Raw meat-based diets for dogs: survey of owners’ motivations, attitudes and practices RESEARCH ARTICLE Open Access Raw meat-based diets for dogs: survey of owners’ motivations, attitudes and practices Giada Morelli* , Sofia Bastianello, Paolo Catellani and Rebecca Ricci Abstract Background: The popularity of raw meat-based diets (RMBDs) for pets has been increasing in recent years even if the reputed health benefits are mainly anecdotal. A web-based survey was developed to better understand the motivations and habits of owners who decided to feed their dogs RMBDs. Results: The questionnaire was completed by 218 dog owners, 62 of whom were living with people whose immune system was impaired or weakened. Internet was the preferred source of information for more than half of the respondents, and feeding dogs a more natural and healthier diet was the main reason behind owners’ interest in RMBDs. About 80% of the participants completely abandoned commercial pet food and showed marked distrust especially towards the lack of clarity on the ingredients used (n = 169). The vast majority of owners interviewed (94%) believed RMBDs to be absolutely safe for dogs, and shinier coat, muscle mass gain, and cleaner teeth were the principal improvements seen on their pets. Controlling the composition and quality of the ingredients provided to their animals was the main advantage of RMBDs for 57% of the owners, while the main disadvantages were related to the purchase of some components (38%) and the time required (22%) for the preparation of the diet. Only 8% of the respondents relied on veterinarians for RMBD formulation, and a wide variety of feeding regimens and combinations of ingredients was observed. Conclusions: As revealed by this study, most owners are unaware of the risks posed by the feeding of RMBDs for both animal and human health, and they often rely on questionable sources for advice on pet nutrition. Owners see RMBDs as a more natural and healthier alternative to commercial pet food even if the actual benefits remain unproven. Consulting veterinarians for proper information and board-certified nutritionists for the formulation of complete and balanced RMBDs should be promoted. Keywords: Dog, Diet, Nutrition, Owner, Raw, Survey Background Feeding raw meat-based diets (RMBDs) to dogs and cats has become a widespread practice in recent years [1, 2]. Many owners have become supporters of diets for pets prepared with fresh uncooked ingredients like meat, offal, and bones as an alternative to commercial dry or canned pet food, and certain health benefits are frequently reported by owners. Despite the increasing popularity of RMBDs, few studies have been conducted on the health effects on pets, and the real advantages have not yet been clearly proven [3]. On the contrary, some undesired consequences of feeding RMBDs to dogs and cats have been well documented. Firstly, the risk of pets consuming incomplete and unbalanced daily meals is high, given that most recommendations for feeding RMBDs published have not been peer reviewed and are not based on the opinion of individuals with proper nutritional expertise [3]; consequently, the defi- ciency or excess of certain nutrients could give rise to health problems, especially in young animals. Secondly, as shown in literature, raw meat and internal organs can be easily contaminated during slaughter, processing or transportation, and often, in fact, test positive for patho- genic bacteria, viruses and parasites [2–5]. The spread of * Correspondence: giada.morelli@phd.unipd.it Department of Animal Medicine, Production and Health, University of Padua, Viale dell’Università 16, 35020 Legnaro, PD, Italy © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Morelli et al. BMC Veterinary Research (2019) 15:74 https://doi.org/10.1186/s12917-019-1824-x http://crossmark.crossref.org/dialog/?doi=10.1186/s12917-019-1824-x&domain=pdf http://orcid.org/0000-0001-5424-4164 mailto:giada.morelli@phd.unipd.it http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/publicdomain/zero/1.0/ zoonotic bacterial pathogens either from contaminated raw meat products or from the feces of pets fed RMBDs has been incontrovertibly demonstrated and therefore poses concrete risks to the health of the people hand- ling raw meat products while