Even though it can be frustrating to deal with the misinformation and strange nutritional questions veterinary clients bring to your exam room, simply declaring war on raw or homemade diets is not the answer, says Donna Raditic, DVM, DACVN, CVA. In a recent Fetch dvm360 conference lecture, Dr. Raditic dove deep into the raw food and homemade diet dilemmas we practitioners face daily with clients. The consensus? There is no perfect diet. The solution? Find common ground with clients and work together.
“It's better to approach this on an educated basis and try to build trust with clients,” Dr. Raditic says. “Raw and homemade diets are here to stay.”
Benefits, potential missteps and best practices for homemade pet diets:
Benefits
- Clients know exactly what their pet's eating.
- Pets won't poop as much (but you may need to warn owners so they don't worry); the majority of the nutrients are being absorbed because homemade diets have higher digestibility.
- Some animals with chronic gastrointestinal issues or multiple chronic disease states do better on homemade diets.
- Therapeutic food-allergy diets use a novel protein or novel carbohydrate as therapy, and homemade diets can do the same.
- Preparing and serving a homemade diet makes some pet owners happy they can help their pet in this way.
Potential drawbacks
- Homemade diets can be unbalanced and even harmful if formulated incorrectly.They can cost more.
- Clients may change a formulation without consulting an expert (for example, replacing olive oil with coconut oil)-a process called “client drift.”
- There are no food trials or nutritional AAFCO analysis reports to help guide feeding decisions.
Best practices
- Have a board-certified veterinary nutritionist formulate recipes or learn how so you can advise your own clients.
- Homemade diet instructions should guide the client how to prepare the recipe in batches that can be frozen to save time and money.
- Combine diets by making one-half or one-quarter of a pet's calories homemade and the remaining calories from a veterinary therapeutic diet. (And now your client has dry or canned food on hand if they run out of homemade.)
- If clients don't want to go all homemade but still want to feed some fresh foods, give them permission to use fruit as treats or to add veggies to usual meals. Provide lists of fresh food options that can be safely added to usual diets. Clients feeding a homemade diet should have routine physical examinations with full blood and urine testing every six months. Use these visits to review the homemade diet and to prevent client drift.
- You can send out your client's homemade diet for nutritional analysis by an independent lab.
The promise (and perils) of homemade
Here are some guidelines to help you help your clients who want to go homemade with their pets' diets.
Start with the “why?”
It's important to understand where your clients are coming from in their desire to feed homemade food to their pets. Dr. Raditic has talked to lots of clients who are:
Worried about processed foods being toxic because of recent pet food recalls involving melamine, pentobarbital and vitamin D. (Sometimes it helps to explain that human food gets recalled all the time.)
Frustrated by pet food labels that are difficult to understand and don't contain as much information as human food labels. A pet food label lists ingredients according to weight-this gives no information about how nutritious the food is, the quality of ingredients used or how they've been handled or processed.
Treating their pets like children. These clients want to be more in control and extend their own attitudes about nutrition to their animals-whether that's an interest in eating organic, vegetarian or vegan.
Concerned that pet foods aren't nutritious or healthy-society and the media are telling everyone to avoid processed, packaged products and eat more whole foods and fresh ingredients.
Using homemade diets when a pet has a medical condition and a therapeutic diet isn't ideal or the pet won't eat the desired diet.
Hot cooking tips
Here are some pointers for formulating and preparing homemade pet diets.
Use cooked gram weights. Don't use cups as a unit of measurement, because a “cup” can vary greatly depending on how fine you cut ingredients. Cooked gram weights (you'll need a scale) is the most accurate way to measure food amounts.
Make large batches and freeze the food. Put the food in plastic bags and lay them flat in the freezer to save space and have portions ready to go.
Keep recipes on hand. Have available complete and balanced homemade diet recipes properly formulated by a nutritionist available for owners of healthy dogs and cats. If clients want more recipes or the patient has special needs, send them to a board-certified veterinary nutritionist.
Grind and blend the food, if possible, so pets don't pick out individual ingredients.
Avoid Maillard reactions by poaching ingredients, not roasting or grilling. Maillard reaction damages protein structures, which may affect essential amino acids absorption or increase antigen load in the diet.
Be a partner, not an impediment. Some clients need to be supported because they're concerned-and rightfully so. Don't be dismissive or they'll feel that you don't understand them and they can't turn to you for advice. If counseling these clients is not something you can take on, ask them to reach out to a nutritionist through ACVN.org.
