Your Pet’s Pancreas and You

Ah, the pancreas… an often overlooked and misunderstood part of the digestive system that only gets noticed by veterinarians and caregivers when it’s not working well.  But the pancreas shouldn’t just get attention when it is inflamed and painful (from Pancreatitis), or not producing enough insulin (from Diabetes Mellitus), it deserves recognition for doing its job well and not causing problems on a day-to-day basis. Today’s post is to familiarize you with the pancreas and (hopefully) give you a few tips to help you keep it happy for years to come.


Happy Pancreas = Happy Dog

Anatomy of the Pancreas

This part gets a bit technical, so bear with me. The pancreas is a glandular organ that sits behind the stomach and extends across the length of the stomach to the upper small intestinal (the duodenum). It connects to the duodenum via the pancreatic duct, which serves at the pathway for release of digestive enzymes and other essential compounds into the intestinal tract. This part of the pancreas’ job is called its exocrine function. This is in addition to the pancreas’ other, probably more familiar role, the production and release of insulin into the blood stream (i.e., its endocrine function). The endocrine pancreas will be covered in my next post on Diabetes Mellitus; I’m not completely ignoring that topic, just pushing off for now.

Pancreatic enzyme release is triggered by the hormone cholecystokinin (CCK) that is secreted from the intestinal cells in response to the intake of certain food components, specifically protein and fat. Both protein and fat will stimulate CCK release, but fat has a much more pronounced effect even at lower intakes. Irrespective of trigger, the secretion of CCK causes the pancreas to contract and squeeze pancreatic enzymes down the pancreatic duct and into the duodenum to begin the breakdown of dietary macronutrients (macronutrients = dietary protein, fat and carbohydrate). There are a few other functions of CCK, such as stimulating contraction of the gall bladder and creating a feedback on the brain to slow food intake, but it’s CCK’s effect on the pancreas that I am focusing on for management (and minimization) of pancreatitis.

knitted digestive tract

Your key digestive organs, without the actual blood and guts

The Exocrine Pancreas

The primary exocrine enzymes produced by the pancreas are trypsin and chymotrypsin (both used for protein digestion), lipase (required for fat digestion), and amylase (essential for starch digestion). These enzymes are produced in their inactive forms, which must be activated by other enzymes in the presence of bicarbonate (also made in the pancreas). For example, trypsin is actually made and stored in the pancreas as trypsinogen. Trypsinogen is packaged into zymogen granules within the pancreas and kept separate from bicarbonate. This isolation of enzymes and activators protects both the integrity of the digestive process and the pancreas itself.  If trypsin becomes activated too early not only will it not get into the duodenum where it is needed for food digestion, but it will start to digest the proteins in the pancreas instead. And this is painful. Very, very painful.

Sparky PN

One of my former patients on IV nutritional support, fluid support and pain meds because of severe pancreatitis.


What Causes Inflammation of the Pancreas?

The clinical name for inflammation in the pancreas is pancreatitis (pancreas- = pancreas + -itis = inflammation). Pancreatitis can either be acute (vomiting and pain within hours) or chronic (low smoldering illness with vague signs that can be confused with other medical conditions).

In dogs, one of the most common dietary causes of acute pancreatitis is eating a non-food item (like 2 lb of bird seed) or eating fatty table scraps (either intentionally fed or found by rooting through the garbage). The exact mechanism of pancreatitis isn’t known but it is believed that the higher than normal fat intake causes the rapid increase in circulating blood fats and then “activation” of pancreatic enzymes within the pancreas. Other risk factors for acute pancreatitis include being a miniature Schnauzer or Yorkshire terrier (sorry pups), or any other dog breed that has a genetic predispositions to hypertriglyceridemia (the term for high circulating levels of triglyceride in the blood); being on medication such as potassium bromide and phenobarbital (two common anti-seizure medication); and being more than 20% over your ideal weight (yep, being a fat dog isn’t a cosmetic issue). Chronic pancreatitis in dogs is a bit more challenging to identify as the clinical signs can be vague and are often confused with other chronic medical conditions, because of this chronic pancreatitis is thought to be an under-diagnosed and under-reported condition. One study out of the UK conducted post-mortem evaluations of 200 dogs that had died from a variety of different causes (none of which were reported to be either acute or chronic pancreatitis in the medical records by the way) and found evidence of chronic pancreatitis in one-third of them.

Cats on the other hand like to be different. Genetics, medications, obesity, and high fat meals are not often associated with pancreatitis in cats. Instead stressful events, like introduction of a new animal into the household or having work done at your home, seem to be the more common histories among cats that present to their veterinarian with signs of acute pancreatitis. Many of these cats may also be diagnosed with what veterinarians like to call triaditis, (triad- = three + -itis = inflammation), meaning they are found to have evidence of inflammation in the pancreas (pancreatitis), in the liver (hepatitis), and in the intestinal tract (enteritis) all at the same time. Chronic pancreatitis can also be seen along with diabetes mellitus in cats, though just like with triaditis it often becomes a chicken-or-the-egg game to figure out which came first.


What Does Pancreatitis Look Like?

Animals, both dogs and cats, with mild cases of pancreatitis may vomit, refuse food, or seem quieter than usual at home. Dogs and cats with chronic, low-grade pancreatitis may have vague signs such as an intermittently poor appetite and weight loss. Severe pancreatitis can cause not only vomiting, food refusal, and lethargy, but diarrhea, fever, and abdominal pain. Severe pancreatitis, if left untreated, can also result in shock, circulatory collapse, and death. So pancreatitis is basically badness, followed by more and more severe badness if not caught and treated.


Signs of pancreatitis aren’t always obvious. 



What Can We Do About It?

Supportive treatment for dogs and cats with pancreatitis is very similar: IV fluids to keep them hydrated, anti-nausea meds to stop them from vomiting, and pain control (whether they are acting overtly painful or not) will be on the list. Dietary therapy on the other hand is less consistent so here is where I’d like to provide some general guidelines to caregivers, vet techs, and veterinarians when treating dogs and cats with known or suspected pancreatitis.

The two most important features of a diet for an animal with pancreatitis are (in order of important): 1) feeding a diet that is LOWER in fat than what was being fed before and 2) feeding a diet that is MORE digestible than what was fed before. If you don’t know what is causing the GI signs you’re seeing and you have pancreatitis as one of the possible causes on the list, err on the side of caution and just feed a lower fat, more digestible diet. Seems straight forward but I see a lot of confusion in practice about how to translate this to an actual diet so I give you…


Dr Weeth’s Dietary Consideration for Feeding Animals with Pancreatitis

dog and food bowl

What is in that bowl is as important as the rest of the medical treatment

  1. Dietary fat is a wonderful thing for healthy animals, except when it’s not. Fat can enhance the palatability of the food (I much prefer half and half in my coffee to skim milk); in the right amounts and with the right fatty acid profile can improve coat glossiness and decrease shedding (and big dogs can shed a lot!); fat also provides more calories per gram than either protein or carbohydrates, so feeding a higher fat diet relative to a moderate or low fat diet will increase energy density, reducing the overall volume of food needed each day; and with this reduction in volume in, so, too, do you see a reduction in the volume of poop coming out. The end result of feeding a higher fat food is often that the dog or cat readily eats their food, has a lovely shiny coat, doesn’t shed very much, and has a low stool volumes. Sounds perfect (and a lot like the reasons people give for feeding raw … hhmmm… maybe it’s not the “raw” part of those diets that is doing anything?…). Perfect unless you are a dog or cat with pancreatitis. When the pancreas is inflamed dietary fat can stimulate CCK release, contraction of the pancreas and release of digestive enzymes… into the pancreas. This promotes continued autodigestion of the pancreas and surrounding tissues, malabsorption of nutrients, and pain. Cats and dogs with abdominal pain can be very stoic, but if you or a human loved one has experienced pancreatitis you know it is not fun. Fat is sometimes your friend, but sometimes your dog or cat’s worst enemy.
  1. Digestibility is important for everyone. In general, over-the-counter (OTC) adult maintenance dog and cats food will be less digestible than the therapeutic intestinal support diets sold by veterinarian. This means that more of the OTC diet you feed (yes, even the “premium” priced ones) becomes poop rather than getting absorbed by your dog or cat. There is some variability in OTC diets and a number of the newer “premium” marketed foods, especially ones that are frozen/freeze-dried raw or fresh pasteurized, can be as digestible as intestinal support diets. BUT, before you think that sounds like a great option for animals with pancreatitis, many OTC diets (especially “premium” marketed foods), will have fat contents that exceed 50% of the calories in the diet. These types of diet would be very harmful for a dog with a history or an active case of pancreatitis. OTC diets marketed as “light” or “lean” will have lower fat contents compared to standard adult maintenance foods, but as the fat dropped in OTC diets, so does the digestibility. What about home-cooked foods you may ask? Some combinations of home-prepared foods, like cottage cheese and white rice or chicken breast and white rice, can be as digestible, if not more digestible, than the therapeutic intestinal support diets, but there is going to be a lot more variability depending on the way they are cooked and specific ingredients selected. Also, many home-prepared diets are rarely balanced for long-term feeding ( and if used should only be fed during the recovery stages of pancreatitis (about 2-3 weeks) before your dog or cat is transitioned to a balanced diet whether it is a commercial diet or you have the home-prepared foods balanced for long-term feeding.
  1. Diet History is key to finding the right diet the first time around. Whenever possible the decision of what to feed and the degree of fat restriction needed should be based on the previous diet intake. This is where diet and treat history are very important. Did your dog (that lovable furry fiend) get into the BBQ remains or a container of bacon grease you’ve been meaning to throw out? In these types of case your dog could have eating a whoppingly high fat intake and as such feeding a moderate fat contenting diet (one that provides between 20-35% fat calories) would be fine. Or did they develop pancreatitis or hyperlipidemia, or both, while eating a diet that was already at 25% fat calories? In this situation, feeding a diet with a similar fat content would not help, and could potentially make them worse. These dogs should be fed a diet that provides less than 20% of the calories from fat. Basically, you want to find out how much fat the dog is eating now and decease it by about half while still staying above the minimum requirement for fat. As I mentioned earlier, cats are a bit different and you want to find a diet that manages whatever concurrent medical conditions your veterinarian finds. Fat triggers and subsequent fat restriction are less important in most cases, but (and I feel like there is always a but) this is not true 100% of the time. I have definitely seen cats in practice that acted more like fat-responsive pancreatitic dogs and needed to fed a highly digestible, fat restricted diet.


