Veterinary homeopathy under fire

RE: Veterinary homeopathy under fire

Arlo Guthrie — Wed, 09 Dec 2015 19:30:37 GMT

Hi again Jan,

I must correct your analysis of what I wrote about scientific understanding.

You say that I'm putting forward the argument that homeopathy cannot work because we don't understand it.

That's not what I said! What I said was that it is unlikely to work because it would mean rewriting everything we DO understand about physics and chemistry.

In other words, a more accurate way to paraphrase what I said would be: Homeopathy cannot work because we DO understand it!

As to your other references:

Kleijnen - outdated by newer trials, and actually concluded that poor trial quality trials and publication bias meant no conclusions could be drawn.

LInde 1999 - This study simply concludes that the better quality the trial, the less positively homeopathy is show to perform.

Cucherat - Apparently, methodological flaws. Did not conclude in favour of homeopathy. On the contrary, concluded that the better quality trials included in the analysis were more likely to be negative.

RE: Veterinary homeopathy under fire

Niall Taylor — Wed, 09 Dec 2015 18:47:53 GMT

"Here are the promised references"

These are some of the top favourites of homeopaths which they use to try and convince people homeopathy works.

They have been thoroughly critiqued over the years and found wanting. Whatever they show the certainly do not in any way prove (or even suggest) that homeopathy is anything other than placebo.

Jan - do you mind if I ask if you have read them yourself? If so, what did you think of them as examples of scientific research?

Niall

RE: Veterinary homeopathy under fire

Arlo Guthrie — Wed, 09 Dec 2015 18:13:41 GMT

Jan, I'll come back to the others later, but Linde 1997 was re-analysed no less than 6 times after publication, not least by Linde himself, and on each occasion produced a negative result. So we can strike that one off the list very quickly!

RE: Veterinary homeopathy under fire

Jan van Dijk — Wed, 09 Dec 2015 18:05:25 GMT

PS: Arlo, you write that any credible evidence in favour of homeopathy would mean turning the world upside down and rewriting most of what the human race has come to understand about physics and chemistry. I think I can classify myself as a 'scientist' and, to me, the more I read or try to investigate, the more I realise how very little we know and the more humbled I feel. Therefore I do not understand the 'it can't be true because we don't understand it' logic. Well I do understand it perhaps - it very much appeals to our collective human arrogance - but I don't think it is very helpful. If homeopathy cannot be shown to do any good, that's another matter; but "it CANNOT work because I cannot understand it" seems silly to me. Human beings have been wrong so many times, and current 'science' can only give us today's snapshot; surely, already our children's children will laugh themselves silly when they analyse our accepted beliefs and 'science'? I hope so, because otherwise there would be no progression...

RE: Veterinary homeopathy under fire

Jan van Dijk — Wed, 09 Dec 2015 17:47:44 GMT

Hi Arlo, sorry - I got sidetracked. Here are the promised references. Yep, they all deal with human homeopathy - but that may just be because veterinary studies are unlikely to attract significant funding (as there is little money to be made in vet homeopathy, practiced by very few). It appears to me that homeopathy may work but that you have to choose your cases wisely.

Kleijnen J, Knipschild P, ter Riet G. Clinical trials of homeopathy. Br Med J 1991; 302: 316–23.

Linde K, Clausius N, Ramirez G, et al. Are the clinical effects of homoeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet 1997; 350: 834–43.

Linde K, Scholz M, Ramirez G, et al. Impact of study quality on outcome in placebo controlled trials of homeopathy. J Clin Epidemiol 1999; 52: 631–6.

Cucherat M, Haugh MC, Gooch M, Boissel JP. Evidence of clinical efficacy of homeopathy – A meta-analysis of clinical trials. Eur J Clin Pharmacol 2000; 56: 27–33.

