Innovative VETERINARY CARE
VOLUME 11 ISSUE 3
MENTAL HEALTH FIRST AID FOR VETERINARY TEAMS
A PSYCHOLOGICALLY HEALTHY WORKPLACE IS ESSENTIAL TO GOOD MENTAL HEALTH. LEARN HOW A STAFF MEMBER OR MANAGER TRAINED IN MENTAL HEALTH FIRST AID CAN BENEFIT YOUR VETERINARY TEAM. — P. 28
GO DEEPER TO HEAL SKIN PROBLEMS
ADDING LASER THERAPY TO FIRST AID PROTOCOLS
HOW PEMF CAN BENEFIT YOUR PRACTICE
MEDICAL-GRADE HONEY FOR WOUND HEALING
The “kill and suppress” paradigm doesn’t offer a cure – treatments must support skin repair and regeneration. — P. 8
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Utilized to treat arthritis, inflammation, pain, wounds, and more, PEMF has strong clinical evidence to supports its use in veterinary medicine. — P. 18
IMPROVE CPR OUTCOMES IN YOUR PATIENTS
The implementation of RECOVER guidelines into CPR protocols may increase survival rates in veterinary patients. — P. 24
Learn why photobiomodulation should be an essential part of veterinary first aid treatment plans. — P. 40
Honey has a wide spectrum of antimicrobial and immunomodulatory effects on the wound healing process. — P. 46
ESTABLISH A REALISTIC WORK-LIFE BALANCE
An achievable approach to work-life balance involves changing the way we practice veterinary medicine. — P. 60
contents FEATURES
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NUTRITION NOOK
HEALING SKIN PROBLEMS IN PETS BY DIVING DEEPER By Ihor Basko, DVM, CVA
Skin problems are difficult to cure using the conventional paradigm of “kill and suppress.” Treatments should support repair and regeneration, and restore normal skin function.
UNDERSTANDING PEMF AND ITS BENEFITS IN VETERINARY MEDICINE
By Deirdre Chiaramonte, DVM, ACVIM, CCRT, CERP, CVA PEMF is used to treat arthritis, inflammation, pain, wounds, and more. Strong clinical evidence supports its use, but different device parameters and claims cause confusion.
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CPR: IT’ S NOT FUTILE!
By Armi Pigott, DVM, DACVECC The implementation of RECOVER guidelines into CPR protocols is showing promise as a way to improve outcome for veterinary patients.
HEMP CANNABIS USE IN PETS IS HERE TO STAY By Karen Gellman, DVM, PhD
MENTAL HEALTH FIRST AID FOR VETERINARY TEAMS By Coral Doherty, RVT, CPHSA
A psychologically healthy workplace is essential to good mental health. Learn how a staff member or manager trained in Mental Health First Aid can benefit your veterinary team.
SUPPORT CANINE HEALTH AND AGING WITH ASTAXANTHIN By Karen Hecht, PhD
DIETARY-DRIVEN DENTAL DISEASE MECHANISMS
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MEDICAL-GRADE HONEY IN VETERINARY MEDICINE By Nicole Greiner, DVM, CVA
Honey’s wide spectrum of antimicrobial and immunomodulatory effects on the wound healing process exceed many currently available dressings.
HYPOCHLOROUS ACID SOLUTIONS FOR WOUND CARE IN ANIMAL PATIENTS By Jelena Spasic
MEDICAL OZONE FOR WOUNDS
By Margo Roman, DVM, CVA, COT, CPT Instead of reaching for antibiotics when treating wounds, consider medical ozone. It can treat a variety of wounds and should be a part of every veterinarian’s first aid toolkit.
COMPARING DOG FOOD TYPES By Gary Tashjian
THE HEALING POWER AND POTENTIAL OF TERPENES
By Elisha Lehrhoff, MS Toxicology
RETHINKING MODERN VETERINARY CARE By Sam Meisler, DVM
An achievable approach to work-life balance involves changing the way we practice veterinary medicine.
NUTRITIONAL SUPPORT FOR IMMUNITY IN ANIMAL PATIENTS
By Doug Knueven, DVM, CVA, CVC, CVCH
By Emily Stein, PhD
LASER THERAPY AND VETERINARY FIRST AID
By Lisa A. Miller, DVM, CCRT Why photobiomodulation needs to be an essential part of your veterinary treatment plans.
