Why the RCVS must prevent vets from prescribing homeopathy
The case against homeopathy has never been clearer, with every well-controlled study showing these remedies are no more effective than a placebo. This is to be expected, as homeopathic treatments contain no active substances at all.
The reason I started this campaign was because I figured I can’t be the only vet who no longer wants to have to see animals whose perfectly treatable conditions have been left to deteriorate because their owners and vets were convinced homeopathic remedies would do the trick. Given more than 1,100 of my veterinary colleagues signed the petition, it appears I was right.
It is clear to me treating animals with homeopathy, at best, leads to unnecessary suffering and a reduced likelihood of a full recovery and, at worst – as with a case of a horse I saw that had been treated for Cushing’s syndrome and chronic laminitis homeopathically – conditions deteriorate so severely that euthanasia was the only option.
I also feel very strongly the use of homeopathy and other pseudoscientific treatments in the profession gives it a bad name. Members of the public expect, when they see a vet, to get advice that represents the best treatment based on the totality of experience and expertise of a medical profession. In the case of homeopathy, they are instead given treatment based on the personal beliefs of an extreme fringe that directly contradicts the wealth of evidence gathered by the veterinary field. This clearly undermines the reputation of the entire field as being reliable, responsible and robust.

Importance

So, if it is only a minority of vets, why is it important? Given more than 22,000 registered vets exist, the 200 or fewer who practise homeopathy (in fact, an article cited 50 vets licensed to practise homeopathy1) represent around 0.25% to 1% of the profession. Yet, if the RCVS fails to end the prescription of homeopathic remedies by this fringe group of vets, it is an implicit endorsement of their use of these treatments.
It would, therefore, also be an implicit acceptance of vets who place animal welfare at risk by putting their personal beliefs ahead of evidence-based medicine and the body of knowledge our profession has accrued. That these treatments are offered by qualified vets suggests to the public homeopathy is not a wacky pseudoscience, but an equivalent, legitimate option, perhaps just as effective as conventional medicine. They may be more likely to use it on themselves or their children.
As some high-profile media cases have highlighted, the consequences of well-meaning parents using homeopathic remedies to treat children suffering from meningitis can be tragic. Preventing vets from using homeopathy would send a clear message to the public of it not being approved by medical professionals, not being a genuine, effective treatment, and being firmly in the “alternative” (and, in fact, disproven) camp, with no backing by conventionally trained professionals.
While the number of companion animals that may suffer as a result of using homeopathic remedies is relatively small, given the fringe nature of belief in homeopathy among vets, clearly, causing any amount of avoidable suffering is deeply unethical. Furthermore, if a vet who believed passionately in homeopathy was to rise to the position of CVO, the potential damage done when forming Government policy regarding antimicrobial resistance or disease outbreaks could be catastrophic.
I have regularly worked on rabies control projects in India to prevent dogs from dying of rabies and to prevent the disease infecting and killing people, too. In Jaipur, as a result of vaccinating and neutering 85% of the street dog population, no reported human cases of rabies have occurred since 2003. This year, I have been working on a post-conflict livestock vaccination programme in Iraq to help improve food security. These are projects that affect not just animal welfare, but human well-being, too. If I were a homeopathic vet, imagine the time, money and lives that would have been wasted if I thought homeopathic nosodes could prevent rabies in dogs, or were a substitute for foot-and-mouth disease vaccines in sheep and goats. This would, rightly, be viewed as ridiculous and no competent vet would use homeopathy in those situations, yet we know colleagues who put their faith in homeopathy offer nosodes in place of vaccination.

