are grains all bad?

There is no nutritional requirement for carbohydrates for dogs. There is also none for fiber, though we well recognize the benefits, and the same could be said for other nutrients like glutamine, Vitamin C and even probiotics. Carbohydrates (in the form of starches) contain calories. Grains contain carbohydrates, vitamins, minerals, fatty acids, fiber, and a little protein.

Recently, carbohydrates (presumably starch, in particular) included in diets for dogs have been vilified, especially in the form of grains such as rice, wheat, corn, barley, oats, etc. The reasons are myriad:

Fallacy 1: Dogs have a shorter GI tract than people, so they cannot digest grains unless they are partially digested first.
Fact: Decades of research proves that dogs digest grains as well as starch quite well.
• The lack of salivary amylase has been stated to be one reason why dogs don’t digest carbohydrates well. Why would dogs need salivary amylase when they gulp their food? Dogs produce potent pancreatic amylase as well as ‘brush border’ enzymes to digest their carbs (like humans).
• Most digestion of carbohydrate occurs in the first part of the small intestine (like humans).
• Some have stated that dogs have more acidic stomachs and retain food in their stomachs longer than people, making a meat based diet more suitable for dogs since protein is initially digested in the stomach. The pH of the dog's stomach ranges from 1.08 to 5.5 (Ouyang et al., 2006, Smith, 1965, Buddington et al., 2003, Sagawa 2009). For people, the pH ranges from 1-4 (Krause's Food and Nutrition Therapy). This makes the acidity equivalent between the species, with the dog ranging slightly more alkaline in certain settings.
It is true that like humans, dogs cannot digest cellulose, a single structural carbohydrate used by plants to form stalks, seed coats, vegetable structure etc. Only herbivores like cows can digest cellulose, turning it into some other vital nutrient, but it doesn’t seem reasonable to compare the GI tracts of dogs and people to cows. Canine digestive physiology resembles human digestive physiology much more closely, so grains and veggies should be cooked or ground as finely as possible (either before or during the act of chewing) to derive the benefits contained in them.

Fallacy 2: Feeding carbohydrates place stress on the pancreas.
Fact: The pancreas was created to produce enzymes to digest fats, proteins and starches. That’s its job. Many people feed digestive enzymes as a daily supplement, I suppose to support what they see as this delicate flower of an organ do its job with protein and fat. There is evidence that supplementing enzymes actually downregulates the pancreas’ own production of proteases. That’s not necessarily a good thing – see my blog from 1-27-09 for more information. But during bouts of pancreatic inflammation (otherwise known as pancreatitis), where those very enzymes are released to cause inflammation and damage to the pancreas and surrounding organs and tissues, the treatment is to reduce fat in the diet in order to suppress production of those enzymes. The treatment is…….high starch diets - and they work.

Fallacy 3: Since food moves through the GI tract rapidly, there is no time to ferment carbohydrates and therefore no need for them. Because carbohydrates are not fermented, if they are included in the diet they will cause gas and voluminous stools.
Fact: Like humans, dogs harbour many lactic acid producing bacteria which ferment starch and soluble fibers contained in grains. This fermentation itself can cause gas. Odiferous gas can also be caused by clostridial organisms. Clostridia are more numerous in the GI tract when dogs are fed a high meat, high fat diet such as raw, grainless diets.

Fallacy 4: Grains cause allergies.
Fact: If dogs have the genetic predisposition to develop food allergies, they can become allergic to certain foods. A recent review of 7 studies indicates that dogs are most commonly allergic to the proteins in the following foods (in descending order): beef, dairy, wheat, egg, chicken, lamb/mutton, soy, pork, rabbit and fish. In cats, the most common allergens are beef, dairy, fish, lamb, poultry and barley/wheat (in equal numbers), egg and rabbit in equal numbers. I will admit that I’ve seen higher numbers of corn allergy than would be suggested by these numbers, as well, but please note that grains do not constitute the majority of allergy offenders.

