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The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

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This month, January 2013, the American Veterinary Medical Association (AVMA) House of Delegates is discussing Resolution 3, which states that homeopathy has been identified as an ineffective practice and its use is discouraged.

Evidently, the AVMA wants veterinarians to take a stand against the practice of homeopathy in veterinary medicine.

In hearing this, I question:

1. Why are veterinarians being asked to do this?

2. Is the AVMA going too far in taking this position in strongly recommending what treatments we veterinarians should not apply to our patients?

First, what is homeopathy?

In Homeopathy: An Introduction, the National Institute of Health’s (NIH) National Center for Complementary and Alternative Medicine (NCCAM) explains its foundations on two theories:

1."Like cures like" — the notion that a disease can be cured by a substance that produces similar symptoms in healthy people.

2. "Law of minimum dose" — the notion that the lower the dose of the medication, the greater its effectiveness. Many homeopathic remedies are so diluted that no molecules of the original substance remain.

Additionally, the NCCAM reports that "most rigorous clinical trials and systematic analyses of the research on homeopathy have concluded that there is little evidence to support homeopathy as an effective treatment for any specific condition."

So why is the AVMA considering Resolution 3?

According to the Veterinary Information Network (VIN), the resolution was submitted by the Connecticut Veterinary Medical Association (CVMA), which has asked "the AVMA to affirm that the safety and efficacy of veterinary therapies should be determined by scientific investigation, and when scientific studies deem therapies to be ineffective or unsafe, those therapies should be discarded."

Evidently, because homeopathic treatments cannot be scientifically proven to work, the AVMA doesn’t want veterinarians to recommend their use.

Where do I stand on this topic?

Although I have not been formally trained in homeopathy, I’ve had an academic introduction through continuing education. I use and see the benefits of certain homeopathic products in my veterinary practice (and for myself).

RESCUE Remedy, a "blend of 5 of the 38 Bach® Original Flower Remedies," is used for stress reduction. The result of its use is a calming effect in both people and pets. I use RESCUE Remedy Pet for my canine and feline patients that need help easing into being cooperative for acupuncture treatment, enduring the chaos of a boarding facility, or for taking the edge off for animals stressed by a multi-pet home or holiday celebrations.

Traumeel and Zeel (both made by Heel USA), which I also use regularly, are products geared toward reduction of pain, inflammation, bruising, and swelling.

I use multiple varieties of Bach and Heel USA products on a frequent and ongoing basis to help with my own stress and osteoarthritis pain management. Their use has permitted me to reduce my consumption of prescription and over the counter drugs (e.g., sleep aids and pain medication) that are known to have a variety of mild to severe side effects. I also use them in my veterinary patients to lessen their reliance on pain relieving and behavior modifying medications.

A placebo effect wouldn’t be seen in a pet, as our companion cats and dogs don’t have the capacity to anticipate that they should feel better after receiving a homeopathic product. Our pets will just improve (hopefully) or worsen (hopefully not), and unlike humans, won’t falsely do so just because they have a belief that a particular product will help.

Even though 100 percent scientific proof of a homeopathic treatment’s success may not be proven, the general safety of products following good manufacturing principles should be available as a complement or alternative to conventional treatments veterinarians can offer to our patients.

What Other Practices Are Being Discouraged by the AVMA?

A similar circumstance occurred this past August at the 2012 AVMA Conference when the AVMA made an announcement discouraging veterinarians from recommending Raw or Undercooked Animal-Source Protein in Cat and Dog Diets for our patients.

The AVMA’s anti raw-food feeding stance is legitimately founded on concerns about the potential for disease causing microorganisms (primarily bacteria and parasites) that could be spread between pets and people.

I understand the AVMA’s concerns, as we veterinarians must strive to promote our patients’ wellness without putting the health of our patients’ human caretakers at risk. My experiences managing immunocompromised patients, including my own dog Cardiff, who has Immune Mediated Hemolytic Anemia, and the pets undergoing oncology treatment at the Veterinary Cancer Group have led to my recommendation of cooked animal-sourced proteins over raw.

What are your perspectives on the AVMA’s discouragement of homeopathy and undercooked animal-source protein diets?

Dr. Patrick Mahaney

Image: Homeopathy Remedies by kh1234567890 / via Flickr

Comments  21

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  • 01/08/2013 05:42am

    pity to note an organization to the status of AVMA acting like agents of Pharmaceutical companies. If one does not know something does not mean that the thing is wrong.You can not God but you can not say there is no God. If we are blind we can help by many ways but if you are pretending to be blind no body help. First study then act
    Dr ramankutty a vet practitioner

  • 01/15/2013 09:43am

    The good news is that the AVMA has not YET taken a stand/position on the topic of homeopathy.
    It's still in discussion.
    Thank you for your comments and sharing your perspective.
    Dr. PM

  • Expectations
    01/08/2013 06:14am

    I would expect many comments on this post. I'll be anxious to read the opinions.

