Uw kibbles & canned talk 2012 final

Ken Lambrecht DVM
Medical Director Westside Family Pet Clinic
Fitness & Rehab Director 4 Paws Swim & Fitness
Presented January 21, 2012
Practical Small Animal Nutrition
University of Wisconsin School of Veterinary Medicine
www.slideshare.net
[email_address]
www.westsidefamilypet.com
Facebook.com/westsidefamilypet .com

Recalls/food safety Raw vs commercial “ Evil” ingredients Big box corporations vs “Mom & Pop”

1940 Hills made first can of Rx pet food…K/D
2002 “Purina study” (Orthopedic & Longevity)
2004 Nestle bought Purina (Switzerland based)
2006 Mars bought Royal Canin (France based)
2007 Melamine Contamination
2010 AAHA Nutrition Guidelines
2011 WSAVA Nutrition Guidelines

Built 4 Paws Swim & Fitness in 2005
CE emphasis on weight loss, Neutracueticals, OA , pain management
Rehab director for 4 Paws 2006-present
Have visited Iams, Hills & Purina’s facilities
Directed Ideal Weight Programs with over 350 participants in past 5 years
Confirmed CE junkie!

Lisa Freeman DVM PhD DAVN
Kathryn Michels MS DVM DACVN
Tony Buffington MS PhD DVM DACVN
Julie Churchill DVM PhD DACVN
Dottie LaFlamme DVM PhD DACVN
Joseph Wakshlag, DVM, PhD, DACVN, DACVSMR
Joe Bartges BS PhD DVM DACVN DACVIM

David Twedt DVM DCVIM
Deb Greco DVM PhD DACVIM
Deb Zoran DVM PhD DACVIM
Michael Lappin DVM PhD DACVIM
Phil Roudebush DVM DACVIM

OCD of shoulder
Hip dysplasia
Irreversible pulpitis 104
Laryngeal Paralysis
Osteoarthritis
Cognitive Disorder Syndrome

Periodontal Disease
Feline Resorptive Lesions(?)
Kidney Disease
Hyperthyroidism
Lung mass
Osteoarthritis
Cognitive disease
IVD Syndrome

Bug Lance

Be evidence based
Be well informed & good communicators
Be the pet’s advocate always
Make a specific recommendation
Ask the tough questions!

Be a practicing scientist
Share CE “Pearls”
Share resources
Listen & learn
Take a preventive approach

Preserve the bond
They want their pet to live a long time
Want us to respect their choices/values
Preventive approach
Control costs

What are you currently feeding?
Are you happy with the food?
How did you decide on that food?
Does he/she seem to enjoy it?
Other pets in house?
How is stool quality, any vomiting etc?

The new 5 th vital sign (WSAVA Nutritional Guidelines 2011)
Temperature
Pulse
Respiration
Pain Assessment
Nutritional Assessment

For every pet
Identify risk factors (animal or diet)
Body Condition score (9 pt system)
Muscle condition score (none to marked)

1) Animal Specific (changes, lab tests,
identify any problems)
2) Diet specific
Caloric density
Other sources of nutrients
Evaluate commercial food
3) Feeding management & practices

Peer reviewed evidence based studies
Board Certified Nutrition DVMS (58+)
Internal medicine boarded “practitioners”
Rx Pet Food Company referenced reviews

Breeders
The Internet
Pet food retailers (big box & boutique)
Random bloggers, magazines etc

Over 70% trust their veterinarian
They want us to make a specific recommendation
We are only ones that can make the nutritional assessment
We are the ones that have the scientific knowledge

Nutritional guidelines (WSAVA & AAHA)
Websites (OSU, Texas A & M, DAVIS, TUFTS)
Consumerlab.com
American Academy of Veterinary Nutrition (AAVN)
American College of Veterinary Nutrition (ACVN)
Books “Chow Hounds”, “Feed your pet right” etc
High Quality CE

AAHA Dental Care Guidelines 2005
AAHA Canine Vaccine Guidelines 2006
AAHA Senior Wellness Guidelines 2009
AAHA Feline Life stage Guidelines 2010
AAHA Nutritional Guidelines 2010
AAHA Anesthesia Guidelines 2011
AAHA/AVMA Dog & Cat Preventive Guidelines 2011
AAHA Canine Life Stage Guidelines Jan 2012

Dentistry (80% )
Obesity (40 to 50%)
Osteoarthritis (20%)
Cancer
Gastrointestinal
Dermatologic
Allergies (Food & Atopy) (15%)
Renal, Hepatic, Cardiac

Periodontal disease causes kidney, heart, and liver disease ( and others) and is 100% preventable.

