Prescription v herbal

[Clodagh]

This is not aimed at anyone but you often see people recommending herbal alternatives to prescription NSAIDS.
Why do vets not prescribe or suggest them as an alternative? Is it because they aren’t as good or because vets make more money prescribing drug company meds?
I’ve always assumed the former. Although mine all start off on OOC stuff by the time we get to the vets I take their advice. Although my two on prescription drugs now both have (recommended by the vets) OOC support as well.
Just interested.

 

[PurBee]

Mainstream Vets cant suggest herbal or prescribe them, because they’re not licensed to, or qualified to. They want to retain their vets license, and know if they step outside the boundaries of it, they risk losing it.
However, many allopathic vets will be open to owners trying other modalities, even encourage the continued use of, for example milk thistle for liver health, if the blood results are showing it helps. But you’ll find they wont actively push a client in that direction due to the legalities and risk to their license.

 

[Birker2020]

Because vets aren't informed about herbal. My last vet thought it was hilarious when I said I had my horse on slippery elm and used to call it sticky oak and really take the p**S.

Slippery Elm has been in use for horse for thousands of years, it provides soothing support for gastric health and the bark from slippery elm can be beneficial in helping to maintain a healthy digestive tract by promoting a healthy balance of bacteria in the hind gut. Slippery Elm bark is rich in mucilage, which becomes a gel when it comes in contact with liquids. This helps to coat and line the gastrointestinal tract and prevents acid splash back.

And of course its about 100 times cheaper than anything veterinary which is crucial when you are being quoted £4800 to treat possible gastric ulcers and you're not insured.

Vets don't know everything, hell my previous vet had never heard of pinworm for example.

 

[ycbm]

Mainstream Vets cant suggest herbal or prescribe them, because they’re not licensed to, or qualified to.

Because vets aren't informed about herbal.

Both of these. Most vets, for example, would probably not know that mucuna is used in the East to treat humans with Parkinsons, and can be used as an alternative to Pergolide, which is also effective against Parkinsons, but was withdrawn from human use due to heart valve damage.

But if they did know about mucuna, they couldn't legally prescribe it, I believe, because a drug tested on horses, Prascend (pergolide) exists and they must prescribe the approved tested drug.

 

[ycbm]

Then there's licencing. It's been well proven in testing that esomeprazole out-performs omeprazole in the treatment of ulcers in horses. But as yet nobody has paid for esomeprazole to be tested and licenced for use in horses in the UK. Vets are therefore stuck with prescribing omeprazole as one of two licensed product ranges when a better, cheaper (lower dose needed) alternative is well known to exist.

I believe vets can prescribe unlicensed products but only when no licenced product is available.
.

 

[Nasicus]

Just wanna point out that my vet recently not only recommended, but provided a Milk Thistle Supplement for my cat, in the form of Denamarin.

One thing to consider, is that with a lot of herbal/natural supplements, you can't guarantee the exact amount of the active/required ingredient per dose. If you have a dog that needs to have x amount of active substance per body weight, then prescribing a medication that contains said substance in a controlled, guaranteed way is preferable to some powdered herb where the base ingredients can have fluctuating levels of active substance between individual plants, leaves, buds etc.

Like how we take aspirin from a bottle instead of chewing on willow bark. We can guarantee we are taking exactly 300mg of acetylsalicylic acid, rather than hoping for the best and gumming some bark which might or might not contain enough salicin to ease your pain.

I'm not dumping on herbal supplements by any means, they have a place. But when the need for accuracy arises, prescription beats natural.

 

[Birker2020]

Both of these. Most vets, for example, would probably not know that mucuna is used in the East to treat humans with Parkinsons, and can be used as an alternative to Pergolide, which is also effective against Parkinsons, but was withdrawn from human use due to heart valve damage.

But if they did know about mucuna, they couldn't legally prescribe it, I believe, because a drug tested on horses, Prascend (pergolide) exists and they must prescribe the approved tested drug.

I think your partly right. I think sometimes they can prescribe unlicensed in horses drugs maybe not now but years ago in some situations.

A previous horse I owned (back in circa 2000) displayed riggy behaviour, he was tested and wasn't a rig but was determined to be a false rig. But the vet said that depo provera which is a drug for humans (birth control) was what was required to stop his riggy behaviour so he had three injections over a course of time (possibly three months) to curb any riggy behaviour. It was that or he wasn't allowed out with the rest of the herd as horses were getting hurt by being mounted and bitten and they thought it was my horse that was causing all the issues. It transpired it wasn't in the end.

I had to sign a disclaimer as it was unlicensed for use in horses.

