INTEGRATIVE  MEDICINE  

CURRENT  TRENDS  IN  USE  

COMMON  CLIENT  QUESTIONS  AND  CONCERNS  

ACUPUNCTURE  –  HOW  IT  WORKS,  WHEN  TO  USE  IT,  HOW  TO  GET  STARTED?  

SOME  INTEGRATIVE  MODALITIES  TO  CONSIDER  IN  YOUR  CONVENTIONAL  PRACTICE  

MY  TOP  3  SUPPLEMENTS/HERBS  THAT  CONVENTIONAL  PRACTITIONERS  SHOULD  BE  USING  

 

 

Cheryl  A.  Cross,  DVM,  DACVP  (Anatomic)  Clinical  Assistant  Professor,  Integrative  Medicine  

The  University  of  Tennessee  College  of  Veterinary  Medicine                      

 

 

1.  

HOW  TO  ATTRACT  WEIRDOS…..  WITHOUT  BEING  WEIRD  The  top  questions  my  best  IM  clients  ask  

 1. Questions  about  food  and  diets    

a. Client  education  about  terminology  is  incredibly  helpful  (see  “What  Foods  These  Morsels  Be”  –  a  guide  to  approved  terms)    

b. Have  the  client  ask  the  questions  of  the  food  companies  (see  Questions  for  Food  Companies)  c. The  number  one  thing  I  try  to  tackle  is  obesity  –  often  the  most  preventable  risk  factor  our  

patients  have  (see  body  condition  score  chart  attached)  i. I  give  clients  the  sheet  and  ask  them  to  score  their  pet  ii. I  have  the  pets  back  for  routine  weigh-­‐ins  free  of  charge  

1. Goal  weight  loss  0.5  –  2%  per  week  for  cats  and  dogs  d. Believe  it  or  not,  I  sell  a  lot  of  Rx  diets  

i. Why?  How?    1. I  tell  clients  it  is  like  handing  them  a  bottle  of  penicillin  –  I  can  guarantee  what  

is  in  there  and  what  isn’t  in  there  2. My  most  prescribed  diets  are  JM,  J/d,  DM  

e. The  Raw  Diet  Questions  i. If  they  are  very  young  or  very  old  in  the  household,  I  forbid    ii. I  point  out  the  risks  there  are  to  the  humans  in  the  house,  largely  iii. I  insist  on  AAFCO  balanced  –  many  raw  diets  are  too  high  in  fat  iv. Cost!  

f. The  Grain  Free  Issue  i. Axelsson  E  et  al.  “The  genomic  signature  of  dog  domestication  reveals  adaptation  to  a  

starch-­‐rich  diet”  Nature,  Online  January  23,  2013,  DOI:  10.1038/nature11837  1. Researchers  looked  at  the  full  genome  of  wolves  and  domesticated  dogs  and  

pinpointed  where  they  differ.  They  isolated  36  regions  that  likely  represent  targets  of  selection  during  dog  domestication.  Half  of  these  regions  harbor  genes  tied  to  brain  development  or  signal  processing  that  occurs  in  the  brain.  The  researchers  also  identified  ten  genes  in  other  genetic  regions  that  play  key  roles  in  the  digestion  and  metabolism  of  starches  and  fats.  They  have  put  the  genes  tied  to  digestion  to  the  test,  determining  that  all  three  genes  governing  the  three  major  steps  of  the  breakdown  of  complex  starches  are  used  more  effectively  in  dogs.  

ii. How  tightly  regulated  are  commercial  diet  claims  anyway?  g. Homemade  Diets  

i. Can  be  wonderful  for  the  right  pet  and  owner  ii. Great  for  attentive  owners  fearful  about  recalls  or  who  want  to  control  

ingredients/additives/preservatives  iii. Homemade  diets  can  be  useful  for…  

1. Elimination  diets  for  food  allergies  2. Increasing  palatability  for  sick  patients  3. Managing  disease  combinations  that  do  not  have  a  commercially  available  

option  4. Renal  disease  +  pancreatitis  5. Food  allergy  +  renal  disease  6. Obesity  +  hyperlipidemia  +  food  allergy  

iv. Must  be  balanced    v. Do  not  trust  internet  diets    vi. Drawbacks?  

