Among owners feeding commercial diets, we found a decrease in the use of grain-free foods, from 22% to 14% among all 128 respondents, after a cancer diagnosis. While this could seem contrary to the concerns of some owners regarding the role of carbohydrate in promoting cancer progression,possible benefits of the low carbohydrate approach have not been supported by any studies. Further, grain-free diets can be lower, similar, or higher in carbohydrate content compared to other diet categories.There has been considerable attention to the association between dilated cardiomyopathy in dogs and the use of grain-free diets,and both veterinarians and pet owners might have increased awareness of this issue. Regardless, given that more than 1 in 5 dogs in the present study were fed a grain-free diet before a cancer diagnosis, this data highlights the need for clinicians to discuss the risk of diet-associated DCM with all dog owners. The most common informational resource for diets and supplements was veterinarians, similar to previous studies for dogs.Veterinarians are a key resource for providing nutritional information, especially after a cancer diagnosis when veterinarians are actively involved with care, and around three quarters of pet owners believe a change is necessary.Additionally, as our data show,indoor plant table many dog owners do alter their dog’s diet. These findings underscore the importance of collecting and assessing a thorough diet history. This enables effective client counseling by the veterinary care team to help guide and ensure the safe use of diets, treats, and supplement products.
Our study did not differentiate whether veterinary advice was taken from general practitioners, cancer-specialists, nutritionists, or elsewhere. Further specifying where owners receive information in a future study would be beneficial for understanding whose dietary advice pet owners value the most. To assess which factors were most likely to result in diet changes, we created a logit model. Our logit model showed that 1 predictor of owners making diet changes was median census tract income, which lowers the chance of diet change as tract income increases. This suggests that people in wealthier areas might be less likely to alter their dog’s diet in response to a diagnosis of cancer. Larger studies are warranted to confirm and further investigate this pattern. One limitation of the current study was only involving dogs referred to a single hospital’s oncology service. Coupled with time restrictions, this survey might not have recruited a large enough sample size to detect all of the patterns in nutritional alteration after a cancer diagnosis. Furthermore, dog owners within the geographical area of the survey might not be representative of the greater population of dogs and owners. Additionally, dog owners visiting oncology services are a subset of the overall dog owner population, meaning these data can only apply to dogs with a recent cancer diagnosis presenting for evaluation by a specialist. Any owners that decided not to pursue a second opinion or further treatment would not have visited the oncology service, and because of treatment associated costs, respondents to this survey could have more disposable income. This study sought to capture a single snapshot in time, namely, when a dog initially presented to an oncology service.
We do not know if this sample of dogs would have eventually shown similar or different patterns than other studies, such as exclusion of commercial diets and using social media groups for dietary and supplement recommendations. It is also possible that these owners would either revert to previously fed diets and supplements or make more extreme changes after treatment. Although we attempted to capture the time-point shortly after diagnosis, there was still a median delay of 61 days from diagnosis to survey. This is likely due the nature of online survey distributions, and the wait to get an oncology appointment which was exacerbated by the pandemic. Additionally, some dogs attempted cancer-related treatments elsewhere before presenting to the oncology service. As a result, some dogs were already undergoing or finished treatments at the time of taking the survey, some of which might have caused gastrointestinal issues before survey completion. Nonetheless, we feel that the time frame from diagnosis to survey enables us to capture additional nutritional changes beyond those simply because of an immediate medical need such as cancer and treatment related gastrointestinal signs. Further study is warranted into how specific treatments might result in changes to what owners feed their dogs. This study also tried to balance the quality and completeness of data obtained with respondents’ time and willingness to complete a lengthy survey. One concern was that adding too many questions would result in many owners not reaching the end of the survey. Since owners who made changes were asked additional questions, we felt these owners would disproportionately fail to reach the end of the survey, possibly skewing results. Another consideration in interpreting the results of this study was if owners who changed their dog’s diet or supplements could recall what was previously given.
