Herbal and acupuncture adverse reactions survey.

100% of survey complete.

This survey will only take 5-10 minutes, please send it to other TCVM veterinarians to help collect a relevant number of responses to help the TCVM community.

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* 1. Please provide your name and email (this information will be kept confidential)

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* 2. What species do you practice on?

canine

feline

avian

rabbit

equine

bovine

other (please specify)

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* 3. For how many years have you practiced Chinese herbal medicine?

Insert number of years

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* 4. How many cases have you treated with Chinese herbal medicine so far?

Insert approximate number

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* 5. What is the percentage of your patients using Chinese herbal medicine?

>90%

80-90%

70-80%

60-70%

50-60%

40-50%

30-40%

20-30%

10-20%

10%

I don't know

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* 6. Have your patients suffered adverse reactions to Chinese herbal medicine?

yes (enter approximate number)

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* 7. What is the percentage of your patients experiencing adverse reactions to herbal medicine?

>90%

80-90%

70-80%

60-70%

50-60%

40-50%

30-40%

20-30%

10-20%

10%

I don't know

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* 8. How many patients did you treat with oral administration of Chinese herbal medicine in the last 30 days?

Please provide number, if none type 0

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* 9. How many patients did you treat with oral administration of Chinese herbal medicine in the last 12 months?

>300

250-300

200-250

150-200

100-150

50-100

<50

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* 10. How many patients reported herbal adverse reactions in the last 30 days?

Please provide number, if none type 0

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* 11. How many patients reported herbal adverse reactions in the last 12 months?

Please provide number, if none type 0

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* 12. List how many of the following adverse reactions your patients have experienced in the last 30 days?

bloating

diarrhea

bloody diarrhea

hematemesis

skin rash

behavioral changes

vomiting

ataxia

elevated liver enzymes

nausea

inappetence

pruritus

other (specify in next question)

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* 13. If you chose "other" in the previous question, please specify

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* 14. What herbal formula/s caused adverse reactions? And what reactions? (you can choose more than one formula and more than one reaction)

