Internet survey of feeding, dietary supplement, and rehabilitative medical management use in flyball dogs

Abstract

A survey was designed to investigate the prevalence and characteristics of feeding, dietary supplement use, and rehabilitative management use in flyball dogs. The survey was completed by 394 respondents. There were 12.5% (n = 49/392) and 33.4% (n = 131/392) of owners who fed home-cooked and raw diets, respectively, to their dogs. About 77.7% (n = 306/394) and 56.6% (n = 223/394) of owners used dietary supplement and rehabilitative management, respectively, primarily joint supplements (89.8%, n = 275/306) and chiropractic (73.1%, n = 163/223). Owners were more likely to use supplements (P = 0.0002) and rehabilitative management (P = 0.0001) when their dogs were injured. Dogs with more than one reported injury received rehabilitative management (P < 0.0001) and used supplement (P = 0.0006) more often.

Key clinical message:

There is considerable demand for non-commercial food, supplements, and rehabilitative management among flyball dog owners, underscoring the importance for veterinarians to understand the motivation of dog owners’ decisions as well as the risks and benefits of these practices to ensure optimal outcomes for their patients.

Introduction

Flyball, a team sport for dogs and handlers, has increased in popularity and has governing organizations across the world. The flyball course consists of 2 teams of 4 dogs competing side-by-side on separate parallel lanes with 4 hurdles spaced 3 m apart and a spring-loaded flyball box in which a tennis ball is loaded. Dogs are released from the start line, stride over the 4 hurdles in sequence, retrieve a ball from the box, and return over the hurdles again to pass on the start line, with the winning team having a lower overall elapsed time for the course (1,2). Unlike agility sports, there has been limited study reported on the injuries in flyball dogs (3). However, given that flyball is a sprinting canine sport similar to agility, parallels can be drawn for comparison. Agility dogs sustain injury with a prevalence of approximately 1/3 (33%) of the dogs experiencing at least 1 injury and more than 1/4 (27.6%) of the dogs experiencing more than 1 injury during agility training or competition (4–6). The most commonly injured regions are the shoulder and back (7–9). To the authors’ knowledge, the prevalence of rehabilitative medical management for sport-related injury has not been reported for flyball dogs.

The use of dietary supplements has steadily increased among the pet population in recent years (10); however, little is known about current trends in dietary supplement use in the canine sporting populations. Additionally, only limited information is available regarding feeding trends among dogs that participate in agility events. In 2017, Dinallo et al (11) conducted a survey of North American agility dog owners, with responses received for 494 dogs. They found that 61% of owners fed primarily commercial dry food, 25% fed foods other than commercial dry (i.e., home-cooked, raw or freeze-dried), 14% fed a mixture of commercial dry food and raw/home- cooked blend, and 62% of owners used dietary supplements (11). To the authors’ knowledge, the prevalence of feeding type and dietary supplement use in flyball dogs is unknown.

The first objective of this study was to determine the prevalence and characteristics of feeding trends, dietary supplement use, and rehabilitative medical management among flyball dogs. The second objective was to investigate whether the number of injuries influence the use of dietary supplements and medical management. We hypothesized that there would be a higher prevalence of dietary supplement use and feeding of home-cooked or raw diets amongst flyball dog owners than has been reported in the general dog population, and that dog owners would be more likely to use dietary supplements and rehabilitative medical management modalities when their dogs incurred a flyball-related injury.

Materials and methods

The survey consisted of 121 questions adapted from a previous questionnaire with tailoring of questions specific to flyball participants regarding gear (i.e., harnesses and carpal wraps), activities (i.e., turnstiles, etc), injury history, types of food, dietary supplements, and rehabilitative medical management (6). Prior to implementation of the survey, all questions were validated for accuracy and comprehension by mock interviews of 10 individual dog owners involved in flyball activity. After revisions, the survey was uploaded into a prescription online Survey Monkey (SurveyMonkey, San Mateo, California, USA) software. The survey was completed either onsite at 1 of 8 flyball events by 2 veterinarians (LJG, KW), or online at their convenience following instructions provided by the interviewers. Responses were collected between March 11, 2017 and December 14, 2017. For the study, we included only data on the prevalence and characteristics of feeding trends, dietary supplement use, and rehabilitative medical management. The survey results of risk factors for injury in flyball dogs are reported elsewhere.

