Veterinary Q&A: Drs. Hilary Quinn and Meri Stratton-Phelps Answer Questions Surrounding the Canine Gastrointestinal System, Its Various Influences and What to Consider When Choosing the Right Diet and Supplementation for Your Dog

Dogs are a fixture in our daily lives, faithfully standing beside us in numerous capacities. From working dogs tailing a herd of cattle, to agility dogs mastering an obstacle course at high speed, to service dogs, show dogs, family dogs and a variety of roles in between — these animals play a pivotal role in not just their jobs but in our families. They’re our partners, our friends and a source of unconditional joy.

As their people, it’s our job to be at the helm of our dogs’ care, making the key decisions that ultimately impact their health and longevity. With seemingly endless options, often we’re left with more questions than answers. Like food, treats, supplements, etc. How do we choose? The answer: Bring your veterinarian into the fold. Ask questions. Discuss the research you’ve done at home, and devise a plan together that best addresses your dog’s individual needs while meeting your goals for results and manageability.

Drs. Hilary Quinn and Meri Stratton-Phelps join Jessie Bengoa of Platinum Performance® to offer their insights and expertise concerning the facts about our dogs’ gastrointestinal (GI) health, how it impacts their overall health, outside influences that can positively or negatively influence GI balance and what to keep in mind when choosing an ideal diet and supplement plan. Hilary Quinn, DVM, is a small animal veterinarian and owner of Wilder Animal Hospital in Santa Barbara, California, and is a passionate advocate for proper nutrition and the role of diet in a dog’s overall whole-body health. Meri Stratton-Phelps, DVM, MPVM, DACVIM (Large Animal, Nutrition), is a renowned Northern California-based multi-species veterinary nutrition expert who is widely published and considered a highly knowledgeable expert in the field.

Jessie: Dr. Quinn, can you give us a lay of the land, per se? What should we know about our dogs’ GI systems in particular?

Dr. Quinn: The canine GI tract, while amazing and complex in its function, is also simple in the way that it works similarly to our GI tract as humans. The GI tract houses a significant portion of the dog’s immune system while also being responsible for nutrient absorption and being home to the gut microbiome, which is the profound and delicate collection of microbiota (a wide variety of bacteria, viruses, fungi and other microorganisms) and their metabolites that play a key role in overall health, propensity for disease and also longevity.

Jessie: It appears that, like other species, a dog’s GI tract and their microbiome are central to their overall health. Dr. Quinn, what choices that we as dog owners make can influence GI health?

Dr. Quinn: The short answer is that everything affects the GI system, although the largest impact on a dog’s GI tract is their diet: What they’re eating in terms of food and supplements and the different macro- and micronutrients they’re ingesting. That all can affect the balance of good bacteria to pathogenic bacteria in the gut microbiome, as can antibiotics, NSAIDs (non-steroidal anti-inflammatory drugs), individual genetics, environmental toxins, stress, sleep and a host of other things your dog may become exposed to. It’s all about maintaining that optimal balance to the best of your ability.

Jessie: Let’s take medications, for instance. In human medicine, we’ve become so much more thoughtful to not overprescribe antibiotics and to be aware that NSAIDs can have a negative impact on our gut lining in particular. While both undeniably have a critical time and place in cases that need them, what’s your approach to prescribing medications to your patients?

Dr. Quinn: My approach has shifted over my years in practice. Where I might have previously prescribed (the antibiotic) metronidazole for a diarrhea case much more readily 10 years ago, now there’s been a big pendulum swing for me. I stop and ask myself, “Does this case of acute diarrhea really need antibiotics or can I instead prescribe a course of high-quality probiotics as well as, perhaps, a binder or an alternative to help support that dog’s GI tract while not harming their microbiome?” I’ll also recommend that their owner considers a short-term transition to a bland diet; something very digestible that is going to help the dog’s gut get back to homeostasis. Certain cases call for an antibiotic, no question, but in cases where the dog appears to improve quickly while taking an antibiotic, my question is, would they have gotten better anyways if we had just treated with probiotics, a binder and dietary intervention?

Jessie: That’s a thoughtful approach where you’re handling each case uniquely. While some cases may absolutely require NSAIDs or antibiotics, others may benefit more from a combination of those drugs, a probiotic/prebiotic and a binder, or perhaps those things alone without a drug. Each case is certainly individualized, but how can that more “whole-body” approach that you take to treatment benefit the dog?

Dr. Quinn: I certainly use this approach in my recommended treatments, but it’s also about prevention. As veterinarians we’d much prefer to prevent than to put out the fire once it’s started; it’s just so much more beneficial for the dog. That whole-body approach has changed the way I look at my patients and certainly how I incorporate diet into every case I see. For instance, I may have a dog that comes in for an ear infection. Clients always wonder, how is the diet related to that? What a lot of people might not realize is that what they're feeding their dog might cause that ear infection. Again, a huge percentage of the dog’s immune system is collected within the GI tract. If the dog is having an allergic reaction to food, it can manifest as an ear infection. Everything is connected. That’s just one small example, but there are so many instances where diet is a key factor that isn’t being considered as it should be.

