Taiwan Today

Asalt-and-pepper miniature schnauzer marches down the corridor on the second floor of National Taiwan University Veterinary Hospital (NTUVH). Occasionally, his back legs lose their footing, but he regains his balance quickly and with finesse. He confidently approaches another patient at the end of the hallway, a yellow Labrador four times his size, and then curiously sniffs her all over with his tail wagging nonstop. The scene draws the attention of several pet owners as they can all tell that the canine is happy and ready to make a new friend.

It is hard to imagine that the little creature was totally paralyzed eight months before following an accident at a pet salon. An injury to his spine meant that he was unable to eat, drink or move any of his limbs and was in constant pain.

On the other side of the wall, in the examination room, a West Highland white terrier mix stands on a stainless examination table, waiting for care. She had collapsed suddenly a week earlier when both of her hind legs failed her. “She was just playing her usual game, chasing the cat we keep, and it happened,” says the pet’s owner Liu Qiu-shui (劉秋水) “We knew she’s had [spinal] bone spurs for years, but we didn’t expect [the condition] would be so serious.” Given the pain in the lower part of her body, the canine could not sleep well and when she tried to walk, all she could do was to drag her back legs. But, after two visits to NTUVH, Liu says, his pet began to sleep much better and can now stand on all four legs again. Both of the animals in question had not received any surgery or medication other than painkillers, so what was behind the “miracle” recoveries? The answer is an old-fashioned remedy—acupuncture.

A primary treatment method of traditional Chinese medicine (TCM), acupuncture is a medical procedure in which the practitioner inserts needles into the skin of a patient at points identified as having therapeutic value. While skepticism remains about the benefits of the treatment among Western medical practitioners, reported effects include pain relief, the resolution of a number of medical conditions and a boost to general health. According to Liu Ching-ming (劉金鳴), the chief veterinarian at the clinic for traditional Chinese veterinary medicine (TCVM) at NTUVH, who treated both the schnauzer and the terrier mix, acupuncture is like “pushing a reset button” for the organs associated with a particular acupuncture point, which allows the body to maintain health by itself. Liu says several types of TCM treatment can be used on animals, including massage and herbal medicine, but acupuncture has been the most commonly practiced.

The origin of traditional medical care for animals can be traced back nearly 3,000 years in mainland China to the book Bole’s Canon of Veterinary Acupuncture (Bole Zhen Jing), which was published between 659 and 621 B.C., according to Liu. Bole was an epithet of the book’s author Sun Yang (孫陽), who is known in Chinese history for having had a remarkable gift for spotting talented horses and understanding the species. Treatment for horses was the earliest therapy developed as the animals were commonly used for drawing war chariots, the veterinarian says, and it was important to help them regain their strength so that they could rejoin the fighting. According to Liu, quite a number of such ancient written records still serve as important references for vets practicing TCVM today. These include Collections of Equine Care and Treatment (Si Mu An Ji Ji) from China’s Tang dynasty (618–907) and Yuan & Heng’s Therapeutic Treatise of Horses (Yuan Heng Liao Ma Chi) from the Ming dynasty (1368–1644).

In Taiwan, veterinarians and vet students began exploring the possibilities of TCVM about two to three decades ago, says Wang Wen-dian (王文典), chairman of the ROC Asian Pacific Association of Traditional Chinese Medicine for Small Animals (APATCMSA) and the superintendent of Hong Ming Animal Hospital, which is based in New Taipei City. At the time, traditional medical care for animals was known to be practiced by farmers from time to time to treat livestock, he says. “I remember a teacher of ours mentioned the example of using acupuncture to boost fertility in sows,” Wang says. “But there was no course [designed to teach that] in the vet school curriculum,” he notes. Vets interested in this discipline had to study the subject independently by reading, conversing with TCM doctors and gradually gaining experience by themselves in clinical practice, he says. This lack of formal TCVM education has held back the development of the practice in Taiwan, Wang says, because studying in isolation is difficult for many of those who are interested in the subject.

In contrast to the well-established system and substantial popularity of TCM for people in Taiwan—5,342 certified TCM doctors were registered with the Department of Health in 2010—there is no formal certification required or available for those who practice TCVM as long as they are certified veterinarians, according to Wang. As a result, “there are virtually no vet clinics or hospitals wholly devoted to TCVM,” he says, adding that veterinarians skilled in the discipline usually practice both Western and traditional Chinese medicine.

The situation has begun to change in recent years, however, as more and more pet owners seek alternative health care therapies for their animal companions, says Wang, who has studied TCVM and practiced both Western and traditional medicine for animals for the past 20 years. “The new generation of owners considers their pets as part of their families, and they find Western medicine doesn’t always offer fully satisfactory treatments,” he explains.

APATCMSA was founded in 2009 to promote the development of TCVM in Taiwan. Since its establishment, Wang says, the organization has invited TCM doctors and veterinarians specializing in the field, both from Taiwan and abroad, to give seminars for local vets.

NTUVH, the first veterinary teaching hospital in Taiwan and one of the most respected veterinary medical institutes locally, was also one of the first to recognize the growing interest in TCVM services. Nearly four years ago, the hospital sponsored Liu Ching-ming to study at the Florida-based Chi Institute of Chinese Medicine, Inc. in the United States, where he received certification as a veterinary acupuncturist. The Chi Institute’s program is centered on acupuncture, but includes massage, herbal medicine and food therapy. The TCVM clinic at NTUVH opened in 2009 following Liu’s return and since then the vet has led the clinical practice at the hospital. Currently, Liu is assisted by one other Western-trained doctor and several student interns. By the middle of this year, the team had treated about 150 cases, 80 percent of which were referred by other veterinary clinics and hospitals as well as other divisions at NTUVH.

