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2010 AAFP/AAHA Feline Life Stage Guidelines | AAHA

Posted: November 29, 2018 at 11:43 pm


Published in 2010 (Jan/Feb)

Amy Hoyumpa Vogt, DVM, DABVP (Canine and Feline), Guidelines Co-Chair | Ilona Rodan DVM, DABVP (Feline), Guidelines Co-Chair | Marcus Brown, DVM | Scott Brown, VMD, PhD, DACVIM | C A Tony Buffington, DVM, PhD, DACVN | M J LaRue Forman, DVM, DACVIM | Jacqui Neilson, DVM, DACVB | Andrew Sparkes, BVetMed, PhD, DipECVIM, MRCVS | Corresponding authors (Co-Chairs): A Hoyumpa Vogt, ahoyumpa@earthlink.net | I Rodan, care4cats@gmail.com

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The AAFP and AAHA welcome endorsement of these guidelines from the European Society of Feline Medicine, and acknowledge the help of the Feline Advisory Bureau's WellCat for Life programme in helping to formulate the guidance.

Cats have become the most popular pet in the United States, yet statistics about veterinary care for cats remain troubling.1 Although most owners consider their cats to be family members, cats are substantially underserved, compared with dogs.

In 2006, owners took their dogs to veterinarians more than twice as often as cats, averaging 2.3 times/year, compared with 1.1 times/year for cats, and significantly more dogs (58%) than cats (28%) were seen by a veterinarian one or more times/year.2 Cat owners often express a belief that cats 'do not need medical care'. Two reasons for this misconception are that signs of illness are often difficult to detect, and cats are perceived to be self-sufficient.2 One role of the veterinarian is to develop a partnership with cat owners that will pave the way for a lifelong health care plan. These guidelines aim to outline an evidence-based life stage wellness program to aid the veterinary medical team in delivering the best comprehensive care for cats. Specific goals are to provide:

Distinct life stages (age groups) in cats are not well defined, in part because individual animals and body systems age at different rates, a process that is influenced by many factors. These guidelines follow one convenient classification (see box on the next page). These age designations help to focus attention on the physical and behavioral changes that occur at different stages (eg, congenital defects in kittens, obesity prevention in the junior cat). It must be recognized, however, that any age groupings are inevitably arbitrary demarcations along a spectrum, and not absolutes.

These guidelines follow a convenient life stage classification developed by the Feline Advisory Bureau and adopted in the recent AAFP Senior Care Guidelines.4,5 Six age groupings are defined, from kitten through to geriatric.

Supporting references for specific recommendations are supplied where possible, and any previously published guidelines on particular topics are referred to where relevant. Readers should note, however, that the guidelines panel was hampered in its efforts by the relative paucity of disease incidence data by age group that is available, and there is an urgent need for research to guide the future of evidence-based feline health care.3

To achieve optimum feline health care, veterinarians must help owners to understand and appreciate the importance of regular preventive care for their cats at all ages.A consistent message from the entire health care team is crucial, beginning with the first kitten visit and reinforced during subsequent visits. Early detection of clinical abnormalities and behavioral changes can improve disease management and quality of life.5,6

The panel supports the recommendations of the American Association of Feline Practitioners (AAFP) and American Animal Hospital Association (AAHA) that a minimum of annual wellness examinations and consultations for all catsis justifiable. More frequent examinations may be recommended for seniors and geriatrics, and cats with medical and behavioral conditions.

Semi-annual wellness exams are often recommended for all feline life stages by veterinarians and veterinary organizations. Their reasoning includes the fact that changes in health status may occur in a short period of time; that ill cats often show no signs of disease; and that earlier detection of ill health, body weight changes, dental disease, and so on, allows for earlier intervention. In addition, semi-annual exams allow for more frequent communication with the owner regarding behavioral and attitudinal changes, and education about preventive health care. Further research is needed to identify the optimal examination schedule to maximize the health and longevity of the cat.

The panel members concluded that preventive veterinary care can improve quality of life, detect illness earlier and, therefore, reduce the long term expenses associated with a cat's health care. They believe that cat owners are willing to seek more veterinary care when it improves quality of life and detects illnesses earlier, thereby reducing the long term expenses associated with their cat's health care. Improved client communication and education of the benefits of regular veterinary care are essential to achieve that goal (Fig. 1).

According to one study, 41% of people looking for their lost cats considered them to be indoor-only pets.9 American Humane Association records reveal that only about 2% of lost cats ever find their way back from shelters, a major reason being the lack of tag or microchip identification. Assuring the identification of all pet cats, regardless of their lifestyle, is recommended to increase the prospect of lost cats being returned to their owners. The wellness examination is the ideal time to discuss the importance of identification with owners. The benefits of both visible (eg, collar and tag) and permanent (microchip) identification should be explained and compliance with identification recorded in the medical records along with other elements of the history.

The reasons pet owners have cited for not seeking care were that they did not know it was necessary, the veterinarian did not recommend it, and the need or benefit was not well explained.7 Other obstacles include the cat's stress or fear associated with veterinary visits and the practical difficulties of transporting cats to receive veterinary care. Suggestions for overcoming such barriers are provided on page 77.

It is not the intent of the panel to reiterate the basics of the veterinary visit, but instead to offer a checklist to assist the veterinarian (see Table 1). Where relevant, aspects of feline behavior, nutrition, and various disease prevention and detection strategies are expanded on in the text.

History-taking includes the use of open-ended questioning (eg, 'How has [cat's name] been doing since the last visit?').8 This approach is often combined with a template or checklist, such as given in Table 1, to ensure important aspects are not overlooked.

When performing the physical exam, particular attention should be paid to:

Although specific data documenting benefits are not available, the panel concluded that regular wellness examinations and collection of the minimum database (MDB; Table 2) can be valuable, allowing early detection of disease or trends in clinical or laboratory parameters that may be of concern. Additionally, it provides a baseline for interpretation of data recorded at subsequent visits.

Specific recommendations about age and frequency of laboratory testing depend on many factors.5,18,24 One consideration in determining this frequency is that the incidence of many diseases increases as cats age. Guidelines for management of mature, senior and geriatric cats may be found in the AAFP Senior Guidelines.5 Retroviral testing is discussed in detail in the AAFP Retrovirus Testing Guidelines.22 Measurement of blood pressure is discussed in detail in the ACVIM guidelines.25 Although limited incidence studies have been performed to identify the age of onset of hyperthyroidism in cats, the panel recommends that veterinarians strongly consider T4 testing in the apparently healthy mature cat. More robust incidence data is needed to develop firmer recommendations.

Energy and nutrient needs vary with life stage, sterilization status and activity, and so general feeding recommendations provide only a starting point. Individual intakes must then be adjusted to maintain the desired weight and body condition score (Fig. 2).

The panel recommends that the veterinary team endeavours to make the veterinary encounter comfortable for both cat and client. Integral to this is a better understanding of feline behavior.10,11 Some specific tips to help minimize the challenges associated with bringing a cat to the clinic are given below.

Once the client arrives at the veterinary clinic, the health-care team can take steps to reduce stress for both the client and the cat, as is feasible for their situation.12 See below for some ideas for the waiting client and cat, and some tips to facilitate examination and treatment.

Reducing the stress of transport

Making the cat and client comfortable at the clinic

Facilitating the examination and treatment

Supplementary Data

An AAFP position statement entitled 'Respectful handling of cats to prevent fear and pain' is available at http://www.catvets.com and included in the online version of this article at doi:10.1016/j.jfms.2009.12.006

Satisfactory diets for cats contain all the required nutrients in proper balance, are palatable and digestible, and are free of spoilage and contaminants. The specific source of nutrients in feline diets is irrelevant when these criteria are satisfied.26 Both canned and dry food have been found to support health during all life stages.27 The presence of a label guarantee that the food was tested using feeding trials provides the current best initial evidence that a diet is satisfactory.

The panel examined published peer-reviewed evidencebased studies in healthy, client-owned cats for any significant health effect of: feeding canned versus dry food (including contribution to dental health); providing a variety of foods versus a consistent diet; feeding high protein, low carbohydrate versus lower calorie and high fiber diets; feeding raw diets; providing dietary supplements, or access to grass or plants. Based on the available data, specific recommendations in favor of any of these practices cannot be made.

Despite the concern surrounding the effects of carbohydrate in dry foods, current evidence suggests that housing and activity (which may be a marker of welfare)28 are more significant predictors of health.2932 Evidence does not support the carbohydrate content of foods as being harmful or an independent risk factor for diseases such as obesity or diabetes.29,33

With regard to home-made foods, the veterinarian should discuss and share evidence about nutritional balance, risks associated with preparation and feeding of foods raw, and advantages of using food formulated for cats, referring clients to additional resources if required (Table 3).

A variety of feeding styles can maintain good health in client-owned cats, including free choice or provision of meals. In addition to monitoring intake, considerations include:

Obesity may occur at any age, but is most commonly encountered in middle age.32,36 The risk of obesity may be reduced by environmental enrichment, increasing opportunities for activity, and individualizing food intake. The energy density of cat foods varies widely, based on the moisture and fat content of the diet. This information should be helpfulin determining a guideline of how much to feed.

Tips and items for discussion with clients include:

An outline of behavior and environmental items for discussion at each life stage is presented in Table 1. The following discussion elaborates on those items, where applicable. For detailed recommendations about normal cat behavior and management refer to the AAFP Feline Behavior Guidelines.10

Photo courtesy of Deb Givin.

Parasite control is important in cats of all ages. Prevention includes both animal and environmental control. The Companion Animal Parasite Council (CAPC) guidelines contain recommendations about prevention of ecto- and endoparasites, fecal testing, and more.20 The United States Centers for Disease Control and Prevention website (see Table 3) also provides information on a variety of zoonoses. Items for discussion are listed in Table 1, and a few specifics are expanded on below.

Table 1 outlines the vaccination priorities to consider when designing a comprehensive, life stage-targeted wellness plan for a cat.

Diseases of the oral cavity are extremely common,53 yet most owners are unaware that dental disease can threaten the health and welfare of their cat. The AAHA Dental Care Guidelines for Dogs and Cats provide details of dental care and dental charting.54 Points of note include:

Although the panel's objective to provide evidence-based guidelines for health care related to life stage was not fully realized, the profession could develop more accurate recommendations through further research and through cooperation and data sharing. More robust data about disease incidence by age would assist practitioners in determining the value and desired frequency of routine wellness testing. In the meantime, we must rely on the available data, personal knowledge and experience to help owners maintain their cat's health during its lifetime.

The AAFP and AAHA would like to thank Boehringer Ingelheim, Merial Ltd, Pfizer Animal Health and IDEXX Laboratories for their sponsorship of these guidelines and their commitment to help the veterinary community develop projects that will improve the lives of cats.

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2010 AAFP/AAHA Feline Life Stage Guidelines | AAHA

2010 AAHA Diabetes Management Guidelines for Dogs and Cats …

Posted: at 11:43 pm


Renee Rucinsky, DVM, ABVP (Feline) (Chair) | Audrey Cook, BVM&:S, MRCVS, Diplomate ACVIM-SAIM, Diplomate ECVIM-CA | Steve Haley, DVM | Richard Nelson, DVM, Diplomate ACVIM | Debra L. Zoran, DVM, PhD, Diplomate ACVIM | Melanie Poundstone, DVM, ABVP

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Diabetes mellitus (DM) is a treatable condition that requires a committed effort by veterinarian and client. This document provides current recommendations for the treatment of diabetes in dogs and cats. Treatment of DM is a combination of art and science, due in part to the many factors that affect the diabetic state and the animal's response. Each animal needs individualized, frequent reassessment, and treatment may be modified based on response.

In both dogs and cats, DM is caused by loss or dysfunction of pancreatic beta cells. In the dog, beta cell loss tends to be rapid and progressive, and it is usually due to immune-mediated destruction, vacuolar degeneration, or pancreatitis.1 Intact females may be transiently diabetic due to the insulin-resistant effects of the diestrus phase. In the cat, loss or dysfunction of beta cells is the result of insulin resistance, islet amyloidosis, or chronic lymphoplasmacytic pancreatitis.2

Risk factors for both dogs and cats include insulin resistance caused by obesity, other diseases (e.g., acromegaly in cats, hyperadrenocorticism in dogs), or medications (e.g., steroids, progestins). Genetics is a suspected risk factor, and certain breeds of dogs (Australian terriers, beagles, Samoyeds, keeshonden3) and cats (Burmese4) are more susceptible.

