The primary focus of this blog is to examine carefully the claims and evidence concerning alternative veterinary medical therapies. I focus less on the failures of conventional therapies and providers to always adhere to the highest standards of science-based medicine partly because the sins of Big Pharma and other such issues are already well-covered, and partly because the problem of inadequate evidence and pseudoscience is far greater in the alternative medical domain.
However, there are some areas of conventional medicine which strike me as inconsistent with good science-based practices, and which are reminiscent of the exaggerated claims and ethically questionable marketing practices commonly associated with alternative approaches. The current wave of commercial stem cell therapies falls into this category.
As I have said before, I have no objection to the idea of stem cell therapy. Unlike some alternative methods which are based on unscientific or pseudoscientific theories, stem cell therapy is a biologically plausible approach with encouraging preclinical and pilot clinical trial research behind it. My only concern is that expensive and invasive clinical interventions are being aggressively marketed to vets and pet owners without adequate evidence to support that they are safe and effective.
There is always a balance to be struck between the need to address important clinical problems and the uncertainty about the best way to do so. I am concerned that the companies currently pushing these interventions have tipped the scale too far in the direction of acting before there is adequate information to ensure that we do more good than harm. The proponents of these interventions undoubtedly believe they work, but they seem to base this belief on personal experience and theory, not sound clinical research, and these lower levels of evidence are inherently not very reliable. There is also, without question, clear financial motivation to be the first to offer these therapies and capture the dominant market position, which will likely prove a very lucrative one if time and further research does eventually bear out the claims made for these therapies.
I recently came across some advertising materials, for veterinarians and also for pet owners, from the MediVet company, the other major provider of veterinary stem cell therapies along with VetStem. These advertising materials exhibited many of the hallmarks of quackery I have written about before. None of these warning signs allows us to conclude this therapy doesn’t work, but because they tend to be found along with unproven or clearly bogus approaches, the more of them we see, the more cautious we should be in believing the claims being made.
1. Appeal to emotion in lieu of presenting real evidence
2. Claims of major scientific breakthrough without supporting published research evidence
3.Use of testimonials to support claims and encourage use of the method
4. Claiming extensive research validates the therapy without providing this evidence
5. Playing to fears about conventional medical treatments
6. Claiming to be “natural” and invoking the fallacy that “natural” means “safe” and “beneficial”
7. Claiming to produce a benefit with absolutely no risks or side effects
1. Appeal to emotion
Of course, emotions is a more compelling marketing tool than facts, and it is unavoidable in any effort to sell something. However, appeals to emotion that are not accompanied by solid factual support for the claims being made are often a smokescreen to obscure the absence of such support. And because of the unique dangers inherent in medical treatment, and the constraints on pet owner’s abilities to make medical decisions for their companions in a purely rational way given the intense emotional connection they have with their animals, it is easy to inappropriately manipulate people with emotional appeals.
The client brochure for MediVet shows a serious looking cat and somewhat sad looking dog staring directly at the reader, and the text reads:
If your pet suffers from pain, arthritis, or joint disorders, ask your vet about the healing power of stem cells. Don’t let your pet suffer any longer.
Clearly an appeal to emotion, with a good dose of guilt and an implied promise of relief if you buy the product.
The marketing materials for vets uses this tactic as well.
Bring back that “PUPPY FEELING”
Enjoy long walks, running and playing again
[Pet owners benefit from] knowing they are easing the suffering from…degenerative diseases
Don’t just live and let live, live and help live.
It is, of course, perfectly appropriate to care about our pets’ pain and to feel good about making it better. This is one of the great rewards of being a veterinarian. But the implications in these materials of dramatic improvements credited to an as yet unproven therapy, and the emphasis on emotion with a relative absence of evidence is a warning sign because it is frequently associate with therapies that must rely on emotion for promotion because they don’t have real evidence of their benefits. Skepticism is appropriate when confronted by highly emotional marketing of a medical therapy.
2. Claims of major scientific breakthrough:
The leading spokesman for MediVet (and previously for VetStem), Dr. Mike Hutchinson, is quoted as saying the company’s product is “the biggest breakthrough in veterinary medicine I have seen since entering the field 24 years ago.” That’s a pretty extraordinary claim given the dramatic improvements in the technology and scientific knowledge supporting veterinary care over the last 2 decades. Elsewhere in the marketing materials, the process is described as “the miracle of stem cells.”
Again, such hyperbole is not unusual in advertising, but it creates an impression of dramatic benefits from this therapy that is not yet justified by solid scientific research. Exaggerated claims are the stock in trade of hucksters selling snake oil, but they are not the appropriate way to market legitimate, science-based medical therapies.
3. Use of Testimonials:
The MediVet pamphlet and website have heartwarming stories of individual pets who, by their owner’s description, suffered severe disability before being treated with stem cells and were dramatically better afterwards. It is always a good thing when a pet’s suffering is relieved, but the hard reality is that stories like this can be told about bloodletting, faith healing, homeopathy, glucosamine, internal mammary artery ligation, and countless other therapies that are clearly worthless or even harmful. Such stories are psychologically compelling while telling us nothing useful about the truth of the claims they support, so they are really a form of deceptive advertising. Testimonials are the mainstay of alternative medicine marketing and justification, and they undoubtedly are highly convincing and sell products and services. But they are a questionable and disappointing technique to rely on when marketing what is purported to be a legitimate, science-based medical therapy.
4. Claiming extensive, but unavailable, supporting scientific evidence.
The MediVet marketing materials claim their product is “the result of hundreds of millions of dollars of research.” Dr. Hutchinson is further quoted as saying “my independent research” supports MediVet’s claims. These sorts of statements are not consistent with the number of clinical studies of stem cell therapy published in the peer-reviewed veterinary literature (a couple of which I have reviewed previously).
There is certainly a huge volume of preclinical and early human clinical research data, but none of this supports the use of this technology even in humans, much less in our pets. An organization of researchers studying stem cell therapies in humans, the International Society for Stem Cell Research, has stated that these therapies are not yet ready for widespread clinical use, and some veterinary scientists researching stem cells have voiced the same cautions regarding their use in animals.
When academic researchers believe the science does not support clinical application of a new technology, and the researchers actively promoting such use are primarily associated with companies selling that technology, there is good reason for the consumer to be cautious. Many products are aggressively marketed during the window between the appearance of promising preliminary research and reliable clinical studies, and the clinical research often does not find the early promise of these products to be fulfilled. If this turns out to be the case for these stem cell therapies, we will at the least have wasted a lot of our clients money and at worst may have actively harmed some patients.
