5800450 33.36

British Homeopathic Journal (2001) 90, 33±36 ß 2001 Nature Publishing Group All rights reserved 0007±0785/01 $15.00www.nature.com/bhj Cushing's Disease: a new approach to therapy in 1Kingley Veterinary Centre, Oldwick Farm, West Stoke Road, Lavant, West Sussex, PO18 9AA, UK Forty-one cases of Cushing's Disease affecting both equine and canine patients were treated with an identical mixture of two homeopathically prepared remedies (ACTH 30c and Quercus robur 30c), and the clinical improvements seen in the cases assessed.
Homeopathy has been described as a medicine that can only be prescribed on the basis of individual symptoms shown, ®tting the remedy to the patient, not the disease. The aim of this study was to de®ne whether a standardised approach, using homeopathi- cally prepared remedies, was a valid system of therapy for this disease, and if so, whether results were repeatable between species. The overall success rate for the therapy was 80% and results were broadly similar between the two species, indicating that homeopathy lends itself to the treatment of Cushing's Disease, and also to both cohort studies and group medicine. British Homeopathic Journal (2001) 90, 33±36.
Keywords: Cushing's Disease; hyperadrenocorticism; equine; canine; ACTH 30c; Quercus commonly observed sign by owners, along with the Cushing's Disease, or hyperadrenocorticism, is the In horses, a variety of clinical signs are seen.
result of the breakdown of the normal hypopitui- Cushing's Disease occurs mainly in aged horses, tary ± adrenal feedback mechanism, leading to exces- with a minimum age of 7 y, and is said to have an sive production of hormones from the adrenal gland, increased prevalence in ponies. The most marked sign in particular the gluco-corticoids (cortisol). In the dog is hirsutism, often with a history of failure to shed this 85 ± 95% (according to the author) of cases are due to coat in the spring. A pituitary neoplasm is the only pituitary neoplasia, either micro, or macroadenomas, clinical condition known to cause hirsutism in the and some 5 ± 15% of cases are due to adrenal neopla- horse1 and in an aged horse the failure of coat sia. In horses and ponies all cases are pituitary in shedding is strongly suggestive of a pituitary neo- origin. Functional adrenocortical neoplasia in the plasm.3 For these reasons diagnosis in the horse is horse has not been documented,1 Ectopic secretion often based on these signs alone. Other useful diag- of adreno-corticotrophic hormone Ð ACTH, as seen in nostic symptoms include hyperhidrosis, polyphagia, 17% of human cases, from hormonally active tumours and in many cases bulging of the supraorbital fat. In elsewhere in the body has not been observed in the the horse two major sequelae of pituitary adenoma are type 2 diabetes mellitus (and associated weight loss) Cushing's Disease is a chronic disease of insidious and also laminitis. Hence an elevated blood glucose onset, and is slowly progressive. One problem with level and alkaline phosphatase (due to the cortisol diagnosis is the variability in the clinical signs seen levels) is used by some as another indicator of Cush- between cases. For example skin changes are only ing's Disease. Other complications include tendency observed in 65% of canine cases2 yet this is the most to infection, infertility, pseudolactation, poor wound healing, seizures and blindness, behavioural changes including reduced response to pain stimuli and *Correspondence: M Elliott, Kingley Veterinary Centre, Oldwick Farm, West Stoke Road, Lavant, West Sussex, PO18 9AA, UK.
