Veterinary Therapies - Combining Therapies

By Tammy Hunter, DVM; Steve Marsden, DVM ND MSOM LAc DiplCH AHG, Shawn Messonnier, DVM and Cheryl Yuill, DVM, MSc, CVH.

Should I be concerned about combining alternative treatments?

The underlying philosophy of alternative medical therapies is the “holistic” approach, in which the patient is treated as a whole entity rather than a collection of organs and parts. The patient is treated as an individual rather than a diagnosis, and treatment is determined by the way the individual is responding to illness.

Once treatment has begun, it is necessary to observe and assess the patient’s response, determine if the response is appropriate, and adjust the treatment if necessary.

If multiple therapies are given to a patient at one time, it is impossible to know which treatment caused which response. The combination of treatments may have acted additively (each treatment worked without interfering with the other treatment), synergistically (the combination of treatments has produced a much greater effect than would be expected from an additive effect), or antagonistically (the treatments interfered with each other, canceling out some or all of their effects).

Which forms of treatment can cause problems when combined?

The alternative treatments most likely to act deeply on the body (initiating internal responses or reactions that can last for prolonged periods) are acupuncture, herbal medicine (including Traditional Chinese Medicine), and homeopathy. Therefore, combining these therapies could cause less predictable interactions. Properly qualified practitioners in these forms of alternative medicine have a sound understanding of how the treatments should be applied, whether a combination is appropriate, and how to assess the patient's response.

In some circumstances, because of differences in anatomy and physiology, animals react differently than humans. Therefore, acupuncture, herbal therapy, or homeopathy should only be prescribed or combined under the advice of a properly trained veterinary professional to avoid interference between the various modalities and enhance the chances of a synergistic or additive reaction.

Caution must always be used when combining these therapies with conventional treatments, including surgery. The use of steroids or anti-inflammatory drugs can mask symptoms of value in prescribing homeopathic remedies, herbs, and even acupuncture. The use of potent compounds such as antibiotics, corticosteroids, pungent ointments, and strong-smelling products such as camphor may interfere with the action of some alternative medicines, especially homeopathy.

Are there any treatments that may be combined safely?

In general, Bach flower remedies, massage therapy, physical therapy, chiropractic, nutritional therapy, and some supplements may be safely combined with most other forms of conventional or alternative therapy. Usually, mild products such as slippery elm, green tea, psyllium husks, and aloe vera juice will not interfere with other treatments; however, research has not tested this.

In some cases, it may be necessary or prudent to determine how much each treatment is contributing individually to a patient's wellbeing. To simplify these assessments, the different treatments should be given at different times or even on different days, allowing the patient's response to each treatment to be assessed.

To summarize, combining alternative medical therapies, either with other alternative therapies or with more conventional treatments, may improve the patient's health or speed the healing of lesions. However, combined incorrectly, these same therapies have the potential to interfere with healing or cause serious health consequences. Veterinary practitioners trained in acupuncture, herbal therapy, and homeopathy are the best sources of information on what conventional and alternative treatments will combine well and which ones should not be used together. Ideally, one veterinary practitioner should assume the responsibility of coordinating the pet’s treatments and care, in cooperation with the pet’s owner or caregiver.

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