The optimal long-term diet choice for a dog or cat with pancreatitis will depend on the inciting cause (genetics, medication, hypertriglyceridemia, or high fat intake) and additional medical issues (diabetes mellitus, IBD, etc). Irrespective of underlying cause, dogs with a history of pancreatitis should never be fed diets or treats with more than 45% of the calories coming from fat due to the risk of recurrent pancreatitis.


Happy and Healthy Feeding!


Lisa P. Weeth, DVM, MRCVS, DACVN


Magic Beans? The Wonderful World of Dietary Supplements, Part 2 of 2

If you walk into any pet supply or grocery store you will find an aisle (maybe more) filled with products promising to make your dog or cat smarter, faster, leaner, prettier, more energetic, better smelling, etc. The list of advertised benefits of any given supplement or nutraceutical goes on and on.


As you read in Part 1 of this series the supplement industry is heavy on business, but can be light on science and regulation. That doesn’t mean that there isn’t a place for supplements on your kitchen or clinic shelves. Today’s commercial pet foods (even those at the economy price point) provide all of the known essential nutrients your dog or cat needs without anything being added, but there are a few condition where adequate may not the same as optimal.

I’ve put together a list of what I consider to be my Top 5 Dietary Supplements for health and wellness. Not all of them (or maybe any of them) will be right for your dog or cats, but they are worth getting to know a little better.

So without further ado…

Dr. Weeth’s Top 5 Dietary Supplements


If only we all had a coat that glistened in the sun…


1. Essential Fatty Acids (EFAs): A balance of linoleic acid (LA; an 18-carbon length essential omega-6 fatty acid) and alpha-linolenic acid (ALA; an 18-carbon length essential omega-3 fatty acid) is necessary in dogs to maintain the normal water barrier function of skin and to maintain the suppleness of the hair coat.

Dogs that aren’t getting enough of one or both EFAs can have dull, dry, hair coats, with skin flakes (dandruff) and excessive shedding. These are the dogs that seem to shed a whole other dog when you brush them out. Yes, shed happens, but it happens more robustly when your dog isn’t getting the right amounts or ratio of EFAs in the diet.

The specific amounts required by an individual animal will depend on the overall balance of fats and fatty acids in the diet as well as breed differences in coat texture and length, which means that even diets marketed as “complete and balanced” may miss the EFA mark for optimal skin and coat health in a given individual. Supplementing higher levels of ALA has been shown to help improve skin and coat quality in otherwise healthy dogs and may help decrease itchiness in those with allergic or atopic dermatitis.

  • Who would benefit? Otherwise healthy dogs with dry, flaky skin or with excess shedding; dogs with dermatitis caused by an allergic reaction (e., abnormal and excessive immune reactions to food, flea, environmental triggers) or atopy (i.e., abnormal and excessive immune reactions to an unknown trigger).
  • How to get it? Many of the powders, pills, and chew that are marketed to “complete” a commercial diet for dogs and cats are simply dressed up ground flaxseed, a source of the essential omega-3 fatty acid ALA. Corn on the other hand (an oft demonized, but utterly delicious cereal crop) is high in the essential omega-6 fatty acid LA. Adding ground flaxseed doesn’t have magic fairy dust-like properties, it simply balances the LA:ALA ratio in most commercial diets, which supports a healthier skin barrier and allows the shedding fur to slip past each other instead of “felting” and coming out in clumps.
  • Use with caution in dogs with a history of pancreatitis or other fat intolerances (hyperlipidemias or diarrhea). Care should also be taken in animals with suspected or document allergies as many of these flaxseed-based multivitamin/multimineral/fatty acid supplements contain additional proteins that could trigger or exacerbate an allergic response.



SAMe and the liver, a happy pair.

2. S-Adenosyl-Methionine (SAMe): SAMe is normally made in the liver of all animals. It serves as a precursor to taurine (an amino acid) and glutathione (an antioxidant); supports liver cell regeneration; and helps the liver metabolize a number of different compounds and drugs.  All features that make SAMe an attractive supplement for animals with liver disease when SAMe production is decreased.

Scientific evidence for SAMe’s use in dogs and cats with primary liver disease is largely anecdotal or based on in vitro (cell culture) tests, though SAMe supplementation has been shown to protect the liver from toxic side effects of CCNU (a type of chemotherapy drug) in dogs undergoing cancer treatment and may improve behavioral traits in dogs experiencing age-related declines in cognitive function (old dogs that start to act like old dogs). Similar cancer treatment and geriatric studies have not been published in cats, but SAMe supplementation has been shown to limit the effects of acetaminophen (the active ingredient in the pain reliever Tylenol) toxicity.


  • Who would benefit? Dogs with congenital or acquired liver disease; dogs undergoing cancer treatment; older dogs in general; and cats exposed to acetaminophen. Cat with liver disease and geriatric cats may benefit form SAMe supplementation as well, but without published evidence on its use, SAMe for cats falls into the category of “not harmful, possibly helpful” so worth a try if you can give pills to your cat.
  • How to get it? There are a number of commercial SAMe supplements sold for both veterinary and human use and either type may work for your dog or cat. When selecting supplements (marketed for pets or people) it is important to know that SAMe is prone to degradation during manufacturing and storage so capsules and enteric coated pills are better than chewable wafers.
  • Another key consideration when supplementing SAMe is that it undergoes a significant first-pass metabolism with approximately 50% of the ingested SAMe being metabolized by the liver before it can be used as SAMe itself. Additionally, the presence of food in the stomach can decrease absorption of SAMe even further, meaning that SAMe supplements should be given on an empty stomach at least 1 hour before a meal to have maximal absorption.


everyone poops

Everybody poops, but maybe probiotics could help them poop better.

3. Probiotics: Probiotics are beneficial bacteria, such as Lactobacillus, Bifidobacter, and Enterococcus, that may help support normal colon cell health and normal gut-associated and whole-body immunity. They do this by inhibit growth of more pathogenic intestinal bacteria strains; enhancing immune function at the level of the gut; and exerting a trophic (growth-like) effect on the intestinal cells themselves.

In otherwise healthy animals, probiotic supplementation may not give your dog or cat perfect poops or make them extract more nutrients from their diet (both marketing claims I’ve seen), but it may help swing the balanced of colonic bacteria away from potentially pathogenic strains such as Clostridia perfringens.

Clostridia overgrowth is associated with acute diarrhea in dogs and cats so theoretically reducing their numbers may have longer-term health benefits. In dogs and cats with acute diarrhea or in dogs with chronic intestinal diseases probiotic supplementation may actually help normalize the colonic bacterial environment (what is called the gut microbiome) and improve clinical signs of soft stool and diarrhea more rapidly than when medical treatments (antibiotics and immune-modifying medications) are given alone. The beneficial effects of probiotics may also extend beyond the gut itself. For example, probiotic supplementation may improve clinical signs of atopic dermatitis in dogs.


  • Who would benefit? Dogs and cats experiences chronic or acute diarrhea; dogs with atopic or allergic dermatitis.
  • How to get it? Probiotics marketed for pets or people can be used to provide a source of beneficial intestinal bacteria, though certain veterinarian strains may be more effective in cats and dogs than the human counterparts. There is also variability between product strains and in manufacturing and stabilization processes, so I recommend using a probiotic supplement from a reputable manufacturer.
  • Unfortunately, the amounts of probiotic bacteria found in fermented foods like yogurts and kefirs are relatively low compared to what is found in a supplements capsule or wafer so you are better off with giving a good quality probiotic supplement rather than relying on a daily yogurt treat. It is also important to know that even the best probiotic supplement won’t be enough to correct diarrhea by itself. If your dog or cat is having diarrhea that lasts for more than 24 hours you should seek veterinary care and treatment sooner rather than later. Your pet and your floors will thank you.


dog with salmon

This old dog has the right idea.

4. Fish Oils: Fatty fishes like salmon, cod, and menhaden are high in the long-chain omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

DHA is incorporated into the fatty insulation of nervous tissue and is essential for normal eye and brain development of puppies. EPA on the other hand isn’t essential in the diet (meaning your dog or cat will survive if fish oils are left out), but in adult animals increased intake of EPA can help decrease production of pro-inflammatory mediators and help manage arthritis pain, atopy, kidney disease, heart disease,  lymphoma treatment, and may help support brain health in older dogs and cats .

