Background The international use of and interest in veterinary naturopathy and complementary medicine are increasing. There are diverse modes of treatment, and owners seem to be well informed. However, there is a lack of data that describes the state of naturopathic or complementary veterinary medicine in Germany. This study aims to address the issue by mapping the currently used treatment modalities, indications, existing qualifications, and information pathways. In order to map the ongoing controversy, this study records the advantages and disadvantages of these medicines as experienced by veterinarians. Demographic influences are investigated to describe distributional impacts on using veterinary naturopathy and complementary medicine. Methods A standardised questionnaire was used for the cross-sectional survey. It was distributed throughout Germany in a written and digital format from September 2016 to January 2018. Because of the open nature of data collection, the return rate of questionnaires could not be calculated. To establish a feasible timeframe, active data collection stopped when the previously calculated limit of 1061 questionnaires was reached. With the included incoming questionnaires of that day a total of 1087 questionnaires were collected. Completely blank questionnaires and those where participants did not meet the inclusion criteria (were not included, leaving 870 out of 1087 questionnaires to be evaluated. A literature review and the first test run of the questionnaire identified the following treatment modalities: homoeopathy, phytotherapy, traditional Chinese medicine (TCM), biophysical treatments, manual treatments, Bach Flower Remedies, neural therapy, homotoxicology, organotherapy, and hirudotherapy which were included in the questionnaire. Categorical items were processed using descriptive statistics in absolute and relative numbers based on the population of completed answers provided for each item. Multiple choices were possible. Metric data were not normally distributed (Shapiro Wilk Test); hence the median, minimum, and maximum were used for description. The impact of demographic data on the implementation of veterinary naturopathy and complementary techniques was calculated using the Mann-Whitney-U-Test for metric data and the exact Fisher-Test for categorical data. Results Overall 85.4% (n = 679 of total 795 non-blank data sets) of all the questionnaire participants used naturopathy and complementary medicine. The treatments most commonly used were complex homoeopathy (70.4%, n = 478), phytotherapy (60.2%, n = 409), classic homoeopathy (44.3%, n = 301) and biophysical treatments (40.1%, n = 272). The most common indications were orthopedic (n = 1798), geriatric (n = 1428) and metabolic diseases (n = 1124). Over the last five years, owner demand for naturopathy and complementary treatments was rated as growing by 57.9% of respondents (n = 457 of total 789). Veterinarians most commonly used scientific journals and publications as sources for information about naturopathic and complementary contents (60.8%, n = 479 of total 788). These were followed by advanced training acknowledged by the ATF (Academy for Veterinary Continuing Education, an organisation that certifies independent veterinary continuing education in Germany) (48.6%, n = 383). The current information about naturopathy and complementary medicine was rated as adequate or nearly adequate by a plurality (39.5%, n = 308) of the respondents of this question. Further, 27.7% (n = 216) of participants chose the option that they were not confident to answer this question and 91 answers were left blank. The most commonly named advantages in using veterinary naturopathy and complementary medicine were the expansion of treatment modalities (73.5%, n = 566 of total 770), customer satisfaction (70.8%, n = 545) and lower side effects (63.2%, n = 487). The ambiguity of studies, as well as the unclear evidence of mode of action and effectiveness (62.1%, n = 483) and high expectations of owners (50.5%, n = 393) were the disadvantages mentioned most frequently. Classic homoeopathy, in particular, has been named in this context (78.4%, n = 333 of total 425). Age, gender, and type of employment showed a statistically significant impact on the use of naturopathy and complementary medicine by veterinarians (p < 0.001). The university of final graduation showed a weaker but still statistically significant impact (p = 0.027). Users of veterinary naturopathy and complementary medicine tended to be older, female, self-employed and a higher percentage of them completed their studies at the University of Berlin. The working environment (rural or urban space) showed no statistical impact on the veterinary naturopathy or complementary medicine profession. Conclusion This is the first study to provide German data on the actual use of naturopathy and complementary medicine in small animal science. Despite a potential bias due to voluntary participation, it shows a large number of applications for various indications. Homoeopathy was mentioned most frequently as the treatment option with the most potential disadvantages. However, it is also the most frequently used treatment option in this study. The presented study, despite its restrictions, supports the need for a discussion about evidence, official regulations, and the need for acknowledged qualifications because of the widespread application of veterinary naturopathy and complementary medicine. More data regarding the effectiveness and the mode of action is needed to enable veterinarians to provide evidence-based advice to pet owners.

ZusammenfassungNaturheilkundliche und komplementärmedizinische Verfahren finden auch in der Tiermedizin zunehmend Anwendung. Ein einheitliches Verständnis ihrer Inhalte und Definitionen stellt die Basis einer gelungenen Kommunikation zwischen Tierhalter und Tierarzt dar. Der Artikel gibt einen Überblick über die vorhandenen Definitionen und Inhalte von tiermedizinischer Naturheilkunde und Komplementärmedizin sowie den ihnen zugeordneten Verfahren. Zur Naturheilkunde gehören Phytotherapie, ausleitende Verfahren, Hydrotherapie, Thermotherapie, Elektrotherapie, manuelle Therapie/Chiropraktik/Osteopathie sowie die Ernährungstherapie. Als komplementärmedizinische Verfahren gelten Homöopathie, Homotoxikologie, Traditionelle Chinesische Medizin inklusive Akupunktur und chinesischer Kräutermedizin, Neuraltherapie, Organotherapie sowie die Bachblütentherapie. Die Evidenzgrade der vorhandenen verfahrensspezifischen Fachliteratur sowie die Möglichkeiten von Zertifizierungen differieren stark. Die Akupunktur weist dabei die bisher größte Datenbasis mit teils hohem Evidenzniveau auf.

Background: The use and interest in veterinary naturopathy and complementary medicine is increasing and modes of treatment are diverse. To this point, only a few data on the German situation in small animal medicine exist. Material and Methods: An online research of 1083 German veterinary homepages for contents of veterinary naturopathy and complementary medicine was performed in September and October 2017. “Veterinarian” and “Chamber of Veterinary Surgeons” were used as search items. Homepages of small animal medicine were included. They were surveyed for modes of complementary and naturopathic treatments and corresponding qualifications of the offering veterinarian. Data were collected and processed using Excel 2013 Version 15.0. Afterwards, a descriptive data analysis was performed. Results: 60.7 % (n = 657) of homepages showed contents of veterinary naturopathy and complementary medicine. The highest percentage was found in the Chamber of Veterinary Surgeons of Saarland (91.7 %, n = 11 out of 12). Homeopathy was cited most frequently (58 %, n = 381). Out of all homepages with relevant content, 31.4 % (n = 206) gave information about user qualifications, with continuous education programs named most frequently (52.9 %, n = 109). Conclusion: The given data illustrate the high number of German veterinary homepages with contents of veterinary naturopathy and complementary medicine, corresponding to actual data of a high usage in veterinary and human medicine. Therefore further scientific research in this field seems reasonable. Modes of treatment and qualifications are highly diverse and despite of controversial public discussions, homeopathy was the most frequently cited treatment modality on German veterinary homepages.