More Nonsense from Holistic Vets about Commercial Therapeutic Diets

One of the subjects that holistic vets and other advocates of alternative practices get really passionate about is the evils of commercial and conventional diets. They promote a laundry list of myths about pet food, many of which I’ve addressed before:

  1. Raw is better than cooked-

Raw Diets for Pets

2.Vets know nothing about nutrition-

This is particularly hypocritical given that the claims made about the evils of commercial food and the virtues of alternative diets are generally made by—yup vets!— and these folks have no more training or expertise than the rest of us. In fact, the most reliable source of expertise on pet food are board-certified veterinary nutritionists, veterinarians with extensive training in nutrition. However, their claims are casually dismissed with innuendos or accusations about financial bias by vets who themselves make their living selling the stuff they advocate for.

What do Vets Know about Nutrition?

3. You can tell the quality of a food from reading the ingredients on the label-

Sorry, you can’t. Partly this is the fault of regulators, who don’t require truly important information to be put on pet food labels in a clear and understandable way. And partly the uselessness of labels as a measure of food quality comes from the meaningless vagueness of the concept of “quality” and all the myths and misconceptions about specific ingredients promoted by these vets.

Pet Food Nutrition Myths
Nutrition Resources for Pet Owners
Dog Food Logic

A recent article from the ever-unreliable Dogs Naturally Magazine gave some alternative vets a platform for repeating some myths and misconceptions about what are often called “prescription diets,” though this is technically incorrect. These are better referred to as “therapeutic diets” because they are intended to be useful in treating or preventing specific medical problems, not simply provide good overall nutrition, but they do not actually require a prescription, merely oversight from a qualified veterinarian.

The evidence for these diets varies from strong (e.g. kidney diets for cats with kidney disease) to weak (e.g. some of the diets for cognitive dysfunction in older dogs), but while there are some good arguments against some of these foods, none of the ones made in this article are worth taking seriously.

The article begins by asking a bunch of holistic vets to rank a few foods based only on the ingredient lists, with one food being a prescription diet. Not surprisingly, the vets tended to rank this diet quite low, based on these sorts of arguments:

Dr Marty Goldstein, author of The Nature of Animal Healing [said] Food #3 ranked last, based on the use of corn for its first ingredient, followed by by-product meal.

Dr Jodie Gruenstern: “This food was the lowest quality in the list. It contains GMO corn, soy (lots of it!), which is a common allergen, synthetic vitamins/minerals, shavings (if you didn’t know, the ingredient cellulose is literally sawdust), natural flavors, which usually mean MSG.”

Dr Jean Dodds: “Poor quality food: the first ingredients are corn, which is often GMO, and chicken by-product meal rather than whole chicken. Flax and soy are phytoestrogens.”

Dr Judy Morgan: “This is a Pet Store Food. Corn is the first ingredient, no muscle meat used, only by-product meal, synthetic vitamin/mineral supplement, corn and soybean are GMO, waste fillers are abundant. Overpriced in my opinion, considering the poor quality, cheap ingredients used).”

Dr Dee Blanco: “This one starts with corn to increase inflammation, then adds lighter fluid to it with soybean products and poor quality protein. Then it tries to make up for the poor quality foundational ingredients by adding synthetic supplements of the poorest quality, such as calcium carbonate, folic acid, ‘generic Vit E supplement’, etc. Looks like they added l-tryptophan to calm the nervous system down after putting the body into overdrive inflammation. Natural flavors?? Could be an entire cadre of carcinogens, allergens and toxins. Argh!”

So we have a long list of villainous ingredients supposed to cause inflammation and other health problems. Any truth in this fear mongering?

Corn and Soy are Evil

Obviously, this sort of simplistic characterization of foods as inherently good or evil is not scientific in tone, and in the case of the particular claims she makes about these ingredients they are not consistent with mainstream opinion or the evidence. Veterinary nutritionists agree that particular sources of protein and carbohydrate in canine diets are not intrinsically harmful or beneficial and that the health effects of diet are a complex set of interactions between many factors. Duck and bison are no more nor less likely to trigger food intolerance than chicken or beef, and tapioca or potatoes or green peas are no better nor no worse than corn and wheat and soy as carbohydrate and protein sources.

