Clinical Nutrition with Jeff Sutherland

In Episode 105 of the Real P3 podcast, host Casey Bradley explores the innovative world of clinical pet nutrition with Jeff Sutherland, CEO of Canine Biologics. They delve into how Canine Biologics is revolutionizing pet nutrition with its unique approach to creating customized, software-driven nutritional plans for critically ill pets. This episode not only highlights the science behind their groundbreaking Nutri-Adapt product but also discusses the broader implications for animal health and nutrition. Through their conversation, listeners will gain insights into the importance of targeted, high-quality nutrition for pets in critical care, the role of technology in advancing animal health, and the challenges and successes faced by Canine Biologics in bringing their products to market. Join Casey and Jeff for a compelling discussion on the cutting edge of pet nutrition, where science meets heart, and knowledge transforms into action.

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Transcript

Casey Bradley
 0:00:00
 Welcome to the Real P3 podcast, hosted by me, Casey Bradley. We're diving into the heart of animal nutrition and health, broadening our scope with insights from the industry leaders and experts from the Sunswine Group and Swine Nutrition Management. Join us for a journey of discovery and practical advice as we navigate the ever evolving world of monogastrics. Produced by the Sun Swine Group and sponsored by Swine Nutrition Management, this podcast is your gateway to the latest in animal nutrition, where every episode promises to be as enlightening as it is inspiring. Tune in, learn, and grow with us. This is the Real P3 podcast, where science meets

Casey Bradley
 0:00:48
 heart and knowledge transforms into action. In this week's episode it's going to be a first for The Real P3. We're changing gears a little bit and we're going to be talking about clinical nutrition with CEO of Canine Biologics Jeff Sutherland. Well welcome to The Real P3. We're changing the P today to pet nutrition and I have my new customer or clients on with K9 Biologics, Jeff Sutherland. Welcome to The Real P3.

Jeff Sutherland
 0:01:18
 Thank you, Casey. It's a pleasure to be here.

Casey Bradley
 0:01:20
 Will you give us a little bit of background of yourself and your company for the audience?

Jeff Sutherland
 0:01:25
 K9 Biologics has a mission of introducing the market in what we really like to think of as innovative pet nutrition. We don't ever want to bring a product that's just kind of another me too situation. And our market offering today called NutriDapt is a liquid enteral nutrition product for primarily meant for dogs and cats that are in critical care. So the ER and specialty veterinary clinics are probably the biggest customers we have at shelters and and even some GPs and advanced primary care

Jeff Sutherland
 0:01:59
 clinics are also in the mix. The product is very different from what has been traditionally in the market. Company's been in existence for about four years now, and we have brought a specialty nutrition product for dogs with cancer to the market. Unfortunately, we really didn't have the big time marketing budget to really market it effectively amongst the pet parents,

Jeff Sutherland
 0:02:23
 but those we did reach, we had a very loyal following, and some really, really nice success stories. Now, the dogs did better. Can we attribute that to our nutrition or to some other factor? It's really hard to say, but we do know that from a quality of life perspective, we significantly had a positive impact there.

Jeff Sutherland
 0:02:42
 But ultimately, that product was just not, we just didn't have the budget to really go big, have any TV commercials or anything like that. And we ended up retiring the product. I hope to bring it back to market. But a couple of years ago, I was approached by a board-certified veterinary nutritionist who had worked on a prior product and said, you know, I don't like any of the products on offer today for enteral feeding, for the liquid feeding of these critical care animals. Would you be interested in developing something

Jeff Sutherland
 0:03:12
 new? And my answer was a guarded yes. And I said, on two conditions. One, it's got to be radically different than anything else today and two, it's got to be radically better. I said, if we can meet those two challenges, we will have enough differentiation in the market that we as a small company can effectively bring us to market. So we started to brainstorm and I asked her to describe her approach and this is you know accepted across the industry, about how do you formulate a specific diet when you're treating an animal, right, a dog or a cat? And let's say in one case we have a dog with pancreatitis,

Jeff Sutherland
 0:03:49
 in another case we have a cat with kidney disease. These are very different diets. One's low fat, one's low protein, you know, there are various combinations of things. And with what was available in the market, which was either premixed liquids that, again, have a fixed level of fat and protein and so forth or taking a can of dog food or cat food and spinning it in a blender with a bunch of water trying

Jeff Sutherland
 0:04:10
 to get it into a viscous form that would go down an NG tube for example, a nasal gastric tube into the stomach for feeding and these tubes can be quite small. She said, there's really nothing out there that I like and it could get very complex, they're trying to mix multiple products, they hit a certain percentage of fat or protein and the math and everything behind it gets very involved and can take especially a non-nutritionist, a veterinarian like an hour to do a meal plan and so forth and get set up to feed. So I said, ìPlease walk me through the process.î So she started describing math like RER calculations, resting energy requirement, how do you achieve certain levels or what do you want to go for certain levels of protein and fat.

