Bibliometric trend analysis of non-conventional (alternative) therapies in veterinary research.

Background: There is an increased interest in Non-Conventional Therapies (NCTs), often referred to as complementary and alternative medicines, in veterinary clinical practice.Aim: To map the bibliometric outputs of NCTs in veterinary medicine, and identify which are most prevalent, and the extent to which their publishing has increased.Methods: Text mining algorithms were applied to detect 17 NCTs-related terms (acupuncture, ayurveda/ayurvedic, traditional Chinese medicine, traditional medicine, chiropractic, electroacupuncture, essential oil, plant extract, ethnopharmacology, herbal medicine, homeopathy, low-level laser therapy, medicinal plant, natural product, osteopathy, phytotherapy, and massage) in the title, abstract or keywords of all retrievable literature until 2020 under the PubMed MeSH term 'veterinary' (N = 377 556). Point prevalence, incidence by decade and cumulative incidence were calculated.Results: Bibliometric trend analysis revealed an overall increase in NCTs-related terms over the last 20 years, with a substantial growth of studies mentioning plant extracts, essential oils and medicinal plants. Traditional Chinese medicine, herbal medicine and natural product have also increased in the same period, although their numbers remain low. Conversely, reference to acupuncture has decreased in the last decade when compared with the previous decade, whereas references to homeopathy, electroacupuncture, osteopathy and chiropractic remained scarce, suggesting that their use in veterinary clinical practice may not be based on published evidence.Conclusion: Further reviews to explore this issue are warranted, differentiating secondary from primary literature, and assessing relevance and methodological quality of individual studies, following the principles of evidence-based veterinary medicine.

Integrative Philosophy: Case Management.

This article serves as an introduction into integrative case management as it applies to the horse's mental health, pain management, and tissue healing. The integrative philosophy pertains to the combination of conventional Western medicine and complementary and alternative therapies to provide the best patient care possible using currently available evidence. The goal is to improve the health of the patient in a more holistic manner.

Optimizing Health - Integrative Medicine & Poor Performance.

Addressing poor performance issues in horses is a common yet challenging request to veterinarians. Often, there are limited field diagnostic or therapy choices. Growing lay popularity in integrative therapies, as well as increasing clinical incorporation, is creating more awareness of their clinical applications. Many modalities are showing increasing evidence of positive outcomes with minimal harm, but additional safety and efficacy evaluation is needed. Integrative modalities have unique ways of perceiving disease patterns that are different from more modern approaches, and these different perspectives can be used diagnostically and therapeutically either combined with more conventional approaches, or when those approaches fall short.

Evidence-Based Complementary and Alternative Canine Orthopedic Medicine.

The use of complementary and alternative veterinary medicine (CAVM) continues to become more widespread, especially for the management of chronic pain conditions such as canine osteoarthritis. Many patients have comorbidities that preclude traditional medical options, have not adequately responded to conventional therapies, or have owners interested in pursuing a complementary approach. Evidence-based CAVM can serve as a safe and effective adjunct to manage chronic pain conditions. There is growing evidence in the veterinary literature for the use of acupuncture and some herbal supplements in the multimodal management of canine osteoarthritis. The majority of evidence supporting chiropractic is limited to equine and human literature.

[Naturopathy and complementary medicine in small animal science - definitions and contents]. / Naturheilkunde und Komplementärmedizin in der Kleintiermedizin ­ Definitionen und Inhalte.

Naturopathic and complementary procedures attain increasing popularity in veterinary medicine. A common understanding of definitions and contents of these fields is crucial for communication between pet owners and veterinarians. This paper reviews the existing definitions and the various contents of naturopathy and complementary veterinary medicine as well as their assigned treatment options. Naturopathy includes phytotherapy, hydro-therapy, thermotherapy, electrotherapy, manual therapy/chiropractic/osteopathy, and dietetic treatment. Homeopathy, homotoxicology, Traditional Chinese Medicine including acu-puncture and Chinese herbal medicine, neural therapy, organotherapy and Bach flower remedies are known as complementary treatments. The level of evidence based on scientific literature and the opportunity for certification procedures differ between treatment modalities. In the area of small animal medicine, the most extensive body of literature is available on the subject of acupuncture, in part comprising high evidence levels.

Horse owners' attitudes towards and motivators for using complementary and alternative veterinary medicine.

