About

As a practicing veterinarian, I am personally and professionally devoted to promoting real, beneficial medical therapies for companion animals, and to discouraging those approaches that have not proven to be safe or effective, or that may even be harmful. I strive for true open-mindedness, but I believe all medical practices must be open to critique and must be validated by reliable science, not merely tradition, intuition, opinion, or anecdote. In this blog I will be addressing the broad range of philosophical, ethical, economic, legal, political, and most of all scientific issues raised by complementary and alternative medicine (CAM), particularly as it is applied to veterinary medicine.

skeptvet@skeptvet.com

65 Responses to About

  1. http://www.savingrarebreeds.org/homeopathy.html
    http://www.savingrarebreeds.org/

    This organization is busy promoting poor animal health practices, .i.e homeopathy!

    Best regards,
    Alan
    Twitter ID: amcell

  2. david says:

    Skeptvet less then 20 percent of medicine is evidence based. Studies have shown doctors are prejudiced agsinst blacks and latinos and provide 50 percent of the care white folks receive. For chronic illnesses doctors do a particularly poor job and no eonder duabetes arthritis is rising much more rapidly then the population for its the poor training of doctors and their careless orientation responsible for the poor medical care in our country so much for your cnidian medicocentric biomedical remediation.

  3. skeptvet says:

    Total nonsense. Conventional medicine has a long way to go in terms of developing adequate evidence to support its interventions, but it is far, far stronger than the evidence that exists to support alternative medicine.

    As for the problems in the equity of healthcare research and delivery, again these are real problems but irrelevant to the issue of homeopathy. Magic water doesn’t suddenly become medicine just because conventional healthcare is imperfect.

  4. Tony Smith says:

    I hate the orgo crowd and their anti-pharma chanting. But I also think it is unfair to turn such a critical gaze into one direction. You come across as biased.

  5. skeptvet says:

    You’re missing the point. Everyone has a bias (whch is just a way of saying a conditioned point of view and classical human cognitive limitations). That’s why science is necessary in the first place. And the process of science is successful at identifying what is true and controlling for bias because 1) the methodology compensates for our perceptual and ocgnitive limitations and 2) it is a competitive process in which people with different biases challenge one another and use scientific evidence to argue their point. There is no such thing as someone who is completely impartial and objective, and anyone who believes they are is deluded.

    The internet is overwhelmed by people selling alternative therapies and providing evidence which appears to support their beliefs, while ignoring the limitations in this evidence and any evidence which is not supportive. This site is one of only a very few in which a different perspective can be found and which provides the evidence CAVM supporters don’t want to talk about. This allows people to make more informed decisions.

    So I don’t see the substance of your objection. If you are looking for a perspective without a perspective, a completely neutral point of view, there is no such thing. If you want a “balanced” assessment, you have to look at mutliple sources and evaluate them all critically. If sites like this weren’t available, then you would be limited to only those sources which wanted to sell you CAM. I am rigorous in adhering to the scientific evidence, whether it supports or contradicts my own beliefs. But I don’t claim not to have a point of view because every human being does.

  6. Alecia Evans says:

    Dear Skeptvet,

    I appreciate modern medicine when I have a broken bone or need stitches, I think it is highly effective and works great. But having experienced that system fully in my youth, then having had the opportunity to study Traditional Chinese Medicine, Homeopathy, Natural Nutrition, Chiropractic Care and Energy Work, I have come to see that all things have their place.

    Western medicine is great for acute care as stated above, but it unfortunately only looks at the physical, it takes little into account about the emotional, psychological and spiritual aspects of the “whole being” of which all of these components are included. It also does not do much to address the root cause of issues and has only been around for the last 150 years or so, as opposed to its Chinese Counter Part which has been around for over 5000 years. So I tend to be more trusting of a system that was designed to heal people and keep them healthy as opposed to a system that more often than not gets people hooked into chemically created drugs.

    Western Medicine is continually looking for a pharmaceutical drug to patent and administer in a very compartmentalized manner in which it attemtps to depict pieces and addresses symptoms but does little to see the whole picture of the entire being. Don’t get me wrong, I wholeheartedly appreciate Western Medicine as the technology of surgery and plates and pins saved me from never being able to use my arm again properly after a horse fall and I appreciated the anti-inflam and pain drugs. But I would not use modern medicine to address my cold, an infection or assist someone in reversing their heart disease, cancer, addisons, cushings, liver disease, diabetes, obesity or a host of other dis-eases- there I would defer to Chinese Medicine or Homeopathy because they address the root cause of the imbalance in the body that allowed the dis-ease to occur in the first place.

    In addition, it is so much more cost effective- if we really want to tackle the health care problem in this country we would save enormous amounts of money by educating people on the root causes of their illnesses and I have found complimentary medicine so much less expensive and so much more effective to heal my animals issues, so I am glad that I live in America where I can make the choices that work for me without being bullied by fearful medicial professionals.

    I appreciate your point of view about Western Medicine and Science and I know that you have assisted so many. However, instead of attempting to make Western Medicine the be all end all for all people, how bout we agree to disagree and as I recall we are in America – so all beings are free here to make the choices that best suit their needs, interests and beliefs. And we agree to allow both to exist and let the people choose.

    If we do look truly at the science, I am sure you will find many, many more lawsuits that involve the ever trusted “science based” medicine and treatments, than you will those alternative practices that involve intuition, hokey pokey herbs and the other words you throw at “alternative medicine.”

    And as a human that has assisted a few hundred animals in healing their fatal medical conditions when Western Medicine failed them and they were left to die, I for one am a big believer in intution, homeopathy, acupunture, chiropractice, natural nutrition and energy work because what I Know For Sure is that animals bodies never lie, but sometimes science does- depending on whose doing the research.

