Change is taking place in the world of equine veterinary medicine as more and more horse owners and practitioners look to alternative or complementary forms of treatment or prevention for a wide variety of maladies. It wasn't very long ago that these therapeutic options were looked upon by veterinarians as quackery. That has changed in the past several years, with more and more veterinarians becoming educated in acupuncture, chiropractic, herbology, homeopathy, massage, magnetic therapy, laser therapy, and therapeutic nutrition.
A term used to describe the use of therapeutic options is holistic medicine. As the term would imply, it means dealing with the whole animal rather than with specific symptoms. Or, as it has often been stated, holistic medicine involves treating the animal, not the disease.
Kim Henneman, DVM, an equine practitioner located in Salt Lake City, Utah, and one of the featured speakers at the American Holistic Veterinary Medical Association Annual Conference held in September in Burlington, Vt., puts it this way:
"Holistic medicine is like filling up my toolbox with a lot of tools. I want to have available all the tools that exist, including conventional medicine."
Henneman, a 1986 graduate of Purdue University School of Veterinary Medicine, today concentrates solely on the holistic approach to treatment of her equine patients. Her practice primarily involves performance horses--ranging from barrel racers and cutters to three-day event competitors--and, geographically, covers the western United States as well as Vermont and Massachusetts in the East.
The alternative procedures that she uses with frequency are chiropractic, acupuncture, and homeopathy, with nutritional therapy and herbology also playing roles.
"I use whatever it takes," she says of her approach. "Every animal is different, so the treatment must address that animal's specific needs. I think things happen in layers, so my examination and treatment procedures are layered."
Because the horses she treats, generally speaking, are performance animals, Henneman says most of the physical problems she encounters are musculoskeletal in nature.
Henneman has a basic procedure she goes through with each new patient.
"I always evaluate the teeth, and I always evaluate the feet. The teeth and feet are foundations. If they need to be fixed and aren't, everything else I do will not matter."
Once past the feet and teeth, Henneman examines a horse with palpation, starting at the head and working toward the rear. The next step is a chiropractic adjustment of problem joints -- one joint at a time -- that have been identified through palpation. That approach, too, is from front to rear.
"That also provides a safety factor as an incidental benefit," she says. "By the time I get to the rear end, the horse is so relaxed I don't have to worry about getting kicked."
If there is residual pain after the chiropractic adjustment, she might turn to acupuncture, homeopathy, or herbs for relief, depending on the condition.
"It is sort of like peeling an onion," she says. "You work your way through the problem one layer at a time."
A problem with administering herbs when dealing with race or performance horses, she says, is that some of them might test positive for illegal substances, depending on what is administered. For example, she explains, an effective herb for pain relief is willow bark, but if the discipline in which the horse is involved forbids the use of aspirin, there is a strong possibility that willow bark will result in a positive test for aspirin.
The same might be true for valerian, the plant that first yielded the drug we know today as Valium. The herb has the capability of calming a jittery horse, but also might result in a positive test that can negate the horse's accomplishments.
This is where another alternative form of holistic medicine -- homeopathy -- is beneficial, says Henneman, because the substance administered is in such minute form that there is no danger of it showing up in a test. She uses homeopathic remedies, she says, in place of phenylbutazone and banamine.
There is a key reason for the usage of homeopathic remedies, other than avoiding positive tests, she says. "Homeopathic remedies do not interfere with the healing process and bute and banamine do because they are anti-inflammatories and inflammation is a necessary part of the healing process."
Her holistic approach to veterinary medicine, says Henneman, is being embraced by more and more horse owners. One race barn in Phoenix, Ariz., that is on her list of clients uses a strictly holistic approach in treating its charges, including disease prevention. "The only vaccines we administer there," says Henneman, "are for tetanus and encephalomyelitis. We deal with other diseases, such as flu and rhinoneumenitis, by keeping the animals' immune systems strong with nutrition and herbs."
Henneman, however, as stated earlier, does not eschew all forms of conventional veterinary medicine. "There are cases where I use antibiotics to buy some time," she said. She views conventional medicine as another tool in the holistic approach to treatment.
Henneman first became interested in alternative forms of therapy while still at Purdue. It was there that she was exposed to acupuncture by Dr. Edwin Page, head of the large animal division at the School of Veterinary Medicine. Impressed with the positive response in the animal being treated, Henneman decided to learn more about the modality.
Eventually, she enrolled in the International Veterinary Acupuncture Society course and become an accredited acupuncturist.
