Interview

Dr.

Richard C. Hill

M.A., Vet.M.B., Ph.D., MRCVS
Waltham Associate Professor of Small Animal Internal Medicine and Clinical Nutrition

University of Florida, FL, USA
interview - Nov/2009

   
esta entrevista em português    
     

Dr. Richard Hill is a veterinarian (Cambridge University, Cambridge, UK, 1980) with Ph.D (University of Florida, 1993). He is a Diplomate at the American College of Veterinary Internal Medicine and the American College of Veterinary Nutrition. Honors and Awards: Phi Zeta Graduate Student Award (1992); Charles F. Simpson Memorial Scholarship (1993); Clinical Sciences Teacher of the Year Award (1998); American Kennel Club Clinical Research Award (2001). Member of the National Academy of Sciences committee that wrote the most recent National Research Council recommendations for the nutrient requirements of dogs and cats (2006).


Dr. Hill was in Brazil giving lectures at the III Symposium of Clinical Nutrition of Dogs and Cats and teaching graduate students at UNESP Jaboticabal/SP in Nov/2009. Check out the following interview which is also authored by Dr. Márcio A. Brunetto and had the technical collaboration of the Ph.D candidate Márcia O. S. Gomes and of Dr. Eliana Teshima.


First Part
01: Why are there so few scientific papers about the nutrient requirements of sick dogs and cats?
02: What’s your opinion about giving high energy diets to pets with cancer?
03: What’s your opinion about raw foods for pets?
04: What’s your opinion about raw foods for pets? (continued)
05: Do obese dogs and cats have hypertension as people do?
06: And what about obesity and diabetes in dogs?

 

Second Part
07: What did you know about Brazil?
08: What was your impression about the Symposium?
09: How do veterinarians provide clinical nutrition at their offices in U.S.?
10: What is important in pet nutritional science now?
11: Who gives financial support to pet nutrition research in the U.S.?
12: Where should a Brazilian veterinary student go?
13: What Congresses do you usually go?

     

     

nutrição.Vet: 01- Why are there so few scientific papers about the nutrient requirements of sick dogs and cats?

 

 

 

Dr. Hill: There are very few scientific papers about the nutritional needs of hospitalized patients. The reason is that it is very difficult to do studies on unpredictable patients. And every hospital sees a few of some diseases and very few hospitals see enough of any one disease to be able to do a scientific study. That’s why most research is being done in normal animals… an exception would be obesity which we can induce and then stop.

 

Other diseases of concern are sporadic so we have no good way of actually doing any effective research on that.

 

 

 

nutrição.VET: 02- What’s your opinion about giving high energy diets to pets with cancer?

 

Dr. Hill: There are very few studies of nutrition and cancer in dogs and cats. We have one study which was published concerned with stage 3 lymphoma in dogs, which suggests that extra fat and extra arginine seem to improve prognosis.

There is one other epidemiologic study that looked at survival in dogs with mammary tumors and that clearly shows that dogs did better with high protein diets, but there was a suggestion that they did better with low fat diets. So, the probability is that the diet that should be used in any cancer may vary depending on the cancer and the stage of the cancer. So this is an area where we need a lot more research to really decide which is the best possible for you to feed. Meanwhile the data we have suggest that for most cancers we should feed extra fat.

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"... Meanwhile the data we have suggest that for most cancers we should feed extra fat.”

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(pg.01.) (continues). (back to the top).

 

     
     

nutrição.Vet: 03- What’s your opinion about raw foods for pets?

 

 

Dr. Hill: There’s a development in the US where some people feel dogs should be fed raw foods. The diet being advocated by each website has a slightly different recipe as to what should be in a raw food diet. There are several issues pertinent to this. Probably the most important for the dog initially is that many of these diets are not complete and balanced.

 

They do not necessarily have all the vitamins, minerals and essential fats or protein that they need. Most of these diets are very high in protein, but many of them are deficient in calcium, many of them are deficient in trace minerals, many of them deficient in essential fats. It’s possible with an expert to balance a raw diet, so that isn’t by itself a problem.

 

The bigger problem and the reason personally I do

 

 

not think raw food diet should be fed is because the raw food often contains potentially pathogenic bacteria. The prevalence in raw food is quite high, that’s why we cook our food.

 

Some people have said that dogs are more resistant to infections than people. This is not true.  They do become infected. It’s true that the dog may not show signs of disease, but they do become infected.

