Effectiveness of Homeopathic Medicine in Canine Urinary Incontinence: Outcomes of Owner Response Survey

Introduction

Urinary Incontinence (UI) in pets continues to be a common challenge socially, and financially [1]. Despite the availability alpha-adrenergic agents, mainly phenylpropanolamine hydrochloride the challenge remains about extremely high costs, risk of disability [2] and limited efficacy in causes other than post neutering, such as ectopic ureters and prostatic cyst, spinal arthritis and following severe spine trauma. Hence, UI is among the common causes of request for Euthanasia [3]. Hence, the concerns of availability of wide-spread therapy, cost and risk of disability still prevail. In UI, the complementary and alternative medicine (CAVM), including homeopathic medicines appear promising in addressing these concerns [4, 5, 6]. CAVM defined as a group of heterogenous medical methods whose principles diverge from the current veterinary practice [4], is a common term used by the group of practitioners who consider this side of medicine as having no acceptable place within conventional medical parameters [5, 6]. However, as observed, many randomized studies reveal the effect of various homeopathic medicines in various conditions of pets (mainly dogs and cats), horse and farming animals [7]. Subset-based evidence of homeopathy improving UI from a large canine and feline study by Mathie, et al. [5], and study by Farrington, et al. [8] represent positive effects of both single and combination homeopathic medicine in UI in a peer sample panel study.

Use of Survey as Research Method

Current practice of evidence generation on veterinary science includes isolated internet-based Prospective animal-owner’s observational surveys. These surveys have clearly traceable activity logs; hence are useful to collect un-biased, voluntary, and realistic responses without psychological effects such as Hawthorne Effect commonly found in randomized studies. In addition to the traceability from internet, the STROBE-Vet is a useful methodology for transparent and effective reporting if the risk of various types of biases that arise from duplicates, selection, dropouts and social desirability are mitigated, especially in cases of social and financial concerns such as UI. This study was a survey- based observation of efficacy of Leak No More combination homeopathic medicine in canine UI.

Lebeau’s Original Findings

Lebeau’s eventual conclusion: The age of a dog of one year is equivalent to a human being a 15 years; a dog of two years to a human of 24 years; and from the age of two years, each year of a dog’s life is equal to four human years. Subsequent studies sought to disaggregate this data further, by size, weight, and breed. Ref https://priceonomics.com/ the-mythology-of-dog-years/ To show a more realistic human age equivalent a site was used https://www.ajdesigner.com/fl_dog_age/dog_age.php Which worked on the LeBeau model but also integrated modifications for the initial rapid Human Equivalent aging of canines and feline during their first two years of life along with variations between breeds and the difference of specific breeds such as beagles? I am grateful for the permission to replicate his work here from Jimmy Raymond of AJ Design Software [14, 15].

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Correlation and Failure Analysis

While the flat results were majorly in favour of the investigational medicine, the analysis of failed and succeeded therapy with age of the animals was the one where most correlation analysis was required [17]. However, considering the diversity of age of the animals by breed, comparison was not feasible by age alone. Hence, analysis of correlation was used as the parameter for correlation of success and failure. In addition to ensure that the analysis is correctly benchmarked, pertaining to the small sample, the obvious correlation analysis of probability distribution of correlation between “Response time to ‘Leaks No More’: "Fast (1) – Slow (5)" and “In your opinion did ‘Leaks No More’ work?” was measured. This analysis confirmed that the probability distribution is valid for correlation [18]. The low Response time was directly related with response satisfaction (P<0.005). The age equivalent probability distribution was fairly balanced. There was a direct correlation of the customer satisfaction as indicated by the response “yes” to the question “In your opinion did ‘Leaks No More’ work?” The age equivalent in the group responding “yes” was 156±110.8* (P <0.005) Roughly 66.3±14.5years in Modified HEA) as compared with 151.4±70.72* (66±9.6years in Modified HEA) (p=0.227) in group responding “no” (Figure 2) Authors Note this was using the unmodified LeBeau model on which original analysis was done but to veterinarians a 156 year old dog is just not the norm! Thus, the search for a modified Human Equivalent Age as the Dog Age to Human Age Conversion Calculator by AJ Design Software - By Jimmy Raymond. The same analysis did not reveal any relationship between the user satisfaction and weight of the animal [19].

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The next level analysis of correlation between age equivalent and owner satisfaction (response “yes”) was performed using ANOVA. This analysis was to identify whether or not the correlation on probability distribution was driven by any major outliers (Figure 3).

The analysis indicated that there was no effect of outliers on the outcome of probability distribution. The correlation of the age equivalent and user satisfaction is significant statistically (P <0.005). However, the analysis of dissatisfaction of the users with age equivalent or weight could not be established.

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Discussion

The methodology used in data collection bears some questionnaire-based similarities to a study which has revealed effectiveness of the CAVM in horses [20] This current study the subject of this paper also showed similar results to the previously published study by Farrington et al. [8] for the same condition with different data sets and from traditional paper collection rather than electronic data collection this further confirmed the action of the homeopathic formulation and also showed that electronic data collection was an effective methodology. It was also observed that the product proved effective across a wide range of routes A) direct inoculation onto a mucous membrane such as the oral cavity (in cattle application via the per-vaginal is also to a mucous membrane). B) When administered in the drinking water also and C) when administered in the food. There is anecdotal evidence of action via the parenteral routes too and this is also the authors experience in practice.

