I came across an especially egregious example of veterinary quackery recently which I wanted to warn people about. Petwellbeing.com, a subsidiary of the Canadian company Natural Wellbeing Distribution sells a product call Supraglan, which it advertises as a treatment for Cushing’s disease (hyperadrenocorticism). Cushing’s disease is a serious, chronic disease in which the body produces excessive steroid hormones, which have a variety of deleterious effects on many different body systems. It is usually caused by a benign tumor in the pituitary gland in the brain, which tells the adrenal glands to make too much of their normal steroid products. Some cases are caused by a tumor of the adrenal glands, which is almost always an aggressive, highly malignant cancer. The symptoms of Cushing’s disease can be created by chronic use of steroids given to treat other diseases, but this is a different condition in that if the patient stops getting the drugs then the symptoms will resolve.
The PetWellbeing website offers a brief, and inaccurate, description of the disease and then claims their product:
is gentle yet effective, safe for long-term use without adverse side effects…Supraglan is designed to restore your pet’s quality lifestyle and to increase life expectancy by reducing thirst and regulating elimination (liver/kidney and digestive); balancing blood sugar levels (endocrine); increasing muscle use and ability (anti-inflammatory); protecting against infection (immune); and by promoting a healthy skin and coat (natural herbs)
Of course, to cover their behinds legally, the company includes the Quack Miranda Warning on their page acknowledging that the FDA has not approved the product for what they are selling it for, but this is intended to apply only to products that are making so-called “structure and function” claims, meaningless and unscientific statements that the product “supports” some body system, not that it treats or prevents an actual disease. So the treatment claims are illegal to begin with since the drug is not FDA approved as a treatment for Cushing’s disease.
Unfortunately, even the minimal restraint showed by the actual manufacturer is not found on other web sites promoting this snake oil. One site states, “There are many similarities between the symptoms of Cushing’s Disease and Addison’s Disease in dogs–both considered fatal in canines. There are many rumors in regard to the miraculous healing of the natural supplement Supraglan, reported to cure both diseases.” Addison’s disease is a lack of adrenal steroid hormones produces by destruction of the adrenal glands. It is, essentially, the opposite of Cushing’s disease, and yet Supraglan is reported to cure both! How does it accomplish this miracle? Apparently, it uses, “natural ingredients to decrease the adrenal system in dogs from a completely hyperactive state, the product slows the overproduction of the corticosteroid hormones which have become overloaded in the dog’s system. Side effects have not been seen yet in the usage of Supraglan.”
So a natural, side-effect free cure for Cushing’s disease and it’s opposite. See any warning signs of quackery yet? So what’s in this miracle elixir?
- Borage: contains natural precursors of adrenal glands hormones; supports endocrine system functions; helps with detoxification; supports adrenal cortex.
- Astragalus: tonic; nutritive; supports liver function; helps maintain immune system.
- Bistorte: astringent, soothing, anti-inflammatory, has a tonic effect on liver and kidneys.
- Eleutherococus Senticosus: helps maintain normal hormonal actions (ACTH and cortisone) on adrenal glands; supports the immune system.
- Wild Yam: natural inflammation management; contains steroidal saponins (dioscin, dioscorin) used as sources of saponins in the preparation of steroid hormones.
- Licorice: adrenal supporting (contains glycyrrhizin, a compound similar to corticosteroids); immune support; anti-inflammatory.
- Dandelion: highly nutritious food; supports liver function, digestion and appetite.
Ok, now here’s the tough part. What’s the evidence to support these dramatic claims? You guessed it–reams of testimonials from “satisfied customers” and not one single research study of any kind. Some of the claims for the specific ingredients are found in reference guides to herbal therapy, usually based only on tradition or limited suggestive in vitro or lab animal studies. A search of the usual source, including Pubmed, Cochrane Reviews, even the National Center for Complementary and Alternative Medicine, which is quite friendly to herbal medicine in general, turned up not a single study that lent any support at all to the idea that these ingredients, individually or in combination, are a safe and effective treatment for Cushing’s disease.
I did find a few studies suggesting why some of the ingredients might be a bad idea to use in these patients. Licorice is known to cause pseudohyperaldosteronism, a hormonal imbalance which messes up the levels of sodium in the blood and can cause high blood pressure and even interfere with proper diagnosis of adrenal disease. Wild yams have been thought to increase some steroid hormones, and so have been used as a treatment for menopausal symptoms, but in reality it does not actually increase steroids, and its apparent effects on symptoms was likely due to adulteration of commercial yam products with synthetic hormones
There probably are some in vitro or lab animal studies, maybe even a small human clinical trial or two, that might have some suggestion of some potential effects on the adrenal hormone system. After all, herbs are essentially drugs, though usually unpurified and inadequately standardized and tested, so they likely do have some effect. I would be interested in any such studies any of you are aware of, but I can promise you there is nothing that would justify selling pet owners whose dogs have a serious, life-threatening disease, this concoction with claims that it will cure them or even meaningfully improve their quality of life. Testimonials, tradition, and blind guesswork based on in vitro studies are not sufficient to make such claims or profit from people with sick animal companions.
