Integrative Peer Reviewed
veterinary care
expanding your service
introducing integrative treatment options to your practice Page 40
Integrative education This program at LSU’s School of Veterinary Medicine is making them a leader in integrative medicine education.
winter ISSUE 2012
www.IVCJournal.com
Animal depression A behavioral perspective on the condition and how it may be treated without drugs.
Cold laser therapy It’s safe and non-invasive, and can replace medication, most physiotherapeutic modalities, and even surgical approaches.
Feline diabetes A look at diagnostics as well as managing early DM with diet, medication and herbs.
Tech talk Focus on massage: This therapy has numerous applications and is a valuable addition to the integrative practice.
What’ s New · Students head to VetCamp · Heartworm alert · Study on equine aging integrative veterinary care
1
contents
advisory board
FEATURES
12
Columns & departments
12
Feline diabetes mellitus – part 1
It’s a disease we see all too often in cat patients. Here’s a look at diagnostics as well as managing early DM with diet, medication and herbs.
16
Cold laser therapy
16
Also known as L3T, this therapy is safe and non-invasive, and has the potential to replace medication, most physiotherapeutic modalities, and in many situations, surgical approaches.
20
Horse sense More than skin deep
20
Conventional treatments are limited when it comes to equine skin disease. A medical approach that includes complementary therapies offers considerably more options.
24
Rehab for a torn CCL
34
Whether or not surgery is needed to correct a ruptured cranial cruciate ligament, a combination of mechanical, physical and energetic rehabilitation therapies is necessary to get an injured dog back to normal again.
28
Leading the way
Since its inception just over a year ago, this unique program at the Louisiana State University’s School of Veterinary Medicine is making the school a leader in integrative medicine education and development.
30
Is your patient depressed?
The symptoms of emotional depression in animals can be vague and challenging to diagnose. Here’s a behavioral perspective on this condition and how it may be treated, without drugs.
34
Tech talk Veterinary massage
This increasingly popular and effective therapy has numerous applications and makes a valuable addition to the integrative practice. Be sure to choose an accredited learning program, and be aware of state laws and regulations surrounding animal massage.
40
Integrative practice Expanding your services
How to get clients, colleagues and staff on board when introducing integrative treatment options to your practice.
46
Hospice care
40 4
integrative veterinary care
Clients are requesting care for their terminally ill animals that compares to what they receive for human family members. Adding this service to your practice involves many considerations, but may be well worth the effort.
5 Advisory board 6 What’ s new? 33 Industry innovations 39 Spotlight 44 Profile Dr. W. Jean Dodds, DVM 51 Veterinary resource guide 53 Marketplace 54 Events
Dr. Richard Palmquist, DVM, graduated from Colorado State University in 1983. He is chief of integrative health services at Centinela Animal Hospital in Inglewood, California, president and research chair of the AHVMA, and an international speaker in integrative veterinary medicine. Dr. Palmquist is a consultant for the Veterinary Information Network (VIN) and co-director of the AHVMA Foundation. He has published two books, one for conventional veterinarians and a second for clients discussing how integrative thinking works. Michelle J. Rivera, MT, VDT, is an instructor at the University of Wisconsin and The Healing Oasis Wellness Center, a post-graduate educational institution offering state-approved programs. She is co-owner of The Healing Oasis Veterinary Hospital, offering massage, rehabilitation, chiropractic and Chinese and Western Herbology. Michelle completed the Chinese Herbal Medicine program from the China Beijing International Acupuncture Training Center, and is certified in Chinese Medicine by the Wisconsin Institute of Chinese Herbology. 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.
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. Dr. Christina Chambreau, DVM, 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 co-author of the Homeopathic Repertory: A Tutorial. Bill Bookout is a founding member of the NASC, serving as president and chairman of the board since 2002. He is founder and president of Genesis Ltd., a company that provides feed and health products for animals. He spent 15 years in the human medical device, drug and animal health industries. Bill received his Bachelor’s degree in physical sciences from the University of Wyoming, and an MBA from Pepperdine University. He has been selected by Health Canada to serve on the Expert Advisory Committee for Veterinary Natural Health Products.
