When it comes to diets and supplements, vets look for – and expect – the highest quality

If veterinarians have one leading concern about their patients’ diets, it’s that they meet their nutritional claims. And, they count on their distributor reps to deliver the goods. “We need diets that are suitable for a [particular] breed of animal, as well as the animal’s stage of life and personal issues,” says Christy Redfearn-Shelton, a DVM who practices in North Carolina. Knowing that a product stands up to the gold standard is a must, she adds. “I look for products that go above and beyond the guidelines established by the Association of American Feed Control Officials (AAFCO).”

Although AAFCO guidelines help keep pet food manufacturers on track, they have not been revised since they came out in the 1940s, Redfearn-Shelton notes. “In the 1950s and 1960s, more pets were free-roaming and fewer were spayed and neutered, which affects their metabolism. “Generally, pets got more exercise back then,” she says. “Today, we tend to keep our pets in the house more. Whereas some dogs used to be outdoor working dogs, today their job is to bark at the UPS guy and greet us when we get home from work!” So, while the directions on a bag of pet food may meet AAFCO standards, according to current recommendations by animal experts, pet owners are overfeeding their dogs and cats by as much as 25 to 30 percent, she points out. “So, the biggest myth about our pets’ nutrition is the amount of food we are feeding them.”

Indeed, overfeeding and pet obesity have been problems for quite some time, according to Rebecca Remillard, PhD, DVM, MS, DACVN, founder of the Veterinary Nutritional Consultations Inc. “It’s a disease,” she says. “We know exactly what causes obesity and what the cure is. But, addressing it requires effort and consultation on the part of veterinarians. And, many clients are in denial. Inevitably one-third of a veterinarian’s clients require some discussion about their pet’s weight. We see 45,000 patients each year, and about 30 percent of the dogs and cats we see are overweight.” If a pet owner reduces the weight of his or her dog to within a healthy range, that may extend the dog’s life by two years, she adds. Overweight cats are at higher risk for diabetes. “Diabetes is a labor-intensive disease to manage,” says Remillard. As such, it tends to be the number one cause of euthanasia, she points out. “If you reduce [overweight] cats’ weight by 20 or 25 percent, almost half of them can be removed from insulin.”

Selecting the right – and safest – diet
Not all pet foods are created equal, according to experts. There is a plethora of diets available to pets, and some foods are higher quality and more nutritionally sound than others. It pays to pay more for pet food, notes Redfearn-Shelton. “If we (veterinarians) believe a certain brand is higher quality, we have a responsibility to recommend it to clients,” she says.
That said, how do veterinarians and their clients negotiate the many pet foods available today? There are two questions veterinarians should ask, says Bill Bookout, president, National Animal Supplement Council (NASC). First, how do you choose the right product that provides optimal benefits for a specific breed or stage of life? Second, how do you choose the right product to suit special needs such as diabetes or allergies?
Indeed, “as veterinarians, we must look at our patients metabolically,” says Redfearn-Shelton. The majority of patients will respond to low-fat, high-protein diets, but this can vary by breed or from one pet to the next, she notes. In addition to metabolism and food allergies, she looks at her patients’ dermatologic needs when recommending diets.

Still, aside from AAFCO guidelines and those proposed by the Animal Feed Safety System (from the Food and Drug Administration, Center for Veterinary Medicine), “there are no consistent quality and manufacturing standards for animal feed, which are nationally mandated,” says Bookout. “There are some in progress, but, to date, none are finalized.

“There is no substitute for [veterinarians] for having confidence in the [pet food or supplement] company they work with,” he continues. Veterinarians should take the time to verify information they receive about products, he points out. “They should pick up the phone and validate the information they are given regarding pet foods and supplements. [Too often], people tend to take others’ word for something or they believe everything they read on the Internet. Instead, they should trust, but verify. They should see who sponsors a study [backing a product].”

Redfearn-Shelton believes the 2007 disaster, when pet food companies were forced to recall contaminated pet food imported from China, was “a wakeup call for us. Certain brands were far less or [totally] unaffected,” she points out. “These were the higher quality products.” And, while she is comfortable recommending or offering certain pet diets to her clients, Redfearn-Shelton finds that a good number would rather price-shop at the larger chains. So, “it’s a huge value to see high-quality brands available in stores,” she says.
Indeed, “it’s a myth that all pet diets are created equal or that all companies create equal diets,” Bookout adds.

