The first, most important step with CIVM is establishing a clinical diagnosis. Clients requesting advice on the use and integration of CIVM should first have their pets evaluated by a veterinarian. When a diagnosis is established, the veterinarian should evaluate the appropriateness of CIVM use along with conventional treatment, present all available conventional and CIVM treatment options to the client, and discuss each specific modalitys advantages and disadvantages.
Most CIVM therapies tend to be safe with relatively low adverse effect profiles, particularly in the hands of experienced integrative veterinarians. Some therapies can be potentially dangerous,6,7 however, or may interfere with the therapeutic effect of the conventional treatment when they are combined.7 For example, using low-level laser therapy for a tumor may instead stimulate tumor growth.7 Also, for example, the herbs Ginkgo biloba, Angelica sinensis, or Salvia miltiorrhiza may interact with anticoagulants and thus increase bleeding tendency.8 Potential benefits should always be assessed to outweigh any potential risks before using these therapies.
Client consent should be obtained before any treatment. Once treatment has started, it is important to look for any adverse effects and to evaluate the disease progress and the patients condition. If the patient fails to improve or experiences undesired effects, the veterinarian must reevaluate the patient and decide whether an additional work-up is needed or the treatment modality should be changed.
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