Label Review #3: Hills Prescription Diet Dog Food and Dog Diabetes

Host Jennifer: Well, welcome back to another episode and we are already on our third episode of label review and I love, I know he said this last time, but I really do love doing these because we are learning and teaching people. So, so much about brands and the claims that they have on outside the packaging, but also what's within the packaging. And we are going to be talking about in this episode, Hill's prescription diet. And if you're not familiar with that, we'll kind of go into what exactly that means. But it's, Hill's prescription diet WD in the full name is WD multi-benefit.

So we'll go through on, you know, what is Hills on their literature, all the, what that multi-benefit means. And it's the number one, it's the top brand. And they'll, you know, the line of products and Hills prescribed for dogs for diabetes. So that is, you know, we'll talk more about my own story with my dog, Maddie, if you're a new listener, I have two small dogs.

We always joke. I have the small dog. Dan has the big dogs, but Manny has had diabetes for two years and it's, it's been a roller coaster. And she, she was on Hills for, um, a good couple of years of that management. So The speeds that this is like the first label review that we've done for a product that one of us has actually fed to our dogs.

Host Dan: It's like, you know, we've done label reviews of other products. And there's plenty of interesting things I think to say about their labels. But in this case, we've got one that one of us actually used has personal experience with. That's like really relevant to the stuff that's on the label to like how the product is put in front of consumers marketed to consumers. So it's a unique thing for us. It's really cool. Yeah. We, we always focus on facts and again, you know, I'll, I'll talk about my personal experience, but it's not a, you know, formal feeding trial or anything scientific, but I think it is important to talk about a personal experience that a person has had, especially with a long-term feeding and yeah, I mean, we, we usually go out to the store online and buy the food that we're reviewing.

And so we can have an on-hand experience. And I, first thing I said to you was, yeah, I still have, you know, a bag of Hills WD, um, in our, in our storage closet because Actually I have some too, I have some, and because we're using it, there's a, a trial, like a study that's being performed as we speak right now at the university of Gwelf where they're comparing in a variety of ways, this product against a ketone product and against something else, they're going to kind of just thing in a variety of ways. Like I actually have some in my house too, cause I was using it for those purposes. Yeah. It's, it's a very, I think a very common, uh, you know, food when we switched, even when we switched fats, uh, with my dog, we were like, oh, she's on WD. I mean, they all have it in stock. It's Hills is huge. We talk about big kibble Hills as a top brand. It's a very well-known brand. So I think this was going to hit home to a lot of people. So we, again, Diabetes it's like there are kind of two foods that are recommended by that are they're available with a prescription. If your dog has diabetes, it's like a food that'll help with that. My beauties and it's this product, this Hill's product. And then a Royal Canin product called glyco balance. And The two that are like for that purpose and we're going to get into, it's not going to be, this is not rocket science, but we are going to get into some legal stuff today about what you're allowed to market as BA how you can market something as being a treatment for diseases, food products, dog food products, as a treatment for diseases, what, what you have to do in order to do that. Um, but yeah, basically those are the two. So if you're listening to the show, your dog has diabetes, the odds are super good that at one point or another, and you're dealing with that disease, you've fed either Hills WD or Royal Canin Blanco balance, for sure. And I'm sure we'll do Royal Canin glyco balance and a few future episodes show. Yeah. Diabetes is such a growing disease in, in the dark population. And it's, it's almost common to the point where it is kind of an everyday conversation, which is very odd to me where it, you know, I'll be talking with a friend. Oh yeah. You know, my dog's on has diabetes is on insulin. Insulin is your dog on. And it's like, it kind of still takes me back, but I think we should start there really. I've just like, let's talk about diabetes. Cause that spilling over into, well, how has Hill's saying that this is helping to treat, uh, diabetes and glucose management. So yeah, let's kind of start there. Like what is diabetes? Okay. So diabetes at. And I think there are definitely other shows we've already done that are relevant to this topic as well. But the tragedy that like the nutshell version of what is diabetes and your dog, it's a disease where your dog can't process glucose as well as it ought to be able to. So glucose is a substance nutritional substance that is found in your body and abundant quantities and your dog's body and abundant quantities. And it, uh, is present in some amount all the time. If there's no glucose in your dog's bloodstream, that's a real big problem. But equally big is the problem. If your dog has too much glucose in the bloodstream, there needs to be a specific like it needs to be within a specific range or else not like chronic disease risk goes up like, oh, some wooey like very severe acute toxicity, death type things, coma type things happen. If you go into what's called hyperglycemia. If you have too much glucose in the blood or hypo glycemia, which is too little glucose in the blood. So if your dog's body is functioning, normally it can deal with fluctuating levels of glucose really. Well, what it does is it produces a hormone that basically gets things back to normal. The hormone is called insulin. And what insulin does is it says like when your, when your dog's body senses that there's too much glucose in the bloodstream, it produces insulin and insulin essentially is the antidote to like high levels of glucose and makes the glucose takes it out of the bloodstream and puts it other places where your dog's body can like manage it safely. And so that's, there's this constant fluctuation going on where glucose levels go up, insulin more insulin is secreted. Insulin levels get higher, brings the glucose levels down, insulin levels, come down and reaction to it. And it's just this ongoing cycle, um, in a healthy dog, in a dog with diabetes, the dog can't produce enough insulin on its own to manage its glucose effectively. So in a diabetic dogs case, the glucose level in the blood comes up. Insulin level tries to rise to meet it, but can't do it. It's on its own. And she wind up. If you