Integrative VETERINARY CARE VOLUME 6 ISSUE 1
CHIROPRACTIC AND THE MUSCULOSKELETAL SYSTEM
HOW THIS MODALITY IS IMPROVING THE LOCOMOTOR SYSTEM IN QUADRUPEDS — PAGE 52
LASER THERAPY IN VETERINARY MEDICINE www.IVCJournal.com
WINTER ISSUE 2015/2016
It has many applications for many conditions, from muscle injuries to skin wounds to arthritis — P. 19
DEGENERATIVE MYELOPATHY
Integrative management can slow, stop or even reverse the progression of DM — P. 12
SUPPLEMENTS FOR OSTEOARTHRITIS
STARTING UP AN INTEGRATIVE PRACTICE
EVALUATING EQUINE POSTURE
WHAT’ S NEW
A look at studies done on Omega-3 fatty acids, SAMe, vitamin E and others, and how they measure up for treating dogs with OA — P. 24
Assessing and understanding a horse’s postural habits can help you diagnose and treat lameness and related issues — P. 40
Setting overall goals is an important first step to launching your new practice — P. 61
•Successful surgery for dog with cleft palate •Equine vets strive for better work/life balance
contents FEATURES
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INTEGRATIVE MANAGEMENT OF DM
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LASER THERAPY IN VETERINARY MEDICINE
A multifaceted treatment protocol can slow, halt or even temporarily reverse the progression of degenerative myelopathy.
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Light energy at the appropriate wavelength and power density has many applications for many conditions.
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NUTRITION NOOK SUPPLEMENTS FOR OSTEOARTHRITIS
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A review of the scientific evidence and research on supplements recommended for dogs with OA, from Omega-3s to SAMe to vitamin E.
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ESSENTIAL OILS –A POWERFUL MODALITY
Learn how this veterinarian has successfully used essential oils as natural and effective treatment options for many health issues.
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POSTURAL EVALUATION IN HORSES
Viewing proven therapies like Osteopathic Manipulations, Reiki, and Healing Touch as Energy Medicine gives you a valuable tool for customizing diagnostic and treatment plans.
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TECH TALK ENERGY AS MEDICINE
Assessing habitual postures, along with understanding the significance of posture, can yield more accurate diagnosis and treatment of lameness and other issues.
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FASCIA AND WHY IT’ S SO IMPORTANT
Restoring the natural intrinsic qualities of a horse’s fascia is the key to pain management, and to unlocking his performance potential.
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CHIROPRACTIC AND THE MUSCULOSKELETAL SYSTEM
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ANTIOXIDANTS AND CANCER
A look at how this valid health care modality can be used to improve the locomotor system in quadrupeds.
When used correctly, antioxidants can be helpful in cancer therapy. Here’s what you need to know about them.
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INTEGRATIVE PRACTICE AN INTEGRATIVE PRACTICE MODEL AS A NEW VETERINARY STARTUP
You need a good sense of your overall practice goals before embarking on this journey – and a good idea of where you see your practice growing and expanding in the future.
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, 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 codirector 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
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Advisory board
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Editorial
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.
s new 11 What’ 23 From the AVH 34 From the AATCVM 38 From the AHVMA
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.
39 Industry innovations 45 From the WAEO 60 Social media 64 Veterinary resource guide 65 From the VBMA 66 Marketplace 66 Events
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. 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.
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by Angela Casey, DVM, Thomas Pfafman, DVM, CAC, and Alexandra Mittner, DVM
Integrative Management
of degenerative myelopathy
D
egenerative myelopathy (DM) is a progressive disease of the spinal cord. It’s found mainly in large breed dogs, with the onset of symptoms typically occurring between seven and 14 years of age. It begins with a wobbly gait (ataxia) in the hind limbs. Affected dogs will sway, cross over, knuckle, stumble up curbs and drag their feet. DM can begin in one hind limb and later affect the other. The clinical course can range from six months to one year, during which the limbs become progressively weaker, with buckling and eventual paraplegia. In later stages, urinary and fecal incontinence can occur, with progression to the front limbs. DM is not associated with pain.
