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Integrative Veterinary Medicine with Dr Matt Muir

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Integrative Veterinary Medicine with Dr Matt Muir

How can we translate the traditional diet of animals in the wild to benefit our modern day pets?

Integrative Veterinarian Dr Matt Muir joins us to discuss some key topics when treating our companion animals, including safe use of medicines, when to use supplements instead of changing the pet’s diet, and how the government can better support veterinary medicine. 

Covered in this episode

[00:50] Welcoming Dr Matt Muir
[01:51] Matt’s background and research on stomach acid of ruminants
[06:55] Translating what wolves eat to apply to dogs
[09:48] How some animals self medicate 
[15:18] The problem with feeding our pets grain based diets
[19:07] The placebo affect in animals
[23:32] Are NSAIDs safe to use in pets?
[25:49] Issues caused by controlled breeding of companion animals
[34:15] Never give your pets sugar
[35:51] Using pro-resolvins in veterinary treatment 
[40:06] Supplements vs diet
[43:53] How the government can better support veterinary medicine
[49:06] Thanking Matt and final remarks

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook. Joining us on the line today is Dr Matthew Muir, who's the clinical director at a fully dedicated Integrative Veterinary Hospital in Australia. On top of his veterinary qualifications, he has post-graduate certification in herbal medicine, acupuncture, Chinese food therapy, and sustainable food development. 

For the modern pet, he's regularly using adaptogenic, insulin-sensitising, and pro-resolvin strategies while improving their nutrition and digestive function to address health challenges. In addition to delivering integrative veterinary medicine to his patients, Matthew is also passionate about the role of pets in translational research for humans and how integrative medicine can give back to animal conservation via eco-health initiatives. 

Welcome to FX Medicine, Matt, how are you?

Matthew: Yeah, very well, thanks. Thanks for having me.

Andrew: So tell us a little bit about your history because you're a vet, but you're very interested in herbal medicine. How did this marriage begin?

Matthew: Look, for me, reflecting back on it, it doesn't seem unusual at all. And really, it sort of stems from childhood for me. And I guess it resonated with my lifestyle and the two merged as I progressed through my studies. When I was a kid, my pets, so I had a rabbit and some birds, and my grandfather showed me the herbs to forage for them, and that's what I fed them as part of their diets. I grew up in the country, so my dog had a very natural diet and had probably two limited trips to the vet, but it was of that era where you take a pet to the vet when they're sick, and their vaccinations. And so, I started with that love of animals and started to be aware of herbal strategies as part of the books that I was getting from the library when I was a kid and from what I was reading about animal care.

Then when I was at high school and starting to think about being able to get into a vet course, I started to use herbal strategies and acupuncture and a few other natural modalities to manage my stress so I could then hopefully improve my brain function so I'd be able to get into the course. And then through the degree, I was fortunate enough particularly and eventually with the dissertation that I did in the effect of the microbiome or microbiota on health of animals. And I went to a university where we had a problem-based learning curriculum down in Wagga, Charles Sturt University.

Andrew: Yeah.

Matthew: And this problem-based learning curriculum and also some of the placements that I did through uni, and also being a member of the student group for acupuncture, I was exposed to practitioners who were using TCVM strategies, like acupuncture and trigger point therapy as a student. And then that culminated with the field research and dissertation into nutrition and microbiome manipulation and the effect on health. 
So when I got into private practice as a vet, it was already kind of deeply ingrained in what I was doing. And then that just accelerated once I started to see a lot of the patterns of chronic disease and also the situations where hands were tied as a clinician with how I could come up with effective solutions for the problems that were presenting themselves.

Andrew: Tell us a little bit more about this field research that you did.

Matthew: Yeah, so I was essentially collecting stomach acid samples, sorry, stomach juice samples from sheep and having animals within different treatment groups on different diets and sort of looking at the patterns of volatile fatty acid production in the gas how that drove health, and looking at pH of faeces and stomach acid. So it was quite a big project. It was a pilot study for a PhD. But when the time came to consider moving further into production animal medicine, I decided that I wanted to go down the companion animal route because it was tied better with my ethics.

