Beyond Conventional Allopathic Medicine:
Options Considered by Wildlife Rehabilitators
Rachel Blackmer, DVM, Indigo Quill Healing Arts, and
Shirley J. Casey and Allan M. Casey, III, WildAgain Wildlife Rehabilitation
This article was previously published in Journal of Wildlife Rehabilitation, Winter 1997, Vol. 20, No.4, pgs 7-13. Used with permission from the International Wildlife Rehabilitation Council.
The Growing Trends in Alternative Health Care
An increasing number of people are pursuing a variety of health care methods to treat injuries and illness. Consider the following research and trends, as recently reported in a variety of technical journals as well as mainstream media:
- Congress created the Office of Alternative Medicine in 1992 to "facilitate the evaluation of alternative medical treatment modalities" to determine their effectiveness (OAM).
- A Harvard University study published in the New England Journal of Medicine discovered some interesting trends (Eisenberg, et al, 1993): in 1990, Americans made more visits to alternative health care healers than to primary care physicians; 34% of adults used one of sixteen health care options not taught in U.S. medical schools or regularly available in hospitals; 72% of patients did not inform their doctors of their use of alternative health care; the alternative health care industry in the USA approximates $14 billion in annual sales.
- Thirty-four of this country's 125 conventional medical schools, including Harvard, Yale, and Johns Hopkins, offer courses in alternative medicine. (Morton, 1997)
- According to a 1996 study by Tiffany Field, Ph.D., infants who were massaged established more weight gain and more regular sleep patterns than a control group of babies rocked instead. (Elias, 1996)
- A consensus panel convened by the National Institutes of Health has just concluded that needle acupuncture is an effective treatment in certain instances. (NIH, 1997)
- In 1997, Washington became the first state to require reimbursement for treatment performed by any licensed or certified health care practitioner, including message, acupuncture and some 30 other techniques and treatments.
Interestingly, these trends seem to suggest that people not only want these services, but are willing to pay out of their own pocket for a great deal of this care, since it is generally not covered by insurance. It is also clear that people are not rejecting conventional medicine, but opting for a combination of conventional and alternative health care, in what some now term "integrative medicine" (Collinge). As these trends continue to grow and influence people's lives and the health care choices that they make for themselves, they have also begun to influence their care for their companion animals and livestock. Again, consider the following:
- Pet owners are increasingly asking for other options when confronted with allopathic drugs with serious side affects.
- There also seems to be an increase in livestock and equine owners turning to alternative health care methods, e.g., homeopathy for organic dairy farmers, chiropractic and acupuncture for horses.
- Veterinarians are beginning to seek more understanding of and skill with a wide variety of alternative health care methods through various publications as well as at professional conferences and continuing education programs.
- Membership in the Holistic Veterinary Medical Society has increased about 10% each year since 1981; membership in the International Veterinary Acupuncture Society has doubled from 1993 to 1995. Membership in the recently formed American Academy of Veterinary Homeopathy is also growing.
- The sales of natural dog and cat food have grown exponentially, with an increasing trend towards the more healthful and wholesome ingredients. Some pet owners now prefer home prepared pet food over purchased products for their companion animals (Altvetmed.com).
All of these trends seem to suggest that people are seeking more natural and holistic approaches to their lives, including supplementing the conventional systems that provide them with health care. Not surprisingly, a natural extension of this trend appears to be that wildlife rehabilitators are considering such alternative, more natural measures of healing when confronted with certain situations involving injured wildlife in their care. This is not to suggest that more conventional medicines and treatments are not highly effective in some cases or should be discontinued. Quite the contrary, it seems that rehabilitators are considering a more broad array of treatment modalities that are complementary when used in conjunction with conventional medicine.
"Alternative", or Just Different?
Alternative medicine is a phrase that is used to describe a wide range of health care modalities including acupuncture, herbalism, homeopathy, massage and other touch therapies, and flower essences among others. It is generally defined as "...those treatments and health care practices not taught in medical schools, not generally used in hospitals, and not usually reimbursed by insurance companies" (OAM). However, even this term is rapidly changing as more conventional allopathic medical practitioners accept and integrate more of the full range of health care modalities into their practices (Walter).
