The framework within which complementary or alternative veterinary medicine is used to treat horses in Sweden could be improved, the results of a new study suggest.

Researchers Karin Gilberg, Anna Bergh and Susanna Sternberg-Lewerin write in the journal Animal, who was put in his study to explore the use of complementary or alternative veterinary medicine (CAVM) in Swedish horses.

CAVM, they said, is an umbrella term that covers a wide range of methods, from those that can almost be considered conventional medicine to those where animal studies are lacking, or that have not even indicated any effect on animals.

Electronic questionnaires were distributed to horse owners, equine veterinarians and CAVM therapists.

Of the 204 responding horse owners, 83% contacted a veterinarian only at lameness, while 15% contacted a CAVM therapist. For back pain, 52% used a CAVM therapist as first contact and 45% a veterinarian.

Only 10 to 15% of respondents did not use any CAVM method to prevent or after injury.

Of the 100 veterinarians who responded, more than half did not use CAVM themselves but 55% referred to people offering this service.

Of the 124 responding CAVM therapists, 72% recommended their clients seek veterinary advice when needed, and 50% reported that they received referrals from a veterinarian, while 25% said they did not work with a veterinarian.

The two most common methods used on horses were stretching and massage.

All three groups were asked whether the use of CAVM in animals should be regulated to improve animal welfare and avoid abuse.

Among horse owners, there was majority support for the protection of professional titles for CAVM therapists, and a belief that they should receive basic training in veterinary medicine. A majority also considered that CAVM therapists should be obliged to refer to a veterinarian when justified and that there should be requirements regarding record keeping. A majority of the participating veterinarians and therapists also supported such demands.

“Many veterinarians wrote that they want better control over the methods used and more research on which methods really work,” the study group reported. “Some veterinarians want more opportunities for postgraduate education in CAVM and some quality-assured titles for such education.

“Many therapists wrote that they want more collaboration between veterinarians and therapists, and many wrote that they already keep records.”

The authors noted that a large proportion of Swedish horses are insured and most insurances cover not only veterinary treatments but also CAVM treatments if they are performed after a veterinary referral.

“This condition presupposes that veterinarians have sufficient knowledge of relevant CAVM methods and CAVM therapists to be able to refer to the appropriate person and method.

“Because veterinarians are legally required to base their treatments and recommendations on science or well-documented experience, and most CAVM methods are not well-documented in animals (if at all), this poses a dilemma.

– On the other hand, certain methods classified as CAVM are well studied in humans and can even be considered conventional human medicine, even if animal studies are lacking. Therefore, it may not be entirely obvious which methods can be considered to be evidence-based and applying veterinary legislation is not always straightforward. ”

The authors discussed their results and noted that international studies indicate that many horse owners use CAVM for movement-related problems and the results from the Swedish horse owner survey showed a similar trend.

The answers showed that CAVM is often used by horse owners as a supplement to veterinary treatments and to prevent health problems.

The findings, they said, emphasize the need for well-designed research studies to ensure evidence-based information on the use of CAVM.

“The fact that there is a waiting period for many CAVM treatments before a competition, not just for medicines, can make horse owners believe that they are really effective, while the main purpose of the waiting periods is to prevent competing with horses in need of any treatment, ie. all horses that are not completely healthy.

– Nevertheless, many therapists also stated that they cooperate with a veterinarian and that they receive referrals from veterinarians, who must ensure that their animal patients have received the necessary veterinary treatment.

However, it is not clear how the referring veterinarian can take responsibility for the CAVM treatment of the animal. Some CAVM therapists work in veterinary clinics, which means that the veterinarian is responsible for the treatment, while others work independently.

“In the latter case, it is important that therapists understand when a veterinary consultation is needed.”

The researchers said that there is some collaboration between veterinarians and CAVM therapists, but the horse owners in this study wanted more of it. “Closer collaborations can lead to better opportunities for accurate veterinarian diagnoses before CAVM therapy,” they said.

Gilberg is with the veterinary service Distriktsveterinärerna Gävle; Bergh and Sternberg-Lewerin are at the Swedish University of Agricultural Sciences.

Gilberg, K .; Bergh, A .; Sternberg-Lewerin, S. A questionnaire study on the use of complementary and alternative veterinary medicine for horses in Sweden. Animals 2021, 11, 3113. https://doi.org/10.3390/ani11113113

The study, published under a Creative Commons license, can be read here.