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Monday, December 28, 2015

Some Euthanasias Are Harder

In early December I had a couple of euthanasias that were harder than most.  This will give you some insight into what veterinarians have to handle and the kinds of cases we see.
The first was a dove that was at least 19 years old.  I had already treated it for pneumonia and the bird started to get better but then relapsed.  On the second exam I felt a likely tumor in his abdomen, which worsened the prognosis.  There really wasn't anything that we could do for the bird so the decision was made to euthanize.  That was hard enough, but there were some other circumstances that made the situation worse.  The owner had been living in a hotel for more than a month because of some damage to her house that was being worked on, and she was looking at at least another month in that hotel.  Her 12 year old son had lost a classmate and friend in a car accident two weeks earlier, and he was really attached to the bird, having had it since before he was born.  Plus we were just two weeks away from Christmas.  That was a perfectly horrible cascade of circumstances that was made worse by the very serious condition of the dove.  The son broke down in tears in the room, and I was tearing up right along with him.
The following day I had an emergency come in, a 115 pound (52kg) Labrador retriever with an injured leg.  The owner had been playing with him at a local park, tossing a ball for him to catch.  On the final throw the ball went past a bridge over a creek and the dog jumped after it.  He got caught on the bridge railing and dangled briefly before the owner could pull him up.  When I saw him he was very painful in that leg and obviously couldn't get up.  We gave him high doses of pain medications and heavily sedated him to take x-rays, which showed a dislocated hip.  I tried putting it back into socket but it slipped out again with the slightest movement.  This dog already had problems getting up and down due to arthritis and was on pain medicine for this.  The only option to correct the problem was surgery, and with his size, age, and joint problems it would have been an extremely difficult recovery, with the possibility of him not being able to walk at all for a couple of months.  As hard as it was the owner decided to euthanize. 
Making the decision to end a pet's life is never easy, no matter how justified and humane it may be.  Under the best of circumstances it is heart-wrenching and often devestating.  But when you're living in a hotel and have had a young friend die suddenly it's one more straw on the camel's back.  When you've just been playing with your best friend and within a couple of hours have to then put him to sleep it's an incredible emotional and mental shock.  When these circumstances are just before a joyous holiday it completely changes the season.
These are the kinds of things that veterinarians have to deal with regularly.  I wish we had more grief training and psychology courses in vet school, as it's often hard to know what to do.  In the end we just have to be as comforting and empathetic as we can, realizing that there are no words or deeds that can make it all better.
My prayers have gone out to both of these families.

Friday, December 25, 2015

Merry Christmas

As I enjoy time with my family I wish all of my readers a very Merry Christmas and Happy Holidays.  I hope you and your pets stay happy and healthy this holiday season.

Wednesday, December 23, 2015

Pet Nutrition & Labels #6--Questions To Ask

After all of this discussion on pet foods and labels, I'm sure you're even more confused than before and are simply wondering "which foods should I feed my pet?"  Luckily there is some help, though it requires calling the food manufacturer and asking some very specific questions.  The following list is commonly used by board-certified veterinary nutritional specialists when trying to determine whether or not a food is of good quality.

Do you have a veterinary nutritionist or some equivalent on staff in your company? Are they available for consultation?
A good food company should have a specialized veterinary nutritionist (not just a veterinarian) or a PhD in animal nutrition on staff.  For basic consultations they should have a veterinary technician or someone with similar credentials who can speak to you to answer questions about the diet, and that technician should have specialized training in nutrition.  If the tech can't answer your questions, they should have a doctor that they can refer you to at the company.  If they don't have anyone like this to speak with you and you are left just with a customer service representative you should avoid the company.

Who formulates your diets and what are their credentials?
A company should have their diets formulated by a board-certified veterinary nutritional specialist, someone certified by the American College of Veterinary Nutrition or a similar regulatory organization. If not, they should have someone with a PhD in animal nutrition.  Anyone without either of these certifications is likely not as qualified to develop foods.  I wouldn't recommend any company without one of these kinds of doctors responsible for food formulation.

Which of your diets are AAFCO Feed Trial tested? Which of your diets have been AAFCO Nutritional analyzed?
AAFCO stands for American Association of Feed Control Officials and is an informal regulatory body established by animal food manufacturers.  Though they have no official legal regulatory authority, they establish standards for various kinds of animal foods and are responsible for giving those guidelines to the food companies.  All good food companies will abide by the standards established by AAFCO (or a similar organization in other countries), but they are not bound by law to do so.  Some food companies actually do feeding trials, where they feed a diet to animals then check their feces and overall condition to determine the digestibility and appropriateness of the nutrition.  Other companies simply make the food according to a formula and never actually test it by feeding it to real animals.  However, some of the companies who manufacture by formulation still have the nutrition analyzed according to AAFCO standards.  Others simply don't.  It's important to know how they determine the nutritional content and quality of their foods, as some methods are more accurate than others.

