Introduction

Pets are increasingly viewed as a part of the family, and this viewpoint is considered the major factor contributing to the growth of the global pet food market.^1,2,3 Pet food marketing centers on the strong emotional connection between pet owners and their animals, and this emotional connection has been shown to impact a pet owner's consumption values (ie, reasons for consumers choosing to buy a specific product, choosing one product type vs another, and choosing one brand vs another), information search methods, and retail preferences.^4,5,6,7

With the growth of the pet food industry, information about pet nutrition available to the general public, especially online, has also grown. However, this information, such as recommendations to feed raw or grain-free diets, may not be scientifically correct or nutritionally appropriate and can be dangerous to dogs and cats.^8,9,10,11,12 If pet owners do not receive information about pet nutrition from their veterinarian, they may source information from the internet and other media.^13,14 Pet owners want to receive accurate information about pet nutrition from their veterinarian, so veterinarians continue to be the most common sought-out source of nutritional information.^{13,14,15,16,17,18}

Despite growing widespread pet nutrition misconceptions and a pet owner's desire to discuss their pet's diet with their veterinarian, a veterinarian's willingness to discuss pet nutrition during an appointment may be low. A study¹⁹ of 284 recorded veterinary visits revealed that only 60% of veterinarians discussed pet nutrition and only 12% of veterinarians recommended long-term, largely health-related changes to a pet's diet. Although veterinarians often focus on therapeutic diets as part of their recommendations for medical management of various diseases, discussion of diet during appointments of healthy pets (ie, wellness appointments) is limited.¹³ Speculated reasons for this lack of discussion include that veterinarians may have limited knowledge of pet nutrition, want to avoid a debate over pet nutrition with pet owners who seem unwilling to discuss or change their pet's diet, and feel overwhelmed about and unfamiliar with the large number of over-the-counter pet foods.^20,21 Some veterinarians may struggle with discussing with pet owners perceived sensitive topics, which may include pet nutrition, and therefore may decide to avoid these topics, as noted with cross-cultural topics and pet obesity.^20,22,23,24 People often omit information regarding foods about which they feel sensitive for consuming²⁵; therefore, pet owners may also feel sensitive about the foods consumed by their pets. Communicating effectively about a pet's nutrition and diet with a pet owner may be difficult, especially when the goal is to persuade a change in diet,¹⁴ because “few subjects are as emotionally loaded and full of personal opinions as what and how people feed their pets.”²⁰ Studies^26,27 reveal how relationship-centered communication styles can positively impact the VCPR, including a dog owner's adherence to an elimination diet trial for their dog. Yet knowledge of the effectiveness of a veterinarian's discussion with a pet owner regarding their pet's diet and of a veterinarian's recommendation of a diet change during a pet wellness appointment is lacking.

Therefore, the primary objective of the study reported here was to determine the effect of the types of statements that may be made by a veterinarian during a pet wellness appointment on a pet owner's decision to consider changing their pet's diet. A secondary objective was to determine which statement types were the most impactful to various pet owners on the basis of pet owner demographic characteristics (eg, gender and highest education level), species of pet, and pet examination routinely by the same veterinarian. A third objective was to determine a pet owner's satisfaction with their pet's current diet.

Materials and Methods

Results

One hundred twenty pet owners elected to participate in the study. Participation rate was not recorded, but most pet owners who were asked to participate did so. Of those pet owners who participated, 100 (83%) presented their animals to the veterinary teaching hospital and 20 (17%) presented their animals to the low-cost veterinary clinic and 84 (70%) were dog owners and 36 (30%) were cat owners. When pet owners were asked about how likely they would be to change their pet's diet on the basis of the types of statements, pet owners overall responded less favorably to personal statements (median, 10; IQR, 9.0 to 12.0), compared with pet health statements (median, 12; IQR, 10.7 to 16.0; P < 0.001) and food manufacturer statements (median, 12; IQR, 10.0 to 13.5; P < 0.001; Figure 1). Although scores were higher for pet health statements versus food manufacturer statements, the difference was not significant (P = 0.069).

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Overall responses (n = 120) to a survey regarding pet diet statements a primary care veterinarian may make from pet owners who presented their pet for a wellness examination at 2 veterinary facilities (veterinary teaching hospital [100] and low-cost veterinary clinic [20]) associated with the University of Wisconsin-Madison. Pet owners responded to each question of the survey using a 5-point Likert-type scale. A—Questions regarding whether a pet owner would change their pet's diet if the veterinarian used specific statements were categorized into 1 of 3 statement groups (PS [personal statement; n = 4], FM [food manufacturer statement; 4], and PH [pet health statement; 3]). B—The importance of various factors on the choice of a pet's diet by a pet owner. Statements and factors are ordered by the most (top) to least (bottom) summed Likert-type scores of 4 (most) and 5 (all).

