Paws, Reflect & Heal with Dr. Randy
This channel appeals to conscientious pet owners who prioritize their pets' health and well-being beyond conventional treatments. They are curious about holistic and integrative veterinary approaches and seek to understand their pets' behavior, nutrition, and health issues deeply. They value expert advice that combines traditional medicine with alternative therapies and want to be proactive in preventing and managing their pets' health problems. The channel resonates with those who view their pets as family members and are motivated to provide the best care possible through education and open-mindedness.
Paws, Reflect & Heal with Dr. Randy
Integrative Approaches in Veterinary Medicine with Dr. Kevin Toman
In this episode of 'Paws, Reflect, and Heal', Dr. Kevin Toman and I discuss our parallel journeys in veterinary medicine, while exploring the shift from traditional Western medicine to holistic practices, the significance of wellness and longevity in veterinary care, and the evolving role of telemedicine in providing accessible veterinary services. We talk about how it's necessary to build strong relationships with pet owners and the impact of lifestyle choices on pet health. We also explore the challenges of navigating veterinary prescriptions in a telemedicine context and delve into the promising potential of rapamycin as a longevity drug for pets.
Main Takeaways to Note
- Curcumin is a natural remedy with proven benefits.
- Veterinarians need to focus on long-term wellness rather than just immediate problem-solving.
- Telemedicine is becoming an essential tool in veterinary care.
- Building relationships with pet owners is crucial for effective care.
- The importance of a holistic view of health applies to both pets and their owners. There is a significant need for trust between pet parents and veterinarians.
- Veterinarians should provide written assessments to pet parents after consultations.
- Rapamycin shows promise in extending pet longevity and improving health outcomes.
- Understanding the quality and efficacy of supplements is vital for pet health.
- Passion and dedication in veterinary care can significantly impact pet health.
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Send your questions to randy@drrandypetvet.com so Dr. Randy can answer them in future episodes!
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Products and Resources I Recommend
Microbiome Testing
Animal Biome - Gut Microbiome Health Test
Nutrition
K9 Natural
Other...
And you know, when I said, well, you know, we we want to check a little bit of blood work, possibly get some some some radiographs or some x-rays, uh sometimes they look at me a scale and go, like, well, I thought you were a natural veterinarian. I go, you know, I'm an integrated veterinarian. And I do the same reminder that you do that um we utilize all the I utilize all the tools. And uh there's definite place for a lot of this to happen, uh, but there are certainly places for the things, the other things, the other options that we can offer, which is really neat. Welcome everybody to PAWS Reflect & Heal with Dr. Randy. Uh we have a great podcast episode coming towards you today. Um I I told this guy, actually, I it was a misspelling on my email to him, but I told him that I think he's a brother from a different mother. And uh only because our our lives in veterinary medicine had very parallel courses, um, but I'm very excited to introduce you to Dr. Kevin Toman. Um he is going to give you his a little bit of his background and bio, and we're gonna talk uh a lot about integrative medicine, um, quite a bit about some new uh things coming down the pike that you really should know about. Uh and uh, you know, we always we we remind you that you can answer uh we can answer any questions you want on drrandypetvet.com for myself or Dr. Toman. And uh we also have uh Dr. Toman's contact information posted on this when we get their show notes up. Kevin, welcome to the show.
Speaker 00:Well, thank you very much, Dr. Aronson. I appreciate your time and your knowledge.
Speaker 02:Uh just just let's do Randy, if that's okay.
Speaker 00:Okay, all right. Randy works just fine. And likewise, Kevin. I mean, uh all my life I've just been known as Kevin, inside the clinic and out. And so perfectly okay with that as well.
Speaker 02:Perfect. Tell our listeners a little bit about your uh your your past and you know how you got into veterinary medicine and kind of what a little bit about your practice, and then we'll talk about what's happening today.
Speaker 00:Okay. Well, my name is Dr. Kevin Toman. I uh have been a veterinarian since the dark ages of 1986. I graduated from UC Davis way back when. And it honestly it was the only thing I ever wanted to do. I'm one of those guys, for better or for worse. And once I got uh out of Davis, I spent some time up in uh the hills of Northern California, then 20 years of Colorado for uh, well, once I turned about 55 or so, that snow was a little bit less attractive to me. So I moved back to the central coast of California because snow's a lot less out here, and this is where I've lived since uh 2011.
