Forum rules

RE: Forum rules

Niall Taylor — Fri, 18 May 2018 16:23:38 GMT

[quote user="Iain Richards"]To responds to Richard's challenge - give me some proper, scientifically based, logic on how homeopathy acupuncture et al work and I might be more understanding[/quote]

It's this that is key for me. We are being asked to accept the validity of homeopathy on the basis of evidence which would rightly be rejected out of hand if it were applied to a new pharmaceutical.

Homeopathic evidence consists entirely of inadequate studies (see all the papers listed here for example) and anecdotes about unexpected improvements when we all know we see so called 'miracle recoveries' every day of the week - unexplained, unexpected sure, but nothing to do with homeopathy.

In the light of this it's no wonder people get frustrated and start to voice that frustration but to be fair, what's sauce for the goose is sauce for the gander. There has been intemperate language used on both sides of the divide. As well as the legal threats and so on from homeopaths which Phil Hyde and others mentioned in a previous thread, I have, along with others, been referred to as a "funt" by a particularly unpleasant homeopath during one debate - well, really!

What can I say? It is a deeply felt subject and some of the debating styles are "robust" on both sides. We need to rise above that and address the issues, irrespective of any percieved slight. As Iain says, give us some proper, consistent evidence and we will all shut up and trot off to the next BAHVS workshop. This isn't conspiracy, it's not some strange ideological objection to homeopathy, no currently conventional vet would suffer financially if homeopathy was found to work, no one is "in the pay of big pharma". It's just about evidence and trust, nothing more. And for me it certainly isn't personal.

Niall

[Edit - added the 'big pharma bit]

RE: Forum rules

Iain Richards — Fri, 18 May 2018 13:02:07 GMT

Interesting comments Martin - not least regarding the pre-patent impact of some helminths. Cat tapeworm? - does it do any harm? Most tapeworms have no mouth, just absorbing nutrients from the lumen, so their pathogenic impact is minimal . The intermediate stages are more of a problem, and then we are back to the zoonotic aspect of Echinococcus and the meat condemnation of Taenia species.
To go back to the original post, if you rely on testing, you have to thoroughly understand the limitations of that test, be it FEC or titres.
To responds to Richard's challenge - give me some proper, scientifically based, logic on how homeopathy acupuncture et al work and I might be more understanding. An example - for many years I gave vivitonin and press to dogs with GVS. As I've learnt that they all got better anyway, I've stopped falsely attributing a recovery to the treatment. It was a challenge to do it, but I did - as I think most of us now have.

RE: Forum rules

Martin Atkinson — Fri, 18 May 2018 09:26:53 GMT

[quote user="Alistair Graham-Evans"]I have often considered the blanket approach of routine worming of adult dogs but I guess we need to consider the zoonotic and epidemiological significance of Toxocara, hookworm and Echinococcus. Also, here in tropical Queensland we have Dirofilaria as a constant threat ( we are seeing about 2 cases a month at present despite the availability of numerous worming products which are alas not always used under veterinary supervision )[/quote]The overall reaction to this is that most of the products we use are multi-purpose. If we're using Advocate or Stronghold etc as routine flea treatment then it also treats them for toxacara so there is no need to treat that separately. If a cat is hunting then it will inevitably be at risk of tapeworm so I will advise treating for that every 3 months. Dogs tend not to eat wildlife quite so much so are less at risk of tapeworm so I don't routinely worm them separately. There may be an argument to treat fleas alone and not use a multi-purpose product but most standalone flea products are ineffective.

The zoonotic potential of toxacara cannot be underestimated - if we are treating dogs solely on the basis of worm counts what potential is there for zoonotic spread unless you test very frequently? Given the potential harm of visceral larval migrans in children how can you balance the possible unnecessary routine worming of dogs, which will cause no harm, against that?

