Just What The Doctor Ordered?!

By Jim Galovski

Published on April 28, 2022

THE BIRTH OF PRESCRIPTION DIETS 

The history of veterinary based commercial foods for dogs and cats started in 1939 when Dr. Mark Morris was asked by Morris Frank if there was a dog ration that could be fed to help ease his dog Buddy's kidney condition. Dr. Morris had founded the Raritan Animal Hospital 11 years earlier and was only one of two small animal hospitals in the country. As such, he was rightfully looked at as an expert which is why Mr. Frank sought his counsel. Since no such diet existed, Dr. Morris and his wife set out to create one in their Edison, NJ kitchen. What they came up with was called Raritan Ration B and was packaged in small glass containers and shipped to Mr. Frank at various locations across the US (Mr. Frank was the co-founder of The Seeing Eye, the nation's first guide-dog school, and travelled extensively to promote the use of dogs to assist the blind). Many of the shipments to Mr. Frank unfortunately arrived broken. As glass was very scarce and expensive during WWII, Mr. Frank secured several thousand cans and a hand operated canning machine for Dr. Morris to package his "Ration B" diet. 

After 9 years of hand canning, Dr. Morris reached out to Burton Hillin Topeka, Kansas for help. With two "special diets", demand was beginning to exceed his ability to produce and package the lines. Hill's Packing Company (founded in 1907 as Hill Rendering Works) was given exclusive rights to produce and can Dr. Morris' Raritan Ration B and Raritan Ration C (the forerunners to k/d and p/d, respectively). Hill's first action was to rename Dr. Morris' products. Raritan had little to no meaning for a National audience and Mr. Hill wanted to not only address the specific health conditions each diet served but make them "exclusive". Mr. Hill and Mr. Morris applied for and received the trademark, "Hill's Prescription Diet" giving birth to the "veterinary channel". In addition to "prescription k/d" and "prescription p/d", Hill and Morris created and released, c/d (calculi diet), i/d (gastrointestinal distress) and r/d (weight reduction). Today, Hill's have a "prescription diet" for almost every letter in the alphabet (long running joke; they have roughly 16 formulas). Burton Hill died in 1962 and 6 years later, Hill's Pet Nutrition was sold to Riviana Foods. In an effort to expand their consumer base in the new and emerging "pet specialty" channel, Riviana leadership asked Dr. Mark Morris Jr. to create an "everyday diet" (based on science) for healthy pets. Dr. Morris Jr.'s first product was called Science Diet Adult Maintenance.

WHEN IS A PRESCRIPTION NOT REALLY A PRESCRIPTION? 

When Burton Hill trademarked "prescription diet", he placed himself in the upper echelon of "master marketers"! Hill's trademark is brilliant and so powerful that any other manufacturers selling in the same channel cannot use the term "prescription" and have had to use "veterinary diet" or "therapeutic diet" for their offerings. The billion dollar question is whether or not "prescription" is just a trademarked marketing term or something more? Dr. Karen Becker, in a 2019 interview with Washington's WJLA Local 12, said, "There is no medicine in prescription pet foods. There's nothing ‘prescription’ in the food at all. There are no drugs, there's no medicine, there's no herb,” said Becker. “So, 'by prescription' means you have to buy it from your veterinarian. But the list of ingredients on the back of the food is usually not much different than regular pet food." 

An active lawsuit, Stevie Kucharski-Berger v. Hill’s Pet Nutrition, contends that there is little to no difference between prescription diets and non-prescription, over the counter diets. From the court documents; “For example, Hill’s produces a Prescription Pet Food product called ‘Prescription Diet Urinary Care c/d Multicare’ cat food that sells for $5.62 per pound, and another substantially similar non-prescription product called ‘Adult Urinary Hairball Control’ cat food that sells for $3.51 per pound. The two products make essentially the same health claims and have a 75 percent overlap in ingredients. The non-overlapping ingredients are not drugs and are not sufficient to justify one product being sold by prescription for a significantly higher price. Given the overlap in ingredients, and the absence of any drug or other ingredient required to be sold by prescription in the Prescription Pet Food product, the only meaningful distinction between the two products that is apparent to Plaintiffs and those similarly situated is the prescription requirement. The price differential is therefore based largely, if not entirely, on the prescription requirement imposed by Hill’s and the other manufacturing conspirators in the combination.” 

Let's take a closer look at two "weight management" diets. Both of these ingredient decks are for diets that, "help maintain" a healthy weight. One of these diets sells for $2.14/lb and the other sells for $3.35/lb (+$31/bag). The GA's for both diets call out 24% Crude Protein and 9% Crude Fat. One diet claims 13% Crude Fiber while the other is 15%.