  • Who would benefit? Older dogs and cats, especially those with chronic diseases, such as heart or kidney disease, or that are being managed for inflammatory conditions, such as skin or intestinal allergies.
  • How to get it? Fish oils can be given as either a liquid or capsule, but manufacturer quality control is essential. Supplements should be checked to be free of environmental contaminants (e.g. mercury or PCBs) or excess levels of vitamins A and D, which can be toxic to dogs and cats. Product quality and testing should be done by every fish oil manufacturer, so it is worth spending a little time looking into manufacturers before spending your money.
  • Caution should be used when adding fish oil to cat diets as platelet abnormalities and bleeding disorders have been reported in cats receiving high dosages of EPA. Additionally, increased intake of EPA and DHA will increase the requirement for vitamin E in the diet. Without enough vitamin E cats fed high fish oil diet are at risk of developing painful inflammation in their fatty tissues (called pansteatitis).
  • Added Note: Fish oil should not actually smell “fishy”; this odor change occurs when the fatty acids in fish oil begin to break down from improper handling or storage. You should also be forewarned, as the long-chain fatty acids from fish oil are incorporated into every cell in your pet’s body they will eventually be incorporated into skin oils, which will begin to oxidize giving your dog or cat a distinct fishmonger aroma.




Old dogs have old joints. Could supplements keep those joints young?

5. Glucosamine/Chondroitin Sulfate: Synovial joints (ones that allow movement between bones) are composed of cartilage matrix (the proteoglycans hyaluronic acid and glucosaminoglycans -or GAGs for short), collagen, and water. Inflammation in the joint (arthritis = arthr– joint + –itis inflammation) can result in damage to the joint tissues and potential loss of chondrocytes (the cells that line the joint and product the matrix proteins).


Oral glucosamine and chondroitin sulfate supplements have been theorized (and marketed) to provide precursors to matrix GAGs and help improve mobility in animals with arthritis, but results of clinical trials on glucosamine and chondroitin sulfate supplements have been mostly disappointing. Lack of efficacy in controlled clinical trials could mean that these supplement just don’t work, or maybe failure of a response is related to the severity of existing damage to the joint and degree of chondrocytes loss rather than complete futility of glucosamine and chondroitin sulfate supplements in all animals.

I wonder if we have been looking at these supplements the wrong way. Maybe oral glucosamine and chondroitin sulfate supplements are more chondroprotective rather than chondroreplacive (I think I just made up a new word), and should be started before damage (or at least significant damage) has occurred. This would be a very difficult to prove or disprove in clinical trials, but since glucosamine and chondroitin sulfate supplements appear to be relatively safe for both dogs and cats, they  fall into the “possible helpful, but not harmful” category.

  • Who would benefit? Canine athletes, feline athletes (if such a creature existed), and possibly every middle age to geriatric dog or cat.
  • How to get it? Veterinary and human glucosamine and chondroitin sulfate supplements are available. Veterinary supplements are often flavored to increased acceptance by dogs and cats, but a number of human supplements products may contain comparable amounts of glucosamine and chondroitin sulfate.
  • Caution should be used if you are considering giving a human supplements as some joint health products may include additional nutrients (like high levels of vitamin D) or herbal mixtures that have not been safety tested in dogs and cats. Occasionally  vomiting has been reported in dogs given glucosamine and chondrointin sulfate supplements, but this appears to be caused by stomach irritation rather than any innate harmful effects of the supplement.


The reality of nutrition is that it is not one-size-fits-all. Needs will vary based on breed, life stage, health status, and activity level. Even though commercial pet foods from good quality manufacturers (check out this link to help define “good quality manufacturers”) will provide all of these essential nutrients at levels adequate for survival, what is adequate for day-to-day living in one animal may not be the same as what optimizes health and wellness in another. This is where supplements come in.

And one last note: Supplements should never replace proven medical treatments for your dog or cat, but when added to a balanced diet, regular exercise, and preventative veterinary care, could help keep them feeling good for years to come.


Happy Feeding!

Lisa P. Weeth, DVM, MRCVS, DACVN


Happy 2016!!

Just a quick note to say that I hope 2015 treated you all well and that 2016 turns out to be a prosperous and exciting year for you and your (two- to four-legged) family.

People often start each New Year by making a list of goals and objectives for the year to come and I thought I would share one of my goals for 2016 with you.

I will be bringing you two posts a month, more if I can swing it, on topics related to dog and cat nutrition. Suggestions for topics are always welcome; otherwise you will get one from the grab bag. Either way, today I finally finished Part 2 of my supplement topic. I hope you enjoy it!


Me and Bubbles wishing you another year of keeping dogs and cats fed, happy, and healthy.

Happy Feeding!

Lisa P. Weeth, DVM, MRCVS, DACVN

The Wonderful World of Dietary Supplements, Part 1 of 2

Food fads and “miracle” supplements.  Even our Victorian-era ancestors fell prey to these marketing gimmicks (click here for some fun adverts). Back then it was whole grain cereals and cure-all liniments that would fix what ails you; now it is gluten-free/paleo/vegan diets and coconut oil that have the marketing companies and self-proclaimed nutrition gurus in a frenzy to separate you from your hard-earned money. They are not just targeting you, but your furry, four-legged companions, too.

But is there a place where nutrition science and marketing converge to improve health and wellness? The answer is a resounding … maybe. But before we get into specifics, let’s take a look at the industry as a whole.

Belgian agility

Faster, stronger, better. That is the marketing woo of many supplement companies.

A Background on Dietary Supplements

The supplement industry is Big Business and growing each year.  Thanks to the 1994 Dietary Supplement Health Education Act (DSHEA for short) supplement companies have almost as much pre-marketing oversight as they did in 1894, but at least now the FDA can step in (after the fact) if there is a problem.  For human supplements that is. Veterinary supplements are not covered by DSHEA and are still considered “animal feed.” As the FDA states “the ultimate responsibility for the production of safe and effective animal feed products lies with the manufacturers and distributors of the products” (to read the original document look here). Not a great comfort knowing that the companies that stand to profit from selling a given product are the same ones responsible for regulating safety and efficacy.

It can be hard, even for me, to keep all the brands and product straight and I still come across new ones all the time. To help me evaluate these new supplements as I see them, I’ve come up with a list of product and company questions that I ask each time.


Just a few things before we get started…

General Questions on Dietary Supplements

  1. How much of each nutrient is in the supplement? I want actual nutrient or compound concentrations in milligrams (mg) or grams (g) here. If I call the supplement provider and ask for specific concentrations of vitamins and minerals and they send me an ingredient list, they may not understand the role of nutrients in health and disease. I’ve even talked to “scientific advisers” who couldn’t understand why I would need to know how much calcium, zinc, iodine, etc., is in the product the company recommends as a supplement to balance home-prepared diets. (The short answer is that I need to know how much to add to meet the dogs daily requirement.) Telling me the ingredients are “all-natural” doesn’t mean anything if it’s naturally deficient in zinc and iron, or has naturally toxic levels of vitamin D.
  2. Is it being used to fill a deficiency or manage a condition? Today’s commercial pet foods are intended to provide all essential nutrients your dog or cat needs, but individual animals may have higher requirements for things like essential fatty acids or fiber than what the diet alone provides. Certain non-essential nutrients, such as long-chain omega-3 fatty acids, may also help animals with chronic medical conditions. Know what you are using and why.
  3. Who makes the supplement? Is it a company that makes both human and veterinary supplements? Or only pet products? Maybe this is a faulty assumption, but I can’t imagine that companies manufacturing both human and pet products use two different sets of quality and safety standards. Not to imply that vet-only products are necessarily lower quality. Many are made by private label human supplement companies, or are members of the National Animal Supplement Council (NASC), or are both. The point is, I would encourage veterinarians and caregivers to know who manufacturers and oversees the supplements they use.
  4. What else is in the supplement? Supplement (for pets or people) do not require pre-market approval, so it is important for veterinarians and caregivers to be in the habit of scanning the ingredient list to look for potentially problematic or harmful ingredients.

what plants crave

What I think about when I hear people spout off about the unproven “benefits” of certain supplements. Repeating marketing catchphrases is not a valid scientific argument.

My quick tips on products to avoid:

  • NO garlic for dogs or cats. Garlic contains a compound that damages red blood cells causing the cells to rupture and animal to develop anemia. Even if you don’t believe that garlic is a problem for dogs (though the science show us that it is) everyone should know that garlic is toxic to cats. If you see a supplement marketed for dogs and cats that included garlic (which I have), put it back on the shelf and walk away. If they don’t know what’s toxic to their intended users, what else don’t they know?
  • Please don’t feed coconut oil to your cats. Coconut oil seems to be the pet health food trend de jour. Claims I’ve read on coconut oil marketing materials: cures skin disease and allergies, eliminates bad breath, elevates metabolism (whatever that means), prevents diabetes, allows your dog to telepathically communicate with you (ok, I made that last one up). It is marketed as a panacea and miracle cure for pets. Coconut oil may have some helpful uses in dogs, though it is not what the coconut oil panderers want you to believe (more on coconut oil for dogs in my next post), but I would not recommend it for cats. They really don’t seem to like it. Yes, I know that there are weird cats out there that love bananas and strawberry jam (I have one), but feeding coconut oil to cats can cause food refusal and an aversion to the diet. I would be highly skeptical of any person or product company that told you to do so.