What specific quality control measures do you use to assure the consistency and quality of your product line?
Do not accept an answer like "we check them regularly"!  You should be given very specific information about the methods and frequency.  You should be told by what method they are tested for consistent ingredients, bacteria, etc. and how often.  For example, Royal Canin has a probe that they can put into a shipment of meat that will immediately tell them if it is the proper animal source.  If it's anything they aren't expecting, such as horse meat, they can know right away and will reject the shipment before it ever makes it into the manufacturing process.  If the company cannot give you specific, detailed information you should avoid their foods.  Do not accept vague answers in this category.

Where are your diets produced and manufactured?
Not to bash China too much, but there have been a lot of foods, treats, and ingredients from that country that have been a problem and have led to numerous recalls.  Even if some of the ingredients are safe (and they are being watched much more closely now), I would want to know who actually produces the food.  Many food companies don't actually own the manufacturing plants, and outsource their foods to a different company.  This outsourcing means that they have much less quality control over their diets, which is one of the big problems that Blue Buffalo has had in recent years.

Can you provide a complete product nutrient analysis and digestibility results of your best-selling canine and feline foods?
If they give you the ingredient list, press them for more.  Remember that the list of ingredients and the guaranteed analysis say little to nothing about the specific nutrients in the diets.  You do NOT want an ingredient list, as it is not the same thing as a complete nutrient analysis.  Press for details on the 35+ nutrients that dogs and cats need.  Besides that you should be able to get results of analysis on digestibility.  Just because something is added to the diet doesn't mean that the animal properly digests and absorbs those nutrients.  A nutrient analysis tells you what is put into the food.  A digestibility analysis tells you how much of that goes into the pet.  They are not the same thing and both are important.  If the company can't give you this information, avoid the food.

That's a lot to find out, isn't it?  I'll bet that the vast majority of pet owners will never do this kind of work, and that will include most of the people reading this post.  It's a lot of work, which is why I don't even do it myself.  I rely on food recommendations from board-certified nutritionists, the ones who are teaching the classes and doing the research.  They're the ones who have gone through the additional education and research and I trust their judgement when it comes to pet foods.  If they choose to feed a food to a pet, I trust their recommendation. 

Which foods do they recommend?  Typically brands from Royal Canin, Iams (including Eukanuba), Hill's Science Diet, and Purina.  If you strongly disagree with any of these companies you're going against the specialists, not me.

That should do it for nutrition topics for now!  I hope you now are better informed as consumers and pet owners.

Monday, December 21, 2015

Pet Nutrition & Labels #5--Manipulative Advertising

I hope that everyone is smart enough to realize that manufacturers deliberately try to manipulate you to buy their products.  Milk is placed in the back of grocery stores so you have to walk past several aisles to get to it and have a greater chance of buying other products.  Food stores in the mall pipe their scents into the walkways to entice your appetite.  Packaging has images designed to ellicit a certain emotion.  Marketing and advertising are huge industries that exist only to somehow convince you to buy their clients' products and services. 

I have no problem with these methods and try to be aware of them.  But you need to keep it in mind when purchasing pet foods and watching commercials.  To illustrate my points I want to show and analyze commercials from two different pet food companies.  And if you've read my other posts in this series it may be easier for you to see the issues.

Here's the first from Blue Buffalo.

First, let's start with showing the woman's cat and talking about it.  This is designed to pull at the heart strings and avoid any real logic or science.  Her kitten is so cute and we must give him the best!

Now look at the lists shown to this woman.  Can you see some problems here?  First, we don't know if those ingredients are listed in the proper order on the label.  Some may be listed out of order, or without the ingredients between them.  This will skew the opinion greatly.  How did they determine which ingredients are listed on those sheets?

Now what about the woman's reaction.  She wanted to see rice in her kitten's food rather than corn.  Why?  Was she informed of the nutrient content of each?  Did she know what percentage of a given ingredient is in the food?  Does she realize that corn gluten is an excellent source of protein?  Or that meal can have higher protein than meat?

The woman is unknowingly making emotional, knee-jerk decisions about the pet food without any real information.  This is a perfect example of an uninformed consumer.

And the person watching the commercial still has no knowledge about the true nutrients in the food!

Time for commercial number two, this time from Eukanuba.