Is periodontal disease Associated with systemic & distant-organ* abnormalities? Yes: There are proven associations between periodontal disease and systemic and distant-organ abnormalities. 7 Two studies conducted in dogs demonstrated that microscopic inflammatory or degenerative changes in distant organs (kidney, liver, heart) increase with rising severity of periodontal disease, 8,9 and 2 studies have demonstrated an association between periodontal disease and cardiac 10 or renal 11 disease, though the extent of periodontal disease in these studies 10,11 was recorded inconsistently.
Periodontal Health: Causes & Consequences Clinicians Brief Jan 2012 By Colin E. Harvey, BVSc, FRCVS, DACVS & DAVDC University of Pennsylvania

vohc.org Foods = 20% better than average Treats & Water products = 10% better Plaque and/or Tartar claim (Gingivitis claim coming)

Obesity is a serious, almost epidemic disease that is as important as any other disease we treat and is 100% preventable.

Canidae All life stage 8 oz cup 468
Purina High Pro 8 oz cup 441
Royal Canine Mature 8 oz cup 373
Iams Wt Control 8 oz cup 328
Purina Rx DH 8 oz cup 276
Hills Rx Diet Canine 8 oz cup 242

Lindner DE & Freeman L “Evaluation of Caloric Density and feeding directions for commercially available diets designed for weight loss in dogs & cats” JAVMA Vol 236 No 1 January 2010
“ Light formulas” range from 224 to 480 cal/cup!!!

Kealy, Gail et al
48 Labrador Retrievers
14 year study (longest ever performed)
Longevity, reducing developmental orthopedic disease, and delaying chronic disease components.

Showed that ideal weight dogs lived an average of 15% longer and had better health and quality of life
Labrador expected life 12 yrs should add 2.2 yrs )

If pet is 2 BCS scores over ideal on BCS or more than 20% over ideal weight a prescription food high in protein should be used
Dogs 1 gm protein per lb of Ideal weight
Cats 2 gm protein per lb of ideal weight

85 lb lab whose ideal weight is 60# has a BCS of 8 needs 60 mg protein daily to get to 60#.
A 13lb cat whose ideal weight is 10 lbs and a BCS of 7 needs 20 mg protein daily to get to 10# safely.

Dear Colleagues,
I wonder if the group can help us with some challenges related to the best evidence related to what really works with our current Rx diets and exactly why they are better than OTC foods for pets that are 20% more than their ideal weight.
What we are hearing from 2 major pet food companies is that it is simply the protein that works because it is muscle sparing, satiates & burns more calories while another company claims that the lysine &/or Carnitine levels are more important .
We have primarily been using the 1 gram of protein per lb of ideal weight for dogs (and 2 gm per lb for cats) as presented by Dr Julie Churchill at U of M and using the evidence based summary from JAVMA by Dr Phil Roudebush from 2008.
Thanks much!
Ken Lambrecht DVM

From a nutritional perspective , the concern with feeding any over the counter food for active weight loss is that when you restrict the amount of food fed to decrease energy intake, you are also restricting other essential nutrients such as protein, amino acids, fatty acids, vitamins and minerals.
Over the counter foods are generally designed to provided appropriate amounts of essential nutrient for pets maintaining their body weight, and when restricted levels are fed, essential nutrients may fall below adequate daily intakes.
Prescription weight loss foods and over the counter foods designed for active weight loss take this into consideration and boost dietary protein as well as other important essential nutrients to help ensure that protein and other essential nutrient needs are met during caloric restriction .