While dogs do not require the starch found in grains or potatoes or any other food, there are some instances where you still might derive benefit from them being there. For instance, grains (and starch-containing tubers) contain certain fibers that are beneficial for the growth of probiotic bacteria in the gut. They also contain various required vitamins and minerals. And since grains, as compared to meats, contain lower fat contents, they can be used as a “place-holder” in a diet that fills a dog up while reducing the fat content. I’ve seen people feed pitifully small amounts of raw diets to dogs whose weights needed better control. Poor hungry dogs!

This is not to say I approve of diets formulated with high concentrations of starch-containing ingredients simply to limit cost. I just want to note that there is no reason to expressly avoid them unless your dog has a specific intolerance to them or some condition that requires use of a diet that is low in carbohydrates. And remember that cats are another matter entirely- they are true, pure carnivores, and as such, should probably not be fed diets that contain noticeable carbohydrate levels.

Back to carbohydrates vs grains – take this to the bank: If it’s a dry kibble, it contains carbohydrates. This is because kibble is made by the process of extrusion, which doesn’t work without a certain minimal level of starch. So those grainless diets that sound so good, and so paleolithic – yeah, those contain carbohydrates. Just in the form of potato, tapioca, or other starch containing food.

My point is that if we are going to eschew grains, let’s do it for the right reasons, and if we instead want to avoid starch, we *have* to read the labels carefully.

I'm back!

OK, I’ve spent a couple of months finishing some schooling and moving my house. One I’ve almost finished, and the next I’ll never do again. At any rate, I can get back to studying, which means my notes become your blog postings. I hope to be a more regular correspondent!

Controversial post, coming up next....

Holistic vets: a threatened species

So considering the post yesterday suggesting why a holistic veterinarian might have a better understanding of holistic choices for sick pets.....

Would you believe that the single 'accreditation' body for veterinary continuing education (CE) has just tightened the rules on signing off on CE related to complementary/integrative/alternative/holistic medicine? In this day and age when more human medical centers are opening integrative medicine programs?

The American Association of Veterinary State Boards maintains a registry of approved continuing education (RACE). From their website: "RACE is a national clearinghouse for the approval of continuing education providers and their programs. All RACE-approved providers and programs are listed on this website. Providers voluntarily apply to the RACE program and agree to abide by the RACE Standards."

"An important aspect of RACE-approved continuing education is that it meets the definition outlined in the RACE Standards: “Continuing education ...shall build on or refresh the participant in the standards for practice and courses as found in the curriculum of accredited colleges or schools of veterinary medicine or accredited veterinary technician programs.”

The National Center for Complementary and Alternative Medicine defines complementary and alternative medicine (CAM) as "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine."

This pretty much means that any RACE approved CE is automatically going to be accepted by a veterinarian's state veterinary board as approved CE. And a CE program that is not approved -well, the veterinarian may have to fight this state government entity to ensure that it's acceptable as required CE. And since CAM (or CAVM, for veterinary medicine) is not considered conventional medicine and therefore not taught in accredited colleges or schools of veterinary medicine.....well, you can see where this is going.

And considering the economy, veterinarians will have to choose wisely how they spend their limited continuing education funds.

So if you want intelligent discussion of holistic options by a veterinary-educated professional, it may be time to get over it. RACE and the AAVSB are going to 'disappear us' right out from under the public's collective noses. What do you think of that?

Treasure Hunts in Alternative Medicine Land

Teaching gives me a chance to get a new perspective on a problem every time. I love it.

So I have a favorite teaching device or two when it comes to educating veterinary students on what their clients will face out there in alternative medicine land. It’s called a treasure hunt, and it puts them face to face with the best and the worst of holistic capitalism…. er….. healing.

Today, I sent two students to a local feed store that apparently concentrates its inventory on the natural/holistic diets. What is a natural/holistic diet, you might ask? Actually, you would only be asking that if you are a veterinarian, nutritionist or a skeptic, because people interested in holistic medicine seem to understand it on an intuitive level, and for everyone else, there is no regulatory definition.

I know what *I* think a holistic diet is. And I plan to talk about that one day, but I’d be more interested in what YOU think it is. Of course, you’ll have to post to start that discussion, and I hope you will.

