Innovative VOLUME 9 ISSUE 4
VETERINARY CARE
WHY WORK-LIFE BAL ANCE M AY N OT M AKE YOU HAPPY TO MAINTAIN YOUR MENTAL HEALTH AND ENERGY LEVELS AS A BUSY VETERINARY PRACTITIONER, YOU NEED TO DO MORE THAN ACHIEVE WORK-LIFE BALANCE. — P. 56
SYSTEMIC APPROACH TO ALLERGIC DERMATITIS
Canine allergic dermatitis isn’t just a local issue — treatment should also address systemic factors using integrative therapies. – P. 14
FALL ISSUE 2019
www.IVCJournal.com
ERGONOMICS IN THE VETERINARY SETTING
It’s just as important for those in the veterinary field as in others — in some cases, even more important. – P. 38
A CLOSER LOOK AT USING CBD FOR YOUR PATIENTS A close-up look at the tricky therapeutic and regulatory landscape of using CBD for animal patients. – P. 31
THE LINK BETWEEN INFLAMMATION AND DEPRESSION
Stress is linked to inflammation, which in turn causes depression. Know what to do about it, and improve your quality of life on and off the job. – P. 10
CRYOSURGERY IN THE VETERINARY PRACTICE
Innovative advances in cryosurgery offer safe and effective treatment options with unlimited potential. – P. 46
HOLISTIC APPROACH TO SELF CARE FOR VETERINARIANS How nutrition and exercise help support your well-being and diminish your susceptibility to “dis-ease”. – P. 24
contents FEATURES
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INFLAMMATION, DEPRESSION — AND THE ROLE OF DETOXIFICATION
By Nancy Scanlan, DVM
Stress is also linked to chronic inflammation, which in turn causes depression. Understanding this connection, and what to do about it, improves your quality of life both on and off the job.
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CANINE ALLERGIC DERMATITIS: A SYSTEMIC APPROACH TO MANAGEMENT
By Ron Carsten, DVM, PhD, CVA, CCRT
Allergic dermatitis in dogs is a clinical issue with systemic contributors. Treatment should address both local and systemic factors using integrative therapies that address key body systems.
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A HOLISTIC APPROACH TO SELF CARE FOR VETERINARIANS
By Barbara Fougere, BSc BVMS (Hons), BHSc (Comp Med), MODT, MHSc (Herb Med), Grad Dip VWHM, Grad Dip VCHM, Grad Dip Vacup, CVA, CVCP, CVBM, CMAVA, MNHAA Implementing strategies such as nutrition and exercise into your self care regime supports your well-being as a veterinary practitioner, and diminishes your susceptibility to “dis-ease”.
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CBD IS EVERYWHERE!
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ERGONOMICS IN VETERINARY MEDICINE
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CRYOSURGERY IN THE VETERINARY PRACTICE
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NUTRITION NOOK
KETOPET SANCTUARY: KETOSIS, CANCER AND CANINES — PART 3
By Chelsea Kent; Shannon L. Kesl, PhD; Corissa Antemesaris, CVT; Stacy A. Hodges, DVM; Barbara Royal, DVM, CVA; Loren Nations, DVM, DipABVP KetoPet Sanctuary tested the feasibility of using a ketogenic diet as an adjunctive therapy in dogs with cancer. In the third part of this article, we’ll look at practical applications for dogs at home.
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INNOVATIVE PRACTICE
WORK-LIFE BALANCE — NOT THE ONLY ANSWER FOR VETERINARIANS By Jenny Elwell-Gerken, DVM
When taking steps to maintain your mental health and energy levels as a busy veterinary practitioner, you need to do more than achieve work-life balance.
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ESSENTIAL OIL USE FOR PROFESSIONAL SELF CARE By Melissa Shelton, DVM, CA
This time-honored modality for healing our patients can also be utilized to heal ourselves.
By Karen Gellman, DVM, PhD
A look at endocannabinoid support and the tricky therapeutic and regulatory landscape of using CBD for pets.
