(Updated) The American Veterinary Medical Association (AVMA) is proposing a policy to discourage the use of homeopathy with pets. Resolution 3, submitted by the Connecticut Veterinary Medical Association, states that homeopathy has been identified as an ineffective practice and its use is discouraged.[i] This resolution is supported by an anonymous white paper that is predominantly a reiteration of policies from medical organizations demanding the use of methods and treatments supported to a scientific standard—these are good policies as I support any policy that encourages strict peer-review standards and quality research methods.
Update from the AVMA:
On January 5, the AVMA House of Delegates voted to refer Resolution 3-2013 (which proposed a policy stating that homeopathy is an ineffective practice and that its use as a veterinary therapy be discouraged) to the Executive Board with a recommendation that it be referred to the Council on Veterinary Service (CoVS). Now what happens?
The resolution will be forwarded to the Executive Board for consideration. It is no longer considered a proposed policy, nor is it a resolution anymore. Simply put, it’s now an item for discussion and consideration.
read here
The white paper’s primary argument can be summarized with this sentence:
… while homeopathy has been studied and used for 200 years, and continues to be supported by small minorities within the scientific and healthcare communities, in controlled scientific investigations it has failed to demonstrate effectiveness beyond placebo for any indication.
However, is homeopathy an issue in need of a resolution? The white paper doesn’t provide any explanation why homeopathy is a problem, merely emphasizes the lack of sound research supporting it. Despite the difficulty to produce reliable results in a lab regarding the efficacy of homeopathy in general, it only took me about ten minutes in the library to find data supporting the usage of homeopathic treatments in non-human cancer. Jonas et al. (2006) published findings that five homeopathic remedies reduced tumor incidence by 23% (P < .0001), decreased tumor size by 38% versus controls (P < .02), and tumors had a 13% lower average weight (P < .05). Tumors in treated animals also showed a 19% increase in apoptotic cell death (P < .05). While this study is just a single study, the conclusion of the researchers is appropriate in that “the findings indicate selected homeopathic remedies for the present study have no direct cellular anticancer effects but appear to significantly slow the progression of cancer and reduce cancer incidence and mortality.” Not every pet owner can afford nor has the desire to put their companion through the pain of chemotherapy, and so where is the harm in recommending an alternative treatment that might help the pet?
The white paper also makes reference to the lack of scientific rigor regarding the ideology behind homeopathy in general. For instance, the white paper makes mention that walnuts are used in homeopathy to improve the brain because walnuts “look like” the brain to some degree. Basing the use of a fruit only on its similarities in appearance is essentially phrenology (which is not science), but what the white paper fails to address is that research indicates walnuts might actually pose real benefits for the brain. Joseph et al. (2009) published findings that dietary supplementation with fruit or vegetable extracts that are high in antioxidants (such as blueberries, strawberries, and yes, walnuts) can improve neurological function and decrease Alzheimer’s symptoms. “Taken together, these results suggest that a greater intake of high-antioxidant foods such as berries, Concord grapes, and walnuts may increase health span and enhance cognitive and motor function in aging.”
While I am not advocating benefits of homeopathy, nor is this blog post intended to produce evidence that homeopathy is supported to a scientific standard or even a science, the AVMA has a history of bogus resolutions[ii] that risk alienating more pet owners who are often simply sensitive to the treatments they give their pets. Resolution 4 of this year’s winter conference stipulates acceptable guidelines for debarking dogs: a monstrous procedure that brings tremendous ethical questions to light. So in effect, the AVMA is stipulating with their policies that debarking dogs is acceptable but giving them walnuts is not. As usual, their motivation is misguided and has undercurrents of questionable conflicts of interest.
