Holistic Overview

Holistic Veterinary Medicine – An Overview

Larry A. Bernstein, VMD ©2019

There are so many different perceptions of the term “Holistic”, that it is important the reader understand what I mean by that term as it applies to human and veterinary medicine. There are many other terms people equate with the word “holistic” – some are accurate, and many are only small parts of the “whole.” It is best to think of the term “Holistic” as an umbrella term that covers many different and separate modalities.

An analogy could be a large department store with many separate and smaller “departments.” Often these individual departments work independently of each other. For example, shoes can be a product unto itself. One can walk into a giant department store intent on finding a pair of shoes. You may have, already, narrowed it down to a specific color, style, or designer.
We have clients come to see us or call us looking for a particular “shoe” or therapy, as they have already decided (usually through experience, an adviser or the Internet), precisely what they KNOW their animal needs. Then some clients walk in without any expectation besides – “please help my pet to heal.” These are two extreme examples, with the latter, usually, being best for the case.

The more common situation is the client who has some idea of a direction they think they want to pursue. “I am coming for acupuncture,” is a good example. Perhaps the patient has responded well to acupuncture previously or is getting regular treatments, but they are moving or visiting. Sometimes, this is the only modality they have experienced so, to them, this is holistic medicine in its entirety. In reality, acupuncture is part of a branch of medicine called Traditional Chinese Medicine or TCM. Besides acupuncture, TCM also includes Chinese Herbs, Shiatsu (massage), and Moxibustion (heating specific areas with the heat and energy from a unique burning herb called Moxa).

Thus, the client thinks that acupuncture is all there is to holistic medicine. They do not realize that acupuncture can be combined with other aspects of TCM and be much more effective. If we go back to our department store example, when you buy a pair of shoes, you might want a belt or handbag, stockings or socks to coordinate with the shoes. You might even want other accessories or clothing that works well with that pair of shoes and create a complete outfit.
Others can go to the store and ask the salesperson to recommend and coordinate choices for a specific event. Attending a party, or class reunion or wedding – there are even personal shoppers that, hopefully, know your tastes and will also do the narrowing down for you.

When I see a case, I prefer to be allowed to bring my skills and experience to bear and choose from various modalities for a coordinated, synergistic healing regimen. In actual practice, it is rarely that perfect a world, and we are limited by accessibility, the cooperation of the patient (and the client), finances, other medications, treatments and even other veterinarians involved in the case. Perhaps the owner is limited by particular circumstances.

Examples are the need to travel for work frequently or perhaps their horse is stabled where the barn rules and manager dictate frequent vaccinations or worming. Maybe the barn uses a particular farrier for shoeing. There are so many possible factors that every case is unique and needs a therapy regimen that fits that individual patient and situation. The plan might not be perfect for the patient, but limitations can be genuine.

There are also limitations imposed that are less real. “I had a dog die after receiving herbs , so NO HERBS” or “my friend’s dog was cured with only Chiropractic, so that is all I want.” I find it essential to respect the client’s wishes, as they are the responsible party and the final decider. I have seen that many times, these artificial limitations come from misperceptions or unawareness of other options. Many clients walk in our door having already decided what will make their animal better, but once they see other modalities may work better or synergistically, the healing possibilities expand. There are so many different modalities ranging from Acupuncture (or TCM) to Chiropractic, to Homeopathy, Laser Therapy, hands-on and distance energy healing (like Reiki) and of course the most significant tool of all – Nutrition. Our next goal is to explore the different primary modalities that make up “Holistic.” veterinary medicine.

Nutrition
Nutrition is such a broad topic and has so many subsections that it is beyond the scope of an “Overview.” Nutrition is the TOP modality to sustain, maintain, and heal your animal. We could spend chapters just covering it alone. We have addressed this in other articles and will expand and update those in future revisions.

