Real doctors treat more than one species&

This is a great phrase that veterinarians (especially students) like to paste on t-shirts!  It is true though.  An MD studies and treats one species, two sexes.  Vets learn 4 species (and much more if you go the exotic route), two sexes!  Whenever I give my high school talks I tell the students MD’s are responsible for us and veterinarians are responsible for every other living and breathing being!

So, when I have to go to my own MD I try not to be arrogant or argumentative, but it can be quite frustrating, because there are just some things I know more about than an MD.  Case in point.  Several months ago I treated a dog in kidney failure.  I grabbed a urine sample, but I was an idiot and did not follow aseptic technique/infectious disease protocol or have any concern for my personal well being and did not wear exam gloves…so I got urine all over my hand.  This usually doesn’t bother me and certainly doesn’t gross me out (I have kids…come on…let’s face it I have seen and touched much worse!).  So I washed my hands and went about my business.  About a week later I got a good scare and a lesson in safety.  The animal was Leptospirosis positive and in fact passed away from the disease after I sent it to the Fox Valley Animal Referral Center for care.

Leptospirosis is a bacteria-like organism (for those dog owners out there…we vaccinate your pet annually for this…it’s the “L” in the DHLPP booster) transferred in urine usually by contaminated water that a mouse, raccoon, deer or any infected mammal has urinated in!  It causes many things to happen to your body but one of them is kidney failure.  It is zoonotic…that means you and I can get it from these animals…including our dogs!

So when I learned that I had been contaminated with Lepto positive urine I started to sweat a little bit.  Usually the disease passes via mucous membranes…eyes, mouth or open wounds.  I usually have open cuts on my hands all the time, so the reality is that I could have been infected.  Again, more sweat.  I was breast feeding Emily at the time and sure enough…it can be spread via breast milk…more sweat.  I called Dr. Neil within minutes of getting the results.  He suggested I have a little Doxycycline with my coffee!  I agreed.  However, the drug of choice for treating this disease was contraindicated while breast feeding…so I reached for the next best thing and started myself on Amoxicillin.  I then quickly called my physician which is my OB because I am never ill and never have to go to the doctor other than to pop out some babies (well if you have read my latest posts…that’s not entirely true…but it use to be!).  They were completely unfamiliar with the disease and suggested I get in to see an infectious disease specialist.

I got an appointment with him a couple of days later.  Low and behold…he didn’t speak very good English…a very thick Indian accent (what is my luck with MD’s that I can’t understand?!?).  I explained to him the situation.  I was a veterinarian; I had been exposed to urine from a dog with a positive Leptospirosis result and that I wanted a titer done on my blood to see if I had an active infection.  In his very thick accent he said “very unusual to see…usually see in the jungle”.  I said, I know, I understand the rarity of this disease in Northeast Wisconsin amongst humans…but I am in a high risk category and I know I was exposed.  Again his response “very unusual…only see in jungle…usually military men in jungle”.  Yes, yes I know…but I was EXPOSED TO LEPTO POSITIVE URINE…calm down…and I am breast feeding and concerned about spreading this to my family.  I just want the titer done so I can see if I have an active infection and if I should continue Amoxicillin therapy.  He then proceeds to tell me all the things that could happen if I were infected, what my CBC and chemistry would look like…this goes on for about 15 minutes.  I tried to keep my calm…and I did a really good job too.  Finally…he says “you want me to run blood work?”.  I said yes.  “CBC and Chem?”.  NO!  Just the titer.  “Yes…let’s run a titer”.  Finally!  We are on the same page!  Then, just to really throw him for a loop I asked since they were drawing blood for labs could he order a Rabies titer…I thought he was going to lose it.  He said “what, you think you have rabies?”

As it turns out my titer for Lepto was negative and my Rabies titer is high…that’s a good thing.

Canine Health from LifeVantage–Protandim by Any Other Name & Still No Real Evidence

I was recently asked to comment on yet another “kitchen sink” mélange of herbs and supplements promoted w/ claims of broad benefits for dogs: Canine Health from LifeVantage. This proved easier than I had expected since the product is identical to Protandim, except for a couple of additional ingredients.

