IVC WINTER 2017/2018
Integrative VETERINARY CARE
INNOVATIVE SOLUTIONS FOR YOUR PRACTICE
VOLUME 8 ISSUE 1
PREVENTING INJURIES IN CANINE ATHLETES
HOW TO SUCCESSFULLY INTEGRATE INJURY PREVENTION INTO YOUR PRACTICE. – P. 50
www.IVCJournal.com
WINTER ISSUE 2017-2018
INTEGRATIVE VETERINARY CARE JOURNAL
OZONE THERAPY TO BUILD AND MAINTAIN HEALTH
OSTEOPATHY AFTER ROUTINE SURGERIES
INTEGRATIVE MEDICINE ENTERS VETERINARY CURRICULUM
BUILDING AND MAINTAINING EQUINE HEALTH
TCVM SEASONAL MEDICINE
UNDERSTANDING PET DIGESTION
A decrease of oxygen utilization can affect our patients’ organs and their functions. Here’s how Ozone Therapy can help cells and organs function at peak levels. – P. 47
Many private veterinary practices and some teaching hospitals now offer integrative veterinary medicine modalities as an adjunct to conventional therapies. – P. 38 Understanding the seasonality of Chinese Medicine and the foods that are helpful to add to patient diets during these times. – P. 20
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Learn why osteopathy alleviates pain, restores freedom of movement, and enhances the body’s innate healing abilities. – P. 58
From vaccination to colic… use your knowledge to help clients make the right decisions for their horses’ health. – P. 42
Providing optimal nutrition to dogs and cats includes understanding their digestive processes, from one end of the body to the other. – P. 28
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contents FEATURES
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HOLISTIC MANAGEMENT FOR BREEDERS
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TCVM PREVENTATIVE SEASONAL MEDICINE FOR PETS
By Karen Gellman, DVM, PhD and Sarah Dayon, DVM
How to help your breeder clients understand the strengths and weaknesses of their particular breeds, and aid in ensuring healthy litters of puppies.
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By Jody Bearman, DVM, CVSMT, CVA, CVCH
Understanding the seasonality of Chinese medicine, the personalities that go with the seasons, and the foods that are helpful to add to patient diets during these times.
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INTEGRATIVE PRACTICE
INTRODUCING A HOLISTIC APPROACH TO CONVENTIONAL PRACTICE By Cathy Lund, DVM
Tips and suggestions for undertaking the journey from conventional to holistic veterinary medicine within the practice setting.
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NUTRITION NOOK UNDERSTANDING PET DIGESTION
By Barbara Royal, DVM, CVA, CIAC
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TECH TALK
PREVENTING INJURIES IN CANINE ATHLETES
By Lynn Nalepa
Learn why osteopathy alleviates pain, restores freedom of movement and enhances the body’s innate healing abilities.
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OSTEOPATHY TO IMPROVE MOBILITY AFTER ROUTINE SURGERIES
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A SIMPLER WAY TO BUY EQUIPMENT FOR YOUR CLINIC
By Laura Taylor, DVM
Learn why osteopathy alleviates pain, restores freedom of movement and enhances the body’s innate healing abilities.
By Bob Simpson
Buying and selling equipment can be overwhelming. Here’s how an equipment broker or exchange network can simplify the process.
INTEGRATIVE MEDICINE IN VETERINARY CURRICULUM By Mushtaq A. Memon, BVSc, PhD, Dip ACT, CVA
Many private veterinary practices and some teaching hospitals now offer integrative veterinary medicine modalities as an adjunct to conventional therapies.
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By Margo Roman, DVM, CVA, COT, CPT
A decrease of oxygen utilization can affect our patients’ organs and their functions. How Ozone Therapy helps cells and organs function at peak levels.
Providing optimal nutrition to dogs and cats includes understanding their digestive processes, from one end of the body to the other.
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OZONE THERAPY–A WAY TO BUILD AND MAINTAIN HEALTH
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STRATEGIES FOR BUILDING AND MAINTAINING EQUINE HEALTH By Elizabeth E. Pantzer, DVM
From vaccination and emerging diseases to de-worming and colic…use your knowledge to help equine clients make the right decisions about their horses’ health.
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advisory board
40 COLUMNS & DEPARTMENTS
5 Advisory board 8 Editorial
s new 11 What’
Dr. Richard Palmquist, DVM GDipVCHM(CIVT) CVCHM (IVAS), graduated from Colorado State University in 1983. He is chief of integrative health services at Centinela Animal Hospital in Inglewood, California, 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 codirector of the AHVM Foundation. He has published two books, one for conventional veterinarians and a second for clients discussing how integrative thinking works.
Michelle J. Rivera, MT, VDT, is an instructor at the University of Wisconsin and The Healing Oasis Wellness Center, a post-graduate educational institution offering state-approved programs. She is 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.
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.
19 From the VBMA 41 From the VMAA 45 From the AVH 46 Industry Innovations 55 From the AHVMA 56 Veterinary resource guide 57 From the AATCVM
Dr. Steve Marsden, DVM, ND, lectures for the IVAS, the AHVMA and the AVMA, and is co-founder of the College of Integrative Veterinary Therapies. He is a director of the National College of Natural Medicine, and authored the Manual of Natural Veterinary Medicine. Dr. Marsden is extensively trained in alternative medicine, including Chinese herbology, acupuncture and naturopathic medicine. He has a veterinary and naturopathic practice in Edmonton, Alberta. In 2010, Dr. Marsden was named Teacher of the Year by the AHVMA.
Dr. Jean Dodds, DVM, received her veterinary degree in 1964 from the Ontario Veterinary College. In 1986, she moved to Southern California to establish Hemopet, the first non-profit national blood bank program for animals. Dr. Dodds has been a member of many national and international committees on hematology, animal models of human disease, veterinary medicine, and laboratory animal science. She received the Holistic Veterinarian of the Year Award from the AHVMA in 1994.
64 From the WAEO 65 Marketplace 66 Events
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.
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Integrative VETERINARY CARE
WINTER 2017/2018
EDITORIAL DEPARTMENT Editor-in-Chief: Dana Cox Managing Editor: Ann Brightman Associate Editor: Christina Chambreau, DVM, CVH Staff Writer: Emily Watson Senior Graphic Designer: Dawn Cumby-Dallin Senior Graphic Designer: Kathleen Atkinson Social/Digital Media Manager: Theresa Gannon Web Design & Development: Brad Vader
COLUMNISTS & CONTRIBUTING WRITERS Jody Bearman, DVM, CVA, CVCH, CVSMT Sarah Dayon, DVM Karen Gellman, DVV, PhD Christopher Kelly Groth Cathy Lund, DVM Mushtaq A. Memon, BVSc, PhD, Dip ACT, CVA Elizabeth E. Pantzer MS, DVM Laura Taylor, DVM Bob Simpson Lynn Nalepa Barbara Royal, DVM, CVA, CIAC Margo Roman, DVM, CVA, COT, CPT Ernie Ward, DVM, CVFT
ADMINISTRATION & SALES Publisher: Redstone Media Group President/C.E.O.: Tim Hockley Accounting: Susan Smith 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.
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 Multimedia Specialist: Kat Shaw, (866) 764-1212 ext. 315 katshaw@redstonemediagroup.com Subscription Services Manager: Brittany Tufts, (866) 764-1212 ext. 115 brittany@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. The opinions expressed in this journal are not necessarily those of the editor, and different views may appear in other issues. Redstone Media Group Inc., publisher of IVC Journal, does not promote any of the products or services advertised by a third party advertiser in this publication, nor does Redstone Media Group Inc. verify the accuracy of any claims made in connection with such advertisers.
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Subscribe to IVC Journal Today! Subscribe to IVC Journal for just $29.95 and receive a FREE 1 year subscription to Animal Wellness Magazine. To order your subscription 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 copyright© 2017. No part of this publication may be reproduced or transmitted by any means, without prior written permission of the publisher. Publication date: November 2017.
IMPROVING THE LIVES OF ANIMALS... ONE READER AT A TIME.
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editorial
BUILDING THE
DREAM Most of us became veterinarians because of our desire to help
offers wonderful advice on how to empower technicians to
animals. When I graduated from veterinary college in 1980, I had
manage exercise programs for both young and old animals, as well
already worked for 18 years in mixed animal clinics and seen the
as athletes and even retired working dogs.
frustration and sadness of clients when their animals developed “aging” symptoms, including arthritis or digestive issues. Today
With winter upon us, you may be wondering about seasonal
we’re also seeing a sharp increase of serious ailments such as
diets. Dr. Jody Bearman discusses the benefits of using TCVM to
Cushing’s, diabetes, cancer, EPM and more in many animals.
identify personalities and foods that relate to the seasons, as a way to dramatically improve lifespans and decrease the probability of
While there are no magic recipes for health and longevity – for
long-term chronic illness.
people or animals – decades of treating animals holistically has shown me that dramatic improvements are possible. My biggest
Of course, the above articles are informative but it’s not always
joy has been working with clients who have been using many
easy to pursue the dream of an integrative practice. Dr. Cathy
different health approaches for decades. Their Great Danes often
Lund shows how you can be creative for mutual benefit by
lived to 17 years old, Shelties were still herding at age 24, cats lived
sharing physical space with a conventional practice while keeping
to 25 to 34 years, and most of these animals remained healthy
the businesses separate legally.
until close to death. Finally, Dr. Mushtaq Memon addresses how many private veterinary Many of the articles in this issue emphasize the importance of
practices and some veterinary teaching hospitals are addressing the
building health rather than merely treating symptoms as they
growing interest in integrative therapies for animals.
appear. Of course, nutrition is the foundation of good health and Dr. Barbara Royal discusses it in detail in her article on how digestion
I want to thank the readers I spoke to at several recent conferences.
can hinder or boost health. Equine veterinarian Dr. Lisa Pantzer
Your comments underlined the value of integrative approaches for
shows how evaluating the entire farm during a visit – fields, barn,
our health and happiness as practitioners. May we each continue
and feed – is a win-win situation for patients as well as vets.
to look for more ways to improve our patients’ health as well as our own. In the meantime, curl up in your favorite armchair
Dr. Laura Taylor talks about the benefits of osteopathy to treat
and enjoy this issue of IVC Journal. And remember to check out
animals after routine surgeries, like spay and neuter, so they can
previous articles of IVC at IVCJournal.com.
stay agile and athletic. Dr. Karen Gellman gives us insight into how the holistic management of breeding programs can help both
Have a happy and healthy winter!
bitch and puppies. Dr. Sarah Dayon talks about the homeopathic medicines that can gently help with parturition, neonates and illnesses in young animals. Dr. Margo Roman shares her experience on why it makes sense to incorporate ozone therapy – a modality on the rise around the world – in your practice. And Lynn Nalepa
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Christina Chambreau, DVM, CVH Associate Editor, drtina@ivcjournal.com
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1. JODY BEARMAN, DVM, CVA, CVCH, CVSMT
Dr. Jody Bearman graduated from the the University of Minnesota College of Veterinary Medicine in 1992. Wanting to help animals that couldn’t be diagnosed or treated with Western medicine, and those that developed severe side effects from Western medicine, she became a Certified Veterinary Acupuncturist in 2005, is also a certified Veterinary Chinese Herbalist, practices Tui-na (Chinese massage and physical therapy) and food therapy, and has instructed at the Chi Institute. Dr. Bearman became certified in veterinary spinal manipulation therapy in 2014, and is a member of the College of Animal Chiropractors. She trained in homeopathy and is a member of the AVH. She has a three-veterinarian integrative practice in Madison, Wisconsin.
2. SARAH DAYON, DVM
Dr. Sarah Dayon graduated from the University of Illinois College of Veterinary Medicine in 1992. She initially worked as a dairy vet in Southern Wisconsin, and in her search for less toxic ways to care for cows, stumbled upon homeopathy. She completed both The Professional Course in Veterinary Homeopathy in 1997, and The Advanced Course in Veterinary Homeopathy in 2001 with Dr. Richard Pitcairn. She currently practices mostly homeopathic small animal medicine with the occasional livestock patient in upstate New York.
3. KAREN GELLMAN, DVM, PHD
Dr. Karen Gellman is a graduate of Cornell College of Veterinary Medicine, and has a doctorate in animal locomotion biomechanics. She has advanced training and certification in veterinary acupuncture and veterinary chiropractic, and has practiced these and other modalities since 1995. She has been an invited or keynote speaker for IVAS, IVCA, AVDF, IAED and the Danish Veterinary Chiropractic Association. Dr. Gellman is the educational director and teacher in the Postural Rehabilitation training course for veterinarians, and teaches biomedical research programs for high school students at Cornell. She is Research Director of Maximum Horsepower Research, and principle investigator of a current study on equine posture funded by the AHVMA.
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7. ELIZABETH E. PANTZER, MS, DVM
Dr. Elizabeth Pantzer received her MS and DVM (1983) from Purdue University. Beginning in a mixed animal practice in Maryland, she then ran the NeoNatal Foal unit at Woodford Veterinary Clinic in Kentucky. After almost 20 years of working as a traditional vet for some of the best horse farms in Kentucky, she became interested in integrative approaches. Dr. Pantzer studied homeopathy, and a move back to her home state of Indiana allowed her to open a new practice which focused on holistic medicine. She took the IVAS class and studied Chinese Herbs, Tai Na and Chinese Diet Therapy. Dr. Pantzer moved to North Carolina in 2016 where she runs Holistic Veterinary Services of Asheville.
8. MARGO ROMAN, DVM, CVA, COT, CPT
Dr. Margo Roman graduated from the Veterinary College at Tuskegee Institute of Alabama, and was on the faculty of Tufts University, teaching anatomy, physiology and acupuncture. She was the consulting veterinarian in an IACUC for Creature Biomolecule in Hopkinton, Massachusetts, studying osteogenic proteins. Dr. Roman’s integrative practice, Main Street Animal Services of Hopkinton (M.A.S.H.), offers chiropractic, physical therapy, massage, Reiki, acupuncture, herbs, conventional medicine and more.
9. BARBARA ROYAL, DVM, CVA, CIAC
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.
10. BOB SIMPSON
Dr. Cathy Lund graduated from Iowa State University in 1988 and has practiced in the Minneapolis area ever since (Altpetvet.com). She lives on an acreage with her husband, kids and pets. Dr. Lund likes to spend her free time hiking, biking and gardening.
Bob Simpson is the founder of Canmedical, which has been serving the veterinary community across Canada for over 35 years. Canmedical specializes in veterinary digital imaging products and also has a service department equipped to fix almost all veterinary clinic equipment. Approximately five years ago, Bob created VEEN (Veterinary Equipment Exchange Network) for the North American trading market; he also has an American trading network, VEENAmerica, based in New York.
5. MUSHTAQ A. MEMON, BVSC, PHD, DIP ACT, CVA
11. LAURA TAYLOR, DVM
4. CATHY LUND, DVM
Dr. Mushtaq Memon received his veterinary education from Pakistan, his clinical residency training from University of Illinois, and his PhD from the University of Minnesota. He is a Diplomate of the American College of Theriogenologists, was on the faculty for 25 years at the veterinary teaching hospital at Washington State University, and spent ten years at the veterinary teaching hospitals of Tufts University, Louisiana State University and Oklahoma State University. Dr. Memon was instrumental in starting the Complementary and Alternative Veterinary Medicine program at WSU, and was elected as the Executive Director of the World Association of Traditional Chinese Veterinary Medicine (watcvm.org). After his recent retirement from WSU, he relocated to Atlanta, Georgia and and is practicing at an integrative clinic.
Dr. Laura Taylor graduated from the Ontario Veterinary College in 1989 and moved to Calgary, Alberta in 1992. Starting in the mid-1990s, she began certification training in veterinary chiropractic, acupuncture and homeopathy. Over a 15-year period, her strong interest in manipulative therapy led her to take training in human craniosacral therapy and human visceral manipulation, since education on the veterinary side of these osteopathic approaches did not exist. Later, she undertook two-year certification training in equine osteopathy. Dr. Taylor’s practice evolved from a small animal conventional practice to a 100% holistic practice using osteopathy, chiropractic and acupuncture. Her current scope of practice is limited to musculoskeletal/neurological cases with a case load that is 50/50 equine and small animals.
6. LYNN NALEPA, LVT, CCRP, CVPP
Lynn Nalepa graduated from Fairmont State University in 1991 and has worked in emergency/critical care, specialty, and general practice. She obtained her certification as Canine Rehabilitation Practitioner from University of Tennessee, and is also a Certified Veterinary Pain Practitioner from the International Academy of Veterinary Pain Management. She primarily works at Dulles South Veterinary Center in Northern Virginia. She is also proud to work with the non-profit group Paws of Honor whose goal is to provide veterinary care and products at no charge for retired military and law enforcement dogs in the Washington, D.C. Metropolitan area.
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what’s new IN MEMORIAM On September 8, 2017, Dr. Alfred Plechner passed away at the age of 79. Dr. Plechner graduated from the University of California Davis School of Veterinary Medicine in 1966. He owned and worked at the California Veterinary Hospital in Los Angeles from 1968 to 2004, and also worked at Cedar Sinai Veterinary Hospital from 2008 to 2016. Dr. Plechner was a caring and compassionate veterinarian, whose concern about increasing cancer rates led to his work with the adrenal gland, and his discovery of Atypical Cortisol Estrogen Imbalance Syndrome (ACEIS), also known as Plechner Syndrome (described in his book, Pets at Risk). He worked with more than 100,000 humans and animals, generously giving his time to interpreting endocrine problems (drplechner.com). Dr. Plechner also purchased a 27-acre parcel of land at the base of the Santa Monica Mountains, and started a wildlife preserve called Stone Wood Meadows, which provided free treatments and relocation for indigenous species. His passion for wildlife led him to the Big Horn Sheep Society of California where he worked as a research immunologist. Dr. Plechner will be deeply missed, but his contributions to veterinary medicine will live on.
NEW RESEARCH INTO CANINE BLOAT
NEW STUDY FINDS CATS REALLY DO MISS US WHEN WE’RE GONE Cats might not express as much excitement as dogs when we return home. But new research suggests that cats initiate more social contact with their owners after being left alone for longer periods of time. The study, led by head author Matilda Eriksson, looked at how 14 domestic cats behaved before, during and after being left alone at home for 30 minutes versus 4 hours. In both cases, the cats displayed no differences in behavior before owner departure, nor during the first and last five minutes of separation, suggesting that they were unaffected by separation length. Upon reuniting with their owners, however, the cats purred and stretched more after being separated for a longer period of time. These findings suggest that while cats cope well on their own, their owners play an important role in their social lives.
