V3I3 (Summer 2013)

Integrative VETERINARY CARE

ANESTHESIA-FREE DENTISTRY VETERINARIANS WEIGH IN ON THE PROS AND CONS. Page 32

CYBERKNIFE CANCER TREATMENT This alternative to surgery eliminates tumors without cutting the skin – and without side effects.

www.IVCJournal.com

SUMMER ISSUE 2013

DENTAL CARE

How diet and client homecare can help reduce dental disease in pets.

TCVM FOR EQUINE LAMENESS How acupuncture and other traditional Chinese therapies help diagnose musculoskeletal problems.

WHOLE FOOD VITAMINS

Foods grown in healthy soil yield a quality of nutrition that can’t be reproduced synthetically.

HOMEOPATHY: 200-YEAR-OLD NANOMEDICINE

Old assumptions about its lack of efficacy are being overturned by advances in modern technology.

WHAT’ S NEW

• Important spay and neuter research • New veterinary trauma centers • Top 10 illnesses in dogs and cats • Latest survey on animal obesity

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IVC Summer 2013

Integrative VETERINARY CARE

SUMMER 2013

edItorIal department Editor-in-Chief: Dana Cox Managing Editor: Ann Brightman Associate Editor: Christina Chambreau, DVM, CVH Senior Graphic Designer: Dawn Cumby-Dallin Senior Graphic Designer: Kathleen Atkinson Social Media Manager: Natasha Roulston Cover Photography: Marjorie Smith

columnIsts & contrIButInG wrIters Meghan Burns, DVM Carmen Colitz DVM PhD DACVO Shelley R. Epstein, VMD, CVH J. Frank Gravlee, DVM, MS, CNS Bud Groth Jean Hofve, DVM Jody Kincaid, DVM, ND, CVA Naomi Kirby, DVM, MS Jarred Lyons, DVM, DACVR Heather Mack, VMD Terri McCalla DVM MS DACVO Johanna Mejia-Fava, DVM Carla Pasteur, DVM Lucy Postins Adriana Sagrera, DVM, CVH Jochen Schleese, CMS, CEE, CSE Laura Austgen Smith, PhD, DVM Susan Swanson, DVM Huisheng Xie DVM, PhD Andy Yersin, PhD Sophia Yin, DVM, MS

We welcome previously unpublished articles and color pictures either in transparency or disc form at 300 dpi.

We cannot guarantee that either articles or pictures will be used or that they will be returned. We reserve the right to publish all letters received. adVertIsInG sales Eastern Sales Manager: Ann Beacom (866) 764-1212 ext. 222 annbeacom@redstonemediagroup.com Midwest Regional Manager: Pam Boyd Bombyk (903) 714-2172 pambb@redstonemediagroup.com Western Regional Manager: Becky Starr (866) 764-1212 ext. 221 becky@redstonemediagroup.com Equine Eastern Sales Manager: Lisa Wesson (866) 764-1212 ext. 413 Lisawesson@redstonemediagroup.com classIFIed adVertIsInG: Libby Sinden classified@IVCJournal.com us maIl: IVC Journal, 6834 S University Blvd PMB 155 Centennial, CO 80122

admInIstratIon & sales Publisher: Redstone Media Group President/C.E.O.: Tim Hockley Office Manager: Sherri Soucie Circulation: John M. Allan Administration: Libby Sinden

cdn maIl: IVC Journal, 202-160 Charlotte St. Peterborough, ON, Canada K9J 2T8.

The opinions expressed in this journal are not necessarily those of the editor, and different views may appear in other issues. Redstone Media Group Inc., publisher of IVC Journal, does not promote any of the products or services advertised by a third party advertiser in this publication, nor does Redstone Media Group Inc. verify the accuracy of any claims made in connection with such advertisers.

suBmIssIons: Please send all editorial material, photos and correspondence to Dana Cox at Dana@redstonemediagroup.com or IVC Journal, 160 Charlotte St., Suite 202 Peterborough, ON, Canada K9J 2T8.

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IVC Prem.ind

IMPROVING THE LIVES OF ANIMALS...

ONE READER AT A TIME.

IVC Summer 2013

3

contents FEATURES

16

INTEGRATIVE DENTAL CARE

24

Dental disease is the most common health problem seen by veterinarians. Learn the role that diet and raw bones play, and how to encourage clients to practice home care between cleanings.

21

TREATING CATS WITH HERBAL THERAPIES–A NOVEL APPROACH

Most cats don’t like taking Chinese herbs orally. A radionics machine enables energetic copies to be made of the herbs, which can then be applied transdermally.

32

24

CYBERKNIFE ROBOTIC RADIOSURGERY FOR CANCER TREATMENT

This non-invasive alternative to surgery uses highly-concentrated radiation therapy to eliminate tumors without cutting the skin – and without the side effects of conventional treatments.

28

Integrative Practice IMPROVE YOUR BOTTOM LINE BY SELLING SUPPLEMENTS AND DIETS

42

49 4

IVC Summer 2013

Many clients are demanding “natural” foods and supplements for their pets. Here’s how to become the source for these products in your own community.

32

ANESTHESIA-FREE DENTISTRY –VETERINARIANS WEIGH IN ON THE PROS AND CONS Is it something you want to offer your patients? We present a variety of veterinary views to help you decide whether or not to recommend or incorporate this form of dentistry into your practice.

42

Tech Talk ARE YOU IN TUNE WITH YOUR PATIENTS’ TEMPERAMENTS? As a veterinary technician, you are often the first person to interact with patients. You can set the tone of the entire visit by reading each pet’s body language and knowing how to put them at ease.

49

EQUINE DENTISTRY– A HORSE’ S HEALTH IS IMPACTED BY THE WAY HIS TEETH ARE FLOATED The temporo-mandibular joint – and the entire health of the horse – can be positively or negatively affected by the way his teeth are floated.

54

TCVM FOR LAMENESS IN HORSES–DIAGNOSIS AND TREATMENT

Acupuncture and other Traditional Chinese Medicine therapies provide a diagnostic modality for equine musculoskeletal problems, and can also be used to help gauge response to treatments.

60

Nutrition Nook WHOLE FOOD VITAMINS – WHY THEY’ RE SUPERIOR TO SYNTHETIC ALTERNATIVES

Naturally occurring whole foods grown in healthy soil produce a quality of nutrition that cannot be reproduced artificially.

74

HOMEOPATHY: A 200 -YEAR-OLD NANOMEDICINE–PART 1

Its acceptance has been hindered by the inability to scientifically explain its mechanism of action. But old assumptions about the lack of particles in high dilutions have been overturned by advances in modern technology.

advisory board COLUMNS & DEPARTMENTS

5 Advisory board 6 Editorial 10 What’ s new 36 Industry innovations 40 Social media 41 From the ICVA 45 Spotlight 46 From the VBMA 59 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.

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.

66 From the AHVMA 68 AHVMA conference highlights 81 Marketplace 82 Events

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 trai ned 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, 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. 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. Mr. Bookout was appointed vice president of global sales for Kemin Industries after Kemin acquired his supplement company, Genesis Ltd. Prior to his work in the animal field, Mr. Bookout spent 15 years in the human medical device, drug and animal health industries. Mr. Bookout 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 IVCSummer Summer2013 2013

5

editorial

Focus on

dental health Decades ago, healthy teeth were the norm. Now, even the most holistically treated dogs and cats suffer from varying degrees of gingivitis, calculi, stomatitis, cavitation and tooth loss. While diet and a healthy immune system help mitigate dental issues, there seem to be other factors causing dental issues in otherwise healthy animals. In this issue of IVC, we explore the importance of good dental care, and how it can best be achieved in our patients.

Find out how feeding a raw meaty bone diet may help animals regain dental health, and how to empower clients to care for their pets’ teeth between visits, in Dr. Jean Hofve’s article on page 16. If you’re considering anesthesia-free dentistry, read what several veterinarians have to say about the pros and cons of this procedure (page 32).

Dr. Heather Mack, meanwhile, shows us how essential good teeth and proper floating are to a horse’s overall health (page 49). I was surprised to learn that improper floating, which occurs more frequently with the newer power floats, causes many behavioral issues in horses.

I love the wide range of other topics covered in this issue. Tempting us to learn new modalities, Dr. Huisheng Xie, Dr. Laura Austgen Smith and Dr. Carla Pasteur show how Traditional Chinese Veterinary Medicine (TCVM) can help us diagnose and treat equine lameness (page 54). And Dr. Shelley Epstein begins a twopart article on homeopathy and its newly proposed mechanism of action involving nanoparticles on page 74.

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IVC Summer 2013

Summer is a busy season, so we want to make it easy for clients to purchase the diets and supplements they need from us (page 28). Dr. Jody Kincaid explains the value of whole food supplements (page 60), and Dr. Susan Swanson’s approach to topical herbal treatment removes the stress from getting cats to take herbs (page 21). And be sure to read about the benefits of CyberKnife for cancer treatment on page 24.

With everything this issue has to offer, it’s well worth squeezing some time away from outside temptations to read it. With the integrative approach, our biggest struggle is finding enough pages for all the great information to help our patients become and stay healthy!

Finally, I look forward to seeing you at the American Holistic Veterinary Medical Association’s Annual Conference in Kansas City in August, and hearing your feedback about IVC. I will be giving many lectures, so you can easily find me. You can also email or call me (Drtina@ivcjournal.com or 410-771-4968) with topics you want covered in IVC, or that you wish to write. We are expanding the IVC website and Facebook page, so please send us your cases and/or a brief biography including why you began integrating holistic modalities into your practice, and what benefits you are seeing.

Have a wonderful summer,

Christina Chambreau, DVM, CVH Associate Editor

IVC Summer 2013

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contributors

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1. sHelleY R. epstein, VmD, cVH

4. JaRReD lYons, DVm, DacVR

Dr. Shelley Epstein is a 1985 graduate of the University of Pennsylvania School of Veterinary Medicine. She immediately started practicing at Wilmington Animal Hospital, and has since become the solo owner of this AAHA-accredited practice. In 1997, Dr. Epstein was certified in veterinary homeopathy by the Academy of Veterinary Homeopathy. She has also studied chiropractic, and her practice incorporates many CAVM modalities alongside conventional medicine and surgery. Dr. Epstein lectures extensively on research in homeopathy.

Dr. Jarred Lyons has been board-certified by the American College of Veterinary Radiology since 2007. He received his veterinary doctorate at UC Davis, completed a one-year surgical and internal medicine internship, and went on to complete a radiation oncology residency at North Carolina State University. He currently practices in the Los Angeles area and is one of the few veterinary radiation oncologists in the world to offer CyberKnife robotic radiosurgery.

2. Jean HofVe, DVm Dr. Jean Hofve earned her Doctor of Veterinary Medicine at Colorado State University. In addition to conventional veterinary training, she studied veterinary homeopathy, homotoxicology, Reiki, and other holistic modalities. She has researched pet food and feline nutrition for nearly two decades, and is an expert on holistic pet health and the commercial pet food industry. She is an official advisor to AAFCO, the organization that sets pet food rules and standards in the US and Canada. Dr. Hofve co-authored the book Holistic Cat Care.

3. JoDY KincaiD, DVm, nD, cVa Dr. Jody Kincaid graduated from the Ohio State College of Veterinary Medicine in 1978. He owns and operates the Anthony Animal Clinic and Holistic Healing Center and the Southern New Mexico Wellness Center. Dr. Kincaid became certified in veterinary acupuncture in 1997 and Chinese Herbal therapy in 2000. In 2001, he received his ND (naturopathic doctor) degree and began treating people as well as animals. Dr. Kincaid lectures nationally on human and veterinary nutrition and hosts a local radio show in El Paso on natural medicine for pets and people.

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5. HeatHeR macK, VmD Dr. Heather Mack graduated from the University of Pennsylvania with a VMD in 1991. She was certified by IVAS in 1992 and AVCA in 1995. She has practiced, raised, trained and lived holistically with horses on her Mystic Canyon Ranch in Idaho since 1994. Dr. Mack has maintained an equine sports medicine practice in Southern California for 12 years. She also teaches holistic horse health clinics and takes people on wilderness horse retreats.

6. aDRiana sagReRa, DVm, cVH Dr. Adriana Sagrera graduated from Louisiana State University School of Veterinary Medicine in 1987. She became a certified classical veterinary homeopath in 1995 and is past president of the Academy of Veterinary Homeopathy.

Dr. Sagrera has trained in veterinary chiropractic medicine, is certified in Western herbal medicine by the Southeast School of Botanical Medicine and is currently studying veterinary Chinese herbal medicine. Her practice is located in Metarie, Louisiana.

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contributors

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Meet the IVC gurus! liKe us on Facebook to learn more about integrative leaders in the veterinary community. facebook.com/ IVCJournal

7. HUisHeng Xie, DVm, phD Dr. Huisheng Xie is a clinical associate professor of Integrative Medicine Service at the College of Veterinary Medicine, University of Florida. He is the founder and president of the Chi Institute of Chinese Medicine, where over 3,000 licensed veterinarians have studied acupuncture, herbal medicine, food therapy, Tui-na and other disciplines since 1998. Dr. Xie has lectured about veterinary acupuncture and herbal medicine around the world and has authored 12 books, including Xie’s Veterinary Acupuncture, Xie’s Veterinary Chinese Herbology and Traditional Chinese Veterinary Medicine: Fundamental Principles.

8. sopHia Yin, DVm, ms Dr. Sophia Yin is a 1993 graduate of the University of Davis College of Veterinary Medicine. She earned her Master in Animal Science focused on animal behavior in 2001 from UC Davis. Dr. Yin (drsophiayin.com) has a behavior house call practice and works at San Francisco Veterinary Specialists.

She has been a behavior expert for shows such as Dogs 101 on Animal Planet, and is the author of over four books, DVDs and publications, including Low Stress Handling and Behavior Modification. She lectures internationally and is on the boards of multiple veterinary organizations.

9. caRla pasteUR, DVm, cVa Dr. Carla Pasteur grew up showing horses in many disciplines, such as reining, saddleseat, dressage and pleasure. She graduated in 1991 from the University of Wisconsin and opened an equine exclusive clinic in Green Bay. The practice grew to cover five counties with emphasis on reproduction and lameness. She received her acupuncture training from IVAS in 1997, sold the conventional practice and began an equine alternative practice. She has been a Chi instructor since 2005 and has lectured internationally.

Her current practice encompasses TCVM, chiropractic and osteopathy focusing on sport horses and performance.

10. laURa aUstgen smitH, phD, DVm Laura E. Austgen Smith earned a DVM and a PhD in veterinary virology at Colorado State University. After completing an internship at Marion du Pont Scott Equine Medical Center, she remained in the Washington D.C. area, working both as a clinical veterinarian and on Capitol Hill in international veterinary medicine. Laura is certified in veterinary acupuncture and spinal manipulative therapy and is pursuing further training in both herbology and functional neurology. Laura has an integrative practice in the Denver, CO region.

sUsan sWanson, DVm Dr. Susan Swanson graduated from the University of Minnesota College of Veterinary Medicine in 1988. She owns the Cat Care Clinic in Mahtomedi, Minnesota and cofounded Caring for Cats, a no-kill shelter for cats, in 1999.

She also co-founded the Feline Leukemia Care Center, which provides a lifelong home for FeLV positive cats, and is working to develop a holistic treatment regimen for the disease. Along with practicing traditional Western Medicine, Dr. Swanson specializes in holistic modalities including TCM herbs, acupuncture, nutritional supplements, Western herbs, essential oils, gemmotherapy, flower essences, homeopathy, Reiki, and cranial-sacral therapy.

IVC Summer 2013

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what’s new Important spay and neuter research Recent results from research funded by the AKC Canine Health Foundation suggests veterinarians should be more cautious about the age at which they spay and neuter canine patients.

A team of researchers at the University of California, Davis evaluated the incidence of cancer diagnoses and joint problems in golden retrievers by neuter status: early (before 12 months old), late (12 months or older) and intact. Results showed an increased likelihood of hemangiosarcoma, lymphoma, mast cell tumors, and canine cruciate ligament (CCL) rupture in neutered dogs. Most profoundly, the risk of hip dysplasia doubled, and disease occurred at a younger age, in early-neutered dogs.

The incidence of CCL in early-neutered dogs was 5.1% in males and 7.7% in females, suggesting that neutering prior to sexual maturity significantly increases a dog’s risk of developing this condition. Cases of lymphoma were three times greater in early-neutered males; however, the incidence of mast cell tumors (males and females) and hemangiosarcoma (females only) were highest in the late-neutered group. akcchf.org/canineathlete

Fat pets the “new normal” Animal obesity is showing no signs of abating, according to the latest nationwide survey conducted by the Association for Pet Obesity Prevention (APOP). The survey found 53% of adult dogs and 55% of cats to be classified as overweight or obese by their veterinarians.

“The most distressing finding in this year’s study was the fact that more people are unaware their animals are overweight,” says veterinarian and APOP founder Dr. Ernie Ward. “In fact, 22% of dog owners and 15% of cat owners characterized their animals as normal weight when they were actually overweight or obese.

This is what I refer to as the ‘fat pet gap’ or the normalization of obesity by animal parents. In simplest terms, we’ve made fat animals the new normal.” petobesityprevention.com

Veterinary trauma centers The BluePearl Veterinary Partners specialty and emergency hospital in Tampa, Florida (pictured below) is one of the first nine hospitals to be provisionally designated Veterinary Trauma Centers by the American College of Veterinary Emergency and Critical Care. It’s part of a new initiative designed to improve treatment outcomes of animal trauma cases. The following veterinary emergency care providers have also received this designation: • Southern California Veterinary Specialty Hospital (Irvine, CA) • VCA West Los Angeles (Los Angeles, CA) • University of Illinois Veterinary Teaching Hospital (Urbana, IL) •T ufts Foster Hospital for Small Animals at the Cummings School of Veterinary Medicine (North Grafton, MA) • University of Minnesota – Veterinary Medical Center (St. Paul, MN) •N orth Carolina State University – College of Veterinary Medicine (Raleigh, NC)

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IVC Summer 2013

• Oradell Animal Hospital (Paramus, NJ) •U niversity of Pennsylvania School of Veterinary Medicine (Philadelphia, PA) The criteria and expectations for Veterinary Trauma Centers include the ability to provide total 24/7 care for the small animal trauma patient, and the availability of board-certified specialists seven days a week in emergency and critical care, surgery and radiology. Another goal is to create a database of information related to animal trauma that can be used for research. bluepearlvet.com acvecc.org

GuIdelInes For euthanasIa The AVMA Guidelines for the Euthanasia of Animals have been revised and are available to veterinarians. Originally published in 1963 and updated at least once every ten years, the Guidelines are designed for use by veterinarians who carry out or oversee the euthanasia of animals. Some of the most recent changes include: • Inclusion of euthanasia methods for invertebrates and other “lower-order” species.

• Recommendations regarding euthanasia of injured or diseased wildlife and removal of animals causing damage to property or threatening human safety.

• Additional information about the handling of animals before and during euthanasia.

• Additional information about confirmation of death and disposal of animal remains.

The Guidelines can be accessed at AVMA.org

doGs haVe posItIVe Impact on autIstIc KIds Families who have children with autism spectrum disorders (ASD) are often faced with major challenges. There has been little research done on how dog guardianship affects these families, but thanks to a novel method of monitoring social media, researchers from the University of Missouri have found that dogs have a positive impact on families with autistic youngsters.

The researchers analyzed word clusters such as “family”, “pet” and “love” from thousands of internet forum and social media posts by families with ASD children.

Based on the analysis of these word groups, they concluded that dogs trained to be service or therapy animals can help children with autism in their social and school lives as well as improve the overall quality of life for all family members. munews.missouri.edu

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what’s new how much do pet owners spend on Vet care?

According to the American Pet Products Association (APPA), overall spending in the pet industry was at an all-time high in 2012, surpassing $53 billion. Almost $14 billion of that was spent on veterinary care, an increase of nearly 2% over 2011, and that number is expected to increase in 2013.

Animal ownership is also at a record high, with 68% of households having a pet. Dog households have swelled to 56.7 million, while cat ownership has grown to 45.3 million households. americanpetproducts.org

top Illnesses In doGs and cats According to a recent analysis of claims filed with Veterinary Pet Insurance (petinsurance.com), ear infections were at the top of the list of canine health conditions in 2012. Here’s the complete list for both dogs and cats.