preparing the diet or simply living in contact with animals consuming RMBDs [2–5]. Major concerns arise especially for in- dividuals with impaired or weakened immune systems (i.e. children, chronically ill people, elderly people and pregnant women) because such category of individuals is more susceptible to developing foodborne infec- tions [3–5]. The aims of this study were to better determine the motivations and the feeding practices of people who routinely administer RMBDs to their dogs. Results Survey participants The survey permitted 218 dog owners to be self-re- cruited (Table 1). Most respondents were women be- tween 21 to 40 years old (51%, 112/218). Sixty-two households (28%) included one or more individuals whose immune system was either impaired or not yet fully developed, such as children, the chronically ill, the elderly, and pregnant women. Canine population Thirty-nine dogs involved in this survey were mongrel; the remainder belonged to 60 breeds, of which the most amply represented were Labrador and Golden Retriever, Czechoslovakian Wolfdog, German Shepherd, Border Collie, Akita Inu, and Australian Shepherd; all other breeds accounted for less than 3% of the dogs consid- ered. As per the national standard, medium and large size breeds prevailed with 61 and 83 dogs, respectively, while 20 dogs were small size and 15 giant size. Males and females were equally represented, most of which were intact. The mean dog age was 3.8 years old (SD: 13.0) and ranged from 0.1 to 15.0 years old. Most dogs (86%) had an ideal body condition in their owner’s per- ception. Table 2 provides a summary of dog demograph- ics. The majority of the dogs enrolled (77%) was reported to live inside the house all day, while 17% lived Table 1 Demographics of survey respondents (n = 218) Dog owners, n (%) Gender Male 40 (18) Female 178 (82) Age, years old < 20 6 (3) 21–40 142 (65) 40–60 70 (32) > 60 1 (0) Household Single 44 (20) Couple 105 (48) Family 60 (28) Other 9 (4) People at risk in the household Children < 3 years old 12 Children 3–10 years old 29 Elderly > 75 years old 19 Pregnant women 4 Chronically ill 21 None 132 Table 2 Characteristics of dogs enrolled in the study (n = 218) Dogs, n (%) Gender Male 112 (51) Female 107 (49) Neutering status Neutered 72 (33) Not neutered 147 (67) Age, years old < 1 29 (14) 1–2 63 (29) 2–7 93 (44) 7–12 25 (12) > 12 3 (1) Weight, kg Mean ± SD 27.2 ± 13.5 Median (Range) 27.0 (1.0–78.0) Body condition (according to owner) Underweight 19 (9) Normal weight 187 (86) Overweight 12 (5) Most represented breeds (8 out of 61) Mongrel 39 (18) Golden Retriever 19 (9) Czechoslovakian Wolfdog 14 (6) German Shepherd 14 (6) Labrador Retriever 11 (5) Border Collie 9 (4) Akita Inu 8 (4) Australian Shepherd 7 (3) Morelli et al. BMC Veterinary Research (2019) 15:74 Page 2 of 10 indoors only a few hours a day and 6% lived outdoors all the time. Owner motivation and attitude Many owners interviewed had chosen diets containing raw products by searching the internet for information (60%, 130/218) or consulting magazines and books (19%, 42/218); for some owners, the feeding of RMBDs was encouraged by breeders (12%, 26/218) or veterinarians (9%, 19/218); 8 owners (4%) gave other answers. The re- spondents were asked to indicate the main reason they chose to provide RMBDs to their dogs: 26% (58/218) said to respect the dog’s carnivorous nature, 24% (52/ 218) to improve the pet’s health condition, 21% (46/218) because commercial pet food had caused problems in the past, 19% (41/218) because they did not trust com- mercial pet food, 6% (13/218) because their dog did not eat commercial pet food, and 4% (8/218) stated another reason. As regards the use of traditional pet food, 79% (173/218) of the owners completely eliminated commer- cial dry food, while 12% (26/218) still used it when ne- cessary (e.g. when not at home) and 9% (19/218) regularly. Almost every owner (94%, 206/218) had had at least one previous experience with commercial pet food and were asked which features were the most undesir- able: 169 respondents (78%) said the scarce information on the ingredients (e.g. origin, quality), 101 (46%) the in- clusion of additives, and 38 (17%) the presence of carbo- hydrates; some owners reported that their dogs were not satisfied because they