Call it coincidence, confirmation bias, or a trend, but I once again ran into the issue of a specialist I refer to recommending a questionable therapy for one of my patients. I recently diagnosed a dog with a nasal cancer and sent him to a board-certified oncologist to consult of options for advanced therapy. The particular disease can’t be cured, but radiation and chemotherapy can have some symptomatic benefit and may prolong a reasonable quality of life. The owner, however, didn’t feel the possible benefits justified the risks and costs, which I think was a reasonable decision. So the oncologist was only able to offer minimal symptomatic care. He offered a non-steroidal anti-inflammatory for pain, and also told the owner to go to a human herbal remedy shop and find the Chinese herbal preparation yunnan paiyao to help with the intermittent nosebleeds the cancer was causing.
I expect specialists to be more cognizant of the need for evidence-based practice than general practitioners, but I am beginning to doubt the truth of this assumption. I accept that sometimes, when there is a compelling need to treat and no established effective treatment available or acceptable to the owner, it may be appropriate to try things that have a weak basis in basic or clinical evidence. However, I am still concerned about the wisdom of recommending therapies that we don’t have at least some reasonable evidence are safe or effective.
Absence of evidence is not, of course, proof something doesn’t work. But it is absence of any good reason to think it does. And the reverse is true for safety. Absence of evidence of harm does not mean it isn’t harmful, only that we don’t know whether it is or not. Yet anecdotal experience is used to justify both safety and efficacy despite the clear evidence of history that this isn’t reliable. Of course, this logic is preferentially applied to CAM therapies. If clinical testing of a pharmaceutical company medicine finds no significant side effects, and then rare harm does appear once the drug is in widespread use, this is trumpeted as a failure of the whole scientific testing paradigm and proof of the evil venality of drug companies and the innately poisonous nature of their products. Yet we seem very comfortable prescribing herbal products about which almost nothing is known concerning safety or efficacy, with the assumption that they must be safe and that even if the only evidence they work is anecdotal at least we they can’t do any harm.
So what is yunnan paiyao, and what is the evidence for or against it? It is an herbal concoction apparently invented in China in the early 20th century, and the details of the ingredients are still kept secret. However, it is widely considered to consist primarily of Panax notoginseng of pseudoginseng root, with a number of other possible plant ingredients. Right away I wonder at the wisdom of prescribing a remedy when no one knows exactly what is in it. Can you imagine a major pharmaceutical company getting away with selling a drug that doctors actually prescribed without disclosing the actual ingredients?! And given the well-documented problem of heavy metal and pharmaceutical contamination of Chinese herbal remedies, and the general inconsistency of such preparations, it is remarkable that any doctor, much less a boarded specialist, would feel comfortable assuming the safety of such a product based on personal experience and anecdotes.
There have been a few papers published in China and in some alternative medicine publications that show the substance has some influence on platelet aggregation, an important step in blood clotting. However, you can mix sand or many other substances in a test tube with platelets and they will activate. One of the reasons it is so hard to make a safe artificial heart is that it’s tough to find substances that don’t trigger platelet aggregation. Some studies have compared the effect of yunnan paiyao with wheat flour or other substances to show it is more likely to cause clotting than these others, but the reliability of the tests and the choice of substances doesn’t make a very convincing case. And we have to remember the problem with the reliability of different sources of published research. Publication bias (the publishing of only positive results and “round-filing” of negative studies) is a problem everywhere. But Chinese journals almost never publish negative studies, and CAM journals are especially prone to select only those papers for publication that support the kinds of therapies the journals were started to promote.
The same issue arises in considering the few clinical trials in humans. A small number of trials with a small number of patients conducted and/or published in low reliability sources might be enough to justify further research, but not to justify widespread clinical use of the product. And, of course, the testimonials and anecdotes of clinicians and users have the same lack of reliability. If the product has been in use for over 100 years, and in that time we have only a handful of small studies of it, I think that is fair reason to be skeptical. If the drug truly has a dramatic impact on bleeding, topically or orally, it shouldn’t be difficult to conduct and publish a well-designed trial for a mainstream journal. Even one such trial would doubtless excite enough interest, through NCCAM or private industry, to stimulate more. Whether this has never been done because the proponents of such therapies don’t see the need for such evidence, or because the drug doesn’t truly have enough promise to survive such a test, is an open question.
Finally, I have found only two published veterinary trials investigating yunnan paiyao. An abstract presented at the 2002 International Veterinary Emergency and Critical Care Symposium took a group of 6 healthy ponies, and anesthetized them twice to check activated clotting time (ACT) and template bleeding time (TBT). The ACT is a moderately reliable test of blood clotting, though it can be affected by temperature, how vigorously and consistently the test tube is shaken, and a number of other factors. The TBT is a much less reliable and more subjective test in which a lancet is used to cut the patient (usually on the oral mucosa) and the time it takes for the cut to stop bleeding is measured.
The only difference reported in methods between the control trial and the yunnan paiyao trial was the position of the patients. They were on their side in the control trial and on their back in the test trial. I wonder if this might affect TBT since the blood flow to different parts of the body is affected by body position, but there isn’t any information in the abstract to determine if this is a factor. The study reported no difference in the ACT value with or without the yunnan paiyao but did report a non-chance difference in the TBT.