I expect I will now receive the usual angry comments of the following sort: ”Who do you think you are?! I used it and my dog got better so you’re stupid! You’ve just been bought by Big Pharma to push their toxic drugs!” I have received such comments following previous posts on similar nostrums such as Neoplasene, Yunan-Paiyao, and so on. I don’t expect to be able to head these off, but I will try to save myself some time later and make a few points:
1. For reasons discussed at length here and anywhere critical thinking is respected, anecdotes are not proof, only suggestions of areas to study more formally. A million people are capable of being wrong as easily as one, so if you believe my assessment of this product is incorrect, show me real evidence, not testimonials. The hierarchy of evidence is the best guide to what is real evidence and what isn’t, if there is any doubt.
2. I make my living practicing medicine, and that includes treating Cushing’s disease. This has nothing to do with my objections to this product. If there were proof it worked, I would use it just like I use conventional treatments now. And don’t forget the folks making and selling this have a financial incentive to promote its use the lack of evidence it works that is far greater than any incentive I have to discourage its use. I am motivated by a belief that evidence and the truth serve my patients and clients better than false hope and misleading marketing.
3. I am not closed-minded, dogmatic, and I am happy to change my mind if the evidence warrants it. Being skeptical doesn’t mean disbelieving things automatically. It means withholding judgment until the facts are in. There are almost no facts to base a judgment on here, so the burden of proof is on those making wild claims (and a profit) on the product, not on those of us pointing out there is no good reason to think it works.
hello , my 10yr old pom has classic cushings symptoms , they do not wax& wane / come & go they stay steady day to day unlike my multiple sclerosis symptoms
she has gained alot of weight went from 13 pds to 17.9 i was shocked , very weak back end cant walk far , even b4 wt gain ,i have to carry her top potty ect , she has a pot
belly appearance even b4 the wt gain , she pants constantly with few rest periods
she drinks bowls full of water several x aday i keep a closed bopwl of water bedside & offer water thru the nite , she has odd hair , lot of graying , she pants , drinks & pee’s excessively , she was trained to go on pads from 6 weeks old did great she refuses to use a pad now must go out side , * word of causion if your pet suddenly starts peeing inside or in places that she dont normally do not scold dog could be a medical problem , like a bladder – uti infection or kidney infection , she has done thios b4 2x in life once because uti infection people its painful & caues frequent urination bladder spasms * ,must be treated asap 2nd time was wen she had a pyometria infected uterus had to have emergencey spay , fyi $ 12oo spay b4 this happens , back to cushings
she sleeps all the time unless panting , pants thru nite i cant sleep wants to be under the bed instead of with me now very irritable with others ^ other pets , she is miserable & it breaks my heart k9 parents please get pet insurance early on my vet said kizzy wldnt be covered because of genetic diseases ? collapsing trachea & luxating bk patelas knees & she also has severe arthritis head to tail
she has never jumped or climed on furniture never , i went to a vet for 4yrs & she ignored kizzys symptoms ect opnce i mentioned cushings she said we alreadfy did test i didnt argue but knew we didnt because of the damn cost , ignored her weight she got so bad with breathing & panting ./rinking & us getting no sleep i went to a new vet & he said he felt cushings was most likely the cause oh she does not have diabetes or heart worms , had kenel cough 1 yr ago , he said test cost $ 200 an 8 hour appt
i said id save up the $ i am on disability due to multiple sclerosis & im a single mother of 4 & 3 k9 kids my mother died 9 months ago today & i inherited her 2 making me # 3 k9 kids i wish id never listen to 1st vet ingnoring every thing even misdiagnoed pyometria 2x out of 3 visits , 1st a resp , 2nd x bladder infec , 3rd time i was waiting at office doors for them to open at 730 am with blood soaked towels under her she was bleeding out they took her straight to surgery out of my arms cost $ 12oo & next day i sat at vets for 8 hours holding her vet said take her home you can take better care of her than we can at this pont , so i did she was 8 1/2 yrs old if diagnosed correctly it wld not of been an emergencey thankfully the bleeding didnt start heavy till 645 am , any how she used to be on metacam for arthritis new vet wants remidel only i preffered the liquid & metacam really worked old vet never did blood work on her , & i had aceamethazine for severe respritory distress from trachea , i only gave her a tiny chipped off piece wen needed new vet dont like that but wen vet is not open & you need it & you dont use much maybe 1x a year for emergencey & you dont have a 1000 for vet er , also she used to get many skin infections cost alot to treat & lots of earinfections till gave grain free food , she dont have many teeth she loves evo small bite crumbles easily so in short i want to try the supraglan because i cant afford the cushings treatment & i think its dangerous , & if you ened up with adisons & had to give steroids steroids cause many problems & cause wt gain so its a horrible place to be too many dog have cushings apparently , i wish youd do a study on it even other sites besides supraglan promote danilion & burdock ect fot tx of cushings ????
herbs have ben used for centries for illnesses ? & in cases these is it not worth a chance , if you give one of the pharmacurical drugs it could harm your dog or heelp him ? its a gamble with life ?
