Twenty years on, the 1998 JAMA “theme issue” editorial[1] is often credited as stimulating debate, study, and serious research. The authors continued: “Whether a therapeutic practice is "Eastern" or "Western," is unconventional or mainstream, or involves mind-body techniques or molecular genetics is largely irrelevant except for historical purposes and cultural interest.”

In calling for “…critical and objective assessment using accepted principles of scientific investigation and rigorous standards for evaluation of scientific evidence,” the authors cautioned that:

“Physicians, insurance plans, medical centers and hospitals, managed care organizations, and government policymakers should base decisions regarding incorporation of and payment for alternative medicine therapies on evidence-based research and objective cost-effectiveness analyses rather than on consumer interest, market demand or competition, well-publicized anecdotal reports, or political pressures from
well-organized and influential interest groups.”

Conventional (AKA: biomedical, orthodox, mainstream) medicine practitioners make therapeutic recommendations (physical intervention, surgery, pharmaceutical drugs) to patients that are grounded in evidence accumulated through research that is typically augmented by clinical trials. There is generally little evidence to “prove” that complimentary or alternative medicine (CAM) therapies work. The scarcity of research, however, does not indicate that those therapies aren’t effective.

The Decision-making Process

Symptom-suppressing drugs
versus…
the body’s innate potential to self-heal?

But What is
“Holistic” Veterinary Medicine?

Before “scientific” medicine (medicine: the science and practice of the diagnosis, treatment, and prevention of disease), curative arts sprung from alchemical treatments and ritual practices that grew from religious and cultural customs, combining practices to maintain and restore heath by the prevention and treatment of illnesses. Alchemy was the medieval forerunner of chemistry, a speculative philosophy practiced in the Middle Ages and the Renaissance, concerned principally with discovering methods for transmuting (transforming) base metals into gold; and with finding a universal solvent and an elixir of life.

Ancient medicine incorporated use of minerals, animal parts, and plants (herbalism), often used ritually—even as magic—by priests, shamans (mystics, or intermediaries between the human and spirit worlds), and “medicine men.” Medical anthropologists study the ways in which societies organize their cultures around matters of health and health care. Spiritual systems include animism (inanimate objects having spirits), spiritualism (pleading to gods or communion with ancestor spirits), shamanism (vesting an individual with mystic powers), and divination (magically obtaining the truth).

Science-based medicine (medicine regarding information that is organized around principles and knowledge drawn from research that can be replicated and tested), is what we know as Western (conventional), or allopathic medicine, and enfolds biomedical research and modern technologies to diagnose and treat: characteristically through chemical medication, surgery, or radiation. This emphasis on machinery, biomedical research and clinical expertise often seems dispassionate and lacking in compassion,focused on depersonalization and disempowerment of the patient, as interaction between becomes fixated on protocols of the (generally accepted) medical model. This distinguishes it from Eastern medicine (Chinese, Korean, Kampo-Japanese, Indian & Unani practices), which is generally based in traditional, anecdotal, subjective, or non-scientific practices.

Allopathy then, is known as the method of treating disease by the use of agents that produce effects different from those of the disease treated: principally the use of pharmacologically active agents or physical interventions to treat or suppress symptoms or patho-physiologic processes of diseases or conditions.

The “Medical Model”

What are the Major Modalities Used
in Holistic Veterinary Medicine?

Modern Drugs, Surgery and Diagnostics

As a professional advocating integrative medicine, the holistic veterinarian strives to remain current on the latest advancements, and selects those which best compliment holistic traditions.

Acupuncture, Traditional Chinese Medicine

Acupuncture has been used in China for 3500 years, and is the primary treatment for a quarter of the world’s population. Acupuncture is a technique for providing local anesthesia (pain relief) and for improving the function of organ systems by inserting needles at specific points of the body. Traditional Chinese Medicine (TCM) postures that “Chi," the vital force that flows throughout the body, travels along corridors of energy stream (meridians).

Chinese medicine explains life as a balance of yin and yang: yin represents the fluids, maternal, quiet, nighttime and passive aspects of the body; yang represents the heat, inflammatory, active, male, daytime and aggressive aspects. As the heat increases, it eventually burns off the essential fluids, or yin, and disrupts this balance.

Inserting fine needles at precise locations, the practitioner stimulates points along the meridians when a condition (a disease) exists that blocks the normal flow of energy along these pathways: the treatments eliciting responses which regulate physiological (organic physical and chemical) processes.

Western-scientific veterinary acupuncture interprets the process differently: as interrupting pain signaling, by increasing the release of neurotransmitters (natural endorphins: morphine-like substances in the body) which help release muscle spasms, and that it stimulates blood flow to aid healing.

Regardless of the approach, each time the dog undertakes a treatment, the effect lasts longer, as the body remembers and builds upon it: so the initial weekly interval will ordinarily be relaxed significantly. Treatments are useful for musculos-keletal pain and conditions that cause lameness or pain in limbs, such as arthritis, dysplasia, and ligament injuries. Some practitioners also claim effectiveness with skin problems and
bladder diseases.

The adaptive/homeostatic regulatory mechanism

Technically, traditional/Chinese acupuncture is a defined as pseudoscience as the theories and practices of traditional Chinese medicine are not based upon “scientific” knowledge. Nevertheless, its efficacy having been well accepted scientifically (through the Western interpretation), the aim of veterinary acupuncture is to provoke and strengthen the body's immune system, through stimulation of the adaptive/homeostatic regulatory mechanism.

Homeostasis is the predisposition of a system (the physiological system of higher animals) to maintain internal stability, owing to the coordinated response of its parts to any situation or stimulus tending to disturb its normal condition or function. When tension is reduced or eliminated, a state of physiological equilibrium is achieved, (of which psychological calm
is a component).

Aromatherapy

Veterinary aromatherapy (also called essential or volatile oil therapy) is the use of plant material and plant-derived substances, such as essential oils, to improve physical, mental, and emotional well-being. Some essential oils may also have anti-microbial effects. As a complementary therapy, aromatherapists manage pain, anxiety and sleep disturbances, certain respiratory distress, fight bacteria or fungal infections, improve digestion, to provoke or support appropriate immune response, for nausea and to alleviate side effects of chemotherapy, and in hospice and palliative care. Aromatherapy can also serve as a substitute for certain pesticides.