Traditional Chinese Medicine (TCM)
TCM consists of four primary modalities that can be used together or separately. All of TCM is based on the concept of Qi (or Chi). The Qi is a life force that moves through the meridians of the body – There are twelve major meridians on both the left and right sides and each pair consists of a related Yin and a Yang meridian. Each of the meridian pairs is associated with an “Element” in Chinese Medicine. Fire, Water, Earth, Wood, and Metal are the five elements and used to help in a TCM  diagnosis along with the concepts of Dry, Damp, Heat, Cold, and Wind.
The Major Meridians
YIN Meridian – paired YANG Meridian – Element associated with the pair
Lung – Large Intestine – Metal
Spleen – Stomach – Earth
Heart – Small Intestine – Fire
Kidney – Bladder – Water
Liver – Gallbladder – Wood
Pericardium – Triple Heater – Fire
These are the 12 (6 pairs) main meridians – the other two main meridians are the Governing Vessel ( Du Mai) – running down the center of the body in the back and the Conception Vessel (Ren Mai), running along the middle of the front. Since each of these is centered, there is no left and right like the other six pairs. These are the basis of all Traditional Chinese Medicine – diagnosis and therapy of these meridians are based on patient symptoms, tongue color, pulses, and other parameters. Treatment of these imbalances is accomplished by the use of four TCM modalities; Acupuncture, Moxibustion, Herbs, and Shiatsu.

Acupuncture and Shiatsu (Massage)
Acupuncture began almost 4000 years ago in China and had survived to this day. In Chinese acupuncture, specific points throughout the body are stimulated or sedated to produce a local or generalized effect. These points are treated by needles, massage and even lasers to balance the body’s energy and promote healing. Modern scientists have studied acupuncture and feel that it stimulates the release of hormones, cortisone, natural pain killers, endorphins and many other substances that account for its effects. It also stimulates the local tissues to respond and the blood supply to increase. It is nice to have a “conventional” explanation to help understand how acupuncture may work but it is important to remember that traditional acupuncture deals with energy and balance.

Moxibustion and Chinese Herbs
Moxibustion (or Moxa) is part of TCM and involves the use of the herb Artemis Vulgaris (Mugwort). The heat and energy of the burning herb transfers to the body or the meridians. Moxa is commonly used to heat acupuncture needles while in place, but is also used to warm and treat parts of the body, especially, joints. Moxa is one of the most effective treatments for Bi Syndrome – the cold, degenerative arthritis animals (and people) often develop with age, injury or joint deformity. Chinese herbal therapy is one of the better-known alternative therapies. There are, however, many Western Herbs too. Chinese herbal therapy helps make up part of that bigger “department” we call TCM.

Chinese herbs can act on the different meridians and have a powerful effect in the same way as acupuncture. There are thousands of herbal treatments that have been passed down from the ancient healers. Herbs can affect the body in many ways and should be used cautiously and with the advice of someone familiar with both their good and bad effects.

Western Herbs and the Allopathic Approach
There are many herbs that do not come under the heading of TCM or Eastern Medicine. They are the Western Herbs. Western Herbs also have their own uses and methods of prescribing. Many of you are familiar with them, as they are often part of the “home remedies” our grandparents and great-grandparents used and we still do. Licorice, Raspberry Tea, Goldenseal, Echinacea, Comfrey, Valerian, Turmeric, Black Walnut, Saw Palmetto, Hawthorne, Cactus and Black Cohosh are some examples of herbs in this category.

Rather than prescribing using the theories of TCM (meridians and the Five Elements etc.) Western Herbs are, usually, classed in categories such as tonifying or cleansing and used in a more allopathic way. By that, we mean each herb is often identified with a particular symptom or illness. For example; “for hot flashes use Raspberry Tea or for prostatitis use Saw Palmetto”.

In TCM these conditions might be described as False Yang or Liver Yin Deficiency and treated for the deeper TCM diagnosis, It is more of an allopathic approach to equate a symptom directly with a disease and prescribe a different, specific herb for each symptom. “For a headache take this herb and for runny eyes add this other herb and for the sore joints add this third herb x times a day” would be an example of an allopathic approach. Allopathic medicine (our main medical system in the West) tends to dismiss the imbalance that is the root cause of these symptoms and tries to address each symptom as a separate disease.

Ayurvedic Medicine
Ayurvedic medicine is another system of medicine in its own “Department”. It evolved in India over the past three thousand years and is based on the integration and balancing of mind, soul and body through the use of herbs, diet, exercise, meditation and general lifestyle changes specific to each case. The discussion of Ayurvedic medicine is for information and completeness as this is NOT one of our practice modalities.

