ABSTRACT OF THE WEEK

Journal of the American Veterinary Medical Association
Volume 261 | Issue 1 (January 2023)

Oil-based compounding flavors more accepted by feline patients.

J Am Vet Med Assoc. January 2023;261(1):104 - 110.

Amy E Nichelason¹, Kelly K Schultz², Alyssa J Bernard³, Juliet E Caviness⁴, Elizabeth E Alvarez⁵

¹ 1Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI.; ² 1Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI.; ³ 2UW Veterinary Care, Pharmacy, University of Wisconsin-Madison, Madison, WI.; ⁴ 1Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI.; ⁵ 1Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI.

Abstract

OBJECTIVE:To evaluate the voluntary acceptance of 10 commercially available compounding flavors in cats.

ANIMALS:46 healthy cats between 1 and 12 years of age.

PROCEDURES:Each cat underwent a 14-day study period consisting of a 4-day acclimation period followed by a 10-day trial period in which each cat was randomly offered 10 different compounding flavors. Owners completed a presurvey along with a daily observation logbook. Kits, including residual amounts of flavors, were returned and weighed to determine residual weight and calculate the amount ingested.

RESULTS:Overall, cats did not voluntarily accept most of the compounding flavors; 58.8% (124/211) and 84.5% (267/311) of offered samples of oil-based and water-based compounding flavors, respectively, were rejected or minimally accepted. Cats were significantly (P < .001) more likely to accept oil-based flavors, compared to water-based flavors. The sweet water-based flavors were least accepted, compared to water-based control and water-based savory flavors (P = .040 and P < .001, respectively). Owner-perceived acceptance was moderately correlated with residual flavor weights (Kendall tau [τ] = -0.466; P < .001). Owners were not able to accurately predict which flavors their cats would accept.

CLINICAL RELEVANCE:Cats should be offered oil-based compounding flavorings when available, whereas water-based sweet flavorings should be avoided. Owner perception of acceptance is a valid metric to assess flavor acceptance, which can be used in future studies evaluating flavor acceptance. Owners may not accurately predict their cats' flavor preferences, limiting their ability to guide optimal flavor selection.

Companion Notes

Report comparing the acceptance of oil-based compounding flavors vs water-based flavors by 46 healthy cats

Introduction on the administration of oral formulations of medications to cats

- in 1 report, owners reported that they couldn’t give 1/4 of the prescribed oral doses

- < 50% of cats voluntarily accepted conventionally flavored tablets

- so owners may try methods such as manual pilling or “dry swallowing”

- this can negatively affect the human-animal bond

- may increase the risk of esophagitis or stricture

- liquid formulations appear to be more palatable than solid ones (tablets or capsules)

- and result in improved client adherence

- veterinarians often use compounding flavors

- to improve palatability

- ease client administration

- enhance adherence to treatment plans

- one measure of palatability is voluntary acceptance of a product

- voluntary acceptance can depend on many factors including the following:

- flavor

- texture

- consistency

- odor

- temperature

- color

- European Medicines Agency has a palatability standard

(FDA Center for Veterinary Medicine has no palatability standard)

- it created a threshold of 70% voluntary acceptance in cats

- to make a palatability claim on a supplementary protection certificate

- acceptance measurements can be obtained in the field or lab setting

- there’s no published studies on acceptance of compounding flavoring agents in cats

- generally, cats have been found to prefer protein and fat

- with specific preferences toward the following:

- fish

- liver

- meat

- sour or acidic flavors

- yeast

- dairy

- palatability of sweet flavors in cats is controversial

Study design

- study population:

- 46 healthy cats between 1 and 12 years of age

- owned by faculty, staff, and students

- at University of Wisconsin-Madison School of Veterinary Medicine

- 41 of the 46 had fully completed surveys

- 61% (25/41) neutered sex:Fs and 39% (16/41) neutered sex:Ms

- procedure:

- owner survey conducted at the time of enrollment

- demographics

- medical history

- feeding history

- each cat underwent a 14-day study period consisting of the following:

- 4 day acclimation period

- followed by a 10-day trial period

- each cat randomly offered 10 different compounding flavors

- flavors chosen were based on those routinely available for compounding

- and flavors preferred in cats in previous studies

- samples were prepared in bulk at UW-Madison

- Ora-Blend (Per-rigo Co plc) as the base (vehicle) for water flavors

- fixed oil suspension vehicle base used for the oil flavors

(Professional Compounding Centers of America (PCCA))

- commercially available compounding flavors

- water-based flavors (vehicle base also included in flavors)

- liver (Liver, Liquid [Water Miscible]; PCCA)

- chicken (Chicken Pot Pie; FLAVORx for Pets)

- tuna (Grilled Tuna; FLAVORx for Pets)

- marshmallow (Marshmallow, Artificial; PCCA)

- vanilla butternut (Vanilla Butternut, Artificial; PCCA)

- oil-based flavors (vehicle base also included in flavors)

- chicken (Chicken Grilled, Natural [Oil Miscible]; PCCA)

- fish (Fish, Artificial, Liquid [Oil Miscible]; PCCA)

- liver (Liver, Artificial, Liquid [Oil Miscible]; PCCA)

- final concentration of the bulk oil-based flavored flavors: 1%

(based on standard pharmaceutical recommendations)

- final concentration of the bulk water-based flavored flavors: 3%

- pH of all the prepared compounding flavors: 4 to 4.5

- flavor trials occurred on days 5 through 14

(owners were blinded to the flavors)

- using provided randomized schedule

- for each trial, bag removed from the refrigerator

- syringe emptied (5 mL) into feeding tray

- feeding tray offered to their cat for 5 minutes

- if cat walked away, owners could try again

(up to 3 times)

- bring the cat back to the feeding tray

- bring the feeding tray to cat

- owners completed a presurvey along with a daily observation logbook

- kits, including residual amounts of flavors, were returned

- weighed to determine residual weight and calculate amount ingested

Results

- overall, cats did not voluntarily accept most of the compounding flavors

- the following were rejected or minimally accepted

- 58.8% (124/211) of offered samples of oil-based compounding flavors

- 84.5% (267/311) of offered samples of water-based compounding flavors

- cats were significantly more likely to accept oil-based flavors

- compared to water-based flavors

- sweet water-based flavors were least accepted

- compared to water-based control and water-based savory flavors

- no flavor was significantly more favored than another

- oil-based chicken was the most preferred followed by oil-based fish

- owner-perceived acceptance was moderately correlated with residual flavor weights

(Kendall tau [τ] = -0.466; P < .001)

- owners were not able to accurately predict which flavors their cats would accept

“When evaluating preferences of each flavor, it was found that the primary determinant of whether cats more or less commonly accepted the flavor was whether it was based in oil or water. Flavors in an oil base were more commonly enjoyed…than flavors in a water base…”

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