{"id":16630,"date":"2021-08-31T11:25:32","date_gmt":"2021-08-31T18:25:32","guid":{"rendered":"https:\/\/todaysveterinarybusiness.com\/?p=10660"},"modified":"2022-06-15T17:48:04","modified_gmt":"2022-06-15T17:48:04","slug":"the-whole-picture","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarybusiness.com\/the-whole-picture\/","title":{"rendered":"The Whole Picture"},"content":{"rendered":"

When Casara Andre, DVM, CVMA, needed to rearrange her home so she could incorporate a recording studio, her cat Cali became so nervous that she stopped eating and experienced an acute renal episode.\u00a0<\/span><\/span><\/p>\n

Cali recovered, but Dr. Andre wanted to help her better handle potentially stressful situations in the future. As the founder and director of Denver-based Veterinary Cannabis Education & Consulting, Dr.\u00a0Andre decided to combine cannabis with training.\u00a0<\/span><\/span><\/p>\n

\u201cSo the next time I need to rearrange my house, she\u2019ll go back to that training and realize that yes, the couch moved, and yes, she\u2019s still OK,\u201d says Dr. Andre. \u201cThat\u2019s what\u2019s going to help keep her healthy for the long-term.\u201d<\/span><\/p>\n

Dr. Andre has embraced cannabis and other alternative treatments for years, but not all veterinarians are as comfortable implementing integrative medicine techniques in their practice.\u00a0<\/span><\/span><\/p>\n

\u201cIt\u2019s not so much a question about thinking outside the box; it\u2019s really about realizing that there\u2019s more than one box,\u201d says Gary Richter, DVM, owner and medical director of Holistic Veterinary Care in Oakland, California. \u201cIt\u2019s about legitimate medical science that maybe just isn\u2019t the mainstream. If my job is to take the best possible care of my patients, then I need to know what the best possible treatments are.\u201d<\/span><\/p>\n

Here are three reasons you should embrace integrative medicine in your practice.<\/span><\/p>\n

Everyone Is Dealing With Increased Stress<\/h3>\n

The past year has been difficult for nearly everyone, including pets, pet owners and veterinary practitioners. We\u2019ve all faced the need to adapt to different scenarios quickly. While humans have faced the obvious challenges, including schedule changes, reduced or lost income, health difficulties, postponed events and more, these challenges have also affected pets.\u00a0<\/span><\/span><\/p>\n

\u201cMaybe a pet owner is suddenly home all the time and they\u2019re really stressed, or maybe a pet was just adopted or relinquished to a shelter. We\u2019re seeing really dramatic cuts in our normalcy, and everyone\u2019s nervous system is facing chaos,\u201d Dr. Andre says. \u201cWe\u2019re all going on the sympathetic up, up, up, but there\u2019s no process to bring it down into parasympathetic.\u201d<\/span><\/p>\n

Dr. Andre says sedation or opioids can help temporarily. \u201cBut cannabis, in particular, gives us some really beautiful ways to address this because of how the different molecules work on the endocannabinoid system that all mammals have,\u201d she explains.<\/span><\/p>\n

The endocannabinoid system (ECS) is designed to help a mammal adjust to a new circumstance because it works to regulate homeostasis, or balance within the body.1<\/sup> When a mammal is facing a stressor, it\u2019s the ECS that will work to regulate and calm them. And, according to Dr. Andre, cannabis affects the ECS, and its compounds \u2014 including cannabidiol (CBD),
\ncannabinol (CBN), cannabigerol (CBG), tetrahydrocannabinol (THC) and others \u2014 can be used to help a mammal adapt to something that has dramatically changed in their everyday environment.\u00a0<\/span><\/span><\/p>\n

\u201cCannabis is not a quick fix. It\u2019s about long-term balance and health,\u201d Dr. Andre says. \u201cIt\u2019s important to recognize early on that if you need Western-based medicine, if you need a pharmaceutical, use a pharmaceutical. But if you want something that gives you more openings and avenues, cannabis opens a lot of doors, simply because there are a lot of molecules that work in different ways. It\u2019s working on this system that\u2019s really taking a toll lately.\u201d<\/span><\/p>\n

In 2020, Drs. Andre and Richter were two of the founding members of the Veterinary Cannabis Society, a nonprofit aiming to educate veterinarians and pet owners, as well as promote common sense veterinary cannabis legislation and regulation.\u00a0<\/span><\/span><\/p>\n

