Supraglan: Empty Promises, Not Medicine

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.

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160 Responses to Supraglan: Empty Promises, Not Medicine

  1. Lindsey says:

    Bottom line: research about this stuff yourself, don’t just take a vets word for it. It has been proven from a science stand point from the Vet schools themselves that yearly vaccines are not necessary! The reason why a lot of vets don’t want to conform to the new findings is because…

    1. They lose $
    2.They don’t want to learn new tricks, they still want to practice the way they were taught when they were in school. They aren’t reading the new studies that have been found.

    That is why you cant take a vets word for it, look this stuff up yourself!

    Vets also don’t tell owners that if they really want to know if their dog is still immune then get a “titers” test done. This will show if a pet is still immune to whatever it was vaccinated for. If it is still high then your pet does not need a “booster!” Titers tests are safe and will save a pet from unnecessary vaccinating!

  2. skeptvet says:

    Sure, the cure to all disease is out there, safe and free, but only an evil conspiracy of doctors who care only about money and government officials has succeeded in keeping it hidden. Forget the polio vaccine, antibiotics, the doubling of the average life expectancy and the dramatic decrease in infant and maternal mortality in the last 100 years. Forget that none of that happened due to folk medicine, homeopathy, or any alternative therapy. All of that us an illusion generated to keep you ill and bilk you out of your money.

    Oh, and the moon landing was a hoax and the CIA killed JFK. Sheesh!

  3. Lindsey says:

    Actually who can honestly say it wasn’t a hoax or a conspiracy? No one…. not you…you really think the government would tell us even if it was? Good grief you are easily mislead!!!

    People have a right to decide how they want to be treated when they are sick, how they choose to be medicated or if they want to be kept alive longer due to technology or if they want just to be left alone so they can die. That right is the same w/ our pets, we have the right to seek out any treatment we feel is best for them and if we choose to use natural or homeopathic remedies shame on you to say it doesn’t work. Have you personally tried any of them? If not, how can you say they don’t work?

    Do you know what Cushion’s Disease medication does to the body? Well let me tell you, it slowly kills the adrenal or pituitary gland so that it stops making too much cortisone. You think that it a safer approach? Your ignorant! There is a reason why animals and humans have these glands, they aren’t expendable!
    These homeopathic remedies will not kill anything, it simple slows down the production of cortisone but does not kill the gland. Also w/ the adrenal gland it controls a lot of other things in the body so if you kill it off it can really screw things up, how are you going to solve those issues…What, w/ more drugs….? Also after the pet is on that medication it eventually stops working so then what? You tell me genius? Ok so, these drugs were taken, it killed the gland, now it stopped working, so I guess on to…..plan B? We’ll prescribe something else to cause irreversible damage to another organ or gland!

    Before you spit off at the mouth w/ your Anti-Homeopathic remedy crap you need to get educated and actually give it a fair try before you knock it.

    I have tried things the Vet’s way and guess what? IT DOESN’T WORK! It causes more and more problems.

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  5. Barbara Sauve says:

    My 7 year old Cairn terrier had elevated levels of a particular enzyme and my vet said this was an indication of Cushings and they would watch these levels. Did some research on Cushings and didn’t like what I was reading – particularly the method treatment. My dog didn’t have a lot of the symptoms of this disease and there did not seem to be any change in her. After the second high reading of this enzyme, I found Supraglan and thought I would give it a try. After using it for 5 months, her enzyme reading decreased for the first time in two years. Needless to say, she continues to be appear to be in good health and I have reordered Supraglan!

  6. skeptvet says:

    Of course, not having done the appropriate diagnostic test to show your dog actually had Cushing’s disease, especially without most of the characteristic symptoms, it is likely that he does not actually have the disease and that you’re treating him unecessarily. Alkaline phosphatase can increase with Cushing’s dissease, but it is routinely elevated in older dogs for lots of other reasons, and it can rise and fall spontaneously in perfectly healthy dogs. This looks like a classic situation in which fake treatments appear to work; namely because the disease they are being used for isn’t actually present.

  7. DB says:

    My sister’s dog has cushings, is a diabetic, and has liver cancer. She was giving her dog all the meds from the vet for all these illnesses. He was also given months to live going down hill fast! I researched cushings and liver in dogs and found many recommendations for supraglan and milk thistle. Found it on pet wellbeing website. My sister ordered both and she just took her dog for checkup with new vet and the dog according to the vet is “he’s fat and happy” and this was 2 years checkup since given the news from previous vet “not much time” I’m not normally a herbal treatment sort of person but this seems to work in this case. But ever case different and it doesn’t hurt to try what’s best for pets, right! My dog is borderline cushings and just recently symptoms have increased and I too ordered the supraglan as I told my sister to do 2 years ago. But in my dogs current situation, after 5 days my dog seemed worst. So I’m taking him back to vet for other options. Conclusion, what works for one may not work for another. You don’t know until you try all avenues.

  8. skeptvet says:

    The problem with this logic, of course, is that it presumes the pet did well because of the supraglan and mil thistle. It’s far more likely that the vet was simply wrong in their prediction of how things were going to go. Most cases of Cushing’s disease live for many years with the symptoms, treated or not, and the symptoms often come and go spontaneously. As for “liver cancer,” without a biopsy diagnosis of an aggressive malignancy, this is likely not the correct diagnosis either. Many liver tumors are benign, and I have seen plenty of dogs “diagnosed” with cancer just because they had a funny looking liver and were old, which is not appropriate. So this kind of anecdote, unfortunately, doesn’t mean what you think it means.

    Of cousre, if there were truly no harm in using these methods, it might not matter if they worked or not, there would be no harm in trying them. But apart from the fact that anything which has a benefit also has a side effect, so if they are helping they must have risks, the reality is that unproven therapies founded on anecdotes like this almost never work as effectively as proven therapy with known risks and benefits. What you don’t hear are the stories of patients who tried such remedies and died unecessarily, earlier than they otherwise would have, or in greater discomfort because tey chose alternative treatment over conventional therapy. Take a lot at the web site What’s the Harm? if you want to see some of these stories.