Top 10 canine claims 1. Ear infections 2. Skin allergies 3. Pyoderma (hot spots) 4. Stomach upsets 5. Intestinal inflammation/diarrhea 6. Bladder diseases 7. Eye infections 8. Arthritis 9. Hypothyroidism 10. Sprains

Top 10 feline claims 1. Lower urinary tract diseases 2. Stomach upsets/gastritis

saFe rIdes

3. Renal failure 4. Intestinal inflammation/diarrhea 5. Skin allergies 6. Diabetes 7. Colitis/constipation 8. Ear infections 9. Upper respiratory virus 10. Hyperthyroidism

Veterinarians see many dogs that have been severely injured from falls or jumps out of rapidly moving vehicles. In fact, the American Humane Society estimates that around 100,000 dogs die every year from falling, jumping or being thrown out of truck beds. A much needed bill has recently passed the Louisiana House – dogs in the back of pickup trucks must be in crates or ventilated cages, and not loose or simply tied to the truck. As of this writing, the bill is heading to the Senate for further debate. nola.com/politics/index.ssf/2013/04/dogs_trucks_animal_welfare_bil.html

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new headQuarters For health products Virbac Canada, Inc. has opened a new 2,000 square-foot office in Cambridge, Ontario to headquarter its Canadian operations. One of the world’s largest laboratories dedicated exclusively to animal health, Virbac develops, manufactures and distributes a wide range of products and services intended for the prevention and treatment of common pathologies in companion animals. It offers products to pet owners through veterinarians, in dermatology, endocrinology, senior health, behavior, tick and flea and oral hygiene. virbac.ca

BehaVIor proBlems and pet stores Dogs from pet stores are more likely to have behavior problems than those from small, non-commercial breeders, says a study released by Best Friends Animal Society and the University of Pennsylvania School of Veterinary Medicine.

The study compared psychological and behavioral characteristics in 413 dogs purchased from pet stores with the same characteristics in 5,657 dogs obtained from small-scale, private breeders. Dogs obtained as puppies from pet stores showed significantly more aggression and fear, had more behavior problems when left alone, and experienced more issues with house-soiling.

It is widely accepted that more than 90% of pet store puppies are acquired from puppy mills, and a 2011 study

by Best Friends and the University of Pennsylvania documented the psychological harm suffered by breeding dogs in puppy mills.

“It is highly likely that this severe stress plays a prominent role in the increased behavior problems,” says Dr. Frank McMillan, who led the team of researchers. vet.upenn.edu, bestfriends.org

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IVC Summer 2013

The

importance

phytonutrients – part 2 of

By Lucy Postins

Even though meat should make up most of a dog’s diet, the health benefits of colorful produce shouldn’t be overlooked.

Red: Includes tomatoes, watermelon and papaya. Rich in lycopene, shown to suppress the growth of tumors. Researchers believe poor communication between cells is a cause of abnormal cell growth.

Lycopene may limit tumor growth by stimulating communication between cells. Effective at quenching free radicals.

Purple/reddish: Includes blueberries, cranberries and blackberries.

Contain anthocyanins, found to help reduce risk of cancer and heart disease. Studies have shown that consuming blueberries is linked with improved memory function and healthy aging. More than 300 structurally distinct anthocyanins have been identified.

Some have anti-inflammatory properties. Studies are looking at their role in inhibiting tumor development as well as in diabetes and ulcer treatment. Anthocyanins may possess antiviral and antimicrobial properties.

Dark green: Spinach, kale, bok choy, cabbage, etc. Contain lutein, another free radical-quenching antioxidant. Dark green foods tend to be good sources of the B-vitamin folate, which helps produce and maintain new cells and is essential for DNA and RNA formation. Helps prevent DNA changes that may lead to cancer.

Orange and yellow: Sweet potatoes, carrots, mangoes, pumpkin, etc. contain beta carotene and zeaxanthin, beneficial for the eyes and immune system. Many beta carotene-rich foods such as papayas and kiwis also contain vitamin C, which helps protect cells from free radical damage.

White: Includes bananas, parsnips, potatoes and garlic, which take their “color” from anthoxanthins and contain allicin. Potatoes and bananas are also good sources of potassium.

Refined and processed foods that have turned brown from high heat or pressure are missing the colorful phytonutrients natural whole foods possess.

Lucy Postins is the co-founder and CEO of The Honest Kitchen pet food company, which makes dehydrated natural dog and cat food, treats and supplements. Lucy has long been interested in the benefits of home cooked and raw food for pets and started researching healthy nutrition for dogs and cats after adopting a Rhodesian ridgeback puppy in 2000. She began formulating pet food products a year later and launched The Honest Kitchen in 2002. thehonestkitchen.com

IVC Summer 2013

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INTEGRATIVE DENTAL CARE

By Jean Hofve, DVM

DENTAL DISEASE is the most common health problem seen by veterinarians. It has a strong genetic component. Some breeds, such as Abyssinian cats, have a tendency to develop severe gingivitis, while brachiocephalic breeds often have overcrowded, maloccluded, problem-prone teeth. Some pets may need very little dental care, yet others might require full cleanings under anesthesia once or even twice a year.

THE DIET QUE TION Diet is another major and often controversial contributor to dental disease. One commonly repeated myth is that “dry food cleans the teeth.” This is patently false. First, as most veterinarians have observed, many pets simply swallow dry food whole. If they do manage to chew a few pieces, the kibbles simply shatter, and do no good for supra- or sub-gingival tooth surfaces.i A survey of 1,350 dogs failed to demonstrate that dogs had better periodontal health when eating dry rather than moist food.ii However, conflicting research suggests that pets eating wet food are likely to have more dental deposits and periodontal disease than those that eat dry food.iii Holistic veterinarians understand that each animal is an individual, and the diet must be tailored to those individual needs. Studies need to be carefully evaluated as to the funding and methods used.

Specially designed dental foods have very large kibbles designed to fracture so that the fragments do abrade some tartar off the teeth.iv However, the major ingredients of most such diets are typically of poor quality (by-product meal, corn gluten meal, corn meal or ground yellow corn). Plus, these foods suffer from all the usual problems of dry food: heat processing,

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IVC Summer 2013

the potential for bacterial or fungal contamination, high carbohydrate levels and low moisture. Because of the health risks associated with dry food in cats (such as obesity,v feline diabetesvi and FLUTDvii), they are unsuitable as the sole diet, although they may have some utility as treats.viii Given that 85% of dogs eat dry foodix and half of them are overweight, and that low carbohydrate diets have been shown to enhance weight loss,x the connection between dry diets and ill health in dogs cannot be dismissed.

Fighting oral disease in pets can seem like a losing battle.

We know that within hours after cleaning, bacteria start to re-colonize the surface of the teeth. They secrete substances to attach themselves more firmly, and to protect themselves from the immune system. If this plaque is not removed, minerals in the saliva turn it into hardened calculus (tartar) within 48 hours. Some of the substances secreted by the bacteria result in gingivitis that can progress to local and systemic disease if untreated. Many a cranky or lethargic older pet has become happy and playful again after hidden dental problems were corrected.

REGULAR DENTAL CARE Excellent pet dental health requires regular veterinary care as well as a commitment to home care from the client. If the pet already has dental disease, the first step is to clean the teeth under anesthesia.

• One incentive to clients is to emphasize how much easier it is to keep pets’ teeth clean than to cope with the alternatives:

increased risk of bacterial endocarditis, pulmonary disorders, renal disease, hepatic disease, polyarthritis, polyvasculitis, auto-immune disorders, discospondylitis, endotoxemia,xi and virtually guaranteed expensive dental extractions in the future.

• Another incentive is to demonstrate the presence of bacteria or tartar that is not easily seen. Since tartar fluoresces, a blacklight will show its presence. Subgingival bacteria can be demonstrated by a new product call Ora Strips. These measure thiols produced by bacteria in active infections. Since oral infections may go through active and quiescent phases, a borderline suspect would be a good case to use the strips on for home monitoring. One vet reported on VIN that the false positive rate was zero after 1,000 tests.

GET CLIENTS TO BRUSH The best way of removing plaque and preventing dental disease at home is by brushing the teeth. Brushing removes plaque on the outside of the crown (above-gum portion) of the tooth and, if done properly, on most of the subgingival surface. It also stimulates the gums to keep them healthy. However, plaque can still accumulate below the gum line; so the need for an annual check-up and cleaning, if necessary, still needs to be communicated as an essential part of a pet’s health program. One recent product involves a test strip that clients can insert into the gum to indicate infection in an apparently normal mouth. Regular use of this product can be an incentive for clients to keep brushing teeth and to seek professional care if the infection persists.

Veterinary technicians can show clients how to brush their pets’ teeth, but the effort may still turn into a battle at home.

You may want to teach, or have clients learn, techniques such as Tellington TTouch, Healing Touch for Animals, acupressure, massage, Reiki, or other hands-on modalities to help reduce their pets’ stress. Flower essences are also very helpful: ten minutes before brushing, give a few drops of Rescue Remedy or other emergency formula, then repeat as needed. It is useful to have the owners take some, too. Here are a few more tips to help owners: • Use a finger brush, never a human toothbrush or even a pet brush on a stick; an unintentional jab can injure the gums.

• Never use force or excessive restraint to get the pet to accept brushing.

The idea is to make it a pleasant experience. A gradual approach that accustoms the animal to brushing is best. Clients should start working with their puppies and kittens as soon as possible.

• Use a toothpaste designed for pets; most dogs and cats love the taste. Human toothpaste is not appropriate for pets; additives such as fluoride can cause gastric irritation, or worse.xii Continued on page 18.

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Continued from page 17.

It’s best to encourage clients to brush every day; then if they miss a day, it’s not a crisis. However, if the plan is to brush every other day, a missed session gives plaque a good head start.

PRODUCTS TO PREVENT DENTAL DISEASE When dogs and cats are truly healthy, they are less likely to have significant dental disease.

Excellent nutrition, homeopathy, TCVM (Traditional Chinese Veterinary Medicine) and other individualized healing approaches to can go a long way toward maintaining dental health.

There are many dental care products marketed for pets. Oral rinses, gels and water additives can help but, depending on the dog, may not control plaque by themselves.The vast majority of treats, meanwhile, contribute little or nothing to dental health, even if they are labeled “Tartar Control”. No proof of effectiveness is needed to put such a label on a treat; it’s primarily a marketing gimmick.

Products approved by the Veterinary Oral Health Council (VOHC.org) at least have passed minimum required protocols to prove their efficacy. Carrying these products can help achieve client compliance with brushing, and your staff can discuss proper home care with clients when they purchase the products.

Most dog chews, including nylon, rubber, rawhide knots and bones, hooves, and large bare bones do little to reduce plaque accumulation, although they are better than nothing.xiii However, hard-textured bones can fracture teeth; and broken teeth are a source of infection and pain to the dog. Any bone, cooked or raw, can splinter, risking perforation of the gut. And if a dog swallows a large chunk of any bone or chew, it could cause a life-threatening intestinal blockage.

Excessive feeding of bones may create an impaction.

Rawhide strips and pig ears may mechanically abrade off some tartar, but be aware they add quite a bit of fat to the diet; and contamination of such treats with Salmonella or other pathogenic bacteria is common.

RAW BONES? Many people recommend a raw meat diet or raw bones for the prevention of dental problems. They point to wild carnivores as the model for this feeding style. However, cats have been developing odontoclastic resorptive lesions since the time of the Egyptian pharaohs, and African wild dog skulls exhibit just as much periodontal disease as their domestic counterparts.xiv xv No diet is a substitute for proper dental care.

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Many holistic practitioners report that they see less dental disease in pets that are fed homemade and raw diets. While there are some risks associated with feeding raw meat and bones, they can be mitigated, and there are proven benefits.

Experimental dogs that were fed 1/2 oxtail once per week for four weeks did not form any calculus; and the calculus the dogs had initially was greatly reduced.xvi While oxtails aren’t common at grocery stores anymore, local butchers may be able to order them; beef and bison oxtails can be purchased online as well.

Chicken or turkey necks can provide a similar chewing exercise for smaller animals.

Another study compared whole, raw bovine trachea, esophagus and attached muscle and fat versus the same food minced. Plaque and gingival inflammation were increased with the minced diet, as well as when the food was tube-fed.xvii The presence of food in the mouth, let alone the food’s character, appeared to be largely irrelevant. In fact, it was reported that feeding whole, meaty, raw tissues had a beneficial effect: “There is reasonable evidence that... foods requiring vigorous prehension and mastication are preferable for dogs and cats.” Raw tissues provide this essential exercise.

Neither wet food, kibble nor a ground raw meat diet require any great effort in prehension or mastication. The negative effects of the ease with which these foods are consumed are highlighted in reference to captive carnivores: “Animals need more ‘hassle factor’ per mouthful of nutrients. The literature contains hundreds of references to the food habits of Continued on page 20.

Bone

guidelines for clients

Here are some guidelines that can be handed out to clients for safely feeding pets raw “meaty” bones, such as chicken or turkey necks or backs, and oxtails or knuckle bones for larger dogs: • Start small; it takes time to develop the necessary neck and jaw muscles, and strengthen the periodontal ligaments.

• Give bones just once or twice a week.

• To kill surface bacteria, dip bones in boiling water for one to two minutes.

• Only give bones on a full stomach.

• Use only appropriately sized, cancellous bones, such as vertebrae – no long bones. For cats and small dogs, give only one or two vertebrae at a time. Use a mallet to break the bones within the muscles to facilitate chewing for very small mouths. Kitchen or poultry shears can be used to divide the vertebrae; some butchers will cut them for you.

• Remove uneaten bones after 30 to 60 minutes.

• Always supervise the pet’s bone-related activities.

• Have a staff member stay current on local sources of organic meat and bones, so you can advise clients where to obtain them.

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Continued from page 18. feral carnivores and, therefore, the appropriate menu is readily available. Convenient prepared diets, those without sufficient ‘hassle factor’, are ruining the mouths and compromising the health of our animals.

Carnivores in their natural habitat eat rabbits, mice, rodents, birds, etc., in toto (i.e., connective tissues, viscera, organs, cartilage, and bones).... The masticatory apparatus of carnivores was designed to be used, and used aggressively and ferociously. If the animals don’t use their dentition and mastictory apparatus, they will in time lose it.”xviii Dogs and cats are structurally similar or identical to their wild relatives. They too need regular stimulation of their jaws and teeth to keep them healthy. However, it’s important to note that large carnivores do not typically consume the bones or hooves of their prey (unless it’s small or young). They gnaw on the cartilage and bone ends with their incisors, but the axial skeleton and large leg bones are left mostly intact.xix Proper dental care is fundamental to optimal health and well being. It’s not easy to convince clients to put in the effort, but if you and your staff concentrate on thorough, practical education, everyone wins.

Logan, et al., Dental Disease, in: Hand et al., eds., Small Animal Clinical Nutrition, Fourth Edition. Topeka, KS: Mark Morris Institute, 2000, p. 487.

Harvey et al., Correlation of diet, other chewing activities and periodontal disease in North American client-owned dogs, J Vet Dent. 1996 Sept;13(3):101-105. iii Gowar JP, Reiter AM, Jodkowska K, et al. Influence of diet on oral health of cats and dogs. J Nutr.

136: 2021S–2023S, 2006. iv Hand MS,Thatcher CD, Remillard RL, et al. Small Animal Clinical Nutrition, 4th Edition.

Topeka KS: Mark Morris Assoc. 2000, p v Zoran DL. The carnivore connection to nutrition in cats. J Amer Vet Med Assoc 2002 Dec 1;221(11):1559-1567. vi Rand J. Current Understanding of the Pathogenesis of Feline Diabetes Mellitus & Principles of Therapy. , 2009. vii Forrester, S. D., Roudebush, P.: Evidence-based management of feline lower urinary tract disease. Vet Clin N Am Sm An Practice. 2007;37: 533, viii O’Rourke JT. The relation of the physical character of the diet to the health of the periodontal tissues. Am J Orth Oral Surg. 1947;33:687. ix Laflamme DP, Abood SK, Fascetti AJ, et al. Pet feeding practices of dog and cat owners in the United States and Australia. Am Vet Med Assoc. 2008 Mar 1;232(5):687-94. x Bierer TL, Bui LM. High-Protein Low-Carbohydrate Diets Enhance Weight Loss in Dogs. J. Nutr. 134: 2087S–2089S. xi DeBowes LJ. The effects of dental disease on systemic disease. Vet Clin North Am Small Anim Pract. 1998 Sep;28(5):1057-62. xii ASPCA Poison Control. http://www.aspca.org/Pet-care/ask-the-expert/ask-theexpert-poison-control/toothpaste.aspx xiii C E Harvey, F S Shofer, and L Laster. Correlation of diet, other chewing activities and periodontal disease in North American client-owned dogs. J Vet Dent. 13(3):101-5 (1996). xiv Watson ADJ. Diet and periodontal disease in dogs and cats, Aust Vet J. 1994;71:313-318 xv Steenkamp G, Gorrel C.Oral and dental conditions in adult African wild dog skulls: a preliminary report. J Vet Dent. 1999 Jun;16(2):65-8. xvi Brown MG, Park JF. Dental calculus in experimental beagles. Lab Anim Care. 1968;18(5):527-535. xvii Watson 1994, op cit. xviii Fagan DA, Edwards MS. Influence of diet consistency on periodontal disease in captive carnivores. Fagan, D.A. - Diet consistency and periodontal disease in exotic carnivores. Proc Am Assoc Zoo Vet.1980a. http://www.colyerinstitute.org/research/diet_consistency.htm xix Why don’t wolves eat all that they kill? http://isleroyalewolf.org/node/42 i

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Treating cats with therapies

herbal

– a novel approach

By Sue Swanson, DVM After years of learning Traditional Chinese Veterinary Medicine (TCVM), including a trip to study in Beijing, China, I almost gave up trying to use Chinese herbs for my feline patients. Cats are masters at detecting even minute quantities of prescribed herbs in their food. My patients often refused to take their herbs regardless of what form I used: powder, pills, tea or a poultice.

After purchasing a radionics machine, I could make an energetic copy of the Chinese herbs into a solution of water and alcohol. This solution is succussed by tapping firmly on the palm ten times prior to each use. The solution is then applied transdermally at the rate of one drop twice daily for most of my feline patients. I apply the solution on the skin in front of the ear, pinnae, paw pads or any place on the body where there is little or no hair. Since most patients object to cold solutions being placed on their skin, I do not recommend refrigerating the energetic herbal solution.

If a patient objects to transdermal application of herbs (some cats mind the wet, even when it is room temperature), I have the owner give the same dose of the energetically made herbal solution (which has no taste) in a small amount of food.

Although it takes a few days longer to see therapeutic effects from an energetic herbal solution used transdermally, and a bit longer still when it’s put in the food, there is a much higher rate of owner compliance, along with happier healthier patients.

Feral cats would certainly benefit from this as you could see them actually eat the dose in the first bite of food.

Most of my canine patients easily take Chinese herbs in powdered form mixed into their food. However, for the few finicky dogs that refuse herbs in food, I make an energetic copy on the radionics machine and have the owner apply it transdermally at the rate of one drop twice daily. Again, it takes a few days longer to see therapeutic effects with this method, but the dogs definitely benefit from receiving the herbs in this manner.

I have a similar approach for using Western herbs in my feline patients. A tincture (alcohol extract) of the herb is applied transdermally at the rate of one drop on the skin for most patients. They are dosed twice daily, or more frequently depending on severity of the symptoms.

For example, for cats with symptoms of FLUTD caused by crystalluira, I use a combination of Sweetleaf, Graveroot and Horsetail. This tincture helps with pain on urination, resolves hematuria and dissolves crystals. When the symptoms are initially severe, I have the owner apply one drop on the skin four or five times daily for the first few days of treatment until the patient is urinating a normal frequency and amount. I then reduce the treatment frequency to twice daily for three to four weeks, or until a urine specimen has been rechecked and found to be normal.

For my canine patients, I use the same technique by applying Western herbal tinctures at the rate of one to three drops on the skin depending on patient size.

Whole herbs, whether Western or Chinese, are the best. However, I have successfully treated ferals, the big cats at The Wildcat Sanctuary and my chickens, goats and alpacas using this method.

I dispense the energetic solutions, as well as herbal tinctures, in ½ oz or 1 oz amber or blue glass dropper bottles.

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Advertorial

Dental products make client homecare

By Bud Groth

Contrary to first impressions among some veterinarians, high quality oral care products are good for business. Advertising by manufacturers along with articles on proper oral healthcare raise awareness among pet owners by not only touting the benefits of products but also showing, with before and after pictures, the benefits and results that can be had with proper care administered daily at home. This increased awareness among clients increases their willingness to bring their pets into the clinic for routine oral examinations and procedures.

The benefits to veterinarians are many. Advising pet owners on proper at-home oral care makes for healthier pets; animals that use oral care products on a regular basis arrive at the office with healthier and cleaner teeth and gums, allowing for easier and less traumatic routine cleaning procedures.

And after a procedure, continued use keeps teeth and gums healthy for the future. These products are especially good for senior and at-risk animals for which there may be concerns about anesthesia.

There are many forms of home oral care products on the market. Toothpastes and brushes, dog chews, dental diet foods, water additives, oral sprays and gels all promote better breath, removal or reduction of plaque and tartar, reversal of gingivitis, and healthier gums. Some products are all-natural and proven to be 100% safe. Many, such as sprays and gels and/or water additives, are easy for clients to use every day since they are simply applied to the mouth and the animal’s tongue and lips spread them around the oral cavity. They require no tedious brushing battles with the pet! They are most effective when no water is taken for 30 minutes before or after application. Very simply, the easier a product is to use, the more likely clients will use it on a consistent and regular basis.

