5 Consideration Before Adding Supplements to Your Dog or Cat’s Diet.

  1. Is the supplement filling an essential nutrient need?

Commercial pet foods labeled as “complete and balanced” provide all of the essential nutrients that are required for life (with the exception of water), and nothing is else except for water needs to be added to the diet. But, while the majority of companion dogs and cats will do equally well and live long, happy lives on a variety of different commercial pet foods (no matter what form or where you buy them), there are a few notable exceptions where “complete and balanced” for longevity may not be the same as optimal intake for health and wellness (I’m looking at you essential fatty acids and dietary fiber). General purpose vitamin/mineral/fatty acid supplements are not providing any magic fixes; they are simply filling in the difference between what the general population needs and what the individual needs. Depending on the ingredients they can be good sources of essential fatty acids, but have relatively low levels of all essential minerals and most vitamins to prevent nutrient toxicity when added on top of a commercial diet. This makes caregivers feel like you are helping their dog or cat without causing any harm (other than maybe to their wallet).

  1. Is it being used as a nutritional pharmaceutical (i.e., nutraceutical)?

It doesn’t matter if it is the long-chain fatty acids in fish oils that are given to dampen inflammation or glucosamine and chondroitin that may help support normal joint tissue. Caregivers give their dogs and cats many supplements and “natural” preparation to have a physiological effect when ingested (this is the same Oxford English Dictionary definition of a “drug” by the way) and not to fill an essential nutrient need. Despite being used to have a drug-like effect, after the passage of the Dietary Supplement Health and Education Act (DSHEA) in 1994, nutrient supplements and animal and plant products (other than tobacco specifically) were classified more like foods. Irrespective of regulation or manufacturing, the bottom line for me is that if you’re giving a supplement or natural preparation in order to change a disease state then you are giving it to have a drug effect. The regular pharmaceuticals industry has its roots in natural plant or animal compounds, the difference is whether the compounds are ingested in their natural states (wanted and unwanted compounds combined) or are taken as a purified and concentrated active ingredient. Kind of like the difference between chewing willow bark for your headache instead of taking 2 aspirin.

To Supplement or Not to Supplement, That is the Question.

hamlet pic

Alas poor Yorrick, if only I had given you more coconut oil and ground chia seeds…

  1. Supplements whether for pets or people are largely unregulated.

The passage of DSHEA was a coup for the supplement industry. Congress officially recognized that the supplement industry was an “integral part of the economy of the United States” and that the “Federal Government should not take any actions to impose unreasonable regulatory barriers limiting or slowing the flow of safe products and accurate information to consumers”. “Unreasonable regulatory barriers” like requiring supplement providers to prove safety, purity, or efficacy before launching a product on an unsuspecting marketplace; providing “accurate information” like marketing pamphlets made available in stores or on company sponsored websites. DSHEA does make allowances for FDA involvement if a product “presents a significant or unreasonable risk of illness or injury” or if a company makes an outright drug claim (like that it will cure cancer or obesity), but the “burden of proof” to prove that a supplement has been adulterated, contains harmful compounds, or that the company is engaged in illegal marketing practices was shifted to the United States government. So it isn’t until after a supplement has been widely sold and has caused harm to people or animals or the company is caught making therapeutic claims, that the FDA can become involved. This is almost the complete opposite of what is required for manufacturers of purified bioactive compounds (i.e., regular pharmaceuticals).

  1. Supplements are Big Business

Prior to the passage of DSHEA in 1994 supplements sales were a steady $4 billion a year, by 2009 the supplement industry was reporting annual sales of $20 billion, and by 2012 they were at a whopping $32 billion a year, and are showing no signs of slowing down.  With a multibillion dollar a year prize, it is not hard to see why so many people are getting into the supplement game. Self-promoting media doctors (human medical and veterinary medical), fitness personalities, animal enthusiasts, celebrity chefs, dog trainers, and even people who are just looking for a get-rich-quick scheme are cashing in on the supplement craze. And why not? Without those silly “regulatory barriers” of having to prove quality or safety, the cost of entry is low and the potential payout is high. If you don’t think raw material providers and supplement marketers will try to cheat the system and make use of this loophole, just look at the recent case of supplement fraud in products sold in New York state or the Nature publication showing that most fish oil supplements sold for people in New Zealand contained significantly less long-chain omega-3 fatty acids that reported on the label. I am not one to buy into conspiracy theories normally, but considering that DSHEA was pushed through by a senator with substantial financial backing from the supplement industry I am a bit suspicious of the true motivations behind this act.

pill pusher

The supplement industry, are they the real pill pushers?

