Complementary Veterinary Medicine Newsletter

Complementary Veterinary Medicine Branch of the New Zealand Veterinary Association

Complementary Veterinary

Medicine newsletter March 2019 Special Interest Branch newsletter of the New Zealand Veterinary Association

Success Stories: CVMB & IVA Raw Food, Wholefood Will & Grace’s Health Conference in Sydney and Commercial Diets – Transformation 14 & 15 September 2019 Where’s the Evidence?

Complementary Veterinary Medicine Branch of the NZVA | December 2018

by Caitlin Mack Complementary Veterinary Medicine

Branch of the NZVA

Our mission

To provide educational opportunities and support vets, Liza Schneider: President as well as the public to make use of integrative medicine, Rose Unsworth: Secretary/Treasurer thus encouraging sustainable healthcare options and Viv Harris working towards a healthier planet. Rebecca Brown Wendy Dixon Jacqui Snell

Contact March 2019 newsletter President’s report Email: [email protected]

In this issue

Welcome to our first newsletter of 2019 which continues to outline the importance of Success Stories nutrition for health and well-being. There are many different pet foods available and it’s When going the extra mile easy to think that if they meet a certain standard, they’re all the same but let me assure makes a difference! you, this is far from the case. There are many aspects of nutrition to consider and many different types and when working in integrative veterinary practice it’s especially CVMB Member Perks obvious how diet impacts health and the powerful tool that we have at our disposal to help transform our patient’s health. Macronutrient Intake of Dogs, Self-Selecting diets varying in There are many buzz words like BARF, raw food, organic and others and it can be a composition offered Ad Libitum minefield working through theseh. For my patients, I encourage feeding a diet that is well-balanced, biologically appropriate (meat-based for cats and dogs), free of artificial chemicals and preservatives with good quality ingredients. The latter can be difficult to find with many foods listing meat meal or animal bye-products as their ingredients. For 2019 CVMB & IVA Conference many of my patients, clients elect to feed raw meat and when this is done correctly in Sydney with Dr Susan dogs and cats love their food and health may be transformed.

Armstrong Many of our veterinary colleagues are concerned about the risks of feeding raw meat. They are correct in that risks are present and it’s important that we educate our clients 2018 MCVT Conference to ensure that these risks are mitigated. It is up to us to outline the risks and benefits of any treatment plan and to ensure that common sense and science guide us in doing the best that we can for our patients and our clients. Having a sound working knowledge of Dr Barbara Fouqere nutrition is invaluable. Raw Food, Wholefood and Commercial Diets – Where’s the Our 2019 conference in September promises to be a fabulous event presented by Dr Evidence? Susan Armstrong. We’re looking forward to learning a lot more about integrative veterinary care and enjoying Cockatoo Island in Sydney.

W. Jean Dodds, DVM and Thank you to our contributors and advertisers, enjoy your read and don’t forget to book your place at our September conference! Adam J Lassin Reduce Inflammation, Improve Liza Schneider Detoxification, and Promote President of Complementary Veterinary Medicine Repair Branch of the New Zealand Veterinary Association

Rose’s Blog

Complementary Veterinary Medicine Branch of the NZVA | December 2018

Complementary Veterinary Medicine Branch of the New Zealand Veterinary Association

Success Stories When going the extra mile makes a difference! If you have a case that you would like to share please send it through, we would love to post it here.

Please note that in integrative veterinary practice, these types of successes are common-place and are often reliant on a multi-modal approach.

Dr Rebecca Brown BVSC Will and Grace

Will and Grace are Shih Tzu x Poodles, brother and Both Will and Grace showed marked improvements sister of 9 years of age. rapidly as we progressed to a maintenance novel protein raw diet. After 5 months they have fantastic They have had marked skin issues for their entire coats, excellent energy, minimal Malassezia on lives, with mostly unsatisfactory short-lasting cytology and no longer require Prednil. They are still responses to many approaches including those of skin having Cytopoint every 4-6 weeks and there is no specialists. At initial presentation, the most recent observed deterioration in between injections. medications were Iatraconazole, Clindamycin and Apoquel. They then moved backed to Prednil for Our approach is to feed a species appropriate raw diet some form of control. and optimise gastrointestinal health, which supports a healthy immune system and minimises inflammation. Their vet announced she had “nothing left on her shelf for them” and as she was so keen for them to trial a raw diet, she cooked for them herself to begin our cleansing protocol. True dedication!

Complementary Veterinary Medicine Branch of the NZVA | December 2018 Complementary Veterinary Medicine Branch of the New Zealand Veterinary Association

CVMB Member Perks – Please Spread the Word

Please encourage new members to help us grow a veterinary profession that values complementary therapies as an important part of animal health care so that we can help to improve patient outcomes, client and job satisfaction.

CVMB membership includes:

• Free student and new grad membership • Regular newsletter and info snippets showcasing successful outcomes with integrative care and information from internationally respected Integrative Vets • Access to our CVMB Member Resources Directory: where to resource complementary therapy products or access contact details of vets with specific skills to refer to or be listed! • Discounted attendance at our 2019 Conference in Sydney • Special member promotions from various businesses aligned with our values • Facebook discussion group • Alliance with the Massey Complementary Veterinary Therapies Group (MCVT) who host an annual vet student conference (known for the best goodie bags) and lunchtime talks often with FREE lunch! • Collegial support and learning • We aim to create a fear free environment for vets to express their ideas, share innovation and encourage open minded discussion • Complementary therapies are a growing trend. For improved patient outcomes, greater client and job satisfaction, join our SIB (Special Interest Branch) to learn more!

All of this for just $45 per year! FREE for students and new grads!

JOIN CVMB MEMBERS ON FACEBOOK

www.facebook.com/groups/260730070711007/

Complementary Veterinary Medicine Branch of the NZVA | December 2018 Complementary Veterinary Medicine Branch of the New Zealand Veterinary Association

Rose’s Blog

Our secretary / treasurer is a lady of many talents and has a number of interesting and invaluable insights to share.