  9. M J Hockman says:

    My Maggie (9 Yr old German Shorthair) was hospitalized last year for acute pancreatitis; it was determined that she also has diabetes. We have been unable to control her glucose levels-she is consistantly off the charts high. The vet regularly suggested increasing insulin dosage (and did again just last week), but no other solutions were even suggested. Now she wants to do an Ultrasound ($400.00) to see if maybe it’s Cushing’s. I spent $5000.00 on her hospitalization; her prescription food and insulin run about $140.00 a month. She has cataracts, and is losing weight even though she eats like a starved animal. My vet is subtly suggesting that I can’t possibly love my dog if I refuse these tests, but the treatment sounds randomly succesful…..”maybe chemo helps; a new drug has shown some success..” I’ve been to a specialist who basically re-affirmed my belief that Maggie’s issues were so complex that none of them knew quite what to do; so they were guessing, and hoping that a battery of tests might help. I’m trying Supraglans now. It seems far easier to believe in this, than to believe in VCA vets who have done nothing for her for a year and a half, yet want to perform thousands of dollars worth of tests that they admit may not do anything; and might make her really sick. I’ll give her Supraglans, and let her live out the time she has left free of hospitalizations, surgical procedures, and expensive guesswork.

  10. skeptvet says:

    It seems far easier to believe in this, than to believe in VCA vets who have done nothing for her for a year and a half, yet want to perform thousands of dollars worth of tests that they admit may not do anything; and might make her really sick.

    This is certainly understandable, and I can’t blame you for feeling this way. I can blame the makers of the product for taking advantage of your difficult situation and making money selling you false hope, though.

  11. M J Hockman says:

    Point well taken. I’m trying some dietary changes now. Read that dry food is probably not as good as wet, so I’m weaning her off that. High protein, low carb. I’m not looking for miracles(well, maybe I am)-just wish there were better suggestions. I’m trying.

  12. M J Hockman says:

    Are Can-C drops for cataracts useless, as well?

  13. skeptvet says:

    There is limited clinical trial evidence in humans, esentially a few in vitro studies suggesting a possible mechanism and one small clinical trial funded by the manufacturer. There are no good quality positive veterinary clinical studies for any of the many eye drop therapies sold for cataracts. One small uncontrolled preliminary trial in dogs was published in 2006 which showed possible benefits, but a larger and better controlled trial has been conducted by the same researcher in Cambridge which found no effect. Unfortunately, this has not yet been published due to a variety of issues, including the reluctance of journals to publish negative studies.

    So the short answer is probably not, given that most “promising” treatments fail to live up to their promise and that after decades of study of various eye drop terapies for cataracts no clear, unequivocal data has emerged. Here is some further information

    http://www.allanimaleyeclinic.com/flexistar/aaec.nsf/lures/a+cataract+cure/$file/a+cataract+cure.pdf

  14. Tallulah says:

    I used this medication for my dog who has Cushings and I am loving the results!! No more symptoms, she is drinking less water and not peeing like she used to. I guess like with anything out there, it will work for some dogs and not with others. Sorry u had a negative experience but mine was totally the opposite!!

  15. Cyndi Sparr says:

    Okay, so what is the answer? My dog has all the symptoms of Cushing’s but the tests are negative. I do not care to spend thousands on doctors who , like human doctors, cannot give me an answer or a solution. There has to be something that works to help ease the symptoms and distress. I am tired of watching my dogs health deteriorate. He is my baby after all.
    What homeopathic remedy is out there, I am sick of conventional medication poisoning my beloved pet.

  16. skeptvet says:

    The answer is that sometimes we don’t know the answer. That is a frustrating and painful aspect of reality. Perhaps your dog has Cushing’s Dz, but i the tests are negative than it likely does not. Perhaps further testing or a consultation with an internal medicine specialist will discover the answer, but perhaps it won’t. I can’t tell you what the answer is, but I can tell you what it is not. The answer is not to seek solace in an irrational and useless bit of nonsense like homeopathy, or worse to try an irrational and quite possibly harmful bit of nonsense like supraglan. You only put your pet in greater danger by grasping at straws like these.

  17. Rebecca says:

    Hello skeptvet. My 14 y.o. Yorkie was just diagnosised with Pituitary Dependent Cushing’s…just got the phone call from my vet. Currently, his only symptoms are increased appetitie & excessive panting. His hair & skin are still beautiful & he doesn’t have the pot-belly. The vet wants to put him on Trilostane. She told me that her dog has Cushings and has been on this medication for 3 yrs & is doing well. As always, I’m concerned about the side effects of the medication & what it will do to my baby. I also researched the Supraglan & was considering trying it but the bottom line is I want to do what is best for my dog…I want him to be healthy & happy & I don’t want anything to give him anything that is going to cause more problems. I know your feelings on Supraglan…can you tell me about Trilostane?! The good, the bad, the ugly…thank you!

  18. skeptvet says:

    Because Cushing’s Disease is a complex disorder with variable and often waxing and waning symptoms, it is very hard to predict the course any individual patient will follow. I’ve had some dogs who did well untreated for long periods, and others who rapidly developed serious symptoms and were misrable. I do generally recommend treating at the early stage since I believe the chances of keeping the pet healthy and happy as long as possible are greater the earlier the disease is controlled, but there isn’t strong evidence to say for sure.

    Like almost every new treatment, trilostance was initially hailed as a miracle cure and turned out to have pros and cons like any other therapy. As I often point out to people, we are tinkering with complex systems, and it is impossible to adjust one aspect without affecting others. If it has benefits, it has risks, and if it doesn’t have any risks that’s because it isn’t doing anything! The original published doses appear to have been too high, so we saw more problems than expected. In the last few years, most of us have started using much lower doses, and subjectively I’m seeing a lot fewer problems.

