Develop a Nutrition Program in Your Practice
This article was originally published in the July/August 2012 “Today’s Technician” column of Today’s Veterinary Practice. Today’s Veterinary Practice is the NAVC’s official, peer-reviewed journal for veterinarians. You can find the full list of “Today’s Technician” articles on the Today’s Veterinary Practice website.
Pet nutrition is big business. In a competitive market, veterinary practices need to maximize their influence as pet care experts to help owners make appropriate, well-informed decisions.
In 2012, it is estimated that pet owners will spend 52 billion dollars on their pets; approximately half of this will be spent on pet food.1 With this amount of money at stake, it’s no wonder that pet food companies invest in large-scale marketing campaigns designed to influence owners’ purchasing habits.
In the midst of marketing, the veterinarian’s voice is sometimes lost. With pet obesity on the rise and ever more complicated pet food options available, experienced guidance is more important than ever. In 2011, AAHA released new guidelines to help veterinarians better incorporate nutritional consults into their wellness examinations.2 However, in busy general practices, performing thorough nutritional consults can be challenging. This article will discuss how to develop a practical nutrition program for your practice.
A Nutritional Resource
Market research shows that owners are increasingly interested in pet nutrition, and are doing more research, usually Internet-based, into nutrition before buying a food rather than simply believing advertising or packaging.3 This environment provides an important opportunity for veterinary professionals to step in and guide pet owners in making informed decisions about nutrition. Doing so helps clarify confusing pet food choices and adds value to the practice’s services.
Deciphering the Choices
The simple truth of pet nutrition is that:
- There are many excellent nutritional options
- The majority of pets can flourish on most of these options
- Basic nutritional needs can be met by any nutritionally complete food designed for the species.
Foods are deemed nutritionally complete if they have been evaluated and meet the Association of American Feed Control Officials (AAFCO) nutritional criteria (which will be noted on the product packaging). Because pets are individuals, however, some foods, even those that have met basic nutritional requirements as set forth by AAFCO, may not be appropriate for every pet.2
The veterinary professional’s job is to:
- Educate owners about their pets’ specific needs
- Discuss owners’ concerns and questions regarding their pets’ food
- Give owners nutritional options that meet both of these criteria.
While most veterinarians address nutrition for patients with medical concerns, wellness nutrition often falls through the cracks. Incorporating nutrition into regular wellness routines is an excellent idea; however, practical concerns, such as appointment length, can interfere with a veterinarian’s ability to do so. This is where the veterinary team, in particular, the technician, can step in to help:
- Complete the nutritional assessments
- Develop, along with the veterinarian, nutritional recommendations
- Communicate that plan to the owner
- Perform follow-up to help owners be successful at home.
In this way, nutrition is an area of practice that offers technicians an opportunity for professional and personal development and the practice an opportunity to increase its profitability with a valuable and popular client service.
Defining Your Message
The key to developing a successful nutrition program is to maintain a consistent message in all areas of the practice. Defining the practice’s philosophy on nutrition and training the entire staff on the key points is the best way to communicate this message to the client. An interested technician is more than capable of developing the veterinarian’s desired message into a comprehensive program and then implementing it in the hospital.
Creating a Nutrition Program
- Develop a consensus regarding nutrition and communicate it to team members—ideally in writing.
- Pay attention to common client nutrition questions or issues you encounter during your regular examinations for a few weeks; develop written positions to address these.
- Ask team members about their own questions and clients’ concerns related to nutrition; address those as well.
- Body condition score (BCS) should be noted during each examination.2 This provides a point of reference for team members when the pet is presented for subsequent visits or weigh-ins.
- All veterinarians should agree to use the same BCS scale (1–5/5 or 1–9/9) and the patient should be assigned a score by the veterinarian performing the examination.
- Team members should be trained to understand the chosen scale and able to discuss the significance of the score with owners.