Dietary supplements can play a valuable role in health and wellness for your pets or your patients, but just like any other treatment though, we need to make sure that what we are doing is safe and effective.

cate and annabelle

We want to keep these two happy, or at least mostly happy. Annabelle doesn’t look like she likes hugs very much.

Happy Feeding!

Lisa P. Weeth, DVM, DACVN

For more on specific supplements to consider for you patients or pets check out my next post!

I Love Cats!…and Cat Nutrition


I would have to say that my home doesn’t feel complete without one (or more) feline companions. Don’t get me wrong, I love dogs, too (and rats, and horses, and bunnies, and birds, and reptiles, and yes, tarantulas … pretty much any animal), but there is something about cats that has resonated with me since my childhood. Cats can be cool and aloof, snuggly and sweet, playful and silly. And let’s face it, usually lower maintenance than any of the animals I mentioned earlier, which is an attractive feature in a busy household.  And I’m not alone in my love of cats. Cats are the most common companion animal in the United States with 30% of households living with 74+ million cats. A recent study even showed that just watching cat videos can make you happier and more productive at work.


With so many cats in the US (and the world) we humans must be doing something right when it comes to the care and feeding of our feline friends, but over the last 10-15 years there has been a push to feed cats what is considered the “natural” diet of the domestic feline and the what and how to feed has become a confusing mess for concerned cat lovers.  What is the natural diet of the domestic cat?  Cats are obligate carnivores, which mean that they are adapted to a diet that consists of eating other animals, and many people (veterinarians and non-veterinarians alike) advocate feeding a high protein, high fat, and preferably wet food diet to every cat. While this may be ok for a young healthy individual, animals with specific medical conditions such as liver or kidney disease can become very ill when fed a high protein diet. Calorie for calorie, wet food is also more expensive than dry kibble. What about families that cannot afford to feed a wet diet exclusively? Like everything in the nutrition world, the purrfect cat diet (sorry I couldn’t resist) depends on the individual cat and the individual household.


A tale of two cat diets…



What is the Ancestral Diet of the Cat?

Archeological and genetic evidence indicates that cats began living with humans approximately 12,000 years ago probably after the shift in food production from a hunter-gatherer life-style to that of farmed (and stored) agricultural products. Chances are the small rodents they found among the stored grains came complete with stomachs full of grain bits, too.  I would argue that barley and wheat (a couple of the earliest domesticated cereal crops) are natural parts of the cat’s diet, albeit in more limited quantities than what can be found in some dry cat foods. Then 50-60 years ago a dietary shift once again occurred when advances in feline nutrition and food technology led to the development of nutritionally complete commercial dry and canned cat foods. Any amount of (hopefully) fresh meat can be put into a can, but extruder (the machine that makes the kibble) technology set the minimum and maximum amounts of protein and carbohydrate that could be used in dry pet food production. Too much wet meat in the extruder and the dough wouldn’t blend or cook properly; Too little carbohydrate and the kibble wouldn’t stick together.  Newer extruders have been developed over the last 10+ years that allow companies to make dry foods with much higher animal protein contents, but to this day many of the “original recipe” dry cat foods on the market will have a lower protein, higher carbohydrates content relative to wet diets because of extruder requirements rather than feline requirements.

Coinciding with this more recent diet shift has been a change in the overall care and husbandry of domestic cats. Cats as a population are spending more time in the safety of our homes with a ready food supply instead of outside defending territory and hunting for prey (such as mice, lizards, small birds, and insects). Indoor-only cats have a decreased risk of exposure to pathogens such as feline panleukopenia and a decreased risk of trauma from vehicles or larger predators, but there is concern in the veterinary profession and among cat owners that this change in diet from a high protein, high moisture, low carbohydrate wild-type diet to a moderate protein, moderate carbohydrate, low moisture diet has contributed to a number of current-day feline diseases, such as obesity, lower urinary tract disease, and diabetes mellitus.

cat mouse

Just a quick game of cat and mouse.


The Influence of Feline Feeding Behavior

Cats, as any cat caregiver knows, are creatures of dietary habit.  Research has shown that kitten food preferences  are influence by maternal food exposure as well as aspects of the diet itself, such as texture, mouth feel, and aroma. As a cat ages it can demonstrate more food aversions and can resist diet change becoming neophobic (i.e., fearful of new things) even when a diet change is in their best interest. This may be an adaptive response to minimizing risk of food toxicity in the wild, but will frustrate veterinarians and caregivers trying to manage certain medical condition where the feeding of a particular style of food may be recommended (e.g., higher moisture canned foods for cats with a history of sterile cystitis). In addition to specific diet characteristics, environment can influence feeding behavior with many cats experiencing a decrease in food intake during stressful times. Yes, there are some cats that relish the new novel diet, but I would argue that this may be due to unintended training by the caregivers (who doesn’t love a good sale on cat food?) rather than the cat beig inherently adventurous. In an otherwise healthy young cat varying the diet textures and flavors may be the most important feeding strategy a caregiver can make to keep their food preferences flexible. I am not trying to help you feed a kitten, I am trying to help you feed for the entire lifespan of the cat.


FYI- These are not on the recommend food list for cats.

Pet Food Manufacturing: Effects on Health and Wellness

Current complete and balanced commercial cat foods are designed to provide adequate levels of all essential amino acids, fatty acids, vitamins, and minerals without the need for supplementation irrespective of diet type. The one exception would be that dry diets provide very little water (8-10% of the volume of a dry food vs. 70-85% of the volume of a wet food) and cats will not simply drink more water to make up the deficit. [This lack of water intake can result in urinary crystals or bladder inflammation in some, but not all, cats.]  Even with the perfect diet design, heat and pressure processing (i.e., cooking) that occur during pert food manufacturing can destroy a number of essential nutrients, which will need to be added back in or accounted for by the manufacturer.  Even without cooking, fats and fat-soluble vitamins will oxidize and become rancid with exposure to air and minerals will antagonize one another and prevent each other’s absorption. These are well known complications of cooking and food processing that can adversely affect feline health and are hopefully well-known by the pet food manufacturer. But even with all of the nutrition and food science knowledge available to pet food manufacturers mistakes can happen that result in serious harm to companion cats such as when 100% of the added thiamine was degraded during manufacturing. These diets looks perfectly balanced on paper, but deficiencies would have been seen during an Association of American Feed Control Officials (AAFCO) feeding trial or if these manufacturers had tested key nutrients after production of each batch.


Feeding for fit, not fad.

“Wild-Type” vs. Dry vs. Canned Diets

A typical well-fed adult house mouse (  is relatively high in moisture (67% moisture as fed), with a crude protein content of 55% on a dry matter (DM) basis, a crude fat level of 24% DM basis, and an estimated carbohydrate content of 8% DM basis. Compare this to a typical over-the-counter adult cat dry food with a lower moisture content (10% moisture as fed), a crude protein level of 34-45% DM basis, crude fat level of 13-20% DM basis, and a carbohydrate content that can range from 8-30% DM basis depending on manufacture and product formulation. The typical over-the-counter adult cat wet diet is a little bit closer, but still not exactly right: Wet diets have a moisture content of 70-85% as fed depending on style, a crude protein content between 40-70% DM basis, a crude fat content of 22-36% DM basis content, and a carbohydrate content that can range from 0-15% DM basis depending on manufacture and product formulation. Just from a simple comparison of a representative “wild-type” prey species, a “typical” dry cat and a “typical” canned cat food, canned diet profile appear to be a closer match the nutrient distribution of a prototypical feline diet. Carbohydrates, both starches and structural carbohydrates (i.e., fiber), are not considered essential nutrients for cats but are essential ingredients for the production of dry cat foods and allow for the formation of a kibble as the ingredients go through the cooking, extrusion, and drying process. Cats are able to metabolize a range of dietary carbohydrate contents whether found in a can or kibble form, and carbohydrates provide a source of non-protein calories that are useful when managing certain medical condition, like kidney disease, when a protein restricted diet is required.

Domestic cats in the wild eat multiple small meals a day (a baby bird here, a cricket there…), and many caregivers will leave dry food out all day to allow their cat or cats to eat at will. While this is a more “natural” feeding pattern for cats, the diets they are grazing on tend to be very palatable and very energy dense (some are 500+ Calories per cup!) and a free-grazing cat can quickly consume more than its daily energy requirement if excess food is available. Some cats are very good at regulating intake, but there is a fat cat in every multi-cat household who ruins it for everyone. Allowing some cats free access to dry food can lead to obesity and its associated complications of diabetes, urinary tract disease, breathing problems, skin disease, and joint disease. Most cats can be trained to eat two to three meals each day with occasional small treats offered in between meals, if extra nibbles are desired, and wet food is especially conducive to portion control.

Porkchop and corn

Shh, don’t tell her she’s not supposed to like corn.

