STUDY OF THE EFFECTIVENESS OF HOMEOPATHY IN DOGS AND CATS
* Veterinary Doctor
In September 28, 2005, we initiated a volunteer work on Liga Homeopática do Rio Grande do Sul, in Porto Alegre, Brazil, directed to the treatment of chronic diseases and behavioural disorders in dogs and cats, prioritizing the care of pets of needy population. At the same time, we develop a research paper, where all clinical cases were appropriately documented, including in video. Our proposal was always prioritize the quality in the attendance of patients, even at the expense of a larger number of patients serviced. This work formed the basis for our study of effectiveness of Homeopathy in chronic diseases and behavioral disorders in dogs and cats, that we develop until November 19, 2013, totalling eight years of study.
Due Homeopathy have a differentiated conception of conventional medicine, there is great difficulty in establishing a dialogue between the homeopathic model (with its peculiarities) and classical science, imposed by the limitations arising from the preparation of clinical study designs that encompass the methodological fundamentals of last. In addition to trying to minimize the obstacles arising from different conceptions, this clinical research aims to contribute to demonstrate the efficacy of homeopathic treatment in veterinary medicine, aiming to present scientific evidence of the effectiveness of Homeopathy in the treatment of chronic diseases and behavioural disorders in dogs and cats.
HOMEOPATHY AND PLACEBO EFFECT
It is considered as placebo effect the occurrence of improvement symptomatic and/or of organic physiological functions arising from stimuli supposedly nonspecific and inert, being correlated, in general, to symbolism that the treatment represents in the expectation positive of patient. Even being present in any kind of interference therapeutic, the medical class tends to give to the placebo effect a derogatory meaning and undesirable, being common consider this psychological therapeutic effect (placebo effect) as the only plausible explanation for the clinical efficacy of homeopathic treatment (TEIXEIRA, 2008).
However, the present study of the effectiveness of treatment by Homeopathy in animals suffering from chronic diseases and behavioral disorders, aims to demonstrate that the explanation of action of homeopathic medicine cannot be based exclusively on the placebo effect, since this "psychological therapeutic effect" proportionate by the symbolism that the homeopathic treatment would represent in the expectation positive of patients would be negligible, because they are canine and feline patients.
OBJECTIVES OF THE STUDY
Demonstrate that the treatment by Homeopathy offers highly satisfactory results, what is evidenced when comparing the results presented by the homeopathic treatment with the results presented by the conventional allopathic treatment and/or period prior to treatment by Homeopathy. Therefore, we aimed presenting the proposal for a study with the purpose of demonstrating, in a clear and objective manner, the effectiveness of treatment by Homeopathy in dogs and cats suffering from chronic diseases and behavioral disorders, in addition to aspire to an approximation to the classic scientific model.
MATERIAL AND METHODS
The sample consisted of canines and felines patients served by the author on Liga Homeopática do Rio Grande do Sul, in Porto Alegre, Brazil, between September 28, 2005 and November 19, 2013.
The patients were divided into four groups:
GROUP I - Includes all patients who underwent an first assessment. Note: it is considered first evaluation in that the patient underwent anamnesis and clinical examination, according to the homeopathic principles and that, moreover, has been carried out a first prescription.
GROUP II - Includes patients who were evaluated for a period equal or higher than six months of treatment.
GROUP III - Includes patients who were evaluated in a period of less than six months of treatment.
GROUP IV - Includes all patients who got the treatment sequence, passing, at least by a reassessment (includes the groups II and III).
All patients were treated with homeopathic medicines administered orally in sucrose globules, handled in homeopathic pharmacies of recognized credibility. The scale used was the Centesimal Hahnemanniana and dynamization of homeopathic medicines prescribed ranged between 4CH and 200CH. Was administered a single homeopathic medicine by outlet, at a dose of 1 to 5 globules.
For the implementation of the medication prescription was used methodology based on a certain homeopathic current, according to the patient's clinical evaluation, having by goal its individualisation, taking into consideration its symptomatic feature entirety, as well as its clinical picture and general condition, represented by presence or absence of organic lesions and/or emunctoriais locks.
