More Than Just A 'Pet' Project
Dr. Lisa Freeman, one of the nation's only veterinarians to be board-certified in clinical nutrition, is reshaping nutrition's role in veterinary medicine.
With the holiday season in full swing, many Americans are reaching for pies, cookies-and pants with expandable waistlines. And according to Dr. Lisa Freeman - one of only a few dozen veterinarians in the country who are also board-certified in clinical nutrition - people aren't the only ones packing on the pounds: their four-legged friends are frequently obese as well.
"Obesity is a very big problem in dogs and cats-30 to 40 percent of dogs and cats are overweight," says Freeman, an associate professor at the Tufts University School of Veterinary Medicine who has been either learning or teaching at Tufts since 1982 (she earned her bachelor's, veterinary and doctoral degrees from the University).
Unlike other common conditions in pets such as heart disease, obesity is "a pure nutritional problem"-one that is typically combated through the administration of a specially-tailored diet. And though it's not yet the conventional wisdom, administering a diet with appropriately modulated nutrient levels, Freeman says, should also be considered an important part of treating problems that are not purely nutritional.
"Many of the animals that come to our hospital come to us with medical issues like heart disease or an injury, so they're often pretty sick," says Freeman, who has made it her mission to draw attention to the importance of nutrition in preventing and managing all types of disease in companion animals. "By getting them on an appropriate diet in conjunction with appropriate medical therapy, you can make a big difference in how the animal feels."
Freeman's professional career has been built upon researching and implementing diets designed to make that "big difference" in companion animals' health. As one of two veterinary nutritionists on staff at Tufts' veterinary school (Dr. Daniel L. Chan is her counterpart), Freeman also teaches nutrition to veterinary students, treats patients in the school's Henry and Lois Foster Hospital for Small Animals, consults with referring veterinarians and animal owners, and conducts clinical research.
"We always have a number of clinical trials going on, looking at, for instance, will a special diet slow the progression of heart disease? We have one going right now," she says. "We take actual patients with heart disease and randomize them, put them either on one diet or another, and follow them and see how they do with that.
"Dogs and cats get heart disease pretty commonly," Freeman adds. "They don't get coronary artery disease, which is the most common type of heart disease in people, but they do get other heart diseases that people also get."
Such overlaps between animal and human health make Freeman's crossover work with researchers in human medicine highly rewarding.
"The nutrition program is a cross-institutional field here, which has been wonderful for me," Freeman says. "I love that aspect of Tufts-I get to interact with people from other campuses, collaborate with them on projects, and we can all learn from one another."
"People are often amazed that dogs and cats do get many of the same diseases that people get," she adds. "We'd do things like go on rounds at the medical school, and [physicians] would be surprised that the pets would require the same intravenous nutrition that the people do."
Freeman finds collaborating with specialists in her own field of veterinary medicine to be equally enlightening-and also highly necessary.
"Nutrition is an adjunct part of the whole medical therapy," she says. "Most of the time, I'm working with other [veterinary] specialists, internal medicine specialists, cardiologists. Nutrition can't work in a vacuum, and for most animals, it's concurrent medical and nutritional management that helps to make the treatment successful."
"Ten or 15 years ago, people didnít really worry about feeding animals in the hospital while they were sick: they worried about medical and surgical therapy and all the other things, but not nutrition. Today, thereís starting to be an increase in awareness that we canít do that. It follows the human recognition, because the same thing happened with people: nobody cared what people in the hospital ate or if they ate at all, and now, in human medicine, theyíre much more aggressive with early nutritional support and specialized diets."
In her quest to make such successful treatment the norm, Freeman is trying to instill nutritional awareness in both the veterinary community and the pet-owning public. She teaches classes within the veterinary school, gives lectures at conferences for veterinarians and owners, and speaks frequently with owners one-on-one.
"They'll call me often with a lot of misconceptions, and I'll try to address those and give them the real info," Freeman says. "But there is a tremendous amount of misinformation, and a huge amount of room for improvement in that area."
That misinformation, Freeman says, can be detrimental to pets' health and much of it is spread on the Internet.
"In terms of evaluating diets, it's tremendously confusing-the pet food industry is huge in the U.S., and there are new diets coming out all the time so there's lots of competition," she says. "There are regulations as to what has to be on the pet food label, but it's also a form of advertisement. People have to remember that because dogs and cats don't pick out their own food, that advertising is directed at us, the owners."
