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Surviving Veterinary Medicine

Leaders of Change – An Interview with Dr. Danielle Anderson

Surviving Veterinary Medicine. Be smart, be bold, be creative, and be your own boss. At the very least, find a practice where you can do what you do in the most positive way that gives you the space to practice medicine as you see fit. Because at SVM we set a higher standard for medicine than what you learned in school.

Dr. Narda Robinson (host, NR): For today’s podcast on Surviving Veterinary Medicine, I’m delighted to bring you Dr. Danielle Anderson from the Southern Ontario Animal Rehabilitation or SOAR Veterinary Clinic.

Dr. Anderson is a popular teacher and speaker on medical acupuncture and integrative rehabilitation for animals. She has been teaching with us for several years at the Medical Acupuncture for Veterinarians or MAV Course, and she is now a major instructor for us in our MOVE Courses, which are CuraCore Vet’s new rehabilitation programs in orthopedic and neurological rehabilitation.

We begin our conversation talking about just the status of veterinary medicine and how so many practitioners and students are looking for something more. And when they see the joy and the results; the clinical outcomes that can be had by integrative medicine and rehabilitation, especially done scientifically, they become very enthusiastic about wanting to learn more.

Dr. Danielle Anderson (DA): That’s not an uncommon thing that we hear, though, right? So, that’s the problem. So, when I did my talk at the vet conference, I had multiple people reach out to me. There’s a lot of mentoring sort of stuff happening. And I’ve had a couple vets reach out to me. One was from down south somewhere, Texas, maybe, through the vet rehabbers community.

And this girl found me on her own and said, “I’m looking at having babies, but how do I manage working and having a baby and doing all these things?” And she’s like, “Can we talk?” And I’m like, “Absolutely.”

So, I called her and she was blown away that I would call her. And I’m like, “But we need to do that. We need to reach out to one another because I wish someone had freaking supported me when I was going through all I was going through.”

NR: Right.

DA: I was talking to her. She said she didn’t know that cases like Twist and cases like some of these others, that they could do well without surgery. She had no idea because we don’t learn that in school.

And I would love to take some of those neurologists and have them come spend a day with me and maybe they can reason through in their head that, “Oh, well, it’s going to get better or it’s not. So, maybe you helped, maybe you didn’t.” Which is usually what we hear. “Well, you can go, but maybe it’ll help, maybe it won’t.”

NR: And then Dr. Anderson describes the response of a colleague who saw how Danielle was treating animals at her clinic and getting results.

DA: Again, she came to spend a week with us and stayed for a month because she’s like, “Oh, my God, these dogs are getting better.” And she had never heard of that and she’d never seen it before.

And so, I think that’s where we need to just start reaching out to everybody and saying, “I’m not saying don’t always do surgery. I’m saying, don’t always do surgery. But I’m saying, yes, surgical intervention sometimes is a good idea, but we also need to look at the big picture and understand and communicate to these clients that there are potential huge repercussions there.

NR: Even though they’re academicians, they don’t study outside their little box. They go through their little tunnel in vet school, then they get accepted, as long as they’re playing by the rules and everything. They get accepted into residency and they’re always in their lane.

Aside from those that do reach out, not all neurologists are uninterested in changing things.

So, I think that’s part of the problem, too, is the general intimidation, maybe by those not in a university. We were even talking about it today in Large Animal MAV, and just realizing that people’s training, even in the big colleges or whatever, is narrow and limited and their word is not gospel, like even clients are led to believe, “Oh, I’m going to the university.”

DA: Right. And that’s how I graduated. I graduated going, “Well, that’s what I was taught. And these are the people that know everything. They’re the ones that taught me.” So, then you kind of start questioning everything.

And I don’t dislike Western medicine and I pull it all together, but I just think people need to think outside the box. There’s a reason I find things that — And most recently, we had a case that was seen by a vet, diagnosed as a psoas. Went to OVC, they diagnosed a cruciate. The dog wasn’t getting better. Went back to OVC, they said, “No, cruciate is not there.” And they were going to do surgery. And then the dog is still lame.

It came to us. My technician went, “I think this dog’s neuro.” I’m like, “Yeah, it is.” So, she videotaped it. And we looked at it. And the owner was like a nurse. And she’s like, “I’ve been saying, this dog’s neuro.” and no one would listen to her, you know?

So, I think we just have an ability to look at it from a different perspective. We’re not discounting everybody else and their opinions because some of them are very good at what they do, but it’s just a different point of view. I mean, I call Tara and Sarah all the time. And I’m like, “Can you just look at this?” And they do the same to me.

So, I think it’s just understanding where you might have a limit and then reaching out to someone who might be able to help you; and not discrediting us.