I found a copy of a book by James Herriot while rummaging in an op shop the other day. For the princely sum of $2.25 I was handed, in mint condition the equivalent of the veterinary bible. For those of you not familiar with his works he was an alcoholic, depressive veterinary surgeon who single handedly inspired more vets to become vets while at the same time creating the equivalent of vet worship in the public. People who had no idea what a cows vagina was or whether male animals had genitalia were soon replete with so much information as to make them instant experts, and unlike Google they had to read a book to acquire this expertise.

There are no favourite bits to his books, they all press buttons and trigger memories and make you smile or shed a tear as you read.

I loathed his books when they were first published. Applications for places at veterinary schools exploded. Everyone had an opinion, or wanted to be a vet and as a student embarking on their career I felt very irritated by the wannabes. I was embracing every aspect of being a vet in the developmental stage and no matter what joys I felt, challenges I faced that damn man had been there before me.

Birthdays and Christmas resulted in my owning several copies of each and every one of his books. I finally deigned to read them and was hooked. He was living the dream and I was going to be part of it.

I worked with an older vet and as we went through the yards at the works I realised he was regaling the stock hands with tales straight out of James’s books but inserting the phrases and then I did or said this or that. He was improvising by stealing someone else’s life. But what a life that was.

It transformed him into a god amongst men. He’d never practiced as a farm vet but he had mastered the art of showmanship laced with extreme plagiarism.

As my career progressed I saw the end of so many aspects of vet practice and farming life. Small farms where every cow was called by her name, the farm kitchen with the Aga and a couple of lambs in the warming drawer, one on one treatments. No more mustard plasters over cows chests for pneumonia. Such is progress. Bigger and better, production at all costs. Daisy is now a production unit computerised and evaluated. Cost of vet and treatment digitalised and put onto a spreadsheet. Stay or go. Live or die. Sometimes a little difficult to get your head around that equation.

At the end Siegfried and James reflect on the changes they have seen. Is this the High Noon of Veterinary Practice they ask. But no it isn’t. They see a vision so bright of their future roles that you simply have to whoop along with them.

As a profession we need to continue to embrace change whilst still embodying all of those special characteristics and values that made us start out on this path and most importantly we need to help others share in our passions and keep all of us enthused and wanting to be part of James and

Complementary Veterinary Medicine Branch of the NZVA | December 2018 Complementary Veterinary Medicine Branch of the New Zealand Veterinary Association

Raw Food, Wholefood and Commercial Diets – Where’s the Evidence? Dr Barbara Fougere BSc BVMS (Hons), BHSc (Comp Med), MODT, MHSc (Herb Med), CVA (IVAS), CVBM, CVCP, CMAVA

Nutrition is an evolving science and it is now (especially when compared to dry food) and the established that diet is the most important influence absence of unnatural additives and by products on associated with processing which may be detrimental human health in Western societies. What we know to health. Phytochemicals and antioxidants are about human nutrition is that a ‘Western diet’ that recognised as beneficial by the pet food industry, with includes frequent consumption of processed and ‘fast many pet foods including them in formulations. foods’, promotes obesity, metabolic syndrome cardiovascular disease (2) and marked whole-body This generally agreed paradigm of what constitutes oxidative stress and endothelial dysfunction (3). On optimal nutrition by integrative veterinarians is in the other hand, evidence shows that a diet of direct contrast to recent statements issued by the minimally processed foods close to nature, American Veterinary Medical Association (AVMA) and predominantly plants, is decisively associated with the American Animal Hospital Association (AAHA). health promotion and disease prevention in humans. These bodies advise against feeding unprocessed Optimal eating is associated with increased life foods, citing human and pet safety and the risk of expectancy, dramatic reduction in lifetime risk of all nutritional imbalance as the key reasons. On the chronic disease and amelioration of gene expression whole, the veterinary profession is comfortable with (4). the research and regulation behind the pet food industry and that foods are formulated to be This growing awareness of the role of diet in health ‘complete and balanced’ as key reasons to and disease for people, coupled with several highly recommend processed foods. The general message is publicized pet food recalls over the past decade, has that feeding raw or home-made diets (or commercial led many pet owners and some veterinarians to equivalents) is dangerous at best. advocate home-prepared foods (raw, cooked or both). Integrative and holistic veterinarians have This controversy and strongly held position is based recommended raw or home-made diets (or their on the espoused evidence that commercial diets are commercial equivalents) as an optimal form of inherently safer and that raw nutrition for a long time. We frequently observe the food/wholefood/commercial equivalents are benefits of such diets for veterinary patients as a part inherently risky and that most people cannot provide of a treatment protocol and to promote health and a balanced diet by using them. It is true we do not wellness. know everything there is to know about all possible permutations of alternative feeding regimes. While it The benefits of wholefoods can include weight is important for veterinarians to appreciate the risks normalization, maintenance of lean body weight and and benefits of such diets, it is equally important to reduced inflammatory and degenerative disease. For examine our assumptions, especially about food example, signs of arthritis and reliance on non- safety. steroidal drugs are frequently abated on a wholefood diet which is anti-inflammatory and normalizes body Manufacturers of pet foods (including raw) in the weight. The underlying reasons why these diets are United States (US) are required to comply with considered to be beneficial multiple regulations to ensure safety. It is the purpose include high levels of antioxidants, phytochemicals of this article to review the evidence and concerns and bioavailable nutrition, lower calorie density around pet food safety comparing raw and homemade foods and processed pet foods.