- Calculate calories — every visit. Train technical staff to calculate calories for owners and to do so at every appointment, along with temperature/pulse/respiration.
- Calculate calories the client is currently feeding AND check with the veterinarian to calculate the calories the pet should be eating.
- The calculation method can be selected by the veterinarian(s); determine whether calories should be calculated at ideal weight or current weight.
- Common calculations for resting energy requirements (RER) in dogs and cats include4-5:
- 30 (bwkg) + 70 = RER
- 70 (bwkg) 0.75 = RER
- Develop a database or bookmark websites to locate calories in pet foods (see Table 1).
- Carry wellness foods in your practice—many clients will buy their pet foods from the practice if you carry your recommended products. This includes treats and supplements.
- Train team members thoroughly about the foods stocked at the practice—both therapeutic and wellness products.
- Take advantage of free training offered by pet food companies; most sales representatives are more than happy to perform team member training.
- Incorporate veterinary conference sessions on nutrition into team member continuing education (see Selecting Continuing Education for Your Practice Team).
- If nutrition is of particular interest to veterinary technicians in your practice, encourage them to pursue credentialing with the Academy of Veterinary Nutrition Technicians (nutritiontechs.org).
- Encourage team members to feed the practice’s recommended pet foods. There’s no better endorsement than telling clients you feed your pets the foods you recommend. In addition, pet food companies may offer programs that allow team members to purchase food at a discounted rate.
- Maintain up-to-date information on current recalls and product concerns; update your website, Facebook page, and Twitter. The FDA has a website that provides this current data: accessdata.fda.gov/scripts/newpetfoodrecalls
- Provide a list of alternative recommendations to the food carried in your practice, including grocery store options. This addresses the needs/desires of ALL clients and makes the practice’s nutrition service helpful and inclusive.
- This flexibility makes recommendations applicable to the “real” world and shifts the focus to well pet care versus a perceived “sales pitch.”
- Team members should understand why the practice recommends certain foods as well as why the in-house diet is superior. This is another way pet food companies can help hone your message.
|Iams Canine Veterinary Diets||tinyurl.com/IamsCanineVeterinaryDiets|
|Hill’s Prescription Diets||hillsvet.com/products.html|
|Natura Vet Products||naturavet.com|
|Popular Dry Cat Foods*||petobesityprevention.com/wp-content/uploads/ 2010/05/Cat_Dry_Food.pdf|
|Popular Dry Dog Foods*||dodgecountycanine.com/files/ Dry_Dog_Food_Calorie_content.pdf|
|Popular Wet Dog Foods*||petobesityprevention.com/wp-content/uploads/2010/05/ Dog-Food-Calorie-Counts-December-2011-Wet-Dog.pdf|
|Purina Veterinary Diets||purinaveterinarydiets.com|
|Royal Canin Veterinary Diets||royalcanin.us/vcn/index.html|
|Other Food/Table Scraps||nutritiondata.self.com|
|*These sites provide information that is continually changing in the marketplace; they should not be relied on for accurate or current information.|
Communicating with Clients
Once you have defined your practice’s position and recommendations with regard to patient nutrition and trained team members to competently deliver the message, it is time to start working with clients. The single most important part is taking a thorough, accurate diet history from the client. The purpose of the history is to identify:
- What and how much the client is actually feeding—food AND treats (what/when/amount)
- Aspects of the diet that are not ideal or inappropriate
- Aspects of the diet that the owner is not able or willing to change
- Recommendations that help owners make better nutritional decisions for their pets.
The AAHA Nutritional Assess-ment Guidelines for Dogs and Cats provides both a basic screening form for regular appointments (aahanet.org/Library/NutritionalAsmt.aspx, scroll down to Table 2) and an extended form for patients that need more in-depth evaluation (aahanet.org/PublicDocuments/NutritionEvaluationForm.pdf).
