Discussion of the ACVBM Application for Specialty Status for Herbal Veterinary Medicine

About six months ago, I reported on the application of a group of veterinarians belonging to the American College of Veterinary Botanical Medicine (ACVBM) for status as a medical specialty group. I explained the main reasons why, despite the potential value of herbal medicine, such status is not warranted at this time:

  1. There is very little high-quality or reliable scientific evidence to support the use of herbal products in veterinary patients.
  2. Herbal prescribing is dominated by Chinese Medicine, Ayurveda, and other unscientific folk belief systems, and those proponents who take a more scientific approach are a small minority generally unwilling to reject the claims or methods of alternative herbal medicine.
  3. Herbal products are unregulated, inconsistent and unpredictable in their chemical composition, frequently contaminated with toxins or even undisclosed pharmaceutical drugs, and almost none have been properly tested for safety or efficacy. There is ample evidence of serious harm to human patients from herbal products. The ACVBM supports industry self-regulation rather than the kind of government oversight accepted as necessary for pharmaceutical medicines without any sound reason for doing so.
  4. The majority of the leadership of the ACVBM are dedicated proponents of alternative medicine, not only for herbal products but homeopathy, acupuncture, energy medicine, and many other unproven or pseudoscientific practices. Many have said clear and troubling things that display a contempt for science and science-based medicine and a desire to use the appearance of scientific methods to gain acceptance for alternative practices. This makes it very likely that approval of the ACVBM as a specialty board would serve as a Trojan horse for the legitimization of other alternative therapies.
  5. The potential of herbal medicines would be better explored from a rigorously scientific approach involving specialists in pharmacology, toxicology, nutrition, epidemiology, and other existing medical specialties.

The deadline for public comment on the application is September 1. As this date approaches, there has been more discussion of this issue. The Veterinary information Network (VIN) News Service recently published an article on the debate in which I and other skeptics, as well as several proponents of herbal medicine are quoted at length.

The American College of Veterinary Internal Medicine (ACVIM) has taken a public position opposing the ACVBM application.

Proponents of the application have also been active, including efforts to gain support from the American Holistic Veterinary Medical Association (AHVMA), the leading advocacy group for alternative veterinary medicine . This actually helps to support and illustrate my objection #4 above. Even members of the ACVBM who claim to support a scientific approach and eschew the alternative roots of herbal medicine are providing links to the AHVMA templates for letters supporting the petition. Herbal medicine is still inextricably linked to alternative medicine, and this will not be fixed by setting up a specialty board run by alternative practitioners.

Similarly, the current president of the ACVBM, Dr. Ihor Basko, has made this statement in his appeal to supporters to write letters in favor of the petition:

Surprisingly there is much opposition to the college, mostly from veterinarians. It also appears that the pharmaceutical industry has hired “trolls” disguised as pet owners to write letters in opposition to the college.

Dr. Basko is an advocate of Chinese Medicine and many varieties of unscientific medical practices, and this sort of consipracist nonsense is typical of the ideology and rhetoric of the alternative medicine community. To suggest the ACVBM will be a rigorously and strictly scientific group when practitioners like Dr. Basko dominate the leadership is disingenuous and not convincing.

I encourage anyone dedicated to truly science-based veterinary medicine to write or email the American Board of Veterinary Specialities before September 1 and declare your opposition to this application. I have provided the contact information and a sample letter below:

 

American Board of Veterinary Specialties
c/o Mr.David Banasiak
1931 N. Meacham Rd, Suite 100
Schaumburg, IL, 60173
DBanasiak@avma.org

Dear Mr. Banasiak:

I am writing to oppose the recognition of the American College of Veterinary Botanical Medicine (ACVBM) as a veterinary specialty organization. The ACVBM does not meet the core criteria set forth by the ABVS, and recognition would not be in the best interests of animal owners nor the veterinary profession.

Botanical medicine is not recognized as a medical specialty, in human or veterinary medicine, in the U.S., Europe, Australia, or most other scientifically advanced nations because the research evidence concerning herbalism and botanical remedies does not support this status. Prescribing practices are largely untested and based on folk medicine beliefs and traditions, and most herbal products are untested and un-regulated. Very few herbal therapies have been validated by the type of high-quality clinical trial evidence typically required for pharmaceutical medicines. Problems with mislabeling and contamination by toxic adulterants and pharmaceuticals is frequently reported for herbal products, with documented harm to patients. While there is great potential for medicinal use of plant-derived compounds, this potential can best be realized through pharmacognosy and other conventional forms of scientific research under the auspices of clinical pharmacology, toxicology, and other existing medical specialties.