But back to the treasure hunt. I ask my students to pose as typical pet owners who are interested in natural and do-it-yourself cures for a chronic and frustrating problem. Not actually all that hard for them to do, because many are faced with the same problems you are – not much money and a long term veterinary expense.

So one goes to a feed store and asks about her cat who has a history of lower urinary tract disease (LUTD). This is a painful and potentially deadly set of diseases – one version is severe inflammation of the bladder, not due to infection and not well understood which, like the similar condition in women, can lead to a serious diminishment in quality of life because the patient lives in constant pain. Another version of LUTD is due to the accumulation of mucus and mineral crystals that form an uncomfortable sludge in the bladder, in some cases blocking the urethra which requires emergency treatment to prevent death.

Veterinarians need a good history and some labwork to decide which of these disorders afflicts your cat. But that doesn’t stop the holistic food manufacturers….no….they simply propose to treat your cat without this information.

Let’s look at the treatment for interstitial cystitis, the horribly painful, bloody cystitis that has nothing to do with a urinary tract infection. Veterinarians doing research in the field believe that this disorder is associated with stress, and some are investigating the theory that an underlying viral infection or other pathology may make it re-activate when the cat is stressed. Recommendations are to dilute the urine by feeding food that has more water in it (i.e. canned or fresh/homemade food) and possibly to treat with glycosaminoglycans (like glucosamine) that are thought to protect the bladder wall. Stress reduction is a vital part of treatment of this disease.

On the other hand, if your cat forms crystals and mucus plugs, the treatment is mostly to dilute the urine so that those crystals are less likely to form. To a lesser extent, we try to manage the acidity of the urine, but on a long term basis this is fraught with danger as preventing one type of stone (struvite) by urine acidification can predispose to another type (calcium oxalate) which gives us a completely different set of management problems.

The newest thinking is that it’s best to manage cats with these problems by making sure they are getting plenty of water in their diets – and this isn’t gonna happen if they eat dry food, unless it’s a prescription diet. Although we used to talk about management of mineral concentrations in the urine by limiting ‘ash’ and then magnesium in the diet, we realized sometime in the last decade or two that this wasn’t really the right target.

And since these problems are sterile (at least initially) – that is – they are not urinary tract infections – no antibiotic therapy is needed at all.

So back to the treasure hunt – here is what the holistic pet food store employee recommended:

1. a low ash diet
2. a diet that contained cranberry (cranberry being for urinary tract infections and to acidify the diet).
3. Not a word about avoiding dry food.

Sigh. Disappointing not only that they are giving out inaccurate information, but that the information is at least 10 years out of date! And this store actually holds ‘nutrition seminars’ given by a local dog trainer!

OK, I’m a fan of holistic diets too, but friends, please ASK about the medical training of a person making recommendations for your sick pet. There are veterinarians out there who can help you with holistic diet and other therapeutic choices. My students now better understand why they need to help their clients find reasonable holistic options rather than leaving it up to chance.

How do I get thee to eat? Let me count the ways…..Part II

So we’ve talked about how we are at fault in making our pets overweight. We somehow get the idea that dogs and cats who have no control over the food they are offered would hold out for some theoretically yummier food that they haven’t ever seen or tasted before. Not.

But animals often stop eating when they are sick. Animals with acute conditions will give you signs of a new development by not eating, often before they show other signs of illness like vomiting, diarrhea, coughing, respiration difficulties, lethargy, etc. Those with chronic disorders signal that they are escaping good control or management by not eating well – often before primary signs of that disorder recur.

Let me list just a fraction of the reasons that a *sick* dog or cat won’t eat:
1. Dehydration. Which can be a part of many, many, many disorders.
2. Constipation. Animals absorb bacterial toxins from the accumulated feces through a compromised colon, and just feel under the weather. Or uncomfortable from the back-up.
3. Nausea. Another sign of many, many, many disorders. And not one that’s always easy to diagnose, except in those animals who are actually vomiting, but sometimes they will salivate or smack their lips.
4. Pain or discomfort. Also not easy to diagnose in some cases. If your general practitioner or internist can’t find the reason your pet isn’t eating, I think it’s a good idea to have a veterinary acupuncturist evaluate your pet using different methods- they often find real pain where no one else can using traditional Chinese medical examination techniques.
5. Infection – fever, pain, dehydration – all of these associated problems make animals with infections less likely to eat.

