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9 Aug 2022

Therapeutic pet foods: benefits and nutritional innovations

author_img

Cecilia Villaverde

Job Title



Therapeutic pet foods: benefits and nutritional innovations

Image © 279photo / Adobe Stock

Veterinary therapeutic diets are those formulated to help with the management of clinical conditions in dogs and cats.

In Europe, these diets are regulated differently than other (physiological) pet food, under the feeds for a particular nutritional purpose (PARNUT) legislation1. They must meet specific characteristics, depending on each PARNUT. In many cases, it will also include a limited length of time for their use, mainly to ensure their use under continuous veterinary care.

These diets are very useful in veterinary medicine, as they have a dual purpose: firstly, providing nutrition and energy for the species and life stage; and secondly, contributing to management of the disease in a consistent manner. This is important to explain to caregivers, to show the benefit of their use, despite a potentially higher cost per day over physiological diets.

Innovations in veterinary therapeutic diets

Nutrient-sensitive diseases are those that respond to dietary management (alone or in combination with other therapies). Some of the diseases where veterinary diets can be used are listed in Panel 1.

Panel 1. Examples of nutrient-sensitive diseases with therapeutic diets available
  • Obesity
  • Adverse food reactions
  • Urolithiasis (struvite, calcium oxalate, purine based, cystine)
  • Feline idiopathic cystitis
  • Diabetes mellitus
  • Acute and chronic gastroenteropathies
  • Liver disease
  • OA
  • Canine cognitive dysfunction 
  • Convalescence and critical care 
  • Chronic kidney disease
  • Skin diseases

While patients with non-nutrient-sensitive diseases still need a feeding plan, a veterinary therapeutic diet is usually not required.

While some of these diets have been available for a long time, the number of conditions for which therapeutic diets are available is growing. Some of the new developments are detailed in this article.

How to use therapeutic diets

It is important to know both the nutritional goals for the patient and the characteristics of veterinary diets, to match them to each patient and use them to their maximum benefit.

To choose the best therapeutic diet for each patient, the veterinary team should perform an advanced nutritional assessment25. This will identify any malnutrition risk factors and help identify the desired nutritional strategies; for example, a low-calorie diet for overweight patients or a phosphorus-restricted diet for a patient with CKD.

Therapeutic diets for the same condition differ in several aspects, including ingredients and texture (and, therefore, palatability), but also nutritional profile, including energy density and concentration of key nutrients.

The availability of multiple therapeutic diets (both wet and dry) for one disease allows customisation to each patient, and even rotation or combination in some cases.

Many companies that sell veterinary therapeutic diets have more detailed nutritional information in their product guides than on the label, and veterinary clinics should request those for the use of the veterinary team.

These guides are particularly useful because they express the concentrations of key nutrients on a calorie basis, which is the best way to compare diets among themselves and to the nutritional goals without the confounding effects of moisture or energy density.

It is also important to assess the evidence for their efficacy, ideally with peer-reviewed publications. It is important to ask each manufacturer for such information, to provide the best care possible to patients.