BACKGROUND: Complementary and alternative veterinary medicine (CAVM) is becoming increasingly popular in horses. METHODS: Online, cross-sectional survey in 1532 horse owners. Attitude towards CAVM, subjective norms, perceived behavioural control and intention for future CAVM use were measured based on the theory of planned behaviour. Structural equation modelling was performed to characterize factors influencing intention to use CAVM. RESULTS: Past use of CAVM, predominantly manual therapies and herbal supplements, was reported by 72.5% of all participants. Frequently reported indications were improving horse's well-being, illness which did not resolve after conventional treatment and chronic illness. The attitude towards CAVM was positive with a median (interquartile range) score of 6 of 7 (4.75-7.00). Predictors for past CAVM use were higher owner age, alternative medicine self-use and higher education (non-university). The strongest predictor of future CAVM usage was perceived behavioural control and perceived CAVM efficacy, as well as positive attitude towards and perceived knowledge about CAVM. The veterinarian was reported as a source of information about CAVM by 86.4% of all participants. CONCLUSIONS: Horse owners showed a high intention to use CAVM with the owners' perceived behavioural control and perceived CAVM efficacy as the strongest predictor. Veterinarian-client communication is important to inform horse owners correctly.

Desire for information and alternative therapies of pet owners is associated with empathy and partnership-building of veterinarians.

OBJECTIVES: The relationship between the pet owners' desire for information and preference of alternative therapies and the veterinarians' ability to build partnership and communicate empathically was investigated using quantitative multifactorial analysis. MATERIALS AND METHODS: In an online survey, 1270 German pet owners were asked about their experience of veterinary appointments regarding communication and relationship building. Additional questions included the type and number of pets, years of animal husbandry, age, gender and education level. The factors associated with the pet owners' desire for further information and alternative therapies were analysed in two multivariable linear models. A recently published structural equation model consolidated the following as latent factors: veterinarian's empathic communication, veterinarian's partnership building, pet owners' desire for further information and pet owners' desire for alternative therapies (e.g. non-veterinary practitioners). RESULTS: The two veterinarian-related factors of empathic communication and partnership building were positively associated with each other, but negatively associated with the pet owners' desires. Dog owners and participants who owned animals for more than 2 years expressed less desire for further information. The desire for further information decreased with increasing age. The desire for alternative therapies was more among animal owners of more than 2 years and those visiting the same veterinary practice for over 2 years. CLINICAL SIGNIFICANCE: Veterinarians' empathic communication and partnership building are key factors that satisfy clients' desires for information and alternative therapies. This comprises communicational skills regarding information sharing, as well as emotional aspects.

[Einfluss eines komplementärmedizinischen telefonischen Beratungssystems auf den Antibiotikaeinsatz bei Nutztieren in der Schweiz]. / Influence of a Complementary and Alternative Medical Advisory Program by Telephone on the Use of Antibiotics in Livestock in Switzerland.

Hintergrund: Der Antibiotikaeinsatz bei Nutztieren fördert die Entwicklung antibiotikaresistenter Bakterien. Die Komplementärmedizin könnte einen Beitrag zur Reduktion von Antibiotika leisten, wird bisher jedoch nicht flächendeckend angeboten. Das Beratungsprogramm "Kometian" unter-stützt teilnehmende Landwirte darin, ihre Tiere komplementärmedizinisch zu behandeln. Methoden und Resultate: 128 von 223 teilnehmenden Betrieben nutzten in den ersten 3 Projektjahren die telefonische Beratung von Kometian. Die Mehrheit der Landwirte hielt Milchkühe. Frühestens 1 Woche nach der Kometianberatung wurde eine telefonische Nachfrage beim Tierbesitzer hinsichtlich des Gesundheitszustandes des Tieres durchgeführt. Es konnten so 661 Beratungsfälle recherchiert werden. In 486 Fällen erfolgte keine weitere schulmedizinische Behandlung, in 373 Fällen gab der Landwirt einen Behandlungserfolg an. Von 188 angefragten und seit mindestens einem Jahr an Kometian teilnehmenden Betrieben stellten 46 ihre Behandlungsjournale zur Verfügung. Die betriebliche antibiotische Behandlungsinzidenz sank signifikant (p < 0,001) von 27 vor Beitritt auf 18 Behandlungen pro 100 Tiere im ersten Jahr. Schlussfolgerung: Es scheint, dass Kometian einen Beitrag dazu leisten konnte, den Antibiotikaeinsatz auf Betriebsebene zu reduzieren. BACKGROUND: A regular use of antibiotics in farm animals is assumed to induce antibiotic-resistant bacteria. Complementary and alternative medicine (CAM) may contribute to a reduction of antibiotic use but it is not extensively offered by Swiss veterinarians. The advisory program "Kometian" supports farmers in treating their animals with CAM. METHODS AND RESULTS: 128 out of 223 participating farmers used the telephone consultations of Kometian in the first 3 years of the project. The majority of the farmers kept dairy cattle. No sooner than 1 week after such a consultation, the famer was questioned by phone about the health progress of the animal. Thus, the development of health could be verified in 661 cases (of 714). 486 cases were not treated further by conventional medicine; in 373 cases the farmer reported a positive treatment effect. Of 188 examined farms, which had participated in the advisory program for at least 1 year, 46 made their treatment records available. The incidence of antibiotic treatment decreased significantly (p < 0.001) from 27 before entering the program to 18 treatments per 100 animals in the first year. CONCLUSION: It seems that the advisory program Kometian could contribute to reduce the use of antibiotics on the farm level.

