EBVMA Podcast- What Is Evidence-based Veterinary Medicine?

Back in April, I was privileged to participate in the inaugural podcast of the Evidence-based Veterinary Medicine Association, a group I have worked with for many years, as a membership of the Board of Directors and former President. In this first podcast episode, I discuss the basics of evidence-based veterinary medicine with Sharyn Esposito, a small animal veterinarian and instructor at the Bel-Rea Institute of Veterinary Technology, and Erik Fausak, the Host and also an instructor at Bel-Rea. Enjoy!

ebvma-podcast-ep01-infographic-2

Posted in Presentations, Lectures, Publications & Interviews, Science-Based Veterinary Medicine | 3 Comments

Acupuncture for Opioid-induced Nausea and Vomiting in Dogs

Having written extensively about acupuncture and the research associated with it during my acupuncture training, I haven’t been inclined to revisit the topic for a while. However, I ran across a recent study which I though illustrated the issues and ambiguities in acupuncture research nicely, so I thought it worth covering.

Scallan EM, Simon BT. The effects of acupuncture point Pericardium 6 on hydromorphone-induced nausea and vomiting in healthy dogs. Vet Anaesth Analg. 2016 Sep;43(5):495-501.

The Study

The purpose of the study was to investigate whether acupuncture could reduce the nausea and vomiting commonly seen with the use of narcotic pain medications before surgery in dogs. The study had some nice design features, including effective randomization and a reasonable sample size.  However, there were also some issues with the study that are common to acupuncture research and make the results more difficult to interpret.

Eighty-one healthy dogs presented for neutering at a veterinary college hospital were randomly assigned to received acupuncture (dry needle stimulation) at PC 6 (a point near the wrist thought to reduce nausea and vomiting), LU 5 (a point near the elbow chosen as a sham point because it is associated with a different nerve and has no history of use for nausea and vomiting), and a group that received no treatment. The dogs were observed for vomiting and signs of nausea (drooling and licking their muzzles).

Results

In terms of vomiting, the apparent effect of acupuncture depended on how the vomiting was assessed. More dogs vomited in the sham (81.4%) and no treatment groups (74%) than in the acupuncture treatment group (37%). However, in terms of the number of vomiting episodes, the sham group appeared to have more than the acupuncture group, but there were no differences between acupuncture and control or sham and control. (The paper is a bit hard to interpret on this point. The authors state, “The median (range) number of vomiting episodes in dogs that vomited were 0 (0–2) in [acupuncture],1(0–6) in [sham acupuncture], and 1 (0–3) in [control].” However, it makes no sense that there could be zero vomiting episodes in dogs that vomited. In any case, there were few vomiting episodes for most dogs, so chance likely would have a strong influence on the differences between the number of episodes in each group.)

In terms of signs of nausea, there were no differences between groups in the amount of muzzle licking that occurred, and between 92-100% of dogs licked their muzzles some. There were also no statistically significant differences in drooling between groups, though in terms of raw numbers the incidence of drooling was nearly the same in the acupuncture group (18.5%) and the sham group (22.2%) and much higher in the control group (44.4%).

So in terms of overall results, it looked like the acupuncture reduced the number of dogs that vomited, though not the number of vomiting episodes in the dogs who did, and didn’t have a significant effect on signs of nausea.

Issues with this Study

One major challenge for acupuncture studies is the effective use of blinding to reduce bias. Patients and researchers who are aware of which treatment a patient is getting in a study commonly report and interpret symptoms differently than observers who don’t have this information, and usually this difference makes the treatment look better than it actually is. While dogs don’t have beliefs or expectations that affect their response to treatments, their owners and researchers in veterinary studies certainly do, and this caregiver placebo effect is well-known to introduce bias into research studies.

The trouble with acupuncture is that it is very hard to fool patients regarding whether or not they are being stuck with a needle, and it is impossible to fool the acupuncturists. Fake needles can help, though they are imperfect, and when they are used often they seem to work just as well as real needles. Sham points, that is needling places not thought to be relevant to the symptoms being studied, is also problematic because sticking a needle anywhere in the body is going to have some effects. Acupuncturists often reject negative studies that find no difference between sham points and the supposedly real point because they argue that rather than proving acupuncture is a placebo, these studies actually prove the sham points work as well as the real ones. This, of course, raises the awkward question of why acupuncture should be seen as a rational, specific system for treating illness requiring specialized training and expertise to employ if it makes no difference where you put the needles.

In this study, the observers could clearly see whether or not the dogs had needles in their legs. Supposedly, the observers knew nothing about acupuncture, so they presumably couldn’t tell the sham treatment from the real treatment, but they could certainly distinguish any treatment from no treatment. Might this have influenced the results? It seems unlikely to have influenced the counting of the number of episodes of vomiting, which ought to be fairly discrete (though even this is a bit subjective; some might call non-productive retching vomiting while others might only count episodes where something is expelled).

However, it seems possible that this incomplete blinding might have influenced the observers’ scoring. Before any medication was given (and so before there would have been any nausea), the observers noted more licking of the muzzle in dogs with acupuncture needles (70.4% of treatment group and 66.7% of sham group) than in dogs with no needles (40.7% of control group).  There’s no reason to think that there should have been any real difference in this behavior before any medication was even given, so this suggests observers were recording behavior differently for those dogs with visible needles and those without.

The authors also noted that the incidence of vomiting in untreated dogs in this study (74-82%) was higher than has been reported in other studies of the same drug (usually around 50%, though it ranges from 25-85% depending on the study). The treatment group showed vomiting at a rate of 37%, which is within the range often seen in other studies for dogs given hydromorphone and not treated. This raises the possibility that the treatment did nothing and that differences in the incidence of vomiting among the groups were simply due to chance.

What About the Alternatives?

Finally, the real impact of any medical treatment has to be evaluated in the context of the alternatives. We have very effective and safe anti-nausea medications that have been tested for this same purpose, preventing the nausea and vomiting associated with hydromorphone given before surgery. How do they compare to the apparent effects of acupuncture in this study?

Here is a summary of the number of dogs vomiting in the treatment and control groups from the studies listed below compared with this acupuncture study:

Acupuncture Study

Acupuncture treatment- 10/27

Sham Acupuncture- 22/27

Control group- 20/27

Hay 2013

Medication group- 0/9

Placebo group- 6/9

Hay 2014

Medication group- 0/20

Placebo group- 5/20

Johnson 2014

Medication group- 0/13

Control group- 6/13

Claude 2014

Medication 30min before- 0/15

Medication at same time- 4/15

Placebo group- 13/15

Hay 2014b

Medication 60min before- 0/10

Medication 45min before- 0/10

Medication 30min before- 0/10

Medication 15min before- 2/10

Medication at same time- 6/10

Control group- 7/10

What this shows pretty clearly is that even if one interprets the acupuncture study generously in terms of the number of dogs who vomited, which is the one measure that looks like there might have been some benefit, it is far less successful that existing medication At best, the acupuncture reduced the incidence of vomiting from 75-80% of dogs to 37% of dogs. By comparison, the medication consistently eliminates vomiting entirely if given at least 30 minutes before the hydromorphone. Once one considers all of the potential issues with the acupuncture study, it becomes even more likely that the real effect was either very small or that the appearance of a benefit was entirely a function of residual bias and chance.

Bottom Line

This study is typical of acupuncture research. Though generally well-designed, it contains a number of limitations that reduce the confidence we can have in the results.  And while this is true of all studies, a comparison with research on conventional treatments for the same purpose shows the conventional therapy to be unequivocally effective, whereas the acupuncture treatment has either a small effect of questionable clinical significance, or possibly no real effect at all.

References

Hay Kraus BL. Efficacy of maropitant in preventing vomiting in dogs premedicated with hydromorphone. Vet Anaesth Analg. 2013 Jan;40(1):28-34. doi: 10.1111/j.1467-2995.2012.00788.x. Epub 2012 Oct 20.