 

An example would be Salmonellosis where dogs commonly will become infected for about two weeks and then they clear the infection. But there are same data from many years ago on greyhounds which clearly show they will suffer from repeat the infections, they won’t just get infected one time. And unfortunately dogs excrete Salmonella and some become chronic carriers of Salmonella. And they will expose people to Salmonellosis because they are excreting Salmonella.  Cats excrete Salmonella in their saliva and they lick themselves (when they groom themselves) and spread the Salmonella onto their coat.  So…  Salmonellosis is a public health risk. 


(pg.02.) (continues). (back to the top).

 

     
     

nutrição.Vet: 04- What’s your opinion about raw foods for pets? (continued)

 


Dr. Hill: .Campylobacter also is a very important health risk, because Campylobacter doesn’t cause diarrhea in dogs unless they have a very high dose, but they still became infected and then they can excrete the bacteria.  People became infected and have signs with very low doses. So if you get exposed to a little bit from your dog, then there is a problem for people. There is a positive association in Australia between Campylobacter in children and feeding raw food to animals in the home.

 

This is just two of many potential pathogens. There is toxoplasmosis, there is Aujesky’s disease. A really nasty one is a parasite caused by the beef tapeworm, Echinococcus that may causes hydatid cysts in the brain and the lung of people.

 

So there are some really important nasty diseases that can be communicated if dogs and cats

are fed raw food.  So, for public health reasons, raw food shouldn’t be fed.
 

Most adult dogs can deal with these infections but we should be particularly wary of feeding raw food to the young, the pregnant, the sick, the lactating and all the old patients

.

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"... There is a positive association in Australia between Campylobacter in children and feeding raw food to animals in the home.”

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(pg.03.) (continues). (back to the top).


     
     

nutrição.Vet: 05- Do obese dogs and cats have hypertension as people do?

 

 

 

Dr. Hill: There are scientists that want to convince the world that an obese dog is a model for the human obese patient.  Unfortunately there are multiple differences in the metabolism of the dogs from the metabolism of people. There are some aspects at the metabolic disease that people get when they  get fat found also in dogs. So, they do become insulin resistant. They do seem to produce increased inflammatory mediators. They do not become very hypertensive. There is a slight increase in blood pressure but is not large enough to be classified as hypertension.

 

 

Likewise there is a slight change in the fat-acid profile but dogs do not have the same disease that people have. And the reason they don’t have the same disease that people have is because dogs have a different fat metabolism. Dogs have a high high densitiy lipoprotein (HDL).

About 2/3 of their lipoproteins are HDL, 1/3 are low density lipoproteins (LDL). So they have high "good cholesterol" and low "bad cholesterol". People are completely the other way around, they have high "bad cholesterol" (LDL) and low "good cholesterol". So these are important differences and for me the obese dog is a model for some aspects of metabolic disease but not for hypertension and not for lipedemia.


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"... for some aspects of metabolic disease but not for hypertension and not for lipedemia ...”

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(pg.04.) (continues). (back to the top).

     
     

nutrição.Vet: 06- And what about obesity and diabetes in dogs?

 

 

Dr. Hill: Dogs that are obese become insulin resistant but I’m unaware of any description of a dog becoming diabetic as a consequence of becoming obese.

 

If they do become diabetic the most common reasons in the dog are, number one: they have an immune disease which damages insulin; number two: they are unspayed, and over time, because they have repeated heats, progesterone excess causes insulin resistance and eventually they develop diabetes; and number three which is an emerging cause: is because they have low grade unrecognized pancreatitis.  And eventually that destroys so

 

 

 

much of their pancreas they don’t have enough pancreas left. 

 

Those are three probably principle causes of diabetes, but at the moment I’m unaware of anybody showing that a diabetic… that fat dogs become diabetic as a consequence of their insulin resistance.

(pg.05.) (continues). (back to the top).

     

nutrição.Vet: 07- What did you know about what was being done on pet nutrition in Brazil and what were your impressions about what did you find here?

 

 

Dr. Hill: I knew very little about nutrition in Brazil but I knew that Aulus Carciofi had a very fine research reputation around the world because of his presentations at international meetings. So I knew that he had very competent nutritional expertise. The thing that I’ve discovered is that there are a lot of people in Brazil who are very interested in nutrition and there looks to me to be some talented students who are very interested in the subject.

