In this episode, Dr. Andy Roark sits down with Dr. Camille Torres, a boarded veterinary nutritionist and associate professor at Colorado State University, to tackle one of the most common concerns with young pets: puppy and kitten gastrointestinal issues. They walk through a real-life case involving a nine-week-old kitten with diarrhea and discuss how to manage soft stools, dehydration risks, nutritional transitions, and client communication during these early, critical weeks. Dr. Torres shares her practical approach to handling GI upsets in young patients, how to choose highly digestible diets that support growth, and ways to engage pet owners in nutritional care without derailing treatment plans. If you’re a veterinary professional looking for guidance on puppy and kitten diarrhea, feeding recommendations, highly digestible diets, and client communication strategies, this episode is packed with practical tips you can use in the clinic today.
This episode is brought to you by Hill’s Pet Nutrition!
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LINKS
Pet Obesity Prevention Organization
Dr. Andy Roark Exam Room Communication Tool Box Team Training Course
Dr. Andy Roark Charming the Angry Client Team Training Course
ABOUT OUR GUEST
Dr. Camille Torres is a board-certified veterinary nutritionist dedicated to optimizing pet health through nutrition. She earned her DVM from Colorado State University in 2001, later achieving diplomate status with both the American Board of Veterinary Practitioners (Canine & Feline) and the American College of Veterinary Internal Medicine (Nutrition). Her passion for preventive care led her to focus on obesity management and the impact of nutrition on disease prevention.
Outside of work, Dr. Torres enjoys the great outdoors in Colorado with her husband, two sons, and their furry family—two cats, a Yorkiepoo, and a French Bulldog.
EPISODE TRANSCRIPT
Dr. Andy Roark: Welcome everybody to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. I got a great one. I am here with Dr. Camille Torres. She is a boarded nutritionist at Colorado State University, and we are talking about puppy and kitten GI issues, so upset, stomach, soft stools, diarrhea, things like that.
I kind of give her a case with a kitten, but we kind of switch back and forth interchangeably between kittens and puppies. And so she does a really good job of sort of hitting both of those. We’re talking about, young dogs and cats. The example is around nine weeks old, just coming home from, from the breeder or from the pound or from the farm in this case, things like that. So, really good episode. Really super useful gang. This episode is made possible by my friends at Hills Pet Nutrition. Make sure you check out Hills Veterinary Academy. If you haven’t taken a look at it, it’s a fantastic resource.
I’ll put a link to it in the show notes. it is great for learning around nutrition and communication. Guys, without further ado, let’s get into this episode.
Kelsey Beth Carpenter: This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark: Welcome to the podcast, Dr. Camille Torres. How are you?
Dr. Camille Torres: I am doing well. How are you? It’s so good to be here.
Dr. Andy Roark: I’m great. Thank you. Thank you so much for being here. For for those who do not know you, you are you are, you’re such a fun unicorn. I love general practitioners that then go back and then get boarded and they have that wisdom and experience of being in general practice.
And then they have the specialty knowledge on top. You are general practitioner, you’re actually double boarded, you’re an ABVP. So, American Board of Veterinary Practitioners, and then you went on and got board in nutrition. You are now an associate professor Prof. You are now an associate professor in clinical nutrition at Colorado State University.
And I am thrilled to have you on today because I have a question I want, I wanna walk through with you if that’s okay.
Dr. Camille Torres: Yeah, that sounds great. Thank you for having me and I am excited to talk about your case.
Dr. Andy Roark: I wanna talk to you about a kitten case, but I also wanna talk about this, about puppies. I think we can probably do both at the same time, but let me give you this, frame this up in sort of a kitten context, and then we can talk about differences with puppies and, maybe try to touch both of those today.
So it’s, it’s ambitious to try to do both. But let’s try. Camille, I have this kitten who is about nine weeks old, and the owners have brought this kitten home. Now they got this kitten at a farm. That’s what I’m big, I’m, this is not a joke. I they got this kitten at a farm and they do not know what kind of food the cat was on before they got it.
They were given a Ziploc bag with some kitten food and so they brought the cat home and they have been, they fed that and then they sort of picked up a grocery store brand, you know, kitten food. They’re coming to me and they’re kind of panicked because they felt like as soon as they got the cat, the wheels fell off.
Meaning very quickly the cat started having soft stools and now it’s just having pitiful sad kitten diarrhea. And so they’re bringing it in. I wanna ask you about this case. So there’s a couple of things here is, number one, you know, obviously the immediate question is, what do we do about this diarrhea?
