Integrative PEER REVIEWED
VETERINARY CARE
SPECIAL NUTRITION ISSUE
NUTRITION AND CANCER
HOW DIET AND SUPPLEMENTATION PLAY A ROLE IN PREVENTION AND TREATMENT Page 28
WINTER LAMENESS Injuries sustained on snow and ice are
www.IVCJournal.com
WINTER ISSUE 2013
diagnostically challenging -- a thorough exam is essential.
CASE FOR WHOLE FOODS How our understanding of
KNOW ABOUT NUTRIGENOMICS? Optimize patient health by
HYPERPERMEABLE BOWEL Leaky gut syndrome and its
designing diets for every individual’s genetic makeup.
WINTER FEEDING FOR HORSES Transitioning to a hay diet may lead to deficiencies in key nutrients.
pet nutrition is changing, and where it’s leading us.
relationship to the immune system and chronic disease.
WHAT’ S NEW • Cancer vaccine in clinical trials • Reverse zoonosis • New $80 million equine complex
contents FEATURES
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KNOW ABOUT NUTRIGENOMICS?
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It’s a new science that studies the connection between nutrition and our genes – and how we can optimize canine and human health by designing diets for each individual’s genetic makeup.
THE HYPERPERMEABLE BOWEL
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Leaky gut syndrome can be treated and managed with a four-part program using diet, herbs and nutraceuticals that reverse the causes and risk factors for increased intestinal permeability.
WINTER LAMENESS
Injuries sustained by active dogs that play, run or work in snowy or slippery conditions can be diagnostically challenging. A thorough exam is essential in dealing with these cases.
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THE ROLE OF DIET AND SUPPLEMENTATION IN CANCER CARE
Growing evidence supports the basic principle in cancer nutrition of minimizing simple sugars and complex carbohydrates, and favoring protein and unsaturated fats as the main energy sources.
MARKETING BASICS
Can you be your community’s “celebrity” vet? Here’s a stepby-step breakdown on how to initiate a public relations strategy.
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Case Study A CASE OF RETRO-ORBITAL ABSCESS
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IVC Winter 2012/13
When medications and surgery failed to help Chelsea, this veterinarian found success with two homeopathic remedies.
WINTER FEEDING FOR HORSES
Transitioning to a hay diet during the cold weather months may lead to deficiencies in key nutrients and a need for supplementation.
BOWEN THERAPY – HOW DOES IT WORK?
Learn how this effective hands-on healing technique can help with musculoskeletal pain and other issues in horses and small animals.
Nutrition nook THE CASE FOR WHOLE FOODS
How and why our understanding of pet nutrition is changing, and where it’s leading us – and why whole food raw diets are so beneficial.
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Tech talk FENG SHUI IN THE CLINIC SETTING–PART 1
This ancient art of placement can help you and your colleagues maintain wellbeing and harmony in the workplace.
advisory board COLUMNS & DEPARTMENTS
5 Advisory board 6 Editorial 10 Whats new 46 Industry innovations 61 Spotlight
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.
67 Veterinary resource guide 73 Marketplace 74 Events
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, CHC, 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.
Bill Bookout is a founding member of the NASC, and served as president and chairman of the board from 2002–2012. 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.
IVC Winter 2012/13
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The
hyperpermeable bowel
THE DIGESTIVE TRACT is more than a means of deriving nourishment. In addition to its very important functions of digestion and absorption, the gastrointestinal tract is also the largest organ of the immune system in the body. The percentage of lymphocytes residing in the GI tract are estimated to range between 60% to 80%.
When we eat, we want the digestive system to absorb all the good stuff while keeping out all the potentially toxic, antigenic and pathogenic materials in food. How can the digestive system possess the innate intelligence to exclude noxious materials while allowing for the entry of nutrients? The answer lies in the four levels of protection provided by the barrier system of the GI mucosal wall: 1. Mucus layer covering the microvilli 2. Tight junctions between epithelial cells 3. GALT-sIgA in the mucus of the glycocalyx 4. Probiotic species
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IVC Winter 2012/13
BY ROBERT J. SILVER DVM, MS, CVA
The GIT (gastrointestinal tract) has the greatest amount of surface area exposed to the environment of all three barrier systems in the body. In humans, the skin has less than ten square meters of surface area, whereas the lungs have about 140 square meters. The human gastrointestinal tract, however, has 320 square meters of surface area exposed to the environment. These surface area relationships are comparable in veterinary species as well.
