Consider the (Caregiver) Placebo Effect

Most people are familiar with the concept of a “placebo effect”, the perception of improved health while unknowingly receiving a sham (placebo) treatment that in reality should have no benefit at all. Growing up, my mother referred to this as “giving someone a sugar pill”. The assumption is that because we believe that we are receiving an actual treatment, our mind tells us that we should feel a bit better. Then amazingly, we do feel better. We notice a reduction in symptoms and ultimately conclude that the “medicine” must be working. The irony is that placebos actually can be powerful medicine (or something), at least for some people, for some diseases, some of the time.

placebo-comic

Placebos and Us: The effects of placebos in human medicine are well-documented and are described with human diseases of almost every type. The highest level of placebo effect is seen with diseases that have subjective symptoms that are patient-reported and difficult to measure directly, that tend to fluctuate in severity, and that occur over long periods of time (i.e. are chronic). Examples include depression, anxiety-related disorders, gastric ulcer, asthma, and chronic pain. In medical research, an average placebo response rate of 35 percent is reported, with rates as high as 90 percent for some health conditions. By any standard, that is a whole lot of sugar pill response going on.

placebo

Placebo Control Groups: Although the reasons that we respond to placebos are not completely understood, medical researchers universally accept the importance of considering them when studying new treatments. Studies of new drugs or medical interventions include placebos as control groups to allow unbiased comparisons with the treatment or intervention that is being evaluated. Any effect that the placebo group shows is subtracted from the effect measured in subjects who are receiving the actual medication. The difference between the two is considered to be the degree of response attributable to the treatment. If a placebo control group was not included, it would be impossible to differentiate between a perceived response (placebo) and a real response to the treatment. Today, double-blind, placebo-controlled clinical trials are considered to be the Gold Standard of study designs by medical researchers. The “double-blind” part refers to the fact that in addition to having both a placebo group and a treatment group, neither the researchers nor the subjects know which subjects are getting the treatment and which are getting the placebo. (For more information about double-blind research trials with dogs, see “Thyroid on Trial“).

What about Dogs? Can a placebo effect occur with dogs? Possibly, but things work a bit differently where our dogs are concerned. Most obviously, while highly communicative in many ways, dogs cannot specifically tell us what part of their body is in pain, how intense that pain is, if it is abating, or by how much. Rather, we use our knowledge of a dog’s behavior and body language to determine how he is feeling. As their caregivers, we are the recorders and the reporters of our dogs’ health, symptoms, and response to treatments. Similar to human studies, this is most relevant when the symptoms are things that are not easily measured using medical tests and that are more subjective in nature.

A second important difference is that dogs are basically always blinded to treatments. Although they may understand that something different is being done to them (or that there is a strange pill buried in that piece of cheese), most people will agree that dogs do not have an understanding that they are being medicated for a particular health problem or are on the receiving end of a new behavior modification approach. As a result, unlike human patients, dogs lack the specific expectations and beliefs about health interventions that may be necessary for a placebo effect to occur directly. However, because it is the owner who reports many symptoms and changes in health to their veterinarian and also who conveys subjective information regarding the dog’s response to a given treatment, a different type of placebo effect may be in action with dogs. This is called a “caregiver placebo effect”. As with human maladies, the conditions for which this type of placebo effect has been described in dogs are those that involve subjective measures of health (pain, activity level, appetite) and that have a tendency to fluctuate in severity.

Let’s look at two examples – the caregiver placebo effect in dogs with osteoarthritis and in dogs with epilepsy.

Does Your Dog Hurt Less? Osteoarthritis is a painful and progressive health problem that can seriously impact a dog’s quality of life. A variety of medical and nutritional treatments are available today for afflicted dogs. These range from NSAIDS (ex. deracoxib, meloxicam), nutrient supplements (ex. glucosamine, chondroitin sulfate) to alternative medicine approaches (acupuncture, cold laser therapy). Researchers who have studied these treatments use subjective measures of lameness in which dogs’ owners and veterinarians numerically rate their dog’s degree of pain, mobility, and interest in daily activities in response to treatment. Some, but not all, studies also include objective measurements of arthritis that quantify the amount of weight-bearing in the affected legs and weight distribution in the body.

Arthritis Studies: In virtually all placebo-controlled studies of this type, a substantial proportion of owners and veterinarians have reported improvement in the placebo-treated dogs. However, when measured using weight-bearing techniques, the dogs in the placebo group showed no change in or a worsening of disease. Michael Conzemius and Richard Evans at the University of Minnesota’s College of Veterinary Medicine decided to quantify the actual magnitude of the placebo effect in this type of experimental trial (1). They analyzed the data from 58 dogs who were in the placebo control group of a large clinical trial that was testing the effectiveness of a new NSAID. All of the enrolled dogs had been diagnosed with osteoarthritis and had clinical signs of pain and changes in gait and mobility. This was a multi-centered design, which means that each dog’s own veterinarian conducted the bi-weekly evaluations of gait and lameness. Both owners and veterinarians completed questionnaires that measured whether the dog showed improvement, no change, or worsening of arthritis signs over a 6-week period. Neither the owners nor the veterinarians knew if their dog was receiving the placebo or the new drug.

