By Dr. Becker
Today, I have a very special guest speaking with me over the phone. His name is Dr. Hubert Karreman, and he is the veterinarian at the Rodale Institute. The Rodale Institute was founded in 1947 by organic pioneer J.I. Rodale to study the link between healthy soil, healthy food and healthy people.
Before he joined Rodale, Dr. Karreman founded Bovinity Health, a small company that provides natural veterinary products for large animal medicine. He also founded his own solo practice, Penn Dutch Cow Care, which he operated for 15 years as a holistic large animal practitioner.
Dr. Karreman now works primarily with certified organic dairy farmers as a consultant. He also lectures widely on natural treatment options for cows, which is the topic of our discussion today.
Entering Veterinary School: A Childhood Dream Comes Full Circle
I asked Dr. Karreman to talk a little about his career path as a large animal veterinarian. He replied that he grew up in the suburbs right outside Philadelphia, in Bala Cynwyd, PA. His dad was a professor at the University of Pennsylvania. Like many other children, Dr. Karreman wanted to be a veterinarian for cats and dogs when he grew up. He was very influenced by books by James Herriot (author of All Creatures Great and Small, among many others), which he read during elementary school and junior high.
When Dr. Karreman was in the eighth grade, the veterinarian his family used came to his school to give a talk about his profession, and Dr. Karreman was even more motivated toward his goal of becoming a DVM.
But when he eventually went away to college at the University of New Hampshire, he began as a biochemistry major. Then he did a bit of "wandering," as many young people at that age do. He worked at a gas station during the summer between his freshman and sophomore years, which got him thinking about the earth's resources. When he returned to school, he began learning about resource conservation. He took a soil science class, really got into soils, and declared that as his new major.
During his time at the University of New Hampshire, he completed a work-study program with the USDA Soil Conservation Service, as it was called back in the early 1980s. Dr. Karreman said it was really wonderful, fun work for a kid from the suburbs, surveying land for conservation practices on dairy farms in southeastern New Hampshire. He could always see dairy cows off in the distance and was drawn to them, but didn't get the opportunity to interact with them while he was involved in soil conservation work.
Immediately upon graduation in June 1984, his desire to learn about dairy cows drove him to work as an apprentice on dairy farms. He mucked out cow stalls and did general farm labor for a pittance. Then in the winter of 1984-85, Dr. Karreman traveled to Holland to visit relatives. They weren't farmers, but he told them, "I'd love to milk cows here in Holland or learn how." So he started milking cows in Holland and was instantly addicted.
For the next six years, Dr. Karreman continued to work on farms. In 1988, he landed on an organic farm and was exposed for the first time to alternative medicine. He thought, "Wow, no way are these going to work, these little BB-sized white pellets in these round little bottles." They were homeopathics. And then he saw them work, and one day it hit him like a bolt of lightning from God. Dr. Karreman says he almost heard a voice from above say, "Go to veterinary school."
Suddenly, his childhood dream of becoming a veterinarian came alive again. He had to take some additional classes to get into vet school, and he knew he had to get really good grades this time around, unlike his University of New Hampshire grade point average! And as Dr. Karreman puts it, "Lo and behold, I got top grades and got in!"
Isn't that a great story? I was exposed to homeopathy while studying wildlife rehabilitation at the age of 16. At that time, I couldn't even pronounce the word "homeopathy," nor did I understand it. But I saw that it worked amazingly well. It sounds like Dr. Karreman had a very similar experience with the use of homeopathy with dairy cows. I asked him what his exposure was to homeopathy in veterinary school.
Dr. Karreman explained that while in vet school he didn't hide the fact that he was into organics and was interested in alternative medicine. And as he thinks back on it now, during his first two years of school while he was learning the basics, the professors he had were more open to discussions about alternative therapies than the actual clinicians who taught him in his third and fourth years.
After Vet School, Dr. Karreman Establishes a Satellite Practice with an Emphasis on Large Animal Homeopathics
Next, I asked Dr. Karreman where he began working after graduating from veterinary school. Did he go with a traditional practice? Or did he open his own practice so he could take a more integrative approach, using alternative treatments like homeopathy?
