The therapies I write about range widely from the likely beneficial, to the plausible but mostly untested and over-marketed, to the implausible and even completely ridiculous. The subject of this post is in the last category, and it is a treatment I have not yet addressed because, thankfully, it is seldom recommended even by proponents of the more extreme varieties of alternative medicine. However, Dr. Carol Osborne, a prolific advocate for unproven and pseudoscientific therapies, has latched onto this one in a recent blog post, Could a Coffee Enema Save Your Dog’s Life? For those of you who don’t have time to slog through the rest of the post, I’ll give you the answer now: No. But it could take your dog’s life.
Dr. Carol begins, as proponents of such nonsense treatments so often do, with a meaningless heartwarming anecdote.
Dr. Carol Osborne has seen first-hand the effects a coffee enema can have a dog – and in one particular case, the effect was nothing short of miraculous. When a friend and clients dog suffered acute liver failure, other veterinarians recommended euthanasia. Unable to part with her pet without at least a second opinion, the pet’s owner contacted Dr. Carol as her last resort. In addition to the administration of intravenous fluids, Dr. Carol gave the small dog a coffee enema. Not only did the dog improve, he began to thrive.
Anyone who follows this blog is familiar with the unreliability of such stories, and all the reasons why bogus therapies may seem to work when they really don’t. Acute liver disease is a classic example of a problem which often, and sometimes unexpectedly, resolves on its own with only supportive care (such as IV fluids), due to the regenerative capacity of the liver. I always find it strange that proponents of alternative medicine frequently talk about the body’s innate healing abilities and yet always seem fine taking the credit when a patient gets better.
The arguments Dr. Osborne gives for why this therapy ought to be helpful are no more valid or convincing than the opening anecdote.
Coffee, when administered via enema, stimulates the production of glutathione by the liver. Glutathione is required by the liver to function properly. When the liver fails, glutathione production ceases. By stimulating production of this vital nutrient, the coffee enema helps the liver to once again perform.
Coffee enemas also work as a detox…
The walls of the intestines, once thin and clean, will become thicker over time with the debris that sticks to the walls preventing the body from digesting and absorbing vital nutrients.
If something is not done to counteract the thickening of the intestinal walls due to residue and debris the pet or person will gradually begin to lose their energy and the ability to function normally…
Interesting theory. Also complete nonsense.
Glutathione is, of course, present in the liver and important for normal liver functioning, along with thousands of other chemicals. The evidence does not support the assertion that coffee enemas increase glutathione levels in humans. (1) There is mixed evidence for changes in glutathione levels from oral coffee intake, with some human and rat studies finding and increase and others not. (2) There is no evidence that coffee can increase this enzyme in dogs. And there is no evidence that any increase in glutathione which might happen from some kind of intake of coffee has meaningful clinical benefits. So this claim is probably wrong and would be of questionable significance even if it were true.
The argument that coffee enemas are “detoxifying” is based on the vague and mythological understanding of “toxins” that underlying many quack therapies. This mythology is not a legitimate understanding of the cause of disease, and it is not a sound rationale for coffee enemas. (3, 4, 5) The colon is not a primary site of digestion and absorption of nutrients, though there are some nutrients that are absorbed there (notably B vitamins) as well as water. And it does not become caked with debris over time which impedes its functioning. The notion that we are fundamentally incapable of normal health without some periodically flushing out our large intestine is simply ridiculous.
So is there any evidence that coffee enemas have health benefits despite the lack of a plausible theory why they should? Nope! The subject has been debated in human medicine for some time, particularly due to claims that coffee enemas can be beneficial in cancer treatment. There is no credible evidence to support this claim and clear evidence against it. (6, 7, 8, 9, 10) And, of course, there is no clinical research of any kind in dogs or cats to test this therapy. And there shouldn’t be!
While not having shown any benefits, coffee enemas unquestionably can cause harm. There are numerous reports of serious harm done to human patients, including dehydration and electrolyte disturbances, tears of the colon and rectum, burns in the colon and rectum, infections transmitted by the procedure, and death. (11, 12, 13, 14, 15)
The fact that caffeine, a prominent chemical in coffee, is a well-known and serious toxin in dogs makes the notion of coffee enemas in these species even more insane, if that is possible.
While it seems as if it shouldn’t even need to be said, clearly coffee enemas for pets are a bad idea. The theoretical reasons for using them range from unproven to completely crazy, there is no evidence in humans or veterinary patients of any benefits, and there is ample evidence of potentially serious harm, including death. Recommending this treatment for pets is irrational to the point of being indefensible.