The other trial was a placebo-controlled trial of yunnan paiyao and another herbal preparation called Single Immortal using five Thoroughbred horses. The horses were run on a treadmill after having received either one of the herbal preparations or the placebo (cornstarch) orally twice a day for 3 days before the experiment. A number of variables were measured, with the main goal to see if there was any effect on exercised-induced pulmonary hemorrhage (EIPH), bleeding in the lungs during exercise. No effect of either remedy on EIPH was seen.
So we have a treatment with uncertain and unregulated ingredients, no demonstrated plausible mechanism of action, a few in vitro and lab animal studies in journals of questionable reliability, a few small human clinical trials in similarly questionable sources, and two very small veterinary trials in equids which found no effect except possibly on a poorly reliable and subjective test of blood clotting. At the same time, we have almost no published reports of adverse effects. There is one case report in a Chinese journal of a contact dermatitis reaction and some suggestion that high doses or chronic use may affect bone marrow cells. And we have a well-established history of toxic contamination and poor quality control in Chinese herbal remedies in general.
For me, this information clearly shows the oncologist’s use of this preparation in my patient to me essentially an uncontrolled experiment with no reasonable assurance of safety or efficacy. It is disturbing to me and certainly shakes my confidence in the judgment and recommendations of this particular specialist, though I fear he may not be at all exceptional but simply part of a larger phenomenon in which anecdote, personal experience, and “expert” opinion is given undue weight and the need for more reliable evidence is underestimated in veterinary medicine.
References:
Epp TS, McDonough P, Padilla DJ, et al. The effect of herbal supplementation on the severity of exercise-induced pulmonary haemorrhage. Equine and Comparative Exercise Physiology 2005;2:17-25.
Graham L. Yunnan Paiyao–Where’s the clinical evidence? Veterinary Botanical Medicine Association Symposium Archive 2005. Available at: http://www.vin.com/Members/proceedings/Proceedings.plx?CID=VBMA&PID=13730&Print=1&O=VIN
Graham L, Farnsworth K, Cary J. The effect of yunnan baiyao on the template bleeding time and activated clotting time in healthy halothane anesthetized ponies. Proceedings International Veterinary Emergency and Critical Care Symposium 2002, San Antonio, TX. Journal of Veterinary Emergency and Critical Care 2002;12(4):279. Abstract only.
Robinson N. Yunnan Paiyao; The following references come from Dr. Robinson’s document:
1 Bergner P. Panax notoginseng Yunnan bai yao): A must for the first aid kit. Medical Herbalism. 10-31-94 6(3):12.
2 Fratkin J. Chinese Herbal Patent Formulas – A Practical Guide. Santa Fe: Shya Publications, 1986. P. 133.
3 Fratkin J. Chinese Herbal Patent Formulas – A Practical Guide. Santa Fe: Shya Publications, 1986. P. 133.
4 Zheng YN et al. Comparative analysis of the anti-haemorrhagic principle in ginseng plants. Acta Agriculturae Universitatis Jilinesis. 1989;11(1):24-27, 102. [Article in Chinese].
5 Jin H, Cui XM, Zhu Y, et al. Effects of meteorological conditions on the quality of radix Notoginseng. Southwest China Journal of Agricultural Sciences. 2005;18(6):825-828.
6 Fan C, Song J, and White CM. A comparison of the hemostatic effects of notoginseng and Yun Nan Bai Yao to placebo control. Journal of Herbal Pharmacotherapy. 2005;5(2):1-5.
7 Fratkin J. Chinese Herbal Patent Formulas – A Practical Guide. Santa Fe: Shya Publications, 1986. P. 133.
8 Liu Y, Xie M-X, Kang J, et al. Studies on the interaction of total saponins of panax notoginseng and human serum albumin by Fourier transform infrared spectroscopy. Spectrochimica Acta. Part A. 2003;59:2747-2758.
9 Chan RYK, Chen W-F, Dong A, et al. Estrogen-like activity of ginsenoside Rg1 derived from Panax notoginseng. Journal of Clinical Endocrinology and Metabolism. 2002;87(8):3691-3695.
10 Cicero AFG, Vitale G, Savino G, et al. Panax notoginseng (Burk.) effects on fibrinogen and lipid plasma level in rats fed on a high-fat diet. Phytotherapy Reearch. 2003;17:174-178.
11 Epp TS, McDonough P, Padilla DJ, et al. The effect of herbal supplementation on the severity of exercise-induced pulmonary haemorrhage. Equine and Comparative Exercise Physiology. 2004;2(1):17-25.
12 Chung VQ, Tattersall M, and Cheung HTA. Interactions of a herbal combination that inhibits growth of prostate cancer cells. Cancer Chemotherapy and Pharmcology. 2004;53:384-390.
13 Chen FD, Wu MC, Wang HE, et al. Sensitization of a tumor, but not normal tissue, to the cytotoxic effect of ionizing radiation using Panax notoginseng extract. American Journal of Chinese Medicine. 2001;29(3/4): 517-524.