Regardless of the underlying etiology, diabetic dogs and cats are hyperglycemic and glycosuric, which leads to the classic clinical signs of polyuria, polydipsia (PU/PD), polyphagia, and weight loss. Increased fat mobilization leads to hepatic lipidosis, hepatomegaly, hypercholesterolemia, hypertriglyceridemia, and increased catabolism. Eventually, hyperketonemia, ketonuria, and ketoacidosis develop and result in progressive compromise of the animal.

In this document, the authors describe different approaches to the animal depending on the level of hyperglycemia and severity of the clinical signs. Animals with DM may be presented with a variety of signs that are dependent, in part, on the time interval between onset of hyperglycemia and the client seeking veterinary help; the severity of hyperglycemia; presence and severity of ketonemia; and the nature and severity of concurrent disease, such as pancreatitis. Clinical signs of PU/PD do not develop until the blood glucose (BG) concentration exceeds the renal tubular threshold for spillage of glucose into the urine. In dogs and cats, glycosuria typically develops when the BG concentration exceeds approximately 200 mg/dL and 250 mg/dL, respectively.

Clinical signs of DM are not generally present in dogs and cats with persistent fasting BG concentrations above the reference range but below the concentration that results in glycosuria (i.e., BG between the reference upper limit to 200 mg/dL in dogs and between the reference upper limit to 250 mg/dL in cats). BG concentrations in these ranges may occur for several reasons, including stress hyperglycemia (in cats), presence of an insulin-resistant disorder (e.g., obesity, hyperadrenocorticism), in association with medication (e.g., glucocorticoids), or as part of the early stage of developing DM.

Dogs and cats that are in the early stage of developing DM are classified as subclinical diabetics. Subclinical diabetics often appear healthy, have a stable weight, and are usually identified when routine laboratory work is performed for other reasons. A diagnosis of subclinical diabetes should only be made after stress hyperglycemia has been ruled out and hyperglycemia persists despite identification and correction of insulin-resistant disorders. Reassessing the BG at home or measuring serum fructosamine concentration may help differentiate between stress hyperglycemia and subclinical DM and help determine if further action is needed.

Clinical DM is diagnosed on the basis of persistent glycosuria and persistent hyperglycemia (>200 mg/dL in the dog and >250 mg/dL in the cat). Documentation of an elevated serum fructosamine concentration may be necessary to confirm the diagnosis in cats.5

Animals with clinical diabetes manifest PU/PD, polyphagia, and weight loss. Some animals present with systemic signs of illness due to diabetic ketoacidosis (DKA), such as anorexia, dehydration, and vomiting. Additional problems may include lethargy, weakness, poor body condition, cataracts (in dogs), and impaired jumping ability and abnormal gait (in cats).

The initial evaluation of the diabetic dog and cat should:

The physical examination of the diabetic dog or cat can be relatively normal or may reveal dehydration, weight loss, dull coat, cataracts, or abdominal pain (if concurrent pancreatitis is present). A sweet odor may be noted on the breath if the animal is ketotic. Some cats with long-standing hyperglycemia may have a plantigrade stance secondary to a peripheral neuropathy.

Laboratory assessment should include the items in Table 1. Typical findings include a stress leukogram and increased glucose, cholesterol, and triglyceride concentrations.

Dogs often show increased alkaline phosphatase and alanine aminotransferase activity. In the cat, the stress leukogram and increases in alkaline phosphatase are variable. Cats with increased liver enzymes may have concurrent liver disease or pancreatitis and should be evaluated further.6

Dogs and cats with DKA may show very elevated BG concentrations, alterations in liver enzyme activity and electrolyte concentrations, azotemia, and decreased total carbon dioxide secondary to metabolic acidosis, osmotic diuresis, and dehydration.7,8

The urinalysis will reveal the presence of glucose and may reveal the presence of protein, ketones, bacteria, and/or casts. A urine culture should always be performed in glycosuric animals, as infection is commonly present.

If thyroid disease is suspected in a dog, it is best to perform thyroid testing after diabetes is stabilized because of the likelihood of euthyroid sick syndrome. All cats >7 years of age with weight loss and polyphagia should be tested for hyperthyroidism, as diabetes and hyperthyroidism cause similar clinical signs and can occur concurrently.

The mainstay of treatment for clinical DM in both species is insulin, along with diet modification. However, insulin treatment is not indicated in dogs and cats with subclinical disease, unless hyperglycemia worsens and glycosuria is noted.

Veterinarians use a variety of insulin products, but only two are presently approved by the Food and Drug Administration (FDA) for use in dogs and cats. One of these is a porcine lente product (porcine zinc insulin suspension) that is approved for both dogs and cats.9 If available, the authors' recommendation is to use this product in dogs. The other FDA-approved insulin is a longer-acting product (human recombinant protamine zinc insulin [PZI]) and is currently approved for use in cats.10 For the majority of diabetic cats, insulin glargine (not veterinary approved) and PZI have appropriate duration of action.

Although bovine PZI is available from compounding pharmacies, its use is not recommended because of concerns about production methods, diluents, sterility, and the consistency of insulin concentration between lots. In addition, bovine insulin causes antibody production in dogs, which may impact control of DM.11

Management of the cat with subclinical DM

Overall goals of treatment

Cats with subclinical DM may attain euglycemia without the use of insulin. Begin management with diet change. Evaluate and manage body weight, identify and cease any existing diabetogenic drug therapy, and correct concurrent insulin-resistant disease. Perform a recheck examination with urine analysis and BG measurement every 2 weeks. If clinical DM occurs despite dietary intervention, initiate insulin therapy.

Diet therapy goals and management

Management of the cat with clinical DM

In addition to diet therapy, insulin treatment is required for cats with clinical DM.

Overall goals of treatment

Management

Insulin therapy in the cat

The insulin preparations with the appropriate duration of action in most diabetic cats are glargine (U-100) or the veterinary-approved human protamine zinc insulin (PZI U-40).31

This panel does not recommend the veterinary-approved porcine zinc (lente) insulin suspension as the initial treatment for the cat, because its duration of action is short and control of clinical signs is poor.32 This insulin should be reserved for cats in which other insulin choices have not yielded satisfactory results.

Judicious dosing is recommended initially, given that diet change may alter food intake and impact the response to insulin. Likewise, with ongoing therapy and reversal of glucotoxicity, the pet's response to insulin will improve with time.17 Use caution in increasing the insulin dose too soon. Increases should only be made once food intake has stabilized and only if clinical signs have not improved after 1 week of therapy.

Most cats are well regulated on insulin at 0.5 U/kg q 12 hours, with a range of 0.2 to 0.8 U/kg.15,33 The panel recommends a starting dose of 0.25 U/kg q 12 hours, based on an estimate of the cat's lean body weight. This equates to 1 U q 12 hours in an average cat. Even in a very large cat, the starting dose of insulin should not exceed 2 U per cat q 12 hours.

Initiating insulin therapy

Outline of initial approach

Precautions and details

Monitoring strategies may be influenced by persistence or resolution of clinical signs. The pressing concern for the newly diagnosed and treated cat is the development of hypoglycemia in individuals that may quickly go into remission. Cats on long-acting insulin may not show overt signs of hypoglycemia until the BG is dangerously low, so it is important to identify impending hypoglycemia by home glucose testing whenever possible.

If BG monitoring is not possible, close attention and documenting changes in clinical signs are imperative. Likewise, urine glucose testing using glucose-detecting crystals in the litter can be helpful for detecting diabetic remission.17

In-clinic (only if home monitoring is not possible)

Every 1 to 2 weeks:

Home

Weekly:

Every 2 weeks:

Advise clients to monitor and record the following:

In-clinic:

Management of the dog with subclinical DM

Diet therapy

Evaluate and recommend an appropriate diet that will correct obesity, optimize body weight, and minimize postprandial hyperglycemia. Dogs with DM can do well with any diet that is complete and balanced, does not contain simple sugars, is fed at consistent times in consistent amounts, and is palatable for predictable and consistent intake.

Dietary considerations include:

Adjunctive treatment

Management of the dog with clinical DM

Treatment of clinical DM in the dog always requires exogenous insulin therapy. The U-40 pork lente (porcine zinc insulin suspension) has been the first-choice recommendation for dogs. The duration of action is close to 12 hours in most dogs, and the amorphous component of the insulin helps to minimize postprandial hyperglycemia.38 However, according to the FDA, that product has recently had "problems with stability," and while the manufacturer is "working with FDA on resolving this issue, supplies may be limited" (http://www.fda.gov/AnimalVeterinary/NewsEvents/CVMUpdates/ucm188752.htm; accessed 4/14/2010). If it again becomes consistently available, it will remain a great option for dogs. In the meantime, diabetic dogs should be started on a different insulin.39

When porcine zinc insulin is not available, U-100 human recombinant Neutral Protamine Hagedorn (NPH) insulin is a good initial alternative, although its duration of action is often <12 hours in many dogs.40

As a third option, human PZI is likely to be a better choice for dogs than is insulin glargine. There are no studies showing effective use of either of these products in dogs, however, glargine would likely require concurrent use of a short-acting insulin due to its slow release from subcutaneous tissues.

Overall goals of treatment

Initiating insulin therapy

Outline of initial approach

Precautions and details

Always tailor the monitoring and treatment to the dog. See Client Education for links to how-to videos and information.

Weekly (every 7 to 10 days):

Tailor monitoring to the dog. Focus on weight, history, physical examination, and client observations regarding thirst, urine output, energy level, and behavior.42 Treat the dog, not the BG results. Always repeat the BGC 2 weeks after any insulin dose adjustment.

In-clinic

At home

BGCs are part of the long-term monitoring plan. Create a BGC when:

Use results to measure the nadir and to calculate the average BG over a roughly 12-hour period (average equals sum of all measurements divided by number of measurements). The BGC is the optimal way to assess:

Initial BG measurements are performed as described under Initial Treatment. This is the protocol for the BGC in established diabetic animals.

If the BGC is performed at home, have client measure BG before insulin or food is given. In free-fed cats, measure BG before insulin is given.

Dogs

Cats

Target results43

Action plan: If nadir is

The "uncontrolled diabetic" is one with poor control of clinical signs. This may include hypo- and hyperglycemic pets, those with insulin resistance (decreased responsiveness to the insulin, defined by >1.5 U/kg per dose), or those with frequent changes (up or down) in insulin doses. Any dog or cat with persistent BG >300 mg/dL despite receiving >1.5 U/kg per dose should be reevaluated [Table 1], as insulin resistance or insulin overdosage causing the Somogyi response is likely.

Give clients a realistic idea of the commitment involved, along with positive encouragement that it is possible to manage this disease. Provide access to trained veterinary support staff and helpful web links. Stress the importance of appropriate nutrition and weight management. Table 2 provides web resources for education of staff and clients. Inform clients about the following:

Recommend new bottle if insulin changes in appearance or becomes out of date.

Management of the diabetic animal requires commitment and excellent communication between veterinarian and client about the treatment, follow-up appointments, associated costs, and home care. Diabetes is a dynamic disease, and successful management requires frequent client education and communication with the veterinary team. With appropriate client commitment, monitoring, and a firm understanding of the variables that are within our control, DM can be well managed.

Important differences exist between the development of canine and feline DM, and understanding these differences will help predict management success. The recommendations made in this manuscript are intended to guide medical decisions and treatment choices, with the recognition that within each animal, variations in response will exist and no two cases are alike. In difficult-to-manage cases, you may consider consulting with or referring to an internal medicine specialist.

Renee Rucinsky, DVM, ABVP (Feline) (Chair)Audrey Cook, BVM&S, MRCVS, Diplomate ACVIM-SAIM, Diplomate ECVIM-CASteve Haley, DVMRichard Nelson, DVM, Diplomate ACVIMDebra L. Zoran, DVM, PhD, Diplomate ACVIMMelanie Poundstone, DVM, ABVP

These guidelines were sponsored by a generous educational grant from Intervet/Schering-Plough Animal Health.

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2010 AAHA Diabetes Management Guidelines for Dogs and Cats ...

Dental Care | AAHA

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With appropriate care, oral and dental disease and the associated pain may be either prevented or minimized. With so many dogs affected, dental care must be incorporated into each dogs wellness plan and discussed at every visit (Table 2). The oral examination performed on an awake patient allows the practitioner to design a preliminary treatment plan. Only when the patient has been anesthetized can a complete and thorough oral examination be performed and an accurate dental score assigned.14

The incorporation of before and after dental cleaning photographs (using intraoral cameras, if available) and dental scoring may help motivate clients to take action either before irreversible damage is done to periodontal tissues or repair becomes extensive.14,56

Each breed and life stage presents new dental needs and concerns. Certain breeds and sizes of dogs have a higher incidence of dental conditions than others.5760 For breeds predisposed to certain oral conditions (e.g., small breeds, brachycephalics, and dogs with malocclusions), evaluate the need for early intervention with either increased frequency of recommended dental procedures or with interceptive orthodontics (e.g., orthodontic management of deciduous malocclusion with select and careful extractions).