Dr. Karreman said that when he was a herdsman from 1988 to 1990 on a Biodynamic organic farm, he received training – as did other farmers in Lancaster and Chester counties in southeastern Pennsylvania – from Dr. Ed Schaefer. Dr. Karreman feels Dr. Schaefer is the best teacher of large animal homeopathics in the U.S.
When he was finishing up vet school, Dr. Karreman asked Dr. Schaefer if he would like him to set up a satellite practice in Lancaster County, since Dr. Schaefer was in Lebanon County. Dr. Schaefer agreed, but couldn't pay Dr. Karreman much because he hadn't planned for someone to offer to open a satellite practice for him! But as Dr. Karreman points out, "When my heart's into something, I do it regardless of the pay." He thinks a lot of veterinarians are like that.
While attending the presentations Dr. Schaefer gave to teach homeopathics, Dr. Karreman started meeting up again with many of the farmers he'd known during his years as an apprentice. As it turns out, he didn't have to do much cold calling to get business for his satellite practice, because he'd made all those contacts years before. This was at a time when organics were really starting to take off, and the farmers he knew were like, "Hey, this is cool. This is Dr. Karreman. He's just out of vet school. And he wants us to use homeopathics just like we all learned from Dr. Schaefer. This is great!" And things just sort of developed from there.
It's really wonderful and unique how things ultimately fell into place. Dr. Karreman believes it was serendipity along with spiritual guidance. He feels he was put on his path when he heard those words from above, "Go to veterinary school" back in the late 1980s. Things have fallen into place almost every day since then.
Beyond Homeopathics to Multi-Potency Homeochords
I asked Dr. Karreman if when he started out, he practiced exclusively holistic medicine, or was it more integrative? Did he practice traditional veterinary medicine at any point?
He answered that interestingly, most vets who get into alternative medicine first spend many years practicing conventional medicine – antibiotics, hormones, steroids, etc. Eventually, they arrive at a place where they say to themselves, "I'm just not seeing the results I want to see," or "I didn't go to vet school just to use these two or three or four treatment protocols." But in Dr. Karreman's case, he actually went to vet school because he had already seen how well alternative therapies work.
But once he started practicing in 1995, he quickly hit sort of a glass ceiling with regard to homeopathics in the treatment of dairy cows. He wasn't a classically trained homeopath. He refers to himself as a mongrel or mutt – an eclectic practitioner. He uses whatever it takes to get the healing response he's looking for. That's why when he attended vet school, he wanted to mix and match different modalities. Every case is different, and he knew that.
For example, let's say a cow is fresh (has just given birth to a calf), hasn't passed the afterbirth, and has pneumonia. She's sunken-eyed and depressed. She's obviously sick. Using homeopathic pyrogen alone isn't going to get the same results as also giving IV fluids, perhaps some calcium (if she's older), and maybe some other therapies as well. Dr. Karreman would try various combinations of treatments – whatever it took to initiate a healing response in the animal.
At that time, he might have been a little quicker to suggest antibiotics (than now). He personally had nothing against antibiotics, but most of the farmers he worked with were looking to use homeopathics rather than antibiotics. That's where he started hitting the glass ceiling with homeopathics. At the time, Dr. Karreman happened to be reading a book by James Duke and Steven Foster called A Field Guide to Medicinal Plants (Eastern and Central North America) (Houghton and Mifflin, Boston, 1990).
He began reading that some plants, like caulophyllum (blue cohosh), arnica, and aconite, are also used in botanical medicine for roughly the same physical indications as in homeopathic medicine. He realized there was a lot of overlap. But physicians from the Eclectic school of medicine and native Indians would use actual botanical juice, but in small amounts -- whereas homeopaths use only the energetic essence of the plant to treat similar conditions. So Dr. Karreman thought, "Why not use both?"
That was back in 1999 or 2000. Now when he uses homeopathics, he likes to use what he calls multi-potency homeochords. He still must "diagnose" (select) the correct remedy. He still needs to know what the remedies are called. But once he knows 3-4 indications, he knows what remedy is most appropriate. He then uses it in a multi-potency combination:mother tincture 1X, 2X,4X,12C, 30C and 200C – equal parts of ever increasing diluted and vigorously shaken original plant material.
