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.
Not too long ago I diagnosed a patient with Cushings disease-I have several others I am currently treating, and are doing very well, but this patient’s owners are both naturopaths. They want to use “natural substances” to treat their pet, and have not contacted me in awhile, so I really wonder what is going on. I was quite surprised that the promoters of Supraglan think it is good for both hyper and hypo-adrenocorticism, which have different etiologies and different treatments anyway. I would not be surprised if my (former?) patient is being treated with something like this.
Thank you for your report. My precious Poodle has been newly diagnosed with Cushings disease and I am looking for answers.
hi skeptvet
thank you for your informative blog! as a pet owner i would be very interested in your opinion about the treatments and services offered by these veterinarians. do they really work?
vhcdoc.com
– alpha-stim
– aura cleansing
– chakra balancing
– healing crystals
– network chiropractic
– pendulum dowsing
– prolotherapy
– qigong
– reiki
– shamanic energy healing
– tui-na massage
holisticvetpetcare.net
– detox blue green papers
– hair analysis
– quartz crystals
– vaccinosis detox nosodes
– pulsating electromagnetic therapy (PEM)
– anti-radiation devices
– dowsing and diversion service
– healing halter
aholisticvet
– applied kinesiology diagnostics (AK)
– contact reflex analysis (CRA)
– rapid induction desensitization (RID) by laser and homeopathic
– bio-magnetics and magnetic mattress pad therapy
– hair mineral analysis
– homoepathic nosodes for vaccinosis
Ellen,
That’s quite a list! It’s a great example of why “holistic” is such a meaningless word. The approaches listed generally have little to nothing in common, and many of them are based on mutually incompatible theories, yet some doctors happily offer them all together with nothing other than the “flavor” of alternativeness to justify not making any effort to decide which might have value and which don’t.
I can’t claim to be familiar with or have researched all of them, but almost all of them are covered at Quackwatch or Science-Based Medicine, and I encourage you to look at what these sites have to say. Of the many on your lists that I have researched and written about myself, none have any theoretical or practical legitimacy, and most of the rest have been thoroughly debunked at these other sites.
if alternative treatments like aura cleansing, healing crystals, applied kinesiology, dowsing and homeopathy are bogus – then why do some doctors use them on their patients? i can see how a pet owner with no scientific training could be duped but aren’t veterinarians supposed to know how to evaluate medical treatments??
Great question, Ellen. I would start by pointing out that the vast majority of veterinarians and MDs do not use most alternative methods. The very label “alternative” refers to a practice that some people believe strongly in but which is not widely accepted by mainstream medicine. So the dedicated alternative practitioners are a smallminority, though most vets have experimented with one improbable therapy or another at some point. It is very hard as a doctor not to be able to help every patient, and it is tempting for us, as well as owners, to try something, anything when there seems to be no real, accepted treatment and little risk of harm to the alternative methods.
Unfortunately, nothing about being smart or well-educated, even in the sciences, guarantees an exemption from the normal human errors in thinking that lead us to false beliefs. People mistakenly believe that being open-minded means assuming all ideas are likely to be true, and they believe the best way to decide if something is true is to try it for themselves. But for a lot of reasons (which I have written about in the posts indicated below), individual experience, even as a doctor, is a very untrustworthy way to decide what works even though it is a very emotionally compelling form of “evidence.”
In addition to the links below, I highly recommend Thomas Kida’s book Don’t Believe Everything You Think, or Michael Shermer’s Why People Believe Wierd Things.
http://skeptvet.com/Blog/2010/03/why-people-believe-weird-things-by-michael-shermer/
http://www.skeptvet.com/index.php?p=1_13_Why-We-re-Often-Wrong
http://skeptvet.com/Blog/2010/04/the-dunning-kruger-effect-why-incompetence-is-blind-to-itself/
http://skeptvet.com/Blog/2009/10/cognitive-dissonance-and-evidence-based-medicine/
I started my cushings dog on the Supraglan several months ago. Her hair is growing back, she drinks way less water therefore she urinates less. It has been great for her. And, so you know a Licensed woman veterinarian in British Columbia develops these products. This is far better for animals than the drugs they use to kill the adrenal gland, most vets won’t tell clients how devastating those cushings drugs are. I have 2 excellent vets as friends, one is an instructor at CSU, and they both believe in alternative medicine. I have a consulting vet, who bases all his choices on what he can get from the drug reps and companies. So before you judge these products that the vet in BC is developing, you better try them and really know what you are talking about before you tell everyone not to use them. I tryed this because I didn’t want to take the chance of making my dog worse from the Cushings protocol!!
I need to correct myself I meant to say the pituitary gland not adrenal
Lori,
You may or may not know, though certainly anyone who is trained as a vet should know, that individual stories like yours may be compelling emotionally, but they are not reliable evidence for what works and what doesn’t. Bloodletting, faith healing (in any of a hundred incompatible religious traditions) and many other methods of treating disease that don’t actually work are justified and believed in because of such stories. Scientific evidence is more objective and reliable, and for Supraglan there is none. I’ll be happy to recommend it if the proponents can provide real evidence, not just testimonials.
