Managing Obese Pets

58
Managing Obese Pets

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Managing Obese Pets. Managing Obese Pets. Definition and incidence Assessing body condition Energy balance Preventing obesity Treating obesity and preventing recurrence. Definition and Incidence. Definition - Increase in body fat →impairs health or function - PowerPoint PPT Presentation

Transcript of Managing Obese Pets

Page 1: Managing Obese Pets

ManagingObese

Pets

Page 2: Managing Obese Pets

Managing Obese Pets

Definition and incidence

Assessing body condition

Energy balance

Preventing obesity

Treating obesity and preventing recurrence

Page 3: Managing Obese Pets

Definition and Incidence

Definition- Increase in body fat

→impairs health or function- > 20% above ideal body

weight

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Definition and Incidence

Increasing incidence of obesity

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Definition and incidence

- Estimated 25-40% pets are overweight or obese

- Owners and veterinarians tend to underestimate incidence of obesity

- Body condition scoring is useful tool for recognition of obesity

Incidence

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Definition and incidence

Owner evaluation of pet weightUnder

2%Over 18%

Average 80%

Dog Cat

Under 4%

Over 19%

Average 77%

1992 AAHA Survey

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Definition and incidence

- Associated with or exacerbates specific diseases

- May make pets less tolerant of metabolic stress

- Can complicate therapeutic and diagnostic procedures

Health risks of obesity

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Health Benefits and Risks

Obesity issues

Metabolic Functional Disease risks

Hyperlipidemia Joint stress Dermatoses

Hyperinsulinemia Dyspnea Reproduction

Glucose intolerance Hypertension Immunocompromise

Diabetes mellitus Tumors

DOD/osteoarthritis

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Assessing Body Condition

Diagnosis of obesity- Body weight- Compare to

weight at 1 year

- Body condition scoring

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Assessing body condition

Body Condition Scoring A clinical assessment of body fat Accounts for animal’s frame size

independent of its weight Uses defined criteria to help make

the process more objective Recommend a 5-point system for

body condition scoring

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DEXA

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Assessing body condition

5-Point Body Condition Scoring System

1 – Very Thin

2 – Underweight

3 – Ideal

4 – Over weight

5 - Obese

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Assessing body condition

3 – Ideal Ribs – Easily felt with

slight fat cover Bony prominences –

easily felt with slight fat cover

Side view – Abdominal tuck

Overhead view – Well-pronounced waist

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Assessing body condition

4 – Overweight Ribs – Difficult to feel

under moderate fat cover

Abdominal fat pad – Moderate

Side view – No abdominal tuck

Overhead view – Back is slightly broadened at waist

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Assessing body condition

5 – Obese Ribs – Difficult to feel

under thick fat cover Abdominal fat pad marked Side view – No waist; fat

hangs from abdomen Overhead view – Back is

markedly broadened Fat deposits – Limbs & face

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Assessing body condition

BCS = 1

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Assessing body condition

BCS=3

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Assessing body condition

BCS = 5

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BCS % Body Fat% Ideal Wt.

1 5 852 6-14 86-943 15-24 95-1064 25-34 107-1225 35-45+ 124-146+

Toll P, et al. SACN, 4th Ed, 2000

Assessment of body condition

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ENERGY BALANCE

Caloric intakeActivity

Intake > Use = Weight GainUse > Intake = Weight Loss

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Energy Balance

Internal– Genetics (breed)– Gender/neuter status– Age– Decreased metabolism– Exessive appetite

External– Food availability– Food palatability– Food composition (high

fat/calorie)– Owner’s behavior

RER TEF Environmen

t Activity Production

EnergyExpenditure

EnergyIntakeFactors

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Energy Balance

Variation in Energy Requirement for Body Weight Maintenance of Dogs

Number of Dogs

% of average metabolizable energy intake per kg metabolic body weight

151413121110987654321

45 50 55 60 65 70 75 80 85 90 95 100 5 10 15 20 25 30 35 40 45 50

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Preventing Obesity

Risk factors

– Owner– Patient– Food– Activities

DVM assessment

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Preventing Obesity

Owner risk factors– Relationship to

food– Overweight– Age– Child substitute

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Preventing Obesity

Patient risk factors– Life stage– Gender– Neutering– Breed

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Preventing Obesity

Life stageObese puppies

and kittens

Obese adults

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Percent Body Fat - Canine

Age: p = 0.0001Age2: p = 0.0001

55

1010

1515

2020

2525

00 11 2 3 4 5 6 7 8 9 10 11 12

Years of Age

%F

at%

Fat

Preventing obesity

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Percent Body Fat - Feline

Age: p = 0.046Age2: p = 0.042

1010

2020

3030

4040

00 11 2 3 4 5 6 7 8 9 10 11 12

Years of Age

%F

at%

Fat

Preventing obesity

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Preventing Obesity

Effects of Age on Obesity

1 - 4 5 - 7 8 - 11 > 1210

30

50

% ofDogsOverweig

ht

Age (years)

Source: Mason, Vet Rec 86:612 (1970)

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Preventing Obesity

Effects of Age on Energy Req.

< 1 2 3-7 > 7

kcal DE/kg

Age (years)

Kleazle & Rainbird, Waltham Symp, 1990

Labrador Retrievers140

150

135

110

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Preventing Obesity

Effects of Gender on K-9 Obesity

Intact Neutered Intact Neutered

10

30

50

% ofDogsOverweight

Male

Source: Edney & Smith, Vet Rec 118:391 (1986)

Female

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Preventing Obesity

Feline Obesity Study

Preneuter Postneuter(3 mos.)