Chiropractic
Chiropractic has long been used to help people, but it has now been accepted for use in animals. You can well imagine the number of traumatic and repetitive injuries an animal can suffer, as well as, the normal wear and tear. Many of the problems that our animal companions show can be attributed to the vertebral subluxations that can impede the flow of their vital energy (called Innate) through the spinal cord and nerves. These subluxations can cause constant pain, muscle spasms and organ problems.

We all know how stress can contribute to our ill health and chiropractic problems. We tend to forget that our pets often take on a lot of our problems and stress, as well as their own. When we have a bad day at work or with the kids, we have less time and tolerance for our pets and they definitely can sense our tension and unhappiness. We have found it is helpful for the owner to be under chiropractic (or other holistic) care so they can be in better balance and place less of a burden on their pet.

Most of the chiropractic manipulations are done gently and by hand. There are instruments that apply high speed, focused force on a narrow area. They are called Activators and are a chiropractic tool, not a replacement for good chiropractic diagnosis and technique. There are some practitioners that merely use the activator all along the spine regardless of the origin of the imbalance. I tend to frown on any “shotgun” or cureall techniques. Once again – people who have experienced these shotgun techniques may think this is all there is to chiropractic. It is not. We often use chiropractic treatment combined with Acupuncture, Laser Therapy or other modalities in our treatment regimens and regular chiropractic tune-ups can benefit every patient.

Physical Rehabilitation and Massage Therapy
I consider different massage and hands-on therapies as an integral part of the holistic realm. Physical therapy and rehabilitative therapy can be an important part of an animal’s care – either for recovery or preventative use. When combined with other holistic modalities such as, Chiropractic, Laser, Acupuncture, Prolozone or PRP, it is an important part of our holistic department store.

Homeopathy
Homeopathy is the treatment of disease with minute quantities of substances to trigger the body’s intelligence (Vital Force) to fight that disease on its own. Homeopathic physicians have discovered over the centuries that the body can recognize ultra-minute amounts of different materials. Recent research has demonstrated the presence of nanoparticles in homeopathic preparations, and current theory offers these as an explanation of action. Whether nanoparticles are the basis of homeopathic action is unimportant once you accept the concept that homeopathic remedies can and do act on the body and can initiate wonderful and often life-saving healing.

These materials or “remedies” have lists of symptoms gleaned over the centuries through a process called provings and from experience with clinical cases. These lists of symptoms and tendencies constitute the picture or image of the remedy. The patient’s symptom picture is matched to a close or similar remedy and can trigger the body to respond to those symptoms and begin the process of healing from a deep level. Classical or true homeopathy is a very pure art and science with numerous rules and protocols. There are veterinarians trained in this classical approach. I have found it to be one of the most powerful of the alternative or holistic therapies and have successfully treated everything from fears to cancer. Since homeopathic treatment affects the body’s vital force, it can work on a very deep level to correct imbalances that have not yet manifested in severe or obvious symptoms. I love seeing patients that are not overtly ill or in crisis, since prevention or early intervention is always the best approach to health. We often say that the very best way to cure something is to prevent it from ever happening in the first place!

Flower Remedies
Hopefully, many of you have heard of the Bach Flower Remedies or, at least, “Rescue Remedy”. These were developed by Dr. Edward Bach (1886 –1936) a physician and homeopath living in Great Britain at the turn of the last century. He created the seven “Bach Nosodes” – also known as “Bowel Nosodes”. He, later, surmised that certain flowers had healing properties and went about creating distillations of the flowers, mixing them with brandy and using them to treat a multitude of illnesses and “conditions”.

The Bach Flower Remedies have been in use for almost 100 years and we use them, extensively, in our practice to help address mental and emotional issues. While often called homeopathic, Bach Flowers are not, in the truest sense since, they are only diluted and not potentized (i.e. succussed). They also do not follow the basic premise of homeopathy – the “Law of Similars”. As we mentioned earlier, the most famous combination of the Bach Flower remedies is Rescue Remedy, which contains Cherry Plum, Rock Rose, Star of Bethlehem, Clematis and Impatiens flowers. We prefer a variant of the original brand called Five Flower Formula by FES (Flower Essence Services in California).