NR: Well, yeah, but we’re kind of like even, especially because the stuff that we do is scientifically based, it’s the same science, it’s the same approaches that have been taught, but we’re actually using them and thinking broadly. And this should be standard of care.

DA: I agree.

NR: Yeah. And having a broader differential diagnosis. So, anyway, we’ll have a lot to talk about, I think.

DA: So, I graduated from the Ontario Veterinary College in 2002. I did my Bio Sci degree before that. And growing up, there is nothing in this world I wanted more than to be a veterinarian. It was never an option to do anything else.

So, I graduated, and I think like most new grads, I was hesitant about my skills. I knew what I was good at, but I felt like there was a lot to learn. And I struggled with finding somewhere where I ethically thought like everybody else, and that I was also supported at the same time. Which seems like it should be completely easy to do,  and it’s not. I never worked for corporate. It was always privately owned companies, but it doesn’t always come without complications.

And so, I think I was two years out of vet school, after my second practice I had attempted and I considered leaving the profession, which was horrible.

And so, my sister in law, who is also my classmate, got pregnant and offered me her mat leave. So, I went to work at her clinic and it did a hundred percent, re-instill my faith in better medicine. I went, “Okay, so privately owned company. They treat their staff well. It’s well-run. She practices amazing medicine. So did her partners.” So, I was like, “Okay, now I just need to find another practice like that.”

And I did. And I worked for a long time in General Practice, and I really just wanted to own my own thing. I had a great gig. I made good money. I would still get, and I’m sure everyone does, you get all of these weird cases coming in that are lame and you can’t figure out what’s going on because you’re taught range of motion. There was no myofascial palpation being taught when I went to school. X-rays would be normal. And you’re like, “I don’t know what’s wrong with this dog.” And I found it horrendously frustrating.

And I also would have these senior dogs come in. And the seniors, you put them on their NSAID or they have kidney failure or kidney elevations and you can’t put them in on an NSAID and you’re like, “What do I do now?”

And often, the answer was euthanasia, which anyone who knows me knows I’m probably one of the most sensitive human beings on the planet and I cry all the time. So, it was really disheartening to go through that.

So, I ended up getting my rehab certification after I have my daughter and I was like, “Okay, I’ve got this. This is what we’re going to do. This is going to totally change everything.”

And while the certification was extremely thorough and great, I went back into practice and went, “How the heck do I incorporate this into my day?” And my boss, who was super supportive in me getting certified, I think, from a monetary standpoint, was really, really hesitant on how it was going to work to pay me well and to not lose money on the deal where we’re seeing these appointments.

And keeping in mind that integrative medicine, whether it’s rehab, acupuncture, any of it, the revenue stream isn’t just about that bottom line. You are going to generate maybe less revenue when you look at an appointment basis, but, man, the loyalty from your clients, the trust from your clients to the point where, and I’m kind of getting ahead of myself, but to the point where you say, “You know what? It is time. We need to do some X-rays or we need to do some diagnostics.” They’re like, “Okay. Well, we trust you. We have that relationship with you.” And you don’t always get that when you see them once every year, every two years for vaccines or a general physical.

So, I ended up leaving that practice because I really wanted to do more rehab and own my own place. So, after locuming and trying to buy practices and searching for a few years, I finally opened this place that I own now, which is SOAR in Burlington.

And I really had a lot of requests for acupuncture. And I had gone to multiple, and it was NAVC at the time, it’s now VMX Conferences and the Western Vet Conference, and I loved them and they were fantastic. And I would sign up for their acupuncture stuff and it was all Chinese medicine based, but I just thought that’s what acupuncture was. I didn’t really have any knowledge about it outside of that.

And so, I did some workshops and everything and I was like, “Okay, I’ve got this.” And I get home and I’m like, “I do not got this.” So, I was like, “Okay.”

So, I was working at a practice part-time while I was running SOAR and the owner was like, “Well, did you look at Narda’s course?” And I was like, “I don’t know what a Narda’s course is.” And she’s like, it was OneHealthSIM way back then, and she was like, “It’s all neuroanatomy, neurophysiology based.” And I was like, “I don’t know if that’s much better.” And she’s like, “Trust me. Try this.”

So, I signed up for the course and I was like, “Okay.” So, it wasn’t like starting from new and learning a new language because I do have some neuroanatomy and physiology in my brain, way back when in vet school. I had to relearn a lot of anatomy, but I’d already done that in my rehab certification. So, I was like, “This makes sense.”

And the more I did it and the more I talk to the amazing people in the program, I was like, you pull it all together and it was probably the best thing I ever did at SOAR, as far as pain management and client outcomes, patient outcomes, things like that.

So, that is what I do full-time now; acupuncture and rehab. I will say, for the most part, I’ve scaled back on the rehab portion of things and I pass that off to my certified techs because the acupuncture is really busy, the pain management is really busy and the second opinions are busy.