Data collected included dog age, sex, spay or neuter status, and breed as general demographic data. Feeding was categorized into primarily i) commercial, home-cooked, raw and/or freeze-dried (calculated as 75% or greater as main meals); and ii) a mixture of commercial and home-cooked, raw and/or freeze-dried. Respondents were also asked about the feeding management they currently used in their dogs, for example administered food type, quantities, frequencies, duration, restriction of food on competition days, and change of feeding strategies or foods based on current training or activity level. The prevalence of commercially available supplements regularly used in flyball dogs was investigated and categorized into:

• joint supplements (e.g., glucosamine/chondroitin, fish oil);

• focus supplements (e.g., ginkgo biloba, Senilife);

• skin/coat supplements (e.g., fatty acid, vitamins);

• performance supplements (e.g., creatine, maltodextrin, glucose/ glycogen repletion);

• heat stress supplements (e.g., glycerol, electrolytes);

• stress diarrhea supplements (e.g., fibers, slippery elm);

• antioxidant supplements (e.g., vitamin E, vitamin C);

• vitamin supplements (e.g., multivitamin, Pet tabs); and

• “other” supplements.

Supplements that were only used during competitions to enhance performance or improve recovery were categorized into electrolytes, glucose supplements, fat supplements, antioxidants, protein supplements, and “other” supplements. The rehabilitative medical management modalities were categorized into physical rehabilitation, laser therapy, therapeutic ultrasound, transcutaneous electrical nerve stimulation (TENS), electromagnetic field device (PEMF), acupuncture, chiropractic, massage and manual therapy, heat and/or cold packing, brace/wrap, use of an orthotic or other immobilization device, and other modalities. Most questions in the survey were closed-ended with choices indicated by check boxes and the opportunity to indicate “other” and provide a text explanation if an appropriate choice was not available. Some questions also included comment boxes so that respondents could provide additional details if desired.

Statistics

All data were collected from the survey and entered into a Microsoft Excel spreadsheet (Microsoft, Redmond, Washington, USA) and spot-checked for accuracy. All descriptive statistics were presented as percentages of total population or portion of the population being examined. Data analyses were performed using JMP Pro 14.2.0 (SAS Institute, Cary, North Carolina, USA). Continuous variables were evaluated using the Shapiro-Wilk test. Normally distributed data were reported as the mean and standard deviation (SD), while non-normally distributed data were reported as the median and range. The association between pairwise ordinal parameters was assessed by Spearman’s rank-order correlation, “ρ.” The association with a categorical variable was evaluated with the Mann-Whitney rank sum test for continuous variables and with Chi-square test of independence (χ² test) for categorical variables. Significance was set at P < 0.05.

Results

Participant characteristics

Completed surveys were received from 413 respondents. Not all respondents answered every question; 394 respondents completed data that could be used for analysis of supplements and medical management, whereas 392 respondents completed data for feeding analysis. The study population consisted mainly of spayed female dogs (41.1%, n = 162/394), followed by neutered male dogs (38.8%, n = 153/394), intact male dogs (11.9%, n = 47/394), and intact female dogs (8.1%, n = 32/394). Dogs were a median age of 5 y (with 1 y being the lowest age category and > 10 y being the highest, and each year in between). The median body weight was 15.4 kg (range: 3.6 to 38.1 kg), and the median body condition score (BCS) was 4 (range: 1 to 6) on the 9-point scale. With 61 breeds represented, most study dogs were mixed or unknown breed (31.2%, n = 123/394). Among the 394 dogs, the most common purebred was the border collie (27.9%, n = 110), followed by the Shetland sheepdog (22.6%, n = 89), Australian shepherd (5.6%, n = 22), whippet (4.3%, n = 17), Labrador retriever (3.8%, n = 15), and Jack Russell terrier (2.3%, n = 9), with a variety of other purebreds reported in fewer numbers (2.3%, n = 9).

Feeding patterns

In the study, 392 of the 394 respondents completed the feeding data for analysis. Most dogs (88.0%, n = 345/392) were fed 2 times a day while the remaining dogs were fed once a day (12.0%, n = 47/392). Feeding patterns showed that 60.5% (n = 237/392) of the respondents fed primarily commercial kibble or canned food, 16.8% (n = 66/392) fed a mixture of commercial and home-cooked (n = 45/66) or raw food (n = 21/66), 12.5% (n = 49/392) fed non-traditional commercial food (primarily raw, freeze dried), and 10.2% (n = 40/392) fed primarily home-cooked or raw food. Among the 10.2% respondents, 92.5% (n = 37/40) of dogs were fed primarily raw food, and 7.5% (n = 3/40) of dogs were fed home-cooked food. Home-cooked diet either as primary or mixed meals was fed to 12.2% (n = 48/392) of dogs. Raw food diets either as primary meals or at least 25% as main meals were fed to 33.4% (n = 131/392) of dogs in the form of either commercial or home-prepared food. For those respondents who provided home-cooked or raw food as primary meals (n = 40/392) or mixture of the diet (n = 66/392), only 14.2% (n = 15/106) based their dog’s main dietary regimen on the advice of a veterinarian, with 6.6% (n = 7/106) from their primary veterinarian and 7.5% (n = 8/106) from a board-certified veterinary nutritionist. In contrast, 85.8% (n = 91/106) of the respondents were using recipe formulations obtained from non-veterinarian resources, including 33.9% (n = 36/106) based on Internet resource, 20.8% (n = 22/106) from friends or colleagues, 11.3% (n = 12/106) from breeders, 8.5% (n = 9/106) from books, and 10.4% (n = 11/106) reported “other” as a source of information.