This information can be reviewed with the veterinarian and a diet plan developed. Obviously, the most difficult part is effectively communicating with the owner. See Table 2 for some tips.
|Be Complete||Make sure to collect the entire diet history, including treats, table scraps, items mixed in with food, what is used to administer medications, and dietary supplements as well as feeding and treat schedules.|
|Be Considerate||Do not judge or lecture: Clients will not be honest if they feel they will be admonished. Always approach issues with the intent to find healthier alternatives rather than criticize choices made. Any conversation about nutrition should be considered an opportunity for education—educated clients follow recommendations because they understand their purpose.|
|Be Sensitive to Client Needs||Many clients derive great pleasure from giving their pets special treats. Often, they associate limiting treats or specific foods with punishment of the pet. Successful nutritionists recognize this, and help the client make healthier choices rather than asking them to abstain completely from behaviors that affect the owner–pet bond.|
|Be Sensitive to the Pet’s Needs||A diet needs to be designed so the pet agrees to eat it and does not initiate undesirable behaviors, such as begging, vocalizing, and food seeking. If the pet appears unhappy to the owner as a result of the nutrition plan, the owner will likely not comply with it. Be willing to modify a plan in order to keep the pet and owner content and be patient while they both adjust.|
|Be Specific||Give the owner specific, ideally written, instructions that include:
|Be Available||It is imperative to be available to pet owners to answer questions or help them address issues that arise as they put a nutrition plan into action. If they can’t reach someone for help, they may simply abandon the plan. Therefore, be proactive—check-in with clients regularly to provide support when necessary.|
When to Use a Specialist
When pets require in-depth help, such as aggressive weight loss, or if the owner has decided to feed raw or homemade diets, referring them to a nutrition specialist, if one is not on the practice staff, helps provide optimum care for the pet. Follow up with both the specialist and pet owner to ensure that you or a team member:
- Is aware of the specialist’s recommendations
- Can help the owner implement them.
Table 3 on the website of the AAHA Nutritional Assessment Guidelines for Dogs and Cats provides an extensive list of resources, including nutrition specialty groups.
View the AAHA Nutritional Assessment Guidelines for Dogs and Cats at aahanet.org/Library/NutritionalAsmt.aspx.
Making It Profitable
Developing a healthy nutrition program should improve clinic sales of both therapeutic and maintenance foods. Additionally, the practice can make decisions to stock treats and dietary supplements that complement nutritional recommendations, which can generate profit and better tie the client to the practice.
With increasing complexity in the pet food market, pet owners are consistently bombarded with information regarding pet nutrition. This environment provides an opportunity for veterinary professionals to provide pet owners with individualized nutrition recommendations, which benefits the owner, pet, and practice. It is also an aspect of care that can be directed by the veterinarian but implemented by the veterinary technician. Nutrition is, therefore, an exciting area where veterinary technicians can potentiate their value by improving client care, satisfaction, and practice profitability.
For a list of “What to Include in Your Practice’s Nutrition Message,” go to todaysveterinarypractice.com Clinical Resources.
BCS = body condition score; bwkg = body weight in kg; RER = resting energy requirement
- Industry statistics and trends. American Pet Products Association. Available at americanpetproducts.org/press_industrytrends.asp.
- Baldwin K, Bargest J, Buffington T, et al. AAHA nutritional assessment guidelines for dogs and cats. JAAHA 2010; 46(4):285-296.
- Market report: Pet owners seek new information sources. PetFoodIndustry.com. Available at www.petfoodindustry.com/Columns/Market_Report/Market_Report__Pet_owners_seek_ new_information_sources.html.
- Hand MS, Novotny BJ. Small Animal Clinical Nutrition, 4th ed. Topeka, KS: Mark Morris Institute, 2002, pp 14-15.
- Zoran DL, Buffington TA. Effects of nutrition choices and lifestyle changes on the well-being of cats, a carnivore that has moved indoors. JAVMA 2011; 239(5):596-606.