As for knowing what I’m talikng about, I find it strange that people such as yourself who believe in unproven therapies on the basis of personal faith and experience always assume a different point of view must be based on ignorance. I’d be willing to bet I’ve treated a lot more dogs with hyperadrenocorticism than you have with conventional therapies, and I am certain your characterization of them is inaccurate and based on what you believe, not what you know. For example, these drugs do actually affect the adrenal gland, not the pituitary, so your confusion on the subject suggests you don’t have a very solid understanding of the pathophysiology of the disease or the mechanisms of the usual drug treatments.
I won’t get into a game of “dueling testimonials,” because ultimately it would change your mind or prove anything anyway, but I know plenty of pet owners who would disagree with your false characterization of the drugs that made their pets better as “devastating” and so on.
I won’t argue either I know what is working and so does my vet. I am not a faith healer nor do I believe in it it looks like the only faith you have is in your holier than though self. You remind me of our consulting vet. you can show him and show him, but when it comes down to the bottom line what the drug companies will do for him, he will jump on their bandwagon even when it doesn’t work…………………….
Skeptvet, I live in the area where one of those pendulum dowsing/chakra reading outfits (see Ellen’s post). I personally believe that there are some legitimate holistic vets, who offer “complementary” therapies to go along with traditional therapies. An example would be nutritional support (including supplements) for a dog undergoing chemotherapy. I have also had a “holistic” veterinarian say to me that a “mainstream” procedure was indicated and was the best option for my pet’s condition (radioactive iodine treatment for thyroid). This vet, BTW, does not do any pendulum dowsing or other similarly dubious “therapies.” What I find disturbing with some of these so-called alternative vets is that they market these services under the guise of being licensed vets. I think vet boards should have a stricter policy and/or require disclaimers when these services are offered by clinics that are run by licensed vets.
lori –
i’m glad your dog is improving, but are you sure she really has cushing’s disease? how was she diagnosed? supraglan can’t cure or control cushing’s disease (too much of the steroid cortisol in the body) because it doesn’t contain ingredients that can lower cortisol levels. in fact it contains herbs, like licorice, that are dangerous for a dog with cushing’s disease. licorice acts like a steroid and can increase cortisol levels and cause high blood pressure.
http://nccam.nih.gov/health/licoriceroot/
Natalie,
There’s of course a continuum of evidence for veterinary therapies, from well-proven through plausible but incompletely tested to unlikely and untested but possible all the way to impossible and ridiculous. Any vet, whether they claim to be “holistic” or not, is likely to be using lots of therapies that are reasonable in terms of consistency with established knowledge but have not been thoroughly evaluated yet. The ones who worry me are those who use, and make aggressive claims for, therapies that are inconsistent with established knowledge and either haven’t been tested or have been shown not to be safe or effective.
FWIW, the label “holistic” is really pretty meaningless (see http://skeptvet.com/Blog/2010/04/holistic-medicine-it-means-whatever-we-say-it-means/), and it is mostly a political/philosophical statement, not in any real sense a scientific term.
My 13 year old male Shih Tzu has recently been diagnosed with Cushings. The biggest problem for me (owner) is evening night terrors. He beging panting incessantly, is obviousloy aggitated, wants to be in my lap, and will not calm down. I have to put him in a pen to get any relief (for me). Is there any thing I can do to help him relax? Why does it seem to be most apparent from around 8 pm to 1 am? I am hesitant to begin medical treatment for three reasons: 1. The expense. 2. He is near the end of his natural life span. 3. The horrific side effects that are so common. Thanks for any help you might offer because our vet tells me that they have not had good results with traditional medical treatment protocals.
Larry,
I am sorry you’re having to face this problem with your friend. I can’t, of course, guide you in the specific treatment of your dog since with a disease as complex as Cushing’s disease successful treatment requires a close working relationship between owner and veterinarian and a lot of moniotring of clinical symptoms and laboratory tests. But I can offer some general thoughts on the problem.
Cushing’s disease can cause very unpleasant symptoms, and there is no perfect treatment. That said, I don’t agree at all that there are not good results with traditional scientific treatments. I have seen many dogs live happily for years on trilostane or lysodren, when properly treated and monitored. If your vet is not comfortable with managing this disease, you would probably be better off seeking another doctor, perhaps even an internal medicine specialist, with more experience in this area.
Of course, as you point out, the treatment is expensive under any circumstances, and more so the more specialized expertise your veterinarian has. Without health insurance for our pets, the economic limitations we face is one of the most frustrating aspects of veterinary medicine. Unfortunately, anyone who tells you than can sell you a cheap and easy fix for your dog’s condition is either lying or deluded.
So what are your choices? There is either conventional treatment, imperfect as it is, alternative treatment, which is of unknown safety and efficacy and just as likely to harm as to help, or no treatment at all, which leaves you in the awful position of deciding when it is kinder to let your friend go than for him to continue to experience his symptoms. Painful and frustrating as it is, this is the situation you are facing.