Disturbances to the GI mucosal barrier The GI mucosal barrier can be disturbed by factors associated with GIT injury, exposure to toxins or infection. Bacterial infections and endotoxins can injure the tight junctions holding intestinal mucosal cells together. Bacterial overgrowth secondary to inappropriate use of H2 blockers and antacids can lead to
proximal gut colonization by pathogenic bacteria that are “attracted” to the more alkaline pH. Immunosuppressed or protein-deficient patients can have decreased sIgA production, which impairs the immunoprotective value of this secretory immunoglobulin. sIgA is embedded in the mucus layer (or glycocalyx) that overlies the mucosal epithelia.
Clinical disorders associated with leaky gut syndrome (LGS) as reported in human literature • Inflammatory and infectious bowel diseases (Katz, 1989) • C hronic inflammatory arthritis (Skoldstam, 1991; Rooney, 1990)
The liver provides defensive activity both in terms of its phagocytic Kupffer cells, and its enzyme detoxification systems. The liver has a dual-phase system of detoxification. Hepatic enzymes decontaminate toxins and metabolic toxic by-products, and help degrade antigens and antigen/antibody complexes. Kupffer cells are the sessile hepatic macrophages found in hepatic sinusoids; they play an important role in the GI immune system by removing bacteria, particulate matter and toxins.
• D ermatoses such as acne, psoriasis and dermatitis herpetiformis (Hamilton, 1985)
Compromised barrier function increases the total toxic load on the body as a whole by allowing ingested toxins and xenobiotics entry into the systemic circulation, bypassing the portal circulation, thus allowing these foreign substances entry into the body without modification by hepatic detoxification enzymes.
• P ancreatic carcinoma (Braganza, 1983)
Contrary to the recommendations of folk medicine, prolonged fasting may do more harm than good in patients with challenged immune systems. “Bowel rest” for more than three days has been shown to cause deterioration of the enterocyte population, which can lead to atrophy of the mucosal surface, alterations in bowel permeability and an overall diminution of gastrointestinal immune function. Studies have shown that early enteral feeding can improve splanchnic blood flow and immune system function. With disrupted barrier function, antigens and pathogens are allowed to gain entrance into the systemic immune system. The first contact of antigens and pathogens is with dendritic cells that then carry the information from those antigens or pathogens to naïve B and T cells, and “activate” them to be specific for those antigens or pathogens. Following their activation, naïve T and B lymphocytes clone themselves and then migrate to the regional mesenteric lymph node. From the regional lymph nodes, these activated lymphocytes enter the lymphatics, and from there the venous circulation and systemic blood supply, ultimately migrating back to a specific anatomical region of the GI tract.
Increased immune mobilization leads to disease When allergens and pathogens are prevented from being absorbed into the systemic circulation by healthy mucosal barrier mechanisms, there can be no systemic immunological response (Hamilton, 1985). Disrupted bowel barrier function, however, will lead to inappropriate increases in antigen and toxin loads
• C onditions triggered by food allergies or specific food intolerance such as eczema, urticaria and irritable bowel syndrome (Faith-Magnusson, 1984) • C hronic hepatitis (Whitcomb, 1994) • A cute and Chronic pancreatitis (Braganza, 1983; Juvonen, 2000)
and will disrupt detoxification mechanisms, thereby creating increased immune system and liver enzyme mobilization. Over time, this can lead to chronic pathology. Disrupted bowel barrier function has three synonyms: 1. Hyperpermeable bowel 2. Increased intestinal permeability 3. Leaky gut Impaired barrier function can also lead to diseases of the immune system. For instance, when bowel permeability increases, classic hypersensitivity to foods and components of normal gut flora can result (Galland, 1993). Bacterial endotoxins, cell wall polymers and dietary gluten may cause non-specific activation of proinflammatory pathways mediated by complement and cytokines. In experimental animals, chronic low grade endotoxemia has been shown to contribute to the development of auto-immune disorders (Branganza, 1983). Increased intestinal permeability may be either involved in the course of each disease, or may be a secondary effect of the hyperpermeability leading to immune activation and hepatic dysfunction, creating a vicious cycle of disease promotion.
Measuring intestinal permeability The measurement of increased intestinal permeability in veterinary species requires measured urinary collection with a urinary catheter in place. This makes it more difficult to diagnose without hospitalization. Typically, in the measurement process, different sized, nondigestible long chain sugars are administered orally, and IVC Winter 2012/13
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