Andrew: Mm-hmm.

Matthew: So that was a project that I was looking at to sort of see what diets animals did better on. But since then, I've translated that into companion animal medicine.

Andrew: Okay. And how did that work in ruminants, which, the production animals, largely ruminants versus carnivores, which is, I mean, they would comprise most of the pets that we would have as companions. I know there's birds and fish, but...

Matthew: Yeah. Well, yeah, I mean, dogs, we definitely looked at dogs as omnivores and cats as carnivores. But, look, the translation is really in ruminants, I guess. It's very clear the impact that the microbiota has on the function of the animal. And since that time that — this is over a decade ago — since that time, it's been increasingly clear in companion animal medicine and I think medicine in general that as non-ruminants, we need to focus on the impact of the microbiome.

Andrew: Okay. So you mentioned dogs being omnivores, and I've got to say in the wild, when we're talking the archaic dog, the wolf, they would largely be carnivores, but I would imagine in hard times and during the winter periods and things like that, that there would be some plant-based foods that they would eat.

Matthew: Sure. Yeah. I mean they'd...

Andrew: But that would be in a time of famine rather than feast, correct?

Matthew: Not necessarily. I think that when we're looking at what a lot of people would term “prey modal feeding” or “natural feeding” for domestic dogs, we look at what wolves eat and we think about the fact that from a phytonutrient perspective and from a vegetable perspective, if a grey wolf is hunting reindeer at certain times through the year they are eating the ingestive of the prey animals. So they're getting rich fermented vegetable...

Andrew: Of course.

Matthew: ...matter and phytonutrients through the gut.

Andrew: Yup. Of course.

Matthew: The stomach contents of wolves, they can find up to 30 different ingredients, 30 different substances that they've consumed. So they are foragers. They have a lot of metabolic flexibility. They really have an amazing digestive ability to biostimulate a lot of different nutrients. Yeah, they definitely gravitate towards meat, and it's increasingly showing that they have differing microbiota between dogs that are fed higher meat content diet versus higher starch-containing diets. So when we think about what a wolf eats, we also need to think that over millennia, the main wolves in Central and South America, they actually evolved probably through a choice to sustain themselves quite well on melons.

Andrew: Oh, really?

Matthew: Yeah. Yeah. There is wild canids that follow a vegan lifestyle. But if they had a readily supply of meat, then perhaps they would evolve back to eating meat. And I would dare say, and I don't believe that this research is out there so I apologise if someone's put their hard hours in with this field research. But I don't know if it matched what the microbiota looks like for a wolf that's evolved to eat melons.

Andrew: Okay. That's a broadside one that one. Melons. I would never have thought that a wild wolf would have subsisted on a melon.

Matthew: Then further to that, when we're thinking, and some people might roll their eyes with regards to do zoopharmacognosy, which is the cognition of animals to self-medicate. And some people say, "Well, my cousin's dog ate dark chocolate and needed their stomach pumped, so dogs can get it wrong." But by and large, really, we have demonstrated that animals can seek out and treat themselves with a wide range of naturally occurring plant-based medicines and clays and things within their natural environment. 

And those preferences can change with time. There's a study in Tanzania when chimpanzees would gravitate towards eating bitter roots when they had high faecal egg counts that reflect parasite burden.

Andrew: Right.

Matthew: They researched and found that during times when the faecal egg counts were high, the chimpanzees would gravitate and eat these bitter roots, that at other times of the year, they wouldn't eat.

Andrew: See, I love this sort of research because one would think that animals use foods as medicine, and then the gainsay would say, well, when David Attenborough was talking about the elephants that walk their way into this totally dark cave to scrape clay...

Matthew: Minerals.

Andrew: Yeah. Clay minerals off the side of the cave, well, that's addressing a mineral deficiency. But I was really interested, I think it was about two years ago, to read that orangutangs were chewing leaves and rubbing them on their arthritic joints.

Matthew: Yeah.

Andrew: Now that's a cognitive, purposeful use of a medicine.

