VetInfo Digest    May 2003

Table of Contents

Basic Dietary Information

Specialized Dietary Care:

    Feline Urethral Syndrome

    Bladder Stones

    Kidney Failure

    Food Allergies, Pruritic

    Food Allergies, Digestive

    Food Sensitivity

    Megacolon

    Diarrhea

    Liver Disease

    Heart Disease

    Diabetes

    Neurologic Disease

    Cancer

 

This Month's Note:

Is food poisoning less likely in pets?

Overall, pets are less susceptible to food poisoning than humans. The major reason for this is a higher tolerance for bacterial toxins from staphylococcal and Clostridium botulinum species of bacteria, though. The lower sensitivity to these toxins reduces the incidence of food poisoning compared to people, since the staph food poisonings are the most common form to affect people. It is clear that dogs are susceptible to infection with both Salmonella and E. coli bacteria that can cause food poisoning but it is not clear whether they are more resistant, less resistant, or of equal susceptibility to these infections than humans are. Dogs are more susceptible to the mycotoxin (fungal toxin) vomitoxin than any other species. The usual signs of vomitoxin exposure are vomiting, diarrhea and refusing to eat. This toxin can contaminate commercial foods in which Fusarum mold species grow and is one of the reasons that dogs sometimes refuse to eat when a new bag of dog food is opened.

The best approach to controlling food poisoning is to be cautious when making foods for your pets and in the handling of commercially prepared diets to minimize the risk of food poisoning. If you intend to feed raw meat it is best to avoid ground meats. Contamination of meat with E. coli and Salmonella species bacteria is more common in ground meats since the grinder itself can become contaminated. When evaluating possibly spoiled foods remember to follow the basic rule: "when in doubt, throw it out!"

 

Basic Dietary Information relating to specialized diets for pets

For some time, I have been contemplating how to do an issue of the VetInfo Digest devoted to nutritional issues and how they impact on veterinary medicine. This is an extraordinarily difficult topic and one that is fraught with the potential for dispensing bad information. So I have approached this with trepidation. The following is an attempt to make some sense of dietary issues and the hodgepodge of specialized diets that veterinarians rely on.

The Basics

1) Your veterinarian's knowledge of nutrition is likely to be much lower than his or her knowledge of pharmaceuticals and medical or surgical care for pets.

2) Your groomer, your friends, your dog or cat's breeder and the even the authors of many of the articles and books on pet diets are also likely to know very little about nutrition.

3) Even the very best of nutritionists are practicing in a field in which the minimum nutritional requirements for life are well known but the OPTIMAL nutritional requirements for any individual pet or group of pets are probably impossible to discern.

4) There are some medical conditions that occur as the result of dietary deficiencies.

5) There are some medical problems that respond to changes in diet. It is important to remember that this does not mean that these medical problems were caused by the pet's original diet.

6) People will try to sell you things that don't do what they say they will do. Pet food companies are not immune from this. On the other hand, it is likely that pet food companies are striving hard to produce good diets because pets who live longer eat more pet food during their life time.

7) Pet food companies sell their foods to the customer, not the pet. Therefore, many of the marketed aspects of pet foods relate to people's perception of what is good or beneficial, rather than what actually is a necessity or what is actually beneficial. An effort is made to find palatable diets because your pet's satisfaction with the diet is an important selling point.

8) Pet food companies will change their diets, or at least their marketing, to accommodate the current fad diet. This should not be taken as endorsement by the scientific nutritional community of the diet's value.

9) Diets marketed to treat specific disease problems in pets are probably over utilized by some veterinarians and under utilized by others. The diets have a relatively low profit margin so they are expensive to keep on hand unless they are sold rapidly. This situation encourages some vets to opt to push the diets hard and others to avoid using them entirely.

10) Many diets made to treat specific conditions can make other medical problems worse. It is very important to look at the overall picture when deciding whether or not to feed a specialized diet.

11) The odds that any one "wonder ingredient" provides enough benefit to make it worth feeding a particular food for life are pretty small. When multiple ingredients thought to have medicinal benefits are combined into one diet, there almost has to be some chance that there is some interference between the ingredients, making it unlikely that you can gain all the touted benefits just by making a food that contains every ingredient ever thought to provide additional benefits to food.

