The Conflation Game - How Misunderstanding the Differences Between Homeopathic and Natural Remedies can Cloud our Thinking

Homeopathy and natural and herbal medicines are not the same thing, but they are often conflated - mistakenly seen as two parts of a single concept.  In this blog, I'll explain the differences between homeopathy and natural medicines, and then discuss why getting clear on these differences is important for making ethical decisions about how we treat our dogs. 

What is Homeopathy? 

Homeopathy was invented in Germany in the 19th Century, by Samuel Christian Friedrich Hahnemann.  He believed that illnesses ought to be treated by restoring the patient�s �vital force�. 

The first principle of homeopathy is that "like cures like". If your dog has a fever, you should treat him with something that is also known to cause fever, in order to balance out his "vital forces". If the dog is itching, we should treat him with something that causes itching, and so forth.

The second principle of homeopathy is that the potency of an ingredient is increased the more times it is diluted using a special shaking method. This is based on the idea, roughly speaking, that "water has a memory". In practice, this means that some homeopathic preparations contain a handful of molecules of the active ingredient listed on the bottle. Some have been shown to contain, on average, less than one molecule - nothing at all that could work, even if the principle of "like cures like" made sense. 

We should all hope that water doesn't have a memory, at least not in the sense of being able to cause effects in the body because of what it "remembers". I wouldn't want memories of velociraptor pee, elephant tears and spawning trout to get into my glass of water!

From xkcd.com

What are "natural medicines"?

Using plants, animals, and fungi as medicine is a practice as old as human civilization itself. Even our companion animals have been said to administer natural remedies to themselves - most people believe that dogs eat grass to induce vomiting or settle their stomachs somehow, although this is disputed!

Natural remedies are also supposed to contain significant and measurable amounts of their active ingredient.  To make a natural remedy, the drug company takes the plant source, treats it to make the active ingredients available, and then encapsulates the desired dosage of the ingredient into a deliverable form, like drops or a pill.

Information about which chemicals found in nature are good for which ailment has come down from a variety of sources - different cultures, experiments and so on. This means there is no single underlying principle, like the homepath's "like cures like", determining which substances to use.

Some systems, like ayurveda and naturopathy, are based on beliefs that are as far-fetched as homeopathy, involving mysticism and other spiritual practices, so consumers should take care that they are informed about the reasoning behind the claim that such and such a herb will cure something.  However, it is possible to use natural remedies without subscribing to magical thinking.

The data on whether natural remedies for dogs are effective is patchy, which is something I have discussed in an earlier article.*  However, whether you believe a particular remedy or formulation is effective or not, at least nothing in principle rules out some remedies being effective.  We don't have to give up on commonsense beliefs, like water just being water.

Why does it matter?

The reason this is important is that studies have shown homeopathic preparations not to be effective. There is ample scientific proof that the principles of homeopathy are unsound, and that medications based on those principles are ineffective.  

In contrast, many preparations derived from natural sources like fungi and plants are effective.  Many poisons and recreational drugs are obtained from nature's larder, as well as more conventional remedies.  There are issues around just how safe and effective commercial natural remedies are, as the recent story about unsafe herbal medicines for humans shows, but the principle that a dose of a chemical derived from a plant, animal or fungus can treat or cure diseases in dogs makes sense. 

The difference in potential for efficacy is one reason why we should be clear about getting the distinction right.  Homeopathy simply cannot work.  Natural remedies could work, even if some of them don't.  In arguments, conflating homeopathy with natural medicine leads advocates of homeopathy to give critics a false dichotomy.  Either they accept that "alternative medicine" works, or they should reject the fact that many medicines derived from plants are well known to work, and even prescribed by "allopathic" doctors.  If you've been prescribed St John's Wort for depression, or peppermint oil for digestive discomfort and you've felt any benefits from them, you "have to" believe in homeopathy too.  As we've seen, this is clearly not the case.  I can keep downing my peppermint oil capsules every time I eat Indian food whilst simultaneously claiming that all homeopathic products are useless and should be removed from drugstores.  There's no incoherence in this position once we get clear on the distinction.  "Alternative medicine" encompasses everything from herbal supplements to crystal healing, and there's no need to believe in all of it or none at all. 