Gastric Dilatation Volvulus (GDV or bloat) is a serious problem among many canine breeds. Yet little is known about the causes of this deadly disease. While any larger dog can be affected, targeted breed-specific research is underway to help advance our understanding of the potential genetic factors that may predispose dogs to bloat. A team headed by Dr. Michael Harkey of the Fred Hutchinson Cancer Research Center recently completed a study of Great Danes which showed that three of the dogs’ immune system genes are significantly associated with bloat. For each of the three genes, one allele (variant) was found at high frequency in dogs with bloat, and the presence of any one of these “risk” alleles tripled the chances that a dog would experience bloat during his lifetime. The research team also showed that bacterial populations living in the intestinal tract (the gut microbiome) were altered both in dogs with bloat, and in those carrying the “risk” alleles. The AKC Canine Health Foundation (CHF) recently announced a new research grant to Dr. Harkey to study the genetics of bloat and its association with specific genes of the immune system and gut bacteria in German Shepherds. “Our hope is to define genetic markers for identification of atrisk dogs of all breeds, and ultimately, to design appropriate probiotic or dietary therapies to prevent GDV,” says Dr. Harkey. Dr. Harkey is seeking samples from German Shepherds and will send sample collection kits to those with eligible dogs. He can be contacted at mharkey@fhcrc.org or 206-667-3369 IVC WInter 2017/2018
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Holistic management for
BREEDERS By Karen Gellman, DVM, PhD, and Sarah Dayon, DVM
Building a better dog begins way before the parents ever meet! Breeders need a thorough understanding of the genetic consequences of their choices. You should coach your breeder clients to understand the strengths and weaknesses of their particular breeds, and to evaluate the conformational and genetic integrity of potential sires and breeding bitches. In the
show dog world, there is an unfortunate tendency to “breed to win” by tweaking a line’s morphology to align with popular fads among judges. This practice has been responsible for highly detrimental shifts in breed standards over the past 100 years, creating dogs that have significant health issues bred into them along with the desired looks.
1915
Once a well-proportioned, athletic dog, the Bull Terrier has transformed discernibly over time. His thicker abdomen and unnaturally rounded head and snout are a consequence of selective breeding.
The bulldog’s ever-increasing size and receding snout has led to numerous health complications. In most cases seen today, medical intervention is required during the birthing of this breed as a result of its large skull.
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Why does the practice of dog breeding create so many inadvertent health problems? Through selective breeding, humans have modified size, coat, skull shape, ear type, tail carriage and other traits. But when looking at a variety of wild canids, and interbreeding populations of feral domestic dogs, a genetic blueprint for canids emerges: medium size, medium coat length, long tail, cone-shaped head, and upright ears. (For more information, see “Recovering canine health: the natural dog” by Michael W. Fox, DVM, and Deanna L. Krantz, IVC Journal, Fall 2017) In particular, changes in skull shape toward extreme brachycephalic and dolichocephalic dogs (as well as brachycephalic cats) has destroyed the health and functionality of breeds that were once exceptional working dogs and robust pets. Some breeds, like English Bulldogs, have such huge heads that they are unable to normally whelp and require a C-section for each litter. his breed is also known for dysfunctional bites, severe dyspnea and cardiac anomalies. Others, like Collies and Shelties, can be expected to have poor dentition and significant eye defects because of their excessively narrow skulls. Vets and breeders need to work together responsibly to prevent these unintentional cruelties.
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For optimal fertility, the breeding bitch should be in excellent general health, with a solid but lean body score (4 out of 10), and given regular exercise. The diet should be high quality and protein-based. Processed commercial foods are not ideal because many kibbles are found to contain contaminants, which risks teratogenic effects, or even abortion in developing fetuses. Additionally, the high proportion of carbohydrate ingredients in dry dog food has a pro-inflammatory effect in the carnivore body. Many canned foods have a similar nutritional profile by dry weight as their kibble counterparts, so careful label reading is important!
PERI-PARTURIENT MANAGEMENT A match has been made, the breeding has “taken”… now what? Prepare, prepare, prepare! The bitch needs to be in tip-top form for birth and lactation. Body score in the final weeks should be 4 to 5. While extreme roughhousing is not a great idea, normal gentle exercise should be encouraged daily, to help keep the bitch fit and supple for whelping. A prenatal ultrasound evaluation tells how many puppies to expect, and flags skeletal abnormalities or extreme size differences in the puppies. A very large puppy is a risk factor for potential dystocia: it can act as a plug in the birth canal. A prenatal chiropractic adjustment for the mom will normalize and balance muscular tone, reduce stress and may reduce risk of dystocia.
During the first half of gestation, the bitch’s nutritional needs are only slightly increased and it is important not to overfeed, as excess weight gain can lead to problems during parturition. If the owner is feeding a homemade diet, it is critical for them to have a proven recipe, a balanced vitamin and mineral supplement designed to provide trace minerals, and an appropriate amount of calcium for this non-lactating adult phase of life. Feeding during pregnancy is a tricky balance. The bitch needs more calories for the developing puppies in the final weeks of gestation, but too much calcium supplementation creates a risk of eclampsia and too little can pull needed minerals from the dog’s bones. For the first six weeks, the quantity of food provided should not alter from her normal diet. In the last three weeks of gestation, however, the size of her meals should increase by approximately 25% each week, while keeping the calcium dose the same. In other words, don’t increase calcium intake with the increased ration. If the dog is fed a commercial food, the 25% increase should consist of fresh meat and vegetables; if the dam is fed a fresh food diet (preferred) the breeder may increase the muscle and organ portion of the diet but not add more bones. A baseline mineral ratio should be 0.8% to 1.5% calcium to 0.6% to 1.2% phosphorous. Continued on page 14.
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Continued from page 13.
WHELPING CONCERNS Breeders need to make sure the prepared whelping box is of adequate size to accommodate the size of the dog and the size of the litter. The environmental surface for whelping must have some traction but not snag tiny toenails. Once whelping is in train, make sure the owner knows to document birth order, weight and markings, and to ensure that all puppies are capable of suckling. If this is the dam’s first litter, a lack of adequate mothering skills can endanger the lives of the pups. Recent research has shown that mothering skills are both genetically and epigenetically programmed, with suboptimal nutrition and an experience of poor mothering while the dam was a pup as known risk factors. Homeopathic Sepia (see sidebar on page 16) can be a great remedy for rewiring these critical connections if the bitch seems disinterested in her puppies. Puppies that are weak and having trouble getting started often benefit from a dose of homeopathic Thuja (see sidebar on page 16). The breeder may need to consider options like a “sow crate” or spacer rails to keep the bitch and pups separated except for nursing. After whelping, lactation demands a higher proportion of calcium and phosphorus: 1% to 1.8% calcium to 0.8% to 1.6%
phosphorus. Because of the nutritional demands during this time, it is even more important to feed a high quality, easily digestible and balanced diet. Most dogs can be fed ad lib until weaning time.
EARLY MANAGEMENT: THREE TO 16 DAYS Most educated breeders know to weigh puppies daily to monitor weight gain and identify problems, but you may have to coach newbies. It is useful to teach them how to document other significant developmental milestones in each puppy, such as eye opening, visual tracking, tonic neck reflex (ability to hold the head upright) and efforts to stand. It may be useful to note structural and developmental differences between puppies relative to birth order and size. The early neurologic stimulation program (Bio-Sensor) developed by Dr. Carmen Battaglia is a proven way of jumpstarting the puppies’ neural and immune competence. It starts on the third day of life, and consists of a short daily routine (three to five seconds each) of varied stimuli: tactile stimulation, positioning upright, positioning upside down, positioning on back, and thermal stimulation with a cool
Gestation
3-5 months prior to breeding Conformational and genetic analysis of parents to improve health of breed Prepare bitch to have robust nutritional and physical health through weight management and exercise
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Mating
• Prenatal chiropractic • Appropriate exercise and nutrition
Birth
• Prepare birth environment • Know how many puppies to expect • Document birth order and weight • Make sure all puppies can suckle
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towel on the feet. Dogs exposed to this program show numerous benefits: improved cardiovascular performance, stronger heartbeats, stronger adrenal glands, more tolerance to stress, and greater resistance to disease. In learning tests, pups stimulated with the BioSensor program were found to be more active and more exploratory than their non- stimulated littermates (breedingbetterdogs.com/article/ early-neurological-stimulation).
FIRST ADJUSTMENT AND RIGHTING TRAINING: 16 TO 30 DAYS The most important intervention you can make to improve litter quality is to evaluate and correct problems of neural organization before the puppies are fully ambulatory. Ideally the timing for this visit should be somewhere within three to five weeks postpartum, as soon as the pups are able to thermoregulate away from the bitch. First, evaluate the bitch for any residual asymmetry from parturition. This is especially important if there was any dystocia. When the mom and pups come in for exam, carefully observe the puppies in the new environment and document differences among the group in terms of curiosity, gaiting abilities and stress levels. These are toddlers, and while they are funny to watch, they are actually experimenting with different aspects of locomotion. Their primary
Positioning puppy upright to challenge extensor reflexes.
Puppies
Puppies
• Follow up adjustments on any asymmetrical or motor incompetent puppies • Repeat full chiropractic and PR on all puppies before weaning • Examine bite carefully at 2 and 4 months - Dental intervention may be necessary for quality of life, if not show dog
• Early neuro stimulation • Document weight gain • Trim nails as early as one week, if necessary • Document development stages - Eye opening - Visual tracking - Tonic neck reflexes - Righting efforts
3–16 days Bitch • Evaluate for symmetry postpartum • Provide adequate nutrition for lactation • Monitor mothering skills - Whelping box proportions - Provide protection for pups if needed
16–30 days Puppies • When the puppies can thermoregulate away from bitch, eyes open not reliably walking • Observe in new environment • Individual exam, assessing symmetry, movement, body confidence and curiosity • First adjustment and postural evaluation with challenge to righting adnormalities in juvenile dentition
Thanks to Dr. Judith M. Shoemaker and the Postural Rehabilitation team for providing the timeline information.
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1– 4 months
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ACUTE PERI-PARTURIENT HOMEOPATHIC REMEDIES (“first aid”)
Classical homeopathy can be a quick and effective way to treat emerging conditions pre- and post-partum. You may want to put together a homeopathic emergency kit for breeder clients who will use it responsibly. It is best to use lower potencies when treating acute problems at home (30c and 6c by Boiron are often available in health food and even grocery stores). The remedies usually come as BB-sized pellets, packaged in small, lip balm-sized tubes. They can be administered either as one to two pellets given orally; or for tiny pups, dissolved in a small amount of water then dripped into the mouth with an eyedropper. Dosing is usually done one or two times, and not repeated until after consulting a homeopathic veterinarian. Please also consult a homeopathic veterinarian for directions using higher potency remedies. Apis mellifica: Mastitis with red, edematous mammary tissue (and lack of thirst) Arnica: Good to give to dam after whelping to promote quick healing of bruised tissues; also good for newborn puppies that seem slow in starting to nurse/move around. Arsenicum: For the puppy that has trouble getting started breathing, is cyanotic Belladonna: Mastitis with redness and heat, bitch is irritable Carbo vegetabilis: For weak, cold puppies Gelsemium: For the bitch that is extremely weak and exhausted during labor Phosphorus: Good for stopping bleeding Phytolacca: For mastitis when glands become indurated and painful, milk is stringy or chunky Pulsatilla: For stalled labor, a dam that seems to have trouble bonding with puppies, or puppies that are weak and cry constantly Sepia: For a dam that is not bonding with her pups at all Silica: For puppies whose teeth are slow in coming, who seem weak and may have large heads Thuja: Helps to stimulate puppies that are weak For a larger and more detailed list of remedies, Homeopathic Care for Cats & Dogs: Small Doses for Small Animals by Don Hamilton is a good beginning resource. The Pitcairn Institute of Veterinary Homeopathy offers a year-long veterinary training program and Dr. Christina Chambreau offers three- to six-day introduction to veterinary homeopathy classes. 16
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gaiting patterns and the kind of play they will soon engage in will require movement in multidimensional space. You can assess functional deficits by observing when puppies are unable to do their intended movements: look for the the one who keeps falling over (roll), the one who falls on its face (pitch and tilt), the one who can’t control its direction (yaw), the one who can swim and sit but doesn’t walk (pitch). This will give you clues about what manual therapy needs to be done, and how you can assess your results. Early childhood adjustments have a huge impact, because they can prevent problems before they are ingrained by growth and development. Litters that are given an early childhood intervention, like the one below, tend to yield a higher proportion of show quality dogs. For each puppy, perform an individual examination, including the following: • Listen to heart, observe any abnormalities • Examine and compare skull and jaw structure and symmetry • Look at tonic neck reflexes (can he control his head in space?) • Examine visual horizontal tracking (can he direct attention, and track with eyes?) • Examine and challenge extensor (standing) reflexes for: - Strength and symmetry - Equal front and hind competence The following exercises are part of the Canine Posture Rehabilitation protocol, as developed by Dr. Judith Shoemaker, Dr. Karen Gellman and Elizabeth Reese. As you work with the puppy, frequently stand it up on all four feet, “rubber side down”, to reinforce the standing posture reflex. Continued on page 18.
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parturition. You may need to treat them more frequently in the first six weeks.
Dr. Judith M. Shoemaker demonstrating gentle extension and flexion of the atlanto-occipital joint with Dr. Leslie Woodcock.
Continued from page 16. Each time you place the puppy, whether on your lap or the floor, the limb extensor reflex should be triggered by the paws touching a support surface. The primary postural reset for the front end is to gently extend the head and neck downward, and flex at the atlanto-occipital junction by bringing the nose towards the chest with a single finger. Make sure the puppy’s head can turn and rotate in every direction. The postural reset for the hind end is a tug downward on the tarsal bone of each hock. Gently! If you are trained in a specific manual therapy, you can go through your usual manipulation routine, bearing in mind how delicate these juvenile structures are. Be especially careful with any high velocity manipulation.
The “righting” exercise, lowering the puppy, head first and supine, with a gentle bend towards one side. The correct response is for the puppy to twist upright and reach out with the near forelimb.
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Remember the giant first puppy whose birth was so difficult? These extra large puppies, often the greatest birth weight, can be slower than their littermates to achieve developmental markers, and may appear somewhat dull. The first puppy in a dystocia birth will have spent a long time having his skull squeezed in the birth canal. These slow pups are especially in need of chiropractic, and even cranial-sacral treatment to recover from their difficult
When your normal manual therapy routine is complete, test the puppy’s righting mechanisms and neural integration. This challenge is achieved by holding the dog supine in your two hands, and lowering it with head down and a slight turn to one side. The righting reflex should trigger the down forelimb to reach to support the body. This should be tested on both sides (see photo below). In some pups, one side may be slower or they may try to reach with their opposite legs, showing cross signaling. This maneuver should be practiced until both sides react symmetrically. It should take no more than three tries in a pup with a normal nervous system. If one side continues to be slow, practice on the good side, then return to the slow side to see improvement. At the end of all manual therapy and righting challenges, reset the posture again and re-examine symmetry and reflexes. Recheck the heart as well after the procedure – if there was an abnormality, it may have disappeared with reorganization and posture change. Reassess each puppy’s symmetry, movement, body confidence and curiosity, and document any changes.
MANAGEMENT AFTER INITIAL ADJUSTMENT Adjust and perform righting challenges (Postural Rehabilitation) again before weaning. In cases of asymmetry, adjust frequently (every one to three weeks) during rapid growth to allow symmetrical growth. Document and address, if possible, abnormalities in dentition every time, along with listings and asymmetries. Dental problems are best addressed in the juvenile teeth, before the adult bite is formed. All carnivores are born with an underbite to facilitate nursing. There is normally a growth spurt in the mandible as the first teeth erupt. If a puppy has teeth that are slow to erupt, a dose of homeopathic Silica (or its constitutional remedy) may correct the problem. Growth asymmetries are usually addressed by removing the baby teeth on the slow side. It is best to consult a board-certified veterinary dentist at the appropriate time. Teaching puppies to chew appropriately by giving them raw chicken necks to learn on is a great way to build good behaviors and even intelligence. Dogs who learn to gnaw the meat off the bone, and grip the bone in their paws, have greater dexterity and problem-solving skills. Getting puppies straight and symmetrical in the beginning will save the owner much time, money and worry. Many puppies raised like this are self-maintaining – needing only six-month or once-yearly checkups unless they experience trauma, toxins or stress. When animals start life with a solid grounding in their relationship with gravity, they can often withstand and heal from severe illness and injury.
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From the VBMA The Veterinary Botanical Medicine Association is a group of veterinarians and herbalists dedicated to developing responsible herbal practice by encouraging research and education, strengthening industry relations, keeping herbal tradition alive as a valid information source, and increasing professional acceptance of herbal medicine for animals.
DID YOU GUESS LAST ISSUE’S MEDICINAL HERB? Gold thread (Coptis trifolia) is an endangered plant. This pretty little creeping evergreen has a slender, golden-yellow creeping root about the size of a coarse thread. It is found in dark woods throughout northern America and Asia. Golden thread is a prompt and bitter tonic. It is used to stimulate appetite during convalescence from febrile attacks, and any febrile episode that has a concurrent weakness in the GI system. It has also been used for aphthous sores in the mouth. Because golden thread is an endangered herb, if you see it, leave it! Please also support the United Plant Savers; as our herbal medicines become more popular, it is crucial to protect these plants from over-harvesting and habitat destruction.
REPORT ON ACTIVITIES This past July, a group of veterinarians went to Iceland to study with Bryndis Petursdottir and Are Thoresen. Many in this group were VBMA members and had a wonderful time studying Iceland’s amazing nature and unique flora. Spectacular lupines covered the landscape as they pony-trekked on the coast and hiked in the mountains. Our webinar series continued in September, featuring the Energetics of Western Herbs with special attention paid to GI herbs. The patterns seen in common GI issues in animals were matched with the energetics of Western herbs. This recording will be available for purchase at vbma.org. We had a very exciting speaker for our track during this year’s AHVMA Conference. Richard Mandelbaum has been an avid student of our native flora for over 25 years. With his extensive herbal training, he has been practicing as an herbalist since 1997, blending the use of native medicinal plants with Chinese and Western herbal traditions. Richard spoke on the intelligence of plants as well as zoopharmacognosy.
We already have several exciting events planned for 2018, starting as priority participants with David Winston from May 3 to 6 in Menla Mountain, located in the lower Catskill Mountains. For almost 40 years, David has been studying, practicing, teaching and researching Cherokee, Chinese and Western herbal medicine. Since 1980, David has been educating herbalists, physicians, nurses, naturopathic physicians, veterinarians, and nutritionists in the art and science of clinical herbal medicine. For registration information, go to nycavma.org. Topics to be covered include herbal pain relief, Lyme disease, autoimmune disease and allergies, adaptogens, and a comparison of organ system remedies, along with herbal walks and being in nature! Join us for this “not-to-bemissed” herbal event!
NAME THIS HERB!
Join the VBMA at vbma.org to find out. The answer will also be published in the next issue of IVC Journal.
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TCVM
PREVENTIVE
SEASONAL MEDICINE
FOR PETS By Jody Bearman, DVM, CVSMT, CVA, CVCH
I
n Chinese medicine, the seasons are associated with different bodily organs, ages and personalities. Encouraging your clients to come in for a seasonal “tune-up” is a good way to prevent future illness in their pets. Sending out wellness reminders with tips for each season can help clients realize that you are committed to their animals’ health, and not merely treating ailments. Discussing the foods that correspond with each season is another way to promote your patients’ health, while encouraging clients to feed a variety of fresh foods.
WINTER
Winter, the coldest season, is associated with the kidneys, bladder, hearing, water and old age. The Water personality is careful, curious, self-contained, meditative, slow, consistent, and has a tendency to hide. Those who are old, cold and have a Water personality will benefit from eating warming foods such as lamb, venison, chicken, garlic, buckwheat, eggs, ginger
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and cinnamon. Warming all food to room temperature or warmer is helpful for Water personality animals in the winter, as well as for most older or cold animals even at other times of the year. Kidney yang deficient animals, who may have a cold back, possibly early morning diarrhea and a sinking hind end, benefit from cooked food rather than raw, as raw feeding requires more energy to digest.
