Empty Medicine Cabinet

Here’s an interesting piece on the evidence behind some common pet meds by a writer whose dog was taking Tramadol (which probably only got him high) and glucosamine (which probably doesn’t work) for hip problems:

If you have a pet, this should be a cautionary tale. Americans spent $14.2 billion on veterinary care for their pets in 2013—and that doesn’t include proprietary health diets and food supplements. Put another way, pet owners pay about $850 annually in veterinary expenses per dog, and about $575 per cat. Factor in the emotional energy we invest in keeping our companion animals healthy, and you’d hope for high confidence in the end results. But as I’ve learned, much of veterinary medicine is based on shaky scientific foundations: The drugs prescribed for your dog or cat may work no better than those we’ve been giving to Kaleb.

Before you get angry, realize that mostly this isn’t your vet’s fault. The biggest problem is that their medicine cabinets are relatively bare. Like it or not, most of what we know about whether drugs work and are safe comes from clinical trials conducted by pharmaceutical companies to win marketing approval. Even though the sums we spend on our pets’ health may seem lavish, they’re a fraction of the budgets involved in human medicine, making it hard for companies to justify the costs of developing new veterinary drugs. That’s why the U.S. Food and Drug Administration’s database of approved human drugs contains more then 6,500 entries, and the list for dogs fewer than 650.

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37 replies
  1. 1
    raven says:

    With my shoulder problems and my decision not to have surgery I’m looking a various ways to address my issues. Bohdi, our husky mix, has also had some joint related problems in the last couple of years. My vet has been careful to say that glucosamine has no been proven effective but it might not hurt. I remember years ago going to an MD in Atlanta for some knee problems and she said “I’m not saying glucosamine works but the Navy Seals I treat swear by it. I’m also taking turmeric for inflammation and I can’r say I’ve noticed any difference.

  2. 2
    Ash Can says:

    This makes me wonder if the cost controls that are a feature of single-payer systems lead to any additional efforts to develop veterinary drugs. Does anyone know?

  3. 3
    Lee says:

    The entire article is a load of crap.

    “Some vets are reluctant to delve into what science has to say….”

    There also quack doctors as well.

    It looks like the author failed to talk to a single person in the industry. A veterinarian can prescribe any drug on the market (human or animal). How the fuck do you think they test human medicine? ON ANIMALS.

    Of course different drugs affect different species differently. That is why they go to school to learn that. That is why you don’t give your cats or dogs Advil or Tylenol (one dose could kill them). That is why chocolate can kill you dog but not your cat. They also prescribe different antibiotics depending on the infection and the species. The same with steroids.

    Yeah I’m a bit testy over this subject as my wife is a veterinarian.

  4. 4
    geg6 says:

    All I know is that the stuff the vet gave us for Otis (I forget what it is that he has is called, but he drags his rear feet and has trouble standing because of it) didn’t work at all. It was some kind of steroid and some prescription pain killers. What has worked, at least a bit, is some crazy concoction John found online that includes green tea, avocados, glucosamine and tofu. We mix a little bit of it in his usual kibble and it seems to have helped. We also give him baby aspirin for pain. He still requires a harness to go outside and he’s still very unsteady on his feet, but he no longer drags the rear feet so much that he cuts them open or break off his claws on the steps outside. And believe me, that’s a huge improvement.

  5. 5
    Miki says:

    Where’s the surprise? Woo is woo, whether it’s foisted on humans or animals.

  6. 6
    raven says:

    @Lee: Lil Bit gets the veterinary application of Restasis (Ciclosporin) for her dry eye (no tear ducts) and she gets it orally to mediate her autoimmune hemolytic anemia. Interesting how that drug has many different applications.

  7. 7
    Miki says:

    @raven: Autoimmune hemolytic anemia? What breed is Lil Bit?

  8. 8
  9. 9
    Capri says:

    There’s a catch 22 with the use of off labeled medications in veterinary medicine. It’s just about impossible to get funding to study drugs in species of interest. The funding agencies say that the manufacturer should pay for it. But it’s a tiny, off-label potential market, so they don’t either.

  10. 10
    karen says:

    @Lee:

    That is why chocolate can kill you dog but not your cat.

    I don’t know about dogs, but I do know that chocolate will kill your cat.

  11. 11
    Thomas says:

    Mileage may vary (and apparently does), but glucosamine/chondroitin treats work wonders for my 11yo lab/chow mutt.

  12. 12
    Thomas says:

    Mileage may vary (and apparently does), but glucosamine/chondroitin treats work wonders for my 11yo lab/chow mutt.

  13. 13
    raven says:

    @karen: We spent $750 when a pound of dark chocolate covered raisins got eaten by ONE for the dogs so we had to take them both to the emergency vet. It was Bohdi and he’s done it twice since and it hasn’t done shit to him.