Dr. Hilary Quinn is a small animal veterinarian and owner of Wilder Animal Hospital in Santa Barbara, California, and is a passionate advocate for proper nutrition and the role of diet in a dog’s overall whole-body health.

Jessie: Lets hone in on diet. Dr. Stratton- Phelps, it seems like we’re faced with near endless options. It’s a little bit overwhelming. What’s your approach?

Dr. Stratton-Phelps: Providing a complete and balanced diet for your dog helps to maintain their health and longevity, but choosing the right diet can be challenging. Today, dog owners are faced with a wide variety of dog diet options from traditional kibble-based or canned diets manufactured by large pet-food companies to boutique dog foods that come in a variety of forms (refrigerated, frozen), to raw food diets. As a consumer, deciding on the ideal dog food can seem overwhelming, but there are some basic principles that can be followed to help owners find the best food for their dogs.

First, start with life stage. Food provides energy and essential nutrients, and decades of research has been performed to identify the ideal concentration of macronutrients (protein, fat, carbohydrates), minerals and vitamins that need to be consumed by an adult dog to meet nutrient requirements. Some nutrients need to be consumed in different amounts by a growing puppy or by a dog during pregnancy, so it is important to consider the life stage of the dog you are feeding and to select a diet that will provide optimal nutritional support.

Next, study the label. When you look at the label of a dog food, one of the first things to find is a statement on the pet food label that the food meets the nutrient requirement of the dog at their current life stage (maintenance, reproduction, growth) or a label that states that the food is designed for “all life stages,” which means that the food will meet the nutrient requirements of the dog during growth and reproduction. Dog foods should be formulated to meet nutritional needs based on the guidelines and nutrient concentrations set forth by the Association of American Feed Control Officials. [AAFCO is a non-profit organization that has guided state, federal and international feed regulators with ingredient definitions, label standards and lab standards for over a century.]

Ask your veterinarian. Your veterinarian is your best resource in helping you choose the right food for your dog based on your dog’s age, weight and health. Some dogs that are overweight require calorie restriction or a diet designed to help promote weight loss. Other dogs may have health problems that require dietary changes to help manage a systemic disease like kidney disease or pancreatitis. Because your veterinarian knows your dog’s health, they can help guide you.

Choose the right option for your dog (and you). Recently, there has been an explosion in the number of dog foods that are available. In addition to working with your veterinarian to select the best food and making sure that the food meets AAFCO nutrient requirements, it can be helpful to look for a dog food that is manufactured by a company that employs nutritionists to formulate the diets. Veterinary nutritionists and animal nutritionists with advanced training understand how to properly balance dog food recipes to make sure that the diets meet essential nutrient requirements and are also palatable. Choices in the textural composition of dog foods (kibble, canned, fresh, frozen) are largely up to the dog owner.

Jessie: That’s an excellent step-by-step guide, Dr. Stratton-Phelps. Digging into the available options, Dr. Quinn, can you give us a high-level look at what we have to choose from?

Dr. Quinn: Absolutely. As dog owners, we do one thing every day that’s the primary influencer for our dog’s GI health but also their overall health, and that’s what we feed them. I tell my clients, “Your dog isn’t in control of that. You are, so it’s important to make the right choice.”

Kibble: With that said, most people feed kibble, which is an extruded diet. There has been a ton of research poured into how to make these extruded, convenient diets as healthy as possible for dogs. Bottom line, we love our dogs, and we want to do everything we can for them. But, we’re also busy, and we’re running around. And, we work, and most people can’t home cook for their dogs in a way that is nutritionally complete. I tell people that it’s better to feed a very high-quality kibble than it is to just cook up whatever you think might be good for the dog. At least with an extruded kibble diet (a good quality one from a reputable company), the kibble has gone through testing and is required to meet the AAFCO feeding guidelines. Better yet would be if it has gone through feeding trials, and we know that it is what it says it is.

Home Cooking: When people home cook, they’re feeding whatever looks like an appropriate balance of things, but it may not be nutritionally complete. It may not have the right amount of various nutrients.

Fresh Diets: Anyone will tell you that a fresh and varied diet is better for your dog’s health than eating kibble. There are a lot of fresh diets that have become available that are nutritionally complete, made with fresh human grade ingredients and they come frozen. You just thaw and serve. There are a lot of companies that also offer these fresh, therapeutic diets for certain conditions. A benefit of these fresh diets is that they can be a better alternative to simply feeding kibble.