Client education is paramount to ensure proper dental care throughout the dogs life. Discuss and demonstrate dental home care options at routine wellness visits, providing visual, verbal, and written information of the benefits and simplicity of effective home care. Discuss avoidance of hard toys that could damage teeth, and provide recommendations for safe products. Comprehensive dental care is described in the AAHA Dental Care Guidelines.

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Dental Care | AAHA

SMART Goals | AAHA

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Interactive tool: Create your ownSMART goals

SMART goals are Specific, Measurable, Attainable, Realistic, and Time-bound. Theyre like a text roadmap that makes it easy to pinpoint what you want and exactly when and how you plan to get it.

If creating SMART goals sounds like a lot of work, dont worry. SMART goals dont have to be long or complicated, and they dont take a lot of time to write. In fact, you can use this online form to create your own SMART goals. Answer the questions and short quizzes below, then click PRINT. Complete the process for each SMART goal you want. Your privacy is important to us, so AAHAs website wont save your responses. Be sure to press PRINT before starting a new form or your answers will be lost.

There arefive easy steps:

Step 1: Write a specific goal statement.Step 2: Define how youll measure your progress.Step 3: Time for a reality check. Is your goal attainable?Step 4: Is your goal relevant?Step 5: Is your goal time-bound?

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Survey shows health benefits of pets linked to improved …

Posted: at 11:43 pm


(WASHINGTON, D.C.) September 8, 2016 The Human Animal Bond Research Initiative (HABRI) Foundation and the American Animal Hospital Association (AAHA) today announced the findings of a new survey on how knowledge of the scientific benefits of the human-animal bond impacts the way pet owners care for their companion animals. The survey asked pet owners about their awareness of research that shows pets improve human health and found that this knowledge motivated them to take better care of their pets, including a significant, positive impact on veterinary care.

When educated about the scientific research on the human-animal bond, pet owners are more likely to take important measures to improve pet health and augment their relationship with their veterinarians, said AAHA Chief Executive Officer, Michael Cavanaugh, DVM, DABVP (C/F). AAHA-accredited animal hospitals continue to raise the standard for veterinary care across the country, and HABRI gives us another way to connect with pet owners to enhance that care.

When 2,000 pet owners were educated about the human health benefits of pet ownership:

When people find out that pets improve heart health, decrease stress, help alleviate depression and address specific conditions that include autism, PTSD and Alzheimers, they become more focused on caring for their pets health, said HABRI Executive Director, Steven Feldman. More awareness of human-animal bond science improves veterinary care and leads to a healthier pet population.

Veterinarians, already viewed favorably by 97% of pet owners, are also viewed as important messengers for scientific information on the health benefits of pets, especially by millennial pet owners:

66% of pet owners (77% of millennials) would have a more favorable view of their veterinarian if they discussed the health benefits of the human-animal bond with them61% of pet owners (74% of millennials) would be more likely to visit their veterinarian if they discussed the health benefits of the human-animal bond with them

The science of the human-animal bond offers veterinarians a real opportunity to improve their relationships with clients, and to provide the best care for their patients, added Cavanaugh.

The online survey, conducted by The Cohen Research Group, included 2,000 interviews and had a margin of error of +2.2%.

Established in 1933 by leaders in the veterinary profession, AAHA is best known for its accreditation of companion animal practices. To become accredited, companion animal hospitals undergo regular comprehensive evaluations by AAHA veterinary experts who evaluate the practice on approximately 900 standards of veterinary care. The association also develops other publications and educational programs and resources designed to help companion animal hospitals thrive. The AAHA membership philosophy is team-focused, allowing every hospital staff member, from veterinarians to receptionists, to benefit from AAHAs resources through one group membership. Today, more than 3,700 practice teams in the United States and Canada are AAHA accredited.

The HABRI Foundation maintains the worlds largest online library of human-animal bond research and information; funds innovative research projects to scientifically document the health benefits of companion animals; and informs the public about human-animal bond research and the beneficial role of companion animals in society. For more information about the HABRI Foundation, visit http://www.habri.org.

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Survey shows health benefits of pets linked to improved ...

Exercise/Activity | AAHA

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Research in humans has shown that combining caloric reduction with exercise offers the best chance of successful and sustainable weight loss.57,58 Physical activity provides several potential benefits including preservation of lean muscle mass, increased caloric expenditure, and promotion of behaviors that aid in sustainable weight loss.59 Although evidence that exercise will enhance weight loss outcomes in pets is preliminary, data from humans suggests that increased activity could have a positive impact on weight loss in pets.40,60

Physical activity differs between dogs and cats. Assess and discuss with the client any pet and/or client physical limitations, client schedule, expectations and goals, possibilities, and limitations (e.g., pet sitter/daycare availability, activity options, adverse weather conditions).

Assess any comorbidities that may affect tolerance and timing of implementation of a physical activity program. Once a patient is deemed healthy enough to undergo an exercise program, design a plan based on endurance, intensity, and type of exercise. For pets with limited mobility, consider either low-impact exercise alternatives (such as swimming) or consultation with a rehabilitation therapist.

Factors to consider when formulating a plan include who will be involved (e.g., client, veterinarian, rehabilitation therapist, referral) and documenting activity (i.e., time, intensity, caloric expenditure, etc.). Use that information along with weight change to adjust the feeding and/or exercise plan as needed.

Evidence is lacking to describe an ideal exercise program for dogs. With the exception of walking, caloric expenditures for various forms of exercise in pets is largely undocumented. One approach for an obese dog with no orthopedic restrictions is to start with a 5 min walk three times/day, if possible. Increase gradually until either the clients or pets limit is reached or once a total of 3045 min of walking/day has been achieved.57

In general, most dogs expend about 1.1 kcal/kg/km at a brisk walking pace of 1010.5 min/km.61,62 A 45 kg dog will burn about 240 calories after 4.82 km at that pace. Walking at a slower pace also has health benefits, although the benefits are difficult to quantify because of lack of current research. Use the above-described estimates to calculate suggested exercise by either duration or distance and incorporate that into the weight-loss plan. Without similar guidelines for other types of exercise, documentation of activity combined with more frequent weight monitoring may aid evaluation of other exercise protocols.

Introducing physical activity in cats can be challenging. Recommendations focus on environmental enrichment to encourage activity and modify behavior as summarized in Table 3. Hunting and stalking simulations may help motivate physical activity in cats. Sources of further enrichment ideas and activities are available and have been summarized in Table 4.63

BW, body weight.

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Meeting the cost of pet care | AAHA

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Our pets provide us with fun, companionship, and unconditional love. In return, we incur the responsibilities that go along with pet ownership, including veterinary care. More dogs receive veterinary care than cats, even though cats outnumber dogs as pets. Cats are a very underserved species in the veterinary profession, and it is important they receive appropriate health care as well.

Providing our pets the preventive health care they deserve, as well as keeping them in a safe environment, significantly reduces the risk of illness and injury. When pets do become sick or injured, todays veterinary profession is capable of providing all levels of necessary care from the basics to highly sophisticated diagnostics, procedures, and treatments.

The American Animal Hospital Association strongly recommends that those considering adopting a pet, and families who currently share their home with a pet, consider the following:

The ability to budget for thesepet health care costsvaries greatly. Some individuals and families simply pay for these things out of the household budget as they arise. Others may need to consider other options for funding proper care for their pets. These options include:

For those considering pet health insurance, AAHA offers the following suggestions:

Pet owners are in control of their pets health. Providing appropriate nutrition in a safe, enriched environment is the obligation of the pet owner. Seeking proper veterinary care and developing a strong relationship with the veterinary practice team is also essential in promoting good health and longevity. Providing an appropriate environment, nutrition, and veterinary care is a small payback for the unconditional love, enrichment of our lives, companionship, and joy that our pets give to us.

Adopted by the American Animal Hospital Association Board of Directors, June 2007.Updated June 2013.

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Meeting the cost of pet care | AAHA

AAHA Anesthesia Guidelines for Dogs and Cats | AAHA

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Richard Bednarski, MS, DVM, DACVA (Chair), Kurt Grimm, DVM, MS, PhD, DACVA, DACVCP, Ralph Harvey, DVM, MS, DACVA, Victoria M. Lukasik, DVM, DACVA, W. Sean Penn, DVM, DABVP (Canine/Feline), Brett Sargent, DVM, DABVP (Canine/Feline), Kim Spelts, CVT, VTS, CCRP (Anesthesia)

From the Veterinary Medical Center, The Ohio State University, Columbus, OH (R.B.); Veterinary Specialist Services PC, Conifer, CO (K.G.); Depart- ment of Small Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knox- ville, TN (R.H.); Southwest Veterinary Anesthesiology, Southern Arizona Veterinary Specialists, Tucson, AZ (V.L.); Phoenix, AZ (W.S.P.); Front Range Veterinary Clinic, Lakewood, CO (B.S.); and Peak Performance Veterinary Group, Colorado Springs, CO (K.S.).

Correspondence: richard.bednarski@cvm.osu.edu (R.B.)

There are no safe anesthetic agents, there are no safe anesthetic procedures. There are only safe anesthetists.Robert Smith, MDa

Safe and effective anesthesia of dogs and cats relies on preanesthetic patient assessment and preparation. Patients should be premedicated with drugs that provide sedation and analgesia prior to anesthetic induction with drugs that allow endotracheal intubation. Maintenance is typically with a volatile anesthetic such as isoflurane or sevoflurane delivered via an endotracheal tube. In addition, local anesthetic nerve blocks; epidural administration of opioids; and constant-rate infusions of lidocaine, ketamine, and opioids are useful to enhance analgesia. Cardiovascular, respiratory, and central nervous system functions are continuously monitored so that anesthetic depth can be modified as needed. Emergency drugs and equipment, as well as an action plan for their use, should be available throughout the perianesthetic period. Additionally, intravenous access and crystalloid or colloids are administered to maintain circulating blood volume. Someone trained in the detection of recovery abnormalities should monitor patients throughout recovery. Postoperatively, attention is given to body temperature, level of sedation, and appropriate analgesia. (J Am Anim Hosp Assoc 2011; 47:377385. DOI 10.5326/JAAHA-MS-5846)

*This report was prepared by a task force of experts convened by the American Animal Hospital Association for the express purpose of producing this article. This report was sponsored by an educational grant from Abbott Animal Health, and was subjected to the same external review process as are all of Journal of American Animal Hospital Association articles.

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Materials, Instruments, and Equipment | AAHA

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As with dental techniques, it is important to keep the dental materials up-to-date and veterinarians must be aware of what materials are considered appropriate for the treatment of dental conditions. Commonly used materials can be found by consulting a dental text and attending continuing education programs presented by a dental specialist.

Instruments and dental equipment require routine and frequent maintenance. Maintenance information can be found in some dental texts and through the manufacturer. Instruments must be sharp and properly stored, and instruments in poor condition need to be replaced. A written protocol needs to be established and followed for equipment and instrument care. As with human dentistry, instruments that enter the oral cavity should be sterilized. Packets organized by dental procedure (e.g., examination, extraction, periodontal surgery) should be prepared and sterilized before use.

Recommended materials, instruments, and equipment for performing dental procedures are listed in Tables 2 and 3 (Pages 7, 9). Consult the reference list associated with these guidelines for recommendations and information on ordering equipment.37

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2005 AAHA Senior Care Guidelines for Dogs and Cats | AAHA

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Published in 2005 (Mar/Apr)

Senior Care Guidelines Task Force: Mark Epstein, DVM, Diplomate ABVP (Canine/Feline), Chair | Ned F. Kuehn, DVM, MS, Diplomate ACVIM | Gary Landsberg, DVM, Diplomate ACVB | B. Duncan X. Lascelles, BSc, BVSc, PhD, MRCVS, Diplomate ECVS, Diplomate ACVS | Steven L. Marks, BVSc, MS, MRCVS, Diplomate ACVIM | Jean M. Schaedler, DVM, Diplomate ABVP (Canine/Feline) | Helen Tuzio, DVM, Diplomate ABVP (Feline)

This paper provides a working framework for enhancing the well-being of senior pet dogs and cats.Approaches to screening the medical status of senior pets are described in detail, with particular emphasis on establishing baseline data in healthy animals, the testing of clinically ill animals, and assessing senior pets prior to anesthesia and surgery. The management of pain and distress and the application of hospice and palliative care are addressed. Advice on ways to approach euthanasia and dealing with end-of-life issues is also provided. J Am Anim Hosp Assoc 2005;41:81-91.