Jeff Sutherland
 0:04:52
 Really what she was describing was a set of algorithms and procedures that to me, and this goes into my background a bit, as a former software guy, an IT guy for two-thirds of my career, I said, ìBoy, that sounds like that could be a software application.î No one else in the industry had been using software for this kind of application. In developing an integral feeding plan for a critically ill animal just did not exist, especially when paired with a given specific product set. So thinking like a systems person, as I was talking with her, I said,

Jeff Sutherland
 0:05:25
 boy, this, A, we could have a software component to what is now known, or what is known in the industry as nutrition math, and then we could have a set of multiple components that when mixed together could achieve different levels of protein and fat and so forth. So we have a base diet that just kind of starts out as a very renal-friendly, low-protein, low-phosphorus, low-sodium, low-fat kind of base for dogs and cats.

Jeff Sutherland
 0:05:54
 And to that, we can add certain levels of protein or fat and additional vitamins vitamins and minerals and amino acids, depending on the species, to on the fly create a customized diet specific for each patient. So when you work with the software, it takes less than a minute to input the data that you need about a given patient. You know, what is their age and weight and species? What is their chief complaint like pancreatitis, parvovirus, IBD, etc.? And does it have any clinical GI symptoms like vomiting or diarrhea, regurg, nausea, etc. And the most important follow-on to that is what has the animal's appetite been like? Has it eaten in the last five days?

Jeff Sutherland
 0:06:40
 Has it eaten less than normal? What's the state of its GI tract is really what we're getting to there. And the clinician takes less than a minute to input those important clinical data and indicators. The software takes about three seconds to generate a meal plan and a recipe. And the recipe is where I like to focus for a second. It basically says, take these multiple components

Jeff Sutherland
 0:07:02
 and mix them at certain ratios. So take the base diet, take so much of the base diet, add so much protein boost and or fat boost. And these again are multiple separate components and so much water to mix them together. And we provide a shaker bottle with this whole system. So you mix all these dried powders or a liquid fat, which is a customized oil blend, and with so much water shake it up and you're ready to feed. This whole process, arriving at a customized diet for the

Jeff Sutherland
 0:07:32
 patient, takes less than five minutes, really about three to four minutes, from beginning of software input to literally being ready to feed. And it's customized for that patient, for that day, or even for that specific meal. And one of the beauties of it is, let's say on day one the patient arrives and has severe diarrhea, but because our product doesn't promote that, we haven't had a single reported case of that as a problem in the field. Let's say on day two the diarrhea clears up. You can go into the software, remove that clinical indicator,

Jeff Sutherland
 0:08:05
 that process takes less than five seconds. Hit a save button and the whole nutrition plan and recipe are regenerated based on this change in symptoms. So, very flexible, highly precise, self-documenting, and you get this on-the-fly customized diet. I dove into a little detail there and I apologize, but it really demonstrates how we approach the world in terms of our products. We take a systemic view, we like a systems approach and that's something that I kind

Jeff Sutherland
 0:08:34
 of brought from my prior background. And we don't want to bring anything to market that's kind of a me too, right? We have some products in our pipeline that we're considering creating and they're all different approaches than what's really available today. So that's kind of how we live and continuous improvement. We have made probably nine or ten changes the software in the last year that improves or enhances its capabilities and these are virtually all based on suggestions from clinicians in the field. So you know

Jeff Sutherland
 0:09:05
 they'll start using the software and go, oh hey could it calculate for example when the early ones was the infusion rate for using a pump or CRI feeding, constant rate infusion. Could you calculate the rate of infusion that we need on day one, day two, day three, et cetera? So we said, you know, that's really just algebra. We baked an algorithm into the software and released it really honestly, and this is no joke, in less than 24 hours from the time the request was made. So we really believe in continuous improvement.

Jeff Sutherland
 0:09:33
 We look for that feedback loop from our customers, our clinics out in the world. Because you know there's always better ideas, different ideas, enhancements that can be made when the people at, you know, the old term, the coal face, the people that are interacting with those patients and interacting with tubes and syringes and pumps and so forth, they can offer really, really valuable feedback.

Jeff Sutherland
 0:09:56
 So personally, I've been in pet nutrition for about 13 years. Prior to that, I was an IT guy. I was a consultant, did some software development, systems analysis, and a range of things in the IT world. I had enough nutrition expertise and knowledge to kind of meet the challenge, but I also had a different way of thinking about nutrition in general and how to apply it to a given problem. And really what we're doing here is this is a problem set, and we've created an expert system in the software.

