Hello, it's Anthony Chadwick for the webinarett welcoming you to another episode of Vet Chat, the UK's number one veterinary podcast. I'm really honoured today to have a good friend of mine, Virgini Guffau, on the line. I met Virginny just prior to the pandemic actually, we were at a meeting together.

Who would have thought that it would be 4 years before we met again? I was over in Belgium. I've always wanted, out of interest, I'm a bit of a history buff, and I studied at O level, GCSE level, revolutionary history, 1789 to 1870 in Europe, and Virginia lives close to a famous, little village called Brain Dalo.

Of course, nobody will know where that is or what that signifies Virginia unless you live in. In Belgium, but of course, if we were going to be completely accurate, the Battle of 1815, which we call Waterloo, I actually live in Waterloo, should be called the Battle of Braindelo, shouldn't it? Exactly, yes.

So the, the monument to this famous battle where Napoleon lost to the Duke of Wellington. Is in, but the monument is in Waterloo, so they have the claim to fame, even though it's not geographically accurate. Well, I think the reason I'm, I'm told that the battle was called Waterloo was because Wellington, actually stayed at the big hotel in Waterloo the night before the battle, and that was his battle headquarters as it were, and hence why, why it's called Waterloo.

And who knows, had it, had it not been called Waterloo, Brain Delo, then of course I might now be living in a suburb of Liverpool called Braindelo, but I live in and then we wouldn't have that great Abba song, would we? Well, yeah, Brain Delo doesn't trip off the tongue quite as easily, does it? It's not quite as aesthetically pleasing to the tongue now, so.

But it was great meeting you before Christmas. We had a good chat about a number of topics, some of which we'll cover during the podcast. But I think just so people kind of get to know you better before we, we start on the podcast proper, people will notice that you're living in Belgium now, but there is a touch of a, of a, Atlantic, mid-Atlantic or transatlantic accents.

So tell us, how has this all happened? Well, so yes, I am Belgian in origin and my parents are are Belgian, and when I was 5, my father's job transferred him to a country town in southern Tennessee. And so this is where I grew up in the country, with a lot of horses, and not my horses, unfortunately, but a lot of horses, cats and dogs, and farm animals, and then then we moved up to Nashville, the capital of Tennessee, and I went to Vanderbilt for my undergrad and biology, and then I went to UT vet school in Knoxville.

And, yeah, so, and then proceeded to move around the country for various jobs and veterinary medicine, large animals in North Carolina, small animals in South Carolina and New Jersey, and then I worked for Verback Pharmaceuticals in Texas and shearing plough in New Jersey, and then somehow managed to move back to Belgium in 2003, so that's where I am now. I spent a very enjoyable Easter last Easter in the state of Tennessee. Based myself mainly in Nashville with my wife.

My wife, is, is a big Dolly Parton fan, so I've been to Nashville before. I won the Frank BT Travel scholarship in '97 to go to the Dern conference there and to spend three weeks with Danny and Danny Scott and Bill Miller, at the, at the vet school in in Cornell. So I'd been there before, she was very keen to see it.

We went down to Memphis to see the, sight of, well, obviously Elvis, the king, but obviously there were the other king sadly died in Memphis, so we saw his motel where he'd been tragically assassinated. And then finally we moved up to Sevierville, where of course Dolly comes from, it's pronouncedville. Seville.evierville, where where the, the Smoky Mountains and Dollywood is and we had a great holiday.

It's a, it's a beautiful state. And in fact we actually dodged a tornado which made life quite exciting on the way down to Memphis, so all, all exciting stuff. So, basically moving back to to Belgium in 2003, and, and obviously, you know, during your time as a vet, you've been very involved in academia, in practise, in pharma, also with EBBS.

Doing something, you know, as an educator into clients as well, haven't you just tell us a little bit about EBVS. Yes, so, in 2019, and, and this, this kind of ties in with my, my, the chronic disease story which we're gonna tell here in a minute. You know, I, I wanted to do something on my own, something where I could manage my own time and chronic illness at the same time.

