Yuwen has been working as an architect for the past 20+ years, and she is a very good one! Thanks to the combination of her modernly elegant taste, slickly simple design, and sentimentally classic soul. Yuwen’s passion towards nature and animals has also given her artsy work a special touch. There are always dogs in her life, and we are excited to learn about how she incorporated her living space with her dogs’.
Q: When you first designed your own house, besides the “standard doggie doors,” what other elements were inspired by sharing the space with your dogs?
A: There is a “window-like” clear area at the lower corner of the front door. That was originally created for one of my past dogs, Fufu, a chihuahua-terrier mixed. Fufu was an anxious dog, and she would always wait by the door eagerly whining and crying when we were gone, in spite of her brother Benny (a Beagle) being by her side. It broke my heart. I felt that maybe she was even more nervous because she couldn’t see what’s going on outside. As an experiment, I made a “Fufu’s window” just at her eye level on the door for her. So she could see outside, and it worked! She calmed down and was able to relax more since. Even though she was still waiting by the door most of the time. The breakfast nook at the corridor was inspired by Benny originally. Because of Fufu, Benny used to hang out at the front door a lot too. He would just lay there and enjoy the sun. One Sunday morning I laid down next to Benny and learned that the sun warm up the worn wood planks and the view out to the garden makes it a perfect chilling nook, so I deck it out with a simple armchair, coffee able and area rug. It’s very tranquil so that corner ended up becoming my Sunday morning spot with Benny. Reading news, drinking coffee, taking the time. Now Fourthie (Yuwen’s current dog) also likes to spend his Sunday mornings with me there too. The Feng Shui does seem to be better there. We also re-arranged the plantation in the back yard. We used to have a Golden Barrel Cactus on the raised garden that was exposed but hidden, especially when it was small. Benny somehow liked to potty on the raised garden. It was fine at first because the plant was small, and we didn’t think much of it. Throughout the year as it became bigger, one day Benny went on doing his business, and as he lifted his leg, he was poked by the spine…. We then changed the plantation, but he didn’t potty at the garden for a very very long time….
Q: What have you learned about Fourthie that you really like?
A: He has a very good attitude towards life. He is very confident and determine. Very honest with his feelings too. Because of him, we establish a healthy routine to always take some time to play and to be active, otherwise he gets agitated. He loves to play with other dogs, and he is very excited when we visit a new dog park. It has become a fun routine for both of us, to explore different parts of the town on the weekends together. Nothing seems to matter that much to upset him long. He lets go of negativities easily. He loves cheap and expensive toys equally, as long as we are playing and spending time together. Overall he is a content and happy dog, and I’m always so looking forward to go home to him at the end of every day!
“Let food be thy medicine and medicine be thy food.” ― Hippocrates
In Traditional Chinese Medicine, it is believed that nurture can be more powerful than nature. Even if an individual was born weak, sick, and underdeveloped (weak prenatal Jing), love and care will reverse that (Zang Fu Jing). With the right nutrition! (Gu Qi)
In conventional Western medicine, the same concept has been translated into the health of gastrointestinal tract (GIT, digestive tract) and appropriate diets/nutrition. Most recently, it is further defined with the terms of “epigenetic” and “microbiome/microbiota/gut flora.” We are well aware of the importance of a healthy gut, however, just as complicated and swiftly changing as the modern diets and lifestyles, the dynamic and relationships between our digestive tract and us are shifting constantly as well. Think of the GI tract as a deep ocean inside us. We know it is crucial in regulating the weather and providing sources of lives. With how deep and how complex it is though, the current technologies can only detect limited range and gather partial information.
Good news is, there are always new discoveries and evidence based research. We are learning about our bodies and what it means to live a healthful life more and more every single day!
Same with our pets. We have recognized the importance of nutrition, and thus we have demanded more options for our beloved pets. As a result, besides the traditional kibbles, canned food, now pet owners can make nutritionally balanced and species appropriate meals for the fur babies at home by following carefully formulated recipes. If fresh ingredients are desired but there’s no time to cook, there are commercially prepared options of dehydrated raw, fresh raw, freeze dried fresh, vacuum packed fresh, …etc.