I’m also concerned about the general attitude towards scientific evidence demonstrated in the marketing of these therapies. In the MediVet materials sent to veterinarians, Dr. Hutchinson says he has been “encouraging all of you to use this procedure in animals as I have done over 60 times…The positive results I witnessed were incredible.” This resembles the “try it and see for yourself” argument so often made by proponents of less plausible therapies, and which for reasons I often talk about is not a reliable way to evaluate a novel therapy. Is Dr. Hutchinson’s “independent research” really just experience with clinical cases? As emotionally compelling as such experiences are, they are only a starting point for suggesting hypotheses that must then be shown either true or false by controlled clinical research. Clinical experience, even that of a smart, well-educated, experienced medical professional, is a very unreliable guide to the safety and efficacy of medical treatments, especially for the complex, chronic, waxing and waning diseases such as arthritis that this therapy is being marketed to treat.
The MediVet materials also suggest that one benefit to the company of veterinarians using their product will be to “build thousands of cases to support our findings.” It should be clear to anyone familiar with the scientific method that research should always be done with the goal of disproving, rather than confirming one’s hypothesis, since it is all too easy for our biases to lead us to see confirmation where it doesn’t really exist. And conclusions based on thousands of anecdotes or case histories is little better than conclusions based on only a few. What is truly needed is more properly controlled clinical research, ideally done independently of the companies which stand to benefit financially from the products, though this is not always practically possible.
It never surprises me when proponents of alternative medicine fail to understand what constitutes reliable scientific validation of an idea and what does not, but it is surprising and disappointing when researchers and clinicians who purport to practice science-based medicine appear not to clearly understand this distinction.
5. Playing on fears about conventional medicine:
The logo for MediVet includes the motto “Drug Free Veterinary Solutions.” The theme that a virtue of their therapies is that they avoid “drugs” is repeated throughout the company’s marketing materials. This is the worst kind of pandering to irrational fear of pharmaceuticals. All effective therapies have potential side effects, and I’m sure these scientists and doctors understand that medicines in common use have great benefits that, in most cases, clearly outweigh and justify their risks. For example, the most common therapy currently for arthritis, which is the largest target indication for MediVet’s product, are the non-steroidal anti-inflammatory drugs, and the evidence clearly shows that these are overall quite safe and their benefits far outweigh their risks when properly and judiciously used.
The marketing materials also talk about the safety of the procedure, stating it is “completely drug and chemical free.” I’d be surprised if the process is free of chemicals, since water is a chemical, as are all of the other substances that are involved in the normal functioning of living organisms. This use of the word is simply an attempt to invoke irrational fear of nebulous “toxins” and as such is more consistent with the style and ideology of pseudoscience than true science-based medicine. It is closely related to the problem of the naturalistic fallacy or appeal to nature, which unfortunately also appears in these advertising materials.
6. Appeal to nature:
The advertising materials state that “the process is entirely ‘natural.'”
“Natural” is one of the most malignant words in medical advertising. It creates an impression that what is being described must be safe and beneficial while really just being an empty buzzword with no real meaning. Cholera, bubonic plague, and hookworm are all “natural.” And antibiotics, polio vaccine, and toilet paper are all “artificial” or “unnatural.”
One could reasonably wonder, of course, whether surgically removing fat from an animal, centrifuging it, and “activating” the stem cells with an L.E.D. machine can fairly be described as “natural,” which probably explains the scare quotes used in the advertisement. But despite this, and despite the fact that the word itself has no relevance to whether the procedure is safe or effective even if it did apply, the authors of the materials undoubtedly included it because of its positive, “feel-good” associations, which again seems a disingenuous, even deceptive advertising gimmick more appropriate to bogus therapies than to real medicine.
7. Claiming a benefit with complete safety:
MediVet actually states, unequivocally, that “there are no side effects at all” to their procedure. Apart from the obvious fact that this cannot be true since the pet must undergo general anesthesia, surgical removal of tissue, and injection of something into their joint or blood, all of which have potential risks under the best of circumstances, the fact is that the research evidence is not nearly strong enough to justify such a dramatic assertion. And as I frequently point out when such claims are made about alternative therapies, there is no free lunch in physiology, so any intervention that has beneficial effects will have potentially harmful effects as well. The obvious problem here is that without systematic, controlled observations, any side effects of stem cell procedures are not noticed, correctly attributed to the procedure, or reported to the professional community. It is difficult to believe that the scientists and doctors involved in this work actually believe they can assure owners their procedures are absolutely without risks, so one must assume this is a willful exaggeration for the purposes of selling a product.
Show Me the Money
Which raises the issue of the financial motives involved in the promotion of stem cell therapies. As I’ve said, I have no doubt the promoters and scientists or doctors at VetStem and MediVet honestly believe their products work. And they may even turn out to be right! But the evidence in human medicine is clear that the source of funding behind a scientific research project influences the results obtained. Subtle, and sometimes not-so-subtle, biases associated with financial interests can easily color one’s perceptions enough to filter out disconfirming evidence and exaggerate the strength and importance of confirmatory evidence. And there is no doubt that making money is an important part of the agenda associated with the creation and marketing of veterinary stem cell therapies.
The MediVet materials aggressively promote the potential income their product will create for veterinarians.
Create a substantial additional revenue stream for your practice.
MediVet’s free marketing will that will drive additional leads to your clinic.
Participate in our “Stem Cell Day” and create an additional tier of income.
2 Procedures a week x 4 = 8per month x 12 = 96 per year. Total additional revenue stream of approximately $150,000.
65% of all animals are candidates for Regenerative Stem Cell Therapy
The pressure to capture market share in this potentially lucrative area is great enough that there has even been litigation between VetStem and MediVet. It is especially interesting that, in the announcement of the settlement agreement between the two companies, it is stated that,
MediVet and VetStem also agree to advertise and promote only factual data regarding the methods, results, technologies, and safety of their respective systems and agree that any comparison used in promotions must be supported by objective data when named or referenced directly.
So while they advertise beneficial effects and safety claims far beyond what is supported by the scientific literature, they have at least agreed not to make claims about each other’s products that are not supported by objective data?
Of course there is nothing wrong with making money from providing high quality healthcare. As I have often pointed out, almost all veterinary medicine, whether science-based or alternative, is provided by the private sector by people who make their living doing so. However, we cannot be blind to the influence of a profit motive on our judgment and our conclusions. The drive to discover and develop effective stem cell therapies may very well be the desire to help our patients, but the drive to bring them to market before they are adequately tested and shown to be safe and effective is clearly a desire to capture market share in a profitable section of the veterinary industry. The excesses of the marketing that I have illustrated here would probably not be as dramatic if there were not potentially a lot of money to be made in this area.
My fervent hope is that stem cell therapies will eventually prove to be of great benefit to pets with many different conditions, and that they will, like most therapies that survive the rigors of proper scientific testing, have benefits which outweigh their inevitable risks. I also hope that the premature marketing of these therapies before such testing has been done will not turn out to be a mistake, either in teasing the public with promises we cannot fulfill and thereby stoking suspicion of scientific medicine or, even worse, in actually harming the patients we intend to help. If my concerns prove unfounded, no one will be more relieved than I. But for now, I am still concerned that inadequate understanding of the limitations of clinical experience, and the incentives of the market, are driving these products into veterinary practices with appropriate and necessary research has been done to ensure they are truly beneficial and safe.
