Tuesday, February 19, 2013

Annual Wellness & Cancer

Cancer is a major cause of pet animal death. I say this based on a study that looked into more than 2000 necropsy cases. This study found that 45% of dogs that lived 10 years or older died of cancer (1). Of the more than 70 million household dogs and  90 million cats in the United States, at least 4 million dogs and about 4 million of cats develop cancer each year.

Why should you (a pet owner) and your veterinarian be concerned about cancer? The prevalence of cancer continues to rise in the US pet population. It continually rises due to several factors, but mainly because our pets are living increasingly longer lives. And they are living longer thanks to the advances in veterinary medicine for better nutrition (read my articles on Pet Foods), vaccinations against deadly viral and bacterial diseases, better preventive medicine (heartworm, tick-borne diseases, parasites) and possibly due to the increased bond between pets and their owners (human-animal bond).

I contend that ethical veterinarians will educate their clients about the need for at least one wellness appointment every year to make sure your pet is doing OK. Remember, they age a lot faster than humans, and a small decline in health could translate into a significantly shorter life-span. During a wellness visit your vet will check for signs of anemia, feel the lymph nodes, check for lumps, and palpate the abdomen in an attempt to feel the liver, loops of the intestines, spleen and kidneys to ascertain their size, texture and if there are possibly masses present in the abdomen.

During a wellness visit, I feel it is important to educate my clients as to the benefit of doing blood work. This is  particularly true for pets 7 years of age and older. I believe that the cost of missing a significant yet insidiously developing disease is too great to justify NOT testing just to save a couple hundred dollars. Blood work will also allow your vet to record baseline values for your pet. The best reference range for a particular pet are the laboratory values for that pet when he/she is healthy! Furthermore, once your vet obtains baseline values for your pet's current health status, serial data collection and evaluation provides the best objective way to assess how a disease is progressing.

And to those who believe that vets who consistently educate their clients about the supreme importance of yearly wellness exams and screening tests do so to increase their income, I strongly object! My own pets are placed on yearly screening tests (especially my senior pets); I believe it is poor medicine not to alert my clients to the fact that the older a pet grows, the more likely he/she will start brewing potentially serious health issues. This is true for obesity, metabolic/inflammatory disorders, organ failure (kidney, liver) and, sadly enough, the number one pet killer in the US: cancer.

The Merriam-Webster Dictionary defines the word prevention as "to anticipate", "to see it coming and ward off".  A $50 wellness appointment together with $200 for a complete health screening may help prevent a potentially painful & expensive situation for you and your pet. Isn't your pet worth much more than $250 per year? Think about it!

1. Bronson RT. Variation in age at death of dogs of different sexes and breeds. American Journal of Veterinary Research. 43:2057-2059, 1982

Sunday, February 3, 2013

Commercial Foods (Final Part)

Nutritional Adequacy Statement: the National Research Council (NRC) recommendations were once used to provide guidelines as to the nutritional adequacy of pet foods. The last NRC update occurred in the 80's  and they are no longer consider valid for this purpose. Since the NRC guidelines are no longer used, the AAFCO established its own standards by using its "feeding trial protocols". This means that a certain pet food has been fed to dogs and cats and has met established standards of proper nutrition, i.e. that it contains the proper amount of protein, carbohydrates, minerals and vitamins, etc. in order to meet the pet's basic nutritional needs. Approved products must bear the following statement in their packages: "Animal feeding tests using AAFCO procedures substantiate that [name of product] provides complete and balanced nutrition". Clearly, all of the above does not tell much about the quality of the food, except that it contains the minimal amounts of nutrients that AAFCO deems adequate to keep your dog alive on that food. It is quite disappointing that AAFCO replaced the opinion of reputable, qualified scientists from the NRC with its own. What pet owners need to be aware of is that AAFCO feeding test standards are not scientifically sound, like one would expect in human research. AAFCO's feeding trial standards are very basic and only require the following:

  1. Only a minimum of 8 dogs is required as a valid "test group"  There are no restrictions regarding breed or sex. Of these 8 animals, only 6 are actually required to complete the 26-week trial. The reasons for which an animal might drop out are losing too much weight or other negative side effects.  
  2. During the trial, the only food available to the test animals is the food being tested. Water is freely available at all times.  
  3. At the beginning and end of the trial the test dogs must pass a physical examination by a veterinarian. The veterinarians evaluate general health, body and hair coat condition.  
  4. At the end (but not at the beginning) of the trial, hemoglobin, packed cell volume, serum alkaline phosphatase, and serum albumin are measured and recorded.  
  5. The diet being tested fails if any animal shows clinical or pathological signs of nutritional deficiency or excess. The maximum permissible weight loss during the trial is 15% of the starting body weight. 
  6. Specific minimum values for the blood tests are given, and applied to the average result of all participating animals that finished the trial. 

