{"id":15576,"date":"2026-03-05T21:53:09","date_gmt":"2026-03-05T20:53:09","guid":{"rendered":"https:\/\/www.ngdcare.nl\/uncategorized\/why-doesnt-one-protocol-work-for-all-patients\/"},"modified":"2026-06-26T12:57:04","modified_gmt":"2026-06-26T10:57:04","slug":"why-doesnt-one-protocol-work-for-all-patients","status":"publish","type":"post","link":"https:\/\/www.ngdcare.nl\/en\/blog-en\/why-doesnt-one-protocol-work-for-all-patients\/","title":{"rendered":"Why doesn&#8217;t one protocol work for all patients?"},"content":{"rendered":"<p><!-- NGD CARE BLOG: Waarom herstel bij ieder dier in een ander tempo verloopt --><br \/>\n<!-- Plak dit in een Custom HTML blok in WordPress \/ Elementor HTML-widget --><\/p>\n<div style=\"font-family: Georgia, serif; font-size: 16px; line-height: 1.75; color: #1a1a1a; background: #f7f5f0; margin: 0; padding: 0;\">\n<p><!-- HERO --><\/p>\n<div style=\"background: #162920; color: #ffffff; padding: 64px 24px; text-align: center; position: relative;\">\n<div style=\"max-width: 680px; margin: 0 auto;\"><span style=\"display: inline-block; background: #d5cd47; color: #162920; font-family: Arial, sans-serif; font-weight: bold; font-size: 11px; letter-spacing: 2px; text-transform: uppercase; padding: 6px 16px; border-radius: 2px; margin-bottom: 24px;\">NGD Care | Dog &#038; Cat<\/span><\/p>\n<h1 style=\"font-family: Georgia, serif; font-size: 2.1em; font-weight: bold; line-height: 1.25; margin: 0 0 16px 0; color: #ffffff;\">Why recovery happens at a different pace in every animal<\/h1>\n<p style=\"font-size: 1.05em; font-weight: 300; color: rgba(255,255,255,0.72); max-width: 540px; margin: 0 auto 20px; line-height: 1.6;\">The same protocol, a different pace. What this difference says about your animal&#8217;s biology. <\/p>\n<p style=\"font-size: 12px; color: rgba(255,255,255,0.35); margin: 0;\">NGD Care | Stefan Veenstra, DVM<\/p>\n<\/div>\n<\/div>\n<p><!-- INTRO --><\/p>\n<div style=\"background: #ffffff; padding: 48px 24px 36px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<p style=\"color: #4a4a4a; margin-bottom: 14px;\">In practice, we often hear this. One dog starts with an intestinal or skin protocol and within two weeks owners see clear improvement. Another dog follows exactly the same trajectory, but only after two months does there start to be movement.  <\/p>\n<p style=\"color: #4a4a4a; margin-bottom: 24px;\">That is not a failure of the protocol. That&#8217;s biology. <\/p>\n<div style=\"border-left: 4px solid #d5cd47; padding: 16px 24px; background: #ffffff; margin-bottom: 8px; font-size: 1.05em; line-height: 1.75; color: #2b5040; font-style: italic;\">A protocol is not a drug that suppresses a symptom, but an intervention that helps the body restore its own balance.<\/div>\n<p style=\"font-size: 13px; color: #8a8a8a; margin: 0;\">\u2014 NGD Care \u00b7 Integrative Veterinary Medicine<\/p>\n<\/div>\n<\/div>\n<p><!-- SECTIE 01: MICROBIOOM --><\/p>\n<div style=\"background: #f7f5f0; padding: 40px 24px 8px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<div style=\"font-family: Arial, sans-serif; font-size: 11px; font-weight: bold; letter-spacing: 2px; text-transform: uppercase; color: #2b5040; margin-bottom: 8px;\">01<\/div>\n<h2 style=\"font-family: Georgia, serif; font-size: 1.5em; color: #162920; margin: 0 0 20px 0; font-weight: bold;\">The gut microbiome: the ecology of recovery<\/h2>\n<p style=\"color: #4a4a4a; margin-bottom: 18px;\">The gut microbiome is not a simple list of bacteria, but a complete ecosystem of bacteria, fungi, viruses, yeasts and their waste products. Together they determine how the immune system reacts, how much inflammation is present, how many nutrients are absorbed and how many neurotransmitters (signaling substances for the nervous system) are produced. <\/p>\n<div style=\"background: #eaf3de; border-left: 4px solid #2e6b4f; padding: 18px 22px; margin: 20px 0 28px; color: #1a4a33; font-style: italic;\"><strong style=\"font-style: normal; display: block; margin-bottom: 6px; font-family: Arial, sans-serif; font-size: 12px; letter-spacing: 1px; text-transform: uppercase; color: #2e6b4f;\">Clinical insight<\/strong><br \/>\nA dog with a relatively stable microbiome can often respond quickly to support. But an animal with years of dysbiosis (disturbed bacterial balance), antibiotic history or long-term medication use simply needs more time before the system comes back into balance. <\/div>\n<\/div>\n<\/div>\n<p><!