If Your Veterinarian Offers Acupuncture, Find a Different Vet

The state of the universe.
May 5 2014 11:52 PM

If Your Veterinarian Offers Acupuncture, Find a Different Vet

Sticking needles in your dog won’t make it feel better.

140505_SCI_DogReiki

Photo illustration by Lisa Larson-Walker

You know what happens to dogs in China, right? No, not that. I mean acupuncture. Eastern-influenced veterinarians claim that Chinese acupuncturists began treating horses more than 4,000 years ago, and today many Chinese schools offer courses on animal acupuncture. The history of animal acupuncture, like the history of human acupuncture, is in serious dispute, but that hasn’t slowed its growth in the United States. Several U.S. veterinary schools now offer acupuncture training, and more than 4,000 veterinarians are willing to stick lots of tiny needles into your animal in exchange for money. Animal acupuncture is a scientifically dubious practice, and it’s unfortunate that so many vets are willing to perform it without a sound basis in evidence.

If you’re an acupuncture enthusiast, you’re probably getting ready to point me toward studies proving the efficacy of veterinary acupuncture. Before you do that, let’s make a deal: I will concede that there are studies supporting veterinary acupuncture if you concede that there are studies opposing it. The issue is assessing the quality of the studies and determining where the weight of the evidence lies.

Four out of five studies on animal acupuncture are unreliable, and the fifth usually debunks the practice. A 2006 systematic review collected 31 animal acupuncture studies and ranked their methodology on a five-point scale. Two studies earned four points, one earned three points, and two earned two points—and none of those studies found any benefit to acupuncture. The remaining 26 studies scored either zero points or one point, and their methodological flaws should be obvious to any layperson. Many of them failed to randomly assign animals to groups that received therapy or did not. Others neglected to blind the evaluators to which animals received treatment and which were controls. The studies that included house pets failed to blind the owners, opening the door to the transferred placebo effect—an owner who thinks his dog has been treated is more likely to say that the dog’s health has improved. In 2010, reviewers looking at the broader category of complementary and alternative veterinary medicine wrote that “the available evidence of [complementary and alternative medicine] in veterinary medicine is weak.”

Advertisement

There is confusion in the literature about how exactly to conduct veterinary acupuncture. Some practitioners, for example, discuss the gall bladder meridian in horses, even though horses don’t have gall bladders. In many studies, acupuncturists send electrical pulses through the needles, which massively complicates the interpretation of the results.

“The idea that you can pump electricity into the body and interfere with the perception of pain has been known since the 1800s,” says David Ramey, an equine veterinarian who worked on the American Veterinary Medicine Association’s guidelines on complementary and alternative therapies. “But are we talking about acupuncture or electricity?”

Some of the reviews that support animal acupuncture border on outright dishonesty. Two years ago, University of Florida veterinarian Huisheng Xie wrote, “An ever-expanding body of evidence-based research supports acupuncture as a clinically useful modality.” Xie styled his collection of studies as a wide-ranging review paper, but he failed to acknowledge the dozens of studies showing that acupuncture does not work. Researchers who write narrative reviews have some flexibility in which studies they choose to include, but to brush aside every study that contradicts your own viewpoint is the professional equivalent of sticking your fingers in your ears and shouting.

Xie’s overzealous support of acupuncture is well-known among veterinarians. “He doesn’t make the effort to use science to control for his tendency to see what he wants to see,” says Brennan McKenzie, president of the Evidence-Based Veterinary Medicine Association and author of the SkeptVet blog.

Xie also has a financial stake in the popularity of animal acupuncture. He founded the Chi Institute of Traditional Chinese Veterinary Medicine, where veterinarians can be certified in acupuncture online or on-site, for $695 or $1350, respectively. Some veterinarians question whether this creates a conflict of interest.

“Xie is running a for-profit endeavor outside the veterinary establishment,” says Ramey. “He’s also promoting herbal products, and he’s making a living out of it. He’s not exactly an unbiased source of information.” (Xie failed to respond to repeated requests for comment.)

Cherry-picking studies to support traditional Chinese medicine is a tradition in itself. The majority of reviews published on the topic in China contain schoolchild errors. Even systematic reviews, the gold standard of unbiased study aggregation, are flawed. The authors rarely explain their criteria for choosing which studies to include, they may omit conflict-of-interest statements, and they combine the results of many studies without accounting for differences in demographics and methodology. Americans who favor “alternative” medicine seem to think they are rejecting the narrow-minded bias of the Western medical establishment, but they’re just adopting someone else’s narrow-minded bias.

Who cares if someone wants to stick needles in their German shepherd? Fair question.

“Animal acupuncture perpetuates a fraud,” says Ramey. “It also dumbs down the practice of veterinary medicine and allows people to promote their nonsense at the expense of others.”

Acupuncture gives people the false impression that they’re helping their pets, which causes them to forego proven treatments. McKenzie once saw a Rottweiler that had been undergoing non-Western treatment for bone cancer, which is an excruciatingly painful disease. When he recommended medication to control the animal’s pain, the owner’s reaction surprised him.

“She first gave me a puzzled look and eventually became offended,” McKenzie says. “She was completely convinced that acupuncture was controlling the dog’s pain. But the animal wouldn’t put any weight on his leg, and when I touched it, he screamed. Acupuncture makes us think we’re helping animals, when in fact we are not.”

There is a debate to be had about the ethics of placebo treatments in human medicine, especially when it comes to pain. If a treatment makes you feel better, in some cases that’s just as good as actual improvement. Animals, however, don’t experience the placebo effect. They don’t know why we’re sticking them with needles or stuffing ground-up herbs down their throats. Those things only make you feel better. That’s not why you go to the vet.

Brian Palmer writes about science, medicine, and the environment for Slate and the Natural Resources Defense Council. Email him at explainerbrian@gmail.com. Follow him on Twitter.