Complementary medicine framework for horses in Sweden could be improved – study

In the Swedish study there was majority support among horse owners for the protection of the professional titles of CAVM therapists and the conviction that they should receive basic training in veterinary medicine.

The framework under 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, who write in Animals magazine, investigated the use of complementary or alternative veterinary medicine (CAVM) in Swedish horses in their study.

CAVM is an umbrella term for a wide range of methods, from those that could almost be considered conventional medicine to those in which animal studies are lacking or which even suggest no effect on animals.

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

Of the 204 horse owners who responded, 83% first contacted a veterinarian in the event of lameness, while 15% contacted a CAVM therapist. For back pain, 52% used a CAVM therapist as the first contact and 45% a veterinarian.

Only 10 to 15% of the respondents did not use a CAVM method for prevention or after injuries.

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

Of the 124 CAVM therapists who responded, 72% recommended their clients seek veterinary advice if needed, and 50% said they had been referred by a veterinarian, while 25% said they did not work with a veterinarian.

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

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

The majority of horse owners supported the protection of the professional title for CAVM therapists and the conviction that they should receive basic veterinary training. A majority also felt that CAVM therapists should be required to see a veterinarian when necessary and that there should be record keeping requirements. A majority of the participating veterinarians and therapists also supported such demands.

“Many vets wrote that they want better control of the methods used and more research into which methods really work,” the study team reported. “Some veterinarians would like more opportunities for postgraduate CAVM training and some quality assured titles for such training.

“Many therapists wrote that they would like more cooperation between veterinarians and therapists, and many wrote that they are already keeping records.”

The authors found that a large proportion of Swedish horses are insured and most policies cover not only veterinary treatments but also CAVM treatments when done after a veterinary referral.

“This prerequisite assumes that veterinarians have sufficient knowledge of the relevant CAVM methods and CAVM therapists in order to be able to refer to a suitable person and method.

“Since veterinarians are required by law to base their treatments and recommendations on scientific or well-documented experience, and most CAVM methods in animals are not well-documented (if at all), this presents a dilemma.

“On the other hand, some of the methods classified as CAVM have been well studied in humans and can even be regarded as conventional human medicine, although animal experiments are lacking. Therefore, it may not be entirely obvious which methods can be considered evidence-based and the application of veterinary law is not always easy. “

Discussing their findings, the authors noted that international studies suggest that many horse owners use CAVM for exercise-related issues, and the results of the Swedish horse owner questionnaire showed a similar trend.

The responses indicated that CAVM is widely used by horse owners as an adjunct to veterinary treatments and to prevent health problems.

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

“The fact that there are pre-competition waiting times for many CAVM treatments, not just drugs, can lead horse owners to believe that they are actually effective, while the main goal of waiting times is to discourage competition with horses using any drug need treatment, i.e. any horse that is not entirely healthy.

“Nonetheless, many therapists also reported working with a veterinarian and receiving referrals from veterinarians to ensure that their animal patients received the necessary veterinary treatment.

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

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

The researchers said there was some collaboration between veterinarians and CAVM therapists, but the horse owners in this study wanted more of it. “Working closer together could result in better ways for veterinarians to get the correct diagnosis prior to CAVM therapy,” they said.

Gilberg is with the veterinary service District Veterinarian 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 in 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.