-- SECTIE 02: PROTEOOM --><\/p>\n<div style=\"background: #f7f5f0; padding: 8px 24px 8px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<div style=\"font-family: Arial, sans-serif; font-size: 11px; font-weight: bold; letter-spacing: 2px; text-transform: uppercase; color: #2b5040; margin-bottom: 8px;\">02<\/div>\n<h2 style=\"font-family: Georgia, serif; font-size: 1.5em; color: #162920; margin: 0 0 20px 0; font-weight: bold;\">The proteome: what the body actually does<\/h2>\n<p style=\"color: #4a4a4a; margin-bottom: 18px;\">In addition to the microbiome, the proteome also plays a role. The proteome is the total amount of protein that the body produces at any given time. These proteins control virtually all processes in the body, from inflammatory responses and enzyme activity to hormone regulation and detoxification.  <\/p>\n<p style=\"color: #4a4a4a; margin-bottom: 0;\">Two dogs with the same diagnosis can therefore be in a completely different state biologically. One dog has a mild activation of the immune system, while the other has been in a state of low-grade inflammation for years with elevated cytokines (signaling substances that drive inflammation). <\/p>\n<\/div>\n<\/div>\n<p><!-- SECTIE 03: MITOCHONDRI\u00cbN --><\/p>\n<div style=\"background: #f7f5f0; padding: 32px 24px 8px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<div style=\"font-family: Arial, sans-serif; font-size: 11px; font-weight: bold; letter-spacing: 2px; text-transform: uppercase; color: #2b5040; margin-bottom: 8px;\">03<\/div>\n<h2 style=\"font-family: Georgia, serif; font-size: 1.5em; color: #162920; margin: 0 0 20px 0; font-weight: bold;\">Mitochondria: recovery costs energy<\/h2>\n<p style=\"color: #4a4a4a; margin-bottom: 18px;\">Recovery takes energy. Intestinal cells have to renew, immune cells have to react, skin has to repair and the liver has to detoxify. All these processes require ATP, the fuel produced by the mitochondria, the energy factories of the cell.  <\/p>\n<h3 style=\"font-family: Arial, sans-serif; font-size: 1em; color: #2b5040; margin: 0 0 10px 0; font-weight: bold;\">Why recovery can be slower<\/h3>\n<p style=\"color: #4a4a4a; margin-bottom: 0;\">When the mitochondria are weakened by chronic inflammation, an accumulation of toxic substances, long-term medication use, oxidative stress (damage due to an excess of free radicals) or aging, recovery is often slower. Sometimes the energy management must first improve before a protocol can have a visible effect. <\/p>\n<\/div>\n<\/div>\n<p><!-- SECTIE 04: STRESS EN LEEFOMGEVING --><\/p>\n<div style=\"background: #f7f5f0; padding: 32px 24px 8px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<div style=\"font-family: Arial, sans-serif; font-size: 11px; font-weight: bold; letter-spacing: 2px; text-transform: uppercase; color: #2b5040; margin-bottom: 8px;\">04<\/div>\n<h2 style=\"font-family: Georgia, serif; font-size: 1.5em; color: #162920; margin: 0 0 20px 0; font-weight: bold;\">Stress and living environment<\/h2>\n<p style=\"color: #4a4a4a; margin-bottom: 0;\">Chronic stress increases the stress hormone cortisol. Long-term elevated cortisol levels affect, among other things, the permeability of the intestinal wall, the composition of the microbiome and the balance of the immune system. A dog that lives in a stable, quiet environment often reacts differently to therapy than a dog that constantly experiences tension or overstimulation.  <\/p>\n<\/div>\n<\/div>\n<p><!