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♘ مدیریت انجمن اسب ایران ♞
There's a Great Divide in the equine community. It's not the endless squabbling among hard-core breed or discipline disciples, and it's not the uneasy relations between animal-rights groups and equestrian enthusiasts. It's the split between those horse owners and equine practitioners who favor a solidly "conventional" approach to veterinary medicine, and those who believe that so-called "alternative" therapies should have a place in--or even replace--conventional methods. The debate seems a bit like the typical U.S. citizen's perception of Congress: It's all about Republicans versus Democrats, right-wingers versus left-wingers. And--judging from each faction's jibes at the other--never the twain shall meet.
In spite of (or perhaps because of) the ongoing debate about the merits of chiropractic, acupuncture, and other "alternative" treatments, these and other modalities are exploding in popularity. First embraced by human medicine, methods ranging from herbs to homeopathy are now being used on the horses and house pets of enthusiastic devotees. Even horse owners who themselves have never had their spines adjusted or their ligaments lasered have turned to non-traditional practitioners when conventional methods failed to cure persistent, mysterious lamenesses or other problems. It's easy to see why a frustrated owner who's spent hundreds or thousands of dollars on conventional treatments and lost months of precious riding and training time, only to see little or no improvement, might become eager to give alternative treatments a try; after all, nothing else worked.
But are such horse owners the equestrian equivalent of the terminal-cancer patient who flies to far-flung lands for exotic curative "cocktails;" desperate and willing to try anything, no matter how outrageous? Some veterinary experts say yes, and warn horse owners against wasting their money on unproven and even potentially harmful substances and manipulations. Others argue that, when employed by experienced practitioners, certain alternative treatments can, indeed, produce good results.
With all the controversy, it might seem unlikely that experts would agree on any aspect of alternative therapies. But when The Horse talked with practitioners on both sides of the issue, we heard some common refrains and advice. In this article, we'll explore the debate in detail, and we'll give you some tools for making informed choices about the treatments your horse receives.
Introduction To Alternative Therapies
Numerous types of alternative therapies exist, and each generally can be classified as either "external" or "internal," according to how they're administered. Here are some of the predominant methodologies, along with descriptions of how they're purported to work.
External Therapies
Acupuncture
Based on one of many ancient Chinese medical theories and practices, acupuncture is the practice of inserting special slender needles into points on the body for a number of purposes, including relieving pain, allegedly by restoring the flow of bodily energies (chi or qi--pronounced "chee" in Chinese). Although various forms of acupuncture might have been practiced for centuries on humans, it was introduced into Western veterinary medicine only about 30 years ago. Acupuncture research indicates that stimulating the various acupuncture points has a variety of effects, possibly triggering endorphins (the body's natural opiate-like substances), which has been suggested as one mechanism by which acupuncture might promote pain relief. (A needleless form of the therapy, acupressure, stimulates the same points on the body and generally is considered a safe, somewhat milder form of treatment.)
Humans who have undergone acupuncture treatment say that the insertion of the needles is not painful. Many horses receiving acupuncture treatment appear undisturbed by the needling and relax markedly during the procedure, despite looking like equine pincushions!
Several varieties of acupuncture treatment exist, including the injection of substances such as saline or vitamins into the acupuncture points, and the use of heated needles. Proponents of such techniques believe that their methods complement the basic needling effect by providing additional stimulation and promoting healing.
Chiropractic
This probably is the most widely practiced alternative or "complementary" form of hands-on treatment in humans. Doctors of Chiropractic (DCs) have become commonplace in human medicine, and some medical-insurance companies now cover the costs of chiropractic care. As with acupuncture, human believers in the therapy have been eager to see it practiced on their animals; and horses, dogs, and cats now can receive regular spinal adjustments.
The derivation of the word chiropractic largely explains how the treatment is effected. The name is a hybrid of the Greek words cheir (hands) and praxis (act or action). The term was coined to describe the theory and approach of the 19th Century Canadian healer Daniel David Palmer, who believed that "subluxations" (defined by chiropractors as a loss of motion between two joints) cause disease by impeding various nerves and affecting related parts of the body as a result. Chiropractors treat human patients with all manner of complaints, from auto accident victims and injured athletes to migraine sufferers.
Equine chiropractors see a similar variety of patients. Some are horses which have suffered injuries, such as a fall while jumping or a lameness brought on after getting cast in the stall. Others are sport horses whose owners or riders complain of nagging, hard-to-pinpoint performance problems, such as back soreness, resistance to picking up one canter lead, or stiffness traveling in one direction. Chiropractic practitioners say they "adjust" their patients' spines by using gentle thrusts to realign vertebrae, thereby restoring full range of movement and allowing unevenly stressed muscles to relax and return to normal.
Lasers
Most people have heard of (or even undergone) surgical techniques using lasers (the word laser is an acronym for Light Amplification by Stimulated Emission of Radiation). Lasers have made possible remarkable advances in surgery by reducing the trauma and lengthy post-operative recuperation periods associated with some procedures. High-power lasers used in surgical procedures utilize light, but even low-power lasers, whose light intensities are far less than those used to cut, have found their way into medical practice in an attempt to speed the healing of wounds and soft-tissue injuries. Laser therapy advocates believe that benefits result from the beneficial effects of electromagnetic radiation, which the laser devices transform into highly amplified beams of light that can penetrate beneath the skin.
Some veterinary practitioners like to use low-power lasers on horses with such injuries as suspensory ligament pulls and bowed tendons. Other laser therapy proponents advocate the use of lasers in the treatment of a much wider spectrum of equine ailments, from navicular syndrome to osteoarthritis.
Magnets
There are two forms of magnetic therapy used in human and veterinary medicine: static magnetic and electromagnetic. The former takes the form of magnet-containing garments, blankets, pads, and the like, which are designed to be worn over stiff or injured areas and which purportedly work by increasing blood flow, relieving pain, and promoting healing. Electromagnetic therapy uses a pulsating magnetic field created by passing an electric current through a coil. Pulsating electromagnetic fields are thought to promote the healing of bone fractures, soft-tissue injuries, and wounds, and to reduce pain by stimulating cellular activity.
A wide variety of static-magnetic devices for horses is available, from hoof pads and leg boots to blankets. Considerably more expensive are the electromagnetic boots or blankets, which deliver a low-amplitude pulsating current to the affected areas.
Massage
The most "low-tech" of the therapies, massage is perhaps more complementary than alternative. Many people enjoy massage simply for its relaxation value, and most of us have enjoyed a soothing back or foot rub. Some athletes and others view massage as an important tool for easing stiffness, promoting circulation, and even preventing injuries. A number of established massage techniques exist, and practitioners of each believe that their methods serve specific purposes in helping their clients feel and perform their best.