Essential oils distillation is attributed to the Persians in the 10th century, though the practice may have been in use for a long time prior to this. These ancient cultures incorporated aromatic plant components in resins, balms, and oils, for medical and religious purposes, as they were known to have both physical and psychological benefits.

The most notable Arabian alchemists was physician and philosopher Avicenna (Ibn-Sina: 980 – 1037 AD), who invented the refrigerated coil, a vital part in improving the crude form of distillation process for plants established by the ancient Egyptians, which forms the basis for modern process to produce essential oils.

Oils are used in massage, taken as drops or supplements, and used as scents for inhalation. The dilution and distillation of essential oils necessitates competent knowledge of their potency and purity, and on the basis of safety, a qualified veterinary aromatherapist in this highly individualized situation is thereby an essential partner in the healing process.

BEHAVIOR Modification

Behavior modification integrates ethology (the study of animal behavior that emphasizes behavioral patterns that occur in natural environments), biology, nutrition, pharmacology, lifestyle evaluation and aspects of modern psychotherapy. Each of these disciplines affects behaviour (particularly homeopathy and Bach Flowers), disease and health. Humane considerations are often at stake.

Canine Nutrigenomics

The study of genetic markers associated with early phases of diet-related disease. Based on the model that nutrition can be optimized for an individual animal’s distinctive genetic makeup (genotype), nutrigenomics supports the cure, management, and prevention of disease by restoring balance, by studying how the whole body responds to a food via systems biology, as well as single gene/single food compound relationships.

Systems biology is a biology-based interdisciplinary field of study that focuses on complex interactions within biological systems, using a holistic approach (holism instead of the more traditional reductionism) to biological research. However, the practitioner thus makes computational and mathematical modeling of complex biological systems. Obesity is one of the most widely studied topics in nutritional genomics.

Examples of food additives include glucosamine chondroitin sulfate (joint health); Vitamin E, beta carotene, and selenium (protection from “free radical” damage to cells); Omega-3 fatty acids (skin health); and oligosaccharides (simple sugar carbohydrates, or prebiotics; and probiotics)
to promote gut health.

Electroacupuncture

Acupuncture spans from ancient Chinese knowledge to state-of-the-art electro-diagnostic instrumentation and electrical augmentation. To support resolving pain or nerve damage, electroacupuncture amplifies this process using very small electrical currents passed between pairs of needles to stimulate acupuncture points. The current, millivolts and microamps, is measured in units that are 1000 times smaller than normal household current. Electroacupuncture has been evaluated through evidence-based studies although results have been largely inconclusive.

FLOWER THERAPY

For behavioral disorders, more than 20 different flower essence systems—watery dilutions of plants or flowers— with more than 1.000 different essences, the most well-known being Bach Flower Therapy, created by Edward Bach in the 1930s, to influence the mental, emotional and physical balance of the individuum.

Flower therapy is distinct in complementary medical practice, as they not homoeopathic, herbal or aromatic in their preparation, typically produced with water, crystal glass and energy and conserved with alcohol. The essences themselves contain no pharmacologic means, have no “scientific” support at this time and no “scientific” studies in domestic animals. The Bach Flower System includes 37 individual plants, spring water, and one combination of five plants (“Rescue Remedy”).

Experience of the practitioner is key, as there is no defined dose-effect relation; the response is based on resonance phenomenon, and so effect is achieved when the frequency at which a force is periodically applied—in this instance, flower therapy—is equal or nearly equal to one of the natural frequencies of the system on which it acts (homeostasis); or, the state of physical, mental, emotional and social harmony of the individual: the state of “peace.”

Bach believed that illness was a “negative mood,” the result of a “energy blocking” which resulted from an internal war between the purposes of the soul and the personality's actions and outlook: the person’s “frequency system.”

Bach Flower Therapy, therefore, is indicated for psychosomatic and behavioral problems, for diseases resistant to conventional therapies in fearful and timid dogs, periods of mourning, hyperactivity, unreasonable barking, or in dogs refusing medication. It is often used for panic phobias, such as travel, or for coping with thunder, fireworks; or as a calming agent in crisis situations, such as
after accidents or fights.

Bach derived his solutions simplistically and intuitively, based on his perceived psychic connections to specific plants, rather than using research based on scientific methods, involving instead a process of combination of the four elements:the concepts in ancient Greece of earth, water, air, fire, and quintessence (natural phenomena), which were proposed to explain the nature and complexity of all matter in terms of simpler substances.

Gold Bead Implants

Permanent acupuncture for pain relief. Acupuncture (insertion and manipulation of needles in the body) affects all the major physiological systems, by stimulating release of a range of chemical neurotransmitters, nerve activity, and the entire immune system, for a substantial
total body curative effect.

In implantation, administered under anesthesia or sedation, minute gold beads or sections of thin gold wire are inserted through a needle into acupuncture points between muscles or under the skin. The precise points are chosen according to the specific needs and neurological problems of the patient: with substantive response noted for hip dysplasia, degenerative myelopathy (diseases of the spinal cord), arthritis, epileptic seizures, “wobbler syndrome” (instability of the neck vertebrae, affecting gait), and intervertebral disc disease. In particular, a 24-month 2007 Norway study documented significant long term pain relief in dogs with hip dysplasia.

Advocates explain that the gold beads or wires limit over-movement within the affected joints, which helps cap pain; eventually, arthritic tissues and excess bone formations are reabsorbed into the treated joints. Additionally, the gold implants exert a positive charge on surrounding tissues, which stabilizes the negative alkaline pH of the joint, supporting pain relief and inhibiting formation of future arthritic deposits.

Administration of other forms of palliative treatment (non-steroid anti-inflammatory drugs: NSAIDs) may be used subsequent to the procedure. Some acupuncturists are critical of implantation, regarding the potential for migration of the embedded needles.

Herbal Medicine

Use of explicit herbs and plants (botanicals) for medicinal purposes has been practiced for millennia all over the world: such use is recorded on fragments of papyrus and clay tablets from ancient Egypt, Samaria and China that date back 5,000 years but document traditions far older still. Over 700 herbal remedies were detailed in the Papyrus Ebers, an Egyptian compilation of medical texts written in 1500 BC.

Veterinary herbal medicines include Western herbs, Ayurvedic (the ancient Hindu art of medicine and of prolonging life) herbs from India, traditional Chinese herbs and other herbs procured from worldwide sources. It is believed that certain herbs have healing powers that are able to balance the emotional, mental and physical proportions of animals; and that the holistic veterinarian, with an accepting sensitivity, can achieve broader clinical effects than conventional allopathic/Western medicine alone.