The lowdown on supplements
Supplements can be beneficial, note the experts, as long as everyone proceeds with caution and sensibility. “In many situations, supplements can be very important,” says Redfearn-Shelton. “But, we need to get across that many of these supplements (e.g., glucosamine chondroitin) are considered drugs in other countries. Also, although supplements and vitamins are FDA-regulated, this is very minimal, so it’s important to understand the science behind how a company manufactures each ingredient [in a product].

“Depending on how a product is manufactured, it may be less absorbable,” she continues. “Molecular weight [of ingredients] is very important with regard to absorption. Also, [we must consider whether] a product contains enough of an ingredient to permit it to work well.” In addition, veterinarians must be confident that the compounding pharmacy is adhering to standards, she notes. “Sometimes, some of the ingredients being used are not tested and standardized.” And, the more sales reps stay on top of these issues, the more qualified they are to service their veterinarian customers.

Experts warn that it is possible for pet owners to give their pets too much in the way of supplements or vitamins. However, as long as they follow directions, “there is enough oversight [in the industry] that supplements and vitamins can’t hurt anyone,” says Remillard. That said, depending on how the product is manufactured, it may only provide a placebo effect, she adds.
Contrary to popular belief, notes Bookout, animal supplements are not regulated by the Dietary Supplement Health and Education Act, which created a specific category for dietary supplements under the law. However, animal supplements are regulated, usually at both the federal and state levels, he adds. Sales reps may visit the National Animal Supplement Council Web site (http://nasc.cc) to see which supplement companies have received the association’s approval.

Working with your customer
Veterinarians have a responsibility to educate themselves on nutrition, including diets and supplements available today, says Bookout. And, sales reps can help. “They should attend educational programs and become knowledgeable themselves,” he suggests, adding that the NASC offers a wealth of information concerning supplements. Reps who have a better understanding of their product can better educate their veterinarian customers, he points out. In fact, “veterinarians’ greatest skepticism when considering new supplements can be their lack of information,” he says. They may be reluctant to consider new products when the clinical data is not available, he adds. “The better question is, ‘Why isn’t there more data for these types of products?’ The reason is simple: because supplement companies cannot recover the monetary investment required to conduct clinical studies. When veterinarians dismiss products from reputable companies on this reasoning alone, they may be doing a disservice to their patients and themselves.”
That said, when sales reps do “come through with the data,” they should do so in a concise manner, says Remillard. Veterinarians appreciate having a single page of easy-to-read facts, which they can “read over a cup of coffee,” she notes. “Distributor reps should give veterinarians a reason to carry their food products and supplements.”

Sales reps who fail to recommend the highest quality products risk losing the respect of their veterinarian customers, says Redfearn-Shelton. “They shouldn’t keep switching their allegiance to different brands, but rather stand by the highest quality products. And, if a practice is already using a high-quality product, reps can provide an alternative, but they should make sure it’s just as high quality, if not higher. They’ll do better in the long-term if they adhere to science and high quality.”

Editor’s note: The American Animal Hospital Association (AAHA) has announced it will begin work on a new set of guidelines targeting nutrition to help veterinarians make sound recommendations to clients. Leaders envision a consortium of organizations and professional associations actively involved in the creation of these guidelines, an AAHA official said. Publication is targeted for June 2010.

Sidebar - 1:
Age-old concerns for aging pets
Nutritional concerns follow pets into old age.

Like people, pets often are plagued by the same health issues as they get older, particularly if their owners don’t address certain concerns early on. That’s why it is important for distributor reps to know as much as possible about the nutritional products they carry, and to educate their veterinary customers on the value of these products.
While older cats face digestion problems and tend to lose weight, many elderly dogs battle obesity, according to Denise Elliott, BVSc, PhD, Dipl. ACVIM, Dipl. ACVN and a partner of Banfield, The Pet Hospital® (Portland, Ore.). Coupled with weight issues are joint disease and arthritis, she notes. In fact, as many as 20 percent of small breed dogs can have osteoarthritis, she points out. Oral health and chronic kidney disease are common among older pets as well. “Chronic kidney disease is the second most common cause of death in cats and the third most common cause in dogs,” she says. Heart disease and cancer are two other common issues facing aging pets, she adds.
“With the exception of cancer, there is good evidence that altering pets’ diets can address these health issues,” says Elliott. “There are diets designed to address heart disease, chronic kidney disease, obesity and oral disease,” Elliott continues. Veterinarians should “partner pets’ diets with medications and supplements,” she explains. Although “very few [supplements] have scientific proof of efficacy,” products such as glucosamine, chondroitin and certain fish oils and omega-3 fatty acids all appear to help manage arthritis in older pets, she notes.
Still, because supplements are not FDA-regulated, “even when pet owners purchase the most expensive product [such as glucosamine], they don’t know for certain that it provides the level of ingredients declared on the label,” says Elliott. However, veterinarians can provide high quality diets that contain supplements, she notes. “For instance, some diets contain fish oils and glucosamine,” she says. “This can be the simplest solution, and pet owners don’t have to worry about adding extra things.”

