Integrative veterinary medicine is defined as the integration of conventional and complementary and alternative diagnostic and therapeutic approaches into a comprehensive preventive and therapeutic approach to disease. Integrative veterinary medicine also considers the mind, body and other relationships in its approach to the prevention, diagnosis and treatment of disease and maintenance of good health. It integrates preventive medicine and health programs, conventional medical and surgical approaches with acupuncture; botanical medicine (herbs, phytotherapy); chiropractic; homeopathy; physical therapy including cold lasers, magnetic therapy, and others; nutritional supplements and nutraceuticals; behavior management; environmental medicine; and other miscellaneous therapies.¹

Integrative Approach to Geriatric Medicine

An integrative approach to geriatric medicine often addresses numerous geriatric conditions including musculoskeletal, neurologic, cardiovascular, metabolic, gastrointestinal and other issues. An integrative approach to geriatric medicine includes a comprehensive conventional diagnostic workup incorporating the physical examination, blood chemistry, urinalysis and diagnostic imaging techniques where appropriate. Based on the diagnosis, a comprehensive therapeutic approach is offered to the client. In addition to conventional approaches, other CAVM therapies are offered. Physical therapy for musculoskeletal conditions including massage, stretching, swimming, low level laser therapy, magnetic therapy and others may be integrated as well. Western botanical medical formulas,³ nutraceuticals, nutritional supplements may also be prescribed. Vitamin and mineral supplements, digestive enzymes, amino acid supplements, essential fatty acid supplements such as fish oil, flaxseed oil and others, antioxidants such as vitamin E, selenium, alpha-lipoic acid as well as others should be considered. Adaptogenic herbs, such as ginseng, ashwagandha and astragalus may be appropriate. They help support hypothalamic-pituitary-adrenal axis function.³ Herb/drug interactions must be considered when prescribing these in addition to conventional medications. Medicinal mushrooms have been found to benefit the immune system in geriatric patients.

Low-level photobiomodulation laser therapy is being integrated into geriatric protocols to assist in increasing circulation, relieving pain, modulating cellular health and improving quality of life overall.

Integrative Approach to Degenerative Joint Disease

An integrative approach to degenerative joint disease can be quite rewarding for the patient and the veterinarian. This goes beyond prescribing analgesic and anti-inflammatory medications to the incorporation of proactive chondroprotective supplements such as injectable and oral glycosaminoglycans. The development of a proactive approach including an appropriate exercise program is essential to proper maintenance of the musculature without overdue stress on the joints. Physical therapy including under water treadmills, stretching exercises magnetic and low-level laser therapy, have been found to be extremely beneficial as well. Acupuncture and physical manipulative therapies can be very beneficial for degenerative joint disease.⁴ Manipulative therapies may be added to treat secondary compensatory problems. Stem cell therapy, PRP and other regenerative approaches may be added as well. Acupuncture may be synergistic with these approaches by increasing the local microcirculation to arthritic areas and thereby increasing the availability to affected areas.

Low-level photobiomodulation laser therapy is rapidly being integrated into musculoskeletal protocols to assist in increasing circulation, relieving pain, modulating cellular health and improving quality of life overall.

Integrative Approach to Cardiovascular Conditions

Acupuncture has been found to be beneficial in the treatment of various arrhythmias, as well as in the treatment of cardiac arrest.⁵ Acupuncture for various cardiovascular conditions will be discussed as well. In addition to acupuncture, certain nutritional supplements may be added such as Co-enzyme Q-10, fish oils, magnesium, potassium, amino acids such as l-carnitine, taurine, Vit E, selenium, as well as western herbal medicines, such as hawthorn.

Integrative Approach to Gastrointestinal Conditions

Numerous gastrointestinal conditions may be responsive to an integrative approach, including inflammatory bowel disease, megasophagus, feline obstipation syndrome and others.⁶ The key to an integrative approach to gastrointestinal conditions, as with most conditions, is proper diet. Acupuncture has been found to be beneficial in the treatment of vomiting and diarrhea. Acupuncture helps regulate gastrointestinal motility.

Nutritional support to support the protective layers of the gastrointestinal tract have been found beneficial as well. These include N-acetyl glucosamine, digestive enzymes, lactobacillus acidophilus as well as other probiotics.