    It is possible to overtreat, in which case the pet develops Addison’s disease, the opposite of Cushings where there aren’t enough steroid hormones. This isn’t a disaster, and in fact it is sometimes done deliberately in humans because it can be easier to manage Addison’s since you simply supplement the hormones that are missing and can accurately control the levels, whereas it is harder to be as precise when trying to bring down steroid levels in Cushing’s Disease. Usually, when the medication is temporarily stopped and then restarted at a lower dose, the Addison’s will go away, but it is possible for it to be permanant. Again, this just means the pet will always need to be on medication, which is true anyay for Cushing’s patients. A very small number of dogs have more serious side effects and can get quite sick or even die during treatment. It is rare but does happen.

    What I would suggest, if it is possible for you, is to talk to an internal medicine specialist, in private practice or at a veterinary school, who has treated many cases both with Lysodren (the older medication most commonly used) and trilostane. Most general practitioners, like myself, see a case or two a year or less. A specialist will have treated far more cases and will usually be far more familiar with the scientific research on the subject, and they can often give you a more accurate understanding of the benefits and risks associated with various treatments. The Internet is no substitute for the advice of someone who knows the literature and has a lot of experience managing Cushing’s cases.

    Good luck, and I hope for the best for you and your baby.

  19. Rebecca says:

    Thank you Skeptvet. I appreciate all of the info & advice. I only want to do what is best for my baby. I am going to follow your advice and talk with an internal medicine specialist. We have an excellent one here where I live. Thank you again!

  20. Standsmom says:

    My 13.5 yr old female dachshund, Bailey, is very classic for cushings. We have not done the acth stem or the ultrasound and have not started medication. We have two dachshunds, each needed back surgery within the last 6 yrs, costing $3500 and $6000 respectively. Recently, my vet thought Bailey was having trouble breathing and sent us for a chest xray. $150 later, they said they didn’t see anything unusual. We feel stuck. We absolutely love our dog. But we also have three children, and everything $$ that comes along with them. Where do you draw the line between seeking out expensive ‘specialists’ for your pet or just allowing nature to follow suit? I hate that she is uncomfortable and getting so weak, but the blood test and the ultrasound alone will cost over $600. That doesn’t even touch the medicine or the retesting. Or the side effects. One thing I find interesting is that when asked about the side effects of trilostane, you never really stated what those were. Other than it could lead to Addisons. So, what are they? Vomiting, fatigue, diarrhea? I asked my vet the same question and she never really told me. But said she had a pet, and patient who’d been on lysodren for years and did great. I know in text, it can be hard to read tone. I’m not annoyed or trying to be accusatory. I’m simply looking for some real answers. Am I a horrible person for just thinking we should just let our pet go? When, with cushings, do you make that decision? Assuming the pet owners don’t have the money to do all of the testing and treating? Bailey is extremely weak. I have to carry her in and out every time she needs to go. Her hind legs slide on the kitchen floor and she struggles to keep herself steady. She drinks probably 3 bowls of water per day. She poops in the house and has recently starting peeing in the house too, unless I get up at 5 am and take her out before she wakes up on her own. She has lost over 2 lbs in the last 3 months. She sleeps at least 20 hrs a day, breathes very uncomfortably most of the time and never barks anymore. I found your blog because I wanted to read more about Supraglan before I got really invested in it. I appreciate your information. Can you give me some real advice as to what we should do with this poor girl?

  21. skeptvet says:

    Obviously, it would be best if you had a relationship with a local veterinarian who knew both you and your dog and with whom you felt comfortable having these difficult discussions. I can offer you some general thoughts, but the kind of advice I can give through the internet, without that personal and professional relagtionship, is very limited.

    As far as the side effects of trilostane, they are listed in detail on the FDA required drug insert, which you can find here: http://www.drugs.com/pro/vetoryl.html
    Most of them (e.g. appetite, diarrhea, lethargy) are very non-specific and can be found on the side effect list for every drug on the market. The way drug testing studies are done is to take a pracutionary approach, which means everything that happens to a patient has to be reported as a side effect, whether it has anything to do with the drug or not. If specific symptoms happen much more often in dogs on the drug than in matched patients on placebo, then you can be fairly sure the drug is the cause. That information isn’t always available, though, because it is difficult, expensive, and time-consuming to collect, In general, the side effects most often seen in dogs on trilostane are a decrease in appetite, GI upset, and lethargy, as they are for most oral medications. As always, the real issue is balancing the risks of the treatment against the severity of the symptoms, the urgency of the disease, and all the variables specific to the patient.

    The bigger question you have, I think, is whether it is right to undertake expensive diagnosis and treatment for your pet. That’s really less of a medical question than an issue having to do with your feelings and values and your finances, so ultimately only you can answer it. If the symptoms are mild and not really bothering your dog, not treating may be a perfectly appropriate option. If the symptoms are negatively impacting her quality of life, then you will have to decide if you have the ability to pursue treatment and if you feel it is ultimately the right thing for her and for you, or if it is better to let her go. I don’t think there is a general “right answer” I can give, since that kind of decision is very personal and involves many factors specific to your specific situation.

    What I do caution against is believing the advertising that says you can avoid making this decision because there is the option of a safe, cheap, and easy answer in the form of some unproven magic tonic like Supraglan. I do understand how hard it is to be in your position, and I try with my own clients to support them and give them the information and understanding they need to come do the decision that is right for them. But I don’t believe anyone is doing you any favor by telling you that you can buy their untested elixir and have a solution to your problem that is free of risk and pain and costs you little. I just don’t believe that exists, and until someone can prove in a legitimat manner that it does, I’m afraid sometimes we just get stuck in a rotten position where none of the choices are perfect.

  22. Irene says:

    My 12 year old Aussie Shep X was diagnossed with cushings. He is 70 lbs. and after 5 days on Trilostane ( 60mg twice a DAY)he was declining rapidly, although his water intake outake had declined. Side effects included loss of appetite, diarehha and rear end weakness. He was not happy, no wagging tail and no “light” in his eyes. We (my vet and I) decided to take him off it. Two days later his appitite is back, bowel movements normal but still weak. My question : is it possible/advisable to try again at a lower dose after stopping for a period of time? I have to say those testimomials for Supraglan look pretty good to a desperate owner of a sick dog! Just want the last bit of his life to be comfortable.