  1. Quality Control in the Supplement Industry is Self-Guided

I think of the current supplement industry much as I imagine the Wild West was once like. Some companies are doing a great job and are upstanding corporate citizens, while others are working just out of view of the enforcers and are focused on profits more than quality (or health). Good quality companies are screening raw materials, are conducting internal and external audits of products and manufacturing facilities, and participate in organizations like United States Pharmacopeia (USP; for human products) or National Animal Supplement Council (NASC; for animal products). The biggest different between USP and NASC is that while they both independently evaluate the manufacturing processes, labeling, and adverse event tracking for participating companies, only USP also performs independent testing of the products themselves to ensure purity and dosages, NASC does not. Both USP and NASC are also voluntary organizations and membership is not a requirement in order to sell products and makes millions (billions?) a year in supplement sales. Consumer Labs is another organization that conducts independent testing of mostly human (and sometimes veterinary) supplements and is a good resource for dog and cat caregivers.

snakeoilpromo

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

I use certain supplements in practice on a regular basis. My general approach is that if I have clear scientific evidence that a particular supplement may help my patient (like is the case with essential fatty acids and animals with dermatitis on questionable diets), or if a supplement may or may not help but is not harmful (like glucosamine in animals with early, not advanced, joint disease – glucosamine has been shown not to work in advanced arthritis cases) then there is little cost to animal health or the family budget in adding these types of products in. But it is important for pet owners to know that supplements can cause harm and that they are basically unregulated pharmaceuticals. You need to know and trust your manufacturer. Supplements can benefit animal health and wellness, but they can also have no effect or make certain conditions worse. At the risk of sounding like a broke record (for those of you who know what a broken record sounds like), my hope that I can help you to become a more informed animal advocate for your furry family members for years to come.

Happy Feeding!

Lisa Weeth, DVM, MRCVS, DACVN

Advertisements

3 Facts about Home-prepared Diets for Dogs and Cats

Fact #1: Animals need nutrients not ingredients.

This is one fact that is guaranteed to stir the home-prepared meal crusaders into a rapid froth. Proponents of preparing your own food for Maggie or Mittens claim that dogs and cats need fresh whole ingredients and anything less is tantamount to negligence. Yes, feeding (and eating) a less processed diet is what our companion animals’ (and our) digestive systems have adapted to handle over tens of thousands (actually millions) of years, but that doesn’t mean that if we take a few digestive short-cuts by feeding a diet containing purified essential nutrients (meaning the nutrients are being provided in their basic structure as opposed to bound in a food) that the dog or cat can’t do well long term. There are dogs and cats (and people, too) living with severe forms of gastrointestinal disease that prevent them from eating foods in any solid form, but they survive and thrive when fed “elemental” (i.e., purified) diets as an oral liquid or even as intravenous nutritional support. Nature has gifted us quite a bit of flexibility when it comes to the types of foods and nutrients our companion animals (and people) can handle.

The true fate of the diet, irrespective of form, is that the ingredients will be broken down into their chemical composition for absorption in the body. Proteins are enzymatically degraded into their single amino acid building blocks and absorbed by specific amino acid transports; fats are broken down into their individual fatty acids and repackaged in gut before absorption across the cell membrane; and carbohydrates are enzymatically broken into their individual sugar subunits and absorbed by specific single sugar transports. Simple compounds are easy to digest and complex compounds require more digestive action, whether that “digestion” is happening in the animal or in a laboratory. The best diet will dependent on the needs of the individual.

Annabelle did very well on her highly synthesized, hydrolyzed protein diet.

Annabelle did very well on her highly synthesized, hydrolyzed protein diet.

Fact #2: Not all supplements are created equally.