And so I decided I thought, I thought that starting a company would, would be easier on my body and mine. It wasn't, but, I, it's the, it's the best years that I've spent, I think professionally. So I started a company that aimed to provide a video, video education by interviewing to to the general public, to pet owners.

By interviewing the top specialists in Europe. And so, through a partnership with the European Board of Veterinary Specialists and relationships with just many, many delightful specialists in Belgium, France, and the Netherlands, created over 500 short educational videos for pet owners on everything from chronic disease, I'm sorry, everything from, from, preventive care, how to pick a pet to breed-related diseases, age-related diseases, you know, heart diseases in the dog and cat, breed, der dermatologic diseases, etc. Parasites.

And so, yeah, just and and created wonderful relationships and friendships with that. And so right now working with a a digital education company to try and and get those into a good format that'll be easier to to share with the public. Fantastic, Virgini.

You know, it's interesting as vets we're very much at the front line fighting disease, foot and mouth pandemic in the UK in 2001, you know, as an example which, Obviously it was a terribly stressful time, you know, for large animal vets, but I remember as a student, and as a young vet, I went out to a lot of farms taking bloods to check for brucellosis. So TB, the dairy herd at that time in the 1990s, we were concerned about TB, we still are. But brucellosis, I think we more or less eradicated by blood tests, etc.

And I think, you know, I was fortunate in, in the sense that it was 19, the, the late 80s, early 90s when I was doing a lot of this testing. And in some ways it was incredibly rare brucellosis then. But of course brucellosis had been a, a serious debilitating disease, not only for cattle, but, you know, particularly for, for vets, stockmen who are coming into contact with those animals.

Obviously people drinking non-pasteurized contaminated milk. And the disease that actually came about was a disease called undulant recurrent fever, and it was so bad and so up and down, people would have fevers, they would get depressed with it. And you know, vets took their own life.

And obviously, . You know, we'd met in 2019, not been able to meet since, and I think the value of those face to face meetings in a lovely cafe in Waterloo was we were able to spend some really good quality hours together, really delving deep into this whole area of chronic illness. I mean, it is just seem to be a problem that's increasing.

And it was fascinating to, to learn about your particular story, you know, about some of these tick-borne diseases like Lyme's disease, but also, you know, Bartonella, cat scratch disease in in humans. 30% of cats carry this, we know it's also carried via flea bites as well. So there's lots of potential for us to catch things as, as vets.

Yeah, but perhaps this is an area that, you know, post that Bruceella recurrent fever that I think was very well recognised and certainly by the 90s and thank God we were, we were moving away from it because we'd managed to eradicate brucellosis to a, a large extent. Now with global warming, tick-borne disease, if anything, is becoming more common ticks are becoming more common, they carry some nasty infections, fleas also. So tell us a little bit about .

You know, your story around chronic illness and maybe also we can delve then later on into some of these particular diseases as well. Yeah, sure. So, you know, I've, you know, I've, I grew, you know, grew up around animals from a very early age and, and so that's, you know, way before I ever thought about becoming a veterinarian and then of course, you know, you're around a lot of of of animals and .

I think that as veterinarians we sort of see ourselves as invincible, you know, I think, you know, we, if we get a cat scratch, we'll kind of blow it off or whatever. Oh, you know, it's OK, I'll just put a little soap on it, don't worry about it, you know, and, and so we, we do, I think, have this sort of invincibility, idea of ourselves, and Not only that, but we feel almost feel like our lives are are and our health is much less important than the health of our patients, and so I think maybe we pay less attention to our own health. Than to that of our patients.

So I think that's just maybe a a general statement that I'd like to make about what kind of people we are, you know, and we're also, I think we tend to be very focused people and people who are hardworking and who, you know, shrug off discomfort, for the sake of, of, you know, of our mission, our passion, which is veterinary, you know, treating animals. And The other thing I like to say is that chronic disease is, is a nasty little thing because it sneaks up on you. It sneaks up on you and, a lot of times it's invisible.