Unlike the horse, in the dog the classical appear- Received 6 September 1999; revised 9 June 2000; accepted 22 ance is of a truncal, symmetrical, non-pruritic Homeopathy and veterinary Cushing's Disease alopecia. However, this only occurs in some 65% of trained homeopath. This paper describes the results of cases. The alopecia may be quite extensive, but it 41 cases seen in practice given a standardised regime usually spares the limbs and head, with the exception of a homeopathic preparation derived from ACTH and of the dorsal muzzle. Cases showing these dermato- logical signs also show some skin thinning, with a lack of tone, and occasionally calcinosis cutis. More systemic signs seen as a consequence of the increased circulating glucocorticoid levels include polydipsiaa polyuria (in 85%), polyphagia, obesity with abdominal enlargement and hepatomegaly, breathlessness, and Cases selected for inclusion in this study were drawn from primary care patients as well as referrals. Clin- It is worth comparing here the homeopathic proving ical con®rmation of diagnosis depended to some of cortisone carried out in 1963.7 This gives a descrip- degree on the clinic they were referred from and tion of not only Cushing's Disease, as seen in man, also the species. Many horses were diagnosed on but also the symptoms of the iatrogenic overdosing of hirsutism and blood glucose alone1,3 while 12 of the steroids encountered in practice in cases on long-term 18 dogs were con®rmed on ACTH stimulation tests,2 therapy. It raises the possibility that cortisone, and the rest displaying classic symptoms and clinical related drugs, have a homeopathic action! history. Cases have been monitored over periods Many conventional therapeutic options for treat- ranging from 2 months to 6 y depending on when ment of Cushing's Disease have been proposed but they were admitted to the study, with success or the pros and cons have to be weighed up for each, also otherwise of treatment assessed after 4 ± 6 weeks of none are registered drugs in the UK. Surgery is not a starting on the treatment. Monitoring is ongoing to practical solution in general practice at present in animals. In the dog conventional medical manage- ACTH is raised as a result of the syndrome if ment is essentially limited at present to one of pituitary dependant, but low if caused by adrenal o,p'DDD (mitotane, lysodren) and ketoconazole, neoplasia. The work of Jouanny4 on homeopathic although other drugs are being developed. With potency of hormones for therapy would suggest a o,p'DDD, although clinical remission is high Ð as 12c or higher therefore if pituitary dependent, and much as 86%5 Ð relapse is common Ð as much as this would cover all horses in the study. However, 5% 57% in year one2 Ð and side effects are many. Keto- of canine cases were ruled out with this remedy alone conazole treatment is only symptomatic, is expensive as they would be adrenal in origin suggesting the need and less ef®cient then o,p'DDD, and can produce for a 7c or lower. Jouanny's principles4 30c was gastritis and occasionally hepatitis. In horses conven- selected as it would ®t most cases and experience tional therapy basically involves the use of either suggests 30c seems to work as a moderating potency dopamine agonists or serotonin antagonists. The latter, as cyproheptidine, is primarily used as a less Quercus robur is derived from tincture of acorns.
expensive option, and is said to reduce plasma ACTH This remedy is useful in dropsy, in depressed cases in 70% of cases.1 Dopamine agonists (such as bro- with reduced mental responsiveness, puf®ness below mocryptine and pergolide) are said to be fairly effec- the eyeballs (not anatomically feasible in the horse tive. In a case report of 25 animals, 23 showed and hence the supra-orbital swelling?), cravings, improvement in clinical signs on pergolide. Side ascites, hepatomegaly, polyuria, breathlessness, vari- effects with pergolide include diarrhoea, depression, cose veins, etc.6 All are symptoms associated with the and colic and anorexia.1 In horses, due to their size, remedy and with Cushing's Disease Ð hence this cost (often around £5 per day) is a major problem for could be called a classical homeopathic prescrip- tion Ð the speci®c for the disease? However, as a Homeopathy is a form of therapy based on `Similia small remedy this doesn't appear in work-ups via the similibus curentur' Ð let like be treated by like. There classical homeopathic repertories, which is a major are case reports of Cushing's Disease responding to fault of that technique. Quercus robur was discovered one remedy-individualised homeopathy. Selection for for use in this study by using radiesthetic principles.8 a remedy by detailed case taking, comparison with The potency was chosen to correlate with the ACTH repertories and with known Materia Medica will so they could be combined for ease of administration.