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.644

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Differences in scores were not significant between statement categories and pet owner gender, salary, or age; pet species; or the length of time pet owners had been feeding the current diet. Pet owners who had ≤ 2 years of college were less likely to consider changing their pet's diet in response to personal statements (median, 9; IQR, 8.0 to 12.0), compared with those who had a graduate or professional degree (median, 11; IQR, 10.0 to 13.0; P = 0.011; Figure 2). Pet owners who had a graduate or professional degree were also more likely to consider changing their pet's food on the basis of food manufacturer statements (median, 13; IQR, 10.0 to 16.0), compared with those who had ≤ 2 years of college (median, 11; IQR, 7.0 to 13.0; P < 0.001) and those who had a bachelor's degree (median, 12; IQR, 10.0 to 13.0; P = 0.031). For each education level, pet owners responded the least favorably to personal statements and the most favorably to pet health statements.

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Box-and-whisker plots of summed Likert-type scores versus personal, food manufacturer, and pet health statements grouped on the basis of pet owner education level (A), pet owner happiness with their pet's current diet (B), and pet owner visits with the same veterinarian (C). The horizontal line within each box represents the median, boxes represent IQR, and whiskers indicate the maximum and minimum values. Individual data points are outliers.

Citation: Journal of the American Veterinary Medical Association 259, 6; 10.2460/javma.259.6.644

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An association was not detected between the number of visits to the same veterinary facility or the number of visits with the same veterinarian and responses to statements (Table 1). Pet owners who usually saw the same veterinarian were more likely to consider changing their pet's diet when their veterinarians used personal statements (median, 11; IQR, 9.0 to 12.0), compared with pet owners who did not routinely see the same veterinarian (median, 9; IQR, 8.0 to 12.0; P = 0.02). Similarly, pet owners who usually saw the same veterinarian were more likely to consider changing their pet's diet when their veterinarians used food manufacturer statements (median, 12; IQR, 11.0 to 15.0), compared with owners who did not routinely see the same veterinarian (median, 10; IQR, 8.0 to 12.0; P = 0.01; Figure 2). Pet owners who usually saw the same veterinarian were no more or less likely to respond favorably to pet health statements than pet owners who did not usually see the same veterinarian.

Nearly all pet owners (98%) were at least somewhat happy with their pet's current diet decisions, and 82% were very to extremely happy. Similarly, most (93%) pet owners were at least somewhat willing to consider changing their pet's diet on the basis of a veterinarian's recommendation, and 65% were very or extremely likely to consider changing. About half (52%) of pet owners were very or extremely happy with their pet's diet but were also very or extremely willing to consider changing their pet's diet if a veterinarian recommended doing so.

Pet owners who were somewhat happy with their pet's diet were more likely to consider changing their pet's diet when veterinarians used personal statements (median, 12; IQR, 10.0 to 15.0), compared with owners who were extremely happy (median,10; IQR, 8.5 to 12.0; P = 0.048; Figure 2). Pet owners were not more likely to consider changing their pet's diet on the basis of their gender or age, pet species, or number of visits with the same veterinarian. Likelihood to consider changing a pet's diet on the basis of veterinary advice trended higher among more educated pet owners (P = 0.069) and pet owners who routinely saw the same veterinarian (P = 0.06).

Pet owners fed their pets the same diet for a median of 1 year (mean, 2.7 years; range, few days to 16 years). Approximately 18% of owners had changed their pet's diet in the last 2 months. When owners were asked about the factors that were important in choosing their pet's diet, pet health, diet ingredients, a veterinarian's recommendation, and a pet's preference were important (Figure 1). Convenience of the diet; whether the diet was grain free, organic, or natural; cost; and variety of the diet were less important. Definitions of convenience and variety were subject to interpretation by owners.

After the appointment, 18% (22/120) of pet owners indicated that their veterinarians recommended they change their pet's diet, and 68% (15/22) planned to follow their veterinarians' recommendation. Eleven of these 15 owners who planned to follow their veterinarians' recommendation agreed to be contacted in the future. Intended weight loss was the reason for recommending a diet change for 37% of pets; other reasons cited included for mitigation of skin allergies and for ensuring gastrointestinal, joint, and overall health.

Discussion

Of the 3 statement categories—personal, pet food manufacturer, and pet health—overall statements regarding pet health (eg, this food will help keep your pet healthy) were most influential to pet owners to consider changing their pet's diet, possibly because of the increasing emotional bond between pet owners and their pets. Personal statements (eg, this is what I feed my own pet) were the least influential. The survey was distributed to 2 groups of pet owners who had unique veterinary experiences, with 83% of surveys completed by pet owners who presented their pets to a veterinary teaching hospital and 17% by pet owners who presented their pets to a low-cost veterinary clinic; thus, data were gathered from diverse clientele (eg, pet owners who had never sought veterinary care for their pets, those that were veterinary medical students, and those that were highly educated and had established VCPRs). These findings were the same regardless of pet owner age and gender, pet species, the amount of time pet owners had been feeding the current diet, and the reasons they chose the diet. Framing the discussion around a pet's health was also found to be effective in a recent study,¹⁵ in which 85% of dog owners highly valued the nutritional advice made by their veterinarian following a cancer diagnosis. Therefore, veterinarians should feel confident that pet owners are receptive to recommendations regarding a pet's diet, especially when the recommendation is made in the context of a pet's health.