It was only about 12 months after he had his final injection that he dropped down dead of a heart attack in the field. I will never know to this day whether it was as a result of the injections he had. I'd never do it again.

 

[Redders]

Licensing means if there is a licensed product for that issue in that species, we legally have to use that. We can use the cascade of licensing if there is a valid reason to do so, the rules state that cost is NOT a valid reason. Some drugs are illegal to use in certain species, some drugs which are fine for one species or human kills another, we have to first see if there is a drug that can reasonably be expected to be safe and effective that is licensed in another similar or another animal species before we go off licence and reach for human drugs.
we do recommend herbal stuff and supplements, but we don’t prescribe it because it’s not a prescription medication, and because if an animal is lame, supplements or herbal products just do not have the evidence and clinical trials behind them to prove that they are Both safe and effective. We practice evidence based medicine - or we are supposed to. If I saw an animal in pain, and I suggested a herbal supplement, I would be failing that animal, because the evidence just isn’t there to say that I would be providing pain relief with a herbal remedy.
And we don’t make money or get perks from selling prescription medications. The company who licensed the drug and the pharmacies and wholesalers who sell it do, we don’t. We can’t even buy our drugs wholesale for the same cost as an online pharmacy sells it for, we don’t have the buying power. This really grips me, because why shouldn’t I make money from my hard earned knowledge and skills?

i treat animals with evidence and safe and effective medications, I often go off licence if I need to.
if a human went to the doctor with a painful foot, and they suggested willow tea over a prescription painkiller then it would be acceptable if that person felt annoyed.
yes many drugs, including chemotherapy drugs and heart drugs are made with compounds found in plants, eating that plant wouldn’t have the same effect, and could quite possibly be fatal.
anyone who would like to could bring a herbal medication up to market standard and licence it (within reason) but it costs millions to do that and requires controlled trials for it to have any hope of being accepted and passing licensing.

 

[SilverLinings]

As Redders said, the veterinary profession is based on scientific reasoning, testing and licensing. A few clients saying X worked to fix disease Y in their pet is not any kind of proof that X works, it could be coincidence rather than causality. Drugs are unable to be licensed until they have undertaken controlled studies with annonymised/blind data to avoid any bias, and have shown through such studies that they are both safe and effective (and effective in a significant number of cases). The positive outcome of a drug must outweigh any possible negative side affect. None of this has been tested in the vast majority of herbal and other alternative remedies. There is also no data with many herbs about how they may work in different species and/or interact with other medications that your pet is also taking.

Until someone undertakes rigorous trials using different herbal remedies on different species with different diseases it is very unlikely that vets will recommend them to clients as there is simply no scientific evidence that they work, and no clear knowledge of whether they may cause harm. Vets have to put the welfare of the animal first so will only offer treatment (under prescription or otherwise) that has been scientifically proven to work.

A huge number of prescription medications for both humans and animals are based on compounds found in plants, and the major drug companies regularly send out expeditions to remote places such as South America to look for new plants to test for medicinal properties. They also look into plants that the local communities use as medicine, and test them to see if there is actually any benefit, and if there is then the active compound eventually goes through trials and then is submitted to the licensing authorities.

 

[Clodagh]

I always go with vet recommendations myself, so all vets I am onside.
I think herbals have a place and are a good start with, for instance, a stiff dog, but I don’t think they are a substitute maybe a support.

 

[Boulty]

It's complicated... Prescribing laws state that if a licensed version of a product exists then that must be used in preference of an unlicensed version (or you'd better have a damn good reason like the licensed product being OOS... Owner can't afford is generally not seen as a good enough reason by the legislators). That said if the vet in question also has an interest in herbal medicine / other nutraceuticals I believe they are allowed to advise which may be helpful to use alongside prescription medications. A lot of these things obviously don't have the research & clinical trials behind them so they may or may not work or be helpful (just nobody has invested the money to prove it to the required standard / in some cases the evidence is there but nobody has decided to manufacture a version for that species yet). Herbs & natural products can cause harm at the wrong dosage/ if they interact badly with other medications or if the animal had certain medical conditions so would be cautious of using in such cases without consulting someone who knows what they're doing.

 

[GSD Woman]

Both of these. Most vets, for example, would probably not know that mucuna is used in the East to treat humans with Parkinsons, and can be used as an alternative to Pergolide, which is also effective against Parkinsons, but was withdrawn from human use due to heart valve damage.

But if they did know about mucuna, they couldn't legally prescribe it, I believe, because a drug tested on horses, Prascend (pergolide) exists and they must prescribe the approved tested drug.

Late to the party here but, in parts of the USA, vets will offer clients off label usage. Smart vets will also get clients to sign a release.