GMOs are Evil

This is a hot-button issue these days, and while it is complex, the evidence to date does not support the sort of hysteria about GMOs these vets promote. This is, of course, a topic which deserves multiple posts on its own. Dr. Dodds and others regularly list GMO ingredients as unhealthy, promoting inflammation and food intolerance, and there is no evidence to support this. While there is always the potential that particular modifications of food crops and animals could lead to health risks, the anxiety about genetically modified organisms is generally ideological and based on misconceptions or poor understanding of the relevant science. It is part and parcel of the Appeal to Nature Fallacy, and the existing evidence does not support most of the hysterical fears about GMO. Dr. Dodd’s claims are not based on research from nutrigenomics but are simply part of her own beliefs and prejudices, and she provides no compelling scientific evidence to support her claims. Relevant discussion of this issue and the evidence can be found here: 1, 2, 3, 4, 5, 6, 7.

By-Products are Evil

Here’s what one nutritionist I’ve talked to has say about by-products:

A by-product only means that it was not the intended main product of the industry. It gives no indication on nutrient profile, digestibility and bioavailability, etc. Many people who dislike by-products will happily buy wheat bran (a by-product of the baking industry). Moreover, by-products vary according to country and culture. Liver, an excellent source of nutrition, is considered a by-product in the US because skeletal meat is the primary product of slaughtering an animal and many people do not eat organs any more. By-products can be excellent ingredients in pet food and it would be wasteful (and terribly self-centered) to not use it to nourish humans or animals.

The concept is meaningless, and used to demonize foods that people think of as “icky” without any reference to their real nutritional value.

Let’s look at some of the other claims. he idea that corn is a major cause of inflammatory diseases is an unproven hypothesis. The claim that phytoestrogens in soy used in pet foods have negative effects on health is an unproven theory. Both of these are presented as facts when they are just personal beliefs.

“Natural flavors” usually means hydrolyzed animal tissues, not MSG, so this is just false. And “synthetic” vitamins are identical to those extracted from plants, so the idea that they are somehow less useful or more harmful is just the Naturalistic Fallacy in action.

The bit about “sawdust is particularly silly. Cellulose is a natural part of the wall of plant cells. Sure, it is present in wood, but it is also present in all the fruits and vegetables that these vets would laud as healthy for our pets. The usual source of cellulose as a dietary fiber in pet foods is the bran from cereals such as wheat, not “sawdust.” Such hyperbole is clear evidence of a preference for ideology over facts.

The article also uses a bit of drama to suggest that therapeutic diets are poor-quality or identical to over-the-counter diets and the designation only serves to justify charging more.

Now, a 30lb bag of the regular food is $47.99 at Petsmart. The prescription diet dog food can also be purchased at Petsmart for $84.95 for a 27.5lb bag. It’s twice as expensive!

Now, you might be thinking this is because the prescription diet was formulated and tested with a specific condition in mind. This is completely false.

While an over-the-counter food with a health claim (such as controls weight) is subject to FDA regulations and enforcement, the FDA practices “enforcement discretion” when it comes to veterinary diets. Put another way, this means the FDA has not reviewed or verified the health claims on any veterinary diet. Did you catch that? There are very few ingredients in veterinary diets that aren’t also in other regular diets.

In the example above, I’d say the pet store brand is a better quality food, wouldn’t you? The prescription diet contains by-product meal (which comes straight from the rendering plant), lots of soybean and corn products (a cheap replacement for animal protein) while the regular food contains more expensive, higher quality ingredients.