  • 01/15/2013 09:44am

    The comments are rolling in!
    Thank you for yours.
    Dr. PM

  • AVH vs AVMA
    01/08/2013 08:12am

    http://www.theavh.org/avma/meeting_report_winter2013.html just like our stance on options to feed our pets; as responsible owners we need to educate ourselves in the varous modalities and work with our Veterinarian - either allopathic or alternative based to do what is in the best interest of the animal.

    the issue of 'raw' is not so much the issue of 'raw' but the issue of common sense handling of food products - be it to feed a dog, or ourselves. Eggs should be washed prior to cracking - as should all fresh produce - regardless if for human consumption or now. Hands, utensils and surfaces should be washed/cleaned before and after handling food.

    My choice of Homeopathic or allopathic care should be left to me. I am my animals owner, not their parent or guardian and just as if they were human children, I reserve the right to feed them or provide medical care of my choice.

  • 01/15/2013 09:48am

    Thank you for bringing up some very valid points about common sense regarding proper food handling.
    In my veterinary practice, I've never actually had an animal get sick from a digestive tract disturbance associated with bacteria raw food. I can't say the same for processed food like kibble, as I have seen this style of feeding sicken pets either on the shorter long-term basis for many years.
    Hopefully, the AVMA will ultimately let veterinarians make up their own minds about the option of using homeopathy to treat our patients.
    Dr. PM

  • AVMA working with AVH
    01/08/2013 11:34am

    Thanks so much for your column about homeopathy. The Academy of Veterinary Homeopathy (AVH) has been hard at work (along with members of the AHVMA) regarding this issue over the past few weeks.

    With all due respect, I need to correct some inaccuracies in your article. First, and foremost, the AVMA is NOT taking a stance against homeopathic veterinary therapeutics. The AVMA absolutely wants pet owners to be properly informed of *every* effective treatment. However, they are required to entertain all properly submitted resolutions. Our full report of the meting is at http://bit.ly/WoTRZ2

    The AVH has been helping educate all of our conventional colleagues including those on the AVMA Board about veterinary homeopathy. Most veterinarians are scientifically-based and therefore keep open minds. Unfortunately a few (such as those that forced this resolution upon the AVMA) do not.

    Another misunderstanding is that homeopathy has not been scientifically proven. However, many peer-reviewed basic science and clinical studies exist. A small sampling (there are thousands) of these references can be seen in the bibliography of the AVH research paper at our web site (http://www.theavh.org)

    Lastly, neither Traumeel, Zeel or Bach flower remedies are homeopathic remedies. The first two do indeed contain potentized (homeopathically prepared) components, However, they have never undergone the rigorous drug trials ("provings") which reveal their therapeutic effects and resultant symptoms. These provings then allow their homeopathic (symptom similarity="like cures like") use.

    Thanks again for providing this wonderful public venue that helps educate all pet caretakers. This resolution has provided a wonderful and heretofore unparalleled opportunity for raising both public and veterinary awareness of veterinary homeopathy.

    It is very, very, important that we therefore work with the AVMA. They are helping educate everyone about this highly effective and fundamentally scientific method of treating animals.

    Have a great day.

    Dr. Jeff

    Jeff Feinman, VMD, CVH
    Certified Veterinary Homeopath
    Chairman of the AVH Research and Education Committee
    http://www.homevet.com/about-dr-jeff

  • 01/15/2013 09:52am

    Thank you for weighing in your expert opinion and helping to clarify some of the miss information I may have inadvertently provided based on that which I have access to through various online resources on the topics.
    My reference to homeopathic products like Bach and Heel/Zeel comes from the manufacturers themselves, so learning your perspective is very helpful in the proper categorization of these options.
    Hopefully, the AVMA will allow we veterinarians to make our own choices when it comes to recommending homeopathy (or not).
    Dr. PM

  • Clarification
    01/08/2013 12:27pm

    I work for the AVMA, and I'd like to clarify a few pieces of misinformation you've received. The AVMA did not draft or propose the resolution that was considered - it was submitted by a state veterinary medical association through the proper channels. As Dr. Feinman indicated, the HOD must consider the resolutions brought forth through proper channels. The white paper that's been the subject of controversy was also submitted by that state association as a supporting document and was not generated by the AVMA. The AVMA accepted it as a supporting document, but that does not imply endorsement.
    The House of Delegates voted to refer the resolution to the AVMA Executive Board, with a recommendation to refer it to the Council on Veterinary Service for review. At this time, it is no longer a resolution, nor is it a proposed policy. It is an item for consideration and will be given no more or less consideration than other items for consideration at the meeting. For more information: http://atwork.avma.org/2013/01/05/proposed-resolution-3-homeopathy-update/

  • 01/15/2013 09:55am

    Thank you for clarifying any potential this information I may have provided based on data which I have access to online.
    I did mention that this was an item of discussion brought up the the Connecticut VMA and not yet "law".
    I look forward to hearing more about where this topic goes in the coming months.
    Thank you for your input.
    Dr. PM

  • Homeopathy & Kidney Fail
    01/08/2013 07:58pm

    Due to the fact that I learned yesterday that my Siberian Husky is now in terminal kidney failure. I'd be very interested in learning where I can turn to in hope of prolonging w/o undue suffering in regards to homeopathy.