Narrative review of therapies for chronic enteropathies in dogs and cats.

BACKGROUND: The optimal medical treatment for chronic enteropathy (CE) in dogs and cats is controversial. Sequential treatment using diet, antimicrobials, and immunosuppressive drugs is the most common strategy used by clinicians. OBJECTIVES: To review the evidence for the effectiveness of dietary, drug, and alternative health interventions for inducing clinical remission in dogs and cats with CE. ANIMALS: Retrospective study of dogs and cats with a diagnosis of chronic enteropathy. METHODS: MEDLINE and Centre for Agriculture and Bioscience International (CABI) databases (1950 to March 2017) were searched for randomized controlled trials (RCTs), observational studies, and case series. The primary outcome was induction of clinical remission. All studies were evaluated using the quality of evidence grading guidelines (I-IV), which assign a score defining the strength and quality of the evidence. RESULTS: Twenty-two studies (11 RCTs in dogs and 2 in cats and 9 cohort studies or case series) met the inclusion criteria for inducing remission of gastrointestinal (GI) signs. Of the 13 RCTs achieving grade I scores, 10 studies (totaling 218 dogs and 65 cats) compared single treatment: diet (n = 3), immunosuppressives (n = 3), antimicrobials (n = 2), anti-inflammatory drugs (n = 1), and probiotics (n = 1). Three case series (grade III) reported clinical remission using an elimination diet fed to 55 cats and use of enrofloxacin to induce remission in dogs with granulomatous colitis (2 studies totaling 16 dogs). CONCLUSIONS AND CLINICAL IMPORTANCE: The current evidence for treatment of CE is much greater in dogs than in cats. There is sufficient strong evidence to recommend the use of therapeutic GI diets, glucocorticoids, enrofloxacin, or some combination of these in dogs with CE. Therapeutic GI diets and glucocorticoids are most useful in cats with CE.

Nontraditional Therapies (Traditional Chinese Veterinary Medicine and Chiropractic) in Exotic Animals.

The nontraditional therapies of Traditional Chinese Veterinary Medicine and chiropractic care are adjunct treatments that can be used in conjunction with more conventional therapies to treat a variety of medical conditions. Nontraditional therapies do not need to be alternatives to Western medicine but, instead, can be used simultaneously. Exotic animal practitioners should have a basic understanding of nontraditional therapies for both client education and patient referral because they can enhance the quality of life, longevity, and positive outcomes for various cases across multiple taxa.

Antibiotic use by farmers to control mastitis as influenced by health advice and dairy farming systems.

Mastitis is a bacterial disease common in dairy farms. Although knowledge about mastitis and its optimal technical management and treatment is now available, some dairy farmers still use antibiotics in inappropriate ways. Antibiotic use by farmers can be influenced by personal restraints and motivations, but it can be assumed that external drivers are also influential. The main purpose of this article is thus to analyse the choices of antibiotic and alternative medicine use for mastitis treatment and investigate the possible influence of two unexplored external drivers in dairy farms: (i) the health advice offered to farmers by farm advisors and veterinarians, (ii) the dairy farming system, as defined by combining the market valuation chosen for the milk, the level of intensification, and the perceived pressure related to investments. Research was based on 51 individual semi-structured interviews with farmers and their corresponding veterinarians and farm advisors. Based on verbatim, the use of antibiotics and alternative medicine by farmers for mastitis treatment, the vet-farmers interactions, and the dairy farming systems are described. The advisory relationships between farmers and farm advisors and between farmers and veterinarians influenced the implementation of selective dry cow therapy, but had very little effect on the use of alternative medicines by farmers, who were more willing to experiment alternative medicines than their advisors. The dairy farming system had very little influence on antibiotic use: some misuse of antibiotics was found whatever the farming system. Systematic dry cow therapy was also a widespread habit in all dairy farming systems except organic. The use of alternative medicine was common in all farming systems.