 

As far as the Industry is concerned, I think it’s a wide open market and I was…  not aware of how much economic pet food played a large part in that Brazilian market. I knew that there were foods made in South Africa which are very poor in quality, I also know that the most of the foods made in the United States are actually quite good quality, and it seems to me that you have a combination of the good quality and the poor quality rather like they do in South Africa.

 

 

 

nutrição.VET: What do you mean with ‘open market’ ?

 

Dr. Hill: I think it sounds like… it’s a developing country with a lot of new manufactorers trying to get involved in nutrition and trying to grab a share of the market, and I think we have to wait and see how that develops. Mainly in the U.S. we have a market where the majority of animals are fed commercial pet food…  I would

say it is a very competitive market, but most of the foods made in the U.S. are really pretty good quality pet foods.

 

The bigger debate in the United States is what should be included in the pet food, not so much whether pet food should be fed, but whether it should be more meat or more carbohydrates, whether it should be raw or whether it should not be raw or one of those alternatives.

Most manufactorers in the U.S. are the large manufactorers whereas here it seems to there are a lot of small manufactorers and some of the food being manufactured is not of a very high quality.

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"... The thing that I’ve discovered is that there are a lot of people in Brazil who are very interested in nutrition and there looks to me to be some talented students who are very interested in the subject..”

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(pg.06.) (continues). (back to the top).

 

     
     

nutrição.Vet: 08- What was your impression about the Symposium?

 

 

Dr. Hill: The Symposium was very well organized.  I could tell the speakers were excellent. I do not have portuguese so I can’t say that I necessarily understood everything but reading the slides where the scientific terms are not that much different from  those in English I could get an  impression of what was been presented. And  I could tell the presenters are really presenting very similar information to the information that would be available in North America or Europe.

 

 

 

nutrição.VET: How do veterinarians at their offices – not inside the University – provide the service of clinical nutrition in the United States? Do they do it themselves or refer to specialists in Clinical Nutrition?

 

Dr. Hill: (pause) ...Can I just finish the question first of all from the previous question? [Sure]  …One of the things  I was struck by this Symposium is how many people were there. There were a lot of people there who were interested in nutrition. And as a follow on to that there are an awful lot of people who are interested in nutrition in Brazil as a discipline. And Dr. Carciofi is training a lot of very competent people. The shame in the U.S. is that we have very few specialists. The American College of Veterinarian Nutrition only has about fifty members… So…  that’s for the whole U.S..


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nutrição.Vet: 09- How do veterinarians at their offices – not inside the University – provide the service of clinical nutrition in the United States? Do they do it themselves or refer to specialists in Clinical Nutrition?

 

 

Dr. Hill: ...So if you do have a nutritional question the usual recommendation is to talk to your veterinarian. Unfortunately veterinarians don’t necessarily have as much interest as they might have in nutrition.

I think...  some do know the answers to questions, and all the veterinary students have nutrition courses in the U. S. schools but unfortunately they don’t necessarily remember the information and under the circumstances there is a tremendous reliance on the information that is coming from pet food companies.

 

And as such, some of the information is certainly biassed or has a sales motive. I think most of the large companies are pretty honest, it’s just that sometimes they tell part of the

truth that they want you to know rather than telling the whole truth. So, under the circumstances it is important to listen to all the companies to get what is correct.

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"... under the circumstances there is a tremendous reliance on the information that is coming from pet food companies.”

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(pg.08.) (continues). (back to the top).


 

     
     

nutrição.Vet: 10- What do you think is important in pet nutritional science now?

 

 

 

Dr. Hill: What is important in nutrition is very much dependent on what is being advertised.  It’s being driven by advertising. So if there is a new nutrient which a pet food company has patented or has got some research on to try convince you to buy their food… then  there’s a lot of discussion of that nutrient. And unfortunately that often gets distorted and so we often don’t necessarily get the whole story about that nutrient.

 

 

So there is a lot of we call ‘nutrients of the day’. So, what is important this week maybe different from what is important next week.  Examples would be things like: fish oil, glucosamine, carnitine.

 

The others big issues that are subject to debate are whether dogs and cats should be

fed carbohydrates, or be fed nutrients from plants; and the other big debate in the U.S. is whether animals should be fed raw food or whether they should be fed cooked… prepared pet food.


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"... whether dogs and cats should be fed carbohydrates, or be fed nutrients from plants; and the other big debate in the U.S. is whether animals should be fed raw food ...”