don't do anything about it, you wind up with a dog that gets hyperglycemic and that's really, really bad. You can have really severe problems very quickly. Um, so the only other thing to note about this as a disease is what causes fluctuations in blood glucose. Like in order to treat this disease and manage this disease appropriately, you have to be able to understand what makes blood glucose go up or down other than insulin. And the key thing there's other, there are other things that impact glucose levels to some degree, but the by and large, like the whole whole thing is basically how much glucose is the animal eating, like where glucose primarily comes from, where you get big shots of glucose into the blood is after a glucose rich meal, you eat a lot of sugar. Like think if anyone that's listening to this has, um, experience with diabetes in their themselves, their own case or a family member, a non K9 family members case, you know, all this stuff too. It's like, there are certain food products that if you eat, you know, are going to drive your glucose up. And it's the ones that have a lot of glucose in them, which most obviously means very sugary things. Glucose is sugar. So if you drink, um, a Coca-Cola a big gulp size, Coca-Cola your blood sugar is going to rapidly increase, but what's somewhat less well like it, it's not really even like not well appreciated seems to get this on some level. And it's why the way that like the veterinary community manages diabetes is so insane, but glucose is not just sugar. It's all carbohydrates. Carbohydrate is glucose complex. Carbs are a long chain of a lot of glucose molecules. Simple carbs are just a couple of glucose molecules, but all of them are made up of glucose. That's what it is. So if you eat a carbohydrate rich meal, even if it doesn't have a lot of sugar and it's all complex carbohydrates, that is a ton of glucose that finds its way into the bloodstream is that meal is digested. It doesn't go into the bloodstream as complex carbs. It all goes into the bloodstream is exactly the same thing, which is glucose. It gets broken down from the complex long chains into single glucose molecules during digestion and goes into the bloodstream as glucose. So the number one thing, of course that drives the dog's blood glucose levels up is a carbohydrate rich meal. If you don't, if the feed the animal food, but not glucose, you have a far less significant reaction. And this is like incredibly well-established and literature is not a controversial point. This is something that's well understood by anyone that has taken a one-on-one level physiology course. So it's like, you're talking about the that's the elephant in the room is how much carbohydrate is in the meal. Um, yeah. And so that's basically, that's how diabetes works. Yeah. And, and it very much is, uh, appreciated to kind of get a refresher course. And I remember my vet trying to like fit it all in, within like a two minute, you know, episode of like your dog has diabetes. Here's what it means. And, and it is a lot to like understand where I have, you know, I don't have family members that have diabetes and I didn't even understand the physiology is the same in your dog. Like rates glucose goes into body, you know, the insulin, all of that works the same. Very, very It's very much like it was. So it's like a good refresher to be like, okay, here's why diabetes is and how it works within the body, because it is very, it is the same physiology within the human body. And We met you, you get into like treatment site, you know, it's like basically the, there conceptually speaking, there are two ways you can kind of treat diabetes. Diabetes is a, body's inability to process glucose effectively. Cause it doesn't produce enough insulin. So you can either, number one, keep the glucose levels lower. So you need less insulin to bring them back down to earth. Or number two, you can supply more insulin than dog can produce on its own. And that's the same year you think about this, this happens with human beings as well. There's retreat, diabetes. You take, you take it via injection insulin. And so this is like, you've gone through this, treating it, right? Like you guys do insulin shots, right? Yeah. We still do. And looking back on her diagnosis, it was, it, it was overnight like we brought her in, she was very sick. We're like, here are her symptoms in, you know, after some blood work and then looking into, after a couple of different things, because she also had pancreatitis. So we were kind of battling of that of like, oh my gosh, did she get too much fat? Like what's going on with her with, you know, maybe she got into something, but no, it was her body literally breaking down. And it was a jump to, she now has to be on insulin. She now has diabetes. There was no mediation. And the reason I say that, I think about like when I had gestational diabetes, so I had a twin pregnancy. So already my, my, you know, risk level was so high up there. But I was, I did not have to go on insulin because it was diet managed. It was a very much like we're going to work with you. We are going to, you know, monitor what you eat. You're going to take your blood sugar, you know, morning after meals, things like that. And I didn't even get a chance to do that with Maddie. It was like, she is so sick that she has to like work on to keep her on the same food. We're going to like, you know, pump her full of vets sullen. And it was just like, it was very scary. It was not a, you know, like here's where she's going. Her blood sugars are unstable. Like let's kind of look at maybe like these three causes. It's just a very, you know, and I feel like a lot of people have that shared experience. Yeah. She, and she's still on, um, you know, insulin, but her, but her insulin has dramatically dropped since we, So that's where I'm going with. This is like basically like the, you as an owner, that's trying to manage your gods diabetes basically have to get pretty expert in understanding how much insulin to give the dog because insulin can kill you and can kill your dog. If you over, do you can overdose on insulin. Um, I manage 10 pounds And so not. I mean, you have to buy this stuff, right? And so if the more you use, the more you have to pay for, but it's also like, you don't, you can't, you don't overuse this or you have problems. And so what you it's like second nature to you now, but it's as somebody whose dog doesn't have this. And if any listeners are like that, it's hard to imagine how much work is involved. Like you gotta take your dog's blood sugar levels. You got to pull blood out of your dog, subject the blood to some kind of analysis so that you can find out how much glucose is in there at any given time, make a determination of what that means in terms of how much insulin to give the dog inject insulin into the dog. Like this is not a small deal to, for a disease