Jeff Sutherland
 0:10:29
 So what you're effectively doing is getting a consult with this clinician who has deep expertise in clinical care nutrition. And so if you said, hey doc, if you're talking to her live, I've got a 10 kilogram dog, pancreatitis, hasn't eaten in five days, has vomiting and regurg, and so forth, how would you want to feed that animal? And she would come back to you with a meal plan

Jeff Sutherland
 0:10:53
 and saying, well, we want to start at a certain percentage of RER, or resting energy requirements, so we don't overwhelm its gut, because it hasn't eaten in five days. We want to go with so much protein and so much fat percentage-wise and so forth, that would be my ideal diet. And really, that's what comes out of the software. I've said a whole bunch of words, and I apologize.

Jeff Sutherland
 0:11:14
 No, I love it. And the audience may understand I have a deep passion for this. My my we have a patent pending. I wrote the application. It's just something I know deeply and I care about even more. So I'll I'll stop

Casey Bradley
 0:11:30
 for a moment and let the host get back in. Well, no, Jeff, thank you for that. Because this is why I wanted to share you in your company with a whole bunch of people because I think you're doing something differently. You're not just providing a nutritional solution. Well, it is a solution, but it's just not nutrition, right? We're not selling a bag of formula or diet for the dog. We're selling a solution to where it makes it easy on the vet techs and the doctors to calculate this because we know that nutrition is not really well taught in vet school to begin with, unless you're a clinical nutritionist and you have that board certification, but also on the vet techs of being able to calculate that. is difficult for the students to learn.

Casey Bradley
 0:12:17
 And so the fact that you take that risk out of doing it wrong, I think, is really critical. And when I've really looked at my career of developing technologies, the most successful ones come with the solution as well, like a software or a calculator. And I don't think we always help our customers or our end users as much as we'd like to. And I think that's phenomenal. How has been the uptake of your product in the market?

Jeff Sutherland
 0:12:58
 Let me answer that first. I do want to get back to your point about risk. So let me put in the risk thing for a moment. In the marketplace, we've been in the market for about a year and a half. The acceptance rate has been phenomenal. When we get an opportunity to demo either virtually or in person the software component and mix up a diet and so forth and show how it all works and comes together. I hate to get too salesy or marketing here, but we've closed about 93%. So if we get the opportunity to present this to a vet specifically, about 93% of the time we have a significant close rate or we do close at that percentage. What that means to me really is when vets are exposed to this system, they just, they're almost literally amazed.

Jeff Sutherland
 0:13:48
 So it comes down to, and when we're demonstrating this, usually about halfway through the software demo, which only takes a few minutes, it's really easy to use, significantly easy to use, we start getting questions like, oh, how do I order this? So the software is kind of, in some regards, the star of the show. But then the ability to mix up this customized diet

Jeff Sutherland
 0:14:10
 on the fly for a specific patient really, really brings it home. I want to go back to the point you made about risk. So picture the vet tech or the veterinarian who's been at the clinic for 12 hours. And they're about to go home, thankfully, and suddenly they have a patient come in that needs some enteral nutrition. You're tired, you know, if you have to work this up by hand and

Jeff Sutherland
 0:14:32
 do a kind of a complex nutritional solution, obviously it's prone to errors, right? You've got a tired human being using maybe a calculator and a pencil and paper and maybe looking at a website or a reference text and, you know, it and there's a lot of math involved. With the software, you just input information about the patient. It's almost all point and click. There's only a couple of fields you type into and you hit the button. It doesn't make mistakes, it doesn't get tired,

Jeff Sutherland
 0:15:00
 it's precise and it's self-documenting. So imagine if you're this vet or vet tech who has to not only come up with this new nutrition plan, but you have to then write it all down. You have to put the notes into the chart or into the EMR system and so on and so forth. With us, it's completely documented. You can drop a PDF from our system into any EMR system.

Jeff Sutherland
 0:15:23
 You can print it out. It's all right there at your fingertips. And obviously the record is stored in a database that you as a clinician have access to. So you can bring the record back up. You can modify it, you can review it, you can show it to your vet tech or let them bring it up and go ahead and do the mix, measure and mix step,

Jeff Sutherland
 0:15:39
 if you will, and then go feed. The risk is absolutely reduced. Because if you make a mistake and you start feeding too much protein to a kidney patient, for example, you know, this can be quite problematic. So we do reduce the risk in developing this significantly, but more importantly to most of the people we talk to, we reduce the time element from maybe an hour

Jeff Sutherland
 0:16:01
 of trying to get this whole thing set up. And this is what vets tell us. We didn't make up the hour on our own. This is what we get feedback continuously from veterinarians. We save an hour. If it's in the middle of the day, what are you gonna do with that extra hour?

Jeff Sutherland
 0:16:14
 Are you gonna go chart? You're gonna see more patients, et cetera. That's an important component. And again, we can mix up, we create the recipe each time the data is entered for both a specific meal and a whole day's worth of feeding. So it's up to them, up to the clinicians, do they want to feed a meal at a time

Jeff Sutherland
 0:16:34
 and see how the patient does? Do they want to mix up a whole day's worth and hang it in a pump and let it feed? So these are the options, but it does significantly reduce that risk.