In the spring of 2004, AAHA gathered together seven respected, experienced veterinarians with a variety of interests, backgrounds, and specialties. Their goal was to create for veterinary practitioners a useful document about Senior Care. These Guidelines were sponsored by a generous educational grant from IDEXX Laboratories.

The purpose of this document is to provide a working framework for veterinarians dedicated to enhancing the well-being of senior pet dogs and cats. Only about 14% of senior animals undergo regular health screening as recommended by their veterinarians.1 The main obstacle to compliance is the lack of a clear recommendation by the veterinary care team.1 Unless otherwise specified, all recommendations in this document apply to both the dog and the cat. Providing optimal care for senior pets:

The specific goals of this document are to help the veterinarian:

The term senior has been chosen to describe the aging and older pet. The number of years considered to be senior may vary, and one must keep in mind that organ systems, species, and breeds of dogs age at different rates. Several papers have suggested specific ages at which pets should be considered old, depending on breed and size, although few recommendations are evidence-based.2-12 Some studies of brain aging in beagles have shown that memory and learning deficits may be found as early as 6 to 7 years of age, with brain pathology found at 12 years of age.8-11 Many books and articles consider cats to be senior at 7 to 11 years of age.2-5

In humans, 56 to 60 years of age is considered to be the start of the senior years. Middle age begins at 42 to 45 and is the time when senior wellness screening generally starts. Middle age would equate to approximately 7 to 8 years of age for most dogs and cats (except for large-breed dogs that may reach middle age a year or two earlier). As the pet enters its senior years, more frequent testing and more extensive examinations are recommended than for younger pets. Rather than attempt to calculate age equivalents to humans, for practical purposes, this task force suggests that practitioners apply these guidelines to dogs and cats that are in the last 25% of the predicted life span for their species and breed.

The purposes of clinical screening of healthy pets are to establish a baseline assessment for future comparison and to detect subclinical abnormalities at a time when preventive and therapeutic intervention may have the most benefit. To illuminate such conditions, there is no substitute for a thorough and complete history and physical examination. A wealth of scientific literature documents the presence of subclinical disease in some healthy-appearing animals; to illuminate such conditions, there is no substitute for a thorough and complete history and physical examination. In addition, subtle changes in laboratory test results may give an indication of the presence of underlying disease.

Construct questions that extend beyond the clients presenting concern and that include physical and behavioral signs.13 Use of both closed (yes/no) and open-ended questions helps to elicit all possible information about quality of life, physical health, specific behavioral changes, and medications (e.g., prescription, over-the-counter, dietary supplements). When possible, to better ensure an accurate and thorough baseline for future comparison, have the client record historical information on a printed form prior to the appointment.

Observe the pet prior to handling, in an open carrier and/or on the floor. Perform a complete physical examination with special attention to the areas of increasing concern in the senior pet. Such areas may include, but are not limited to:

Tests to be included in the minimum laboratory database for the healthy-appearing senior animals are listed in Table 1. Additional testing is based on breed, age, sex, previous medical history, and ongoing medications.17,18

Preventive care is directed at making recommendations prior to the onset of disease in order to prevent or temper the effects of disease or adverse health conditions. This task force recommends that senior wellness tests begin for pets at middle age, to establish baseline values and to insure that there are no clinically silent health abnormalities. During middle age, retesting is recommended at least once a year (equivalent of 4 to 5 human years). Routine health care visits, including a minimum laboratory database, are recommended for senior animals (i.e., those in the last 25% of their predicted life span) every 6 months (equivalent of every 2 to 3 human years).

Such areas include, but are not limited to:

Although senior dogs and cats are affected by many of the same conditions as younger animals, some disorders are of particular significance in the senior pet. These disorders include, but are not limited to, those listed in Table 2.25-39

Malignant neoplasia is a frequent finding in senior pets, and this is often a life-limiting ailment. Lists of the most common neoplastic conditions are found in a variety of texts and articles.40,41 It is important to note that a number of cancers are easily misdiagnosed or overlooked early in their disease process. Special consideration should be given to the following common, but often elusive and illusory, neoplastic conditions:

First read and follow the healthy-animal assessment guidelines, above. Obtain a comprehensive history, observe the animal, and perform a complete and thorough physical examination, as described for the healthy senior pet. Pay particular attention to any clinical changes or signs of pain.

Consider all of the pets conditions and the best available scientific evidence when designing a treatment plan. Specifically, contradictions or contraindications among diseases, drugs, and diets may necessitate prioritizing modalities for an optimal outcome and/or quality of life.

Veterinarians and clients share responsibility for monitoring for side effects or complications. Require clients to closely monitor the intake of any medication administered in food. Cats in particular may develop food aversion if they are given medication by this route. Consider using flavored or formulated medications instead. Modify drug dose or dosing interval based on renal and hepatic function. Perform drug concentration testing when appropriate. Each disease state may require specific monitoring tests (e.g., fructosamine or blood glucose curve for diabetes mellitus; tonometry for glaucoma; blood pressure measurements for hyperthyroidism, chronic renal failure, and heart disease). Consider the effects of each drug on other diseases (e.g., furosemide, NSAIDs, or methimazole on renal failure), and alter treatments as necessary based on response.

A formal hospital callback or client follow-up system is crucial to successful case management. Consider other resources such as consultation and/or referral to a specialist based on the type of disease, the veterinarians level of expertise, and the available equipment (e.g., magnetic resonance imaging, computed tomography, endoscopy). The use of electronic media and communication to transmit and gather information facilitates remote consultations with specialists.

Patient Assessment. The importance of complete and accurate historical information cannot be overstated, including current medications (e.g., over-the-counter, prescription, alternative, supplements) with regard to their potential impact on anesthesia and recovery. Perform a complete and thorough physical examination, including assessments of weight, temperature, pulse, respirations, and pain.

Consider a preanesthetic blood pressure evaluation, especially in cats. Pay special attention to cardiopulmonary status. If any physical abnormalities are detected (e.g., heart murmur, arrhythmia, poor pulse quality, abnormal respiratory sounds), consider expanding the cardiopulmonary evaluation to include thoracic radiographs, electrocardiography, echocardiography, and/or blood pressure measurements. 28,46 Whether a preanesthetic electrocardiogram is needed for pets without detectable abnormalities is uncertain. There is some evidence that conduction abnormalities may exist subclinically (especially in cats) or be overlooked because of animal disposition, operator error, etc.28,46 An electrocardiogram is strongly recommended when abnormalities are found on auscultation.

Laboratory Evaluations. All healthy senior pets should have wellness screening tests along with measurement of electrolytes and a platelet count, ideally within the 2 weeks preceding anesthesia. However, for healthy senior pets that have had routine wellness tests within the previous 6 months, the practitioner must determine which tests should be repeated or added, based on the pets age (e.g., middleaged versus senior), risk factors, and the procedure to be performed. In addition to any tests not done in the previous 6 months, a complete blood count and dipstick urinalysis with specific gravity should be repeated prior to anesthesia. Obtain at least a hematocrit and platelet count if surgery is planned. Remember that automated platelet counts are unreliable in cats, so if the platelet count is low, a manual recount should be performed. Consider further workup if test results are not within the normal ranges.47

When anesthesia of a sick pet is necessary, perform the sick pet screening [Table 3] and compare the results to any earlier wellness screening tests. Perform additional tests as appropriate based on previous, ongoing, or new health issues discovered in the history, examination, and laboratory results. For example, perform coagulation function tests on at-risk animals, such as those with liver disease, malassimilation/ maldigestion disorders, NSAID usage, and breed predisposition.

Client Communication. Before anesthesia, discuss all risks and benefits with the client and obtain written, informed consent for all procedure(s). Prepare postoperative instructions. Provide clients with clear, concise, verbal and written take-home instructions that include information about possible complications, drug effects, nursing care, nutritional management, home monitoring, and after-hours veterinary phone contact.

Patient Management. Create a plan for anesthesia, analgesia, intravenous fluid administration, antimicrobial therapy, and body temperature maintenance during surgery.48,49 Begin analgesia prior to induction of anesthesia, giving special consideration to the combination of systemic analgesia and local or regional anesthetic blocks. Perioperative pain is best controlled by an aggressive, preemptive, multimodal approach.50,51

Intravenous access via an indwelling catheter is necessary for anesthetic induction, intraoperative fluid administration, and administration of appropriate medications. Initiate fluid preloading when indicated (e.g., renal disease, dehydration). When antimicrobial therapy is specifically indicated, begin the medication prior to surgery.52,53 Provide preoxygenation when indicated (e.g., obstructive upper airway disease, cardiac disease) via mask, oxygen cage, nasal cannula, or other methods. Ensure adequate ventilation via endotracheal intubation for general anesthetic procedures. Provide manually or mechanically assisted respiration as necessary.

Based on animal risk factors, consider placing an indwelling urinary catheter to measure fluid output during and after surgery, and/or the measurement of central venous pressure to prevent both under-hydration and over-hydration. Detailed attention to cardiopulmonary and renal functions is crucial for the successful outcome of anesthesia in senior animals. Close monitoring is essential during all stages of anesthesia. The greatest risks to the animal occur during the induction of anesthesia and from the time anesthetic agents are discontinued until full recovery.

One trained person should be dedicated to the monitoring and recording of vital parameters, such as body temperature, heart rate and rhythm, respiration, oxygen saturation via pulse oximetry, blood pressure, and end-tidal carbon dioxide. An apnea monitor is also helpful. Intravenous fluid support is essential, and care should be taken to customize the type and rate of fluids administered (e.g., lower rate with cardiac disease, increased rate with renal failure).54,55 Continue pain management, giving special consideration to constant- rate infusion of intravenous analgesics.

Maintain an open airway via intubation until the animal is swallowing. Continue oxygenation when appropriate, as described in the preanesthetic section of this report. Continue to maintain body temperature and to provide intravenous fluid support at least until the animal is ambulatory (or stable), or for longer as indicated (e.g., dehydration, hypothermia, renal compromise, other metabolic disorders).

Regularly monitor and record vital signs. Continue a preemptive and multimodal approach to pain. The adaptive mechanisms of animals make it difficult to accurately assess their degree and perception of pain; therefore, administer pain medications on a schedule appropriate for the drug(s) and the condition being treated. Do not wait for the animal to show signs of pain.56-58 Continue to assess the individual needs of each animal, as all individuals react differently to pain and to medications for pain.

Provide appropriate nursing care for recumbent animals, including warming and turning, human touch, and compassionate verbal encouragement. When recovery is delayed or prolonged, promote movement via massage, passive motion exercises, and sling-assisted walking.

Identify, prevent, and minimize pain. Use pain assessment as the fourth vital sign, using scales such as the University of Melbourne Pain Scale or the Glasgow Composites Measures Pain Scale.59,60 Under-managed or intractable pain may become a criteria for euthanasia.

Signs of acute or chronic pain vary and are described elsewhere. 16,56,61-65 Any behavioral change or change in vital signs may be an indication of pain. Signs of pain may be modified by factors such as demeanor (e.g., stoicism) or concurrent drugs. Involve, educate, and continually communicate with the client about recognizing and monitoring for signs of acute and chronic pain.66

Treatment options vary depending on the type of pain (e.g., acute or chronic). Single drugs or combinations of drugs may be used. To intervene at multiple sites of the nociceptive pathways, use multiple drugs.67 Control pain early in the course of chronic diseases. Chronic pain is best controlled by aggressive initiation of drugs and other modalities, followed by a tapering of the treatments to the minimum schedule or dosage that is still effective. Resources to help veterinarians keep current with new developments and recommendations for managing pain are becoming available, such as http://www.ivapam.com, which is maintained by the International Academy of Pain Management.

Educate clients about possible adverse events and/or interactions of drugs. When appropriate, perform laboratory monitoring during drug therapy. Maintain and document communications with clients and reassess the animal frequently. Address anxiety on the part of the client regarding the pets pain, disability, and/or physical impairment.

The American Veterinary Medical Association has published guidelines for veterinary hospice care.69 Veterinary hospice care is defined as giving clients time to make decisions regarding a terminal companion animal and to prepare for [its] pending death. The comfort of the animal must always be considered.69 In human medicine, hospice and palliative care are considered to be the model for quality, compassionate care for those facing a life-limiting illness or injury.70 Palliative care, based on the animals specific requirements, might include outpatient/home care; pain management; easy access to food, water, and litter; wound management; a stable and consistent environment; good hygiene and sanitation; clean bedding and padding; and mental stimulation. Visits to the home by veterinarians and/or support staff may be offered or encouraged whenever possible.

