MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

The Horse‘ is not a publication I often read. But I was alerted to an article in this magazine that fascinated me. Allow me to show you a few short quotes:

In essence, holistic medicine falls under the realm of what we now refer to as, “complementary, alternative, and integrative veterinary medicine,” or CAIVM. The American Veterinary Medical Association (AVMA) describes CAIVM as “a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices that are not considered part of conventional (Western) medicine as practiced by most veterinarians.”

… Joyce Harman, DVM, owner of ­Harmany Equine Ltd., in Flint Hill, Virginia, is one veterinarian committed to the practice of CAIVM. She’s certified in acupuncture and chiropractic and has completed advanced training in veterinary homeopathy, nutrition, and herbal medicine. “If you’re looking for a local practitioner, find one with extensive training in the modality you’re interested in,” she says…

Let’s have a look at the actual evidence for or against these treatments. Here are (again) the most up-to-date systematic reviews for acupuncture, chiropractic and homeopathy in veterinary medicine:

ACUPUNCTURE

Acupuncture is a popular complementary treatment option in human medicine. Increasingly, owners also seek acupuncture for their animals. The aim of the systematic review reported here was to summarize and assess the clinical evidence for or against the effectiveness of acupuncture in veterinary medicine. Systematic searches were conducted on Medline, Embase, Amed, Cinahl, Japana Centra Revuo Medicina and Chikusan Bunken Kensaku. Hand-searches included conference proceedings, bibliographies, and contact with experts and veterinary acupuncture associations. There were no restrictions regarding the language of publication. All controlled clinical trials testing acupuncture in any condition of domestic animals were included. Studies using laboratory animals were excluded. Titles and abstracts of identified articles were read, and hard copies were obtained. Inclusion and exclusion of studies, data extraction, and validation were performed independently by two reviewers. Methodologic quality was evaluated by means of the Jadad score. Fourteen randomized controlled trials and 17 nonrandomized controlled trials met our criteria and were, therefore, included. The methodologic quality of these trials was variable but, on average, was low. For cutaneous pain and diarrhea, encouraging evidence exists that warrants further investigation in rigorous trials. Single studies reported some positive intergroup differences for spinal cord injury, Cushing’s syndrome, lung function, hepatitis, and rumen acidosis. These trials require independent replication. On the basis of the findings of this systematic review, there is no compelling evidence to recommend or reject acupuncture for any condition in domestic animals. Some encouraging data do exist that warrant further investigation in independent rigorous trials.

CHIROPRACTIC

There are no studies of chiropractic for animals and hence no systematic review. However, I did publish a blog-post about veterinary chiropractic. It arrived at this conclusion: chiropractors treating animals and those treating humans have one important characteristic in common. THEY HAPPILY PROMOTE BOGUS TREATMENTS.

HOMEOPATHY

Meta-analysis of randomised controlled trials (RCTs) of veterinary homeopathy has not previously been undertaken. For all medical conditions and species collectively, we tested the hypothesis that the outcome of homeopathic intervention (treatment and/or prophylaxis, individualised and/or non-individualised) is distinguishable from corresponding intervention using placebos.

All facets of the review, including literature search strategy, study eligibility, data extraction and assessment of risk of bias, were described in an earlier paper. A trial was judged to comprise reliable evidence if its risk of bias was low or was unclear in specific domains of assessment. Effect size was reported as odds ratio (OR). A trial was judged free of vested interest if it was not funded by a homeopathic pharmacy. Meta-analysis was conducted using the random-effects model, with hypothesis-driven sensitivity analysis based on risk of bias.

Nine of 15 trials with extractable data displayed high risk of bias; low or unclear risk of bias was attributed to each of the remaining six trials, only two of which comprised reliable evidence without overt vested interest. For all N = 15 trials, pooled OR = 1.69 [95% confidence interval (CI), 1.12 to 2.56]; P = 0.01. For the N = 2 trials with suitably reliable evidence, pooled OR = 2.62 [95% CI, 1.13 to 6.05]; P = 0.02).

