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Innovative VETERINARY CARE

VOLUME 14 ISSUE 2

REGENERATIVE MEDICINE AS AN ALTERNATIVE TO ORGAN TRANSPLANTATION HOW THIS CUTTING-EDGE THERAPY COULD IMPROVE PROGNOSIS IN PATIENTS WITH CONDITIONS LIKE CHRONIC RENAL FAILURE AND HEPATIC FIBROSIS. — P. 8

INTEGRATIVE APPROACH TO FELINE LIVER DISEASE

SUPPORTING JOINT HEALTH WITH NUTRITIONAL STRATEGIES

HOW CHIROPRACTIC CARE PROMOTES MOBILITY IN AGING DOGS

TREATING CANINE ARTHRITIS WITH ESSENTIAL OILS

STREAMLINE YOUR PRACTICE BY CREATING YOUR OWN APPS

TOP 5 LESSONS FROM CLINICAL VETERINARY PRACTICE

Manage liver disease in cats by considering a treatment regimen that includes diet, IV therapies, castor oil packs and more. — p. 44

SPRING 2024

www.IVCJournal.com

This alternative modality can be used to effectively identify and treat primary causes of musculoskeletal dysfunction in canine patients. — p. 32

Developing custom veterinary apps offers a valuable opportunity to improve your practice, elevate patient care, and foster stronger connections with clients. — p. 36

A balanced diet, glycosaminoglycans, and quick-acting pain-relieving herbs can be used along with weight management and exercise to keep canine joints healthy. — p. 12

Learn how essential oils can be used alongside medications to provide relief in dogs with arthritis. — p. 26

A career as a veterinarian involves continuous learning as well as personal and professional growth. It will also humble you more times than you can count. — p. 40

contents

FEATURES

MEDICINE FOR 8 REGENERATIVE ORGAN FAILURE IN DOGS — WHERE DO WE STAND?

by Hannah Godfrey, BVETMED, MRCVS

by Jared Mitchell, DVM, CVMA, CVA, CVFT

Regenerative medicine is a potentially effective alternative to organ transplantation in dogs, and could improve prognosis in chronic renal failure and hepatic fibrosis.

Conventional medications provide relief for canine arthritis, but often have side effects. Essential oils can be used alongside conventional treatments, or on their own.

12 NUTRITIONAL STRATEGIES FOR JOINT HEALTH IN DOGS NUTRITION NOOK

by Chris Bessent, DVM, MSOM, DIPL. OM, LAC Used with weight management and adequate exercise, nutritional strategies for joint health in dogs include a balanced diet, glycosaminoglycans, and quickacting pain-relieving herbs.

OF REGENERATIVE 18 APPLICATIONS MEDICINE IN VETERINARY HEMATOLOGY by W. Jean Dodds, DVM How regenerative medicine and stem cell therapy are being utilized to enhance hematological knowledge in pets and treat related conditions in these species.

CONSTRUCTION: USING 22 UNDER BIOENGINEERED SCAFFOLDS TO REPAIR AND REPLACE CANINE TISSUE

by Emily Singler, VMD

Bioengineered scaffolds will likely become available as an advanced modality for dogs in need of tissue replacement.

22 12 4

IVC Spring 2024

OILS FOR TREATING ARTHRITIS IN DOGS 26 ESSENTIAL

CARE FOR AGING DOGS: PROMOTING 32 CHIROPRACTIC MOBILITY by Judy Morgan, DVM, CVA, CVCP, CVFT Chiropractic care is an effective diagnostic and therapeutic modality for identifying and treating primary causes of musculoskeletal dysfunction in dogs.

DEVELOPMENT FOR VETERINARY PRACTITIONERS 36 APP by Omer Rashid, DVM

Developing custom veterinary apps offers a valuable opportunity to improve and streamline your practice, elevate patient care, and foster stronger connections with clients.

TOP 5 LESSONS FROM VETERINARY PRACTICE 40 MYCLINICAL by Melissa L. Magnuson, DVM

A career as a veterinarian involves continuous learning as well as personal and professional growth. It will also humble you more times than you can count.

44 44

INTEGRATIVE APPROACH TO TREATING LIVER DISEASE IN FELINES by Nancy Brandt, DVM, OMD, MSOM, DIP. OM, CVC, CVA, CVMA Liver disease in cats can rapidly become serious. An integrative approach that includes diet, IV therapies, castor oil packs and more can help manage the condition.

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.

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 coowner 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

7 Editorial 11 From the AHVMA 25 From the VMAA 31 Industry Innovations 35 From the IVAS 46 From the VBMA IN THE NEWS:

17 New study reveals urgent need for retention strategies in veterinary profession

21 American Bar Association advocates for non-animal testing methods

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.

