Animal Diet and Disease

• Balanced diets must reflect the animal's specific needs
• Prioritize the most threatening health condition to ensure prompt and effective care.
• Life stage is a critical factor in determining appropriate nutritional strategies.
• Diseases disrupt the body's homeostasis
• Diseases are classified according to the body system of origin.

Structural Diseases

• Skeletal issues
• Muscular problems
• Integumentary conditions
• Cardiovascular diseases

Visceral Diseases

• Digestive disorders
• Respiratory illnesses
• Urinary tract conditions
• Reproductive system diseases

Coordinating Diseases

• Nervous system disorders
• Endocrine imbalances

Malnutrition Forms

• Obesity, a widespread concern
• Starvation, though less prevalent

Obesity

• Obesity is readily identifiable in pets
• Obesity is a very common nutritional disease affecting both dogs and cats
• Affects all organs
• Obesity is highly preventable with proper management
• Animals 10-19% over normal weight = overweight
• Animals over 20% of normal weight = obese

Starvation

• Starvation is a rarer condition compared to obesity
• Starvation is considered a serious and life-threatening condition.
• Obesity is a widespread epidemic affecting cats and dogs.
• Obesity is largely preventable
• 35-40% of adult pets are overweight to obese
• 50% of pets over 7 years old are overweight to obese.

Factors

• Excessive caloric intake contributes to weight gain.
• Decreased physical activity leads to fewer calories burned.
• Genetics can predispose animals to obesity.
• Neutering or spaying can affect metabolism and weight.
• Breed plays a role in predisposition to obesity.
• Age influences metabolic rate and activity levels.
• The type of food and feeding methods impact weight.

Main Causes

• Overfeeding during the growth phase is the number one cause of obesity.
• Eating more than expenditure during the maintenance phase is the number two cause of obesity.
• Genetic factors is the number three cause of obedience.

Health Risks

• Diabetes mellitus
• Cardiovascular diseases
• Increased risk of cancer
• Respiratory problems
• Skin issues and conditions
• Lower urinary tract issues
• Hepatic lipidosis

Difficulties in a Hospital Setting

• IV catheter placement challenges
• Cystocentesis procedures
• Intubation difficulties
• Slower recovery from illness or surgery
• Delayed wound healing
• Obesity decreases life expectancy.
• Growth creates new fat cells
• Excessive calories cause extra fat cells in growth stage
• Adipose tissue serves as more than an energy storage site
• Adipose tissue is involved in homeostatic and pathologic processes.
• Adipose tissue releases cytokines that affect immune functions and inflammatory processes.

Predisposed Breeds

• Sheltie
• Golden Retrievers
• Dachshunds
• Cocker Spaniels
• Labrador Retrievers
• Dalmatians
• Rottweilers
• Mixed Breeds
• Genetic Factors
• Genetic factors influencing fat are not well understood

Rule Out

• Underlying conditions that may cause obesity
• Hypothyroidism
• Cushings

Weight Management Program

• Consistent and accurate weight measurement/ patient monitoring.
• Effective client communication is crucial.
• Use of tools to reinforce compliance
• Client and patient support
• Program restructure as needed

Steps to Weight Management

• Determine pet's ideal body weight.
• Determine the number of daily calories to promote weight loss and provide proper nutrition to meet DER.
• Use basic formulas for RER (Resting Energy Requirement)
• Determine DER (Daily Energy Requirement)

DER

• For dogs that are obese prone use daily energy requirement = 1.4 x RER
• For dogs that need weight loss daily energy requirement = 1.0 x RER
• For cats that are obese prone, daily energy requirement = 1.0 x RER
• For cats that need weight loss, daily energy requirement = Weight loss/0.8

Total Weight Loss Program

• Target weight or weight loss goal
• Maximum daily caloric intake
• Specific food, amount of food and method of feeding
• Exercise is the the only way to increase energy expenditures
• Exercise benefits obese patients by lessening the loss of lean body mass, while maintaining, or imprving RERs (Resting Energy Requirement)
• Exercise may improve metabolic abnormalities
• When starting an exercise program, start gradually if sedentary
• 15-30min/day for at least 5 days/week is a good start
• Increase duration and intensity over time

Exercise for Cats

• Treat balls
• Harness walks
• Placing food where they must climb
• Toys
• Laser pointer

Weight Management Guidelines

• Emphasize feeding consistency, including using the pet's designated dish only.
• Ensure the client is using an 8 oz measuring cup.
• Recommend appropriate weight loss food and calculate initial feeding amount.
• Discuss the importance of total energy intake (do not feed anything other than the recommended food at the designated amount).
• If the client wants to treat the pet, make appropriate recommendations and adjust the caloric intake.
• Encourage clients to feed their pets separately if possible.
• Recommend appropriate exercise for the pet.
• Suggest non-food ways for clients to reward or bond with their pets.
• Evaluate, adjust, communicate, and encourage consistently.
• Celebrate success.