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advisory board 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.
28 COLUMNS & DEPARTMENTS
7 Editorial 23 From the AVH 36 Industry innovations 38 From the VBMA 44 From the NASC 45 Profitable Practice — Dermoscent 51 From the VMAA 52 Business profile — NOW Pets 66 News bites
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. 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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nutrition nook BY IHOR BASKO, DVM, CVA
Healing skin problems in pets by
diving deeper
Skin problems in animals are generally very difficult to cure using the conventional paradigm of “kill and suppress.” Treatments, including nutrition and supplements, that support repair and regeneration, and restore normal skin function, are a better approach.
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The most frustrating skin problems integrative veterinarians see are chronic issues that have been treated by the conventional medicine paradigm of “attack and kill” (antibiotics) and suppressing the hyperactive immune system (steroids, antihistamines, chemotherapy). Unfortunately, these therapies offer no cure. Most medically-conscious pet owners, even without “being holistic” themselves, understand the likely outcome: no cure, side effects from drugs, and a lot of expense. These pet owners search the internet for advice or a holisticallyminded veterinarian for a second or even third opinion. After multitudes of conventional treatments that lead to no cure, where does one begin? Usually, after an onslaught of antibiotics, antifungal medications, steroids and antihistamines, the patient with skin problems is left to heal on their own. By this time, however, the skin has been sterilized, with a dead or dying microbiome in both the skin and digestive tract. Skin cells are unhealthy overall, and healing mechanisms and the immune system have been suppressed, making the patient more vulnerable to re-infection.
HEAL FROM WITHIN Most of the focus in conventional veterinary treatment plans is on only the surface of the skin. Topical antibiotic ointments and steroid creams as well as immuno-suppressive drugs and injections are often prescribed to help suppress symptoms (inflammation, itchiness, and infection). To facilitate skin healing, however, it is important to consider nutrients obtained from the diet, as well as supplements, to support the individual needs of the patient. Occasionally, veterinarians will recommend a “skin supplement” containing Omega-3 fatty acids and ground flax seeds. Integrative veterinarians might add evening primrose oil or hemp oil to decrease inflammation in the body and promote healing, and may also recommend vitamin, antioxidant, nutraceutical, and mineral supplements.
and give it a name (that does not explain the causative factors) such as atopic dermatitis. However, there are similarities among all the various acute and chronic skin problem patients: • Most were raised eating puppy or kitten chow and have eaten commercial pet food and treats most of their lives. • T hey do not get bathed enough with the proper shampoos. • T hey are over-treated with harsh shampoos, antifungal drugs, antibiotics, and suppressive drugs. • T hey take very few to no beneficial supplements to support skin regeneration and repair.
TREAT THE WHOLE ANIMAL To create a successful treatment plan, it is important to consider the ailing pet’s overall condition: age, current medical problems, diet, supplements, current drugs, climate (temperature and humidity), geographical location (tropical vs. desert; mountainous vs. prairie; Northern hemisphere vs. Southern). Most pets with skin problems have some underlying deficiency that has not been resolved: low thyroid hormones, lack of antioxidant-rich foods, impaired liver function, impaired digestion, nutritional deficits, and agerelated problems (kidney and cardiac weakness) due to oxidative stress. The most common supplemental deficiency is a lack of the appropriate number of antioxidants. Continued on page 10.
Veterinarians trained in TCVM (Traditional Chinese Veterinary Medicine) will add Chinese formulas to improve blood flow and energy circulation; improve detoxification and elimination of toxic by-products from metabolism, oxidative stress, and dead and damaged cells; and reduce inflammation.
