Tuesdays with Shlomo

Nutrition with Dr. Katy Miller

Dr. Shlomo Freiman
November 7, 2023

When Hippocrates said, “Let thy food be thy medicine and medicine be thy food,” around 400 B.C., he probably didn’t have dog food in mind. However, his wisdom applies to pets just as much as its intended audience. Pet parents are more concerned than ever with their pets’ diet, and rightfully so. Diet is a major determinant of overall health.

Just like staying current on your pet’s labs and coming up with a good preventative medicine plan for them, ensuring proper nutrition is extremely important to having a healthy, happy pet. But how do you do that when the “right” diet seems to change every day? Do they need raw food? Do they need a grain-free diet? What about prescription diets? With so many new approaches to pet nutrition, it can be hard to understand what will work for your pet.

To help unravel the intricacies of the ideal pet diet, the usual Tuesdays with Shlomo duo — Dr. Shlomo Freiman and Tobias Coughlin-Bogue — brought in an actual expert: Dr. Katy Miller, who served as the Director of Dog and Cat Health and Nutrition for Mud Bay for 11 years before going into consulting for the pet food industry. In this episode, Drs. Freiman and Miller lay out in clear, easy-to-understand terms the best approach to diet and nutrition for pets. As they say, there’s no one-size-fits-all solution, but rather an individual approach for each pet. In this conversation, they give pet parents the framework to find the right one.

Dr. Shlomo Freiman: So today we’re talking about nutrition, something you have a very informed perspective on. What do you think is the number one nutritional problem that we see in pets?

Dr. Katy Miller: Hands down, it would be obesity. Humans equate food with love, and we’re “over-loving” our pets. So I think the most common thing we see in any veterinary clinic is going to be pets that have a little too much weight on them.

Tobias Coughlin-Bogue: What are some of the best ways to combat obesity?

Well, one of the best ways is to start the process of keeping them at a lean body condition early, when they are a puppy or a kitten. You should work with your vet and figure out exactly how much they should be eating and then measure it out. Measuring their meals is really important. It’s also important to be really honest with yourself and your vet about how much you’re feeding, including treats and anything extra in the diet. Your veterinarian needs to know that so that they can properly calculate the right amount of food for your pet. Beyond that, it helps to keep them active and make sure they get plenty of exercise. Both dogs and cats need to get plenty of exercise.

SF: I don’t know if you read the book The Omnivore’s Dilemma by Michael Pollan, but I went to a lecture with him a couple of years ago. He was not talking about animals, of course, he was talking about people, but he has that point about how, if you want to cut down your caloric intake, the first thing you need to do is get plates that are smaller. I think a lot of it also applies to the way we feed our pets. I think it’s very hard for people to adjust size. They just look at the bowl and it looks so small. Of course, we love our pets and this is our love language and so on and so forth. So I think that is big part of it that people need to work on, too.

Yeah and I think it’s key to realize that what looks little to us can be really highly packed with nutrition for them. Especially in today’s market, we have really highly energy-dense diets, so they just need less of their food. One of the things that I like to also emphasize is adding moisture to the diet. It’s a way that you can also kind of reduce the calorie content and increase the portion, feeding things like wet foods, fresh foods, and foods that have a really high moisture content.

TCB: So, to Dr. Shlomo’s point about plates, I’ve always been curious about the bowls with the giant bump in the middle. My dad feeds his two Bernese out of those. Is it basically the dog equivalent of a smaller plate?

Yeah, it makes it a tiny plate. The idea behind it is to slow them down so they can’t eat as fast. They’re called slow feeders, or they can be called a “puzzle” feeder. Either way, they’ve got little things inside the bowl, or you can put a big ball inside the bowl in the middle of it. And because they have to move the ball around to get to the food, or if there’s something in the middle, an object in the middle that they have to work around to get the food, it slows them down so they’re not wolfing down that food real fast. If we think about the way that especially dogs evolved eating, they’re in competition with everybody else that’s trying to consume that same food. And so they tend to eat a lot really fast, and that’s just natural for them. Getting them to eat slower can help with things like gulping air and vomiting issues from eating too fast.

SF: Let me move on here. The next question is one of the most common questions I get from clients: What brand should I get? Does brand matter? Is there a brand that you recommend?

First off, there’s so many brands out there that are really good. There’s very few brands that I would say are not great to feed your pet. While most brands are reputable, it just helps to check for a few key pieces of information. Part of it is knowing what your individual dog or cat needs, but in general you want to look for brands that are made by a nutritional scientist or formulated by a board-certified nutritionist. You want good sourcing of ingredients, good manufacturing practices, good testing to make sure there’s no microbial contamination. You want to look and make sure that your brand does all that

.Beyond that, there are a few other things to look at. What kind of formulas do they have? Do they have a formula that’s a good fit for your pet? If there’s several brands that do that, then you also get to look at things like whether they use sustainable farming practices, whether they have recyclable packaging, and things that are kind of more important to the human than they are to the pet.

