The general concept of veterinary or prescription diets is sound; it’s well-accepted by all nutrition experts that nutrient levels and ingredients can be manipulated in various ways in order to have beneficial effects on animals (including humans) with specific health conditions. We’ve known this ever since the 1930s, when veterinarian Mark Morris innovated the first diet for dogs who were suffering from kidney failure (see “The Morris Family and the Dawn of Veterinary Diets”).
Unfortunately, nearly a century later, the concept is in danger of being a victim of its success. In the past 15 years or so, there has been a tidal wave of prescription foods being brought to market. Pet food makers have been enjoying seemingly endless success by marketing foods to the owners of dogs of ever more specific descriptions – there’s a food being pitched for adult Yorkshire Terriers! there’s one for Pug puppies! – and this trend has spread to the veterinary foods.
There are so many products that even veterinarians are often confused about which food to recommend to their clients.
The development and marketing of these products got so out of hand, that in 2016, the U.S. Food & Drug Administration (FDA) created a guidance document for its staff, intended to educate them (and, sort of subversively put pet food makers on notice) about the laws that apply to these products.
Prescription Diets for Dogs Defined
There are a few differences between a prescription diet and an over-the-counter food.
Prescription diets are defined as those that are labeled and/or marketed as intended for use to diagnose, cure, mitigate, treat, or prevent diseases and are labeled and/or marketed to provide all or most of the animal’s total daily nutrient requirements by serving as the pet’s sole diet. They are meant to be marketed by and used only under the direction of a licensed veterinarian, who bears the responsibility of ensuring that the pet receiving the diet has been properly diagnosed as suffering from a disease or other health condition for which the food would constitute an appropriate treatment. A veterinarian is also expected to provide periodic assessment of how the animal has reacted to the diet and to discontinue the product when warranted.
Consumers are not supposed to be able to purchase prescription diets without a prescription, due to the potential for misusing the product and/or misunderstanding its role in the treatment of the pet’s condition.
There’s one quirky aspect of the rules regarding the labels of prescription foods: They are not allowed to include any representation that the product contained therein can be used to treat or prevent disease. Discussion of that technical information and the specific factors of the food that are therapeutic or beneficial to pets with the diagnosed condition are supposed to be limited to veterinarians only. That’s why manufacturers of these foods maintain separate websites – one for veterinarians and a separate one for pet owners – that describe their products.
Our Peeves About Prescription Dog Foods
Though we love and believe in the concept of truly therapeutic foods, we have a few peeves with prescription foods, starting with the practice of making the technical information about the products inaccessible to owners. We believe that interested owners can and should be trusted with information about how the prescription diet is supposed to affect their dogs. We also think that giving owners access to this information would also help them discern the differences – if there truly are any – between the prescription foods and non-prescription foods whose labels may also wink and hint at certain nonspecific health benefits. Over-the-counter food labels probably read as more therapeutic than prescription food labels!
Our biggest pet peeve, though, has to do with the ingredients that tend to appear in prescription diets. These foods are full of by-products!
In a way, this is a legacy of the original inventors of prescription diets, the father and son veterinarians who developed all the original diets for Hill’s Pet Nutrition. It’s unclear whether there were any nutritionally adequate dog or cat foods on the market before Dr. Mark Morris, Sr., formulated his first products. Dr. Morris graduated from veterinary school as the Great Depression dawned. There were shortages of food for humans, so you could be certain that what was left over for making into pet food was not the most appealing material. But Dr. Morris had something that few (if any) pet food makers at the time had going for him: a scientific mind, honed at the best veterinary college of its day, and knowledge about the nutritional requirements of animals. He, and his son after him, focused on meeting those requirements – proteins, fats, vitamins, and minerals – from whatever foodstuffs were at their disposal, at the right price. Nutrients, not ingredients, became the Science Diet way – and the company’s formulators defend it to this day (though the marketing people have pushed for greater inclusions of ingredients that are more appealing to consumers (“humanization” is the industry parlance).
We don’t think there needs to be a wall between these schools of nutritional philosophy. Of course the nutrients in a food are the most important thing – but why can’t they originate from less-processed ingredients?
We developed WDJ’s dog food selection criteria with the quality of ingredients as the most important factor. In prescription dog food, the factors that are responsible for the therapeutic action of the food are of the utmost importance; we can look the other way when we see powdered cellulose as a fiber source or corn gluten meal as a protein source when we know that there are other functional attributes of those ingredients that have qualified them for inclusion. (Though when lay people can’t access the rationale for the inclusion of those ingredients, it’s frustrating!)