Pretty nice, right?  My wife has been all over this commercial because we have a lab and she wants her to live as long as possible.  But as smart consumers what are we to make of this advertisement?

This one is a bit different because there is actual science behind it with a 10 year longevity and health study.  You can look at more information on the study at this link.  And here's an article that gives more of a summary viewpoint.  Unlike the Blue Buffalo commercial this one is based on a scientific study and not consumer opinion.  Even if you disagree with the study, there is still real science behind it.

The study isn't perfect, as it didn't just look at the food fed, but also "proper care" including veterinary visits and preventative care, as well as activity and human interaction.  How much of the longevity is due to the nutrition and how much is due to the other factors?  A better study would have kept everything the same other than the food.  This doesn't completely invalidate the results, but only adds another question to it.  And we aren't even considering the genetic aspect of bloodlines and families having longer than average lives.

Even so, the commercial is absolutely trying to pull on your love of your own dogs and your desire to see them live forever.  How can you resist those images of active, running Labrador retrievers who are far beyond the average age for the breed?  Who wouldn't want a 17 year old lab like that?  But we don't know if they all were in that kind of condition.  Even if the results of the longevity study are true, we don't know if all of them were this active.  I'm sure that Eukanuba chose these dogs for specific reasons based on their appearance.

To be perfectly honest, I don't like Blue Buffalo and do like Eukanuba, so there's a bit of disclosure.  But you can hopefully see how both companies are trying to convince you that their food is best.  But one is relying purely on uninformed opinion while the other is trying to include some science.  Be careful about how much stock you put in the commercials themselves.

My next post will be the last in this series, and will give you tools and questions so that you really can be informed about your pet food choices.

Sunday, December 20, 2015

The Force Awakens.....Yes, It's Good!

I'm taking a quick break from nutrition posts to share my glee about the latest geek phenomenon.

Today I went and saw the new Star Wars movie, The Force Awakens, with my family.  I have always been a big Star Wars fan, even from a young age.  I saw the first movie three times in its original release in 1977 and have seen every movie in the theaters since then.  Growing up I had more Star Wars toys than any other kinds of toys.  As an adult I've never gotten too much into the "Expanded Universe" books and novels, but have always retained a huge love for the movies.  So it was with great anticipation that I awaited this movie.  Thankfully I avoided spoilers and went into it only with knowledge from the trailers (which I devoured many times!).  

It was great!  And I'll avoid spoilers since it's worth seeing it without knowing too much.  So here are some impressions.....

The opening crawl and music made me grin and squirm in my seat.  I really started feeling like I was eight all over again. 

Daisy Ridley and John Boyega are great.  They have a good, natural chemistry, are great actors, and it's nice not having seen them in much before.  I really think they are perfect as inheritors of the new Star Wars franchise.  I love both characters, and how they're both very different and yet a little familiar to what we've seen before.

The first flight in the Millennium Falcon.....WOW!  I was so giddy during that whole scene!  Really amazing with some great beats of action and humor.

BB-8 is as cute as we have hoped for!  He's a worthy successor to R2-D2, and got me almost as excited as I did with R2 in the original trilogy.  I'll admit that I still like R2 better because he has more attitude, but BB-8 is a close second.

Han and Chewie!  Harrison Ford puts that role back on like a well-worn glove.  The presence of the two of them is amazing and really helps closely tie together this movie with the older ones.  I'm so glad that they actually got Peter Mayhew to play Chewie again, despite his age.  They could have put almost anyone in the suit, so it says a lot to me about J.J. Abrams and the other creators that they cared enough to get him back.

I may be in the minority compared to some of my friends, but I actually liked Adam Driver as Kylo Ren.  He's a different sort of dark lord than we've seen, and I really like the writers' take on the character.

The big surprise.....there's only one really big one, so I'm not going to spoil it.  You'll see it coming, the whole time thinking "no, no, no!"  Even though you have time to expect and prepare it doesn't lessen the gut punch that you'll feel.  I understand the plot and character need for it, but it still hits hard.  It's the one part of the movie I think I'll always have a hard time watching.  

The reveal at the end?  Too short, too small.  But it really does tease Episode VIII and leaves you wanting more.

This is a better Star Wars movie than any of the Prequels, and to me compares in quality to Return of the Jedi.  I can't wait to see it again, and I'll be buying it as soon as it comes out on DVD.  My family also liked it and my daughter now wants a costume to cosplay Rey.

In honor of this new movie, to keep everything spoiler-free, and to celebrate the love of all things Star Wars, here are a couple of covers of the music from the films that I love.  The first is something I just found while the second is one I've known and loved for a few years.