Next came chiropractic. "I had grown up in a family that considered chiropractors quacks," she says, "but a treatment I witnessed changed my thinking. I saw a horse that had been given an adjustment go from a grade three to a grade one lameness in a matter of a few minutes, and I was convinced."
That experience led to enrollment in a chiropractic course, and today she also is certified in that modality. Later she enrolled in homeopathic courses, and she is on her way to certification in that form of therapy as well.
In addition to the positive early experiences with acupuncture and chiropractic, she was led to the holistic approach as the result of frustration with results obtained with conventional veterinary medicine after leaving college and working in a private practice.
"I was doing a lot of small animals at the time and was getting very frustrated with the limited tools available," she says. "I kept asking myself, 'Why do I have to keep injecting this animal?' I wanted more tools at my disposal."
Until several years ago, Henneman's attitude was the exception rather than the rule among veterinarians. Not so today. There has been a tremendous increase in the number of veterinarians enrolling in acupuncture courses, for example, and the same is true of chiropractic schools.
Interestingly, none of the holistic modalities are new. Some have been practiced in one form or another for thousands of years. They simply are being rediscovered today as the defenses of infectious organisms seem to stay head-to-head with the weapons that science has aligned against them.
The discovery of penicillin in the late 1920s, perhaps, was instrumental in the belief that modern science successfully could combat disease with a variety of sophisticated drugs. Powerful antibiotics knocked out one infectious organism after another, then the swing of the pendulum began to change as these organisms fought back and successfully erected barriers against the crippling effects of the weapons sent against them.
Penicillin is a case in point. The dosage that was effective to treat an infectious condition in a horse as recently as 10 years ago must be increased greatly today to effect the same result because of the resistance that bacteria have developed.
Science has answered the challenge with highly sophisticated synthetic antibiotics that, for the time being at least, are fooling infectious bacteria and stymieing their efforts to raise effective defenses. Will science be able to maintain the upper hand, or will it be just a matter of time before bacteria develop an effective counter attack?
Whatever the reason, the fact remains that more and more people are turning to alternative or complementary forms of medicine for themselves, their pets, and their horses.
A survey reported a couple of years ago by the New England Journal of Medicine estimated that in the year 1990, Americans made some 425 million visits to providers of unconventional care and spent approximately $13 billion on such services, the bulk of it out of pocket rather than insurance.
Still another study that was reported in the New England Journal of Medicine in 1995 found that human patients are turning with frequency to alternative forms of medicine for these conditions: cancer, arthritis, chronic back pain, AIDS, gastrointestinal problems, chronic renal failure, and eating disorders. The study also found that 70% of the patients did not inform their physicians about the alternative treatments.
It stands to reason that if individuals are using alternative therapies for their own maladies, they will do the same for their horses.
A survey of veterinarian readers conducted by the magazine Perspectives provided the following information, as reported in the September/October 1995 edition, in an article on alternative therapies by Carin Smith, DVM:
80% of respondents said they have been asked by clients about alternative therapies, such as acupuncture, chiropractic, or homeopathy. Although some veterinarians reported being skeptical of alternative therapies, increasing client interest has spurred their own efforts to become more informed.
Questions clients ask most frequently include whether and how therapies work, how much treatments cost, and whether their veterinarian thinks the treatment is valid. Other clients showed interest in information on nutritional aids, chemotherapy options, chronic pain management, and the comparison of alternative therapies to more traditional veterinary medicine.
Clients, it was reported, most frequently ask about homeopathy, followed by acupuncture, holistic medicine, herbal therapy, and, finally, chiropractic.
36% of the respondents replied that they currently incorporate alternative therapies in their practice. Of the 64% who said they did not use alternative therapies, 12% indicated they are interested in, or are in the process of, learning more about them.
Reputable holistic practitioners like Henneman do not lay claim to miracle cures via the holistic approach and are quick to point out that the modalities should be practiced only by persons with a medical background--such as a DVM--who also have been trained in that specific therapy field. Inappropriate administration of a form of alternative therapy can cause harm to the patient, they point out.
Herbology, the selective use of herbs to treat disease, is a case in point. The herbologist operates under the theory that a natural herbal product is safer, more effective, and causes less disruption to the body than a manufactured substance.
Examples of herbal use are garlic to ward off insects, ginseng and valerian to calm nervous animals, and aloe to soothe burns and sores. Many of these herbal products can be purchased in fresh form, dried in oils, or as extracts and in poultices and creams.
As is the case with all forms of alternative medicine, herbology is not new. As far back as 77 AD, a Greek pharmacologist named Pedanius Dioscorides compiled a list of about 1,000 plant-based remedies.