Hay Kraus BL. Efficacy of orally administered maropitant citrate in preventing vomiting associated with hydromorphone administration in dogs. J Am Vet Med Assoc. 2014 May 15;244(10):1164-9. doi: 10.2460/javma.244.10.1164.

Johnson RA. Maropitant prevented vomiting but not gastroesophageal reflux in anesthetized dogs premedicated with acepromazine-hydromorphone. Vet Anaesth Analg. 2014 Jul;41(4):406-10. doi: 10.1111/vaa.12120. Epub 2013 Dec 16.

Claude AK, Dedeaux A, Chiavaccini L, Hinz S. Effects of maropitant citrate or acepromazine on the incidence of adverse events associated with hydromorphone premedication in dogs. J Vet Intern Med. 2014 Sep-Oct;28(5):1414-7. doi: 10.1111/jvim.12414. Epub 2014 Aug 21.

Hay Kraus BL. Effect of dosing interval on efficacy of maropitant for prevention of hydromorphone-induced vomiting and signs of nausea in dogs. J Am Vet Med Assoc. 2014 Nov 1;245(9):1015-20. doi: 10.2460/javma.245.9.1015.

 

 

Posted in Acupuncture | Leave a comment

Science-based Veterinary Nutrition Success Stories

In all the debates here and elsewhere about the relative merits of commercial pet diets and homemade, raw, or other alternatives, advocates of alternative diets often claim that conventional diets are unhealthy. Scientific evidence is not typically provided to support these claims, of course. Similarly, alternative dietary approaches are often claimed to be healthier than conventional diets, but there is no scientific evidence to support this belief. What this means is that, while there may be health risks associated with commercial diets and health benefits associated with alternatives, we don’t know what these are, which animals are affected, or how important the effects may be. Without real evidence, not simply anecdotes, claims about nutrition for our pets are simply opinions.

There is, however, some scientific evidence relevant to these issues. I’ve reviewed some research, for example, looking at claims regarding raw foods. This research so far fails to show any health benefits but does support the potential for risks associated with infectious organisms in raw meat. I have also reported on some of the research showing that homemade diets are often nutritionally imbalanced or incomplete, which would likely negate any potential benefits to the fresh ingredients used to make them.

A recent review paper adds a bit of perspective to this subject by reminding us that there is also research evidence illustrating the beneficial effects of some scientifically formulated diets that veterinarians use for specific health problems.

Davies M. Veterinary clinical nutrition: success stories: an overview. Proc Nutr Soc. 2016 Aug;75(3):392-7. doi: 10.1017/S002966511600029X. Epub 2016 Jun 8.

This brief article discusses the evidence for some of the clearest examples of therapeutic diets that have real benefits for patients. These include:

  1. Diets formulated for dogs and cats with kidney disease, which improve quality and length of life as well as laboratory markers of disease.
  2.  Diets for dissolving certain urinary tract stones, which allow cats and dogs with these stones to avoid surgery
  3. The discovery of the link between taurine deficient diets and cardiomyopathy, a life-threatening heart condition in cats that has been nearly eliminated by dietary supplementation of taurine.

There is also discussion of some less clear examples, including the potential use of dietary therapy for hyperthyroidism in cats and the use of special diets for treatment of arthritis and support of dogs undergoing chemotherapy treatment for lymphoma. These diets appear to have some benefits in these cases, though the evidence is not quite as robust.

Obviously, these examples don’t answer the larger questions about the relative risks and benefits of different dietary approaches. But they do illustrate that using scientific methods, we can develop diets that have measurable and significant health benefits. This is far more promising than simply relying on unsupported nutritional theories, haphazard trial and error, or anecdotes, which is the kind of evidence usually used to justify alternative nutritional practices.

As usual, I expect the comments will include the following invalid arguments, so I will address them pre-emptively:

  1. Vets know nothing about nutrition. Actually, they do know something.
  2. But I fed my dog X and then Y happened. Why We’re Often Wrong Testimonials Lie The Role of Anecdotes in Science-Based Medicine Why We Need Science: “I saw it with my own eyes” Is Not Enough Don’t Believe your Eyes (or Your Brain)

 

 

 

 

Posted in Nutrition | 36 Comments

Get Involved: Tell the Washington Veterinary Medical Board to Protect the Public from Alternative Medical Nonsense

Dr. Harriett Hall has posted an article on the Science-Based Medicine blog informed by a colleague of mine who is trying to fight the infiltration of pseudoscience into veterinary medicine in Washington State.

SBM Post re WA VMB

In the United States, each state regulates veterinary medicine independently through a Veterinary Medical Board (VMB). The VMB sets rules for the practice of veterinary medicine and issues licenses allowing vets to have, essentially, a monopoly on healthcare for animals. The reasoning behind this is that the public will be protected from dangerous and incompetent veterinarians due to the requirements for a license, which include a veterinary degree from a recognized educational institution, a test of one’s medical knowledge, and a requirement for regular continuing education to make sure vets have a current, scientifically valid knowledge base for their practices.

Unfortunately, proponents of unscientific alternative medical approaches are gaining greater influence over the regulation of veterinary medicine, which is fundamentally a political process that is influence by public opinion and the beliefs of individuals in government more than by the scientific evidence concerning such practices. In Washington, the VMB is considering allowing a large proportion of the continuing education vets use to maintain their licenses to be about alternative therapies.

This is not due to any new evidence supporting these therapies. It is due to the vocal involvement of a mall number of holistic vets who are able to disproportionately influence the political process. The chair of the VMB, for example, is a vet who practices “Quantum Healing,” a bit of New Age mystical nonsense that is essentially religion masquerading as medicine. Her influence has clearly trumped objections to this policy based on science.

I’ve written before about the ineffectuality of government regulation of veterinary medicine and the stunning degree to which even the most extreme rejection of science and scientific medicine is tolerated by regulators. The only way that we can protect the public from quackery is if we tell our representatives and regulators that we expect the standards of veterinary medicine to be based on real science, not mystical nonsense.

Such efforts can be successful. Attempts to expand legal authority for naturopaths in California, for example, were recently rejected by legislators thanks to active, informed input from the public. Getting involved is the only way to help protect the public and our pets from the influence of “quantum vets” on state regulators. Please take a look at Dr.  Hall’s article and consider voicing your opinion, especially if you live in Washington state.

A public hearing will be held on September 19th. Comments on the proposed rules can be submitted on the department’s Rules Comment webpage, or directly to the program manager, Loralei Walker, at Loralei.Walker@doh.wa.gov by September 12, 2016.

 

Posted in Law, Regulation, and Politics | 1 Comment

More Vets Passionately Promoting the Delusion of Homeopathy

I’ve written at length about homeopathy: the evidence that it is has no real effects; the reasons why the evidence homeopaths cite to support it isn’t convincing; and the dangerous and irresponsible things homeopaths often claim about their magic water nonsense. Despite the fact that most homeopathic products have no effects at all, for good or ill, beyond placebo, and despite the fact that relatively few people use them for their pets, the delusion that homeopathy is a form of real medicine is still potentially dangerous. Homeopaths mislead people into thinking they are helping treat their pets when they are really only affecting their own perceptions of their pets’ illness. And homeopaths frequently steer people away from truly effective medicine with misinformation and outright falsehood.

A recent example comes from two veterinary homeopaths, Dr. Christina Chambreau, whom I’ve written about before, and Dr. Wendy Jensen. Dr. Chambreau’s role in this example was simply to promote Dr. Jensen’s dangerous misinformation, but the nonsense itself in this case comes from Dr. Jensen’s article in an online homeopathy magazine. This article contains all the major talking points of homeopathic extremism, and it presents them in a tone of unabashed fanaticism. Dr. Jensen begins by comparing modern medicine, and the poor saps who use it to help their sick loved ones, to slave owners tending the wounds they themselves inflicted upon their slaves.

