Snake Oil or Cure All? How Can We Tell The Difference?

Have you ever heard of snake oil? It’s an expression generally reserved for unproven remedies for various ailments or maladies, but is also often used to describe any product with questionable or unverifiable benefit.

Chinese workers, building the First Transcontinental Railroad in the mid-19th century, used snake oil to treat the painful inflammatory joint conditions resulting from their labors.

The workers began sharing the tonic with their American counterparts, who marveled at the positive effects it had on ailments such as arthritis and bursitis. Rich in the omega-3 fatty acids that are now known to possess anti-inflammatory properties, Chinese snake oil likely provided some comfort for workers experiencing job-related soreness and swelling.

Looking to capitalize on the financial gain, American “healers” gave their Chinese counterparts a bad name when they developed their own “snake oil” concoctions, which they claimed provided equal benefits to the Chinese remedies, yet lacked the necessary ingredients.

Over time, the term “snake oil” has become synonymous with substances whose ingredients are considered proprietary and marketed to provide a miraculous cure-all for a variety of maladies. Unfortunately, I can’t help but think about the phrase when pet owners ask me about complementary or alternative medicine treatment options for pets with cancer.

Many owners discover information which suggests the beneficial effects of various herbs, anti-oxidants, “immune boosting treatments,” and dietary supplements via searching the internet.

The more common products owners will inquire about include Tumexal, Apocaps, K9 Immunity, K9 Transfer factor, coconut oil, turmeric, essiac tea, and wormwood products (Artemisinin). A primary appeal is these substances are touted as “natural” and “non-toxic,” making their usage relatively inarguable.

What most owners fail to recognize is that supplements and herbal products are not subject to the same regulations by the FDA that prescription drugs are. Owners are also unaware that carefully worded claims to efficacy are not backed up by scientific research in the vast majority of cases, despite the plethora of supportive testimonials listed on product inserts or on websites.

One of the most popular products I’m asked about is K9 Immunity, a dietary supplement manufactured by Aloha Medicinals, reportedly “the industry’s leading company in the cultivation of medicinal mushroom species.” The product’s website includes several impressive logos: USDA organic, Quality Assurance International Certified Organic, and even one for the Food and Drug Association (FDA) as well as sweeping statements related to an ability to “strengthen and balance your dog’s immune system so the body recognizes and destroys damaged cells” and an assurance that the product “has no known side effects.”

This latter statement is my biggest concern with the animal supplement industry; the lure of alternative and complementary options centering on the ideology that these options are benign. Countless times, owners mistakenly assume these products have undergone testing to determine purity, safety, and efficacy. Despite the lack of specific data proving these products are bioavailable, safe, and/or effective in pets (other than what is put forth on their respective websites), owners elect such treatments.

With minimal probing, I discovered a warning letter from the FDA addressed to Aloha Medicinal dated 4/6/10 outlining numerous violations the company made regarding potential beneficial claims related to several of their manufactured products. Yes, this example is out dated; however smart owners have to consider what it means.

The American Veterinary Medical Association (AVMA) is the organization tasked with protecting, promoting, and advancing a strong, unified veterinary profession that meets the needs of society. Within their code of ethics you will find the following statement:

“It is unethical for veterinarians to promote, sell, prescribe, dispense, or use secret remedies or any other product for which they do not know the ingredients.”

This simple sentence provides me with the entire pause I need when it comes to the owner asking whether or not a particular supplement would help their pet. I cannot, and I will not, promote such a thing until the data tells me to do so.

My concern is that “alternative” products are marketed as panaceas. We cannot accurately report efficacy because the substances were never scrutinized in any sort of clinical trials (despite the hundreds to thousands of animals they are stated to be helpful for); it’s all anecdotes and testimonials.

I believe many of the companies marketing these supplements are preying on the emotions of owners who are desperate for a shred of hope. This isn’t a new concept, the internet just makes it easier for them to do so.

What is often most difficult for owners to understand is that words like “miraculous” play no role in medicine. I’m not arguing against the existence of outliers—there will always be patients who live longer than we expect. Conversely, there will be many who succumb to disease before their time. However, products should refrain from including unrealistic claims and using words such as “cure” or “prevent.” Likewise, they shouldn’t only report testimonials and should offer scientific data supporting their assertions.