And I want you to run through for me, early kitten, you know, management of, of diarrhea, but then also getting this cat sort of on track nutritionally just the best practices there. So let’s start at the beginning. When you see this, you know, 8 to 12 week old kitten they’re having diarrhea.
What was kinda, what is your, what are your initial thoughts on sort of dietary management or, or intervention in this case?
Dr. Camille Torres: That’s a, great question and a great case be to talk about because I think it is something that, we do see very often in practice I think we all have our flow of how we approach a, case. And I like to start with kind of where am I at before I jump to what do I think is going on?
And so, you know, gathering that history. Now in this case, I. It’s hard because this kitten just came into the home and doesn’t really, we don’t know what they’ve been fed. I’m certainly gonna be worried about infectious disease, though. Parasites. Those are things that are kind of top of my list. I also worry about kittens and puppies, both that they can become dehydrated so quickly.
So making sure that we’re acting quickly rather than saying, you know, let’s give it a day or so and see if. This gets better, you know, and so I, I think it’s great that you know that we’re in this place now that they’re in here and they’re, they’re seeing us.
Dr. Andy Roark: I’m glad you sort of call out dehydration. That’s always one of the things that, that makes me, it makes me sweat, right? Because I’m talking about, you know, a a two pound kitten. And, you know, my thought is diarrhea can pretty quickly make this cat dehydrated and we’ve got a real problem.
I don’t wanna be too lackadaisical about the case, but I also don’t want to go just completely hog wild. And also, you know, in both puppies and kittens and, and so young pets, I just, I don’t wanna load them up with nine different things and we’re, past the days of reaching for, you know, metronidazole like that.
That’s, we don’t do that any anymore. Talk to me about this. So, so just the truth of the matter is very limited history coming in. I, I don’t really know kind of what’s going on. I like your call out of parasites and infectious diseases. I mean, any, anything else, any other boxes that I should check in that regard and.
And then talk to me a little bit more about what you’re really trying to get in a history.
Dr. Camille Torres: Yeah. So now I’m gonna dive a little deeper into what they are feeding. So perhaps we didn’t know what they were feeding before, but now what have they decided to feed? Are they feeding the bag of food that was given to them, or have they made a fast transition to perhaps a new food? You know, probably our simplest
first step would be perhaps the transition was too quick and now that’s, you know, this kitten has diarrhea because of that. So, going back a little and finding out are there other concerns with appetite energy level, that’s gonna help me kind of gauge that. How can concerned do I need to be? The more lethargic they are the more inappetant they are.
I’m going to be, you know, shifting my, plan from maybe trying some treatments versus having them stay with me and get supportive care.
Dr. Andy Roark: So sort of working through a combination of our history and our physical exam. Let’s, we’re let’s say that we’re at a place where let’s say that we’re not seeing ac acute signs of dehydration, let’s just say that, that the cats gums are moist and, and sort of seems to be okay, not a rowdy kitten, but, but also not comatose anything where I think, oh my gosh, I have to intervene.
I, I, I think where I am with the case honestly, is, I don’t want it to get away from me. You know, I don’t, I don’t wanna, not do enough for it, and I don’t wanna over intervene. And so yeah. The, the owners are kinda looking at me. let’s start with sort of, the immediate sort of presenting complaint.
What are your initial thoughts in these young kittens when we have sort of acute onset diarrhea?
Dr. Camille Torres: My initial thoughts. I mean, when I think about infectious disease, I’m definitely gonna be worried about, you know, things like panleukopenia, if it’s a puppy, parvo, distemper, parasites, roundworms are gonna be something that are top of my list. And so some of these things we can test for in the clinic, and then other things we may need to treat for and see how they respond.
At the same time collecting a fecal sample to evaluate that. So I’m looking for any of those medical reasons because as a nutritionist, ultimately I’m going to be getting to a point where I’m going to feed them. But what I want to do before I say, you know, let’s not, let’s make sure that before we start feeding them, I know that we have checked a lot of things off our list as far as concerns.
And so yeah, I want, I wanna make sure that. I’m covering the things that are common. I’m supporting them from a nutrition standpoint too. And so when I start to think of, okay, I’ve ruled out infectious disease. I have a fecal pending, you know, maybe I’m waiting. I’m giving a broad spectrum dewormer, and so I’m covering a lot of the things that I think are common.
But now we’re at that, you know, let’s say, you know, this kitten is okay to go home, so then it’s gonna be, what? What am I gonna feed this kitty when I get home? And so then my mind is going to shift to, nutrients the body can adjust to not having every nutrient, every time.