Casey Bradley
 0:16:43
 Well, I think that's really important and I think it's kind of neat how you've combined it with tech and I think that's a good example of precision nutrition as well. What is some of the other characteristics, because you talked about the main products out there as a liquid comes in a can, if I remember right, or some type of carton container of liquid nutrition. What makes your product different that you can get away from the liquid standpoint?

Casey Bradley
 0:17:12
 I mean, I don't know how much you want to go into some

Jeff Sutherland
 0:17:15
 unique characteristics of your product. There are some important ones and I'll touch on some of them. Back to your question about uptake, market uptake, in addition to the clinics we're already working in, we're also in, I think it's Fiverr, six of the top veterinary colleges in the country. So the veterinary schools are using us as well and we feel, you know, proud, very proud about that because these are some of the places like Cornell that are using the products. So we're really happy about that.

Jeff Sutherland
 0:17:40
 But onto your question about our differentiation in these product sets. So number one, we are not a pre-mixed product. You mix it on the fly. So you're not buying a product that's in a bottle that you like, you know, ensure or something you just shake up and feed. Obviously that's fairly, you know, easy,

Jeff Sutherland
 0:17:57
 but you don't provide the optimal nutrition to the patient from a, do you have the right amount of protein and fat? But maybe more importantly, several of the biggest products on being used in clinics that are for the veterinary space and even in some human ones that they bring in and use in the veterinary space.

Jeff Sutherland
 0:18:16
 Number one, they rely significantly on high glycemic index or glycemic load components. And I'll give you a quick example. Several of the products rely heavily on maltodextrin. It's like the number two component or ingredient in their ingredient list. Maltodextrin has a higher glycemic index than table sugar. So while you can get some calories in that way,

Jeff Sutherland
 0:18:37
 you tend to spike blood sugar, and because of the osmolarity of the product, you tend to drive diarrhea. And many vets have told us that when they're using products like this, especially as they get toward 100% RER, resting energy requirement for the patient, that's when they start seeing diarrhea problems.

Jeff Sutherland
 0:18:54
 And obviously, nobody wants to induce that problem, and the vet techs don't like cleaning up after that problem, right? So we like to say we're saving time on both ends, the front and the back end, if you'll pardon the pun. So that's one really big differentiator. Number two, energy density. We are literally at the highest end of the scale from an energy density perspective, from 33 to 60% more energy

Jeff Sutherland
 0:19:18
 dense than other products on the market. And what that really means in terms of use is a smaller volume going into the patient. So if you've got an empty gut, or even if it's not terribly empty, but we're trying to feed you a number of calories, the smaller volume of fluid going into your GI system, the better, right? We're not putting a ton of fluid in, so we're not getting GI distress and we're not promoting diarrhea because of just the total fluid load. And then again, we're not bringing more fluid in through the walls of the

Jeff Sutherland
 0:19:48
 intestine because we don't have that high sugar content that's trying to be diluted inside the GI tract. Those two things, the glycemic load and the volume related to energy density, are really important. Another factor is all of our food components are completely 100% human edible. We buy from the human supply chain. For example, we use whole powdered eggs as a significant protein source.

Jeff Sutherland
 0:20:16
 We use brown rice flour. We use things like that that you'll see in your, you know, on the grocery store shelves basically, right, in mixes or straight up as components. We have what I consider to be a very safe supply chain, right, for the most part. Because of the state of the animal's health that is receiving this product,

Jeff Sutherland
 0:20:37
 these are animals in critical care. Could be trauma, could be a disease condition like advanced kidney disease or pancreatitis and so forth, but they're in critical condition for the most part. And I want to provide the highest quality nutrition we can because I don't want to create any additional problems for these patients. I want to help them. So we use really high quality components.

Jeff Sutherland
 0:20:59
 We have high energy density. We have a low glycemic load type product and we're very, very palatable. And to those in the audience thinking, well, if you're feeding this down a tube into the stomach, why does that matter? So two things. One, it's not always fed that way. I'll get into that in a second. But even secondarily to the tube, we have, for example, we know a vet who is a cancer

Jeff Sutherland
 0:21:24
 survivor and he told us that when he was on an NG tube himself, when they fed him, he could still taste the product. He'd get like this aftertaste, this metallic aftertaste. Even though it was going directly into the stomach, he was still kind of tasting it and he said it was really, really unpleasant. One of his guiding bits of advice to us as we're developing a product was make it palatable and that has definitely been true. We have dogs and cats that we have not yet, not that it won't happen, we have not yet seen a dog or cat in like a clinical setting where

Jeff Sutherland
 0:21:59
 we've tested this a number of times that doesn't just dive into a bowl. Like they love lapping this up out of a bowl. So if they can, it's good for a patient to do that. It can be syringe-fed into the oral cavity for, say, a puppy or a kitten, and they really, really enjoy the product. So it makes that whole thing, you know, that whole process of feeding far, far easier. Palliability, which isn't necessarily there with some of the other products. We don't drive diarrhea, we have high energy density, so low bolus volume in feeding and these human edible

Jeff Sutherland
 0:22:33
 components. So we take a lot of pride in that and it makes us definitely different from the market. There are not only veterinary products are used in this space, but as I mentioned a moment ago, sometimes the clinics will go out and buy human products, right? They'll buy Vivinex, which is a Nestle product for cancer patients primarily. They'll buy even a bottle of Ensure or Boost or something. And the problem there is that many don't recognize or realize is just a few years ago, the FDA or the USDA, I think it was, changed their vitamin D guidance and basically said you need to bring your levels up in the human product.

