Innovative VOLUME 10 ISSUE 1
VETERINARY CARE
4 INTEGR ATIVE APPROACHES TO PAIN YOUR PRACTICE CAN BENEFIT FROM TECHNOLOGICAL ADVANCES IN PAIN MANAGEMENT, FROM LOW-LEVEL LIGHT THERAPY TO HYPERBARIC OXYGEN THERAPY. – P. 10
www.IVCJournal.com
WINTER ISSUE 2019/2020
FEEDING INDOOR CATS FOR OPTIMAL HEALTH
UNDERSTANDING EQUINE METABOLIC SYNDROME
A CLOSER LOOK AT THE“OTHER”CANNABINOID
HOW MBRT CAN CHANGE BEHAVIOR FOR THE BETTER
An investigation into physiology explains why the diets of indoor cats need to model those of their wilder relatives. – P. 17
We know CBD has a variety of medical and veterinary indications…but does THC have a part to play? – P. 36
5 WAYS TO REVITALIZE YOUR PRACTICE
Stuck in a rut? Here are five simple ideas that will help rejuvenate yourself and your practice. – P. 26
Research sponsored by the Morris Animal Foundation is helping to unravel the complexities of EMS. – P. 52
Positive shifts in behavior may arise from Microbiome Restorative Therapy (MBRT) in companion animals. – P. 22
TCVM FOR GERIATRIC ANIMALS
Traditional Chinese Veterinary Medicine offers an effective two-pronged approach to treating older patients. – P. 60
contents FEATURES
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4 INTEGRATIVE APPROACHES TO PAIN USING VETERINARY TECHNOLOGY
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NUTRITION NOOK
By Jessica Dreyfuss, DVM, CVA, CCRT, CVFT
From low-level light therapy to hyperbaric oxygen therapy, technological advances in pain management for animal patients are a boon to veterinary practice.
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FEEDING THE INDOOR CAT FOR HEALTH AND LONGEVITY
By Chris Bessent, DVM, MSOM, Dipl. OM, L.Ac.
Feline physiology explains why the diets of indoor cats need to model those of their wilder relatives.
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BEHAVIORAL CHANGES RESULTING FROM MICROBIOME RESTORATION
By Margo R. Roman, DVM
The potential of Microbiome Restorative Therapy (MBRT) to positively affect behavior in companion animals.
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5 IDEAS TO REVITALIZE YOUR PRACTICE
By Cheryl A. Cross, DVM, DACVP
Stuck in a rut? Here are five simple ideas that will help revitalize you and your practice.
INNOVATIVE PRACTICE TM
FEAR FREE APPROACH TO PAIN MANAGEMENT IN COMPANION ANIMALS
By Anne C. Hermans, DVM, CVH (AVH)
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TESTING THE CANINE HEALTHY SOIL HYPOTHESIS
By Steve Brown, Natasha Lilly, DVM, CVA, and James Pendergast
Is healthy soil the secret ingredient to better health for dogs? This article tells you how to participate in the groundbreaking research being done by the Canine Healthy Soil Project.
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CASE STUDY
By Barb Fox, DVM
Integrating essential oils into the treatment plan for a cat with severe oral trauma.
EQUINE METABOLIC SYNDROME
By Kelly Diehl, DVM, MS, Dipl. ACVIM
Research sponsored by Morris Animal Foundation is helping unravel the complexities of EMS.
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ACUPUNCTURE AND ANALGESIA IN VETERINARY MEDICINE
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THE TCVM APPROACH TO GERIATRIC ANIMAL CARE
By Neal J. Sivula, DVM, PhD, FAAVA, MDiv
An exploration of how this ancient modality treats pain in animal patients.
By Michelle Tilghman, DVM, CVA, CCRP
When treating older animals, the first goal is to diagnose and alleviate pain, and the second is to restore quality of life. Here’s how TCVM can help accomplish both aims.
Developed by a veterinarian, this initiative approaches the management of painful patients in a way that leads to improved outcomes and a rewarding therapeutic experience.
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THE“OTHER”CANNABINOID... DOES THC HAVE A ROLE IN VETERINARY MEDICINE?
By Karen Gellman, DVM, PhD
In the last issue, we looked at veterinary indications for CBD. We now explore questions surrounding THC, the “other” cannabinoid.
