"Prescription" diets never seemed totally on the level to me, so I'm not at all surprised to hear that it's entirely a marketing ploy. Looking at the crap ingredients in a lot of prescription diets (corn, soy, etc) I found it really hard to believe that not only were vets selling this stuff, but that it was also endorsed by a medical body.

I am kind of surprised that there are no labeling restrictions on calling something "prescription" when legally no prescription is required. I mean, great marketing on th part of the pet food companies, taking advantage of this loophole, but it's highly misleading for consumers. The word "prescription" really strongly implies that it is a medication and comes with all the testing, regulation and oversight that drugs do.

But hey, pet companies (and some vets unfortunately) using dirty tactics to mislead consumers and line their own pockets? Well, that's just what I've come to expect these days (and probably why I don't trust pet food companies at all, and scrutinize any veterinary advice with a scpetical eye.)

Anlina Sheng - abnormalloveofcats.com June 8th, 2009 10:27:50 AM

Monopolies

Evet June 8th, 2009 10:46:57 AM

Bravo, Dr. Khuly!  I would imagine that this post won't make you popular with some veterinarians who still consider prescription diets a profit center, and it definitely won't endear you to the manufacturers of these diets!  I always felt that the hassle of carrying these products (the amount of space they take up, so many different options so how do you know which ones to carry, etc.) and the low mark up were more trouble than it's worth.

It also seems that views on what constitutes a good diet for different disease processes are constantly changing.  And quite frankly, if I compare the list of ingredients on some of these prescription diets with the ingredients on some premium natural diets (and yes, I know that the term "natural" can't be taken at face value), I can't imagine that feeding a pet with a system already compromised by diseases such as kidney, liver, gi or heart disease a diet that contains corn, soy, and sometimes even chemical preservatives will actually benefit the pet just because it may meet some specific requirements in terms of protein or sodium levels.

Ingrid King June 8th, 2009 11:13:34 AM

How interesting. I will not support Hills no matter what. I think it's kind of funny how all of my animals have never once needed a prescription diet, (okay probably in part because my one cat that "might " benefit from a urinary diet would nvever not eat the other food that is down so he is treated successfully another way) yet I know people who spend more than they should, in fact more than they can on rx diets for their pets because their vet has insisted the pet needs that food...

Good for you for making the behinds the scenes clear on this. Once again another good reason to cook for your pet....The big BIG business of pet foods and the companies behind them is convoluted at best. And down right scary if you look at the programs within the veterinary community that gets money from them. There is little room for honesty, and again how important is it to have a vet you can trust to tell you the truth.

again I can't help but say that by feeding homecooked diets, you are able to eliminate many of the preservatives and unnecessary food additives you pets are getting, as well as eliminating things like salt.

LorriM June 8th, 2009 11:40:28 AM

More than just soy and corn, when the first ingredient is animal by-products, you are feeding your pets absolute garbage.  One of my cats developed a pretty severe problem with crystals in her urine. Yeah, I fed her the crappy RX diet to resolve the problembut I did not continue with it even though the vet (not the one I see now) recommended it.  I switched her over from dry to wet food and voila! no more problems.  It was pretty simple - she rarely drank any water and ate dry food - hence crystal build up.  Feed wet food (RX or not) and there's no build up.

This isn't a money thing.  I'm pretty sure the premium, high protein, no grain, no animal by-products stuff I now  feed is as expensive as the RX food.  But I prefer to avoid feeding my pets diseased parts of animals unfit for human consumption (meat by-products) or rancid cooking oil collected from restaurants (added fat), thanks anyway. 

2CatMom June 8th, 2009 11:45:22 AM

Having been in the industry for donkeys ages--I've always tried to get people to question the quality of recommended diets by looking at the labels and pondering the marketing behind many of the brands.

Glad to see you tackled part of this topic in your post. I remember when Science Diet was purchased by Hills and they swore they didn't change the formula--and anyone with a brain could see that they did. The animals who had been loving it also noticed the change and were not so keen on it after (early 1980s).

Anyway, there is such a selection of premium foods these days that a little research and price comparions can usually help you find the food that is both within your budget and attractive and nutritious for your pet. 

Ark Lady June 8th, 2009 12:04:10 PM

I would be interested in hearing if anyone has experienced a problem with long term use causing another unintended disease process with a particular prescription diet/food?

Barb A./NH June 8th, 2009 12:07:38 PM

Thank you for addressing this situation here and for including the story of Louie, my Chinese Crested.  We have been appalled at the fact that a so-called "prescription" product can be changed in such a drastic way by the manufacturer.  Hopefully I will manage to find enough food to keep Louie going for the rest of his life, but I am sure we are not the only ones impacted by such changes.  This is an issue that needs to be brought to light, and I applaud you for doing that here. 

Louie's Mom June 8th, 2009 12:15:07 PM

Dr. Khuly, thank you!

Ingrid and LorriM, I know not everyone will want to go to the website and read Louie's entire story, but one detail I will mention: Louie's owner tried a number of home-cooked diets as well as other low-fat and prescription products. The Royal Canin Digestive Low Fat Canned with fish as the first ingredient really is the only thing that has worked for him. And by "worked" I mean, he's no longer staying in bed all day except when carried to the kitchen to eat or outside to potty. It's a scary situation for Louie's family.

Lis June 8th, 2009 12:15:51 PM

well ilooked into soem Prescription diet food    gee it has thae same junk the  stuff u can buy at the store  has

sorry  but its a rip off    if my vet ever offers  good food i will buy it in an instant

james June 8th, 2009 12:58:09 PM

Hey, Barb A., I was just at Patricia McConnell's blog (otherendoftheleash), and she mentioned a study about certain vegetables shown to help with urinary cancer in Scotties.  'Just wondered if you'd seen it.

KateH June 8th, 2009 01:49:20 PM

Dr. Khuly,

Did you forget about the science that is behind these diets? Are you aware that that reason the costs are where there are is do to the resources and technology that go into producing diets that are CLINICALLY PROVEN to improve the quality of life of our animals. Get all of the facts straight before you post dangerous blog posts like these. I can't tell you the number of pet owners who have had cats block again after coming off of prescribed diets because of things they read on the internet.

Jes June 8th, 2009 01:56:15 PM

A few years ago, our vet changed their policy that if we had not had our pet in to see them for a year, they would not provide the prescription food.  We had this exact discussion with them - THIS IS FOOD!!!  I believe they might have said it was required by law as well. Our cats were young at the time and so we were a bit lax on the annual exam and sometimes were a few months late.

The food they were eating was Royal Canin Weight Control 38 prescription food - two had a weight issue, one didn't but wanted to eat what his brother ate.  Interesting - the two that were on it the longest (7 years or so).  Both now have IBD & pancreatitis. 

The one developed GI issueson about his second year on the RC 38 food. We tried various prescription foods and he refused them all. We tried prescription and non-prescription canned foods and discovered he could not tolerate any of them. We tried the "better" dry foods and each time he became sick. His magic food - Hills I/D kibble. Not my choice, but it works for him and he gained a lot of weight.   

The second cat was gaining too much weight on the RC diet food - so first we tried to switch him to their diabetic kibble and he became sick.  Later we transitioned him to a non-prescription canned food which worked fine, but a couple misteps resulted in a very sick cat. He now has a very delicate GI system that can tolerate very little change, although he is doing great on the non-prescription canned food.  We tread lightly with any new medications or supplements (he became very sick on Cosequin).

And as for the third cat....No IBD, but I have to be careful when switching date batches of food for him, or trying anything new. He also has possible food allergies.

As for RC...I noticed all the formula changes they went through recently. Seems like they changed something in just about all their foods. Don't they realize how easily a pet can get sick because of that? 

Jenny June 8th, 2009 02:07:34 PM

Yup.  See you've already got Hill's riled up. :)

Patty P June 8th, 2009 02:14:24 PM

Do you understand the reason companies require a rx is that the vet has control of what their patients are eating....and thats a good thing. Some of these rx diets are not meant for long term feeding or could actually do harm if feed incorrectly or to the wrong animal. These diets are not just food.

Becky June 8th, 2009 02:16:05 PM

Becky, that would be great if it were true.  Unfortunately, in our case, no one told us that the formulation of the food was changing, and I have a very sick dog who reacts badly to some of the ingredients in the new formula, and can't seem to eat anything else.  The vets don't control what goes into the food, the manufacturers do. 

Louie's Mom June 8th, 2009 02:33:29 PM

Thanks for the real deal...hard to believe this would be just a marketing ploy...(sarcasm may not show)...The more that know all the facts the better...Ignorance is not bliss and thanks!

Carol June 8th, 2009 02:37:01 PM

Actually I trust my own instincts on what to feed my cat better than the vets.  Now, when I briefly questioned whether Bo should remain on his Welless turkey he has done so well on, I've been told by two vets to leave it alone and glad I've listened.  But as for finding the right food, I have poured a lot of research and effort into finding the right foods for them for my three cats. I track every food change and what their reaction to it is. I do research to see if the company has had recalls.  I review the nutritional profile and ingredients. (My vet joked and said I could be a nutritionist) 

Perhaps something like a diet for CRF might be something that would make sense being prescription because the nutrient profile is very different than what a cat should normaly eat. I just have one cat with possible very early CRF and haven't had to make that decision. But most of the foods (e.g. weight control formulas, diabetic foods, foods for various crystals, etc) - in general there is really no reason to use them in the first place.

Interesting - the RC 38 food says it is not meant for long term feeding, but the vet never seemed concerned.

Jenny June 8th, 2009 02:38:39 PM

lol - I really should proof read before I hit enter.  Sorry for all the typos.

Jenny June 8th, 2009 02:40:16 PM

Just another rip off in the pet industry. Vets know that people care so much about their pets that they will put out as much money as they have to, and so its taken advantage of. Its crazy that Hills goes along with the ploy, because you know what Hills, the vets are going to still sell your food even in other places sell it, because they still have clients that won't buy their food anywhere but in the vets office AND, shame on PetSmart for requiring an RX. Totally out of line for them to do this and people need to start writing them and telling them they are switching pet shopping places if they don't knock it off.

colleen June 8th, 2009 03:07:21 PM

All I know is, my dog had blood coming out of both ends for months while I tried every variation of diet the vet recommended.  When we gave her Hill's i/d, her tummy problems stopped and she's been a happy, sassy, healthy dog ever since (5 years) with no recurrence of that nightmare.  It just depends on what works for your pet.  I know Hill's isn't probably the best quality food, but it keeps her tail perky and that's good enough for me.

Shasta June 8th, 2009 03:18:18 PM

Jes: I don't recall that I addressed food quality in this post so I would thank you to keep your uncomfortable and unwarranted recriminations out of my comment section.

This post was not intended as a condemnation of any food, merely as an explanation of how marketing works in veterinary medicine and how it can have negative consequences on pets from time to time. Hope that's clear to everyone now. 

Dr. Patty Khuly June 8th, 2009 03:23:48 PM

I too would like to thank for you for printing Louie's plight! 

Cynthia June 8th, 2009 04:01:36 PM

Becky: You raise a good point about some of these diets. Some (though by no means most) really aren't meant for long-term feeding. I would agree that over a lifetime some of these diets might be woefully nutritionally insufficient for some pets. The stated reason behind the Rx is that a veterinarian is the one ideally suited to recommend them for conditions he/she has diagnosed. It's not to protect the animal. If it were, the Rx wouldn't apply to the vast majority of Rx-only foods. 

