The adage, “Let food be thy medicine, and medicine be thy food”1 sounds simple, but that was before ultraprocessed foods (UPFs) came along. If not outright deadly,2 3 UPFs in humans exhibit strong links to rising rates of cancer, heart disease, diabetes mellitus, psychological maladies, and premature death. Now, when social media influencers sound the alarm about UPFs in conventional kibble, how should veterinarians respond? When a client brings us a package of fresh, human-grade, minimally processed, preservative-free dog food and asks for our approval, where do we start?4 Part of why we find ourselves perplexed stems from the lack of adequate—if any—formal nutritional education in vet school. Yes, we may have learned extremely well how to promote pre-packaged products for specific disease states, but when clients ask if a relationship exists between artificial additives and cancer,5 inflammatory bowel disease,6 or obesity,7 what do we say then? In this modern era, many of us have cultivated a heavily reliance on UPFs. From The Guardian: “In the UK and US, more than half the average diet now consists of UPF. For some, especially people who are younger, poorer or from disadvantaged areas, a diet comprising as much as 80% UPF is typical.”8 A series of articles in The Lancet reviewed evidence concerning the rise of UPF intake in current-day diets and its effects on the prevalence of non-communicable disease. The editor summed it up this way: “The rise of ultra-processed foods (UPFs) in human diets is damaging public health, fuelling (sic) chronic diseases worldwide, and deepening health inequalities. Addressing this challenge requires a unified global response that confronts corporate power and transforms food systems to promote healthier, more sustainable diets…”9 From a One Health perspective, UPFs are also bad for the environment: “The harms extend to planetary health. Industrial production, processing, and transport of agri-commodities are fossil-fuel intensive systems, and plastic packaging is ubiquitous in UPFs.”10 So, what, exactly, are UPFs? “Ultra-processed foods include carbonated soft drinks; sweet or savoury (sic) packaged snacks; chocolate, candies (confectionery); ice cream; mass-produced packaged breads and buns; margarines and other spreads; cookies (biscuits), pastries, cakes and cake mixes; breakfast ‘cereals;’ pre-prepared pies and pasta and pizza dishes; poultry and fish ‘nuggets’ and ‘sticks,’ sausages, burgers, hot dogs and other reconstituted meat products; powdered and packaged ‘instant’ soups, noodles and desserts; and many other products.”11 Ingredients that characterize UPFs fall into two categories: a) Food substances with no or rare culinary use (i.e., something not recognized or used in home cooking), and b) Additives designed to improve palatability in the end-product.10 Now-infamous ingredients with no or rare culinary use include “varieties of sugars (fructose, high-fructose corn syrup, ‘fruit juice concentrates’, invert sugar, maltodextrin, dextrose, lactose), modified oils (hydrogenated or interesterified oils) and protein sources (hydrolysed proteins, soya protein isolate, gluten, casein, whey protein and ‘mechanically separated meat’).”12 Then, there are the “hyper-palatable” or “cosmetic” additives, rampant throughout both human and companion animal highly processed foods. They include flavors, flavor enhancers, colors, sweeteners, thickeners, emulsifiers, carbonating, foaming, gelling, and glazing agents. These substances disguise undesirable sensory aspects, either from the ingredients themselves or as a result of processing, packaging, or other stages of production. Conversely, they may contribute to an alluring and lingering aftertaste that makes the consumer yearn to have “just one more bite.” “Big Pet Food” is facing heavy pressure to “get fresh” and offer “gently cooked” food.13 Consequently, veterinarians will need to be conversant with the pros and cons of fresh, freeze-dried, frozen, and ultra-processed formulations. With artificial additives being a big part UPFs’ bad reputation, let’s begin with those. Food additives in pet food Roudebush defined food additives as “substances purposely incorporated in foods to provide desirable characteristics: color, flavor, texture, stability, or resistance to spoilage.”14 He noted, “The words preservative and additive are often used synonymously, but they are distinctly different. Preservatives are substances added to foods to protect or retard decay, discoloration, or spoilage under normal or storage conditions. Thus, all preservatives are additives, but not all additives serve a preservative function.” Preservatives Preservatives’ mechanisms of