“Together, dental problems and issues related to what pets are fed account for most serious diseases in cats and dogs today,” says veterinarian Dr. Michael Fox. “It is critically important, especially for older pets and toy breeds, to feed a wholesome diet, provide safe chew toys – and get them used to regular tooth cleaning. Wrap a moist gauze bandage around your index finger and get the pet used to having teeth and gums rubbed. The oral gel made by PetzLife Oral Care Products…loosens scale/tartar, and helps reduce inflammation and infection. A spray is also available. Safe and effective dental products are the missing link in holistic pet healthcare, where good nutrition and chew toys go handin-hand with dental health.”

Bud Groth has a background in life and health insurance. His own health issues started him on a quest to find natural products to treat illness, and his interest extended to pets as well. He started PetzLife in 2003 when he found there was a need for no-brush dental care products.

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CYBERKNIFE ROBOTIC RADIOSURGERY FOR

canceR tReatment

Photo courtesy of Accuray Incorporated

By Jarred Lyons, DVM, DACVR

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INTEGRATIVE

PRACTICES focus on individualizing

treatment, building health and beginning with the gentlest approaches. The integrative practitioner looks for the least invasive, least toxic approach, with the fewest side effects, to deal with illnesses such as cancer. One of these options is CyberKnife robotic radiosurgery.

Non-invasive alternative to surgery Despite its name, veterinary CyberKnife cancer treatment is a non-invasive alternative to surgery. It utilizes highly-concentrated radiation therapy to eliminate cancerous and non-cancerous tumors without cutting the skin.

Radiation therapy is widely accepted as an effective way to treat cancer, but the side effects are more than some patients can withstand.

CyberKnife robotic radiosurgery is a form of stereotactic radiosurgery, a highly effective version of radiotherapy that mitigates many

typical side effects of conventional radiation therapy, and involves two to three treatments given within a week.

Mild anesthesia is required

Standard curative intent conventional radiation therapy usually requires between 16 and 22 treatments given daily over the course of a month.

Both stereotactic radiosurgery and It often causes short term reversible side effects such as mucositis, conventional definitive radiation therapy desquamation of the skin, and inflammation of underlying structures. require the patient to be completely still during Although these side effects generally resolve over one to three treatment. In human medicine, this rarely proves problematic because patients can be verbally told weeks, they are rarely seen with CyberKnife robotic radiosurgery.

OTHER COMMON TUMORS IN VETERINARY MEDICINE THAT HAVE BEEN TREATED WITH STEREOTACTIC RADIOSURGERY INCLUDE PRIMARY BONE TUMORS OF BOTH THE APPENDICULAR AND AXIAL SKELETON.

to stay in the same position. In veterinary medicine, however, patients require the aid of a mild general anesthesia in order to minimize movement and facilitate necessary treatment positioning.

In conventional radiation therapy needing more than 16 sessions, the daily treatments usually last between ďŹ ve and ten minutes with daily anesthesia episodes of between ten and 20 minutes. Although each treatment of CyberKnife robotic radiosurgery Cyberknife radiosurgery relies on real-time body imaging to guide needs 20 to 50 minutes, there are fewer than ďŹ ve radiation delivery by an intelligent robotic arm. This technology sessions, thus limiting the total overall anesthesia enables high dose gradients to be delivered with sub-millimeter accuracy time. Limiting anesthesia risks is especially important in compromised or high-risk to the neoplastic masses and the targets of choice. Because stereotactic patients (those with brain tumors, renal radiosurgery is delivered with such accuracy and precision, much higher disease and cardiac disease). doses of radiation can be directed at tumors without the concern of affecting surrounding normal tissues. This avoids or minimizes side effects typically associated with definitive conventional radiation therapy. This increased effectiveness is why patients typically require fewer than five treatments that can be completed in less than a week.

Continued on page 26.

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PRELIMINARY DATA FROM ONE STUDY HAS SHOWN THAT STEREOTACTIC RADIOSURGERY USED FOR DOGS AND CATS WITH BRAIN TUMORS PRODUCED MEDIAN SURVIVALS OF OVER 30 MONTHS (VETERINARY CANCER SOCIETY ANNUAL MEETING, 2011). radiosurgery beams, structures including the eyes and brain can be avoided, thus eliminating both short term and any late term irreversible side effects from the radiation. The typical reversible short term side effects seen with conventional radiation in this region include mucositis to the oral and nasal mucous membranes and desquamation of the skin. The late term effects of radiation therapy to this region can include cataracts, rhinitis and tissue necrosis. These side effects can be typically avoided with CyberKnife radiosurgery.

Above: A comparison plan image. CyberKnife automates the entire planning process including the setting of parameters and dose calculation. Complete treatment plans are generated based on the clinical objectives defined by the veterinarian, and then presented for review and approval.

Continued from page 25.

Treats many tumors CyberKnife radiosurgery can be used to treat tumors in most parts of the body, including the head, spine, lung, prostate, bone, liver, kidney, pancreas and perianal region.

• Preliminary data from one study has shown that stereotactic radiosurgery used for dogs and cats with brain tumors produced median survivals of over 30 months (Veterinary Cancer Society annual meeting, 2011). Another achieved median survivals of over 19.4 months with 92% of patients having an improvement in their clinical signs (Veterinary Cancer Society annual meeting, 2012). In comparison, conventional definitive radiation therapy median survivals for brain tumors have been shown to range between eight and 23.3 months and usually require between 16 and 20 daily treatments.

• Dogs treated with CyberKnife for nasal tumors (carcinomas, adenocarcinomas and sarcomas) have comparable median survivals to dogs treated with conventional definitive radiation therapy. Preliminary data has shown median survivals of approximately one year with little or none of the morbidity typically associated with conventional radiation schemes. With the high accuracy of Cyberknife

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• Other common tumors in veterinary medicine that have been treated with stereotactic radiosurgery include primary bone tumors of both the appendicular and axial skeleton.

Osteosarcomas of the limb in non-amputation candidates have been treated with radiosurgery, and median survival times have ranged from 255 days to 572 days. This is much better than the one-year survival time using the current standard of care of

amputation and chemotherapy. Fracture repair of a bone with an active tumor in a dog with advanced osteosarcoma is not usually pursued, so amputation or humane euthanasia is recommended. However, with a limb that has undergone radiosurgery, the primary bone tumor should theoretically be controlled, and therefore, fracture fixation and the possibility of normal bone healing can be expected. CyberKnife robotic radiosurgery may be a good definitive alternative for nonamputation candidates.

• Other tumors that have been treated with radiosurgery include transitional cell carcinomas of the urethra in dogs where survivals ranged between 81 and 860 days; nonsurgical vaccine-associated sarcomas in cats where the median progression free intervals are over 432 days; and canine multilobular osteochondrosarcomas, which produced median survivals of approximately 252 days.

Photo courtesy of Accuray Incorporated

The field of radiosurgery is fairly new but is rapidly developing in veterinary medicine. With advanced technology such as stereotactic radiosurgery with CyberKnife, it is now possible to pursue a definitive therapy option for our patients, with little to no side effects or morbidity.

References Amsellem, P. “Stereotactic radiosurgery and fracture fixation of 6 dogs with appendicular osteosarcoma”, Proceedings of Veterinary Cancer Society, 2009.

Bacon, N.“Stereotactic radiosurgery in the treatment of urethral transitional cell carcinoma in 10 female dogs”, Proceedings of the Veterinary Cancer Society, 2011.

Berg J, G. M. “Effect on timing on postoperative chemotherapy on survival of dogs with osteosarcoma”, Cancer, 1997.

Berg J, W. M. “Response of osteosarcoma in the dog to surgery and chemotherapy with doxorubicin”, J Am Vet Med Assoc, 1995.

Charney, S. “CyberKnife radiosurgery for irradiation of non-lymphomatous nasal tumors in dogs and cats”, American College of Veterinary Radiology, 2011.

Custis, J. “Stereotactic radiation therapy for intracalvarial tumors in dogs”, Proceedings of the Veterinary or Cancer Society, 2011.

Custis, J. “Stereotactic radiation therapy for the treatment of multilobular osteochondrosarcoma”, Proceeding of the Veterinary Cancer Society, 2011.

Griffin, L. “Stereotactic radiation therapy for the treatment of the canine meningiomas”, Proceeding of the Veterinary Cancer Society, 2012.

Nolan, M. “Stereotactic radiation therapy for feline vaccine associated sarcoma”, Proceedings of the Veterinary Cancer Society, 2011.

Ryan, S. “Clinical Experience with Stereotactic Radiosurgery for Extremity Osteosarcoma Limb Salvage”, Proceedings of the Veterinary Cancer Society, 2009.

Withrow S. Vail D. Small Animal Clinical Oncology, Fourth Edition, 2007.

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integrative practice

IMPROVe YOUR bOTTOM lINe bY SellING SUPPleMeNTS aND DIeTS

By Adriana Sagrera, DVM, CVH

O

ne concern many veterinarians have as they integrate holistic modalities into their practices is replacing the OTC sales income. There are many ways to address this issue, including restructuring your hourly charges for services. Many integrative practices do well selling OTC diets and supplements. My practice in New Orleans successfully sells raw food diets and supplements; currently, the practice income is approximately 48% medical services and prescriptions and 52% sales. Of these sales, 30% to 35% is raw food.

SellING RaW FOODS Some practices are challenged in their efforts to retail any type of diet. Clients can often find lower prices at stores or even on the internet. They may purchase when recommended during an office visit, but then not come to the clinic for any further purchases. One benefit of selling raw meat diets at your practice is that they are not readily available at all pet stores, so clients are more likely to come back to your clinic.

Several concerns arise when deciding to provide prepared raw food diets to clients. One is how to get them to change to a new diet. They may be it “Will it cost reluctant to try for many reasons. “Will my dog/cat like it?” more?” “Why should I change change?” “Will it be harder to feed?” Another concern is finding space for the freezers, choosing the brands and stocking appropriately.

My integrative practice is based on finding the best treatments (often homeopathy), lifestyles, exercise and environment for every patient, and empowering clients to see the unique needs of each animal. A cornerstone of my practice is nutrition, so at every visit clients will hear about the importance of individualizing diets for their animals’ specific needs. Many clients seek me out for nutritional consultations when their animals are being treated for cancer and they want a nograin diet. Even with no specialized nutritional training, you can be the “go-to” clinic for anyone seeking complete, raw food diets for health benefits. Let the community at large know you are offering these foods.

SellING SUPPleMeNTS Choosing lines of supplements and deciding how much inventory to stock can be a challenge to conventional as well as holistic practitioners. To maximize sales, it is important to determine the following:

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 What companies do you respect?  What conditions benefit the most from supplements?  What specific nutritional supplements are needed for the daily diet?  What’s the percentage of feline and canine products needed?  What are your profit margins (will clients buy from you, or via the internet or at a local pet store if it is available at a lot less there)?

Supplements fall into five categories:  Basic nutritional health supplements (vitamins, minerals, whole foods, probiotics, digestive enzymes, etc.)  Digestive disorders (nutritional, flower essences, enzymes, antiinflammatories)  Renal and liver support  Immune building  Detoxification – herbal pills, herbal tinctures, herbal teas At this time, we carry supplements from 15 different companies. The companies change as new products are added or quality changes.

Continued on page 30.

tch diecthsnician opens

nts swi lping clie

iet, a te e, tr y a new d er animal at this tim to d e re g a h e r s (w a fo h d g t e n x in la lie nd Once the c food I am recomme cause my clinic is re essential e e some of th right in the office. B flower essences and imal will it i, an and offers attitudes, feng shu and clients), the e patient e ts T iv n . it e e s ti pa hom h use po relax both s readily here as at treats are tested lp e h to od a oils ribe nd even b nt brands, t the new fo usually ea d different foods a to rotate the differe e brand. n l ere can be off office. It is beneficia ey no longer like o e clinic th th e e to th id c ls e in a als d anim right times anim nts can bring their lp discover what is e m o s e c sin lie he ers and c can again My custom and the technician e at any tim ble. imal ta la a p hat the an g. t w re mos lo p x e in table feed diet is to lizing the guardian is comfor ome with the a u id iv d in e ts go h Par t of what th of my clien counts for dically and needs me carefully done, 95% tinue with it. This ac n is When that ed diet and 75% co ractice. p d recommen me of sales for my lu o v h the hig

He

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Selecting raw food brands When I began selling raw diets 17 years ago, there were few from which to choose.

As more veterinarians have seen the value of feeding fresh foods, dozens of new companies have appeared. My criteria for adding a new brand are the sourcing of their ingredients, the packaging, the cost per serving and their reliability in delivery.

We also have to weigh the number of recalls from a food company against the cost of their food.

We carry four different raw food companies and individual meat sources that are both local and commercial. By listing the different meats and companies that are available on our website, we attract customers in addition to our existing clients. The categories we list are: balanced raw diets, raw meat and bones, commercial foods, treats, vitamins and supplements.

BAD hair days

Continued from page 29.

The key to successful sales is educating clients and letting them be part of the selection process. Since my clients already know that my practice recommends individualized treatments and values their feedback, most continue to purchase supplements from us. We often send samples home with the owners, since many are concerned their animals may not readily accept the supplement. If the owner cannot get her pet to take the supplement, or if for any reason we need to stop it, she can always return whatever portion she has remaining.

I often will stock a few bottles of a rarely-used supplement I feel is beneficial. If my office manager brings to my attention that one or more products are staying on the shelf too long, I decide whether that product is important enough to continue stocking in small amounts, or if I can use a replacement product from a different company.

IMPROVING HealTH aND PRaCTICe INCOMe Our commitment as veterinarians is to maximize the health of our patients.

We also want to be financially successful. Selling raw food diets and healthy supplements will definitely improve patient health. Many clients are now searching the internet for “natural” foods and products, so you can become the source for products in your own community. By providing sampling in the clinic, sending samples home and educating your clients, you will improve the health of your patients and your practice.

Advertorial

– do they need more than a bath?

By Meghan Burns, DVM

Clients can be so focused on keeping a pet’s coat clean and shiny that they may miss the underlying cause of bad hair days. Bathing on a regular basis with the right product can make a big difference in a pet’s comfort level and skin health. Shampooing not only removes dirt and loose skin cells, but also gets rid of allergens and bacteria while in some cases cooling and rehydrating.

For special problems, shampoos contain a variety of medications, and newer formulations can help keep medication in contact with the skin longer. Moisturizing and medicated cream rinses can aid

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this process. With all the options out there, the best thing a client can do is get proper advice from a great resource – her local veterinarian.

Shampoos with advanced technology specifically designed for a variety of skin problems can achieve the results your clients require. Shampoos containing advanced glycotechnology can provide “an extra coat of protection”. This process uses naturally-occurring sugars to inhibit bacteria and yeast from adhering to the skin. This bacteria and yeast can multiply and result in skin infections, so the anti-adhesive technology helps protect the pet and clean the coat. Glycotechnology can also help reduce irritation by decreasing the release of inflammationcausing compounds (cytokines).

The Virbac line of shampoos, rinses, leave-on products and treatments are color-coded to assist you in identifying the right product for a patient’s needs. Some products have a sustained effect on the skin with SPHERULITES® Microcapsules, which have layers that gradually break down and release specific ingredients. When chitosanide is added, this natural biopolymer creates a protective film on the skin and coat.

Dr. Meghan Burns attended Michigan State University where she received her degree in veterinary medicine and continued her post-doctoral studies. She has published papers and articles detailing her findings in peer-reviewed journals. Dr. Burns recently joined Virbac Animal Health and is currently serving as a Technical Manager.

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Anesthesia-free

dentistry – veterinarians weigh in on the pros and cons

By Christina Chambreau, DVM, CHC According to the American Veterinary Dental Society, up to 85% of dogs and 70% of cats develop periodontal disease by age three. Dental disease (cavitation, periodontal, etc.) is the number one issue facing dogs and cats. As a profession, we are definitely not addressing this issue properly. While anecdotal reports show there is a smaller percentage of pets with dental issues in holistic practices, ranging from zero to 40% for different veterinarians, there is still a need for dental procedures. Since systemic illnesses can be triggered by oral problems, routine dental care by professionals is important.

about lay dental care along with homecare, as they may be getting the dental at a groomery or pet store.

Anson J. Tsugawa, VMD, DAVDC, emphasizes that the quality of any service varies by the individual providing the service. This is true for the practice of non-anesthesia dentistry as well, whether it is preformed by a veterinarian, technician, or lay individual providing the service.

Veterinarians have always performed dentistry, usually under anesthesia, as a routine part of preventative health care. In 1987, dentistry became a specialty and there are now over 100 boardcertified dentists. Every conference has dental seminars and practicums. A recent arrival is anesthesia-free dentistry, done either by the veterinarian and staff, or by laypeople trained in this area. Clients are requesting this because of the lower cost and perceived lower risk of no anesthesia. Veterinarians’ opinions range from violently opposed to very positive.

Dr. Tsugawa strongly believes patients must be anesthetized in order to safely and properly perform optimal dental care. He is concerned about patients with a history of nonanesthesia dentistry who have received substandard care, and has treated many patients over the years that should have seen a veterinary professional sooner. He also has seen many clients seek treatment as a direct recommendation of a lay individual performing non-anesthetic dentistry; this is remarkable and noteworthy since these individuals are not veterinary professionals, yet have correctly identified significant oral pathology.

Is anesthesia-free dentistry something you want to offer at your practice? Do you want to do it yourself, train technicians to do it, or hire local or national companies who have been doing it for years? This article presents several different views from veterinarians on anesthesia-free dentistry and may help you decide whether or not to recommend or incorporate it into your practice. It will also remind you to query clients

Dr. Tsugawa recognizes one benefit of non-anesthetic dentistry; there are more “eyes” on each animal, and more encouragement for the client to brush. More frequent examination of the patient’s oral cavity will encourage clients to do the same, and to be more aware. Hopefully, this will help gingivitis, oral cancer and other significant oral pathologies to be identified earlier.

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Finally, Dr. Tsugawa acknowledges there are inherent risks with any anesthesia-related procedure, so a client’s fear of anesthesia should not be quickly discounted. When clients are not ready to pursue an anesthesia dental procedure, education and patience is needed. Usually, a reassuring, guiding and consistent approach leads fearful clients to perform the recommended anesthetized dental work on their companions, though on their terms.  Dr. Jennifer Ramelmeier, who has a homeopathic and house call practice, does anesthesia-free dentistry at her monthly hands-on clinic. She is very pleased with client acceptance and improved dental health. There is no difference in tarter accumulation between dentals, with or without anesthesia. Some patients are scaled every six months. Dr. Ramelmeier can do almost any cat or big dog, though she has difficulty with small dogs; she uses cat bag restraint. Occasionally, a big dog will put a paw on her arm, but usually there is no reaction.

First she chunks off big pieces, then puts the scaler up into the gum to get the tarter off. She polishes the teeth with no problem. She can occasionally pull teeth if they are very loose. She does not use anesthesia-free dentistry when applying sealer, as the teeth need to be dry to apply it. She also cannot remove tartar on the inside. If Dr. Ramelmeier feels an animal is too nervous, she will give him herbal California Poppy (from Animal Apawthecary), Young Living – Peace and Calm, and Bach Rescue Remedy on the ears and sprayed in the room.

Dr. Shawn Messonnier, DVM, author, speaker and owner of Paws and Claws Animal Hospital, has written about the myth

that animals cannot have anesthesia for dentistry because of health or aging. He says that regular dental cleanings are critical to keep chronic infections and inflammation at bay. While many veterinarians discourage this in geriatric patients, he says that with comprehensive physical examinations, laboratory testing, individualized anesthetic and medication, using gas anesthetics (i.e. isoflurane or sevoflurane), any animal can have his teeth properly cleaned under anesthesia, and go home within minutes after waking up. He feels it is impossible to adequately clean teeth without anesthesia.  Brook A. Niemiec, DVM, DAVDC, FAVD, NAD stated in a recent article that anesthesia-free dental practitioners or companies typically have limited to no training, and are therefore not educated

Possibilities for improving dental health

1 Diet. level of health – resolving underlying vibrational 2 Overall imbalances with homeopathy, TCVM, chiropractic and 3 4 5 6

other modalities.

Show clients the anatomy of each animal’s mouth to individualize homecare.

Offer coaching for easy examination of teeth, maybe using the new indicator sticks that show “silent” periodontal disease.

Have a conversation about cleaning with or without anesthesia, with plenty of client education materials.

Educate clients about daily dental care – have staff trained (or see what the dental services you hire are teaching) to be sure that homecare (brushing, finger cot, gels, sprays) can be easily handled by the client.

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or experienced enough to find and identify dental pathology. In addition, attempting to scale teeth with sharp instruments in awake and moving patients presents many dangers. Furthermore, the most important part of the “cleaning” is subgingival, which means that scaling the crowns is limited to a cosmetic benefit only.

Radiographs are critical to good dental care and require anesthesia.

Dr. Niemiec states that a proper and beneficial prophylaxis or cleaning includes many steps which cannot be performed without anesthesia. These steps include: supra- and subgingival scaling; polishing; sulcal lavage; and complete oral examination (including periodontal probing). Dr. Niemiec also points out that the financial cost of a proper dental cleaning done annually is comparable to the typical annual frequency of NAD (four times per year or more).