As you can see, these standards are not scientifically rigorous. What is even more concerning is that if a particular product meets the AAFCO standards, ALL products of that same line are given the same status of "balanced nutrition" - even if they have greater amounts of protein, carbohydrates, minerals, etc. In animals with specific nutritional requirements and in breeds with specific health issues this can result in serious problems, like developmental orthopedic (bone) disease in large breeds, metabolic deficiencies in Terriers, Malamutes/Huskies and diabetes in toy breeds, to name a few. AAFCO standards do not take these issues into consideration.

Feeding Directions: owners need to understand that pet food manufacturers provide an average, basic estimate of food intake for the size, breed and level of activity of a pet. Here good sense is important. I suggest clients to start feeding the amount recommended in the label and then "tweak" the amount given based on whether your goal is weight maintenance, weight gain or loss. It is also important to take into consideration your pet's age and level of activity AND any underlying health issues  such as metabolic diseases (diabetes, hypothyroidism, Cushing's) or liver, heart or kidney diseases. Your veterinarian is the most qualified person to assist you with this information. We are well trained to assess your pet's body condition score (BCS) to inform you whether you're feeding your pet properly or not.

Calorie Statement: if a caloric statement is made on the label, the manufacturer must express it in kilocalories per kilogram basis. It can also be expressed "per cup" or "per can". This information is very helpful for clients to make meaningful comparison between products to chose the most suitable for their pets. Since the caloric statement is made on an "as fed" basis, one must also correct for moisture content to make meaningful comparisons. Caloric content and guaranteed analysis should be always taken into consideration together. The more calories offered by a food per unit of weight, likely more digestible the food is. Keep also in mind that fats provide more than twice as much calories (energy) as carbohydrates. Don't forget that when you compare a cup of two different foods in terms of volume (i.e. cup) they most likely won't have the same weight. Dry foods in particular have different densities, so one cup of food A may have 90 grams of food while one cup of food B may have 115 grams. 

If available, use the metabolized energy (ME) to compare different products. Example:
Food A provides 1680 Kcal of metabolized energy per pound of product
Food B provides 1400 Kcal of metabolized energy per pound of product
Product A is of better quality and digestibility for it offers more calories per pound (in terms of ME).

Other Label Claims: don't be fooled by terms such as "premium", "gourmet", "natural", "organic", "ultra-especial", etc. As explained previously, the pet food industry is not regulated by the USDA and these names have no official meaning in regards to the real quality of the food or the way it was processed or manufactured. Additionally, pet food manufacturers are not required to describe substances like preservatives, ingredients, coloring chemicals, pesticides and additives that they did not add to their products themselves, but their suppliers did.  

Summary: the pet food industry is not under the regulation of the USDA. Rather, they are under the auspices of the AAFCO, whose standards for manufacturing pet foods are questionable. Pet owners and veterinarians have the right to know what they are recommending or feeding to their pets. This information is available on the food labels. However, despite offering a lot of information, such labels can be very deceiving and distracting to the naive person. Educate yourself and don't be swayed by marketing strategies! If you have any questions contact your veterinarian. In most instances, he/she should be able to help you. In addition, you can always call the manufacturer or regulatory agency and ask for further information.


Here is a list of foods that I highly recommend. I hope you find these articles very helpful. Should you still have any concerns don't hesitate to drop me an email!