Selecting the right remedy, and providing some of the juice plus some of the homeopathic energetic essence, in Dr. Karreman's opinion, stimulates a deeper healing response than using just one or the other.
Back to the Future: Searching for Effective, Fast-Acting Alternatives to Antibiotics in the Treatment of Dairy Cows
I asked Dr. Karreman if his multi-potency homeochords led to some of the really neat non-antibiotic products he sells through Bovinity Health.
He explained that in working with certified organic dairy herds, there are federal rules that must be followed – some of which Dr. Karreman helped shape during his five years as a member of the National Organic Standards Board. From the beginning, antibiotics have been prohibited from use with certified organic livestock in the U.S. If they are administered to an animal, that individual is removed permanently from the herd and from organic production. In small herds like those found in Lancaster County, where there may be only 30 to 50 cows, removing one animal is significant as compared to removing one cow from a herd of say, 3,000.
Many of the farmers Dr. Karreman works with began becoming certified organic back in the late 1990s, and the number has been growing ever since. He estimates there are about 150 certified organic dairy farms in the county he serves, which has a very high density of dairy farms in general compared to other regions of the country. So Dr. Karreman had a great training ground for practicing veterinary medicine without antibiotics, as well as hitting a glass ceiling with homeopathics, integrating botanicals into therapeutic protocols, and being open to using whatever was needed to stimulate a healing response.
As Dr. Karreman explains, however, when it comes to working with dairy farmers, a veterinarian has about one shot to get it right. It's not like working with homeopathics with small animals, where you can peel the layers away gradually to get to the root cause and the right treatment. Large animal or farm animal holistic medicine treats animals in production that must be back on their feet as soon as possible. Dr. Karreman needed effective, hard-hitting alternatives to antibiotics to treat those animals.
So he decided to look back in time. He began buying veterinary books from the 1920s and 30s. That time represented the pinnacle in terms of the use of botanicals and other substances like mineral-based medicines. But what was really interesting to Dr. Karreman was the use of biological medicines. They were basically antibodies derived from horses. They were used for humans as well, for diphtheria and measles. They also used equine-derived antibodies for calf scours (diarrhea), hog cholera, and equine flu. These therapies made sense to Dr. Karreman – they were rational and scientific. But they were lost to history with the advent of pharmaceuticals, especially, the miracle of antibiotics.
But as Dr. Karreman points out, we've overused antibiotics to the point that we now have widespread resistance to those drugs, including in human medicine. And he wonders why the medical community doesn't think outside the box just a little bit and look at what was used before there were antibiotics.
For example, hyperimmune serum (plasma) was used before antibiotics, and Dr. Karreman has been using it for the last 15 years. He uses hyperimmune plasma primarily to treat systemic illness when there's a fever, even if he doesn't know the exact root cause. He also uses botanicals and fluids in the vein.
Treating the #1 Health Problem of Dairy Cows Without Antibiotics
I asked Dr. Karreman if he treats a lot of cases of mastitis in his work with dairy herds. He replied that indeed mastitis is the number one problem on dairy farms, similar to the problems of colic and lameness in horses. Many animals develop a weak or overused organ based on the intended purpose of the species.
When it comes to mastitis in cows, Dr. Karreman explains that farmers like to put things in the quarters (mammary glands) of cows to treat mastitis. Antibiotic tubes can help and they're easy to use. But farmers also like to use botanicals like aloe, for example. They unscrew the bottle top, fill up a syringe, attach a cannula, and insert it in the teat. They do it because that's where the milk comes out. They think if they put something directly into the teat, it will help. And sometimes the area really does need local irrigation with an antiseptic.
Dr. Karreman makes the point that there are a number of antibiotics used for mastitis, and while they are sometimes appropriate, he believes many times they're not. Just as food-producing animals can't be off feed for too long – they have to get feeling better so they will eat – dairy cows can't have mastitis for too long. The problem needs to be resolved.