DON’T TREAT THE DISEASE… TREAT THE PATIENT Each skin problem is different, as is each patient. The tendency is to group similar symptoms into a category IVC Summer 2021
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UNDERSTANDING
Pulsed Electromagnetic Field Therapy (PEMF) AND ITS BENEFITS IN VETERINARY MEDICINE
BY DEIRDRE CHIARAMONTE, DVM, ACVIM, CCRT, CERP, CVA
PEMF therapy is used in both human and veterinary medicine to treat arthritis, inflammation, pain, edema, fractures, and acute and chronic wounds. Even though strong clinical evidence supports its use, different device parameters and claims have caused confusion. Pulsed electromagnetic field (PEMF) therapy is a noninvasive electrotherapy that uses an electromagnetic waveform delivered by antenna. PEMF devices have been approved by the US Food and Drug Administration (FDA) to treat non-union fractures, and cleared to treat soft tissue post-operative pain and edema.1 PEMF therapy devices have been in use for more than a century.1 During the 1930s, a vacuum tube-based diathermy machine used to deliver heat deep into tissue was modified by changing the duty cycle to not produce heat. This new non-thermal device was discovered to have therapeutic effects in pain reduction and wound healing. In the 1970s, orthopedic researchers and clinicians began to surgically implant electrodes into bone to treat non-healing fractures.2,3 Shortly thereafter, non-invasive antennas were used to pulse electromagnetic fields across non-healing fractures in dogs and humans.4 This gave rise to low-powered PEMF devices called bone growth stimulators (BGS), later approved by the FDA.5 During the 20th century, more and more research and clinical evidence led to a greater understanding of how PEMF works.6,7
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DIFFERENTIATING PEMF DEVICES Several parameters determine the mechanism of action, efficacy, and safety of each device, including the electromagnetic waveforms they emit, the size and geometry of the antenna, and the difference in treatment applications. These combined variabilities necessitate the need for validation of each individual PEMF type device. Different PEMF devices have different magnetic fields that can vary from less than one gauss to several thousand gauss. A gauss is a measure of magnetic induction, also known as magnetic flux density. As defined by today’s International Systems of Units, a tesla corresponds to 10,000 gauss. • Devices generating biological effects from magnetic fields are usually categorized as low frequency, with less than 1,000 Hz carrier frequency. • H igh frequency devices with greater than 1,000 Hz carrier frequency usually produce biological effects stemming from electric fields.
Additionally: •T argeted PEMF (tPEMF) devices have waveforms specifically produced to deliver energy to tissue and modulate biologically signaled cascades. • Non-targeted PEMF devices employ waveforms that are not designed to enhance specific biological effects, and are less efficient. Increased calcium ion (Ca2+) signaling has been recognized as an important factor supporting the clinical effects of tPEMF as well as other PEMF technologies and predecessors.8,9 PEMF exposure releases intracellular calcium, which in turn enhances binding of Ca 2+ to calmodulin (CaM).
TARGETED PEMF MECHANISM OF ACTION Targeted PEMF induces downstream production of nitric oxide (NO). Dr. Louis Ignarro and colleagues described the role of NO in biology as a gaseous signaling molecule, particularly about its cardiological effects.10 In 1998, they were awarded the Nobel Prize in Physiology or Medicine for their research.10,11,12 NO is an important homeostasis signaling molecule as it can function as a vasodilator and also influence the nervous and immune systems.13,14 Targeted PEMF enhances NO production
which clinically reduces pain, edema, and inflammation by reducing programmed cell death, promoting blood vessel dilation, and enhancing circulation.1,9,15,16,17,18,19,20 Calcium binds with CaM when increased concentrations of Ca 2+ are present in the cytoplasm. Rapid bursts of NO are produced when Ca 2+ to CaM binding activates constitutive nitric oxide synthase (cNOS). NO binds to soluble guanylyl cyclase and increases production of cyclic guanosine monophosphate (cGMP). Anti-inflammatory responses, enhanced blood flow, and production of growth factors are activated following enhanced NO and cGMP — all required for tissue repair and healing. After tissue injury, surgical or traumatic, a complex inflammatory cascade occurs to avoid infection, enhance tissue remodeling, and start tissue healing. Concurrently, an anti-inflammatory cascade is initiated, decreasing inflammation, increasing cGMP, and releasing growth factors to bolster vascularization, tissue regeneration, and remodeling. Heat shock proteins (HSP) are inducible proteins that are expressed under stressful conditions but are considered cytoprotective and prevent apoptosis. 21 A specific group of HSPs — HSP70, important in protein folding — are induced by tPEMF therapy, also imperative for tissue healing.22,23,24 Continued on page 20.
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