

”Psychoneuroimmunology and Aromatherapy: A Neuropsychologist’s Perspective” and “Aromatherpay and Emotions”, by Dr. Joie Power, PhD

• After ACL surgery, prolotherapy can protect the cruciate ligament in the non-surgical leg; in my practice, I use it extensively for cruciate problems in small dogs, and in what I perceive to be partial cruciate tears in larger dogs.

Vivian Zottola specializes in canine communication and behavior modification training using olfactory therapy. She is a Certified Professional Dog Trainer and a Small Animal Aromatherapy Practitioner. NatureNose.com, vivian@bostonk9concierge.com

IVC Summer 2015

ALTERNATIVE veterinary pain control for surgeries and injuries By Dr. Gerald M. Buchoff, BVScAH

No matter what kind of surgery or injury an animal goes through, he is going to experience pain.1 Individual dogs, cats, horses and other animals have varying perceptions of pain, depending on their emotional makeup and experiences.1a No to moderate analgesia is needed for routine neutering operations, most dentistry work, and mild injuries, depending on the individual patient. Alternative (non-drug) therapies are often sufficient to control such minor pain. In certain individuals, however, and with more painful surgeries such as orthopedics, exploratory laparotomies and major trauma, conventional drugs may be helpful and alternatives may work even better. It is difficult to accurately evaluate for pain, since pets will often hide signs of discomfort in the presence of a caretaker. There are many ways of decreasing pain from surgeries or injuries. Conventionally, analgesic drugs such as non-steroidal anti-inflammatory and narcotic medications are used for all types of pain. The side effects associated with these may make them unattractive to practitioners and pet owners, at least at their full recommended dosages, and many feel that the drugs alone may be inadequate for major pain relief. Using alternative methods in conjunction with analgesic drugs at lower doses is often acceptable for these more painful procedures.1b,1c So what are the alternatives? Following is a list of therapies that are being successfully used for pain in a variety of veterinary practices.

IVC Summer 2015

LASER THERAPY Lasers are becoming popular in both conventional and integrative practices. Veterinarians using Class III and Class IV lasers on a regular basis see less post-operative pain in their patients, even when the lasers are applied for only a few minutes soon after surgery. According to Companion Therapy Laser,1ci laser therapy is effective in treating post-surgical or traumatic pain and inflammation via a number of biological effects. It reduces painful inflammation, activates the lymphatic drainage system, and reduces pro-inflammatory mediators. Analgesia is also produced by “suppression of nociceptors, an increase of stimulation threshold, and an increased release of tissue endorphins”. “The Respond Systems laser is my go-to modality for treatment of both acute and chronic pain,” says Jennell Appel, DVM, CCRT, of SPORTVET Canine Rehabilitation & Sports Medicine. “I utilize it for post-operative pain, soft tissue injury, joint pain, and wound healing. I use it not only for immediate pain relief with one treatment, but also for extended, longterm relief with just a few short sessions.” Dr. Bill Inman1cii uses the following frequencies with Erchonia laser systems: 465 and 25 for pain, 300 for capillary vascularization, 20.5 for connective tissue rehabilitation,

365 for arterial supply, 100 for venous return, and 230 for lymphatic drainage, plus skin frequencies. “Treatments are applied twice a day on the day of surgery, twice a day the next day, then usually two more times within the next two weeks,” he says. “The 465 frequency increases the blood supply to the surgical site and actually diminishes the pain chemical by converting it as it moves through the arachidonic acid pain cycle. Healing fractures has been proven to be three times faster for simple fractures that are reduced surgically. Simple skin incisions heal 30% faster. The sutures should be removed at day seven instead of day ten to avoid ‘railroad tracks’.” For all trauma, use the basic frequencies 9, 16, 230 and 53. For general trauma pain, also use 3, 24, 111, 279, 465, 666, 25 and 125. For bone trauma, add 380, 1550, 802, 10000, 880, 787, 727 and 2720. For cerebral trauma, add 33, 60, 4, 9 and 151. For neural emotional trauma, add 60, 151, 1151, 465, 43 and 59. Continued on page 20.

Dr. Buchoff administers post-operative laser therapy to two canine patients. Laser therapy after surgery can help speed healing as well as lessen pain. IVC Summer 2015

Continued from page 19.

ACUPUNCTURE Although acupuncture is applicable to almost every medical condition, it is classically known for its ability to control pain,1e both acute and chronic. Acute pain from physical trauma is a manifestation of the local stagnation of Qi (slight trauma) or of Blood (severe trauma, incision) caused in the area.2 Acupuncture aids the body’s self-healing and can resolve swelling, give pain relief, speed healing, and restore normal transmission of nerve impulses. Electroacupuncture demonstrates even greater anti-inflammatory effect than dry needling.3 Classically, the acupoints ST-36 and LI-11 are often used, as well as local points.

for one or two days as an analgesic and anti-inflammatory, and to deter licking.

HERBS One of our oldest holistic treatment modalities, herbs have been well-known for centuries as a way to relieve pain during wars, epidemics, childbirth and more. Dr. Cynthia Lankenau3e sees excellent results using: Yunnan Paiyao for bleeding control and pain; The Great Mender, a patent Chinese herb formula, especially for bone pain; and Corydalis for soft tissue pain,with Indian Pipe if cancer is involved. The herbal formula should match the total pattern in the herbal Materia Medica. Dr. Ihor Basko3f treats “injury or post-surgical trauma by using ‘Blood Moving’ herbs both internally and topically...sometimes along with ‘blood cooling’ herbs. It will make a large difference with pain (without blocking any pain receptors) and recovery.”

ESSENTIAL OILS Essential oils have been used for over 5,000 years for people and animals. We often look to these oils for emotional help (e.g. Lavender for calming). They do have a wide range of actions, and can be important for pain relief and healing as well as emotional support. Dr. Melissa Shelton applies the essential oils Copaiba, Peppermint, Helichrysum, and/or Myrrh to mucus membranes before surgery or during anesthesia to minimize pain and promote healing. Helichrysum has the added property of minimizing bleeding during surgical procedures. “For me, this has certainly replaced all our NSAIDs – and is doing a better job than many of them,” says Dr. Shelton. 1d

This author often applies Lavender essential oil to an incision immediately post-op, and has clients do the same

IVC Summer 2015

In this author’s practice, we apply wheat germ oil to an incision or traumatic wound twice daily by pin-pricking the Standard Process gel cap. You may want to mix with a badtasting deterrent like Lavender essential oil. This greatly assists healing and comfort.

CHIROPRACTIC While chiropractic treatments are regarded as mostly useful for injuries and chronic lameness, they are also effective for acute pain and post -surgery. “It is important to note that just opening up the tissue with the scalpel blade will create a phenomenon of vertebral subluxation complex, which will produce a vasoconstrictor response at the site, therefore [causing] pain,” says Dr. Inman. “(VOM) adjustments can treat the subluxations and are given while [the animal is] recovering from anesthesia, the next day, seven days later, and then 14 days after that.”

HOMEOPATHY By rebalancing the quantum field, homeopathy can heal almost any illness or condition. It is excellent for acute as well as chronic conditions. For acute pain, it can give immediate relief, and since it is absorbed through the mucus membranes, it is easily given during surgery or to comatose injured animals. Many holistic veterinarians give Arnica, directly in the mouth or dissolved in water, just after surgery or a traumatic occurrence. An article in JAMA reported that facial reconstructive surgery patients taking perioperative homeopathic Arnica montana exhibited statistically less ecchymosis.3a The keynote to Arnica for pain is that the patient is so painful he does not want to be touched. Even a very sweet dog may bite or growl. Bellis is needed for deep organ or muscular pain when Arnica does not help. Hypericum is effective for puncture wounds, pain at injection sites, and gum pain. The strength of the medicine may vary, based on the practitioner’s assessment of the energetic level of assault on the body produced by the trauma or surgical procedure, and the energetic level of the animal’s vital force. For example, a gentle routine surgery usually requires just 30C whereas a very recent severe accident in a young animal may call for 10M.

OZONE Ozone has become very popular over the last few years in the veterinary field, although it has been used in the human field for decades. Many studies have documented its efficacy for pain relief, such as a meta-analysis of randomized trials on lower back pain.5 Dr. Margo Roman6 gives “a saline infusion of ozone which has been percolated with ozone for 30 minutes at 80 Gamma. Dosage ranges from about 30 cc to a 10 lb cat; 100 cc to a 40 lb dog; 160 cc to a 80 lb dog.” Ozone injected into joints (prolozone) can stop the pain/inflammation cycle in orthopedic surgery or joint trauma. Areas of trauma can also be covered with a plastic bag and ozone gas mixture pumped into it with a tube or large syringe (bagged) to control pain and promote healing. Continued on page 22.

IVC Summer 2015

Continued from page 21.

HOMOTOXICOLOGY

FLOWER ESSENCES

A variant of homeopathy developed by Hans-Henrich Reckeweg, MD, homotoxicology uses specific combinations of homeopathic medicines to address specific health issues. It can be very effective for pain of surgery or injuries.

Used for over 100 years, totally safe flower essences are essential in the hospital as well as for home care. While often considered primarily for emotional treatment, they are excellent for many physical ailments, especially pain with its emotional component.

Dr. P.J. Broadfoot3b routinely uses Traumeel (from Heel – now owned by MediNatura) post-surgery, both IV and SQ (and it can be sent home with the owner). “You can also use other homotoxicological preparations for specific cases,” says Dr. Broadfoot. “Zeel, Discus comp for bone surgeries, Cutis comp for dermatology support, Echinacea comp if there is some concern about secondary infections, Placenta comp if there is poor circulatory function or compromised blood supply, Nux Vomica/Hepar/Veratrum if doing GI surgery, etc.”

Dr. Christina Chambreau3g believes every clinic (and person) should be using Rescue Remedy, a combination of five Bach Flower Essences selected to relieve pain, decrease shock and aid healing. Rescue Remedy is 100% safe and has no negative interactions with conventional or holistic therapies. Many clinics give a few drops (diluted 4 drops in 1 ounce water) before every surgery, mist the surgical suite before surgery, and frequently post-op until the animal is back on his feet or resting comfortably. Other Bach essences can deal with specific pains,4 and additional companies (Green Hope Farms, Spirit Essences, and Anaflora to name a few) have specific combinations for use after surgeries for pain and emotional changes. Clients can give the dilution orally on the mucus membranes, or rub a bit on the inner ear flap any time they observe any hint of pain in their companions.

Dr. Richard Palmquist3c cautions that when using Zeel after joint surgery, it is more effective to concurrently use Traumeel, especially topically in its gel preparation. “If you are starting detox or a natural program, it can be hard to suddenly hit a patient with surgery,” he says. “So be sure she is stable on her current program before you do the surgery.”3d Dr. Palmquist has seen good pain control by giving Traumeel by dropper or sublingual tablet just before and just after surgery; having the client continue it TID for three days, and BID for two more days; and giving narcotic medications for more severe pain.

SOME FINAL THOUGHTS Dr. Carvel Tiekert, founder of the American Holistic Veterinary Medical Association, counsels that good anesthetic and surgical techniques are also important in minimizing surgical discomfort. Handle tissues gently, use firm but not tight Continued on page 24.

IVC Summer 2015

Continued from page 22. subcuticular skin sutures, apply a little procaine in the incision just before closing, and/or apply wheat germ oil to the closed incision from day three after surgery, to reduce the potential for electrical disturbances at the scar. For elective procedures that he knows will be significantly traumatic, Dr. Tiekert starts the patient on enzymes two days prior to surgery. Dr. Palmquist adds that keeping the incision small, and using surgical laser and appropriate fluid therapy, also helps prevent surgical pain.

CONCLUSIONS

gentler ways to resolve the pain arising from surgeries or injuries. Other modalities that relieve pain include biofield therapies, Reiki, massage, sound therapy, prolotherapy (see article on page 14), Sonotron therapy, hydrotherapy, magnet therapy, hyperbaric chambers, and more. Employing one or more commonly used alternative therapies can adequately control the pain of surgery or trauma, or at least reduce the dosage of opiates or other medications needed, thus enhancing recovery and general healing.

Pain is increasingly being addressed with drugs in veterinary clinics. These along with holistic modalities can offer safer,

Väisänen MA, Tuomikoski SK, Vainio OM. “Behavioral alterations and severity of pain in cats recovering at home following elective ovariohysterectomy or castration”. J Am Vet Med Assoc. 2007 Jul 15;231(2):236-42.

Seeley, Brook, MD et. al. “Effect of homeopathic Arnica montana on bruising in face-lifts –results of a randomized, double-blind, placebo-controlled clinical trial”. Arch Facial Plast Surg. 2006;8(1):54-59.

H ansen, Bernie. “Assessment of Pain in Dogs: Veterinary Clinical Studies”. ilarjournal.oxfordjournals.org/content/44/3/197.full

Broadfoot, PJ. (Private email). Broadfoot Veterinary Clinic, Van Buren, AR.

Palmquist, Richard. (Private email). Centinela Animal Hospital, Inglewood, CA

Wynn and Marsden. Manual of Natural Veterinary Medicine. pp 474-480.

Schoen and Wynn. Complementary and Alternative Veterinary Medicine

Lankenau, Cynthia. (Private email). Holistic Center for Veterinary Care, Colden, NY; and president of the Veterinary Botanical Medicine Association.

Basko, Ihor. All Creatures Great and Small, Kapaa, HI. Wrote on CAVM website.

Chambreau, Christina.

Palmquist, Richard. CAVM website.

1c 1ci

itecure.com/companion Inman, Bill. (Private e-mail). Inventor of the Veterinary Orthopedic Manipulation (VOM) chiropractic technique.

1cii

Shelton, Melissa. (Personal communication). Crow River Animal Hospital, and founder of Animal EO, OilyVet.com.

Bresler et al. “Review of research findings of the UCLA Research Project”. 1975, anesthesiolrev, p 10, Jan 1976.

Magalhaes FN, et al. “Ozone therapy as a treatment for low back pain secondary to herniated disc: a systematic review and meta-analysis of randomized controlled trials”. Pain Physician, 2012 MarApr;15(2):E115-29.

Maciocia, Giovanno. The Foundations of Chinese Medicine. Elsevier 2005.

Schoen, Allen, Ed. Veterinary Acupuncture. Mosby 1994.

HAVE A QUESTION ABOUT YOUR PRACTICE, A PATIENT, OR EVEN YOUR OWN PETS?

JOIN THE CONVERSATION! IVC JOURNAL EDITOR, DR. CHRISTINA CHAMBREAU, HOSTS A LIVE Q&A TWICE A MONTH ON FACEBOOK.

Graham, Helen; Vlamis Gregory. Bach Flower Remedies for Animals. Findhorn Press 1999.

Roman, Margo. Main Street Animal Services, Hopkinton, MA

DO YOU HAVE A STORY TO SHARE?

2-3pm EST Last Monday of the month Facebook.com/HealthyAnimalsVet 2nd Monday of the month Facebook.com/ AnimalWellnessMagazine

WE WANT TO PUBLISH YOUR STORIES OF MIRACULOUS RECOVERIES, HUMOROUS MISHAPS, AND FASCINATING CASES. Simply submit your story to socialmedia@redstonemediagroup.com for a chance to have it featured in

IVC Journal!