The practitioner may administer a single herb (a simple) internally or externally, combine with other herbs, or blend a carrier or emissary herb in a continuous or pulsed (on-off) treatment to reduce side effects. Particular herbs are identified with anti-inflammatory and antispasmodic efficacy, to blunt anxiety (nervines), to draw out inflammation and congestion or to promote circulation (rubefacients), and as long-term tonics to restore overall homeostasis.

The American Veterinary Medical Association considers the practice of veterinary herbal therapy to be the practice of veterinary medicine. This is important as the production of herbs themselves is not regulated, and so particular expertise in diagnosis and administration for efficacy and
safety is essential.

Herbalists are often conservationists who drive awareness of global sustainable agriculture techniques, including permaculture, since the source environments in which they are grown may be endangered by indiscriminate access and commercial trade. It is a natural farming philosophy of ecological and environmental design and engineering, construction and integrated water resources management that develops regenerative and self-maintained habitat and agricultural systems modeled from natural ecosystems.

As a systematic treatment, herbal medicine utilizes whole plants and extracts in the treatment of disease and safeguarding of health. Certain herbs provide vitamins and minerals in naturally synergistic relationships and high bioavailability, which may support lowering doses of pharmacologic ingredients used. Whereas traditional allopathic/Western medicine has only food stuffs to strengthen chronically ill patients, herbal medicine adds tonic herbs to these nutritional protocols, recognizing the whole body approach (that the mind and body interact in health and disease), manifested in the use of herbal adaptogens.

Adaptogens are diverse natural substances that support the adrenal glands to produce adjustments in the body to balance hormones, in order to adaptive-ly manage, combat and increase resistance to day-to-day biological and psychological stress. Examples include garlic, ginseng, echinacea, ginkgo, goldenseal, and taheebo.

In addition to current scientific knowledge, diagnosis and prescription is augmented by diverse cultural traditions that can date back thousands of years: this makes herbs unique in complementary and alternative medicine because their use combines ancient knowledge and modern science to develop patient treatment plans.

Practitioners of complimentary medicine rightly respond to critics by pointing out that herbal and botanical sources are the origin of as much as least a third of all modern pharmaceuticals, and that the active ingredients of many pharmaceuticals are identical to, or are derivatives of, bio-active constituents of historic folk remedies. Collaborative and complimentary veterinary attention would be important in many cases, since, for example, combining herbs with chemotherapy may interfere with metabolizing enzymes and drug transporters.

Hyperbaric Oxygen Therapy

Placing the patient in an airtight chamber supplied with pure oxygen, and raising the atmospheric pressure: the high oxygen concentration combined with an increase in air chamber pressure, increases available oxygen to the lungs for inhalation and thus raises the plasma oxygen concentration for delivery throughout the body to diffuse into tissues. For support of burn and wound healing, infection, acute pancreatitis, snake bites, post-radiation swelling, head and spinal injuries, near-drowning or asphyxiation, smoke inhalation, herniated discs, and treating
neurological disorders.

Homeopathy

Although Samuel Christian Hahnemann, a German medical doctor in the late-1700’s, developed the system used today, homeopathy dates to ancient Greece (370 BC). The word “homeopathic” is derived from the Greek words homeos (similar) and pathos (disease or suffering). Homeopathy means to treat with a remedy that produces an effect similar to the disease or suffering, “Similia Similibus Curentur,” or “like cures like”: that administration of a homeopathic dilution of a substance that causes the symptoms of a disease in healthy people would cure similar
symptoms in sick people.

Homeopathic remedies are carefully chosen substances that are serially diluted in alcohol or distilled water and ultimately, not even a molecule of the original substance remains in the remedy; but nanoparticles—which have very large surface area related to volume—still have effect owing to a physics-based “quantum structure” explanation, in which information in the water—an energy “footprint” and vibration of the substance—is transferred through a succession, a banging
method of shaking. Thus the energy could be sustained over time and transferred to the patient. The remedy is thus one that is potentized ( rather than being a large amount of the chosen substance), and transformed into a mechanism of healing.

Historically then, the concept of “doctrine of similars” (proving the value of a medicine by testing it on healthy individuals) is identified with Hippocrates in 400 BC, when he prescribed a small dose of mandrake root to treat mania, knowing it to produce mania in much larger doses. Correspondingly, in the 16th century, Paracelsus, a Swiss physician, alchemist, and astrologer of the German Renaissance, wrote “similia similibus curantur” (close to Hahnemann’s subjunctive), commonly translated as “what makes a man ill also cures him.”

Hahnemann devised his “system of provings”—first tested on himself—in which the participants tested the effects of ingested substances by carefully recording all of their symptoms, as well as the ancillary conditions under which they appeared. Thus evolved his technique for making dilutions that he believed would preserve a substance's therapeutic properties while removing its harmful effects: because the low doses (nano-dose) aroused and enhanced “the spirit-like medicinal powers
of the crude substances.”

Made from plants, minerals, drugs, viruses, bacteria, animal or insect substances, homeopathic remedies do not suppress symptoms, but are intended to affect the deepest constitutional causes of the illness. The remedy is carried by bloodstream to particular receptors in the body; it is not a “cure,” but acts as a catalyst for healing: stimulating the immune system to re-establish equilibrium.

The principle is that homeopathic remedies contain vibrational energy essences that match the patterns present in the diseased state of the patient. Energy-based therapies include flower essences (application of plant infusions for emotional or behavioral issues), reiki (transferring healing energy to the patient), and kinesiology (testing muscle strength to determine optimal treatment paths in a holistic plan).

Although the remedies are prepared from substances found in nature, homeopathy should not be confused with herbal medicine. Whereas herbal medicine uses tinctures (extracts, typically dissolved in ethyl alcohol) of botanical substances, homeopaths use ultra-dilute “micro” doses made from plants, but also minerals or many other substances found in nature.

Homeopathic treatments are highly individualized, and there is no uniform prescribing standard for homeopathic practitioners. They are not prescribed for specific diseases but rather for specific syndromes of diseases, to which the effects (symptoms) may differ widely. Some homeopathic veterinarians may also focus on nosodes (homeopathic immunizations) as substitutes for conventional allopathic immunizations.