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(pg.09.) (continues). (back to the top).


     
     

nutrição.Vet: 11- Who gives financial support to pet nutrition research in U.S.?

 

 

Dr. Hill: Is the same as in Europe.  There are big government funds available but it’s not usually used for pet nutrition.

 

It’s expensive to use dogs and cats where rats and mice would work. The alternative is to measure what is going on in people and a lot of this money is used for medical research.

 

So unfortunately, whereas the dog used to be a model, in the sixties, and there are a lot of very good old papers, there are very few new papers that are not funded by pet food companies.

 

So the drawback of field research in the U.S. and in Europe is that it is being funded by pet food companies.

 

 

 

There are some foundations which are willing to fund research such as the American Kennel Club, and Mark Morris Foundation…  But we are competing not just for nutrition funds, but also for funds for other medical problems.

(pg.10.) (continues). (back to the top).

     

nutrição.Vet: 12- If a Brazilian veterinary student wants to know more about pet nutrition, if he/she wants to get an internship or training or maybe do a masters or a PhD, where in the world do you think this Brazilian student could go?

 

 

Dr. Hill: The PhD students need to go where there is money to support them.


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"... The best thing is word of mouth. So let people know you are interested in nutrition.”

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And that is a very individual thing. Some people, like myself, sometimes I have money and sometimes I don’t have money. It depends a little how active he or she is and the best thing any prospective student can do is to make people aware that they are interested.  Send a Curriculum Vitae, and an explanation of what they plan to do and why, to members of the pet food nutrition community.

 

If you are applying to an American or British School it would be important that you could speak English. If you are applying to a European School it would be important you

spoke the language of interest. There are also some programs which have a much higher tradition of taking students like Dr. Carciofi’s or there is Davis (University of California).

 

If you are going to do a residency there are much fewer places that are potential options because there are very few places where there are residencies.  The residency programs in the U.S. are very much on an individual basis, again, where there is money. The most productive program is the University of California, Davis, because they have regular positions available.

 

But doing a residency in nutrition is quite competitive and, again it is a question of looking at their websites and finding what is available and talking to some of the people in your country as to what might be available. The best thing is word of mouth. So let people know you are interested in nutrition… what you’re interesting in doing, get your C.V. (Curriculum Vitae) ready, and it needs to be a place where you speak the language.


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nutrição.Vet: 13- What Congresses do you usually go to keep yourself up to date on pet nutrition?

 

 

Dr. Hill: I’d like to go to more meetings than I can. The one that I definitely go every year is the American College of Veterinarian Internal Medicine Forum (ACVIM), and I go to there because I’m an internist, and because at the beginning of it is the American Academy of Veterinarian Nutrition (AAVN) Research Meeting. So I get the combination of nutrition and internal medicine and there is some nutrition as part of the internal medicine meeting. It’s a very big meeting and it teaches about advanced diseases management. So it’s more a meeting for a specialist than a generalist, or a very good, above average practitioner.

 

 

The next meeting I attend often is the North America Veterinary Conference which is in Orlando(FL).  It happens in the spring and I go there because is right next door to where I work. It’s the largest veterinary meeting in the world and it’s designed very much for the practitioner. It’s very well organized and anybody going there will have a good time. It’s a good place to enjoy Florida and they really look after you well. It’s primarily directed to practitioner and it has medicine, nutrition, and all other specialties. It’s a very good meeting.

 

 

I occasionally go to the European Society of Veterinary and Comparative Nutrition (ESVCN) meeting. I like to go to

that because is a larger nutrition meeting than the AAVN Meeting. The AAVN Meeting is only one day, this is usually two or more days and it is much more cosmopolitan (it involves many different countries) and it’s very good for meeting other people who are interested in veterinary nutrition just like the AAVN Meeting.

 

Then, each of the pet food manufacturers periodically puts on a meeting. The Purina meeting is usually every year, sometimes every other year. The IAMS Meeting hasn’t been held for a number of years, the Mars Meeting is held about every three years. Some of those are invitation only and sometimes they are open meetings. I find them very useful, again, for meeting other people who are interested in my discipline, and so I always enjoy those meetings.


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"... The one that I definitely go every year is the American College of Veterinarian Internal Medicine Forum (ACVIM)...”

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(pg.12.) (final). (back to the top).

 

 

 


see also

 

 



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