39 Breakthrough treatment for FIP utilizes human COVID-19 drug

47 Veterinary mid-level practitioner role gains traction in Colorado and Florida

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.

IVC Spring 2024

APPLICATIONS OF REGENERATIVE MEDICINE IN VETERINARY HEMATOLOGY BY W. JEAN DODDS, DVM

How regenerative medicine and stem cell therapy are being increasingly utilized to enhance hematological knowledge in companion animals and treat related conditions in these species.

Regenerative medicine involves replenishing and utilizing the body’s undifferentiated stem cells, which then become specialized for replacing or repairing body tissues damaged by disease or injury. This article looks at how regenerative medicine is being used to enhance our knowledge of hematological issues in dogs, cats, and horses, and help treat a range of conditions in these species.

BIRTH AND DEVELOPMENT OF REGENERATIVE MEDICINE The benefits and clinical applications of medicinal therapies have been well-recognized for centuries, long before the term “regenerative medicine” came into common use.1 In fact, these medical developments and methods were pioneered by ancient civilizations in Mesopotamia, Egypt, China, India, and South America. The roots of this technology were anchored in the concept of epigenetic regeneration (modification of gene expression), as shown mostly in paintings depicting myths along with descriptions of the generation and regeneration of animals. The principles of regenerative medicine evolved from the historical milestones and scientific breakthroughs that occurred over subsequent generations, with more research being done in the 18th and 19th centuries.1

IVC Spring 2024

Today, this scientific knowledge and the potential of regenerative medicine has rapidly expanded to restoring human health in an assertive, consistent manner.2-9 In 2023, the ability to grow red blood cells from the stem cells of healthy human donors in the laboratory initiated further in vitro research, with the first human trial being carried out in the UK.3

REGENERATIVE MEDICINE AND VETERINARY HEMATOLOGY Currently, this knowledge is being applied to laboratory research and companion animals, and is now involved at the forefront of health care for all species.3-13 In 2010, the North American Veterinary Regenerative Medicine Association (NAVRMA) was formed to encourage the development, training, and knowledge of veterinary regenerative medicine. This group remains fully active today, holding an annual conference and awarding training and travel grants for graduate students (navrma.org). Let’s review how this technology has been, and will continue to, apply to comparative and veterinary hematology:3,4,10,11,13-18 • Regenerative therapies that include mesenchymal stem cells, platelet-rich plasma, and autologous serum products are increasingly utilized in veterinary medicine for treating horses, dogs, and cats.4,8,9,13,18

• Veterinary regenerative medicine is an active area of research for developing new cell and tissue therapies for animals. These therapies act to “repair, replace, restore, and regenerate damaged or diseased tissues”.8,9,13-18 • A list of the number of commercially available bioscaffolds in 2021 appears in the appendix to footnote nine: tissue sources = collagen (6); extracellular matrix (ECM) (29); hyaluronic acid (HA) (7)9

CURRENT APPLICATIONS AND RESEARCH • In one study involving dogs, several transcription factors were used to forcibly reprogram somatic cells and turn them into induced pluripotent stem cells.4 Even after multiple cell passages, these new cell lines derived from canine peripheral mononuclear cells enriched with specific media, and a small molecule inhibitory factor maintained the karyotype of normal cells.4 Dogs share many diseases and environmental exposures with humans, making them an ideal translational species for comparative investigations, but canine somatic cell reprogramming has been fraught with problems of low efficiencies and incomplete pluripotency.15 Other factors such as cost, safety, and feasibility are potential roadblocks to the widespread clinical use of this technology for treating canine diseases. • In other research, earlier reprogramming into an embryonic stem cell-like state was done using mouse and human fibroblasts. Mice with induced humanized sickle cell anemia were subsequently shown to be rescued after transplantation with hematopoietic progenitors that provided gene-specific targeting.10 Application of this approach for treating affected mice needs to address issues with the use of retroviruses and oncogenes for the reprogramming, before it can be applied clinically to humans and companion animal species. Canine induced pluripotent stem cells have typically used fibroblasts for translational research in regenerative medicine, developmental biology, drug screening, and disease modeling.17 Newer technology with improved reprogramming efficiency used urine-derived cells that were reprogrammed under feeder-free conditions with a Sendai virus vector.17

IVC Spring 2024

CONCERNS ABOUT STEM CELL THERAPY IN HUMANS WITH KOA

• In 2002, the veterinary company Vet Stem began development of its patented stem cell therapy using adipose-derived cells tissues in horses. Their first clinical treatment of a horse took place in 2004, and since then, more than 4,000 horses have been treated with their technology for bowed tendons, ligament injuries, and joint disease. In 2011, commercial treatment was extended to dogs and cats for osteoarthritis and soft tissue injuries. Over 14,000 animals have been treated with a very low reported adverse reaction rate (0.1-0.3%). Peerreviewed, double-blinded, placebo-controlled studies have been published, as well as retrospective and case studies for degenerative disorders. Vet Stem holds licenses to over 70 patents and has worldwide veterinary rights for use of adipose-derived stem cells.