Friday, December 18, 2015

Pet Nutrition & Labels #4--First Ingredients & Manufacturer Manipulation

I'm sure you've all heard "the first ingredient is meat!" bragging claim from some pet food companies.  And that really seems like an important thing, right?  Would you believe that it really doesn't mean much and is very easily manipulated?

Let me show you how.
Look at the following ingredient lists and think about which diet is "better".  The ingredients are listed as they would be on the label, and are actually taken from real pet foods in my local PetSmart.
Food A:  Chicken, chicken meal, ground whole grain sorghum, oat flour, ground whole grain barley, fish meal
Food B:  Chicken, brewers rice, whole grain wheat, poultry by-product meal, soybean meal, corn gluten meal

Food C:  Brewers rice, chicken by-product meal, corn, chicken fat, dried plain beet pulp, natural flavors

Food D:  Chicken by-product meal, corn meal, ground whole grain sorghum, chicken fat, chicken, ground whole grain barley

Can you tell which one is more nutritious?  Some may think Food A or B because they have "real chicken" as the first ingredient.  But if you've read this far you have probably picked up on the fact that this can be manipulated so you're not going to pick that brand.  Some may avoid B, C, and D because of by-products.  Those people don't realize that nutritional specialists consider by-products to be the most nutritional part of the carcass.  Some would avoid C because meat isn't the first ingredient, even though that statement is essentially meaningless (as we will soon see).

Let's stop and break a few things down for a minute.  An ingredient list is based on pre-cooked weight.  The ingredients that weigh more get listed first.  Can you start to see the potential problem there?  The weight of an ingredient says absolutely nothing about its nutritional quality or nutrient profile.  Ingredients are listed in decreasing weight, not decreasing nutritional density. 

Why does this matter?  When you see "chicken", think of a chicken breast you might cook for yourself.  The next time you make chicken for dinner, measure and weigh the breast before you cook it.  Then measure and weigh it after you cook it.  Unless you've added breading, water, sauce, or similar ingredients, after cooking the breast will weigh less, and be smaller.  Why does that happen?  Meat contains a large amount of water, and in the cooking process you remove that component.  Water is actually very heavy (have you lifted a case of bottled water?) and contributes a significant amount to the weight of the food.  So "chicken" on the ingredient list simply weighs more because of water, and therefore is higher on the list.  By the time it makes it through the manufacturing process it weighs a whole lot less.

That ingredient list would be VERY different if it was based on the final product!

"Meal" is ingredients that have been processed before cooking, having been cut up and ground down.  During this process a lot of moisture is lost, which means that the final product may weigh less but contain a higher density of nutrients.  Compare a pound of chicken to a pound of chicken meal.  The meal weighs the same but has less moisture and therefore a higher nutrient density.  So which has more protein and other nutrients?  A pound of chicken or a half pound of chicken meal?  It's possible that the meal is actually more nutritious!

You can hopefully start seeing how the first ingredient isn't necessarily the "best" or most nutritious.  The meal in Food C may give more protein than the chicken in Food B, even though B lists it first!

How else can the ingredients list be manipulated?  Remember that the ingredients are listed by weight of each component.  But several components may give similar nutrient profiles!  Why use so many different ingredients?  Sometimes it's to keep a single ingredient from weighing more and therefore being higher on the list!

Look at Food A.  Chicken and chicken meal are the first ingredients, followed by three different kinds of grains.  These grains all add up to carbohydrates.  What if we simply compared protein versus carbs?  The sorghum, barley, and flour could potentially weigh more when combined than the chicken and chicken meal.  If the company just used ground whole grain barley and not the other ingredients it might actually jump to the first ingredient.  In Food A the first two ingredients are protein sources and the next three are carbohydrates.  Food B has a protein source first followed by two carbs and then another protein.  Which has a higher percentage of protein versus carbohydrates?  We can't tell.  We are never given the absolute weight of the ingredients in order to tell the percentage of each ingredient.

Let's compare Foods B and C, looking at the first two ingredients.  Many people would choose B because "real meat is the first ingredient".  But start piecing together what we've been discussing.  Both may contain the same amount of brewers yeast (though we have no way of knowing).  Remember that meat weighs more than meal, so Food C may actually contain more protein and other nutrients than Food B!  But C doesn't list it first because the meal weighs less than the rice.

Pretend you're a pet food company and you know that consumers are convinced that they should look for meat as the first ingredient.  How can you make sure that your food has this first?  Very simple.  Choose multiple carbohydrate and fiber sources rather than a single one.  Since each ingredient is listed individually, that means that you list each source by themselves rather than their aggregate weight.  Since they individually weigh less than the meat source, that meat suddenly jumps higher on the list.  Voila!  You now have "meat first"!

