Nutritional concepts for the veterinary practitioner

How and why pet cats are fed the way they are: a self-reported owner survey

OBJECTIVES

This study used an owner-directed online questionnaire to collect data regarding their food and water provision for their pet cats. The survey was conducted in 2019.

METHODS

The anonymous online 30-question survey was available via vetprofessionals.com.

RESULTS

A total of 1172 cat owners fully completed the questionnaire. The respondents each owned a median of two cats (range 1-6). They reported being most strongly motivated to feed a particular ration because of palatability, observed and/or expected health benefits, or that the diet was/is perceived as 'natural'. The majority of owners (n = 946, 80.7%) fed their cats exclusively a commercially purchased complete wet food, dry kibble diet or mixture of both. Compared with a previous (unpublished) survey conducted by the same authors in 2013,1 there were substantial increases in the number of owners feeding therapeutic diets (26.6% vs 0.7%) and the inclusion of raw meat in cats' rations (15.6% vs 3.7%). The proportion of respondents providing at least one feeding station per cat was 83.1%, with significant use of enrichment feeding methods (29.1%).

CONCLUSIONS AND RELEVANCE

Veterinarians need to be aware of changing trends in cat feeding to provide owners with appropriate support. Veterinary advice was frequently sought by owners and can be used as an opportunity to improve cat health and welfare, particularly in multi-cat households, but was not often influential to client decision making.

Conversation Analysis of Clients' Active Resistance to Veterinarians' Proposals for Long-Term Dietary Change in Companion Animal Practice in Ontario, Canada

The impact of nutrition on animal health requires effective diet-related treatment recommendations in veterinary medicine. Despite low reported rates of veterinary clients' adherence with dietary recommendations, little is known about how clients' resistance to nutritional proposals is managed in the talk of veterinary consultations. This conversation-analytic study investigated clients' active resistance to veterinarians' proposals for long-term changes to cats' and dogs' diets in 23 segments from 21 videotaped appointments in Ontario, Canada. Clients' accounts suggested the proposals themselves or nutritional modifications were unnecessary, inappropriate, or unfeasible, most often based on patients' food preferences, multi-pet feeding issues, current use of equivalent strategies, or current enactment of the proposed changes. Resistance arose when veterinarians constructed proposals without first gathering relevant diet- and patient-related information, soliciting clients' perspectives, or educating them about the benefits of recommended changes. Veterinarians subsequently accommodated clients' concerns more often when resistance involved patient- or client-related issues rather than clients' lack of medical knowledge. The design of subsequent proposals accepted by clients frequently replaced dietary changes in the initial proposals with nutritional or non-nutritional alternatives and oriented to uncertainty about adherence. This study provides evidence-based findings for developing effective communication training and practice guidelines in nutritional assessment and shared decision-making.

Randomised, prospective, blinded, clinical trial of opioid-free injectable anaesthesia with or without multimodal analgesia in kittens undergoing ovariohysterectomy

OBJECTIVES

This study compared an opioid-free injectable anaesthetic protocol with or without multimodal analgesia in kittens undergoing ovariohysterectomy.

METHODS

In this prospective, randomised, blinded, clinical trial, 29 healthy kittens (mean ± SD weight 1.55 ± 0.46 kg; aged 10 weeks to 6 months) were included. Anaesthesia was performed with an intramuscular injection of ketamine (4 mg/kg), dexmedetomidine (40 μg/kg) and midazolam (0.25 mg/kg). In the multimodal group (MMG), cats (n = 14) received meloxicam (0.1 mg/kg SC) and intraperitoneal bupivacaine 0.25% (2 mg/kg), whereas the same volume of saline was administered in the control group (CG; n = 15). Atipamezole (0.4 mg/kg IM) was given 15 mins after ovariohysterectomy. Postoperative pain was assessed using the UNESP-Botucatu multidimensional feline pain assessment scale - short form. Rescue analgesia (buprenorphine 0.02 mg/kg IM in MMG/CG and meloxicam 0.1 mg/kg SC in CG) was administered if pain scores were ⩾4/12. Soft food intake (after 2 and 60 mins) was evaluated at specific time points postoperatively. Statistical analyses were performed with linear models and post-hoc pairwise comparison with Benjamini-Hochberg corrections (P <0.05).

RESULTS

The prevalence of rescue analgesia was higher in the CG (n = 15/15) than the MMG (n = 1/14; P <0.001). Pain scores at 1 h, 2 h and 4 h postoperatively were higher in the CG (4.1 ± 2.8, 4.8 ± 3.0 and 5.3 ± 1.2, respectively) than in the MMG (1.6 ± 1.0, 1.1 ± 1.0 and 0.9 ± 0.8, respectively; P <0.001). Food intake (%) at 1 h postoperatively was higher in the MMG after 2 and 60 mins (10.4 ± 9 and 71.9 ± 29, respectively) than in the CG (1.4 ± 2 and 13.9 ± 7, respectively; P <0.001).

