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

Happy New Year from The Science Dog! (The 2017 Pet Blogger Challenge)

Happy New Year from The Science Dog!

To start the year off, I am participating for the first time in The Pet Blogger Challenge that is organized by the travel site, Go Pet Friendly. Many thanks to my friend Eileen Anderson for alerting me to this annual event. Below are this year’s queries and my responses. I hope you enjoy learning a bit more about The Science Dog!

  1. When did you start your blog and, for anyone who is just seeing it for first time, please provide a description of your site. Would you say your blog focuses more on sharing stories with your readers, or providing a resource for your audience? Answer: I created The Science Dog in September of 2013, shortly before the publication of my fifth book, “Dog Food Logic“. The purpose of The Science Dog is to provide up-to-date, evidence-based information to dog folks and pet professionals about dog training, behavior and nutrition. My focus is primarily on original scientific research that has been published in peer-reviewed journals. I try to find studies whose results are relevant to trainers and dog owners and then summarize these in what I hope is a “user-friendly” style. Oh, and yeah, sometimes I editorialize a bit.

    soapbox

    GETTIN’ UP ON THE OL’ BOX

  2. What was your proudest blogging moment of 2016? Answer: I published the second Science Dog book in July of 2016, entitled “Only Have Eyes for You“. Both writing and promoting it has been a lot of fun! My husband Mike designed the cover for the book (as he did for “Beware the Straw Man“), and I was especially tickled that he used a photo of four of our dogs, posed in our garden. The oldest girl, Cadie, has since passed away, so this photo is very near and dear to my heart.

    Cadie Chip Vinny Cooper May 2013

    CHIPPY, VINNY, CADIE AND COOPER

  3. Which of your blog posts was your favorite this year and why? (Please include a link.) Answer: I enjoyed writing all of the posts, especially the nutrition essays, as I had focused the first two years of the blog on topics related to behavior and training. In 2015, I started to include more essays about nutrition and feeding practices. However, my personal favorite of 2016 has to be “The Perfect Dog“, because it reviews two recent papers that provide some insight into the gap between what people think a dog should be versus who dogs actually are (and also, to some degree, places the responsibility for this exactly where it lies).       Unrealistic Expectations
  4. Year after year, one goal that we all seem to share is that we want to reach more people. What one tool did you use or action did you take this year that had the most impact on increasing traffic to your blog? Answer: I use FaceBook quite a bit, and have a FB Science Dog page that gives dog folks access to the blog and allows readers to chat and to contact me directly. I love to hear from readers, especially when they have ideas for new science-based topics for the blog! (hint-hint).
  5. Which of your blog posts got the most traffic this year? (Please include a link.) Have you noticed any themes across your most popular posts? Answer: The essay that received the largest number of hits (~ 18,000) was “When Sit Doesn’t Mean S*it“. Catchy  little title aside, I think that it resonated with shelter professionals because it presents a set of research studies conducted by Alexandra Protopopova’s team that both challenged a prevailing belief about training and adoption rates and presented some unique solutions that may be more effective as predictors of dogs’ chances for adoption.   Sit Ubu
  6. What blog do you find most inspirational and how has it influenced your blog? (Please include a link.) Answer: There are a number of dog-related blogs that I follow regularly and enjoy. Two that are among the best are Eileen Anderson’s not-to-be-missed essays about dog training at EileenandDogs and Julie Hecht’s excellent research summaries at Dog Spies.
  7. What is one thing your readers don’t know about you or your pets that would surprise them? Answer: What my readers may not know (but all of my friends do) is that while I hold a Masters Degree in Canine/Feline Nutrition, I cannot cook a human food meal to save my life. I started volunteering two years ago at our local soup kitchen, The Daily Bread, and the other volunteers quickly learned this little secret. I am now a designated dish-washer and happily report that I excel at that particular task, keeping everyone safe (and well fed).

    daily-bread-people-2

    SUPPORT YOUR LOCAL SOUP KITCHEN! 

  8. What is something you’ve learned this year that could help other bloggers? Answer: Not to point any political fingers (interpret this as you like), but my advice to other writers (and citizens) is: Don’t lie and stick to the facts that have evidence to support them.    just-the-facts-maam-2
  9. What would you like to accomplish on your blog in 2017? Answer: The biggest challenge that I may have in 2017 is finding enough time to work on all of the writing and dog training projects that I am excited about. I am currently writing a new dog training book that presents evidence-based training and the applications that we use at our training school, AutumnGold, plus developing a few new training courses with several of AutumnGold’s instructors and writing essays for The Science Dog (many of which will appear, in some form, in the new book). Add in training and enjoying time with my own dogs, and it looks like it will be a busy and fun year!