There are 38 original Bach Flowers and these are detailed in another chapter, but there are also a multitude of additional flower essences that have been developed in the last century since Dr. Bach. These are useful for many of the same emotional situations and newer problems like EM (electromagnetic) sensitivity. Greenhope Farms in Vermont and Anaflora in California are sources of these more unique and custom remedies. Our good friend and healer, Sharon Callahan of Anaflora, will also make custom formulations based on her sense of the specific patient need. This is beyond the scope of our chapter but it is always important to make people aware of the finesse and skill that can and should be applied to these remedies.

We will make up combinations of different flowers based on the needs, emotional state and personality of the patient. Storm fears, aggression, separation anxiety or grief are just some of the examples of the things we treat with Flower Remedies. We will often use these in conjunction with our other modalities, including homeopathy, and rarely see anything but positive effects. We do not feel that Flower Remedies, when used in moderation, antidote homeopathic therapy.

Cold Laser Therapy
Laser Therapy is also called Low-Level Light Therapy (LLLT) and has been a tool in our practice for almost 30 years. We began with an infrared LCD diode system – all that was available at the time besides the small laser pointers used for presentations Later, we added a Class 3a portable unit (Respond Systems) that was our first true laser. We still use a version of that portable unit and purchased a stationary Class 4, a high power – top of the line unit with multiple applications and wavelengths. Classes are assigned by the FDA based on the power level . Safety and handling restrictions increase with the class. When we think of lasers we think of intense heat and cutting. There are many surgical lasers used in medical and veterinary practice. Therapy lasers work differently. They generate minimal heat (depending on wattage and absorption frequency), usually use a Helium Argon laser generating unit and operate at various or multiple frequencies. The wavelength of these lasers is usually in the near to far infrared spectrum (600-1200 nm) with the most effective wavelengths still hotly debated. We have found that lasers in the 808 to 980 nm range work well for our needs. When the wavelength gets much higher, the tissue tends to absorb less and reflect more of the applied energy. When this happens, the energy is converted to heat and can cause burns.
The benefits of LLLT are multi-fold. Some of the uses include:
Pain relief
Reduced scarring
Anti-Inflammatory effects
Improved nerve function
Increased blood flow and metabolic activity at the therapy site Accelerated cellular reproduction and growth All of these contribute to faster and improved healing – the laser stimulates cellular development in the injured tissue. Coupled with pain relief, this can be of great benefit in postoperative or trauma cases. It can improve many other conditions such as arthritis, ear inflammations, dental issues, skin problems and much more. Laser therapy is not a “one size fits all” modality. There are many units, power levels, classes and frequencies available. Real laser units (versus LED) are usually a few thousand up to thirty thousand dollars and are not usually cost-effective for home therapy. Some veterinarians and companies rent units for short term home use and many horse trainers have portable units they use under veterinary guidance. There are very inexpensive LED units on-line with green, red or blue light and I have seen these help small lesions to some degree. There are also units in the laser pointer class that can help act on acupuncture points at home. Some commercial veterinary units use high wattage as a selling point but the wattage is not as important as the wavelength – if the wavelength is one that is not readily absorbed then much of the energy is reflected and these units can create enough heat to burn the patient. That is why some of these commercial units warn that the applicator must be kept in constant motion to avoid severe burns.

There are also units that allow selection of various wavelengths and some that use mixed wavelengths for each application. Lasers can also be used in place of needles for acupuncture. This is especially valuable in patients that are sensitive or dislike needle acupuncture. This is not intended to be a manual for the purchase of a cold laser unit, but it is valuable to know that all lasers are not the same and just because a veterinarian has a unit, does not mean it is the right unit for your situation. One also has to be careful of appropriate eye protection for the user, the onlookers and the patient since laser light can damage eyes.

Nutraceuticals and Supplements
The US Congress, in 1994, defined a dietary supplement as a product that contains substances like vitamins, minerals and amino acids. It may also contain herbs or more specifically, botanicals and is intended to supplement the diet. These are administered orally and come in many forms. Nutraceuticals, are chosen to do more than just be dietary supplements. They help the body deal with more specific issues. A commonly used example is Glucosamine and Chondroitin in joint disease. It is frequently used in DJD (Degenerative Joint Disease) and other forms of arthritis. It does more than just supplement the diet. Nutraceuticals help with disease prevention and treatment.