CONCLUSIONS AND RELEVANCE

This opioid-free protocol using multimodal analgesia produced adequate postoperative pain relief, while almost eliminating the need for rescue analgesia in kittens undergoing ovariohysterectomy. Pain decreased food intake.

Using bioelectrical impedance analysis for modeling regression and predicting body fat accumulation in dogs in East Thailand

Background and Aim: Obesity in dogs leads to several health problems, such as premature death, and contributes to other diseases. Recently, body fat percentage has been considered to represent the body condition of dogs, and bioelectrical impedance analysis (BIA) is the most effective method for accurately measuring body fat in dogs. In Thailand, information on the body condition of dogs is limited, and there is no standard body fat level for Thai or mongrel dogs. This study was designed to evaluate and analyze the body fat percentage in dogs through BIA using a handheld instrument. The results of this study can help enhance the quality of life and health of dogs and aid in setting a standard body fat level for Thai or mongrel dogs. Materials and Methods: The body fat percentage of 340 Thai and mongrel dogs in East Thailand was measured in the standing position, and the body condition score (BCS) (range, 1–5), sex, sterilization status, age, type of diet, and lifestyle were recorded. A linear regression model was developed to compare the variables and the predicted body fat percentage, and multiple linear regressions were used to analyze the factors for body fat increment. Results: The linear regression model used to estimate the percentage of body fat (y) for each BCS (x) was y = 0.84 + 8.36x (R2 = 0.7219; p < 0.0001); the average body fat percentage was 27.52% for all studied dogs; specifically, 24.83% for the Thai Bangkaew, 26.42% for the Thai Ridgeback, and 27.65% for mongrels. The median body fat percentage was significantly higher in female than in male dogs. We found that as age increases, body fat percentage also increases; this increasing trend begins at the age of 5 years. However, increasing the level of activity and decreasing meal frequency leads to an increase in body fat percentage in neutered male dogs. Conclusion: The average body fat percentage of dogs in East Thailand is 27.52% and this value is expected to increase when these dogs reach the age of 5 years. BIA is a valid and effective measurement tool for detecting the body fat percentage in dogs.

Knowledge, attitudes and application of nutrition assessments by the veterinary health care team in small animal practice

OBJECTIVES

To assess the impact of the WSAVA Global Nutrition Committee's work in promoting nutrition as the fifth vital assessment and enhancing knowledge of nutrition. Further objectives were to ascertain use of existing Global Nutrition Committee assessment tools, identify potential new tools and determine which members of the veterinary health care team are responsible for carrying out nutrition assessments, planning and intervention in practice.

MATERIALS AND METHODS

A 16-question online questionnaire on the awareness, use and frequency of nutritional assessment was completed by 2740 veterinary health care team members. Statistical association was tested between the reported frequency of nutritional assessment in practice and the likely establishment of normal dietary regime, calculation of energy requirements and creation of nutritional plans.

RESULTS

Most respondents (95%) currently had responsibility for providing small animal nutrition education, yet only 27% were aware of the WSAVA guidelines. Over half (64%) recognised nutritional evaluation as the fifth vital assessment. Only 4% consistently used WSAVA tools to perform a systematic nutritional assessment. Veterinarians and veterinary nurses/technicians were the most frequent source of nutritional advice in practice, with the consultation recognised as the most important contact point with clients.

CLINICAL SIGNIFICANCE

Awareness of nutritional assessment is apparent, yet implementation in practice is inconsistent. These findings will help the WSAVA Global Nutrition Committee prioritise future activities to support the veterinary health care team and pet owners with nutrition-related knowledge, tools and resources.

The effect of a raw vs dry diet on serum biochemical, hematologic, blood iron, B12 , and folate levels in Staffordshire Bull Terriers

Background

To date, very few studies have compared the effects of different types of feeding practices on canine physiology, such as feeding exclusively dry, raw, or homemade foods.

Objectives

We aimed to report the changes in hematologic, serum biochemical, plasma folate, B₁₂, and whole blood iron levels in dogs fed two different diets.

Methods

A pilot study was developed to compare the effects of a heat‐processed high carbohydrate (HPHC) and nonprocessed high‐fat (NPHF) diet. A total of 33 client‐owned Staffordshire Bull Terriers were used; 18 had canine atopic dermatitis, seven were healthy, and eight were grouped as “borderline” dogs since they did not fulfill at least six of Favrot's criteria. The comparisons were made between the diet groups at the end visit of the diet intervention, as well as within the diet groups during the study.