Likewise, equine massage therapists claim that their services go beyond just "rubbing horses." Many point to satisfied horse owners who say massage treatments helped reduce or eliminate symptoms of back soreness, stiffness, or even lameness in some cases.
Internal Therapies
Herbs
Some people turn to herbs or "botanicals" in lieu of conventional pharmaceuticals and over-the-counter remedies, believing that the plant-derived preparations are safer, more effective, or more natural than other drugs, whose active ingredients might be synthesized. Recently we have seen an explosion in the popularity of herbal remedies--from topical creams and compresses to teas and pills. Well-known human vitamin labels now offer tablets containing herbs that are purported to enhance immunity, ease mood swings, or boost energy, among other benefits their manufacturers claim.
Many of these same herbs are available to lay horse owners, as well as to specially trained practitioners of herbal medicine, including Chinese herbal medicine. (For more information see our cover story on page 28.) Horse owners who wish to treat their animals with herbs can obtain them easily from practitioners, specialty catalogs, health food stores, tack shops, and feed stores. To locate some of these refer to The Horse Source. Books, magazine articles, and Web sites describe how to prepare and administer herbal remedies to treat a wide variety of external and internal complaints. Caution should be used in that herbals can cause serious problems if not administered properly
Homeopathy
This perhaps is the most controversial and difficult to understand of all alternative therapies. An 18th Century German physician, Dr. Samuel Hahnemann, developed an unusual theory: that exceedingly diluted substances--the more dilute, the more potent--could cure disease. The active ingredients in some homeopathic remedies are toxic when ingested in larger doses (think of poisonous plants and the like). Used in homeopathy, however, the substances are diluted to the extent that they are present in infinitesimal amounts--if at all--in the liquid that's consumed, making them generally unlikely to produce harmful side effects.
Equine homeopaths use the remedies to treat numerous ailments, from internal disease to skin disorders.
Nutraceuticals
Like the word chiropractic, "nutraceutical" is a coined term. In this case, it is a blend of the words "nutrient" and "pharmaceutical." A nutraceutical is a dietary supplement (ingested as food) that purports to offer drug-like health benefits that extend beyond the realm of good nutrition. Nutraceuticals generally are lumped into the category of alternative remedies because their use is relatively new, they aren't regulated as foods or as drugs, and their effectiveness has not been proven conclusively across the board.
People generally use nutraceuticals for many reasons, including to enhance athletic performance or to relieve pain. Human athletes might take such supplements as the amino acid carnitine, which some believe decreases lactic-acid formation and thus lessens muscle fatigue. Osteoarthritis sufferers might take oral joint health supplements containing the cartilage "building blocks" glucosamine and chondroitin sulfate, which, advocates claim, help stave off arthritis' degenerative process. Countless other substances, from other amino acids to bee pollen, also are categorized as nutraceuticals.
As most horse owners know, equine nutraceuticals are available in a dizzying array of ingredients, claims, and brand names. Most fall into one of the same two classes as their human equivalents: performance enhancers or degenerative joint disease (DJD) deterrents. Some, such as vitamin E, have antioxidant properties and thus are marketed as disease preventives.
Which Therapies Work?
Here's where the real controversy begins. Some experts regard the practice of "alternative" veterinary medicine as little more than modern-day quackery. They assert that the therapies are largely unsupported by solid scientific proof of their effectiveness. Even worse, they add, the practitioners themselves basically are snake-oil salespeople: untrained laymen who are interested only in profiting from horse owners' ignorance by selling them useless products and services--and who might even cause harm to horses.
Other experts believe that at least some alternative therapies have a place in modern horse care and management. They point to the many satisfied horse owners who swear that alternative therapies helped their animals when conventional veterinary approaches had little or no effect.
Whom should you, the concerned horse owner, believe? If you're like most of us horse people, you want the best for your animal: the safest and most effective care and treatment. You want him to feel good and to realize his athletic potential, and you're probably not opposed to spending a little extra toward those ends. On the other hand, you're not thrilled with the thought of throwing any of your money away on products and treatments that simply don't work. You'd like to be able to make informed decisions as to how you spend your horse care dollars.
To help you make those decisions, The Horse talked with well-respected experts on both sides of the issue: skeptic and supporter. We found that, although the Great Divide still exists, a middle ground appears to be forming--that of the "integrated" practitioner who advocates a holistic approach using elements of both alternative and conventional veterinary medicine. Read for yourself what our experts had to say, and make up your own mind on this controversial and fascinating issue.
The Skeptical View
David Ramey, DVM, is one of the most outspoken critics of alternative therapies. An equine veterinarian in private practice in Glendale, Calif., he is the author of several plain-language, no-nonsense guides to equine health care, including Horsefeathers: Facts versus Myths About Your Horse's Health and the Concise Guides series. In his latest book, Consumer's Guide to Alternative Therapies in the Horse (Howell, 1999), he and an assemblage of experts reviewed the medical and veterinary literature concerning the major alternative therapies. They also explored such related issues as medical ethics, scientific method, and the placebo effect, and how each can influence a horse owner's perceptions about the effectiveness of a given method. (Before we go further, a disclosure: This writer edited the Consumer's Guide.)
Almost without exception, Ramey disdains so-called alternative therapies. "There is effective medicine and ineffective medicine. There is no alternative to that which works. There is no 'alternative' form of airplane engineering or colic surgery," he points out. "In an effort to promote their own therapies, alternative-therapy practitioners often mischaracterize medicine and imply that there is an alternative to proven, effective vaccines, drugs, and treatment methods."
If you're hoping to find scientific evidence to substantiate claims of alternative therapies' effectiveness, you might find the literature reviews in the Consumer's Guide a bit of a rude shock. Here's a sampling of what Ramey has to say about the well-known modalities:
Acupuncture
"The concept of qi has no basis in physiology and has never been demonstrated. It is not possible to prove that acupuncture works by affecting qi because qi cannot be defined in nonmystical terms.The vessels or meridians along which the needling points are supposedly located have not been shown to exist and do not relate to human or veterinary anatomy. Specific acupuncture points have not been shown to exist." He recognizes that acupuncture, like many other stimuli, may cause an increase in the body's levels of endorphins (naturally occurring opiates), producing temporary relief of pain; it also might give rise to the "placebo effect," in which the horse owner's belief in the therapy's effectiveness causes her to "see" improvement when in fact there has been none. "In any case," Ramey concludes, "even if needling is an effective therapy, where the needles are placed may be unimportant. In trials in which researchers have compared 'real' acupuncture (in which the needles are inserted according to traditional theory) and 'sham' acupuncture (in which the needles are inserted in spots that lack therapeutic utility, according to Chinese philosophy), no difference in effectiveness has generally been found."