Fortunately, change is coming – and the newly crowded veterinary-diet market affords consumers more options, even for highly specialized products.
The concept of pet foods formulated to benefit dogs with specific health problems was innovated by Mark L. Morris, Sr., a veterinarian who started his first practice in 1928 in Edison, New Jersey, after graduating from Cornell University. At a time when most veterinarians treated mainly livestock and working farm animals, Dr. Morris focused his veterinary practice, the Raritan Hospital for Animals, on the care of companion animals.
At that time, the nascent pet food industry produced two types of foods for dogs: baked biscuits and canned foods that consisted almost exclusively of horsemeat. Most people fed table scraps to their pet dogs; only more affluent, urban or suburban owners augmented their dogs’ diet of leftovers with a commercial dog food.
These products were anything but “complete and balanced” – living conditions caused by the Great Depression meant that only the least-nutritive foodstuffs were going into pet food. Dr. Morris noticed that his veterinary practice saw an unusually high number of dogs with kidney disease, and he speculated that this had something to do with their diets, comprised mostly of poor-quality protein. He started conducting research on pet nutrition; he believed that he could better treat his patients by using proper nutrition from a balanced diet.
Dr. Morris worked with Dr. Jim Allison at Rutgers University’s biochemistry department to develop techniques for diagnosing diseases in small animals and to develop and test recipes for better dog and cat diets; he started selling his first pet food formulas in 1939.
That was the same year that he met Morris Frank, a young man who had lost an eye in an accident as a young child and lost vision in the other in a boxing match as a teenager. Frank traveled to Europe in 1928 to acquire his German Shepherd guide dog, Buddy; shortly after he brought Buddy back to the U.S., Frank started America’s first guide dog school in New Jersey. In 1939, he and Buddy were “The Seeing Eye” guide dog school’s national ambassadors – though Buddy was by then an old dog suffering from kidney disease. Frank sought out Dr. Morris, desperate for anything that might help Buddy.
Dr. Morris formulated a special diet for Buddy, canning it in glass jars in his kitchen with the help of his wife, Louise. Legend has it that the dog’s health improved and soon, this formula – dubbed Raritan Ration B – was in great demand. Frank sent Dr. Morris a canning machine and a commission for thousands of orders. By 1948, with the popularity of the food growing – and no doubt, wearying of operating the canning machine – Dr. Morris took his formula to a Topeka, Kansas, canning company, the Hill Packing Company (named after its founder, Burton Hill), which had been canning dog food (as well as horse meat for human consumption!) since 1930.
The business relationship thrived and by 1948 became a partnership, Hill’s Pet Nutrition. Raritan Ration B was given a new name, “Canine k/d” (for “kidney diet”). Dr. Morris continued to create new formulas for diets that addressed pet health problems and Hill’s produced, packaged, and marketed them. In 1951, Dr. Morris moved his laboratory to Topeka, where new products are developed and tested at the Hill’s Global Pet Nutrition Center to this day.
Mark Morris, Sr., was instrumental in the founding of the American Animal Hospital Association. He also established the Morris Animal Foundation and served as president of the American Veterinary Medical Association.
Mark and Louise Morris had two children, Mark Jr. and Ruth. Mark Jr. earned a doctorate’s degree in veterinary medicine in 1958. After serving in the U.S. Army Veterinary Corps, he completed a Ph.D. in veterinary pathology and biochemistry. Later, he joined Hill’s Pet Nutrition, where he expanded the company’s offerings. In 1968, he oversaw the development of a new line of dog and cat foods called Science Diet, formulated with preventative health in mind. Mark Jr. was a founding member of the American College of Veterinary Nutrition and co-authored Small Animal Clinical Nutrition, the definitive textbook for companion-animal nutrition.
Hill’s Pet Nutrition has been purchased by large corporations twice: Riviana Foods bought the company in 1968, and in turn was purchased by Colgate-Palmolive in 1976. Hill’s is currently ranked fourth on the list of the largest pet food companies in the world, with $2.5 billion worth of sales annually.
Recommendations for Prescription Dog Food Use
We can’t (won’t) tell you which company’s prescription diets to choose for your dog; only a veterinarian can do that! But we encourage you to dig in for (and prepare to pay for) an extended conversation with your veterinarian about any prescription diets she may recommend for your dog. We’d suggest the following discussion points if your veterinarian recommends a prescription diet for your dog:
- The first thing to ascertain is whether your vet can describe what, specifically, the product offers to your dog. What are the specific attributes that are therapeutic for your dog’s condition? It’s not enough to just point owners toward a “kidney diet” any time there is a dog of any age with almost any sort of abnormal urine test result.