And perhaps, most importantly, he and his colleagues have many cases showing NAD to be ineffective and dangerous.1 Dr. Shelley Epstein, owner of an AAHA hospital, said that for years she hesitated to use anesthesia-free dentistry because she had been told how inadequate this procedure was. A classmate began working with a company that offers it and raved about the results. After a long, probing conversation with the owner of the company, Dr. Epstein learned the limitations of their work (gingival sulci not more than 2 mm) as well as the benefits. He also detailed the extensive training his hygienists/technicians undergo, as well as their proprietary comfortable restraint techniques. The classmate’s technician came to the practice and did an impressive demo on a clinic. Dr. Epstein’s clinic has been using the company for over a year now, and client satisfaction rate is extremely high.2 Dr. Barbara Phillips at the Caring Animal VCA Hospital was initially excited about the gentle handling that allowed for dental care by an anesthesia-free dental service. Over time, though, she found that only the buccal surfaces were being scaled, allowing the lingual surfaces as well as spaces between the teeth to continue to build tartar. The service did not polish the teeth, so repeat visits were often needed at three, six and nine months.

Therefore, clients would elect for anesthesia and a more thorough cleaning and polishing that would last one to two years.

Dr. Doug Knueven, owner of the integrative Beaver Creek Animal Hospital, says that the only way to do a complete and proper dental cleaning is with the pet anesthetized, because of the difficulty in properly cleaning the lingual surfaces and subgingival surfaces, and because extractions cannot be done. On the other hand, there are patients for whom anesthesia would pose an unacceptable risk. For these animals, some dentistry is better than none at all. Dr. Knueven states that anesthesia-free dentistry should only be done at a veterinary office by a professional (veterinarian or certified veterinary technician).

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Addressing

concerns

The recently developed professional Outpatient Preventive Dental (POPD) option addresses the concerns about non-anesthesia dentistry so veterinary practices can feel more confi dent recommending it.

nerve regulators

A study was done in 2009 on 12 cats and 12 dogs, half with a history of a prior anesthetic dental and half without. The POPD was done (no anesthesia) and then each animal was examined under anesthesia by a board-certified dentist.

The results showed that the concerns had been adequately addressed – there was no plaque sub- or supra-gingivally, there were no post treatment complications and any pathology had been recognized and documented by the hygienists.3

Dr. Pema Malu of Veterinary Holistic Care in Maryland reports that their anesthesia-free service does an excellent professional job cleaning teeth and caring for gums both with hand instruments and an ultrasonic scaler. They also use ozonated water on the gums for healing. They properly refer to the veterinarian for antibiotics, extractions, severe periodontal disease, neck lesions and fractures. Many clients opt for regular anesthesia-free dentistry, thus avoiding periodontal disease in the future.

The American Veterinary Dental College recommends dentals be done only by veterinarians with the use of anesthesia.4 However, many veterinarians have found great satisfaction in a wellperformed anesthesia-free dental done in the veterinary clinic. Most of the objections raised and problems seen are from poor training.

Polishing, cleaning lingual surfaces, and calm patients with lack of damage are possible in the right hands with the right training.

Maintaining dental health is critical for the health of all animals. In an integrative practice, there are many approaches to this. Client education is always primary, so explain how dental health affects metabolic and mental health (and vice versa) and offer multiple approaches to dental health. Have your clients continue to evaluate dental health along with other health criteria, and encourage them to call with even the slightest concern. Re-visit your decisions for dental care recommendations at least annually.

North American Veterinary Conference Clinician’s Brief, January 28, 2013 wilmingtonanimalhospital.com/services_dental.php 3 nationalpetdentalassociation.com/veterinarians/studies/ 4 avdc.org/dentalscaling.html 1 2

How do you feel about anesthesia-free dentistry? Weigh in at ivcjournal .com

By J. Frank Gravlee, DVM, MS, CNS

Tryptophan, thiamine and magnesium are three nutrients that are important in normal nerve function. They can be considered “nutrient nerve regulators”. A relative deficiency of any one of these nutrients can lead to neurological effects.

1

Tryptophan, an essential amino acid, is a precursor to serotonin and niacin (vitamin B3). A deficiency of dietary tryptophan may lead to a low level of the neurotransmitter serotonin. Low levels of serotonin in humans have been associated with depression, anxiety and irritability. Tryptophan has been used therapeutically to treat depression and anxiety.

2

Thiamine (vitamin B1), an essential nutrient that must be present in the diet of mammals, is used in the biosynthesis of the neurotransmitter acetylcholine and gamma-aminobutyric acid (GABA). Thiamine deficiency has a potentially fatal outcome if it remains untreated. In less severe cases, nonspecific signs include malaise, weight loss, irritability and confusion. Thiamine supplementation can reverse these symptoms.

3

Magnesium deficiency has long been known as the primary factor in cattle with grass tetany. Also, in 1968, it was reported by Wacker and Parisi that magnesium deficiency could cause depression, behavioral disturbances, headaches, muscle cramps, seizures, ataxia, psychosis and irritability. Magnesium supplementation was found to reverse these symptoms.

Dr. Frank Gravlee graduated from Auburn University School of Medicine. During a residency in nutritional pathology, he received a Masters degree in nutritional biochemistry and intermediary metabolism. In 1973, he founded Life Data Labs (lifedatalabs.com) and is the developer of Farrier’s Formula®.

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industry innovations Herbal bites Here’s an herbal solution designed for easy administration that cats and dogs will love. Herbsmith Herbal Bites combine herbal formulas with a complimentary US-sourced meat in one easy-to-administer freeze dried medallion. Each delicious morsel delivers a quarter teaspoon of herbs without any grains, preservatives, additives, fillers or fuss. Herbsmith Herbal Bites are available in 16 popular core formulas that address common issues seen by holistic veterinarians.

herbsmithinc.com

For hormone imbalances Animals and birds alike sometimes suffer hormonal imbalances.

Releaves® is a new nonsynthetic whole food dietary supplement from Harrisons’ Pet Products.

This blend of sustainable red palm fruit oil enhanced with organic red raspberry leaves and extract was developed to provide relief for common medical conditions believed to be related to hormonal imbalances. May help with reproductive disorders, behavioral problems from hormonal stress, etc.

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Bandaging made easy

Aiding

equine immunity

Equine clients often need help with responses to allergens in horses whose immune systems are essentially in overdrive. PhytoQuench contains plant-based extracts abundant in antioxidants that can help support respiratory health and immune function. It contains ingredients that give backup assistance to the body’s immune defenses, such as quercetin, vitamins E and C, garlic, turmeric, grape seed, ginger, gingko biloba and citrus bioflavonoids.

uckeleequine.com

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Every veterinarian knows the hassle of bandaging wounds, hot spots, surgical sites and more. PawFlex comes to the rescue with its award-winning line of non-adhesive, furfriendly, super stretch “all in one” disposable bandages.

Water resistant and breathable, they’re easy to use and the quick catch and release double Velcro fastener and nonslip grip ensure they stay on and in place. Five designs, each ideally created for a specific wound care area.

pawflex.com

IVC Summer 2013

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Advertorial

PROBIOTICS

101

Probiotics have increasing applications in both human and veterinary medicine. In order to have a benefit, they must positively interact within the gastrointestinal tract (GIT). This is no small task, as the GIT contains greater than 1014 organisms and at least 500 different species of bacteria. The GIT is also the largest immune organ of the body, which means bacterial composition is in a dynamic state and gut microflora have health, immune and growth promoting or suppressing effects.

The three commonly cited modes of probiotic action include: 1. Suppression of pathogenic viable cell count by production of antibacterial compounds, competition for nutrients, and competition for adhesion sites 2. Alteration of microbial metabolism through increased or decreased enzyme activity 3. Stimulation of immunity through increased antibody levels and macrophage activity Probiotics must also provide the following features with supporting data: • Exert a beneficial effect on the host animal • Be non-pathogenic/non-toxic • Be present as viable cells, preferably in large numbers • Be capable of surviving and metabolizing in the gut environment (resistant to low pH and organic acids) • Be stable and capable of remaining viable for long periods under storage and other conditions In short, a good probiotic should be safe, stable and provide one or more benefits to the host animal. Stability and storage

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By Andy Yersin, PhD

are critical. In general, non-spore forming organisms require protection from the physical environment. Other organisms, such as Bacillus species, are Gram-positive, catalase positive bacteria that have the ability to form a tough, protective endospore that allows the organism to tolerate extreme environmental conditions.

In 2002, Kemin scientists isolated, identified and registered Bacillus subtilis PB6 (ATCC-PTA 6737). It is a unique strain that has been shown in vitro to produce antimicrobial substances, with broad activity against various strains of Campylobacter sp. and Clostridium sp. In various animal model studies, PB6 was also found to exhibit properties against a number of harmful pathogens, not inhibit the growth of commensal flora in the gut, and demonstrate other beneficial responses in the host such as helping to improve stool quality and support overall GI health. These studies, combined with additional stability and safety data, illustrate the positive aspects of PB6 and provide an example of how laboratory and field studies can expand our knowledge and provide credibility for probiotics.

For a more detailed technical overview of Bacillus subtilis PB6, contact resources@kemin.com.

Andy Yersin, PhD holds a Bachelor’s degree in animal science and a Master’s degree in reproductive physiology from the University of Maryland. He completed his PhD in pathophysiology at North Carolina State University, and has worked at the National Animal Disease Center in Iowa. He is president of the companion animal health division of Kemin and is also an active member of the American Society of Animal Science, American Association of Swine Veterinarians, American Association of Avian Pathologists and the Poultry Science Association.

He also serves on The Institutional Animal Care and Use Committee at Iowa State University.

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From the ICVA

International Chiropractic Veterinary Association

Chiropractic Care for Your Patients

Animal Chiropractic is a rapidly expanding area of interest in integrative veterinary health care. In concert with traditional therapies, chiropractic is utilized for the treatment of neuromusculoskeletal conditions and is gaining popularity in the integrative treatment of many other complaints. Benefits include enhanced performance, better overall function and improved quality of life. Treatment results are so promising that 61% of veterinary faculty surveyed believe that chiropractic should be included in their school’s curriculum. Practitioners also report an increase in patient visits, better client compliance, higher client satisfaction and an overall increase in revenues when they added chiropractic to their practices.

Modern Animal Chiropractic education was created in 1989

by Sharon Willoughby, DC, DVM. She began by training both Veterinarians and Doctors of Chiropractic (DCs) and certifying both in Animal Chiropractic. This was leading edge since until then only veterinarians were licensed to treat animals with any modality. Her school, Options for Animals, began as a 100-hour post-graduate course and has developed into an intensive 210-hour course provided exclusively to doctors of chiropractic and/or veterinary medicine. The original Options for Animals College of Animal Chiropractic moved in 2005 from Hillsdale, Illinois to a ten-acre campus in Wellsville, Kansas with over 14,000 square feet of learning space, including an attached barn.

Consumer demands for Animal Chiropractic have spread globally, with skilled doctors in over 30 countries. This rapid growth encouraged the creation of the International Veterinary Chiropractic Association (IVCA). Grounded by the principles of Dr. Willoughby and the original AVCA, the IVCA is now recognized as a world leader in the certification of Animal Chiropractors, the credentialing of Animal Chiropractic schools, and the creator of Animal Chiropractic educational and practice standards.

It’s important to note that a large number of Animal Chiropractors have been certified: 795 by ICVA and 549 by AVCA. This gives veterinarians a great base from which to select professional practitioners. Chapters of the IVCA are being created around the world. Many other doctors have completed their Animal Chiropractic training at IVCA and AVCA approved schools but have chosen not to be certified. Although other practitioners may use the descriptive term “chiropractic”, methods performed by lay practitioners and inadequately trained professionals are not recognized by international standards as quality, efficacious Animal Chiropractic.

More information and links to chiropractic training classes is available at: IVCA – i-v-c-a.com AVCA – animalchiropractic.org – Annual conference - Dallas, TX - November 15 - 17, 2013

Dr. Willoughby also founded the American Veterinary Chiropractic Association (AVCA), creating a national credentialing organization for the field of Animal Chiropractic.

Standards of education and practice were developed based on input from both the chiropractic and veterinary professions.

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tech talk

Are you in

temperaments?

TUNE with your patients’

By Sophia Yin, DVM, MS

The

veterinarian we had last time was great,” a client told me. “She greeted Bruno, he immediately liked her and she was able to do a full exam. The veterinarian we had today seemed cold.

She rushed up to Bruno without greeting him and he got scared and growled. When she went to put a muzzle on, that was it. We couldn’t do anything with him after that. I don’t think we can go back unless we can get the friendly veterinarian.”

What makes one veterinarian so much better at handling pets than another? It’s all about reading an animal’s body language so you can recognize fear or anxiety, knowing how to avoid approaching in inappropriate ways that make the pet’s fear worse, and learning how to put the patient at ease. As a veterinary technician, you are often the first person to interact with each patient, so you can set the tone of the entire visit.

Recognizing FEAR Most people recognize overtly fearful dogs. They show a cowering response by leaning away, making themselves small and averting their gaze.

Muscles are tense, the tail is between the legs, and the ears are flattened to the back or side. Cowering is a very clear sign of fear, but many signs are more subtle and easily missed. When anxious or fearful, dogs may become hypervigilant, meaning they frequently glance in different directions in search of imminent danger. Or they may fleetingly try to hide or step away. They may lick their lips or salivate, yawn, pant or tremble when there is otherwise no reason for doing so. They may look sleepy or move in slow motion, which is often misinterpreted as good behavior. Fear can also

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When anxious or fearful, dogs may become hypervigilant, meaning they frequently glance in different directions in search of imminent danger. show in the facial expression. The facial muscles may be tense, the brow furrowed, and the ears slightly out or back.

The highly aroused fearful cat will have piloerection of the hair from the back of the neck to the tip of the tail. He may stand in an arched-back posture with the tail straight up, while hissing at you. These are the most obvious signs of fear. The sign people often miss is failure to interact; cats deal with conflict by trying to avoid the situation. That is, they flee or freeze unless they are pushed to fight. In a new environment, a comfortable cat explores and is relaxed. In the exam room, many cats lie down in one spot with tail and paws tucked under. This lack of movement is a variation on the freeze response.

If the object they are fearful of comes closer, they may become increasingly fearful until they attack. So if the earlier signs of fear are missed, the cat may be pushed to a stage of aggression where he Cats will often freeze when fearful (left). can no longer be handled that day. If the feared object gets too close they may prepare to attack (right).

How veterinary staff can UNINTENTIONALLY worsen fear

Many people can’t understand why a dog or cat would be afraid of them when they’re obviously making friendly gestures. If you look at it from a different perspective, however, the picture becomes clear. For instance, if you’re afraid of spiders and your friend shoves a hairy tarantula in your face while reassuring you that it’s friendly, would you feel safe?

Similarly, if a dog or cat is fearful of humans and you stare right at him, lean into his personal space, place your face directly into his, or reach towards him, he may react defensively.

How to greet CORRECTLY In general, if the pet is showing any ambivalence or lack of interest in you, assume he may be fearful. To avoid increasing anxiety in a dog, stay out of his personal space and avoid direct eye contact. Instead, let the dog approach you at his own pace and make first contact.

You’ll do even better if you offer him something he likes, by tossing tasty treats to him. This works best if the owner has been asked to withhold the dog’s food for the day and bring his favorite bite-sized treats. The dog is also more likely to eat if the hospital is comfortable – low traffic, quiet rooms, lack of sudden loud noises or echoes, and some washable throw rugs. The room should be comfortable enough that he will focus on the treats you toss to him, and that will put him in a calm, happy emotional state. If you have to move closer to him, you can do so by approaching sideways or backwards. Exams can even be performed from a position next to the dog and facing forward, rather than facing directly towards the dog.

We can often keep cats comfortable by providing a way for them to hide. Exams can be done with the cat in his crate with the top This dog exhibits fear by leaning away from an outstretched hand and showing the whites of his eyes.

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removed, or under a towel. Avoid automatically scruffing cats, since it can agitate some felines. Instead, control movement by placing your hand in front of his chest or wrapping a towel around the front of him so that if he pulls forward the towel puts pressure against his chest (Handling a Difficult Cat: lowstresshandling.com/about).

Continue your thoughtful INTERACTIONS Once you get through the greeting and the animal appears comfortable, it’s important to continue practicing thoughtful interactions. Any quick movement or change in position can cause the pet to become fearful and snap or flee. You’ll need to change positions slowly, and even give treats as you change position around a dog. Avoid leaning over a dog, reaching over his head or grabbing and hugging him, which makes him feel confined. Instead, move slowly and smoothly to give him a chance to back away. Most important, always be aware of the signals he’s sending you with his body language.

The body language you’d like to see when greeting a dog is one that says this whole business is ho-hum, like greeting a casual acquaintance. The dog should remain relaxed with his muscles loose rather than tense and stiff. His gaze should be steady and soft. His tail should either wag in a relaxed manner

or hang loosely down, and he should never suddenly freeze.

Beware of misinterpreting a tail wag. A wagging tail can be an indicator of high arousal or of a dog in conflict, debating whether to approach or flee, rather than an indicator of a friendly, happy pet. In general, a wide, sweeping wag in a tail held somewhat even with the body is more likely to indicate the dog is friendly and relaxed. For a cat, the body position should be relaxed and the tail should remain stationary rather than twitching.

These tips and others (see sidebar) seem simple, but they make a world of difference between whether a pet is calm, relaxed and compliant, or aggressive and unsafe to handle. Practice them on a daily basis and your clients will see the practice as a petfriendly hospital and you as the caring technician.

What else can you do?

Correctly approaching a dog or cat and having thoughtful interactions is just the beginning of the simple changes you can make to help your patients.

Others include:



preparing the patient for the visit. a. Encourage clients to train cats and dogs to love their carriers and the car ride to the clinic. b. Have them visit the clinic without an appointment. c. Suggest that clients have a friend do a pretend exam on their pets.



You can also prepare the hospital by making it more comfortable for pets. a. Provide visual barriers in the waiting room so that pets don’t have to see each other. b. Decrease noise by using sound-dampening measures (acousticsurfaces.com) or playing white noise or Through a Dog’s Ear CD. c. Create hiding places for cats in their cages and block visual access for dogs who are fearful and in kennels.



Handle with finesse rather than relying on force. a. Control movement in a way the pet understands.

For instance, it’s important to walk dogs from location to location in a way they know how to follow and be on a loose leash. Prevent pacing and squirming as both can increase the pet’s arousal and anxiety. b. Often, you can calm a dog simply by placing a hand loosely on his collar so he understands you would like him to remain still. c. Support animals in a way they feel safe.

For instance, when repositioning dogs from standing to lateral, they frequently struggle and flail; however, when supported correctly, the transition is smooth (Placing a Dog on Its Side: drsophiayin.com/lowstress/about).

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spotlight darwIn’s natural pet products We make it possible for more pet owners to feed a high-quality, fresh raw diet to their dogs and cats. We start with species-appropriate ingredients combined with the most current nutritional research to create meals that are complete and balanced for all life stages. We source ingredients directly from US-based growers and deliver directly to customers’ homes.

You and your clients can be confident that the meals they are feeding are the freshest possible. Darwin’s supports pet nutrition research through the AHVMA Foundation.

Email James Pendergast, or visit our website, to learn more and to inquire about a no-obligation feeding trial.

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Pep Up™ is a brand new dehydrated make-at-home broth for dogs and cats. It’s designed specifically for pets needing nourishment and increased moisture intake, for example to support healthy urinary tract function, following veterinary procedures or other occasions when the appetite for solid food is diminished. For a limited time only, The Honest Kitchen is offering full size boxes (which contain 16 single-serve packets) for free to veterinarians, vet techs, animal nutritionists and vet students in the US. These individual pouches may be given out for free to patients. Email us with your clinic’s address to request a free box.

darwinspet.com James@darwinspet.com

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photonIc health lIGht therapy Want to integrate Light Therapy into your Practice for a price that won’t break the bank? Photonic Health light therapy products are the best hand-held products on the market today. While most battery-operated units lose their power band as soon as the device is turned on, ours retains 100% of its power through most of the battery life. This means the strongest therapy to your clients with the convenience of portability! We guarantee results. Simple, Affordable, Effective.

stayonstm poultIce wraps & Boots A better generation of poultice wraps has arrived. Lightweight, dry ingredients are held in sealed pocketed wraps. Soaking in water for 15-20 seconds provides a malleable poultice-gel wrap. The mess of premade poultice application & removal is eliminated. Repositionable, re-usable boots secure hoof wraps in less than a minute. Application videos are available on our website. See your distributor for more details.

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med Vet Med Vet International is proud to announce our newly redesigned sterile Oasis Skin Stapler. The new lever action design allows it to fit comfortably in your hand to enhance control and reduce surgery time. The angled head and arrow indicator allow visibility for precise staple placement, while the staple count indicator gives you an accurate count of remaining staples.