However, the pet food companies can't have it both ways. If they invest in the R&D and marketing they certainly deserve their profits. But to advance the requirement for a prescription is more than a little disingenuous if they don't have to conform to all the rules and requirements for other prescription products. Given that this designation confers a marketing benefit, I would offer that it's even more questionable. 

btw, I'm not the only veterinarian who takes this tack on Rx-only foods. On threads on VIN (the Veterinary Information Network--for vets only), it's not only clear that many veterinarians resent the obfuscation, it's also obvious that many veterinarians truly believe these diets are FDA regulated and require a script. And they do not. All the pharmacy and legal experts on VIN were clear on that. 

Sure, we wouldn't want some random guy at PetSmart recommending Royal Canin's SO for stones when he has no idea what kind of stones your pet has or even if she was ever diagnosed with them. But let's be honest: that's one more of another zillion "buyer beware" issues faced by consumers in all spheres. It certainly doesn't defend the Rx designation as far as I'm concerned.

Dr. Patty Khuly June 8th, 2009 04:20:16 PM

Do you understand the reason companies require a rx is that the vet has control of what their patients are eating....and thats a good thing. Some of these rx diets are not meant for long term feeding or could actually do harm if feed incorrectly or to the wrong animal. These diets are not just food.

Then, Becky, how do you justify the change in the formula of Louie's food with no notice to anyone, and no apparent consideration of the impact on pets dependent on it? If these were real prescription products, you couldn't do this without extensive oversight, review, and notice. In fact, pharmaceutical companies can't do this to even non-prescription drugs without extensive oversight and review.

Dr. Khuly is right; you are trying to have it both ways--all the marketing benefits of having a "prescription" product, while all the freedom you have with any other food to reformulate it at any time for any reason with no oversight, review, or notice to anyone.

Lis June 8th, 2009 04:33:20 PM

For those who feel the "prescription" diets are a complete rip-off...I (and many clients and vets) beg to differ.  You are either exaggerating your views or are misinformed.  For example, my own dog has a history of bladder stone (removed in its entirety surgically).  Four years later, despite the likelihood of recurrence, the food she eats encourages her water intake, thereby producing pH neutral and fairly dilute urine inconducive to crystal or stone formation...in other words, no more crystals or stones!  Hill's s/d formula can actually dissolve certain types of stones, possibly sparing your pet surgery.  For pets with confirmed yet undetermined (with regards to ingredient) food allergies, the hypoallergenic diets work wonders.  I'm not entirely sold on the weight loss, or "reduction" diets...I think most pets would be better served by smaller portions and more exercise, but for some, it appears to be the only thing that works.  At any rate, you simply can't argue that the diets have zero merit.  And no, I don't work for a pet food company nor am I reimbursed for my opinion. :)

That being said...I hate the whole business of these foods.  Most of you guys know I work for a Banfield.  (BTW, several months ago corporate issued out a very stern memo that forbid us from using the term "prescription diet"...instead, we are to use the term "therapeutic diet".  I imagine it was for precisely the reasons Dr. K outlined above.) We have the unenviable position of being the middle man when it comes to PetSmart's retailing of these foods (Banfield does not = PetSmart, regardless of what you may believe, at least at the practical level).  Which means...PetSmart orders, stocks, and sells the food, while the resident Banfield clinic is held responsible for policing the food.  This means that PetSmart will only sell you the food if we have issued you a "MedCard" for that particular food...and we can only issue you a "MedCard" (in essence, play the pharmacist) if we are able to verify that your veterinarian intends for your pet to eat this food...assuming you are not an established client with our practice, we can call your vet for you, your vet can fax us a "prescription", or you can present us a "prescription" on your vet's letterhead with their signature.  Easy enough, right?  And I think it's pretty reasonable, really...whether clients like it or not, there need to be some safety checks in place so that pets are eating the proper food (I can't tell you how many times I've called for a client only to find out that the food they've got in their cart is the wrong one..."oh, I thought it was the light green bag").  And we try to be SO nice about it, seeing as how we typically spend a good deal of time sorting this out for someone who's not even our client (we don't charge for the card).  It never fails that we have at least ONE person a day who is pissed that they have to go through "red tape" to buy the food (really? "red tape"?  give me five minutes to call your vet, bud, and you can have as many freaking cards as you want!).  Or someone who swears we'll be held accountable when Fluffy dies tonight from having to eat something other than her "rx" food because the owner didn't realize she was out until 6:30 p.m. and while my clinic is still open, their vet is closed so I can't call to confirm Fluffy's records.  Or the owner who throws a fit in the lobby Sunday afternoon because we don't care about her pet enough to take her word for it and her vet's not open until tomorrow.  Sheesh.  So, FWIW, I'd give anything for PetSmart to STOP selling those foods, lol.  But, for those of you who do buy your food there...please...make it easy on yourself...get a note from your vet, and keep it in your wallet.  It's really that easy. 

anna June 8th, 2009 04:34:34 PM

I do understand that some of the diets can (and do) help with certain conditions - as long as the formulations aren't changed (as in Louie's case, for example).  Some of the diets really aren't meant for long-term use, but some of them are fine (even necessary) for the life of the dog/cat (i/d really helps a lot of dogs with intestinal issues and they can live on it, when other diets set off vomitting/diarrhea).  And some of the diets only seem to help some dogs, but that's no reason for them not being available (b/d was the only change in a couple older dogs lives, and the owners saw noticable improvement, but it didn't make any difference to others).

However, the over prescribing of r/d (and other 'diet' foods) is often (I admit there are a few exceptions) just laziness on the part of the owner who only thinks a 'magic prescription' is going to get their vet to stop bugging them about the dog being fat, and laziness on the part of the vet who doesn't find out more about nutrition and other foods, yet continues to tell people their dogs need to lose weight.

KateH June 8th, 2009 05:02:38 PM

KateH: Yes, there was a study published by Purdue that cruciferous vegetables are supposed to aid in prevention of TCC, actually, I think that same study had been published for humans, years earlier. Thank you for mentioning it, though.

For a while I had been doing it, mostly adding a little chopped fresh broccoli. Honestly though, I think it holds as much weight as all the food human studies. I'm still betting on the avoidance of : pesticides, herbicides, repeated vaccines, judicious use of heartworm & flea applications to as necessary.

I read that Jenny has had some issues with pres. foods. I have wondered ever since my friend's feline dilemma & use of certain Hill's prescribed foods.

All in all, I wish I have gone over to fresh cooked or raw diet for my remaining dogs. That seems the ultimate. But I have gone to a once weekly "raw bone chew" !! And teeth are looking good---

Oh, have switched all over to Wellness Senior kibble, with addition of various canned. No problems as of yet. This was as a result of Pearl's( sealyham) & now Zoe's (scottie) confirmed chronic pancreatitis disease

Louie's Mom & Lis: need to read your site. Quite a few Sealyhams have been diagnosed with "intestinal lymphangiectasia."and some Scot's with intestinal form of lymphoma.

My blog

Barbara A./NH June 8th, 2009 05:09:01 PM

My one cat went through Acute Renal Failure a couple years ago and during the episode she was put on Purina NF - dry; it was all she would eat.  I was grateful she would eat anything at all at the time but I am thrilled that she was willing to continue to eat it.  She does not like the wet food, but I do have a fountain and she drinkds regularly (not PU/PD).  She has maintained her weight and other than the occasional hairball she is GREAT....knock on wood.  As a vet I do rec some specific 'prescription foods' and I do think that some have their time and place; just like everything.  I am torn about how I feel as far as considering it 'prescription' and getting a vets okay to buy it elsewhere.  I guess I feel like it helps prevent the wrong person from feeding a food for what it is designed for.  I see it as a way to initiate a nutrition discussion with my clients/owners.  I would love if everyone fed the best or cooked but I know that I know they all can't.  Like I said I use it mostly as a way to start a conversation and see what they are willing to do, buy, etc.  If someone wants to get it somewhere else I wouldn't deny them.  I just want them to try and do the best they can for their pets. 

J.C. June 8th, 2009 05:18:00 PM

I also wish all vets would fully explain WHY a certain food is being suggested for specific conditions.  For alleries, explain the whole 'limited antigen' thing and that sometimes, because of common fillers (corn. wheat gluten, etc.), it's not going to matter if the main ingredient is salmon, venison, or kangaroo.  There's a person who comes in to get z/d ultra when her regular vet is out, and we have the prescription, but (I'm not kidding), mixes it with Purina One (because her dog 'won't eat without the Purina') and says it works.  Oookkkkaaayyy, but that's not how the z/d is supposed to be used - if your dog has such incredible allergies that you need a hydolized protein, then how does it work that adding Purina One does set off the allergies.  Somewhere in there is either a vet who sees a loony owner with enough $$ to pay for z/d (although the dog hates it) and/or a loony owner who heard about this 'new, special' food and insisted her dog needed it.

KateH June 8th, 2009 05:21:33 PM

That should be "doesn't set off the allergies"  Sorry

KateH June 8th, 2009 05:24:55 PM

Dr. K, I think you were too hard on Jes.  Other commentators on here were discussing food quality - why can't Jes?  Just because he/she doesn't agree with you?  Why didn't you ask other commentators to stick to the subject - marketing of diets?

My take on this, as an animal nutritionist, is that calling diets prescription diets is indeed just a marketing ploy.  I actually prefer the term 'therapeutic diets', as anna mentioned.  There is a place for these diets, but that is not the focus of this post.  Requiring a 'prescription' is not necessary, but it is a way to CYA for the vet. 

Situations like Louie's are not caused by the vet, but by the food manufacturer.  And I have my issues with a lot of food manufacturers, including some that sell what many commentators here would call 'high-quality, premium food'.  Did you know that calling a food 'wholistic' or 'human-food grade' is just a marketing ploy?  There is no legal definition of those terms, so a manufacturer can slap a label on a bag that says that, and unless there is a complaint, will get away with it.

The pet food industry is all about marketing.  I can't count the number of clients I have that tell me "Oh, he's on a great food - Pedigree!" or Beneful, or whatever.  No, they aren't necessarily great foods (and I'm not wanting to get into a debate about what brands are best), but they have GREAT marketing!

In everything, let the buyer beware!

Sassy June 8th, 2009 05:28:23 PM

Barb, the study is on green, leafy vegetables and yellow-orange vegetables - not cruciferous ones like broccoli, but spinach and other greens, as well as squashes, at least 3 times a week correlated with lower rates of urinary bladder carcinomas- so although the study is from 2006, perhaps it's a different one than you are referring to? 

KateH June 8th, 2009 05:35:26 PM

 Dr. K, I think you were too hard on Jes. Other commentators on here were discussing food quality - why can't Jes? Just because he/she doesn't agree with you? Why didn't you ask other commentators to stick to the subject - marketing of diets?

Maybe because Jes as well as Becky appear to be pet food company shills who aren't identifying themselves as such? Just my guess.

Situations like Louie's are not caused by the vet, but by the food manufacturer.

Um. Yeah. Glad you got that.The food manufacturer arbitrarily changed the formula of a so-called "prescription" food, and now a little dog who has harmed no one is dependent for his life on his mom and her friends being able to find and accumulate enough of the old formula to last the remainder of his natural lifespan.

