Wednesday, March 2, 2016

A Tribute to Bronx Butler by Meg Smart DVM, PhD

A Tribute to Bronx Butler(May 20th2003-Feb22nd 2016)

During my career as a veterinarian and a clinical nutritionist, certain clients and their pets have played a significant role in changing my thoughts on the role of nutrition in health and the quality of life. Veterinary therapeutic diets claim to give the veterinarian an instant “scientifically proven” way to nutritionally manage a particular disease. All the controversy surrounding the purity and safety of many of the major ingredients, the integrity of the suppliers, and the marketing strategies of the manufacturer brings into question the true nature of the science behind many of these diets sold to the pet owners.

After completing my PhD in ruminant nutrition (Department of Animal Science, Univ of Sask), I returned to W.C.V.M., to develop the clinical nutrition program. The clinical cases sent to me were pets that failed to respond to the conventional treatment of symptomatic drugs and therapeutic diets. These animals were primarily on the slippery slope to euthanasia.  Such referral often occur after the client inquired if W.C.V.M. had a nutritionist that they could talk to.
Bronx and his guardian Kim Butler was one of my first cases that fit this picture. He was a three year old Rottweiler with a history of weight loss and chronic diarrhea often with blood. On several occasions he was presented to the clinic in shock, with abdominal pain, bloody diarrhea, and severe dehydration.   

He was diagnosed with severe inflammatory bowel disease which initially responded to the conventional treatments of fluids, antibiotics, and a long term deworming strategy, corticosteroids and therapeutic diets for gastrointestinal problems. He also developed a severe pancreatitis induced by the massive doses of corticosteroids . Kim inquired on numerous occasions about possible alternative treatments and a better nutritional approach. After a severe episode and asking again if the college had a nutritionist she could speak to, she and Bronx were referred to me.
When Kim came see me with Bronx she came armed with a lot of cyberspace information on alternative diets especially raw in the management of inflammatory bowel disease. She said she was reluctant to share this information with veterinarians as the response was often negative citing the dangers to children, and the elderly from salmonella and other food borne pathogens.
We discussed the options available and decided on a home-made balanced diet of lean turkey and fresh   fruits and vegetables. Bronx’s response was disappointing and he took a severe turn to the worse with severe internal bleeding and a grave prognosis. Euthanasia was suggested. Kim elected to take him, home. The next day she tried feeding beef steak which he ate and tolerated. The conclusion was he may have a severe poultry intolerance which was later confirmed after he reacted to eggs and other poultry products.
Bronx’s diet was switched to red meats: beef, lamb, deer, moose and elk primarily muscle, internal organs, bone and tripe. He gained weight, his bouts of bloody diarrhea stopped but the pancreatitis would on occasion flair up.
  On Feb 22, 2016 he died doing what he loved best playing with his family.
 Ten years ago Kim started a small raw food Company “Bronx’s Best”, her raw diet is simple but balanced, she takes a personal interest in all of her pet parents. She and Bronx have helped many very ill pets onto the path to wellness or improved the quality of life.
My experience with Bronx, changed my approach to both my teaching of nutrition and the application of whole food nutrition (raw or home-made) to chronic illnesses in pets, to improve their quality of life. I researched the scientific literature on raw foods looking for unbiased research that these diet were more of a threat to the health of young children, the immune suppressed and the elderly than kibbles. The evidence was not convincing.
My teaching methods changed from a lecture format to one of student self-directed learning and discovery through carefully constructed group assignments and debates about controversial topics within the industry. They had to make a presentation to the elective students and write a paper some of which I have published on my blog. I encouraged them to think about Nutrition and ask questions rather than accept what the companies or even I was telling them.

I investigated therapeutic diets and found many interesting yet disturbing facts:
·         Formulation and Efficacy
§  Often the formulations and ingredients are  common to both over the counter and the therapeutic diets manufactured by the same company
§  Formulations are  often based on third person research and anecdotal evidence although this may not be obvious from the websites
§  Research consists of potentially biased clinical trials primarily in house or external research heavily funded by the manufactures with the potential for bias
§  Although the marketing strategies have changed over the years in keeping with the consumers demands, knowledge and market trends; the ingredients and  formulations remain primarily the  same. Figure1
§  Most veterinarians do not monitor the efficacy of the diets they are selling, on average most clients feed the prescribed diet for 3 months  and then go to a specialty pet store for additional advise on nutrition
·         The pet food industry has launched an effort within the Veterinary profession through their Associations to discredit alternative diets such as home-made, raw, and whole food diet. This involves:               
o   The pet food  industry giving financial support to these veterinary organizations
o   The industry supports and takes part in continuing education and  undergraduate teaching of nutrition
o   the pet food industry lobbying the governmental agencies responsible for  food safety and pet food regulations to set the standards for alternative diets higher than required for their products
Figure 1:The change in the same diet over 18 years


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