Preserves lean muscle mass
in dogs Hannah SS LaFlamme DP J Vet Int Med 1998;12:224
in cats LaFlamme DP, Hannah SS Intern Applied Res Vet Med 2005
Contributes to satiety
in dogs Weber M, Bissot et al J Vet Intern Med 2007 21:1203-1208
in cats Vasconcellos et al J Nutr 2009 139:855-860

To feed to get 10 # ideal wt Purina OM Hills R/D Purina DM Royal Canin Mobility Support Science Diet Hairball Control Light Nutrisource Weight Management % protein 50% 37% 53% 26.5% ? ? Protein gms/100 kcal 15.7 11.4 12.9 7.2 10.2 9 Calories/cup 321 263 592 392 283 280 Cups to feed 180kcal 1/2 2/3 3/10 4/10 2/3 2/3 Gm protein provided (20 gm ideal) 28 21 23 12.9 18.3 16.2

85 lb Lab
Ideal weight 60#
2 Previous TPLO’s
Owner free feeds

To feed a dog with goal of 60# Royal Canin CC HP Purina OM Hills RD Purina JM Hills JD Nutri source Weight management Protein g/100 Kcal 12.2 10.4 8.6 7.4 5.1 6.3 Kcal per cup 234 266 242 295 356 340 Cups to feed per day 700kcal 3.0 2.6 2.9 2.4 2.0 2.1 Gms protein provided (60 gm desired) 85 73 60 55 36.2 44

Ohio State website Dr Tony Buffington www.vetosu.edu/nssvet Texas A & M website Dr Deb Zoran www.vetmed.tamu.edu UC Davis Dr Sally Perea www.vetmed.davis.edu Consumer Labs www.consumerlab.com Association of Pet Obesity Prevention Dr Ernie Ward www.petobesityprevention.com

57 participants
20 cats (all cats were WFPC clients)
Pets lost from 0 to 3.8% per week
Most on Rx food (two on raw)
Clover

Continuously assess BCS (every visit)
Keep them on lean side = fist/knuckles test
Teach clients how to count calories
Help them choose a safe diet food
I am more concerned about Ideal weight than any one or group of ingredients!
Ideal weight = best health insurance!

(Kealy, Gail Smith et al) using Purina’s research dogs & facility
48 Labradors
Followed for 15 years

Osteoarthritis in Control dogs Osteoarthritis in Lean-fed dogs Effect of Calorie Restriction on OA

We can reduce degenerative orthopedic diseases (DOD) = hip dysplasia, elbow dysplasia and OCD of shoulder
By keeping pets at their ideal weight for their entire life.

Impellizeri JA, Tetrick MA, Muir P J Am Vet Med Assoc. 2000 Apr 1;216(7):1089-91.
“ Effect of weight reduction on clinical signs of lameness in dogs with hip osteoarthritis.”

Results —Dogs (9) lost between 11 and 18% of initial body weight. Body weight, body condition score, and severity of hind limb lameness were all significantly decreased at the end of the weight-loss period .
Conclusions and Clinical Relevance —Results suggest that in overweight dogs with hind limb lameness secondary to hip osteoarthritis, weight reduction alone may result in a substantial improvement in clinical lameness . ( J Am Vet Med Assoc 2000;216:1089–1091)

Rousch J K et al “Evaluation of the effects of dietary supplementation with fish oil omega 3 fatty acids on weight bearing in dogs with osteoarthritis” JAVMA Vol 236 No 1 Jan 1, 2010

Results —Dogs (129) fed the test food had a significantly higher serum concentration of total omega-3 fatty acids and a significantly lower serum concentration of arachidonic acid at 6, 12, and 24 weeks. According to owners, dogs fed the test food had a significantly improved ability to rise from a resting position and play at 6 weeks and improved ability to walk at 12 and 24 weeks, compared with control dogs.
Conclusions and Clinical Relevance — Ingestion of the test food raised blood concentrations of omega-3 fatty acids and appeared to improve the arthritic condition in pet dogs with osteoarthritis.

OR OR Plus DASUquin or Glycoflex 294mg EPA/cup 394 mg EPA/cup 330 mg EPA/cup Contains Perna GLM

13 yr old DSH 11.9 lbs BCS 7
2# weight gain in past 4 months
Client is free feeding RC LP & RC Intestinal and giving DASUquin & Denamarin daily

History of undiagnosed hepatic disease at UW
Stage 2 IRIS Renal Disease
Mild IBD

Examined 1/19/12 for one episode of falling after missing a jump, not jumping up as much, not quite as active
Weight gain of another 0.5 lb since last visit
All else normal

Repeated labwork (cbc, chem, u/a) Had Creat 3.1 on 10/31/11 (2.6 on 1/19/12)
Phos normal range both visits
UspG 1.022 10/31/11 (1.022 on 1/19/12)
Radiographs of lat elbows & vd pelvis normal
Articular facets of spine poorly defined

