As a practicing veterinarian, I am personally and professionally devoted to promoting real, beneficial medical therapies for companion animals, and to discouraging those approaches that have not proven to be safe or effective, or that may even be harmful. I strive for true open-mindedness, but I believe all medical practices must be open to critique and must be validated by reliable science, not merely tradition, intuition, opinion, or anecdote. In this blog I will be addressing the broad range of philosophical, ethical, economic, legal, political, and most of all scientific issues raised by complementary and alternative medicine (CAM), particularly as it is applied to veterinary medicine.
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I’m glad the blog is useful for you!
I just acquired a 7 week old black lab from a breeder in Minnesota. He guaranteed
his dogs for progressive retinal atrophy, hip and elbow dysplasia for 25 months.
He also recommended using NuVet Plus tablets as a supplement, but not as a condition
for his guarantee.
After reading your article, I’m not sure if using NuVet would be wise. I would appreciate your guidance.
Well, as I say in the article, there is virtually no information to support claims of safety or effectiveness, and I don’t generally recommend supplements that haven’t been scientifically tested in any real way. Whether they will cause any problems is just as unclear as whether they might have some benefits, but it is certainly not necessary to provide such supplements to have a healthy dog.
I have a Schnazer that is 10, she has CHF and a enlarged heart, would Protandim help her?
There is no research evidence at all to suggest Protandim would be helpful for your dog. If you have not already done so, I would suggest consulting a veterinary cardiologist.
My dog already takes up to 6 Lasix a day and a heart pill am and pm and she does this coughing sound like she is choking, Vet says it’s because of her CHF, what do you thing? Would the Protandim help her?
Sorry, but as I discuss in my article about Protandim there is no good reason to believe it is helpful for any condition in dogs.
I just watched Pet Fooled. It is very convincing. Here’s my problem: Becker basically starts the whole thing by saying no one really knows because there isn’t enough research.
To me, that causes every single argument that follows – for or against whatever – to fall apart, instantly. How can you advise anyone anything if you don’t have research to back it?
When I first arrived at this website I thought it was a classic debunking site, which are often just as convincing. Then I started reading the articles. I am not any closer to knowing what I should feed my dog, but this site looks like it has some useful information and some actual science.
Thanks for this site.
While there are, of course, gaps in our knowledge about pet nutrition, and no on can determine the optimal diet for any individual pet, Dr. Becker is wildly wrong about almost everything else. We actually have decades of nutritional research that veterinary nutritionists use to formulate pet diets, and Dr. Becker ignores almost all of it. Instead, she substitutes her intuition and personal beliefs about what is “natural” and “toxic” and so on, beliefs based on evidence that is poor quality, misinterpreted, or non-existent. Pet Fooled represents a narrow, ideologically driven bit of propaganda that ignores almost all the extensive scientific information about nutrition in favor of conspiracy theories about the pet food industry and unreliable, anecdotal beliefs about nutrition.
If you want reliable, science-based discussion of issues in pet nutrition, the book Dog Food Logic is a much better resource. Or you could find a veterinary nutritionist, a highly trained specialist in pet nutrition who knows a lot more than I or Dr. Becker do about the subject.
I have been reading about CBD (cannabidiol) as a possible treatment for seizures in dogs. There does not appear to be a whole lot of research/information as to how well it treats dogs with epileptic seizures. Can you provide any insight on this subject. There appears to be a number of sites sell dog biscuits lace with CBD.
Here is what I’ve written about marijuana and cannabis-based products for pets. There is essentially no clinical research in dogs, so every use of these products is a guess based on human research or anecdote. And, unfortunately, there is no regulation or quality control for cannabis products aimed at veterinary patients, so you really do roll the dice with each one. I hope the growing interest and decreasing stigma spur the research we need to find out what these compounds will ultimately be good for, but right now everybody seems to want to sell them, but we have little real evidence to go on.
I am so glad I found this site. Keep it up! Many more clients asking about ‘Veterinary naturopaths’ these days.