We have the wounded, the sick, we have the caregivers, the hospitals, the physicians. But in our eagerness to soothe the hurt, to comfort the sick, we avoid the knowledge of our own complicity. Like colonial plantation owners tending to a sick slave, we soothe our own guilt with warm milk and honey.

She defends this bizarre and offensive simile by claiming that everything we know about health and disease and how to treat it is wrong and that all conventional medicine does is make things worse.

We are suffering from wrong understanding. We are dying believing that the symptom makes the sickness. We accept that cutting off a tumor and then irradiating the body is the best we can do. We allow our trusted doctors to amputate ulcers and administer toxic drugs for cancer. We encourage immune-suppressing steroids for breathing problems, anything to stop the suffering, without regard for the long term; blind to the true health of the whole person. We support the system that creates illness, entrenches sickness, and deteriorates our health more severely with each added generation.

Ever wonder why some diseases are considered ‘incurable’? That’s because modern medicine, with its myopic focus on diagnosis and prevention, has lost sight of the big picture.

We are afraid to admit that giving bronchodilators to the coughing child now leads to life-long asthma in the adult. We just want it to stop now, and for this insistence, we pay dearly. Knowing somewhere inside that we could have made different choices, that we caused the suffering, knowing this truly, is too hard to allow into our consciousness. So we pray, we hold hands, we bake, we sing, we provide solace up until the end, and then after the tears dry, we move on to the next bedside.

The answer to this self-destructive approach is, of course, to abandon all we know and take a blind leap of faith into the Wonderland of fantasy conjured by Hahnemann– homeopathy.

There is a better way. There is a system of medicine that does not create illness with its treatments. Homeopathy is a time-honored means to treat disease at its source, rather than futilely trimming away the external manifestations.

The reason homeopathy does what scientific medicine cannot is, of course, because it doesn’t heal the body but the immortal soul, also known as the “Vital Force.”

Illness begins at the energetic level…This is the level at which homeopathy heals. The term “vital force” is a useful one to describe the energetic component of the body. This is what leaves when we die. The vital force has to be present for wounds to heal, bee stings to hurt and then ease, broken bones to knit. Yes, we need the cells that march in to eliminate infection and reconstruct tissue, but without the vital force these cellular components would not even be called into action. We can keep the wound clean and set the bone, but without the vital force all we would ever get would be a clean wound and a casted limb. Homeopathy partners up with our vital force to strengthen our body’s innate knowledge and bring an end to the diseased state.

For anyone crass enough to ask for evidence of these claims, Dr. Jensen does provide some anecdotes, which I have no doubt she believes count as evidence despite all the reasons they do not.** Unfortunately, what really emerges from her anecdotes is a willingness to take advantage of people’s desperation and take credit for the outcome when it is favorable (and, of course, not to tell any of the stories where it isn’t).

As a living example from my practice, Sally (her name changed) is a huge bull mastiff dog who woke up one morning with a terrible pain in her leg. She cried and limped all the way to her veterinarian’s, where her saddened caretakers were told that she needed to be given chemotherapy and have her leg amputated to save her life. With this treatment, she could live four more months. Her guardians struggled with this decision, buying time with pain medications that only partly worked. Finally they called me, and now Sally is walking four-legged and pain free nearly three years after her diagnosis.

Such anecdotes can obscure the fact that there has never been objective, consistent evidence that homeopathy can cure anything. If it truly had such miraculous powers, it would be impossible to hide this, and it would undoubtedly have replaced every other form of medicine by now.

Yet the invention of homeopathy did nothing to improve life expectancy, reduce infant mortality, or in any other verifiable way improve human health. This only occurred when scientific medicine began to develop as the primary form of healthcare. And despite over 150 years of use and study, homeopathy hasn’t been able to demonstrate its miraculous powers in any objective way. Only anecdotes and faith continue to validate it.

Some may say that giving hope to the desperate is a kindness. I believe that giving hope based on falsehoods and denying the benefits of real, scientific medicine, which have been demonstrated again and again unequivocally, is not a kindness. It is mistaking religion for medicine and misleading people in need.

**
Why We’re Often Wrong
Testimonials Lie
The Role of Anecdotes in Science-Based Medicine
Why We Need Science: “I saw it with my own eyes” Is Not Enough
Don’t Believe your Eyes (or Your Brain)

Posted in Homeopathy | 6 Comments

Cupping for Animals- Yes, Apparently that Really is a Thing!

I’ve written before about so-called Traditional Chinese Veterinary Medicine (TCVM). It is the adaptation for veterinary patients of a hodgepodge of pre-scientific folk theories and practices cobbled together for largely political reasons by Mao in the 20th century. The most popular TCVM therapy is acupuncture, which I have discussed in exhaustive detail many times. TCVM herbal therapies are also fairly common, and its variety of massage (Tui Na) as well as some dietary practices are sometimes recommended by TCVM practitioners, though they have not become as common outside this community as acupuncture.

There is one Chinese Medicine treatment that I haven’t discussed before, largely because I had never heard of it being used in veterinary patients: cupping. Cupping has had a moment in the limelight lately because it is the alternative medicine fad du jour among some Olympic athletes this year (much as kinesio taping was in 2012, though that seems less popular this year.

cupping-olympics

Cupping is basically the practice of placing a glass or plastic container on the skin and creating a partial vacuum, with heat or a suction pump. Sometimes, the skin under the cups is cut or scarified (so-called “wet cupping”) to induce bleeding. This leaves a visible bruise, which is often impressive, and is supposed to prevent or treat injury by increasing blood flow, expelling toxins, moving Ch’i, or any of a number of other purported mechanisms. Others have written about cupping, explaining why it is implausible in theory and entirely unproven in practice. And though it is probably mostly harmless, it can be the cause of serious injury if improperly done.

cupping-feature-e1466719915513

After the news media starting discussing cupping by Olympic athletes, I was asked about the use of this practice in veterinary patients. I had assumed it would not be practical since most of my patients are covered in hair, which would impede the creation of a seal necessary for generating a partial vacuum. Unfortunately, even I had underestimated the lengths to which some TCVM practitioners will go to inflict their methods on animal patients. Here is an example of a dog subjected to cupping.

cupping dog There is even a video of this being done to an apparent wound on a horse.

To be fair, cupping does seem pretty uncommon even among TCVM practitioners however, there are references to it on practice web sites along with acupuncture and other TCVM therapies, and lectures on cupping have been given at a number of continuing education conferences for alternative medicine vets (e.g. from the Ch’i Institute, the leading organization teaching and promoting TCVM, and the American Academy of Veterinary Acupuncture and International Veterinary Acupuncture Society joint conference).

So once again, while it shouldn’t need to be said:

There is no legitimate evidence that cupping is effective for any medical condition in any species.

  1. Human patients report it to be moderately uncomfortable, so there is no excuse for applying to animals who cannot give their consent to a painful procedure when there is no reason to believe there will be any benefit.
  2. It can cause serious injury, and while this appears to be rare it is not a risk that it makes any sense to take when, once again, there is no good reason to believe it has any benefits.

 

 

 

 

 

 

 

 

Posted in General | 17 Comments

Tellington TTouch- How to Sell Petting and Magic Rituals as a Powerful Healing Practice

Tellington TTouch is a subject I have long avoided, as I tried to avoid talking about pet psychics, because it is such vapid nonsense that there is really very little to discuss. As Thomas Jefferson once said, in another context,

Ridicule is the only weapon which can be used against unintelligible propositions. Ideas must be distinct before reason can act upon them…

The description provided by the inventor of this magic ritual may help to illustrate the problem with trying to take TTouch seriously as a medical practice:

[TTouch] is a bodywork and training method based on circular movements of the fingers and hands all over the body. The intent of the TTouch is to activate the function of the cells and awaken cellular intelligence — “turning on the electric lights of the body.” The TTouch is done on the entire body, each circular TTouch complete within itself. It is not necessary to understand anatomy to be successful in speeding up the healing of injuries or ailments, or changing undesirable habits or behavior.