Chiropractic
"Many state laws describe human chiropractic as the finding and removing of subluxations. Yet to this day, no definitive evidence of the clinical meaningfulness of subluxations exists; and in carefully designed studies, chiropractors themselves have been unable to agree on the presence or absence of subluxations." Even in its most common application in humans--low back pain--evidence of effectiveness has been hard to find, he adds. Furthermore, he argues, "Is it even possible to adjust a horse? Equine vertebrae are the size of your fist or larger and covered on all sides by thick, tough layers of muscle, tendon, and ligament that are several inches thick. How can the human hand possibly apply enough force to significantly affect a horse's vertebrae? Yet proponents of equine chiropractic assert that the technique requires almost no force at all."
Lasers
"Laser beams have a unique ability to penetrate deeply into tissue. It seems reasonable to suppose that tissues near the skin surface might respond to laser treatment. Whether lasers can be used effectively to treat humans and animals is far less clear. There are few reported investigations of the effects of low-intensity laser therapy in horses, and most of the reports that do exist are anecdotal, poorly controlled, and unblinded." (A "blind" study is set up so that neither the researchers nor the subjects are aware of what's being tested, to avoid the results' being tainted from bias or the placebo effect.) "Some tantalizing indications of benefits exist, but firm clinical evidence does not. Even in cases that are most likely to benefit from laser therapy (such as by relieving pain), the optimal wavelengths, intensities, and dosages have not been determined."
Magnets
"(Some) studies suggest that electromagnetic therapy may help promote nerve regrowth and healing of chronic wounds and other soft-tissue injuries. It also may be useful in pain management. (However) electromagnetic therapy may have limited benefit to injured tendons, perhaps in part because these tissues appear to lack electrical activity." Still, study findings are conflicting. As for static magnetic devices, Ramey writes, their purported benefits are "almost completely unsupported by scientific evidence. Claims that magnetic fields increase circulation, reduce inflammation, or speed recovery from injuries are simplistic and unsupported by the weight of experimental evidence. The effects of magnetic fields on bodily tissues are complex, poorly understood, and likely to be of little or no biological significance. Although existing magnetic therapies may be harmless, that does not mean that they are worth a try."
Massage
"Your horse may appear to enjoy being massaged, and standard techniques are unlikely to cause any harm. But at this time, there's no reason to believe that massage is critical in maintaining its health or boosting its athletic performance. However, before any firm conclusions can be drawn, much more data is needed."
Herbs
"Effective herbal products contain active pharmacological ingredients--they're not benign, harmless substances. Numerous horses have tested positive for substances forbidden by the sport associations under which they compete after having been administered one or more commercially available herbal products." Herb users risk potentially harmful drug interactions and toxic administration levels, Ramey warns. Many herbs used on horses appear to have no therapeutic benefit, says Ramey, and so the use of "natural" substances as substitutes for conventional deworming products or other medicines might even pose a threat to your horse's health if the "natural remedy" is ineffective.
Homeopathy
"If homeopathic remedies are effective, then how do they work? No one knows. If they do work, they must do so in a way that violates established principles of physics, chemistry, and pharmacology, or in a way that is yet to be discovered." Most studies of the method's effectiveness on animals have failed to show positive results, Ramey writes. His impatience with therapy advocates who disdain scientific evidence is evident in the following statement: "One leading advocate of homeopathy has asserted that it is not important to prove the therapy's effectiveness through scientific research and suggests that personal experience is more important than any number of carefully controlled studies. (Of course, if you believe that something is going to work, it just might.)"
Nutraceuticals
Most nutraceutical products have not been demonstrated to be effective, Ramey writes, with one possible exception: "Research indicates that glucosamine may have some promising anti-inflammatory and joint protective effects, particularly if used early in the treatment of arthritis." Some findings show that injectable joint health products might be more effective than oral joint health supplements, he adds, but the jury is still out. Warns Ramey, "The claims made for nutraceuticals sold to horse owners have not been adequately tested. Because efficacy, safety, and even content testing are not currently required in order to market most such products, it is difficult to say whether such testing will ever be done. You, the consumer, are in the awkward position of having to do the research yourself, with your horse the subject of that research."
Alternative Views
Despite Ramey's and others' criticisms, alternative therapies--and their providers--remain popular. According to Joyce Harman, DVM, MRCVS, sales of alternative or complementary products and services have increased by 25% each year for the past several years. If anything, interest in--and consumer demand for--alternative therapies is on the rise. Why? Can it be that most of us horse owners are so hoodwinked by alternative practitioners' claims that we cheerfully open our wallets to anyone who promises a cure? That we're not savvy enough to recognize the fallacies in alternative therapies' claims of effectiveness?
Of course not, say the thousands of horse owners and respected veterinary professionals who consider alternative therapies integral parts of their equine management programs. They point to cases where horses which failed to respond to conventional veterinary treatment approaches showed marked improvement after acupuncture, chiropractic, or some other complementary therapy.
Some say that orthodox Western medicine, whether for humans or for animals, tends to treat the symptom without necessarily looking for the underlying cause. Alternative practitioners, they say, approach their patients from a wellness perspective. They treat the whole horse, not just the lame leg or the sore back, and they consider all facets of the horse's management, care, and training in making a diagnosis and prescribing treatment.
They're as vigilant as the skeptics when it comes to insisting that alternative practitioners be properly trained and licensed (see "Selecting an Alternative Practitioner" on page 43), and they believe that many alternative therapies can be effective adjuncts to conventional veterinary medicine.
Harman is the immediate past president of the American Holistic Veterinary Medical Association; her Harmany Equine Clinic in Washington, Va., offers acupuncture, chiropractic, homeopathy, and Chinese herbal remedies in addition to conventional treatments and services.
"Little clinical research (on the effectiveness of alternative therapies) in the horse has been conducted," Harman says about some areas of treatment. However, she points out, some alternative medical research has been done using rats, mice, and other laboratory animals, and "it is not invalid to extrapolate those results to other species, including humans and horses. That's how drug research is conducted, after all."
A fair body of evidence does exist for some alternative modalities, says Harman. "There has been a tremendous amount of research on herbs and nutraceuticals. The use and efficacy of Chinese herbs has been studied extensively in China, although all of it isn't currently translated into English. The Chinese also have done research on equine acupuncture with good results. The studies haven't all been translated, and they weren't double-blind, but the researchers used many more samples than are employed in most Western studies. The Chinese often study 300 horses at a time. We make decisions about drug safety and efficacy based on studies of as few as 12 or 14 horses; 100 horses constitutes a huge study in America."
As for chiropractic, "Lots of basic research has been conducted on both animals and people," says Harman. "We know that spinal physiology is similar among species," and therefore it is reasonable to apply human chiropractic theory and practice to animals, including horses.