The Bottom Line…

As with most aspects of diet selection, there is not one perfect approach to feeding cats. Individual animal and caregiver characteristics will influence diet selection and owners should be encouraged to offer a variety of taste and textures early in life to help ensure acceptance of a range of food types as the cat matures. Canned adult maintenance cat foods may be more similar in moisture, crude protein, crude fat and estimated carbohydrate content compared to whole prey (though this is not universally true of all caned cat foods). But, neither a canned cat food nor a dry kibble exactly matches the “wild-type” diet of a domestic cat. Providing a complete and balanced diet, irrespective of diet type, is known to promote health, wellness, and longevity and there is no evidence to support the notion that either canned or dry diets are nutritionally superior for the average healthy adult cat. Dry cat foods are more convenient and economical for owners than canned cat foods, whereas higher moisture canned diets may aid in the medical management of numerous feline maladies. Diet selection should be based on the individual cat and household needs rather than on current diet trends and fads. And don’t forget to keep your cat lean!



Dusty getting his 1-2 servicing of insects each day.


Happy Feeding!

Lisa P. Weeth, DVM, MRCVS, DACVN


Nutrition and Cancer: What We Can and Can’t Do

In case you were wondering what a typical day in the life of a Veterinary Nutrition Specialists is like, my working days are mostly filled by those with chronic diseases: diabetic cats with kidney disease; dogs with food allergies and pancreatitis; maybe a diabetic dog with food allergies, history of pancreatitis, kidney disease, AND a picky appetite just to make it interesting. But on one particular day a few years back my first appointment of the morning was a little different. The reason for the visit as listed in the medical chart was “questions about preventing cancer” and my soon-to-be patient was a 4 month old Golden Retriever puppy full of happy, healthy, fluffy, puppy cuteness.


Not an actual picture of my patient, but just as cute.

After introducing myself to the puppy and his people I quickly learned what brought them in seeking cancer prevention advice. Turned out that this particular puppy was the fourth in a series of GoldenS cared for by the owners over the previous 20+ years. The first died at 10 years of age from hemangiosarcoma (an aggressive cancer of blood vessels that usually starts in the spleen and quickly spreads in the body), the second at age 6 from osteosarcoma (an aggressive cancer of the bone that usually starts in one bone and can spread throughout the body), and the third died at 2 years of age from lymphoma (an aggressive cancer of one of the white blood cell families, that can go and do whatever it wants). Their most recent loss was less a year before our appointment, so needless to say, this couple was very concerned about losing this new puppy too soon. They wanted to know if there was anything they could do diet and supplement-wise to prevent cancer from striking another four-legged family member.



Another gratuitous puppy picture.

If any of my readers were wondering that same thing, the short answer was no. There are no proven dietary changes or nutritional supplements that have been definitively shown to prevent cancer in dogs and cats. Cancer is a leading cause of death in dogs and cats with genetics, viruses, environmental toxins, age, and neuter status all having a direct or indirect role in the development of certain types of cancer.

So what do dog and cat caregivers need to know about cancer and possible nutritional prevention/treatments?

#1: What causes cancer?

Cancer results from damage to DNA (the genetic code of every cell) that 1) allows that cell to replicate itself unchecked, 2) to avoid normal housekeeping systems that would otherwise destroy an abnormal cell, 3) to induce new blood vessels growth to supply the cancerous cells with nutrients, and 4) to spread either locally or distantly (or both).

Cancer incidences are higher in certain pure-bred dogs than in mixes; viruses such as feline leukemia virus (FeLV) and transmissible venereal tumors (TVT) can induce cancer development and are acquired by close contact with infected animals; unneutered male dogs can develop testicular tumors just as unneutered females can develop uterine cancer (the risk of these two tumor types is virtually eliminated with neutering); cats and dogs living in households with heavy smokers have an increased risk of oral and nasal cancers due to environmental tobacco exposure. Additionally dogs and cats today are living longer thanks to vaccines, complete and balanced commercial diets, and advances in medical prevention/treatment of other diseases. Essentially, by preventing other potentially fatal diseases we have opened up the playing field for cancer in older aged dogs and cats.

Breed predispositions play an especially important role in cancer occurrence in Golden Retrievers. Goldens are beautiful, smart, dedicated family dogs, steadfast companions, but they are also a breed that has among the highest risk for cancer development at any age. This is one of the primary reasons for the development of Golden Retriever Lifetime Study. This study enrolled 3000 young Goldens and will track the genetics, environment and diet of each individual dog to help identify risk factor and possible prevention strategies for cancer as well as other chronic disease. This is a huge undertaking not only by the researchers, but the family committing their beloved canines and their own time to this study. At the time of my puppy appointment, the Golden Retriever Lifetime Study had not yet been launched and it will be at least a decade, if not longer, before we have any inkling of results.

What can dog and cat caregivers do about these risks? If you are adopting a purebred dog or cat, learn about the breed and what conditions can typically affect that breed. Do your research on any potential breeders as well. Find out what steps (if any) they are taking to screen their breeding pairs for known and potential health problems. Is the breeder tracking disease incidences (including cancer occurrence) in their lines? Once that cat or kitten is in your care, vaccinate for FeLV, if they are considered to be at-risk for this disease. Since FeLV is a “social” virus that required direct contact with an infected cat, indoor only cats in a FeLV-free household don’t typically need annual boosters. But talk to your veterinarian about your individual cat’s risk before stopping any vaccine regime. Canine TVT is a sexually transmitted disease, and both testicular and uterine tumors require intact reproductive tracts so the best way to prevent all of these is by neutering your dog. And if you are a smoker who hasn’t/can’t/doesn’t want to end their habit, at least smoke outside away from your dog or cat.


Old age happens, but it’s better than the alternative.


#2: What about specific foods and cancer risk?

If you are reading my posts, you are interested in canine and feline nutrition and have likely read other websites that claim that “kibble causes cancer” or that there are “cancer causing preservatives in pet food”, but scientific evidence for these claims is very much lacking. These claims are also almost always made by either a distraught pet owner looking for someone to blame for unexpected cancer diagnosis or by a person or business trying to market their own special line of “miracle cure-alls.” Our old Labrador, Maggie, lived 14 ½ years eating primarily dry dog food (with the occasional pizza or bread roll stolen from the counter when we weren’t looking), and ultimately died from a stroke-like event that hit her one morning. My 18-year-old cat Oliver is asleep next to me right now, has eaten dry commercial food his whole life and, other than his arthritis, is the picture of geriatric health; while our 3-year-old cat Cosette had eaten a variety of canned and dry foods over her short life, loved eating cat grass (that I grew myself) every day, and just died from transitional cell carcinoma in her left kidney (a rare cancer in cats, let alone in one so young). I don’t blame Cosette’s once-a-day cat grass habit for her developing cancer nor do I attribute Oliver’s longevity and health to dry food; cancer happens even to good cats and dogs.

But what does the vet literature say? There are some published veterinary studies that have tried to find an association between specific food intakes and cancer risk. One study looked at feline oral squamous cell carcinoma and another looked at thyroid adenomas in cats, but both of these studies relied on owners to report frequency and types of foods given over years to decades prior to the cancer diagnosis. Another study in dogs tried to draw a connection between intake of fresh fruits and vegetables with lowered risk of transitional cell carcinoma in Scottish Terriers. Again, these researches relied on owners to recall types and amount of fresh produce fed over the previous years. Most people can’t recall how much fruit and veg they fed themselves over the last week, let along how much they fed their dogs. I’ve worked with people who can’t even remember the name of the food they use (“it’s the purple bag with black writing”) or live in household with multiple feeders (intentional and unintentional). Recall bias is essentially the over- or under-reporting of foods and lifestyle habits that a responder thinks may be associated with a particular disease state. Recall bias is a significant enough problem in human health studies that nutritional epidemiologists have almost completely abandoned this method of data collection, yet for some reason veterinary researchers still rely on it. Food recall is always faulty in my clients, and they are highly motivated to remember their dog or cats food intake. To date, any veterinary study using only caregiver food recall to draw conclusions about diet and cancer risk in dogs and cats should be taken with a heavy dose of skepticism.

What do cat and dog owners need to know about commercial diets and cancer risk: Improvements in disease prevention, nutritional needs, medical care, and diagnostics mean that today’s cats and dogs are living to ages when accumulated DNA damage can result in cancer. Feed a complete and balanced diet that meets your individual animal and family’s lifestyle needs. If you want to feed a varied diet or a portion of fresh foods on a regular basis, that is no problem, as long as the overall diet still meets your dog or cats nutritional needs, they tolerate it well, and the foods selected are not harmful (no toxic foods like garlic or grapes, and avoid feeding foods that contain Salmonella or Campylobacter).

vegetarian dog

The wild ‘carnivore’ back from the hunt.

 #3: What about the role of obesity in cancer development?

This may be the one area of nutrition and health that could impact disease prevalence. In people, obesity has been shown to increase risk of specific cancers, such as uterine, liver, and post-menopausal breast cancer. These same associations haven’t been seen in dogs or cats, but calorie restriction has been shown to decrease cancer risk in rodent and primate models. The only published prospective (meaning they started with healthy dogs and followed them forward in time) study in dogs to date that looked at lifetime intakes and disease prevalence showed an equal number of cancer occurrences in lean and overweight dogs, but the small sample size (only 48 dogs in total) make this comparison almost meaningless. The results of the Golden Retriever Lifetime Study may give us more insight into this question.