consumed their meals too fast (13%, 28/218) or did not like their food (7%, 16/218); 21 owners (10%) gave other answers; on the other hand, 66 owners (30%) said they liked preparing food for pets and 36 (17%) preferred giving pets fresh ingredients. Most owners reported health improvements in their pets, including a shinier coat, muscle mass gain, and cleaner teeth (Fig. 1). As regards the dog’s behavior, 51% (112/218) of the owners reported no abnormalities, while the remaining noticed a calmer (35%, 76/218) or livelier (21%, 45/218) attitude; no one reported nervous- ness or aggression. Almost all respondents (94%, 206/218) said they con- sider RMBDs safe for pets, while only 1% (2/218) ac- knowledged the possibility of health risks associated with this kind of diet and 5% (11/218) never raised the issue. Additionally, 141 owners (65%) stated that dogs cannot get ill by consuming a RMBD, 38 (17%) that it is possible but no reason for worry, and 10 (5%) had never heard of this possibility; on the contrary, 29 persons (13%) said dogs can get ill by eating RMBD. Fifty-five percent of the owners interviewed (119/218) never noticed side effects after eating RMBDs, while the remaining 45% reported mainly diarrhea, constipation, and vomiting (Fig. 2). Owners were also asked if they would refuse the administration of RMBDs in certain conditions: 8 (4%) said for puppies, 5 (2%) for senior dogs, 5 (2%) for dogs with health problems, 2 for preg- nant bitches and 2 for lactating bitches (1% each). As the main advantage of feeding dogs with a RMBD, 57% of the owners interviewed (125/218) reported the total control over the diet and awareness of its compos- ition, while 23% (51/218) mentioned animal origin pro- teins as principal component and 11% (23/218) the long time it requires to be eaten by the dog and the animal’s consequent greater satisfaction. Only few owners consid- ered good palatability (3%, 6/218), the absence of carbo- hydrates (1%, 2/218) or the rawness of the ingredients (1%, 2/218) as the main advantage, and 4% (9/218) gave different answers. As main drawbacks, 38% (83/218) re- ported having to procure certain ingredients, 22% (48/ 218) the amount of time required for preparation, 13% (28/218) the cost, 5% (10/218) the risk of bone ingestion, 4% (9/218) the dog’s loss of appetite with some ingredi- ents, and 2% (5/218) diarrhea or vomiting. Further dis- advantages were reported under the “other” options (16%, 35/218), among which prevailed the difficulty of feeding the dog a RMBD when the animal is looked after by someone else and the large space occupied by the in- gredients stored in the refrigerator. Owner practices and RMBD formulation Most RMBDs were formulated by the owners themselves following other people’s advice available online (33%, 71/ 218), using nutritional guidelines published in websites or in books (31%, 67/218), or following no rules (19%, 41/218). Only 8% (18/218) turned to the veterinarian and 5% (12/218) to a nutritionist for RMBD formulation, and 1% (3/218) relied on guidelines provided by online raw meat product sellers; 3% (6/218) gave other answers. Respondent owners affirmed buying raw meat prod- ucts at the butcher shop (47%, 102/218), at the super- market (36%, 78/218), at online shops (28%, 62/218), at the slaughterhouse (17%, 38/218) or at any of these in- distinctly (29%, 63/218). Figure 3 shows the most com- mon raw meat products used by the respondents. The most frequently purchased meat types were beef, chicken and turkey, while the most common meat parts were skeletal muscle (i.e. minced meat), green tripe, and chicken neck, back and thigh. Among the offal, liver and heart were the most widely used. Also, 95% (208/218) of the owners regularly used raw fish, among which sal- mon, sardines and cod prevailed. As regards bones, 41% (90/218) of the owners gave them to their dogs daily, 41% (90/218) once or twice a week, 10% (22/218) rarely, and 8% (17/218) never. Other commonly used animal origin ingredients were eggs (85%, 185/218), yoghurt (59%, 128/218), cheese (34%, 74/218), milk (11%, 24/ 218), lard (5%, 11/218), butter (3%, 7/218), tallow (2%, 4/ Morelli et al. BMC Veterinary Research (2019) 15:74 Page 3 of 10 Fig. 2 RMBD-related health issues reported by dog owners interviewed Fig. 1 Health benefits of