Matthew: Sure. And look, it isn't a far cry really from the thought of how acupuncture probably came to be that, Ötzi the Iceman and...

Andrew: Yes, Ötzi. Yes.

Matthew: ...5,000 years ago, and the Smithsonian Institute found evidence that he was probably just poking himself with sticks and things and how people with headaches intuitively kind of rub at the back of their heads which is an acupoint point to feel better. I mean, lions sleep under bushes that the bushes excrete a volatile compound that keeps flies away.

Andrew: Wow.

Matthew: You know? And orangutans, they've started to have a penchant towards eating soap that they find outside of villages and they don't quite understand why they're doing that, but the thought is that they could be using the soap as some sort of parasite control.

Andrew: Wow.

Matthew: Yeah. So, I mean, trying to elucidate and define interventions that reflect what's done in nature, that's exciting. But nature, the more we learn in medicine as a whole, we learn that we don't know that much. The more we learn, we start to think, "Wow, yeah, Mother Nature is very smart.” And there's often a contrarian argument why something will or won't work and how can we really try to replicate that with medicine? And that's one of the reasons that I'm motivated to work with integrative strategies as a Western-trained vet is that A, it resonates with my lifestyle, and B, I like having more solutions. And I like sort of working within a framework that I think that animals, if we're looking back to their wild cousins, we're taking an approach that might resonate better with the animal and especially for using nutritional strategies and in-feed supplementation or herbal medicines that might reflect what an animal might self-medicate with.

It could become a potentially joyous way for families to provide health care for their pets which tend to differ quite considerably from the high levels of medicine that some animals need within conventional medicine frameworks. Which would the dog choose, in-feed supplementation versus an IV delivery of drugs? 

But granted that at certain times, particularly within emergency and critical care and weighing up all of the risk-benefit analysis, certainly, these tools in medicine are there and for a reason. And certainly, I use them when I need to, but definitely trying to always go back and say, "Look, how can I treat something more naturally where appropriate, and how can I do that in a way that ideally is very upstream?"
And preventative medicine is something that really, is what motivates me with integrative medicine, is really trying to avoid the dramas. In previous clinics, now I work fully dedicated in integrative consultancy, but in the past I worked in emergency clinics and conventional clinics, and there's a lot of drama that can be avoided if we go further upstream with our preventative medicine.

Andrew: I just have to go back to a point you said earlier, and that was starch-based foods.

Matthew: Yes.

Andrew: Now, do cats and dogs in the wild eat cereals?

Matthew: No. I mean, tenuously a cat may eat a mouse that has ingested grains, right?

Andrew: Right. Yeah.

Matthew: Sorry, and because if they're eating the mouse whole there's some argument that, okay, grains are species-appropriate or biologically appropriate sources of nutrients for cats and dogs. But the reality is that it'd be such a low percentage of the diet, that that doesn't really reflect the highly processed or even minimally processed high starch-containing diets. Grains, the pet food industry historically has built in more plant-based sources of both the proteins and obviously carbohydrates, probably because of economic reasons and certainly storage reasons.

Andrew: Yeah.

Matthew: Yeah. So I firmly believe that it's species inappropriate to feed these high carbohydrate and starch-based diets, and also, high saturated fat diets aren't great either. Rewind five years ago, I probably would have said, "Look, the biggest, issue that we face with health overall, veterinary and human, is an immune system dysfunction." And I think that is largely the case, but I've sort of gone a bit further to start saying, "Well, I think the biggest issues that we're seeing is endothelial dysfunction and diet-driven inflammation, metabolic inflammation, oxidative stress off the back of these high-glycemic diets, and the impact that it has on the liver's ability to clear antibiotics from the body, etc., just culminates in a pattern of hugely unaddressed and unabated chronic inflammation."

Andrew: So just addressing that mouse who ate the grain, the part of the mouse that comprises the alimentary tract of the mouse is rather small compared to the huge amount of cereal that's comprised of the modern food that's often found in supermarkets these days. 

Matt: Sure. Yes.

Andrew: So we really need to think about another change. So where do we get that better food from?