-- SECTIE 05: LEEFTIJD EN KLACHTDUUR --><\/p>\n<div style=\"background: #f7f5f0; padding: 32px 24px 8px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<div style=\"font-family: Arial, sans-serif; font-size: 11px; font-weight: bold; letter-spacing: 2px; text-transform: uppercase; color: #2b5040; margin-bottom: 8px;\">05<\/div>\n<h2 style=\"font-family: Georgia, serif; font-size: 1.5em; color: #162920; margin: 0 0 20px 0; font-weight: bold;\">Age and duration of symptoms<\/h2>\n<p style=\"color: #4a4a4a; margin-bottom: 18px;\">The age of an animal and the duration of the symptoms also affect the speed of recovery. With age, the diversity of gut bacteria often decreases, the capacity of the mitochondria decreases, and oxidative stress increases. <\/p>\n<p style=\"color: #4a4a4a; margin-bottom: 18px;\">The duration of complaints makes a substantial difference. Long-term symptoms can lead to changes in tissue structure, epigenetic adaptations (changes in how genes are read, without changing the DNA itself) and chronic activation of inflammatory processes. The longer a problem is present, the more time the body needs to rebalance the system.  <\/p>\n<p style=\"color: #4a4a4a; margin-bottom: 0;\">Genetic predisposition also plays a role in this. Some breeds have a stronger sensitivity to inflammation or other fatty acid metabolism. <\/p>\n<\/div>\n<\/div>\n<p><!-- SECTIE 06: VOEDING EN OPNAME --><\/p>\n<div style=\"background: #f7f5f0; padding: 32px 24px 8px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<div style=\"font-family: Arial, sans-serif; font-size: 11px; font-weight: bold; letter-spacing: 2px; text-transform: uppercase; color: #2b5040; margin-bottom: 8px;\">06<\/div>\n<h2 style=\"font-family: Georgia, serif; font-size: 1.5em; color: #162920; margin: 0 0 20px 0; font-weight: bold;\">Nutrition and absorption<\/h2>\n<p style=\"color: #4a4a4a; margin-bottom: 18px;\">Not only the quality of food is important, but also the question of whether the body can actually digest and absorb this food. Factors such as gastric acid production, digestive enzymes from the pancreas and the health of the intestinal wall play a major role in this. <\/p>\n<p style=\"color: #4a4a4a; margin-bottom: 0;\">Puppies born by caesarean section or given antibiotics early in life may develop a different microbial basis. As a result, they are sometimes more susceptible to allergies, skin problems or fatigue, even without obvious intestinal complaints. <\/p>\n<\/div>\n<\/div>\n<p><!-- FACTOREN GRID --><\/p>\n<div style=\"background: #162920; padding: 48px 24px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<div style=\"font-family: Arial, sans-serif; font-size: 11px; font-weight: bold; letter-spacing: 2px; text-transform: uppercase; color: #d5cd47; margin-bottom: 10px; text-align: center;\">Overview<\/div>\n<h2 style=\"font-family: Georgia, serif; font-size: 1.4em; color: #ffffff; margin: 0 0 32px 0; font-weight: bold; text-align: center;\">The factors that determine the rate of recovery<\/h2>\n<table style=\"border-collapse: collapse;\" role=\"presentation\" width=\"100%\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td style=\"vertical-align: top; padding: 0 12px 28px 0;\" width=\"50%\">\n<div style=\"font-family: Georgia, serif; font-size: 1.05em; color: #d5cd47; font-weight: bold; margin-bottom: 4px;\">Microbiome<\/div>\n<div style=\"color: rgba(255,255,255,0.65); font-size: 0.92em; line-height: 1.5;\">State and diversity of the intestinal flora<\/div>\n<\/td>\n<td style=\"vertical-align: top; padding: 0 0 28px 12px;\" width=\"50%\">\n<div style=\"font-family: Georgia, serif; font-size: 1.05em; color: #d5cd47; font-weight: bold; margin-bottom: 4px;\">Proteome<\/div>\n<div style=\"color: rgba(255,255,255,0.65); font-size: 0.92em; line-height: 1.5;\">Topical protein production and inflammation<\/div>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"vertical-align: top; padding: 0 12px 28px 0;\" width=\"50%\">\n<div style=\"font-family: Georgia, serif; font-size: 1.05em; color: #d5cd47; font-weight: bold; margin-bottom: 4px;\">Mitochondria<\/div>\n<div style=\"color: rgba(255,255,255,0.65); font-size: 0.92em; line-height: 1.5;\">Energy management and recovery capacity<\/div>\n<\/td>\n<td style=\"vertical-align: top; padding: 0 0 28px 12px;\" width=\"50%\">\n<div style=\"font-family: Georgia, serif; font-size: 1.05em; color: #d5cd47; font-weight: bold; margin-bottom: 4px;\">Genetic predisposition<\/div>\n<div style=\"color: rgba(255,255,255,0.65); font-size: 0.92em; line-height: 1.5;\">Breed sensitivities and fatty acid metabolism<\/div>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"vertical-align: top; padding: 0 12px 