And so, you know, you, chronic disease for you may be, you know, constant low grade or, or maybe fluctuating levels of pain or fatigue, you know, chronic fatigue, and it may be depression, it may be anxiety, and it may be difficulty in, in getting over a viral infection, and you're just like, ah, you know, I'm, I'm maybe, and, and, you know, combined with, of course, what we know about the medical profession and in particular the veterinary profession, which is a very stressful environment to work in, it's very demanding. We know about the time pressures. We know about, you know, now with with the internet, the kind of social, social media pressures that we that we have and people, you know, giving you bad reviews and then people being more and more demanding.

So from a psychological point of view, a veterinary medicine is It is more difficult now and Also, I think for Ginny, you know, a little bit hidden. I met you in 2019, I had no idea. You would have had no idea you were battling against, you just came across as a very vivacious woman.

So people don't recognise it, and I suppose a bit like the kind of mental health thing which has come on so much. We, we maybe aren't as . Compassionate and sympathetic towards it either compared with, you know, somebody who's got a broken leg, that's very obvious, isn't it?

That's correct, yeah. Yeah, it it it isn't obvious and, and, you know, of course, we, we do our very best to hide it, because it doesn't, people don't like hearing people complain about how they feel. And we always want to put our best foot forward, and so we're gonna hide if we don't feel good, as much as possible.

And so, You know, I had been, I've been dealing with decades and decades of low, medium to high level of chronic pain, decades of it, and fatigue and depression sometimes and anxiety, and By and large, you know, I've, I've got a few sort of radiographic abnormalities in my spine and some arthrosis, and, I, I was like, oh well, I guess it's just because I'm, I'm a little arthritic and maybe I just pushed myself too hard and maybe that's why I'm tired, blow it off, blow it off, blow it off. And then in 2015, at age 47, out of nowhere, I was training for a half marathon, so I've always been very athletic. Health conscious in my diet.

I've never really drank or smoked or anything like that. And so I don't nowhere I have a heart attack. And they detect that I have quite a lot of arterial debris, quite a lot of atherosclerosis, which has no reason for being there.

They're like, oh, we don't know, or, and, you know, I'm kind of a high strung energetic person, so they're like, oh, maybe, you know, it's stress and it's takosubo, which is that heart attack that comes from, you know, great stress. I have stress like everyone else has stress, you know, do I think it's stress worth causing a heart attack? Not really.

And so the The diagnosis was, you know, arterial plaques, don't really know why it happened, don't really know why you have plaques. Just take aspirin and you'll be fine. So 6 months later, I become crippled with debilitating pain.

And brain fog and cognitive disorders, memory loss, really inability to focus, and, you know, calculating abilities, that are, that are diminished. And then I go to see some doctors and a rheumatologist says, oh, you have fibromyalgia and chronic fatigue. So he prescribes painkillers and sleep medicine, and says, good luck with that.

None of that works, of course. And so as the years go on, I become progressively more, more in pain, and more exhausted, and, you know, I I'm still trying to hold down full-time jobs in the pharmaceutical industry, and it's becoming impossible. The doctor puts me on disability here in Belgium.

And then I'm like, you know, as, as a person of kind of our ilk, the veterinary ilk, I am like I have to do something. I have to work and so I created this aimed solutions thinking that it would be easier, but it wasn't. It was much harder.

And in doing my EBVS specialist interviews, I came across this wonderful woman who's a small animal internal specialist, internal medicine specialist, who told me her story about Bartanella, and she said, you know, I have, I was wheelchair bound for several years of my life, and I've been suffering with, you know, this, with neurologic problems, and of course, extreme fatigue and pain. And didn't know what to do, went to many, many doctors and couldn't find relief. And she said, then I went and and was referred to this doctor, the specialist in Flanders in Belgium.

