"Therapeutic nutrition can play different roles in managing pets with health conditions. In the case of a condition such as a food allergy, obesity or feline diabetes, food is a primary means of managing the dog or cat with the condition." - Jason Gagné, DVM Therapeutic diets, increasingly part of pets’ health care regimens, are good tools at veterinarians’ disposal when addressing specific ailments. A problem surrounding these diets, however, isn’t whether they work; it’s discussing their benefits with clients. As helpful as these diets can be for pets, owners hear and absorb the misinformation about their effectiveness, cost and necessity. How a veterinarian approaches the topic can help address some of issues before they arise. The dollar debate The expense of specialized diets is a common concern voiced by pet owners, but breaking it down so clients can see what they’re getting for their dollar helps them understand the value. “It’s a fallacy to assume that all veterinary therapeutic diets are more expensive than over-the-counter diets,” said Valerie J. Parker, DVM, Dipl. ACVIM, Dipl. ACVN, of The Ohio State University Veterinary Medical Center. “Many OTC diets actually are similar—or more expensive. If owners have concerns about cost, then realistically, diets should be compared on a per-100-calorie basis, not a price-per-pound or price-per-bag basis.” According to Douglas Mader, MS, DVM, Dipl. ABVP (C/F, R/A), Dipl. ECZM (Herpetology), of Marathon Veterinary Hospital in the Florida Keys, prevention in the form of diet actually saves owners money. “Veterinarians must put things in simple terms that owners can understand,” he said. “For instance, a bag of Royal Canin’s Canine Ultamino may cost $50 for a month. But if the dog responds, it is far less expensive than a veterinary visit with medications, which could be $100-plus.” Compliance is key Emphasizing the medicinal qualities of such diets can help pet owners further understand exactly what they’re paying for and how they’re actually treating their pets. “You are literally buying medical treatment in that bag or those cans,” said Lou Anne Wolfe, DVM, in Tulsa, Okla. “For example, therapeutic urinary diets alter urine pH to prevent formation of crystals, which can block the urethra or concentrate into bladder stones. If a veterinarian prescribes the food, she realizes it will cost more and therefore would not do so if she did not feel it necessary. So I would implore clients to avoid the mistaken notion that therapeutic food is an option.” "Owners need to understand that therapeutic diets are a type of medicine, just like penicillin or aspirin. The owner has to believe in their need and be willing to follow medical instructions or they will not work." - Doug Mader, DVM Therein lies the rub: As important as therapeutic food can be for pets’ health, many clients simply do not feed it. “The 2003 AAHA Compliance Study found that only 7 percent of pets that could benefit from a therapeutic food were actually on such a regimen,” said Ellen Lowery, director of U.S. Professional and Veterinary Affairs at Hill’s Pet Nutrition in Tokepa, Kan. “Nutrition has been established as the fifth vital assessment in dogs and cats, and incorporating good nutrition based on an individual assessment enhances a pet’s quality and length of life. In addition to wellness care, clinical nutrition is an important component of a pet’s treatment regimen, and there are key nutritional factors to consider in each case.” In addition to cost concerns, experts believe that misconceptions plague the therapeutic diet market. With so many OTC and veterinary dietary options available, clients often are simply overwhelmed or don’t know what to believe. “Unfortunately, it’s an industry that’s full of myths and misperceptions, and it can be very confusing for pet parents,” Lowery said. “In some cases, what defines a quality pet food may be in contrast to what pet parents value. Expertise in clinical nutrition will remain critical to identifying ingredients and developing foods that provide proven benefits to pet health.” The good news is that compliance is easy—a pro that veterinarians should emphasize, said Jason Gagné, DVM, Dipl. ACVN, director, Veterinary Technical Marketing, for Purina Pro Plan Veterinary Diets in St. Louis. “There’s no need to worry about forgetting a dose or a pill being spit out,” he said. “Dogs and cats need to eat every day, and many therapeutic diets are designed as ‘maintenance’ diets, so pets can eat the diets for the rest of their lives, if necessary.” Another benefit comes with compliance, said Dr. Gagné: a low risk of side effects. “Unlike medications, feeding a therapeutic diet typically does not present a risk of side effects, although it’s advisable to transition food changes gradually when introducing a new diet,” he said. “Safety is tantamount for pet owners today, and many owners like the idea of a balanced approach to managing a pet with health problems that includes nutrition as well as medications and/or procedures.” Forming partnerships with clients The relationship between veterinarians and pet owners can help form a bridge to better information. “The first thing I would suggest to pet owners is to stop reading stuff on the internet or listening to the employee at the pet store,” said Sherry Lynn Sanderson, BS, DVM, Ph.D., Dipl. ACVIM, Dipl. ACVN, associate professor in the department of Physiology and Pharmacology at the University of Georgia College of Veterinary Medicine. “The internet and pet store employees do not have the training or knowledge of a veterinarian, and if a veterinarian has any questions, they are also able to contact specialists for answers. It is also important to know when it is appropriate to use a therapeutic diet and when it is not appropriate or even when it is contraindicated, so that is why these diets are sold through veterinarians. There is no diet or drug that I could tell you will work in 100 percent of the patients that receive it, but therapeutic diets do really work, and depending upon the condition you are trying to treat, they can be the most important thing you can do to manage your pets medical condition.” Dr. Sanderson has tested the stores in her area by sending her students to local pet stores. The results confirmed to her that veterinarians must play a key role the nutritional aspects of pets’ diets, especially those animals in need of special food. “The students in my nutrition rotation just recently posed as secret shoppers and went into pet stores posing as pet owners,” she said. “It was very disconcerting what some of the employees in these stores told them, and many of these things were being said by employees in large chain stores.” In addition to the relationship between vet and client, manufacturers often provide educational materials for owners to take home and study. The better informed pet owners are, the more likely they are to trust a veterinarian-recommended diet and to follow the instructions as directed. “Veterinary clients are highly involved in their pets’ health care including nutrition,” said Greg Reinhart, Ph.D., senior vice president, research and development for Blue Buffalo in Wilton, Conn. “Blue Buffalo provides educational brochures for veterinarians to share with clients to help them understand the need for and benefits of therapeutic diets.” This proactive approach can help pet owners and their animals down the line when they begin weighing options for their pets’ nutrition. “Every pet is an individual,” said Dr. Parker. “Its unique medical condition(s) should be taken into account when determining what the optimal nutritional plan is, whether that’s a veterinary therapeutic diet or not. Specific nutritional goals should be considered and then diets that meet those goals should be identified, rather than simply using company marketing to choose the best diet(s).” Food for thought Therapeutic diets are poised for further growth, thanks to ongoing research and development, Parker said. “There is constant refining of veterinary therapeutic diets based on several factors, including new research regarding diseases, palatability studies and nutrient requirements as set forward by the Association of American Feed Control Officials,” he said. These are factors that vets can pass along to clients while breaking down how the foods work, Gagné said. “Food has the power to positively affect everything from the brain and the gut, to the teeth and gums and the endocrine system, and we’re learning more all the time about how nutrition and the immune system can interact. It’s an exciting time to be working in the field of therapeutic nutrition.” When pet owners looking for inexpensive food options approach Dr. Wolfe, she ensures they understand the importance of nutrition, especially when it comes to therapeutic diets. “I emphatically tell them there is no comparison,” she said. “I remind customers that they paid for the veterinarian’s knowledge and encourage them to follow her advice.” And that advice, Gagné says, is priceless. “Veterinary guidance is critical to ensuring the correct diet is selected, to assess the effectiveness of the treatment plan, and to address any health changes the pet may experience over time,” he said. “Veterinarians should not discount the power of their own recommendation.”