What do cat and dog owners need to know about obesity and cancer risk: Lack of scientific data doesn’t mean that there is not an association between obesity and cancer development in companion dogs and cats, it just means that we don’t have a study that could answer this question. Even in the absence of a clear link between obesity and cancer, excess weight is a proven risk factor for other problems in dogs, and cats including joint disease, diabetes, skin disease, breathing difficulties, and at least in dogs has been shown to decrease longevity.



There may be less to love, but you can love them longer.

#4: What about the role of carbohydrates and cancer?

A quick Google search on “carbohydrates and cancer” will give pages of websites claiming to prevent or cure cancer by avoiding carbohydrates, and especially carbohydrates that include GMOs and gluten (the “evil” ingredients du jour). And there is big money in making these kinds of diet claims. Just look at the recent Belle Gibson story. Her fake cancer and food cure story garnered her hundreds of thousands of followers (and dollars), spawned a book, an app, and stories in international magazines, until she was recently exposed as a fraud and a thief.

There is one veterinary study that the anti-carb people like to point to and shout, “See, carbohydrate influence cancer!” It was published in 2000 and looked at response to cancer treatment in dogs with lymphoma fed a low carbohydrate (18% of the calories) diet supplemented with fish oil and arginine. Low carb advocates (including one of the lead authors) have cherry-picked the results of this study to make claims like “dogs with cancer should be fed a low carbohydrate diet” and “carbohydrates feed cancer” (emphasis is mine), yet when you read the entirety of the paper you learn that the control diet (the non-supplemented diet used as a comparison for the supplemented diet) had the exact same carbohydrate content as the study diet, just no fish oil and extra arginine. And the low carb control diet had absolutely no influence on cancer progression relative to expected outcomes. Again, feeding a low carbohydrate diet alone made no difference in disease free interval or survival time in these dogs with lymphoma. Yes, cancer cells utilize blood sugar (glucose) more rapidly than the surrounding normal cells, but this happens whether the individual consumes carbohydrates directly in their diet or if the blood glucose is produced from glycogen (a type of carbohydrate stored in the muscle and liver) or from gluconeogenesis (production of glucose in the liver) from metabolism of fatty acids and amino acids (building blocks of protein). The body of an adult, non-reproducing, non-lactating animal is very good at maintaining blood sugar levels, even when fed a carb-free diet. Additionally, there is not a single veterinary study that has demonstrated that dogs or cats fed low to no carbohydrate diets have less cancer incidence than dog or cats fed moderate to high carbohydrate diets. Not that I am advocating that dogs and cats should be fed lots of starches and simple sugars, I just don’t want people to wave the cancer prevention/treatment flag when touting the “benefit” of a carbohydrate-free diet.


What do cat and dog owners need to know about carbohydrates and cancer risk: At this time there is no evidence that a diet with a low (less than 20% of the calories), moderate (20-40% of the calories), or high (greater than 40% of the calories) carbohydrate content has any bearing on cancer development in dogs and cats. There may be other reasons to feed a reduced carbohydrate diet, like management of feline diabetes, and animals with insulin secreting tumors (insulinomas) will often benefit from a reduction in overall carb intake, but like for all conditions the specific diet selected for your dog or cat should encompass their whole health needs.


Porkchop and corn

Psst, no one told her she wasn’t supposed to like corn.


#5: What about antioxidants for cancer protection?


The most common supplements marketed for “cancer prevention” or “cancer treatment” include combinations of antioxidant compounds, such as vitamin C, vitamin E, carotenoids, and selenium. On the surface this may seems to make sense. Antioxidants exist within each cell to balance and prevent the accumulation of reactive oxygen species (ROS) that are formed during normal cellular metabolism. These ROS can have damaging effects on nearby DNA, effects that could potentially end up in cancer development. The balance between formation of ROS and antioxidant capacity of the cell is dependant on dietary intake of antioxidants compounds, as well as the demand on the antioxidant systems through exposure to oxidative damage. So supplementing antioxidants seems like a smart thing, right? Maybe not. In people increased intake of antioxidants may influence cancer development, but not in the way we want. Prospective studies in people have shown that supplementing beta-carotene and vitamin A may increase the risk of lung cancer in smokers; high dosage vitamin E may increase prostate cancer risk; and women (but not men) taking high dosages of vitamins C and E, selenium and zinc, may actually be at an increased risk of skin cancers.  And there are a number of other studies looking at different cancer that have shown no effect (good or bad) of antioxidant supplementation. It is important to note that these studies in people were based on longer term (5-15 year studies) using tens of thousands of individuals. Veterinary medicine hasn’t done anything like this, until the Golden Retriever Lifetime Study and even that would be considered small by human study stanards.  There are no published studies evaluating specific antioxidant supplementation and cancer prevention in dogs and cats, though increased antioxidant intake in older dogs may help protect cognitive ability.

What do cat and dog owners need to know about antioxidants and cancer risk: There is no evidence that increased intake of antioxidants will prevent cancer in dogs and cats, and if anything, the studies in people have demonstrated that megadoses (10-100X normal dietary requirements) of certain antioxidants may actually increase risk of certain cancers. Antioxidants consumed as part of a healthy, balanced diet are fine, as are naturally occurring antioxidants found in fresh fruits and vegetables (non-toxic ones of course). There may also be some benefit to cognitive function with moderate increases in antioxidant intake in middle age to older dogs and cats.


food scale

It is all about finding the right balance (and avoiding known risks).

The bottom line…

There are no proven dietary strategies or techniques to prevent cancer development in dogs and cats. Defects in tumor suppressor genes, exposure to environmental toxins, obesity, and chronic inflammation have been proposed as causes of tumor development in people and many of these same mechanisms may occur in dogs and cats. Genetic factors and environmental toxins may not be avoidable or preventable, but avoiding obesity and feeding a complete and balanced (no deficiencies, no excesses) are within every caregiver’s control.




Happy Feeding!

Lisa P. Weeth, DVM, MRCVS, DACVN



The Importance of Annual Exams (even for young “healthy” animals)

I realize it has been awhile since you have heard from me. Things can get a little crazy in a household with 2 human-kids, 3 cat-kids, and a husband that travels for work. Throw in some laundry and other household chores, add homework and a few school shows, toss in a spring break trip to the other side of the world to visit extended family, and let’s not forget professional obligations and work deadlines. It is easy to see how my “free” time vanishes, quickly. But this week I had something unexpected, and more than a little worrisome, come up with one of the cats that reminded me it is always important to stop and pay attention to our pets, even if they look normal on the outside.

Our seemingly healthy, 3-year-old, female spayed, domestic short haired cat, Cosette, is unwell. You wouldn’t know it by looking at her, of course. She’s grooming normally and her coat looks great; she has been eating and drinking normally (loves her food!); she has been tussling with the 1-year-old trouble maker; rolling over for belly rubs (loves having her belly rubbed for as long as you are willing to do it!); and she isn’t now, nor has she even been a vomiter. The litter boxes for the 3 cats are virtually unchanged (I say virtually because Oliver being 18, has less concentrated urine so when the first wetter pee showed up in box that Cosette and Loki prefer to use, I just thought Oliver must have jumped in). Cosette has always been my easy keeper. She can eat anything, tolerates just about anything, she is sweet, affectionate, never a concern. Until now.


Even in the exam room today, Cosette still likes her ears scratched.



We came back from our recent spring break trip to find Cosette looking a little rounder in the belly than normal. I initially thought that maybe the friend who was checking on the cats had been overly generous with the food love, or that maybe Cosette hogged more than her fair share when no one else was around. (It’s been known to happen before. The one and only time we tried to leave the 3 cats for more than an overnight, and without a cat-minder, Cosette must have eaten 4 days’ worth of food for 3 cats all by herself.  When we got home on Day 3 the boys, Oliver and Loki, were looking a bit gaunt and were very glad to see us, while Cosette was casually lounging on the sofa looked like she had gained a couple pounds.) Needless to say Cosette has always enjoyed her food and has always been on the voluptuous side, so round belly this week wasn’t an immediate red flag. But just a few days ago while I was petting her I thought she seemed to have lost some of the muscle mass along her backbone. I gently felt her belly again and thought maybe it was a bit too round.  When I pushed a little deeper I felt a firm, lumpy mass around her left kidney. That she really didn’t like me pushing on.


The picture of health? Cosette just 2 days ago.


Luckily one of my new vet friends here was willing to meet me at his clinic on his day off to take some images of her abdomen. Turns out that what I thought was a mass around her kidney was her kidney. Not only did she have left hydronephrosis (hydro– means “fluid”,  –nephrosis means “kidney disease”, so hydronephrosis  literally means fluid distended left kidney), but on ultrasound she had quite a bit of ascites (free fluid in her abdomen) as well as abdominal lymphadenopathy (enlarged lymph nodes). The big kidney and ascites were what was giving her the portly appearance, not extra kibble and treats. Blood work was boring (even low normal kidney values and normal red blood cell concentration), but her urinalysis was dilute, so her kidneys not only looked unhappy, they were starting to act unhappy, too.  She is having a few additional tests today and right now she is feeling ok, but that could change any day. I don’t have all the answers about her condition yet, but it doesn’t look good.

Either way I wanted to take the time to share 4 things I’ve been reminded of in the last 48-hours.