\u201cThere is a lot of research out there indicating the medical benefits of cannabis. There\u2019s even a growing body of research that is veterinary-specific to show the medical benefits of cannabis,\u201d says Dr. Richter, who speaks with his clients about cannabis regularly. \u201cA lot of veterinary professionals are hesitant to start talking to people about it, partially because of concerns about legal issues and partially because of a lack of understanding what to tell people.\u201d<\/span><\/p>\n

Even practitioners who are uncomfortable talking about cannabis with clients should have an understanding about the ECS, says Dr. Andre. \u201cEvery mammal has an ECS, and learning about the ECS is every practitioner\u2019s responsibility and obligation,\u201d Dr. Andre explains. \u201cBut then whether you want to work with cannabis is your choice.\u201d\u00a0<\/span><\/span><\/p>\n

Dr. Richter thinks industry organizations have been slow to adapt. \u201cThe reality is that you can buy cannabis products for animals in every pet store, in every gas station, on every corner in the country. Pet owners are buying these things and giving them to their pets without any direction because their veterinarians are saying, \u2018I don\u2019t know\u2019 or \u2018I\u2019m not allowed to talk to you about it,\u2019 and that\u2019s a really big problem,\u201d he says. \u201cThe federal government is going to legalize medical cannabis. It\u2019s an inevitability. And it sure would be nice if the veterinary profession was not caught flat-footed when that happens.\u201d<\/span><\/p>\n

You Are What You Eat<\/h3>\n

Clients who look to take a more proactive role in their pet\u2019s health are increasingly interested in the role nutrition and supplements play. The only problem is that they may not seek counsel from their veterinary healthcare team first. That\u2019s why it\u2019s important to open the conversation about each patient\u2019s diet and the possible benefit of dietary supplements.\u00a0<\/span><\/span><\/p>\n

\u201cA lot of the issues coming up right now are related to pet food. Are grain-free diets bad? What about raw food? There\u2019s a lot of conflicting information out there, both from the perspective of the pet food industry and from the perspective of the veterinary profession,\u201d says Dr. Richter.\u00a0<\/span><\/span><\/p>\n

Nutrition has long been a hot topic in veterinary medicine, and Dr. Richter says we\u2019re looking at it the wrong way.\u00a0<\/span><\/span><\/p>\n

\u201cWe all know from our own health that eating more fresh, whole foods and less highly processed food, the better off we are,\u201d Dr. Richter said. That\u2019s why Dr.\u00a0Richter recommends fresh, whole foods to his clients \u2014 whether cooked, raw or freeze-dried \u2014 and he says these foods have improved the quality of life for many of his patients. There are many high-quality brands that have been balanced by qualified veterinary nutritionists.<\/span><\/p>\n

Fresh, professionally balanced diets are increasing in popularity among pet owners, and these premium options are part of the driving force that is helping the pet food market grow in the U.S., according to market research company Packaged Facts. But it is also important to counsel clients on the importance of maintaining balanced diets, which can be skewed if the pet owner tries to take matters into their own hands and prepare the food at home.2,3<\/sup><\/span><\/p>\n

Much like CBD supplements, other nutritional supplements and nutraceuticals are growing in interest among pet owners. Packaged Facts estimates retail sales of pet supplements in the U.S. to surpass $1\u00a0billion by 2025 after the market grew by 21% in 2020. This represents an opportunity for practitioners not only to grow their revenue but also to inform pet owners about the best course of action on a topic that is not cut and dried. Because regulatory oversight is lacking in veterinary supplements, even when compared with human dietary supplements,4<\/sup> it\u2019s important to consult the latest scientific research and recommend trusted brands. This research can go a long way in improving outcomes for your patients and trust from your clients.<\/span><\/p>\n

\u201cIntegrating nutraceuticals as part of a multimodal treatment plan may provide a better management of the disease and improve outcomes, thus resulting in a better quality of life for our patients,\u201d says Ronald Koh, DVM, MS, CVA, CVCH, CVFT, CCRP, CVMMP, and chief of the integrative medicine service at the UC Davis School of Veterinary Medicine. \u201cProbiotics and prebiotics both are my go-to nutraceuticals for supporting digestion problems and gut health. Probiotics also have immunoregulatory effects, which show therapeutic potential for several immune response\u2013related diseases, such as atopic dermatitis and allergies.\u201d<\/span><\/p>\n

Dr. Koh says that integrating supplements while using a multimodal approach to treatment can also increase the pet owners\u2019 satisfaction. While there are many supplements and nutraceuticals on the market, Dr. Koh believes research supports the following:<\/span><\/p>\n