RE: Veterinary homeopathy under fire

Niall Taylor — Wed, 02 Dec 2015 18:39:16 GMT

Oops, sorry, I've posted the same link twice! Martin's second critique is here - http://tinyurl.com/j5r2re7

RE: Veterinary homeopathy under fire

Niall Taylor — Wed, 02 Dec 2015 18:36:42 GMT

Many people who are sceptical about veterinary homeopathy have studied a lot of the papers put forward as evidence by homeopaths in great detail and they present consistently as being of poor quality or even, in some cases as not even saying what the homeopaths claim they say. Martin Whitehead has reviewed a couple of the more significant papers here [http://tinyurl.com/jm8w7zr] and here [http://tinyurl.com/jm8w7zr]. I have also spent some time looking at the long lists produced by some of the homeopathic groups out there. You can read the critiques here [www.rationalvetmed.org/the%20best%20they%20can%20do.html], and there are more papers also considered here [www.rationalvetmed.org/academic%20papers.html]. Jan, I would greatly appreciate your comment on the information given in the links but I don't think it's fair to criticise those who have found homeopathy wanting by claiming they haven't looked at the evidence - we have!

Of course, for every one paper that is painstakingly analysed and critiqued, it's easy for a homeopath just to throw in another ten claiming that they too, offer proof. It's a never ending task so long as homeopaths are prepared to accept poor quality research and claim it supports their position.

The BAHVS have produced a list of 800 papers which they claim support the idea that homeopathy works. I'm no more hopeful they will prove to be any more convincing than the ones dealy with above, but if you'd like to critique them I'd be genuinely interested in your opinion of them.

Niall

RE: Veterinary homeopathy under fire

Arlo Guthrie — Wed, 02 Dec 2015 15:01:26 GMT

Jan, I'm not sure I would agree that "homeopathy is bad for animal welfare when a sick animal is prescribed water as a medicine instead of a proven treatment that would have relieved symptoms or offered a cure" is a belief-based statement. It's a self-evident fact, surely?

Perhaps the more pertinent question - you're right - is what scale it occurs on, for which I have no evidence beyond cases reported here, and the existence of homeopathic practitioners both within and outside the veterinary profession (not all of whom prescribe homeopathic to the exclusion of conventional treatment, of course).

Anyway, I'll look forward to the references. I'm going to be surprised if you're able to present good quality studies / analyses that haven't already been discredited, not least because it will mean turning the world upside down and rewriting most of what the human race has come to understand about physics and chemistry. Not impossible, of course, but unlikely.

RE: Veterinary homeopathy under fire

Jan van Dijk — Wed, 02 Dec 2015 14:30:39 GMT

That's not evidence, that is belief - exactly what you accuse the homeopathists of. 'Common sense' is not evidence.

Will post the references later.

RE: Veterinary homeopathy under fire

Arlo Guthrie — Wed, 02 Dec 2015 14:07:05 GMT

Hi again, Jan,

I am GENUINELY not trying to ridicule anyone. I presume you are referring to the paragraph in which I say that "homeopaths ask us to believe that condoms, placenta (Welsh), light from the planet Venus are indicated for the treatment of disease."

Whilst I am not trying to ridicule anyone, I do agree that these things sound ridiculous. But they are documented homeopathic remedies. I'm just stating facts.

Could you give me a reference for the 4 or 5 large meta analyses that have shown results in favour of homeopathy?

You say that narrowing the spectrum of treatments available is not going to serve animals. I would argue that on the contrary, focusing on those that are effective will serve animals. Significantly.

You ask for evidence that homeopathy is bad for animal welfare. I would have thought that self-evident: when a sick animal is prescribed water as a medicine instead of a proven treatment would have relieved symptoms or offered a cure.

RE: Veterinary homeopathy under fire

Jan van Dijk — Wed, 02 Dec 2015 13:46:32 GMT

The belief system, 'conformation bias', works two ways Arlo, with the majority of vets being just as fanatical in their beliefs that it doesn't work (without ever reading any papers about it, being present in a homeopathic consult or anything) as homeopathists are in the belief that it does work. Four out of five large meta-analyses, presenting, for example, the overall odds ratio of homeopathy having a positive effect, drawing from very many studies analysed after setting strict inclusion criteria, actually present conclusions in favour of homeopathy. You can say you don't belief it but don't say the work doesn't exist.

