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

If you think that the papers published on SCAM for humans are bad, you should have a look at those in the veterinary sector. Take for instance this article from the AHVMA (American Holistic Veterinary Medical Association) Journal:

Evidence demonstrates that acupuncture and herbal medicine are useful and effective for the treatment of seizures. In the perspective of Traditional Chinese Veterinary Medicine (TCVM), seizures in dogs and cats can be classified into 6 patterns:

  1. Obstruction by WindPhlegm,
  2. Internal Profusion of Phlegm-Fire,
  3. Stagnation of Blood,
  4. Liver Blood Deficiency,
  5. Liver/Kidney Yin Deficiency,
  6. Yin Deficiency with Blood Deficiency.

This article focuses on how to differentiate and treat these patterns using herbal medicine and acupuncture. An overview of clinical trials is provided, and case examples are also included.

The authors from the ‘Equine Acupuncture Center/University of Florida, USA, concluded that the combination of TCVM and Western medicine (WM) can be an effective therapeutic approach to control seizures and epilepsy. WM is effective for initial control of severe seizures and in identification of the cause of the disease. TCVM can be effectively used for the treatment of milder cases and to help control seizures in those patients that fail to respond to WM. 

Having done some research into acupuncture for animals myself, I was particularly interested in this aspect of the paper – interested and disappointed, I have to admit. The sad truth is that, despite the opimistic conclusions of the authors, there is no sound evidence. As no good evidence has emerged since, our own systematic review of 2006 (which was not cited by the authors of the above article) still holds true:

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.

The AHVMA-article becomes wholly farcical, once we see the heading the AHVMA-journal has given it:

SCIENTIFIC REVIEW

The AHVMA-journal is the official publication of the American Holistic Veterinary Medical Association, according to their own statement, is the mindful leader elevating the veterinary professional through innovation, education, and advocacy of integrative medicine.

One stated objective of the AHVMA is to advance and educate in the science and art of holistic veterinary medicine. If their new ‘scientific review’ is anything to go by, they seem to have a most bizarre view about science. The question that occurred to me while reading the paper was this: are they not promoting animal abuse, a term defined as any use or treatment of animals that seems unnecessarily cruel, regardless of whether the act is against the law?

 

11 Responses to Traditional Chinese Veterinary Medicine for the Treatment of Seizures in Dogs and Cats – is the AHVMA promoting animal abuse?

  • 1. Obstruction by WindPhlegm,
    2. Internal Profusion of Phlegm-Fire,
    3. Stagnation of Blood,
    4. Liver Blood Deficiency,
    5. Liver/Kidney Yin Deficiency,
    4. Yin Deficiency with Blood Deficiency.

    Reheated Galenic garbage that real medicine trashed 150 years ago. And they call it “science”? They’re an utter disgrace to the veterinary profession and should not be permitted within a hundred feet of anything with a pulse.

  • Thank you Edzard for again addressing topics in veterinary medicine.

    There are a number of reasons why I believe continued reporting on SCAM in veterinary medicine is very important.

    TCVM has been making large insidious gains into the mainstream of veterinary medicine. Universities and Colleges of Veterinary Medicine are complicit in allowing this creep into our colleges and universities. What makes TCVM so special as compared to other shamanistic, folkloric, belief based purported healing modalities to be mainstreamed and incorporated into the traditional allopathic medical curriculum…..money. It is rather odd that while the university supports TCVM, and there is a college of TCVM down the road from the University of Florida (https://chiu.edu/) not too much emphasis is given to it in the core curriculum…What does that say about the importance of TCVM if the instructors at the college do not feel necessary to include it in the basic curriculum of their veterinary students?

    Having universities become beholding to big donors, abandon their mandate to teach science and evidence based medicine is a disservice to our medical students…It should not be incumbent on the student to know what is or is not “real” medicine and not some artifact from the age of Mao. That is one of the reasons to attend school . Teaching this and other SCAM and equating it to EBM both legitimizes SCAM and does a disservice to students of medicine , clients and ultimately patients. Having school deans take medical programs down blind canyons of learning does not advance the profession , rather moves the curriculum back to a time where science and evidence doesn’t really matter. All this in the name of money.

    2. Supporting TCVM helps in the legitimization of TCM overall. If veterinary patients are being recommended to use and prescribed TCVM therapies, animal owners will view this as an endorsement of the use of TCM overall and thus be more likely to use the SCAM therapies on themselves. Edzard you have written extensively on the harm these non evidence based alt med modalities can cause, there is no need to have you expound on this.

  • Some vets are superb, such as the Queen Mother Hospital, who operated on my spaniel for a broken neck (see the BBC TV programme Supervets, Series 1, Episodes 3 and 4 – not to be confused with The Supervet, which is about a different practice), and my local vet in Devizes who supervised his recovery (he recovered from his paralysis and lived a further seven years).

    Then there are those such as a locum who saw another of our spaniels more recently after she had managed to wound herself running through a barbed wire fence. She not only recommended Manuka honey (OK, honey does contain antibacterial substances but it makes a sticky mess and the pharmacological version is quite expensive) but also vitamin C, as it promoted wound healing. Vitamin C deficiency certainly prevents wound healing in humans, as it is required for collagen synthesis – this is one of the main features of scurvey. However, ascorbic acid is not a vitamin as far as dogs are concerned because they, along with most other mammals, can readily synthesise it. Indeed, the only effect of giving vitamin C to dogs is to increase the risk of kidney stones.

    There was also the vet in Chelsea I had to take my dog to once when she developed haemorrhagic diarrhoea – it was a Sunday and my regular vet was closed – whose practice looked more like a Harley Street clinic, and who had posters everywhere advertising their holistic vetinary service. Thankfully they did give my dog proper care and she survived. But clearly this sort of nonsense is quite a money-spinner.

