Picky pet prescription: What to do when your pet won’t eat her prescribed therapeutic diet

by Lisa M. Freeman, DVM, PhD, DACVIM (Nutrition)

At Petfoodology, we’ve written before about how to get your picky pet to eat.  The first thing we always recommend is checking in with your veterinarian to see if there’s an underlying reason for a finicky appetite.  But what about when you know your pet has a medical issue and has been prescribed a therapeutic diet to help manage the condition and your dog or cat won’t eat it?

Therapeutic diets are intended to help manage or diagnose diseases and are an important part of the overall treatment of your pet.  These diets typically have special properties that are not available in over-the-counter diets.  It’s important to use them correctly so they’ll have the most benefit for your pet (see our post on tips your veterinarian wants you to know).

However, sometimes we find that a dog or cat won’t eat their prescribed therapeutic diet or won’t eat enough of it without the owner “dressing it up” with other foods or treats.  Reduced or altered appetite is common in dogs and cats with a variety of medical conditions.  Animals can have a complete loss of appetite but, more often, they have either reduced food intake (but are still eating) or have altered food preferences or variable appetite.  I find the altered preferences or variable appetite to be the most common; for example, not being interested in eating in the morning but eating well in the evening; eating a diet for a few days then losing interest (but eating a different diet well); or not eating their food unless the owner adds various toppings.

Reasons for reduced or altered appetite can include the underlying condition itself (for example, heart or kidney disease, cancer, respiratory infections), medication side effects, stress, weakness, or a variety of other factors.  No matter what the cause, reduced or altered appetite can make it difficult to get an animal to eat enough food or to eat the optimal diet for her underlying medical issues.  Therefore, our first step is to figure out if an adjustment of medication is needed to better manage the disease or to reduce side effects of medications (adjusting doses or the medications being used).  Once the medical treatment is optimized, we then look at dietary options as a way to improve intake of a therapeutic diet.

For some diseases, there are multiple commercial therapeutic diets available.  A good example is diets available in the US for animals with kidney disease.  At last count, there were more than 15 different diets available for dogs and more than 20 available for cats.  Manufacturers have dramatically improved not only the nutrient profiles of therapeutic diets in recent years, but also how tasty they are.  There are often multiple forms of diets – dry, different forms of canned (minced, pate, stew) – as well as different flavors and aromas.  However, it is important to know that not all “renal diets” (or all “gastrointestinal” diets) have the same properties and may not interchangeable.  Be sure to talk to your veterinarian or a veterinary nutritionist to find out the best options for your pet.  I typically identify several different products with a similar nutrient profile that is optimal for each animal so that the owner can try them and find out which one the pet likes best.  Having multiple diets with similar profiles also provides multiple options for animals with reduced or altered appetite which may need a rotation of diets.

For some medical conditions, there may be over-the-counter options that will work if cost of therapeutic diets is too high or if you need more options to improve your pet’s appetite. However,  be sure to talk to your veterinarian first before trying any diet not specifically recommended by him or her for your pet.  Even if an over-the-counter diet was recommended on the internet or by a friend, it may not be a good choice for your pet.  And don’t forget that the therapeutic diet is not the only important part of your pet’s diet.  You can counteract all of the beneficial effects of a therapeutic diet depending on the treats, table food, and foods used to give medications to your pet so be sure to talk to your veterinarian about ones that are appropriate for your pet (for example, if you’re feeding a low sodium therapeutic diet for your dog with heart disease, you should also be sure any treats, table foods, rawhides, supplements, and foods used to give pills are low in sodium as well).

What are some other ways to get your pet to eat her therapeutic diet?

• If there’s a chance your pet might be nauseous, talk to your vet about possible treatments to address this issue. It’s difficult to get pets to eat well if they’re feeling nauseous.
• Go into it with a positive attitude. Pets are very intuitive and if they sense you’re hesitant or anxious, they may assume the same about the food before even trying it!
• Flavor enhancers: Depending on your pet’s underlying medical issues and recommended therapeutic diet, there may be specific foods that you can add to make his diet even tastier.  Your veterinarian or a Board-certified Veterinary Nutritionist^® can help you with recommendations.  For flavor enhancers and other tips for dogs and cats with heart disease, check out our HeartSmart website.
• Temperature: If you’re feeding a canned therapeutic diet, experiment with different temperatures.  Most cats prefer their canned food at room temperature or slightly warm (be careful not to get it too hot), but dogs are more variable – some prefer it slightly warm, some prefer room temperature, and some actually prefer it cold or even briefly frozen!
• Appetite stimulants: There are now two FDA-approved drugs that help to stimulate appetite – Mirataz^® (mirtazapine transdermal ointment) for cats and Entyce^® (capromorelin oral solution) for dogs. Talk to your veterinarian about appetite stimulants if your pet isn’t eating enough of an optimal therapeutic diet for his underlying condition.
• Feeding tubes: Feeding tubes are a great solution for many pets with short-term or long-term conditions that are associated with reduced or altered appetite, such as chronic kidney disease.  Pets do very well with feeding tubes and they can carry on an otherwise normal lifestyle at home.  Feeding tubes can maintain pets’ body weight and muscle mass to help keep them strong.  But they also can improve quality of life of both the pet and pet’s human family since feeding tubes can help reduce the stress of feeding your pet adequate amounts of the optimal diet and provide an easy way give many medications.

Therapeutic diets can be very beneficial as part of your pet’s medical treatment.  I hope these tips help to make feeding them a little easier for you and your pet.

Lisa M. Freeman, DVM, PhD, DACVIM (Nutrition)

Dr. Freeman is a veterinary nutritionist and a professor at Cummings School of Veterinary Medicine at Tufts University. She is on the cutting-edge of science, with hundreds of articles in prestigious journals, speaking engagements at national and international conferences, and awards for her scientific achievements. However, she also is passionate about providing objective and accurate information on pet nutrition to veterinarians, pet owners, and other animal enthusiasts.

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