SF: Can you explain food rotation for both dogs and cats a bit? What is it and what’s your take on it?

I think food rotation is extremely important with any pet because most pet foods are kind of like a static formula. Pet food makers work really hard to try to keep everything the same. While we know what keeps dogs and cats alive, we don’t necessarily know what’s optimum for them as far as the nutrients go. And so when we change formulas, you get a different nutrient profile. It’s still complete and balanced, but it’s different. So you can make up for any slight little nutritional deficiencies or excesses by changing to different formulas. We are also learning a lot about allergies. If we think about people and the peanut allergies, we used to keep young children away from peanuts because we were worried that they were going to have an allergic reaction to peanuts. We’ve actually made the peanut allergy worse in the world because we keep children away from peanuts when they’re young, but that’s when they’re actually supposed to be exposed to different things so that they don’t have allergic reactions to them. The same logic applies for pet food. When they’re puppies and they’re kittens, exposing them to different proteins, different formulas, different ingredients makes their immune system more well-rounded. So as they get older, they’re not going to have as many intolerances or allergies to things that they may be exposed to later in life.

SF: Do you do a gradual transition between foods or switch just cold turkey?

No, usually we do a gradual transition. With cats it’s easier to rotate, as you can switch between cans of wet food; there are so many wet food formulas out there. With dogs, I try to give them five to seven days to transition between foods. So you want to get your new food about a week before you run out and then mix it in over that week. The more the pets get used to rotation, the easier that transition usually is for them. Another thing you can do is if your dog has problems with transitions, you can add digestive enzymes. The body only makes certain amounts of digestive enzymes, so if it’s a bigger change in formula, you may need to add some digestive enzymes. Or you can take two to three weeks to transition so it’s more gradual and the body can start to make its own digestive enzymes to keep up. But in general, I recommend rotating between foods with a pretty similar guaranteed analysis, which is what we call their protein and fat and other levels in a given formula.

SF: So let’s touch on wet food. A lot of us don’t like it because it’s messy and it’s smelly and all of that, but it’s pretty important for dogs and cats, right?

I love wet food. I think it smells and it’s disgusting and it’s gross. But I also know that for my pet, if I love my pet — and I really love my pet — I will put up with it. Especially for cats, that is the number one thing that you can do for their health. The biggest improvement you can make in their nutrition is to give them wet food. With dogs it’s kind of more of the benefit of moisture. More moisture in the diet is good: It helps with digestion, it helps keep that caloric density down that we talked about. Canned foods also tend to be less processed. A lot of them have fewer carbohydrates in them. They’re more protein and fat, which is what our dogs and cats are designed to eat. But while wet food is good for our pets in general, for cats it’s essential.

Cats have a history of being a desert-dwelling animal. They have a really low thirst drive because they evolved in a desert and in a desert there are times where you’re not going to have water. And if your drive for thirst is higher than your drive to eat, you’re going to spend your time looking for a water source, not a food source. And so they evolved with a lower thirst drive so that their hunger kind of overrides that need for moisture. Basically, they evolved to get their moisture from their food. We have seen a lot of studies done in cats that show that cats drink less water if they get plenty from their food. On the other hand, if they’re eating kibble, they will increase their water intake, but we don’t believe that it’s enough to make them well-hydrated all the time. Things that chronic dehydration can lead to are urinary tract infections, urinary crystals, urinary blockages — a lot of problems with the urinary system and kidney area. Dr. Shlomo can tell you how frequently you see those conditions in cats.

It’s a huge problem with cats, so how we can help with that is that we can feed them wet food. There’s also the obesity issue and so diluting the caloric content is also key. These guys need to eat frequently throughout the day, so we can dilute the amount of calories they’re eating at each meal by having those meals be high in moisture. Honestly, I could sit here for hours and talk about moisture in cats because it is that important and it’s my soapbox and my hill I will die on.

SF: Well, let’s hope it doesn’t come to that! I appreciate the enthusiasm though. So, what kind of treats are best for dogs and cats? Are there any treats people should avoid? Food from the table, certain meats, bad brands, etc.

I think that it depends on your pet. So for most pets, freeze dried meats are a great treat. Again, you want it from a pet store. You don’t want to be feeding your pet beef jerky for humans because we put nitrates, nitrites, sugars and a lot of salt in it to preserve it. Pets don’t need all that and it’s not good for us either. Even though I love myself some jerky, the preservatives we put in there are not the best. In fact, if you get a good brand, humans can eat the jerky from the pet store and it’s actually better for us than getting some from the gas station.

