The American Animal Hospital Association promotes itself as an organization which accredits veterinary hospitals and claims, “The Standards developed and published by AAHA are widely accepted as representing those components of veterinary practice that represent high quality care…Because of the AAHA Standards of Accreditation, you can be sure that your pet will receive top-quality care at an AAHA-accredited hospital.” Unfortunately, a recent uncritical fluff piece on “complementary medicine” on the AAHA HealthyPet.com site suggests that rigorous adherence to legitimate science-based medicine may not be a component of the AAHA standards. It does not stimulate confidence in the value of an AAHA certification if the organization freely promotes bogus therapeutic approaches.
The piece begins by assuming that complementary and alternative veterinary medicine (CAVM) is beneficial for humans and suggesting it ought to be applied to animals as well:
Have you ever basked in the luxury of a professional massage? Ever been to a chiropractor to have that creak in your back fixed? Are you a true believer in taking Echinacea to recover from colds more quickly or gingko to improve your circulation? If you answered yes to any of these questions, then you understand how alternative forms of medicine can benefit you. But did you ever think Spot or Fluffy might want to give these methods a try, too?
Massage? It is certainly relaxing and feels good, which can ease the discomfort of anyone who is ill. This is a legitimate and perfectly mainstream practice. But when massage therapists begin to claim healing or disease prevention benefits from their practice, it does become an alternative practice, and there is no evidence-based reason to believe massage affects the course of any disease or prevents any medical condition.
Chiropractic? An implausible and thoroughly debunked theory, in humans clinical benefits only for lower back pain which are no better than standard therapy, and no reliable evidence that it is safe or beneficial in animals.
Echinacea? Thoroughly tested and consistently found to have no meaningful benefits for cold prevention or treatment.
So if these remedies don’t work for humans, under what “standards of excellence” would we suggest they are good for Spot and Fluffy?
Next, the article cites an AAHA survey suggesting an increasing number of pet owners are using CAVM.
According to the American Animal Hospital Association’s 2003 National Pet Owner Survey, 21 percent of pet owners have used some form of complementary medicine on their pets. Compare this to the 1996 survey, in which only six percent of pet owners said they’ve used alternative therapies on their pets.
It’s always difficult to know how to interpret such figures because the percentage of people using CAVM depends on how CAVM is defined and explained. Does it include massage? Glucosamine? Prayer? If the trend seen in the survey is real, it certainly is a sign for concern given that most of the approaches that fall under the CAVM rubric are unproven at best or in many cases clearly worthless.
What such a figure does not indicate is anything about the safety or efficacy of such therapies. Just because something is becoming more popular does not mean it is true or a good thing. The implication proponents of CAVM make when citing such statistics is that such things are growing in popularity because they are effective or because they are becoming a legitimate and accepted part of mainstream medicine. However, science is not a popularity contest, and truth is determined by evidence not by the extent of public belief.
Next, the article drags out the tired cliché about “holistic” medicine treating the entire patient while conventional medicine treats only symptoms or isolated parts. It then offers what amounts to a guarantee that CAVM treatments are safe and helpful:
Holistic practitioners consider your pet’s entire well-being, not just individual symptoms or conditions, and mix and match treatments to best serve Spot’s or Fluffy’s needs. A holistic approach to your pet’s problem will likely prove beneficial in nearly all cases.
Unfortunately, “holistic” is a marketing term that CAVM proponents have long ago stripped of any consistent, real meaning. It is used almost exclusively as a buzzword to suggest that conventional medicine ignores any treatment or preventative that isn’t a vaccines, drug, or surgical procedure, which is patently ridiculous. Of course, considering the entirety of relevant variables in health and disease “will likely prove beneficial,” but focusing on nonexistent entities like “energy” or the vertebral subluxation, or adding worthless therapies like super diluted water to real medical treatments doesn’t provide any benefit. And the evidence of potential harm is clear.
Finally, this article lists a number of CAVM therapies and makes a variety of claims about them, most of which are unproven or outright untrue.
1. “Acupuncture has been practiced by the Chinese for more than 3,000 years.”
No, it hasn’t. The best available historical research shows that acupuncture, understood as the placing of small needles into the skin at points believed to have effects on internal organs or health, has only been commonly practiced on companion animals since the 1960s.
2. “Acupuncture can relieve muscle spasms, increase blood circulation, stimulate nerves, and help release natural pain control hormones and other helpful chemicals produced naturally by the body…. You may want to consider acupuncture for your pet if it has musculoskeletal, skin, respiratory, or digestive problems. It can also help with some reproductive problems.”