RMBDs reported by dog owners interviewed Morelli et al. BMC Veterinary Research (2019) 15:74 Page 4 of 10 218) and other (9%, 20/218). Although carbohydrates were generally not used in the diet (52, 113/218), some reported adding potatoes (23%, 51/218), bread (18%, 39/ 218), rice (regular, 15%, 33/218; puffed, 12%, 27/218), pasta (6%, 12/218) or other cereals (18%, 39/218). Owners were also asked whether they used vegetables and fruit, and the answers were not homogeneous. Carrots (91%), zucchini (87%), leafy vegetables (75%) squash (58%) and celery (57%) were the vegetables most commonly used, but not on a daily basis (circa once a week) (Table 3). Similarly, the most common fruit were apple (89%), banana (65%) and pear (57%), generally administered as a snack one to four times per month (Table 4). The owners interviewed were found to use many other ingredients as supplements, among which salmon oil, garlic and linseed oil were the most common (Fig. 4); only 21 owners (10%) reported supplementing RMBDs with a vitamin and mineral supplement, and 45 (21%) said they used no other ingredient or supplement than the ones already mentioned in the questionnaire. Mean daily RMBD preparation time was 10 min for 110 owners (50%), 20 to 30 min for 40 owners (18%), 30 a b c d Fig. 3 The most common meat (a), anatomical parts (b), offal (c) and fish (d) purchased by the RMBD-feeders interviewed Table 3 Vegetables used by participating dog owners (n = 218) Never Rarely (1–3 times/month) Once a week Often (2–3 times/week) Daily Artichokes 88 10 1 1 0 Beans 83 13 2 1 1 Bell peppers 87 9 3 1 0 Cabbage 60 26 10 2 2 Carrots 9 16 28 30 17 Celery 43 25 18 9 5 Eggplant 92 6 1 1 0 Green beans 64 20 11 5 0 Leafy vegetables 25 30 20 16 9 Peas 69 19 8 3 1 Squash 42 35 13 7 3 Zucchini 13 19 26 29 13 Table 4 Fruit used by participating dog owners (n = 218) Never Rarely (1–3 times/month) Once a week Often (2–3 times/week) Daily Apple 11 24 28 26 11 Apricot 61 28 7 3 1 Banana 35 37 17 8 3 Citrus 67 25 5 3 0 Fig 83 11 4 2 0 Melon 59 25 10 4 2 Peach 56 27 12 5 0 Pear 43 25 18 12 2 Pineapple 76 18 4 2 0 Strawberry 78 17 2 2 1 Watermelon 52 32 10 5 1 Morelli et al. BMC Veterinary Research (2019) 15:74 Page 5 of 10 to 60 min for 6 owners (3%) and 60 to 120 min for one owner (1%); 42 owners (19%) stated they were unable to quantify the time spent on RMBD preparation, whereas 19 (9%) simply waited for frozen prepacked RMBDs to defrost. Discussion Despite the growing popularity of RMBDs in recent years, few studies have been conducted to gather infor- mation on the motivations and habits of people who choose to feed their pets raw meat. Information col- lected in this survey shows that dogs fed RMBDs had a common profile: they were mainly intact, young, and belonged to medium and large size breeds. The most relevant demographic data gathered on the owners inter- viewed was that 28% lived with pregnant women, young children, or older adults and chronically ill people. Such individuals are at greater risk of developing foodborne illness and should therefore minimize the handling of undercooked or raw meat products that are commonly contaminated by a variety of pathogens [2–5]. Also, ani- mals fed raw food diets may be a potential cause of ill- ness in susceptible people due to the environmental shedding of zoonotic pathogenic bacteria and parasites [4, 6]. Interaction with all family members is inevitable, given that the majority of the respondents’ dogs was re- ported to live inside the house all day; therefore, the feeding of RMBDs should be reconsidered in households with individuals at risk. The consumption of raw meat, in fact, has been strongly discouraged for dogs enrolled in pet therapy programs and interacting with people having compromised immune systems [7]. Bearing in mind that RMBDs may have a negative impact on both pet and owner health, the veterinarian’s role in the nutritional education of the client should not be underestimated. Most of the respondents affirmed relying on informa- tion sources other than veterinarians and, according to other surveys [8–10], an important percentage of owners consult websites to learn how to feed pets nowadays. This is especially true for owners who do not feed com- mercial pet food owing to their distrust in the veterinar- ian’s nutritional