After they’ve as an adult kitten, or excuse me as an adult dog or cat, they have more in reserves. But when we’re looking at kittens or puppies, you know, they don’t have a lot of reserves to build from. So we really need those complete and balanced diets that are formulated for growth or formulated for all life stages because this is a time in their life where they need those nutrients the most.
So while we can do some things like, we’ll sometimes hear feed a chicken and rice diet to, you know, a puppy just to get ’em back on their feet. I always cringe a little because I feel like, but they need those nutrients that, while chicken and rice will provide some protein and calories, it’s not gonna be all the nutrients that they need.
And they’re in a place in their life where they really need those the most. And so when we break down what does chicken and rice do? And, and not that’s as common with this kitten, but you know, just kind of thinking about when we recommend a diet that isn’t complete and balanced to help them get through.
You know, a gastrointestinal upset, what is that providing? Why does it work? Well, one of the main reasons it helps is because it’s, it’s very digestible. It’s highly digestible. So if that puppy or kitten is having a hard time absorbing nutrients, by feeding them a highly digestible diet, we are are making it easier for their body to get those nutrients that they need.
But if we look at, okay, that’s what I want, a highly digestible diet. The good news is we have a lot of complete and balanced, highly digestible diets to lean on. So we don’t necessarily have to go with an unbalanced diet. We can feed something that’s going to be, you know, Hill’s i/d for example. We have it’s formulative for growth for puppies and for kittens.
So we can use it for our adult dogs, but we can also use it for puppies and kittens.
Dr. Andy Roark: Tell me about a highly digestible diet.
Dr. Camille Torres: Yeah, so highly digestible diets are gonna be diets that are easy for our puppies and kittens to absorb the nutrients. Some of the examples we do have prescription products and Hill’s has an i/d puppy and Hills i/d kittens specific diet. So now we’re meeting their nutrient requirements for growth while at the same time providing that highly digestible diet.
Dr. Andy Roark: when the owners come in, I, it’s always been one of my perception that the big selling point for chicken and rice is people wanna feel like they’re doing something. You know, I think the fact that they make it with their own hands, I think that makes them feel really special. It makes them feel loving. I, I do. You know, and so yeah, I think it’s that impression of, we’re doing something that, that matters or it’s different. Do you find that it’s challenging to talk pet owners in when they come in with their puppy or their kitten and they’re like, you know, we’re bringing ’em home and, and we change the food and now we’re having this problem, and you say, well, let’s consider yet another kind of food.
Do you find that to be a hard conversation?
Dr. Camille Torres: I think it can be, I feel like it’s so important to kind of elicit that client’s perspective on nutrition. You know, just having met with the first year veterinary students yesterday we started, we kicked off our Healthy Dog Healthy Cat lectures. And one of the things I start with is just how passionate that families can be about what they feed their,
their pets. And so I think it’s really important to understand before I just start saying, this is what, you know, what we’re gonna do today. I do like to take some time to understand where they’re coming from and what’s important to them. Because if there is obstacle with the diet that I’m wanting to recommend, the more I can kind of hear from them what’s important to them, the more I can start building a plan in my mind that may align with it.
Or if I feel like we really need to discuss, you know, your concerns with feeding this. You wanna feed chicken and rice, and I want you to feed a complete and balanced diet. Let’s have a conversation around. Why I feel like this is, is so important to feed this diet, but I, I’m using my time when I’m interviewing kind of that, family, finding out what’s important to them with nutrition to basically kind of think about where am I going to prioritize this conversation.
Because especially in general practice, you may not have that much time. So if you hear right from the beginning that participating in that pet’s care is going to be really important. And we need to think about, you know, finding a way to incorporate that. If I just say, don’t worry about it, it’s not a big deal then I’ve, I’ve potentially damaged that, trust, that relationship a little and I’d rather build it up
Dr. Andy Roark: What does that inclusion look like? So say that, you know, say that this client is, they’re like, ah, Dr. Roark what can I do? I am, this is my baby and I want to be a part of this. Yeah. What are the types of things that, that you would. That you would sort of empower them to do that you feel like is gonna, is I would love for it, be genuinely beneficial, but at least not sort of derail or make other things
I’m doing hard. The worst is when you say, well, you know, we’re gonna, we’re gonna use this sort of prescription diet, or we’re gonna, we’re gonna use this highly digestible diet. And they go, okay. They go home and they cover it in ground beef, like, you know, 75% lean ground beef and nuke the whole process.
