Evidence based nutrition & supplements: Which products have the ability to treat & prevent disease?
As a practicing wellness veterinarian for over 25 years no area has been as exciting (or challenging!) as treating and preventing disease with nutrition. The following data has been compiled from the following lectures given by board certified veterinarians (most un-affiliated with pet food companies). I have provided links directly to peer reviewed websites as many as possible so you can do you own research in this very exciting area.
I am well aware that talking about nutrition is akin to discussing politics & religion. We all have firmly held beliefs and our emotions are often involved. As a veterinarians based in science we owe you the best science based perspective to help you make the right decisions regarding nutritional products, amounts to feed and what wellness issues are specific to your breed (or mixture of breeds). There is even some exciting emerging evidence that certain breed specific feeding has merit.
Recent lectures by board certified DVM’s (Nutrition, Internal Medicine & Surgeons) that I have attended to compile this review.
Naturally Neutraceutical Dr Rob Silver DVM Madison WI Sept 2006
Using Nutrition to Enhance Patient Care Dr Lisa Freeman DVM DACVN Oct 2007
Hills Symposium of Evidence Based Nutrition Dr Phil Roudebush DVM DACVIM Nov 2007
UW Orthopedic Considerations for the Canine Athlete Dr Paul Manley DVM DACVS Nov 2007
Rehabilitation in Veterinary Medicine Sherman Canapp DVM DACVS et al April 2008
International Veterinary Rehabilitation Symposium Dr Julie Churchill DVM DACVIM Aug 2008
Practical Small Animal Nutrition Dr Kathyrn Michels DVM MS DACVN Lake Delton Feb 2009
Important Disclaimer:
This information is in no way to be used without the guidance of your own veterinarian. The assessment of health status and deciphering the best nutrition & supplements for your dog is a complex science and art!
ALL OF THIS INFORMATION NEEDS TO BE CROSS CHECKED AND USED WITH THE ASSISTANCE & GUIDANCE OF YOUR VETERINARIAN
Without their guidance with regard to lab testing , a good physical exam including a body condition score, knowing all underlying conditions (and for rescues/mixed breeds their true genetic makeup) much of this information cannot be properly or safely applied.
Most common diseases that we see as wellness clinic veterinarians
- 75 to 85% have Periodontal Disease
- 50 to 60% are above their Ideal Weight
- 20 to 30% have Osteoarthritis
- 10% to 20% have Allergies (inhalant or food)
- 10% to 20% Organ Failure (Kidney, Liver, Pancreatitis, Diabetes)
- 5 to 10% have Urinary Stones (kidney or bladder)
Many of these are breed specific i.e. small breeds get much more periodontitis and larger breeds generally have much more arthritis & orthopedic problems like hip dysplasia
List of diseases we commonly treat with Rx foods & supplements (partial list)
- Diabetes
- Obesity (over 20% of ideal weight)
- Periodontitis
- Renal failure
- Inhalant allergies
- Food allergies
- Liver disease
- Pancreatitis
1) To prevent Periodontitis (Grades 1 & 2) affects 75 to 85% of pets
Best resource for products: Veterinary Oral Health Council vohc.org
Best assurance of quality: VOHC seal of approval given if food is at least 20% better than typical commercial brand in preventing. Plaque claim is better than just a tartar claim
Specialists viewpoints Dr Fraser Hale DVM FAVD Dip AVDC
Dr Jan Bellows DVM FAVD Dip AVDC
Products Rx Foods Hills T/D ® & Purina Dental Diet ® (VOHC accepted plaque & tartar claim)
OTC Foods Hills Oral care ® (VOHC accepted plaque & tartar claim) & Iams Dental Defense ® (VOHC tartar claim one product in family)
Rawhide chews Cheweez rawhide chews have VOHC acceptance, CET Hextras have good evidence (but are not VOHC labeled)
Water additive healthymouth.com 1st VOHC seal for a water additive
Home care using tooth pastes, a plaque retardant gel (Oravet) and a periodontal vaccine are outside the scope of this nutritional discussion but are the mainstays of prevention and should be discussed with your veterinarian.
Breeds we specifically need to watch
All dogs under 20#, all Brachycephalics (bulldogs, pugs etc) because of teeth crowding and greyhounds (have a genetic predisposition towards)
Best source to discuss: dentistry oriented veterinarian- ideally an American Veterinary Dental Society Member (AVDS) or a board certified veterinary dentist (We have 3 at U of Wisconsin!)