Most medical practitioners in the U.S., including veterinarians, have been trained in conventional allopathic medicine, so it stands to reason that anything outside that accepted body of conventional practice would be viewed as non-conventional, or "alternative". Interestingly, many of these alternative medical approaches have been in existence for hundreds if not thousands of years in various parts of the world. Herbalism has been a primary method of health care around the world for thousands of years. Acupuncture, an ancient health care modality originating in the Far East, has roots that are at least 3000 years old. Homeopathy, traces its early beginnings to Germany over two hundred years ago, although Hippocrates discussed the basic principle of the "like cures like" philosophy that is a basic tenet of homeopathy in fourth century Greece.
Herbs, acupuncture and homeopathy are still used effectively and extensively in many countries around the world, and are often viewed as the primary form of treatment in those countries. In fact, according to the World Health Organization (WHO), it is estimated that about 3 billion people, between 65-80% of the world's human population rely on traditional medicine, which many North Americans would call "alternative" as their primary form of health care (Morton).
So it would appear that whether a form of medical practice or set of procedures is termed conventional or alternative is determined more by a relative ethnocentric framework, than by the proven, observable effectiveness or success of the modality. The Office of Alternative Medicine of the National Institutes of Health suggests that "...Complementary and alternative medicine is defined through a social process as those practices that do not form part of the dominant system for managing health and disease." (Jonas, 1996). It would also seem that a medical practitioner could enhance the chances of medical success in any given situation by embracing a wide range of medical approaches, regardless of whether they were fully accepted by the traditional establishment in that community. Clearly this requires an open mind and flexibility in approach. This openness and flexibility, coupled with increased success in the use of different modalities, have drawn wildlife rehabilitators to consider such approaches. These and other reasons are described more fully below.
Reasons for Considering Alternative Methods
Concern Over Undesired Impacts of Conventional Allopathic Medications. The use of conventional or allopathic medications has enabled many injured and ill wild creatures to recover and be released back to the wild. At the same time, however, there are a number of conditions that conventional medications cannot treat, such as viral disease. There are also a variety of conditions in which conventional medications are high risk or unsafe, e.g., cannot be used if the animal has impaired renal or liver function, or with some species that cannot tolerate them.
There has been continuing concern about allergic reactions, drug sensitivities, and side affects of certain conventional medications (e.g., diarrhea after using antibiotics; depressed immune systems after use of corticosteriods). Also some allopathic medications may have a different affect on wildlife species than they have on domestic animals, thus creating unexpected reactions.
In addition to some concerns about short-term affects of allopathic medications, there are growing concerns about long-term affects. While there has been some research on long-term affect of antibiotics or corticosteriods, it has been mainly focused on humans rather than other species. Plus, with expanded research and dialogue about the harmful impacts of a variety of environmental chemicals (e.g., insecticides, pollutants, toxins) on wildlife, a growing number of rehabilitators are raising questions about the affects of a wide variety of medical chemicals used on wildlife. Discussions of possible impacts include the affect of wildlife treated with allopathic medications on the food chain (i.e., what is the affect on a predator eating an animal that was treated with cortiosteriods?) and the genetic impact on future generations.
There also seems to be a growing concern that some conventional medications are being overused and misused. For example, in some cases, antibiotics may be used when there is no confirmed bacterial infection or an antibiotic may be selected without knowing if it will be effective on a particular bacteria. Also, in some cases, antibiotics are not given according to the directions; e.g., they may not be given long enough to eliminate the specific bacteria. The popular media has recently highlighted similar problems with humans involving antibiotic resistant strains of tuberculosis and resistant strains of bacteria implicated in pneumonia, among others. Also, there is concern about the overuse of broad-spectrum antibiotics, such as Baytril®, where a simpler, more directed treatment or antibiotic could be just as effective.