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Eggs contain qi (strengthening) and yin (cooling). Since eggs are the beginning of life, they also strengthen kidney jing, or life force, which comes from egg and sperm, and decreases with age. It is important to also nourish kidney yin, as all animals need the balance of yin and yang (qi plus warmth). Animals with kidney disease or bladder damp heat (blood, crystals or bacteria in the urine) are often very thirsty, may seek cool areas and may have a red dry tongue, often indicating yin deficiency. Some foods that nourish kidney yin are duck, pork, kidney, tofu, eggs, asparagus, cabbage, apples, barley, black beans and honey. Even if an animal is not old or a Water personality, all animals can benefit from slight feeding changes in winter.
For an animal with a cold back or cold hind end, moxa treatment can be very helpful. Moxa, or compressed mugwort, is lit and moved over the cold areas (but not touched to the skin). Smokeless moxa keeps odor away, but regular moxa seems stronger in my experience. If you are using this in a clinical setting, be sure to warn those around that it smells a bit like marijuana. This video provides a demonstration: youtu.be/bb7aQTibVTQ. Massage can also strengthen the back and organs. Nie-fa, or skin rolling, can be done on the sides of the spine from head to tail. This loosens the fascia, allowing more free movement of the spine and supporting the immune system. Watch this video for a demonstration: youtu.be/qs4_z7BBwIg.
SPRING
Springtime is Wood season, and associated with youth, the liver and gallbladder (even in those animals without a gallbladder). The Wood personality is decisive, assertive, confident, athletic and wants to be alpha. These animals can be prone to irritability, ear problems, conjunctivitis, a purple color to the tongue (excluding Chows and Chow mixes of course), nail and foot problems; and tendon and ligament issues.
bison liver, while heat seeking animals can handle chicken liver. Wood animals like to work hard and need both mental and physical exercise. Food dispensing toys can help when weather is too hot for physical exertion. Wood animals enjoy difficult competitive exercise, such as agility, lure coursing, endurance competition and racing, and tend to do well as they have the will to succeed.
To prevent these problems in young Wood personality animals (and all animals in the springtime), feeding cooked or pureed dark leafy greens such as kale, collards, turnip greens, beet greens, mustard greens, chard, spinach or broccoli is very helpful. Older animals or those with weak intestinal tracts do better with cooked greens, whereas young strong animals can handle pureed raw greens. Mixing greens with scrambled eggs or meat or onion-free broth can make them very palatable for finicky pets.
Springtime is also the time of Wind, which can be internal or external. Internal Wind manifests in the form of seizures, and external Wind as itchiness. Dark green vegetables help decrease the risk of both ailments. Acupuncture or acupressure of liver points such as Liver 3 (on top of the hind foot between the second and third metatarsal bones) and blood points can help decrease Wind issues. The empty cases of cicadas can also help. Children often love searching for these and adding them to their dogs’ food.
Continued on page 22.
Carnivores also benefit from eating liver. Those with sensitive gastrointestinal tracts can handle freeze-dried liver better than freshly cooked. Animals who run warm should have beef or
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Continued from page 21.
SUMMER
Summer is associated with the Fire personality, adolescence, the tongue, the heart and pericardium, small intestine and the Triple Heater, which doesn’t fit an exact anatomical organ but is somewhat similar to the thyroid. The Fire personality is outgoing, friendly and likes to be the center of attention. In the heat of summer, Fire problems such as shen disturbance, which can be seen as noise phobia or other abnormal behaviors, are more likely to occur. To cool Fire animals or any other hot animals in summer, feed cooling foods such as watermelon, celery (which also drains damp, helping hot animals with diarrhea or moist dermatitis), greens as mentioned earlier, brown rice, millet, turkey, rabbit (which is also strengthening), clams, cod and other whitefish. Feeding heart is also helpful. A cooling bed or fan is a great adjunct in hot weather. Since the tongue is the sense organ of the Fire element, heart disease and shen disturbance can sometimes be suspected by a red and/or bell shaped tip to the tongue. Determine diagnostics
needed (such as an echocardiogram) with a Chinese pulse examination and a very thorough physical. Treatment with food therapy, acupuncture and herbal medicine, along with any conventional medicine needed, can also help. It may give a clue to which cats may have a propensity to hypertrophic cardiomyopathy before saddle thrombus or sudden death occur, so prevention can begin. To correctly assess the tongue, the animal must show it freely, without having the mouth opened externally. Often when a person sticks out their tongue, the animal will do the same. Watching closely to catch a glimpse can be done but it can be tricky! If necessary, peek through the lips between the teeth to see the general tongue color, shape and moisture. Shen disturbance can be helped with Chinese herbal medicine (often a heart yin tonic) and non-Chinese medicine adjuncts such as Rescue Remedy for pets given orally or rubbed on the hairless parts of ears several times a day. This is especially important in the instance of fireworks and thunderstorms.
LATE SUMMER Late summer is associated with the Earth personality, adulthood, damp heat and the gastrointestinal system, called the Spleen and Stomach in Chinese medicine. Earth personality animals are laid back, mellow, round and large, sociable and sympathetic. To help a weak gastrointestinal system in an Earth personality animal, well-cooked quinoa, sweet potato, pumpkin or squash are strengthening, along with beef, bison, rabbit and tripe. Damp-draining foods for those with loose stool or moist dermatitis include celery (which is also cooling), mushrooms and turnips. Avoid dampening foods such as watermelon, pork and salmon, as these worsen moist dermatitis and diarrhea.
cool at the tips, the nose should be cool and moist in dogs and cats and the paw pads should be soft and pliable in a healthy animal. If these areas are hot, too moist or dry, use foods to correct the imbalance. The tongue in an animal with damp may be thick and even have tooth impressions, giving another clue as to which foods to feed. Earth personalities are prone to worry, so Rescue Remedy for pets, pheromone-based products such as Dog Appeasing Pheromone, and Feliway can be helpful. Strengthening the gastrointestinal tract with Chinese herbal medicine (spleen qi tonics) and probiotics can also help ease worry.
Hot spices such as garlic and ginger can help prevent dampness and are good as long as the animal is not too hot. Limbs should be cool from the carpus distal and the tibiotarsal joint distal in all animals, the ears should be warm towards the head and
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Advertorial
AUTUMN Autumn, with its cool and often dry weather, is associated with middle age, Metal personalities, and the lung and large intestine, which are prone to drying out and causing cough and constipation. The skin and haircoat may also be dry and coarse. Metal personalities are aloof, love order and obey the rules. To moisten the respiratory tract and prevent cough, pears and honey are excellent foods, especially local honey as it contains small amounts of local allergens, helping prevent respiratory allergies. Yin deficient (or hot dry) coughs are more common at night, and the animal may have a red tongue and warm dry nose. If the cough is weak or in the daytime, walnuts can help strengthen lung qi. Sardines help prevent constipation with their unique blend of yin and blood, which are, respectively, cool and moist, and warm and moist. Feeding lung also helps the lung, and if the large intestine is weak, such as in constipation, strengthening foods such as pumpkin, sweet potato and winter squash are helpful. Other moistening foods that help the lung, large intestine, skin and coat are eggs, duck, barley, tofu and rice. Understanding the seasonality of Chinese medicine, the personalities that go with the seasons and foods that are helpful to add at these seasons can help animals be healthier all year long. Of course, each individual animal can be much more complicated. Traditional Chinese Veterinary Medicine Volume 1 by Huisheng Xie and Vanessa Preast is a good place to start for a more thorough understanding of this ancient medicine.
VetzLife All-Natural News By Christopher Kelly Groth
Eliminate calculus from your patients’ teeth – without brushing “But I’ve been brushing his teeth!” How often have you heard this from clients? Yet a checkup reveals that the patient has calculus buildup. You and I can floss and brush our own teeth every day, but the dentist will still find something to scrape off. The same is true for our pets. Typically, a traditional clinic will want to schedule a dental appointment for the pet. But what if you want to avoid inducing the patient with anesthesia for a dental, and tackle the issue another way? What are your options? You could recommend an anesthesia-free scaling from a trusted professional. But what if you don’t have access to that? What is your best recommendation? More brushing? Something you can offer your clients that will actually eliminate existing calculus is VetzLife Oral Care. This allnatural gel and spray will not only prevent plaque from forming, but will also dissolve existing tartar. All your clients need to do is comply with the basic instructions and stick to it. And they will love hearing that they don’t need to brush! They just need to get it in the mouth twice a day, and voila! “Clinical results suggest the topical application of VetzLife oral care products improves periodontal and dental disease not only as a sole treatment but also in combination with surgical and non-surgical therapies,” states the Drexel University College of Medicine. Find out more at Vetzlife.com. Christopher Kelly Groth is the Senior Sales Executive for PetzLife Products.
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integrative practice INTRODUCING A
HOLISTIC APPROACH TO CONVENTIONAL PRACTICE By Cathy Lund, DVM
M
any veterinary practitioners who embrace holistic medicine have a personal story. Perhaps conventional medicine failed them, or one of their loved ones, and it was only when they turned to alternative therapies that they saw any true health improvements. These experiences tend to change their outlook on medicine, inspiring them to learn more about holistic treatments and begin introducing them into their own practices. This article follows my own journey towards holistic medicine and how I went about adding it to daily practice.
HOW I GOT INTERESTED IN HOLISTIC MEDICINE My story began with our son, Ben, who suffered for years with headaches, hours-long temper tantrums, skin rashes, night terrors and one ear infection after another. With diet changes and cessation of vaccines, and working with chiropractors, Qigong masters and homeopaths, he started to smile again, and became healthy. Now 18, Ben is a college freshman. He sees an acupuncturist/ herbalist to help with anxiety, eats what he wants, and has learned how to keep his moods stable with his own flower essence blend and essential oils. He’s not perfect, but he’s pretty good.
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A couple of years into Ben’s treatment, I finally recognized the discordance between what I now believed was “health care” for my family, versus how I had been treating animal patients at the practice for 18 years.
LEARNING MORE At my first AHVMA conference, I met top notch practitioners – specialists in acupuncture, chiropractic, PT, homeopathy, herbs and more. Some practiced out of AAHA-certified hospitals and even referral centers. A few sported braids and sandals! But they all had one thing in common; they had discovered that their Western medical training fell short of their expectations. Soon after the conference, I read an article by Dr. Christina Chambreau about seeking your “right livelihood”, the work that completes you as a person on all levels. This concept really hit home; I wasn’t in my right work anymore. So I gave six months’ notice at my practice and started taking local holistic veterinarians to lunch – acupuncturists, homeopaths, herbalists, chiropractors. They were incredibly helpful in providing some shape to my new business. I wanted to know where they practiced, what modalities they used, where they trained, and the pros and cons of different types of integrative practice approaches.
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OFFERING HOLISTIC THERAPIES IN A CONVENTIONAL SETTING Then I approached the owners of the conventional practice where I’d been an associate for ten years, and we agreed to a shared percentage: • 60% (me)/40% (clinic) on exams • 25% on radiographs, labs • 12.5% on referred surgery, dentals, specialist consults. The clinic provides me with an exam room, an assistant/technician when needed, scheduling and diagnostics. The owners have been very understanding of my clients’ choices – running titers and recommending raw diets, especially since they are a fully Western AAHA-certified hospital. They see a demand for alternative medicine, and know I’ll refer medical and surgical cases to them as needed. Their lawyer and my tax guy strongly suggested the businesses be kept separate – my name is not on the door, the clinic literature or the website. Clients are instructed to contact me at my own Animal Wellness Center and call or email my home office even though pets are seen at the clinic. Most of my supplies, primarily Chinese herbs and Standard Process supplements, are kept at my home.
WHAT TO KEEP IN MIND • In holistic practice, you will see many cases with advanced disease. Some will lose the battle, but when you can extend that pet’s life far beyond conventional predictions, that’s good. • Your clients, on average, will be a bit more high-maintenance, so be sure to charge for your time. • Soft fleece blankets, extra time and lots of treats make your hospital a fun place (or at least tolerable!). Provide cats with a quiet room, a place to perch or hide, and time to adapt before their exams. • These are clients you will typically see more often than in a conventional setting. You’ll get to know them better, and will walk through life’s challenges together. For me, this has been a great joy.
Initial intake exams are 90 minutes. I review records prior to the appointment for the medical history. I typically chat with the owner at length before examining the pet. We discuss medical history; treatments that have worked or failed; their goals (which may not be the same as mine!); vaccines, heartworm, flea and tick prevention and (oh-so-important) diet. Typically, diet is the first change we make, if appropriate. I ask owners to feed a commercial raw or fresh-cooked diet and start whole food supplements while I select the Chinese herbs. Commonly, I hear things like: “She’s so much more energetic!”, “His eyes are brighter”, “No more gas – thank you!” from the diet change alone. This lays a foundation for healing, the owners are receptive and the herbs will amplify that process. On the flip side, a pet on a fresh diet who isn’t doing well will occasionally show up (e.g. a German shepherd with chronic GI issues who was worse on raw diet). I find that some of these animals do better on hypoallergenic kibble short-term. After a few months of treatment, they can often transition back to raw/ cooked diet and do well. Recheck exams are 40 minutes long – I repeat an exam, review treatment success, and make a plan for moving forward. If the Continued on page 27. IVC WInter 2017/2018
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CASE STUDY #1
Roxanne, a 16-year-old SF DSH cat Roxanne was presented in November of 2014 for a second opinion on treatment for kidney failure. The owner’s conventional veterinarian had recommended urine culture, urine protein, creatinine ratio and blood pressure – all declined due to cost. Three renal diets were sent home, all of which Roxy refused. The owner gave SQ fluids for a few weeks, but because she’s older, she found it difficult to continue. She reported that Roxy was lethargic, 70 inappetant, PU/PD and vomiting occasionally.
labs. I stressed the importance of doing so, and continued to check in every couple weeks. Ten weeks later, Roxy presented for labs only: • BUN 35 • Creatinine 1.9 • Phosphorus 2.9 Her owner reported that she was “bossing the other cats around again”, was much more playful, eating well, still PU/PD. She was eating consistently, so we added Standard Process Renafood.
Roxanne’s labs were: • BUN 155 mg/dl • Creatinine 8.9 mg/dl • Phosphorus 10.7 mg/dl • USG 1.010 On exam, Roxy was quiet, 6% dehydrated, had a strong rapid pulse, with kidneys bilaterally small and smooth, and loss of spinal muscling. As Roxy only agreed to eat higher-protein canned diet, we continued that diet, but I asked the owner to offer the food lukewarm, with water added to a soupy consistency. I started Roxy on Zhi bai di huang wan tincture at 0.15 ml PO BID, and asked the owner to return for a recheck exam and labs in two weeks. On callback seven days later, the owner reported that Roxy was eating somewhat better (and taking the herbs in food, as the owner could not medicate orally). After two weeks, the owner reported that Roxy was feeling “much better”, but that she absolutely could not afford a recheck exam and
I finally saw Roxy for a recheck exam and labs six months after her initial exam with me (I’d long given up hope that the owner would make another appointment, but was happy with her progress reports). Roxy was still 5% dehydrated, but she had a stable weight and was perky. A mini-screen was normal. She continued to eat high protein canned diet, with the owner rotating proteins. I learned two things from this kitty. I will never limit protein in any standard chronic renal failure cat. My Chinese training taught me that protein increases renal blood flow. So if there is no sign of renal inflammation (infection, ^UPC, etc.), high protein diets are indicated. I know this topic had been discussed to death on both conventional and alternative forums. There are DVMs far more qualified than myself who can speak to the physiology involved, but I continue to have good success in CRF cats with water-added high protein canned diets, and a proper herb Rx (which is the difficult part sometimes, right?). Secondly, I learned that animals can heal, even under less-than-ideal circumstances.
CASE STUDY #2
Copper, an eight-year-old MN Viszla Copper presented two weeks post-splenectomy for hemangiosarcoma. On exam, he was shy, had several fatty masses, BCS 6/9, mm slightly pale, pulse deeper and thinnish. He had been very sleepy on Tramadol (a yin tonifier). So he appeared to be blood deficient and damp in TCM terms. I started him on Yunnan bai yao, Dang gui shao yao san, cod liver oil, medicinal mushrooms, IP6. Through the next 15 months of treatment,
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I tried various additions to the DGSYS, but was never able to quite correct Copper’s thinner pulse. He eventually had an acute bleed and was euthanized. I know there are reports of much longer survival times with HSA patients undergoing herbal care, but with minimal side effects the owner and I were happy to have provided Copper with a period of time well beyond what was expected for splenectomy alone, and even chemo.
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Continued from page 25. client has a conventional veterinarian, I try to keep labs and diagnostics within that clinic as much as possible. Some rechecks are done by phone for clients who live far away, have cats or dogs who are stressed by car rides, or who cannot make my appointment schedule. While not ideal from a TCVM perspective, clients are grateful for this option and will continue with holistic treatments. These cases do move forward. I charge by the minute for calls and extensive emails. I continue to vaccinate younger animals, but using only core vaccines that are given singly. Per Dr. Ron Schultz, I titer puppies after their last DHPP, then typically do not repeat. Rabies is given every three years in healthy pets. I recommend seasonal heartworm preventative and use pyrethrin or essential oil sprays for fleas and ticks. For cats, I give a single FVRCP and one rabies vaccine if they’re kept indoors.
WORKING WITH A BUSINESS COACH After ten years, I finally hired a business coach because generating income was a challenge without typical practice sales. I strongly recommend working with a coach at the beginning of your foray into predominately holistic medicine. We’re making progress on pricing, a new website, and charging for my phone and email time when lengthy ($100/hour). My typical clients are middle-aged woman whose beliefs are similar to mine. They are presenting their pets for holistic care, and any conventional work (spay/neuter, vaccination, specialty referral) is considered “alternative”. I love that! Typical cases are chronic medical issues such as IBD, seizures, cancer, atopy and behavior problems. My practice is now aligned with my personal beliefs about wellness, and my patients are benefitting with improved health. IVC WInter 2017/2018
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nutrition nook
UNDERSTANDING
PET DIGESTION By Barbara Royal, DVM, CVA, CIAC
“Outside of a dog, a book is a man’s best friend. Inside of a dog, it’s too dark to read.” – Groucho Marx
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F
rom the outside, pet nutrition seems like an easy subject. Buy a bag of pet food. Feed the same dry food to the pet every day of her life. No fresh food, no variation. As veterinarians, this is typically what we are taught. But is that really the best recipe for pet health? Does it make sense? To find the answer, it is best to shine a light on the inside of a dog (or cat), and examine what they really need, from the lens of my 20 years of veterinary practice.
HEALTH IS ENTIRELY DEPENDENT ON NUTRITION The best way to insure vibrant health and longevity is to provide an excellent and species-appropriate plane of nutrition. Digestion is the product of both the complexity and simplicity of nature. All animals on the planet keep themselves alive and healthy through the actions of finding food and water, ingesting, regulating, digesting, absorbing, rejecting, and defecating. Every aspect of the food our pets eat – moisture, freshness, processing, balance, structure, sourcing, amount, ingredients, frequency of meals, and even how it is served – plays a role for good or ill, in the digestive process. Not being able to find ways to truly heal animals can be frustrating for veterinarians and pet parents who are depending on inappropriate foods for the animals in their care. Why did we ever think that a processed dry food would be better for our beloved animal family members? Why is it so difficult to consider feeding fresh food? If fully changing to a fresh raw food is daunting, it is possible to simply add some fresh food even a few times a week. The health changes can be dramatic. Often, just adding a sardine or two to the food, and using a small amount of fresh meat or pre-prepared raw foods (even lightly cooked) a few days a week can improve health. It is possible (and often a great first step) to mix and match processed and fresh foods. The real first step to creating a healthier animal is to understand digestion. It is clear that food supports the overall development, growth and maintenance of strong bones, muscles, nerves and organs; the regulation of gene expression, the immune system, circulation, and fluid balance; the daily balancing of hormonal/ endocrine reactions and behavior; the support of the bacterial biome in the GI tract, skin and throughout the body, and creating an overall happy, healthy and long life. Understanding why and how all these are affected by diet choices is an important and typically absent part of veterinary care. So what is happening in there (inside, in the dark) that we don’t know about?
