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.

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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.

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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.

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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.

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Feeding for fit, not fad.

“Wild-Type” vs. Dry vs. Canned Diets

A typical well-fed adult house mouse (https://archive.org/details/CAT11124570)  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!

 

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

 

Happy Feeding!

Lisa P. Weeth, DVM, MRCVS, DACVN

 

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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.

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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.

 

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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.

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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).

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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.

 

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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.

 

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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.

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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.

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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.

    Pet-library---feeding-a-cat

    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.

    stock-footage-portrait-of-mature-couple-petting-dog

    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.
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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.
labrador_retriever_puppy

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.
snakeoilpromo

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.

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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.

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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!

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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_chemical_structure

Propylene Glycol is not…

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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…

 

the-hitchhikers-guide-to-the-galaxy

Generally a good approach to life.

 

Happy Feeding!

Lisa P. Weeth, DVM, MRCVS, DACVN

 

 

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.

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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.

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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

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.

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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.

Another word from our site’s sponsor…Me

I know that I will have detractors, especially as I reach more readers, but before getting back to my regularly programmed topic [The Good (and Bad) of Home-Cooked Diets] there are a few things I wanted to clear up.

#1: No One is Paying Me to Recommend Diets

I realize that my moderate, consider-the-facts approach to feeding dogs and cats is less sexy than making inflammatory statements about commercial pet foods. Statements like Big Pet Food are “big money recycling companys [sic] who don’t give a damn about the health of your pet” (real comment I received from a reader) really do catch the eye and imagination. Clickbait headlines like “Low Grain and Carbohydrates Treat ALL Chronic Illness” (Spoiler Alert: they don’t and depending on the disease can actually make your dog or cat much, much worse) are more exciting than an article that advocates for putting the patient first and then finding the diet strategy that fits their needs.

As a practicing Veterinary Nutrition Specialist I have worked with patients that have eaten a variety of different pet food brands as well as home-prepared foods; I have toured pet food manufacturing facilities large and small to see how pet food is made and what kind of safety and quality control standards are (or are not) in place; and have been invited to speak at local, state and national veterinary conferences. Sometimes my speaker’s fees and travel expenses have been sponsored by a pet food company, sometimes it comes from the conference organizers, and sometimes if it is close to home for an organization that I support I’ve paid my own travel expenses and waved a speakers fee. Whichever way, it hasn’t changed my patient-first approach to nutritional therapy. There is there is no one-size-feeds-all diet and to quote one of my favorite movies The Princess Bride: “Anyone who says differently is selling something.”

princess bride

Who doesn’t love The Princess Bride?

So for the record, I have never been an employee of anyone other than a veterinary hospital or clinic (or myself) and no one is paying me to promote a particular food or a particular feeding philosophy. I have served as a paid consultant for a few pet food and treat companies, but you won’t find me promoting any one food strategy or brand as better than all others. I did not go into veterinary medicine or Veterinary Nutrition to become wealthy, I chose these fields because I want to help animals and their families. If my primary goal was financial gain, I would have a website selling my own brand of supplements and foods or at the very least I would include a link to an online retailer that sent me a “fee” for funneling sales to them. Instead I have a site dedicated to sharing the knowledge that I’ve accumulated over my years in practice and it is yours to read or dismiss for free. No membership fee required.

#2: No One Else Paid for My Education

There are a few online veterinary “experts” that like to stir up conspiracy theories about Veterinary Nutrition Specialists. They make claims like Big Pet Food “might be encouraging veterinary nutritionists to speak out in defense of mass-marketed commercial pet food formulas” or that there are problems with “veterinary nutritionists and their ties to the pet food industry”. I’ve even heard the accusation that Big Pet Food pays for veterinary education and the education of Veterinary Nutrition Specialist. Unfortunately for me and my personal finances, no one has paid for my veterinary education other than me (and I still have the student loan debt to prove it!) and my residents salary (all $30K a year) was funded by the University of California, Davis.

go aggies

Lifetime of Aggie Pride!

