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WINTER 2021/2022

EDITORIAL DEPARTMENT Editor-in-Chief: Dana Cox Managing Editor: Ann Brightman Associate Editor IVC: Laurin Cooke, DVM Senior Content Editor: Emily Watson Senior Graphic Designer: Dawn Cumby-Dallin Senior Graphic Designer: Alyssa Dow Junior Graphic Designer: Ethan Vorstenbosch Web Design & Development: Lace Imson Digital Media Specialist: Carlos Reyes

COLUMNISTS & CONTRIBUTING WRITERS

Jan Bellows, DVM, Dipl. AVDC, ABVP (canine and feline specialties) Josie Beug, DVM, CVA Bill Bookout Nancy Brandt, DVM Cheryl Brocki, DVM Todd Cooney, DVM, CVH Kris Hansen, DVM Melissa Kellagher Chery F. Kendrick, DVM, MPVM, MLT, CFS Cynthia Lankenau, DVM Susan Leopold Sungwon Lim, PhD Melissa Magnuson, DVM Kate Meyers, CVT Marybeth Minter, DVM Herb Moskowitz, DDS Judith E. Saik, DVM, DACVP, CVA, CVCH, CVFT Emily Stein, PhD Deborah Thomson, DVM Tavor White

ADMINISTRATION & SALES Publisher: Redstone Media Group President/C.E.O.: Tim Hockley Accounting: Donna Bailey Circulation & Office Manager: Libby Sinden

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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. We welcome previously unpublished articles and color pictures either in transparency or disc form at 300 dpi.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: Senior Media Specialist/Editorial Associate: Kat Shaw, (866) 764-1212 ext. 315 Katshaw@redstonemediagroup.com Business Development/Editorial Associate: Becky Starr, (866) 764-1212 ext. 221 Becky@redstonemediagroup.com Marketing Associate: Mattias Wahl, (866) 764-1212 ext 222 Mattias@redstonemediagroup.com SUBSCRIPTION SERVICES MANAGER: Donna Bailey, (866) 764-1212 ext. 113 Donna@redstonemediagroup.com CLASSIFIED ADVERTISING: Libby Sinden classified@IVCJournal.com US MAIL: IVC Journal, 6834 S University Blvd PMB 155 Centennial, CO 80122 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.

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IVC Journal (ISSN 2291-9600) is published four times a year by Redstone Media Group Inc. Publications Mail Agreement #40884047. Entire contents copyright© 2022. No part of this publication may be reproduced or transmitted by any means, without prior written permission of the publisher. Publication date: January 2022. improving the lives of animals... one reader at a time.

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contents FEATURES

A VITAL ALLY DURING 8 OSHA: THE PANDEMIC

By Chery F. Kendrick, DVM, MPVM, MLT, CFS Explore the pandemic’s effects on regulatory control programs; OSHA compliance issues unique to veterinary medicine; and the agency’s role in veterinary mental health.

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NUTRITION NOOK PLANT-BASED DIETS: A SUSTAINABLE CHOICE FOR DOGS AND CATS By Marybeth Minter, DVM

Making sustainable choices means helping conserve the planet’s limited resources. Can the way we feed our companion animals be both healthful and sustainable?

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ZOOBIQUITY: THE CONNECTION BETWEEN ANIMAL AND HUMAN HEALTH Our energy and the energies that surround us can contribute to dis-ease or well-being in ourselves, our patients and pets.

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THE POWER OF COMPARATIVE ONCOLOGY By Sungwon Lim, PhD

How dog cancer treatments affect human chemotherapy.

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INNOVATIVE PRACTICE CREATING A CULTURE OF SUSTAINABILITY IN YOUR VETERINARY PRACTICE By Cheryl Brocki, DVM

By taking steps to nurture a culture of career sustainability for both our peers and future veterinarians, we can create much-needed positive change in our profession.

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TCVM: A MODEL FOR SUSTAINABLE MEDICINE By Josie Beug, DVM, CVA

Traditional Chinese Veterinary Medicine is a time-tested One Health paradigm that has been around for thousands of years.

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VETERINARIANS AND ONE HEALTH

By Deborah Thomson, DVM How you can help inspire clients and your community to understand and value One Health.

By Melissa Magnuson, DVM

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FAMILY DYNAMICS AND PET HEALTH By Kate Meyers, CVT

Explore how you can help your patients thrive emotionally and physically amid the challenges and changes of living with humans.

SUSTAINABILITY IN VETERINARY HERBAL MEDICINE By Susan Leopold

Factoring sustainability into herbal medicine is increasingly important to the health of our planet and its ecosystems.

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advisoryboard 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

7 Editorial 30 From the NASC 35 From the AHVMA 36 From the AATCVM 37 Industry research 44 New study 46 Industry innovations 55 From the VMAA 56 In the news

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.

63 From the AVH 65 From the VBMA 66 News bites

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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1. JOSIE BEUG, DVM, CVA

Dr Josie Beug is a licensed veterinarian who specializes in Traditional Chinese Veterinary Medicine. She has had a thriving holistic house-call practice in South Florida for nearly 20 years, and is a teaching assistant at Chi University. She can be found online at drjosies5elements.com and in her private online community, Reverence. p.48

2. CHERYL BROCKI, DVM

Dr. Cheryl Brocki is the VP of Veterinary Relations with Vet’s Best Friend, where she focuses on team recruitment, mentorship, and professional development. She has been practicing general veterinary medicine for over 15 years, and held Chief of Staff and Medical Director positions before joining Vet’s Best Friend. She is a graduate of the Ross School of Veterinary Medicine and lives in Massachusetts. Her favorite part of veterinary medicine is working with students and mentoring new graduates. p.38

3. CHERY F. KENDRICK, DVM, MPVM, MLT, CFS

Dr. Chery F. Kendrick is the owner of VetOSHA and The Veterinary Learning Center. She is an active speaker on numerous topics, including regulatory control as well as work-life balance. She makes her home in the foothills of the Smoky Mountains of eastern Tennessee with her cattle dog, Aggy. Nature and teaching make her complete. p.8

4. MELISSA MAGNUSON, DVM

Dr. Melissa Magnuson has been practicing veterinary medicine fulltime since 1999 at her three wholly-owned AAHA-accredited hospitals across southern New Hampshire. In 2019, Canobie Lake Veterinary Hospital was selected as a finalist for AAHA Hospital of the Year, an honor bestowed on only three other hospitals in North America. Dr. Magnuson recently authored her first best-selling book, Animality — How Pets and People Connect, available on Amazon. p.20

5. MARYBETH MINTER, DVM

Dr. Marybeth Minter earned her veterinary degree from Colorado State University, after which she worked in small and mixed animal practice. She began Mariposa Veterinary Service in 1998, with holistic roots. In 2003, she completed the Professional Course in Veterinary Homeopathy, advancing her study through the Pitcairn Institute of Veterinary Homeopathy Annual Meetings. Dr. Minter continues to offer homeopathic consults and helps clients successfully transition their animals to healthy, humane, and sustainable diets. p.14

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6. DEBORAH THOMSON, DVM

Dr. Deborah Thomson, author of The Art of Science Communication: Sharing Knowledge with Students, the Public, and Policymakers, combined her passions for One Health and education when founding One Health Lessons. In the last year alone, this organization has inspired 10,000 children to value One Health. Dr. Thomson’s lessons are being translated into 88 languages and are taught to children as young as six. p.52

7. SUSAN LEOPOLD, PHD

Susan Leopold is an ethnobotanist and passionate defender of biodiversity. Over the past 20 years, she has worked extensively with indigenous peoples in Peru and Costa Rica. She is the Executive Director of United Plant Savers, and currently serves on the Board of Directors for Botanical Dimensions and the Center for Sustainable Economy. Susan is an advisory board member of the American Botanical Council, and a proud member of the Patawomeck Indian Tribe of Virginia. p.32

8. SUNGWON LIM, PHD

Dr. Sungwon Lim is the CEO and Co-Founder of ImpriMed, Inc. He received his PhD degree in Bioengineering from Stanford University and a master’s degree in Translational Medicine from the UC Berkeley–UCSF Joint Bioengineering Program. Sungwon is a bioengineer and entrepreneur with 20 years’ experience in academia and biotech companies, with a focus on the development of novel cancer therapies. He is an advocate of functional precision medicine – personalizing a cancer treatment regimen based on a patient’s cancer cells’ functional responses to anti-cancer drugs. p.26

9. KATE MEYERS, CVT

Kate Meyers is a Certified Dog Bite Prevention Educator with a passion for health and wellness. Her blog and consultation services are tailored for new, prospective, and veteran pet owners to create an educational hub for well-rounded family dynamics. With an emphasis on individualized support, Kate offers a unique approach to pet ownership and care (happytrailspets.net). p.58


editorial

Many beings, one

Earth

I volunteer with a senior cat rescue in my community. We are currently foster-based, but have plans for a sanctuary that would provide comfort and care for up to 60 senior cats. We have big dreams and there’s a big need. We get more calls for help than we have available foster homes. One elderly woman was entering a care facility and had no one to take her healthy, 12-year-old calico. Another woman died, and her daughter could not keep her kitty. A man was moving to another country for work, had run out of time to rehome his senior cat, and was contemplating euthanasia rather than relinquishing her to the county shelter. A woman called in tears, threatened by her husband to get rid of the cat. An aunt phoned on behalf of her disabled niece who was moving into a group home, and her diabetic, ten-year-old cat needed a place to go immediately. This is just a sampling of the stories we have heard in only the last few months. Our founder must have a direct line with some influential kitty angels, as she has been remarkably successful at finding fosters and adopters for these cats, but the calls keep coming, and I’m certain that even after we build our sanctuary, we will reach capacity there as well. Additionally, I have agreed to care for the pets of family and friends, should they become unable to do so themselves. I pray in earnest that we all stay healthy…with my parents’ menagerie alone, my own house would soon be overflowing! The pandemic has brought into sharp focus the fragility of our existence. The question of what happens to our animals

if our lives change or even end is a crucial one to contemplate. As ambassadors for animal health, veterinary teams support long lives for their patients. But what happens when the animals outlive their human caregivers, or circumstances change? I feel we should be adding this question to our list of important conversations to have with clients. Animal life is tied to human life, from each individual relationship to our global one. In this issue of IVC Journal, we explore sustainability and One Health. Learn ways to help your patients thrive through the inevitable changes that come with living among humans. Embrace One Health and proactively educate your community. And discover practice management tips for creating a sustainable workplace for your coworkers and staff. We also cover the sustainable use of herbal medicines, plant-based diets, OSHA’s role in helping practices navigate the pandemic, zoobiquity, the time-tested paradigm of One Health offered by TCVM, and the value of comparative oncology. Blessings to you for the New Year! We must choose a sustainable future for all.

Laurin Cooke, DVM Associate Editor, drlaurin@ivcjournal.com

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OSHA:

A VITAL ALLY DURING THE PANDEMIC BY CHERY F. KENDRICK, DVM, MPVM, MLT, CFS

Explore the pandemic’s effects on regulatory control programs; OSHA compliance issues unique to veterinary medicine; and the agency’s role in veterinary mental health.

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Over the past two years, we have fought diligently to keep our practices open through the COVID-19 pandemic. We struggled to keep our patients healthy and our clients happy. We worked hard to find a balance between ensuring our employees’ safety, earning a living, and keeping ourselves and our families healthy. Who could have guessed that OSHA (Occupational Safety and Health Administration) would turn out to be a valued partner during this difficult time? OSHA is usually seen as that big, ever-looming government agency with thousands of pages of regulations written in somewhat unintelligible legalese. These regulations are often not applicable to our practices, yet it is up to us to decipher how they apply to us, and then make sure we follow them. OSHA inspectors can arrive unannounced, and they have a mandate to fine us for any infraction they can find, even if we immediately correct it. OSHA’s role in workplace safety used to be one of partnering with employers to help them figure out exactly how to comply with the law. Their stated goal was employee safety. Then, OSHA became that dreaded agency whose informative capability came with big fines.

ONCE MORE A TRUSTED PARTNER But things have changed again during these days of COVID-19. We once more saw a caring and informative partner who helped us figure out the maze of keeping our doors open and employees safe, in the middle of an unprecedented and overwhelming pandemic. The surprise visits no longer happened. Rather, when OSHA received a complaint about a clinic, usually from an employee worried that there were not enough safeguards in place to protect them from COVID at work, OSHA would send an email (followed up with a letter) and make a phone call. They would state what the complaint was and ask for a copy of the clinic’s COVID protocols. They would then offer some guidance as needed, providing information from the Centers for Disease Control and Prevention (CDC) on recommendations about how to stay healthy while remaining open, caring for our patients, and dealing with our clients. And best of all there were no fines — just help and encouragement.

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Working diligently with OSHA, we addressed how we would balance seeing and treating our patients, and dealing with our clients, to provide the high quality medicine we were used to providing while keeping our employees safe and healthy. Added to the equation were the outside forces that affected every decision we made.

How did this happen? What caused OSHA to become the more benevolent government partner they used to be? The simple answer is that, like the rest of us, they were trying to figure out how to keep the doors open and the lights on while surviving a deadly pandemic.

BALANCING SERVICE AND SAFETY Keeping our doors open in order to continue seeing patients, as well as educating the public, brought up the very real concern of how to do this safely, while also protecting the health and well-being of our employees. This is, after all, OSHA’s primary goal — to ensure that employers provide a safe and healthy work environment for all employees. The fact that OSHA understood the nature of veterinary work, and that our original purpose is public health, was an amazing relief. OSHA listened and worked with us to determine exactly how we could continue to care for animals, and thus fulfill our public health responsibilities. We were therefore able to develop a plan of action that addressed all phases of our practices, address different concerns for different types of practice, and help OSHA understand that each had unique needs. We were then able to work with the agency to look at the needs specific to:

Small animal practices

Emergency and specialty practices

Farm animal practices

Mobile practices

Workplace safety practices such as limiting clinic client access (curbside) and house/farm calls, and changes to our masking and disinfecting protocols, were the first things we did to attempt to maintain this balance. When COVID began to hit our staff, we then had to incorporate protocols for handling exposure, quarantine, time off, and dealing with staff shortages.

OSHA AND MENTAL HEALTH Tempers flared as people’s fears mounted, and concern for family members rose with each exposure. As human hospitals filled up, so too did it seem that veterinary professionals were seeing more patients. Stress levels hit a high point when many left the profession due to illness, the need to stay home to care for family members, or from job burnout. It was at this juncture that we developed a new relationship with OSHA. The agency has always been concerned with issues such as workplace violence, bullying, and sexual harassment, but the pandemic brought increased concern about the general state of mental health and well-being in employees. As we moved away from just the concept of compassion fatigue in veterinary medicine, even as it remains a valid concern, to what we now understand to be burnout from being overstretched, asked to do too much with too few resources (think short-staffing), we realized that this burnout, this physical, emotional, and mental fatigue, had also become a topic of interest to OSHA. In fact, the agency decided that the summer months of 2021 would be dedicated to Mental Health Awareness. The tragedies the pandemic brought about reminded us that teamwork is essential. OSHA encouraged workplace teams to have open discussions about the mental health and well-being of their members, and prompted employers to utilize the wellness plans their insurance companies offered and to take advantage of community resources for mental health support. Companies and workplaces across the country instituted great team-building and appreciation events and activities. By working with OSHA, and with the CDC and the Department of Labor (DOL), we also developed a plan to come out of

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The essential nature of veterinary medicine, past and present The first question asked when the pandemic began was whether we were an essential service/industry. Fortunately, it is generally understood that veterinary medical services are indeed an essential public health service, so for the most part, we were able to continue to offer care to our patients, albeit in a more limited way in some instances. It was refreshing and empowering to review with others the essential part that veterinarians play in public health: • Think of the original role veterinarians played in the control of zoonoses, such as tuberculosis from cow’s milk and rabies in dogs, cats, and other small animals, and you see the essential work they have done in controlling deadly and disfiguring diseases in humans by controlling them in animal populations. Veterinarians have also had an important part in limiting or eliminating the dangerous parasites humans were exposed to in the pork industry. And the list goes on. • Veterinarians have traditionally served as educators about public health issues, through discussions with clients and from speaking at local town halls and other forums. During the COVID-19 pandemic, veterinarians provided a vital service by educating and calming people’s fears around zoonotic risk, reassuring clients and the public about the safety of their pets. • Veterinarians have traditionally drawn links between human and animal populations, stressing the connectedness of all things, including health concerns. Historically, the interdependence of humans and animals has been viewed in terms of food resources. However, this interconnectedness now takes a much broader perspective, as our relationships with animals offer emotional support and companionship.