IVC Summer 2015

L ASER THER APY FOR

A NECROTIZING WOUND

– a success story

By Lisa A. Miller, DVM, CCRT Case and photos courtesy of Dr. Jeffrey W. Foltz, Dover Veterinary Clinic in Dover, Ohio An eight-year-old Labrador retriever was presented to Dover Veterinary Clinic after the owner noted partial weight bearing lameness and severe swelling in the left front leg. The patient had been chasing the family cat three days prior, and the owner assumed the dog had slipped on the floor. Initial examination and radiographs revealed only soft tissue swelling and pain on flexion and extension of the left elbow. A sprain/strain was suspected at this time. However, 72 hours after this initial presentation, the patient represented, now febrile with increased swelling and pitting edema extending from elbow to carpus. The patient was also now non-weight bearing and had evidence of a wound with severe tissue devitalization and avascular necrosis. Additional swelling was noted in the ventrolateral neck area. At this time, another family member recalled seeing the cat bite the dog and added that the cat had previously bitten another family member, resulting in hospitalization for treatment of “a rare bacteria”. Initial neck and leg wounds 11/6/14

The rapid progression and worsening of the dog’s symptoms along with this unusual history prompted a modification of the original treatment plan. Intensive case management with appropriate medical treatments (antibiotics, analgesics and wound care) as well as laser therapy was responsible for the patient’s ultimate recovery. The dog responded positively to the effects of laser therapy. Staff noted minimal drainage from the wound, and a lack of any putrid odor during bandage changes. Additionally, edema within the leg and neck resolved within days of starting treatment, and the patient remained comfortable, never bothering or chewing the bandage. The wounds healed rapidly and completely with very minimal scarring, and since the laser helped accelerate tissue repair and reduce fibrous scar tissue formation, no other skin grafts or surgeries were required after initial debridement.

11/26/14

Final treatment 12/19/14

The patient received 21 laser treatments over a period of seven weeks, initially beginning with a dose of 2,520 total joules to the entire affected area (target energy density of 4 to 5 J/cm2) and decreasing the dose as the wound area became smaller. “When [the patient] came to our clinic, we had only been using laser therapy for seven months,” says Dr. Foltz. “The dramatic improvements my staff and I witnessed [in this patient] as a result of laser therapy made us true believers in its ability to improve patient comfort and healing...[this] success story has caused me to re-evaluate how I practice veterinary medicine after 23 years. This case has challenged and encouraged me to look for ways to use the laser for many other conditions, as I want all my patients to benefit. With each case I find myself asking, ‘Could laser therapy help in this situation?’”

Recheck evaluation 1/15/15

Dr. Lisa Miller is a graduate of the University of Tennessee, College of Veterinary Medicine. She completed an internship in internal medicine, and became certified in canine rehabilitation therapy at the Canine Rehabilitation Institute. She practiced canine rehabilitation, sports medicine, neurological rehabilitation, and acupuncture for several years before returning to general practice. IVC Summer 2015

CANINE INFLUENZA OUTBREA K

– treating and protecting your patients the integrative way. By Barbara Royal, DVM, CVA

The recent outbreak of a virulent canine type A flu virus (H3N2) has caused a great deal of alarm in the Chicago area. Originally an avian virus that came from Korea in 2007, it has adapted to affect both dogs and cats.

• Feed a fresh, well-balanced diet, preferably raw and without chemicals, fillers and carbohydrates. • Ensure the animal receives regular exercise.

The virus causes upper respiratory signs – nasal discharge, cough, lethargy, decreased appetite and fever. It can progress to pneumonia and become lifethreatening. Not all dogs and cats show all signs.

• Consider supplements that help boost the immune system and fight inflammation, bacteria and viruses – these include turmeric, oregano, garlic and fish oils.

Because this current outbreak is not from the H3N8 flu virus (which was originally a horse virus), the currently available canine flu vaccine may not provide any protection to the H3N2 virus causing the outbreak.

ALTERNATIVE TREATMENT OPTIONS

PNEUMONIA IS BIGGEST ISSUE The biggest concern with this particular virus seems to be how it opens the respiratory system to secondary bacterial infection, making bacterial pneumonia a more common sequelae to the initial virus. Antibiotics with good pulmonary activity are typically needed to help fight bacterial pneumonia (Baytril and Clindamycin seem to work well). Holistic practitioners have found additional help battling this condition by using nutrition, herbs and essential oils. Many alternative treatments can be used to help bolster the immune system and decrease the progression of the virus into pneumonia. It is reassuring to note that this is a seasonal flu virus, and so far, most animals have recovered well with sensible attention to their care using holistic and/or conventional treatments.

AN INTEGRATIVE APPROACH TO PREVENTION • Avoid contact with animals that may be shedding the flu virus. • Avoid unnecessary vaccines and topical ﬂ ea and tick pesticides during a flu outbreak. Vaccines and

pesticides can temporarily distract or decrease the function of the immune system.

IVC Summer 2015

When an animal is showing flu signs, conventional medical treatment will include antibiotics, cough medicine, subcutaneous fluids and B vitamins. Alternative medicine options include the following:

1. Homeopathy Homeopathic viral nosodes, and other homeopathic combinations for flu and colds, like Oscillococcinum or Bryonia, are effective for reducing signs, lowering fever and improving upper respiratory condition. They are effective and safe – especially for cats. They include ingredients like Belladonna, Aconitium napellus, Echinacea angustifolia, Eupatorium perfoliatum, Gelsmium sempervirens, Ferrum phosphoricum and Inﬂuenzinum. Often, animals in an epidemic need the same remedy, so homeopaths find the genus epidemicus by listing the symptoms of all infected animals, then finding a remedy with which to begin treatment. It’s sometimes necessary to find the simillimum, the matching remedy for each individual animal, to both deeply heal from the virus and build overall health.

2. Chinese herbs and other supplements • Six Gentle Pets is a very effective Chinese herbal combination that can reduce phlegm and decrease coughing. • Colloidal silver, either in a nasal spray or oral, may also be beneficial. • Antibacterial and antiviral herbs and supplements can also be used separately.

3. Acupuncture Acupuncture and aquapuncture (with Traumeel or vitamin B12) may be helpful for the immune system, but the contagious nature of this virus makes it difficult to recommend repeated vet visits. Points should be chosen as dictated by exam, and may also include BL13 (wind/cold in lung), LU7, 9, 10 (circulation/clearing/ fever lung), GV14, 20 (immune system), BL10 (local release of muscle tension from cough), 11 (lung), and LI11 (wind invasion).

4. Massage Massage can often do what no medications can. It improves circulation, increases drainage of lymph and phlegm, and relieves pressure from inflammation. It also provides emotional support to an ailing animal. In addition to general massage techniques, animals can get relief from small circle massages around the eyes and face and over the neck, and from upward strokes across the thorax and ribs.

5. Steam with essential oils To help decrease coughing, put the pet on a bed on the bathroom floor for a few minutes, with a hot shower running nearby. Put three to four drops of any of the following essential oils on a cotton ball, and put it in the bathroom too: Thieves oil (also an effective antiseptic agent for surfaces) Eucalyptus oil Peppermint oil Sage oil Oregano oil The smell shouldn’t be too strong, just noticeable. Remember, an animal’s sense of smell is over 20x stronger than ours, so don’t stress him out with too strong a scent. Remember to caution the client against overheating the pet, especially if there is a fever involved. Given that the current canine flu vaccine is ineffective against the new virus, implementing these alternative approaches will help you treat and prevent illness and infection in your patients.

IVC Summer 2015

By Ihor Basko, DVM, CVA

HERBS OFFER SAFE, EFFECTIVE PAIN MANAGEMENT

Many pet owners want ways to relieve their animals’ pain without side effects. Commonly prescribed drug combinations do not always fully address the causes of a pet’s pain, often have unpleasant side effects, and cannot be used long-term. In contrast, an herbal approach to pain can address causes, has few to no side effects, and can be used over a long period. Pain often arises from intense stimuli that cause tissue damage, leading to the accumulation of inflammatory metabolic compounds in the area: histamines, prostaglandin-E, bradykinins, the metabolites from arachidonic acid metabolism (cyclooxygenases and lipoxgenases), and leukotrienes. Leukotrienes will result in chemotaxis, chemokinesis, the synthesis of super oxide radicals (ROS) and the release of lysosomal enzymes by phagocytes. This sets up a process of cyclic pain, starting at the sensory nerves through the spinal cord pathways to the brain, and is difficult to assuage unless all contributing factors are mollified. No one drug or herb can completely and effectively block this process. The veterinarian must understand the biochemical pathology and how it detrimentally affects physiology. When multiple tissues are involved, mollifying pain can be a challenge. NSAIDS are designed to control the release of prostaglandins, but therapeutic inhibition of the 5-lipoxygenase pathway is minimal. As a result, veterinarians are now adding opiates and other drugs to the pain control treatment plan. Because most dogs having issues with pain and chronic inflammation are older or geriatric, using NSAIDS, steroids or opiates long-term will often result in gastric and intestinal ulcers, vomiting, diarrhea, behavioral changes (from synthetic opiates) and liver damage. With long-term use, many NSAIDs will inhibit joint cartilage repair and regeneration and worsen the condition. Herbal formulas, alone and in combination, should be considered for pain management. Boswellia, for example, reduces inflammation through the inhibition of pro-inflammatory 5-lipoxygenase chemicals, thereby decreasing leukotriene synthesis. Boswellic acid and its derivatives have anti-inflammatory, anticarcinogenic and anti-ulcerogenic effects. Ginger has anti-inflammatory actions due to its inhibition of arachidonic acid and subsequent decreased syntheses of cyclooxygenase and lipoxygenase enzyme and leukotriene pathways. Active gingerols were shown in clinical studies to be more potent prostaglandin inhibitors than indomethacin and a number of NSAIDS. Relieving pain due to aging or any long-term inflammatory process requires a combination of antioxidants and a complementary blend of herbs to prevent DNA damage, facilitate repair, improve blood flow and circulation, decrease the sources of pain, and support liver function and detoxification. A multi-therapeutic plan is most beneficial and may consist of vitamins C and E, minerals such as selenium and manganese, and herbal formulas containing complementary blends of antioxidant and anti-inflammatory herbs like ginger, licorice, turmeric, yucca, noni, boswellia, alfalfa, cat’s claw, devil’s club and meadow sweet. The addition of joint repair supplements such as anti-inflammatory chondroitins from sea cucumber or perna mussel, and Omega-3 from fish or krill oil, may also be useful in conjunction with hydrotherapy, massage and acupuncture. Drugs alone will not satisfy the pain-quelling needs of patients, or support their health and longevity. Dr. Ihor Basko graduated from Michigan State University, and studied Chinese medicine, acupuncture, herbology and homeopathy. He joined the IVAS, and is a member of the AHVMA, AVMA and VBMA. Dr. Basko practices TCM/acupuncture and nutritional therapy in Hawaii.

IVC Summer 2015

From the AHVMA

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

Annual conference celebrates AHVMA’s 30th anniversary

ur annual conference runs October 17 to 20 in Augusta, Georgia, and we are planning an inspiring celebration for our 30th anniversary! Look for events, comedies, displays and information about our past 30 years – and the next 30 years. We are expecting a large turnout of members and exhibitors.

Find the entire conference schedule at ahvma.org/conferenceschedule; and link to the Exhibitors Hall at ahvma.org/exhibitor-map. AHVMA is a member of the AVMA House of Delegates. Because we’re an allied organization of the AVMA, many states grant blanket approval for AHVMA CE. The AHVMA is applying to RACE, RAIVE and individual states that do not grant blanket approval of CE. We will have a total of 104 hours of CE, with 24 As always, this year’s conference offers classes and workshops hours available to any one attendee. for veterinarians and technicians. Lectures and workshops encompass subjects such as: the efficacy of cancer treatments with Meeting today’s challenges herbal medicine; how essential oils affect resistant infections; The need for an informed holistic voice in veterinary medicine is how the immune system can be bolstered by acupuncture and becoming clear as we face global medical concerns. Demand is supplements; and much more. growing for holistic approaches to treat resistant infections, new Other popular activities include the annual Retreat (October 13 to 16 at Gravatt Camp and Conference Center in Aiken, South Carolina), the Herb Walk, the Newcomers’ Social, the Council of Elders Forum, and our fun-filled Sunday Banquet/Ball and Silent Auction. The auction is typically loaded with amazing items, from fashion and jewelry to practical medical books and devices. Proceeds benefit the AHVMFoundation’s student scholarship fund.

viruses, chronic debilitating musculoskeletal disorders, hormonal diseases, obesity, cancers, and overworked immune systems. Pet parents are looking to holistic medicine for prevention and first line defense rather than as a last resort when conventional medicine is unsuccessful.

Acupuncture, chiropractic, nutrition, physical rehabilitation, herbal medicine, homeopathy, ozone, shock wave, essential oils, massage, and many more holistic modalities are being used Our large Exhibitors Hall is an excellent place to collect by practitioners often enough to study them more and provide information on what’s new and how to use current products. Our better data on their efficacy. Our synergistic relationship with exhibitors are an integral part of our holistic family, providing the the AHVMF has allowed us to see larger grants and improved essential products and services we need to offer alternatives to funding for researchers in holistic medicine. The newly designed our patients. AHVMA website and our media relations team have established the groundwork for an even stronger veterinary network. In addition to cutting-edge continuing education provided by many world-class speakers, we offer a variety of Breakfast AHVMA is becoming increasingly involved as the leader, voice Meetings. These meetings are sponsored by organizations in and resource for integrative practice. Conventional practitioners, our industry. This year’s sponsors include: BioAge, Darwin’s the media and our own parent organization, the AVMA, have Natural Pet Products, Options for Animals, College of Animal found the AHVMA ready and able to discuss research, education Chiropractic, Vet Classics/Garmon Corporation, Primal Pet and options in an integrative approach. The AHVMA continues Foods, MultiRadiance Medical, VetriScience, O3 Vets, Nature’s to be a positive force in providing effective holistic solutions for Variety, Thor and the AHVMF. the many challenges we face in veterinary medicine today.

IVC Summer 2015

tech talk

INTERESTED IN

ANIMAL

behavior? By Pat Miller, CBCC-KA, CPDT-KA

Becoming a veterinary behavior technician adds value to your credentials. Veterinary technologists and technicians are invaluable members of any clinic staff. They perform a multitude of procedures under the supervision of licensed veterinarians and assist in the diagnosis and treatment of animal injuries and illnesses. Techs can also specialize in areas of particular interest, including (but not limited to) nutrition, dentistry, internal medicine, pharmacy, and a relatively new kid on the block (recognized in 2008 as an area of specialty) â&#x20AC;&#x201C; animal behavior. Behavior has long been the neglected stepchild of veterinary medicine. While many clients look to their veterinary IVC Summer 2015

A sampling of clinic behavior programs

Here are just a few of the behavior programs and services you could offer your clinic as a VBT.