28px 0;\" width=\"50%\">\n<div style=\"font-family: Georgia, serif; font-size: 1.05em; color: #d5cd47; font-weight: bold; margin-bottom: 4px;\">Stress &#038; living environment<\/div>\n<div style=\"color: rgba(255,255,255,0.65); font-size: 0.92em; line-height: 1.5;\">Cortisol, routine, overstimulation<\/div>\n<\/td>\n<td style=\"vertical-align: top; padding: 0 0 28px 12px;\" width=\"50%\">\n<div style=\"font-family: Georgia, serif; font-size: 1.05em; color: #d5cd47; font-weight: bold; margin-bottom: 4px;\">Age &#038; duration of the complaint<\/div>\n<div style=\"color: rgba(255,255,255,0.65); font-size: 0.92em; line-height: 1.5;\">Duration and depth of the disturbance<\/div>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"vertical-align: top; padding: 0 12px 0 0;\" width=\"50%\">\n<div style=\"font-family: Georgia, serif; font-size: 1.05em; color: #d5cd47; font-weight: bold; margin-bottom: 4px;\">Nutrition &#038; absorption<\/div>\n<div style=\"color: rgba(255,255,255,0.65); font-size: 0.92em; line-height: 1.5;\">Quality and digestibility<\/div>\n<\/td>\n<td style=\"vertical-align: top; padding: 0 0 0 12px;\" width=\"50%\">\n<div style=\"font-family: Georgia, serif; font-size: 1.05em; color: #d5cd47; font-weight: bold; margin-bottom: 4px;\">Medication history<\/div>\n<div style=\"color: rgba(255,255,255,0.65); font-size: 0.92em; line-height: 1.5;\">Antibiotics, corticosteroids, anti-inflammatories, insecticides<\/div>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<\/div>\n<p><!-- WAT BETEKENT DIT IN DE PRAKTIJK --><\/p>\n<div style=\"background: #f7f5f0; padding: 40px 24px 8px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<h2 style=\"font-family: Georgia, serif; font-size: 1.5em; color: #162920; margin: 0 0 20px 0; font-weight: bold;\">What does this mean in practice?<\/h2>\n<p style=\"color: #4a4a4a; margin-bottom: 18px;\">When an animal does not respond immediately to a protocol, it does not mean that it does not work. It means that recovery is a complex process that involves multiple systems at once. <\/p>\n<div style=\"background: #fdf6dc; border-left: 4px solid #d5cd47; padding: 18px 22px; margin: 8px 0 24px; color: #5a5320;\"><strong style=\"display: block; margin-bottom: 6px; font-family: Arial, sans-serif; font-size: 12px; letter-spacing: 1px; text-transform: uppercase; color: #8a7c1a;\">Did you know?<\/strong><br \/>\nThe first signs of recovery are often subtle: better sleep, calmer behavior or a milder form of the symptoms. These are the first signs that the system is moving towards recovery. <\/div>\n<p style=\"color: #4a4a4a; margin-bottom: 0;\">Sometimes more is needed than just the protocol. Additional therapy can speed up recovery, such as acupuncture, Chinese herbs, ozone therapy, gold acupuncture, laser therapy or sometimes temporary use of regular medication. <\/p>\n<\/div>\n<\/div>\n<p><!-- CONCLUSIE --><\/p>\n<div style=\"background: #ffffff; padding: 40px 24px 48px;\">\n<div style=\"max-width: 720px; margin: 0 auto;\">\n<h2 style=\"font-family: Georgia, serif; font-size: 1.5em; color: #162920; margin: 0 0 20px 0; font-weight: bold;\">Conclusion<\/h2>\n<p style=\"color: #4a4a4a; margin-bottom: 14px;\">From integrative and system-oriented veterinary medicine, we develop our protocols as carefully as possible. Yet there is no universal protocol that works in exactly the same way for every animal. <\/p>\n<p style=\"color: #4a4a4a; margin-bottom: 14px;\">Every animal is a unique biological system. The microbiome, the proteome, the mitochondria, the genetic predisposition, the stress level, age, the diet and the living environment together determine how quickly recovery can take place. <\/p>\n<p style=\"color: #2b5040; font-style: italic; font-weight: bold; margin-bottom: 0;\">Comparing with other animals is not biologically useful. Guiding with insight, patience and customization is. <\/p>\n<\/div>\n<\/div>\n<p><!-- CTA --><\/p>\n<div style=\"background: #2b5040; padding: 44px 24px; text-align: center;\">\n<div style=\"max-width: 600px; margin: 0 auto;\">\n<p style=\"color: #ffffff; font-size: 1.1em; margin: 0 0 24px 0; line-height: 1.6;\">If a protocol does not have sufficient effect on your animal, please feel free to contact us.