that a lot of folks think impacts at least a million dogs in the United States right now. So yeah, if you don't have it, it's easy to underappreciate how big a deal it is. Yes. And it, and it's, and it's not just like, oh, you know, taking her blood. I mean, we have to do every now and again, blood sugar curves, which is a whole day experience of two to three hours pulling blood from her. I mean, we're talking from the moment she wakes up to the, you know, even after she goes to bed, I'm like waking her up to take her blood sugar to make sure, uh, we do, uh, the inside of her mouth. Um, we found, so that's another interesting point. Just a side note as like a diabetic dog, mama was sometimes with pod, depending on like the depth of penetration, um, where you're taking it on the body. We were getting inaccurate readings from her ears, her paws, and the only stable readings we were getting was inside her mouth. We do take it from her gum, um, is our personal experience, but what works for her, It's still it's, I've read about this. A fair amount. How like it, humans with diabetes have recently benefited from a bit of a technological revolution. It used to be not very long ago at all. That that same process essentially was what you had to do to, to draw your own blood and figure out how much insulin you needed to get there. But now there's a class of new ish devices that are continuous glucose monitors. They live on the body, you stick them on, they've got these really tiny needles that get beneath the skin and into the blood painless. And they just consistently all day are spitting out a reading of the, you know, they're taking it every 60 seconds or whatever, and digitally submitting it. They don't work great for dogs yet. Like they have been to a very limited extent like trial in that way, realized in that way. And some people would make the case that like, yeah, we know, I know how to do this well enough where I can use this with my dog. I've not had that experience. I've found them to be pretty difficult, still. Like they're dead. You're like repurposing a human use one for adults. So you gotta like shave the hair off so that you can get the thing to stick. And there's just a bunch of stuff like that convert the reading, but yeah, it's getting there and I, I have no doubt, no doubt, because I've looked at doing it as a matter of business that within 10 years, that's going to be the norm because I've really common in dogs and it's such a big step for it makes life so much easier that you don't have to stick a needle in your dog. Yeah, I agree. Yeah. The, the diet diabetes management as a pet owner, it's extremely stressful because not only are you worried about right. The actual, you know, the exact dosage of insulin and also as the timing like, oh my God, did she get her shot? Um, you know, uh, giving her over to someone else to take care of her, did you get her shot? Like all of those things. Um, but it's also, did she get the right amount of food? We have two dogs. We have to make sure monitoring, she's not eating more food than she should, or eating food off that other dog's plate. So it really, you know, the, the diet and what she's eating is such a huge part of it. And so that's why like, kind of going back to that conversation in the vet's office, we did kind of breathe a sigh of relief when the vet said, well, you know, we put her on Hills WD, which, which I'm like, I know this product inside and out and for her pancreatitis because of the low fat content, she, she did very well as in, she did not have any pancreatitis episodes. And then the vet said, well, you know, to make sure she has a nice long lifespan and to get her blood sugars where they need to be, she's going to continue on WD. And we just kind of took it as, as like, of course, that would make sense. Like, she's on this for pancreatitis and we're just going to roll it now, roll it over into diabetes management. Right. So she was on Hills for a good year and a half before we switched her off of it. And it was an absolute nightmare in terms of her blood sugar numbers. So she didn't have any other like digestive issues or anything else. Cause she had been on it for quite a while before that. And it was all the, you know, VAT conversations were okay. Uh, lower her, uh, intake of food by like we were going by like tablespoons at that point, like Tiny Half pounds. Right? So like take a tablespoon of food out, increase insulin by 0.2, five units, try this for anyone would be like a couple of weeks trial of that things weren't working. Okay. Now we're going to like increase our food and like increase insulin. And it was, um, it was just a night, it was a roller coaster. Um, and she was labeled as a quote difficult dog. And that's hard to swallow as a pet parent too, of like, why, why is my dog different than any other dog with diabetes? Um, until we switched her off into a different food that was, you know, low in carbohydrates, as well as some other nutritional value and her blood sugars have stabilized and we're down to like two units of insulin, which she hasn't been on anything in a long time. And so it's just been, so that's kind of just my own personal experience where the only change it. Wasn't like, let's try a different food. Let's see what she's eating. Let's see like what's going in. How is that affecting her blood sugar? It was like, let's tweak what she's eating by these microscopic amounts. Yeah. I mean, and so I think that part of the reason that you experience that is really there are only these two food product, dog food products that are marketed to vets as being treatment for metabolic conditions like diabetes that involve glucose management. Um, and, uh, and, and so basically, and they're like similar in a lot of ways, these two glyco balance and this Hills WD. And so if you're a vet and you think that part of how to help your patient manage their dog's glucose, their, their diabetes is to use a dietary intervention. You got two prescription ones to choose from that are like, I mean, I don't know, you're generalizing and speculative to say like, of course vets are going to opt for the prescription only claims because that's like prescription strength versus over the counter strength, which is not as strong. But I think what basically where we need to take this podcast now is to talk a little bit about how pet foods that are marketed to vets as treatments for specific diseases, how those products are regulated because they're regulated somewhat differently than products that are available without a vet prescription. And it's super relevant to like understanding why these products a are so popular B why what's, what you see on the label is what it is. Um, and, and see kind of what is so wrong in the system. Overall, having a system where this is the product that is the standard of care for this disease. Um, I agree. And I think it's important to know