Jeff Sutherland
 0:23:09
 Well, it's at a point now where it could become toxic for, especially for dogs and cats. So when you're when you're mixing in or using primarily a human product that's something that needs to be kept an eye on right and as you mentioned some of the some of the vets don't it's nothing against them they don't have time they learn I'm so in awe of vets because they learn multiple species multiple breeds you know it's a big big big job and and a bit of minutia like a vitamin D level in a given product could be out there on the edge of a knowledge space.

Jeff Sutherland
 0:23:43
 So we pay attention to things like that so they don't have to. But when we hear that a clinic, oh yeah, we go out and buy these human products and maybe we'll mix it up with some canned food and some water and try to get, it's like A, why? We can do this for you so much easier

Jeff Sutherland
 0:24:01
 than what you're doing. And B, potentially, now again, it depends on the length of feeding, how many days and so forth, but those vitamin D levels could become problematic. So we wanna keep an eye on that.

Casey Bradley
 0:24:12
 Wow, you brought on another, I mean, really big topic we've had in pet nutrition with the whole vitamin D and issues on that and recalls in the past. But there's a lot that goes into nutrition and I love hearing it from your perspective of how you're balancing it for different not only just dogs or cats but the ill and helping them survive and I think you gave me a number in the past do you know how many dogs or cats that you've impacted? Oh it's in the thousands I

Jeff Sutherland
 0:24:42
 don't I don't have the exact number at my fingertips but you know we have it we we know that it's in the thousands of patients and you know, what is most impressive to me about that is not the raw number because you know other products may have treated hundreds of thousands because they've been on the market longer and they have high acceptance. But we've got enough data now where we believe you know we can see these trends and we also get a lot of feedback from the field and one of the things we love to hear and we hear this quite often, an anecdote we hear about parvovirus, right? Parvovirus is something our product is used a lot to help with.

Jeff Sutherland
 0:25:17
 If you're familiar with the disease state itself, this will make a lot of sense. One of the vet techs likes to say, I can get more nutrition into this patient with Nutradapt than I've ever been able to in the past because they're constantly losing everything from all orifices, if you will. So they're throwing up, they have diarrhea and so forth and we have been told many many times that you know our product really helped turn the tide in the case of you know part of it doesn't always happen to puppies it's it's it seems more prevalent there but it does happen to older dogs as well and you know that's a success story I love I

Jeff Sutherland
 0:25:54
 love hearing about I love hearing those those not only is the product we think very very high quality and very targeted but to hear the outcome side, right? To hear it was easy to use, it was quick, we know it's all customized and so forth, but then to hear, and my patient did really well. You know, that's what really, really sings the song for me. And we believe over time, you know, those thousands of patients will become tens of thousands

Jeff Sutherland
 0:26:19
 and so on and so forth. But, you know, we're still young, we're still new in the game, if you will.

Casey Bradley
 0:26:23
 Yeah, I think on a nutrition front, I wanna bring up for the audience as well, you made a point about palatability and being able to taste it. And what a lot of people don't realize is we have taste receptors in our gut, throughout our stomach and our intestine that have the same type of receptors that we have in our tongue and they do different things and they cascade different things, but it is still there. And a lot of times we think, oh, well, like you said, we don't need taste or chickens don't really have a taste palette. But I think there is

Casey Bradley
 0:26:58
 some things there that we we don't understand yet with phytogenics and different flavorings. I use that as an example, because that's a popular trend today in the gut health space. And I'm curious on how, since you work in clinical nutrition, primarily today, how do you define gut health?