Complementary Veterinary Medicine Branch of the NZVA | December 2018

Food Safety such as heavy metals in tuna and salmon fish foods, toxoplasmosis in raw meat etc plus other pathogens, Raw foods do impose a risk to humans and animals. as well as pesticide/herbicide contamination in fruit The US Food and Drug Administration (FDA) (5) and vegetables depending on source and quality of screened over 1000 samples of pet food including 196 ingredients. Most commercial pet foods are samples of commercially available raw dog and cat considered to be safe, but incidents of non-bacterial food and showed that raw pet food was more likely to contamination occur. There were 11 major pet food be contaminated with pathogens. Of the 196 raw pet recalls in the US between 1996 and 2010 that were food samples analysed, 15 were positive for due to chemical contaminants or misformulations: 3 Salmonella and 32 were positive for Listeria aflatoxin, 3 excess vitamin D3, 1 excess methionine, 3 monocytogenes. Of the remaining samples, only one inadequate thiamine 1 adulteration with melamine dry cat food (of 120) was positive for Salmonella. and related compounds and an additional 2 warnings While FDA and others (6, 7, 8) cite feeding raw meat concerning a Fanconi-like renal syndrome in dogs as a risk to public health and there have been isolated after ingesting case reports of illness in humans associated with large amounts of chicken jerky treat products (12). Of Salmonella in household pets (raw food was not the 586 reported cases of melamine- induced identified in these cases), there are no studies nephrotoxicity in 2007, 278 pets (171 cats and 107 conclusively documenting the risk to either pets or dogs) were reported to have died (13). Similar figures owners (9). More recently Imanishi et al (10) for raw or home-made feeding over the same period document an outbreak of salmonellosis in 53 humans could not be found. including children and 31 dogs in the US and Canada directly linked to dry dog foods. Sixteen brands In Austria, the occurrence of mycotoxins in involving 30000 tons of dry dog and cat food were commercial dog food was evaluated in 76 dry dog recalled. It is imperative that the risk of potential food samples from 27 producers. Mycotoxins contamination with Salmonella and other pathogens evaluated were: deoxynivalenol (DON), zearalenone and implications for human and pet safety are (ZEA), fumonisins (FUM), ochratoxin A (OTA) as well as discussed with clients in the context of raw feeding, aflatoxins (AF). AF were not detected in any sample although evidence shows the risk is also present with however the results show that dry dog food marketed processed pet foods. While more human outbreaks of in Vienna are frequently contaminated with Salmonella/bacterial contamination have been mycotoxins (DON 83%> ZEA 47% > FUM 42% > reported in kibble versus raw foods, the relative OTA5%) in low concentrations. The mycotoxin levels volume of sales/use of each needs to be considered. found in dry dog food were considered to be So if we hear of two incidents in raw products and 20 safe in respect to acute mycotoxicoses, however it incidents in kibble products, the incidence rate is was noted that repeated and long-time exposure of vastly lower in the kibble products due to the dogs to low levels of mycotoxins may pose a health prevalence of those products in the market (11). risk (14) and research on long-term effects of Another consideration is that until a few years ago, exposure have not been conducted. most raw food manufacturers were low volume, niche manufacturers. As such, fewer were likely to comply Another form of contamination can occur with protein with regulations or simply do the right thing when it antigens. A study assessed 12 canine dry limited- came to actively encouraging consumers to report antigen diets (11 novel-protein diets and one problems and to issue recalls, so adverse events may hydrolysed diet) for potential contamination by have been less likely to be reported. There are now ingredients of animal origin (avian, fish, mammalian) several commercial raw food diets that are subject to not mentioned on the label. Only two pet foods High Pressure Processing (HPP), a cold pasteurization contained ingredients that matched those listed on technique. This reduces bacterial counts significantly the label and the others were contaminated. This may with pressure instead of heat, making them possibly explain why dogs might fail to respond to commercial safer than foods that have not undergone HPP. limited-antigen diets (15). One of the benefits of a homemade diet is that all the ingredients are known. However, it is possible if the protein source has been fed on a particular food Other Contamination source (for example cattle on corn) and the patient is corn sensitive, that reactivity may still occur (16). There are very likely to be some contaminations in raw and home-made diets (aside from Salmonella), Complementary Veterinary Medicine Branch of the NZVA | April 2018

Nutritional Deficiencies reviews of compliance, monitoring animal health and dietary supplementation are usually necessary. In unbalanced homemade diets, there are isolated However, we also need to be concerned about case reports of nutritional diseases such as: seizures nutritional and severe nutrient deficiencies in a puppy fed a deficiencies in commercial pet food. They are not homemade diet consisting of ground beef, white rice, always complete and balanced. An analysis of raw apple, broccoli, chicken-based dry food, whole thiamine concentrations in commercial canned foods raw egg with shell and a dietary supplement (17); formulated for cats showed 12 of 90 products (13%) calcium deficiency in a dog fed an unbalanced were below the minimums for AAFCO and 14 of 90 homemade elimination diet, over many years and a (15.5%) were below the minimums for NRC. Thiamine puppy fed an unsupplemented deficiency should be considered as a differential in homemade diet (18); thiamine deficiency in a cat cats with neurologic dysfunction (29). In a case report, changed onto a homemade diet within two weeks of a cat was fed poorly stored dry food and developed a it being fed boiled anchovies and shrimp (high heat thiamine deficiency over three months (19). destroys thiamine) (19). Thiamine deficiencies associated with feeding raw fish, home-cooked food Processed Foods and Inflammation and meats preserved with sulphite have been previously reported in dogs and cats (19); In human health, the increased prevalence of hypervitaminosis A in a cat (20); feline pansteatitis impaired glucose tolerance and cardiovascular disease (21) and nutritional secondary hyperparathyroidism in (also known as metabolic syndrome) attributed to a litter of German shepherd puppies (22). Nutritional processed foods, can partly be explained by frequent osteodystrophy has been reported in two litters of 6- episodes of high-glucose levels caused by high week-old large-breed puppies fed a bones and raw glycemic foods. We can expect the glycemic index of food (BARF) diet from about three weeks of age (23). dry foods and possibly canned foods to be relatively high compared to a raw/cooked meat based diet. In A recent survey analysed the rations of BARF diets both dry and wet pet food manufacture, the structure given by pet owners in Germany. Typical ration of starch granules through the grounding of plant ingredients were meats, fish, offal, dairy products, particles (corn, wheat, rice etc) eggs, oil, nuts, cod liver oil plus natural and is destroyed, thus inducing higher susceptibility to α- commercial supplements. Nutrients were compared amylase degradation. Extrusion of dry foods allows to recommended allowances. 10% supplied less than starch granules to be completely gelatinized during a the recommended amount of calcium and Vitamin D short cooking time under high temperature/ high and 90% supplied adequate calcium. Half the rations pressure conditions; likewise, a similar effect on were low in iodine and many were starch occurs in canned foods through appertization low in zincd and copper and 25% of rations supplied (sterilization under high moisture/high temperature inadequate vitamin A. In all, 60 % of rations had some conditions), which also allows a high degree of starch form of imbalance (24). Clinically overt deficiencies cooking (30). Processed carbohydrate- were not observed in the study. Rich sources of containing foods can influence the rate of starch Vitamin D include fish, fish oils, egg yolk and poultry hydrolysis and the amount of ingested sk. Naturally high sources of calcium include fish meal, starch is directly shown to influence the postprandial algae, kelp, many leafy green vegetables, bone meal, glucose response in dogs (31). blood meal, eggshells and whole eggs and bone (25). BARF diet, if without bone, may require a calcium In response to the charge made against feeding dry supplement and animals should be monitored for foods resulting in high blood glucose levels, Hewson- vitamin D, calcium and phosphorus levels (25). Hughes et al (32) looked at the post-meal concentrations of plasma glucose and insulin in adult In a report that evaluated 200 homemade recipes cats (11) and dogs (9). Labrador retrievers were fed from texts, books and the web (64% written by vets), dry diets with low-starch (LS 9.5g/100g as fed), only five recipes met AAFCO (26) or NRC (27) moderate-starch (MS 23g/100g as fed) or high-starch requirements for a complete and balanced diet (28). (HS 31.7g/100g as fed) levels. Only the HS diet This is a concern for all veterinarians who have clients resulted in significant cost-meal increases in plasma feeding raw and homemade diets. A diet that is glucose concentration in cats and dogs. Plasma insulin complete and balanced over the course of a day or a was significantly elevated following the MS and HS week is important. We know unbalanced diets cause diet. In cats, plasma insulin was significantly greater problems. Careful supervision and appropriate after the HS diet. While this insulin increase does not