It comes with 35 pre-loaded staples that are available in two styles, wide and regular. This skin stapler is manufactured with quality construction in a simple design that provides consistent reliable performance and is affordable for any budget.

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From the VBMA

herbal medicine

Why is perfect for today’s health issues Practices are challenged by record low health as our patients present with many severe illnesses at younger and younger ages. Cancer and auto-immune disease lead in the cause of death. Herbal medicine is perfect for today’s health issues.

Also called botanical medicine, it contains a multitude of phytochemicals that interact in the body. They are rich in vitamins, minerals, flavonoids, carotenoids and amino acids.

These phytochemicals act on many different levels in the body and each has a wide range of action. Not only will their effects, for example, be antimicrobial, anti-inflammatory or choleric, but their synergistic effects can increase intestinal absorption and influence the cellular transport of molecules, to name a few benefits.

A special class of herbs that’s very useful in practice is known as the adaptogens. They support the pituitary-adrenal axis, helping animals handle the ill effects of chronic stress from disease, work or environment. Many other herbs are termed trophorestorative because they can restore and protect various organs. Milk thistle is perhaps the most widely known of these, with its amazing ability to protect the liver from chemical insults.

tradition alive as a valid information source, and increasing professional acceptance of herbal medicine for animals.

We offer many educational resources, conferences and teleconferences (recordings are available at vbma.org). We cover a variety of topics: organic farming, cancer, IBS, metabolic disease, skin disease and Materia Medica studies. Through the VBMA, you can receive a discount on Herbal Training through the College of Integrative Veterinary Therapy. We have an active list-serve, hold eco-tours, and are a really vibrant active group. Come join us!

Plan now for the Kauai Eco-Tour, which runs March 10 to 16, 2014.

Learn more about Hawaiian herbs and how to use them yourself and in your veterinary practice. There will also be lomi lomi massage, salt scrub, resting and hiking. Go “back to the roots”, listen, learn and reexperience the Hawaiian culture of plants – and bring it home! Let us know if you are interested, contact us through vbma.org, and we will put you on the list. We can only accept 30 participants (plus family members), and we already have veterinarians coming from Australia, Japan, Canada and the US mainland.

Name this herb

Herbs can be helpful in most illnesses: 1. Acute inflammation a. Antiviral herbs when there are no safe drugs. b. Antibacterial herbs when there are drug-resistant organisms. c. Acute trauma herbs have an incredible hemodynamic ability to influence blood flow.

2. Chronic ailments where there is no conventional treatment, or to soothe the side effects of conventional medicines.

The Veterinary Botanical Medicine Association is a group of veterinarians and herbalists dedicated to developing responsible herbal practice by encouraging research and education, strengthening industry relations, keeping herbal

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Do you know what this herb is? Join the VBMA at vbma.org to find out. The answer will also be published in the next issue of IVC Journal.

IVC Summer 2013

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Advertorial

CHRONIC INFECTIONS AND BIOFILMS

By Kim B. Perkins, PhD

The incidence of antibiotic-resistant bacteria has risen dramatically in recent years, thanks to the increased prevalence of indiscriminate antibiotic use. In order to determine which antibiotic is the most appropriate, most veterinarians will send samples for culture and sensitivity testing.

A typical antibiotic sensitivity testing assay is based on the disk diffusion method, where antibiotic-soaked disks are placed on plates inoculated with the sample bacteria. The size of the zone of inhibition, an area of no growth surrounding the antibiotic disk that results from bacterial sensitivity to the antibiotic, is measured.

Additional assays using microtiter plates or automated antibioticsensitivity test cards are also commonly used.

Although rapid and reproducible, these tests may be inadequate because they only determine the effectiveness of antibiotics on bacteria present in the planktonic or free-floating state. In most cases of chronic infection, it is now known that the bacteria are not in the planktonic state but are primarily present as a biofilm, a complex community of bacteria encased in an extracellular matrix composed of proteins, DNA and polysaccharides. This extracellular matrix acts as a physical barrier, protecting the bacteria inside the biofilm from a variety of environmental insults.

This protective extracellular matrix, and the associated intercellular signaling occurring between the bacteria in the community, means biofilm bacteria are significantly more resistant to antibiotics than planktonic bacteria – in some cases, over 1,000-fold more resistant.

Although antibiotic treatment may initially result in decreased symptoms, once treatment is discontinued the remaining bacteria will renew the biofilm and symptoms may recur (see Figure 1).

A recently developed assay, the becSCREEN assay, is designed to investigate the antibiotic resistance of both planktonic and biofilm bacteria. The assay features a microtiter plate with 96 pegs

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projecting from the lid. These pegs allow for bacterial adherence and biofilm formation in order to perform the antibiotic sensitivity analysis. Following the formation of the biofilm, the pegs are incubated in growth media containing several concentrations of a variety of antibiotics. After the initial antibiotic incubation, the pegs are washed and then further incubated in a recovery plate.

The sensitivity or resistance of the bacteria to each concentration of a particular antibiotic is assessed by the observation of growth in the microtiter plate. Once completed, the assay gives the antibiotic sensitivity results of the sample bacteria in both the planktonic and biofilm state, allowing for easy comparison.

The assay has been used to successfully treat a variety of chronic veterinary infections including chronic recurrent pyoderma and chronic pyogenic otitis externa in dogs, and hemorrhagic cystitis and chronic sinusitis in cats. In each case, traditional antibiotic testing was performed and the initial therapeutic course of action failed to resolve the condition. Following becSCREEN testing, an alternate therapeutic course of action was determined and, in all cases, the condition was resolved within two months of initiating treatment.

Antimicrobial treatment Resistant fraction

Resistant variants

Biofilm survival

Mature biofilm

Biofilm growth

Figure 1

Kim Perkins joined the Spectrum Group in early 2012 and is currently the Laboratory Director where he oversees the development, optimization and manufacture of veterinary diagnostic assays. He obtained his Ph.D. from Arizona State University while studying the molecular mechanisms of viral pathogenesis, focusing on the role viral dsRNA-binding proteins play in disease. He has presented at several conferences, both national and international, including the American Society of Cell Biology, Virology and Microbiology, and was an invited speaker at the International Angiogenesis Conference in Greece.

The author most often uses hand instruments to perform equine dentistry.

The author addresses the incisors of an equine patient.

Equine dentistry – a horse’s health is impacted by the way his teeth are floated

By Heather Mack, VMD

E

quine dentistry is practiced by veterinarians and veterinary technicians as well as certified and uncertified laypersons all over the world. There are many levels of consciousness in the way it is being taught and practiced. The intention of this article is to bring higher awareness to how the temporo-mandibular joint (TMJ), and therefore the entire health of the horse, can be positively or negatively affected by the way the animal’s teeth are floated.

The goal of dentistry is to maintain an ideal relationship of anatomical alignment of the TMJ, molars and incisors with the body. When teeth are properly floated from a young age through the final stages of life, there will be fewer medical and behavioral conditions.

The TMJ is a convergence point for six acupuncture meridians – three to the front legs, and three that go through the entire body and down the pelvic limb. More importantly, it is

the closest joint proprioceptor to the brain and brainstem.

Proprioception is a natural defense mechanism that prevents injury, and the immediate interaction between the brain and the voluntary muscle response. Poor proprioception leads to an imbalance in sympathetic and parasympathetic responses, placing inordinate stressors on the entire system. The TMJ is the most highly innervated joint in the body. Dysfunction of the jaw affects the facial and trigeminal cranial nerves.

The TMJ’s proximity to the auditory tube or acoustic meatus directly affects the vestibular system.

While it’s important to eliminate the rims and sharp points of the teeth, it’s critical to consider the comfort and biomechanics of the TMJ. Restoring proper function and neurology to the jaw joint is key to physical and mental health in the horse.

When horses are over-floated (common with power tools) to the point where there is no molar contact, they clench hard to get their molars together. This causes articular pain and even IVC Summer 2013

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dysfunction (TMD), which involves more muscular, myofascial and ligamentous pain. What can start out as a bit of imbalance and discomfort can lead up to a raging headache, an unpleasant and potentially dangerous horse to handle or ride, tail wringing, head tossing, running backwards and more behavioral problems.

Dental exam – listen, look and feel

LOOK and FEEL: First, look for symmetry of the nostrils, eyes, ears, facial crests and muscles. Note the spacing between the atlas and the ramus of the mandible.

Second, begin to palpate the TMJ by feeling the energy field around it. Pain will cause fear and worry in the horse’s eyes as you move your hands toward his jaw.

First, relax and take a deep breath. You cannot rush this exam.

LISTEN and LOOK: Listening is receptivity.

Listen with your whole body, not only with your ears but with your hands, face, even the back of your neck.

You can listen and look at the same time. Observe the horse eating at ground level, which is where all horses should be fed. There should be a clean, clear, almost hollow sound of molars grinding. This resonance is a frequency or vibration that is a lullaby to the nervous system.

This horse will have a contented expression and manner of foraging.

With limited molar contact or dental pathology, you may hear nothing or you may hear strange squeaks, pops and crepitus in the joint. The horse is anxious, tense and perturbed in his effort to forage.

You will see it in his eyes and his hurried “I can’t get enough food” attempt to masticate.

This horse will often have asymmetric gaits, unidentified lameness, abnormal posture and possibly a compromised immune and nervous system.

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Then palpate the soft tissue. The masseter and temporalis muscles are easy to palpate for tone and/or atrophy. Although the pterygoid muscle is difficult to palpate it has a very obvious trigger point – two fingers’ width dorsal to the angle of the mandible on the medial aspect. I also take great care to palpate the hyoid apparatus, the gyroscope of the body. I regularly do a hyoid release taught me by Dr. Kerry Ridgeway (see video at balancedequinewellness.com).

When teeth are PROPERLY floated from a young age through the final stages of life, there will be FEWER medical and behavioral conditions.

Next, palpate the joint space itself; it should be bilaterally even.

Challenge the TMJ by applying pressure to the front of the coronoid process of the mandible across the joint, and to the caudal aspect of the zygomatic process of the temporal bone.

The horse’s reaction will be crystal clear!

Finally, check the anterior and posterior motion of the mandible. This may be the single most important indicator of proper TMJ biomechanics. Run your fingers along the incisor line, feeling for any changes when you lift and lower the head. Alternatively, you can part the lips and observe changes in the incisor bite as you elevate and lower the head.

The change in the bite need only be 3mm to 5mm to allow the jaw to move into the desired neutral position. With good anterior motion of the mandible the horse can lower his head, flex at the poll, lift his lower cervicals and withers, elevate the spine and engage his hindquarters. This is the balance a horse needs for walking up and down hills, jumping over jumps, performing reining maneuvers, cutting cows, etc.

Proper use of dental instruments The wave of power instruments on the market, and schools or courses training equine dentists to use them, has been enormous in the last decade. “Time is money,” say many power float practitioners. But at what cost? Whose cost? Some highly skilled dentists use power instruments with care and do a good job balancing horses’ mouths. I have power instruments myself and

use them judiciously when I come across extreme pathology.

But I always finish my work with hand instruments.

I usually start by balancing the incisors.

One goal is to have the horse aware of the subtle changes to the nervous system as we make adjustments Incisor alignment with pony in to the teeth (so neutral position. minimize sedation).

This also allows the horse’s head to be in a natural position. I often find myself on my knees and up close and personal with the mouth to best determine the most appropriate angles for that individual, especially for the incisors. The goal is to have a three point balance between the incisors, molars and TMJ. I find that proper length and angle on the incisors is key to holding this balance together.

Most horses are so content with the improvements to their incisors that they allow us to do the molar work without more sedation. I may titrate more sedation at this point or simply use some Bach Flowers and/or essential oils to continue with the dental work. The angles on the molar arcades are responsible for guidance of the jaw joint and proper neurological input. Having

conditions inhibiting anterior motion of the mandible • Overbites or overjets (Figure 1): These horses are prone

to poor proprioception and TMJ distress because the upper maxillary incisors basically “capture” the lower mandibular incisors, preventing them from sliding forward when the head is lowered. This usually causes the mandible to rest in caudal position, typically creating rostral hooks on the upper first cheek teeth (#6’s) and ramps or hooks on the last lower molars (#11’s).

• Accentuated transverse

the horse’s head in a neutral position is important, so again minimum sedation is best.

Evaluation of the floating is best when using minimal sedation and allowing the head to be in a normal position. Each horse is unique, so it is not just about taking points off the teeth.

Concerns with power tools are that the horse has to be heavily sedated to even get these loud vibrating instruments into his mouth. The head needs to be propped, held or tied up to allow the practitioner to work because the horse is too drugged to hold his head up. Usually, the speculum is open quite wide, and there may even be a very bright light shining in his eyes while he is overextended at the poll. All this rigging is tedious to let down so the horse is often in this unnatural position for as long as it takes to get the job done! If the horse should shake his head or move suddenly, it is easy to mistakenly put an incorrect angle on one or several teeth since many of these instruments are quite aggressive. Evaluation of the results may not be as accurate.

Potential problems with power instruments While inaccurate floating can be done with hand tools, I generally see many more problems when power tools are used.

Putting the same angle on the near and far side molar arcades is essential for good balance. With small tooth-specific hand instruments, we use both the left and right hand for the corresponding arcades. Often, power tool operators use their dominant hand on both sides, creating different angles. Usually a right-handed person will flatten the horse’s left molar arcade and leave the right side steeper.

Continued on page 52.

Figure 1

ridges (ATRs) in the molar tables.

• Missing molars or wave complex.

Power dentistry is performed with the horse’s head hoisted up.

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Continued from page 51.

Recommend proper grazing position

Far too often, teeth floated with power tools have had the molar tables completely flattened in an attempt to eliminate buccal and lingual rims, and the surface is left smooth. The amount of tooth is limited, especially in the older horse with an attrition rate of around 2mm or 3mm per year. One pass of the more aggressive power instruments will take that off in 20 seconds. There needs to be texture to the molars for grinding.

When molar tables have been over-floated, the incisors are often untouched. This

In nature, horses graze 16 to leaves the horse riding on his incisors with little or no contact between the molars. These horses are in severe myofacial pain as they clench in an attempt 20 hours a day on native grasses to get molar contact. Food boluses are not being cut and sheared properly. containing silica and flint that wear The temporalis muscle often over-develops and a vertical mastication their teeth down. If an equine patient is pattern ensues, causing extreme body soreness as the horse’s nervous not grazing, his owner should frequently systems are fighting minute by minute for their balance. give him hay during each 24 hours, fed low or on the ground.

Power tools can create thermal damage because the cementum absorbs With the head down, the atlano-axial joint opens (C1-C2), the mandible comes down and forward, the upper cheek teeth meet at optimal occlusion and the muscles and soft tissues of the head and neck go into the perfect balance of repose for proper chewing and neurological input.

There are many new feeders available that slow the horse down while eating hay. This also helps prevent stomach ulcers by increasing saliva and keeping the GI tract full and lubricated.

the heat, altering the chemical structure. The surface becomes too hard, preventing the necessary vibration in the periodontal ligament that stimulates proper eruption of the tooth. Therefore, the tooth does not wear normally. While adding a water cooling system may help, proper hand floating is better.

If the horse should shake his head or move suddenly, it is easy to MISTAKENLY put an incorrect angle on one or several teeth since many of these instruments are quite AGGRESSIVE.

Healthy teeth = healthy horse We humans have the responsibility to do what is best for the animals, not what is easiest for ourselves. Take the time to look, listen and feel. Keep the horse’s head in natural positions. Change the way you look at things, and the things you look at change.

Keep blades sharp and use floats that are ergonomically correct and designed to fit in the horse’s mouth. Use minimal sedation.

If power is needed, do it with great care and consideration.

See each horse as an individual needing a tailored approach.

Horses frequently perform brilliantly after TMJ awareness dentistry. Recently, I treated a meter 40 horse with chiropractic and acupuncture because she “just wasn’t powering up from behind.” After the show, I did dentistry.

Three days after the dental, her owner rode her by my treatment stalls and said, “Hey Doc, she’s jumping the top of the standards, I’m going to see if I can qualify for Young Riders on her!” I get this kind of response more regularly from my dentistry than from any other form of treatment. It is so satisfying!

REFERENCES

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Baker, Gordon J. & Easley, Jack (2002) Equine Dentistry W.B. Saunders Co. Ltd. Dacre, Ian, T. PhD, MRCVS, Histological and Ultra structural Anatomy of Equine Teeth (2002) Gellman, Karen, DVM, PhD. 2007 Veterinary Dental Forum. Living with Gravity: Posture and the Stomatognathic System.

Lytle, Larry, M.D. Proprioception to the Brain, proper dental muscle alignment is the key.

Laserlightinstitute@earthlink.net May, Kevin J., DVM. (2008) Interrelationships Between Equine Acupuncture, Chiropractic and Dentistry, Prick. Of 34th IVAS 2008 International Congress, Keystone, Co. Rooney, James R. Clinical Neurology of the Horse. KNA Press Inc. 1971 June, First Edition.

Upledger, John E., D.O., F.A.A.O. Craniosacral Therapy II, Beyond the Dura. Eastland Press Inc. 1987

Advertorial

Saddle Fittin g IN VETERINARY MEDICINE

By Jochen Schleese, CMS, CEE, CSE Throughout my career in the equestrian industry, I have worked with open-minded experts dedicated to ongoing professional development. But in a world where information is growing exponentially, some professionals don’t know how to integrate recent developments in saddle fitting into their practice.

I can testify that many equine issues (behavioral, back, hock, SI joint) are prescribed various treatments when the underlying cause is simply a poorly-fitting saddle. The study of saddle fitting is usually missing from the curricula of veterinary colleges, though the tide is shifting.

My colleague Dr. Gerd Heuschmann, DVM has integrated saddle fit principles into his own practice, and has received Saddlefit 4 Life® certification as an Equine Ergonomist. Using a comprehensive system to diagnose saddle fit to horse

and rider, analyzing bio-mechanics in static and dynamic states to determine pressure points, Dr. Heuschmann offers recommendations to clients to prevent saddle-related problems before they become health issues.

As an Equine Ergonomist, a veterinarian has the opportunity to earn additional income for saddle fitting diagnostics, referring clients to qualified saddle fitters where warranted. I invite equine veterinarians to attend a one-day Professionals’ Seminar (June 27 in Caledon, Ontario) to learn about becoming a Saddlefit 4 Life® associate (info@saddlefit4life.com). Help your clients by increasing your awareness of issues caused by poorly-fitting saddles.

Jochen Schleese is a Certified Master Saddler who graduated from Passier and came to Canada as Official Saddler at the 1986 World Dressage Championships.

He registered the trade of saddlery in North America in 1990. Jochen’s lifelong study of equine development, saddle design, the bio-mechanics of horse and rider in motion, and the effects of ill-fitting saddles, led to the establishment of Saddlefit 4 Life in 2005 (saddlefit4life.com), a global network of equine professionals dedicated to protecting horse and rider from long term damage.

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tcvm

TCVM FOR LAMENESS IN HORSES

DIAGNOSIS AND TREATMENT

E

very horseperson knows the adage “no foot no horse”. Indeed, much equine lameness involves the distal limb. Some equine lameness arises from acute, targeted trauma, but most patients suffer chronic discomfort in multiple body regions. This may be secondary to the strain of performance, or can result from abnormal body carriage used to compensate for a primary lameness. Even with advances in sophistication and a variety of diagnostic technologies, accurate and thorough equine lameness diagnosis remains a significant challenge in veterinary medicine.

Most clinicians are only able to diagnose and treat one or two regions that display the most severe clinical signs, potentially overlooking root causes that are more difficult to detect or treat.

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By Huisheng Xie DVM, PhD, Carla Pasteur, DVM and Laura Austgen Smith, PhD, DVM

Acupuncture and the Channels (Jing Luo) provide a diagnostic modality for equine musculoskeletal problems, and can also be used to help gauge response to treatments. Sensitivity at specific groups of acupoints along the meridians is highly correlated with discomfort originating at various local and referred body sites in people1-5 and in veterinary literature.6-13 Clinicians skilled at assessing Jing Luo diagnostic points find it to be a straightforward, non-invasive, low cost and invaluable clinical skill. Subtle and even subclinical musculoskeletal problems can be identified and treated, enhancing the horse’s performance and well being, and potentially helping prevent progression to more serious conditions.

performing the diagnostic scan The clinician must be familiar with the Jing Luo and the acupoints, and develop a consistent and sensitive approach to the technique.

As with any procedure, there is considerable individual variety in the approach to the diagnostic scan. Most practitioners utilize a small, blunt instrument such as a hypodermic needle cap, thermometer case, acupuncture needle guide tube, or the paired tips of a closed forceps as a tool for their scan.

First, the skin overlying a neutral area of the horse – one that does not contain diagnostic acupoints, such as the region at the base of the neck commonly used for intramuscular injection – is stroked firmly with the scan tool. This preliminary step both familiarizes the horse with contact by the tool and helps the clinician gauge the amount of pressure to exert on the skin of the individual. Pressure should be sufficient to be easily felt by the horse in the skin and underlying musculature, but should be well tolerated – below the threshold necessary to elicit a response from the horse (twitching skin, local muscle spasm or increased tension, stepping away from the pressure, turning to look at the veterinarian).