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this pandemic with a renewed sense of commitment, not just to our patients and clients, but also to each other. OSHA partnered with the CDC to bring attention to mental health and to provide the tools and resources we need to help make self-care and care for each other important topics in the workplace. We became more resourceful and empathetic. There was a sense of having survived a horrendous event together, and now we were here to support each other through the post-traumatic stress resulting from the pandemic. Empathy and mental health awareness have taken on a whole new importance in our everyday work life, and have found a permanent place in our commitment to help each other through tough times. The concept of work and play balance has become paramount. These last two years of the COVID-19 pandemic have been lifechanging in so many ways. They have brought much isolation and exacerbated mental health issues. They have also changed what we are willing to accept in life, and helped us understand that there can and must be a better balance to work and play. They also brought us back an old friend, a benevolent partnership with OSHA. While the agency will still fine us for infractions such as inadequate staff training, improper labeling of secondary containers, and other safety violations, the pandemic has brought us all to a different place, a different understanding. We understand that our work, as veterinary medical providers, is essential; our work as educators is essential; and that teamwork also includes kindness and empathy for one other. And that is good. Visit www.VetOSHA.com to learn more.


ADVERTORIAL

Molecular iodine What is it and why are periodontists adopting its use in record numbers? BY HERB MOSKOWITZ, DDS

We are all familiar with iodine. As an antiseptic, it has become a global standard of care in infection control. Its excellent therapeutic benefit outweighs its staining potential. What you may not know is that povidone iodine contains a substance that, while present in only trace amounts (1-3 ppm), is responsible for all its biocidal efficacy.1

A “SUPER IODINE” The term “povidone iodine” may be misleading because it is not just one substance. It is an aqueous solution of several different species of iodine that are physically-complexed to a large organic molecule, polyvinylpyrrolidone. These iodine species are in dynamic equilibrium and are present in an aggregate concentration of approximately 31,600 ppm.2

I2 FOR PETS

Two recent clinical studies of dogs, conducted under VOHC guidelines, determined the feasibility of using a nutritional quantity of I 2 as a daily pet drinking water additive.7 The studies showed an average reduction in dental plaque of 44% compared to the placebo-treated group over one month (Figure 1). This compares very favorably to a plaque reduction of only 37.4% for once-daily brushing, and 24.8% for once-every-other-day, veterinarian-supervised brushing for the same time period.8

Figure 1: VOHC Study — Plaque Staining

One of these species, molecular iodine (I 2), is truly a “super iodine.” This non-staining, antimicrobial agent has powerful, broad spectrum activity against viruses, bacteria, fungi and spores. I2 is so safe for animals and humans that it is considered an essential nutrient, required for the prevention of iodine-deficiency diseases.3 Recently, I 2 solutions have been developed and patented (ioTech International, Boca Raton, FL) that have all of the advantages of povidone iodine and none of their disadvantages. These non-staining solutions are far more effective, much safer to use, and do not permit the development of bacterial resistance.4 ioRinse, a patented I 2 oral rinse, was universitytested for its effectiveness against SARS-CoV-2. Compared to other rinses recommended by the American Dental Association, it was the only rinse found to be fully effective. 5 Subsequent studies have shown it to be the only COVID rinse proven to be effective in the presence of saliva.6

Placebo

Molecular Iodine Treated

IoVet ORAL™ (www.iotechinternational.com) is an innovative, patented, I 2 pet drinking water additive now available for veterinarians to recommend or sell to clients. It is an important advance in veterinary dental care that is well accepted by pets and supports a lifetime of healthy mouths.

Wada H, et al. Relationship between virucidal efficacy and free iodine concentration of povidone-iodine in buffer solution. Biocontrol Science. 2016;21(1):21-27. 1

Frank P, et al. Mouthwashes and their use in dentistry: A review. Oral Health. 2021; 3(3): 22-34.

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Preedy VR, et al. Comprehensive Handbook of Iodine: Nutritional, Biochemical, Pathological and Therapeutic Aspects. Academic Press (Elsevier); 2009:801-810. 3

Because I2 is so rapidly effective against periodontal pathogens, its use has become commonplace in dental offices throughout the US. It is used in-office as a pre-procedural rinse and for subgingival irrigation. Thousands of dental offices sell or recommend ioRinse RTU to their patients for daily, at-home rinsing to help control periodontal disease. These offices are seeing far better periodontal treatment outcomes since their patients have been using I2 rinses, irrigants, and gels.

U.S. Patent #10092006 Stable Compositions of Uncomplexed Iodine and Methods of Use.

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Moskowitz H, Mendenhall M. Comparative analysis of antiviral efficacy of four different mouthwashes against Severe Acute Respiratory Syndrome Coronavirus 2: An in vitro study. International Journal of Experimental Dental Science. 2020; 9(1). 5

Christensen G. Clinicians Report. 2021; 14(3): 1-3.

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VOHC Study Results. ioTech International. August, 2021; 1-2.

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Harvey C, et al. Effect of frequency of brushing teeth on plaque and calculus accumulation and gingivitis in dogs. J Vet Dent. 2015; 32(1). 8

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nutritionnook

PLANT-BASED a sustainable choice for companion animals BY MARYBETH MINTER, DVM

Making sustainable choices means helping conserve the planet’s limited resources. Can the way we feed our companion animals be both healthful and sustainable?

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DIETS: I

t is no secret that our planet and its inhabitants are facing a climate crisis. In August of 2021, the United Nations Intergovernmental Panel on Climate Change released its latest report, showing that human influence has warmed the atmosphere, oceans, and land to unprecedented levels over the past 2,000 years.1 As a result, we are seeing daily news reports of extreme temperatures; extended droughts, fires, storms, and flooding; and planetary, human, and animal suffering.

gas (GHG) emissions. Estimates of the GHG levels (methane, carbon dioxide, nitrous oxide, fluorinated gases) produced by animal agriculture vary, but almost all point to meat, dairy, and egg production, as well as crops grown solely for animal consumption, as major contributors to the overheating of our planet. Probably the most quoted figure, from a major study done by the United Nations several years ago, puts emissions from animal agriculture at 14% of all GHG.

It is easy to become overwhelmed and feel despair. What can be changed, and how can we even comprehend the enormity of the crisis facing our planet? And how can any of this relate to how we choose to feed our companion animals?

But now, an extensive new (2021) University of Illinois study of the entire food production system worldwide, published in Nature Food, has upped that percentage considerably. Their model-data integration approach took into account full consistency between subsectors, providing explicit estimates of production and consumption-based GHG emissions worldwide from plant- and animal-based human food in circa 2010 (mean of the 2007 to 2013 period). Researchers collected detailed data on a wide variety of both animal and plant food production from 200 countries.

The topic of a “sustainable diet” for humans, let alone our companion animals, is a deep and complicated subject, often emotionally charged and wrought with many opinions. I think we can all agree, however, that we want our animals to thrive and be healthy. I believe many of us also want our planet to heal, and to see the humane treatment of all animals, including those consumed by humans and our carnivorous dogs and cats. In this article, I will attempt to illustrate the current scientific evidence and concerns that guided me to change not only the way I am feeding my own animal companion, but what I am recommending to clients as well. Keep in mind that this is a vast topic, and it’s beyond the scope of this article to illuminate every facet of the environmental, health, and ethical concerns as they pertain to feeding our companion animals.

ANIMAL-BASED AGRICULTURE AND SUSTAINABILITY Growing, harvesting and processing food, all of agriculture, is part of the human activity that is warming the planet. To what extent does animal-based agriculture contribute to the problem? The wealth of climate science is now immense, and many reports and studies measure many parameters. One paramount contribution to global warming is greenhouse

Their conclusion is that nearly 60% of all GHG can be traced to our food supply systems, and animal products account for almost twice as many emissions as all plant-based foods combined.2 In the elapsed decade, with population growth and rising demand for animal foods, the emissions have risen higher yet, surpassing even those of the fossil fuel and transportation industries.3 Food system inputs beyond GHG emission include land use, deforestation, loss of habitat, depletion of freshwater resources, and pollution of aquatic and terrestrial ecosystems through excessive nitrogen and phosphorus accumulation and use. In addition to requiring more land than plant crops to produce the equivalent protein energy, animal production has considerably greater impacts on water and fossil fuel use, erosion, greenhouse gas emission, fertilizer and pesticide use. The conversion rate of plant-based to animal calories per kg is about 2:1 for poultry, 3:1 for pigs, farmed fish, milk and eggs, and a most inefficient 7:1 for cattle. These are IVC Winter 2021/2022

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calculations carried out by the United Nations Environmental Program for the calories lost during animal food production. Over 70 billion animals are slaughtered each year to keep up with the demand for meat. The biggest consumers are rich, mostly Western countries, while developing nations are emulating Western appetites. Animal products are expensive, yet the meat industry still receives huge government subsidies, especially in the United States. There is a current, encouraging interest in animal-involved regenerative agriculture. But in recent years, the regenerative agriculture movement seems to be driven by those who are promoting meat consumption. If animal-involved regenerative agriculture were used worldwide in the place of concentrated animal feeding operations (CAFOs), that would be a great improvement.

Environmental impact of companion animal diets A 2017 study found that the dietary footprint of dogs and cats in the US constitutes about 25% to 30% of the environmental impacts from animal production in terms of the use of land, water, fossil fuel, phosphate, and biocides.4 Dog and cat animal product consumption is responsible for the release of up to 64 million tons of CO2-equivalent methane and nitrous oxide, two powerful greenhouse gases. The US is home to the most pet guardians in the world. As pet guardianship increases in some developing countries, especially China, and global pet food trends continue toward higher meat content and quality, pet guaurdianship will further compound the environmental impacts of human dietary choices.

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The scientific evidence is clear that the more overall meat consumption is reduced, the more our environment will have a chance to regenerate and heal. Regenerative crop agriculture, restoration of grasslands and forests, and rewilding are of course greatly needed to restore the health and carbon-storing ability of our soils. See sidebar at bottom left for a look at where companion animal meat consumption figures in all this.

ARE THERE EVIDENCE-BASED ALTERNATIVES? Many guardians of companion animals are interested in plant-based diets for their dogs and cats because of the environmental impacts and humane concerns discussed above. But can dogs and cats eat healthy plant-based diets, or at least significantly fewer animal protein sources? Current research indicates they can, and more studies are coming. A 2016 article comprehensively reviews the evidence of four studies that examined the nutritional adequacy of vegetarian diets for cats and dogs.5 To obtain additional information,


they surveyed 12 pet food companies, and examined the nutritional soundness of meat-based companion animal diets, reviewing the evidence concerning the health status of vegetarian, carnivorous, and omnivorous companion animals. The authors concluded that both cats and dogs may thrive on vegetarian diets, but they must be nutritionally complete and reasonably balanced. They recommended that guardians should also regularly monitor urinary acidity and correct urinary alkalinization through appropriate dietary additives, if necessary. Another study from the primary author looked at palatability.6 Based on guardian-reported behaviors, the results indicated that vegan pet foods are generally at least as palatable to dogs and cats as conventional meat or raw meat diets, and do not compromise their welfare when other determinants such as nutritional requirements are adequately provided. Clinical trials are, of course, needed. A 2009 study was the first to demonstrate the potential of a meat-free diet being nutritionally adequate for exercising dogs.7 In a 16week controlled experiment, a meat-free diet maintained hematological characteristics in sprint-racing sled dogs (Siberian Huskies). Importantly, these findings pave the way for commercial pet food manufacturers to produce nutritionally adequate meat-free diets for dogs. Dr. Tonatiuh Melgarejo, a clinician-scientist at Western University of Health Sciences in California, and his team of scientific collaborators, are soon publishing their results from a first-of-its-kind plant-based nutrition feeding trial in companion dogs. Fifteen clinically healthy dogs aged one to nine years were followed for a year while being fed a nutritionally-complete commercial plant-based diet. These dogs had all been previously fed a meat-based diet. The dogs were allowed to live at home with their human companions, so were not caged in a laboratory. They were routinely examined and followed with relevant tests to study cardiac function (echocardiogram), blood (serum) chemistry and hematology, as well as vitamin and amino acid profiles and microbiome measurements, accumulating hundreds of biomarkers. A preliminary summary reveals that all these dogs remained clinically healthy at the end of 12 months. The study results so far look promising, and support the idea that dogs can live as healthily, if not healthier, on plant-based diets as they can on meat-based diets. What is particularly helpful is that this study has produced a significant amount of valuable new data.8

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MY PERSONAL EXPERIENCE Nearly a decade ago, I routinely recommended grain-free, meat-based kibble and raw meat diets for both dogs and cats. As I became increasingly concerned with what climate science was revealing, and grew more aware of the dire state of the welfare of food animals, along with the prevalent chemical contamination of our food supply, I started to question the soundness of my dietary advice for the long-term health of my clients’ animals. When my own beloved Border Collie passed, I began wondering how her meat-based diet affected her health and final condition. I listened to respected colleagues who were also looking at the industry focus on high-meat diets. I discovered that dogs were being fed more meat in the last 40 to 50 years than at probably any time in their long evolutionary history with humans. I questioned the assumption that dogs were “mini-wolves”, as the marketing narrative of many meat-based dog food brands claimed. Dogs are carnivorous in nature, but are considered omnivores, like humans. As they were domesticated over thousands of years, they developed more ability to digest starches. This speaks to their overall malleability and adaptability and how they could survive and thrive with humans who developed agrarian and herding lifestyles. I began to more thoroughly understand bioaccumulation through diet, realizing its potential health effects in humans, dogs and cats, who are perched at the top of the food chain.9 Given the rise in chronic diseases and cancers that are often irresolvable with veterinary treatment, I was seeing that feeding highly concentrated animal-sourced diets could be a significant contributor.

If an animal has chronic health issues, transitioning to plantbased diets may take time and patience, but this is true for any feeding change. Using holistic healing modalities can aid in the transition. I don’t see that novel “meat alternatives” are needed to feed and nourish our companion animals. Healthy and sustainable food already exists in the form of legumes, grains, nuts, seeds, vegetables, and fruits. Much knowledge has been accumulated from those who have been feeding plant-based diets for decades, whether they use a commercial complete diet or one that is home-prepared.10 Today, more clinical research is advancing our understanding of feeding plant-based diets to dogs. Many recipes, supplements, and commercial brands are available to help an animal guardian make the change, and more are on the way. In closing, navigating our global situation and implementing ways to try and change the course of our climate crisis can feel overwhelming. To reference Jane Goodall’s work and teachings around hope, we can, every single day, make a choice to buy or do something that has a lower impact on our environment. We can choose something we care about and that is doable, right now. Choosing to feed our animal companions a plantbased diet, or at least significantly less animal protein, is a step we can take right now without the need for developing new speculative technologies. That choice would allow care for all animals, and take us a step forward to helping heal the Earth.

A R6 Climate Change 2021:The Physical Science Basis. Intergovernmental Panel on Climate Change. August 9, 2021. https://www.ipcc.ch/report/ar6/wg1/#FAQ.

1

X u X, Sharma P, Shu S, et al. Global greenhouse gas emissions from animal-based foods are twice those of plant-based foods. Nat Food. 2021; (2): 724-732.

2

Knight A. https://andrewknight.info/articles/climate-change/

3

Okin GS. Environmental impacts of food consumption by dogs and cats. PLOS ONE. 2017; 12(8).

4

As I began feeding plant-based diets to my own dog, and helping interested clients, I started noticing many chronic inflammatory conditions (skin, digestive, urinary, and musculoskeletal) began to improve. Obese animals became more fit and energetic. Chronic vomiting, constipation, and anal gland issues resolved. Anxiety-related behaviors often decreased.

Knight A, Leitsberger M. Vegetarian versus meat-based diets for companion animals. Animals. 2016; 6(9);57.

5

K night A, Satchell L. Vegan versus meat-based pet foods: Owner-reported palatability behaviours and implications for canine and feline welfare. PLOS ONE. 2021; 16(6).

6

B rown, W, Vanselow, B, et al. An experimental meat-free diet maintained haematological characteristics in sprint-racing sled dogs. British Journal of Nutrition. 2009;102:1318–1323.

