Sunday, October 11, 2009

Last week an interesting discussion occurred on VIN and spilled over onto The SkeptVet Blog. Coincidentally, NPR's Science Friday for October 9th was about veterinary medicine, and included some discussion of Stem Cell research. Dr. Lisa Fortier is an equine surgeon who is active in research in the areas of cartilage and tissue repair. She mentioned that there is still a lot of basic research that needs to be done to answer questions about what types or stem cells will be most effective for certain treatments, and to evaluate the safety and effectiveness of stem cell treatments. She also made a good comment in response to a question about Lyme Disease regarding the difficulty of diagnosis, and the fact that the antibiotics used to treat Lyme disease can have anti-inflammatory effects that can cause improvement in lame horses that may not have had lyme disease in the first place. I thought this comment demonstrated the problem of confusing correlation and causation quite well.

There was also a small animal veterinarian on the panel, Dr. Sarah Meixell from Veterinary Care of Ithaca. During the question and answer period, at about the 33minute point in the show, Dr. Meixell stated that acupuncture and Chiropractic were very effective treatments for animals, with no mention of any evidence to support the claim. Even worse, a minute or two later, someone asked about "organic" treatments and she said that there are Homeopathic vets who treat animals. When the show host Ira Flatow gently challenged this statement by saying that homeopathy might just keep the owner happy, she said "No it actually helps the pet".

I thought the show demonstrated the contrast between science and evidence-based veterinary medicine and alternative medicine in an interesting way. While the other veterinarians on the show seemed to be careful to emphasize science and evidence, Dr. Meixell boldly asserted that several CAM modalities, including homeopathy, were effective. She does not seem to practice CAM herself, at least from what I can see on the Veterinary Care of Ithaca website, but she appears to accept it's use uncritically, and gave many listeners the impression that it works.

This is exactly the type of situation that many veterinarians tend to find themselves in when trying to discuss CAM critically. If we challenge statements supporting modalities that are not supported by the evidence, we are accused of being rude, no matter how politely and discreetly the challenge. It was interesting to see the researcher involved in studying stem cells qualify her answers and explain what still needed to be discovered, while another vet seemed to accept several varieties of CAM uncritically.

1 comment:

  1. Thanks for pointing out the NPR discussion. I have contacted Dr. Fortier in the hope she might offer an informed opinion on the current state of the evidence regarding stem cell therapy. It seems quite tenuous and preliminary to me, particularly given that VetStem is already marketing a fom of stem cell therapy as a clinical treatment, but I'm hoping she will be willing to weigh in.