1. Cost  and  time  in  the  kitchen  2. No  nutrient  analysis  and  food  trials  

3. We  insist  on  PE  and  minimum  database  after  1  month  on  diet  and  q  6  months  afterward  

vii. Where  to  go  for  homemade  diets  that  are  balanced  by  a  nutritionist?  1. University  of  Tennessee  

a. utvns@utk.edu  b. www.vet.utk.edu/clinical/sacs/nutrition.php  

2. UC  Davis  a. www.vmth.ucdavis.edu/vmth/services/nutrition/nutrition.html  

3. Balance  IT  a. www.balanceit.com  

4. Veterinary  Nutrition  Consultations,  Inc.  a. www.petdiets.com  

h. Vaccines    i. I  do  offer  titers  

1. Cornell  Diagnostic  Lab  or  Hemopet  for  DAP  2. Kansas  State  Diagnostic  Lab  for  Rabies  

ii. Client  and  pet  selection  is  critical  iii. Client  education  and  risk  assessment  is  critical  iv. I  tell  clients  if  the  titers  are  unimpressive,  we  must  vaccinate  v. I  tell  clients  the  legal  ramifications  if  we  do  not  vaccinate  for  rabies  vi. The  vaccine  I  routinely  encourage  in  the  at-­‐risk  dog?  Intranasal  bordatella  

i. Internet  supplements/nutraceuticals/herbs  i. Most  formulas  “kitchen  sink”  the  herbs  ii. Typically  clients  pay  more  than  they  would  talking  to  a  vet  and  get  better  quality  iii. Susan  Wynn  “veterinary  herbal  medicine”  has  nice  materia  medica  iv. Steve  Marsden’s  quick  consult  “Natural  Veterinary  Medicine”  has  some  

recommendations  listed  by  system    

SITTING  ON  PINS  AND  NEEDLES  2. Everything  you  ever  wanted  to  know  about  acupuncture...  and  probably  more!  

a. Introduction    i. Long  history  of  use  –  most  likely  2000-­‐4000  years  old  ii. Original  practice  a  part  of  Chinese  Medical  Diagnosis  

1. Chinese  herbal  medicine,  Tui-­‐Na,  Food  therapy  2. A  very  reductionist  model  would  say  it  emphasized  living  in  harmony  with  

nature  iii. Intended  to  keep  workers  healthy,  not  treat  once  sick  iv. Many  variations  in  style  v. Medical  Acupuncture  a  more  modern  approach  

1. Trigger  point  therapy,  neuromuscular  approaches  vi. Current  teachings  in  vet  med  revolve  around  TCVM  and  MA  typically  

1. Being  taught  and  used  in  a  few  veterinary  schools  (brief  introductions)  2. Typically  used  as  a  standalone  therapy  when  in  vet  schools  and  by  some  

practitioners  b. Mechanisms  of  action  

i. Complete  MOA  unknown  1. Cascade  release  of  endorphins  and  monoamines  2. Alters  peptide-­‐rich  milieu  3. Gate  theory  of  pain  transmission  4. Releases  fascial  planes  5. Treats  trigger  points    6. Dampens  central  windup  

ii. fMRI  information  shows  it  is  more  than  placebo  iii. Excellent  for  pain  (musculoskeletal  >  visceral)  

1. EAP  

2. Moxibustion  iv. Human  studies  –  depression,  anxiety,  seizures,  OA  v. Most  veterinary  studies  are  on  OA  and  pain  (IVDD,  etc)  vi. Neuromodulatory  and  immunomodulatory  vii. I  always  discuss  “resting  and  digesting”  with  clients    

c. Studies  are  very  contradictory  and  frustrating  –  why?  i. Acupuncture  in  research  is  really  not  the  same  as  in  practice  

1. Randomization  2. Static  protocols  3. Sham  needling  4. Blinding  and  bias  5. All  approaches  –  TCVM  to  MA  –  emphasize  individualization  of  tx  

d. Patient  selection  and  disease  selection  i. Pain  >  internal  disease  (in  theory)  ii. Non-­‐local  points  and  local  points    iii. I  ask  clients  to  commit  to  a  series  (usually  4-­‐6  tx  one  week  apart)  iv. I  often  combine  acupuncture  with  laser  therapy,  or  sometimes  laser>acup  

e. Where  to  learn  more  i. www.ivas.org  ii. www.tcvm.org  iii. www.colovma.org  iv. www.civtedu.org  