	GI	skin	kidney	liver	behavioral	nervous system
New Xiang Ru San [JT]	New Xiang Ru San [JT] GI	New Xiang Ru San [JT] skin	New Xiang Ru San [JT] kidney	New Xiang Ru San [JT] liver	New Xiang Ru San [JT] behavioral	New Xiang Ru San [JT] nervous system
Double P 2 [JT]	Double P 2 [JT] GI	Double P 2 [JT] skin	Double P 2 [JT] kidney	Double P 2 [JT] liver	Double P 2 [JT] behavioral	Double P 2 [JT] nervous system
Max Formula [JT]	Max Formula [JT] GI	Max Formula [JT] skin	Max Formula [JT] kidney	Max Formula [JT] liver	Max Formula [JT] behavioral	Max Formula [JT] nervous system
Stomach Happy [JT]	Stomach Happy [JT] GI	Stomach Happy [JT] skin	Stomach Happy [JT] kidney	Stomach Happy [JT] liver	Stomach Happy [JT] behavioral	Stomach Happy [JT] nervous system
Zhen Xin San	Zhen Xin San GI	Zhen Xin San skin	Zhen Xin San kidney	Zhen Xin San liver	Zhen Xin San behavioral	Zhen Xin San nervous system
Dock’s Formula [JT]	Dock’s Formula [JT] GI	Dock’s Formula [JT] skin	Dock’s Formula [JT] kidney	Dock’s Formula [JT] liver	Dock’s Formula [JT] behavioral	Dock’s Formula [JT] nervous system
External Wind [JT]	External Wind [JT] GI	External Wind [JT] skin	External Wind [JT] kidney	External Wind [JT] liver	External Wind [JT] behavioral	External Wind [JT] nervous system
Damp Heat Skin [JT]	Damp Heat Skin [JT] GI	Damp Heat Skin [JT] skin	Damp Heat Skin [JT] kidney	Damp Heat Skin [JT] liver	Damp Heat Skin [JT] behavioral	Damp Heat Skin [JT] nervous system
Hindquarter Weakness [JT]	Hindquarter Weakness [JT] GI	Hindquarter Weakness [JT] skin	Hindquarter Weakness [JT] kidney	Hindquarter Weakness [JT] liver	Hindquarter Weakness [JT] behavioral	Hindquarter Weakness [JT] nervous system
Wei Qi Booster [JT]	Wei Qi Booster [JT] GI	Wei Qi Booster [JT] skin	Wei Qi Booster [JT] kidney	Wei Qi Booster [JT] liver	Wei Qi Booster [JT] behavioral	Wei Qi Booster [JT] nervous system
Cervical Formula [JT]	Cervical Formula [JT] GI	Cervical Formula [JT] skin	Cervical Formula [JT] kidney	Cervical Formula [JT] liver	Cervical Formula [JT] behavioral	Cervical Formula [JT] nervous system
Suo Quan Wan	Suo Quan Wan GI	Suo Quan Wan skin	Suo Quan Wan kidney	Suo Quan Wan liver	Suo Quan Wan behavioral	Suo Quan Wan nervous system
Body Sore [JT]	Body Sore [JT] GI	Body Sore [JT] skin	Body Sore [JT] kidney	Body Sore [JT] liver	Body Sore [JT] behavioral	Body Sore [JT] nervous system
Bu Fei San	Bu Fei San GI	Bu Fei San skin	Bu Fei San kidney	Bu Fei San liver	Bu Fei San behavioral	Bu Fei San nervous system
Lily Combination [JT]	Lily Combination [JT] GI	Lily Combination [JT] skin	Lily Combination [JT] kidney	Lily Combination [JT] liver	Lily Combination [JT] behavioral	Lily Combination [JT] nervous system
Bu Yang Huan Wu	Bu Yang Huan Wu GI	Bu Yang Huan Wu skin	Bu Yang Huan Wu kidney	Bu Yang Huan Wu liver	Bu Yang Huan Wu behavioral	Bu Yang Huan Wu nervous system
Happy Earth [JT]	Happy Earth [JT] GI	Happy Earth [JT] skin	Happy Earth [JT] kidney	Happy Earth [JT] liver	Happy Earth [JT] behavioral	Happy Earth [JT] nervous system
Si Jun Zi Tang (Four Gentlemen)	Si Jun Zi Tang (Four Gentlemen) GI	Si Jun Zi Tang (Four Gentlemen) skin	Si Jun Zi Tang (Four Gentlemen) kidney	Si Jun Zi Tang (Four Gentlemen) liver	Si Jun Zi Tang (Four Gentlemen) behavioral	Si Jun Zi Tang (Four Gentlemen) nervous system
Shen Calmer [JT]	Shen Calmer [JT] GI	Shen Calmer [JT] skin	Shen Calmer [JT] kidney	Shen Calmer [JT] liver	Shen Calmer [JT] behavioral	Shen Calmer [JT] nervous system
Mai Men Dong San (Ophiopogon Formula)	Mai Men Dong San (Ophiopogon Formula) GI	Mai Men Dong San (Ophiopogon Formula) skin	Mai Men Dong San (Ophiopogon Formula) kidney	Mai Men Dong San (Ophiopogon Formula) liver	Mai Men Dong San (Ophiopogon Formula) behavioral	Mai Men Dong San (Ophiopogon Formula) nervous system
Wind Toxin [JT]	Wind Toxin [JT] GI	Wind Toxin [JT] skin	Wind Toxin [JT] kidney	Wind Toxin [JT] liver	Wind Toxin [JT] behavioral	Wind Toxin [JT] nervous system
Rehmannia 11 [JT]	Rehmannia 11 [JT] GI	Rehmannia 11 [JT] skin	Rehmannia 11 [JT] kidney	Rehmannia 11 [JT] liver	Rehmannia 11 [JT] behavioral	Rehmannia 11 [JT] nervous system
Shi Quan Da Bu	Shi Quan Da Bu GI	Shi Quan Da Bu skin	Shi Quan Da Bu kidney	Shi Quan Da Bu liver	Shi Quan Da Bu behavioral	Shi Quan Da Bu nervous system
Di Tan Tang	Di Tan Tang GI	Di Tan Tang skin	Di Tan Tang kidney	Di Tan Tang liver	Di Tan Tang behavioral	Di Tan Tang nervous system
Li Wei DI Huang (Rehmannia 6)	Li Wei DI Huang (Rehmannia 6) GI	Li Wei DI Huang (Rehmannia 6) skin	Li Wei DI Huang (Rehmannia 6) kidney	Li Wei DI Huang (Rehmannia 6) liver	Li Wei DI Huang (Rehmannia 6) behavioral	Li Wei DI Huang (Rehmannia 6) nervous system
Red Front Door [JT]	Red Front Door [JT] GI	Red Front Door [JT] skin	Red Front Door [JT] kidney	Red Front Door [JT] liver	Red Front Door [JT] behavioral	Red Front Door [JT] nervous system
Rehmannia 14 [JT]	Rehmannia 14 [JT] GI	Rehmannia 14 [JT] skin	Rehmannia 14 [JT] kidney	Rehmannia 14 [JT] liver	Rehmannia 14 [JT] behavioral	Rehmannia 14 [JT] nervous system
Liver Happy [JT]	Liver Happy [JT] GI	Liver Happy [JT] skin	Liver Happy [JT] kidney	Liver Happy [JT] liver	Liver Happy [JT] behavioral	Liver Happy [JT] nervous system
Ding Xian Wan	Ding Xian Wan GI	Ding Xian Wan skin	Ding Xian Wan kidney	Ding Xian Wan liver	Ding Xian Wan behavioral	Ding Xian Wan nervous system
Stasis Breaker [JT]	Stasis Breaker [JT] GI	Stasis Breaker [JT] skin	Stasis Breaker [JT] kidney	Stasis Breaker [JT] liver	Stasis Breaker [JT] behavioral	Stasis Breaker [JT] nervous system
Jin Suo Gu Jing	Jin Suo Gu Jing GI	Jin Suo Gu Jing skin	Jin Suo Gu Jing kidney	Jin Suo Gu Jing liver	Jin Suo Gu Jing behavioral	Jin Suo Gu Jing nervous system
Tendon Ligament [JT]	Tendon Ligament [JT] GI	Tendon Ligament [JT] skin	Tendon Ligament [JT] kidney	Tendon Ligament [JT] liver	Tendon Ligament [JT] behavioral	Tendon Ligament [JT] nervous system
Di Gu Pi	Di Gu Pi GI	Di Gu Pi skin	Di Gu Pi kidney	Di Gu Pi liver	Di Gu Pi behavioral	Di Gu Pi nervous system
Coix Formula [JT]	Coix Formula [JT] GI	Coix Formula [JT] skin	Coix Formula [JT] kidney	Coix Formula [JT] liver	Coix Formula [JT] behavioral	Coix Formula [JT] nervous system
Loranthus Powder [JT]	Loranthus Powder [JT] GI	Loranthus Powder [JT] skin	Loranthus Powder [JT] kidney	Loranthus Powder [JT] liver	Loranthus Powder [JT] behavioral	Loranthus Powder [JT] nervous system
Equine Du Huo [JT]	Equine Du Huo [JT] GI	Equine Du Huo [JT] skin	Equine Du Huo [JT] kidney	Equine Du Huo [JT] liver	Equine Du Huo [JT] behavioral	Equine Du Huo [JT] nervous system
Epimedium Powder [JT]	Epimedium Powder [JT] GI	Epimedium Powder [JT] skin	Epimedium Powder [JT] kidney	Epimedium Powder [JT] liver	Epimedium Powder [JT] behavioral	Epimedium Powder [JT] nervous system

