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PRESCRIPTION DIETS
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THERAPEUTIC DIETS
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AN OVERVIEW AND EXPLANATION OF
PRESCRIPTION DIETS
by T. J. Dunn, Jr. DVM
This article originally appeared in Dog World Magazine in 2004
This page updated
April, 2006
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Please Note!
The pet food industry is a dynamic enterprise that is
constantly changing recipes, types of therapeutic diets, methods of delivery to
the veterinarian and pet owner and other parameters. The brands, names and
recipes of any of the diets mentioned here
may change at any time with little notice. Always consult
with your veterinarian regarding the best therapeutic or prescription diets for
your dog or cat.
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In 1940 a veterinarian named Mark Morris, Sr. evaluated a dog that was suffering from kidney disease. Morris felt that nutritional therapy might work just as well as medication to help his patient gain some relief from the effects of kidney disease and hopefully would restore the dog to a higher quality of life. He devised a pet food that would lessen the work the patient’s kidneys needed to do… and his patient improved greatly and lived longer than anyone expected. That diet was called Prescription Diet KD for (kidney diet). Mark Morris, Sr. set in motion a revolution in veterinary medicine that continues and evolves today. His humble start led to the emergence of Hills Pet Nutrition, the nation’s leader in research and development of what the company calls Prescription Diet Brand Pet Food.
WHAT ARE PRESCRIPTION DIETS?
Therapeutic Diet or Prescription Diet … what’s the difference? I posed that
question to Dave Geier, of Geier Enterprises, Highlands Ranch, CO. A former
executive with Hills Pet Nutrition and a consultant to the pet food industry,
Geier explains, “The term ‘Prescription
Diet’ is
used as a brand line for Hills Pet Nutrition’s therapeutic diets. The term
‘Therapeutic Diets’ refers to any food that is available only by or on the
order of a licensed veterinarian and that aids in the recovery from a
disease or disorder or assists in delaying the progression of disease.”
Amy Dicke, DVM, technical services veterinarian at The Iams Company states “A prescription diet is one available only through a veterinarian. The term therapeutic better represents the diet’s use - whether it be the sole therapy or an adjunct in the course of support for a medical condition that is diagnosed and monitored by a veterinarian.”
If you look at the wording on some of the therapeutic diet labels you will see that the emphasis is on the veterinarian being in charge of dispensing these foods. Hills Pet Nutrition displays the wording “Veterinary Exclusive Pet Food”. Also, on a bag of Hills Prescription Diet CANINE C/D you will read “Dietary Animal Food… use only as directed by your veterinarian”. On a bag of Purina EN-Formula it states “Purina Veterinary Diets® are authorized for prescription and sale only by veterinarians”. Eukanuba Veterinary Diets, made by the Iams Company, on its Nutritional Skin and Coat Formula, Response FP, it states on the label “Dog food prescribed by Veterinarians for dietary management of skin and coat health and dental health”. Royal Canin Veterinary Diets (formerly Innovative Veterinary Diets) displays the statement “Sold and distributed by licensed veterinarians only”.
No matter who the manufacturer is, therapeutic diets are available only at animal hospitals or selected outlets that are staffed by veterinarians. You won’t see therapeutic diets in grocery stores, pet shops or feed stores. Geier continues ”In 2005 there were five major companies making therapeutic diets and approximately fifty different types of these diets that assist in the treatment of problems associated with liver, kidney, heart, diabetes and many other metabolic problems. They are available in canned and dry and biscuit form for dogs and cats.”
WHY “PRESCRIPTION ONLY”?
Therapeutic diets are “Available only by or on the order of a licensed veterinarian”. That label designation indicates a veterinarian must prescribe the diet to the consumer because the product has specifically designed nutrient formulations that have a targeted impact on the health of the dog consuming that diet. If that or similar wording is present on a pet food label the food can only be sold through a veterinarian’s prescription.
Therapeutic diets have been formulated to target specific metabolic processes of animals; and these processes are actually modified to effect certain changes in the animal’s digestion, immune responses, blood pressure, renal function, liver metabolism or blood glucose levels. To achieve an impact on the animal’s body chemistry, therapeutic diets have scientifically formulated amounts and ratios of various nutrients. Nearly all therapeutic diets, designated by the manufacturer to be available ONLY on the order of a licensed veterinarian, have certain nutrients either reduced in amounts or have nutrients that are elevated above typical levels for normal dogs.
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Therapeutic diets greatly assist in the management and prevention of
bladder stones in
dogs and cats. Click images below to see closeup view |
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| Radiograph of dog with bladder stones | Bladder exposed surgically for stone removal | One of many bladder stones being removed | Stones are sent to a lab for analysis |
A
good example would be a diet that is used for only short periods of time in
order to assist in the non-surgical elimination of certain urinary tract stone
formations. A diet such as this may not be wise to use long term nor in an
animal not needing therapy for urinary
calculi.
Diets targeting therapy for Diabetes Mellitus in dogs, liver dysfunction, or
kidney failure are not appropriate for normal dogs. And anyone feeding a growing
pup a low protein therapeutic diet designed only for dogs with kidney failure
will surely cause harm to the innocent pup. Likewise, a sodium-restricted diet
used to treat congestive heart failure would not be appropriate to feed a
healthy, vigorous retriever. Diets formulated for heart disease have lower
sodium, and therapeutic diets for diabetes control have a higher fiber and may
have a higher protein than what is considered appropriate for healthy adult
dogs. Diets for food allergies have novel proteins that the pet has not been
exposed to such as kangaroo, duck, potato or venison. Therefore, prior to
feeding any animal a diet specifically formulated to modify body chemistry, a
veterinarian must make an appropriate medical diagnosis. For health, safety,
liability and ethical reasons, veterinarians need to have exclusive domain over
the use of these therapeutic products. Think of therapeutic diets as you would a
drug, although they do not actually contain drugs. Their profound effects on the
patient are not to be taken lightly.