And yet, so many people, including myself, have seen stem cell treatment work with amazing results.
Nice to hear your views on this Skeptvet. I wrote about one of my concerns regarding stem cell therapy in this month’s Veterinary Practice News; i.e., the possibility of inducing or promoting neoplastic growth.
With so much positive push out there for stem cells, I felt like quite the outlier writing anything less than 100% enthusiastic.
I share your views regarding the potential benefits for stem cell therapy. I wonder, however, what information clients are given when they sign up for it in terms of potential, perhaps unknown, risks.
Yes, I think we are absolutely in agreement here. I doubt very much that the fundamentally experimental nature of the process is clearly explained to clients, and I am not seeing rigorous controlled clinical trials or an objective, systematic mechanism for monitoring safety accompanying the aggressive marketing and expanding use of these therapies. I hope the therapy lives up to its promise and the kinds of potential risks you outline in your article don’t turn out to be a significant problem, but I don’t think the way these therapies are being brought into practice is consistent with good scientific practices or the best way to protect our patients.
I think that one of the implications is that vets can employ experimental therapies on dogs more readily than on humans (due to more lax regulations?). This then supposedly benefits dogs by providing cutting edge therapies sooner and then translating those insights to humans after (?) further testing.
That said, I also realize that having a painful dog can make one desperate to try anything and even if clients knew there might be risks, they could very well make the same decisions.
But, as with Chinese herbs et al, I would like to know clients are well-informed about the unknowns and potential downsides of stem cell implantation before proceeding.
My understanding is that there is a loophole in the regulatory system for autologous transplantation, because the assumption is that taking something out of an individual patient and putting it back into the same patint with only what the regs call “minimal processing” is inherently safe. Obviously, this is not guaranteed to be true, which is why I think more research would be appropriate before moving ahead with this approach.
The human field is more cautious about proceeding with clinical use of this stuff before the science is adequate because of concerns about risk, especially litigation, are greater. Human autologous stem cell therapies are mostly available through medical tourism to places like India, Mexico and other countries with fewer safeguards for patients, which is a big part of what the ISSCR is warning against.
I certainly understand the motives of pet owners and veterinarians, and I think it would be fine to make this available to those patients with a great need and unable to benefit from established therapies. But as is done in humans, this should be through the process of compassionate use and registered clinical trials, which require a great deal of close monitoring and data collection to ensure 1) the patients are protected and 2) that this use contributes menaingful data to help determine if in fact the process is safe and effective. Companies, of course, object to such processes because they are expensive, and there is a balance to be struck between concerns for safety and making the economics of getting new therapies developed and into the market. I just think that the current situation is unbalanced, excesively permissive and so open to greater risks than necessary.
My understanding is that there is a loophole in the regulatory system for autologous transplantation, because the assumption is that taking something out of an individual patient and putting it back into the same patint with only what the regs call “minimal processing” is inherently safe. >>>
forty years ago a vet could culture a dogs staph infection and have someone make a vial of bacterin injections from it. That may be where all this got grandfathered in. I did not see it addressed here but I suspect the usda not the fda rides herd on autologous transplantation in vet med while the FDA does in human medicine. The usda will allow vet stuff to be sold with a usda approved label that does not work where the FDA is going to make you show them two RCT if you want to sell something new fda approved. The “organic” healthfraud promotions are USDA regulated not FDAs
art malernee dvm
fla lic 1820
And this is where autologous injection can go with CAVM mixed in….blood coated syringes combined with Heel remedies/nosodes and injected back into the animal to cure things like cancer:
And this is where autologous injection can go with CAVM mixed in….blood coated syringes combined with Heel remedies/nosodes and injected back into the animal to cure things like cancer:>>>
The VAS group members I belong to reported using a black caustic salve to put on vaccine caused cancers. I guess that could be called a heel remedy. I guess if you add blood and sterile water to the oil mix more tissue might look like it was falling off from the sarcoma lumps.
art malernee dvm
fla lic 1820
skeptvet, dr. robinson, dr. malernee, and dr. kurmes:
speaking of dodgy advertising, i would be very interested in your professional opinions regarding an anti-cancer supplement called apocaps, which was developed by dr. demian dressler, “a world-reknown dog cancer veterinarian and author.”
“a world-reknown dog cancer veterinarian and author.”>>>
I bet the supplement does not say on the bottle it cured anything or treated any disease just some “aids in the support of ” mumbo jumbo they are allowed to put on the label. Of course if your clients think you are a “a world-reknown dog cancer veterinarian and author” they may miss the fact that the cancer vet says it cures cancer but the bottle labeling does not.
art malernee dvm
fla lic 1820
here’s the product label:
here’s the disclaimer:
“No medical claims are being made for Apocaps™ on this website. The information provided on this site is based on valid scientific research in addition to expert opinions of professionals that are involved in the development and application of Apocaps™. Statements that describe how Apocaps™ is used will not necessarily reflect the findings of scientific research or any level of success in the treatment of disease. The US FDA Center for Veterinary Medicine has not evaluated or rendered statements concerning Apocaps™ or any information that is presented on this site.”
i would love to see the manufacturer’s response to this query!
Shelly on February 20th, 2010 3:56 pm
“… would like to know if this product will guarantee a longer life and that my current pets/ family members will live a longer life?”
Yet another random collection of vitamins and herbs with no legitimate scientific justification. Individual ingredients may or may not induce apoptosis, or simply cell death, in vitro but there is no clinical trial evidence that this concotion does anything beneficial to real, living patients. It is depressing that the Quack Miranda Warning is all someone needs to allow them to legally promote such snake oil as if it were legitimate, science-based medicine.
skeptvet, haven’t there been in vivo studies and clinical trials (human/animal) using beta glucan (mushroom) and curcuma longa (turmeric, curcumin)?
There are certainly in vitro studies on many of the individual ingredients in this capsule. Beta glucans, for example, seem to stimulate cell-mediated immune cells, so they could turn out to be useful in infectious disease and cancer prevention or treatment. There is minimal clinical trial evidence in humans concerning the effects in real patients, though there are a few promising preliminary studies for patients with cancer also receiving conventional therapy. A key fact, though, is that these studies have used injectable beta glucans because they are not absorbed orally in mammals. So how exactly does this translate into maintaining health, extending life, and preventing disease when given orally to healthy dogs in combination with the other ingredients in the snake oil, which have no better or more relevant evidence to support their use individually and certainly have never been tested for this use in combination?
If the company selling this stuff had any legitimate, relevant clinical trial evidence to support their claims, they would feature it prominantly and most likely obtain an FDA label approval which would cause far more people to use the product, thus helping more animals and making more money. Instead, they have vague statements about “supporting” normal function and the Quack Miranda Warning admitting that there isn’t any real evidence after all.