WHO’S ON THE INSIDE? Digestive activity is not limited to textbook pictures of the organs and cells of the GI tract. There are many players in digestion besides the animal’s own cells – in fact, nearly 70% of what happens in the GI tract results from other organisms’ actions, production and reactions. The most important component of the digestive process may well be a healthy combination of “good” and “bad” bacteria (a healthy GI biome). There are thousands of species of bacteria that play roles in animal health. In fact, we know that the number of bacteria living in an animal’s body significantly outnumber their own cells. The symbiotic relationship between the body and its GI biome is responsible for a significant portion of the regulation, fermentation, border patrol, absorption and production of nutrients. Healthy animals eating species-appropriate foods are feeding and supporting appropriate GI bacteria. This healthy population of bacteria then keep the animal healthy. Appropriate bacteria play vital roles in the breakdown of fibers and toxins, vitamin production, protection from pathogenic bacteria, integrity of the GI tract lining, and appropriate absorption. We see dysbiosis and illness when bad bacteria overrun the good. Dysbiosis, GI disorders, absorption problems and other GI related health issues are becoming more prevalent in our pet populations. It is likely that the increase in these disorders is related to bacterial imbalances resulting from increased use of antibiotics, herbicides and pesticides, as well as speciesinappropriate, sterile processed foods.
MISCONCEPTIONS ABOUT BACTERIA • If we get rid of all bacteria, we will be healthier. (Just not true.) • If bacteria are resistant to antibiotics, we have no other solutions. (Integrative medicine has many options – e.g. essential oils, honey, herbs, immune supplements, and excellent foods can all help cure resistant bacterial infections.) • If we sterilize surfaces and bathe more, we will be healthier. (The more we rid our environment of good bacteria, which fight bad bacteria, the more likely we will have troublesome problems with bad bacteria, which will multiply unabated and become resistant. Also, sterile environments are implicated in allergy and immune system issues in youngsters.) • Plastics are safer than wood surfaces. (Wood has natural antibiotic properties, and what IVC WInter 2017/2018
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protects trees from bacterial invaders protects wood products from bad bacteria.) • All raw meat foods contain harmful bacteria for animals. (While testing is done, healthy dogs and cats are designed to fight many pathogens in their meats, including E.coli and Salmonella. After all, they eat poop, pick up and swallow who-knows-what old meat/animal parts outside, and are fine.) • Eating pasteurized, cooked, processed foods is safer for our pets, and for owners and vets. (There are risks and recalls for all meat pet foods. Companies making raw foods are just as concerned about pathogens as processed food makers. Pathogenic bacteria – more of an issue for humans, and not always a problem for pets – have been found in all types of pet foods, whether kibble, canned, raw, freeze dried, treats, etc., and no one food is inherently safer than another. The best advice is to be careful with all foods.)
moisture, but it will not be a natural activity for them, so they may wait until they are significantly dehydrated before taking a drink. If, for their whole life, for every meal, cats are given dry food that provides little moisture and requires significant moisture from the body just to digest it, we are setting up a situation that causes dehydration and stresses the kidneys. Over time, this can translate into urinary tract disease, stones, infections or kidney disease.
The GI tract functions as an absorptive, protective, motile, interactive immune surface full of live organisms. It protects the body from bad bacteria, disease and toxins, absorbs and creates nutrients, and provides triggers for hormonal, immune and neurologic interactions.
MACRONUTRIENTS AND MICRONUTRIENTS Nutrients and water are obtained, absorbed and moved through the gastrointestinal (GI) tract to support the many systems of the body. The three generally recognized macronutrients (needed in large amounts) are protein, fat and carbohydrates. Micronutrients are vitamins and minerals that are needed in small amounts. Water is not considered a macronutrient, although it is needed in large amounts for most of the processes, reactions and transportation functions of digestion. It also provides a structural vehicle in which nutrients are presented for use. When we remove water from fresh foods, we create a jumble of dry ingredients that the body needs to untangle. In their original form, fresh foods maintain their cellular integrity and form. The water’s structure creates an appropriate vehicle and an orderly balance for recognition and absorption. Adding or taking away water should not be done lightly.
CATS IN TROUBLED WATERS Moisture-appropriate foods are even more important for cats. It is possible that cats may be prone to developing kidney problems because we feed them dry foods. They are desert animals and inclined to get their moisture from their prey, as fresh water in the desert is scarce. They will drink to get their
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SMELL, TASTE AND TEMPERATURE Detecting an appetizing smell is essential to start the body’s juices flowing. There are many medications that affect smell and taste, so it is useful to be aware of the side effects of medications. If an animal develops a decrease in olfaction from non-steroidal anti-inflammatory drugs (NSAIDS), it can affect his appetite. This is something known to the owners of dogs who do nose work, so they avoid NSAIDS, especially when the dog is working. Animals will generally also avoid foods that do not smell appetizing, or that smell rotten or toxic (except for some Labradors named Orion, Quincy or Darwin!). This is also true for taste. The ability to detect unhealthy odors or tastes is an important first defense. Temperature and moisture can also play a role in enhancing odors and tastes and stimulating the appetite. Meats would typically be at least at room temperature or even “body temperature” when animals hunt and eat. There is something to be said for trying to mimic what would make a carnivore excited about his food in the wild.
TEETH – NOT FOR CHEWING The dentition of a carnivore is specifically geared towards tearing off chunks of food and getting
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them ready to swallow, not for chewing. Dogs and cats have these little pyramids of teeth. Their teeth are sharp, and they interlock to hold and rip flesh. The teeth have done their job if what they have torn off can fit down the esophagus. There are no flat “chewing” teeth. Carnivores can chew, but it is not the “point” of their teeth. We learn in grade school what different teeth do from their shape. There is a difference between large, wide, flat chewing cow teeth and sharp pointy carnivore teeth. Moist meaty foods are easily cleaned off the surfaces of the teeth with a swipe of the tongue. Inappropriate, dry, sticky carbohydrates will stick to the teeth and create tartar. Changing to a fresh, moistureappropriate food can be one way to improve dentition and mouth biome health.
SALIVA, DROOL, SLOBBER – LUBRICANT The carnivore mouth is just a momentary stop for food on the way down. Saliva reflects that purpose. Saliva’s main activity in dogs and cats is to act as a lubricant, although it will mix with bacteria – both good and bad. It even has a bit of antibacterial capacity to fight pathogens, but its main purpose is to allow easy and quick swallowing.
WOLFING IT DOWN – DOGS HAVE THE STOMACH FOR IT The term “wolf it down” is correct for Canids. This is what they do – they swallow first and ask questions later. Which is why we have hundreds of radiographs of foreign objects (including a personal favorite – an entire GI Joe) in the stomachs of dogs. But in nature, wild dogs would grab large pieces of meat from their prey, or even the whole prey, and swallow. A dog can eat a huge amount of fresh meat and organs in seconds, and show no ill effects. In fact, their digestive tracts appear to be designed to do just that. Dogs can keep about 70% of their ingesta in the stomach, and only 30% in their intestinal tracts. In humans, those percentages are reversed – 30% in the stomach and 70% in the intestines. So people eat smaller meals, more frequently. We only encounter problems with a dog or cat’s instinctual speed-eating when we feed dry foods, because these foods are not what the body expects. The stomach is made for more moistureappropriate diet. Animals eating meals of dry IVC WInter 2017/2018
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processed foods are five times more likely to bloat than animals eating large amounts of fresh moisture-appropriate foods.
metals essential in the production of enzymes), making them unavailable for these metabolic processes.
THE STOMACH
The large intestine is involved in the absorption of water, electrolytes, vitamin production and absorption. Both the small and large intestines contain a great deal of bacteria that serve a number of functions. They are essential for the absorption of vitamins (especially B and K), they produce small fatty acids used as energy by GI epithelial cells, and they are needed to break down indigestible fibers and molecules.
The stomach creates a very large muscular acid bath for the food. In fact, the stomach acid of a carnivore has a pH of 1 – extremely acidic. When food arrives in the stomach, it stimulates parietal cells to secrete hydrochloric acid (HCl), which decreases the pH. Eventually, a negative feedback mechanism recognizes there is enough HCl and shuts off production. The acid bath softens foods, kills pathogenic bacteria, breaks bonds, and starts the digestive process. The muscular motion of the stomach wall mechanically mixes the acid with the foods.
Esophagus
Liver
Stomach Duodenum
Large intestine
Anus Tonque
Pharynx
Cecum
Spleen
Small intestine
INTESTINES, SMALL AND LARGE As acidic ingesta moves from the stomach into the duodenum, the fats, proteins and lowered pH of the ingesta will stimulate pancreatic and bile secretions, cholecystokynins and digestive enzymes that further digest and neutralize the acid in the food. Proteins are somewhat digested to amino acids, di-peptides, tri-peptides (short-chain polypeptides) by pepsin. Triglyerides (fats) are emulsified, broken down and absorbed. Nutrients are transported across epithelial layers with help from bacteria and the brush border enzymes, pancreatic juices and bile salts. Sugars are fast energy and are absorbed and used quickly (and will affect inflammation and the glycemic index). Note: Production of digestive enzymes depends on appropriate levels of micronutrients and minerals like iron, manganese and selenium. Animals may become deficient in many micronutrients because of an increase in herbicide chemicals like glyphosate in pet foods. Glyphosate insolubly binds many micronutrients and minerals in foods (specifically
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WHAT THE POOP? Defecation in the carnivore should not involve huge, voluminous soft feces. Normal canines use most of their food, and the resulting poop should be very firm, relatively dry, not horrible-smelling and in a small amount. When carnivores eat healthy, appropriate fresh food, “even the poop is cute”. Poop odor and flatulence in dogs and cats is related to their biome. Bacteria produce many unpleasant gasses and smells, and an unhealthy biome will smell unhealthy. Pets defecating more than twice a day, and creating soft, odiferous and large feces, reflect the amount of filler and inappropriate ingredients we put in pet food, and is not a normal condition for dogs and cats. A good way to monitor proper feeding amount is by looking at weight and monitoring the frequency of defecation. Dogs and cats normally defecate one to two times a day at a maximum. The stool is small, firm, and doesn’t always look exactly the same. If dogs and cats are pooping more than that, they are either eating too much or ingesting too much filler.
DIARRHEA AND VOMITING Vomiting or diarrhea can be a reaction to something in the food, or symptoms of a systemic illness. If it is a reaction to food, expelling the food with urgency might be a sensible mechanism. The body is saying “wrong food!” and removes it as quickly as possible. Medical interpretation often describes vomiting and/or diarrhea as a disease process in itself, so medications to stop the expulsion of food are prescribed. These medications can be useful to stop the cycle of GI distress, but they do not solve the problem if the diet is deficient. The answer for many cases of chronic or even sudden GI upsets could be simply to slowly change to a more biologically appropriate, fresh organic food. The natural bacterial biome will be nourished, it will more easily assist in digestion, and the body will be healthier. During diet changes, it can be useful
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GI INFLAMMATION
Inflammation in the GI tract, including inflammatory bowel disease (IBD), is often just the body reacting sensibly to “wrong food!� by becoming inflamed for protection and to keep absorption of the wrong food to a minimum. Resolution of signs can often be as easy as supporting the bacterial biome with supplements and changing the food to something appropriate (fresh, organic). Sometimes an animal needs some extra help to re-florinate the population of bacteria. to take a couple weeks to change foods, and consider the need to add an appropriate prebiotic fiber, probiotic bacterial supplement and perhaps even some enzymes for support.
TEAMWORK IN THE END Helpful bacteria, fungi and parasites live in harmony within the body and play an important role in digestion. With the overuse of antibiotics in pets and food animals, and an increase in pesticides/herbicides in many pet foods (like glyphosate, which has known antibiotic properties), we are seeing more problems than solutions to bacterial problems. As new resistant bacteria become more common, and helpful bacteria diminish, we are upsetting the delicate balance needed for proper digestion. In addition, over-cleaning, overbathing, sterile foods and lifestyles do not help pets replenish a healthy biome. There are cases in which the only way to fully replenish a damaged bacterial population is to perform a fecal transplant (ivcjournal.com/micro-biome-restorative-therapy-healing-theimmune-system). This procedure involves taking feces from a healthy, fresh food-eating dog or cat, using a special recipe IVC WInter 2017/2018
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EAT LESS, GET HEALTHY, CLEAN UP! Eating once, or at most twice, a day is normal fare for a carnivore. A hunt would provide a meal, they would eat, rest and digest, and maybe not hunt again that day. It may appear that certain dogs or cats are “nibblers” and need/like to eat a little bit all day. This is likely a misunderstanding of what is happening. It is not the ancestral behavior of a carnivore (a dog or cat) to nibble on their prey. It is possible that a bowl of dry kibble left out for free-feeding may be so uninteresting that a pet will only eat a little at a time, hoping for something better. Most animals, when they are changed to a fresh food diet, eat quickly and consume all the food. They don’t need a dry kibble left out all day to snack on if they are eating the wet food well. Cats and small dogs do well on twice-daily feeding, while medium to large dogs may do well on once-a-day feeding. Learning about digestion involves not only learning about how animals process food, but also how they manage when they are hungry. A strong body of evidence suggests that many animals tap into the body’s natural ability to reinvigorate itself when they are hungry. Certain processes that make an animal healthy only turn on when he feels hunger, or when he goes into a fasting, ketogenic state. The animal will switch from the processing food mode to a clean-up mode. This is very different from the type of ketogenic condition we see in a diabetic, where there is a high blood sugar, no insulin, resultant ketones and illness. In a healthy ketogenic condition, the blood sugar is low but not a health threat, and the body is producing ketones to effectively use as energy while it turns on body systems to seek out unhealthy cells, assess mitochondria, DNA and organelles for damage, and repair them. When hungry, the body recognizes the need to hunt more efficiently with a healthy body, so it gets to work on its own cells.
to create a liquid that can be introduced to the unhealthy animal through an enema or capsules. This procedure, while it seems crude, can be tremendously effective in a depleted animal with poor absorption.
DON’T GIVE UP, TRY FOOD! As we think about all these interactions, and the complicated anatomy and biology of the digestive tract, we may feel overwhelmed by how intricate the system is. There is much to consider: available pet foods, food animal conditions, organic sourcing, pesticides, GMO, costs of various foods, GI bacterial relationships and bacterial species, pH motility, secretions, digestive triggers, external stressors, automatic activity, autonomic nerve reactions, parasympathetic reactions (rest and digest), sympathetic reactions (fight
Because there is little education about the existence of this health mechanism, we rarely let our pets get hungry. A way to think about this is that the body will be conservative and only do what is necessary. If there’s plenty of food, why clean up? Things must be fine. Or imagine the difference between having a party with plenty of food for everyone, and having the food run out and the kitchen in a huge mess. It’s time to clean the kitchen. If we never let an animal feel hungry, he will never “clean the kitchen”.
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and flight), enteric nervous system intrinsic to the GI tract, histamine releases, HCl secretions, bile flow, absorption, nutrient loss, toxin rejection, defecation issues and more.
the balance with a less than optimal food, a gut-changing medication or other intervention, we may see unexpected and unwanted side effects as a result.
The sensible way to maintain health is to be aware of this complexity, and use that understanding to recognize that before we interfere with this naturally balanced system, we should make sure there is really a good reason. When we tip
For every case, complicated or obvious, healthcare should always begin by focusing on returning to a natural, biologically sensible dietary balance. It is possible that given the right tools, the body can take care of the rest for us.
References and Bibliography
• Rodney Habib Planet Paws Facebook -- Easy to Make Homemade Dog Food Recipe
• AAFCO Official Publication, 2016 update.
• Harrington, Kohl, Director, Pet Fooled, Documentary, Gravitas, 2016.
• Brown, Steve, Unlocking the Canine Ancestral Diet, Dogwise Publishing, 2010; pp 5-10.
•M artin, Nancy L., Challenging the Pet Food Paradigm, pp 221-230 In: Proceedings of the Annual Conference of the American Holistic Veterinary Medical Association, 2016.
• Becker, Karen Shaw and Taylor, Beth, Dr. Becker’s Real Food for Healthy Dogs and Cats, Natural Pet Productions, U.S., 2009 • Brown, Steve, Can High-Fat Beef-Based Raw Diets Lead to Behavioral Issues and Aggression in Some Dogs?” Integrative Veterinary Care Journal, winter issue 2014-2015, pps 36-38. • Dierenfeld, ES, Alcorn HL, Jacobsen KL, “Nutrient composition of whole vertebrate prey (excluding fish) fed in zoos,” Zoo Biology. 1996; 15:525-537. • Federation europeenne de L’industrie des aliments pour animaux familiers (The European Pet Food Association) Nutritional guidelines, 2013.
• Merz, Walter, ed., Trace Elements in Human and Animal Nutrition, 5th Ed., vols.1&2, Academy Press, 1987 • National Nutrient Database, USDA #05139 and #05144, reference #28. • National Research Council of the National Academies, Nutrient Requirements of Dogs and Cats, 2006. • R oyal, Barbara, The Royal Treatment: A Natural Approach to Wildly Healthy Pets, Simon and Schuster, New York, 2012. • Royal, Barbara, The Essential Pocket Guide to Pet Food, Chicago, 2016
• Fox, Michael J., Not Fit for a Dog: The Truth About Manufactured Cat & Dog Foods, Quill Driver Books, Fresno, CA 2009
• S tevens, C.E. Physiology implications of microbial digestion in the large intestine of mammals: relation to dietary factors. The American Journal of Clinical Nutrition, 1978; 31: 5161-5168
• Gross, K.L., Yamka, R.M., Khoo, C., et al. Macronutrients, Micronutrients: Minerals and Vitamins. In: Hand, M.S. ed. Small Animal Clinical Nutrition, 5th Ed. Topeka, Kan.: Mark Morris Institute, 2010
• R oyal, Barbara; Habib, Rodney; Becker, Karen; Orrego, Daniel; Brown, Steve; Wild Health Nutrition Course #1701, Royal Animal Health University, San Luis Obispo, April 8-9, 2017.
• Preventing Bloat Naturally, Peter Dobias, DVM. In Dogs Naturally Magazine. http://www.dogsnaturallymagazine.com/preventing-bloat
• Thixton, Susan, TheTruthAboutPetFood.com, Website
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THREE TIPS TO TREATING SENIOR PETS NATURALLY By Ernie Ward, DVM, CVFT
One of the greatest joys in veterinary practice is restoring health and vitality to an older pet. We love helping a senior dog overcome his struggle to get into the car, so he can continue to enjoy walks in the park. We cherish the opportunity to boost an elderly cat’s immune system, enabling him to combat chronic illness and maintain high quality of life for as long as possible. Over 40% of U.S. dogs and cats are estimated to be “senior”, or over seven years of age. And as pet owners seek integrative treatment alternatives for themselves, they are increasingly interested in natural options for their aging animals. Here are three tips to help you treat your senior patients naturally.