Dr. Camille Torres: I know. Yeah, no, you’re right. I mean I think that’s just it is that if we give that space to let them feel like they have they’re taking a role, an active role in participating of creating the plan. ‘Cause it is that fine line. We are there to give recommendations. We have the training to make those recommendations.
But when there’s three or four ways we could get there, then that’s when I like to include the clients. We have three options here, which one might align with what is really gonna be important for you? And then together we can say, okay, well then, you know, now it’s a win-win. We’re both be able to achieve what we want.
So if there is concerns about feeding this highly digestible diet, and I’m saying, this is what I’m recommending that we send this home. If I’ve spent some time investing in understanding where they’re coming from, as well as giving them you know, my perspective on how I think we can help, usually I feel like together then it’s not as difficult to say, and this is the diet I recommend
and I’ve already built the case for why it’s important. So now we’re looking at the problem, you know, together as opposed to one on one side, one on the other.
Dr. Andy Roark: I like it. I think that, building the case up before you make the presentation I think it’s super smart. let’s say that we’ve got our puppy or kit and we’ve, done sort of our infectious disease rule outs. We’ve done the fecal examination, you know, no, it’s parasites, things like that. We don’t have any obvious, you know, causes of, of GI upset, irritation. How do you start to approach the presenting problem, which is, you know, help my kittens having these liquidy stools in the, you know, in the litter box or, or outside the litter box even worse.
Dr. Camille Torres: Yeah. For that case, I’m going to be really, I’m gonna be kind of going through my list. I think. So often with nutrition, we feel this pressure to make the decision the right decision right now to today and we have a little time to see how they’re going to respond. So my general approach is going to be, let’s start with highly digestible, something that their body is gonna be really easy for them to absorb and use these nutrients.
At the same time, I want that highly digestible diet to still provide them with all their essential nutrients that they need. So they’re gonna continue to, you know, get what they need. During a time when they’re recovering for the kittens and the puppies that that works for, that their stool may resolve, they go back to normal.
And then I want to plant the seed for, you know, do we need to stay on this long-term? Are we gonna transition to another diet if they have another diet at home already? I think it’s reasonable to get the, you know, the diarrhea to calm down and then start a slow transition over to that new that the diet that they already have at home.
If the diarrhea returns, then we’re either getting into perhaps this diet isn’t gonna agree with them and we, or do we need to maintain on a highly digestible diet and we can, because those diets are formulated for growth, you can continue them throughout their kitten, puppy hood, they may just not necessarily need that diet.
I like to just kind of plant a this, you know, I always try to plant a seed for this is what we’re gonna do if this happens, and this is what we’re gonna do if this happens. So if I have a kitten or a puppy, I’ve tried my highly digestible diet. Doesn’t seem to be working, then I’m gonna be looking at, okay, what else?
I’m really gonna be tuning it. Trying to understand could it be related to the amount or a lack of fiber that’s in the diet. And while we usually think of fiber more for our, older. Dogs and cats. I still think fiber can play a role in some of these puppies and kittens and we wanna be careful that we’re thinking about, you know, what type and how much, because it’s not, when we say the word fiber it kind of feels like it’s one thing, but it’s actually so many different types.
So then I look at my current diet and I look at the diet they were on, and I try to make some comparisons of how much. How much fiber are they getting in this diet? Is it low in fiber? And perhaps that’s the next place I need to look. If that doesn’t work, I’m looking at the type of protein, now I’m getting into a very uncommon, but is it possible that we have some adverse reaction to food?
And again, that just doesn’t seem to be as common in puppies and kittens. They typically have onset later in life. I think it’s also reasonable to be prepared for what do I do if they don’t get better?
Dr. Andy Roark: Yeah. What kind of monitoring do you set patterns up to do at home? So they’ve come in, you know, we looked at the problem, we’ve done the history, we’ve talked through ’em. We said, Hey, look, we’re gonna, we’re gonna change your diet up here, and, and I think that we can resolve this way. And we send ’em out again.
We started and said, this is sort of a nine week old kitten. We’re about two pounds. Obviously we sort of wanna keep an eye on it. Camille, what, kind of guidance do you get to pet owners? What should they be looking for? What do, when do they call me? When do they start to worry that this isn’t working?
You know, if it is working, you know, what kind of follow up schedule do you set talk to me about once they go back out into the world, I’m gonna have a little bit of anxiety just because this is such an itty bitty that I, you know, that I, I just, I said I, I don’t wanna get away from me. But I also. I want to be clear with them about what they’re looking for, how they’re helping and supporting me, and then, and then it’s gonna let me sleep well at night to know that they’ve had good guidance on what to do and when.