You may recall that Protandim is a supplement which I have reviewed previously (1), and which Dr. Harriet Hall has discussed at Science-Based Medicine several times (2,3,4). The theoretical justification for the product rests on the supposed anti-oxidant and anti-inflammatory properties of the ingredients. None of the ingredients have well-demonstrated benefits or clear evidence that there is negligible risk in using them, though several have interesting properties that warrant further study. It would not at all surprise me if compounds derived from some of these ingredients turned out to have therapeutic value, but that is a far cry from justifying the kind of claims made for this product.

In any case, there is growing doubt about the hypothesis that oxidative damage is a significant cause of many disorders or that anti-oxidants are necessarily safe and beneficial (5,6). And all well-studied anti-inflammatory medications have significant potential risks as well as benefits, so it is almost certain the same would be true for compounds like those in Protandim if these turned out to have significant anti-inflammatory effects.

Of course, it doesn’t appear that scientific research and evidence is necessarily the primary concern for the founder of the company that sells Protandim, based on his own explanation for why he has discovered a miraculous remedy the scientific community has overlooked:

I already mentioned this in Entry #1: Motivations, but it bears repeating here. All the details you’re about to read concerning the development of Protandim mean nothing – absolutely nothing at all – without acknowledging that God used me as a vessel in brining Protandim to fruition. For almost 35 years scientists were looking for this tool after Dr. Joe McCord and Dr. Irwin Fridovich discovered Superoxide Dismutase (SOD) in 1969. For almost 35 years the pharmaceutical industry failed. For almost 35 years the nutraceutical industry failed.

Then God intervened . . . and has taken us on this unlikely, exciting journey.

The bottom line for this supplement hasn’t changed since my original review:

The underlying theory used to promote this product, that anti-inflammatory and anti-oxidant effects are always safe and beneficial, is highly doubtful. There is only weak in vitro and animal model research to indicate that the ingredients in Protandim, or the combination product, have potentially useful effects on cells or biochemical markers. There is absolutely no clinical trial evidence to indicate Protandim has any of the claimed benefits in humans or animals. While the absence of evidence is not proof the product is unsafe or ineffective, it is absolutely a reason to be skeptical of wild claims of miraculous benefits. At best, using this product is simply rolling the dice and hoping for the best.

Like Protandim, CanineHealth is said to prevent or improve a wide range of seemingly unrelated conditions, including problems in the joints, brain, heart, and eyes. It is purported to do so by reducing “oxidative stress.” The difference between the two products is the inclusion in Canine Health of omega-3 fatty acids” and “Type II chicken sternum collagen.” As with Protandim, no details or dosages of these ingredients is disclosed.

The most common source of omega-3 fatty acid supplements is fish oils. There is good evidence that these can improve symptoms of allergic skin disease (7), some weak evidence suggesting a benefit for arthritis treatment (8,9). It has been suggested that their inclusion in diets can improve signs of dementia in dogs, but the mmore specific evidence in human isn’t very supportive(10, 11). It isn’t clear if fish oil is even the source of essential fatty acids in Canine Health, but if it is it has only weak evidence to suggest a benefit, and there is no reason to mix it with all of the other untested stuff in the product.

With regard to Type II Collagen, despite a number of studies there is insufficient evidence to support any benefit of this supplement as a treatment of arthritis in humans (12, 13). There is also no convincing evidence supporting use in dogs.

As for the product itself, the company claims to have paid another organization to conduct a double-blind, placebo controlled clinical study showing “a reduction in oxidative stress, improvement in mobility and improved cognitive function.” Naturally, the results of this study have not been published and the details are not available to the public, so we have to take LifeVantage’s word for the results.

So we have another catchall, anti-oxidant based mixture of herbs and supplements claimed to have wide-ranging benefits but with no convincing scientific evidence supporting these claims. Numerous red flags of quackery are present, and there is heavy reliance on testimonials and celebrity endorsement rather than scientific research to promote the product. None of this is definitive proof that it doesn’t have some or all of the miraculous benefits claimed, only that there is currently no good reason to believe it does. Yet another roll of the dice with our pets’ health.

 

 

 

 

 

 

 

 

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