Again, here’s the response of a nutritionist who actually knows something about veterinary diets to this claim:

This is a misrepresentation. Veterinary diet claims do have to be substantiated as well. The FDA did have some leniency regarding veterinary diets regarding the extent of their health claims because they are usually used under the guidance of a veterinarian to improve the life of the pets. However, the FDA is concerned about many so called therapeutic diets now marketed directly to the consumer, so they might start enforcing legislation if they are not used properly, i.e. under veterinary involvement

Regarding price, good companies invest in research, that goes into designing the food, sometimes funding basic research that would further our knowledge on particular diseases (without an immediate product to market and sell) plus trials in healthy and diseased pets, etc. So, I understand why a veterinary diet from a responsible company costs more money, not because the ingredients are more expensive, but due to the knowledge invested behind it.

These holistic vets are so ideologically biased against commercial diets that they even claim that ingredients they routinely recommend as beneficial for many health conditions magically become harmful when included in such foods:

And fish oil is a terrible addition to pet foods. It’s much too fragile to be added to processed foods and as soon as the bag is opened, it will oxidate and cause inflammation in your dog. Ironic isn’t it, when the food is supposed to be treating inflammation in the first place?

Actually, it’s not ironic, it’s just a bit of ignorance and prejudice masquerading as an informed opinion. Fish oils can be added to foods in a manner that has all the same health benefits of giving them separately, if this is done properly by a company with real nutrition experts who know what they are doing.

Bottom Line
I usually write brief summary of my conclusions for these posts, but in this case I could not write anything that makes the point better than the following, again from a nutritionist knowledgeable about these issues:

All these arguments are just guilt trips and not based on reliable science and assume the quality of a final product depends solely on certain random criteria form the individual ingredients rather than in deep knowledge of the current state of nutritional science, excellent quality control during formulation, reception of ingredients, extrusion, and storage conditions.

What we have here is unsubstantiated belief presented as fact. And this kind of fear mongering has real dangers. There is, for example, very good evidence that feeding commercial diets for cats with kidney disease can reduce suffering and prolong life. Yet I have seen clients feeding unbalanced and completely inappropriate homemade concoctions instead because they have been frightened and misled by this kind of propaganda and are unwilling to feed diets with proven benefits.

As I’ve said many times, no one knows the perfect diet for any given patient, and I am open to the possibility that there are benefits to feeding alternatives to the usual canned and dry commercial diets. But these benefits must be proven, not simply invented out of whole cloth or wrung out of twisted misrepresentations of nutrition science.

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72 Responses to More Nonsense from Holistic Vets about Commercial Therapeutic Diets

  1. skeptvet says:

    Sorry, but dismissing the entire domain of clinical nutrition in favor of what seems right to you isn’t a compelling or convincing argument.

  2. BrianWessels says:

    Hello, Dr. Skepvet,

    Here is my personal take with regard to canine and feline nutrition. Here are the questions that I ask myself when trying to find out is a food is good, bad or just plain rubbish.

    Many individuals, including some veterinarians, most probably select a food from the different INGREDIENTS that are listed in the displayed ingredient panel. For those that do their selection in this manner I say the following: “the list of ingredients means NOTHING”!

    To me, what is important is, “What NUTRIENT/S is/are present in each ingredient? and how much of each NUTRIENT is present in each ingredient? That is;

    A. What is the TOTAL QUANTITY of protein (amino acids), in each ingredient. Next, what is the total protein content of the entire formula? Are there sufficient essential AA’s since some non-essentials are made from the essentials?

    B.Are there any “exotic” AA? (i.e. an AA that is not present in either a dog or a cat.)

    C. Are all the different ingredients, that have amino acids in them, are they all digested in the same time frame? This is VIP when it comes to the cellular uptake of different amino acids.

    D. What is the total amount of 3,6 & 9 poly-unsaturated omega fatty acids that are present in each and every ingredient? Additionally, are any of the waxy-OFA present in any of the ingredients? These are very important, especially in those dogs that work during hunting season.

    E. Does the formula contain fat from fat or does most of the fat come from “carbohydrate fat”? [Note – carbohydrate fat = “junk fat”].

    E. What is the total quantity of carbohydrates in the formula? (The dog’s and cat’s need for carbohydrates is LOW.)

    F. What are the total quantities of vitamins & minerals, including the trace elements?

    G. For me, this is of particular importance! – What “type” of fiber is included – an ‘expandable or “non-expandable” fiber?