2) To treat & prevent Obesity (20% over Ideal Weight) affects 40 to 50% of pets
Best national site Association for Pet Obesity Prevention
Best resource for why & how your veterinarian or westsidefamilypet.com
Products Prescription Rx Foods: Hills, Royal Canin, Purina, Iams (all available from your veterinarian) Rx because physical exam, lab testing and calorie counting to be safe and effectively used.
“Over the counter” OTC foods: “light formulas” (must be under 320 Calories/cup)
Supplements: L-Carnitine, Isoflavones, EPA/DHA (fish oils), Level 2 evidence exists
Breeds we specifically need to watch Beagles, Pugs, Scotties, Dalmatians, Labs & Golden Retrievers
3) To treat & prevent Osteoarthritis (includes degenerative disease related to hip dysplasia, elbow dysplasia, ACL tears) 20 to 30%
Best way to prevent JAVMA wt loss study
Best resource for supplements Consumerlab.com
Products Rx Foods Purina JM ® & Hills J/D ® (force plate studies have been done by each company)
Over the counter (OTC) Foods Calorie Appropriate Feeding
EPA/DHA Fish oils 20mg of EPA per lb per day (details)
Joint supplements (DASUquin ® & Glycoflex ®) per label (details)
Challenges: Not FDA controlled so there are major quality control & effectiveness issues
Breeds we specifically need to watch Labs, Golden Retrievers & all large breeds, Cavalier King Charles, cats!
4) To help treat Allergies (inhalant & food) 10 to 20%
Nonspecific treatment only (inhalant blood testing & food elimination trials must be done to diagnose)
EPA/DHA 20mg EPA/lb about 7 to 8 human fish oil capsules for a Labrador
Challenges: dosing & convenience/compliance
Best resource for general info (human & some pet info) consumerlab.com
5) Probiotics (emerging area)
Proviable by Nutramax first to have good evidence
Nutriflora, Vetriscience & Prostora
Quality control a huge issue (colony forming units etc)
6) Breed specific nutrition
Royal Canin has established some very interesting information with regard to breed specific nutrition. Although there is certainly not data for all breeds and it needs to be researched much more they have provided some excellent and comprehensive background. See their Yorkshire Terrier example
Other useful websites for additional information:
Ohio State College of Vet Med website “Comparing Prescription Diets”
Your thoughts welcomed! Lets begin the dialogue.
Dr Ken
EPA/DHA Fish oils resources
Freeman, Lisa OSU Waltham 2002 Nutritional Conference
Mueller RS, et al. J Sm An Proc 2004, 45:293-297.
Simopoulos AP. J Amer Coll Nutr 2002, 21:495-505
Bauer JE. I Am Vet Med Assoc 2006, 229:680-684.
Caterson B, et al. Hills European Symposium Genoa, Italy, Apr 2005:14-18.
Brown SA, et al. J Nutr 1998, 128:2765S-2767S.
Smith CE, et al. J Vet Inter Med 2007, 21:265-273.
Obesity resources
1. “Feeding for Fitness” Dr Julie Churchill DVM DACVIM PhD Intl Rehabilitation Symposium Aug 13 2008.
2. “Obesity’s missing link: The union of metabolism, genome & disease” Dr Jane Armstrong DVM MS MBA DACVIM U of Minn
3. “An evidence-based review of the use of therapeutic foods, owner education, exercise, and drugs for the management of obese and overweight pets” Dr Phillip Roudebush DVM, DACVIM et al JAVMA Vol 233 No 5 Sept 1, 2008
4. “An evidence-based review of the use of nutraceutical and dietary supplementation for the management of obese and overweight pets” Phillip Roudebush DVM, DACVIM et al JAVMA Vol 232 No 11 June 1, 2008
5. Effect of weight reduction on clinical signs of lameness in dogs with hip osteoarthritis Mark A Tetrick, Peter Muir Journal of the American Veterinary Medical Association Apr 2000, Vol. 216, No. 7, Pages 1089-1091: 1089-1091.
Misc resources
Isoflavones Research Report Purina Research Report Volume 12 Issue 1
Obesity’s Missing Link: The union of metabolism, genome and disease Hills
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