Nutrition Module 2 - Obesity Case

1. Module 2 Case
Marge Chandler
DVM, MS, MANZCVS,
DACVN, DACVIM, MRCVS

2. Clara – 9 yr FN Labrador cross
Owners presented
Clara for weight loss…
And the first thing the
owners said was….

3. Clara – 9 yr FN Labrador cross
Owners presented
Clara for weight loss…
And the first thing the
owners said was….
“She hardly eats
anything!”

4. The first thing we need to do is a diet history

5. Clara – Diet History
On a commercial “lite” diet (320 kc/100g)
Fed 400 g as recommended for 30 kg dog
320 kc/100g x 400g = 1280 kcal
Dental “ treats” = 70 kcal
Snack after dinner : Digestive biscuit = 71 kcal
To give meds (NSAID): one inch cheese cube = 69
kcal
Total = 1490 kcal
at least…

6. Clara – Physical Exam
Wt: 40 kg
BCS 9/9
Ideal wt: 30 kg
Muscle condition – appears ok
Coat and teeth – good
No other abnormalities noted

7. Clara – Calorie Plan
What is your recommendation?
A. “Feed less”
B. RER at ideal wt
C. 80% of RER at ideal wt
D. 80% of current intake

8. Clara – Calorie Plan
What is your recommendation?
A. “Feed less”
Not very likely to work
B. RER at ideal wt** = about 900 kcal
My starting point
C. 80% of RER at ideal wt? = 720 kcal
Maybe… - see next slide!
D. 80% of current intake* = 1200 kcal
Probably would also work but more slowly

9. Feeding at iRER vs 80% iRER
Clara’s RER at ideal wt = BW e.75 x 70 =
30e .75 = 12.8
iRER = 12.8 x 70 = 897 (~ 900 kcal)
80% of that is about 720 calories – or about ½ of
what she has been on!
What might happen if you recommend halving her
food intake? How might the dog react? How about
the owners, who already think Clara eats almost
nothing?!

10. Treats?
Do you recommend:
A. feed treats as before
B. ad lib
C. no treats ever
D. 10% of calorie intake

11. Treats?
Do you recommend:
A. feed treats as before
B. ad lib
C. no treats ever
D. 10% of calorie intake* (and low calorie
treats)

12. Treats?
A. feed treats as before
That hasn’t worked too well so far
B. ad lib
Well, that’s never going to work!
C. no treats ever
Compliance?
D. 10% of calorie intake* (and low calorie
treats)
Probably the best option

13. Clara – What Food?
A. Continue on current diet but feed less?
B. Switch to an obesity diet?
Why might owners want to continue on
current diet?

14. Current diet
Current diet – would require about 280 g with no
snacks to provide iRER of 900 kcal
Or with 10% for treats: 810 kcal or 250g food
Protein = 18% as fed = 45 g in 250 g
Protein requirement = minimum 2.62 g BW^ .75 power
(from NRC, recommended amount =3.28 g^75)
Or for Clara = 42 g protein, i.e. just enough, but low
At 80% iRER = 225 g food or 40.5 g protein - deficient!

15. Protein in Weight Loss
Helps maintain lean body mass
Weight loss goal is to lose fat not weight
Increased lean body mass increases calorie use
May improve satiety

16. Obesity Diets
E.g. commercial therapeutic wt loss diet = 270
kcal/100g
900/270 =3.33 or 330 g fed at iRER
Or with 10% treats = 810/270 = 300 g fed
This is ¾ of previous feeding
Protein = 30% x 300 = 90 g!
Also includes omega 3 fatty acids, glucosamine
and chondroitin sulphate

17. Follow up?
Are you going to:
A. Have the owner phone in sometime
B. Phone the owner
C. Have the owner make an appt for a weigh in
D. Sign the dog up for a nurse obesity clinic

18. Follow up?
Are you going to:
A. Have the owner phone in sometime
B. Phone the owner*
C. Have the owner make an appt for a weigh in**
D. Sign the dog up for a nurse obesity clinic**
E. The owner may or may not phone in, and you
might get too busy to remember (although fine
if you have a system). I like C or D!

19. Questions? – send them in!