Before the beginning of the homeopathic treatment was recommended to owners of patients follow fully the guidelines established by the veterinarian responsible for the clinical care of the patient in question and/or another specialty. Was also requested those responsible by their patients to sign a liability waiver, consenting fully with this research paper.
Were included in the study patients belonging to groups II, III and IV, i.e. all patients who got the treatment sequence, passing, at least for a reassessment.
The comparative study between groups I and IV aims to show the rate of abstention on the continuity of treatment (patients who underwent an initial assessment and without having treatment sequence), in addition to the caractererísticas of the owners of their patients, as to their age group.
The study included patients who underwent an first assessment until the date of April 2, 2013.
It was established to evaluate the outcome of patients during treatment by Homeopathy in the following aspects:
* Clinical diagnosis related to the chief complaint (reason why the owner sought homeopathic care).
OPTIMUM: cure or asymptomatic for significant period.
GOOD: significant decrease in the degree of intensity of symptoms and/or decrease the frequency or intensity of crises, without need to use conventional allopathic medicines, during the period of treatment.
REGULAR: significant decrease in the degree of intensity of symptoms and/or decrease the frequency or intensity of crises, with necessity of use of a smaller number of conventional allopathic medicines or in lower dosage during the period of treatment.
UNSATISFACTORY: absence of significant improvement during the period of treatment.
** Presentation of significant improvement with regard to the quality of life (criteria to evaluate the quality of life: happiness, disposition, liveliness, sociability, playfulness, sleep quality, etc.).
*** Presentation of significant improvement compared to conventional allopathic treatment and/or period prior to homeopathic treatment.
**** Presentation of significant improvement as for the behavioral symptoms.
***** Presentation of significant improvement as for the organic symptoms.
The patients evaluated in the study were classified as follows:
A - Carriers of behavioral disorders.
B - Carriers of behavioral and organic disorders.
C - Carriers of organic disorders.
As for the assessment of the evolution of the clinical condition that prompted the consultation (diagnosis related to the chief complaint), it was considered, in addition of clinical improvement (and, eventually, laboratory), the inherent and specific phenomena related to homeopathic treatment, dependent of intrinsic factors on the patient (represented by its genetic and hereditary character, organic condition, period of involvement of the disease in question, age, etc.), phenomena that would reveal a probable indication that the patient would be directed to a growing degree of stability and/or a possible cure.
DISCUSSION AND COMMENTS
Drew attention the high percentage of drop out after the first evaluation (26/77, or 33,77%). One of the features of this group is the lower age range of the patients ' owners, when compared to the age group of owners who gave the sequence to the treating of your pets (average of 46,08 years, against 55,24 years of Group II, 51,76 years of Group IV and 48,42 years of Group III). One of the hypotheses for this fact lies in immediate expectation of owners, deriving of relations increasingly fast and superficial of contemporary world, that brings in a significant decrease in patience to collaborate with the methodology employed, absence of a greater interest in understanding the concepts and phenomena related to homeopathic therapeutic system, which aims to provide consistent and positive results in the medium and long term (in the case of conditions of chronic character, which is the aim of this study), being the same possessor of a differentiated conception and, for the most part, strange and unknown to the general public. Other hypotheses for the high percentage of drop out after the first evaluation are related to lack of empathy with the homeopath, lack of confidence in the work of the same, discredit and mistrust related to Homeopathy, frustration in expectation of the owners (by the occurrence of medium and long-term results), obstacles caused by conception different of homeopathic therapeutic system , incompatibility of dates available to attendance between professional and owners of patient, in addition to other possible factors not yet identified.
In function of Homeopathy have a peculiar conception, that It aims to individualize the patient and evaluate it in its entirety, the treatment of chronic diseases and behavioural disorders in dogs and cats by Homeopathy requires a period followup longer, through periodic revaluations, in order that be made the required adjustments in medication prescription. This makes the clinical and behavioral effects of homeopathic treatment more evident, what is evidenced when comparing the results presented by the group II (composed of patients evaluated in a period equal to or greater than 6 months of treatment) with the group III (composed of patients evaluated in a period less than 6 months), in that patients who were evaluated in a longer period of time (group II) present a clear advantage in relation to the effectiveness of treatment, when compared to patients evaluated over a period of time bottom (group III).