This is the problem with taking theoretical and in vitro ideas and turning them into products before the process of scientific investigation has been followed. The vast majority of promising ideas turn out not to work in real life, and some turn out to do more harm than good. It is unethical, in my opinion, to sell products like this on the slim chance that the theory and lab research, undoubtedly supported by testimonials and personal experiences of the people already committed to the product,has led to guesses about what it does that will turn out to be true.
Would be nice if it worked; sounds like the company is doing some research which may be good http://functionalnutriments.com/functional-nutriments-awarded-federal-grant-to-apply-its-dog-nutraceutical-research-to-human-cancer/ .
However, I am uncomfortable with this being a “proprietary blend” and not knowing how much vitamin C is in the mixture. This could impact chemotherapy, bleeding times, and GI health.
what do y’all think of the clinical trial results and testimonials??
Apocaps, marketed by Functional Nutriments LLC
Health supplement for dogs draws funding
“They decided to market their apoptogen product as a nutraceutical rather than a pharmaceutical. Nutraceuticals, which have a less rigorous certification process and are less costly to bring to market than pharmaceuticals…”
if this product (apocaps) really works and they want it to be taken seriously as a legitimate anti-cancer agent, why didn’t they market it as a pharmaceutical? do they stand to make more money marketing direct to consumers instead of through pharmaceutical channels?
Pharmaceutical companies have to spend a lot of money proving their prodcts have benefits to justify their risks. Most of the products they research never come to market or make them any money. But when they do get a popular licensed drug, they rake in huge profits. The reason companies like Functional Nutriments elect to forgoe seeking an FDA label is
1. The up front expense and the chance that they won’t be able to prove the benfits/safety sufficiently to ultimately market the product
2. The much more lax regulations under DSHEA governing nutraceuticals and supplements, which make it much easier to market a product with implied claims of benefit so long as the pro forma caveats are made.
Supplements are less profitable than pharmaceuticals, but the investment/return ratio is much more favorable for small companies that cannot afford a large investment in something that may not pan out. Unfortunately, this creates a situation in which products which are ineffective, often contaminated or mislabeled, or even harmful can be easily marketed and can only be regulated if the most dramatic evidence of harm is collected, at government expense (as for ephedra).
Testimonials are never proof of anything. You can line up a bunch to support absolutely anything, including things already confirmed not to work based on rigorous testing.
The trial appears to have been conducted in-house and not published. There is always a high risk of bias with trials conducted by the company trying to market the products, and there is no indication that the methodology of the trial was in any was rigorous enough to control for bias or justify publication in a reviewed journal. Such trials almost always confirm what the investigators already believe is true, which is why properly conducted clinical trials are so improtant. It’s fine to use such data as part of a pilot investigation to see if there are suggestions of benefit or harm, but anything that is ultimately going to be FDA approved requires far better quality research. Again, I think this amounts to somebody having a reasonable idea or theory, trying it out on their own and then seeing the apparent benefits they expect to see due to all the usual cognitive errors and biases that we are prone to. Then this data is taken to investors, a company is formed, a product is put on the market and begins to make money. The further uncontrolled or poor quality studies are conducted with the intent of getting confirmatory evidence to support the marketing of the product. This is how the supplement industry functions, but it is not how real, high quality science is done.
The pharmaceutical industry is the paradigmatic example of the dangers of this kind of approach, and the malfeasance and problems in that industry are well known. Big Pharma, however, is at least very closely reglated and supervised, which improves but doesn’t eliminate these problems. COmpanies like this, on the other hand, are entirely on the honor system, and when cognitive dissonance, professional reputation, deep faith in an idea, and one’s livelihood are at stake, it is nearly impossible for the honor system to adequately protect even the smart, honest, and well-intentioned from strolling down the garden path. This is not the way to find new medicine or to protect the health of patients.
skeptvet, dr. malernee and dr. robinson- thank you for your thoughtful and insightful replies. much appreciated. ellen
Thanks for providing this perspective.
My old aussie shepherd had acellvet ecm put in her arthritic hip this past July. I decided on that product because they had credible studies. My experience post injection very closely mirrored the expectation set based on their double-blind study. I knew I would see 4 to 6 months of serious improvement and that the procedure would need to be repeated.
I reached out to e vet that did the acellvet injection to discuss another acellvet implant and she said to look at the Medivet product as she was also doing that now.
Lovely website, interesting testimonials, but no scientific studies, no peer reviewed studies… that is how I ended up here.
I am now leaning back toward the acellvet product, but would appreciate your thoughts and review of that product and the science as well. Not looking for a testimonial, just a good skeptical eye. thanks – Linda
Thanks for the comment, Linda. I took a quick look at the Acell site. Of course, they also make use of testimonials to market their product, which is probably inevitable but unfortunate since it creates the impression of providing reliable evidence when that is not really the case.
I did read the one peer-reviewed study they provided, and overall it looked like a well-designed and well conducted study with clear positive outcomes. I do not believe it is possible to draw definitive conclusions from one manufacturer-funded study in only 20 dogs. However, I agree that this is better quality evidence than I have yet seen for the stem cell products I’ve discussed, and it does suggest that there might very well be a true benefit from the product. I find that conventional therapy (weight loss, phsyical therapy, NSAIDs and adjuntive analgesics) are safe and effective in most patients, so that would still be my first line recommendation. If, however, you have a patient unable to tolerate those therapies or not apparently adequately treated by them, use of this product would not be unreasonable. I would say it is still experimental, given the very limited literature on the subject, but it seems plausible and the little evidence there is is encouraging.
Hope this is helpful.
skeptvet, since stem cell therapy in dogs has not yet been scientifically proven and has not been accepted into mainstream medicine, would you consider it a CAVM therapy? i find it interesting that the procedure is being used primarily by holistic veterinarians (based on a web search and testimonials on yahoo pet groups).
this compelling youtube video is making the rounds on pet forums:
I’m not convinced that it is primarily being used by “holistic” practitioners. I’m not aware of any actual research on the subject, but stem cell therapies are touted at all the major meetings, I know many otherwise conventional vets who are using them, the North Amrican Veterinary Regenerative Medicine Association was formed at a major meeting at UC Davis, and so on. I also know of some alternative practitioners who find the process too technological and “unnatural” to fit with their philosophy. Granted, proponents do paly of fears about drugs, but overall I think from a “cultural” or philosophical point of view, it is a conventional or science-based therapy. My concerns have more to do with the marketing and widespread use of it before it has been adequately tested.
The definition of what is alternative is, of course, a bit fuzzy around the edges. In general, I use it to describe interventions which are based on unscientific or pseudoscientific theories and/or which are primarily justified by anecdote and testimonial in the absence of research evidence or even in the face of clear contradictory evidence. Stem cell therapy is inherently plasuible and based on solid preliminary science, it’s just being pushed into the market prematurely for reasons which I suspect are mostly about economics and market share. So I would be inclined not to put it in the alternative category.