And I have my issues with a lot of food manufacturers, including some that sell what many commentators here would call 'high-quality, premium food'. Did you know that calling a food 'wholistic' or 'human-food grade' is just a marketing ploy? There is no legal definition of those terms, so a manufacturer can slap a label on a bag that says that, and unless there is a complaint, will get away with it.

Indeed. And I have a nagging memory that Dr. Khuly covered this at some point recently--ah, here it is! http://www.dolittler.com/2009/06/01/When-canine-%E2%80%9Cnatural%E2%80%9D-is-not-so-natural-and-feline-%E2%80%9Cgreen%E2%80%9D-is-not-so-green.html Last Monday.

Lis June 8th, 2009 05:42:02 PM

Wow.  Lots of revelations in that post.

I don't think we can trust the NECESSITY of any Rx diet when veterinarians are getting such kickbacks and profit motives abound for both the RX food producers and veterinarians. 

The most ethical veterinarians I know argue against the necessity of RX diets, saying that they are full of low-quality ingredients and that diets can be made or purchased that serve the same purpose but have better ingredients. 

Some vets argue:

"But there are no published studies based on radomized control trials (RCTs) using any of those alternatives, and the efficacy of this Rx diet has been proven in RCTs etc,."

Yeh, it's a chicken-egg phenomena.

Only RX foods are used in RCTs to determine their efficacy.

Therefore, only RX foods are backed by study results.

This is a self-fulfilling prophecy.

Hence the conundrum for educated clients and ethical vets.

For example, studies show that low-protein, low-phosphorous diets seem to slow the progression of kidney disease.

Some vets I know argue that low protein diets do not help at all, and in fact, they can hurt.  It's the phosphorous, they argue, that is the key to slowing progression of renal disease, not the protein.

OTOH, others say: "Well, there has never been a study of phosphorous content restriction ONLY in the absence of protein restriction, so until there is, I recommend restricting both." 

Granted, most high protein foods are also high in phosphorous, but it is possible to create a diet that is comparatively low in phosphorous but higher in protein and of a better quality source than an RX diet.  But that's never been studied.  Why?  Because the companies don't make any such food, that's why.  And until they are contemplating making it, and making $$$ off of it, there will be no formal study on it (RCT etc) and therefore, no evidence that it does/doesn't work, and for BOTH of those reasons vets won't recommend it.

It's a self-reinforcing loop primarily driven by profit.

Stefani June 8th, 2009 05:51:34 PM

Which means...PetSmart orders, stocks, and sells the food, while the resident Banfield clinic is held responsible for policing the food. This means that PetSmart will only sell you the food if we have issued you a "MedCard" for that particular food...and we can only issue you a "MedCard" (in essence, play the pharmacist) if we are able to verify that your veterinarian intends for your pet to eat this food...assuming you are not an established client with our practice, we can call your vet for you, your vet can fax us a "prescription", or you can present us a "prescription" on your vet's letterhead with their signature. Easy enough, right? And I think it's pretty reasonable, really...whether clients like it or not, there need to be some safety checks in place so that pets are eating the proper food (I can't tell you how many times I've called for a client only to find out that the food they've got in their cart is the wrong one..."oh, I thought it was the light green bag"). And we try to be SO nice about it, seeing as how we typically spend a good deal of time sorting this out for someone who's not even our client (we don't charge for the card). It never fails that we have at least ONE person a day who is pissed that they have to go through "red tape" to buy the food (really? "red tape"? give me five minutes to call your vet, bud, and you can have as many freaking cards as you want!). Or someone who swears we'll be held accountable when Fluffy dies tonight from having to eat something other than her "rx" food because the owner didn't realize she was out until 6:30 p.m. and while my clinic is still open, their vet is closed so I can't call to confirm Fluffy's records. Or the owner who throws a fit in the lobby Sunday afternoon because we don't care about her pet enough to take her word for it and her vet's not open until tomorrow. Sheesh.

Or, the utter horror and complete irresponsibility of someone coming in with, no, not a prescription on prescription pad paper, but a complete medical history from the dog's own vet, clearly indicating that the dog is eating a particular diet, and wanting to buy that particular diet. Trying to buy up enough of the old formula of a food that has been arbitrarily changed because the price of fish has gone up that a dog who can't survive on anything else can continue to live and thrive.

And, due to the time difference between east and west coast, there was plenty of time to call the vet on the west coast, and verify, but we still had to wait for the owner to get out of a business meeting and make the phone call herself, and then fax it to the store.

Not all pet owners are too stupid to tie their own shoes, Anna.

And the last time I was unable to buy a prescription food at that particular Petsmart/Banfield, it was for my own cat and I did have the prescription from my own vet in hand.

Meanwhile, a different Petsmart/Banfield in another city was being a lot more helpful.

(Oh, and I want to be totally clear, here: the Petsmart employees at the first store wanted to help, but they believed what the Banfield employees told them, including about the big fine for selling a "prescirption" food without a prescription. They made the sale anyway and stored it in the manager's office, so that it couldn't "disappear" while we were waiting for the prescription to be faxed in.)

Lis June 8th, 2009 06:00:56 PM

KateH: Same study, possibly didn't refer to all the veges, although broccoli is the most common one used--I think it even went to suggest 3 spoons a day. It was published in the Bagpiper, the Scottish Terrier Club of America's quarterly. I'm not 100% positive, but I think the club funded the study.

The club is waiting for word on possible genetics & hereditary components in Scotties for TCC risk study, but scuttlebut has it that it is complicated "risk", not easily determined.

Pocket may have had TCC, as impartial review detrmined one enlarged kidney thought to be "blocked", but I suspect liver involvement, also upon outside review of curiously dated x-ray of an abnormal liver lobe. Her dam had a definite large "tumor" in the liver seen shortly before death. (hmm, another secret revealed--on my favorite Dolittler site, I guess this could be construed as one form of justice!) Still pitiful for $3700, I do not know for 100%, but some people sure do know.

Barb A./NH June 8th, 2009 06:11:11 PM

Louie's Mom: I read his story...I hope it works to have his needed food. I can't believe that pork would even be considered in dog food....isn't that an absolute no no for "fats" issues??

Barb A./NH June 8th, 2009 06:27:11 PM

It's always fascinating to me how any article about pet food generates such emotion - and I completely understand why it does!

Lis - I appreciate the situation with Louie, and my heart goes out to his people.  I went through something similar many many years ago with a cat who was dealing with IBD/lymphoma.  Sometimes it's not even that a formula is discontinued, it can be something as minor as the manufacturer changing one ingredient in a formula.  We all know how finiky animals can be, especially sick ones, and what a relief it is when you finally find something that works, and then it's changed or discontinued. 

Ingrid King June 8th, 2009 06:29:17 PM

Lis - seriously?  All I'm doing is relating my experiences with the topic at hand...namely, I think the whole "rx" food game is a pain in the rear, too - and I'm on the end of having to police the sale of those foods.  And I really meant the "carry a rx in your wallet" as a tip for those who do purchase their foods from PetSmart, as in, "need to buy a "rx" food from PetSmart?  Here's what's required of you, straight from someone who knows the rules".  Why do you take every comment I make so personally, as if I'm somehow directing the comment at you?  I'm sorry if you had a bad experience trying to buy your food from a PetSmart (or if you've had a bad experience at a Banfield), but I'm tired of you lambasting me personally, implying that I think pet owners are "too stupid to tie their own shoes"...and it's not the first time.  Please stop.

anna June 8th, 2009 07:11:42 PM

Sassy (and Jes): I guess I just go overboard when I'm accused of getting my facts wrong on something I didn't discuss. I'm sensitive. Sorry for the negativity. Pax. 

Dr. Patty Khuly June 8th, 2009 07:19:03 PM

Barb A, thank you.  Believe it or not, I'm more worried about the chicken that they have added to this food, as he seems to be sensitive to it.  I tried a homecooked diet with chicken as the protein and did everything I could to get it down to minimal fat levels, thinking it was the fat he must be reacting to, but even with just a bare hint of chicken in the mix, he just never did well with it.  The pork probably isn't great for him, either, but I know that chicken doesn't work for him. 

Ingrid, thank you also.  This is exactly our situation.  They are still making and marketing this product under the same name, but the ingredients are completely different.  We went through sheer torture over the course of a year and a half trying to get Louie back on his feet and stable, and this has just brought me to my knees again.  It is hard for me to believe that they can just decide to make these kinds of changes to products that are marketed as treatments for medical conditions. 

Louie's Mom June 8th, 2009 07:27:12 PM

I'd also like to address the issue of "kickbacks." Most veterinarians do not make a lot of money selling these foods. We do so as a convenience to pet owners.

Sure, I'd love to see my clients head straight to the nutritionist and get their diets formulated and follow a recipe, but I know that's unlikely to happen with most pet owners--for lots of reasons. That's why I happily accept the help of manufacturers who produce foods that are usually "second best." And that's why my hospital carries them--in fact, it's the only reason (i.e., for convenience). It's also why I don't mind PetSmart selling them. Less work for me, I say. We don't get paid enough from selling these diets to make up for the headache of having to carry them. 

Some veterinarians, however, do make more money on them than we do. They either charge more, have more space or have better inventory protocols to help them make these foods more profitable. But they don't get kickbacks, per se, just a meager profit on a product most of us believe in as a convenience item for those who don't have the time, flexibility, energy money, and/or dedication to see a specialist and cook for their pets.

Commercial diets just make sense for most people. And veterinarians are largely trying to do right by their patients. Nothing nefarious there. 

Dr. Patty Khuly June 8th, 2009 07:32:37 PM

Dr. Patty, is Hills C/D a long term feeding food? 

Two of my cats have had Struvite urinary crystals and had been on Methioform with some canned C/D and now no crystals.  These particular cats will eat some wet food but prefer to eat dry so my vet suggested switching their dry food to the C/D as well and stopping the Methioform then do another urinalysis in a month. 

From a pet owner perspective, with 7 cats in the house and one already on meds for Megacolon, it would seem like feeding a RX food would be so much simpler than crushing up those Methioform for every meal.

I was just curious what your opinion is of long term feeding of C/D was.  The two cats in question are 7 years old and 5 years old.

Thank you.

cl June 8th, 2009 07:55:59 PM

cl: C/D is designed as a nutritionally complete diet. Hill's says it's OK for cats to be fed these diets long-term. Hope that helps. 

Dr. Patty Khuly June 8th, 2009 08:17:50 PM

It's the same model that Big Pharma companies use to push their products on the public through physicians.  I find it interesting that most continuing ed programs for doctors are put on by the drug companies.  Is the same true for vets?  I don't know but it would not surprise me.  I continue to be skeptical at the ease at which vets push Rx products as the solution for our pets. 

Anne Good June 8th, 2009 08:20:36 PM

Louie's mom, someone called our clinic on Friday asking if we had any of that food (sorry, we don't carry it, so couldn't help).  Could it have been someone trying to get it for Louie?  I'm in Michigan.

I agree, Dr. K, that vets don't make much from these 'Rx' foods.  It gets me riled up when people say that vets are money-grubbing because these foods are sold in their clinics.  Where I live, there is nowhere else to get them - the nearest Petsmart is 70 miles away.  The people who comment on here tend to be those who will get the best nutrition they can for their pet.  But the vast majority of the public want convenience, and they don't want to cook for their pets - they don't cook for themselves either!  It is a struggle to get them to use something other than old roy sometimes!

