Diet History Recap

Nutrition conversations may be challenging for veterinary teams if they are not approached in an objective manner that creates trust with the pet owner. In order to objectively evaluate every patient’s current diet and feeding plan and identify nutritional risk factors, a nutritional assessment should be performed as part of every visit.

Therefore, we gather information on the Circle of Nutrition, including:

• Animal-specific factors,
• Diet-specific factors,
• Feeding management and environment factors.

A comprehensive diet history is obtained as part of the patient history.

Why?

The diet history is:

• important to identify nutritional risk factors to assess the need for an extended nutritional evaluation.
• essential for determining whether a patient is receiving an appropriate and adequate diet.
• the foundation of a nutrition recommendation.
• an opportunity to check in on client’s beliefs, concerns and expectations.

An incomplete diet history creates an obstacle that often undermines a veterinary professional’s nutrition recommendation, as this recommendation may not align with the client’s own goals or beliefs.

How?

A comprehensive diet history can be gathered in several ways to ensure accuracy and completeness:

• Verbal: Start with broad exploratory lines of open-ended inquiry, then move to more focused lines of open-ended inquiry before using closed-ended questions.

Simple what-prefaced questions obtain limited information and encourage defensive responses from clients.

Also, treats are less likely to be disclosed, warranting more focused questioning or use of different wording (e.g., snacks, rewards, extra foods) to avoid the threat directly associated with the word “treat.”

• Written: Use a diet history form

An example is available in the WSAVA Nutrition Toolkit  . Also the American College of Veterinary Nutrition (ACVN) has a fillable diet history form available.

Save time by asking clients to complete the form prior to arriving for the appointment or to fill this form out in the waiting room.

Use your support staff. They can ask clients not only to fill out this form, but also to bring all pet foods, treats, supplements, medications, etc. to the appointment or provide an email address where pet owners can email photos of all items being fed.

• Diet Log: Have the pet owner keep a diet log for 3-7 days if more information is needed.

This approach is especially helpful for patients with an abnormal body condition score (e.g. <5/9 or >5/9), patients with food hypersensitivities or when clients are preparing homecooked recipes.

What?

A comprehensive diet history requires exploring questions related to the animal, its diet, its environment, and the humans living with them.

• Animal: As with any veterinary visit, this includes signalment, developing the presenting complaint, body systems review, identification of risk factors. As part of the nutritional assessment, body weight and body condition changes, appetite, feeding and drinking behaviors, gastrointestinal function and skin/coat are further explored.

• Diet: What food? We need details; type, brand, flavor. Previous foods fed? Where is the food purchased from? Quantity? How is it measured; gram scale, cup, eye balled? Treats, extras, rewards or snacks? Human foods? Preparation and storage methods? Supplements? Medications and food given for medications? Unmonitored food sources? Anything that goes into the pet’s mouth should be considered.

• Environment: Feeding routine? Meal fed vs free fed? Frequency? Location of feeding? Food and water bowl type? Automated feeders? Food toys and puzzles? Who feeds the pet? Who else in house; children? Other pets in house? Activity level?

• Human-related: We should also explore the client’s rationale for feeding a specific food or brand. This gives the veterinary team an understanding of the pet owner’s dietary viewpoints and will help avoid misunderstandings about the nutrition recommendations.