    H. How much fiber – BY VOLUME – is included in the formula of the food? (The company only gives the weight of the fiber. When individuals are feeding a dog/cat it is never how heavy is the food, it is how much SPACE it will occupy in the stomach and small intestine, before the stretch reflexes get into action!. Hence, VOLUME is the important factor when it comes to fiber, NOT WEIGHT.

    Dogs & cats eat ingredients. Next – the ingredients have to be digested and only then can the nutrient/s be “extracted” from the ingredient. Finally, the “extracted” nutrient has to be internalized (absorbed). Thereafter, the nutrients will circulate and will eventually be taken up by the different cells in the different organs and tissues, thereby creating the total biochemistry in each and every organ/tissue. Finally,it is the biochemistry that creates the many different physiological functions.

    Hopefully, this may some show some correct thinking with regard to dietary intake. I await your critical and honest reply.


  3. skeptvet says:

    Nutritional assessment of commercial diets is challenging, and not many people have the information and expertise to do it. In particular, the nutrient content and digestibility is rarely something easy to find from the manufacturer, and it certainly is not on the label. Most of the things you mention are reasonable items to evaluate, though I do wonder how you get the data and whether you use the NRC guidelines or some other resource as a basis for assessing adequacy. The one point I would dispute is that “carbohydrate fat” is an oxymoron since fat and carbohydrates are different macronutrients, so I’m not sure what you mean by this.

  4. BrianWessels says:

    Dear Skeptvet,
    Thanks for the reply -very constructive. I will reply soon and explain .

  5. Brian says:

    (Please do not print my surname – TY. I am a veterinarian with in a little in-depth practical knowledge in functional histology, biochemistry and physiology. I am intimately involved in breeding dogs and hence dietary intake is an important subject for me.]
    This is the way that I “see” fat in both dog and cat.
    Basically, there are two types of fat that are required by the dog and cat for their survival, that is, “visible” and “invisible fats”.
    “Visible” fats can be made by the dog’s and cat’s body from carbohydrates, sugars or amino acids, or ingested as the “visible fat” of other animals. [This fat is required, mainly subcutaneously, as an “insulator” in very cold weather. An excess of this fat can lead to overweight and obese problems. Additionally, dogs have difficulty converting this fat to calories, hence its accumulation.]
    On the other side of the coin “invisible” fats are intracellular and form part of the structural material (eg cell wall) of the cells (check the histology!) in many of the body’s vital organs, especially in the brain, liver, kidneys, heart muscle, testes spleen, pancreas and skin.
    Amazingly, in both dog and cat about 60% of the brain is fat. Furthermore, both the dog and cat can only make 50% of the different fatty components of their brain, the other 50% should be supplied by the dietary intake of ‘good’ fat.(In passing, why do so many veterinarians ‘see’ so many dogs and cats with anxiety and behavioral problem/s, plus those that are very finicky/fussy eaters! It makes one wonder about their dietary intake of good quality fat!)
    Interestingly, just as proteins are built from amino acids and the “essentials” are used to construct the “non-essentials”, something very similar occurs in fats. It is important to note that some fats can be made by both dog and cat but those that are used for cellular construction cannot be made by either the dog or cat, these fats must be eaten.
    A fatty acid is a simple chemical, comprised of a string of carbons, saturated with hydrogen and they have an acid group at one end. Dog and cat can produce saturated acids but only plants can produce the polyunsaturated acids. The carbon atoms in the string are normally joined by single bonds; however, some of the hydrogens can be removed to form double bonds between adjacent carbons. In this manner the acid becomes unsaturated.
    There are two “essential” acids in dog and cat, one with two double bonds (linoleic) and the other with three double bonds (linolenic). The structures in active plant cells use both of these polyunsaturated acids in their construction. When herbivores eat plant matter, they not only incorporate the parent acid directly into their own cell structures, but also build on them.
    Starting with a string of 18 carbon atoms with 2 or 3 double bonds, animals can extend the length of the carbon chain to 20 or 22. Once there are double bonds to work on, then animals can introduce even more, thereby producing the long chains with 4-6 double bonds needed for cellular construction and maintenance of cells. In this way, the “structural”(invisible) fats of animals are more complex than those of plants.
    Although animals can make the parent acids longer and introduce more double bonds, they cannot change the originals (parent). As linolenic acid starts with three double bonds, neither it nor any of its long chain derivatives can be made from linoleic acid with only two double bonds. Consequently, and because of the specific role of this fatty acid in the specialized tissues (e.g., skin), linolenic acid should be considered an essential dietary constituent. When one ‘sees’ the diversity of so called fat in the different commercial diets it is no wonder that veterinarians attend to so many dermatological patients!
    Herbivores and omnivores eat plants and then the carnivorous dog and cat eats these omnivores and/or herbivores.