People who don't belief in it will never take any existing evidence on board. That is the way the world works... creating simple black and white messages, ridiculising what other people do and especially a degree of hysteria, invariably goes down well - it seems to appeal to us all, especially if we present it as if we have 'ecvidence based medicine' on our side. Your reply just repeats the phrases we have been presented with and adds a few things to unjustifyably make homeopathy look ridiculous. This works fantastically well in terms of point scoring. But whether all of this actually does any animals or vets a service remains to be seen. I would rather see that both 'parties' actually try to learn from each other. 'Alternative therapies' tend to have been around for very much longer than the therapies we prescribe. Narowing the spectre of treatments available - ridding ourselves of knowledge on alternatives - is not going to serve animals.

Can you please show me the evidence that homeopathy, as claimed, is BAD for animal welfare?

RE: Veterinary homeopathy under fire

Arlo Guthrie — Wed, 02 Dec 2015 12:58:31 GMT

Hi Jan,

You ask how many people who signed the petition actually know what homeopathy really is.

I suspect, like you, not many really understand how implausible it really is.

Homeopathy asks us to believe that a very large variety of substances, including condoms, placenta (welsh), light from the planet Venus and Hadrian's Wall has been proven to cause certain symptoms, and by extension is indicated for the treatment of disease. It further demands that we believe that if you dilute these substances till not one single molecule remains, the remedy is made more effective.

In addition, it asks that we ignore the vast body of scientific evidence which has proven homeopathy ineffective.

There is no 'good evidence' that homeopathy is an effective treatment for anything. There is good evidence that the human mind is hugely fallible, and when evaluating the efficacy of treatment, we seek to affirm our own beliefs (confirmation bias) and often ignore other factors like regression to the mean.

And that, actually, answers your question about 'why homeopathy'. What better example to demonstrate the fallibility of the human mind than with a treatment which so many people believe in despite the vast weight of evidence to the contrary.

As to whether there are more important issues to campaign about. Sure. Antibiotics? Definitely. Wholeheartedly agree with you. That doesn't make this unimportant. On the contrary, I personally believe that the campaign could have a profoundly beneficial effect outside the veterinary profession, and into the field of human healthcare.

Our campaign is not about bashing anyone. It's not personal. It's about critical analysis. Homeopathy should not be above that.

RE: Veterinary homeopathy under fire

Jan van Dijk — Wed, 02 Dec 2015 12:31:05 GMT

I work at a university and I am not a homeopathist, in fact I have never prescribed a homeopathic product in my life. I cannot help but feel annoyed by the typical short-sighted 'jump on the bandwagon' nature of this campaign, actively run within our profession.

Can I just ask how many of the people who signed the petitions actually know what homeopathy really is...? I would not be surprised if quite a few think that it means something like 'plant medicine'. 'Homeopathy' actually takes the time to analyse the ailments, and their associations, of an animal in great detail and then tries to kick-start the animal's own defense system into dealing with the disease. Why is this deemed so bad...? We all have a lot to learn from the homeopathists. What is it that us 'conventional' vets have to offer instead? Apart from surgery we perform and the vaccines we administer (with vet homeopathists offer the same services of course) we almost entirely focus on medication suppressing SYMPTOMS - pain killers, steroids, antibiotics, you name it... We throw this at animals all day, during our 10-minute consults. Is this really something to be so desperately proud of, the desirable alternative to a homeopathist taking the time to really look at the animal in a holistic manner?