generally yield the best results in most cases of Each case was given a combination of ACTH and chronic disease. The use of a standardised homeo- Quercus robor in 30c potency. Dosage was twice pathic approach has not, as far as I am aware, been proposed before. The purpose of this study was to Clinical responses were assessed as excellent when establish whether one could standardise an approach, clinical symptoms appeared to resolve completely, with homeopathically prepared remedies, suitable for poor when some symptoms remained even if the all cases of diagnosed Cushing's Disease, for general animal appeared to improve in health, and a failure use, without the need for an experienced classically Homeopathy and veterinary Cushing's Disease The remedies were made up by Ainsworth's Homo- Equine cases counted for a total of 23, of which eopathic Pharmacy in 30c and supplied as 95% 91% (21 cases) responded excellently, one case tincture which was diluted down into 40% alcohol responded poorly, and one case failed to respond at all solution (vodka) at a rate of one drop concentrate, of Canine cases, where success rate was predicted to each, to 1 ml vodka, or added to lactose tablets at a be lower as the therapy wasn't designed to cover rate of two drops of each 95% solution to a 7 g adrenal neoplasm, were actually less successful.
vial. Dosage was two drops, or one tablet, of the Twelve cases (67%) responded excellently, three cases poorly and three cases not at all.
Over the follow-up period four cases suffered relapses, three of which were subsequently found to be due to the development of thyroid problems. These A total of 41 animals were treated by the combination were: one horse which developed an active thyroid medicine, of which some 80% (33 cases) responded tumour, treated successfully homeopathically with a excellently in achieving remission from clinical symp- combination of Flor de piedra 12c, Thyroidinum 30c, toms, four cases responded only poorly, and four cases and Iodum 30c; and one dog and one pony which failed to respond at all. Almost all the responding developed hypothyroidism (con®rmed by blood test- cases are still alive and well at time of writing.
ing) treated with soloxine. Both responded well and Data used for Cushing's Disease trial analysis Abbreviations: M ˆ male, F ˆ female, Mn ˆ male castrated, Fn ˆ female castrated, y ˆ years, m ˆ months, Nak ˆ not known; ACTH Stim ˆ ACTH Stimulation test, Clin symp ˆ Classic clinical symptoms, SympaBld ˆ Clinical symptoms and typical blood parameters, Dex supp ˆ Dexamethasone suppression test, TRH Stim ˆ TRH Stimulation test.
Results Abbreviations 1 ˆ return to clinical normality, 2 ˆ improvement but not complete resolution of symptoms, 3 ˆ No response to Homeopathy and veterinary Cushing's Disease returned to their healthy condition. The other two In addition the therapy is inexpensive and easy to cases responded to increasing the frequency of administer, with no side-effects; making treatment dosing in proportion to the severity of the symptoms more available to the petahorse owner, which can seen. One of these then stabilised with the addition of Uranium 6c, again discovered by radiesthesia.
All cases remain on treatment inde®nitely as with- drawal of the treatment appears to result in slow The author would like to thank the veterinary sur- geons and owners who collaborated in this study.
DiscussionThe association of Cushing's Disease with thyroid function,2 and seen in some cases in this study, might suggest that all unstable cases, and poor responders, 1 Van der Kolk JH. Equine Cushing's Disease. Equine Veteri- should be screened for thyroid dysfunction The author has encountered this association in a number of cases 2 Heripret D. Canine hyperadrenocorticism. Waltham Focus suffering Cushing's Disease, including one other 3 Eustace R. Equine pituitary neoplasia. In Practice 1991; 13: horse, other than those included in the study The production of these results, broadly repeatable 4 Jouanny J. The Essential of Homoeopathic Therapeutics. Lyon: between species, indicates that the combination of ACTH and Quercus robur, in a 30c potency, is a valid 5 Hertog E, Braakman JC, Teske E, et al. Results of non-selective system of therapy for Cushing's Disease which can be adrenocorticolysis by o,p'DDD in 129 dogs with pituitary- dependant hyperadrenocorticism. Veterinary Record 1999; used by any veterinarian, whether homeopathically trained or not. Success rates are comparable, if not 6 Clarke JH. Dictionary of Practical Materia Medica, 3rd edn.
better, than most conventional drug orientated Sittingbourne: The Homoeopathic Book Service, 1991, pp approaches with little relapse. This study suggests the protocol would also lend itself to a double-blind 7 Julian OA. Materia Medica of New Homoeopathic Remedies.
Beacons®eld: Beacons®eld Publishers Ltd, 1971, pp 186 ± 194.
trial, especially with the equine cases, something that 8 Tansley DV. Radionics Interface with the Ether Fields. Saffron has become a Holy Grail for homeopathic researchers.

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