Amiee Stubbs is a pet and wildlife photographer from Nashville, TN. She works as the assistant photographer at the Nashville Zoo, and volunteers as a photographer for several animal rescues in her area. She will graduate with a photography degree from MTSU this spring. See her extensive portfolio at amieestubbs.com.
integrative veterinary care
5
contents
advisory board
FEATURES
12
Columns & departments
12
Feline diabetes mellitus – part 1
It’s a disease we see all too often in cat patients. Here’s a look at diagnostics as well as managing early DM with diet, medication and herbs.
16
Cold laser therapy
16
Also known as L3T, this therapy is safe and non-invasive, and has the potential to replace medication, most physiotherapeutic modalities, and in many situations, surgical approaches.
20
Horse sense More than skin deep
20
Conventional treatments are limited when it comes to equine skin disease. A medical approach that includes complementary therapies offers considerably more options.
24
Rehab for a torn CCL
34
Whether or not surgery is needed to correct a ruptured cranial cruciate ligament, a combination of mechanical, physical and energetic rehabilitation therapies is necessary to get an injured dog back to normal again.
28
Leading the way
Since its inception just over a year ago, this unique program at the Louisiana State University’s School of Veterinary Medicine is making the school a leader in integrative medicine education and development.
30
Is your patient depressed?
The symptoms of emotional depression in animals can be vague and challenging to diagnose. Here’s a behavioral perspective on this condition and how it may be treated, without drugs.
34
Tech talk Veterinary massage
This increasingly popular and effective therapy has numerous applications and makes a valuable addition to the integrative practice. Be sure to choose an accredited learning program, and be aware of state laws and regulations surrounding animal massage.
40
Integrative practice Expanding your services
How to get clients, colleagues and staff on board when introducing integrative treatment options to your practice.
46
Hospice care
40 4
integrative veterinary care
Clients are requesting care for their terminally ill animals that compares to what they receive for human family members. Adding this service to your practice involves many considerations, but may be well worth the effort.
5 Advisory board 6 What’ s new? 33 Industry innovations 39 Spotlight 44 Profile Dr. W. Jean Dodds, DVM 51 Veterinary resource guide 53 Marketplace 54 Events
Dr. Richard Palmquist, DVM, graduated from Colorado State University in 1983. He is chief of integrative health services at Centinela Animal Hospital in Inglewood, California, president and research chair of the AHVMA, and an international speaker in integrative veterinary medicine. Dr. Palmquist is a consultant for the Veterinary Information Network (VIN) and co-director of the AHVMA Foundation. He has published two books, one for conventional veterinarians and a second for clients discussing how integrative thinking works. Michelle J. Rivera, MT, VDT, is an instructor at the University of Wisconsin and The Healing Oasis Wellness Center, a post-graduate educational institution offering state-approved programs. She is co-owner of The Healing Oasis Veterinary Hospital, offering massage, rehabilitation, chiropractic and Chinese and Western Herbology. Michelle completed the Chinese Herbal Medicine program from the China Beijing International Acupuncture Training Center, and is certified in Chinese Medicine by the Wisconsin Institute of Chinese Herbology. 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.
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. Dr. Christina Chambreau, DVM, 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 co-author of the Homeopathic Repertory: A Tutorial. Bill Bookout is a founding member of the NASC, serving as president and chairman of the board since 2002. He is founder and president of Genesis Ltd., a company that provides feed and health products for animals. He spent 15 years in the human medical device, drug and animal health industries. Bill received his Bachelor’s degree in physical sciences from the University of Wyoming, and an MBA from Pepperdine University. He has been selected by Health Canada to serve on the Expert Advisory Committee for Veterinary Natural Health Products.
Amiee Stubbs is a pet and wildlife photographer from Nashville, TN. She works as the assistant photographer at the Nashville Zoo, and volunteers as a photographer for several animal rescues in her area. She will graduate with a photography degree from MTSU this spring. See her extensive portfolio at amieestubbs.com.
integrative veterinary care
5
collagen synthesis in fibroblasts, increased action potential of nerve cells, stimulation of the formation of DNA and RNA in the cell nucleus, local effects on the immune system, increased formation of capillaries by the release of growth factors, increased activity of leukocytes, transformation of fibroblasts to myofibroblasts, and a great number of other measured effects.”
