IVC SPRING 2017
Integrative VETERINARY CARE VOLUME 7 ISSUE 2
INTEGRATIVE MANAGEMENT OF NEUROLOGIC CONDITIONS How integrative modalities can help treat neurological ailments in dogs and cats. — P. 13
PREVENTING AND TREATING EQUINE HERPES MYELOENCEPHALOPATHY
FEEDING THE INTESTINAL MICROBIOME
CAN PRIMARY OR IDIOPATHIC SEIZURES BE CURED?
Surgery, cage rest, lifetime meds and euthanasia are not the only options – P. 20
www.IVCJournal.com
SPRING ISSUE 2017
INTEGRATIVE VETERINARY CARE JOURNAL
SUCCESSFUL INTEGRATIVE TREATMENT OF SPINAL DYSFUNCTION
Good health requires a healthy gut, so dietary choices play a crucial role for your canine and feline patients. — P. 30
MANAGEMENT TIPS FOR A SUCCESSFUL PRACTICE
Learn to keep the daily pressures, interruptions and business details of running a veterinary clinic from eroding your well-being. — P. 42
What we know about the neurologic form of the EHV-1 virus, and how an integrative approach can help prevent and treat it. — P. 58
Unlike conventional medications, which only control seizure symptoms in dogs and cats, homeopathy offers the possibility of a genuine cure in the majority of cases. — P. 50
WHAT’ S NEW • Wanted: your success stories using herbal medicine • New research looks at microRNA as a way to detect cancer cells in dogs • Study on equine health and management highlights industry trends
contents FEATURES
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INTEGRATIVE TOOLS FOR NEUROLOGIC DISEASES By Janet Gordon Palm,
DVM, CVCP
Neurological conditions in pets may be managed with a combination of approaches for evaluation, and modalities such as neuronal adjustment, myofascial release and FSLLLT.
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INTEGRATIVE TREATMENT OF SPINAL DYSFUNCTION
By Margie Garrett,
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AN INTEGRATIVE APPROACH TO EQUINE HERPES MYELOENCEPHALOPATHY
By Kimberly Henneman, DABT, CVA, CVC
A look at what is currently known about this neurologic manifestation of the EHV-1 virus, along with integrative therapies for prevention and treatment.
DVM, CVA, CIVCA, CVTN
How acupuncture, homeopathy and other therapies can help in the treatment of intervertebral disc disease (IVDD) and spondylosis in canine and feline patients.
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NUTRITION NOOK
INGREDIENT SOURCING FOR OPTIMAL NUTRITION IN DOGS AND CATS
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By Nancy L. Martin,
MS, DVM, CVA
A look at the intestinal microbiome and why fresh organic food is the healthiest choice for your animal patients.
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PROTOMORPHOGENS By Tom Cameron, Sue Howell, DVM
DVM
and
This novel integrative nutritional approach to neurologic disorders and autoimmunity in cats and dogs uses tissue-specific protein extracts.
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INTEGRATIVE PRACTICE
CREATING A HOLISTICALLYMANAGED PRACTICE
By Cindy Maro,
DVM, CVA, CAC, VMRT
Many factors contribute to a thriving veterinary practice that supports the financial abundance and mental and emotional well-being necessary for long-term success.
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HOMEOPATHIC TREATMENT OF PRIMARY OR IDIOPATHIC SEIZURES
By John Saxton, Vet Med, Vet FF Hom, Cert IAVH, MRCVS Unlike conventional medications, which only control seizure symptoms in dogs and cats, homeopathy offers the possibility of a genuine cure in the majority of cases.
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IVC Spring 2017
DVM, DACVSMR, FAAVA,
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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, 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.
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
5 Advisory board 8 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’ 27 From the WAEO 41 Industry innovations 48 Veterinary resource guide 49 From the VBMA 56 From the VMAA 63 From the AHVMF
Dr. Steve Marsden, DVM, ND, lectures for the IVAS, the AHVMA and the AVMA, and is co-founder of the College of Integrative Veterinary Therapies. He is a director of the National College of Natural Medicine, and authored the Manual of Natural Veterinary Medicine. Dr. Marsden is extensively trained in alternative medicine, including Chinese herbology, acupuncture and naturopathic medicine. He has a veterinary and naturopathic practice in Edmonton, Alberta. In 2010, Dr. Marsden was named Teacher of the Year by the AHVMA.
Dr. Jean Dodds, DVM, received her veterinary degree in 1964 from the Ontario Veterinary College. In 1986, she moved to Southern California to establish Hemopet, the first non-profit national blood bank program for animals. Dr. Dodds has been a member of many national and international committees on hematology, animal models of human disease, veterinary medicine, and laboratory animal science. She received the Holistic Veterinarian of the Year Award from the AHVMA in 1994.
