Scientific basis for common holistic treatments (Proceedings)

There are a number of references for various modalities accessible through PubMed as well as summarized in various texts. The texts in the references at the end of this article are excellent sources for those who want more detail, including hundreds of individual references. There are also companies with good online references, also included with the references. This paper will discuss the validity and availability of research.

Acupuncture

Acupuncture has an increasingly broad base of favorable research. Before the United States, research in Sweden and France had highlighted much of its promise, but essentially none of it was translated into English. Much of the existing Chinese research has also not been translated, and the research published during the 1960's and 1970's is suspect, because of the political situation at that time. More current research from China is increasingly translated into English, and follows accepted standards of practice.

In the United States, some early research is based on faulty premises. For example, if an acupuncturist is needling a point, it is difficult to truly have sham acupuncture. With experience, it is possible to detect acupuncture points without seeing an entire body, and, if told to place a needle within an area, one might tend to place a needle in an acupoint, slightly away from the intended spot. Experienced acupuncturists often have results that are superior to beginners, even when needling the same points. True acupuncture consists of patterns, not single points. Research based on sham acupuncture is not reliable, in my opinion.

Other research methods don't always match actual use. For example, research on one point that is used for cardiovascular collapse (GV26) involved anesthetizing sheep with halothane and then stimulating the point. They saw no arousal. In real life, the point would be used when a sheep stopped breathing or its heart stopped beating, and anesthesia would have been stopped when the point was stimulated. All of us who have been using acupuncture for a long enough period have a story about restarting the heart again using this point.

However, there is an increasing body of research that illustrates the ability of acupuncture to influence the release of endorphins, enkephlins, serotonin, and reproductive hormones. It can influence heart rate, blood pressure, and peristalsis. Red and white cell count, IgA, phagocytic activity of neutrophils,

and Natural Killer Cell activity can be increased with acupuncture. (See Schoen's Veterinary Acupuncture for specific citations.)

Some research has shown that healing may be quicker with acupuncture. In addition, Robert Becker, MD, as detailed in his book The Body Electric, found that electrical currents measured in microvolts and nano-amps can speed or delay healing, depending on the direction of flow.

Herbs

Many are the basis for Western drugs. Pharmaceutical companies devote much of their time screening compounds isolated from plants for various activities. They do not always get the same results as herbalists—often because the ultimate action is from a combination of factors, not one single chemical. Nevertheless, a number of useful drugs deroved from plants are in common use, such as aspirin, from Salicis cortex (willow bark), digoxin from Digitalis purpurea (foxglove), Taxol from Taxus brevifolia (Pacific yew), Vincristine from Catharanthus rosea (periwinkle plant) and Synephrine from Citrus aurantium (bitter orange).

Medline or PubMed can be used to research herbs. You must know what you are looking for, which may be a derivative or an extract. For example, a search for "silymarin" will generally give you more results that searching for milk thistle (for liver problems). "Sanguinarine" will bring up results in the use of bloodroot for cancer.

The Germans have been researching herbs for decades. In Germany, their use is regulated by the government, and before an herb can be used, it must pass muster with their governmental Commission E. The Commission determines what is supported by research, what can and cannot be used, and publishes a monograph on each herb. Fortunately for us, the complete monographs have been translated into English. Unfortunately, the translated book is expensive. Phytopharmica is a company that bases their products on the German Commission E requirements.

Chinese herbal formulas are centuries old. The Chinese have compared their actions to conventional medicine in trials involving hundreds of people, with comparable results. Unfortunately, much of that research is published in Chinese. Much of the initial research in the United States looked at individual herbs instead of formulas, and concentrated on anti-cancer effects. Health Concerns, an American company based in Oakland, California, has conducted clinical trials on a number of its formulations, showing favorable or superior results to conventional medicine. Chinese herbs are especially good for chronic conditions, an area that is not favorably addressed by Western medicine.

To work properly, herbs and herbal formulations should be used the way they were designed. Death by ephedra in weight loss products occurred because this was a use never intended in the original formulas. To use herbal products correctly and safely, and to design research correctly, a competent herbalist, an ethical herb company, or a valid text must be consulted. For Chinese medicine, this means someone licensed for the use of Chinese herbs (an OMD). For Western herbs, someone who is a member of the American Herbalists Guild (AHG) is preferable.

Nutraceuticals

Interest in nutritional supplements to help various health problems has grown tremendously in the last decade. Hills, Iams, Purina, and Royal Canin have all invested time and money in research and development of various supplements as additives to veterinary prescription formulas. The holistic world has explored them for far longer. Some of these include: taurine (for heart problems), glucosamine (for arthritis), SAM-e (for liver problems), omega 3 fatty acids (for arthritis and cancer), and fiber (for diarrhea). In addition, some dermatologists have recommended vitamin E for atopy, and the need for ±2 in the treatment of prolonged diarrhea is now recognized.

One needs to read the research carefully. For example, Recommendations from Iams for optimum ratios of omega 3: omega 6 oils is based on research that started at 1:10, but did not continue fully to 1:0 or 1:1. Each increase in omega 3's showed more improvement in results, with the most improvement at the highest ratio shown, but I suspect the endpoint is an even higher ratio than recommended. Of course, this is expensive, and I suspect this is why the company did not continue the series.