It may be obvious from the wide variety of specialized diets that there is a market for them. These diets fulfill some of the dream goals of dog food company marketers. The most important one is that a pet that needs a specialized diet for life is a likely lifelong customer of a company making a diet that fits its needs. The second most important one is that they are sold to you by someone you are likely to trust, overcoming one of the hardest initial hurdles to marketing anything -- getting your attention.

I hope that it is also obvious that when there is a lot of money to be made, there will be some folks willing to make it by promoting things that aren't proven to work or that they may even know don't work. Also, if a diet is successfully marketed, even if it doesn't actually provide the benefits promised, other companies will make a similar diet and market it in a similar manner. This is called "me too" marketing by my most straightforward pharmaceutical manufacturer. TV viewers might recognize this syndrome and hopefully also notice that it doesn't mean a product or its imitators are necessarily good -- just that people want more of it right at that moment.

Diets are also promoted by people who make their living off the promotion itself, even though they don't actually produce a commercial pet food. They might write books, give lectures or simply act as agents for companies that do make diets, even it isn't clear that is happening. Many of these people are sincere in their belief that a particular diet or dietary strategy is best -- but not always.

Some diets are marketed by people who are not associated with any company, do not make money off the diet and who are sometimes almost evangelical in their zeal to spread the word about the benefits of a particular diet or dietary approach to life. These folks are sincere and it is hard to ignore them but their enthusiasm is sometimes far greater than their knowledge of nutrition. One of the first things you should try to find out when people are touting the latest dietary trend is how long they have been using this new diet. In almost all cases, you will not find anyone who has fed any of these diets for multiple generations and made any objective effort to evaluate the health of their pets on a consistent basis during that time.

Companies that are serious about making good dog food do test their products and they do study groups of dogs and cats who are fed their diets over their lifetime and over the lifetime of their puppies and kittens. In some cases there are twenty or more generations of pets who have been fed a company's diet and evaluated throughout that time. This doesn't even come close to allowing a company to say their diet is the optimal diet for a pet -- but it does at least make it extraordinarily likely that the diet meets the minimum nutritional needs of the pets it is intended for.

No one, absolutely no one, can tell you the optimal diet for your pet. People can tell you success stories based on their pets or on groups of pets. They can tell you about lack of success using other diets. It is possible to analyze a diet and show that it can't meet basic nutritional requirements or that it does meet these requirements. Everything else is just a guess. Some of the guesses seem to have a lot of weight in scientific study behind them, but they are still guesses at this time. No one really knows for sure if extra antioxidants really make pets live longer or even if glucosamine and chondroitin supplementation really works to slow the progress of arthritis. We just think that some of these things are true based on the information available so far. Most dietary claims cannot be proven or shown to be false with certainty. This is a situation that we will have to live with for a very long time because it is very hard to isolate the effects on one dietary component on the lifetime of a pet, or a person.

If you keep these basic thoughts in mind when thinking about diets for your pet, it will help some in your decision making when dietary changes are suggested. I am not going to try to cover the risks or benefits of current fad diets in this issue. I will try to point out which of the diets veterinarians are likely to promote seem to work and which ones are questionable. I will also try point out the times that these diets should be used with caution, even when it seems appropriate to use them.

The original impetus for "therapeutic" diets were diets made to control feline lower urinary tract disorders (FLUTD or FUS) and bladder stones in both dogs and cats. The success of these diets led to efforts to control other conditions using dietary therapies. Today there are specialty diets for a great number of conditions, including food allergies, food sensitivities, kidney failure, liver failure, heart disease, neurologic disease, cancer, reproduction and more. The success of these diets varies from condition to condition and there is a risk of treating one condition only to make another one worse. A brief outline of the available diets, their potential usefulness and known risks may be helpful.

 

Feline Lower Urinary Tract Disorder / Feline Urologic Syndrome

Struvite bladder stones or struvite urethral plugs cause approximately 40% of cases of chronic lower urinary tract disease in cats. For this group of cats, a diet that acidifies the urine can be very helpful, as struvite crystals dissolve in acid urine. Magnesium ammomium phosphate (MAP) stones are another name for struvite stones because they contain these three minerals. Overall, less than 1% of cats have clinically significant struvite crystal formation or struvite bladder stones.