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By Sara C. White, DVM, MSc
Ergonomics is as important for those in the veterinary field as in other areas of work — perhaps even more important, in some cases.
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By Ryan E. Walrath, DVM
Innovative advances in cryosurgery offer safe and effective treatment options with unlimited potential in the hands of the veterinarian.
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advisory board Dr. Richard Palmquist, DVM GDipVCHM(CIVT) CVCHM (IVAS), graduated from Colorado State University in 1983. He is chief of integrative health services at Centinela Animal Hospital in Inglewood, California, former president and research chair of the AHVMA, and an international speaker in integrative veterinary medicine. Dr. Palmquist is a consultant for the Veterinary Information Network (VIN) and a past president of the AHVM Foundation. He has published two books, one for conventional veterinarians and a second for clients discussing how integrative thinking works.
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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.
COLUMNS & DEPARTMENTS
8 Editorial 22 Emerging technology profile
— Torigen
29 From the NASC 30 From the VBMA 35 From the AVH 37 Industry innovations 55 Business profile
— Sustenance Herbs
63 2019 IVC Award Nominees
— call for nominations
64 From the VMAA 65 Marketplace 66 News bites
Dr. Joyce Harman, DVM, MRCVS, graduated in 1984 from Virginia Maryland Regional College of Veterinary Medicine. Her practice is 100% holistic, using acupuncture, chiropractic, herbal medicine and homeopathy to treat horses to enhance performance and those with a variety of chronic conditions, with an emphasis on Lyme Disease. Her publications include the Pain Free Back and Saddle Fit Books, and numerous articles in lay and professional magazines. She maintains an informative website: www.harmanyequine.com. Dr. Steve Marsden, DVM, ND, MSOM, Lac. Dipl.CH, CVA, AHG lectures for IVAS, the AHVMA, the AVMA, and numerous other organizations. He is co-founder of the College of Integrative Veterinary Therapies and is a director emeritus of the National University of Natural Medicine in Portland OR. He authored the Manual of Natural Veterinary Medicine (Mosby); and Essential Guide to Chinese Herbal Formulas (CIVT). Dr. Marsden is extensively trained in alternative medicine, including Chinese herbology, acupuncture and naturopathic medicine. He has holistic veterinary and naturopathic medical practices in Edmonton, Alberta. In 2010, Dr. Marsden was named Teacher of the Year by the AHVMA; and Small Animal Veterinarian of the year by the CVMA in 2009. Dr. Jean Dodds, DVM, received her veterinary degree in 1964 from the Ontario Veterinary College. In 1986, she moved to Southern California to establish Hemopet, the first non-profit national blood bank program for animals. Dr. Dodds has been a member of many national and international committees on hematology, animal models of human disease, veterinary medicine, and laboratory animal science. She received the Holistic Veterinarian of the Year Award from the AHVMA in 1994.
Dr. Barbara Fougere, DVM, CVAA graduated in 1986, and was named the American Holistic Veterinary Medical Association Educator for 2011. Dr. Fougere is the principal and one of the founders of the College of Integrative Veterinary Therapies. She has continued studying over the last 26 years, and has three Bachelor degrees, two Masters degrees, three post Graduate Diplomas, several Certifications and numerous other courses under her belt.
Dr. Christina Chambreau, DVM, CVH, graduated from the University of Georgia Veterinary College in 1980. She is a founder of the Academy of Veterinary Homeopathy, was on the faculty of the National Center for Homeopathy Summer School and has been the holistic modality adjunct faculty liaison for the Maryland Veterinary Technician Program and is the former Associate Editor of IVC Journal. Dr. Chambreau teaches classes in homeopathy for animals, lectures on many topics, speaks on Radio and TV, and is the author of the Healthy Animal’s Journal among other titles. She is now on the faculty of the Holistic Actions Academy, which empowers members to keep their animals healthy with weekly live webinars.
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PEER-REVIEWED
Canine
allergic dermatitis: A SYSTEMIC APPROACH TO MANAGEMENT
Allergic dermatitis in dogs is not just a localized problem; it is a clinical issue with systemic contributors. Therefore, treatment should address both local and systemic factors using integrative therapies that address key body systems.