7

Personal Communication, 28 Sep 2021, with Tonatiuh Melgarejo, DVM, MS, PhD; Tenured Professor of Translational Medicine and Antimicrobial Resistance; College of Veterinary Medicine, Western University of Health Sciences, Pomona, CA. Dr. Melgarejo is also the co-founder of the Western U True One Medicine Initiative (TOMI), which serves to advance species-spanning medicine through evidence-based research and ethical decision-making in science, hereunder the study of plant-based nutrition in companion dogs.

8

Pitcairn, R. Feeding the dog in the 21st century. Dog’s Naturally Magazine. March/April 2015.

9

Pitcairn, R, Pitcairn, S. Dr. Pitcairn’s Complete Guide to Natural Health for Dogs and Cats. 4th ed. Rodale, 2017.

10

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BY MELISSA MAGNUSON, DVM

exploring the connection between animal and human health “Zoobiquity”, a term created by cardiologist and author Barbara Natterson-Horowitz, MD, looks at human health through the lens of what we share with Earth’s other creatures. By examining our shared vulnerabilities, zoobiquity can lead to new solutions for mental, emotional, and social health across all species.* This article explains how zoobiquity can inform our veterinary work and help us better serve both our patients and clients. During the COVID-19 pandemic, the veterinary profession showed that it is recession-proof. No one could have predicted the onslaught of appointments and increased demand for veterinary care, not only for existing patients, but many newly-acquired animals as well. Some clients were brand

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new pet owners seeking companionship during quarantine. Many were also anxiety-ridden. Veterinary teams found themselves overwhelmed and often depleted. However, as I reflect on the last 18 months, I see a different connection (see sidebar on page 24).

THE CONCEPT OF MIRRORING Perhaps you can think of cases where clients and their pets share the same disease. I call it mirroring. It happens not only with clinical signs, but also clinical findings on laboratory tests. For example, I have sometimes told a client that their dog has protein in their urine, only to have them interject, “That’s weird, I have protein in my urine.” I go on to explain that


the dog needs to be tested, and the owner often understands because they have had the same tests. Hypothyroid disease is another common condition that pets and their owners will often share. The next time you diagnose a dog with hypothyroidism, pay attention to what the owner says. Another commonly-seen shared dynamic includes behavioral concerns. Do you recall clients exhibiting anxious behavior telling you how anxious their pets are too? This mirroring phenomenon can be observed if you start to look for it. Not all the time, of course; but once you do find it, what does it mean and what should you do?

DIS-EASE AND RESISTANCE TO FLOW The word “disease” breaks down into “dis” and “ease” (disease), meaning there is a lack of ease that is causing the body to not function properly or maintain homeostasis. The origin of all disease, in the most simplistic terms, can be broken down into inflammation. Something becomes inflamed, initiating a cascade of events that then leads to a lack of homeostasis.

For example, a cat eats a mouse; the mouse has parasites that infect the cat. The parasites grow and cause inflammation in the cat’s gut. The cat stops eating and experiences episodes of vomiting and diarrhea initiated by the inflammation caused by the parasites in the gut.


A CASE EXAMPLE OF MIRRORING

A new client brought her cat, seven-yearold Jessica, to see me. Jessica presented with multiple problems. She was not eating or drinking, she could barely walk, and her breathing was labored. Her owner was very concerned as she herself had been in and out of hospital and felt she was not giving enough attention to her feline friend. Upon exam, Jessica was thin, depressed, and very lethargic. Her temperature was only 98.7°F and she lay purring in a curled ball. Diagnostic tests were performed, and radiographs and urinalysis were uneventful; her blood work, however, was very concerning. Jessica’s white blood cell count was so elevated that we repeated the test again for validation. It was 79,900 K/µL with an over-representation of lymphocytes. I explained to the client that Jessica’s white cell count was extremely high; so high, in fact, that I was concerned about the possibility of serious illness.

Another example is a dog experiencing an adverse vaccine reaction. After coming home from a routine vaccination appointment, the owner realizes the dog’s face is swollen and the eyes are barely open. The dog is having an allergic reaction that is causing severe inflammation in the soft tissues of the face. Due to the swelling, the dog has difficulty breathing and starts pawing at his face. In both cases, there is a cause or trigger, followed by inflammation, and then a response to the inflammation (resistance to flow such as vomiting, or pawing at the face). Without some type of intervention, the “dis-ease” will continue and the body will continue to react against the steady state where it should be. Now, let’s look at humans. Our bodies are bombarded daily by the detrimental effects of computer screens, cell phones, microwaves, viruses, bacteria, foods (some healthy, some not), exercise (or lack thereof), sun exposure (or not), vaccinations, daily medicines, sleep (or lack of), polluted air, and chemicals on our clothes, in the air, and in our environment, as well as the interactions among these effects. All these factors, just as in animals, can contribute to dis-ease. The environments we choose to live and work in affect us, our loved ones, and our pets. As veterinarians, we are fortunate to know and understand the function and dis-ease of many animals. We know that many species share the same diseases. For example, rabbits and horses have a similar build in terms of their digestive systems and share dis-eases like ileus and colic. We call them by different terms, but what happens is often the same. Something triggers the gut to move incorrectly, causing inflammation, gas and severe pain for the patient.

Her “mom” asked how high the values were, because she was sick herself and her own white blood cell count was very elevated. She shared with me that her own count was 80,000 K/µL and asked if Jessica’s was that high.

Cats and dogs are similar with regards to pancreatitis. This condition is often set off by a gastrointestinal (GI) disturbance that inflames the pancreas as well. Isn’t it intriguing that humans who have pancreatitis also have underlying GI disease? We are all connected. We share dis-ease. As complicated as we have made medicine, in its most simplistic form it boils down to inflammation causing a resistance to the flow of normal homeostasis.

How strange that both Jessica and her owner had the same white blood cell count. What are the odds of this happening? Do people and pets share the same disease, even if it’s not infectious? In this case, it turned out they did. Both the client and Jessica had lymphocytic leukemia.

So why do pets mirror humans? Often, our dis-ease does not come from a parasite or the food we eat, but the space and environment we share. This shared environment includes everything from the water we drink, to the air we breathe, to the energy in the spaces around us. Humans who are under an unbearable amount of stress, whether self-induced or from sources beyond their control, can pass this energy to their pets.

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SHARED ENERGY AND A PATH FORWARD I propose that this theory of energy connection is the foundation of zoobiquity. The connection we share with one another and our pets has not been formally studied in this realm, but the pandemic has given us an avenue to see how our stressors (energy) affect ourselves and others (pets.) At no other time have we treated so many sick patients.

Let’s examine this concept through the common phrase, “when it rains it pours.” An unexpected negative incident happens in your life. You may then catch a cold, for example; then it seems your cat gets sick, and subsequently your son as well. Why does this happen all at once? Many believe in the Law of Attraction, which states that energy attracts more of the same kind of energy. Atoms are bouncing all over the place, constantly in motion, generating chemical reactions on the smallest of levels. This energy cumulatively affects all living beings — people, dogs, cats, horses and wildlife. The energy that affects humans affects animals too. I think it’s pertinent for us to start thinking on the “energy level” to better understand this connection and help unlock dis-ease.

Our pets and children are our greatest teachers. They reflect back to us what we need to work on. Have you ever had your dog or child incessantly bark or talk at you while you were on the phone? They want you to be present with them; and perhaps they know better than we do what is healthful for us. I challenge you to pay attention and look for this energy connection in your patients and clients. If you recognize it, I encourage you to recommend that the client see a medical professional to get help for their own dis-ease or stress. I believe this is an area we need to focus on in order to understand dis-ease more fully; our energy and the energies that surround us can contribute to dis-ease or well-being in ourselves and our pets.

*Natterson-Horowitz B, Bowers, K. Zoobiquity: The astonishing connection between human and animal health. A.A. Knopf; 2012.

SICKER PETS DURING THE PANDEMIC Back in March 2020, while many of us were closed to preventative exams, we were seeing more sick pets than ever. Some ER vets have told me that they saw more blocked cats than ever before during that period. Let’s think about this. We know blocked cats, or those diagnosed with FLUTD, have experienced an underlying “stressor” causing inflammation in the bladder, and sometimes urinary plugs or stones. When the pandemic struck, the world shut down and people stayed home. Not only did many cats experience the dramatic change of having their owners home all the time, but perhaps those owners were very stressed themselves. The pandemic caused many unknown variables to surface in the lives of people around the world. Our collective and individual anxieties rose dramatically. This energy affected us, and it affected our pets. On an atomic level, our energy affects others whether you are aware of it or not. Remember learning about x-rays? When we take an x-ray, we produce pictures by stimulating ions through radiation. In large doses, this radiation (energy) kills cells. Our energy or our clients’ energy, though emitted in micro-doses when compared to radiation, does the same thing. This is how mirroring happens. Our dis-ease is just the start of zoobiquity, an understanding of our shared vulnerabilities.

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How much a dog can bite off and chew:

the state of chew safety and efficacy This article is a pre-publication preview of a recentlycompleted seminal study. The objective was to assess chew safety and efficacy, while progressing chew safety/efficacy science.

As a trusted veterinarian, you advise clients on the healthiest dog diets, best treats, and safest chews. However, it can be extremely difficult to sift through available information to provide your clients with knowledgeable guidance. That’s why we conducted this study. Chewing is essential to dogs, and they benefit from it in a variety of ways. It enhances oral health and satisfies psychological needs. Many chew packages claim high digestibility and longevity, which implies they are safe for dogs to consume over an extended period. Yet many dogs suffer from severe gastrointestinal obstructions due to chews. They also

BY TAVOR WHITE

experience lesions or lacerations to their gums, mouths, or digestive tracts from chews that break into sharp shards upon mastication. And chews often do not last all that long. The study evaluated 32 dog chews across ten categories, five safety metrics, and two durability measures. Tests included in vitro canine digestive studies (Figure 1). Unfortunately, we found that only one commercial chew we tested (3.13%) can be considered safe. This product is not durable. Eighteen chews we tested (56.25%) claim high digestibility on their packages, yet none exhibited this consistently. Two new chews to the market (commercialization Q2 2022) claim “Highly Digestible Degradability” and they tested that way (Figure 2). Sixteen chews in the study claim “LongLasting” on their packages. Just four

Figure 1: Example In Vitro Canine Digestive Tests

(25%) were found to be durable, and only two of those were also found to be safe. These two were the products to be commercialized in 2022. In other words, many commercial dog chews are unsafe and falsify packaging claims. The study debunked a few myths: • Soft chews are safer: Not necessarily. Although they may pose a reduced lesion/ laceration risk, they can be extremely undigestible, presenting a heightened GI obstruction risk. • It is OK to throw your dog a bone: No, it is not. Bones are some of the least digestible and unsafe chews available, highly prone to fracturing into sharp shards. • Hard cheese chews are safe because they are natural: No, they are not. They are extremely undigestible, are prone to fragment into sharp shards, and can even expand in a dog’s digestive tract. • Dental chews are safe: Not necessarily. Some were found to be quite undigestible. Disclosure: The author of this publication developed DigestaBone™ — an all-natural, safe, and durable dog chew supporting digestive health, and has a financial interest in True Health Enterprises, LLC (DBA Chews Happiness®, chewshappiness.com, info@chewsafetyinstitute.org),

Figure 2: % Digestible Degradability By Chew Category* (based on 32 chews tested)

Tavor White holds a B.S. and M.S. in Chemical Engineering with a specialty in Applied Chemistry and Materials Science, as well as an MBA, all from Columbia University in NYC. He has over two decades of experience working in R&D and has conducted extensive research in materials science, surface chemistry, and in vitro canine digestive studies. Tavor started studying dog chew safety when his first dog experienced an almost fatal GI obstruction. For the past eight years, he has been researching dog chew safety and efficacy, and has conducted hundreds of tests on experimental and commercial dog chews.

*Higher is better. Low Digestible Degradability means a chew presents a significant digestive obstruction risk.

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THE POWER OF

How dog cancer treatments affect human chemotherapy. BY SUNGWON LIM, PHD

The veterinary cancer market has historically lagged behind the human market. Until recently, for example, almost all the drugs used for canine cancers were those approved for use in human patients. At the moment, there are only four dog-specific cancer drugs approved or conditionally approved, and several others in development. Interestingly, however, the animal cancer market has begun to influence the human cancer market, instead of the other way round.

HOW DO THE VETERINARY AND HUMAN CANCER MARKETS DIFFER? Access to treatment Cancer is, unfortunately, a common disease; in the U.S. alone, 1.8 million people are diagnosed with cancer every year. It is even more prevalent among our furry companions.1 Twelve million pets are diagnosed with cancer each year — about six million dogs and six million cats.2 While cancer is a serious diagnosis for people, we have more access to treatment than our dogs and cats do; there are more hospitals and oncologists, and insurance covers more treatments for humans. While the animal cancer market is growing rapidly, there are a limited number of doctors and treatments for the much larger number of patients. As of 2020, there were only 462 pet oncologists in the U.S. and around 250 specialty hospitals for animals. 3 Although the number of animal owners purchasing pet insurance increases annually, people still tend to pay out of pocket for treatments.

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Regulations The regulatory situation is also different for the veterinary cancer market than it is for humans.4 Although the FDA regulates drugs for animals through its veterinary arm, the Center for Veterinary Medicine (CVM), it doesn’t regulate vaccines for animal diseases. Veterinary biologics, including animal vaccines, are regulated by the U.S. Department of Agriculture (USDA). Human medical devices always require the FDA’s approval, but animal devices do not have to be approved by FDA to go to market. However, the FDA monitors and regulates misbranded or misused devices. Reference lab services for animals that involve sending and receiving clinical sample collection kits, and require patient information from veterinary clinics, are considered animal devices, and therefore bypass FDA or USDA regulatory pathways. Also, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and


HOW HAS

comparative oncology

HELPED DOGS AND HUMANS?

Information from veterinary oncology has already been used to help at least one human cancer patient. Emily Brown, who was diagnosed with terminal bone cancer at the age of 11, was given three months to live.6 Her therapy was a drug that had been used to treat bone cancer in dogs. Brown’s doctor worked with Colorado State University’s Dr. Stephen Withrow, founder of the Flint Animal Cancer Center.7 Although the drug was not yet approved by the FDA for use in humans, she was offered the drug on a compassionate care basis. Now in her 30s, Brown believes the drug saved her life. The reverse has also happened, as drugs intended for humans move over to the veterinary market. The drug Tanovea was originally developed for treating lymphoma in humans, but its manufacturer, Gilead, decided not to pursue human trials of the drug.8 It was later developed for use in dogs, who were better able to withstand the drug’s toxicity.

the Clinical Laboratory Improvement Amendments (CLIA) don’t apply to animals. In general, this implies that veterinary researchers can move more quickly with a larger patient population and shared data than their human medical counterparts, who need to move through layers of regulation to obtain FDA approval for medical products. This speed in veterinary oncology research can benefit both veterinary science and human cancer research.

WHAT IS COMPARATIVE ONCOLOGY AND HOW CAN IT HELP BOTH DOGS AND PEOPLE? There has long been a relationship between researchers studying animal cancer and those studying human cancer. Comparative oncology is the study of naturally-occurring cancer in animals and how it compares to humans, so that treatments and cures that benefit both can be developed. The National Cancer Institute’s Center for


Cancer Research has been running the Comparative Oncology Program since 2003. 5 Take the example of a dog who gets sick with cancer. The dog is similar to his human owner in many ways — he lives in the same home and is exposed to the same carcinogens. The cancers that affect dogs are the exact same ones people get, and for good reason; dogs share more than 80% of our genome (cats share 90%). But there is also a striking difference in the way dogs get sick with cancer; their cancers progress much more quickly, for example. On the positive side, dogs are much more tolerant of the toxicity of chemotherapy treatments than humans are; most breeds don’t lose their hair and they don’t get as sick with other side effect as humans do. Most importantly, dogs tend to respond quickly when they’re given treatments that work for them. A dog’s fast response to chemotherapy is great for the patient, and also beneficial for researchers in the field of comparative oncology. As mentioned above, animal patient data is not regulated by HIPAA’s privacy rules. Therefore, an extensive amount of data can be collected under a consent form signed by the owners. As a result, the data from veterinary patients can be used to inform human cancer treatments. In addition to

the less restrictive regulations around veterinary oncology, the significantly accelerated speed of collecting drug responses is something both veterinary researchers and their human counterparts can benefit from. In many ways, veterinary patient data can be more helpful to a researcher than drug trials on a lab mouse. Laboratory animals are born and live in specific conditions — their immune systems are artificially suppressed, and human cancer cells are injected into an easily measurable site rather than the tissue the cancer cells originated from. Conversely, data from the treatment of dogs with cancer is invaluable to improving human cancer care because dogs live with humans at home, their cancers are naturallyoccurring, the treatment courses are relatively short, and they’re living their natural lives — they aren’t test subjects in labs. Comparative oncology is a boon for both human and animal medicine — dogs and humans will eventually develop drug resistance to chemotherapies, so the more drugs on the market for both groups, the better. By working together, researchers can make use of drugs like Tanovea (see sidebar on page 27) that don’t work well for humans but work for animals, and vice versa.

