By Renee Streeter, DVM, DACVN

Veterinarians are the most utilized source of information for owners regarding their pet’s health and nutrition.¹ Yet, so many of us are stretched for time during our exams, with scarce opportunity to delve into the complex and often, emotional questions owners have surrounding nutrition for their pets.

Owners are pressured through marketing and media to constantly reassess what they are feeding their pets, which creates confusion and mistrust. Relationships with pets are humanized, which further affects feeding and exercise practices.² Since all our patients eat, and owners are expecting advice on how best to nourish their pet, general practitioners should have a sound, working knowledge of nutrition. Further, they should be aware of recent advances in nutrition and products available to help them meet their patients’ nutritional goals. A thorough diet history, weight, and body condition should be assessed at each visit, and changes to the diet made, if needed. All veterinarians should feel comfortable calculating daily energy requirements and adjusting recommended intake based on diet history and body condition. They should also be knowledgeable of the nutritional goals associated with the management of various conditions. Often times, however, there is more involved regarding a case, and at some point, there may be a need to enlist the help of a board-certified veterinary nutritionist to help manage a patient.

Client beliefs versus pet health

Nutrition is an emotional topic. Owners may have strong feelings and beliefs about the best way to feed their companion. There are times when the pet’s well-being necessitates reeducating the owner to help them realize that feeding their pet in a different manner will be best for them. However, often it’s about being able to find or create a diet plan that takes into account aspects of feeding the owner is most comfortable with, and one that also works for the pet’s needs. This is something a veterinary nutritionist can accomplish through discussion with the client and getting a diet history, freeing up time for the referring veterinarian to focus on other aspects of preventive medicine and health care.

Multiple disease processes

There are times when a patient presents with multiple issues, requiring various, and sometimes conflicting, nutritional goals. For instance, a patient with renal disease may also need a novel and/or low-fat diet to manage concurrent chronic enteropathy or pancreatitis. A veterinary nutritionist can present commercial diets that may help manage multiple disease processes, or be able to create a balanced homemade diet to meet all nutritional requirements and goals.

The overweight or obese patient

Obesity remains a common problem in the pet population.^2,3 A veterinary nutritionist can create a weight-loss plan using appropriate diets as well as determine nutritional goals for the patient. These plans take into account owner concerns and feeding practices, and involve scheduled rechecks and diet adjustments. This all helps clients feel they have a partner in the process and someone who holds them accountable, which may help improve the chances of success.

Patients needing help to gain weight

Cases with chronic enteropathies, cachexia of chronic disease, starvation, and refeeding may benefit from consultation with a veterinary nutritionist. Here, they determine the best diet to help the patient’s underlying condition, creating a feeding plan to get them eating the appropriate daily caloric intake for weight gain within an appropriate timeframe. 

Enteral, parenteral nutritional support

Creating tube-feeding instructions can certainly be performed by a general practitioner. Example calculations can be found in various textbooks.^4,5 It is important to keep in mind appropriate feeding volumes, maximum gastric capacity calculations, and any adjustments needed in IV fluid administration. A veterinary nutritionist can help create feeding plans, including recommendations for any adjustments in IV fluid volumes. For patients who cannot tolerate enteral feeding, nutritionists can create custom total parenteral nutrition (TPN) or partial parenteral nutrition (PPN) formulations and send them to compounding pharmacies to be made or give recommendations for premade products, as well as administration instructions.

Homemade diets

While homemade diets are unnecessary for most patients, more owners are feeding them to their pets than previously.⁶ For some patients who have multiple conditions with various nutritional goals, homemade diets may be the best choice, as they can be customized. In addition, these diets can be very palatable and preferred by some dogs over commercial food, which makes them very useful for picky or inappetant dogs. General practitioners can guide owners to programs that can help create balanced homemade diets for their pets.⁷ However, if there are health issues to consider, a consultation with a veterinary nutritionist is ideal.

While clinical nutrition consultation is a major aspect of what a board-certified veterinary nutritionist does, these professionals also work in the pet food industry. Manufacturers often employ their own veterinary nutritionists to help make decisions, review diets, and provide consultation to owners or continuing education. Some board-certified veterinary nutritionists own their own supplement companies, while others consult for various food, treat, and supplement suppliers/makers, educate owners.

Veterinary nutritionists can help take the pressure off time-consuming and emotional cases. To locate a veterinary nutritionist, visit American College of Veterinary Nutrition’s (ACVN’s) website at ACVN.org. Some specialists require in-person consultations, while others—particularly at universities—take remote consultations. Many provide diet recommendations to the referring veterinarian with the help of the patient’s records and diet history.

References

¹ Laflamme, DP, et. al Pet feeding practices of dog and cat owners in the United States and Australia. 2008. Jour Am Vet Assoc. 3232 (5) 687-694.

² Chandler, M., et al. Obesity and associated comorbidities in people and companion animals: J Comp Pathol. A one-health perspective. 2017. 156 (4):296-309.

³ Corbee, R. Obesity in show dogs. J Anim Physio An N. 2013. 97 (5): 904-910.

⁴ Larsen, JA. Enteral nutrition and tube feeding. In: Fascetti, A., Delaney SJ. Applied Veterinary Clinical Nutrition. 2012. Wiley Blackwell. Chinchester, West Sussex. 329-352.

⁵ Saker, KE. Remillard RL. Enteral assisted feeding. In: Hand, Tatcher, Remillard Roudebush, Novotony. 2010. Small Animal Clinical Nutrition, 5th ed. Mark Morris Institute. Topeka, KS. 339-476.

⁶ Dodd, S. et al. An observational study of pet feeding practices and how these have changed between 2008 and 2018. 2020. Vet Record. 186: 643-652.

⁷ www.BalanceIT.com. DVM Consulting, Inc.

Renee Streeter, DVM, DACVN, obtained her undergraduate degree in animal science from Cornell University and served as a farm animal nutritionist for a major feed company before attending veterinary school at Ross University School of Veterinary Medicine (RUSVM). Her clinical rotations were done at Cornell University’s College of Veterinary Medicine, where she stayed on to do her clinical nutrition residency. There, Dr. Streeter saw clinical nutrition cases and researched the relationship between omega-3 fatty acids, adipokines, and canine obesity, as well as selenium deficiency and white muscle disease in horses. While working in general practice and clinical nutrition for the next six years, she also founded a veterinary nutrition consulting company. Streeter currently helps industry clients through her position as the clinical nutrition services practice principal at BSM Partners and helps veterinary patients as a clinical nutritionist, taking referrals through veterinarians and seeing patients at a specialty hospital in upstate New York.