Acupuncture is a theatrical placebo, nothing more. It has no “curative powers,” and, when studied objectively in good double-blind, randomized controlled clinical trials with proper sham acupuncture controls, there is consistently found to be no difference between sham and “true” (or, as they like to call it, “verum”) acupuncture. (Indeed, I have written about this many times.) The only exceptions to this rule tend to be studies that come out of China. Basically pretty much all acupuncture studies that come out of China are positive because they appear to be conducted with the intent to confirm the prior assumption that the treatment is effective. Yet, there continue to be true believers who think that acupuncture is basically a panacea for anything that ails you. Worse, of all the quackery that is being “integrated” into medicine by “pioneers” in “integrative medicine,” acupuncture is one of the most ubiquitous, if not the most ubiquitous of them all. Pretty much every quackademic program in integrative medicine offers acupuncture, even though even the largest meta-analyses presented in favor of its efficacy, when examined critically, do nothing of the sort, although they do leave advocates of quackademic acupuncture sputtering at the criticism.
Yet acupuncturists and the various “integrative health” specialists who have embraced acupuncture persist. I was reminded of this by a story I saw over the weekend. Itinvolved acupuncture for pets, a particularly pernicious form of animal abuse, in my not-so-humble opinion, that was recently glorified (yet again) by a local news station that seems to have a thing for doing stories about subjecting pets to uselessly being stuck with needless. It’s the sort of story that is meant to interest, even amaze, readers by showing something that seems unbelievable on the surface, all wrapped up in a human (or, in this case, pet and human) interest story in which representatives of man’s best friends are portrayed as being relieved of suffering that no other veterinarian is able to relieve. Everyone is happy at the end, and acupuncture is normalized as not quackery; that is, if you believe the narrative.
Be that as it may, it was actually a bit abnormal that I saw this story on the local news, because normally I don’t watch the local news on Sunday night. Instead, I usually watch Last Week Tonight with John Oliver instead. However, for whatever reason, Oliver’s show was not on at its usual 11 PM Sunday time slot this week; so instead I watched the same local news show that I usually do on weeknights (if I haven’t fallen asleep by 11 PM), the WDIV local news. Whenever I see woo on the local news, it always seems to be WDIV, which has featured credulous pieces on acupuncture several times before, including at least one two previous story touting acupuncture for pets. This is the same station that actually did a story about orbs. Yes, I kid you not. Orbs. Of course, that could just be confirmation bias or selective sampling because my wife and I watch WDIV more often than the other local newscasts because we generally like the anchors and reporters more than on the other stations, although the occasional story like this one tries our patince. This time up, the story is Acupuncture for your pets? Some owners swear by it:
It might as well be a commercial for Dr. Mike Petty, a local veterinarian who is a “pet acupuncture specialist.” His clinic offers quite a cornucopia of alternative medicine treatments for pets, including:
- Medical Acupuncture
- Myofascial Trigger Point Therapy
- Rehabilitation Therapy/Physiotherapy
- Stem Cell Therapy
- PEMF Therapy
- Pharmaceutical Therapy
- Laser Therapy
- Manual Therapy
Stem cell therapy? WTF? For chronic pain? The only modalities on that list that could be science-based appear to be rehabilitation therapy/physiotherapy, surgery, pharmacological therapy, and maybe manual therapy (that is, unless it’s chiropractic for pets). Of course, Dr. Petty comes across as very caring in this video and the one above:
I bet he probably is caring in real life, but he’s no Dr. Jeff, and his caring doesn’t excuse his embrace of dubious therapies. In the WDIV clip, we are treated to, as with previous WDIV reports, testimonials interspersed with clips of Petty waxing enthusiastic about the various woo he offers. I will admit, however, that his description of why acupuncture “works” is different than any I’ve heard before. About a third of the way through the report, he claims that sticking needles in certain places distal to where nerves have been injured “reminds the nerves they’re there, and that they have a job to do, and you can slowly start waking them up.” Later, he claims that putting needles in and twisting them causes “microtrauma” (which is true) but then goes on to claim that that “microtrauma” brings the anti-inflammatories into the area. I must say, that’s different from what I learned about neurological function in undergraduate and medical school.
