I recently interviewed a board-certified veterinary nutritionist. She shared all of her advice on what we should be feeding dogs with cancer. She provided a wealth of information and resources over the hour-long interview. For the purposes of this article, I will share the top five tips that you can focus on as a dog owner.
If you have questions, as usual, please reach out. Or better yet, consider either an in-person or remote consultation with a board-certified veterinary nutritionist!
Alright, so first things first. What is a veterinary nutritionist? Well, just like a veterinary oncologist, they are specialists (experts) in the field of veterinary nutrition. They have completed four years of veterinary school, a one-year rotating internship, then either a two or three year residency in veterinary nutrition. They have also passed rigorous board certification exams.
How do you know if someone is a veterinary nutritionist? This is important. Not everyone giving nutrition advice is a board-certified nutritionist.
It's easy to know if a vet is a board certified nutritionist or not. Board certified veterinary nutritionists will have the letters DACVN after their "veterinary letters" (which are usually DVM or VMD). DACVN stands for Diplomate of the American College of Veterinary Nutrition. Here's an example of a veterinary nutritionist: Lauren Foster, DVM, DACVN.
You can look for those letters when trying to determine if someone is a boarded nutritionist or not.
Okay - let's get to the tips!
1. It's important that we don't make dietary changes immediately after a cancer diagnosis simply because we feel that we have to "do something". Make sure that you are following nutritionist-backed advice.
Most nutritionists would feel that if you are already feeding a complete and balanced diet from a reputable manufacturer, formulated for the specific life stage of your dog (ex. adult maintenance) and your dog is an appropriate body condition (not over or underweight), we probably would not have to make any changes. Just because we have a diagnosis of cancer doesn't mean we have to make any drastic changes in the way that we're feeding.
Similarly, as an oncologist, we actually do not want any abrupt dietary changes just before surgery or a new medication or treatment. Often, abrupt dietary changes can lead to soft stool or diarrhea, which can cause dehydration. If a patient develops soft stool and they've just started chemo AND they've had a diet change, it becomes very challenging to figure out the inciting cause. A diet change should be done slowly over the course of two weeks, with the approval of a veterinarian.
The easiest way to feed a complete and balanced diet is to feed a commercial diet. This could be a dry or canned diet or a combination of the two. It should be from a reputable manufacturer and specifically state that it is complete and balanced - look for AAFCO certification on the label.
If you prefer to home cook you can still achieve a complete and balanced diet, it just takes more time and effort in terms of food preparation. It's also very important that the diet is formulated by a board certified veterinary nutritionist. Shockingly, 95% of home cooked recipes available online (even those formulated by veterinarians) have been shown to have at least one essential nutrient deficiency.
2. A dog with cancer has the same nutritional needs as a dog without cancer.
This means that regardless of their diagnosis, we still have to meet all of their essential vitamin, mineral and nutrient needs. However, two dogs with cancer (just like any two dogs) are not going to have exactly the same recommendations, because every dog is different (different body weight, different size, perhaps different lab work or kidney function etc).
3. Should we avoid carbohydrates in the diet?
A low carbohydrate diet traditionally means that carbohydrates are providing less than 20% of total daily caloric intake. The low carbohydrate diet was created based on the way cancer cells metabolize nutrients compared to a normal healthy cell. Cancer cells derive most of their energy from glycolysis (breaks glucose --> lactic acid), which requires a lot of glucose. In theory, if we provide a low glucose diet, we can starve the cancer cells of their main energy source so they become stressed and damaged, while the host (dog) can use other sources of energy aside from carbohydrate (fat, protein).
Despite the theory, we don't have any published data showing that feeding a low carbohydrate diet to a dog will provide any clinical benefit (help them live longer, help their cancer slow down). That being said, there is probably little harm in feeding a low carbohydrate diet to most dogs (never make a diet change without asking your care provider if it is safe for your dog).
However, since low carbohydrate diets are usually high in fat, dogs that would NOT be good candidates for this type of diet would be those that have a history of pancreatitis, are over weight or obese, those that have hyperlipidemia, and those that experience gastrointestinal upset from diet changes.
The most responsible way to give your dog a low carbohydrate diet is under the guidance of a board-certified veterinary nutritionist. Please never make any diet changes without consulting your veterinarian (or oncologist if you have one).
Be certain to choose supplements based on published efficacy in the literature.
Manufacturers can make almost any claim, but none have to be true. This is a very unregulated industry, and it's important to remember that these are not necessarily benign treatments.
Please consult your veterinarian (or oncologist if you have one) prior to beginning a new supplement or herb.
If you begin a supplement and your dog develops soft stool, lethargy, or decreased appetite, please stop it immediately and alert your vet/oncologist.
You can search the Integrative Medicine section of the Memorial Sloan Kettering website.
This is helpful to uncover herb-drug interactions and possible contraindications and side effects. Note that this information is based on studies in people, so it will not uncover every possible side effect or contraindication for veterinary patients.
5. Reasons to Consult with A Veterinary Nutritionist
-You want to make sure you are feeding the "best" in terms of nutritional needs
-Your dog won't accept a commercial diet
-Your dog has multiple conditions; a commercial diet doesn't exist to meet all dietary needs
-You want to home cook but understand that 95% of home cooked diets online (even those formulated by veterinarians) are incomplete/unbalanced and can lead to malnutrition
Normally, when a nutritionist formulates a home cooked diet, there will be an added vitamin & mineral mix to ensure that the formulation is complete and balanced. A whole food diet (without a mineral mix) is unlikely to be balanced and complete.
How To Find A Veterinary Nutritionist:
A board certified veterinary nutritionist has completed veterinary school, a one-year medical/surgical internship, followed by a 2-3 year nutrition residency.
You can either have a in person consultation with a nutritionist or a remote consult (the website will let you know which nutritionists offer remote consults, meaning that you don't have to come in person).
For a remote consult, your regular vet would share records, lab tests, and fill out an extensive history.
A nutritionist can make homemade diet formulations, commercial diet recommendations, etc.
What if you are interested in having a home-cooked diet but not doing the work yourself?
Nom Nom will deliver fresh whole food each week to your door. These diets are complete and balanced and actually exceed AAFCO certification standards. The recipes were developed by Dr. Justin Shmalberg, a board-certified veterinary nutritionist.
Similarly, Just Food For Dogs has nutritionists on staff and can be ordered online; it is also available at certain pet stores. A prescription is needed. These diets are also complete and balanced and can be shipped to your home.
I hope you found this article helpful! Excellent nutrition is extremely. Board certified veterinary nutritionists are extremely under-utilized specialists - reach out and request a consult with a nutritionist if you have additional nutrition questions. They are a wealth of nutrition knowledge!
Dr. Lori Cesario
Board Certified Veterinary Oncologist
PS: I'm happy to now offer online oncology consultations. Learn more about how this service can help by visiting the Vet Cancer Consultants site.
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