Jeff Sutherland
 0:27:17
 It's a great question and a great area to explore. Gut health to me means keeping the, if you want to get somewhat down to the nitty gritty, keeping the enterocytes, the cells that line the gut healthy and capable, right? So years and years ago, and this has been proven to be an incorrect approach over the last 20 years, many, many studies on this,

Jeff Sutherland
 0:27:42
 but originally it was rest the gut, right? Don't put anything else into the gut when you have an ill patient. And it's been proven to be the wrong approach generally, not 100%, but most of the time. The earlier you feed and keep that gut healthy, literally the mucosal lining, the enterocytes, keep them healthy, on a number of factors,

Jeff Sutherland
 0:28:05
 the better the patient will do, including generally shorter hospital stays, lower infection rates, better medication uptake, and lower inflammation, which is a big problem in gut health, along with the rest of the overall systems. But by feeding early in the clinical journey of a patient, the better the gut stays. And as we, you know, probably everybody listening

Jeff Sutherland
 0:28:31
 to this knows, we're learning leaps and bounds about the impact of the microbiome in the gut. So keeping those flora and fauna in proper balance and allowing them to do their jobs, the healthy ones, the good ones, if you will, and reducing the inflammation and the bad flora and fauna, for lack of a better term. The use of a product like this and we believe specifically ours can make a

Jeff Sutherland
 0:29:04
 significant impact on the journey of the patient. And just like in human medicine, when you have patients that are effectively in an ICU setting, it's more expensive, right? So if I'm the pet parent, you know, not only do I want my as soon as possible? But it's an expensive day by day by day stay

Jeff Sutherland
 0:29:18
 when they're in that kind of deep clinical critical care. And if we can help that happen, get that journey done more quickly, get that animal back to a healthy state that it can go home, we think that's a win for everybody. So that's a significant bit. But gut health, we're learning a lot,

Jeff Sutherland
 0:29:35
 but I still think we're years and years and years away of really understanding all the dynamics. I read an article yesterday about a new, they're called, the term they're using is obelisk. It's almost like a subcomponent of a virus and it's an entirely new class of animal, lack of a better term, that has never been recognized before. And the science has only come out in the last, you know, weeks or months. I mean, it's really new. So you've got viruses, you've got bacteria, you've got fungi, you've got these other components

Jeff Sutherland
 0:30:10
 that we've known and documented for a long, long time. And now they recently discovered, oh, there's this whole other class. So we're learning a lot, and this is primarily in the oral cavity, but also in the GI tract. And oh my gosh, there's a whole new lack of, it's not an animal, it's not really a living entity as they describe it, but what is its impact on nutrition? We don't know, right?

Jeff Sutherland
 0:30:33
 It's kind of a brand new thing. So I'm excited about, you know, learning and then as necessary changing our product to take advantage or exclude, you know, the impact on items, on animals, components in our gut like that. So, we'll answer your question, but I hope I got at least close.

Casey Bradley
 0:30:52
 No, that's perfect because we are still learning and it's kind of difficult to navigate. And one of the hardest things I find as a nutritionist in working with production animals, obviously in the clinical setting, we can use tube feeding and help get the right nutrition into the animals from that perspective. But when they're not in a clinical setting and they're in a production system or in a home, it's really application of nutrition. And everybody that goes to school and works in nutrition wants to have a perfect formula. And in my mind, there's never really a perfect formula, but it's the application of nutrition there where we fail of, we use like the fever, well, you shouldn't eat

Casey Bradley
 0:31:39
 while you're sick, because there's a reason and there's some rationales to that, but changing how we deliver nutrition, and I've tried to push the industry to look at more oral type nutrition and go visiting IPP eaters last week, there is quite a few new products coming out in the market, even for production animals that are looking at that application of getting the right nutrition into the gut and the enterocytes where it needs to go. And so I'm kind of really excited as we learn how those products fit and we just don't think

Casey Bradley
 0:32:13
 about nutrition from a traditional feed perspective, but from even a water or oral type product similar to what you're doing.

Jeff Sutherland
 0:32:23
 Yeah, and it's such an extremely complex scientific space. You've got hundreds and thousands of variables between a disease process, the normal functioning or the abnormal functioning of a gut, of other systems in the body, and then all the variables in nutrition itself. Do I use this protein source or that protein source? Does it need to be hydrolyzed, et cetera, et cetera? There's so many variables. And then when you speak to the experts, it's like, well, we think it should be 1.2% of

Jeff Sutherland
 0:32:58
 a given component and someone else says, well, it should be 1.3% and someone else says 1.0%. There's still some fuzziness around the edges. I think there are major planks of good nutrition and more and more is being understood every day and being anti-inflammatory. If we use components that are anti-inflammatory, so like a high sugar component, that's generally recognized as a very good thing nowadays. But when you've got disease states

Jeff Sutherland
 0:33:26
 and maybe multiple disease states, and let me give you a quick example. In our software, we can only accommodate one chief complaint, one primary condition, because adding a secondary condition in the software as it stands today becomes, and I'm not joking, becomes exponentially more complex to accommodate that in the software, again, because of so many variables.