In any event, if you don’t think that pets can experience placebo effects, you haven’t been paying attention. Human contact has effects on animals and the expectancy effects underlying placebo effects can work on animals through their human owners who expect the treatment to work and, not coincidentally, often pay a lot more attention to their pet when acupuncture is being done, with petting and treats and all those things that most dogs, for example, love. As veterinarian David Ramey once put it:
The reported intensity of subjective symptoms such as pain, fatigue, and depressed mood in an animal may vary over time for all sorts of reasons, not all of which have to do with actual changes in symptom severity. Further complicating such analyses are treatment effects that might exist on the part of both the animal owner, as well as the veterinarian with a personal investment in an “alternative” approach.
Client expectations can be very powerful motivators. Having participated in a therapeutic transaction, clients generally expect to see some results. Optimistic owners may be more likely to diligently pursue treatments. Even failing obvious results, normal reciprocal responses often result in clients reporting improvement, at least initially, even when no improvement has occurred. At the very least, veterinarians can help clients understand what problems are occurring in the animal – such comfort and reassurance may make a problem easier for the client to deal with. That’s a good thing, mostly, unless the veterinarian steers the client into areas that are unsupported by evidence.
So, yes, placebo effects can occur in animals, although mainly through the influence of their owners.
Petty also claims that “90+%” of dogs respond to acupuncture. Personally, my response to this would be that, if this is true Petty really should publish his results in the peer-reviewed veterinary literature, because I smell confirmation bias here. Of course, one of the two dogs featured in the story is portrayed as having had a “miraculous” recovery. The other dog, for whom “expensive surgery” had been recommended, was also portrayed (at least by his owner) as having had great improvement. The story is then capped off with co-anchors Steve Garagiola and Priya Mann expressing awe and wonder at how fantastic Dr. Petty is. Garagiola was particularly effusive in his praise, but also inadvertently revealed a bit more about what goes on as he mentions how the dogs sit in a quiet room and get a little dish of ice cream when they get their treatments, with what Garagiola characterizes as “amazing results.” He even said that Petty had “worked some miracles.” I don’t know about you, but whenever I hear language like that, my skeptical antennae start twitching wildly.
As I watched the story, it all sounded very familiar to me. I could swear I had seen Petty before somewhere. So I searched the old blog archives and quickly found that Dr. Petty had been featured before in 2013 on this very same newscast, in which he was shown supposedly producing even more miraculous results with acupuncture for a dog with a severe closed head injury. Guess who did the story? Yes, it Steve Garagiola again. In fact, this story in 2017 is practically a carbon copy of the story in 2013, featuring two anecdotes about two dogs who supposedly experienced “miraculous” recoveries thanks to acupuncture interspersed with Dr. Petty explaining how acupuncture “works.” That time around, nearly four years ago, Dr. Petty blathered about how acupuncture isn’t magic and the needles aren’t magic, emphasizing that the needle doesn’t heal anything, but rather is “telling the body how to heal itself.” I wondered at the time exactly how the needle pulls off this amazing feat and noted at the time that, contrary to what Dr. Petty claimed, magic is exactly what he was claiming for acupuncture. There’s nothing less magical in the 2017 edition, although the magic is gussied up in less blatantly mystical terms. There was an interesting reversal, though. In 2013, Garagiola emphasized that “this is science, not magic.” In 2017, he all but gave that up, repeatedly referring to acupuncture results in the two dogs featured in his report as “miracles.”
What I said about that piece in 2013 applies equally well to this piece. It might as well have been a commercial for Dr. Petty and his clinic. At least a commercial would have been honest. One has to wonder what the connection is between Dr. Petty and Steve Garagiola and/or WDIV is, for him to be featured in what are essentially commercials disguised as news features.
Published at Tue, 28 Mar 2017 07:00:53 +0000