"There is less good research on homeopathy, and the research that has been conducted has tended to be of poor quality," Harman continues. "Better research is currently in progress; in fact, two conferences on scientific homeopathy are being conducted within the next year."
She recognizes that homeopathic theory does tend to defy conventional logic, but she asserts that it's tough to argue with success. "Most of the homeopathic cases I get are ones that failed to respond to Western medicine," she says, "yet they respond to the homeopathic remedies."
Magnets and electromagnetic devices "can be useful, but also can be abused," Harman cautions. "They shouldn't be used for long periods of time." As for laser therapy, electrical stimulation, and therapeutic ultrasound, she says, "The machinery is considered part of conventional physical therapy, but the practitioners tend to have little training." Improperly prescribed or administered, she says, any of these therapies can be ineffective at best, and harmful at worst. As an example, she says, research indicates that a magnet's north pole should be used in chronic conditions, but that many people use bipolar magnets for hours at a time, possibly to the detriment of their horse's health over time.
Kevin Haussler, DVM, DC, PhD, echoes many of Harman's sentiments regarding alternative therapies. A member of the faculty at Cornell University College of Veterinary Medicine in Ithaca, N.Y., Haussler holds a unique combination of degrees: He's both a veterinarian and a doctor of chiropractic. He heads Cornell's Integrative Medicine Service, which offers chiropractic and acupuncture along with traditional veterinary medical care.
"I use chiropractic to treat problems that we really can't address with conventional veterinary medicine," explains Haussler, who says he pursued his chiropractic degree after he became a veterinarian. "In conventional veterinary medicine, if a horse has a sore back, we generally don't know of much else to suggest other than resting him and perhaps turning him out. But in human medicine, if someone is recovering from an injury, we don't just tell that person to do nothing--that's the worst thing you can do in terms of healing and regaining full movement. The field of equine physical therapy is far less advanced than that of human physical therapy, but I see chiropractic and acupuncture as ways to help horses with physical problems, rather than just putting them out to pasture for six months."
According to Haussler, research indicates that equine spines can indeed move, and that it is possible to adjust equine vertebrae. "We don't fully understand the implications of our findings, and we're trying to develop a horse model," he says of the research efforts. He says he sees three main types of back problems in his equine patients: bony (arthritis or the so-called "kissing spines," in which vertebrae rub together and impede movement), soft-tissue (tendon, ligament, or muscle damage), and neurologic (damage to the nervous system, such as that caused by equine protozoal myelitis). In his practice, he primarily treats horses with soft tissue injuries; he estimates that his chiropractic treatments help an average of seven or eight out of every 10 horses he sees.
Chiropractic can help alleviate many equine performance and behavior problems--from "cold backs" and refusal to take or switch leads to poor transitions and jumping refusals or deteriorating form over fences, says Haussler. As an adjunct form of therapy, he says, acupuncture can be very effective; four veterinary acupuncturists currently are on staff at Cornell's Integrative Medicine Service.
He's less acquainted with other forms of alternative therapy, but he does say that homeopathy "has value and merits. It's hard to explain, but it can give very good results."
Finding Common Ground
The "left-wing" and "right-wing" factions in the alternative therapy debate are alive and well, but some experts are attempting to find a middle ground. "Lack of research, understanding, and training" have kept some orthodox practitioners from accepting alternative therapies, says Harman. "Alternative practitioners would love to see more research on their treatments, but in the past, such studies weren't funded. Today, the money is starting to appear."
In February, the American Association of Equine Practitioners (AAEP) awarded three grants for alternative therapy research. The first is on acupuncture's effectiveness in controlling pain during colic episodes; the second is on using acupuncture to stimulate mares' heat cycle in the winter; and the third is on the effectiveness of electroacupuncture, infrared light, and "bute" in relieving chronic laminitis pain. The selected researchers prevailed over more than 40 applicants, a number that would appear to indicate significant interest in garnering solid scientific evidence as to alternative therapies' claims.
What puzzles many practitioners the most is that some alternative therapy advocates don't seem bothered by the fact that such valid research has been, for the most part, non-existent. "The astonishing improvement in human health and longevity during the 20th Century is entirely the result of evidence-based advancements in public health and hygiene, progress in agriculture and food-handling technology, and improved medical and surgical techniques," writes Ramey. "None of the traditional systems of alternative medical care, which are based on unscientific ideas about health and nutrition, achieved a fraction of this success in all their years of existence."
A convincing argument; but even conventional, "science-based" practitioners can't agree on what works and what doesn't, says Harman. "Take, as an example, prostate cancer--one of the most common diseases in humans. Prostate cancer has been researched extensively--as much as, if not more than, any other disease. Yet, if you review the literature, you'll see that the medical community still can't agree on the best course of treatment. The same holds true for veterinary medicine.
"One of the most common diseases in animals is canine Cushing's disease, yet a study of how 500 veterinarians treat Cushing's disease showed that they couldn't agree on how to treat it. Medicine has not evolved to the point where we can say, 'This treatment works for this condition in all cases,'" she says. To further complicate matters, she says, even many great medical discoveries, such as antibiotics, were not readily accepted by the medical community. Likewise, it will take time for alternative therapies to prove their worth through scientific testing.
For you, the horse owner, there are no easy answers when it comes to alternative therapies. The experts we consulted agree that an educated owner can make more informed choices as to the type of care a horse receives. Bone up on the existing literature ask questions, and choose alternative therapy practitioners wisely (see "Selecting an Alternative Practitioner," article #146). It's up to you to decide whether the treatments your horse gets are quackery or quality.
For More Information
Want to dig deeper into the subject of alternative therapies? A world of information and literature is at your fingertips, thanks to the Internet. The following web sites offer articles, viewpoints, study results, and plenty of links to fuel your own research efforts.
Alternative, Complementary, and Holistic Veterinary Medicine (www.altvetmed.com): Information about alternative topics; directory of members of the American Holistic Veterinary Medical Association
American Association of Equine Practitioners (www.aaep.org): Limited information for horse owners and consumers (most of the site is members-only); tips on finding an equine practitioner
Equine Veterinary Network (www.equinevetnet.com): Conventional and alternative veterinary news and information; links to the Journal of Equine Veterinary Science and other resources
Health Care Reality Check (www.hcrc.org): Information on benefits of various treatments
Medline (www.nlm.nih.gov): Exhaustive searchable database of medical and veterinary literature
National Council for Reliable Health Information’s Veterinary Task Force (www.seanet.com/~vettf): Clearinghouse of information on health-benefit claims of various practices and treatments, including links to related articles
Quackwatch (www.quackwatch.com): Skeptics unite!