He saved my life, and I was like, whoa, that's a big deal. He saved your life, he says, and she says, I'm, I'm back to normal. I'm back to myself after 7 years of debilitation.

And I was like, OK, I guess maybe I should see this guy. So, I made an appointment with this doctor last summer, summer 2023. And he looks at me and he listens to, he does a thorough anamnesis, and he listens to my history, my medical history, and he looks at me and he looks at my, you know, and he does a physical exam, and he says, I'm 90% sure that you have active infections with 12, or 3 of the following organisms, Babezia, Bartanella, and Borrelia.

And that you have an autoimmune syndrome that is the result of this, and that this is the cause of your your decades of chronic illness, and that's probably the cause of the heart attack that you had, and I said, OK, you know, sounds a little witch doctory. All right. So, I had to sign an agreement to do all the testing you wanted to do because it was gonna cost me thousands of euros, which it did.

And 2 months later, after all the tests came in, he says, I have good news. And I said, OK. He says, you're gonna be one of the few people in this world who gets healthier with age.

And I said, OK. He said, you do in fact have Babezia, active Babezia, active bartella, and active Borrelia, not limes Berea, but other species of Berelia which cause something called relapsing fever. So Lyme is negative, but positive for other Borrelia.

You also have active Epstein-Barr virus, which has been kept active by the extreme immunosuppression that you're dealing with with these parasites and bacteria. You also have small intestinal bacterial overgrowth, you have low blood volume and barrow receptors that don't function. You have irritable bowel syndrome, and you have Temporary dementia, you have cognitive impairment.

As a result of these bugs, affecting the nervous system in a very, very negative way, which can also lead to, you know, severe depression as well. So, you know, that all falls into line. And your heart attack was due to the Bartonella.

Bartonella invades the endothelium. And causes atherosclerosis and can even affect the myocardium directly. So he's in one big diagnostic effort.

Has given me the precise reason why I've had decades of health problems. And And of course it's interesting, Virginie if. You don't, if you're not aware of these diseases, you know, if it, if it's not on your differential diagnosis list, you'll never actually make that diagnosis.

So if doctors aren't thinking about this and we as vets aren't thinking about it, then it's not gonna be diagnosed. And then even if we do think about doing tests, of course, not all tests are 100% sensitive, specific and accurate, so. They can be missed and I know you kind of have got some information about that.

You know, I remember when I newly qualified and a pathologist got me to do a test and then said, well, because of that test, it was a urine cortisol creatinine ratio. This dog that you've got has Cushing's disease, and as a young vet I took the pathologist at his word. And of course it wasn't, you know, one of the diagnoses it could be was Cushing's, but there were other things going on.

So it's important that while we know that there's a lot of really clever pathologists around, we shouldn't treat them as gods, you know, they like us also make mistakes and and make incorrect diagnoses, don't they? Well, that's correct, and it's not just, it's not, it's not just the pathologists, it's the tests themselves. So, especially with these kinds of infections, there for, for the majority of the tests that you can run on these, there's an enormous amount of false positive and false negative across the board.

Some organisms, and I'll just use, Barton, or sorry, . Borreli as an example, is particularly hard to test for because not only does it, does it have a lot of antigenic variation that allows it to escape detection and also escape treatment, but it creates a biofilm around itself to hide in the body. And so, if the doctor doesn't know that you need to first treat the patient with a little over a week of a supplement that will dissolve that biofilm.

That will make it detectable, you're going to get false results. Not only that, tests that are currently available for for Berelia species are simply inaccurate. The only test that this doctor, swears is, is actually accurate is a phage PCR test.

So if the phage is present, the Borrelia is present, but that's the only test he trusts, but there are so many Borrelia tests out there that are simply inaccurate. And so there, you know, we're talking about a A diagnostic and therapeutic, problem that is global, that that lies in that doctors, most doctors don't know about these diseases and the co-infections, you know, most ticks that will bite you will, will be carrying and transmitting more than one disease that are not looked for. If it's not lined with the bull's eye, doctors don't think about, you know, that being a possibility.