 EASY  BREEZY  BEAUTIFUL  INTEGRATIVE  MEDICINE  

3. How  to  get  started  tomorrow  a. Laser  therapy    

i. Effects  are  not  thermal  ii. Chromophores  

1. Melanin,  water,  hemoglobin,  cytochrome  C  oxidase  2. End  point  of  transcription/translation  and  “appropriate  cell  turnover”  3. Research  has  been  done  looking  at  potentiation  or  exacerbation  of  neoplasia  

a. Powell  et  al.  The  effect  of  laser  irradiation  on  proliferation  of  human  breast  carcinoma,  melanoma,  and  immortalized  mammary  epithelial  cells.  Photomedicine  and  Laser  Surgery,  2010,  28(1):115-­‐123.  

4. Wavelength  is  important  a. Optical  window  for  therapy  is  red  to  infrared  (600-­‐700nm)  

5. Treatable  Conditions    a. Infrared  Wavelengths  (800-­‐1000nm)-­‐  Deep  Tissue  Penetration:  

i. Sprains  &  strains    ii. Wounds  and  abrasions  iii. Hematomas    iv. Ligament  &  tendon  injuries    v. Inflammation    vi. Joint  injuries    vii. Myofascial  trigger  points,  pain  points  and  deep-­‐tissue  

acupuncture  points    viii. Chronic  &  acute  pain    ix. Non-­‐union  &  small-­‐bone  fractures    x. FIC  (FLUTD)  xi. Neuropathies  

b. Visible  Red  Wavelengths  (630-­‐700nm)  -­‐  Shallow  Tissue  Penetration:  i. Wounds  &  abrasions    ii. Allergic  reactions  iii. Skin  disease  (pemphigus,  allergic  dermatitis,  pyoderma)  iv. Superficial  acupuncture  points    

v. Mucous  membranes    vi. Post-­‐surgical  wounds    vii. Otitis    

c. Advantages:  i. Ease  of  use  ii. Ease  of  training  

1. Wavelength  (nm)  2. Power  (Watt  or  J/s)  3. Treatment  time  (seconds)  

iii. Suggested  doses  (variable)  1. Analgesic  effect:    

a. Muscle  pain:  2  to  4  joules/cm2    b. Joint  pain:  4  to  8  joules/cm2  

2. Anti-­‐inflammatory  effect:    a. Chronic:  4  to  8  joules/cm2  

iv. Safety  1. Eye  wear  2. Not  in  pregnancy  3. Not  over  malignancies?  4. Not  over  growth  plates?  5. Not  in  animals  on  steroids?  6. Wash  off  iodine/furacin/pigmented  medicines  7. Clip  the  fur??  8. Do  not  apply  over  tattoos  

v. Efficacy  vi. Easy  to  use  in  a  variety  of  patients  vii. Respond  Luminex  Ultra  

1. Red  and  Infrared  lasers  in  one  unit  b. Pulsed  Electromagnetic  Field  (PEMF)  therapy  

i. Extremely  low  frequency  fields  generated  by  external  magnetic  coils  that  induce  electric  fields  in  the  body’s  conductive  tissue  through  inductive  coupling  

ii. Produce  eddy  currents  iii. Wraps,  mats,  or  beds  

1. easy  to  use  at  home  iv. Biophysical  interactions  between  the  PEMF  signals  and  biological  tissues  are  not  well  

understood  1. Most  accepted  MOA  suggests  external  magnetic  stimuli  interact  with  cells  

either  via  transmembrane  receptors  or  ion  channels,  initiating  one  or  more  signal  transduction  cascades  or  cell  functions  

v. Anti-­‐inflammatory  and  chondroprotective  via  upregulation  of  adenosine  cell  receptors    vi. Increase  in  growth  factor  synthesis    vii. Studies  have  variable  design  methods  –  hard  to  interpret  as  a  group  viii. FDA  approved  for  non-­‐healing,  non-­‐union  fractures  ix. OA  x. Wound  healing  xi. OC  lesions  xii. Contraindications  

1. Pacemakers/implanted  defibrillators  c. Acupressure/Home  Massage  Programs  for  owners  

i. Often  good  for  client  and  patient  ii. Slow,  moderate  pressure  stimulates  rest  and  digest  