– a concerned DVM student
I have been giving my 12 yr old dog Nzymes for about two months. The reason i looked for alternative treatment for him is because his VET treated him for his chronic scratching and itching skin with Aquapel, which she raved about. Told me how she gives it to her own dog, it’s SO SAFE, it is so good. At $70 per refill, i thought she would allow him to continue. nothing else worked this well. He had relief for the first time his whole life. Then, suddenly, she will not refill for him. She says “well you know, he has that yeast problem….” yes, i know, and it is never over. so, now we are done with her, as she let me down so hard. The antibiotics treated the yeast..then, the itching returns. i am going to continue the Nzymes till i know for myself. I do not trust the Vets now.
It’s always unfortunate when a vet doesn’t communicate well or makes decisions or recommendations that don’t seem to make sense. That said, giving up on veterinary medicine and trusting a random company on the internet selling something with no real scientific evidence behind it isn’t a better choice. I would encourage you to look for another vet you feel you can work better with. Ideally, if your pet has skin problems, I would look for a veterinary dermatologist near you.
Wonderful site! My dog has perianal fistula and I belong to a yahoo group. Yesterday someone was promoting the food tolerance test by Jean Dodd. Sounded totally bogus.
Glad to see your paper confirms my impressions.
PS. I went to UCSC to, BA, MA, PhD, all biology
We recently relocated to a small town with only two vet offices nearby. We bailed from the first practice for several reasons, one being the repeated use of cold laser for everything from sore hips to post-op wound healing in our dogs. A neurologist friend suggested their use was totally bogus, and my own experience as a Ph.D. biologist in vert. A&P made me tend believe he was probably right. Have there been any science-based studies on the effects, if any, of cold laser treatment in veterinary settings? I didn’t see any posts on this subject in your blog history. Thanks.
I have actually done a number of reviews on veterinary laser. Hope this helps!
Dear Skepvet: five years into our cancer fight (my 13 y/o Shepherd elkhound has perianal adenocarcinoma the vet calls it), I have tried various alternative therapies, as well as mainstream surgical mass removals and chemo (chlorambucil and doxycycline). The tumours are now open outside the skin and ulcerated. We are now in palliative care mode. I frantically try to find yet another “cure”, and have read dozens of suggestions from well meaning folks on pet cancer internet boards/pages. The temptation is to chase another cure; spend more money and hope. I am actually grateful for your blog because it has given me the justification to just stop frantically chasing and cherish the time I have left with my boy. It was terrifying me to believe there was a cure out there I hadn’t found that could’ve saved my dog. But your intelligent, rational, logical, and well articulated blogs (especially on bloodroot – my search into info on that led me to your site) give me a much needed sense of peace. Our vet is a wonderful person: caring, professional, and ethical – she puts Indie’s well-being forefront. I trust her that she’s done all that can be done for our boy, in our region, with our financial resources, and most importantly that has been substantiated with scientific evidence. I just needed to hear it from a stranger, that these CAMs other people are insisting will cure my dog have not been proven scientifically. So thank you. I can now cease the chase and begin to accept that there is nothing else we can do except keep Indie comfortable and enjoy our time left with him. PS – I’m sorry you get hate mail. I admire your courage to stick to your passion and perspective despite the ugly things hurting and angry people say. Keep up the good work finding the evidence for those of us who don’t know how to and rely on objective quantifiable fact based evidence.
I am sorry you and your companion have had to go through this experience. As someone who has lost pets to cancer, I understand how difficult it is. And as a vet who treats cancer patients every day, I know how hard it is to when treatment is in the best interests of the patient and when it is time to accept our limitations and focus on comfort and a peaceful goodbye. I am glad you have a caring vet to work with and that you have found something here useful. Take care.
Thank you. Your reply has done more good than you may realize. ?? Compassion and science – a powerful medicine.
Skepvet – there’s no scientific evidence to prove God exists. But that doesn’t stop anyone from praying or believing or seeing the results. Your approach to healing seems quite narrow minded. It seems you are offended by homeopathy and natural medicine because it’s not proven. Who cares? Vaccines almost killed my dog. Those sillly homeopathic remedies stopped the reaction. How is that possible? Why would you ever be against something that could possibly save an animals life?