By now you hopefully understand that the ingredient list merely places the ingredients in order of descending weight.  This doesn't necessarily mean ascending or descending nutrient density.  A higher quality ingredient may be lower on the list just because it weighs less.  And you can't tell how much more or less an ingredient is!  It's only relative position.  Does this kind of a list really tell you what is in your pet's food and what nutritional quality it contains?
Now back to the basic question.  Looking at these four ingredient lists, which one has better quality nutrition?  How can you tell?
You can't! 
Seriously! By simply looking at these ingredients you can't tell anything about the true nutritional quality of the foods.  As you can hopefully see by now (especially if you're reading this whole series and my previous ones on nutrition) you can't just look at the ingredient list to determine quality.  Meditate on and remember the following statement, given by a veterinary nutritionist at a recent conference.

Pets need nutrients, not ingredients.

Think about that for a moment.  What really matters is the nutrients, not the source of the nutrients.  Yes, some food components are more digestible and available to the body than others.  But in general the source doesn't matter if all other things are equal.  If you can get similar quality protein from corn gluten meal or chicken meal, then it really doesn't matter which one is included as an ingredient (and yes, studies have shown that the quality and bioavailability is similar).  Both ingredients will give the same nutrients.  If that is the case, then the only reason to prefer one ingredient over the other is nothing but marketing and consumer psychology.  And those aren't good reasons to pick one ingredient over another.

Confused and surprised yet?
In the next post in this series I'm going to look at examples of how some pet food companies manipulate you with misleading advertising.  And later I'll talk about what questions you can ask food companies to learn more about their food.

Tuesday, December 15, 2015

Pet Nutrition & Labels #3--Guaranteed Analysis

Let's spend some time looking at the box on the pet food label designated as "Guaranteed Analysis".  I feel that there is more misinformation about this section than almost any other part of the label besides the ingredient list itself.   Here is a picture of a typical pet food label.

Looks pretty thorough, right?  Okay, tell me how much protein this diet has.  You're probably saying "21%".  Well, that's correct in a way, but look at the label again.  It says "min" next to the 21%, meaning that this is the minimum amount and the actual protein could be higher than that.  Is it 25%?  30%?  82%?  Honestly we simply don't know!  And it's also just a percentage, not an actual value.  Can you tell how many grams of protein a serving size contains?  Nope.  Heck, a "serving size" will vary greatly depending on the size and health of the pet.  A serving size for a poodle is going to be very different from that of a mastiff.  But we don't even get how many grams per cup!

What about fiber?  Okay, you're doing better if you can see that it has a maximum of 12% fiber.  But again, we don't know if this is 1%, 8%, 11.9% or something else.  There are also different kinds of fiber that can be included in foods, both soluble and insoluble.  Different kinds of fiber do different things in the body, some beneficial and some neutral.  You have no way of telling what kind of fiber is in this diet or in what amounts.

What about calories?  Can you easily tell how many calories per cup the food has?  Or what about the amount of each nutrient compared to the recommended daily allowance? Nope, none of this is on the label.  All of these values have the same problem.  They're minimums and maximums, but not absolute amounts and there is no way to tell the real value based on the label.  And there is a lot that is left out.  

Most pet food labels limit the information to protein, fat, fiber, and moisture.  These are four nutrients (if you count water as one), and really they are rather broad categories.  Did you know that there are over 30 nutrients that are important in the daily diet of pets?  There is absolutely no information whatsoever on labels about these other nutrients.  So the majority of what your pet needs is nowhere to be found on the package.

Can you start seeing the problems with relying on this label on pet foods?  Let's look at a human food label by comparison.

Can you see the difference?  We get a serving size, how many calories, the actual grams of essential nutrients, and what percentage of daily value it has.  You can get a lot of good information when you are looking at the labels of human foods.  Pet foods?  Not so much.  

So what does a guaranteed analysis on a pet food label tell you?  Diddly-squat!!!!  It's not even really worth looking at.  I wish that pet food companies would start really detailing the specifics of the nutrients in the same way that is required of human foods.  If they did that we would have a much better basis for comparison between foods.

Yes, it really is this difficult to read pet food labels!

Next time we'll get into details of what the ingredient list really means and how easy it is to manipulate it.

Saturday, December 12, 2015

Pet Nutrition & Labels #2--Categories Of Food

One of the things that many people don't understand on pet food labels is the category or type of food that is being marketed.  Companies have to be very careful and specific as to what words and phrases they use, as this aspect is carefully mandated by law (at least here in the US).  Let's look at some of that wording, all of which would be found on the main packaging, not on the ingredient list.