Another thing is, if you have a pet that does need to lose weight, you do need to be paying attention to how many treats you’re giving because that’s part of their calorie intake every day, and it needs to be less than 10% of their total diet, otherwise you’re going to imbalance their diet. I tend to tell people to put them in a single baggie and then make sure everybody in the household treats the pet out of that bag. That way, we know exactly how many we’re giving every day, and we don’t have five people separately giving Fluffy four treats when Fluffy is only supposed to have six all day. Also, if you have a pet that’s overweight, a lot of pets really like simple fruits and vegetables. And so you can give them things like carrots. Some of them will even eat celery or lettuce. Green beans are another great one. Even cats will sometimes like fruits and vegetables. It’s not as common, but sometimes they do.

SF: All right, you ready for the next big one? I want to get your perspective on raw food. A lot of my clients are asking me about raw food, but they also have these mixed messages about it. Like, “What if I just buy high quality raw hamburger meat like I would buy for my own family and give it to my dog?” What’s the deal with that?

I think raw food has potential benefits. I think we still need to do research to actually prove that it has the benefits people think it has. But I think that there are a lot of people out there that at least anecdotally see benefits in feeding raw foods to their pets. I think it can be done if it’s done safely. The one thing that you want to be really careful of is to not feed raw hamburger or chicken or raw meats from your grocery store to your pet. For one, it’s not balanced to just add raw meat to your pet’s diet. If you’re already feeding a complete food alongside it, you’re now throwing their diet out of balance. And if you’re only feeding them raw meat, that’s also not balanced. There’s no vitamins and minerals. You’re missing your calcium, your phosphorus. Big vitamins and minerals are missing.

Also, another big thing is that the USDA allows some bacteria to be in our food because we are intended to take it home and cook it. It’s actually kind of scary to look at how much salmonella and E. coli can be found in grocery store meats. Pet food, however, is regulated by the FDA. The FDA has a zero tolerance policy for any of those pathogenic bacteria. You can have none. So there’s a discrepancy there. When you feed a reputable, high quality raw pet food, they have taken a lot of steps to make sure that there’s not any bacteria that could be harmful in that food. So if you feed your pet raw meat from the grocery store, you have a high chance of actually having bad bacteria in that food. Now, pets have shorter digestive tracts. They have a higher acidity in their stomach. They kind of have ways of dealing with bacteria. I mean, if you think about it, dogs eat rotten carcasses, so they’ve been built to deal with some of those heavier bacterial loads that we don’t deal with so well. But while they’re not as likely to get sick, they can pass it to you. So in their stool, they’ll be shedding that bacteria and then you might pick it up. Also, as you’re making that meal or feeding them that raw food, you’re getting it on your hands and you can infect yourself. So it’s really not recommended to be feeding your pet raw meat from the grocery store.

If you do want to do a raw diet, I would just recommend getting it from a reputable company. There are a lot of raw foods out there that are mailed directly and they don’t go through a pet store. Unfortunately, those are more likely to have some contamination or have some issues because they tend to get missed by FDA regulators. When they’re not on a shelf, the FDA doesn’t really see them. Whereas if you’re a brand that’s in a pet food store, the FDA knows you’re there. The FDA is going to look at your foods, they’re going to be testing them, they’re going to be pulling them off the shelves if there is any bacterial contamination.

SF: Another controversial topic is grain-free diets. Can you enlighten us here a little bit about what the possible benefits and costs of going grain-free are?I think grain-free pet food can be a good fit for some dogs and completely unnecessary for other dogs. There are some dogs that really do better on a grain-free diet, and I think that’s why these diets exist. But if we look at it, dogs and cats have no nutritional requirement for carbohydrates in their diets at all. I think we can look for diets that are lower in carbohydrates but, when it comes to most dogs, they don’t need a grain-free food. A grain-inclusive food may be just as nutritious as a grain-free food. I think it just depends on your particular pet and your dog. One of the things that we have encountered, though we haven’t been able to prove any correlation yet, was a risk of DCM (dilated cardiomyopathy) when feeding a grain-free diet.

It’s tricky because it’s multifactorial. There’s a lot of things going on. There’s genetic components to it that we’re not sure we understand. There may be a formulation aspect to it that we’re not able to prove out yet. But the one thing that was consistent with these dogs that were affected is that they were being fed the same formula for months to years and in the form of dry food. So I think to reduce the risk of DCM, I would try variety. Try that food rotation that we were talking about so that you’re getting a variety of different nutrients and different food formulations in the diet, and then also make sure to add moisture to the diet. Don’t feed a whole diet of kibble; mix it up and make sure that you get some variety in there. Not only of the formulation, but also of the food type that you’re feeding. Because that is the only correlation we could see between DCM and grain-free diets is that it occurred with dry foods and with the same formula being fed for months to years. So don’t feed the same formula for months to years and don’t only feed dry food.