    Respectfully,

    Alecia Evans

  7. skeptvet says:

    “I appreciate modern medicine when I have a broken bone or need stitches”

    In other words, when the problem is undeniable and requires immediate attention, science based medicine clearly works. There’s a reason alternative therapies haven’t found wide use in emergency medicine or birth control-because success and failure are a lot more definitive than in management of chronic disease, where variation over time makes it much more difficult to accurately assess the impact of a treatment. If the theories behind TCM, hoemopathy, and so on were true, wouldn’t they work for broekn legs and birth control just as well and just as clearly as conventional medicine? Why don’t they?

    “it takes little into account about the emotional, psychological and spiritual aspects of the “whole being””
    I’ll agree that the current healthcare system doesn’t address psychological needs as well as it could. That’s not a sign that scientific medicine doesn’t work, it’s just a feature of how we’ve built our healthcare delivery system. Unfortunately, it creates a window of opportunity for approaches that do address the psychological but actually fail to heal the body, which is much of CAM. This is a cruel, if unintentional. deception of patients. We should be able to care for people and heal their physical disease at the same time.

    As for spiritual needs, the problem here is that the word can mean anything you want it to, which immediately means any therapy treating the spirit can never be proven not to work. Spiritual and “energy” medicine gets a free pass because it’s entirely faith-based and subjective. That’s a problem since thousands of years of treating people this way accomplished nothing like the improvement in health and longevity and infant survival and all of the other accomplishments of science-based medicine. Belief is not enough, since reality doesn’t conform to our beliefs. Reality is what it is, and if we misunderstand it we fail in our effort to maintain and restore health. Any system of medicine which is based on a totally subjective and unfalsifiable spiritual belief will never know if it has misunderstood reality and so will never discover and correct its own mistakes.

    “has only been around for the last 150 years or so, as opposed to its Chinese Counter Part which has been around for over 5000 years”
    And in all those thousands of years, we never pushed our average life expectancy above the 40s, we lost nearly half of our children to disease before they reached adulthood, we routinely lost our wives and sisters and daughters in childbirth. Scientific medicine has brought us more and better health on a scale unprecedented in all of human history and unrivaled by any traditional, folk medicine. In places where scientific medicine isn’t available, traditional methods continue to fail to macth the accomplishments of scientific medicine. History is not evidence for TCM, Ayurveda, and other pre-scientific systems; it is a warning against them.

    “continually looking for a pharmaceutical drug to patent and administer in a very compartmentalized manner in which it attemtps to depict pieces and addresses symptoms but does little to see the whole picture of the entire being”
    This is a straw man. It would be a damning indictment of scientific medicine if it were true, but it simply isn’t It’s a charicature invented by proponents of CAM to denigrate conventional medicine. Apart from the fact that science-based medicine does not attend to the spiritual, which I agree is true but which I see as a strength, not a weakness, the rest of this simply is a false image that is easier to dismiss than reality.

    “I would not use modern medicine to address my cold, an infection or assist someone in reversing their heart disease, cancer, addisons, cushings, liver disease, diabetes, obesity or a host of other dis-eases”
    Apart from the common cold, choosing alternative therapies over conventional medicine for these diseases means condemning patients to unecessary suffering and often premature death, and doing so is deeply and tragically misguided. It is the substitution of blind faith in hostory and your own experience for true understanding built out of systematic study by many individuals over years or decades of time. It is the real danger of alternative medicine, that ineffective therapies are substituted for real medicine out of the delusion that they are as good or better.

    “Chinese Medicine or Homeopathy because they address the root cause of the imbalance in the body that allowed the dis-ease to occur in the first place. ”

    Nonsense. They claim to address root causes, of course, but these claims are only believed by adherents of these methods because they have never been convincingly demonstrated in any believable way to the rest of us. They must be taken on faith. Hahneman believed, for example, that an imbalance of the non-physical “vital force” was the root cause fo disease and that his magic water could fix your spirit and thus heal your body. As I said before, none of this can ever be proved or disproved, so it is simply a kind of religious belief. And sadly, it kills people. Here’s the story of one little girl killed by this delusion.

    ” instead of attempting to make Western Medicine the be all end all for all people, how bout we agree to disagree and as I recall we are in America – so all beings are free here to make the choices that best suit their needs, interests and beliefs. And we agree to allow both to exist and let the people choose.”
    Of course everyone is free to bleieve what they like. If you think that my criticism of homeopathy or other forms of alternative medicine is somehow an infringement on anyone’s freedom, you have no idea what oppression really looks like. In the free market of ideas, you make your case and I’ll make mine, and people will make up their own minds. That’s as it should be. But it doesn’t mean one of us isn’t wrong.

  8. v.t. says:

    Alecia Evans,

    Cite evidence. I seriously doubt you’ve cured any animal of a primary disease using acupunture, chiropractic, natural nutrition and energy work. I know for a fact that you have never aided a single animal using homeopathy and “energy”-anything.

    Since this is a veterinary blog focused on disputing much of the CAVM nonsense, and since many of the readers and commenters are animal lovers, explain your rational for the senseless killing and near extinction of animals and animal parts used in the nonsense of TCM.

    when western medicine failed them and they were left to die“. Ah, the age-old excuse to make up for lack of ethics, scientific education, and primarily, lack of evidence for your rediculous claims.

  9. Cee says:

    As one vet wrote: “It is axiomatic in science that “lack of evidence does not equal evidence of lack.”

    I would not use or recommend things unless there is evidence that they are not going to cause more harm, and may be of actual benefit. I haven’t seen any evidence that “magic water” works, unless it’s possibly the placebo effect or coincidence – the pet owner’s behaviour could change and that could also affect their animal. If new evidence becomes available, I’d look at it and see if others could duplicate it.

    There have been times when I’ve brought info to a vet that they didn’t have. They looked into it and found it had become mainstream with evidence of that it had benefits. I then obtained info on how to use the product. If I had thought the vet seemed closed to new information or didn’t think we were partners in our animal’s health, I might not have been able to bring that information to her.