Whereas the allopathic practitioner treats symptoms as simply being manifestations of a disease or syndrome, and thus, concentration is on suppression of symptoms (example: anti-inflammatory medications), the holistic practitioner views symptoms as the body’s attempt to combat an underlying imbalance on a more fundamental, energetic level. Symptoms are regarded as tools to determine a needed remedy, and for monitoring the healing process. The homeopath believes that that suppressing symptoms negatively impacts the body’s struggle to heal because it can obstruct the expression of the original disease: perhaps actually driving the disease to a more extreme level. In homeopathy, health is defined as not just the absence of symptoms, but a feeling of well-being and vitality.

Homeopathy is a controversial topic in complementary medicine research. Key concepts of homeopathy are inconsistent with fundamental concepts of chemistry, physics, and psychology; and the practice is therefore dismissed by “allopathic” practitioners as rooted in publication bias and other methodological problems. There is also disagreement in the homeopath profession between a purist interpretation (high dose) vs. a more “rational” view (low potency), and so, practitioners vary on their insistence regarding “mother tinctures,” and the range extending to those with a near undetectable hundred-thousandths and millionths concentration.

Homeopaths, as non-medical practitioners, are criticized as misrepresenting physicians as “allopaths,” and that this distinction is merely in order to differentiate their practice guilds based upon conflicting philosophies rather than ideology versus science. Homeopaths deride allopaths as ignoring underlying causes of disease, while only suppressing symptoms; a process that interferes with the body’s innate immune processes. Critics dismiss such as rhetoric: as ideological homeopaths refer to a metaphysical life force rather than actual causes of disease such as viruses, bacteria, protozoa, genetic defects, radiation, chemical insult, and more.

In the US, homeopathic preparations are recognized as drugs pursuant to the Food, Drug, and Cosmetic Act of 1938; and in 2017, the U.S. Food and Drug Administration (FDA) proposed a new risk-based enforcement approach to homeopathic products. Testimony in a 2015 review on homeopathic product regulation described the principle as conflicting basic principles of modern biology, chemistry and physics; and that decades of scientific examination of homeopathic products had offered no evidence of effectiveness other than acting as a “placebo.”

This perhaps coincided with the anti-homeopathic movement in Europe which became even more fueled by the 2015 publication of an “Information Paper” from the Australian National Health and Medical Research Council. The body claimed to look at the published research about homeopathy effectiveness and categorically discredited it, concluding: “There are no health conditions for which there is reliable evidence that homeopathy is effective.”

The report provoked an international hostility against homeopathy, fanned by UK-based opponents who sought to have the discipline barred from reimbursement within the national health system. However, analysts found financial conflicts of interest associated with the researchers, and the study model arbitrarily eliminated scores of scientifically valid studies—which may have supported interpretation of homeopathic efficacy—from the scope of consideration. An entire first draft of the report was rejected, and its whereabouts are unknown.

The Homeopathy Research Institute, (HRI) citing “procedural and scientific misconduct,” developed a scientific analysis of the report that was used as part of a submission of complaint to the Commonwealth Ombudsman in 2016, augmenting demands for release of the “missing report.”

The modern business potential of homeopathy has spurred mainstream growth especially in the last two decades. However, the low concentration of homeopathic preparations—which often lack even a single molecule of the diluted substance—has been the locus of question for hundreds of years. Pharmacological research has found instead that beneficial effects of an active ingredient come from higher, not lower doses. In contest, contemporary advocates of homeopathy describe a concept of “water memory,” through which water “remembers” the substances mixed in it, and conveys the energy effect of those substances when consumed. This theory is inconsistent with the current understanding of matter, as the lack of any biologically plausible pharmacological agent or effect of physiological mechanism cannot be convincingly explained. The HRI was established, in part, to conduct research on this particular hypothesis.

Mega-nutrients

Orthomolecular Medicine uses supplemental minerals, vitamins and nutrients that correct deficiencies, prevent pathology (the conditions and processes of a disease, or, any deviation from a healthy, normal, or efficient condition in the dog’s body), and reverse tissue damage. It is an augmentation therapy that seeks to treat disease by increasing, decreasing, or otherwise controlling the intake of natural substances, especially vitamins (i.e., megavitamins). Pathology in this framework refers to Supplements are prescribed that support the organs and body tissues, aid body detoxification and boost energy to support the healing process.

Nutritional Therapy

Advocated by holistic veterinarians as a primary preventative medicine. The patient is designed a specific diet which will be palatable, preservative free, practical and cost-effective, environmentally sensible and accommodating the guardian’s abilities to provide.

Osteotherapy

The term “osteopathy” originates from the Greek words osteon, meaning “bones”, and “pathos”, which can be translated to mean “suffering” or “feelings.”

As complimentary therapy, osteotherapy is based on the principle that the musculoskeletal system (structural system of bones, muscles and nerves) is the underpinning of the body’s overall health. Practitioners use non-invasive, gentle hand manipulation to return the musculoskeletal system to is proper state of structure, mobility, and functioning—using the body’s own intrinsic corrective mechanisms—and thereby, all systems of the body are brought into balance, building wellness. The veterinary osteopathic “feels” how each system of the body is working, as compared to how it is should, and identifies the root cause of the dysfunction, which may be in a totally different area than the one
presenting the symptoms.

As such, treatment functional/integrative and aims to positively affect the body's nervous, circulatory, and lymphatic systems.

(Human) Osteopathic physicians are also qualified as medical doctors (MDs: perhaps se), and as such, are more trained than other complementary therapists, such as naturopaths. Whereas chiropractic massage concentrates primarily on improving mobility of the spine, osteopaths do not concentrate only on the problem area, but work to restore balance to the body, and may hand manipulate certain organs to address inflammation.

Some state veterinary medicine boards have begun to regulate the independence of “manual therapy practitioners,” requiring certification by an institution accredited by the American Veterinary Medical Association, and that the use of “osteopathic” to describe non-veterinarians is inappropriate. Thus, veterinary osteopathy can be provided either by a veterinarian who specializes in osteopathy or by an osteopath who works under the supervision of a licensed veterinarian.

Prolotherapy

Ligament reconstructive therapy (“proliferation therapy” or “regenerative injection therapy”), a nonsurgical othorpaedic procedure, in which the practitioner injects a proliferating agent such as dextrose (corn sugar) or vitamin B-12 combined with lidocaine (a synthetic crystalline anesthetic, also used to manage certain arrhythmias) into the affected tendons or ligaments, specifically, where the ligaments attach to the bone.