Regardless of which route you choose — kibble or fresh — I advise my clients to choose a company who has a good reputation and track record, whose products are developed by nutritionists and veterinarians, and who offers the right fit for their dog’s individual needs.

Jessie: Can we look at raw diets for a moment? What’s your take on raw diets and do you, or do you not, recommend them?

Dr. Stratton-Phelps: Feeding raw dogfood diets increases the risk of bacterial contamination of the preparation area (often the owner’s kitchen), which can lead to exposure of the owner, their family and the dog to pathogenic bacteria that can cause illness. Raw dog-food recipes often contain bones, and these increase the risk of damage to the dog’s GI tract if they puncture the wall of the intestine during the digestive process.

Dr. Quinn: I agree. I don’t recommend raw-food diets for the reasons Dr. Stratton- Phelps mentioned. Dogs can absolutely have terrible GI distress from a foodborne pathogen. They can also carry those pathogens in their fur. There have been a lot of studies done on this in dogs being fed the B-A-R-F (Bone And Raw Food) diet. These pathogens are on their fur and in their fecal material. There’s too much potential for contamination for both the dog and your family. For people who want to feed something other than kibble, there are many good, fresh options out there rather than turning to a raw diet. In addition, much like home-cooked diets, my other concern with raw diets is that they too are often unbalanced or nutritionally incomplete and lacking key vitamins and minerals that can leave your dog susceptible to conditions like nutritional hyperparathyroidism (a disease of abnormal calcium and phosphorus regulation) or dilated cardiomyopathy (DCM, or an enlarged heart), with the latter possibly leading to heart failure and even death. These are serious and not entirely uncommon, so I stress to my clients that they need to make sure their dog’s diet is nutritionally balanced.

“Not all supplements are created equal. That’s the main take-home message I try to tell my clients,” says Dr. Hilary Quinn.

Jessie: We know that in humans and other animal species, there are required levels of nutrients vs. optimal levels of nutrients. At Platinum Performance, this is where we focus on achieving optimal nutrient levels, as well as on more advanced nutrition for performance and recovery. Do you recommend supplementation, and if so, what should dog owners take into consideration while choosing the right formula(s) for their dog?

Dr. Quinn: The AAFCO guidelines for your dog’s food are a minimum. Take omega-3 fatty acids, for instance. There are minimum guidelines, but that doesn’t mean that most dogs wouldn’t benefit from additional omega-3s for their joint health or their cognitive health. In many situations, supplementation with a reputable bio-available formula is going to be beneficial in filling nutritional gaps but also in supporting each individual dog’s needs, whether that be seasonal allergies, achieving an optimal weight, GI concerns, joint health, etc.

Jessie: At Platinum, we’re intensely focused on the quality of our ingredients and our finished formulas, as well as on testing for quality, potency and purity. That’s a central part of who we are, but as a veterinarian, why do you advise clients to ask those questions of the companies that they purchase from on behalf of their dog?

Dr. Quinn: Not all supplements are created equal. That’s the main take-home message I try to tell my clients. You can’t just go out and grab any omega-3 fatty acid. Find a supplement whose manufacturer does the appropriate testing, make sure the ingredients are bio-available (absorbable) and ask questions about quality testing, ingredient sourcing and where and how the products are made. You may be surprised by the answers, both positively and negatively depending on the company you’re asking.

Dr. Stratton-Phelps: I agree with Dr. Quinn. While supplements can provide additional healthy nutrients to the diet, not all supplements or supplement companies are created equal. It is ideal to select supplements that are manufactured by a company that has a trusted reputation for quality and that has products that are formulated by veterinary nutritionists. Ingredients used in dog dietary supplements should be of the same quality used in pet foods. Finding a supplement company that meets the strict guidelines of the National Animal Supplement Council (NASC) and one that manufactures their products in their own certified Good Manufacturing Facility (cGMP) facility helps to ensure that the product you are feeding is of high quality and is made using best manufacturing practices.

Jessie: Any closing thoughts that you like to leave your clients with, Dr. Quinn?

Dr. Quinn: I always admire how much my clients love their dogs. We have three dogs in my family, so I get it. They’re a huge part of our life. We’re all trying to make the right choices to allow our dogs to live long, comfortable, healthy lives. At the end of the day, I encourage my clients to always take diet into consideration and to never underestimate what the right diet and proper supplementation can do to support your dog’s gastrointestinal health but, past that, to support their whole-body health and vitality. Try to choose the highest quality, most nutritionally sound diet you can for your dog, then explore the right supplements to fill nutritional gaps and to support their individual needs. Don’t just walk into the pet store and grab a dog food or a supplement off the shelf and think that it’s a sufficient quality or always safe and effective because it’s there. Ask questions of the companies you buy from, so you’re an advocate for your dog. With the right food, supplementation, lifestyle and veterinary care, your dog will hopefully live a long and happy life.