Jeff Sutherland
 0:33:47
 But to make up for that, we allow the clinician to modify some of the outputs of the software, specifically protein and fat levels, and the target protein and fat levels that we're gonna derive for a given patient, and the percent RER that we're gonna be feeding them at. And a quick example here is let's say, dog comes in, was hit by a car,

Jeff Sutherland
 0:34:10
 it's a trauma case, right, maybe gonna go into surgery. So our diet for trauma is generally a high protein, moderate fat kind of targeting mix, if you will. But the clinician says, oh, yeah, two weeks ago, the same dog was in for an acute body pancreatitis. So while the software is telling me high protein, moderate fat,

Jeff Sutherland
 0:34:31
 to be on the safe side, I, the clinician, I'm gonna override the moderate fat recommendation and take it down to a low fat. And then the system will go, okay, fine, and it'll mix up the nutrition plan and the recipe to accommodate that target.

Jeff Sutherland
 0:34:47
 Right, so we allow for the clinician with the knowledge and history with their patient to input or modify certain variables so they can accommodate a more holistic view of that patient, right? It's not just a trauma case, it's trauma with a pancreatitis background and things like that.

Jeff Sutherland
 0:35:06
 But again, this is highly customizable and highly variable so we can accommodate virtually, I mean, we have 30 conditions in our software that can be accommodated, and we haven't yet had a clinic call us and say, hey we've got a condition here that's not on your list. Right, so that's a really important component as well. And we even have a condition called diagnosis pending,

Jeff Sutherland
 0:35:32
 which means, gosh, I really wanna, you know, I'm the clinician, I really want to get some calories into this patient, I really want to keep its gut healthy, but I don't have my test results back yet to clearly identify what the disease state is. So for a meal or two, they can start with a diagnosis pending condition, the software will generate a recipe for that, a nutrition profile.

Jeff Sutherland
 0:35:57
 And then they can go back in and literally in five seconds they can say, oh, it's no longer pending, now I know it's pancreatitis or hepatitis or whatever and regenerate that meal plan and go from there forward. So you know getting into you know just getting the gut healthy again that that's you know a big big part and keeping it healthy as the patient progresses through their recovery journey is more and more important. Again, since about the year 2000, there have been multiple studies and trials done

Jeff Sutherland
 0:36:32
 on enteral feeding that basically say in almost all situations, it's better to get that patient fed early and it will improve the outcome across all those dimensions that I described earlier.

Casey Bradley
 0:36:46
 And I love it. And I would say the same thing if I was working with pigs, poultry, cows, like the, if you have a sick animal, the sooner you can get them up and eating and drinking, the better off we're going to be. But thanks. And before we go, I usually, I need to get back in the habit, but so I'm going to turn the table. And if you have a question for me or any last minute thoughts for our audience.

Jeff Sutherland
 0:37:09
 Well, I know, and I'm not stroking Casey's ego for the audience here, but I do know that she is a prolific author, a prolific researcher, and really does know nutrition very well, especially, as I understand it, how to transport nutrition components across cell membranes and so on and so forth. So if I were to really sit down and pick your brain,

Jeff Sutherland
 0:37:38
 it would be about how do we optimize for the ability to get the nutrition where it needs to go, right? So how do we, do we need to go to different components, different concentrations, temperatures? I mean, there could be a range of variables here, but, you know, and I don't know if you'll have a solid, you know, specific answer,

Jeff Sutherland
 0:38:02
 because I know it's a highly complex area of research, but what can we do to optimize, or anyone really, to optimize the ability to transport nutrition into the cell, right? So we can get the whole glucose metabolism cycle started and ongoing, actually. What are some tips and tricks or pointers, or even just areas to think about as we optimize our

Jeff Sutherland
 0:38:30
 formulae over, you know, over time. Well that's a good question and it's going to

Casey Bradley
 0:38:36
 be my new soapbox because I can't disclose everything that's in the background of what I'm working with with other people but I think you brought up a good point and as I look at this from not only a feed additive standpoint, but nutrition, it's really, like you said, getting that component to where we want it to work. And a lot of times, and I can use the example in the swine industry and cattle and poultry, we all call it a different, cattle call it DECAD, poultry call it DEB, swine we're calling it ABC4, You know, electrolytes, acid-base balance, and that kind of thing. We get in there and we think it's just a number, and the more I study, it's really how do we balance the, as you said,

Casey Bradley
 0:39:24
 and to me gut health is homeostasis, and each part of the gut has a different homeostasis, and each part of the gut wants a specific type of nutrient. And so how do we optimize that digestive power all the way from truly the mouth, the oral cavity all the way through, it goes out the other end. And I think we're finally learning on some of these things, some coding technologies, and we can use the ruminants as an example. They have come up with rumen bypass fats or amino acids, for instance, in different things by using fat coatings because the bacteria won't eat the fat. And so it gets into the lower gut and that protein goes to the cow and not necessarily the bacterial population. So I think they've started that when we look at that coating technologies the rumens are doing. I think it's really interesting working on something else. You need to get certain fiber, right?