Acting as an irritant, the solution stimulates the body’s immune system to propagate contiguous tissue: the repaired connective tissue stabilizes and supports the afflicted joint, relieving pain. As an alternative to the pain, risk, and recovery time of surgery, prolotherapy can treat chronic joint pain including arthritis, hip dysplasia, chronic tendonitis, certain disc diseases, and spinal stenosis.

The risks of prolotherapy are significantly less than the risks of surgery. There is no need for general anesthesia or hospital stays, the recovery period is shortened, and with a significant decrease in the chance of infection. The patient would generally be leaving the clinic in about 30 minutes. Lower cost is a significant benefit.

Veterinary Chiropractic

Chiropractic is the therapeutic system for diagnosis and treatment of mechanical disorders of the musculoskeletal system, based upon the interactions of the spine and nervous system, dogs often in pain from vertebral lesions known in chiropractic as subluxations; the method of treatment usually being to manual manipulation of the spinal column. Chiropractic can be used to treat a broad spectrum of conditions dogs in animals through manipulation of related bones, joints, muscles, and soft tissues to restore whole body homeostasis.

Healing potentials achieved through chiropractic are not achievable by other forms of therapy. The goal is to alter the progression of the disease process and restore the critical relationship between the spine and the central nervous system.

A veterinary chiropractor may provide some of the same treatment modalities categorized as physical therapy, but the manipulation should not be portrayed as “physical therapy,” which is a specific discipline. In the scope of considerations should be awareness of differences between the term “manipulation” versus “mobilization,” as an example.

The chiropractor may augment with forms of acoustic compression therapy (see: ESWT and ACT, below) as a form of “trigger point therapy,” directing the sound waves to specific points on the body where tense muscles or muscle groups have caused nerve irritation, which may be triggering pain elsewhere in the body.

Chiropractors are not medical doctors, and the framework of chiropractic conflicts with mainstream medicine, as the practice is sustained by pseudoscientific ideas such as subluxation (partial dislocation) and “innate intelligence” philosophy that rejects the inferential reasoning of the “scientific method,” and relies on deductions from vitalism first principles— a doctrine that ascribes the functions of a living organism at least in part to self determination, to a vital principle distinct from chemical and physical forces— rather than on the materialism of science.

Canine Rehabilitation Therapies

Acoustic compression therapy (act)

(See also, below: “Extracorporeal Shockwave Therapy”)
Uses focused sound waves to provide deep-tissue massage (expansion and concentration within the focus, leading to a change in density, and subsequent increase of circulation to facilitate pain relief). ACT is used as a form of trigger point therapy, as directing the sound waves to specific focal points on the body where tense muscles or muscle groups have caused nerve irritation, which may be triggering pain elsewhere in the body.

ACT is a gentler form of treatment (see: ESWT, below) for chronic musculo-skeletal pain that will not irritate the skin or bruise tissues.

Principles of shockwave generation

A clinical shockwave is a controlled explosion that creates a sonic pulse, much like an airplane breaking the sound barrier. The primary effect of a shockwave is a direct mechanical force.

Three main techniques through which shockwaves are generated: electrohydraulic, electromagnetic, and piezoelectric principles. Additional to the principle of shockwave generation of each device, the important parameters to compare the three techniques of shock wave creation include pressure distribution, energy density and the total energy at the second focal point.

First-generation electrohydraulic shockwaves are high-energy acoustic waves generated by the underwater explosion with high-voltage electrode spark discharge, and the acoustic waves are then focused with an elliptical reflector and targeted at the diseased area to produce therapeutic effect. Electrohydraulic is characterized by large axial diameters of the focal volume and high total energy within that volume.

Electromagnetic shockwaves are generated by passing an electric current through a coil to produce a strong magnetic field. A lens is used to focus the waves, with the focal therapeutic point defined by the length of the focus lens. The amplitude of the focused waves increases by non-linearity (not proportional) when the acoustic wave propagates toward the focal point.

Shockwave of piezoelectric technique (Greek, piezein, to squeeze or press; and piezo, push) involves (generally more than 1,000) of piezocrystals (certain rock crystals or ceramics, and biological matter such as bone, DNA and various proteins) mounted in a sphere and receives a rapid electrical discharge that induces a pressure pulse in the surrounding water steepening to a shockwave. The arrangements of the crystals cause self-focusing of the waves toward the target center, and lead to an extremely precise focusing and high-energy within a defined focal volume.

Cold Laser Therapy

Used to treat arthritis, muscular-skeletal abnormalities, tendon or soft tissue injuries, to reduce post-trauma swelling, promote wound healing, and facilitate pain relief. Cold laser therapy is also used post surgery to help regenerate nerve tissue at an accelerated pace.

Class IV or low-level laser therapy uses deep-penetrating light to promote a chain of chemical reactions known as photobiostimulation. This process helps relieve pain through improved blood circulation and the release of stored endorphins, neurotransmitters (chemicals that bind to receptors within an synapse to allow an “action potential”) produced in the brain (endogenous opiates) that act to open electrical gateways that mediate pain perception. Endorphin release appears to provide the phenomenon of continued pain relief after cessation of actual stimulation.

The physiological effects include accelerated cell division via mitochondrial stimulation, increased leukocyte phagocytosis (the process by which white cells consume bacteria), stimulation of fibroblast (connective tissue cells) production, enhanced synthesis of ATP (energy storage molecules) and angiogenesis (development of new blood vessels).

Cold laser therapy is also used to treat ear infections, gingivitis, hot spots and open wounds, and anal gland infections. The laser used for this type of treatment will not burn your dog's skin.

Cryotherapy

(Thermotherapy: both heat or cold) The term comes from the Greek cryo (icy cold) and surgery (“hand work”). Ice or freezing therapy, typically uses cold packs to reduce pain and inflammation, speed healing, and decrease deep tissue bleeding. Cryotherapy along with rest is highly curative for muscle tears and pulls. Techniques include vapocoolant gel (cold sprays), even an “ice bath,” freezing a specific body part, and even placing the dog in a cryotherapy chamber for a brief period.