Results: Half of the owners (50 percent) stated that their dog’s lameness decreased during the study, 40 percent reported no change, and 10 percent said that their dog’s pain had worsened. When these reports were compared with actual change as measured by force platform gait analysis, the caregiver placebo effect, (i.e. thinking that improvement occurred when there was either no change or an actual worsening of signs), occurred in 40 percent of owners. The veterinarians performed no better. A placebo effect occurred 40 to 45 percent of the time when veterinarians were evaluating dogs for changes in gait or pain. This means that not only were the owners strongly invested in seeing a positive outcome, so too were their veterinarians. This effect occurred despite the fact that all of the human participants were aware that their dog had a 50 percent chance of being in the placebo group or the drug group, and that there was no way to be certain which group their dog was in.

Seizure Study: This study used an approach called a “meta-analysis” which means that the researchers pooled and then reexamined data collected from several previous clinical trials (2). Veterinarians from North Carolina State University College of Veterinary Medicine and the University of Minnesota reviewed three placebo-controlled clinical trials that examined the use of novel, adjunct treatments for canine epilepsy. During the treatment period owners were asked to record all seizure activity, including the length of the seizure, its intensity, and the dog’s behavior before and immediately following the seizure. The pooled results showed that the majority of owners of dogs in the placebo group (79 %) reported a reduction in seizure frequency in their dog over the 6-week study period. Almost a third of the owners (29 %) said that there was a decrease of more than 50 percent, the level that was classified in the study protocols as indicative of a positive response to treatment.

What’s Going On? Well, several things, it appears. The most obvious explanation of the caregiver placebo effect in dogs is owner expectations of a positive response when they assume an actual treatment is being administered to the dog. Whenever we introduce a new medication or diet or training method and anticipate seeing an improvement in our dog’s health, nutritional well-being or behavior, we naturally tilt toward seeing positive results and away from seeing no change (or worse – a negative effect). This is a form of confirmation bias – seeing what we expect to see and that confirms our preexisting beliefs. In fact, an early study of the caregiver placebo effect in dogs found that when owners were asked to guess which group their dog was in, the owners who said that they were certain that their dog was in the treatment group (but was actually in the placebo group) demonstrated the strongest placebo effect (3).

Such expectations may be an especially strong motivator when we are dealing with maladies that have affected our dog for a long time, infringes upon the dog’s ability to enjoy life, and for which we feel that we are running out of options. Osteoarthritis and seizure disorders were the health conditions studied in these papers, but I can think of several other problems with our dogs for which we may easily succumb to the power of the placebo effect. These include chronic allergies, adverse reactions to food ingredients, anxiety-related behavior problems and even cancer.

Cognitive Dissonance: Another factor that may contribute to the caregiver placebo effect is finding oneself in a state of contradiction. When we invest time and money (and hope) into a new treatment for our dogs, it follows that we will naturally have high expectations that the treatment will work. Indeed if it does not, we may experience cognitive dissonance, the uncomfortable feeling caused by holding two contradicting beliefs in one’s mind at the same time. For example, “I was told that giving my dog dehydrated gooseberry rinds would cure his chronic itching; these rinds are expensive and hard to find. He does not seem any better…… Uh oh. This is not a good feeling….”

Psychologists tell us that our brain reduces this discomfort for us (without our conscious awareness, by the way) by simply changing our perceptions. “Oh look! I am sure that the dehydrated gooseberry rinds ARE finally working. It just too some time – several months in fact. Still the effect MUST be the gooseberry rinds. YAY!”  In this case, convincing oneself that the dog does seem a bit less itchy, her coat is a bit healthier and overall, she does really seem to be feeling better, immediately solves this problem for the brain and for our comfort level.

cognitive-dissonance

The Hawthorne Effect: Finally, a related phenomenon that is common enough to have earned its own name is the Hawthorne Effect, also called observation bias. This is the tendency to change one’s behavior (or in our case how one reports their dog’s behavior) simply as a result of being observed. The Hawthorne Effect suggests that people whose dogs are enrolled in an experimental trial may behave differently with the dog because they know they are enrolled in a trial that is measuring many aspects of the dog’s life. In the case of the arthritis studies, owners may have altered how regularly they exercised their dogs, avoided behaviors that worsened the dog’s arthritic pain, or began to pay more attention to the dog’s diet and weight.

The point is that when people are enrolled in a research trial or are starting a new medical treatment, diet, or training program and are being monitored, they will be inclined to change other aspects of how they live with and care for the dog as well. These changes could be as important (or more important) than the actual treatment (or placebo). This is not necessarily a bad thing, mind you, and is another reason why we always need control groups, but the occurrence of the Hawthorne Effect emphasizes the importance of recognizing that the thing that we think is working for our dog may not actually be the thing that is doing the trick.