I think especially right now with Covid, I think general practitioners are so overwhelmed. And they’re not just corporate, they are everywhere. They are overwhelmed. It is super, super busy. They do not have time sometimes to sit down for half an hour with these stressed out clients. A lot of surgeries got pushed back because of Covid or canceled altogether. Referrals were really, really tough to get. And so, we were slammed.

And I can’t say I don’t enjoy it because I actually really do. We really enjoy working through some of these tough cases.

And I mean, you and I have talked about this. It’s not that nobody else is capable of figuring out what’s going on with these animals. It’s just a different perspective and way of coming about that problem. And as far as acupuncture goes, I mean, they respond so incredibly well.

And it’s nice to have some rehab background as well, because let’s say, because it does happen, let’s say you have a patient that they’re just not having acupuncture. They will not do it. They will not sit for it. There’s nothing you’re going to be able do to change their mind, whether it’s using the smallest needle possible or maybe it’s the owner, because we’ve had owners that are supersensitive with regards to acupuncture; they’ve had bad experiences in the past.

It’s nice to have other options because once you’ve used your kind of new way of examining these patients and gotten your diagnosis, then you’re like, “Okay, well, if acupuncture doesn’t work, what else can I do? Or if rehab, doesn’t work and they won’t walk in the water treadmill or they’re deaf and blind and they can’t really do therapeutic exercises, what can we do for them?” It’s nice to have all of those things and kind of integrate it all together.

I see stressed out vets. I see stressed out techs. And I think there’s so many different reasons for it. In my opinion, I think a bit of it is, yes, there’s corporations that — It’s a very business-oriented sort of model, and there’s a lot of practices that operate, and I’m not saying it’s wrong. I’m saying one hundred percent was not for me.

There are some vets that are so Type A personality. They like being busy. They’re in and out in 15 minutes. They’re okay with that and they can do it. I really like my appointment times being a half an hour to an hour where I can really spend time and be patient with that animal, not rush things.

Because some of these animals have had really bad experiences before. And the last thing I want to do is jump on them and hold them down and do what we need to do. And then it’s just made things one hundred times worse.

So, I think in regular practice, especially with things being as busy as they are, with clients not being allowed in the building a lot of the times, I think you’re doing one hundred times more things; you’re going outside after, or you’re calling them on the phone or you’re having to email them. And the stress is real, even for the best of veterinarians who have Type A personalities.

So, I think having an option like rehab or acupuncture where you can just, even if it’s part of your day, just settle down. For me, when I was in regular practice, that was my surgery time. And I know you’re not a huge surgical fan. You didn’t love it. But I mean, it was my — Even dentistry, right, where you had just a couple hours, you could just kind of tune out, kind of regroup yourself and do those surgeries; whether it was a spay or a neuter or whatever the case may be or a dental. I liked that.

And I think I liked it, not because I really loved surgery, but I liked that aspect of surgery.

And so, I think we need to find time in our day to make sure that we’re just taking a deep breath. And it’s funny because I was talking to someone this morning and they’re like, “Danielle, you just need to take a deep breath.” I’m like, “I guess I do.” And it’s funny that I’m making that recommendation now.

But it’s true. We all need to do it. And, you know, in our day, I can’t imagine going back to that environment where it’s just go, go, go, go, go and emergencies are being brought in and emergencies are being squeezed in because there’s nowhere else to put them. You know, we squeeze things in, too, but it’s such a different environment.

And you don’t need to leave general practice to experience that. It’s a pretty good option to incorporate in your day, if you work at a practice that will let you do that.

NR: Well, and I think that what we talked about before is, I mean, we’re both supersensitive. And I think that also means that we take in a lot. We’re sensitive and there’s a certain amount of stimulation out there or data, and because we are affected by a lot of that, at least speaking for me, it’s overwhelming.

That’s why after I was planning to be a neurosurgeon and then realized I didn’t want to do that all day, and then there was a period of time where I interviewed for psychiatry residencies until I saw how crazy that whole system was from the provider end, just being able to sit and whether it’s not necessary, philosophize, but to absorb somebody’s story.

And because I can’t just shut it out, that’s how especially in medical school, because I knew better by the time I went to vet school. But just the walls I had to put up around me and around my heart and everything, it took me a long time to get those walls just broken down.

And then there was some PTSD-ey stuff, not like being in a war zone, but even after vet school is just like I was thinking, “Why did I even do this?”

So, for me, my survival of veterinary medicine was because I know I can’t be around euthanasias. You know, it’s just so many things that I can’t do. But I can do this little piece and I enjoy helping others learn how to do this, especially people like you. I mean, there’s lots of people like us that want more of a bond, just that we’re sensitive, we can, I think, understand how the animal is sensitive and feels overwhelmed or fearful or painful, and they don’t want their necks being cranked around and everything, and I think that’s a lot with empathy there.