- Ask follow-up questions. If, in the example above, your vet suggests that her recommended “kidney diet” has lower-protein, and that your dog should be on a lower-protein food, ask her what amount of protein she thinks is suitable for your dog. Many kidney diets have protein levels that are very low, far too low for a young or middle-aged dog in the early stages of kidney disease – so low, in fact, that dogs who are fed these diets for a long time start losing muscle mass as their bodies attempt to function without enough dietary protein. It’s easy to find foods at any level of protein she thinks is appropriate, with higher-quality sources of protein than are typically used in prescription diets.
- Buy a small amount of the food for the first time. Many prescription diets are not very palatable.
- If your dog won’t eat it, don’t fall for the “He’ll eat it if he gets hungry enough” speech. If your dog is not well, going hungry will not improve matters. As soon as possible, ask your vet for a more palatable alternative.
Alternative Dog Food
Starting below, we’ve listed all the prescription dog foods currently on the market in a searchable database. We’ve included the complete ingredients list, as well as the protein and fat content, of each of the foods on this list. We strongly suggest that you compare the ingredients of all the products that are formulated for whatever condition your dog is being treated for. Then ask your veterinarian if she could investigate the technical information for your preferred product and perhaps prescribe it for your dog, too.
Hi! I’m curious how you feel about the balanceit powders and recipes? They offer these for prescriptions. I have been getting the powder for my dogs with kidney disease because I can use that to “treat” the ailment and also control the quality of the rest of the ingredients. They have recipes that can be adjusted, etc. Have you ever tried this and what are your thoughts?
Hi Amy, I’m just another subscriber commenting here. As the former owner of a dog who had kidney disease and was on a Balance IT based diet, I just want to slightly correct what you say, for the benefit of other readers. The Balance IT powders are just vitamin and mineral supplements that create a complete balance for their homemade recipes. The recipes control for the protein, fat, and other needs for a home cooked whole foods based therapeutic diet for the particular disease (in the case of kidney disease that would be focusing on a palatable diet that restricts phosphorus content, which is a bigger issue than protein), and the supplements insure no micro nutrients are missing. I would expect that the WDJ editors would be in favor of this approach since it does not involve processed prepackaged food.
I’m another subscriber who started BalanceIT with the support of my vet. It’s a company she likes and recommends for home prepared foods. She stressed the supplements are a must. Marlys Ray’s description of BalanceIT is spot on.
The recipes are formulated by veterinarians for specific ailments and ingredients can purchased in the grocery store. The recipes are free, but the supplements are not. They are not price gouging on the supplements though.
Their customer service is great. I contacted them by chat twice, and they responded quickly and the cs rep was knowledgeable.
We love the Balance It approach and supplements. Their recipe-generating software is terrific.
Hi – When I’m unable to prepare my dog’s food from scratch (I use a nutritionist for recipes), the prescription food that I’ve had the best success with is made by Rayne Nutrition. I’ve used both their kidney formulations and their low-fat, pancreatitis, formulations. The food is certainly distributed in the US but I don’t see it listed?
I have a comment: Recommendations for Prescription Dog Food Use…”about any prescription diets she may recommend for your dog”….why not use the pronouns “they” or “he/she” when referring to veterinarians ? After 42 years as a veterinarian, I have seen many changes in our profession. Even though men are the minority as veterinarians today, we continue to be integral to animal care.
What about Just Food for Dogs?
Thanks for this in-depth article. My senior (some years back) was fading from Kidney failure and wouldn’t eat the canned prescription stuff. THis was before Just Food for Dogs, so wonder if that wouldn’t be more palpable.
The products made by Just Food For Dogs are on the list.
