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30 Aug 2022

Obesity: long-term strategies for weight issues in cats and dogs

Mike Davies discusses how veterinary professionals can work with owners to reverse and prevent this major issue in UK pets.

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Mike Davies

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Obesity: long-term strategies for weight issues in cats and dogs

Image © Роман Самсонов / Adobe Stock

It is generally accepted that a pandemic exists of excessive weight in both cats and dogs in the UK, with surveys suggesting the prevalence rate is 51% in dogs and 44% in cats (Pet Food Manufacturers’ Association, 2015).

However, only 14% of dog owners and 18% of cat owners consider their pet to be overweight; furthermore, despite known health risks associated with being overweight, 31% of pet owners do not believe that overweight pets are at increased risk of developing serious diseases and 35% do not realise they have shorter life expectancy (PDSA, 2021).

Obesity changes many metabolic processes, including reducing metabolic rate (Tvarijonaviciute et al, 2012). Interestingly, apart from revised calorie requirements, the other essential nutrient requirements for obese cats and dogs do not appear to have been determined. The assumption seems to be that they remain proportionally related to energy requirements, the same as normal individuals (National Research Council, 2006).

Good nutrition to prevent obesity in later life starts during pregnancy, as puppies with low birth weights are predisposed to develop obesity in later life (Mugnier et al, 2020; p value = 0.032), with a 70% prevalence of obesity among dogs with low tissue mass birth weight compared to 47% in dogs born with high tissue mass birth weight. Being overweight was also associated with advancing age and in neutered dogs (p value = 0.029 and 0.005 respectively).

Serious disorder

The secret to maintaining optimum bodyweight and fat composition is to get owners to understand that being overweight is a serious disorder, and for them to embrace the concept of lifelong weight control through diet and exercise. Failure to comply with veterinary recommendations is the main reason why owners lose control of their pets’ body condition (Porsani et al, 2020)

According to the American Animal Hospital Association (AAHA), compliance and adherence to veterinary advice can be improved by a variety of means (Table 1).

Table 1. Factors improving adherence with veterinary recommendations (American Animal Hospital Association, 2009)
Factor Finding
Length of appointment Pet owner data indicates that adherence is high when an appointment lasts more than 10 minutes
Written information Respondents who received written information had higher adherence
Follow-up calls Pet owners who received a follow-up call achieved higher adherence
Reminders for ongoing management Pet owners who received reminders were more compliant than those who did not receive reminders
Continuity with the veterinarian Pet owners who reported seeing the same veterinarian at each visit reported higher adherence
Cost of treatment The cost of treatment did not correlate with adherence

In its 2009 report, the AAHA documented specific changes in practice that had improved compliance from its report in 2003 (Panel 1).

Panel 1. Changes made in practices that improved client compliance with veterinary recommendations (American Animal Hospital Association, 2009)

When practices employed four or more of these good habits, they achieved greater compliance:

  • Recording nutritional recommendations in the clinical record.
  • Frequent monitoring of compliance.
  • Monitoring several areas of compliance.
  • Attending compliance training workshops.
  • Using multiple approaches to client education and communication.
  • Conducting staff training exercises.
  • Investing in compliance improvement.
  • Developing and using written practice protocols.
  • Providing written care plans.
  • Providing printed educational material.
  • Scheduling an appointment before the client leaves the practice.
  • Making telephone follow-up calls if no appointment is scheduled.
  • Sending reminders.
  • Mailing educational material for follow-up.
  • Printing a recommendation on the bottom of the invoice.
  • Reviewing issues covered during the visit, by a client relations specialist or other staff member.

Steps that can be taken to control bodyweight and condition throughout life are summarised in Table 2.