Another reason is that if we equate homeopathy with naturally-derived supplements like Zylkene or Anxitane for our dogs, and we want to try these supplements, we might automatically assume that we should see a "homeopathic vet".  This is not the case.  Many "allopathic" vets and veterinary behaviorists are knowledgeable about supplements like Zylkene and Anxitane, indeed many will sell them to you without prescription.  They are also widely available online and in pet stores, so there's no need to give up on your family's vet.

When we are looking at supplements, it is because our dog has a problem and is suffering.  If a dog is suffering, the most ethical thing to do is choose those options that have the best chance of working.  There is a lot of evidence that homeopathy doesn�t work, and as we have seen, the principles it is based on don�t fit into common sense or science.  Natural remedies, by contrast, at least could work, so if you have a commitment to trying over-the-counter remedies, it seems ethical to choose the path with the most chance of having some effects.  Conflating homeopathy and natural medicine is inaccurate, and it gives homeopathy false credibility.

* SkeptVet blog has also generated a lot of information on natural supplements for dogs, a list of articles can be found here.

Shock Tactics: Why Banning E-Collars is a Poor Solution to the Problems in Dog Training.

The use of electronic collars ("e-collars") is one of the most divisive issues in world of dog training and welfare.  The collars are already banned from sale and use in some countries, particularly in Europe, and recently they have been banned in Wales, which marks the first ban in an English-speaking country.  Both sides of the debate over e-collars are entrenched, and vociferous in their criticism of the other. Those in favor of the ban claim that e-collars are "barbaric" and those who use them are de facto animal abusers. Those against claim that their opponents have a sentimentalized view of dogs, seeing them as babies to wrap in cotton wool, and that they lack adequate knowledge of how the collars are supposed to work.  

Tools designed to be painful or frightening to dogs should never be used as a first-line approach in behavior modification.  This is the position of the AVSAB, the IAABC, and the CCPDT. For that reason, I believe that shock and prong collars should not be widely available in pet stores or online. They should not be as easy to pick up as a bag of treats, and we should work to make them less available by lobbying wherever they are sold. But banning them entirely won't work. 

I am going to argue against calls from the UK Kennel Club, among others, to place an outright ban on the sale and use of e-collars.  This does not mean I am arguing in favor of their use - I have never used an e-collar on my dog, or anyone else's. I am merely arguing that banning a piece of equipment as an attempt to change the way dog trainers operate would be a mistake. 

Practicalities 

Obviously, electronic collars are not the only way to cause physical suffering to a dog.  Other kinds of corrective collar are not covered by the proposed ban by the UK Kennel Club.  Kicking the dog is not covered by this ban.  By delivering a short, sharp sensation to the dog, e-collars are more likely to be associated with the undesirable behavior.  To contrast, jerks on pinch collars, alpha rolls and kicks in the ribs are less easy to get the timing right and more likely for the dog to associate with the owner or trainer as well as, or even instead of, the behavior.  By focusing on one item, the "ban the shock� lobby risk taking the best tool out of the compulsive trainer�s toolbox, making room for things that are more invasive and more unpleasant.  They are not addressing the underlying issue, which is, I will argue, that dog training remains an unregulated profession.  

An Ideal World 

The lobbyists often claim that no dog "needs" to be trained using positive punishment.  Any dog - every dog - could be successful with non-compulsive methods, and now that the information on how to use these methods is widely available, there is no excuse for using any other technique.  They point to listings of force-free trainers and organizations like the Pet Professional Guild, as well as all the online resources owners have at their disposal, and argue that because these exist, no dog ought to be subjected to any other kind of training than completely force-free. At the present time, however, such claims amount to utopianism. 