Nutritional maintenance is paramount. Balance the pets need for a particular therapeutic diet with maintaining caloric intake. Reassess the need for all ongoing medications and treatments in pets with end-stage disease and an anticipated short life span. Consider whether medications should be reduced, stopped, or changed, particularly in light of their side effects and risk-benefit analysis. Medications or combinations of drugs that might otherwise be contraindicated or used cautiously (e.g., narcotics, NSAIDs) may be considered as the best or only choice for maintaining a good quality of life.

Provide guidance and resources for clients to deal with debilitating or chronic disease, with dying and death, and with euthanasia. Consider the clients state of mind and the impact of the client on the pet. Consider and discuss the clients realistic ability (given financial, physical, and time constraints) to adequately care for the pet. Discuss the effect of the aged or sick pet on other pets and the potential impacts (both positive and negative) of introducing a new pet.

Discuss specific criteria for reevaluation of the senior animal and for deciding upon euthanasia. When possible, help the client consider end-of-life issues at this time (i.e., during the anticipatory grief period), rather than during a terminal crisis.

During the euthanasia decision-making process and after the decision is made, provide the client with resources about the process and impact of euthanasia on the family and other pets. Such resources include web sites, hotlines, books, brochures, and professional counselors for both adults and children.71-74 Web site examples include http://www.argusinstitute@ colostate.edu, http://www.rainbowsbridge.com, http://www.aplb.org, and http://www.deltasociety.org. Examples of pet loss support hotlines include those at Washington State University (509- 335-5704), the University of California-Davis (530-752- 3602 or 800-565-1526), Tufts University (508-839-5302), the Chicago Veterinary Medical Association (630-325- 1600), Cornell University (607-253-3932), and the Delta Society (619-320-3298).

Consider and discuss with the client the five freedoms to aid in assessing the animals welfare and in making an ethical decision.75 The five freedoms include freedom from hunger and thirst; freedom from physical and thermal discomfort; freedom from pain, injury, and disease; freedom from fear and distress; and the freedom to express normal behavior.75 Assess the severity and duration of the animals condition with these freedoms in mind and use them to help clients identify their own criteria for treatment or euthanasia. Such criteria might include financial, moral, religious, cultural, physical, and mental/emotional factors.

Avoid imposing ones own values and emotions on clients. Let clients make informed choices based on all known options. Support clients in their informed choice for euthanasia or for further diagnostic, therapeutic, or palliative care. Be an advocate of the pet and try to factually present options and consequences without promoting inappropriate feelings of regret, self-blame, or guilt.

Discuss with the client the following points:

Describe specifically what will happen, what the animal may experience, and what the client may see or hear. Create an appropriate area in the hospital for euthanasia; a place the client can give the pet a final farewell. Consider providing the client with a remembrance item such as a paw print casting or lock of hair, followed by a sympathy card.

Provide staff training and debriefing on the difficult issues that inevitably arise from being frequently exposed to endof- life events. Such issues include grief management, pet loss support, periodic hospital memorial services, bereavement outlets, and compassion fatigue. Give the staff permission to grieve and express their emotions. Recognize each individuals limitations. Refer clients to outside resources when available.

This document is intended as a guideline only. Evidencebased support for specific recommendations has been cited whenever possible and appropriate. Other recommendations are based on practical clinical experience and a consensus of expert opinion. There is a need for further research to document some of these recommendations, and it is hoped that in the future, collaborative research involving general practitioners, referral institutions, and commercial laboratories will facilitate a more rapid and comprehensive development of evidenced-based clinical knowledge regarding senior pets.

Veterinarians must base their decisions and actions on their own expertise, experience, and knowledge. Veterinary practitioners are also charged with making decisions for each individual animal based on the best available scientific evidence, in conjunction with clinical experience.

The actual incidence of subclinical disease that is detected by routine screening tests remains undetermined. Practitioners are urged to develop systems for identifying and recording such conditions, perhaps in a collaborative effort with the commercial laboratory most frequently used. It is hoped that in the future such data will allow computation of the incidence, prevalence, risk factors, and effects of early detection and treatment of subclinical diseases.

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2005 AAHA Senior Care Guidelines for Dogs and Cats | AAHA

Patient Assessment | AAHA

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History and Physical Examination

The history must include prior home dental hygiene delivered by the client; diet; access to treats and chews; chewing habits; current and previous dental care and procedures; prior and current diseases, including any behavioral issues and allergies; and medications or supplements currently administered. Perform a physical examination of all body systems based on the species, age, health status, and temperament of the animal. If the patient is presented for a complaint not related to dentistry, give due consideration to the primary complaint, performing the diagnostic tests and treatments indicated. Establish priorities if multiple procedures are indicated.

Focus on age-related dental conditions and common abnormalities in the dog and cat. From birth to 9 mo of age, evaluate the patient for problems related to the deciduous teeth, missing or extra teeth, swellings, juvenile diseases (such as feline juvenile onset periodontitis), occlusion, and oral development. From 5 mo to 2 yr of age, evaluate the patient for problems related to developmental anomalies, permanent dentition, and the accumulation of plaque and calculus. Periodontal diseases may begin during that time period, especially in cats and small-breed dogs. The onset andseverity of periodontal diseases varies widely depending on breed, diet, and home dental care. In a small-breed dog without home dental care, periodontal diseases can start as early as 9 mo of age. In a large-breed dog, periodontal diseases may not start until later. Many small-breed dogs have periodontal diseases by 3 yr of age.912 Beyond 2 yr of age, evaluate the progression of periodontal diseases, damage to tooth structures, occurrence of oral masses, and the existence and adequacy of preventive home dental care. As the animal ages, continue to evaluate the patient for progressive periodontal diseases, oral tumors, and other aspects of dental pathology.13

Record all findings in the medical record (Table 5, Page 10). Evaluate the head and oral cavity both visually and by palpation. Changes in body weight, eating habits, or other behaviors can indicate dental disease. Specific abnormal signs to look for may include pain; halitosis; drooling; dysphagia; asymmetry; tooth resorption; discolored, fractured, mobile, missing, or extra teeth; inflammation and bleeding; loss of gingiva and bone; and changes in the range of motion or pain in the temporomandibular joint. In addition, the practitioner should assess the patients occlusion to ensure it is normal, or at least atraumatic. Evaluate the patients eyes, lymph nodes, nose, lips, teeth, mucous membranes, gingiva, vestibule (i.e., the area between the gum tissue and cheeks), palatal and lingual surfaces of the mouth, dorsal and ventral aspects of the tongue, tonsils, and salivary glands and ducts. Note all abnormalities such as oral tumors, ulcers, or wounds. A diagnostic test strip for the measurement of dissolved thiol levels can be used as an exam room indicator of gingival health and periodontal status.14

The oral examination performed on a conscious patient allows the practitioner to design a preliminary diagnostic plan. Take into consideration potential patient pain. Do not offend the patient by probing unnecessarily when such manipulations can be better achieved under anesthesia. Also, realize in many instances that the examiner will underestimate the conditions present because it is impossible to visualize all oral structures when the patient is awake. It is only when the patient has been anesthetized that a complete and thorough oral evaluation can be accomplished successfully. The complete examination includes a tooth-by-tooth visual examination, probing, and radiographic examination. Only then can a precise treatment plan and fees for proposed services be tabulated and discussed with the pet owner(s).

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Patient Assessment | AAHA

Individualized Approach | AAHA

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Encourage clients to acclimate dogs to safe travel prior to the veterinary visit. Require all clients to restrain dogs on a leash or in a carrier upon entering the practice. Arrange the reception entrance to be dog friendly, and to allow clients to minimize encounters with other pets.

Plan appointments to minimize wait and create a quiet, calm environment. Create a strategy to manage timid and fearful dogs to reduce the stress for the patient, the client, and the veterinary team.

Train the veterinary team in low-stress handling techniques. As appropriate, use positive reinforcement (e.g., treats or toys) and minimize distractions. Use quiet, calm body language and a calm voice.6 Pheromones may be helpful for their potential calming effect.7,8 Providing sedation or antianxiety medication for the patient may be appropriate to reduce patient stress and fear, and to provide safety for the veterinary team.9 Consider sending the patient and client home if undue stress or fear results. Reschedule the exam for another time, and provide positive reinforcement techniques instead of the exam.

Use relationship-centered client communication to establish trust. Recognize that the client, as the caregiver and final decision maker, is the most important member of the healthcare team. Clients provide important information regarding the pets condition and frequently do the bulk of the work involved in performing prescribed care. Communication with empathy, reflective listening, and attention to body language improves the ability to gain relevant information, increases agreement to treatment plans, and improves outcomes in patient care, clinician effectiveness, and client satisfaction.10,11

In addition to standard body systems review, a thorough history includes asking about the items listed in Table 2, including the daily routine and using open-ended questioning techniques when appropriate. Inquire about behavioral, physical, or other changes since the last visit.

Include a veterinary exam and consultation at each of the routine puppy visits as well as prior to the spay/neuter surgery. Provide a wellness exam and consultation for adult dogs at least annually.12 Consider semiannual wellness exams because a dogs health status may change in a short period of time. Pets age faster than humans and many medical conditions are not associated with clinical signs; therefore, earlier detection of items such as body weight changes, dental disease, and other concerns allows for earlier intervention. In addition, semiannual exams may allow for more frequent communication with the owner regarding behavior and preventive healthcare. Consider more frequent examinations especially for mature, senior, and geriatric dogs.

Perform a thorough exam including the five vital signs (temperature, pulse, respiration, pain, and nutritional assessment) as well as the items listed in Table 2.13 When possible, use a defined scoring system (e.g., body condition score, muscle condition score).1318 The exam may also include the following: pain score; heart murmur grade; gait analysis; body mapping for skin masses and skin lesions; evaluation for breed-specific risks; and laboratory testing and/or imaging as appropriate for breed, age, and individual circumstances.19,21,23

*See section in text titled Individualized Approach to the Veterinary Visit. Conduct testing based on signalment and findings on physical exam and in history.

Routine tests such as the minimum database (Table 3) may be helpful for the wellness evaluation of any age dog, but are particularly important for the mature, senior, and geriatric patient, allowing early dedtection of disease or trends in clinical or laboratory parameters that may be of concern.4 Performed early in life, these tests may also provide a baseline for interpretation of data obtained at subsequent visits and may establish trends that would be more specific to the individual patient than cumulative laboratory data from many individuals.

Table 3 shows a sign for many tests because there is limited evidence about exactly when to begin testing for each item.5,2427 Create individualized recommendations based on current evidence, clinical experience, and the dogs specific breed and circumstances. Individualize the approach for each dog to ensure an effective plan for early disease detection and to maintain optimum health.

There are several hundred distinct canine breeds and many more mixed-breed dogs, each with different genetics and diverse lifestyles.28,29 At least two-thirds of dog breeds have at least one recognized genetic disorder.30 Various resources describe breed-specific normal values and disease predispositions. Understanding these can help guide decisions for testing.3137 Be aware of whether your diagnostic laboratory includes information about specific breed variations of normal values. DNA testing in mixed-breed dogs may offer information to the veterinarian to be watchful for specific breed behavior tendencies or health concerns (e.g., orthopedic, cardiac, ophthalmologic, or drug sensitivity).

There are too many examples to list them all here; however, one example of a breed-specific test would be performing a urine protein-to-creatinine ratio in breeds predisposed to glomerulopathy.38 As other examples, blood pressure measurement or thyroid disease screening may be part of a wellness exam if the breed (or other findings) warrants monitoring these parameters.39 Measurement of blood pressure is discussed in detail elsewhere.40 Thyroid disease screening is also described in many texts.41

Work closely with clients who are involved with breeding programs. Promote responsible breeding practices, and encourage collaboration among breed associations, dog breeders, and university-based canine research programs. Using the current references on breed-specific disorders can reduce perpetuation of disease and promote wellness through careful selection of individuals used for breeding programs. See the current position statements of the AVMA and AAHA regarding procedures such as ear cropping, tail docking, dewclaw removal, and ownership of wolf-dog hybrids.

Working and service dogs not only provide companionship, but also important service roles. These dogs must maintain optimum health and specific physical abilities to be available to perform or provide their special use or assistance.4244 Clients with these high-performing dogs may opt for more frequent evaluations or specific preventive care.45 For optimizing wellness in these valuable service animals, it is vital to share the latest knowledge available.

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Individualized Approach | AAHA

Anti Aging | NMN Supplement With Resveratrol – HerbalCart

Posted: at 11:42 pm


Natural aging is an ineluctable process as skin loses its buoyant charm with increasing years. The bitter truth is, no one can stop it; the sweet truth is, Nicotinamide Mononucleotide & Resveratrol can fix it. Unique in their own way, when these anti aging fighters come together, golden phase for skin begins. Foes like dark spots on face, fine lines, wrinkles & crows feet are fixed to restore a flawless face with supple & glowing skin.