Concerned Pet Parent
You have actually made a point that I myself have made many times: belief in alternative medicine is like religion in that it is based on faith, not evidence. Faith is fine for personal religious belief, but it has been a dramatic and consistent failure in identifying what works in medicine, and science has been far more successful. Faith-based medicine was the mainstay of healthcare for thousands of years, and in all that time half our children died before adulthood, most women died due to childbirth, and our lives were shorter and more miserable than we today can possibly imagine. Replacing personal faith with scientific evidence in medicine changed all that, and going backwards, as you seem to feel we should, will injure and kill many people and pets.
If you have an open mind, here are some discussions of why personal belief is so unreliable a way to evaluate medical treatments:
Why Anecdotes Can’t Be Trusted
What are the cancer rates today in dogs and what about auto immune? What were they 50 years ago? Dogs are dying. MRSA is on the rise. It’s not because those dogs ate too much turmeric. hell yes let’s go backwards. The only thing we’ve got to show for these deaths is more scientific based medicine, more drugs, more vaccines, more flea meds. Chemicals and toxins kill pets (and people) Not herbs and nature.
How many salmonella infected homeopathy poisoned pets have you treated? Then tell me how many kidney failures, UTIs, iatrogenic cushings disease cases have you seen or has the the average vet treated?
Animals are nature – to completely assume that they can’t exist and survive or heal without scientific evidence is insane. You realize this on some level, no?
My dog eats grass when his stomach hurts. There’s no scientific evidence that it could possibly help him. My dog must be an idiot with zero instinct. He’ll probably die of the bacteria in the grass. But definitely not from Apoquel or his 8th distemper shot.
I’m a business person. Not a vet. And as a business person and a pet parent, what you’re saying to me sounds like it’s about money and I want to know who’s paying you.
Why do you want people to believe the only way to heal animals if they pay out of their a$$? What’s your incentive?
Show me some evidence of all those animals that were brutally murdered with natural herbs? And then I’ll show you a dog who has 3 inches of calcium growing out of her skin thanks to scientifically proven prednisone. That was sciences proven cure for toe cysts. Epsom salt works too.
You are projecting human beliefs on animals as if it’s for their benefit. It’s disturbing and I think this needs to be addressed. I’ll be back.
I so appreciate your blog and some of the informative comments.
Had my 9 yr old small breed in for her annual, cholesterol a little low, unexplained weight loss, might be nothing, or could be something.
All other labs WNL
Will be feeding her a little extra and bringing her in for a weigh in (free) in a month.
I guess there is a digestive disorder we may want to test for, if her weight continues to go down. Low cholesterol is one of the symptoms….
Because of your blog I have been able to find a vet that I trust.
I just came across your blog as my husband asked me to look at an herbal product being marketed for Cushing’s. Our 14 year old mixed breed dog has this. She is on Vetoryl. I am a retired psychologist who knows the value of relying on good scientific research. I just wanted to tell you that I appreciate your good advice and will be following your blog. I may be asking for some of your advice in the future.
What brand of dog food do you recommend the most? I have a 1 yr old pit/boxer. I want her to get the right nutrients to be healthy. She’s very picky and hates pedigree. She also doesn’t like to eat dry food she only eats it if we’ve put water in it. If we put water in her food and leave it out will it go bad?
I don’t recommend any particular brand since there is no real research to suggest one is better than another for dogs generally. I would suggest the book Dog Food Logic to help you evaluate the dog food marketplace.
Bob, I agree with you. I have had more success with complimentary medicines, esp. where my pet is allergic and have had reactions to traditional, science based medicines. I have been giving my pets herbs, holistic remedies, and more unscientific cures for over 45 years. I have 45 years of proof from my success and that is good enough for me to know that it works. It is not cost effective for long term trials to be done on complimentary medicine, as there is no profit in this for the drug companies. Four years ago I treated a dog who had lymphoma, and was given 2-4 weeks to live. The dog is doing fine today, and that dogs owner has passed the “word” to other dogs owners about how her dog was saved with complimentary medicine. Last week I treated a cat that was 12 weeks old, weighed less than a pound, had severe dehydration due to severe diarrhea. Traditional meds failed this cat. I put this cat on a herbal mix, and the diarrhea stopped that night, and to date the cat gained 6 ounces in a week, and is healing and now playing like a kitten should. Pets do very well with “unproven” complimentary medicine.