Once a suitable pressure for the patient is established, the scan should be executed in a brisk, methodical fashion. Most practitioners run the scan tool in short, overlapping, gentle but decisive strokes in a cranial-to-caudal direction, beginning with GB-20 or ST-7 and ending at BL-39 or Feng-long. Points that elicit reactions can be re-scanned three to four times to determine the consistency and magnitude of the horse’s reaction. It is helpful to semi-quantitatively grade responses on a numeric scale of 0 to 5: • 1 for mild local reactions • 2 for moderate local reactions • 3 for moderate regional or mild whole body reactions • 4 for moderate whole body reactions • 5 for horse that kicks, bites or attempts to run away when a point is scanned The severity and patterns of sensitive acupoints should be considered in conjunction with history, chief complaint, and other examination findings in formulating a treatment plan.

Sensitivity at specific groups of acupoints along the meridians is highly correlated with discomfort originating at various local and referred body sites in people and in veterinary literature.

prActice tips • Reactions to acupoints can be quite profound, and may be directed at the examiner or handler, so exercise both compassion for the horse and sensible horsemanship.

• Horses that seem reactive “everywhere” cannot be meaningfully assessed. This hypersensitivity can often be cleared by inserting 25-gauge hypodermic needles at acupoints TH-1 and BL-67 and allowing a few drops of blood to drain from both sites.

• Be calm and focused; minimize bias by performing the scan prior to inquiring about the history.

• Consider that sensitivity at diagnostic acupoints may correlate with internal medicine conditions14-15 or local discomfort, rather than always indicating pain at the corresponding musculoskeletal region. For example, BL-13 is associated with pain at three different body regions. It will be reactive in patients suffering local back pain, splints, or lung issues. It is therefore critical to assess patterns of reactivity.

• Musculoskeletal pain is caused by Qi-Blood Stagnation, but may have other root causes.

• Wood and Fire constitutions are more likely to show signs of lameness compared to more stoic Earth horses. Thus, abnormal scan findings and/or clinical lameness in Earth horses should be attended to promptly.

• Chronic disease conditions may result in “fatigue” of the diagnostic acupoints. When this occurs, the magnitude or even presence/absence of a response at the points are no longer reliable indicators of discomfort in the corresponding body regions.

• Perform Western medical examinations and diagnostics as appropriate for each patient.

Continued on page 56.

The diagnostic scan can be used to assess the efficacy of treatment. A decrease or disappearance of reactivity at acupoints during an acupuncture treatment, or over a more protracted clinical course, is generally indicative of improvement in the associated body regions. Serial evaluation of diagnostic acupoints may be particularly useful in gauging response to subtle, vague or subclinical problems, such as those that result in a chief complaint of suboptimal performance, and/or lack significant findings on Western physical examination.

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Continued from page 55.

diAgnosis Acupoints of foot And heeL pAin15

The reactive acupoints are indicative of Qi-Blood Stagnation in the meridians of the foot region, and can be re-scanned during

an acupuncture treatment of foot pain to help gauge efficacy.16-17 In addition to local points such as Qian-ti-men, insertion of acupuncture needles in the distal points including LI-3 and SI-3, or Jing-well points including PC-9, LU-11 and TH-1, can help clear Stagnation in the foot and therefore ameliorate or eliminate the reactivity in the diagnostic acupoints. Certainly, changes in reactivity at the acupoints may also be among the clinical indicators used to evaluate other treatment protocols such as therapeutic shoeing.

CLINICAL SIGNS:

HERBAL ORAL MEDICATION:

• Lameness or foot soreness

Modified Shen Tong Zhu Yu or Body Sore 18-19

• Very sensitive to palpation at LI-18 and PC-1

• Invigorates Qi/Blood, resolves Stagnation and relieves pain, tonifies

Four primary categories of pain in the foot and heel region can be detected with the diagnostic scan: general hoof/heel pain, laminitis (acute, chronic, metabolic or “road founder”), low and high ringbone, and navicular disease/caudal heel pain syndrome.

• Other points including BL-13, BL-14, BL-15, GB-21, LI-15, TH-14, SI-9

Kidney Qi and strengthens the bones.

• Dosage: 15 grams of each, PO BID for one month.

or SI-10 may also be sensitive • Tongue: normal or red/purple

Modified Yin Chen San or Hot Hoof II 18

• Pulse: normal or fast/wiry

• Clears Damp-Heat and Heat-Toxin, activates Blood and relieves

TCVM DIAGNOSIS: Local Qi-Blood Stagnation TREATMENT PRINCIPLES: Move Qi-Blood to resolve local Stagnation

ACUPUNCTURE TREATMENT: 15 • Six local points (per session): TH-1, PC-9, Qian-ti-men, SI-3, LI-3 and LU-11 (can alternately use other local points including LI-1, LI-2, HT-9, SI-1, TH-1, TH-2, TH-3).

• Two distal points (2 points per session): TH-15 and GB-21 (can alternately use other distal points including TH-14, SI-9, SI-10,

pain. Has been used for laminitis for over 300 years.

• Use for acute onset of laminitis. Use as early as possible because the greatest effect is achieved if Hot Hoof II is given before the distal phalanx has rotated.

• Best results are obtained if this is used in combination with topical treatment as above.

• Acute laminitis: Give 30 to100 grams PO BID for up to 14 days, then reduce to a lower dose as necessary for up to two months • Discontinue and replace with Hot Hoof I after local inflammation is under control.

LU-1, LI-14, LI-15, LI-16, HT-7).

• Pattern/balance points: BL-11, BL-23, Shen-shu

ACUPUNCTURE PROTOCOL: • Hemo-acupuncture (22 to 25 gauge hypodermic needles) for acute onset of laminitis: LU-11, LI-1, HT-9, SI-1, TH-1.

• Dry needles (six to ten points): LU-1, LU-7, LU-9, LI-2, LI-3, LI-4, LI-11,

Modified Hong Hua San or Hot Hoof I 18 • Clears Damp-Heat, moves Qi, activates Blood and relieves pain.

• Use after local inflammation of laminitis is controlled and Hot Hoof II has been discontinued. Hot Hoof I has a primarily pain-relieving effect with a reduced anti-inflammatory effect in comparison to Hot Hoof II.

LI-14, LI-15, LI-16, HT-7, SI-2, SI-3, SI-4, SI-9, SI-10, BL-11, BL-13, BL-23,

• Give up to 100 grams PO BID for one to three months.

PC-1, PC-6, PC-9, TH-2, TH-3, TH-5, TH-14, TH-15

• May also be used for prevention of laminitis.

• Electro-acupuncture (for chronic hoof/heel pain cases including navicular disease and laminitis): GB-21 + LI-16, BL-11 + TH-15,

Sang Zhi San + Body Sore 18

Qian-ti-men + LI-3, PC-9 + SI-3, BL-18 + BL-18, Shen-shu + Shen-shu.

• Use together to treat navicular disease or chronic foot pain due to

HERBAL TOPICAL APPLICATION: Zhi Tong Gao (Relief Salve)18-19

Qi-Blood Stagnation with Yang Deficiency and Damp/Cold.

• Sang Zhi San tonifies Kidney Yang, dispels Wind, Damp and Cold, invigorates Qi and Blood, warms the Channels and relieves pain.

• Invigorates Blood, moves Qi, relieves pain and dissipates swelling.

• 15 grams of each, PO BID for up to three months.

• Massage into the skin for five to ten minutes per day for 10 to 20

• Do not use Sang Zhi San if there are signs of Yin Deficiency.

days, wrapping the limb for 12 hours on, 12 hours off.

• Discontinue if blistering or irritation occurs.

Herbs including Shen Tong Zhu Yu, Yin Chen San, Hong Hua San are

• Do not use on open wounds.

contraindicated in pregnant mares.

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See case study on page 57, and Table on page 58.

CASE STUDY A 15-year-old Quarter Horse-Thoroughbred cross pleasure horse presented with a threemonth history of left thoracic limb lameness.

The referring veterinarian had diagnosed navicular disease after radiography and nerve blocks.

On examination, the horse was 3/5 lame on the left thoracic limb. He was very sensitive to palpation (4/5) at LI-18, left PC-1 and left BL13, and was also sensitive (2/5) at BL-18/19 and left LI-15/16. His tongue was purple and his pulse wiry. His constitution was Wood.

The TCVM diagnosis was Qi-Blood Stagnation in the foot of the left thoracic limb. Treatment included the following: 1) Acupuncture: one treatment every two weeks for a total of six weeks. a. Dry needles: BL-18, BL-19, Bai-hui b. Electro-acupuncture (20 Hz for 20 minutes) at the following four point pairs: PC-9 + PC-9, Shen-shu + Shen-shu, Qianti-men + Qian-ti-men and Left LI-1 + SI-3 c. Aquapuncture: SI-9 and PC-9 bilaterally 2) Topical herbal medicine: Four Herbs Salvea was rubbed around the coronary band of the left front foot, once daily for 21 days, and the foot was wrapped for 12 hours on and 12 hours off.

Even though radiographs showed only mild improvement of the pathological changes of the navicular bone, the horse’s lameness was completely resolved after six weeks (three acupuncture treatments and daily herbal medication). He returned to normal pleasure riding (45 to 60 minutes twice weekly) without lameness for the next three years.

READ THREE MORE CASE STUDIES AT

IVCJournal.com

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Subtle and even subclinical musculoskeletal problems can be identified and treated, enhancing the horse’s performance and well being....

Table 1: Acupoints associated with referred pain from the front foot region of equidae Diagnostic points

Clinical significance

Comments

LI-18 PC-1

Correlation with pain in the foot region of the forelimb

Necessary points for diagnosis

BL-13, BL-25

Medial aspect of foot

BL-14

Heel

BL-15, BL-27

Lateral aspect

LI-15, LI-16 and/or SI-9

Secondary shoulder pain

Photo courtesy of Dr. Carla Pasteur from Traditional Chinese Veterinary Medicine-Fundamental Principles, 2nd edition, Chi Institute Press

Not necessary points but are supportive of diagnosis

Diagnostic acupoints used for TCVM evaluation of equine forefoot pain.

Yu BY, Yu BH. Yuan-Heng’s Therapeutic Treatise of Horses (In Chinese).

Beijing, China: China Agricultural Press 1963 (Originally published in 1608).

10

Alvarez DJ, Rockwell PG. Trigger points: diagnosis and management.

Am. Fam. Physician. 2002; 65(4):653-60. Review.

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2

Ge HY, Fernandez-de-Las-Penas C, Yue SW. Myofascial trigger points: spontaneous electrical activity and its consequences for pain induction and propagation. Chin. Med. 2011; 6:13.

3

Ge HY, Arendt-Nielsen L. Latent myofascial trigger points. Curr. Pain Headache Rep. 2011; 15(5) 386-92.

4

Macgregor J, Graf von Schweinitz D. Needle electromyographic activity of myofascial trigger points and control sites in equine cleidobrachialis muscle-an observational study. Acupunct. Med. 2006; 24(2):61-70.

Janssens LA. Trigger points in 48 dogs with myofascial syndromes.

Vet. Surg. 1991; 20(4)274-8.

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Janssens LA. Trigger point therapy. Probl. Vet. Med. 1992; 4(1):117-24.

Chvala S, Nowotny N et al. Use of the Meridian test for the detection of equine herpesvirus type 1 infection in horses with decreased performance. J. Am. Vet. Med. Assoc. 2004; 225(4):554-9.

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5

Oleson TD, Kroening RJ, Bresler DE. An experimental evaluation of auricular diagnosis: the somatotropic mapping of musculoskeletal pain at ear acupuncture points. Pain. 1980; 8(2):217-29.

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6

Shmalberg J, Xie H. The Clinical Application of Equine Acupuncture. Journal of Equine Veterinary Science. 2009 Vol 29 (10): 753-760

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Tangjitjaroen W, Shmalberg T, Colahan P, Xie H. Equine Acupuncture Research: An Update. Journal of Equine Veterinary Science. 2009 Vol 29 (9): 698-709

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Shmalberg, J, Xie H. Acupuncture and Chinese Herbal Medicines for Treating Horses. Compendium: Continuing Education for Veterinarians.

May 2011 E1-E11

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McCormick WH. The origins of acupuncture channel imbalance in pain of the equine hindlimb. Journal of Equine Veterinary Science, Volume 18, Issue 8, August 1998: 528-534

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McCormick WH. William H. Oriental channel diagnosis in foot lameness of the equine forelimb. Journal of Equine Veterinary Science, Volume 17, Issue 6, June 1997: 315-321

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Xie H, Priest V. Xie’s Veterinary Acupuncture. Ames, Iowa: Blackwell Publishing 2007: 27-122.

Sumano López H, Hoyas Sepúlveda ML, Brumbaugh GW. Pharmacologic and alternative therapies for the horse with chronic laminitis. Laminitis: Vet. Clin. North Am. Equine Pract. 1999; 15(2):495-516, viii.

Waguespack RW, Hanson RR. Surgical views - treating navicular syndrome in equine patients. Compend. Contin. Educ. Vet. 2011; 33(1):E1-E10.

Xie H, Preast V. Chinese Veterinary Herbal Handbook 3rd Ed. Reddick, FL: Chi Institute of Chinese Medicine, 2012: 67,136,187,287.

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Xie H, Preast V. Xie’s Chinese Veterinary Herbology. Ames, Iowa: Wiley-Blackwell 2010: 449-461, 543-547

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Veterinary Resource Guide ASSISTIVE DEVICES HandicappedPet.com Amherst, NH USA Phone: (603) 577-8858 Website: www.handicappedpets.com Best Friend Mobility Myrtle Beach, SC USA Phone: (503) 575-9407 Email: sylvan@sylvancompany.com Website: www.bestfriendmobility.org

ASSOCIATIONS Academy of Veterinary Homeopathy - AVH Leucadia, CA USA Phone: (866) 652-1590 Website: www.theavh.org American Academy of Veterinary Acupuncture - AAVA Glastonbury, CT USA Phone: (860) 632-9911 Email: aava@cttel.net Website: www.aava.org

EverGlo-Naturals Gloria Dodd, DVM Gualala, CA USA Phone: 707-785-9171 Email: everglo@mcn.org Website: www.holisticvetpetcare.net Mark Newkirk, VMD Margate Animal Hospital & Alternative Care Center Egg Harbor Township, NJ USA Toll Free: (609) 645-2120 Phone: (609) 645-2120 Website: www.alternativevet.com Steven Marsden, DVM Edmonton Holistic Veterinary Clinic Edmonton, AB Canada Phone: 780-436-4944

NATURAL PRODUCT

MANUFACTURERS & DISTRIBUTORS GenesisValley Center CA USA Phone: (760) 751-3360 Website: www.genesispets.com

RESOURCE DIRECTORY

American Veterinary Chiropractic Association - AVCA Bluejacket, OK USA Phone: (918) 784-2231 Email: avcainfo@junct.com Website: www.animalchiropractic.org

INTEGRATIVE VETS Dr. Shawn Messonnier Paws and Claws Vet Clinic Plano, TX USA Phone: (972) 712-0893 Email: shawnvet@sbcglobal.net Website: www.pettogethers.net/healthypet East York Animal Clinic Toronto, ON Canada Phone: (416) 757-3569 Email: eyac@ca.inter.net Website: www.holisticpetvet.com

Traditional Chinese Veterinary Medicine TCVM Reddick, FL USA Phone: (352) 591-5385 Email: register@tcvm.com Website: www.tcvm.com Veterinary Information Network - VIN Davis, CA USA Phone: (530) 756-4881 Email: vingram@vin.com Website: www.vin.com

SUPPLEMENTS Herbsmith Inc. Hartland, WI USA Phone: (262) 367-1372 Email: mail@herbsmithinc.com Website: www.herbsmithinc.com

SmartPak Plymouth, MA USA Phone: (774) 773-1125 Email: customercare@smartpak.com Website: www.smartpak.com

National Animal Supplement Council - NASC Valley Center, CA USA Phone: (760) 751-3360 Website: www.nasc.cc

Cassie Schuster, ND, MH Waller, TX USA Phone: (713) 502-0765 Email: cassie.schuster@yahoo.com Website: www.wellranch.com

Tallgrass Animal Acupressure Institute Castle Pines, CO USA Phone: (303) 681-3033 Email: nancy@animalacupressure.com Website: www.animalacupressure.com

MVP Laboratories Omaha, NE USA Phone: (402) 331-5106 Email: mvplabs@mvplabs.com Website: www.mvplabs.com

Association of Veterinary Acupunturists of Canada - AVAC Beaconsfield, QC Canada Phone: (514) 697-0295 Email: office@avac.ca Website: www.avac.ca

EQUINE NATUROPATH

PetMassage Ltd. Toledo, OH USA Phone: (419) 475-3539 Email: info@petmassage.com Website: www.petmassage.com

SCHOOLS & WELLNESS EDUCATION Animal Spirit Network Pekin, IL USA Phone: (815) 531-2850 Email: carol@animalspiritnetwork.com Website: www.animalspiritnetwork.com

The Honest Kitchen San Diego, CA USA Phone: (858) 483-5995 Email: info@thehonestkitchen.com Website: www.thehonestkitchen.com

THERMAL IMAGING

College of Integrative Veterinary Therapies - CIVT Rozelle, NSW Australia Phone: (303) 800-5460 Website: www.civtedu.org

Integrated Touch Therapy, Inc Offering Small, Hands-On Intensive Classes in Animal Massage and Bodywork 1-800-251-0007 wshaw1@bright.net www.integratedtouchtherapy.com

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nutrition nook

Whole food – why they’re superior to synthetic alternatives

By Jody Kincaid, DVM, ND, CVA

What are the best supplements – synthetic or whole food?

Mammalian physiology has not changed much in the “modern” evolutionary window, so nutritional requirements for adequate health maintenance have changed little in the last several centuries.

However, sources of nutrition have undergone a radical shift caused by the unintended consequences of population growth, and the development of modern scientific production methods to enhance our foods. Soil nutrients are depleted.

Without adequate renewal of the soil through sustainable farming techniques, the quality of food has declined. Modern agricultural development, especially through the introduction of genetically modified foods, has also drastically altered the quality of food being grown today.

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Early nutritional research The new field of research for synthetic vitamins began because soil depletion was leading to less than adequate foods, along with modern food processing and production. Early research was conducted with extracts and concentrates of vitamins obtained from natural, food-based sources. The production of synthetic vitamins began with the synthesis of vitamin C in 1928 by Szent-Gyorgyi.1 The intention of early nutritional researchers was to produce synthetic, concentrated forms of vitamins to supplement less than adequate diets. The fortification of diets, especially animal diets, with synthetic vitamins is standard operating practice in food production today. But are synthetic vitamins the same as those found in the original whole foods which dogs, cats and horses ate? The answer is resoundingly “no”.

A vitamin is a group of complex organic compounds present in minute amounts in natural foods. Vitamins are essential to normal metabolism and their lack causes deficiency diseases.1 Classification is based on function, not structure.1 Vitamins are catalysts for the biochemical reactions necessary to maintain cellular maintenance and reproduction. They serve as co-factors in multiple enzyme pathways. For example, riboflavin (vitamin B2) is involved in over 100 enzymatic reactions. Other vitamins may have fewer activities, yet are essential to normal cellular function. Hence, a functional deficiency of the vitamin complex will result in a dysfunctional cellular response (disease) or outright cellular death.

Consider vitamin C We are taught (erroneously) that vitamins are chemicals – for example, vitamin C is legally defined as ascorbic acid and folic acid as pterolyglutamic acid. In naturally occurring whole food forms, vitamin C is a complex of molecules with many functions. Folacin has more biologic forms in foods than any other known vitamin.1 What is the difference?

Naturally occurring whole foods grown in healthy soil produce a quality of nutrition that cannot be reproduced artificially.

Designed specifically for geriatric pets, Cholodin® may help with the following symptoms: Disorientation, confusion • Loss of appetite • Increased sleep time

•

Impaired hearing

Poor, thin, or dry coat Inappropriate urination

800-856-4648

www.mvplabs.com

Available through your Veterinary Clinic

Let us consider vitamin C. Ascorbic acid is a single, naked molecule synthesized by processing glucose (corn syrup – and most corn is now GMO) with sulfuric acid to produce the hexuronic acid form.

In whole foods, the vitamin C complex is much more than one molecule. To function properly, more than ascorbic acid is needed.

Tyrosinase is an enzyme activated by a bivalent copper atom (Cu++).

Tyrosinase is essential for the production of the oxidative burst in white blood cells that destroys engulfed pathogens. Tyrosinase is also essential in the production of steroid hormones in the adrenal cortex,

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“The assumption that human technology could improve on the wisdom of Nature has become a primary cause of disease in the modern world. We dissect food, take out the most glaringly obvious parts, attempt to recreate them in a laboratory, and label them as ‘active ingredients’. In fact it is the symphony of nutrients working synergistically that provides the quantum healing power of whole foods.”