1

Cancer statistics. National Cancer Institute. https://www.cancer.gov/about-cancer/understanding/ statistics#:~:text=Statistics%20at%20a%20Glance%3A%20The,will%20die%20from%20the%20disease. Accessed October 13, 2021.

6

Quick pet cancer facts and questions. Facts. https://fetchacure.org/resource-library/facts/. Published November 29, 2017. Accessed October 13, 2021.

7

2

Veterinary specialists 2020. American Veterinary Medical Association. https://www.avma.org/resources-tools/ reports-statistics/veterinary-specialists-2020. Accessed October 13, 2021. 3

What FDA does and does not regulate. U.S. Food and Drug Administration. https://www.fda.gov/animalveterinary/animal-health-literacy/what-fda-does-and-does-not-regulate. Accessed October 13, 2021. 4

Comparative oncology program | center for cancer research. Comparative Oncology Program. https://ccr.cancer. gov/comparative-oncology-program. Accessed October 13, 2021. 5

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Dunn L. Genetic similarities between dogs and people are helping cancer research. NBC. https://www.nbcnews. com/health/cancer/genetic-similarities-between-dogs-people-are-helping-cancer-research-n841556. Published February 10, 2018. Guiden M. Awareness builds for what we can learn by studying animal cancers. Source.. https://source. colostate.edu/awareness-builds-for-what-we-can-learn-by-studying-animal-cancers/. Published July 27, 2017. Accessed October 13, 2021. Guiden, M. CSU veterinarians help bring groundbreaking cancer drug to market. Source. https://source. colostate.edu/colorado-state-university-veterinarians-help-bring-groundbreaking-cancer-drug-market/. Published January 4 2017. Accessed October 13 2021. 8



From the NASC

Demand for animal

immune health supplements is strong

Ask these 5 important questions when selecting quality animal supplements for your practice. BY BILL BOOKOUT

As we continue to navigate the

their animals. Offering these types

daily multivitamin supplement is

COVID-19 pandemic, we are finding

of products through your practice

one way to help bridge the gap and

that more and more consumers are

enables you to coordinate care and

provide essential micronutrients a pet

becoming interested in supporting their

make proper recommendations to

may be missing.

immune and gut health to help support

your clients, which may encompass

overall well-being. For many, this

complementary natural products

•A ntioxidant supplements — Free

means including supplements in their

in conjunction with mainstream

radicals are unstable molecules

regimen. A recent consumer survey

modalities. These may include:

produced by the body during normal

by Cargill found that immune support has become more important to 64%

metabolic and immune system • Daily multivitamin supplements

activity, as well as by external

of US consumers since the start of the

— Even if a dog or cat is being

factors such as dietary deficiencies,

pandemic, and 43% said they will take

fed a top quality pet food, it’s

ongoing stress or exposure to

an immune health supplement in the

likely he or she can benefit from a

environmental toxins. When too

next six months.

multivitamin supplement to help

many free radicals accumulate and

optimize nutrition. “Complete and

cannot be managed by the body’s

balanced” pet food means the food

own natural antioxidants, the result

has adequate macronutrients (fat,

is oxidative stress, which over time

PEOPLE WANT THE SAME FOR THEIR PETS

protein, fiber, moisture, fatty acids)

may account for the degenerative

Since we know that many pet owners

and other required micronutrients

changes associated with aging and

who feel they benefit from taking

(vitamins, minerals) to sustain life.

many related diseases. Antioxidants

supplements also want their pets to

But there’s so much more an animal

can play an important role in helping

experience the same advantages, you

can benefit from that goes beyond

neutralize the damaging effects of

can assume some of your clients will

adequate nutrition, and these missing

free radicals and their build-up, and

come to you with questions about

pieces are an absolute necessity when

support cellular health and normal

immune health supplements for

supporting health and wellness. A

cell function.

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IVC Winter 2021/2022


•D igestive support supplements —

you reach out to manufacturers for

The digestive tract is the largest

answers to the following questions

4 . Is the product labeled properly?

immune-supporting organ in the body

around quality, and how the products

If a product label or marketing materials

and home to the gut microbiome,

are made:

overtly claim — or even imply —the

a unique collection of bacteria and

product will treat, prevent, mitigate

crucial for digesting food, utilizing

1 . Who formulates the product?

nutrients, and shaping immune

Select products formulated by a

consumers. The label should also

health. We often only give thought

veterinarian or qualified professionals

have a lot number, which tells you the

to the harmful microbes that cause

with knowledge and expertise in pet

manufacturer likely complies with some

illness but it’s important to also

supplements, and with a solid track

type of quality standards requiring

remember and care for the beneficial

record of producing animal nutritional

product traceability.

microbes that keep a dog or cat’s GI

or health supplements.

other microorganisms (microbes)

tract healthy. Supplements such as

or cure any disease, the supplier is violating the law and misleading

5 . Does the product have the NASC Quality Seal?

probiotics may help support a healthy

2 . What quality standards does the company follow?

gut microbiome, which is essential to

It’s not enough for a company to say

verification are widely recognized as

overall wellness and maintaining a

they follow quality standards. They

the “gold standard” in the industry. The

strong immune system.

should specifically be following Good

NASC Quality Seal indicates a product

Manufacturing Practices (cGMPs)

comes from a responsible supplier that

modeled after the FDA’s cGMPs for

has passed a comprehensive third-

human dietary supplements as defined

party audit and maintains ongoing

in 21 CFR Part 111, and for animal

compliance with rigorous NASC

food defined in 21 CFR Part 507 of the

quality requirements.

digestive enzymes, prebiotics and

MAKING SURE YOU RECOMMEND QUALITY PRODUCTS As you evaluate supplements to recommend to your clients, we suggest

The NASC Quality Program and audit

Federal Food, Drug and Cosmetic Act.

3 . Is the product independently tested by an analytical lab? Independent testing consists of a third-party analytical

It is important to establish faith in the companies that supply pet supplements to your practice. Don’t be afraid to question manufacturers and suppliers until you find those who welcome your questions and are eager to gain your trust!

lab that tests a finished product purchased from the marketplace (not provided by the manufacturer) and verifies that the product meets label claims.

Bill Bookout is president and founder of the National Animal Supplement Council. He has more than 30 years’ experience in the animal health industry and holds a bachelor’s degree in physical sciences from the University of Wyoming, and a master’s degree from the Pepperdine University Presidents and Key Executives MBA program.

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Me dicine

Sustain ab ili

al

ty

rinary e t e He V n i rb

BY SUSAN LEOPOLD

Factoring sustainability into herbal medicine, whether we’re using it in veterinary practice or for our own well-being, is increasingly important to the health of our planet and its ecosystems. The well-being of the planet, and thus ecosystem resiliency, is deeply linked to the sustainability of herbal medicine and the preservation of cultural traditions. Using herbs in either a holistic veterinary practice or on a personal level elevates our awareness not only of what the plants can do for an ailment, but more importantly, what we can do for the plants and the planet. The interconnectedness of human, animal and planetary well-being is becoming more apparent than ever. The pathway of learning about herbal therapeutics and understanding how a plant grows, what part of the plant is used, where the plants are sourced and the challenges they are exposed to in the supply chain, brings about important questions to navigate. This article seeks to provide resources to help address those questions.

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SUPPORTING SUSTAINABLE SUPPLY CHAINS Conservation through cultivation is a path towards sustainability if a plant can be propagated easily. For example, in the 1980s, Paul Strauss developed his herbal Golden Salve to treat his farm animals and himself. The founder of Equinox Botanicals, Paul was instrumental in encouraging United Plant Savers (see sidebar on page 34) to establish a botanical sanctuary in Rutland, Ohio, because the land had an established population of goldenseal that spanned several acres. A wonderful movie, Sanctity of Sanctuary, tells the story of how Paul became a self-taught herbalist, farmer, and land steward.


Goldenseal is an iconic American medicinal plant with a long tradition of use among numerous tribes; it’s also part of the Eclectic Materia Medica. It can be propagated, but most of the goldenseal on the market today is wild harvested. United Plant Savers is working with farmers through the USDA Beginning Forest Farmer Coalition and the Plant Saver’s Forest Grown Verification program to support a more sustainable supply chain for this popular herb. Unfortunately, many at-risk plants cannot be easily propagated. The seeds may be difficult to germinate, or they may not propagate by cuttings, which means sustainable harvesting and management becomes critical to the plant’s survival. The United States has no governance on plants harvested for trade. Choosing a company that you trust and has transparent practices is vital.

WHY DOES BIODIVERSITY MATTER? We certainly want to be mindful of the conservation concerns surrounding the medicinal plants that go into the products we use, but why does the state of the world's biodiversity matter? In a recent Nature article entitled “Why deforestation and extinctions make a pandemic more

Databases for conservation status • NatureServe in the US manages a database of the conservation status of all plants. However, it is important to take into consideration that each state has limited resources and the data provided is often decades old. • The International Union for Conservation of Nature (IUCN) Red List is a global database of all species; that said, many medicinal plants have not been evaluated and the status is “unknown.” • The Kew Royal Botanic Gardens in the UK has recently started producing an annual report called The State of

the World's Plants, which is a great resource for upto-date information on plants.1 The very first report, published in 2016, stated that of 391,000 known plants, 17,810 have known medicinal uses. It also stated that a staggering 21% of all plants around the globe are threatened by extinction, primarily due to deforestation and land use changes. In fact, we are in what many scientists are calling the Earth’s sixth mass extinction. A mass extinction event is when species vanish faster than they are replaced. IVC Winter 2021/2022

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United Plant Savers —

CONSERVING NATIVE MEDICINAL PLANTS The International Herb Symposium (IHS) is an iconic bi-annual herbal gathering that has been taking place in New England for 30 years. Founded by herbalist Rosemary Gladstar, the symposium is where the seed of United Plant Savers sprouted in 1994, after she posed a pivotal question to the herbalists, seed collectors, growers, harvesters, formulators, herbal educators, and entrepreneurs gathered at the event: “Should we start raising awareness and protecting wild populations of native medicinal plants?” The answer was a resounding yes, so United Plant Savers was formed as a non-profit organization dedicated to native medicinal plant conservation, with the International Herb Symposium held as a fundraiser. The IHS brings people together from many diverse backgrounds and ways of working with plants. Learning from elders is at the heart of herbal traditions, and the heart of the symposium as well. The event is currently a virtual platform, launched in 2021 and continuing through 2022. The 2021 theme focused on how human health and the health of the planet are interconnected, with the keynote address delivered by Diana Beresford-Kroeger, a prolific author who has extensively studied forest volatile organic compounds. Featured online were Diana’s film, Call of the Forest, A Force for Nature, about the life of botanist Lucy Braun; and the classic Juliette of the Herbs, highlighting Juliette de Bairacli Levy, an herbalist specializing in holistic veterinary medicine, and one of the original IHS elders. United Plant Savers carries on the legacy of the Herbal Vet Track inspired by Juliette and nourished all these years by Rosemary Gladstar. Visit www.unitedplantsavers.org and join their email list to stay informed about plant conservation news and the International Herb Symposium.

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likely,” Jeff Tollefson cites a recent study that helps reveal why: “While some species are going extinct, those that tend to survive and thrive — rats and bats, for instance — are more likely to host potentially dangerous pathogens that can make the jump to humans.”2 On September 17, 2020, the IUCN posted a call to members that now is the time to form a Global Wildlife Health Authority: “The COVID-19 pandemic has revealed how vulnerable we are to emerging diseases, and exposed the lack of wildlife health oversight, surveillance and management across the world. Our disturbance of the natural world and growing human and domestic animal populations are increasing contact with wild species and novel emerging infections. To help prevent future emergence of novel pathogens and outbreaks of known zoonotic diseases, the global community should designate a global authority for wildlife diseases and strengthen capacities to monitor and manage disease risks, argue members of the IUCN SSC Wildlife Health Specialist Group.”3 The IUCN also released a statement about the COVID-19 pandemic on April 8, 2020, stating that land use change is a key driver of emerging zoonotic diseases.4 Deforestation rates have increased astronomically; in just the last 100 years, the world has lost as much forest as it did in the previous 9,000 years — that’s nearly one-third of the planet's forests, according to OurWorldinData.org.5 While it is difficult to grasp such numbers and concepts, what we do know is that trees are not only


Deforestation rates have increased astronomically; in just the last 100 years, the world has lost as much

From the AHVMA The mindful leader elevating the veterinary profession through innovation, education and advocacy of integrative medicine.

forest as it did in the previous 9,000 years — that’s nearly one-third of the planet's forests.

amazing at supporting biodiversity, providing oxygen, and cooling the planet, but they also produce forest volatile organic compounds that have numerous benefits to human and animal health. All the benefits provided by trees and plants, and how they sustain life on the planet, along with the interconnectedness of human health and ecosystem health, are becoming more apparent as the concept of One Health gains momentum.

T horn J and Kew Royal Botanic Gardens. Kew State of the World’s Plants 2016. January 2016. https://www. kew.org/science/state-of-the-worlds-plants-and-fungi.

1

T ollefson J. Why deforestation and extinctions make pandemics more likely. Nature. August, 7, 2020. https://www.nature.com/articles/d41586-020-02341-1.

2

I t is Time for a Global Wildlife Health Authority. International Union for Conservation of Nature. September 17, 2020. https://www.iucn.org/crossroads-blog/202009/it-time-a-global-wildlife-health-authority.

3

I UCN Statement on the COVID-19 Pandemic. International Union for Conservation of Nature. April 8, 2020. https://www.iucn.org/news/secretariat/202004/iucn-statement-covid-19-pandemic.

4

R itchie H, Roser M. Forests and deforestation. OurWorldInData.org. 2021. https://ourworldindata.org/ deforestation.

5

The AHVMA is holding their Annual Conference at the Palm Beach County Convention Center in West Palm Beach, Florida from September 10 to 13, 2022. The host hotel, the Hilton West Palm Beach, is conveniently connected to the Convention Center via a covered walkway, and is located in the heart of downtown, with plenty of shopping and dining available! The conference offers over 80 hours of lectures on topics ranging from integrative cancer treatments and herbal medicine to mindfulness and self-care. Not only will you be exposed to a wealth of knowledge; you will also acquire information on how to integrate these modalities into your practice. We encourage students from AVMA-accredited veterinary schools to attend these lectures as a way to broaden their education. We are already registering Associate Members for 2022 and receiving scholarship requests. If your company is interested in associate membership, exhibiting, or sponsorship, please contact office@ahvma.org. Thank you for your early commitment and support.

INTERIM EXECUTIVE DIRECTOR The AHVMA Board would like to inform readers that Dr. Charles Emely is no longer serving as Executive Director. We wish him the best in his future endeavors. We are pleased to welcome Lauana Paradine, whom many of you will know, as Interim Executive Director. We are grateful to have Lauana back in the AHVMA family and are excited to work with her. Her knowledge of our Association and its membership is invaluable as we look to the future.

Submitted by Melissa Kellagher

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FROM THE

AATCVM

The American Association of Traditional Chinese Veterinary Medicine (AATCVM) is a non-profit organization founded in 2006 to support practitioners of Traditional Chinese Veterinary Medicine (TCVM) and promote high quality research in all aspects of TCVM, including acupuncture, Chinese herbal medicine, Tui-na and food therapy. Members of AATCVM also enjoy dual membership with the World Association of Traditional Chinese Veterinary Medicine (WATCVM).

ACTIVITIES AND NEW MEMBERSHIP BENEFITS

CASE REPORT SUMMARY — FROM THE WATCVM NEWSLETTER

As a member of AATCVM/WATCVM, you will now have access to the complete, approximately 200-page Clinical Manual of Chinese Veterinary Herbal Medicine in an easy-touse, online format at watcvm.org. Other exciting new offerings include monthly case presentations by organization members from all over the world (in Zoom meeting format), as well as a program called IVM-GO (Integrative VetMed Grassroots Outreach). This locally-focused pet assistance program involves volunteer veterinary members of both AATCVM and WATCVM providing TCVM treatment to pets in shelters, rescues, and other non-profit organizations.

