Even the vibe between vet and pet is evaluated in veterinary offices offering traditional Chinese medicine such as acupuncture and herbal remedies.

Animals are typically not sedated for acupuncture, so a calm, amiable rapport is a must when inserting needles and otherwise assessing an animal’s health.

"Our energy, the veterinarian’s energy is important to connect to the patient," said Dr. Lei­anne K. Lee Loy, a vet at VCA University Animal Hospital in Manoa. Noting that some pets can feel "bombarded" by a tone of voice or just the swing of a door, she checks her own demeanor before entering an examination room.

Before prescribing a treatment, such as Chinese herbs, "we talk about what are the diseases that we’re looking at," she said. "What are the patients like at home? What types of surfaces do they like? Cold? Warm? Do they pant? What sort of food do they eat?

"There’s a lot of interaction to get to know each patient. Then we go into the physical exam. We’re looking at the patient, feeling the patient — checking pulses, tongue color — and then we start to talk about the care of the patient."

While both Eastern and Western approaches to veterinary medicine hold up prevention as the key to good health, traditional Chinese medicine stresses "treating the individual as a whole" over tackling symptoms with quick fixes such as antibiotics, Lee Loy said. In her office an initial Western-style exam for an ailing pet might last 30 minutes, while an exam that folds in Eastern-style methods could take an hour.

"It’s about giving family members quality-of-life" options, she said of using both approaches. "That’s what I like about bringing the two worlds together."

Makai Animal Clinic Kailua’s Dr. Wendy Asato dedicates most of her work week to acupuncture care. For Asato, who started her practice 11 years ago, Eastern medicine has always been a part of her life. "I go to see my acupuncturist before I see an M.D." for everyday concerns, from colds to skin rashes, she said.

On practicing acupuncture on pets, "it’s harder on animals because you can’t just say, ‘Can you open your mouth and let me see your tongue?’"

In such moments rapport makes a difference. "You have to find a way of looking at the tongue without prying open the mouth because then it will change color," Asato said.

In traditional Chinese medicine the tongue is a map that corresponds to parts of the body. The tip is connected to the heart, for example. Tongue color, texture and coating are part of a diagnostic checklist. Also on the list are a dozen pulses, checked for varying depths, thickness and quality.

During an acupuncture session, fine needles are inserted into the skin at points called meridians. The needles stimulate nerves that signal the brain to block pain. Typically, animals can relax and might even become sleepy during a treatment, Asato said.

Over the last decade, her office has seen a steady increase in pet owners wanting to learn about traditional Chinese veterinary medicine, which includes acupuncture, herbal medicine, a form of massage that incorporates techniques similar to those used in chiropractic and shi­a­tsu practices, physical movement and exercise, and food therapy.

"I’m impressed with the ones that bring their puppies and kittens in because you know they’re serious about it," Asato said. The more typical new patient, though, is an aging animal with multiple medical problems.

Some families turn to Asato when their pet can no longer tolerate Western drugs, such as anti-inflammatory pills, without a high risk of harmful side effects, such as liver or kidney damage.

"Among the success stories, Lee Loy said, is the case of an older dog with a knee injury. Its owners opted for acupuncture while deciding whether to pursue surgery. "It did help to alleviate the pain," she recalled. "It didn’t take away the fact that surgery was eventually needed, but it gave them time" to think through health care decisions.

Another pet — diagnosed with a fast-growing and painful bone cancer — was treated with Chinese herbs. "With herbs we were able to extend a good quality of life" for about six months beyond the initial expectations, Lee Loy said. "They’re really happy that they had more time" before the pet succumbed.

The American Veterinary Medical Association guidelines for alternative and complementary care, first issued 15 years ago, describe acupuncture as an "integral part of veterinary medicine." Still, during the mid-1990s, when Lee Loy began her practice after graduating from the University of Missouri-Columbia, it was largely unheard of for vet schools to offer courses delving into traditional Chinese methods.

These days, Lee Loy says of training in Eastern approaches, "veterinarians are asking for it," and courses are routinely offered at various veterinary schools and through continuing-education programs for licensed vets.

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Maureen O’Connell is a freelance journalist in Honolulu.