Casey Bradley
 0:40:30
 You're talking about glucose and that's kind of an upper intestinal tract that we want to get that energy in and the fat and things and get that going. But when we think about gut retention because when you mentioned diarrhea, it goes back to the different hormones and the cascades that we found with, you know, slowing down that retention, the viscosity of the gut, that all impacts on how different nutrients are absorbed. So, utilizing enzymes with certain feedstuffs like wheat to help reduce the viscosity issues that we have has been one area that we've been able to improve. We look at, lipase has not really been fed or really popular, but if we do have like an instance in sick animals and we're feeding a high-fat diet or something, you know, utilizing

Casey Bradley
 0:41:22
 different enzymes and technologies and then these coding things. And, you know, I met with a company called Nuco and, you know, they're doing a double encapsulation on some certain nutrients because they want the first part to be used in the small intestine and they want the second part to be utilized in the hindgut or the cecum for different effects. And I think that's really important because you also mentioned the microbiome and we also need to optimize the nutrition for them. And I think it's really complex. I don't have a great answer, but I think the strategy of nutrition, if we're talking about amino acid, a fat, a fiber, or even a trace mineral or a vitamin, is how can we code it?

Casey Bradley
 0:42:08
 And how can we get it to the specific part of the gut that we need to? And obviously, we do need to keep it healthy. So keeping disease out or disease prevention is absolutely essential from a nutritional perspective. And just working with that, if we can't keep it out, we're like learning and from a swine perspective, purrs, for instance, that they need higher soybean level, the pigs respond better to purrs or they come out of it better. And so we're learning a lot, I think that goes into even what you're talking about. And I saw the connections and I was like, oh my gosh, he wants to work with me, this is going to be fun, because I can learn from you and hopefully bring value to you as well as a nutritionist.

Casey Bradley
 0:42:52
 But I think there needs to be more of these silos being broken down in talking across species and definitely there's a lot to learn from the pet side, the human side, the livestock production side that I think we can help each other. But as you said, the train's just leaving the station. I still think we're loading the cars right now on that aspect of how we can truly optimize the gut and the diet that we apply nutrition to really optimize it in every kind of situation precisely. Yeah and I think A, I agree obviously, but

Jeff Sutherland
 0:43:32
 B, you know, we number one we want to be safe as we explore new components like use of peptides. You know, what is the optimal mix and what does the research say? We all, you know, have to live, or definitely be consistent with the AFCO guidelines, for example, in the United States. So, you know, sometimes we're doing things that are like in any, almost all areas,

Jeff Sutherland
 0:43:56
 especially technology, right? Whether it's nutrition technology or software and systems, we're getting ahead often of the regulators, at least in the research phase. And we want to use the best product and mix that we can for the animal's health, period. But can we use it, are we allowed to use it, depending on the state of regulatory,

Jeff Sutherland
 0:44:22
 what's the compliance, what's the guidelines and so forth. But one of the things we really talk about is continuous improvement and being an innovative product and company. So how do we take advantage of the newest research and in a safe, forward-thinking manner. So these are areas that we could talk hours about. But yeah, I'm excited about the state of nutrition today,

Jeff Sutherland
 0:44:49
 about the advancements that are being made, but there are many, many more that can be made. And given your expertise, especially as you talk about, you know, the transport mechanisms, how we deal with lipids and how we deal with sugars and so forth and proteins and amino acids, I mean, this is where we go from kind of the blunt sword to the scalpel, right?

Jeff Sutherland
 0:45:13
 Where we can really start to dial in, as you say, different parts of the gut with different, you know, I love the idea about the double encapsulation. That is a really interesting approach. I was aware of a company a few years ago who put like a charge, if you will, that helped electrically move things across cell membranes. So they kind of put a charge on their encapsulated payload, if you will, to the gut. And then this charge literally was meant to help move across the membrane.

Jeff Sutherland
 0:45:45
 I don't know where that came out, I don't know where it ended up, but if it's possible to do something like that, right, if it's effective, once it gets into the gut, I love learning about this stuff and I want to apply it as quickly but as safely as we can. So again, thank you for your expertise and your area of knowledge.

Jeff Sutherland
 0:46:02
 It's always a challenge to go from there to a commercialized product that can be used out in the field and that's a big, big part of the whole process. But we look forward to working with you and continuing to perfect this product and hopefully bring others to market that can benefit from your area of expertise. So thanks again.

Casey Bradley
 0:46:21
 Well, thank you. And thank you to the FDA for taking this seriously and hopefully that new law or change to the law will be passed to make these technologies that we're discovering keep up and be able to be used quicker in the industry. Absolutely. Well thanks Jeff that was great to have you on the Real P3. All right I look forward to hearing it and

Jeff Sutherland
 0:46:45
 sharing it with our customers and friends so thanks again for your time

Casey Bradley
 0:46:48
 today Casey it was a pleasure. Well everybody wants to know what I'm doing. Well, now you know that I'm doing some fun things with some pretty cool nutrition companies. But if you get a chance today, hug a pig for me. But if you get a chance today, hug a pig for me. Or maybe your dog or cat, too.

 
 
 Transcribed with Cockatoo