Speaker 02:Beautiful area. We love uh visiting that area. We just had some friends that got married a little bit inland um and just enjoyed the heck out of it. So um, so you um you you and I I graduated a little bit before you, um, but not too much. So I always tell people it's before the light bulb was was invented uh for us. Um but I think we're parallel in the fact that I, you know, it's really all I wanted to do also. Um I had uh went to undergraduate school in in um in pre-med, and there were no pre-veterinarians at this program, and everybody was wondering, oh, you know, you must be going into veterinary medicine because you don't really like people. And as you and I know, that couldn't have been farther from the truth. So uh I think the fact that you and I are doing this today shows our our love for um our our pet parents, but especially our pets that we that we want to take care of. So talk a little bit about um so in the early days, um, probably like myself, you were doing a lot of Western or allopathic medicine. What happened or where was there what was there a switch or was there something that came about for you that said, you know, I need to be looking a little bit more outside the box?
Speaker 00:Well, uh I'll give you a little bit more detail. And I actually started back uh when I first got out of school, I was a large animal veterinarian, horses and cattle primarily. And yet I found that sometimes the economics of the veterinary profession uh dictating whether a pet, whether an animal survived or not, that was pretty difficult for me to uh to live with. And so I uh gradually made a transition into small animal clinic and have been happy there ever since. In answer to your question, uh uh until about uh let me do the math here, uh until about 2001 or so, I was pretty much a Western uh medicine guy. You and I were likely trained in the same way, for better or for worse, because I can speak to some of the deficits in that in the veterinary training that I received anyway at UC Davis, in particular, no dental uh care at all back in the day. I mean, just none. Uh, you know, no, and certainly no no dental radiographs, none of the things that you and I take for granted as part of the diagnostic workup these days. And yet, in in to answer that question of yours, um uh a few years ago, 15, well, a little bit longer, but 17 or 18 years ago now, uh spent a lot of time in the gym, went in for routine blood work, Randy, and my creatine was a little elevated. And so my GP at that point in time in rural Colorado uh ordered a full blood panel of and including serum electrophoresis, and come to find out I had a uh pre-malignant disease called uh monoclonal gamopathy of, quote, unknown significance, MGUS. And that is a precursor for uh the fatal cancer myeloma. And so you can imagine it took me uh took took my attention and uh I ended up working through a lot of diagnostics because I was being told by the local docs that I did have myeloma, and I self-referred down to a mayo clinic in Scottsdale, Arizona, and went through a complete workup, including bone marrow biopsy down there, and found that this was in fact a precursor, but not a malignancy. And the interesting part of this, I'm circling back around to your question, there's only one substance that has been proven to help slow the transition of this MGUS precursor into myeloma, and that's a natural herb called curcumin. There are no chemotherapy drugs, there are no allopathic drugs, no Western medicines that are uh that are proven to work. And so that that was my uh that opened the door into integrative therapy for me because all of a sudden, you know, the antibiotics, the anesthetics, the things that you and I have in our back pocket all day long had been proven ineffective. And in their place was uh a natural herb that had been used for centuries uh by by different civilizations. And so that that kind of cracked the door open into herbal medicine, and then from there I expanded into uh an acupuncture practice, a laser practice, and and eventually into prescription longevity drugs, which is where your path and mine uh crossed.