Preneuter Postneuter(3 mos.)

80

60

40

20

0

Food Intake (g/day)

Male Female

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Preventing Obesity

Feline Obesity Study

Preneuter Postneuter(3 mos.)

Preneuter Postneuter(3 mos.)

40

30

20

10

0

%Weight Gain

Male Female

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Preventing Obesity

Food risk factors– High palatability– Ad-lib intake– Competition– Treats– Table scraps– Hunting and

scavenging

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Commercial Foods - Forms

Frequency of feeding

Dog dry Cat dryCat moist

Once daily 45% 22% 43%Twice daily 26% 19% 30%Bowl always full 26% 51%

3%< once daily 1% 2%

18%

Habits & Practices Study, Sept 2002

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Preventing Obesity

Activity risk factor assessment– Lifestyle of owner and

pet– Concurrent diseases in

pet

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Treating Obesity

Success in obesity treatment– Humans 0-5%

– Animals up to 50%

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Treating Obesity

Successful treatment depends on:– Owner education– Owner motivation– Veterinary involvement– Provision of key nutritional

factors

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Treating Obesity

Veterinary involvement– Estimate ideal weight– Select reducing food– Calculate food dose– Recommend exercise– Graph weight vs. time

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Treating Obesity

Weight Loss Performance Chart

Weig

ht

321 4 75 9 1110 12 1413 1586

GOAL

Time (Weeks)

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Treating Obesity – Energy Restriction

Determining energy req’t– Resting Energy Requirment

RER = 70BWkg0.75 or 30BWkg

+70– Daily Energy Requirement

Dog 1.6 X RERCat 1.2 x RER

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Treating Obesity – Energy Restriction

Determining energy req’t

Use care in feline caloric restriction

Dogs: 1.0 RER(60% DER)

Cats: 0.8 x RER(70% DER)

@ estimatedideal weight

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Treating Obesity

Food dose calculation– Example: 13.5 kg obese dog

10 kg ideal weight

– RER (kcal/day) = (30 Wtkg+70)[30 (10) + 70] = 370 kcal/day

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Treating Obesity

Select a reducing diet:

260 kcal/can370 kcal 260 kcal/can =1.4 cans (vs. 0.75 can maintenance food)

200 kcal/cup370 kcal 200 kcal/cup =1.85 cups (vs. 1.25 cups maintenance food)

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Treating obesity

Nutritional technology for weight loss:- Calorie Control – reduce caloric density- Intake Control

- Reduce internal drive to eat – satiety via fiber, water, AA’s

- Metabolic Control- Shift metabolism from storage to usage- Carnitine

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Treatment Options

Reducing diet characteristics– Moderate kcal restriction

(20-50%)– Non-energy nutrients

balanced to dry matter intake

– Low fat– High fiber for satiety and

kcal– Protein and micronutrients – Profile suitable for dogs and

cats

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Treating obesity

Key nutritional factors for weight loss (DMB):- Energy canine < 3.4 kcal ME/g- Energy feline < 3.6 kcal ME/g- Fat 5-12% for dogs, 7-14% cats- Fiber 12-30% crude fiber- Protein >25% for dogs, >35% for

cats

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highhigh

highlowlow

lowlowFiber (energy dilution)

Energy Diet

Low

Fat

, Low

Fib

er

Inta

ke

Inta

ke

Low

Fat

, Low

Fib

er

Low

Fat

, Mod

erat

e F

iber

Low

Fat

, Hig

h F

iber

The Effect of Fiber on Energy and Total Diet Intake

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Effect of a Dry Fiber-Enhanced, Low Calorie Food* for Weight Loss in DogsEffect of a Dry Fiber-Enhanced, Low Calorie Food* for Weight Loss in Dogs

-1.7-1.6

-37.9 -40.4

2.5 -2.0

-39.0

-7.6

-47.0

-8.6

-30.4

-39.0

-50

-40

-30

-20

-10

0

10

Weight, g/d Fat, g/d Muscle, g/d %BW/wk

Tis

su

e C

ha

ng

e (

gra

ms

/d)

Test 1 Test 2 Test 3

* Prescription Diet Canine dry r/d Fed at 1.0 x RER at ideal weight

Treating obesity

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Typical Energy Metabolism

Treating feline obesity

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Metabolic Control for Weight LossTreating feline obesity

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Treating feline obesity

Ketones are normal metabolites produced in mitochondria as a by-product of fatty acid metabolism

Ketone levels when fat metabolism is increased (benign dietary ketosis)

Ketones can be measured in the serum.- beta-hydroxybutyrate (BHBA)- acetoacetate- acetone

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Magnitude of Ketogenic Effects

Condition Quantity of Ketones

Fed State 0.1 mmol/L

Overnight Fast 0.3 – 0.7 mmol/L

Low CHO diet 1-3 mmol/L

Diabetic Ketoacidosis >15 mmol/L

Treating feline obesity

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Treating feline obesity

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Treating feline obesity

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Preventing Recurrence

Maintain lifestyle changes – exercise helpful

Monitor weight Portion control

– Lower energy food

– Limit treats

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Summary

Obesity is most common form of malnutrition

Body condition scoring is a useful clinical tool

Body composition is controlled by energy balance

An ounce of prevention is worth a pound of cure

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Summary

Health risks associated with

obesity are reversible Effective obesity treatment

requires a team effort – vet, technician, owner

Dietary fiber enhances satiety

Feline obesity can be managed via traditional reducing diets or low CHO diets