Other (please specify formula and/or adverse reaction if not in the above list)

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* 15. For how many years have you practiced acupuncture?

Insert number of years

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* 16. How many cases have you treated with acupuncture so far?

Insert approximate number

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* 17. Has any of your patients suffered an adverse reaction to acupuncture?

yes (insert number)

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* 18. What percentage of your patients showed weakness post-treatment?

	none	< 5% of cases	5-10% of cases	10% of cases	25% of cases	50% of cases	75% of cases	> 75% of cases
weakness post-treatment for less than 24 hours	weakness post-treatment for less than 24 hours none	weakness post-treatment for less than 24 hours < 5% of cases	weakness post-treatment for less than 24 hours 5-10% of cases	weakness post-treatment for less than 24 hours 10% of cases	weakness post-treatment for less than 24 hours 25% of cases	weakness post-treatment for less than 24 hours 50% of cases	weakness post-treatment for less than 24 hours 75% of cases	weakness post-treatment for less than 24 hours > 75% of cases
weakness post-treatment for more than 24 hours	weakness post-treatment for more than 24 hours none	weakness post-treatment for more than 24 hours < 5% of cases	weakness post-treatment for more than 24 hours 5-10% of cases	weakness post-treatment for more than 24 hours 10% of cases	weakness post-treatment for more than 24 hours 25% of cases	weakness post-treatment for more than 24 hours 50% of cases	weakness post-treatment for more than 24 hours 75% of cases	weakness post-treatment for more than 24 hours > 75% of cases

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* 19. What is the percentage of bent needles in your practice?