Speaker 02:Really cool. And you know, it's amazing how for for for many of us um it's really uh kind of like you had described uh self-necessity or self-awareness to kind of look outside the box when something comes up. I didn't have quite that um that bit of a journey. Um I uh just to give you a little background, for me, uh I was practicing um after um I I spent a year um I graduated Penn and then I spent a year doing a rotating internship in medicine and surgery. I also went there thinking I was gonna be an equine surgeon until I saw the economics of what happened with racehorses and how insurance money deemed everything. And it was just not why I went into vending medicine. So after that year internship and uh in medicine and surgery, I went to the Animal Medical Center in New York City. Um the reason for me is I'm I'm a visual learner, I can read 10 times. If I see something once, I'm good. And so, you know, having 60,000 cases a year uh was amazing, and I was doing endoscopy and laparoscopy there, which was really fun. Um But I got out to to Tucson, which is where I ended up uh starting my practice, and I probably it was about 10 years into the practice that I realized for me that all I was doing was putting out fires. Um I could be I was a great diagnostician. I I'm I'm not you know giving myself any any you know rubs on the back, but it was I was doing great. I mean I I was far above what was out in medicine at the time just because of my training. Uh but um I didn't feel like I was getting anywhere towards wellness and especially not health span or longevity. So um heard about this guy, Andrew Weill in Tucson. Dr. Weil is uh you know a very famous MD that really started laying the groundwork for looking at herbal medicine and Chinese herbs. And and I um I went and got training in Albuquerque for uh what I thought was adding Chinese herbs to my practice, only to learn I had to learn Chinese medicine, which was another whole paradigm shift in my life, uh, which led to the acupuncture certification and herbal certification, and then from there um rehab certification because of you know what I saw my practice as a necessity for a lot of our senior pets and and obviously recoveries from surgeries and whatnot. So it was a great pathway, uh, but it really took a long time, and I'm sure, like yourself, you know, there was a lot of reticence from the veterinary community about what was going on. I I actually um to kind of prove my point, started this radio show in Tucson, went for 10 years on Saturdays for two hours asking QA, and most of it was what you and I know about basically, you know, how come methylcobalamine helps the bowel? Or, you know, why am I, you know, and and then you know, basically pet owners would go to their their veterinarians and they'd be calling me and saying, like, well, what are you telling this person? You know, I don't even know anything about this. Yeah. So it was an educational process, but uh well worth it. I mean, obviously. And and then, you know, I I'm sure for you started seeing some amazing results in practice. You know, things that I could not put my finger on. You know, we were I I had this ongoing argument with the oncologist here in town about uh using um turkey tail for mastell tumors. And I told her that it worked as well as prednisone. I just I kept on harping on it. And then like five years into this argument between the two of us, Penn releases a study on turkey tail versus prednisone, and that you know the results were equal, you know. So uh it's nice, I think, for both of us to have things borne out. But I think like you probably, and and I and I'd love you to address this, the proof is seeing the benefit to our pet payer you know, patients. I mean, to see what we can do um to help them, especially not only to work on disease, but also on longevity health span and wellness.
Speaker 00:Yeah, I could approach that in a couple different ways. Number one, um, I think as you pointed out, most veterinarians are very good at solving problems. Uh, you know, if if Annabelle, my my my aforementioned 11-month-old golden retriever, comes in with a uh a cut pad, you and I are very good at sewing that up. If she gets parable, we're very good day in and day out at solving that. But what we aren't so good at is trying to develop a plan, uh an integrated plan that looks down the road and says, well, how do I help this 11-month-old golden retriever as an example? A breed that we know is absolutely prone to cancer, absolutely prone to orthopedic disease, absolutely prone to allergies. How do I help that dog or that patient live their very best life? And what I found early on was that people were coming to me because they had heard that I was a natural doc, a natural naturopath. And one of the first things I told them was, well, in fact, that's incorrect. You know, um, I listen, I do believe in the value of herbal therapy. I do believe in the value of a class four laser, but I also believe in the value of surgery and steroids and and you know, the occasional vaccine. It's just that in I think that many folks, whether they be veterinarians, whether they be pet owners, tend to limit themselves to one approach or two approaches and think that they're doing all they can for their pet. And when I'm asked those questions, I start waving my arms around and say, well, you know, we can use uh uh immune suppressants over here, we can use the turkey tail mushrooms over here, we can cut that rascal out. You know, I mean there's there's a lot of different ways to approach wellness for a pet. And in in general terms, I like to think, you know, it's the same approach to wellness that I use. You know, I I try to stay in shape, I try to eat right day in and day out. Um I'm not opposed to taking uh allopathic medicines, but I'm also taking the prescription longevity drugs that you and I might get around to at some point in time. I take herbal medications as well. And so I think it's a uh it's a total lifestyle. And I think that as, you know, I'm 65 at this point in time, and as folks of our demographic uh kind of grow up, Randy, you know, and and and maybe face mortality, um, all of a sudden, you know, I think it's there's increasing interest, I think, in in taking uh an integrated and all-encompassing view of our own health, and that translates very well to our pet patients.