Complementary Veterinary Medicine Branch of the NZVA | April 2018 tell us anything about insulin resistance, the the study compared to their free-fed litter mates. carbohydrate content of contemporary North Diet-restricted dogs in this study had 7 and 32% lower American dry cat diets appears to be in the range of basal circulating glucose and insulin concentrations 4.5 to 12g/100 kcal (33) which equates to 18-48 (5.19 versus 5.59 mmol/L and 48.4 versus 70.8 g/100g approximately. Therefore, there are pet foods mmol/L compared to the free feeding dogs, on the market that fall into the ‘moderate’ and ‘high’ respectively). They showed high insulin sensitivity was starch category. This may be important for obese cats positively associated with low hazard of dying from, or where it has been calculated that every kilogram needing treatment for, chronic disease. This increase in body weight leads to a 15-30% increase in important study showed an improved healthy insulin resistance in cats (34). longevity for dogs and although the implications are circumstantial, optimum glucose tolerance and insulin Obesity is the most common nutritional disorder in response appear to be integrally involved in the cats and dogs and also one of the fastest growing health and longevity of dogs. They concluded that health problems (34). Obese dogs show changes in long-term control of food intake to minimize glucose and insulin that are correlated with the circulating glucose and enhance strategic insulin degree of obesity. For dogs with a degree of obesity response will improve the quality and increase the less than 40%, their insulin and glucose tolerance is quantity of the dog’s life. Likewise, weight loss can similar to normal dogs. In dogs with obesity levels decrease chronic inflammation in dogs (38). between 40-70%, hyperinsulinemia is present and in dogs exceeding 70% glucose, intolerance is also As most pet dogs in developed countries are fed seen (34). Metabolic syndrome is the term recently commercial diets (39) and obesity is prevalent, it is applied to dogs that exhibit signs similar to human important to acknowledge it is not just the metabolic syndrome. These include visceral obesity, carbohydrate content that is important, but the fat hypercholesterolaemia, hypertriglyceridemia, content too, with overall calorie density and ad hypertension and fasting hyperglycaemia. Obese dogs libitum feeding both significant contributing factors. are known to develop resistance to the glucose- One major factor in favour of a well-balanced lowering effects of insulin. They develop increased wholefood (raw, lightly cooked) diet is the lower circulating concentrations of triglycerides, cholesterol calorie density compared to dry food. We can benefit and blood pressure, but do not go on to develop type from this information when formulating home-made 2 diabetes, atherosclerosis, coronary heart disease diets, by considering the contribution of fats and and stroke. Therefore, it is suggested that the use of carbohydrates to calories and the form of the the term metabolic syndrome in dogs does not appear carbohydrate (whole versus ground). In general, to have merit (35). However, high glucose/sucrose integrative practitioners will recommend no or low levels promote oxidative stress and low-grade grain/carbohydrate (less than 25% of calories) diets. inflammation in dogs (3, 36). Perhaps we need to Fat content should be considered too. Glycemic index consider that metabolic syndrome represents low- can be lowered by consideration of the types of grade inflammation, a precursor to disease in vegetables used. Root vegetables are higher in starch companion animals. It may be that the metabolic than leafy green vegetables, for example. Vegetables influences of glucose are just as influential on health are an important part of raw/homemade diets but and disease in animals as in humans. also can benefit dogs fed on commercial diets. A combination of fruit and vegetables in a Calories are important. Research in 2003 by Larson et supplemented processed food fed to aged beagles al (37) on diet restriction indicated that improving was shown to increase selected flavonoids in the insulin sensitivity through restriction correlated with blood (40). In addition, a complex mixture of reduced risk for chronic disease in dogs. They antioxidants has been shown to slow cognitive decline highlighted the principle that diet restriction in in aged dogs as well as improving behaviour (41). mammals has consistently resulted in a reduction in Mixed colourful vegetables are an excellent source of circulating glucose and insulin and that that lifetime antioxidants, as is fresh meat. reduced levels of glucose and insulin may explain in part the delayed senescence observed in such studies. Processing By - Products The key diet change for the diet-restricted dogs (dry food diet) was limited calories and meals rather than Another factor in processed foods (and overcooked free access; and the proportions of energy reduction homemade foods) causing oxidative stress and consisted of 50% from carbohydrates and 25% each inflammation is the presence of certain food from protein and fat. Dogs were kept lean throughout components formed during heat treatment, so-called Complementary Veterinary Medicine Branch of the NZVA | April 2018