  23. skeptvet says:

    The symptoms you describe may be due to the trilostane, but they can also occur witht he sudden decrease in steroid hormone. Cushing’s dogs can get used to the abnormally high levels of steroids their bodies are producing and may feel poorly when these are rapidly redued. It may be possible to use trilostane at a lower dose, to use it while supplementing a little bit of steroid hormone. If the trilostane is the cause of these symptoms, then of course it may not work for you pet, which leaves the other commonly used medictaion, lysodren, or choosing between not treating or trying one of the many unproven options. A hard place to be in, but all I can say is that while well-understood therapies may not always get us the results we want, rolling the dice with unproven therapies is even riskier.

    I hope you find the best solution for you and your pet.

  24. Cynthia Wilcox says:

    This article is the epitome of my debate. I have a 13 year Vizsla. Two years ago she had some liver tests that came back “off” and increased thirst. We didn’t do all the tests but my vet placed his bet on Cushings. We decided not to do medicine, just see how it progressed. Present day her liver function has stabilized though not perfect, boney face, thirst, back end ,neurological issues (twitches, circling,staring, etc – see video: http://www.youtube.com/watch?v=52FR2NNLFk0) Cushings?Who knows. Right now she takes low dose aspirin daily, muscle relaxant as needed for muscle ticks and I just picked up some Phosphatidyl Serine100 ? worth a shot for her cognitive decline.Went grain-free too. Funny thing is she still runs in the woods, waywardly but she runs.Good days and bad. Could be me but days where the weather is thick or humid (barometric?) are worse. So my question to you is, in my quest for something that is not a hail mary pass in this losing game, any ideas on some things that are worth a shot, show promise, no harm no foul? Something that even if it is debatable, has no negative side effects?

  25. Brenda Bean says:

    I have an 8 year old mixed breed that has suspected Cushing’s. He has all the classic symptoms, increased thirst, frequent urination, heavy panting, etc. My vet suggested running the tests for Cushing’s which would run about $400. She told me upfront they may be inconclusive. She also suggested the treatments that would be expensive and the repeated monitoring through blood tests, which are also expensive. Bottom line is that I could not afford to treat my dog. I was almost to the point of having him put down when I ran across the testimonials for Supraglan. I also saw your blog saying it is nothing more than a scam. I decided to try it anyway. I felt I had to do everything in my power (that I can afford) before making the decision to put him down. He has been on the supplement for only a week and a half and his symptoms are already showing improvement. He has not had an ‘accident’ in the house for 3 days but his biggest sign of improvement was he starting chewing his rawhide bones again. He used to love his bones and had simply given up chewing them because he felt too bad. I am glad I decided to try the supplement and am fully aware that only time will tell how long it will continue to help him but at least I know he feels better for the time being.

  26. skeptvet says:

    I’m glad, of course, that your pet feels better. The hard part is acceping that it doesn’t necessarily say anything about the product you’re using. Cushing’s symptoms wax and ane, some cases resolve for long periods witout treatment, and ultimately we tend to see what we want to see. It is understandable why this kind of occurrence makes it seem like the product must be working. But the same kind of evidence kept us draining blood out of people as a medical therapy for thousands of years, even though that only made things worse. So while I understand why you made the decision you did, and why you now feel it was the right one, all I can say is that there is a long, detailed history to medicine and science that shows such examples aren’t a reliable guide to what works and what doesn’t.

    Best of luck.

  27. Marion says:

    SkepVet — I’m no fan of snake oil, but surely you understand the frustration of many dog owners and why many are equally skeptical about vets. Our 15 year old baby-girl was recently diagnosed with Cushings. It was suspected for a while due to elevated liver enzymes, but wasn’t being treated as we didn’t see the symptoms. Then she started drinking excessively and urinating all over the place. Given her age and the possible nasty side-effects, we considered not treating and putting her down, but she didn’t seem ready to go. We’ve since seen her crash into Addision’s twice on Vetoryl. We are hemorrhaging money, and while she seems okay today, we have no idea of whether we are prolonging her life or her suffering. When the cure is often than the disease, and vet’s have a financial stake in prolonging treatment, why would pet owners take their word over other claims or the testimonials of other pet owners?

  28. skeptvet says:

    Frustration over the complexities, difficulty, and expense of Cushing’s Disease is absolutely understandable. Most alternative medicine thrives in treating conditions like this for which no ideal conventional treatment exists. So I don’t fault anyone for being frustrated or seeking alternatives. What I object to is people selling them alternatives that are bogus and don’t help.

    Sure, veterinarians make their living from practicing medicine. This does give them a financial interest in what they do. My own experience is that most veterinarians are ethical people who genuinely want the best for their patients and clients, so I think most try to do what’s best regardless of the financial incentives, and I suspect those that take advantage of people in your situation are few. But let’s not forget the makers of Supraglan also make their living selling this product, so they have no less of a financial interest in getting you to use it. The main difference is that what the veterinarian is doing may be imperfect, but the risks and benefits have been studied extensively, and we have at least some understanding of what they are. In contrast, Supraglan consists of a mishmash of ingredients with no plausible reason to expect them to be safe or effective and no real evidence to show that they are. Medicine has a long history of such snake oils turning out to be useless or harmful, and while the same can be true of treatments based on real science, over time science has consistently provided better results. Scientific medicine is the only thing in all of human hisory that has successfully eliminated or controlled disease on a large scale, and while we have a long way to go and much to learn, nobody is doing you or your pet any favors selling you concoctions like this that are just a kind of medical Russian Roulette.

    If you truly don’t trust your veterinarian or believe they are prolonging your pet’s illness to make money, then by no means should you continue to see them. The patient/client/veterinarian relationship requires trust, and it doesn’t work without it. I think it is very unlikely that this is what your vet is doing, but you have to be comfortable with the choices you make for your pet. All I can do is urge you not to be led by your doubts about your vet into trusting huksters on the internet who make a good living exploiting the frustration, fear, and sadness of people whose pets have a terible disease for which there is no perfect treatment.

    Best of luck to you and your girl.

  29. chopoodles mom- says:

    Skeptvet- I read your post as I am considering Supraglan for my dog and doing my research first. I have read many articles and online posts on Supraglan.