1 2

Pre-adoption counseling – Many behavior problems can be avoided by helping your clients select an animal companion – species and breed – that’s well-suited to their lifestyle. You can help them establish reasonable expectations, and set them up for success from the outset with appropriate management and training programs for their new family members. Fun vet visits – One of the reasons so many dogs behave badly at your clinic is that every visit involves some degree of stress and pain: restraint, exams and manipulation, vaccinations, poking and prodding. If every stressful visit was offset by several fun visits, dogs could stay happy about going to the vet. Fun visits can be simple – for example, the owner drops by with her dog several times a week for a round of “feed treats and play”. Or they can be more formal, such as enrollment in a regular daycare program.

Clinic daycare – A well-run clinic daycare program can turn your canine clients into your biggest fans. Conditioning to routine handling practices can be included as part of the daycare package, or as add-ons for an additional fee. Look – it’s fun to hop up on the scale! Good stuff happens when you’re on the exam table! Paw-handling is a great game! Thermometers, stethoscopes and otoscopes make yummy treats appear!

Good manners training and behavior modification – While you’re at it, offer basic good manners training for your clients. Daycare staff can use positive reinforcement to teach dogs to sit, lie down, walk nicely on a leash, greet people politely, and come when called. You can also work with daycare dogs with identified behavioral challenges. And offer good manners classes, in which you teach clients how to use modern, positive reinforcement-based training methods to help their dogs become well-mannered canine citizens. This also strengthen the human-animal bond necessary to ensure lifelong loving homes.

5 6

Client homework – Your clients can do a lot with their pets at home to make clinic visits easier. Collect, create and offer handouts to help them help their pets develop a positive association with pawhandling in preparation for nail trims, ear-touching for ear exams, and more. Behavior consults – Inevitably, your clinic will see animals that have significant behavioral issues, including everything from barking, digging and house soiling, to chewing, anxiety and aggression. With proper education and experience, you can help clients overcome many of these behavioral challenges, and salvage relationships that might otherwise end badly, with a pet being rehomed or even euthanized.

7 8

Staff training – A large and growing body of knowledge surrounds low-stress handling methods for veterinary practices. Share this information during staff in-service training sessions so clients benefit from the most up-to-date advice on humane handling and care for their animal companions. Public seminars – Offer free monthly seminars to the general public on a variety of behavior and training topics for all species. This is a great way to disseminate accurate behavioral information to your community as well as attract new clients to your practice.

IVC Summer 2015

professionals for behavioral advice, most veterinary schools and vet tech courses have been decidedly lacking in providing or requiring comprehensive courses about behavior. There are, of course, boarded veterinary behaviorists who are very knowledgeable on the subject, as well as non-boarded, welleducated veterinarians who specialize in behavior. However, far too many veterinarians doing their level best to answer client questions still rely on old-fashioned folklore or television show drama for their behavior and training knowledge. As a result, clients may receive well-intentioned but scientifically unsound, ineffective and sometimes dangerous advice. Fortunately, as the need for quality behavior professionals has become more evident, this unhappy state of affairs has begun to change. As a vet tech, you can seize this opportunity to expand your knowledge base, and add to your market value, by becoming a certified veterinary behavior technician (VBT). This field is wide open, and a trained VBT is a tremendous asset to any veterinary practice.

MODERN SCIENCE-BASED TRAINING AND BEHAVIOR Far removed from old-fashioned methods that focused on punishing an animal for purportedly willful misbehavior and alleged “dominanceseeking”, the field of modern, science-based training and behavior recognizes that animals offer unwanted behaviors for a variety of legitimate reasons:

 They’re frightened and defensive  They’re stressed and anxious  They have not been taught or reinforced for desirable behaviors

r They have been reinforced (deliberately or inadvertently) for undesirable behaviors. The appropriate response to any of these is to: • Manage the environment to prevent over-threshold exposure to fear and stress-causing stimuli • Manage the environment to prevent reinforcement for unwanted behaviors • Implement appropriate behavior modification protocols to change associations with and responses to fear and stress-causing stimuli • Implement appropriate training programs to teach/reinforce desired behaviors. In short, today’s science-based training emphasizes the value of programs that focus on reinforcing desirable behaviors rather than suppressing unwanted behaviors or coercing behavior through the use of force, intimidation or pain. An educated behavior professional recognizes that old-fashioned force-based methods carry a high risk of behavioral baggage such as fear, avoidance and aggression. Armed with the knowledge and experience a good behavior program will provide, you’ll be able to help clients identify and appropriately address behavior problems and, equally important, prevent them from occurring in the first place. You will also be able to influence your clinic’s practices and move toward the low-stress handling methods advocated by the late veterinary behaviorist Dr. Sophia Yin, who was a champion of improving

Working with a client to teach her dog how to file her own nails, using a canine emory board. (see sidebar next page).

Teaching a client to trim his dog’s nails without restraint. Involves allowing the dog to sit in a natural and comfortable position.

IVC Summer 2015

levels of behavioral knowledge in veterinary settings. You can develop programs for your employer’s clinic that will provide additional revenue streams while helping to ensure behaviorally healthy patients. (See sidebar on page 32.)

GETTING STARTED Up for the challenge? According to VetTechEDU, once you have obtained your degree and passed the licensing exam qualifying you as a veterinary technician or technologist, you should acquire additional education to excel in your VBT specialty. While no special education or certification is required in order to work professionally in animal behavior, credentialing in this field gives you more credibility and increases your value (read “bigger paycheck”) and effectiveness. Many veterinary facilities show preference for a VBT who is certified; it’s a confirmation that you have an advanced level of expertise in your field.

Low-stress handling example: nail trimming

Many clients bring their dogs to the veterinarian for the simple husbandry procedure of nail-trimming, either because they aren’t comfortable doing it themselves, or because the dog resists the procedure. It’s common practice (although not universal) for clinic staff to muzzle and forcibly restrain dogs in order to get the trimming done with minimal risk to humans. But it’s not necessary. Rarely is nail-trimming an emergency procedure. If your clinic is already committed to promoting a behaviorallythoughtful environment, clients and staff are likely to be open to a new approach to nail trimming. Here are some alternatives to forcible restraint:

Voluntary compliance: Some dogs aren’t as stressed about the trimming itself as they are about the restraint. A percentage of your canine clients will be surprisingly compliant about the procedure if you simply have them lie on the exam table (or the floor, if the table is stressful for them). With front paws extended forward in the normal “down” position, toenails are accessible and the dog’s paws don’t need to be restrained in order to clip the claws. You can then use a treat to encourage the dog to rock onto one hip, making the hind paw nails accessible for trimming – again, without restraint.

2 3

Counter conditioning: Of course, other dogs do find the actual clipping procedure very aversive. You can provide your clients with a written counter conditioning protocol designed to give their dogs a positive association with clippers and the clipping procedure. Alternatively or additionally, offer the behavior modification as an additional service, for a fee. Canine emory board: You can easily construct a doggie nail file by affixing self-adhesive sandpaper-like stair tread material to a wooden board. Show your clients how to reinforce the dog for scratching at this board (thus filing his own nails), or provide the training yourself as an additional service, for a fee.

Both the Society of Veterinary Behavior Technicians (SVBT) and the National Association of Veterinary Technicians in America (NAVTA) can guide you in your search for proper education. The Academy of Veterinary Behavior Technicians (AVBT) offers a program that takes two to five years for certification. In order to become certified through AVBT, you will need to show proof of graduation from an accredited vet tech program, and have at least 4,000 hours or three years of experience as a vet tech, with behavioral experience that also includes clinical and research experience. Another requirement for certification is documented proof of 40 hours of continuing education, as well as 50 case logs, in the behavior field. Five of those cases need to be detailed from diagnosis through treatment solutions. You also need two letters of recommendation from veterinary professionals, and should be a member in good standing with the NAVTA and SVBT. These two organizations offer reading lists that can help you prepare for the certification exam. The North American Veterinary Community (NAVC) holds an annual conference with an excellent behavior track, as do several regional veterinary conferences. Vet techs are always welcome and well-represented at these events. For additional credibility and credentialing, consider taking the exam to be a Certified Professional Dog Trainer and/or a Certified Behavior Consultant, Canine, through the Certification Council for Professional Dog Trainers. These certifications each require you to sit for a written exam, and provide documentation of 300 hours’ experience and a supporting statement from a CCPDT certificant or a veterinarian. Once you are certified, countless opportunities are available to you, from working in veterinary clinics, to zoos and animal parks, laboratories and more. Because there’s a shortage of trained, certified behavior professionals, there will be a demand for your services as a VBT. You could be on the verge of an exciting new step in your career as a vet tech. Are you ready?

Resources Here are some websites that can provide you with additional educational resources and information on becoming a VBT: Academy of Veterinary Behavior Technicians, avbt.net Certification Council for Professional Dog trainers, ccpdt.org National Association of Veterinary Technicians in America, navta.net North American Veterinary Community, navc.com Society of Veterinary Behavior Technicians, svbt.org VetTechEDU, vettechedu.com Western Veterinary Conference, wvc.org

IVC Summer 2015

VITAMIN D IN DOGS AND CATS By Robert J. Silver, DVM, MS

An insuﬀiciency is associated with a range of disease states.

In recent years, researchers have uncovered new findings about vitamin D in dogs and cats. Diseases such as congestive heart failure, neoplasia, renal disease, infectious illnesses, IBD, and feline oral resorptive lesions (FORL) are all associated with low stores of vitamin D in these animals. Vitamin D primarily regulates the absorption of calcium and phosphorus from the bowel, and in concert with calcitonin and PTH, regulates calcium homeostasis. Vitamin D also has an antiinflammatory effect in the tissues where it is active. Chronic inflammation underlies many chronic conditions, including neoplasia and immune-mediated disease. It is apparent that serum vitamin D levels high enough to prevent the development of rickets are still insufficient for maintaining cellular health and dampening inflammatory processes.

NORMAL RANGES OF SERUM VITAMIN D3 In a landmark study involving 282 German shepherds and golden retrievers, Selting et al (2014) established optimal ranges for vitamin D in dogs. Following protocols used in human studies, 25(OH)D3 was measured along with four other biomarkers: canine C-reactive protein (cCRP), intact parathyroid hormone (iPTH), calcium and phosphorus. The study examined the inverse relationship between 25(OH)D3 and iPTH, as well as the anti-inflammatory effects of vitamin D by measuring cCRP. This study established that vitamin D sufficiency is obtained when blood levels reach 100 to 120 ng/mL and helped further define deficiency, insufficiency and sufficiency.

INSUFFICIENT VITAMIN D MAY BE A RISK FACTOR FOR NEOPLASIA • Wakshlag et al (2011) found that Labrador retrievers with cutaneous mast cell tumors had significantly lower serum concentrations of 25(OH)D than unaffected controls (42 ng/ mL versus 48 ng/mL). • Husbands (2013) reported that median serum 25(OH)D concentrations were significantly lower in dogs with cancer versus dogs without. He evaluated 335 dogs with cancer and found a median 25(OH)D concentration of 62.6 ng/mL as compared to 67.4 ng/mL in the control group. Additionally, it was reported that cancer types associated with significantly lower 25(OH)D levels were: carcinoma, histiocytic sarcoma, hemangiosarcoma, lymphoma and sarcoma. • Selting et al (2014) measured the serum concentrations of 25(OH)D in 62 dogs presenting with hemoabdomen due to neoplasia, and compared them to 282 healthy dogs without neoplasia. The relative risk of splenic neoplasia was found to be inversely proportionate to 25(OH)D concentrations.

SUMMARY Based on the evidence that vitamin D insufficiency creates a greater risk for chronic disease, vitamin D testing and supplementation should become part of annual wellness programs and testing protocols. By sampling patients for vitamin D status at the same time each year, when heartworm and other preventative tests such as vaccine titers are performed, clinicians can identify dogs and cats at higher risk, and through oral supplementation and retesting, establish long-term vitamin D sufficiency, and with it a reduced risk of developing chronic disease.

Dr. Robert Silver has pioneered the use of diet, herbs and nutraceuticals in his integrative veterinary practice in Boulder, Colorado for the past 25 years. He is a consultant to the pet food and medical cannabis industries and Chief Medical Officer of RxVitamins for Pets. Dr Silver writes and speaks to veterinary audiences on the value of blending holistic modalities with conventional medicine. IVC Summer 2015

industry innovations Colostrum for aging issues

Phycocyanin fights free radicals

Keeping their beloved pets full of youth and vigor is your clients’ main goal. So when arthritis and other symptoms of aging cause patients pain and limit their mobility, reach for the only clinically proven, veterinarian approved colostrum supplement – Colostrum-LD® from Sovereign Laboratories. It comes from certified healthy, hormone/ antibiotic/pesticide-free pasture-fed cows and is minimally processed. Colostrum-LD helps stop the destruction of joint tissue and assists pets to age well.

Phycocyanin is a natural antioxidant derived from blue-green algae. It has powerful free radical-scavenging properties that can support the body’s normal defenses against cellular damage and inflammation. Phycox Soft Chews from Dechra Veterinary Products includes phycocyanin as well as glucosamine, MSM, Omega-3s, creatine and other nutrients to help support bone, muscle and joint health in active dogs or those of any age that require moderate joint support. Dechra-US.com

ColostrumTherapy.com

Help for cognitive dysfunction

CE correspondence courses

The population of older pets is growing, and with it comes a responsibility to provide for their care. Because of this aging population, dementia and cognitive dysfunction are seen more often in canine patients. That’s why Herbsmith formulated Senior Dog Wisdom. Based on cutting-edge research, these soft chews help support cognitive health in aging dogs by providing nutrients such as alpha lipoic acid, L-carnitine, and phospholipids. Available in 60 count small and 60 count large chews.

The Rocky Mountain School of Animal Acupressure and Massage is offering the following correspondence courses: Equine and Canine Massage, Aromatherapy and Essential Oils for Animals, Large and Small Animal Acupressure Theory, Canine Anatomy, Equine Anatomy, Being an Effective Practitioner – Building your Chi, and many others. Courses start at $150 and are self-paced with an 18-month completion time. These classes are approved by IAAMB and NBCAAM as continuing education and/or electives.

HerbsmithInc.com

RMSAAM.com

IVC Summer 2015

Meeting your ultrasound needs

Flower essences calm and comfort

Advanced Ultrasound Electronics has launched a new division for veterinarians. Advanced Veterinary Ultrasound meets the growing ultrasound needs of the veterinary community â&#x20AC;&#x201C; from parts and service to repairs and maintenance. It offers new and refurbished system sales, a large inventory of new and refurbished parts, in-house technical repair services, and a trained field service staff. AVU specializes in GE, Philips, Siemens, Toshiba, Esaote and other popular ultrasound systems.

Many situations cause stress and anxiety in animals, from moving house and bereavement to travel, illness, trauma, and being in a shelter environment. Animal Relief Formula from Flower Essence Services was formulated on the principles of Dr. Edward Bach, the founder of flower essence therapy. It contains a blend of 12 essences such as Arnica, for recovery from shock and trauma; Bleeding Heart, to help with abandonment and separation issues; and Red Clover, to ease anxiety and panic.