Everyone loves a good conspiracy. Yes, there are Veterinary Nutrition Specialists that work for pet food companies, but the majority of ACVN members (>60%) are at universities teaching and conducting research that benefits animal health. Some of this research is funded by their individual universities, some by government organizations like the National Institutes of Health (NIH), and some of this research is funded by pet food or supplement companies. Research funding for animal health and nutrition studies is limited and sometimes beggars can’t be choosers. Outside of industry and academia there are a few ACVN members like me who are scattered in private practice settings (<10%). We work directly with caregivers and primary care veterinarians and our relationships with pet food companies are limited to what we use to treat our patients. No matter where we are, every member of ACVN that I know (and I know all of them) loves animals; we all have our own furry family members large and small; and we all want dogs, cats, horses, etc. to live long happy lives irrespective of what type of food caregivers decide to feed.

# 3: Pet Food Safety is a Priority for Me

I am anti-raw animal products for reasons that have nothing to do with the nutritional aspects of feeding a less processed food and everything to do with the increased health risk to caregivers and other animals in the household. Yes, dry pet foods have been recalled for Salmonella contamination, too. The Centers for Disease Control and Prevention (CDC) reported that 70 people were diagnosed with salmonellosis after coming in contact with contaminated dry pet foods between 2006-2008. The CDC also reports an estimated 1.2 million cases (i.e., people) acquiring Salmonella infections each year associated with eating raw or undercooked meat and eggs, though contaminated fresh fruits and vegetables are a close second. When you compare cases of Salmonella from dry pet foods (70 between 2006-2008, plus an additional 22 from 2011-2012) with exposure from people foods (1.2 million/year), dry food contamination represented 0.0009%-0.003% of all human Salmonella cases during the years of these outbreaks. So yes, I am much more worried about raw meats and other people foods carrying Salmonella than I am about dry pet foods.

In 2008 the Food and Drug Administration Center for Veterinary Medicine (FDA-CVM) began routinely testing dry pet foods for Salmonella, while commercial raw pet foods analyses did not begin until the end of 2012.  Lack of a recalls for a raw-meat diet before 2012 does not mean that raw meat diets are “safer”, just that no one has been looking at them. You also need to consider market shares. Dry (i.e., kibble) pet foods make up 80% of the pet food and treat market with 6.5 million metric tons of dry food produced each year. I can’t find specific data on the raw commercial market, but all wet foods (canned, pouched, refrigerated, and frozen; cooked and raw) make up only 15% of the total pet food and treat market each year.

cat eating meat

This is not the “natural” diet of cats.

#4: Raw Meat Diets are Not Magical

Raw meat fans always like to talk about how their dog or cat’s skin allergies were “cured” when they changed from their dry food to a raw meat diet and that by recommending against raw meat I am “ignoring” the many problems that “disappear when going from ‘dry’ food, to high quality, fresh foods”.  What these raw meat advocates fail to recognize is that when they made the diet switch they also changed almost every other aspect of feeding. They also changed the ingredients, the digestibility, and the fat content. Feeding a higher fat, more digestible, limited ingredient diet can absolutely help with many skin conditions. If these same caregivers had cooked the food, they would have seen the same improvements AND they would have reduced their risk of making themselves or their animal sick. I am not opposed to caregivers feeding a fresh, less processed diet to their dogs and cats and I have definitely seen the benefits of this diet type in my patients and my personal animals. But … home-prepared foods don’t work for every dog and cat or even every family.

#5: I Want Caregivers to Be Informed Consumers

I advocate for animal health and wellness. In some cases that means feeding a balanced home-prepared diet and others that means feeding a balanced commercial dry or wet diet. As long as the diet in question provides all of the essential nutrient’s (and even a few non-essentials that may be beneficial) and does not contain anything toxic or harmful and it makes you as a caregiver happy to feed, then feed it. I don’t think there is not one diet strategy that trumps all others as long as it is balanced and safe.

smart consumer

Be a smart pet food shopper!

Happy Feeding!

Lisa Weeth, DVM, MRCVS, DACVN