Sunday, February 24, 2013

Equine Recurrent Uveitis

Equine recurrent uveitis (moonblindness) is unfortunately a common condition and in my practice is most often seen in the Appaloosa and Paint breeds.  The exact cause of the condition is even today unknown, but the end result can be chronic pain, ocular damage and vision loss.

Uveitis is essentially inflammation of the internal components of the eye, which has been posed to be a result of a breakdown in the blood vessels around and in the eye.  This breakdown of blood vessels (vasculitis) is then thought to allow the exposure of the immune system to the internal components of the eye, in which they then mount an immune response.  There is no doubt that this disease has a strongly inflammatory and immune component, but the question is what potentially triggers this vasculitis that is thought to head the syndrome?

There have been proposed many 'triggers' to the condition and include bacterial infections such as Leptospirosis, viral infections, parasitic infections as well as systemic inflammatory conditions related to other diseases such as colic or even pneumonia.  Another thought is that it is strictly an 'immune mediated' type of condition in which the immune system misfires and become hyperactive.

In early stages with uveitis, most horses in my experience, present with mild to moderate levels of eye pain which is indicated by increased squinting as well as ocular drainage or tearing.  Sometimes these horses are perceived as being off personality wise, secluded, not eating well or head shy at times. Often times,
these horses are very resentful to having their eye examined and require sedation as well as peripheral nerve blocks to remove pain sensation.  In some horses, the condition affects only one eye, while in others it will present in both eyes.  It is common to have a horse affected in one eye soon present for the same condition developing in the opposite globe.  Once the horse is sedated and nerve blocks performed, the eye can then be further evaluated.  For starters, the eye is evaluated extensively, looking for damage to the cornea, cloudiness or what is termed neovascularization. The cornea may be stained to evaluate for scratches or ulcers.  Ocular pressures may be measured as well looking for glaucoma. If possible, the anterior and posterior chamber are evaluated for debris and other findings such as a cataract, flare or even blood accumulation.  In some horses with extensive disease, there may be cataract formation or even severe scarring of the cornea, which can lead to a blueish type of look with craters, which gives rise to the term "moonblindness".


As we can see, there are a variety of presentations for this disease from the clinically normal eye with evident pain to a horse with glaucoma, cataracts and visual blindness.  The difference between these levels of disease is dependent on the level of inflammation that has been ongoing as well as time.  The longer this condition goes undiagnosed and treated, the more damage that occurs.  In the long term, one has to understand that this condition is best 'managed' and not likely to be cured.  ERU is the most common cause of blindness in the horse and it has been noted that around 50% of ERU horses will lose vision in one or both eyes at some time.  The question comes as to how to best manage these cases?


Current therapeutics include the use of injectable or oral NSAIDs, of which Banamine is most often chosen.  Banamine helps to reduce pain and modulates the inflammatory response to a degree.  In cases of suspected infection, antibiotics may also be chosen. Other options include the use of topical atropine, which dilates the pupil, reducing pain and helping to reduce adhesions within the eye.  Corticosteroids are often utilized in a topical or injectable fashion, which again help to modulate the inflammatory and immune response.  Cyclosporine is a medication that modulates the immune response and is often used topically, but can also be implanted into the conjunctiva around the eye, which allows for a low level release of medication over time.  I feel that the cyclosporine implants are best for early cases of ERU and do not yield very good results in chronic cases, not to mention that they are expensive and involve general anesthesia, which carries its own risks.  In the long term, a high percentage of ERU horses are often times on daily doses of medications to control the condition, but even in these instances, many of the horses continue to have flare ups with more damage occurring to the eyes.


The inflammatory response is the key area of my research and considering the pathophysiology of ERU, it is quite possible that this condition can be better managed by implementing herbal therapy along side of traditional therapeutics.  In our patients, I will use our EQ Green or EQ Plus products with great success.  The determinant in which product is chosen is dependent on how severe the pain is in the patient.  I will dose the products twice daily for 14 days, then re-evaluate the patient.  In many cases, I will use injectable or topical medications as well, but for the short term which is usually just 5-7 days, after which I will have the owners discontinue, as this is ample time for the herbal formulas to begin to work.  At the recheck evaluation, about 80% of our patients are markedly improved with much less pain and less ocular reactivity.  In the other 20%, I may have to restart some medications or I will add in one of our Immune Formulas to help modulate the immune response.  ERU has a strong immune component, characterized by lymphocyte involvement.  The mushroom polysaccharides in our Immune Formulas have been shown to modulate the lymphocyte reaction and have proven to be very valuable in our ERU patients.