In 2009, the hospital also began offering two elective undergraduate courses, veterinary herbal medicine and acupuncture, at NTU’s School of Veterinary Medicine. The classes teach the basic theory of traditional Chinese medicine and its applications for animals. “At first, students came out of curiosity,” Liu says, “but as they personally witnessed more and more successful cases in clinical practice, most of them were amazed and became much more interested [in TCVM].”

Two Traditions

Liu Ching-ming believes incorporating both Western and traditional Chinese medicine in veterinary care offers animals the most benefits. The regular practice at NTUVH is to give patients a thorough examination based on Western medicine before offering owners the option of TCVM treatments. “Surgery and plenty of medical instruments and equipment are still the strengths of Western medicine,” he says. He suggests that, ideally, TCVM practitioners should also be trained in Western veterinary medicine in order to establish some common ground between the two disciplines. Otherwise it can be difficult to convince pet owners or other Western vets to entrust an animal to the care of a TCVM practitioner.

Hsu Tai-yu (許泰裕) is the superintendent of Taipei Animal Hospital and has been in veterinary practice for nearly 20 years. Although he practices only Western medicine, he believes TCVM could play a vital role in supporting Western medical care for animals. “Traditional Chinese treatment does offer certain [therapeutic] effects,” Hsu says. “I’ve come across a few cases where pets were still unable to walk a month after receiving spinal surgery. I suggested they try traditional Chinese veterinary medicine and those who did often saw good results,” he says. Another situation where TCM could be useful is to offer pain relief for pets suffering cancer, Hsu says. Since radiation therapy for animals is not available in Taiwan due to the expensive equipment it requires, the common cancer treatment for pets is chemotherapy, Hsu says. “But the costs of chemo are high and the side effects are significant,” he explains. In that case, TCVM is a good alternative as it can ease the pet’s discomfort and help improve the animal’s quality of life, he says. Hsu says there is a great opportunity for TCVM to develop into an important segment of veterinary medicine as he has seen the number of interested vets grow significantly in the past 10 years.

TCVM can also be applied to a wide range of pets, according to Wang Wen-dian. Besides common pets such as cats and dogs, traditional care, including acupuncture, has been administered to birds, fish and rabbits, Wang says. Liu Ching-ming says that the physical structure of human beings and that of other animals are “in general very similar” in key respects. “For example, just like us, dogs have 14 main meridians, or energy channels, and the acupuncture points along these channels are similarly located,” he says. Vets must take into account the different body sizes and shapes between humans and animals when they want to identify the exact point to insert an acupuncture needle, however. The point Tsu-san-li, for example, is located about three inches below the knee in humans. A vet must estimate a proportional distance on each animal, Liu explains. Other TCM approaches, like balancing yin and yang energies and treating patients according to patterns or groups of symptoms instead of isolated signs of illness, can all be applied to veterinarian care.

TCVM also holds certain advantages over its Western counterpart in some cases. Take spinal disc herniation, the most common medical condition Liu encounters. When the herniated discs, or bone spurs, become serious, they can produce pressure on nerves and the spinal core, causing pain and weakness or even lameness in the limbs. Western medicine offers very limited treatment options besides surgery. Liu says that for most cases, acupuncture alone or together with herbal medicine—mostly powdered concentrates—are able to relieve pain and restore function to paralyzed limbs. Such treatment provides an option for animals that are either too old to undergo surgery or have too many bone spurs to have them removed at one time. As TCVM gains popularity, Liu says, some owners also seek out acupuncture treatments to help speed up their pet’s healing process after surgery.

According to the NTUVH veterinarian, the relatively low cost of TCVM treatment is another benefit. A visit to the clinic at NTUVH costs no more than NT$1,000 (US$33) and the condition of some patients improves after only a couple of treatments. Bone spur surgery costs at least 10 times that amount, Liu says.

TCVM does have its limits, however. “Traditional therapies can’t help restore, say, a fractured bone to its original position,” Liu says. “Neither can they remove the bulging spurs between bones,” he adds. Wang Wen-dian warns that, since TCVM therapy generally is milder and works more slowly than Western medicine, pet owners have to be patient and vets must take care to adjust their prescriptions as healing progresses.

Veterinarians in Taiwan might have had a comparatively late start in developing TCVM, but Liu Ching-ming believes the country has the potential to catch up quickly. “Plentiful certified TCM doctors are an important asset for veterinarians interested in improving their know-how,” he says of one of Taiwan’s advantages. He also points out that most references for traditional Chinese veterinary medical care originate from ancient Chinese texts, so vets in Taiwan enjoy a great advantage in unlocking the healing power of tradition. “Taiwan shares the same language and a similar background with mainland China; we don’t need further translations or interpretations of these ancient texts,” the veterinarian says. “If we capitalize on this strength, together with our well-developed veterinary health care sector, which is ahead of that in mainland China, [Taiwan] could place itself far enough ahead that it would be difficult for other countries to catch up.”

Write to Audrey Wang at audrey@mail.gio.gov.tw