Acidic urine may be a factor in the formation of calcium oxalate stones. There is at least circumstantial evidence that the increased use of acidifying diets in cats has led to an increase in the incidence of calcium oxalate stone formation in cats. For this reason, it is important to be reasonably sure that your cat actually has struvite crystal formation prior to using an acidifying diet on a lifelong basis. These diets should not be used as a routine preventative measure for all cats, because the possibility of an increased risk of calcium oxalate stones offsets the risk that a cat might have significant problems with struvite stones in the future.

Cats do not form bladder stones as often as dogs do, but struvite control diets will work to inhibit the formation of struvite bladder stones, if a cat has a prior history of forming these stones.

Diets that are supposed to control struvite stones include Hill's c/d-s (tm), Purina (UR tm), Innovative Veterinary Diets' Control Formula (tm), Purina's Special Care (tm), Alpo Urinary Formula (tm), Waltham's S/O Control pHormula Diet (tm), Eukanuba Low pH/s Formula (tm) and there are others. These diets do appear to work well when struvite crystals are a major contributing factor in lower urinary tract disease in cats. They do not work well for male cats whose urinary blockages appear to be due to mucus plugs in the urethra. When a male cat suffers a complete urethral blockage there is often enough material flushed from the urethra in the process of breaking down the blockage to allow analysis. It is best to ask your vet to send in the urethral plug for analysis whenever possible.

 

Canine and Feline Bladder Stones

Bladder stones, or uroliths, are more common in dogs than in cats and there may be some difference in the underlying reasons why they occur. In dogs, struvite bladder stones are almost always associated with urinary tract infections. It is thought that these stones don't form unless there is a bacterial infection of the bladder. In some patients control of urinary tract infections on a consistent basis is not practical or in a few cases, possible. In this situation, it is reasonable to consider the use of a diet that acidifies the urine on a long term basis to try to prevent stone formation. Hill's c/d (tm) diet and Innovative Veterinary Diets Control Formula (tm) are available for dogs. The feline diets that work for struvite crystals also aid in the control of struvite bladder stones. As discussed under crystal formation, cats will form struvite stones without the presence of infection.

It is possible to dissolve struvite bladder stones once they have formed, using dietary therapy. It is necessary to identify the type of bladder stone prior to attempting dietary therapy. Collecting a bladder stone for analysis may require surgery but it is sometimes possible to induce a smaller stone to pass using a technique referred to as "retropropulsion", in which the bladder is filled with sterile saline and allowed to suddenly empty (using a urinary catheter) to encourage flushing of small stones. This is a procedure that requires anesthesia but can sometimes be used to avoid surgery. Once a stone has been obtained and analyzed and confirmed to be struvite (MAP) in origin, it is reasonable to use Hill's s/d (tm) diet to try to dissolve the stone(s) rather than having the stones removed surgically. This diet is available for both dogs and cats.

Both dogs and cats can form bladder stones composed of calcium oxalate. These stones do not require bacterial infection to occur and are more likely to form in acid urine and less likely to form in basic urine. There has been a rise in the incidence of calcium oxalate stones in both dogs and cats over the last decade or so and the reason for this is unclear. One theory, at least in cats, is that many diets are now formulated to produce acid urine since it was discovered that diets that led to urinary acidification reduced the incidence of struvite stones and that these diets are encouraging the increase in calcium oxalate stone formation.

There is no diet that will dissolve calcium oxalate stones once they have formed. Diets that keep urine basic and that promote water intake do help in keeping these stones from forming in dogs and cats prone to making them, however.

Dog diets capable of helping prevent calcium oxalate stone formation include Purina's DCO and NF (tm) diets, Hill's k/d, u/d, and w/d (tm) diets and Waltham's Low Protein, Medium Protein and Modified Formula (tm) diets. Cat diets that can be helpful in preventing calcium oxalate stones inlcude Hill's c/d oxl, k/d and w/d (tm) diets, Waltham's Low Protein, Mature Formula, Modified Formula, Weight Formula and Control Formula (tm) diets, Eukanuba's Moderat pH/o (tm) diet and Purina's NF (tm) diet. Encouraging water intake, including the use of canned foods rather than dry foods, can be helpful in preventing calcium oxalate stone formation, as well.

Urate kidney stones are fairly common in dalmatians. They occur in both dogs and cats when portosystemic liver shunts are present. These stones can be dissolved in many instances in dogs using Hill's k/d or u/d (tm) diets and these diets will also limit stone formation when fed as prevention diets. In cats Hill's k/d diet (tm) can help to dissolve urate stones or prevent them, as well.

