Q: Have you done an investigation into pet acupuncture? What’s the story behind that?

—M. Downey

A: Pet acupuncture is not a topic that has gotten much specific attention from skeptics. It’s not widely practiced among professional veterinarians, though it does have its adherents. Many fields are inherently sketchy, acupuncture and psychic phenomena among them. When applied to nonhuman animals, the claims get exponentially more dubious. One key issue is falsifiability: Can the claim be proven true or false, proven or disproven?

The basic premise of acupuncture is that needles placed at certain points on the body, often along imagined meridian lines, can be used to manipulate the body’s imagined energy field and thus treat or cure myriad medical maladies. A full skeptical analysis of acupuncture is beyond the scope of this column, but suffice it to note that different acupuncture traditions use different acupuncture points. Like other pseudosciences, including astrology and dowsing, there’s not even any agreement on the fundamentals of the practice—such as where to place the needles on the body. It varies by person and practice; some acupuncturists manipulate the body’s presumed energy fields only in certain places, such as the ear or hand. Others claim it needs to be done all over the body—and there’s no universal agreement about where those places are, with pretty much anywhere on the body being claimed by someone or other as an important meridian. The lack of standardized, stringent research methods and practices might be understandable for a new therapy, but proponents claim that acupuncture has been practiced for thousands of years. (It hasn’t, and even if it had been, it’s troubling that millennia of practice hasn’t led to improvement.)

In the real world, it can be difficult to prove correlation—and cause and effect relationships even more so. This is why the gold standard for research in many fields is a randomized, controlled, double-blinded study. That doesn’t mean that other study methods (cross-sectional, case-controlled, etc.) are necessarily flawed or invalid, just that they don’t have the power of higher-quality studies. This is especially applicable to acupuncture claims and especially to pet acupuncture claims.

One of the main challenges with scientifically testing acupuncture is that people tend to know whether or not they’re being stuck with needles. It’s kind of a hard thing to miss, though some researchers have attempted to control for this confounder by using sham needles (for example, ones that don’t actually penetrate the skin) or putting the needles outside of the designated meridian lines (presumably the treatment wouldn’t work a few centimeters in any direction off the lines).

One review (Moffet 2009) examined thirty-eight acupuncture trials and found that “Most studies found no statistically significant difference in outcomes, and most of these found that sham acupuncture may be as efficacious as true acupuncture, especially when superficial needling was applied to non-points.” Overall, the study concluded that “The findings cast doubt on the validity of traditional acupuncture theories about point locations and indications. Scientific rationales for acupuncture trials are needed to define valid controls, and the theoretical basis for traditional acupuncture practice needs to be re-evaluated.”

To the extent that acupuncture “works,” it’s largely due to the placebo effect—and because pets can’t know or understand that the needles being put in them are supposed to relieve pain, the placebo effect can’t work on them. Unlike humans, animals can’t communicate reports of reduced pain—that can only be indirectly inferred by observation, and of course that raises the problem of observer (pet owner) bias.

As with most types of alternative medicine, virtually all the “evidence” for pet acupuncture is anecdotal. Animals may exhibit a problem behavior (such as crying) and then stop when their owner or another person does something different or new (such as spending time treating the pet), and in many cases the behavior might change. This is seen by many as validating the treatment, but it’s a classic example of the logical fallacy post hoc ergo propter hoc (after this, therefore because of it). Animals are sensitive to cues, and it could be that doing anything different would have fixed the problem—paying more attention to the animal, taking it to any new place (including a pet psychic or acupuncturist’s office), etc. Any change in behavior may have nothing to do with the specific treatment. The owner may also re-interpret the behavior in a different way, subjectively deciding that the pet seems better after a treatment.

If the condition doesn’t improve, that does not necessarily demonstrate to the pet owner (or acupuncturist) that the premise underlying pet acupuncture is inherently flawed. After all, no medical treatment—even on people—is completely effective all the time on all patients. It’s easy enough to rationalize away any failures.

David Ramey of the ever-useful Science-Based Medicine blog examined animal acupuncture, noting:

Acupuncture points haven’t been shown to exist in animals (or people, for that matter). In fact, the acupuncture charts devised for animals are inventions of the 20th century, made by “transposing” one of the myriad human charts directly onto animals. That’s one reason why horses have a “gall bladder” meridian (putative channels which connect acupuncture points, which also haven’t been shown to exist), even though they don’t have a gall bladder. But, when it comes to animal acupuncture, there’s apparently no absurdity sufficiently large to cause practitioners any embarrassment. (Ramey 2009)

As for the scientific literature, well, it’s sparse. Continues Ramey:

One can occasionally find positive studies, especially if the studies have been poorly designed. There have been two reviews on veterinary acupuncture. One, looking at the evidence across all animal species, concluded that there wasn’t enough compelling evidence to either support or refute the practice; the other, in horses, concluded that there wasn’t good evidence to support the practice, and that the best studies were uniformly negative. (Ramey 2009)

As far as treatments go, acupuncture itself is relatively safe. There are some minor risks to any acupuncture (mostly from contaminated needles), but at least nobody is cutting open bodies or introducing dangerous drugs to the patient. The bigger dangers are the fact that whatever malady the pet is actually suffering from isn’t being treated and the time and money wasted on ineffective treatments.

References

Moffet, Howard. 2009. Sham acupuncture may be as efficacious as true acupuncture: A systematic review of clinical trials. The Journal of Alternative and Complementary Medicine 15(3).

Ramey, David. 2009. Animal acupuncture. Science-Based Medicine (June 8). Available online at https://sciencebasedmedicine.org/animal-acupuncture/.

Caption: The author looking suitably skeptical outside a pet acupuncture clinic in Los Ranchos, New Mexico. Photo by Shana Pedroncelli.