Overview of Complementary and Alternative Veterinary Medicine
Complementary and alternative veterinary medicine (CAVM) as defined in 2001 by the American Veterinary Medical Association, is “...a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices. The theoretical bases and techniques of CAVM may diverge from veterinary medicine routinely taught in North American veterinary medical schools or may differ from current scientific knowledge, or both.” Although some of the myriad approaches have been used to treat animals for centuries, many have not. Instead, they have been extrapolated from human approaches without first undergoing assessment for safety and effectiveness in nonhuman animals.
Despite the popularity of CAVM among some segments of the public, along with intensive promotion by certain groups, much remains unknown regarding the true therapeutic utility of many aspects of CAVM. Thus, to gain a legitimate foothold in modern medicine, CAVM must demonstrate a rational mechanism of action and withstand scientific scrutiny.
The diversity of approaches that constitute CAM range from the well-studied to the bizarre and baseless. Certain treatments, such as homeopathy, lack biologic plausibility. Others require belief systems more consistent with faith-based healing than medicine. Much of the material published regarding CAM promotes unreliable and potentially dangerous advice. CAM providers cannot always provide a scientific basis and critical perspective for what they practice.
The responsibility for protecting and benefiting veterinary patients remains with the scientifically educated clinician. Veterinarians who consider referring patients for CAVM or practice modalities have a responsibility to distinguish tried-and-true from too-good-to-be-true. This is accomplished by conducting well-designed scientific trials to investigate relevant clinical questions and by regularly reviewing the medical literature to reassess which modalities have accumulated independently confirmed data. Even if a certain clinical application has not yet received research scrutiny, studies showing a plausible and unique mechanism of action, as well as a safety record, can help support a rational decision about whether to recommend it.
Although numerous modalities and treatments are associated with CAVM, the ones discussed below are some of the more well known or considered for veterinary use.