Another term we often use is Glandulars. Glandulars are supplements that work as Nutraceuticals that are derived from food products (i.e. the name and source) and help to increase the presence of substances like hormones and vitamins that are usually derived from glands. Some common glandulars in our practice include, thyroid, adrenal, thymus. We also use many formulas that are targeted at specific organ systems and are derived from those organs and I tend to lump them in the same category. Liver, kidney and pancreas are examples of things we often prescribe. In fact, most raw food diets contain or recommend organ meat on a regular schedule due to the high nutritional content of these sources. Other items used as nutritional supplements include vitamins, minerals and amino acids.

Intravenous Micronutrient Therapy – IVMT
Intravenous Micronutrient Therapy (IVMT) is a therapy involving direct IV injection of vitamins, minerals, and other substances. Some of these cannot be absorbed orally even in a normal dog or cat. Advantages of this therapy include; faster assimilation, the ability to interact directly with the body without the interference of digestive enzymes and flora, the ability to administer essential vitamins and minerals that are not readily absorbed. IVMT can be, especially, helpful in IBD or malabsorption cases where the gastrointestinal tract has inflammation, scarring or other problems that interfere with normal absorption. The danger of an upset GI tract from oral dosing is also avoided. The Myers’ Cocktail is a name given to one of the first and still, most widely used, formulation in IVMT. It is named after Dr. John Myers, one of the founders of modern IVMT therapy. The basic Myers’ Cocktail contains vitamin B1, B2, B3, B5, B6, and B12, Vitamin C, the minerals Calcium and Magnesium plus other trace minerals and cofactors. We find this formula and various variations can be extremely helpful in stressed, debilitated or ill animals. It is also effective in working animals as a boost, animals with IBD, animals with pancreatitis and other GI issues and, of course, cancer.

Chelation Therapy
Chelation therapy involves the intravenous administration of EDTA to bind and help remove the heavy metals (such as lead, mercury, arsenic to mention a few examples) and minerals accumulated in the body from many sources. It does bind to calcium and has been used to help clear arterial plaque and may be helpful in treating or preventing coronary artery disease. .

Ozone and Oxygen Therapy
Ozone therapy is the administration of Ozone (usually medical grade unless in water or oils) to an animal or person to gain the benefits of its oxygenation, antioxidant, and immune-stimulant properties. There are so many physiologic, immunologic and biochemical benefits of Oxygen and Ozone in the body that it would be impossible to do more than a short list and summary. There are thousands of papers on this subject. Ozone has many anti-aging properties and even can affect the telomerase (responsible for DNA repair and rejuvenation).

Some of the MAJOR Biochemical effects of Ozone – Oxygen therapy are: Increased energy available at the cellular level via ATP, NAD and other pathways. Increased Immune response via cytokines, Interleukins and many other immune system factors. More efficient metabolism of sugars, carbohydrate, fat’s and lactic acid, to name a few. Increased antioxidant and buffering activity. Increased repair of the cellular components, especially the mitochondria or cell’s power source.

Ozone effectively kills foreign organisms and sick or weak cells that have decreased or missing anti-oxidant systems since these are especially vulnerable to the oxidative effects of that 3rd Oxygen molecule. Among these are bacteria, viruses, the spirochetes that cause Lyme, Anaplasmosis, Ehrlichiosis, and, of course, cancer cells.

Ozone therapy is often combined with UltraViolet Bio Immunotherapy (UVB or UVBI) to create a potent mixture that kills the bad cells and organisms and also activates the body’s immune system to battle the ones that have not come into direct contact with the Ozone. Re-infusion of the sensitized white blood cells spreads the message to the body’s other white cells and help the entire immune system react to the virus, parasite, bacteria or cancer cell.