If you don't have super swollen lymph nodes, they don't think about Martinella. They don't understand chronic infection and, you know, and then you have to know, yeah, which tests and how to interpret it in a very holistic anamnesis of the patient. Very few doctors have those capabilities and also relationships with laboratories that can give accurate results.

So I think for Ginny, the the other thing that you mentioned is, obviously the expertise, but also he spent a significant amount of time with you in that first consult, which allowed him to take a really, really good history and I found the same thing. With my dermatology service, obviously I knew a little bit more than than most vets would know about dermatology, but I think the biggest gift I had, blessing I had was the fact that I could spend an hour with the client, particularly that first consult, spending time on the history, watching the dog as I was taking the history. And quite often by the end of that 20 minutes, half an hour, I was pretty sure I knew the one or 2 or 3 things it could be, and then it was just a case of bringing the tests in to actually differentiate all that, which, you know, clearly would take a little bit more time, but sometimes I remember, you know, I remember two young doctors brought in a dog.

And you could see the dog was itchy and scratchy for the 20 minutes, it was there, of course, the one question, do you have lesions as well? These were both young GPs. Oh yeah, we scratch quite a lot as well.

Mm. Well, I think I might know what's going on here. But of course that was all just down to taking good history and then of course being good at finding scabies mites on a scrape, and if you couldn't find them on a scrape, you could do a blood test.

Yeah. So the, the history and having that extra, he obviously has a lot more knowledge, but that extra knowledge in that area is critical, isn't it? Yeah, it is, and, and most GPs won't have that kind of time, or or knowledge, yeah.

So, what, what I'm doing right now, as you know, Anthony, is that, you know, I'm sort of on a mission to sensitise not only veterinary professionals, but also other people who are at high risk for contracting these types of diseases, you know, anyone who works outdoors. You know, and hunt hunters, environmentalists, you know, farmers, to, to this, and also to develop, almost a service to help people navigate the healthcare system because it's not, it's not always easy, you know, in the US and I think maybe in the UK, you can't just get like here in Belgium, we can just make an appointment with a specialist, you know, if we get the the name of a great specialist, we can just make an appointment with that specialist, you know. In the US, you generally, if I'm, I mean, I'm not up on it yet.

I need to do more research, but you have to go through your GP and get approval to go see a specialist, then maybe they'll decide which specialist you can go see. You don't necessarily have a choice of which labs are doing, you know, or analysis on your on your samples. So, These are all things that I'm still working out to to help people navigate this.

Anyone who's suffering from chronic fatigue, myalgic encephalitis, fibromyalgia, long COVID, chronic Lymes, depression and anxiety, especially if they have any kind of gut issues. These are people who are at a very high risk of being infected without knowing it. With something that's very treatable.

That's very treatable, and I think that's the main message here is that, maybe what you have isn't just a chronic illness that you're going to have to deal with for your whole life and try dealing with with symptomatic care. Maybe this is something that with the right specialist can be cured and I know we're running out of time, so I'd like to just sort of close with my own situation. I, I've I've been on 6 weeks of intense antibiotic therapy, intravenously, I was on 3 different antibiotics.

I was on metronidazole, a 3rd generation cephalosporin and doxycycline for 6 weeks. And now I've just finished an 8-week course of treatment with disulfira, which is an abuse for alcoholics, but it also has antibacterial properties. And whereas I was living with pain levels that were, you know, between 7 and 9 out of 10 every day.

My pain levels are now down to 0 to 2 or 3 every day, whereas I woke up. You know, if I was able to sleep, I would wake up 1315 times a night, or I just wouldn't sleep at all for the whole night, zero sleep, and definitely non-restorative sleep. Now, I'm sleeping through the night, most nights.

So, You know, I'm a, I'm converted. I'm a believer, and I'm not the only one. Of course, you know, I, you know, he has many, many, case, cases that he has told me about.

