Remote supercession

Re: Remote supercession

Evelyn Barbour-Hill — Sun, 19 Dec 2010 23:45:24 GMT

[quote user="Niall Taylor"]What's that - Chinese researchers claiming that oriental dogs are the oldest and most ferocious? Surely not! Still, by the RMB rule of 'chronological precedence' this paper must be the definitive one as it's the newest. [/quote]

Chinese researchers claiming that Tibetan dogs are the oldest and most ferocious. There's something devious going on. All part of "normalising" the Chinese occupation of Tibet.

Re: Remote supercession

Bob Russell — Sat, 18 Dec 2010 11:01:50 GMT

This is mainly a matter of good manners. I am in the difficult position of being questioned on a regular basis about the treatment being given to an ex-patient. The owners moved and I have to find ways of 'not giving' advice which for a vet is not second nature!!

A number of times I have suggested things to discuss with their vets but the message is always 'I don't know, I have not seen the dog for years and you should discuss this with your own vet!'.

Why should a homoeopathic vet think they can treat a patient they have never seen? Possibly because they are not really treating the patient but are 'treating' the owner!

Re: Remote supercession

Mark Hedberg — Fri, 17 Dec 2010 22:41:06 GMT

[quote user="Martin Jones"]

There's a particularly English quality about being ruder to one's allies than one's adversaries. In this case, though, isn't it ironic that the interference by a homeopath is actually less harmful than if a conventional vet had intervened in a similar manner?

[/quote]

Funny, I hadn't thought of it that way. :)

Re: Remote supercession

Martin Jones — Fri, 17 Dec 2010 21:49:44 GMT

Re: Remote supercession

Niall Taylor — Fri, 17 Dec 2010 17:20:43 GMT

[quote user="alex gough"]we dont even have to even give the medication to the cat any more - we just squirt it in the air nearby![/quote]

Steady now, don't give it too little, you don't want to overdose!

Niall

Re: Remote supercession

Alex Gough — Fri, 17 Dec 2010 16:04:33 GMT

And since the homeopathic vet has said that we can apply the treatment by "nasal misting" we dont even have to even give the medication to the cat any more - we just squirt it in the air nearby!

Re: Remote supercession

Alex Gough — Fri, 17 Dec 2010 16:03:29 GMT

The second one. And although it is the code of conduct that is being breached, even if that wasn't in black and white, I would still think it pretty off for someone to advise about a case that they had zero clinical knowledge about. I'm a fairly reserved sort of chap so dont blow a gasket often. however, I take your point that I might have been even more concerned if the interfering vet had prescribed something other than water.

Alex

Re: Remote supercession

Martin Jones — Fri, 17 Dec 2010 15:52:12 GMT

Alex,

Indulge me in an exercise in semantics. Which of the following most clearly defines your view of the situation:

- a homeopath is interfering in your case without regard to the code of conduct, which is typical of homeopathic vets

- a vet is interfering in your case without regard to the code of conduct; incidentally, the vet is a homeopath

If, for example, the vet in question had not been a homeopath but had got involved, would you have been quite so reserved: might you have been firmer and more sure of your ground? Does the fact that homeopathy won't, to say the least, interfere with your treatment regime mean that you're less likely to blow a gasket than if the vet in question had handed the owner a bottle of painkillers, with instruction that these must be used alongside whatever you're doing?

Would a homeopath alter case management based on radiography: if, for example, you diagnosed symphysis separation, would that indicate a different treatment to a rostral mandibular fracture?

For the record, I have lost faith entirely in homeopathy, but have no issues with others peddling it, provided that a safety net of clinically-proven and indicated treatment is in place.

Martin

Re: Remote supercession

Gerry Henry — Fri, 17 Dec 2010 15:29:55 GMT

Just ask the client to choose who's treating the cat, you or Florence MRCVS. If you, make it clear to client and Florence that you won't take kindly to interference.

Re: Remote supercession

Niall Taylor — Fri, 17 Dec 2010 15:03:53 GMT

[quote user="alex gough"]

BTW, regarding Roger's assertion that dogs were domesticated 16000 years ago, and your reference is out of date, see below:

J Genet Genomics. 2008 Jun;35(6):335-40.

Origin and phylogenetic analysis of Tibetan Mastiff based on the mitochondrial DNA sequence

[/quote]

What's that - Chinese researchers claiming that oriental dogs are the oldest and most ferocious? Surely not! Still, by the RMB rule of 'chronological precedence' this paper must be the definitive one as it's the newest.

