A Cautionary Illustration

It's all very well being aware that our pets may recover from illnesses by themselves, but what difference can this make in the real world?

In my last blog, I was talking about the fact that sometimes when our pets get sick, they’ll get better by themselves without us needing to do anything. Let's look at that quote again:

The art of medicine consists of amusing the patient while nature cures the disease.

If you don’t fancy reading the previous blog, the conclusion was that there’s at least a little truth in this rather dismissive-sounding quote. Specifically, we talked about coughs and cold in cats and dogs, and how most of them will clear up by themselves without antibiotics, or indeed any treatment at all from your vet. There are many implications if this is the case, but one of the more interesting ones is that the opportunity it creates for the unscrupulous salesperson.

The Conniving Scenario

If I was in need of cash, and prepared to suspend my morals, I could set up a company that sells "cough drops" for pets. I'd probably market it at dogs, because they're easier to give medication to. I'd make them honey flavoured, because dogs like sweet things and everyone loves hot honey-and-lemon when they've got a cold (or I do, anyway). Honey famously has antibacterial actions (which may help infected wounds or certain kinds of burns, but doesn't seem to do much for kids' coughs) so I can claim some kind of science basis there. I'd advertise on Facebook, and maybe via a few of the pet websites that promote alternative medicine, using an ad that looked something like this:

Here's the kicker - I wouldn't even have to fake the reviews. If enough people bought them, there would be plenty of people whose dogs had kennel cough, or something else benign like a hoarse voice from barking. They'd take the drops, dog would get better, and bam! Genuine positive reviews. Of course, there would be a few people that it wouldn't work for, but as long as I had enough positive reviews to drown them out it wouldn't matter. Tidy little profit for me, and I move on to my next project selling diarrhoea "cures" or joint supplements to treat limps that would go by themselves anyway.

If you're thinking this all sounds immensely cynical, you're probably right. After a few years in this job I am a bit of a cynic, but perhaps by now you might be getting an insight into why. There are an awful lot of pet remedies, foods and supplements out there just like this, with little or no scientific basis being sold every day. You can find them online, in pet shops, and, yes, even in vet surgeries.

However, I'm not jaded enough to think that everyone out there who does this is just trying to make money. I think there's a second kind of scenario where this happens, more subtle and far less malicious, but unfortunately just as wrong.

The Innocent Scenario

Instead of being a morally deficit lowlife who's out to make money, imagine I'm just a dedicated owner who loves my six dogs. Then, one by one, they all come down with coughs. They’re hacking away, day and night, and they’re miserable. I decide to give them all some warm honey - I like it, and the vet said it wasn't going to do any harm, so it's worth a try. And then, over the next day or two, they all get better! Even old Fluffy who has a bad heart! I'm thrilled.

The next week, my friend's dogs get the same cough. I recommend the honey to them, and they get better. My friend is very grateful, and credits their recovery to my honey suggestion. So, when someone posts about their coughing dog on a Facebook group later that month, I mention the honey thing. Once again, the dog gets better, and there's praise for the idea.

I begin to wonder if there's anything in this, so I do some research online. I find that honey has antibacterial properties and that humans have been using it to treat coughs for thousands of years. I do a bit of experimenting at home, and find a recipe with honey and other natural ingredients that my dogs love, but that I can send through the post. With my friends' encouragement, I set up a small online shop selling these HoneyDrops. The story behind them makes them very appealing - people love that personal touch, which feels very different to some mass-produced medicine. So they order them, and try them. Most of the coughs disappear after they give the drops, the good reviews start coming in, and the business grows.

There's no ill intent in this second scenario, but we still end up at the same place, with that same Facebook advert, selling a treatment that's unproven and ultimately unnecessary. The possible outcomes are the same, too - in the best scenario, owners are simply wasting time and money. In the worst one, they're delaying taking a sick dog to see a vet because they're relying on a treatment that won't work, which leads to unnecessary suffering and potentially even premature death.

The Real-World Implications

In real life, I suspecting these two examples are just two ends of a spectrum, and many of these type of products fall somewhere in the middle. And, of course, we can’t say for sure that these HoneyDrops do nothing - it might be that honey does help the coughs get better more quickly. Given the available evidence, it seems unlikely there would be any significant benefit (which is why it’s right for us to be sceptical) but it is possible.

To find out, we’d have to do a study with these fictional HoneyDrops. We’d take group of dogs with coughs, of all ages and breeds, and randomly split them into two groups. One group would take the real HoneyDrops, and the other would be given a sugar pill (or, given the high glucose content of honey, perhaps we should say a different kind of sugar pill!). Neither the people dispensing the pills, nor the owners, would know which one they had. We’d monitor the dogs closely and see if there were any differences between the two groups. If more of the dogs who took HoneyDrops got better, or they got better faster, then we’d know that they did something.

This is why evidence-based care is so important. You don't want to waste money, or risk your pet's health, on treatments that have no reason to work. When we're thinking about how we look after our pets, we don't want to be connived by the character in the first scenario. We have to look beyond the superficial appeal to the deeper scientific basis - have they published any data to show it works? If not, is there and good reason to think it would?

And when we see a wonderful, compelling, personal story of how this treatment, or pet food, or accessory was discovered (by accident!) by a normal person just like you but it's so wonderful and it's changed their pet's life and they just want you to have the same thing - then we do have to embrace our inner cynic, and look beyond the emotion. Is there another reason why that person might have seen an improvement? Could it be a placebo effect (yes, that's a thing in pets too)? Is there any other evidence we could look at on whether it works or not?

And, most cynically of all, are they just using a personal story to try and manipulate you into buying something? After all, the most effective way for someone in the first scenario to sell you something might just be to pretend that they're someone from the second scenario.

It's harder work doing this, rather than just accepting what we're told at face value, but I hope you'll find that it's worth it. If someone was making decisions around my health and daily care, I know I'd want them to approach things this way, and I think that our pets deserve that, too.