A four-month-old foal, previously treated with NSAIDs, presented to a referral clinic with intermittent fevers and lethargy. Abdominal and thoracic radiography revealed evidence of pneumonia, enlarged lymph nodes, and an intra-abdominal abscess. A transtracheal wash identified a Rhodococcus equi infection. Antibiotics were started, but 24 hours after hospitalization, severe watery diarrhea developed. The pneumonia improved but since the fevers and diarrhea persisted, along with severe depression, euthanasia was recommended.

Membership in AATCVM/WATCVM also provides a yearly subscription to the American Journal of TCVM, which publishes clinical research studies and continuing education articles. Upcoming articles feature a clinical research study on using TCVM with conventional medications to treat thunderstorm fear in dogs; and a study that compares the efficacy of trazodone to aqua-acupuncture when treating canine veterinary visit FAS (Fear, Anxiety, Stress). Additional articles include using Tui-na to treat cats, food therapy for a horse with Cushing’s disease, and a TCVM approach to equine diarrhea. Along with AJTCVM’s publishing activities, a new website (ajtcvm. org) featuring the journal’s extensive archives as well as current articles will become operational in 2022. The site will partner with online search engines, such as Google Scholar, to provide article abstracts with full downloads free to AATCVM/ WATCVM members.

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The foal’s owners requested TCVM therapy. The TCVM clinical exam diagnosed Spleen Qi Deficiency with Heat Toxin. Acupuncture (dry needle, aqua-AP) and herbal therapy (Mume Formula, 15g BID) focused on clearing Heat and tonifying Qi. After three days of treatment, the foal’s pulses were stronger, appetite improved, and he began to show interest in the surrounding environment. At ten days, the diarrhea resolved, and the foal was able to graze with his mother again. Over a three-month period of TCVM therapy and antibiotics, the foal continued to improve until finally all treatment was stopped. Submitted by Judith E Saik, DVM, DACVP, CVA, CVCH, CVFT


industryresearch

STUDY SHOWS THAT VETERINARIANS WITH GOALS ARE LESS BURNED OUT A study carried out over 2020 and 2021 revealed that veterinary professionals who have goals are significantly less burned out than those who don’t. Authored by Veterinary Integration Solutions (VIS) and Galaxy Vets, the Burnout and Work-Life Balance Study assessed burnout rates among veterinarians, while also looking at factors that influence employee satisfaction.

The benefits of having professional goals Among other factors, the study sought to determine whether goal-setting has a connection with burnout rate. The hypothesis was that veterinary professionals might be at higher risk of the under-challenge burnout subtype because of their high-achieving natures. Monotony, boredom, underutilization of skills, and lack of learning opportunities are some of the common contributors to this type of burnout. The study showed that veterinary practitioners who have professional goals are less likely to feel burned out. Compared to peers who don’t set and record goals annually, these vets report feeling happier and more valued. This finding suggests that goal-setting can be an effective tool for protecting the mental well-being

of veterinary professionals and employee retention. “It’s a practical takeaway that can be immediately instrumentalized by veterinary professionals and practice leaders,” says Dr. Ivan Zak, founder of IVS and CEO at Galaxy Vets, a veterinary healthcare system co-owned by its employees.

Other key findings

q The study also found that burnout rate has increased in all groups of veterinary professionals over the past two years, with 2021 showing a significant increase even over 2020. w Younger veterinary professionals under the age of 30 are the most burned-out group. e Veterinary technicians revealed the highest burnout levels among all roles. r Women report significantly higher burnout levels than men. t There is a direct correlation between caseload and burnout rate, and between work-life balance and burnout. y Respondents who indicated that their employers have a clear burnout prevention strategy revealed a significantly lower burnout rate than the rest.

Taking action “There is a need to expand our understanding of veterinary professionals’ mental well-being, and by recognizing individual differences, take a more targeted approach to burnout prevention,” says Dr. Zak. “Findings from this study will help us, and hopefully other veterinary practices, design a burnout prevention program that considers specific challenges different groups face, based on their age, gender identity, or role in the practice, and ultimately better tailor the work environment to their teams and needs,” adds Dr. Lauren Catenacci, Head of People and Culture at Galaxy Vets. “We are already building work-life balance and goalsetting features into the software that will be used by all employees — from the front-line staff to HQ executives.” Study participants were asked what kind of actions they would like their employers to take in order to help them improve work-life balance by setting better boundaries. Most respondents cited hiring more staff, mandatory days off and vacation days, reduced caseloads, limiting work hours, and making sure there are breaks during the day.

https://vetintegrations.com/insights/burnout2020/, https://vetintegrations.com/insights/burnout2021/ IVC Winter 2021/2022

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ADVERTORIAL

DENTAL CHEWS — WHAT TO RECOMMEND

BY JAN BELLOWS, DVM, Dipl. AVDC, ABVP (CANINE AND FELINE SPECIALTIES)

Many dental chews on store shelves are downright dangerous, potentially leading to esophageal or intestinal blockages, as well as fractured teeth. When recommending a dental chew for your clients’ dogs, consider the following. How readily will the dog gulp the chew? Gulping is especially common in Labradors and Golden Retrievers given rawhide chews, but it can occur in any dog with any chew. Dog treats that are swallowed whole, or in part, must degrade rapidly in the digestive system in order to prevent dangerous blockages. Companies concerned about blockages sell weight-appropriate chews, determined by examination of a dog’s caudal oral cavity compared to the dimensions of the chew (see photo). To deter gulping, the size of the caudal oral cavity is smaller than the chew. How fast will the chew dissolve? Dog chews that are swallowed whole or in

large pieces should be made to degrade rapidly in the canine digestive system. For example, some treats such as YummyCombs® include proprietary additives that promote solubility and digestion (Slick’M®). Water and digestive juices dissolve edible dental chews, but some chews are poorly soluble due to excessive compression in the manufacturing process, which doesn’t allow water to be absorbed. The result is a hard product that may lead to digestive blockage. Will the chew’s texture or hardness lead to tooth fractures? What the chew is made from is paramount to safety. Never recommend bones (even nylon), hoofs, antlers, or other chews with thick walls. Dogs love to chew on them but they can cause injury that exposes the carnasial’s dental pulp. Side with chews that have thin walls, that bend and have a non-abrasive texture.

Dr. Jan Bellows has authored five dental texts, is a frequent contributor to DVM Newsmagazine, and a charter consultant of Veterinary Information Network (VIN). He was also chosen as one of the dental experts to formulate AAHA’s Small Animal Dental Guidelines, published in 2005 and updated in 2013 and 2019. Dr. Bellows’ practice, ALL PETS DENTA,L is located in Weston Florida (dentalvet@aol.com).

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Further reading • Harvey CE, Shofer FS, Laster L. Correlation of diet, other chewing activities and periodontal disease in North American client-owned dogs. J Vet Dent 1996; 13:101-105. • Lage A, Lausen N, Tracy R, Allred E. Effect of chewing rawhide and cereal biscuit on removal of dental calculus in dogs. JAVMA 1990; 197:213-219. • Duke A. How a chewing device affects calculus build-up in dogs. Vet Med 1989; November:1110-1114. • Gorrel C. The role of a “dental hygiene chew” in maintaining periodontal health in dogs. J Vet Dent 1996; 13:31-34. • Gorrel C, Warrick J, Bierer TL. Effect of a new dental hygiene chew on periodontal health in dogs. J Vet Dent 1999; 16:77-81. • Johnson, RB. Recent dental advances for companion animals through dietary means, in Proceedings. TNAVC January 2002. Orlando, FL; 179-180. • Cox, ER, Lepine, AJ. Use of polyphosphates in canine diets to control tartar. J Dent Res 2002; 81:A349 (Abstr.). • Stookey GK, Warrick JM, Miller LL, Katz BP: Hexamethaphosphatecoated snack biscuits significantly reduce calculus formation in dogs J Vet Dent 12(1) 27-30, 1996.


innovativepractice

CREATING A CULTURE OF SUSTAINABILITY IN YOUR VETERINARY PRACTICE By taking steps to nurture a culture of career sustainability for both our peers and future veterinarians, we can create much-needed positive change in our profession.

The Vet’s Best Friend team at Boston Road Animal Hospital in Sutton, Massachusetts strives to create a culture of support.

BY CHERYL BROCKI, DVM

Like most veterinarians, I knew what I wanted to be from a very young age. Becoming a veterinarian was never just a job, but a chance to follow my lifelong passion of caring for pets. Practicing veterinary medicine has been amazing, exhausting, exciting, stressful, invigorating, and interesting. I can say with confidence that I wouldn’t change the path I have taken. I have also seen firsthand some of the harsh realities veterinarians face in hospitals on a daily basis. Since graduating from Ross University School of Veterinary Medicine, I have worked in many facets of general practice, primarily in the hospital setting, and held several positions including Associate Doctor, Chief of Staff, Medical Director, and most recently, Vice President of Veterinary Relations for a veterinary practice company, Vet’s Best Friend.

Fortunately, in my current role, I have an opportunity to create positive change in our profession. Since I am no longer practicing medicine in the traditional sense, I feel a great responsibility to use my experience and knowledge in the field to create a culture of career sustainability for my peers and future veterinary medicine candidates.

WHAT CAN WE DO BETTER? As we all know, veterinarians have an alarmingly high suicide rate. Vet school is demanding, to say the least, and anxiety is par for the course. I remember being a fresh Ross graduate, feeling proud to enter this profession but also scared, nervous, and oftentimes questioning my skills; other days I felt IVC Winter 2021/2022

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Things you can start doing differently now From a general practice perspective, I hope this gives you ideas and inspiration on how to lead your teams to career sustainability, and further, career fulfillment and a work environment they can truly enjoy. Here are some more practical tips, whether you operate a single location or many, whether you’re managing staff or just looking to inspire your coworkers.

1

Create healthy boundaries when it comes to clients. Guide your teams to strive for mutual client-caregiver respect, and foster an environment in which your team knows they are protected and supported.

2

Some days, all a team member needs is an ear — for someone to listen and understand. Look for ways to get ahead of problems and listen to your team for what changes they would like to see.

3

Talk about time off and CE often. Encourage doctors and teams to plan vacations and CE in advance so these activities are on their calendars. Taking planned time off is so important for well-being, especially now that our days are so busy. It is also important for teams to see their leadership take time off as well, so they know it is an accepted and welcome practice, and they can rest easy when away from their work.

4

Constantly brainstorm new ideas that can help your doctors and teams. Many great ideas come directly from the hospitals. Encourage an environment where everyone has a voice, and every voice is heard.

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unstoppable and ready to take on anything and everything that came my way. Inevitably though, a few years into the career, that excitement begins to wear off. The pride we take in doing what we do is still there, of course, but so are the looming realities of stressful interactions with clients, student debt payments (in 2020, the average veterinary student debt was $188,853, with some debt as high as $500,000 according to a 2020 AVMA survey), and other overwhelming struggles due to the burnout and exhaustion of being worked too hard, too fast. We also witness the toll the profession takes on our wonderful support teams and staff, causing burnout for them as well. Add in an unprecedented global pandemic, with clients sometimes on the brink of breakdown, plus a surge in adopted pets, and a normally already stressful day seems nearly impossible. It’s important to improve day-to-day support for veterinarians and their teams and show that a career in veterinary medicine can remain exciting and rewarding. One way to do that is to take away any external issues and stressors and remind teams of the reason they joined the industry to begin with.

PRIORITIZING WORK-LIFE BALANCE Promoting a sound work-life balance means implementing strategies to support physical and mental health. One way to do this is to prioritize more vacation and time off by hiring extra staff via referrals, adjusting operating hours, and utilizing relief services. Another option is to make it standard practice to not see patients from 12pm to 2pm daily. This gives staff the opportunity to recharge with lunch, go outside for some fresh air, and get caught up on appointments and paperwork.

Creating wellness initiatives to help teams manage stress These program ideas can be implemented to create a culture around employee wellness and job satisfaction: 1. Employee Assistance Program An Employee Assistance Program (EAP) is a voluntary, work-based program that offers free and confidential assessments,


short-term counseling, referrals, and follow-up services to all employees who have personal and/or workrelated problems. There are third party companies that offer EAP services to small businesses and their teams. 2. Yoga and fitness classes A veterinary technician at one of our practices offered to teach the team a weekly virtual yoga class, which included meditation and reflection. Yoga is a great way to relax and unwind after a busy day. Local gyms may also offer discounts on memberships, and you can make going to the gym a fun outing for staff, or take a class together.

It's important to improve day-to-day support for veterinarians and their teams and show that a career in veterinary medicine can remain exciting and rewarding. IVC Winter 2021/2022

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3. Mental health discussions (with CE credits) Stress is inevitable, and our teams need the tools to manage anxiety and take care of themselves outside the hospital setting. My current employer in particular offers mental health discussions across the country, with Dr. Kimberly PopeRobinson. We encourage practices to join us for these free events, in which Dr. Pope-Robinson speaks to her experience and stress working in a clinical setting, and ways we can support ourselves and each other to create healthy boundaries and habits.

4. Veterinary social work There are hundreds of Licensed Social Workers on https:// www.psychologytoday.com/us who can help individuals in the veterinary field. One such social worker in Massachusetts visits practice teams for group therapy sessions, and gives practical tips on how team members can look out for themselves and protect their mental well-being. Some of the tips include holding a weekly staff meeting to connect, watch out for each other, and celebrate successes. She also recommends debriefing after a difficult case or situation, to feel your emotions and not let things be left unsaid. Further, she recommends that teams should focus on what they did to help the pet, instead of focusing on the past or factors that are out of their control. Group sessions with a licensed therapist are a great way to “feel your feelings” and talk through challenging situations.

FOCUSING ON FLEXIBILITY AND AUTONOMY Another way to empower hospital leadership is to create work schedules that fit not only the needs of the practice and the community of clients, but also the employees’ lives. A huge stressor for me when I was seeing appointments daily was losing autonomy over my client schedule. This support is crucial so that employees feel supported in whatever they want to do, whether learning a demanding specialty like acupuncture, or pursuing a hobby they want to spend more time on in their personal lives. Allowing them the flexibility to structure their days around what works for the team creates the happier, healthier work environment we all strive for.

STARTING EARLY One of my passions is to mentor the next generation of veterinarians — vet med students. Along with giving pets great care, helping students is incredibly rewarding and can grow your practice and lead to career sustainability. Paid externs can observe and participate in many aspects of general practice, including surgery, medicine cases, client communication, conflict management, and leadership. We have the opportunity to learn a lot from students as they provide insight on how we can continue to focus on the needs of veterinarians and our teams in this ever-changing landscape of veterinary medicine.

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newstudy

Study to identify genetic risk factors for anal furunculosis in German Shepherds and Leonbergers

Anal furunculosis is a painful disease that affects certain dogs. It causes inflammation, ulceration, and the development of tunnel-like lesions that can extend from the anus into the rectum and colon. It’s common in German Shepherds and is also seen in Leonbergers. Although anal furunculosis has been recognized for decades, its genetic underpinnings remain elusive. But that might be about to change.

Details of the study

Morris Animal Foundation has awarded a grant to researchers at the Royal Veterinary College (RVC) in the UK to study anal furunculosis and identify the genetic risk factors behind its development. The grant is funded by the American German Shepherd Dog Charitable Foundation through Morris Animal Foundation’s Donor-Inspired Study program, which allows individual donors and foundations to directly support research topics for which they have a passion and there is a pressing need. Applications for this particular grant were reviewed and rated, based on impact and scientific rigor, by a Foundation scientific advisory board.

The team will sequence the whole genome from banked DNA samples of ten German Shepherds and three Leonbergers with anal furunculosis; and five German Shepherds and two Leonbergers without the disease. Other dogs will be recruited with Dr. Hall’s assistance.

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The grant’s recipients are Dr. Brian Catchpole, Professor of Companion Animal Immunology, and Dr. Lucy Davison, MRC Clinician Scientist Fellow and Professor of Veterinary Clinical Genetics at the RVC. Dr. Alison Hall, a Postgraduate Research Student and boarded veterinary internist and practitioner at the college, will be carrying out the research.

“We’re building on work our team has previously undertaken on another complex disease, diabetes in dogs,” says Dr. Davison. “We can pull in all these big data sets from different studies and use our computational resources to prioritize genes of interest. One thing that’s important, and that we’re doing in this study, is to ask why certain dogs don’t get the disease. There might be something protective in these dogs that we can mimic in at-risk dogs.”