expertise [8, 11–13]. This could lead to misinformation on the appropriateness of RMBDs, their virtues and safety, because content available in websites, books and magazines may be biased by the author’s opinion and level of scientific background. Promoting the importance of consulting a veterinarian and greater dissemination of the proven health implications of RMBDs in the mass media could help pet owners to make more informed science-based decisions [14]. How- ever, although the majority of veterinarians adopt a crit- ical stance towards the practice of raw feeding, 9% of the respondents reported contacting veterinarians in favor, in demonstration of the fact that the profession is di- vided – albeit unevenly – on the issue of feeding pets raw meat [1]. The main reasons that respondents switched to a RMBD for their pets are evenly distributed instead: 1) to respect the dog’s ancestral carnivorous nature, 2) to give the dog a healthier diet, 3) to avoid commercial pet food. These three principles were also significantly adopted by RMBD-feeding owners surveyed in previous studies [8, 11, 14]. Providing a diet that mimics the one that wild, non-domesticated dogs ate before their evolution into pets is popular rationale in owners who support Fig. 4 The most common ingredients used as supplements by the RMBD-feeders interviewed Morelli et al. BMC Veterinary Research (2019) 15:74 Page 6 of 10 RMBDs. In our opinion, RMBDs clearly resemble the wolf ’s diet more closely than kibbles, and this meets the dog’s behavioral needs, which are seriously taken into account by owners. From a nutritional point of view, however, it must be borne in mind that the do- mestication of the dog implied genetic modifications that enabled its metabolism to differ significantly from its ancestor’s: the modern dog’s clearly demon- strated ability to digest starch is a good example [15]. Therefore, although feeding RMBDs for the behavioral aspect sounds reasonable, reducing owners’ preference for this type of diet to merely a way of excluding car- bohydrates may be simplistic. Moreover, the choice of feeding a RMBD also implies accepting certain fea- tures (e.g. ingredient contamination and bone con- sumption) that may not be optimal for pet dogs living in a home environment [3]. The second main reason for switching to RMBDs, improving the pet’s health, was also cited by the persons interviewed by Morgan and colleagues [8]. Despite the owners’ firm opinion, however, the reputed health and therapeutic benefits of raw diets are mainly anecdotal and suffi- cient scientific validation has yet to be made [3]. Lastly, owners feeding noncommercial diets firmly support the nutritional superiority of RMBDs over commercial pet food, about which they generally tend to have more concerns and misgivings [11]. In fact, even if one out of five owners interviewed continued using commercial dry pet food (more or less regu- larly) due to its convenience, most abandoned it per- manently. Whether some owners used wet pet foods or cooked meats along with the RMBD was not in- vestigated. Undeniably, pet food does not always allow clear identification of its ingredients and has been the target of scandals (e.g. melamine inclusion, contamin- ation, fraud) [16]. The scarce information provided on the ingredients used and the inclusion of additives such as preservatives and colorants were, in fact, the most displeasing features of commercial pet food re- ported in our survey. In this respect, the possibility for owners to feed their dogs meals prepared with unprocessed fresh ingredients is a reasonable point in favor of RMBDs. However, it is difficult to compare the safety and quality of pet food and RMBDs be- cause the latter have a more limited market and lack rigorous quality controls, and their associated illnesses probably go unreported and therefore underrated [3]. The most common health benefits reported here were shinier coat, muscle mass improvement, and cleaner teeth. At present, only one recent study by Marx and colleagues [17] demonstrated that daily supplementation with raw bovine bones (i.e. bovine raw cortical bone from femur diaphysis) reduced the amount of dental cal- culus up to 70.6% after 12 days in eight beagle dogs; unlike other studies [18–20], teeth fractures were not