Vets Speak Out: Overprescribed or Underused?

Veterinarians often observe that dietary supplements in canine practice fall into two extremes—either they are overprescribed for healthy dogs with little need, or underused in cases where evidence supports their benefit. Finding the right balance through evidence-based decision making ensures optimal patient outcomes and fosters trust between veterinarians and pet parents.

The Overprescription Dilemma

In many general practices, it’s become routine to recommend joint supplements, multivitamins, or “immune boosters” for nearly every canine patient. While well-intentioned, this approach has drawbacks:

• Unnecessary expense and pill burden. Healthy adult dogs eating complete, balanced diets already receive essential nutrients; adding multivitamins or amino acids without indication merely increases cost and complexity of care.
• Questionable efficacy. Many over-the-counter supplements lack rigorous clinical trials demonstrating benefit. When pet parents don’t see measurable improvements, they lose confidence in professional recommendations.
• Risk of nutrient imbalances. Excessive supplementation can disrupt mineral ratios (e.g., zinc interfering with copper) or lead to hypervitaminosis (notably with fat-soluble vitamins), potentially causing subclinical organ stress.

Veterinarians identify common areas of overprescription:

1. Arthritis “preventive” nutraceuticals. Glucosamine and chondroitin are widely offered to all middle-aged dogs, yet studies show inconsistent disease-modifying effects unless osteoarthritis is already diagnosed.
2. Generic “immune support” blends. Proprietary mixtures of antioxidants and botanicals promise broad benefits but often lack peer-reviewed data in dogs, making their use more marketing-driven than medicine-driven.
3. Probiotics for every upset. While evidence supports probiotics for acute diarrhea and antibiotic-associated dysbiosis, routinely prescribing them for minor dietary indiscretions without clear indication may be overkill.

The Underuse of Proven Supplements

Conversely, certain supplements with strong evidence of benefit remain underutilized:

• Omega-3 fatty acids for inflammatory diseases. Clinical trials consistently demonstrate that EPA and DHA reduce pain and improve mobility in canine osteoarthritis. Yet many dogs diagnosed with arthritis never receive an omega-3 protocol alongside NSAIDs.
• Probiotics in perioperative care and antibiotic courses. Probiotics reduce postoperative ileus and antibiotic-associated gastrointestinal signs. Despite this, they are often omitted from surgical protocols and long-term antibiotic regimens.
• Nutraceuticals for cognitive support in seniors. Medium-chain triglycerides and specific B-vitamin blends help mitigate age-related cognitive decline, yet few geriatric wellness plans include them.
• Vitamin D in chronic enteropathies. Dogs with inflammatory bowel disease frequently exhibit low serum vitamin D levels that correlate with disease severity. Supplementation of 25-hydroxyvitamin D improves clinical outcomes, yet is rarely measured or corrected in practice.

Barriers to Optimal Supplement Use

Several factors contribute to both over- and underutilization:

1. Knowledge gaps. Rapid growth of nutraceuticals outpaces veterinary curricula, leaving many clinicians unsure which supplements are evidence-based versus fad products.
2. Client expectations and marketing. Pet parents often request the “latest” supplement after seeing social media ads, pressuring veterinarians to prescribe without critical review. Conversely, they may resist suggestions to add supplements they haven’t heard of, even when recommended.
3. Economic incentives. Retail revenue from supplement sales can bias practices toward stocking high-margin items, unintentionally promoting overprescription. At the same time, discounted bulk diets and pharmacy medications receive more focus than nutraceutical protocols.
4. Time constraints. Thoroughly reviewing the literature and discussing supplement pros and cons requires time many appointments don’t allow, leading to blanket recommendations or omissions.

Striking the Balance: Evidence-Based Guidelines

To navigate these challenges, veterinarians can adopt a structured approach:

1. Assess individual risk and need. Supplements should be considered only when a specific, evidence-based indication exists—diagnosed osteoarthritis, documented dysbiosis, cognitive decline, or nutrient deficiency.
2. Prioritize high-quality products. Recommend supplements with published, peer-reviewed clinical trials in dogs, third-party quality validation, and clear dosing protocols. Avoid proprietary blends lacking strain- or ingredient-specific data.
3. Implement outcome monitoring. Define objective parameters—lameness scoring for joint supplements, stool quality indices for probiotics, cognitive testing for senior dogs—to evaluate efficacy and discontinue ineffective products.
4. Educate pet parents. Use clear explanations to set realistic expectations regarding onset of action, potential side effects, and criteria for success. Encourage questions and provide written guidance or follow-up appointments focused on supplement evaluation.
5. Foster continuing education. Integrate nutraceutical reviews into staff meetings and pursue targeted continuing education on emerging evidence, ensuring the entire team remains current.

Clinical Pearls from Veterinarians

• “Don’t prescribe supplements like candy.” A leading internist advises reserving joint nutraceuticals for radiographically confirmed osteoarthritis rather than as universal “prevention.”
• “Use probiotics strategically.” A surgeon incorporates probiotics into all perioperative protocols and long-term antibiotic courses, reporting fewer postoperative GI complications.
• “Watch for nutrient interactions.” A nutritionist highlights zinc-copper antagonism when owners stack multiple mineral supplements, emphasizing the importance of balanced formulations.
• “Consider cost vs. benefit.” A general practitioner calculates that the modest monthly cost of omega-3 supplements often offsets the need for higher NSAID doses, reducing risk of gastrointestinal ulceration.

Conclusion

Veterinarians stand at the crossroads of pet parent expectations, marketing influence, and evolving scientific evidence. By moving from impulse-driven supplement prescription toward evidence-based, patient-centered recommendations, clinicians can avoid overprescribing unnecessary products while ensuring underused, proven supplements reach the patients who truly benefit. This balanced approach optimizes patient health, reinforces professional credibility, and strengthens the veterinarian–pet parent partnership—ultimately delivering the best possible care for canine companions.