CANNED FOODS
Artemis Pet Food Co, Inc.
Blue Buffalo Co.
Breeder's Choice Pet Foods
Canidae Corp.
Castor & Pollux Pet Works
Diamond Pet Products
Dogswell LLC.
Drs. Forster & Smith
Fromm Family Foods
Lotus Natural Food
Natural Balance
Natura Pet Products
Nature's Variety
Solid Gold Health Products of Pets, Inc.
Vet's Choice
Wellpet

DRY FOODS
Addiction Foods
Annamaet Petfoods
Artemis Pet Foods
Blue Buffalo Co.
Breeder's Choide Pet Foods
Canidae Corp
Castor & Pollux Pet Works
Diamond Pet Products
Dogswell, LLC.
Dr. Gary's Best Breed
Drs. Foster & Smith
Firstmate Pet Foods
Fromm Family Foods
Horizon Pet Nutrition
Lotus Natural Food
Natura Pet Products
Nature's Variety
PetGuard
Smartpak Canine
Solid Gold Health Products of Pets, Inc.
Vet's Choice
Wellpet     
**********************

Wednesday, January 30, 2013

Wellness for a healthy pet!

Wellness Exams
Aging is a progressive degenerative process tightly integrated with inflammation. Cause and effect are not clear. A number of theories have been developed that attempt to define the role of chronic inflammation in aging: redox stress, mitochondrial damage, ageing of the immune and endocrine systems, epigenetic modifications, and age-related diseases. However, no single theory explains all aspects of aging; instead, it is likely that multiple processes contribute and that all are intertwined with inflammatory responses.

In a study by the University Of Georgia College Of Veterinary Medicine, veterinarians examined data from the Veterinary Medical Database to determine the cause of death for nearly 75,000 dogs over the 20-year period of 1984 through 2004. They classified the deaths by organ system and disease process and further analyzed the data by breed, age and average body mass. Eighty-two breeds are represented in their study, from the Afghan hound to the Yorkshire terrier. The study, published in the Journal of Veterinary Internal Medicine -- http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2011.0695.x/abstract , can be used to create breed-specific health maintenance programs and is a starting point for future studies that will explore the genetic underpinnings of disease in dogs.

While some of the findings corroborate smaller, breed-specific studies, the UGA researchers also found plenty of surprises. Toy breeds, such as Chihuahuas and Maltese, are known to have high rates of cardiovascular disease (19 and 21 percent of deaths within the breeds, respectively), for example, but the researchers found that Fox Terriers also have high rates of cardiovascular disease (16 percent of deaths). Golden retrievers and boxers are known to have high rates of cancer (50 and 44 percent of deaths, respectively).

The study is very important because anticipates how things can go wrong for dogs, thus guiding veterinarians to formulate wellness programs to help keep dogs as healthy as possible. Yet, that cannot be done unless clients understand the importance of regular veterinary check-ups. A wellness program is particularly important for “middle-aged” pets, (pets 6 or 7 years of age or older), when health begins to decline more rapidly. Since every year for a dog or cat is equivalent to five to seven human years, many aspects of your pet’s health can change in a short amount of time. Regular wellness exams allow your veterinarian to evaluate your pet’s general health and become aware of any health problems before they become serious illnesses. Your veterinarian may also wish to perform routine blood testing, urinalysis (urine testing) and other tests are recommended for all pets in their “senior years.”

Make sure your pet does not miss his annual exams, particularly if your pet is “senior”. The AAHA recommends that healthy dogs and cats visit the veterinarian once a year for a complete exam and laboratory testing, if possible. Senior dogs and cats should receive a wellness exam and lab testing more consistently (often twice a year) in order to effectively prevent and treat illnesses that come with age such as cancer, kidney, heart, liver diseases, inflammatory or metabolic diseases, etc.

"He who cures a disease may be the skillfullest, but he that prevents it is the safest physician." [Thomas Fuller] ... think about it!

 

Monday, January 28, 2013

Commercial Foods (Part 2)

Taxonomically, domestic dogs belong to the family Canidae. This family also includes the African dogs, wolves, foxes, coyotes and jackels. Many of these animals are considered omnivors, as is the domestic dog (Legrand-Defretin, 1993). In the wild, dry food is not available to canids. Their natural diets contain from 60-80% moisture and are rich in protein and fat. Canids have no nutritional requirement for carbohydrates and that is why it is so harmful to feed them carbohydrate-rich foods. It is important to keep this in mind, as the pandemic of obesity, diabetes and other metabolic disorders in US pets are on the rise.