Evaluating the results presented by patients included in group II, it is observed that, of the total of 25 patients canines and felines, 24 (96%) received evaluation "Optimum" (14/56%), "Good" (6/24%) or "Regular" (4/16%), regarding the assessment of the effectiveness of treatment by Homeopathy related to clinical diagnosis associated with the main complaint (reason of looking by homeopathic treatment), while only 1 patient (4%) received evaluation "Unsatisfactory“. The same absolute figures and percentages were achieved on the issues, both of the improvement of patient's quality of life during treatment by Homeopathy, as occurrence of significant improvement of the patient in relation to conventional allopathic treatment and/or period previous to homeopathic treatment (24/96% yes, 1/4% no). It is important to consider that of the 24 patients with behavioral disorders before starting the homeopathic treatment, 23 (95.83%) achieved significant improvement in relation to behavioural symptoms, whereas, of the 24 patients who presented organic disorders, 23 (95.83%) achieved significant improvement in relation to physical symptoms, during the evolution of treatment by Homeopathy.
When examining the results presented by 51 patients canines and felines included in group IV (that is, all those who underwent the treatment sequence), it is observed that 42 patients (82,35%) received evaluation "Optimum" (20/39,21%), "Good" (12/23,53%) or "Regular" (10/19,61%) while only 9 patients (17,65%) were evaluated as "Unsatisfactory", as to effectiveness of treatment by Homeopathy related to clinical diagnosis associated with the main complaint (reason for looking by homeopathic treatment). Noteworthy is also that 44 patients (86,27%) of this group showed significant improvement with regard to the quality of life, while only 7 (13,73%) failed to obtain improvements in this sense. In relation to have or not significant improvement, when comparing with the conventional allopathic treatment and/or period prior to homeopathic treatment, 42 patients (82,35%) showed improvement, while 9 patients (17,65%) not exhibited improvement in this aspect. Note also that of 44 patients with behavioral disorders prior to the start of the homeopathic treatment, 39 (88,64%) showed significant improvement in symptoms of behavioral sphere, while of 46 patients who presented organic disorders, 41 (89,13%) showed significant improvement related to symptoms of organic nature, during the period of evolution of treatment by Homeopathy.
It is observed results substantially lower with regard to the evaluation of the effectiveness of homeopathic treatment in relation to the group III (composed of patients undergoing a evaluation period less than 6 months of treatment). Of the 26 patients canines and felines in this group, 18 (69,23%) received evaluation "Optimum" (6/23,08%), "Good" (6/23,08%) or "Regular" (6/23,08%), while 8 patients (30,77%) received "Unsatisfactory" assessment, as for the evaluation of the effectiveness of treatment by Homeopathy related to clinical diagnosis associated with the main complaint. As to the quality of life, 20 patients (76,92%) showed significant improvement, while 6 (23,08%) not presented. As to the question of whether or not significant improvement compared to conventional allopathic treatment and/or period prior to homeopathic treatment, 18 patients (69,23%) showed improvement, and in 8 patients (30,77%) were not observed improvements in this regard. While 16 (80%) of the 20 patients who presented behavioral disorders have obtained significant improvement regarding the symptoms of this order, 18 patients (81,82%) showed significant improvement related to symptoms of physical order, of the total of 22 with organic disorders prior to the start of the homeopathic treatment.
If, on the one hand, the analysis of the results shows that patients undergo a greater treatment period (group II) had a greater degree of effectiveness, at the same time it is observed that patients undergoing a shorter treatment period (group III) also presented effective results, despite revealing a degree of lower efficacy when compared to patients in the previous group. This fact shows that the treatment of chronic diseases and behavioural disorders in dogs and cats by Homeopathy can provide effective results (or, at least, start a movement in this direction), in a short period of time.