    Clinical evidence is still evidence. My experience has been that the veterinary profession often recommends things where there is evidence of long-term harm, but they don’t want to discontinue such practices. I have seen where it’s due to perceived pressure from other vets, incorrect assumptions, partial information, or because what they are doing is considered the norm; profitable but not necessarily best for the animals and clients. As one vet I spoke to who agreed with me said, “I gotta eat”.

    Other times veterinary professionals are influenced by information from biased sources. Someone who studied animal nutrition at Cornell writes: “I’ll never forget one particular lecture where the teacher/veterinarian was discussing the different forms of pet-food products — dry, canned, and so on. While she was talking about the semi-moist products, she mentioned in an offhand way that she would never feed them to her pets. Then she quickly laughed and said, “Oh, my boss would kill me if he heard me say that!”

    She notes “only a couple of my professors weren’t paid employees of pet-food companies.”

    I think it smart to look at all opinions and evidence, and apply scientific principals. More and more I’m looking at overall health, going back to the foundation of health (for both animals and people), finding that foods (nutrition, or lack of it) have a MUCH larger role to play. It’s still only part of the picture but continues to be overlooked. I believe this is very harmful and costly for pets, clients, taxpayers, and society in general. The news continues to report and misinterpret various “studies” without anyone reviewing and critiquing the information. There seems to be little accountability in the media when they report incorrect information.

    Have you ever read the research by Francis M. Pottenger, Jr., MD?

    I don’t think we know everything there is to know yet, and health professionals are treating things in isolation, not looking at the whole person or animal, including history. It makes sense when people have to do their own research and take responsibility for their own health and that of their pets. Having medical professionals who see themselves as partners are important.

  10. skeptvet says:

    The fact that “we don’t know everything,” which is indisputable, is not the same as “anything can be true.” Skepticism is not the automatic rejection of ideas, it is the refusal to pass judgment in the absence of sufficient evidence. However, some kinds of evidence are more trustworthy than others. Anecdotes are useful for suggesting hypotheses to test and useless for actually proving anything. And the fact that an idea could only be true if large swaths of well-established science are wrong makes it less likely to be true. It is a waste of scarce resources to treat every idea as equally likely and spend time and money studying, say, magic and astrology instead of therapies that we actually have reason to believe might work,

    As for Pottenger, his work comes up a lot in discussions of raw diets. As I have said befroe, though not bad for his era, his work with the cats is pretty sloppy by modern standards, and there is not enough information in his published writings to determine crucial things like whether there were differences other than cooking between the food the two groups received, whether the groups of cats themselves were different in terms of condition, health, age, sex, and all sorts of other relevant variables. And even from the information that is out there, it is clear that neither group received an adequate diet, especially in terms of taurine, not discovered to be an essential amino acid for cats until after Pottenger’s time. So his work cannot legitimately be regarded as scientific evidence in favor of raw diets, though it is often cited as such.

    Finally, the “doctors don’t look at the whole animal” is a bit of empty propoganda from alternative medicine advocates.

  11. TC Vet says:

    To whom it may concern above:

    “And as a human that has assisted a few hundred animals in healing their fatal medical conditions when Western Medicine failed them and they were left to die,”
    So what conditions have you cured, how did you do it and what papers have you published to support your conclusions that your methods have miraculously saved all these hundreds of animals that could not be saved by Western medicine? Holding on to such information does such a disservice to animals and those who would help them including veterinarians. Please help us out.

    “My experience has been that the veterinary profession often recommends things where there is evidence of long-term harm, but they don’t want to discontinue such practices. ” This is a rather broad sweeping generalization. How many vets does this include and what percentage do they represent of the entire profession? Does it allow for the “trickle down” of information that is required to change any school of thought in any profession, including those practitioners of the Eastern arts?

    “I don’t think we know everything there is to know yet, and health professionals are treating things in isolation, not looking at the whole person or animal, including history.”
    Another broad sweeping generalization. Again, what percentage of the profession do this? Also, are the homeopaths and alternative medicine professionals out there doing the same thing? Are the considering the whole patient and when Western medicine might have the advantage? Here is my broad sweeping generalization: no they are not.

  12. Bluedevilchica says:

    Can I contact you without posting publicly? I just saw one of your posts that resonated with me. It was regarding the “Plechner syndrome’. Brilliant post by the way. Right on.

  13. skeptvet says:

    Apparently, there was an error in the contact plugin. You should now be able to send an email using the Contact Form.

  14. Keta says:

    I am SO happy to have found your website! I am a recently retired clinical research nurse who was trained by brilliant physician-scientists. Thus it is that I’ve entered a whole new realm with the recent acquisition of a rescued dog with severe separation anxiety issues. I found a wonderful vet who I like because she isn’t “precious” about food. This was a relief as I was the long-term primary sitter for a dog whose owner would blanch at the thought of feeding her carrots, Persian cucumbers, celery and dry-roasted, unsalted almonds. But back to the anxiety issues. As I’m retired I can be with her almost all of the time — in a very tiny 2nd flloor apartment (493 sq ft with a tiny balcony). As she is bright, curious and has lots of energy it is making it very difficult to a) keep her from being bored and b) help her to understand that after three foster moms and whatever else she experienced in her previous probably two-years, that I will always come back to her. Which is a long-winded way of saying that pheromones were suggested but they also encouraged me to do my research. Which is how I found you! Will be following faithfully form now on. Thanks!!

  15. skeptvet says:

    I’m glad you found the site useful. Separation anxiety can be a difficult problem, but it sounds like you’re in a good position to manage it. Good luck!

  16. Christina says:

    Hiya, just wanted to say and thanks. I’m getting a kitten and was considering a barf diet, but after doing my research, and coming across your site, I’m relieved to say I won’t be feeding my pedigree any raw food. They almost managed to pull the ‘woo’ over my eyes, but I tend to be a skeptical thinker anyway, and your site slapped me across the face… What was I thinking?