The rep’s role
Veterinarians know that good nutrition can keep pets healthier for longer, says Elliott. And, they are looking to their distributor reps for high quality diets and literature that supports those diets, she adds. In addition, sales reps can increase veterinarians’ awareness of the importance of diets in alleviating the symptoms and pain of arthritis and other conditions, she points out. “They might ask their veterinarian customers, ‘Doctor, did you know we have diets available that contain supplements, such as glucosamine, to reduce pets’ pain?’”
The good news for sales reps is that pet owners can only purchase these diets though their veterinarian. One of the best ways to address the changing needs of aging pets is through sound nutrition, says Elliott. When veterinarians offer their clients the right diets for their pets, it’s better for the animal and healthier for the image of the practice.

Side – 2:
A healthy inventory

Veterinarians will pick and choose nutrition products to have on hand.
Are distributor reps helping them make the best choices?

Space is at a premium at veterinary practices and animal hospitals. And while smaller clinics generally face the greatest space constrictions, even larger practices value their shelf space. Particularly as the number of therapeutic and wellness diets expands, veterinarians must pick and choose products they believe will best service their patients. As such, distributor reps can provide a value-added service by asking the right questions and supplying quality solutions that fit the bill.

A must-have
No matter how tight space is, if there’s one product veterinarians do not want to sacrifice, it’s therapeutic diets, says Scott Handler, DVM, marketing communications and education, Webster Veterinary Supply (Sterling, Mass.). “You would be hard-pressed to find a hospital without therapeutic diets, including those for diabetes, heart failure, urinary problems, etc.,” he says. “Some smaller clinics may have space problems [that preclude them from carrying these products], but they are few and far between. Most veterinary practices have them. It comes down to what the distributor reps are carrying.”
Wellness diets may present a tougher sell to veterinarians, he continues, especially since veterinarians often compete with specialty pet stores, which may offer similar products for less. Indeed, pet owners are likely to price shop, Handler points out. But, if they go to a specialty store, the salesperson doesn’t necessarily have the educational background to direct the pet owner to the most appropriate product. So, this is an opportunity for distributor reps to reinforce the need for veterinarians to keep wellness diets on hand, he says.
“The veterinarian’s concern is not with the diets themselves, but with the space to hold them,” he continues. As the number of therapeutic diets continues to grow, so do space issues. And given pet owners’ tendency to shop around for wellness diets, these inevitably are the first to be omitted from the veterinarian’s inventory.

Nutriceuticals, such as joint, liver and GI products, is another product area that some veterinarians may be reluctant to add. “Because these products are not backed by clinical data, nor are they FDA-approved, veterinarians may be more [reluctant] to carry them,” says Handler. “That doesn’t mean there aren’t veterinarians who don’t purchase these products and use them freely. But, many are looking for the clinical data to back them up.”

Solid communication
“The bottom line is, clients are looking for recommendations from their veterinarians, yet they don’t always walk away with a clear understanding of those recommendations,” says Handler. Distributor reps should reinforce to their customers that they must communicate their patients’ nutritional needs to their clients, he adds. Clients should not leave the practice uninformed.

And, timing is everything when it comes to pets’ health, notes Handler. “Veterinarians treat many disease states that are tied to nutrition, later in [the patient’s] life,” he says. Take obesity, he says. By treating this issue with the proper diet when the pet is one year old, the veterinarian can help prevent obesity. By offering veterinarians high-quality nutrition solutions, distributor reps enable their customers to service their patients more appropriately, and in a timely manner.