By Dr. Becker
Recently, I came across a rare article in a veterinary industry journal that provides a real-life example of the sometimes wildly different methods used by traditional vs. holistic veterinarians when it comes to patient care. The title of the article: "Holistic vs. FDA-approved: Two veterinarians take divergent approaches."
The article tells the story of two vets, one with a conventional approach to treating patients (let’s call him Dr. T), and the other, more holistically oriented (we’ll call him Dr. H). Apparently, Dr. H filled in for Dr. T while he was on vacation, which is where the story gets interesting.
Dr. H Steps in to Care for One of Dr. T's Patients in His Absence
Dr. T has been practicing veterinary medicine for 31 years. He owned his practice until about five years ago when a corporation purchased his clinic. These days, Dr. T works as part of a team of DVMs at the clinic.
One of Dr. T’s patients is a 10 year-old Golden Retriever he has been seeing since the dog was a pup. The dog, we’ll call him Buddy, came in for his yearly checkup the day before Dr. T was leaving for vacation. Dr. T ran a senior blood profile and ordered x-rays of the dog’s pelvis and spine. Buddy’s owners are committed to staying one step ahead of any health problems their beloved senior pet might be developing. Since Dr. T was leaving for vacation the next day, he told Buddy’s owners that one of the other vets at the clinic would contact them with their dog’s test results.
As it turned out, Buddy’s blood test results showed elevated liver enzymes. In addition, his urinalysis showed that his urine was on the alkaline side with scattered struvite crystals, and his x-rays suggested some mild degenerative joint disease in both hips and early lumbar spondylosis (arthritis of the spine).
Based on the test results, in Dr. T’s absence Dr. H called Buddy’s owners and said that while the dog’s issues were fairly common in older large breeds, they should be addressed. He recommended what he considered a safe, holistic approach to addressing Buddy’s situation. Dr. H recommended glucosamine for the arthritis, cranberry extract to acidify the urine and manage the struvite crystals, and SAM-e for the elevated liver enzymes. Buddy’s owners picked up the supplements and started their dog on Dr. H’s holistic protocol.
Dr. T Returns from Vacation and Is Incensed at Dr. H’s Treatment Protocol for Buddy
When Dr. T returned from vacation, he reviewed Buddy’s test results and Dr. H’s recommended treatment plan, and he was infuriated. This was not the way he would have approached Buddy’s health challenges, and he was very much against “untested and unapproved holistic medications.” Dr. T only prescribed medications that were FDA-approved.
Dr. T dressed down Dr. H for treating his patient in a “reckless” manner, and he called Buddy’s owners to tell them he wanted to modify their dog’s protocol. Since the owners were long-time clients of Dr. T, they honored his wishes but also told him that they felt Buddy was doing very well on Dr. H’s natural protocol.
The two veterinarians then met to clear the air. Dr. T, while appreciative that Dr. H pitched in with Buddy while he was away on vacation, was nonetheless adamant that his patients should not receive holistic treatments for medical issues. Dr. H, of course, did not agree and felt that as long as he discloses to clients the “untested” yet anecdotal success of the use of holistic remedies, he is within his ethical and professional boundaries.
Dr. T decided they would have to agree to disagree, and he let Dr. H know he no longer wanted his help with his patients in his absence.
Despite Dr. T’s Disapproval, Dr. H Was Well Within His Professional and Ethical Boundaries in His Treatment of Dr. T’s Patient
According to Dr. Marc Rosenberg writing for dvm360, Dr. H:
“… was well within his rights as a licensed practitioner to prescribe holistic medications for [Buddy], as long as he also informed the pet owners that these were not FDA-approved products. This is not to say that they would not work but rather that they had not been subjected to the FDA scrutiny required to achieve approved status.”
Dr. Rosenberg goes on to say that he uses both mainstream and holistic medications in his own practice. He talks with pet owners about the differences between the two types of medications and they make the decision together as to the best way to proceed.
Needless to say, my approach in this case would be similar to Dr. H’s. His suggestions were excellent. I would also recommend physical therapy and perhaps acupuncture or chiropractic to help with Buddy’s arthritic hips and spine.
Why I Almost Always Start with Natural Healing Therapies, and View Prescription Drugs as an Option of Last Resort
Since Buddy’s health problems were relatively mild and certainly not life threatening, I would recommend natural remedies and therapies first and continue to closely monitor the dog’s liver enzymes and urine pH, along with his mobility and quality of life.
If Buddy’s liver enzymes were headed in the right direction on his follow-up blood tests, if his urine pH also dropped into a healthy range, and if his arthritis was being well managed, I would consider his natural healing protocol a success. Then I would continue to routinely monitor his progress and overall health.
If, on the other hand, part or all of my recommended protocol was not having the desired effect, I would try other combinations of natural remedies and possibly further diagnostics, if warranted. Sometimes it takes several different combinations of therapies and protocols before healers find the combination that unlocks the body’s innate healing mechanisms. As long as Buddy’s health remained stable and he was comfortable, I would only move to traditional “FDA-approved” drugs if all my efforts failed or Buddy’s condition seemed to suddenly worsen or his quality of life plummeted. In my experience, it’s very rare for an animal with Buddy’s mild, age-related health issues to be completely unresponsive to natural therapies.
If a health condition can be resolved or well-managed with natural treatments that have no known side effects, why take risks with synthetic pharmaceuticals that almost certainly come with side effects?
One of the tremendous benefits of Dr. H’s approach, and mine, is that if we can reverse or manage a disease process with safe, natural treatments, we are able to avoid the inevitable, often significant side effects of those FDA-approved medications Dr. T swears by. Most importantly, many holistic modalities treat the root causes of disease, not just the symptoms, which are most commonly addressed with traditional drug protocols.
From my point of view, traveling the safer, more natural route first is the essence of this statement from the Hippocratic Oath:
"I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous".
First, do no harm.