  14. 14
    Wag says:

    @raven:

    Cyclosporine is a potent immunosuppressant. I use it to treat Lupus and other autoimmune diseases, and to prevent organ rejection in my transplant patients. Using it to treat autoimmune dry eyes and autoimmune hemolytic anemia is standard.

  15. 15
    J.W. Hamner says:

    @Lee:

    How the fuck do you think they test human medicine? ON ANIMALS.

    Mainly on mice and rats though. Once upon a time dogs and cats from shelters were used in that kind of research (and still are to some extent I think – but much less than in the past), but public perception has shifted to the point that many/most people are horrified at the thought of it.

  16. 16
    Miki says:

    @raven: My last standard poodle (also a rescue) had a fucked immune system – Addison’s disease, calcium oxylate stones, chronic pancreatitis, etc. Never did have IMHA but I am aware of many SPs who did/do have it.

    With SPs, a bottle neck in the gene pool and idiotic breeding practices (Thanks, AKC!) has pretty much guaranteed sick dogs unless and until some new blood is brought in. Although I love the breed I am not ready to try again …

    BTW – Tucker’s Addison’s disease was successfully controlled for 10 years with monthly injections of Desoxycorticosterone Pivalate and a daily verrry small dose of prednisone – both drugs developed initially for humans. The latter drug was cheap, cheap, cheap. The former drug not-so-much.

  17. 17
    Lee says:

    @raven:

    It is a weight to coaco(sp?) determination. If a yorkie eats 2 bars of 92% dark chocolate and a 100lb lab eats a half a bar of milk chocolate you’ll get different results.

  18. 18
    raven says:

    @Wag: I sort of know that since I’ve been paying for it for 5 years.

  19. 19
    Lee says:

    @J.W. Hamner:

    They still do it, but under much tighter controls and security. Some vet colleges do the testing there.

  20. 20
    raven says:

    @Miki: Yea, Lil Bit got dumped on our vets doorstep. She had fucked up eyes, peeing blood and this disease. She’s the happiest Lil Shit in the world as long as she gets her cookies!

  21. 21
    Tokyokie says:

    Several years ago, when I was getting ready to move across country and lugging a couple of cats in the U-Haul with me, I went by my vet to get something to hopefully calm them down for the road trip. Without hesitation, he gave me a bunch of diazepam (Valium) and said cats’ reactions to it vary and that it might not work. (As I recall, it worked on one, not on the other.) But what boggled my mind was he was handing me, at a very low cost, a benzodiazepine that lots of people back then were abusing. I asked if it was the same formulation, and he said yes, just a lower dose. And I asked him how he could ensure that pet owners wouldn’t keep it for themselves, and he just shrugged.

  22. 22
    SiubhanDuinne says:

    @raven: I remember that!!

  23. 23
    Miki says:

    @raven: Tucker was sweet and beautiful, but not the brightest bulb in the pack.

    My first SP, Mike, was the wizard. Lost him at age 11 to laryngeal paralysis ….

    Have a miniature poodle (rescue) now (Sully). He’s brilliant, beautiful, healthy as a horse, and evil.

  24. 24
    Joey Maloney says:

    One of my cats is extremely anxious, aggressive, and territorial. He never settled in well to the household and it had gotten to the point where I was afraid I couldn’t keep him: he was attacking the other cats and constantly peeing all over the house, on the walls, on the bed, on one notable occasion on ME while he stood on my lap.

    He now gets 5 mg of Prozac a day and it has radically changed him for the better. He’s still kind of an asshole but he’s an asshole you can live with. And he’s become a world-class snoodler.

  25. 25
    Comrade Scrutinizer says:

    @karen: Pish tosh. It didn’t kill mine. LC ate chocolate ice cream for breakfast with Comrade Mrs Scrutinizer for about 10 years, and lived 12 more after that.

  26. 26
    karen says:

    @Comrade Scrutinizer:

    Maybe chocolate ice cream is more diluted. Maybe it’s pure chocolate, like a candy bar?

    I also thought that milk gave cats diarrhea.

  27. 27
    cleek says:

    @karen:
    it’s the lactose. most adult mammals can’t handle it. (some) humans are weird in that they can digest it in adulthood. our cats don’t care for it. they love ice cream (and whipped cream, and butter), though. mmm. milk fat.

    but, you can give a cat Lactaid (or Cat-sip, same thing) with no ill effects.

  28. 28
    kideni says:

    @raven: The problem might have been the raisins as much as the chocolate – a sizable percentage of dogs will go into kidney failure from raisins or grapes.

  29. 29
    The Other Chuck says:

    Maybe it’s coincidence, but my 10 year old cat responded wonderfully to her glocosamine treats after a few months of them. She went from only carefully and gingerly jumping up onto the couch and never onto the counter, to tearing around all parts of the house like any cat is supposed to.

  30. 30
    Lee says:

    @The Other Chuck:

    It is the same with one of our dogs. She has gone from hobbling around with bad hips to bouncing around like the spaz she normally is.