- Teekachunhatean S, Tosri N, Sangdee C, Wongpoomchai R, Ruangyuttikarn W, Puaninta C, Srichairatanakool S. Antioxidant effects after coffee enema or oral coffee consumption in healthy Thai male volunteers. Hum Exp Toxicol. 2012 Jan 16. [Epub ahead of print]
- Chen TS, Chen PS. Intestinal autointoxication: A gastrointestinal leitmotive. Journal Clinical Gastroenterology 11:343-441, 1989.
- Green, S. A critique of the rationale for cancer treatment with coffee enemas and diet. JAMA. 1992,Dec 9; 269(13),1635-6.
- Ernst, E. M.D., Ph.d., F.R.C.P. (Edin). Colonic Irrigation and the Theory of Autointoxication: A Triumph of Ignorance over Science. Journal of Clinical Gastroenterology. 24(4):196-198, June 1997. (Make sure to follow the references to the primary sources).
- Alison Reed, Nicholas James and Karol Sikora. Mexico: Juices, coffee enemas, and cancer. The Lancet. Volume 336, Issue 8716, 15 September 1990, Pages 677-678.
- M. E. Shils and M. G. HermannBull . Unproved dietary claims in the treatment of patients with cancer.N Y Acad Med. 1982 April; 58(3): 323–340.
- Brown BT. Treating cancer with coffee enemas and diet. JAMA. 1993;269:1635-1636.
- Cassileth, B. Gerson Regime. Oncology, Volume 24, Issue 2, 2010 Page 201.
- Atwood, K. “Gonzalez Regimen” for Cancer of the Pancreas: Even Worse than We Thought (Part I: Results). Science-Based Medicine Blog, Accessed May 13, 2012 at http://www.sciencebasedmedicine.org/index.php/gonzalez-regimen-for-cancer-of-the-pancreas-even-worse-than-we-thought-part-i-results/
- Keum, B. et al. Proctocolitis caused by coffee enemasAm J Gastroenterol. 2010 Jan;105(1):229-30.
- Lee, C.; Song, S.; Jeon, J.; Sung, M.; Cheung, D.; Kim, J.; Kim, J.; Lee, Y. (2008). Coffee enema induced acute colitis. [The Korean journal of gastroenterology] Taehan Sohwagi Hakhoe chi 52(4): 251–254
- Eisele, J.; Reay, D. (1980). Deaths related to coffee enemas. JAMA: the Journal of the American Medical Association 244(14): 1608–1609.
- Sashiyama, H.; Hamahata, Y.; Matsuo, K.; Akagi, K.; Tsutsumi, O.; Nakajima, Y.; Takaishi, Y.; Takase, Y. et al (2008). Rectal burn caused by hot-water coffee enema. Gastrointestinal Endoscopy 68(5): 1008–1009
- Jones LE, Norris WE. Rectal burn induced by hot coffee enema. Endoscopy.2010;42 Suppl 2:E26.
How distressing. Thank you for covering this.
I have too much respect both for my animals’ bums AND for coffee to be tempted by this dangerous nonsense!
It is phenomenal what people can believe, isn’t it?
the coffee enemas do not have near the detox effectiveness of the homeopathic enemas.
Art Malernee dvm
One thing that is rarely addressed…
Can such a dangerous post and obvious practice by this quack, be reported to the state veterinary board in which state she practices? When does this NOT border on malpractice and disregarding state veterinary practice laws? I really want to know because this needs to be stopped before someone innocently believes her and ends up killing their pet because they found this on the net. Would she not be liable?
I certainly think a case could be made that coffee enemas constitute malpractice. It’s anyone’s guess what a given state board might rule in response to a complaint on the subject, though.
Has anyone (another vet perhaps?) tried an intervention with Dr. Carol? This really is too, too much and someone must try to reason with her. I know firsthand the futility of attempting to reason with the unreasonable, but surely this must constitute malpractice and someone has to act on behalf of the helpless pets?
All this nonsense (humans and pets) has increased as the result of licensing (and thereby legitimizing) these practices–starting with the chiros, then acupuncture, naturopathy in some states, and all the rest. People who aren’t well informed in basic science assume that because these people are licensed, they are legitimate. Of course, it is all even worse when it comes from actual MD’s/vets who really ought to know better.