Speaker 02:Absolutely, absolutely. And you know, I think on on the personal note, I'm on this very similar pathway. I mean, I love I I work out three days a week in in the gym. I actually have a gym in my ha my garage. Um but I and I also bike three days a week. And um and I found that um even just recently, this is kind of an interesting personal thing, I don't mind being transparent, but um, you know, I wasn't feeling that well. There was a lot of pain and aches that I didn't feel like should have been normal, and I wasn't going to take um, you know, a lot of the pain type medications and whatnot. And reached uh found a doctor who I think like uh a guy named Peter Utia that many of our listeners may know about practices what I call medicine 3.0, and that is really being proactive about, you know, I realized that after doing a DEXA scan, I had way too much visceral fat. Uh I was eating too many carbs. And you know, after that nutritional recycle for me and um and and kind of doing a lot of biohacks, some biohacks, and and obviously raphamycin, which we're gonna talk about in a little bit, uh it's been amazing. Uh you know, I lost uh 25 pounds. Uh I feel so much better. And this is kind of what I look at for my pet uh patients, because uh many times I have a dog that's coming in uh for most of my cases now, my practice or my telemedicine cases are all second and third opinions. So I have a dog that you know is a golden retriever who's gotten to 10 years old, but he's having a very hard time getting up. Uh he's um he's not he doesn't seem to be feeling well, he's maybe a little bit more grumpy or aggressive. And um I think my clients start they're a little bit amazed in the fact that the first thing I talk about is diet and and uh supplements. And we talk a little bit about some of the other things like like you mentioned class four laser, we have PEMF, which is post-electric magnetic therapy, we have underwater treadmills, um, trying to get these guys into uh a situation where you know I make them aware that the dog is obese and and needs to lose weight body score, you know, of seven and needs to be at five. Uh and all of a sudden everything starts getting better. Uh and and the you know, the pet parent just is like so thrilled, and of course I'm always so thrilled to see what's going on. Uh, and then I've added some newer things and we can talk about in a little bit using uh microbiome work uh that has really been impressive with some of the allergy looking, you know, looking at some of the allergy stuff. Uh, and it's been great. It's been just been a godsend.
Speaker 00:Yeah, I understand. And uh, you know, one of the things that you and I spoke of before is the fact that many pet parents have a tendency to reach towards the the newest shiny object, you know, the uh whatever whatever is in the news uh as a basis for their pet's health care. And the reality is so often it comes back down to the basics, uh the same things that you and I speak of, whether it be exercise or nutrition or for for small dogs and kitties, the you know, the dental care that uh that eliminates both pain and long-term inflammation, you know, and the old in the larger dogs paying a little bit more attention to orthopedics or alpha allergic disease, uh, you know, early cancer detection, etc. And some of these things are very simple to take care of and and oftentimes very cheap. But the reality is that um they play a vital role for our pet parents and keeping our their pets healthy.
Speaker 02:Absolutely, absolutely. Um talk a little bit about um so you uh I know you you had a um a practice that you had sold not not that long ago. Um how what did you see as far as where you were going with with this? I mean, did you visualize you being um in uh the longevity space? Did you visualize this being a telemedicine consult kind of thing for you to happen and and and exactly like tell our listeners what you're doing now? That would be great.