Of course, I can point to plenty of examples and even scientific studies where people and dogs do better on science-based medicine than alternative medicine, but those anecdotes would not, I suspect, influence your beliefs since only anecdotes that support alternative medicine seem to count most of the time. That’s one of the many reasons anecdotal evidence just isn’t reliable:
Why Anecdotes Can’t Be Trusted
Just want to say thank you for producing such amazingly educating contents with scientific rigor and empirical prudence. In this crazy milieu teeming with paranoiac pet parents and cultish advocates (with all due respect to those who aren’t), it is hard to find a public platform like yours with a voice so scientifically careful yet reassuringly informative. Keep up the good work!
Thanks for the kind words! I’m glad the site is useful for you.
I appreciate so much your dedication to telling the truth, in spite of the opposition from some.
I’m struggling to find a good new veterinarian. I looked up animal hospital certification organizations and vet certification programs, but the few certified vets in our state are an hour or more away. What can I look for on my own to find a good local veterinarian? Are there better vet colleges? What should I expect from a checkup?
I don’t mind driving to take my dog to a specialist when needed, but would like a reliable local vet for normal checkups, dental cleanings, etc.
It is very difficult to judge whether your vet is good at the medical aspect of their job. Just as I can’t tell in a brief conversation how good the pilot flying my plane is, it is hard to judge competence in any subject you aren’t an expert in yourself. The most important thing for most people in choosing a vet is effective communication. A good vet should be able to explain their reasoning and the evidence behind their recommendations in terms that make sense to you.
Obviously, I would be skeptical of anyone who promotes alternative therapies and rejects well-established scientific principles, but even some very competent vets have fallen for some of the alternative ideas out there, so ultimately the best you can do is meet with the vets in your area and see if their style and perspective aligns with yours.
Start with Co Q10
How do I subscribe to this website. Thank you
I’m going through some gastrointestinal issues with my 4 yr old Husky that seems to have came out of nowhere. Vomit, regurgitation, diarrhea, and very low energy (specks of blood sometimes in vomit and diarrhea). I was giving him (and my other dog; Alaskan Malamute) GreenMin and FeelGoodOmega from:
up until about a month before the symptoms showed up for my dog. While I know you can’t advise me on my pet without evaluating him, is it possible these supplements were actually harming him and now causing these issues, or maybe even masking an underlying problem all along? Waiting on biopsy results from a scope (x rays, blood work, ultrasound all already done) to hopefully confirm what is just IBS or a worse IBD. Of course a form of cancer is the fear, though at only 4 years old I’m hoping that’s unlikely.
The problem with supplements, unfortunately, is we rarely know what’s actually in them and what risks or benefits they have. No way to tell if these particular products negatively affected your dog, but certainly a lot of people end up harmed by supplements every year.
Hoping for good news!
Thank you for your wonderful website! Please keep up the posts, we need more sites like yours.
I’m so glad I found this site. I have a new puppy and had a difficult time finding a vet that didn’t sell acupuncture, naturopathy and homeopathy. I wanted to be sure that if I’m paying for treatment that it will do something. I am a frequent reader of the blog Science Based Medicine (for humans ?) so was glad to find this site for animals. I had no idea that alternative “medicine” had infiltrated veterinary medicine but I guess I shouldn’t be surprised. Thanks for the work you do!
Adrienne, alt med has infiltrated vet med for at least the last 20 years, and there’s no end in sight 🙁
Hopefully, skeptvet will allow me to say the following:
Skeptvet and one another vet do also provide guest posts at SBM on occasion, you can search SBM for them!
Hello, I just came across your blog while also reading Dr. Jean Dodds’ latest article warning caution regarding the results of the dog food/DCM studies. I am a true skeptic about naturopathy and homeopathy, and it boggles my mind that Dr. Mark Hyman is associated with one of the foremost hospitals in the world. However, I can’t seem to find your name or credentials anywhere on your blog. Much of what you are saying here makes sense to me, but I would feel more comfortable reading this if you would let readers know who you are and what your veterinary degrees and experience are. I realize you want to be protected from harassment, but if you are legit, that’s just part of the job. If you come forward and make claims–scientific or not–please stand behind them. And my final comment is that, although I’m not a big believer in supplements, my 15-year-old bichon/lhasa mix started having trouble walking up the stairs about five years ago. The vet started him on Dasuquin for Cats (lower does because he’s 13 pounds), and it was like a miracle. At age 15, he can still run up a flight of stairs. He has other health issues to be sure, and I would like your opinion on some of his meds, but not until you reveal yourself.
