Opening Shots columnist Dr. Ernie Ward is an award-winning veterinarian, impact entrepreneur, book author and media personality. When he’s not with family or pet patients, Dr. Ward can be found contemplating solutions during endurance athletics and meditation and on his weekly podcast, “Veterinary Viewfinder.” Learn more at drernieward.com
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If you want to risk having an argument these days, ask people what they feed their pets. Many of us struggle to understand how feeding dogs and cats became so contentious when the answer has historically been “dry kibble” or “canned.” Today, the answer’s also raw, organic, fresh, frozen and nearly any other human food trend you can imagine. Blame it on an explosion of choices, nutritional misinformation, manipulative marketing or viral videos, but ask the wrong pet food question or offer misaligned advice and you might end up in a squabble.
This article is the second in a three-part series on developing a successful nutrition program in your clinic.
Pet food is deeply personal for many cat and dog owners. What they feed their furry family members often signals many health and economic priorities, beliefs and shopping preferences. To successfully educate and avoid offending clients, veterinary professionals need to have a communication strategy, remain emotionally neutral and focus on nutrition’s impact on the pet’s well-being.
Food Is the Foundation
Food provides the foundation for a pet’s health and well-being, directly affects longevity and quality of life, and impacts everything in between. Disease prevention, the ability to fight infection, strength and endurance, and even learning and behavior are dependent on the macro- and micronutrients that pets consume. It’s our professional responsibility to ensure they receive a safe, complete and balanced diet appropriate for their needs. Those reasons make discussing pet nutrition not only undeniably necessary but concurrently challenging.
Today’s pet owners understand the importance of diet and might feel judged based on why or what they feed a cat or dog. However, regardless of personal opinions or choices, feeding is elemental to pet parenting, and no one wants to feel inadequate or shamed by a veterinary professional.
The justification that good food is the foundation of good health begins with what food is. Food, in whatever form, is essentially a vessel for nutrients. That’s why we’re taught to feed nutrients, not ingredients. The body cares little for how a vitamin, mineral, protein, fat or carb is packaged and delivered, only that it arrives on time and intact. While we might argue the nuances of a particular nutrient, veterinarians have a good grasp on the larger picture, especially nutrient minimums and maximums. I’ll be the first to admit that veterinary nutrition is as much art as science, but the current science paints a vivid portrait of what an animal’s body needs to thrive.
To put it bluntly, veterinary professionals need to become more involved in recommending maintenance diets. As someone who helped start a pet food company (and later became disillusioned and left), I can reveal that veterinarians and veterinary technicians are considered largely inconsequential in consumers’ pet food choices. Many companies rely on hip advertising, food fashion, influencer content and massive marketing to blur evidence-based recommendations. Others lean into cost and convenience to clobber nearly everything else.
Even within the veterinary community exists considerable in-fighting and disagreement, principally with maintenance formulations, further encouraging concerned pet owners to seek help elsewhere. I’ll never forget one of our consumer survey responses: “My vet knows nothing about pet food. She only sells two brands. I trust my pet store and the internet to help me choose my dog’s food.”
There’s a lot to unpack in that response, notably that we might appear disconnected and misinformed about the broader pet food landscape by offering or discussing only a few brands. Even worse, by failing to enter the “What should I feed my healthy pet?” arena, we risk appearing uninterested or uneducated in basic nutrition. Additionally, because retailers and online stores benefit from making firm, even controversial, stands on hot topics, they earn social currency and respect. All that occasionally spills over into exam room tension.
The hard truth is your team might become pessimistic if pet owners repeatedly ignore their nutritional advice. This could lead team members to become discouraged and demoralized, preventing them from addressing future dietary issues. That’s why it’s essential to train your staff to focus the pet food conversation on a narrative nutritional history.
How to Make It Work in Practice
Narrative nutritional history is the term I use to describe asking open-ended medical history questions to facilitate a client’s storytelling. Such conversations are more natural for clients and allow team members to elicit and investigate subtle feeding behaviors and activities in a non-threatening manner. It’s a friendly conversation, not a dueling debate.