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advisory board
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Dr. Richard Palmquist, DVM GDipVCHM(CIVT) CVCHM (IVAS), graduated from Colorado State University in 1983. He is chief of integrative health services at Centinela Animal Hospital in Inglewood, California, former president and research chair of the AHVMA, and an international speaker in integrative veterinary medicine. Dr. Palmquist is a consultant for the Veterinary Information Network (VIN) and a past president of the AHVM Foundation. He has published two books, one for conventional veterinarians and a second for clients discussing how integrative thinking works. Michelle J. Rivera, MT, VDT, is an instructor at the University of Wisconsin and The Healing Oasis Wellness Center, a post-graduate educational institution offering state-approved programs. She is 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.
COLUMNS & DEPARTMENTS
8 Editorial 16 From the NASC 33 From the VMAA 34 Innovation awards 40 Profitable practice
— Digatherm
46 Industry innovations 51 From the AATCVM 59 From the AVH 64 From the VBMA 65 Marketplace 66 News bites
Dr. Joyce Harman, DVM, MRCVS, graduated in 1984 from Virginia Maryland Regional College of Veterinary Medicine. Her practice is 100% holistic, using acupuncture, chiropractic, herbal medicine and homeopathy to treat horses to enhance performance and those with a variety of chronic conditions, with an emphasis on Lyme Disease. Her publications include the Pain Free Back and Saddle Fit Books, and numerous articles in lay and professional magazines. She maintains an informative website: www.harmanyequine.com. Dr. Steve Marsden, DVM, ND, MSOM, Lac. Dipl.CH, CVA, AHG lectures for IVAS, the AHVMA, the AVMA, and numerous other organizations. He is co-founder of the College of Integrative Veterinary Therapies and is a director emeritus of the National University of Natural Medicine in Portland OR. He authored the Manual of Natural Veterinary Medicine (Mosby); and Essential Guide to Chinese Herbal Formulas (CIVT). Dr. Marsden is extensively trained in alternative medicine, including Chinese herbology, acupuncture and naturopathic medicine. He has holistic veterinary and naturopathic medical practices in Edmonton, Alberta. In 2010, Dr. Marsden was named Teacher of the Year by the AHVMA; and Small Animal Veterinarian of the year by the CVMA in 2009. Dr. Jean Dodds, DVM, received her veterinary degree in 1964 from the Ontario Veterinary College. In 1986, she moved to Southern California to establish Hemopet, the first non-profit national blood bank program for animals. Dr. Dodds has been a member of many national and international committees on hematology, animal models of human disease, veterinary medicine, and laboratory animal science. She received the Holistic Veterinarian of the Year Award from the AHVMA in 1994.
Dr. Barbara Fougere, DVM, CVAA graduated in 1986, and was named the American Holistic Veterinary Medical Association Educator for 2011. Dr. Fougere is the principal and one of the founders of the College of Integrative Veterinary Therapies. She has continued studying over the last 26 years, and has three Bachelor degrees, two Masters degrees, three post Graduate Diplomas, several Certifications and numerous other courses under her belt.
Dr. Christina Chambreau, DVM, CVH, graduated from the University of Georgia Veterinary College in 1980. She is a founder of the Academy of Veterinary Homeopathy, was on the faculty of the National Center for Homeopathy Summer School and has been the holistic modality adjunct faculty liaison for the Maryland Veterinary Technician Program and is the former Associate Editor of IVC Journal. Dr. Chambreau teaches classes in homeopathy for animals, lectures on many topics, speaks on Radio and TV, and is the author of the Healthy Animal’s Journal among other titles. She is now on the faculty of the Holistic Actions Academy, which empowers members to keep their animals healthy with weekly live webinars.
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Behavioral Changes Resulting from Microbiome Restoration: AN INTEGRATIVE VETERINARIAN’S PERSPECTIVE BY MARGO R. ROMAN, DVM
THE POTENTIAL OF MICROBIOME RESTORATIVE THERAPY (MBRT) TO POSITIVELY AFFECT BEHAVIOR IN COMPANION ANIMALS. Evidence supporting the critical role of a well-functioning microbiome in the health of veterinary patients continues to grow. Research indicates that significant components of the immune response originate in the gut,1-6 supporting the claim that disease conditions may arise from damage to the gut’s microbiome.7-13 Exposure to antibiotics and other medications, as well as environmental toxins and poor diets can alter the microbiome, weakening the immune system and setting the stage for gastrointestinal illness (GI) and allergies.14-18 The widespread use of hand sanitizers, bleaches, antimicrobials and chemicals such as pesticides, herbicides and preservatives, could contribute to the depleted numbers of microbes being found in human infants and pets.19-24 There is now growing evidence that such damage may be ameliorated by fecal transplantation, and this therapy, while still in its infancy, is increasingly being utilized in both human and animal medicine.25-34 Microbiome Restorative Therapy (MBRT) is a term this author coined in 2012 (as opposed to the customary term Fecal Microbiota Transplantation or FMT) to better describe what this therapy actually does — restore the microbiome.