Switch to RC mobility JS 160 kcal/day
Weight loss to get to Ideal weight of 10#
Consider gabapentin or amantadine
Could supplement EPA as well
Will discuss therapeutic laser, acupuncture etc

Lascelles, BD et al “Evaluation of a Therapeutic Diet for Feline Degenerative Joint Disease” J Vet Intern Med 2010 1-9 Conclusion: A diet high in EPA & DHA and supplemented with green lipped mussel extract and glucosamine/chondroitin sulfate improved objective measures of mobility. Dietary modulation might be 1 method to use to improve mobility in cats with DJD associated pain.

372 kcal/cup 438 mg EPA/cup (212 mg EPA/180kcal) Perna GLM 506 kcal/cup 605 mg EPA/cup (216 mg EPA/180 kcal) No joint support

OA Treatment Pyramid And foods!<<<

1) First & ALWAYS = Ideal weight & exercise plan
2) Hills JD, Purina JM, Royal Canin Mobility or supplement with 20mg/lb EPA
3) DASUquin or Glycoflex or RC Mobility
4) Next steps based on client preferences

Inflammatory bowel disease
Food allergies
Diarrhea

Dogs (n=198)
Beef 36%
Dairy 28%
Wheat 15%
Egg 10%
Chicken 9.6%
Lamb 6.6%
Soy 6%
Cats (n= 89) Beef 20% Dairy 14.6% Fish 13% Lamb 6.7% Poultry 4.5% Barley/wheat 4.5% Verlind A, Hesta M et al Food allergy in dogs & cats a review Crit Rev Food Sci Nutr 2006 46:259-273 Corn is not listed on dog or cat and chicken low on dog and missing from cat!

If 3-5% of all pets are food allergic…
36% beef 1.8% of all dogs
28% dairy 1.5% of all dogs
16% wheat 1.1 % of all dogs
10% egg 0.5% of all dogs
9.6% chicken 0.5% of all dogs
6% soy 0.3% of all dogs

Inflammatory bowel disease
Food allergies-skin manifestations
90% of food allergic dogs can be detected using hydrolysate diets (soy or chicken)
vs novel protein diets

ECVIM paper demonstrates almost a 100% replacement of lactulose, pumpkin, etc!

= + Vohc label 294 mg EPA/cup 600 mg EPA/cup

Hands down the toughest question a client can ask us!
Marketing challenges
Anthromorphizing
“ Over animalizing”
What is the truth?

FDA & AAFCO regulated
Is a legal document

Manufacturer’s info
Ingredients list in order of weight
(Salt is divider between major & minor)
Guaranteed analysis
Feeding directions
Nutritional adequacy statement
Meets nutrient profiles
or
Feeding Trial Statement

Calories per cup
EPA per cup
Perna, Glucosamine & chondroitin sulfate per cup
Quality of Ingredients
Organic

Grains (corn, wheat & soy)
By products
Rendering, preservatives, digest

opponents proponents corn filler poor protein source poorly digestible causes allergies corn meal is good source of protein soy cheap source of inferior protein Fine if used w/ complementary grains wheat allergenic not allergenic

Link to aflatoxins?
Allergies?
Filler?
Link to high fructose corn syrup?
Marketing spin?

An ingredient that has no nutritional purpose

better nutrient balance than other grains
highly available CHO source
good linoleic source
essential amino acids
fiber source
Not a common cause of allergies

Soybean meal excellent source of lysine & tryptophan
NOT highly allergenic (6% of allergies to 36% for beef)
Doesn’t cause bloat

Incidence in people _?_%
Incidence in pets 1.6%?
Irish Setters 1990 study

Poultry by product meal 65 to 70%
Chicken meal 63 to 67%
Fish meal 60 to 65%
Corn gluten meal 60 to 64%
Meat & bone meal 50 to 55%
Soybean meal 46 to 50%

Wild canids are not apex predators (like wolves) they are more like coyotes and ate small prey, insects, mollusks, carrion, and plant materials (berries, fruits, nuts, seeds, roots, grass, seaweed, gut contents of herbivores)
Grains have a higher consistency of amino acid quality than meat protein (e.g. lamb has poor methionine & taurine)

Make sure a meat protein is in the top three ingredients
As long as amino acid needs are met grains are fine