This collection of impressive-sounding but meaningless words is worthy of a Deepak Chopra quote generator. “Cellular intelligence” gives the game away by its similarity to the “innate intelligence” of Palmer’s chiropractic, or the “vital force” of Hahnemann’s homeopathy, as well as “Q’i,” “Prana,” and all the other mystical energy forces that cannot be identified or evaluated by science but which magic healers claim to be able to manipulate to affect health.

TTouch, like Reiki, Therapeutic Touch, and all the other varieties of faith-healing and “energy medicine” out there, is simply a spiritual practice masquerading as a medical treatment. None of the “energies” that are claimed to be behind these therapies and to have such tremendous power have ever been shown to actually exist, and none of the therapies themselves can provide convincing evidence of any effect beyond the placebo.

Ms. Tellington further illustrates the fundamentally faith-based nature of this personal religious healing practice in her use of language. She notes that, “My philosophy that all beings–humans and animals alike–are reflections of the Divine Whole formed the early basis of Tellington TTouch and anchors it today.” She frequently refers to “the magic of TTouch. And, of course, she employs the vague and deceptive references to “quantum” phenomena that are so common in efforts to make faith-healing methods sound scientifically legitimate:

This book is an introduction to quantum science, explaining how we can be effective with our intention working from a distance. This is not new but many people are just now awakening to the “infinite possibilities” offered by quantum science…you will discover fascinating studies that have been done around the world with many universities and research institutions about the effect of intention and the understanding that all information is contained in the quantum field and is available to us when we learn to listen.

The claims made for the effects of TTouch are broad, covering almost every aspect of the physical, psychological, social, and spiritual dimensions of life:

a simple and effective means to relieve a vast range of common and uncommon health issues — from a simple headache to a life threatening emergency.

can improve performance and health

solutions to common behavioral and physical problems

helps establish a deeper rapport between humans and animals through increased understanding and more effective communication.

a newfound sense of well-being and renewal

relief from everyday physical and emotional issues such as headaches, backache, neck pain, depression, and sensitivity to touch.

can be effective in relieving asthma

teachers are using these techniques in the classroom to address behavioral issues and to facilitate problem-solving and positive growth and development in their students.

enhance relationships beyond the constraints of language. Parents are finding new channels to connect with their children. Spouses are deepening their relationships and discovering new ways to nurture one another in a non-sexual context. Friends come to new levels of understanding and appreciation. TTouch is a powerful tool to enrich all your interpersonal relationships.

TTouch-for-You is used successfully for:

  • Fostering a sense of well-being

  • Reducing stress

  • Pain relief in neck, back and legs

  • Migraine relief

  • Depression

  • Releasing unfounded fear and anxiety

  • Managing panic attacks

  • Management of arthritis pain

  • Stroke support

  • Enhancing focus and learning in the classroom

  • Helping youth at risk

  • Improved quality of life for seniors

  • Deepening interpersonal relationships

  • And much more

That’s a pretty impressive list of accomplishments for a system of touching rituals made up by one person based entirely on her own intuition. Unsurprisingly, however, there is absolutely no reliable evidence to support any of these claims. The TTouch web site claims, “We have also gathered a rich legacy of anecdotal evidence to support the effectiveness of TTouch to enhance personal wellness and quality of life” without any apparent recognition that this is meaningless in terms of validating the claims made for the treatment (see discussion of anecdotal evidence below).

However, as is so often the case, there is an understanding on the part of those selling quackery that science has marketing value and people want to believe that such a powerful, life-changing treatment has been scientifically validated, even if they rely primarily on anecdotes to judge the practice themselves. So there is a page devoted to “Research and Studies.”

Nothing could illustrate more clearly the contempt and lack of understanding of science than the collection of links grouped under this heading. They consist almost entirely of anecdotes dressed up as science. Uncontrolled case reports or case series with no placebo control, subjective measures of effective, and little to no effort to account for chance and bias are the meat and potatoes of faux science used to promote rather than investigate alternative therapies.

The few links that lead to actual scientific research concern only the effects of touch in general. While there is evidence that some domesticated animal species seek human touch and that they both appear to enjoy it and exhibit physiologic responses that support this interpretation, that says nothing about the validity of the grand claims made for TTouch. Gentle touching almost certainly does have calming effects and generates real physiologic responses in domestic animals. But this gives us no reason to think the specific methods of Tellington TTouch are superior to, or any different at all, from ordinary petting or that there is any mystical energy involved. And it certainly does not justify claims to improve the healing of serious, even “life-threatening” disease!

Ultimately, TTouch is just one in a seemingly endless collection of magic rituals invented and successfully marketed by one individual based entirely on wishful thinking and anecdotes. There is no reason to think it has any more value than any gentle, kind touch, or that it can prevent or treat disease. TTouch is, however, a marvelous illustration of an impressive number of Warning Signs of Quackery. Here are a few of the items on Dr. Walt’s list that appear just on the first few pages of the TTouoch web site:

Is the product or practice promoted as a “Major Breakthrough,” “Revolutionary,” “Magic,” or “Miraculous”?

Do the promotions try to simply elicit an emotional reaction rather than present clear information to help you make an informed decision about the product?

Is only anecdotal or testimonial evidence used to support claims of effectiveness?

Are claims made about scientific support without giving specific details?

Is the information about the therapy or product being provided by a professional lacking in the proper credentials?

Are technical words used without a clear definition?

Would a treatment require you to abandon any well-established scientific laws or principles?

Is the treatment said to be effective for a wide variety of unrelated physiological problems?

Is the product a quick and easy fix for a complicated and frustrating condition?

Do proponents use statements that are basically true but unrelated to the therapy?

Does the proponent disguise the truth with vague and misleading statements?

A Word about Anecdotes and Testimonials
As has happened for every other product or practice I have criticized on this blog, I have no doubt I will receive a steady trickle of comments about TTouch saying, in essence, “I tried it and it worked” or “How can all those people who have used it be wrong?” I will try to pre-empt some of this by referring readers to this collection of articles explaining why anecdotes and testimonials prove absolutely nothing.

  1. They are unreliable because uncontrolled observation is very prone to error and misinterpretation.
  2. There is a bias in the posting of testimonials. People with positive experiences are more likely to share them than people with negative experiences, so they misrepresent what people are actually experiencing.
  3. Similar testimonials can be found to support every single treatment ever invented, including those proven to be useless or even harmful. If we accept testimonials as evidence, than everything works. It’s a test no treatment ever fails.
  4. Tens of thousands of year of trial-and-error and anecdote led to virtually no improvement in human health and longevity. A mere couple of centuries of relying on science instead has double our life expectancy, dramatically reduced death, disease, and suffering, and proven that science work better than stories.

I encourage you to read these articles that discuss in much more detail why anecdote simply don’t help us evaluate medical treatments.

Why We’re Often Wrong Testimonials Lie
The Role of Anecdotes in Science-Based Medicine
Why We Need Science: “I saw it with my own eyes” Is Not Enough
Don’t Believe your Eyes (or Your Brain)

Posted in General | 23 Comments

Surgical Checklists Reduce Complications for Veterinary Surgery Patients

Evidence-based medicine (EBM) is a useful set of principles and tools that can help improve patient care. Unfortunately, there is little that is sexy and dramatic about EBM. Science in general tries to avoid the grandiose generalities that make for good marketing, and EBM in particular tries to focus on narrow, well-defined questions and answers that are constrained by the available evidence. This makes the impact of EBM methods less clear and dramatic, though no less real.