<\/p>\n<p><a style=\"display: inline-block; background: #d5cd47; color: #162920; font-family: Arial, sans-serif; font-weight: bold; font-size: 14px; letter-spacing: 1px; text-decoration: none; padding: 14px 32px; border-radius: 2px;\" href=\"https:\/\/www.ngdcare.nl\/en\/contact\/\">Contact us \u2192<\/a><\/p>\n<\/div>\n<\/div>\n<p><!-- TAGS --><\/p>\n<div style=\"background: #f7f5f0; padding: 28px 24px;\">\n<div style=\"max-width: 720px; margin: 0 auto; text-align: center;\"><span style=\"display: inline-block; background: #eaf3de; color: #2b5040; font-family: Arial, sans-serif; font-size: 12px; padding: 6px 14px; border-radius: 14px; margin: 4px;\">Systems biology<\/span><br \/>\n<span style=\"display: inline-block; background: #eaf3de; color: #2b5040; font-family: Arial, sans-serif; font-size: 12px; padding: 6px 14px; border-radius: 14px; margin: 4px;\">Microbiome<\/span><br \/>\n<span style=\"display: inline-block; background: #eaf3de; color: #2b5040; font-family: Arial, sans-serif; font-size: 12px; padding: 6px 14px; border-radius: 14px; margin: 4px;\">Integrative Veterinary Medicine<\/span><br \/>\n<span style=\"display: inline-block; background: #eaf3de; color: #2b5040; font-family: Arial, sans-serif; font-size: 12px; padding: 6px 14px; border-radius: 14px; margin: 4px;\">Recovery<\/span><br \/>\n<span style=\"display: inline-block; background: #eaf3de; color: #2b5040; font-family: Arial, sans-serif; font-size: 12px; padding: 6px 14px; border-radius: 14px; margin: 4px;\">Gut health<\/span><\/div>\n<\/div>\n<p><!-- FOOTER \/ DISCLAIMER --><\/p>\n<div style=\"background: #162920; padding: 28px 24px; text-align: center;\">\n<p style=\"color: rgba(255,255,255,0.35); font-family: Arial, sans-serif; font-size: 12px; max-width: 600px; margin: 0 auto; line-height: 1.6;\">This text is intended as general information and does not replace individual veterinary advice. If in doubt, always contact your veterinarian.<br \/>\nNGD Care | Stefan Veenstra, DVM <\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>NGD Care | Dog &#038; Cat Why recovery happens at a different pace in every animal The same protocol, a different pace. What this difference says about your animal&#8217;s biology. NGD Care | Stefan Veenstra, DVM In practice, we often hear this. One dog starts with an intestinal or skin protocol and within two weeks &#8230; <a title=\"Why doesn&#8217;t one protocol work for all patients?\" class=\"read-more\" href=\"https:\/\/www.ngdcare.nl\/en\/blog-en\/why-doesnt-one-protocol-work-for-all-patients\/\" aria-label=\"Read more about Why doesn&#8217;t one protocol work for all patients?\">Read more<\/a><\/p>\n","protected":false},"author":2,"featured_media":16043,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"wds_primary_category":0,"footnotes":"","_members_access_role":[],"_members_access_error":""},"categories":[178,13786],"tags":[7468,7470,7466,7475,7464,7473,7477,7480,7479,7471],"class_list":["post-15576","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-en","category-systems-biology","tag-chronic-complaints-dog","tag-dog-recovery-process","tag-gut-microbiome-dog","tag-holistic-veterinary-medicine","tag-integrative-veterinary-medicine","tag-intestinal-health-dog","tag-microbiome-dog","tag-recovery-in-dogs","tag-skin-and-intestinal-problems-dog","tag-systems-biology-veterinary-medicine","infinite-scroll-item"],"meta_box":[],"_links":{"self":[{"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/posts\/15576","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/comments?post=15576"}],"version-history":[{"count":1,"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/posts\/15576\/revisions"}],"predecessor-version":[{"id":23396,"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/posts\/15576\/revisions\/23396"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/media\/16043"}],"wp:attachment":[{"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/media?parent=15576"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/categories?post=15576"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ngdcare.nl\/en\/wp-json\/wp\/v2\/tags?post=15576"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}