[Ingredient]--If used by itself, the food must be at least 95% or more of the total weight of all ingredients other than water, but no less than 70% of the total product.  e.g. "Beef for dogs", "Tuna for cats"
[Ingredient] Dinner--When used with a qualifier such as "dinner", "platter", "entree", "formula" or anything similar this means that the ingredient named must be at least 25% of the total weight (excluding water), but no less than 25% of the total product.  e.g. "Chicken dinner", "Beef platter", "Lamb formula"
With [Ingredient]--The ingredient named highlights only minor ingredients, which must be at least 3% of the total product.  e.g.  "Fish platter with shrimp" (shrimp is the minor ingredient)
[Ingredient] Flavor--There is no minimum amount of this ingredient, and it usually indicates that it constitutes less than 3% of the product.  An ingredient that gives a characteristic flavor can be used instead of the actual named ingredient.  "Beef" means bovine meat, but "beef flavor" is accurate even if no actual meat is used, but instead the manufacturer uses beef digest or beef by-products because the flavor is similar.  Some ingredients can be less than 1% of the total product and still appear as a "flavor".

Keep in mind that these phrases don't say anything about the actual quality of the food itself.  These are purely marketing tools to point out things to the consumer.  There are legal definitions to prevent a manufacturer from emphasizing an ingredient when it makes up only a small percentage of the product.  Unfortunately the above definitions and percentages are far from common knowledge so most pet owners are clueless about these phrases, and may often think that "beef entree" and "with beef" mean the same thing.  But depending on the other aspects of the food they could be nutritionally equivalent.  So it really can be confusing!
So now you know!  Next time you go to the store for more pet food look at the various packages and pay attention to these phrases.  You may be surprised at what you see and how that changes your expectation of pet foods.

In the next part of this segment I'll go over just what the nutritional analysis really means....or doesn't mean.

Wednesday, December 9, 2015

Pet Nutrition & Labels #1--Understanding Basic Definitions

Long time readers probably will get tired of me bringing up pet nutrition as frequently as I do, but it really has become an interest of mine.  Just do a quick search on this blog (top left corner) for "nutriton" and you'll see the numerous posts I've written over the years on this topic.  And I still stand by every one of them.
This time I want to spend some time explaining a bit about pet food labels.  There really is a lot that the majority of consumers don't understand, and this misunderstanding contributes to being easily manipulated by the food companies.  And yes, even the best ones are worried about marketing and may use various techniques to give you a particular view of their diets that may not be "real". 
There are a few things to understand about pet food packaging and labels.  Certain aspects are mandated by law, especially when it comes to specific phrases and words.  Other parts of the label can be easily manipulated to make the food appear a certain way.  Do you want to know the biggest secret of all?
You can't judge the quality of a food by reading a label.
Yes, that's surprising but true.  I've had board-certified nutritional specialists admit that they can't read a pet food label and tell exactly how good or bad it is.  And as good as I am about working around the wording I still have to rely on information that never makes it onto the labels.  So how is the average pet owner supposed to tell a good food?  Especially when many vets have misconceptions about some diets?
Today let's start with reviewing some definitions that you may commonly see on labels, advertisements, or in discussions.
Natural--This simply means that nothing additional was added to the diet.  It does not mean that the food is unprocessed.  In fact, many "natural" diets are just as highly cooked, mixed, cut, extruded, and otherwise processed as the "non-natural" diets.  Natural isn't necessarily "better" than other foods, and there is no evidence that the nutritional content is higher quality than other foods.