One example of a simple, inexpensive practice that is supported by good evidence and has real impact on patient well-being, but which nevertheless seems dull when talked about, it pre-surgical checklists. In his book The Checklist Manifesto, surgeon Atul Gawande eloquently argued that the simple process of having a formal, explicit checklist of procedures to g o through before, during, and after surgery would reduce medical errors. And despite the scoffing of many surgeons, who felt they were too smart and educated to need anything so obvious as a checklist to prevent their mistakes, the evidence has accumulated that the use of such checklists reduces errors, cost, injuries, and deaths.

Sadly, evidence for even such simple, low-cost interventions is often hard to come by in veterinary medicine. However, a recent study has now provided some data supporting the use of surgical checklists in the care of veterinary patients.

Bergström, A., Dimopoulou, M. and Eldh, M. (2016), Reduction of Surgical Complications in Dogs and Cats by the Use of a Surgical Safety Checklist. Veterinary Surgery, 45: 571–576.

The study involved assessing the rate and severity of surgical complications in 300 dogs and cats undergoing surgery prior to the introduction of a surgical checklist. The checklist was then put in use,  and the next 220 surgical patients were also evaluated for complications. The comparison showed quite clearly that, “The frequency and severity of postoperative complications was significantly decreased after introduction of a surgical checklist.”

This is the sort of simple, inexpensive tool that can be put into use and which, over the many thousands of surgeries done on veterinary patients every year, can have a dramatic effect on the welfare of patients. While it may not be as dramatic as announcing a “revolutionary breakthrough” in disease treatment, it is the kind of tangible improvement in medical care brought about by science and evidence-based medicine.

 

 

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More Nonsense from Holistic Vets about Commercial Therapeutic Diets

One of the subjects that holistic vets and other advocates of alternative practices get really passionate about is the evils of commercial and conventional diets. They promote a laundry list of myths about pet food, many of which I’ve addressed before:

  1. Raw is better than cooked-

Raw Diets for Pets

2.Vets know nothing about nutrition-

This is particularly hypocritical given that the claims made about the evils of commercial food and the virtues of alternative diets are generally made by—yup vets!— and these folks have no more training or expertise than the rest of us. In fact, the most reliable source of expertise on pet food are board-certified veterinary nutritionists, veterinarians with extensive training in nutrition. However, their claims are casually dismissed with innuendos or accusations about financial bias by vets who themselves make their living selling the stuff they advocate for.

What do Vets Know about Nutrition?

3. You can tell the quality of a food from reading the ingredients on the label-

Sorry, you can’t. Partly this is the fault of regulators, who don’t require truly important information to be put on pet food labels in a clear and understandable way. And partly the uselessness of labels as a measure of food quality comes from the meaningless vagueness of the concept of “quality” and all the myths and misconceptions about specific ingredients promoted by these vets.

Pet Food Nutrition Myths
Nutrition Resources for Pet Owners
Dog Food Logic

A recent article from the ever-unreliable Dogs Naturally Magazine gave some alternative vets a platform for repeating some myths and misconceptions about what are often called “prescription diets,” though this is technically incorrect. These are better referred to as “therapeutic diets” because they are intended to be useful in treating or preventing specific medical problems, not simply provide good overall nutrition, but they do not actually require a prescription, merely oversight from a qualified veterinarian.

The evidence for these diets varies from strong (e.g. kidney diets for cats with kidney disease) to weak (e.g. some of the diets for cognitive dysfunction in older dogs), but while there are some good arguments against some of these foods, none of the ones made in this article are worth taking seriously.

The article begins by asking a bunch of holistic vets to rank a few foods based only on the ingredient lists, with one food being a prescription diet. Not surprisingly, the vets tended to rank this diet quite low, based on these sorts of arguments:

Dr Marty Goldstein, author of The Nature of Animal Healing [said] Food #3 ranked last, based on the use of corn for its first ingredient, followed by by-product meal.

Dr Jodie Gruenstern: “This food was the lowest quality in the list. It contains GMO corn, soy (lots of it!), which is a common allergen, synthetic vitamins/minerals, shavings (if you didn’t know, the ingredient cellulose is literally sawdust), natural flavors, which usually mean MSG.”

Dr Jean Dodds: “Poor quality food: the first ingredients are corn, which is often GMO, and chicken by-product meal rather than whole chicken. Flax and soy are phytoestrogens.”

Dr Judy Morgan: “This is a Pet Store Food. Corn is the first ingredient, no muscle meat used, only by-product meal, synthetic vitamin/mineral supplement, corn and soybean are GMO, waste fillers are abundant. Overpriced in my opinion, considering the poor quality, cheap ingredients used).”

Dr Dee Blanco: “This one starts with corn to increase inflammation, then adds lighter fluid to it with soybean products and poor quality protein. Then it tries to make up for the poor quality foundational ingredients by adding synthetic supplements of the poorest quality, such as calcium carbonate, folic acid, ‘generic Vit E supplement’, etc. Looks like they added l-tryptophan to calm the nervous system down after putting the body into overdrive inflammation. Natural flavors?? Could be an entire cadre of carcinogens, allergens and toxins. Argh!”

So we have a long list of villainous ingredients supposed to cause inflammation and other health problems. Any truth in this fear mongering?

Corn and Soy are Evil

Obviously, this sort of simplistic characterization of foods as inherently good or evil is not scientific in tone, and in the case of the particular claims she makes about these ingredients they are not consistent with mainstream opinion or the evidence. Veterinary nutritionists agree that particular sources of protein and carbohydrate in canine diets are not intrinsically harmful or beneficial and that the health effects of diet are a complex set of interactions between many factors. Duck and bison are no more nor less likely to trigger food intolerance than chicken or beef, and tapioca or potatoes or green peas are no better nor no worse than corn and wheat and soy as carbohydrate and protein sources.

GMOs are Evil

This is a hot-button issue these days, and while it is complex, the evidence to date does not support the sort of hysteria about GMOs these vets promote. This is, of course, a topic which deserves multiple posts on its own. Dr. Dodds and others regularly list GMO ingredients as unhealthy, promoting inflammation and food intolerance, and there is no evidence to support this. While there is always the potential that particular modifications of food crops and animals could lead to health risks, the anxiety about genetically modified organisms is generally ideological and based on misconceptions or poor understanding of the relevant science. It is part and parcel of the Appeal to Nature Fallacy, and the existing evidence does not support most of the hysterical fears about GMO. Dr. Dodd’s claims are not based on research from nutrigenomics but are simply part of her own beliefs and prejudices, and she provides no compelling scientific evidence to support her claims. Relevant discussion of this issue and the evidence can be found here: 1, 2, 3, 4, 5, 6, 7.

By-Products are Evil

Here’s what one nutritionist I’ve talked to has say about by-products:

A by-product only means that it was not the intended main product of the industry. It gives no indication on nutrient profile, digestibility and bioavailability, etc. Many people who dislike by-products will happily buy wheat bran (a by-product of the baking industry). Moreover, by-products vary according to country and culture. Liver, an excellent source of nutrition, is considered a by-product in the US because skeletal meat is the primary product of slaughtering an animal and many people do not eat organs any more. By-products can be excellent ingredients in pet food and it would be wasteful (and terribly self-centered) to not use it to nourish humans or animals.

The concept is meaningless, and used to demonize foods that people think of as “icky” without any reference to their real nutritional value.

Let’s look at some of the other claims. he idea that corn is a major cause of inflammatory diseases is an unproven hypothesis. The claim that phytoestrogens in soy used in pet foods have negative effects on health is an unproven theory. Both of these are presented as facts when they are just personal beliefs.

“Natural flavors” usually means hydrolyzed animal tissues, not MSG, so this is just false. And “synthetic” vitamins are identical to those extracted from plants, so the idea that they are somehow less useful or more harmful is just the Naturalistic Fallacy in action.