Starting from the premise that the placebo effect in animals is insignificant (for allegedly do not they are fully aware they are being treated, nor receiving a medical veterinarian care differentiated and "humanistic" - own of the doctor-patient relationship of homeopathic treatment in humans -, what no would cause in a positive psychological effect, related to the symbolism that this "differential" treatment would provide in expectation of improvement in such patients), the high percentage of improvements related to clinical diagnosis associated with the chief complaint (reason for seeking homeopathic treatment), quality of life of patients and comparison with conventional allopathic treatment and/or period prior to homeopathic treatment, besides of significant improvements related to behavioral and organic symptoms concomitant, demonstrates be the homeopathic medicine endowed with real and consistent therapeutic potential, distancing himself, so, of the assumption that it wouldn't pass of an inert substance and null in relation to its therapeutic content, acting only on a psychological level. In this way, the highly satisfactory results achieved in the medium and long term, for this study of efficacy of treatment of chronic diseases and behavioural disorders in dogs and cats by Homeopathy demonstrates, a way clear and indisputable, be virtually impossible to justify the action of the homeopathic medicine exclusively by placebo effect. Thus, one should look for other explanations, whether theoretical or originated from scientific research, for the action of homeopathic medicine, since the treatment of chronic diseases and behavioural disorders in dogs and cats by Homeopathy proved to be highly effective, according to the results indicated by this study (we suggest reading the article "Alguns comentários sobre a ação do medicamento homeopático", of this same author).
The high incidence rate of significant improvement, not just related to symptoms associated with the clinical diagnosis concerning the chief complaint, but, also, as to the quality of life and other symptoms, both behavioral character and/or organic presented by patients, corroborates, expressively, the concept of integral and globalizing treatment, inherent in homeopathic therapeutics. In this way, this therapeutic system, in view of its particular conception, it is proposed to address and treat the patient in its entirety (in your mental/behavioral aspect, general and physical) and not specifically the disease presented by same (that is usually the reason for the search by treatment), bringing, as a consequence, the improvement not only of symptoms related to the diagnosis of chief complaint, but of other symptoms presented concurrently by the patient; these symptoms are fundamental to the configuration of the feature image presented by sick and for choosing homeopathic chain (with its own methodology) best suited to treat him, which induces to its individualisation, since the treatment by Homeopathy is specific to each patient.
With a differentiated conception, which seeks to understand and treat the sick, and not only the disease that he presents, approaching it in its entirety and seeking their individualization, Homeopathy qualifies on condition of therapeutic system able to add a high degree of safety, efficacy, effectiveness and efficiency (TEIXEIRA, 2008) to the conventional veterinarian treatment, providing health, well-being, happiness and quality of life for animals, according to the results of the present study.
From the presentation of the results of this study, we have the ambition to contribute to that more work of study and research in Homeopathy are made, in order to demonstrate the efficacy of Homeopathy as a therapeutic system, who uses evidence-based principles.
This study concludes in a clear, logical and objective manner, that there is a strong indication that the clinical effects of Homeopathy are clearly superior to the placebo effect, in the light of the results achieved by the homeopathic treatment in dogs and cats suffering from chronic diseases and behavioral disorders, since most of the patients evaluated after treatment by Homeopathy showed sensitive clinical and behavioral improvements, compared to the period prior to homeopathic treatment, in which it was used or not conventional allopathic medication. Therefore, it would be necessary seek other explanations, not based upon the placebo effect, for the action of homeopathic medicine, that would justify the high percentage of effectiveness of treatment by Homeopathy of patients canines and felines suffering from chronic diseases and behavioral disorders.
Porto Alegre, may 2014.
For more information, we suggest reading of "Estudo da eficácia da Homeopatia no tratamento de doenças crônicas e distúrbios comportamentais em cães e gatos", of this same author.
Dr. Celso Affonso Machado Pedrini
ARENALES, Maria do Carmo. Sintomas Mentais dos Animais Domésticos (A visão homeopática fazendo ponte entre o psiquismo animal e humano). São Paulo, Ed. Mythos, 1995.
