Complimentary (or alternative) therapies are commonly practiced in the horse world.  These therapies include, but are not limited to acupuncture, chiropractic, massage, homeopathy, energy work, aromatherapy, magnetic therapy and cold laser therapy.  Equine health problems that don’t have easy solutions - such as equine back problems - naturally lend themselves to many different alternative therapies.   Usually these therapies are based on modes of thinking completely different from that which underlies Western medicine.

MY CONCERNS

I and many other equine veterinarians have historically hesitated to advocate the use of these therapies because many of them have not been subject to rigorous scientific verification.  Some of these practitioners are trained in these therapies for human application and lack a basic understanding of basic equine anatomy and physiology.  Many of them have little understanding of the diagnostic abilities and treatments available from a licensed equine veterinarian.  Likewise, it is often very difficult to judge the efficacy of these modalities in horses.   To me, it seems like the novelty and mystique that surrounds these approaches is often their greatest selling point.

One of my biggest concerns is the way in which many alternative practitioners provide treatments without first identifying the underlying problem.  They simply skip or assume the diagnosis.  If the horse recovers, the therapy is credited but there is really no way to objectively discern whether it actually helped.  For recurring problems and ones that worsen over time, the failure to secure a diagnosis may prolong the problem, ultimately increasing the cost of treatment, and may even cause unintended harm.

In fact, many veterinarians have been turned off to the value of alternative approaches because we have often had to face the disaster at the end.  Much pain and suffering in horses has occurred because an owner had too much faith in an alternative cure, and the veterinarian was not called until the very end.  Horse owners should understand how difficult it is for us to be brought into the crisis too late, when the costs to save the animal have increased and the prognosis may have worsened.  We were trained to help, and that is what we always want to do.

I have met and watched a number of non-veterinary practitioners of alternative therapies work on horses. I am usually disappointed by their skill and on occasion, have witnessed situations where they have harmed a horse.  I have been surprised by their lack of basic knowledge, particularly equine anatomy.  Generally, the practitioners that have impressed me are fellow equine veterinarians that have added an alternative skill to their already strong medical training.

It is important to note that there is also often no accountability for lay practitioners of these therapies.  If a non-veterinary practitioner of alternative therapies charges you for a treatment that is ineffective or even hurts your horse, you have little recourse to hold this individual accountable.  A veterinarian, on the other hand, holds a professional license to practice in a given state and must answer to their state licensing board.  There are also issues regarding the legality of practicing certain modalities on equines without a veterinary license.  You should check with your state veterinary board if you have any questions.

NEW DEVELOPMENTS

Nevertheless, things are changing.  More and more educational programs are providing equine veterinarians with training in these areas.  It is very important for horse owners to understand the qualifications of their practitioner and what these qualifications really mean.  The information available on the Internet varies wildly, and much of it is unreliable.  Horse owners should use a critical eye in reviewing claims and studies.

As in human health care, there is a place for a traditional western-approach and a place for alternatives.  The key is in knowing how to integrate these approaches for the best outcome for your horse.  Questions I would ask an equine alternative health care provider before they treat my horse are:

• Are you a licensed veterinarian?

• Did you graduate from an accredited program that teaches this therapy for application in equines?

• What do you think is wrong with my horse and why?

• Why do you think your therapy will help?

•  How will we evaluate the effectiveness and outcome?

• Should I also call my local veterinarian so that you two can work together on this issue?

I realize it may be difficult to bring this team together for the development of an integrated approach, but that is the ideal that we all should be working towards.  I still strongly recommend that you start with your equine veterinarian, because he or she is the one who should know your horse in health and is therefore able to discern disease.

ACUPUNCTURE & CHIROPRACTIC THERAPIES

Although I grouped various alternative therapies together in my opening paragraph, the two most commonly used alternative therapies are acupuncture and chiropractic, and they deserve additional discussion.

Acupuncture involves the evaluation of points on the skin which correspond to the structure and function of organs and regions of the body remote from that site.  These sites are assessed diagnostically and are treated by needle stimulation with or without injection of substances or electrical or heat stimulation.  There is great variation in technique among practitioners.  It is stated that there is local pain killer release (endorphins) at the acupuncture sites.  I have mixed feelings about the efficacy of this therapy because, in my experience, the stated benefits of acupuncture are far more profound and longer lasting than can be explained by endorphin release alone.  Nevertheless, equine acupuncture has gained wide acceptance as an effective therapy in a wide variety of situations.

The International Veterinary Acupuncture Society provides education and accreditation in acupuncture to veterinarians who want to complement their Western medical training.  I periodically refer my clients to licensed veterinarians who have such training, and sometimes there is a perceived benefit.

Chiropractic involves the manipulation of bones in the vertebral column such that they are operating within their ideal and have pain free range of movement.  This theoretically involves the movement of these bones by intense manipulations of the hands, called adjustments.  There is controversy over the effectiveness of chiropractic in humans, despite its widespread use.  The controversy is heightened in horses because of the mass of equine back muscle, size of the vertebrae and toughness of the support structures of the joints.

I am personally skeptical about the capability of a practitioner to know whether an equine vertebrae is “out” when it is buried by six inches of dense muscle and connective tissue.  Also of concern is whether the practitioner is then able to make the adjustment, i.e., actually move the bone so that it is now fully in “in adjustment."  Finally, it is often difficult to discern whether the primary complaint has been resolved for any reasonable duration of time.  Although I remain skeptical, I do not rule out chiropractic treatments where it may be indicated as an additional complementary approach.

The American Veterinary Chiropractic Association provides education and accreditation in chiropractic therapies to veterinarians who want to complement their Western medical training.  Occasionally, I refer my clients to licensed veterinarians who have such training, and sometimes there is a perceived benefit.

CONCLUSION

There is so much left for the equine veterinary profession to learn.  Western medicine cannot solve all equine health care problems.  As veterinarians, it is our responsibility to help horse owners navigate the complex world of equine health care, which is constantly expanding.

In cases where a traditional Western approach is insufficient, I consider alternative approaches provided that they are practiced by qualified professionals.  In my experience, that has often been by another equine veterinarian.  I am not opposed to meeting and even referring my clients to a competent lay person that has proven their knowledge and skill to me first-hand.  Keep in mind, however, that I will continue to be highly critical of the majority of these practitioners until I see more than smoke and mirrors.

If you are a practitioner of equine alternative therapies and you have more information for me to consider regarding your work or any comments about my article, please contact me.   I am happy to begin a dialogue with you in the interest of improving and expanding my knowledge of equine health care.