One of the products Dr. Karreman created was a tube just like pharmaceutical companies use that is essentially sterile. It contains a combination botanical product that has antibacterial, anti-inflammatory and pain relief properties. He has seen the product work very well in his practice. And at North Carolina State University, for data towards her thesis, Ph.D. student Keena Mullen researched the efficacy of Dr. Karreman's botanical formulation to treat mastitis in drying-off cows (lactating cows that are being rested to regenerate mammary tissue)
This past November Mullen was the first person in the U.S. and maybe the world to receive her Ph.D. in the non-antibiotic treatment of mastitis. Dr. Karreman was pleased to be in the audience during her dissertation defense. Mullen did four research projects showing efficacy compared to no treatment. When compared to antibiotics, the results aren't as clear-cut, but her research demonstrates that there's an alternative to the reflexive use of antibiotics to treat mastitis.
How to Know if a Farm Is Certified Organic Just by Looking
I asked Dr. Karreman if he's seeing a growing interest by farmers in alternative veterinary treatments, and also in becoming certified organic.
He replied that he thinks the conventional agriculture community thought the organic sector would just fade away. Of course it has not, and in fact, certified organic farming is probably agriculture's brightest light.
The conventional farming community is starting to look at the organic community and asking, "What are they doing? They're still around." Dr. Karreman says he likes to act as a bridge between the two worlds. He's immersed in the organic world, and likes to be a bridge to the conventional world. He says many conventional veterinarians who work with organic dairy farms come to him for information, and he enjoys sharing it with them. Not only does he feel appreciated, he feels if he can impart rational-based information to vets about natural treatments, it will help elevate veterinary medicine to the next level. That is his goal. Dr. Karreman knows if he can encourage the use of more natural treatments in agriculture, it will make for a better world in the long run.
I asked Dr. Karreman, if he were to walk onto an unfamiliar dairy farm, how quickly he could tell whether it was certified organic. What does he look for?
Dr. Karreman answered that traveling the roads in Lancaster County where there are many Amish dairy farms, it would be impossible to tell which are organic and which aren't. Except for one thing – the main thing. According to federal law, certified organic farms must provide livestock with at least 30 percent of their dietary dry matter intake from grazing during grazing season. By contrast, more and more conventional farms confine their animals inside. So when you see dairy cows outside, especially in small groups in a sort of strip formation, grazing well-managed, lush green land, chances are you're looking at an organic dairy farm -- either an organic farm or a farm that is actively transitioning to organics. And if you should come upon a conventional grazing operation, chances are it will be transitioning to organic farming in the near future, because it's not a big leap to move from a good quality conventional grazing farm to an organic operation.
Dr. Karreman's Ideal 'Vaccination Program' for Dairy Cows: Dry Bedding, Fresh Air, High-Forage Diets, Smart Grazing, and Sunshine
Dr. Karreman says that inside a barn, at least in his area of the country, you might not be able to tell whether it's organic until you open the medicine cabinet and notice a lack of the usual antibiotics in injection bottles. And if you look at the feed, you'll probably see more hay, because high-forage diets are used in place of high-concentrate diets.
In his experience, Dr. Karreman has seen that organic dairy cows can develop every single problem a conventional cow develops, but there will be significantly fewer problems in the herd overall. There can be cases of salmonella and gangrene on any farm, but you'll see far less digestive problems, for example, on organic farms.
That is because the animals are being nourished in a species-appropriate manner. They're eating what nature intended them to eat. There are no drugs or resistance issues clouding the picture. I asked Dr. Karreman if less nutritional stress in organic cows means less physiologic stress. Because not only are they eating well, they're outdoors, exercising, and breathing fresh air. I asked him if he considers stress a contributor to disease in large animal medicine.
Dr. Karreman answered that he believes a high density of animals living together in confinement is extremely stressful. He said he could go on and would sound pretty negative, and doesn't want to be too critical of conventional farming. He does feel that dry bedding, fresh air, high-forage diets, smart grazing, and sunshine – which Dr. Karreman calls "the best vaccination program there is" -- go a long way toward raising healthy animals that are able to express their natural behavior, and are therefore less stressed.
The Challenge of Persuading Large Animal Vets to Consider Treating Farm Animals More Naturally
As many of you know, I'm a vegetarian. I need to know that everything I put in my mouth had a happy, healthy life. I'm not opposed to death; I'm opposed to bad living. Death is totally natural, but having a bad life is not.