Complementary treatments work alongside conventional ones, whereas alternative treatments act as a substitute for them. I adhere to the ideology that there is no alternative medicine. “Alternative medicine” that works is called medicine, period.

Top 10 medical conditions affecting dogs and cats

Nationwide Insurance recently reported the top ten medical conditions affecting dogs and cats and their associated costs based on data from claims from over 1.3 million owners for more than 550,000 pets.

I assumed cancer would be the top disease on the list for both species. It is the most frequently diagnosed illness in older pets and treatments can be expensive, therefore making it a “model” disease to be represented on a survey for pet insurance.

I was stunned to discover that not only was cancer not the top disease reported, it didn’t even make either list.

The top ailments in dogs included:
Allergic dermatitis
Otitis external
Benign skin neoplasia
Pyoderma and/or hot spots
Osteoarthritis
Periodontitis/dental disease
Gastropathy
Enteropathy
Cystitis or urinary tract infection
Soft tissue trauma

The top medical conditions for cats included:
Feline cystitis or feline lower urinary tract disease (FLUTD)
Periodontitis/Dental disease
Chronic renal disease
Gastropathy
Hyperthyroidism
Enteropathy
Diabetes mellitus
Upper respiratory infection
Allergic dermatitis
Inflammatory bowel disease

The results of the Nationwide report undeniably represent several areas of bias.

Though pet insurance is becoming more popular, a rise in the number of pets covered by insurance over the past 5-10 years is a relatively recent finding. Most owners purchase policies for their pets when they are puppies or kittens. As cancer is more frequently diagnosed in older animals, a disproportionate number of animals currently covered by insurance would be of a younger age than those expected to develop cancer.

Another confounding factor is that some insurance companies do not automatically provide reimbursement for diagnostic tests and treatment plans related to cancer unless owners have a specific rider for such coverage. Therefore, despite being insured, pets may not be eligible for reimbursement for cancer care simply as a result of lack of coverage.

Another possible reason for cancer not showing up on the survey is that despite the frequency that this disease is diagnosed in companion animals, owners are reluctant to spend money on the necessary recommended treatments.

This could result, at least in part, from the higher costs associated with medical care for pets with cancer. The diagnostic and therapeutic options I endorse can run into thousands of dollars. Few owners have such resources, regardless of what sort of assistance comes from an insurance company that is helping with the bottom line.

Setting these possibilities aside, I’m concerned that the absence of cancer on the list of frequent diseases covered by an insurance company is the result of owners who avoid seeking consultation with a veterinary oncologist out of fear, anxiety, or misinformation.

Each time an animal is diagnosed with cancer, veterinarians are responsible for disseminating information to the owner about the specifics of the disease, including potential causes, testing, and treatment options.

It is imperative the information put forth is accurate. Misinformation and miscommunication lead to distortion of the facts and could contribute to lack of treatment.

As an example, I recently met with an owner who, upon leaning of a diagnosis of lymphoma in her dog, described to me how her veterinarian instructed her that chemotherapy would cost upwards of $15,000 and would likely result in her pet experiencing significant illness from treatment for the remainder of its life, which would only be for a few short months.

Though she was provided with information, nearly every aspect of what this owner was told was incorrect.

While chemotherapy may be costly, protocols vary and treatment plans can be tailored for individual patients and their owner’s financial capabilities. Even so, $15,000 is a gross overestimation of the cost of a typical protocol.

Dogs undergoing chemotherapy for lymphoma are not constantly sick. In fact, more than 80% experience no side effects whatsoever. Those that do have a bad reaction are typically treated supportively and recover. And veterinary oncologists would never continue to treat a pet that is constantly sick from treatment.

The prognosis for dogs with lymphoma may be variable; however, most pets are living between 1-2 years after diagnosis rather than “only a few months,” as suggested by my owner’s veterinarian.

When myths and misconceptions prevent owners from seeking options for their pets with cancer, animals may not be afforded the opportunity to receive potentially beneficial care.

I don’t necessarily wish to see cancer topping the list of diseases covered by insurance companies, but I’d like to see every owner and animal have a fair chance at survival when this devastating diagnosis is made.