I hope you are able to find a solution that works for you and your companion. 13 is old, it’s true, but I’ve seen plenty of Shih Tzus live longer. The real issue is not how long we can make your pet live, since that is always unpredictable, but can we make him feel good and live happily while he is with us. Though nothing is certain, I think there is a good chance that traditional treatment can help him
You have been so kind to offer your help. I will now seek a local vet with more experience with Cushings and hope for the best. I love Ralph and he loves and trusts me to take care of him.
Thank you
Just me two cents for Larry:
SHOP for a good vet. My 10 yr old Brussels Griffon was incorrectly diagnosed for “dry skin” (not cushings) by 5 vets. I finally found a vet 5 months ago who knew his stuff, did blood tests, and correctly diagnosed my dog’s condition (which was in fact Cushings) and prescribed Trilostane.
Contrary to this blog owner’s statement, treatment need NOT be expensive. My vet has arrangements with a vetmed wholesaler (provides meds for horses, dogs, cats, etc.) and treatment is VERY affordable. If you buy from your vet, however, the cost of treatment (trilostane) can get pricey…. Because (most) vets mark up medication costs by 200 to 500% or more in my experience here in Phoenix, AZ.
Also, make sure you pick a vet who has existing, long lived cushings patients…. My vet has treated several 15, 17, 18 year old dogs who are living long, happy lives with treatment.
As for SupraGlan, I have used it in conjunction with Trilostane for 3 months. I ran out and noticed increased water consumption and panting, so I resumed it and the symptoms lessened, so I recommend both trilostane and Supraglan.
Frankly, I don’t know why so many people doubt herbal remedies… I mean, penicillin was derived from moldy orange peels, aspirin was first synthesized from willow bark, certain glaucoma treatments are derived from THC (cannabis)’ etc, etc. And many medicines have plant origins.
So find a GOOD, informed vet, Larry. Shop around. Do it fast and get your companion animal the medication needed, don’t let anyone talk you out of it or suggest euthanasia as a remedy for for Cushings.
I am at a loos of what to do my dog has had the blood work she is 6 the vet says it cushing I cant afford the treatment breaks my heart. Should I try this product.She pants so much and is over weight and always hungry. Not to much of a hair problem dry skin she is a minpin. I would appricate any input, thanks
The only thing sadder than the situation you’re in is the fact that the people who make and sell useless products like this one will try to make money from it. I wish we lived in a world where all our pets could get the best care possible regardless of cost, but of course we don’t.
I can’t tell you what to do, and unfortunately the kind of desperate situation you are in is part of why useless treatments can survive. I hope things work out well for you and your dog whatever you decide.
Will this stuff hurt her if I give it to her I don’t want to make her worse. I believe she has had this for awhile already the constant hunger has been a problem and the panting for a few yrs already she has the pot belly we just always thought she was fat. her one count that should be like 175 was 975 when they did the blood work. I want her to be comfortable she is happy most of the time. SO nice to have a site to go to for input.
The problem with remeies such as this that nobody has tested scientifically is that no one knows if it will hurt patients. Most herbal remedies, even if they don’t help, usually turn out not to beharmful. But some have turned out to have toxins in them or side effects that did cause harm, and without testing any claims hat they are safe are just stuff people made up. I think it’s safer not to use these kinds of unproven remedies, but I can’t really tell you if they will help or hurt your pet.
Had I found your website first, I likely would have not ever tried Supraglans. Im glad things worked out the way they did. As far as testimonials, or more specifically, personal experience with this product being worthless and not scientific enough to be valid, I thought clinical trials were pretty much a give it to em and see if it works deal. Only difference is it being closely monitored by a third party. Isnt that true? If there were some offered here, I would go that route. As it is, I try to be open minded and not see just what I want to see. Here’s my experience as a pet owner with a cushoid dog of 11 years old.
My girl was a rescue dog 5 years ago when I got her. She had been treated experimentally by a local vet with some sort of shots for her heartworms, which, as it happens was recalled before she could receive the second of the two shots about the time i adopted her. She began having seizures about once or twice a month, which I believe was caused by the treatment. Her hearworms were not cured, but died off naturally over the next year, being carefully monnitored by our vet. She is now heartworm negative. About a year and a half ago, she started having to go out several times a day and was always thirsty. She was also always panting, and had this distended belly with weight gain.. I thought diabetes since I never heard of Cushings, and took her in for a sugar test, which was negative. Over the next few months with no improvement, I started reading and self-diagnosed her with cushings, at this time, the doctor examined her and agreed.
I read of the treatments and decided to work on her diet, giving her gluten free food, and bought some Cushex drops, another natural treatment, from a mail order pet place. Well, I found the results to be maybe a 10% improvement in symptoms, mainly the water consumption thing. Then I decided to try Supraglans. Well, the results were not as great as a lot of reviews were claiming, but there was noticeable improvements in her symptoms. So I continued its use and also searching the internet for information. What I discovered was a study done on cushoid horses using chaste tree berries that showed promise for curing or controlling cushings. I found a supplement from the same company that sells Supraglans in a liquid form and started giving her 1/3 dosage (it was prescribed for humans) and the results were quite impressive when used with the supraglans. I also give her coQ10 and magnolia bark, which I had also seen recommended for Cushings. She is markedly improved, with her main remaining symptoms being the pot belly and some thin skin (according to my vet). She seems healthy and happy for the most part.