Organic--This is legally defined by the USDA for human foods.  Pet food companies can use this word if they follow the same guidelines as for human foods.  Natural and organic are not the same!
Holistic--This word has no legal definition and is completely unregulated.  What it means and how it relates to food is completely up to the company that markets it as such.  You can't rely on any consistency between companies as to what this really states.
Human-Grade--This does have an official definition, and can only be used if the food is made in a plant that is also approved for manufacturing human food.  Otherwise this phrase is meaningless.  All pet food should be safe for human consumption!  There should be nothing harmful or malnutritious if a human eats dog or cat food.  By those standards all pet food is "human-grade".  Many people think that this phrase means that they are feeding the same cuts of meat that we ourselves would eat, but this is untrue.  Pet foods can use any cut of meat and it can be "human-grade" using tongue, esophagus, and similar sources that we may not want to eat.  Keep in mind that what we may or may not want to eat is mostly cultural.  Here in the South of the US pickled pigs' feet are a delicacy and a treat.  Yet many people (even a Southerner like myself) would never eat them.  Many cultures routinely eat tongue and stomach from livestock, while others would never touch it.  Hindus won't eat any kind of beef, but most of the rest of the world loves its hamburgers and steaks.  Just because we may not want to eat something doesn't mean that it isn't safe and nutritious.  And just because we want to eat a cut of meat doesn't mean that it's better nutrition.
Meat--You may see this show up on a label, as "meat by-products", "meat meal", or just "meat".  This ingredient is made up of a mixture of mammalian species and there is no way to distinguish which one(s) are used or in what proportions.  Species that would be included as "meat" are beef, pork, goat, and sheep.
Beef Meat--This is any bovine muscle tissue and can include leg muscles, tongue, esophagus, heart, and diaphragm.  Really, any muscle in the entire body of a cow or bull can be included and still be covered under this phrase.
Poultry--Like meat this is a mixture of species, this time avian.  Animals included as poultry would be chicken, turkey, duck, and goose.  Again, there is no way to tell which ones or in what proportions.

No Definitions--The following words and phrases have no official, legal definition and therefore are essentially meaningless:  high quality, super premium, hypoallergenic, high meat, high digestibility.
In the next entry I'll focus on the titles or names of certain pet foods and what those labels actually mean. 

Monday, December 7, 2015

Planning For Your Pets After Your Death

My father often sends me newspaper articles that he thinks I will find interesting, and generally he's right.  One of the more recent ones came from the News & Observer in Raleigh, North Carolina, and was a topic about which I haven't often thought.  What happens to your pets after you die?
This is a very legitimate question, especially for elderly pet owners.  My father is in his 80s and if he got another dog there would be a decent chance that a young dog would outlive him.  One of my favorite clients are an elderly couple also in their 80s.  Last year they got a new Sheltie puppy after their older one passed away.  Given that their last one lived to be 16 their younger dog may be around after they have died.  As both people and pets live longer lives this is becoming an increasingly real scenario, and one which may pet owners are ill prepared to handle.

So what do you do?  How can you prepare for and care for your pet after you or a loved one passes away?

If you have the financial means, you can find a lawyer who will set up a "pet trust".  This can provide funds and directives to help take care of your pet after your death.  It's similar to a trust fund for humans and is certainly legal in the same way.  While pets can't inherit property they can be set up under this kind of trust.  A person or nonprofit will need to be designated as a caretaker, but then there is an assurance that your pet will not end up in a shelter.  Unfortunately not all states allow this kind of trust, so consult an estate planning attorney in your area to see if this is possible.

You can also designate a caretaker in your will so that nobody has to figure out who gets the pets after you're gone.  However, this is not a trust and that person will have to financially provide for the pets out of their own funds.  It is therefore important that you have the person's understanding and agreement!

While it may be morbid, such planning isn't a bad idea for younger people.  My wife and I are in our 40s and included our pets in our will.  We definitely aren't planning on dying any time soon as both of us are in good health.  However, we do travel long distances several times per year as a family, so it is possible for us to get into an accident or have something else serious happen to us.  What would happen to our many pets in such a circumstance?  We have it planned out.

Nobody likes to think about their own death.  But it is important to plan for that eventuality, especially if you have children or pets that would be left behind.

