Alternatives for controlling animal pain

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Dr. Peter J. PascoeHolistic medicine is becoming increasingly common in human health care. The appeal lies in the practitioner's efforts to treat the entire individual, both mind and body, rather than the ailment alone. Not surprisingly, a growing number of veterinarians have incorporated alternative and complementary therapies into their practices.

Dr. Peter J. Pascoe took up this controversial topic in his lecture, examining whether acupuncture, homeopathy, magnetic field therapy, and several other alternative techniques are useful for controlling animal pain. Dr. Pascoe is a professor of veterinary anesthesiology at the School of Veterinary Medicine at the University of California-Davis, and is a diplomate of the American College of Veterinary Anesthesiologists and the European College of Veterinary Anesthesia.

For the veterinarian, Dr. Pascoe said, the first welfare issue concerning the use of alternative techniques is whether they control pain. Few scientific data exist on clinical efficiency of alternative techniques in animals, he said, with much of the information largely derived from human literature.

Acupuncture is the best researched and most effective alternative method for providing analgesia for surgery, according to Dr. Pascoe. Although there is no doubt that acupuncture stimulation does increase the pain threshold, clinical data for the efficacy of acupuncture in the management of clinical pain are less convincing. The National Institutes of Health and British Medical Association have examined the evidence for the efficacy of acupuncture and found benefits in a few conditions, such as postoperative dental pain and nausea, but they did not examine acupuncture's clinical relevance for animals.

Nutrition is often emphasized by holistic practitioners and other veterinarians as affecting health and disease. There is a correlation between the amount of food eaten and the development of osteoarthritis of the hips, and between body weight in animals and a predisposition to hip dysplasia. What's more, animals on a restricted diet have some decrease in lameness as they lose weight. Overnutrition during growth has also been shown to cause problems in giant-breed dogs and other species.

In addition, n-3 fatty acids and other dietary supplements are increasingly used to manage such painful conditions as arthritis.

Homeopathy is a system of medicine more than 200 years old. The idea is similar to that of vaccination, Dr. Pascoe explained: low concentrations of a substance are prescribed to a patient to stimulate the body to eliminate signs induced by that substance at high concentrations. The problem with this treatment for Western science is that homeopathic remedies are thought to be more potent the more they are diluted, when in traditional medicine, the opposite is true.

Dr. Pascoe said there are few published studies with homeopathy being used to manage pain, but there is some evidence for its efficacy in people. He has been unable, however, to locate placebo-controlled veterinary studies on the use of homeopathy for pain management.

Herbalists believe certain herbs and plants are of therapeutic value because of their unique combination of ingredients. Randomized, controlled trials of herbal remedies have been published, and some positive effects have been reported. But because herbs are not regulated as strictly as drugs are, practitioners must be sure that suppliers adhere to stringent standards of authenticity and preparation.

Chiropractic is a relatively new discipline to veterinary medicine and is based on manual manipulation of the spine. The belief is that many diseases and disorders are caused by a dysfunction of the spinal column. There is a good deal of evidence that chiropractic is effective for treating human back problems. A major challenge for establishing chiropractic as a credible treatment is the difficulty in providing a placebo effect against which results can be measured. Reports of chiropractic's efficacy in veterinary medicine are largely anecdotal, Dr. Pascoe said. More research and formal training is likely, with the recent creation of the American Veterinary Chiropractic Association.

Magnetic field therapy has been around for many years. Two types of magnets are used: static magnets and electromagnets. The former can be applied to the skin, whereas the latter require a source of electricity. In human medicine, pulsed electromagnetic fields have been used to treat a range of conditions, from fractures to chronic skin ulcers, and have helped reduce pain. A recent preliminary study in dogs undergoing ovariohysterectomy found that dogs given morphine and magnetic therapy had lower pain scores than those receiving morphine or magnetic therapy alone, but the differences were not significant.

A review of available data suggests that alternative and complementary methods for pain management in people appear to be as safe or safer than pharmaceutical remedies, according to Dr. Pascoe. But a great deal of research still needs to be done before the same can be said for controlling pain in animals.

2001 AVMA Animal Welfare Forum - Pain Management