The bit about “sawdust is particularly silly. Cellulose is a natural part of the wall of plant cells. Sure, it is present in wood, but it is also present in all the fruits and vegetables that these vets would laud as healthy for our pets. The usual source of cellulose as a dietary fiber in pet foods is the bran from cereals such as wheat, not “sawdust.” Such hyperbole is clear evidence of a preference for ideology over facts.

The article also uses a bit of drama to suggest that therapeutic diets are poor-quality or identical to over-the-counter diets and the designation only serves to justify charging more.

Now, a 30lb bag of the regular food is $47.99 at Petsmart. The prescription diet dog food can also be purchased at Petsmart for $84.95 for a 27.5lb bag. It’s twice as expensive!

Now, you might be thinking this is because the prescription diet was formulated and tested with a specific condition in mind. This is completely false.

While an over-the-counter food with a health claim (such as controls weight) is subject to FDA regulations and enforcement, the FDA practices “enforcement discretion” when it comes to veterinary diets. Put another way, this means the FDA has not reviewed or verified the health claims on any veterinary diet. Did you catch that? There are very few ingredients in veterinary diets that aren’t also in other regular diets.

In the example above, I’d say the pet store brand is a better quality food, wouldn’t you? The prescription diet contains by-product meal (which comes straight from the rendering plant), lots of soybean and corn products (a cheap replacement for animal protein) while the regular food contains more expensive, higher quality ingredients.

Again, here’s the response of a nutritionist who actually knows something about veterinary diets to this claim:

This is a misrepresentation. Veterinary diet claims do have to be substantiated as well. The FDA did have some leniency regarding veterinary diets regarding the extent of their health claims because they are usually used under the guidance of a veterinarian to improve the life of the pets. However, the FDA is concerned about many so called therapeutic diets now marketed directly to the consumer, so they might start enforcing legislation if they are not used properly, i.e. under veterinary involvement

Regarding price, good companies invest in research, that goes into designing the food, sometimes funding basic research that would further our knowledge on particular diseases (without an immediate product to market and sell) plus trials in healthy and diseased pets, etc. So, I understand why a veterinary diet from a responsible company costs more money, not because the ingredients are more expensive, but due to the knowledge invested behind it.

These holistic vets are so ideologically biased against commercial diets that they even claim that ingredients they routinely recommend as beneficial for many health conditions magically become harmful when included in such foods:

And fish oil is a terrible addition to pet foods. It’s much too fragile to be added to processed foods and as soon as the bag is opened, it will oxidate and cause inflammation in your dog. Ironic isn’t it, when the food is supposed to be treating inflammation in the first place?

Actually, it’s not ironic, it’s just a bit of ignorance and prejudice masquerading as an informed opinion. Fish oils can be added to foods in a manner that has all the same health benefits of giving them separately, if this is done properly by a company with real nutrition experts who know what they are doing.

Bottom Line
I usually write brief summary of my conclusions for these posts, but in this case I could not write anything that makes the point better than the following, again from a nutritionist knowledgeable about these issues:

All these arguments are just guilt trips and not based on reliable science and assume the quality of a final product depends solely on certain random criteria form the individual ingredients rather than in deep knowledge of the current state of nutritional science, excellent quality control during formulation, reception of ingredients, extrusion, and storage conditions.

What we have here is unsubstantiated belief presented as fact. And this kind of fear mongering has real dangers. There is, for example, very good evidence that feeding commercial diets for cats with kidney disease can reduce suffering and prolong life. Yet I have seen clients feeding unbalanced and completely inappropriate homemade concoctions instead because they have been frightened and misled by this kind of propaganda and are unwilling to feed diets with proven benefits.

As I’ve said many times, no one knows the perfect diet for any given patient, and I am open to the possibility that there are benefits to feeding alternatives to the usual canned and dry commercial diets. But these benefits must be proven, not simply invented out of whole cloth or wrung out of twisted misrepresentations of nutrition science.

Posted in Nutrition | 180 Comments

Anti-Medicine Vets: Should Rejection of Scientific Medicine Disqualify One from Practicing as a Licensed Veterinarian?

There is a wide range of opinions about most medical topics in veterinary medicine, and rarely sufficient evidence to definitively establish who’s right and who’s wrong. For better or worse, we have tremendous individual latitude in deciding what treatments to offer and in counseling our clients.

But is there ever a point where a vet is so vehemently opposed to so much of what constitutes modern veterinary medicine that they shouldn’t be allowed to hold a medical license? If someone reviles the rest of the profession, claims that our most common and well-established interventions are useless or harmful, and offers ONLY unproven or disproven alternative treatments, why should they be allowed to hold the same license and practice under the same terms as the rest of us? Is it misleading for animal owners to call oneself a veterinarian when one’s entire philosophy and practice inconsistent with the accepted approach of the veterinary profession? Are there truly absolutely no standards at all for what constitute legitimate veterinary medicine?

Of course, in reality there is virtually nothing in the way of a standard of care within veterinary medicine. Government seems uninterested in regulating the profession beyond policing drug abuse. And the institutions of organized veterinary medicine, such as the AVMA, have absolutely no interest in interfering with the sacred autonomy of individual veterinarians, regardless of what sort of treatments they employ. The AVMA notoriously refused to consider even the small step of acknowledging that homeopathy is a useless fraud,  and it includes complementary and alternative medicine as part of the definition of veterinary medicine, despite being unable to define what it is. The general approach is that if something makes vets money, it is fine to offer regardless of the state of the scientific evidence.

However, there are some principles of law and ethics that have been articulated which the extreme anti-medicine vets seem to violate. For one, veterinarians are generally required by law to have a degree from an accredited school of veterinary medicine. The overwhelming majority of what is taught in such schools is science-based, conventional medicine. The purpose of such a requirement is to ensure the public is not harmed by practitioners who don’t understand science or scientific medicine and offer instead unscientific, dangerous quackery. But what is the value or meaning of such a degree if an individual repudiates nearly all of what they have been taught? A vet who explicitly rejects the basic principles of science and the core therapies of veterinary medicine is no less a threat to the public than a homeopath or other non-veterinarian who practices on animals without a formal veterinary education. In fact, such faux veterinarians are even more of a threat to veterinary patients because the public can be misled into believing they are practicing as legitimately medical practitioners.

The AVMA ethics guidelines also specifically prohibit deliberately defaming other veterinarians or deceiving the public in one’s capacity as a vet:

Veterinarians must not defame or injure the professional standing or reputation of other veterinarians in a false or misleading manner. Veterinarians must be honest and fair in their relations with others, and they shall not engage in fraud, misrepresentation, or deceit.

Yet the extreme alternative vets who base their practice entirely on dismissing mainstream medicine as useless and dangerous, and who claim to be part of this profession while rejecting its basic foundations are inherently defaming other vets and deceiving the public. What is the purpose, other than being able to make money from clients, of calling yourself a veterinarian while simultaneously denouncing the rest of the profession as greedy, negligent, and dangerous? Why should this be allowed?

Of course, even the majority of so-called “holistic” veterinarians make at least some concessions to science and scientific medical practices. I am not suggesting that merely offering untested on unproven therapies disqualifies one from serving as a licensed veterinarian. Even offering clear nonsense, such as homeopathy and “energy medicine” can be combined with otherwise acceptable patient care in an integrative model, though I believe the profession needs to do more to inform the public about the lack of value to such practices. But there are some pretty extreme voices in alternative veterinary medicine who reject the core values and practices of the profession, and it seems unfair to the public and the profession that these individuals can present themselves as licensed veterinarians on an equal basis with the rest of us. Here are a couple of examples of these most extreme voices in alternative veterinary medicine.