Speaker 00:Well, it's it's been an evolution. I um I'm kind of a serial entrepreneur, and so uh through the years, and uh you know, I kind of migrated to wherever wherever there were either waves or trap. That was kind of one of the defining uh uh uh uh characteristics of the places that I used to live. And so I I came to San Luis Obispo when I got tired of the snow and and built uh what at that point in time was a just a one-dock practice and and grew it to uh a five, five and a half doc practice and you know 25, 30 some odd employees. And I just um uh and and then to be candid with you, uh that was back in in 2018, and and as you probably know, that was kind of the beginning of the private equity move, the venture capital move into veterinary medicine. And and I could talk at length about that um from both a pro but also a lot of cons. And the reality is that I was made that proverbial offer that I could not refuse. We had kind of a little bit of a referral uh practice going on at that point in time, and so we had a pretty good reputation, and and I just knew that uh as my practice enlarged, I was losing one of the things that mattered most to me, and that was the the contact with the individual. You know, I spent more time as an administrator, I guess, at the end of the day, to cut you know, to get right to the chase here. I spent more time doing the paperwork and keeping the hospital running than than solving things, you know, and uh that's one of the things that that I hold hold myself to be as a little bit of a fixer. And uh I had lost that component of my day-to-day work, and so I just uh I took that offer that I could not receive, or could not uh turn down, I should say. And that freed me up to go ahead and explore the part of veterinary medicine that I really love, which is building that relationship, building that one-on-one relationship with an individual pet parent, and being able to say, listen, I'm gonna follow your pet, not just for the days associated with uh, you know, a vaccine or a surgical procedure, but for for weeks or months or years in an effort to really provide them the very best care. And these days, you know, California has incrementally liberalized their uh their telemedicine uh statutes as a result probably of COVID. And I'm trying to take full advantage of that because you know we were laughing about it. Um I've I was talking with another uh pretty savvy individual um about business development, and he said, you know, really one of the things we're trying to do is democratize veterinary medicine. And that sounds kind of funny, but not everybody lives in in the Tucsons or or Phoenixes or San Fernando Valleys, the San Luis Obispo of the world. I mean, some folks live in uh in the wise river, Montanas, or the Scow Vegans, Mains. And I think that telemedicine, the access to a veterinarian like yourself who really cares about not just solving a problem, but about trying to build a longevity plan for this particular patient, can make all the difference in the world in today's uh internet age, where you know, social media isn't you you can get opinions all over, but what you can't develop is a relationship with somebody. And that that is my goal uh with some of the things that I'm doing right now.
Speaker 02:Uh it's you know, couldn't have said it better. I mean that's that's amazing that um you know uh again, I I think the evolution for both of us was very similar. Um I do remind my clients, like you know, we used to get initially people come in and say, Well, I just want acupuncture for my dog. And I go, Well, I I can do the acupuncture, but let's just see what the situation is here so that we can figure out why we're doing that or what the necessity or what our plan is. Like you said, planning is always very important. And you know, when I said, Well, you know, we we want to check a little bit of blood work, possibly get some some some radiographs or some x-rays, uh sometimes they look at me as you and go, like, well, I thought you were a natural veterinarian. I go, you know, I'm an integrated veterinarian. And I do the same reminder that you do that um we utilize all the I utilize all the tools. And um there is definite place for a lot of this to happen, uh, but there are certainly places for the things, the other things, the other options that we can offer, which is really neat. Um so so um you sold the practice, you started um this um was it beginning in telemedicine? Is that how it started for you? Or or was it?
Speaker 00:No, I was uh kind of the uh mail order practice uh mail order, you know, basically just selling supplements back in the day. Uh because you know, I I I took my initial interest in curcumin and and really did the research necessary to kind of um find you know without putting a sales spin on it. I I I did the research necessary to find what I thought were the very best ingredients, the very most effective ingredients around. And there's there's a lot of smoke and mirrors in the pet supplement world, you know, a lot of marketing um spin by folks that have never set foot into a veterinary clinic. And what I tried to do is to offer folks a little bit different approach. And I tried to look at things, you know, I I I don't I don't sell, I don't even talk about things that don't have any science behind them. You know, I think the really a PubMed study or two is kind of the entry, the the door through which any supplement has to strive before I'll I'll have a look at it. And I think that uh uh there there was there was a need. People were receptive to that. Uh and you know, I I agree that business one person at a time. You know, there are some some lean times uh to go along with it, but the reality is that uh now we seem to have developed a little bit of word of mouth, folks that are kind of uh that the type of medicine that you practice resonates with them, and and so uh much like you, there's there's a receptive audience out there.
Speaker 02:So talk a little bit to our listeners um about one, how people find you and basically kind of what your goals are going forward from where you are right now.
Speaker 00:Well, again, I I don't want to make this uh an advertisement for myself.
Speaker 02:I'm asking. I'm asking.