    Cooper and Alice Standing Platforms

    PLATFORM TRAINING AT AUTUMNGOLD!

  10. Now it’s your turn! You have the attention of the pet blogging community – is there a question you’d like answered, or an aspect of your blog that you’d like input on? Answer: Thanks to GoPetFriendly for sponsoring this blog challenge and hop! This is a Blog Hop!

“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

Want Flies with that Shake?

Fries with Shake Mod

Well, not actually you, but rather your dog.

Before food purists get up in arms over  this topic, consider that numerous human cultures have historically viewed insects as acceptable and even highly desirable food items. And today, our ever-expanding human population and the increasing need for sustainable sources of food have led to increased consideration of insects as food in almost all human cultures.

Insects for Dinner

So, it’s not much of a jump to ask – what might this mean for feeding dogs?

It’s all about the protein: Protein is the most expensive nutrient in the diet of all animals, including humans. It is expensive both in terms of the monetary cost of its production and its ecological impact upon the environment. In the spirit of sustainability (a buzzword that pet food companies and other corporations love to trot out) and with the goal of reduced production costs (i.e. making foods more cheaply), pet nutritionists at The Nutro Company recently identified a number of potential alternative protein ingredients for dog and cat foods. Bugs, being plentiful, cheap, and protein-replete are included on that list.

And protein is all about amino acids: Although we talk about a dog’s protein requirement and about a food’s protein level or quality, the actual requirement that dogs and all animals have is for the essential amino acids (the building blocks of the dietary protein) and the nitrogen that dietary protein supplies. The reason that the parlance of nutrition centers on dietary protein is simply because foods contain protein, not individual amino acids. It is during the process of digestion that a food’s protein is broken down in the small intestine into its component amino acids, which are then absorbed into the body. So, at the level of an animal’s metabolic needs, it is the amino acids that actually count. This is why one of the first steps that nutritionists take when examining a potential protein-containing ingredient is to examine its amino acid composition.

So, can insect protein supply all of the essential amino acids that dogs require? The nutritionists at Nutro and at the University of California at Davis decided to find out (1).

The Study: A wide variety of different plant, algae and insect species were identified as potential alternative (and sustainable) protein sources for pet foods. Within the group of insects, the researchers focused on the adult and larval forms of various species of flies, cockroaches, and ants.

Cockroach      Ants                    COCKROACHES                                                           ANTS        

 

           Blowfly adult         Blowfly larvae                          FLY (ADULT)                                                     FLY LARVAE

All of the bug samples were analyzed for total protein and amino acid content. (I will spare you the details regarding sample acquisition and preparation in case you are reading this during your lunch hour). Amino acid analysis included measurement of the 10 essential amino acids plus taurine, a special type of amino acid that is found primarily in animal tissues. Many readers are probably familiar with taurine as an essential dietary nutrient for cats. Because there is evidence that taurine may be needed during periods of physiological stress in some dogs, it has recently been classified as a “conditional essential amino acid” for dogs as well. Because sources of taurine are limited, it is an important essential nutrient to measure when considering new ingredients for dog and cat foods.

Results: Larval and adult forms of five different insect species were analysed. Here are their primary findings:

  • High in protein: Total protein levels in all of the insect species were quite high. When reported on a dry matter basis, concentrations ranged between from 46 % in Black Soldier Fly larvae to 96 % in cockroaches. (Cockroaches? Who knew?).
  • Bugs can do it: All but one species of insect (Black Soldier Fly larvae) were found to contain sufficient concentrations of protein, essential amino acids, and taurine to meet or exceed the NRC requirements for growth for dogs and cats. The finding for taurine was rather surprising because it has been previously assumed that rich sources of taurine included only skeletal muscle and organ meats.
  • Ants and flies are best: Two groups of insects, ants and adult flesh flies, contained the most concentrated sources of taurine. However, these initial results suggest that all three of the groups that were studied – ants, cockroaches, and flies – may be nutritionally acceptable protein sources for dog and cat diets.

Take Away for Dog Folks

Dogs and cats (like humans) require nutrients in their diet, not ingredients. Therefore, if a particular protein ingredient can supply most or all of the dog’s essential amino acids, is nutritious when fed, and is safe and palatable, then it technically meets the criteria (ick factor aside) to be considered as a potential dietary ingredient. Having passed the first test of adequate protein and amino acid content, where do insects fall on these other criteria?

