I had a talk with a couple in the exam room. Their dog has a chronic disease and they were asking if they had caused it. My honesty made that a hard answer.

Every time we do something we have a choice. We can choose to do something that is good for us or our pets or we can choose to do something that is not. Some answers are obviously bad ideas. Giving Tylenol to a cat will cause the red blood cells to melt and kill the cat. Naproxen will harm dog kidneys. Oral bleach does not kill parvovirus.

Some ideas are bad, but not as obvious. Letting a tom cat that cannot pee wait until Monday is really a bad idea. Natural remedies include arsenic and other toxic compounds. European hemlock is very natural and fatal. Bones that are eaten by wild dogs are not cooked. Cooked bones shard and then can slice intestines. Raw diets also seem natural but have been implicated in pet and child deaths due to bacterial contamination. Grapes, raisins, onions, and garlic are all natural and toxic.

Some ideas seemed okay, but really were not. Aspirin causes gastrointestinal bleeding in 100% of the dogs studied. That is all of the dogs. All dogs that got aspirin and were checked had ulceration and bleeding of the intestines. Veterinary medicine has known this for 25 years or more and yet it is still listed as safe by some “experts.” Retractable leashes seem like a good idea, but can amputate fingers, break pet legs and still allow the pet to be hit by a car and killed.

Some things were never recommended by professionals, but had strong marketing. That grain free diet craze is now scientifically associated with potentially fatal heart disease. Dilated cardiomyopathy or DCM is caused by a dietary taurine deficiency in cats. We figured that out in 1987 and commercial cat foods supplemented taurine and DCM became very rare. DCM is rare in dogs and typically only occurs in large- and giant-breeds, such as Doberman pinschers, Boxers, Irish Wolfhounds, and Great Danes, where we think it is because of a genetic component. But recently, there has been an upswing in DCM in dogs. Even breeds not usually associated with DCM, such as Miniature Schnauzers or French Bulldogs. It seems to be associated with eating boutique, vegetarian or grain-free diets. Some of the dogs improved when their diets are changed. We don’t understand all of the reasons for taurine deficiency in dogs, but reduced production of taurine due to dietary deficiency or reduced bioavailability of taurine or its building blocks, increased losses of taurine in the feces, or altered metabolism of taurine in the body could play a part. I do know as part of my Master of Science project, I necropsied 500 coyotes and foxes and looked at gastrointestinal contents. Many of these had bellies full of corn, grain or persimmons. They would either eat them directly or as the stomach contents of their prey.

Other things are not obvious. When are blood work and radiographs worth the money time and effort to run? Obviously, with hindsight results they can save lives, but before it may be a baseline that could wait. Anesthesia-free dental cleanings avoid the risk of anesthesia, but do nothing for periodontal disease that causes heart and kidney issues.
Some things have pros and cons. Spay and neuter at an early age prevents breast cancer in both males and females, but can predispose to bone cancers. (Breast cancer is much more common than bone cancer.)

And many things are situational. It was a really good idea to sign up to do the Glo Run 5K last night. It was a team event, exercise and a very pleasant evening. Twenty years ago, I might have run it. Ten years ago, I might have walked it. Last night the shortcut to make it a thirty-minute stroll was a really good idea. Indeed, me running the 5K last night with no preparation would have been a really bad idea. Meanwhile, the $5 lunch next door at Dairy Queen is probably a bad idea from a nutrition and calorie point of view. But the fact that it comes with a hot fudge sundae might relieve my stress level enough to avoid a heart attack or someone’s demise.

So, every single decision we make during our lives has something to do with what happens to our bodies. Do we walk or wait for a ride? Do we eat fast food or bring a lunch? Do we walk the dog or let it out? Do we skip vaccines or heartworm prevention or do we pay the rent? Each and every time we make a decision, we make the best decision we can at the time and move on. I may have a weight-related disease, but I will not have a stress-related disease. Yes, if I knew now what I do, I might have made some different decisions. But the people in front of me made the best decision that they knew how to make at the time and while I might make some recommendations for the next time, the only thing that matters is they made the best decision that they knew.