[quote user="Alistair Graham-Evans"]Angiostrongylus has emerged as a problem in the UK. Prevention is probably better than cure with many of these parasites![/quote]

Angiostrongylus is common in the UK especially in Southern England where I practice, and every case I've seen has been life threatening. Are you going do a McMaster test on every dog to see if there are larvae before deciding to treat by which time it may well be too late anyway? No, so prophylaxis is important.

RE: Forum rules

Alistair Graham-Evans — Fri, 18 May 2018 08:39:29 GMT

[quote user="Richard Allport"]I am not going to get into discussions about all this because views are entrenched and I am not going to waste my time[/quote]

With respect it seems a little futile publishing a post on a discussion forum if you are not prepared to discuss it.

My thoughts on homeopathy mirror those of Arlo.

I have often considered the blanket approach of routine worming of adult dogs but I guess we need to consider the zoonotic and epidemiological significance of Toxocara, hookworm and Echinococcus. Also, here in tropical Queensland we have Dirofilaria as a constant threat ( we are seeing about 2 cases a month at present despite the availability of numerous worming products which are alas not always used under veterinary supervision ) and apparently Angiostrongylus has emerged as a problem in the UK. Prevention is probably better than cure with many of these parasites!

We follow WSAVA guidelines for vaccinations but I would be pleased to see a separation of Parvo antigen from the Distemper and Hepatitis components as the latter are probably unnecessary in adults.

RE: Forum rules

Clive Ansell — Fri, 18 May 2018 07:28:26 GMT

[quote user="Jill Butterworth"]Just to continue the balanced debate, you understand, the subject doesn't truly needle me. [/quote]

Me neither, but there are those who get a little prickly about it (Allegedly).

RE: Forum rules

Niall Taylor — Fri, 18 May 2018 07:14:51 GMT

[quote user="Jill Butterworth"]Just to continue the balanced debate, you understand, the subject doesn't truly needle me.[/quote]

Alright, we get the point

Niall

RE: Forum rules

Jill Butterworth — Thu, 17 May 2018 22:18:00 GMT

[quote user="Bob Russell"]Is acupuncture scientifically validated?[/quote]

Maybe...rather than a resounding yes.

The BMJ group took over publication of 'Acupuncture in Medicine' in 2009 and seem to publish scholarly articles and research, including meta-analysis, from a quick read, the conclusions are not all negative.

Just to continue the balanced debate, you understand, the subject doesn't truly needle me.

RE: Forum rules

Michael Woodhouse — Thu, 17 May 2018 20:12:43 GMT

[quote user="Bob Russell"]Is acupuncture scientifically validated?[/quote]

No better than a placebo for back pain:

http://www.iflscience.com/health-and-medicine/exercise-better-acupuncture-treat-lower-back-pain/

No better than a placebo for improving IVF success:

https://www.independent.co.uk/news/health/acupuncture-ivf-placebo-sham-treatment-birth-rate-clinical-trial-a8352711.html

Interesting look at the evidence:

https://sciencebasedmedicine.org/acupuncture-doesnt-work/

RE: Forum rules

Anthony Todd — Thu, 17 May 2018 17:36:22 GMT

[quote user="Martin Atkinson"]Someone may wish to correct me but as far as I was aware Zoetis' Versican is still the only current vaccine that uses a CPV2b strain even though this has long been the field strain many years after this research. Now we're seeing CPV2c strain where does that leave us?[/quote]

As I understand it the manufacturers of any vaccine could produce "evidence" of titre response to any antigen [of theirs] and claim, therefore protection, [with fingers crossed] that, because risk is usually low and, anyway, one failure in Xt000000 is not evidence, that their "vaccine" is fine!

Still waiting for any evidence that boosting, even daily, is harmful......

RE: Forum rules

Martin Atkinson — Thu, 17 May 2018 17:14:43 GMT

[quote user="Anthony Todd"]

[quote user="Clive Ansell"]

How useful are titre tests?

Is there any evidence that vaccination as per data sheet is harmful?

[/quote]

We went through all this when the parvo epidemic was in full swing.