What I’ve listed above are general causes for loss of appetite. You may or may not be able to pinpoint those causes at home. Here’s the rub- you still don’t have the key to resolving the problem because a diagnosis is needed. This is why your vet wants you to come in for an exam, and usually labwork. Your pet is going to regain his or her appetite only after the renal disease, inflammatory bowel disease, cystitis, food allergy, hepatitis, pancreatitis, ketoacidosis, diabetes insipidus, gastrointestinal obstruction, gas, back pain or other serious disorder is diagnosed and appropriately managed.

My particular challenge in practice as a nutritionist is to convince people that they need more than a yummy diet. Just this week, 2 clients expressed their surprise when I recommended labwork to find out why their pets weren’t eating. I’m very happy to charge an office visit and diet formulation fee, but I want your pet to eat my diet, and if he or she is sick, we are all going to lose. Your close attention to your pet’s appetite is a powerful diagnostic tool, and diet is a powerful treatment. Let’s keep them in their proper places.

So the take-home message is as I’ve said – if your pet isn’t eating, he or she is either over-fed or sick. Learn how to do a body condition score, keep ‘em lean, and if anorexia persists for longer than 2 days, get ‘em checked out.

How do I get thee to eat? Let me count the ways…..Part I

I see so many pets presented for a picky appetite, you’d think I could make a living recommending a diet they will eat, right?

The overriding theme among the owners I talk to is that their pets won’t eat because they are tired of their diet. I think dogs and cats are honest and plain-spoken in their own ways, and I’ll break it down for you. They are either overfed, or sick. Repeat after me – if my pet isn’t eating s/he is either overfed or sick.

Let’s start with the overfed pets. I’ve talked a lot about body condition scores in the past week or two. What is your pet’s body condition score? If you don’t know, please go to my website and look at the body condition score charts from Purina:
http://www.susanwynn.com/BCS__dog.php
http://www.susanwynn.com/BCS__cat.php

So if your dog or cat is overweight, let me suggest a way of thinking from their perspectives. Lessee…..”I spend a bunch of time around the house hanging out, not doin much, not enough trips outside…….I get fatty meals that taste great and lots of them……I’m feelin a bit full and need to cut back…..now my bowl has even yummier stuff – this is great and I’m gonna eat all of it!......oh man I’m full – I’m gonna cut back…..Oh wow, now she’s putting the real gourmet stuff in front of me – what’s a dog to do?– I’ll eat it all….for awhile…. And why has it become some darn difficult to jump up on the bed or take long walks?”

Now the interesting thing here is that we make some assumptions about what dogs and cats understand about food. Let’s take a 5 month old puppy adopted from the shelter – this pup has probably never had anything but cheap dog food, may be enough of it and maybe not. We adopt him, put too much food in his bowl, and when he leaves some behind, we assume it’s because he envisions some delicious meal that he’s never had, but that must be perfect. And he’s holding out for it. Where’s the logic?

So we note that they eat less and less, but we ignore the fact that the ounces and pounds are piling on while we try to find foods they like even more! All the while, this lovely dog or cat has been trying to stay trim and we sabotage them every step of the way!

Here’s my advice: feed your pet a diet that is high in variety – different manufacturers and different ingredients (just avoid the exotic ones like venison, duck, rabbit, pheasant etc – more on that at a later date). Learn what your dog or cat likes and looks best on. Feed the amount that maintains him or her at a perfect body condition score. If the body condition score goes over 5/9 (or 3/5), don’t feed so much.

There are times these rules don’t apply. Dogs and cats who refuse to eat anything for more than a day or two, or who LOSE WEIGHT while refusing to eat aren’t healthy – they should be checked out right away. Dogs and cats with confirmed diagnoses of chronic conditions like kidney disease or pancreatitis need to be checked out if they don’t eat for a couple of days. More on this in the next post.

New dog treat recall

Recall -- Firm Press Release
FDA posts press releases and other notices of recalls and market withdrawals from the firms involved as a service to consumers, the media, and other interested parties. FDA does not endorse either the product or the company.