I’m sick to death of it and am approaching becoming a recluse due to the prevalence of all this. The number of people who will believe absolutely any anecdote they hear is just unbelievable, to say nothing of the lack of basic thinking skills to refute it–even in many college graduates and even MD’s and vets. It’s getting impossible to even find dog food that doesn’t make all kinds of silly and outrageous “health” claims on the bags–to say nothing of the load of nonsense you will get if you ask any of the staff about pat feeding.
Oh dear, I’m getting into a real rant and I apologize, but this post really set me off–thinking of that poor little dog getting a pointless and potentially harmful enema when he was already probably miserable was just awful. I’m not some overly sentimental person who uses my dog as a child substitute or anything, but this story really got to me.
It really gets to me too, Janet, in a very bad way.
I suppose it would be a fine line between actual practicing vs internet posting on a blog/website, with a potential new area of legality, but one that is definitely in need of exploring. We see this all too often now, dispensing medical advice on the net, and dangerous advice at that. I would hope a board would see through the generic disclaimers on a blog or website, as well as the faith based nonsense of a defense. One would think ethics should be a priority.
I’m tempted to report her, nonetheless.
Believe me, I understand how maddening it is. And given that she did apparently give the treatment to a patient, a VMB report might be appropriate. Of course, the owner probably believes it worked, so they would contest any complaint made, and ultimately I’m not sure how much state boards really care about scientific validity so long as the customers seem happy. *sigh*
I’m thinking that perhaps the end result of a potential board review/action could prevent other innocent pets from suffering or death. Clients also may be better informed, since I’m guessing there’s a fair amount of owners who trust that coffee enemas are just so safe and effective because Osborne says so. She of course has an anecdote to pass on to her clients (among countless others I’ll bet). Do you honestly believe those on a board wouldn’t acknowledge the potential for death by coffee enema? Either way, it looks like malpractice to me, and perhaps this single dog survived, but what about the next?
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I do not agree with you people, and the fact that you are so aggressive with your comments against this vet is even worse. This article delayed me for sometime before I did the coffee enema on my own dog, who has been with me for 15 1/2 years and the past year had kidney problems. After speak to many conventional vets who all they wanted to do is run tests for issues he doesn’t even have, I decided I had nothing to lose. We did the coffee enema a week ago, and since than he has not looked back. My dog has more energy than every other dog in the neigbhourhood, and that twitching his kidneys for several nights stopped. So for all you aggressive conventional medicine people, I’m sure if you had cancer you’d cut it out before you’d use your brain and think, him well maybe my internals need a maintenance check before I just remove my left breast from cancer…. gee hum could it be that my kidney’s are not functioning properly and that is why my bloodstream is too acidic as clearly my bloodstream must be acidic as cancer can not survive in an alkaline state…. was it the overload of stress that caused this to happen or was it the food I consumed…. it all relates to each other doesn’t it……….I guess, maybe just I will start to face days on a happier note and be grateful for what I have…and imagine and feel what it will be like to be healthy again.. maybe just this will bring about my healthy state. hum, no I don’t think maybe anymore I think “I know it will :)”
Lucy, I sure hope you’re not as foolish as you sound, that is, substituting coffee enemas for proper breast cancer treatment. SIGH.
Also, you do realize don’t you, caffeine is toxic to pets? How dare you question our warnings when you are in fact, causing your dog more harm than anything purported to be beneficial. Did you even bother to read Skeptvet’s post and let those warnings sink in?
Wow. So distressing that anyone would dream of putting a helpless, sick animal through a coffee enema. It’s abusive. And how does one justify administering a known toxin (caffeine) to a pet as somehow holistic or detoxifying??
As with any medical treatment caution should be taken to ensure it is not given in overdose quantities, therefore with proper administration this is indeed a treatment that has proven completely successful and yes with a dog who has already lived to the ripe old age of 15 1/2 (he doesn’t understand how old he is, before the enema he was dragging his little body around refusing to accept its lack of mobility but now he is running around). I encourage others to not be shut down by the negativity of this post in general, and to please research further to ensure this is a step you could comfortably take, and sometimes what else do you honestly have to lose. As to the proper treatment of breast cancer comment well good on you :).
Ah yes, another “brilliant” holistic/homeopathy/energy healing/throw-everything-but-the-kitchen-sink-at-unsuspecting-owners-and-their-poor-pets-useless book; one, I might add, that includes mainly bogus treatments that a ton of other holistic vets promote, never mind there’s no evidence to evaluate.