But this is just my esperience, so doubt you will think it invalid. It is more important to me that I am seeing such good results with my dog. I havent tried conventional treatmentn because of the chemo side effects and the expense. I wS going to try Anapryl, but it was very expensive from my vet ($82 a month) and being on a fixed income couldn’t see maintaining my dog for the rest of her life on it.
What has been your experience on this drug?
Cindy,
While I’m glad your dog is doing well, your story illustrates exactly why remedies like this can continue to be sold even if they may not work. First, some facts about Cushing’s disease. It is a complex disease that affects many different organ systems and can appear quite different in different patients. It is chronic, which means it devlops over a long time and persists for a long time. During this time, symptoms can come and go, someimes getting betetr and sometimes worse, and some symptoms may disappear entirely and be replaced by others. And not every dog with Cushing’s disease even needs to be treated, depending on the severity of their symptoms, other conditions they have, age, how they react to medication, etc. If this were an acte disease with discrete, objectively quantifiable symptoms, it would be easy to say what worked and what didn’t. This is part of wy complex, chronic diseases are the major market for unporoven therapies. You rarely see such things applied to acute conditions with clearly defined outcome measures because it is harder for us to fool ourselves with such conditions.
Another reason to be cautious is that every single remedy every tried has somebody somewhere who swears it works. I’ve heard success stories for homeopathy, herbal remedies, prayer, acupuncture, and I’ve even heard people whose dogs had been diagnosed with Cushing’s and then all the symptoms went away without any treatment at all. So does everything work? Is there no way to judge one treatment better than another except to try every single one in every dog and see what happens? No, fortunately, we have better (though not perfect) methods, including clinical trials.
“I thought clinical trials were pretty much a give it to em and see if it works deal. Only difference is it being closely monitored by a third party. Isnt that true?”
I’m sorry, but this is absolutely not true. The main advantage to clinical trials over a “try it and see” approach is not just systematic monitoring, but a whole host of other controls to eliminate sources of confusion. Patients must be matched in terms of every possible variable so that we are sure the groups on different treatments are the same in every way except for the treatment. If, for example, the dogs getting a placebo had adrenal Cushing’s disease (due to a cancerous tumor of the adrenal gland) and the dogs getting the experimental treatment had pituitary Cushings (a benign pituitary tumor) then some of he treatment dogs would get better and others wouldn’, but the placebo dogs would all die and we’d think the treatment was great even if it did nothing.
Randomization, blinding, placebo conrols, statistical analysis, and many other methods used in clinical trials help correct for all kinds of errors we don’t even think about or know we are vulnerable to. Over and over again in medicine, treatments that everybody believed worked were compared with a placebo, for example, and it turned out the patients getting the placebo got better just as often. We are simply too confident in how things seem. And in clinical trials, we try to measure objective variables. Instead of saying “well, I think he’s peeing less and panting less” we might measure his alkaline phosophatase, measure exactyly how many ounces of water he drinks and how much urine he produces, check his blood cortisol levels, and other things that are much more reliable than our impressions.
So though I understand why what you see with your own eyes is so convincing, and I don’t expect I’ll ever be able to convince you to doubt it, the reality is that most of the useless treatments we don’t use any more (like bloodletting) and most of the effective treatments that have made our lives so much longer and better were only correctly understood with scientific research. Thousands of years of trying things out and watching what happened failed to accomplish what only a couple centuries of science has managed, so I think a large helping of self-doubt benefits us all.
As for anipryl (seligilene) it has been tested and most of the results suggest it is not very effective (e.g. Aust Vet J. 2004 May;82(5):272-7.
Inefficacy of selegiline in treatment of canine pituitary-dependent hyperadrenocorticism. Braddock JA, Church DB, Robertson ID, Watson AD). Trilostane and lysodren are the best therapies for Cushing’s disease, and while they undoubtedly have poential side effects, they are likely to give most dogs a longer life and a better quality of life than doing nothing or using ineffective therapies like Supraglan.
Thank you for your reply…
I guess your explanation of what makes for good scientific evidence is convincing enough. The problem is, how do I use it to help my dog. There seem to be only two effective treataments according to you available right now, and as far as I know no others being thoroughly tested at this time, or if they are, I find no mention of them. My dog probably wont live long enough if she waits for another alternative treatment. As for the Anipryl, I thought it was either not effective at all or very effective, depending entirely on the exact location of the tumor on the pituitary. I had it suggested that I try it on her for a couple of months to determine if she was a good candidate or not..
Have you read anything about the research being done on horses using chaste tree berries? I believe it is being done in England…In any case, it is a bonefide scientific study not based on testimonials, etc… I realize it’s only being done on horses, but it seems like it could work for dogs as well. My dog seems improved since I have been giving it to her, even more than the Supraglans, and that is also the opinion of her vet, who could benefit from selling us the chemo drugs..
