Introductions and Navigating Client Conversations Around Pet Supplements

Bill Bookout: So, let's start by taking a look at the state of pet supplements from the practitioner and the manufacturer's perspective. First question is for Dr. Pachel and Dr. Morgan. How do you navigate discussions with clients about how they can employ supplements in their pet care? So, answer that question first, and then I'll ask you some follow-ons. Dr. Pachel, we'll start with you.

Dr. Chris Pachel (he/him): Certainly, so in clinical practice, I would say that the supplement conversation can arise in a variety of different ways. Sometimes it's initiated by the client themselves, saying, “Hey, I'm already trying some stuff that I'm grabbing down the street. I'm shopping online. Instagram is throwing a bunch of stuff in my feed, what should I do?" In other cases, the conversation is started by me, if the owner or the pet is in need, or would potentially benefit from something. So, the way in which the conversation evolves can vary quite a bit.

Where I tend to guide the conversation really depends on the magnitude of the issue that we are navigating. I'm a veterinary behaviorist, so I'm functioning specifically within that field of behavior, so a slightly narrower lane than sort of the broad, supplement conversation, but with that said, we're often looking at supplements that may be targeting musculoskeletal health, osteoarthritis, looking at gut health, brain function, just overall health and longevity. And so the conversation evolves in a variety of different ways and I think it's enjoyable to talk about with clients to help them understand the wide multitude of options that they do have available to them, and then their perspective on that will guide how the conversation actually evolves.

Bill Bookout: Great, Dr. Morgan, you have any additional thoughts.

Dr. Judy Morgan: Yeah. So, when I had my two hospitals in New Jersey before retiring from clinical practice, I was known for being a more holistic practitioner. But we actually had integrated hospitals. What I found was probably 75% of my clients were integrated, so they would use traditional medications if we felt that that was the best path at the moment, but the goal ultimately would be to move into alternative methods of therapy so that we could get rid of the side effects and the potential pitfalls with long-term medication use.

I did have probably 5% of people who came in the door, who said, “Oh, forget all the hocus pocus stuff. I just just give me a pill for it. I want to make it go away.” And those were really frustrating for me, because I knew that I was putting a Bandaid on the situation, instead of being able to get the body to actually heal and make the problem go away forever. So, the conversation could start in a lot of different ways, but because my practices were known as being integrated, and I was known for really wanting to get outside of that realm of the side effects and the problems with long-term medication, and also the long-term detriment to health of the animals. I think that chronic disease conditions in veterinary medicine, well, even in human medicine, are such a huge issue, and we do a disservice to ourselves, to our patients if we aren't looking for a better alternative than long-term medications and chronic health problems.

Bill Bookout: I think you hit on a really key point. So often, we focus on drugs, alleviating symptoms, not preventing a long-term health condition. Right? So I think supplements are a valuable component, and the practitioner is best positioned to put the pieces together that create this picture, this three-dimensional thing that achieves long-term health and wellness for our pets, just like we want to achieve for ourselves. So yeah, I think supplements are not a magic bullet, but they're certainly a valuable component of a long-term comprehensive care program for sure. And I think you all would agree with that. Right?

Dr. Chris Pachel (he/him): The only thing that I want to sort of call out there a little bit, which I think is potentially a variant in the perspective is, I don't necessarily, and I may have misheard you, Dr. Morgan, but I don't necessarily look at it as sort of an either/or, that medications are going to sort of minimize symptoms, whereas supplements are likely to allow the body to heal. I actually find that both can do both. And so I'm curious, just from that perspective, I just want to make sure that my view on that is well represented here. I think a responsible practitioner can absolutely use pharmaceuticals to do exactly the same thing. With that said, I completely agree with you that both in human and in veterinary medicine, there is a wide overuse of medications in that way of doing exactly what you described. I just wanted to be clear that I was hearing that distinction correctly.

Dr. Judy Morgan: Yeah. So, for instance, I really think that traditional medications are really good for acute problems. So, if we have an anaphylactic reaction, I'm not going to go grab Quercetin and hope that that's going to solve the problem. I'm going to use something that's going to save that animal's life. If I have an autoimmune disease where the platelets are being killed, the red blood cells are being killed, the kidneys are being killed, we're going to reach for immune suppressants, but then the goal is to not have them be on high doses of immune suppressants for the rest of their life. The goal is, let's figure out what's underlying this problem. And how can we responsibly use those medications and then wean them off the medications while we've done other things, including diet. And then stress, so many things that go into it. So, I'm not against using medications. Believe me, if I get hit by a bus, I want some real pain medicine, first thing. Treat me for shock, do all the good stuff, but then I'm not going to get addicted to opioids and take them for the rest of my life. And so, unfortunately, that happens to so many people and so many animals, where we just throw all the medications at them, and we're like, “Oh, good! Look at that! It's working,” and then we never work to get them off of them. For instance, I had a Doberman years and years ago, and he developed autoimmune meningoencephalitis, granulomatous meningoencephalitis secondary…The neurologist thought secondary to distemper vaccination. This was before I was holistic, and he was put on very high doses of steroids, and he was on them for a year, a year, and he developed fungal infections. He lost all his muscle mass. He couldn't stop peeing and drinking. It was a horrible, horrible year, and I never want to see that happen to my patients, or you know what, the client, when you have a hundred-pound dog who can't control his pee, that's a big problem.

So you know, I look back on that and think, “Wow! There's no way. I would have kept that dog on high doses of steroids for a year, knowing what I know now.” But that was the state of the art back in 1989. So, we know a lot more now. But I do, even in records that I get from people, I still see these animals being kept on really high doses of immunosuppressants for really long periods of time, much longer than I think is beneficial for the animals, the same with seizure medications, just so many things that it's just like, “Well, it seems to be working. We don't know what will happen if we stop, so we don't want to wean them off,” and it's like maybe we should find out.

Bill Bookout: I think what I'm hearing both of you say is, you know, health is three-dimensional right? And there are many factors, and you know the practitioner’s job is to put the pieces together that create the best outcome for long-term health and wellness. And you know other things that we haven't mentioned that are also equally important: Diet, exercise, environment, things like that. Supplements, allopathic treatments, drugs, all those things are components of, you know, long-term health and wellness, because we really want to have for our animals the same thing we want to achieve for ourselves: long, happy, healthy life to the maximum degree possible.