Overview of Integrative Veterinary Medicine

Integrative veterinary medicine (IVM) is the practice of complementary and alternative therapies used in conjunction with conventional (mainstream) care. A key difference between complementary and alternative and conventional medicine is the strength of evidence supporting best practices. Mainstream medicine, when possible, bases its practices only on the most conclusive scientific evidence. In contrast, complementary and alternative bases its practices on evidence-informed practices—practices based on the best evidence available, even when such evidence does not meet the highest, strictest criteria for efficacy and safety. Nonetheless, as the scientific evidence for nondrug, nonsurgical techniques grows, the legitimacy and acceptance of integrative approaches continue to expand. In fact, the convergence of science-based integrative medicine, fear-free veterinary care, rehabilitation, and bond-centered practice is culminating in a new vision of what frequently constitutes a "typical" veterinary practice.

Despite the popularity of IVM, the need to verify its safety and effectiveness remains. This requires research and objective endpoints. Methodologies that indulge in metaphysical mechanisms and metaphorical explanations may attract a following but cannot withstand scientific scrutiny. Simply put, it is impossible to test a metaphor. For example, when a Traditional Chinese Veterinary Medicine (TCVM) practitioner claims to balance "Yin and Yang", ie, two complementary systems that purportedly comprise all phenomena in the universe, how would one quantify changes in "Yin-ness" or "Yang-ness"? Terms such as these, as well as "Five Elements," "Eight Principles," and others constitute leftover terminology from centuries-old ideologies. Instead of remaining mired in a prescientific era and retaining imprecise descriptors, IVM is better served by approaching acupuncture, manual therapy, nutrition, and botanical modalities rationally and with contemporary biomedical understanding.

Pseudoscientific practices such as homeopathy, applied kinesiology or muscle testing, and flower essence therapy, which are based on metaphysical energies and vital forces, are waning in popularity as more clinically meaningful and science-based methodologies are replacing them. In fact, veterinarians are learning multiple ways to care for their patients with far fewer pharmaceuticals and much less surgery. Combining integrative medicine and rehabilitation, for instance, can often provide effective, nonsurgical options for patients with neurologic and orthopedic ailments. Such IVM interventions typically include medical acupuncture, photomedicine, medical massage, and botanicals. Furthermore, recommending nonopioid options lessens the risk of facing drug diversion, drug shortages, and untoward outcomes.

To this end, factual information about the benefits and risks of all therapeutic options should be available to clients/animal owners, especially for conditions such as intervertebral disc disease and cranial cruciate ligament injury that call for making difficult choices based on finances, uncertain prognoses, and/or invasiveness of the procedure and potential for long-term disability. Basing treatment recommendations on science and substance, rather than myths and metaphors, allows veterinarians communicate with clients rationally and with empathy while discussing the pros and cons of integrative medicine compared with traditional drugs and surgery.

This chapter describes the most commonly sought IVM treatments, including how they work (or why they do not), what they may treat, and inherent concerns about safety or legitimacy.