Not only was there significant variation in titres between labs, but I don't think anyone ever showed that significant titres prevented infection if there was field challenge [titre was against vaccine antigen not field antigen...]

Is there any evidence that repeated vaccination actually is harmful, considering that every time we breath or swallow or blink, we are in contact, daily, with many antigens?

Considering that, by now, vaccine viruses may be far removed, immunologically, from field virus it seems to me that repeated vaccination with as many different vaccine viruses as you can find is probably a good thing in case of a field challenge.

[/quote]As I understand: the issue was that the first CPV1 vaccines were modified FPV vaccines and offered little protection as the virus evolved to CPV2. The second generation of vaccines developed from the CPV2 strains were largely tested by HI method which could give erroneously high levels of confidence that they were cross protected against CPV2b strain whereas if tested by Nt antibody method some were shown not to be protective against CPV2b which was then the field virus (Pratelli et al 2006). As far as I'm aware few vaccine trials involved infecting dogs with field virus so they were not being challenged. This with a drop off in overall vaccination may have led to the increase in CPV infection in the dog population we have observed.

Someone may wish to correct me but as far as I was aware Zoetis' Versican is still the only current vaccine that uses a CPV2b strain even though this has long been the field strain many years after this research. Now we're seeing CPV2c strain where does that leave us?

I can see how this would lead to a lack of confidence in vaccine companies, even blood testing rather than routine boosters if using HI method may not be reliable and a nosode may have been just as effective in some cases.

RE: Forum rules

Clive Ansell — Thu, 17 May 2018 16:52:22 GMT

[quote user="Mark Hedberg"]because in the 18th century, conventional doctors used bleeding, firing, mercury, arsenic, and didn't wash hands before surgery.[/quote]

You don't need to go that far back in time. I have seen bleeding (to inject in to a stifle joint), firing (Horse tendons), not washing hands (very well) and homeopathy being used in the 21st century! and

RE: Forum rules

Mark Hedberg — Thu, 17 May 2018 16:49:12 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Mark Hedberg"]Context, as always, is key.[/quote]

Mercury was very effective as a treatment for syphilis, and there certainly wasn't any other treatment.

I'd rather take the mercury than have my nose rot away and die of GPI.

[/quote]

Really? I had no idea! I knew they used it all the time in the Aubrey-Maturin novels, but always thought it was just one of those things they used because they had no idea what fixed things!

Fascinating!

RE: Forum rules

Evelyn Barbour-Hill — Thu, 17 May 2018 15:41:35 GMT

[quote user="Mark Hedberg"]Context, as always, is key.[/quote]

Mercury was very effective as a treatment for syphilis, and there certainly wasn't any other treatment.

I'd rather take the mercury than have my nose rot away and die of GPI.

RE: Forum rules

Mark Hedberg — Thu, 17 May 2018 14:41:53 GMT

I've heard it said that in the 18th century, homeopathy outperformed conventional medicine. Which I can believe, because in the 18th century, conventional doctors used bleeding, firing, mercury, arsenic, and didn't wash hands before surgery. You could be forgiven for taking your chances with rest and water! (in fact you'd probably get me at the front of the queue!)

Context, as always, is key.

RE: Forum rules

Bob Russell — Thu, 17 May 2018 13:32:26 GMT

Is acupuncture scientifically validated? I am not against its use (and have been treated with it by our Chinese Doctor up the road) but can it be said that it really is proven by proper trials?

Herbal remedies may be valid but how many are properly tested for efficacy?

Acupuncture may work, mechanism of action is not beyond belief. Herbal remedies may work but many are poorly tested or not at all.

Homoeopathy is beyond scientific or logical understanding. Quackery mixed in with a bit of things that might work.

There! No personal comments, nothing nasty or aggressive and no naming of individuals. Not that difficult is it?

RE: Forum rules

Jill Butterworth — Thu, 17 May 2018 12:38:12 GMT

There is scientific logic to checking titres and worm counts so as to only give drugs if they are needed. That implicitly acknowledges that Nosodes etc are not viable replacements.