Personally, I wish I had more time and patience to prepare home-made foods for my dogs. Home-made foods allow one to more appropriately select ingredients of quality and assure that the diet more closely resembles those natural diets of canids, which are rich in protein, fat and water. However, for most of us time is a precious commodity. If you don’t have time available to prepare home-made dog food, there are some convincing reasons to offer your dog canned/wet foods as part, if not the whole, of his diet:

  • All canned foods contain an appropriate (high) amount of moisture which is critical for good digestion. This is also critical for dogs and cats with urinary tract problems.
  • The protein in canned foods is more likely to have a higher amount of an animal-based protein versus plant-based protein. This is also important for cats which are strict carnivores.
  • Canned/wet foods contain lower carbohydrate (sugar) levels than most dry foods
With this introduction in mind, let's understand how the US Pet Food Industry works. The agency responsible for the regulation of the pet food industry is not the United Stated Department of Agriculture (USDA). Rather, it is a non-governmental agency called the Association of the American Feed Control Officials (AAFCO). Its board consists of state and federal representatives, in addition to individuals directly involved in the industry. According to the definition on their website, the AAFCO "provides a mechanism for developing and implementing uniform and equitable laws, regulations, standards and enforcement policies for regulating the manufacture, distribution and sale of animal feeds". Since this process includes business insiders, it is likely to provide some protection of their business interests before anything else. 

The AAFCO avoids using a detailed, descriptive labeling system to pet foods in order to allow for products to look better than they actually are. Their labels contain a plethora of information, but it can be easily misleading to anyone who does not carefully study the topic. AAFCO’s pet food labels offer ambiguous, confusing information which seem to protect the interests of the industry over the consumer.  Inevitably, this effectively protects those companies that sell poor quality food. Furthermore, many of the terms used by the AAFCO to describe foods and labels in advertising materials are not legally defined because the pet foods are not under USDA umbrella like human foods. With that said, don’t be allured by the fancy description of mouth-watering gravy, grilled meat, mixed veggies, spices, or the beauty of the package or miraculous manufacturer’s claims such as “organic”, “whole”, “natural” or “premium”.  These terms bear no legal or technical meaning when applied to a pet food or ingredient. The interpretation and use of a label term is variable and the definition is therefore dependent on the philosophy and marketing strategies of the individual pet food manufacturer.

What you need to know is what the food will actually deliver to your pet!  You will gather this information only by breaking down all the products in the labels.  In order to do so, focus your attention on the following: 

  1. The product name 
  2. Net Quantity Statement 
  3. Manufacturer's name and address
  4. Ingredient list
  5. Guaranteed analysis
  6. Nutritional adequacy statement
  7. Feeding directions
  8. Calorie statement
  9. Label claims 
The Product Name: this is the first part of the label noticed by the consumer, and can be a key factor in the consumer's decision to buy the product. For that reason, manufacturers often use fanciful names or other techniques to emphasize a particular aspect. Since many consumers purchase a product based on the presence of a specific ingredient, many product names incorporate the name of that particular ingredient to highlight its inclusion in the product. The percentages of named ingredients in the total product are also dictated by four AAFCO rules. For instance, if a food is named specifically, e.g. "Lamb Dog Food", the named ingredient (lamb) should constitute at least 95% of the total weight if the water required for processing is excluded. Or, at least 70% if water is included in the calculation. If more than one ingredient is named, e.g. "Beef and Liver Dog Food", all of them combined must constitute at least 95% (or 70% if water is included respectively) and they must be named in descending order of content by weight. This description is used almost exclusively for canned foods.

If a food name includes the word "dinner" (or similar ones like "formula", "nuggets" etc.) such as in "Lamb Formula", the named ingredient (lamb) must constitute at least 25% of the total weight. If more than one ingredient is named, e.g. "Lamb and Rice Formula", all of them combined must represent at least 25% and they must be named in descending order of content by weight. Since the named ingredients are only required to make up 25% of the total product, the manufacturers don’t even need to be descriptive of the main ingredients! As such, you may see a package named “Chicken and Rice formula”. Yet, in the list of ingredients they will appear in this order: ground wheat, ground corn, chicken and bone meal, chicken products, chicken, brewer’s rice. See how misleading this can be? An honest use of the product’s name should appear like this: chicken, whole rice (followed by others).