    I think what barf supporters need to realise is that yes, maybe if the cat were in the wild and catching its own game, that’s ‘au naturel’ … But the food we buy them is handled by humans in a factory, laden with bacteria and germs, with potentially relabelled dates, etc. Is it possible to buy cat food kibble that’s not got so much grain in it? Is grain in kibble bad for a cat?

    Anyway, thanks for the wake up call, normally I’m a bit quicker to the take.

  17. skeptvet says:

    Cats have no requirement for carbohydrates in their diet, unlike humans, but they can use them as an effective energy source as part of a balanced diet. Grains are no better nor worse as a source of carbohydrates than anything else, and they also provide usable protein. No one has demonstrated any adverse effects of grains in cats despite the hysterical claims that surround this dietary fad.

    Grain free diets can be perfectly healthy, but you have to be aware of the specifics of the diet. If the grains are substituted with another carb, like potatoes or tapioca, as is often done, then you haven’t really gained anything. And while reducing carbs to increase protein content may be reasonable in an obligate carnivore like the cat, some of these diets are incredibly high in fat and contribute to obesity, which is a serious health risk. (see this consensus statement from the veterinary internal medicine board on carbs and diabetes in cats)

    Here are some resources which should help you in rationally picking a healthy diet for your sweetie.

    Dog Food Logic: A book I recommend for anyone trying to understand the pet food market from a science-based perspective.
    Nutrition Resources for Pet Owners– This is a collection of links put together by recognized veterinary nutrition experts which should be useful and relatively free on the nonsense so easily found on the Internet.

  18. Annie Keech says:

    Thanks for the science-based common sense! Found you via researching source for Iams Prostora which my Rottweilers have used for years (thanks to Todd Carter, DVM, Ph.D, initially at Michigan State, now in Pennsylvania) for rapid relief of flatulence. Am presently working with local vet and Purdue North Central to maintain a 9+ year old spayed female Rottweiler with arthritis and some meds-related rear weakness (she was OFA Good, so not structural); expect to be using Prostora to help with whatever meds and doses finally give best results. Thanks again!
    Annie + Wright’s RG Riviera, CD, CGC, RN, TDI

  19. Theresa says:

    I came across your web page on NuVet. After reading your findings on the ingredients it gave me something to think about. I did how ever get samples.

    I tried the Nu Vet Joints supplement for 12 days and for 6 days and In seen a difference in Laverne 17 yrs old. She no longer slip on he hind legs and was walking on the tile without slipping . she ate better and slept all night till inn the morning.

    When I ran out of samples she ate with help and slipped on hind legs. So they did work . She has been on Winstons joint formula all natural with calcium…eetc. She even has the strength to pick herself up.

    After reading what you say seems negative when it works for my dog.

    I do many natural things for my pet found through research and on earth clinic.com including from pawhealers Chinese herbs. I give them Dr. Schulzes eyebright for cataracts A special formula and my kiwala eyes are showing the black cornea and not all white.

    Please let me know if I should order the nu vet product it helped my Laverene…Bbut!! I was totally confused after what you said on product

    Thanks

    Terry

  20. skeptvet says:

    The difficult issue here is that the fact that we see an apparent change when we use a product doesn’t actually tell us if the product is working. There are many reasons for this. We often see what we expect or hope to see. We often do many things at once, and then we have to decide which one actually is responsible for what we observe. Things often change on their own, and we tend to give the credit/blame to whatever we’ve most recently done. There is no therapy anyone has ever invented which didn’t look to someone like it worked. Things like bloodletting and exorcism looked like they worked to thousands of people for centuries, until science proved they actually did more harm than good.

    Only you can decide whether or not to use this or any other product. In the absence of good scientific evidence, I can’t tell you if it works or not. All I can tell you is that there is not yet any reliable reason to believe it does, and anecdotes, even our own, don’t really help us much.

    Good luck!

  21. Pingback: Spay and Neuter: When and If ever? - Page 19 - YorkieTalk.com Forums - Yorkshire Terrier Community

  22. Ryan says:

    these articles are really refreshing, and I appreciate your thorough approach. I’ve unfortunately locked into a contract with a breeder who has one of those clauses, requiring Nuvet vitamins for lifetime health guarantee. Any advice for what to do? I’m planning on confronting him about it.

  23. skeptvet says:

    Well, as I mentioned to someone else, I’m not sure what penalties a breeder could apply for failing to abide by the contract. I believe the only thing they can do is refuse to take the dog back and refund your money if the dog becomes ill. But in my experience, even if a new pet develops some medical problem, very few people choose to return them for a replacement because there’s already a personal bond. Breeders generally don’t pay medical bills, and while I’m no lawyer I think it extremely unlikely that they would try to go to court to reclaim a dog just because you didn’t give it a supplement.

    So I think these contracts are really pretty empty words really.

  24. v.t. says:

    Ryan,

    Nothing in that contract dictates you must be as gullible as the breeder, and nothing dictates you must follow her MLM approach if in fact, she is selling the supplement.

    As skeptvet has said, the contract is essentially in place should a health issue arise that the breeder has a guarantee against – and your option of returning the dog. Breeders insert all sorts of clauses in their contracts for nutrition, supplementation, even vaccinations etc – it’s your decision to choose how you feed and care for your paid-for dog.

  25. Juliette Hernandez says:

    I’m really confused at all the negative comments here. I am really grateful to have this resource to help me filter through all the claims that I see on every bag of food as well as feel better about not spending money on unneeded supplements. For what it’s worth, thank you.

  26. skeptvet says:

    That’s very kind, thank you!