re- ported. As already discussed however, the abovemen- tioned benefits remain unproven and future studies are needed to clarify the positive aspects of feeding pets RMBDs. On the other hand, 45% of the owners inter- viewed reported health concerns related to feeding a RMBD (gastrointestinal signs were the most common), even if the vast majority (94%) had previously declared RMBDs safe. The failure to recognize that the consump- tion of RMBDs may be a risk factor for the development of illness in pets was also reported by Connolly and col- leagues [12], who found that 65% of the dog breeders interviewed disagreed with such statement. Owners should be counseled on the safety risks resulting from feeding RMBDs because many cases of pet foodborne disease and other health issues have been reported in lit- erature [3]. Also, very few respondents said they would avoid administering RMBDs to puppies, ill dogs, and pregnant or lactating bitches. Nutritional imbalances are very common in this type of diet [21, 22] and the effects of prolonged administration could be more detrimental in young or sick dogs; furthermore, similarly to as in humans, dogs with impaired immune systems could show a decreased resistance to pathogens that leads to the development of foodborne illnesses. The biggest advantage of RMBDs (57% of the answers) appeared to be the total control the owner has over the pet’s diet obtained by procuring its ingredients autono- mously. Surprisingly, very few people named highly popular RMBD features like palatability, absence of grains, or rawness of the ingredients as a main advan- tage. The reasons why owners feeding RMBDs favor raw over cooked home-prepared diets should be better inves- tigated, and studies comparing the benefits of one versus another would help understand whether such preference is correctly motivated. It appeared that even if owners grant highest priority to their management of the RMBD, ingredient collection and preparation time were indicated as the main drawback rather than health risks to the dog. The present study revealed that only 14% of the persons interviewed had asked a veterinarian or a nutrition-trained expert for advice on formulating a RMBD. Most owners created their own recipes following other peoples’ advice or guidelines available online or in books and magazines. This should be discouraged, because some studies [23–25] have shown such published recipes of home-prepared di- ets for dogs and cats to have multiple nutritional imbal- ances (i.e. 95 to 100% of the recipes analyzed failed to meet all essential nutritional requirements for the target animals). More specifically, two other studies demon- strated most self-formulated home-prepared RMBDs to be nutritionally inadequate, and multiple mineral and vitamin imbalances (especially for calcium, phosphorous Morelli et al. BMC Veterinary Research (2019) 15:74 Page 7 of 10 and vitamin D) were shown in respectively 100 and 76% of the recipes considered [21, 22]. Furthermore, a minority of the owners we surveyed (1%) said they followed the feeding instructions provided on the labels of the com- mercial RMBDs they purchased. It must be noted however that even if the labels claim they meet the requirements for growth, reproduction, and maintenance [21], commer- cially available RMBDs also have significant mineral and vitamin imbalances. The long-term consumption of nutri- tionally incomplete and unbalanced diets could result in severe concerns to canine health, especially in young indi- viduals. Taylor et al. [26] reported vitamin D–dependent rickets and suspected nutritional secondary hyperpara- thyroidism in an 8-month-old Shetland Sheepdog con- suming an incomplete and unbalanced home-prepared RMBD. Moreover, the fact that only 21 owners declared using a mineral and vitamin supplement might suggest that most RMBDs prepared by the participants were in- complete and unbalanced. As already argued by Connolly and colleagues [12], the low frequency with which pet owners and breeders consult board-certified nutritionists is quite concerning. Other health issues associated with the composition of RMBDs have been reported along with nutritional deficiencies. Köhler and colleagues [27] de- scribed 12 dogs showing elevated serum thyroxine values, six of which developed