Meili was presented eight weeks later and was substantially improved. Mrs Jansen was happy that she was able to stick to the home‐made diet, even though it was more work that she was doing in addition to food preparation for her other family members. She also lamented why pet food companies were able to sell foods with such ingredients that were capable of making pets sick.
Dr Green congratulated Mrs Jansen on her ability to persevere for the entire dietary trial, but had one other request just to conclusively determine a cause‐and‐effect relationship. He didn't want Mrs Jansen to have to cook for Meili forever, or to try diet after diet to find an acceptable commercial option, so he asked if she would be prepared to try one other scientific trial – reintroduce the original diet to see how long it took for the clinical signs to start to recur. After all, if the problem was really the diet, they should be able to induce the clinical signs with reintroduction of the offending allergen(s), and then make them quickly go away again by stopping the diet once again. Once they had conclusively established the diet as the culprit, they would commence challenge feeding to determine which ingredient(s) were actually problematic.
Mrs Jansen was a bit unsure of the process, and didn't want Meili to suffer, but she agreed to the trial realizing that she could reverse any ill effects quickly, and that it would appease Dr Green's scientific curiosity so they could get on with more permanent solutions. However, with challenge feeding, Mrs Jansen was surprised that Meili did not get worse when she reintroduced the original diet, even after she had fed it for a full two weeks. She even fed Meili some bread and pasta, the gluten content of which she was sure would aggravate Meili's condition … but it didn't. Dr Green explained that the likelihood was that Meili was allergic to certain pollens which were prevalent during the period when she was symptomatic, and perhaps food was not playing a major role after all. He praised Mrs Jansen for her willingness to explore the complexity of Meili's condition, provided her with information on atopic dermatitis, and asked her to track Meili's clinical signs on a calendar and if major problems recurred, they would have some documentation to compare with allergy test results to determine the most likely allergens implicated.
Don't be fooled – the placebo effect is evident in animals.
Caregivers are responsible for judging the impact of interventions on clinical issues and their impressions can be influenced.
Simply enrolling in a study or taking part in a therapeutic trial can influence the perception of benefit. This is known as the Hawthorne effect.
Most chronic conditions tend to wax and wane over time, and sometimes medication benefits can be attributed to times when clinical signs would be waning regardless.
People can be influenced to expect that certain interventions are likely to have bad effects, even if not likely. This is known as the nocebo effect.
Recommended Reading
1 Conzemius, M.G. and Evans, R.B. (2012). Caregiver placebo effect for dogs with lameness from osteoarthritis. J. Am. Vet. Med. Assoc. 241 (10): 1314–1319.
2 Gruen, M.E., Dorman, D.C., and Lascelles, B.D.X. (2017). Caregiver placebo effect in analgesic clinical trials for cats with naturally occurring degenerative joint disease‐associated pain. Vet. Rec. 180 (19): 473.
3 McKenzie, B. (2018). What is a placebo? Animals receiving inert treatments may show improvement due to causes other than direct placebo effects. http://veterinarypracticenews.com/what‐is‐a‐placebo
4 McKenzie, B.A. (2019). Placebos for Pets? The Truth about Alternative Medicine in Animals. England: Ockham Publishing, Newmachar, Scotland.
5 Munkevics, M., Munkevica, S. (2017). Why does placebo work on dogs and cats? http://pet‐happy.com/why‐does‐placebo‐work‐on‐pets
6 Sifferlin, A. (2018). Placebo's new power. Time Magazine 3/10: 65–69.
2.14 Benefits of the Human–Animal Bond
Jacqui Ley, BVSc (Hons), PhD, DECAWBM, FANZCVS (Veterinary Behaviour)
Melbourne Veterinary Specialist Centre, Glen Waverley, Victoria, Australia
2.14.1 Summary
The human–animal bond (HAB) is the glue that keeps companion animals in families. The strength of the HAB affects if a pet is obtained, its management and healthcare and if it is retained and valued by its family. Many benefits arise from the HAB such as improved human physical and psychological health. Veterinary clinics and the wider community benefit from strong HABs. Understanding how the bond is expressed and how it affects owner decisions can aid veterinary practices to provide the kind of care they want while avoiding compassion fatigue.
2.14.2 Terms Defined
Attachment: The enduring emotional bond between individuals. It is characterized by behaviors such as seeking proximity to the individual and being attentive to their needs.
Compassion Fatigue: Also known as secondary traumatic stress disorder, this is the gradual loss of compassion by people who work with individuals who are ill, suffering, or victims of trauma. This includes veterinary staff working with worried clients with sick or injured animals. Signs include indifference, disengagement, withdrawal from patients and co‐workers, and even physical signs relating to chronic stress.
Human–Animal Bond (HAB): A measurable psychological construct encompassing the feelings of attachment between an owner and a pet. It has been well described from the human perspective but is not well understood from the animal's view.
Problem Behavior: Behavior exhibited by the animal that is considered undesirable. The behavior may be normal for the species or it may be due to a mental health disorder.
It can be difficult to understand why one owner will do everything for their pet and another will only do the bare minimum. The cause may be differences in the HAB. The HAB describes the connection people feel toward animals for which they care. The expression of the HAB is affected by many things but two factors important to veterinary practice, because they affect owner healthcare decisions, are owner attachment and owner commitment to the pet.
The HAB may affect owner decisions as to the choice of pet and where it is acquired, how the pet lives with them and owner lifestyle such as where they live, work, and take holidays. The bond is affected by the owner's experience of pet ownership, expectations of this pet and perceived social expression and norms, among other factors.
The human experience of the HAB is well described. Owners can be located along a continuum from highly attached (the pet is considered a valued family member) through to less attached (the pet is a thing). For example, owner attachment levels may affect an owner's willingness to accept the financial costs of treatment for a pet. Highly attached owners may also have difficulty accepting that their pet is unwell [1]. Some highly attached owners may also struggle emotionally when