Equine Recurrent Uveitis is a complex condition and one that we still have many questions about.  We do know that there is a strong inflammatory component, which is readily evident, but there is also a strong immune component.  It is possible that an underlying inflammatory or immune component is leading to the vasculitis, which then snowballs into the ERU syndrome.  As a veterinarian, I have found tremendous value for our patients through utilizing our formulas, but keep in mind that not all horses respond, despite the therapy route chosen.  Many horses end up having to have an eye surgically removed for the best outcome, while others are so severe that euthanasia is the only option.  I do feel that if we approach this condition in a more thorough manner, that it is possible to at least reduce the dependence on various medications, if not eliminate them while reducing the number of flare ups that occur.


I hope this information helps those affected by this horrible condition.


Tom Schell, D.V.M.
www.curost.com

Sunday, February 10, 2013

Laminitis in the Horse


Laminitis In The Horse: Causes, Signs and Treatment Options
Laminitis is unfortunately a common condition affecting of any discipline; whether if they are a Grand Prix Jumper or a backyard family companion.  This condition can be devastating in terms of overall health and is considered to be one of the main causes of euthanasia second to colic by many standards.  Laminitis is closely connected with a variety of clinical diseases including carbohydrate overload (grass or grain), road founder, concurrent or contralateral limb lameness as well as septicemia associated with a multitude of conditions ranging from pneumonia to colic.

Despite years of clinical research, not many new answers have been discovered or therapies implemented over the past 20 years.  The same therapies that I was taught as a veterinary student 18 years ago, are still implemented today unfortunately.  To be honest, I am not sure we have really put a dent into the overall survival rate associated with this condition either, but none the less, we continue to move forward.

Laminitis is essentially a condition in which there is inflammation of the laminae.  The laminae is the connective tissue which supports and affixes the coffin bone within the hoof capsule.  In basic terms, the coffin bone (P3) is held in a certain position within the hoof capsule by two layers of laminae; the sensitive and insensitive laminae.  When discussing this concept with my clients, I use an empty hoof capsule which contains grooves on the inside.  I liken the joining of the tissue on the inside of the hoof capule to the tissue covering the coffin bone as like a Ziplock bag type of enclosure.  The tissue from both surfaces essentially locks together through these groove like structures.  This is of course simplified for the sake of discussion.
What we do know is that in cases of laminitis, there is a disruption of blood flow to the laminae, which in turns impacts the overall tissue health.  As the tissue becomes impacted, the level of attachment or integrity degrades and the coffin bone is not longer held rigid in position.  Under normal conditions, when viewing an X-ray, the front edge of the coffin bone should be relatively parallel to the front of the hoof wall.  In cases of laminitis, the laminar health degrades and the coffin bone begins to rotate downward due to weight of the animal as well as backward pull of the deep flexor tendon.  In this image, one can see two important points.  First, the front of the coffin bone is relatively parallel to the hoof wall and second (red lines), the palmar aspect or bottom of the coffin bone should have a slight angle to the floor or bottom of the hoof wall.  (Blue Lines)  The coffin bone should not, in ideal circumstances, be parallel to the ground surface.   Teach Foot Image 
Now, this image is not ideal, because actually this horse had low grade signs of laminitis due to a couple of other anatomical issues.  First, this horse has too long of a toe, which contributes to a fulcrum type of effect and is common in laminitic horses due to chronic changes in hoof growth.  Second, the alignment of P1, P2 and P3 has a somewhat concave shape.  Ideally, these three bones should be in a straight line type of alignment.  This type of concave can actually predispose to degenerative joint changes, such as ringbone, which is actually present in a non-articular fashion in this horse's coffin joint.
Clinical signs of laminitis in my experience are usually an acute onset type of lameness involving the two front feet and possibly all four, in which in most instances the horses are unwilling to walk or move forward.  Here is nice video demonstrating a severe lameness in a draft mare at my veterinary facility.  Click Here

On clinical evaluation, these patients have an increased digital pulse to the foot involved, which is again usually both front feet.  The reason that it is the front feet is that this is where the majority of the weight is carried in the horse.  Aside from the digital pulses, these horses are also usually painful in the toe region when hoof testers are applied.  