Once the sequencing is completed, the team will compare their findings to data from other dog breeds without the condition. This approach will allow the researchers to identify the most important candidate genes associated with anal furunculosis as a first step toward prospectively identifying at-risk dogs, as well as new treatment targets. “What we learn from this work could also shed light on the immunological defects that lead to this perianal inflammation,” says Dr. Janet Patterson-Kane, Morris Animal Foundation’s Chief Scientific Officer. “A greater understanding of the immune response in these patients could have broader application to inflammatory conditions of German Shepherds and other breeds.” “Anal furunculosis is a significant welfare problem for affected dogs and their owners,” adds Dr. Catchpole. “Treatment is lifelong and expensive. We hope our findings can shed more light on this disease and perhaps lead to new insights on treatment and prevention.”

morrisanimalfoundation.org


ADVERTORIAL

WHAT SHOULD YOU KNOW ABOUT DENTAL MICROBIOLOGY? A better understanding of dental microbiology can help you halt the growth of tough pathogens in your patients’ mouths, resulting in better overall oral health. Ten-year-old West Highland Terrier with moderate gingivitis was given TEEF's Protektin42™ — (SMMRT)® for 14 days.

BY EMILY STEIN, PHD

Deep below the gumline, where no dental equipment or laser can reach, lives a complex community of bacteria and fungi, whose activities can either promote the health of their host or lead to tissue damage and destruction.1 How can you promote the health of your patients’ dental microbiology, and what determines a healthy outcome versus an eventual tooth extraction? As a microbiologist, having worked on environmental and healthcare-related microbial biofilms, I can attest to their durability, dynamism and complexity. It turns out that antibiotics, antiseptics, detergents, ozone, enzymes and physical scaling/planing only make a slight dent in affecting the subgingival biofilm.2 The secrets to biofilm management are much easier than killing the microbes. Rule number one — it is easier to influence the microbial strains that call the biofilm home. Rule number two — the easiest factor to influence is what these strains eat.3,4

PATHOGENS — they’re tougher than you think We are all taught about the pathogens, such as Porphyromonas

gingivalis, Treponema denticola, Catonella morbi, and others, that activate the innate immune system and wreak havoc on the periodontal ligament and the gingival tissue. These organisms have a diverse repertoire of defense mechanisms that make them difficult to effectively combat with ozone, antibiotics, antiseptics and enzymes.1 Surrounding the periodontal ligament, neurons, and blood vessels, they are too deep to be lasered or scraped away.

clinical success in humans and pets. Selective Microbial Metabolism Regulation Technology (SMMRT)® uses clinically-validated molecular nutrition to apply nutrient pressure to microbes in a biofilm — specifically designed to selectively favor the growth of beneficial microbes in the mouth and subgingiva, and halt pathogen growth and the production of pathogenic factors driven by sugar fermentation. The result is naturally-improved outcomes for better dental health.

The biggest side effect of these approaches is that the beneficial, health-promoting commensal microbes that also inhabit the subgingival biofilm are sidelined and unable to do their job of limiting pathogens, regulating healthy immunity, and helping maintain gingival integrity of their host.5-7

Emily Stein, Ph.D. founded Primal Health (TEEF for Life), which produces oral microbiome modulation products. She spent 14 years developing Selective Microbial Metabolism Regulation Technology (SMMRT™) at Primal Therapies, Inc. Prior to that, she was a research fellow at Stanford University in Rheumatology and Immunology. Emily holds a PhD in Microbiology from the University of California at Berkeley and received her B.S. in Microbiology and Immunology at the University of Iowa.

AN INNOVATIVE SOLUTION

3 https://www.cell.com/trends/microbiology/fulltext/S0966842X(17)30213-5?_returnURL=https%3A%2F%2Flinkinghub. elsevier.com%2Fretrieve%2Fpii%2FS0966842X17302135%3Fshow all%3Dtrue

https://mmbr.asm.org/content/78/3/510

1

https://www.sciencedirect.com/science/article/abs/pii/ S0753332217350990?via%3Dihub

2

https://onlinelibrary.wiley.com/doi/full/10.1111/jcpe.12679

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What can you do to help your clients? Believe it or not, the most effective approach is to affect what the dental biofilm can eat. We have been working on an approach for harmful biofilms for over 14 years with demonstrated

https://www.sciencedirect.com/science/article/abs/pii/ S0011853216301318?via%3Dihub

5

https://journals.sagepub.com/doi/10.1177/0022034517735295

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https://journals.sagepub.com/doi/10.1177/0022034517742139

7

For more information, visit

teefhealth.com

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industry innovations Vet-recommended Omega-3 softgels support patient immunity A healthy immune system is vital. NOW® Pets Immune Support boosts your patients’ immune systems and innate resistance to pathogens, and helps enhance liver and kidney function. This veterinarianformulated supplement provides nutrients from natural foodbased sources that are easy for the body to absorb, such as organic mushrooms, milk thistle, ashwagandha, selenium, turmeric, burdock root, licorice root, and red clover. nowfoods.com/pet-health

Health benefits of mushroom extract The Coriolus versicolor mushroom yields a range of beneficial properties. I’mYunity® contains the proprietary and standardized extract from this medicinal mushroom, and can be helpful for animal cancer patients. It is used to strengthen immunity, reduce pain, improve appetite and energy level, and reduce side effects from chemotherapy. A study conducted by Penn Vet found this compound lengthens survival time in dogs with cancer. buyimyunity.com

Orthotics for CCL tears Animal orthotics and prosthetics have developed tremendously over the last decade. The most common injury we see are CCL tears in dogs — when braced properly, a Stifle Orthosis will stabilize the CCL, LCL and MCL based on hinge stiffness, and limits rotation as well. Specialized Pet Solutions’ design offers a built-in Patellar bar to prevent forward motion of the tibia, and an Achilles relief channel for maximum comfort, mobility and long-term use. specializedpetsolutions.com

Probiotics that balance the oral biome One out of three pets suffers from gum health issues. ProBioraPet is a patented probiotic blend in a concentration formulated to address the oral care needs of dogs and cats. It restores natural balance to a pet’s mouth by going directly to the teeth and gums, crowding out the bad bacteria and increasing the good to support gum health and freshen breath. Just sprinkle it on food once a day. probiorahealth.com/product/probiorapet/

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Address chronic digestive issues Digestive issues in pets can be challenging to treat. AnimalBiome™ Veterinary Gut Restore Supplement for dogs and cats is a unique fecal microbiota transplant (FMT) in capsule form. It’s more powerful than probiotics and prescription diets, because seeding the gut with beneficial microbes helps restore it to a more balanced state. Addresses chronic health issues including diarrhea, vomiting, constipation, and itchy skin. animalbiome.vet


Supplements for whole pet wellness Canine and Feline Whole Body Support supplements from Standard Process® provide daily support of all body systems, with an emphasis on a healthy endocrine system. They provide an excellent nutritional foundation because they are made from whole food ingredients, organ and tissue extracts, botanicals, and other ingredients that can help fill nutritional gaps. Also, all Standard Process Veterinary Formulas™ are made using the same meticulous processes we use to create our human products. standardprocess.com/veterinary-formulas

A low-carb spread for dogs Dogs love peanut butter, but it’s high in carbs and Omega-6s, which are known to increase inflammation and chronic disease risk. Dogs should be powered by fat and protein instead of carbohydrates. Visionary Pet’s peanut butter alternative for dogs is high in healthy fats and proteins and very low in digestible carbs. This chicken and ghee spread is also highly palatable, so your canine patients will love it — it makes a healthy and delicious treat. visionarypet.com

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New cross-sectional study supports plant-based diets for cats Evolution Diet Pet Foods, a non-GMO, organic, grain-based vegan dog and cat food, was involved in a recent survey of 1,325 pet parents, which showed surprising results regarding plant-based diets for cats. The study, conducted by the University of Guelph Ontario Veterinary College and published in the BMC Veterinary Research Journal in early 2021, reported that more owners of cats fed plant-based diets believed their cat to be in very good health, and had less GI and hepatic disorders than those fed meat-based diets. No differences in reported lifespan were detected between diet types. Results of the dog portion of the study are still to be published. To read the study, visit bmcvetres.biomedcentral.com/articles/10.1186/s12917-021-02754-8

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Award for innovative MRI scanner Halllmarq Veterinary Imaging is the recipient of a Queen’s Award for Enterprise in the Innovation category, for its 1.5T high-field MRI scanner, developed specifically for the small animal veterinary market. The design includes a unique V-shaped bed and spine coil to aid spinal alignment and patient positioning. This innovation has the added benefit of improving image quality compared with a flat surface, typical in human machines. hallmarq.net

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TCVM

a model for sustainable medicine

Traditional Chinese Veterinary Medicine is a time-tested One Health paradigm that has been around for thousands of years.

BY JOSIE BEUG, DVM, CVA

According to the CDC, “One Health is a collaborative, multisectoral, and transdisciplinary approach — working at the local, regional, national, and global levels — with the goal of achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their shared environment.”* There is much talk these days of multidisciplinary approaches between human medicine, veterinary medicine, and a variety of other disciplines. I propose that we have a ready-made, time-tested, One Health paradigm that has been in our midst for thousands of years: Traditional Chinese Medicine/Veterinary Medicine (TCM/TCVM).

THE “ORIGINAL FUNCTIONAL MEDICINE” We are most familiar with TCVM through its best known treatment modality of acupuncture, but this approach to veterinary medicine is much more than that. Acupuncture is just part of a system of medicine, wellness, and lifestyle that aims to maintain balance and harmony within the body, and between the body and the external environment, including the social and physical environments. TCVM does not separate physical ailments from emotional, psychological or spiritual ailments, but sees them as interwoven pieces of a microcosm, which in turn is a reflection of the greater macrocosm of our ecosystem, climate, planet, and cosmos.

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In our modern world, we have the habit of taking a single element from another culture that looks promising or works really well, and leaving behind the background, philosophy, and cosmology of which it was a part. By doing so, we lose out on much of its potential. So let’s explore the philosophical system underlying acupuncture and TCM/TCVM — that of Taoism.

COSMOLOGY OF TAOISM TCM/TCVM is rooted in the philosophical cosmology of Taoism, which is based upon recognizing the interconnection between people, animals, plants, and their shared environment. The ancient Taoists developed their cosmology by witnessing and closely observing the natural world around them and the inner world of their bodies. They saw the body as a microcosm of the greater macrocosm, or universe, around it. The totality of the Universe was called the Tao. They divided it into two polarities, Yin and Yang, male and female, dark and light, which exist in a state of dynamic balance. The dance between these polarities creates the Five Elements, which are energetic processes whose interplay goes on to create material reality. The Taoists proposed that the universe works harmoniously according to “its own ways”, which they mapped out in a diagram of the Five Elements (see figure on next page). It


illustrates the interrelationships and cycles of creation, control, and destruction. In the creation cycle, each element nourishes and supports the following element. The Taoists recognized that there are limits to growth in nature, so they included a control cycle, where one element controls the next. If the creation cycle is reversed, it becomes the cycle of destruction, when things are completely out of harmony and balance, and when harmony is attempting to restore itself. The Five Elements maintain a state of dynamic balance between one another. If this balance is disrupted, disease results. The goal of the TCM/TCVM practitioner is to help the individual return to a state of harmony, both within and without.

History of Taoism Traditional Chinese Medicine has been intertwined with Taoism for millennia. Besides Ayurveda, it is the oldest medical system still in use throughout the recorded history of humankind. It has survived multiple dynasties across many centuries, coevolving alongside humanity.

The Five Elements act as a correspondence chart, a map of the interrelationships between aspects of the macrocosm and the microcosm. Everything, including the cycle of the seasons, the compass directions, the climate, hours of the day, the life cycles of living things (birth, growth, maturation, aging and death), the energetics of plants and herbs, and food energetics can be mapped out using the Five Elements (see chart on page 50).

TCM/TCVM has a historical record reaching back into the Shang dynasty (1766 to 1066 BCE). Documents from the time reveal that veterinary doctors were treating horses using TCM principles. Many of TCM’s most famous masters, including Sun Si Miao, “the king of medicine”; and Ge Hung, who originated first aid in TCM, were Taoist masters and alchemists.

TCM/TCVM does not separate the physical from the emotional, mental or spiritual. Emotions, tastes, colors, mental states, and even parts of the soul can be categorized according to the Five Elements. And of course, organ systems and body parts are included.

Taoism most likely developed from ancient Chinese shamanic practices. The early Taoists were very interested in cultivating longevity practices, with the elusive goal of achieving immortality. These masters developed both the theory of TCM and its treatment methods by closely observing processes occurring in the natural world around them, and how those processes affected the internal workings of the body. They believed if one lived one’s life in harmony with nature, one could live forever.

Another fascinating application of the Five Elements involves looking at constitutional types determined by the dominant element within an individual. All Five Elements exist within each

wood

fire

water

earth

metal The Five Elements

Ancient textbooks and herbal formulas from those ancient times are still in use today, illustrating their effectiveness over eons. The Yellow Emperor’s Classic of Medicine is one of the oldest medical texts still in existence. Some say it dates back to 2600 BC, while others report 300 BC; either way, it is ancient. It explains the Taoist interrelationships between humans, the environment, the cosmos, and how disease is related to imbalance and dis-harmony with the universal flow of the Five Elements. Shennong Ben Cao Jing, the first systematic summary of Chinese herbal medicine, was written between 200 and 250 CE and is still being used in modern Chinese hospitals. TCM’s long history, and the fact that many methods and herbal formulas are still being used today to heal humans and animals, is a testament to its strong foundations. IVC Winter 2021/2022

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The Five Elements Correspondence Charts

individual human or animal, but one is usually predominant, describing personality, likes and dislikes as well as disease predisposition and weaknesses. TCM/TCVM practitioners can treat the constitution of an individual, strengthening it and enriching the environment, thus reducing stress and the likelihood of future disease.

r Tai chi/qi gong: exercise t Tui-na: massage, bodywork y Feng shui: environmental placement u Astrology/cosmology i Meditation

TCM/TCVM offers eight different branches of treatment that illustrate its broad depth:

One can see how it is not just about treating disease, but about living a harmonious lifestyle with the inner world in a state of dynamic balance with the outer world, emphasizing health, wellness, and longevity.

q Herbalism: plants as medicine w Acupuncture e Food therapy: nutrition 50

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The correspondences of the Five Elements can guide us in formulating diets based upon the season of the year, the


individual’s constitution, and the organs that may be struggling. Herbal remedies can be selected based on the constitution or elemental imbalance present, often treating imbalances before they become overt disease. Lifestyle choices, such as types of exercise and social activities, can be made based upon the stage of life and the individual’s preferences. The effects of climatic factors on the body can be taken into account before they create disharmony and resulting illness. Even the colors of fruits, vegetables, and herbs in bloom can give us clues as to how to use these foods to bring the body into harmony with seasonal changes.

A BROADER PERSPECTIVE Western scientific thought has allowed us to zoom into the microscopic, molecular level of nature and its inhabitants. The materialistic reductionism of modern science is excellent at breaking things down into their component parts, all the way past the atom to electrons and subatomic particles. Yet it loses the perspective of the whole picture, of the forest and the planet, and our place in the universe. Interestingly enough, traditional indigenous populations, those still living close to the land and ecosystem they inhabit, know they are a part of a greater whole and are aware of the dynamic balance between all those parts. They map out their activities based on the cycles of nature, realizing their survival depends upon the survival of the world around them. In our information-overloaded modern times, we tend to gloss over history and theory, going straight for the practical method or result. By doing so, we miss the nuance and the wider applicability we might find if we took a wider perspective and looked at the forest instead of just the leaves on the trees. Traditional Chinese Medicine/Veterinary Medicine, with its foundation in Taoism, can allow us to zoom out and get a broader perspective of our place in the world. It has actually given us a map to follow of the energetic processes and interrelationships between the microcosm and macrocosm, and how to maintain a harmonious balance so all lifeforms may thrive on this beautiful planet we call Earth. ____________________________________________________ *One Health. Centers for Disease Control and Prevention. Updated September 30, 2021. https://www.cdc.gov/onehealth/ index.html. IVC Winter 2021/2022

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Veterinarians and

One Health BY DEBORAH THOMSON, DVM

How you can help inspire clients and your community to understand and value One Health.

