Prior to visiting Veterinary Rehabilitation & Sports Medicine for the first time, we request our clients take a moment to complete our New Client/Patient Questionnaire. This form is used to gather client contact information and your pet's medical history, allowing us to better serve you and your pet by ensuring you have more time with our rehabilitation practitioners and less time filling out paperwork! Please call to schedule your consultation, as submitting this form is not an appointment or consultation request.
This form is used to gather a brief pain inventory for your dog based on the past seven days of activity. This information provides us a better understanding of your dog's current pain level.
Our Policy Acknowledgement form states general information and appointment scheduling policies. This form must be signed prior to your first visit and is an acknowledgement and agreement of our policies. Thank you for taking a moment to review and submit this form!
Every three years we ask our clients to complete a Medical Records and Information Release form. This allows us to send your pet's medical history to your primary veterinarian, emergency clinics, specialists or pet insurance companies on your behalf.
Diet-Associated Dilated Cardiomyopathy
July 22nd, 2019
Heart disease is common in our companion animals, affecting 10-15% of all dogs and cats, with higher rates in particular breeds. Recent studies have shown a direct correlation between diet and some versions of heart disease. Our goal is to shed light on the important role nutrition plays in the development of dilated cardiomyopathy and educate pet owners with the correct information to protect and care for their family pet.
What is dilated cardiomyopathy (DCM)?
DCM is a serious disease of the heart muscle which causes the heart to beat weakly and to enlarge. DCM can result in abnormal heart rhythms, congestive heart failure (a build-up of fluid in the lungs or abdomen), and even sudden death. In dogs, it typically occurs in large and giant breeds, such as Doberman Pinschers, Boxers, Irish Wolfhounds, and Great Danes. In these breeds, genetics play a role. Additional studies have shown DCM in dogs is more complicated than genetics; diet plays a role. The exact link between diet and DCM is currently a topic of vigorous research by the FDA and veterinary nutritionists.
Is diet the cause?
Cause is yet to be determined, but correlation between DCM and BEG diets has been shown. Cardiologists recognized a surge of DCM diagnoses in atypical breeds and learned affected pets were much more likely to be eating BEG diets. The term BEG diet refers to boutique, exotic ingredient, and grain-free diets. Such diets incorporate unusual ingredients like kangaroo, lentils, fava beans, tapioca, salmon, barley, bison, and venison to name a few. The exact link between BEG diets and DCM is currently being studied. One area of research is focusing on possible deficiencies in the non-traditional carbohydrate or protein sources used in BEG diets. Nutritional expertise and quality control of smaller pet food companies is another targeted area of investigation. Cardiac specific toxins are being considered.
Initially, the research was heavily focused on the possibility of taurine deficiency within BEG diets. This theory gained traction and word spread that taurine deficiency was the primary issue. While taurine still may prove to be a principal player, it is now known that many of the individuals diagnosed with DCM are coming back with normal taurine levels.
The truth about boutique, exotic ingredient & grain-free diets
It is certainly true not all BEG diet manufacturers are created equally. Many have high standards and use high quality ingredients. Many employ veterinary nutritionists and take great care to produce a balanced and nutritious diet. Many pets have benefited from eating a grain-free diet or perhaps a diet with a unique protein source. For example, pets with food allergies can often benefit from such feeding. Conversely, many manufacturers of BEG diets focus largely on effective marketing and less on the product. BEG diet marketing, by and large, has propagated the myth that grains and traditional proteins are unhealthy inclusions for pet food across the board. The vilification of the term “byproduct” has also been a goal of BEG diet marketing when, in fact, byproducts (non-muscle sources of protein such as liver, heart, kidney, etc) are completely nutritious and provide a proper balance of nutrients, vitamins, and minerals.
I’ve been feeding my dog a BEG diet. What should I do now?
The FDA is currently investigating the association between diet and DCM, but in the meantime, there are some things you can proactively do until more information is available:
Reconsider your dog’s diet. If you’re feeding a BEG diet, assess with your veterinarian the possibility of a diet change to a more traditional diet. Be skeptical of information regarding pet nutrition available online. Much of the online information is heavily influenced by marketing myths and subjective anecdotal information. It is important to seek objective criteria such as peer reviewed research and nutritional expertise from veterinary professionals. Seek pet food manufacturers with excellent nutritional expertise and rigorous quality control standards.
