Wednesday, April 20, 2011

RI Podcast - Episode 89. Horses for Courses.

Those lovely Righteous Indignates kindly asked me to help out with the podcast this week, and you can download the full episode from the RI website.

Topics of discussion included the French banning the burqua and an interview with Steven Upton, who is a minister for the Spiritualist's National Union. I did a news piece on some odd goings-on in the world of equine arthritis, and shoe-horned as many horse-based colloquialisms, metaphors and adages as I could. Childish, but fun.

Transcript of the news piece is below.

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I’ve got a horsey story this week, seeing as it was the Grand National on Saturday – and much to Hayley and Trystan’s moral disgust, I took a punt on Ballabriggan and my goodly lady popped a few quid each way on Oscar Time. Happily for us they came in first and second which resulted in the rest of Saturday being somewhat blurry.

Like many mammals, arthritis affects horses, but especially performance horses who have been worked intensely – high levels of stress on joints and bones in gallops and jumps can increase the onset of the disease, and given the crazy value that some of the top racehorses can hold, keeping arthritis as bay or at least delaying the onset is a key part of horsey management.

It’s fair to say that in general poor people don’t have horses; stabling costs, access, feed, and vet bills are pretty hefty, and despite being a long-standing stereotypical desire of teenage girls inspired by Mills & Boon, for most people a pet pony is out of the question. It’s really only for the well-shod.

So we have an extremely valuable asset, owned almost exclusively by people with money to burn – could there be a more desirable market for the snakeoil salesman?

Needless to say, homeopathy in horses is a huge market – the placebo effect by proxy is well-documented in horses like any other pet, but somehow the strong bond felt by the owner ,between them and the horse seems to make it even more acute.

Like in humans, dogs and cats, the favoured dodgy supplement for arthritis in horses is Glucosamine. Due to being a food-supplement rather than medication, the barrier to entry is low and it’s easy to get your product on the market. There a hundreds of sellers and due to heavy marketing in all areas of human and animal arthritis , glucosamine is well-known for being a safe treatment for arthritis. Note my wording – a safe treatment for arthritis. Like homeopathy, glucosamine is safe – even in high doses, which produces lots of products with MAX in the name. (See episode 74 of the Pod Delusion for my take on glucosamine-pill name fun).

Unlike homeopathy glucosamine actually has got plausibility, but like homeopathy the evidence is fairly clearcut – there is no effect compared with a similar administered placebo – I’ll put a link to a recent article by SkeptVet which goes through the evidence base behind glucosamine’s safety, plausibility and efficacy.

Straight from the horse’s mouth, if you will.

Anyway, why the interest in glucosamine? Well, two suppliers of glucosamine for horses have in the last few weeks been bitching about each others adverts via the Advertising Standards Authority.

The runners in this two-horse race are Equine America and VetVits Ltd. Equine America are based in Horsham (...) and VetVits are based in StPeter’s Port Guernsey, a place with a lot of history of quack product sellers and an address very familiar to the ASA.

Each have had complaints against each other upheld by the ASA in a bizarre insight into how these type of companies operate and the logical sumersaults they perform to keep their placebos selling in preference to their competitor’s.

First out of the stalls was Equine America. On 2nd March, they complained about VetVits who claimed in an ad that their glucosamine product Equiflex was clinically proven to work. After the ASA had finished pissing themselves at the rubbish 18 horse trial, the complaint was upheld and VetVits were told to change the ad.

Good Old Equine America, standing up for evidence-based medicine. But hold your horses, what’s this? Just last week, the ASA published the result of a subsequent complaint, this time by VetVits on an ad from Equine America.

Equine America, despite complaining about lack of clinical evidence for their competitor’s product, claimed their own product had clinical evidence. Not only that, but they claimed all the other competitor’s products didn’t have any clinical evidence.

The ad stated “The following Chondroitin / Glucosamine equine joint supplements have no objective clinical evidence of improving joint mobility - NAF Five Star Superflex, EquiFlex, PREMIERflex HA, ExtraFlex HA, STRIDE HA, My Joints, Arthri Aid and NEW MARKET JOINT SUPPLEMENT”.

They claimed their product Cortaflex did have.

Once again, the ASA spat their tea all over the laptop in surprise at the howlingly naff level of evidence presented by Equine America – basically a conference proceedings rather than anything in a published scientific journal.

ASA upheld the complaint, and told Equine America not to discredit other marketers or products in future.

So both these companies know that they have don’t have any robust clinical evidence for their products. Both these companies know that their competitors don’t have any robust clinical evidence for their products, yet both are prepared to ride roughshod over the evidence in order to enhance their pill sales to credulous horsey people, who presumably have the best interests of the horse at heart.

The analysis of this sort of joust always leads to the same place – hooray for the ASA (although as it relies on complaints to current ads, it is closing the stable door after the horse has bolted) and boo to the pillpushers, who can play irrationality in customers to whatever level they want.

In this instance though, it’s hard to see that their pill-pushing comes from a position of delusion, like for instance the homeopath’s. They may spout nonsense, but at least they believe it – given how these companies have acted, I don’t get the feeling of a well-meaning, but misguided supplement provider, but I can only guess.

The other side is the horsey people themselves – stuck in a difficult position; having been told so often that it works, no amount of evidence can convince a user that they’ve been duped.

As the man said, You can lead a horse to water....

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