By Ron Carsten, DVM, PhD, CVA, CCRT Allergic dermatitis is a common and challenging problem in dogs. This article briefly describes canine allergic dermatitis and its local and systemic components, including the influential role of the small intestine, liver, adrenal glands, central nervous system, microbiota and anxiety in allergic inflammation. The importance of a complete patient evaluation will be highlighted, and the rationale for a systemic approach to management using nutritional supplements, herbs, probiotics and homeopathic medicines will be outlined.
MORE THAN A LOCAL SKIN ISSUE Allergic dermatitis has long been viewed as a disease that’s localized in the skin. It is now clear, however, that it is a complex clinical issue with local and systemic inflammatory processes influenced by secondary contributing factors. The local reactions are an intricate and finely orchestrated interaction between the allergen and resident immune cells.
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IVC Fall 2019
These local reactions are also capable of recruiting non-resident immune cells to reinforce local immune reactions. Unfortunately, from a clinical management perspective, the local reactions are not the complete story. Beyond the local reaction is an incredible interwoven pattern of interaction between the immune system, nervous system, endocrine system, skin and mucosal barriers with associated immune elements, and the microbiota. Each reacts to and is influenced by the other, meaning that effective integrative management must support multiple body systems simultaneously.
CANINE ALLERGIC DERMATITIS — ENVIRONMENTAL ALLERGENS AND ADVERSE FOOD REACTIONS
Three main allergy categories have been described: insect bite (i.e. flea) hypersensitivities, adverse cutaneous food reactions, and atopic dermatitis from environmental
allergens.1 Classically, canine atopic dermatitis is defined as a pruritic allergic skin disease commonly associated with IgE to environmental allergens in genetically predisposed individuals.2 Interestingly, an atopic-like dermatitis has been described with similar clinical signs as canine atopic dermatitis; however, an IgE response to environmental allergens cannot be demonstrated,3 implying that IgE-mediated reactions are not always the central process in allergic inflammation. It is estimated that 10% to 15% of dogs are affected by dermatitis resulting from reactions to environmental allergens.1 Cutaneous manifestations of adverse food reactions are recognized as indistinguishable from the classic environmental allergic disease.3 The incidence of adverse food reactions in the dog is not completely clear, but an estimated 9% to 40% of pruritic dogs and 8% to 62% of dogs with allergic skin disease are affected.4 Approximately 30% of dogs with allergic dermatitis are affected by reactions to both environmental allergens and food.5 Since canine atopic dermatitis is a clinical diagnosis that can result from environmental allergens and adverse food reactions, both will be referred to here as canine allergic dermatitis (CAD), and their intertwined features will be outlined. Clinical signs of CAD generally include pruritus and erythema. Self-induced alopecia and excoriation are common. Secondary infections occur with microbes like Malassezia with epidermal hyperplasia, hyperpigmentation and lichenification; and Staphylococcus with crusts, papules and pustules. Affected areas include the ventral abdomen, distal extremities, axillae, and the inner pinnae, perioral, periocular and perianal regions. Otitis externa is reported in half of dogs with canine atopic dermatitis.2 The predominant lesions in atopic dermatitis dogs occur in the skin; however, other organs like the digestive and respiratory tracts can be involved.1 Breed predisposition and breed-associated cutaneous distribution patterns have been reported. Criteria for diagnosing atopic dermatitis have been developed. Accurate diagnosis and evaluation of secondary factors is essential. Ruling out ectoparasites like fleas is critical. Adverse food reactions can have cutaneous signs that mimic atopic dermatitis in addition to gastrointestinal signs.6 CAD related to environmental allergens is generally seasonal at onset; however, it can exhibit a non-seasonal pattern. The majority of dogs with a seasonal pattern have clinical signs in the spring or summer, while those with a non-seasonal pattern are often worse during a specific season. The presence of pruritus is considered an essential component of diagnosis. However, otitis externa was the initial clinical presentation IVC Fall 2019
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