DA: Totally.

NR: Yeah.

DA: Yeah, and I think you have to also be true to yourself. So, I think it’s easy in veterinary medicine to see a lot of judgment; judgment towards each other, judgment towards other vets. And I think, I’ve had to correct myself multiple times and go, “Okay. So, yes, I’m not happy with the way that relationship ended. That doesn’t mean that that person, that vet, that tech, that whatever is a bad person. It means we are just not good at working together. We have very different personalities.”

And I’m trying to adopt that more because I think you have to be true to yourself. And the number of people that said, “Danielle, you need to just get over it. You need to stop crying so much. You need to not be all over the place.” And I’m like, I get that to an extent, because it can be exhausting. But I’m never going to apologize for sitting on the floor and crying with an owner. I’m never going to do that because that is who I am. And I’ve developed that relationship with that family. And I have an inability to shut that empathy off and compare it to myself when I lost my dog or to see in the future when that’s going to be my kids saying goodbye to that animal they’ve had for 15 years.

I can’t. It has to be controlled. And I think, you can’t let it get the better of you, but I think you also need to just be really, really true to who you are.

And maybe you’re not that emotional person. Maybe being true to yourself means that you are completely stoic in all of these situations. And as much as I need to reel it in, maybe, channeling some empathy isn’t necessarily a bad thing either.

And I think clients are drawn to people who are empathetic, because they don’t necessarily get that, especially in very, very busy referral hospitals where you’re in and out; academia’s much like that, too. They do not have time to sit down with you and hold your hand and go through everything. But that doesn’t mean clients don’t need it.

And there are vets who that is the one hundred percent last thing in the world that they would want to ever do, but I like doing it and I want to do it. And so, I think for people like me or you, I think that that’s a good option, right?

NR: Right. And I think that a lot of times the people that refer to us are happy to have us take that client.

DA: Yes, I agree.

NR: And spend that time. So, it can work out. But it’s just I think that the frustrating thing is how much suffering there is out there that doesn’t need to happen, that if there was better medicine, better astute diagnoses. And I just personally think that I would like to see veterinary schools — I’d like to restart a whole one from the freshman year and on and really integrating the anatomy of acupuncture, the physiology of it, photomedicine.

And I think that I pattern that after my osteopathic education, where from the beginning, it’s a lot about structure and function and movement and endogenous methods of healing. And I see that if we could do that with veterinary medicine and that’s what we try to approximate with the CuraCore stuff, that is just part and parcel, that wouldn’t it be exciting and illuminating for people instead of memorizing structures and muscles and attachments, it’s like, “Look at this is where the golgi tendon organs are. There’s a lot of facial innervation there and that’s where a lot of acupuncture points land because we can influence muscle tone and function and release fascia.”

You could learn in so much more deep ways about how the body is built. I find it intriguing and I think it would be a big leap forward for medicine in general.

DA: I agree.

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Topics include; structures of clinical relevance on the head and neck, the trunk and pelvis, the thoracic limb, the pelvic limb and the sympathetic and parasympathetic nervous systems.

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DA: There’s such a huge relationship to structure and function, right? You go to any of the conferences now, there’s multiple lectures on structure and function and how they’re related. So, why is that getting missed in vet school? I have no idea.

So, I think reaching out to these students, when they’re vet students, and kind of saying, “Think outside the box.” You get so focused on, “The dog is lame in the knee. The dog is lame in the knee. The dog is lame in the knee. It must be cruciate or it must be hip dysplasia.” And I’m like, “Did you check the hock? And did you check the front end? Because is there anything going on up there that might relate back?”

And so, I know when you’ve had me teach anything for acupuncture, I cannot focus on just acupuncture. It’s super, super hard for me. Because it’s such a huge part of why we do what we do, because you’ve taught us to look at the whole animal. And I think that’s where we become better practitioners.

And it’s hard; it kind of reminds me of when you go to human hospital, it’s so compartmentalized; everyone, like you said, stays in your lane. And as much as you want people to stay in their lane, as far as their certifications and their capabilities, it doesn’t mean that you can’t look and go, “I’m an orthopedic surgeon, but that dog one hundred percent, looks neurologic. And let’s pass that off.”

And I’ve had amazing, amazing boarded people do that. And those are the people I tend to trust and want to refer to, because I think, you’re looking outside of your lane in kind of a big general picture. And I’m like, “I need that. I need that in my life.”

NR: And if they’re patient centered, too, rather than in some practices, if they’re like, “I want to do five TPLOs a day.”

DA: Is that a thing that they want to do that?