Thermotherapy results in vasodilation (dilatation of blood vessels, which decreases blood pressure) with secondary increased local circulation, a decrease in pain, relaxed muscle tone, reduced muscle spasm, and an increase in tissue extensibility, cellular metabolism and local tissue oxygenation. Absence of systemic side effects is a primary benefit.

For skin disorders or surface-oriented tumors, the application of extreme cold to destroy abnormal or diseased tissue: when target cells are subjected to freezing temperatures, ice crystals form inside the cells, causing them to tear and rupture. Additional cellular and tissue damage occurs when blood vessels supplying the diseased tissue freeze. Cryotherapy is thus most appropriate for destroying neoplastic tissues (tissues that divide/replicate uncontrollably) that are relatively accessible—tumors involving the skin or mucous membranes—to avoid freezing too many normal cells.

The intense cold also kills bacteria, and so is advantageous when dealing with infected tissues. In this case, using liquid nitrogen as a cryogen (sprayed, dabbed, or needle-infused), or directed to target cells, causing them to die and fall off the surface of the dog’s skin; a simple and cost-effective procedure (argon gas a recent development: the Joule-Thompson principle).

Thus also called cryosurgery, the accompanying numbing of surrounding sensory nerves reduces pain and discomfort. Cryosurgery is indicated for elderly patients considered high risk for general anesthesia, and prolonged surgical techniques where a long anesthetic may present unacceptable risks. Some form of sedation and pain relief is necessary, as the actual freezing process is painful.

Extracorporeal Shockwave Therapy (ESWT)

(See also, above: “Acoustic Shockwave Therapy”)
Used to break down scar tissue, reduce swelling, inflammation, and muscle spasms, Sesamoiditis (inflammation caused by degeneration of small knuckle bones in the foot that can cause persistent lameness); hip and elbow dysplasia, degenerative joint disease, osteoarthritis, osteochondrosis (abnormal bone growth), tendinopathy and ligament lesions or injuries, non- or delayed healing bone fractures, back pain; and chronic or non-healing wounds.

ESWT utilizes therapeutic ultrasound devices that transmit focused, high-energy pulsed sound waves through the dog’s skin (causing soft tissues to “vibrate” and generate heat as they expand and contract, causing a change in local density), facilitating vasodilation (increasing blood flow), oxygenation, and nutrient-flow to internal injuries and wounds.

Originally developed to break up kidney stones in humans (lithotripsy): the high pressure amplitude of the shock waves cause high stress forces on the stone surface, and combined with the “short rise time,” exceed the elastic strength of the stone causing cavitation, disintegrating its surface.

In contrast to lithotripsy, orthopedic shockwaves are not being used to disintegrate tissue, but rather to microscopically cause interstitial and extracellular responses leading to tissue regeneration.

ESWT (see also: acoustic compression therapy, or ACT) initially stimulates nerves around the target area to the extent that their activity begins to diminish, sending fewer pain signals to the brain. Over time, it operates as a “gate control mechanism” in which the signals being sent by the machine override the pain signals sent to the brain.

When ESWT is applied to areas of non-healing tissue, it may trigger release of acute cytokines (proteins that are involved in autocrine signaling, paracrine signaling and endocrine signaling as immuno-modulating agents) that stimulate healing by provoking an intensified immune response. (for this reason, dogs that are immune-compromised may not respond as well to ESWT). Accompanying pain relief may be the result of increased serotonin activity in the dorsal horn (located in the spinal cord).

The electrohydraulic technology used to generate sound shockwaves is noisy, and the process is painful, so the dog is sedated during the procedure. Care is taken to avoid the brain, heart, lungs and intestines, as well as neurovascular structures (major nerves and blood vessels). ESWT is not recommended for dogs with clotting disorders due to the potential for bruising.

Hydrotherapy

Aquatic Therapy: (swimming and underwater treadmills) in which the buoyancy of water enables range of motion by reducing pressure on the dog's injured or painful joints: as a completely non-weight-bearing environment. At the same time, water provides resistance that supports strength conditioning, and is especially beneficial to arthritic dogs work their joints, maintain muscle mass, lose weight, and move around comfortably all while minimizing discomfort. Hydrotherapy increases blood circulation, speeding tissue healing, and contributes to improved cardiovascular fitness and stamina. The duration of exercise needed in water may be less than that needed for similar exercise on land, which many older dogs could not tolerate.

Neuromuscular electrical stimulation (NMES)

Low-volt electrical stimulation (electrotherapy) of motor nerves delivered via leads and flexible, low-resistance (sticky pad) electrodes that conform to the skin, to cause muscle contractions: contraction/relaxation of the dog's muscles can help to improve musculoskeletal and vascular (especially blood flow/oxinization) conditions associated with internal medicine.

NMES is used in rehabilitation to treat injuries that present muscle atrophy, whether this is due to inactivity or trauma related problems that have caused damage to muscle or the nervous system.

At the cellular level, electrotherapy causes nerve cell excitation and changes in cell membrane permeability, therefore stimulating protein synthesis, osteosynthesis (metal stabilizing implants) and fibroblast (connective tissue) formation. At the tissue level, electrotherapy causes skeletal muscle and smooth-muscle contraction. At the segmental level, it facilitates muscle-pumping action, resulting in improved joint mobility as well as circulatory and lymphatic drainage. This makes it ideal for post surgical recovery, “muscle re-education,” and strengthening, or in cases of
delayed wound healing.

Transcutaneous Electrical Nerve Stimulation (TENS)

Antialgic electrotherapy is used on dogs to combat pain, the most common being the TENS current, or transcutaneous (applied, or measured across the depth of the skin, commonly sticky pads) electrical nerve stimulation. The conventional TENS mechanism of action blocks the pain stimulus at the medulla level (the inner region of an organ or tissue) so that it does not reach the central nervous system (complex of nerve tissues in the brain and spinal cord that control the activities of the body) and then be promoted to the higher nervous centers. It works by stimulating faster sensory nerves causing an overload of interneurons, which limits the ability of sensory nerves to transmit pain signals to the brain, creating analgesia for the patient.

The endorphinic TENS stimulates the release of endorphins—hormones (peptides) secreted within the brain and nervous system which activate the body's opiate receptors, causing an analgesic effect—to suppress pain signaling.

Pulsed electromagnetic field (PEMF) therapy

For pain management in orthopedic injuries and in chronic conditions, including hip dysplasia. veterinary PEMF is used to speed healing and relieve pain, by exposure to a combination of electric and magnetic fields that promote ion transport across cell membranes, improving cell metabolism and healing. Veterinary PEMF delivery is most common through battery-operated jackets and beds or pads; timers allow for a standard 20- to 30-minute treatment session.