Sassy June 8th, 2009 09:30:42 PM

Anne: The same is true for vets--but not to the extent to which it once was for physicians. Truth is, new laws and guidelines for the human medical profession severely limit the financial relationships between them and pharmaceutical companies. Same is beginning to be true for the vet profession--though we never "enjoyed" such impressive benefits as those afforded the human side of medicine. 

Still, I'd like to think that veterinarians tend to be "free-thinkers." We're very skeptical, as a profession. 

Rx solutions have their place. Where would we be without penicillin, anyway?

Dr. Patty Khuly June 8th, 2009 09:34:00 PM

<<Where would we be without penicillin, anyway?>> licking moldy fruit? lol....cantelope I believe...

What about all the hills/iams/purina supported university projects? certainly that sways thinking about the diets as well as many of the other educational programs supported by the pet food industry.

I don't know any vets who actively push Rx diets, but certainly the limiting of them is best for profits for the companies, not the vets...I just don't think that the diets are the best possible food sources for our pets, especially since so many problems have come to the surface in the last few years and still continue to occur. (ie the nutro recall http://www.nutroproducts.com/press-recall/press-recall.html ). Seems to me that Rx or not, there needs to be high standards, better nutrition and oversight in this area.

LorriM June 8th, 2009 09:50:14 PM

LorriM: I don't believe that the relationship with pet food companies and veterinary programs/research is as 'evil' as those of us Monday-morning quarterbacking might assume. Pet food companies were looking for a 'way in.' And veterinary teaching institutions were looking for a 'way out'...of their financial burdens. 

At the time (early 80s), few would have predicted the surge in pet owner interest/veterinary market for incredibly expensive foods and other high-priced veterinary therapies. It was a mission to get pet owners to accept we take X-rays, professionally clean teeth and prescribe pain-relieving drugs at the time (sometimes it still is). So when pet food companies came a-calling, veterinary programs were all ears--especially true given the then-problem of land-grant institutions losing all their state funding. 

While it seems 'somehow wrong' in this day and age to let pet food companies dictate the terms of our research, I can assure you that that's not the case across the board. Many pet food companies fund needed institutional research that does not necessarily favor their foods.

Sure, that may be because it furthers their marketing goals in some way, but that's not always the case nor should we discount this research out of hand simply because pet food companies financed it. rather, we should use our analytic brains to consider all factors involved when the information is presented--as we should do with all science (after all, someone pays for it and it deserves to be scrutinized from all angles). 

And while I may cry foul whenever the pet food companies cross the line (as I often have cause to do), I'll never forget that commercial pet foods made pet-keeping possible for millions of Americans who would otherwise never have had the chance to fall in love with animals. 

Dr. Patty Khuly June 8th, 2009 10:12:26 PM

Sassy, it very well might have been for Louie.  I am a member of an online, breed specific forum and members from all over the US and Canada have been calling around for us over the past week.  I am sure we are not the only ones looking for this food, but I do believe I have a shipment of food coming in from somewhere in Michigan, so it might have been that same person who called you, as well.  

Louie's Mom June 8th, 2009 10:33:18 PM

<<While it seems 'somehow wrong' in this day and age to let pet food companies dictate the terms of our research, I can assure you that that's not the case across the board. Many pet food companies fund needed institutional research that does not necessarily favor their foods.>>

I'd object less if they brought more ethics into it. I have a family member who has worked as an outside contractor for many of the pharmaceuticals and some of food companies (proctor/gamble/nabisco) and as well as Iams, I object to the type/level of animal research.

Don't get me wrong, I am not for banning the use entirely of animals. As obvious drug research for animals should be done with animals, it is many of the others that need some ethical improvement. Nor do I totally object to the food companies support worthwhile research. Without expectation.

LorriM June 8th, 2009 11:57:20 PM

Unannounced formula changes are a huge, huge, huge pet peeve of mine.

I have a sensitive cat who vomits most high-quality canned foods. As of our last trip to the pet store, he suddenly has zero tolerance for the one brand that had really been working for us (not a prescription diet). I suspect that something in the formula has changed, but have NO idea what it is. This has happened with a number of the brands we've used in the past. I can't find any evidence that he has a problem with animal proteins or grains (latest offenders are grain-free). It's probably a very minor formula change involving a minor ingredient, but whatever it is, it sure isn't working for Nick.

I'd been thinking about inquiring about prescription foods the next time he goes in... very disheartening (and irritating!) to know that going the prescription route still wouldn't eliminate the possibility of unannounced formula changes.

Ramen Connoisseur June 9th, 2009 01:13:20 AM

I'm not very happy about charities obliging donors to buy Hill's products. Hills only supplies dry food (both prescription and non-prescription). Dry food really shouldn't be the exclusive diet of shelter animals IMHO. It also gives adopters (and pet owners) the idea that Hills is the product to buy for their new animal. The ALL FOOD referred to is just dry food, no wet included.

The BC SPCA is a non-profit organization that helps nearly 40,000 injured, abused and homeless animals each year and relies almost solely on generous donations from its supporters. You can help the animals by supplying any of the items listed below.

Have you heard the news? Hill's® Science Diet® is now donating all food for dogs and cats in BC SPCA shelters across BC!

With the nutritional needs of our dogs, cats, puppies and kittens now met through the Hill's Science Diet "Second Chance for Love" program, our shelters no longer require donations of regular dog and cat food.

However, we warmly welcome donations of Hill's® wet pet food for dogs and cats, Hill's® special diet and senior food, and food for rabbits, birds and small animals.

Jean June 9th, 2009 02:46:05 AM

I'm thrilled you're outing on this topic!

While it is true that "prescription" is merely an advance written directive, these days it certainly implies that a prescription drug is involved unless it is clear to the contrary.  I know doctors tend to use a single type of printed Rx pad but I seriously question the use of those pads in this manner as it confuses the matter.  I don't think patients know that those pads don't really have some magical power; that what is on them are merely directions/instructions/etc.  Yes, I think the manufacturers are, at a minimum, trying to obfuscate.  However, I think any vet who puts an authorization to buy these products on an Rx pad is inherently participating in that obfuscation.  Vets should use some other form and, if the manufacturers object, they may well be passing from obfuscation to fraud.  Wouldn't it be great to use a form that says "order for Prescription Diet, this script is required by the manufacturer, NOT the FDA; this is an OTC product"?

PJBoosinger June 9th, 2009 06:26:40 AM

OT but one of our favorites around here... On food quality...

http://www.pbs.org/now/shows/523/index.html

And what we can do about it

http://www.pbs.org/now/shows/523/food-health-tips.html

OK, a little on the light side but it's a start :)

PJBoosinger June 9th, 2009 06:28:33 AM

"Requiring a 'prescription' is not necessary, but it is a way to CYA for the vet."  Couldn't let that "CYA" comment pass.  Not only does it NOT CYA the vet, there's a good argument that the vet is participating in the obfuscation (possible fraud) by these companies.  It also puts the manufacturers in the position of being able to call these diets "vet approved".  I can't imagine there's enough profit in these products to the vets that a vet would want to share in the potential liability (that I, for one, am sure is coming).  These manufacturers are subject to virtually no oversight.  Why on earth would a vet want to be caught in the cross fire when it comes?

As to the quality and effectiveness of these "Prescription Diets"...  Anyone have any cites on that other than marketing materials from the manufacturers or those they paid?  If not, then for all I know, these are equivalent of the cheapest store brand I can purchase and we already know how little oversight there is for pet food generally.

PJBoosinger June 9th, 2009 07:00:18 AM

"I can't imagine there's enough profit in these products to the vets that a vet would want to share in the potential liability (that I, for one, am sure is coming).  These manufacturers are subject to virtually no oversight.  Why on earth would a vet want to be caught in the cross fire when it comes?"

We have been caught in that crossfire. It was called the pet food recall. That's what started many veterinarians and pet owners down this path of calling for more oversight. No veterinarian was ever sued over it. The pet food companies will always have the deep pockets, it seems. But there was discussion of this topic and it angered many veterinarians. Honestly, though, what's our choice when it comes to these convenient therapeutic diets? 

Dr. Patty Khuly June 9th, 2009 07:52:11 AM

For pets with confirmed yet undetermined (with regards to ingredient) food allergies, the hypoallergenic diets work wonders.

I'd love for you to tell that to my IBD whippet, Bart, but I had to euthanize him after he went from 34 to 25 pounds.  Z/D and Z/D Ultra were the last kibble he was on.  =(  Oddly enough, the vet specialist didn't provide any real alternatives, other than to keep trying, but Bart was suffering, so I did what I had to do.

Julie in OH June 9th, 2009 12:29:11 PM

Until dog/cat/whatever animal food is regulated by FDA (just like human food), I will continue to feed my dogs a homemade diet, consisting of lean hamburger, turkey, chicken, and fish mixed with wild brown rice, and vegetables.  My dogs love also bananas, apples, oranges and any fruits that their humans eat!  My logic:  if it's good for me, it's got to be good for my dogs, especially since my diet is exclusive Mediteranean with olive oil, fruits and vegetables.

My mom's cat "Jack" lived to be 20 years old and his only diet was my mom's homemade food.  He not even ONCE saw a vet, no vaccination, and no preventative fleas/ticks.  Now I realize why he lived a healthy long life.  NO pet food industries and no vets were involved in his long life!

Asproolee's Story

Fotini June 9th, 2009 01:03:25 PM

<<But there was discussion of this topic and it angered many veterinarians. Honestly, though, what's our choice when it comes to these convenient therapeutic diets?>>

Dr K,

there it is in a nutshell....CONVENIENT....and until that changes there is little you can do that you are not doing already by discussing it.

LorriM June 9th, 2009 01:11:51 PM

I also say Thanks for posting about Louie's Plight he's very special to us and this all has been an awakening experiance!

Noid also has been affected with the outright cancellation of production of a mineral supplement that I used in his special home cooked diet. Not much I can do regarding it but it sure would be nice if a little heads up was given so we as pup-parents can work with our vets and find some other solutions or alternatives instead of being blindsided one day when we go in to get a refill. 

It just annoys me to no end that the manufacturers can just change ingrediants or stop producing stuff with no notice what so ever!

Noid's Mom June 9th, 2009 02:10:24 PM

<<But there was discussion of this topic and it angered many veterinarians. Honestly, though, what's our choice when it comes to these convenient therapeutic diets?>>

Dr K,

there it is in a nutshell....CONVENIENT....and until that changes there is little you can do that you are not doing already by discussing it.

Not everyone can homecook. A lot of people are afraid to--and not just because their own vet scares them with the possible Dire Consequences. And while in general I'd agree that a good home-cooked diet is better, it doesn't always work. Louie's mom tried a vareity of fish-based home-cooked diets for Louie, and they didn't work for him, while the Royal Canin prescription diet has.

What we need is more options, not fewer. But we also need the companies to be honest with us about what's in the food, and not to make arbitrary formula changes--especially with "prescription" foods, but really, with any food. A lot of animals had problems when Canidae changed its formula, not because the new formula was bad in itself, but because they didn't announce it in advance, and didn't make the change obvious when they shipped the new formula, so that people who had always trusted Canidae suddenly found their pets having intestinal upsets or just not wanting to eat it. Without notice, people had no chance to transition their animals, didn't know why they were getting sick, and lost faith in Canidae.

