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AN OVERVIEW AND EXPLANATION OF
“PRESCRIPTION DIETS”
by T. J. Dunn, Jr. DVM
This article originally appeared in Dog World Magazine.
Some data may be different at this time.
Please Note!
The pet
food industry is a dynamic enterprise that is constantly changing recipes,
types of therapeutic diets, methods of delivery to the veterinarian and pet
owner and other parameters. The brands, names and recipes of any of the
diets mentioned here
may change at any time with little notice. Always consult with your
veterinarian regarding the best therapeutic or prescription diets for your
dog or cat.
In 1940 a veterinarian
named Mark Morris, Sr. evaluated a dog that was suffering from kidney
disease. Morris felt that nutritional therapy might work just as well as
medication to help his patient gain some relief from the effects of kidney
disease and hopefully would restore the dog to a higher quality of life. He
devised a pet food that would lessen the work the patient’s kidneys needed
to do… and his patient improved greatly and lived longer than anyone
expected. That diet was called Prescription Diet KD for (kidney diet). Mark
Morris, Sr. set in motion a revolution in veterinary medicine that continues
and evolves today. His humble start led to the emergence of Hills Pet
Nutrition, the nation’s leader in research and development of what the
company calls Prescription Diet Brand Pet Food.
WHAT ARE
PRESCRIPTION DIETS?
Therapeutic Diet or
Prescription Diet … what’s the difference? I posed that question to Dave
Geier, of Geier Enterprises, Highlands Ranch, CO. A former executive with
Hills Pet Nutrition and a consultant to the pet food industry, Geier
explains, “The term ‘Prescription
 Diet’
is used as a brand line for Hills Pet Nutrition’s therapeutic diets. The
term ‘Therapeutic Diets’ refers to any food that is available only
by or on the order of a licensed veterinarian and that aids in the
recovery from a disease or disorder or assists in delaying the progression
of disease.”
Amy Dicke, DVM, technical
services veterinarian at The Iams Company states “A prescription diet
is one available only through a veterinarian. The term therapeutic
better represents the diet’s use - whether it be the sole therapy or an
adjunct in the course of support for a medical condition that is diagnosed
and monitored by a veterinarian.”
If you look at the wording
on some of the therapeutic diet labels you will see that the emphasis is on
the veterinarian being in charge of dispensing these foods. Hills Pet
Nutrition displays the wording “Veterinary Exclusive Pet Food”. Also, on a
bag of Hills Prescription Diet CANINE C/D you will read “Dietary Animal
Food… use only as directed by your veterinarian”. On a bag of Purina
EN-Formula it states “Purina Veterinary Diets® are authorized for
prescription and sale only by veterinarians”. Eukanuba Veterinary Diets,
made by the Iams Company, on its Nutritional Skin and Coat Formula, Response
FP, it states on the label “Dog food prescribed by Veterinarians for dietary
management of skin and coat health and dental health”. Royal Canin
Veterinary Diets (formerly Innovative Veterinary Diets) displays the
statement “Sold and distributed by licensed veterinarians only”.
No matter who the
manufacturer is, therapeutic diets are available only at animal hospitals or
selected outlets that are staffed by veterinarians. You won’t see
therapeutic diets in grocery stores, pet shops or feed stores. Geier
continues ”In 2005 there were five major companies making therapeutic diets
and approximately fifty different types of these diets that assist in the
treatment of problems associated with liver, kidney, heart, diabetes and
many other metabolic problems. They are available in canned and dry and
biscuit form for dogs and cats.”
WHY
“PRESCRIPTION ONLY”?
Therapeutic diets are
“Available only by or on the order of a licensed veterinarian”. That label
designation indicates a veterinarian must prescribe the diet to the consumer
because the product has specifically designed nutrient formulations that
have a targeted impact on the health of the dog consuming that diet. If that
or similar wording is present on a pet food label the food can only be sold
through a veterinarian’s prescription.
Therapeutic diets have
been formulated to target specific metabolic processes of animals; and these
processes are actually modified to effect certain changes in the animal’s
digestion, immune responses, blood pressure, renal function, liver
metabolism or blood glucose levels. To achieve an impact on the animal’s
body chemistry, therapeutic diets have scientifically formulated amounts and
ratios of various nutrients. Nearly all therapeutic diets, designated by the
manufacturer to be available ONLY on the order of a licensed veterinarian,
have certain nutrients either reduced in amounts or have nutrients that are
elevated above typical levels for normal dogs.
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Ask your veterinarian if a
therapeutic diet would be a valuable addition to your pet's
medical profile.
Therapeutic diets greatly assist in the management and prevention of
bladder stones in
dogs and
cats.
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Radiograph of dog with bladder
stones |
Bladder exposed surgically for stone
removal |
One of many bladder stones being
removed |
Stones are sent to a lab for
analysis |
A good example would be a
diet that is used for only short periods of time in order to assist in the
non-surgical elimination of certain urinary tract stone formations. A diet
such as this may not be wise to use long term nor in an animal not needing
therapy for urinary
calculi. Diets targeting therapy for Diabetes Mellitus in dogs, liver
dysfunction, or kidney failure are not
 appropriate
for normal dogs. And anyone feeding a growing pup a low protein therapeutic
diet designed only for dogs with kidney failure will surely cause harm to
the innocent pup. Likewise, a sodium-restricted diet used to treat
congestive heart failure would not be appropriate to feed a healthy,
vigorous retriever. Diets formulated for heart disease have lower sodium,
and therapeutic diets for diabetes control have a higher fiber and may have
a higher protein than what is considered appropriate for healthy adult dogs.
