Friday, September 04, 2015

Figuring Out What Works - and What Doesn't

I frequently enjoy reading David Ramey, DVM's interesting articles on his website and the variety of 
 comments they evoke at his Facebook page. While I identify with Dr. Ramey's common sense approach and his feelings about the many costly yet ineffective treatments and interventions marketed to horse owners, I often can't agree with his blanket approach of throwing out any intervention which isn't totally based on published scientific study.
Equine research is expensive - ask any horse owner how quickly we can go through a huge portion of our income - and unless there is opportunity for a substantial financial return there is little incentive to run original research studies or seek FDA approval.
Unfortunately, this has led to many purveyors of products targeted to horse owners making unsubstantiated claims of effectiveness based on myth, inappropriate use of studies in other species with little or no bearing on equine health and inflation of prices on anything labeled for "equine".
Midas turns his daughter into gold
I once saw a claim by a mineral supplement manufacturer that the sodium (salt) in the supplement would be changed in the gut to potassium.  In alchemy, this is known as transmutation - and has also been known as the "Midas touch".  I would be very hesitant to purchase a supplement from a source which doesn't understand basic chemistry or digestion.
Another (well known and "trusted") manufacturer lists all the intrinsic elements of the base ingredient (flax) in their supplement. This grossly inflates the length of the "analysis" listing, even though these individual substances appear in insignificant amounts.  This makes it easier to justify their high cost and may falsely lead someone to believe they're actually providing all their horse needs. (I use HorseTech for all my custom supplement needs - they list "flax" as simply "flax", not a compendium of 18 or more substances that are intrinsic to flax and not added by them.)
Cross-species extrapolation can be a valuable research tool but needs to be validated in the target species, not just assumed that what is good for one is good for another.  Look at Xylitol - an artificial sweetener which can help reduce cavities in humans but can be a life-threatening toxin to dogs.
One way to validate is by extensive field trial, which has been successful in helping to establish the protocols used by the ECIR Group with Insulin Resistant and Cushing's horses.
Horse owners can objectively validate the usefulness and success of a supplement, feed, medical treatment or alternative intervention by tracking clinical signs, along with taking quality photographs and videos.  Some time ago I developed a simple Clinical Signs Tracker which you can use to observe and track changes in your horse.
You should be specific in defining what you're trying to fix (which requires a proper and specific diagnosis), tin understanding how the intervention (supplement, medicine, treatment, etc.) is supposed to address the issue and how quickly the intervention is expected to resolve or improve the issue. For example, an intervention for ulcers (medical treatment, stress management, changing feeding management) should take your horse from a "3" to an "7" or "8"on the Attitude scale fairly quickly - often within a week, while adjusting the diet for improved hoof quality can take upwards of three months to see significant results and a full hoof growth cycle or more to completely resolve hoof problems.
This won't work if you're looking for a magic bullet but can be very useful in determing if the medication or laser treatment or expensive supplement actually made a difference or just lined someone's pocket. Depending on the intervention, you might track and photograph only on a weekly basis, while for something like wound healing, daily photos - at least initially - might be helpful.
The best reward? Someone asking "When did you get a new horse?" and having the documentation and photos to show your hard work paid off.

With best regards,

Patti
in warm, wet, cloudy Vail AZ

Links
http://www.doctorramey.com/if-you-see-results-what-else-is-there-to-say/
https://www.facebook.com/DRRameyDVM
‪https://www.dropbox.com/.../Clinical%20Signs%20Tracker...‬
http://ecirhorse.org
http://www.horsetech.com