University of Wisconsin-Madison’s Veterinary Medical Resources (www.library.wisc.edu/libraries/Steenbock/electron/vetsites.htm): Links to practically every vet care-related site imaginable, from databases to vet schools
U.S. Food and Drug Administration’s Center for Safety and Applied Nutrition (http://vm.cfsan.fda.gov/): Site contains a searchable database of reports of adverse reactions to dietary supplements and herbal remedies
In spite of (or perhaps because of) the ongoing debate about the merits of chiropractic, acupuncture, and other "alternative" treatments, these and other modalities are exploding in popularity. First embraced by human medicine, methods ranging from herbs to homeopathy are now being used on the horses and house pets of enthusiastic devotees. Even horse owners who themselves have never had their spines adjusted or their ligaments lasered have turned to non-traditional practitioners when conventional methods failed to cure persistent, mysterious lamenesses or other problems. It's easy to see why a frustrated owner who's spent hundreds or thousands of dollars on conventional treatments and lost months of precious riding and training time, only to see little or no improvement, might become eager to give alternative treatments a try; after all, nothing else worked.
But are such horse owners the equestrian equivalent of the terminal-cancer patient who flies to far-flung lands for exotic curative "cocktails;" desperate and willing to try anything, no matter how outrageous? Some veterinary experts say yes, and warn horse owners against wasting their money on unproven and even potentially harmful substances and manipulations. Others argue that, when employed by experienced practitioners, certain alternative treatments can, indeed, produce good results.
With all the controversy, it might seem unlikely that experts would agree on any aspect of alternative therapies. But when The Horse talked with practitioners on both sides of the issue, we heard some common refrains and advice. In this article, we'll explore the debate in detail, and we'll give you some tools for making informed choices about the treatments your horse receives.
Introduction To Alternative Therapies
Numerous types of alternative therapies exist, and each generally can be classified as either "external" or "internal," according to how they're administered. Here are some of the predominant methodologies, along with descriptions of how they're purported to work.
External Therapies
Acupuncture
Based on one of many ancient Chinese medical theories and practices, acupuncture is the practice of inserting special slender needles into points on the body for a number of purposes, including relieving pain, allegedly by restoring the flow of bodily energies (chi or qi--pronounced "chee" in Chinese). Although various forms of acupuncture might have been practiced for centuries on humans, it was introduced into Western veterinary medicine only about 30 years ago. Acupuncture research indicates that stimulating the various acupuncture points has a variety of effects, possibly triggering endorphins (the body's natural opiate-like substances), which has been suggested as one mechanism by which acupuncture might promote pain relief. (A needleless form of the therapy, acupressure, stimulates the same points on the body and generally is considered a safe, somewhat milder form of treatment.)
Humans who have undergone acupuncture treatment say that the insertion of the needles is not painful. Many horses receiving acupuncture treatment appear undisturbed by the needling and relax markedly during the procedure, despite looking like equine pincushions!
Several varieties of acupuncture treatment exist, including the injection of substances such as saline or vitamins into the acupuncture points, and the use of heated needles. Proponents of such techniques believe that their methods complement the basic needling effect by providing additional stimulation and promoting healing.
Chiropractic
This probably is the most widely practiced alternative or "complementary" form of hands-on treatment in humans. Doctors of Chiropractic (DCs) have become commonplace in human medicine, and some medical-insurance companies now cover the costs of chiropractic care. As with acupuncture, human believers in the therapy have been eager to see it practiced on their animals; and horses, dogs, and cats now can receive regular spinal adjustments.
The derivation of the word chiropractic largely explains how the treatment is effected. The name is a hybrid of the Greek words cheir (hands) and praxis (act or action). The term was coined to describe the theory and approach of the 19th Century Canadian healer Daniel David Palmer, who believed that "subluxations" (defined by chiropractors as a loss of motion between two joints) cause disease by impeding various nerves and affecting related parts of the body as a result. Chiropractors treat human patients with all manner of complaints, from auto accident victims and injured athletes to migraine sufferers.
Equine chiropractors see a similar variety of patients. Some are horses which have suffered injuries, such as a fall while jumping or a lameness brought on after getting cast in the stall. Others are sport horses whose owners or riders complain of nagging, hard-to-pinpoint performance problems, such as back soreness, resistance to picking up one canter lead, or stiffness traveling in one direction. Chiropractic practitioners say they "adjust" their patients' spines by using gentle thrusts to realign vertebrae, thereby restoring full range of movement and allowing unevenly stressed muscles to relax and return to normal.
Lasers
Most people have heard of (or even undergone) surgical techniques using lasers (the word laser is an acronym for Light Amplification by Stimulated Emission of Radiation). Lasers have made possible remarkable advances in surgery by reducing the trauma and lengthy post-operative recuperation periods associated with some procedures. High-power lasers used in surgical procedures utilize light, but even low-power lasers, whose light intensities are far less than those used to cut, have found their way into medical practice in an attempt to speed the healing of wounds and soft-tissue injuries. Laser therapy advocates believe that benefits result from the beneficial effects of electromagnetic radiation, which the laser devices transform into highly amplified beams of light that can penetrate beneath the skin.
Some veterinary practitioners like to use low-power lasers on horses with such injuries as suspensory ligament pulls and bowed tendons. Other laser therapy proponents advocate the use of lasers in the treatment of a much wider spectrum of equine ailments, from navicular syndrome to osteoarthritis.
Magnets
There are two forms of magnetic therapy used in human and veterinary medicine: static magnetic and electromagnetic. The former takes the form of magnet-containing garments, blankets, pads, and the like, which are designed to be worn over stiff or injured areas and which purportedly work by increasing blood flow, relieving pain, and promoting healing. Electromagnetic therapy uses a pulsating magnetic field created by passing an electric current through a coil. Pulsating electromagnetic fields are thought to promote the healing of bone fractures, soft-tissue injuries, and wounds, and to reduce pain by stimulating cellular activity.
A wide variety of static-magnetic devices for horses is available, from hoof pads and leg boots to blankets. Considerably more expensive are the electromagnetic boots or blankets, which deliver a low-amplitude pulsating current to the affected areas.
Massage
The most "low-tech" of the therapies, massage is perhaps more complementary than alternative. Many people enjoy massage simply for its relaxation value, and most of us have enjoyed a soothing back or foot rub. Some athletes and others view massage as an important tool for easing stiffness, promoting circulation, and even preventing injuries. A number of established massage techniques exist, and practitioners of each believe that their methods serve specific purposes in helping their clients feel and perform their best.
Likewise, equine massage therapists claim that their services go beyond just "rubbing horses." Many point to satisfied horse owners who say massage treatments helped reduce or eliminate symptoms of back soreness, stiffness, or even lameness in some cases.
