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Herbal Medicines in a Modern Vet Practice

What you should know

Until quite recently many vets would perhaps have said that herbal medicine has no place in a modern practice. The veterinary profession has always tended to approach herbal medicines with scepticism and distrust. There is certainly more than one reason for this and it is worth considering some of these in relation to the place of modern herbal medicine, in an age when more and more people are using alternative therapies for themselves and demanding the same for their pets. Mary Boughton of Dorwest Herbs explains.

Firstly and perhaps the most common cause for this mistrust is that most veterinary surgeons know very little about herbs, having had little training or instruction in the use of natural medicine or its place and relevance to modern day medicine, although recent reports indicate that veterinary colleges are now to include this as part of their courses.  Of course, most are aware that many invaluable drugs were originally derived from plants and that synthetic versions are in everyday use.

The obvious advantages of synthesising the active ingredient from a plant is that it eliminates variation, removes any possibility of contamination and enables accurate administration. Those trained in herbal medicine would maintain that by administering the whole plant in its natural form in the correct dose, adverse reactions and long term side effects are virtually eliminated whilst the benefits are still appreciable.  These two schools of thought, although seemingly opposed, are actually both achieving similar results and using similar drugs, whether synthetically produced or naturally occurring.

Another reason for the suspicion of herbal medicine is that many vets wrongly assume that those advocating this form of treatment expect it to be used for all diseases and conditions. No intelligent person would presume to ignore the need for surgical operations or to dismiss the plethora of effective modern drugs that are regularly and effectively used for conditions where no botanically produced alternative is or ever will be available.

The majority of drugs are not produced from botanic origins and of course they have proved their worth in treating many diseases which would have remained incurable in the past.  However, this should not mean that the botanic drugs and their plant origins should be ignored and dismissed as totally out of date.  For many chronic but not life-threatening conditions they could, and perhaps should, be the first form of treatment having proved their worth over centuries of use. The two disciplines can and do work together and not against each other, thus giving the client and patient the benefit of appropriate all-round treatment of disease.

Many people will notice that the one aspect not mentioned so far in this article is the enormous amount of money made by pharmaceutical companies and the power that they wield. Like doctors, veterinary surgeons are bombarded on all sides by companies eager to promote their products. Of course, the research and development of new drugs involves great expense and no-one with a sick animal waiting for a new drug to be developed would begrudge them their profits, but would simply be grateful for the cure. Nevertheless the herbal medicine industry is unable to compete with the large pharmaceutical companies in terms of product promotion or profits. You cannot after all put a patent on a plant !

Of course the client or pet owner, albeit unwittingly, also has some responsibility for the lack of alternative treatments available from their local vet. When an animal is presented for treatment, the veterinary surgeon wants to treat it effectively and appropriately and we, the customer, often expect that a single visit and a short course of treatment will deal with the problem.  This pressure to cure, also has a part to play in many vets reluctance to use herbal medicines.

This expectation of the 'quick fix' is something that people have become accustomed to, probably ever since the introduction of antibiotics at the beginning of this century which are so quick acting and almost magical in their effects.  Perhaps all of us, as dog owners, should reduce our demands, accept sometimes slower results and thereby allow our vets to use alternatives when appropriate, accepting that they may be slower acting but still effective.  Licensed herbal medicines can be used with confidence - they are pure, safe, efficacious, of the highest quality and are appropriate for many of the common complaints that we visit our surgery for.  Their great advantage has always been the minimal side effects and that after all is the one aspect of modern medicine that causes most concern and which we all want to avoid or minimise whenever possible.

Herbal medicine certainly has a place in the modern veterinary practice and already is again regaining its traditional place in many surgeries for the treatment of many common and chronic complaints.  With more information, education and understanding of this old form of medicine it will perhaps soon be as widely available as it deserves to be.