Acupuncture is well researched and proven to help some things not others.

Herbal medicines contain pharmacologically active ingredients and have been used for centuries. There is never likely to be significant research unless a marketable product can be made, so I'm still listening.

Which leaves homeopathic remedies, dreamt up by Samuel Hahnemann in the 18th century, when scientific experiments weren't as rigorous and he came to erroneous conclusions. I can forgive his errors, in the light of available science at the time, but not in the 21st century. Presumably Richard, you do not deep down, really believe it, because you aren't doing all those tests in order to administer a nosode...you are using an actual, useful, tested vaccine.

So in conclusion, I can agree with some of how you work, when using scientific principles. For the other part, the solution for me, in response to the fact that people clearly want alternative medicine for their pets, would be to do constant clinical audits to ensure satisfactory and humane outcomes. This isn't a replacement for a drug trial, obviously.

Richard has bravely showed us how he practices, and allowed us to comment on the good, bad and inconsistent parts. We cannot assume that all homeopathic practitioners are the same. We would be likely to find flaws in the way many individual conventional vets apply medicines, as EVBM is not yet widely accepted as a concept, i.e. we tend to do what we think works, despite evidence to the contrary.

RE: Forum rules

Anthony Todd — Thu, 17 May 2018 12:16:31 GMT

[quote user="Clive Ansell"]

How useful are titre tests?

Is there any evidence that vaccination as per data sheet is harmful?

[/quote]

We went through all this when the parvo epidemic was in full swing.

Is there any evidence that repeated vaccination actually is harmful, considering that every time we breath or swallow or blink, we are in contact, daily, with many antigens?

RE: Forum rules

Phil Hyde — Thu, 17 May 2018 11:54:43 GMT

[quote user="Richard Allport"]

Having been on the receiving end of posts in the past which have been abusive and hateful

[/quote]Ah, this refers back to a recent post that I made requesting such details. Could you give me some idea of the abusive and hateful posts that you have received?

RE: Forum rules

Clive Ansell — Thu, 17 May 2018 11:11:08 GMT

[quote user="Richard Allport"] I treat patients with homoeopathic and herbal medicines and acupuncture.[/quote]

Fair enough. I am keeping an open mind on the subject and await with bated breath the published peer reviewed evidence that it works, and is not as some might say, bunkum.

[quote user="Richard Allport"] I advocate vaccination but not regular boosters without first titre testing.[/quote]

Why?

How useful are titre tests?

Is there any evidence that vaccination as per data sheet is harmful?

[quote user="Richard Allport"]I advise regular faecal worm egg counts rather than routine worming treatment.[/quote]

I find myself agreeing with this, and think it would be good medical practice. I think anti parasitic drugs are vastly over used, just as antibiotics were/are. I still don't understand why a strictly indoor cat needs monthly advocate and/or Milbmax.

An RVN I occasionally work with did her training in Florida, US. She was telling it was standard practice there (in conventional practice) to do worm egg counts and only treat if needed.

RE: Forum rules

Edward Jones — Thu, 17 May 2018 11:06:56 GMT

My views are certainly not entrenched. I'm very willing and open to have my views changed 180°, all it takes is good quality evidence. I have never come across a homeopath who is open to changing their own views, however.

RE: Forum rules

Martin Atkinson — Thu, 17 May 2018 09:17:07 GMT

[quote user="Richard Allport"]I am not going to get into discussions about all this because views are entrenched.... [/quote]I tried to resist a post that is clearly meant to play Devil's Advocate if not openly Trolling and Arlo has answered more rationally that I normally would. But suggesting those of us who dismiss most of the alternative views you propagate are entrenched is pots and kettles, glass houses and stones, red rags and bulls if you for one nano-second are suggesting your views and those of other evangelical alternative medicine advocates are not entrenched.

As you have said you're not entering into discussions, why make inflammatory posts?

RE: Forum rules

Arlo Guthrie — Thu, 17 May 2018 08:20:26 GMT

Hey ho, here we go. Morning campers.