RCVS reasons for continuing to allow homeopathy

The RCVS states one reason for permitting vets to prescribe homeopathy is pet owners will want to use homeopathic treatments anyway, so it is better for a vet to administer this as he or she will be better placed to monitor welfare. It does not want homeopathic treatments to be forced “underground”. On the surface, this argument appears to make sense, but I believe it is flawed for a number of reasons.
Firstly, it does not make any difference to the animal whether effective treatment or painkillers are withheld by a layperson or a qualified vet. A layperson can be prosecuted for not seeking veterinary treatment if he gives homeopathy instead of appropriate interventions. However, if he goes to a homeopathic vet, the outcome is the same for the animal, but neither the owner nor the vet face any rebuke and the owner does not realise he has been done a disservice.
Secondly, I don‘t believe homeopathic vets are best placed to monitor animal welfare because, I feel, their belief in a disproven modality casts doubts on their clinical judgement. Take the example of a cat with hyperthyroidism – if a homeopathic vet is willing to administer homeopathy instead of appropriate treatment, we know this lack of valid treatment can cause the animal’s health to deteriorate.
At what point do we trust the homeopathic vet to stop giving the homeopathy and treat the animal properly? When it develops renal failure? When its weight drops below a certain amount? Likewise, if he or she is willing to treat a horse with laminitis with homeopathy, can we trust him or her to monitor welfare by giving proper treatment at some point? Maybe when the heart rate is more than 60 beats per minute, or when there is visible rotation of the pedal bones on radiographs?
The British Association of Homeopathic Veterinary Surgeons (BAHVS) claims to cure cancer with homeopathy and Geoff Johnson – the homeopath whose claims the BAHVS features prominently on its website – claimed during an interview with the BBC he was treating “many” dogs with a view to curing their cancer. He told the BBC’s Victoria Derbyshire his ability to cure cancer with homeopathy was one of the main reasons animal owners chose to get treatment from him2.
I do not believe we, nor the public, are able to trust the clinical judgement of vets who believe they can cure cancer with homeopathy – instead, these animals need appropriate treatment or possibly euthanasia. Their owners are being offered a disservice by being sold ineffective treatments that offer false hope.
The RCVS stated “homeopathy is accepted by society”, though it doesn’t make it clear what it means by this claim – what constitutes “societal acceptance”? Evidently, it ignores the fact every credible expert and a large proportion of the public sees homeopathy as a nonsensical and potentially dangerous waste of time. Even if it were true that homeopathy was accepted by society, it says nothing about whether the treatment works.
We do not make health interventions on the beliefs of a small, but vocal, fringe group in society – we must follow the evidence. Many beliefs in society are incorrect, but it is the purpose of research and expertise to help educate. Condoning and pandering to mistaken fringe beliefs does nothing to improve society’s understanding of science and medicine.
Paddy

Changing beliefs

I want to make it clear I have no particular axe to grind with homeopathy specifically, other than it runs so clearly counter to evidenced-based medicine. Unlike homeopaths, if clinical trials showed a particular drug or surgical technique I had been using for years was useless, did more harm than good or had simply been superseded by something superior, I would be eager to change my position.
I actively want to know when and if I can improve my clinical practice, whether that means to stop using a product, or switching to something better. Indeed, it would be intellectually bankrupt of me to desperately seek out every piece of anecdotal evidence I could find to support my existing position or to cherry pick whatever study justifies continuing along my path in the face of overwhelming evidence to the contrary.
When discussing a faith-based belief system, such as homeopathy, emotions inevitably run high, which is perhaps why this debate remains so persistent, despite it being fewer than 1% of vets who put their belief in homeopathy. I am aware no amount of scientific evidence will change the opinions of the hardcore believers – that is the very nature of such a belief system.
If you are a believer in homeopathy, I fully understand you may be feeling persecuted by my petition and my calls to prevent homeopathic treatments. I know a belief in homeopathy some will have held for decades will form a large part of their identity. I can identify with your position – I was brought up in an evangelical church that taught us the earth was created in six days, exactly as The Bible described, around 6,000 years ago and evolution is a lie. These kinds of beliefs shape your whole identity. It affects how you interpret scientific information. I have personal understanding of how hard it can be to tear yourself away from a belief that has influenced your thinking for years. When I realised no big coordinated deception by the scientific community existed, I began a painful process to accept a literal six-day creation was incorrect.
It was never my intention to deliberately upset anyone and I’m sorry for any hurt caused. This is why I have directed this campaign towards the RCVS – to be an impartial third party. Just like the rest of us, homeopaths want what is best for animals under their care – and what is best for the profession. Unfortunately, being well-intentioned and deluded is no substitute for being right – especially when the cost of being wrong causes animals to suffer and brings the profession into disrepute.

References

  1. Glaister D (2016). ‘I’ve been a homeopathic vet for 40 years, so how can I be seen as a fraud?’ The Observer, www.theguardian.com/science/2016/jul/16/vet-homeopathy-medicine-royal-college
  2. BBC (2016). Should vets use homeopathy on animals? www.bbc.co.uk/news/science-environment-36748693 Original article appeared in Veterinary Times in December 2016 (free to access but need to log in): https://www.vettimes.co.uk/article/...