Recognize the need for more nutrition information. In veterinary school, some of us were taught to familiarize ourselves with pet food labels so we could better advise clients. Nope, says Dr. Raditic: “Don't waste your time. They aren't comprehensive enough. You still may not know what's really in that bag of food. This is why consumer demand for transparency and improved pet food labelling is real!”
To demonstrate how unreliable labels or marketing claims can be, Dr. Raditic shares information on diet-testing studies using ELISA and PCR.1 Over-the-counter (OTC) diets that claimed to contain venison only, for instance, included other meat proteins such as soy, chicken and beef. In another study using PCR, many diets contained meat sources not identified on the label (due to either mislabeling or contamination).2
“They don't declare everything on the labels and legally aren't required to,” she says. “Therefore, selecting between OTC diets is very difficult.”
You're better off getting your clients to feed therapeutic veterinary diets or homemade diets, says Dr. Raditic. ELISA testing performed on therapeutic diets showed that they were more reliable. What they said was in the bag was in the bag.
Recognize that these clients want what's best for their pets. But they don't always have the knowledge to make it happen. One study showed that 90% of homemade diets on the internet were nutritionally inadequate because they were formulated incorrectly.3 Ideally, homemade diets need to be formulated by someone familiar with the pet and their nutritional needs, which is you, the veterinarian, who then can collaborate with a board-certified veterinary nutritionist.
The real truth on raw
When it comes to raw, start exactly like you did with the homemade food discussion: Remember to ask clients “why?” and find out more. Find common ground, and don't get defensive or judgmental-like the veterinary students who've shadowed Dr. Raditic.
“Students can be so adversarial,” she says. She hears them metaphorically “huffing and puffing,” aghast that a pet owner would feed a raw diet. But take a chill pill, she tells them: Do they eat anything raw?
“Have you ever eaten raw cookie dough?” she asked the Fetch dvm360 audience. “Eighty-four percent of veterinary clients feeding raw diets have a college education. They aren't stupid.”
“Eighty-four percent of veterinary clients feeding raw diets have a college education. They aren't stupid.”
The fact is that there are a number of food companies with Association of American Feed Control Officials (AAFCO)-certified raw diets out there. Pet owners gravitate toward them because they look more like real food than kibble.
Dr. Raditic shares some of the possible advantages and disadvantages for raw pet food:
Possible pros
- Raw foods may be more digestible and bioavailable due to less processing and often have limited ingredients, which may reduce their antigenicity.
- They may result in less stool output, and owners often report a better coat and a healthier overall appearance.
- Contamination can be reduced by searing or cooking the outside of meat. Also, pet owners can purchase freeze-dried raw or flash-pasteurized formulations.
Possible cons
- Some raw diets have an AAFCO-like “statement,” but this is not the same as an official AAFCO statement and can be misleading.
- Some commercial raw diets have excess fat content, so read the label because, as you know, pets eating too much fat are at risk of weight gain or gastrointestinal upset.
- The calcium-to-phosphorus ratio can be high or even off, so caution against raw diets for dogs with orthopedic diseases or growing animals (you're looking for 1:1 or 1.4:1 calcium to phosphorus).
Inevitably, you're going to face that veterinary client whose dog with a food allergy or chronic gastrointestinal problem switched from processed food to raw food and saw a “miracle” change. This could simply be a result of increased nutrient bioavailability and reduced antigenicity, and this probably could've been achieved with homemade as well.
Recommend that your clients read what experts at the Centers for Disease Control and Prevention have to say on the topic, especially with regard to food safety for meals prepared at home.
Hilal Dogan, BVSc, CCTP, practices medicine in Denver, Colorado. She started the Veterinary Confessionals Project as a senior veterinary student at Massey University in New Zealand.
References
- Raditic DM, Remillard RL, Tater KC. ELISA testing for common food antigens in four dry dog foods used in dietary elimination trials. J Anim Physiol Anim Nutr 2011;95(1):90-97.
- Pagani E, Soto Del Rio MLD, Dalmasso A, et al. Cross-contamination in canine and feline dietetic limited-antigen wet diets. BMC Vet Res 2018;14(1):283.
- Stockman J, Fascetti AJ, Kass PH, et al. Evaluation of recipes of home-prepared maintenance 424 diets for dogs. J Am Vet Med Assoc 2013;242:1500-1505.