64 From the AVH 65 Marketplace 66 Events
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.
IVC Spring 2017
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Integrative treatment of
spinal dysfunction
How acupuncture, homeopathy and other therapies can help in the treatment of intervertebral disc disease (IVDD) and spondylosis in pets. By Margie Garrett, DVM, CVA, CIVCA, CVTN I have seen it time and again: a client brings in a sweet beloved pet that cannot use his hind legs. Depending on which segment of the spinal cord is affected, the animal may also be unable to urinate or defecate with control. The client is understandably upset but still holding out hope that something can be done about her pet’s spinal dysfunction, which may signify IVDD, spondylosis, or other conditions. Many pet owners today are asking for an integrative approach to treating spinal dysfunction, in addition to conventional pain management, after learning about successful outcomes through word of mouth, the Internet and social media. It seems the high cost of surgery, plus the time and pain involved in what is called conservative therapy (total cage rest, pain medications, anti-inflammatories) is leading owners to look for alternatives. Even some conventional experts are questioning conservative therapy. In a recent textbook, Curtis Dewey, DVM, MS, states that one study found “no association between duration of cage confinement and success of medical therapy”.1 In my integrative practice, I treat many species with neurological conditions, including intervertebral disc disease (IVDD) and spondylosis deformans. In my experience, localization of the spinal lesion can best be
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done by combining conventional exam and diagnostics, and holistic techniques.
CONDUCTING THE PHYSICAL EXAM The integrative veterinarian may be presented with anything from lameness, organ dysfunction, proprioceptive loss and ataxia, to paresis and paralysis. The first step in diagnosing the condition is a physical exam. This typically means repeating the tests made by any conventional veterinarian with the goal of locating the lesion and delineating the cause.
Conventional Most of the time, pain will impede many normal responses, and muscle stenting and compensatory changes in joint movement are also present, so while examining the dog, avoid anything but gentle palpation in the area. Evaluate the nervous system from head to toe: • Check for cranial nerve deficits. • Palpate to test for painful areas along the vertebrae. Are they lumbar, thoracic or cervical? • Determine if the lesion is Upper Motor Neuron or Lower Motor Neuron. Are the leg reflexes hyper- or hypo-reflexive? Is there a panniculus response?
• Test the integrity of the proprioceptive pathway. Does the brain respond to the foot being turned over?2
Acupuncture The TCVM practitioner interviews the client, observes the patient, takes the history and evaluates the tongue and pulse as part of the exam to determine: • Preferences to hot or cold • Pain behaviors – is the animal in pain or is there weakness without pain? • Wet or dry presentation • Which acupoints are sensitive and what portion of the nervous system are we trying to modulate by stimulating the nerves and the local humoral response?
From these points, the practitioner can differentiate between spondylosis and IVDD to select the most appropriate treatment. IVDD will generally present with a stagnation pattern of pain (in muscles or joints, and/or stiffness in the joints), and also present with the Bi syndrome. (Table 1) Spondylosis is more chronic and slow to progress since it can develop as generalized Bi syndrome over a long period, reflecting spinal instability. Most commonly, the patient presents with ataxia but he/she may present acutely, showing weakness without pain due to loss of neurological function. This pattern is the Wei syndrome. (Table 2) (For more on the TCVM exam, read “The Integrative Physical Examination”, IVC Journal, Volume 6, Issue 3.)
Continued on page 22. Table 1 – Bi Syndrome Pattern3
Bi syndrome patterns
Tongue
Wind-Cold-Damp invasion with external Qi/Blood stagnation
Clinical findings / grade of deficits
Superficial, strong, slow, wiry
Grade 1 acute neck or back pain. No paresis or paralysis.
Deep, weak, worse on left, rapid, thready or wiry
Grade 1 acute neck or back pain. No paresis or paralysis. Panting, cool-seeking, warm ears, back, feet, dry skin.
Purple
Deep, weak, worse on right or wiry
Grade 1 acute neck or back pain. No paresis or paralysis. Heat-seeking, cold ears, back, feet.
Spinal cord Qi/Blood stagnation with Kidney Qi deficiency
Pale purple, wet
Deep, weak, worse on right or wiry
Grades 2-5 deficits acute or chronic. Paresis or paralysis (+/=) neck or back pain.
Spinal cord Qi/Blood stagnation with Kidney Yang deficiency
Pale purple, wet
Deep, weak (weaker on right), slow, Grades 2-5 deficits acute or chronic. Paresis or may be wiry paralysis (=/+) neck or back pain. Heat-seeking, cold ears, back, feet.