One of my two biggest concerns with pop-culture recipes for dogs and cats is the complete disregard for essential vitamins and mineral. I’ve seen recommendations to use children’s chewable multivitamins in recipes for dogs and cats (which you should not do as most of them contain xylitol, a known toxin for dogs and cats) or to use any general purpose adult multivitamin/multimineral, if one is recommended at all. When I develop a home-prepared diet formulation, I am very specific with the type and sometimes the brand of supplements that I include. Not because I am getting any financial benefit from these human over-the-counter supplements, but because they are made by reputable manufacturers, are widely available for purchase, use forms of essential nutrients that are well absorbed by animals, and are free from harmful ingredients or toxic levels of certain nutrients.  Human supplements are developed to fill common human nutrient deficiencies and some of these nutrients, like vitamin D, can be provided at toxic levels to dogs and cats. Potentially toxic ingredients aside, there is a huge variation in what and how much of each nutrient is included in supplements intended for human consumption and they won’t all work in home-prepared diets for dogs and cats.

Don’t even get me started on veterinary supplements. There are only three that I have found that will work marginally well to balance home-prepared diets, and none of them are available at your local health food or pet supply store. The vast majority of canine or feline multivitamin/multimineral supplements that you will find available over-the-counter or through your veterinarian are actually intended to be added to already complete and balanced commercial foods, not to fill deficiencies in home-prepared ones.

There is more that distinguished supplements than just color and size.

There is more that distinguished supplements than just color and size.

Fact #3: Not all proteins (or oil or carbohydrates) provide the same nutrients.

The second big concern I have with pop-culture recipes is that they often make big sweeping ingredient recommendations without any consideration for the nutrient variation in those ingredients or the nutrient requirements of dogs and cats. I can’t tell you how many recipes I’ve seen that advocate substituting protein sources with dramatically different fat (and calorie) contents or call for adding one of a list of different oils, none of which provide enough essential fatty acids.  An ounce of cooked chicken thigh and an ounce of cooked salmon may be comparable in calories (about 50 Calories each), but an ounce of browned and fat drained 80% lean ground beef has 50% more (77 Calorie) while an ounce of low-fat cottage cheese has 50% less (25 Calories).  Olive oil is high in the non-essential omega-9 fatty acid oleic acid (80% by weight), with a very low concentration of the essential omega-6 fatty acid, linoleic acid (9% by weight); coconut oil is a medium-chain triglyceride with almost no linoleic acid content (1% by weight). Olive or coconut oil (or borage, hemp or chia seed oils for that matter) do not meet the canine or feline essential fatty acid requirements and should not be relied on as the sole source of fatty acids in the diet.

Who wouldn't like a home-cooked meal every day?

Doesn’t everyone’s pantry look like this?

You can absolutely use different protein sources on a rotational basis for a healthy dog or cat and, assuming that the overall essential fatty acid intake for the week remains adequate, you can alternate oil sources, too. But unless you understand the requirements of the individual dog or cat AND the nutritional properties of what is being fed, inadvertent over or under feeding or feeding of an unbalanced diet can occur.

I want to help you keep your companion dogs and cats happy and healthy for years to come.

Happy Feeding!

Lisa Weeth, DVM, MRCVS, DACVN

The Good (and Bad) of Home-cooking for Your Dog or Cat

There are different reasons people give for recommending or feeding home-prepared foods to companion dogs and cats. Some insist that it is a more “natural” way to feed them, while others will list concerns about commercial pet food safety and a general distrust of industrial food supplies. Whatever the reason, what most home-cooking crusaders leave out is the potential harmful effects of feeding an unbalanced diet. If raw meats are being recommended as part of the “natural” diet, they also omit the very real risk to both caregivers and companion animals if that raw meat has been contaminated with “natural” food-borne pathogens. I don’t have anything new to add to my position against raw meat diets, but if you want a quick review you can pop over to my previous post on that topic.

a889014997260c982db3bd814994beec

The “best” feeding plan takes into account the needs of the cat or dog and the needs of the rest of the family.

So assuming that the food is pathogen-free, I don’t believe there is one diet or feeding strategy that works universally for all animals. My nutrition training gave me an understanding and appreciation for the basic requirements for healthy dogs and cats and how those requirements can be altered by disease. My clinical experience has shown me that while there are generalities in nutritional management, individual animals may not always read the textbooks and there needs to be flexibility in diet planning. My approach to nutritional management of my patients is fairly consistent: Step 1 is to identify the nutritional needs of the patient; Step 2 is to make a list of the different ways of getting those nutrients in (commercial- or home-prepared, or both); Step 3 is to pick a starting strategy; and Step 4 is to monitor for effect and adjust as needed.