Take Away for Dog Folks: When trying something new with our dogs, might we, at least some of the time, in some situations, be inclined to see improvement when it does not truly exist? When interpreting our dog’s response to a novel therapy or supplement or training technique are we susceptible to falling for the sugar pill? It seems probable, given the science. It is reasonable to at least consider the possibility that a placebo effect may be influencing our perceptions of our dog’s response to a new food, a new supplement, a new training technique or a novel treatment. This is especially true if the approach that we are trying has not been thoroughly vetted by research through double-blind, placebo-controlled trials. While the development of new medications and foods and training methods is exciting and important, we must avoid the tendency to see improvement from something that is novel simply because we expect and desire it to be so.

CITED STUDIES:

  1. Conzemium MG, Evans RB. Caregiver placebo effect of dogs with lameness from osteoarthritis. Journal of the American Veterinary Medical Association 2012; 241:1314-1319.
  2. Munana KR, Zhang D, Patterson EE. Placebo effect in canine epilepsy trials. Journal of Veterinary Internal Medicine 2010; 24:166-170.
  3. Jaeger GT, Larsen S, Moe L. Stratification, blinding and placebo effect in a randomized, double blind placebo-controlled clinical trial of gold bead implantation in dogs with hip dysplasia. Acta Veterinaria Scandinavica 2005; 46:57-68.

Excerpted from: “Beware the Straw Man: The Science Dog Explores Dog Training Fact and Fiction” (2015).

Beware Straw Man Cover

“Only Have Eyes for You: Exploring Canine Research with The Science Dog” – Kindle Edition Now Available!

The Kindle edition of Only Have Eyes for You: Exploring Canine Research with The Science Dog” is now available! Click on the image below for more information and to order.

Book description:  In her second Science Dog book, Linda Case tackles commonly held beliefs about canine nutrition, pet foods, behavior, social cognition and training. Each of the book’s 32 chapters explores a current issue that is of interest to dog owners and pet professionals and presents the scientific evidence that supports or refutes commonly held claims and beliefs. Learn about pet food ingredients and research showing that what is on the label may not always be in the food, about measures of food quality (and what consumers may not know about the foods that they buy), and about the safety and digestibility of popular dog treats and chews. Other chapters review new information regarding how dogs communicate, factors that help or inhibit a dog’s ability to learn, and the effectiveness of different types of training. Find out if dogs are capable of “knowing what someone else knows”, if they feel empathy for their friends, if they bark for no reason, and if they are capable of feeling guilt following a misdeed. Learn more about breed stereotyping, factors that influence our perceptions of dogs, and which canine characteristics most influence our attraction to particular dogs. This newest Science Dog book has something for everyone who works with and trains dogs, as well as for those who simply love dogs and enjoy learning more about our canine best friends.

                                                                             ♥♥♥♥♥♥♥♥♥♥♥♥♥♥

coversnip

New Book! “Only Have Eyes for You: Exploring Canine Research with The Science Dog”

Only Have Eyes for You: Exploring Canine Research with The Science Dog” (paperback version) is now available! Click on the image below for more information and to order. (Kindle version will be available soon!)

Book description:  In her second Science Dog book, Linda Case tackles commonly held beliefs about canine nutrition, pet foods, behavior, social cognition and training. Each of the book’s 32 chapters explores a current issue that is of interest to dog owners and pet professionals and presents the scientific evidence that supports or refutes commonly held claims and beliefs. Learn about pet food ingredients and research showing that what is on the label may not always be in the food, about measures of food quality (and what consumers may not know about the foods that they buy), and about the safety and digestibility of popular dog treats and chews. Other chapters review new information regarding how dogs communicate, factors that help or inhibit a dog’s ability to learn, and the effectiveness of different types of training. Find out if dogs are capable of “knowing what someone else knows”, if they feel empathy for their friends, if they bark for no reason, and if they are capable of feeling guilt following a misdeed. Learn more about breed stereotyping, factors that influence our perceptions of dogs, and which canine characteristics most influence our attraction to particular dogs. This newest Science Dog book has something for everyone who works with and trains dogs, as well as for those who simply love dogs and enjoy learning more about our canine best friends.

                                                                             ♥♥♥♥♥♥♥♥♥♥♥♥♥♥

coversnip

What’s in Your (Vegetarian) Food?

Here we go again.

It appears that there may be more than what dog owners expect to find in vegetarian dog food.

Hold the Spam, Please: Before all of the  “Dogs are Carnivores (and a pox on your mother if you think differently)” devotees begin posting comments (in all caps ) that dogs should NOT be fed a vegetarian diet in the first place, let me state that this is not what this blog piece is about. So please, don’t even start. The point of this essay is not to argue (again…..) whether or not dogs have an absolute requirement for meat in their diet (here’s a hint: They don’t). Rather, today we examine new information about undeclared ingredients that may be present in dog food and the mounting evidence of regulatory violations within the pet food industry.