Integrative Approach to Neurologic Conditions

With the improved ability of diagnostic imaging equipment including CT scans and magnetic resonance imaging, veterinary neurologic diagnostics have greatly progressed and we are able to have much more specific neurologic diagnoses. With this ability, we are now able to be much more specific in the treatment of neurologic disease with integrative approaches. In additional to conventional medical and surgical approaches, acupuncture, Chinese herbal medicine, physical therapy and nutraceutical’s have been found to be clinically beneficial in the treatment and management of neurologic conditions including various causes of paralysis, paresis, seizures, coma, etc.^7,8,9

Integrative Approach to Cancer

Acupuncture may be used as an adjunct therapy for cancer in order to decrease the side effects of chemo and radiation therapy as well as having immunoregulatory effects. Clinically, I have used an integrative approach for the treatment of cancer for 30 years and in numerous cases I have seen an improved quality of life as well as an extended life span beyond the prognosis based on just conventional veterinary medicine.

Mind/Body Medicine Approach

Mind/Body medicine is a rapidly expanding field in human medicine and its applications for veterinarians are just beginning to be explored. In its simplest definition, Mind/Body medicine is the use of our mental activity, thoughts and feelings to help prevent and treat various “dis-eases”. Studies in mind/body medicine document the effects of thoughts on the release of various neurotransmitters and neurohormones and the impact that has on our physical, mental and emotional health.¹⁰ I have found that integrating various practices of mind/body medicine into a comprehensive integrative approach is beneficial for veterinarians, their staff, their clients and patients. Workshops and training on mind/body medicine have been offered at the World Small Animal Veterinary Conference as well as the Canadian Veterinary Medical Association Annual Conference. Mind/body medicine can be of benefit by creating an atmosphere of calmness, compassion and mindfulness when working with animals and their human caretakers. It can help prevent compassion fatigue and burn out for veterinarians and their staff.

Conclusions

No one form of medicine has all the solutions to all diseases. The future of veterinary medicine should include the most successful approaches to specific conditions including conventional western medicine and surgery along with CAVM. An individualized specific integrative approach to a patient will allow the animal to live a longer, quality life with their human caretaker.

References

1.  Schoen AM, Wynn, S. Complementary and Alternative Veterinary Medicine, Principles and Practice, Mosby Inc.: St. Louis; 1998.

2.  Schoen A. Incorporating Complementary Veterinary Therapies into Conventional Small Animal Practice, in Schoen, AM & Wynn, S, Complementary and Alternative Veterinary Medicine, Principles and Practice, Mosby Inc.: St. Louis; 1998:589–600.

3.  De Guzman E. Western Herbal Medicine: Clinical Applications, in Schoen, AM & Wynn, S, Complementary and Alternative Veterinary Medicine, Principles and Practice, Mosby Inc.: St. Louis; 1998:337–378.

4.  Schoen AM. Acupuncture for Musculoskeletal Disorders, in Schoen, AM, Veterinary Acupuncture, Ancient Art to Modern Medicine, Mosby, Inc, St. Louis; 2001:161–170.

5.  Smith F. Acupuncture for Cardiovascular Disorders, Schoen, A., 2 ed. Veterinary Acupuncture, Ancient Art to Modern Medicine, Mosby, Inc.: St Louis, MO; 2001.

6.  Dill S, Bierman N. Acupuncture for Gastrointestinal Disorders, in Schoen, AM, Veterinary Acupuncture, Ancient Art to Modern Medicine, Mosby, Inc.: St. Louis, MO; 2001:239–244.

7.  Kline K et al. Acupuncture for Neurologic Conditions, in Schoen, AM, Veterinary Acupuncture, Ancient Art to Modern Medicine, Mosby, Inc.: St. Louis, MO; 2001:179–192.

8.  Jannsens L. Acupuncture for Thoracolumbar and Cervical Disk Disease, in Schoen, AM, Veterinary Acupuncture, Ancient Art to Modern Medicine, Mosby, Inc.: St. Louis, MO; 2001:193–198.

9.  Xie H et al. Traditional Chinese Veterinary Medicine for Neurological Diseases. Proceedings of the 13th Annual International TCVM Conference. Jing Tang Publ. Reddick, FL. 2011.

10.  Schoen A. Mind/Body Medicine for Veterinarians and Applications in Clinical Practice, Canadian Veterinary Medical Association Annual Conference Proceedings. CVMA. July, 2013.