Last month I wrote a column for the Miami Herald addressing the topic of so-called “prescription” diets for pets. In it, I lambasted therapeutic diet manufacturers for requiring a vet’s prescription to purchase pet foods without having to prove that these diets are safe or effective.

It’s always rubbed me the wrong way that pet food manufacturers were able to usurp the term “prescription” as a marketing tool. It’s not just that it’s confusing to pet owners and veterinarians when something that doesn’t legally require a prescription goes by the name, “prescription.”

It’s also that it seems fundamentally unfair that a legitimate legal term that denotes drug safety and efficacy has been co-opted corrupted by pet food manufacturers in the service of their brands’ bottom line. And now it seems they want to have their cake and eat it too.

Let me explain:

As I wrote in my piece for the Herald,

“Therapeutic [AKA, “prescription”] foods are ubiquitous in veterinary medicine. They’re designed to address everything from renal failure and gastrointestinal sensitivity to allergic skin disease and liver disorders.

When these products were developed in the 1970s and ’80s, they were initially marketed as “prescription diets” [by the Hill’s pet food company] The idea was that these foods were not only more scientifically advanced but also that they were so tailored for specific illnesses and were not considered appropriate for healthy pets.

Consequently, they were marketed exclusively through veterinarians. This not only ensured that a vet would be in charge of monitoring a pet’s response to a restricted diet, but that the pet food company had a vet’s expert recommendation, a prized commodity. This arrangement also provided a veterinary hospital with a secure source of significant profits. When clients began asking to purchase these foods from other sources, manufacturers began to require written prescriptions.

Fast-forward 20 or 30 years, and greater competition in the pet food market means expanded distribution online and through big-box retailers. The concession to veterinarians who were unhappy with the competition was to continue to require prescriptions.

[These] diets are not regulated by the FDA [like drugs are]. They did not have to endure rigorous safety and efficacy trials as drugs do. As such, the requirement of a prescription, though legal, is not strictly necessary.”

Confused?

You’re not alone. Ask ten veterinarians and I’d bet a generous majority couldn’t correctly explain the FDA’s role in pet food labeling –– much less the legal issues surrounding therapeutic diet sales. A testy inter-colleague exchange in Veterinary Economics magazine last month is proof enough of my profession’s collective confusion on the subject.

As if to make matters worse, the FDA recently proposed an even more convoluted approach to these diets. It’s currently seeking comments on a September proposal to begin requiring veterinary oversight on diets that make specific therapeutic claims.

In other words, it effectively wants to sanction what these therapeutic diet manufacturers’ marketing arms already do (requiring veterinary say-so if you want to feed your pets these diets), meanwhile keeping supermarket players from edging in on the veterinarian’s turf with vague claims like “supports urinary tract health” and “promotes joint wellness.”

Which would be fine with me. After all, I well understand that some diets can actually harm pets if they’re not fed correctly. Unfortunately, the FDA is hoping to ink this regulation without actually requiring that veterinary diet manufacturers prove safety or efficacy on their therapeutic claims.

If it happens, it’ll be a big win for both manufacturers who want to continue to sell through vets and for veterinarians who make a some income off therapeutic diets. But it also institutionalizes the sizable economic loss consumers currently endure as they’re forced to buy foods through less competitive channels of distribution.

Sure, the idea of making all the obfuscating loser labelers on Petco shelves go away is compelling to me, but how can the FDA pretend to regulate products on the basis of labeling claims alone?

For all we hear nutritionists talk about the very real dangers of misusing therapeutic diets, veterinarians have to take it on trust that the manufacturers are producing a safe and effective product. Not to pick on Hill's, but here’s my take:

If Hill’s and it’s ilk can't prove safety and efficacy, why should they be allowed to enjoy the benefits of FDA labeling and veterinary-only distribution?

In other words, I simply don't think it's enough to put all diets with health claims under the veterinarians' exclusive purview. If the move is really about better protection for pets then we need the therapeutic diet manufacturers to step up and independently demonstrate

a) that their diets actually work,

b) offer specific indications and

c) provide evidence-based guidelines for safe and effective use.

Only then can we credibly demand that the supermarket shelf pretenders go away.

Luckily, I do believe we can count on the power of inertia to lend us a silver lining: With all it’s got to do, I seriously doubt the federal government is willing to pick fights with Nestlé (among others) over its labels. The FDA is clearly over-reaching here and I doubt anything will ever come of it.

Pic:"Kitten food"