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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You’re correct that the evidence is mixed and not conclusive. In general, there is some evidence that the risk of long-term development of orthopedic problems, especially cruciate ligament rupture, may be increased in large-breed dogs neutered before 1-2 years of age. The relevant variables are probably growth plate closure (which is delayed in neutered animals) and obesity (which is more common in neutered animals). I think there is a reasonable case to be made for waiting until full growth (about 12-14 months for a breed the size of a golden) to reduce this risk, but the supporting evidence for this is limited.
Even more questionable is the role of neutering on long-term risk of development of some cancers. Female Goldens may have a higher relative risk of some types of neoplasia if neutered. It is not clear what role the timing of neutering might play in this, and the absolute risk is not greatly changed. Furthermore, this finding hasn’t been seen in males or several other breeds, so it is pretty tenuous. Set against the risk of mammary cancer and pyometra, which are far more common in intact females than any of the cancers that might be slightly more likely with neutering, I think the balance of evidence is still in favor of neutering. It is not at all clear how much impact delaying neutering has on this issue.
If you’re not sure what to do, it means you have correctly interpreted the evidence as mixed and limited. I generally recommend waiting until full growth for females based on the logic that there is some evidence of benefit and little evidence of risk, but I don’t think the data is strong enough to make a strong claim that it is wrong to neuter earlier.
Hello Skeptvet, again, and thank you for having a well-balanced scientific approach to healing conversations. I previously approached you about an ‘Aural hematoma Treatment’ the Auralsplint. The five-year study has been self-published on Researchgate.com and is available at your pleasure to read and evaluate. I have also written a few articles supporting my beliefs the non-surgical approach using an auralsplint is both very effective and a good alternative to surgery if used at early onset. To correspond with your intent of scientific analysis, the study manuscript Auralsplint – Descriptive Report is lengthy and very encompassing. I hope you find it interesting and informative.
Are allergy shots ok to give to Yorkies?
“Allergy shots” is used in a number of different ways, so I can’t be sure what you are referring to. Most commonly, this means hyposensitization or immunotherapy, in which dogs with environmental allergies are gradually desensitized to their triggers using gradually increasing antigen exposure. This is typically done by a dermatologist and can be done in any breed.
There are also a variety of medications used for symptomatic treatment of allergies that can be given by injection, and these are sometimes called “allergy shots” by owners. There isn’t anything about Yorkies that would preclude them from using these medications in general, but of course the risks and benefits for any individual dog should be something you discuss with your vet.
It seems my silver lab has diluted alopecia. I am aware there is no cure or treatment. But do you have any recommendations of things that could potentially help my dog. I’m not expecting miracles but just to help his coat and skin. Unfortunately he’s also allergic to fish so fish oil is a no go.
Dear Skeptvet
I do find it interesting that you are willing to condemn Dr’s that are willing to put their name out there in the name of veterinary medicine but I find no mention of who you are or what your credentials are on your website. They open themselves up to lots of harassment by putting their name forward but obviously believe in what they do. Why don’t you? It would five you some credibility.
You are mistaken. There is nothing secret about my identity, and my credentials are readily available, so you don’t seem to have looked very hard. The real question, though, is why it matters. Does who I am change the strength of the evidence of the arguments I make. Are scientific questions settled by reputation or appeals to authority? How do we use what we know about someone to inform how we evaluate what they say, and is that useful or legitimate?
Hey Skeptvet,
I was watching an interesting documentary about Neuroscientists discussing NDE. One doctor said an interesting statement that made me think of you. He said, “if you look at the history of science, all science starts as collecting anecdotes. And then finding patterns among those different stories.”
I was just curious what your thoughts were regarding this statement being about anecdotes.
Thanks so much
All science absolutely STARTS with observations and anecdotes. But it doesn’t end there, whereas pseudoscience does.
My 13 year old Nova Scotia Duck Toller developed a stage 3 soft tissue sarcoma and mast cell tumors. I am fortunate to live in an area where great science based veterinary care is available, expensive, but available. I was told my dog would have 3 to 5 months to live. My dog’s vet found a possible treatment in Boston and after raising money my dog went thru treatment….surgery to remove as much tumor as possible and then 3
Treatments of stereotactic radiation to the area . My dog no longer limps and is lively, and is now almost a year out from treatment. A CT scan may be next to check on any new growth but to date I am thrilled with her recovery. No alternative medicine given.
Hooray for science based research, and treatment!
Hello Dr. McKenzie,
Do you have any comments on PEMF therapy on tumors? Thank you.
My latest look at the evidence is here. Hope it helps!
I would be more than happy to share the data I have for my dog who has been getting treated with PEMF since January 2020.
If you are comfortable with software used to view CT and PET/CT files I have those as well.
Unfortunately, a case report, even with detailed data, doesn’t support general conclusions about the safety or efficacy of specific therapies. This is essentially a well-documented anecdote, and as such can only suggest hypotheses for formal testing, not answer the question “Does it work?”