You can find the information you are asking for in the FAQ or with a Google search.
That said, I would be cautious of how you use credentials to judge the reliability of anyone’s claims. One of the classic logical fallacies is Argument from Authority, where claims are accepted as true or likely true based on the credentials/reputation/prestige of the person making the claim. Expertise is a real phenomenon, and those with specialized training often do have a better understanding of their area expertise than others, but it can be difficult and unreliable to judge the worth of credentials. There are Nobel laureates who believe in homeopathy, and smart, educated people can be wrong just like anyone else.
This may not be true of you, but most people who ask about my background are looking for an excuse to judge my arguments on some basis other than the evidence I present.
I understand the conundrum involved in judging people by their credentials. Yet I still think you could be more transparent. That said, I also believe in the bias theory (not sure what it’s called) in which you believe what you read if it agrees with your beliefs (as in the real news/fake news issue). That said, I stand by my skepticism of naturopathy and homeopathy–and yet, the study of the gut biome and its effects, once considered a fringe concept, is now seemingly accepted by many medical professionals (MDs). I sense from your comment in another post above, “even some very competent vets have fallen for some of the alternative ideas out there” indicates that you are the skeptvet you say you are. Are you a DVM? And how will we ever know if naturopathic concepts work despite our skepticism? I have a very good friend who goes to a “holistic” chiropractor (spider sense says “quack”), but she has had some good results with a few conditions. Anyway, may I please have your opinion about using 225 mg/day Denamarin for liver support in a 15-year-old bichon/lhasa mix (13.5 lbs) who also takes 62 mg/day Ursudiol? He also takes daily Keppra for a seizure disorder and has early kidney disease. I know you can’t diagnose anything–just wondering if the Denamarin is a reasonable thing to add, and is 225 mg/day too much for a 13.5-lb dog? It seemed to be making him nauseated, so we discontinued for a week and will try again with a half dose; I am skeptical. Thank you!
Have you looked at my credentials. You sound like you haven’t, so if you really want to know that information is available here and, as I said, through a simple Google search.
There is limited evidence for the use of Denamrin and other milk thistle products in preventing or delaying liver damage. You can search the blog for a couple of articles on the subject, but most of the research is specific to particular causes of liver damage (e.g. chemotherapy drugs, mushroom poisoning, etc.), so more general statements about “liver support” are too vague to be clearly evaluated.
I did indeed look at your credentials. I replied (probably mistakenly) to the email that informed me about your new comment. I am comforted by your educational background and honors. They do mean something. I am the granddaughter of an M.D. and thought about medical school for myself (instead, I became a writer and editor). I served as a medical editor for three years (verifying data in articles for medical journals), so I just brushed the surface of medicine and drugs, but I have always found solace in scientific facts. Of course, as sure as the sun rises, “mistakes have been made,” and there have been too many dangerous drugs approved by the FDA. But if I am sick—or my beloved dog is sick—I am going the science route every time.
Thank you for your honesty. Not sure I agree with your stance on anonymity, but I respect it. And thank you for your thoughts on Denamarin. My dog has liver cysts (determined by MRI; malignancy not determined) and elevated liver enzyme levels (I don’t know what they are). So that is what the Ursodiol and Denamarin are for. I am going to investigate further. Thanks again.
According to Nutramax, and if it’s only the Denamarin tablet with nothing else added, your 13 lb baby falls into the “medium dog size” range for dosing, so the 225 mg once daily would be the ‘recommended dose’ according to the manufacturer. However, only your vet should determine the dose based on his needs, whether it’s effective, and if any side effects have been observed, as you have, his nausea (you did the right thing by ceasing the dose and talking with your vet about any alteration of dose). Nutramax claims that most of their supplements can be used with other medications (and should be fine to use with ursodiol), but again, only your vet can determine that per your dog’s needs, treatment protocol and followup.
Beautifully written and I echo your sentiments! Glad you found peace and can enjoy your boy now.