Meta-analysis provides some very limited evidence that clinical intervention in animals using homeopathic medicines is distinguishable from corresponding intervention using placebos. The low number and quality of the trials hinders a more decisive conclusion.

So, what shall we make of ‘holistic horse care’ in view of this evidence?

I think I let you answer this question.

14 Responses to Holistic horse care

  • Should not acupressure point TW5 be a centimeter more proximal?

    • yes, I was wondering too

    • Sorry, Mr. Rawlins, but I must chime in before this thread gets out of hand.
      Yes, the figure is not accurate, but if you knew anything about horse psychology, you would have seen that the REAL acupressure point TW5 is located 1 cm DISTAL, not proximal!
      Thank you for demonstrating how ignorant you are!
      Please leave discussions about such serious issues to the professional horse whisperers.

      • Okay, you got me. I am not a doctor. (Which means, of course, I could easily call myself a chiropractor or naturopath!) So, as I started to read, I thought, “Oh, boy, this guy is a piece of work.”

        Then I got to the punch line.

        Brilliant!

  • My friend coined a term to describe how a proper veterinarian assesses these charlatanistic practices….He uses his “BULLSHITOMETER”. The modalities you cited above all seem to spike the device into the complete BS zone.

  • In case anyone wonders what these GB20 and GB21 points are: those supposedly are ‘acupoints’ on the gall bladder meridian. From the book Acu-Horse: A Guide to Equine Acupressure:
    “The Gall Bladder stores and excretes bile as needed for digestion. This yang organ system is paired with the liver, a yin organ system. The functions of the Gall Bladder are closely related to the Liver’s capacity to provide a harmonious flow of chi. Known in Chinese as Dan, the Gall Bladder assist the Liver in many of its functions. This organ system is thought to affect the animal’s courage and ability to make initiative and make decisions …”

    This is absolutely amazing – in fact, it’s bordering on the bloody miraculous. Because horses don’t have a gall bladder.

    • interesting but irrelevant, because horses, like humans, also have no meridians.
      it’s ALL fantasy!

      • You are, of course, absolutely right. Yet there is a qualitative difference: those meridians are claimed to be non-tangible in any case, so that our holistic friends can keep insisting that they’re there.
        Gall bladders, on the other hand, can simply be pointed out in many species – but not in horses. Which makes it all the more clear that our holistic friends are talking nonsense when they refer to a horse’s gall bladder.

        (Yeah yeah, I know, this is ‘solved’ by the alternative universe by saying that the meridian in question in horses is merely analogous to the ‘real’ gall bladder meridian in other species – never underestimate human fantasy…)

      • Yes, you are right! horses like humans..Horses can read human facial expressions and remember a person’s mood.

    • What seriously? I knew horses don’t have gall bladders because it comes up a lot in jokes about not extrapolating from animals to humans. But someone actually wrote this down?!

      It reminds me of the triple burner, which apparently is a “conceptual” organ.

  • I would like to know where the REN-1 point (AKA: “Conception Vessel 1” and “Huiyin Meeting Place of Yin”) is located on the horse.
    I would also want to know what it is used for? In humans it is partiularly useful for resuscitating the victim of drowning. It also works for constipation, erectile dysfunction and related disturbances.
    If the point is anywhere close to the correspoinding location in humans (See under “Location” in the webpage linked above) , I guess you have to wait till the horse is rather unrespoinsive before puncturing this panaceous point, the risk of being kicked would otherwise be prohibiting, I would think?

  • This makes my blood boil.

    Horses are prey animals. They have no instinct to fight back when serious illness occurs. They tend to shut down and die.

    Horses in our care depend on us to take care of them by giving them REAL medicine and REAL treatments under the care of REAL veterinarians.

    Joyce Harman, you are a heartless and, obviously, cognitively challenged charlatan. Selling this crap to unknowing and desperate horse-owners is shameful.

    Hand in your license (if you even have one) before you kill any more horses.

  • I know that you have to bond with your horse and it permanently disappears when it dies but can you for example take a skinny horse-like in RDR there are sickly skinny horse and feed and take care of them and you slowly see them build up muscles and their skin and fur becomes better

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