In terms of diagnostic testing, usually the first two tests performed are bloodwork as well as digital x-rays to detect rotation and overall status of the hoof and bony relationship.  In some cases, these horses will not walk or lift a foot for the examination, so nerve blocks may be employed to facilitate the exam and x-rays.  

When viewing the x-rays, I will usually look for several things including amount of rotation of P3, sole thickness as well as presence of any gas pockets in the hoof capsule which may indicate a concurrent abscess.  Let's look at a couple of x-rays for comparison sake.
Image One

In this x-ray (Image One), we can see that there is a marked rotation of the coffin bone in comparison to the hoof on the lateral view.  The three phalanges; P1, P2 and P3 are not in alignment and the coffin bone is rotated backward due to the pull of the deep flexor tendon.  The sole thickness appears adequate in this case, the actual measurement is unknown but ideally, again in my opinion, the sole should be a minimum of 10 mm, which this horse demonstrates.

Now, let's look at Image Two.  This horse has obvious rotation of P3 in relation to the hoof capsule, however, all three phalanges are in good alignment, albeit a little steep in terms of angle.  The amount of rotation of P3 in relation to the hoof capsule in this x-ray is about 11 degrees.  Now, personally, if I encounter a laminitic horse, I prefer this type of scenario because I feel that they are fairly responsive to corrective trimming in order to get P3 back into alignment with the hoof capsule.  In this case, the sole thickness is good and a lowering of the heel as well as slight trimming to the toe can often restore stability to most of these situations.  Again, one has to take into consideration the underlying cause of the laminitis, which dictates prognosis.  I do, however, feel that many horses with this type of scenario seen above are actually more predisposed to laminitis due to conformation alone.

One has to take into consideration that some horses presenting with laminitis may not demonstrate any rotational changes on x-rays.  This is often the case in acute cases that have just developed.  The degree is rotation does not often correlate with the degree of pain or lameness.  Many times, the ones with no evident rotation are often the most painful for various reasons.  In many cases of chronic laminitis, we often will see dramatic rotation, which has developed over time and the horse has accomodated and there is mild lameness.  

Now that we have taken x-rays, the next step is to evaluate bloodwork looking for any evidence of infection as well as possible organ failure, that may be contributing to the laminitis.  Obviously, if we have concurrent disease such as pneumonia, endometritis, concurrent limb injury or even colic, we need to address those problems and treat accordingly.  In many situations, bloodwork is often times normal, which is common to those horses experiencing carbohydrate overload from lush pastures.  


In terms of managing the laminitis, the list of therapies is long.  In most cases, we will use NSAID anti-inflammatories such as bute or flunixen to help manage pain levels.  Other therapies include medications to alter blood circulation to the foot and include acepromazine, heparin and pentoxifylline.  Some clinicians will also incorporate isoxsuprine, but I have found this medication to yield poor results clinically.  Dependent on response to pain medications, some clinicians will also incorporate narcotic medication as well as other topical therapies to improve circulation.  Of course, most of these therapies are done in conjunction with other therapies if there is a concurrent medical issue.  


In addition to medical therapy, the foot often times needs to be addressed.  In early or acute stages, I will often apply styrofoam pads to the bottom of the hoof and affix with duct tape for several days.  As the coffin bone rotates, it is crucial to help support the sole, create cushion, ease discomfort and hopefully help to stabilize the bone.  Some will use other pre-formed pads such as Lilly pads or rubber applied to the frog region to provide support and upward pressure.  Each veterinarian is different and there are many philosophies on how to manage these cases.  Trimming of the foot is also vital, in my opinion, based on the x-ray.  If there is too much toe, then we need to remove it in order to decrease the fulcrum effect.  If the heel is too low, then there is too much strain on the deep flexor tendon and an increased pull on the coffin bone.  In these cases, we may need to apply a temporary wedge to increase the heel angle.  Personally, I am not a fan of applying corrective shoes early in the process and feel that stabilization is most important initially.  Once the patient is stable, then corrective shoes can be applied if they are indicated.  In many of our cases, we will just trim the hoof to try to achieve bony alignment and manage without shoes.  If the soles are too thin, then we will often times use various boots to provide sole protection.  I don't feel that shoes are an absolute in many of these cases.