Thank you for your comments.
She was on Previcox for several years and it did appear to help her. Although the last year, she really continued to slow down, not wanting to walk, refused steps, became very solitary and shunned cuddling.
About a year ago her BUN/Creatinine numbers shot up to a dangerous level. Took her off previcox and the numbers came down to just slightly elevated. Put her back on and the numbers shot up, took her off and back down to slightly above normal, so she came off of it for good.
Follow up exrays in May/2010 showed that the inflammation was significant and that the arthritis was continuing to degrade both the femur and acetabulum. Tramadol and Predisone help, but from a quality of life perspective I felt compelled to look at all options. Surgical solutions -either hip replacement or removing the femur head just didn’t have the success levels for a dog of her age and size. I am sure if they did the replacement the way they do in humans now – small incisions worked under radiograph – it could have been tolerated, but …..
I am not big on hype, just wanted to make sure some good science is being applied and I haven’t seen it on the adult stem cell procedures. Not saying they don’t work, just saying I need to know what to realistically expect and I don’t.
Anyhow, thank you – you are providing some great objective information. I hope it moves some of these companies to do the research and studies that demonstrate if there is value and in what situation there is value in using their products/proceedures. thanks – Linda
Like most medical professionals you don’t seem to care about the suffering that is caused when a loved one cannot be treated by “established and approved” medical procedures (often meaning that only the traditional medical establishment has the power and knowledge to pass judgment on the efficacy of the treatment). As the family care givers we are expected by doctors and vets to sit by and accept the suffering because “nothing else can be done” or we need to “run a few more tests” before you prescribe yet another ineffective treatment. What boggles my mind is that you do all this even though you know that there is a treatment available that has great promise to end or alleviate the suffering even though it may be “experimental” in your eyes. Don’t you think we know that something is experimental? As far as I am concerned everything you do in medicine is “expiremental”. When have you ever given a guarantee that a treatment would work or that it would cause no harm? I’ll answer that, NEVER! The next time you give advice or provide treatment that you guarantee will work will be the first time.
You are simply being a hipocrite and the god complex that is pervasive in the medical profession demands that only doctors (and even a subset of doctors that YOU trust) can determine what treatments we poor suffering slobs can have access to. To compare stem cell therapy to bloodletting and thalidomide is preposterous and smacks of the worst kind of scare tactics available in your considerable arsenal. You should be ashamed. I applaud companies that are not afraid to bring promising new treatments to market using their own research and development dollars when the established medical profession doesn’t have the interest or funding to do the same. We are talking about using these treatments on our pets (the same animals you would use in your blind trials that never happen) not our children. This is exactly the type of market that should be pushing the envelope on medical advances. While I may not be willing to try this treatment on my child (notice I said may since it would depend on the direness of the circumstances) I am willing to take that risk to help my dog and if the company makes money in the process so be it. After all, this would not be the first time a vet or a drug company soaked up a large portion of my disposable income only to tell me that they are “sorry but the treatment didn’t have the desired effect so we need to go in another direction”. The landscape is littered with such stories and the sad part is that there is nothing that can be done to stop it since there is no money in veterinary malpractice.
You need to get off your soapbox and leave vets like Mike Hutchinson and the companies they tout alone. There is no advocate for suffering pets because they are not people and the only way new treatments are developed is if companies like Vet-Stem take risks and vets like Mike Hutchison are willing to apply their own intelligence and make a treatment choice to help their patients. At least stem cell therapy is being administered by trained and licensed vets and not sold out of a catalog or over the web. If the procedures do not work as they say, these companies will eventually disappear from our landscape. The fact of the matter is, that many pets have been helped by stem cell therapy and those that haven’t probably weren’t going to be helped by “traditional, accepted treatment” so what is the harm? Either way, the vet is going to take my money. The only difference is whether its a vet you prefer or one that I believe is actually trying to help my pet live a better life. Frankly, I find you to be way out of line on this subject.
The blind anger and hostility in your comments suggest some painful personal experiences with health care, and if that is the case then I am not surprised you feel this way. That said, I disagree with much of what you say, and I utterly reject your suggestion that what I am doing is in any way inappropriate or not in the best interests of my patients and their owners. Why you (and so many opponents of evidence-based medicine) cannot disagree with me without impugning my motivation is a mystery.
A few points:
“you don’t seem to care about the suffering that is caused when a loved one cannot be treated by “established and approved” medical procedures ”
I care about this suffering, and I care about the suffering caused by ineffective or harmful quack therapies and by the misinformation and propoganda that drives people to use them instead of truly effective treatments.
“only the traditional medical establishment has the power and knowledge to pass judgment on the efficacy of the treatment”
Truth is not a popularity contest, and not all opinions are equally likely to be true. Science has proved itself time and again as better than tradition, intuition, and personal experience in determining what is true. This is not about turf but about how we know what is real and how we fool ourselves.
“As the family care givers we are expected by doctors and vets to sit by and accept the suffering because “nothing else can be done” or we need to “run a few more tests” before you prescribe yet another ineffective treatment.”
Again, if this is your experience of medicine, your anger is understandable. But it is not an accurate or objective characterisation of how medicine really works. Despite the common belief in America that all things are possible, the unfortunate reality is that sometimes there really is nothing to be done that will help more than it hurts. Accepting this is hard, but denying it is just a form of self-deception that brings only more suffering. And the whole point is that scientific medicine is more effective than the alteratives, so the fact that it doesn’t always work is not evidence that any or all the alternatives do.
“you know that there is a treatment available that has great promise to end or alleviate the suffering”
This same argument is always used to justify promising therapies. But most of them turn out not to work. And though you disdain the example, thalidomide is a perfect case of something in which the benefits were considered and the uncertainty and risks ignored (primarily in Europe, sine fortunately in the U.S. we were more cautious) at great cost of human suffering. Again, you seem to think you can have something for nothing–benefits without real, tangible risks. It’s easy to say “why not take the risk” until it is your loved one who is hurt, at which point you shout “why didn’t the government/the doctors/somebody see this coming and protect us” and then call for a lawyer.
“As far as I am concerned everything you do in medicine is “expiremental”.
So we know nothing at all and thus everything we try is the same? Nonsense! If I give amoxicillin for a UTI I know a lot more about the risks and benefits than if I try out a brand new drug or surgical procedure that’s never been done outside a lab before.
“There is no advocate for suffering pets because they are not people”
On the contrary, I am an advocate for suffering pets. You might be willing to experiment on them more freely than on your children, but a part of my job is to help people understand what will benefit their pets, what is uncertain, and what is useless of harmful. You may just wish the veterinary profession to guess and “try it out” regardless of the risks, but I think we can serve our patients better than that.
“If the procedures do not work as they say, these companies will eventually disappear from our landscape.”
And if it causes cancer? Joint infections? Just keep your eyes closed, hope for the best, and let the market sort it out is NOT the best way to run a healthcare system, for animals or people.