Maillard reaction products (MRPs). Heating food One of the principles of integrative and holistic induces the formation of MRPs by the reaction of medicine is individualization of treatment. Raw food reducing sugars with proteins or amino acids. More may be contraindicated in some households where notorious outcomes of the Maillard reaction in heat- animals (for example on high doses of prednisolone or treated processed food and overcooked home-made chemotherapy) or humans are immunocompromised. foods are 5-hydroxymethylfurfural and acrylamide, Cooking lightly can enhance palatability for some both potential carcinogens. Outcomes of the Maillard animals and can improve digestibility, especially for reaction include compounds also known as Advanced those patients with ‘Spleen Qi deficiency’, a reference Glycation End products (AGEs). These can also be to poor digestion characterised by loose stools and a formed in the body, especially when glucose levels are poor appetite. Cooking with aromatic spices reduces high, and they normally accumulate with age (42). It is cooking by well-recognised that MRPs including AGEs are products and increases the antioxidant potential of associated with pathophysiological conditions in meals. Lightly cooked home-made diets can be cooled humans including diabetes, renal and cardiovascular and frozen or refrigerated. Oils should only be added disease (43) and with inflammatory and age-related after cooking; olive oil and coconut oil are suitable for degenerative processes (44). cooking. Add supplements to daily meals rather than during or after cooking. Acrylamides have been studied intensively over the past decade. The research began when Dr Eden Handling raw foods can present a risk and FDA Tareke was studying acrylamide levels in wild animals provides appropriate guidelines for handling raw and domesticated pet. Unexpectedly high levels of the meats. Hand hygiene is the most important and we compound in pets were found to be attributable to should remind owners to wash their hands after consumption of highly processed food (45). handling raw meat. In addition, we should Considering what is known about the Maillard recommend frozen raw meats be thawed in the reaction and human health, it is surprising that it is refrigerator to minimize bacterial growth. unknown to what extent advanced MRPs are present in pet foods, and if dietary MRPs can be Nutritional adequacy of raw and home-prepared diets associated with the development of diseases such as is also of concern. Dietary variation is important diabetes and impaired renal function in pet animals’ where possible. A lean protein, vegetable-based diet (46). In human foods, MRPs ‘play a decisive role in the with additional supplementation for calcium, vitamin successful marketing of foods’ as flavor enhancers D (or chicken skin, egg yolks etc), organ meat, omega- (44). Perhaps even more concerning is that the 3 fatty acids and supplements that provide Maillard reaction is a frequently exploited palatability micronutrients is exceptionally good at restoring enhancer in pet foods as well. For example, in the health and reducing or resolving inflammation in manufacture of wet pet foods, sterilization guarantees patients. It is important to recommend a complex microbiological safety of products during their shelf wholefood supplement formulated to meet the life, and it has a ‘great influence on flavor micronutrient and macronutrient development (mainly through Maillard reactions)’ requirements commonly missing in a home-prepared (47). This author describes the palatability enhancer diet. This might include certain nuts, green foods and (PE1) as a complex mix of Maillard precursors (amino berries. Raw bones that are suitable for the size and acids and reducing sugars) together with other shape of the dog or cat are unsurpassed in the ingredients. Pettelot (47) describes a study which author’s experience for dental hygiene and behavioral used a wet pet food product containing 50% chunks enrichment, however owners must be warned about and 50% jelly. The PE1 the possible risks. The benefits on the whole outweigh was added to the jelly (2%, making 1% of the total these. weight) and the products were packaged in 100g pouches. After retorting (processing at 127°C for 17 Cooking raw food can alter the nature of the protein. minutes), consumption of the product was higher with Raw foods are not intrinsically hypoallergenic even the presence of PE1, demonstrating that palatability though we frequently prescribe them for in animals enhancers are a key factor for palatability of wet pet with food allergies or food sensitivities. A study on food. More research is warranted in understanding patch testing for food allergy in dogs found some the risks and benefits of palatability enhancers. reacted to raw meats but not to the cooked meat (48). We must monitor our patients over the long Recommendations term and regularly check in with pet owners about feeding regimes for diet drift. For young fast growing Complementary Veterinary Medicine Branch of the NZVA | April 2018 breeds, regular assessment during growth and know all there is to know, especially when it is monitoring of calcium, phosphorus and vitamin D may counterintuitive to the observed daily benefits to our be warranted. patients of feeding real food.