CASE EXAMPLE
Kimberley
Brosofske, Ph.D., a Research Ecologist in Rhinelander, Wisconsin, presents an
interesting success story regarding therapeutic diets. Her mixed-breed dog had
chronic problems that resolved after implementing a therapeutic diet. Brosofske
tells us, “Five years ago Buddy was diagnosed with hypothyroidism when I
realized he was 30 pounds overweight, had skin problems and his coat was rough
and dull. After being placed on medication, these problems went away and his
health was excellent… until three years ago. Buddy then started developing
occasional ‘hotspots’ and very flaky, dark-colored skin. His coat, previously
very shiny, became dull and was covered with flakes of dead skin that would
slough off. He developed chronic ear infections that required constant
medication. He also seemed to have a perpetual stomachache, often vomited and
had bouts of diarrhea. His veterinarian suggested that either he might need a
change in the dosage of his thyroid medication or he might have allergies. After
some testing the veterinarian determined Buddy’s thyroid was not the problem but
rather that he had food allergies. The veterinarian suggested I feed Buddy only
a therapeutic diet (Innovative Veterinary Diets Venison and Potato). Within a
short period of time the ear infections ceased, the vomiting and diarrhea ended,
and Buddy’s skin cleared up, leaving him with a flake-free, shiny coat. He looks
and feels great! He’s had no more hotspots, and he shows gusto for his food bowl
again.
COMPLIANCE ISSUES
In my practices I have often had to defend the cost of therapeutic diets. There seems to be a resistance in some dog owners to purchasing expensive dog food and yet there is little reluctance to purchase a drug or medication “as long as it helps”. My response is that the therapeutic diet should be looked upon as a form of “medication” because of its specific effect on the individual consuming the diet. With that concept of “food as medicine” in mind we can see why these diets need to be restricted to use only in special and specific circumstances. High quality ingredients with specific, metabolically targeted effects, simply cannot be manufactured, delivered and sold at what anyone would term “cheap” prices. “Expensive” diets may very well worth every penny if the product performs well. And in most cases it truly costs only pennies more per day to feed a therapeutic diet than a conventional diet.
ARE THERE DANGERS ASSOCIATED WITH THERAPEUTIC DIETS?
Because of the unique properties of therapeutic diets the manufacturers make
their formulations available only to veterinarians. If a formulation is misused
by feeding longer than recommended or fed to an animal that has new or changing
requirements, they can be more harmful than helpful. Targeting specific medical
disorders, therapeutic diets can benefit animals with such problems as food
allergies, gastrointestinal disorders, diabetes, urinary tract dysfunction,
kidney disease, heart disease, liver disease and even some forms of cancer.
Patients with these problems often require certain nutrients to be added or
eliminated from their diets. Therefore, the misuse of specifically formulated
therapeutic diets can be hazardous… and veterinarians need to be the responsible
source of their distribution to
the dog owner. Dicke’s comment applies to any therapeutic diet when she says,
“All Eukanuba Veterinary Diets are available only through a veterinarian. These
diets are designed to address certain medical conditions that should be
diagnosed and monitored by a veterinarian.”
WHO MAKES THERAPEUTIC DIETS
Hill’s Pet Nutrition is the largest manufacturer of therapeutic diets with their Prescription Diet brand, followed by Eukanuba Veterinary Diets (Iams Company). With Mars’ purchase of Royal Canin and Royal Canin's purchase of IVD from Heinz, and the Waltham brand going away, Royal Canin would be a growing number 3 behind Hill's, still dominant, and Iams. Companies, such as The Iams Company, offer numerous choices for therapeutic diets. For example, Dicke indicates, “The Iams Company produces 28 therapeutic products, including dry, canned, and biscuits. These formulas address a variety of medical conditions in the dog and cat, including food allergy, intestinal disorders, renal disease, obesity, and urinary health.”
FUTURE DEVELOPMENTS
Today, pet food companies spend tens of millions of dollars on research and
development of better diets for pets. What this means is that pet owners are
demanding and purchasing higher quality diets that enhance the life experience
of their dogs. Proof lies in the fact that since Dr. Morris’ early explorations
into the theory that food can be used as therapy there now exists a
multi-million dollar industry based on the production of therapeutic diets for
pets. New nutritional principles are rapidly being discovered through modern,
scientific research. “Nutrition research has moved beyond defining minimal
requirements for animals and on to defining optimal nutrition under various
conditions,” says Dottie Laflamme, DVM, PhD, DACVN, Veterinary Nutrition -
Communications Specialist with the Nestle Purina PetCare Company. Our companion
animals today are beneficiaries of newer nutritional research and development
that has made available to us a wide spectrum of therapeutic diets. Today’s
veterinarians dispense a multitude of therapeutic diets, and they have become as
much a part of daily veterinary practice as antibiotics, gas anesthesia or
Heartworm prevention. Additional pet food manufacturers are entering the
therapeutic diet arena. The bottom line is this: Therapeutic diets, acquired via
a veterinarian’s prescription, are a vital aspect of modern pet health care
services.
Why? Because they work.
T. J. Dunn, Jr. DVM
PURINA CNM (CLINICAL NUTRITIONAL MANAGEMENT)
INNOVATIVE VETERINARY
DIETS (IVD) and WALTHAM VETERINARY DIETS are now incorporated in the
ROYAL CANIN
family of products.
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