“The fact of the matter is, that many pets have been helped by stem cell therapy and those that haven’t probably weren’t going to be helped by “traditional, accepted treatment” so what is the harm?”
The fact of the matter is that you’re making this up and really have no idea if it is true or not. It just fits what you want to believe. Self-righteous indignation matched with ignorance is a dangerous combination.
It seems like I exposed your thin skin and tweaked one of your ivy league nerves. Maybe it’s the old doctor-as-god complex rearing its ugly head again. How dare a mere civilian untrained in the ways of the medical profession question my superior authority and intellect when I have the scientific method to validate my truth. Once again, even with the scientific methods that you are so proud of, the “truth” evades you. The best you will ever do, Dr. Science, is marginally increase the odds that you are right. Medicine is not now, nor will it ever be, the universal yardstick for truth or certainty. Doctors give us their best guess at treatment and that is all we can ever expect from your profession. It absolutely astounds me that you can’t bring yourself to admit this “truth”. Please don’t kid yourself by saying only you know what is true. Your post, more than anything I could ever write, shows the incredible arrogance of your profession. Do you not see it? Are you so full of yourself that you can’t open your mind to the possibility that you don’t possess all of the knowledge worth knowing in the healthcare universe?
Maybe we should scientifically examine the problem. You easily ignore and dismiss pet owners (not greedy corporations) who can tell you, unequivocally, that their pets were helped tremendously by stem cell therapy because the therapy hasn’t met your rigorous standards of scientific testing. You offer no solution to the enormous problem of funding animal healthcare research to scientifically “prove” that the therapy is effective and thus all those who subscribe to such therapies are, in essence, ignorant “quacks” or snake oil salesmen. I guess that is not your problem since your claim to fame is exposing these charlatans for what they are. How elegant your mind must be. You crow at the fact that more often than not you can predict that an antibiotic will cure a urinary tract infection (alert the media) yet you will refuse to accept experimental efforts to end an animal’s suffering far more damaging to their quality of life than a burning sensation when they urinate. And with regard to your lame thalidamide example, how can you compare taking a treatment risk on a human with that of an animal? Are you insane or just so enamored with the visual horrors of thalidamide that you thought it somehow proved your point? It is animals who have bore the brunt of your scientific testing throughout medical history yet now, all of a sudden, you develop a conscience. Maybe you should describe how compassionate doctors “practice” their surgical technique and learn their trade in medical school on healthy dogs and other domestic pets. Yes I said “trade”, for medicine is nothing more than a trade. I realize that you like to be called a scientist since it’s sexier and implies great knowledge but a real scientist does discover immutable truths like mathematical equations or laws of physics. You are, at best, a social scientist who is skilled at tearing down the theories of others using some well-worn parlor tricks and an air of superiority. A real scientist would be performing research to better society, not reveling in his ability to expose the weakness, as he sees it, in the research of others.
You, even with your so-called scientific methods and Ivy League education are no better than me or countless other caring pet owners who don’t care where you went to school or how many footnoted treatises you read to formulate your scientific opinion. You are wrong as much as you are right that’s why they call it “practicing medicine”. Keep practicing, good doctor; maybe someday you will get it right.
Oh, and by the way, I haven’t had a bad experience with the medical profession as I have been blessed with good health. Like any good amateur scientist, I just observe medicine’s practitioners and report what I see. You may want to look into the patient satisfaction surveys of hospitals though.
Is there a full moon?
“Is there a full moon?”
Sadly, lunacy is a continuous rather than cyclical phenomenon.
Now that’s clever.
Interesting that the clinical acupuncturist and herbalist, Dr. Narda Robinson, comes to your rescue. Who was it that said, “With very little risk of harm, and no convincing evidence of benefit, the use of acupuncture in animals should be seen as an experimental adjunct to conventional therapy, not a replacement for proven medical treatments.” Oh yeah, that was you. I guess she’s not a quack even though she employs ancient Chinese remedies in her veterinary practice since her research is not directly funded by a for-profit corporate entity but by a university which obtains funding from a variety of for-profit corporate entities. I am sure it doesn’t hurt that she opted to post an ad hominem quip in support of your major theme that anybody that doesn’t agree with your methods is somehow a “lunatic”.
Yet, it is somehow ironic that someone who “recently completed two studies on the value of Traditional Chinese Medical diagnostic approaches in dogs, specifically on the ancient assessment tool of tongue diagnosis” can be one of your supporters. How exciting! It is not the moon that is full; it is your ego.
Not coming to anyone’s rescue. Merely asking what forces might be at work that inspired this level of vitriol into an otherwise civil discussion.
My Dear Dr. Robinson, Do you even read his blog? SkeptVet’s sniping and vitriol knows no limits when he feels that he is in hot pursuit of another quack. I am simply trying to suggest to the good doctor that he needs to have a little humility since his methods do not always uncover the “truth” as he wants us all to believe. The practice of medicine is a very inexact “science” that has grown into a big business where the amount of money involved can corrupt even the most altruistic practitioner. How many of these so called “scientific studies” which have been cited for years are now being discredited for a variety of reasons including data fraud. Need I refer you to the recent case of the study linking vaccines to autism (http://www.cnn.com/2011/HEALTH/01/06/autism.vaccines/index.html). SkeptVet needs to stop suggesting that the scientific community has cornered the market on “truth” and that those who don’t follow their lead are idiots and lunatics. Given your predilection for Eastern medicine you would be wise to jump off his bandwagon before it runs you down.
Humility means recognizing one’s own limits. Deferring to the scientific method precisely because it is designed to compensate for the limitations of individuals is true humility. I argue for deferring to science because it has proven more reliable than opinion and personal experiences, mine included. Believing what you see or think looks true or just want to believe is not humility.
Being critical of bad ideas and false claims is also not arrogance, it is conscience. If you have specific facts you wish to offer in rebuttal of my argments, feel free. If you just wish to harass because my opinions annoy you, you’re wasting my time and yours. I can be convinced I’m mistaken by rational argument, but I won’t go away just because you huff and puff at me.
Another word you might wish to look up is irony, since your comments have been far more hostile and far less humble than anything written on this blog. As Dr. Robinson pointed out, reasonable, thoughtful people can disagree calmly and politely. Even those who don’t alway agree with me recognize your comments as unecessarily hostile and inflammatory.
Your mention of the discredited autism study is an even greater example of irony. Science-based skeptics such as myself have been challenging that nonense for years, and it is our efforts that finally resulted in it being recognized for the fraud it was and retracted. The only ones who treated it as though it were real science were those on the anti-vaccine and, often concurrently, alterative medicine train. Science has many failings, but it is still the most reliable game in town.