    What was interesting was in all of my extensive research I have done on this and similar products; I found that you were the first “official” to actually use the word “cure”. The website authority who sells the product does not use the term “cure for cushings” anywhere on their website. Some of their customer testimonials have suggested it a cure and the website/product representative repeated corrects its customers in the Q &A section reiterating that it is an herbal supplement and should be used under the supervision of a vet.

    Additionally, I do understand your skepticism for the unproven science, however bear in mind, modern medicine had to come from somewhere- even accomplished, milestone scientist and researchers had in their time, been referred to, as you call them, “quacks.”

    I do suggest that you review you own work and pick a side, as you yourself are contradictory in your cynical, bias and also un-sited commentary; where as you condemn your readers for not solely relying on their vets diagnoses and harsh medications, however also seem to conveniently claim that if the diagnoses was missed it must have been the error of the vet, as medicine of course is and “exact science.” (Yes that is sarcasm but I am sure you will have an answer for that, as you seem to for everything.) So which is it? The vet is always right, or is sometimes wrong- except you, of course.

    Your concern for the well being of animals is understood, however your emphasis is seemingly more directed at slander and defamation of the brand, than of actual review of what potentially could be a positive step for many who struggle the heartbreak of watching their pet suffer from confirmed or unconfirmed Cushings disease – or the sort.
    The bottom line: You seem to have quite a bit of opinion here; but do you have a better idea, all-mighty knower-of-all?

  30. skeptvet says:

    You clearly have not understood my actual critique and simply chosen to project your own biases onto it. Nowhere do I ever suggest that veterianrians are perfect, that science is “exact” (by which you seem to mean infallible), or that I or anyone else knowns everything. And I have clearly and unequivocally NOT condemned anyone for seeking out information and options for their pets.

    What I have said is really quite clear. The marketers of supraglan make ridiculous and unsupported claims to sell a product when there is no good evidence that it is safe or effective. This is wrong, and people should be warned that there is not good quality scientific evidence behind this product or any reliable reason to believe it will help their pets. There are many reasons why it might appear to work even if it doesn’t, and misdiagnosis is one. I have siad, again quite clearly, that Cushing’s Disease is difficult to diagnose and that there is no unequivocal test to prove it exists. Misdiagnosis does not imply incompetance, but it is a reason why a dog believed to have Cushing’s might get better while taking this remedy even if it is useless–because the dog may not have actually had the disease at all!

    As for the question of exactly wat claims are made, my article was quite clear that the company does not claim a cure (though only because to do so would be illegal) but that such claims are found on other web sites promoting the product. Did you chastise them for making illegal and unsupported claims?

    As usual, I find it strange that supporters of this product feel it is somehow wrong of me to offer my analysis of the evidence and my conclusions for people to consider when making choises for their pets, but it is ok for the company to say whatever it wishes, with or without supporting evidence, in order to sell the product. Why is that?

  31. Domhuaille says:

    skeptvet….I recently read an abstract about a new trial with some ACTH and a few other homepathic drugs that seemed promising according to the review. Here is the weblink:
    http://www.bahvs.com/CushingsArticle.pdf
    I’d appreciate your opinion on this methodology as my 15 year old Fox/Jack Terrier has been positively diagnosed with Cushing’s and i am looking for the least invasive and most affordable treatment available that is genuinely credible. Thanks in advance

  32. skeptvet says:

    I undersatand how difficult it is to be in your position, and it makes sense to look at all your options.

    Unfortunately, this paper is a classic example of meaningless pseudoscience that can only serve to fool people into falling for a useless treatment. Even ignoring all the general evidence against homeopathy, which has repeatedly shown it to be nothing more than a placebo for any condition, this sham scientific study proves nothing. It was published in a journal specifically devoted to publishing homeopathy studies that cannot be published in general medical journals because they cannot meet the standards for methodological quality. There was no randomization of study subjects, no control group of any kind, no blinding of investigators or owners, and the criteria used to determine response are not even described in the paper anywhere! It amounts to people who believe in homeopathy giving homeopathic remedies to patients and then later deciding that most of them got better because of the treatment. No attempt at objectivity or control for bias is made at all. If members of a religious cult went on a retreat and prayed to their chosen deity and then came back and reported that their deity had confirmed his existence to them in their prayers, would this be scientific evidence that their beliefs were true? That is the same kind and quality of evidence as offered in this paper–essentially nothing more than the personal beliefs of the authors.

    Homeopathy is, of course, completely without any risk of side effects because it is nothing more than water. It is also completely without any chance of helping your pet, though thanks to a variety of psychological factors it could convince you and your homeopath that it had helped, at least for a while. There is nothing credible about it, and you are better off seeking treatment that has some genuine scientific evidence of real benefit.

  33. Mabakari says:

    I have an 8 yr old Yellow Lab who has had Hip Displaysia for many years but was just recently diagnosed with Cushings. His “Quality of life” is playing ball and hunting. If he doesn’t have one or the other or both then where is his quality of life. The vet was very helpful in giving me both options: To treat the Cushings or not to treat the Cushings. If we treat the cushings with the constant testing/medications costing us $1,000.00/month for the first few months we have a high chance that the Hip Displaysia and Arthritis that are currently “masked” by the Cushings will come to be more painful and will more than likely hace to be treated with pain killers. He is 8, He is a Lab, Hunting and Fetch are his Love and Quality of Life. I am against treating the Cushings with all the Medications the vet recommended because what Quality of life will he have being on pain meds and sleeping 24 hours a day? Right now yes he does have a large belly and drinks/pants a lot and I am waking up 3 to 4 times a night so he can have relief, but if a natural remedy will help ease these “minor” symptoms (I say “minor” compared to the time wasted on treatment and testing to get vet med dosages right and then being put on pain meds for arthritis…) what scientific proof do you have that the rememdies DON’T work. Do you have one case to back up your opinions?
    In researching Supraglan I also found another
    “Symptoms of Cushings in Dogs Quelled With Ancient Herbs & Modern Science”
    CortiQuel
    http://www.natural-wonder-pets.com/cushings-in-dogs.html

    What is your opinion on this product?