NR: Oh, I think some people. It being a multibillion-dollar profession income generator. And now that they’re doing TPLOs on small dogs, I mean, so that’s another whole thing.

DA: Well, I think I’m spoiled a little bit. You know, some of the referral surgeons and neurologists that we have up here, especially in our area in Ontario, they’re really good. Like we’ve had several go, “Yeah, surgery could be an option.”

I think they’re pretty good at going, “You know what? Maybe surgery, but I’m still not convinced. Why don’t you try this first?” And I’m like, to me, that’s fantastic. That’s what we want, right?

And even with neurologists, we have some amazing, amazing neurologists up here that then look at it and go, “Well, you know, we’re still ambulatory. Could we try conservative management first?” “Yes, we could do that.”

And so, it’s not necessarily the completely quadriplegic dogs that they’re recommending conservative management for which, you know, they’re going for surgery, but they are at least talking about it. And that’s huge. That’s a big difference from 15 years ago.

So, I think the next step then is to let general practitioners know that those patients coming in that are quadriplegic or completely paralyzed on just their hind end or whatever the case may be, that they can’t go for referral. There are still options.

And I think that’s where we need to start addressing things and clients, for that matter. Clients are the first ones that are like, “Hold on. My friend’s dog didn’t go for surgery, did get better.”

And yes, it is not one hundred percent. There is not a guarantee that I can make your dog walk again. But let me tell you, I’ve seen some pretty horrific complications post-surgery; whether that’s orthopedic surgery or neurologic surgery. And I think we just need to have those open conversations with people so they understand.

NR: Right. Right. Right. Yeah, because what I’ve heard and seen is when surgeons that, as the first person that clients might see, when they advise against acupuncture or rehab or keep them in a cage, so strict confinement, for weeks and weeks, and then they’ve had all kinds of functional changes and can’t necessarily even walk again. You have so much repatterning of the nervous system that would be required.

But yeah, and just getting out that basic science understanding, maybe we assume that a neurologist might understand, and maybe they do, the primary and secondary pathophysiologic effects of spinal cord injury. But maybe what they don’t get is that acupuncture, photomedicine, massage, therapeutic exercise address directly from a mechanistic standpoint, all those features of secondary pathophysiology of spinal cord injury, which is the cause of so much morbidity and long-term neurologic deficits, surgery only addresses the first one, maybe, but there’s all kinds of trauma that happens.

So, yeah, let’s say I was a client and let’s say I have my dog here. My dog can’t walk and I couldn’t get in for a referral, so can you help him? And if so, how would that work?

DA: What was wrong with your dog? I missed it.

NR: He can’t walk.

DA: Oh, he can’t walk.

NR: At least, on the back end.

DA: I’m like, “Yes, we can try and help.” So, let’s say because Opie, and we’ve talked about Opie before and Opie’s parents are lovely. So, I talk about Opie all the time.

So, he had come to me. He had been referred by his vet. They did all the right things. They talked about referral. They ended up saying, “Okay, conservative management.” The dog was ambulatory; just a little bit painful, just a little bit not wanting to jump up on the beds and do stairs and things like that. Little dachshund and adorable.

And so, they started all the meds. They referred to him over. Three days later, when he was supposed to come, he woke up paralyzed.

And so, when the owner called, I picked up the phone and I said, “Do you still want to come here? Do you want to go right to emergency?” And she said, “I think I want to come see you first.”

So, I said, “Sure.” Brought her in. And he was, yeah, he had no pain. He had no movement. He was very, very sad and very, very painful. And we discussed referral. He’s also a Doxie that had four visible calcified discs in his spine. So, who knows what was going to happen to that poor dog?

And so, they said, “We can’t.” And at the time, OVC was at capacity. So, they couldn’t guarantee they could see him even that day, although because he was acute, they were hoping that they could.

So, they said, “You know what? Let’s try conservative management.” And it was acupuncture. It was muscle stim. It was eventually therapeutic exercises. It was pain management. We wanted to control that pain in his back. And it was communication. I spent a very long time talking to them and educating them and talking about what the future is going to look like. So, if they went for surgery or if they conservatively managed.

And there were potential reoccurrences. And I know what the studies show. I know the studies show that you have a greater chance of recurrence with conservative management, but I don’t know if we have the proper studies to really say that.

NR: No. See, I would disagree because in my talks, I point to the data that shows more recurrences with surgery. I mean, what are you doing? You’re destabilizing the spine. You’re rongeuring out bone and you’re messing with the proprioceptors on the muscle. And then by the second time, there’s one report that talks about, yeah, if a Dachshund should has a second surgery, then 50 percent of those get euthanized because people say, “I can’t do that to my dog again.”

DA: Right. So, I will say and again, you know, are we just seeing a different skewed population of patients? Right. So, with Opie, he came back a year later, again, starting to have that stiffness in his back. So, we treated him again, I think, maybe two or three treatments and then he’s good.

