Report on Consultation

Consultation Period: November 4, 2020 to February 12, 2021

Submissions: 112 Submissions

What is the Issue 

The College’s current Position Statement: The Practice of Complementary and Alternative Veterinary Medicine has not been updated since it was published in 2009. In 2019, this Position Statement was placed under review to allow for the College to determine its relevancy in the current practice context.

Reasons for this review included:

• That the Position Statement was outdated; 
• That the Position Statement focused too heavily on restrictions and lists; 
• That the Position Statement listed many therapies as alternative that are now viewed by the public as mainstream (i.e. rehabilitation, massage, etc.); and
• That the Position Statement did not properly reflect the different animal care options and providers that have come to exist in the public domain.

Since the Position Statement was placed under review, the College has been in the process of developing a new proposed Statement that is more reflective of the current environment and the evolution of the public’s expectations related to their ability to choose a provider when accessing lower-risk activities for their animal(s). In particular, the College has focused on developing a evidence-informed Statement that outlines the professional expectations that exist for veterinarians who integrate non-conventional therapies into their conventional practice.

In September 2020, Council reviewed the proposed draft Position Statement: Use of Non-Conventional Therapies in the Practice of Veterinary Medicine. Following discussion, Council directed that the proposed amended draft be circulated for public consultation. 

Why is it Important 

In recent years, members of the public have demonstrated an increased interest in direct access to various non-conventional therapies for their animals. The popularity and prevalence of these therapies has grown in both human and veterinary medicine. Many veterinarians offer non-conventional therapies as part of their practice. However, there is ongoing debate within the profession regarding the efficacy and appropriate use of these therapies.

As the use of non-conventional therapies continues to expand in the practice of veterinary medicine, the safety and quality of the treatment and/or care provided to animal(s) remains paramount to animal welfare and the public intertest. 

Overview of the Proposal

The draft Position Statement: Use of Non-Conventional Therapies in the Practice of Veterinary Medicine is available through a link below. 

Consultation Process

The draft Policy Statement was sent for public consultation for a 100-day period during which members of the College and members of the public were asked to provide their feedback. 

What we Heard 

Major Themes 

(a) Concerns about requiring an established diagnosis before proceeding with treatment

• There were several comments that noted that an established diagnosis is not always possible even in conventional medicine.

(b) Requests for even further emphasis on veterinarians providing only evidence-based treatments 

• There were also several comments that called for a ban on the practice of homeopathy. 

(c) Document is forward-thinking and reflective of current ways in which animals receive care

Additional Themes

(d) Requests for non-veterinary professionals to have additional training/credentials to provide non-conventional therapies to animals 

(e) Celebration of the document’s focus on interprofessional collaboration

(f) Requests for non-conventional therapies to be limited to use on animals by veterinarians/those working under their supervision

(g) Questions regarding the delegation of non-conventional therapies (to whom, level of supervision required, referrals, etc.)

(h) Requests for the expectations and requirements to be clearer and mentioned earlier in the document 

Sample Comments

The following quotes, summarized from comments received, reflect suggestions received through the College consultation: 

• "veterinarian integrating non- conventional therapies must do so with established diagnosis"-  this requirement is problematic. Even within the practice of conventional medicine, it is not always possible to convince all clients to do all the necessary tests to reach a final diagnosis. Sometimes we still go ahead and treat based on most likely differential.  Vets choosing integrative therapies shouldn't be held to a stricter standard.

• I appreciate the emphasis on "do no harm".  I am concerned that there is no emphasis on evidence based treatments. Many "alternative" therapies seem to be more "magical thinking" than evidence based. The college should provide more guidelines for distinguishing alternative therapies with promise from those with nothing more that wishful thinking behind them.

• The differentiation between therapies such as rehabilitation and acupuncture that have research supporting their use vs homeopathy and non-scientific practices needs to be laid out.

• Thank you for recognizing the value of non-conventional treatment by non-veterinarians.  My pets have benefited greatly from treatments by skilled and certified animal therapists, and specifically from laser, shock wave and massage.  These are modalities that my own vet would recommend but is not trained. Just as I would like to contact my physiotherapist, acupuncturist, chiropractor without going through my family doctor, I want the same access for my pets.

• Very forward thinking, and appropriate to the times....

• It is important to identify WHO should be administering the non-conventional therapies.  This should only be performed by a trained professionally that has obtained certification or has a certificate of knowledge in the area on companion animal rehabilitation.

• I would like to have specified what "qualified" therapist means exactly. What certificates/diplomas/schools are accepted? Who is going to be the governing body of the complimentary/alternative therapies? Is the CVO going to setup an "Alternative Therapies" board? How can one on such a board? Please understand, I am all for governing this area as there are too many e.g. equine or canine massage therapists out there that only took a 2 day course.... Thank you for your time.

• If we are going to accept other professionals (physiotherapists, chiropractors, etc.) providing alternative therapies for animal patients, then there needs to be some collaboration with the other colleges in respect for those licensed individuals having proper qualifications and further education to treat those species. I do not think that alternative therapies should be allowed if there is a boarded specialty (The ACVSMR) that provides those services for veterinary patients.

• It is gratifying to see that the CVO recognize the benefit of working together with non-veterinary providers.

• I think it is important for regulated health care providers to work collaboratively in the best interest of animals.  This progressive standard is in the best interest of animals.  I congratulate the CVO for creating it.

• I feel that this position statement is a step backwards in protecting the health and welfare of animals in relation to non-conventional veterinary therapies.    Non-conventional veterinary therapies should only be permitted under direct supervision by, and/or delegation from, a veterinarian.  Ideally, they should only be accessed through a VCPR.  Public expectation to access these non-conventional care modalities is not a reason to forgo a proper medical diagnosis for a health or behaviour concern and may prevent an owner from seeking appropriate veterinary care.  With today’s access to the internet, we see more and more owners trying to diagnose and treat their animals on their own.   Marketing for non-conventional therapies could sway an owner from seeing a veterinarian and cause often limited funds to be wasted on non-science based treatments.   This may also prolong animal suffering.

• I prefer the current position that was drafted over ten years ago as it respects the importance of the VCPR and the importance of veterinary involvement and guidance.

How We Responded 

College staff made several revisions to the proposed draft Statement based on the consultation feedback. College staff also made several recommendations to help support the posting of this Position Statement – including the introduction of a College public campaign related to the accountability of clients for choices made related to the care of their animals. These revisions recommendations, along with all the consultation feedback received, were brought forward for Council review and consideration in March 2021. 

Council reviewed the proposed amended draft Position Statement: Use of Non-Conventional Therapies in the Practice of Veterinary Medicine at its March 2021 meeting and directed the draft Statement be returned to College staff for further work and consideration.