Dietary supplements

In the study, 77.7% (n = 306/394) of the respondents reported that they currently gave their dog dietary supplements. Of these, 34.0% (n = 104/306) were given 1 type of supplement, 27.8% (n = 85/306) received 2 types of supplements, 18.0% (n = 55/306) had 3 types of supplements, 11.4% (n = 35/306) were given 4 types of supplements, 4.6% (n = 14/306) consumed 5 types of supplements, and more than 5 but less than 8 types of supplements were given to 4.2% (n = 13/306) of dogs. As shown in Figure 1, the most common dietary supplements were joint supplements (89.9%, n = 275/306), followed by skin/coat supplements (44.1%, n = 135/306), performance supplements (30.1%, n = 92/306), stress diarrhea supplements (25.5%, n = 78/306), antioxidant supplements (19.9%, n = 61/306), heat stress supplements (18.3%, n = 56/306), vitamin supplements (16.0%, n = 49/306), and focus supplements (12.7%, n = 39/306). Additionally, owners feeding home-cooked or raw diet and non-traditional commercial dog food were significantly more likely to give their own dog dietary supplements as well (χ² = 15.246, P = 0.009).

Figure 1.

Categories of dietary supplements used in flyball dogs. Total number of dogs receiving one or more supplements, n = 306/394.

During competitions, about 24.4% (n = 96/394) of respondents gave dietary supplements to enhance performance. The most commonly used dietary supplements for enhancing performance were electrolytes (53.1%, n = 51/96), followed by protein supplement (20.8%, n = 20/96), glucose supplement (10.4%, n = 10/96), fat supplements (10.4%, n = 10/96), and antioxidants (5.2%, n = 5/96).

Medical treatment

Of the 394 respondents, 56.6% (n = 223/394) of the dogs received at least 1 of the following treatments for a chronic injury or for wellness: physical rehabilitation, laser therapy, therapeutic ultrasound, pulsed electromagnetic field therapy (PEMF), acupuncture, chiropractic, massage and manual therapy, heat and/or cold packing, brace/wrap, orthotic or other immobilization device. As shown in Figure 2, the 5 most commonly used modalities were chiropractic (73.1%, n = 163/223), massage and manual therapy (56.5%, n = 126/223), laser therapy (43.0%, n = 96/223), physical rehabilitation (29.1%, n = 65/223), heat and/or cold packing (20.2%, n = 45/223), and acupuncture (12.1%, n = 27/223). The least common treatments included therapeutic ultrasound (4.9%, n = 11/223), immobilization devices (4.0%, n = 9/223), PEMF (1.8%, n = 4/223), and TENS (0%, n = 0/223). Among the respondents who used medical management for their dogs, 30.0% (n = 67/223) received 1 treatment modality, 30.9% (n = 69/223) received 2 modalities, 17.5% (n = 39/223) received 3 modalities, 10.3% (n = 23/223) received 4 modalities, and 11.2% (n = 25/223) received ≥ 5 but < 8 modalities.

Figure 2.

Categories of rehabilitative medical management used in flyball dogs. Total number of dogs receiving one or more forms of rehabilitative medical management, n = 223/394.

PEMF — Pulsed electromagnetic field therapy; TENS — Transcutaneous electrical nerve stimulation.

Injury report

Of 394 dogs, 38.8% (n = 153/394) were reported injured. Approximately 69.3% (n = 106/153) of dogs sustained 1 injury, 16.3% (n = 25/153) had 2 injuries, 6.5% (n = 10/153) suffered 3 injuries, and 7.8% (n = 12/153) incurred more than 3 injuries. Injuries were further categorized into acute injury (68.6%, n = 105/153) and chronic injury (31.4%, n = 48/153). When the dog was injured, nearly 3/4 of respondents (70.6%, n = 108/153) sought veterinary attention, 20.9% (n = 32/153) of respondents removed their dog from competition, and the remaining 8.5% (n = 13/153) either continued activity as usual or pursued “other” as a course of management for their dog. Owners were significantly more likely to use medical management (χ² = 25.768, P = 0.0001) and dietary supplements (χ² = 13.829, P = 0.0002) for their dog with 1 or more injuries. Dogs which suffered more than 1 injury were significantly more likely (ρ = 0.2978, P < 0.0001) to have more rehabilitative medical modalities performed and to have greater supplement use (ρ = 0.1742, P = 0.0006). However, there were no other significant differences between acute and chronic injury in medical management (χ² = 0.4366, P = 0.4380) and supplement use (χ² = 0.4642, P = 0.4657).