Diets for food allergies have novel proteins that the pet has not been
exposed to such as kangaroo, duck, potato or venison. Therefore, prior to
feeding any animal a diet specifically formulated to modify body chemistry,
a veterinarian must make an appropriate medical diagnosis. For health,
safety, liability and ethical reasons, veterinarians need to have exclusive
domain over the use of these therapeutic products. Think of therapeutic
diets as you would a drug, although they do not actually contain drugs.
Their profound effects on the patient are not to be taken lightly.
CASE
EXAMPLE
 Kimberley
Brosofske, Ph.D., a Research Ecologist in Rhinelander, Wisconsin, presents
an interesting success story regarding therapeutic diets. Her mixed-breed
dog had chronic problems that resolved after implementing a therapeutic
diet. Brosofske tells us, “Five years ago Buddy was diagnosed with
hypothyroidism when I realized he was 30 pounds overweight, had skin
problems and his coat was rough and dull. After being placed on medication,
these problems went away and his health was excellent… until three years
ago. Buddy then started developing occasional ‘hotspots’ and very flaky,
dark-colored skin. His coat, previously very shiny, became dull and was
covered with flakes of dead skin that would slough off. He developed chronic
ear infections that required constant medication. He also seemed to have a
perpetual stomachache, often vomited and had bouts of diarrhea. His
veterinarian suggested that either he might need a change in the dosage of
his thyroid medication or he might have allergies. After some testing the
veterinarian determined Buddy’s thyroid was not the problem but rather that
he had food allergies. The veterinarian suggested I feed Buddy only a
therapeutic diet (Innovative Veterinary Diets Venison and Potato). Within a
short period of time the ear infections ceased, the vomiting and diarrhea
ended, and Buddy’s skin cleared up, leaving him with a flake-free, shiny
coat. He looks and feels great! He’s had no more hotspots, and he shows
gusto for his food bowl again.
COMPLIANCE ISSUES
In my practices I have
often had to defend the cost of therapeutic diets. There seems to be a
resistance in some dog owners to purchasing expensive dog food and yet there
is little reluctance to purchase a drug or medication “as long as it helps”.
My response is that the therapeutic diet should be looked upon as a form of
“medication” because of its specific effect on the individual consuming the
diet. With that concept of “food as medicine” in mind we can see why these
diets need to be restricted to use only in special and specific
circumstances. High quality ingredients with specific, metabolically
targeted effects, simply cannot be manufactured, delivered and sold at what
anyone would term “cheap” prices. “Expensive” diets may very well worth
every penny if the product performs well. And in most cases it truly costs
only pennies more per day to feed a therapeutic diet than a conventional
diet.
ARE
THERE DANGERS ASSOCIATED WITH THERAPEUTIC DIETS?
Because of the unique
properties of therapeutic diets the manufacturers make their formulations
available only to veterinarians. If a formulation is misused by feeding
longer than recommended or fed to an animal that has new or changing
requirements, they can be more harmful than helpful. Targeting specific
medical disorders, therapeutic diets can benefit animals with such problems
as food allergies, gastrointestinal disorders, diabetes, urinary tract
dysfunction, kidney disease, heart disease, liver disease and even some
forms of cancer. Patients with these problems often require certain
nutrients to be added or eliminated from their diets. Therefore, the misuse
of specifically formulated therapeutic diets can be hazardous… and
veterinarians need to be the responsible source of their distribution to
the dog owner. Dicke’s comment applies to any therapeutic diet when she
says, “All Eukanuba Veterinary Diets are available only through a
veterinarian. These diets are designed to address certain medical conditions
that should be diagnosed and monitored by a veterinarian.”
WHO
MAKES THERAPEUTIC DIETS
Hill’s Pet Nutrition is
the largest manufacturer of therapeutic diets with their Prescription Diet
brand, followed by Eukanuba Veterinary Diets (Iams Company). With
Mars’ purchase of Royal Canin and Royal Canin's
purchase of IVD from Heinz, and the Waltham brand going away, Royal Canin
would be a growing number 3 behind Hill's, still dominant, and Iams. Companies,
such as The Iams Company, offer numerous choices for therapeutic diets. For
example, Dicke indicates, “The Iams Company produces 28 therapeutic
products, including dry, canned, and biscuits. These formulas address a
variety of medical conditions in the dog and cat, including food allergy,
intestinal disorders, renal disease, obesity, and urinary health.”
FUTURE
DEVELOPMENTS
Today, pet food companies
spend tens of millions of dollars on research and development of better
diets for pets. What this means is that pet owners are demanding and
purchasing higher quality diets that enhance the life experience of their
dogs. Proof lies in the fact that since Dr. Morris’ early explorations into
the theory that food can be used as therapy there now exists a multi-million
dollar industry based on the production of therapeutic diets for pets. New
nutritional principles are rapidly being discovered through modern,
scientific research. “Nutrition research has moved beyond defining minimal
requirements for animals and on to defining optimal nutrition under various
conditions,” says Dottie Laflamme, DVM, PhD, DACVN, Veterinary Nutrition -
Communications Specialist with the Nestle Purina PetCare Company. Our
companion animals today are beneficiaries of newer nutritional research and
development that has made available to us a wide spectrum of therapeutic
diets. Today’s veterinarians dispense a multitude of therapeutic diets, and
they have become as much a part of daily veterinary practice as antibiotics,
gas anesthesia or Heartworm prevention. Additional pet food manufacturers
are entering the therapeutic diet arena. The bottom line is this:
Therapeutic diets, acquired via a veterinarian’s prescription, are a vital
aspect of modern pet health care services.
Why? Because they work.
T. J. Dunn, Jr. DVM |