Moreover, recent researches have established the correlations between the GIT health and the good bacteria living in the gut. If we are feeding the good bacteria, the body will be stronger and healthier, with less chance of chronic diseases, cancer, pain, and even emotional/behavioral issues. There are hundreds to thousands different types of bacteria living inside us and the animals, and we are just getting to know them! We know that the populations differ drastically from individuals to individuals, and we know that the different bacteria need different nutrients and conditions to thrive. As a result, it is important to offer varieties of high quality options to strengthen the good groups of bacteria.
Feed balanced and consistent meals to your pets, but don’t forget to change things up every so often! (For pets with specific medical conditions, please consult with your veterinarians before making any drastic adjustments on the meals and care regimen. )
How to decide when to change the feedings and what to change to? The answer is, based on the seasons! In a more modern perspective, fresh, natural and in-seasoned ingredients are always better. The nutrients are more complete, with less “against the nature” efforts (i.e. chemicals, growth hormones, artificially created environments, transportation,..etc) spent on the processes. Better for the individual’s health, as well as the environmental sustainability.
From the Traditional Chinese Wellness view, the food that is consumed should help maintain the “harmony” of the body. For example, the weather is getting cold, and therefore more “warming food” should be considered to keep the body balanced. Some of the “warming food” include beef, lamb, chicken, turmeric, ginger, lentils, oats,…etc. To make it more relatable if this is a new concept to you: What makes you feel good after walking in the snow for an hour, when it’s 10 degree outside? A cup of hot cocoa? Or a glass of watermelon juice? Vice versa. Do you feel like some fresh cucumber lemonade or mocha, after jogging for an hour, under 80 degree sunny weather? If you have chosen the hot cocoa and the lemonade, your body "gets" the basic Chinese Food Therapy concept!
Email us or leave a comment if you have any questions!
---Helen Chiu, DVM, CVA
A Traditional Culture
In Turkey, Black Sea region is known for its dark sea, fish, balmy weather, enriched farmlands, hazelnut, honey, Laz people’s jokes, and most importantly, the lush plateaus.
The sea, the land, along with the weather, have cultivated the ways of living, especially for people who live in the small villages surrounding by the highlands. In the villages, people grow fruits, nuts, keeping bees, making yogurt. When it’s summer time, they take their live stocks to stay on the plateaus so the animals can enjoy the fresh grass.
A Different Type of Relationship
In many parts of Turkey, especially small towns where people live more traditionally, keeping indoor pets is still a less appreciated concept. Dogs and cats roaming around freely are more like part of the community instead. People are reminded to offer them water and food, especially on hot summer days. As a result, most of the dogs and cats are friendly towards strangers. You can easily pat a napping cat or quickly befriend a playful puppy.
Among the highlands in Black Sea, Kackar mountains are known for their high elevation and breathtaking landscape. Most of the visitors spend at least one night camping. There are two main camp sites along the route from the village Yayalar to the 3937 meters tall peak (~13,000 ft). The first camp ground, Dilberduzu, is on the plateau side before an intensive climb, and the other one is next to the Deniz lake deep in the mountains. There are more people gathered at Dilberduzu, and many tents are set up already. With more resources, most of the free roaming dogs mainly live around Dilberduzu. Among the dogs, there are a few Kangal Shepherd Dogs.
The Gentle Guardian
Kangals are originated from Turkey as working and guardian dogs. You see them frequently around the Black Sea plateau regions as protectors of the livestocks. They are extremely strong dogs that can even fight bears, but they are very sweet to people, especially great with kids. The Kangals at the campground are used to travelers, and therefore are very easy going. They know the mountains well, and an intensive 8 hour summiting hike for people, to them, is like a stroll in their backyard. The Kangals thus often accompany trekkers to explore the mountains. Sometimes for food, sometimes just for fun.
Each culture and each region has its own special way of living, and its own dynamic with the dogs and the cats. They are all different, because we are all different. However, the affectionate bondings between human and animals, are all based on love and respect towards life and nature. No matter how a society changes, no matter how the world progresses, we should never lose that special love and respect.
Remember Billy, the 10 year-old Lab mixed who suffered from joint pain but unable to continue the conventional nonsteroidal anti-inflammatory medications because of his liver and kidneys conditions? Even though a newer, potentially milder version of NSAIDs was offered, combining with pain medications, Billy’s owners opted for more natural alternatives. After consulting with a holistic veterinarian, Billy starts receiving once a week acupuncture sessions, therapeutic doses of turmeric supplements, along with the previously initiated joint supplements containing glucosamine and chondroitin.