14 Chen FD, Wu MC, Wang HE, et al. Sensitization of a tumor, but not normal tissue, to the cytotoxic effect of ionizing radiation using Panax notoginseng extract. American Journal of Chinese Medicine. 2001;29(3/4): 517-524.
15 Leung KS-Y, Chan K, Chan C-L, et al. Systematic evaluation of organochlorine pesticide residues in Chinese materia medica. Phytotherapy Research. 2005;19:514-518.
16 Leung KS-Y, Chan K, Chan C-L, et al. Systematic evaluation of organochlorine pesticide residues in Chinese materia medica. Phytotherapy Research. 2005;19:514-518.
17 Leung KS-Y, Chan K, Chan C-L, et al. Systematic evaluation of organochlorine pesticide residues in Chinese materia medica. Phytotherapy Research. 2005;19:514-518.
18 Leung KS-Y, Chan K, Chan C-L, et al. Systematic evaluation of organochlorine pesticide residues in Chinese materia medica. Phytotherapy Research. 2005;19:514-518
Skeptvet and v.t. –
Thank you for taking the time to reply. I really appreciate the advice you have both given me on this matter.
To Kat…have them check for Aspergillosis. I have been dealing with this aweful fungus that attacks the nasal sinus cavity of dogs and is very difficult to diagnose and even more difficult to treat. Your blog sounds exactly what I was going through for 5 mos. before we were finally able to get the official diagnosis. It is a dog owners worst nightmare and the sooner it is diagnosed, the better. We have been through 5 major procedures to try to save my Golden’s life at the cost of $13,000 at one of the best hospitals around. After 9 full months of no symptoms, we feel it has returned as he has started with the one sided nasal bloody discharge and fear what lies ahead. My vet recommended the Yunnan a couple of weeks ago as the conventional meds that your dog is on were not working for my dog either and the bleeding has stopped as well as much less nasal discharge. He is so much more comfortable at this point so it is worth the risk of the unknown for us. We have been through so much to try to cure him and I don’t care what any skeptic says. When a dog is terminal as with a human…it is about quality of life and if it takes a chinese herb to do that than that’s what I will do. I have been a nurse for over 20 yrs listening to people that can speak their wishes to me when it comes to a terminal illness and most would do anything to ensure the best quality of life they have left. If dogs could speak I think this skepvet might be surprised at what they would say to him. Everyone is entitled to their own opinions and ultimately we as dog owners must take the information we are given and do what we feel is right for our beloved friends. After the nightmare we have been through with this Aspergillos diagnosis, I would do anything to keep my dog comfortable knowing he is terminal at this point. Sometimes we need to stop living by what the “textbook” says and start taking the word of others that have tried these alternatives with success and maybe we may find there are other answers out there. I would never want the opinion of this vet who obviously has a one track mind and there is no changing it. I have been so blessed to have a vet for the last 25 yrs who always goes by what she was taught in medical school but occasionally will look “outside the box” if it might mean a better quality of life for a terminal patient where no other methods have helped…just a thought!
I recently pierced my hand with a chefs knife at work. The owners of the restaurant are asian, chinese I think when she saw that I was bleeding seriously she packed the wound with the yunnan mixture and it stopped within minutes. I have never seen anything like it before. I now keep a small bottle with me in my chefs bag in case of injury. I wont hesitate putting it to work on my injuries in the future.
Thoughts?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228586/#!po=11.3636
The study looked at mice who were given an irritating chemical in their drinking water to induce inflammation in their GI tracts. Some were given the herb and some not. Lots of inflammatory mediators were measured and the differences between the intestines of treated and control mice were evaluated after 8 days. Also, some cell culture experiments were done as well. In a brief look, I was not able to find any statement as to whether or not the evaluators were blinded to the treatments. Some measures differed between the groups of mice/cell cultures.
So what does this mean? It means that the chemicals in the herb have some impact on living cells in culture and in mice. That is not surprising. It also might suggest the specific effects could be useful in treating inflammatory diseases. However, there is a huge gap between this and the demonstration of any meaningful value as a clinical treatment. Why? Well, to begin with living systems are very complex, and the overwhelming majority of potential treatments that do well at the in vitro and animal model stage (over 95%) fail to work as real therapies for real patients for a variety of reasons. And without regulations to require it, herbal products actually available to patients frequently do not contain predictable kinds and amounts of chemical substances, and often contain toxins and undisclosed pharmaceuticals. So taking Yunan Baiyao for inflammatory bowel disease on the basis of a report like this would be completely irrational and dangerous.
I do think this sort of research is useful. It establishes the fundamental plausibility of the idea that a substance, or mixture of substances, could have medical uses. But the ultimate goal, a useful medicine, requires a lot more than this to justify using it in real patients.
Poor quality control of herbs from China – noted. However, there is much to criticize in the crimes of western drug companies as well. I live in the USA and Western medicine was failing me. I’ve been scoped, imaged and diagnosed. However, when my hemhoroids ulcerated the treatment offered by a doctor I respect failed – I turned to yunnan baiyao. Long story short, the bleeding is gone AND I have not had functionality like this since I was a much younger man. The healing process was only a matter of days and I have been suffering for years. I know this is only a “N=1” experiment. THIS experiment helped me keep my job.