Prolozone, Prolotherapy, and PRP
Prolotherapy versus Prolozone Therapy
Prolotherapy – The basic protocol with Prolotherapy requires a series of injections into and around the joint and, while preferable to surgery, Prolotherapy has a number of limitations when compared to Prolozone. It often requires more treatments to be effective. Also, as just discussed, most Prolotherapy acts, primarily, by creating temporary joint inflammation and some fibrous tissue (scar) formation thus “tightening” the joint and joint capsule. It may also help create a healing environment for collagen, but that is dependent on components included and each situation. Do not get me wrong, Prolotherapy has helped many people and animals and can have excellent outcomes. Prolozone Therapy is an alternative to traditional Prolotherapy and it is unfortunate they sound so alike – I prefer Joint Restorative Therapy but it has yet to catch on. Prolozone Therapy (first developed by Dr. Frank Shallenberger for people) delivers impressive results by offering a non-surgical approach that involves the injection of vitamins, procaine and other healing items, PLUS Ozone gas into and around the joint. This treatment isn’t as painful as Prolotherapy and usually does not irritate the tissue. Another major plus is that Ozone has antibacterial properties resulting in a much smaller risk of infection compared to Prolotherapy.

While Prolozone Therapy can be used to treat any damaged joint, older Prolotherapy it is most commonly used to treat damaged knee joints that have endured a torn cruciate or a torn meniscus. With Prolozone Therapy, we also see significant improvement in osteoarthritis, scar therapy and related issues. This may be the healing effect of the Ozone alone, but the Prolozone solutions we use appear effective (though less so) even when Ozone has been withheld. It is the combination that seems the most beneficial. We have recently added PRP therapy to our tool chest, and having the ability to add the occasional (usually 1-2) PRP injections to this regimen, may be our most promising therapy yet for severe cases or cases that are not responding to Prolozone Therapy alone.

PRP Therapy
Platelet Rich Plasma (PRP) Therapy is another regenerative medicine therapy. PRP is alive with growth factors, which can stimulate healing in a degenerative or injured joint or tissue. These growth factors do not transform into stem cells, but they have regenerative capacity, are anti-inflammatory and appear to stimulate stem cell attraction or production. PRP Therapy can be used for degenerative joint disease, arthritis and musculoskeletal injuries. It is also used in bone grafts, dental implants, wound therapy and cosmetic procedures (in people) but that is a WHOLE other paper.

A sample of blood is collected from the patient and is mixed in a special sterile tube or apparatus, usually with ACD anticoagulant. The sample is then spun in a special centrifuge. The Platelet Rich Plasma portion with the growth factors and other important components is separated and collected into a syringe and injected into the joint or affected area. In the cases of intra-articular (joint) injections, the injection site is surgically prepped, and depending on the patient, a sedative may or may not be used. We prefer to inject while using the ultrasound to help us place the PRP solution exactly where we want it.

Other Energetic Modalities of Reiki and Matrix Energetic – Quantum Healing Each section I completed reminded me of other modalities not on my original list. This “Overview’ chapter could become a book unto itself. With that limitation in mind, I want to conclude with a discussion of energy and energy medicine. This discussion could have been at the beginning, but I decided it would have more impact and clarity once you had read through and made it this far. All of the modalities we have mentioned, have their basis in “Energy”. Chi (TCM), Vital Force (Homeopathy), Innate (Chiropractic), Laser, Ozone, Herbs, Acupuncture, and even vitamins and nutrition have an energetic component.

Finding methods that use energy in a compatible way is a very important part of holistic medicine. To do this properly, one needs a deep understanding of each system and an understanding of energy both in the patient and in the world around us. There are other types of healing that are closer to the pure energetic level and farther from the physiologic level. Herbs, Acupuncture needles and Chiropractic tend to operate on a more physical level albeit there is always a strong energetic component that truly skilled practitioners touch.

There are also modalities that operate on a purely energetic level. Reiki, Quantum Healing – Matrix Energetics, NAET all are examples of this kind of healing. I think we can also put faith and especially prayer in this category. Studies have shown that patients that pray leading up to cardiac surgery do statistically better than those who do not. I am not advocating one way or another – but have seen that proper intent can go a long way to helping and even curing the incurable. When this happens, the other veterinarians often call it a misdiagnosis (“I guess the biopsy was wrong because animals with this kind of cancer do not live this long so there must have been a mistake in the diagnosis”). I have heard this so many times, I now ignore it, smile and know that true healing can occur with all these modalities whether the current medical system can see it or not. I hope this has given you a better understanding of the nebulous term “Holistic” and you will continue your journey knowing there are so many more options for prevention and healing than you realized previously.