Pets require a satisfactory diet to maintain normal structure and function at all stages of life. I define a satisfactory diet as one that is complete, balanced, palatable, digestible, and safe. Complete means that the diet provides adequate amounts of all required nutrients; balanced means that the nutrients are present in the proper proportions. Balance is crucial because excesses of some nutrients may cause deficiencies of others.
The goal of clinical nutrition is to sustain the nutritional health of the pets we care for without adversely affecting the quality of the bond between our clients and their pets. To do this we consider the signalment of the animal, the most suitable diet to recommend given the pets physiological state and (or) disease, and the most appropriate feeding strategy for both the pet and her owner.
During the last 150 years or so, spectacular advances have been made in the science of medicine. The discoveries of the principles of adequate sanitation and nutrition, and of antibiotics, vaccines, and other drugs have demonstrated the value of the scientific approach to health problems. As a result, most health care professional education now focuses on the scientific aspects of treatment of disease.
For joint supplements, the news isn't good. Despite the enthusiasm, and aggressive marketing, not only is compelling evidence for efficacy lacking, there is evidence against efficacy. For example, a recent study in humans1 concluded that, "Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee.
Cats currently are the most popular pet in America, and are considered a family member by many cat owners. Despite these facts, cats do not receive the veterinary care they need; in 2006, only 64% of cats (compared with 83% of dogs) visited a veterinarian (1).
Our ability to communicate with clients determines our success as clinicians and caregivers. This is because client adherence to our recommendations depends in part on the relationship we share. In medicine, as in life, improved interpersonal interactions between caregiver and patient lead to increased commitment and satisfaction for all concerned.
Keeping cats indoors has become common veterinary advice to reduce the risk of exposure to infectious diseases and injury from vehicles or other animals. This advice may not be completely beneficial for cats, however. As early as 1925, Kirk suggested that "too close confinement to the house" increased the risk of lower urinary tract signs (LUTS). Results of subsequent epidemiological studies have confirmed his observations.
A diagnosis of interstitial cystitis in people and cats requires identification of the presence of characteristic (although non-specific) sub-mucosal petechial hemorrhages--referred to as glomerulations--by cystoscopy, though the diagnostic value of this criterion is under debate.