There are still parts of many countries that are not covered by force free trainers at all, and there are places where dogs need training outside a home or class environment, like dog shelters, who do not have access to skilled, experienced force-free trainers for whatever reason.  In real life, compulsive trainers who use e-collars might still be the only option for some people and dogs, if those trainers are the only ones who are accessible.  Taking away their e-collars is not going to provoke some kind Damascene moment of conversion to clicker training; it's more likely to lead to a fall back on more aggressive, more violent techniques.  Not all owners are capable of training their own dogs, especially for difficult or dangerous issues like predatory drive and aggression.  Expecting owners to train their own dogs using methods they are not skilled in is not only unfair, it's potentially dangerous.  

Banning e-collars doesn't change these realities, it merely makes force-free trainers look like they�re doing something.  Just because "something must be done" and you are doing something, doesn't mean you are doing what must be done!

Positive Punishment within a LIMA Framework

Force-free lobbyists often use emotive language in their arguments.  The Kennel Club even refers to e-collars as "barbaric".  We should remember, however, that the use of positive punishment can be a part of the LIMA (Least Invasive Minimally Aversive) approach, widely considered to be the standard of best practice in the ethics of dog training.  LIMA is a principle to guide decisionmaking about which approach to take to achieve a training goal.  It is most commonly, although not necessarily, related to the Humane Hierarchy.  If no other approaches are possible given the trainer's ability and the dog's specific problem, and if the training goal is required for safety, then neither the LIMA approach nor the Humane Hierarchy rules out the use of an e-collar or other method of delivering positive punishment. 

The Association of Pet Dog Trainers, and International Association of Animal Behavior Consultants� position statement on LIMA makes this point clearer:

LIMA requires that trainers/behavior consultants work to increase the use of positive reinforcement and lessen the use of punishment in work with companion animals and the humans who care for them. LIMA protocols are designed to be maximally humane to learners of all species. In order to ensure best practices, consultants/trainers should pursue and maintain competence in animal behavior consulting through education, training, or supervised experience, and should not advise on problems outside the recognized boundaries of their competencies and experience.

Competence is the most important factor in dog training.  We need trainers with a flexible set of skills and a commitment to continuing education.  But we should take something else from this statement too: trainers have different competences and the LIMA approach does not mandate any particular technique, only that the technique is the least invasive and minimally aversive given the situation.  This includes the owner�s abilities, the dog�s temperament and issues, and the trainer�s skills. 

Regulation, Regulation, Regulation

A much better solution than banning e-collars - or any other tool - would be to make dog training a regulated profession.  I�ve made some arguments about this in a previous post.

Ian Dunbar famously said:

To use shock as an effective dog training method you will need:

• A thorough understanding of canine behavior;

• A thorough understanding of learning theory;

• Impeccable timing.

And if you have those three things, you don't need a shock collar. 

If this is true, then making sure that all dog trainers have demonstrated their education and skills to a required level would theoretically lead to the end of e-collar use and of all compulsive training, which is really the goal of the force-free movement.  Such regulation would also make for higher-quality training of every other sort, too - many positive reinforcement trainers mistakenly believe that they "cannot do R+ wrong�.  And, on those rare occasions where trainers do feel that suppressing a behavior is the best approach, the e-collar would still be available with all the benefits it has over other corrective tools. 

In demanding that governments ban e-collars, all the force-free lobby is doing is risking the alienation of a whole group of trainers who use them, including as an adjunct to mark and reward and as part of a LIMA approach.  Until we regulate dog training as a profession, there is no way to minimize the kinds of abuse that go on behind closed doors, and we won�t be able to make progress towards regulation unless there�s widespread support among trainers in all camps.  Dog trainers would need to show that regulation has strong support, and put pressure on governments.  

Furthermore, a regulation system will only be truly fair if it is consented to by as many trainers as possible.  Getting rid of one tool and using language like �barbaric� and �cruel� to describe everyone who uses it is not a step in the right direction because it will ultimately and lead to more divisions, less willingness to co-operate and less likelihood that regulation will happen.  Instead of focusing our energy on banning tools, we should be demanding higher professional standards for the people who use them.