Patrick Quillian American Journal of Natural Medicine, September 2002

among other functions.2,3 Surrounding the core of tyrosinase are the bioflavonoids and P factors. These components of the vitamin C complex support production and maintenance of collagen and elastin.2 Initially, the ascorbic acid was thought to prevent scurvy, but subsequent investigation with improved laboratory procedures demonstrated that another element in the vitamin C complex actually alleviated scurvy. This led to the recognition of the bioflavinoids and P factors.2 Further research showed that the vitamin C complex also included some vitamin K activity and hemoglobin production co-factors, designated J factors.2 A vitamin needs all the co-factors to function properly. It is a complex of activities defined by function, not chemical description. The elements of this complex of bioactive molecules are susceptible to oxidation, so the plants that produce vitamin C enclose the active constituents with a shell of ascorbic acid.

Ascorbic acid is a functional component of the vitamin complex but only comprises five to eight percent of the actual vitamin complex.2 Ascorbic acid is the marker molecule used to identify vitamin C activity and the presence of vitamin C in a food source.

Isolated ascorbic acid is not vitamin C, except by legal definition.

Nature’s shell This duality of description exists throughout nutritional research.

In order to identify the presence of a functional vitamin, a specific marker is employed in analysis. The isolated marker, however, does not necessarily indicate the level of activity and function of the vitamin in the foodstuff. Because vitamins are elements of living foods, processing (heat, etc.) and time (oxidation) both reduce the functional level of vitamin activity in foods.

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Nature attempts to protect vitamin complexes by wrapping them in a shell of antioxidant activity or providing them in a stable form in the food which must then be activated by the consumer.

1 2

scorbic acid is the protective shell. It is also used by the A consuming species as an antioxidant but that is not its primary function to the consumer. he vitamin E complex in wheat germ oil is a rich complex of T fatty acids essential to the production of steroid hormones (antisterility), lipid membrane integrity, and the source of ubiquinone.

Eight layers of tocopherols and tocotrienols wrap around these volatile fatty acids to protect them from oxidation.3 Modern nutritional science merely measures the levels of alpha tocopherol as an indicator of vitamin E activity because it is easy to measure and produce from soybean oil (again a major GMO crop).2,4

3

Thiamine (B1) and other vitamins are found in plants in a stable form that serves as a source of the pre-vitamin.Thiamine must undergo two trans-methylation reactions to be converted into cocarboxylase for mammalian use. This conversion requires methyl donors and other co-factors to occur efficiently. Plant sources grown on healthy soil provide all the co-factors for a mammal to convert the stable plant pre-vitamin form to the active form it needs. Pre-vitamins in food sources are like epoxy kits; you mix the components and get a product that must be used or it will degrade. Synthetic B vitamins are often extracted from crude oil products during distillation, but the living complex of co-factors is destroyed.

These distinctions between the naked molecule versus the whole food vitamin with its co-factors, pre-vitamins and other synergistic components are key to successful use of supplements in your veterinary practice and your own personal health.

Synthetic vitamins only work to a point It seems synthetic vitamins do help our patients, at least initially.

Our cells can actually take a naked molecule and draw the Continued on page 64.

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necessary co-factors from reserves in other areas of the body. A thiamine molecule can be utilized so long as the body has the methyl donors and mineral co-factors available to accomplish its conversion to cocarboxylase. Once the co-factors are depleted, the synthetic vitamin can no longer work. Many times, in both animals and people, the benefits appear to diminish or disappear after several months. The return or worsening of symptoms is viewed as a reoccurrence of the original condition. Instead, the body had exhausted its supply of co-factors and simply cannot process the chemicals (synthetic vitamins) it was ingesting. Because it is now deficient in that vitamin, even more serious conditions may result.

Early research at UC Berkeley by Alice Faye Morgan PhD (from the letters of Dr. Royal Lee) demonstrated that dogs fed a generally deficient diet supplemented with either thiamin or niacin developed physiologic disorders more rapidly than dogs fed a diet balanced in its nutritional deficiencies. The conclusions were that when vitamin co-factors were exhausted by the administration of high doses (ten milligrams) of these B vitamins, the entire system suffered from the lack of these co-factors. A body has epigenetic mechanisms designed to cope with starvation, high stress levels and other environmental challenges. However, these mechanisms are based on the balanced function of the enzymatic systems in cells. When one factor is super abundant and another is deficient, it presents a challenge that was not present from an evolutionary standpoint, and leads to dysfunction.

The importance of right and left Another issue in the production of synthetic vitamins lies in the nature of chemical reactions. In a living system, molecules (such as vitamins) are produced with either a right (D form) or left (L form) optical rotation. The chemical composition of the two forms is identical, but the structures are mirror images, just like right and left handed gloves. Cells can generally only use one form of the vitamin in their enzymatic function. The majority of amino acids, for example, operate in the L form (L-arginine, L-tryptophan). Foods provide the correct rotation to which cells have adapted.

The enantiomer (reverse form) of the natural vitamin can competitively inhibit the utilization of the form of the vitamin that the cell needs. In synthetic chemical

Comparing synthetic and whole food supplements Whole food

Synthetic

Multiple functions

Single function

Several substances working synergistically

Naked molecule

Correct rotation (D or L)

Draws on body stores of co-factors

Provides nutrition needed for action (co-factors and pre-vitamins)

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Combination of D & L

Advertorial

reactions, the D and L forms will be produced in more or less equal amounts. Thus a synthetic vitamin which has not been separated into its D and L factors prior to formulation (a step that raises cost and labor) will be predictably less effective than a concentrate of the form found in whole foods.

Balancing act – Omegas 3 and 6

Whole food vitamins are alive Yet another element of whole food vitamins and their interactions with living cells lies in the vibrational frequency of the food source. Cells, as living organisms, operate at certain energy levels. The integral membrane proteins that serve as receptors in the cell membranes vibrate at certain frequencies. A prime example of this is the function of the insulin receptors in the cell wall.16 The molecules must work together to perform their function. Synthetic chemicals do not vibrate with the electromagnetic frequencies of living foods, hence cells cannot utilize them as effectively as a whole food source of the vitamin. In Minerals for the Genetic Code, Dr. Richard Olree demonstrates that the expression of the genetic codon for arginine depends on activation by a Se-2 atom, as found in healthy plants. The other forms of selenium found in pure in mineral extracts (Se+6 and Se+4) produce an altered transcription, which results in an aberrated protein. The valence of a single atom can affect the outcome of a living process. Whole food vitamins are alive and electromagnetically compatible. Synthetic chemicals are not.

In a living system, molecules (such as vitamins) are produced with either a right (D form) or left (L form) optical rotation.

In summary, naturally occurring whole foods grown in healthy soil produce a quality of nutrition that cannot be reproduced artificially. It’s not nice to fool with Mother Nature. The work by Dr. Morgan demonstrated that artificial supplementation can actually be more harmful than helpful.

The practice of mixing some whole food powders with chemical vitamins is an attempt to correct the problems created by pure synthetics. However, common sense would dictate that a whole food source is more effectively utilized than a blend of chemicals and foods that have not yet been digested and processed by the body. Animals evolved eating real food – how can we improve upon that? Dr. Royal Lee, an early nutritional pioneer, had it right when he stated: “Let us take vitamins which come from food.” Amen.

McDowell. Vitamins in Animal and Human nutrition. Iowa State University Press 2000.

DeCava. The Truth About Vitamins and Antioxidants. Selene River Press 2006.

Brody. Nutritional Biochemistry. Academic Press 1994.

4 Proceedings of the National Academy of Sciences, Vol. 97, October 2000.

1

2 3

Read the article online to see a list of the top vitamin-rich whole foods! IVCJournal.com

Dog fanciers have long turned to fatty acids to rejuvenate lackluster coats. More recent studies have shown the benefits of Omega fatty acids extend beyond simple aesthetics, and play a role in controlling allergies, inflammation and overall general health.

•

The inability of animals to synthesize Omega-6 and Omega-3 fatty acids via Δ12 and Δ15 desaturases is the cornerstone of fatty acid essentiality. Both Omegas 3 and 6 are the biologic foundation in a range of metabolic processes – including immune function, histamine reaction and inflammatory response. If the diet contains too much Omega-3 and not enough Omega-6 (or vice versa) these metabolic processes cannot properly take place.

•

Processed dog foods also contribute to the imbalanced ratio of EFAs. Biochemically delicate EFAs face exposure to heat and oxygen during the manufacturing process. This renders them rancid and much less beneficial. Ingredients are listed on the food’s packaging, but their presence in full active form is questionable. Inappropriate storage in the distribution process and on store shelves also contributes to this rancidity.

•

Chronic conditions and age affect a dog’s biologic ability to make the best use of dietary EFAs. Both these factors contribute to a decrease in metabolic activity. The immune system’s ability to regulate healthy histamine activity declines. Endogenous enzymes are depleted. As a result, EFAs and dietary nutrients are misused.

A quality supplement will contain a blend of flaxseed oil and virgin olive oil in addition to fish oil (such as salmon).

Additional EPA and DHA in an antioxidant-protected EFA formula provide maximum benefits. By replenishing the diet with a robust fatty acid supplement, we help optimize the diet while maintaining healthy inflammatory reaction and supporting overall health.

Article provided by BiologicVET (biologicvet.net) IVC Summer 2013

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From the AHVMA

Important news bites New benefits The AHVMA is developing new benefits for its members. The latest addition, thanks to the AHVM Foundation, is Natural Standard, a database of nutritional and herbal supplements.

Natural Standard has assembled references, including those not found in Pub Med, and created 100-page monographs describing the use of these supplements, potential side effects, and a categorization of research support (ranging from strong to weak). Natural Standard also holds training sessions that are free to members. Watch the AHVMA website and the e-newsletter for announcements of the next sessions.

homotoxocology, Western herbs, Chinese herbs and acupuncture. The technician track covers nutrition, massage, training clients to help their animals at home, and much more. AVBMA, AAVA, VBMA and AVH each provide days of lectures in their specialties, and a wide range of other holistic lectures fill out the five to six tracks per day. Following the conference, the Healing Retreat – yes, as practitioners it is also time to care for yourselves! – will be held at the nearby Unity Village and will include our annual sweat lodge along with many healing opportunities.

Funds for new research

Standing up for holistic medicine

The American Holistic Veterinary Medical Foundation (AHVMF) held their first two-for-one matching fund drive in 2012 and raised nearly half a million dollars! People are excited about the Foundation’s mission to increase and expand holistic veterinary research and education. The AHVMF is the only group founded exclusively for this purpose. It is difficult for researchers to find funding for this type of research.

Drug companies will not fund them, and the subject is not popular in most colleges and universities, which do most of the veterinary medical research. Money for quality research is badly needed.

I n a survey conducted in 2008, when asked to rank the activities of the AHVMA in order of importance, representation of holistic medicine in national and state organizations was ranked last. However, at crucial times, this can turn into the most important of all our functions. The anti-homeopathy resolution presented to the AVMA House of Delegates (HOD) at their winter meeting is an excellent example of this. A resolution was introduced by the Connecticut delegate to discourage the use of homeopathy because it is “unscientific.”

Fund drives continue to bring in needed research money. If one million people (encourage your clients and staff) contributed $1 per month for one year, the Foundation would have $12 million, which could fund a lot of research and help establish departments of integrative medicine in the ten veterinary schools that have expressed interest in this.

Annual conference The AHVMA Annual Conference will be held in Kansas City, August 24 to 27. The CVC Kansas meeting will be held concurrently at the Marriot, so attendees of either conference will be able to visit exhibitor booths, and attend a day at the other conference at reduced rates. Newly interested in some holistic modalities? The introductory day-and-a-half gives you lectures on the healing potential of homeopathy,

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The AHVMA and Academy of Veterinary Homeopathy (AVH) warded off this attack on homeopathy. They sent research evidence to HOD delegates as well as the AVMA Executive Board, House Advisory Committee, Referral Committee, Council on Biologic and Therapeutic Agents, and the Council on Veterinary Services (COVS).

The COVS is also reviewing the current Guidelines for Complementary and Alternative Veterinary Medicine.

AHVMA and other CAVM organizations are formulating recommendations which will go to the COVS. We encourage you to comment on the guidelines.

AHVMA.org foundation.ahvma.org

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AHVMA Conference Highlights Pet King Brands

ZYMOX® Enzymatic Dermatology Products provide antibiotic alternatives with broad spectrum effectiveness. Our line of topicals utilizes the patented LP3 Enzyme System with demonstrated antibacterial, antifungal and anti-yeast properties for the management of infections and irritations as well as allergic symptoms. We are also featuring the Advanced Formula ZYMOX® Otic with biofilm dissolving enzymes for resistant microbes such as pseudomonas. pkbanimalhealth.com

Booth 507 Darwin’s Natural Pet Products We’re committed to making it possible for more pet owners to feed a high quality, fresh raw diet. Our integrative approach starts with species-appropriate ingredients combined with the most current nutritional research to create meals that are complete and balanced for all life stages. We source ingredients directly from US-based growers and deliver meals directly to customers’ homes. You and your clients can be confident that the meals they are feeding are the freshest possible. Darwin’s supports pet nutrition research through the AHVMA Foundation. Contact us to learn more and inquire about a no-obligation free trial for your clinic. james@darwinspet.com darwinspet.com

Booth 212 68

IVC Summer 2013

Kan Essentials

Our classical formula line of Kan Essentials products adapted

by Steve Marsden, DVM, LAc, and designed specifically for companion animals, is now comprised of 36 formulas to address nearly every concern that busy veterinarians encounter in their practices. All products are made and tested in the US following stringent Good Manufacturing Practices. Our Certificates of Analysis reflect our commitment to the quality, safety and efficacy of our products.

1-800-543-5233 customer@kanherb.com kanherb.com

Booths 501 & 503 Animal Essentials

For 18 years, Animal Essentials Inc. and Animals Apawthecary have been a trusted source of premium quality natural supplements among veterinarians. Owned and operated by herbalist/author Greg Tilford, we offer the best in natural supplements and herbal remedies. Used in hundreds of veterinary clinics worldwide, each product is made using only the finest ingredients from sources verified within the US. Based from our USDA certified organic facility in Victor, Montana, we are committed to quality, environmental ethics, and customer service. animalessentials.com

Booth 814

Kansas City, Missouri August 24-27, 2013

PetMassage

Consider offering canine massage in your clinic. It will shift the quality of your patient care; radiating relaxation and calm to your staff and clientele. Visualize your clinic as a place dogs and their people want to come to: a positively infused destination for happiness. Learn the rationale for canine massage, its techniques, vocabulary, history, clinical applications, benefits for clients and your clinic, and how to get accredited training. Order online, or stop by the PetMassage booth to purchase copies of the new book Art and Essence of Canine Massage, PetMassage and DVD Dog Handling in Canine Massage: Yoga Consciousness.

1-800-779-1001, Outside US, 419-475-3539 info@petmassage.com PetMassage.com

Booth 416 The Honest Kitchen

Visit The Honest Kitchen to learn about two new exciting products: Pro Bloom™ and Pep-Up Tonic™. Pro Bloom™ is an instant, dehydrated shelf-stable goat’s milk with probiotics.

Pep-Up Tonic™ is a nourishing make-at-home broth which is available exclusively through veterinarians. The Honest Kitchen makes a line of dehydrated human-grade foods for dogs and cats, as well as all natural treats and supplements. Stop by for free samples, literature and full size boxes. thehonestkitchen.com

Booth 418

Kemin

Since our founding in 1961, Kemin has used science and research to enhance nutrition and health for humans and animals worldwide. We are proud to offer high quality companion animal health supplements marketed exclusively to veterinarians under the RESOURCES™ brand. Developed in conjunction with Ihor Basko, DVM, a recognized leader in integrative and complementary medicine for animals, each product has been individually formulated, combining natural, science-backed ingredients with traditional herbs and antioxidants. Stop by our booth to learn more about upcoming clinical trials and our proven probiotic supplement, Protegrity™ GI. 1-877-738-7454 kemin.com/RESOURCES

Booth 602 Dr. Rose’s Remedies

Our products are the result of ten years of investigation and formulation by Dr. Rose DiLeva, a holistic veterinarian. In both salve and spray, these products are antibacterial, antifungal and anti-inflammatory as well as anti-itch, antiseptic and moisturizing. A combination of natural ingredients, Dr. Rose’s contains no artificial preservatives, colorings or steroids. Just a small amount applied to the skin will facilitate the healing of rain rot and scratches in horses, to hot spots, surgical incisions, dermatitis, wounds and lacerations in dogs. Check out our website to see our testimonials and photos. drrosesremedies.com

Booth 308 IVC Summer 2013

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AHVMA Conference Highlights Grizzly Pet Products

Located in Washington state, Grizzly Pet Products specializes in all-natural pet products derived from wild Alaskan salmon and other wild fish. We love to educate pet owners about the research-documented health benefits of daily supplements of fish-based Omega-3 fatty acids. Our products include Grizzly Salmon Oil (the most complete source of long chain Omega-3 fatty acids), Grizzly Pollock oil (an affordable alternative for dogs with skin issues), Salmon Fillet Treats (pure, dehydrated wild Alaskan salmon), NuTreats (nutritious oven-baked wild salmon without any fillers, grains, glycols, sugars or salt), and Joint Aid 4 Dogs (joint mobility and digestive support).

1-888-323-5575 grizzlypetproducts.com

BRAVO!

Our Healthy Bites offer a high protein, low fat treat in the most bio-available form for cats: pure muscle meat. We selected chicken and turkey muscle meats high in vital amino acids, plus salmon for its high levels of Omega 3 fatty acids. Chicken and turkey Healthy Medleys combine liver, gizzard and heart with pure muscle meat for a single protein treat rich in easily absorbable vitamins and minerals, including vitamin A, B vitamins, selenium, iron and taurine. Morsels of cod and salmon are combined with tiny shrimp in Mariner’s Medley to offer Omega 3s, B vitamins, selenium, etc.

1-866-922-9222 info@bravorawdiet.com bravopetfoods.com

Booth 510 Respond Systems

We are makers of Class 3 and Class 4 Laser Therapy and Bio Pulse Magnetic Therapy systems and are celebrating our 30th year. Since our founding in 1983, we’ve built our reputation around the world for quality and customer service. Offering a choice of lasers, we will work with you to find the system that best fits your needs, because one size does not fit all in laser therapy. From fast post-surgical treatments to arthritis pain and laser acupuncture, Respond lasers can benefit your patients and your practice from Day 1. respondsystems.com

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IVC Summer 2013

Booth 815 Herbsmith

We are your one-stop shop for quality holistic veterinary supplies with a wide variety of Traditional Chinese Herbal Formulas, single herbs, acupuncture needles, holistic clinic supplies, and TCVM educational literature. Select herbal formulas are available as powders, tablets, teapills, capsules, flax plus blends for horses, and new herbal bites of freeze dried meats for dogs and cats.

Our herbs undergo two to three tiers of testing. Backed by 25 years of veterinary experience, we have everything you need to easily integrate holistic solutions into your practice. Call to learn about prescription fulfillment and commission opportunities to minimize inventory.

1-800-624-6429 mail@herbsmithrx.com herbsmithrx.com

Booth 717

Kansas City, Missouri August 24-27, 2013

VetzLife

We are pleased to be celebrating our 10th year providing all natural health products to the veterinary market. VetzLife Oral Health Care is a unique dental product – a valuable addition to the veterinarian’s tool chest when it comes to proper home oral care. Our newest product is Complete Coat, a topical flea and tick treatment that works and is 100% safe for pets. VetzLife products are used by thousands of clinics with great success and are carried by major veterinarian product distributors such as Midwest, MWI, First Veterinary Supply, Penn Veterinary Supply, and Hawaii Mega-Cor. 1-888-453-4682 Henry@VetzLife.com vetzLife.com

Booth 601

Brookside Barkery

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Advertorial

MATURE PETS – think healthspan, not lifespan

By Meghan Burns, DVM

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ith advances in veterinary care, the pet population in the US has been gradually “graying”. As more dogs and cats reach their senior years, a greater emphasis must be placed on their medical, nutritional and behavioral needs.

Just because a pet is growing older doesn’t mean his senior years can’t be healthy ones. Think of the concept of “healthspan” when dealing with mature pets, not just “lifespan”. Within that “healthspan”, it is important to determine the level of care required, and make adjustments as the pet transitions through the different life stages.

Clinical screening of healthy pets prior to their senior years can set baselines for comparison when their systems begin to experience changes. Healthy pet screening, in addition to owner education from the veterinary team, is crucial to prevent the continuous evolution of health changes from creeping up on family members. Education will help owners recognize gradual changes that they might otherwise assume are “just old age”. For example, changes in eating habits and weight (both increases and decreases) may indicate underlying disease, including hypothyroidism; a decrease in mobility, meanwhile, may mean osteoarthritis. An increase in water consumption, possibly paired with an increase in urination, can be important signals of renal dysfunction, diabetes or other endocrine disorders.

Monitoring water consumption can be quite challenging as few owners typically measure what they give their pets, and is even more daunting in a mult-pet household.