In this newest pair of studies, a team of veterinary nutritionists at the University of California tested vegetarian pet foods for label compliance and ingredient content.  I have written about this before, and unfortunately once again, the news isn’t good.

25-Foods-That-Seem-Vegetarian-But-Arent

Label Compliance: In the first study, the researchers collected samples of 24 dog and cat food brands that carried a label claim of “vegetarian” (1). The majority of the foods were over-the-counter products purchased at a local pet supply store. Three products were veterinary therapeutic diets. Of the group of products, 19 were formulated for dogs or for dogs and cats, and five were formulated exclusively for cats.  Product labels were examined for their compliance with the Association of American Feed Control Official (AAFCO) model regulations, which are the basis for most state mandated pet food regulations. Pet food samples were also analyzed for total protein and essential amino acid content. Results: Of the 24 foods, only eight (33 %) were in complete compliance with AAFCO label regulations. This means that 16 brands (66 %) had one or more violations. The most common infractions were the omission of feeding instructions or caloric content, improperly reported guaranteed analysis panels, and mislabeled ingredient statements. Nutrient analysis showed that all but one of the foods met AAFCO’s minimum crude protein requirements. However, six brands had deficient levels of one or more of the essential amino acids. This means that while the total amount of protein that the food contained appeared to be sufficient, essential amino acid requirements, which are more important, were not always met.

Presence of Animal-Based Ingredients: In a second study, the same group of researchers tested 14 brands of vegetarian pet foods (2). They purchased each food on two occasions to obtain samples as duplicates from different manufacturing batches. Six were dry and eight were canned products. Samples were analyzed for the presence of mammalian DNA using an accepted laboratory technique called multiplex polymerase chain reaction (PCR). Since all 24 foods were marketed as vegetarian (and in some cases, as vegan), none included animal-based components in their list of ingredients. Results: All six of the dry (extruded) foods that were tested contained DNA from beef, pork or sheep and five of the six contained DNA from multiple animal species. These results were consistent across batches for all 7 products.  Only one of the 8 canned vegetarian foods contained animal DNA (beef) and this finding was not repeated in the second sample. In this study, the researchers also tested for the DNA of dogs, cats, goats, deer, horses, rats, mice and rabbits. DNA from these species was not detected in any of the samples. Similar to earlier studies that have found the DNA of undeclared meats in dog foods, the amount of animal-based ingredients in the foods could not be quantified. The researchers could not speculate whether the labeling violations were a result of deliberate adulteration or unintentional cross-contamination of vegetarian products with meat-containing foods produced at the same facility.

soapbox

Soap Box Time: The Federal Food, Drug and Cosmetic Act requires that all pet foods sold in the United States are safe, produced under sanitary conditions, contain no harmful substances, and are truthfully labeled (emphasis mine). Perhaps I am being picky, but labeling a food as vegetarian and then not ensuring that the food indeed lacks the meat of cows, pigs and sheep, seems to qualify as not being truthful. (Some might even call it lying, I suppose). Not only are such egregious errors in violation of both FDA and AAFCO regulations, but they seriously impact the trust that dog owners have in pet food manufacturers. And rightly so.

To date, the majority of pet owners in the US continue to feed dry, extruded food. Of the dry-type vegetarian foods tested in this study, all of them, 100 % were, in fact, not vegetarian at all. This leads one to ponder about other products on the market and whether it is more the norm than the exception for dry dog foods that are sold as vegetarian to be nothing of the sort. While the authors note that this was a small number of products and so do not represent all vegetarian foods, the fact that all of the foods failed their DNA tests is alarming.

What can you do as a dog owner? Contact the manufacturer of your food and ask them how they verify the integrity of their products, specifically, the ingredients that they include in their foods. If they are not forthcoming and transparent with their response, find another producer who is. The good news is that the pressure that research studies such as these place on pet food companies and upon the industry as a whole will hopefully encourage increased transparency and improved regulatory oversight – something that we are apparently in dire need of.

Cited Studies:

  1. Kanakubo K, Fascetti AJ, Larsen JA. Assessment of protein and amino acid concentrations and labeling adequacy of commercial vegetarian diets formulated for dogs and cats. Journal of the American Veterinary Medical Association 2015; 247:385-392.
  2. Kanakubo, K, Fascetti AJ, Larsen JA. Determination of mammalian deoxyribonucleic acid (DNA) in commercial vegetarian and vegan diets for dogs and cats. Animal Physiology and Animal Nutrition 2016;  doi: 10.1111/jpn.12506.

 

How Reactive is Your…….Lysine?