  27. Lucinda Huntress says:

    Dear SkepVet,
    I embrace and share your pursuit of the best care for our companion animals.
    Your stated openness to evidence is admirable and something we all need to practice.
    I am writing to ask you and your readers to consider additional practices as valuable, perhaps not a choice for you or others in their practices, but to consider tolerance of new data and different methods for the purpose of adding to our knowledge base.
    In the Flexner Report, circa 1910, a decision was made to accept or deny certain forms of medical practice – based upon no evidence. “Conventional medicine” became the form of medical reasoning that was accepted-without evidence.
    “AMA approval” was offered to advertisers products, providing they paid the necessary fees to the AMA and advertised in their journal back then. That fostered enormous increases in the AMA annual income and public standing – without evidence or testing by anyone, not even the AMA, of the efficacy of the advertised and approved medications.
    None of these were evidence based. But you and I have both been taught to follow a certain line of medical/veterinary reasoning. Skepticism is helpful as we approach a question in a balanced manner to consider the evidence.
    To exclude information which may bear positively upon the treatment outcomes of our respective patients is a loss for all and skews outcomes.
    There is a growing body of evidence, including double blinded clinical trials, not supported by the pharmaceutical industry – that provide statistically significant outcomes demonstrating not only a need for further study, but also indicating positive outcomes with homeopathic medicines, yes, homeopathic, under the correctly prescribed parameters for such medicines. They are not funded by pharmaceutical giants, unlike new conventional medications, hence fewer such studies.
    One example for your consideration that there are serious concerns in certain conventional treatments, is the conventional treatment of prostate cancer having been practiced in the form of chemical castration & radiation, now found to have been based upon the results of a single patient study, and in practice has statistically poor outcomes. Is it reasonable to balance one’s views and consider these sorts of conventionally accepted medical practices when one castigates homeopathy? How much harm is done by learning more, including different methodologies?
    Our practices need good science as you proffer, and my belief is that there is value in a broad spectrum of viewpoints, studies and practices.
    Marie Curie was deemed a “quack”, but is there a doctor who has not used an x-ray for their patient when indicated? And the derogatory German appellation “quaacksilber” referred to dentists who filled teeth with silver/mercury amalgams (not allowed now in Europe) that the American Dental Association still firmly supports, despite the established evidence of the harm from mercury exposure.
    And then there is the NY Times article about the 17 ghostwritten articles by a Maryland ad company, signed (but not written) by doctors, published in all of the prominent conventional medical journals for a pharmaceutical company that promoted a menopausal medication that turned out to be deadly.
    My point: we can argue, knock down a point of view, create rancor; or we can move forward in our respective practices, doing our best and contributing to the greater knowledge and for the good of our patients. I would love to read about your success with a conventional medication that served one of your patients well. I would learn from it.
    I only ask that you consider these thoughts, correct them if factually incorrect, with my appreciation for good scholarly work on your part. It makes us all stronger to share good data. We can decide where we take our practices, we all have our gifts.
    Some evidence is by nature heuristic. I will admit my own discomfort with that, but have learned that also has value.
    Properly designed studies of homeopathic medicines exist, that meet stringent conventional experimental design parameters. And they have the same sorts of results we commonly see “conventionally”; that more study is needed and certain treatments have statistically significant positive outcomes making further study appear worthwhile.
    So if you ever have a goat munching on the first spring grass, with s & s of hypomagnesemia, N&V, going down fast, and no other treatment or transport available; mine was saved with Carbo Vegetabilis 30C HPCUS, dissolved in a syringe, Delivered PO, 15-20 ml, Q 15 mins x 3 hours. Cudding in 4 hours. My vet was too far away to be able help me other than by phone, was supportive and helpful in every way possible. He was preparing me for losing my dear goat companion and thrilled to learn otherwise.
    Anecdotal? Yes. Absolutely. Reproducible? Probably, but how do we get there, who pays for the first study and so forth?
    I cannot help but remember that Marie Curie gave her life developing evidence that has helped us all.
    I only ask your consideration, for your stated openness to change and the possibility that we have new evidence to develop, learn and apply. Thank you for providing this venue and for applying consistent standards to our collective work.

  28. skeptvet says:

    The call for “open-mindedness” is all well and good, but as has often been said, our minds should not be so open our brains fall out. There is a difference between being open to new evidence and accepting claims without evidence, and when the evidence clearly shows something doesn’t work. The advent of science and the scientific approach to evaluating medical therapies did not bring about perfection. We have not cured every disease and eliminated all risk from our therapies. However, we have accomplished more, using this approach, in a couple of centuries than in all the previous millennia of human history. We have improved the length and quality of our lives immeasurably, which pre-scientific methods failed to do. It would be foolish to ignore this history and suggest that it is just as reasonable, or just as good for our patients, to accept therapies based on anecdotes, history, tradition, or implausible theories as equivalent to scientific medical interventions.

    And in talking about the flaws in the evidence for science-based medicine, which no one denies and which I talk about myself regularly, you are not somehow validating alternative therapies. The fact that the evidence is imperfect for, say, many pharmaceuticals doesn’t magically turn homeopathy from a form of witchcraft into a legitimate medical therapy. All therapies should be judges by the same standard, and that standard is the generation of an evidence base from pre-clinical investigations through clinical trials, with the quality and limitations of the evidence critically evaluated at each stage. All veterinary medicine is based on less than ideal evidence. The problem is that proponents of CAM either argue they don’t need such evidence, because they “now” it works based on personal experience, or they accept only evidence that seems to agree with their beliefs and reject any possibility that research might prove their preferred methods don’t work. This is not a scientific view, and it certainly isn’t being open-minded about new evidence.