So, the owner knows what to watch for. The owner is very good at monitoring and keeping up on things. And so, he hasn’t — Oh, my God, knock on wood. I haven’t seen him this summer yet.

But then I look at some of the other Dachshunds, ones that have had surgery, and those dogs have gone for surgery, and then a month later, needed another surgery. And then a month later, they needed another surgery. And we have at least six dogs, I can even think of just offhand, that have had multiple spinal surgeries.

NR: Right.

DA: And sometimes in the same spot. And I’m not saying that they did something wrong. I’m saying this is a potential problem and a potential consequence of this surgery. And I don’t always know if clients intake that information that is given to them because they’re so stressed. They’re so stressed. These dogs are painful. They’re down. They think they’re dogs are never going to walk again. They’re told, “We can do surgery. We can fix. Great.” Sometimes these dogs end up incontinent when they’re picking them up and they’re like, “Oh, my God. We didn’t know this was going to happen.”

They probably were told. But when you are that stressed out, do you take in that information? I know you’re —

NR: Yeah, right. Maybe they weren’t told.

DA: Maybe they weren’t told.

NR: Maybe they weren’t told or when they get TPLO and not told about osteosarcoma and all that. Yeah. And I think that there is blaming of the client like, “Oh, yeah, maybe the dog was thrashing around in the cage or whatever.” or “Look, another thing happened.” I mean, yeah, that need for another surgery, like even when I would be at the institution.

I mean, it’s just like blaming the dog, blaming, but never really like, “Oh, yeah, we didn’t tell you that this happens.” And they don’t even, I don’t think, have statistics on the tip of their tongue about how many do. I think that there’s a certain amount of blind spot there or hemorrhage or like I’m saying that polio myelomalacia.

If clients at that study out of Georgia had been told, “Here are the risks.” or even somebody else now, they’re, “Okay, in JAVMA, there was just this report of three dogs who after surgery, all succumbed to this ischemic event of their cord after surgery.” or “Yeah, okay, maybe you can try acupuncture and rehab and all that. That would be another option.” What do you want; the risk of dying? Nobody that I know has ever died from a veterinary acupuncture appointment or laser or rehab. And then the amount of money outlay.

DA: So, you know, would it be then, you would think, important to — Because it’s really not the fault — I can’t fault, personally; the surgeons, the neurologist, the specialist, because when they go through their residency programs and they go through all the stuff, there’s no one standing there going, “Okay, let’s try doing a study on acupuncturing these dogs instead of doing surgery” or “Let’s do a double blinded and study.” That’s not happening.

So, they’re shown and taught, and it filters down through generations, “This is how you deal with these situations.”

So, in saying that, it’s fantastic that these individuals still refer for these things and it’s good that they’re accepting them as treatment plans. But it would be nicer to have some data to say, “Hey, if we didn’t do surgery on this dog, this Grade 2 or Grade 3 IVDD, could we still get a benefit?” I don’t know.

NR: Right. Well, and even with my recent experiences with trying to submit a letter to the editor of JAVMA for publication about these options, I had cited several studies out of JAVMA that have looked, retrospectively, for some of them, about dogs that got electroacupuncture and how did they do electroacupuncture with no surgery, electroacupuncture with surgery, or just surgery. And the dogs with just electroacupuncture did better. And of course, it’s retrospect, but JAVMA published it.

So, we do have several studies on dogs. And so, we have target species specific information. We have basic science physiologic information.

And, yeah, I tend to be a little bit less peaceable, I guess, about my interactions, because having been at the institution for 20 years, it’s like, “Okay, by this time, don’t you think we should?” And so, it’s when they know and then they don’t refer.

DA: Yeah. Yeah.

NR: But I do think the fact that it’s scientific. I mean, in the general scheme of things, it’s not like you have to refer only to people that imagine invisible chi, and things like that, going through the body.

So, it’s nice, I think, probably maybe for some, that they can send it to somebody that understands the science behind it.

DA: You know, it’s always exciting to me. And the staff kind of giggle, because I’ll be like, “Ah, the vet college just sent us another one and specifically said we should try this.”

And it makes me so incredibly happy that they would trust us to do it or that I’m getting residents, especially surgical residents, reach out and go, “Hey, any chance you can see this dog? It’s not getting better.” Well, that’s great. So, that’s where we need to get them.

So, if the residents are reaching out, then that means once they’re boarded, they’re still going to reach out. They’re going to refer. In our area, we seem to be seeing more of that. I don’t know what that’s like internationally or throughout even the States, but I know in our area it makes me very happy to see it more and more.