CAUSES OF DM During the 80s and early 90s, Roger Clemmons, DVM, PhD, professor of Neurology at the University of Florida, suspected DM was an autoimmune process, resulting in demyelination of the affected spinal cord segments, as in multiple sclerosis (MS) (Clemmons, 1992). We now know that DM is not simply “doggie MS”, but more closely related to amyotrophic lateral sclerosis (ALS). The lesions invariably start between T3 and L3, presumably because this cord segment is supplied by smaller
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arteries, making it more subject to ischemia and oxidative stress. Super oxide dismutase (SOD-1) is a free radical scavenger, abundantly present in the CNS cytoplasm. Dogs affected with DM have a mutation in the SOD-1 enzyme. Oxidative stress upregulates the synthesis of the mutated SOD-1 enzyme. The mutation results in the mis-folding of proteins, which potentially alters cellular function, substrate selection, and ultimately results in an accumulation of toxic by-products in the axon. It is these toxic by–products that lead to the disruption of axoplasmic flow – “excitotoxicity”. Destruction of myelin and replacement of normal axons with astrogliosis (sclerosis) follows later (Coates and Wininger, 2010).
DIAGNOSING DEGENERATIVE MYELOPATHY DM is a diagnosis of elimination. Radiography, myelography and MRI are used to rule out other causes of weakness, such as intervertebral disc disease, fibrocartilagenous infarct, tumors, cysts and infection. A definitive diagnosis can only be made by an examination of post-mortem tissues. A DNA test has been developed at the University of Missouri-Columbia and is available through the
Orthopedic Foundation for Animals. It clearly identifies dogs that have two normal copies of the SOD-1 enzyme gene; those that are carriers (one normal copy and one mutated copy); and those at high risk of developing DM (two copies of the mutated gene) (Coates and Wininger, 2010). Sixty percent of homozygous affected dogs will eventually express the disease, while 40% remain unaffected. There must be other factors, in addition to the SOD-1 mutation, that lead to the clinical development DM in dogs. (Zeng et al, 2014) Hallmark clinical traits considered uniquely characteristic of DM include: • Disease progression • Asymmetric UMN weakness at onset • Pelvic limb proprioceptive ataxia • Lack of pain These findings are considered sufficient to rule out other disorders, although DM is often paired with other orthopedic or neurological problems that are considered incidental (Coates and Wininger, 2010). Common examples of co-morbidities include: • Disc disease • Degenerative joint disease • Cruciate ligament laxity
THE EVOLUTION OF DM THERAPY The only treatment protocol currently in the literature was formulated by veterinary neurologist Roger Clemmons (see sidebar on pg 14.).
depends on assessing the animal’s personality as well as what body systems are affected. In TCVM, muscles are associated with the Spleen/Earth element and the tendons and ligaments with the Liver/Wood element. Since degenerative myelopathy causes weakness, ataxia and muscle wasting, it is most commonly diagnosed in TCVM as Spleen Qi deficiency with Liver Yin deficiency. Other systems may also be simultaneously out of balance. Acupuncture and herbal therapies may help slow the progression of the disease, while improving quality of life and relieving GI symptoms. Points are chosen for the disease pattern (i.e. Spleen Qi deficiency) as well as the animal’s constitution and secondary symptoms (Xie, 2013).
A CONTEMPORARY CLINICAL MODEL AND STRATEGY (MARSDEN, 2014)
cord trauma
oxidative stress
SOD-1 induction
Excitotoxicity
1. CORD INJURY: BEGINS AS THORACIC CORD ILLNESS • Starts in same cord location T3-L3/highest cord:canal ratio • Disc disease/spondylosis • Slip and fall • Autoimmune • Aging of the spine
Clemmons found that dogs placed on an unprocessed diet, supplements and a structured, regular exercise program experienced the slowest progression of the disease, and in some cases stabilized and even improved. An independent study in the UK tested only the supplement regimen. No diet or physiotherapy was implemented. In this case, 70% of the dogs progressed to complete paraplegia within six months.
• Surgery
Treatment goal • Gently restore spinal mobility to distribute motion across all vertebral segments • Break down ligamentous calicification that promotes spondylosis and rigidity
In 2006, a physiotherapy efficacy test showed that animals receiving intensive (n=9) physiotherapy had longer (P=< .05) survival times (mean 255 days), compared to those with moderate (n=6; mean 130 days) or no (n=7; mean 55 days) physiotherapy (Kathmann et al, 2006). Physiotherapy, in addition to strengthening the legs, would likely promote general spinal flexibility and circulation, helping to avoid induction of defective SOD-1. Therefore, diet and exercise appear to play key roles in slowing or halting the progression of degenerative myelopathy (Marsden, 2014).
• Preserve muscle tone and strength with early intervention
Degenerative myelopathy is a multifactorial disease in traditional Chinese veterinary medicine; making a diagnosis
• Underwater treadmill
• Start while dogs are still walking
Methods • Chiropractic adjustments to address vertebral fixations from cervical to lumbosacral spine • Massage for circulation, tone and static range of motion/ breaks down calcification • Swimming: alternate day sessions recommended • Walking: can be alternated with swimming • Stretches
Continued on page 14.
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