  29. Lucinda says:

    Then we agree on evidence and for our brains to not fall out. And we agree that a healthy skepticism is warranted and useful. My view is skepticism helps us to suspend judgement until there is actionable evidence. My concern comes from a rush to judgement that may discard a potentially useful tool of healing, or our experience of what works, without adequate study. And I acknowledge we need the time and resources to do so. And I acknowledge our world, practices, data, evidence all have flaws. I was not simplistically concluding that homeopathy is the answer to pharmaceutical abuses, but rather clearly observing that the patient need was left behind in the rush to profits.
    I find value in our prevailing system of medicine, recognizing there are gaps in our success which could well be addressed by other trained professional’s experience with additional modalities, one of which is homeopathic medicine. My vision and hope is that we can work together in respectful, scientifically supportable ways for the greater good of our patients, creating a practice that also feeds the doctor’s personal satisfaction with their life’s work.
    It is a rush to judgement to conclude an approach is worthless or worse, without reasonable understanding of any particular approach. I can certainly appreciate the incredulity when considering high dilutions in homeopathic medicines. Consider, however, the new work on nanoparticles for the delivery of medicines, or sublingual delivery systems…there are threads upon which mutual understanding can be built.
    And I return to our collective experience. We all know there is experience with prescribing a medicine “off-label” because it works – not because it has been well-studied. And we allow that practice. How shall we move forward, avoid potential threats of delayed appropriate care, and still utilize our experience?
    We need to elevate our thinking to utilize our best talents. You are right that we have accomplished so much. If we stand on pinnacles, islands, if you will, knocking other work down the slope for its’ contrast in texture, color or shape to our pinnacles of knowledge, then we are unable to either understand or benefit from new information. It is so human to avoid the unfamiliar, but there was a time when each of us was untrained & uneducated; unfamiliar with our present work – yet we have each learned more and grown into our present skill, talent and ability.
    I really do appreciate your thoughtful response and your willingness to discuss these ideas.
    Very best of the holiday season to you and yours,

  30. skeptvet says:

    I think we agree on a great deal, but then you are talking in very general terms. Certainly we agree that

    1. We should be open to new ideas and new evidence
    2. We ultimately want the best care for our patients and their humans
    3. We want satisfaction from our work

    But I think if we ventured into more specific territory, we would find much less to agree on. For example, you suggest my objection to homeopathy, and specifically the doctrine of potentisation by dilution and succession may be “a rush to judgement to conclude an approach is worthless or worse, without reasonable understanding.” I can assure you, I understand the theory and the evidence in great detail, as you would know if you looked at my previous critiques. The vague references homeopaths make to nanoparticles, quantum physics, and so on are intended to suggest these subjects provide a plausible, or even a proven mechanism for the effects of ultradilute homeopathic remedies. Yet, in fact, this insinuation is completely false, rejected by experts in those fields, and accepted as meaningful only by believers in homeopathy. And this suggestion actually flies in the face of extensive evidence showing no biological activity to such remedies.

    My point is that it may be comforting to think those who disagree with you do so out of ignorance, but this is not only self-serving and uncharitable, it is plainly untrue. I was once open-minded about the potential usefulness of homeopathy. My conviction that it is useless was born of careful, thorough evaluation of the theory and the evidence, and my understanding that the type of evidence which is most persuasive to believers in the practice, personal experience, is the least reliable.

    So I am happy to discuss these issues respectfully, but I hope we can also discuss them substantively, with enough specifics to make discussion meaningful. I am not blindly “knocking down the hill” potentially valuable ideas. I am carefully evaluating and then communicating the claims, beliefs, and facts about these subjects so that people can have all the information needed to make up their own minds about what constitutes the best for their pets and patients. Criticism does not suppress of information or choice, it expands and enhances it.

    Happy holidays to you as well. 🙂

  31. v.t. says:

    Lucinda, I would certainly not call 200 years failure of homeopathic “medicine” (which it is NOT medicine, mind you), a “rush of judgement”, as you say, [to discern as worthless].

    Please familiarize yourself with the many many articles on the homeopathy subject which skeptvet has taken to task quite considerably, as have many many others. The so-called studies you keep mentioning, are essentially worthless, they are weak, the methods done very poorly, and are seriously biased. But, that doesn’t stop homeopaths from regurgitating those failed studies to make their grand claims to fleece the public.

    I just love the argument “you don’t understand how homeopathy works”! Guess what, neither do homeopaths, but that doesn’t stop them from making stuff up and “prescribing” at will, and having the audacity to call themselves professional medical practitioners (and they think for some odd reason, they are deserving of such titles next to the well-educated and learned REAL physicians). Don’t forget the glaring reality: real physicians must be held to standards and regulations and be accountable for their practice and actions – homeopaths aren’t accountable for anything, so when you’re duped, you will receive no consolation prize.

  32. Sandra says:

    Dear SkeptVet,

    I really like your blog but I’m finding the cat nutrition space to be a real minefield and feel very frustrated about this. Even my vet was too diplomatic in that she avoided recommending any type of food and said that the topic is too controversial and that there is no solid research to back up if one food is better than other. So how do I know what to feed?

    You have said before that if something seems to be working it doesn’t mean it’s doing your pet any good but can be pure coincidence. So how can I tell if a particular food “works” or not?

    FYI currently feeding Royal Canin for cats aged over 7 (my cat is turning 8 soon). On many forums I’m finding people are bashing RC and then recommending indie brands with high meat content and grain-free. I’m thoroughly confused and would basically like to know how to assess if my cat truly does well or if it’s just coincidence. N.B. I’m based in Europe where there’s no AAFCO labels as far as I know.

  33. skeptvet says:

    Sandra,

    The issue of how to choose the best pet food is indeed a complex one, and there are no absolutes or guarantees. In general, most mainstream commercial diets are unlikely to have any dramatic deficiencies or excesses, and for a health animal I don’t think it’s unreasonable to assume that if all is well (body condition, coat quality, stool quality, etc.), then the food you are feeding is appropriate. Part of the trouble we create for ourselves is imaging we can optimize absolutely everything for our pets, when the reality is that while we are getting steadily better at preventative and therapeutic care, there is not, and probably never will be, a “perfect” approach.

    One of the best resources I can suggest for help in making this decision is a book I had the opportunity to review last year, Dog Food Logic. Though the title suggest it applies only to feeding dogs, it is really a much more general guide to decision making about pet nutrition, with lots of discussions about how to read labels, what to look for in a good manufacturer, and other things thatw ill be just as applicable to your situation as a cat owner.