Here’s a bit more detail on why anecdotes aren’t very helpful:
Why Anecdotes Can’t be Trusted
My dog suffered severe trauma being beaten as a puppy before I adopted her and has elbow issues that causes her to limp at only 4 years old. She already has osteoarthritis and bone spurs in that elbow. Other than that she is eager and healthy and wants to run and play which only causes more issues. I have tried…..and am trying Galliprant, CBD, Dasuquin with MSM, goats milk, massaging her elbow. I even tried laser therapy but none of this has made any difference. I am not sure if there is anything else out there that I should try. It is a very bad place for acupuncture, I have checked into that option. My orthopedic vet is helpful but has said that surgery on the elbow rarely is successful. I read the article on the assisi loop and it does not seem to promise much benefit. Thanks for any thoughts and suggestions.
It sounds like you have been very thorough. If you haven’t done so already, you might talk with a boarded specialist in veterinary rehabilitation (the vet equivalent of physical therapy). They may have some additional idea, though it doesn’t sound like there will be any perfect fix.
Good luck!
https://www.mspca.org/angell_services/elbow-replacement-in-dogs/
This is AWESOME. I’m a veterinarian working in general practice. Debunking pseudoscience I hear from clients feels like an uphill battle. Your writing is appreciated!
Thanks! Keep up the fight!
I have a senior dog who has CCD. the biggest issue is the disruption (to say the least!) of his sleep wake cycle.
An Holistic vet was recommended to me and that Vet uses herbs, supplements and mushrooms of some sort to treat this.
I am hesitant to shell out the $400 for her consult without any evidence.
I have tried all of the prescription drugs my regular vet has prescribed in various combinations and doses with no consitant results.
Would love to hear your opinion.
I am sorry to hear your dog is struggling with this awful condition.The frustrating bottom line is that this condition is very similar to Alzheimer’s disease in humans. Despite enormous investment of resources in research, we don’t have an effective treatment for most people, and not surprisingly we have even less in the way of proven options for dogs.
The herbs etc. that you are talking are pretty much just a roll of the dice, with no evidence to show they are safe or effective. When we are desperate enough, sometimes rolling the dice is appropriate, but when a holistic vet tells you they have an effective treatment, they aren’t talking about something that has ever been scientifically tested or proven to work in dogs with CCD. They are simply relying on speculation, extrapolation from lab animal studies, and personal experience. I won’t say it is wrong to take a chance, but I will say you are at least as likely to see no change or even to see things get worse as you are to see improvement.
Good luck!
Could you please post about food intolerance, preferably the rare cases you encountered? And yes, I do not mean food allergy, but intolerance.
My cat’s been diagnosed of a severe case of food intolerance and honestly, it’s probably specific to my region (oh and I’m from South Korea) but the vets I’m taken him to also have no idea what to do with him. Tested him for several underlying diseases and worms. All negative. Gave him steroids under the assumption he might have IBD and that did not work as well.
His symptoms are only vomiting 3-5 times, each time 4-5 hours after he’s eaten, and this happened every single day since we adopted him from a foster who lied he was perfectly healthy and then got out of touch quickly. Absolutely no skin-related issues whatsoever.
We were only able to put a stop to this nightmare after we fed him cooked chicken (he won’t eat raw stuff, and you’ve posted a lot about the dangers of raw diets, to which I agree). But we know this can cause extreme nutrient deficiencies. It’s just that all the kibbles and cans we tried failed miserably.
Many vet articles say food allergy and intolerance are usually about protein (most commonly chicken or beef) and not vegetables, crops or “chemical” additives to commercial pet food. But my cat is fine when he is just fed chicken, and vomits massively when fed the tiniest bit of carrot or corn. Could he be a rare case of food intolerance to vegetables, crops or additives? Have you ever had a similar case? If you have, how did you treat him/her? I sincerely hope I could feed him a nutritionally balanced commercial pet food, I hate the burden, time and cost spent of home made diets that could potentially harm my cat……
Sorry to hear you are having this struggle with your cat. Ideally, of course, you would take him to a gastroenterologist for a full evaluation. I am not a specialist and cannot diagnose or treat individual patients online. I will say that ruling out a food-responsive enteropathy often involves a trial with a hydrolyzed protein diet. The proteins in these are pre-digested in a way that prevents adverse reactions, and they are nutritionally complete. If the cat does well on such a diet, then you have the option of continuing this or testing individual ingredients over a period of time to see what he can or cannot handle. If he does not do well on such a diet, then it may be a GI tract problem that is. not going to be managed w/ for alone, and additional testing is needed. But again, if you can find a veterinary internist to consult with that would be the bests option.
Good luck!
Hello! Great site! Found accidentally 🙂
I do like happy accidents!
My newfy is 3, and has struvites without cysteinuria (huzzah!) Allergy testing revealed reaction to oats, peas, peanuts, rice and corn. Im struggling to find a kibble that can help drop her urine pH (9 at dipstick) that also doesnt contain the allergens mentioned…shes also allergic to a number of really common weeds, spores and pollens, so i may well be fighting against something beyond her ability to cope with…hopefully not.