Limited Options. At times, conventional medicine and treatment can be highly effective with some conditions affecting wildlife. However, there are situations when conventional allopathic procedures or medicines are not often effective, such as viruses, some mutating bacteria or emerging diseases, some toxins and many chronic conditions. Plus, allopathic treatments focus on physical symptoms, whereas holistic treatments address multiple levels of the creature's health, including emotional and mental levels. Rehabilitators have often reflected on the negative impacts of captivity and stress on the animal's recovery or lack of it. Some rehabilitators believe that supplementing conventional care with holistic treatments may accelerate an animal's recovery, improve overall health, and reduce the adverse affects of captivity.
Invasive and Long-term Treatments. Many of the conventional medical procedures and medications can be extremely invasive when administered to wildlife in captivity. They often involve extensive handling and restraint to administer the medication orally or by injection. Many of the allopathic drugs must be administered multiple times a day over an extended time. This frequent handling increases the stress on the animal and risk of injury due to handling, and/or the possibility of imprinting on humans, as well as the increased risk of injury to the human handler.
High Costs of Some Allopathic Treatment. Some of the allopathic medications and complex veterinary procedures, such as surgery, are extremely expensive, placing a strain on already limited finances of the rehabilitator. Some of the complementary approaches are far less costly than conventional approaches.
Suppressing or Palliating Symptoms. Also, in the area of illness, allopathic medicine aims primarily to rid the patient of one or several key visible symptoms. However, there is a growing concern that palliating (treatment that provides temporary relief while when the medication is taken) or suppressing an animal's symptoms can result in the same symptoms returning or a more serious condition arising when the medications are stopped. Examples of suppression or palliation of symptoms have been observed in domestic animals. There is growing concern that the same thing may occur with wildlife that is treated with the aim of eliminating visible symptoms without strengthening all the systems. Alternative modalities, on the other hand, attempt to strengthen the body in order to heal itself rather than just eliminate the visible symptoms.
Other Concerns about Allopathic Medicine. Some conventional medications are controlled substances and not available except at veterinary facilities. Other allopathic medications can have a very limited shelf life.
Sample of Alternative Health Care Options Available for Wildlife
There is a wide variety of healing methods that the wildlife rehabilitator can consider using in conjunction with standard, conventional medicine. Many of these approaches may be considered effective healing methods when used correctly by the trained practitioner. Many of them require fairly intensive study and are administered according to firmly established guidelines and protocols. These methods are generally not to be attempted by a layperson without such prior knowledge, training and apprenticeship. If the wildlife rehabilitator feels such alternative courses of action have potential, a close coordination with his or her veterinarian is still important. This partnership may benefit from working with veterinarians skilled in holistic medical approaches (see accompanying article on holistic veterinary services, "Finding and Using Holistic Veterinary Services").
Herbalism or Botanical Medicine. Herbal healing has been used and taught around the world for thousands of years as every culture, tribe and geographical area had its own plants and relevant knowledge. Herbalists use medicinal flowers, leaves, and roots with the belief that plants are more powerful when closer to their natural form. Some herbs are used topically, while others are taken internally. Herbs have been used successfully on a large number of acute and chronic conditions, including wounds, skin problems, respiratory conditions, and external parasites. There has also been documentation of some wildlife seeking out specific types of plants when their health has been compromised (Heinerman). Since some of the herbs include toxic properties, it is absolutely critical to understand their chemistry, potencies, and interactions and to use them correctly.
Expanding research in this area is evidenced by the recently launched study at Duke University examining the benefits of St. John's Wort (known also by its botanical name, Hypericum perforatum.) The three year study is sponsored by a $4.3 million grant from the National Institutes of Health, the Office of Alternative Medicine and the Office of Dietary Supplements (NIH, 1997). Americans currently spend $2.5 million annually on extracts of the herb (Okie, 1997).
Homeopathy. This treatment modality has been used extensively around the world with humans and animals since 1790 and is based on the principle of "like cures like." Homeopaths believe that the body is constantly striving for health. When the body is threatened, the defense mechanism creates symptoms that send the body a message that something is wrong and needs attention. Thus homeopaths see symptoms as having a very positive function (this is different from the allopathic belief that symptoms are negative and need to be treated or suppressed). Homeopathic practitioners believe that giving a dose of the homeopathic remedy serves as a catalyst to prompt the body to heal itself. Homeopathic remedies are made from dilutions and succussions of a variety of substances (e.g., plants, minerals, insects). The remedy itself only contains a minute quantity of the initial substance which affects its healing through vibrational principles. The effective selection and administration of homeopathic remedies is quite different from allopathic medicine and requires careful study. Homeopathic remedies are commonly used to treat a wide variety of both acute and chronic conditions.