What is a medicine and what is not a medicine?
There are many products on the market that are presented and advertised as medicines, claiming to cure or control various ailments and problems. This can be very confusing for the consumer who can get bogged down in the quagmire of products available.  A medicine, however always has a Product Licence (PL) number on the label; if it doesn't then it is being sold as a dietary supplement. This sounds simple, but many people are confused - after all if you buy something advertised to improve your dog's health which is recommended for  rheumatism, arthritis, skin disorders, nervousness etc. surely you can expect it to be effective?  Yes, of course you can providing that you ensure that the product you buy has a PL number which means that it is a Licensed Medicine and that it is strictly controlled by the terms and conditions of its licence under the Medicines Act 1968. It must conform to specific controls regarding what it contains, the conditions in which it is manufactured, where it may be sold and for which conditions it is recommended.

These controls cover the ingredients which must meet strict criteria on purity by conforming to the specifications for each constituent - in the case of herbal medicines the active ingredients or plant materials will conform to either a British Pharmacopeia or British Herbal Pharmacopeia specification.  This is of paramount importance for a medicine containing botanic ingredients where natural variation in the plant is normal and depends on the country of origin, environmental conditions and seasonal variations.  Manufacture of medicines must be undertaken in a licensed factory where the equipment, methods and controls are inspected and approved by Ministry inspectors to ensure that they conform to the Good Pharmaceutical Manufacturing Practice code. Total quality control is exercised at every stage of manufacture and quality is checked and rechecked. These technical controls continue right through to the finished product and afterwards to the packaging, labelling, shelf-life, transportation and storage. 

Of most interest to the consumer, however, is the efficacy of the medicine and in the case of veterinary medicines this will have been proved and approved by practising veterinary surgeons and the Veterinary Medicines Directorate to confirm its effectiveness in treating the conditions for which it is recommended before a license is granted.

Many people do not realise that herbal medicines have to conform to the same criteria as any other pharmaceutical medicine.  The only exception being that because of their traditional use and  well documented effects over hundreds of years, they are not subject to animal testing or double-blind trials. This makes them a particularly suitable form of medicine that is in line with today's growing concern over unethical testing procedures.

To obtain a Veterinary Product License a great deal more information is required by the authorities than for a comparable human medicine - this is something which is perhaps quite the opposite to what most people would expect. The basis for this is similar to that which requires only qualified veterinary surgeons to treat an animal that is not their own. It is to protect the animal.  After all we, as people, can decide whether to take a medicine by considering the facts and the implications;   an animal cannot and therefore a great many more safeguards have to be in place to protect our dogs and cats.

You can see that the Product Licence Number on a medicine really does tell you a lot about the product you purchase.  It gives a strong assurance that proper care has been taken to achieve purity, quality and the highest level of manufacture, as well of course telling you that it is a medicine that will be suitable to treat the condition for which it is advertised and recommended.  On the other hand, a product without a PL number it may be disappointing  to purchase these supplements expecting them to act as if they were medicines to treat specific medical conditions - for that you need a Licensed Medicine, then you can be sure of getting the result you expect with the assurance of the quality and effectiveness of a product which has been thoroughly investigated and approved.

When buying dietary supplements it is wise to always purchase from an established and  reputable manufacturer who will want to safeguard their reputation by ensuring  that the  same controls are used for their supplements as for their medicines.

But which is sold as a supplement, will not have had to conform to any of these criteria.  It can be manufactured anywhere in any conditions, the ingredients do not have to meet any specifications of quality or purity, the finished product is not subject to veterinary scrutiny and the quantity of ingredients do not have to be declared.   It can only be sold as a dietary supplement  and should not be advertised or recommended to treat any medical condition,  although it is sometimes difficult to identify this as  advertising can be ambiguous.  Of course, many products we buy for our dogs are excellent food supplements and they are useful in maintaining good health and providing a balanced diet, particularly for dogs who may need supplementation, such as the young, old, bitches in whelp or just those that need  something to boost their condition.