    Sincerely,

    Ranger’s Mom

  34. skeptvet says:

    The ingredients listed for this remedy are:

    Shittake mushroom- I can find no evidence to suggest any benefit for Cushing’s disease. NO data exists on safety.
    Rehmannia- One paper published in China in 1988 found some effect on adrenal gland activity in rabbits. There appears to be no other research evidence to suggest a benefit for Cushing’s disease. No data exists on safety
    Dandelion- I can find no evidence for any benefit in Cushing’s disease. There is evidence that the herb can cause increased urination (already a problme in dogs with Cushing’s) and can interfere with the activity of some antibiotics.
    Rhodiola-There are many claims concerning Rhodiola and “adrenal fatigue,” a fake disease that doesn’t have any evidence it exists. There is no research evidence to siuggest it has any benefit in Cushing’s disease
    Alfalfa-There is no evidence of any benefit in Suching’s disease.

    So what you have is a collection of herbs none of which has any legitimate scientific evidence to suggest either safety or benefit for Cushing’s disease. A mishmash of chemicals (yes, herbal products contain chemicals or they wouldn’t have any effects at all) with no reason to think it is safe or effective. Could it be? Sure. Could a pig be born with wings and learn to fly? Sure. But there’s no reason to expect either will actually happen. Medical therapy is about balancing the urgency of treatment with the risks and uncertainties of the interventions we employ. The degree of uncertainty with an intervention like this is tremedous, so it truly is a roll of the dice.

  35. Amy says:

    An interesting mix of opinions on this page, always good to have healthy debate so that people can make better decisions.

    Since you were so kind to give thoughts on other products I was wondering what your thoughts were on Native Remedy’s CUSHEX DROPS for dogs with Cushings?

    Ingredients: Dandelion, Burdock, Astragalus, Arsenicum, Hepar sulph, Merc sol, Sulphur.
    It claims to:
    — Improves adrenal gland health and functioning
    — Promotes balance in the pituitary gland
    — Maintains healthy blood pressure and blood sugar levels
    — Encourages strong skin and a healthy coat
    — Supports normal urination and electrolyte balance
    — Promotes healthy corticosteroid fluid levels
    — Maintains healthy digestive functioning

    I have to add that my dog has been taking these drops for 4 weeks now in addition to liver support vitamins. The 3rd week on the drops his evening bathroom breaks dropped in half from 4 a night to 2. A blessing for sure, but I’m not sure if it’s the drops helping or just lucky coincidence. Thank you for your time and providing a place for discussion.

  36. skeptvet says:

    Many of the ingredients in this reedy are the same as in the other two I have discussed in this post and in the comments, and the bottom line is the same. No consistent preclinical evidence to show that they should work, and no clinical trial evidence at all to show thay they do work. So it’s a roll of the dice with no way to predict if there will be a benefit, no effect, or active harm. Such remedies are not, despite what their advocates say, know to be safer than conventional treatment. Their risks and benefits are simply unknown because they are based on anecdotes and theories, not actual research evidence. While conventional treatments are not simple or without risk, at least we know wat they do, so they still seem the safer bet to me.

  37. rebecca field says:

    Hey Skepvet- I think youre right. My sister bought this for our dalmation, two bottles of it. Our dog used to be on conventional treatment for cushing’s disease, but worrying about the addison’s disease, we decided to do this. I think its BS and doesn’t work. The dog still drinks a ton of water daily and needs to be let out a thousand times a day. Bah, I want to put her back on the conventional stuff.

  38. Kimberly Scott says:

    My 11 year old Shiba Inu was diagnosed with Cushings a year ago. The vet put her on Trilostane. It controlled the symptoms for a few months; but then it got to where I she would hardly eat, was very weak and lethargic, and had loose bowels. Was very hard for me to watch her take a turn for the worse. I thought her days were numbered, and wouldn’t be with me much longer. I decided to take her off the Trilostane and try the Supraglan. All I know, is that my dog still has Cushings, but the Supraglan seems to keep her at a more “normal” state. I might stop giving her the Supraglan for a couple weeks and see what happens….

  39. Debra Eisenberg says:

    I’ve had several vets over the years – in Maryland and Florida. My 3 Maltese dogs have all been prescribed Denamarin by these top rated vets — and this is a supplement with many of the natural remedies you are denegrating. My 15 yr. old’s liver spots faded and he virtually came back to life, frisky as a youngster. My 12 yr. old, who has the highest, most troublesome blood results, is also doing much better, but I was considering putting him on Supraglan – though there appears to be redundancy with the dandelion. If Denamarin is widely vet prescribed/recommended, then why not Supraglan – which contains similar ingredients? I no longer vaccinate my pups, and they are amazing for 12, 12 and 15. Is there a dog food or supplement you would recommend to help dogs’ own immune system deal with Adddison’s &/or Cushings? I cannot afford tests and don’t want to put my pups through the agony, even if we could — at their ages.

  40. skeptvet says:

    You seem to be saying that all supplements are the same, and that one either believes in them all or disbelieves in them all. Like anything else, each particular supplement needs to be evaluated on its own. Denamarin contains silymarin (from milk thistle) and s-adenosylmethionine (SAM-e). I have reviewed the evidence concerning this supplement (see HERE and HERE for examples), and while there is still some uncertainty, there is some reason to think these may have benefit for some conditions.

    Supraglan has neither of these ingredients, and as you can see in my review there is no good reason to think it is actually helpful, though until the apppropriate scientific testing is done it is impossible to know for sure. So the answer to why vets are more likely to use Denamarin than Suprglan is that the evidence, while not perfect for either, is much better for Denamarin.

    There is also no evidence that diet can significantly affect either Addison’s or Cushing’s disease. Unfortunately, while it is understandable that you are looking for alternatives to the expense and concerns about conventional therapy, there really isn’t anything else that is likely to help them. And while looking for such alternatives is perfectly understandable, it is unfortunate that so many people are willing to sell you false hope.