Matthew: Yeah. Well, the gut of a mouse is certainly not an argument I'd make for feeding a high carb diet. And that comprises probably less than 0.5% of the overall diet of a cat at the end of the day. And to point out that's a whole grain that's not been milled.

Andrew: Yeah. Well done.

Matthew: So the glycemic index and the endosperm of the grain has a lot of fibre and nutrients, and certainly doesn't have glyphosate. Well, probably, unfortunately, it would have glyphosate in nature nowadays.

Andrew: Unfortunately.

Matthew: Yeah, and other endocrine disruptors, unfortunately. But that's not the same as a grain that's been highly refined. That just translates to a postprandial hyperglycemia just to get this massive spike in glucose. And in the pre-diabetes metabolic syndrome, insulin resistance, this is what we're increasingly recognising in veterinary medicine.

Andrew: Matt, I need to ask you a devil's advocate question, and that is we know that animals pick up on the minutiae of human behaviour. How do you know that you're not invoking a placebo response when you're initiating a therapy, like for instance, trigger point therapy.

Matthew: It is increasingly recognised that what we call “transference anxiety” and in particularly dogs and cats as well. Cats have, I think, layers of intuition that are yet to be characterised by biomedicine. Dogs can smell stress on their pet guardian and they can understand healing intention and things. So the lines between a energetic kind of medicine and faith-based medicine and the use of the placebo effect, which is a scientifically demonstrated effect, versus using medicines that are within the evidence-based framework, I think there is a lot of overlap. And I think that probably is for the use of, as was recently in the media, the use of antibiotics for, how much doctors are still prescribing antibiotics for the common cold...

Andrew: Yes.

Matthew: ...with a placebo intention. So with the therapies that I do, I definitely try to motivate and encourage my clients to feel good about what we're doing. It can be a rate-limiting step with veterinary medicine, and particularly with cats, actually trying to convince the family that their cat is going to eat this herb in their food in, say a fussy cat, or they can change from eating a high carb diet to a more biologically appropriate diet. So I do have to use motivation and, certainly, what some of the human phytotherapists and herbalists say is that having a positive attitude about the taste of the herb will increase compliance. So there's a bit of that.
However, the therapies that we're using are within the evidence-based framework. So we are trying to choose things that if it's a placebo and it works, fantastic, because the side effect profile for a lot of the herbal strategies that we're using is very minimal. And the cost is generally not outrageous. So if it ends up being a placebo effect, or we can't really pin down the mode of action of an integrated care plan that we're putting in place, it's a shame because we can't easily generate meaningful research from that outcome because of the amount of confounding factors and how individualised care plans can be. 

But because we're using a logarithmically increasing evidence-base for natural compounds, we're still staying within that framework with how we recommend a lot of the natural strategies. And where the evidence is really based on tradition and nothing else, or maybe tradition plus some proof of concept mode of action in a en vitro model and we're left with no other solutions.

And another thing in veterinary medicine that motivates me is when people can't afford to move forward with standards of care, which is another opportunity for how I can practice integrative medicine that a human doctor or naturopath may struggle to implement, is that if someone can't afford $20,000 worth of treatment and there's no clinical evidence-based or high level evidence-based for one of the natural compounds we want to use, with informed consent and within the code of conduct of the veterinarian and looking at knowledge-based versus evidence-based, taking on board the traditional medicine strategy from the World Health Organization, taking all of these factors on board. I'll use strategies that if it ends up being that it was a placebo or it doesn't work, at least we've given peace of mind to a pet guardian that they've explored every option.

Andrew: Right. With regards to the individual or the peculiar biochemistry to each species, an example here is the dog, humans can take a vast variety of NSAIDs, non-steroidal anti-inflammatory drugs for their arthralgias, whereas many of those are poisonous. They'll kill their kidneys. However, you might get one or two, like, for instance, meloxicam is considered rather safe in dogs.

Matthew: That's arguable. No, but I'm being a little bit facetious.

Andrew: No, no. How cautious do you have to be with regards to natural medicine approaches between the species? Are there some that are certain to one over the other?