Internal Therapies
Herbs
Some people turn to herbs or "botanicals" in lieu of conventional pharmaceuticals and over-the-counter remedies, believing that the plant-derived preparations are safer, more effective, or more natural than other drugs, whose active ingredients might be synthesized. Recently we have seen an explosion in the popularity of herbal remedies--from topical creams and compresses to teas and pills. Well-known human vitamin labels now offer tablets containing herbs that are purported to enhance immunity, ease mood swings, or boost energy, among other benefits their manufacturers claim.
Many of these same herbs are available to lay horse owners, as well as to specially trained practitioners of herbal medicine, including Chinese herbal medicine. (For more information see our cover story on page 28.) Horse owners who wish to treat their animals with herbs can obtain them easily from practitioners, specialty catalogs, health food stores, tack shops, and feed stores. To locate some of these refer to The Horse Source. Books, magazine articles, and Web sites describe how to prepare and administer herbal remedies to treat a wide variety of external and internal complaints. Caution should be used in that herbals can cause serious problems if not administered properly
Homeopathy
This perhaps is the most controversial and difficult to understand of all alternative therapies. An 18th Century German physician, Dr. Samuel Hahnemann, developed an unusual theory: that exceedingly diluted substances--the more dilute, the more potent--could cure disease. The active ingredients in some homeopathic remedies are toxic when ingested in larger doses (think of poisonous plants and the like). Used in homeopathy, however, the substances are diluted to the extent that they are present in infinitesimal amounts--if at all--in the liquid that's consumed, making them generally unlikely to produce harmful side effects.
Equine homeopaths use the remedies to treat numerous ailments, from internal disease to skin disorders.
Nutraceuticals
Like the word chiropractic, "nutraceutical" is a coined term. In this case, it is a blend of the words "nutrient" and "pharmaceutical." A nutraceutical is a dietary supplement (ingested as food) that purports to offer drug-like health benefits that extend beyond the realm of good nutrition. Nutraceuticals generally are lumped into the category of alternative remedies because their use is relatively new, they aren't regulated as foods or as drugs, and their effectiveness has not been proven conclusively across the board.
People generally use nutraceuticals for many reasons, including to enhance athletic performance or to relieve pain. Human athletes might take such supplements as the amino acid carnitine, which some believe decreases lactic-acid formation and thus lessens muscle fatigue. Osteoarthritis sufferers might take oral joint health supplements containing the cartilage "building blocks" glucosamine and chondroitin sulfate, which, advocates claim, help stave off arthritis' degenerative process. Countless other substances, from other amino acids to bee pollen, also are categorized as nutraceuticals.
As most horse owners know, equine nutraceuticals are available in a dizzying array of ingredients, claims, and brand names. Most fall into one of the same two classes as their human equivalents: performance enhancers or degenerative joint disease (DJD) deterrents. Some, such as vitamin E, have antioxidant properties and thus are marketed as disease preventives.
Which Therapies Work?
Here's where the real controversy begins. Some experts regard the practice of "alternative" veterinary medicine as little more than modern-day quackery. They assert that the therapies are largely unsupported by solid scientific proof of their effectiveness. Even worse, they add, the practitioners themselves basically are snake-oil salespeople: untrained laymen who are interested only in profiting from horse owners' ignorance by selling them useless products and services--and who might even cause harm to horses.
Other experts believe that at least some alternative therapies have a place in modern horse care and management. They point to the many satisfied horse owners who swear that alternative therapies helped their animals when conventional veterinary approaches had little or no effect.
Whom should you, the concerned horse owner, believe? If you're like most of us horse people, you want the best for your animal: the safest and most effective care and treatment. You want him to feel good and to realize his athletic potential, and you're probably not opposed to spending a little extra toward those ends. On the other hand, you're not thrilled with the thought of throwing any of your money away on products and treatments that simply don't work. You'd like to be able to make informed decisions as to how you spend your horse care dollars.
To help you make those decisions, The Horse talked with well-respected experts on both sides of the issue: skeptic and supporter. We found that, although the Great Divide still exists, a middle ground appears to be forming--that of the "integrated" practitioner who advocates a holistic approach using elements of both alternative and conventional veterinary medicine. Read for yourself what our experts had to say, and make up your own mind on this controversial and fascinating issue.
The Skeptical View
David Ramey, DVM, is one of the most outspoken critics of alternative therapies. An equine veterinarian in private practice in Glendale, Calif., he is the author of several plain-language, no-nonsense guides to equine health care, including Horsefeathers: Facts versus Myths About Your Horse's Health and the Concise Guides series. In his latest book, Consumer's Guide to Alternative Therapies in the Horse (Howell, 1999), he and an assemblage of experts reviewed the medical and veterinary literature concerning the major alternative therapies. They also explored such related issues as medical ethics, scientific method, and the placebo effect, and how each can influence a horse owner's perceptions about the effectiveness of a given method. (Before we go further, a disclosure: This writer edited the Consumer's Guide.)
Almost without exception, Ramey disdains so-called alternative therapies. "There is effective medicine and ineffective medicine. There is no alternative to that which works. There is no 'alternative' form of airplane engineering or colic surgery," he points out. "In an effort to promote their own therapies, alternative-therapy practitioners often mischaracterize medicine and imply that there is an alternative to proven, effective vaccines, drugs, and treatment methods."
If you're hoping to find scientific evidence to substantiate claims of alternative therapies' effectiveness, you might find the literature reviews in the Consumer's Guide a bit of a rude shock. Here's a sampling of what Ramey has to say about the well-known modalities:
Acupuncture
"The concept of qi has no basis in physiology and has never been demonstrated. It is not possible to prove that acupuncture works by affecting qi because qi cannot be defined in nonmystical terms.The vessels or meridians along which the needling points are supposedly located have not been shown to exist and do not relate to human or veterinary anatomy. Specific acupuncture points have not been shown to exist." He recognizes that acupuncture, like many other stimuli, may cause an increase in the body's levels of endorphins (naturally occurring opiates), producing temporary relief of pain; it also might give rise to the "placebo effect," in which the horse owner's belief in the therapy's effectiveness causes her to "see" improvement when in fact there has been none. "In any case," Ramey concludes, "even if needling is an effective therapy, where the needles are placed may be unimportant. In trials in which researchers have compared 'real' acupuncture (in which the needles are inserted according to traditional theory) and 'sham' acupuncture (in which the needles are inserted in spots that lack therapeutic utility, according to Chinese philosophy), no difference in effectiveness has generally been found."