when we say prescription only, we are literally talking about this as a product. You cannot find at a pet store. This is not something you go walk into Petco, you grab a bag and you walk out, this is, you buy it from, you, get a prescription from your vet and you purchase it from a vet's office. That's right. And so it's like, um, I think that it makes the most sense to talk about like how the, how the regulations work and then pull up the label so we can walk through it with everybody and show you the specific claims and, and highlight like, you know, talk about, see, this is an example of where we were talking. That sounds perfect. All right. So basically here's where you start from. There's two categories of consumable pet products that are regulated by the government in the United States. One is food. The other is drugs. Okay. Drugs as a broader definition than the, than the common understanding of the word it's anything that is being marketed as a treatment or something that helps you prevent a disease. So if you are in any way, going to make a dog consumable product that you're saying is going to help treat or prevent any disease. It counts as a drug in the eyes of the regulators, which is the FDA. If you want to sell a drug for dogs or people in the United States, you go through a massive process. It's involves a ton of legal work, scientific work, and a timeline that involves years. It's like a pre it's, just a big, big process. There are whole law firms that do just this for big drug companies. Um, and basically if you're going to do it, it is pro you can't, it is very difficult to create a startup pet food brand. That's going to basically make FDA qualifying drugs. That's just like in order to do that as a huge amount of work that's required. However, in recognition of that, the FDA created basically like a little exception to this broad rule. Usually you have food on the one hand, you have drugs. On the other hand, if you're going to make drugs, you got to go through this massive process. But the FDA said, look, at the case of dog food products, there are these, like, there's a class that's like, it's a drug and it's food. It's like, you could feed this to a dog. It's going to meet all of its nutritional requirements. But also the manufacturer says it can help with these diseases. It can help to treat or prevent a disease. And those class of products like, okay, should we, we're not going to subject those to the same massive pre-clearance drug process. So they created the special exception and we'll have a link to the relevant regulator in the show notes. There you go. This is the meat of it. Um, this is like basically how this exception works. What the FDA said is like, okay, look, if you're going to make a dog food product that is also going to be marketed to some degree as a treatment or prevention of disease, you don't have to go through the whole big years, long process. As long as you do a few of these things. If you do these few things, we won't come after you. It's technically still going to be a violation of the law, but we're not going to enforce the laws of non-enforcement policy. We won't come out right here are the key things you got, you got the, some of the key ones highlighted here. Number one, product can only be available with a veterinarian's prescription. Okay. Number two, the label itself doesn't include disease claims. So between those two things together, you can't have like a consumer like you and I, who is not veterinarians, pick up the bag and go, well, this looks like a good thing to me for diabetes go. It says right here on the bag, cures, diabetes, you can't do that label can't have anything. And so when we go into the WD label specifically, we'll explain w walk through this. But basically that you fall into this exception of number one, the label doesn't say anything about treatment or prevention of diseases. And number two, only available with the vet's prescriptions. You can't get this product just by going into Petco. And number three, there are, if to the extent that there are communications marketing communications made that this is a product for treatment or prevention of disease, that goes only to veterinarians only to the veterinarians. So what, what the FDA is essentially saying is we're going to trust the vets on this one. Like as long as the company that makes the food is only marketing to vets and not to consumers about the disease benefits of the product. And as long as a vet has to sign off, we're going to trust that that vet is scientifically literate and discerning enough to digest the marketing materials that are made available to them, prescribed the product, if it's appropriate for the client. And, and, and not if otherwise, Yeah. And actually a two pages, uh, before this, I won't scroll up because this is such a good list, but it, it gives an exact example of what you're just talking about. If like they did, do not want customers going in and saying, oh, it's glucose management and then going home and not giving their dog insulin, like they need to have that same. This is to help manage, uh, blood sugar levels like this. But insulin is yeah. As the primary, uh, prescription. Exactly. And so it like, you know, it's just a, it's a, it is an area that any advanced, like culture needs to regulate. You can't just give it my belief. You can't give companies, manufacturers, carte blanche to create products that market straight to non-expert folks about diseases. You can't say Dan's aids cure, Dan's COVID cure. And I just go by it, expecting that to happen. And then I ended up getting sick anyway, dying, anyway, dumping a bunch of money into it. You have to have doctors and other medical professionals serving as intermediaries. And that's kind of the way this regulation works, right? And Hills WD is a product that is, that is, has been, is being allowed to be sold by the FDA not being there's no enforcement action against them, as far as I'm aware, because it complies with this regulation. They haven't gone through the new drug approval process, which you would have to go through. If you created a cure for cancer, you're going, they're going through this. They're complying with this stuff. And so FDA is coming after them. And so if we go down our, like the list of the three most important ones, number one, this product is only available through veterinarians. Like you said before, this is part of a line of Hill's products. That's prescription only pills kind of has two main product lines. They have what they call their science diet product line, which has stuff you can get in the pet store, you yourself without a veterinarian. And then they have what they call their prescription diet line. And that stuff that intuitively enough is only available with the best prescription. And the WD is one of those. Okay. Number two, the labeling, what the consumer actually sees, not the vet, but