  • Nutritious when fed: This refers to how digestible and bioavailable the essential nutrients of the ingredient actually are, when fed to the dog. For example, some insects and plants contain anti-nutritional factors, compounds that interfere with the ability to digest or use certain nutrients. Some of these compounds can be toxic or so potent as to cause illness, making their presence a clear “no-fly zone” for pets (pun intended).
  • Safety: Many species of bugs have ways to protect themselves from becoming someone’s meal. They produce toxins that cause illness or consume plants whose by-products are toxic to animals. They may also just taste really, really nasty. Clearly, toxic bugs are out.
  • Acceptability: Living with four dogs, one of whom is a notorious poop-eater, I would venture that the acceptability issue is as much about the human side of the equation than it is the dog side. Still, dogs must not just accept a bug-flavored food, they must relish it.
Dogs Watching Eating 2

THE BOYS WATCH MIKEY AS HE TRIES THE LARVAE-FLAVORED CHOW

Will owners accept it? Might Cockroach Recipe for Seniors or Fly Formula for Active Dogs be a hard sell? My (gut) instinct is to say yes, especially in the US. We all project our own preferences and desires onto our dogs – it is our nature to do so. This is why dog foods that depict entire roasted chickens and sirloin steaks on their front panels sell so well (however misleading such graphics may actually be).

Still, seeing that there is a booming market for dog foods containing alligator meat, brushtail (Australian Possum), and Unagi (freshwater eel), along with treats made from dried bull penises, pig hooves and cow tracheas, one must admit that the bar is already set pretty low. Will insect dog food be next up?

Cited Study: McCuster S, Buff PR, Yu Z, Fascetti AJ. Amino acid content of selected plant, algae and insect species: A search for alternative protein sources for use in pet foods. Journal of Nutritional Science 2014;3:e39;1-5.

 

 

 

 

 

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.

 

Dog Food Marketing – Science Weighs In

Marketing researchers know a lot about advertising strategies that successfully increase sales. This is no less true for pet foods than it is for any other consumer goods. Some of the more obvious approaches to attracting dog owners to a particular brand are advertisements that appeal to our emotional attachment to dogs, capitalize on our desire for expert approval, or that exploit our fascination with the lives of celebrities.

Appeal to Emotion 3    Appeal to Authority 1

                    APPEAL TO EMOTIONS                                             APPEAL TO AUTHORITY

 

Appeal to Celebrity

APPEAL TO CELEBRITY

One of my personal favorites of the “I love celebrities” category is an ingenious brand of Nestle’-Purina’s in which the celebrity to whom the product refers, supposedly a famous chef, does not, um, actually exist…….

Chef Michael

The Ad: It’s not just dog food. It’s Chef Michael’s. Crafted with great care, attention to detail and inspiration from our executive chef”

The Disclaimer: In the spirit of full disclosure (and to avoid litigation), the company provides the following response to inquiries about the whereabouts of the personage who is Chef Michael: “Chef Michael is not a real person, but a reflection of the many people inspired to make mealtime special for their dogs”.  I dunno. I think I would still like to get the guy’s autograph.

So, pick your poison – there is a dog food advertising campaign out there designed to appeal to just about every dog owner demographic. And, even though each and every one of us will insist that these schemes do not work on us (and that we select a dog food based solely upon its nutrient content, ingredient quality and suitability for our dog, thank you very much), these campaigns do indeed work very well.

Marketing’s Holy Grail: One category of advertising claims that has been shown to work particularly well, increasing human and pet food sales more than any other, are health claims. Because of the cumulative effects of a series of three laws that were passed in the 1990’s, the regulatory oversight of health claims on foods has been drastically curtailed over the last 35 years. Over time, the loss of regulatory oversight over health claims in human foods has led to labels that look like this:

Health Claims Human Foods

Dog foods quickly followed suit.  And pet foods are no different. As it stands today, pet food companies may include general health claims on their labels with no legal obligation to substantiate those claims. In other words, they neither have to prove the claim nor provide any evidence supporting the claim to any regulatory agency. Marketers must simply word their brand name or advertisement carefully enough to prevent the FDA from considering it a drug claim (which are regulated).

The difference between a general health claim (allowed and no proof needed) and a drug claim (not allowed; regulated by FDA) for pet foods turns on just a few words and phrases, as shown in the table below from Dog Food Logic.

