The power of nutrition in two acts: tragedy and comedy - Veterinary Practice
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InFocus

The power of nutrition in two acts: tragedy and comedy

Talking about nutrition isn’t always a priority, be it in emergency visits or routine consults, but discussing nutrition throughout a pet’s life is beneficial in the long term and can even save their life

When it comes to the power of nutrition, pets’ stories can be told in two genres – the comedy and the tragedy. Here I look back at two case studies that reveal just how the discussion of nutrition throughout a pet’s life can tip the balance of the act.

Act one – Minnie

Minnie, an eight-year-old spayed female domestic shorthair cat, presented to the emergency department in respiratory distress one evening during my internship at a busy small animal referral practice. On physical examination, it was noted that Minnie had a grade IV/VI heart murmur, body condition score of 3.5/9 and was non-visual.

Minnie was an indoor/outdoor cat and had a sparse veterinary care history, mostly consisting of sporadic trips to the vet after altercations with other neighbourhood cats. During these visits, she would be treated for her wounds and caught up on overdue vaccinations and parasite prevention. I’m sure recommendations were made to follow up for a more thorough wellness consultation, but Minnie’s owners never made those appointments because she seemed outwardly fine and healthy.

I’m sure recommendations were made to follow up for a more thorough wellness consultation, but Minnie’s owners never made those appointments because she seemed outwardly fine and healthy

Though I wasn’t present for any of those urgent care visits, I can be pretty sure that Minnie’s nutritional status wasn’t discussed. I know this because when I, a young intern with the luxury and habit of being overly thorough, asked what Minnie’s diet consisted of, her owners reported that she primarily “ate” a product labelled as “milk for cats”. They purchased it in the pet food section of the grocery store and were proud to say that Minnie really loved it, returning home every morning and evening for her meal. Not being familiar with the product in question, I looked it up and discovered that it was technically labelled as a supplement or treat, and was not formulated to be a complete and balanced pet food.

This is how, in 2008, I saw my first case of taurine deficiency in a cat, something I had only heard of as a vague, mythical problem from decades past. Minnie did not survive the night, and her owners felt heartbroken and guilty that they hadn’t been giving her what she needed. But I couldn’t entirely blame them. Reading the fine print on pet food labels to understand if a product is a complete and balanced food is not an intuitive task for most pet owners. They assume that products sold in the pet food section or store will safely and effectively nourish their pet.

Reading the fine print on pet food labels to understand if a product is a complete and balanced food is not an intuitive task for most pet owners. They assume that products sold in the pet food section or store will safely and effectively nourish their pet

I know how crazy a day in a vet clinic can be, whether it’s a double-booked day of appointments with walk-in urgent-care patients slotted in over lunch or an emergency department shift with actively dying patients. I get it. I’ve lived it. Asking about a pet’s diet history can seem like an irrelevant fine point when treating a cat bite abscess or a broken femur. We want to assume those things will be taken care of at the pet’s regular wellness consultations. But Minnie’s case taught me first-hand how important it is to ask about a pet’s diet every single time they walk through the doors of my clinic, regardless of the presenting complaint. If Minnie’s owners had been prompted to have that discussion years earlier, she needn’t have died of a preventable nutritional condition.

Act two – Rory

Rory came into my life via a friend who came to stay with me for a time. Rory, an 11-year-old spayed female domestic shorthair cat, had been owned by a housebound elderly couple who loved her, and showed that love with food. When her owners passed away, Rory was inherited by their adult granddaughter who also loved her but didn’t have the ability to properly care for her. My friend was close with this family and was concerned about Rory’s health. She had a body condition score of 9/9 at almost 7.5kg, was having severe daily coughing bouts and had a brittle coat with areas of alopecia and superficial pyoderma. She was also urinating around the house and had overgroomed her abdomen completely bald. She was eating a grocery store food with her previous family, and my friend had recently switched her to a more expensive, “natural” food without much improvement in her condition.

I took one look at Rory and knew she needed more. A minimum database showed unremarkable CBC, chemistry and urinalysis results. I diagnosed her with feline asthma and started her on inhaled fluticasone treatments twice daily. Her coughing decreased and fairly quickly disappeared. But there was still the matter of her weight, her feline idiopathic cystitis and her poor skin and coat condition despite no apparent ectoparasites.

With nutrition alone, three conditions that were impacting her welfare were resolved. She’s now 16 and as playful as any young cat I’ve known

I calculated her ideal weight using an online tool and transitioned her to a prescription diet for weight care and urinary stress based on this calculation. Within two weeks, she had stopped urinating outside of the litter box. Within three months, her hot spots were filled in and her coat shinier with less pruritus. Within the year, she had reached her ideal weight of 4kg. It took another full year for her abdomen to grow back its full coat after years of overgrooming, but with nutrition alone, three conditions that were impacting her welfare were resolved. She’s now 16 and as playful as any young cat I’ve known.

Epilogue

These are just two anecdotal cases in a profession that loves data, but to these two animals and their families, their individual quality of life matters more than statistics. Pet owners see their pet every day. They respond to the real-life changes they see when provided with the best care. Vaccines, parasite prevention, screening diagnostics, dental prophylaxis and necessary medications are all important and have their place, but nutrition, something provided daily, is one of the easiest and most visible ways to make an impact on a pet’s quality of life and their owner’s satisfaction.

Nutrition, something provided daily, is one of the easiest and most visible ways to make an impact on a pet’s quality of life and their owner’s satisfaction

We need to see nutrition as part of the medical process for both well and sick pets at every visit, rather than as a supplemental or optional retail product. Yes, it takes a bit more time, but it is so worth that investment, and saves time and money in the long run. There are more and more tools available to the veterinary healthcare team to make the nutritional conversation easier and faster.

There are a wide range of useful resources and tools available online, some of which are detailed below. Your nutrition company representatives are likely to have even more training, tips and tools available for your entire team, so use them!

WSAVA Global Nutrition Toolkit
European Pet Food Industry fact sheets
2021 AAHA Nutrition and Weight Management Guidelines

Hillary Pearce

Veterinary Affairs Manager, United Kingdom and Republic of Ireland at Hill’s Pet Nutrition

Hillary Pearce, DVM, is an associate professional and veterinary affairs manager, United Kingdom and Republic of Ireland, at Hill’s Pet Nutrition. She has spent over 14 years in the veterinary profession, including small animal practice and roles managing educational programmes for students, recent graduates and nurses in industry. She is also currently completing a residency in animal welfare.


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