When will they learn?

Lis June 9th, 2009 02:55:17 PM

PJ, re:

"As to the quality and effectiveness of these "Prescription Diets"... Anyone have any cites on that other than marketing materials from the manufacturers or those they paid?"

I know that for Purina DM and Hills KD, studies exist that support their efficacy for the purposes prescribed.

The reason the studies exist of course, is someone wanted to prove that these foods worked.  So they paid for these studies, which found that these foods were better than whatever was being fed to the control group.  That allows them to make claims, but it leaves many questions unaddressed, by design, such as: 

Are there other foods that would work as well as or even better than these RX foods that don't require a prescription?

(We will never know, because no one funds studies of these alternatives)

Are the studies potentially misleading, in that they attribute therapeutic results to the FOOD itself, rather than to individual or collective qualities of hte food that are also possessed by alternatives?

For example, for Purina DM, the studies show improvements for pets with diabetes.  But this diet is characterized by high protein, low carb profile that can be matched or exceeded by other commercially available diets.  Many pet owners achieve similar improvements with non-RX diets, but those alternatives have never been studied formally so vets (and Purina) can continue to claim: "Studies show that this works.  There are no studies on that other stuff you are talking about."  Thus, the self-fulfilling prophecy of studies demonstrating that RX diets marketed by Hills, Purina, et al. work.  Who is going to fund a study showing that Nature's Variety might work just as well, or home-made food, etc. ????

Stefani June 9th, 2009 03:04:07 PM

"what's our choice when it comes to these convenient therapeutic diets"  For now, probably your best bet is what you're doing, educating that these aren't what they appear to be at first blush.  I suspect I would refuse to sign the permission slip to buy them.  Perhaps it would be better to have a list of all the available products and highlight the ones that might be effective, give that to the owner and send them to an outside vendor.  I suspect the manufacturers would get over that "script" thing quickly if vets refused to sign them or sign any exclusivity contracts.

PJBoosinger June 9th, 2009 04:59:03 PM

Ramen  - it may not always be a change in formula either.  I have two cats that are very sensitive to date lot variation.  Being a regular on a feline IBD list ad well as based on discussions with my vet, differences in canned food from date lot to date lot does exist and can account for GI upset at least for cats.  I now purchase in large quantity from a single date lot and when I have to change from one to another I mix foods for several days in increasing quantities to cut over to the new batch. Ths has really helped a lot. 

Jenny June 9th, 2009 05:23:25 PM

Dr. Khuly, with all due respect, did you read the opinions of an EQUAL number of VIN vets who support the "prescription" of the Prescription Diets?  This is so that the vet can ensure compliance from the client during treatment.  Otherwise, they'd probably never see the pet again, and that pet would get lost in followup.

To all the complainers, you should be so priveledged those evil Big Commercial Pet Food companies have funded research, supported research, funded university programs to better understand and improve pet health care in numerous areas.  How many smaller, lesser known commercial pet food manufacturers can claim those philanthropical successes?

Do some of the research yourselves, then prove that any other company has come close to the research and success of many of those Prescription Diets.  Of course, not all pets are going to respond to all diets, but at least the research is there to support the success of those who DO well on them. (liver disease, kidney disease and Feline FLUTD/FUS are among the top conditions in which Prescription Diets are extremely beneficial to the patient and carry a higher success rate than any other commercial pet foods)

Let's not forget, every single Big Commercial Pet Food company that you feel are in a conspiracy against you, has an exemplary customer service to answer your questions, as well as a great vet-to-vet service for answering questions vets have about the products and point-of-sale.  How about asking them first rather than accusing them?  Vets aren't in a conspiracy either, they don't get kickbacks, and if you think YOU are frustrated with prices, ask a vet how frustrated the recent increases are to thier practice.  Hill's for example, made a recent change to a HIGHER QUALITY ingredient, as opposed to a lesser-quality ingredient, because they do not wish to compromise quality standards.  Does that not mean something to you people?

No product on the market of any sort is immune to a marketing ploy.  Just as you might be in a business for yourself, you're going to get on a marketing strategy, that's a fact of life.  Not all marketing is a conspiracy.

No, I do not work for a pet food company.

lexipup June 9th, 2009 06:46:23 PM

<<No, I do not work for a pet food company.>>

well obviously you have missed your calling,.

LorriM June 9th, 2009 07:04:24 PM

So, Lexipup, do you figure that Louie's mom is an ungrateful shrew for complaining about Royal Canin taking a "prescription" food, the only food that allows her dog to live and thrive, and changing its formulation to something that he cannot eat? What do you figure she should do--continue to feed this "prescription" food with the same name but radically different formulation, even though it would no longer support his life and health?

The companies make huge profits off of marketing these foods as "prescription" foods, but they accept none of the burdens of actually manufacturing genuine prescription products, or even over-the-counter medications. If they did, these unannounced, unreviewed, arbitrary formula changes would not be possible; even the Bush-era FDA would have landed on any pharmaceutical company pulling something like that like a duck on a June bug. They would hardly  know what had hit time.

The pet food companies want to have it both ways, and they don't like the fact that their customers, previously their trusting patsies, are starting to notice, and resist.

Lis June 9th, 2009 07:22:01 PM

I am just curious.....if a 'RX' food works for someone and they want to use it are they bad???  If someone doesn't want to cook for their pets (because they don't even have time to cook for themselves....whole 'nother issue) but instead use commercial diets are they terrible pet owners?  Do their pets get loved less, or have been cheated out of any less of an exsistence (sp?)

<p>

The way I see it it is my job to provide owners with options and the information to make their own decisions.  I can make recommendatsions based on my knowledge and experience and what I feel would be the best choice; which sometimes I do think is a perscription form type food.  These foods are unique in their composistion and I just don't think that there are natural or home cooked alternatives that are going to be something an owner can do.  And if they can't then I don't begrudge them the ability to use a perscription diet.

<p>

I may not know if my cat will live longer on a different food as opposed to the RX food she is on now.  But I feel I have made the best choice I can (and really what she will eat) and I have to go with that.  Her quality of life is good and ultimately I can only 'control' so much. 

<p>

I think that most things in this world have the potential to be bad for someone.  Look at strawberries.....for most people they are a wonderful fruit, full of good stuff....to someone with a diverticulum in their intestines......NOT GOOD!  People need to be educated and active in their pets lives; but realistically I have owners who do very little and maybe they shouldn't have pets but I don't think we will ever not face that possibility.  Again I am not sure that a vet having to sign a perscription or something of that nature is the answer but if they are going to provide a product that could have negative effects when it is improperly fed then there has to be something to regulate how it goes out.  Are people saying that the answer is not to have them at all??  I am just a little confused by some responses. 

J.C June 9th, 2009 08:01:25 PM

lexipup: There are far more veterinarians supporting pet food companies happily than those that choose to turn a jaundiced eye to their approaches. And it's not because they're in the pocket of the pet food companies. It's because they're in tune with the mass market--people who require convenience to maintain their pets. And, frankly, because there's so much going on in the world of animal medicine that nutrition tends to take a back seat. The pet food companies work hard to do the research so that the veterinarian doesn't need to even think about the diet once they prescribe it. That's got a good side and bad side to it, obviously. 

Nonetheless, it's clear to me that we shouldn't take the claims of pet food companies or their marketing tactics at face value. It especially irks me when many veterinarians don't understand that a "Prescription Diet" doesn't formally require an Rx. There's something very wrong when we don't fully understand our own recommendations and when we aren't willing to look past the curtain.

Dr. Patty Khuly June 9th, 2009 08:06:51 PM

Lis, admittedly, I cannot find any information other than the posts in this thread about Louie's Mom's situation, so unless she wants to provide her vet's assessment of the situation and what tests or processes of elimination she's thus far done, I'm afraid I'm not qualifed to answer.  Her posts on this thread indicate she's not even exactly sure what the offending ingredient may be, other than assuming chicken.  What if it isn't chicken at all, but some other ingredient?  There are various protein sources in other foods she could try, for example, novel protein, or hypoallergenic brands.  Wysong is an example.

Having said that however, and not being disrespectful to Louie's Mom, thousands of products undergo changes in ingredients all the time, human and pet food alike.  Due to lack of quality ingredients so the next best thing must be obtained, or due to new evidence another ingredient may be better or safer, the variables are endless.  Even your grocery store pet foods have undergone many of those changes.  Nothing is constant.  Ever.

So, not knowing anything about the pet's condition, I would suggest that Louie's Mom get a consult with a board certified small animal nutritionist (try petdiets.com) to develop a tailored diet to fit the needs, but ideally, her vet should be referring her.  If a process of elimination hasn't already been done to identify the offending ingredient(s), that should be approached.  An allergy test (providing it is validated) might help as well.  A call to the manufacturer might result in a service representive finding/tracking the original product's supply elsewhere (this has been done for countless of products in different situations).  If a comprehensive chemical analysis hasn't been done thus far (or repeated), it might prove helpful.  The vet should be ruling out other health problems in combination with singling out a food's ingredients etc.

lexipup June 9th, 2009 08:10:41 PM

But let me be clear in case anybody thinks me hypocritical: I use these foods daily. They help my patients. They help my clients. But I also won't shy away from offering other choices. And knowing something about the good and bad of pet food manufacturing and marketing means that I can offer a more informed point of view when I make my case. 

Dr. Patty Khuly June 9th, 2009 08:10:59 PM

Dr. Khuly, I guess we can agree to disagree.

But, remember, ALL pet food companies are in the business of marketing.  And MANY pet food companies market on claims bordering on absolute hype and no evidence to back up their claims.  Why shouldn't they be held to the same standards if you're going to criticize a more popular company?

lexipup June 9th, 2009 08:15:17 PM

I think the biggest problem with my experience with prescription diets is they destroyed my trust in my vet and almost killed my cats. In 2005 my vet reported as a result of bloodwork that two of my three cats were in kidney failure and I needed to give them prescription kidney diets.  They were 13 and had no symptoms of kidney failure.  He also said my 3rd cat would do well on the same food. I trusted him so I began feeding Hills KD.  Later I went back for Purina NF.  And finally Royal Canin Renal LP thinking each time a different brand would stop the decline of the cats.  Finally 6 months later I was clipping their nails and saw no pink in the nail beds.  I looked at the gums and they were white.  I pushed on the gums and no blanching.  I held up the cat's ears to a light bulb and could see no veins.  This told me my cats were anemic.  I looked up anemia and kidney failure on the internet and saw that anemia goes along with kidney failure.  All three cats were emaciated, lethargic, anemic and not really drinking all that much.  I could probably expect the two cats with kidney failure to die but why was the third cat just as debilitated? I had lost cats to kidney failure in years past and so could expect to lose these but 13 was young in my experience and the 3 rd cat without kidney failure was just as near death as the others.  And trying to solve things by changing brands wasn't working.  I looked finally at the ingredients and found they were almost all corn, corn fragments, and the only animal product was chicken fat at the 3rd on the list.  Then I remembered long ago when my cats were on kidney diets they were canned, in other words, meat.  And cats are carnivores.  Why would my vet prescribe grains to a carnivore?  I felt sick when I thought maybe I was making my cats sick by following my vets' advice.  I went to the Natural Pet Market and bought Innova EVO canned cat food and slowly it brought my cats back to health.  In one week they began producing red blood cells as shown in nail beds, gums, and ears.  My cats had been suffering malnutrition.  Four months later I went back to my vet to talk to him about what happened to my cats and get new bloodwork.  He said he didn't know much about nutrition but he knew many cats had been helped by these diets.  The bloodwork showed no kidney failure in any of the cats and the cats were very healthy again.  But I think it is a kind of malpractice to prescribe corn to a carnivore and I lost my trust.