Niall

Re: Remote supercession

Alex Gough — Fri, 17 Dec 2010 13:12:23 GMT

BTW, regarding Roger's assertion that dogs were domesticated 16000 years ago, and your reference is out of date, see below:

J Genet Genomics. 2008 Jun;35(6):335-40.

Origin and phylogenetic analysis of Tibetan Mastiff based on the mitochondrial DNA sequence.

Li Q, Liu Z, Li Y, Zhao X, Dong L, Pan Z, Sun Y, Li N, Xu Y, Xie Z.

Laboratory of Animal Reproductive Genetics and Molecular Evolution, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, China.

Abstract

At present, the Tibetan Mastiff is the oldest and most ferocious dog in the world. However, the origin of the Tibetan Mastiff and its phylogenetic relationship with other large breed dogs such as Saint Bernard are unclear. In this study, the primers were designed according to the mitochondrial genome sequence of the domestic dog, and the 2,525 bp mitochondrial sequence, containing the whole sequence of Cytochrome b, tRNA-Thr, tRNA-Pro, and control region of the Tibetan Mastiff, was obtained. Using grey wolves and coyotes as outgroups, the Tibetan Mastiff and 12 breeds of domestic dogs were analyzed in phylogenesis. Tibetan Mastiff, domestic dog breeds, and grey wolves were clustered into a group and coyotes were clustered in a group separately. This indicated that the Tibetan Mastiff and the other domestic dogs originated from the grey wolf, and the Tibetan Mastiff belonged to Carnivora, Canidae, Canis, Canis lupus, Canis lupus familiaris on the animal taxonomy. In domestic dogs, the middle and small breed dogs were clustered at first; German Sheepdog, Swedish Elkhound, and Black Russian Terrier were clustered into one group, and the Tibetan Mastiff, Old English Sheepdog, Leonberger, and Saint Bernard were clustered in another group. This confirmed the viewpoint that many of the famous large breed dogs worldwide such as Saint Bernard possibly had the blood lineage of the Tibetan Mastiff, based on the molecular data. According to the substitution rate, we concluded that the approximate divergence time between Tibetan Mastiff and grey wolf was 58,000 years before the present (YBP), and the approximate divergence time between other domestic dogs and grey wolf was 42,000 YBP, demonstrating that the time of origin of the Tibetan Mastiff was earlier than that of the other domestic dogs.

Re: Remote supercession

Alex Gough — Fri, 17 Dec 2010 13:11:02 GMT

Anyone would think you had already made your mind up, Niall. Sorry about the letters in Vet Times this week - it feels like Deja Vu for regular followers of the controversial corner of the forums!

Re: Remote supercession

Niall Taylor — Fri, 17 Dec 2010 12:26:27 GMT

[quote user="Bob Russell"]Are the homoeopathic vets respected by the larger veterinary community?[/quote]

Hmm, tricky one... Do I respect a vet who claims to be able to cure cancer and other life threatening conditions and also relieve pain and treat infections, fever and endocrinopathies with water?..

Do I believe that solutions of the Berlin wall, peregrine falcon, dead bees, clams and condoms diluted to the point at which none of these ridiculous ingredients remain are effective therapeutic agents?..

Nope, can't decide, I guess I'll climb back on the fence with most of the rest of the profession and our esteemed governing body.

After all, isn't it a case of individual choice; science doesn't know everything; what harm can it do;we have to give clients what they want; wouldn't it be awful if they went to someone who wasn't a vet for their magic water; blah blah blah... [insert platitude of choice]

Niall

Re: Remote supercession

Bob Russell — Fri, 17 Dec 2010 11:34:02 GMT

Are the homoeopathic vets respected by the larger veterinary community?

Re: Remote supercession

Martin Atkinson — Fri, 17 Dec 2010 08:48:38 GMT

[quote user="Mark Hedberg"]

I believe that Alex Gough's response was totally courteous and very appropriate. A more aggressive and dismissive response would have merely given the homeopathic practitioners ammunition in their quest to show that they aren't respected by the larger veterinary community.

[/quote]

And they wonder why?

Re: Remote supercession

Alex Gough — Fri, 17 Dec 2010 08:26:35 GMT

Thanks Mark.

Re: Remote supercession

Mark Hedberg — Thu, 16 Dec 2010 20:37:03 GMT

I believe that Alex Gough's response was totally courteous and very appropriate. A more aggressive and dismissive response would have merely given the homeopathic practitioners ammunition in their quest to show that they aren't respected by the larger veterinary community. Quoting their own code of conduct was a stroke of genius in this case.

