Fat, fluffy or just big boned?
August 7, 2014
From the desk of Dr. Voorheis
As promised before I went hiking (and yes I am proud to say I did finish my 36 year journey on the John Muir Trail!), I said the next blog was to be on obesity. Some of you were kind enough to share your success stories of your pet’s weight loss with me and I have included some of those below. All puns aside, this is a huge topic and one I will not be able to completely address in the confines of this blog. It is not a simple subject as you can probably imagine. Yet in both people and our pets it is a sensitive subject that is usually ignored or minimized. It is also not well addressed by the veterinary community, either in treatment or acknowledgement that some of what we do as veterinarians can contribute to obesity. I’ll share more on that later.
I’m a veterinarian, and this is a veterinary blog but I would venture to guess that everyone who reads this knows there is an obesity problem with people in this country. The causes are multi factorial and it is a significant problem for society as a whole and for individuals. We can point to sedentary lifestyles, poor eating habits and food preparation, the ease of the fast food drive thru, portion size (which has increased by 30% plus in the past 50 years) and genetic predisposition.
Whatever we may blame or point to as an excuse, obesity is the result and the same factors also affect our pets.
The simple fact is that fat cells once thought to be benign storage cells with no metabolic activity are now known to be active. They are critically involved in a number of metabolic processes such as angiogenesis (blood vessel formation) fat cell recruitment, dissolving and reforming structures around fat tissue, generation, storage and release of fat, growth factor production, glucose metabolism, production of factors that affect blood pressure, cholesterol metabolism, enzyme production, steroid metabolism, blood clotting, and immune response. Fat cells produce pro-inflammatory compounds such as leptin, interleukins, tumor necrosis factor alpha, c-reactive proteins and on and on. If fat cells release too many pro-inflammatory compounds, the net pro-inflammatory response can contribute to metabolic disease. That metabolic disease contributes to inflammation in joints, type 2 diabetes, hypertension, reduced HDL levels and elevated triglycerides. The challenges for people dealing with obesity are significant. The same is true for our pets.
In veterinary medicine, obesity is defined as a clinical syndrome involving the excess accumulation of body fat. Obesity is considered the most common form of malnutrition in small animal practices like WBAH. National surveys suggest that 25 to 40% of all pets presented to a veterinarian are overweight or obese. I think those numbers are low. I believe the numbers are much closer to 50% or more. Obesity is associated with an increased risk of arthritis, diabetes mellitus, hepatic lipidosis, feline lower urinary tract disease, urine incontinence in spayed female dogs, constipation, dermatitis, heart problems, and respiratory problems. There is more cruciate injury in dogs that are obese than their non-obese counterparts. Obese animals are also anesthetic risks. There is a 3 fold increased risk of death in obese middle aged cats compared with lean middle aged cats. Dogs that are lean live almost two years longer than littermates that are overweight.
Obesity develops when energy intake consistently exceeds energy expenditure. That is the bottom line. This is true for animals and humans. Think calories – if you consume more calories than you burn, you gain weight. So do our pets. Here are some risk factors that enable this to happen so easily and so gradually that you don’t even notice.
- Decreased daily exercise due to confinement of the pet in the house and overfeeding of the pet in those circumstances.
Let’s talk about overfeeding for a minute. The guidelines of how much to feed your dog or cat were developed for intact (i.e. not spayed/neutered) maximally working dogs. Maximally working dogs are dogs running 8 hours per day. For example, if the back of the dog food bag says to feed the dog 1 cup twice a day for its weight, bear in mind that if your dog is not running 8 hours a day, and instead is confined in a house, then its caloric needs are markedly less than what the dog food bag says to feed. The dog food bag is not the end all, be all. Again, you are your pet’s biggest and most important health care advocate. That’s right, YOU not me. YOU live with your pet. You are ultimately responsible for keeping your eyes and ears open and making sure that your pet is acting normal, eating and drinking normally, pooping normally etc. Your pet depends on YOU first and foremost for their well being. So the next time you look into the cute face of your dog or cat and think to yourself “oh you are so cute – here have a treat” or worse yet “here have a bite of my burger or a piece of my bacon”, think again. A better way to think in that situation is “oh you are so cute… and I want you to live longer and be healthy so I WON’T stuff you full of treats and table scraps”. And then maybe take Fido for a walk or throw the ball for a while. Grab a cat toy and engage your cat in some good play time. This is a much better reward for both of you. Need a visual on this?
In addition, I alluded earlier to the veterinary community’s role in obesity in our pets. We promote spay and neuter. Remember my blog on that? It’s important because pet overpopulation leads to millions of dogs and cats being euthanized in shelters across the country every year. So it is correct and appropriate to recommend spay and neuter. However, we need to bang on the drum once we have spayed/neutered your pet. Its caloric requirement will change. It becomes much easier to gain weight when spayed/neutered than when intact. The bottom line is the day after your pet is spayed you can probably start feeding less food. How much less? I’d start with 10 to 20% less and make adjustments from there. Again, you live with your pet, I don’t. So watch and see. If they start to pack on the pounds, decrease another 10% until you see a better result. For our cats, many if not most of our cats are now indoors and spayed/neutered. They are indoors for a reason because we don’t want them to be exposed to the dangers of cars, aggressive dogs, feral cats, and coyotes. So they are not out hunting which is their nature. They are lolling around free feeding on dry food all day. Obesity is a consequence.