Cold laser therapy
Photo courtesy of Ruckersville Animal Hospital & Veterinary Laser Therapy Center
Three parameters of laser therapy
Also known as L3T, this therapy is safe and non-invasive, and has the potential to replace medication, most physiotherapeutic modalities, and in many situations, surgical approaches. by Bill Ormston, DVM
L
ow level light therapy (L3T), or cold laser therapy, is becoming an important component of many integrative veterinary practices, and is most often used for pain control and tissue healing. A laser produces electromagnetic radiation in the visible and near infrared light band (400 to 10,000 nanometers). Cutting lasers are usually over 1,500 nm, while therapeutic lasers will be under 1,500 nm.
All living cells emit units of light (biophoton emission) at the point of excitement (when the mitotic split occurs). Biophoton emission can be an important source of information about an organism’s status. When muscles or nerves are activated, the intensity of biophoton emission increases. Characteristics of biophoton emission indicate the health of the cells and whether they are multiplying or dying.1 It is possible to discriminate between cancer cells and normal cells by measuring the spontaneous low level luminescence. Electromagnetic radiation reacts two ways; partially as a wave
16
integrative veterinary care
movement with all the typical properties of waves (wavelength, etc.) and partially as a flow formed of particles with their properties of mass, quantified energy, etc.2 Ancient Qigong texts speak of absorbing light energy from the sun, moon and stars and of the body radiating varying degrees and qualities of light depending on the individual’s state of health and consciousness.1 L3T is based on the quantum physics premise that each living cell or matrix has an inherent vibration, or coherent radiation. “Treatment with laser therapy is not based on heat development but on photochemical and photobiological effects in cells and tissues,” say Tuner and Hode.3 “Therapeutic lasers cannot penetrate the tissue more than a fraction of a millimeter, so there is no other primary responding tissue other than the outer part of the dermis.” Still, such irradiation has “secondary systemic effects.” Therefore, the light “leads in turn to a number of secondary effects (secondary responses), which have been studied and measured in various contexts: increased cell metabolism and
1
Power is probably the most talked about parameter in lasers. Its impact determines the treatment time needed to deliver an adequate dosage to the target. Lasers, like ultrasound, stimulate at lower levels. At higher levels, they become destructive.4 Most cutting lasers are over 100 W and only penetrate 1 cm at a time. Robert Becker, MD, noted in his 1985 book, The Body Electric, Electromagnetism and the Foundation of Life,5 that plants could regenerate severed branches at three times the normal rate by applying two to three microamperes for five days. A microampere is one-millionth of an ampere. “Larger amounts of electricity killed the cells and had no growth-enhancing effect,” says Dr. Becker. In his experiments with cellular regeneration, he noted: “The best window [of current] was somewhere between 200 and 700 picoamps. This was an infinitesimal tickle of electricity, far less than anything a human could feel even on the most sensitive tissue, such as the tongue, but it was enough to goose the cell into unlocking all its genes for potential use.”
LED therapy lacks the mono-chromaticity and coherence qualities of a laser but is much cheaper to purchase and operate. With normal wounds, LED gives 3% acceleration in healing, compared to 30% for laser.12 Possibly the most important article to be aware of regarding the effects of the energy output of lasers was published in the January 2006 issue of the authoritative journal Lasers in Surgery and Medicine.6 This article noted that a lower dose of laser irradiation “has a stimulatory influence on wounded fibroblasts with an increase in cell proliferation and cell viability without adversely increasing the amount of cellular and molecular damage. Higher doses were characterized by a decrease in cell viability and cell proliferation with a significant amount of damage to the cell membrane and DNA.” These authors further noted that by spreading the light out over 3.3 cm, “the light is divergent and is not as harmful as a narrow parallel beam that allows the entire volume of intense laser light to be focused or concentrated on one small area.” The laser discussed in this study used only 3 MW of power. The FDA approves class 3a, 3b and 4 lasers based on the amount of radiation exposure. Class 4 lasers usually create heat.
2
Dosage measures the total amount of energy delivered per unit of area and is expressed in J/cm2. Tuner and Hode recommend 1 to 10 J/ cm2 for the treatment of superficial or deep pain conditions; 16 J/cm2 integrative veterinary care
17
collagen synthesis in fibroblasts, increased action potential of nerve cells, stimulation of the formation of DNA and RNA in the cell nucleus, local effects on the immune system, increased formation of capillaries by the release of growth factors, increased activity of leukocytes, transformation of fibroblasts to myofibroblasts, and a great number of other measured effects.”