NMN is a ground-breaking product that turns back the age clock for both, men and women. Hitting all the right notes, it is an unquestionable version of ambrosia towards agelessness. Being one of the best anti aging products, NMN boosts collagen production, replenishes elasticity, triggers fine lines & spots and removes gunk to keep the skin stay young.

anti aging supplements,best skin care products

An antioxidant belonging to the polyphenols group, Resveratrol has 17 times more antioxidant activity as compared to idebenone, a potent antioxidant used in anti-aging products. Also, it alleviates oxidative stress and inflammation that are the leading causes of premature aging. It fights external aggressors like pollution and UV rays to protect the skin and instill younger look.

A form of vitamin B3, Nicotinamide Mononucleotide is a potent NAD+ precursor supplement. NMN activates sirtuins, the naturally-occurring proteins that serve as anti-aging genes. This way, loose skin, lines and wrinkles are prevented along with cognitive decline.

By decreasing water loss through the outer skin layer, Nicotinamide Mononucleotide increases hydration in the skin. Moreover, it has properties to reduce sebum, enhance complexion and decrease redness of aging skin & blotchiness.

Conquering aging by popping a tablet is no more a long pending urge. Keeping you away from expensive spa appointments and dermatologist visits, NMN:

As a dietary supplement, consume 2 capsules daily, 30-40 minutes prior to meals or as directed by a physician.

Yes, you can trust NMN without a second thought. Unlike other products that are filled with harmful ingredients, this product brings together two very best skin-friendly compounds that recover stubborn evils of aging.

Nope. You need not take any other stuff apart from NMN. Follow the recommended dosage and keep patience, as everyones skin is different and results are seen accordingly.

Definitely. Before bringing it you, we have got it checked under clinical standards to keep the users away from any consequences.

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Anti Aging | NMN Supplement With Resveratrol - HerbalCart

The Use of Complementary and Alternative Medicine in the …

Posted: at 11:41 pm


In December 2008, the National Center for Complementary and Integrative Health (NCCIH) and the National Center for Health Statistics (part of the Centers for Disease Control and Prevention) released new findings on Americans' use of complementary and alternative medicine (CAM). The findings are from the 2007 National Health Interview Survey (NHIS), an annual in-person survey of Americans regarding their health- and illness-related experiences. The CAM section gathered information on 23,393 adults aged 18 years or older and 9,417 children aged 17 years and under. A similar CAM section was included in the 2002 NHIS, providing the opportunity to examine trends in CAM use, too.1

CAM is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. Integrative medicine combines conventional and CAM treatments for which there is evidence of safety and effectiveness. While scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered through well-designed scientific studiesquestions such as whether these therapies are safe and whether they work for the purposes for which they areused.

In the United States, approximately 38 percent of adults (about 4 in 10) and approximately 12 percent of children (about 1 in 9) are using some form of CAM, shown in figure1.

People of all backgrounds use CAM. However, CAM use among adults is greater among women and those with higher levels of education and higher incomes. Figure 2 shows the percentage of people using CAM by age. Figure 3 shows CAM use byrace/ethnicity.

Figure 2: CAM Use by Age(2007)

Figure 3: CAM Use by Race/Ethnicity Among Adults(2007)

Nonvitamin, nonmineral natural products are the most commonly used CAM therapy among adults. Use has increased for several therapies, including deep breathing exercises, meditation, massage therapy, and yoga. Figure 4 shows the percentage of people using the most common CAM therapies and therapies with significant increases between 2002 and2007.

Figure 4: 10 Most Common CAM Therapies Among Adults(2007)

An asterisk (*) indicates a practitioner-based therapy. For definitions of any of these therapies, see the full report (PDF) or contact the NCCIH Clearinghouse.

The most popular natural products are fish oil/omega 3, glucosamine, echinacea, and flaxseed. Figure 5 ranks the top 10 natural products used among adults in 2007 and 2002 (note that the 2007 survey asked about use in the last 30 days, whereas the 2002 survey asked about use in the lastyear).

Figure 5: 10 Most Common Natural Products Among Adults (2002,2007)

People use CAM for an array of diseases and conditions. American adults are most likely to use CAM for musculoskeletal problems such as back, neck, or joint pain. The use of CAM therapies for head or chest colds showed a substantial decrease from 2002 to 2007. Figure 6 ranks the top 10 conditions prompting CAM use among adults for 2007 and2002.

Figure 6: Diseases/Conditions for Which CAM is Most Frequently Used Among Adults (2002,2007

The 2007 NHIS asked selected adult respondents about CAM use by children in their households. Overall, approximately 12 percent of children use some form of CAM. Use is greateramong:

Figures 79 show survey findings on CAM use by children, including top therapies, natural products, anddiseases/conditions.

Figure 7: 10 Most Common Therapies Among Children(2007)

Figure 8: Most Common Natural Products Among Children(2007)

Figure 9: Diseases/Conditions for Which CAM is Most Frequently Used Among Children(2007)

NCCIH plans to collaborate with NCHS on further analyses of the survey findings. Among the areas of interest to the researchers are CAM costs and spending, dietary supplements, and reasons for CAM use. Future reports will be published by NCHS and posted on the NCCIH website.

The mission of NCCIH is to define, through rigorous scientific investigation, the usefulness and safety of complementary andintegrative healthinterventions and their roles in improving healthandhealthcare.

The report's citation is Barnes PM, Bloom B, Nahin R. CDC National Health Statistics Report #12. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. December 2008. It is available, along with a press release and graphics, at nccih.nih.gov/news/camstats/. People who do not have access to the Internet can contact the NCCIH Clearinghouse for acopy.

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The Use of Complementary and Alternative Medicine in the ...

Bioluxmedical.com | Learn to Live a Healthy Life

Posted: at 11:41 pm


Frequent Health Issues Related With Giant Breasts

November 25, 2018Meadow

Health and Wellness Coach salaries can vary quite a lot. The great factor is, because the health advantages of milking the prostate is very in style as of late, there are a whole lot of products out there that present glorious demonstrations of the right way to do prostate milking safely and effectively. L-carnitine has each antioxidant and anti-inflammatory properties, which makes it a really invaluable substance for penis pores and skin health.

Vitamin E will increase blood circulate throughout the physique, all the best way to these tiny blood vessels that make up the penis, this speeds healing and helps keep the health of the penis tissue. Vitamin E has many health boosting properties, one in every of which being its antioxidant function antioxidants struggle free radicals within the physique which may trigger cancer, as well as indicators of untimely getting old.

Most cancers is the uncontrolled growth of abnormal cells in the body.These normal cells develop out of control and even intrude in different surrounding tissues. For instance, for those who work for a corporation as an Worker Health and Wellness Administrator (around $50,000 yearly), your job will involve less accountability than in the event you have been a Wellness Program Manager (around $seventy five,000 annually).

It causes extra deaths per population than any other illness and the older you get the extra prone you might be to contracting the disease; Statistics present that the variety of individuals cancer kills globally each year is about 13 in each one hundred.

The Siberian Husky can develop hereditary or juvenile cataracts as early as three months of age. If you happen to choose a distinct career path, and like to turn into an worker as a Health and Wellness Coach, chances are youll discover that as with every occupation, the larger the function and responsibility, the higher your pay.

Vitamin E is an especially vital nutrient for skin care, as it helps retain moisture, prevents skin dryness and can help defend the skin from UV rays. Despite the fact that eye problems dont occur typically within the Siberian Husky theyre severe and should by no means be missed or underestimated.

Nonetheless, with proper care and monitoring you possibly can attempt to keep away from these conditions in your canine and assist them to reside a protracted, healthy life. There are some healthy issues for males that make intercourse after the age of 60 troublesome that are extra on the mental degree than anything else. Read More..

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Bioluxmedical.com | Learn to Live a Healthy Life

LA Fitness | DALLAS Gym | 2690 N HASKELL AVE

Posted: at 3:41 am


*Offer is not available (different pricing applies) for Signature Clubs and clubs in Canada, New York (Metro & Premier Plus), Delaware and Tennessee. Memberships are subject to a $49 annual fee to be billed 3 months after enrollment date and each year thereafter, except as required by law. Enrollment in a 9-month initial term required. Membership will automatically renew on a month-to-month basis after 9 months. Early termination fee of $49 applies if membership is terminated prior to the expiration of the initial 9-month term. Must be 18 years of age or older, sign membership agreement, and pay first and last months dues upon enrollment. Recurring monthly charges must be paid by electronic funds transfer from a checking or savings account or automatic transfer from an accepted credit or debit card. Offer is not available in conjunction with other discounted rates, coupons or promotions. Pro Results personal training services are subject to an additional agreement and requires payment of an additional fee. Offer ends December 2, 2018 and is subject to change. Additional terms and/or restrictions may apply.Photos depict a typical LA Fitness club. Amenities may vary by location and some may require an additional fee. Access is based on membership type. Other membership options may be available with different terms.

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LA Fitness | DALLAS Gym | 2690 N HASKELL AVE

LA Fitness | Gym Info | SPRING | 20127 INTERSTATE 45 NORTH

Posted: November 26, 2018 at 7:46 pm


*Offer is not available (different pricing applies) for Signature Clubs and clubs in Canada, New York (Metro & Premier Plus), Delaware and Tennessee. Memberships are subject to a $49 annual fee to be billed 3 months after enrollment date and each year thereafter, except as required by law. Enrollment in a 9-month initial term required. Membership will automatically renew on a month-to-month basis after 9 months. Early termination fee of $49 applies if membership is terminated prior to the expiration of the initial 9-month term. Must be 18 years of age or older, sign membership agreement, and pay first and last months dues upon enrollment. Recurring monthly charges must be paid by electronic funds transfer from a checking or savings account or automatic transfer from an accepted credit or debit card. Offer is not available in conjunction with other discounted rates, coupons or promotions. Pro Results personal training services are subject to an additional agreement and requires payment of an additional fee. Offer ends December 2, 2018 and is subject to change. Additional terms and/or restrictions may apply.Photos depict a typical LA Fitness club. Amenities may vary by location and some may require an additional fee. Access is based on membership type. Other membership options may be available with different terms.

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LA Fitness | Gym Info | SPRING | 20127 INTERSTATE 45 NORTH

Alzheimer’s disease | Alzheimer’s Society

Posted: November 25, 2018 at 3:40 am


Alzheimers disease is the most common cause of dementia. The word dementia describes a set of symptoms that can include memory loss and difficulties with thinking, problem-solving or language. These symptoms occur when the brain is damaged by certain diseases, including Alzheimers disease.

Alzheimers disease, named after the doctor who first described it (Alois Alzheimer), is a physical disease that affects the brain.

During the course of the disease, proteins build up in the brain to form structures called plaques and tangles. This leads to the loss of connections between nerve cells, and eventually to the death of nerve cells and loss of brain tissue.

People with Alzheimers also have a shortage of some important chemicals in their brain. These chemical messengers help to transmit signals around the brain. When there is a shortage of them, the signals are not transmitted as effectively.

Current treatments for Alzheimers disease can help boost the levels of chemical messengers in the brain, which can help with some of the symptoms. Alzheimers is a progressive disease. This means that gradually, over time, more parts of the brain are damaged. As this happens, more symptoms develop. They also become more severe.

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Alzheimer's disease | Alzheimer's Society

Alternative Medicine – Study.com

Posted: November 24, 2018 at 10:44 am


The principles of alternative medicine are rooted in ancient healing methods combined with modern medicine to treat and prevent illness. Continue reading to learn whether a career in alternative medicine is right for you.

In most cases, alternative medicine excludes prescription drugs and tends to focus on the use herbs and other forms of natural healing. This form of healthcare comprises a diverse array of specialties and sub-specialties that tend not to rely on standard or conventional methods for treatment. These include naturopathic medicine, complementary medicine, acupuncture, herbal therapy, aromatherapy, holistic medicine and many more.

The common denominator among these specialties is the belief that the body has the ability to heal itself, making the goal of the alternative medicine practitioner to educate patients on nutrition and to encourage lifestyle changes that bring the body back into balance while curing itself of illness. In addition, a mixture of ancient remedies and modern medical technology may be used to restore health without the use of major surgery and medications.

Methods used for healing vary by profession. For instance, practitioners of Oriental medicine work with herbal remedies, acupuncture and acupressure massage. Naturopathic physicians blend modern medicine with ancient healing remedies to perform minor surgeries and use holistic methods to cure and prevent common ailments, such as chronic pain, hormonal imbalances and adrenal fatigue.

