Nutrition: Why treading lightly is often the best approach

Some clients may lean toward raw food diets for the wrong reason – like soulful puppy dog eyes. Photo: Anna-av/Bigstock On a first well-puppy visit, we do our best to welcome the new pup with open arms, lots of treats, and little freebies to get them started. So as not to forget any crucial conversation topics (as we are want to when faced with so much cuteness), I’ve posted exam room checklists of miscellaneous new pup concerns. These include innocuous items like socialization, breed-related healthcare, microchipping, etc. Pretty vanilla stuff — until, that is, you get to the topic of actually feeding the baby. Of all the seemingly nontoxic puppy topics, nutrition has evolved into the one area I’ve learned to tread lightly. It’s the third rail of all exam room topics of conversation, second only to politics and religion for the fervor it inspires — especially should you accidentally trip on a stray word in the minefield of unmentionable ingredients or excesses. In fact, speaking positively of the commercial pet food industry is the quickest way to get yourself canceled by a certain kind of client. However, I’ve learned in so many other ways, those who share this almost religious distaste for commercial pet food are very much my favorite kind of client. While, admittedly, these are the clients most likely to out you on Instagram for being in the pocket of Big Pet Food, they’re also pretty good pet owners in general. They ask smart questions. They’re quick to agree to diagnostics and treatment without quibbling with prices. They’re typically insured. And they’re more willing to work hard to do what’s best for their pets. So, if I have to put up with some nutritional quirkiness to get someone who’s of a mind to bathe my derm patient three times a week…I’ll take it. In fact, I’ve been so impressed with most of my die-hard “special diet” clients that I’ve learned how to speak to them, how to work with them, and, overall, how to get them to look at nutrition more critically. They, in turn, have taught me quite a bit along the way. By researching their nutritional claims, I have found evidence both supporting and debunking various myths. By keeping an open mind over the years (decades now), I’ve actually changed it more often than I expected to. And though I approach my clients’ nutrition claims with the same healthy dose of skepticism as I did in the ’90s when I first graduated, my clients have succeeded in helping me learn nutrition research is, problematic, at best. Nutrition-related talking points In any case, I thought I’d provide a brief primer on how I talk to my nutritionally focused clients, just in case you decide you just might want a few of these gems for yourself: 1) Talking to those who feed raw diets means never saying no Am I a raw food proponent, you ask? Hell, no! But I know better than to try to talk my clients out of feeding their pets raw diets. These clients are often as wedded to feeding their pets raw as they are to their religious beliefs and/or political orientation. It’s an identity issue and, as such, it should never be directly challenged. (Especially since they’ve been told that all vets hate raw feeding.) Instead, I work with them, explaining the pitfalls while conceding some points wherever I can, thereby disproving that all of us hate raw feeding. At the first opportunity (usually at the first bout of gastroenteritis), however, I pounce. That’s my chance to explain why more diagnostics are needed in this case, and which additional precautions the whole family should be taking. It’s moments like these that help you make your case without having to be heavy-handed. It plays right into the reason they went for raw to begin with. At the first sign, the risks might not be worth the nebulous but oh-so-attractive rewards, most raw-feeding clients will answer the diet question a little differently on their next visit’s intake questionnaire. 2) Make home cooking look every bit as difficult as it should be I lived (and practiced) through the pet food recall of the mid-aughts. I was a baby veterinary blogger at the time, so I cut my teeth on posts about transitioning to home cooking while most veterinarians were busy telling clients to get a grip and keep feeding commercial diets. Truth is, I believe a dedicated home cooker who uses fresh ingredients and balanced recipes is taking the virtuous route and deserves to be given the tools they need to do it right. They don’t deserved to be dressed down or talked down to. Are most of my home cookers doing what I tell them to? Of course not. But that’s typical of all our clients when it comes to our feeding recommendations. Actually, my home cookers are better than most. They fall into two categories of roughly equal size: 1) the lazy home cookers who do so to appease finicky appetites, and 2) the dedicated, who happily dive into pet diets and balance like they were born to swim among the nutritionally neurotic. More power to the second group (the first can’t be helped). 3) What I tell clients who want to feed their pets a specialized diet that reflects their own diet choices (typically veganism) Get a rabbit. There is a line in nutrition, and I draw it brightly at feeding the basic nutrients a species requires. The way I see it, keeping an obligate carnivore like a cat or even a carnivorous omnivore like a dog (questionably an obligate carnivore in some nutritionists’ estimation), means you’re committing to that animal’s way of life. Imposing your social mores on them is morally questionable and, frankly, probably unsafe. Can you find a vegetarian diet? Sure. Would you trust the nutrition research on said diet to sustain your pet throughout his or her entire life? Given the piddly sample sizes and black-box methodologies that plague peer-reviewed nutritional research (in humans and animals, alike), I’d be very uncomfortable adopting a one-bag-for-life diet (of any kind) for my own pets. 4) How to discuss nutrition in general The hardest thing about discussing nutrition is veterinarians have relatively few well-researched commercial choices to offer our clients. What’s more, we have no access to the complete research; when we do, it’s pretty much the findings and maybe an abstract. (The methodology and relevant stats are often missing.) Finally, federal regulations on pet foods are such that we’re not necessarily assured of the ingredients in our patients’ food, and so we pretty much have to take the pet food company’s word for it (independent research on ingredients in diets labeled “limited ingredient” is one example). Given all those challenges, is it any wonder we hate talking about nutrition in the exam room? That nutrition seems like such a mine field to so many of us? That we feel interrogated by clients who question us on nutrition? It’s really not our fault, or is it? Patty Khuly, VMD, MBA, owns a small animal practice in Miami and is a passionate blogger at drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of VPN Plus+.

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