Ideal Rate of Weight Loss

• Dogs: 1-2%/week
• Cats: 1-1.5%/week

Refeeding Syndrome

• Metabolic alterations after starting nutritional support in severely malnourished, underweight, or starved patients
• Hypokalemia is the most common electrolyte disturbance
• Glucose absorption triggers insulin secretion, potassium is taken up by cells along with glucose

Clinical Signs

• Glucose intolerance
• Muscle weakness
• Ileus
• Respiratory depression
• Cardiac arrhythmias
• ECG changes
• Hypomagnesemia: Common with prolonged starvation, diabetes mellitus, or renal disease

Clinical Signs

• Neurological abnormalities
• Cardiac arrhythmias
• ECG changes
• Secondary effects on homeostasis
• Can supplement parenterally with magnesium sulfate in several cases

Hypophosphatemia

• Hemolysis, cardiac, and neurological complications
• It's often a consequence of enteral nutrition in veterinary patients and insulin administration in diabetic patients
• Uncommon in dogs and cats
• The most significant disturbance in refeeding syndrome
• Supplement with additional supplementation in their IV fluids
• Possible thiamine deficiency

What Happens

• Food reintroduced = blood glucose rises, the body releases insulin
• Glucose and potassium pump intracellularly
• Occurs in disease conditions such as starvation.
• Feline hepatic lipidosis
• Overall malnutrition
• Prolonged diuresis
• Greatest risk is in severely malnourished patients experiencing significant lean body mass loss

Signs in Cats

• Anorexia
• Weight loss
• Lethargy
• Weakness
• Nausea and/or vomiting
• Diarrhea
• Restlessness
• Seizures
• Coma
• During the initial period of starvation (24-72 hours), the liver depletes glycogen stores.
• Skeletal muscles provide amino acids for new glucose production
• After 72 hours, metabolic pathways shift.
• Energy is drawn from ketone production due to free fatty acid oxidation.
• This spares protein use from skeletal muscle

Prevention

• Begin feeding equal to patients' estimated RER.
• Do not use any stress/illness factors in the initial energy calculation.
• Adjust based on the patient’s response for the safest course of action.
• Initiate feed slowly.
• Gradually increase the amount, as tolerated, over 3-5 days.
• 25-30% of RER for the first 24 hours, working up to 100% after 5 days.
• Bodyweight and BCS should be recorded at least once daily.
• Signs of Cancer
• Weight loss
• Weight loss is the only criterion for cancer diagnosis in animals
• The patient may lose weight due to the location of the tumor or complications due to cancer treatment

Cancer Cachexia

• Wasting syndrome
• Often occurs with anorexia
• Some patients may have progressive weight loss despite apparent adequate caloric intake.
• Physical wasting with disease causes loss of weight and muscle mass.
• Patients with advanced cancer and chronic progressive diseases may appear cachectic.
• Equal loss of muscle and fat is characterized by increased catabolism of skeletal muscle.
• Starvation fat is used first.
• Some tumors can use glucose for energy and produce lactic acid.
• The host must expend energy to convert glucose to lactic acid.
• There is a net energy gain for the tumor and net loss for the animal.
• Avoid giving fluids that contain glucose or lactate.
• Some tumors benefit from a high-fat diet.

Nutrition

• Intended to improve the quality of life, enhance the effectiveness of treatment, and increase survival time

Nutritional Factors

• Keep soluble carbohydrates as low as you can while still feeding the tumor.
• Fiber is needed to maintain stool consistency
• Due to cachexia, provide a highly digestible and high amount of protein
• Arginine is an essential amino acid that may help improve immune function, promote wound healing, and inhibit tumor growth.

Fat and Omega-3 Fatty Acids

• Omega-3s may have a preventative and therapeutic role in cancer therapy.
• Reduced tumor growth and metastasis.
• Shows to influence clinicals signs, increase survival time, provide longer remission time, and improve quality of life.