1. DON’T WAIT FOR DISEASE
Consider offering nutritional supplements, dietary changes and diagnostic testing before symptoms develop in older pets. Many veterinarians wrongly view natural treatments and lifestyle changes as last-ditch efforts instead of preventive measures. Begin discussing diet, supplements, stress reduction, and environmental enrichment strategies during a patient’s early adulthood, before illness strikes. Look for subtle signs of illness and investigate any changes in behavior, routine or appetite. I’m especially passionate about giving antioxidants, Omega-3 fatty acids, joint health and digestive aids, and B-vitamins to nearly every pet I see, especially those over age seven. I try to catch disease as early as possible through regular exams, blood and urine tests. Many times, if the condition is recognized quickly, natural treatments and lifestyle changes can stall or prevent progression.
2. TAKE A TEAM APPROACH
A well-trained and dedicated veterinary healthcare team is essential to overseeing the medical care of older pets. If your medical philosophy emphasizes natural and integrative
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modalities, it’s imperative that you involve receptionists, technicians and assistants in sharing your message. Clients are likely to ask a staff member: “Does it really work?” The answer they receive largely determines their compliance with your advice. Staff training empowers your team to confidently answer these inquiries and reinforce the importance of your recommendations. Create a one-page summary of a natural supplement or integrative treatment, role-play common communication scenarios, and ask for honest feedback from your team. By understanding their questions and the client concerns they encounter, you can better prepare them to promote your message of integrative medicine.
3. REMEMBER THAT IT’S A JOURNEY
Lifestyle changes and integrative veterinary care is about more than the destination; it’s about the journey. Focus on tiny daily changes pet owners can sustain. For example, replace a processed treat with a whole food alternative; add a simple urinary tract aid or antioxidant to a meal; commit to a ten-minute walk each day. Optimal health builds on daily habits; make sure your clients understand the healthy habits their pets need to stay mentally and physically strong. You can help guide your pet patients on a lifelong pursuit of good health by embracing – and encouraging – proven natural treatments and healthful habits. The destination is to achieve and maintain a state of optimal health, mental sharpness, and emotional strength in the dogs and cats we care for.
Dr. Ernie Ward has spent his entire career practicing, writing, teaching and encouraging better care for animals, earning the title of “America’s Pet Advocate”. Whether he’s discussing the dangers of obesity, or answering pet owner’s questions about nutrition or surgery, Dr. Ward’s unifying theme is: do what is in the pet’s best interest.
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By Mushtaq A. Memon, BVSc, PhD, Dip ACT, CVA
Integrative Medicine
IN VETERINARY CURRICULUM
T
here’s an increasing interest in integrative therapies within human medicine, and animal owners are seeking similar therapies for their pets. Many private veterinary practices and some teaching hospitals are now offering integrative veterinary medicine (IVM) modalities as an adjunct to conventional therapies.
nutrition, herbal and massage. The data support the fact that IVM can be successfully incorporated into conventional veterinary practices.
A REVEALING STUDY
To understand the need for IVM to be taught at veterinary colleges, 32 veterinary specialists have agreed on an IVM curriculum. Guidelines recognizing the important modalities to be taught to veterinary students as an introduction to IVM were recently published in Open Veterinary Journal.2
The results of a recently published retrospective analysis of 5,195 integrative patient treatment sessions suggest that acupuncture, laser therapy and hydrotherapy were utilized in more than 50% of the patients. 1
Medical records from a mixed animal IVM service at an academic teaching hospital over a 400-day period were collected. The multiple modality treatment sessions were most commonly utilized for patients (n=274) with neurological (50.7%) and orthopedic (49.6%) conditions in dogs (95.6%), cats (3.0%) and horses (0.8%). Acupuncture treatments included dry needle acupuncture, which was used in most patients (81.5%), followed by electro-acupuncture (60.5%) and aqua-puncture (9.8%). Next most frequently used were laser (66.3%), hydrotherapy (51.8%), therapeutic exercises (37%), and conventional drugs (37%). Other modalities included ultrasound, TENS/NMDS,
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INTEGRATIVE VETERINARY MEDICAL MODALITIES IN VETERINARY CURRICULUM
Veterinary students should receive adequate exposure to the principles, theories and current knowledge supporting or refuting these therapies. A proposed IVM course guideline would broadly introduce students to these veterinary treatments while increasing their ability to respond to questions from clients from a position of knowledge about IVM in clinical practice. Such a course should be evidence-based, unbiased, and unaffiliated with any particular IVM advocacy or training group. Training future veterinary professionals in IVM may produce an openness to new ideas about scientific methods and a willingness to pursue and incorporate evidencebased therapies in clinical practice, including those presently regarded as integrative, or complementary.
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A survey of AVMA-accredited colleges indicated that students should be aware of IVM modalities because of strong public interest.3 Nearly 25% of recent Washington State University graduates reported facing questions about IVM on a weekly or daily basis, and polled veterinary students had a positive outlook towards IVM education. These findings prompted the formation of a national curriculum committee, supported by the American Academy of Veterinary Acupuncture (AAVA), tasked with developing a model curriculum for veterinary students.
Committee members met during the AAVA annual conference in May of 2013, and agreed that IVM should be the focus and title of a model training course. The course outline was discussed, and consensus was established that the following IVM modalities commonly used in veterinary practices should be included in the curriculum: acupuncture, veterinary manipulative therapy, integrative nutrition, physical rehabilitation/sports medicine and herbal therapy (see Table 1).
TABLE 1: TOPICS AND HOURS FOR INTEGRATIVE VETERINARY MEDICINE (IVM) INTRODUCTORY COURSE RECOMMENDED FOR VETERINARY STUDENTS MAIN TOPIC Basic concepts
LECT. HRS. LAB. HRS. 3
SUB TOPICS
0
(a) IVM: History and definitions (b) Applications of evidence-based medicine to IVM, and controversies, e.g. homeopathy, placebo (c) Multi-modality treatments and integration of complementary therapies with conventional therapy
Acupuncture (ACP)
3
2
(a) Anatomy and physiology of ACP related to soft tissue and neurologic concepts (b) Traditional theories of ACP: an assessment of the validity and current controversies (c) Integrative ACP: clinical approaches and current scientific literature (d) Laboratory: proposed location of ACP points in canine/or equine with a discussion of the controversies in point placement and naming
Manual therapies
2
1
(a) Veterinary manipulative therapies: neurology, biomechanics, and available evidence (b) Massage therapy and myofascial principles laboratory: palpation lab, and demonstration of techniques
Botanical medicine
2
0
(a) Origins and major systems of herbal therapy with selected evidence-based interventions (b) Adverse events, herb-drug interactions, supplement evaluation and regulations
0
(a) Novel trend in nutrition: raw diets, home-prepared diets, grain-free diets, owner perception and current marketing (b) Nutrition in obesity, performance, physical rehabilitation, and integrative medical approaches (a) Functional anatomy in physical rehabilitation and sports medicine with an emphasis on relevant orthopedic and neurologic pathology (b) Rehabilitative assessment and interventions (c) Laser, shockwave, ultrasound, hyperbaric oxygen, and other rehabilitative modalities (d) Laboratory: demonstration of canine/equine physical rehabilitation techniques and use of selected therapeutic modalities
Integrative nutrition
2
Physical rehabilitation
3
2
Total hours
15
5
JOINT EDUCATION EFFORTS BETWEEN IVM ORGANIZATIONS Non-profit organizations and one institution are assisting in accomplishing two goals – IVM education offered as a part of veterinary curriculum, and having IVM modalities become a part of veterinary practice. Joint efforts between IVM-related organizations are needed to assist veterinary students in learning IVM, helping veterinary faculty to become certified in IVM modalities, and increasing public awareness of the IVM benefits. A. World Association of Traditional Chinese Veterinary Medicine (WATCVM, watcvm.org) – This non-profit organization was founded in Spain on Sept 14, 2013 by 45 TCVM practitioners from 25 countries, with the mission to:
• unite the global TCVM community through promotion and publication of research on all aspects of TCVM •d evelop guidelines for TCVM practice (standardize acupuncture points, channels, and herbal medicines – dosage and usage, etc.) • r aise funds to support research and scholarship for veterinary students/faculty • to help establish TCVM curriculums for veterinary colleges globally.
1. The Stuart Rosenburg International Scholarship – This scholarship is designed to support veterinary school faculty in developing countries with a per capita annual income less than US $2,000. Veterinarians from Bangladesh and Ecuador IVC WInter 2017/2018
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have received the Rosenburg Scholarship in 2015 and 2016, respectively, to support their veterinary acupuncture education to become Certified Veterinary Acupuncturists. 2. Veterinary student support – In addition to other student membership benefits, WATCVM provides speakers to give presentations and demo acupuncture labs to veterinary students, meet veterinary college faculty/administrators
to seek support for IVM, and assist in development and support of TCVM student clubs. Since its inception in 2013, WATCVM representatives have assisted various AVMAaccredited veterinary colleges including Iowa, Ohio, St. George’s, Oregon, Ross, Tuskegee, North Carolina, Colorado and Washington. TCVM is also promoted by WATCVMBODs in their native counties or regions on the world, including China, Costa Rica, India, Indonesia and Japan.
TABLE 2: GRANTS AND SCHOLARSHIPS PROVIDED FOR VETERINARY STUDENTS IN 2017 BY THE AHVMF GRANT OR SCHOLARSHIP
PURPOSE
AMOUNT OR IN-KIND
AHVMF Student Education Grant
To attend Annual AHVMA Conference
Airfare, registration, hotel
Dr. Richard Kearns Memorial Grant
To further education in holistic medicine
$1,500
The Veterinary Classic Dr. Pedro Rivera Grant
To further education in holistic medicine
$1,500
The AHVMF Student Research Grant
Integrative research
$1,500
Dr. Sharon Willoughby-Blake Commemorative Grant
To attend Annual AHVMA Conference
$1,000
Royal Treatment Nutrition Grant
To attend Annual AHVMA Conference
$1,000
B. Chi CVM Scholarships – These scholarships are offered by the Chi Institute of Traditional Chinese Veterinary Medicine. Founded in 1998, Chi Institute offers educational programs in TCVM modalities, including acupuncture, Chinese herbal and food therapy, and Tui-na. Promoting TCVM in veterinary colleges is the main purpose of the Chi CVM Scholarships. Chi grants, a total of $40,000, are awarded to veterinary students, veterinary college faculty, residents and graduate students (tcvm.com/Resources/ CVMScholarships.aspx). C. IVAS Scholarships – The International Veterinary Acupuncture Society (IVAS, ivas.org) is one of the first international organizations (it was started in 1974) to offer veterinary acupuncture certification. Currently, IVAS offers a 50% tuition scholarship to fourth-year veterinary
students for its acupuncture course. IVAS has been working on scholarship fundraising; it has also awarded one full tuition scholarship to a veterinary faculty member in the past (personal communications). The promotion of IVM education as a part of veterinary curriculum is a promising trend and one that should result in more conventional practices offering integrative therapies. Acknowledgments: The information in this article is adopted from manuscripts authored or co-authored by the author and are cited as references, and were presented at the annual AHVMA Conference in October. The author is grateful for the encouragement and assistance provided by Dr. Christina Chambreau, Associate Editor for IVC Journal.
1 Shmalberg J, Memon MA. “A retrospective analysis of 5,195 patient treatment sessions in an integrative veterinary medicine service: Patient characteristics, presenting complaints, and therapeutic interventions”. Veterinary Medicine International, (open access journal), Volume 2015 (2015), Article ID 983621, 11 pages, hindawi.com/journals/vmi/2015/983621/. 2 Memon MA, Shmalberg J, et al (18 additional authors). “Integrative Veterinary Medical Education and Consensus Guidelines for an Integrative Veterinary Medicine Curriculum within Veterinary Colleges”. Open Veterinary Journal 6:41-56, 2016, openveterinaryjournal.com/2016/Volume%206%20(1)/OVJ-169-12-15%20M.A.%20Memon%20et%20al.pdf. 3 Memon MA, Sprunger LK. “Survey of colleges and schools of veterinary medicine regarding education in complementary and alternative veterinary medicine”. J Am Vet Med Assoc. 239: 619-623, 2011.
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From the VMAA
The Veterinary Medical Aromatherapy® Association (VMAA) is an organization of veterinarians and veterinary technicians dedicated to the responsible use of aromatherapy in animal practices. Their mission is to promote standards of excellence in animal aromatherapy, to provide outreach and education to veterinarians and axillary animal practices, and to promote continual improvements in Veterinary Medical Aromatherapy®. The VMAA is elevating the veterinary profession through innovation, education, and advocacy of integrative medicine.
DID YOU NAME THE OIL DISTILLED FROM THE PLANT PICTURED IN THE LAST ISSUE?
Helichrysum oil (Helichrysum italicum) comes from a flowering plant traditionally wild-crafted in the mountains of Croatia; now, however, it is cultivated, harvested and then ideally steam-distilled. Its scent when diffused is sweet and stimulating. It can be applied topically to cleanse and enhance skin appearance. In Veterinary Medical Aromatherapy®, it has been used to support the cardiovascular and neurologic systems.
CASE REPORT
Submitted by Pam Fisher, NP and guardian, attending veterinarian Glacier Bay, aka Nemo, is a ten-year-old equine. His guardian was told he had sustained irreparable damage to the nerve tissue inside his left front (LF) hoof digital cushion (DC). Essential oils of helichrysum, cypress and copaiba were applied three times per day for about six weeks. This regimen restored Nemo’s neurologic function. “During the palmar angle study, the DC remained unchanged, essentially dead, on the LF at 50 mm, whereas the DC on the other feet increased 5 mm to 15 mm,” said Pete Healy, AFA, a farrier who did the study on Nemo. “After the oils usage, the LF gained 10 mm.”
According to the Journal of Ethnopharmacology: “regarding Helichrysum italicum in vivo activity, the highlight goes to the anti-erythematous and photoprotective activities of its flavonoids, demonstrated both in animals and humans, and to the anti-inflammatory properties exhibited by its flavonoids, acetophenones and phloroglucinols, as seen in animal models.”1 Perhaps it is some of these properties that have made this oil useful in blends for discomfort, bruising, ear hematomas and other injuries we see in veterinary practice.
If you have an essential oils success story of your own, email contact@DrJodiesNaturalPets.com.
NEWS AND NOTES
• October 2017: The VMAA exhibited at the AHVMA Convention and held its annual meeting in San Diego. • February 2018: VMAA R.E.A.C.H in Las Vegas (February 23 through 25) will feature keynote speaker Kurt Schnaubelt and a hands-on workshop at Dr. Nancy Brandt’s clinic. CE credits will be available. To follow, “like” facebook.com/vmaa.vet. For more information on educational courses, discounted classes, online webinars, books and our newsletter, visit VMAA.vet.
Name the oil distilled from this plant! The answer will appear in the next issue. IVC WInter 2017/2018
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t building
Strategies FOR
AND maintaining
Equine HEALTH By Elizabeth E. Pantzer, DVM
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he practice of veterinary medicine has changed dramatically in the 35 years since I graduated from veterinary school. Today, clients seek information from all kinds of sources – the internet, their extension agents, or even worse, chain farm supply store sales agents and promotional signage. In this climate, we veterinarians need to use our unique knowledge to stand back and get the big picture on our equine patients’ health. And we need to be proactive in promoting and “selling” this service. Below are a few areas equine veterinarians can consider.
1. VACCINES AND ANTIBIOTICS Vaccinations and antibiotics are available at every farm store, even though recent regulations require a prescription for stores to dispense antibiotics, which implies a valid CPV relationship. As equine veterinarians, we need to learn how to advise our clients on the proper time to vaccinate for each disease, and which vaccines are necessary, based on the susceptibility of each horse. Not every horse needs every vaccine. Holistic veterinarians are aware of the problems associated with over-vaccination
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(ivcjournal.com/rabies-vaccinosis-in-horses). Even though there are multiple holistic treatments for these ailments (vaccinosis), the horse is often left more susceptible. Careful vaccine recommendations can improve longevity and health.
2. EMERGING DISEASES Get current on emerging infectious diseases, and re-learn obscure diseases. The relocation of animals after the recent spate of natural disasters will result in previously unseen diseases in your area due to transfer by animals or fomites, or by insect vectors. Climate change has also resulted in shifts in insect populations and the timing of their lifecycles. We may see Tabenid flies and noseeums earlier; or cayenne ticks, which transmit spiroplasmosis, farther north.
3. DE-WORMING In the past, equine practitioners in Lexington, Kentucky would deworm 250 head of horses before lunch. Today, tube deworming has been largely replaced with paste deworming done by the owner, often too frequently and with limited efficacy. We need to help our clients develop strategic deworming protocols because many of the anthelmintics are no longer effective. Even the need for anthelmintics can be questioned. A herd of horses on the research farm at the University of Kentucky in Lexington, for instance, has not been dewormed in 35 years. They provide untreated helminthes for research. The horses maintain good weight and show no external signs of parasitism.
4. COLIC Colic is a big issue today, mainly because of parasitism and incorrect feeds. Every horse and owner combination should learn and be comfortable with proper handling so that in a colic crisis, a veterinarian can easily and safely pass a nasogastric tube. Show the owner how to auscult normal gut sounds. Owners can also be trained in acute TCVM and homeopathic treatments, which may quickly resolve most colics.
5. FARM VISITS Equine veterinarians should schedule twice-yearly farm visits to review management, and perform wellness exams. These farm visits, which are billed for based on time, give the practitioner the opportunity to review the housing situation, including companionship for each horse, and the horse’s level of boredom or over-stimulation. Natural light exposure and potential EMF or microcurrent exposures should be evaluated. It is important to do a pasture walk with the owners to assess safety factors such as inadequate fencing or proximity of toxic plants. These pasture walks should be repeated at different seasons because there are different toxic plants present at different times of the year. Most horses will avoid toxic plants if there is good forage present, so the forage should also be evaluated. It is important that the pasture not be a monoculture; it should include trees and shrubs for browse as well as forbs, which have deeper root systems and may bring nutrients to the surface.
Decreasing a horse’s parasite load When horses are kept in rotated pastures, with ample space and access to non-grass plants, they may have few to no worms. The addition of other species, like goats or chickens, which are not hosts, will decrease egg and larval loads. We do not need to deworm unless there is a heavy parasite load. A few adult worms in the lumen prevent maturation of larvae, so this host/ parasite interaction improves, rather than lessens, health.
While at the farm, veterinarians should also inspect the feed room. Open the feed bins and see if there is contamination with rodent feces, especially opossums (whose feces may have protozoa for EPM).
Continued on page 44.
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Continued from page 43. Look for ventilation to help assess the potential for mold in the feed. Find out how often the owner buys feed and how long it is stored on site. This gives the veterinarian a chance to discuss the ration formulation as well as make recommendations on feeding whole grains. Highly processed grains are digested too quickly and can change the population of gut bacteria. Horses need to be able to munch on forage all day long to decrease acid production in the stomach and to relieve boredom. Horses with a tendency to gain weight can wear a muzzle (equinewellnessmagazine. com/grazing-muzzle), while those not on pasture can use slow feeders. Remember to also inspect and discuss the mineral source at the farm. White salt blocks have a very little nutritional value for horses. Combination salt/mineral blocks force a horse to eat too much salt or too many minerals. Loose minerals are much easier for horses to lick, and different free choice minerals can allow them to self-medicate. Know the mineral deficiencies and excesses specific to your region’s soil so you know what to recommend. Establish a relationship with a PhD nutritionist in your area who can help you analyze the hay fed on a farm and match that to the correct grain and mineral combination. We must also be aware that animal feed may no longer contain all the nutrients listed in every table since so much farmland soil has been depleted.