The primary distinction the ACVBM offers between its approach and current conventional research and application of herbal remedies is the use of “traditional knowledge” to guide herbal prescribing. This means that the theories and practices of folk medicine traditions are considered sufficient to guide the use of herbal medicines, even when controlled research evidence is unavailable or contradicts traditional theory and practice. Almost none of this “traditional knowledge” has been validated by controlled research, and much of it is incompatible with established scientific principles and knowledge.

Illustrating the reliance of the ACVBM on unscientific principles is the affiliations and practices of the members of the ACVBM Organizing Committee. Nearly all are affiliated with the Chi Institute or other Chinese Medicine organizations, and most are practitioners of Traditional Chinese Medicine (TCM). TCM is an alternative system for understanding health and disease which is entirely independent from, and inconsistent with, science-based medicine. It views disease as arising from imbalances of mystical forces, such as Chi or Yin and Yang, and metaphorical humors such as Wind, Damp, Heat, and so on. Diagnoses such as “Rebellious Chi” or “Excess Wind” are made based on behavioral and historical information, tongue color and texture, pulse quality, and other traditional means. These diagnoses are then used to guide the use of herbal products, which are categorized in their effects by taste, appearance, and historical use rather than any scientific analysis of their components or physiologic effects. TCVM is not a specialty area within scientific veterinary medicine, it is an alternative to it. Recognizing the ACVBM would effectively identify TCM herbalism as a legitimate scientific medical practice without appropriate evidence to support this status.

Additionally, a majority of the ACVBM leadership is also affiliated with the American Holistic Veterinary Medical Association (AHVMA), and many have served in the leadership of this group. The AHVMA promotes and defends every type of alternative medicine, from herbalism and acupuncture to homeopathy and faith healing. Most of the Organizing Committee members promote or utilize numerous alternative therapies other than herbal medicine, and many have been publicly critical of conventional and evidence-based medicine and have recommended greater reliance on traditional knowledge and personal experience. These views do not support a rigorous scientific standard for developing safe and effective therapies and would not promote more evidence-based and higher-quality patient care.

The best way to develop the potential of plant-based medicines is to continue rigorous scientific research into herbal remedies, based on established scientific principles and methods. This progress can best be accomplished through the existing veterinary specialty areas. Traditional use may suggest testable hypotheses, but it is not a reliable guide for prescribing. Recognition of the ACVBM would be counterproductive in encouraging folk medicine-based approaches and in giving the ABVS imprimatur of scientific legitimacy to theories and practices which do not merit it. This would mislead veterinarians and animal owners and encourage the promotion of unscientific alternative practices.

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5 Responses to Discussion of the ACVBM Application for Specialty Status for Herbal Veterinary Medicine

  1. letta says:

    Just a word from an ordinary dog owner form Poland
    Please start first from that “ rigorous scientific research “ in so called prescriptions diets which are widely available in each veterinary surgeon.My epileptic dog was given a snack during our routine checkup- and it triggered a seizure. With all respect but most vets has no idea what food they sell- some leaflet from a food producer will do.
    My another dog with pancreatitis would be killed by most of these prescription diets if I was stupid enough to feed that trash food to him.Don’t they know (after making that rigorous scientific research of course) that too much fiber is not recommended in pancreatitis? And fat as well?
    As for herbs – “research evidence concerning herbalism and botanical remedies does not support this status” – that is true but herbs are not the ones to blame. Just ask scientists to work harder instead getting rid of herbs completely. In many chronic illneses herb are invaluable and can strongly support allopathic medicine. Support- not replace! Ordinary chamomile tea helps a lot to my dog with IBD/IBS( no one can diagnose it so far properly), and some other herbs also bring at least some temporary relief- that means a lot to me and to my dog too. I do not need scientific research- I just see the results !!! And for sure it is not placebo !!!! Herbalism is a heritage of mankind and it is a science too although you prefer to think different- just educate your herbalists, give them university degree instead of destroying the whole idea because you can’t use it properly. Complementary or integrative medicine should be our future goal. -for the sake of us all and our animals.Regards.