I imagine that the word “reactive” caused most readers to think of this:

reactive dog

REACTIVE DOG

However, what we will actually be talking about is this:

Lysine-zwitterion-2D

LYSINE – AN ESSENTIAL AMINO ACID

Yeah, not quite so dramatic, I admit. However, the reality is that the amount of  reactive lysine present in your dog’s food is much more likely to have an impact on his health and wellness than is the somewhat lower risk of meeting Mr. Crabby Pants pictured above.

The reason? Well,  its all about the protein quality of commercial dog foods –  the good, the bad, and the reactive.

Reactive lysine: Lysine is one of the 10 essential amino acids (the building blocks of proteins) that must be provided in a dog’s diet. The term essential means that dogs cannot produce these amino acids endogenously (in the body) and so they must be supplied by the protein in the food. Of the essential amino acids, lysine is rather unique in that it has a reactive amino group (the blue H3N+ in the graphic above). This group hangs out into space waving its H+ around, which is ready and able to engage and link up with other molecules. And, just as with reactive dogs, these encounters do not always end well.

When food proteins are subjected to heat treatment and other processing conditions, some of this lysine binds to certain sugars and amino acids. When this occurs, the modified form of lysine is not available, meaning that the dog is unable to use the lysine, even after it has been digested and absorbed into the body. Some of the altered lysine may be modified further to produce compounds called “advanced Maillard compounds“. Maillard products are actually quite well-known to most people – they cause the browning of the toast that you eat for breakfast, on the onions that you caramelize, and form the grill lines on your hamburger.

Maillard-reaction-graphic-062912

JUST TO BE CLEAR

Reactive lysine in dog foods: Tasty toast aside, for dogs and commercial dog foods, measures of the amount of reactive lysine and Maillard compounds provide an indication of a food’s protein quality. This goes above and beyond digestibility (which we discussed in an earlier blog, “Scoopin’ for Science“), because the amount of reactive lysine reflects the actual nutritive value of the protein once it has been digested and absorbed into the body.

Processing damages protein: The heat treatment that is used to produce commercial dog foods has many benefits – it functions to improve a food’s overall digestibility, enhances shelf life, and assures food safety. However, heat and mechanical processing can also result in damage to the food’s protein. The good news is that the degree of this damage can be measured using laboratory procedures that analyze reactive (available) lysine (RL) and total lysine (TL). A ratio is then calculated between these two values (RL:TL). A high ratio value reflects more reactive lysine, less protein damage and higher quality protein. Conversely, a low value signifies greater loss of lysine during processing, more damage to the protein, and lower quality.

Cool, right? Well, yeah. Really cool. Because measuring reactive lysine ratios provides us (dog folks) with an indication of how processing such as canning, extrusion, rendering, and even dehydration or freeze-drying, might damage food protein and reduce the overall quality and nutritional value of a dog food.

Too bad this information is never reported by pet food companies. (To date, they are not required to report any measures of food digestibility or protein quality to their consumers).

Even though pet food manufacturers are not reporting these values, a group of scientists have been.

science-header

The Study: Researchers with the Animal Nutrition Group at Wageningen University in The Netherlands have been examining reactive lysine content and Maillard reaction products in a variety of commercial pet foods. In a recent paper, they collected 67 different brands of dog and cat foods, formulated for different life stages (1). Lysine levels were measured for each, and RL:TL ratios were calculated. The researchers also compared available lysine levels in the foods to the minimum lysine requirements reported by the current NRC Nutrient Requirements for Dog and Cats.

Results: A wide range of RL:TL ratios were reported, suggesting that protein damage in commercial foods is highly variable and may not be dependent simply on the type of processing that is used:

  • Processing type vs. ingredients: Overall, as reflected by the RL:TL ratio, canned foods had less protein damage than extruded foods, which had less damage (surprisingly) than pelleted foods.  However, the range of values within processing type was very high with the three types of foods showing a lot of overlap. This suggested that source and type of ingredients may matter as much as or even more than processing type.
  • Ingredients: Many of the ingredients that are used to produce pelleted and extruded foods are pre-treated with heat, drying and grinding. For extruded foods, this refers primarily to the production of meat meals (see “What’s the Deal with Meals” for a complete discussion of protein meals). It is speculated that this processing and how well it is (or is not) controlled is the most important determinant of changes in protein quality.
  • Meeting lysine requirements: Of the foods that were examined in this study, up to 23 percent of a product’s lysine could be damaged and made unavailable to the dog. When these losses were considered while accounting for expected protein/lysine digestibility, some of the foods were expected to be at risk to not meet the minimum lysine requirement for growing dogs.

The authors conclude: “Ingredients and pet foods should be characterized with respect to their reactive lysine content and digestibility, to avoid limitations in the lysine supply to growing dogs” I would add to this that these measures should be available in some form to consumers, as a measure of the protein quality of the food that they are considering buying.