Cindy,
Anipryl has been studies in dogs and humans with Cushing’s disease, and it appears that only about 20% of patients respond at all to it, and that response is not very good so long-term control is poor. And it is not without side effects. It can cause temporary agitation and neurologic symptoms and can interact negatively with a number of other medications. Trilostane and lysodren get a lot of bad press, but the reality is that if properly used and carefully monitored, they work and without unacceptable side effects in most dogs. Part of the danger of ineffective treatments that we tend to overlook is that even if they don’t have significant side effects, they leave the underlying disease untreated, and that can definately harm the patient.
I don’t do equine medicine, so I have limited knowledge about chaste tree berry. There are, of course, lots of positive testimonials, but as I said before that is true for every treatment every tried, and it doesn’t tell us much that is useful. Equine Chushing’s disease is fundamentally very different from the disease in humans and dogs, since a different area in the pituitary is affected, so it is not necessarily true that if the chaste berry works in horses it will in dogs. And in any case, there is negative research evidence that contradicts the testimonials (1), so I don’t have a lot of confidence in it. That said, there are no research trials on its use in dogs, so we can’t be certain either way.
1. Beech J, Donaldson MT, and Lindborg S. Comparison of Vitex agnus castus extract and pergolide in treatment of equine Cushing’s syndrome, in AAEP Proceedings, Vol. 48, 2002, pp. 175-177.
I’ve never used the product, but am considering it. I have been actively looking for negative reports so I will not waste my money. I started off taking you seriously, but after reading a few of these exchanges, you lost all credibility with me. Someone who was truly unbiased would at least consider the fact that it MIGHT work. Even if it has not bee scientifically proven, a true skeptic does’t come to ANY conclusions without evidence. You have clearly come to a conclusion without evidence, and your bias became clearer and clearer the further I read. Bias is nearly always based on something personal. So did you have a negative experience with this product, or a similar one, or are you being paid? You will of course say that the only conclusion you’ve come to is that someone shouldn’t buy or use a product that does not have proven benefits, and has proven negative effects. (Well, actually, you only mentioned *potential* negative effects of Licorice, and left out the proven negative effects of over prescribed veterinary meds that purposely attack the dogs system, assuming the ends justify the means.) However, it should be obvious to anyone reading this sustained attack that you either do not believe this product works, or you are getting some gain from appearing to not believe this product works. You have offered no more proof that this product doesn’t work than the company has offered that it does work. For someone who would deign to lecture others on the merits of critical thinking, that’s a pretty big failing in an article called “Empty Promises, Not Medicine.” You made the claim with that title that this medicine DOES NOT WORK, and then offered no studies to back up your claim that it does not work. So basically this was just a rant attacking a lack of controlled study, and showing your disdain for intuition and the powers of observation of pet owners. If you want to discard human powers of discernment and behave like a robot, or a computer, that’s fine, but at least follow your own rules. You can not make claims about a product’s performance based no studies to show it’s performance or lack thereof- WHILE ranting about people who use their own powers of observation instead of relying on “experts” to tell them what to believe. At least not if you expect to be taken seriously by any thinking person. Clearly you expect to only encounter only non thinking persons. Your whole act of “Let me, the expert, the person who is more informed than you, enlighten you about critical thinking and scientific study so you do not harm yourself in your ignorance” is just as bad as any snake oil salesman. You can only peddle that crap to someone who doesn’t know enough to spot bullshit and call it. I can’t imagine why you’d try so hard to discredit a product when you have no evidence that it doesn’t work unless you are being paid by big pharma, so I’m not surprised you’ve been accused of it before. Where there’s smoke, there’s fire. If this is just a hobby, playing expert on a product based just on looking at a website… well… Maybe you should try going out? Or knitting? Something productive?
It never ceases to amaze me how people who write such excessively emotional, personalized rants don’t see the irony in accusing me of having an axe to grind or not basing my criticisms on facts. You begin by pretending to be an objective, disinterested consumer, but your tired accusations about “big pharma” and financial conflict of interest, despite my explicitly addressing that in the post and the FAQ page, reveal your real biases.
As far as critical analysis:
1. The theory presented for the product and the claims that it treats both Cushing’s and Addison’s disease clearly make no sense and shows the manufacturers don’t understand the diseases they are selling a cure for. Would you take your car to a mechanic that thought it was powered by tiny gnomes in the engine because it is ‘t fair to judge him unless you test his services to see if he can actually fix your car?
2. There is no evidence to support the specific ingredients or the claims made for the. Could herbs possibly be helpful in this disease? Sure. Does that mean that it is ok to sell people a cure made out of watever random collection of herbs you want to throw together? No.
3. The best you defense you can offer for the product is that I can’t prove it doesn’t work? Well, I can’t absolutely prove Santa Claus doesn’t bring presents or that astrology might not be able to predict the future, but I’m not holding my breath. Absence of evidence may not be evidence of absence, but absence of evidence AND aggressive advertising based on BS is not a legitimate reason to make money selling false promises. The burden of proof is always on those making the claim.