Regenerative medicine is often applied for wound healing purposes using nano-scaffolds, 3D-printed surgical dressings, and biomaterials for chronic diseases and to promote tissue regeneration.5-9 However, these advances come with a warning about the potential toxic effects of nanoparticles.2 Further, a recent review of stem cell therapy for knee osteoarthritis (KOA) in humans was scathing.14 Fifty clinical studies and 13 systematic reviews/meta-analyses were included. The conclusions highlighted the inefficiency of stem cells, the risk of potential complications, and the limited quality of evidence, and stated that current study results “precluded any recommendation for using stem cell products in patients with KOA” and that “clinical translation of stem cell therapies remains baseless and should be cautiously approached until more robust evidence is available.”14

he many stated benefits of using adipose-derived T regenerative cells rather than those from bone marrow or allogeneic and autologous tissues include ready availability; greater numbers of stem cells than bone marrow; differentiation into multiple lineages for repair of bone, cartilage, and heart; and a heterogeneous mixture of regenerative cells (vetstem.com).

Dias-Ferreira J, Teixeira MC, Severino P, et al. Applications of biomaterials in wound healing management: from fundamental physiology to advanced technology. Eds: Maria H. Santana, Eliana B. Souto, Ranjita Shegokar. In Nanotechnology and Regenerative Medicine, 2023, Ch. 13, 349-369. http://doi.org/10.1016/ B978-0-323-90471-1.00020-7. 6

• Similar equine mesenchymal stem cell studies were recently published in 2019 and 2020.13 Feline research for inflammatory bowel disease, asthma, kidney disease, and chronic gingivostomatitis was published by others in 2018, while canine research for osteoarthritis, osteochondritis, tendonitis, ligament rupture, fractures, and cartilage regeneration was reported in 2019.13 Also see celltherapytools.com. Clearly, these reported successes in animals contrast with the expressed concerns about human stem cell therapy for treating osteoarthritis (see sidebar).13,14

Soriano JL, Ríos M, López E, et al. Chapter 16 - Tissue engineering in wound healing. Eds: Maria H. Santana, Eliana B. Souto, Ranjita Shegokar. In Nanotechnology and Regenerative Medicine, 2023, Ch. 16, 411-453. http://doi.org/10.1016/B978-0-323-90471-1.00017-7. 7

Londono R, Badylak SF. Biologic scaffolds for regenerative medicine: mechanisms of in vivo remodeling. Annals of Biomedical Engineering, 2015, 43(3),577-592. http://doi.org/10.1007/s10439-014-1103-8. 8

Dewey M, Badylak SF. A review of bioscaffolds for functional tissue repair. JAHVMA, 2021, 65 Winter, 37-47.

Hanna J, Wernig M, Markoulaki S, et al. Treatment of sickle cell anemia mouse model with iPS cells generated from autologous skin. Science, 2007, 318(5858), 1920-1923. doi: 0.1126/science.1152092. 10

Garner S. Texas veterinarian saving anemic dogs through the use of stem cells. Stem cell therapy is a useful weapon in the fight against immune-mediated hemolytic anemia (IMHA). Vet Pract News, 2021, July 9, Digital Edition. 11

Manfiolli AO, Amaral R, Caliari-Oliveira C. Stem cells, organoids, and cellular therapy. Eds: Maria H. Santana, Eliana B. Souto, Ranjita Shegokar. In Nanotechnology and Regenerative Medicine, 2023, Ch. 10, 233263. http://doi.org/10.1016/B978-0-323-90471-1.00003-7. 12

For additional information, see also ingeneron.com, ardenanimalhealth (formerly MediVet Biologics) and safarivet.com.