Discussion

This is the first examination of flyball management as it relates to feeding practices, supplement use, and veterinary rehabilitative care. Prior feeding and supplement practices in agility dogs were reported with an abnormally high number of respondents using home-cooked or raw diets (25%) and supplements (62%), compared to a 2008 survey (12) which reported that approximately 3% of dogs were fed primarily raw or home-prepared foods and only 13.2% of dogs utilized supplements. Although most dogs in this study were fed primarily commercial kibble or canned food, there was a high incidence of feeding home-cooked and raw diets among flyball dogs in the United States. The rates of dogs feeding home-cooked or raw diet either as a sole source of nutrition or a mixture in the study were consistent with results from a previous survey of agility dogs (11), but are much higher than results in other reports (13–15). Additionally, there appears to be increasing interest in using raw food diets among flyball dog owners. The frequent consumption of raw diets either as a primary meal or at least 25% of their dog’s diet was 1 in 3 dogs in the present study which is the highest reported to date in a cohort of dogs. Pet owners make the decision to feed their pet a home-cooked or raw diet for many reasons including pet health problems, distrust of the commercial pet food industry, the belief that home-cooked or raw food is healthier, a desire to use or avoid certain ingredients, or anthropomorphism of pets (14–17). Such diets may also be used by owners of sporting or working dogs with the thought of meeting nutritional and energy demands, enhancing performance, or providing supplemental protein, fat, or calories. Home-cooked or raw diets allow pet owners to select diets based on an assessment of ingredient quality and sourcing, safety and transparency, and customization and variety. The humanization or anthropomorphism of dogs by their owners is a growing trend driving more dog owners to increase amount of time, effort, and money on providing care for their dogs as an expression of deep caring and passionate devotion to them (18). More owners consider that providing a specific kind of food for their pets, such as high-end foods, home-cooked or raw foods, organic foods, treats, and supplements, is a way of expressing their strong attachment to their pets, and believing that these foods have health benefits and will lead to particular positive outcomes for their pets (17,19). While the health benefits remain to be determined, feeding non-commercial or complementary foods may be less nutritious or balanced than desired and, therefore, dogs may be at risk for nutrition-related diseases (20). Veterinarians should make owners who feed such foods to their dogs aware of the risks for potential nutritional imbalances.

Another important finding from the present study was that only 14% of owners reported a veterinarian or Board-certified veterinary nutritionist was their primary resource regarding their pet’s home-cooked diet formulation — a finding that has also been reported in other surveys (15,16). Approximately 76% of the home-cooked diets were formulated by the owners themselves based on non-veterinarian advice, including Internet resources, a friend or colleague, breeder, and a book, as a primary source of information on pet nutrition. Similar to previous studies (12,15,16,21), more than a quarter of owners in this study used Internet resources as their primary source of home-cooked diet formulation. The findings indicate that, as in previous studies, owners who feed home-cooked or raw diets trust veterinarians less than other resources in determining what to feed their pets (13,16,22). This suggests that primary care veterinarians should ask detailed questions to obtain a comprehensive dietary history for their patients involved in flyball activities, and be aware of the nutritional needs of these patients so that they can provide appropriate advice. Considering most self-formulated or published recipes of home-cooked or raw diets have been shown to be nutritionally inadequate with 1 or more nutrient deficiencies, especially for calcium, phosphorus and vitamin D (23–27), the involvement of Board-certified veterinary nutritionists may be best.

