Healthy Integration

Perhaps you have heard about "holistic" veterinarians, or maybe you are considering trying a veterinarian who uses a holistic approach? But a part of you wonders what it really means to be holistic.
  • holistic
  • medicine
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Dog World in July 2008

If you choose this route, does it mean you abandon standard veterinary medications and technology in favor of massage, acupuncture needles, and herbs?

Quite the opposite. Any good holistic veterinarian has a grounding in Western science. Does this sound like a contradiction? Whether you are interested in alternative approaches, or set against such things from the start, you might be surprised to learn what holistic truly means.

What Are We Talking About?

Being holistic means including the "whole" range of possibilities (there "w" is missing because the word comes from Old English, "hol"). This begins with education. Like any other veterinarian, holistic veterinarians earn degrees from one of the country's 28 veterinary colleges or universities. After completing their traditional education, holistic veterinarians add extra layers of knowledge – various methods ("modalities") such as acupuncture, acupressure, massage, chiropractic, or the use of herbs. They add these layers over many years, as they develop a widening view of potential treatment options. You could say they become holistic naturally.

Dr. Narda Robinson, professor of complementary and alternative medicine at Colorado State University's College of Veterinary Medicine and Biomedical Sciences, believes all veterinarians could incorporate holistic modalities into their practices. She also believes that veterinarians, and clients, must be skeptical. Dr. Robinson teaches a unique course on holistic modalities to fourth-year veterinary students, a perfect opportunity to describe what it means, and what it does not mean, to be holistic. "We're at the forefront. Still, we're not teaching acupuncture as 'energy medicine' or piling on herbs, and we're not talking about shamanistic or folk-medicine approaches."

Beyond college, Dr. Robinson says practicing holistic veterinarians must maintain the same vigilance. "We shouldn't do anything that delays effective treatment. When there's a lack of a critical eye in the holistic world, it drives me insane. Don't go to someone who claims to be looking at the whole animal, but is really doing vague 'energy work.' There can be a disconnect between saying you're holistic and actually practicing it."

Holding holistic modalities up to scientific scrutiny is the way to gain legitimacy. This applies not only to veterinarians, but also to clients. "I once had a client come in asking for acupuncture," Dr. Robinson explains. "She said, 'That's black magic, right?' The thing is, she was fine with that. Too many people get enamored of this idea of holistic as magic."

Dr. Lisa Lancaster runs a veterinary practice in Denver, CO, using acupuncture and chiropractic. Working holistically allows her to focus on the patient, and figure out what is most beneficial. "Animals are like people. They prefer one treatment over another. If you only do one type of treatment, you won't help as many animals. You have to offer the best of everything that's available."

Dr. Konrad Kruesi has run the Cold River Veterinary Center in North Clarendon, VT, for 10 years. As he puts it, "Being holistic is a way of looking at patients in comprehensive, long-term ways. It's helping the body maintain itself, rather than always relying on synthetics to treat conditions." Dr. Kruesi's father was a human physician who slowly adopted holistic approaches, leaving his son with some guiding principles, including this: "The best thing a doctor can do is teach people how to be well." That applies to our dogs as well.

Dr. Carvel Tiekert is the founder of the American Holistic Veterinary Association (AHVMA), which maintains a network of qualified holistic veterinarians. Besides running the AHVMA, Dr. Tiekert has also managed a veterinary practice in Bel Air, MD, since 1964. He is critical of anyone with a narrow focus, even if that person is holistic. "The word holistic is meant to exclude nothing. We may be getting too many specialists, and not enough generalists. That's a problem for any approach, whether it's acupuncture or something Western. Acupuncture is a phenomenal therapy, but a broader sense of health helps patients more. By the same token, don't just treat a dog's eye without seeing it as part of an entire animal."

Including Everyone, and Everything

When you meet a holistic veterinarian, one immediately noticeable difference is appointment time. Initial consultations can last one hour, and a lot of discussion takes place before physical assessments of the dog. Dr. Amy Matthews, a veterinarian at Frontier Medicine, in East Granby, CT, uses chiropractic, acupuncture, and dietary consultations. She needs longer appointments because "We expect our clients to engage in conversation about what's happening to their pets."

That discussion includes the dog's physical and emotional life. "Doctors are often faulted for not listening, disregarding the patient's input," Dr. Kruesi says. "They are criticized for forming opinions before learning about the case." He says being holistic means taking time to figure out everything in the dog's life. "If the vet does not get a sense of the nuances, especially in a chronic case, we're doomed to short, easy answers."

Dr. Michael Lemmon, a co-founder of the AHVMA along with Dr. Tiekert, runs the Highlands Veterinary Hospital in Seattle, WA, where he has administered acupuncture and massage since 1963. Before touching a dog, he assesses subtle cues. "Some things I set out to find consciously, other things I pick up subconsciously. You observe what the dog is like, how the dog interacts with owners, or with other dogs or people."

To get a complete view of the dog's life, owners must be as much a part of the process as veterinarians. After all, no matter how good a veterinarian is, the exam room is only a snapshot: most of the animal's life takes place outside the veterinary office. "I ask my clients to describe what the dog is like at home," Dr. Kruesi explains. "You can't ask the dog! So a successful holistic practitioner needs clients who problem solve with you."

As an example, Dr. Kruesi talks about a dog with behavioral problems. Rather than focusing directly on the behavior, he asked, "Maybe there's something causing low blood sugar levels making the dog uncomfortable, affecting mood and clarity of thought? It's not enough to say the dog gets a 'complete' or 'balanced' diet. Maybe there's something the dog doesn't like."

