INTEGRATING ALTERNATIVE

THERAPIES FOR IMPROVED CLINICAL

OUTCOMES

GI Disease

Digestive Enzymes

Digestive Enzymes

Digestive system absorbs nutrients. Food has to be broken down into its nutrient pieces:

amino acids (from proteins), fatty acids and cholesterol (from fats), and simple sugars (from carbohydrates), + vitamins, minerals, etc.

If we don’t have enough digestive enzymes, we can’t break down our food

DE come from food or the GI tract

Digestive Enzymes

Saliva- carbohydrases (amylase) Not in the wild

Stomach- proteases (pepsin) Pancreas- lipases (which break down fats) Further break down of carbohydrates and proteins

Small intestines Digestion should be complete to single molecules

Enzymes

Feed your pet enzymes with her meals, they aid in digestion.

When you feed the exact same enzymes at other times, they work systemically for metabolic purposes.

Enzymes away from meals

Support the healthy circulation of blood Maintaining normal immune function Clear cellular debris while cleansing tissue Stimulate healthy new cell growth Promote normal cell growth Promote a healthy immune response Support normal detoxification processes Clear away undigested proteins, cleansing the lymph

and blood

The Best Digestive Enzymes to Feed

Animal based Pancreatic supplements

EPI

Fungal based Aspirgillus niger Survive in a wide range of pH Allergies

Plant based

When to Recommend Digestive Enzymes

Exocrine pancreatic insufficiency (EPI), pancreatic hypoplasia, and pancreatitis, diabetes

Inflammatory bowel disease (particularly lymphocytic-plasmacytic gastroenteritis) may impact the production and/or release of digestive enzymes

Immune compromise Animals on processed food or kibble Chronic diarrhea

Benefits of Digestive Enzymes

Saves clients $ — pets will be getting more nutrition from the same food, they may be able to feed less,

Reduces the amount of stool because less food is wasted through improper digestion.

Improves the quality of the stool. Makes pets feel more satiated, which can reduce

begging. Makes pets healthier because they are getting more

of the nutrition they need.

Bromelain in Inflammation

Proteolytic enzyme bromelain, from pineapple, reduce inflammation from infection and injuries.

The University of Maryland suggests that bromelain can be used to decrease swelling, bruising, healing time and pain after surgery and physical injuries, such as tendinitis, sprains and strains, and other minor muscle injuries.

In Europe, bromelain is used to treat sinus and nasal swelling following ear, nose and throat surgery or trauma.

The dose for this special use is 50 mg to 100 mg per ten pounds of body weight, divided into two doses; mix with cool water and administer orally for up to ten days.

Which enzymes to choose for GI supplement

At a minimum protease, lipase and amylase

Many also look for cellulase, which is useful if the food contains fibrous vegetables or grains

Probiotics

Probiotics

Live microorganisms that provide health benefits when consumed

Primarily bacteria but can be yeast Many types but most Lactobacillus (upper GI) Bifidobacterium (lower GI)

Probiotics

Overall gastrointestinal maintenance and health

Faster promotion of gut health Defense from emotional and physiological stressors Support for pets in less-than-optimal health, such as

runts, and shelter animals

Probiotics

Widely recognized to help in cases of IBS IBD Infectious diarrhea (from bacteria, viruses or parasites) Antibiotic related diarrhea

Separate from antibiotics

Consider for chronic or recurrent UTI- some studies in people

How do they work?

Probiotic "good" bacteria lower intestinal pH Helps boost their own numbers Lowers the numbers of disease-causing bacteria Produce SCFA which make it harder for potentially

disease-causing pathogens to set up shop

How can they help?

boosting poor immune function addressing bacterial imbalance enhancing the health of the cells in the tissue of the

GI tract help with digestion by providing their own digestive

enzymes

Dosing

Human products- give full adult dose for 40-60 lb dog

To help with digestion, probiotics should be taken with meals

Otherwise they may survive better if given between meals, particularly if taken with liquid that helps to dilute stomach acid and move them more quickly into the digestive tract

Probiotics

Studies indicate that multi-strain high innoculates (1-10 billion CFU) work best

Does not need to be from host species to be effective Controversial as to value of live organisms

Preventative and therapeutic probiotic use in allergic skin conditions: experimental and clinical findings. Biomed Res Int. January 2013;2013(0):932391.