    Nature knows best! A hungry dog in the woods will hunt flesh and bone and won’t be cooking it over a fire. All the dog’s nutritional needs are in the skin, fur, feathers, flesh, blood, organs and bones. Kibble being an ideal or nutritional healthy food source for dogs is simply a liei, but some are better than others, and super convenient for dog owners. Yes, I feed raw (most of the time), but I keep so called quality kibble for convenience.

  7. skeptvet says:

    “Natural” means being infested with parasites, suffering from malnutrition and dying young. What is “natural” is not necessarily good. You are mythologizing a life you and your dog have never had to endure. This is called the Appeal to Nature Fallacy, and it is a common misconception now that most of us are so unfamiliar with what life without modern science and technology is actually like.

  8. L says:

    A hungry dog in the woods is lucky if it lives a year, at the most. It will most likely suffer a slow painful death.

    That is the reality.

  9. mark hoy says:

    This is SO SIMPLE:

    BUY SOME CANNED DOGFOOD & some dry treats — AND GIVE YOUR DOG A LITTLE –once in awhile —
    for the organ meats etc.

    it’s so easy.

  10. skeptvet says:

    This is a completely unbalanced and inappropriate diet, and it is likely to raise the risk of nutrition-associated disease The fact that you don’t see instant problems when feeding a dog this kind of tbhing is a testament to how resilient they are in the face of poor nutrition, not to the quality of such a diet.

  11. Gitte says:

    My contribution to “nature knows best”: sure, nature will unsentimentally eliminate all genetic material which cannot thrive to a minimum extent under the prevailing conditions. So if you feed your dog as nature intended you might find that the genetic material of your dog might not be up to scratch and you might have to find a new dog which is.

    Which would be good for dogs as a species, but not all that helpful if you happen to be inordinately attached to a particular individual of the species with all its genetic baggage. If you want to argue that commercial dog food is a problem it could be that it allows dogs to survive and procreate which nature otherwise would have eliminated. Nature did not intend for every single dog to be saved. Since I am too attached to my particular genetic messes of dogs to want to test them with nature, I try to feed them food which is better than what nature intended and if possible free of parasites and pathogenic bacteria.

    Now if breeders would consistently select dogs for their capabilities of thriving with food as nature intended, we might not have that much discussion about dog food. I could be wrong, but I haven’t gotten the impression that they do.

  12. ingrid aquino gomez says:

    Everything gets really complicated because there so many dog food out there. I hope I am doing ok as a dog owner. My oldest lived till he was 18 years old. He ate everything I gave him lol which including vegetable and fruit.In his old age he was on a low protein diet and but in his last 2 weeks, I gave him whatever he wanted and tolerate to eat .
    My other more mature dogs does not like to eat the raw mixture and so I have to cook them a little but they eat kibbles for senior in between and all have maintained a steady weight and energy.

  13. Donald says:

    I just watched Marty Goldstein’s pitch on the internet and stated polyethylene glycol Is an ingredient in antifreeze. He’s not smart. Ethylene glycol is in ingredient in antifreeze. That tells me he is full of it.

