Delusional medicine

RE: Delusional medicine

Cinzia Gandini — Fri, 06 Mar 2026 14:00:41 GMT

[quote userid="2490" url="~/f/non-clinical-questions/31319/delusional-medicine/248498#248498"]something like homeopathy I am very clear that I think it’s nonsense [/quote]

I understand your point of view, but I think you need to be very careful and skilled when questioning the efficacy of a treatment like homeopathy, given that in human medicine millions of people believe in it and use it, and that these remedies are sold in pharmacies. You cannot simply tell people that because it has not been scientifically proven to work in dogs, homeopathy does not work at all. Moreover, in the eyes of many clients, the situation is further complicated by the fact that, if I have understood correctly, the Royal College of Veterinary Surgeons (RCVS) does not “approve” homeopathic treatments but does not ban them either; its position is more nuanced. Personally, I don’t believe in it, but I would express this carefully and diplomatically when speaking with clients.

RE: Delusional medicine

Clare Tapsfield-Wright — Fri, 06 Mar 2026 13:29:54 GMT

[quote userid="8663" url="~/f/non-clinical-questions/31319/delusional-medicine"]One of my concerns is when colleagues take that view that treatments with no rational basis are harmless. Client wants to try reiki? Harmless? No. It diverts money and energy (emotional effort, for example, not quackery energy) from treats that might be effective or delays effective treatment. [/quote]

I think browbeating deluded clients doesn’t achieve much as they will just not return for treatment until the situation is dire if at all. While never condoning eg homeopathy or supplements I think you need to set out the arguments for evidence based treatments without a really negative client confrontation . If something like homeopathy I am very clear that I think it’s nonsense but my objective is to get the client to realise that it doesn’t work , not to drive them away. Most are wavering anyway or they wouldn’t have made an appointment, I think our job is to convince them but sometimes especially with a chronic condition that waxes and wanes they sometimes need persuading rather than bollocking .

RE: Delusional medicine

Cinzia Gandini — Fri, 06 Mar 2026 11:58:09 GMT

[quote userid="8663" url="~/f/non-clinical-questions/31319/delusional-medicine"] treatments with no rational basis[/quote]

It’s also true that while many treatments have been studied in human medicine, far fewer have undergone scientific scrutiny in veterinary medicine, and even fewer therapies based on relaxation have been evaluated. Considering that many animals live in conditions that do not meet their natural needs, such as being kept in cages for long periods or living in stressful environments, it is not surprising that there is interest in approaches that work for humans and in exploring whether their benefits could extend to animals.

RE: Delusional medicine

Stephanie Wellings — Fri, 06 Mar 2026 11:40:13 GMT

I think in veterinary medicine sometimes we have to rely on things other than proper high quality evidence, because the studies just haven’t been done. A lack of evidence that it works isn’t evidence it doesn’t work.

For instance, I personally don’t generally prescribe omeprazole with NSAIDs but I might do occasionally if I feel the patient has increased risk/history of side effects. In human medicine, they do give out omeprazole with chronic prescription NSAIDs, so there must be some evidence somewhere for it being a thing - whether it is applicable for dogs at the doses we currently use is obviously uncertain, but I don’t think the risk outweighs the benefit (unless for instance they can only get one tablet into the dog and they’ve got to choose which one). I’d always try and discuss with the owner if the evidence base is particularly patchy, but often it’s a ‘throw everything at the problem’ situation.

If clients are super driven to use a certain food/supplement/crystal arrangement alongside my medical treatment, then I tend to just say that’s not my area of expertise and I can’t really comment on it. I don’t doubt that sometimes it might divert energy/resources from the treatments I want to give, but my job is to facilitate owners caring for their pet, not micromanage their life choices.

RE: Delusional medicine

Alasdair Hotston Moore — Fri, 06 Mar 2026 09:35:38 GMT

[quote userid="8991" url="~/f/non-clinical-questions/31319/delusional-medicine/248487#248487"]Why then are surgeons wedded to them when there is evidence (beyond personal experience) that other methods are as effective?[/quote]

I think there is evidence that that the osteotomy procedures are better. But only moderately better at best. It’s not surgery I do myself.

RE: Delusional medicine

David Mills — Fri, 06 Mar 2026 01:38:56 GMT

I think we have to be careful for a number of reasons. The homeopathy debate seems to have simmered down a bit in the last couple of years, unsure why. There was a guy on here a few years back – Neil Taylor? – who was very much against ‘alternative’ medicine and there was heat in the debate.

I don’t think there is evidence for diverting money/energy away from traditional medicine (but I haven’t looked into it). Caregiver placebo is a thing I think I see (joint supplements being a big one; laser therapy too) quite frequently (esp in older dogs). But I think you cn have both – harmless and probably useless turmeric and interaction with scientific medicine that works.

It’s been covered on another thread recently but people in glass houses come to mind. Our evidence isn’t great – as you highlight re omeprazole (takes 7 days to work fully, handed out like sweeties) but also and I know we’ve been here before – TPLOs. Yes they work, but so do other options. Why then are surgeons wedded to them when there is evidence (beyond personal experience) that other methods are as effective?