No question conventional medicine is imperfect and cannot solve some problems. However, it is easy to forget all the problems it has solved which remained unchanged for thousands of years since we don’t have them anymore. There is good reason to believe scientific evaluation of treatments works better than trial and error. Maybe this product truly helped you, and maybe it didn’t. N of 1 experiments, also called anecdotes, are compelling psychologically, but they are deeply misleading. This is how pre-scientific medicine has always validated its practices, and it has worked pretty poorly for millennia, so it’s hard to see the wisdom in trusting in it at this point.
When one is desperate, it is perfectly reasonable to grasp at straws, and if you’re lucky enough to have found one that truly helps you, that’s great. But I wouldn’t see that as any kind of support for the principles on which this treatment is promoted, or as a safe guide for anyone else to what they should do.
Appreciated this article. I prefer evidence also, but many times the evidence is just not there because those who have the expertise and equipment have no incentive to test a particular product. Or gathering the animals and people to test on isn’t feasible. However, when my dog has a terminal health problem and someone suggests something inexpensive that may help, I’m willing to try an “unproven” herb. I have given yunnan baiyao to 2 dogs, one with a spleen tumor and one with a nasal tumor. Over the course of 6 months the (externally visible) spleen tumor caused bouts of internal bleeding resulting in abdominal swelling, pale gums, bloody stool, and obvious discomfort. 1-2 oral capsules of yunnan baiyao produced symptom relief in 1-8 hours EVERY time! Finally she had a massive bleed and died quickly in 2013. Thanks to this herbal concoction, her last 6 months were actually very happy and active and the discomfort of cancer was held to a minimum. My other dog developed a fast growing nasal tumor that did not bleed much. By the time the tumor started bleeding more 2 months later, she had quit eating so I couldn’t give anything to her orally. I dabbed a *tiny* amount (1/8th of a capsule?) of yunnan baiyao on her tongue and on her nose and it stopped the bleeding in less than an hour, all three times. The first time I tried it, I “knew” such a small quantity would be useless, so when it worked, I was most impressed! Even if the ingredients remain undisclosed, I sincerely hope that one brand of the product can someday be tested on animals and humans, but I won’t hold my breath.
I certainly agree that in desperate circumstances, trying something unproven may be appropriate. Where I have a problem is with the idea that trial-and-error experiences like yours tell us anything useful about the safety and efficacy of the treatment. You give the product credit for the outcome in your pet, but I’ve seen exactly the same pattern of bleeding and recovery over this period of time in patients getting no treatment at all, so I don’t think we can say with any confidence this product works without real scientific evaluation. We may need to roll the dice sometimes, but we need to understand clearly that is what we are doing, and we need to remember that sometimes we can make things worse (see this article for a truly tragic example).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228586/
http://www.civtedu.org/uploads/41572/ufiles/News/Yunnan_Baiyao_invitro_paper_HSA_lines_dogs_VCO_2014.pdf
A study looking at proxy markers in mice that suggests the compound may have some effect on inflammatory processes in the GI tract. Useful work, but not really directly relevant tot he issue of whether the product is useful for treatment of hemorrhage in clinical veterinary patients.
Interesting. This is much more directly relevant. Of course, it is still not a study that demonstrates any benefit in cancer patients. What the study showed was that some version of the remedy killed canine hemangiosarcoma cells in the lab. Interesting as this is, it begs several important questions. It can be shown in exactly the same way that bleach kills cancer cells in the lab, but obviously bleach is not a safe and effective cancer therapy. There are many, many steps between this sort of work and a real medicine. No comparison was made between the effect on cancer cells and on healthy cells. If the product kills healthy cells just as readily, it’s obviously not going to be a useful medicinal compound. And, of course, patients with cancer are very different from cancer cells in a test tube, so far more work would need to be done to justify giving the remedy to real patients. I am absolutely in favor of further research. I simply think it is wrong to put the cart before the horse and subject real patients to this treatment before we know if it is safe and effective.
The article also points out one of the major problems with such unregulated remedies:
We would never let a pharmaceutical company get away with selling a remedy without telling everyone what is in it, but we still think this is ok for herbal remedies.
Is there a substance that works well for major or arterial bleeding that’s not expensive?
I don’t know what you mean by a “substance,” but the only effective treatment for arterial bleeding is to ligated the damaged artery or remove the organ that is bleeding. If this is not possible ((as in the nose, for example), sometimes packing the area and allowing pressure to build and stem the bleeding can be effective.
There are a number of substances suggested for local application to stimulate coagulation. These come in the form of powders, liquids, gels, foam blocks, etc. Some of the likely to speed the process of clot formation, though there is little in the way of controlled studies on actual patients to support this, mostly laboratory studies in test tubes or lab animals. They are not likely to be sufficient in the case of major trauma or a ruptured internal organ.
Anything given systemically can only work by promoting blood clotting, and this has some potential risks. Blood clots that block blood vessels are a type of stroke, so if a drug promotes clot formation it is possible it could cause strokes. The details of how the substance works, whether it is sufficient to stop serious bleeding and whether it has serious side effects all need to be worked out through careful research. Yunan paiyaqo is one of many candidates for this kind of substance, but the problem is people are using it freely without doing the necessary research to know if it really works or if it is safe.