The long term prognosis for laminitis is overall guarded in any horse.  In many cases, we will use the amount of rotation as an indicator for survival, with the higher amount of rotation being worse.  However, this does not always hold true and it is common to find chronic cases with slight lameness and a high amount of rotation.  Many of these horses, once stabilized, are often time advised to not be on pasture and are destined for a life in a dry lot.  It is also common for these horses to continue to receive low doses of NSAID medications along with application of expensive corrective shoes, sometimes for the life of the animal.  


I think that in the case of laminitis, we are often times missing the big picture of inflammation and the course that it plays.  I have discussed the course of inflammation in other blog posts in depth and feel that underlying chronic inflammation is predisposing many horse to laminitis.  In my opinion, I feel that most, if not all of our current therapies are doing little to mitigate this inflammatory response during the course of therapy as well as with long term management.  If the inflammatory condition is addressed in a more complete manner, in addition to concurrent therapies, the overall recovery rate is better and long term management is improved.  


Laminitis is a complex issue and disease and every horse is different.  I do feel that it is crucial for the horse owner to understand what is going on and why, in order to help improve the long term prognosis.  I hope this information helps, but please let me know if there are questions.


Tom Schell, D.V.M.
tschelldvm@nouvelleresearch.com
www.curost.com

Monday, February 4, 2013

Joint Disease in the Equine Athlete

Athletes come in many different sizes, shapes and species.  The human athlete makes tremendous demands on their cardiovascular system, pulmonary system, muscles as well as joints.  The equine athlete is no exception and in many instances, places more demands on their bodies than the human.  No matter what discipline we are discussing from barrel racing to the elite dressage athlete, the wear and tear on the body can be tremendous.

The number one area that takes the most pressure are the joints and there are many!  A joint is essentially the region where two bones come together and were motion is present in order to facilitate movement.  On the end or surface of each bone involved in the joint is cartilage that essentially acts like a cushion and surrounding the joint is a capsule that helps to contain joint fluid which lubricates the two bony ends, in simple terms.

In terms of joints, we generally have two types; high motion and low motion joints.  The fetlock, for instance, is Fetlock a high motion joint and has a high range of overall motion.  Other regions, such as the hock or tarsus, are more complex and actually consists of 4 joints in that region.  Of these 4 joints, we have high motion joints on the upper part and low motion joints on the lower part.  Hock

With increased use, comes increased strain to the joint, resulting in subsequent inflammation.  When we couple increased use wear and tear with other issues such as poor conformation, we can have double the damage.  There is no perfect horse, in my opinion, in terms of conformation, but alignment of bones is crucial for even distribution of weight and pressures to minimize strain.  A club footed horse or one with straight hocks can still perform as a jumper, but one has to be aware that the affected joints will be more prone to inflammation and damage.

The inflammation that is normally created as a consequence of competition or exercise starts at a low level and is often not detected.  Usually, the first signs of excessive inflammation may be a mild lameness due to pain.  Often times, the horse is rested and recovers fully in the short term.  As the inflammation progresses, it is often then seen in the joint capsule with increased fluid production in the joint, called effusion.  If the condition continues, the next area of attack is the joint cartilage, which is often manifested as cartilage erosion and destruction.  If the cartilage erodes too much, then we have what is termed 'bone on bone' contact within the joint, which then causes tremendous irritation or inflammation within the joint and leads to bone remodeling, resulting in bone spur development in many cases.

So, as you can see, degenerative joint disease is a continuous and progressive condition.  It isn't something that should persuade you not to compete, but it is something that should raise the question as to how to prevent or at least slow the progress?
Joint Therapy Options
syringe Joint protection is crucial for every horse, but especially for those in active competition or training.  Once the damage is done, there is no reversing it but there are options to slow the progress.  It is always best to act in a preventative fashion, more so than chase treatments.

One of the most commonly used supplements consist of glucosamines, chondoitin sulfate and possibly other additives.  In my eyes, these supplements are termed chondroprotective agents and are mainly trying to replace what is being lost as a result of inflammation.  Human and animal research has raised the question of the value of these ingredients, including absorption, but it does appear that they help in some instances.

