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Veterinary Practice News December 2009 Letters to the Editor
Tell Me More
Editor:
I thoroughly enjoyed Dr. Alice Villalobos’ November 2009 Bond and Beyond column [“Balancing Motherhood, Veterinary Practice”].
Dr. Jennifer Kitchen’s excerpt was very enlightening, but I want more details! I would love to see her expound on her experience with maternity leave and practice.
As a newlywed considering starting a family, I’ve found a severe dearth of information regarding maternity leave, part-time schedules and how to negotiate the mommy process with my employer.
Leanne Browne, DVM
Jupiter, Fla.
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Not a Gender Issue
Editor:
The Argus Institute would like to respond to Dr. Kurt E. Blaicher’s Letter to the Editor [“Oh, Man,” October 2009].
The article he referenced [“Problem Visits Hamper Communication,” July 2009] should have stated, “A paternalistic style during problem appointments carries the potential for negative consequences.”
In this, the use of “paternalism” is devoid of gender connotations. It describes a style of communication and a type of veterinarian-client-patient interaction. A paternalistic relationship is one in which the veterinarian sets the agenda, the veterinarian assumes that the client’s values are the same as the veterinarian’s, and the veterinarian takes on the role of a guardian.
This is in contrast to relationship-centered care, which represents a balance of power and a collaboration between the veterinarian and client. The relationship is characterized by negotiation between partners, resulting in the creating of a joint venture to care for the animal.
Research indicates that a partnership approach enhances clinical outcomes, such as client and veterinarian satisfaction, patient health outcomes, adherence and reduction in malpractice complaints.
Jane R. Shaw, DVM, Ph.D.
Director, Argus Institute
Colorado State University Veterinary Teaching Hospital
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Defining a Vitamin
Editor:
I read with interest Dr. Narda Robinson’s Complementary Medicine column [“Natural vs. Synthetic Vitamins,” October 2009]. I’d like to further discuss the supposition/premise of the variance of natural vs. synthetic vitamins.
The definition of a vitamin is any of a group of organic substances essential in small quantities to normal metabolism, found in minute amounts in natural foodstuffs or sometimes produced synthetically and their deficiencies produce specific disorders. Some of the compounds discussed by Dr. Robinson are not true vitamins. Only for vitamin E (alpha-tocopherol) and folacin (folic acid) is there a difference between that found in nature and the synthetic sources. All other vitamins, whether natural or synthetic, have the same chemical structures.
Natural vitamin E is RRR-alpha-tocopherol, while synthetic vitamin E (all-rac-alpha-tocopherol) is a racemic mixture of eight stereoisomers of which only one is identical to the natural RRR-isomer. Furthermore, tocopherol transfer protein (aTPP) preferentially recognizes and transports the RRR-isomer to all tissues of the body when compared to the synthetic isomers. The international unit (IU) is a means to give a biological potency to the fat-soluble vitamins. Natural vitamin E is recognized to have 100 percent higher biological activity (IU) when compared to an equal quantity of synthetic.
According to the Dietary Reference Intakes for Vitamin E, the only tocopherol molecule that has vitamin E activity is alpha-tocopherol (National Academy Press). Beta-tocopherol, gamma-tocopherol and delta-tocopherol including the tocotrienols have no vitamin E activity. The mixture of the four tocopherols (a, b, g, and d) are utilized as natural preservatives in pet foods.
Research showing that tocotrienols have possibly more antioxidant properties than alpha-tocopherol has primarily been conducted in vitro and not in vivo. The major problem with tocotrienols is lack of stability in complete foods and supplements. It is impossible to include tocotrienols in a product other than in a gelatin capsule, due to the instability of tocotrienols.
An interesting observation about beta-carotene (pro-vitamin A) is that some animals are excellent converters of beta-carotene to vitamin A (sheep, rats, chicks), while others are incapable of converting beta-carotene to vitamin A (cats). Early NRC publications on nutrient requirements for horses listed a requirement of beta-carotene in addition to vitamin A, while the current NRC lists only a requirement for vitamin A. Due to beta-carotene’s role in reproduction, horses fed in confinement and not allowed to graze lush pasture, rich in beta-carotene, may need to be supplemented with beta-carotene in addition to vitamin A.
Hundreds of compounds may impact bodily functions; however, due to the definition of a vitamin, they cannot be called a vitamin, either natural or synthetic.
Robert L. Stuart, Ph.D.
President, Stuart Products Inc.
Bedford, Texas
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Veterinary Practice News December 2009 Letters to the Editor
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