Detractors might argue that RL:TL ratio is “too complex” for consumers to process and understand. I disagree. A simple classification chart, such as “poor, moderate, and high” quality could be derived from the range of reactive lysine values that are reported. Knowing this information, along with the type and source of ingredients, would allow owners to make meaningful quality distinctions among foods.

soapbox

DRAGGIN’ OUT THE OL’ BOX

I have argued elsewhere that pet food producers should be required to provide digestibility information about their products, when requested. This is not too much to ask, seeing that manufacturer’s claims of “Complete and Balanced” promotes the feeding of their products as the sole source of nutrition to our dogs.  And now, according to the results of research coming from Wageningen University, there are additional measures of protein quality that can differentiate among poor, adequate and superior foods.

It is time to ask for more of pet food manufacturers. Measuring digestibility and reactive lysine levels of foods and ingredients provide measures of product quality that are directly pertinent to nutritive value and to our dogs’ health. Here is your chance, as your dog’s advocate, to be a bit reactive (no – PROACTIVE) with your pet food manufacturer…… Politely request this information about the products that you are buying – let me know what you hear back!

Proactive and Reactive handwritten on whiteboard isolatedCited Study: van Rooijen C, Bosch G, van der Poel AFB, Wierenga PA, Alexander L, Hendriks WH. Reactive lysine content in commercially available pet foods. Journal of Nutritional Science 2104; 3:e35:1-6.

 

Dogs are Carnivores, Right?

There is a great deal of confusion (and opinion) today regarding how to classify the domestic dog. Those who identify dogs as carnivores (meat-eating) animals tend to focus on the predatory nature of the dog’s closest cousin, the wolf. Conversely, those who are inclined to classify the dog as an omnivore (consumes both plants and meat) rely upon the dog’s scavenging nature and ability to consume and digest a wide variety of food types. So, which is it? And, perhaps more importantly why does what we call the dog, carnivore or omnivore, seem to matter so much to us? (And why do discussions about this issue seem to quickly escalate into shrillness, name-calling and spamming?)

That Escalated Quickly

First, let’s all just calm down. From a scientific viewpoint, it appears that some confusion may arise from the dual use of the term “carnivore”. This term is used as both a taxonomic classification and as a description of a species’ feeding behavior and nutrient needs. Both dogs and cats are classified within the taxonomic order of “Carnivora”, a diverse group of mammals that includes over 280 different species.

Taxonomy

Some eat meat…..some don’t: While many of the species within Carnivora hunt and consume meat, not all are predatory or nutritionally carnivorous. The species within the order Carnivora vary considerably in the degree of dependency that they have upon a meat-based diet. For example, all of the cat species, including our domestic cat, Felis catus, are obligate carnivores. In contrast, bears and raccoons consume both plant and animal foods, while the Giant Panda subsists on a vegetarian diet. Therefore, while all of the species within the order called Carnivora can eat meat, their typical feeding behaviors exist along a broader spectrum, ranging from the obligate carnivores at one end to animals that are almost completely herbivorous at the other end.

So, where does the dog fall along this spectrum?

Cats vs Dogs: Let’s consider this question by comparing our two best animal friends, the dog and the cat. The label “obligate carnivore” (sometimes called true carnivore) means that the cat is incapable of surviving on a vegetarian diet and must have at least some meat (animal tissue) in its diet. This means that a diet that is composed of all plant materials cannot meet all of the cat’s essential nutrient needs. Specific nutrients that are problematic if Fluffy is fed a vegetarian diet include Vitamin A, a type of amino acid called taurine, and an essential fatty acid called arachidonic acid. All three of these nutrients are found in a form that cats can use in meat products and but are not found in plant foods. During evolution, cats either lost or never developed the ability to produce these nutrients in the body from the precursor forms that are found in plant foods.

The Adaptable Canine: In contrast, most of the canid species, including the domestic dog, are more generalist in their eating habits and subsequently in their nutrient needs. In the wild, wolves and coyotes exist as opportunistic predators, hunting and eating the type of prey that happens to be available. In addition to the flesh of their prey, wild canids readily consume viscera (stomach, intestines) which contain partially digested plant matter. Canid species also scavenge carrion and garbage and regularly consume fruits, berries, mushrooms, and a variety of other plant materials. Similar to its wild cousins, the domestic dog is a predatory species that also consumes plant foods and scavenges, and is capable of consuming and obtaining nutrition from a wide variety of food types.

Not only does the dog naturally choose a wider variety of foods to eat than do cats; the dog is capable of deriving needed nutrients from plant foods more efficiently than do cats. Let’s look at the three nutrients that we mentioned earlier; Vitamin A, taurine and arachidonic acid:Dogs vs cats

Finally, anatomically, dogs’ gastrointestinal tracts, from their mouths to their intestines, are consistent with other predatory species (i.e. meat-eating) that consume a varied diet. They have some ability to grind food (molars), and possess a small intestine that is longer in length (relative to body size) than that of obligate carnivores, but that is shorter in length than that of herbivorous species.