2. Owners may overfeed their pets because a good appetite is perceived as a sign of good health, they may use food as a palliative (comfort) agent when they leave for work- they replace exercise with food and begging behavior is “endearing”
By far and away, the number one cause of obesity in our animals is overfeeding. Only about 5% of overweight or obese animals have a medical problem such as hypothyroidism, hyperadrenocorticism, hyperinsulinism, acromegaly or hypopituitarism. Again, the overwhelming reason is too many calories consumed for too little energy expenditure.
In practice, the diagnosis of overweight or obesity is done in the exam room. Every animal examined is assigned a body condition score (BCS). We use a scoring system on a scale of 1-9, with 5 being ideal and 8 or 9 being obese. Animals with 6 and 7 are considered overweight. BCS’s have the advantage of being fairly quick and easy to perform. Another system, developed by Hill’s which has a terrific app for your smart phone that allows you to calculate ideal body weight using a system called BFI calculator. Using your smart phone, search for Hill’s HWP weight management app. Using a measuring tape, you can quickly make 4 measurements and calculate your dog’s ideal weight. The BFI system is something you can do at home, and/or we can show you and we can quickly develop your pet’s ideal weight. If you don’t happen to have a smart phone, you can also go to the website where there is an instructional video to help show you how to get the proper measurements. You can click here: http://www.hwp.hillsvet.com/resources/resources.html
So, how do we get to an ideal weight once we have arrived at the decision that our pet is too heavy? First, we determine who feeds the dog or cat. Does the animal free feed or do you feed them? Write down all the calories (everything that crosses the animal’s lips in a twenty four hour period). We can choose to make a diet change, i.e, move to a prescription diet designed to have an animal lose weight. By far and away, the best weight loss diet to come about in recent years is a prescription diet by the Hill’s/Prescription diet company. This is a better food than their original weight loss diet called r/d. The new diet is called Metabolic Diet. Again, the app or the link I provided will help you decide how much to feed in a 24 hour period. There are even treats for dogs and cats in the Metabolic line, so they have covered everything!
There are other methods of feeding, designed for weight loss. Adherence to these methods will also result in weight loss. Feed less. Don’t change the food you are feeding but instead feed 25% less. Cut treats in half, literally. Your pet just wants the treat. They don’t know that you cut it in half. Then, instead of giving 6 treats per day, give 3. They can still have 6 treats per day, but once you cut the treat in half, they are actually getting half the treats there were originally getting. And they won’t know the difference. This way, you aren’t the big meanie that took the treats away. Re-weigh and re-measure in one month. If no weight loss or no significant weight loss, feed 25% less and cut treats in half again. Re-weigh in one month. There is no question that if you decide to commit to getting weight off of your dog or cat, you will succeed. You see, they can’t sneak candy bars and stop at the drive through like we can. They don’t have to deal with self control and cravings like we do. Getting weight off your pet is not brain surgery. It just takes commitment and patience on your part. Don’t we wish we had someone to this for us? Let me say this another way, if I could promise you that I had a pill in my pharmacy that would guarantee two extra years with your dog or cat, would you not ask for it? That magic pill is a body condition score of 4/9 for a dog and 5/9 for a cat. Believe it. For some cats, the easiest way to weight loss is to stop free feeding and instead feed a measured amount of food. Or feed canned food twice daily and give no dry food.
As promised, here are some client comments on diet and weight loss:
“Very good results with Sasha (cat) on Hill’s Diet you prescribed for him a few months ago. There were struggles at first, but we learned together how to make it work.” ……Nancy A.
“My cat has been fat all of her life… I free fed her for years…. Now she is 11. 4 lbs (down from 16) and she is more energetic at 11 year of age than she was at 6. ¼ cup measured metabolic diet two times a day. I feed dry food only”. – Nelson V.
“You provided perfect advice for the weight problem our Akita (Tika) had. She was something in the 100 lb range. You wanted her at 88 lbs. Your solution was simple… reduce the feedings by 25%. Easy enough… I used a ¾ measuring cup using Wellness Core brand food. And I fed her treats with a minimum protein content of 70% and kept up the daily walks. We weighed her monthly as the weight came down about 1-2 lbs a month. With all that success, we kept her on the diet and stopped monthly weighings. Big mistake. After several months, we checked her on a Petsmart scale that read 82 lbs. WBAH recorded her weight at 83 lbs. I have since increased her food and she is now 88 lbs and I am working to find the right balance to maintain her here .. expect experience will find that level. Essence of story… your solution was easy and very effective.” – Glenn and Carole M.
“Red is a really sweet boy who likes to sit at the table while we eat our meals (A habit that started since the day he was found on our doorstep). This is a really “adorable” way of begging in my opinion but needless to say, we let him join us. Everyone thought it was cute to give him a “bite” of people food. That was when we began our first effort to control Red’s weight. We stopped giving him bites, or “just a taste” of our meals. His health became more important than his participation at the dinner table. Also, since Red was growing in years we switched his food to a “senior” product of the same food. I don’t know how much difference “age appropriate nutrition” factored into his weight loss but I believe it was significant. We also cut the mixture of wet/dry food and opted only for “dry only”, which I’m guessing is better for his oral health as well, but that is only a guess. Red still joins us at the table and is very polite given he is denied the little “treats” that were contributing to his obesity. -Toni M.
A HUGE thank you to those clients who provided me with some feedback on this topic! Your input is invaluable because, once again, YOU are your pet’s biggest health advocate.
Until next time…..