Ingredients not used for human food
Includes liver, spleen, tripe etc
Does NOT include hair, hooves etc

The animal feed industry has always used the by products of the human food industry
High variability in quality esp meat by products
Source of considerable marketing “spin”

Non-rendered, clean parts other than meat derived from slaughtered animals. It includes but is not limited to lungs, spleen, kidneys, brain, livers, blood, bone, partially defatted low temperature fatty tissue, and stomachs and intestines freed of their contents. It does not include hair, horns, teeth & hooves.
(This does not include backs, necks, and chicken “racks”)

Rendering = cooked & processed into meals
Digest = similar to bouillon, sprayed on for palatability
Rendering is presently a “necessary evil” of
converting waste from human food processing
(meat & plant) into usable items to feed to
other animals. According to “Feed Your Pet
Right” authors it needs much more regulation.

“ Besides, the pet food industry serves an important ecological function by using up food that would otherwise be thrown out,”
“ If everyone cooked human food for the 472 million cats and dogs in America, it would be like feeding an additional 42 million people.”
Dr. Nestle author of “Feed Your Pet Right”
quoted in NY Times article.

Probiotics are killed by heat
Fish oils decrease the shelf life of food
Value of Prebiotics?

Urolithiasis Cats & Dogs
Protein quality/inflammatory bowel disease Cats
May help satisfy pets to lose/maintain weight
Cost, environmental issues, etc
Dental benefits of dry?

Do you have a veterinary nutritionist on staff?
Are they available to answer questions?
Which of your diets are tested using AAFCO feeding studies?
What specific quality control measures do you use to assure consistency & quality?
What kinds of research on your products has been conducted and are results published in peer review journals?

Dogs with chronic renal disease (less than 1% of all adult dogs) may benefit from restricted levels of protein & PO4 Low protein Moderate Protein High Protein Humans 14% Dog <18% 18-25% >25% Cat 20-30% 30-50% >50% Hills J/D Canine 20.1% Purina JM Canine 34.2%

Zoran D, Buffington T “Effects of nutrition choices and lifestyle changes on the well being of cats, a carnivore who has moved indoors” JAVMA Vol 239 No 5 Sept 1 st 2011

Protecting them from their natural predators (larger carnivores and primates) and providing preventative medical care to decrease their risk of illness from infectious diseases has increased the average lifespan of cats from 4.5 years (which is typical of an outdoor cat) to nearly 15 years. 7 However, despite these benefits, this crepuscular carnivore has been removed from a free-roaming, active existence to a captive, indoor, sedentary one.
Cats have gone from frequent consumption of small meals that consisted of animals they could catch and kill to consumption of prepared diets of human choosing, which are often available in excessive amounts and consist of less protein and a wider variety of protein, fat, and carbohydrates than is found in wild birds, insects, and small rodents.

Cats are one of the few true carnivores humans have attempted to domesticate. People also have attempted to get cats to adapt to human lifestyles and preferences, which sometimes leads to a failure to recognize or understand the perils of domestication and its effects on feline behavior, well-being, and health. As a result, there is increasing evidence that many of the chronic health problems of domestic cats are directly or indirectly related to nutrition or lifestyle changes that have been imposed on them by their owners

Prebiotics/probiotics
Role of protein in inflammatory bowel disease
Obesity
Osteoarthritis
Renal disease
FLUTD

Small, firm and dark
Trial & error
What works in one pet will not always work in others
Give several options
Can always re-evaluate & change

Cost of pet foods
Missing ingredients (antioxidants, enzymes, vitamins like Vit E, probiotics)
Recalls, Treat contamination

Earlier publication of studies from pet food companies in peer reviewed journals
Better FDA regulations (calories and EPA levels per cup on label, get rid of food families, etc)
EPA at 40mg/kg in every pet food
Less “negative” marketing
More good studies supported by independent groups like ACVIM, ACVN, AAFP, AAHA, AVCSM

Protein levels approaching wild diet
Anti-inflammatory levels of EPA
Probiotics & prebiotics at optimal levels
Evidence based joint protectants added
Organic and no preservatives or by products
Inexpensive & convenient to feed!

Thank you for your attention! Questions? www.slideshare.net

Uw kibbles & canned talk 2012 final

by Ken Lambrecht on Jan 21, 2012

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Uw kibbles & canned talk 2012 final — Presentation Transcript