I cannot accept that this blog engages in thoughtful, calm and polite disagreement as long as you are calling people quacks, charlatans and frauds. Calling a medical professional a quack, charlatan or fraud without proof is unconscionable, especially coming from another medical professional. You are being libelous and are actively trying to hurt these individuals economically and destroy their reputations and you know nothing about them. You disprove nothing, yet all who don’t prove their ideas to your satisfaction are deemed to be quacks and charlatans of the highest order. How is that civil discourse in your mind?
You suggest that I must not know the meaning of humility because I choose to believe what I see and you follow your conscience by trusting in science even though (I assume) it contradicts what I see. Huh? You lack humility and exude arrogance not because you follow your conscience but because you believe that those who don’t agree with your premise must be wrong. You say that, “Being critical of bad ideas and false claims is also not arrogance, it is conscience.” How is it that you have the wisdom to decide which ideas are false and which claims are bad? If you are intent on claiming that everything they do is false then you need to provide the proof since failing to prove the positive (in your eyes) does not prove the negative. How is it that you decided that you would be the arbiter of all that is good medical practice. I see that you read some of the papers and belong to organizations of other like-minded professionals but why does that make your opinion more valid than the people who make the claims and did the research? Maybe you should just present the facts and allow your readers to decide what they want to believe.
I innocently happened upon this blog while searching for information about stem cell therapy and really had no intention of engaging you in a debate over the convictions of your conscience. However, it seemed odd to me that your bold and often libelous pronouncements went unchallenged and I honestly wanted to see if you had the data to discredit the claims. Instead of “scientific evidence” discrediting the claims, you base your opinions on what you consider a lack of data all the while ignoring the facts (ostensibly coming from pet owners and vets in the field) that you decide are unworthy. You then use your unsupported opinions to proclaim a whole universe of professionals and businesses as fraudulent! My intent is not to harass you but to challenge you to show me the “evidence” of the fraud. Proving that fraud occurred is very difficult since it requires that you provide credible evidence of intent to deceive. You offer no evidence of fraud yet you do not hesitate to dismiss these people and their work as “charlatans” and “quackery”. Maybe it is you who needs to go the Steadman’s Medical Dictionary which defines a charlatan char•la•tan (shär’l?-t?n), as a person fraudulently claiming knowledge and skills not possessed. Since you make such bold claims it is up to you to prove them and not up to me to offer “facts” to disprove your opinions and rebut your unsupported arguments. When confronted with evidence from pet owners and other vets you dismiss it with the back of your hand as “unscientific”. That is the hallmark of arrogance from a pseudo intellectual. You essentially are saying that your opinion is better than their observations. That is what I meant when I suggested that you need to develop a little humility.
I must say that I have enjoyed our little discussions and I suggest to your readers that this blog needs more debate. I say this not because I find myself or you all that interesting but at least you finally got to hear some dissent. It doesn’t seem that you enjoy it as much as me though. Most of your posts are simply validated by those followers that have their minds right on the subject of scientific evidence. I assume this emboldens you into believing that you are on the side of the righteous and strengthens your resolve to vanquish the Visigoths. May I suggest to the few out there in the ether who may be following this exchange that they need to question these opinions and demand the proof. You have strong opinions that I am sure you have given a great deal of thought but that alone does not make you right and everyone else wrong. And, if everyone else is wrong, that does not make them a quack or a charlatan. Many of those you call quacks and charlatans are more compassionate than you and they are fine people who are committing no fraud. Unless you really have the evidence, you should stop the name calling now. It just makes you look petty and uninformed and could land you in court one day.
BTW, ironically (no, I don’t need to look up the definition), I knew you would suggest that the vaccine study was one of the things that you and others like you had protested for years (yes, I read your other blog entries) but once again you have an uncanny ability to miss the point. You implore people to only trust medical therapies that have been vetted by scientific study. Studies are published every day about one thing or another and the media is quick to report the latest medical breakthrough. If we accept your premise that what passes for scientific evidence is good then we are equally at risk if the researcher turns out to be a bad man committing a real fraud (as opposed to the puffery claims made by some of your targets in this blog). That study was reported in 1998 and it took almost 13 years to uncover the alleged fraud and it was uncovered by a journalist not another scientist in pursuit of the truth. “Science” has yet to prove him wrong though I am quite certain that the rigors of the British judicial system will uncover the truth if he did falsify data. The bottom line is that “scientific evidence” doesn’t provide all the answers and never will. There will always be doubt and skeptics with every medical claim, even those that seemingly have the scientific pedigree you require. Good luck to you dear doctor. You ought to consider using that superior intellect of yours to actually do some research and solve some medical mysteries. To paraphrase Woody Allen, those that can’t do teach and those that can’t teach author critical blogs about those that do.
While I do sometimes use words like “quack” where I see a persistant disregard for the evidence and a blind faith in a practitioiner’s own judgement to the exclusion of all sources of doubt or contrary ifnromation, I am generally far more carful to avoid personalizing the debate than you have been. For example, I can think of no individual I have discussed more deserving of the label “Quack” than Dr. Gloria Dodds, yet even in her case I have tried to be as civil and fair as possible. After exhaustively detailing her inaccurate claims and providing information about why they are inaccurate, I also said, “She truly believes, based on her personal experiences, that these therapies work, and she dismisses any objective evidence that contradicts her beliefs. She is also deeply religious and sees faith in the unseen as an indispensible part of understanding how the world works, including understanding health and disease. I have no doubt she is a nice, caring, and sincere person… I have no doubt Dr. Dodd sincerely believes she is doing good work, and that she is a caring veterinarian. I also believe she is utterly deluded in her approach to medicine, and that her remedies do little to no good and potentially harm her patients.” I believe she is wrong and is harming patients, so I feel a moral obligation to say so. But I don’t feel it necessary to challenge her motives or caracter, as you do mine, only her factual understanding of how the world works.
You claim I present only opinion and no evidence, but that is clearly disproven by simply reading my posts. I present a great deal of evidence to support my opinons, and then I present those opinions. Your problem with my blog seems to be that you don’t think it is appropriate to offer an opinion or to be critical of anyone else’s. For example,
So it is arrogant to say that those people I think are wrong are wrong? And I should never decide and announe that some ideas are false and some claims are bad? Essentially, you’re saying that it is wrong and arrogant to even form an opinion much less to share it with others on a blog. Apart from being hypocritical, since you make no secret of your opinions and judgements are criticize me far more harshly than the overwhelming majority of my critiques of others, this makes no sense. Some ideas are true and others aren’t, so how could we possibly function without trying to decide which is which? Do you really want a doctor so open-minded that they are willing to try absolutely anything that someone else claims worked for them? Is there no point at all in trying to make factual, evidence-based distinctions between true and false?