AdvancedVeterinaryUltrasound.com

FESFlowers.com

Certification course in acupuncture The International Veterinary Acupuncture Society offers a summer acupuncture course in Richmond, Virginia, beginning in June. The Certification Course in Basic Veterinary Acupuncture covers both the scientific basis for acupuncture and the Traditional Chinese Medicine view. It provides clinical application for small and large animals, avian and exotic species. Graduates are prepared for more advanced study of veterinary acupuncture from either a scientific or TCM perspective, and can also pursue the study of Traditional Chinese Herbology. IVAS.org

IVC Summer 2015

nutrition nook

Supplements every pet

needs

By Jean Hofve, DVM Many doctors graduate from veterinary school thinking that processed foods have all the nutrients dogs and cats need for good health. As they begin to realize that cooking and processing produce inferior nutrition, they may recommend better quality or fresher food (homemade, raw, freeze-dried, etc.). But even when such diets contain a full complement of vitamins, minerals and other required nutrients, there is still plenty of room for improvement. In fact, no matter what type of pet food you recommend to your clients, a few specific supplements will complement and improve every diet for every animal, and provide a major boost to diet quality.

OMEGA-3 FATTY ACIDS

Polyunsaturated fatty acids (PUFAs) play many roles in the body, but only two fatty acids are considered essential: linoleic acid (LA, an Omega-6) and alpha-linolenic acid (ALA, an Omega-3). All others can, at least theoretically, be produced in the body from those two precursors. The Omega-3s that get the most buzz are eicosapentanoic acid (EPA) and docosahexanoic acid (DHA). Neither is considered essential, although DHA is needed during growth in puppies and kittens, so itâ&#x20AC;&#x2122;s a required ingredient in commercial puppy and kitten foods. But the only meat that contains any EPA/DHA (and even then, perhaps not enough) is 100% grass fed meat. All the rest is feedlot finished or grain-raised, and therefore contains virtually zero EPA/DHA. The vast majority of plant-based oils are in the form of Omega-6 fatty acids, which are typically over-supplied in our petsâ&#x20AC;&#x2122; diets. Flaxseeds and a few other seeds and nuts also contain Omega-3 alpha-linolenic acid (ALA). ALA has beneficial effects of its own, particularly on skin and coat health. However, even though ALA is technically a precursor of EPA and DHA, dogs and especially cats have an extremely limited capacity for converting it (no more than 1% to 2% for EPA and virtually 0% for DHA after weaning). Only marine-sourced oils (fish oil, cod liver oil, krill oil, green-lipped mussel oil, and some algae oils) contain the pre-formed EPA and DHA that our carnivorous animals can absorb and utilize. Cats and dogs must receive EPA and DHA directly.

IVC Summer 2015

• EPA is important for cell membrane ﬂ uidity, circulation, skin health and immune system function. It has powerful anti-inflammatory effects, is helpful for many inflammatory and degenerative conditions, and is specifically beneficial for chronic kidney disease, arthritis, feline asthma, dermatitis and cancer. • DHA is the most abundant fat in the brain, and the main component of myelin. It is crucial for nervous and visual system development. Research suggests that DHA deficiency may even play a role in anxiety, hyperactivity and aggression; supplementation may be helpful in these cases.

Keys to selecting a good Omega-3 product • Look for products made from wild (not farm-raised) fi sh that are harvested sustainably, or from clean, cultivated mussels or algae. • Cod liver oil should be free of added vitamins A and D, which can reach toxic levels in small animals. • Products should be independently tested for freshness. • They should be free of toxins such as mercury, PCBs and dioxin, which are widespread in the world’s oceans. I recommend the Nordic Naturals (nordicnaturals.com/petVet/) line of pet products for their freshness, purity, and outstanding veterinary support.

DIGESTIVE ENZYMES

Digestive enzymes break down foods so they can be absorbed and utilized by the body. When food is not properly broken down, larger particles can enter the bloodstream and set off an immune response that may lead to inflammation, allergies, and other chronic health problems. Digestive enzymes also improve digestion, reduce gas, help regulate weight, and in the case of proteolytic enzymes, decrease inflammation throughout the body. Normally, the pancreas supplies these needed digestive enzymes, although production slows as animals get older. Raw foods contain many enzymes, including an array of digestive enzymes within cellular lysosomes. Cooking denatures enzymes. Supplemental digestive enzymes are especially needed by animals eating processed commercial pet food (in addition to any enzymes listed on the label). Geriatric animals may also benefit, even if they’re on a raw food diet. Digestive enzymes may also be useful in the treatment of parasites such as giardia, and may prevent the pancreatic hypertrophy that can result from eating a processed diet. Continued on page 40. IVC Summer 2015

Keys to selecting a good probiotic product • Look for a supplement containing at least Lactobacillus and Bifidobacteria. • There should be a label guarantee of live microorganisms. • The product should be of sufficient potency (at least 100 million per dose).

Note: Many products combine digestive enzymes with

probiotics, and these can be a good, cost-effective choice, especially for fussy pets who are difficult to supplement.

4 Continued from page 39.

Keys to selecting a good digestive enzyme product • Look for one from a plant or fungal source, in order for it to work in the widest range of pH and temperature. • It should contain, at least: protease, amylase, lipase and cellulase.

PROBIOTICS

Probiotics include beneficial bacteria such as L. acidophilus and certain Bifidobacteria, Enterococcus and Streptococcus species. Probiotics help keep normal gut bacteria balanced and healthy. The intestinal microbiota is an essential part of overall health. Constant back-and-forth interaction occurs between the gut bacteria and brain through neural, endocrine, immune and humoral links. A balanced gut ecology has implications for not only physical but also emotional and mental health. It prevents pathogenic bacteria from gaining a foothold; produces B vitamins, vitamin K, and short-chain fatty acids; and supports normal immune system function. Supplemental probiotics have benefits for allergies, including atopy, food allergies, and inflammatory bowel disease. They are also helpful for pets with any type of digestive problem, including vomiting, diarrhea, constipation, IBD, colitis, and even hairballs. Probiotics are also essential for animals who are, or have been, taking antibiotics (including natural antimicrobial therapies such as herbs, medicinal mushrooms, colloidal silver, etc.). Continue probiotic supplementation for at least two weeks after treatment. Unfortunately, testing has found that many pet foods and supplements claiming probiotics contain few, if any, live organisms.

IVC Summer 2015

ANTIOXIDANTS

The function of antioxidants is to scavenge and neutralize oxygen free radicals. Cells make controlled quantities of free radicals as weapons against viruses, fungi, bacteria and abnormal cells. However, excess unbalanced free radicals create oxidative stress, which can damage normal cells and create chronic inflammation. Processed pet foods are typically high in pro-inflammatory Omega-6 fatty acids, so supplementing with antioxidants is very important. Free radical damage is at the root of virtually all degenerative and inflammatory diseases, as well as many we don’t necessarily think of as involving inflammation, such as diabetes, cancer, hypothyroidism, heart disease, and cognitive dysfunction. By reducing oxidative stress, antioxidants likely have value in disease prevention as well as treatment. However, the mechanisms are complex, and robust scientific proof is still lacking. Nevertheless, antioxidants can universally be considered helpful for most inflammatory and immunemediated diseases.

Further considerations

Getting supplements – especially multiple supplements – into the patient is always a challenge in veterinary medicine. Palatability can be a real problem. Products formulated for pets are often better accepted, but may have issues with potency and viability. Supplements are poorly regulated, and overblown (if not downright fraudulent) claims are rampant. Clients often come in with lots of ideas from Dr. Google and friends, and it’s hard to judge the validity and value of products you’ve never heard of. Fortunately, reputable companies back up their products with good research; Thorne, VetriScience, Nordic Naturals and Standard Process come immediately to mind. Products bearing the NASC seal have passed rigorous standards and can be relied on. And knowledgeable colleagues are an invaluable resource that can be reached nearly 24/7 through the CAVM-List, Veterinary Information Network, and other forums.

Advertorial

Keys to selecting a good antioxidant product • It should contain multiple antioxidants, such as vitamin E, carotenoids (e.g. beta-carotene and lycopene) and flavonoids (like Vitamin C and quercitin). • Look for a natural or whole food-derived product, rather than one that’s chemically synthesized. Natural products are typically found in l-form as opposed to d- or dl-form; for example, d-alpha tocopherol is a synthetic product. • Plant and fungal sources may be more bioactive. • For cats, avoid products containing alpha lipoic acid, due to toxicity concerns.

VetzLife All-Natural News Stomatitis in cats Also known as “oropharyngeal inflammation”, stomatitis involves severe, painful inflammation of the gums and other oral tissues. The exact cause is unknown, but some cats may have a hypersensitivity or allergic reaction to bacterial plaque. Other contributors could include environmental stress, diet and genetic predisposition. Symptoms include irritability, aggression, depression or reclusiveness. The cat may drool excessively and have difficulty eating. She will often have bad breath (halitosis) and may not groom herself adequately. Gums bleed very easily, and she may paw at her mouth and grind her teeth.

Incorporating these four supplement categories into your patients’ diet regimes, regardless of what food they’re eating, will help ensure overall optimal health.

References Carabotti M, Scirocco A, Maselli M, et al. “The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems”. Ann Gastroenterol. 2015 Apr-Jun;28(2):203-209. Edakkanambeth Varayil J, Bauer BA, Hurt RT. “Over-the-counter enzyme supplements: what a clinician needs to know”. Mayo Clin Proc. 2014 Sep;89(9):1307-12. doi: 10.1016/j.mayocp.2014.05.015. Epub 2014 Aug 4. Fetterman JW Jr, Zdanowicz MM. “Therapeutic potential of n-3 polyunsaturated fatty acids in disease”. Am J Health Syst Pharm. 2009 Jul 1;66(13):1169-79. Firuzi O, Miri R, Tavakkoli M, et al. “Antioxidant Therapy: Current Status and Future Prospects”. Curr Med Chemistry. 2011;18:3871-3888. Grześkowiak Ł, Endo A, Beasley S, Salminen S. “Microbiota and probiotics in canine and feline welfare”. Anaerobe. 2015 Apr 8;34:14-23. Hajhashemi V, Vaseghi G, Pourfarzam M, et al. “Are antioxidants helpful for disease prevention?” Res Pharm Sci. 2010 Jan-Jun; 5(1): 1–8. Hickman MA. “Interventional nutrition for gastrointestinal disease”. Clin Tech Small Anim Pract. 1998 Nov;13(4):211-6. Howell E. Enzyme Nutrition: The Food Enzyme Concept. New York, NY: Penguin Press. 1985. Konturek PC, Brzozowski T, Konturek SJ. “Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options”. J Physiol Pharmacol. 2011 Dec;62(6):591-9. LeBlanc CJ, Horohov DW, Bauer JE, et al. “Effects of dietary supplementation with fish oil on in vivo production of inﬂammatory mediators in clinically normal dogs”. Am J Vet Res. 2008 Apr;69(4):486-93. Roxas M. “The role of enzyme supplementation in digestive disorders”. Altern Med Rev. 2008 Dec;13(4):307-14.

During the oral exam, which needs to be done under anesthesia, multiple lesions are seen. They can be on the gums, the roof or back of the mouth, tongue or lips. Sometimes, tooth resorption is seen. Radiographs of the mouth are necessary, and often show moderate to severe periodontal disease. Cats with juvenile onset gingivostomatitis may respond to an intense program of oral hygiene that includes regular dental cleaning, daily home care, good nutrition, etc. Mature cats with gingivostomatitis are less likely to respond to conservative treatment. In cats with more extensive disease, the current protocol is to extract all the teeth. Cats can manage ﬁne with no teeth, and it is much better than leaving them in severe pain. A holistic alternative to try before extraction is VetzLife Feline Oral Care Gel for Stomatitis. Amazing results have been reported in less than seven days, with complete cures in as little as six weeks. Article provided by VetzLife/PetzLife all-natural products (VetzLife.com or 1-888-453-4682).

Tou JC, Altman SN, Gigliotti JC, et al. “Different sources of Omega-3 polyunsaturated fatty acids affect apparent digestibility, tissue deposition, and tissue oxidative stability in growing female rats”. Lipids Health Dis. 2011; 10: 179. Wysong RL. Rationale for Animal Nutrition. Midland, MI: Inquiry Press. 1993; pp. 44-46.

IVC Summer 2015

Tui-Na:

Chinese medical massage By Michelle C. Schraeder, DVM, MEd, FAAVA

Charlie receives Nie fa – the skin and muscles are grasped with the thumb and ﬁngers, and lifted (see page 44).

The earliest documentation of Traditional Chinese Medicine (TCM), written about 2,500 years ago, includes among its five branches Tui-na or Chinese medical massage. Tui-na (pronounced twee-nah) utilizes massage manipulations that stimulate acupressure points or surface regions of the body to: • restore physiological balance by re-establishing flow to the channels and collaterals • promote blood circulation • regulate Yin and Yang All branches of TCM view the body as an integrated whole (this, holistic medicine), and the theories of Yin and Yang, five element, and meridian/channel all embrace this basic concept. By restoring balance, Tui-na supports the body’s natural functions to combat excess or deficient conditions as needed. It helps keep Qi and blood moving freely, strengthens tendons, ligaments and muscles, promotes normal function, and eliminates fatigue.

HISTORY OF TUI-NA AND OTHER ORIENTAL MASSAGE TECHNIQUES While Tui-na originated in China, it spread via trade missions to other countries like Japan and Korea during the sixth century,

IVC Summer 2015

Cou fa is great for paresis or paralysis and helps a normal return to function.

and became the basis for the myriad of Oriental bodywork styles that exist today, including Shiatsu, Thai, and Indonesian massage. Like Tui-na, all these forms consider the body from a holistic perspective, as a whole. Swedish and other Western types of massage, on the other hand, are based more on treating a particular symptom or injury. However, Western massage texts do refer to methods that have similarities to various Tui-na techniques. Goats1 reviewed previous research on the mechanism of action for different Tui-na techniques: • Effleurage – to slide or glide over skin with smooth stroking hand movements, frequently at the beginning and end of a treatment session. With effleurage techniques, gradual compression reduces muscle tone and induces a general state of relaxation that relieves muscle spasm and prepares the patient for more vigorous treatment. Firm pressure accelerates blood and lymph flow, improves tissue drainage and thus reduces recent swelling. Rapid strokes have the opposite effect and will increase muscle tone, which can be useful for competition. • Petrissage – to lift, wring, or squeeze soft tissues in a kneading motion, or to roll tissues. Petrissage is particularly useful for

stretching contracted or adherent fibrous tissue, and will relieve muscle spasm. It also promotes the flow of body fluids and can resolve long-standing swelling. Kneading promotes the flow of tissue fluid and causes reflex vasodilation and marked hyperemia, thus reducing swelling and inflammation. Vigorous kneading decreases muscle spasms and can stretch tissues shortened by injury. • Friction – to rub superficially to create heat, or deeper to stop tissue adhesions. The localized stretching and degradation of collagen caused by friction techniques can restore fibers to a more normal alignment during the remodeling phase of healing. • Tapotement – to perform percussive massage techniques that trigger cutaneous reflexes and cause vasodilation. Much research has been done, mostly in humans, on the various types of massage. One “high-quality study” that compared acupuncture massage (Tui-na) with classic Swedish massage showed that acupuncture massage was superior (irrespective of the type of exercise received) on measures of both pain and function.2 The claim that Tui-na influences health through organ effects may be explained by the activation of autonomic nervous system effects on the organs via stimulation of the afferent pathways and the subsequent efferent influence on tissues and organs.