    Another great resource is the World Small Animal Veterinary Association Nutrition Toolkit, which contains resources for pet owners as well as vets.

    No one who is informed about pet nutrition and has a science-based perspective is likely to tell you which specific food to feed a healthy cat because there simply is no single right answer to this question. But these resources should help you make an informed decision.

    Good luck!

  34. marge chandler says:

    Thanks for getting evidence based veterinary medicine and nutrition, as well as good sense, out there! Also thanks for mentioning the WSAVA Global Nutrition Toolkit!

  35. Jayne says:

    Skeptvet….any chance you would share with us what your identity is? Give us some detailed background: Vet college you attended? Where your practice is? How many years you have been in practice? You know…the same information available to all pet owners when they hire a doctor of veterinary medicine to be the caregiver for their pets. I navigated yor entire web site and could not find any of these answers….until then my Vet said I should be Skeptpetowner. You know pet owners during difficult times when their pets are sick are very vulnerable and go on line for answers…..so I trust you understand. Thank you ….looking forward to your reply.

  36. skeptvet says:

    1. You didn’t look very hard since the information is readily available on this site and elsewhere. http://skeptvet.com/Blog/frequently-asked-questions-faq/

    2. All of this information is irrelevant to the truth of anything I say. Evidence, not credentials, is how arguments should be judged. Whether I am a Nobel laureate, an unemployed janitor, or something in between has less to do with the legitimacy of my claims than the evidence and arguments I provide for them. Most people only ask about such personal details because they are looking for an excuse to dismiss something I’ve said that they don’t agree with using an argument based on who I am rather than what I’ve said. Whether you agree or disagree with me shouldn’t have anything to do with my resume.

  37. VJones says:

    Who is skeptvet and what are his or her credentials?
    I see in the “About” blurb the author claims to be a veterinarian, however, there is no transparency of name and proof of training included.
    Additionally, the banner photo, format, and tag, “A Vet Takes a Skeptical & Science-Based Look at Veterinary Medicine”, appears to be a direct imitation of well-known and respected homeopathic veterinarian, Dr. Richard Pitcairn, DVM, PhD, the Animal Natural Health Center, and their tag, “The Teachings of Richard Pitcairn DVM PhD”.

  38. skeptvet says:

    You are clearly just hunting for flimsy excuses to dismiss ideas and evidence you don’t like. The information you ask about is both readily available on the site and irrelevant. The photo came with the version of WordPress. The tag line bears no resemblance to Dr. Pitcairn’s, and given how critical I have been of him and homeopathy, he would be the last person I would imitate. If you have a substantive argument or evidence to offer regarding something specific I have said, you are welcome to comment in the appropriate post, but this sort of silliness is pointless.

  39. v.t. says:

    VJones, the answer is on the site.

    Familiarize yourself with wordpress. Skeptvet wouldn’t copy anyone’s format, least of all, Pitcairn’s, not in a million years.

  40. Carole says:

    Thank you for being a beacon of common sense and logic in a world filled with assumptions and misinformation presented as irrefutable fact! I think finding your blog may have lowered my blood pressure.

    I’ve been a vet tech for many years, though now I’m a full time artist. It was a constant battle undoing the damage of unsubstantiated ideas regarding subjects from food to vaccines, no matter how well-intentioned.

    Like Sherlock Holmes said …”Insensibly one begins to twist facts to suit theories, instead of theories to suit facts.” I would much rather know the truth regardless of whether or not it agrees with what I want or think.

    Keep doing what you’re doing… it’s (sadly) needed!

  41. skeptvet says:

    Thanks, Carole, you’re very kind!

  42. Mary Anne Whitonis says:

    I have always fed my dogs a homemade diet among all the claims that homemade diets cause dogs to live a shorter lifespan. My dog who died recently was 12 and only died because of cushings. My other two dogs are 11 and 10 and are years past their life expectancy. So, I don’t believe that homemade diets aren’t good for dogs. They work. My dogs are healthy and energetic and happy. And my one dog recently diagnosed with a rare form of cancer is better equipped to fight the disease because her diet has corrected protein wasting in her intestinal tract. Homemade diets are helping be in a better position to fight her disease.

  43. Mary Anne Whitonis says:

    I do agree about the raw food. As a dietitian, I am leery about raw meat products not matter what the benefits are touted for partially or completely feeding them in that manner. Now, if it is grass fed or free range and you know the people, etc. than maybe, but I simply can’t get past it.

  44. skeptvet says:

    My last two large breed dogs lived to 14 and 16 years on commercial dog food. Once again, dueling anecdotes get us nowhere. , and the mere fact that you believe something doesn’t make it reality.

  45. jules says:

    I just stumbled across this blog. I like to use a combination of western medicine as well as eastern. My vet is a mainstream western medicine vet who I trust with my dogs and cats and whose advice I trust implicitly. He never, however, puts down, nor does he insist that all eastern medicine treatments are bad. He has never once been defensive or sarcastic when I have asked him his thoughts on anything holistic. If he thinks it could be bad for my pets, he will certainly let me know. He has been practicing since the early 70’s. The practice itself has been around since 1947 and there are many wonderful mainstream vets in this practice. Recently they added on (actually about 2 years ago) a holistic vet and she is a combination of eastern and western medical practice. The mainstream vets and this holistic vet work as a TEAM. And I appreciate it. You don’t become a holistic vet without becoming a mainstream vet first. You have to have the same knowledge as western vets. So what is the problem?? The problem is that instead of going to a holistic vet for help, people will use what they consider to be helpful holistic supplements, etc thinking they know what they are doing!!! Don’t put down something you really don’t know anything about. These vets are legit and as I said, the two that I know (and it happens to be in the Silicon Valley where people have the money to go to holistic vets) were mainstream vets BEFORE becoming holistic vets. They found that a combination of eastern and western medicine works well more so than just one alone. They never poo-poo mainstream medicine and ALWAYS combine both types of treatments.