You don’t seem to care that these people take advantage of pet owners who want to help their sick animal companions by selling them an unproven and implausible snake oil with empty promises and that they haven’t made apparently any efforts to rigorously test the product or demonstrate that it woks or even that it is safe. Yet you get all heated up over my criticis of the product. You accuse me of financial self-interest, which isn’t true, and you ignore the fact that the folks pushing this product make money off of it. Your indignation is wildly misplaced.
I have a dog diagnosed with atypical cushings. He is on flax hull lignans and 9mg melatonin. He has been on this for a year and so far so good. I would recommend joining the Cushings Disease Group on Yahoo. I have and they are so informative and very well knowledgeable of this disease.
My dog has been diagnosed with Cushing’s disease 2 years ago. She was very sick. I did what the vet said but it all just got too expensive. I tried Superglan and she doesn’t even seem like she has the diesease. I think everyone has their own opinion and if you want to try it, then try it. Who cares what everyone else thinks! As long as your dog is happier, what else really matters?
Everyone is entitled to their own opinion, but not their own facts. It eithe works or it doesn’t, and without proper study we don’t know. People told the ame kind of story you just did about bloodletting for a thousand years, and it killed many people and helped none. The truth matters.
Hemochromatosis, the way to get relief and cure it…Bloodletting
You dont believe me? Go to the mystery diagnosis website (a Discovery Channel show)
and look up the episode of the “Man who turned Orange”.
You should maybe change your line as this practice saves lives when medicine can not compare.. Im just sayin.
Yes, I’m well aware of the role of phlebotomy in treating polycythemia and other such rare disorders. This, of course, has absolutely nothing to do with the widespread use of bloodletting for infectious disease, cancer, malnutrition, and even blood loss from traumatic injury that persisted for centuries. Many thousands of people were killed by inappropriate use of this therapy based on anecdotes that led people to believe it worked, and given how rare disorders that require it are, the liklihood is that almost no one was actually ever saved by it before the era of modern, science-based medicine. It remains one of the best examples of how what we think we know often isn’t really true and why we need science to tell us what really works and what doesn’t.
But back to my point, it does save lives (plural not one) this condition without bloodletting leads to complications, leads to death.
I think you’d be better off making your point by using an analogy that fits not one that supports opposite your opinion.
Again, I’m just sayin.
Reading over all of this makes me feel like I should flip a quarter and guess “heads or tails”. Personally with my cushoid 6+yrs, diabetic 3yrs., chronic renal failure 2yrs. I took no chances ever with her med care. I never considered any unproven remedy because I loved her too much to gamble unnecessarily with her health. I agree with the doc. In my research for my girl I saw the supragland ads but if it looks too good to be true than it probably is. Cushings is a very complicated serious disease that requires diligence from the parent and the internal med doc. And really the costs are not so bad if you’re willing to sacrifice a bit for the ones you love. After all one wants to know at the end of the day he did do his very best with the situation. My girl received lysodren therapy for 6yrs 4 mths and had the nasty diabetes not arisen 3 yrs into treatment I feel she would have lived even longer. I am not a docter just a parent who wanted the best offered for her kid’s health care. Personally I would not want any witch doctering done on me. As with any health care and treatment become informed so that you may make intelligent decisions. After all a life depends upon you.
Thanks for your comment. The advocates of Supraglan often act as if conventional therapy is a waste of time and does more harm than good. Yet despite known risks, there are also known benefits, as you experienced. Suprglan only offers unknown risks and unknown benefits, and it’s advocates seem offended at the idea that they ought to be expected to provide the same level of evidence as exists for conventional treatment. But as you say, there is a real need for real information so pet owners can make the best choices for their companions.
what makes me laugh is that the anti – alternative drug mentality is so typical amoung doctors and vets because they arent taught anything about vitamins or herbs in medical school. why ? because the drug companies send doctors on free vacations during and after medical school to keep them beholding to them !
yeah , theres just a little bit of bias against alternative drugs .. just a little !
Another poster said it best; pencillian is made from a mold. so why arent doctors warning their patients about that ? because pencillian is a standard drug company product.which everyone makes money off of ..
I’m not clear what you mean. Penicillin is a refined, purified drug derived from a natural source, as many drugs are, and thoroughly tested in vitro, in animal models, and in the species in which it is used. It has known benefits and known risks (primarily allergic reactions) which doctors certainly communicate to their patients/clients when using it.
This is nothing like giving random concotion of herbs with unknown chemical ingredients not tested scientifically in any way, so the comparison doesn’t seem to clarify anything.
In short, BS. The assumption that disagreeing with your beliefs can only happen if people are ignorant or brainwashed/bought by corporations is just an arrogant and dishonest way of avoiding dealing with the substantive criticisms about the implausibility and lack of evidence for specific interventions, like Supraglan. It is dishonest, unfair, and frankly childish to respond to criticism in this superficial way.
I guess if this skepvet offered alternatives other than just negativity I’d be tempted to not immediately dismiss them. I for one won’t pay any attention to this person who spends a lot of time calling people quacks. Maybe you ought to look in the mirror.