Shes on low dose steroids and chlorphenamin for associated inflammatories, (20mg pred/20mg chlor) which seem to be helping prevent hotspots but the food issue is a blimmin nightmare…im not keen to get into making food for her myself as im not a nutritionist but its beginning to look like thatll be my only option..i keep reading about royal canin fillers etc, like plaster of paris (ugh) for stool consistency and really wonder why these companies get away with leading us into thinking theyre premium brands when the only premium involved seemingly is the price!
Just to be clear, there is no test that will reveal a food allergy other than feeding single-ingredient diets exclusively for at least 8 weeks, so I think you may have been misled into eliminating a whole bunch of ingredients from potential diets unecessarily. Food allergies are actually a pretty uncommon cause of skin problems compared with environmental allergies, and most dogs don’t actually have them. You can always try a hydrolyzed protein diet trial to see if this dramatically deuces symptoms, in which case the diet may be a useful part of controlling her symptoms, but otherwise I think the focus on diet may not be very helpful as far as the skin goes.
I’m not sure if you mean struvite stones or only crystals. Crystals can be normal in urine, and pH varies throughout the day, so I see a lot of owners told they have to be on special diets for life based on a single urinalysis, and this is not appropriate. If she does have a history of struvite stones, then I recommend following the University of Minnesota management strategy, and this means either a commercial diet formulated of this issue or a homemade diet formulated by a veterinary nutritionist specifically for your dog.
Good luck!
I just stumbled on your page while looking for aids for our cat with chronic FHV. Not to do with our cat, but I’m curious if you have any experience or information you’d be willing to share regarding mega-esophagus and/or esophagitis? This has been one of the most frustrating issues to even get diagnosed in our dog, and it seems the vets we have taken him to know very little, if anything, about it. We’ve found more useful information from other owners who have dogs with the issues, and, so far, has been the only help in keeping him from losing any more weight from regurgitation and lack of appetite from aspirated pneumonia. He’s 13 and has lost 10+ pounds since February, so we’re at wits end with this condition. Any input or recommendations regarding what type of specialty vet would be immensely appreciated!
Yes, megaesophagus is a challenging condition, and there are no perfect solutions. Management can be quite successful for some dogs, though, so I’m. glad you’ve found a supportive community of other owners. This is usually managed best by an internal medicine specialist or a veterinary neurologist, though an informed general practitioner can be fine as well. Management mostly involves changes in feeding (type of food, position and training for the dog, etc.). Medications may be helpful, though nothing has yet been proven to make as much of a difference as we would like, and the condition is almost always permanent.
GOOD LUCK!
I have a 13.5 year old lab, always in great physical shape with slim build. She has arthritis and 3 months ago, vet suggested Galliprant. In Canada, the drug has only just been introduced and the vet had no experience with it. My pup was fine on it until about 2.5 months in when she developed severe diarrhea. I stopped the galliprant, went to vet. She thought bowel infection but nothing turned up in stool. Blood work was fine. She then suggested mild pancreatitis but by then my pup was already showing improvement. I suspect Galliprant. My pup showed satisfactory improvement on Galliprant so would like to start her again on it though maybe half dose. Have you seen any pancreatitis associated with Galliprant? Any thoughts on natural anti-inflammatory? She is on a glucosamine vet recommended supplement, I see no obvious benefits. Thank you so much!
Nothing specific linking Galliprant to pancreatitis. Some cases of diarrhea are seen in studies, which is honestly true of almost any oral medication, but overall the safety profile is very good. Every dog is unique, of course, so it could be the cause of the signs in your pup, but it would be pretty unusual to see this problem only after 2.5 months on the drug, since that sort of usually shows up a lot sooner.
Not sure what you mean by a “natural anti-inflammatory.” If it reduces inflammation enough to benefit the dog, it is a drug, whether we call it a supplement or “natural” or whatever. Turmeric, for example, causes GI upset just like any other anti-inflammatory, but we have a lot less data on its risks and benefits.
I agree, the evidence is very solid that glucosamine is of little to no value.
I have a 9 year old Maltese girl, Sushi who was diagnosed with B-cell lymphoma.
We tried multiple treatment options but it seems her condition is getting worse.
We would like to try Artemisinin and look for advice. I really appreciate your kind help.
Hi there! I’m a third year veterinary student (starting clinics in 3 months, ahhh!) and I just wanted to say thank you for your blog! I’ve found it to be very informative. I greatly appreciate how you respond to all the proponents of CAVM, raw diets, etc. with tact, patience, and, of course, scientific evidence. Even in my short time as a vet student I have become discouraged by the seemingly growing trend of people mistrusting science and veterinarians. It’s all very frustrating. Your blog gives me hope!
Thanks so much for your comment! Nothing keeps me going more effectively than knowing that the work is useful, especially to those who are the future of veterinary medicine!
Hi
What pet food do you reccomend for a dog with elevated liver enzymes? He has a folded liver, and the specialist said it wasn’t life threatening and therefore he didn’t require any special diet, but I would love to know what your thoughts might be on diet? We would like to optimize his health as much as possible. Thanks so much !!
While there are some diets intended for dog with serious, diagnosed liver disease, in general I wouldn’t recommend a particular diet just for elevated liver values on bloodwork. It is important to know what the cause of this is, if possible, though unfortunately sometimes that requires invasive testing, such as a biopsy.
Good luck!