Conclusion References

There are many more issues surrounding alternative 1. Child G, Foster DJ, Fougere BJ et al (2009). Ataxia feeding regimes and processed foods. The and paralysis in cats in Australia associated with precautionary principle is useful. It is clear there is still exposure to an imported gamma-irradiated more to be learnt about small animal nutrition. There commercial dry pet food. Aust Vet J. 87(9):349-351. are some strong indicators in human nutrition that a 2. Manzel A, Muller DN, Hafler DA et al (2014). Role of return to real foods provides disease prevention and “Western diet” in inflammatory autoimmune health benefits. Instead of advocating against raw and diseases. Curr Allergy Asthma Rep. 14(1):404. home-made diets (and their equivalents), it may be 3. Heinonen I, Rinne P, Ruohonen ST et al (2014). The more prudent to research the outcomes of long-term effects of equal caloric high fat and western diet on effects of processed foods on health compared to metabolic syndrome, oxidative stress and vascular balanced raw/homecooked food. The assumption that endothelial function in mice. Acta Physiol (Oxf). Feb 7. processed pet foods are safer and promote health 4. Katz DL and Meller S (2014). Can we say what diet is could be challenged on the basis of the link between best for health? Ann Rev Public Health. 35:83- 103. high use of commercial foods and the growing 5. Nemser S and Reimschuessel R. Food Emergency incidence of obesity. This makes for a compelling Response Network (FERN), Microbiology Cooperative counter argument when coupled with the known Agreement Program (MCAP), FDA Center for inflammatory effects of moderate and highly Veterinary Medicine (CVM) Special Project: Pet food processed carbohydrate-based diets on blood glucose testing for selected microbial organisms. Final Report and insulin and the effect of high-heat processing on 2010- 2012. the production of potentially harmful by-products. http://www.fda.gov/animalveterinary/resourcesforyo u/animalhealthliteracy/ucm373757. As integrative practitioners, we should trust our htm experience and instincts and what we see before us 6. Sanchez S, Hofacre CL, Lee MD et al (2002). Animal clinically. The author’s personal opinion is there is no sources of salmonellosis in humans. J Am Vet Med one single all-purpose paradigm that is right for all Assoc. 221:492–497. animals. There is good and bad in all food types – raw 7. Finley R, Reid-Smith R and Weese JS (2006). Human food, wholefoods, organic, cooked, grocery, premium, health implications of Salmonella contaminated frozen, freeze dried, dry, canned natural pet treats and raw pet food. Clin Infect Dis. and semi moist. An unbalanced wholefood, organic 42:686–691. raw diet may be detrimental compared to a premium 8. LeJeune JT and Hancock DD (2001). Public health low-grain dry food diet that is balanced in a fast concerns associated with feeding raw meats to dogs. J growing puppy. The spectrum goes from canine Am Vet Med Assoc. 219:1222–1225. siblings – one that thrived on BARF, the other in 9. Schlesinger D and Joffe D (2011). Raw food diets in danger of euthanasia due to weight loss and companion animals: a critical review. Can Vet J. 52:50- maldigestion and then recovered with a dry food diet 54. – to numerous animals with chronic disease that 10. Imanishi M, Rotstein DS, Reimschuessel R et al return to health on well-supplemented raw or lightly (2014). Outbreak of Salmonella enterica serotype cooked wholefoods. From patients that do poorly on Infantis infection in humans linked to dry dog food in inadequately supplemented home-made raw or the United States and Canada, 2012. J Am Vet Med cooked diets, to a pair of fragile diabetic Burmese on a Assoc. 244:545-553.11. Wynn SG (2014). Personal prescription processed diet that improved comm.12. Bischoff K and Rumbeiha WK (2012). Pet dramatically when fed a raw food diet. I have seen it food recalls and pet food contaminants in small all. The most common nutritional disease observed in animals. Vet Clin North Am Small Anim Pract. practice is obesity and these cats and dogs nearly 42(2):237-250. always are on a veterinary recommended dry-food 11. Wynn SG (2014). Personal comm. diet, even a prescribed weight-reducing diet. 12. Bischoff K and Rumbeiha WK (2012). Pet food recalls and pet food contaminants in small animals. It is difficult to accept there is only one professionally Vet Clin North Am Small Anim Pract. 42(2):237-250. approved way to feed animals today when we do not

Complementary Veterinary Medicine Branch of the NZVA | April 2018

13. Rumbeiha WK, Agnew D, Maxie G, et al (2010). diets for dogs. J Am Vet Med Assoc. 242(11):1500- Analysis of a survey database of pet food-induced 1505. poisoning in North America. J Med Toxicol. 6(2):172- 29. Markovich JE, Freeman LM and Heinze CR (2014). 184. Analysis of thiamine concentrations in commercial 14. Böhm J, Koinig L, Razzazi-Fazeli E et al (2010). canned foods formulated for cats. J Am Vet Med Survey and risk assessment of the mycotoxins Assoc. 244:175-179. deoxynivalenol, zearalenone, fumonisins, ochratoxin 30. Packaged Facts U.S. Pet Market Outlook, 2010– A, and aflatoxins in commercial dry dog food. 2011 (2010): Tapping into post-recession pet parent Mycotoxin Res. 26(3):147-153. spending. www.packagedfacts.com. 15. Ricci R, Granato A, Vascellari M et al (2013). 31. Nguyen P, Dumon H, Biourge V et al (1998). Identification of undeclared sources of animal origin in Glycemic and insulinemic responses after ingestion of canine dry foods used in dietary elimination trials. J commercial foods in healthy dogs: influence of food Anim Physiol Anim Nutr (Berl). 97, Suppl 1:32-8. composition. J Nutr. 128 (12): 2654S-2658S. 16. Dodds WJ (2014). Personal comm. 32. Hewson-Hughes AK, Gilham MS, Upton S et al 17. Hutchinson D, Freeman LM, McCarthy R et al (2011). The effect of dietary starch level on (2012). Seizures and severe nutrient deficiencies in a postprandial glucose and insulin concentrations in puppy fed a homemade diet. J Am Vet Med Assoc. cats and dogs. Br J Nutr. 106 Suppl 1:S105-109. 241:477-483. 33. Buffington CA (2008). Dry foods and risk of disease 18. Becker N, Kienzle E and Dobenecker B (2012). in cats. Can Vet J. 49:561-563. [Calcium deficiency: a problem in growing and adult 34. Hoenig M (2014). Carbohydrate metabolism and dogs: two case reports]. Tierarztl Prax Ausg K pathogenesis of diabetes mellitus in dogs and cats. Kleintiere Heimtiere. Apr 24; 40(2):135-9. [Article in Prog Mol Biol Transl Sci. 121:377-412. German]. 35. Verkest KR (2014). Is the metabolic syndrome a 19. Moon SJ, Kang MH and Park HM (2013). Clinical useful clinical concept in dogs? A review of the signs, MRI features, and outcomes of two cats with evidence. Vet J. 199(1):24-30. thiamine deficiency secondary to diet change. J Vet 36. Adolphe JL, Murray D, Huang Q et al (2012). Sci. 14(4): 499-502. Postprandial impairment of flow-mediated dilation 20. Polizopoulou ZS, Kazakos G, Patsikas MN et al and elevated methylglyoxal after simple but not (2005). Hypervitaminosis A in the cat: A case report complex carbohydrate consumption in dogs. NutrRes. and review of the literature. J Feline Med Surg. 7:363– 32:273–284.37. Larson B, Lawler D, Spitznagel Jr E, et 368. al. Improved glucose tolerance with lifetime diet 21. Niza MMRE, Vilela CL and Ferreira LMA (2003). restriction favorably affects disease and survival in Feline pansteatitis revisited: hazards of unbalanced dogs. J Nutr 2003: 133 (9):2887-2892. home-made diets. J Feline Med Surg. 5:271–277. 37. Larson B, Lawler D, Spitznagel Jr E, et al. Improved 22. Kawaguchi K, Braga III IS, Takahashi A et al (1993). glucose tolerance with lifetime diet restriction Nutritional secondary hyperparathyroidism occurring favorably affects disease and survival in dogs. J Nutr in a strain of German shepherd puppies. Jpn J Vet Res. 2003: 133 (9):2887-2892. 41:89–96. 38. Wakshlag JJ, Struble AM, Levine CB et al 23. DeLay J and Laing J (2002). Nutritional (2011).The effects of weight loss on adipokines and osteodystrophy in puppies fed a BARF diet. AHL markers of inflammation in dogs. Br J Nutr. 106, Suppl Newsletter. 6:23. 1:S11-114. 24. Dillitzer N, Becker N and Kienzle E (2011). Intake of 39. Suarez L, Pena C, Carreton E et al (2012). minerals, trace elements and vitamins in bone and Preferences of owners of overweight dogs when raw food rations in adult dogs. Br J Nutr. 106, Suppl buying commercial pet food. J An Physiol Anim Nutr 1(0):S53-56. (Berl). 96(4):655-659. 25. Cline J (2012). Calcium and vitamin D metabolism, 40. Zicker S (2005). Cognition and behavioural deficiency and excess. Top Comp An Med. 27(4): 159- assessment in dogs and pet food market applications. 164. Prog Neuropsychopharmacol Biol Psychiatry. 29: 455- 26. Association of American Feed Control Officials Inc 9. (2011). Official publication, Oxford, IN. 41. Roudebush P, Zicker SC, Cotman CW et al (2005). 27. National Research Council (2006). Nutrient Nutritional management of brain aging in dogs. J Am requirements of dogs and cats. National Academies Vet Med Assoc. 227: 722-728. Press, Washington DC. 42. Tareke E, Lyn-Cook B, Robinson B et al (2008). 28. Stockman J, Fascetti AJ, Kass PH et al (2013). Acrylamide: a dietary carcinogen formed in vivo? J Evaluation of recipes of home-prepared maintenance Agric Food Chem. 56(15):6020-6023. Complementary Veterinary Medicine Branch of the NZVA | April 2018 Complementary Veterinary Medicine Branch of the New Zealand Veterinary Association