Chiropractic
"Many state laws describe human chiropractic as the finding and removing of subluxations. Yet to this day, no definitive evidence of the clinical meaningfulness of subluxations exists; and in carefully designed studies, chiropractors themselves have been unable to agree on the presence or absence of subluxations." Even in its most common application in humans--low back pain--evidence of effectiveness has been hard to find, he adds. Furthermore, he argues, "Is it even possible to adjust a horse? Equine vertebrae are the size of your fist or larger and covered on all sides by thick, tough layers of muscle, tendon, and ligament that are several inches thick. How can the human hand possibly apply enough force to significantly affect a horse's vertebrae? Yet proponents of equine chiropractic assert that the technique requires almost no force at all."
Lasers
"Laser beams have a unique ability to penetrate deeply into tissue. It seems reasonable to suppose that tissues near the skin surface might respond to laser treatment. Whether lasers can be used effectively to treat humans and animals is far less clear. There are few reported investigations of the effects of low-intensity laser therapy in horses, and most of the reports that do exist are anecdotal, poorly controlled, and unblinded." (A "blind" study is set up so that neither the researchers nor the subjects are aware of what's being tested, to avoid the results' being tainted from bias or the placebo effect.) "Some tantalizing indications of benefits exist, but firm clinical evidence does not. Even in cases that are most likely to benefit from laser therapy (such as by relieving pain), the optimal wavelengths, intensities, and dosages have not been determined."
Magnets
"(Some) studies suggest that electromagnetic therapy may help promote nerve regrowth and healing of chronic wounds and other soft-tissue injuries. It also may be useful in pain management. (However) electromagnetic therapy may have limited benefit to injured tendons, perhaps in part because these tissues appear to lack electrical activity." Still, study findings are conflicting. As for static magnetic devices, Ramey writes, their purported benefits are "almost completely unsupported by scientific evidence. Claims that magnetic fields increase circulation, reduce inflammation, or speed recovery from injuries are simplistic and unsupported by the weight of experimental evidence. The effects of magnetic fields on bodily tissues are complex, poorly understood, and likely to be of little or no biological significance. Although existing magnetic therapies may be harmless, that does not mean that they are worth a try."
Massage
"Your horse may appear to enjoy being massaged, and standard techniques are unlikely to cause any harm. But at this time, there's no reason to believe that massage is critical in maintaining its health or boosting its athletic performance. However, before any firm conclusions can be drawn, much more data is needed."
Herbs
"Effective herbal products contain active pharmacological ingredients--they're not benign, harmless substances. Numerous horses have tested positive for substances forbidden by the sport associations under which they compete after having been administered one or more commercially available herbal products." Herb users risk potentially harmful drug interactions and toxic administration levels, Ramey warns. Many herbs used on horses appear to have no therapeutic benefit, says Ramey, and so the use of "natural" substances as substitutes for conventional deworming products or other medicines might even pose a threat to your horse's health if the "natural remedy" is ineffective.
Homeopathy
"If homeopathic remedies are effective, then how do they work? No one knows. If they do work, they must do so in a way that violates established principles of physics, chemistry, and pharmacology, or in a way that is yet to be discovered." Most studies of the method's effectiveness on animals have failed to show positive results, Ramey writes. His impatience with therapy advocates who disdain scientific evidence is evident in the following statement: "One leading advocate of homeopathy has asserted that it is not important to prove the therapy's effectiveness through scientific research and suggests that personal experience is more important than any number of carefully controlled studies. (Of course, if you believe that something is going to work, it just might.)"
Nutraceuticals
Most nutraceutical products have not been demonstrated to be effective, Ramey writes, with one possible exception: "Research indicates that glucosamine may have some promising anti-inflammatory and joint protective effects, particularly if used early in the treatment of arthritis." Some findings show that injectable joint health products might be more effective than oral joint health supplements, he adds, but the jury is still out. Warns Ramey, "The claims made for nutraceuticals sold to horse owners have not been adequately tested. Because efficacy, safety, and even content testing are not currently required in order to market most such products, it is difficult to say whether such testing will ever be done. You, the consumer, are in the awkward position of having to do the research yourself, with your horse the subject of that research."
Alternative Views
Despite Ramey's and others' criticisms, alternative therapies--and their providers--remain popular. According to Joyce Harman, DVM, MRCVS, sales of alternative or complementary products and services have increased by 25% each year for the past several years. If anything, interest in--and consumer demand for--alternative therapies is on the rise. Why? Can it be that most of us horse owners are so hoodwinked by alternative practitioners' claims that we cheerfully open our wallets to anyone who promises a cure? That we're not savvy enough to recognize the fallacies in alternative therapies' claims of effectiveness?
Of course not, say the thousands of horse owners and respected veterinary professionals who consider alternative therapies integral parts of their equine management programs. They point to cases where horses which failed to respond to conventional veterinary treatment approaches showed marked improvement after acupuncture, chiropractic, or some other complementary therapy.
Some say that orthodox Western medicine, whether for humans or for animals, tends to treat the symptom without necessarily looking for the underlying cause. Alternative practitioners, they say, approach their patients from a wellness perspective. They treat the whole horse, not just the lame leg or the sore back, and they consider all facets of the horse's management, care, and training in making a diagnosis and prescribing treatment.
They're as vigilant as the skeptics when it comes to insisting that alternative practitioners be properly trained and licensed (see "Selecting an Alternative Practitioner" on page 43), and they believe that many alternative therapies can be effective adjuncts to conventional veterinary medicine.
Harman is the immediate past president of the American Holistic Veterinary Medical Association; her Harmany Equine Clinic in Washington, Va., offers acupuncture, chiropractic, homeopathy, and Chinese herbal remedies in addition to conventional treatments and services.
"Little clinical research (on the effectiveness of alternative therapies) in the horse has been conducted," Harman says about some areas of treatment. However, she points out, some alternative medical research has been done using rats, mice, and other laboratory animals, and "it is not invalid to extrapolate those results to other species, including humans and horses. That's how drug research is conducted, after all."
A fair body of evidence does exist for some alternative modalities, says Harman. "There has been a tremendous amount of research on herbs and nutraceuticals. The use and efficacy of Chinese herbs has been studied extensively in China, although all of it isn't currently translated into English. The Chinese also have done research on equine acupuncture with good results. The studies haven't all been translated, and they weren't double-blind, but the researchers used many more samples than are employed in most Western studies. The Chinese often study 300 horses at a time. We make decisions about drug safety and efficacy based on studies of as few as 12 or 14 horses; 100 horses constitutes a huge study in America."
As for chiropractic, "Lots of basic research has been conducted on both animals and people," says Harman. "We know that spinal physiology is similar among species," and therefore it is reasonable to apply human chiropractic theory and practice to animals, including horses.
"There is less good research on homeopathy, and the research that has been conducted has tended to be of poor quality," Harman continues. "Better research is currently in progress; in fact, two conferences on scientific homeopathy are being conducted within the next year."