TUI-NA IN PRACTICE Let’s look at a specific example of how Tui-na might work in practice. Back pain is a common problem whether you are a human or animal. The Western or conventional approach would be to prescribe anti-inflammatories, rest, and possibly surgery. Back pain comes with tension in the back muscles and eventual weakening of the legs. Tui-na and other massages can help manage chronic pain by relieving it directly through muscle relaxation, and indirectly through stressreducing mechanisms. These include the enhancement of parasympathetic nervous activity, and the activation of inhibitory mechanisms that suppress pain, increase relaxation, and improve sleep.3 As a potent mechanical stimulus, massage is a particularly effective trigger for short-lived analgesia from the “pain gate” mechanism.1 Longer-lasting pain control, which happens via the “descending pain suppression mechanism” and results in endorphins being released from the brain during massage, brings about both Continued on page 45.

How Tui-na affects Qi

In Chinese medicine, Qi is collectively referred to as the vital energies of the body. Qi and Blood stagnation (lack of movement) can result in pain, stiffness, emotional stress, anger, frustration, depression, various organ diseases, and masses. Through many types of body manipulation, Tui-na seeks to move Qi and/or Blood to relieve pain. Since excess emotions and life stresses can also affect Qi flow, one can achieve emotional and physical balance and provide rest and relaxation for the patient by restoring the free flow of Qi.

IVC Summer 2015

Technique

Movement

Benefit

Gliding or Swinging Finger or palm rubs gently and loosely A good introductory and safe technique. 1. Circular Rubbing (Mo fa) over the area in a circular motion at about Useful for the very debilitated and geriatric (one of the original ancient techniques) 120 times/minute. Apply slowly to tonify, animal. and briskly to sedate, move or clear.

Mo fa

2. Pushing (Tui fa)

Tui fa Picking Up and Squeezing 1. Pinching (Nie fa)

Nie fa

2. Grasping/Pulling (Na fa)

Fingers, palms or fists held in various Relaxes tendons and improves circulation; especially good for lateral muscles along positions are pushed over the skin. spine (inner Bladder channel). Because many animals will react negatively to this technique, it should be preceded by others, such as Ca Fa, to relax the animal and his muscles first (see below). The thumb opposes a finger and pinches the treatment area deeply but gently and quickly, without the palm making contact with the skin.

A simple technique often taught to owners to do at home on the backâ&#x20AC;&#x2122;s Du channel, and bilaterally on the inner Bladder channel. May be applied locally to any area of adhesion and stagnation.

Forcefully grasp the skin and muscle with By grasping with the thumb and forefinger in thumb and fingers, and lift. Increase pressure opposition, you can used this technique to treat any acupuncture point or Ah shi point. gradually with repeated grasping at site.

Na fa Kneading 1. Rotary Kneading (Rou fa)

Move the balls of one or two fingers or the Good for all species and for making friends. heel of the palm in a circular motion so that the hand/finger does not slide over the skin, but pulls it along at about 120 times/ minute. Deeper and more penetrating than the circular rubbing of Mo fa.

Rou fa 2. Broad Circular Kneading (Yun fa)

Like Rou fa but uses the forearm or elbow Especially good on horses and other larger to treat a larger area. species.

Yun fa Warming With Friction 1. Friction rubbing (Ca fa)

Rub gently and rapidly back and forth over Useful for geriatric animals and can be easily the skin until patient feels heat, without applied by owner at home. moving underlying muscles.

Ca fa 2. Piston Rubbing/Kneading (Cuo fa)

Cou fa

IVC Summer 2015

Using both hands, friction rub in opposite Great for Wei syndrome and paresis/ directions going back and forth or up and paralysis, and essential for normal return to down, like the pistons of an engine. If done function after nervous system trauma. on a leg, it looks like making a breadstick, with hands on opposite sides of the leg.

Contraindications

It’s inadvisable to perform Tui-na: • Directly on inflamed or broken skin • On brittle bones • D uring pregnancy on lower back or abdomen, and on certain acupuncture points contraindicated in pregnancy • At acute fracture sites • On very old and very weak patients.5,6 Continued from page 43. mental and muscular relaxation. Increased heat and local circulation from vasodilation help to further reduce pain and speed healing. The subsequent outcome is a feeling of vitality and well-being.

INDIVIDUAL TECHNIQUES Tui-na techniques focus on specific painful sites, acupressure points, meridians, and muscles and joints. Each of these techniques has aspects of quantity (duration and force) and quality (evenness and softness). For equipment, all you need are your fingers, hands, elbows and knees. The sampling of techniques in this article (see chart at left) is grouped by type of motion.4,5 Many of the movements are not difficult, so we can empower clients to become part of the healing process – something every caring animal owner desires. Often, I briefly demonstrate these techniques on owners so they better understand them.

CONCLUSION Tui-na is useful for muscle and joint pain from injury or chronic wear and tear, as well as stress-related disorders. It can also be used to support other treatment modalities. Performance animals, chronically ill and geriatric patients can all greatly benefit from regular Tui-na from their owners or veterinarians. For further training, a veterinary Tui-na course is available through the Chi Institute in Reddick, Florida.

Goats GC. “Massage-the Scientific Basis of an Ancient Art”. BR J Sports Med. 1994; 28: 149-156. Furlan AD, Brosseau L, Imamura M, Irvin E. “Massage for Low-Back Pain: A Systematic Review within the Framework of the Cochrane Collaboration Back Review Group”. Spine. 2002; 27(17):1896-1910.

Hart J. “Complementary Therapies for Chronic Pain Management”. Alternative & Complementary Therapies. April 2008; 64-68.

Ping, Chen (ed). Chinese Tuina and Therapeutic Applications: Advanced TCM Series, Volume 7. Beijing: Science Press, 1998: 72-91.

Chi Institute. Application of Tui-Na in Veterinary Practice. Proceedings of 5th Advanced TCVM Seminar, 2003: 135, 147- 149.

Mercati, Maria. The Handbook of Chinese Massage: Tui Na Techniques to Awaken Body and Mind. Rochester, VT: Healing Arts Press, 1997:11-12.

IVC Summer 2015

From the AVH

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

REMINDER – OUR ANNUAL CONFERENCE IS FREE

and no remaining signs. Two weeks later, the owner emailed: Learn more about veterinary homeopathy at Sweet Briar “The hen is doing great – I have to admit I’m still surprised College, Virginia from June 12 to 14. Details are available at how well homeopathy works – don’t quite understand it – TheAVH.org; e-mail office@theAVH.org; or contact conference but glad it does. Thanks again.” coordinator Dr. Sid Storozum at vetoracle@earthlink.net.

HOMEOPATHY WORKING GROUP WEBINARS The webinars continue to be excellent and are included as a benefit of AVH Membership. In March and April, Dr. Jamie Oskin, ND, of Arizona Natural Health Center, discussed how to use the Boenninghausen Repertory to analyze clinical signs. Cured cases included seizures in a toddler, longstanding eczema, chronic fainting and residual cough and severe orchitis after influenza. The June session will feature world-renowned homeopath Dr. Paul Herscu of The New England School of Homeopathy.

CASE REPORTS

By Lisa J. Melling, DVM, CVH

Pitcairn Institute of Veterinary Homeopathy, Faculty Instructor

omeopathic treatment of acute H respiratory disease in a chicken An eight-month-old female speckled Sussex hen presented for respiratory difficulties that occurred this past February, when temperatures dropped below 0°F in Michigan. The hen was unthrifty, had increased respiratory effort with wheezing, and a barking cough aggravated by cold air. The owner brought her indoors but the symptoms persisted. Two doses of homeopathic Hepar sulphuris calcareum 30C were prescribed, two hours apart. Within five hours of the first dose, the hen’s respiration improved, the coughing diminished, and she was making normal chicken sounds. Two days later, her owner reported that she had great energy

IVC Summer 2015

Homeopathic treatment of fever and swollen hocks in a Sharpei mix

A five-year-old spayed female Sharpei mix presented with acute onset of lip swelling, panting and reluctance to move. There was no known trauma, toxin or heat exposure. On exam, she was tachycardic and tachypneic, with bilateral tibiotarsal joint swelling and a fever of 105.2°F. For treatment, 250 ml of subcutaneous fluids were administered, and homeopathic Bryonia 30C was prescribed hourly for a total of six doses. The following morning, her temperature was 103°F and she was drinking, eating and ambulating well. Bryonia 30C was repeated at 9 am and noon. By 3 pm, her temperature was 100.1°F and 90% of the hock swelling had resolved. One dose of Bryonia 200C was administered at bedtime. The following day, the owner reported her signs had resolved: she did not have a fever and was going on short walks. The patient was found to be well at her recheck appointment the following week and was still well at her next exam six months later. The owner emailed to say: “Thanks again for your knowledge, help and support! You have made this clinical nurse a believer in homeopathy.” The Pitcairn Institute of Veterinary Homeopathy is accepting students for the 2015 course beginning in September. Visit PIVH.org to learn more about how you can enhance your veterinary skills with homeopathy.

Veterinary Resource Guide ASSISTIVE DEVICES Best Friend Mobility Myrtle Beach, SC USA Phone: (503) 575-9407 Email: sylvan@sylvancompany.com Website: www.bestfriendmobility.org HandicappedPet.com Amherst, NH USA Phone: (603) 577-8858 Website: www.handicappedpets.com

ASSOCIATIONS Academy of Veterinary Homeopathy - AVH Leucadia, CA USA Phone: (866) 652-1590 Website: www.theavh.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 International Veterinary Acupuncture Society - IVAS Fort Collins, CO USA Phone: (970) 266-0666 Email: office@ivas.org Website: www.ivas.org

Website: www.healfasttherapy.com

INTEGRATIVE THERAPIES

Healfast Therapy North Caldwell, NJ USA Phone: (551) 200-5586 Email: support@healfasttherapy.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@holisticpetvet.com Website: www.holisticpetvet.com

NATURAL PRODUCT

MANUFACTURERS & DISTRIBUTORS GenesisValley Center CA USA Phone: (760) 751-3360 Website: www.genesispets.com Harrisonsâ&#x20AC;&#x2122; Pet Products West Palm Beach, FL Phone: (800) 946-4782 Website: www.vet.HEALx.com

VETERINARY OPHTHALMOLOGY

National Animal Supplement Council - NASC Dr. Nancy Park Valley Center, CA USA Board Certified Veterinary Ophthalmologist Phone: (760) 751-3360 Integrative Ophthalmology For Pets - IOP Website: www.nasc.cc Los Angeles, CA, USA Phone: (818) 962 - 0467 CLINIC FOR SALE Email: info@iopeyes.com Website: www.iopeyes.com Reeves Veterinary Clinic Tyler, TX USA Phone: (903) 595-1088 SCHOOLS & WELLNESS Email: drbarj@aol.com EDUCATION Website: www.reevesvetclinic.com FOR SALE: Small Animal integrative practice, Animal Spirit Network established for 44 years. Owner willing to stay Pekin, IL USA a while for smooth transition! Great location Phone: (815) 531-2850 on loop. Great Clientele that is very desirous of Email: carol@animalspiritnetwork.com holistic modalities. We are the only integrative Website: www.animalspiritnetwork.com practice in East Texas, many people in the area are health conscious. Owner wishes to retire. College of Integrative Veterinary Therapies - CIVT EQUINE NATUROPATH Rozelle, NSW Australia Phone: (303) 800-5460 Cassie Schuster, ND, MH Website: www.civtedu.org Waller, TX USA International Veterinary Acupuncture Phone: (713) 502-0765 Society - IVAS Email: cassie.schuster@yahoo.com Fort Collins, CO USA Website: www.wellranch.com Phone: (970) 266-0666 Email: office@ivas.org Website: www.ivas.org

PetMassage Ltd. Toledo, OH USA Phone: (419) 475-3539 Email: info@petmassage.com Website: www.petmassage.com Pitcairn Institute of Veterinary Homeopathy - PIVH Portland, OR USA Phone: 760-230-4784 Email: info@pivh.org Website: www. pivh.org 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 Equine IR Bonsall, CA USA Phone: (888) 762-2547 Email: info@equineIR.com Website: www.equineIR.com

IVC Summer 2015

Product Profile

OTITIS EXTERNA: no pre-cleaning

By Naomi A. Kirby Sismour, DVM, MS Antibiotic resistance is a huge concern and finding alternative ways to manage chronic ear infections has become very important to both veterinarians and pet owners. Enzymatic formulations, such as ZYMOX® Otic Solution, has demonstrated to be effective and easy to use. One of the ways in which ZYMOX Otic differs from topical antibiotics is it requires no pre-cleaning of the ear prior to application. That’s because the enzymes in ZYMOX work in conjunction with organic material such as the pus and exudate. Bacteria generates by-products that serve as catalysts to interact with the enzymes and thiocyanate or iodide within ZYMOX to produce an antimicrobial system. In contrast, topical antibiotics must have the “gunk” removed in order to be effective. Cleaning infected ears can also be very painful and client compliance may drop due to pet discomfort and time commitment. Sometimes Pre-cleaning may be warranted such as when examining a patient for the first time, or to observe the health of the eardrum or rule out a foreign body. In those situations, it is recommended to wait 24 hours before applying topical enzymes to allow the development of some organic material.

ZYMOX® Otic Solution works without antibiotics and utilizes a patented combination of enzymes – lysozyme, lactoferrin and lactoperoxidase (LP3 Enzyme System) – which have proven efficacy and are easy to use in dogs and cats to manage acute and chronic otitis externa caused by bacteria or yeast. • Lactoperoxidase disrupts the metabolism of the microbe by producing ions that oxidize and inhibit bacterial metabolic enzymes pathways. • Lysozyme specifi cally targets Gram-positive bacteria (such as Staphylococcus aureus and group D and G streptococci) and splits the cell walls. • Lactoferrin reduces the availability of iron and specifi cally targets Gram-negative bacteria (such as Pseudomonas aeruginosa, E. coli, Proteus mirabilis, and Klebsiella pneumoniae). It is important to note that Zymox Otic Solution should be applied liberally and gently massaged into the ear and not be used in conjunction with any other ear topicals. The pet should be allowed to shake his head; this promotes movement of the solution deeper into the ear canal. There are several options when choosing ZYMOX ear care products. The Otic with 1% Hydrocortisone is for red inflamed ears in the presence of infection, while the Otic without Hydrocortisone is for long term use as well as pregnant or lactating females. Advanced Formula ZYMOX is for use in highly resistant cases such as MRSA and pseudomonas; it features additional enzymes formulated to destroy the biofilm slime layer that protects and hides the DNA of a microbe. To learn more about the ZYMOX Otic family of products, or about other dermatology products, visit pkbanimalhealth.com

Dr. Naomi Kirby Sismour is the Technical Services Manager at PKB Animal Health (pkbanimalhealth.com).

IVC Summer 2015

integrative practice

INTEGRATIVE

HOSPICE How “Pawspice” honors the human-animal bond while improving quality of life.