And I had a dog at the same time with three years of chronic diarrhea, chronic flatulence, compulsive pica, poor coat, skin anal gland and ear infections, and finally hunched posture and vomiting.  By this time I was paying $150/mo. for vet costs.  Other than Hills I/D for a short time they never suggested I change food.  I read an article in Whole Dog Journal about IDB and realized this was my dog. They recommended a raw diet.  In one week my dog had no flatulence and stopped compulsively eating objects.  It took 6 months for my dog to become completely normal and he has been normal since.  Food was his medicine.

And my friend cured her cat of FUS with a raw diet after years of Hills CD.  She had been ready to euthanize the cat because of the urine issues in the house and the cost of maintaining her house with constant inappropriate peeing in the house.  Again, why would a vet prescribe kibble to a cat when most of it is a grain and it is dry.  Cats get most of their moisture in their food.

So my problem with prescription diets is they are inappropriate for cats and I have come to believe dogs are carnivores and some dogs are intolerant of the ingredients in kibble.  In the case of the cat prescribing grains is a kind of fraud.  I sat in my vet's waiting room for the whole afternoon and this vet is selling more food than PetSmart nearby.  The door opened and closed constantly.  And I think the pets pay the price.  And I no longer trust as I once did.

Pat Herrmann

Patricia Herrmann June 9th, 2009 08:18:13 PM

lexipup: I'll criticize them all if they mislead the public. Remember, I had a thing or two to say about a many of them last week on my rant on natural and green labeled products. It just so happens that Hills, Eukanuba and Royal Canin and IVD are calling their foods prescription products when they aren't. Doesn't the public deserve to know?

Dr. Patty Khuly June 9th, 2009 08:32:20 PM

Fair enough, but it isn't "recent" news.  To my knowledge, a fair amount of pet owners have known that prescription diets have not been "legally" prescription products for several years now.  And, they also learned the reason most vets wish to prescribe them as opposed to handing out bags at will to just anyone.  Because of the makeup of vital nutrients, vitamins and minerals in the formulation, in correlation to the condition for which it is intended.

Let's take one really good example of a prescription diet that should not be handed out to Joe Public at will.  Hill's Prescription Diet S/D (before it was determined CD-Multicare would be the multi-approach for FLUTD/FUS in some cases).  If fed long term, it could lead to development of oxalate crystals.  Or, how about Hill's Prescription Diet A/D, or I/D.  Neither should ever be fed long term, for obvious reasons, and those reasons are stated in their "rationale".

But those are just a few examples, and they apply to numerous "prescription diets" from other veterinary prescription diets.  I personally would not feel confortable recommending handing over a bag or case to a client based on the mere fact they do not fall into a legal classification for a prescription.  There are risks, and those risks must be explained.  I think the term "prescription" in a veterinary prescription diet is therefore justified.

lexipup June 9th, 2009 08:47:56 PM

Lexipup, Louie's story, albeit not including his detailed medical records, is here: http://www.savelouie.com/  Shockingly, I do not believe Louie's mom owes you his detailed medical records before she is allowed to state her conclusions based on the many months of working to find a successful management plan for Louie's condition.

And, yes, products undergo changes of ingredients all the time. And yes, products get lots of factually unsupported hype all the time. But a claim that something is a prescription diet is a fundamentally different claim than claiming that it will make you "sexier" or that it "tastes better" or "makes colors brighter." It trades explicitly on expectations created by human prescription and non-prescription medications, which are produced and sold under tight federal regulation which means that this kind of unannounced, unreviewed formulation change is very, very seriously illegal.

That makes change in formulation in these products very, very different from a change in formulation of Tostitos. Or even a change in formulation of Canidae, which makes many assertions about its high quality, but none at all about being a "prescription" food.

Yes, it's quite true that the purpose of a for-profit corporation is to make a profit. However, that does not mean that any action at all that increases the profit margin is automatically morally and ethically justified, merely by the fact of being profitable, regardless of its subsidiary effects.

Lis June 9th, 2009 08:52:00 PM

There certainly seem to be no shortage of opinions on this issue.  For me, the real controversy has nothing to do with the quality or usefulness of these foods (remember that we are reliant on one of these products) but the fact that there is an implicit assumption being made on the part of many of us that something which is designated a "prescription" product is subject to some sort of regulation similar to the sort of regulation that exists with regard to prescription products sold to humans.  

In fact, there is nothing magical or special in any legal sense about this prescription designation when it comes to pet foods, and therefore there is no mechanism in place to protect people like me or you in the event that the manufacturer decides that they can make the product more cheaply or for any other reason decides to change what is in these products.  There's absolutely no liability on their part for any damage this might cause, regardless of the money I have spent to get my pet well (ultimately by using their foods) or the money I might spend nursing him along if he can't thrive on the newly formulated diet.  

This is not, of course, about money, but it seems to me that if they are marketing food as medicine there should be some consumer protection in place for those who are reliant on these therapies.  I think this stands as a completely separate issue from the quality of the foods, the efficacy of the diets, or the wisdom of controlling distribution channels by limiting the sale of the foods to certain vendors (in this case, veterinarians).  

Louie's Mom June 9th, 2009 09:14:46 PM

By the way, it looks like we have found enough food for Louie that I can call off the food drive.  We are fortunate, and extremely grateful!  

Louie's Mom June 9th, 2009 09:16:29 PM

Oh, sheesh, Lexipup.  We've been through a year and a half of diagnostics and many diet trials, and are being seen by a team of vets at one of the best veterinary schools in the country.  Lis is right that I don't owe anyone the exhaustive story of the research I, myself, have done on this issue, never mind what I've gotten from my vets.  His file at UC Davis is three inches thick.  Let's just say that I've made it my mission to keep this dog alive and at this point it's pretty darned clear, through process of elimination (no pun intended) that my dog reacts poorly to foods that have chicken in them. I don't need to walk up to the edge of disaster with this situation and really resent the implication that I have not done any homework on this issue.  

Louies Mom June 9th, 2009 09:23:42 PM

""It just so happens that Hills, Eukanuba and Royal Canin and IVD are calling their foods prescription products when they aren't"

 If you are calling out all prescription diets you should add Purina to the list, and Royal Canin and IVD are now one compay.  I think if everyone here is going to critisize, you should at least show some respect for these companies.  As big, bad and terrible as they are (illegal, criminal and other derogatory comments) they have helped many pets.

The comments and hostility on this blog from the beginning of the comments until the end are rude to anyone who has a difference of opinion. 

Joan June 9th, 2009 10:19:17 PM

I suggest that anyone who wants to understand the "prescription" pet food situation might begin by reading "Mark Morris, Veterinarian." Briefly, this book includes the history of the first Rx pet food.  Dr. Mark Morris Sr., of blessed memory, was treating "Buddy," one of the first seeing-eye dogs at his Riviana NJ practice in the 1930's. As Buddy got older, he developed chronic renal disease (CRD). Dr. Morris had read about the Giovanetti diet for people with CRD  (Remember this was before dialysis or renal transplantation). Morris cooked up an analogous diet with low quantity, but high quality protein for Buddy and supplied it in glass jars.  Buddy's (blind) was concernedbout broken glass if he happened to drop a jar, so Dr. Morris installed not only cooking but canning (in metal cans) equipment. Eventually word got around and other veterinarians started to obtain the food from what was then called "Riviana Foods." For more of the story, read the book.  Although what became KD has been quite popular for CRD patients, I think it needs veterinary supervision. The lower protein seems to mitigate an important EXTERNAL sign of CRD. That is it seems to reduce the increased thirst and urination (PU/PD). Some heavy scientific studies by Kronfeld (also of blessed memory?) showed that the low protein actually reduced kidney function as reflected in glomerular filtration rate. I think KD has saved lives for pets that would have been euthanatized earlier because of the burden to owners of their PU/PD, but I wonder whether they (the pets, not the owners) suffer things like headaches or other kinds of dysphoria because of diminished kidney function.  Similarly, I think that most of the prescription diets mitigate -- some better, some worse -- a part of an ailment, but need to used in the context of a comprrehensive treatment program.

Dr. Steve Dubin June 9th, 2009 10:49:15 PM

Lexipup, you say that "Hill's for example, made a recent change to a HIGHER QUALITY ingredient, as opposed to a lesser-quality ingredient, because they do not wish to compromise quality standards."  What higher quality ingredient was that?  If you can tell us what this ingredient is, how do you know this is true?  Who told you?

All foods with corn as an ingredient (which most of these diets use, some in large quantities), had large cost increases because of the increase in ethanol production.  (As if corn should be used to feed cars instead of animals, which is a whole 'nother controvery.)  Also, the last huge spike in gas prices 2 years ago increased costs of shipping, which were then passed on to the middleman and end consumer.  All pet foods, including bird seed and Ol' Roy, for cryin' out loud, had an increase in price, and it had nothing to do with some higher quality ingredient.

KateH June 10th, 2009 07:48:29 AM

Joan: I agree--I'll add Purina to the list. And yes, sorry for the and instead of a slash between IVD and Royal Canin. Now owned by the same company. 

Again, I'm not attacking the companies' products in this post. Rather, I'm decrying their methods, which I firmly believe are confusing to pet owners and veterinarians, alike. Sorry for the negativity. Food has a way of bringing out the best and worst in pet lovers, for some reason.

Dr. Patty Khuly June 10th, 2009 08:35:57 AM

Dr. Dubin: I agree that Rx diets should have veterinary oversight. After all, these are often sick animals we're talking about. But then, any patient with a condition that requires any therapy, including dietary management (whether the diet is in a bag and labeled Rx or a recipe recommended by a nutritionist), should be continually monitored. But I don't believe this fact gives the companies the right to market only through veterinarians with an Rx on the label any more than I believe certain flea and tick products should be marketed exclusively through vets. 

Ultimately, I believe that pet food, drug and product companies will always use veterinarians to get a leg up on their products' marketing then "hang us out to dry," as many vets like to say, after we've changed our practices to accommodate products and their profit margins. There's nothing evil there, it's just business, but veterinarians need to be aware of corporate practices that may lead them down a road that isn't in their best interest in the long run.

But that's a whole,'nother can of worms, right?

Dr. Patty Khuly June 10th, 2009 08:38:42 AM

If you are calling out all prescription diets you should add Purina to the list, and Royal Canin and IVD are now one compay. I think if everyone here is going to critisize, you should at leastshow some respect for these companies. As big, bad and terrible as they are (illegal, criminal and other derogatory comments) they have helped many pets.

Yes, Purina should be included in the list of companies making "prescription" foods. I even feed one of their "prescription" foods to my cats. In the past, for other cats, I have used Hills "prescription" foods. However, I am not sure that Dr. Khuly intended that to be an exhaustive and fully-researched list; i think it was just the ones she happened to think of at that moment.

Yes, the "prescription" diets have helped many pets. The particular case being discussed in some detail here is that of Louie, a Chinese Crested Dog with intestinal lymphangiectasia, who after much testing as well as food trials, has been found to do well on one and only one diet, a particular "prescription" diet from Royal Canin. I do believe Louie's mom was extremely grateful to Royal Canin for the existence of this food.

