For pets with cancer, eating can be the difference between life and death
Veterinary technician content is sponsored by Elanco for the month of October.
Pets suffering from cancer have a plethora of health issues accompanying their disease, including a risk of not getting enough nutrients due to a decrease in appetite. As pet parents prepare to cope with their pets suffering from cancer, veterinary teams also need to communicate the importance of a nutritional protocol to help support their pets' quality of life.
During her lecture "Communicating Nutrition to Pet Parents of Cancer Patients"1 at the Directions in Veterinary Medicine symposium in Nashville, Tennessee, Vicky Ograin, MBA, RVT, VTS (Nutrition), scientific communication specialist at Hill's Pet Nutrition, explained to attendees how the veterinary team can play a crucial role in helping pet parents get their pet the nutrients they need while battling cancer.
According to Ograin, pet parents whose pets have cancer are typically very engaged and motivated to do what is needed for their pet. Pet parents are likely to utilize other options such as "Dr Google," to get a better understanding of options and care for their pets. They are also known to put extreme value on the guidance and advice that veterinary teams tell them. In fact, a study conducted in Ontario, Canada, found that 85% of pet parents highly valued the nutritional advice they received from the veterinary team.2
“We have a pet that has come in that has been diagnosed or is going to be diagnosed with cancer. We want to be really, really proactive about that nutritional conversation [and] start early, not later. Basically, when they're still feeling well. Don't get them when they're now at a point where they're at the end of the path, and the owner is giving them anything they want. We want to make sure we have them on the right nutritional plan so that they can navigate going through the treatment, and hopefully, are with us even longer because obviously that's the goal,” Ograin expressed to attendees.
When making each patient's nutritional plan, Ograin recommends to have specific goals in mind to meet the needs of each individual pet. Some goals veterinary teams must consider when making these plans are preserving lean muscle and minimizing metabolic and gastrointestinal (GI) intolerance to food.
Learning what your clients are feeding their pet is the place to start when trying to figure out how much, because a transition may be needed. Through treatment, pets are at risk of GI issues, so changes in their diet may be necessary or even may help them eat more if there is a decrease in appetite. Ograin told attendees that it is also important to be empathetic when trying to figure out what a pet's diet is because answers may vary. For example, asking a pet owner what their pet is ingesting may only mean food to them, not treats, or what their partner feeds the dog. To help get to the bottom of it, Ograin had this recommendation:
“I think in cancer patients, we absolutely have to be so empathetic and help them figure out what they're feeding, how we can make sure they're still getting nutrients and eating that good, complete and balanced diet [while] navigating what they're going through with the dog or the cat that has cancer. So some people like to use forms [and] WSAVA has a really great nutrition diet history form,” Orgain explained.
“What I would do though, even if they use the handout, keep in mind [it] says what pet food are you feeding? I'm still going to say okay, 'I see you're feeding, for example, Science Diet Dry Can and you're giving a little bit of chicken as a treat. Okay, no problem. What else?' I'm still going to do the what else?” she concluded.
Ograin warned attendees to not let the pet parents decide how much food to give their pet. The questions that you ask in your exam will help determine what should be recommended. In order to calculate how much food, veterinary professionals will need to calculate the resting energy requirement (RER). Teams can calculate this either using RER= (70x kg BW0.75) or RER= 70 + (30xkg BW) and then multiply this by a factor that takes into account the pet's age, activity, or physiology.3
She also reminded attendees that treats are sometimes how pet parents show love to their pets, and a sick pet will probably get more treats than normal. She told attendees that it is important to incorporate treats into the food plan but inform clients that treats should never be more than 10% of the calories. It also cannot hurt to remind clients that they can show love without giving food such as with praise or play activities.
A transition may not be easy for some pet parents, and they may need some helpful tips from teams to ensure their pets are eating the food they need. Some tips that Ograin offered were to have pet parents warm the food, but instruct them to make sure it is not too hot. Pet parents could also try using separate bowls because they may not like different foods in the same bowl. Pet parents can also try a different texture. If the pet is not eating the dry food, try the wet food version. If all else fails, a salt-flavored broth or a small amount of oregano can be added. However, this should not be recommended if the pet has hyperthyroidism.
Finally, follow up with the clients. While they are at the clinic, the shock of their pet's diagnosis might not give them the chance to ask questions that are important to them or that came up once they had time to sit with the information. This can also be a time when any family members who were not at the appointment can have their time for questions. Ograin recommends calling 2-3 days after the diagnosis, 2 weeks, and then 1-2 months to see how they are doing.
According to Ograin, the most important follow-up the team will have with the client is that 2-3 day call. This call is when the pet parents will be in the transition and are at high risk of giving up on the new food for their pet. Be their cheerleader on this phone call and help them through any issues they share.
“The last thing that is really important is you need to follow up. I'm sure you are with these patients, right? You don't diagnose cancer, say come back for chemo and you never see them again. They're coming in all the time. They're coming in for treatments [and] for rechecks. When they're doing that, stop in and talk to them, see how they're doing with their food or call them. I did a lot of calling [and] these calls really don't take a lot of time,” said Ograin
“But to me, it helps the owner know that you care about their pet because you do. It bonds them to the clinic, but it's really going to help them. Keep in mind, they're devastated. I usually will call in a couple of days, hopefully by then they've kind of wrapped their mind around what's going on, and now all the questions come out,” she concluded.
Once you have reached the 2-month point of check-in calls, it is up to each team and case to determine how much you should call after that.
Once pet parents receive the diagnosis that their pet has cancer, they will need the veterinary team to advise them on the proper nutritional direction for their pet. Nutrition is an important part of the treatment plan for these patients, and it starts with communicating with the clients on how to help their pets. This support and guidance can help pets continue to live their best lives as they fight their cancer.