Patricia Jordan-

Dr. Jordan is one of the most vehement opponents of vaccination in the veterinary field. She is the owner and author of the web site and book Mark of the Beast Hidden in Plain Sight: The Case Against Vaccination. Here is a sample of the rhetoric from her site.

mark of beast

WE SHOULD REWRITE THE BOOKS OF MEDICINE TO REFLECT THE UNDERSTANDING THAT DISEASE HAS EVOLVED FROM THE VERY USE OF VACCINES.

NEVER SHOULD WE HAVE ALLOWED THE INNOCULATION OF POISON, THE GRAFTING OF MAN AND BEAST. NOW WE ALL CARRY THE SCAR, OF MEDICAL SUPERSTITION THE GENETIC PLAGUE OF INQUITY

The purpose of putting the Mark of the Beast together was to provide education for the reader or listener to a very important quest that apparently has been going on from the beginning of the illusion of time….conventional medicine [is] not the direct path to true healing and wellness…true health and wellness comes from a very natural setting and one from the relationship of the individual in balance with the earth and all of the treasures a healthy ecosystem has to offer…The important ingredient everyone also needs is right relationship with the other living organisms of the environment we share, respect for each other and the most holy relationship that of the one with the intelligence that designed this most wonderful system. Our fall from right relationship is as much responsible for disharmony and disease as is the turmoil the daily disturbance this imbalance maintains…Vaccines and drugs are at odds with the intelligence of the almighty design and getting back to the garden means getting back to the natural form…

Not only does she espouse absolutely insane ideas about the dangers of vaccination, she promotes bizarre conspiracy theories about cover-ups at the CDC and malign cabals of pharmaceutical companies hiding clear evidence of widespread harm to people and pets from vaccines, and she actively blames the veterinary profession for choosing profit over the welfare of patients.

THE PROFITABLE SECRET OF VACCINE INDUCED DISEASE

Brave veterinarians are speaking out, revealing veterinary malpractice committed through pharmaceutical pressure and greed.  THIS visual documentation is the first on the horrors of VID.

DEATH BY VACCINOSIS
Patricia Jordan, DVM, CVA, CTCVH, & Herbology

Unforgettable photos, video and veterinary records prove widespread veterinary malpractice through unregulated over-vaccination.

Vaccines are criminal in what they are doing to our pets and our people….CRIMINAL

Listen to the parents, not the Pediatricians! Listen to the pet owners and not the vets!

Doctors that spend the time to find and promote health take more time in the exam room, and it doesn’t make financial sense. Doctors aren’t rewarded for the health of their patients; they are rewarded when their patients are sick and they need testing and medical intervention. And even the most idealistic and dedicated doctors arrive in the profession with large student loans to pay. Volume of patients, not vitality of patients will pay the bills

Doctors and veterinarians are not trained in nutrition because it will not help them financially. There is much more money in surgery and drugs. We learn our medicine in programs and teaching hospitals that are typically funded by those who have the most to gain financially: the drug companies.

Have heard good reports on my AVH [Academy of Veterinary Homeopathy] listserve about [pet] insurance. Of course you shouldn’t be getting any of the conventional poison in the first place and it would be highly doubtful you would ever need it anyway.

Bottom line, doctors get paid a lot of money to pander vaccines PERIOD.

[Bill Gates, specifically in his efforts to support avccination of poor children] is NO PHILANTHROPIST he is in fact the biggest money launderer for getting funds to the harmaceutical industry for which our government is intimately involved with profit sharing WAKE UP PEOPLE

Apparently the DEA also works for the FDA which works for the harmaceutical companies…….

Another whistleblower, another bit of truth that is being covered up by the CDC.. The government admits that live virus vaccines should not be administered to those with immune deficiencies. What they ***KNOW BUT FAIL TO DISCLOSE*** are the mechanisms of immunosuppression. It’s a cascade effect that leads to the diseases that are denied by the criminal CDC to protect profits instead of human life.

Of course the WHO is as conflict ridden as the rest of health care and governments who profit directly from it.

The vaccines are unsafe and they are unnecessary, they are also the FOUNDATION of conventional medicine which unfortunately is not to be confused with conventional “wisdom”. This is an example of how the system is built upon a foundation of “speculation” or unethical medicine that is now being questioned. Vaccines DO NOT confer herd immunity and they DO NOT confer individual immunity. They are however, the “golden calf” of the white coats that grows into the “sacred cow” of vaccine induced disease. What will they do when the public figures out they have been lied to for the purpose of “making a living by killing” by the pharmaceutical medical industrial complex that is only in operation due to government financial scaffolding and protection?

This level of vitriolic condemnation of the entire veterinary profession, human medical profession, and public health system would seem to disqualify one from being considered a doctor in any meaningful sense.

Will Falconer-

I’ve written about Dr. Falconer several times. He is a homeopath who is adamantly opposed to almost all vaccination, parasite prevention and treatment, antibiotics, conventional diets, and just about everything else that constitutes the practice of scientific veterinary medicine and animal care.  As with Dr. Jordan, he not only practices the completely worthless nonsense that is homeopathy, he actively recommends it instead of conventional medicine, and his advertising of his practice if founded on denigrating the rest of the veterinary profession.

I put the antibiotics away for good when my own cat Cali, in trying to have her first kittens, did so out in the wilds of Haleakala on Maui, and came dragging herself in with a horribly infected uterus, leaking a foul smelling discharge, and clearly seriously ill. I knew even antibiotics would have a hard time helping her, but I also knew I had something deeply curative to offer now: homeopathic medicine.

Cali was treated with pyrogenium 30C, a remedy made from rotten beef…Ater a few doses of this remedy and a couple of uterine flushes with a bit of anti-infective Chinese herb (Yunnan Paiyao), Cali made a full and remarkable recovery. It was as though she’d never been sick. I had an “Ah-ha!” moment, and tossed my antibiotics in the trash.

The best that conventional medicine can do with chronic disease is to control symptoms through suppressive therapies. This is fraught with problems, including side effects from the drugs, and apparently “new,” more serious diseases arising from the continued course of suppression.

Heartworm prevention kills dogs?

I never knew that when they first came out with the heartworm drugs, back in the 80’s. I learned it when I left conventional practice and started to dig into what can hurt your dog, make her ill, and even kill her…It turns out that the drugs commonly pushed on you as “heartworm prevention,” carry the risk of autoimmune disease.

The Top Five Ways to Healthy Pets

Here are the five things that will have the greatest impact in keeping your animal vital, healthy, and living a long, joyful life with you.

(doing the opposite has been the biggest predictor of illness and dying too soon that I’ve seen in my 30+ years of practice)

  1. Stop Vaccinating Them.
  2. Feed Them What Their Ancestors Ate.
  3. Stop Using Pesticides to Kill Fleas.
  4. Stop Using Poisons for Heartworm Prevention.
  5. Give Them Raw Bones (for the whitest teeth and freshest breath ever).

Imagine avoiding risky vaccinations while getting very strong immune protection against parvo and distemper, the two potentially deadly diseases of puppies.

You know vaccinations are grossly over provided in our broken system of veterinary medicine. The pushing of vaccinations by Dr. WhiteCoat throughout your animal’s life doesn’t add to her immunity…And you know that vaccines are harmful. Chronic disease often follows vaccination, even a single vaccination.

The model of disease prevention put forth by conventional veterinarians is fundamentally flawed. It is in fact damaging the animals whose owners partake in it.

This broken model of disease “prevention” will never change from Dr. WhiteCoat’s side, who sells it:

  • He refuses to see the possibility of it causing harm.

  • He’s comfortable in it; change loses to maintaining the status quo.

  • He profits from providing it and profits again from the disease it causes.

Charles Loops-

Dr.Loops, another homeopathy, is an example of the alternative medicine convert. After practicing conventional medicine initially, he has decided that science-based medicine is worthless, and he uses homeopathy almost exclusively, even for fatal diseases such as cancer. In what sense is he a veterinarian rather than simply a homeopath? What does it matter if he has a veterinary degree if he has repudiated everything he learned in getting it? Should the public know that he has chosen to practice magic instead of medicine, and should he still be able to legally practice as a veterinarian?