Baouche M, Ochota M, Locatelli Y, Mermillod P, et al. Mesenchymal stem cells: generalities and clinical significance in feline and canine medicine. Animals, 2023, 13, 1903-1917. http//:doi.org/10.3390/ani13121903. 13

Shang Z, Wanyan P, Zhang B, Wang M, et al. Review. A systematic review, umbrella review, and quality assessment on clinical translation of stem cell therapy for knee osteoarthritis: Are we there yet? Stem Cell Research & Therapy, 2023, 14, 91-107. http://doi.org/10.1186/s13287-023-03332-5. 14

Santana MHA, Huber SC. History and evolution of regenerative medicine. Eds: Maria H. Santana, Eliana B. Souto, Ranjita Shegokar. In Nanotechnology and Regenerative Medicine, 2023, Ch. 2, 23-44. https://doi. org/10.1016/B978-0-323-90471-1.00011-6. 1

Formoso I, Shegokar R, Zielinska A, et al. Applications of nanotechnology in chronic diseases and tissue regeneration. Eds: Maria H. Santana, Eliana B. Souto, Ranjita Shegokar. In Nanotechnology and Regenerative Medicine, 2023, Ch. 14, 507-527. http://doi.org/10.1016/B978-0-323-90471-1.00021-9. 2

Lawrence L. Lab-grown RBCs start long journey of discovery. AABB News, 2023, May; 12-15. www. aabb.org.

Kimura K, Tsukamoto M, Tanaka M, et al. Efficient reprogramming of canine peripheral blood mononuclear cells into induced pluripotent stem cells. Stem Cells Dev. 2021 Jan 15; 30(2),79-90. doi:10.1089/scd.2020.0084.

Kuzma-Hunt AG, Shah V, DiMarco S, et al. Opening the “black box” underlying barriers to the use of canine induced pluripotent stem cells: a narrative review. Stem Cells Dev, 2023, 32(11-12), 2 Jun, 271-291. http:// doi.org/10.1089/scd.2022.0300. 15

Menzorov AG. Pluripotent stem cells of order Carnivora: technical perspective. Int J Mol Sci. 2023, Feb 15, 24(4), 3905. doi: 10.3390/ijms24043905. 16

Tsukamoto M, Kimura K, Yoshida T, Tanaka M, et al. Generation of canine induced pluripotent stem cells under feeder-free conditions using Sendai virus vector encoding six canine reprogramming factors. Stem Cell Reports 2024, 19, 141-157. http:.//doi.org/10.1016/j.stemcr.2023.11.010.

Handa M, Soni M, Beg S, Shukla R. Nanoscaffolds and role of 3D-printed surgical dressings for wound healing application. Eds: Maria H. Santana, Eliana B. Souto, Ranjita Shegokar, In Nanotechnology and Regenerative Medicine, 2023, Ch. 14, 371-395. doi.org/10.1016/B978-0-323-90471-1.00021-9.

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Canine induced pluripotent stem cells open new frontiers in veterinary medicine. IVC Journal, 2024, Jan 8. https://ivcjournal.com/canine-induced-pluripotent-stem-cells-open-new-frontiers-in-veterinary-medicine.

In the news

AMERICAN BAR ASSOCIATION ADVOCATES FOR

NON-ANIMAL TESTING METHODS In a landmark move, the American Bar Association (ABA), representing the legal profession in the United States, has issued its first-ever statement on animal testing. It’s calling on governments to promote and incentivize the use of non-animal testing methods (NAMs). The ABA’s resolution, passed during its midyear meeting, underscores the significance of advancing humane and human-relevant ap-proaches in scientific research.

Central to the ABA’s resolution is recognition of the bipartisan Humane and Existing Alternatives in Research and Testing Sciences (HEARTS) Act (H.R. 1024, 118th Cong.). This legislation, aimed at addressing deficiencies in existing laws governing research proposals funded by the National Institutes of Health (NIH), is lauded as a crucial step towards promoting ethical and scientifically rigorous research practices.

As one of the lead co-authors of the information report and resolution, the ABA has highlighted the myriad benefits associated with the adoption and advancement of NAMs. These methods not only prioritize animal welfare but also drive innovation, safeguard the environment, and optimize taxpayer-funded research investments by ensuring the development of safer products and higher quality medicines.

The HEARTS Act, endorsed within the ABA’s report, embodies a balanced approach that advances scientific progress while simultaneously prioritizing human health, environmental protection, and the welfare of animals. Its inclusion in the ABA’s resolution serves as a testament to the ongoing scientific and ethical advancements aimed at phasing out the use of animals in research.

By championing NAMs and endorsing legislation like the HEARTS Act, fostering a culture of compassion and responsibility within the scientific community will become more plausible. Furthermore, this initiative aligns with broader societal trends towards greater awareness and concern for animal welfare and ethical research practices. The ABA’s call to action marks a significant milestone in the ongoing dialogue surrounding animal testing and research ethics. As stakeholders continue to collaborate and advocate for the widespread adoption of non-animal testing methods, the prospect of a future where scientific progress and ethical considerations coexist harmoniously grows ever closer. https://crueltyfreeinternational.org/latestnews-and-updates/american-bar-associationcalls-advancement-non-animal-researchand-testing

IVC Spring 2024