action vary. Some have antioxidant benefits, while others exert antimicrobial effects or enhance and maintain the color of the food. Products with a high fat content are susceptible to degradation by oxidation. Antioxidants reduce the chances of rancidity and maintain desirability. Further, lipid oxidation may foster the formation of detrimental degradation compounds. “Side reactions” with amino acids and fat-soluble vitamins detract from food functionality. Dry foods have more antioxidants than wet on account of their greater likelihood of oxygen exposure. Over time, antioxidant preservatives in pet food have included citric acid, ascorbates, tocopherols, ethoxyquin, propyl gallate, and tertiary butylhydroquinone along with butylated hydroxyanisole (BHA) and hydroxytoluene (BHT).15 Consumer advocates have expressed long-standing concerns about the potential carcinogenicity of BHA and BHT as well as links to endocrine disruption and possible organ injury (liver and kidney). Governmental agencies have expressed that, in limited amounts, they present “no concern for consumer safety”, and that they are “unlikely to pose a risk for the environment,” although “for cats…a safe dose could not be established from the tolerance data.”16 Now, ethoxyquin is receiving extra scrutiny. According to one author, “A metabolite of ethoxyquin has been identified as being possibly genotoxic and an impurity associated with ethoxyquin has been named as a possible mutagen…Allergic reactions and skin, liver, kidney, thyroid and reproductive problems have been reported in dogs….Ethoxyquin has been prohibited as a feed additive for all animal species and categories in the European Union since June 2020.”17 Ethoxyquin is still approved for use in animal feed in the United States, according to the FDA Center for Veterinary Medicine.18 Sulfites may occur naturally or be added to pet foods. Sulfite preservatives may react with thiamine (vitamin B1) and convert it to poorly bioavailable thiamine disulfide. Due to this, recipients could develop thiamine deficiency unless extra thiamine is added back in.19 Sulfites have also caused problems in humans, such as asthma, digestive problems, dermatitis, and urticaria.20 For moist foods, we see both humectants and antimicrobial preservatives. Humectants prevent water loss and help them retain their soft, pliable texture. Antimicrobial preservatives inhibit bacterial putrefaction and mold.21 According to Roudebush, “Dry pet foods are resistant to microbial spoilage, in large part, because of their low moisture content of 6 to 10%. Semimoist pet foods have moisture contents of 25 to 50%, which means they must contain ingredients which reduce water activity and make water unavailable for antimicrobial use…Humectants also prevent loss of water after processing…Propylene glycol was frequently used as an antimicrobial preservative and humectant in soft-moist pet foods and treats [but has been removed] from the GRAS (generally recognized as safe) list for use in cat food.”22 High levels of propylene glycol induce Heinz body anemia in cats.23 Coloring agents Colorants can be natural (such as carotenoids) or synthetic. Synthetic formulations include iron oxide and coal tar derivatives. Examples of the latter comprise tartrazine (FD&C yellow No. 5), sunset yellow (FD&C yellow No. 6), and allura red (FD&C red dye No. 40), as well as brilliant blue (FD&C blue No. 1) and indigotine (FD&C blue No. 2). Chemicals that prevent discoloration include nitrites, bisulfites, and ascorbate. Flavors and flavor enhancers According to Roudebush, “Natural and synthetic flavors may be added to provide flavor claims for pet foods. A flavor designation cannot be used on a pet food label unless the designated flavor is detectable by a recognized test method, or provides a characteristic distinguishable by the pet. This usually means that the flavor is included a 1 to 5% of the total product.”24 Manufacturers may add flavor enhancers to overcome the “palatability gap” of dry foods compared to moist. Acids, such as phosphoric acid, sprayed on the surface of dry kibble for cats, can enhance palatability. However, high amounts of phosphorus may harm geriatric cats and those with chronic kidney disease. During veterinary school, many of us may have reacted with varying levels of revulsion when learning about a pet food ingredient called “animal digest.” See what you think after reading this description, again from Roudebush: “Digests are probably the most important factors…for enhancing the palatability of dry food. Digests are produced by controlled enzymatic degradation of various animal tissues, most commonly ground poultry viscera, fish, liver, and