Dr. Camille Torres: Yeah, I, I think that’s a important piece of not just nutrition, but also just management of our young patients that are coming in that we want to have a very clear roadmap of where, when they need to come back and, you know, just on a regular schedule for vaccines. But also, what do I expect? What’s the course of this disease gonna look like?
And so I’m, I’m going to coach them through some signs that would worry me. You know, if it’s lethargy or decreased appetite, that’s not something I wanna wait on. I wanna know about that right away. If the stool is starting to get better, but still soft, I wanna give it a little time, you know, but with a little time in a kitten or puppy is probably gonna be a few days. I don’t wanna let this get away from me because I want an opportunity to modify my feeding plan if I’m not on the right path. And I also wanna make sure that we don’t have any new signs that have popped up. So these are the patients that, you know, I don’t, I think everyone has their own system.
I used to have my, my records that I would flag, these are the cases that I wanna make sure I’m calling back. You know, we can have our technician team call back at some of our cases as well, but on those first couple, you know, when, I’m not sure I wanna be the one, ’cause I just hate to miss something that, you know, maybe I didn’t describe it in a way they understood.
And so I want to know that things are on track.
Dr. Andy Roark: Okay. Thinking about puppies and kitten and sort of nutritional management and gastrointestinal issues, what do you know now as a boarded nutritionist that you didn’t know when you were in general practice?
Dr. Camille Torres: You know, I, I think it’s just the power of food is, is so much, I didn’t realize how, what an impact diet could have and I felt like sometimes, you know, if I had a case with a particular medical condition. And I’d reached for that diet that aligned with that. And then I, if it didn’t work, I kind of felt well, I guess diet won’t work.
And now I realize, you know, there’s so many more options beyond that first choice. And it’s okay if we don’t get resolution on the very first step. I mean, of course our goal is to have that resolution. But I try to, I think I would definitely tell myself that each success or failure is helping you understand where that may be coming from.
So if they’re not responding to the diet in the way that I would like them to, that’s information in itself. And so with each diet that I select now, I always wanna. I wanna kind of justify to myself, why are you reaching for this diet? Like, is it, what do I have in this diet that I didn’t have in the other diet?
And maybe I’m looking at digestibility, well, if these are both to highly digestible, why would this work over this work? Maybe the fiber content is higher or lower. So now it’s, more of a, I’m reaching for this diet because it’s different in these ways. And by it being different, it will help me now test.
Is this this patient gonna be an diet responsive to this particular nutrient profile?
Dr. Andy Roark: Camille, if someone’s got a budding interest in nutrition, maybe they were like you used to be, they’re in general practice and they start to say, I think there might be more over here for me to explore. Or if they’re just, I don’t know. They’ve got a, they’ve got a challenging case. What are your favorite resources out there?
Dr. Camille Torres: You know, I think the exciting thing is there’s so many neat, like online resources for nutrition. It’s definitely a passionate topic. There’s the Hills Academy, that’s a, great resource. I, think that’s a great place to not only look at nutrition, like options, but also communication. How do we have these conversations around diet?
So I, I think realizing that nutrition is, it’s different, you know, it’s not like prescribing your ear medications for an ear infection. You don’t have a lot of debate. There’s a lot more of, we have to include the families in the decision making. And so being comfortable with communication skills, I think that can be a huge help.
But if that, there’s truly that interest, it’s looking for those webinars and those opportunities that come up so you can just start learning because that’s ultimately how I started.
Dr. Andy Roark: Thank you so much for being here and talking through this with me. I really appreciate you. Where where can people find you online?
Dr. Camille Torres: Yeah, so I’m at Colorado State University and we offer remote consults, so we have clients from all over the country. It’s really exciting that we can see people all over. We have and have some clients from Canada, and so it’s. It’s great to be able to provide this resource to families all over.
We also offer veterinary consults if there’s questions. So we can be reached through our website. We have a link there. And we’re available for families and for veterinary teams.
Dr. Andy Roark: Thanks so much for being here, gang. Thanks for tuning in and listening. Everybody take care of yourselves, gang. We’ll talk to you later on.
And that’s what I got guys. Thanks for being here. I hope you enjoyed it. I hope you learned something again. If you, if you’re into Nutrition Hills Vet if you into Nutrition Hills Veterinary Academy is an outstanding place to learn. And just, it’s such good resources there. So anyway, guys, check it out. Take care of yourselves. I’ll talk to you later on.