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MICROBIOME INOCULATION AND RATIONALE FOR MBRT
Mammalian transit through the birth canal at parturition results in microbial inoculation. This “vaginal gulp” occurs as the fetus emerges, bathed in vaginal fluid containing lactobacillus and other microbes. Recent research suggests that even prior to birth, fetuses ingest amniotic fluid, the individual’s first “meal” of microbes. 35 Further microbial exposure takes place as the newborn nurses and later explores its environment. In the wild, baby animals crawl around in a dirt den while the mother regurgitates the food she has eaten to feed them or offers recently killed prey. This initial inoculation of the microbiome is the beginning of the individual’s immune system. Individuals not receiving these microbiome inoculations as well as other healthy, normally-occurring environmental bacteria may lose immune strength due to deficient exposure.1-7 In humans, full-term C-section babies who do not get their initial inoculation from the birth canal benefit from an oral transfusion of their mother’s microbiome. 36
In the case of animals, coprophagia may be a natural way for them to try to replenish their microbiomes. Giving them a healthy, balanced microbiome by transplantation can reset the gut flora and stop the coprophagia and eating of other undesirable things. 37,38 Animals in the wild often eat particular plants and other substances that provide certain nutrients as well as diverse bacteria, an additional way to balance the microbiome.
CAVEATS ABOUT
BEHAVIORAL EFFECTS OF MBRT
Ideal donors should be generational holistically-raised and be naturally reared and organically fed as much as possible. They should be thin in their body weight and have positive happy dispositions. Donors should be free of chronic medical conditions and be screened for parasites such as hookworms, roundworms, whipworms and tapeworms. Consider a PCR test for Giardia, C. difficile, C. perfringens, E. coli and Salmonella. A fecal analysis from animalbiome.com (with a 16s DNA sequencing) can show possibilities of a variety of microbiome species. Additionally, ensure that fecal donors have not been exposed to environmental or dietary gut microbe-killing chemicals or herbicides.14,17,18
This author and her clinical colleagues have observed through years of working with MBRT that this therapy is beneficial not only for its physical healing qualities, but also for its effects on behavior, adding to the possible positive outcomes of fecal transplants in companion animals. We have witnessed in our veterinary clinic, or through client feedback, distinct behavioral and even personality changes in MBRT recipients. While we do not know why these behavioral changes occur, we posit that microbiome restoration appears to be at least partially responsible for this effect. We have observed an added dimension of mental health and behavioral improvements within just a few hours or days of this novel treatment, and appreciate this as a significantly different consequence from the typical positive outcomes of other holistic treatments. A better understanding of the role the gut plays in emotional and psychological well-being is timely and necessary, and can inform the possibility of incorporating fecal transplants into behavioral therapeutic approaches for animals as well as humans.
A “ONE HEALTH” APPROACH The “One Health” concept is a relevant paradigm from which to approach this issue. Published scientific and subjective accounts describe how some organ transplant recipients seem to suddenly take on emotions and characteristics unlike their own, but very similar to those of their donors.39-44 This effect has been documented in heart, lung, kidney, liver and other organ and body part transplant patients (although the most dramatic and long-lasting effects seem to occur with heart transplants) 45,46 This intriguing side effect of organ transplants raises interesting questions regarding the nature and mechanisms of some kind of cellular memory that would generate such changes. Likewise, when we hear compelling subjective accounts of similar personality changes after fecal transplants in humans, this raises questions regarding the possible emotional and behavioral effects of MBRT in our animal
DONORS
Enough is now known about predictable clinical treatment outcomes of MBRT to emphasize the vital importance of having pre-screened, healthy, happy, uncontaminated and varied fecal donors.
It is nice to have knowledge of the donors’ success rates. At mashvet.com, our donors have been used successfully for over 7,000 MBRT cases, and have been used by many other veterinary clinics in the US.
WHEN TO
REPEAT MBRT In some transplant cases, we have seen animals completely changed and healed after only one treatment. Others require repetition; one of our patients needed 19 transplants. The criterion for reinoculation is a recurrence of symptoms. However, some owners of formerly very ill animals elect to give their pets MBRT orally on a weekly, bi-weekly or monthly basis for optimal maintenance. The addition of nutraceuticals can also help the microbes thrive, while exposure to certain chemicals could cause transplant disruption. Which foods and chemicals can help or hurt the effects of MBRT is another area of research to be explored and developed. IVC Winter 2019/2020
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