Matthew: Yeah, certainly, on the subject of the NSAIDs, certainly in cats with Salicylic acid and the, certainly, herbs that we have to be very mindful not to use in cats. Certainly, we have to watch what excipients are in products, especially xylitol for our pets. They can't tolerate xylitol.

Andrew: Yeah. Yeah.

Matthew: But, yeah, look, I think by and large, a lot of the systems, and there is some difference, but animals can have idiosyncratic reactions like humans can to certain medications. NSAIDs is one of them, and that that's an unlucky dip, I guess, if that happens to your pet, that they have an idiosyncratic reaction to meloxicam.

Andrew: Yes.

Matthew: And certainly, some people have very unfavourable views of that drug or that drug class if their pets have suffered a hepatic or renal episode from that...

Andrew: Yeah. Yeah.

Matthew: ...or even a gut bleed. But the systems are generally pretty deeply set as mammalian systems. There are some differences, but from a comparative physiology perspective, a lot of it can be translated and we now know that particularly dogs are great complex animal models for translating to human medicine, and that's definitely something that I'm quite passionate about.

Andrew: Matt, what about breeding issues? I mean, this is a massive issue with regards to how dogs are in all sorts of shapes and sizes now. Some dogs have a massive issue with hip displasias, others with breathing issues. What are you seeing here? How do we treat? Where do we place this?

Matthew: Yeah, it's a great question. I think it's a major concern. I think that over the next few years we're really going to have to tackle this question head-on as a profession. Some of our most endearing breeds, the Labrador Retriever is probably top of the list there, our most endearing breeds, Golden Retrievers are another, has some of the worst risks of significant disease, cancer being top of the list. And the cancer rates are out of control in companion animal medicine, even compared to human medicine. Really quite concerning.

Andrew: Wow.

Matthew: And we know, further from the obvious kind of issues associated with the brachycephalic breeds like the squishy face breeds and their inability to...

Andrew: Breathe, yeah.

Matthew: ...healthily oxygenate themselves, that and the Love is Blind campaign that the RSPCA runs regarding that. More insidious and, certainly, that can compromise animal welfare, but more insidious I think is that we need to pay attention to our genetics and certainly looking at single nucleotide polymorphisms and, promoted variants and things that canine dogs have been found to have. And this is very early concepts in veterinary medicine as a whole, we've got a population of dogs that are line-bred. A breed is homogenised with how they look.

Andrew: Yeah.

Matthew: And there is an argument that every generation that a Labrador looks like a Labrador, it's more related. And so we may have got to a genetic bottleneck that is echoed as to what's happening in the wild where if we want to keep having these breeds, the cost of this line-breeding and not outbreeding is that these dogs, A, might have a whole bunch of promoter variants that are functionally significant, that alter gene expression. We might have a population of dogs that their metabolome or their metagenome of their microbiome is very inbred in itself and going a long way away from the microbiome of dogs three generations ago. And I think that's a big issue, particularly looking at the allergy rates...

Andrew: Right.

Matthew: ...that we're seeing in pets. But this question sort of starts to say, “Okay, well, what do we have to do to make the breeds that we love healthy again?” And there's an argument to say that, and some people are proponents to saying that, actually, a breed needs to not look like a breed for 50 years, and to then cross back and recreate the breed and get some of these health issues away. 
But these concepts have their place, but I think that probably the more meaningful and likely to be uptaken approaches is looking at nutrigenomics and upstream preventative medicine with the constraints that we have and focusing more on the epigenetic stuff rather than delving deep into the gene engineering. However, obviously, with CRISPR, people are starting to dabble in that, making glow in the dark dogs and whatnot.

Andrew: That's right. Now, you've said a couple of things there that twig a very interesting point. And one is, just a quick one, are you saying that bitters are better? That crossbreeds are better? Like when you get a Border Collie Cattle Kelpie cross, that that might actually be better for their health?

Matthew: Look, I think so. I think through heterosis or hybrid vigour that they're technically better. There have been some epidemiological studies that sort of show that there's no statistically significant difference though. So I have to kind of bow down a little bit to the research in that. 