I could give examples and argue either side of the pet food debate. I have seen patients suffer from chronic gastrointestinal disease (diarrhea or vomiting, or both) or chronic skin disease while eating a commercial diet, yet when switched to a home-prepared diet their signs improved. But, I have also seen growing kittens and puppies suffer from avoidable nutrient-deficient diseases, like bone fractures and rickets, from being fed unbalanced home-prepared diets and adult animals develop diarrhea when the caregiver attempted to transition to home-prepared meals. I don’t think any of these clinical signs or subsequent improvements/worsening had much to do with the inherent “wholesomeness” of the foods offered, rather that there was a patient/diet mismatch.

dobie rickets

Cute Rottweiler puppy with rickets after being fed an supplemented home-cooked diet. Yes, he made a full recovery once the diet was corrected.

I’ve seen website claiming that one doesn’t need a “fancy spreadsheet” or “letters behind (their) names” in order to feed a home-prepared diet correctly. They make statements like “rotation is the key” or “our own diets are not balanced that closely and we seem to be just fine”. But I would argue that collectively people are not that good at balancing their own diets. Human nutritionally-related diseases like goiters caused by iodine deficiency and rickets caused by vitamin D deficiency are making a comeback in the United States. It is not just people with limited access to food who are affected, but those born into educated, more affluent family. Most people don’t do a very good job of balancing their own diets on any given day or even over the course of the week, let alone take the time to think about every essential nutrient and plan every meal.

mybowl image

How much thought do you put into your own “bowl”?

Recommendations for making home-cooked foods have cropped up online and on popular tv talk shows in past years, especially after the large-scale, multi-brand, multi-national pet food recall in 2007. With some notable exceptions, almost all of the pop-culture pet food recipes promoted through websites or in books are coming from individuals with little to no training in nutrition and almost all have significant (and potentially harmful) nutritional gaps. These recipes often give vague recommendations (like “give a multivitamin”) or list ingredient that may provide calories but not adequate amount of essential nutrients (sorry, coconut oil is not a good source of essential fatty acids).  I worry that by trying to fix one problem, such as concerns about safety of the food supply, these “resources” are creating a whole host of new problems with nutrient deficiencies. Or should I say re-emerging old problems.

Published reviews of the nutritional adequacy of home-prepared diet recipes for healthy maintenance, kidney disease, or cancer treatment have found that very few of the recipes available to pet owners provided a complete and balanced source of nutrients or are appropriate for specific disease states. This highlights the importance of working with someone trained in dog and cat nutrition when deciding to feed a home-prepared diet. Feeding a complete and balanced home-prepared diet to a dog or cat isn’t difficult, but it does take planning, an understanding of basic nutrient requirements, and an appreciation for how nutrients are affecting by cooking and storage. Good quality commercial pet food manufacturers have already thought about all of this. When you switch to a home-prepared diet the responsibility (and the blame if things go wrong) shifts to you.

cat fork fed

Home-prepared meals take time, but so does hand feed your cat. Can we say “spoiled kitty”?

I am less concerned about what is being fed (assuming it is balanced and free from contaminants) and more focused on supporting optimal health in the individual.

Happy Feeding!

Lisa Weeth, DVM, MRCVS, DACVN


Home-Prepared Diet Pros and Cons

Pros:

  1. Palatable
  2. Digestible
  3. Ingredient Control
    1. Fresh foods
    2. Provide variety
    3. Avoid preservatives
  4. Human-animal Bond: emotional involvement with feeding
  5. More “natural” diet

Cons:

  1. Potential nutrient deficiency
    1. Ingredient omission or substitutions
    2. Veterinary supplements may not provide adequate levels essential nutrients
    3. Selective consumption (picking out and eating only certain foods)
    4. Nutrient interactions or degradation (with cooking or storage)
  2. Potential food-borne pathogen (if fed raw or undercooked)
  3. Cost: can be more expensive than commercially-prepared diet
  4. Time: takes more time to plan and prepare foods

Ultimately, the most important thing is to select the right thing for you and your companion dog or cat whatever the feeding strategy.