Veterinary recommendations were overall more effective when the pet owner perceived that they had a relationship with the veterinarian (eg, VCPR). Although veterinary students rotated through the primary care service every 2 weeks and primary care interns rotated annually, the primary care clinical instructors were constant, allowing for the establishment of a VCPR. Pet owners who reported routinely seeing the same veterinarian (vs not seeing the same veterinarian) responded more favorably regardless of the statements used but specifically more favorably to food manufacturer and pet health statements, compared with personal statements. In contrast, owners who did not routinely see the same veterinarian responded most favorably to pet health statements alone. The length of time of a VCPR was not as important because the number of hospital or clinic visits did not affect responses to all statements. This finding implied that having an established VCPR,^20,27,28 not necessarily the length of the VCPR, affected the impact of each statement on a pet owner's willingness to consider changing their pet's diet. This supposition is consistent with findings of studies^{26,27,28,29,30,31,32} that indicate how relationship-centered communication can positively affect adherence to recommendations made by veterinarians, as well as positively impact the care that pets receive. Also, a pet owner who believes that their veterinarian is an effective communicator are more likely to have a strong bond with their veterinarian, and nearly 70% of owners that have a strong VCPR follow recommendations made by their veterinarians.²⁶ In the present study, building a or having an established VCPR positively influenced a pet owner's willingness to consider changing their pet's diet.

The findings of the present study also indicated that the majority of pet owners were satisfied with their pet's current diet, with most (82%) highly (very to extremely happy) content with it. Most pet owners who were content with their pet's current diet were speculated to be reluctant to change their pet's diet; however, 93% of pet owners were unexpectedly at least somewhat willing to consider changing their pet's diet on the basis of a veterinarian's recommendation, and of those pet owners who were very or extremely happy with their pet's diet, 52% were very or extremely willing to consider changing their pet's diet if a veterinarian recommended doing so. This finding indicated that many owners were open to changing their pet's diet after receiving nutrition advice from their veterinarian, despite being satisfied with their pet's diet.

Study limitations were primarily because the study was preliminary. The number of participants was relatively small, given the total annual caseload at the veterinary facilities, such that a proportionally robust margin of error needs to be considered with the data. The survey was not presented in a random order. Rather, pet owners who were amenable to take the survey agreed to do so. Most pet owners agreed to take the survey; however, a participation rate was not gathered. Lastly, the veterinary medical students who distributed the survey were affiliated with a veterinary teaching hospital; therefore, pet owners may have been biased toward more favorable responses, compared with responses that may have been elicited had the surveys been distributed by someone not affiliated with the veterinary teaching hospital (or in the veterinary profession).^14,18 As is common with most social science research, social desirability bias (ie, the tendency of survey respondents to answer questions in a manner that will be viewed favorably by others)³³ likely occurred with the present study, evidenced by responses frequently skewed to favorable scores of the Likert-type scale. However, because a veterinarian's personal statements were least persuasive, social desirability bias may not have been an important factor with statement agreeability. Despite that most pet owners were at least somewhat willing to consider changing their pet's diet on the basis of a veterinarian's recommendation, the likelihood of actually changing the diet was thought to be low. After the appointment, 18% of pet owners indicated that their veterinarians recommended that they change their pet's diet and 68% of those planned to follow that advice. Because a small sample size of only 11 pet owners agreed to be contacted in the future, follow-up was not done, so whether any pet owner actually changed their pet's diet was unknown. Diet behavior change for people is discussed extensively in published studies,^34,35 specifically with regard to diseases such as diabetes mellitus. However, models of diet behavior change for animals have been only briefly discussed in published studies,^20,27,36 and those often focused on the management of specific medical problems like obesity²⁰ and on the compliance with elimination diet trials.^20,27,36 Future studies may benefit from larger sample sizes and longitudinal research that includes an assessment of pet owner compliance rates with veterinary recommendations and the degree of information each pet owner retains in response to different methods of communicating the need for a change in their pet's diet. Use of a qualitative methodology to explore in greater depth the reasons for pet owner compliance and subsequent longitudinal change of compliance would also be beneficial.

Pet owners may be passionate about their pets' diets,⁹ and veterinarians may then erroneously assume most owners are unwilling to change their views on their choice of a pet's diet. Yet results of the present and previous studies¹⁴ indicated that veterinarians influence a pet owner's choice of their pet's diet when diet is discussed. With a better understanding of the impact that a veterinarian can have on a pet owner's decision to change their pet's diet, veterinarians can make more informed decisions about how and when to discuss a pet's diet with owners. The results of the present study provided insight on the willingness of various pet owners to consider changing their pets' current diets, and specific statements that are related to a pet's health may be best for a pet owner to follow through with a recommended diet change.

Supplementary Materials

Supplementary materials are available online at: avmajournals.avma.org/doi/suppl/10.2460/javma.259.6.644.