the consumer actually sees can't include disease treatment or prevention claims. So let's take a look at the label of a Hill's WD dry dog food products. I don't know if you have like either a, I know you have like a personal bag, but we can also pull it up. Yeah. Yeah. Well, it's actually look at the website and in the packaging. Yup. Yeah. So what you have here is language that is suggestive of relationship with disease, but not specific cure or prevention claims. Right. So We recently went through a redesign. That was something I noticed too. Um, just, just a as an observational point because my bag, I, which is, she's been off of it for like nine months now, but it has, you know, the prescription diet, but they did have like digestive weight, glucose, bladder, like right on the front. Um, And this, what I've got here, and we're going to get to the significance of this in like a, in a minute. But this is, I think from 2016, this was like a Hill's marketing product from 2016. And the WD formula, as of that point actually includes the word diabetes on there. It's the diabetic formula. Low-fat diabetic gastro, not graph gastro intensive intestinal. So you can see that they're right on the boundary line of these regulations. And they're being reactive probably to FDA patients or whatever. But what you do see now is language. That's suggestive of a relationship with disease, but not explicitly about treatment or prevention. And specifically what I'm referring to is in the middle here. The like one description of the product section, it says clinically tested nutrition, formulated for multiple benefits, just of health, weight management, blood, sugar management, and urinary health. Now, those what you're not seeing there, the other way they could have framed this, the more forceful direct way that you could do, but would be in violation of the FDA's rules is you would say clinically tested nutrition, formulated for multiple benefits, prevents indigestion prevents or cures obesity, or help prevent obesity helps prevent diabetes. You don't have that here because it's not allowed under the regulation that we just went through. So instead you have referenced to management of these conditions of these like, um, aspects of physiology that are the core of the disease. So weight management is not a disease. Obesity is a disease that has to do with weight. So I can say weight management and not be talking about disease. Similarly, diabetes, it's a disease of blood sugar essentially, but blood sugar management is not a way of saying treatment of obesity or prevention of obesity, but it's a strong implication. It's enough where if you're a pet owner and your vet has recommended this, prescribed this for your dog, with diabetes, you, that, that that's an echo that, that, that language echoes that same like recommendation based on, Right. And, and there are additional marketing materials here in like this image gallery, they use the verb help, you know, help maintain lean muscle helps manage blood sugar. Correct. They're there, they're not going as so far as like, we are, we are curing out, we do lower blood sugar. We, you know, like we do have make your dog lose weight. So yeah, that's a really good point. Okay. So those are the first two of our three key variables where the FDA says, okay, we'll allow you to do this one. You can see it's prescription only. Number two, the label itself doesn't make claims about it's just this annoying corporate speak multi-benefit WDS, right? Um, uh, but the third is disease. Specific claims are made only to veterinarians with appropriate scientific support. And this is kind of the crux of the issue, right? Like, I mean, at least in the FDA's eyes, this is, this is really important, right? You don't want, you can't give just the vet licensed to prescribe anything and whatever. It's like, you have to trust that the veterinarian is going to get information upon which they can exert their influence, figure out whether it's a good fit for their patient and prescribe it if appropriate. Right? And so what you have to then go look at the third thing to look at here. Third part of our conversation is what are the vets being told by the manufacturer? Because you're, you know, it's going to be different. They're getting some type of marketing material that the consumer doesn't get, because FDA says consumer, you can't have that. Like we're not doing, I was going to say, this is a very important point. This is something that is not available online. This is something that is not right. It's not a brochure. It's not anything available to us as consumers, that this is for vet eyes only. And this is, uh, what, what Jen has pulled up on the screens. This more than any episode we've probably ever done. This is one where you got to watch the video. Cause there's a lot of It in the show notes. Yeah. But what this is, I'm holding it up right now is this big pamphlet, uh, hundreds of pages. Um, that's entitled Hill's keys to clinical nutrition. And I was given this at a Hills continuing education program that was put on for veterinary professionals while I was doing the research that would go into the book that I wrote. And, um, so this is not something that was produced this year. This would have been like 2016. Um, I know, you know, dozens of veterinarians and I promise you that every day of the calendar in the United States, there is a version of this being handed out to a veterinarian by somebody from Hills in this day and age to this day, this is the 2016 version. But the concept is the same. This is something that Hills uses to tell veterinarians about their prescription diet line. And these are the benefits of it. These are the specs, that kind of thing. And as you'd imagine, it's produced by somebody who's trying to sell the product. It's got a, Hill's favorable spin on it, but that's, you know, like, of course it's going to, but like, what we're going to drill into here is like, what are the marketing claims that are made here that are not being made to consumers? Because these are where the meat should, should be found, right? Like if there's that recommending this product for a dog with diabetes, it should be because these materials help them to reach that conclusion. And so there are kind of like, you know, this is a multi benefit product. And so you've got a bit of like kind of material or two pages, maybe a little bit more, maybe three in my version where I've got a material about this specific product, as opposed to some other Hill's product. But the main things to call attention to are kind of two things. One is there is a description of, and this is actually on the other second page of this. Okay. There's a here you've got kind of feeding amounts and what they ingredients and key benefits. Okay. And the key benefits is where the rubber meets the road when it comes to, uh, our analysis today, because you can see