So ultimately, I’m not aware of anything supported by strong clinical evidence that meets your description.
Can’t find original message and response.
I mean ‘external'(more or less) severe or arterial bleeding as might be caused by a bullet or a chainsaw or knife etc. The military uses products called Quik Clot or Celox. There are others. I was looking for a cheaper more readily available option. Thx.
I have been using the yunnan paiyao powder for many years . It really stops the bleeding. I accidently cut myself when cutting vegetable or meat. It stops the bleeding on contact.
I have had two board certified vets recommend Yunnan Baiyao, one an oncologist for a dog with hemangiosarcoma to be used in conjunction with traditional treatment, the second was an internal medicine specialist who recommended it for end stage kidney disease to increase the survival time and comfort level. Both of these vets work out of the same large, California veterinary specialty center.
My regular general vet was not familiar with it. After my previous experience, I have used it for bleeding ulcers brought on by NSAID use and for the bleeding of transitional cell carcinoma.
My personal experience, and yes it is personal:
The hemangiosarcoma dog (tumors in heart and liver) had no more serious bleeds. He was euthanized when the disease process eventually caused heart failure. The vet never mentioned it for treating the cancer itself, just for stopping bleeding.
The kidney disease (hematuria) dog was given Yunnan Baiyao and Silver nitrate with monthly monitoring and bleeding was stopped for 10 months then the dog had massive hematuria, lethargy and was euthanized after increasing medication doses did not help. She had a great quality of life for 10 months though.
The TCC dog (treated by the regular vet, not specialist) initially came to our rescue with large quantities of gross blood in the urine and clots. She was a hospice case, but the bleeding was causing anemia, so I asked my vet about trying YB and he was skepical, but agreed it was worth a try since I had success with it previously. It did stop the gross blood in the urine, but UA still showed + for some blood. Her anemia improved and was resolved, but within three months the tumor caused blockage of her ureters and we euthanized her.
We had an elderly dog on NSAIDs for arthritic pain, who developed pneumonia after aspirating food complicated by an already partially collapsed trachea. He had to be given large doses of dexamethasone without a wash out period for the NSAID and developed a bleeding ulcer. He was given YB at home (first one of the little red pills in the center of the pack which are for shock and more serious bleeds – followed an hour later by the normal capsule, then he was given YB twice a day for two weeks and when checked, his ulcer had resolved.
Another had PLE/IBD and was bloody diarrhea. Initially we gave her YB along with her PLE drugs, which were changed over time, the last and most effective being chlorambucil. Although both myself and the vet were concerned about PLE clot formation being made worse by the YB (although it is claimed it does not cause clotting that can cause blockages or embolisms, there is little research and we were concerned) we eventually took her off of it. She did fine for a couple months, she didn’t have a return of bloody diarrhea after stopping the YB, but she dropped dead of a massive stroke very unexpectedly. Her albumin had been good, for her, at 1.8 and her energy level and appetite was good and no diarrhea, but she just dropped dead on the patio one morning. I tried CPR, but was unable to revive her. The vet doubted the YB could have caused it two months after stopping, but that death remains a mystery.
If I notice one of the residents (I have a sanctaury for geriatric, special needs and hospice pugs) losing color in their gums and they are on an NSAID, I will usually give them YB and watch closely. Normally within 2-8 hours the gums pink back up again.
I have had enough positive experiences with it that I will always keep it on hand and use it when needed…..HOWEVER I would like to see good testing done, and I have major concerns about contamination and purity issues. But at this time those concerns do not outweigh the results I have had.
I think a reason it has not been tested on a large scale is because the Chinese Govt. holds the formula for YB as a State Secret and it has been in use since 1902, so is now not patentable, so any drug company with the money for large scale testing, have no financial incentive to do so as they can’t patent it and may run into issues with the Chinese Govt. if they tried to duplicate it commercially. It is very inexpensive and I think any major drug company would have a tough time doing all of the research and testing, developing and marketing the product and competing with established product financially.
An interesting article about the predicament the company is in over protecting their “State Secret” but still conforming to the US disclosure laws: http://www.chinaiplawyer.com/intellectual-property-analysis-dilemma-yunnan-baiyao/
Would love to see you evaluate Neoplasene (not black salve), colloidal silver (in particular the nano-particle types), medicinal cannabis and fecal transplants – all having interesting anecdotal evidence….but so little solid study. As I understand it, studies done on black salve showed great harm could be done and it was an indiscriminate cell killer, but Neoplasene is supposed to be different and not as dangerous.