Aside from oral joint supplements, we have many prescription routes of therapy including injectable chondroprotective agents as well as medications injected directly into the joints.  The most common mode of therapy are joint injections and include the use of corticosteroids as well as medications that encourage joint fluid production, which include hyaluronic acid.  These routes of therapy are often times very effective in the short term and useful for acute flare ups, in my opinion, but not ideal for the chronic joint condition.  They can be effective in resolving pain and stiffness, but some research has actually indicated that long term use of steroids in the joint could lead to increased joint cartilage loss.

As a veterinarian, I have seen all forms of joint disease from the early joint effusions to the joints that are so ridden with bone remodeling that they are almost fused.  I think the thing we have to address with these horses is the process of inflammation, which is the underlying cause of all of the pathology.  I have never been 'okay' with repetitive joint injections in the equine athlete, because I feel that the joint is a sacred place and one not to be violated repetitively.  The joint is sterile and each time a needle is placed, infection is a real risk that can cause tremendous damage.  With each joint injection, there is actually an incitement of inflammation, which results in damage over time and increased injections.

Of course, we also have non-steroidal anti-inflammatory medications, which there are two commonly used in the equine field.  The medications essentially target pain production and combat inflammation from a single entity standpoint which is prostaglandin inhibition.  Side effects from long term use of these medications can be very high and include gastric ulcers, large colon ulcers as well as potential kidney damage.  They are very valuable for short term and acute conditions, but again are not ideal for long term use.

If we tackle the inflammatory component of the condition, it is very possible to really slow the progress of the destruction.  Ideally, we want to control the inflammation from a preventative aspect in the horse with no active joint pathology.  In many horses, the damage is done and lameness is persistent....but yet can still be managed if we control the inflammation. 

Many current therapies attempt to control the inflammatory process, but do so by addressing one aspect of the cascade of events.  We often times see mixed results with these therapies because of this reason.  Inflammation is a complicated process and requires an approach from multiple angles.  In my opinion, herbs are the solution when used properly and can yield phenomenal results.

One also has to keep in mind that multiple joints are often affected in these patients and the inflammatory process can also be affecting other aspects of their performance and health.  It is not wise to inject multiple joints repetitively, and these therapies do not impact the systemic inflammation...so what is one to do??

Our Cur-OST line of products tackle inflammation at the cellular level, resulting in the multi-angle approach as well as combat oxidative stress.  Take the logical step to joint protection and combat it from the standpoint of inflammation prevention.  Why just replace what is being lost in the joint as a result of inflammation, when you can potentially control the process at a higher level?

Joint pathology is a very common problem in the equine athlete as well as backyard animal.  There can be many questions, but very few answers.  I think it is important that every horse owner understand what is happening as well as what options are available. 

One of the biggest joys I have is opening my email and reading stories of recovery from horse owners, companion pet owner as well as people.  Our Cur-OST products can produce fantastic results and often times very quickly!  Thank you all for sharing your stories!

Check out our video section to view some results in real patients!  Also visit us on our YouTube channel.

I hope this information is useful!