Table 1. Long-term prevention of overweight/obese state (American Animal Hospital Association, 2009)
Action Methods
Set optimum bodyweight
  • Maintain weight at optimum for the breed and body conformation – if this figure is reported.
  • Ask owner to weigh regularly – every month is ideal, but every two to three months for healthy active adults. Every month for at-risk breeds and elderly pets (more than seven years old).
Maintain optimum body condition score (BCS)
  • Set target optimum bodyweight to provide a BCS of 2 to 3 on a 5-point scale, or 4 to 5 on a 9-point scale.
  • Assess BCS regularly – the author thinks every month is ideal.
Strict control of calorie intake
  • Feed according to estimated energy requirements, but adjust up or down in response to bodyweight changes.
  • Use small bowls (owners tend to fill them).
  • Feed low calorie (low fat, high protein, high fibre) foods (Wei et al, 2011a; German et al, 2010; Vasconcellos et al, 2009) – especially to high-risk patients such as the Labrador retriever, neutered pets or pets with reducing ability to exercise.
  • Avoid unnecessary calories – snacks, treats, leftovers and supplements.
  • Use part of main ration as treats and/or reduce amount of main ration to compensate for treat calories.
  • Feed multiple small meals per day – this increases calorie use for digestion and absorption.
  • Advise owners against feeding less of a regular diet – this can result in nutrient deficiencies (Linder et al, 2012).
  • Adding water to foods can increase satiety and reduce calorie intake in cats (Cameron et al, 2011; Wei, 2011b).
  • Use veterinary therapeutic diets rather than revert back to regular foods once weight loss has been achieved in overweight pets (German et al, 2012a).
Modify gene expression for obesity through diet
  • Feed a diet that has been shown to modify gene expression in dogs predisposed to become overweight.
Maintain exercise
  • Regular daily exercise.
  • If the pet has age-related or other mobility problems, increase frequency and short duration of lighter exercise.
  • Maintain play, walking, running, swimming, hunting for food, ball games, food puzzles, treadmills or underwater treadmills (Chauvet et al, 2011; Shmalberg et al, 2013).
Regular weighing
  • Use same weigh machine to avoid variability.
  • The author recommends every month.
  • Record weight every time.
  • Plot weight changes graphically in a chart.
Regular checking of BCS
  • Regular use of validated BCS charts.
  • Train owner how to assess BCS properly.
  • Do not rely on owner interpretation – check BCS yourself. regularly and compare with the owner assessment.
Keep in regular contact with the owner
  • Email, phone texts, written letters, newsletter.
  • Frequency – the author recommends monthly, but some owners may think this is excessive. Get input and permission from owners.
  • Build in feedback; for example, bodyweight, BCS, exercise level and any emerging clinical signs to monitor case.
Regular full clinical re-examinations
  • Frequency – more than a single annual check-up (such as vaccination booster appointment). The author recommends every four months for healthy adults, but more frequently – at least every three months – for older pets (more than seven years old).

Many key reference texts can be found on the subject of management of obesity in cats and dogs that can be used in practices (Diez and Nguyen, 2006; German and Martin, 2008).

Controlling calorie intake is critical and easy to say, but not so easy to implement. However, steps can be taken, including the use of low calorie and other therapeutic diets, providing small portions, eliminating treats and snacks, or replacing them with main ration. Owners tend to want to fill a bowl, so encourage them to use a smaller bowl.

Body condition score (BCS) should be maintained at just below the midpoint on current BCS charts, and dogs should be kept slightly lean, as this has been shown to prolong lifespan by about 18 months in the Labrador retriever and delay the onset of age-related diseases by two years (Kealy et al, 2002). In that study, none of the Labrador retrievers developed clinical hip arthritis over their lifespan.

However, do not rely on owners to report BCS values accurately because they may underestimate their pet’s size and condition – even when using a validated chart (Teixeira et al, 2020).

Early intervention

In cats and dogs that do become overweight, early intervention is needed to return weight and body fat levels to optimum.

Obese animals have a lower metabolic rate and energy requirements (German et al, 2011), and intake needs to be reduced to 60% of calorie requirement at optimum weight to achieve weight loss. They also have poorer quality of life (German et al, 2012a), as well as shorter life expectancies (Salt et al, 2019).

Only recommend properly formulated diets that are low-calorie dense and high in essential nutrient content, or that have been formulated to modify gene expression to encourage weight loss. Only recommend diets for which clinical trials have proven that they work (Linder and Freeman, 2010; Roudebusch et al, 2008).

Advise owners not to revert to feeding regular foods once optimum bodyweight is reached because twice as much risk exists that they will gain weight again compared to continuing with a weight control diet (German et al, 2012b). Homemade weight loss formulas are unlikely to be complete and balanced when owners are compiling the ration themselves, and cannot be recommended (Davies, 2014).

Image © zinkevych / Adobe Stock
Image © zinkevych / Adobe Stock

Conclusions

It is important to maintain optimum bodyweight and BCS throughout life. Owners must be motivated to remain vigilant to identify increasing bodyweight through regular monitoring.

Veterinary practices can play a very important role by educating owners and maintaining contact to reinforce the need to maintain optimum body conditions to prevent the secondary diseases, reduced quality of life and reduced life expectancy that result from obesity.