Obtaining a narrative nutritional history takes only a few minutes and gives the veterinary team a more accurate assessment of the patient’s diet, activity and lifestyle in an inviting and nonjudgmental format. The technique often yields insightful information about the pet’s overall care and health beyond the food bowl.
The four general steps of a narrative nutritional history are as follows.
1. Invitation: A broad, open-ended question that encourages a conversation and asks permission to proceed. Try open-ended questions focused on the client’s pet feeding habits and the animal’s lifestyle, environment and physical activities. While many veterinarians worry that this type of questioning will result in time-consuming answers, few clients know how to begin.
Veterinary team member: “Would you mind describing a typical day in Buster’s life for me?”
Client: “Oh, I don’t know, it’s nothing special. Buster has a normal dog’s life!”
2. Pivot and acquire trust: Many clients are accustomed to closed-ended, “yes” or “no” medical inquiries. You might need to earn the client’s trust by sharing your interest in the pet and asking a slightly more specific or tangential question, known as a communication pivot.
Team member: “I think Buster is not only normal but a very special dog with a fantastic family. OK, for starters, what’s the first thing Buster does each morning?”
Client: “Buster immediately goes out to potty.”
Team member: “Do you take him for a walk then?”
Client: “Heavens, no! I haven’t had my coffee. I let him out, and he usually does his business and comes right back inside. While he’s out, I usually pour his food.”
3. Active listening: An essential element of narrative veterinary medicine is attentive listening and allowing the conversation to progress naturally, rather than simply instructing, recording dictation and not forging a personal connection.
Team member: “What brand of food? Do you use a measuring cup?”
Client: “Right now, I’m using XYZ food because my groomer recommended it for his coat. I fill the bowl about half full (indicates size bowl).”
Even though the client didn’t give an exact amount, the team member determined the brand and the food wasn’t measured. If the pet is diagnosed with obesity, the veterinarian can advise measuring or weighing food as an initial treatment option.
4. Elaboration: As the conversation progresses, you can ask for clarification on important points. One of the biggest challenges in obtaining an accurate nutritional history is uncovering the number of treats and food rewards. Clients are often reluctant to share daily treating habits for fear of being judged. Most cat and dog owners understand that excessive treats are unhealthy and don’t want to risk being viewed as a “bad pet parent.” To uncover hidden treats, you must allow the client to elaborate and spontaneously share the daily routine in a non-threatening way.
Team member: “Thanks. What happens next with Buster?”
Client: “Well, I get everyone out of the house and then leave for work. I let Buster out again, and I usually give him a dog cookie to tide him over until I come back at lunch to let him out.”
Team member: “When you get home, what does Buster do?”
Client: “I let him out again, and then I give him something like a doggie treat if he’s been a good boy. He always is!”
Team member: “And he stays inside until you get home from work?”
Client: “Yes, we’ll go for a long walk as soon as I get home.
He starts twirling as soon as he sees me grab the leash.”
Team member: “How long do you usually walk him?”
Client: “Oh, a good 15 to 20 minutes.”
Team member: “And dinner?”
Client: “Yes, I give him the same as in the morning, although I have to admit, I usually give him a little something special as soon as I get home. He loves a different dog cookie. I’m sure he’s hungry after being alone all day.”
Team member: “What about after dinner? Does he go outside or anything else?”
Client: “Sure, I let him go potty a few minutes after he’s done eating, and he stays out a good 10 to 15 minutes. After dinner, my husband will also give another kind of cookie when we sit down to watch television.”
Here’s what such a narrative nutritional history teaches us:
- The client feeds a specific brand twice daily.
- The client doesn’t precisely measure the food.
- The client gives several brands of treats.
- Buster gets treats at least four times a day.
- Buster gets minimal exercise.
Allowing a client to tell a story yields more detailed, authentic information and gives you the chance to share more precise food recommendations. The technique can be applied to various clinical topics and helps foster more trust and collaboration between veterinary professionals and pet owners.