The holistic world used these supplements before the official results were in, and uses other supplements on a regular basis. Some use is based on human studies, while other is more empirical. Holistic practitioners rely on case studies and word of mouth, as well as research, in deciding what to use. As the big companies search out other ways to beat the competition, I am sure we will be hearing about these other supplements also. One example: dl-phenylalanine (not l-phenylalanine) for pain relief in degenerative joint disease and hip dysplasia.

Nutrition

Pet food is designed to use up products (such as by-products) that humans won't eat. If a pet can grow and reproduce, the food is considered adequate. As the recommendations for increased taurine (twice) in cat food shows, this does not necessarily mean adequate for an animal's entire lifetime. The holistic approach is to try to reproduce the diet of an animal's wild ancestors. There is some basis in this approach. For example the prolonged processing of meat products at high heat causes loss of some amino acids and cross-linkages of others. Meat meal and meat by-products do not have the same amino acid profile or digestibility that raw meat does. Another example is hyperthyroidism in cats, which was not reported until 1978. It was an unknown disease when I graduated in 1970. There is a strong suggestion that it is diet related. Diets that do not incorporate gluten meals and by-products often help animals with IBS.

Current raw diets make varying attempts to include parts of a wild diet (bones, vegetables, fruits, organ meats). None of them include fur, and none are seasonal (fat meat in the fall, sprouts in the spring, fasting in the winter). Grass-fed meat approaches the fatty acid profile and low bacterial count of wild game, but most raw diets do not incorporate them. We do not have a study similar to the China Study or the study of the Mediterranean diet that compares the more natural diet to commercial diets. More research is needed here.

The wild diet was designed for wild animals that would grow and reproduce as much as possible, given the exigencies of climate variation with resultant feast or famine conditions. It was not designed to support geriatric animals or those with chronic fatal disease. Current research exists among the Big 3 in prescription diets, but even that research can be conflicting. (See information from Hills and Iams on low protein vs moderate protein for kidney failure.)

Detoxification

In a nutshell: there are 2 main liver enzyme phases that substances go through when they are processed by the liver. Phase 1 oxidizes and reduces substances. This can result in a substance that is more toxic than the original. Phase 2 conjugates them which usually results in something that is less toxic. If the liver is overwhelmed, the substances themselves may accumulate, or there can be a buildup of substances resulting from Phase 1 processing. Either way, they spill over into the blood and are first stored in body fat, and later in other places including the interstitial area of the body. When enough accumulate, there is damage to cells and, at the final phase, to mitochondria of cells. The concept of detoxification is to get rid of these, by increasing their excretion, and by neutralizing them with antioxidants, etc. The most extreme "detox" is fasting, which can be harmful if too many toxins are released too quickly. We see this in obese cats.

The Institute for Functional Medicine organizes yearly seminars on the latest in this field.

Trigger point therpy

Trigger points are mostly unrecognized by conventional medicine, but are very real to people and animals who have them. Trigger points can be found with MRIs, and with thermography. They have a lower temperature than surrounding muscle. Trigger points are hyperirritable, and very painful with normal digital pressure (dogs will bite, horses will kick, and cats will attack when a trigger point is pushed on).

Histologically, a trigger point has excessive collagen fibers and abnormal muscle fibers with clusters of nuclei, knots of myofibrils, loss of cross striations, swollen mitochondria and ragged red fibers. There is local vasoconstriction and hypertonia of the area.

The reference section has books that are helpful for finding and treating trigger points.

Chiropractic

Chiropractic is in wide use by humans, insurance companies pay for chiropractic treatments, but for some it is still controversial. There are published papers supporting its use, especially in horses. There are structural differences in animals vs humans, so I would recommend only using those certified by the AVCA.

Homeopathy

Homeopathy is based on the idea that a substance that causes symptoms of illness in large doses can cure that illness in smaller doses. Digitalis (the original substance, derived from the foxglove plant) in large doses causes heart arrhythmias and heart failure. In very dilute doses (equivalent to the strongest doses in homeopathy) it can help congestive heart failure. Its use by physicians is essentially homeopathic.

Heel is one company that is performing research to validate effectiveness of homeopathy. They use low dilutions of substances, and you can taste some of them in their products.

Aromatherapy

Aromatherapy is based on the idea that scents can have major effects on behavior. Research done in the 1960s showed that aromas that were undetectable to the conscious mind could still be detected subconsciously and had an effect on the detector's mood.

Intent

The idea of Intent is an important one in holistic medicine. Those who practice with the intent of healing, and the belief that they can heal, rather than to merely make money or to prove that something doesn't work, will have more success than those who try to use exactly the same methods for their own personal gain or in an experiment to show that holistic medicine doesn't work. Medicine is as much art as science. You are constantly faced with either/or, degrees of intensity, and what-if questions. Self-confidence and awareness of your patient and his owners plays as big a part in the process as selection of a specific antibiotic. It is easy to self-sabotage if you have self doubt.

References available upon request