Should I change vets

February 16, 2021 8:24 AM

We've been with the same vet for years. I've never had any problems with her.

My kitty was limping and we took her in. Doc gave us gabapentin, T-Relief and Glycoflex for arthritis.

She's doing a lot better now.

Yesterday, I just caught a glace of the bottle and took a closer look. It's a homeopathic preparation. I only found out about this because previously, I was getting it in a pill bottle from the vet's pharmacy. I borrowed a bottle from my brother (same vet) and that's why I saw it.

I do not believe in magic sugar pills. I called the vet this morning to ask if I could decrease the gabapentin and also why she's prescribing sugar pills. I'll get an answer later today.

But is this worth finding a new vet over? We've been happy patients for years. I was a bit skeptical about the Glycoflex (and probably should do some research on it), but homeopathy? That crosses a line for me.

posted by kathrynm to Pets & Animals (19 answers total)

This would really bother me. I give you permission to find a new vet.
posted by cakelite at 8:28 AM on February 16, 2021 [8 favorites]

I can understand your concern — I share your attitude towards homeopathy — but if I'm remembering right, the T-relief cream is actually arnica; homeopathic-associated, for sure, but not diluted to oblivion and with some evidence behind it. Glycoflex of course has the supplement spin on it too, but has an understandable mechanism of action; some of my family pups have seemed to benefit (from green-lipped mussels, right? there are different formulas (I, II [III?]) with different makeup). None of these strike me as over-the-line woo. I didn't quite follow what you were saying about the sugar-pills, perhaps you could clarify? Pill-form arnica?
That said, you have to be happy with your vet, not anyone else! Glad to hear your cat's doing better.
posted by alexandermatheson at 8:36 AM on February 16, 2021 [5 favorites]

So if I understand correctly, it's the T-relief that's homeopathic? I understand your frustration, but I also think that there are a lot of complicated ways that our medical (and veterinary) system and our expectations of it are really keyed to action, to doing something, when a patient comes in. So I think that otherwise competent providers can end up with supplements, or even homeopathic remedies, that aren't evidence-based, so that they have an action to recommend. There is positive feedback for this "responsiveness" for patients and prescribers.

So if you're otherwise happy with this vet, I wouldn't drop them for this alone. (As a parallel, I have a friend with a pediatrician she loved who recommended homeopathic teething drops, as one add-on treatment. My friend knows that's not really a thing, but the sugar in the drops was soothing/distracting to the baby, and she's continued to be happy with the doc.)

TLDR: there's a bias to action, rather than inaction, that can lead to including supplements/homeopathic treatments when there may not be a clear evidence based path forward.
posted by mercredi at 8:41 AM on February 16, 2021 [1 favorite]

(Basing my answer on your understanding that these pills have no medical effect. I have no information to evaluate that.)

The placebo effect may cause the act of being prescribed and taking pills with no medical effect to help a human taking them.

But in my opinion it is not possible for the placebo effect to work on cats because they lack the necessary understanding, and giving a cat pills is difficult and fairly traumatic and causes the cat and owner at least some harm. Normally this harm is offset by the necessary benefit of the pills, and it's hard but it's the right thing to do.

So in this case I believe the vet has violated the most sacred duty of a medical provider, which is to do no harm.
posted by fritley at 8:43 AM on February 16, 2021 [10 favorites]

Just ask for stronger arnica if it’s important to you. I wouldn’t leave over this. Your pet is doing well. It would be different if your vet refused to do surgery or something else a deep level homeopath would do.
posted by michaelh at 9:00 AM on February 16, 2021 [5 favorites]

All I know is that I once left a vet that I otherwise had a long-standing and good relationship with for the same thing, and I had no regrets over finding a vet that didn't prescribe homeopathic remedies. Being told to give my poor little sweet cat medication, the process of which stressed her out beyond belief, that wasn't even real medicine? The vet knew my buddy was a literal scaredy-cat and she still wanted us to go through this? There was no coming back from that.
posted by k8lin at 9:04 AM on February 16, 2021 [7 favorites]

My dogs go to the practice at veterinary school at an R1 university, which is overseen by the professors. I had a vet there recommend T-relief for my elderly dog's arthritis. She basically told me at the time that it was homeopathic and there should be no reason it works but it appears to for some dogs. I was very skeptical (for the same reasons as you) and didn't end up trying it for him, but there may actually be research behind it due to the arnica.
posted by pixiecrinkle at 9:17 AM on February 16, 2021 [2 favorites]

Response by poster: We don't have to pill Gidgette. I can crush both the gabapentin and the T-Relief into her food. So that isn't an issue. I think I'm going to wait until I talk to the vet about it and get her reasons. Maybe she misunderstood (highly doubtful) but I'm willing to listen.

Thanks for you points of view. Cat tax (Gidgette on the left, Ivory on the right)
posted by kathrynm at 9:21 AM on February 16, 2021 [2 favorites]

So-called alternative medicine is becoming very common with vets, for many reasons. My vet offers doggy acupuncture. I think it would be difficult nowadays to find a vet practice which is complete free of this sort of thing.

