When I write about junk medicine and pseudoscience, I generally stick to human medicine. Recently, I wrote about the asinine people who refuse canine vaccinations, which led me to search for other alternative veterinary medicine that mirrored those for humans. That’s when I ran into veterinary acupuncture.
I’ll explain the evidence in more detail later in this article, but it needs to be stated right up front – acupuncture is a pseudoscience unsupported by any real scientific evidence. Acupuncture is generally supported by anecdotes, which are not data, and terrible clinical studies that, at best, show acupuncture to be nothing more than a placebo.
Given the lack of evidence supporting the efficacy of veterinary acupuncture, there’s only one way to describe the insertion of needles into your pets – it’s animal cruelty. It’s animal torture. It is not veterinary medicine.
If you want to believe that acupuncture works because you buy into the pseudoscience, go for it. Pay the charlatans pushing this nonsense because you trust in your beliefs rather than in science. It’s your choice.
But subjecting your pets to this travesty, who have no choice? Back to what I said before, it’s animal cruelty. Why would you do that to your favorite pet?
Like I said, let’s look at the pseudoscience behind veterinary acupuncture. Then put it in context of animal cruelty.
Does acupuncture work?
The simple answer is no. First of all, the concepts of meridians and qi, which are supposed to tell the acupuncturist where to insert needles, have long ago been dismissed as nonsense. “Modern” practitioners have mostly abandoned meridians, qi, and other “energies.” They now focus on just placing thin needles in random locations to treat pain.
The scientific evidence supporting the effectiveness of acupuncture is underwhelming. In fact, most of the evidence flatly states that it does not work. Most scientists consider attempts to support the effectiveness of acupuncture to be quackery, pseudoscience and theatrical placebo.
Acupuncture has mostly settled into trying to provide evidence that it can treat pain. The problem with studying this area is that it’s entirely subjective. One person’s painful knee may be just an annoyance to another person. Each of us responds to pain differently.
This makes acupuncture easily susceptible to a placebo effect. We can convince ourselves that pain is less through a method like acupuncture.
On the other hand, acupuncture will have no effect on cancer, diabetes, or any other chronic disease, because your mind can’t trick you into believing that your cancer has disappeared after getting acupuncture.
So let’s look at some of things that a “veterinary acupuncture” practitioner would use on your favorite cat or dog. Let’s see if there’s any evidence it works.
Acupuncture for pain
A systematic review of systematic reviews (which are at the pinnacle of the hierarchy of scientific evidence) found that real acupuncture was no better than sham acupuncture (the control group) in treating pain. They concluded that numerous reviews have provided little evidence to support acupuncture as an effective treatment for pain.
Another systematic review that examined the effects of acupuncture on lower back pain found insufficient evidence to recommend for or against either acupuncture or dry needling for acute low back pain. A clinical trial found that even though it appeared that acupuncture was effective for treatment of low back pain, the authors concluded that “it remains unclear whether acupuncture or our simulated method of acupuncture provide physiologically important stimulation or represent placebo or nonspecific effects.”
In a Cochrane systematic review of the effectiveness of acupuncture on chronic low back pain, the authors concluded that:
This systematic review demonstrates that acupuncture may have a favorable effect on self-reported pain and functional limitations on NSCLBP. However, the results should be interpreted in the context of the limitations identified, particularly in relation to the heterogeneity in the study characteristics and the low methodological quality in many of the included studies.
This is an ongoing caveat with many reviews of acupuncture – the poor design of many studies provide us with false information about the efficacy of acupuncture. Moreover, heterogeneity of studies included in a systematic review, meaning there is variability in design and analysis of the underlying studies, is always a major problem in meta-analyses of any kind looking at the effectiveness of the therapeutic intervention.
In other words, as the luminous Orac says – “garbage in, garbage out.” Meta or systematic reviews that show positive results are based on garbage studies simply tell us nothing about the effectiveness of acupuncture. People who try to convince the world that acupuncture is effective in treating pain are not basing it on scientific evidence.
Acupuncture for arthritis pain
Arthritis is a common ailment for older pets, and, of course, older humans – acupuncture is often recommended for arthritic pain. And once again, the evidence supporting its use is either “garbage in” or clearly doesn’t support its use.
The American Academy of Orthopaedic Surgeons (AAOS) has issued a 1200 page report (pdf) evaluating the evidence for various treatments for knee osteoarthritis short of total knee replacement surgery. The AAOS concluded that there was “strong evidence” against the use of acupuncture for the treatment of knee osteoarthritis. They stated that,
The majority of studies were not statistically significant and an even larger proportion of the evidence was not clinically significant.
