1. Ken Lambrecht DVM
Medical Director West Towne Veterinary Center
Presented at University of Wisconsin School of Veterinary Medicine
February 24, 2014
klambdvm@westtownevet.com
www.Slideshare.net/KenLambrecht
www.facebook.com/AmazingAdventuresofLittleBug

2. 1.Up to 59% of pets are overweight Lund et al Intern J Applied Pract
2010 & Courcier EA et al Scotland J Feline Med 2010
2.Excess weight can reduce longevity and quality of life Kealy et al
JAVMA 2002
3.Hormones & inflammation caused by fat lead to a state of chronic
inflammation Wakschlag et al Br J Nutr 2011
4.Excess weight leads to skin, respiratory, renal
disease, diabetes, orthopedic disease and some types of cancer
LaFlamme J Anim Science 2012

3. 1. Veterinarians need to become
comprehensively “Nutri fluent” with the
recent flood of evidence based articles
2. Food manufacturers need to become more
accountable and transparent
3. Organized veterinary medical groups need
to continue to cooperate
(AVMA, AAHA, etc)

4.  Increasing rates of obesity
 Increasing rates of obesity related disease
90% of cats get arthritis
58% of cats overweight
Relationship??
Catalystcouncil.org

5. The veterinary team is the preferred source of nutritional information and has a
key role in advising clients about the quality and safety of food and
supplements, especially with recurrent food safety issues and misinformation
about canine diets.
Discussions about nutrition are appropriate at every visit to strengthen the
veterinarian’s role and provide sound nutritional advice including
all of the items in Table 2.
AAHA and the World Small Animal Veterinary Association Nutritional
Assessment Guidelines provide excellent discussions of comprehensive
nutritional plans that can be individualized for each dog.13,17,48

6. With more than 40% of dogs in the United States
considered overweight or obese, the primary care
veterinary team is in a pivotal position to detect abnormal
body condition scores and provide tools
for clients to routinely make appropriate adjustments
beginning at the dog’s first visit. 13,17,49–53
Dogs kept at their ideal weight from puppyhood
through the senior life stages live an average of 15%
longer. 54

7. Advocate evidence-based nutrition.13,17
An emerging body of evidence infers that certain nutrients may turn gene
expression on and off and help prevent disease.55
Monitor the emerging body of knowledge with regard to
supplements, implementing those if and when peer-reviewed evidence-based
studies support these potential benefits (e.g., probiotic support of the immune
system, the role of Eicosapentaenoic acid in inflammation).13,17
Additionally, use and refer to veterinarians who are board-certified through the
American College of Veterinary Nutrition to answer questions
and provide nutritional consultations (Table 4).

8. Obesity may occur at any age, but is most commonly encountered in middle age.32,36 The
risk of obesity may be reduced by environmental enrichment, increasing opportunities for
activity, and individualizing food intake. The energy density of cat foods varies
widely, based on the moisture and fat content of the diet. This information should be
helpful in determining a guideline of how much to feed.
 Slowly (<10% increments and decrements) adjust calorie intake to life stage and
conditions (eg, sterilization, indoor housing).
 Provide environmental enrichment to increase activity.35
 Switch to a diet with lower energy density (reduced fat, increased air, fiber and/or
moisture).
 Change the feeding strategy.
 Switch to meal feeding, with portion control.
 Introduce foraging devices (see above).
 Introduce barriers to food access (eg, baby gates, elevated feeding stations).

9. Standard Physical Exam 5 Vital signs
1. Temperature
2. Pulse
3. Respiration
4. Pain Assessment
5. Nutritional Assessment

10. Up to 59% of dogs and cats are overweight, making this the most
common nutritional disorder identified in veterinary practice
Weight management, including obesity prevention and
treatment, remains a challenge for veterinarians and clients alike.

11.  Client challenges
 Data challenges (calories per cup, grams
protein/1000 kcal etc)
 Time challenges

12.  In December 2010 the AVMA added
“prevention of disease” to the veterinary
oath.

13. ● Periodontitis 80% of dogs 2 yrs of age
● Obesity 59% of pets are overweight
● Arthritis 20% of dogs, 90% of cats over 10 yrs
● Infectious disease (Distemper, Rabies, etc)
● Vector borne Heartworm
● Internal parasites Roundworms, hookworms etc

14.  Feline Life Stage Guidelines 2010
 AAHA Nutritional Guidelines 2010
 Canine Life Stage Guidelines 2012
 WSAVA Nutritional Guidelines Guidelines 2011
 AAHA Weight Management Guidelines 2014
https://www.aahanet.org/Library/Guidelines.aspx

15. Clients would visit their veterinarian IF:
1. They thought a visit could prevent expensive treatment later
2. They believed their pet needs more frequent exams (30%
missed heartworm meds, had oral disease, or lameness
identified by an online survey)
3. They were convinced it would help their pet live longer

16. Organized Veterinary Medical Groups
● AAHA American Animal Hospital Association
● AVMA American Veterinary Medical Association
● WSAVA World Small Animal Association
● CVMA Canadian Veterinary Medical Association
● NAVTA National Association of Veterinary Technicians
Association
● AAVN American Academy of Veterinary Nutrition
● ASVE_______________

17. American College of Veterinary Nutrition

18. ● Purina
● Hills
● Iams

19. www.PetNutritionAlliance.org
 Questions & Answers & Myths for Pet Owners
 Non branded Tools for Veterinarians
 Effective branded tools
 Evidence based & practical
Just launched in July 2013 …Needs your input!