Turmeric is one of the most popular natural herbal remedies that has been studied extensively over the past decade. Curcuminoids are the active components that give turmeric powerful medicinal properties, and curcumin is the most potent among the different curcuminoids. On average, pure turmeric powder has approximately 3% curcumin by weight. Curcumin is well documented in the literatures to show high safety range and positive effects on treating aging-associated diseases, especially inflammatory conditions. In other words, curcumin is a great alternative for Billy. Since Billy is hard to give pills to, the vet suggests to mix organic curcumin extract powder into his dish. However, here comes the issue: Billy hates the taste of turmeric, and goes on a hunger strike when his food is mixed with the powder! (To be honest, I don’t blame Billy…. We all love some yummy Indian curry, but, have you ever tried any turmeric tea or turmeric juice blend from grocery stores? Let’s put it this way, they taste healthier than healthy, and I needed to hold my breath to finish them.) To entice Billy, and meanwhile to increase the bioavailability, (improve the absorption of turmeric) Billy’s owners were advised to either look into turmeric supplements that Billy likes, (for example, Vetcreations Turmeric Supplements) or cook the powder and make it into homemade "golden paste."
After two months of taking turmeric, consistent acupuncture, and occasional pain medications when Billy is particularly sore, he is doing so much better! He eats well, has great energy, and his guffy party-loving personality is back! Billy's humans can't be happier!
1. He Y, Yue Y, Zheng X, Zhang K, Chen S, Du Z, et al. Curcumin, inflammation, and chronic diseases: How are they linked? Molecules. 2015;20:9183–213. [PubMed: 26007179]
2. Mathews VV, Binu P, Paul MV, Abhilash M, Manju A, Nair RH. Hepatoprotective efficacy of curcumin against arsenic trioxide toxicity. Asian Pac J Trop Biomed. 2012;2:S706–7.
3. Sathish Sundar Dhilip Kumar, Nicolette Nadene Houreld and Heidi Abrahamse. Review: Therapeutic Potential and Recent Advances of Curcumin in the Treatment of Aging-Associated Diseases. Molecules. 2018, 23, 835.
4. Tayyem RF, Heath DD, Al-Delaimy WK, Rock CL. Curcumin content of turmeric and curry powders. Nutr Cancer. 2006;55(2):126-31.
As health care providers, one of the many challenges that we face on a daily basis, is to customize individualized care/treatment plans every 20-40 minute or less, and be able to explain/deliver them in a clear and an effective way. There are general concepts, but there are no one-fits-all formulas, and therefore no matter how well a specific type of food works on your friend’s diabetic cat, and your cat has the similar symptoms as that cat, it doesn’t mean that the same food will help your cat. As a result, please consult with a veterinarian if you have any concerns regarding your pet, as well as before making any drastic changes on the way you care for your fur babies.
“But doctor, which food should I feed my dog/cat?” “What do you think about raw food?” “Is people food bad for Fluffy?” “Should I avoid chicken?” “Is grain-free really better?” “What should I feed my 9 week old puppy/kitten” “Should I switch food now that my dog/cat is a senior?” ….
We will answer all those most frequently asked questions, but let’s take a step back to the basics first. More common than not, you will be able to answer many questions by yourself once you have a general idea on why and what to look for.
Hope these guidelines help! We will discuss more specific concerns in the future. Let us know what confuses you the most too when choosing what to feed your beloved pets!
More for references:
Offers home cook recipes that are designed by board certified veterinary nutritionists.
Learn more about what the terms used on the pet food labels mean.
3. Association for Pet Obesity Prevention
Approximate daily caloric needs for average indoor dogs and cats.
----Helen Chiu, DVM, CVA
Acupuncture is one of the most magical and intriguing modalities that Traditional Chinese Medicine offers. Both Dr. Chen and Dr. Chiu practice Integrative Veterinary Medicine that combines conventional medicine and Eastern medicine.
Do you know that acupuncture has been applied to animals for thousands of years as well? It was first utilized to treat lame horses used in the war in ancient China, and now we mainly use acupuncture needles to help our furry friends. Many large animals, zoo animals, marine animals, and even exotics/pocket pets are benefit from this amazing modality as well in the modern veterinary medicine.