Those working in alternative medicine must receive formal training. The intensity, level and length of training vary according to the chosen specialty and desired salary. Generally, a bachelor's degree in the chosen field is required, as well as the completion of a 4-year graduate level program through an accredited school. However, certificate programs may allow for study in a more specific profession. A doctoral degree is not usually required, but could be helpful in some fields, such as naturopathy.

Those wishing to specialize in Oriental medicine should enroll in programs accredited by the Accreditation Commission for Acupuncture and Oriental Medicine, recognized by the U.S. Department of Education. Similarly, those wishing to pursue a career as a naturopathic physician should enroll in programs recognized by the Association of Accredited Naturopathic Medical Colleges. Review the links below for details about relevant training programs.

Most programs for alternative medicine require clinical hours and hands-on training, but in some instances students can obtain degrees through distance learning instruction. Online degrees can be found at all levels of education. Here are some options to consider.

The majority of alternative medicine practitioners are self-employed, but many can find positions in private practices and medical centers. In some instances, employment may be acquired in a hospital setting, but specialty hospitals that concentrate on holistic care offer the most opportunities for alternative medicine specialists. Jobs may also be found in community health centers and clinics. The following articles from Study.com show just some of the career possibilities in this field.

Licensing requirements vary depending on the field of specialty and location. To become a licensed naturopathic physician, one must successfully complete the Naturopathic Physicians Licensing Examination administered by the North American Board of Naturopathic Examiners in order to work in any of the 16 states requiring this certification. Similarly, the field of acupuncture has licensing standards in 40 states and the District of Columbia. Licensing is provided by the National Certification Commission for Acupuncture and Oriental Medicine, and membership with the American Association of Oriental Medicine may be a benefit.

Salaries for practitioners of alternative medicine vary by specialty, location and level of experience and education. According to Payscale.com, as of April 2014, naturopathic physicians in the 10th-90th percentile range earned base salaries of $29,799-$109,690. As of the same year, acupuncturists in the same percentile range earned $29,142-$93,688.

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Alternative Medicine - Study.com

Alternative Medicine 2019 | Traditional Medicine Conferences …

Posted: at 10:44 am


Sessions/Tracks

Session 01: The Rise of Traditional Medicine

The earliest evidence for humans use of traditional medicine was the use of plant for healing which dated back to the Neanderthal period. There is still 75-80% of the world population who depend on the herbal medicine for primary health care. The traditional medicine is based on knowledge, skills and the practices that are developed over generations. It is called as the Indigenous or folk medicine. It has popularity in number of Asiatic countries such as China, India, Japan, and Pakistan. WHO estimates that the traditional method of birth attendants assists up to 90% of all the rural births and about 70% of the births in the developing countries.

Related conferences:

Global Experts Meeting on Frontiers in Traditional & Alternative Medicine, July 18-20 2019, London, UK | 3rd world congress and expo on traditional and alternative medicine, June 06-08, 2019, Berlin, Germany | 6th annual conference ICNM, 5-7 July 2019, London, UK | 3rdGlobal Summit on Nutritional Science & Food Chemistry, June 10-12, 2019, Osaka, Japan | 8th International Conference on Drug Discovery & Therapy, February 13-15, 2019, Bangkok, Thailand | 9th International Conference on Traditional Medicine and Acupuncture, June 17-18, 2019, Osaka, Japan | 5thInternational Meeting on Traditional & Alternative Medicine, April 22-23, 2019atRome, Italy

Related Associations and Societies:

Acupuncture Association of Colorado | American College of Healthcare Sciences | European Herbal & Traditional Medicine Practitioners Association | British Acupuncture Council(BAC) | Naturopaths and HerbalistsAssociation of Australia | American Holistic Medical Association | Australian Traditional Medicine Association(ATMA ) | Herb Society of America.

Session 02: Idolization of Herbal Medicine

Herbal Medicine is the study of plants and the use of plant products for medicinal purposes. It is believed that the medicinal plants and the herbal remedies are in use from approximately 60,000 years ago. Herbal remedies and home remedies are most common in the European subcontinent. The modern-day drugs also make use of the compounds from evident based pharmaceutical drugs. Usually the herbal dietary supplements come under this category.

Related conferences:

International Conference on Traditional Medicine and Ethnomedical Research, May 15-16, 2019, Tokyo, Japan | 21st International Conference on Complementary, Alternative, Integrative Medicine and Health, May 23-24, 2019, London, United Kingdom | 8th Annual Midwest Women's Herbal Conference, May 31, June 01-02,2019, Almond, WI | 21st Annual International Conference on TCVM,August 30 to September 2, 2019, Shanghai, China | 3rd International Integrative nursing Symposium, May 22-23, 2019, Galway, Ireland | 10th International Conference on Alternative Medicine, August 26-27, 2019, London UK | 5th World Congress on Medicinal Plants and Natural Products Research, April 15-16, 2019, Hong Kong

Related Associations and Societies:

Acupuncture Association of Missouri | American Association of Acupuncture and Oriental Medicine (AAAOM) | Veterinary Botanical MedicineAssociation | Indian board of Alternative Medicine | The National Institute of Complementary Medicine, Australia | British Herbal MedicineAssociation | Natural Health Products Research Society of Canada.

Session 03: Naturopathy: Self-healing Science

Naturopathy is the system of treatment which recognises the existence of the vital force that is found within the body of every individual. It is a form of alternative medicine that follows pseudoscientific practices which are non-invasive and helps in promoting self-healing. It follows the fact that the accumulation of morbid matter in the body leads to disease and the elimination of this morbid matter is the treatment for all diseases. The important part of the treatment involves the prayer according to ones own spiritual faith and the food as the only medicine.

Related conferences:

Mind-Body-Spirit Conference, 2019, June 7-8, 2019, Toronto, Canada | Euro Summit on Toxicology and Pharmacology, May 13-15, 2019, Rome, Italy | 2ndInternational Conference on Pharmaceutics, Pharmacology and Drug Delivery Systems, September 23-25, 2019, Valencia, Spain |3rd World Congress on Pharmacology & Toxicology, September 12-14, 2019, London, UK | 30th International Conference on Ayurveda, Yoga, Spirituality, March 1-3, 2019, Aegina, Greece | 7th International Conference and Expo on Acupuncture and Oriental Medicine, April 08-09, 2019, Toronto, Canada | 4th International Conference on Holistic Medicine and Nursing Care, March 25-26, 2019, Florida, USA

Related Associations and Societies:

American Holistic Health Association | The Association ofTraditional Chinese Medicine and Acupuncture UK | American Medical Association | Association forNatural Medicine in Europe | Australian Natural TherapistsAssociation (ANTA) | Research council for Complementary Medicine | Japan Institute of Traditional Medicine.

Session 04: The Healing Art of Kampo

Kampo is the Traditional Japanese Medicine that was developed and used in China during the Han dynasty (206 BC 220 AD). It is the formulation corresponding to Sho. The idea of Kampo is that the human body and mind are inseparable and a balance of physical and mental is essential for human health. Kampo employs a symptom-oriented, holistic approach. It does not focus only on the condition of diseased parts of the body but checks the condition of the entire body and mind. It also seeks to produce a proper balance of all organ systems to recover health in patients. The western medicine and Kampo are being used together in clinical treatment. This combination therapy has contributed to enhanced patient quality of life.

Related conferences:

Global Experts Meeting on Frontiers in Traditional & Alternative Medicine, July 18-20 2019, London, UK | 3rd world congress and expo on traditional and alternative medicine, June 06-08, 2019, Berlin, Germany | 6th annual conference ICNM, 5-7 July 2019, London, UK | 3rdGlobal Summit on Nutritional Science & Food Chemistry, June 10-12, 2019, Osaka, Japan | 8th International Conference on Drug Discovery & Therapy, February 13-15, 2019, Bangkok, Thailand | 9th International Conference on Traditional Medicine and Acupuncture, June 17-18, 2019, Osaka, Japan | 5thInternational Meeting on Traditional & Alternative Medicine, April 22-23, 2019atRome, Italy

Related Associations and Societies:

Acupuncture Association of Colorado | American College of Healthcare Sciences | European Herbal & Traditional Medicine Practitioners Association | British Acupuncture Council(BAC) | Naturopaths and HerbalistsAssociation of Australia | American Holistic Medical Association | Australian Traditional Medicine Association(ATMA ) | Herb Society of America.

Session 05: Qigong: Life Energy Cultivation

It is the ancient medicinal practice that is 2,000 years old. It is defined as the mind-body-spirit practice that opens the meridians and helps enhance our ability to feel the Life force in the physical world. This healing technique involves meditation, controlled breathing and the movement exercises. Thus, it helps in increasing fluid movement and builds the awareness on how body moves through space.

Related conferences:

International Conference on Traditional Medicine and Ethnomedical Research, May 15-16, 2019, Tokyo, Japan | 21st International Conference on Complementary, Alternative, Integrative Medicine and Health, May 23-24, 2019, London, United Kingdom | 8th Annual Midwest Women's Herbal Conference, May 31, June 01-02,2019, Almond, WI | 21st Annual International Conference on TCVM,August 30 to September 2, 2019, Shanghai, China | 3rd International Integrative nursing Symposium, May 22-23, 2019, Galway, Ireland | 10th International Conference on Alternative Medicine, August 26-27, 2019, London UK | 5th World Congress on Medicinal Plants and Natural Products Research, April 15-16, 2019, Hong Kong

Related Associations and Societies:

Acupuncture Association of Missouri | American Association of Acupuncture and Oriental Medicine (AAAOM) | Veterinary Botanical MedicineAssociation | Indian board of Alternative Medicine | The National Institute of Complementary Medicine, Australia | British Herbal MedicineAssociation | Natural Health Products Research Society of Canada.

Session 06: Massage: Friction of Kneading

It is one of the Complementary and Alternative Medicine (CAM), which is found in ancient Chinese medical texts more than 4,000 years ago. It involves the scientific manipulation of the soft tissues of the body by applying the techniques of holding, moving muscles and body parts, fixed or movable pressure etc where touch remains the fundamental medium of the therapy. It is generally administered to improve the blood and lymph flow, enhance tissue healing and reduce muscle tension or flaccidity. It embraces the concept of "vis medicatrix naturae" which means the ability of the body to heal by itself.

Related conferences:

Mind-Body-Spirit Conference, 2019, June 7-8, 2019, Toronto, Canada | Euro Summit on Toxicology and Pharmacology, May 13-15, 2019, Rome, Italy | 2ndInternational Conference on Pharmaceutics, Pharmacology and Drug Delivery Systems, September 23-25, 2019, Valencia, Spain |3rd World Congress on Pharmacology & Toxicology, September 12-14, 2019, London, UK | 30th International Conference on Ayurveda, Yoga, Spirituality, March 1-3, 2019, Aegina, Greece | 7th International Conference and Expo on Acupuncture and Oriental Medicine, April 08-09, 2019, Toronto, Canada | 4th International Conference on Holistic Medicine and Nursing Care, March 25-26, 2019, Florida, USA

Related Associations and Societies:

American Holistic Health Association | The Association ofTraditional Chinese Medicine and Acupuncture UK | American Medical Association | Association forNatural Medicine in Europe | Australian Natural TherapistsAssociation (ANTA) | Research council for Complementary Medicine | Japan Institute of Traditional Medicine.

Session 07: Homeopathy: Nature law of Cure

Homeopathy is derived from Homois meaning similar and Pathos meaning suffering. It was given scientific basis in early 19th century. It is a pseudoscience which has a belief that is incorrectly presented as scientific. Homeopathic preparations are not effective for treating any condition. About 10% of the Indian population depend on homeopathy for health care. It is the system of alternative medicine.

Related conferences:

Global Experts Meeting on Frontiers in Traditional & Alternative Medicine, July 18-20 2019, London, UK | 3rd world congress and expo on traditional and alternative medicine, June 06-08, 2019, Berlin, Germany | 6th annual conference ICNM, 5-7 July 2019, London, UK | 3rdGlobal Summit on Nutritional Science & Food Chemistry, June 10-12, 2019, Osaka, Japan | 8th International Conference on Drug Discovery & Therapy, February 13-15, 2019, Bangkok, Thailand | 9th International Conference on Traditional Medicine and Acupuncture, June 17-18, 2019, Osaka, Japan | 5thInternational Meeting on Traditional & Alternative Medicine, April 22-23, 2019atRome, Italy

Related Associations and Societies:

Acupuncture Association of Colorado | American College of Healthcare Sciences | European Herbal & Traditional Medicine Practitioners Association | British Acupuncture Council(BAC) | Naturopaths and HerbalistsAssociation of Australia | American Holistic Medical Association | Australian Traditional Medicine Association(ATMA ) | Herb Society of America.