6. PHYSICAL EXAMS A physical exam of each horse is important during every visit. This can be as complicated as a full physical exam or as brief as looking at the horse move in a pasture. The condition of the feet and teeth should be noted. Watch how the horses interact in the field and observe how the owners handle them, especially as they saddle and mount the animals. This is also a good time to discuss deworming and vaccination protocols. The various pieces of the veterinary care pie are divided among many sources these days. It is important that, as veterinarians, we develop relationships with the nutritionist, farrier and “tooth fairy� so that we may work with them to develop a treatment plan for a horse or for a farm. Learn equine massage, chiropractic, osteopathy or other modalities so you can add to your bottom line, or partner with other practitioners for modalities you do not want to learn. Stay current on infectious diseases. Understand the effects of feed on the gut microbiome. Do regular proactive farm visits. Gain knowledge so you can be a more effective leader in the health care of your equine patients.
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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.
The annual conferences for the Academy of Veterinary Homeopathy (AVH) and the American Holistic Veterinary Medical Association (AHVMA) took place jointly in San Diego this past October. AVH presentations demonstrated the effectiveness of homeopathy in the treatment of asthma, pemphigus complex, seizures and inflammatory bowel disease. A three-hour lecture introducing homeopathy and acute prescribing at the AHVMA conference was very well attended. Meanwhile, a pre-dinner presentation
open to both AHVMA and AVH attendees –called “Top Ten Reasons to be a Veterinary Homeopath” – highlighted cases in which homeopathy cured conditions in animals ranging from infectious tracheobronchitis to paralysis. Additional information on the benefits of AVH membership, along with a list of certified veterinary homeopaths, is available at theavh.org. The following remarkable case was presented by Dr. Richard Pitcairn on behalf of Julie Matthews during the “Top Ten” presentation.
From left to right are Richard Pitcairn, Todd Cooney, Lisa Melling, Laura Weis.
Homeopathic cure of paralysis with Lachesis By Julie Matthews, DVM, CVA (Acupuncture), CVH (Homeopathy)
Kodiak, a ten-year-old male Rottweiler, became suddenly paralyzed in all four limbs on January 24, 2014. Physical exam confirmed this paralysis. Deep pain with an inability to withdraw the limbs was also evident. The cranial nerves and swallowing reflex were not visibly affected, although the owners reported that Kodiak’s bark had changed. Megaesophagus was absent on lateral thoracic radiographs and neither regurgitation nor vomiting was present. And inability to urinate with urine retention was noted. Spinal hyperesthesia (pain) was absent. The physical signs were most consistent with lower motor neuron disease. Most likely differentials included idiopathic polyradiculoneuritis, coonhound paralysis, tick paralysis, botulism, and acute (fulminant) myasthenia gravis. Of these, idiopathic polyradiculoneuritis was deemed most likely, given the lack of exposure to ticks (it was a snowy winter in Maine) and raccoons. Acute myasthenia and botulism were ruled out based on normal cranial nerve function as well as the absence of megaesophagus.
Kodiak presented to my hospital for a second opinion on his fifth day of paralysis. The owners had been providing hospice care, regularly turning him from side to side, massaging his limbs, and manually expressing the bladder as well as removing feces from the rectum. The emergency hospital at which Kodiak first presented had prescribed Doxycycline and Carprofen and recommended referral to a neurologist. His owners mentioned that Kodiak was weakest in the morning on waking, which is typical of snake remedies. Homeopathic repertorization suggested Lachesis, based on physical symptoms. Treatment was started with a 30C potency of Lachesis on the day of presentation. As this video shows (youtube.com/ watch?v=3fmdtQ9tnW8&feature=em-share_video_user), the response to the remedy was immediate and progressive. Increases in potency (200C, 1M) were administered when improvement stalled or failed to progress. At no time during treatment did Kodiak ever relapse or regress. He was walking with assistance within a few days, and recovering fully in three weeks.
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industry innovations Paw protection and traction If your canine patients need outdoor paw protection, indoor traction to assist them with navigating smooth floor surfaces, help with mobility or wound care, Woodrow Wear’s Power Paws™ are the answer. Power Paws can also be used after surgery or for dogs in rehab. Outdoors, they protect paws from snow, ice, and salt as well as allergens and extreme heat. They are comfortable and breathable, and dogs don’t mind wearing them. Available in 13 sizes, two foot shapes, and three durability levels. woodrowwear.com
Supplements that support health Keeping your patients healthy means ensuring they receive the right balance of nutrients. NOW® Pets quality pet supplements are specially formulated to support pet health and well-being. With formulas developed by Dr. Barbara Royal, DVM, CVA, an expert in integrative animal care, these supplements help address common pet health concerns, and are certified by the National Animal Supplement Council (NASC). In business for 50 years, NOW® Pets parent company is one of the natural products industry’s oldest and most respected manufacturers. nowfoods.com/pet-health
Keeping them fit Regular physical activity is essential for optimal health. The Gyms For Dogs™ Natural Bridge Climb provides an innovative play and exercise product for dogs. It offers important climbing features as well as a training platform and a tunnel underneath. This multifunctional product exercises various parts of a dog’s body by encouraging him to climb and descend; or, he can rest on the platform or chill out in the tunnel. gymsfordogs.com
New Animal Health Corridor member Companies with a location in the Kansas City Animal Health Corridor account for more than half of sales generated by the global animal health industry. The Corridor is anchored by Manhattan, Kansas City, and Columbia, Missouri, and is home to more than 300 animal health companies. Its newest member, Companion Animal Health, was officially welcomed to the Corridor in September 2017 following its opening of a regional office in Lee’s Summit, Missouri. Companion is committed to improving the quality of life for animals through innovative health care solutions, and works closely with veterinary professionals to identify industry needs and develop products to fulfill those needs. companionanimalhealth.com
Hydrotherapy treadmill Hydrotherapy is an important aspect of canine rehabilitation, whether dogs are recovering from injury, surgery, or just need some help for their arthritic joints. The AQUATREAD 1900 BASIC is a new state-of-the-art treadmill that will meet any canine hydrotherapy needs. It features a touch screen and motorized incline, and is designed to require only minimal and DIY maintenance. Full custom installation and setup, with delivery anywhere, are included as standard features. aquatread.co.za
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PEER-REVIEWED
OZONE THERAPY: a way to build and maintain health
A
ging and degenerative diseases are caused by a decrease of oxygen utilization that can affect many of our organs and their functions. If we keep oxygen levels high using ozone therapy, cells and organs can function at peak levels, causing the body to operate more efficiently. Young animals may even age more slowly. Frank Shallenberger, MD, says: “Every single aspect of healthy living exerts its effects by improving oxygen utilization. The reason taking that vitamin or doing that exercise, or whatever it is we’re talking about, makes you better and healthier is because it’s improving your oxygen utilization. They’re all doing the same thing. So when you measure oxygen utilization, you’re measuring the sum totality of everything you can possibly do that is working in your body.”1 Oxygen is utilized in many parts of the body, including mitochondria and red blood cells.
OXYGEN FOR MITOCHONDRIAL HEALTH In our current environment, air quality is poor, oxygen has been reduced, and our patients are increasingly exposed to more pollution and chemicals. Not surprisingly, immune systems are at risk. As we additionally undermine the internal microbiome within gastrointestinal tracts with antibiotics and other medications, the body’s defenses are further damaged. The work of Nobel Prize winner Dr. Otto Warburg showed that decreased oxygen utilization caused by decreased mitochondrial function is the underlying factor in the development and progression of all disease processes.
By Margo Roman, DVM, CVA, COT, CPT
This is partly due to the fact that detoxification is so mitochondrial-dependent. In order for an animal’s body to function at peak efficiency, its mitochondria, which make up 10% of the body weight, need to be operating at their highest potential. They are the batteries of the body’s cells (some individual cells may contain thousands of mitochondria) and they require oxygen to convert sugars, fats and other chemical fuels into ATP. Ozone Therapy can increase mitochondrial function, thereby helping the animal’s body to operate optimally and heal more effectively (micro.magnet.fsu.edu/cells/mitochondria/mitochondria.html).
OXYGEN FOR THE CIRCULATORY SYSTEM Healthy blood flows to the tissues via the circulatory system. For good health in any individual, it is essential that this system operates optimally. With adequate oxygenation, red blood cells clump less and have more flexibility to pass through the vessels, which allows more oxygen to flow into the tissues via the microcapillaries.
HOW OZONE THERAPY WORKS Ozone (O3) is an activated, trivalent (three atoms) form of oxygen (O2). It easily breaks down into an oxygen molecule (O2) and a singlet oxygen atom. This singlet oxygen atom has unpaired electrons, making it unstable, so it is sometimes referred to as an “oxygen free radical”. Though free radicals are considered damaging to health, this oxygen atom behaves as an ion (O2-), at normal physiological blood pH, and creates lipid peroxides. It is these peroxides that mediate the many positive effects of ozone therapy in biological systems. Continued on page 48.
BUILDING HEALTH STRATEGIES A key to health and longevity is good nutrition. By regularly stimulating the mitochondria to provide more efficient oxygen utilization, cells can better metabolize nutrients. While there are many ways to do this – improved nutrition, nutraceuticals, vitamins and exercise – Ozone Therapy can further improve the process, especially if the animal is not thriving. The bottom line is that no matter what treatment you are giving your patient, the results will be better when adding in Ozone Therapy. IVC WInter 2017/2018
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Continued from page 47.
OZONE THERAPY USE IS EXPANDING Ozone Therapy for veterinary use has seen dramatic growth in the last several years. There are now three US organizations promoting veterinary medical ozone, and over 800 veterinarians in Brazil and 300 in Japan using ozone. (Brazil and Japan have also formed organizations.) Dr. Zullyt Zamaro, veterinarian and PhD, has written the first veterinary textbook on ozone therapy, including double placebo blind studies and clinical applications. The state of Massachusetts has added Ozone Therapy to the practice act.
THE BENEFITS OF OZONE Ozone offers many benefits to the body, including: • Killing bacteria, viruses and fungi. Healthy cells are well protected by antioxidant enzyme systems (glutathione peroxidase, catalase, glutathione reductase and superoxide dismutase). Cancer cells, compromised cells and microbes of all kinds do not have this protection, and are thus destroyed by the oxidative stress provided by ozone therapy. • Optimizing cellular function. Ozone peroxides improve oxygen delivery, endothelial function, nitric oxide formation and oxygen utilization. • Activating the immune system by stimulating production of cytokines, including interferons, interleukins, tumor necrosis factor, etc. • Decreasing damage from harmful free radicals, and stimulating the body’s protective NRF2-activated enzyme systems helps protect healthy cells from injury. • Increasing energy production. Ozone accelerates the Kreb’s Cycle in the mitochondria, increasing the amount of ATP produced. Providing more efficient overall metabolism thus increases energy production. This decreases the number of toxic byproducts used to produce energy in the body.
USES OF OZONE THERAPY Ozone Therapy can help treat: • wounds, hot spots, abscesses, allergic dermatitis, etc. • infections: chronic ear, stomatitis, gingivitis, viral and bacterial diarrhea • chronic and acute Lyme and other tick borne co-infections • acute and chronic liver, kidney, pancreatic and Cushing’s disease • heart disease and circulation problems. It can also be used: • as an adjunctive cancer therapy, and for seizures and autoimmune reactions • to decrease the amount of drugs needed. Concurrent use of ozone dramatically increases the effects of most hormones, drugs, vitamins, and herbs, by facilitating more complete oxidation reactions.
OZONE DELIVERY SYSTEMS Photo courtesy of Margo Roman
Ozone Therapy requires the following equipment: 1. Ozone generator – look at the American Academy of Ozonotherapy website (aaot.us), for the criteria for an acceptable clinical generator. Select a company that offers good training and support. The price can range from $2,000 to $20,000, depending on the different attachments and additional functions selected. Under $4,000 should be sufficient for most practices. 2. Pure surgical oxygen, at least 99% pure 3. Ozone saline maker 4. Syringes, catheters, and IV tubes, which you already stock in your clinic
Administering prolozone – ozone with prolotherapy – for cruciate repair. It helps bring more O2 to the location, increases stem cell production, and prevents infection. Consider as an option for cruciate and other musculoskeletal issues.
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METHODS OF ADMINISTRATION Ozone is not stable, so several methods are used to ensure the efficacy of increasing oxygen into the mitochondria: 1. Auto-hemo therapy (frequently used). A percentage volume of blood by weight is removed and mixed with ozone or ozonated saline, then reintroduced to the body.
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Photo courtesy of Margo Roman
treatment is being used, the addition of Ozone Therapy will provide for better results.
Shallenberger, Frank, MD, HMD, ABAAM. The Principles and Applications of Ozone Therapy, John Cole, 2011.
1
Injecting a mandibular abscess with ozone gas in Baxter, a 15 year old dog. This healed with no antibiotics or other drugs. 2. Ozonated saline. Ozone is bubbled through the saline in the “Saline Maker” to saturate the saline with O2 and O3. It’s best used immediately (chilled on ice in glass, it only lasts 30 hours). Given as Sub Q or IV fluids, the ozone quickly works in all parts of the body. Ears, skin, wounds, hot spots and any infected area can be flushed with ozonated saline in the clinic. 3. Rectal insufflation. Unhealthy biofilms interfere with a balanced microbiome diversity, thereby weakening the immune system. When ozone is rectally insufflated, it kills bacteria (more likely anaerobic than aerobic), fungi and yeast – even the potentially good ones. When this procedure is done higher in the colon, it enhances Microbiome Replacement Therapy (MBRT). When it is done in the distal rectum, it is absorbed into the caudal rectal vein and goes via the portal system into the liver where it works on the millions of mitochondria in the hepatic cells. Ozone optimizes the function of the stem cells of the colon. Because stem cells have more mitochondria than mature cells, they have a more critical need for oxygen.
FOR FURTHER LEARNING • Read The Principles and Applications of Ozone Therapy by Dr. Frank Shallenberger, MD, available on Amazon. • Published literature – nearly 3,000 different indexed articles – many of them authored by veterinarians, can be accessed through the “Library” portal on the American Academy of Ozonotherapy website at aaot.us. • Ozone certification courses and videos of conferences are available through: - American Academy of Ozonetherapy (aaot.us) - Society of Progressive Medical Education (sopmed.org) - Ozone Therapies Group (ozonetherapiesgroup.com) • Just published – Ozone Therapy in Veterinary Medicine by Zullyt Gamora, veterinarian and PhD. It will be available at Ozone Therapies Group. • Madrid Declaration 2015 – purchase online. Report from 20 countries on Ozone Therapy. International Scientific Committee of Ozone Therapy (isco3.org)
4. Ozonated olive oil. Available in oil, cream, suppositories and toothpaste, products can be made in the clinic or purchased. In the fridge, products stay therapeutic for years and can be used topically for ears, wounds, hot spots, etc., to speed healing. Ozonated olive oil suppositories can be given rectally for colon problems, like tumors, or put in the vulva for vaginitis. Ozonated toothpaste can be used for gingivitis, stomatitis or preventative dental care. Some of these products can be sold to clients for home use. Important note: Ozone gas itself is very irritating to the lungs, so it should never be breathed directly.
CONCLUSION As oxygen uitilization loses efficiency, the rate of free radical damage escalates and ultimately leads to mitochondrial decay. The benefits of increased mitochondrial biogenesis and ATP through Ozone Therapy include increases in metabolic function, energy level, exercise performance, cognitive function and lifespan. Helping young animals heal rapidly from any infections, injuries and surgical procedures can speed their return to normal growth functions. No matter what course of IVC WInter 2017/2018
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tech talk
Preventing injuries in canine athletes By Lynn Nalepa
The focus of modern healthcare is to prevent injury and disease. Dogs, like humans, are enjoying longer active lives and many people are looking for progressive medicine that integrates a variety of care approaches for their pets throughout each stage of life. Many dogs engage in regular physical activity and can be considered athletes even if they are not competitive champions or on active duty in the military or police force. An athlete is defined as an individual who is trained or skilled in exercises, sports or games requiring physical strength, agility or stamina.1 As with humans, there are different types and ages of canine athletes participating in work, sports, competition and play. Canine athletes can be found in the military, police departments, on search and rescue teams, or working as service dogs. Many pet dogs can also be considered athletes when they engage in regular physical activity with their owners. According to the AKC, in agility alone, 1,223,660 entries for competitions were recorded in 2016.2
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KEY COMPONENTS There are many opportunities for veterinary teams to integrate injury prevention into general or holistic practices. Key components of injury prevention include client/handler education, age appropriate conditioning, nutrition, and early recognition of warning signs. Expanded general health assessments and a knowledge of the sport or pet’s activity and associated risks will further assist the veterinary team in prevention and early recognition of injury. Veterinary technicians and assistants can be instrumental in empowering handlers and dog owners to take a proactive role in maintaining a healthy lifestyle with their canines. Many different preventive programs can be implemented to educate pet owners and handlers, beginning with puppies, or at any age. Although most agility and canine sports have minimum age requirements of 12 to 14 months, owners may start at any age. They may be exercising or conditioning dogs with little or no professional guidance.
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AGE APPROPRIATE CONDITIONING: PUPPIES AND ADOLESCENTS Recently, I was asked to review age appropriate exercise with an owner after a puppy exam due to “joint stiffness and pain”. The owner was jogging with the 12-week-old puppy to help “work off puppy energy”. This notion can lead people to push puppies into inappropriate levels of exercise in an effort to solve behavior problems. But puppies are prone to injuries that may affect them for the rest of their lives. Growth plates dictate safe activity levels for a growing puppy. These soft areas at the ends of long bones are vulnerable to injury until closed, which may occur from 12 to 18 months of age, depending on breed and individual. If a dog has been spayed or neutered prior to that time, a more conservative approach of waiting until 20 months may be indicated for heavier impact activities.3 Puppies also have softer bones and are at a higher risk for fractures caused by falling off furniture, accidental dropping, having their limbs or feet stepped on, or rough play with other dogs. Mind-body awareness is a good focal point for both puppies and adolescent dogs. Slowing down movements, promoting hind end awareness, and promoting a sense of balance help build confidence and prevent injury. Exercise guidelines for puppy owners should be reviewed by the veterinary team. Educational tools can range from a simple handout, guidelines listed on the clinic website, or integrated into a puppy preschool or socialization program. Some clinics or rehabilitation practices also offer individual sessions to review and practice appropriate puppy exercises, in addition to providing training resources. This is a good opportunity to create educational programs to review safe exercises and provide socialization. Continued on page 52.
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Continued from page 51.
BASIC EXERCISE GUIDELINES FOR PUPPIES
DISABILITY IN WORKING DOGS
• Allow self-directed play on varied moderately soft ground such as yards or gardens. • Avoid repetitive exercise such as long hikes or long walks, especially on hard surfaces. • Avoid going up and down stairs until the puppy is three months of age or older. • Don’t allow jumping or jump downs higher than “wrist” height until the pup is six months of age; and no higher than elbow height until 18 to 20 months old.4 • Avoid pulling during tug games. • Allow short training periods for learning commands.