Claims Table

TABLE EXCERPTED FROM “DOG FOOD LOGIC“, by Linda P. Case, page 175

Here are a few product examples:

Skin Coat 3                 Skin Coat 5            Skin Coat 7                        Skin Coat 8

Might these health claims be confusing to pet owners? A recent study asked exactly that question. 

The Study: A group of researchers at Tufts University’s Cummings School of Veterinary Medicine examined the nutrient profiles and ingredients list of 24 brands of dog food that all were marketed for skin and coat health (1). The objective of their study was to identify consistencies (or inconsistencies) among different commercial products making claims of promoting skin and coat health in dogs.

Results: They examined 15 dry (extruded) foods and 9 canned foods, representing 11 different brand names. Here are their results:

  • Its all in the name: All 24 products included the terms skin, coat plus a descriptor of skin/coat health in their brand name. They also included additional health-related terms on their labels and on websites. The most commonly used were sensitive, skin sensitivities, digestive sensitivity, digestive health, and limited/unique ingredients.
  • Ingredients: If you had thought there would be a handful of specific ingredients that are known to be beneficial to skin and coat, think again. The protein sources in the 24 foods were all over the map and included chicken, fish, egg, venison, beef, pork, duck, lamb, soy, peas, and turkey. A similar cornucopia was found for carbohydrate sources, with rice, potato, wheat, oats,  barley,  millet, corn, quinoa and tapioca all making an appearance.
  • Not so special fatty acids: Thirteen of the 24 foods (54 %) identified fatty acids as nutrients that are important for skin and coat health. While this may be true for certain specific omega-6 and omega-3 fatty acids (and their ratios), 10 of the 13 foods did not identify these by name but instead used vague (and meaningless) terms such as “omega fatty acids” or “omega oils”. Less than a third of the foods provided information about the amount of any specific fatty acid in the food. When this information was provided, the range in EPA and DHA (two important omega-3 fatty acids) concentrations overlapped with those found in foods not labeled for skin/coat health.
  • More nothin’ special: The essential nutrient content and caloric density (number of calories per cup) of the 24 foods varied enormously and overlapped with other brands that are sold for adult dogs but which are not specifically marketed for skin health. (In other words, not to put too fine a point on it, there was nothing that was consistently special or unique about the nutrient content of these foods. Even omega-3 fatty acid concentrations were all over the map, making the claims of “Source of Omega-3 Fatty Acids” essentially useless to consumers).

Conclusions: The researchers were rather circumspect in their conclusions, stating that the wide variety of ingredients and large range in nutritional value of products marketed for skin and coat health make product selection for owners who are interested in these foods confusing. (Personally, I go further than “confusing”).

 

soapbox

OUT COMES THE OL’ BOX….

Up on My Soapbox: I could be wrong, but I rather doubt that a concerned owner, whose dog is experiencing skin or coat problems and who sees a food that is specifically labeled “Sensitive Skin“, stops and ponders: “Well, the company does not actually state outright that this food cures sensitive skin problems. Nor do they say that they have proven that the food supports healthy skin. Therefore, I know better than to expect this food to do much of anything at all to help my dog”.

I may be going out on a limb here, but I believe this owner is much more likely to be thinking “Oh, look! A food that is designed to help Muffin’s sensitive and itchy skin! I will give it a try because poor Muffin’s skin has been terribly bad lately. I bet this food can help her!”. Ka-ching. Another day, another unregulated and misleading pet food claim, another sale. Poor Muffin.

Take Away for Dog Folks: If your dog is continually or excessively itchy or has skin problems, please make a visit to your veterinarian, not to your local pet supply store. It is important to obtain an accurate diagnosis for skin problems because the majority of these are not related to food. Rather, the most common causes of excessively itchiness in dogs are allergies to environmental allergens such as house dust mites, pollens and molds or fleas. Only after these causes have been eliminated should food be looked at as a potential underlying cause. (Note – The diagnosis of food allergy can only be made through the use of an 8 to 10 week elimination feeding trial, which is a topic for another blog at another time).

(By the way, if you find Chef Michael, get an autograph for me).

Cited Reference: Johnson LN, Heintze CR, Linder DE, Freeman LM. Evaluation of marketing claims, ingredients, and nutrient profiles of over-the-counter diets marketed for skin and coat health of dogs. Journal of the American Veterinary Medical Association 2015; 246:1334-1338.

 

 

 

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:

science-header

  • 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).

coversnip