Sure, there are many questions surrounding homeopathy in terms of how it could possibly work - and no one claims to know the answer exactly. But does that mean that it therefore can't work? Can I just ask how many of the people who have signed the petitions have actually bothered to read any of the "non-existent evidence" for homeopathy? If they did, they would find meta-analyses presented in journals like the Lancet, providing the evidence for a measurable positive effect of homeopathy. Of course it doesn't work for all indications - and neither does conventional medicine of course - but there is good evidence to show that homeopathy works well for allergies and respiratory disease in particular. Advanced cancer is unlikely to be on the list of diseases that respond well to homeopathy - but I cannot imagine that vet homeopathists claim that is does. "Homeopathy does not work" is a broad, unhelpful, statement equally silly as, say, "Corticosteroids do work" - well that would depend on your definition of 'work', the cases you use it for, and the aims and objectives of the 'treatment'. Sure, there will be papers that show that homeopathy has a significant positive effect on certain diseases and other papers coming to other conclusions. But that is exactly the same for conventional medicine. If, say, I examine the evidence for positive effects of worming adult cows on their milk production then some papers find a positive effect whereas others don't. This is a problem relating to what we call 'confounders' and not something related to homeopathy.

What I fail to understand is why Guthrie et al choose to target homeopathists....? Do veterinary homeopathists really pose a significant threat to animal welfare? Can I ask those behind the campaigns to supply us with the EVIDENCE that homeopathy is bad for animal welfare? Are homeopathists significantly more likely to withhold pain relief when animals are suffering? Should we not be presented with that sort of evidence before we decide to back attempts to put pressure on the RCVS. Please make the effort to try to convince us with evidence instead of simply appealing to the sceptical FEELINGS of the masses.

And why do we not see similar campaigns trying to tackle the real issues threatening animal and human welfare? A far more significant, measurable, threat to animal welfare is the very random prescription of antibiotics in a 'it won't hurt and it may help' sort of way. Or the continuous supply of antibiotics to animals kept so close together that only antibiotics can save them from a certain infectious-disease-related death. The 'conventional medicine' we all appear to be so fond and proud of is creating massive problems. Why do I never hear any vets talk about this? How many vets do you think would sign a petition to stop the random, non-evidence-backed use of antibiotics in veterinary practice?

Let's try to learn from homeopathists instead of subscribing to the random bashing of their practices.

RE: Veterinary homeopathy under fire

Arlo Guthrie — Wed, 25 Nov 2015 21:13:18 GMT

I'm here Ray.

I don't personally subscribe to the conspiracy theory that big pharma has anything to do with the decision made by a university to stop training in homeopathy. A more plausible explanation is that they have been unable to find any evidence of efficacy beyond placebo in humans.

And I'm afraid that sales figures are not evidence of efficacy either.

RE: Veterinary homeopathy under fire

Ray Thomas — Wed, 25 Nov 2015 20:56:04 GMT

Lets get real here, Boehringer Ingelheim and Bayer are very serious Pharma companies in Germany.

YET! in Germany every Apotik has one WALL of homeopathic medicines that have been around for over 200 years.

Homeopathic medicine works....... why would it be in every German Pharmacy?

20 yrs ago in the USA you could graduate with a diploma in homeopathic medicine,

Since Big Pharma took over, there are no more universities that offer studies in homeopathic medicine.

I have produced,Homeopathic products for IA use, for IM use and even as TQ's,

Of course i cannot make any medicinal claim because you have to give up Euro 1 million and 5 years to bring a product to market.

The Campaign for Rational Veterinary Medicine has been set up by a group of practitioners including the BSAVA Past President, Mike Jessop, Alex Gough, Martin Whitehead, Niall Taylor, Phil Hyde, Martin Atkinson and Brennen McKenzie, supported by VetSurgeon.org Editor, Arlo Guthrie. It also has the support of the noted author, academic and erstwhile dog owner, Professor Edzard Ernst.

Actually, i have no idea what the above statement means, I do know Arlo Guthrie, so best i ask his advise?

I will put up my homeopathic Arnica product for IA use against Triamcinolone.

we sell 12,000 doses a year with no advertising.