Altogether, the nutrient, metabolic, and anatomical characteristics of dogs place them on the omnivorous side of the spectrum within the wide range of species who hunt prey, scavenge, and consume plant foods

Carnivore Evidence

When we look at the evidence, we see that both nutritionally and taxonomically, the dog is best classified as an omnivore, an animal that consumes and derives nutrition from both animal and plant food sources. More specifically, the dog evolved from a species that made its living primarily through hunting and consuming prey but that also consumed whatever was available through scavenging. (Anyone who lives with a Golden Retriever is well acquainted with the scavenging part).

Time to drag out the box.

soapbox

UP ON MY BOX

So, why is it that we read multiple websites, listen to certain “experts”  and talk to Joe next door (who happens to know a lot about dogs) and they insist that the dog is an (obligate) carnivore? Why are some folks so incredibly (and one might venture, obsessively) invested in this belief? Not to put too fine a point on it, many proponents of the “dog as carnivore” hold on to this conviction like a dog with a meaty bone. One may wonder, why is this distinction even important, except perhaps for academic interest?

My own opinion is that the keen interest that we see in recent years is caused by an unusual and somewhat unprecedented focus on a desire to “feed dogs naturally.” Oddly enough, prior to the development of commercially prepared dog foods in the early 1900’s, domestic dogs were fed naturally – they were fed scraps of human food…..in other words, they scavenged. So, we appear to have come full circle, with the only difference being that the fervent adherence to a mantra of “feeding dogs naturally” now focuses on the dog’s hunting and meat-eating history rather than on its equally significant existence as a proficient scavenger.

dog at table

I’D LIKE SOME OF WHAT YOU ARE HAVING, PLEASE.

Do dogs thrive on diets that include animal-based ingredients (i.e. meat, poultry, fish) – Yes, definitely (and especially if those ingredients are of high quality). Do dogs enjoy (and probably prefer) meat in their diets. Probably. Do dogs have a nutritional requirement for animal-based ingredients in their diets? No, they do not.

EXCERPTED FROM: Dog Food Logic: Making Smart Decisions for Your Dog in an Age of Too Many Choices, by Linda P. Case (click below for purchasing in formation).

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Got Gullet?

Innovative dog chews and treats are all the rage these days. Despite the claims of their sellers, most of these products are new twists on an old theme – taking the parts of food animals that we typically discard as inedible waste and turning them into expensive and often highly sought after dog treats. A few examples are bully sticks, pig ears, pig/cow hooves, cod skins, and the topic of this essay, beef gullets (esophagus) and tracheae. In addition to coming in a dried form as a chew, the entire neck regions of beef, lamb, chicken, turkey and other food animals are also included in some commercial and homemade raw diets.

The Question Is: Are gullets and tracheae (necks) safe for dogs to consume?

Beef Gullet Twist  Beef Gullet Chew  Beef Gullet

The Answer: Not if the thyroid gland came along for the ride.

Thyroid Gland 2

Quick Anatomy Lesson: The thyroid gland is a small organ that wraps around the upper portion of an animal’s trachea (wind pipe). When a cow is dissected for the production of human-grade meat, the trachea and esophagus are removed together as by-products. Although a law passed in 1986 prohibits their inclusion in human foods, these animal parts can be used in pet foods, which is exactly where they end up (along with other animal by-products that are deemed not for human consumption).

Thyroid Tissue in Your Dog’s Food: Thyroid tissue contains the hormone thyroxine, which will not be destroyed by the dog’s gastric acid or digestive enzymes. It is absorbed into the body and remains active. If a dog consumes enough thyroxine from the diet, an elevation in circulating thyroid hormone occurs and the dog develops hyperthyroidism (or more technically correct, thyroidtoxicosis). Some dogs develop elevated serum thyroxine but do not show clinical signs. Others develop signs that include weight loss, hyperactivity, excessive panting, and polydipsia/polyuria (increased drinking/urinating).

So, is this a problem that owners should be concerned with? Possibly; especially if you are feeding a raw diet.  Here is the evidence:

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  • Twelve dogs fed raw diets: In 2012, German veterinarians at  Justus Liebig University reported elevated plasma thyroxine levels in dogs that were being fed either a raw diet or large amounts of fresh or dried beef gullet (1). Clinical signs of hyperthyroidism were reported in half of the dogs (6/12). Following diagnosis, seven owners immediately switched to a commercial dry food and stopped feeding gullet. Veterinary rechecks 2 weeks and 2 months later revealed that plasma thyroxine concentrations had returned to normal in all dogs and clinical signs had resolved. One owner did not change her dog’s diet. Repeated thyroid hormone tests showed elevated levels one and four months following diagnosis and the dog was experiencing chronic weight loss. At that point, the owner switched the dog to another food, clinical signs resolved and plasma thyroxine levels returned to normal.
  • Two more cases: Two cases were reported in 2014. In the first, an 11-month-old male Rottweiler was examined for signs of weight loss, excessive panting and increased blood thyroxine levels (2).  A complete diet history revealed that the dog was being fed a commercial raw diet. After switching the dog to a commercial dry food, signs resolved and blood thyroxine levels returned to normal. In a second case study, a two-year-old female Miniature Pinscher was examined for a failure to come into estrus (3). The dog was fed a homemade raw diet that included beef cuts from the head and neck region purchased from a local butcher shop. The dog had highly elevated serum thyroxine levels.  Changing the dog’s diet led to normalization of serum thyroxine and normal estrus cycles.
  • Raw foods and chews: Most recently, a study published in the Journal of the American Veterinary Medical Association reported findings of thyrotoxicosis in 14 dogs fed either a commercial raw diet or a variety of different chews or treats (4). All of the treats were some type of sliced or rolled jerky chew. Clinical signs resolved and thyroid hormone levels were normalized within four weeks of discontinuing the suspect products. The authors were able to obtain seven samples of the brands of food or treats that owners were feeding. When tested, all had elevated thyroxine levels when compared with control foods. The authors end with this statement: “The presence of high T4 concentrations in a variety of pet foods or treats sold under different labels suggests that the problem of thyroid tissue contamination of such items may be widespread and not confined to only a few products or manufacturers.”  (The authors also sent samples and identifying information about the products to the FDA for further investigation).

Take Away for Dog Folks: Okay, before raw feeders start flooding my blog with hate mail and sending in the trolls, let me state up front that these research results are by no means presented as a personal vendetta against feeding raw. 

No Trolls

NO TROLLS PLEASE

Those of you who have read Dog Food Logic know that my position is that there are many approaches to feeding dogs healthfully, and a well-balanced, properly selected (and sourced) raw diet can be one of those approaches.

However, the evidence strongly suggests that the recent increase in diet-induced hyperthyroidism is likely a result of the increased popularity of both raw diets and of feeding unusual types of chews such as gullets and tracheae to dogs. At the very least, this set of case studies provides sufficient evidence that diet-induced hyperthyroidism is a health risk that warrants further study and investigation of the identified companies and brands.

soapbox

UP ON MY SOAPBOX

Draggin’ out the ol’ box: Fear not. I do have a personal opinion on this matter (though I would be hesitant to go so far [yet] as to call it a vendetta). This has to do with data reported in the 2015 study, which were collected in the United States. In that study, all 14 of the dogs were being fed commercially prepared foods at the time of diagnosis. These were foods that the owners purchased from a company, trusting that the products would not only provide good nutrition to their dogs, but that they were SAFE. This should not be such a high bar to clear, yet it repeatedly seems to be for the pet food industry.

Here’s the thing: The knowledge that the presence of animal thyroid tissue in foods can cause hyperthyroidism is not new information. Outbreaks of diet-induced hyperthyroidism in people are well-documented and are the reason that “gullet trimming” as a source of ground beef was outlawed in the 1980’s. Yet, these tissues are still allowed in the foods that we feed to our companion animals. Why is this?

I maintain that pet owners should be able to easily discover exactly what is in the pet foods they feed to their dogs, including the source and quality of the product’s protein ingredients.  Yet this information is rarely provided and requests are often ignored, denied or responded to with evasive platitudes and assurances. Here’s a suggestion – Ask your pet food manufacturer if the food that you feed contains animal necks and if they guarantee that it does not contain thyroid tissue. Let me know what you hear back.

Request Denied

In a perfect world (and when I am queen), we will ban the inclusion of unsafe body parts in the foods that we feed to our canine family members. I know it is an outrageous suggestion, but a person can dream, cant’ she?

Got Gullet? Let’s hope not.

Cited References:

  1. Kohler B, Stengel C, Neiger R. Dietary hyperthyroidism in dogs. Journal of Small Animal Practice 2012; 523:182-184.
  2. Cornelissen S, De Roover K, Paepe D, Hesta M, Van der Meulen E, Daminet S. Dietary hyperthyroidism in a Rottweiler. Vlaams Diergeneeskundig Tijdschrift 2014; 83:306-311.
  3. Sontas BH, Schwendenwein I, Schafer-Somi S. Primary anestrus due to dietary hyperthyroidism in a Miniature Pinscher bitch. Canadian Veterinary Journal 2014; 55:781-785.
  4. Broome MR, Peterson ME, Kemppainen RJ, Parker VJ, Richter KP. Exogenous thyrotoxicosis in dogs attributable to consumption of all-meat commercial dog food or treats containing excessive thyroid hormone: 14 cases (2008-2013). Journal of the American Animal Hospital Association 2015; 246:105-111.

Excerpted from: “Only Have Eyes for Your: Exploring Canine Research with the Science Dog” (2016).

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