In other words, after a review of all of the evidence for the use of acupuncture in knee pain, they not only saw little statistically significant evidence, but most of the evidence was not clinically significant, meaning the outcomes were no better than what is currently available for treatments.
A systematic review of the effectiveness of acupuncture in treating arthritis pain found that “the potential beneficial action of acupuncture on osteoarthritis pain does not appear to be clinically relevant.”
Another systematic review of acupuncture and arthritis concluded that acupuncture “has no effect on ESR (erythrocyte sedimentation rate, a method to measure inflammation from arthritis), CRP (C-reactive protein, another tool to measure inflammation), pain, patient’s global assessment, number of swollen joints, number of tender joints, general health, disease activity and reduction of analgesics.”
We can assume veterinary acupuncture will have the same exact effect on your family pet. Meaning none at all.
Acupuncture for other conditions
Veterinary acupuncture is used for several other conditions, for which there is limited or no evidence of effectiveness.
- Gastrointestinal conditions – a systematic review showed no clinical effect on irritable bowel syndrome. Another systematic review stated that there were no well designed studies that supported acupuncture’s use for gastrointestinal conditions.
- Skin conditions – a systematic review of the effectiveness of acupuncture on dermatitis showed that only small heterogenous studies were available, and the effect may not be clinically significant.
- Asthma – a systematic review of the use of acupuncture for treating asthma showed no clinical effect.
Acupuncture and China
Many studies and systematic reviews from China have shown an extraordinary amount of bias. A systematic review of acupuncture clinical trials show that studies conducted in China generally show a positive outcome in their conclusions about acupuncture.
Edzard Ernst, one of the most published scientists for reviews of alternative medicine, said this about these results from China:
The question why all Chinese acupuncture trials are positive has puzzled me since many years, and I have quizzed numerous Chinese colleagues why this might be so. The answer I received was uniformly that it would be very offensive for Chinese researchers to conceive a study that does not confirm the views held by their peers. In other words, acupuncture research in China is conducted to confirm the prior assumption that this treatment is effective. It seems obvious that this is an abuse of science which must cause confusion.
Dr. Steven Novella, at Science Based Medicine, concluded that:
This essentially means that acupuncture trials out of China are worthless. Because they are 100% positive they have no predictive value. Keep in mind, even treatments that work do not produce 100% positive studies, which would be statistically highly improbable, and is therefore a marker for bias.
As I stated elsewhere, much of this acupuncture research seems to start from an a priori conclusion, and the researchers try to produce data that support that conclusion. Real science works differently, the conclusion should be derived from the evidence.
The conclusion about acupuncture
We have examined acupuncture for a wide variety of conditions – there is a simple conclusion we can make, and that is, it doesn’t work.
Mark Crislip, at Science Based Medicine, makes two key points about reviewing acupuncture “research” (my scare quotes, not his):
- It’s “garbage in, sausage out” with respect to meta reviews that show positive effects of acupuncture. It’s almost like the authors of these “pro acupuncture” systematic reviews have a preconceived conclusion about the procedure, so they look at the data and try to force it to fit the conclusion. They want a delicious sausage from garbage. OK, the metaphor may not work for many of you.
- “There is no acupuncture but a multitude; as many acupunctures as there are practitioners. And they all do nothing.” Acupuncture is worthless.
Veterinary acupuncture is torture
So we looked at the effectiveness of acupuncture for a wide variety of medical conditions, and at best, we could find only weak statistical and clinical significance. Mostly, large meta reviews based their conclusion on weak, heterogenous and small studies – as Orac says, “garbage in.”
As I mentioned above, if you want to ignore all the data, including the fact that veterinary acupuncture has known risks, and get the pseudoscientific treatment for yourself, go right ahead. That’s your choice as a human being.
But when you force a person or animal, whether it’s a baby or a pet who have no ability to consent or reject the procedure, to undergo this useless procedure, it is unethical. It is immoral.
Medical treatment is considered ethical when there is informed consent to the procedure. That is why clinical trials can be ethical, because the trial enrollee is full informed of the benefits and risks of the study. Every medical procedure requires some level of informed consent. (In case you’re going to use this argument against vaccinations, because some of you will, vaccines are shown to work, as opposed to acupuncture.)
But how can a pet (or worse yet, a baby) give informed consent to veterinary acupuncture. They can’t.
According to an article on acupuncture and animal cruelty, Andy Lewis wrote:
The owner, or carer, makes that choice. It is in these circumstances that the utmost care must be taken to ensure that any treatment given to an animal has robust evidence to support it and can be shown to be in the best interests of the animal. For acupuncture, there can be no such demonstration of benefit to the animal, and so such treatments must be considered as highly questionable and unethical.