  2. skeptvet says:

    Unfortunately, your beliefs about these issues simply don’t match the facts. The amount and quality of evidence is never ideal for any treatment, but there is vastly more evidence to support most dietary interventions than most herbal treatments. And if individual veterinarians are sometimes less knowledgeable than they should be, that doesn’t magically make herbal medicine scientific or reasonable. Your comments about “trash food” are just talking point cliches from alternative medicine advocates, again not based in any real evidence. And anecdotes aren’t evidence for anything, so your beliefs, for example about chamomile and IBS or a snack triggering a seizure, are just beliefs, not facts. You make all kinds of assumptions that are accurate here, which makes the general points your making not very convincing.

  3. letta says:

    You’ve never heard about chamomile soothing effect on gastrointestinal tract and for you dietary intervensions equals prescription diet (dog food brands) ??? Very sophist…icated .
    So to make it short- my general point is- as long as most vets are not knowledgeable enough (and that is a fact not belief) they also have no right to ban herbs. Beacause it is what I suppose you are trying to do- ban herbs entirely.
    I like your blog and I came across it during my constant net browsing in search of knowledge.Partially you are right- herbs are not the panacea and can be dangerous. So the same drugs. But that’s why I say-seek only help of experienced herbalist.

    I am a fan of science and thanks God for lidocaine in dentistry. I always go to the doctor first but surprise surprise- sometimes they can’t do much-couldn’t rescue my epileptic dog, can’t relieve my IBD dog nor treat its allergies, there is no cure for pancreatitis or eosinophilic esophagitis which I believe my dog developed too. Old good prednisone-that’s all they have. Science is not the panacea either( or you would say we have stupid vets here in Poland because American ones have the cure ?)

    So my point is- don’t tell me not to use chamomile if you have nothing in return. Primum non nocere – and If you know even anegdotical evidence/supported by generations of people safely using some herb) which could help your patient when your medicine is helpless and you don’t reveal it to him because of your PRIVATE belief- then you do harm.

    Thanks you for your time.Ps –an article of artemisin is excellent.I’ll try it if need arises;-))

  4. skeptvet says:

    “You’ve never heard about chamomile soothing effect on gastrointestinal tract ”

    Sure, I’ve heard of it, there is just no evidence to support the claim it has value in dogs.

    “no right to ban herbs”
    Where did I say I wanted to “ban herbs?” Total straw man, not anything I’ve actually advocated.

    “don’t tell me not to use chamomile if you have nothing in return”
    Again, you’re just projecting here, because this isn’t anything like what I’ve said. What I am saying is
    1. Don’t make claims that aren’t supported by appropriate scientific evidence. Whatever claims you do make should be proportional to the evidence for them, and in the case of most herbal remedies, the best we can say is “might help, might not.”
    2. “Experienced herbalists” don’t add any value to the treatment if their experience is all based on anecdote and folk tradition, which are not reliable sources of information most of the time.
    3. “don’t tell me not to use chamomile if you have nothing in return” Often, I do have something to offer. And often when alternative medicine practitioners claim they can do better than science-based medicine, they are making it up. Prove to me an herb works better than conventional treatment, and I’ll get on board. Claim it based on faith or tradition or anecdote, and I’m not buying.

  5. letta says:

    If you are not going to ban herbs that’s OK then;-) In case of war, or some other serious crisis people won’t be even able to recognize that chamomile in question in the fields. The tradition of herbal medicine is systematically destroyed- yes it is mostly empirical knowledge but I believe that knowledge/science begins with experience.
    I do not agree with you that herbal medicine is not able to present any science evidence in its favour- there are thousands of scientific research on herbs and some strong conclusions are drawn.Plenty of science medicines originated from herbs. People first used willow and other salicylate rich plants then invented aspirin.But it doesn’t matter- folk tradition means something more than using chamomile because my grandmother did it too. It is knowledge gathered by generations all over the world over the ages.

    I said that herbs can be of help in case of many chronic diseases not that they can replace drugs completely. Giving up the achievements of modern medicine would be sheer stupidy –but …. let me quote

    “It is also to say that—faced with pandemic threats such as that posed by AI, and echoing the wisdom of WHO as much as 30 years ago—it would be foolish not to investigate all promising preventive, control, or mitigation options that might derive from EVM savvy for enhancing the health and well-being of animals, humans, or both”
    Veterinary Herbal Medicine by Susan Wynn Barbara Fougere

    As for some alternative practitioners- you’re right. If I was able to find a phytotherapist with a university degree in medicine I would definitely prefer him to so called healer.
    Anyway, thank you for your attention. I won’t be bothering you again;-) I wish you very best.

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