Physical Rehabilitation for the Management of Canine Hip Dysplasia.

Hip dysplasia is among the most common orthopedic conditions affecting dogs. Joint laxity is responsible for abnormal development of the femoral head and acetabulum, leading to excessive wear of the articular cartilage. Wear leads to secondary osteoarthritis. Rehabilitation is either conservative or after surgical management. Conservative rehabilitation therapies are directed at decreasing pain, improving hip range of motion (ROM), and building or maintaining muscle mass. Postoperatively, rehabilitation focuses on decreasing postoperative pain and inflammation, improving comfort and limb use, and protecting the surgical site. Once the patient has healed, rehabilitation is directed at improving ROM and promoting muscle mass.

Celulite em codornas japonesas alimentadas com extrato de orégano nas dietas e inoculadas com Escherichia coli / Cellulitis in Japanese quails fed oregano extract in the diet and inoculated with Escherichia coli

Com o objetivo de avaliar a utilização do extrato de orégano nas dietas de codornas japonesas (Coturnix coturnix japonica) e desafiadas com cepas de Escherichia coli, sobre as características de desempenho, a incidência de celulite aviária e titulação de anticorpos específicos contra antígenos de E. coli, foram utilizadas 360 codornas japonesas, com 90 dias de idade, distribuídas em gaiolas de arame galvanizado em galpão convencional. O delineamento experimental foi inteiramente casualizado, em esquema fatorial 5x2 (extrato de orégano x desafiado ou não com E. oli), totalizando dez tratamentos com seis repetições de seis aves por gaiola. Os níveis do extrato de orégano (EO) avaliados foram: 0,00; 0,025; 0,050; 0,100 e 0,150%. Foram avaliadas características de desempenho produtivo, lesões macroscópicas da celulite após períodos pós-inoculação das cepas e amostras de soro foram colhidas para verificar a titulação de anticorpos nas aves. Os dados obtidos foram submetidos à análise de variância e as médias comparadas pelo Teste T. Foi observado efeito de E. coli sobre todas as características produtivas, independentemente dos níveis de EO avaliados, onde grupos desafiados apresentaram piores resultados de desempenho. As lesões macroscópicas, características da celulite, observadas somente nas aves desafiadas com E. coli foram classificadas como grau leve e sem presença de hemorragias. Para a titulação de anticorpos específicos, houve maior quantificação para aves desafiadas com as cepas de E. coli em relação às não desafiadas. Pode-se concluir que o extrato de orégano suplementado nas rações não se mostrou eficaz frente ao desafio com E. coli em codornas na fase de postura e as aves desafiadas com E. coli apresentaram maiores respostas imunes humoral e celular, em relação às não desafiadas, caracterizadas pelo aumento na titulação de anticorpos e pela lesão macroscópica peitoral, independentemente dos níveis de extrato de orégano avaliados.(AU)

The aim was to evaluate the use of oregano extract in Japanese quail (Coturnix coturnix japonica) diet, challenged with Escherichia coli strains, on performance, incidence of avian cellulitis and of antibody specific antigens against E. coli. Three hundred sixty Japanese quails with 90 days of age were distributed into galvanized wire cages in a conventional shed. The experimental design was completely randomized in factorial 5x2 design (oregano extract x challenged or not with E. coli), totaling ten treatments with six replicates of six birds per cage. Oregano extract levels were 0.00, 0.025, 0.050, 0.100 and 0.150%. Performance productive characteristics were evaluated, macroscopic lesions of cellulitis were measured after post-inoculation of the strains, and serum samples were collected for antibodies during experiment. The data were subjected to analysis of variance and averages compared by T test. Effect of E. coli was observed on all productive characteristics, regardless of the EO level evaluated, where challenged groups showed worse performance results. The macroscopic lesions, characteristic of cellulitis, observed only in birds of groups challenged with E. coli, were classified as mild and without bleeding. For specific antibodies, there was a higher number of birds challenged with E. coli strains in relation to unchallenged birds. It can be concluded that oregano extract supplemented in the diet was not effective against the challenge with E. coli in laying quails, and challenged birds with E. coli showed higher humoral and cellular immune response, compared with unchallenged birds, characterized by increased antibody titer and pectoral macroscopic lesion, regardless of the oregano extract levels evaluated.(AU)