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Monday, July 13, 2015
Renal Diets: The Importance of Proper Nutrition and a Comparison of Available Diets by Jessica Fung and Kimberly Hsu
Chronic renal failure (CRF) is a problem in small animal practice, with 15-20% of all older dogs and cats exhibiting some degree of renal azotemia.4 The first goal is to identify the underlying cause of the renal disease, often this is not possible so treatment is directed at managing the complications of renal failure and maintaining quality of life.7 In dogs, CRF is progressive and irreversible, leading to uremia and death within months or years after the initial diagnosis. In contrast, cats often have long periods of clinically stable renal function interspersed between episodes of progression.15 In addition to medical therapy, nutritional modification is one of the mainstays of treatment for chronic renal failure. Renal diets are formulated to modulate the metabolic disturbances and slow the self-perpetuating destruction of nephrons associated with CRF.
These papers were written in 2010, by my students as an assignment for their 4th Nutrition Elective. The data, results and conclusion drawn from this paper can be compared to the diets presently available from the same companies, to determine if any modifications of the2016 diets were made by the same companies. If changes have occurred have they cited the research to support the changes? One major change has been the sale of Iams to Walthams.
In human medicine, food allergy refers to adverse food reactions involving a humoral response mediated by immunoglobulin E (IgE). Other food hypersensitivities involve cellular immune responses mediated by T lymphocytes. Food intolerance, by contrast, is a non-immunologic adverse food reaction (Hillier and Griffin, 2001).
Figure 1: Classification of adverse reactions to food (Kennis, 2006).
Both Type I and Type IV hypersensitivity reactions have been reported in dogs. The ACVD task force recommends using the terms “adverse food reaction” in veterinary medicine to refer to an aberrant reaction after ingestion of food or additives since the true pathogenesis is often very difficult to determine (Hillier and Griffin, 2001).
Diabetes mellitus is a relatively common disease in our companion animals. Dogs typically have decreased insulin production and are dependent on insulin to manage the disease. Diet may play a role in management as often these dogs are overweight. In dogs, weight loss, complex carbohydrates, and fibre in the diet can help manage diabetes mellitus. Cats, however, tend to have a problem with insulin resistance, not insulin production, because of being overweight. One theory is the high processed carbohydrate content in most commercial dry diets may be contributing to obesity and the development of diabetes mellitus; thus, a diet low in simple sugars and higher in protein may be beneficial.
In recent years, the human-animal bond has become very important. People are treating their pets as part of the family and providing them with the best possible care has become a priority. Along with this trend, the pet nutrition industry has also been growing with diets specific to a life stage, health condition, and even breeds. Due to increasing demand, the number of pet diets available has increased exponentially . To a client, the number of food choices can be overwhelming. In addition to the over the counter diets, some wellness and therapeutic diets are available only through a veterinarian.
The task given to us as veterinary students was to evaluate the prescription veterinary diets available for diabetes mellitus and choose a corresponding commercial diet to compare to that is available from a pet store that might be appropriate for a diabetic patient, which, generally resulted in choosing weight loss diets for dogs and kitten diets for the cats.
Analysis of Therapeutic and Commercial Diets for Diabetes Mellitus, Allergies Weight Loss and Renal Disease:WCVM 4th Year Nutrition Elective Assignments
This series of paper was written in 2010, by my students as an assignment for their 4th Nutrition Elective. The data, results and conclusion drawn from these paper can be compared to the diets presently available from the same companies, to determine if any modifications of the2015 diets were made by the same companies. If changes have occurred have they cited the research to support the changes? One major change has been the sale of Iams to Walthams.
Introduction to the Series (written by Meg Smart DVM, PhD)
Veterinarians are spokespersons for the pet food industry. A responsibility that should not be taken lightly. As advocates of the industry, veterinarians must understand nutrition and be able to judge independently what is best for the clients and their pets. In the past, veterinarians have left this responsibility in the hands of the industry and now the time has come for the profession to take over the reins.
Our professional associations and veterinary schools have formed lucrative and mutually beneficial partnerships with the pharmaceutical and pet food industry.[i] These affiliations leave us as veterinarians accountable to the public, as trained professionals, to the verify the claims made on our behalf by these companies. The Canadian veterinary medical Association suspended the operation of its pet food certification program in 2007. In the fall of 2007 a brief survey of CVMA members indicated that:
- “— 82% of CVMA members surveyed think the CVMA should continue to be involved in the certification and on-going monitoring of pet foods ensuring they meet nutritional standards.
- — 85% of CVMA members surveyed want the CVMA to be actively involved in the certification and ongoing monitoring of therapeutic diets distributed through veterinary clinics.
- 84% of CVMA members surveyed support CVMA involvement in potential new federal regulation regarding pet food.” [ii]
An article appearing in Veterinary Economics suggests that during these tough economic times, veterinary practices need develop strategies to grow their revenue. One opportunity is to increase the sale of therapeutic diets. Client awareness and education can be accomplished by “a nutrition advocate” position to increase this market. This individual must be well educated about the therapeutic diets sold; in order to serve as liaison between the veterinarians and clients.[iii] But who will educate this advocate ? Data have shown that while veterinarians place between 35% and 45% of patients on therapeutic diets, less than 7% of pets remain on the diet year-round. If owners have to come to the clinic each time they need more food, most will only keep their pet on the diet for about 3 months.[iv]