And I think, again, all of a sudden, you treat one patient at a hospital and then those vets, they may never have even known that this was a thing. Maybe it’s never even on their radar because they’re so busy. But you treat their technician’s dog or maybe you treated their dog, because, yes, all of a sudden, maybe that vet is in a position where surgery is not an option or they’ve been told that there’s nothing else they can do and they’re like, “Hold on. That Danielle chick. She might actually see our dog.” And then, all of a sudden, you’ve earned their trust.

And I think that’s how we keep spreading the rehab and acupuncture love in our area anyways. And you see more and more individuals starting to open these practices and do these things. And I think it’s super, super important.

NR: Right. And network.

DA: Because clients want it. Clients are seeking these things out. And not just to avoid surgery; like clients, really, they’ve been through physio. How many people do you know who have had knee replacements or knee surgery or cruciate surgery? I’m like, I think three of my staff members had cruciates. They’ve all gone through physio. They all know it’s important. So, we just need to continue to spread that and let everybody know and educate people.

NR: Yeah. Well, you’re one of the best messengers out there, of course, making those inroads.

DA: Thank you.

NR: You’re welcome.

DA: I try.

NR: You’re doing well.

DA: We’re seeing some amazing cases. I know we’re going to start chatting about those kind of in a teaching platform. I encourage any GP out there who is feeling stuck. You know what? I really hate Covid because, prior to Covid, we had so many people come hang out with us. And whether they were volunteers and we were trying to inspire them to do something really amazing with their lives. And they could be high school students. They could be kids who wanted to go to vet school. Maybe they were tech students; any of those things.

And so, sometimes they were vets and they just wanted to come hang and see what it was that we were doing. And I miss that because we can’t really do that right now. And I’m hoping in the future we’ll be able to do it again. And just, I think, opening up our practice is a good thing.

Because my husband’s funny. He’s always like, “So, I don’t really understand why would you train people to do what you do? Because doesn’t that mean then you won’t get the work?” And I’m like, “Yeah, but there’s so — I can’t see them all. There’s just no way I can see every patient; none of us can.” And we have to be aware of that. So, we have to collaborate. And if that means also teaching one another and saying, “Hey, have you tried this? Does anybody else have any ideas about this patient? Because I can’t seem to get any headway on it.”

I’m like, I think that’s what we don’t need to do. We don’t need to shut it down and go, “This is mine and you can’t do it. And you definitely can’t do it as well as I do it.”, because that’s not true. It should all be about collaboration and kind of helping each other out. That’s my opinion.

So, hopefully one day Covid will not be such an issue. And we can have people back in the practice to kind of learn more about what it is we do so that maybe that’s something that they’ll pursue in the future.

NR: Yeah. Well, I think based on our last teaching session, even seeing video of your treatment and meeting you through this kind of platform, I think that that’s the next best thing is having that available, which can kind of broadcast and gets to more people at one time, too.

DA: Sure. And clients. And social media is a pretty incredible thing that I have only started using in the last couple of years. But it reaches, maybe not necessarily vets, although we do have some vets that follow us. It reaches everybody.

And so, it’s really funny because sometimes you get someone who comes in to the practice and they’re like, “We’ve been following you on Instagram for like two years.” I’m like, “Really?”

And they’re actually excited to be coming to the practice. I’m like, “You should not be excited that you have to come see us, because that usually means there’s something wrong with your dog.”

But they’re excited about it and they’re excited to see all of the different things that we can do and that their dog might be able to do. And I think it’s way more fun than going to a regular practice and getting some vaccines and some blood work done.

NR: Well, exactly.

DA: That’s exciting.

NR: Yeah. I mean, whether it was a kid that loved animals like we did and thought, “What can I be?” That was part of me going to med school. First was I volunteered at a vet when I was 16 and I saw the euthanasia of a one-year old cat, just because this person would cycle through kittens every year and I thought, “Okay, never, ever am I going to do that.” And it’s like I can’t even approach veterinary medicine.

And so, to see a joyous practice like yours and just with all the burnout and everything. Again, Surviving Veterinary Medicine started because of the suffering that veterinarians have. And like you saw and you found a path to another way. And I think it’s great for vet students to learn about this. And vets.

And even with this last group that we had through today, I mean, there was one person; she was planning to sell her practice in seven years and then do acupuncture. And that was when she was here with the small animal portion. And then she was here today with a large animal. And she’s like, “I have sold my practice and I’m moving to this new house, new state where I wanted to be. And I just didn’t feel like waiting for seven years. I want to do it now.”

DA: Wow.

NR: Yeah.

DA: That’s awesome. And the other thing is, so let’s say you are a general practitioner and you’re like, “I actually really like medicine and surgery. I like general practice.” And there are vets that do. And we need general practitioners, right? We can’t exist without them.

But that doesn’t necessarily mean not knowing about these things isn’t advised either. Because, again, I remember being in general practice and having those seniors and not having options for them.