  1. Every dog and cat should have an annual wellness exam. Even “healthy” animals can be hiding things like dental disease, heart disease, or kidney disease. Cosette’s condition is an extreme example of what can happen in a young cat with no outward signs of illness. Annual wellness exams are a quick and easy way to check in with your primary care veterinarians and allow them to get to know your dog or cat and hopefully catch problems before they get out of control. Annual physical exams are not the same as “vaccine appointments”. Vaccine schedules and plans vary by geographic area and the individual’s risk factors, but annual physical exams are important for every dog and cat no matter where they live and spend their days. Your primary care veterinarians will look in their eyes and ears; examine teeth and gums; listen to heart and lung sounds; palpate (i.e., feel) over glands, lymph nodes, and abdominal organs; and (for dogs) will perform the unpleasant, but very important, rectal exam. I like a good medical challenge just like the next vet, but I much prefer preventing illness or at least catching it early enough to give the best chance of recovery.

    exam image

    You won’t find anything if you don’t look.

  2. Medical problems caught early are often easier to treat then those found after the animal becomes “sick”. I can’t tell you how many times I’ve examined seemingly healthy dogs and cats before a diet change and then found underlying kidney disease, early hypo- (dog) or hyperthyroidism (cats), elevated liver enzymes, high cholesterol and triglycerides, or an asymptomatic bacterial bladder infection on additional screening tests. We found these medical conditions in the early stages because we looked, not because the animal was acting sick. The caregivers in every case had reported no change in appetite or behavior and outwardly the dog or cat looked fine. Believe me, it is a lot easier to transition a dog or cat to a new diet when they are feeling good rather than when they are feeling bad. If you wait until the dog or cat is in kidney failure and has started to refuse all food, of course they’re not going to eat the vet theraputic diet.  They don’t want to eat anything.  This is not to say that every dog and cat should have full blood work and urine test repeated every year, but I recommend a healthy adult screening (around 3-4 years of age) and then repeating specific tests depending on individual risk and annual exam findings.


    Make their regular diet the best diet for all of their health needs.

  3. Know your dogs and cats. I am definitely not advocating that caregivers stay home 24/7, follow their dog or cat around nonstop monitoring their every move, but some attention to small details is a good idea. If the cat is normally the first one to the food bowl, but starts hanging back or even starts to lose weight despite eating well, is there a social stressor (if you have multiple cats) or something else going on? If you normally scoop small, firm urine clumps out of the litter box, but lately have noticed the clumps fall apart or the urine has spread out and don’t form a round clump (without any change in litter or food type), a trip to the vet may be warranted. If your dogs or cats eliminate outside, once or twice a week walk out with them and watch what happens. Are they posturing to urinate or defecate without producing anything? Squatting multiple times instead on just one longer time? Or do they go out, do their business and then bounce back inside? When you’re brushing your dog or cat, get in the habit of also running your hands over their torso, arms and legs feeling for lumps and bumps. Like an extended rub down of love. If you don’t find any then great! But if you are familiar with what should and shouldn’t be there, you may be able to pick up something when it is small and relatively easy to address. I worked with a caregiver who could predict a pending drop in their dog’s blood albumin (blood protein) level simply because they felt a change in muscle mass. And another who caught their cat’s diabetes in the early stages because they always used a measured cup to fill the water dish and notices that they were filling in more frequently. You will know your dog or cat’s day-to-day habits better than any veterinarian, which can be a powerful tool if (when) they get sick.


    You and your primary care vet make the best team.

  4. Every day of seemingly good health is a gift. I know, sappy sentiment alert. No matter what we find out this week about Cosette’s disease, I know now that we will have less time with her than we expected. Could be weeks if it’s cancer (which would really and truly suck), could be years if it is a stone blocking her kidney flow (still sucky, but then she’d at least have a longer life span). When we adopted her from our local shelter 3+ years ago, Cosette was a cute playful ball of fluff and both kids fell instantly in love with her. We all expected her to be with us for at least 15, if not 20 years. Now her future is a question mark.  I know bad things happen to good people and animals.  Sometimes we can prevent illness and sometimes we can’t. We can’t control everything, but what we can always do is show our love for the friends and family members.

Cosette in her younger, carefree days.


Happy Feeding and Hugs to Your Dogs and Cats!

Lisa P. Weeth, DVM, MRCVS, DACVN

Considerations to help you find the perfect (for you) pet food…

It can be challenging for caregivers to know whether they are making the right food choice for their canine and feline companions, which is why I’ve made a list of what I consider the top 4 questions you should have for any food or treat you even consider feeding. Some of these questions can be answered by perusing the pet food label, while others require a call or email to the company. Either way, it is important for dog and cat caregivers to become familiar with whatever food they decide to feed.

cat on computer

Edu(cat)e yourself on pet food companies.


#1: Is the food completed and balanced for the given life-stage?

  • Growing animals should be fed diets that support growth and adult animals should be fed diets intended for maintenance. This doesn’t mean that the diet must be a commercial kibble or canned, just that their diet should provides all of the essential building blocks to help them grow normally and have a long happy life.

Not an adult, so don’t feed like an adult.


#2: Who developed the diet?

  • Ideally the diet formula would be developed by someone with both an understanding of the basic nutritional needs of dogs and cats as well as food science. For example, the high temperature and pressure required of canned food production will degrade the water-soluble vitamins irrespective of whether those ingredient are considered “natural” or not. This vitamin loss must be accounted for pre-production and monitored for post-production otherwise dogs and cats will get very sick. Most veterinarians have received some training in the nutrient requirements for health and disease, but have had no formal training in diet formulation or how to manufacture pet foods. The exception would be a veterinarian that has undergone additional food science or nutrition science training at a graduate level (Master’s or PhD). I think it is safe to assume that breeders, trainers, celebrity personalities, and savvy marketers have less nutrition training than Veterinarian Nutritionists.
acvn logo

Shameless plug for ACVN.


#3: Who makes the diet?

  • Do they make their own food or just provide the label? Is it a subsidiary of a large corporation or an independent company? Companies that own the manufacturing equipment or are part of a larger organization (or both) are more likely to have internal checks and balances in place to help prevent production errors and ensure food safety and quality. Smaller companies and those that outsource manufacturing may be doing this as well, but many of them do not have the resources to monitor production lines or raw materials. But these generalities don’t always hold true. I’ve come across large manufacturing companies that don’t conduct any post production testing and smaller companies that outsource manufacturing, but conduct their own independent quality and safety checks. The only way to know what a particular company does may be to call and ask.

If the food sounds too good to be true, it probably is.


#4: Is it safe for you and your pet?

  • Feeding raw meat diets, whether prepared at home or purchased from a veterinarian or a pet supply store, will increase your household’s risk of exposure to pathogenic bacteria, such as Salmonella, E. coli, Campylobacter, and Listeria. Yes, there have been recalls for Salmonella contamination in dry pet foods, but this is still a lower percentage than the bacterial counts on raw meat products.
Caitlin and Maggie hugs

Dr. Weeth, working to keep everyone happy and healthy.


I want pet owners to be informed guardians and make the best decisions for their furry companions.

Happy Feeding!

Lisa P. Weeth, DVM, MRCVS, DACVN

Location! Location! Location: What’s the REAL difference between grocery and “premium”?

There are some key differences between the pet foods you find at the grocery store and those sold through specialty pet supply stores, but it’s probably not what you’re thinking. You can find high quality foods at the grocery stores just as you can find poor quality (terrible really) foods sold at specialty pet supply stores.  As I’ve said before price doesn’t always equate to quality when it comes to pet food. “Premium” refers to the price pet owners are willing to pay, and not necessarily the quality of the food.

Different distribution channels (the industry term for the way products get to the marketplace) exist because people attach an emotional value to where they shop. Those who buy their pet food from a specialty boutique wouldn’t dream of grabbing a quick bag at the grocery store, and those who buy whatever pet food is on sale during their weekly grocery run think that spending the extra time and money at the pet super store is a waste. Companies will target different distribution channels for different types of pet food shoppers. This same marketing phenomenon holds true for clothing, coffee, and even our own foods, so pet food is not unique in this.

cat reading food food

Who really decides what food you buy?


The best way to select a food is not by where it is sold but by considering the needs of your dog or cat, as well as your family life style and budget constraints. Paying more for pet food doesn’t mean you love your dog or cat any more, just as spending less doesn’t mean you treat them like any less of family member. The reality in my household is that my cats don’t really care where their food comes from as long as it is in the bowl on a regular basis. And for our dogs, any food was cause for a celebratory butt waggle.


Raider’s best “feed me” face.


Other than the market trappings, what are the real differences between brands sold through grocery stores and pet supply stores? It largely comes down to cost of raw materials and how they impact the formulas, ratio of plant to animal proteins, and digestibility of the overall diet.

Formulas: Does the food have a specific ingredient list, or has the company built-in ingredient flexibility? Most grocery or discount retail store brands will use what I consider “open” formulas. Meaning that they list things like “meat”, “poultry”, and “by-products” instead of “beef”, “chicken” or “pork liver”. Check out my post on ingredients if you’d like to learn more about these differences, but in general using broad ingredient definitions allows manufacturers to substitute nutritionally similar ingredients (like chicken for turkey) without having to change the label, get approval from the FDA-Center for Veterinary Medicine first, or having to pay more money for an ingredient that is in limited supply. The nutrient profile of the finished product will be the same no matter the specific ingredients used, but having an “open” formula will lower manufacturing costs, which in turn lowers the cost of the finished diet to the consumer. This is not good or bad for the general population, it just is. Some dogs and cats do very well on varied diets, but for those with food intolerances or allergies this inherent variety can be problematic. Though even with over-the-counter pet foods and treats using specific named ingredients, undeclared ingredients can still show up. Technically, pet food companies that name specific ingredients are required by law to follow the same formula and ingredient list with every batch, which will drive manufacturing costs up when ingredients are in short supply since substitutions are not legally allowed.