Cold laser therapy
Photo courtesy of Ruckersville Animal Hospital & Veterinary Laser Therapy Center
Three parameters of laser therapy
Also known as L3T, this therapy is safe and non-invasive, and has the potential to replace medication, most physiotherapeutic modalities, and in many situations, surgical approaches. by Bill Ormston, DVM
L
ow level light therapy (L3T), or cold laser therapy, is becoming an important component of many integrative veterinary practices, and is most often used for pain control and tissue healing. A laser produces electromagnetic radiation in the visible and near infrared light band (400 to 10,000 nanometers). Cutting lasers are usually over 1,500 nm, while therapeutic lasers will be under 1,500 nm.
All living cells emit units of light (biophoton emission) at the point of excitement (when the mitotic split occurs). Biophoton emission can be an important source of information about an organism’s status. When muscles or nerves are activated, the intensity of biophoton emission increases. Characteristics of biophoton emission indicate the health of the cells and whether they are multiplying or dying.1 It is possible to discriminate between cancer cells and normal cells by measuring the spontaneous low level luminescence. Electromagnetic radiation reacts two ways; partially as a wave
16
integrative veterinary care
movement with all the typical properties of waves (wavelength, etc.) and partially as a flow formed of particles with their properties of mass, quantified energy, etc.2 Ancient Qigong texts speak of absorbing light energy from the sun, moon and stars and of the body radiating varying degrees and qualities of light depending on the individual’s state of health and consciousness.1 L3T is based on the quantum physics premise that each living cell or matrix has an inherent vibration, or coherent radiation. “Treatment with laser therapy is not based on heat development but on photochemical and photobiological effects in cells and tissues,” say Tuner and Hode.3 “Therapeutic lasers cannot penetrate the tissue more than a fraction of a millimeter, so there is no other primary responding tissue other than the outer part of the dermis.” Still, such irradiation has “secondary systemic effects.” Therefore, the light “leads in turn to a number of secondary effects (secondary responses), which have been studied and measured in various contexts: increased cell metabolism and
1
Power is probably the most talked about parameter in lasers. Its impact determines the treatment time needed to deliver an adequate dosage to the target. Lasers, like ultrasound, stimulate at lower levels. At higher levels, they become destructive.4 Most cutting lasers are over 100 W and only penetrate 1 cm at a time. Robert Becker, MD, noted in his 1985 book, The Body Electric, Electromagnetism and the Foundation of Life,5 that plants could regenerate severed branches at three times the normal rate by applying two to three microamperes for five days. A microampere is one-millionth of an ampere. “Larger amounts of electricity killed the cells and had no growth-enhancing effect,” says Dr. Becker. In his experiments with cellular regeneration, he noted: “The best window [of current] was somewhere between 200 and 700 picoamps. This was an infinitesimal tickle of electricity, far less than anything a human could feel even on the most sensitive tissue, such as the tongue, but it was enough to goose the cell into unlocking all its genes for potential use.”
LED therapy lacks the mono-chromaticity and coherence qualities of a laser but is much cheaper to purchase and operate. With normal wounds, LED gives 3% acceleration in healing, compared to 30% for laser.12 Possibly the most important article to be aware of regarding the effects of the energy output of lasers was published in the January 2006 issue of the authoritative journal Lasers in Surgery and Medicine.6 This article noted that a lower dose of laser irradiation “has a stimulatory influence on wounded fibroblasts with an increase in cell proliferation and cell viability without adversely increasing the amount of cellular and molecular damage. Higher doses were characterized by a decrease in cell viability and cell proliferation with a significant amount of damage to the cell membrane and DNA.” These authors further noted that by spreading the light out over 3.3 cm, “the light is divergent and is not as harmful as a narrow parallel beam that allows the entire volume of intense laser light to be focused or concentrated on one small area.” The laser discussed in this study used only 3 MW of power. The FDA approves class 3a, 3b and 4 lasers based on the amount of radiation exposure. Class 4 lasers usually create heat.
2
Dosage measures the total amount of energy delivered per unit of area and is expressed in J/cm2. Tuner and Hode recommend 1 to 10 J/ cm2 for the treatment of superficial or deep pain conditions; 16 J/cm2 integrative veterinary care
17