I'll just give you 11 sort of last amazing example, which is, a, a Green Beret, soldier who had been bedridden for 4 years. He had been bedridden, seen all kinds of doctors, and his commander somehow, Villavia found in the name of this specialist, and he brought him to the specialist who diagnosed pretty much the same bugs that I was diagnosed with. He treated him.

It was about a year's worth of treatment, which is about what I'm gonna have, about a year's worth of treatment. And within a year, this bedridden soldier, 4-year bedridden soldier, was back on active duty. And his commander said, you know, doctor, you have just given me back my best soldier.

Yeah. And that's just one of many, many stories like that one and me that are just propelling me to say, you know, to reach out to people at risk. Well, I only have one word for Ginny.

Hallelujah. Hallelujah Hallelujah. That's right.

It's, it's so, you know, it was such a powerful story. To chat to you, you know, when I came to Brian Deer and. I think it's certainly something that I hope will spread with the help of the podcast and I know obviously at the end of the podcast, you can see various links to various things, you know, including your own details.

Yeah. To, to let people, you know, come into contact and chat and . See if we can help more people out because it's great when you've got something that is supposedly chronic, you're never gonna get over it and then somebody actually tells you, no, we can sort this out.

Yeah. I know they, they . The doctors based in the the Flemish speaking part of of Belgium, but presumably there are other people throughout the world that are also, you know, in that kind of group of people.

Yeah. With this doctor who kind of recognised that there are things that were, that we're missing. I know, I remember reading about toxoplasma causing all sorts of issues as well, so it's not just these three bugs, there are other bugs, and as you said, even with long COVID.

There can be other things going on. It's not just an inflammatory, right, this is it, not in all cases, obviously, but, we, we've seen the effect of, viruses, protozoa, bacteria and causing all sorts of. Yeah, I mean, other big ones are anaplasma, Erlichia.

These types of organisms are also, and, and just to specify, you know, many people think, for example, that relapsing fever is transmitted only by soft ticks. It's not true. So hard ticks, you know, dermisant or exotes, these are ticks that can transmit all of these.

Bacteria, parasites, viruses, moulds, toxins in one bite, and I said, I said to the doctor, I've never been bitten by a tick. I've never found a tick on me, he said, that's normal. He said only 20% of people who have ever who have been bitten by ticks ever know they've been bitten by a tick.

Generally we're talking about nymphs that take a short bite. It's not true that they have to be attached for 3 to 6 days or 1 to 3 days, to transmit Lyme disease even. They can, they can bite for just a short amount of time, drop right off, you'll never see that in them.

And of course we've probably all had a flea inhabit us in the, in the job that we do and obviously can be significant. And I think maybe one of the little prophylactic messages for people is I. Invariably if I go out into the countryside to walk, you know, I like bird watching, etc.

I will always wear long trousers in that situation and put some on the bottom of your pants. Yeah, exactly, just to protect against these things as well. But, but Ginny, it's so gratifying.

I saw you about 5 or 6 weeks ago. You look even better than you did, 5 or 6 weeks ago and you can, you can see that there's . There's a little, you know, kick in your step now which is which is great.

So, obviously we'll have details post podcast that people can get in contact with you, and obviously there's a lot of information out there that you can share as well, but just thank you for coming on. I think it's. When we've been through an experience ourselves, it's so good to be able to then go out and teach other people about it, isn't it?

Yeah, I really thank you for the opportunity, Anthony, because You know, I think this could change a lot of lives. Yeah, no, I, I, I am concerned that it's a, you know, that it's a bigger problem than we perhaps realise, so it's something we should be looking at. Virginny, thank you so much for coming on.

You know, I really appreciate it. Thanks everyone for listening. Please do get in touch with Virginny if you've got any questions.

And of course, yeah, welcoming you to another podcast or webinar very soon. Virginny, thanks again and thanks for. Have a great day.

Thanks a lot. Bye bye.