Tom Schell, D.V.M., DABVP
tschelldvm@nouvelleresearch.com
www.curost.com

Inflammation and the Impact on Health

Inflammation is a necessary evil in many instances and comes in two distinct forms: acute and chronic.  Acute inflammation is characterized by 5 cardinal signs including pain, heat, swelling, redness and loss of function.  This type of inflammation is often seen when you stub your toe or a local area of infection arises due to multiple causes.  Acute inflammation is needed to rid the affected area of bacteria as well as increase blood circulation to clear damaged tissue and supply nutrients for repair. This process is temporary by nature and resolves once the condition is resolved.         Joint Techno
It is not this acute inflammation that is the concern, but more so chronic inflammation.  Acute inflammation can turn into chronic inflammation given the right circumstances.  Chronic inflammation is a process by which the inflammatory condition continues, releasing increased levels of inflammatory proteins (cytokines) into the blood stream, recruiting more inflammatory cells and causing tissue damage and cellular alteration.  Many things contribute to chronic inflammation and we are all undergoing this process to a certain degree.  Other factors include unresolved infections, uncontrolled immune responses, dietary influences, environmental factors, ongoing stress, excessive exercise, toxin exposure as well as various medication interactions including vaccines.  Chronic inflammation is closely connected with the aging process in humans as well as animals and is responsible for cellular deterioration due to free radical production.
Chronic inflammation is associated with a host of conditions affecting animals as well as people.  In people, there is a strong connection with arthritis, joint pain/stiffness, cancer, diabetes, allergies and cardiovascular disease.  In horses, we have a direct connection with arthritis, joint deterioration, laminitis, navicular syndrome, COPD, uveitis, tendon conditions and insulin resistance.  Companion pets are in the same group and are affected by arthritis, back conditions, skin conditions....the list goes on and on. Horse
As a veterinarian treating these conditions, I find there are many limitations and often times, pharmaceutical medications leave many gaps.  Chronic inflammation is a huge player in overall health as well as in recovery. It is a process that I feel is not being addressed.  Many prescription pain medications often times only focus on a small facet of the inflammatory process, usually affecting pain levels only, which leaves the process ongoing with tissue potentially being affected, not to mention overall health being impacted.
Many herbs, including curcumin and boswellia, have been heavily researched and proven effective on multiple levels against inflammation, often times superior to prescription medications.  Given the major connection between ongoing inflammation and disease, the ultimate question is 'what are you doing to control chronic inflammation?" 
I firmly believe we should be proactive in our health as well as that of our pets and horses.  We ask so much of ourselves and our pets, that in return we need to provide some level of protection.  Like many of you, I encounter individuals affected by a variety of health conditions that could be impacted for the better by addressing chronic inflammation.  Many take advantage of the options available, while unfortunately others do not.  The same holds true for pets and many horses.  There is way too much dependence on pharmaceutical medications, in my opinion, and less exploration as to the root causes of the condition.  This is an area of interest to me and an area of focus for our research, hopefully to benefit others.
Thank you all again for your support and I hope you find this information valuable!
Tom Schell, D.V.M.
Nouvelle Research, Inc.
tschelldvm@nouvelleresearch.com
www.curost.com

The Health Benefits of Spirulina

Spirulina blue green algae is known to be one of the world's best sources of all around nutrition.  In fact, the algae has been used as a prime food ingredient in many cultures to sustain overall health as well as to prevent and aid in the recovery from malnutrition.  Spirulina is grown across the world in many countries in various controlled ponds, as see in the photo below, then harvested and processed.  In its raw form prior to incorporation into our formulas, the algae is dark green, sweet smelling powder as seen above. 
spirulina pond
A couple of words regarding the processing of spirulina, primarily due to one of it natural properties.  Spirulina has been shown in various human studies to have the ability to detoxify the body primarily through binding and removal of various heavy metals.  By nature of its growth in ponds and due to heavy pollution of our environment, one has to be cautious about the heavy metals that Spirulina may contain in its raw form.  In many instances, water run off into ponds could carry heavy metals as well as other pollutants, which could then be taken up by the algae.  This is true of almost any algae species and one must use caution.  Our spirulina is all natural, containing no preservatives, dyes, pesticides or any radiation during processing.  As with all of our ingredients, our spirulina is tested for heavy metal levels as well as microbial contamination prior to incorporating into our products.
So, what is so great about Spirulina?  This blue green algae has been shown to have tremendous nutritive capabilites for starters.  On analysis of 100 grams of spirulina the nutritive breakdown is as follows:
  • Calories 386
  • Total Fat  7.5 grams
  • Carbohydrates  14 grams
  • Protein 69 grams
  • Beta Carotenes  150 grams
  • Vitamin A  250,000 iu
  • Vitamin K  850 mcg
  • Vitamin B-12   160 mcg
  • Calcium  177 mg 
  • Iron   68 mg
  • GLA  1.3 grams
  • Potassium  1640 mg
I firmly believe in obtaining as many nutrients as possible in their natural form due to available co-factors that may be present to aid in assimilation.  Spirulina has provided a great source for our patients to aid in overall health as well as provide nutrients needed for recovery and strengthening.   

In terms of other benefits, spirulina has shown the ability to aid in overall detoxification by binding heavy metals as well as other toxins that may be present in our bodies, as well as those of our pets and horses.  Spirulina has also shown to have potentially anti-inflammatory and anti-cancer properties, helping to support the immune system and controlling the inflammatory response. This blue green algae has also been shown to tonify the blood, improve brain and heart function, increase energy levels and also help to balance the gastrointestinal tract. 