Friday, December 4, 2015

The Stress Of Making Mistakes

Doctors are human. 
It's a simple but profound statement that I think many clients may forget.  Sure, they know that we're human beings, but I don't know that everyone goes to the full extent of that particular concept.
It means that we make mistakes.
Sorry to break it to you, but no doctor (human or animal) is perfect and always does things exactly right.  We aren't any more imperfect than any other person, and we are prone to the same oversights and failings as anyone else.  I can promise you that there isn't a person alive that hasn't made a bad decision or a mistake in their job.  And if a doctor tells you that they've never made a mistake I will call them a liar to their face.
The difference with mistakes made by a doctor is that they can directly impact health and life. 
We know that and it weighs heavily on us.  It's a different kind of situation than getting pizza topings wrong, scratching a car's paint during an oil change or even getting a hotel room booked for the wrong dates.  Our choices are often literally a matter of life and death.  We try everything we can to always make the right diagnosis, chose the right medications, perform the surgery correctly, and order things properly.  We are fully aware of the potential consequences of our mistakes and how important our decision-making skills are.  The majority of us veterinarians are in this profession knowing full well that we're never going to be rich and are unlikely to make six-figure salaries like most of our human counterparts.  We do it because our hearts call us to it.  And most of us care deeply about our clients and patients.  We actually take it very personally when we somehow mess up and fret about it constantly, mentally beating ourselves up.
Yes, I've made many mistakes in the past.  And yes, I've made some recently, which is why I'm writing about it today.  Perhpas this is kind of a catharsis.
Some of those mistakes don't involve patients or aren't even really "mistakes".  For example, recently I had a surgery that didn't do well post-operatively after taking a tumor off the foot.  The tissues didn't heal well and there were some big complications.  I did the surgery to the best of my ability and have done tumor removals like this in the past, so I know that I'm a competent surgeon.  But I still second-guess myself and what could have been done differently.  I've been worrying over that case for weeks, even though there wasn't anything else that could have been done differently.  In the case of non-patient related issues, I make the schedules for the vets in my hospital and a couple of sister hospitals in our practice and accidentally over-scheduled one of the doctors.  I also didn't appropriately schedule one location for Christmas eve, and had to fix both of those very quickly.
There is no way that we can do our job perfectly every time.  Hopefully we succeed more than we fail, otherwise we need to revisit our career choice.  But it is inevitable that we will screw up, get a dosage wrong, make the wrong diagnosis, or otherwise slip up where we really shouldn't have.  We then have to do everything we can to make it better and fix the problem that we ourselves created.
Any caring doctor will worry about these mistakes and berate themselves for making them.  Believe me, I've been losing sleep over some of my bone-headed recent mistakes and worry how those things will impact my clients, patiemts, staff, and colleagues.  Yet how can we not sometimes mess up?  It's a real dilemma and is one that significantly contributes to burn-out and mental health issues in this profession.  We are expected to be perfect by most clients, and even expect it of ourselves.  Then when the inevitable mistake happens the clients get mad (sometimes justifiably so) and we struggle with anxiety and depression because we see what we could have done better or should have done differently.  We are presented with impossible circumstances where we are never supposed to err or fail, and yet inevitably will do so because of our humanity.

Please understand that I'm not saying that just because mistakes will happen we should always excuse them.  Some mistakes are small and have little impact.  Others are life-changing and could be considered malpractice.  These latter cases really do need to be taken seriously.  Heck,  all mistakes need to be taken seriously!  But we need to show compassion, forgiveness, and understanding when something goes wrong, especially to ourselves.  And clients need to understand our imperfection and give us the opportunity to fix it.  There is a big difference between an accidental oversight and willful negligence.

Be kind to your vet.  You often don't know the burdens he/she is carrying and how much they worry about what they do.

Tuesday, December 1, 2015

Do Clients Notice Hair Styles?

My latest foray in acting has me and my wife cast in our community theater's production of A Christmas Carol.  The director wanted me to have facial hair appropriate to the period, and I'm generally game for doing whatever is needed.  After all, facial hair can be cut, trimmed, and regrown.  I've done a lot of different styles over the years, but this was a brand new one for me.

A pretty radical departure!

I went from a beard to this yesterday morning.  When I was done shaving we called our kids into the bedroom.  My daughter just stared in disbelief for a full minute.  My son took one look, went into his bedroom and slammed the door.  Neither one of them likes it when I do anything other than my typical beard or goatee.  They think it looks too weird, and I can't say that I blame them.  One of our dogs kept sniffing and licking my chin like she was trying to figure out what had happened to my face.

When I went to work this morning I was anticipating a number of strange looks.  Unfortunately I was rather disappointed.  I did see a couple of double-takes from my staff, but most of them have been with me for several years and have seen various kinds of facial hair styles on me, so I think they just took it in stride.  I'll admit that it disappointed me a bit as I was expecting bigger reactions.

I had several of my regular, long-term clients come in today, and not a single one of them said anything.  I'm sure they noticed, as all of them are used to my beard, and this is a VERY different look for me.  Heck, very few men wear this style in 2015, so it would stand out on anyone.  I'm certain that at least a few of them noticed it and had some kind of thoughts.  But how do you make that kind of comment to your doctor?  How easy is it to bring up your impression of "What the heck is he thinking?"  

I think that many clients wonder about these changes, especially when a man makes such a drastic change.  To me this is a bigger switch than a woman getting a perm or shorter haircut.  I know that I'd quickly notice if my own physician suddenly had a bushy beard the next time I saw him, even though I typically only have to go in for an annual physical.  And I don't think I'd say anything to him.  So I'm sure my regulars will notice and remain silent.  Truthfully I wouldn't mind them mentioning it, as it's a great conversation starter and they might want to come to see the show.

Our first performance is this coming Friday and we have a three weekend run.  So it will be another three weeks before I can start going back to my normal look.  

My son's still not happy about that.