Part XV — Alternative and complementary therapies

15.1 What the evidence base supports

• Physical rehabilitation / hydrotherapy — strong evidence for osteoarthritis management, post-orthopaedic-surgery recovery.
• Acupuncture — moderate evidence for pain management; growing evidence in canine osteoarthritis. Practitioner training matters; look for IVAS or CIVAS certification.
• Chiropractic (canine) — weaker evidence; controversial; some musculoskeletal benefit reported in individual cases. Should be practised by a veterinarian trained in chiropractic (AVCA certification).
• Massage — reasonable evidence for muscle-tension relief and post-exercise recovery.
• Laser therapy (photobiomodulation) — moderate evidence for wound healing and pain modulation.
• Nutraceutical support (omega-3, glucosamine-chondroitin, green-lipped mussel) — modest evidence for joint support.

15.2 What the evidence base does NOT support

• Homeopathy — no plausible mechanism; no consistent evidence of efficacy beyond placebo. Discouraged by every major evidence-based veterinary organisation.
• Reiki / energy healing — no plausible mechanism; no evidence beyond placebo.
• 'Detox' regimens — no clinical basis; dog kidneys and liver detoxify effectively unless diseased.
• Colloidal silver and other unregulated supplements — no evidence; toxicity risk.

15.3 CBD (cannabidiol)

• Legal status varies by jurisdiction — CBD's regulatory status is unsettled as of drafting. Cannabis-related products are regulated by the Narcotic Drugs and Psychotropic Substances Act, 1985; comparable laws apply in many countries. Legal counsel required before recommending any CBD product.
• Evidence in dogs — moderate evidence for reduction in seizure frequency (an anti-convulsant class effect); modest evidence for chronic pain; anxiety-reduction evidence is early and mixed.
• Product quality — the unregulated pet-CBD market is a mess. Third-party lab-testing certificates of analysis (COA) matter.
• Dally position — the platform does not recommend or dispense CBD; owners should discuss with their vet.

15.4 Herbal medicine

• Ayurvedic and traditional Indian herbal formulations — used widely for pets in some regions; efficacy varies. Safety cannot be assumed — many herbs are hepatotoxic or nephrotoxic (garlic, chaparral, willow bark).
• Traditional Chinese veterinary medicine (TCVM) — an established system with its own evidence base; overlaps with acupuncture.
• Dally position — herbal supplementation must be discussed with the vet; the vet has drug-interaction and toxicity information that the herbalist may not.

15.5 How to evaluate a claim in complementary medicine

• Is there a plausible mechanism?
• Is there peer-reviewed evidence in dogs (not just cats or humans, and not just anecdote)?
• Is the practitioner licensed and trained in the modality?
• Is the product independently third-party tested?
• What does the treating vet (who knows your dog) say?