  14. Bea says:

    The FDA resource you linked in the comments section basically said they don’t verify the claims in vet prescription diet. My new shelter cat was prescribed royal canin’s “calm”. Both her vet and I think she clearly has an anxiety issue. Where can I find evidence that the diet works? As a scientist, I have journal access, but am not quite sure where to begin looking for veterinary outcomes.

  15. skeptvet says:

    Some diets have been the subject of published clinical trials, such as some of the kidney and joint diets. These are sometimes independent, but they are usually funded and/or conducted by the company making the diet, which adds some potential for funding bias, though good methodology can often overcome that. I have found a couple of studies for this diet, and thee is some research on the purported therapeutic ingredients, but overall the evidence is tenuous.

    Kato M, Miyaji K, Ohtani N, Ohta M. Effects of prescription diet on dealing with stressful situations
    and performance of anxiety-related behaviors in privately owned anxious dogs. Journal of Veterinary
    Behavior. (2012), 7, 21-26

    Gary Landsberg, Bill Milgram, Isabelle Mougeot, Stephanie Kelly, and Christina de RiveraTherapeutic effects of an alpha-casozepine and L-tryptophan supplemented diet on fear and anxiety in the cat. Journal of Feline Medicine and Surgery Vol 19, Issue 6, pp. 594 – 602

  16. Donna Givens says:

    Thank you for this information. Is the “Blue” brand of dog food a good product or “Natural Balance”? If not, could you name a brand? I have a 1 year old shelter dog that looks like a Jack Russel gone awry mixture, 15 lbs.

  17. skeptvet says:

    There’s no evidence comparing brands in terms of any objective health outcomes, so there’s really no way to say if one is “good” or not. I would recommend the book Dog Food Logic to learn more about the dog food market and how to evaluate foods.

  18. Pam says:

    Brian, would you tell me what you feed your dogs? Thank you!

  19. incog99 says:

    My cat, Nehemiah, will not eat those fancy freeze dried foods. He sticks his nose up at them, much to my chagrin after spending 100 dollars on them. He likes cat junk food like Temptations and Fancy Feast. I feed him what he likes. What good is trying to feed an animal food he hates? Since he broke his arm, I add supplements that my vet suggests like Glucosamine with MSM. I trust my vet and do not necessarily trust sales guys on the internet hawking the latest cat food fad.

  20. Jack Spence says:

    Since there isn’t any effective regulation in the pet food industry, many of the comments her are meaningless. How honest will a company remain if there is no verification of their claims? Profit motives can be a very powerful reason to take short cuts.
    I suggest that you look at your amimal’s teeth (or even your own) if you want to get any idea of a proper diet. Most pets have only sharp teeth. They need a good deal meat, preferably processed with low heat or even uncooked.

    I don’t recommend formulating your pet’s food on your own. You can cause more problems than you solve. Do your research on the internet. Be wary of headlines like “The Ten Best Dog Foods” or something similar. They are usually paid articles, with the #1 recommendation brand, being the company that sponsors it. Find independent research that doesn’t supply a link to Amazon, or other stores.

    Spending a little extra money for better pet food will save you a ton of money on vet bills, in the future. If you’re constantly running your pet in to the vet’s office, then you may want examine the diet.

  21. skeptvet says:

    Unfortunately, there’s not much evidence to support your ideas that dentition dictates nutritional requirements or that what you consider “better pet food” will have any health benefits. You are right, though, that the regulation of marketing claims in the pet food industry is less than optimal. Of course, there is zero regulation or quality control for homemade diets.

  22. emeraldgirl says:

    In response to incog99, cats love the cheap cat foods because they are formulated to be tasty, not healthy. They typically contain more salt, fat and other flavor-enhancers than the more high quality food formulations.
    Transitioning your pet away from those can take time. Try mixing the new food in with the prior food, slowly increasing the percentage. At first they may pick out the old food, leaving the new. This behavior seems to diminish over time. I went through this for a diabetic cat with kidney disease. In his case. wet was mixed with dry to support better hydration.

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