We have three anti-inflammatory products that contain spirulina as a primary base; one for horses (Cur-OST EQ Green), companion pets (Cur-OST SA) and people (Cur-OST HU).  I firmly believe in the value of this potent nutrient and have found tremendous benefits in our patients.  I see an overall improvement in mentation, skin and hair coat as well as energy levels.  In horses, we have seen a marked improvement in hoof condition and growth as well, likely associated with the nutritive value and b-vitamins.  I have also found tremendous benefit in aiding the recovery of various tendon and ligament conditions. 

The only downside to spirulina is the overall taste.  Most companion pets and horses will readily consume the products due to added natural flavors.  I have found that many cats will readily consume the Spirulina powder as well.  The human formula has a light natural berry flavor to aid in disguising the spirulina, but in some cases, it is still readily tasted.  Suggestions for covering up the flavor in the human formula include mixing the formula with a fruit juice, which appear to neutralize the flavor.

I hope you find this information valuable!  Please let us know if you have any questions.

Tom Schell, D.V.M.
Nouvelle Research, Inc.
www.curost.com

The Power of Curcumin to Influence Health

Curcumin is one of my favorite herbs as a veterinary practitioner.  It has been used for centuries in both Ayurvedic and Chinese medical cultures for various health conditions ranging from gastrointestinal complaints to management of pain and inflammation.  

Curcumin is actually the active ingredient found in the root of Turmeric and ranges in concentration from 2-4%.  It is formulated as a bright yellow orange powder as seen in the photo below.  Curcumin is high in demand due not only to published medical research touting its benefits, but it is also used in the cosmetic and dye industries as seen with its potential staining capabilities.  In my eyes, this is curcumin's only downfall!

Research has found that Curcumin inhibits transcription factor NF-kB, which then results in the decreased formation of many pro-inflammatory cytokines or proteins.

Curcumin photoroot
        
Upregulation of NF-kB has been connected with many health conditions ranging from inflammatory conditions such as arthritis, but has also been connected with other health concerns such as diabetes, gastrointestinal problems, respiratory conditions and even cancer.  By downregulating NF-kB with the use of Curcumin, we can potentially reduce the incidence of many of these conditions and improve the quality of life for many people as well as animals.  

So, how can Curcumin improve your life or that of your companion pet or horse?  As mentioned above, Curcumin reduces the inflammatory cascade at a cellular level and impacts the formation of several inflammatory proteins.  This results in a more broad approach to inflammation and pain reduction.  Many prescription pain medications inhibit only a small piece of the inflammatory cascade and tend to have an 'all or nothing' type of approach, which results in side effects. 

Personally, I use our Cur-OST formulas in instances of pain associated with injuries, arthritis, joint problems but also use them routinely in horses for management of arthritis, laminitis, navicular syndrome and even conditions such as asthma and ocular problems.  Remember, inflammation is connected with many different types of conditions and pain doesn't have to be present to indicate inflammation!  I find that by using our Cur-OST formulas, we are able to reduce or eliminate prescription pain medications, but also the patients seem to recover more completely with improved health as well.  We also utilize our Cur-OST formulas in almost every cancer case, whether that is a companion pet or a horse.  The amount of research on Curcumin and cancer is stunning and I feel by using these formulas we are able to improve the quality of life for our patients but also promote overall health.

Curcumin is one of many herbs that can inhibit NF-kB.  It is best, in my opinion, to utilize multiple herbs which complement one another in order to gain effect as well as allow the reduction of needed dosages.  One issue has been raised regarding the bioavailability or absorption of curcumin.  Research has shown that despite administering high doses to patients, blood levels have only indicated trace amounts of the compounds.  In our Cur-OST products, we utilize a patented form of Curcumin called BCM-95, which utilizes volatile oils found in the turmeric root to help improve absorption and resulting in higher blood levels.  We have found this to be true in our patients in comparison to other Curcumin preparations and by using this patented compound, we are able to reduce overall doses and yet, achieve good results.  Curcumin is a fat soluble herb and thus is best consumed with food in my opinion to enhance absorption.

I hope that you find this information useful and educational.  Your health, as well as that of your companion pet and horse are my priority.  In future editions of our email newsletter,  I hope to introduce you to more of our ingredients in a more in depth fashion.

Tom Schell, D.V.M.
Nouvelle Research, Inc.
tschelldvm@nouvelleresearch.com
www.curost.com