Are you curious how it's done? Seeing is believing!
After losing our 19-year-and-11 month-old cat, my partner/husband-to-be and I started fostering shelter animals, as well as pet sitting for friends. Giving unconditional but not completely committal love seems to be helping us cope with the void of loss, the ache of grief.
We are currently hosting two kittens from WLA Shelter, as well as our friend’s dog Juelz. (Learn more about Juelz)
The kittens are brothers from the same litter, and they have been staying with us for the past 5 weeks since they were 3 weeks of age. They are so wonderful and we love having them around so much! Any forms of baby, human, cat, dog, others, are just the most fun-loving-energetic-joyful little creatures that melt everyone’s heart.
On my days off, there was a serious heat wave in Los Angeles. Everyone in our house was miserable, and even one of the kittens was panting while playing! (Note: Cats should never breath with their mouth open. If a cat does that consistently, that would be a medical emergency.) With less than 48 hours, two 8 week-old wild kittens, one easily overwhelmed dog, us two “heat-induced lazy” people, the trip must be easy and relaxing. That means, away from LA but not too far, close to the nature but not too remote, and modern/convenient but not too crowded.
I love California in general, and Central California is definitely special. It’s beautiful, laid back, great food, tasty wine; the atmosphere is amazingly friendly and people are ridiculously nice. Compared to Santa Barbara and San Luis Obispo, Lompoc is not as well visited but it still certainly has all the getaway elements that we were looking for. We brought the kittens along with their large crate and a small carrier, Juelz’ tent which she already had, as well as our own tent. We hung out in town for late afternoon supper and some groceries, and then set up our tents at Jalama Beach. The campground is pet friendly and it’s right next to the beach. It was 95% full when we got there, but because people were all very respectful of each other’s space and privacy, it didn’t feel packed. Many people brought their pets as well, and Juelz even made a new bunny friend named Banana!
To my surprise, the trip was very stress free. Even though we consciously chose a mellow and easy place, the unpredictable nature of having this many “random” animals for camping itself seemed intense already. I contribute most of the smoothness to the people we encountered. It appeared that they were all animal lovers. They politely and genuinely wanted to meet Juelz and the kittens, and they were eager to share the stories of their own beloved pets, or the foster experience that they had.
At the end of our trip, not only we human were relaxed, but the kittens and Juelz also seemed happier, more playful, and ate better in spite of the heat.
For more information about Lompoc and Jalama Beach--
Kittens are ready to go home with the human love of their life! Please visit WLA Shelter website to see how you can help—-
The pet friendly restaurant where we had both great food and fun conversations—-
The article is written from Helen’s point of view and does not necessarily reflect the position of Vetcreations.
Billy is a 10 year-old male neutered Labrador Retriever mixed, who has been loved and well taken care of by his wonderful family. However, for the past few months, they have noticed that Billy seems to “slow down” a little bit. It takes him longer to get up from his bed in the morning, he sleeps more, and he doesn’t snuggle on the couch as often. His spirit is still high when taking a walk, but his gait is stiff, and he seems hesitate to play with his friends at the park. Two days ago, Billy started limping noticeably on his back legs and he is not getting better after restriction of activities. Therefore Billy is taken to the vet. After the exam, lab work and the X-ray, they learn that Billy has arthritis of his hip joints, a degenerative disease of the joints from chronic wear and tear. Arthritis is very common in older pets. The veterinarian recommends Billy to lose weight to help relieve some pressure from his joints, and to start taking joint supplements with glucosamine and chondroitin. With how sore Billy is, he is also prescribed with an anti-inflammatory medication (non-steroidal anti-inflammatory medication, NSAID, similar to Advil in people) to relieve the severe discomfort. Even though the NSAID is an effective medication, there are some potential side effects, and therefore the owners were told to watch Billy closely for any changes of water consumption, appetite, behaviors, and/or tummy discomfort.
Billy’s humans are very dedicated owners. They start the weight management, the medication and the supplement. Billy is definitely a lot better once they started the new regimen! He is running around and acting like his old self again. Five months later, however, Billy seems to not be so excited about eating anymore. He still eats, but becomes picky. The owners are worried and take him for a follow up exam. The bloodwork shows that there is mild liver damage and early indication of underlying kidney diseases. It is not certain if the changes are directly related to the medications, but they were advised to discontinue the non-steroidal anti-inflammatory medication because it will further complicate the kidney and liver issues.