Seems like you’re not reading very closely. I offer balanced discussions of those therapies for which there is some evidence, and I have many articles about the real, evidence-based approaches to problems for which CAM therapies are often used. I reserve “quacks” for those people who aggressively market and profit from therapies that are either proven not to work (like homeopathy) or that we have no real information to tell us if they are safe or if they work (like Supraglan). It is immoral, and in fact in many states criminal, to sell desperate people useless or dangerous unproven treatments, and I make no apologies for identifying and labeling those who do so.
My 12 year old dog Dollie appears to have Cushings. The symptoms match and the vet suspects it. We have not gone through the tests yet to confirm it. I am looking for anything that will help her with her condition while trying to keep treatment from blowing a huge hole in my budget. I still dont know what treatment I will chose. She is drinking a lot more but still has good bladder control and does not seem to be in pain. She is functional but sleeps a lot more now. Today I came across Supraglan and have been trying to look at all sides of the issue. I dont know what I will do but I do think Dollie is doing well enough at this stage that I might at least buy a couple of bottles and give it a try while I still debate on the issue of what “traditional” method to use and afford.
Skeptvet may be right that this drug does not work. There maybe no clinical trials that support the claims of the manufacture of this product. As I been researching Cushings what is clear to me is the standard treatments dont promise a cure. It is all about managing the symptoms and maintaining a reasonable quality of life. If this product for whatever strange reason improves the lives of some dog than that really is all that matters and they have saved themselves a lot of money. If the owners perceive their dogs to do better, the dog is not in pain and is functioning better for whatever reason what really is the problem?
If it does not work after say a few months one should try something else. Yes one wasted some money but the total cost will be less than one of the many blood tests that one has to do with the traditional methods.
I recognize that the sun is setting on Dollie. She has had a good life and I will miss her greatly when she does pass. My goal is simply to let the remaining months she has with me to be pleasant for her as well as for my family. The issue really is how much will it really hurt the dog to try Supraglan for a few months period if the dog currently is doing ok without any treatment? If one sees improvement than that is what counts. If one does not see improvement than one has to recognize this fact and perhaps go to a traditional method. At the very least, it will give the owner a better peace of mind knowing they tried everything possible for their dog and did not neglect something that was out there.
Several misconceptions which I feel obliged to point out.
1. You assume supraglan might or might not be effective but is at least safe. Just as there is no evidence to suggest it works, there is also no evidence to indicate it is safe. Pharmaceuticals are extensively tested before being licensed for use, and even then problems are sometimes found with systematic post-market monitoring. Products like Supraglan are not tested at all, and they are not systematically monitored when in use, so if they commonly cause subtle, long-term harm or even outright kill a small proportion of users, how would we know. It is a common mistake to assume that because we know the risks and side-effects of conventional therapies and we know nothing about the risks of these kinds of alternatives that the alternatives must be safer.
2. You seem to feel that if the patient looks like they are better after you start the treatment that means it is working. But Cushing is a chronic progressive diseases with waxing and waning symptoms which are usually subjectively observed by the owner. This means that you are likely to see some improvement when you start using it even if there really isn’t any. It’s the reason real studies have placebo controls, because almost every condition that doesn’t have a 100% objective numerical measure of change will seem to improve even on a known fake therapy. The fact is that we are easily fooled by our own expectations and by random changes that have nothing to do with the treatment, and this kind of normal human fallability is why we need science. Sadly, it is also why “remedies” like Supraglan can make money even when they don’t work. The blood tests aren’t needed just because vets treating dogs conventionally feel like doing them. They are needed precisely because subjective assessment of symptoms is an unreliable way to determine if a treatment works, even a treatment proven to be effective.
So if Dollie does have Cushings (and without the proper testing you don’t really know, so you may be giving her an unsafe and useless remedy for a disease she doesn’t even have), I hope she does well regardless of the treatment you choose. But I hope at least some of the pet owners who read this discussion understand why, whether she does well or poorly, it isn’t data to prove or disprove anything about Supraglan.
I have read with great interest what has ben writen here. I have a 13 year lab terrier
and she has some of cushings . We have gone with many tests and may know for sure in 2 weeks. I also have been doing reserch into what type of medication to use if she realy has cushings. Mitotane(Lysodren) is a insecticide that has adrenocorticolytic effects , so many side effects to numerous to write down. The one that looks more promasing is Trilostane. It has side effects but not as many. And of course Supraglan.
Now I know the side efects of the first two but not any of the last one. So now I have to do more reserch before I choose. I have a hard time when I think about giving my girl something that is an insecticide. But on the other hand giving her something that has not been proven . Of course I would like to believe there is something that can help my girl. I don’t believe much of the rank ranting of the owner of this blog. You sir are entitaled to your opinion. I on the other hand have not made up my mind about what medican to choose. But I will discuss it with my vet.