Cheers,

Mark

Re: Remote supercession

Rob Loxley — Thu, 16 Dec 2010 17:42:23 GMT

[quote user="Martin Atkinson"]I would then have given the owner a stark choice: that she either accepted the cat was under my care and my treatment or arrange for it to be transferred back to other vet. [/quote]

Agreed. If the animal was already on homeopathic remedies for unrelated problems then I'd be inclined to try and continue them for goodwill of the client, but not allow another vet outside the practice to dictate the treatment I'd give for the presenting problem.

Re: Remote supercession

Martin Atkinson — Thu, 16 Dec 2010 17:15:46 GMT

I'm amazed how restrained everyone is on this thread. What weight does the BAHVS rules of conduct have anyway in the real world? I would have told the homeopathic vet that he had no interest in the case unless the owner requested to be transferred back to him for a second opinion and he was not thus entitled to any history especially as he had already surrendered his entitlement to any co-operation by not complying with the RCVS rules on succession, but I would nontheless consider the benefit of his suggested medication and administer it only if I thought it would be to the benefit of the patient. I would then have given the owner a stark choice: that she either accepted the cat was under my care and my treatment or arrange for it to be transferred back to other vet. Life is too short for this sort of aggravation. Why do we tear ourselves inside-out sometimes to conform to unreasonable demands?

Re: Remote supercession

Alex Gough — Thu, 16 Dec 2010 13:18:02 GMT

Re: Remote supercession

Hannah Wynne Richards — Thu, 16 Dec 2010 13:00:58 GMT

Alex Far from being OTT, I would say your restrained reply makes you a candidate for Secretary General of UN

Wynne

Re: Remote supercession

Alex Gough — Thu, 16 Dec 2010 12:45:40 GMT

My reply (am I being too OTT about this?):

The first communication we had from your practice for a history was subsequent to the owner arriving to administer medication, and your email above is the first communication we have had from you regarding what you have recommended.

May I remind you that the BAHVS code of conduct states:
"14. In the case of animals unable to travel to the clinic, it is imperative that those clients are directed to closer veterinary homeopathic help if appropriate. If that option is not open, by virtue of no one practising near to the client, then such animals shall only be remotely treated with the consent of and via the attending veterinary surgeon, unless he/she declines that latter option."
and that the RCVS Guide to Professional Conduct says in section 1F
"Veterinary surgeons must:
a. always liaise with colleagues where more than one veterinary surgeon is involved in or has responsibility for the care of a group of animals"
It might interest you that a more local homeopath declined to get involved in the treatment of this animal because it was not under his care.
We were disappointed that this didn't happen, and wonder if you might want to review your procedures regarding interacting with colleagues.
The owner will be allowed to administer the medication, and nasal misting seems like the least invasive way to do this. We will liaise with local homeopathic colleagues when the cat is stable if the owner wants further alternative therapy while she is in our area.
I will have a copy of the history forwarded to you.

Re: Remote supercession

Alex Gough — Thu, 16 Dec 2010 12:45:40 GMT

My reply (am I being too OTT about this?):

Re: Remote supercession

Alex Gough — Thu, 16 Dec 2010 12:43:59 GMT

I got a reply from the vet this morning:

Mrs xxx has always preferred a fully integrated approach to the healthcare of her animals which has included homeopathy. Mrs xxx requested homeopathic support for xxx to complement your approach. In order to do this responsibly I informed her that you must be fully involved and in agreement and I requested a copy of the radiographs and history in order to make informed clinical decisions as any professional would do I hope...

As a centre that probably sees a high number of trauma cases you might be interested to see if you can discern any differences in the recovery quality/timecourse with this animal compared to your normal expectation if you sanction the owner using these complementary medicines on her animal. Obviously one animal will not convince you of efficacy but it is a start. I have given the dose rate/potency selections to Mrs xxx as she is familiar with the use of homeopathy. She has sourced the remedies from a reputable homeopathic pharmacy in Bath.

Ultimately the cat is currently in your care and if you refuse this treatment and to work with me I trust you will explain this to Mrs xxx.

Re: Remote supercession

Niall Taylor — Thu, 16 Dec 2010 12:41:08 GMT

[quote user="Andre Escudeiro-Vieites"]Just about some people and Homeopathy[/quote]

Andre, that is a dreadful story - there are well documented cases of human patients dying after abandoning real medicine in favour of quackery for life threatening conditions.

The solution for this poor, brow-beaten woman - get her sister to swallow a lethal dose of some easily available domestic poison (say, antifreeze) and then cure her self homeopathically - let's leave it up to narural selection!

Niall