Personally, I use the Sovereign Silver brand of colloidal silver to treat minor inflammation or mild corneal abrasions in the pugs with good success, but not so good with deeper scratches or ulcers. I tried a cannabis tincture on a dog with end stage lymphoma who had lost her appetite and another with MCT that had gone to his liver and was not eating, hoping to stimulate appetite for both dogs, not trying to cure the disease, it did not work. They were both euthanized when it didn’t work as their quality of life was bad and I didn’t want them to starve to death. I applied it topically to a dog with a grade 2 MCT the size of a grape on her toe, who had to delay surgery until her weight was down (she came to us obese with difficulty breathing). It dramatically shrunk the tumor in days. You could no longer see it and it was barely palpable.The vet was really impressed. But then a week or two in, she started licking it off and we were concerned about her ingesting it as she would become visibly intoxicated, so discontinued it, whereupon the tumor came back. On a strict diet she lost the weight and had the surgery, losing one toe, but getting clean margins.
Just my experiences, but thought I would pass them along. I am a lifelong skeptic, atheist and generally unemotional, intellectual type – but I am willing to try something when there are no other options or the other options are contraindicated or financially out of reach.
Take care,
Lisa
As for Neoplasene, I did review it, and no, it is not any safer or different from Black Salve. In fact, there has been one case report of a dog severely injured by this product, which I also wrote about.
Colloidal silver has been reviewed elsewhere, and it is also a scam. I’m afraid that most of these supposed miracle therapies are either untested or simply don’t work, and unfortunately people still succeed in marketing with anecdotes and testimonials despite the overwhelming evidence that these are not to be trusted. I agree that we cannot decide on the safety and efficacy of many of these products without rigorous pre-clinical and clinical testing, but I think people overlook how dangerous it is to try them “just in case” when we lack this data. This attitude harms many people and pets.
Don’t Believe your Eyes (or Your Brain)
Medical Miracles: Should We Believe?
Testimonials Lie
Alternative medicine and placebo effects in pets
Placebo effects in epileptic dogs
Medical Practices Once Widely Accepted that Proved Ineffective or Harmful when Studied Scientifically
The Harm Complementary and Alternative Medicine Can Do
Try this study: http://www.sciencedirect.com/science/article/pii/S0901502708004360
Interesting study. What the authors report is that in a small group of patients undergoing two-part orofacial surgical procedures, there was a small difference in the estimated amount of blood lost during the procedures between those than took Yunnan Baiyao ahead of time and those that did not. Specifically:
The YB group lost on average 48mls less blood than the control group during procedure 1, and this was statistically significant (p=0.015)
The YB group lost on average 40.8mls less blood than the control group during procedure 2, and this was not significant (p=0.058)
There are a number of reasons why this study shouldn’t be used as support for the use of Yunnan Baiyao in veterinary surgical patients.
1. For one thing, it is a single study looking at a single type of surgery in humans, so generalizing it to other procedures in other species is questionable.
2. The difference shown in blood loss did not have any clinical significance. There were no differences in blood pressure or other measures of well-being under anesthesia, no differences in the number of blood transfusions needed, and no difference in post-operative recovery. 40-48mls of blood is a very small amount, so even if this study did see a real difference (and only one of the two comparisons showed statistical significance), it wouldn’t have any impact on the outcomes for patients. And since the blood loss was estimated by weighing sponges and other methods with some degree of uncertainty, we would have to repeat the study or use a more precise measure of blood loss to even know if the difference was real.
3. There is, of course, the ever-present question of the reliability of the study itself. While the reported methods were quite good and the journal reputable, it has been shown previously that China is one of the countries in which almost every study of an alternative therapy is positive, which suggests some potential for publication bias or other concerns.
So what we have is one study showing a small, clinically insignificant, difference in blood loss which may or may not be real in humans. It is intriguing enough that I certainly think more research is warranted, but it is not the kind of evidence one should rely on when deciding whether or not to use this supplement in veterinary surgical practice.
There comes a time where you have to understand who the FDA is in the pockets of? Does pharmecutical companies come to mind. I do not believe in Western medicine. Spending $10,000 at Colorado State to try and save my dog with osteoscaroma when the bone sparing margin was screwed up and the tumor was back in less than a month. All the poisons in our food chain, chemicals in our water and 4-d meats being used in dog foods and treats which have killed thousands of animals. Then there are those Vets out there that make their tons of money administering unnecessary vaccines and performing surgeries that are not necessary, I for one could write a book . My 9 year old giant breed had a perianal tumor by two different Vets. One Vet wanted to castrate him and then remove the tumor said it was caused by hormones. $2,000 grand later The other Vet said a biopsy should be done. I decided that either suggestion was not the right thing to do. Anesthesia was risking and the recovery period and chances of the dog being fecal incontinent was too great of a risk for me. So for this Vet writing the article discounting the use of Yunnan Paiyao he has alot to learn. My dog’s tumor was abscessed it was the size of a apricot. Bleeding constantly. After countless hours on the internet I went with my gut feeling and gave the dog Yunnan 2 pills at a time a total of 6 pills throughout the day. The next day the tumor was gone. Blood all over. The dog had a piece of loose skin with the opening where the tumor broke. Two vets had confirmed in was an anal tumor and not an asbscess. I called them the following Monday and sent pictures to them. They were astounded. So for the ignorant remark made above by skeptvec who thinks he knows everything I can assure you he does not.