clinical signs of hyperthyroidism due to the inclusion of raw beef gullet with thyroid tissue; thyroxine concentrations returned within the reference range in all dogs after changing the diet [27]. Again, many cases of fractured teeth and gastrointestinal obstructions or perforations were reported following the consumption of RMBDs containing bones [18–20], and this survey showed that 92% of the dogs received bones regularly. It is noteworthy that 28% of the participating owners ordered RMBD products via internet. Online purchase of pet food has become very popular in recent years, and particular care should be taken with fresh raw prod- ucts because they should be handled with scrupulous hy- giene criteria and require the cold chain to remain uninterrupted. Moreover, the risk of microbiological growth increases due to the probability of higher tem- peratures during transport [28]. Regarding ingredients, beef and poultry were the meats most commonly in- cluded in RMBDs, and offal were found to comprise an important part, as 86% of the owners used them regu- larly, especially liver and heart. Other common ingredi- ents were green tripe, probably due to its attributed probiotic property, and animal origin protein sources like fish, egg, and yoghurt. Fruits and vegetables were shown to play a marginal role, and carbohydrate sources were not very common despite a mild preference for po- tatoes. Interestingly, garlic was seen to be popularly used as a supplement despite the fact that evidence of its tox- icity has been documented [29]. The present study had certain limitations. Although the online survey was an efficient approach to directly target pet owners feeding RMBDs, electronic recruit- ment through a social media site may have led to an un- der-representation of people who did not use such resources. Additional studies are needed to determine whether the feeding practices and motivations investigated in this study are representative of all RMBD-feeding dog owners in Italy and other countries. Conclusions Dog owners’ growing interest in RMBDs appears to be mainly motivated by the intention to feed their animals a more natural and healthier diet. The benefits derived from the administration of raw foods that owners commonly report must be verified by future studies. Whereas the search for a feeding regimen alternative to commercial pet food is defensible, choosing a diet that puts both animal and human health at risk should not be encouraged. As revealed by this study, most owners underestimate the risks posed by feeding RMBDs and often rely on questionable sources such as the internet to gather information on pet nutrition. Public health agencies need to become more aware of the popularity gained by RMBDs and emphasize the educational role of the veterinarian, whose consultation may help owners make better-informed decisions for their pets and them- selves. Referral to a board-certified nutritionist for the formulation of complete RMBDs that avoid long-term nutritional imbalances should be promoted as well. Methods Participant recruitment and survey design In order to recruit owners who feed their dogs RMBDs, a web-based survey in Italian language was created using an online survey tool (Google Forms). The online ques- tionnaire was piloted among the authors before its launching on the web but the results of this test were not included in the analysis. The link to the open survey was shared through groups of RMBD-feeding dog owners on a social media website (Facebook) for 4 weeks between September and October 2015 and no individ- uals had access later in the questionnaire period. Al- though the survey was intended solely for people who feed RMBDs to their dogs, no other exclusion criteria were fixed. The respondents came from a convenience sample of owners who saw the online link and freely volunteered to participate in the study. The questionnaire contained 44 closed questions (43 of which were mandatory, only one was optional) and was divided into three sections. In the first section, in- formation on the owner (personal and household data) was collected; in the second, the dog’s signalment (breed, age, sex, body weight, health status) was entered; the Morelli et al. BMC Veterinary Research (2019) 15:74 Page 8 of 10 third part of the survey