However, I'd say that anecdotally myself and many other people within the industry and many other people, pet guardians and animal lovers, that kind of research may...they might like to question that research and say, no, I think that they are better. But the adage that's sort of coming through particularly a lot with the designer dogs is two wrongs don't make a right.

Andrew: Right. Right.

Matthew: And sometimes, we've got a breed that we want to maintain the positive aspects of the breed, so are we going to cross-breed it with another breed, and the hope is that some of the problems from both purebreds don't sort of converge in the one designer dog. But unfortunately, that doesn't always happen.

Andrew: And you were talking about bowing down to the research. What's the research on SNPs? This is really interesting.

Matthew: Look, so with the SNPs, there's been — and this is quite interesting, actually — and I think the whole SNPs in human medicine is super fascinating as well and highly important for the future of health. We've found, not me personally, but the researchers found a canine promotion variant 3'-UTR microsatellite variant which seems to affect the glutathione conjugation of antibiotics. And while we don't really understand the full functional significance of this yet, we do know that in humans that a third of them alter gene expression in a significant way. 

But this one's quite interesting when we think, okay, so what it seems, what I sort of gather from the research is that it's hypothesised that this variant may increase susceptibility to carcinogens and affect response to chemotherapy. So, I think in light of the cancer rates in pets exceeding humans, I think we need to go further down that route. I've definitely read a lot of the work by Dr Ben Lynch and the dirty genes kind of...

Andrew: Yup.

Matthew: ...concept and spoken to some veterinarians in the field, Dr Sue Armstrong and Dr Jean Dodds about when you read those approaches to orthomolecular supplementation and supplementation in humans where if someone has a dirty COMT gene, they might feel good or awake on this supplement, or feel sleepy and not so good on this supplement. That's something you go, “Oh, wow.” Beyond using physiohumoral systems and Chinese energetic systems and comparing that to biomedical evidence-based with how we use herbal medicines in assessing the patient and treating them for what their energetics are telling us, we don't really know if a dog feels more...how they feel on supplements. So it comes back to, well, when we start to know more about pharmacogenomics with dogs, the nuanced use of a lot of therapies is going to be critically important going forward. And I think veterinary medicine's going to be vastly different in 10 years' time.

Andrew: Yeah. Matt, I need to ask you about sweeteners. And this is one of the things that humans give pets, human food. And human foods are obviously made palatable for humans by sweeteners. There are some sweeteners that are quite deleterious to pets. Is that right?

Matthew: Oh, look, I'd say they all are.

Andrew: Right.

Matthew: Yeah. I'd say they're all are, even if they have no apparent clinical signs attributable. I think on a subclinical level, anything that alters the microbiome and it changes a pet's...potentially gets the pancreas to send messages that they don't need and have the body more leptin-resistant and things, I think is just not a good idea. And particularly when dogs can't, they can certainly put on, and cats can put on a good campaign for wanting food, but they can't go to the pantry and, I mean they might sneak in every now and then, but they can't really go to the pantry and get a lot of the processed foods that contain these products. I'd say that if it's like Stevia, obviously I think that would be a lot better than moving into the territory of the old school sweeteners, but...

Andrew: Yeah.

Matthew: Yeah. And I don't think it's really toxic, but certainly, xylitol is a problem and that's certainly crept into a lot of human foods.

Andrew: Right. Now, I also am aware that you do a lot of work with pro-resolvin strategies. What's this? What are you doing there?

Matthew: Yeah. So, look, on a daily basis, I practice some combination of classical acupuncture, osteopathic acupuncture, trigger point release, Western herbalism, nutritional counselling, and Chinese herbal medicine, and conventional medicine adjunctively when I feel I need it or when the patient needs it. So within that, what we're needing to think about is increasingly, we need to look at actively resolving chronic inflammation. A lot of my work in practice is second opinion work. So I do have the opportunity to be presented with an animal and their full medical record and read backwards from what the current often scary diagnosis is that facilitated the family seeking a different perspective and a second opinion. And I can read back and really see a whole procession of chronic inflammatory, or potentially acute inflammatory events through the pet's life.

