Pets depend on their people, so nutritional assessment is about more than your pet.
Veterinary Nutrition Care takes a holistic approach for each pet. Because the word holistic seems to mean many different things to different people, let's explain that statement. Every pet has unique nutritional needs: specific amounts of calories and many different nutrients, but feeding pets is about more than that. While a big part of your veterinary nutritionist's job is using nutrition to support whatever we ask of our pets; whether that is to just stay healthy, live with a disease, recover from surgery, or do a job, even looking at the patient as a whole isn't the complete picture. There are two other important components to every pet's nutritional assessment: the diet he/she is being fed, and the people with which he/she lives (because they affect what, and how, the pet is fed, and the pet's jobs in life). Understanding of these three factors is necessary for a complete nutritional assessment for any pet.
Why is understanding the patient's diet and family just as important as understanding the pet's individual needs? Here are some examples:
Princess is a 4 month-old Golden Retriever puppy. She should be bouncing around, exploring everything, but she can't. She is depressed, and stays curled up in her bed; she doesn't move much. When she does move, she cries in pain. Princess's family is very dedicated and diligent; they are really worried about her. They take her to be examined by her veterinarian. At first, it looks like Princess has a neurological problem, but after taking a detailed look at Princess' diet, it is found that the diet is an unbalanced home-prepared diet of chicken and vegetables. This diet does not provide enough calcium for a growing puppy (or any dog, for that matter), and her pain is the result of the collapse and fracture of her weakened bones. This happened rapidly because of the tremendous nutrient needs of growing puppies. Unfortunately, in this case, Princess' family's desire to give her the very best by providing her with special home-prepared meals, without understanding her nutritional needs, caused the problem.
Salsa is a 12 year old house cat. He is otherwise healthy, but has gained too much weight over the past year. He eats a therapeutic diet recommended by his veterinarian for use in an appropriate weight loss plan. Much to his owner's frustration, Salsa has not lost any weight at all. In fact, he's even gained a bit over the last month! Upon more thorough investigation, it was found that Salsa's family also includes a 4 year-old boy, who has been "helping" by feeding the cat!
Looking at the complete picture guides the plan.
Once the nutritional assessment is complete, that is, a pet's nutritional needs have been determined, the pet's diet has been examined, and the pet's family life is understood, a description of an ideal nutritional plan can begin to take shape. For example:
Roxy is a Jack Russell Terrier who has always had a finicky appetite. Her current diet is a mixture of an over-the counter small-breed dog diet and hard-boiled eggs, which her owner has always added to Roxy's food to get her to eat. She eats this mixture well, but Roxy's current diet is no longer appropriate for her, since the over-the-counter diet has too much phosphorus to accommodate her newly-diagnosed chronic kidney disease. Her owner has just changed jobs and is now working from home. She enjoys cooking, and would like to cook for Roxy. Roxy's owner is a vegetarian and would prefer not to purchase or prepare meat.
Based on all of the above information, which was collected during the nutritional assessment, it was determined that a balanced home-prepared diet could be formulated for Roxy that would accommodate her kidney disease, her typically finicky appetite, and her owner's preferences.
A balanced egg-based home-prepared diet, which included appropriate vitamin and mineral supplements was formulated for Roxy, along with specific feeding, preparation, diet transition, and follow-up instructions.
A plan is not forever.
No nutritional plan should ever be static, and no nutritional plan is complete without a plan for follow up. Changes in the pet's needs, the family's needs, and the diet being fed all happen over time. The change may be something that we aim to achieve, such as in a weight loss (or gain) program, or it may be a natural progression of of life or a disease process; it may also be a change in the home that affects the feeding of the pet, or even because a pet owner changed the ingredients or preparation of the diet over time (this happens more than you might think!). Applying the same nutritional plan to these changed circumstances isn't usually the right thing to do. Follow-up, either in person or by phone or email is a very important part of any nutritional plan. Checking for changes in the pet, the family, and the diet allows the process of nutritional assessment to be repeated so that the new picture can guide a new plan.
To use Roxy as an example:
Two weeks after transition to the new diet was complete, Roxy was found to have lost weight, despite eating the new diet fairly well. After checking for (and not finding any) other (medical) causes of weight loss, Roxy's feeding plan was adjusted to slightly increase the amount she was fed each day, and the plan was made to follow-up in another two weeks.
Two weeks later, Roxy was weight-stable and doing well, so the plan was made to see her again in 3 months.
Roxy's periodic follow-up evaluations were unremarkable for nearly a year, when routine labwork showed a progression of her chronic kidney disease. Based on this new knowledge, Roxy's diet was further modified to accommodate her later stage of disease. It also gave Roxy's owner a chance to receive counseling on what to expect from further progression before she would have to make decisions on how to manage it.