She is not quite so grateful for the fact that Royal Canin has now arbitrarily changed the formulation of this "prescription"  food, with no prior notice. and no apparent concern for how it will affect dogs who have been dependent on it.

I am not certain why precisely you think that commercial, for-profit corporations, pursuing their primary goal of making a profit, are entitled to any special respect for themselves or for their decisions and actions when they make changes to their products that do serious damage to their customers. We believe we have now located enough of the food to see Louie through his expected natural lifespan, but it isn't Royal Canin that did that. It was Louie's family and friends and a community of Chinese Crested lovers that did it.

The question of the efficacy of these "prescription" diets is separate from the question of whether they are really "prescription" products, and separate again from the question of whether for some of the conditions they are "prescribed" for there might be other either commercial or home-prepared diets that would be just as good at lower cost or less vulnerability to arbitrary formulation changes, and separate again from the red-herring issue that some (not by any means all) of these diets are not "complete" and therefore not suitable for long-term use.

If the pet food companies applied the "prescription" label only to those therapeutic diets that are not safe for extended use for healthy animals, I'd have a lot more sympathy for their position. As it is, they are exploiting the marketing value of calling these foods "prescription" while accepting none of the responsibilities that that label entails in genuine prescription products.

The comments and hostility on this blog from the beginning of the comments until the endare rude to anyone who has a difference of opinion.

Pet food is always a highly emotional issue. I'm not sure why someone interested in the question would not be aware of that.

Lis June 10th, 2009 08:46:21 AM

"am not certain why precisely you think that commercial, for-profit corporations, pursuing their primary goal of making a profit, are entitled to any special respect for themselves or for their decisions and actions when they make changes to their products that do serious damage to their customers. We believe we have now located enough of the food to see Louie through his expected natural lifespan, but it isn't Royal Canin that did that. It was Louie's family and friends and a community of Chinese Crested lovers that did it."

 Isn't a veterinary clinic commercial and for profit?  The ultimate goal for any business is to make a profit. 

I am curious if Louie's Mom ASKED Royal Canin or any of their local reps to find the old digestive Low Fat?  Did they give them a chance to help?

Joan June 10th, 2009 08:58:49 AM

Of course I did.  All they offered was to have their veterinarian speak to my veterinarian, which never happened.  I tried to call them again yesterday after being told that one of their reps wanted to speak with me, and when I called he told me he did not know what I was talking about, did not know who I was or why I was calling, and was in a meeting and would call me back, which never happened.  

Louie's Mom June 10th, 2009 09:57:22 AM

By the way, if anyone actually went to the savelouie.com website to read the story (doesn't sound like many did) then you would see that I was quite kind to Royal Canin, expressing gratitude to them for even making the food in the first place.  

There are others who submitted stories to my blog whose opinions are less generous, and I posted those opinions unedited because everyone should have the opportunity to have their voice heard.  But their opinions are not my opinions.  I am not in a war with Royal Canin and the whole point of the site originally was to persuade them to put this issue on their radar so that they would make an effort to help us.  When it became clear that they were not going to do this, the food drive began.  I do not think they have handled this very well, and it could have been a great opportunity for them to step up to the plate in a very visible way which would have made it a win-win situation for everyone.  That was their choice, but the opportunity was certainly there.  

Louie's Mom June 10th, 2009 10:04:30 AM

Joan, yes, Louie's mom ASKED Royal Canin. Some of the people at Royal Canin were sympathetic, bu they weren't the ones who found the food, and they have not so far supplied the name of the fish used in the old formula.

Yes, veterinary clinics are for-profit. So are most human medical offices, too.

But veterinarians and human medical doctors are professionals in an old-fashioned sense: they belong to professions that have a code of ethics. They need to make a profit, but they have something else that is an equally high priority for them. They need the profit to keep doing what they're doing, but if you woke them up in the middle of the night and asked them what the purpose of their operation is, it wouldn't be "generate a higher quarterly profit."

In any case, you must be awfully new to reading this blog (another pet food company rep?) if you think readers of this blog extend much respect to veterinarians who do things that do injury to their clients' pets just because it's more profitable. Were you a regular reader, you'd know that Dr. Khuly agonizes over the question of what to do about "clients" who walk in with pets in serious need of care, when past experience has taught her that they either cannot or will not pay. She doesn't just shrug it off. And readers have had a good deal to say about vets who require payment up front for expensive procedures--both for and against.

These are serious issues; the difference is that individual professionals and professional corporations treat them differently than major corporations that think they are supposed to be about those quarterly profit statements.

But that doesn't mean that major corporations must treat these issues as a matter of indifference. I don't know if you're old enough to remember the 1982 Tylenol murders,  but when people started dying and the only common element was Tylenol, Johnson & Johnson didn't try to claim it was a coincidence, or that only specific lots were affected, or even wait to be sure it was really Tylenol. They halted all production and advertising of Tylenol, distributed warnings to hospitals and pharmacies. It issued a nationwide recall. After it was deterimined that only capsules were affected, they offered to exchange tablets for capsules. They didn't whine about the huge cost being unfair because it wasn't their fault (and it wasn't their fault. The adulteration wasn't happening in the factory or anywhere under their control.)

The end result was that Johnson & Johnson received a huge boost to their public image and the level of trust that consumers placed in their products.

But the beancounters never learn. They continue to tell companies, and companies continue to believe, that the visible, countable costs of advertising changes or problems, and making customers' concerns a priority, outweighs the "fuzzy" benefits of squishy good feelings about the company. And yet, Johnson & Johnson has been taking those "squishy" benefits to the bank for nearly thirty years.

Lis June 10th, 2009 10:08:46 AM

"when many veterinarians don't understand that a "Prescription Diet" doesn't formally require an Rx"  That's so sad!

"Rx diets should have veterinary oversight"  Define oversight please.  A diabetic needs a script for insulin but not for their food.  Why should a dog on vacation have to cart their food with them or locate a supplier and have a script in hand?

PJBoosinger June 10th, 2009 01:45:13 PM

"In any case, you must be awfully new to reading this blog (another pet food company rep?) if you think readers of this blog extend much respect to veterinarians who do things that do injury to their clients' pets just because it's more profitable. Were you a regular reader, you'd know that Dr. Khuly agonizes over the question of what to do about "clients" who walk in with pets in serious need of care, when past experience has taught her that they either cannot or will not pay. She doesn't just shrug it off. And readers have had a good deal to say about vets who require payment up front for expensive procedures--both for and against."

Lis, I have been around long enough.  I actually left after everyone was critizing a guest writer and the whole "my vet killed my pet poor me" thing happened.  I usually just look at the headline on my email and if it interests me I will read it.  But rarely do I venture down here;.  My cat has been on z/d for about 4 years so I came down, and nope.  The atmosphere hasn't changed.   

Joan June 10th, 2009 02:24:24 PM

Lis, go back and read my post, and point out to me specifically where I said I demanded Louie's Mom provide veterinary records. I said unless she offers them, that I am not qualified to answer. Where you determined that was obligatory, I have no idea. I went to the link you posted, and could not find evidence of anything other than she suspected chicken as the source of protein/offending ingredient. I'm not asking for veterinary record proof, I'm sure her veterinary team has worked diligently.  My point being, I read posts on this thread and was not aware of this pet owner's particular story.  You sure seem angry at vets, and you seem angry at posters who might have a different opinion.

Now about the fish. If the fish ingredient that Royal Canin used was replaced, chances are, it was replaced due to increasing problems with the quality of fish in the fishing industry. Please do some research and find out why the quality of some fish remains a problem for food producers. Look up toxins and contaminants and bacteria, etc. Now maybe that wasn't the reason for the ingredient change, Royal Canin needs to supply that information. Nonetheless, a qualified, board-certified nutritionist is probably capable of looking into a quality fish type to formulate a suitable diet for Louie.  I wouldn't dare to profess they could replicate the original Royal Canin diet, but they might come very close.  Prescription or not, pet food manufacturers are not obligated to have a press release if they change an ingredient or formulation. They do however, strive to obtain the best quality ingredients and quality control, which other manufacturers (obviously) don't put as much emphasis on.

Louie's Mom, I never infered you never "did your homework". I responded to Lis' rather accusatory post.  I am not at all unsympathetic to your situation, on the contrary.

KateH, it was posted on VIN (and somewhat related to concerns of ingredients and quality control following the pet food recalls).  And veterinarians carrying Hills products were provided a letter regarding the cost changes.  Vets then, are obligated to inform clients of why prices increase etc.

lexipup June 10th, 2009 02:44:35 PM

Hi Lexipup,

Royal Canin has come forward with two different explanations for the formula change.  One is that they have a hard time controlling the fat content (at least, this is the explanation which is implied in the e-mail they are sending out in response to inquirires).  The other explanation which I was personally given by them in a telephone conversation and which was also provided via -mail to at least one veterinarian who contacted them was that they do not have a consistent supply of fish with which to make the product.  This is a reasonable explanation, but it doesn't help Louie very much.  

I don't know which of these explanations is true; perhaps they both are, or perhaps neither is.  The impression I had from the phone call I received was that they were hoping they could talk me into trying the new product and we'd all live happily ever after.  I believe that, in their discussions about this, it was probably suggested that to admit that one dog might have a problem would be to somehow admit that the formula change was a bad idea.  In fact, I don't know that it is.  It's likely that most dogs will tolerate the change just fine.  However, not all dogs will, and my dog is one of them.  

The nutritionist I spoke with at Royal Canin seemed a bit taken aback when I explained that it is the chicken in the product which is likely to cause a problem, and not the pork.  This was after she explained that pork was always in the product as part of the "meat by-products."  i explained to her that, at one point, I had Louie on a nutritionist-provided recipe which included chicken and rice (rice is also in the Royal Canin product) and a supplement, and he never thrived on this diet, but continued to worsen.  As I said, I don't have to walk up to the edge of disaster in this situation to know that giving him a food that contains chicken is a bad idea.

I have since attempted to use that recipe as a base while swapping out various kinds of low-fat fish to attempt to discover a kind of fish that will work for him.  No luck so far.  I do have a sample of commercial grade fish meal on the way and will do another diet trial with that as well.  We have not given up on finding out what he can eat-- we know he can eat something.  Royal Canin knows the difficulty of our situation but do not seem interested in even telling us what kind of fish to try, so I don't really think I can count on them to provide any further information, despite the fact that I continue to encourage people to ask.  

Louie's Mom June 10th, 2009 03:25:52 PM

Louie's Mom, I appreciate your taking the time to explain, and I understand what you are up against.

While it would seem futile, perhaps continuing your quest to get information on the specific food source they used prior.  Perhaps a letter from your nutritionist or one of the university vets who are working with you might provide some more clout in your quest.  For proprietary reasons, they may not reveal that specific source, but it doesn't hurt to try and the vet who requests as much could sign a waiver of some sort. 