The American Veterinary Medical Foundation (a non-profit annex of the AVMA) was audited by the IRS both in 2010 and 2011 and they determined the net value of the AVMF in 2011 was $6,313,649. Of this net amount, over $1,000,000 came in the form of donations from Pfizer Inc alone.[iii] Just a few days ago, Bayer, who was already contributing upwards of half a million dollars in donations to the AVMF, just increased their contributions to the veterinary field by giving the American College of Veterinary Internal Medicine $120,000 a year in research grants. The AVMA supports beyond repute the excessive use of antibiotics in livestock[iv], even though there is solid evidence that antibiotic use in livestock feed is the direct cause for superbugs.[v]
Our results strongly suggest that livestock-associated MRSA CC398 originated in humans as MSSA. The lineage appears to have undergone a rapid radiation in conjunction with the jump from humans to livestock, where it subsequently acquired tetracycline and methicillin resistance. (Price et al., 2012)
It is of course only coincidence that the AVMA appears to have intimate conflicts of interest regarding these policies, as stopping the practice of putting antibiotics in animal feed would potentially cause financial loss to donors of the AVMF.
Douglas G. Aspros, President of the AVMA from 2011-2012, whose involvement with Novartis Pharmaceuticals from 2005-2009 was just recently—perhaps conveniently—deleted from his CV, says in a transcript from the Federal Trade Commission that “17% of all revenue in the veterinary field comes from Rx.”[vi] This is not a bad thing, drugs are important, medications are essential in healthcare, and veterinarians have to make a living as well. As Dr. Aspros further added, “Veterinarians primarily dispense drugs and pharmaceuticals to ensure the health and welfare of their animal patients. We would be wise to remember this dictum as we go through the rest of today’s presentations.” If the AVMA wants the public to believe that they are more than a money pinching organization that capitalizes on conflicts of interest (which while I honestly don't think they are, but I still sit back and wonder from time to time), then they need to adjust their priorities when proposing future resolutions. Healthcare providers who sell treatments under the impression that they work, but do not have evidence to attest to it, are indeed guilty of a serious crime (such as some homeopaths). However, there is no harm in telling a client that belladonna root probably isn't going to help their pet, but a good health care provider would improve the relationship with their client by guiding them towards other alternatives that do have some evidence of efficacy, even if they don't come in an Rx bottle.
It is the obligation of veterinarians to prevent and relieve the suffering of animals by consulting with clients on available treatment methods that are amenable solutions for the client. However, the AVMA impugns the potential benefits of alternatives with their resolutions, which are not backed by indisputable evidence. The damage this does to clients who value alternative medicine in the bond with their companions can be seen in the continuing decline of pet owners seeking regular veterinary care—a significantly larger problem than the use of homeopaths.
References:
Jonas, W. B., Gaddipati, J. P., Rajeshkumar, N. V., Sharma, A., Thangapazham, R. L., Warren, J., … Maheshwari, R. K. (2006). Can Homeopathic Treatment Slow Prostate Cancer Growth? Integrative Cancer Therapies, 5(4), 343–349.
Joseph, J. A., Shukitt-Hale, B., & Willis, L. M. (2009). Grape Juice, Berries, and Walnuts Affect Brain Aging and Behavior. The Journal of Nutrition, 139(9), 1813S–1817S.
Price, L. B., Stegger, M., Hasman, H., Aziz, M., Larsen, J., Andersen, P. S., … Schupp, J. (2012). Staphylococcus aureus CC398: host adaptation and emergence of methicillin resistance in livestock. MBio, 3(1). Retrieved from http://mbio.asm.org/content/3/1/e00305-11.short
[i] atwork.avma.org/2012/11/13/proposed-resolutions-and-bylaws-amendments-for-the-house-of-delegates-2013-winter-session/
[ii] http://www.examiner.com/article/a-review-of-the-avma-s-proposed-policy-against-raw-food
[iii] American Veterinary Medical Foundation, http://www.avmf.org/main/our-donors/
[iv] [click here to download position statement]
[v] http://www.npr.org/blogs/thesalt/2012/02/21/147190101/how-using-antibiotics-in-animal-feed-creates-superbugs
[vi] Competition & Consumer Protection Issues in the Pet Medications Industry, Federal Trade Commission, October 2, 2012, [click here to download transcript]
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