1. Pressure  =  blanch  the  fingernail    2. Toe  tugs,  running  the  spine  3. “Four  Paws/Five  Directions”  by  Cheryl  Schwartz  

a. nice  intro  on  TCVM  points  

b. acupressure  “recipes”  and  theory      

I’VE  GOT  AN  HERB  FOR  THAT!  4. Some  of  my  favorite  underutilized  herbs/supplements  for  conventional  practice  

a. Omega  3  fatty  acids  (fish  oils)  are  beneficial  for  several  disease  processes  i. Renal  disease  ii. Atopy  iii. Arthritis  iv. Multiple  published  dosing  options  

1. 1000mg  capsule/10  pounds  2. 40mg  EPA/kg  3. I  start  typically  at  40-­‐60  mg/kg  EPA+  DHA  

a. GNC  triple  strength  for  large  dogs  b. DVM  Pharmaceuticals  or    “snip  tips”  –  a  vet  only  product  c. Keep  in  the  fridge  d. Watch  for  GI  side  effects  e. High  doses  can  alter  platelet  aggregation,  especially  in  cats  

b. Rehmannia  glutinosa  i. Common  Names:  Chinese  foxglove,  di  huang,  sheng  di  huang  (raw  root  of  rehmannia),  

shu  di  huang  (cured  root  of  rehmannia),  shojio  (Japanese),  saengjihwang  (Korean)  ii. Classic  Chinese  herb  for  “Kidney  and  Yin  deficiency”  –  “thirsting  and  wasting”  disorder  iii. Selected  Constituents:  Bitter  constituents  (iridoids,  including  ajugol,  rehmanniosides),  

phenylethanoid  glycosides  (verbascoside,  echinacoside),  sugars,  sterols,  etc.  iv. Clinical  Action:  Antioxidant,  aperient,  bitter  tonic,  anti-­‐inflammatory,  antipyretic,  

antibacterial,  diuretic,  hepatoprotectant  v. Kidney  disease    

1. In  a  study  in  which  acute  renal  failure  was  induced  in  rats  in  an  ischemia-­‐reperfusion  model,  rehmannia  root  extract  improved  creatinine  clearance,  urine  sodium  excretion,  and  urine  osmolality.  In  addition,  administration  of  rehmannia  influenced  expression  of  certain  renal  electrolyte  and  fluid  transport  channels  (Kang,  2005).  In  a  diabetic  nephropathy  rat  model,  rehmannia  extract  reduced  increases  in  BUN  and  glucose,  as  well  as  histopathologic  changes  in  kidneys  (Yokozawa,  2004).  

2. In  a  Chinese  case  series,  a  combination  of  astragalus  and  rehmannia  may  have  improved  the  clinical  status  of  people  with  chronic  nephritis,  with  significant  improvement  observed  for  91%  of  the  treatment  group  compared  with  67%  of  the  control  group  (Su,  1993).  The  classical  formula  liu  wei  di  huang  enhanced  renal  blood  flow  and  reduced  hypertension  in  rats  (Li,  1974).  

3. Rehmannia  6  vs  Rehmannia  8  a. “R  8”  has  2  additional  “warming”  herbs  

vi. Hemostasis  a. Improvement  of  proliferation  and  differentiation  on  hematopoietic  

stem  cells  and  bone  marrow  erythropoiesis  progenitor  cells    b. Antagonism  of  coagulation  time  prolonged  by  aspirin  

vii. Anti-­‐neoplastic  properties  a. Significantly  enhanced  T  lymphocyte  proliferation  in  vivo  in  tumor  

bearing  mice  and  exerted  an  inhibition  on  tumor  growth    b. Rehmannia  markedly  increased  P53  and  C-­‐fos  gene  expression  

increased  intracellular  gene  expression  in  Lewis  pulmonary  cancer  tissue  

viii. Immunomodulatory  ix. Endocrine  stabilizing  

1. In  laboratory  animal  studies,  administration  of  the  root  seemed  to  reverse  adrenal  hormone  production  and  morphologic  changes  associated  with  long-­‐term  steroid  administration.  