For example, she says, "people think that all foods that are labeled as 'light' or 'reduced calorie' or 'weight maintenance' are low-calorie, but they're not necessarily-they vary a lot in their caloric density."
And though there are many correlations between human and pet health, people should also shy away from "trying to transfer information from human medicine to their pets."
"A diet that works in people may not be appropriate in dogs or cats," says Freeman. "For instance, sometimes owners will tell me they're feeding a low-fat diet to their dog because they're worried about heart disease. Yet dogs really don't get coronary artery disease, so the low-fat diet's not the issue."
Freeman's pet-specific specialization in clinical nutrition is something relatively new to the field of veterinary medicine.
"In the past, nutrition and veterinary medicine was pretty much focused on production in animals - how to make cows produce more milk; how to make chickens produce more eggs," she says. ""There are fewer veterinarians going into farm animal practice when they graduate - most people are going into companion animal practices."
Freeman's own interest in companion-animal nutrition didn't come about until her years as an undergraduate at Tufts.
"I'd been interested in doing equine medicine, but in college, I became more and more interested in nutrition, and realized that a focus on small-animal nutrition was a better way to go for me," said Freeman, who attributes her directional shift to "gradual increased awareness of the importance of nutrition in animal health and the power of nutrition to help manage disease."
While earning her doctorate from Tufts' School of Veterinary Medicine, Freeman "started to see more and more what nutrition actually could do with patients."
"As I was going through school, it was during a time when there was an increased recognition of the importance of nutrition in the profession in general," she adds. "Ten or 15 years ago, people didn't really worry about feeding animals in the hospital while they were sick: they worried about medical and surgical therapy and all the other things, but not nutrition.
"There's starting to be an increase in awareness that we can't do that; that it's not good for animals," continues Freeman, who earned her doctorate in nutrition at Tufts' Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy in 1996. "It follows the human recognition, because the same thing happened with people: nobody cared what people in the hospital ate or if they ate at all, and now, in human medicine, they're much more aggressive with early nutritional support and specialized diets."
Now, Freeman is making the most of her opportunity to highlight the importance of nutrition in disease management and treatment-and to encourage the next generation of veterinarians to broaden awareness of that importance even further.
"We just got an education program grant from the National Institutes of Health, and the goal of that grant is going to be getting more veterinarians involved in research," she says. "That can be directed specifically at the interns and residents: trying to attract them to research; to show them that research is fun-it's not staring at test tubes in a lab, it's actually really exciting. You can answer a lot of your clinical questions."
And according to Freeman-who "[feels] such an allegiance to Tufts, having spent half [her] life here," she says-the University provides a great environment for finding the answers to those questions.
"The focus on nutrition at Tufts has helped shape what I do," she says. "Tufts is very strong in the field. The fact that they hired me shows their recognition that nutrition is important: many of the veterinary schools still don't have a clinical nutritionist, so the fact that Tufts has two now says a lot about their faith in us and what we do."
For Freeman, that faith is gratifying and inspiring. So is seeing the effect her research and recommendations have on her patients-and their owners.
"You'll start a weight loss program with a pet, and you'll have owners say, 'It's like I have a new pet because they have so much more energy!'" Freeman says. "One of my clients, a cat, was very overweight. The cat over 10 pounds, and went down to 13 pounds. It takes quite a long time, and during that same time, the owner lost weight! Things like that are really gratifying, seeing that it was successful for the pet and also for the owner."
And Freeman - an owner herself - replicates that success in her own home: there are no fat cats (or pudgy pups) in her household.
"I have a reputation to uphold," she says, laughing. "They have to stay nice and trim!"
Profile written by Patrice Taddonio, Class of 2006
Patrice Taddonio, a native of Holland, Pennsylvania, is an English major and a communications and media studies minor. Currently the Tufts Daily's head features editor, she interned with the Improper Bostonian magazine during her sophomore year, and worked as a temporary text editor with the Associated Press at this July's Democratic National Convention. A member of the Class of 2006 and a songwriter, Taddonio has also performed on guitar and vocals at on-campus venues and at Boston-area benefits.
This story originally ran on Dec. 13, 2004