Flower Essences. This modality addresses emotional conditions in order to enhance the animal's health. These products are made from plants and water according to a specified process. Research on the flower essences in the 1930's identified different emotional states, such as fear or grief,that were addressed by the different essences. Users of flower essences believe that by addressing emotional issues, physical healing can be accelerated.
The following modalities involve different types of physical contact that may be of less concern or risk to domesticated species than with wildlife. Use of these modalities with wildlife requires consideration of ways to minimize handling since excessive contact could also result in increased stress, risk of injury to the handler or animal, possible imprinting and more.
Acupuncture and Acutherapy. The Chinese have been using acupuncture extensively with humans and livestock for over 3000 years. Acupuncture and acutherapy involve the examination and stimulation of various points on the body to redirect and rebalance chi or energy. A healthy chi is a balance between positive and negative energy. A diseased state occurs when energy is blocked, out of balance, or flowing in an uncoordinated manner. Charts of acupuncture meridians, or energy paths, are required to identify the sites for treatment and have been developed for many domesticated animals and some captive wildlife species. The acupuncturist must first identify the probable blockages to or incoordination of the energy by evaluating the energy pulses or otherwise assessing the overall being of the animal. The acupuncturist then stimulates the relevant acupuncture points via acupuncture needles, soft pressure, cold laser, light, metal beads, magnets or other means. Acupuncture is used to treat a variety of conditions including skeltetal injuries or conditions, digestive disturbances, neurological disorders, pain and skin lesions.
The National Institutes of Health has just recently issued a Consensus Statement on Acupuncture. The statement, resulting from a convened panel of experts in the field, concludes "...there is sufficient evidence of acupuncture's value to expand its use into conventional medicine and to encourage further studies of its physiology and clinical value" (NIH, 1997). Clearly this suggests that such "unconventional" modalities are becoming more readily accepted, even in the established medical communities.
Chiropractic, Rolfing, Craniosacral, and Skeletal Manipulation. These modalities involve examination, diagnosis and treatment through manipulation and adjustments of specific joints (including the spine, extremities and cranial sutures). Chiropractors and practitioners of various manipulative therapies believe that misalignment or fixation of joints can cause a variety of health problems. They believe that bringing the body back into proper alignment helps to eliminate the cause of the problem and to restore nerve function. While such skeletal adjustments have been used with humans for many years, they are becoming increasingly common treatments for animals with bone, muscle, nerve or movement problems as well as improper organ function, chronic illness or general imbalances.
Physical Therapy and Touch Related Therapy. Veterinary physical therapy involves the use of non-invasive techniques to enhance the rehabilitation of injured animals. Massage, particularly deep tissue massage, is another modality that can help increase circulation, improve muscle condition and release tension. There are a variety of physical and touch related therapies, including Reflexology, Shiatsu, and Tellington Touch.
Tellington Touch is an example of a touch-related therapy which works to change old patterns, especially related to illness and injury and reestablishes a normal flow of nerve impulses and energetic function. With wildlife it may used to help reroute messages from the body to the brain during recovery from tissue, musculoskeletal, or neurological injuries. The positive results of this modality have been documented on wildlife in zoos (Tellington-Jones).
Reasons That Some People are Not Interested in Alternative Health Care
Science. There are a variety of reasons that some people are not interested in considering alternative health care modalities. One of the primary reasons seems to be that many people want to understand the scientific basis for each modality. However, to date, there are only limited explanations of how many of these alternative and complementary modalities work. Members of the scientific community have voiced serious concerns about the lack of scientific research and documentation as well as the difficulty of evaluating results. Increasing research is being conducted on many of these modalities and it is beginning to result in some interesting insights. More research is certainly needed to better understand these modalities and their potential use in general, and specifically on different species.
