Unveiling the World of Veterinary Nutrition

What’s the importance of medication in your role as a nutritionist?

If my patients don’t eat, I can’t do my job. I will pull out all the tips and tricks I can that are not medication-related, not because medications are bad, but it’s just one more thing to ask a pet parent to do. There are absolutely times and places where medications are not only helpful as an adjunct but are the main part of the medical treatment, and nutrition is actually the adjunct.

A lot of people don’t know what board-certified veterinary nutritionists do and think we just treat with food, but we are experts in biochemistry and metabolism. We know what the individual cells of the body need, and we combine medication and nutrition to help the pet in the best way possible. Most of the patients that I see are on some form of medication. Again, I try not to use medications if I can get away with it, but when I’m communicating with my pet parents, having expectations from the beginning is very important because nobody likes veterinary medical surprises.

So, if I have a dog with GI disease, we can probably treat this with diet, but there’s always a possibility that we’re going to need immunosuppressants in the future. Or, if the pet feels nauseous, we’ll need anti-nausea / anti-emetic medications. Most diseases that are nutrition-responsive are absolutely medication-responsive as well.

What is the typical response from pet parents when you tell them there are going to be multiple aspects of a treatment plan?

I feel like by the time a pet parent gets to me they understand that their pet’s condition is probably a little more complicated than usual. Typically, I handle pets facing challenges where either a single ailment proves unresponsive to specific treatments, or they are grappling with multiple diseases. So, we have to bring everything together. And again, it’s all about expectations and communication. I tend to be a very empathetic person; empathy is probably my superpower (and also my downfall, haha). When I’m talking to pet parents I spend most of the appointment focusing on their pet, going through records together, and talking about all the different diseases that my detective work has brought to light., A lot of the pet parents haven’t heard of the things I share with them. We take time talking about how that disease affects their pet so that they understand why I’m recommending different things. If a pet has kidney disease, we will put them on a kidney diet. But as the doctor, I want to really explain to the pet parent each aspect of why their pet’s kidneys aren’t functioning properly so they understand, nutritionally and medically, how we are handling it.

It’s all about communication and making the pet parent feel like they’re part of the team and not just being told what to do. As the pet parent, they are the experts on the pet, so I want them to tell me what is going to work best for them and their pet. If I’m recommending that you medicate your cat four times a day and your cat causes a world war every time you bring out the pill bottle, we’re going to have to have a different conversation. That’s where that empathy factor comes in, being upfront that I’m going to ask you to do things and it’s okay if you can’t; you’re doing your best, and that’s okay. Most pet parents are willing to try the treatment once you let them know that there’s a choice and they’re not going to be judged.

I try to make it relatable. In veterinary school, you start by learning from the book. But what has made me a better doctor is having real-world experience, especially with my own pets. It makes it much easier to understand each case and makes the pet parents feel like they are not alone.

503B outsourcing facilities focus on quality and consistency. How does that influence your choices about what medications to prescribe and how to inform pet parents of those benefits?

The most important thing for me is that my clients have easy access to medications. I try to give them a choice, but I also try to educate them. The easier I can make it on my clients, the more likely they are going to be compliant. So, if it’s a standard medication that can be ordered from an online distributor such as a vet source or from a human pharmacy, I’m happy to do that if it’s easiest for them. When it comes to compounding, whether a dog is super small or needs an exact dose, I strongly recommend going with one from a 503B facility because you know for sure that the quality is consistent; it’s manufactured and basically human quality. I’ve seen cases where the quality is not there from other facilities. I would rather err on the side of caution, especially when it comes to certain medications like chemotherapeutics and blood pressure medications that can have negative effects if dosed incorrectly. The little extra cost is worth the peace of mind.