Session 08: Ayurveda: Wisdom of Life

Ayurveda is the oldest traditional practice of Indian subcontinent since the 12th century BC. The earliest trace of Ayurveda is in the Vedic period when the Aryans compiled the Vedas with maximal reference in Rigveda and Atharvaveda (1500-800 BC). It believes that the illness is caused due to the delicate imbalance of the mind, body and spirit. It is the sister science of yoga. It spreads from India and influences the ancient treatments of China and Greek medical practices. Hence it is called as the Mother of all healing. The fundamentals of ayurvedic treatment called Mool Sidhant are Dosha, Dhatu, Mala, Agni.

Related conferences:

International Conference on Traditional Medicine and Ethnomedical Research, May 15-16, 2019, Tokyo, Japan | 21st International Conference on Complementary, Alternative, Integrative Medicine and Health, May 23-24, 2019, London, United Kingdom | 8th Annual Midwest Women's Herbal Conference, May 31, June 01-02,2019, Almond, WI | 21st Annual International Conference on TCVM,August 30 to September 2, 2019, Shanghai, China | 3rd International Integrative nursing Symposium, May 22-23, 2019, Galway, Ireland | 10th International Conference on Alternative Medicine, August 26-27, 2019, London UK | 5th World Congress on Medicinal Plants and Natural Products Research, April 15-16, 2019, Hong Kong

Related Associations and Societies:

Acupuncture Association of Missouri | American Association of Acupuncture and Oriental Medicine (AAAOM) | Veterinary Botanical MedicineAssociation | Indian board of Alternative Medicine | The National Institute of Complementary Medicine, Australia | British Herbal MedicineAssociation | Natural Health Products Research Society of Canada.

Session 09: Arabic and Unani Medicine

The Unani system originated in Greece and was introduced by Arabs and Persian around 11th century in India. It was laid by Hippocrates in late 460-377 BC. It is based on the classical four humours as Phlegm, blood, yellow bile and black bile. Health is thus a state of the body in equilibrium with the humours. With extra commitments of restorative astuteness from different parts of the Middle East and South Asia, Unani solution came to be referred to likewise as Arabian, or Islamic prescription.

Related conferences:

Mind-Body-Spirit Conference, 2019, June 7-8, 2019, Toronto, Canada | Euro Summit on Toxicology and Pharmacology, May 13-15, 2019, Rome, Italy | 2ndInternational Conference on Pharmaceutics, Pharmacology and Drug Delivery Systems, September 23-25, 2019, Valencia, Spain |3rd World Congress on Pharmacology & Toxicology, September 12-14, 2019, London, UK | 30th International Conference on Ayurveda, Yoga, Spirituality, March 1-3, 2019, Aegina, Greece | 7th International Conference and Expo on Acupuncture and Oriental Medicine, April 08-09, 2019, Toronto, Canada | 4th International Conference on Holistic Medicine and Nursing Care, March 25-26, 2019, Florida, USA

Related Associations and Societies:

American Holistic Health Association | The Association ofTraditional Chinese Medicine and Acupuncture UK | American Medical Association | Association forNatural Medicine in Europe | Australian Natural TherapistsAssociation (ANTA) | Research council for Complementary Medicine | Japan Institute of Traditional Medicine.

Session 10: Chiropractic: Hand-on-therapy

It is a health profession or a form of alternative medicine which involves the treatment approach especially by hands. A system of diagnosis and treatment based on the concept that the nervous system coordinates all the body's functions, and that disease occurs due to lack of nerve function. It focuses mainly on the functioning and the manipulation of the spine so that pressure on nerves coming from the spinal cord due to displacement (subluxation) of a vertebral body may be relieved. It is the best treatment for acute lower back pain. Among those who have used the treatment for the back pain, 66% perceived greater benefits.

Related conferences:

Global Experts Meeting on Frontiers in Traditional & Alternative Medicine, July 18-20 2019, London, UK | 3rd world congress and expo on traditional and alternative medicine, June 06-08, 2019, Berlin, Germany | 6th annual conference ICNM, 5-7 July 2019, London, UK | 3rdGlobal Summit on Nutritional Science & Food Chemistry, June 10-12, 2019, Osaka, Japan | 8th International Conference on Drug Discovery & Therapy, February 13-15, 2019, Bangkok, Thailand | 9th International Conference on Traditional Medicine and Acupuncture, June 17-18, 2019, Osaka, Japan | 5thInternational Meeting on Traditional & Alternative Medicine, April 22-23, 2019atRome, Italy

Related Associations and Societies:

Acupuncture Association of Colorado | American College of Healthcare Sciences | European Herbal & Traditional Medicine Practitioners Association | British Acupuncture Council(BAC) | Naturopaths and HerbalistsAssociation of Australia | American Holistic Medical Association | Australian Traditional Medicine Association(ATMA ) | Herb Society of America.

Session 11: Holistic Medicine

Holistic medicine means consideration of the complete person all their physical, psychological, social, lifestyle values and spiritual, in the management and prevention of disease. This therapy is favoured for more spiritual individuals who feel that the spiritual healing is helpful to them. It helps in to restore the bodys natural balance hence helping to lad a more sustained and rewarding quality of life

Related conferences:

International Conference on Traditional Medicine and Ethnomedical Research, May 15-16, 2019, Tokyo, Japan | 21st International Conference on Complementary, Alternative, Integrative Medicine and Health, May 23-24, 2019, London, United Kingdom | 8th Annual Midwest Women's Herbal Conference, May 31, June 01-02,2019, Almond, WI | 21st Annual International Conference on TCVM,August 30 to September 2, 2019, Shanghai, China | 3rd International Integrative nursing Symposium, May 22-23, 2019, Galway, Ireland | 10th International Conference on Alternative Medicine, August 26-27, 2019, London UK | 5th World Congress on Medicinal Plants and Natural Products Research, April 15-16, 2019, Hong Kong

Related Associations and Societies:

Acupuncture Association of Missouri | American Association of Acupuncture and Oriental Medicine (AAAOM) | Veterinary Botanical MedicineAssociation | Indian board of Alternative Medicine | The National Institute of Complementary Medicine, Australia | British Herbal MedicineAssociation | Natural Health Products Research Society of Canada.

Session 12: Siddha: Ashtamahasiddhi

The origin of siddha system was attributed to Agastya, who is believes as the father of siddha medicine. In India the siddha medicine is coordinated by The Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy. According to Siddha any changes or disturbances in the physiological components of the body causes diseases. Also, the diet and lifestyle play a major role in curing diseases. The diagnosis is carried out by examining the eight items which are called as enn vakaith thervu. The physiological components of human body are classified as Vadham, Pitham, Kapam.

Related conferences:

Mind-Body-Spirit Conference, 2019, June 7-8, 2019, Toronto, Canada | Euro Summit on Toxicology and Pharmacology, May 13-15, 2019, Rome, Italy | 2ndInternational Conference on Pharmaceutics, Pharmacology and Drug Delivery Systems, September 23-25, 2019, Valencia, Spain |3rd World Congress on Pharmacology & Toxicology, September 12-14, 2019, London, UK | 30th International Conference on Ayurveda, Yoga, Spirituality, March 1-3, 2019, Aegina, Greece | 7th International Conference and Expo on Acupuncture and Oriental Medicine, April 08-09, 2019, Toronto, Canada | 4th International Conference on Holistic Medicine and Nursing Care, March 25-26, 2019, Florida, USA

Related Associations and Societies:

American Holistic Health Association | The Association ofTraditional Chinese Medicine and Acupuncture UK | American Medical Association | Association forNatural Medicine in Europe | Australian Natural TherapistsAssociation (ANTA) | Research council for Complementary Medicine | Japan Institute of Traditional Medicine.

Session 13: Acupuncture- Moxibustion

Acupuncture is a form of alternative medicine which is a key element of Traditional Chinese Medicine (TCM). It is believed to be originated around 100 BC in China. It is a treatment in which the needles are inserted into the body that helps in to relieve pain. It believes that Qi (energy flow) is responsible for the essential health. Any changes or disruptions in Qi leads to disease. It is found that it helps in the stimulation of hypothalamus, pituitary glands and the secretion of neurotransmitters.

Related conferences:

Global Experts Meeting on Frontiers in Traditional & Alternative Medicine, July 18-20 2019, London, UK | 3rd world congress and expo on traditional and alternative medicine, June 06-08, 2019, Berlin, Germany | 6th annual conference ICNM, 5-7 July 2019, London, UK | 3rdGlobal Summit on Nutritional Science & Food Chemistry, June 10-12, 2019, Osaka, Japan | 8th International Conference on Drug Discovery & Therapy, February 13-15, 2019, Bangkok, Thailand | 9th International Conference on Traditional Medicine and Acupuncture, June 17-18, 2019, Osaka, Japan | 5thInternational Meeting on Traditional & Alternative Medicine, April 22-23, 2019atRome, Italy

Related Associations and Societies:

Acupuncture Association of Colorado | American College of Healthcare Sciences | European Herbal & Traditional Medicine Practitioners Association | British Acupuncture Council(BAC) | Naturopaths and HerbalistsAssociation of Australia | American Holistic Medical Association | Australian Traditional Medicine Association(ATMA ) | Herb Society of America.

Session 14: Integrating Traditional & Modern Medicine

The concept of integration of the traditional medicine and the so called modern medicine is achieved by using modern scientific knowledge and techniques. It is used to supplement the weakness of current conventional medical systems. Thus, it is promising to offer reciprocal benefits to each system for the greater welfare of mankind. It also enhances the quality of practitioners. Based on the scientific evidence the acupuncture, medicinal plants, traditional exercise and meditation has been used as a part of oncology setting. Ayurvedic preparations can be used along with chemo and radiotherapy for cancer treatments.

Related conferences:

International Conference on Traditional Medicine and Ethnomedical Research, May 15-16, 2019, Tokyo, Japan | 21st International Conference on Complementary, Alternative, Integrative Medicine and Health, May 23-24, 2019, London, United Kingdom | 8th Annual Midwest Women's Herbal Conference, May 31, June 01-02,2019, Almond, WI | 21st Annual International Conference on TCVM,August 30 to September 2, 2019, Shanghai, China | 3rd International Integrative nursing Symposium, May 22-23, 2019, Galway, Ireland | 10th International Conference on Alternative Medicine, August 26-27, 2019, London UK | 5th World Congress on Medicinal Plants and Natural Products Research, April 15-16, 2019, Hong Kong

Related Associations and Societies:

Acupuncture Association of Missouri | American Association of Acupuncture and Oriental Medicine (AAAOM) | Veterinary Botanical MedicineAssociation | Indian board of Alternative Medicine | The National Institute of Complementary Medicine, Australia | British Herbal MedicineAssociation | Natural Health Products Research Society of Canada.

Session 15: Propitious Future

The patients seeking traditional medicine is now in great demand because of its better compatibility, acceptability and minimal side effects. Hence its use now is growing exponentially. To be used as an alternative to modern medicine, a vigorous method of scientific and clinical validation must be carried out to prove the effectiveness of the product, to gain public trust and to bring the herbal product into mainstream of todays healthcare system. The side effects, misuse and overuse of allopathic drugs lead the World Health Organisation (WHO) in 2013 to develop and launch the WHO Traditional Medicine Strategy 2014-2023 which focuses and emphasised on integrating traditional and complementary medicine to ensure a better quality, safety and effectiveness. Hence the world is now looking for some cost effective, easily available and compatible medicines to provide basic healthcare to all.

Related conferences:

Mind-Body-Spirit Conference, 2019, June 7-8, 2019, Toronto, Canada | Euro Summit on Toxicology and Pharmacology, May 13-15, 2019, Rome, Italy | 2ndInternational Conference on Pharmaceutics, Pharmacology and Drug Delivery Systems, September 23-25, 2019, Valencia, Spain |3rd World Congress on Pharmacology & Toxicology, September 12-14, 2019, London, UK | 30th International Conference on Ayurveda, Yoga, Spirituality, March 1-3, 2019, Aegina, Greece | 7th International Conference and Expo on Acupuncture and Oriental Medicine, April 08-09, 2019, Toronto, Canada | 4th International Conference on Holistic Medicine and Nursing Care, March 25-26, 2019, Florida, USA

Related Associations and Societies:

American Holistic Health Association | The Association ofTraditional Chinese Medicine and Acupuncture UK | American Medical Association | Association forNatural Medicine in Europe | Australian Natural TherapistsAssociation (ANTA) | Research council for Complementary Medicine | Japan Institute of Traditional Medicine.

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