	>90%	80-90%	70-80%	60-70%	50-60%	40-50%	40-50%	30-40%	20-30%	10-20%	10%	5%	3%	1%	0	I don't practice on this specie
equine	equine >90%	equine 80-90%	equine 70-80%	equine 60-70%	equine 50-60%	equine 40-50%	equine 40-50%	equine 30-40%	equine 20-30%	equine 10-20%	equine 10%	equine 5%	equine 3%	equine 1%	equine 0	equine I don't practice on this specie
bovine	bovine >90%	bovine 80-90%	bovine 70-80%	bovine 60-70%	bovine 50-60%	bovine 40-50%	bovine 40-50%	bovine 30-40%	bovine 20-30%	bovine 10-20%	bovine 10%	bovine 5%	bovine 3%	bovine 1%	bovine 0	bovine I don't practice on this specie
canine	canine >90%	canine 80-90%	canine 70-80%	canine 60-70%	canine 50-60%	canine 40-50%	canine 40-50%	canine 30-40%	canine 20-30%	canine 10-20%	canine 10%	canine 5%	canine 3%	canine 1%	canine 0	canine I don't practice on this specie
feline	feline >90%	feline 80-90%	feline 70-80%	feline 60-70%	feline 50-60%	feline 40-50%	feline 40-50%	feline 30-40%	feline 20-30%	feline 10-20%	feline 10%	feline 5%	feline 3%	feline 1%	feline 0	feline I don't practice on this specie
rabbit	rabbit >90%	rabbit 80-90%	rabbit 70-80%	rabbit 60-70%	rabbit 50-60%	rabbit 40-50%	rabbit 40-50%	rabbit 30-40%	rabbit 20-30%	rabbit 10-20%	rabbit 10%	rabbit 5%	rabbit 3%	rabbit 1%	rabbit 0	rabbit I don't practice on this specie
avian	avian >90%	avian 80-90%	avian 70-80%	avian 60-70%	avian 50-60%	avian 40-50%	avian 40-50%	avian 30-40%	avian 20-30%	avian 10-20%	avian 10%	avian 5%	avian 3%	avian 1%	avian 0	avian I don't practice on this specie
other species	other species >90%	other species 80-90%	other species 70-80%	other species 60-70%	other species 50-60%	other species 40-50%	other species 40-50%	other species 30-40%	other species 20-30%	other species 10-20%	other species 10%	other species 5%	other species 3%	other species 1%	other species 0	other species I don't practice on this specie

Specify most common acupuncture point/s for bent needles

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* 20. Have you ever had a broken needle?

	no	1 case	2 cases	3 cases	4 cases	5 cases	6 cases	7 cases	8 cases	9 cases	10 cases	more than 10	I don't practice on this specie
equine	equine no	equine 1 case	equine 2 cases	equine 3 cases	equine 4 cases	equine 5 cases	equine 6 cases	equine 7 cases	equine 8 cases	equine 9 cases	equine 10 cases	equine more than 10	equine I don't practice on this specie
bovine	bovine no	bovine 1 case	bovine 2 cases	bovine 3 cases	bovine 4 cases	bovine 5 cases	bovine 6 cases	bovine 7 cases	bovine 8 cases	bovine 9 cases	bovine 10 cases	bovine more than 10	bovine I don't practice on this specie
canine	canine no	canine 1 case	canine 2 cases	canine 3 cases	canine 4 cases	canine 5 cases	canine 6 cases	canine 7 cases	canine 8 cases	canine 9 cases	canine 10 cases	canine more than 10	canine I don't practice on this specie
feline	feline no	feline 1 case	feline 2 cases	feline 3 cases	feline 4 cases	feline 5 cases	feline 6 cases	feline 7 cases	feline 8 cases	feline 9 cases	feline 10 cases	feline more than 10	feline I don't practice on this specie
avian	avian no	avian 1 case	avian 2 cases	avian 3 cases	avian 4 cases	avian 5 cases	avian 6 cases	avian 7 cases	avian 8 cases	avian 9 cases	avian 10 cases	avian more than 10	avian I don't practice on this specie
rabbit	rabbit no	rabbit 1 case	rabbit 2 cases	rabbit 3 cases	rabbit 4 cases	rabbit 5 cases	rabbit 6 cases	rabbit 7 cases	rabbit 8 cases	rabbit 9 cases	rabbit 10 cases	rabbit more than 10	rabbit I don't practice on this specie
other species	other species no	other species 1 case	other species 2 cases	other species 3 cases	other species 4 cases	other species 5 cases	other species 6 cases	other species 7 cases	other species 8 cases	other species 9 cases	other species 10 cases	other species more than 10	other species I don't practice on this specie

If yes, provide acupuncture point/s for broken needle and size of needle

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* 21. If any of your patients has swallowed a needle, please choose below