Reiki

Bio-energy healing that targets the energy fields around the body. Used to promote relaxation and reduce stress, (regarded particularly prior to medical treatments); speed post sickness/surgery healing, pain relief, inappetence, and to help resolve fear or anxiety-related behavioral problems. This is based on the concept of the omnipresent nature of energy as root cause of all disease, illness, mental, emotional and spiritual issues.

Of Japanese late 1800s origin, Reiki (Rei, “universal life,” and Ki, “energy”: “mysterious atmosphere, miraculous sign”) is a healing art based on the principle that the therapist can channel “universal energy” into the patient using spiritually guided life force energy through the palms, to activate the natural healing processes of the patient's body and restore physical and emotional well-being. This spiritual basis (“vitalism”) is part of the Japanese holistic healing system that uses specific meditative, breathing and other practices to support energetic rebalancing and the self-healing process. The “Usui System” of Natural Healing (1922: Japanese Buddhist Mikao Usui) is the form most widely practiced (American counterpart: TT, or “Theraputic Touch”).

However, Reiki is not affiliated with any particular religion or religious practice. Students undertake the learning process of “attunement” through Reiki masters, who raise their students’ vibrations and thus imbue them with healing capacity. Reiki is not massage, nor necessarily need involve actual physical touch. Not based on belief or suggestion, it is instead non-contact energy manipulation, inviting the participation of angels, beings of light, or spirit guides for assistance with treatment.

Practitioners explain that energy can stagnate in the body where there has been physical injury or possibly emotional pain. In time, these energy blocks lead to symptoms of physical, mental, or emotional imbalance. Practitioners act as a conduit to transfer energy through their own palms (“laying on hands,” that may become hot) held over the patient until the energy stops flowing, thus (among other terms): centering, clearing, beaming, infusing, extracting harmful energies, and smoothing of the patients “aura.”

Reiki seeks to enable the patient to realize their ability to connect with his own healing energy and use it to strengthen and restore balance so that “ki” is strong and free-flowing: a positive state of health that facilitates
healing on all levels: physical, physiological, mental, and emotional.. This holds significance for animals, who cannot verbalize fear or discomfort, and so allopathic/Western veterinarians therefore must focus on “clinical symptoms” and diagnostic testing to devise a treatment plan. The Reiki practitioner seeks to penetrate that communication barrier by tapping into the energy centers (chakras), of an ailing or distressed animal, enabling him to move that life energy within the body
to restore balance.

Reiki remains controversial in that “scientific,” peer-reviewed research into its effectiveness is lacking, with existing studies criticized as suffering from methodological flaws that render them inconclusive, and in any event, that “life energy” is unseen and therefore un-measurable. However, a 2008 study demonstrated that cells in a petri dish responded favorably to Therapeutic Touch treatments, which completely removed the “mind/body” aspect that researchers are often critical of.

Stem Cell Therapy

Harvesting cells derived from the dog’s fat, bone marrow, or umbilical cord blood to treat traumatic, autoimmune, and degenerative disease: stem cells move to the inflamed or damaged tissue, suppress the inflammation, relieve pain, and trigger new tissue growth. Limited by access and cost, the procedure requires anesthesia (at least twice), which brings associated risks.

Therapeutic ultrasonography

Application of variable sound waves directly to the skin to produce a “vibration” in the underlying tissue, used in veterinary rehabilitation to treat joint swelling, muscle spasms, strain lesions and biciptial tenosynovitis (inflammation of the biceps brachii tendon and its enveloping synovial sheath that display as forelimb lameness in larger or older dogs). Intensity can be adjusted depending on the desired effects, such as deep local heating, increasing in blood flow, and breakdown of scar tissue.

Similar to diagnostic ultrasonography, therapeutic ultrasonography converts electricity to sound waves by a piezoelectric (mechanical) effect in the transducer head. Ultrasound waves are reduced by the tissues they pass through: bone attenuates the waves the most; followed by cartilage, tendon, skin, blood vessel, muscle, fat and, lastly, blood. Thus, the treatment for deep tissue is established, including duty cycle, frequency, intensity and treatment duration.[3]

GLANDULAR THERAPY

The use of tissues and extracts from animals to treat organ disease, chronic inflammation, or cancer. Prominent examples: use of thyroid and pancreatic tissue to treat hypothyroidism and exocrine pancreatic insufficiency, using “like supports like,” or, using foods or supplements with tissues specific to those that are damaged or malfunctioning; (i.e., feeding heart, which has all the components, or “building blocks”: the complete nutrient profile that makes up heart, to a patient with heart disease). Subsequent to conventional treatment or pharmaceutical support from the conventional/Western doctor, the integrative veterinarian will administer highly bioavailable supplements derived from bones, organs, and plants; that is: “whole-food ingredients.”

AHVMA Modalities; Quick Reference:

Finding a
Trained Integrative/Holistic Veterinarian

Holistic veterinary medicine is becoming more mainstream, which develops opportunities for conventional practitioners to become educated, certified, and develop practices that will grow. But as market-driven demand elevates, so it can lead to consumer confusion, and perhaps even misapplication of terminology by vendors. There are veterinarians that claim to be holistic yet they may not fully understand the definitions or what consumers may expect. Many mix standard allopathic/Western treatments with natural therapeutics, and are more comfortable with this model: especially for management of emergent and life-threatening symptoms.

The western medical model takes a very reductionist view of health, both in the diagnosis and treatment of chronic diseases. From this approach prescription drugs have become the backbone of modern medical practice.

Finding a holistic or non-aversive veterinarian is a more challenging task than a locating a general practitioner, particularly for those living in more rural areas with few vendors, or, communities where veterinarians are less progressive to adopt, or at least be open to acknowledging, holistic therapies and alternative medicines.

Today, attitudes are continually broadening. A Morris Animal Foundation survey identified that approximately 50% of disease-related deaths in dogs are due to cancer, this ever-increasing trend essentially an epidemic: the ultimate expression of autoimmune disease, in which a weakened and confused body begins attacking itself; a disease of the young.