Based on initial piloting of the survey, some owners did not recall their dog’s previous diets and supplements and were frustrated by the survey. As a result, the survey program did not force a response for these questions. This was done to ensure owners who did not remember previous nutritional information would be able to complete the survey without guessing unknowns. While we feel this goal was achieved, it is also likely that some owners who remembered simply skipped past these questions for the sake of time. This study strived to be inclusive to all answers by providing text boxes, often referred to as “other” within the survey, if the owner felt the listed multiple-choice options for a question did not apply. However, as the owners largely filled out the survey online by themselves, many either did not list what we were looking for, or possibly used the text box as an additional place to put information, rather than intending to respond with “other.” These factors limited the value of the free text responses, and we feel that studies in the future could avoid these issues by either limiting free text responses in favor of more comprehensive multiple-choice options or by administering the survey in person. Overall, many dog owners make alterations to diet or supplements after their dog has been diagnosed with cancer. Clinicians should counsel owners regarding cancer treatment and its relation to nutrition to assess the current diet and enable educated decisions for any changes. Topics of focus could include discussing owner concerns regarding commercial diets, formulation of home-prepared diets, and the use of certain herbal supplements,hydroponics flood table including mushrooms and CBD.In the USA, synthetic cannabinoids have been detected in products obtained via smoke shops, gas stations and the Internet . Many of these substances are surmised to be full agonists of cannabinoid receptor 1 and cannabinoid receptor 2 . The consumption of synthetic cannabinoids and related products has been linked to adverse effects including agitation, confusion, hypertension, respiration issues, seizures, tachycardia, paranoia, hallucinations, psychoses and acute kidney injury . They have also been associated with several driving under the influence or impairment cases and have been implicated in human deaths . During the summer of 2012, President Obama signed legislation which placed 15 synthetic cannabinoid compounds and 5 overall cannabinoid structural classes into Schedule I of the Controlled Substances Act . These compounds include, but are not limited to, AM-2201, JWH-018, JWH-019, JWH-073 and JWH-122 . The tetramethylcyclopropylindole cannabinoids, UR-144 and XLR-11, became prevalent for much of the remaining portion of 2012 and were ultimately controlled by the Federal government in April 2013 . In early 2013, a new wave of compounds that contained a large change in chemical structure emerged and are classified as quinolinyl carboxylate derivatives. 1–1H-indole-3-carboxylic acid 8-quinolinyl ester, also known as 5F-PB-22, is a quinolinyl carboxylate derivative that differs from the earlier generation naphthoylindole, AM-2201, by replacing the naphthalene group with an 8-hydroxyquinoline moiety . Pharmacological and toxicological data for this compound do not currently exist, but similar to other synthetic cannabinoids, it is expected to be a CB1 and CB2 receptor agonist. Currently, this compound is considered a controlled substance in the states of Minnesota and Florida. On 10 January 2014, the US government temporarily placed four synthetic cannabinoids, including 5F-PB-22, into Schedule I of the CSA via emergency schedule . There are no published reports of the detection of this compound in postmortem toxicology cases. We describe a liquid chromatography with tandem mass spectrometry method for the quantitation of 5F-PB-22 in blood and report a series of four fatalities involving these compounds.Alcohol use and binge drinking in youth aged 12 to 21 are frequent causes of accidents and injuries, preventable death, disease and psychosocial problems. Though past-month binge drinking1 and alcohol use among adolescents and young adults in the United States have declined over the past decade, rates remain high: 23 % report current alcohol use and 14 % binge drinking. Over the past several decades, there have been extensive efforts to address alcohol use among young people.
Some interventions have focused on environmental factors while others have been individual or group level interventions aimed at improving knowledge and attitudes, and reducing alcohol use. These have been primarily face-to-face interventions delivered in structured school or community-based settings. The application of theory is widely recognized as a crucial component of behavior change interventions. Theories help explain the pathways that lead to or predict behavior and in doing so, provide guidance on how to influence or change behavior. Interventions, that clearly articulate their use of theories, can contribute to a greater understanding of not just what interventions work, but why they work. While the interventions targeting alcohol use among youth have resulted in mixed findings, this vast body of work has contributed to the evidence base for what constitutes effective interventions. Interventions that are grounded in established theories of behavior change, and include approaches that address social norms, build self-efficacy and enhance skills to resist pressure to use alcohol, have been found to be more effective than those lacking a theoretical framework. As the field of preventing/reducing alcohol use among adolescents and young adults is evolving, there has been growing attention to the development and use of computer-based modes of intervention delivery. They are more likely to be implemented with fidelity because they do not rely on the skills, motivation, or time of the facilitator; and they provide a standardized approach to delivering the intervention content. In addition, recent technology innovations enable CBIs to be interactive, provide individually tailored messages and simulate experiences where adolescents can learn and practice skills in convenient and private settings. CBIs also have the potential to be more cost effective than face-to-face interventions. Additionally, computers have become widely accessible and are especially popular among adolescents and young adults. CBIs provide a promising approach to addressing alcohol use among adolescents and young adults. Over the last decade, there have been five literature reviews that have examined the nascent field of digital interventions for alcohol use prevention targeting adolescents and young adults. Overall, many of the CBIs have been shown to improve knowledge, attitudes, and reduce alcohol use in the short-term. Three of the five literature reviews examined interventions for college students. One review found that CBIs were more effective than no treatment and assessment-only controls, and approximately equivalent to various non-computerized interventions. Another review found that CBIs, when compared to non-CBIs, were more likely to reduce alcohol use. The third review found that CBIs reduced short term alcohol use compared to assessment-only controls, but not compared to face-to-face interventions. In addition to the reviews focused on alcohol use among young adults, there were two reviews of CBIs targeting younger adolescents. One demonstrated that CBIs delivered in middle or secondary schools effectively reduced alcohol, cannabis and/or tobacco use. The other review was a met analysis focused on computer games to prevent alcohol and drug use among adolescents and concluded that the games improved knowledge, but it did not find sufficient evidence that these games changed substance use attitudes or behaviors. While these reviews suggest that CBIs have the potential to be efficacious, the mechanisms that contribute to improvements in attitudes and behaviors are not well understood.