2. Diabetes  a. Rats  rendered  hyperglycemic  through  various  means  were  

administered  rehmannia  extract  and  experienced  lower  blood  glucose  levels  (Zhang,  2004a).  The  authors  found  that  an  extract  high  in  stachyose  was  most  effective  (Zhang,  2004b).  

x. Atopic  dermatitis  1. In  humans  and  dogs,  formulas  that  contain  rehmannia  reduce  pruritus  and  

other  signs  of  atopic  dermatitis.  The  human  formula  contained  10  herbs,  including  rehmannia,  and  was  called  zemaphyte.  The  veterinary  formula  consisted  of  three  herbs:  Rehmannia  glutinosa,  white  peony  (Paeonia  lactiflora),  and  licorice  (Glycyrrhiza  glabra).  Investigators  at  the  University  of  Minnesota  studied  50  atopic  dogs  in  a  randomized,  double-­‐blind,  placebo-­‐controlled  trial  (Nagle,  2001).  Dogs  were  given  the  formula  just  described  or  a  placebo  that  contained  dextrose  and  food  coloring;  they  were  assessed  by  veterinarians  and  owners.  In  all,  37.5%  of  the  herb  group  improved,  compared  with  13%  of  the  placebo  group,  but  this  was  not  a  statistically  significant  difference.  Deterioration  of  the  itch  score  was  significantly  worse  in  the  placebo  group  at  the  final  visit,  and  more  dropouts  were  reported  in  the  placebo  group  because  of  worsening  of  clinical  signs.  No  significant  differences  were  observed  in  surface  damage,  seborrhea,  coat  condition,  or  general  demeanor.  

xi. Contraindications:  None  described  xii. Toxicology  and  Adverse  Effects:  AHPA  class  2d.  Contraindicated  with  diarrhea  and  

indigestion.  Safe—generally  used  over  the  long  term,  usually  in  formulas.  Diarrhea  was  described  in  a  small  number  of  subjects  in  Chinese  studies.  

xiii. Drug  Interactions:  None  reported.  xiv. Dosage:  

1. Small  Animal:  a. Dried  herb:  50-­‐400  mg/kg,  divided  daily  (optimally,  TID)  b. Decoction:  5-­‐30  g  per  cup  of  water,  administered  at  a  rate  of  ¼-­‐½  cup  

per  10  kg  (20  lb),  divided  daily  (optimally,  TID)  c. Tincture  (usually  25%-­35%  ethanol)  1  :  2-­1  :  3:  1.0-­‐2.0  mL  per  10  kg  

(20  lb),  divided  daily  (optimally,  TID)  and  diluted  or  combined  with  other  herbs.  Higher  doses  may  be  appropriate  if  the  herb  is  used  singly  and  is  not  combined  in  a  formula.  

References  Kang  et  al,  2005  .Rehmannia  glutinose  ameliorates  renal  function  in  the  ischemia/reperfusion-­‐induced  acute  renal  failure  rats.  Biol  Pharm  Bull,  28,  pp.  1662–1667  Li,  1974.  Chinese  Herbal  Medicine,  US  Department  of  Health,  Education,  and  Welfare,  Public  Health  Service,  National  Institutes  of  Health,  Washington,  DC  ,  pp.  21–23  DHEW  Publication  No.  (NIH)76–732.  Nagle  et  al.,  2001.  A  randomized,  double-­‐blind,  placebo-­‐controlled  trial  to  investigate  the  efficacy  and  safety  of  a  Chinese  herbal  product  (P07P)  for  the  treatment  of  canine  atopic  dermatitis.  Vet  Dermatol,  12  (2001),  pp.  265–274.  Su  et  al.,  1993.  Clinical  and  experimental  study  on  effects  of  man-­‐shen-­‐ling  oral  liquid  in  the  treatment  of  100  cases  of  chronic  nephritis.  Zhongguo  Zhong  Xi  Yi  Jie  He  Za  Zhi,  13  (1993),  pp.  269–272  259–260.  Yokozawa  et  al.,  2004.  Amelioration  of  diabetic  nephropathy  by  dried  Rehmanniae  Radix  (Di  Huang)  extract.  Am  J  Chin  Med,  32  (2004),  pp.  829–839.  Zhang  et  al.,  2004.  Hypoglycemic  effect  of  Rehmannia  glutinosa  oligosaccharide  in  hyperglycemic  and  alloxan-­‐induced  diabetic  rats  and  its  mechanism.  J  Ethnopharmacol,  90,  pp.  39–43.  Zhang  et  al.,  2004.  Stachyose  extract  from  Rehmannia  glutinosa  Libosch.  to  lower  plasma  glucose  in  normal  and  diabetic  rats  by  oral  administration.  Pharmazie,  59,  pp.  552–556.    