  41. John F. says:

    It’s always good to see varying viewpoints on all topics to make us think and help us to make educated decisions. I’m not a veternarian but I am a professional in my own field, trained to make decisions not on guesses, or gut instinct, but on proven data. After $3500 of tests and treatments, we arrived at at the diagnosis that my dog has Cushings decease with all the big symtoms clearly present. For what will amount to another #3500 – $5000 over his remaining unknown lifetime, we could punish him with the “accepted” treatments and chemicals – which will not cure him, but “may make him confortable”, if he’s not overdosed in the process! At this point I did decide to “take a shot” and try the $30/month Supraglan. Here’s the data part. Based on my observations, after only four weeks, his raspy breathing is almost gone, his urine dribbling is almost gone, his back leg strength has returned to 100%, his spunk and behavior is like he’s 1/2 his current age! Granted, there “could be” other variables that have caused these improvements, but I would like to meet the person that could prove with 100% confidence that the Supraglan is not the reason for these improvements. If some of these ingredients are harming him, I will rest easy knowing that when he dies, he went out more comfortably than he was just one month ago – which is no more of a guarantee than the “accepted” treatment could offer – at 100 times the cost! The difference between scientific proof and observed results is not necessarily “quackery” but simply a call for more study to take place!

  42. Mybabysmama says:

    I think it’s really thoughtful Skepvet that you would take the time to warn uneducated
    folks of the false hopes that they might be buying into. However what I seem to keep reading is a lot of people’s reviews stating that the product IS actually working for their pets. The actual statements from real people in so many different situations dealing with Cushinoid symptoms with such great results speaks volumes to me. This is why I too bought the product. Of course I would appreciate Medical test results however as I have heard you reiterate several times it is so HARD to diagnose Cushing’s so why would that surprise you? When a Vet can not make a definitive diagnosis then shouldn’t people try other alternatives? Especially one’s that hail such wonderful reviews whether they be medically founded or not. I give my pet vitamins that I have been told can also have different reactions and I wouldn’t not give them to her because they might interact with each other. My dogs immune system would suffer if that were the case. I would much rather hear real life experiences instead of
    Medical research that may or may not apply to my pet because of the various symptoms and many variables that can be misdiagnosed by our own Vets. I agree with chopoodlemom regarding your cynicism with such harsh verbage as snake oils and ridiculous claims that are unsupported. Me thinks the Vet doth protest too much. This product does seem to be supported by it’s huge following and testimonials. Truth be told I indeed purchased Supraglan in hopes it might be the treatment I was looking for. I wish I could give the product my own personal endorsement but sadly even though my little Yorki-Shu showed signs of decreased urination and thirst, her numbers increased almost two fold from when I took her off of the Vetroyl. I took her off of the Vetroyl because of chronic fatigue, loss of appetite, and increasing muscle failure in her back legs I know these are all typical symptoms of Cushing’s but she was so lythargic I felt as if she were at deaths door. That being said Supraglan was not the answer for me either but I am happy it is working so well for others and I will continue to TRY other alternatives and not just give up. Because the bottom line is what works for some doesn’t necessarily work for others and I don’t think there is a right or wrong answer. My own Vet can’t even give me a definitive diagnosis for my dog. All he can do is offer his expert opinion. Which is ” If he were a betting man in Vegas he would guess that she is pituitary dependent and not adrenal even though in x-rays her left adrenal gland is so enlarged” and her numerous neurological symptoms might be from large tumor pressing against the brain or it could be from electrolyte imbalance and liver etc…etc…honestly I read all of that online when I researched the disease. I guess I paid hundreds of dollars for medical tests that offered no more that an educated guess when I was hoping for more answers instead. So don’t belittle people for looking for alternatives that Medicine or medical officials can’t always offer the answers to. Blogs by others having the same symptoms and see the results they have encountered is many times worth
    an expensive medical OPINION a.k.a. diagnosis.

  43. skeptvet says:

    1. Tetsimonials are moving but worthless in deciding if a therapy works. People who believe the product works love to say so, and people who think it doesn’t just move on to the next thing for the most part. So you get a biased sample. And ultimately, every failed medical therapy in history, from bloodletting, to dung poultices, to animal sacrifice has been justified by people saying “It worked for me.” The hardest thing about science is it requires us to have the humility to recognize our limitations and to understand that what looks to be the case to our eyes often isn’t how things actually are.

    2. No, vets and science aren’t perfect. But making stuff up and guessing is even worse.

    3. “I don’t think there is a right or wrong answer” Well, I think often there is, and only by trying to be thorough and objective are we going to find it. Grasping at strwas may be understandable, but it’s not effective.

  44. skeptvet says:

    “Who is there with ten or twenty years experience in the profession, that has not seen the most marked advantages from bleeding in the protracted state of fever.”

    Review of Dewes Practice of Physic. The Maryland Medical Recorder, 1829. 1(1):736.

    “He thought it really saying too much…that we should assume to be so much wiser than our fathers, who had lent their approval to a custom that had been sanctioned by ages of experience.”

    Bloodletting-The Lost Art. Reviewed by H. Boyland in The Clinic. Oct 16, 1875. p. 183.

    All of human history, we have been taking situations like yours and saying “How could anyone believe this doesn’t work?” And for all of that time, we have believed in useless or even dangerous therapies while failing to make a significant change in our life expectancy or health. And then along comes the scientific method, and in a couple hundred years we have doubled our average life expectancy, eliminated numerous diseases that plagued us for tens of thousands of years, and made everyone with access to scientific medicine healthier than any humans in history ever were. Now, we are turning those methods to different kinds of diseases, those that arise when one lives long enough to get them because one didn’t die of the things that used to kill us earlier. And yet if we fail to miraculously banish these problems in less than a generation, people decide to give up on the scientific approach and go back to deciding what works based on individual experience and anecdote. Whatever your undoubtedly rigorous professional training or personal intelligence, calling your experience “data” and arguing that it is probative regarding this product shows that in this area, you really don’t understand science or history.