The only thing that is confusing at this point at least, is, are you absolutely certain it is the fish source alone that improved Louie's condition, or, could it in fact be another or combination of other ingredients?  (like fish oil for example, or a fatty acid supplement, etc).  Are your vets claiming Louie responds better to certain types of fish alone, or sources of fat and protein?  The two are not exactly synonymous in terms of formulation of the dietary product.  Just tossing ideas here.

lexipup June 10th, 2009 04:22:02 PM

Lexipup, I asked you what this more expensive, higher quality ingredient was, and you say "it was posted on VIN" but don't provide even a link, let alone give the answer to my question.  Not helpful.  And I work at a vet's and while I don't see every single piece of mail, I see a lot of it, and the only letter I saw from them concerning price increases stated clearly that it was because of the rise in the price of transportation costs (mid 2007 - and this was after a previous rise for the same reason prior to that when fuel was $4+/gallon).

So, again, what is the magical higher quality ingredient?

KateH June 10th, 2009 04:26:04 PM

Today, Royal Canin told me "ocean-raised" fish. They did not say "ocean-caught." They also said it wasn't necessarily always the same species of fish. That would tend to suggest that the costs of production rather than access to supply are more likely to be part of the problem. Using more than one species would also explain why they might have had trouble keeping the exact level of fat the same.

They were, interestingly enough, openly dismissive of the idea that I was not just a random person who had just read your website and decided to call them.

Lis June 10th, 2009 04:26:43 PM

No, I don't think it is the fish source that improved his condition, per se.  An extremely low fat diet is the treatment for lymphangiectasia, not a particular protein.  I cannot give him fish oils; I cannot even give him vitamin E capsules because of his sensitivity to fats.  However, he's also had recurring pancreatitis, he has a lot of autoimmune disease, and, in general, based on my own observations of various food trials we've done with him, he seems to be sensitive to a variety of protein sources, so we've really had a very difficult time finding anything at all that agrees with him.  Either the fat content is too high, or the protein source seems to irritate him intestinally (which, in turn seems to trigger the lymphangiectasia).  All I really know regarding this particular food is that it appears to have been the magical combination of things that agrees with him somehow, and I was really hoping we would not have to make any changes once we got him back on his feet and feeling well.  It was a very long road to get here, which we were very lucky to stumble upon, and it is incredibly frustrating to find ourselves in this position with his food again after all we have been through with him. 

Louie's Mom June 10th, 2009 04:36:20 PM

Dr Khuly, you said ".....But I don't believe this fact gives the companies the right to market only through veterinarians with an Rx on the label any more than I believe certain flea and tick products should be marketed exclusively through vets".

May I ask (and I'm being respectful here), what other outlets would you like to see prescription diets offered through?

I'm reminded of Greenies informing vets that their product will no longer be available through common outlets since they seem to think pet owners don't know how to use them or supervise.  Now, only "qualified veterinary or pet store staff" are allowed to "educate" pet owners on the proper use of Greenies.  Pet store staff!  Considering the average pet store staff is "educated" via rep, and the turnover for staff is very very high.

Does that not indeed apply to the OTC flea and tick upheaval?  The manufacturers are claiming owners don't know how to use the products (gee, a large percentage of owners must be incompetent), yet they remain on shelves in nearly any pet store, supermarket and freely online.  That to me does not imply concern on the part of the manufacturers.

lexipup June 10th, 2009 04:38:15 PM

KateH, if you work in a vet's office, then you have access to call Hills yourself and request the information. 

There's a reason VIN is a private membership service.  I'm not about to violate their TOS.

lexipup June 10th, 2009 04:45:08 PM

I didn't ask you to violate anything belonging to VIN - I asked you to name this magical higher quality ingredient - which you refuse to do.  I, and many others, I'm sure, do not belive that the is a higher quality ingredient that went in to all of the diets to justify an across the board price increase, and I do not believe you just because you say it exists.

KateH June 10th, 2009 04:58:35 PM

lexipup: I think it's fine to distribute non-Rx products through non-veterinary sources. That means pet shops, online suppliers, etc. I'd actually like to see a situation where the manufacturer would go directly to the consumer. I don't feel the need to be the middleman for items that don't carry an Rx labeling. 

Dr. Patty Khuly June 10th, 2009 06:57:56 PM

Ok, but what about the few examples I provided earlier?  What about those diets that do require veterinary supervision?  Should they be excluded, or actually require a written prescription?  How would you propose to get around that and other implications? 

lexipup June 10th, 2009 08:15:32 PM

Lexipup, there's no intrinsic reason why diets that actually do require veterinary supervision should not be treated differently than those that don't. It's not illogical, it's not inconsistent, it would in fact be a clear gain in logic and consistency over what the pet food companies are doing now.

However, to qualify as genuine prescription products, they would need to prove both safety and efficacy to standards the pet food companies do not currently need to meet, and which they have shown no signs of wanting to meet. Plus, the companies would lose the right to arbitrarily reformulate them due to changing costs or availability of ingredients. I'm betting these are all costs the pet food companies have no interest in meeting.

On the third paw, if they were only applying their current restrictions to the foods which genuinely do need veterinary supervision, I'd be a lot less inclined to criticize them for it. That they are applying these restrictions to foods which they know perfectly well don't require it, is suggestive of intentions a bit more mercenary than you're apparently willing to concede. It shows a lack of that thing we were discussing earlier--professional responsibility and professional ethics, the kind of thing we expect of vets, but have learned not to expect of major corporations.

Lis June 10th, 2009 09:42:57 PM

While I think that some Rx diets require vet supervison because the nutrient profile is so different than what would normally be good for a pet (kidney diets being a great example), I think not every condition requires a veterinary diet.  Weight loss and IBD are perfect examples, at least from a cat perspective. Many cats have done better with weight loss and IBD using non-prescription foods.  That having been said, some cats with IBD do well on things like Z/D, and the prescription novel protein diets.  It is all about finding the right food regardless of whether it is prescription or not. I have two cats with IBD and pancreatitis. One does best on Hills I/D kibble. The other either won't eat or has been made sick by the prescription products we have tried and eats a store brand.  The main guidance my vet provided for the second cat was that once I found the right food for him, to not change it. 

As for weight loss diets for cats, I agree that ideally you would work with a vet to agree on how many calories to reduce, and how quickly the cat should loose weight, but I'm not aware of any magic formula with prescription weight loss diets.

So, I guess what I'm saying is the vet should be involved in managing the condition, and that may include providing guidance on what types of foods might be helpful. But vets need to be open minded because a store-brand food may be even better than a prescription product.

I do agree that the pet food companies have provided a lot of valuable research as well.

Jenny June 11th, 2009 09:07:11 AM

Thank you Dr. Patty, that makes me feel better. 

I have been feeding the C/D dry for a couple days now and the kitties like it so well they pick it out of the bowl to eat first.  So much for a 'gradual' change in food. LOL 

cl June 11th, 2009 08:58:49 PM

If anyone is feeding Purina prescription diets (NF, UR, etc.), pay attention to the fact that the weights of the bags have changed - while the prices have not. (Canine diets of 20# bags are now 18#, feline diets of 18# are now 16#, for example)  That's a price increase in disguise.  Interesting marketing concept.  Is anyone going to claim they have a mysterious higher quality ingredient that added to their production costs to justify this price increase?    Bueller...Bueller...?

KateH June 11th, 2009 11:45:42 PM

My dog had bladder stones when he was about 3 years old, and operated on, the stones were analysed and I was told to put him on Hills U/D to keep the ph level of his urine at a constant safe level so that more stones wouldn´t form.

I did this. He lived the rest of his life on Hills U/D and I even couldn´t give him any chews that contained anything digestible.

He had countless more operations for bladder stones. The Hills UD diet did NOT work and it was a complete farce costing a lot of money and a lot of stress both for me and my poor little dog until he died aged 11.

It ruined his quality of life that he couldn´t eat anything else, (and mine too), and it did NOT work, and it must have made the vets and Hill's very rich because it was not at all cheap to buy.

I find it disgusting that the vets would rather sell this kind of stuff with no proof it works, than educate themselves and their clients on exactly what proper REAL foods to give and to avoid, to a dog in need of dietary changes for health reasons.

If anyone ever suggests to me that my dog has to go on a prescription diet for any reason, I will insist on being given the equivalent information regarding what foods to give or avoid, and no way will I ever waste a lot of money again on those things, which in any case never worked for me the first time round.

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Louisa June 17th, 2009 07:28:02 AM

BTW, Something that I give one of my cats that is prone to urinary crystals is a gel called Methigel. My vet had mentioned she heard of a gel that could be used in lieu of a prescription diet, but her distributor did not carry it, and she did not know what it was called. None of the six vets I called afterwards to try and procure it had ever heard of such a thing. After doing a google search, i found it- Methigel is non-prescription, and is about 4 dollars for a tube. It is used the same way you would use a hairball gel. It seems to work great, knock on wood no more flare-ups. I have three cats, and none of them get food with any by-products, corn, or soy, and I wasn't about to start with the crappy Science diet prescription food. I find it really disturbing that a cheap, low cost alternative exists, and none of the vets I had spoke with knew anything about it. I showed it to my vet, and she confirmed that it has the methinone that the prescription diet had, She asked me to please let her know if it worked, because a lot of others that see her have the same problem with their cats. Just wanted to let everyone know, there ARE alternatives available out there. Vets don't know everything, just like your own doctor.

michelle June 18th, 2009 12:00:38 PM

I am in the same  position as Louies Mom   This RC food is the only thing that has helped her and we have been at this for years and this is with medication. and now it is  gone and the replacement is garbage food all by products, corn and dried beet pulp all no nos. I do not intend to use it.  Sounds likke just a cheaper food to make.  The by products in the old formula bothered me enough.  I use the canned I back stocked cases but you have to be aware of the expiration dates so you can not stock a life times so bad times are ahead.  I have been told by RC that the fish is wild caught so it is interesting that somepone was told ocean raised DIFFERENT answer we need to  get that answer straight and I was told it was tested for mercury and PCBs that is something to think about when you are giving fish all day and they are telling people to eat it only 3 times a week.  I bet it is a mixture of many different kinds of fish. Maybe in the long run it is better to get them off this after a run of a year or two because of this although I don't know what I will go to maybe try homecooking again or raw although it scares me or dehydrated Stella and Chewys.

worried mom June 28th, 2009 11:25:34 AM

Is there a low protein diet that you can recommend that is not Hills or Science Diet?

The vet is suggesting switching my senior cat, Mikey - 14 yrs old to a low protein diet. I don't remember which of the foods she mentioned because I don't want to put my cats on Science Diet.

At this point Mikey is not sick. His kidney levels were a little above normal but not enough to be a problem. I would like to address this before it becomes an issue. I am just having trouble finding a good quality food to switch to.

To complicate the matter, whatever food I switch Mikey to, I will have to give to my younger cat, Tiger Lily - 2 yrs old as well. They are both grazers so it would be difficult to give them two different diets.

Mary July 26th, 2009 05:55:11 AM

Dr Khuly - can you address whether this is correct or not?  My understanding has been that the reason why you need a "prescription" for these so-called prescription diet is because they do not meet the established AAFCO nutrition guidelines due to reduced protein etc. etc. My experience is that I have still been able to find a quality food that is very similar in profile to these diets - only without the by-products, glutens, carcinogens, corn or soy.  I am glad to see that Wellness is now reaching out to vets to combat the brainwashing Hills and Purina have done.

Tracy July 26th, 2009 04:10:37 PM

Mary:

Check out Wellness Healthy Weight Cat and compare to the prescription Science Diet.  :-)

Tracy July 26th, 2009 04:13:36 PM