Similar factors have led to increased interest in alternative therapies for humans; and the medical and insurance professions have begun to acknowledge (and reimburse for) practices which used to be openly dismissed as in-efficacious. People now inquire if these same protocols might work for their dogs—especially for older dogs—to augment or supplant conventional or invasive medical treatments, and to treat conditions without drugs and their attending side effects.

Importantly, democratization of information through the internet means that medical professionals are no longer in sole possession of medical knowledge. As either patients themselves or as pet guardians examining these issues, challenging conventional treatment choices which link cure rates to the level of invasive-ness of a medical remedy has made holistic alternatives more attractive. As interest turns to investigating a less unnatural approach that acknowledges our authentic connection to both a spiritual and physical earth, virtually every alternative or complimentary therapy in use for humans is being practiced on some level for domestic animals.

Whether you would be searching for a specific discipline/modality, or, may not be certain what is appropriate for your dog, it is important to locate a veterinarian with suitable training and credentials. The organizations below list and/or accredit veterinarians in specific modalities, and you should further carefully question the experience of the practitioner.

For you to choose a holistic veterinarian it is practical to first narrow down your needs. If you would be satisfied with a doctor that has a regular practice but is open to alternative medicine, the field is large and many of the veterinarians listed by The American Holistic Veterinary Medical Association might meet your requirements.

Further to first-hand referrals from your friends and neighbors who own dogs... breeders, pet supplies stores, dog trainers, animal shelters and welfare groups may have practitioners to suggest to you. A useful approach may be to consult with holistic doctors or practitioners for humans: some have personal relationships with, or have holistic veterinarians in their network; (use the same terms in your search). Although it may appear archaic, the local phone book can be your best source to locate a holistic veterinarian: some don’t have Internet access or feel comfortable maneuvering technology; and many holistic veterinarians or practitioners have yet to incorporate technology into their “system.” For this reason, many won’t have a website highlighting their services.

RESOURCES:

Alternative Medicine: The American Holistic Veterinary Medical Association. There are organizations that train and certify holistic veterinarians in different disciplines as well, as the AHVMA maintains a list of interested (but not always holistic) veterinarians.

Homeopathy: The Academy of Veterinary Homeopathy.

Acupuncture: The American Academy of Veterinary Acupuncture. Some of the veterinarians in their list are totally holistic, and some don't even use acupuncture in their practices; but all have gone through the training and passed the certification exams.

Chiropractic: The American Veterinary Chiropractic Association.

Osteopathy: The Worldwide Alliance of Equine Osteopaths (formerly International Association of Equine Osteopaths), certifies animal osteopaths.

OTHER RESOURCES:

The Veterinary Institute of Integrative Medicine strives to raise awareness of the benefits of integrative approaches in veterinary medicine, and works with holistic organizations and animal wellness consultants to broadcast information about developments in the field.

AltVetMed: information on complementary and alternative veterinary medicine.

The Veterinary Research Council: Clinical trials of holistic remedies and natural compounds in veterinary medicine.

Chi Institute of Chinese Medicine: traditional Chinese veterinary medicine.

The Veterinary Medical Aromatherapy Association: promotes standards in animal medical aromatherapy, providing outreach and education to veterinarians.

The American Botanical Council: provides science-based and traditional information to promote responsible use of herbal medicine; publishes a peer-reviewed journal.

The Homeopathy Research Institute (UK): promotes scientifically replicable research to provide decision makers, academics, healthcare practitioners and patients with reliable, academically sound information about homeopathy.

[1] Journal of the American Medical Association, 280 (Nov. 1998, Theme issue): 1618-1619, Phil B. Fontanarosa, MD; George D. Lundberg, MD, Editorial: “Alternative Medicine Meets Science.”

[2] Example: Bausch + Lomb’s U.S. patent 6,660,297 (the ‘297 patent) covering PreserVision® AREDS (Age-Related Eye Disease Study) and AREDS 2 Formula eye vitamins. Two extended trials were partially sponsored by Bausch & Lomb, but also received tens of millions of dollars in taxpayer funding through the National Eye Institute (NEI), one of 27 institutes and centers of the US National Institutes of Health, an agency of the US Department of Health and Human Services.

[3] Recent research seems to hold promise to advance on principles of photodynamic therapy, in which chemical agents (sono-sensitizers) are injected into tumors, then activated by laser light to generate oxygen free radicals which in turn damage DNA and induce programmed cell death (apoptosis) of the tumor cells.

Sonodynamic therapy (focused ultrasound) may also be able to activate many of these same chemical agents, for example the dye 5-ALA that is absorbed preferentially by tumor cells, which are injected intravenously. Upon application of focused ultrasound to the targeted tumor, the agents induce the same toxic effect as in photodynamic therapy, causing death of targeted cancer cells.

Sonodynamic therapy offers the advantage of its non-invasive manner, and capability of treating regions deeper in the body where light would either be blocked or require more invasive delivery methods. Focused ultrasound can also provide conformal dosage of energy, and thus induce apoptosis throughout the entire tumor. Furthermore, toxicity can be induced in a precise location while minimizing harm to other areas of the body.

[4] See: James George Frazer: The Golden Bough: A Study in Comparative Religion (1890; re-titled The Golden Bough: A Study in Magic and Religion). Note, for example, relevance with respect to glandular therapy, above.

I am an ember faintly burning,
A fragment of love long ago,
If you kindle my spirit,
And I will warm you,
You can feel your heart start to glow.

But you worry about the demon of darkness,
The snarling beast in the night,
With my release you will find peace,
Healing your wounds and mine.

I am a painter with prism and palette,
Sleeping inside of your soul,
Honor the purpose,
Cherish the wisdom,
And I will make you whole.

I am a meadow ablaze in crimson,
Come and rest with me here,
Bathe in the beauty,
Breathe in the fragrance,
And you will conquer your fear.

I am a river flowing beside you.

—Bill Leslie

Come home to me, when darkness falls,
and the light of day is sleeping,
your heart will be just for my keeping,
if only in dreams, where all of the eternal light of love shines forever.

N.B.: This essay is written for informational purposes. Our goal is to build awareness of concepts and define common terminology to stimulate discussion. We draw your attention to issues and concepts that are or may be important to the subject at hand, but do not consider that our interpretation is necessarily complete. Links are in blue & will illuminate when you pass your mouse over them. Nothing in this page is intended to be interpreted as advice. Any person who intends to rely upon or use the information contained herein in any way is solely responsible for independently verifying the information and obtaining independent expert advice if needed.