Ratio of Plant to Animal Proteins: The reality is that animal proteins are expensive, as anyone who shops for the family groceries will tell you. Just compare the cost of a pound of beef to that of a pound of rice. A pet food that uses a combination of plant and animal proteins to balance the essential amino acid profile will be less expensive to produce than a food that uses primarily animal proteins. Again, less cost to manufacture typically means less cost to the pet owner. Dogs are omnivores and can thrive on a variety of different balanced foods from all meat to all vegetarian and every combination thereof. Cats on the other hand are carnivores and while they can do well on balanced diets that include small amounts of carbohydrates and plant proteins, they tend to do best on higher amounts of animal protein.

Digestibility: Digestibility just means how much of what you feed actually gets incorporated into the dog or cat vs. coming out as poop. For commercially-prepared dry and canned foods, digestibility tends to be lowest for grocery store brands (around 75-80% digestible), moderate for “premium” priced brands (consistently 80%), and highest for foods sold through veterinary offices (closer to 85% digestible). Fresh food ingredients are even more digestible still (over 90%), but this can vary depending on ingredients and cooking technique. There are exceptions to every rule, but these can be used as general guidelines. Digestibility is affected by the quality and processing of the raw materials (animal- and plant-based), the presence of other ingredients (especially fiber), and the processing and cooking of the combined diet (heat and pressure cooking). Unfortunately there is no way of knowing the quality of the ingredients and digestibility of the diet just by reading the label. This comes from knowing the manufacturers and having experience with the diet. Even a diet labeled as having undergone “AAFCO feeding trials” may be less digestible than one that bares a “formulated to meet the needs” label since “increased volume of stool” and “excess gas production” are not grounds for failing a feeding trial.  Sometimes lower digestibility can be a good thing, like a dog that need to eat a higher fiber diet to maintain intestinal health, but can also be an issue if you live in a fifth floor walk-up. And it’s the middle of winter.


Too many choices! And that is just a small fraction of the whole store.


So what do you need to know?

If your otherwise healthy dog or cat has a sensitive gastrointestinal track and is a frequent vomiter/breaks with diarrhea if they sniff the wrong food (and has been seen by your vet to ensure that nothing else is wrong), then buying a brand that has a proven higher digestibility or even a veterinary therapeutic brand may be a necessary. On the other hand, if your dog or cat is an easy keeper and can eat any type or brand of food without incident, then you have more shopping flexibility. You and your pup may enjoy taking a trip to the pet supply store together to buy food, or maybe you are pressed for time (or money) on a regular basis and in that case buying dog or cat food at the grocery store is perfectly acceptable.  I pass no judgment about where caregivers buy their food. My loyalty is to my patients, not the store owners.

You know your companion dog or cat better than the clerk at the store or even your friends at the dog park. My criteria for finding the right brand are simple. If your dog or cat is eating a balanced diet; is looking good and feeling good; the food in question is safe for the whole family (no unpasteurized raw meat, please); and the manufacturer is invested in ensuring the health and wellness of companion dogs and cats (as opposed to making a quick profit) then feed away!


Annabelle willing you to get up and fill the bowl.


Happy Feeding!

Lisa P. Weeth, DVM, MRCVS, DACVN


Kibble Chaos: What to do when the fear mongers come out

Important Notes: The following post contains my personal views and is not an endorsement or detraction for any particular products. I do not have detailed knowledge of any pending legal cases, nor am I associated with the defendant pet food company.


I am sure most of you have already read about the lawsuit filed in California last week against Nestle Purina by a concerned and grieving pet owner. This lawsuit claims that all three of the owner’s unrelated dogs became ill after consuming Beneful dog food, with one of them, an eight-year-old English Bulldog, dying from this mystery illness. The lawsuit further alleges that an ingredient used in the food (propylene glycol) is toxic to dogs and that the grains were contaminated with mycotoxins. The lawsuit seeks to prove that both factors caused the dogs’ illness, or at the very least they seem to be trying to hammer Nestle Purina with enough bad PR through emotionally charge, but poorly detailed media reports that they will settle out of court.

I have had a number of friends and family contact me over the last week asking what I thought about the lawsuit or if they should stop feeding Beneful to their dogs. My good friend over at Pawcurious recently addressed this question in her blog, but I wanted to chime in officially, too (mostly because I had already started writing this post). The short answer is no, if your dog is doing well (eating, drinking, acting normal) then don’t change their diet. But…as I’ve said before, there is no one perfect diet-feeds-all when it comes to dog and cat foods and if you have any specific concerns then Beneful (or whatever brand you are feeding) may not be the best diet match for your pet.  My heart goes out to anyone who has lost a beloved companion. The death of a dog or cat is always hard and bereaved caregivers are often left looking for someone or somewhere to place the blame, but it is important to look at the merits of a media claim before jumping to conclusions for your own furry family member.


Lawsuit Problem Point #1: Propylene glycol is a compound used as a humectant (meaning it retains water) in pet foods and treat, and also has the added bonus of being anti-bacterial and anti-fungal. This is what keeps the chewy bit chewy, but prevents them from becoming green and fuzzy. Propylene glycol has been used in dog foods and treats for decades and is “generally regarded as safe” (GRAS) for dogs by the FDA even at high dosages. On the other hand, propylene glycol is definitely toxic to cats (causes damage to red blood cells resulting in anemia) and has been banned in and around cat foods since 1996. Since the diet in question is clearly a dog food, I am not worried its use here. Propylene glycol and ethylene glycol are NOT the same thing. Ethylene glycol is antifreeze and is toxic to everyone. There is no antifreeze in Beneful.


Propylene Glycol is not…


Ethylene Glycol.

Lawsuit Problem Point #2: Beneful is the most popular diet Nestle Purina sells, with a reported 1.5 billion “meals” served in 2014. Which means just based on the numbers, even if 0.0001% of those meals caused a problem you would be able to find “thousands” of unhappy customers (1,500 each year to be exact) on an internet fishing expedition. If the same food only sold 1.5 million “meals” on any given year, that same percentage would only cause 1.5 adverse events each year and no one would have even noticed. I am making up these percentages and numbers, but you get the idea. With enough sales, even normal variations are magnified. Yes, there will be dogs that have not and will not do well on Beneful, just as there are dogs that will not do well on every other brand of food out there. In practice I have seen and treated dogs for adverse reactions to every single brand of food you can think of (and some you’ve probably never heard of).  No one food is perfect for every dog.

Lawsuit Problem Point #3: The clinical signs reported through the media and named in the lawsuit do not fit with any pattern to establish food toxicity. The signs listed range from vomiting and diarrhea, to seizures and bloat, to internal bleeding, liver failure and kidney failure. If this was something like ethylene glycol (actual antifreeze) or even melamine and cyanuric acid contamination, every dog would develop kidney damage. If this was a mycotoxin I would expect vomiting, diarrhea and liver damage. I find it very hard to believe that a particular food would have not just one of these food-borne issues, but all of them. The signs listed are too varied and inconsistent to have a pattern, which is what happens when dogs get sick from random chance and just happen to be fed the most popular diet sold in the United States.

Lawsuit Problem Point #4: It is being promoted through the media, not the FDA or other knowledge based sources. Conspiracy theorists may start to scream and shout that Big Pet Food is in bed with the Government, but the reality is that every pet food company and animal feed raw material provider screens for mycotoxins and while it is nearly impossible to have a zero mycotoxin level, this is regulated by the FDA and high levels are an actionable offense.  Additionally, real or potential product contaminations are a serious health and public safety concern and are why the FDA established the Reportable Food Registry in 2009. Any pet food or treat at any time (no matter where it is sold or how much it costs) can have a production issue and the FDA relies on diligent pet owners and primary care veterinarians to report any suspected problems as soon as possible so they (the FDA) can investigate and force a recall if and when needed. The FDA would not take a “wait and see” approach with human or animal health and Nestle Purina did not become a multi-billion meal provider by harming dogs. That is a terrible business strategy.

So what do I think may be the real story behind this lawsuit? If I was to guess I would say older pets without regular heath screening fed a low cost diet that does not fit their particular needs. We don’t know the health status of the dogs in question before the diet change, or why the diet was changed in the first place. Also having a lower price point does not mean that a food is “bad” or “junk food” it just means that the combination of ingredients and larger amounts of plant-based ingredients are less expensive from a manufacturing standpoint. Less cost to manufacturer means less cost to the pet owner, but these combinations can also make the diet less digestible. A less digestible diet result in more poop being produced; a fact that will not agree with every dog, but no food is perfect. At the risk of talking in clichés, correlation is not the same as causation and cost does not always equal quality. So in the immortal words of Douglas Adams…



Generally a good approach to life.


Happy Feeding!

Lisa P. Weeth, DVM, MRCVS, DACVN