Cystine bladder stones are not very common but they can occur in dogs and cats. In dogs, Hill's u/d (tm) diet is reported to be helpful in dissolving existing stones and in preventing new stone formation. There is no diet available for cats that will help in dissolving existing cystine stones but Hill's k/d (tm) diet is helpful in preventing new stone formation once cystine stones have been removed and identified as the problem.

 

Diets for Kidney Failure (or Kidney Insufficiency) in Dogs and Cats

There are several diets that can be helpful in dogs and cats, if used appropriately, when kidney failure is a problem. In addition, increasing water intake, using medications as necessary to control secondary effects of poor kidney function and working hard to prevent dehydration can be very helpful in limiting the progress of kidney failure.

It is critically important in cats and dogs to avoid diets made to acidify urine, when chronic renal failure is diagnosed. Many of the available adult cat foods promote acidic urine. Cats who have been on acidifying diets due to crystal formation in the urine should be switched to another diet if kidney failure becomes a problem later in life. Dogs are less likely to be on diets that acidify urine but if they are, it is necessary to change them to a different diet if kidney failure occurs, as well.

Dietary restriction of protein and phosphorous has been promoted as a method of slowing the progress of kidney disease in dogs and cats. The use of protein restriction was based on studies done in rats. When these studies were repeated using dogs, there was no benefit to protein restriction as a preventative measure for kidney failure. Once renal failure causes moderate to severe rises in BUN (>75 ) and creatinine (>2.5 ) then the use of protein and phosphorous restricted diets makes sense. At the present time it is assumed that this information also applies to cats, although cats have not been studied as extensively as dogs. It may be necessary to use a very protein restricted diet to get the BUN and creatinine to drop back to normal ranges. After this occurs, it is probably best to try to find a higher protein level that will keep these values within acceptable ranges. There are low protein and medium protein products on the market and it is reasonable to mix a lower protein diet with a normal adult maintenance diet if it looks like it may be possible to use a higher protein diet.

If protein restriction isn't necessary prior to the time that BUN and creatinine levels rise, does it cause harm to use them earlier? This is unclear at the present time but there is definite potential for harm from low protein levels in the diet when given over long periods of time, so it is probably best to avoid the use of protein restricted diets until they are actually more likely to be beneficial.

There are a number of low protein diets on the market, including Hill's k/d, u/d and w/d diets (tm), Purina's NF (tm), Walthams Low Protein (tm), and Innovative Diets Modified Formula (tm) and Mature Formula (tm) - (cats only). Iam's Nitrogen Trap (tm) diet and Waltham's Medium Protein (tm) diets are attempts to provide increased protein levels compared to the other restricted protein diets but it is unclear if there are significant benefits to this approach at this time.

 

Food allergies, pruritic

Food allergies appear to be able to cause itchiness affecting the skin and ears or to cause digestive disturbances. It is easier to discuss these problems separately, because there are differences in the approach to food allergy for the two conditions. When dogs or cats have skin disease leading to itching, especially involving the feet and ears in dogs and the ears and face in cats, food allergies should be considered in the rule outs for an underlying cause. This is especially true for non-seasonal itchiness that is not very responsive to cortisone administration.

If a pet is allergic to a food ingredient, or to several food ingredients, it is possible to resolve their itchiness by avoiding the feeding of the offending ingredient. There are a number of food ingredients that dogs can be allergic to but beef, corn, chicken, wheat, soybean, lamb, milk and rice are among the more commonly diagnosed allergens. In cats, beef, chicken, milk, fish and rabbit are fairly common food allergens. Many people think that a pet is allergic to a particular type of dog food, but the allergy is to specific ingredients, not whole foods. If a dog is allergic to beef, changing from one food containing beef to another food containing beef is not helpful, for instance. Change to a food that doesn't contain beef can be very helpful, though.

The only way to accurately diagnose food allergy is through the use of special dietary trials referred to as "elimination diets". This is a diet that contains a protein and carbohydrate source that the pet has never eaten before. The most common diet used for this testing in dogs used to be a lamb and rice diet. With the increase in foods containing lamb or rice this diet doesn't work well, anymore. For indoor cats, rabbit can often be used in food trials but for outdoor cats this is a poor choice, at least in areas in which it is possible for cats to catch rabbits and eat them.