By Alice E. Villalobos, DVM, FNAP The human-animal bond is a celebrated and cherished one. This bond grows even stronger during an animal’s end-of-life journey. When pets enter their final decline, often involving cancer, owners usually feel strong emotions and may suffer anticipatory grief. They want to spend as much time with their pets as possible. Integrative care can improve the quality of life for terminal patients, and reassure their owners that they’re doing a good job helping their animals through their last days. At our practice, clients don’t expect us to recommend euthanasia without first perusing reasonable supportive and palliative care options. They seem to be pleased when we tell them we provide integrative care. While many practices still use the “either/or” system of recommending euthanasia versus potentially expensive treatments for cancer patients, many are now offering veterinary hospice (“Pawspice”) as a third option. A major difference between human and animal hospice is that we can begin to offer pets hospice care upon diagnosis, rather than merely when they’re near death. Animal hospice provides an alternative to further aggressive treatment when rounds one or two have failed. We can propose compassionate at-home palliative care to meet the special needs of end-of-life patients. A well-conceptualized integrative palliative plan may be the very best medicine we can offer a terminal patient in support of the human-animal bond.

QUALITY OF LIFE

When is an animal suffering too much? How best can this be judged? I use a Quality of Life Scale that incorporates seven

important criteria (with the acronym “HHHHHMM”) to make it easy to remember a pet’s needs and desires. We feel every Pawspice program should strive to monitor the following: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad days. Clients, technicians and veterinarians can assess the patient daily using a 0 (worst) to 10 (best) scale. Scores above 5 on most criteria are acceptable for maintaining a pet in hospice. Each animal’s situation needs to be customized, and each pet owner needs to be recognized as an individual who requires kind, supportive coaching to come to terms with the decision to end a best friend’s life. The HHHHHMM Quality of Life Scale can be downloaded at pawspice.com.

IMMUNONUTRITION AND CHEMOPREVENTION – NUTRITION AND NUTRACEUTICALS

According to Dr. Philip Bergman, when he was at M.D. Anderson Memorial Cancer Center, chemoprevention involves the use of natural or synthetic compounds that may reverse or suppress the process of carcinogenesis, metastasis and recurrence. Nutritional advice and a nutraceutical supplementation program that underscores cancer prevention for treated, untreated or terminally ill companion animals may be professionally and sensibly supervised at your veterinary facility. This service creates further client confidence that the primary care veterinarian is helping address the pet’s immune system and organ function as much as possible. Continued on page 50. IVC Summer 2015

Continued from page 49. Some natural supplements or nutraceuticals have been shown to reduce cancer risk by playing a role in the cell cycle. I call these natural compounds “foodiceuticals” to emphasize to clients that they are generally non-toxic and found in nature.1,2

Palliative pain control is helping this patient with a large inoperable STS of the right forelimb.

Neo, a 121/2-year-old Old English Bulldog who has trouble getting up and walking, is on the GAT pain protocol along with an NSAID. As part of Neo’s end of life care program, he is receiving cold laser Tx to his severely arthritic elbows using the MicroLight830 Smart Laser.

Diapers are helpful to reduce household soiling from pets with incontinence.

IVC Summer 2015

• Inositol hexaphosphate (IP-6), derived from soybeans, rice, sesame seeds, beans, legumes and cereals, is an anti-carcinogenic. It has potent antioxidant action and enhances natural killer-cell activity.3 • Agaricus Bio contains beta glucans derived from the Agaricus blazei mushroom; these stimulate macrophage activity and increase natural killer cells to destroy viral, bacterial and malignant cells. It is used for the prevention of a wide range of chronic conditions.4 • Advanced Protection Formula (APF) Drops with Siberian ginseng enhance adaptogen activity, help with energy and appetite, and may stabilize diabetic pets.5 • Hepato Support contains milk thistle (silymarin), B vitamins and alpha lipoic acid to help liver function and increase glutathione levels up to 35%, protecting the liver and helping it detoxify chemotherapy drugs.6 • Platinum Performance is a comprehensive and beneficial blend of vitamins, minerals and supplements that I favor for my cancer patients. Some dogs may develop soft stools or diarrhea due to the Omega-3 fatty acids, so we introduce it to the diet gradually.7 • Standard Process has a line of excellent products that support various organ functions. I use K-9 Musculoskeletal Support for many of my frail patients.8 • Onco Support contains Hepato Support, botanicals, probiotics and ginger that help the immune system and the GI tract during the stress of chronic disease and neoplasia.9 • Primal Dose is bovine colostrum that nourishes the immune function of dogs and cats with chronic disease and cachexia. Cats like it and it is great for pets on feeding tubes.10 • Diet may be a prescription food, a high quality life stage diet, or a home-prepared grain-free diet high in protein and fatty acids and low in carbohydrates and sugars.

SUPPORTING THE EMOTIONAL NEEDS OF CLIENTS

Based upon personality, marital/family situations, and other life issues, pet owners may respond with a wide range of emotions, from panic to shutdown, when faced with a terminal illness in their animals. We must always speak kindly and respectfully to support the emotional needs of clients who choose to journey to the end with their beloved pets. Many pet owners are so upset and worried about the future that they miss out on today’s enjoyment with their animals. Not recognizing anticipatory grief, a distraught pet owner can even lessen the quality of her pet’s remaining life. In Pawspice, we can help clients realize that at the present, their pets are still very much alive. We must try to uplift and guide sad or depressed clients, help them value the good parts of each day, and encourage them to interact and communicate with their pets during private moments. Referring clients for pet loss counseling at the Association of Pet Loss and Bereavement (aplb.org) can not only help clients, but also retain balance for the clinician. Continued on page 52.

IVC Summer 2015

Continued from page 50. During your patients’ lives, their owners become bonded to you and your staff, and to visiting your facility and interacting with you. This social contact ends with a pet’s passing. So for a client, hospice is more than a farewell for a beloved animal; it is also a parting of connections and supportive relationships with you and your staff. In addition, when the enormous burden of caring for a dying pet comes to an end, clients may experience a sense of relief

that then makes them feel guilty or remorseful. With a hospice program, you can help ameliorate these feelings.11

KEY POINTS FOR A SUCCESSFUL HOSPICE PRACTICE

Increasing your communication skills and paying attention to your clients’ values, keeping your patients’ best interests in mind, and

CASE REPORT

Emma Moon was a 14-year-old F/S shepherd mix, the only pet in the household of a vibrant film business couple. A very upset man walked into our office and asked my receptionist, Jennifer, if we had time to provide a second opinion. The couple had been told that day by both an internist and a surgeon to euthanize Emma, because she was very old and had two kinds of cancer.

Jennifer comforted the man and told him she would ask me if we could do anything to help. When I got to him, he was sitting on the floor with tears running down his face. I asked him to tell me what was going on. He managed to tell me that Emma was diagnosed with osteosarcoma (OSA) a few months ago, and now had a large tumor in her groin diagnosed as mast cell cancer. He said that today’s x-rays showed a hairline fracture in the bone cancer. Both specialists agreed that Emma Moon should be put to sleep ASAP. Her owner and his wife were tormented over this advice; they were not ready to let Emma go because she still wanted to eat and be with them. “Your dog does not have to die from euthanasia today if you are not ready,” I said emphatically. “We can enter Emma in Pawspice now, and in a few days or weeks, you will come to terms about the right time.” We carried Emma Moon into the exam room on a big soft pad. She had pink mucous membranes and a pleasant, interested look on her face. The man’s wife had joined us, puffy-eyed, and they both looked at me with hope. Emma was breathing comfortably and had no heart murmur. She had a large swelling on her left humerus, and a huge, bright pink mass extending along her left caudal mammary chain was diagnosed by fine needle aspiration cytology as a mast cell tumor. Her abdomen was normal on palpation with no organomegaly. “Look at her,” the couple said. “She isn’t ready to die yet. She still gets up to do her business and she eats and wags her tail and likes being in the center of things. We want help to keep her with us until we feel she is ready to go. She has not given us that message yet.”

IVC Summer 2015

I defended the opinions of Emma’s doctors and did not disagree with them. I told the couple that the doctors were right about Emma experiencing pain. I explained that pets often don’t exhibit pain clearly, and dogs by their very nature want to stay with their packs by appearing bright despite their discomfort. I told the couple that the sheer volume and location of Emma’s mast cell cancer was, on its own, enough to warrant a poor prognosis for any dog of any age. The referral x-rays demonstrated a hairline fracture in her huge OSA lesion, but no displacement. We entered Emma into Pawspice. We set up a special home care treatment calendar that provided pre-emptive pain control for OSA, and palliative treatment for the mast cell cancer. We started Emma on Duragesic pain patches every 72 hours for OSA pain control. We administered IV dexamethasone and vinblastine for the mast cell cancer, along with famotidine and benadryl injections and gave SQ fluids with vitamins B, C and B12. We taught the couple how to use the calendar with its specific instructions for giving oral prednisone, chlorambucil, benadryl and famotidine, along with combination pain control drugs and a list of supplements.. The integrative part of Emma’s Pawspice program included supplements and agents that are proven to have chemoprevention and immunonutrition activity. These included Onco Support, Agaricus Bio, IP-6, APF Drops, Platinum Performance, Musculoskeletal Support, etc. The family also used OTC supplements from their own research, which we integrated into the total program. Emma’s family was instructed to discontinue all NSAIDs and recheck with us weekly for several more vinblastine injections, for a reassessment of her quality of life. Thanks to her specialized integrative Pawspice care program, Emma’s mast cell tumor regressed, and her OSA pain stabilized. She survived in her loving home with a good quality of life for an additional eight months from the date of our first meeting.

practicing everyday ethics and care are the mainstay keys to a successful hospice practice. • You can help increase client compliance by making your records more transparent; give a copy of your medical notes to the client at each visit, along with the patient’s Quality of Life Scale Score and recommendations on how to improve certain criteria. • Help clients access pet comfort aids such as ramps, lift harnesses, or proper bedding from reliable sources. • Show clients how to keep their pets clean and odor-free. • Give them handouts and website access information from VIN (veterinarypartners.com). • Introduce clients to others with similar problems so they can network. Help them find case-similar chat rooms and guide them to the Association for Pet Loss and Bereavement. • Help clients plan for their pets’ afterlife needs with referrals to trusted pet cremation facilities, and/or cemeteries where viewing and memorial services can be held. Clients appreciate having a like-minded community! For the technical and logistical requirements needed to establish a pet hospice practice, there are plenty of readily-accessed reading materials and webinars available from members of the International Association of Animal Hospice and Palliative Care (iaahpc.org). One article in particular – “Establishing a Hospice and Palliative Care Practice”, by Yazley in the 2013 IAAHPC Proceedings – describes key points in detail.12 Animal hospice is a rewarding and enriching experience, not just for your clients and their pets, but for you and your practice as well.

Canine and Feline Geriatric Oncology: Honoring the Human-Animal Bond, 2007, Wiley.com

pawspice.com

phytopharmica.com

atlasworldusa.com

auburnlabs.com

RxVitamins.com

platinumperformance.com/pets/allproducts

standardprocess.com

A WELL-FITTING SADDLE

CONNECTS HORSE

AND RIDER

Courtesy of Jochen Schleese, German-trained Master Saddler, Certiﬁed Saddle Ergonomist

“A prerequisite for harmony between horse and rider is the pairing of a healthy, mature horse with a practiced, empathetic, sensitive, and well-trained rider. The saddle is the connection between two totally disparate living beings; it will either bring them together or distance them – biomechanically speaking.” These words were written by Dr. Gerd Heuschmann, DVM (author of Tug of War, Balancing Act) for my book Suffering in Silence – The Saddle Fit Link to Physical and Psychological Trauma in Horses. I have worked with Gerd while teaching Saddlefit 4 Life® at The German National Riding School, and lecturing at North American clinics. “A well-fitting saddle is key to ensuring commonality in motion, and plays a critical role in successful training for horse and rider,” he continues. “It can help a rider with a good seat find harmony with the horse, but can also restrict and prevent this if it is not fitted properly to both. “Only a balanced rider not forced into position can adhere to the goals of ‘classical riding’. The saddle trees should accommodate specific and individual requirements for female and male riders. Only a rider with a properly made and fitted saddle can give his horse the proper aids so the horse can move freely.”

Robert Silver, DVM, formulator for Rx Vitamins for pets

primaldose.com

”Relief is a Natural Part of Grief”, Veterinary Practice News, columns by Dr. Villalobos

c.ymcdn.com/sites/www.michvma.org/resource/resmgr/mvc_proceedings_2014/yaxley_02.pdf

Jochen Schleese teaches Saddlefit 4 Life® to riders and professionals, and is the author of Suffering in Silence – The Saddle Fit Link to Physical and Psychological Trauma in Horses (2013). Contact 1-800-225-2242 or info@saddlefit4life.com, or visit Saddlefit4life.com SaddlesforWomen.com. IVC Summer 2015

APPLIED KINESIOLOGY

and subtle neuromuscular weakness in horses

common conditions and how to assess and correct them. By Lynn S. Peck, DVM, MS, cICAK Subtle neuromuscular weakness is common in horses. It may go undetected except perhaps as a non-lameness performance or training problem that persists despite efforts to address nutrition, saddle fit, training regimen, conditioning, etc. Once identified, many of these weaknesses can be easily corrected, sometimes in a single treatment. The material presented here is based largely on human Applied Kinesiology (AK) techniques. I have adapted AK to horses over the last four years and have collected data and observations from approximately 150 Thoroughbred racehorses between the ages of one and four, as well as sport, pleasure, and rescue horses of different ages and breeds. A number of these techniques require the use of a surrogate, knowledge of manual muscle testing (MMT),1,2 surrogate muscle testing (SMT)3 or a â&#x20AC;&#x153;strong/weakâ&#x20AC;? testing technique.

LOWER MOTOR NEURON DYSFUNCTION Neuromuscular weakness can result from either upper motor neuron (UMN) or lower motor neuron (LMN) dysfunction. This article focuses on LMN-related weakness. LMN cell bodies, also called ventral horn motor neurons, are located in the ventral horn of the spinal cord. These neurons form part of the ventral nerve root of spinal nerves and travel via spinal nerve dorsal and ventral branches to provide motor innervation and trophic factors to specific muscles, as well as receiving sensory input from joints, proprioceptors, and a variety of superficial and deep cutaneous receptors. They contain two types of motor nerve fibers: alpha and gamma. Alpha motor neuron (AMN) fibers are large, heavily myelinated, and innervate the extrafusal muscle fibers of skeletal

IVC Summer 2015

muscle. Gamma motor neurons are smaller, less myelinated and specific for the spindle cells.