c. Yunnan  Baiyao  (Paiyao)  i. Classic  formulation  consisting  predominantly  of  Astragalus  and  Panax  notoginseng  ii. Hemostatic  powder  –  comes  as  a  plaster  and  capsule  also  iii. Developed  1902    

1. "Qu  Huanzhang  Panacea"  which  became  Yunnan  Baiyao  ("White  medicine  from  Yunnan”  

a. Battlefield  remedy  b. “Absorbs  excess  bleeding,  invigorates  the  blood,  enhances  healing”  c. Exact  proportions  and  ingredients  unknown  (?)  d. Oral  dose  prior  to  surgery  e. Our  surgeons  have  “dumped”  into  the  abdomen  f. Prior  to  nasal  biopsies  g. Hemangiosarcoma  h. Dose  is  somewhat  empirical;  I  use:  

i. Large  dog  –  3  capsules  TID  ii. Md  dog  –  2  capsules  TID  iii. Small  dog/cat  –  1  capsule  TID  iv. I  use  this  often  and  usually  when  I  need  it,  animals  are  dying  

and  better  to  over-­‐  than  under-­‐dose    Reference  Tang,  Z  et  al  (2009).  "Effects  of  the  preoperative  administration  of  Yunnan  Baiyao  capsules  on  intraoperative  blood  loss  in  bimaxillary  orthognathic  surgery:  a  prospective,  randomized,  double-­‐blind,  placebo-­‐controlled  study."  International  journal  of  oral  and  maxillofacial  surgery  38  (3):  261–6.    

d. D-­‐mannose  i. Mannoside  simple  sugar  found  in  cranberries,  pineapple,  other  plant  sources  ii. Largely  excreted  in  the  urine  

1. We  used  caution  in  diabetics/have  had  no  issues  with  hyperglycemia  2. Prevents  biofilm  and  thus  bacterial  bladder  wall  adherence  3. No  noted/reported  side  effects  4. “Pure  Encapsulated”  –  powder  

a. 1  scoop  =  ½  tsp.    i. Large  dog  –  ½  scoop  TID  (1/4  tsp)  ii. Medium  dog  –  ¼  scoop  TID  (1/8  tsp)  iii. Small  dog/cat  –  1/16  tsp  ()  TID  –  a  “pinch”  

References  http://www.modernmedicine.com/modernmedicine/Clinical%2BPharmacology/Investigational-­‐agent-­‐for-­‐chronic-­‐UTI-­‐successful-­‐i/ArticleStandard/Article/detail/751515?contextCategoryId=40184  Alton,  G  et  al  (1998).  “Direct  utilization  of  mannose  for  mammalian  glycoprotein  biosynthesis”.  Glycobiology  8(3):  285-­‐295.    

   

                               

 

 

 

Term Official Term? Definition

Biologically appropriate raw food

No

A food that is made of raw ingredients, also called Bones and Raw Food (BARF). Raw is defined as “Food in its natural or crude state not having been subjected to heat in the course of preparation as food.” (Association of American Feed Control Officials, 2011 Official Publication, p.361)

Grain-free No

A food that does not contain any grains or grain-derived protein. It implies that the protein is derived solely from animal sources, but does not imply low carbohydrate or high protein as the food may contain non-grain carbohydrate. Grain is defined officially as “(Part) Seed from cereal plants.” (Association of American Feed Control Officials, 2011 Official Publication, p.359)

Gourmet No A food that is allegedly composed of higher quality ingredients.

Human grade No

Human grade refers to the quality of the finished product and is applied to a product that is legally suitable and approved for consumption by a human being in accordance with the Food and Drug Administration (FDA) Code of Federal Regulations (CFR) Title 21. “Made with Human-grade Ingredients” does not mean that the finished product is actually, legally human grade. An ingredient may start off being fit for human consumption, but once processed in a pet food plant in accordance with regulations for animal feed-grade products, it is no longer “human-grade”.

