Response to the letters regarding the treatment of canine atopic dermatitis with a homeopathic remedy

Dear Sir,

We are delighted that so many veterinarians read and decided to comment on our article (Can Vet J 2002;43:601–603)! We are not professionally trained homeopaths, and our goal was not to validate or invalidate such individuals or their therapeutic armamentarium. However, as professionally trained practitioners of “Western medicine” — in particular the board-certified specialty of dermatology — we are constantly besieged with questions on the value of all sorts of therapeutic agents, be they “Western” or “alternative”.

We have a long history of evaluating (and publishing our findings!) all sorts of “therapeutic” agents, be they traditional, standard, anecdotal, previously “validated,” proprietary, or over-the-counter. The over-the-counter homeopathic remedy investigated in our study is being sold to dog owners with unsubstantiated claims of benefit for itching, allergic dermatitis, eczema, and so forth. Clearly, even the entities allegedly being benefitted are ambiguous. Virtually every disease in Muller & Kirk's Small Animal Dermatology VI can be associated with itching. The term of allergic dermatitis embraces several types (atopy, food, contact, insect, etc.), while eczema is a worthless term that we have been trying to eliminate from the veterinarian's vocabulary for years.

If it requires a professionally trained homeopath to find “unique differences” and prescribe “individual remedies,” what hope does the dog owner have for successfully using a commercial over-the-counter product that is receiving anecdotal praise from individuals and the media? No mention is made about the need for a professionally trained homeopath's diagnosis, the unique differences between patients, and individual remedies included with the product information.

Since “pruritus” and “allergic dermatitis” were major label claims of the commercial remedy, we decided to study our most common type of canine allergy and itching, atopic dermatitis. We designed a study in standard fashion by (1) documenting the disease in the most precise way possible, (2) giving the medicine according to a specific, standardized protocol, (3) including a placebo, and (4) making sure the responses were reproducible and sustainable. Dr. Van As does us an injustice by suggesting that we have no regard for concurrent illnesses and behavioral changes. We believe that our history taking and physical examinations are as good as most. Our patients had no other illnesses or behavioral changes.

Nowhere in our article did we “lead readers into believing” anything about homeopathy in general. We did indicate that the efficacy of homeopathic remedies in veterinary medicine is “largely unproven and quite controversial,” which is accurate. Dr. Van As correctly identifies the difficulty that many of us have with homeopathy and other forms of alternative care; few, if any, controlled, interpretable studies have been published. Why shouldn't veterinarians who are engaged in alternative treatment methodologies be held to the same standards as “Westerners”? Why should it be so hard to define a disease or condition, patient variables, detail a therapeutic protocol (individualized or not) and placebo, and demonstrate repeatable and sustainable responses? The pet-owning public is hungry for answers, and so are we. Show us the proof!

In conclusion, we conducted a real life study on an over-the-counter homeopathic remedy following the manufacturer's recommendations, and the remedy was found wanting. If we have touched a nerve, we can only hope that this will stimulate homeopaths to design their own studies and get them published in peer-reviewed journals. They owe it to our profession.

Danny W. Scott, DVM, DipACVD

William H. Miller, Jr., VMD, DipACVD

Department of Clinical Sciences

College of Veterinary Medicine

Cornell University

Ithaca, New York 14853-6401, USA