beef lungs. Proteolytic enzymes, present in or added to the tissues, partially digest the protein. Degradation is stopped by the addition of heat and acid (usually phosphoric), which stops enzymatic action and creates a pH unfavorable for future enzymatic action. The resulting liquid material, called digest, is sprayed on the exterior of dry foods and treats at a 1 to 10% concentration…Different digests are often used to justify different flavor designations for dry pet foods that contain the same basic ingredients.” While animal digest as a pet food additive could be considered “natural” and not “synthetic,” it is wise to consider the sources of animals being digested along with the amount of drug, such as pentobarbital, they may have been given prior to death.25 Emulsifying agents and stabilizers/thickeners Gums, glycerin, glycerides, and modified starches prevent ingredients from separating and keep highly palatable gravy-filled foods from liberating free water. The long-chain, high-molecular-weight polysaccharides in gums dissolve in water, elevate viscosity, and even form gels. Gums in pet foods include alginates and carrageenan from seaweed, guar gum from seeds; tree exudates such as gum arabic; microbial gums such as xanthan gum (from bacteria), and a chemically modified cellulose product called sodium carboxymethylcellulose. Guar gum may impair protein digestibility for cats, especially seniors.26 Carrageenan has been linked to intestinal inflammation and ulceration in experimental animals.27 Certainly, more additives, both natural and synthetic, could be discussed; however, a recent discovery by researchers at the University of Minnesota reminds us that even fresh, homemade diets may contain ingredients that can cause harm, especially from added supplements. In the fall of 2025, the University of Minnesota published an update from their Minnesota Urolith Center. The title read, “UMN researchers discover new urinary stone—and a likely cause.” As it turned out, “[F]resh dog food may be behind the calcium tartrate tetrahydrate (CTT) urinary stones.” Choline bitartrate is the main compound found in CTT uroliths. Several years ago, the Center began receiving these abnormal stones. Researchers deduced that the chemical may have originated from the dogs’ diets. “Dogs get choline bitartrate, the main compound in CTT uroliths, from fresh dog food and through supplements recommended for dogs that eat homemade food, to ensure they’re being fed a balanced diet. Fresh dog food companies have gained popularity in the last few years, as more owners make the switch from dry food. That trend appears to be having unintended consequences for some dogs.”28 The main author of the study added, “Because some brands would not disclose what type of choline bitartrate they used, it’s still not clear exactly which types may put dogs more at risk for CTT uroliths. But because the new discovery found both a new type of stone and its suspected cause, Lulich says CTT uroliths will likely be very preventable. It’s also possible that if the link is confirmed, brands will change the type of choline bitartrate they use in their fresh dog food.” The article appeared in the May-June 2025 issue of the Journal of Veterinary Internal Medicine. 7 tips about raw meat pet diets Given all the problems and publicity surrounding ultraprocessed foods, it makes sense that our clients would be drawn to minimally processed foods, and raw meat diets. One of the main criticisms of commercial kibble pertains to the formation of “advanced glycation end products” (AGEs) during heat-processing. AGEs produce the characteristic browning, color, and flavor of cooked food. However, ingesting high amounts AGEs has been strongly associated with type 2 diabetes mellitus, cardiovascular disease, obesity, atherosclerosis, systemic hypertension, neurodegenerative diseases, and stroke.29 Research published in October 2025 revealed improvements in metabolic parameters when dogs ate minimally processed food, compared to those on conventional kibble. “Senior dogs fed fresh, human-grade food demonstrated increased metabolites consistent with ketosis, including BCAA metabolism, increased fatty acid β-oxidation, and lipolysis. Serum EPA and DHA were increased in the fresh food treatment group, which can be explained by the inclusion of chia seeds and salmon oil in the treatment food. This supports the use of ingredients high in ALA as metabolic precursors to EPA and DHA in dogs. The fresh food treatment group had decreased concentrations of serum AGEs compared to the control group. Senior dogs demonstrated dramatic changes in metabolism after 30 days when transitioned from a kibble diet to a