And I remember there was one vet that was doing acupuncture in our area and people would seek her out. And I was like, “I have no idea who this woman is, but okay, well, it can’t hurt, like, go get acupuncture done.” And they loved it and they did so well.

Having that option to refer and not go, “Well, we’ve hit the end of the road. I’m sorry your 14-year old dog is lame. He can’t take NSAIDs. I guess we’re done.” And now you can say, “You know what? Not true. Why don’t you go try some other things?”

Not every client is going to want to. Not every client is going to want to take their cat and put it in a water treadmill. Not every client is going to want to spend the money and the time and the effort to go to these appointments. But holy Moses, there are a lot of clients that are.

And I think if every single clinic has even 20 percent of those A clients that will do those things, then I think that takes the relief off of our shoulders that we’re like, “There’s 20 percent more that I didn’t have to euthanize today.”

NR: Right. And as a survival thing, the patient has survived, the client whose heart would have been broken and that might be their lifeline; that’s the small special being to them, they’ve survived better and the repercussions through the family. And then the practitioner who hates that part of their job, meaning that brick wall, they’re better.

I mean, there’s evidence, like in the human profession, how learning acupuncture reduces burnout and it just makes for healthier work environment, I think, as well.

So, yeah, the other thing I was going to say; whether it’s whatever neuro things or also orthopedics that if you’re not slammed because of Covid and everything, but those practices that are interested in keeping their patients in, it’s like so a dog has hind limb lameness. You do not have to send them right away to the orthopedic surgeon and lose them to follow up or have whatever dastardly things might happen to them, in my words.

But anyway, you can keep them in the practice and build that in; like you’re kind of suggesting, too, is that could be part of what happens in your practice and you’re doing better medicine and you’re keeping your clients very close to you.

DA: Yeah. I mean, I think it’s funny because some of the seniors that have been referred to us, one year or two year, three years out, whatever the case may be, they’re always super thankful for their vet who sent them to us and then to us.

So, their loyalty is still, unless they found us on their own and then they’re angry, they become, “Well, why didn’t my vet recommend this? Why wouldn’t my  vet have sent me here knowing that this was an option?” I’m like, “You know, well, maybe they didn’t know it was an option.” So, now you tell them about it and now they know that this is an option for the future.

So, I think, again, it’s all about education and it’s one baby step at a time. I didn’t know this was an option; maybe it wasn’t an option 20 years ago. But now that we know it is, it’s becoming more mainstream and it’s our job to just make sure everybody’s educated and is doing the right things.

NR: Right. Right.

DA: For those pets anyways, right? And again, just because it’s limping on one leg doesn’t necessarily mean surgery on that leg. Maybe there’s something else. If it’s limping on the right hind leg and you’re like, “Oh, yeah, it’s got hip dysplasia.” I’m like, “Yeah, but the hip dysplasia in the other leg. So, why is it…” you know, like, “Let’s look at this and figure out what’s going on before we rush to surgery or rush to any specific treatment. We just want to know. Look outside your box.”

NR: And look at the patient, feel the patient. So, it gets back to the basics of medicine; examine your patient, listen to the history, have hands on, because that big missing piece of the myofascial examination and even a little bit of neuro exam doesn’t hurt either, though, or more, even neuro exam.

But just feel the patient and what makes sense. And you don’t need to jump to a lot of expensive diagnostics. And even if one did and didn’t localize the area enough, you’re wasting money and time and everything because you’re looking at the wrong area.

So, again, it’s just better medicine, better regular medicine and more options and empowering the clients, empowering practitioners to bond and to make different choices instead of just drugs and surgery. So, yeah.

DA: Yeah, absolutely.

NR: Yeah. Well, thank you for being an ambassador of this goodness and helping all the animals and people that you are helping.

DA: Well, thank you. Because without you, I never would have learned any of this.

NR: Thank you for helping communicate.

DA: Okay, you’re going to become Canadian if you have one more thank you.

NR: I know. Well, I’m so sorry.

DA: So sorry. Thank you.

NR: So sorry. Thank you. I almost was Canadian and I daily wonder if I should.

DA: So close.

NR: I know. I know. I still might make that though.

DA: Next week, you might change your mind.

NR: Yeah, yeah. I know how to do it. That’ll be the third move up north.

DA: Yeah.

NR: I know the process well. We’ll, thanks and I hope to do this more, so we will help people survive veterinary medicine.

DA: Absolutely. Thanks, Narda.

NR: Okay, thank you. I’ll talk to you soon.

DA: Okay, bye.

NR: Okay, bye.

If you’d like to learn integrative medicine from a scientific perspective, visit us at curacore.org. Thanks for listening to another installment of Surviving Veterinary Medicine.