queried dog owner attitudes re- garding RMBDs. More specifically, the questions in the final section were intended to determine the motivations for the feeding of RMBDs, the effects on the dog per- ceived, the level of awareness of associated risks, the positive and negative aspects of handling a RMBD, and details on formulations and ingredients. No approval by an institutional review board was re- quired because enrollment was on a voluntary basis and the participants consented to anonymous information collection. Survey participants were instructed that only one member of a household should complete the question- naire and that every respondent could be responsible for just one dog. All data were checked to verify that no multiple en- tries from the same individual were included. This was done by comparing respondents’ variables (such as time of submission, postcode area, gender, age etc.). The study was open to Italian-speaking owners, but no re- spondents were excluded because their postcode or hometown were outside Italy. Respondents were not allowed to submit incomplete questionnaires, which were automatically deleted without being recorded. The translated survey is available as a supplementary material (Additional file 1). Data analysis The data collected from the survey were transferred into a spreadsheet (Excel, Microsoft) and submitted to de- scriptive analysis. Additional file Additional file 1: Translated Survey. This document provides the questionnaire translated into English. The questions were numbered sequentially, from number 1 to 44, and were divided into three sections (1–9: information about the owner; 10–17: dog’s signalment; 18–44: dog owner’s attitudes regarding RMBDs). If multiple answers were possible, this was specified in brackets after the question. (DOCX 19 kb) Abbreviations RMBDs: Raw Meat-Based Diets; SD: Standard Deviation Acknowledgements Not applicable. Funding No special funding was needed for this study. Availability of data and materials The datasets analyzed during this study are available from the corresponding author on reasonable request. Authors’ contributions GM: Support data analysis and preparation of manuscript. SB: Design of questionnaire, questionnaire promotion, data management and data analysis. PC: Design of questionnaire and data analysis. RR: Planning of the study, design of questionnaire, support data analysis and preparation of manuscript. All authors read and approved the final manuscript. Ethics approval and consent to participate No ethics approval either within national or EU legal systems was needed for such procedure as enrollment was on a voluntary basis and the participants consented to anonymous information collection as per Italian Data Protection Code - Legislative Decree no. 196/2003. Interviewees agreed to participate in the study voluntarily by self-enrolling. They were informed that their answers would be published in a study. By completing and returning the survey, they agreed to the inclusion of their data. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Received: 23 February 2018 Accepted: 26 February 2019 References 1. Waters A. Raw diets: are we at a turning point? Vet Rec. 2017;181:384. 2. van Bree FPJ, Bokken GCAM, Mineur R, Franssen F, Opsteegh M, van der Giessen JWB, Lipman LJA, Overgaauw PAM. Zoonotic bacteria and parasites found in raw meat-based diets for cats and dogs. Vet Rec. 2018;182:50. 3. Freeman LM, Chandler ML, Hamper BA, Weeth LP. Current knowledge about the risks and benefits of raw meat–based diets for dogs and cats. J Am Vet Med Assoc. 2013;243:1549–58. 4. Hinney B. The trend of raw meat-based diets: risks to people and animals. Vet Rec. 2018;182:47–9. 5. LeJeune JT, Hancock DD. 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BMC Veterinary Research (2019) 15:74 Page 10 of 10 Abstract Background Results Conclusions Background Results Survey participants Canine population Owner motivation and attitude Owner practices and RMBD formulation Discussion Conclusions Methods Participant recruitment and survey design Data analysis Additional file Abbreviations Acknowledgements Funding Availability of data and materials Authors’ contributions Ethics approval and consent to participate Consent for publication Competing interests Publisher’s Note References