My veterinarian just had to extract 13 teeth from my 10 1/2 yr Terrier mix, Gypsy, who has been on an Honest Kitchen Fruit and Veggie Base plus canned sardines in water. Vet says this diet accounts for Gypsy’s periodontal disease and recommends the following:
“Since she’s not a big fan of getting her teeth brushed, I would recommend switching her to a dog food that is designed to help keep her teeth healthier. Below is a list of the ones that have been approved by the Veterinary Oral Health Counsel (VOHC):
“Hills Canine t/d®: Original Bites
Hills Canine t/d®: Small Bites
Science Diet® Oral Care for Dogs
HealthyAdvantage™ Oral Care for Dogs
Eukanuba® Adult Maintenance Diet for Dogs
Purina Pro Plan DH Canine Formula dry dog food
Purina Pro Plan DH Small Bites Canine dry dog food
Royal Canin® Veterinary Care Nutrition™ Canine
Royal Canin® Veterinary Care Nutrition™ Canine Dental Small Dog”
I sent her a list of the ingredients in the first product, “HIlls Canine t/d: Original Bites” and asked how exactly that formula aids in preventing plaque and tartar. Her reply was,
” The fiber matrix of the kibble holds it together longer to help mechanically “scrub” the tooth surfaces as well as the larger size of the kibble which gets the “scrubbing” all the way up to the gumline.”
I don’t believe a word she’s saying. She referred me to a veterinary nutritionist at a MASH hospital in town. I’m trying to get an appointment with that specialist now. Please let me know your thoughts. Thank you.
Happy that you’re going to see a specialist! The vet’s response makes about as much sense as your dentist telling you to eat more fiber because it will scrub your teeth.
That list is full of horrible dog foods, every single one of them! Look at the dangerously low levels of protein in the Blue Buffalo diets for kidney disease!!! Not all vets feel a low-protein diet is even necessary, and these foods, 14% protein or less in most cases, aren’t even enough to sustain life! People think these “prescription diets” are great because they come from the vet’s office or on his recommendation. Did you know most vets get some sort of compensation for pushing these foods, like family trips to Hawaii??? These are just a racket.
I’m sorry to hear your dog is having dental problems. I used to feed my dachshund The Honest Kitchen. She loved it for a few months and then she quit eating it. She didn’t offer an explanation. I guess she knows more about dog foods than I do. She eats Farmina grain-free chicken and pomegranate now and has eaten it in addition to whatever I cook (more of that now) for seven years without one single problem.
I started to eagerly read this article hoping for information on prescription dog foods for dogs with pancreatitis. My understanding is that pancreatitis is a fairly common condition but I never see it addressed by WDJ in their dog food analysis. Maybe I missed something but continually disappointed by WDJ on this topic.
When my 15 yo dog was diagnosed with kidney disease, I followed the vet’s recommendation for prescription diet. We’ll he hated the food and just ate it because he was so hungry. Then I found out about Dr. Harvey’s Canine Health food. It is all dried fresh grains and vegetables and then you add water and whatever protein you want to it in specific amounts according to weight. My dog has thrived on this and he has not shown any progression in his kidney disease. It is worth checking out.
The only thing that prescription diets help is the bank account of the prescribing vet. It’s the same petrified garbage, only at a much higher price.
While it may be profitable for your vet, I’m not sure that I would call ALL prescription diets “petrified garbage.” There are brands which have a good mix of foods based upon conditions’ dietary needs. The best that we can do is seek those which don’t use fillers and limit the unnecessary ingredients which might be exacerbating the problem(s).
We are unable to provide a homemade diet which addresses our pet’s issues (past and present) so we do the best we can by seeking out alternatives we can combine to help our pup through the problem.
I noticed today that the list omits Blue Buffalo HF Hydrolyzed Protein Dry Formula but includes duplicated entries for Blue Buffalo NP Novel Protein Alligator Dry Formula.
I hope that the list is corrected soon.
What about raw, fresh foods like Darwin’s that needs a prescription for some of its foods. I used one of theirs for a kidney problem one of my dogs had and it was very helpful.
We were unaware that Darwin’s made prescription foods. We will be adding these to our database. We love the fact that these kinds of alternatives are available.
I’ve never had a dog on prescription food, by Royal Canin Urinary SO helped my cat who had urinary crystals I tried a non
– prescription food for urinary health because it was grain free and had better ingredients,but the crystals came back.
I was looking for liver care food types, amazing that they are called food!
Very interesting article. Please consider not just the problems with the main ingredients in most of these foods, but the vitamin/minerals that are added. I discovered that these ingredients come from all over the entire world, from whatever country has them available and at the best price. I know several dogs that proved to have a problem with that actual part of the formula. Home prepared diets are labor intensive and well worth the effort.
I was forced to go to Royal Canin golden retriever (when I discovered my 3 year old had DCM. My last golden died at 10 in 2013 when they were first discovering the grain free diets being a culprit. When I took my young golden in for an eco cardio gram she had the beginning states of DCM. The cardiologist put her on RCGR and it actually HEALED her heart. I was NOT a believer of food this horrible could do this but it did. That is why she is on this horrible ingredient food.