Wow! You managed to fit conspiracy theories and evil financial motives, the false labeling of scientific medicine as “Western,” a personal attack on someone simply for not agreeing with you, meaningless use of the term “chemicals,” and an anecdote that proves nothing into one long paragraph. A nice illustration of the bad arguments often used in place of real evidence to support what are essentially faith-based practices, not medical care. You are entitled to your beliefs, but without real evidence no one is obligated to take them seriously.
You won’t bother to read them, but here are some discussions of why your story doesn’t prove anything, and some listing of the kind of clichés you make free use of:
Don’t Believe your Eyes (or Your Brain)
Medical Miracles: Should We Believe?
Testimonials Lie
Alternative medicine and placebo effects in pets
Placebo effects in epileptic dogs
Medical Practices Once Widely Accepted that Proved Ineffective or Harmful when Studied Scientifically
Why We’re Often Wrong
Dr. Walt’s Warning Signs of Quackery
Skeptvet, which I’m guessing stands for skeptic, which kind of says it all.
So, credentials. Nursing Services Coordinator. Led on CEs for nursing and medical staff. Telemetry. Radiology. Health Occ (RN, LVN, CNA, Rad Tech, DA, DH) office for a college. Included was doing studies and data collection for said studies.
ALL evidence in clinical trials is technically anecdotal/subjective except for labs/objective. Questionaires for all participants include things like a) explain any reactions after taking medication(s); b) explain any new symptoms since beginning medication(s); c) explain any change in symptoms since beginning medication(s); etc., etc., etc. Anecdotal. Which just happens to also include the opinions and theories of medical personnel.
As to testing of drugs. Get real. Most have been “bought” to get them approved. If you think that drugs are safer than homeopathic and Eastern medicine, then you need to do additional homework.
Every single year people die BECAUSE of *approved* medications. *Supposedly* well tested. And, if you are in the medical profession, in whatever capacity, then you surely know that there are even jokes about Big Pharma and testing. Take Gardasil, for example. The standing joke is the HPV stands for Help Pay for Vioxx. It was tested for a whole 4 years. BEFORE the 4 years of human trials began they had hired a PR firm and the ads were already up and ready to go. I mean, after all, there was a race between Merck and GlaxoSmithKline, so who cared what the results were or how they were fudged as long as it was the first on the market and thus was assured the bigger market share.
So, I also have complete medical records on our AmStaff who was, literally, run over by two cars. The first one ran over her and the tires spit her out the back and under the tires of an oncoming car. She was bleeding from ALL orifaces and x-rays showed extensive fluid in her lungs. She hacked up a massive clot and then collapsed. The vet asked if we wanted to a) put her down or b) did we have enough money to cover a shot he had experience with but wasn’t on the approved list. He said it would stop the bleeding. He called it “magic Chinese powder.” We said “go for it.” He gave her the shot and within an hour all bleeding had stopped. We gave her the pills for a week and the second set of x-rays showed no fluids in the lungs or other evidence of edema in her organs. Her leg was set. HOWEVER, we were told she wouldn’t live too long because she already had early signs of hip dysplasia and her pelvis had been crushed. We then proceeded to give her all those “untested” herbs and vitamins for bone health, joint health and arthritis. She turned 13 in October and still jumps fences.
And then we have an exception to your rule that Hemangiosarcoma. Parents: the bitch was an AmStaff, the dog was a Black Mouth Yellow Cur/Treeing Walker Hound X. In January 2014, we took her to the vet because she suddenly stopped eating, didn’t want to move and was doing a weird throat clearing/coughing. The vet decided she had an upset stomach and gave us some doggie Pepto. A month later nothing much had changed. Back we went and x-rays were taken but no one seemed to see anything. Shrugged shoulders, oh well, she’s old (12). I put her on a lamb and rice diet with grass fed/grass finished beef broth. She would eat that and not choke or cough. I added a multi-vitamin and immune system builders, plus Ubiquinol. Two months ago she passed out and fell off the bed. We rushed her to the vet. More x-rays and blood tests but this time they noticed an extremely enlarged spleen and a tumor in her heart. “Oh dear, we don’t have the old x-rays. We don’t keep them.” @@ “Would you like us to put her down. She has about 4 or 5 days to live.” Thanks but no thanks, so they gave us a bunch of prednisone and pain killers. We took her home and decided that we’d had enough of “western” medicine. Tossed the prednisone as it kills off the immune system. Added IP-6, mushrooms, the “magic Chinese powder” (Yannum baiyou) and C-Caps. We also decided to go mostly grain free as carbs are known to feed tumors. She is now back to chasing deer. You can call it anecdotal but the x-rays confirmed what we could visually see (abdomen no longer distended), that the spleen is no longer enlarged. That would be objective. And, since you have very strong thoughts about Hemangiosarcoma, then would you care to class her as a miracle, which would be subjective, or to perhaps ponder the objective labs that were taken precisely two months apart even though you are a non-believer?
And, as you surely know, certain breeds are prone to Hemangiosarcoma and they are inherited. We also have a large American bulldog/Pitbull X. He has hypodermal hemangiosarcomas. His father died from it. We is on the same protocal as the hound X. His large tumor on his ribs has shrunk to half the size it was and he has no new tumors. Subjective? Yes, but he has also beaten the odds that are generally published about hermangiosarcomas. The only difference between these dogs and your stats are homeopathic and Eastern medicine.