Speaker 00:Yeah, okay. Well, I run I run a couple of uh websites. I guess um the the one that most folks know me through is just helpingpets live longer.com. And on that uh there's a mix of of both prescription longevity drugs uh that are available through by prescription from other veterinarians or after a consult with me. Uh some of the proven supplements that we've discussed. And then I'm I'm really trying to expand the consult part of things because I think there is such a need for pet parents to develop a relationship with somebody that they can trust, somebody who's in this not just for days or weeks, but for the long term. So that you know, there's there's nothing more satisfying to me, uh Randy, than uh, you know, seeing a uh you know the puppy, the proverbial puppy that you and I take care of. Uh, you know, we can give vaccines, eight, twelve, sixteen weeks of age or whatever, guide them through middle age and and eventually, you know, approach palliative care with them and sometimes get you know the next generation of pets uh coming. And and that to me is is really why I got into veterinary medicine. And so um I I acknowledge the fact that you know there are many supplement uh suppliers out there, and and that field's probably gonna get a little bit more crowded over time, as you and I've talked about. But one thing I don't think will ever get uh get too crowded is the ability to look somebody in the eye, even if it's on Zoom, and say, listen, you know, this this is this is what I think we need to do. This is this is how you and I, by working together, can help our pet. And I and I think that's very important.
Speaker 02:I do too. Well said. And um I you know the interesting thing um that I uh allude to a lot of my uh pet parents when they come to see me is a lot of what you said as far as the the you know what what they're picking as far as supplements and why and and you know, uh many, many times I I refer to Google, Dr. Google as the N of one. Meaning like, you know, I had this golden retriever, it had this, and I gave this, and it, you know, this is the best product in the world. You know, this Dr. Google's an N of one, and people like you and I have N of hundreds. And we look at, you know, the tumor products, let's say, that are out there, or the curcumin products that are out there, and know how it's made and know the quality and know the efficacy. Same with the other supplements. And I'm with you. I I you know I um I I think without any kind of research or or back background, um, I'm more apt to be a little skeptical until proven otherwise. And um I think that really helps. Um do you do a lot of your telemedicine cases by Zoom or do you do mostly phone calls, or how does that work for you?
Speaker 00:I try to do Zoom calls where I can. And the reality is that I I like to look at the yeah at the parent, pet parents that I'm talking with. I like to be able to look at a pet, you know, as goofy as that sounds, you know, because sometimes what what a pet parent will say uh will describe sometimes uh is different uh is looks different to me. Looks different to me, you know. Uh whether it be a pet being lame on on one leg, you know, and maybe they maybe they turn out to be painful on another, or you and I might describe uh an area of baldness or or hair loss or the like a little bit differently than a pet parent will. And so in in answer to your in direct answer to your question, I start with a four-page pet health questionnaire that I would ask you to fill out. Uh, you know, where did you get your pet? What is their lifestyle like? I mean, when when they go outside, where do they spend time? How many pets, how many other animals do they come in contact with? Uh, you know, we discuss uh you know preventive care, et cetera, you know, the heartworm, the flea and tick medications, et cetera. And and then I get very specific, you know, what is your specific concern? You know, what have you tried in the past? What are you what uh what has your local veterinarian helped? And and if uh I mean, do you have problems with your local veterinarian? Is there something that you feel like you guys just simply aren't connecting with? Uh, because all that is vital information if you're really trying to get to the bottom of things. And and then I I do ask for the last two years of a PET's veterinary records as well, including all images and lab work, just to get a handle on on what has gone on. And then the third component of that of that three-legged stool is is in fact trying to set up a Zoom call.
Speaker 02:Perfect. It sounds great. Yeah, so you you know that that's the thing that I think a lot of people like to know is that um, you know, Dr. Tolman going in is well educated on what's going on with your pet and and basically what you're looking for, and and can think about what the options might be laid out after that's all assessed, which is great. Yeah, I think that's really important.
Speaker 00:Um Yeah, and again, and I will and I'm I'm sorry Randy to interrupt you, but I should mention that the other part of things that that I've done even in veterinary practice is uh I'm I made a habit. I I've I uh I forced all these poor doctors that worst worked with me. We always uh sent a written letter home for every every sick pet that we saw, sick or injured pet. Now, this is not the standard you know Spay or Newter uh post-op instructions, but um I believe pet parents are entitled to to that written um explanation of lab work, to to an idea as to uh a written idea as to prognosis or what the next step is. Because listen, when I go to my dentist or when I go to a doctor, you know, I listen like hell. You know, I'm I'm I'm paying attention just to the I'm paying rapt attention. But then I get home and I think, hmm, what what exactly was said there? And so that's part of it, what that's part of my philosophy around these consults, too, is that at the end of the day, uh a pet parent will get anywhere between a page and and sometimes two or three pages of a written assessment of their pet's health, not just where they're at right now, but what uh where they're headed, in my opinion.