SF: The next thing I want to ask you is about prescription diets. They’re more expensive, you can only get them in certain places and you need a script for it. A lot of the time when I prescribe these diets, clients will ask me, “Why can’t I just go and get something over the counter? What is the difference between these diets and a high-quality over the counter diet?”

Unfortunately, foods which are formulated to treat specific conditions, tend to be imbalanced. So they’re not healthy to feed a healthy dog or cat, they’re only meant to be used for pets in a diseased condition. Because of this, they are typically made prescription-only so that a veterinarian that knows the pet and knows what condition that pet has and knows the nutrients that they need for that condition is monitoring that pet.

It’s meant to be monitored because it’s not complete and balanced. Unfortunately, that means that there’s not a lot of it in pet stores and online. They’re going to have foods that are complete and balanced so that anybody could feed that food to any pet. With the prescription diets, because the nutrients are at different levels because of a disease condition, there is the potential to do harm if they’re fed to a pet that doesn’t need that diet. It’s a shame that’s it’s so hard to access prescription diets, and we’re working on ways to make them more accessible to pet parents who do need them, but there are also some good reasons for it.

TCB: I wanted to jump in and ask about supplements before we wrap up. You’ve both talked about supplements as being pretty important to proper pet nutrition, but I assume not all supplements are created equal. Like, my dad feeds his dogs reishi mushrooms and I always wonder if it actually does anything. Does it just make the pet parents feel better? What supplements are good? What supplements are kind of bogus? And should you even need supplements if you’re feeding your dog the right diet in the first place?

Well, okay, so there’s people that think that if you’re feeding a complete and balanced food, you shouldn’t need a supplement. And I think that there are certain supplements that you don’t need. You shouldn’t need a vitamin and mineral supplement if you’re feeding a complete and balanced food. Things like reishi mushrooms — unfortunately, a lot of our supplements are like that in that we don’t have a lot of scientific support for using them. But they’ve also been used for years. And mushrooms are just amazing. They are just incredible, amazing little nuggets of nutrition. They have so many things going on that we don’t even understand. Everything that’s in a mushroom is good. They have certain carbohydrates that are good, they have vitamin D in them, they have certain nutrients, they have antioxidants, they have all sorts of chemical compounds in them that are just amazing. We don’t know what they are yet and how they work exactly, but we know that when you feed them good things happen. So I don’t think they’re just coming in out of nowhere. There’s something to it.

I think we should look at history too. I know that there’s the strictly scientific, veterinary side of me that says that we have to have proof, we have to know why, we have to know how, we have to know every exact dosage for it to be true. And then there’s the other side of me that says let’s use a little bit of common sense here and kind of look at this and say, “Well, they’ve been using mushrooms in Chinese medicine for thousands and thousands of years and if it didn’t work or there wasn’t something to that, we wouldn’t be using them, right?” My biggest thing is if the supplement is safe. If there is any risk to giving a supplement, I think you need the proven benefit. But if there isn’t a danger in using the supplement, I don’t think that there’s any harm in trying it. I don’t think that there’s harm in adding something like a mushroom supplement. Mushrooms are anticancer. They’re antioxidant. They are a great supply of natural vitamins and minerals.

TCB: That was a great answer. So, sometimes we try to end with a story about a particular pet. I wanted to ask if you’ve ever had a situation where a change in diet completely turned around a pet’s health that you were working with.

Well, let’s see. My husband is a dog trainer, so I have quite a few stories about dogs that came in for training. Because they’re in for training, we get to control their diet and we can also start them on supplements, because the owners tend to know what I do for a living. We had a dog come in that was really resistant to training. He was an overweight German Shepherd and he was really hard to train because you couldn’t get him to sit or lay down. He was just really resistant. We were trying to figure out why and what we realized is that he actually had joint problems. He was resistant to training because his hips hurt. So we put him on a weight loss program and we also put him on a joint supplement. With those two things, within six weeks, that dog was amazing. He was one of those dogs that you see on dog shows running through obstacle courses and jumping over walls and doing all sorts of crazy stuff. Once we got his weight and his joints under control, he was a superstar.

TCB: We love a happy ending! Thank you again for joining us. It was fun getting to watch you two experts chat and just kind of sit back and learn.

Yeah, anytime. I’m happy to talk about nutrition. I love it!

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