fresh food diet, which were sustained during the year-long feeding period, showing healthy adaptation to a lower carbohydrate, minimally processed food. Implications regarding improved antioxidant status (carnosine, anserine, and ergothioneine), healthy ketosis (BHBA and BCAA ketoacids), and reduced serum AGEs on longevity and disease prevention should be investigated further as it relates to generalized inflammation and immune status using similar dietary approaches.”30 For clients who want their dogs on “full-bore” fresh, uncooked food, we may need to remind them of these seven problems: 1) Bacterial contamination, potentially with highly resistant organisms such as salmonella, listeria, and E. coli, can occur. 2) Parasitic infection. Some meat may contain parasites such as toxoplasma gondii, trichinella spiralis, tapeworms, and more. 3) Viral transmission: “The FDA is tracking cases of H5N1 in domestic and wild cats in California, Colorado, Oregon and Washington State that are associated with eating contaminated food products. Scientific information is evolving, but at this time it is known that H5N1 can be transmitted to cats and dogs when they eat products from infected poultry or cattle (e.g. unpasteurized milk, uncooked meat, or unpasteurized eggs) that have not undergone a processing step that is capable of inactivating the virus, such as pasteurizing, cooking or canning.”31 4) Nutritional imbalance. Homemade raw diets often lack balance and essential nutrients. These deficiencies and/ or excesses may damage bones, organs, or development in young animals. 5) Raw bone consumption. Chewing and swallowing bones may injure teeth, lead to choking, and irritate the gastrointestinal (GI) tract. 6) Communicable disease. Handling and feeding raw meat to dogs and cats exposes individuals in the home to zoonotic disease, sometimes from highly resistant organisms. This can become especially dangerous for immunocompromised individuals, young children, and seniors. 7) Professional and community recommendations against raw meat diets. The American Veterinary Medical Association (AVMA) and various public health agencies advise against consuming raw meat. 32 Some veterinary clinics may not allow dogs to eat their usual raw meat diet during boarding or hospitalization, due to infectious disease concerns. In summary, veterinarians in the past may have been able to dismiss raw meat diets and minimally processed foods as “fringe” or “niche.” Not anymore. As Kiprotich et al. wrote: “The era of raw and minimally processed (RAMP) pet foods is upon us. It is in our common interests (public health safety) to ensure that these diets are safe, nutritious, and meet regulatory requirements without sacrificing consumer expectations and needs. Therefore, as additional research in safety and nutrition in the RAMP segment of pet food increases, the nomenclature and semantics that describe these diets should not only be reconciled to meet the requirements of manufacturers and state feed control authorities, but also consumer expectations and demands. With consumer expectations and state feed control officials’ requirements fulfilled, pet food manufacturers can then proceed efficiently to provide nutritious and microbially safe RAMP diets to meet the increasing demands of consumers.”33 Narda G. Robinson, DO, DVM, MS, FAAMA, practices osteopathic medicine and veterinary medicine. Dr. Robinson taught science-based integrative medicine at the Colorado State University College of Veterinary Medicine and Biomedical Sciences for 20 years. In 2016, Robinson established her academy in Fort Collins, Colo., where she teaches medical acupuncture, integrative rehabilitation, medical massage, and other integrative medical approaches. Dr. Robinson offers programs in Sidney, British Columbia as well as Colorado. Columnists' opinions do not necessarily reflect those of Veterinary Practice News. References Quote attributed to Hippocrates but not confirmed. See Witkamp RF, van Norren K. Let thy food be thy medicine….when possible. Eur J Pharmacol. 2018 Oct 5;836:102-114. doi: 10.1016/j.ejphar.2018.06.026. Epub 2018 Jun 21. PMID: 29936236. Suksatan W, Moradi S, Naeini F, Bagheri R, Mohammadi H, Talebi S, Mehrabani S, Hojjati Kermani MA, Suzuki K. Ultra-Processed Food Consumption and Adult Mortality Risk: A Systematic Review and Dose-Response Meta-Analysis of 207,291 Participants. Nutrients. 2021 Dec 30;14(1):174. doi: 10.3390/nu14010174. PMID: 35011048; PMCID: PMC8747520. 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Safety of Vitamin K1 and its use in pet foods. 2018;252 (5): 537-542. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/menadione Accessed on 12.15.25.
