Acupuncture is quackery.

As with naturopathy (a medical pseudo-"specialty" that embraces acupuncture and other so-called traditional Chinese medicine), when I write about acupuncture I like to start out with a provocative statement, a statement of—dare I say it?—judgment in order to shock new readers and let them know exactly where I'm coming from. Why I consider acupuncture to be quackery now, after years of not being sure, is simple and well documented in many posts on this blog. (Just type "acupuncture" into the search box if you don't believe me; here's an example.) Basically, I started really reading the acupuncture literature. I mean really reading it in detail. When I did that, I realized that, when acupuncture is studied rigorously with real, valid sham acupuncture controls, there really isn't any appreciable difference between acupuncture and placebo.

One aspect of acupuncture that irritates me to no end is its embrace by certain woo-friendly veterinarians. The local media here seem particularly enamored of doing stories about vets applying acupuncture to pets and reporting seemingly miraculous results, as I wrote about here and here. The reason why acupuncture applied to our pets annoys me so much is because a competent adult is free to choose to have himself stuck full of needles that won't do him any good. On the other hand, animals, like children, have to rely on their adult human guardians to decide what's best for them. When a dog owner chooses to have his fine furry friend stuck full of needles, my reaction is almost as intense as it is when a parent subjects her child to quackery.

So this time around, I was annoyed when somehow this article, entitled Cat-upuncture! Windsor Terrace vet does Chinese medicine on pooches and pussies, by Lauren Gill in—of all newspapers—Brooklyn Paper. I realize that this is probably just a local throwaway paper, but the way this article is written is one aspect of what's wrong with how the media cover alternative medicine. Basically, it's spun as a cutesy, uplifting story of vets willing to do something different to help our furry companions:

Don’t call her a quack — she only deals in meows and woofs. A Windsor Terrace vet is using acupuncture and medicinal herbs to treat ailing borough pussies and pooches. The alternative cures are controversial in the animal-healing world, but the dog doctor claims she has seen enough proof in her own surgery to have faith that they work. I get really excited about it because I know it works,” said Dr. Suzy Ryan, who operates out of the newly reopened Brooklyn Heights Veterinary Hospital on Cranberry Street and Alison Animal Hospital in Windsor Terrace.

"Don't call her a quack"! Haha! So very funny.

Let's take a look at Dr. Ryan's page on the Alison Animal Hospital website:

Susan believes in a holistic approach when working with her patients and their families. Her deep commitment to them is evidenced not only by her medical expertise, but the time she takes to listen and the comprehensive care she gives them. She believes in the integration of Western and Eastern veterinary practices and given this proclivity, she is a graduate of the Chi Institute in Florida.

Ack! So it's not just medicine; there is "integrative" veterinary medicine, too, which integrates quackery with real veterinary medicine. One wonders if this is already a specialty. No, one doesn't. It is. (I really wish I hadn't Googled that.) In fact, there's even "integrative veterinary oncology." (Now I really, really wish I hadn't Googled that.) It's not bad enough that there are oncologists "integrating" quackery with real oncology for humans, but what did the animals do to deserve the same from their vets?

For example, the Chi Institute, where Dr. Ryan studied, offers many courses in acupuncture, as well, including small animal acupuncture, equine acupuncture, advanced TCVM diagnostics, herbal medicine, and more. There's even veterinary Tui-na, which is basically a system of manipulation, complete with a photo of a woman doing some sort of musculoskeletal manipulation on a horse.

So we learn from the article that Dr. Ryan has been "feeding pets herbs and sticking tiny needles in their scalps and for a year and a half" and that these are an "increasingly popular option for owners who have exhausted conventional drugs and surgeries." It's amazing how, animal or human, the same arguments for quackery prevail. In the article, a systematic review of animal acupuncture that found no compelling evidence that acupuncture should be used for any veterinary condition or disease, but it's then pointed out that "but a growing number of vets believe they do, and Ryan’s clients say they are converts, too." Heck, there is even now an American Academy of Veterinary Acupuncture.

And what's the evidence? Regular readers will know, of course. It's anecdotes:

One human says she brought in her 13-year-old German Shepherd with a muscle injury last year, expecting she’d have to put her beloved pet down. Instead, Ryan suggested acupuncture — and she was flabbergasted when her canine got better. “I just can’t shut up about it,” said Kensington resident Maria Sandomenico, who still brings her dog Madra in for restorative jabs twice a month. “I wasn’t expecting my dog to still be around at this point.” In another act of dog, Ryan says she treated a huge tumor in a hound’s mouth with herbs when all else had failed, and even she was astounded when the growth disappeared within months.

Notice in each case, we don't know what, exactly, the clinical situation was. For instance, the natural history of most muscle injuries is to heal. They might heal with scarring, so that function is never the same. They might heal and leave the victim with chronic pain. But they do eventually heal. Why did this woman think she'd have to euthanize her dog over a "muscle injury"? Who knows? Maybe it was just age. In any case, that the dog ultimately recovered with apparently a good functional result does not mean that it was the acupuncture that is responsible for this favorable outcome.

As for the second case, what was this "huge tumor"? Was it biopsied? Without a pathological diagnosis of what this mass was, it's really impossible to tell if there was anything "miraculous" about its resolution or if it is likely that it was the herbal concoction that caused it to resolve.

Of course, if you really want to know the reason why "integrative veterinary medicine" has become so popular, look for the financial consideration:

The four-legged folk healing doesn’t come cheap — Ryan charges at least $85 for each acupuncture session — but she says Brooklynites are forming closer bonds with their furballs these days, and they are willing to shell out for more than just a patch-up when things go wrong.

Yes, acupuncture and various woo represent a nice new revenue source for vets.

Now, I don't entirely blame the reporter for producing such a credulous article. She works for a small local paper. Maybe her editor thought it would be a cute story (which is just how it's written). Even so, she should have been more skeptical, even though her job is not investigative journalism but rather local interest stories. She probably thought that mentioning that there isn't a lot of evidence for acupuncture and linking to a systematic review of veterinary oncology. That's better than most would have done, but the anecdotes following the throwaway line basically undermined any skepticism.

Again, I realize that this is just a small article in a small newspaper. However, it's a microcosm of the problems we see with how "integrative medicine" is reported. You could see this sort of credulousness in a larger paper, in a news report on local TV, and even on international news reports.