Dr. Matthews concurs, adding that detailed consultations allow holistic veterinarians to gather ideas far beyond medicine. "We'll often get into training techniques or how to interact better with their dogs. It's not always just an internal disease process. Many stresses can cause imbalances in the body." This engagement gives clients information they use to do more than simply cure a problem. "We're helping people empower themselves. Then they can empower the dogs for a consistently supportive, healing role."

Western vs. Holistic?

By nature, holistic thinking is far ranging and difficult to define. Because it includes all worthwhile approaches, responsible holistic veterinarians do not create an "us versus them" scenario, pitting against Western practitioners. Everyone wants to see their patients be healthier. The difference is in specific decisions. To clarify, Dr. Kruesi describes Western ideas as "interventionist," and uses the word "natural" to describe holistic ideas. "The interventionist model uses surgery or medication, very deliberately putting something into the body to correct current circumstances. The natural model looks at root causes, anticipating problems and using the animal's own maintenance and repair systems."

Dr. Matthews says that after her veterinary school education, she found that an interventionist-only approach did not offer enough options for her clients. "When I was only using Western medicine, I was frustrated. It has lots of tools for diagnosis, but not enough for support."

As an example, Dr. Kruesi talks about chronic ear infections. "You can't solve this with repeated, short visits and medications. Just looking at the ears repeatedly isn't giving insights into something deeper preventing the dog from getting over the infections."

As dogs live longer, Dr. Kruesi says, it is becoming imperative that people gain a better idea of how the body works. "More older dogs means more problems. We'll have to completely re-think our health-care model. Drugs alone won't correct the weaknesses that cause the long, slow, insidious process of falling apart."

Coming Together: Integrating Western and Holistic

If being holistic means focusing on anything that improves life, it makes sense that qualified holistic veterinarians must also include Western ideas. In fact, a good test of holistic veterinarians is whether they embrace Western treatments whenever an interventionist approach makes more sense. This free flow between Western and holistic viewpoints is often referred to as "integrative," a word gaining favor among veterinarians.

Dr. Lemmon moves between Western and holistic, without worrying what he calls it. "If someone comes to me with a dog that has a bad leg, I request an X-ray to make sure we're not dealing with cancer. If you say, 'I only do acupuncture,' you might easily miss a serious problem. I use pharmaceuticals, but I'll consider alternatives if they can be more effective and gentle. You have to encourage Western diagnoses along with everything else."

Responsible integrative veterinarians strongly disapprove of holistic practitioners who close themselves off to Western ideas. Dr. Tiekert has seen cases where a misguided holistic veterinarian has done more harm than good. "We've all had dogs come into our offices after two or three 'holistic workups' for a serious neurological problem. I send them immediately to a neurologist. Sometimes it's too late. People claiming to be holistic can cause more problems if they are only seeing a small part of health."

Working with cancer patients in the pain center at Colorado State University, Dr. Robinson constantly integrates. Many dogs she sees are undergoing chemotherapy. "I'll talk to people about drugs, and non-drug options such as herbs. But we make sure to know how the herbs interact with the drugs. People sometimes come in after a holistic vet said give the dog two cloves of garlic each day. That's no good, because it causes anemia. Or the vet said to feed the dog immune-stimulating herbs. That's bad, because it counters the effects of chemotherapy."

Dr. Kruesi says the question is about whether the dog needs emergency care, which demands Western medicine, or long-term care, where holistic medicine succeeds. "Hey, if your dog has food poisoning, get her to an emergency room. On the other hand, if your dog has a chronic dietary issue that may be contributing to a slow, degenerative disease, go with the holistic model."

In less dramatic ways, Western measurements are a constant part of Dr. Kruesi's practice. "Before I offer any treatments, I do complete blood chemistry, check thyroid levels and urinalysis results. If I'm using an unconventional approach like herbs or nutritional supplements, I watch the dog's liver enzymes to make sure the levels are right. The physical realm of chemistry is just so honest! All doctors need to do this."

Rather than creating a divide between Western and holistic, Dr. Robinson says it is more important for holistic veterinarians to adopt the best conventional ideas so they know all that is going on in their patients. "Holistic veterinarians need to have a basis in science, and they need to scrutinize themselves for safety. You need to be able to defend what you do. If a dog needs an MRI, don't prescribe homeopathy."

What holistic veterinarians want is for strictly Western practitioners to adopt an open-minded view of successful holistic approaches. "I don't do ultrasounds," Dr. Tiekert explains, "I don't know enough about them. But I know enough so I'm aware when to refer patients who need one. In the same way, I'd like Western veterinarians to know enough about holistic practices to refer out when that's appropriate. As long as we stay non-confrontational, animals benefit."

Dr. Matthews comments that too many people, including her own veterinary colleagues, maintain an outdated view of holistic medicine. "There's still this stereotype that holistic veterinarians don't have the same scientific rigor as someone trained in Western medicine. But that's not always true."

What's Next?

If holistic veterinarians are using Western techniques, and Western veterinarians open up to holistic ideas, then what does it actually mean to be "holistic"? Dr. Tiekert, who has watched the holistic philosophy evolve for over 40 years, hopes for a natural fusion, a day when labels are obsolete. "We're oriented towards putting names on things. In some ways it's necessary, but what we call alternative today might be conventional tomorrow."

To make this happen, he calls for healthy self-scrutiny of all approaches. "People with science backgrounds need to look at holistic ideas. When that happens, it will remove any voodoo. Then they'll see how effective this can be, which benefits everyone."

Dr. Kruesi expects the future to keep getting better. "We're all interested in greater comfort, less pain, better life. We need to integrate the best information to provide the broadest base for our patients. Miraculous, quick-fix medications are great, but without considering where you want to go long-term, you lose balance."