    From what my wife has read is that glocosamine is hit and miss. Sometimes it works and other times not so much. They are trying to figure out what is the factor when it actually works so they can replicate it on a more widespread basis (or limit its use when they know it won’t work).

  31. 31
    WereBear says:

    Dry gelatin, added to his food, was what worked for James Bond (88 human years old) and his joint issues. Heck, it (and gluten free) is what worked the best for my joint issues, too.

    I’m not getting worked up over this article because: human drugs are a hodge-podge of marketing, money, and badly sourced science. The same caveats apply.

    I’m all about serving the best food I can muster. My cat fountain cost as much as ONE vet visit, yet has probably headed off many, considering how often cats suffer from UTI.

  32. 32
    Comrade Scrutinizer says:

    @Lee: That was our experience with glucosamine. One cat recovered a great deal of mobility, one had a slight improvement, but the third was mostly unaffected.

  33. 33
    Three-nineteen says:

    @WereBear: Really? My cat fountain cost around $20 and lasted ten years, at which point I bought one that cost $30 (it is specially shaped to fit in a corner).

  34. 34
    WereBear says:

    @Three-nineteen: We have four cats. They can drink down a small one to the point of pump death.

    After experimenting with the cheaper ones, we went for one that was both pretty, and easy to clean.

  35. 35
    Michelle says:

    Glucosamine and chondroitin have actually been studied extensively in dogs. Studies of this nature can be very subjective with animals especially because we must rely on observation which can be heavily biased. Even double blind studies can lead to “placebo effect” type results, just like in humans. Force plate studies in which gait and weight bearing are physically measured in arthritic animals before and after supplement administration have shown conclusively that weight bearing and gait typically improve significantly when the supplement is administered EVERY DAY and at the proper dosage. The daily dosing and dosage being key.

    Chocolate is toxic but is very dose dependent (the darker the chocolate the more serious the toxicity) and is much more toxic in dogs that cats. We rarely see issues in cats primarily because cats typically won’t eat chocolate. Raisins are also toxic and can cause severe kidney issues. So ignoring a pet that has ingested chocolate covered raisins is playing with fire. I would absolutely make sure a dog that ate chocolate (especially dark chocolate) covered raisins was seen by a vet. At the very least the pet should be induced to vomit very soon after ingestion.

    Finally, the FDA requires all the same testing, procedures, studies, etc for a medication to be approved for use in pets as in humans. The costs to perform the studies can be daunting and unless a company believes they will recoup the costs of all this testing and research (which can take many years), they are unlikely to spend the time and effort to do so. For this reason, many medications in veterinary medicine are prescribed “off label”. Meaning that while some testing and research has been done on the medication in regards to the specific species, it has not been tested to the point of being “FDA approved” for use. Prozac in cats for anxiety and certain other behavioral issues being a perfect example.

    Michelle DVM (Lee’s lovely wife😊)

  36. 36
    Michelle says:

    Glucosamine and chondroitin have actually been studied extensively in dogs. Studies of this nature can be very subjective with animals especially because we must rely on observation which can be heavily biased. Even double blind studies can lead to “placebo effect” type results, just like in humans. Force plate studies in which gait and weight bearing are physically measured in arthritic animals before and after supplement administration have shown conclusively that weight bearing and gait typically improve significantly when the supplement is administered EVERY DAY and at the proper dosage. The daily dosing and dosage being key.

    Chocolate is toxic but is very dose dependent (the darker the chocolate the more serious the toxicity) and is much more toxic in dogs that cats. We rarely see issues in cats primarily because cats typically won’t eat chocolate. Raisins are also toxic and can cause severe kidney issues. So ignoring a pet that has ingested chocolate covered raisins is playing with fire. I would absolutely make sure a dog that ate chocolate (especially dark chocolate) covered raisins was seen by a vet. At the very least the pet should be induced to vomit very soon after ingestion.

    Finally, the FDA requires all the same testing, procedures, studies, etc for a medication to be approved for use in pets as in humans. The costs to perform the studies can be daunting and unless a company believes they will recoup the costs of all this testing and research (which can take many years), they are unlikely to spend the time and effort to do so. For this reason, many medications in veterinary medicine are prescribed “off label”. Meaning that while some testing and research has been done on the medication in regards to the specific species, it has not been tested to the point of being “FDA approved” for use. Prozac in cats for anxiety and certain other behavioral issues being a perfect example.

    Michelle DVM (Lee’s lovely wife)

  37. 37
    Mnemosyne says:

    @WereBear:

    You may already be long gone, but do you have to deal with hard water deposits? We had a cat fountain but it kept getting encrusted with white lime deposits that would NOT come off, and all of the lime-removal products I could find said they were not safe to be used on items that would be for human or animal consumption. Scrubbing with vinegar and baking soda did absolutely nothing. So we ended up with bowls again. :-(

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