Dietary Training

4. Dietary Training

Training for Veterinarians

The importance of expertise in this field cannot be overemphasized. Competency requires extensive training in nutrition, and in cases where the diet will be used therapeutically, veterinary medical training is a must. Caution should be exercised when consulting individuals who do not have the appropriate training and credentials to formulate diets. Diplomates of the ACVN or ECVCN that provide this service have the necessary skills and training, and should be consulted.

Most veterinary nutritionists reserve the use of a home-cooked diet for:
- Clients that cannot be dissuaded from home preparing their pet's food
- And for patients with multiple, concurrent disease processes that cannot be appropriately managed using commercially available diets.

Home-cooked diets have the disadvantage of being more expensive than commercially prepared food, labor intensive and prone to "diet drift". "Diet drift" refers to the tendency of some clients to slowly adjust diets over time without realizing, or considering the consequences of adding more of a particular ingredient or eliminating a necessary supplement. These concerns aside, home-cooked diets are often the only option in instances where a commercial product is unacceptable to the patient, or there is not one product that can meet that animals needs. In addition, home-cooked diets also allow for the use of novel ingredients, can be formulated to take advantage of recent research that has not found its way into a commercial formulation, or that may not be economically practical to mass produce.

It may be difficult enough evaluating the total calorie content, never mind conducting a nutritional analysis of the diet solely on the basis of a list of ingredients. A veterinarian must however be able to identify nutritional deficits in home-made diets to recognize the need to enlist the assistance of a trained veterinary nutritionist.

Training for Clinical Staff

Integration of nutrition into clinical practice is dependent on fully utilizing a practice's support staff. Support staff can assist beyond stocking diet, feeding hospitalized patients and selling food. Technicians and nursing staff should be trained to monitor daily food intake in all patients. This requires that feeding orders be clearly provided for each animal. An American study showed that in 22% of hospitalized dogs presenting an undernourished condition, the problem is simply due to a poor understanding of written recommendations (Remillard et al., 2001).

Follow-up monitoring of dietary performance can become the responsibility of the technical staff. Many support staff would welcome the additional responsibility of weigh-ins for weight loss programs or monitoring urine pH or specific gravity in patients with a history of urolithiasis. Receptionists should be trained to recognize the appropriate use of therapeutic diets so that client purchase inconsistencies can be quickly identified and addressed.

Technicians and nurses can also be trained to provide client education on the specific nutrient differences between therapeutic and maintenance diets.

Conclusion

Without question, nutrition is a vital component to providing optimal patient care. Clinics that have not already integrated nutritional management, monitoring and counseling into the care of each animal, must begin to do so in order to provide the highest standard of care. Additional resources and expertise that can help any practice achieve these goals may be found in the references listed in Table 4.