American Health Kennels, Inc. Announces a Voluntary Recall of Baked Dog Treats Containing Peanut Butter
Contact:
4351 NE 11th Avenue
Pompano Beach, Florida 33064
1-954-781-0730 or
barkbars@aol.com

FOR IMMEDIATE RELEASE -- Pompano Beach, Florida -- February 13, 2009 -- As a result of the expanded recall by the Peanut Corporation of America’s (PCA) Blakely, Georgia facility, American Health Kennels, Inc. has issued a voluntary recall for certain baked dog treats containing peanut butter supplied by PCA. The Blakely PCA facility is the subject of an ongoing U.S. Food and Drug Administration (FDA) investigation into potential Salmonella contamination of peanut butter. American Health Kennels, Inc does not know that any of the peanut butter from PCA that was used in our process was infected with salmonella. The parameters in our formulation and baking process (280F) are well in excess of the CDC’s guidelines (190F) for an effective salmonella bacteria kill; further American Health Kennels Inc. has had no reports of illness associated with our products.

We are effecting this recall in the interest of public safety even though we know our product is safe.

According to the FDA, pets with salmonellosis may be lethargic and have diarrhea or bloody diarrhea, fever, and vomiting. Some pets may exhibit milder systems such as decreased appetite, fever and abdominal pain while other pets may show no symptoms at all. Well animals can be carriers and transmit the bacteria to other animals or humans. If your pet has consumed the recalled product and exhibits these symptoms, please contact your veterinarian.

While the risk of animals contracting salmonellosis is minimal, there is risk to humans from handling these products. It is important for people to wash their hands--and make sure children wash their hands--before and, especially, after feeding treats to pets.

The following items manufactured by American Health Kennels, Inc. are subject to this recall:

American Health Kennels, Inc., Cookie Bars: Creamy Peanut Butter UPC 725999522004; PB & Carob Chips UPC 725999523001; Lucious Carob UPC 725999521007; 4pack Cookiebar Assortment UPC 725999538005; Best Before: 11/09

American Health Kennels, Inc., Peanut Butter Crunch 12oz UPC 725999001103; 16oz UPC 725999161104; Best Before: 11/09

American Health Kennels, Inc. Bark Bars Peanut Butter: 1.5oz Jumbo UPC 725999000168; 2.25 Pillow Pack UPC 725999333105; 2.5lb canister UPC 725999005064; 5lb bulk UPC 725999001257; 6oz Smiles UPC 725999530009; Giggles UPC 725999530009

American Health Kennels, Inc., Christmas Stocking 6oz UPC 725999000175; Christmas Card Mailer UPC 725999513003; Birthday Mailer UPC 725999528006; “With Love” Hearts UPC 725999512944; Holiday Smiles UPC 725999222300

American Health Kennels, Inc., 100 Calorie 2oz Pillow Pack UPC 725999539101; 100 Calorie 14oz dispenser UPC 725999539200; Gravity Trial 2oz UPC 725999400166; Best Before: 11/09

American Health Kennels, Inc., Bark Bars Minis UPC 72599953300; Best Before: 11/09

American Health Kennels, Inc., Bark Bars Animal Snackers 3oz UPC 725999512098; 12oz UPC 725999512098; Best Before: 11/09

American Health Kennels, Inc., Bark Bars Milk & Cookies UPC 725999333808; Best Before: 11/09

American Health Kennels, Inc., Dog Ate My Homework Jumbo UPC 725999531006; 2oz Pillow Pack UPC 725999535004; Best Before: 11/09

American Health Kennels, Inc., Bark Bars Naughty or Nice UPC 725999530092; Best Before: 11/09

American Health Kennels, Inc., Bark Bars Carob & Peanut Butter, 2.5lb canister UPC 725999005071; 2.25oz Pillow Pack UPC 725999333402; 5lb bulk UPC 725999003251; Best Before: 11/09

American Health Kennels, Inc., Bark Bars Brownie Delight 12oz UPC 725999003107; 5lb bulk UPC 725999003251; Best Before: 11/09