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One of the most frustrating changes owners can experience beyond the normal aging process involves behavior. Cognitive function, when declining or impaired, can affect an otherwise healthy pet and result in significant behavior changes that impact his quality of life. Cognitive Dysfunction Syndrome (CDS) can be devastating to a family when a much-loved pet becomes disoriented, gets “lost”, soils the house, doesn’t interact with others, or develops a disrupted sleep cycle.

Most previous studies and data gathering on CDS have been focused on canines. While dogs exhibit similar signs of CDS when compared to felines, findings of excessive vocalization, irritability and decreased self-hygiene were more prevalent in cats. This new emphasis on felines is supported by a recent study that investigated cognitive decline in cats. The study demonstrated the positive effects of NOVIFIT® (NoviSAMe®) Tablets on improving executive function, an important measurement in the assessment of CDS,1 giving you a proven treatment option for feline patients with cognitive dysfunction.

1 Araujo JA, Faubert ML, et al. “NOVITI® (NoviSAMe®) Tablets improve executive function in aged dogs and cats: Implications for treatment of cognitive dysfunction syndrome.” Intern J Appl Res Vet Med. 2012: 10(1): 90-98.

Dr. Meghan Burns attended Michigan State University where she received her degree in veterinary medicine and continued her post-doctoral studies. She has published papers and articles detailing her findings in peer-reviewed journals. Dr. Burns recently joined Virbac Animal Health and is currently serving as a Technical Manager.

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Homeopathy:

By Shelly Epstein, DVM, CVH

– part 1

hypericum

Homeopathy has been around for

over two centuries and is the second most utilized form of complementary and alternative medicine in the world.1 The acceptance into widespread use for humans and animals has been hindered by the inability to scientifically explain its mechanism of action. Recently, old assumptions about the lack of particles in high dilutions have been overturned by advances in modern technology.

As conventional medicine evolves, veterinarians find themselves in possession of more tools to help patients. But with these tools, like fourth generation antibiotics, joint prostheses and even kidney transplants, come concerns for drug resistance, adverse events and of course impossible price tags.

Fortunately, this 200-year-old system of medicine that many veterinarians find safe, effective and inexpensive is experiencing a resurgence.

known as materia medicas and repertories. When a patient is sick, his symptoms (signs in animals) are analyzed and the remedy that most closely matches with the symptoms experienced by the provers is given to the patient to cure him.

For example, in the proving of Arsenicum album, a remedy derived from arsenic (with no toxic arsenic effects when homeopathically prepared), the provers reported frequent thirst for small sips of water, nausea, vomiting of blood, diarrhea, restlessness with severe weakness, with all symptoms worse after midnight. Likewise, when a dog wakes his owners at 1AM with an urgency to go outside, and diarrhea and vomiting are accompanied with the dog pacing around all night and wanting to drink water, the remedy that may help is Arsenicum album. Homeopaths often find in such a case that the dog will make a full recovery by morning.

Pathogenetic trials Homeopathy is based on one unifying principle: like cures like. The medicines, referred to as remedies, are first tested in healthy humans in a process known as provings, or by the contemporary term pathogenetic trials. The test subjects record their mental, emotional and physical symptoms, paying special attention to the modalities, or what makes each symptom or the person feel better or worse. The most peculiar symptoms are of special importance.

The symptoms experienced by all the provers are then collated and organized into searchable books

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thuja

nux vomica

The founder of homeopathy, Dr. Samuel Hahnemann, based his theories of practice on meticulouslydocumented experimentation and observation, and initiated the first system of drug testing.

Many applications In practice, veterinarians use homeopathy for a wide range of conditions. In first-aid situations, remedies can be used for conditions such as trauma, bite wounds, abscesses, musculoskeletal injuries and bee stings. Homeopathy is also used successfully for a wide range of chronic conditions in animals. These include inflammatory bowel disease, allergies, cancer, seizures, mastitis and behavioral problems.

With limited training, veterinarians can learn the indications of a small number of remedies for the most commonly encountered acute conditions (see sidebar on next page).

With comprehensive training, almost any condition can be treated with homeopathy.

Homeopaths do not aim for merely a disappearance of clinical signs in their patients. Rather, the goal of homeopathy is to cure the patient, and in the least harmful way. To a homeopath, cure means: • The symptoms are gone with no future relapses.

• No more medications or remedies are required.

• The patient’s level of health has been raised so that she feels better overall, has more energy and is more resistant to diseases and other physical and emotional influences.

In other words, there is something special about a remedy that does not simply suppress a symptom, but rather causes the entire body to heal itself – and become healthier.

What’s causing the controversy?

Three years after the American Institute of Homeopathy was founded in 1844, the American Medical Association was founded in reaction. A clause in their charter prevented members from consulting with practitioners “whose practice is based on an exclusive dogma, to the rejection of the accumulated experience of the profession.”2 Allopathic doctors risked expulsion from the society if they talked to homeopaths. This clause remained in medical society applications until the 1920s.

Homeopathy has suffered the lingering effect of the poor relationship between homeopaths and allopaths. Although it was the first system of medicine to stress experimentation at a time when unfounded ideas about the origin of disease abounded, its failure to secure a major role in modern medicine is likely attributed to what many refer to as its “implausibility”.

Simply stated, the argument claims that the high dilutions used in the making of remedies means these medicines contain nothing other than water. In other words, the claims of tens of thousands of homeopaths throughout the world, the purported claims of healing by patients, and the observed convalescence of animal patients can be nothing more than placebo. The suggestion has been taken one step further to imply that administration of homeopathic remedies is therefore unethical.

Continued on page 76.

Since its founding as an empirically-derived system of medicine in the late 19th century, homeopathy has suffered from an extreme lack of respect among practitioners of conventional medicine. The founder of homeopathy, Dr. Samuel Hahnemann (1755-1843), based his theories of practice on meticulouslydocumented experimentation and observation, and initiated the first system of drug testing. Unfortunately for homeopathy, Dr. Hahnemann was no diplomat, and the medical method he founded was markedly less interventional and expensive than the prevailing treatments of the time (bloodletting, leeches, mercury, etc.). His disparaging writings about these mainstream treatments had the net effect of a negative response toward his new system of medicine by the “regular” medical community.

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Continued from page 75.

Remedy sources Homeopathic remedies are made from substances in the animal, vegetable and mineral kingdoms.

A nimal kingdom remedies are made from products such as venom of the bushmaster snake (Lachesis), whole ground honeybee (Apis) and bitch’s milk (Lac caninum).

• Plant remedies include poison hemlock (Conium maculatum), pot marigold (Calendula) and leopard’s bane (Arnica montana).

• Mineral remedies are made from any element of the Periodic Table as well as any of their salts. Sodium chloride (Natrum muriaticum), phosphorus, and calcium carbonate (Calcarea carbonica) are three commonly used remedies.

•

The preparation process The preparation involves successive dilution steps. The first three steps entail grinding the starting material in milk sugar, typically using a mortar and pestle, or making a tincture following precise instructions in the Homeopathic Pharmacopeia3.

The remaining steps entail dilution in ethanol and then water.

Of major importance is the process known as succussion, which

Remedy Aconitum napellus

Dilutions are performed in either a 1:9 or 1:99 series until the desired potency is reached. For example, a dilution of 1:9, first in milk sugar and then in ethanol, carried out 12 times, would be designated as a 12x dilution, where the “x” designates the “1 to 10” dilution. A dilution in the 1:99 series carried through 200 steps of dilution would be designated a 200c dilution, where the “c” designates the “1 to 100” dilution.

According to “Avogadro’s constant”, after a total of 24 “x” dilutions or 12 “c” dilutions, no particles of the original substance should theoretically be present in these preparations. While it is possible to practice homeopathy using low dilutions that theoretically should contain the starting material, most homeopaths use dilutions in the magnitude of 30c, 200c and beyond – way beyond where Avogadro’s constant says any starting material should be present. To further confound the situation, according to homeopathic principles, the higher the dilution, the more “potent” the remedy! pot marigold Continued on page 78.

Indication Acute, sudden, violent illness with a high fever. Physical and mental restlessness. The patient exhibits fear, fright, shock, anxiety. Triggered by very hot weather or dry cold weather.

Arnica montana

For trauma in all its forms – injuries, falls, blows, contusions – like HBC. Overuse of any organ, strains. Worse with the least touch. Fear of approach especially because the animal does not want the injured part to be touched.

Hypericum

Injuries to nerves or areas rich in nerve endings. Shooting pains from injured parts. Bites on digits, tailbone pains from injuries, broken toenails, some spinal injuries. Prevents pain after dentistry.

Ignatia

A remedy for grief. Sighing is often observed by the owners. Treats a variety of ailments as long as grief was the inciting cause.

Ipecacuana

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is the rigorous shaking or agitation of the solutions between each dilution step.

For ailments accompanied by extreme nausea. Great for kennel cough with vomiting.

Lachesis

For little dogs attacked by big dogs in which the skin turns purple, looks like it will become necrotic. Left-sided. Oozing purple blood.

Nux vomica

For adverse reactions to medicines (including anesthetics) and pesticides. Look for irritable nervous system signs: aggression, twitching, seizures. Vomiting and diarrhea.

Spongia tosta

For kennel cough accompanied by lethargy.

Staphysagria

A remedy for post-catheterization; has speedily resolved the prolonged dysuria that often accompanies cystotomies, urethrotomies and related procedures when catheterization with or without stones in the urethra has occurred.

Thuja

Oral papillomatosis. Vaccinosis remedy with many indications, but works wonders if “paralysis” occurs after vaccination (including myopathies).

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Continued from page 76.

Of major importance is the process known as succussion, which is the rigorous shaking or agitation of the solutions between each dilution step.

New evidence shows homeopathy is plausible Up to now, the nature of homeopathic remedies has been a major sticking point. Skeptical voices have claimed that homeopathy is nothing more than placebo, and ordinary chemical analyses of these dilutions have supported these claims. Conventional practitioners and even some integrative ones are hesitant to use homeopathy for fear of being labeled unscientific. Yet by using these medicines, homeopaths claim to cause significant reversals in the health of their patients, including in animals which are not susceptible to the placebo effect.

Exciting new research in diverse fields of science is providing insight into potential mechanisms for the action of homeopathic remedies in the body. In Part 2 of this article (Fall issue of IVC Journal), we will explore some of the latest research that shows the following: • Homeopathic remedies, even at high dilutions, contain nanoparticles (NPs) of the starting substances under transmission electron microscopy.

• These NPs are super-potent forms of their source material with multiple properties distinct from those of their original bulk forms.

NPs can penetrate membranes easily to enter the blood and lymph nodes and can even pass through the blood-brain barrier.

• The cells perceive very low doses of these NPs as hormetins, mild or low intensity stressors that stimulate a cascade of

adaptive responses in the cells and across the entire organism.

The emergent result is a self-organized healing response.

• This healing works best for the individual as a whole when mobilized according to the principle of like cures like. This principle involves matching the complex pattern of symptoms that the source material can cause in healthy people with the cross-adapted pattern of symptoms that the patient experiences as his/her “disease.” The nonlinear dose-response relationship of hormesis and endogenous metaplasticity leads to self-organized reversal of disease symptoms and recovery.

• The body integrates this healing response dynamically throughout all its biological systems as an interconnected complex adaptive network.

WHO Global Atlas of Traditional Complementary and Alternative Medicine (Map Volume); C.K. Ong, G. Bodeker, C. Grundy, G. Burford and K. Shein; Kobe Japan; 2005.

Winston,JW The Faces of Homeopathy: an illustrated history of the first 200 years. Great Awk Publishing, Tawa, Wellington, New Zealand. 1999.

3 The Homœopathic Pharmacopœia of the United States; hpus.com/ 1 2

Supporting canine immune health

By Terri McCalla DVM MS DACVO, Carmen Colitz DVM PhD DACVO, and Johanna Mejia-Fava, DVM

M

any factors can adversely affect immune function, including breed, nutrition, stress, mitochondrial dysfunction, and xenobiotic factors such as certain medications and environmental toxins.

Dogs with chronic disease states usually have poorly functioning immune responses. One example involves obesity and lipomas: fat is the body’s largest endocrine organ and secretes adipokines, which normally regulate immune function, hemostasis, energy homeostasis, angiogenesis, lipid and glucose metabolism. Excessive fat secretes proinflammatory adipokines, triggering generalized chronic inflammation that exacerbates diseases like arthritis and diabetes. Excess fat contains macrophages, which together with adipocytes, secrete inflammatory and endocrine mediators. Because obesity is present in one-third of dogs, at least 33% of our canine patients are in chronically inflamed states with compromised immune health.

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Appropriate immune function requires effective natural killer (NK) cell cytotoxicity, phagocytosis, and nitric oxide production. Enhancing immune function is a critical adjunct therapeutic goal in the management of all disease states.

Besides therapeutic diets, treatment strategies can include polysaccharide nutraceuticals.

Beta glucan is a hemicellulose polysaccharide found in plants and fungi. It has potent immune-enhancing activities; it fights fungal and viral diseases, boosts antibody and cytokine production and phagocytosis, reduces tissue damage, increases NK cell destruction of cancer cells, and provides antioxidant and free radical scavenging activities.

Dr. Terri McCalla is a board-certified veterinary ophthalmologist and a member of Animal HealthQuest LLC, the creator of canine vision nutraceutical Ocu-GLO Rx™. Dr. Carmen Colitz is one of the world’s leading veterinary ophthalmologists. Dr. Johanna Mejia-Fava is a graduate of the Mississippi State University College of Veterinary Medicine.

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Product Profile

Dental health – saliva is a key player

By Naomi Kirby, DVM, MS The definition of a special needs pet has evolved to encompass any animal with special health, behaviorial or physical conditions. Even the geriatric or obese pet can be considered special needs due to a predisposition for other diseases and health concerns, as well as the level of care that may be required.

Good dental health is vitally important to any pet, with daily brushing generally considered the gold standard. However, a special needs pet may need special oral care, with a plan and products tailored to his needs.

Even with the push to educate pet owners to brush and schedule routine cleanings, compliance is a huge factor. Additionally, the paradigm is shifting as clinicians gain a greater understanding of the role of saliva – more specifically, how the quality and/ or sufficient quantity of saliva can be adversely affected by certain disease states such as diabetes, or even the medications prescribed to manage common diseases often associated with aging. Some of those medical conditions are osteoarthritis, renal disease, hyperthyroidism, hypothyroidism, pancreatitis and urinary incontinence. When saliva is compromised, the mouth can become a breeding ground for germs and plaque accumulation. This increases the risk of periodontal disease and of the bacterial load being absorbed into the bloodstream and possibly affecting the organs. Often, the first sign is bad breath.

When considering recommendations for an oral care plan tailored to a special needs pet, it is important to consider: • Pet acceptance of brushing, and realistic expectation that the pet owner will provide consistent care.

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• Products currently being used, and whether an additional

product is warranted.

• Medications the pet is taking which may affect saliva.

The Oratene® Veterinarian Brushless Oral Care line (formerly known as BioteneVeterinarian) features the LP3 Enzyme System, a patented trio of enzymes that works to replenish what may be missing in the saliva of a special needs pet, and balances healthy oral flora while also reducing odor-causing bacteria and fungi. An additional enzyme system renders plaque biofilm water soluble and unable to adhere. The products can be used in conjunction with each other, separately, or incorporated into an existing oral care routine. They include: • Water Additive: brushless care when the pet drinks from his water bowl • Dental Gel: for use with or without brushing. Ideal for cats that don’t drink much water • Breath Freshening Spray • Antiseptic Oral Gel: for severe oral conditions, mouth ulcers, sores, post dental prophy, extractions, FeLV/FIV, stomatitis For a list of commonly prescribed medications that may contribute to compromised saliva, visit petkingbrands.com/ information/PDF/xerostomia.pdf.

Dr. Naomi Kirby completed her three-year residency/post-doctorial degree in laboratory animal medicine at Massachusetts General Hospital and Massachusetts Institute of Technology.

Her many years of graduate studies were focused on nutrition and dermatology related issues.

She provides veterinary technical assistance, research and product development support to Pet King Brands Animal Health.

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events Top Ten Soft Tissue Surgical Procedures June 7-8, 2013 – Las Vegas, NV This course is RACE approved for 16 hours of continuing education credits and will cover common basic and intermediate level surgical procedures for cats and dogs. Lectures immediately precede the laboratory hands-on experience for the surgical procedures.

For more information: Dannielle Cheney (702) 443-9246 dannielle@wvc.org www.oquendocenter.org/veterinary

Jackson Hole Veterinary Rendezvous June 14-19, 2013 – Jackson Hole, WY This event will have up to 16 continuing education credits and 10 Practice Management hours for both small and large animals. You will find many practical lectures presented by world renowned speakers as well as view state of the art products in the exhibit hall. And don’t forget about the opportunity to network with colleagues.

For more information: Vicki Smith (208) 922-9431 registration@jhvr.org www.jhvr.org

Pacific Veterinary Conference June 20-23, 2013 – Long Beach, FL This four day conference continues to bring great continuing education along with excellent networking with veterinary professionals from across the globe. Best of all, it’s at a worldclass vacation destination where you can still have plenty of time to spend with your friends and family.

For more information: Nicole Grialou (800) 655-2862 info@pacvet.net www.pacvet.net

Emerald Coast Veterinary Conference June 26-30, 2013 – Destin, FL This conference is the culmination of two years of combining summer conventions for the Alabama and Georgia Veterinary Medical

Associations. The combined meetings have been proven to be so successful that the ALVMA and GVMA have decided to re-brand the meeting to introduce veterinarians across the country to a different kind of veterinary conference. Both conventions have previously been producing exceptional Continuing Education for more than 100 years!

For more information: Melissa Williford (334) 395-0086 Melissa@franzmgt.com www.emeraldcoastvc.com

65th Annual CVMA Convention

Veterinary Thermal Imaging Conference July 25-28, 2013 – San Luis Obispo, CA You will find 26 RACE approved Continuing Education credits at this event that will be presented by Dr. Tracy Turner, Dr. Kimberly Henneman and Dr. Ken Marcella.

For more information: (800) 458-8890 info@veteldiagnostics.com www.veteldiagnostics.com

CVC Conference for Veterinary Care

July 10-13, 2013 – Victoria, BC This years’ convention is built around the theme ‘Ocean of Knowledge, Mountains of Progress’.

This theme links the scenic beauty of Western Canada – the Pacific Ocean and the Rocky Mountains – to the current and progressive knowledge that will be shared at the meeting.

This strong scientific program, with 28 speakers from Canada and the United States, offers up to 24 hours of Continuing Education and 4 days worth of labs that explore companion animals, equine, bovine and small animal welfare topics.

August 23-26, 2013 – Kansas City, MO For more than 20 years, CVC’s vision has been to provide veterinarians, veterinary technicians, practice managers, and team members the best convention experience possible by offering premium educational programming, expert clinical education, hands-on labs and workshops, practice management programs, and team training sessions from the award-winning editors and doctors behind DVM Newsmagazine®, Veterinary Medicine®, Veterinary Economics®, Firstline® and dvm360.com.

For more information: (613) 236-1162 admin@cvma-acmv.org www.canadianveterinarians.net

With expert speakers and exceptional service that is affordable and accessible and offered at 3 convenient locations annually: Washington (DC), Kansas City, and San Diego.

2013 AVMA Annual Convention July 19-23, 2013 – Chicago, IL Join in this year in Chicago to help celebrate AVMA’s 150th Anniversary! This year’s convention will incorporate a variety of resources to commemorate AVMA’s role and highlight the impact on the veterinary profession while honoring 150 years of achievement. You will find everything from education to entertainment, events to exhibits and you’ll be informed, inspired and in-touch with the brightest minds in the profession.

For more information: (800) 248-2862 www.avmaconvention.org

For more information: (800) 255-6864 cvc@advanstar.com www.thecvc.com

2013 AHVMA Annual Conference August 24-27, 2013 – Kansas City, MO This years’ conference will be at Marriott in Kansas City and will be at the same time as the CVC Kansas City Meeting. In addition to the great things you will find at this conference you will also be able to tour CVC’s exhibit hall at no extra charge, and for just $100 more all registrants can attend one full day at CVC which normally costs over $300.

For more information: (410) 569-0795 office@ahvma.org www.ahvma.org

P o s t y o u r e ve n t o n l in e at: IVCJournal.com 82

IVC Summer 2013

Healing Through Hyperthermia

The I-Therm is a revolutionary system that safely heats tissue and promotes healing with depths of penetration not observed with any other treatment modality.

The I-Therm activates molecular motion 1000 times smaller than the capability of ultrasound. It is this molecular motion that induces hyperthermia. w and thereby Molecular hyperthermia increases bl promotes a dramatically more e cient delivery of oxygen and nutrients and the more rapid removal of toxins in the targeted area.

The I-Therm delivers the exact dose prescribed to animals by means of a non-invasive applicator which includes temperature sensors that safely monitor and control internal and external temperatures.

Hyperthermia • Increased metabolic rate to accelerate wound healing • Vasodilatation • Increased oxygen, plasma and nutrient delivery • Rapid removal of toxins and cell waste • Repolarization of cell membrane • Polarization of water •

ry response

• Alteration in sensory nerve conduction / pain perception • Apoptosis

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