Hopefully skeptvet deletes the link trash above.
I agree with Lucy wholeheartedly. These conventional people are so quick to attack to judge, because they must be so ‘confident’ in their own treatments. Everything they promote has dangerous side effects: vaccines, drugs, chemo and radiation. But, coffee seems to be worse? Give me a break.
So vaccines are dangerous but coffee in the rectum is “natural” and safe? Give me a break!
Science is a ‘confident’ method in determining safety and efficacy. There, fixed that for you.
Of course rectal coffee is natural.
You see, in the wild, cats and dogs will gather coffee fruit, remove the beans, light a fire, roast the beans, grind them between stones, and then use implements to boil water to infuse it. Then the dogs and cats fashion perfectly natural enema equipment from mud and sticks, and then rectally infuse their coffee. Just as Mother Nature intended, and as they have been doing for millions of years.
Totally different from those products of Big Pharma where they take natural products, process them, and administer them via some weird method like putting them under the tongue or having you eat them. How unnatural.
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Veterinarians have extreme pressure to hold up to the protical given to them by their veterinary board. Going beyond their scope of practise could loose their license. It is the job of the pet owners to communicate with the usda and pharmacy manufactures what works best. If a prosedure is financially beneficial for them, we will see science based evidence supporting the theory. All said and done we as pet owners need to put pressure on the veteinarian board to keep a well balanced protical for optimum health, and that is what I see needs help:)
Let the debate continue!!!
Less risk of caffeine toxicosis, no change in risk of trauma and other harm from enemas, still no rational reason to think any benefits.
Have you ever tried a coffee enema yourself????
It is standard medical care in some countries. I try to stay open minded to all therapies. Integrative medicine is the way to go.
People once thought you should not wash your hands between deliveries of babies…
I have gotten much relief from using therapies many consider ‘extreme’.
Debbie, no one in their right mind need consider a coffee enema for any reason, none, whatsoever. And anyone claiming this nonsense works for pets, deserves the same as a vet being sanctioned by a state veterinary board. Do you understand the concept of ….. caffeine is TOXIC to pets, need I say it again? Caffeine is TOXIC to pets!
I am reading these comments with deep sorrow for mankind. My dog is 15 and we just went for a 3 mile walk. When he saw a squirrel he ran. No one believes he is the age he is. I challenge anyone to PM me and I will send them a video of my boy. I give him weekly coffee enemas. It’s a special coffee specifically formulated for rectal administration. I myself have done this post-cancer diagnosis and I am in full remission. I am close to 50 years old and have honestly done enemas every week for almost 11 years now. I look 35. My dog is my very best friend in the world. I would never hurt him and would never forgive myself if I ever caused him harm. But I am so glad I tried it. He is FAR from being harmed from this protocol. If anything he is THRIVING. I invite anyone to come and ask questions. I can send pictures and hope that I can enlighten people seeking to improve their and or their dogs lives. I speak from experience I assure you.
Have you heard of this unknown veterinarian hospital called VCA?
And I can assure you of several things:
1. Personal experience and anecdotes are deeply misleading. They prove nothing, except that we are easily swayed by stories, and they support every idea ever invented. You will find people just as certain as you, based on their experience, that chemo works, prayer works, homeopathy works, and that they have been abducted and cured of their cancer by aliens. Either we give up on knowing the truth and accept everything anyone believes, or we accept that our belief isn’t reliable evidence.
2. After 20 years of medical practice, I have plenty of stories like this of patients saved by science-based medicine and harmed or killed by alternative medicine. I don’t parade them here because the whole point is that these stories don’t prove anything.
3. Nothing anyone says will ever shake your faith in your own experience,. yet you will believe it is the rest of us who are closed-minded.
Here are lost of discussions of why anecdotes don’t mean what you want them to, which of course you won’t read or care about.
Why Anecdotes Can’t be Trusted
Yes, and I’ve heard of Steve Marsden, a firm believer in pseudoscience and mythical Chinese Medicine. Not a reliable source.
Have you heard of this unknown medical specialty know as clinical oncology? Hmmmm, looks like VCA has too.
Of course, the small number of vets who agree with you are right, and the beast majority who don’t are wrong. At least we agree that there is cause for sorrow for mankind. This is the kind of unshakeable, faith-based belief in nonsense that has killed millions of people in the last two years by convincing them to reject safe and effective scientific medicine.
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