The veterinary team can help keep older working dogs moving, even with a disability. Many working dogs retire following a back injury and surgery. A common recommendation is to never allow the canine to jump down again. Although ideal, not many dogs I know will heed this recommendation. The rehabilitation professional can help develop exercises to keep such dogs active and to minimize risks of future injury. A variety of holistic health approaches can be taken in the clinic or by the client at home. TCVM, homeopathy, chiropractic, osteopathic, massage, Reiki and more can keep these older dogs as active as they wish. There are also increasing numbers of assistive devices available, such as carts or braces, to help keep canines active. Disabled pets require a higher level of nursing care from owners, who look to the veterinary team for guidance and education.
In preparation for work or sport, certain baseline health screenings are recommended, usually between nine and 12 months of age, or prior to beginning a sport in older adults. • Physical exam, including lab work (CBC, Serum chemistry). • Radiographs for hips, elbows, check patellas. • Consider referrals to check eyesight and/or heart as needed. • Gait and postural assessments: stance, sitting, walk, and trot. • Fitness level and conformation assessment (evaluate risks for injury). • Consider referral to sports medicine or rehabilitation professional. Once baseline health has been established, determine what type of conditioning is required. Conditioning programs take into account the types of activity to be performed and their frequency, and the overall health of the canine. “Weekend warrior” activity should be discouraged and replaced by consistent, appropriate exercise and play.
COMPONENTS OF A CONDITIONING PROGRAM • Warm up: athletes have improved performance with warm ups.5 A warm up may include walks of five to ten minutes, and activities to encourage active range of motion or movements to be performed during the sport or activity. • Exercises: strength (core strength, front limb, hind limb), endurance, flexibility, skill training, balance and proprioception. Careful attention to form is essential! • Cool down: a slow trot or walk for five to ten minutes, active stretching exercises. • Periods of rest: one month off from competition, and jumping at full height only a percentage of the time during training, to help avoid repetitive injury.
SENIOR ATHLETES As we already know, old age is not a disease and aging athletes will continue to benefit from exercise. Many working dogs reach age ten or older before retiring. However, seniors may develop other health conditions, including arthritis, heart disease or diabetes, which may require adjustments in their exercise program or activity. Sporting events often offer different levels of competition to allow seniors to participate at lower levels of stress or impact. Osteoarthritis management programs designed to treat the condition in the early stages will help pets remain active longer. Pain scoring as a vital sign is also an essential aspect of monitoring any veterinary patient, especially the aging canine athlete.
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• Environment: surfaces should ideally be non-slip and compressive during training. • Therapies: massage, acupuncture, chiropractic • Caution: to avoid overheating and dehydration.
NUTRITION AND SUPPLEMENTS Obesity is considered an epidemic and is so common that owners may not recognize their dogs are overweight. Avoiding excess calories and calcium intake is also important for growing dogs. Along with nutritional counseling, maintaining objective measurements such as body condition scores and weight:height ratios will help owners and handlers better understand how weight might contribute to injury. The weight:height ratio can be obtained by dividing the dog’s weight by his height (measured at the withers or top of shoulder blades to the floor). “Dogs with ratios higher than 2.5 experience greater amounts of stress on the musculoskeletal system during running, jumping, and turning.”4 Nutritional counseling programs provide further details to help dog owners calculate energy requirements and percentage of fat and protein recommendations for high energy sports. Supplements such as Omega-3 fatty acids and chondroprotectants may also be helpful for long term joint health.6 Dogs should also avoid large meals prior to activity. A light meal with access to water is recommended.6
KNOWLEDGE OF THE SPORT OR WORK, ITS RISKS AND ASSOCIATED COMMON INJURIES A wide variety of activities are available beyond the dog park. A basic knowledge of what is expected of the dog during such events will help the veterinary team prevent and recognize injury. The once popular method of treating injury with rest and Rimadyl often leads to a recurrence of the injury once the dog returns to activity. An understanding of common sporting injuries will lead to earlier diagnosis and improved outcomes. Sporting injuries often initially present as performance issues, such as decreased run times, “knocking poles” in agility, or a new reluctance to perform a specific duty. Working dogs are often stoic and may work through pain, only showing obvious signs once the condition has progressed. A survey of agility handlers revealed that the most common injuries incurred during the sport were soft tissue injuries such as sprains and strains. The same survey cited shoulders as the IVC WInter 2017/2018
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most common location of injury.7 Unfortunately, many cases of strains or sprains are not presented to a veterinarian for early diagnosis, and therefore become chronic conditions.
Bikejoring
Common sporting injuries
• Biceps brachii tenosynovitis • Supraspinatous insertionopathy • Medial shoulder instability • Teres minor strain • Lumbosacral disease • Iliopsoas strain • Stress injuries to carpus or tarsus • Superficial digital flexor tendon injury • Achilles tendon injury • Gracilis myopathy • Foot pad injuries • Partial or complete cruciate ligament rupture Canine sporting events: (non inclusive)
• Agility • Flyball, disc dog, Triebball • Dock diving • Schutzhund • Field trials, retrieving trials, tracking • Nosework, barn hunt, earth dog • Bikejoring, mushing, carting, scootering, skijoring • Conformation showing, junior showmanship • Dog parkour (urban agility) • Dog hiking, pack hiking, trail running • Hare coursing, lure coursing, herding • Musical canine freestyle, trick dog • Obedience, rally obedience
CONCLUSION There are many opportunities for the veterinary team to further their education in providing quality care for canine athlete of all ages. Many therapies, including massage, also offer diagnostic benefits such as picking up on vague lameness, structural imbalances, or myofascial trigger points. Start asking your clients about activities their dogs participate in, and attend local events. Obtain pain scores as part of the medical history to help monitor trends. Develop educational programs to assess fitness and develop exercise programs, manage nutrition and weight, monitor for pain and osteoarthritis, or offer rehabilitation therapies. Learn about and practice fear-free handling, because sporting dog handlers expect it and all pets deserve it. Your patients will love you for it.
Suggested Resources: • IVAPM: become a CVPP, learn more about pain scoring • North East Seminars/University of Tennessee: Canine Rehabilitation, Massage, Fitness, Nutrition, Osteoarthritis management Courses • fourleg.com: Learn more about puppy programs, senior programs and anything related to rehabilitation
Flyball
• PennVet Working dog Center • CRI: Canine Rehabilitation Institute
References
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1
https://www.merriam-webster.com/dictionary/athlete
2
http://images.akc.org/pdf/events/agility/MACH_EndYear2016.pdf?_ ga=2.248095552.676954721.1508876515-1754799958.1507561129
3
Stubbs, Salmeri and Bloomberg. 1995. Early neutering of the dog and cat by In: Bonagura (ed), Kirk’s Current Veterinary Therapy, XII, Philadelphia WB Saunders & Co., pp.1037-1040.
4
C. Zink, J. Van Dyke, Canine Sports Medicine and Rehabilitation, Wiley-Blackwell, 2013, pp. 9-10.
5
http://www.latrobe.edu.au/news/articles/2012/article/warm-up-to-increase-athletic-performance
6
https://www.researchgate.net/profile/Wendy_Baltzer/publication/271206936_Sporting_dog_injuries/ links/54c1956c0cf25b4b80728148/Sporting-dog-injuries.pdf
7
https://www.cleanrun.com/index.cfm/feature/65/a-survey-of-injuries-occuring-in-dogs-participating-inagility.htm
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From the AHVMA The mindful leader elevating the veterinary profession through innovation, education and advocacy of integrative medicine.
2017 CONFERENCE HIGHLIGHTS
The AHVMA’s Annual Conference from October 21 to 24 in San Diego, California was the largest in the organization’s history, with over 500 attendees. While the majority were practicing veterinarians, we were amazed by the very significant increase in student attendance (including strong SAHVMA representation). As always, the conference offered a wide range of topics, including Traditional Chinese Veterinary Medicine, cancer treatments using herbs and supplements, the microbiome, energy medicine, homeopathy and more. Presenters included keynote speaker Ihor Basko and his wife Jane, Erin Bannink, Steve Marsden and Huisheng Xie. (Don’t forget: conference proceedings are available online for AHVMA members.) This year’s AHVM Foundation Silent Auction included items ranging from jewelry and books to vacation property getaways. All proceeds from the auction benefit the AHVM Foundation’s student scholarship fund. This year’s auction raised over $11,000! The AHVM Foundation’s end-of-year fund drive runs until December 15. Please visit ahvmf.org for more information. Our exhibit space increased another 10% over last year! Our exhibitors are an essential part of the AHVMA Conference, providing the products and support we need to offer alternatives to our patients. Exhibitors sponsor many special events, including Breakfast Meetings, the AHVMA Conference Mobile App and the brand new, extremely successful Lunch & Learn Meetings. This year’s sponsors included Primal Pet Foods, VetClassics, The Honest Kitchen, animalEO, Darwin’s Natural Pet Products, Nature’s Variety, CuraCore, New Zealand Deer Velvet, VDI Labs, Photonic Health, Cutting Edge Laser, BIOAGE, Radagast Pet Food, Natural Path Herb Company, Evermore Pet Food, MultiRadiance Medical, Standard Process, Kan Herb Company, SOJOs, Herbalist and Alchemist,
San Diego Skyline
Komfy K9, CIVT, Katie’s Pet Products, Calm My Pet, Dr. B’s Longevity, and Natural Ophthalmics. We are so grateful to all the sponsors and exhibitors who helped make this year’s conference an amazing success. AHVMA remains a proud member of the AVMA House of Delegates. Because we are an AVMA Constituent Organization, many states grant blanket approval for AHVMA CE. The 2017 AHVMA Annual Conference featured a grand total of 104 hours of lectures and labs to choose from. We once again received AAVSB RACE Approval for over 90 hours of continuing education credits!
ON THE RISE
AHVMA’s Annual Conference registration and membership continue to rise. This is a strong indicator that the demand for holistic approaches to treat infections, new viruses, cancer, and overworked immune systems also continues to rise. Pet owners are looking to holistic medicine for prevention and first line defense rather than as a last resort when conventional medicine has failed. Acupuncture, chiropractic, nutrition, physical rehabilitation, herbal medicine, and many more modalities are being introduced in conventional clinics. These modalities (and more) are being researched, with studies published in the Journal of the American Holistic Veterinary Medical Association on a quarterly basis. The AHVMA continues to be a positive force, providing members with effective holistic solutions for the multitude of challenges facing all veterinary practitioners, and improving the health and lives of all pets. IVC WInter 2017/2018
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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 American College of Veterinary Internal Medicine - ACVIM Denver, CO USA Phone: (800) 245-9081 Email: acvim@acvim.org Website: www.acvim.org American Holistic Veterinary Medical Association – AHVMA Abingdon, MD USA Phone: (410) 569-0795 Email: office@ahvma.org Website: www.ahvma.org 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 International Veterinary Acupuncture Society - IVAS Fort Collins, CO USA Phone: (970) 266-0666 Email: office@ivas.org Website: www.ivas.org National Animal Supplement Council - NASC Valley Center, CA USA Phone: (760) 751-3360 Website: www.nasc.cc
CLASSIFIED Main Street Veterinary Services is located in London, Ontario, Canada. We are a busy integrative office seeking a part time associate Veterinarian to add to our well established, growing practice. We are passionate about what we do. We’re a small, closely knit team of kind hearted humans interested in making a positive impact in the world of our clients, and patients, every single day. For the right doctor, a longterm relationship with the potential for full time employment is an option. To see the full ad please go to www.http://mainstreetvetservices. ca/job-opportunities/
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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 Harrisons’ Pet Products West Palm Beach, FL Phone: (800) 946-4782 Website: www.vet.HEALx.com
VETERINARY OPHTHALMOLOGY Dr. Nancy Park Board Certified Veterinary Ophthalmologist Integrative Ophthalmology For Pets - IOP Los Angeles, CA, USA Phone: (855) 623-3937 (EYES) Email: info@iopeyes.com Website: www.iopeyes.com
SCHOOLS & WELLNESS EDUCATION Animal Spirit Network Pekin, IL USA Phone: (815) 531-2850 Email: carol@animalspiritnetwork.com Website: www.animalspiritnetwork.com College of Integrative Veterinary Therapies - CIVT Rozelle, NSW Australia Phone: (303) 800-5460 Website: www.civtedu.org International Veterinary Acupuncture Society - IVAS Fort Collins, CO USA 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
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From the
AATCVM The American Association of Traditional Chinese Veterinary Medicine (AATCVM) is a non-profit organization founded in 2006 to support practitioners of Traditional Chinese Veterinary Medicine (TCVM). It promotes high quality research in all aspects of TCVM, including acupuncture, Chinese herbal medicine, Tui-na and food therapy. The AATCVM also promotes the practice of evidence-based TCVM by funding high quality studies of the basic science and mechanisms of action of treatments, and randomized clinical trials of treatment efficacy.
This past August, over 160 practitioners attended the 19th Annual International TCVM Conference in Toronto, Canada. Topics included end-of-life care, geriatric and pediatric conditions. Attendees added to their clinical expertise with presentations on rehabilitation to enhance acupuncture results. Keynote speakers included Drs. Huisheng Xie, Bruce Ferguson, Tami Shearer and Ronald Koh. The 20th Annual International TCVM Conference will be hosted at the Chi Institute of Chinese Medicine’s main campus in Reddick, Florida from November 1 to 4, 2018. This very special anniversary conference will have two days of lectures and two days of rotating workshops. The main themes will include lameness, neurological, endocrine and reproductive disorders. For 20 years, practitioners and scientists from around the world have come together at this conference to learn from top TCVM experts, enjoy hands-on experience with Chinese medicine, and lecture on their own clinical experiences and research findings.
NEW MEMBERSHIP BENEFITS, COMING IN 2018 We are excited to announce that WATCVM and AATCVM will be joining forces to offer one all-inclusive membership offering new member-only benefits. In 2018, you can expect to see an electronic library including TCVM books and articles, easy-toaccess online presentations, reference materials and searchable online journal issues with newsletters. The new site will feature individual country associations, with updates and news from around the world.
AJTCVM ABSTRACT In February 2017, the peer-reviewed American Journal of Traditional Chinese Veterinary Medicine, published twice a year, included a retrospective study documenting the clinical benefits of acupuncture and Chinese herbal medicine as an effective treatment for dogs diagnosed with Cushing’s Disease in a veterinary school teaching hospital setting. “The Therapeutic Effect of Acupuncture and Chinese Herbal Medicine in 12 Dogs with Hyperadrenocorticism” was authored by Ronald Koh, DVM, MS; Huisheng Xie, DVM, PhD; May-li Cuypers, DVM, DACVIM. Medical records of all dogs diagnosed with hyperadrenocorticism and treated with acupuncture and Chinese herbal medicine between 2004 and 2013 were reviewed. Twelve dogs met inclusion criteria. Dogs had received acupuncture for five to 42 months at the time of review. Mai Men Dong (Ophiophogon Formula®) alone or combined with modified Jin Gui Shen Qi (Rehmannia 14®) or modified Chai Hu Shu Gan (Liver Happy®) or modified Xia Xiao Fang (Rehmannia 11®) alone were administered to all dogs for 12 to 45 months. No adverse side effects were seen. Following treatment, polyuria, polydipsia and panting resolved in all 12 dogs. Lethargy improved more than 50% in all dogs. Polyphagia resolved in 7/12 dogs and improved over 50% in 5/12 dogs. Skin and hair changes and distended abdomens were more resistant, but improved more than 50% in 7/12 and 5/12 dogs respectively. Based on the treatment results in 12 dogs, acupuncture and Chinese herbal medicine may be a safe and effective alternative to conventional medication and surgery for the treatment of some dogs with hyperadrenocorticism. Visit aatcvm.org, email support@aatcvm.org or call 1-844-422-8286.
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By Laura Taylor, DVM
TO IMPROVE MOBILITY AFTER ROUTINE SURGERIES
O S T E O P A T H Y
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Osteopathy is a system of medicine based on manual manipulation. It alleviates pain, restores freedom of movement and enhances the body’s innate healing abilities. Though people often assume osteopathy is similar to chiropractic, it’s actually a whole body approach that considers fascia, viscera, vascular and lymphatic flow, and is not exclusively focused on the spine and joints. While it is a newer modality in the world of integrative and holistic veterinary treatments, osteopathy has, for me, been revolutionary in getting to the “why” of many musculoskeletal conditions, and has resolved many mobility issues in dogs, cats and horses.
In addition to “tight” organs, organ dysfunction or pathology can also have an influence on altered autonomic nerve flow back to the spine. When health returns to the affected organ, the altered autonomic nerve flow will return to normal and will be reflected in restored normal range of motion in the affected joints.
I became certified in veterinary chiropractic in the mid1990s, and over the following 15 years my small animal and equine practice consisted of 100% chiropractic and acupuncture. The majority of my cases then and now have been neurologic/musculoskeletal conditions. Over the years, I began studying osteopathy in the form of human craniosacral therapy and human visceral manipulation, and later took extensive training in equine osteopathy. I adapted what I learned on other species to treat dogs and cats. Along the way, I made some remarkable discoveries of my own concerning the deep underlying causes of certain mobility issues in small animals.
The goal of visceral manipulation is to release excessive mechanical tension around any organ, thus improving mobility, nerve function and blood/lymph flow in the area. Techniques include direct, gentle mobilization and more passive “listen and follow” fascial releases.
Osteopathic principles regard the importance of the afferent nerve flow (from the organ back to the spinal vertebrae and cord) as well as the influence of the efferent autonomic nerve flow (nerve flow going from the spinal cord to the organs).
While chiropractic and other manipulative techniques can help when joint restriction is truly local, at least 50% of joint
Conditions commonly treated by osteopathy include lameness, back or neck pain, arthritis, ACL (CCL) injuries, prevention of ACL tears, lumbar/thoracolumbar disc disease, iliopsoas muscle strain, spondylosis, lumbosacral stenosis, Wobbler syndrome, urinary incontinence, lick granulomas and common mobility issues in older dogs/cats (stiffness, hind end weakness, loss of normal physical activity). I also see canine athletes to improve their performance and prevent injuries, as well as puppies and litters of puppies to address alignment and joint freedom very early on.
THE 3 PILLARS OF OSTEOPATHY
1. Visceral manipulation (visceral osteopathy) Fascia, including the ligaments that tether organs to other internal structures, can become excessively tight from trauma, surgery or inflammation. An adhesion is tissue that has lost its normal gliding movement with any surrounding tissue. This form of excessive tension can change autonomic nerve flow back to the spine (via gamma interneurons), which causes rotation and reduced mobility in the sacrum (if pelvic viscera is involved) and can also cause two to three vertebrae to fixate as a group. When the tight fascia is released, these previously restricted bones automatically become free on their own without direct intervention. This leads to a longer-term correction than a manipulation of these particular joints.
Visceral manipulation of the bladder ligaments to release the spay surgery adhesion (normalizes autonomic nerve tone to the sacrum and upper lumbar vertebrae). IVC WInter 2017/2018
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restrictions in the spine, pelvis and shoulders can originate from organ issues (too tightly attached or not working at 100%). If a bone (sacrum, vertebra, scapula) has lost its normal motion from a visceral cause, addressing the internal visceral issue will lead to automatic release of the joint restriction without the need for any local treatment.
(from trauma, repetitive strain, stress) and is resolved via a direct manipulation (chiropractic, osteopathic, etc.). The second cause occurs via altered autonomic nerve flow from an organ issue. Resolving the organ issue (adhesion, dysfunction) will cause the joint(s) to automatically normalize on its/ their own.