Skepticism. In addition, it is not unusual for those trained in conventional allopathic medicine to be skeptical about alternative modalities and sincerely question their effectiveness. Research and broader education on these modalities may help people better understand them and determine if and when their use might be appropriate.
Special Skills Required. Another concern is that some of these alternative and complementary modalities require some basic knowledge and skill in order to be used most effectively. While the number of veterinarians educated and skilled in these alternative modalities is growing, the number is far less than those practicing conventional veterinary medicine. It can be difficult to find veterinarians that can provide a range of conventional and holistic services. There may also be some situations where only one veterinarian is available and that person refuses to consider alternative modalities, or to work with a rehabilitator using any alternative modalities. All of these considerations must be taken into consideration.
Limited Database with Wildlife. Also, while there is a growing base of information on alternative health care for humans and pets, far less has been published on wildlife or the types of problems viewed by wildlife rehabilitators. As more information is gathered and published, and more training programs are offered, the knowledge and skill base of rehabilitators should increase. This could help rehabilitators decide if and when it might be appropriate to consider alternative methods.
Time and Cost. Using alternative health care may involve some changes in rehabilitation practices, can be time consuming, and in some cases actually increase cost. Some people may be unable or unwilling to commit to such holistic practices and costs that can not guarantee results (but then neither does conventional medicine guarantee results). Also, while some of the treatments and recoveries are rapid, others take considerably more time to achieve the desired results or to evaluate the results.
Those interested in considering alternative and complementary modalities should also become familiar with the indications and contraindications of a specific modality. For example, chiropractic treatment may be appropriate for a misaligned joint, but not for external parasites; physical therapy may be used to rehabilitate atrophied muscles but may not be appropriate for acute diarrhea and vomiting; homeopathy may be used for treating shock but in conjunction with heat, quiet and fluids.
There are many situations that require the immediate and direct administration of conventional medical practices, such as removing an obstruction to breathing, or stopping bleeding. While some alternative practices are considered ways to support and accelerate healing, judgement must be exercised in order to ensure that the animal gets the best possible care. As in other situations, the wildlife rehabilitator strives to provide the best care for the animal and to do no harm. The rehabilitator must continue to keep in mind the animal's condition so as not to cause any further pain or interfere with the animal's long term survival and release potential. Alternative and complementary modalities should only be considered with that in mind.
Wildlife rehabilitators and others concerned with wildlife health seem to be increasingly discussing holistic therapies and alternative options. This does not suggest that conventional medicine does not offer critical aid for some conditions, but rather that conventional medicine should be considered more realistically for the benefits it offers as well as its limitations. The authors suggest that alternative modalities provide additional options for wildlife rehabilitators to consider. The authors also recommend that such consideration be done with study, care, and the assistance of veterinarians offering holistic services (see companion article on "Finding and Using Holistic Veterinary Services").
Special appreciation for help with this article is given to Bridget Sparks, Wildkind, Humane Society for Larimer County, Fort Collins, CO and Marge Gibson, Raptor Education Group, Antigo, WI.
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About the Authors
Dr. Rachel Blackmer, DVM, graduated from Tufts University School of Veterinary Medicine in 1991. While at Tufts she worked extensively at the Tufts Wildlife Clinic and left with a deeply entrenched interest in helping wildlife of all species. After leaving Tufts, she began work in a conventional veterinary practice in Vermont. Her growing concerns about conventional therapies lead her to study a variety of alternative health care modalities. She was certified by the International Veterinary Acupuncture Society in 1993. She also studied veterinary chiropractic in 1996; her certification from the American Veterinary Chiropractic Association is pending. She became a Reiki Master in 1996. She also took extensive training in classical homeopathy from 1994 through the present. Dr. Blackmer was co-owner of Indigo Quill Healing Arts, a holistic veterinary practice in Colorado and later served as the Director of the Cape Wildlife Center in West Barnstable, owned and operated by the Humane Society of the United States. She currently practices veterinary medicine in Durham, NC.
Shirley and Allan Casey are licensed wildlife rehabilitators in Evergreen, Colorado. See About Us for more info.