She recognizes that homeopathic theory does tend to defy conventional logic, but she asserts that it's tough to argue with success. "Most of the homeopathic cases I get are ones that failed to respond to Western medicine," she says, "yet they respond to the homeopathic remedies."
Magnets and electromagnetic devices "can be useful, but also can be abused," Harman cautions. "They shouldn't be used for long periods of time." As for laser therapy, electrical stimulation, and therapeutic ultrasound, she says, "The machinery is considered part of conventional physical therapy, but the practitioners tend to have little training." Improperly prescribed or administered, she says, any of these therapies can be ineffective at best, and harmful at worst. As an example, she says, research indicates that a magnet's north pole should be used in chronic conditions, but that many people use bipolar magnets for hours at a time, possibly to the detriment of their horse's health over time.
Kevin Haussler, DVM, DC, PhD, echoes many of Harman's sentiments regarding alternative therapies. A member of the faculty at Cornell University College of Veterinary Medicine in Ithaca, N.Y., Haussler holds a unique combination of degrees: He's both a veterinarian and a doctor of chiropractic. He heads Cornell's Integrative Medicine Service, which offers chiropractic and acupuncture along with traditional veterinary medical care.
"I use chiropractic to treat problems that we really can't address with conventional veterinary medicine," explains Haussler, who says he pursued his chiropractic degree after he became a veterinarian. "In conventional veterinary medicine, if a horse has a sore back, we generally don't know of much else to suggest other than resting him and perhaps turning him out. But in human medicine, if someone is recovering from an injury, we don't just tell that person to do nothing--that's the worst thing you can do in terms of healing and regaining full movement. The field of equine physical therapy is far less advanced than that of human physical therapy, but I see chiropractic and acupuncture as ways to help horses with physical problems, rather than just putting them out to pasture for six months."
According to Haussler, research indicates that equine spines can indeed move, and that it is possible to adjust equine vertebrae. "We don't fully understand the implications of our findings, and we're trying to develop a horse model," he says of the research efforts. He says he sees three main types of back problems in his equine patients: bony (arthritis or the so-called "kissing spines," in which vertebrae rub together and impede movement), soft-tissue (tendon, ligament, or muscle damage), and neurologic (damage to the nervous system, such as that caused by equine protozoal myelitis). In his practice, he primarily treats horses with soft tissue injuries; he estimates that his chiropractic treatments help an average of seven or eight out of every 10 horses he sees.
Chiropractic can help alleviate many equine performance and behavior problems--from "cold backs" and refusal to take or switch leads to poor transitions and jumping refusals or deteriorating form over fences, says Haussler. As an adjunct form of therapy, he says, acupuncture can be very effective; four veterinary acupuncturists currently are on staff at Cornell's Integrative Medicine Service.
He's less acquainted with other forms of alternative therapy, but he does say that homeopathy "has value and merits. It's hard to explain, but it can give very good results."
Finding Common Ground
The "left-wing" and "right-wing" factions in the alternative therapy debate are alive and well, but some experts are attempting to find a middle ground. "Lack of research, understanding, and training" have kept some orthodox practitioners from accepting alternative therapies, says Harman. "Alternative practitioners would love to see more research on their treatments, but in the past, such studies weren't funded. Today, the money is starting to appear."
In February, the American Association of Equine Practitioners (AAEP) awarded three grants for alternative therapy research. The first is on acupuncture's effectiveness in controlling pain during colic episodes; the second is on using acupuncture to stimulate mares' heat cycle in the winter; and the third is on the effectiveness of electroacupuncture, infrared light, and "bute" in relieving chronic laminitis pain. The selected researchers prevailed over more than 40 applicants, a number that would appear to indicate significant interest in garnering solid scientific evidence as to alternative therapies' claims.
What puzzles many practitioners the most is that some alternative therapy advocates don't seem bothered by the fact that such valid research has been, for the most part, non-existent. "The astonishing improvement in human health and longevity during the 20th Century is entirely the result of evidence-based advancements in public health and hygiene, progress in agriculture and food-handling technology, and improved medical and surgical techniques," writes Ramey. "None of the traditional systems of alternative medical care, which are based on unscientific ideas about health and nutrition, achieved a fraction of this success in all their years of existence."
A convincing argument; but even conventional, "science-based" practitioners can't agree on what works and what doesn't, says Harman. "Take, as an example, prostate cancer--one of the most common diseases in humans. Prostate cancer has been researched extensively--as much as, if not more than, any other disease. Yet, if you review the literature, you'll see that the medical community still can't agree on the best course of treatment. The same holds true for veterinary medicine.
"One of the most common diseases in animals is canine Cushing's disease, yet a study of how 500 veterinarians treat Cushing's disease showed that they couldn't agree on how to treat it. Medicine has not evolved to the point where we can say, 'This treatment works for this condition in all cases,'" she says. To further complicate matters, she says, even many great medical discoveries, such as antibiotics, were not readily accepted by the medical community. Likewise, it will take time for alternative therapies to prove their worth through scientific testing.
For you, the horse owner, there are no easy answers when it comes to alternative therapies. The experts we consulted agree that an educated owner can make more informed choices as to the type of care a horse receives. Bone up on the existing literature ask questions, and choose alternative therapy practitioners wisely (see "Selecting an Alternative Practitioner," article #146). It's up to you to decide whether the treatments your horse gets are quackery or quality.
For More Information
Want to dig deeper into the subject of alternative therapies? A world of information and literature is at your fingertips, thanks to the Internet. The following web sites offer articles, viewpoints, study results, and plenty of links to fuel your own research efforts.
Alternative, Complementary, and Holistic Veterinary Medicine (www.altvetmed.com): Information about alternative topics; directory of members of the American Holistic Veterinary Medical Association
American Association of Equine Practitioners (www.aaep.org): Limited information for horse owners and consumers (most of the site is members-only); tips on finding an equine practitioner
Equine Veterinary Network (www.equinevetnet.com): Conventional and alternative veterinary news and information; links to the Journal of Equine Veterinary Science and other resources
Health Care Reality Check (www.hcrc.org): Information on benefits of various treatments
Medline (www.nlm.nih.gov): Exhaustive searchable database of medical and veterinary literature
National Council for Reliable Health Information’s Veterinary Task Force (www.seanet.com/~vettf): Clearinghouse of information on health-benefit claims of various practices and treatments, including links to related articles
Quackwatch (www.quackwatch.com): Skeptics unite!
University of Wisconsin-Madison’s Veterinary Medical Resources (www.library.wisc.edu/libraries/Steenbock/electron/vetsites.htm): Links to practically every vet care-related site imaginable, from databases to vet schools
U.S. Food and Drug Administration’s Center for Safety and Applied Nutrition (http://vm.cfsan.fda.gov/): Site contains a searchable database of reports of adverse reactions to dietary supplements and herbal remedies