Treatment X

A particular drug, supplement or therapy – let’s call it ‘treatment X’ – works well. Isn’t that proof that treatment X works? This question is a good example of anecdotal evidence. You’ve probably seen this term come across before, but what is it? Anecdotal evidence is non-scientific evidence that is based on some (or a lot of) people’s experiences. In the case of treatment with a substance or a therapy, we could call it “happy customer proof”. However, to demonstrate whether a treatment works or not, these experiences are rather useless. You are never unbiased and that can easily be explained:

• No one can escape the placebo effect. Certainly not if you have already invested a lot of time, money and effort in a treatment method. Then you want to see improvement so much that it will take place. Or so it seems.
• You cannot estimate whether the health of your horse would have improved without the treatment. We usually focus on several problems at the same time. Is the improvement in your horse’s insulin dysregulation due to treatment X or did the new batch of hay that contains less sugar did the trick?
• The manifestations of a disease can fluctuate. The seasonal rise in ACTH in a horse with PPID is a good example of this. If at the end of this period you have treated your horse with remedy X, you can be mistaken and think that remedy X is to be thanked for the improvement in clinical presentation.
• It is difficult to tell the difference between suppressed clinical signs and an actual cure. Less pain does not necessarily mean that the source of the pain has been removed.
• You don’t want to disappoint the practitioner. As crazy as it sounds, we have that tendency. If the practitioner thinks to be successful when this is not actually the case, one has to be very confident to go against it.

Treatments that are truly successful provide tons of anecdotal evidence of course. But that evidence is in addition to clinical experience from veterinarians and evidence from solid scientific research. So, don’t blindly follow your friend at the stable who won’t stop raving about treatment X because it saved her horse from death. Maybe it did so; maybe not.

Treatment X is clearly working for my friend’s horse but not for mine. How is that possible?

We never treat just one aspect of the horse or its condition. The horse’s body is a complex framework in which all kinds of systems work closely together and influence each other. Intestines, blood vessels, hormonal glands, nerves … it’s all connected. Perhaps the treatment of your friend’s horse affects another aspect of the disease a bit more. Do you know all the ins and outs of nutrition, housing, exercise and hoof care that her horse receives? Is her horse of the same breed, the same sex, the same age as yours? Does her horse have the same underlying causes? Are we talking about the same type of laminitis (endocrinopathic, SIRS-related, traumatic)? After reading the six points at the beginning of this page, you may even wonder if the treatment her horse is getting really works as well as you think.

You could ask your friend to tell you what else she’s doing to help her horse. Also, ask the person who treats her horse why the same treatment turns out to be less successful for your horse. Maybe they see a difference you don’t see. If you have not already done so: find the cause, together with your vet and remove it as much as possible. Make sure that the hooves are properly and regularly trimmed and look into the benefits of hoof boots. Make an effort to improve every aspect of the living conditions of your horse. Who knows, maybe your horse will soon be doing so well that your friend will wonder how on earth that is possible.

Want to read more of these enlightening answers?
The book “The laminitis answer book : over 200 question answered” is packed with them.
Also available for download as eBook.