    There is quite a contrast between practices in London and in Wiltshire, where most of the clients are farmers who keep a firm eye on their bottom line.

  • Isn’t HRH well known for treating his farm animals with homeopathy?
    Some local vets use acupuncture for all sorts of ailments and there are local equine chiropractors.
    For all those who say “but placebos can’t work on an animal” – they work very well on gullible owners and vets.

    Personally I believe that sticking needles in a non-consenting animal is cruel and using inactive compounds to treat mastitis or other infections in farm animals is abuse. Somehow people believe that this is more “natural” or has an appeal to antiquity – although acupuncture as we know it is really a modern invention from the time of Mao though he would never use it preferring “Western medicine” for himself.
    Auricular acupuncture is a French invention from the latter half of the 20th Century – nothing ancient or mystical in it – or even effective come to that.

    I particularly love the Qi and meridian diagrams than are transposed onto images of the horse complete with points for the gallbladder for acupuncture – which organ is of course absent in a horse. Just one of many areas which go to show the complete ignorance of TCM with regard to anatomy, physiology and biochemistry -and reality come to that.
    Wind Phlegm and Liver Yin Deficiency – really?

    • I particularly love the Qi and meridian diagrams than are transposed onto images of the horse complete with points for the gallbladder for acupuncture – which organ is of course absent in a horse.

      LOL, I did not know that: must’ve got kicked out before that class. Obviously my mistake was going to the Dick when I should’ve gone to the School of Making Sh*t Up. So what’s their excuse?

    • John,

      I particularly love the Qi and meridian diagrams than are transposed onto images of the horse complete with points for the gallbladder for acupuncture – which organ is of course absent in a horse.

      If the acupuncture points for the gall-bladder are invalid, are you suggesting that points for treating other structures might not be?

      Interestingly, the concept of Qi seems to be all-pervasive in oriental life, although there is no equivalent word in English. In Japanese The Kanji 気, pronounced ki, is the same as the Hanze for qi in Chinese. So you might well greet a colleague as follows:
      “Ohaiyo gozaimasu! O-genki desu-ka?” (おはようございますお元気ですか)

      The whole greeting means something like:
      “It is early! You have original spirit / vitality / vigor?”

      The equivalent in European languages might be:
      “Guten Morgen. Wie gehten zie dir?”
      “Bonjour! Comment voulez-vous?”
      “Bon giorno. Come stai?”

      Though in China they simply ask “You good?”. But then, Chinese has no grammar to speak of, and the Chinese themselves don’t go in for the same degree of ritualised formality as the Japanese.

      The Japanese word for weather is tenki, 天気, which approximates to heaven-spirit. The symbols are the same in Chinese (slightly simplified on the mainland), but the pronunciation is a little different.

      • I always find interesting the lack of grammar in the Chinese languages and the way it influences the way Chinese speakers use English.

        “What you want? Shop close.”

        Clearly agrammatical. But also entirely comprehensible.

        Maybe we could learn something.

        • Or 好久不見 (hǎojiǔ bù jiàn in Mandarin – the accents indicating the tones, though because of the rules forbidding two third or fourth tones in a row the first and third syllables are pronounced with a second tone, i.e. medium pitch and rising) “Long time no see”.

          The verbs don’t conjugate at all, and there are no genders or plural forms. On the other hand many nouns require a “counter” to indicate what kind of object they are. You can’t just say “two dogs” or “three tickets”. It is a bit like saying “a loaf of bread” in English rather than “a bread”. The counters vary with the type of object – animals for dogs and small flat things for tickets.

          Mandarin is supposed to be one of the most difficult languages to learn, though Chinese children don’t seem to have any trouble picking it up. I suppose one reason is the writing system, since there are thousands of symbols to memorise, though there is a system to them, and since written Chinese is independent of pronunciation anybody in China can understand what anybody else has written, even if they speak a completely different language. In fact you can learn to read and write Chinese without knowing a word of Mandarin.

          The chief difficulty that English speakers seem to have is getting the hang of the tonal system; I never found this a problem, perhaps because I am a keen (though not very skilled) musician. Whenever I tried anything out on my Mandarin-speaking friends their response was a surprised “I can understand what you are saying!” because of course without the right tones it is completely incomprehensible. My main difficulty was vocabulary, as there is very little in common with English (unlike Indo-european languages such as Hindi). Also I know my accent is terrible.

          Japanese has a completely different set of problems. It is much easier to pronounce, and there is a phonetic writing system (two, actually, which they use jumbled up with Chinese characters and Roman ones, as I saw to my amusement the other day when I was looking at the instruction booklet for an Epson scanner I had just bought). There are also a lot of words directly lifted from English, and some from Portuguese. The grammar is complex, however, and rather different from European languages, and there are completely different ways of speaking depending on your status relative to who you are speaking to (and indeed to some extent whether the speaker is male or female). Most words have suffixes attached to them known as particicles indicating their function in a sentence, rather like the different word endings in Latin; the word order is also similar to Latin, with the verb at the end.

          Knowing a little Latin isn’t just helpful for getting the hang of Japanese, of course. It enables you to recognise which English words have Latin roots, which gives you a vocabulary in French, Italian, Spanish, Portuguese and Romanian, and which don’t, which gives you a vocabulary in German. And it makes you more aware of key grammatical concepts.

          • My wife’s aunt is a professor of linguistics and an expert in tone languages. She’s one of these odd people who can learn languages the way that we can learn a poem. She’s also one of the rare people who can speak several Basque dialects, reportedly THE most complex language on Earth.

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