DISORGANIZATION OR 1 NEUROLOGIC “SWITCHING”

The most common neuromuscular weakness I encounter is related to neurologic disorganization, more commonly called “switching”. This problem often appears as a disruption in left to right communication within the brain. Switching can be demonstrated as a regular or cyclical fluctuation in muscle strength of (and presumably LMN input to) the left and right sides of the body, or different regions of the body, with observed periodicities from approximately five to more than 60 seconds. Using direct manual muscle testing (MMT) and surrogate muscle testing (SMT), it is possible to observe several different patterns. Nearly 100% of horses I’ve tested in the last four years have been positive for switching. Neurologic disorganization or switching is most often caused by shifting of the skull bones, called a cranial fault. This changes pressure along, and mobility of, the skull sutures. It can easily occur when the head is bumped or hit, or when excess pressure is applied to an area. Even mild pressure, applied at the right angle, can cause a cranial fault. Dental issues, TMJ problems, a shift in the position of the hyoid apparatus, heavy metal toxicity, and sacral issues may also cause switching. Most horses I have examined had one or more cranial faults; of those, most had a sagittal suture fault on the midline at the poll, involving the suture between the left and right parietal bones. This cranial fault is specifically associated with weakness of the rectus abdominus muscles. In horses with dropped back, sway back, or poor engagement of the abdominal muscles (and potentially those with overriding spinous process – “kissing spines”) the rectus abdominus may be neuromuscularly inhibited. Correcting the sagittal suture fault will often restore normal muscle function with improvements seen immediately or in a short period of time. Assessment: Using MMT or SMT (see sidebar), first check for switching, usually a five-second pattern. Test for a strong muscle, then touch (therapy localize, TL) the midline at the poll and see if the indicator muscle goes weak, indicating a problem at that location. Also check both the left and right rectus abdominus. Correction: Put finger and thumb on either side of the midline at the poll, straddling the sagittal suture. Very gently, using light tension, check whether opening (lateral) or closing (medial) tension makes the weak indicator strong (usually the suture needs opening tension). Maintain light tension for three to five seconds, then release. Check your indicators to make sure switching is resolved and TL is strong.

WEAKNESS RELATED TO PREVIOUS INJURIES

The injury recall technique (IRT) was created by podiatrist Dr. Robert Crotty, and further developed by Walter Schmitt, DC, DICAK, DABCN, as a means of finding and addressing a local or remote area of previous trauma that’s creating neuromuscular weakness and/or pain at a

AK as a diagnostic tool

Applied Kinesiology is a diagnostic and therapeutic discipline that combines knowledge of muscle and nervous system function with biochemistry, anatomy, neuroanatomy, nutrition, cellular physiology and other biomedical fields. It can be described as functional neurology, providing a means to detect and correct a wide range of neuromuscular functional abnormalities stemming from previous injury or nutritional, biochemical, metabolic, or emotional factors. AK was initially developed 50 years ago by chiropractor Dr. George Goodheart. It’s now an international discipline primarily practiced by chiropractors, physicians, acupuncture physicians, and some veterinarians. AK utilizes manual muscle testing (MMT) as a “window into the nervous system”. It tests the functionality of the AMN as a means of testing muscle strength and ability to respond to increasing force challenge. The ends of a muscle are apposed by positioning the limb or body so that the origin and insertion are closer to each other and the muscle is in a relaxed but slightly shortened position prior to testing. The muscle is challenged by a gradually increasing force over three to five seconds and opposing the normal action of the muscle. A “strong” muscle resists the challenge; a “weak” or neuromuscularly inhibited muscle is not able to maintain the contracted position against the challenge. Loss of input (“weak test”), or deafferentation, can be caused by trauma, both accidental and surgical, chemical toxins, nutritional imbalances or deficiencies, structural issues such as subluxations, or even emotional and psychological factors. Partial deafferentation of AMN impulses results in muscle weakness with or without significant atrophy and may be reversible; complete deafferentation results in paralysis and may be permanent. After corrections, the muscle will test “strong”.

References for AK techniques Cuthbert SC, Rosner AL, McDowall D. “Association of manual muscle tests and mechanical neck pain: results from a prospective pilot study”. J Bodyw Mov Ther., 2011, Apr 15(2):192-200. Pollard HP, Bablis P, Bonello R. “Can the ileocecal valve point predict low back pain using manual muscle testing?” Chiropr Aust, 2006, 36:58-62; Jacobs, G, Franks, T, Gilman, G. “Diagnosis of thyroid dysfunction: applied kinesiology compared to clinical observations and laboratory tests”. J Manipulative Physiol Ther., 7(2):99-104.

IVC Summer 2015

specific site. The mechanoreceptors of the foot, ankle, and neck are particularly important in supplying afferent information to the brain for postural balance and equilibrium. Extension of the head and neck is one of the reflex responses to trauma. Memory encoding of head and neck trauma appears to reside in a cervical extensor reflex pattern.4 In the horse, the IRT neck correction works well for injury on any part of the body, provided the horse is standing. Assessment: Using SMT or other strong/weak muscle test (see sidebar on previous page), test a muscle at the problem or suspected problem area. If the muscle tests weak/inhibited, activate the muscle spindle cells by stretching the fibers in the middle third of the muscle belly using both hands, along the long axis opposite the direction of contraction. This technique is called autogenic facilitation (AF). If the AMN control mechanisms are functioning normally, a weak muscle will strengthen after AF. If it does not, then IRT is needed. Correction: The basics of IRT are to find and connect the neurologically active area of injury (NAAI) with the affected muscle, while reversing the head and neck extension trauma reflex. This is done by touching (therapy localizing, TL) the problem area, which should test weak, then over the whole body to identify locations that when touched make the

weak muscle test strong. TL identifies neurologic connections between two things but not the nature of those connections. Once the NAAI is mapped out, the horse is asked by way of treats or gentle encouragement to several times flex the head and neck, particularly the occipital-atlantic (O-A) joint, while the cutaneous receptors of the skin overlying the weak muscle and the NAAI are stimulated simultaneously by light snatches or pincering with the fingertips. Retest the original muscle afterwards. It should now be strong. In most cases, only a single treatment with IRT is needed unless there is repeated injury, a deeper layer of trauma, or other issues involved. In some cases, particularly involving head or neck injuries, surgical procedures, scars, IV catheterization, injection site issues, TMJ, hyoid or dental issues, the muscles of the surrounding area may all test strong. In this case, put the horse’s head and upper cervical vertebrae into extension (particularly the O-A joint) by raising the head and extending the nose forward. With the horse’s head in this position, recheck the muscles and see if there is now one that is weak or inhibited (positive test). TL the entire area thoroughly to find the NAAI, then flex the horse’s head and neck while stimulating the two areas, as above. IRT can be done sequentially over days, weeks or months, as new areas with an IRT spindle cell pattern will usually continue to surface for quite some time. This technique is also excellent for helping or resolving many chronic pain and scar issues.

WEAKNESS ASSOCIATED WITH VACCINATION INJECTION SITES

In evaluating and detoxifying almost 150 yearling and twoyear-old racehorses, it became apparent that the area(s) on the neck around the site for vaccines and other injections was almost universally a site of apparent muscle atrophy and neuromuscular inhibition. Further (unpublished) work has shown that muscles outside the immediate area of the neck injection site can also be affected. This raises the question of an association between the injection of inflammatory chemicals such as formaldehyde, aluminum hydroxide, thimerosal, and chronic chiropractic problems and/or bony inflammatory lesions of the lower cervical vertebrae. Assessment: With the flat of the hand, carefully palpate the sides of the neck from cranial to caudal to assess muscle tone and thickness. If there are areas of muscle atrophy, use SMT or one of the other methods described to assess neuromuscular status in the affected area. Correction: IRT at the site can often improve or even resolve neuromuscular inhibition, as well as apparently improve local blood or lymphatic circulation. This is evidenced shortly

IVC Summer 2015

afterwards by visual and palpatory changes in the character of the muscles at that site.

PAIRED MUSCLE WEAKNESS: PATTERNS ASSOCIATED WITH ORGANS OF DETOXIFICATION Paired or bilateral muscle atrophy can frequently be observed in equine sport/racehorses as well as pleasure horses, and often involves muscles of the shoulders (deltoids, supraspinatus and infraspinatus), withers (trapezius), and particularly the dorsal hindquarters (gluteals and long head of the biceps femoris). The degree of muscle loss is sometimes surprising, considering the level of training and conditioning in some affected individuals, plus the fact that the gluteal muscles are the most powerful for running and jumping. If a neuromuscular circuit is inhibited, however, conditioning alone may not be sufficient to stimulate muscle development. In human AK, muscle-organ and muscle-gland relationships have been identified by manual muscle testing of individual muscles and by finding the reflex point or tissue extract that counteracts weakness of the specific muscle. This suggests that at least some paired muscle weaknesses may be related to stress, dysfunction and/or toxicity of major organs of detoxification. Frequently encountered specific paired muscle weaknesses and their associated organs are: deltoids and lungs, pectorals (deep) and

liver, caudal trapezius and spleen, psoas and kidneys, popliteals and gallbladder (horses lack a gall bladder but still produce bile and have a Gall Bladder meridian involved in liver and lateral hindquarter muscle function), gluteals and reproductive organs (removed in geldings and some mares). The spleen may have a role in detoxification because red blood cells sequestering lead, cadmium, mercury, zinc and other heavy metals are taken out of circulation in the spleen5, suggesting that some of these metals may accumulate or have local effects there. Continued on page 58.

Left: Strong test using latissimus dorsi muscle. Right: Weak test using latissimus dorsi.

IVC Summer 2015

Continued from page 57. A multiple muscle-to-gland relationship exists between the medial stabilizer muscles of the hindquarters and the adrenal glands. These muscles include the inner thigh muscles (adductors, gracilis and sartorius), the gastrocnemius and soleus, and the posterior tibial muscle, which becomes part of the deep digital flexor tendon, with an apparent functional association with the suspensory (interosseous) ligament (my unpublished observation). This association means that a problem with the adrenal glands, such as stress from shipping, hard training and showing, inadequate nutrition, or environmental

Chapman’s Neurolymphatic Reflex Points for Organs of Detoxification.

Photo courtesy of Nicole Macname

Bilateral Atrophy of Gluteal Muscles before treatment.

Lateral weakness of hindquarters during lateral tail test.

Immediate improvement in lateral strength after rubbing Chapman’s Neurolymphatic Reflex Points for the adrenal gland.

Same horse as in top photo, 13 weeks after regular treatment with Chapman’s Points.

chemicals, affects those specific muscles, causing dysfunction leading to weakness. The reverse is also true: weak muscles from injury or another cause can also impact the associated gland or tissue. When organ-muscle association is the main reason for neuromuscular weakness, circular rubbing of the associated neurolymphatic reflex point can often bring immediate improvement. Neurolymphatic reflex points were discovered by oeteopath Dr. Frank Chapman in the 1930s. When stimulated, they were observed to cause rapid improvements in organ or gland function in human patients. Later, Dr. Goodheart found he was able to cause dramatic improvement in the associated muscle’s strength and function by rubbing the points. In horses, similar improvement in muscle strength and nervemuscle function occurs when the appropriate neuro-lymphatic reflex is stimulated by circular rubbing. These points can be rubbed daily for three to five minutes as part of treatment or routine management of equine athletes, or in cases of severe organ, gland, or metabolic stress/dysfunction.

CONCLUSION Using these techniques is very often clinically rewarding and may help resolve chronic issues related to muscle weakness and dysfunction in horses.

Walther, David S. Applied kinesiology: Synopsis (second edition). Systems DC, 2000, pp. 448-449.

Thie J, Thie M. Touch for Health: The Complete Edition. DeVorss and Co, 2005, pp 3-8, 16-23.

2 3

Ibid, p. 256.

Walther, David S. Applied kinesiology: Synopsis (second edition). Systems DC, 2000, pp. 184-186. Arak S, Aono H, Murata K. “Mobilisation of heavy metals into the urine by CaEDTA: relation to erythrocyte and plasma concentrations and exposure indicators”. British J Industrial Med, 1986, 43:636-641.

IVC Summer 2015

A L LERGI ES By Kim Perkins, PhD

AND THE BENEFITS OF SERUM TESTING The best definition of an allergy is: “a classic overreaction by the immune system to an otherwise harmless substance”. Pollen from Bermuda grass, for example, is typically harmless, but in atopic patients, the immune system may identify it as harmful. This sets off a cascade of events in the immune system resulting in the increased production of allergen-specific IgE. Like all antibody isotypes, IgE is composed of two fragments: Fab and Fc. The Fab fragment has a high affinity to the allergen against which it was produced, while the Fc fragment has a high affinity to specific receptors on the surface of mast cells. IgE bound to mast cells via the Fc fragment can bind its specific allergen via the Fab fragment, resulting in the release of histamine, bradykinin, serine proteases and other factors that result in an onset of symptoms (Figure 1). There are two methods of identifying allergens that are causing symptoms – intradermal and serum allergy tests.

Intradermal testing involves introducing a small amount of a specific allergen into the patient’s skin and observing whether or not a reaction occurs.

Serum allergy testing involves quantifying the amount of IgE in serum that specifically recognizes an allergen of interest.

Both methods have their merits, but this article will summarize the benefits of serum testing.

The goal of serum allergy testing is to measure the amount of allergen specific IgE in the serum. Individual allergens are coated onto the bottom of a 96-well dish and the serum exposed to each individual allergen. An ELISA assay is performed, allowing for the quantification of IgE antibody specific to a particular allergen. Allergens that bind large amounts of IgE are considered the most allergenic. Due to the relatively low abundance of serum IgE and interference from other antibody isotypes, especially IgG, standard ELISA assays are subject to dramatic false negatives. The SPOT Platinum assay improves on the standard ELISA. It optimizes the coating of allergen to the plate by retaining the three-dimensional structure of the allergen for maximum antibody binding. Concurrently, blocking the allergen plates has been improved by reducing the binding sites for all antibody isotypes other than IgE. These two steps increase the specificity and sensitivity of the test to more than 97%. Add to this the modifications in reagents at other steps in the assay, and you have a test that not only answers past criticisms but surpasses them. While food allergy testing has had its share of criticism, studies have shown a 53% decrease in symptoms simply by introducing a diet change based on testing results. When combined with hyposensitization to inhalant allergens, improvement rates can exceed 85%.

Figure 1

Dr. Kim Perkins joined the Spectrum Group in early 2012 and is the Laboratory Director, overseeing the development, optimization and manufacture of veterinary diagnostic assays. He obtained his PhD from Arizona State University while studying the molecular mechanisms of viral pathogenesis, focusing on the role viral dsRNA-binding proteins play in disease. IVC Summer 2015

CHOOSING THE

BEST MODELS

FOR

INTEGRATIVE

RESEARCH By Nancy Scanlan, DVM, MS, CVA

Studies structured to meet the expectations of conventional medicine, while conforming to the basic tenets of an individual modality, will encourage a better understanding and wider acceptance of integrative medicine.

IVC Summer 2015

CONVENTIONAL MEDICINE focuses on separating out the individual actions of substances that have an effect on systems or diseases defined by conventional research. For example, the action of milk thistle on the liver is mostly defined in research as the action of silymarin (silybin) upon physiologic processes in the liver. Silymarin was chosen as the single most active chemical in milk thistle. With the exception of death from liver failure, most physiologic processes in silymarin studies are measured by laboratory tests used to measure liver function. Actions of natural substances, as with the actions of drugs, are measured by their ability to decrease or increase an abnormal value back to normal. These actions are by and large viewed as one-way. For example, Western drugs for hypertension decrease blood pressure. One side effect of such drugs is to reduce blood pressure below normal.

INCORPORATING INTEGRATIVE RESEARCH INTO A CONVENTIONAL MODEL Any integrative research has to recognize this world view and incorporate it, if possible, into the research model. However, to properly study traditional medicine, you must also include the basic precepts of whatever modality you are studying. If this is not done, you run the risk of improper setup of the research protocol, and/or improper interpretation of test results. Investigators on both sides of the question run the risk of such impropriety. For example, some herbal formulas for blood pressure can both increase or decrease blood pressure, depending on whatever is needed to return blood pressure to normal values. This also implies fewer side effects related to blood pressure itself, or effects that are more likely to be related to nausea and diarrhea with an overdose, rather than abnormally low blood pressure. Another example is the idea of “normalizing” a body’s immune reaction. In conventional medicine, tests are done on substances to see if they will increase or decrease the activity or numbers of various white blood cells (WBCs). Such action is looked upon as one-way; if a substance increases numbers/ actions of WBCs in one set of circumstances, and decreases them in a different set of circumstances, this is usually interpreted as “conflicting” evidence (see sidebar on page 62).