Being practicing veterinarians, Dr. Chen and I see so many “Billys” everyday. They can be a dog, large and small, or a cat. They are all so well loved, but the road to recovery is less straight forward. They have an inflammatory conditions that causes the constant discomfort. The conventional medication works great and offers an immediate strong pain relief. Sometimes that’s all the pet needs. An immediate relief, and the body takes care of the rest of the recovery with resting, good nutrition and regular exercise. However, more often than not, especially with senior patients like Billy, they need a long term plan that’s gentle and sustainable. A plan that fits that particular patient’s needs, as well as the lifestyle of the family that’s caring for him/her. We love our patients and their humans, and we feel for them. We understand how overwhelming and how lonely it gets when caring for a sick patient, and we are eager to help! With the knowledge and the experience we have, Vetcreations creates products that serve as powerful tools to complete the individual and personalized care regimens.
For future posts, we will talk more about besides conventional NSAIDs and pain medications, what other supplements and medical treatments can be considered for pain management. Please leave us a message on the comment section, if there are any subjects regarding holistic veterinary medicine that you are interested in learning more about.
---Helen Chiu, DVM, CVA
When I first met Jennifer, I immediately developed a sense of closeness to her. Not only because she is beautiful, personable, passionate, but more importantly, her genuine love and kindness towards dogs are so raw and so tangible. The love and care should be mandatory, considering the fact that she is the founder of “Bullies and Buddies”, a Los Angeles based dog rescue. However, after being in the veterinary industry for a while, I’ve realized that the truth is, not everyone does things out of love towards animals, regardless the titles or status quo. Most of the time, people who truly care and fight to do the right things somehow end up struggling a lot. However, Jen has kept her spirit up with a very positive attitude, because there’s really “no time and no room for negativity.”
Bullies and Buddies
10 years ago, Jen was a successful aesthetician working for herself. She was a dog lover, and she established “Bullies and Buddies” in memory of her beloved Lady, who unfortunately left this world as a young dog. When Jen and Diamond first met, Diamond was only 8 weeks old. She was hopelessly adorable, and helplessly abandoned in one of the “kill shelters” in LA. Despite the sad situation, Diamond was spunky, and simply loved life. Having Diamond around, and seeing how she had thrived and transformed into a happy healthy dog under the nurturing home environment, Jen couldn’t ignore the strong force that push her to further dedicate everything she had gotten for the “other Diamonds” who hadn’t found a loving home yet. She had worked so hard for “Bullies and Buddies” that she eventually quitted her day job and focused on the rescue work.
To many of us, our animals don’t just offer “companionship.” They are part of our lives, and more often than not, they give mundane daily routine meanings. To Jen, Diamond has given her so much courage and reasons to get out of the bed in the mornings, especially when things are rough. They went through the beginning period of “Bullies and Buddies” together, from when Jen stood outside of a café every Saturday by herself advocating for suffering dogs, till now that “Bullies and Buddies” has saved hundreds of dogs; from Jen going through difficult times of her life, till now she knows where she stands, Diamond has always been there for her, full heartedly.
Therefore, when Diamond was diagnosed with osteosarcoma, an aggressive bone cancer, Jen was almost defeated. “ I couldn’t breath,”Jen said, “it felt so surreal. We were just hiking and Diamond was totally fine…. Even now, I still hope it’s just a bad dream… I mean how could this be?! I spent so much time and so much effort to save dogs, and my own dog ends up having this awful cancer….”
At the point of our meet up, Diamond had had amputation surgery and went through the first round of chemotherapy. She was bouncy, loving, energetic, as if walking and sometimes, running on three legs was not a big deal, and nothing had happened. “She is definitely a tough girl.” Jen looks at Diamond full of love and admiration. The proud look mixing with heart sore, the unique look that I often see on pet owners who deeply feel for their fur babies who are fighting severe conditions. “But I know, I can’t be indulging in sadness.”Jen took a breath and said, “Because Diamond is so sensitive to how I feel, and I don’t want her to be sad.”
