When my wife and I got our COVID breakthrough, I got a text from a friend telling me and my wife to take ivermectin. If we couldn't find a doctor to write us a script, we were told to buy the animal stuff from Amazon and they would send us dosage adjustments. This was all based on information gleaned from friends and whatever crazytown groups they were involved with. I just took some Benadryl, napped, and let the vaccine do its work instead. I kept my intestines in tact and felt better in about three days.
I don't think the average ivermectin proponent makes much of a distinction between horse paste and taking medicine under the direction of a doctor. Since they generally make no distinction, calling it "horse paste" is a fair description of the treatment advocated by movement. Any attempts to legitimize it with the veneer of medical legitimacy is just perpetuating disinformation. Spreading this kind of thinking only serves to spread death and suffering. You can hide in asking questions and a motivated pedantry that distorts reality, but it's still dishonest and destructive.
This is distinct from honest discussion of legitimate attempts by real doctors to find COVID treatments.