Changing to a raw or homecooked diet will not necessarily protect your dog from DCM and may increase the risk for other nutritional deficiencies. If your dog requires a home-cooked diet, be sure to talk to a veterinarian or a veterinary nutritionist before making this change.
If your pet has benefited from a BEG diet, it may not be appropriate to change foods. Understanding the risk/reward of feeding BEG diets for a particular pet is an important assessment. Monitor your pet for early signs of heart disease such as coughing, slowing down, exercise intolerance, shortness of breath, or fainting. Your veterinarian will listen for a heart murmur or an abnormal heart rhythm and may recommend additional tests such as x-rays, blood tests, electrocardiogram, or ultrasound of the heart (echocardiogram). Your veterinarian may also refer you to a veterinary cardiologist if necessary.
My dog has been eating a BEG diet & has been diagnosed with DCM. What’s next?
If your pet has been eating a BEG diet and was recently diagnosed with DCM, ask your veterinarian to test taurine levels and report the diagnosis to the FDA. This report can be done either online or by phone. Change your dog’s diet to one made by a traditional, reputable company. Your veterinarian will likely start your pet on taurine supplementation. Thankfully, correcting the diet can lead to improvements in the condition of the heart. Such improvements may take 3-6 months. Your dog will need regular monitoring and will require medications to treat the disease.
We will continue to update our clients on this topic as we receive more information from the FDA and veterinary nutritionists. If you have additional questions involving diet, nutrition, or diet-associated dilated cardiomyopathy, please contact your veterinarian.
October 15th, 2018
As a facility that is proudly among the 15% of those accredited by the American Animal Hospital Association, we regularly take a look at our policies and practices to make sure that we are providing the best care in every possible way. This recently led us to review how we have addressed rabies vaccination for our patients within our facility, and we realized that we needed to develop a clearer policy that puts the safety of our patients, clients, staff, and community at the forefront.
Tennessee state law is very clear with regards to the requirements for rabies vaccination for dogs and cats, and as a rehabilitation facility, we take our duty to protect public health very seriously. At the same time, we recognize that there are circumstances that result in concern about vaccination for certain pets. With both of these factors in mind, we have worked together to create a policy that we believe strikes a good balance.
Starting November 1st, in order to receive care at our facility, patients must either be up to date on their rabies vaccination or they must have a blood test done once a year to determine whether they have an adequate level of antibodies against the rabies virus present in their system. As long as an adequate level is demonstrated each year, we will allow that patient to forego vaccination. If the test comes back showing an inadequate level of antibodies, we will require that patient to receive a rabies booster prior to receiving any further care.
Please note that the blood test is not a substitute for a rabies vaccination in the eyes of the state. If a pet were to bite another pet or a person or if that pet were to be exposed to a potentially rabid animal such as a skunk or bat, then animal control would still treat that pet as unvaccinated. This could result in a significant fine, a strict quarantine of 4-6 months in an animal control facility, or even euthanasia.
Our top recommendation is for all pets to be up to date on their rabies vaccine. This is best practice from both a legal and public health standpoint. Vaccinating for rabies every 3 years will nonetheless be much less expensive than the annual blood test. At the same time, we do want to provide an alternative for those who have concerns about vaccines for their pets that still ensures the safety of all people and pets who come to our facility.
We appreciate you entrusting us with the care of your pets, and we hope this policy serves to further build that trust. If you have any questions, please feel free to call us.
We value our relationships with referring veterinarians and although we do not require a referral, we prefer to have a completed form submitted for each patient prior to their initial consultation. In order to maintain these important relationships, should a patient need further care or diagnostics outside of veterinary rehabilitation, we refer them back to their primary doctor or specialist as needed. While Veterinary Rehabilitation & Sports Medicine is a separate entity from Animalia, we are located on the same campus. Out of respect for our referring veterinarians, our clients are required to sign a policy agreement not to pursue primary care with Animalia. Communication between providers is also vital to the health and well-being of each patient, so all initial consultation and progress reports will be submitted to the patients' primary care provider in a timely manner. Thank you for taking a moment to review and submit this referral form!