that we've got disease claims here, right? I've got explicit reference to diseases, including constipation, colitis, diabetes, weight management, instead of obesity there, but weight management, but diabetes. And it says helps minimize blood glucose fluctuation, which may reduce insulin dosage. So if we recall back to how diabetes works, that makes all the sense in the world, right? We know that it's a disease of inability to manage glucose. And so if I'm going to reduce glucose fluctuation, that's a good thing. That means I'm going to need less exogenous insulin. And, um, my diabetes, my dog's diabetic condition is going to be less significant for the dog and where this is highlighted in the Hill's materials is under the heading of fiber. Fiber increased means diabetes helps minimize blood glucose fluctuation, which may reduce insulin dosage. And they are totally right, totally The case that all else being equal. If you add fiber to a dog's food product, and again, all else being equal, the food product is otherwise exactly the same dietary regimen is otherwise exactly the same. And you add some degree of insoluble fiber, their blood glucose will fluctuate less violently. Um, that is demonstrated in literature. This is a factually true statement, but it is super misleading, super misleading. And the reason that it's super misleading is that the extent to which adding fiber helps to reduce violent blood sugar fluctuations is tiny in comparison to a much more direct and profound way to reduce blood sugar fluctuations using diet, which is just to take the sugar out of the diet. So the studies show that basically you add a little bit of fiber to food and you'll tend to get somewhat less reduced, minimized blood sugar spikes. And the reason for that is that fiber basically slows the digestion of glucose. You put it in there and you have your complex carbohydrate and you introduce fiber into it as well. It takes longer to break it down into individual glucose molecules. And so less of it gets pushed. Less glucose gets pushed into the bloodstream all at once. So fiber is a good thing, but just think about it for a second. This is better. If you're dealing with a 40 or 50% carbohydrate product without fiber or a 40 or 50% carbohydrate product, that's got 5% insoluble fiber unquestionably. This will probably help to some degree to have the fiber, But Much more direct, significant, profound way to do it is to just take the glucose out all together. And that's the real, that's, what's such an outrage about this product. Jen, you can pull back up the current formulation and you can see the like nutrition data on this, uh, on the current formulation right now, this is a product that is stuffed with. Okay, great. Um, let's See. 5%. What are the ingredients that the first ingredient is the first ingredient? Some kind of, it's gotta be one of the first Green Wheat. Okay. Again, it's not until the third ingredient. Yeah. It's insane. What's running through my mind. Like when you say this, it's like it's saying the glucose that is coming into your dog's body because of the high carb content of most doc food, including this prescription diet that's prescribed for diabetes is like a Mack truck that is going to hit your dog. Now the fiber or the brakes on the fact truck, which will help low it have to be a Mack truck. And the trial, his analogy with me in our rehearsals. This is a great analogy. I love a good analogy. Yeah. Does it have to be a Mack truck slamming your dog's body shooting up your curve? Like You could just, and so by extension, if you take, take the analogy further, what if you just, oh, I don't know. Took all the carbohydrate out of the product in the first place, because as we've covered in a million shows at this point, carbohydrate is not an essential nutrient for dogs. They don't need it. Study after study has show the, take it out of their diet altogether. Nothing bad happens at all the vast majority of their evolutionary heritage. And they never ate it just over the past few, whatever dozen generations they've started consuming it, learning how to digest it. And now it's half the diet, even if your dog has an inability to digest it or to metabolize it. So what's the, you know, okay. And the analogy is why not trade the Mac truck right. For a, um, you know, a scooter. Yeah. And it's exact it's so right on the money, I Feel outraged on two levels. Right. I feel outraged on the level at Hills because to me, it's, there's nobody that's making this product that doesn't know that the, this is like saying, just tap the brakes a little bit before the Mack truck hits her dog, they all get it. And they're selling it any way. They know they could sell a product that was just the little bird scooter or whatever the equivalent, but they don't, and that's outrageous. They should be calling attention to that. But I gotta tell ya. I'm just about as outraged at the veterinarians who felt, I mean like, this is not, this is involved science, but it's not rocket science. This is not like, you don't need a PhD to understand why this logic does it hold up. You mean, you'll understand it just as well. If you have a PhD or if you have a regular high school education, and yet all it's it's, you know, this is a billion dollar brand. This is one of two products. And they're both subject to all these same criticisms that are used as a standard of care for a dog with diabetes, you experienced it yourself. And in that case, I'm not saying, you know, the outrage is tempered a little bit because I don't believe that a veteran's knowingly doing that is going, like, I know this is going to hurt the dog, but ha ha. I'm doing it anyway, which is Not malicious intent at all. So Criminally negligent, I mean, not permit. I've got to be careful my words. I mean, I don't mean that literally it's not literally criminal, but it is absurdly negligent because go let me know. Like I said, the literature showing that taking the carbohydrate out of the diet altogether has a much more significant impact on blood glucose is undeniable and easiest pie to find you search pub med one time, you'll find all the studies. It's super easy. The other thing that is criminally negligent, again, figuratively speaking, not literally speaking about how veterinarians are approaching the marketing material and translating that into prescriptions for this product is on the first page. Here you go. Exactly. So there's a section here, scroll up a little bit that, um, highlights the evidence-based clinical nutrition for this product. And what that is, is one statement with two citations, new nutrition of prescription WD canine is clinically proven for weight management in dogs, prone to weight gain. That's it. Okay. And so the end, there are two citations to the only scientific site citations in the entire marketing thing. Okay. So the was designed to be like, okay, look, you can market disease