    My thought is that what works for one dog might not work for another, just like humans. It is that way with my three dogs and two cats. So I’m sorry but I don’t buy into “it’s all or nothing” mentality, this black and white mentality. You have been addressing people who make up their own treatments for their pets ills. My questions to you are, have you ever bothered to work with a holistic vet? Why haven’t you bothered to ask the people who don’t agree with your way of thinking whether they had been to a holistic vet or if they were just playing doctor to their own pets? Does that not matter to you? Why do you sound so defensive when someone doesn’t agree with your way of thinking? I’ve seen people here defend something you don’t believe in and your answers are curt, patronizing and defensive. But when someone praises you and your way of thinking you are so grateful with a big THANKS and end with exclamation points at the end of your responses. Why is that? That to me seems suspect. And I would feel the same way if a holistic vet responded in the way you have. Frankly, I don’t trust anyone (vet, doctor etc) whether they are holistic or mainstream that believe there is only one way of doing things. That in itself is very concerning as it means not having an open mind. I’m weary of people like that. Be a little more even in your responses to both agreeing and disagreeing posts and then you will have more credibility. And before you go calling this “hate mail”, this is nothing even close to it. These are valid questions and what I have written from my own experiences are fact. Have a good day

  46. skeptvet says:

    Most of your questions illustrate that you haven’t really read my blog and don’t really understand what I’m saying. To suggest I don’t know much about what I’m criticizing, for example, is ludicrous given the enormous amount of time and effort I make to make my posts factually accurate and informed. I even went to the trouble of getting certified in acupuncture and have spent literally years evaluating the claims and evidence for this modality. I have written evaluations of the evidence concerning homeopathy that include and synthesize hundreds of research studies. I have read the books, web sites, and articles I critique thoroughly and evaluate them point by point. So the suggestion that I must disagree with you only because I’m ignorant is indefensible, self-serving, and inconsistent with the facts.

    Similarly, the idea that I automatically dismiss specific therapies without seriously considering the arguments and evidence for them clearly shows you haven’t read or paid attention to my posts. I don’t accept or reject things on the basis of their labels but on the basis of scientific evidence. You are the one assuming an ideological approach towards CAM which my writing clearly shows I am not taking.

    And yes, I am appreciative of supportive comments because they help to balance the literally hundreds of emails calling me a monster, wishing for my death by cancer, accusing me of torturing my patients, and all the rest. I block those kinds of messages, but I receive them regularly. When I receive a civil message such as yours, I don’t attack the writer and I respond, as I am doing now, substantively. I do, of course, clearly identify claims I think are untrue or mistaken, as I have done with yours. You may choose to take that as an attack, but I don’t think agreeing with those who agree with you and disagreeing with those you disagree with is being unfair or undermines credibility. It shows consistency and adherence to the underlying principles, logic, and evidence behind the issues. If you believe that telling someone they are wrong and pointing out why is “defensive,” that’s your projection. I am not being defensive, but I am challenging factually incorrect and logically mistaken reasoning and claims.

    As for so-called “integrative Medicine” combing CAM and science-based medicine, I have written about why that is not, as you believe, an open-minded and sensible approach but a mistake, and you can read my articles on that subject if you are interested. It is not a mark of a more compassionate or more effective veterinarian to integrate unproven or ineffective therapies with scientific medicine, it is simply a sign that even a veterinary education does not completely immunize one against ideological, faith-based reasoning and logical fallacies. I appreciate your attempt to be civil in your comment, but that doesn’t mean I agree or that I have an obligation to refrain from telling you you are wrong where I believe you are. You are free to take that as you choose.

  47. v.t. says:

    jules said: The mainstream vets and this holistic vet work as a TEAM. And I appreciate it. You don’t become a holistic vet without becoming a mainstream vet first. You have to have the same knowledge as western vets. So what is the problem??

    The problem is that the majority of holistic has never undergone the rigorous scientific method to determine safety and efficacy. Yet the holistic vet has no qualms treating your pet with questionable substances with no evidence to support their use.

    Just because a conventionally trained vet employs holistic, does not mean he or she is practicing sound evidence-based medicine by integrating holistic with conventional. Quite the contrary, since the overwhelming majority of holistic modalities have never been proven to be safe or effective. Likewise, we’ve seen the same problems in human medicine where herbs and supplements have consistently shown contamination, adulteration, inclusion of harmful ingredients, excesses and deficiencies in ingredients, and all the dubious unfounded claims that come with them.

    A number of vets employ holistic associates, including acupuncturists and chiropractors etc – however, I’d guess the majority do so simply to generate revenue for the practice. Science be damned, it’s all politically correct now, doesn’t mean it’s ethical or safe for your pet.

  48. John V says:

    SkeptVet, you’re doing a fantastic job on behalf of us all, including for those people who don’t really understand – or don’t want to understand – the value of your research, comments and efforts.

    So, while you might get abusive emails from some of those who disagree with your comments, I’m sure you know there’s a very big group of us out here who support your approach and value your voice.

  49. SG says:

    So happy to have found your blog! I have only begun to browse the vast amount of information here, but good for you for putting the time and effort into helping pet owners wade through the nonsense that pervades the pet industry. As a new dog owner, I’ve been bombarded by questionable advice on what to feed and not to feed my healthy shelter adoptee, and the huge choice available in stores these days, not to speak of the vast amount of s0-called information on the web has left me very confused. My last dog, a German Shepard I owned in the 80’s, lived to a ripe old age of 13 on a standard diet of purina kibble (gasp!) supplemented by the occasional treat of cooked (gasp!) beef or chicken. After 12 years of having no health issues ever, he finally succumbed to heart failure, probably due to heartworm infection which, had the vaccine been more well known and readily available, may have been preventable and allowed him to be with us for a few more years. As a believer in evidence-based decision making, I thank you for being a much-needed the voice of reason.

  50. skeptvet says:

    Thanks, John. I always appreciate the support to balance all the rage. 🙂

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