Beware of food with names that include the phrase “with *ingredient*” For instance, a food of Lamb and Rice with Beef. In this case, the named ingredient (beef) must be at least 3% of the total weight. This form of description does not help at all! You may see a label like this: “corn, wheat, whole wheat, oats, chicken byproduct, animal fat, lamb meal, rice, and beef meal”. As you can see, lamb and rice are not first in the ingredients’ list, thus they don’t comprise the majority of the ingredients used. In addition, lamb is appearing as lamb meal. Finally, beef is not one of the first ingredients listed and the manufacturer is using beef meal, which IS NOT pure meat. 

Net Quantity Statement: you must find out how much product is in the container. This is particularly important when comparing products of different sizes. For instance, a 35 lb bag of food from company “X” may cost more than a 50 lb bag from “Z”, however, the smaller bag may contain better quality ingredients and they may be concentrated, which means you will use a lot less every time you feed your pet. Additionally, be aware that if a particular food is sold in bags of different sizes, the smaller the size, more it will cost you per unit of weight. Example: 

Lamb and rice from “X” company sells bags of 3, 15, 25 and 35 lb. 
A 3 lb bag costs $10; the price per pound is $3.33
A 15 lb bag costs $ 40; now the price per pound is $2.6
A 25 lb bag costs 50; now the price per pound dropped to $2
A 35 lb bag costs 60; now the price per pound is $ 1.7
As you see, you are paying more than twice the amount per pound when you buy the smallest bag. 

Manufacturer’s Name and Address (this is straight-forward): the food should clearly state “manufactured by” identifies the company responsible for the quality and safety of the product and its factory location. If the label states “manufactured for or distributed by” that means the food was produced by an outside source, but the name on the label still identifies the responsible party. Not all labels include a street address along with the city, State, and zip code, but by law, it should be listed in either a city directory or a telephone directory. Many manufacturers also include a toll-free number on the label for consumer inquiries. If a consumer has a question or complaint about the product, he or she should not hesitate to use this information to contact the responsible party. 

Ingredient list: by law, all ingredients must be listed in order of percentage by weight, including the water content. They must be listed by their common names. This weight refers to weight before processing! This is important when you compare products with different moisture contents. This is also important because different dry and wet foods have different moisture contents. Companies often use of schemes like ingredient splitting to make their product look better than they actually are. Other tricks include using good quality ingredients that retain a lot of water in their wet versions, but in dehydrated ones less desirable ingredients are used. Here are a few tips: 

Look for the first named source of fat in the ingredient list. Everything listed before that (including the fat) make up most of the food. Other items are just added in tiny amounts such as flavors, preservatives, vitamins and minerals. Example (with first source of fat in red): Food A: yellow corn, chicken meal, chicken meat and bone meal, chicken fat, corn germ meal, wheat, potatoes, rice, brown rice, sweet potatoes, carrots, flaxseed, garlic, salt, vitamins, minerals. Food B: Lamb, lamb meal, barley, ground brown rice, sweet potatoes, fish meal, eggs, beef fat, herring, apples, blueberries, sunflower oil, probiotics, vitamins, minerals.  

So, even though Food B has lamb as first ingredient, the meat still contains about 75% water. Once dehydrated, the moisture is removed to reach the final percentage of about 10%; the meat will have shrunk to 1/4 of the original amount, while relatively dry ingredients like the different rice components will not change much. Food A lists yellow corn as first ingredient, but since chicken is added in already dehydrated meal form, the amount will not shrink any further. Yet, together with the lamb, fish meal and eggs, Food B may contain higher amounts of better quality animal protein than product A. Furthermore, look how many different sources of underlined carbohydrates Food A contains (corn, corn meal, rice, potatoes, carrots, brown rice). If you calculate the total amount of carbohydrate (sugar) per weight delivered by Food A, your pet might be in trouble - particularly if already overweight or with chronic pancreatic issues.

Ingredient definitions can be deceiving. While some animal proteins in “meal” form are of good quality, including the whole carcasses of animals (minus feather, head, entrails, feet, etc.) others like “beef & bone meal” are made from leftovers after the high quality cuts of meat have been removed for human consumption. Foods that do not contain a quality protein/meat source - despite how nice the package may look - will have things like this on the ingredient label: meat (whatever source)-bone meal; digest of cattle or poultry; byproducts of chicken or beef; meat byproduct meal, etc. Again, remember that companies can manipulate the list of ingredients in different ways to make their food look a lot better than it actually is. 