Spinal cord Qi/Blood stagnation with Kidney Yin and Qi deficiencies
Pale or red, purple, wet or dry, cracked, chronic
Deep, weak, may be on both sides, rapid, thready, may be wiry
Grades 2-5 deficits acute or chronic. Paresis or paralysis (=/+) neck or back pain. Panting, coolseeking, warm ears, back, feet, dry skin
Spinal cord Qi/Blood with Kidney Yin and Yang deficiencies
Pale, red or purple, wet or dry
Deep, weak pulses on both sides, may be rapid or slow or wiry
Grades 2-5 deficits acute or chronic. Paresis or paralysis (=/+) neck or back pain. Seeks heat or cold, may or may not pant, warm or cold ears, back, feet. May be warm in front and cold in back.
Kidney Yin deficiency with external Qi Blood stagnation
Purple
Pulse
Reddish purple, dry
Kidney Yang deficiency with external Qi Blood stagnation
Table 2 – Wei Syndrome Pattern4
Wei syndrome patterns
Tongue
Pulse
Clinical signs
Damp Heat
Greasy, moist
Rapid, slippery
Obesity, chronic skin problems, edema, weakness in back legs, no paralysis.
Spleen Qi deficiency
Pale, swollen
Deep, weak
Pale, moist
Very deep, weak
Weak and cold lumbus and hind end, difficulty rising. Weakness to immobile rear legs.
Pale or red and dry
Weak, thin
Emaciation, weak hind end, dry skin, false heat, coolseeking, weakness to immobile rear legs.
Kidney Qi and/or Yang deficiency Qi and Yin dual deficiency
Weak limbs, flaccid loose stools, weakness in rear legs.
Differentiating Bi and Wei syndromes facilitates choosing the correct acupuncture points, Chinese herbal formulas, Tui Na massage plans, and food therapy for each animal.
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nutrition nook
Ingredient
sourcing for
optimal nutrition in dogs and cats
Why fresh organic food is the healthiest choice for your patients. By Nancy L. Martin, MS, DVM, CVA Many holistic or alternative veterinarians still express some angst regarding their recommendations on the type of food clients should feed their pets. Confusion about what constitutes the appropriate diet for dogs and cats comes from an interesting convergence of food production and labeling politics; marketing strategies in OTC pet foods and veterinary prescription diets; food journalism as it applies to animal and human health; and the science of nutrition. The science of nutrition, rather than adding clarity to the discussion, has obscured our understanding of food with its emphasis on the material contents of food and the internal metabolic machinery of each species.1,2
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THE MICROBIOME, THE BIOSPHERE, AND QI The missing link in our education involves what exactly happens to food as it passes through our patients’ guts. We are only now beginning to understand that the miraculous transformation of food into tissue could not take place without the contribution of an enriched broth of bacteria and fungi we call the intestinal microbiome (each individual’s microbiome outnumbers their own cells by ten to one). Only a few pathogens negatively impact animal health.3 All plants and animals share their functional life with a nurturing and supportive microbiome from birth (or sprout) to decomposition.4 Likewise, the earth
could not support plant or animal life if not for the rich mat of organic material that inhabits its crust.5 The TCVM concept of Qi, the vital life force that encompasses all living things, is remarkably similar to our current understanding of the planet’s robust biosphere, and its continuous cycle of promotion and decay – a cycle that has been taking place in the deepest, farthest, and most extreme places on the planet for billions of years.6 Veterinarians learn that healthy ruminant digestion relies on a partnership with microbial inhabitants. A similar discussion of the microbiome in dogs and cats was largely overlooked in small animal nutritional textbooks, as if it was only marginally involved in digestion and overall health.1,2 In fact, each pet’s microbiome is establishing residence within one hour after birth, and hastily begins directing the development of the structure of the host’s intestines, immune system and neurologic system.4,7 The resident microbiome, in concert with the host’s cells, is responsible for an elaborate communication system that influences nutrient assimilation, tissue growth and repair, body composition, inflammation, neurological development and mental health. At weaning, the microbiome population alters as the food substrate changes. In carnivores, this means that microbes and enzymes associated with carbohydrate digestion begin to naturally diminish, while microbes, intestinal cells, and organs that assist in amino acid and fat digestion flourish and develop.7 The host’s hormonal state during puberty, estrus, pregnancy and lactation influences the bacterial population in the intestines by promoting a shift towards microbes that are more efficient at harvesting energy from the diet. The external environment also influences the microbiome. Research shows that animals and people who spend time outdoors have more robust microbiomes, as do humans that live in multi-generational households, or share their living space with pets.8 Continued on page 32.
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