	1 case	2 cases	3 cases	4 cases	5 cases	6 cases	7 cases	8 cases	9 cases	10 cases	more than 10
needle passed through GI in 2 days	needle passed through GI in 2 days 1 case	needle passed through GI in 2 days 2 cases	needle passed through GI in 2 days 3 cases	needle passed through GI in 2 days 4 cases	needle passed through GI in 2 days 5 cases	needle passed through GI in 2 days 6 cases	needle passed through GI in 2 days 7 cases	needle passed through GI in 2 days 8 cases	needle passed through GI in 2 days 9 cases	needle passed through GI in 2 days 10 cases	needle passed through GI in 2 days more than 10
needle passed through GI in 3 days	needle passed through GI in 3 days 1 case	needle passed through GI in 3 days 2 cases	needle passed through GI in 3 days 3 cases	needle passed through GI in 3 days 4 cases	needle passed through GI in 3 days 5 cases	needle passed through GI in 3 days 6 cases	needle passed through GI in 3 days 7 cases	needle passed through GI in 3 days 8 cases	needle passed through GI in 3 days 9 cases	needle passed through GI in 3 days 10 cases	needle passed through GI in 3 days more than 10
needle passed through GI in 4 days	needle passed through GI in 4 days 1 case	needle passed through GI in 4 days 2 cases	needle passed through GI in 4 days 3 cases	needle passed through GI in 4 days 4 cases	needle passed through GI in 4 days 5 cases	needle passed through GI in 4 days 6 cases	needle passed through GI in 4 days 7 cases	needle passed through GI in 4 days 8 cases	needle passed through GI in 4 days 9 cases	needle passed through GI in 4 days 10 cases	needle passed through GI in 4 days more than 10
needle passed through GI in 5 days	needle passed through GI in 5 days 1 case	needle passed through GI in 5 days 2 cases	needle passed through GI in 5 days 3 cases	needle passed through GI in 5 days 4 cases	needle passed through GI in 5 days 5 cases	needle passed through GI in 5 days 6 cases	needle passed through GI in 5 days 7 cases	needle passed through GI in 5 days 8 cases	needle passed through GI in 5 days 9 cases	needle passed through GI in 5 days 10 cases	needle passed through GI in 5 days more than 10
needle passed through GI in 6 days	needle passed through GI in 6 days 1 case	needle passed through GI in 6 days 2 cases	needle passed through GI in 6 days 3 cases	needle passed through GI in 6 days 4 cases	needle passed through GI in 6 days 5 cases	needle passed through GI in 6 days 6 cases	needle passed through GI in 6 days 7 cases	needle passed through GI in 6 days 8 cases	needle passed through GI in 6 days 9 cases	needle passed through GI in 6 days 10 cases	needle passed through GI in 6 days more than 10
needle was not recovered	needle was not recovered 1 case	needle was not recovered 2 cases	needle was not recovered 3 cases	needle was not recovered 4 cases	needle was not recovered 5 cases	needle was not recovered 6 cases	needle was not recovered 7 cases	needle was not recovered 8 cases	needle was not recovered 9 cases	needle was not recovered 10 cases	needle was not recovered more than 10

Patient/s signalment

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* 22. Has any of your patients suffered from bleeding post-acupuncture (not counting intentional hemoacupuncture)?

	no	< 5% of cases	5-10% of cases	10% of cases	25% of cases	50% of cases	> 50% of cases	I don't practice on this specie
equine	equine no	equine < 5% of cases	equine 5-10% of cases	equine 10% of cases	equine 25% of cases	equine 50% of cases	equine > 50% of cases	equine I don't practice on this specie
bovine	bovine no	bovine < 5% of cases	bovine 5-10% of cases	bovine 10% of cases	bovine 25% of cases	bovine 50% of cases	bovine > 50% of cases	bovine I don't practice on this specie
canine	canine no	canine < 5% of cases	canine 5-10% of cases	canine 10% of cases	canine 25% of cases	canine 50% of cases	canine > 50% of cases	canine I don't practice on this specie
feline	feline no	feline < 5% of cases	feline 5-10% of cases	feline 10% of cases	feline 25% of cases	feline 50% of cases	feline > 50% of cases	feline I don't practice on this specie
avian	avian no	avian < 5% of cases	avian 5-10% of cases	avian 10% of cases	avian 25% of cases	avian 50% of cases	avian > 50% of cases	avian I don't practice on this specie
rabbit	rabbit no	rabbit < 5% of cases	rabbit 5-10% of cases	rabbit 10% of cases	rabbit 25% of cases	rabbit 50% of cases	rabbit > 50% of cases	rabbit I don't practice on this specie
other species	other species no	other species < 5% of cases	other species 5-10% of cases	other species 10% of cases	other species 25% of cases	other species 50% of cases	other species > 50% of cases	other species I don't practice on this specie

If yes, provide most common acupuncture point/s

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* 23. Add anything you want to explain further

Thank you for participating in this survey and for your contribution to TCVM