I understand that you don’t agree with my premise that scientific research is more reliable than personal observation or anecdote. And as I say clearly in my FAQ, if you don’t accept this premis than nothing else I say here will make any sense to you. I think I present ample evidence and sound rational arguments for why this premise is true, but you are free to believe what you like. However, the notion that somehow I’m not letting people decide for themselves but offering my opinions and the reasons for them is absurd. Search the internet for almost any of the products I discuss, and you will find hundred of pages, mostly advertising from someone selling them, making claims about how safe and efffective they are. You may find my site and one or two others talking about the details of the theories or evidence behind them and presenting a skeptical perspective. Is this not exactly what people need to make their own judgements–a variety of viewpoints and arguments on both sides to examine? Should we only alllow positive testimonials and paid advertising for these things, whether they work or not, since it is arrogant and impolite to say anything critical?
As for my needing some dissent, as you see I am not afraid of it since I’m happy to let you make your points and to respond to them. The majority of the feedback I get is from people who disagree with me, but unlike you I don’t feel such disagreement is inappropriate, though I think you are mistaken in thinking that I am not civil and polite about it the majority of the time, and certainly more so than you have been here.
And finally, with regard to the issue of the reliability of scientific evidence, I would paraphrase Winston Churchill: It is the worst of all possible systems, excpet for all the others that have been tried. We stuck with bloodletting and faith healing for thousands of years, and we’ve persisted in using homeopathy and chiropractic for things they don’t actually help for over a century out of faith in the authority of their founders and anecdotal evidence. Yet a false research finding which most scientists never believed to begin with took all of 13 years to be thoroughly discredited. So which system works better? What alternative do you propose to trusting scientific evidence first and personal experience a distant second?
Frankly, as much as I have enjoyed getting to know more about the man behind the blog, I can endure no more of this discussion. You will be happy to know that this will be my last post regardless as to what you write in reply. You are on a mission and the internet has provided you with a forum (yet another reason to dislike Al Gore) and you will not stop the filibuster. Before I leave you, I offer the following:
• Actually you use the words “quack”, “quackery”, “charlatan” and “fraud” quite often. While you may think that calling someone a “quack” means that they engage in “persistant disregard for the evidence and a blind faith in a practitioiner’s own judgement to the exclusion of all sources of doubt or contrary ifnromation”, you would be wrong. A simple dictionary search turns up the following: 1. a fraudulent or ignorant pretender to Medical skill. 2. a person who pretends, professionally or publicly, to skill, knowledge, or qualifications he or she does not possess; a charlatan. So I guess what you are really saying is that these people are deceiving the public as to their medical credentials or skills.
• I have personalized this debate somewhat, but it is because I am criticizing the critic and your belief that only in science can one divine the truth. You have personalized this debate as well.
• If you want to define yourself as the Ralph Nadar of the animal health industry who am I to stand in your way?
• You are going to need a little thicker skin and deeper pockets if you keep accusing people and companies of fraud.
• While “truth” may be a possible defense to libel (the legal technicalities associated with the defense of a libel suit are too numerous to discuss here) it is exceptionally difficult to prove that an actual fraud occurred. If you don’t think I know right from wrong wait until you get before a jury.
Anyway, we all knew how this would end: You are “right” and I am the one who is “wrong”, “absurd”, “hypocrtical”, “harsh”, “lunatic”, “inflammatory”, “hostile”, “self-righteous” and “ignorant” even though you don’t personalize your criticism (yes, you said all those things about me but, to be fair, I also said many of those things about you). I am sure you feel that I am all of these things and that you are a kind, dispationate, polite, civil and reasoned scientist with a blog.
One of these days I suspect that you will bully the wrong person or company and say the wrong things and it will change your life. Before I go I have to ask you one final question: You are suffering from an horrible disease and the doctor tells you, I can give you this pill that in scientific studies published in the NEJM is effective 25% to 50% of the time and may only put the disease in remission for 6 months for 30% of the patients or we can try this new stem cell procedure which hasn’t been tested all that much and is controversial but legal and I’ve seen it work miracles on three other patients who are all doing great 2 years later. Please tell me, which do you choose? “Neither” is not an acceptable answer.
Howard- I would ask you how many people it didn’t perform “miracles” in that you had given it to. I would also ask you side effects- but since there has been no studies, you wouldn’t be able to tell me anything.
However, I am a little more rational than the general public…upon hearing “miracle” they would probably jump at the opportunity for the stem cell treatment you lay out here, even though it hasn’t been studied accurately.
getting my dog his stem cells harvested and injected this week, will try to let y’all know how it went. BTW, I think there is excessive skepticism on this page, however we will soon know another “anecdote”.
You’re welcome to offer your anecdote, but of course it won’t clarify the value of stem cell therapy either way. It is almost certain to be positive, since subjective evaluation of medical interventions almost always are, whether they work or not. There are lots of reasons why therapies appear to work other than an actual therapeutic benefit. Controlled research can help to separate specific effects from non-specific effects (placebo, regression to themean, natural history of disease, etc), but the accumulation of anecdotes doesn’t really shed much light.
Well, Nate, I sure hope to see a lot more skepticism here, it is after all, a skeptical look at pseudoscience type of blog.
A call for evidence based medicine…how refreshing. Kudos.
As a vet having conducted (or participated to) some research projects on stem cell (and platelet rich plasma) therapy, I must add that some scientifically proven techniques do work well. I worked intensively with some very known companies selling regenerative therapies…
That said, DO NOT trust companies that cannot show any scientific results!!! MediVet does not mention any of their scientific studies or validation studies… surely because their is NONE!!! and I made an extensive literature research… They have no research department. Also, some of the other techniques mentioned on their web site are totally old and not reliable! I cannot understand how this can be tolerated by authorities. Financial aspects are much more important than your animal to these companies…be sure!!!
Moreover experience of many vets I know (me inclusive) has shown that platelet rich plasma therapy brings very comparable results, as long as tissue damage is not too extensive! (I mean loss of tissue substance)
Here, too, you have to be CAREFUL what your animal gets injected, as there so many different products on the market, showing large differences in their biologic activity!!!
There are very bad and very good products and price is not the decisive parameter…
So please be very suspicious and ask more than one vet before to treat your animal with these new regenerative medical methods.
Sorry for my bad English
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According to the press release at http://www.prweb.com/releases/2016/01/prweb13165727.htm the Medivet people ran a double blind trial at the University of Kansas just recently. It’s the only study I’m aware of, unfortunately. I sent an email to try to get more information about how it was actually performed, if I’m told anything useful I’ll post it. I do think it seems like a step in the right direction in that it tries to use measures beyond only subjective assessment
In any case I was wondering how much the press release would affect your assessment of the treatment.
It looks like it was only initially intended as a safety study and to determine what effect size might be expected in an actual efficacy study, so it doesn’t sound like it was intended to actually prove efficacy:
“Initially this study was designed for safety and as a power analysis to be used for future studies. When we received the data points back from the statistician we were encouraged to learn we reached p-value statistical significance in owner and veterinary evaluation as well as some objective endpoints.”
If this is true, then the fact that they reached statistical significance doesn’t mean very much. But the devil is in the details, so hopefully this will be fully published so we can see how good the evidence is.