One Health can be explained as both a concept and an approach. The concept refers to the interconnection between human health and the health of animals, plants, and their shared environment. The approach refers to collaboration between people of different disciplines, strengths, and backgrounds to prevent and alleviate health challenges. Wherever you are practicing veterinary medicine, you can share a One Health mindset. By communicating with clients, speaking about One Health during career day talks, or volunteering to teach One Health Lessons (more on this below), you can learn to speak with others about this topic in ways they can understand.

experience took place during Earth Day celebrations at an elementary and middle school (K-8). It was wonderful seeing the kids learn about One Health and start to care about it. By 2018, on my days off from the clinic, I was teaching regularly in elementary schools about leptospirosis and Lyme disease, using lessons I designed. I recruited students from the University of California-Berkeley as well as friends from Toastmasters to teach the lessons with me. Even though they lacked a teaching background, they loved it and wanted to teach more.

As a veterinarian, I wear that badge with pride at every meeting I attend, particularly those in which I give keynote speeches. I speak about why I chose to be a vet — “to help my patients, but to also help the people who are reliant on those animals”.

In January of 2020, I was working in Washington, DC as the AVMA’s Congressional Science and Engineering Policy Fellow in the office of Senator Dianne Feinstein. After the workday finished, I created additional One Health Lessons for both children and adults, with a focus on the COVID-19 pandemic. These lessons addressed where the virus likely originated, how students and their families could protect themselves today and in the future, vaccines (and why are they important), and mutations (and why it’s important to track them).

In 2016, I combined my two passions of veterinary medicine and teaching to bring One Health learning material and activities into communities in California. The first

These lessons became available for all in May, when www.OneHealthLessons.com was launched. At the time, the website offered seven age-appropriate lessons focused on

THE EVOLUTION OF ONE HEALTH LESSONS

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Left: One Health offers education and hope. Below: One Health Lesson being taught in a Peru classroom.

Lessons network, thanks to hundreds of volunteers around the world. In addition, the free Train-the-Trainer Program (also known as the Lesson Leaders Program) is in full swing, with approximately 100 certified volunteers now able to teach One Health topics in K-12 classrooms and at public events in their own communities around the world.

THE LESSON LEADERS PROGRAM The Lesson Leaders Program consists of four hours of training:

COVID-19. The lessons were (and still are) freely available for download, to teach either in person or online. After only one month, the lessons were being translated into over ten languages. Over 1½ years later, the COVID-19 lessons are being translated into 88 languages through the One Health

1 2 3 4

he first portion trains participants on how to T communicate One Health to both children and adults. rainees then watch a recorded lesson and pass a T pedagogy quiz. Next, they observe a live lesson being taught. he final segment involves teaching a class with an T experienced assistant.

With this well-established and successful system, adult volunteers (who must be at least 18 years old) are certified to


HOW YOU CAN GET INVOLVED •A ttend four hours of self-paced online training to become a Certified Lesson Leader. •B ecome a One Health Lessons Ambassador to train others how to teach the lessons.

Clockwise from top left: Young One Health learners participate in Nigeria.

•B ecome a translator (translate or proofread lesson translations).

Dr. Thomson teaches young students about zoonotic diseases.

•B ecome an intern (weekly meetings are involved with a weekly commitment of 10-25 hours) . •A ssist interns with finding volunteer translators to improve accessibility to lessons. •A ssist with fundraising efforts. •S ponsor an intern. •C onnect local virtual classrooms with Lesson Leaders. • I nspire your clinic’s management to host or sponsor a One Health community event such as those advertised on www.OneHealthLessons.com, particularly in celebration of One Health Awareness Month (January), Earth Day (April 22) and International One Health Day (November 3). •S ponsor a One Health webinar event. •S ponsor the development of a new One Health lesson. Such lessons could be about water-borne diseases, food-borne diseases, vector-borne diseases, environmental health, vaccines and much more. •E xpand the One Health Lessons’ network. •P articipate in global contests that support the One Health movement.

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Dr. Thomson leads a classroom discussion about vaccinations.

teach One Health lessons. So far, volunteers trained through the Lesson Leaders Program have taught virtually and at in-person classrooms (where safe and appropriate) in Canada, the United States, Mexico, Peru, Argentina, Basque Country, Portugal, the UK, Hungary, Turkey, Guinea-Bissau, Burkina Faso, Nigeria, Uganda, and Hong Kong. By teaching children in multiple countries virtually, a Lesson Leader comes to appreciate that our planet is quite small. It is common to see similar health problems around the world. However, the goal of One Health Lessons is to not only bring awareness but to improve the health of the world, for today and tomorrow. By serving as science role models and instilling a passion for One Health in younger generations, Lesson Leaders are helping to place the suffering planet into capable hands. I see children as stem cells — they can develop into anything, becoming teachers, politicians, veterinarians, ecologists and more. Wouldn’t it be nice if a politician had an innate knowledge of One Health since childhood? How would the world change if this was the case? It is time to act and inspire the next generation to see the world as one.

HOW CAN YOU HELP? If you’re interested in contributing to the global One Health movement, you can use these lessons to educate your clients and community as a Certified Lesson Leader. If you don’t have time to teach, consider sponsoring a One Health Lessons’ global event


From the VMAA or intern to help further the mission. Another option is to encourage your hospital to sponsor a community activity to increase One Health awareness. For example, a clinic-sponsored walkathon could raise proceeds for One Health-associated organizations such as One Health Lessons, the Wildlife Conservation Society, or The Jane Goodall Institute. There are many other ways to volunteer and contribute to the mission of One Health Lessons, inspiring children and adults around the world to value the interconnection between our health and the health of the environment, animals and plants. See sidebar on page 54 for a full list of ways to you can take part in this important mission. I often think about what my patients are exposed to in their environments. I also think about the people sharing the household with my patients. Would I prescribe a topical flea preventative for a dog when there’s a toddler in the home? Probably not. While speaking during career day events in local schools, I emphasize how a veterinarian can impact the lives of people. Some vets work with farm animals and protect a nation’s food supply. Others work with animals who are seen as family members by their clients. Some work toward developing vaccines and other medications where lab animals are needed, and still others help craft national or international policies to improve the health and well-being of both animals and people. With your veterinary degree, you have the power to improve countless lives — both today and in the future. If you are looking for inspiration, participating in the global One Health education movement can make a profound impact.

FOR MORE INFORMATION: www.OneHealthLessons.com

The Veterinary Medical Aromatherapy® Association (VMAA) is an organization of veterinarians and veterinary technicians dedicated to the responsible use of aromatherapy in animal practices. Their mission is to promote standards of excellence in animal aromatherapy, to provide outreach and education to veterinarians and auxiliary animal practices, and to promote continual improvements in Veterinary Medical Aromatherapy®. The VMAA is elevating the veterinary profession through innovation, education, and advocacy of integrative medicine.

HOW BAEOS AFFECT THE HUMANANIMAL BOND

Human energy patterns affect pets, and vice versa, a phenomenon substantiated by the concept of entanglement in quantum physics. Biologically Active Essential Oils or BAEOs (not oils of inferior or adulterated quality) carry their own quantum field and shift the energy or psycho-emotional patterns between biological entities. BAEOs are used in human psychotherapy to assist with unlocking memories and facilitating psycho-emotional healing.1,2 Olfaction lands firmly in the limbic system, the house of emotions and memory. Using BAEOs affects both the animal and the guardian, and subsequently the emotional health in the home, which is as essential to well-being as good nutrition.

CASE REPORT

A four-year-old spayed Pug named Angel presented for a third opinion for chronic anxiety. At home, the environment was very hostile and unpredictable. The client had already tried pharmaceuticals and many different CBD products. Chronic stress leads to a breakdown of homeostasis. The use of specific BAEOs that fit the pattern of the guardian’s behavior neutralized Angel’s stress. The BAEOs affected the human-animal bond entangled quantum fields and changed the overall behavior of all parties in the home. Affecting a change within the field is far more powerful than at physical or biochemical levels. The use of BAEOs is crucial to creating sustainable bonds and health, helping patients shift from simply surviving to thriving. Contact a VMAA member for guidance on safe and effective usage of essential oils in your practice — visit vmaa.vet.

@OneHealthLessons Babar A, Naser AA, Saiba S, et al. Essential oils used in aromatherapy: a systemic review. Asian Pacific Journal of Tropical Biomedicine. 2015; 5(8):601-611.

1

Rombolà L, Scuteri D, Watanabe C, et al. Role of 5-HT1A receptor in the anxiolytic-relaxant effects of bergamot essential oil in rodent. Int J Mol Sci. 2020;21(7):2597.

2

OneHealthLessons@gmail.com and LessonLeadersProgram@gmail.com

Submitted by Nancy Brandt, DVM IVC Winter 2021/2022

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inthenews

New Cornell department unites veterinary medicine and public health The Cornell University College of Veterinary Medicine recently launched its new Department of Public and Ecosystem Health. It’s the college’s sixth academic department, and its first new one in over 20 years. “This department unites the programs and activities at the College of Veterinary Medicine that already leverage a One Health approach, and will link interdisciplinary work that benefits the well-being of people, animals and the environment,” says Lorin D. Warnick, DVM, PhD, the Austin O. Hooey Dean of Veterinary Medicine. “This is an important step for Cornell in preparing the next generation of scientists to meet the complex health challenges that attend changes in climate, animal habitat and human behavior,” adds Provost Michael I. Kotlikoff, who served as dean of the College of Veterinary Medicine from 2007 to 2015. “This new department will provide a home for Cornell’s outstanding public health program.” The founding chair will be Dr. Alexander Travis, professor of reproductive biology and director of Cornell’s Master of Public Health Program. “It is an honor to help start this unique department,”

Dr. Alexander Travis, professor of reproductive biology and director of Cornell’s Master of Public Health Program, is founding chair of the new Department of Public and Ecosystem Health.

Dr. Travis says. “Most academic departments are organized around either a specific subject or a common disciplinary approach. Instead, we unite faculty from different professions and disciplines to work together to tackle some of the world’s most pressing challenges.”

Three themes These challenges are organized within three main themes: 1. Healthy food systems, encompassing everything from food production to consumption and associated nutritional and health impacts 2. Emerging health threats, grappling with topics such as novel infectious diseases, antimicrobial resistance and climate change 3. Biodiversity conservation, which is needed to preserve the systems on which all life depends. These challenges effectively boil down to two things — sustainability and equity. “Many of the worst problems plaguing us today stem from the unsustainable ways that humans interact with other species and the environment, and the inequitable ways that we interact with each other,” notes Dr. Travis,

adding that the ongoing COVID-19 pandemic demonstrates the need for a department to focus on these interconnected issues. In addition to emerging infectious diseases, the department’s three themes encompass a host of interconnected problems facing humanity. Climate change affects human health and food production, and increases the frequency of historic disasters, such as fires and floods that harm people and can drive wildlife to extinction. Poverty and discrimination affect people’s nutrition, environmental exposures, stress and more. And loss of biodiversity reduces humanity’s sources of food and medicine, making people more vulnerable to disease and reducing services, ranging from pollinating food crops to protecting people from storm damage or keeping air and water clean. “Cornell has experts who are the best in the world in their fields,” says Dr. Travis. “We plan to build on that excellence in research, teaching and practice through university-wide collaborations, so we can maximize our impact in New York State and beyond.”

https://news.cornell.edu/stories/2021/10/new-department-unites-veterinary-medicine-and-public-health

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How natural remedies promote healthy balance in animals A veterinarian’s insight on how natural remedies can enhance the health and well-being of dogs and cats. BY KRIS HANSEN, DVM

Like most of my colleagues, I have always been proud of the amount of schooling and knowledge it takes to be a veterinarian. We must have intimate knowledge of multiple body systems in multiple species. During one appointment, you wear your “dermatologist” hat; the next, it might be an “ophthalmologist” hat. It is in this diversity that a veterinarian finds interest as well as challenge. We are always looking for the best treatment options for our patients. A good practitioner always keeps an open mind and a willingness to learn.

AN INTRODUCTION TO NATURAL REMEDIES It was in this context that my eyes were opened 15 years ago to the benefits of natural remedies. During that time, I met Bob and Susan Goldstein, the founders of Earth Animal. We began with discussions on how natural remedies, in conjunction with traditional medicine, could benefit my patients. This led to Dr. Bob and I working together in an integrative approach to disease. We collaborated in addressing cancer, where the addition of natural remedies can lessen treatment side effects by boosting tissue protection and reducing pain and inflammation. We also worked together on diseases of all the major body systems — skin, gastrointestinal, and urinary to name a few. In case after case, I could see the positive benefits an integrative approach brought, both in desired outcomes and in lessening the impacts of traditional treatments.

THE PROOF IS IN THE PUDDING As time has passed, Dr. Bob has taught me the benefits of stand-alone remedies on the body systems of our furry

family members. For example, using remedies to boost the immune system serves to fight off disease from both outside invaders and from within. We have learned that 75% of the immune system lies in the gastrointestinal tract of all animals. Knowing this, the benefits of a natural, prophylactic GI remedy for gut health cannot be overstated. Recent studies show that a healthy gut has a positive impact not only on the immune system, but also on the mental status of our companion animals. Mental health has a huge impact on their quality of life, as it does ours, and it is important to keep that balance. Anxieties can be targeted and reduced by a multinatural approach. Combining remedies to improve gut health, boost immunity, and gently calm animals can have wonderfully positive impacts on their daily lives. There are natural remedies for all major body systems and diseases in animals. I personally continue to explore and learn about the many positive impacts these can have on the lives of our four-legged companions, and strongly encourage you to do your own research into their many health benefits. Dr. Kris Hansen earned his Bachelor’s degree from Hobart and William Smith in Geneva, NY where he majored in science. He received his DVM degree from Ross University, graduating with honors. In 2000, Dr. Hansen opened his own practice in Bridgeport, CT, where he is driven to deliver excellent medical and surgical services with both expertise and compassion. Since 2006, he has worked with Dr. Bob Goldstein, VMD, practicing integrative medicine with his patients and researching its benefits. IVC Winter 2021/2022

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BY KATE MEYERS, CVT

Family dynamics and pet health: creating a path towards sustainable bonds When contemplating the bond between humans and animals, we often think of providing affection, training, socialization, and daily general care. But at some point, we must stop and ask: “Is there something more? Is the pet truly happy? Or am I providing just enough?” I often talk with clients about surviving vs. thriving when it comes to the nutrition and food they give their pets. Can we apply this same philosophy to more than just diet? In the recent economic crisis, many pet owners have found themselves at a crossroads. How do we keep our dogs,

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Explore how you can help your patients thrive emotionally and physically amid the challenges and changes of living with humans.

cats, and other critters happy during difficult life changes? This doesn’t relate to just the pandemic, but with everyday obstacles we may face at any given time.

DO ANIMALS EXPERIENCE STRESS LIKE WE DO? Life stressors come in many shapes and forms. For people, it can mean a break-up, losing a job, moving, or a death in the family. But what about our animals? Are they affected by these changes? Do they experience emotional turmoil, stress, and grief? You bet they do. Not only do animals have


a keen ability to sense their surroundings as a whole, but they also have the ability to tap into our emotions and read the energy (whether positive or negative) we give off on a daily basis.1 Life stressors for pets could very well be the same as ours: • Moving • Adopting a new pet • Bringing home a new baby • Aging • Death of a family member • Death of another pet • Children moving out • Divorce • Separation from other pets • Military deployment of a family member • Natural disaster/evacuation • People returning to work (pets left home alone more) There’s no telling what scenarios we may find our families facing on any given day. While humans are aware of the general guidelines to follow when faced with changes such as bringing home a new baby, our pets have no idea what is going on. This causes them stress and uncertainty.

HELPING CLIENTS AND THEIR PETS DURING CHANGE AND HARDSHIP All too often, veterinary professionals and animal shelters see the forefront of hardship among people and their pets. At the top of the list is an inability to pay for care, and the surrender or euthanasia of an animal. 2 This frequently happens when the individual or family is facing a crisis. When speaking with clients about difficult life circumstances and their concerns, such as a pet’s behavioral problem, family finances, thoughts of surrendering an animal, or even the dreaded topic of euthanasia, we need to first step into their shoes and understand where they're coming from. • Do they have the support they need (i.e. family or friends)? •A re they educated on the topic at hand (i.e. a specific health issue)? IVC Winter 2021/2022

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Signs a pet may be stressed due to changing family dynamics Behavioral changes may be the biggest complaint we hear as veterinary professionals, aside from illness and injury. Changes in behavior are also the most obvious and more noticeable. They appear as anxiety, resource guarding, decreased grooming, inappropriate urination, biting, growling, hissing, fearfulness, destructive behaviors, hiding, aggression, etc. We may also see physiologic changes like increased cortisol and upset stomach/loose stools.4,5 For example, consider the following scenario. A cat is hiding a lot and urinating outside the litter box. Of course, we first need to rule out any potential medical conditions such as a UTI. But what happens if all tests are within normal limits? I get messages about this quite often. Owners are distraught that their cats’ bloodwork and urinalysis results are totally normal, yet they are still struggling with the “urinary” problem.5 Could we be missing something? Is the problem behavioral? Many pet owners don't feel comfortable about using behavioral medications for their pets. If so, what else can we offer them? How do we dig deeper to find a solution without much quantitative data at hand?