BEAVER, Bonnie V. Comportamento Canino. Um Guia para Veterinários. São Paulo, Ed. Roca, 2001.
BEAVER, Bonnie V. Comportamento Felino. Um Guia para Veterinários. 2ª ed. São Paulo, Ed. Roca, 2005.
CARILLO JUNIOR, Romeu et al. Estudo de Eficácia do Tratamento Homeopático Versus Tratamento Alopático em Pacientes Portadores de Transtornos Decorrentes do Tuberculinismo Infantil. Homeopat. Bras., vol.9, nº1, 2003.
CARILLO JR., Romeu. Fundamentos de Homeopatia Constitucional. São Paulo, Ed. Santos, 1997.
CARILLO JR., Romeu. Homeopatia, Medicina Interna e Terapêutica. São Paulo, Ed. Santos, 2000.
FENNER, William R. Manual de Prática Clínica Veterinária. Rio de Janeiro, Ed. Guanabara Koogan, 1985.
GÓMEZ, Juan Agustín. A Homeopatia na Vida de Nossos Animais. Rio de Janeiro, Ed. Luz Menescal, 2005.
GOUGH, Alex & THOMAS, Alison. Predisposições a Doenças de Acordo com as Diferentes Raças de Cães e Gatos. São Paulo, Ed. Roca, 2006.
HAHNEMANN, Samuel. Organon da Arte de Curar. 6ª Ed. São Paulo, Ed. Robe, 2001.
HORWITZ, Debra F. & NEILSON, Jacqueline C. Comportamento canino & felino. São Paulo, Ed. Artmed, 2008.
KENT, Jame Tyler. Homeopatia Doctrina. Caracas, Universidade Central da Venezuela, 1986.
KIRK, Robert W. Atualização Terapêutica Veterinária. Pequenos Animais. São Paulo, Ed. Manole, 1984.
LATHOUD. Matéria Medica Homeopatica. Buenos Aires, Ed. Albatros, 1991.
MASI-ELIZALDE, Alfonso. Homeopatia. Teoria e Prática. Rio de Janeiro, Ed. Luz Menescal, 2004.
MEDIO, Horacio De. Introduccion a La Veterinaria Homeopatica. Buenos Aires, Ed. Albatros, 1993.
MINOTTI, Angel Oscar. Traumatismos, Heridas, Complicaciones y Secuelas. Buenos Aires, Ed. Albatros, 1990.
MULLER, George H., KIRK, Robert W. & SCOTT, Danny W. Dermatologia dos Pequenos Animais. 3ª ed. São Paulo, Ed. Manole, 1985.
RIBEIRO FILHO, Ariovaldo. Repertório de Sintomas Homeopáticos. São Paulo, Ed. Robe, 1995.
SAMPAIO, Antonio. Homeopatia em Medicina Veterinária. Curitiba, Ed. El Erial, 1995.
SOUZA, Heloisa Justen M. de. Coletâneas em Medicina e Cirurgia Felina. Rio de Janeiro, Ed. L. F. Livros de Veterinária, 2003.
TABER. Dicionário Médico Enciclopédico. 17ª ed. Barueri-SP, Ed. Manole, 2000.
TEIXEIRA, M. Z. Pesquisa clínica em homeopatia: evidências, limitações e projetos. Pediatria (São Paulo) 2008; 30(1): 27-40.
TILLEY, Larry P. & SMITH JR., Francis W. K. Consulta Veterinária em 5 Minutos. Espécies Canina e Felina. 2ª ed. Barueri-SP, Ed. Manole, 2003.
TYLER, Margaret L. Retratos de Medicamentos Homeopáticos. Vols. I e II. São Paulo, Ed. Santos, 1992.
VANNIER, Leon & POIRIER, Jean. Tratado de Matéria Médica Homeopática. 9ª ed. São Paulo, Ed. Andrei, 1987.
VIJNOVSKY, Bernardo. Tratado de Matéria Médica Homeopática. Vols. 1, 2 e 3.