References

  • AAHA (2009). Compliance: taking quality care to the next level; a report of the 2009 AAHA compliance follow-up study, American Animal Hospital Association, Lakewood.
  • Cameron KM, Morris PJ, Hackett RM and Speakman JR (2011). The effects of increasing water content to reduce the energy density of the diet on body mass changes following caloric restriction in domestic cats, Journal of Animal Physiology and Animal Nutrition 95(3): 399-408.
  • Chauvet A, Laclair J, Elliott DA and German AJ (2011). Incorporation of exercise, using an underwater treadmill, and active client education into a weight management program for obese dogs, Canadian Veterinary Journal 52(5): 491-496.
  • Davies M (2014). Variability in content of homemade diets for canine chronic kidney disease, Vet Record 174(14): 352.
  • Diez M and Nguyen P (2006). Obesity: Epidemiology, pathophysiology and management of the obese dog. In Pibot P, Biourge V and Elliott DA (eds), Encyclopedia of Canine Clinical Nutrition, Royal Canin Centre de Recherche, Aimargues.
  • German AJ and Martin L (2008). Feline obesity: epidemiology, pathophysiology and management. In Pibot P, Biourge V and Elliott D, Encyclopedia of Feline Clinical Nutrition, Royal Canin, Ithaca: 3-49.
  • German AJ, Holden SL, Bissot T, Morris PJ and Biourge V (2010). A high protein high fibre diet improves weight loss in obese dogs, The Veterinary Journal 183(3): 294-297.
  • German AJ, Holden SL, Mather NJ, Morris PJ and Biourge V (2011). Low-maintenance energy requirements of obese dogs after weight loss, British Journal of Nutrition 106(S1): S93-S96.
  • German AJ, Holden SL, Wiseman-Orr ML, Reid J, Nolan AM, Biourge V, Morris PJ and Scott EM (2012a). Quality of life is reduced in obese dogs but improves after successful weight loss, The Veterinary Journal 192(3): 428-434.
  • German AJ, Holden SL, Morris PJ and Biourge V (2012b). Long-term follow-up after weight management in obese dogs: the role of diet in preventing weight regain, The Veterinary Journal 192(1): 65-70.
  • Kealy RD, Lawler DF, Ballam JM, Mantz SL, Biery DN, Greeley EH, Lust G, Segre M, Smith GK and Stowe HD (2002). Effects of diet restriction on lifespan and age-related changes in dogs, Journal of the American Veterinary Medical Association 220(9): 1,315-1,320.
  • Linder DE and Freeman LM (2010). Evaluation of calorie density and feeding directions for commercially available diets designed for weight loss in dogs and cats, Journal of the American Veterinary Medical Association 236(1): 74-77.
  • Linder DE, Freeman LM, Morris P, German AJ, Biourge V, Heinze C and Alexander L (2012). Theoretical evaluation of risk for nutritional deficiency with caloric restriction in dogs, Veterinary Quarterly 32(3-4): 123-129.
  • Mugnier A, Morin A, Cellard F, Devaux L, Delmas M, Adib‑Lesaux A, Flanagan J, Laxalde J, Chastant S and Grellet A (2020). Association between birth weight and risk of overweight at adulthood in Labrador dogs, PLOS One 15(12): e0243820.
  • National Research Council (2006). Nutrient Requirements of Dogs and Cats, National Academies Press, Washington, DC.
  • PDSA (2021). PDSA Animal Welfare (PAW) Report 2021.
  • Pet Food Manufacturers’ Association (2015). Obesity Report.
  • Porsani MYH, Teixeira FA, Amaral AR, Pedrinelli V, Vasques V, de Oliveira AG, Vendramini THA and Brunetto MA (2020). Factors associated with failure of dog's weight loss programmes, Veterinary Medicine and Science 6(3): 299-305.
  • Roudebusch P, Schoenherr WD and Delaney SJ (2008). An evidence-based review of the use of therapeutic foods, owner education, exercise, and drugs for the management of obese and overweight pets, Journal of the American Veterinary Medical Association 233(5): 717-725.
  • Salt C, Morris PJ, Wilson D, Lund EM and German AJ (2019). Association between life span and body condition in neutered client-owned dogs, Journal of Veterinary Internal Medicine 33(1): 89-99.
  • Shmalberg J, Scott KC, Williams JM and Hill RC (2013). Energy expenditure of dogs exercising on an underwater treadmill compared to that on a dry treadmill, Proceedings of the 13th Annual American Academy of Veterinary Nutrition Clinical Nutrition and Research Symposium, Seattle.
  • Teixeira FA, Queiroz MR, Oba PM, Olivindo RFG, Ernandes MC, Duarte CN, Rentas MF and Brunetto MA (2020). Brazilian owners perception of the body condition score of dogs and cats, BMC Veterinary Research 16(1): 463.
  • Tvarijonaviciute A, Ceron JJ, Holden SL, Holden SL, Cuthbertson DJ, Biourge V, Morris PJ and German AJ (2012). Obesity-related metabolic dysfunction in dogs: a comparison, BMC Veterinary Research 8: 147.
  • Vasconcellos RS, Borges NC, Goncalves KNV, Canola JC, de Paula FJA, Malheiros EB, Brunetto MA and Carciofi AC (2009). Protein intake during weight loss influences the energy required for weight loss and maintenance in cats, The Journal of Nutrition 139(5): 855-860.
  • Wei A, Fascetti AJ, Liu KJ, Villaverde C, Green AS, Manzanilla EG, Havel PJ and Ramsey JJ (2011a). Influence of a high-protein diet on energy balance in obese cats allowed ad libitum access to food, Journal of Animal Physiology and Animal Nutrition 95(3): 359-367.
  • Wei A, Fascetti AJ, Villaverde C, Wong RK and Ramsey JJ (2011b). Effect of water content in canned food on voluntary food intake and body weight in cats, American Journal of Veterinary Research 72(7): 918-923.

Meet the authors

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Mike Davies

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