Everyone is entitled to their own opinion, but not their own facts. The facts are that there is a long list of potential side effects for lysodren and no for supraglan because lysodren is a real medicine that has been studied and used extensively, and the pros and cons are well known. While it has risks, there is ample evidence that the benefits far outweigh the risks for most patients with clinically significant symptoms of Cushing’s disease. Sup raglan, on the other hand, is a random concoction of ingredients that has not demonstrated it’s worth or identified it’s potential side effects through any kind of scientific testing. One advantage to promoting a remedy like this is that you can pretend it is possible to get something for nothing, that you can have benefits without risks, because the risks are entirely unknown (as are the benefits, if any). Those promoting real medicine are at a disadvantage because they are stuck with the inconvenient truth that anything that has a real effect on the body will have unwanted effects as well as those that are intended. Making stuff up is always easier than finding out and telling then truth.
So how will you make up your own mind when the promoters of supraglan can say anything they like, anything they think you want to hear, without having to prove any of it? And how can you judge the truth when you don’t mind the promoters of this remedy making things up to sell a product, but you think criticism of their lack of evidence is “rank ranting?” The whole point of this blog is to help owners make decisions based on facts rather than advertising, but I’m amazed at how many people seem offended by my criticisms and questions but perfectly happy with the advertising of those selling supraglan.
hi skeptvet.. i just stumbled upon your website as i was doing some research into Supraglan.. i have a 13 1/2 year old porty with cushings.. we gone through both sets of heavy medications.. the lysodren did work but makes him sick.. so what we have now is a dog that whines and cries all nite and tries to lift the toilet seat to get water.. is there anything you can suggest to help with the thirst issue.. its quite exhausting as you may imagine.. i was just about to purchase the Supraglan . Im glad i read what you have to say and are thankful for your comments.
any help or suggestions would be greatly appreciated.
thanks
Andrew
Andrew,
I’m sorry to hear the lysodren had unacceptable side effects. This can happen with any effective treatment, but it is frustrating. Trilostane is the other, newer medication widely used for Cushing’s Disease. It has it’s own pros and cons, but it is a reasonable choice for many dogs with this disease. There are some other medications sometiems used that are much less likely to have a meaningful effect, but in any case I would discuss the options with your veterinarian. If they are not up to date on the current treatments, it would be ideal to see a board-certified veterinary internist if there is one in your area.
Cushing’s disease can very often be successfully managed, but it is a laborious and often expensive process that isn’t perfect. That hard reality is largely why unproven and ineffective therapies manage to survive, usually with empty promises. I hope you are able to find a solution that works for you and your dog. Good luck!!
The reason why vets bad mouth natural or homeopathic remedies is because they lose $! They are in bed with the drug companies and get kick backs when they prescribe their medicine despite how harmful it is to pets. When pets get sicker they prescribe something else and when they sick from that they prescribe something else……and round and round we go! If a natural remedy works for someone’s pet then great! It’s a lot safer and better for your pet than these drugs that destroy organs or glands in pet’s body. My dog is suspected to have Cushion’s Disease we are waiting for the test results, if she has it I will try natural remedies before I would put this harmful drugs in her body.
I don’t even vaccinate my dogs anymore because it has been proven from vet schools around North America that after the 1st years vaccines animals can be immune for years if not for life. But what do Vets do? They keep giving our pets these yearly booster shots! They are over-vaccinating our pets for $!!! It has also been proven that these so called yearly booster don’t boost anything it actually suppresses the immune system and can cause irreversible damage to our pets. Also they give the same amount of the vaccines to a 100 lb dog as they do 5 lb Chihuahua, that is ridiculous! When I asked the vet about this he said it’s protocol. Doctors don’t give a human baby the same amount to an adult, because it would probably kill the baby. And they surely don’t give yearly boosters… because they are unnecessary! So same with pets these shots are unnecessary and VERY harmful!!!!!!!!!!!!!!!!!!!!!!!
When we take our pets to the Vet we trust their judgement, but they are in it for the money so of course they are going to say your pet needs this shot or needs this medication…blah blah blah. So we need to do our own research like I do and tell our vets what WE want, NOT do what they want to do. They are our pets NOT theirs. DO YOUR OWN RESEARCH AND MAKE THE CHOICE YOURSELF!!!!
Thanks for providing a concise collection of logical fallacies and myths.
1. Ad hominem fallacy- No one could possibly disagree with you out of honest and informed opinon, so it must be all about the money.
2. Apppeal to Nature fallacy-“Drugs” are bad but “natural” medicines are good
3. Vaccines should be given in weight-appropriate doses- This ignores the facts about how the immune system functions and how vaccines work, which I’ve written about here repeatedly.
4. Too many vaccines damages or overloads the immune system- Another classic anti-vaccination myth.
5. Surfing the internet makes you an expert and your pet will be better off if you read a few web sites and ten tell your vet what to do, since their years of education and training are all just Big Pharma brainwashing anyway and not as useful as your few hours on the Internet.
Another comment: Of course the FDA is not going to approve natural or homeopathic remedies because it would put Doctors and Vets out of business. Even if it has been proven to work they still won’t approve it. Duh! People seriously, the FDA is very smart they know how to keep people and pets sick so as to make $!!! That is why WE have to make our own decisions, not let the government to it for us! The FDA is a joke!! I don’t trust them farther than I can throw them!! >:(