20. http://www.petobesityprevention.com/ http://catalystcouncil.org/

21. PNA Non Branded Tools Committee

22.  Board Certified Veterinary Nutritionists
 Only 87 in the world
American College of Veterinary Nutrition

23.  Lectures from ACVN diplomats
 PNA Pet Nutrition Alliance
 AAVN American Academy of Veterinary Nutrition
 ACVN American College of Veterinary Nutrition

24.  Prevention
 Nutrition
 Dentistry
 Cats

27. 1. How to PREVENT
2. How to ASSESS
3. How to CHOOSE an appropriate diet
4. How to CALCULATE what a pet needs
5. What EXERCISE & ACTIVITY

29.  This is an 100% preventable problem!
 Prevention begins with puppies & kittens
 (Effect of neutering, how much to feed etc)
 Continues at middle age
 Communication issue

30.  Good communications skills (e.g Franke program)
 Effective Tools (available on PNA website)
 Educated Support staff (Hills, Purina, Iams, Royal
Canin, PNA Continuing education programs)
 Support from software providers
(Impromed, Patterson etc)

32.  Effective Visual aids (Static BCS & % over)
 Ability to track progress (trending tools for BW, BCS
etc)
 Non branded tools

33.  Calculating % over ideal
 Conversion of Body Condition Score (BCS) to a %
 Muscle Condition Score (MCS)
 Weight Trends

34. 
 Visual trending (BCS and weight) use graph
 Easily accessible Calorie and protein source
 Easily calculated RER (chart vs calculation)

35.  Food Recommendation
 Written Calories and Cups to feed
 Measuring cup
 Food intake & exercise diary

37.  History
 BW, BCS, MC
 Clients pet food education/orientation
 Must touch the pet!
 Baseline Bloodwork r/o
hypothyroidism, Cushing's etc

38.  little or no fat covering ribs
 defined body waist
 minimal abdominal fat (ideal = 20%)
 often correlates to 1 yr of age weight

40. Purina’s BCS for Dogs

42. your

44.  Fist/knuckles (Dr Katherine Michel)
 One year body weight
 When your friends tell you your pet looks too
thin…..you’re almost there! (Dr Julie Churchill)

46. Up to 20% over ideal (BCS up to 3.5/5 or 6/9)
= OTC food if no other problems)
If 20%-30% over their ideal (BCS 4/5 or 7/9) =
Prescription food or high protein OTC food
Over 30% over their ideal = Rx food only

47.  Protein level
 Satiety
 Wet vs dry
 L Carnitine & Isoflavones
 Rx & OTC

49.  RER calculation/chart
 Protein calculations

52. When: when over 20% of their ideal weight (BCS 7/9
and 4/5)
Why: to insure adequate protein
Low number of Cals/Cup (Lisa Freeman study)
Insure micronutrients and vitamins
Higher fiber, lower fat
Satiety factors

54.  Association for Prevention of Pet Obesity
 Internet
 PNA app someday ??

55. Dogs 1-2% per week
60 lb dog
0.6 to 1.2 lbs/week
Cats 0.05 to 2.0% per week
15 lb cat (240 ounces)
1.2 to 4.8 ounces/week

56. 1) Overweight Dog 10Kg ideal weight
2) Food has 21% crude protein and 3,490 kcal/kg (on label)
3) RER = 80% (70 x 10 kg 0.75) = 315 kcal/day
4) Grams Protein in food = (% crude protein/kcal/kg of food) X
10,000=g/1000 kcal 21/3,490 x10,000 = 60 g/1000 kcal
Minimum daily protein requirement = 5g/kg for cats
2.5g/kg for dogs = 25 g for 10 kg dog
This food 315 kcal has 315/1000 or 31% of 60 g =18 gm
NOT ADEQUATE

57. 1) Assume Overweight Cat of 5 kg ideal weight (11 lbs)
Food with 31% crude protein and 3490 Cal/kg
60% (70 X 5KG 0.75) = 150 kcal/day
2. G of protein in food
(% crude protein/kcal/kg food) X 10,000 = g/1000 kcal
31/3490 X 10,000 = 90 g/1000
3) Cats daily protein requirement
5g/kg 5kg cat = 25 grams
4) Food sufficiency
150 Kcal/ day X 90 kcal food only has 13.5 grams
NOT SUFFICIENT!

60.  preserve lean muscle mass
 increase caloric expenditure (1 kcal/kg/km)
at brisk walk 45 kg dog will burn about 250
kcal in 5K
 “promote behaviors that aid in sustainable
weight loss”

61.  Client communication skills
 Make sure it is evidence based
 Constant reassessment
 Keep it fun

62.  Environmental enrichment
 Strict Calorie control
 Protein is a huge issue!

64.  Sat April 5th 12:30 to 2 PM
 8 week Contest Kickoff
 Preventive Pet Care Fair
 Raised over $2500 for local rescues in its 5
year history

65.  Biggest Loser category (Dogs & Cats more than 20%
over ideal)
 Iron Dogs & Iron Cats (between 5 and 20% over
ideal)
 Dog Packs & Cat Prides (3 or more in a team
challenge)
 Over $1000 in pet food prizes
 $5 for each pound lost to any rescue chosen

66.  Satiety
 Behavior
 Data/tools
 Client communication skills

68.  Getting owner buy in
 Respect their relationship with pet
 Emotional nature
 Difficulty in choosing food

72. Slideshare.net/KenLambrecht