Age and Aging as Risk Factors

Among the common risk factor of UI is old age. However, in veterinary practice, definition of old age is complex due to variety of animal species and breeds. It is practically impossible to generate and use evidence of the effect of medication in each species and breed. In fact, over the actual age of the animal, relative aging with respect to breed’s median lifespan may be a better indicator to understand actual effect of the medicine. Often, just considering age as a demographic parameter may also be misleading as when age is taken as the parameter, it assumes that the lifespan of an animal is constant. However, often, the animals die before completion of study tasks, even including enrolment. Hence, stratification of risk by age stands as a challenge for effective evidence generation. Hence, Human age equivalent is a parameter of more realistic value [21]. In analysis of this survey, age and human age equivalent both are used as demographic factors.

One point of discussion is why a homeopathic product? For veterinarians who are homeopaths it seems a straightforward choice, much as acupuncture and osteopathy are to veterinarians trained in those disciplines, but for non- complementary practitioners with little or no exposure to and in most cases no understanding of homeopathy, it’s principles or action, this can be a major obstacle.

Many wonder how a medication with no chemical action can work and yet the results in this and other papers show they do. This reluctance to consider non-chemical-based therapies is reducing the options to effectively treat patients as in the previous paper by Farrington et al [8]. In that paper one data set comprised only of subjects who were non responders to conventional therapy and yet a positive clinical response was elicited despite the failure of “conventional chemical therapies” for UI. The use of non-chemical imponderable treatments such as radiotherapy, nuclear medicine, MRI, PET Scan, Laser therapy and thermography or attendance at electronic virtual training sessions are all acceptable, yet many CAM’s with papers showing repeated and verified clinical responses are ignored showing not just a bias, but also a disservice to both owners/guardians along with the animals in their care, who could despite a failure to respond to “conventional chemical therapies” may respond to a CAM treatment and as in the case of complex homeopathic formulations such as Homeopet ™ ‘Leaks No More’ are used in much the same way as conventional therapeutics for conditions such as UI there is little excuse for the belief that it requires a who new field of training [22]. To this end there are many publications and articles on homeopathic research showing positive outcomes some of which are noted in the bibliography Hahn RG. Homeopathy: meta-analyses of pooled clinical data25. In addition, there are research papers and articles published by Drs. Farrington & Smith. These cover a range of cases, conditions and trials using a homeopathic approach both alone and in conjunction with homeopathy [23].

The advantages of an approach using homeopathic complex medicines such as Homeopet™ ‘Leaks No More’ are many fold.

• Lack of chemical interactions so common with conventional medical approaches.
• Lack of toxicity. (Homeopet has recorded as required by the FDA for drugs adverse reactions both in a large range of trials and reported ADR’s (Adverse Drug Reactions) Over a twenty-five-year period and over millions of doses the levels are (In the year to October 2020 to 2021 Out of 35,000 bottles (14 million doses) there were zero ADR's Reported and this is repeated in other years) The ADR Rate against doses sold from 2017 to 2023 was 0.000005 especially when compared to chemical therapies.
• No additional metabolic burden which means no medicine induced nutrient deficiencies that are so common with conventional medications
• No metabolic component breakdown in the body which is particularly important in patient(‘s) with compromised organ(s), systems or multiple system failure which often cannot bear the additional burden of another medication even the more modern biologicals such as immunological therapies such as monoclonal antibodies, mRNA therapies, and the like. These are often given in lieu of conventional molecular drug medications. An example being an older pet with incontinence partially contributed to by arthritis, but as often in an older patient with co-morbidities such as compromised heart, lung, liver and kidney issues. These cases can suffer catastrophic complications even with a mild but common allergic reaction to even these modern therapies. Yet homeopathic medicines because of their very nature and as yet not fully understood mode of action do not adversely impact these patients and can improve their quality and extent of life by the very fact, they do not cause any of the issues outlined above. Dr. Farrington one of the authors regularly has feedback from exactly such patients that are alive and well long beyond the MST (Median Survival Time) for their condition due specifically to this lack of adverse therapeutic action and metabolic burden, a point that is so often overlooked when one has a purely limited viewpoint only considering conventional medical options, when there are viable and safer alternatives with an evidence base such as presented in this and related articles. This is particularly so with conditions such as urinary incontinence where the age and health profile often predisposes to these adverse outcomes with conventional therapeutics something which can be avoided using homeopathic therapeutic approaches integrated into the normal conventional non CAM approach especially when they are used as the first line of approach, as one of very wise professor of veterinary medicine once said “First do no harm” unknowingly echoing the words of the modern founder of Homeopathy Samuel Hahnemann.

Conclusion

The results from the online data collection confirmed and aligned with results obtained by traditional paper questionnaire data collection carried out by university-based veterinarians and regulatory authority supervised owner response paper questionnaires. This allowed us to conclude that Online Electronic Data Collection in the format used was a valid method for this and future product safety and efficacy data collection. The correlation between all three sets of data, two from the previous paper ‘Canine Urinary Incontinence successfully treated by Homeopathic Medicine: A Real- world Clinical Evidence Panel Study’ Open Access Journal of Veterinary Science & Research ISSN: 2474-9222 MEDWIN PUBLISHERS and this current data set further confirm known predisposing factors for Urinary Incontinence UI and Urethral Sphincter Mechanism Incompetence (USMI). The results, particularly when taken as a group, show that a homeopathic product can be a valid option for the treatment of UI. Finally, that the product Homeopet ™ ‘Leaks No More’ is both safe and effective in treating UI.