specific stuff, but it has to go directly to veterinarian so they can be experts, judge, judge this stuff and prescribe it. If they think it's appropriate. Cool. Got it. You got two studies. Actually you have one, you have two citations because one of them just says data on file. Hill's pet nutrition, Inc. Okay. So one of the 50% of the citations are two, not a published study. This isn't a peer reviewed piece of evidence. This is just hill says they have it somewhere. And if that was, you know, lots of vets are like, okay, that, that makes sense. Um, and then the second is just as bad. Basically. It's one study. Do you have a link to this? The P Pull it back we'll study. And this is peer reviewed. This is published, Right? It doesn't, it says some degree of scientific relevance. It just has nothing to do with the efficacy of this food as compared to other foods to treat any disease in dogs. Basically what this is, is like, is, is, are people better at losing weight? If they are trying to lose weight with their dog or not, you got a group of people, this is all summarized this abstract. Like you can just pull it up on the website, reef yourself, right. I think I'm describing it pretty faithfully. You've got a group of 50 or so people that have obesity and no dogs, you've got another group that are fit 50 people that are, have obesity and have obese dogs also. And they get subjected to the same conditions. And it's like, did either of them lose weight better? And I think basically the conclusion is they didn't, but that's, that's not the point. The point is that like Hills is using this as a citation for the fact that their food works as a, as a weight management tool. It doesn't, this is not comparing Hill's product with any other product. I think it's not cited on the abstract here, but I presume that the Hill's diet is what was used for the dogs. Like they, they had the obese dogs that were half study and they were given, it says here, calorie restricted feeding with the prescription diet. So what happened in this case is the people that put together the study said, okay, here's these dogs let's figure out how many calories we need to feed them in order to get them to lose weight. And we'll feed them, uh, this diet, this is the prescription diet. And they did that. And the dog's lo and behold lost some weight, like, okay, they did, you could have done the exact same thing with any dog food product. If you ahead of time, go, okay, I'm going to calculate how many calories are in here. I can figure out if I feed the dog, this many calories, how much weight it's going to lose. Yeah. It's kind of a bare minimum exercise too. And they started off with, so the, so there were two sets of, uh, participants, the first being an obese person with an obese pet, which is their PP group as they called it, which was only 36 people to begin with. But only 61% of those 36 went to the end of the trial. So this whole study is based upon like what, like 17 people or something. Yeah. And it doesn't even like that. You'll see that the actual, like the main point is this study. Wasn't looking at whether this product helps start to lose weight. That's the key take home, but there's tons of absurdities. I mean, the absurdities are like, it didn't actually do what they were testing. Like does a dog exercising as a person and help the person lose weight? More like, no is the answer. But, but like, that's, again, that's not even the point. The point is like, how a veterinarian you have, I'm sorry, this is, I'm putting myself into somebody else's head here, but I, you gotta convince me that I'm not being reasonable in this. You don't see this read that abstract, not even the study, just read the abstract and then go, okay, this supports the point they're trying to make here. There is no way that you do that. This does not in any way, make the idea that this product helps with diabetes. Any bit more persuasive. It's not part of it. The only, only way you can assume that this material makes the event more likely to prescribe this product for diabetes is if they don't read it at all, that's the only conceivable way. There's no way you can pull anything about diabetes out of that study. They don't look at diabetes in that study. They barely look at dogs. Right? Okay. So there's an inescapable conclusion that what's going on here is vets get they'll pitch, get the material, don't look at the science and then prescribe the product anyway. And that's, that's why it's like so negligent. Like that's exactly what the law is designed not to. And so it's Responsibility for them to take on too, because not only are they prescribing the food, they are becoming then a distributors, right? So they're stocking the food for people to then come in to continue to feed the food to their dog. So it's E Again, I'm not imputing Right? Alice to the vets in this case. But like, that's a soft factor. Like if your job, if you're, if a steady stream of income is reliant on you being negligent, you're going to be, so I believe it encourages you to be negligent and who is selling the insulin. The veterinarian is selling the insulin, selling this prescription only product the veterinarian's sell on the prescription only product. If you want to buy a non-prescription product without the marketing plan, you can go, there are plenty that you can buy that will do a better job. Might I tell you at ma preventing diabetes, managing your dog's diabetes without a prescription at the pet store, but your fat doesn't get a cut of it. Now, do you feel that the studies, we just went through, uh, you know, flimsy or not, but do you feel that that's what they're using for this cornerstone marketing language of clinically tested? Cause that's something they throw on website, packaging, all of that. You know, what, from your perspective, scientifically speaking, in, in being in the pet food manufacturing business, where do you, where do you kind of feel that they're positioning that around? Well, I mean, there is the fact that this is a four or five-year-old thing more than that five or six, whereas the clinically proven clinically tested language is found on today's label. Correct? Said if we break down the language clinically tested clinically proven that clinical in my judgment is a buzzword for a consumer that has a general respect for the idea that science is helpful in disease, but doesn't really have a nuanced understanding of how food products are vetted through the scientific process. And so it's something, some kind of reference to veterinarians, it's basically saying in some kind of way, this is a product that has been tested in a clinic. That's just like, as much as I can say, it's sort of like saying basically there's no, like if it was tested, it's just such a general like clinicals, obviously very general term tested as much more general. It's like, if you could say it's clinically tested for