43. Tessier FJ and Birlouez-Aragon I (2012). Health effects of dietary Maillard reaction products: the results of ICARE and other studies. Amino Acids. 42(4):1119-1131. 44. Webster J, Wilke M, Stahl P et al (2005). [Maillard reaction products in food as pro-inflammatory and pro- arteriosclerotic factors of degenerative diseases]. Z Gerontol Geriatr. 38(5):347-353. 45. Everts S (2012). The Maillard Reaction turns 100. Chem Eng News. 90(4):58-60. 46. van Rooijen C, Bosch G, van der Poel AF et al (2013). The Maillard reaction and pet food processing: effects on nutritive value and pet health. Nutr Res Rev. 26(2):130-148. 47. Pettelot E. Retort effects: How does retorting affect wet pet food palatability? http://www. petfoodindustry.com/Retort_effects.html; 16 May 2007. 48. Bethlehema S, Bexley J and Mueller R (2012). Patch testing and allergen-specific serum IgE and IgG antibodies in the diagnosis of canine adverse food reactions. Vet Immunol Immunopathol. 145:582–589.

For more details see:

http://www.civtedu.org

Complementary Veterinary Medicine Branch of the NZVA | December 2018 Complementary Veterinary Medicine Branch of the New Zealand Veterinary Association

Massey Complementary Veterinary Therapies (MCVT)

Our vet student group are a very important part of our special interest branch and we look forward to working together this year to create more learning opportunities for vet students about integrative veterinary care.

Join www.facebook.com/groups/813434878763355/ for info about student talks (often with FREE pizza) and the 2019 conference with legendary goodie bags!

Complementary Veterinary Medicine Branch of the NZVA | December 2018

Complementary Veterinary Medicine Branch of the NZVA | April 2018 Complementary Veterinary Medicine Branch of the New Zealand Veterinary Association

