Integrative Peer Reviewed
veterinary care
Adaptogenic herbs
How they help treat HPAT axis exhaustion Page 24
Integrative oncology Form a strong working relationship with a veterinary oncologist to give your patients a better-than-fighting chance
spring ISSUE 2012
www.IVCJournal.com
Talking titers More than a decade of clinical experience shows them to be a reliable way of monitoring immunity to many infectious diseases
Pain management Using conventional and complementary therapies along with weight management, exercise, diet and supplements
Chiropractic case report
Demonstrating that chiropractic is an effective physical modality in the treatment of mobility problems
Are you burned out? Recognizing, preventing and treating veterinary burnout is crucial to your continued success and well being
What’ s new? • Ground breaking feline studies • Gene mutation discovery • Heads up for California chiropractors integrative veterinary care
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contents FEATURES
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Integrative oncology
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Human cancer centers are already using an integrative approach to oncologic care. Many veterinarians are going in the same direction, but more studies and clinical trials are needed to help us better understand how conventional and complementary treatments can work together to optimally treat animal patients.
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Talking titers
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Though some veterinarians challenge the validity of vaccine titer testing, published studies and more than a decade of clinical experience have shown it to be a reliable way of monitoring immunity to many of the most important infectious diseases.
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Integrative pain management
For optimal results, both conventional and complementary therapies should be utilized along with close attention to weight management, exercise, diet and supplements.
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Adaptogens for the HPAT axis
This exceptional category of herbs has many veterinary applications. Let’s look at their effectiveness for hypothalamic-pituitary-adrenal-thyroid exhaustion.
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The worm turns
Equine parasites are now resistant to many of the drugs currently in use. The time has come to rethink deworming by adding some alternative strategies to the treatment arsenal.
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Nutrition nook Digestive enzymes
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integrative veterinary care
These key nutrients can be used for pancreatic and GI issues, but are also beneficial for healthy patients eating heat-processed pet foods.
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Integrative practice The integrative umbrella
More clients are asking for CAVM, but how do we respond when we don’t have ideal scientific evidence to back up these therapies? Here are the tools to weather this dichotomy.
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Feline diabetes mellitus
A look at insulin stabilization and home monitoring, as well as long term management and complications.
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Chiropractic case report
This dog’s experience demonstrates that chiropractic is an effective physical modality in the treatment of mobility problems.
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Are you burned out?
Your profession may be hazardous to your health. Recognizing, preventing and treating veterinary burnout is crucial to your continued success and well being.
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Undiagnosed lameness
It’s a common complaint, but in many cases, the culprit is poor saddle fit and balance.
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Tech Talk Bach Flower Remedies
Though their efficacy isn’t backed up by much science, these remedies have nevertheless found a place in many integrative practices as a way to shift emotional states to aid recovery, and to help with behavior or training problems.
advisory board Columns & departments
5 Advisory board 6 What’ s new? 41 Industry innovations 39 Spotlight 49 Veterinary resource guide
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.
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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.
integrative veterinary care
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Talking
Titers
Though some veterinarians challenge the validity of vaccine titer testing, published studies and more than a decade of clinical experience have shown it to be a reliable way of monitoring immunity to many of the most important infectious diseases. \\\\ by W. Jean Dodds, DVM
\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\ Producing effective and safe vaccines for prevalent infectious diseases in animals has become increasingly challenging. In veterinary medicine, evidence implicating vaccines in triggering immune-mediated and other chronic disorders (vaccinosis) is compelling.
are being addressed today because the widespread use of vaccination programs has effectively reduced the risk of disease while simultaneously increasing the population’s “herd immunity”.
Serologic vaccine titer testing While some of these problems have been traced to contaminated or poorly attenuated batches of vaccine that revert to virulence, others apparently reflect the animal’s genetic predisposition to react adversely upon receiving the single (monovalent) or multiple antigen “combo” (polyvalent) products routinely given to pets. Animals of certain susceptible breeds or families appear to be at increased risk for severe and lingering adverse reactions to vaccines. In cats, while adverse vaccine reactions may be less common, aggressive tumors (fibrosarcomas) can occasionally arise at the site of vaccination. We need to acknowledge, however, that these concerns
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integrative veterinary care
Some veterinarians continue to challenge the validity of using vaccine titer testing to assess whether individual animals are protected against the common, clinically important infectious diseases. Nevertheless, titer testing has been around for more than a decade now, and published studies along with extensive clinical experience have shown them to be useful and reliable for monitoring immunity to canine distemper virus (CDV), canine parvovirus (CPV-2), canine adenovirus (CAV-1 and -2), feline panleukopenia virus (FPV), and rabies virus (RV). Modified-live virus (MLV) vaccines for the first four listed viruses induce sterile immunity when the animal has been
properly immunized, thereby rendering him immune to viral replication and re-infection upon exposure. Serum titer levels for these diseases are directly proportional to the degree of clinical protection. By contrast, titers for feline herpes virus (rhinotracheitis virus) and feline calicivirus are less reliable. All licensed rabies vaccine are inactivated, killed products, so they cannot replicate in the host animal, but still convey longlived immunity.
The antibody tests performed most often to monitor immunity are CDV, CPV-2 and FPV, especially after completion of the puppy and kitten vaccination series. Today, vaccine titer tests are routinely offered by university teaching hospitals, state and provincial diagnostic laboratories, and private laboratories. There are now also two USDAapproved in-hospital tests available that provide a positive or negative result: Canine TiterCHECK®, Synbiotics Corp. (Pfizer Animal Health, www.synbiotics.com) and VacciCheck®, ImmunoComb (Biogal-Galed, www.biogal.com). The antibody tests performed most often to monitor immunity are CDV, CPV-2 and FPV, especially after completion of the puppy and kitten vaccination series (at least two to four weeks later, and then a year later). Once an animal’s titer has stabilized, it should remain constant for many years. Importantly, this animal has immunity to prevent clinical disease, and doesn’t need to be revaccinated, especially when the vaccine could cause an adverse reaction (hypersensitivity or other adverse event). Actually, one should avoid vaccinating animals that are already protected. It has been said that the antibody level detected is “only a snapshot in time”. That’s simply not true; it is really a “motion picture that plays for years”. The presence of any measurable serum antibody titer indicates the presence of “immune memory” and signifies protection from disease. However, titers do not distinguish between immunity generated by vaccination and/or by exposure to the disease, and one should expect the magnitude of immunity produced just by vaccination to be lower (but still adequate).
Interpreting results Some laboratories may report results with an actual titer measurement, or as less than, equal to, or greater than a measured titer, while others simply indicate a result that’s either positive (antibody is present) or negative (no antibody was detected). The positive titer test result is fairly straightforward, but a negative result is more difficult to interpret, because it is not the same thing as a zero titer and doesn’t necessarily mean the animal is unprotected. A negative result usually means the titer has failed to reach the threshold of providing protective immunity. For the clinically important viral diseases of dogs and cats (CDV, CPV-2, CAV-1, FPV), a negative or zero antibody titer indicates the animal is likely to be unprotected against these diseases. Please remember that some dogs and cats are genetically unable to mount protective immunity to these agents. They are termed low- or non-responder animals, and are still susceptible to contracting these diseases, so exposure risk should be minimized. The estimated frequency of nonresponders for CPV is 1:1,000 and for CDV is 1:5,000.
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