Speaker 02:Perfect. Perfect. Um do these um do your telemedicine consults are they usually are like an hour in length or
Speaker 00:Is there any specific time frame or yeah, well the the uh uh the homework is done ahead of that. Sure. But yeah, then then the the Zoom consults themselves are set up on the hour. Perfect. Um so yeah, I I try to give folks just as much as much time and room as they need to run with this.
Speaker 02:How do you get around the um the issue? I often get this question on medicine, um, actual prescriptions of medicine when you're doing these.
Speaker 00:Um Well, uh, you know, I I can prescribe within within the the state of California, but the reality is that outside the state, um, you know, that uh current veterinary laws, whether they and you and I could talk all day long about some of this, to be candid with you, but uh current veterinary laws prevent uh a veterinarian from prescribing outside their their state. And so uh, you know, I try to work with local veterinarians, and many times, you know, people already have a cabinet full of medications, it's that they're not quite sure how to use them or when to use them. And so there are a lot of different ways to to work with that, but I'm not it I want to be absolutely clear. My goal is not to alienate or or to uh ostracize the local vet. My goal is to is to do everything we can. Again, you know, work work with specialists. Uh, you know, I have a little specialist network that you and I can talk a little bit more about. Uh uh so I try to bring specialists in as needed, but work with a local vet. Sometimes, you know, the rehab vets, the physical therapy folks, in an effort to establish a healthcare team for these pets, a healthcare team instead of a one-man band.
Speaker 02:Perfect. Perfect, perfect. Um, let's take a little time, if you don't mind, um, and talk about rapamycin and and how this came about for you and and kind of what you see it situation and and what it looks like in the future.
Speaker 00:Okay. Well, yeah, rapamycin is probably the single most widely studied and widely used prescription longevity drug in the world right now. Um, you know, and as as a lot of folks realize, it came into human medicine actually as an immune suppressant, and in particular for uh for transplant medicine. But what they found is that at lower doses it had pretty profound uh metabolic benefits. And at this point, uh I I think I can say categorically that it has extended life in every species study to date, and in mammal species, uh typically by about four uh by up to about 14% or so. And of course, that anything that extends life by what could be a you know up to a decade for for a schmo like you or me, um, or you know, a year, a year and a half, or two years for a pet. Now, listen, there are no guarantees. I don't think any medication works for everybody, but the potential for actually a safe intervention uh into helping our pets or helping ourselves live longer, I mean, that's awful appealing for a lot of folks, uh, folks like me.
Speaker 01:Sure.
Speaker 00:And so I began using rapamycin in my clinical practice back in 2016, 2017, primarily in an oncology setting, because you and I both know that um it's difficult sometimes to uh to have an oncologist or have a general uh GP doc just say, Oh, there's nothing you can do. And there's pretty compelling uh studies in human medicine for a variety of different diseases, lymphomas, the various sarcomas of the world, mammary cancer, melanomas, uh in our case, anal gland adenocarcinomas, the rapamycin has has a benefit for these patients. And I I saw some pretty substantial results, um, especially with melanoma, oral melanomas, and the and anal gland cancer. And uh so uh based on that and a safety record, I eventually began taking it myself in candor and then made that switch. I mean, so many people um you know the last thing in the world that that a pet parent wants to hear is that your pet is growing old and there is nothing we can do. There is nothing we can do. And uh listen, there are a lot of lifestyle change uh uh components to this, as you've already alluded to. There's a lot of standard medic medical uh therapies like dental care or you know, sometimes vaccines or whatever that can that can help a pet. But um if if you truly love your pet, like you and I do, or like many, many pet parents do, uh, you'll stop at nothing. You know, and and rapamycin has been proven safe. Uh, you know, the studies support its use uh uh for both longevity and well, it has longevity, it has anti-cancer and anti-inflammatory benefits. And I'm gonna talk a little bit more about cardiac care in just one minute. And to this point, it's it's been an off-label use for both dogs and for cats. But there was a study that came out, uh put out by a company called Trivium, an Irish uh veterinary uh products company called Trivium, about a year and a half ago that showed that rachamycin has the potential to slow, stop, and occasionally even reverse a fatal cardiac disease in kidneys known as hypertrophic cardiomyopathy or HCM. And why is this so important? Well, because HCM is the single most common cardiac disease that cats run into. And I'm gonna be honest with you, in the 40 years that I've been in veterinary practice, up until now, it has been a uniform death sentence. If I told you that your cat had HCM, it was equivalent to telling you, go out and dig a hole. Go out and dig a hole. And now rapamycin is a safe alternative that, again, does not work for every cat, but I would tell you that in our hands and in the cats that we've had rechecked by uh echo exam by veterinary cardiologists, about three-quarters of those cats have either stabilized or in a few instances, 10 to 15 percent, actually improved. And this is borne out by a study that uh by a wider study that has been done at and I think completed at this point at North Carolina State University. And so it's a fascinating time to be uh a veterinarian who's interested in longevity medicine because in in addition to the lifestyle and the herbal supplements and and uh the physical therapy that uh that you and I are very versed in, now we have a a whole different uh a whole different arm of medicine. We have a totally different way to help our pet parents uh help their pets live longer. And that's pretty that's pretty exciting to me.