Natural Yes

“A feed or ingredient derived solely from plant, animal, or mixed sources, either in its unprocessed state or having been subject to physical processing, heat processing, rendering, purification, extraction, hydrolysis, enzymolysis, or fermentation, but not having been produced by or subject to a chemically synthetic process and not containing any additives or processing aids that are chemically synthetic except in amounts as might occur unavoidably in good manufacturing practices.” (Association of American Feed Control Officials, 2011 Official Publication, p.360)

Organic Yes

“A formula feed or a specific ingredient within a formula feed that has been produced and handled in compliance with the requirements of the USDA National Organic Program (7 CFR Part 205).” (Association of American Feed Control Officials, 2011 Official Publication, p.360)

Premium No A food that is allegedly composed of higher quality ingredients.

Whole foods No

Foods that are unprocessed and unrefined or processed and refined as little as possible before being consumed. Whole foods do not contain added ingredients (e.g. salt or fat). The term is often confused with organic food, but whole foods are not necessarily organic, nor are organic foods necessarily whole foods.

 

 Body Condition Scoring (BCS) Systems.

5 Point

Description 9 Point

1/5

Dogs: Ribs, lumbar vertebrae, pelvic bones and all bony prominences evident from a distance. No discernible body fat. Obvious loss of muscle mass. Cats: Ribs visible on shorthaired cats; no palpable fat; severe abdominal tuck; lumbar vertebrae and wings of ilia obvious and easily palpable.

1/9

1.5/5 Dogs: Ribs, lumbar vertebrae and pelvic bones easily visible. No palpable fat. Some evidence of other bony prominence. Minimal loss of muscle mass. Cats: Shared characteristics of BSC 1 and 3.

2/9

2/5

Dogs: Ribs easily palpated and may be visible with no palpable fat. Tops of lumbar vertebrae visible. Pelvic bones becoming prominent. Obvious waist. Cats: Ribs easily palpable with minimal fat covering; lumbar vertebrae obvious; obvious waist behind ribs; minimal abdominal fat

3/9

2.5/5 Dogs: Ribs easily palpable, with minimal fat covering. Waist easily noted, viewed from above. Abdominal tuck evident. Cats: Shared characteristics of BSC 3 and 5.

4/9

3/5

Dogs: Ribs palpable without excess fat covering. Waist observed behind ribs when viewed from above. Abdomen tucked up when viewed. Cats: Well proportioned; waist observed behind ribs; ribs palpable with slight fat covering; abdominal fat pad minimal.

5/9

3.5/5 Dogs: Ribs palpable with slight excess fat covering. Waist is discernible viewed from above but is not prominent. Abdominal tuck apparent. Cats: Shared characteristics of BSC 5 and 7.

6/9

4/5

Dogs: Ribs palpable with difficulty; heavy fat cover. Noticeable fat deposits over lumbar area and base of tail. Waist absent or barely visible. Abdominal tuck may be present. Cats: Ribs not easily palpable with moderate fat covering; waist poorly distensible; obvious rounding of abdomen; moderate abdominal fat pad

7/9

4.5/5 Dogs: Ribs not palpable under very heavy fat cover, or palpable only with significant pressure. Heavy fat deposits over lumbar area and base of tail. Waist absent. No abdominal tuck. Obvious abdominal distension may be present. Cats: Shared characteristics of BSC 7 and 9.

8/9

5/5

Dogs: Massive fat deposits over thorax, spine and base of tail. Waist and abdominal tuck absent. Fat deposits on neck and limbs. Obvious abdominal distention. Cats: Ribs not palpable under heavy fat cover; heavy fat deposits over lumbar area, face and limbs; distention of abdomen with no waist; extensive abdominal fat pad

9/9

       

Questions for a Pet Food Company:

1. Do you have a Veterinary Nutritionist or some equivalent on staff in your company? Are they

available for consultation or questions?

2. Who formulates your diets and what are their credentials?

3. Which of your diet(s) is AAFCO Feed Trial tested? Which diet(s) has been AAFCO Nutritional

Analyzed?

4. What specific quality control measures do you use to assure the consistency and quality of your

product line?

5. Where are your diets produced and manufactured? Can this plant be visited?

6. Can you provide a complete product nutrient analysis of your best-selling canine and feline pet

food including digestibility values?

7. Can you give me the caloric content per can or cup?