Dietary supplement use was common in dogs in the present study. Recently, Dinallo et al (11) showed overall use of any dietary supplement in agility dogs to be 62%, which is slightly lower than the 78% reported in the present study. The prevalence of dietary supplement use herein was considerably higher than those reported by Laflamme et al (12) and Freeman et al (28). The difference in usage may be due to a trend in this specific population of sporting dogs and/or to a universal increase in the number of supplements used since the original survey in 2006 (28). Similar to what was reported by Dinallo et al (11), our survey showed joint supplements were the most commonly used supplements, followed by skin/coat supplements and performance supplements. Additionally, dogs with sport-related injury were more likely to receive supplements from their owners, as previously reported (28). Interestingly, dogs with increased number of injuries in the present study were significantly associated with a higher supplement use. The reasons for this association are unclear, but it may be due to the owner’s belief that a combination of supplements may provide more effective pain relief or healing for their injured dog. In addition, the present study found that owners who fed home-cooked diets and non-traditional commercial dog food such as raw foods tend to provide more dietary supplements for their dogs. This might be linked to an overall concern of the owner regarding nutritional intake in their dogs fed home-cooked or raw diets, as they were more likely to be unbalanced and nutritionally inadequate (23–27).

Approximately 24% of owners reported providing a dietary supplement to enhance athletic performance during flyball competitions. Electrolytes are the most commonly used supplements for this purpose, followed by protein supplement, glucose supplement, fat supplements, and antioxidants. Although several supplements have been suggested to improve the performance of racing dogs, no controlled studies have shown any clinical benefit (29). The use of electrolyte supplements is not warranted in sporting dogs if they are being fed a complete and balanced dog food at their metabolic requirement (29). In sled dogs, the use of supplements containing high doses of antioxidants failed to attenuate exercise-induced muscle damage as measured by plasma creatine kinase activity (30). Greyhounds were slower when mock racing track tests were performed in dogs supplemented with 1000 mg of vitamin C (31). The literature suggests that antioxidant and electrolyte use in performance dogs is without merit and owners should be advised as such. The use of maltodextrin-dextrose has advantages in intermediate athletes and there is canine data to suggest its ability to increase muscle glycogen (32). However, in a recent study, Frye et al (33) found that supplement consisting of maltodextrin–dextrose and whey/soya protein had no effect on performance in competitive weight-pulling dogs. Additional research is needed to compare dietary supplement use across a wide variety of canine sports so that sport-specific nutritional requirements and optimization of performance can be established.

To the authors’ knowledge, this is the first report in which medical management for injury or wellness in flyball dogs is reported. The incidence of sport-related injury in flyball dogs in the present study was similar to findings in agility dogs in previous reports (5,6,9). Acute injury was more commonly reported than chronic injury in the study. Despite the type of injury, most owners sought veterinary attention when their dog was injured and had received at least 1 rehabilitative medical treatment modality, with chiropractic being the most commonly used in the study, followed by massage and manual therapy and laser therapy. Therapeutic ultrasound, use of an immobilization device, and PEMF were the least common treatments used in the present study. Additionally, there was a significant increase in the number of rehabilitative medical modalities used by owners when their dogs incurred more injuries. Intuitively, it makes sense that dogs with a greater number of injuries would require a multimodal treatment approach to more adequately and comprehensively address pain and facilitate functional recovery in the affected region (34). However, when duration of injury (acute and chronic) was assessed statistically, there was no association with the number of medical management modalities or supplements used in dogs. Thus, it is unlikely that acute or chronic pain/injury is the main factor influencing the owners’ decision to implement use.

The present study was not without limitations. Primarily, recall bias may have been a major factor since data were collected retrospectively and reported by respondents without verification of the responses. Secondly, owners in this population may not be representative of all flyball dog owners: owners of dogs with a greater personal interest in study results or greater personal experience with dogs injured in sporting-related activities might be more likely to complete the survey. Nevertheless, the incidence of injury in the present study is consistent with previous surveys (5,6,9), making this issue less concerning. Thirdly, in the present study, no definitive veterinary diagnosis was required for confirmation of the dog’s injury as reported by the owners. Finally, the present study did not specifically compare geographical location of owners or the travel distance to a veterinarian with rehabilitation modalities which may have influenced our outcomes.

In conclusion, the current study showed that rehabilitative medical management modalities are commonly used by owners to manage sport-related injury in their dogs and dogs that have more injuries are treated with more modalities. Additionally, our results suggest that there is an increased trend in feeding home-cooked or raw diets, and dietary supplements among flyball dog owners. As such, veterinarians should be aware of this growing interest in non-commercial diets, complementary foods, and dietary supplement use among owners. A comprehensive dietary evaluation should be undertaken and dietary advice provided to ensure that the home-cooked or raw diet is complete and balanced, and to ensure that the owners are aware of potential risks if raw food diets or supplements are fed. Additionally, understanding the owner’s attitudes toward pet food and supplement use could help veterinarians in their educational role. Furthermore, the use of home-cooked or raw diet, the incidence of injury, and the number of injuries were all found to influence dietary supplement use in the current study, just as the number of injuries was also found to increase modalities used in the recovery process. CVJ