Veterinarians and animal guardians have to come to realise that they are not protecting animals from disease by annual vaccinations, but in fact, are destroying the health and immune systems of these same animals they love and care for. Homeopathic veterinarians and other holistic practitioners have maintained for some time that vaccinations do more harm than they provide benefits.

My practice is mainly by referral and 95% by telephone consultation. I have treated thousands of cases using the principles of classical homeopathy and I continue to find this system of gentle healing to be the most effective therapy that has ever existed.

Sixty percent of my new cases have cancer and most of these several hundred companions each year survive longer and have a better quality of life than cancer patients treated with Western medicine or other modalities…Having practiced 32 years as a veterinarian, ten with Western medicine and over twenty with homeopathy, there is little doubt about which is the more effective system and which has the most curative approach to disease. The side-effects of homeopathic treatment are improved, overall health and a heightened sense of well-being; side-effects not typically found with Western medicine.

Jenifer Preston-

Another example of such a convert from veterinary medicine to anti-medicine is Dr. Jenifer Preston. She too bases her approach on blaming the rest of the veterinary profession for nearly all the illnesses pets suffer from. So again, how is she a veterinarian rather than just a homeopath?

Dr. Preston practiced allopathic medicine for twenty five years before realizing that the vaccinations and drugs she dispensed daily were causing more problems than they ever solved and often to a more severe degree…The drugs prescribed every day were literally destroying healthy organs and shortening lives.

Over the years, drugs and vaccines have made our pets, our beloved companions, seriously sicker and have shortened their natural life span. Why do we so often see premature aging? How do we STOP this trend? Treat holistically!

Epilepsy in dogs and cats can develop at any age. Allopathic veterinarians do not give you any real reason that this develops in your beloved dog or cat.

What the vets don’t realize is that they themselves have very likely created this syndrome with vaccines. Yearly administration of multi-valent vaccines assault the animal’s immune system over and over. More and more animals are developing ‘auto-immune’ diseases and the allopathic community has no idea why.

A majority of diseases plaguing dogs, cats, and horses today are what is termed auto-immune syndromes. This means that your companions have had their whole immune system severely compromised, so that their body cannot naturally maintain optimum health. Nature’s defense, so cleverly installed in every mammal, has been dismantled. What are the obvious culprits here?? The use of VACCINES and DRUGS over and over and over.

Do you know that EVERY drug has at least one side effect–many very serious or fatal?

Do you know that animal vaccines always contain mercury, formaldehyde and/or aluminum?

Do you know that animal insecticides are not only poisoning your pet but poisoning our planet?

Over the years, drugs and vaccines have made our pets, our beloved companions, seriously sicker and have shortened their natural life span. Why do we so often see premature aging? How do we STOP this trend? Treat holistically! Naturopathic veterinarians have found that these alternative products are accepted so much easier by the animal’s body and therapy is so much quicker and more complete!

Al  Plechner-

Of course, Dr. Plechner has provided material for some of the most read articles and most virulent hate mail on this blog. He is an odd duck in that his practices fit under neither mainstream nor typical alternative medical systems. Basically, he has invented his own cause of all disease and his own treatment for all disease, utilizing conventional tests and medications in completely idiosyncratic ways. There is no scientific legitimacy to his practices, merely his opinion and those anecdotes he chooses to promote. And I have heard not only from pet owners whose animals have been harmed by him, but also from veterinarians who have had to treat patients injured by his practices. These veterinarians have been unwilling to tell the public about their experiences out of a desire to avoid conflict and a sense of loyalty to the profession. This sense is clearly one Dr. Plechner doesn’t share, as he promotes his practices, once again, on the basis of condemning mainstream veterinary medicine as greedy and ineffective.

profits made by all of the cancer treatment drugs and the associated services involved in treating cancer. Sad to say, the treatment of cancer has proven itself to be, a tremendously successful revenue builder. Why wouldn’t you keep a possible cure under wraps?

But of course, this is purely a hypothetical question. We couldn’t possibly believe that our medical institutions could be callously driven by the pursuit of profit. Why, they’re as ethical as our great financial institutions are and look at how successful they’ve been.

The frightening fact is that a cancer cure could prove to be financially disastrous to the pharmaceutical and all of the other dependent medical industries.

“HE WHO PAYS THE PIPER, CALLS THE TUNE”

Much of so called ‘science’ operates on this basis.

And most of the medical/ big pharma colluded industry has a cozy little relationship with government, msm and the educational institutes to boot.

We should class them as ‘Disease Care’ providers, and not Health Care!

Tom Lonsdale-

Dr. Lonsdale is a promoter of raw diets. This in itself is not unusual. However, his obsession with this topic has led him to a broad rejection of nearly every aspect of science-based  veterinary medicine, and a barrage of accusations characterizing the veterinary profession as fundamentally corrupt and intentionally harmful to animal health.

He has called the move towards more evidence-based practice “laying smoke screens, rearranging the deck chairs on the sinking ship and fiddling whilst the pets crash and burn.”

There’s a creeping realisation that much veterinary ‘evidence’ fails the scientific test. Over-servicing based on dubious interpretations of the evidence — or suppression of the evidence — is commonplace. Needless vaccinations against non-existent diseases prop up the veterinary economy.

Pick up any veterinary publication and you’ll see big pharma exert control and invoke their interpretations of the ‘evidence’. Of greater concern, junk pet-food makers enjoy special relationships with veterinary regulators, schools, associations, researchers, suppliers and practitioners.

Defenders of the system employ dodgy assumptions and defective logic. Little or no consideration is given to subjective assessments, the basis of most decisions by clients and clinicians, or the complex interconnectivity of our world. Vets pursue the reductionist, treatment and germ theory paradigms with varying degrees of commitment and expertise, but seldom or never consider the limitations of those belief systems.

Why there is an alliance between junk pet food makers (‘barfers’ included), many veterinarians and fake animal welfare groups designed to keep pet owners confused and in the dark?

See how incompetence and maladministration characterise the veterinary endeavour.

The situation is grim and starts with the veterinary profession’s inattention to detail. Whilst it is obvious to most folks…that junk foods are bad for health the veterinary profession appears to have been too busy to notice. Once pointed out, the fact that an artificial diet fed monotonously either directly or indirectly poisons animals, the profession should have risen up and acted. Instead the professional ethic ruled that a mass cover up should apply. With the cover up safely in place profits were to be made. Increasingly elaborate ploys are now used in persuading the populace to a. keep more animals and b. feed them high priced artificial concoctions.

It is my belief that the profession’s political mismanagement and acquiescence is matched by a naive scientific methodology… Our way out of the mire is via a holistic assessment…. Since the holistic approach is not usually taught or practised, here are a few tips which may be of help. Firstly, make sure to have fun. There are no columns of meaningless figures in this approach nor disembodied dry facts.

Bottom Line

The purpose of regulating veterinary medicine, licensing veterinarians, and establishing even the minimal standards of practice and ethics that exists is to protect the public. People should be able to expect that a licensed vet not only has an education in the principles of science and science-based medicine but is prepared to utilize them in patient care. While there is great space for individual judgment and variation in exactly how we treat patients, it is deceptive to the public, unfair to other veterinarians, and dangerous to patients to allow vets who actively repudiate the core principles of science and scientific medicine, defame the rest of the profession, and offer only treatments that are untested or directly incompatible with science to practice as if they were legitimate doctors of veterinary medicine. If they wish to abandon the profession and its values and methods, then they ought to give up the rights and privileges of membership and not present themselves as veterinarians but as homeopaths, herbalists, Plechnerists, or whatever other type of alternative practitioner fits their ideology.

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