Clinical improvement especially in IgE-sensitized eczema and experimental models such as atopic dermatitis-like lesions (trinitrochlorobenzene and picryl chloride sensitizations) and allergic contact dermatitis (dinitrofluorobenzene sensitization) has been reported. Although there is a very promising evidence to recommend the addition of probiotics into foods, probiotics do not have a proven role in the prevention or the therapy of allergic skin disorders. Thus, being aware of possible measures, such as probiotics use, to prevent/heal atopic diseases is essential for the practicing allergy specialist.

Prebiotics

Prebiotics

A nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the gut and thus improves host health

Fructooligosaccharides (FOS) are the most common

Prebiotics

Provide food for the bugs Can be used alone to fortify endogenous probiotics or

enhance exogenous probiotics Soluble fiber Found in many plants and herbs

Sources include inulin (a form of FOS extracted from chicory),

larch (a source of arabinogalactins), pectins, beet pulp, gums (such as guar gum), and wheat dextrin

When to Recommend Prebiotics

Immunosuppression Digestive disorders- chronic diarrhea Following antibiotic therapy

Studies done on rats show that prebiotics may help

correct hyperlipidemia

Other Useful Therapies

Montmorillonite Clay

Calciuim Aluminosilicate (CAS) Silica sheets adsorb

Toxins Inflammatory cytokines Endotoxins Aflatoxins Chemotherapy biproducts

Montmorillonite Clay

Increases mucopolysaccharide 2 which provides mucus protection to bowel mucosa epithelial cells

Does not interfere with nutrient or drug absorbtion Study in dogs showed 65-85% improvement in

intractable diarrhea where conventional therapies failed (metronidazole, tylosin, etc)

Good for acute and chronic diarrhea

Rice water fast

Congee Cook 1 cup white rice with 3-4 cups water until water is creamy Strain the rice Water opens the Chloride channels Sodium will follow the Chloride Water will follow that

Blend with chicken baby food for taste if needed

Good for acute and chronic diarrhea

Fasting Principles

Feed substantially less food while having diarrhea! Use binding, soluble fiber foods like white rice,

pumpkin, sweet potato or squash Keep it simple with bland, easy-to-digest protein

sources like eggs and/or cooked chicken

Micro-biome Restorative Therapy

The Power of Poop IBD Chronic Diarrhea Clostridium Giardia

Fecal Transplant Considerations

Donor choice important Improve the microclimate of the gut Pre and probiotics, fresh foods, colostrum

Remove the recipient’s Biofilm Conventionally antibiotics

Dose orally and/or rectally

Single Useful Herbs for GI

Cat’s Claw

Anti-inflammatory Anti-diarrheal IBD

POA (anti-inflammatory alkaloid) vs TOA

(proinflammatory) Look for a product with TOA in the single digits

Ginger root

Good for vomiting or diarrhea Tea for acute vomiting May be too warming for some situations Anti-inflammatory Regulates peristalsis Can increase appetite

Ginger Root Tea

1/2 teaspoon dried ginger root or grated fresh ginger steeped in 6 oz hot water for 10 minutes, strain and administer PO in 1-3 cc amounts for smaller patients and 3-6 cc amounts for larger patients

Can give by retention enema if patient can not tolerate PO

Marshmallow

IBD Indigestion Acute vomiting Ulcers Straining to defecate Leaky gut

Mucilage-coats the stomach lining Best as combination of root and leaves

Slippery Elm Bark

Mucilage Reflux Ulcerative colitis IBS Diarrhea Use in old and debilitated patients

Be careful of sourcing (marshmallow is alternative)