i wish supraglan was not $ 45 dollars but 45 is better than 1000 to try & its worth a try rather than her suffering & comteplating having her put down just so she dont suffer no more ? she is not happy rt now , i love her enough to let her go as that will be for me , some x that is our last loving kindness we can give o our k9 fur baby kids we will be with them once again some day ! cynthia martin
I just received the Supraglan on Friday April 20, 2012. I gave my dog who is standard snhauzer 3 years old the recommended dose which was one drop for every 2lbs (1kg) of body weight. I gave him that only one time the Friday and One time the next day which was Saturday. He had seem . to be more active before I gave it to him. That Saturday night he threw up. He threw up two times yesterday and two times today which is Monday. He is now not eating his dog food nor snacks but is drinking plenty of water. He is losing weight rapidly. What suggestions do you have? I need to know asap because I am getting scared and do not want to lose my baby.”
April 16th My dog was diagnosed with diabetes after taking the suphraglan. He constantly threw up and his blood sugar was high, liver enzymes high and more bodily functions was harmed. I tool him to his regular vet, specialists, and my baby died May, 1, 2012. I am very distraught. can somebody help me please. My baby is gone!!!! These people need to pay for my loss!!!!!! Please Help me Please. Today is May 3, 2012 and I am totally out of it. My heart aches bad! My baby is Gone!!!!
I’m so sorry that you’ve had to experience this loss. While nothing can take away the sadness of losing a beloved companion, there are some groups of people who’ve had similar experiences and who can offer you some understanding and support. Please don’t be hesitant to reach out for the support you need to heal.
UC Davis Pet Loss Support
http://www.vetmed.ucdavis.edu/ccah/programs/petloss/index.cfm
Cornell University pet loss support hotline
http://www.vet.cornell.edu/Org/PetLoss/
University of Illinois pet loss helpline
http://vetmed.illinois.edu/CARE/
Michigan State University pet loss support hotline
http://cvm.msu.edu/alumni-friends/information-for-animal-owners/pet-loss-support/pet-loss-support-hotline
Tufts University pet loss support hotline
http://www.tufts.edu/vet/petloss/
Washington State University pet loss hotline
http://www.vetmed.wsu.edu/PLHL/
WEB RESOURCES
Pet Partners–counselors, groups, websites, memorials, articles
Pet Loss and Bereavement Directory
http://www.deltasociety.org/Page.aspx?pid=307
Association for Pet Loss and Bereavement
http://aplb.org/index.html
My cocker spaniel is 15 yrs. old. He was diagnosed with Cushings about a year ago. He has undergone expensive surgery to remove 2 anoil tumors. He has all the classic symptoms, i.e. panting, excessive drinking, weakness in his hind leg, sleeps a lot. I started him on Supraglan right after his diagnoses thinking that it could not possibly hurt. I have not noticed any adverse side effects and he is still with us and does not seem to be suffering in general. He even exhibits moments of playful energy. I figure it is worth the $45 about every other month if it helps him at all and does not harm.
Well, that’s the question, i sn’t it? There’s no reason to think it helps, but no studies have been done so no one really knows. And you can find anecdotes from people who think it helped, people who think it did nothing, and people who think it killed their pets. Again, no one really knows since anecdotes like these can be found for every medical therapy every tried. The bottom line is using this product is a roll of the dice, nothing more.
The outrageous claims made by Supraglan and others make my blood boil. These people prey on pet owners, especially those who have recently gotten the dreaded diagnosis and are desperate to find anything but conventional meds to treat. I have written to every one of these companies and asked them if they have anything to support their bogus claims about their products. At least Pet Well Being, manufacturer of Supraglan, was honest with their answer. My question to them was very direct: “Can you please tell me if your company has conducted scientific clinical trials or studies that show by way of acth stimulation test, low dose dexamethasone suppression test and/or urine cortisol:creatinine ratio that supports your claims regarding Supraglan’s efficacy in treating cushing’s?” Their answer: “Unfortunately no scientific tests or trials have been conducted on this product to support the claims you inquired below about. The items we offer on http://www.petwellbeing.com are not drugs or medicines, but rather all natural herbal alternatives. Please be aware that these products are not guaranteed to cure or treat all animals, as each individual animal and their situation’s are different.”
PetWellbeing Customer Service
1-877-633-2401
Wouldn’t it be nice if these snake oil companies were honest?
Yes, technically they are not allowed to claim any preventative or treatment benefit without FDA approval, which involves lengthy and expensive scientific evaluation. Since the law allows them to sell their products without evidence so long as they only imply a benefit, and since most people (especially when desperate) are more convinced by testimonials than clinical trials anyway, there is no motivation to test these products fairly. Even saying “these products are not guaranteed to cure or treat all animals” is trechnically against the law since it suggests they treat or cue some, but the FDA really doesn’t have the staff or the interest to enforce such rules. It makes it very difficult for even dedicated pet owners to make truly informed decisions about how best to treat their pets, and it clearly takes advantage of people’s fear and depseration in order to make a profit. A shame.