Traditional Chinese Herbal Veterinary Medicine - What's the Evidence?
In veterinary training, we are taught that randomised, double-blind, placebo-controlled trials (RDBPCTs) represent the gold standard of evidence. These trials are extremely valuable and form the backbone of modern pharmaceutical medicine. However, it is important to understand that not all therapies are equally suited to this research model, and this is particularly true for Traditional Chinese Herbal Veterinary Medicine (TCVM).
This does not mean Chinese herbal medicine lacks evidence. It means the type of evidence looks different, and must be interpreted appropriately.
Why Chinese herbal medicine doesn’t resemble pharmaceutical drugs.
Most pharmaceutical drugs are:
• Single, isolated chemical compounds
• Designed to target one receptor or biochemical pathway
• Used in fixed doses for a defined condition
This design aligns very well with double-blind placebo trials, which are built to isolate one variable and measure a direct cause-and-effect relationship.
Chinese herbal formulas, by contrast, are:
• Multi-component blends containing dozens to hundreds of naturally occurring bioactive compounds
• Designed to act on multiple physiological systems simultaneously
• Often adjusted to suit the individual animal and modified over time.
Because the intervention itself is complex, expecting herbal formulas to behave like single-compound drugs is not comparing like with like.
The role of synergy and balance.
Chinese herbal formulas are intentionally constructed so that:
• Some herbs address the primary clinical issue
• Others support digestion, circulation, immunity, or resilience
• Others reduce potential adverse effects or improve tolerance
For example, a formula used in heart disease may include herbs that:
• Support cardiac function
• Improve circulation
• Reduce inflammation
• Calm anxiety or stress
• Protect digestive function
Testing these herbs individually may fail to capture the therapeutic effect of the formula as a whole, because much of the benefit comes from synergy and balance between components.
Why there are fewer double-blind trials.
Double-blind trials are extremely expensive.
High-quality RDBPCTs typically cost millions to tens of millions of dollars to design, run, analyse, and publish. These costs are usually borne by pharmaceutical companies, not individual clinicians or small manufacturers. Pharmaceutical research is driven by patentability. Drug companies invest in research where there is a clear path to:
• Patenting a single, novel compound
• Exclusivity of manufacture
• Financial return on investment
Traditional Chinese herbs are:
• Naturally occurring substances
• Often used for centuries
• Not easily patentable as single compounds
As a result, there is little commercial incentive for large pharmaceutical companies to fund expensive trials on whole herbs or traditional formulas, even when they are widely used and clinically promising.
The absence of large trials therefore reflects economic and structural barriers, not necessarily a lack of biological activity or clinical value.
What kinds of evidence do exist?
Although pharmaceutical-style trials are limited, TCVM is supported by several other forms of evidence:
Historical and documented clinical use.
Many Chinese herbal formulas have been used continuously for hundreds to thousands of years, with detailed written records describing indications, dosing, and safety. While historical use is not the same as a modern clinical trial, consistent long-term use without widespread harm is meaningful, particularly when patterns of benefit are reproducible.
Modern scientific research
There is a growing body of:
• Laboratory studies identifying active compounds
• Mechanistic research showing effects on inflammation, immunity, circulation, metabolism, and organ function
• Small clinical trials and observational studies in both humans and animals
These studies often demonstrate biological plausibility, even when large double-blind trials are absent.
Veterinary clinical experience
Many veterinarians use Chinese herbal medicine:
• As an adjunct to conventional treatments
• When standard therapies are insufficient or poorly tolerated
• To support quality of life in chronic or degenerative disease
When consistent clinical responses are observed across many practitioners and patients, this represents a meaningful form of real-world evidence — particularly for low-risk therapies.
Safety, risk, and proportional evidence.
Evidence standards should consider risk as well as benefit.
Pharmaceutical drugs often:
• Have high potency
• Carry a higher risk of adverse effects
• Have narrow safety margins
This justifies very large and expensive trials.
Most professionally prescribed Chinese herbal formulas:
• Have wide therapeutic windows
• Are used at relatively low toxicity
• Are adjusted or discontinued as the patient changes
Requiring identical evidence thresholds for low-risk therapies as for high-risk drugs does not reflect how clinical decisions are made in real veterinary practice.
Evidence-based medicine is broader than one study type.
Modern evidence-based medicine is not based on a single type of study. It integrates:
Best available research evidence
Clinical expertise
The patient’s (and owner’s) values, needs, and circumstances
Chinese herbal veterinary medicine often draws more heavily on the latter two, while being increasingly informed by scientific research.
Traditional Chinese Herbal Veterinary Medicine is not unscientific — it is scientifically complex. Its multi-component, individualised nature makes it difficult to study using pharmaceutical trial designs, and economic realities limit large-scale trials. However, this does not mean it lacks evidence or value.
When prescribed by a trained veterinarian using quality-controlled herbs, Chinese herbal medicine can be a reasonable, evidence-informed adjunct to conventional veterinary care — particularly for chronic disease management, supportive therapy, and quality-of-life improvement.