Speaker 02:Absolutely. Um we're kind of running out of time, and I'm really sad because I think we have I have so much more that I wanted to talk to you about. Hopefully, maybe we could do this again. Um if that would be okay with you. Um is there anything you want to leave uh our listeners with? Anything new on the horizon for you or anything changing? Uh of course, I'm gonna have all your contact information if our listeners want to uh want to get a hold of Dr. Tolman, want to get a telemedicine uh consult set up. Um but any any uh any closing thoughts, Kevin, at all?
Speaker 00:No, not really. I just appreciate uh I appreciate your work and the skill and time that you brought into veterinary medicine because I can tell you that uh people with your passion, people with with your dedication to uh to healing pets, I mean, they're rare in our profession. I mean sometimes it's easy to take it take the easy way out, sometimes it's easy to limit yourself to to what you were taught in school 20 or 30 or 40 years ago. And it seems like you're on the cutting edge of all this. And so I think that uh your your clients, your pet parents are very lucky to have you as part of their healthcare team.
Speaker 02:Well, and back at you because I, you know, after I got to to know a little bit about you and and especially with this conversation, I'm so impressed. I mean, I I you know uh I'm a little older than you are, but the two of us are still kicking and and wanting to do this, and the passion is really there. One of the things I thought about is uh at some point it'd be fun uh for you and I to go speak somewhere and and do something like this in in person. Uh we can reach out to some you know pet organizations or whatever, but it would be really kind of cool to kind of uh piggyback off of each other because I think it works amazingly well. So uh maybe we can pull that off.
Speaker 00:Yeah, you know, I've often thought that there was room to establish kind of a pet longevity conference, and it's it's funny that um uh I I came across uh a human longevity. I try to pay a lot of attention to some of the human longevity conferences, and there was one in um in Switzerland, and I think it was Lucerne or or or uh don't quote me on Lucerne, but the reality is that uh there was a human uh uh longevity summit in Switzerland that you and I just missed. It just happened this last week. And their statement is that they're putting together a pet longevity summit in Switzerland for next summer. And so yeah, there's uh that's that's an intriguing thought, my friend. It's an intriguing thought.
Speaker 02:It'd be it would be a nice trip and uh we could uh we could have fun kind kind of laying out the the pathwork for our our our pet parents and and for people that would listen. Kevin, I can't thank you enough um again for all that you do. Um I do have um definitely have some some rapamycing people who want to talk to you and and um I you know I um I want to keep on I as in in all transparency I also take it. Um I only I don't have my dogs on it at this point, but I'm I'm working towards that. Um had a little trouble with it prescription wise. I I will bounce that off of you, I think. Um but uh um I really really appreciate all that you've done. And um it is uh for our listeners, this is really cutting edge stuff. Um spread the word, check out Dr. Thoman on his website, uh contact him if you'd like to have a telemedicine consult, uh, and um we'll come back with with more uh Pause Reflecting Heel soon. Kevin, thanks again, buddy. I really appreciate it.
Speaker 00:All right, Dr. Andrew, have a great day.