After several months dealing with pain in both my elbows, secondary to playing hockey and playing keys in a jam band (neither well, mind you) I went to see my physio-therapist, who had helped me with a knee injury in the spring (from playing hockey, not keyboards.) He tried to convince me that as an adjunct to the ultrasonic treatments on both of my elbows, a treatment that my sports doc insisted was perfectly plausible but that I still kind of doubt, that I should try acupuncture to relieve the pain; by relieving the pain, the arm would heal faster. After I expressed my doubts at having a needle passed subcutaneously for little benefit, he offered electro-acupuncture that was “just as effective”. I bit my tongue and chose not to respond with “just as effective while eliminating some of the risk? Why is that not the first line treatment then?” I just refused acupuncture on philosophical grounds and left it at that.
Later, they tried to insist that acupuncture now has a scientific basis, one to do with afferent nerves confusing the pain centres in the brain, and that, after all, it works on animals! After giving me a copy of the Cochrane review that my physio-therapist insisted found a positive effect with acupuncture, and that actually found no evidence for or against it, I began to think about animal models of CAM therapies and how, especially in the recent naturopathy debates on Skeptic North and in the National Post, that animal studies are the standard response by CAM practitioners to charges of placebo effects. Could this have a basis in reality?
11 Herbs and Spices
Herbal preparations show the most promise when applied to animal models. The animal model in testing is one of the steps of drug discovery, and is the logical step after in vitro testing on a collection of cells. Animal models do not always reflect what may happen in human subjects, but it is a good start and many chemical pathways and systems in lab animals are congruous with the same systems in humans. At the very least, an animal model of testing herbal preparations can give us the heads up when there are safety concerns, like the potentiality of liver failure, in some herbal preps. The animal model of testing should, in fact, be a requirement for testing, at the very least in safety tests, prior to release of a new herbal preparation.
Homeopathy is where the line should be drawn, however. There has been testing of homeopathic remedies in animals and some veterinarians and clinics offer homeopathic medicines for animals. Unfortunately, the animal trials suffer the same problems and the human ones for homeopathy: poor controls, un-blinded tests, a small number of subjects and subjective outcomes. Much like my physiotherapist insisting there was another message in the Cochrane review than was actually spelled out, one review of homeopathic modalities, with respect to immunology,
insisted that this is a promising field of research and that the “like-cures-like” model can be shown to work in many immunological models, BUT, that most of the studies are poor, lacked independent replication and show poor methodological design. That does not sound like good science to me.
There is a cottage industry of scientists testing acupuncture on small animals, mostly in China, go figure. The common study uses some sort of electro-acupuncture, the standardisation of which is highly lacking
The studies all seem to take the same tack: identify a chronic condition, diabetes, dry eyes, or arthritis for example, identify a chemical pathway that may or may not be associated with that condition, gather 8-10 animals in the study group, 8-10 animals in a control group and see if poking them with an electric stick changes the levels of any of the chemicals. This may or may not be a real effect, as poking a dog with a stick does illicit touch and pain receptors in the locality of the poke, and this does travel to its brain, and its interpretation of the poke as a threat or a comfort will then have a systemic response, and it may or may not change its serotonin, dopamine, or glucose levels (as a small sample) beyond their normal ranges. To extrapolate these animal studies to a human model, however, that has different nerve and organ systems and thus should have a different meridian system (i.e. the horse apparently has a gall bladder meridian, without having a gall bladder – neat trick) is a stretch rivalling Mr. Fantastic.
Chiropractic has been practiced on animals since Palmer first developed the theory in the 19th century. The SkeptVet has done a good review of the literature and shown that those trials on animals are small, lack controls and show small effect – all hallmarks of dubious and unsubstantiated science. The fact that the upright walking humans, prone to back problems because of their odd gait, are not a good model for spinal therapies in animals.
The most dubious and least plausible of CAM modalities performed on animals is therapeutic touch. In 1996, Jock Ruddock developed a technique called “vibromuscular harmonisation technique” or VHT based on “an aikido-based move” and asked the inevitable question “can this be used on horses?” A question that I leap to when ever I try out something new.
He called the therapy “Equine Touch” and it is apparently taught all over Europe and North America, including Canada. His wife, Ivana Ruddock, a veterinary surgeon of all things, used Jock’s techniques and applied them to dogs as “Canine Touch” and purports that it is meant to relax the dog, lower stress hormones, treat the system instead of the individual problem etc.; all of the same claims that are used to sell CAM therapies.
I could not find any scientific studies that supported these energy healing techniques, which are based upon the Bowen technique of unblocking energy flows in the body. Although, there were some case studies as reported by the practitioners themselves, but never published in a peer-reviewed journal. I have no idea why.
If It Quacks Like A Duck…
Most of the positive studies on these therapies in animals, as illustrated above by the SkeptVet, have a few things in common. The most compelling reason to doubt their effect is the subjective nature of the outcomes of the trials. The placebo effect may not work on an animal ignorant of the therapy being applied to it, but the researcher who is trying to quantify the effects would certainly feel its results. Most of the studies were un-blinded, such as this canine acupuncture study, where the practitioner who was applying the therapy was quantifying the pain in the animal! For someone to remain unbiased in this case would be almost impossible.
None of the studies I read showed profound results. There were no home-runs. Virtually all concluded that the study was equivocal at best and required further tests. When these are done, just like in the most recent acupuncture studies in humans, the increase in controls, better quantification, larger study groups, and blinding and randomising will probably eliminate any apparent small effect shown by the above CAM procedures.
So the next time someone tries to sell you Canine Touch, tell them you can pet your dog just fine by yourself, thank you.