I would be unhappy and I would question prescriptions before I accepted them. I don't like vets that just prescribe things and say "I'll give you something for the pain" without explaining what it is. Even if it wasn't homeopathic, did your cat really need three prescriptions for a limp? Our dog has arthritis and we have been slowly slowly adding supplements and then pain control over years, not starting on three different drugs.
posted by muddgirl at 9:29 AM on February 16, 2021 [1 favorite]

Looking at the label of T-Relief, many of the ingredients are present at 2X dilutions, which means that they are, essentially, 1% solutions. This is baaaarely homeopathic, which is to say, some active ingredient is present.

Some supplement/OTC medicine manufacturers label their products as homeopathic in order to avoid FDA regulation, when they do, in fact, contain measureable amounts of the active ingredients. So it could be that your vet thinks that some of the ingredients in this preparation will benefit your pets.

I was prescribed an arnica cream by an MD, and the only way I could get it was in a 2X "homeopathic" cream, which for sure contained arnica, considering the warmth and tingling sensations. That said, I have no clue whether it would have any desirable affects taken in a pill?

However, I note also that they didn't shy away from prescribing gabapentin, which is a no joke allopathic Rx, so I wouldn't worry that your vet is prescribing homeopathy instead of effective treatments, at least.

So I'd suggest talking to your vet to gauge their level of woo.
posted by BrashTech at 9:30 AM on February 16, 2021 [11 favorites]

You say what they've told you to use is working, cats are not prone to placebo effects, I'd stay with the vet.
posted by wwax at 9:31 AM on February 16, 2021 [4 favorites]

Seconding Brashtech. At least one of your prescriptions is an active Rx. The others may compliment the Rx in a way you may have been unaware. I'd speak with her.

If you didn't ask for the functionality previously, just start asking from now on. She may have presumed you alright with the script, this seems really innocuous, if not well intended.

Btw, the umbrella of homeopathy has it's caveats, it isn't completely baseless. Some work folds into herbalism, and from then on, into modern medicine- it really depends on the specific experience.
posted by firstdaffodils at 9:59 AM on February 16, 2021 [1 favorite]

I have a long-standing and very trusting relationship with my vet of many years, and it's pretty normal for her to both give us prescription meds and say "you may also want to try X supplement, some of my patients seem to do well with it." She's always been clear about what's a prescribed med and what's an OTC supplement and that it's not always clear why some things work well for some pets but not others, and if I have questions we talk about the research behind whatever I have questions about. But again, we have a really long-standing relationship of working through some rare pet health issues and doing research on new treatments together, so she knows I'm really interested in exactly what my pets are taking and why and what the supportive science is. My impression is that's not necessarily something all her clients want from her.

I think it's reasonable to expect that sort of information from your vet if you've signalled that it's what you want. So it seems perfectly reasonable to me that you want to have a follow-up conversation to understand better what's being given to your pet and why, especially if it's in a form that isn't easy for your pet to take. (e.g., the bar for me giving a supplement to a pet is a lot higher if I have to get a pill into them than if I can mix something into their food that they don't seem to notice.)

After that if I were you I'd go into a wait and see mode and ask more active questions in the future about treatments. This one thing alone wouldn't be find-a-new-vet territory for me. If it turned into a pattern of treatments I was uncomfortable with, without the sort of supporting information I want to know before medicating my pet, then it might become find-a-new-vet territory eventually.
posted by Stacey at 10:08 AM on February 16, 2021 [1 favorite]

To me, a medicine with active ingredients that is labeled in order to avoid FDA oversight is worse than a sugar pill.
posted by muddgirl at 10:10 AM on February 16, 2021 [3 favorites]

I think waiting to hear what the vet has to say makes sense.

Something that I don't see mentioned is that throwing in (and presumably charging for) a homeopathic (and therefore optional) supplement along with prescribed medicines without checking with the client and being clear about it seems especially iffy/not great these days when a lot of people are struggling financially. I 100% know people who would give up things they need or go into debt for their pets' medical care, and (potentially) tacking on homeopathic stuff to that bill seems particularly bad.
posted by needs more cowbell at 10:15 AM on February 16, 2021 [1 favorite]

To me, a medicine with active ingredients that is labeled in order to avoid FDA oversight is worse than a sugar pill.

I agree, and believe me, I was spitting nails about having to spend my money on something with "homeopathic" on the label. But sometimes that's the only available formulation, and if it is provided by an otherwise reputable company, it could be the only viable option.
posted by BrashTech at 10:40 AM on February 16, 2021 [3 favorites]

Apologies BrashTech that wasn't meant to be a callout and it sounds like you went into the situation informed about the purpose of the drug and the formulation.
posted by muddgirl at 10:41 AM on February 16, 2021 [1 favorite]

many of the ingredients are present at 2X dilutions, which means that they are, essentially, 1% solutions.

I'm unclear about how to interpret a label that lists amounts of active ingredients as something like 2X followed by a figure in milligrams. Does this mean that each pill contains that many milligrams of the active ingredient, or that many milligrams of a 1% solution of it?

That aside: guaranteeing that the preparation you're selling cannot possibly interact negatively with other medications is logically equivalent to guaranteeing that it contains completely negligible quantities of anything resembling an active ingredient.

If your vet were my vet, those are the points I'd be raising. Whether or not I then decided to switch vets would depend on how the ensuing conversation went.
posted by flabdablet at 4:49 PM on February 16, 2021

Response by poster: My vet's response (through the office manager) was don't believe everything you see on the internet. Off to find a new vet. Thanks
posted by kathrynm at 5:05 PM on February 17, 2021 [6 favorites]