There are a great number of diets made specifically for testing for food allergy and/or as maintenance diets once food allergies have been diagnosed. General practitioners tend to favor attempting to diagnose food allergies by recommending one of these diets but dermatology specialists tend to favor making a diet at home because there is greater control of the ingredients used. Home made diets won't contain preservatives, food coloring or other supplemental nutrient ingredients which can lead to food allergies in some dogs and cats. The commercially available limited antigen diets include the d/d (tm) series of diets from Hill's, Innovative Diets limited antigen diets and a number of other diets made with a single protein source. In addition, there are diets made from hydrolyzed proteins. In this process, protein size is restricted to low molecular weight proteins in a sort of "pre-digestion" process. Proteins that are very low molecular weight are thought to be unable to cause allergic reactions. Hill's z/d (tm) and Purina's HA (tm) diets fit this category.

A food trial is done by feeding the restricted diet to the pet for 6 to 8 weeks. It is critically important that ONLY the food trial diet be given. No treats or flavored medications should be given during the food trial period. Dogs and cats must be confined or controlled in some manner which eliminates the possibility that they will obtain food on their own or from neighbors or other well-meaning persons. This makes food trials extremely difficult to do properly, especially in households with more than one pet. Eight weeks is a long time but it is necessary to go this long in many instances in order to adequately rule out food allergies. If a pet does manage to find food that isn't on the dietary plan during this period, it is necessary to extend the trial for at least 2 to 3 weeks after the offending food is eaten.

We know that some of our clients will never be able to successfully conduct a food trial. This probably doesn't matter much from a practical standpoint, though. If it isn't possible to control the pet's diet for two months, it isn't likely to be possible to control it for life. In this situation, it is simply necessary to use other means to control the clinical symptoms caused by the food allergy. Several references claim that food allergy symptoms can last up to three weeks after ingestion of a food item the dog is allergic to. Our clinical experience suggests that this is more true for dogs who have ear inflammation from food allergies than other forms of irritation, but it does make treatment for food related allergies frustrating, in any case.

We have had some luck simply changing dogs and cats to the z/d (tm) or HA (tm) diets. While many of these pets still do get some exposure to other protein sources there is often enough improvement, over time, to discern whether food allergies are a likely problem.

 

Food allergies, intestinal

Currently, diarrhea due to food allergy is thought to occur in about 15% of pets who have food allergies. This is one cause of chronic diarrhea in pets. Diagnosing the problem is very similar to diagnosing food allergies that are causing skin irritation. However, intestinal signs from food allergies seem to be more responsive to changes in the diet. In addition, intestinal signs tend to go away more quickly when the offending food is removed from the diet, making it less of a problem to regulate this type of food allergy. In fact, some of our clients have managed to figure out which foods their pets are allergic to without going through elimination diet protocols, by paying attention to when diarrhea occurred and how long it lasted.

In our experience, commercial diets work better for diagnosing allergic bowel symptoms than for skin symptoms. We have had pretty good luck using Hill's z/d (tm) diet and Purina's HA (tm) diets for diagnosing food allergy, as well as the some of the limited antigen diets. We occasionally have good success using Hill's w/d (tm) diet for chronic diarrhea and it unclear to us whether this is due to the lower fat in the diet or the fact that the diet doesn't contain beef, one of the more common causes of food allergies. The w/d diet does contain peanut hulls as a source of fiber, which can be problematic for some dogs since this is thought to be an occasional cause of food allergies, as well.

 

Food sensitivities

Food sensitivities are a little different from food allergies. This term refers to an inability to process or tolerate a food ingredient that most animals can handle. Examples of this include lactose intolerance (inability to digest milk) and wheat gluten intolerance. In these cases, a special diet is not normally necessary except when they are the only option for avoiding the food ingredient that bothers a particular pet.

Some dogs and cats with chronic colitis problems will do much better when they are fed low fat diets. In this particular situation, some of the "grocery store" brands, such as Fit and Trim (tm) will work just fine for dogs. More specialized diets for this condition for both dogs and cats include w/d and r/d (Hills, tm). Low fat diets can be helpful in some kittens with chronic diarrhea. If it is possible to use a low fat diet for a short period of time there should be no adverse effect on the health of the kitten. Longer term use is a compromise that must sometimes be accepted but which may have some impact on growth.