The "Prescription Diet" calls out the use of a "unique fiber blend from fruits and vegetables" yet the only thing that comes close to a "fruit" on their deck is "dried tomato pumice". With almost the exact same GA's and 80% plus of the ingredients being the same (not to mention both are high temperature/high pressure extruded products), it is hard to understand the difference between the OTC offering and the "prescription" line.

Some advocating for "prescription only" pet food will argue that pet owners would misuse these diets, not seek out other treatments and/or feed their pets the therapeutic diet long-term and/or exclusively; none of which is good for the pet. Others (e.g. staff at Tuft's Cummings Veterinary Medical Center) argue that the high cost of a veterinary diet is due to the "science" and testing done to ensure the diet is "complete" and does what it says it will do. Regulatory agencies provide oversight to what can be said to a consumer and what can be said to a veterinarian and their staff (another "prescription" requirement). For example, I don't know more than a handful of consumers that know the number of daltons (molecular weight) in a hypoallergenic diet. Do we really need to censor and/or "sanitize" what information is available to consumers, especially with the all-knowing internet available at our fingertips? Maybe it would be better to control and regulate the marketing puffery that exists in the pet industry instead. Regarding the "higher" level of testing, ALL pet foods should be rigorously tested prior to being made available and fed to hundreds of thousands of pets! And the logistics costs...millions of pounds of product are shipped to individual homes every week and the price for those products isn't 30-50% higher! If a product says, "prevents, treats or cures", the manufacturer is required to submit their research findings to the Center for Veterinary Medicine (CVM), a department of the Food and Drug Administration (FDA). Of course words like, "promotes, aids and assists" are free from that requirement. 

Treatment or Prevention?  

Much like the human side, the pet industry is focused on the treatment, rather than the prevention, of a "disease". I am not saying that 100% of the current formulations available through veterinarians are not needed, but a lot/most would be irrelevant if the "daily wellness" foods from all manufacturers were better for our dogs. If the everyday diets were highly digestible, palatable, nutrient dense, contained "quality" proteins (essential amino acids) and no artificial or synthetic ingredients, you'd probably just need one or two special diets. Here is an example of SKU proliferation in the veterinary channel. Canine urinary issues (struvite and calcium oxalate) cannot be resolved by diet alone. Struvites require an antibiotic to treat the underlying staphylococcal infection; calcium oxalate stones normally require a surgery or special procedure (urohydropropulsion or lithotripsy) to break down and pass the stones. A third type of stone (purine) are the most receptive to dietary changes. One common requirement for long-term urinary health is an increase in water consumption (dissolution is the solution)! Despite all this, sales of canine urinary health diets in the veterinary channel are in the millions of dollars annually. From Hill's website, the mechanism of their u/d formula is, "Controlled levels of high quality, highly digestible protein; Low sodium & calcium; and Enriched with taurine, L-carnitine & antioxidants." Does this mean that their other diets are low quality protein and low digestibility? And if you are going to state that your diet is "low in copper" or "low in sodium", has "added Omega 3 & 6 fatty acids" or with "therapeutic levels of Carnitine", shouldn't you post/share what those levels are in your diet? For reference: The urinary pH target is 7 and the urinary specific gravity target is 1.025. AAFCO has an adult maintenance minimum for sodium of 0.06% and a copper minimum of 7.3 mg/kg. How does your diet compare?

"Let Food be Thy Medicine" Analogy 

We've all heard the expression, "you are what you eat" and it plays out even more so for our pets. They eat (practically) the same food (ultra processed by any definition) twice a day for their entire lives. There is quite a bit of research being done on the impact that Advanced Glycation End-Products (AGEs) have on our pets as well as research on the other end of the spectrum showing the benefits of less processed and/or "fresh" foods (including raw). To illustrate the idea, think of your dog's body like a filter. In order to get the "good stuff" (high bioavailability of essential amino acids, vitamins and minerals), the filter needs to stop the impurities from getting through. The harder the filter needs to work, the more likely problems are to arise. Eventually, the filter won't be as effective at doing its job and it may become impaired from doing its job properly (e.g. a disease/health issue). Is it better to temporarily address a health issue (change what we put through the filter) or improve the everyday intake? The current veterinary diets are still ultra processed and loaded with AGEs, low cost calories and in many cases, not very different from the daily OTC brands. This thinking fits the definition of insanity: doing the same thing over and over again and expecting different results. 

I'm not saying there isn't a need for certain "veterinary, therapeutic or prescription" diets but I am saying there is another way. As an industry, let's focus on making better food that prevents health issues, a reality. Let's be more transparent on the processes and the analytics of our diets. Let's be honest in our marketing. Over 150 million pets in the US depend on us daily; they deserve our best!