In the 17th Century, European explorers learned that the bark of the South American cinchona tree could be used to treat malaria. The popularity of the remedy led to a scarcity of cinchona bark and inspired the English researcher, Edward Stone, to experiment with the bark of the willow tree. He concluded willow bark was effective in lowering fever. His research would lead to the discovery that acetylsalicylic acid is a component of willow tree bark. Today this component is known as aspirin and is manufactured synthetically.
However, there are drawbacks and dangers involved in the use of herbs, especially by the uninitiated. Herbs, although found in nature, contain chemicals that have specific actions and can be harmful if administered inappropriately. When a substance is manufactured, all undesirable substances are removed. This is not the case with herbs. The plant might indeed contain the substance desired, but also can contain other substances that are harmful.
"I tell my clients," says Henneman, "that just because it is natural doesn't mean that it is safe. A good example is Amica (Amica montana), which is used as a very common treatment of trauma. As a direct herbal tincture, it is poisonous and cannot be taken internally, but it makes a great topical ointment or salve. The dilutions undergone for homeopathy make it safe for internal use, and it is one of the most common over-the-counter homeopathic remedies available in the U.S."
Anecdotal evidence exists that administering herbs can be useful in treating a variety of ailments. Henneman described a case involving one of her own horses. The animal suffered a deep cut as the result of a kick, and the cut was not suturable. She treated the animal with a homeopathic remedy and herbal salve. The wound healed quickly and left no scar.
The key, it would appear, is to know which herbs to use and for what purpose.
The same could be said of all alternative modalities. Henneman, for example, will say that there are times when administering a chiropractic adjustment is inappropriate, such as when an animal is suffering from a recently inflicted injury.
The key to successful use of the holistic approach, say Henneman and other reputable practitioners, is to start with a foundation of knowledge, such as is obtained by becoming a veterinarian, then branching out from there to incorporate the alternative therapies.
"The typical conventional practitioner may find that it is easy to feel confused by all the choices in alternative and traditional therapy," writes Smith in her Perspectives article. "Based on research conducted for this article, a good general approach to handling such therapies may be along lines of the following:
"First, make a sound diagnosis and then list all of the treatment options that are suitable for that problem, including any possible alternative methods. Fishing for treatments does a disservice to the client, the pet, and to the treatment itself, since failure may cause you to label the treatment as bad when, in fact, it simply showed that the treatment was not appropriate for that disease.
"Discuss the pros and cons of each treatment with your client. To protect yourself, consider asking the client to sign a waiver if proven treatments are declined in favor of alternative therapy.
"Refer the client to someone who has received specific training in the method you choose. Remember, too, that certification often has no special meaning other than to the credentialing agency. According to Dr. Edward Ames, the American Veterinary Medical Association's Director of Scientific Activities, 'The AVMA has not evaluated any alternative medicine courses. Veterinarians who attend these courses are not recognized as specialists. Before you refer clients for alternative treatments, first get specific information from alternative practitioners. What does their certification mean? How many hours of additional education were obtained? How many patients with similar problems have been treated and what were the outcomes?'
"Finally, avoid referring your client to practitioners who see one alternative method as the sole answer to all disorders. Also remember that alternative practitioners without a veterinary background may simply treat signs of a disease without an adequate understanding of the underlying disease processes."
Henneman adds this comment concerning a horse owner who is seeking an appropriate alternative medicine practitioner: "Human alternative practitioners are not familiar with common animal disease patterns, which often are different than humans or stem from different causes. For example, homeopaths who deal with human patients do most of their prescribing based on mental symptoms, which is difficult to do with animals without anthropomorphizing."
One of the problems facing various forms of holistic or alternative medicine is the lack of scientific research on specific therapies. Anecdotal evidence truly exists, but no one can say from a scientific research point of view, for example, exactly how homeopathy works.
One thing seems certain, based on existing evidence--alternative forms of medicine are here to stay and their usage is growing.
The important approach for horse owners, it would seem, is to make certain that the therapy chosen is appropriate for that particular horse's ailment. This means that the first approach should be a thorough examination by a licensed veterinarian.
About the Author
Les Sellnow is a free-lance writer based near Riverton, Wyo. He specializes in articles on equine research, and operates a ranch where he raises horses and livestock. He has authored several fiction and non-fiction books, including Understanding Equine Lameness and Understanding The Young Horse, published by Eclipse Press and available at www.exclusivelyequine.com or by calling 800/582-5604.
POLL: University Equine Hospitals