And if veterinary acupuncture is used instead of science-based treatments that are known to be effective, that is a cruel choice indeed for the family pet.
Our pets deserve the best veterinary medicine that we can offer them, not junk science that attempts to wrap itself around some fake antiquity (it only arose in the 1970s) or pseudoscientific effectiveness. Acupuncture, and veterinary acupuncture, doesn’t work (and please, spare me and the readers your anecdotes), and there is no ethical basis for using the procedure on your favorite dog or cat or horse.
Back to Andy Lewis:
It always amazes me how we casually and blithely accept acupuncture despite the fact that is founded on obvious mumbo-jumbo and has an evidence base that is composed mostly of studies from China that are little more than simple promotional propaganda.
Our animals deserve better. If your vet offers acupuncture, find another vet. If your aquarium or zoo is giving acupuncture to its animals, choose another day out.
Citations
- Ahn AC, Colbert AP, Anderson BJ, Martinsen OG, Hammerschlag R, Cina S, Wayne PM, Langevin HM. Electrical properties of acupuncture points and meridians: a systematic review. Bioelectromagnetics. 2008 May;29(4):245-56. doi: 10.1002/bem.20403. Review. PubMed PMID: 18240287.
- Amezaga Urruela M, Suarez-Almazor ME. Acupuncture in the treatment of rheumatic diseases. Curr Rheumatol Rep. 2012 Dec;14(6):589-97. doi: 10.1007/s11926-012-0295-x. Review. PubMed PMID: 23055010; PubMed Central PMCID: PMC3691014.
- Casimiro L, Barnsley L, Brosseau L, Milne S, Robinson VA, Tugwell P, Wells G. Acupuncture and electroacupuncture for the treatment of rheumatoid arthritis. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD003788. Review. PubMed PMID: 16235342.
- Cherkin DC, Sherman KJ, Avins AL, Erro JH, Ichikawa L, Barlow WE, Delaney K, Hawkes R, Hamilton L, Pressman A, Khalsa PS, Deyo RA. A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain. Arch Intern Med. 2009 May 11;169(9):858-66. doi: 10.1001/archinternmed.2009.65. PubMed PMID: 19433697; PubMed Central PMCID: PMC2832641.
- Ernst E, Lee MS, Choi TY. Acupuncture: does it alleviate pain and are there serious risks? A review of reviews. Pain. 2011 Apr;152(4):755-64. doi: 10.1016/j.pain.2010.11.004. Review. PubMed PMID: 21440191.
- Furlan AD, van Tulder MW, Cherkin DC, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. Cochrane Database Syst Rev. 2005 Jan 25;(1):CD001351. Review. PubMed PMID: 15674876.
- Lam M, Galvin R, Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2124-38. doi: 10.1097/01.brs.0000435025.65564.b7. Review. PubMed PMID: 24026151.
- Langhorst J, Wulfert H, Lauche R, Klose P, Cramer H, Dobos GJ, Korzenik J. Systematic review of complementary and alternative medicine treatments in inflammatory bowel diseases. J Crohns Colitis. 2015 Jan;9(1):86-106. doi: 10.1093/ecco-jcc/jju007. Epub 2014 Nov 28. Review. PubMed PMID: 25518050.
- Lim B, Manheimer E, Lao L, Ziea E, Wisniewski J, Liu J, Berman B. Acupuncture for treatment of irritable bowel syndrome.Cochrane Database Syst Rev. 2006 Oct 18;(4):CD005111. Review. Update in: Cochrane Database Syst Rev. 2012;5:CD005111. PubMed PMID: 17054239.
- McCarney RW, Brinkhaus B, Lasserson TJ, Linde K. Acupuncture for chronic asthma. Cochrane Database Syst Rev. 2004;(1):CD000008. Review. PubMed PMID: 14973944.
- Vickers A, Goyal N, Harland R, Rees R. Do certain countries produce only positive results? A systematic review of controlled trials.Control Clin Trials. 1998 Apr;19(2):159-66. PubMed PMID: 9551280.
- Vieira BL, Lim NR, Lohman ME, Lio PA. Complementary and Alternative Medicine for Atopic Dermatitis: An Evidence-Based Review. Am J Clin Dermatol. 2016 Dec;17(6):557-581. Review. PubMed PMID: 27388911.
- Wang SM, Harris RE, Lin YC, Gan TJ. Acupuncture in 21st century anesthesia: is there a needle in the haystack? Anesth Analg. 2013 Jun;116(6):1356-9. doi: 10.1213/ANE.0b013e31828f5efa. PubMed PMID: 23709075.
[wp_ad_camp_5]