Andrew: Mm-hmm.

Matthew: And we need to look at trying to actively resolve these. And so increasing, and then if we rewind to my cheeky comment regarding NSAIDs being dangerous, one of the main reasons there is the medicine can become the poison when we're using medicines that may, they’re like COX inhibitors or LOX inhibitors that actually, in addressing acute inflammation, actually stop the process of resolving chronic inflammation because resolvents and lipoxins and these specific pro-resolving mediators aren't allowed to do their thing.

Andrew: Yeah.

Matthew: So, I'm using multimodal strategies always and looking for the synergies that come through with that. But when we're looking at what herbs we're using, particularly and the fatty acids and lipids that I'm electing to use, I’m looking for things that promote nitric oxide pathways to actively resolve the chronic inflammation, certainly paired with the diet advice to stop the ongoing metabolic inflammation that's diet-driven. 
But increasingly using TCM strategies generally is what I go to initially, to resolve the chronic inflammation while the diet changes are taking place. And around that, animals are under various stressors, so using a lot of adaptogenic strategies with Withania and skullcap. I use that a lot with regards to resolving strategies. One of the main synergies that I like is turmeric and boswellia. I think that does quite a neat job there. Yeah. 
And then probably the other big sort of logical and probably I think it’s — in my perspective — so obvious that I forget to mention it sometimes is to address the gut. Rehab the gut and address the gut hyperpermeability or what some people might describe as leaky gut syndrome. And work with the plasticity of the animal microbiome to manipulate the microbiome to better protect the lining of the gut and stop that source of inflammation as well.

Andrew: Yeah. Do you ever favour just fish in the animal's diet versus supplements? Concentrated EPA, DHA-type supplements, or even the new...

Matthew: I do.

Andrew: ...or even the new specialised pro-resolvin mediators on the Australian market? Do you ever use these?

Matthew: Yeah. I was actually talking to a client yesterday who's a nutritionist about this.

Andrew: Yeah.

Matthew: I try to favour whole food nutritional strategies where possible. So, normally, say with fish, yes, I do. I do definitely like to incorporate fish into the diet where it's appropriate and where the animal can tolerate it and enjoy it. Sardines is a major source for me because it also has quite a good vitamin D profile, and calcium and other minerals. So yes, yes, definitely. I try to do that before moving more into nutritional supplements and then moving more into nutraceuticals. But it really depends on the significance of the current health of the animal and how far from homeostasis they are and how many strategies we need to use or overlap to if we get them back to homeostasis. So, yes, I do like to use fish. 

And then the other problem, I think...and the other thing in veterinary medicine that I guess your listeners might need to remember, particularly if they're coming from a human medicine perspective, is we need to recommend strategies that people can afford...

Andrew: Yes.

Matthew: ...because it's highly privatised medicine. And so, the specialised pro-resolving mediators and really good quality omega blends, etc., that are the dioxin PCB, mercury pre-tested, and definitely, higher quality with regards to risk of rancidity and things like that. That might be unattainable for the pet guardian within what they're already spending to feed the dog and already spending on medicine privately. So, yeah, definitely trying to build from a foundational basis of good nutrition rather than getting too fancy.

And that's certainly something that I need to always put the brakes on myself and see that there needs to be often a supplement hierarchy and prioritisation list based on economics and what the pet will accept and what the pet won't get sick from. I definitely use a lot of omegas particularly in my cancer care, for sure, use a lot of... And then to get animals high enough in their omega to meet sort of anticancer diet strategies which are clinically proven in dogs since 2010, and recently backed up with a 15-year study called the Morris Animal Foundation Study where they've found that dogs that have high levels of omega-3 within their diet have less cancer risks over a lifetime.

Andrew: Right.

Matthew: So, yeah, absolutely. I go to the nutraceuticals when I think that that's the best solution for that individual animal.