In humans, the only consistent beneficial effects are on pain and nausea, and these are psychologically mediated, meaning they are less than achieved with pain control medications and can be achieved through “fake” acupuncture techniques (placing needles randomly or stimulating the skin with toothpicks, for example). Beneficial effects based on psychological mechanisms, such as expectancy and therapeutic ritual, may have small but real benefit for people. Unfortunately, it is unlikely that these benefits are available to veterinary patients, so there is little reason to think that acupuncture is useful to our patients.
3. “Research shows that this complementary medical procedure can work well in many instances.”
This claim is not supported by the limited research available on veterinary acupuncture, which in the most charitable light can only be said to be inconclusive. Studies routinely claim benefits not actually seen in the data generated, or confuse the effects of electrical stimulation of nerves and muscles with the mystical Chinese practice of acupuncture.
1.”Chiropractors believe that some illnesses result from misaligned vertebrae that diminish the flow of impulses from the spinal cord to the body’s muscles, organs and tissues. By manipulating and adjusting specific joints and cranial sutures in animals, veterinary chiropractors try to restore the flow of impulses.”
As already mentioned, though chiropractors may believe in the myth of the subluxation as a cause of disease, it is just that: a myth.
2. “Chiropractic treatments may help if your pet has a spinal disability, such as a slipped disc or pinched nerve; or even in some cases of epilepsy, skin disorders, and behavioral problems.”
There is absolutely no scientific evidence to support these claims in animals, and most of them have proven untrue in humans.
C) Physical Therapy and Massage
These approaches certainly do have proven benefits in humans. There is less research in veterinary patients, but it is quite likely that these approaches have real benefits for our patients. The problem is, they aren’t “complementary” or “alternative,” they are mainstream science-based medicine. I routinely refer patients to a veterinary physical therapy facility, and I am certainly not a CAVM practitioner. This is an example of those who are CAVM practitioners trying to falsely claim that truly effective therapies, other than drugs and surgery, are ignored by conventional medicine. Diet and exercise are frequently presented in human health care as somehow alternative therapies even though they are among the most commonly discussed and recommended strategies in primary care practice. This is a marketing strategy designed to convey a false impression of the differences between alternative and science-based medicine.
1. Homeopathic treatment relies on the administration of substances that can produce clinical signs similar to those of the disease being treated. The idea is to provide the substances in small enough amounts to be harmless, yet enough to encourage the body to develop a curative response to the disease…The substance is diluted and made more potent, after which it’s usually put into pellet or liquid form.
The Granddaddy of all Quackery, homeopathy is pure mumbo jumbo. The so-called Law of Similars described above is merely the mystical idea of sympathetic magic, and the Law of Infinitesimals that says the less of something you have the stronger it is can only be true if the fundamental principles of physics and chemistry are all wrong.
2. “Administered properly, homeopathic treatment can help a wide variety of ailments, including allergies, wounds, poisonings, viral infections and many diseases.”
No high quality, repeatable scientific study has ever shown homeopathy to be effective in treating anything, in humans or animals. Enough studies done by enough believers in the practice will eventually lead to some claiming a positive effect. But the overwhelming, consistent pattern of the available evidence is that homeopathy doesn’t work.
E) Herbal Medicine and Nutraceuticals
1. “Many modern drugs, such as aspirin, are derived from plants, but these drugs go through chemical processing that is thought by some to diminish the plant’s original healing power.”
Yes, many medicines originate from plants. But there is no sound scientific basis to the notion that impure, inconsistent, and complex mixtures of chemicals contained in whole plants are in any way as safe or as effective as purified, identified, extensively tested isolated compounds (aka “medicine”). This is a mystical belief, not an established fact, and there is abundant evidence that it is untrue. Certainly, some herbal and nutraceutical products may be safe and effective, but others aren’t. There is nothing about being an herb or dietary supplement that guarantees safety or positive effects. These things need to be tested scientifically like any other medicine, and few of them have been, mostly for political reasons.
The American Animal Hospital Association portrays itself to the public as the source of reliable standards that can ensure a pet owner the veterinarian they go will provide high quality care. It is worrisome that the organization blithely endorses the kind of misinformation in this article. If adherence to accepted scientific methods and principles is not a part of their standards, then of what value are they? If the organization is willing to promote such utter quackery as homeopathy, how can they claim to be a trustworthy source of information about the quality of veterinary care individual doctors and hospitals offer.