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•H ave they been struggling with finances? If so, why? What resources or help can we offer? • W hat do they need to feel (and be) successful? What recommendations or alternatives could we suggest? Coming from a place of empathy is of utmost importance when helping our clients and their pets. Sometimes, we may find ourselves in the mindset of “How do I help the animal?” when in many cases we should be asking: “How can I help the owner, so they can help their pet(s) in the best way possible?” My philosophy for the consultations I provide is to give owners the tools they need to help their pets live the healthiest lives possible (physically and emotionally). Simply put, education and support are key elements in developing sustainable human-animal bonds and well-rounded family dynamics. Just as we must adapt to life stressors, we must also help clients see their pets through the changes they are experiencing. Just because something has tipped their world upside down doesn’t mean we need to make it worse (like re-homing the animal). The truth is that dogs and cats thrive on routine, so when a part of their life goes haywire, you can expect to see some resistance. Stress not only impacts behavior and emotions, it also affects appetite, the microbiome, the immune system, inflammatory responses, digestive tract function, 3 and more (see sidebar at left for signs of stress in pets).

WHAT DO WE LOOK AT FIRST? Any time we see an animal come into the clinic, we automatically start running our brains to rule out potential causes of the presenting complaint, such as: • Is the animal in physical pain? • Does he have a UTI? • I s this a GI disorder, allergies or food intolerance? • W hat did the bloodwork say? • Could we do more tests? • Have we tried medication?

Cats may seem scared and hide in times of uncertainty and stress.

But one thing that is rarely addressed when discussing various behaviors (such as inappropriate urination, anxiety, hiding, growling, etc.) is the pet’s environment and routine, which sums up their emotional wellbeing. So we should also be asking:


Moving can be difficult for pets. Packing up the home may result in pacing or other changes in behavior.

• Has something changed? Is the animal stressed? •H ow can we improve the conversation to not only help the pet adapt to his ever-changing environment, but also help the owner adapt to her pet’s changing emotions, behaviors and overall needs? •H ow do we detect (or even prevent) the problem and begin the conversation with clients? • W hat else can we offer a pet owner besides ruling out medical conditions, prescribing medications, running more tests and so on?

VIEWING THE PROBLEM FROM A DIFFERENT ANGLE: CREATING SUSTAINABLE BONDS We may not want to pry into the lives of our clients, but since animals can’t talk, it’s essential. One thing I like to make certain of is that I do some diligent digging. Depending on the situation, we may come from a proactive or reactive standpoint. A proactive approach may be used for wellness visits with no major presenting complaints, such as annual check-ups or new pet appointments, where we can take the extra time to set the family up for success and give them important tools for down the road. Here are some questions to ask clients: •D o you expect any big changes in the next year (new job, moving, baby, etc.)? •H ow do you prepare your pet(s) for big events like holidays, birthdays, etc.? (Training is key!)

• How much time will you dedicate to training? • I s there a plan in place for where a pet will go if his elderly owner passes? (Remember, pets grieve like humans!) A reactive approach may be taken when a pet is presented with a problem the owner would like help with, such as those listed earlier. •H as anything changed since we last saw you (e.g. work schedule, family members, food/ supplements, house or living situation, even changing the type of litter used, etc.)? •H ave any stray animals or other family pets been visiting the yard or house? • Is the animal getting enough physical exercise? • I s enough mental stimulation and enrichment being provided? •D oes the pet feel threatened, cornered, or defensive on a regular basis (e.g. small kids bothering them, stress/ conflict with another pet in the house, no escape from noises/daily commotion, etc.)?

•H ave you considered extra training and planning before your new baby arrives?

• A re there enough clean litter boxes in the house?

•A re you prepared to handle your pet’s grief when your other animal passes from old age?

Remember, even the smallest shift in a pet’s environment and routine can turn his or her world upside down.

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DEVELOP A PLAN OF ACTION Always speak with clients in the manner that best suits their needs. Though we prefer to be proactive, we also need to be reactive at times and help remediate the problems that have developed. Take time to listen and ask open-ended questions such as “When did this all begin?” or “What has changed recently?” Puzzle toys are a great enrichment activity, regardless of breed or age.

1. Be proactive and think ahead It may be a difficult topic to bring up, but asking elderly clients if they have a plan in place for the care of their pets should they no longer be able to provide it can help them feel that their animals will be okay and in good hands. Families expecting a baby may benefit from recommendations of additional training and one-on-one support for bite prevention and child safety. Touch base with clients who you know are moving, expecting a baby, or may have family members leaving the home (kids going off to college, divorce, etc.). Help them understand that these are big changes not only for the family but for their pets as well. Recommend appropriate tools and resources to help the family navigate their new journey.

2. Offer education to new pet owners Talk to new pet owners about the essentials regarding their animals in order to avoid surrender

Top left: Dogs and cats should always be provided with a safe space, away from guests and kids. Bones and toys should never be within reach of children. Bottom left: Education for new pet owners is key to creating sustainable bonds, avoiding stress, and preventing surrender of the animal.

— e.g. decompression, potty training, socialization, and proper nutrition. 3. Inspire clients to provide enrichment Enrichment should be a part of every pet’s life. This is especially needed in times of stress and when behavioral issues or big life changes arise. 5 Puzzle toys, nose work, trick training, and interactive games are all great ways to enhance mental stimulation and bonding. I always

Other resources to utilize Our world has changed dramatically in recent decades. An explosion of resources is now at our fingertips, including the endless supply of internet forums, Facebook groups, YouTube videos, etc., plus fellow professionals who are ready and willing to help. Proactively provide clients with lists of reputable online resources and allied professionals. •P ET HEALTH COACHES AND CONSULTANTS

• NO-KILL SHELTERS OR SANCTUARIES

Sometimes, one-on-one support is the best option. If your clinic is unable to provide longer consultations with individualized care, consider growing your network by seeking out a coach or consultant specializing in various areas of health and education who you can refer clients to.

This is a great option to offer clients who are considering euthanasia for problems that can potentially be resolved with more time and resources. Let them know that the animal will go to a safe place and receive the care he or she needs.

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• FOSTER PROGRAMS

• TRAINING REFERRALS

Dogs On Deployment offers foster programs for military members who are deploying and in need of care for their pets (of all species!) until they return. This prevents surrendering the animals to shelters.

Always have local trainers available and ready to take your referrals. Growing a trustworthy team is important for a pet owner to be able to enjoy a long, healthy and successful bond with a furry companion.


encourage enrichment with clients who have children in the home, as kids can safely be involved with these activities.

4. Discuss appropriate nutrition Nutrition is the foundation of health. Providing high quality food is essential for not only physical (gut and brain) health but emotional and behavioral well-being as well.6 When animals are truly nourished and have proper gut health, certain behaviors such as anxiety and even destructiveness may be eliminated.

5. Talk about herbal and supplement support Many herbs, supplements, probiotics7 and homeopathic remedies can be very helpful for addressing a variety of concerns, such as grief, anxiety, fear, frequent diarrhea and much more.

6. Encourage crate or kennel training Crate or kennel training can eliminate and even prevent problematic behaviors. Always encourage clients to crate/kennel train pets of all ages (cats and dogs). This can come in handy in many circumstances, such as emergencies, injuries where strict rest is needed, stomach upset when kenneling is ideal, and when moving or welcoming home a new baby, during which the pet needs to be calm and out of the way.8

7. Address the environment Are pets in the home experiencing conflict in high traffic areas? Is the pet stressed by a new visitor, such as a stray cat outside the front window? Does the dog have a safe space away from the newly-crawling toddler? Do cats have enough clean litter boxes in different areas of the home?

8. Don’t assume the pet will figure it out We’ve all heard it before: “They'll figure it out.” This often happens when folks adopt a new pet, have kids, or move. They truly think the dog or cat will just sort out the problem on their own. Dogs and cats are clever and adaptive creatures. But with domestication comes the need for human assistance. Gently remind clients that by allowing pets to “figure it out on their own,” they risk their pets solving the problem in the only ways they know how. This could come in the form of growling or biting when a new pet or baby gets in their face. Pet owners must guide their animals with proper coping skills and training during times of change, and give them safe and healthy mechanisms for adapting. References available at IVCJournal.com

From the AVH The Academy of Veterinary Homeopathy is comprised of veterinarians who share a common desire to restore true health to their patients through the use of homeopathic treatment. Members of the Academy are dedicated to understanding and preserving the principles of Classical Homeopathy.

HOMEOPATHY, ONE HEALTH AND SUSTAINABILITY The idea of One Health and Sustainability can differ according to medical philosophy. The CDC presents an allopathic view, with a focus on zoonotic diseases such as rabies, influenza, brucellosis, anthrax, and viral hemorrhagic fevers like Ebola and Rift Valley Fever. Indeed, the CDC’s One Health office is located within the National Center for Emerging and Zoonotic Infectious Diseases in Atlanta, Georgia. Homeopathy offers a unique view of One Health. Both health and disease are understood as a dynamic continuum, originating in subtle life energies of the body (vital force). A balance of this energy equals harmony or health, while imbalance equals disease. Homeopathic medicine, agriculture, and environment/ecology are the three large areas involved in a holistic One Health approach. Jan Smuts first coined the word “holism” in 1926 (Holism and Evolution, available free at reflexus.org), although the ancient Greeks were also familiar with the idea. Reductionism, the opposite of holism, is the main philosophy today, and guides allopathic thinking and medicine. The body is reduced to individual parts, functioning separately, and treated by “specialists.” Holism sees the body as an entire functioning unit, which can’t be reduced to individual parts. Homeopathy addresses all symptoms of the body as the “totality of symptoms,” and treats this totality with a single remedy. Healthier humans and animals need less medicine, are less susceptible to illness, and are more resilient. Homeopathy is the best choice for any needed intervention for several reasons: • It’s easy to apply • It’s environmentally friendly/sustainable • It’s economical compared to drugs • It’s the most stable choice/conserves raw materials. Homeopathic medicines can neither contaminate the patient nor the environment, unlike the drugs now appearing in our water supplies (ground and surface), wildlife, and food sources. Homeopathy, organic agriculture, and responsible environmentalism combine to make a truly holistic union that’s much greater than each area individually. This is the true path to One Health and Sustainability.

Submitted by Todd Cooney, DVM, CVH IVC Winter 2021/2022

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From the VBMA

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

DID YOU GUESS LAST ISSUE’S MEDICINAL HERB? The narrowleaf evening primrose (Oenothera fruticosa) is similar to its cousin Oenothera biennis. Both species are common to North America and are considered weeds in the temperate zone. The root bark, leaf, flower, and seed all have medicinal indications. As is true for most plants, different aspects of the plant have different effects. The herb/root/flower have antidepressant, anti-inflammatory, antispasmodic, astringent, diuretic, and sedative pharmacological effects. The oil has antiinflammatory, hypocholesterolemic, and nutritive influences and is a vasodilator. Evening primrose is well known for its medicinal seed oil, but very few are familiar with the herb’s uses. It is effective for treating IBS/spastic colon; IBD with a mucus or bloody discharge; and diverticulitis or dysentery, especially with sallow, dirty-looking skin, a large, puffy tongue with a yellow-gray lingual coating, and a puffy, expressionless face (David Winston, two-year class). Evening primrose oil increases prostaglandin-1 synthesis and reduces production of inflammatory prostaglandins. It is beneficial for dry eyes and menopausal symptoms in humans. Research also indicates it can be a useful part of a protocol for inflammatory autoimmune diseases such as rheumatoid arthritis or Sjogren’s syndrome, as well as allergic conditions like atopic eczema and allergic asthma. It has also been found effective for treating canine atopy.

disease. He experienced periods of poor appetite with loose manure. Dried evening primrose herb (1 tsp twice a day) was added in with his Lyme formulas. He experienced a marked improvement in his appetite and manure consistency, which was attributed to the addition of herbal evening primrose.

VBMA EVENTS The VBMA’s professional sister organization, the ACVBM, is developing an advanced curriculum to integrate traditional uses of botanical medicines with the phytopharmacology of our herbal friends. The ACVBM’s virtual annual conference, which took place on October 9, 2021, featured a four-part lecture by Richard Mandelbaum, RH, who has been practicing as an herbalist since 1998. He has a background in both Chinese and Western herbal traditions, and a passion for our native, local plants. Richard spoke about the often disconnected threads of phytochemistry (plant chemistry, pharmacology, and herbal medicine), zoopharmacognosy (how animals in the wild use botanical remedies), and Gaia theory (the scientific theory that all life on Earth acts collectively, akin to a single organism). The lecture is available to purchase on demand at acvbm.org. Our next webinar will focus on grief, as these past two years have resulted in extraordinary stress and loss for many. Submitted by Cynthia Lankenau, DVM

GUESS THIS HERB!

CASE REPORTS • Ivory, a small, six-year-old, mixed breed dog with atopy, was placed on evening primrose oil. She has experienced new hair growth and is markedly less inflamed. • Red, a 34-year-old appendix quarter horse gelding, suffers from leaky gut and IBS associated with chronic Lyme

Join the VBMA at vbma.org to find out. The answer will also be published in the next issue of IVC Journal.

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newsbites WHICH STATES PAY VETS THE MOST — AND THE LEAST? A recent study released by Veterinarians.org has revealed the highest- and lowest-paying American states for veterinarians. The states were ranked using 2020 U.S. Bureau of Labor Statistics. Here are some highlights: •A rkansas is the highest-paying state for veterinarians in the US. Vets here earn an average salary that’s 146.7% higher than the state’s average salary across all occupations.

STUDY FOCUSES ON NASAL MICROBIOTA IN HORSES WITH EHV-1 While the majority of horses have been exposed to the Equine Herpes Virus, it doesn’t cause serous problems for most. Nevertheless, learning more about the disease is an important step towards successful management. Dr. Diego Gomez-Nieto, researcher at the Ontario Veterinary College at the University of Guelph, is part of a study on the EHV-1 virus that made a significant discovery about the nasal microbiota of infected horses as opposed to those of a healthy control group. The researchers found that nasal bacterial microbiota in healthy horses is richer and more diverse than previously reported using culture-based methodology. “We found…a myriad of different types of bacteria in the nasal cavity of the horse, and they are kept in a normal balance,” says Dr. Gomez-Nieto. “However, when there is a respiratory infection from a virus (like EHV-1), the normal balance of the nasal bacterial population is disrupted, allowing some pathogenic bacteria to proliferate and cause disease. One of those diseases is pneumonia. The results of our study helps to explain why and how pneumonia develops in horses after a viral infection of the respiratory tract. “We are learning more about the interaction between viruses and bacteria,” he adds. “Usually, the virus enters the respiratory system, produces inflammation and decreases the mechanisms of defense of the respiratory tract. When those mechanisms are not working anymore, pathogenic bacteria are able to colonize the respiratory tract.”

thehorseportal.ca/2021/11/ehv-1-research-study-andinfection-control-tips/

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•T he top ten list of highest-paying states also includes: South Carolina (140.5%), West Virginia (136.5%), Idaho, (135.2%), Texas, (133.8%), North Carolina (130.7%), Ohio (126.5%), Florida (125.3%), Oregon (116.0%), and Mississippi (115.4%). •A lmost half of the top ten states are also home to highly ranked veterinary schools, including North Carolina State University, Ohio State University, Texas A&M University, and the University of Florida. •W ashington is the lowest-paying state with an average salary of $102,080, only 52.7% higher than the average salary across all occupations in the same state. • The other nine lowest-paying states are: Colorado (57.6%), Minnesota (58.0%), Massachusetts (59.2%), Alaska, (61.9%), Oklahoma (67.2%), Nebraska (70.9%), Connecticut (71.6%), Montana (73.3%), and New Mexico (74.3%).

veterinarians.org/how-much-do-veterinarians-make/




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