Andrew: Now, your work obviously transcends just private practice. You're passionate about animal conservation, eco-health initiatives, indeed integrating and liaising with government and industry. So you were speaking earlier about veterinary medicine being a highly privatised profession. How could integrative veterinary medicine better be supported by government or, indeed, industry?

Matthew: Yeah. Yeah, there's a few ways for sure. I'd say that Medicare would be the dream for most vets.

Andrew: Oh, absolutely.

Matthew: So I'd better sort of stand by my colleagues and say Medicare for pets would probably be very handy so we didn't have to talk about money so much. But we need to talk about money in the world that we live in. 

I do really believe that phytomedicine as a whole and integrated medicine really can contribute to healthy ecosystems through one-health and eco-health and also through social corporate responsibility, particularly with regards to supply chain and empowering the people who might be producing raw materials for phytomedicines. So I think that some of the big line policies and things to consider for the Australian government as a whole is probably the OACD's eco-innovative guidelines to green growth business. I think that's a really important initiative for the government to pay attention to.

Definitely, I propose that the government critically evaluate how integrated therapies could alleviate some of the financial constraints within medicine and really strive further to deliver better upstream medication and medicine strategies, and increase funding for complementary medicine. And of particular interest to me, and something that I've kind of brainstormed with various people in various organisations is that veterinary medicine an under-utilised tool for translational research from a one-health perspective. We did a pilot study that found which was trying to see if dogs were a good model for naturally occurring blood-borne cancers. So they used dogs with splenic hemangiosarcoma, which the do-nothing approach for a dog that's been diagnosed with a ruptured splenic hemangiosarcoma is 19 to 90 days and only 6 months with chemotherapy.

Andrew: Yeah.

Matthew: Now, they used Coriolus Versicolor, turkey tails, mushroom, PSK, PSP standardised to test this as a pilot study as to, “Okay, can this be a good model for human research that can be translated?” And it was found that the health span and disease-free interval and overall longevity of the dogs in this pilot study, albeit a small study, were the longest ever recorded for this malignant disease in dogs. And that wasn't even the purpose. The purpose was just to see if dogs are good complex model. And they are. It's validated that they are a good complex biological systems to look at a gap between lab animals, obviously en-vitro studies, between humans.

So I think that there's a gap where veterinary medicine can be better utilised as a way for government to direct funds and certainly to maintain the R&D incentive and tax incentive in Australia to come up with good proof of concept in more complex animal models to move through to fast-tracking human clinical trials. I think taking on board the APVMA, I'd like to see take on board more from the World Health Organization's traditional medicine strategy.

Andrew: Yeah.

Matthew: And streamlining registration, I think is a major issue especially where there is translational research opportunities, or it's entirely valuable. Dogs and cats, and the cancer, insulin resistance, and diabetes, there's huge opportunities of naturally occurring disease in veterinary medicine. And ethically, if an animal needs to enter a trial for trying to see if a herbal, natural compound might be better up against chemo as a standard of care challenge or as an adjunctive therapy or as an alternative strategy, the difference with veterinary medicine is that if someone can’t afford $20,000 out of pocket for chemotherapy, then ethically, having other streams that they can enter to feel like they're not completely powerless to do something and to contribute to research that could then be translated into human medicine, this is where we still say there are windows of opportunity for better utilisation of monitoring medicine that's already happening in Australia.

Andrew: Matt Muir, I cannot thank you enough. In fact, I take my hat off to your work, not just on a patient level, but on a professional level for your peers, for the veterinary profession as a whole. You're doing incredibly good work. I thank you so much indeed. There's so much more to cover. Would you be okay to come back on to FX Medicine and maybe we can...

Matthew: Yeah, I'd love to come back on.

Andrew: ...delve into some specific areas of treatment?

Matthew: Yeah. Yeah. I'd love to come back. Thanks so much for giving me the opportunity to share my experience and some of my views.

Andrew: Matt, it's been an absolute pleasure and an honour. Thank you so much for joining us on FX Medicine.

Matthew: Fantastic, thank you.

Andrew: This is FX Medicine. I'm Andrew Whitfield-Cook.



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