References

  • European Union (2020). Commission Regulation (EU) 2020/354 of 4 March 2020 establishing a list of intended uses of feed intended for particular nutritional purposes, Official Journal of the European Union.
  • Elliott DA (2006). Nutritional management of chronic renal disease in dogs and cats, Vet Clin North Am Small Anim Pract 36(6): 1,377-1,384.
  • Geddes RF, Van den Broek DHN, Chang Y-M et al (2020). The effect of attenuating dietary phosphate restriction in cats with azotemic CKD and ionised hypercalcemia, Proc 2020 ACVIM Forum, online.
  • Hall JA, MacLeay J, Yerramilli M et al (2016). Positive impact of nutritional interventions on serum symmetric dimethylarginine and creatinine concentrations in client-owned geriatric dogs, PLOS One 11(4): e0153653.
  • Schauf S, Coltherd JC, Atwal J et al (2021). Clinical progression of cats with early-stage chronic kidney disease fed diets with varying protein and phosphorus contents and calcium to phosphorus ratios, J Vet Intern Med 35(6): 2,797-2,811.
  • Mueller RS and Unterer S (2018). Adverse food reactions: pathogenesis, clinical signs, diagnosis and alternatives to elimination diets, Vet J 236: 89-95.
  • Cave NJ (2006). Hydrolyzed protein diets for dogs and cats, Vet Clin North Am Small Anim Pract 36(6): 1,251-1,268.
  • Lesponne I, Naar J, Planchon S et al (2018). DNA and protein analyses to confirm the absence of cross-contamination and support the clinical reliability of extensively hydrolysed diets for adverse food reaction-pets, Vet Sci 5(3): 63.
  • Freeman LM (1998). Interventional nutrition for cardiac disease, Clin Tech Small Anim Pract 13(4): 232-237.
  • Smith CE, Freeman LM, Rush JE et al (2007). Omega-3 fatty acids in Boxer dogs with arrhythmogenic right ventricular cardiomyopathy, J Vet Intern Med 21(2): 265-273.
  • Freeman LM (2010). Beneficial effects of omega-3 fatty acids in cardiovascular disease, J Small Anim Pract 51(9): 462-470.
  • Li Q, Heaney A, Langenfeld-McCoy N et al (2019). Dietary intervention reduces left atrial enlargement in dogs with early preclinical myxomatous mitral valve disease: a blinded randomized controlled study in 36 dogs, BMC Vet Res 15(1): 425.
  • Larsen JA, Owens TJ and Fascetti AJ (2014). Nutritional management of idiopathic epilepsy in dogs, J Am Vet Med Assoc 245(5): 504-508.
  • Molina J, Jean-Philippe C, Conboy L et al (2020). Efficacy of medium chain triglyceride oil dietary supplementation in reducing seizure frequency in dogs with idiopathic epilepsy without cluster seizures: a non-blinded, prospective clinical trial, Vet Rec 187(9): 356.
  • Berk BA, Law TH, Packer RMA et al (2020). A multicenter randomized controlled trial of medium-chain triglyceride dietary supplementation on epilepsy in dogs, J Vet Intern Med 34(3): 1,248-1,259.
  • Pan Y, Landsberg G, Mougeot I et al (2018). Efficacy of a therapeutic diet on dogs with signs of cognitive dysfunction syndrome (cds): a prospective double blinded placebo controlled clinical study, Front Nutr 5: 127.
  • Packer RMA, Law TH, Davies E et al (2016). Effects of a ketogenic diet on ADHD-like behavior in dogs with idiopathic epilepsy, Epilepsy Behav 55: 62-68.
  • National Research Council (2006). Nutrient Requirements of Dogs and Cats, The National Academies Press, Washington.
  • Leib MS (2000). Treatment of chronic idiopathic large-bowel diarrhea in dogs with a highly digestible diet and soluble fiber: a retrospective review of 37 cases, J Vet Intern Med 14(1): 27-32.
  • Freiche V, Houston D, Weese H et al (2011). Uncontrolled study assessing the impact of a psyllium-enriched extruded dry diet on faecal consistency in cats with constipation, J Feline Med Surg 13(12): 903-911.
  • Pilla R and Suchodolski JS (2021). The gut microbiome of dogs and cats, and the influence of diet, Vet Clin North Am Small Anim Pract 51(3): 605-621.
  • Villaverde C and Chandler M (2022). Commercial vs homemade cat diets: what you need to know, J Feline Med Surg 24(5): 415-428.
  • Zanghi BM, Gerheart L and Gardner CL (2018). Effects of a nutrient-enriched water on water intake and indices of hydration in healthy domestic cats fed a dry kibble diet, Am J Vet Res 79(7): 733-744.
  • Davis H, Franco P, Gagne J et al (2021). Effect of Bifidobacterium longum 999 supplementation on stress associated findings in cats with FHV-1 infection, Proc 2021 ACVIM Forum, online.
  • Freeman L, Becvarova I, Cave N et al (2011). WSAVA nutritional assessment guidelines, J Small Anim Pract 52(7): 385-396.

Meet the authors

author_img

Cecilia Villaverde

Job Title