2. Joint manipulation The purpose of an adjustment/manipulation is to restore normal range of motion to the joint (spinal, extremity or rib) through normalizing local neurologic reflex loops (by interrupting irritated gamma and alpha motor neurons and restoring normal afferent stimuli). This inhibits local spinal muscle spasms that are maintaining the restriction in the joint. Other benefits include the release of local adhesions in the joint, restoring local circulation, and decreasing local or referred pain. Two techniques are used:
3. Craniosacral therapy (CST) CST addresses not only increased mechanical tensions in the dural tissues of the central nervous system, but also fascial strain patterns anywhere in the body, including the thoracic and abdominal cavities, visceral ligaments, and fascia around joints. Intense physical activity and trauma (slips, falls, extreme play) can cause increased tensions in internal fascial tissue, and the respiratory diaphragm, etc., that can be released via CST. An indirect light touch technique (5 grams of pressure, or the weight of a nickel) encourages the self-correcting mechanisms of the body to release abnormal tensions.
• Direct techniques – These go into the direction of the barrier or “stuck-ness” and include osteopathic slow, long lever manipulations or short lever, high velocity, low amplitude thrusts (HVLA) (similar to some chiropractic techniques). • Indirect techniques or functional indirect techniques – These techniques move away from the restriction barrier to the “side of ease”. This is a more individualized way to release a joint; it involves “listening” to where all the tissues want to go in three dimensions, and then slowly following these unique unwinding movements until there is a complete release of the entire joint, including all surrounding soft tissues. Joint restrictions are “neurologically mediated” from two different causes. The first cause is local to the joint itself
OSTEOPATHY IN PRACTICE – OBSERVATIONS RELATED TO SPAY/NEUTER Over the last decade, I have made three significant observations – all related to routine spay/neuter: 1. R outine spay/neuter surgeries cause a sacro-iliac (SI) fixation in all dogs, cats and horses. This reduces normal motion and power in the hind end, setting them up for future mobility problems. Quadrupeds are “rear wheel drive” creatures so it is all about maintaining full power in the hind end for as long as possible. Mechanical issues (non-visceral) can also be going on in the sacro-pelvic region (which is why chiropractic can help with hind end issues); however, the spay/neuter influence will always have more significant impact due to the young age at which these surgeries are done. This loss of symmetrical freedom and mobility in the hind end is not noticed at this age, and many animals adapt to it for several years until they no longer can. 2. ACL (CCL) injuries/tears can be potentially prevented if early treatment of spay/neuter adhesions are addressed to normalize SI movement. The fibula is involved in this pattern of susceptibility.
Checking sacro-pelvic symmetry/balance.
3. Front end lameness is often directly related to an SI fixation in the pelvis on the same side, and can be a stubborn problem to treat. We truly need to look at the whole dog/ cat in these cases.
Checking sacro-pelvic symmetry/balance.
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HOW SPAY/NEUTER ADHESIONS RESTRICT MOBILITY IN DOGS AND CATS As I summarized above, spay/neuter can affect mobility in three ways: 1. Sacro-iliac fixations The mild fascial adhesion created subsequent to routine spay/ neuter surgery causes a subtle loss of normal mobility at the level of the distal bladder (ligaments of the bladder lose their full motion by only a few millimetres). This changes afferent autonomic nerve flow (sympathetic and parasympathetic) to the sacrum and to the first and second lumbar vertebrae, causing them to rotate/lose normal mobility. The sacro-iliac joint restriction (sacral rotation and ilium rotation) involves loss of normal SI motion on one side only. In osteopathic language, this is often referred to as a “dorsal inflair” of the ilium (same as “PI” – Posterior Inferior ilium in chiropractic terminology). For my clients, I call it “Crooked Butt Syndrome” to relay the idea that there is no longer symmetry in how the animals use their bodies. This pelvic crookedness is the basis of the commonly-noticed “side winding” or “crabbing” gait. There are both short lever (chiropractic) and long lever motion tests to find which SI joint is affected, but I find the long lever (hind limb abduction or “pee on a tree”) test more accurate.
It is very EMPOWERING to get at the root of mobility issues very quickly in dogs and cats, and see longlasting, EFFICIENT responses in just a few treatments, often leading to a
PERMANENT cure of lameness or musculoskeletal pain.
Lumbar 1 and 2 restrictions are in a lateral side-bending pattern and both to the same side. This restriction pattern is often in extension and feels “softer” than a typical vertebra restricted in flexion that is easy to palpate and release with chiropractic manipulation (like a lower thoracic vertebra). Lumbars 1 and 2 lose their mobility due to direct ANS influence (afferent sympathetic flow) and automatically return to normal motion when the adhesion around the bladder is released. Improving the motion of Lumbars 1 and 2 by treating spay/neuter adhesions can significantly help dogs with thoracolumbar disc disease and back pain, and probably prevent some cases as well. Direct, gentle mobilization and release of the spay/neuter adhesion will resolve the rotated sacrum/ilium and lumbar restrictions immediately, without actually having to go to those osseous structures directly. It takes one to three treatments (a week or more apart) to permanently resolve spay/neuter adhesions. I am a strong advocate for spaying/neutering (although not prepubertal); however, in an “ideal” world, veterinarians would know to treat these adhesions soon after surgery. Other visceral causes of sacropelvic/lumbar restrictions include congestion of the prostate in intact male dogs, and adhesions from severe cystitis, cystotomy, C-section, and hormonal imbalance in some bitches. Continued on page 62. IVC WInter 2017/2018
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From left: Cranial drawer test for ACL integrity; Proximal and distal ends of fibula and relationship to stifle joint; Treating distal end of fibula. This normalizes motion of fibula at both ends, thus automatically ‘resetting’ normal tone/tension of cruciate ligament (with or without damage yet).
Continued from page 61. 2. ACL (CCL) injuries / tears At any given time, 30% or more of my patients are dogs with ACL issues. I discovered that the side of surgical repair (in the first knee) and the side of SI restriction from the earlier spay/neuter surgery were correlated almost 100% of the time. The early SI restriction causes a subtle loss of motion at the area of the distal fibula/calcaneal-tarsal joint on the same limb. This leads to a loss of subtle motion at the proximal fibula near the stifle and an early mild laxity of the ACL. No lameness occurs with this very mild laxity. It is like a “pre-pre” positive drawer sign – in a joint that has had no damage. Yet this laxity is reversible to 100% tightness when the normal motion of the fibula is restored. It is an immediate change mediated by what I think is some local neurological reflex between the fibula and the stifle joint. It is my belief that this treatment could be highly preventive of future ACL injuries since the early, reversible laxity can be a form of weakness in the ligament, which sets it up for a potential future tear. In dogs that already have a partial ACL tear, treating the fibula/tarsus still addresses some laxity and can help joint stability. Restoring normal SI motion strengthens
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the hind end with or without surgical repair of the ACL. By restoring power to the hind end in dogs that have an ACL issue in the first knee, it’s possible to prevent the second knee from getting a future ACL injury. My clients who have “ACL-prone” breeds bring in their young dogs for early treatment of the spay/neuter adhesion and to normalize the biomechanics of the affected limb. The potential is always there to actively prevent a devastating ACL problem. I agree with recent epidemiologic research that there is a greater incidence of ACL issues in spayed/neutered dogs, but I believe the true cause has more to do with this abnormal mechanical influence of the SI joint to the fibula rather than to the loss of hormones from surgery. 3. Front end lameness The dura mater around the brain and spinal cord are firmly attached at only the pelvis and skull, so excessive tension at one end is relayed directly to the other end on the same side. When the SI joint gets restricted (from either a mechanical or visceral cause), there is a corresponding reciprocal restriction in the temporal bone on the same side. Along with that comes an upslip (dorsal/ ventral) restriction in the scapula (via the brachycephalicus muscle connecting the
skull to the humerus). I see an almost 100% correlation between the side of front end lameness and SI restriction from earlier spay/neuter adhesion. When the SI restriction is resolved (via treating either the visceral or local mechanical cause), normal mobility automatically returns to the scapula. This truly shows the fascial continuity of the body. In the front-end lameness cases that do not respond to other approaches (conventional, chiropractic, acupuncture, physio/rehab) I have had excellent results in many patients by directly restoring normal scapular movement via the treatment of pelvic viscera. Once the scapula is moving normally up and down, the previous soft tissue lesion causing the pain/lameness can actually heal. All spayed/neutered dogs and cats have a scapular upslip on one side, but not all become lame in that limb. The susceptibility for future pain/lameness will always exist on that side since the loss of ideal scapular motion is a setup for potential soft tissue strain in the shoulder area. These local soft tissue pathologies are commonly found by rehab/physio/orthopedic-oriented vets
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but often these practitioners do not find the underlying reason for the strain pattern since it often exists at the other end of the body (SI joint, viscera). Also, since quadrupeds do not have a clavicle when the scapula loses its normal dorsal-ventral motion, the lower cervical vertebrae are directly affected, which sets up animals for neck issues (stiffness, lameness, referred nerve issues such as lick granulomas, etc.).
CONCLUSION Visceral osteopathy seems magical at times. Treating spay/neuter adhesions has literally revolutionized my practice. It is very empowering to get at the root of mobility issues very quickly in dogs and cats, and see long-lasting, efficient responses in just a few treatments, often leading to a permanent cure of lameness or musculoskeletal pain. Having treated older dogs and cats for 20 years, I know what I am also preventing if I see them when they’re younger and get the chance to restore symmetry and balanced mobility early on. Videos of the osteopathic exam and treatment of the spay/ neuter issue can be viewed at TaylorHolisticVet.ca/video.
References Barral, Jean-Pierre. Visceral Manipulation (revised ed). Seattle: Eastland Press, 2007. Barral, Jean-Pierre. Visceral Manipulation II. Seattle: Eastland Press, 1989. Barral, Jean-Pierre, Croibier, Alain. Trauma: An Osteopathic Approach. Seattle: Eastland Press, 1997. Becker, Rollin. The Stillness of Life. Portland: Stillness Press, 2000. Becker, Rollin. Life in Motion. Portland: Stillness Press, 1997. Budras, Klaus-Dieter. Anatomy of the Dog. Hannover: Schlutersche, 2007. Chaitow, Leon. Fascial Dysfunction: Manual Therapy Approaches. Edinburgh: Handspring Publishing, 2014. Felten, David, Jozefowicz, Ralph. Netter’s Atlas of Human Neuroscience. Teterboro: Icon Learning Systems, 2003. Kern, Michael. Wisdom in the Body. The Craniosacral Approach to Essential Health. Berkeley: North Atlantic Books, 2005. Paoletti, Serge. The Fasciae: Anatomy, Dysfunction and Treatment. Seattle: Eastland Press, 2006. Schleip, Robert et al. Fascia: The Tensional Network of the Human Body. Churchill Livingstone Elsevier, 2012. Schwind, Peter. Fascial and Membrane Technique. Churchill Livingstone Elsevier, 2006. Stone, Caroline. Visceral and Obstetric Osteopathy. Churchill Livingstone Elsevier, 2007.
ADVICE ON HOW
TO BUY LOWER-COST
EQUIPMENT
Buying and selling equipment can be overwhelming. Here’s how an equipment broker or equipment exchange network can simplify the process.
W
By Belinda and Bob Simpson
hen a veterinarian is opening a practice, there’s usually a sense of “sticker shock” when the total cost of outfitting the new clinic comes in. Often, buying new equipment is just too expensive. Wouldn’t it be wonderful if you could buy the entire contents of a closing clinic for the fraction of the cost? Alternatively, if you have extra equipment you no longer need, wouldn’t it be great to sell it? But it’s not always that easy, for various reasons. Some of the barriers that arise when sales are conducted between veterinary clinics include:
j The seller doesn’t know how much equipment should
be listed for, and the buyer doesn’t know how much to pay.
k Neither party knows how to repair equipment that’s not working, so it makes for a very confusing transaction.
l Unclear contracts and transaction dealings
(i.e. should I collect the money before or after they get the equipment?)
m Lack of knowledge regarding shipping and packaging, especially where larger items, such as cages, are concerned.
n Veterinarians are typically very busy – especially if they don’t
have a business manager. They often have little time to sell surplus assets or acquire used equipment from each other.
Not surprisingly, veterinarians typically have reservations about buying technical equipment from other veterinarians because of the risk involved. At the end of the day, it’s usually easier just to buy technical equipment from dealers because of the assurance of assistance in such cases – but again, this gets pricey. A used equipment broker or equipment exchange network can help you overcome all the aforementioned obstacles. These options can help find a buyer if you’re selling, and a seller if you’re looking to buy. They also provide valuable services such as repairs, warranties, shipping and escrow type services, making buying and selling used equipment a low risk, stress-free experience. IVC WInter 2017/2018
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The Worldwide Alliance of Equine Osteopaths (WAEO), established in February of 2013, is a non-profit corporation that seeks to unite the profession of Equine Osteopathy. We intend to serve as a resource for practitioners, researchers, educators and students of Equine Osteopathy. We aspire to be the link that allows Equine Osteopaths from all over the world to connect and converse. There is much to learn about each other and the profession of Equine Osteopathy as it is practiced throughout the world.
From the
WAEO The WAEO had an excellent conference in Green Bay Wisconsin this past September. Important individuals in the growth of the Equine Osteopathy field were recognized: • Janek Vluggen, MRO, EDO – a founder of the Vluggen Institute for Equine Osteopathy. • Andre Teunnissen, MRO, EDO – a founder and examiner for the International Registry for Equine Osteopathy. • Jean Albright, DVM, EDO – a founder and past President of the WAEO. We also recognized 23 new certified EDO members and graduates. We are creating a new European Chapter of the WAEO to facilitate communication and international planning. New officers were elected and three members agreed to stand on a committee to create a publication for the organization starting this year.
Topics covered at the conference • Dr. LuAnn Groves discussed the great success she has had treating EPM in horses with a holistic approach. The key is treating the immune system. Osteopathic clinical signs indicating EPM include sensitivity over the occiput when pressure is applied, and immobility on the right side of the body from the 12th thoracic vertebrae to the 6th lumbar vertebrae. Treatment suggestions include deworming for encysted small strongyles with a protocol that includes multiple deworming therapies, herbal immune boosters and anti-protozoal medicines. • Dr. Neil Valk, DVM, DACVS, CHCP spoke about the research analyzing common hoof balance patterns, and the farrier’s influence on the horse’s overall balance. Many studies seemed to show a significant pattern that we as osteopaths also recognize and feel we can perhaps influence. More horses have a longer dorsal wall on the right front than the left front, and the bones in the feet appear to be larger/wider on the left front foot than the right. Also, when
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landing, more horses landed with the left front landing medial side first, and the right front foot landing lateral side first. Since these findings were found over and over again, the researchers called this a normal finding. But is it?
Our question from last issue How can we correct toed-in conformation by treating the chest? Immobility in the scapula, forearm, chest and base of the neck, as well as the poll and TMJ can have a profound effect on how the horse holds the front leg and how he lands on it. Many horses have immobility issues in the accessory carpal bone restricting their ability to rotate the leg medially or laterally. This often coincides with a decrease in sliding motion of the sesamoid bone proximal. Mobilizing the lower thoracic limb can have a profound effect on the medial-lateral balance of the foot. Without treating the scapula, chest, thoracic vertebrae, poll and TMJ, this change is transient, but by treating the whole, landing and foot fall can be changed for the long term and farriers will thank you for making their job easier! More details will be found in a future article. For more information on membership or courses, go to EquineOsteopathy.org.
New board members of the WAEO President: Dr. Ann-Marie Hancock Joan Wilcoxen Anna Kudick Vice President: Lorre Mueller
Secretary: Frances Loehr Treasurer: Kerilyn Peck Dr. Lu Ann Groves
Kay Dee Munns-Olson Casey Jones
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marketplace
ADVERTISE HERE!
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events
To post your event, email us at: info@IVCJournal.com
2018 AVMA Veterinary Leadership Conference January 4–7, 2018 – Chicago, IL Enhance your leadership skills and expand your professional network while attending the Veterinary Leadership Conference. The VLC offers three days of networking and workshop opportunities and is open to any veterinary professional interested in learning more about leadership and team building. Continuing education credit is available for attending select sessions. For more information: www.avma.org/Events/Convention/Pages/default.aspx
Ontario Veterinary Medical Association Conference January 25 – 27, 2018 – Toronto, ON The 2018 OVMA conference offers more than 100 hours of continuing education options to choose from as well as top-rated speakers from Canada and the United States. This 3-day event is the largest annual veterinary conference in Canada and combines education with a tradeshow filled with products and equipment.
CenCan Veterinary Conference February 2–4, 2018 – Winnipeg, MB Hosted by the Manitoba VMA and the Manitoba Animal Health Technologists Association, this event will be a prime opportunity to connect face-to-face with the veterinary community. Have a new product or service to promote? Want to meet with existing clients or potential clients? Then this is the conference for you! For More Information: (204) 832-1394 www.mymvta.ca/event/cencan-2018/
2018 AAHA Veterinary Meeting & Expo February 3–6, 2018 – Orlando, FL Join us to experience something new and unique at AAHA Nashville 2018. This annual veterinary conference offers the opportunity to learn practices from industry experts, discover the latest and greatest in products and services, and network with fellow veterinarians and technicians from around the country. Austin’s magic draws you in. The innovative CE you receive at the AAHA conference will delight you. For more information: (800) 883-6301 www.aaha.org
North American Veterinary Conference February 3–7, 2018 – Orlando, FL The annual NAVC Conference welcomes almost 16,000 attendees from more than 70 countries, offers more than 30 hands-on laboratories, and provides 1,300 Continuing Education credits. You will also see more than 350 nationally renowned speakers. This is the first large veterinary conference of the year where the most current medical and product advances are first released.
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For more information: (352) 375-5672 info@navc.com www.navc.com
Minnesota VMA 121st Annual Meeting February 15–17, 2018 – Rochester, MN The 121st Annual Meeting and Convention of the Minnesota Veterinary Medical Association offers an outstanding continuing education program and great opportunities to network with friends, veterinarians, veterinary technicians, hospital staff, and veterinary students. Also enjoy multiple seminars and a silent auction. For more information: info@mvma.org www.mvma.org
2018 Virginia Veterinary Conference
For more information: (800) 670-1702 info@ovma.org www.ovma.org
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The NAVC Conference is a nonprofit organization whose mission is to provide world-class continuing education for all members of the veterinary healthcare team.
February 22–24, 2018 – Roanoke, VA The 2018 Virginia Veterinary Conference offers two full days of continuing education in small animal, equine, technician, public practice (Friday only) and complementary medicine (Saturday only). If you attend the conference Friday and Saturday, you may earn the necessary 15 hours to renew your Virginia veterinary license. For more information: (804) 346-2611 www.vvma.org
Midwest Veterinary Conference February 22–25, 2018 – Columbus, OH The Midwest Veterinary Conference (MVC), hosted by the Ohio Veterinary Medical Association, is a growing, regional veterinary conference packed with educational, networking and social opportunities for every member of the veterinary team. Bringing together highly regarded experts from around the world and hundreds of industry vendors, the MVC is a national-caliber conference. For more information: (800) 662-6862 info@mvcinfo.org www.mvcinfo.org
90th Annual Western Veterinary Conference March 4–8, 2018 – Las Vegas, NV The WVC provides comprehensive continuing education to veterinary professionals and is an interactive educational opportunity for networking with the veterinary community. WVC grows in size each year adding new speakers that present state-of-the-art hands-on labs in a comfortable environment. Conference registration automatically enrolls the registrant as an association member for the following year. For more information: (702) 739-6698 carolyn@wvc.org
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