Reduce Inflammation, Improve Detoxification, and Promote Repair

W. Jean Dodds, DVM and Adam J Lassin, DVM www.hemopet.org; [email protected]

Like most humans our pets can develop arthritis as they can alter gene expression and protein/metabolite age. All joints can be effected; hips, shoulders, wrists production. Specific nutrients found in the diet change and elbows. Our pets will begin to show signs of the bodies response in a form defined as a “signature” arthritis by being less active, lame, trouble getting up, or “molecular dietary signature”. reluctance in jumping and lethargic. The main treatment offered by conventional veterinary visits There are 5 basic concepts of Nutrigenomics. The diet includes non-steroidal anti-inflammatory drugs can be a serious risk factor for a number of diseases. (NSAIDs), prescription diets, glucosamine/chondroitin, Ingredients found in certain foods act on the animal’s and Adequan injections. However, there are many DNA make-up directly and indirectly to alter gene more holistic/alternative options we have to help expression. Nutrigenomics effects every individual decrease inflammation secondary to arthritis, detoxify differently based on that individual’s genetic makeup. toxins that promote the inflammatory response, and Various foods act upon certain regulated genes in the repair/improve joint health. body that effect the onset, incidence, progression, and/or severity of chronic diseases, such as arthritis. Diet alone is one of the most important factors in Based on an individual animal’s nutritional helping improve our pets quality of life when it comes requirement and DNA, diet can be used to prevent, to arthritis. Most veterinarians will prescribe treat, or cure chronic disease. prescription diets that contain grains (glutens) and have joint supplements added to the kibble, along with Nutrients, amino acids, vitamins and supplements anti-inflammatory medications. Most of the NSAID found in food can be used to balance and strengthen medications can cause damage or injury to tissues of the immune system. Immune function requires many the liver, kidneys, and bone marrow with long term key nutrients that includes zinc, selenium, vitamin E, use. Many processed grains and omega-6 fatty acids vitamins B12 and B6, vitamin C, vitamin D, linoleic acid, contain pro-inflammatory precursors found in some of and carotene (lutein and beta-carotene). Many natural these commercial diets. Another common ingredient sterols and sterolins found in fruits, vegetables, and found in pet food is white potato, which has been medicinal plants combine to improve immune system shown to promote inflammation, as have other homeostasis. Natural antioxidants include vitamin E members of the nightshade family of plants, such as and C, citric acid, rosemary, turmeric (curcumin), peppers and eggplant. The sweet potato surprisingly oregano, and blueberries. has anti-inflammatory properties, a fact largely unknown to many people. Please remember that it is a Many alternative supplements are available for our different plant species from the white potato. pets which can accomplish the above: Nutrigenomics, described below, can be applied to optimize our pets diet to help decrease the Glucosamines from shellfish, bones, and some fungi inflammatory response in the body. are precursors of the glycosaminoglycans found in joint cartilage. Nutrigenomics is a new emerging science that studies the molecular relations between nutrition and the Grape Seed Extract is a powerful antioxidant. It also has response of genes in promoting health. Applying anti-carcinogenic and strong anti-inflammatory nutrigenomic principles has shown that the diet properties. possesses significant health promoting properties including the management of pain, and not that just Bee Pollen has been used for many different properties caused by arthritis. Diet plays an important role which including its anti-inflammatory function. More of the

Complementary Veterinary Medicine Branch of the NZVA | December 2018 health benefits of bee pollen such as anti-cancer and Green (or Black) Tea Leaf Extract has potent its antibiotic properties, and immune boosting have antioxidant and anti-inflammatory properties which not been fully explained. come from the tannis and polyphenols in teas.

Royal Jelly is milky substance made from digested DLPA (D,L Phenylalanine) is an essential amino acid pollen, honey, and a chemical secreted from the and endorphin stimulant to help control chronic bone pharyngeal glands in the heads of worker bees. It is and muscle pain. used for its anti-inflammatory and immune boosting properties similar to that of Bee Pollen. Turmeric (curcumin) a relative of ginger, comes from the middle east; India and Pakistan. It is a potent Ginger is used mostly for digestion, but also for antioxidant. It also has anti-carcinogenic and strong arthritis. anti-inflammatory properties.

MSM (MethylSulfonylMethane) acts as a natural anti- Traumeel (by Heel) is a popular homeopathic remedy inflammatory for joints . for aches & pains. The ingredients include Aconitum napellus (wolfsbane) , Arnica montana (leopard’s Polyunsaturated Fatty Acids (ALA, EPA, DHA) come bane) , Belladonna (deadly nightshade) , Bellis from many fish and plant oils of wild salmon, sardines, perennis (garden daisy), Calendula officinalis herring, cod, trout, green lipped mussel, anchovies, (marigold), Chamomilla (ground apple), Echinacea krill, algae extract, flax seed, hemp, olive, canola , and (purple cone flower), Hamamelis virginiana, Hepar soybean. These are used for their anti-inflammatory sulphuris calcareum, Mercuris solubilis, Millefolium, properties. Symphytum officinale. (comfrey).

Propolis (resin) is found on the buds, bark and leaves of Other Useful Supplements: Boswellia, andrographis deciduous trees and some vegetables, and can be used paniculata (King of bitters), hawthorn, licorice, nettle for its analgesic pain controlling properties. leaf, yucca root, raw apple cider vinegar, and willow bark (relative of aspirin, but do not combine with Deer or Elk Velvet helps alleviate arthritic symptoms by NSAIDs), and other herbal therapies. rebuilding cartilage, improving joint fluid, increasing tissue and cellular healing times, and improving circulation. It contains many beneficial ingredients; “Wholesome nutrition is a key component for proteins, amino acids, collagen, lipids, minerals/trace maintaining a healthy immune system and resistance elements; calcium, phosphorus, sulphur, magnesium, to disease.” potassium, sodium, manganese, zinc, copper, iron, selenium, cobalt, growth factors, glycosaminoglycans, glucosamine, chondroitin, phospholipids, prostaglandins, and hyaluronic acid. Growth Factor IGF 1 (Insulin growth factor) and IGF 2 are both found naturally in deer and elk velvet. IGF 1 influences cellular growth that involves every cell in the body. Muscle, cartilage, bone, and many other organs in the body are positively affected. IGF 2 works with IGF 1 to promote cellular growth and organ development.

Green Lipped Muscle (Perna canaliculus) decreases inflammation by inhibiting enzyme which is responsible for transforming essential fatty acids into inflammatory leukotrienes(mediators of inflammation from white blood cells). Contains important nutrients, proteins, amino acids, glycosaminoglycans, chondroitin, hyaluronic acid, and proteoglycan.

Thymus Glandular enhances, improves, and maintains a strong immune system.

Complementary Veterinary Medicine Branch of the NZVA | April 2018

For more details see:

http://www.civtedu.org

Complementary Veterinary Medicine Branch of the NZVA | April 2018 Complementary Veterinary Medicine Branch of the New Zealand Veterinary Association

Rose’s Blog

Our secretary / treasurer is a lady of many talents and has a number of interesting and invaluable insights to share.

There are no favourite bits to his books, they all press buttons and trigger memories and make you smile or shed a tear as you read.

It transformed him into a god amongst men. He’d never practiced as a farm vet but he had mastered the art of showmanship laced with extreme plagiarism.

Complementary Veterinary Medicine Branch of the NZVA | December 2018