We recently lost our 12 year old dog to cancer. Her cancer was melanoma and we were offered a vaccine treatment which was purported to be highly effective. I expected to find a reassuring number of clinical trials in the literature supporting the efficacy of the vaccine but there is nothing! One trial showed no effect of the vaccine and another was a retrospective study with no control. The standard of USDA approval for a veterinary medication is ridiculously low. We rejected the vaccine and she lived another 12 months in good health.
Pain management was our primary goal in the final months. I was surprised when our veterinarian prescribed gabapentin, as I had not realized this medication was approved for veterinary use. Once again, I found no controlled studies supporting the use of gabapentin in dogs to control pain. Worse, no studies exist to support the use of commonly prescribed opioids, especially tramadol. Only the cox inhibitors have good quality data to support use in pain management.
It is disheartening that veterinary care is rife with misinformation and inappropriate treatment. The problem is not limited to boutique practitioners of holistic treatment methods, it must originate in the country’s top veterinary schools. I hope you dedicate a future blog to the widespread lack of scientific evidence for some of the most commonly prescribed treatments in mainstream veterinary practices.
It is true that there is often less evidence than we should have, and it is a very frustrating problem. Unfortunately, it is not a simple problem to solve.
The willingness of vets to accept low-quality or low-level evidence is a problem, and one I have worked on for many years. However, the reality is that high-quality clinical trial data costs money, and the value of pet health in society is less than the value of human health, so there is far less money available for research. The bulk of research is funded by for-profit companies with something to sell, and this is problematic even when the studies are well-controlled. Even this, though, is a tiny fraction of what these companies spend on human clinical research. And, as you say, there is no regulatory requirement for the same level of evidence required in human medicine, so with no coercion and relatively small profits to be made, convincing companies to run large, high-quality studies is very difficult.There is a small amount of non-profit grant funding, and virtually nothing from the government.
While we would all like to see better evidence, unfortunately if we wait for human-level data before we use any therapy, we will have almost nothing to offer, so that’s not realistic. For example, most canine epileptic patients are treated with phenobarbital or potassium bromide, drugs that haven’t been the primary first-line therapy for humans in decades because safer, more effective medicine are now available. However, there is good clinical research evidence for the effectiveness of these drugs in dogs, so they are still widely used despite high rates of side effects. Anecdotally, newer drugs are safer and provide better quality of life, but we can’t say this for certain without clinical trials. It is very difficult to say to a client considering euthanizing their epileptic dog because it is heavily sedated by phenobarbital that we can’t try anything else without good clinical trial evidence, but the reality is that if we try these drugs based on open-label studies or case series, which is what we currently have, we may be misinformed about their true efficacy and safety. It’s a tough choice that vets face every day. We have to teach vets to expect better evidence, but we also have to acknowledge that they need to do the best they can to treat their patients based on the evidence we have, not the perfect evidence we wished we had.
The special problem with alternative medicine is a deep cultural and ideological resistance to every rejecting a personal belief, based on anecdote or tradition, even when evidence is available to contradict it. Now that there is evidence tramadol is ineffective, it is gradually going out of favor. This may take several years, which is too long, but it will happen. On the other hand, we’ve known homeopathy is useless for many decades, yet its proponents refuse to accept any level of evidence for this. The problem with trusting low-level evidence exists everywhere, but it is definitely worse in some domains than in others.
Thank you for your review of the evidence regarding spaying and neutering in dogs, which I found very helpful. As a physician, I was very impressed with your approach to interpreting the literature. I have a female 7 month old Golden Retriever, and after reading the study by Hart from 2103, was going back and forth as to what age would be best (medically) to spay her, because of concerns about early spaying leading to an increased incidence of orthopedic issues. She is currently scheduled to have it done at about 8 months, but was considering delaying to 12 months for this reason. After reading your review, it seems to me that there really is not a good medical reason to wait based on the evidence. (It would be very inconvenient for me to have to wait to 12 months since she is at day care, and if/when she has her first heat, they will not take her any longer until she is spayed. We also go to the dog park frequently.) Would I be correct in interpreting your review in this way, ie there is no reliable evidence suggesting spaying her at one year is better than at 8 months? Thank you.