Happy, healthy animals turn into happy, healthy meat for human consumption. It's a concept holistic large animal vets know all about. Unfortunately, there are very few holistic large animal practitioners around. I asked Dr. Karreman if he sees his arm of the profession growing.
He replied that he thinks the interest is there in how to treat farm animals more naturally, as long as the residues of natural treatments can be shown to be not harmful to the human food supply. That's a big thing for food animal practitioners – they are always asking, "What about the residues?" And it's a valid point.
Dr. Karreman believes the organic and natural food processors should be raising funds to look into the residue question. The botanical mastitis tubes he developed were looked at by the USDA's Food Animal Drug Residue Avoidance Databank at NC State. The agency looked at the residues of those tubes in lactating dairy goats. So he has actual data he can provide, and he hears the sighs of relief from large animal vets when he presents the study to them.
Dr. Karreman also conducted an online survey in 2010 while he was recuperating from heart surgery. He queried his bovine practitioner colleagues. He asked if they or their farmers were interested in complementary and alternative veterinary medicine (CAVM). He received 185 replies, and about 92 said they were interested. Then he asked, if CAVM is presented from a rational, pharmacologic standpoint, would they be interested. Out of the same 185 replies, the number of those interested jumped from 92 to 147.
What this tells us is that as long as things are explained clearly and there is no harm to the human food supply, dairy or farm animal practitioners – not necessarily the academics, but the practitioners – are open to using alternatives where it makes sense. According to Dr. Karreman, that's also why, unfortunately, classical homeopathy will never be very applicable with practitioners.
Veterinary Medicine as Both Science and Art
That pretty much pinpoints where we're at with homeopathy in small animal holistic medicine as well. We need research. Veterinarians are by nature scientists. We like to see clinical data. But research is expensive, and it's hard to find funding for studies in alternative medicine. We need the ability to prove what we know to be true.
Dr. Karreman responded that it's interesting that all veterinarians are trained as scientists. In practice, however, it seems vets are either more science-based, or, like Dr. Karreman, are more about bedside manners and clinical impressions. He says he knows that term isn't well-liked in the academic world, but there really is art in the practice of veterinary medicine. And he likes to maintain a good balance between art and science. He believes if you're too scientific, you're just too cold.
I absolutely agree, and like Dr. Karreman, I also practice intuitively as well as scientifically. That's another term that isn't well-liked – intuitively. Many veterinarians are confused by the concept, and it can even make them a little defensive. I have had personal success with treatments that I can't explain scientifically – I just know they work. That doesn't go over well when I try to explain it to other practitioners. And that's where studies would be of great benefit in helping our peers learn and evolve.
Dr. Karreman recently gave a talk to students at Cornell University. During his discussion of different modalities, he brought up the biologics that were used in the 1920s and 30s against infectious disease. He also talked about botanicals and their rational pharmacologic basis. He talked about acupuncture as well. But he announced that he wouldn't be talking about homeopathy (it's a strategy he uses). His goal is to get students interested in thinking outside the box, and inevitably after his talk, two or three students who want to learn about homeopathy will approach him and they'll have a conversation on the side.
Dr. Karreman says he typically gives his presentation, and then if there are people who want to talk more in-depth about, for instance, laying-on of hands, he's happy to talk with them about that.
My Sincere Thanks to Dr. Karreman!
I expressed to Dr. Karreman that he and I practice very similarly. I will try whatever is available of a non-toxic nature to help my patients heal. Sometimes it's a strange, weird protocol and I can't explain it. Other times, it's very logical and I can provide recent research to explain my approach. But the goal is always to help patients improve.
What's wonderful about Dr. Karreman's career is that he's been able to forge his own path in large animal medicine and be successful without using a lot of chemicals. And he's able to draw from treatments in use before we had antibiotics, which is really neat – all that forgotten veterinary medicine. Dr. Karreman jokingly remarked that he really likes that term, and he may just start titling his presentations "Forgotten Veterinary Medicine." He says he'll credit me, because it resonates!
I so appreciate Dr. Karreman's generosity in spending time with us today. It's refreshing to meet a holistic large animal practitioner, and he is actually the first one I've ever met! I look forward to watching the evolution of his techniques and practices. I hope we'll be able to speak again in the future.