[quote user="Richard Allport"]

Just received a vetsurgeon.org e mail which states:

Forum etiquette rules now rigidly enforced. Good manners no longer optional.

Apparently posts must not be abusive, hateful or defamatory.

Having been on the receiving end of posts in the past which have been abusive and hateful (you know who you are Mr Mills) I'd like to test this 'rigid enforcement' out. I treat patients with homoeopathic and herbal medicines and acupuncture. I advocate raw feeding for most patients. I advocate vaccination but not regular boosters without first titre testing. I advise regular faecal worm egg counts rather than routine worming treatment.

I am not going to get into discussions about all this because views are entrenched and I am not going to waste my time - I'm too busy helping numerous patients failed by 'conventional' medicine. But I will be interested to see if the rules really are rigidly enforced.

Sent with hope but not expectation.

Richard[/quote]

Richard Allport - Hi Richard. I think it is fair to say that when debating a scientific subject, the line is drawn between being personal and impersonal. In other words, it is absolutely OK to criticise an idea, but to denigrate the person for having it in an online forum of their peers is not on.

Where we get a bit unstuck is when it comes to more controversial subjects, like homeopathy. Here I think critics of homeopathy sometimes stray over the line and allow their criticism to sound or be more personal than it should. Equally, I think homeopaths often claim reasonable criticism of the subject as a personal attack (and then use the 'bullied' argument to shut down further debate).

I guess what I am saying is that, yes, Richard, the rules are being enforced. Taking homeopathy as an example, that means being able to say that the good quality trials have been able to show nothing more than placebo or statistical anomaly, and that there is an increasing body of evidence showing the more plausible explanation to be the errors in human thinking which make us think a treatment (alternative or conventional) is working, when it isn't.

I'd go further and say it is OK to say that homeopathy is daft. The idea that you can dilute weedkiller, Berlin wall, condom, or anything else for that matter, to the point where there is no weedkiller, Berlin wall or condom left, and then expect it to have an effect on the body, is, in my opinion bonkers. Totally bonkers.

Have I just strayed over the line by calling an idea which is obviously personal to you 'totally bonkers'? I'd argue not. I wish you no ill, Richard. I certainly don't hate or want to abuse you! But what I DO think is that scientific or medical ideas need to be open to challenge, even to the point of ridicule.

I think when it comes to ridiculing ideas, there is a greater responsibility for posters to state, as I just have, that they mean nothing personal (and not just assume the reader knows that).

RE: Forum rules

Evelyn Barbour-Hill — Thu, 17 May 2018 01:45:54 GMT

Hmm.

New rules of etiquette breached as effectively as the Mohne and Eder dams, already.

It didn't take long, did it.

RE: Forum rules

Gillian Mostyn — Thu, 17 May 2018 00:13:04 GMT

[quote user="Richard Allport"]I am not going to get into discussions about all this because views are entrenched and I am not going to waste my time - I'm too busy helping numerous patients failed by 'conventional' medicine. [/quote]

Oh good, because most of us vets are too busy helping the many thousands of patients helped by 'conventional' medicine.

p.s. I find that the best way to avoid getting burned is not to throw the match into the petrol in the first place.

RE: Forum rules

Liz Barton — Wed, 16 May 2018 23:06:30 GMT

[quote user="Richard Allport"]Apparently posts must not be abusive, hateful or defamatory.[/quote]

One could extend this to include inflammatory. That said subjects in which innate controversy and disagreement exist must be freely aired on the forums. There are ways and means of doing this in the professional manner in which we conduct ourselves daily, i.e. imagine the other person is in the room.

[quote user="Michael Woodhouse"]So goading of homeopaths (PROVEN NOT TO WORK) has to be allowed[/quote]

Goading - perhaps not. But counter-argument with evidence in a productive, educational manner - absolutely! Difficult to not let this descend into head-bashing and eye-rolling where emotions run high and the blood is pumping. But please, be civil.