INTEGRATIVE MEDICINE LOOKS AT CASES INDIVIDUALLY When traditional medicine looks on diseases and physiology as circular, as seen in the Five Element cycle of Traditional Chinese Medicine (TCM), different practitioners may decide to attack the same disease process at different parts of that cycle. The treatments may be seen as different by conventional medicine, but

While each modality has unique research challenges, scientific methods can be adapted to produce credible results. can be consistent within the confines of TCM. When looking at case studies or case series involving such circular views, therefore, final conclusions should be based on two criteria: were the cases treated successfully, and were all cases within the series consistent based on the traditional, not the conventional, view? With situations that are even more individualized, such as in the TCM diagnosis of a case, there may be agreement on the basic diagnosis (such as inflammatory bowel disease) but various cases may have TCM differences within that basic diagnosis (such as Heat or Cold signs). In studies of human acupuncture, researchers are starting to look at basic points that everyone would use, plus two or three optional points that will differ depending on the specific TCM diagnosis. When designing a study for integrative medicine, this approach can help satisfy both the conventional method of choosing treatments, and traditional methods that ensure better outcomes.

AN AGREEMENT OF STUDY STANDARDS IS NEEDED Often, herbal research looks at isolated herbs within a successful formula to determine what each one does, and which are most likely to be effective for specific conditions. If a formula has withstood the test of time and has been used for decades or even hundreds or thousands of years, it is most likely that there’s a reason for using a specific combination of herbs, as opposed to a single herb, for the disease in question. The isolation of individual compounds in one herb, or of a single herb in a formula, can help us understand part of the contribution the compound or herb makes to the whole. But IVC Summer 2015

Before herbal medicine can be taken seriously, there must be some agreement of standards.

such research should not be used to champion single herbs or compounds, separate from the traditional formula, when the sum of the parts is most likely to have the best results. When looking for a treatment for a specific disease or syndrome, a standardized (as much as possible) formula should be consistently used in all research involving the same formula and disease. Otherwise, research reviews of integrative medicine will continue to conclude that a formula has little to recommend it because individual components have weak actions against the problem. There is some precedent for this in cancer therapy, where combinations of chemotherapy (either together or sequentially) have been found to be more effective than a single method. Herbs can vary greatly in their activity, depending on how and where they are grown and harvested and which parts of the plant are used. Even with the help of older texts, the exact combinations and quantities of herbs in a formula, and the exact doses of that formula, may vary from author to author. The situation is less extreme for Traditional Chinese herbal formulas, but there is still variation between brands. Before herbal medicine can be taken seriously, there must be some agreement of standards. If researchers can agree on the formulas most in need of study (to become more widely accepted), and on one specific formula and dose, integrative herbal medicine could find wider acceptance. A standardized formulation and dose meets the conventional need for studies of a standard disease with a standard treatment. Once acceptance occurs, individual variations can be introduced. Finally, in the case of modalities such as homeopathy, where every case of a conventional disease is looked at even more

IVC Summer 2015

individually than in TCM, the research may need to be structured a little differently. In order for acceptance to occur, initial research may need to be more standardized. While palliation is not the desired endpoint, the fact that a remedy fairly consistently “improves” (to the conventional eye) the symptoms of a specific “disease” (as defined by conventional medicine) may open the door to acceptance of homeopathy as a valid part of integrative medicine.

CONCLUSION While each modality has unique research challenges, scientific methods can be adapted to produce credible results. If research is structured in such a way that conventional expectations can be met, while conforming to the basic tenets of the individual modality, the needs of both sides can be satisfied. In addition, an explanation of an expected holistic effect before demonstrating it (such as bringing a reaction back to the norm, whether or not it is above or below the baseline measurement), can go far to allaying misinterpretations of what are seen as “inconsistent” results.

Conﬂicting or supporting evidence? Echinacea (most commonly Echinacea purpurea) has usually been studied with the expectation that it will increase immune reactions in some way. However, it may have more of an immune-modulating effect, as evidenced by at least one trial showing a decrease in WBC activity. Instead of viewing this as conflicting evidence, it would be better to examine herbal tradition, including the translation of original documents, to see whether this herb has been used as an immune “normalizer”. If so, the conflicting evidence is actually supporting evidence for the original premise.

From the AAVA The American Academy of Veterinary Acupuncture is committed to improving animal health care by the advancement of veterinary acupuncture, Traditional Chinese Veterinary Medicine and Traditional Asian Veterinary Medicine, through education, research and leadership.

Our keynote speaker, Steve Marsden, set the mood for the conference. He stated that the original concept of evidencebased medicine included the incorporation of clinical treatments, with results reported by clinicians and their patients. He has created a website (curedcases.com) dedicated to the collection of data from our enormous body of clinical work, to demonstrate the effectiveness of acupuncture and integrative treatments. He encouraged us to enter each case on initial presentation. More excellent speakers and wet labs filled the days of the conference, with both large and small animal tracks. Members presented interactive case studies (we will use these next year, so submit your cases). Topics ranged from lame horses to itchy dogs to Acupuncturists Without Borders, a group that treats human patients for PTSD after disasters; the latter discussion included how veterinarians can create their own group to help traumatized animals.

COME TO TACOMA In June of 2016, join us in Tacoma, on Washington’s Puget Sound, for a joint conference with the IVAS. Tacoma is 32 miles from Seattle and has a view of nearby Mount Rainier. It will be a breathtaking place to meet! Visit aava.org for more information about our shared community of alternative therapies.

WHAT’S THE POINT? Can you determine the correct acupuncture point from these clues? • Associated with the Greater Occipital nerve. • In TCM it’s called “Heaven’s Pillar” – refers to the point’s location near the upper cervical region and the surrounding muscle that supports the head – or “heaven” – like a pillar. • One of five referred to in the Spiritual Pivot as points of the “Window of Heaven” – indicated for “sudden contraction, epilepsy and dizziness, with inability of the legs to support the body”, and when chaotic and rebellious Qi rises to the head, as in mental disorders. • The point’s location varies from text to text. IVAS locates it (in dogs) in the depression of the cleidocervicalis m., medial to the wing of the atlas and overlying its transverse foramen, approximately 1 cun lateral to the dorsal midline. Robinson (MAV) states it’s just caudal to the wing of the atlas on the dorsolateral neck region; and Xie situates it in a depression at the junction of C1-C2, 1.5 cun from the dorsal midline. In horses, IVAS, MAV, Xie and Schoen locate the point 2 cun lateral to the dorsal midline in the depression caudal to the wing of the atlas. Thoresen considers it a diagnostic point for the contralateral stifle in horses, and locates it at the little hair whirl just behind the ear, close to the mane. In humans he puts it at the lateral edge of the trapezius muscle, on the natural hairline of the occiput. • Important in “dispelling wind”. Used for cervical, shoulder and back problems; vertigo, nasal congestion and discharge; febrile disease, asthma, throat pain and swelling; and epilepsy.

Answer: BL10

he 2014 AAVA conference was held in Boston on the St. Patrick’s Day weekend, during which the city broke its all-time snow record. But the weather didn’t dampen our collective energy. We even had a few Irish attendees, among them “leprechaun” Doctor Leslie with her prosthetic green ears. That’s a story in and of itself, and that story is about the laughter, camaraderie and learning we share at AAVA.

IVC Summer 2015

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

DID YOU GUESS LAST ISSUE’S MEDICINAL HERB?

UPDATE ON ACTIVITIES

Milk thistle (Silybum marianum L.) is today one of the most well known herbs in conventional veterinary medicine. It is very useful for a vast number of liver conditions and is especially treasured as a protectant against toxins – chemical pollutants, drugs, Amanita fungus, and additives in food.

• From June 12 to 14, the VBMA sponsored a track of speakers

It is classified as hepatoprotective, demulcent, cholagogue, choleretic, galactoagogue, antioxidant, hepatic trophorestorative, alterative, antibacterial, antifibrotic, anti-diabetic, hypocholesterolemic, immunomodulatory, anti-cancer, and nephroprotective. This multitude of actions explain why milk thistle is very useful when treating hypercholesterolemia, hyperlipidemia, varicose veins, hepatitis, cholangio-hepatitis and hepatic lipidosis, as an adjunct for treating giardia, and for protecting the pancreas during pancreatitis. It can also increase lactation and protect cows from ketonemia. Milk thistle is currently being used to treat insulin resistance in horses.

at the International Herbal Symposium at Wheaton College in Norton, Massachusetts. Dr. Barbara Fougere came from Australia to speak about essential oils, mushrooms and herbs found in her backyard. Dr. Rona Sherebrin spoke on phytochemicals, and Dr. Jordan Kocen on case evaluation with Chinese herbal medicine, liver imbalances, herbal medicines and their integration into conventional practice. Dr. Cindy Lankenau covered difficult equine and bovine respiratory cases and an ethnobotanical case of Lyme disease self-treatment in the equine. • The March webinar on Lyme disease given by Dr. Joyce Harman was excellent. Recordings of these webinars are available for purchase at vbma.org. Stay tuned to our website, as we have two more high-flying webinars happening this year.

This is truly an impressive herb that can energetically tonify and move Liver and Gallbladder Qi while clearing toxins and regulating

• The American College of Botanical Medicine’s fi rst annual

Spleen Qi. Milk thistle can also can help treat Heart Yang deficiency.

the annual AHVMA conference. Information is available at acvbm.

conference will be on October 16 in Augusta, Georgia, preceding org. Additional herbal lectures will also be offered during the

Case report

Ben, a very active 12-week-old golden retriever puppy with an insatiable appetite, ate a clump of positively identified Destroying Angels (Amanita bisporigera). At the time of ingestion, Ben’s owner had thought them to be the common field mushroom Agaricus campestris. Within 15 minutes after eating the mushrooms, Ben threw up large volumes of frothy material, several times. In an hour, he was found staggering around the house.

AVHMA conference (ahvma.org).

NAME THIS HERB!

Ben’s owner was instructed to immediately give the dog milk thistle. He had the herb in a commercial encapsulated power form, and gave Ben a capsule every 15 minutes. Ben was hospitalized for the night for fluids and to keep him in a confined safe environment; while there, he was dosed with ½ tsp of milk thistle every hour. By next morning, Ben was mentally normal, and his liver enzymes were ALT: 12 U/L (5-18), Alk. Phos 178 U/L (77-199). He survived a massive Amanita bisporigera poisoning thanks to the use of milk thistle.

IVC Summer 2015

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

marketplace

IVC Summer 2015

events

To post your event, email us at: info@IVCJournal.com

Pacific Veterinary Conference

June 18-21, 2015 – Long Beach, CA Join us under the sun while earning continuing education units and listening to the veterinary profession’s best speakers. Explore a two-day Vet Expo with the latest innovations from the veterinary industry, mingle with future colleagues, and in your downtime discover the city! We want to see you in Long Beach for #PacVet2015.

UC Davis 8th Annual Back to School Seminar

Pacific Veterinary Conference

June 23-26, 2015 – San Francisco, CA This four day conference continues to bring great continuing education along with excellent networking with veterinary professionals from across the globe. Best of all, it’s at a world-class vacation destination where you can still have plenty of time to spend with your friends and family. For more information: (800) 655-2862 info@pacvet.net www.pacvet.net

July 10-14, 2015 – Boston, MA AVMA’s Annual Convention mission is to advance the knowledge and skills of veterinarians and related professionals by providing: superior and diverse continuing education, a platform for dissemination of research, a forum for associated organizations, and an opportunity for collegial interaction. You will find everything from education to entertainment, events to exhibits and you’ll be informed, inspired and in-touch with the brightest minds in the profession. For more information: (800) 248-2862 convention@avma.org www.avmaconvention.org

July 16-19, 2015 – Calgary, AB The 2015 Convention offers you a variety of new discoveries. Choose from sessions that focus on IVC Summer 2015

July 25-26, 2015 – Davis, CA This continuing education seminar will provide 16 CE credits and will take place at UC Davis, Valley Hall. Sponsored by UC Davis Veterinary Medicine Center for Continuing Professional Education. For more information: Karl E. Jandrey, DVM, MAS, DACVECC (530) 752-3905 kejandrey@ucdavis.edu www.vetmed.ucdavis.edu/ce/

25th International WAAVP Conference

2015 AVMA Annual Convention

Continue your learning journey by wandering through the lanes of our exhibit hall to discover state-of-the-art products and services. In addition to the learning opportunities, Calgary has much to offer as a travel destination. For more information: (613) 236-1162 admin@cvma-acmv.org www.canadianveterinarians.net

For more information: (800) 655-2862 info@pacvet.net www.pacvet.net

67th Annual CVMA Convention

small animal, equine, bovine and ruminant medicine, animal welfare and business management. Specialized workshops, including a Level 2 dental lab and an orthopedic lab, are available.

August 10-15, 2015 – Liverpool, UK We have great pleasure in inviting you to the 25th International Conference of the World Association for the Advancement of Veterinary Parasitology in Liverpool, United Kingdom. 2015 will bring together parasitologists from around the world to present and discuss the latest advances in their research as well as important issues relevant to veterinary parasitology. The theme for the 2015 Conference is “looking to the future”. The scientific program has been designed to bring together leading scientists who use cutting edge technologies, including specialists in parasiticide resistance, novel diagnostic methodology, and modelling and climate change, among many other topics; to inform, excite and inspire veterinary parasitologists from the newest PhD recruit to the most senior of professors.

9th Keystone Veterinary Conference August 13-16, 2015, Hershey, PA This conference will be taking place at the Hershey Lodge in Hershey, PA. More event information will become available at a later date. Register online. For more information: (888) 550-78620 cgacono@pavma.org www.pavma.org

CVC Conference for Veterinary Care

August 28-31, 2015 – Kansas City, MO For more than 20 years, CVC’s vision has been to provide veterinarians, veterinary technicians, practice managers, and team members with the best convention experience possible by offering premium educational programming, expert clinical education, hands-on labs and workshops, practice management programs, and team training sessions from the award-winning editors and doctors behind DVM Newsmagazine®, Veterinary Medicine®, Veterinary Economics®, Firstline® and dvm360.com. With expert speakers and exceptional service that is affordable and accessible and offered at three convenient locations annually: Washington (DC), Kansas City, and San Diego. For more information: (800) 255-6864 cvc@advanstar.com www.thecvc.com

2015 AHVMA Annual Conference

October 17-20, 2015 – Augusta, GA This year the AHVMA conference will be taking place in Augusta, GA and over 100 hours of CE are available, including several labs. Online registration for the 2015 Annual AHVMA Conference is now available. For more information: (410) 569-0795 office@ahvma.org www.ahvma.org

For more information: +44 28 9066 4020 cs@happen.co.uk www.waavp2015.com

For more events, visit: Facebook.com/IVCJournal/events

IVC Summer 2015