Quality of Life
Jennifer has intentionally cut down her hours at work since Diamond had the surgery. “I want to focus on her. She is my priority.”Diamond recovered very well from her surgery and the first round of chemotherapy. “At first I thought I wouldn’t do much, because I don’t want her to suffer and to linger just for me.”Indeed, even though with many cutting edge treatments and therapies that the modern veterinary medicine offers, many of us are hesitant when it comes to extensive treatments. Finance may be one thing, but more importantly, we don’t want our beloved pets to be miserable and dragging through the last part of their life journey just because the medicine can prolong their lives. As a result, it is crucial to listen, to respect, and to pay attention to what the individual pet can handle. Each of them is so unique. With Diamond, Jen really listened, “She bounced right back the day after the surgery! That really encouraged me to try more and give everyone a chance.”Diamond and Jen went to see a veterinary oncologist to learn about all their treatment options, and they decided to start with the first round of chemotherapy. “Diamond never stops impressing me. She did so well during and after the sessions! She is happy, eating, hopping around, energetic, totally acting like her normal self…. Even though we both know that the fight and effort don’t stop here, we are taking it one day at a time and trying to keep a positive attitude. “
Bullies and Buddies:
To learn more about osteosarcoma:
Written by Helen Chiu, DVM, CVA
@Vetcreations, LLC. All Rights Reserved.
It is impossible to talk about Juelz’ story without mentioning Shaka, who sadly had left this world at the end of 2016.
Shaka was the definition of a “perfect dog.” He was loyal, smart, gentle, calm, happy, nurturing, sweet, docile, loving, and selfless. He put others’ as his priority instead of himself. I always remember that even when the days he wasn’t feeling well, the first thing he tried to do when he saw me, was to stand up and greet me with the sweetest tail wagging and to come close to me, so I can pat him and hug him. It was impossible to not love Shaka. He was not only perfect, but also “ therapeutic.” He had even helped the owner’s little cousin, who used to be scared of dogs, to get over his fear. The boy eventually adopted a pitbull because Shaka had shown him that dogs and pitbulls are actually very amazing!
It’s All Very Overwhelming
Juelz came from an abusively neglecting situation. She spent her first few months in life being left outside in the backyard without much human nor animal interaction other than her brother from the same litter. When she was first rescued by Bullies and Buddies, she was very skittish and was very disconnected from this world. Everything was a trigger to overwhelm her. She jumped when there was a car driving by, she bolted when someone closed the door, she froze and ducked when being approached, she trembled and urinated when in a new environment. She was afraid of people, intimidated by other dogs. The world was so big and scary that she just didn’t know what to do with herself, and she was constantly stressing out with anxiety to the point where she would start biting and showing aggression out of fear. She was not happy because she was trapped in her own mind.
And then, Juelz met Shaka.
Shaka had always been very good with other dogs. He was especially gentle and patient with Juelz. He seemed to know that Juelz had already gone through a lot at a young age, and there was this sweet little girl hiding behind the constantly overwhelmed anxious wild puppy. Shaka earned Juelz’ trust within a short amount of time, and thus Shaka’s human, Mao, kindly took Juelz in because he believed that Juelz would become a happier and a calmer dog by learning from Shaka.
And Juelz did! She did amazingly well by living with Shaka and Mao. She started to trust people, started to socialize better with other dogs, started to open up to new experience and the world, gradually and steadily. All because of Shaka’s loving patience and Mao’s dedicated care.
Love is the best language that translates and transforms. Because of Shaka’s love, Juelz has overcome her fear and started to open up, because of the love towards Shaka, Mao saw what Shaka had seen in Juelz, and continues working on her anxiety, so the sensitive but loving Juelz can understand the world better and face life.
Being young and athletic, Juelz always seems to have endless energy. Currently as the only dog, she especially needs lots of exercise. However, just like an introverted person, Juelz loves to play with her friends, but she needs slow introduction when it comes to strangers and new dogs. Therefore, Mao takes her for long walks away from the traffic and the crowd, as well as to less known parks where she can enjoy running around and catching balls without worrying about random encounters. The Juelz without distractions and noises is engaged and eager to please, and she can learn a new trick within less than 30 minutes!
Juelz has gone a long way to become who she is now. She is happy and curious about the world, thanks to Shaka, Mao, and many others that had/have believed in her and worked with her! It is never easy to heal a soul when it’s broken and hurting. However, giving it a chance with love and understanding, amazing and powerful results will follow.
Written by Helen Chiu, DVM, CVA