She sometimes goes to the Royal Canin Saiety for weight management which is prescription. That also works. But full of filler so once she decreases I try and get her back to the regular RCGR. I would like to make my own food, but I am afraid of taking her off this food because of her heart. She also has a leaky valve so goes for the Ecco every six months.
I am wondering about DCM being “ healed” ….. I was told that it is an incurable heart disease both in dogs and people. My Doberman Pinscher died of DCM at 6 yrs .
I just want to clarify that the JustFoodForDogs’ Pantry Fresh line is NOT canned food.
Pantry Fresh measures up to JustFoodForDogs’ exacting standards for quality and nutrition. Like all their proven healthy whole food fresh frozen dog food, Pantry Fresh is made from the finest fresh human grade ingredients, including the highest-quality meats and produce, the same ingredients that you can find in the grocery store and that restaurants offer. A complete meal, cooked fresh and ready to serve with no preservatives.
Pantry Fresh uses a unique methodology, cooking ingredients at low heat, under pressure, inside their packaging. This protects both the nutritional value and great taste of their fresh pack dog food.
According to the USDA, any foods that are cooked inside their sealed packages ARE canned. “ ‘Canned product’ is defined in 9 CFR 431.1 as a meat or poultry food product with a water activity above 0.85 that receives a thermal process either before or after being packed in a hermetically sealed container.”
Years ago, we used the term “wet” foods to try to make it clear that we were including shelf-stable foods that are “canned” in actual cans as well as those that are “canned” in glass jars or the newer Tetra Paks (like the Just Food For Dogs’ Pantry Fresh line), but we found that it confused people, who weren’t sure why we were not including fresh, refrigerated or frozen diets in the same category.
Perhaps in the future we can update our database to indicate which products are canned in cans vs. glass or Tetra Paks.
What can you offer me on allergies? My rescue has been suffering for 4 years with almost continual scratching. Three vets have prescribed the same antifungal, antibiotic and apoquel. Blood tests show sensitivity to lamb, dairy, and mites.
Has your pup seen an allergist that can test for environmental allergies? One of my client dogs turned out to be allergic to all sorts of grasses; doing therapy with the allergist (involves drops micro-dosing with the allergens) has relieved her symptoms substantially.
I am considering this: https://nextmune.com/us/how-to-treat-your-pets-allergy-pet-parent/ and also Cytopoint. But maybe if Apoquel didn’t help, Cyopoint wouldn’t help as well.
Thanks for that link.I wasn’t aware that the companies that make desensitizing substances (aka “allergy shots”) have a marketing component that reaches out to owners directly.
According to our vet author, Cytopoint may be the better choice, and a combination is sometimes necessary for highly allergic dogs. See https://www.whole-dog-journal.com/health/groundbreaking-allergy-medicine-for-dogs-apoquel-and-cytopoint/
Great article but you’ve missed several companies that are coming with prescription equivalent foods such as Diamond Care, SquarePet, Forza10 and Farmina. We sell most of these over the counter and they all do fantastic and have WAY better ingredient panels than most.
That also works. But full of filler so once she decreases I try and get her back to the regular RCGR.
Thank you for your product details.
My fourteen year old Golden Retriever was diagnosed with kidney disease when he was about 13. The vet prescribed Hill’s KD diet, which he took for about a year before dying of malnutrician. While on the KD diet he lost muscle and weight, becoming a shadow of the healthy dog he had been before starting that diet.
I grieve every day for what this fraudulent miserable “diet” did to him and will never use one of these prescription diets -especially Hills – again. I will instead educate myself to provide a wholesome home-made diet of “real” food
Honestly..the misinformation and delusion in the article and comments is disturbing.As a veterinarian of over 20years I can categorically state that we do not receive trips to Hawaia or kick acks for selling rx food.what nonsense!The markup on rx foods is low…it is not a major profit for clinics.The t/d diet is clinically proven to slow calculus formation in clinical studies.I have used it for years including on.my own pets.Renal diets when used appropriately have improved renal values and quality of life in thousands of patients.This fearmongering about byproducts is emotionally based sensationalism.Just because I dont want to eat organ meats doesn’t mean it is bad for my pet to do so.The non science fad based pet foods such as the grain free debacle were not rx foods and they created heart disease in dogs.all because of human fears about gluten and grains…which do not apply to pets…pssst dogs and cats dont get celiac dz.we have scientific knowledge…key s use ot.btw I feed all my own pets hills rx food…most vets feed their own pets rx food.