Complementary and Alternative Veterinary Medicine

January 24, 2020

Position

The Canadian Veterinary Medical Association (CVMA) holds that the treatment of animals using complementary and/or alternative therapies and modalities, constitutes the practice of veterinary medicine. In addition, the CVMA holds that complementary or alternative veterinary medicine (CAVM) should be subject to similar standards as conventional veterinary medicine. Safety and efficacy should be demonstrated by scientific method and evidence-based principles and the practice of CAVM should be provided within the context of a valid veterinary-client-patient relationship (VCPR).

Summary

CAVM should be performed under veterinary supervision within a valid VCPR;
The benefits of a CAVM therapy should substantially outweigh the potential risks;
Not all CAVM modalities have the same level of evidence as in conventional medicine;
CAVM should be subject to similar standards as conventional veterinary medicine. Safety and efficacy should be demonstrated by scientific method and evidence-based principles.

Background

“Alternative Medicine” has been defined as existing separately from, and as a replacement for conventional veterinary medicine, whereas “Complementary Medicine” has been defined as referring to the use of alternative together with conventional veterinary medicine. “Integrative medicine” brings conventional and complementary approaches together in a coordinated way (1).
The quality of studies and reports pertaining to CAVM vary. The CVMA encourages veterinarians to use those therapies and modalities, that offer the best balance considering risks, benefits, and level of scientific evidence (2). Veterinarians are uniquely positioned to advise clients on the risks of therapies, and the evidence to support the benefits of their use. The CVMA supports research to assess safety and efficacy of CAVM therapies, including their potential use alongside conventional veterinary medical therapies.
A large number of CAVM modalities exist with varying degrees of scientific evidence of therapeutic effectiveness. (3-5).
Treatments that employ CAVM should be performed by a veterinarian or under veterinary supervision within a valid VCPR. The CVMA encourages veterinarians who practice CAVM to clearly explain the differences between CAVM and conventional veterinary medicine when presenting the therapeutic options available to their clients. Veterinarians are advised to receive informed consent from clients before initiating therapy.
The CVMA does not currently recognize specialist status or certificates other than those awarded by the American Veterinary Medical Association, American Board of Veterinary Specialties (ABVS) (6). The CVMA supports the rigorous criteria imposed by the ABVS for distinct and identifiable specialties of veterinary medicine whereby diplomates hold a common basis of knowledge based on standardized educational goals and examinations. The CVMA supports the concept of ABVS certification for those CAVM therapies and modalities, that are based on sound scientific evidence as to their safety and efficacy.
The CVMA recognizes that provincial veterinary regulatory authorities license veterinarians in Canada, and thus regulate the practice of veterinary medicine, and determine within their jurisdictions:
- procedures that constitute the practice of veterinary medicine;
- what constitutes a valid veterinary-client-patient relationship;
- what constitutes “veterinary supervision”, and the limits of supervision as it pertains to any given therapy, including CAVM, and how a non-veterinarian(s) may or may not be involved in a CAVM therapy;
- any requirement to obtain owner consent prior to initiating any treatment, including a CAVM therapy, or modality (7-10).

References

National Institutes of Health National Centre for Complementary and Alternative Medicine. Available from: https://nccih.nih.gov/health/integrative-health Last accessed August 24, 2018.
Masic I, Miokovic M, Muhamedagic B. Evidence Based Medicine – New Approaches and Challenges. Acta Informatica Medica 2008;16:219-225. Available from: https://www.ejmanager.com/mnstemps/6/6-1300616203.pdf?t=1535726713 Last accessed August 24, 2018.
Doehring C, Sundrum A. Efficacy of homeopathy in livestock according to peer-reviewed publications from 1981 to 2014. VetRecord 2016;179:628. Available from: https://veterinaryrecord.bmj.com/content/179/24/628 Last accessed August 24, 2018.
Lees P, Pelligand L, Whiting M, Chambers D, Toutain P, Whitehead ML. Comparison of veterinary drugs and veterinary homeopathy: part 1. VetRecord 2017;181:170-176. Available from: https://veterinaryrecord.bmj.com/content/181/7/170 Last accessed August 24, 2018.
Habacher G, Pittler MH, Ernst E. Effectiveness of Acupuncture in Veterinary Medicine: Systematic Review. J Vet Intern Med 2006;20:480-488. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1939-1676.2006.tb02885.x Last accessed August 24, 2018.
AVMA American Board of Veterinary Specialties. Available from: https://www.avma.org/ProfessionalDevelopment/Education/Specialties/Pages/default.aspx Last accessed August 24, 2018.
Alberta Veterinary Medical Association 2010 Council Guidelines For The Practice Of Complementary And Alternative Veterinary Medicine.
College of Veterinarians of BC. Guidelines for the Responsible Use of Alternative Therapies and Sample Consent Form. Available from: http://cvbc.ca/Files/Bylaws-Policies/AlternativeTherapy/Guidelines_and_Sample_Consent_Form.pdf Last accessed August 24, 2018.
College of Veterinarians of Ontario. 2009 POSITION STATEMENT The Practice of Complementary and Alternative Veterinary Medicine. Available from: https://cvo.org/CVO/media/College-of-Veterinarians-of-Ontario/Resources%20and%20Publications/Position%20Statements%20and%20Guidelines/CompAltVetMed2015.pdf Last accessed April 24, 2019.
Positions et politiques de l’Ordre des médecins vétérinaires du Québec (OMVQ). Available from: https://www.omvq.qc.ca/l-ordre/positions-et-politiques.html Last accessed August 24, 2018.

Position Statements