The important of quality herbal ingredients
We all want the quality of items we purchase to be the best possible, and this is particularly so when it is something that we are going to take ourselves or give to our pets.  But how can you be sure of the quality of the ingredients ?   Many manufacturers will tell you that their ingredients are "of the highest quality", but how can you be sure if this is true or if it's just clever advertising jargon?

The reason that quality is important is because it's the quality of the herbs that make the products effective.  If the ingredients have been kept in poor conditions, are old and musty or have been exposed to the damp then the beneficial properties will have deteriorated and the product they are incorporated in will not be effective.  We sometimes hear people say that they have tried using herbal products with only limited success and this may often be due to the quality of the products being in doubt.  Subsequently when a high quality item is used the effective result they were looking for is obtained.

With herbal ingredients there are many different qualities available depending on the origin of the plant, the way it has been dried and the conditions in which it has kept before being incorporated into a product.  Most importantly, of course, is that the plant used is actually the correct species and that it has not been adulterated with some other cheaper or inferior herb.  Some herbs, such as Valerian, Rhubarb, Senna and Buckthorn have standards which are laid down in the British Pharmacopeia, but the majority do not.

To overcome this problem and provide a standard specification for all herbs, in 1971 the British Herbal Medicine Association produced the first edition of the British Herbal Pharmacopeia (BHP).  The latest 1990 edition is now used by the medical and scientific professions as a standard work for checking herb quality and specifications.  The BHP gives definitions and standards of purity for all herbs as well as macroscopical and microscopical descriptions.  It lays down the way in which the herb should be identified using laboratory techniques such as thin layer chromatology and also the storage and preparation requirements to ensure the continued presence of the efficacious ingredients throughout the shelf life of the product in which it is included.

Licensed herbal medicines have to conform to these specifications and identification tests, so that you can be sure that any LICENSED herbal medicine, which is identified by a Vm number on the label, will contain this quality of ingredients and therefore be effective.  Unfortunately, there is no such requirement for unlicensed herbal products, which include vitamins and many of the dried, powdered and liquid mixes that are available today.  Regrettably, tests on some of these products have shown that some suppliers adulterate the herbs with up to 70% of a cheaper product and in some liquids the amount of the herb shown on the label as being included in the product has been too small to even identify !  These inferior, cheaper ingredients can be used by manufacturers who are inexperienced in herbal products and do not test the materials before including them in their products.  Because of the lack of regulations these products can, and sometimes are, produced in unhygienic conditions which most dog owners would find totally unacceptable but of which they are not aware.

What can we all as consumers do to make sure that we are getting good quality herbal products that will work? Firstly, always use a Licensed medicine if possible, as this means you can be sure of the quality and purity. However, when it is necessary to use an unlicensed herbal product, always buy from an experienced manufacturer and ask if the ingredients used conform to the standards laid down in the British Herbal Pharmacopiea. Try to establish whether they are manufactured according to accepted standard practices in a satisfactory environment.

The British Herbal Medicine Association's veterinary committee are actively encouraging all manufacturers of herbal medicines and supplements to employ proper quality control procedures for their products, whether licensed or unlicensed.  Unfortunately, there will always be inexperienced manufacturers who use untested, cheaper ingredients which they can then retail at lower prices. However, these produce inferior quality products which are often ineffective and give the entire herbal industry an unprofessional reputation. It is important therefore that to obtain the best results, all consumers are vigilant in insisting on only using herbal products for themselves or their animals that have been made by experienced manufacturers using quality tested herbal ingredients. In this way, we can all help to ensure that the quality and therefore the effectiveness of this form of treatment is maintained, which will help restore its professional status as a viable and valuable form of medicine and most importantly will continue to be of enormous benefit to all our animals

About the author...
Mary Boughton
owns and manages Dorwest Herbs. She is a Member of NOAH’s Companion Animal Sub-group and the British Herbal Medicine Association's Veterinary Committee