safety, which is to say, it will make your dog sin. You could say it's clinically tested for efficacy with regard to some specific application, diabetes, weight management, blah, blah, blah. It doesn't say that. And that's why it's like, it's just, it's really just the buzz word, halo effect of that expression that I think is the reason that it's included on there. Um, because it's not, you can make, if somebody put somebody sued Hills and said, I think you're being misleading about use of the word clinically tested here. I predicted Hill's response to that would be like, our products are used in more veterinary clinics than the other product that is clinical. That is testing. That is what we're doing. Maybe something to that effect. Yeah. I mean, going back to, even when we were going through that FDA regulation list, I mean, there are no certain buzz words. Like there's nothing around you saying clinically tested and what that means. I mean, there's just no regulation to that point of that exact language or other language that makes it seem like it very medically necessary. Yeah. It kind of feels very, You could see pull up the Hills, uh, the website again, that has the current label on it because I'm pretty sure it's, this is something you can find, like there's like stuff about veteran veterinarian recommended, number one, veterinary recommended, like that's all, there you go. And I think like, at least it's certainly used to say number one. Yeah. Maybe Scroll down page, like lower than not just the label itself. Number one, veterinarian recommended. Yeah, exactly. And so that's, that's a lot, I think if you were to put their feet to the fire and what they mean by clinically tested, it would be like that. We'd be like, we're the number one more vets recommend our product than any other, which is a reflection that reflects really poorly on the veterinary community. I think because we're walking through the logic that they've got to use, there's no like piece to this that we're not looking at. This is just straight forward and they're all fudging it up. Um, so yeah. Yeah. It seems it's yeah, it kind of just feels like the toothpaste thing of like, you know, three out, uh, whatever the now or whatever they use right now in their language, or have always used cross does like, oh Yeah, yeah. The Hills. Yeah. So, so for, I know we covered this in another episode, but basically Hills is owned by Colgate Pall mall of Colgate Palmolive makes Colgate toothpaste and they got huge amount of success, marketing Colgate toothpaste products through dentist offices. So they said, we're not going to market directly to te people we're going to market to their dentists. And because we're going to rely on the theory that you don't make your own choice for you, don't actually evaluate the evidence when you're figuring out what toothpaste is best to keep your teeth clean. You just ask your dentist. And they de enjoyed huge success doing that acquired Hills shortly thereafter. And there is very well reported. This is not a matter of like, I think is what happened. This is all very, well-documented basically said, we're going to do this same exact thing that we did so well with toothpaste, with, uh, pet food. And that's how they developed Hills into like this huge prescription, only life science diet line rides on the prescription only line, like the backbone of their business is selling through veterinarians. If they didn't do that, it would be a completely different business. And I don't think it would work. And so it's like, yeah, that day, what they do really well because they invest money in it. And it's, their strategy is sell through a lot of veterinary offices. So that you're less, they're the number one veterinarian recommended products by far. Yeah, I agree. And I think it's important to wrap this episode with, because this is a prescription item because this is highly recommended for diet for diabetic dogs. So please just, don't go out and just stop feeding your dog this one day. Like, please continue to have that line of communication with your vet for your specific dogs, health, and wellbeing. And all of that, we are just kind of walking through of these are the claims, but just opening that door right. Of like the actual science and what studies they're using and claiming, and how glucose works and how diabetes works in your dog's body. So these are all things to bring awareness and then you can then advocate for your dog. Yeah. It's a super good point. I can really go to like, I've I can talk about this stuff, assuming that it's got an academic application, it's an application about the issues and not about real-world application of how those issues are analyzed. I can go like totally off on that. And you're exactly right. The like, you definitely should go talk to your veterinarian about the content of this podcast, as opposed to taking this content and acting on it in your product decisions, how you feed your dog, how much insulin. Cause you can screw that stuff up. And so talk to your veterinarian about it, but man, I encourage you to do that. Yeah, absolutely. And that's how I feel this podcast is like, we want an open line of communication between, you know, what feedback do you, what topics do you want to see about diabetes? What feedback or topics do you want to see about like the veterinary community? What other brands, you know, we always say reach out to us and I'll have the email contact in the show notes of, we want to help educate you to open up those like communications with your fat too, of saying, Hey, you know, cause this is the podcast effects I heard this study done. Dah, dah, dah, dah, dah. Can we talk about it? Can we talk about how it applies to my dog. Um, we should always advocate for our dogs, right? And, um, we all want our dogs to live long healthy lives. And you know, this is just one way we're helping educate everyone is, is by looking at these big brands, big brands, small brands, whatever you guys want us to talk about. This was just such an important one because it is, it is the top prescribed one for diabetes and diabetes, such a cornerstone of this, uh, podcast as well. So we hope you learned many things. I feel like we covered a lot. This was your, I look forward to hearing the feedback on what people found useful, confusing. Cause there's like we covered regulation and law and science and business. And so there's a lot covered there and hopefully we get feedback. People need us to go deeper into elements of that or re-examine elements of that. And I would presume that, you know, we will certainly have a very dedicated episode, diabetes only dedicated episode of obesity only. I mean, these are huge topics. We just can't cover it all. I mean, we would be here for three hours. We do try to keep these 45 minutes to an hour. So, um, well anyway, thank you for listening and until next time again. All right.