 

Megacolon

Megacolon occurs more commonly in cats than in dogs. This is enlargement of the colon due to neuromuscular degeneration in the colon. Some cats with this condition appear to do better when fiber is added to their diet and this is a common recommendation. Lately, there has been more emphasis on the use of highly digestible diets that produce less stool volume. Eukanuba Low Residue (tm) is the most commonly recommended diet in this category but premium growth (kitten) diets can also be useful.

 

Diarrhea treatment

For years the standard recommendation for dietary treatment of acute diarrhea has been to withhold food for 24 to 48 hours and then to use a "bland" diet for several days to a couple of weeks, prior to switching back to the usual dog or cat food. There has never actually been much proof that this approach had major beneficial effects. Some gastroenterologists are currently recommending just going immediately back to the usual diet as long as it isn't suspected to be part of the problem. We have been using this approach for some time and it seems to work well.

 

Liver Disease

Low to moderate protein diets are indicated for pets with chronic liver disease, once clinical symptoms of ammonia toxicity occur, such as confusion, incoordination or seizures. It is not known if controlled protein diets are helpful in extending the time period between onset of liver disease and the onset of clinical symptoms if they are used before symptoms appear. Increased omega-3 fatty acids are also thought to be helpful in chronic liver disease. The renal failure diets are a reasonable choice for protein control. Hills makes a diet specifically for liver disease, l/d (tm), which is suitable for chronic liver disease such as cholangiohepatitis or chronic active hepatitis. This diet is not considered to be an optimal diet for hepatic lipidosis in cats. In this particular liver disease, it is better to feed a high protein diet (normal protein) diet. No special diet exists for hepatic lipidosis and it is unclear whether anything other than a "normal" diet is necessary, since the major goal of treating hepatic lipidosis is simply adequate caloric intake.

 

Heart disease

Salt restriction has long been thought to be helpful when chronic heart failure is being treated. There is some question about how important salt restriction really is at this time, based on recent studies in dogs. It seems reasonable to feed specialized low sodium diets, such as Hills h/d (tm) or Purina's CV (tm) diet, if a pet will eat the diet readily. If not, it is more important for a pet with heart disease to maintain normal caloric intake than to eat a salt restricted diet.

 

Diabetes

Dogs with diabetes generally do better when fed a diet with increased fiber. Cats with diabetes tend to do better when fed a diet high in protein and fat and lower in carbohydrates and fiber. This is a radical difference between the two species. This difference has caused some controversy, especially among feline practitioners, over the role of fiber in cats with diabetes. At the present time I think that the majority opinion among practitioners is that the higher protein, lower fiber diets do work better for cats.

Diets such as w/d (tm), Fit and Trim (tm), Cycle Lite (tm) and other increased fiber diets should be considered for dogs with diabetes. The only commercially available diet specifically made to follow the increased protein protocol for cats is Purina's DM (tm) diet. Many practitioners think that premium brand kitten foods come close enough to this profile to make them just as useful in managing diabetes in cats, though.

Dogs do best when fed 4 meals a day when they have diabetes (2 meals, 2 "snacks"). The timing of food intake doesn't appear to have nearly as much impact on cats and it is thought that for the most part, timing of meals is not critical in regulating diabetes in cats. Most people can't feed their dog four times a day due to practical concerns, but at least two meals a day really is important.

 

Neurologic disease

A couple of the specialized pet foods claim to slow the onset of cognitive dysfunction (senility) in older dogs. If these claims are true, they have not been well documented at this time.

 

Cancer

Researchers at Colorado State University developed a dietary protocol that was shown to be helpful for dogs with lymphoma, one of the more common forms of cancer in dogs. Hills makes a diet n/d (tm) that follows the general guidelines for this diet. It is not clear that there is any benefit to feeding this diet for any other form of cancer at this time, although the diet may be useful in preventing some of the extreme weight loss (cachexia) sometimes associated with cancer. It is probably not possible for this diet to be adequately duplicated using ingredients that the average pet owner could purchase locally, so if you wish to pursue this dietary approach to cancer, the commercial diet is probably the only choice. Some aspects of the diet, such as high protein, moderate to high fat and low carbohydrate content, as well as additional omega 3 fatty acid supplementation, can be duplicated at home and this may be enough to control cancer cachexia.

Thanks for Your Support!

The VetInfo Digest is published by:

TierCom, Inc.

P.O. Box 476

Cobbs Creek, VA 23035.

The opinions expressed in this newsletter are those of Michael Richards, DVM., author.

Copyright 2003, TierCom, Inc.