    “Quackery” is selling something with claims not proven by scientific evidence. Observations like yours, no matter how numerous, have proven wrong time and time again. “More study” would make sense if any study at all had been done and had shown positive results. But these folks can make all the money they want on this product without any studies at all because of anecdotes like yours, so they are the reason we don’t have such research. I am constantly calling for objective scientific studies on this kind of thing, but the manufacturers have no desire to conduct them. So if you really believe such study is worthwhile, perhaps I’m not the one you should be telling.

    I’m glad your pet is doing well, and I hope that continues. I also hope others don’t draw the wrong conclusion from your tale and avoid therapies with known risks and benefits in favor of rolling the dice on this unproven remedy.

  45. Lee O'Hara says:

    Have a seven year old doxie who has such a bad liver that he cannot be on medication, so he needs constant monitoring so the rectal valium can be given as his seizures are lengthy. He is positively a cushing dog, went through all the urine, blood, ultrasounds and I was suprised the vet prescribed the traditional cushings medication, despite their toxicity. I feel the risk of the medication to his liver is too great and although the medication sits on the table, I can’t give it to him. Even the alternative medications seem too risky. What do you think I should do? He drinks a lot, but has no accidents in the house and seems to have no other signs of the disease. Thank you. Lee

  46. skeptvet says:

    Obviously, I cannot give you advice about an individual patient via the Internet. I don’t know what “a bad liver” means here. Some liver disease is caused by Cushing’s, so if that were the case then treating the Cushing’s would be best. If there is another problem with the liver, this should ideallly be identified and, if possible, treated independently of the Cushing’s. Lysodren and trilostane, used to treat Cushing’s, are not specifically toxic to the liver, however they are broekn down in the live,r so if the liver is not functioning normally lower doses may be necessary and the risk of side effects does increase. So then it becomes a balance between the severity of the Cushing’s symptoms and the potential risks of treatment. There is not perfect solution, but to automatically assume treating the Cushing’s isn’t going to be good for the patient doesn’t seem justified to me.

    As for the Supraglan, since there is nor esearch to identify potential risks and benefits, the uncertainty is far greater than for the conventional medications, so I don’t see how rolling the dice that way is a reasonable choice. It is painful to see your pet uill and to be told that there is no clear ideal way to make him better, but the truth is certainly better than the fictions the marketers of this remedy put out. I think the best you can do is find a veterinarian, ideally a board-certified internal medicine specialist if one is avilable, and someone with whom you can have a clear conversation about what is wroong and what your options are. This should include bpth potential risks and benefits of treatment, risks of not treating, and the degree of real uncertainty about the outcome. With that information, at least you can make the most informed possible decision.

    Best of luck to you and your friend.

  47. Wayne says:

    I know that you are not a fan of homeopathic remedies, but I am curious to know what you think about this treatment for dogs and horses with Cushing’s Disease suggested by a UK vet. Are there any follow-up studies on this course of treatment? Do you have any concerns about the safety of administering this treatment to dogs? The article can be found at this link… http://www.homeopathicvet.co.uk/pdf%20files/Cushings%20Research.pdf

  48. skeptvet says:

    There are enough problems with that report to make it essentially useless for demonstrating any effect from the remedies used.

    1. The criteria for diagnosis of Cushing’s wasn’t clear. Clinical signs alone are not reliable, and ACTH stimulation tests, like all diagnostic tests, have known error rates. So to begin with, it is not certain that all of the cases even had the disease. This is especially concerning since the authors make reference to adrenal neoplasia as a posible cause for Cushings and claim to have selected remedies with this in mind, yet no mention of identifying or ruling out this form of the disease was made.

    2. There was no control group (receiving standard care or plcebo), so there is no way to know what would have happened to these cases if treated differently or not at all. Cushing’s symptoms wax and wane spontaneously over months to years, so changes can occur even without treatmet.

    3. Assessment of response was totally subjective (and the method not even described in the paper) and made by people who knew what the treatment was and believed it would help. No objective testing, such as followup ACTH stimulation tests, was conducted to document a physiologic response. Absolutely no attempt was made to control for bias, which is the whole point of conducting scientific clinical trials. What this paper describes is not a clinical study but simply a case where people who believe a certain treatment is effective tried it out and then decided that it looked like it worked. Such a setup is guaranteed to produce an apparently positive result, which is why clinical trials were invented in the first place.

    This paper is an example of marketing masquerading as research, and it is absolutely unreliable. There is no actual scientific evidence to suggest homeopathic remedies have any value for Cushing’s disease. They are, of course, completely safe since they contain nothing but water, and they don’t do anything at all except for provide a placeb effect by proxy through owners and veterinarians who, like most human beings, see what they want to see.

  49. Sam says:

    just wanted to say thanks to Lindsey for voicing what I wanted to despite skepvet’s ‘logic.’ The vets treatment based on his almighty researched only proved to be another nail in my dog’s coffin… it wasn’t until I stopped all allopathic medicine and put my dog on herbs and all natural remedies/treatments that I was able to drag him back from death’s door. Sometimes anecdotal research is all you’ve got when it comes to supraglan (he was only mildly bad before I took him to the vets, but their meds had me in tears having to make the big decision whether I should put him down or not from all the horrible side effects of their meds, when I gave all natural a shot and prayed I wasn’t making him suffer more needlessly). Yes, the makers of supraglan are making a very modest profit, but no, not what bigpharma makes so they can’t shell out the millions to satisfy your research parameters. Research HAS been done on those herbs independent of each other and they do indeed show that they can balance hormones, answering why supraglan can treat opposing conditions. But if you did a little research skepvet, you would know that…..

  50. skeptvet says:

    Happy to look at any research you have, though you contradict yourself by both saying research has been done and anecdotal research is all there is to go on. Anecdotal research kept us bloodletting, purging, and casting out demons to heal for thousands of years, so unfortunately it has earned its status as unreliable, low-level evidence. If we had stuck with anecdotes and hadn’t given preference to the scientific approach, which has given us almost all of the advances in sanitation, nutrition, and medical care responsible for the dramatic increase in our well-being over the last couple hundred years, many of us wouldn’t be alive today. So you are free to believe what you like, but your belief is not evidence no matter how intense it may be.

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