  • 01/15/2013 09:57am

    I am sorry to hear about your pets recent diagnosis.
    Here is a reference to help you find a homeopathic vet in your area:
    http://www.theavh.org/referral/index.php

    Thank you for your comments,
    Dr. PM

  • 01/09/2013 02:55am

    Coming from a country where everything used to be censored, including what people were allowed to believe or to think, I really feel strongly about freedom of choice.

    I think that evidence is sometimes tricky thing.

    But in any case, I believe that everybody should be free to choose any type of treatment they desire for themselves or their dog, whether their choice may or may not be erroneous. I believe it's one of the basic human rights.

  • Homeopathy
    01/11/2013 02:15pm

    Science is not everything. When you see the results on hundreds, thousands of patients, human or other animals (don't forget humans are animals too), you can judge on the efficacy of the treatments.
    Bach Flower remedies are not homeopathy. Homeopathic remeries are substanses diluted tens, hundreds, and even more time (potency). The efficacy of those remedies come from the energy of the substance transmitted to the water. Classical homeopathy usually will work with one remedy at a time. Homotoxicology is derived from homeopathy, using mixture of low to middle potencies. Traumeel and Zeel are homotox remedies. You can read more on Heel's internet site.
    And don't forget neither that conventional medicine is never 100%.

  • 01/15/2013 09:59am

    Thank you for sharing your perspective.
    It is interesting to hear you and Dr. Jeff Feinman for that Bach and Heel/Traumeel are not homeopathic products.
    In researching the article, I was using information provided by the companys' websites and other marketing literature (as I mentioned that I am not formally trained in homeopathy).
    I appreciate you taking the time to read my article and hope to see you back again on my Daily Vet page.
    Dr. PM

  • 01/15/2013 11:05am

    I do not say that Traumeel and Zeel are not homeopathy, but not classical homeopathy.Homotox is a form of homeopathy. Easier to work with, as they are complexes, and not only one remedy, so you need much more knowledge about the remedies to get the one that will work in classical homeopathy.

  • The Evidence
    01/11/2013 05:51pm

    I've been watching this development from Ireland and wondering why nobody is actually discussing the evidence available of Homeopathy's effectiveness in treating animals?

    Here:
    http://www.homeopathy-soh.org/research/evidence-base-for-homeopathy-2/animal-studies/

    and here:
    http://www.homeopathy4health.ie/2testimonials&researchlevel2veterinaryresearch.htm

    And the perspective of this experienced Dairy Farmer is worth considering:
    http://www.homeopathy4health.ie/2testimonials&researchlevel2veterinaryresearch.htm

    the evidence is there and should enter the discussion, since it's being claimed that there is none. That's demonstrably untrue.

    M

  • 01/15/2013 10:02am

    Thank you for sharing the links to these references.
    I look forward to reading more about the studies, etc.
    I hope to see you back again on my Daily Vet page in the future.
    Thank you for your comments,
    Dr. PM

  • Homeopathy works
    01/22/2013 10:30pm

    After being trained in the use of homeopathic remedies for acute situations with rehabilitation animals, my colleagues and I have very good success treating some conditions that simply did not respond to conventional pharmaceuticals. To have a professional organization come out against a practice that does no harm...and more often than not does good is distressing to me.
    To be honest, it smacks of the greasy palms between the association and the pharma companies.
    Too bad vet med has to go the way of human med...dollars before care.

  • 01/28/2013 05:46pm

    My view seems to differ from most of the comments. Granted there is both positive and negative evidence for homeopathy that's the nature of any potential drug or treatment. If only positive evidence was used to market drugs, the true effectiveness of a drug would be unknown. Systematic reviews are used to sort these things out. Studies can be graded and ordered. That's why when you look at the body of evidence it fairly certain that homeopathic remedies are placebo.

    I was surprised at your comment "A placebo effect wouldn’t be seen in a pet". The placebo effect is a problem that has to be accounted for when dealing with both animals and babies in drug trials. Confirmational bias and their reaction to your reactions cloud the picture very easily.

    Is it ethical to give placebos or placebo treatments? I think it is not. When the best evidence for something is this clear, the reccommendation should be not to use. This should be the stance no matter how popular the treatment is.

  • Blinding/placebo
    07/28/2014 05:44am

    I find it a common thread in those performing studies in and commenting on homeopathic treatments do not place any importance in blinding and placebo effects.

    Because animals cannot directly communicate, reported effects of placebo can be even more powerful than with people. The blinding of the experimenter and the clinician in vitally important. This means that the owner does not know what treatment the pet is receiving, and the researchers who evaluate the animal or interview the owner do not know what treatment the pet has received.

    An example study is "A double-blind placebo-controlled study into the efficacy of a homeopathic remedy for fear of firework noises in the dog" doi:10.1016/j.tvjl.2007.04.007

    Note that both the control (placebo) and homeopathic treatment group showed significant improvement in their dog's responses. However, there was no significant difference between the two groups. I hope this helps people know what to look for when doing research on their own.

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