As my Gramma used to say, the proof is in the pudding. You can be a close minded, uptight, only Western medicine knows anything snob, or you can investigate alternatives instead of dismissing them out of hand.
BTW, my husband had Stage 4 colon cancer. We didn’t follow the rules for him either and luckily found a radiology oncologist and surgeon who were willing to work with us. The cancer had grown through the colon wall. Didn’t do a chemo push but opted, with a fight, for a continual infusion pump. Changed his diet and loaded on the alternatives. We gave the list to the rad oncologist. He did routine blood tests and x-rays. The tumor shrank back through the colon wall. His original prognosis was an ostomy and a survival rate of 5 years. No ostomy and this is EIGHTEEN years later and all colonoscopies have been clean. Not so much as a single polyp. Oh, and the rad oncologist was published in the New England medical journal on my husband’s case.
Try to be a little more open minded. That is how many scientists have made great discoveries. They though outside the box!
Ah, so much anger at having your beliefs questioned. And quite a few misconceptions.
So, irrelevant. I can run through mine (which you can find on my FAQ) as well, but why? Am I right if I have more degrees, more relevant degrees, more years of clinical experience? Let’s just accept that we both have medical and scientific credentials. It doesn’t help decide who is correct.
False. Outcome measures in clinical trials can be objective or subjective, but all such outcome measures are data derived from controlled research methods, and as such at lower risk of bias than anecdotes, which by definition are simply stories told about individual experiences without any formal control for bias. Sure, objective outcome measures (e.g. mortality) are less subject to some kinds of bias (e.g. placebo effects associated with expectation and belief) than are subjective outcome measures (e.g. pain, nausea), but both can be influenced to some degree by the kinds of errors controlled research is designed to minimize (confounding and various types of bias). And all data derived from such studies is more reliable than anecdotal evidence, which functions only to generate, not prove or disprove, hypotheses.
So your initial premise, that somehow clinical trial evidence is no more reliable than the kind of anecdote or case report you present is false from the beginning, which undermines your attempt to use the anecdote to demonstrate something about the efficacy of Yunan Baiyao.
Just plain silly. Of course treatments that are regulated and subject to clinical trial validation are safer and more effective than magic (e.g. homeopathy) or a hodgepodge of untested folk traditions (assuming by “Eastern medicine” you mean something like TCM; The whole notion of “Eastern” and “Western” medicine is itself meaningless. Science-based medicine works anywhere in the world and is widely accepted as the dominant form of healthcare in China, Japan, Korea, and the rest of “the East” because it works. It’s not just a cultural point of view, it’s a system of testing medical treatments that works).
As for the Big Pharma conspiracy crap, that’s irrelevant. Sure, big companies do bad stuff. Big herbal medicine companies, big supplement companies, and big pharmaceutical companies are all about profit. The safest are those which are the most closely watched and regulated, and that would be the ones working on science-based treatments. Perfect? No. Completely safe? No. Far, far better than making stuff up based on folk myths? Absolutely.
This is the post hoc ergo propter hoc fallacy. You gave the stuff and the bleeding stopped, so the stuff must have stopped the bleeding. This is right up there with “I washed my car and that made it rain.” Sounds like the dog was fortunate enough to have an effective system for clotting that managed to get the bleeding under control before intolerable hemorrhage occurred. I’ve seen it happen in literally dozens of cases without ever having given Yunan Baiyao, so there’s no reason to think, based on this one story, that the product was necessary or helpful in this or any other case.
We can go through the issue of how long a dog with HSA would live with or without this treatment, but the reality is nobody ever knows, which is yet another reason why clinical trials are needed. I’ve seen untreated HSA dogs die in days, and I’ve seen others live more than a year without treatment. So the fact that you try something and the patient lives longer than average or expected proves nothing other than that we don’t have a very precise ability to predict prognosis for these cases.
Finally, you really don’t know what “open-minded” means. It doesn’t mean believing anything just because someone else believes it or has a nice story about it. It means being open to changing your mind if there is reason to do so. Good scientific evidence proving that Yunan Baiyao is safe and effective at controlling hemorrhage or prolonging median survival in dogs with HSA would have me giving it to my patients in a heartbeat. I am open-minded, I just don’t believe what you think of as convincing evidence.
Am using it now an had a wound for years now getting great result in only one week.
Lynda, so your vet gave pepto-bismal, and in all your grave concern for no improvement in your dog, you did nothing more for a month. By all means, that’s reason enough to blame the vet and bignastyevilpharma.
Also, there’s this thing called spontaneous remission. There’s another thing called misdiagnosis. Too many facts left out of your anecdotal novel for anyone to discern how your vets actually diagnosed and treated. We’re to believe you took unnecessary risks and refused to “follow the rules”, and healed everyone with nothing but herbs/TCM and homeopathy?
Sorry, but the homeopathy did nothing. Nada. Zilch. That’s what you get for being so open-minded.
SkeptVet, you are a breath of fresh air.
There is a saying in human medicine which is too often ignored:
“In God we trust. All others must provide double-blinded clinical trials evidence.”
Keep up the good work.
R