Guaranteed Analysis: pet food manufacturers must include minimal the amount of “crude” protein, fat and maximal amounts of moisture and fiber in their products. The crude does not refer to ingredient quality but means the content regardless of quality or digestibility, leaving you without any means to determine the true quality of the product from this analysis. A nice chunk of meat and feet may have the same amount of protein; however, the digestibility and quality of protein delivered by feet/hooves to your pet is unquestionably inferior.

The guaranteed analysis is given on an "as is" or "as fed" basis. Some manufacturers include guarantees for other nutrients as well. The maximum percentage of ash (the mineral component) is often guaranteed, especially on cat foods. Cat foods commonly bear guarantees for taurine and magnesium as well. For dog foods, minimum percentage levels of calcium, phosphorus, sodium, and linoleic acid are found on some products. In order to compare products with different moisture content you will have to calculate percentages for both products at equal moisture content. If they differ, you need convert the values for all products to an equal percentage of moisture. Important: the more moisture/water the food contains, the less nutritious dry matter is present - meaning you pay for extra water while you get less nutrients!

Additionally, different proteins and fat vary considerably in their digestibility (i.e. how much of it is broken down and absorbed during digestion) and availability (how much of the protein is actually delivered to the cells). Dr. T.J. Dunn Jr. published the approximate digestibility values for some proteins:

·         Egg whites and whey protein 100%
·         Muscle meats (chicken slightly higher than beef or lamb) 92%
·         Organ meats (heart, kidney, liver) 90%
·         Fish, whole soybeans (not leftover fragments!) 75%
·         Rice 72%
·         Oats 66%
·         Yeast 63%
·         Wheat 60%
·         Corn 54%

Note: The above does not refer to the total digestibility of the item, but specifically to the percentage to which the protein part can be utilized. 
(part 3 to follow)

Sunday, January 13, 2013

Commercial Foods (Part 1)

My first Irish Setter puppy was raised on Nutro Natural Choice. I knew it was supposed to be one of the top notch commercial foods available out there, at least I thought so. When he reached about 2 years of age he started having digestive issues - vomiting in the mornings, passing soft stools, going on hunger strikes for a couple of days… disinterested in food. I did all I could to make him (a beautiful show Irish Setter) feel enthusiastic about his meals. This means doctoring his food (adding fresh meats, some veggies, soft/canned foods, warming his food up – you name it). All of that to no avail. Next, came blood screening tests, x-rays, abdominal ultrasounds…yet, nothing abnormal could be found.  I eventually gave up and labeled him as the guy with a “sensitive stomach”.

As clients began asking what commercial diets they should feed their pets, I felt unprepared to offer a precise answer. With so many copious options in the market and new ones appearing each year, one can easily get overwhelmed. In general, what one feeds his pet depends on a wide range of factors like costs, brand name, ingredients, pet’s lifestyle, etc. Considerable scientific evidence suggests that food impacts both the gastro-intestinal (GI) function and the microbial ecology and overall health of the canine GI tract. With the pandemic of serious health issues in our pets (not to mention GI problems), a question began to taunt me: what are we really feeding our pets? To properly answer this question, one must first address the dynamics of the pet food industry.

Brand names like Purina, Nutro, Hills, Iams, etc. rank high in the gross retail sales in the world. If they sell, one must reason that the food must be good, right? As a vet, I can't possibly give my full support to that assumption. Can what they produce really be considered optimum nutrition? Good quality ingredients are not easy to find as they are used for human consumption as well. If these companies manufacture gigantic quantities of food, are they really using high quality ingredients? And at what cost, if they are competing with human food producers for the same ingredients? The price of most pet foods doesn't seem to be rising much compared to the rising costs of human food such as chicken, pork, lamb or beef. Everyone has felt the increase in food prices. So, there is clearly a paradox. What is wrong with the picture?

To answer the initial question of what to feed your pet, you must address the issue of ingredient quality first. Good quality ingredients will surely cost more. Do a price/quality comparison at Whole Foods vs. Aldi and you’ll understand what I am talking about. If that little can or bag of food is cheap – beware! It can’t possibly offer what dogs need the most: good quality meat!

 (part 2 to follow)