Results

Significant differences between and within the diet groups were observed, although the majority of outcomes remained within the RIs. The median time of diet intervention was 140 days. Red blood cell counts, mean cell hemoglobin concentrations, and platelet counts were significantly higher, and mean cell hemoglobin, mean cell volume, alkaline phosphatase, inorganic phosphorus, and cholesterol were significantly lower in the dogs fed the NPHF diet compared with those fed the HPHC diet after the diet trial was completed. In addition, folate, B₁₂, and iron decreased significantly in the NPHF diet group.

Conclusions

This pilot study indicated that diet had an impact on blood values, although most remained within RIs, pointing out the need for further studies.

A multidisciplinary study of pain in cats undergoing dental extractions: A prospective, blinded, clinical trial

This study aimed to evaluate pain scores, analgesic requirements, food intake and serum inflammatory cytokines in cats before and after clinically recommended dental treatment. Twenty-four cats were included in a prospective, blinded clinical trial. Cats were equally divided into minimal (minimal dental treatment) or severe (multiple dental extractions) oral disease groups. They were admitted (day 0) and underwent oral examination/radiographs/treatment under general anesthesia (day 1; acepromazine-hydromorphone-propofol-isoflurane-meloxicam-local anesthetic blocks). Serum inflammatory cytokines were measured on days 0 and 6. Pain was scored using the Glasgow composite measure pain scale-feline (CMPS-F). Rescue analgesia was administered with hydromorphone if CMPS-F ≥ 5/20. Dry and soft food intake (%) during 3 minutes and 2 hours, and daily soft food were calculated. The Cochran-Mantel-Haenszel and Chi-square tests, Spearman’s rank correlation and linear mixed models were used for statistical analysis (alpha = 0.05). Pain scores were significantly increased in cats with severe disease when compared with baseline (up to day 4) and minimal disease (all postoperative time points). Prevalence of rescue analgesia was significantly higher in severe (91.7%) than minimal disease (0%); analgesics were required up to day 3. Pain scores and frequency of rescue analgesia were significantly correlated with the number of tooth extractions, gingival and calculus index. Prevalence of rescue analgesia was significantly correlated with the number of missing teeth, teeth extractions and gingival index. Dry and soft food intake during 3 minutes, and dry food intake during 2 hours were significantly lower in the severe than minimal disease group throughout the study. Some cytokines differed between groups between day 0 and day 6 and were associated with the presence of tooth resorption and number of missing tooth and tooth fractures. Long-term analgesia is required after dental extractions in cats with severe oral disease. This condition reduces food intake and influences serum inflammatory cytokines.

Conversation Analysis of Veterinarians' Proposals for Long-Term Dietary Change in Companion Animal Practice in Ontario, Canada

Nutritional changes recommended by veterinarians to clients can have a major role in animal-patient health. Although there is literature on best practices that can inform veterinary communication training, little is known specifically about how veterinarians communicate their recommendations to clients in real-life interactions. This study used the qualitative research method of conversation analysis to investigate the form and content of veterinarian-initiated proposals for long-term dietary change in canine and feline patients to further inform veterinary communication training. We analyzed the characteristics and design of veterinarian-initiated proposals for long-term nutritional modification as well as the appointment phases during which they occurred, in a subsample of 42 videotaped segments drawn from 35 companion animal appointments in eastern Ontario, Canada. Analyses indicated that veterinarians initiated proposals at various points during the consultations rather than as a predictable part of treatment planning at the end. While some proposals were worded strongly (e.g., "She should be on…"), most proposals avoided the presumption that dietary change would inevitably occur. Such proposals described dietary items as options (e.g., "There are also special diets…") or used mitigating language (e.g., "you may want to try…"). These findings seem to reflect delicate veterinarian-client dynamics associated with dietary advice-giving in veterinary medicine that can impact adherence and limit shared decision-making. Our analyses offer guidance for communication training in veterinary education related to dietary treatment decision-making.

Symmetric Dimethylarginine: Improving the Diagnosis and Staging of Chronic Kidney Disease in Small Animals

Chronic kidney disease (CKD) is a common condition in cats and dogs, traditionally diagnosed after substantial loss of kidney function when serum creatinine concentrations increase. Symmetric dimethylarginine (SDMA) is a sensitive circulating kidney biomarker whose concentrations increase earlier than creatinine as glomerular filtration rate decreases. Unlike creatinine SDMA is unaffected by lean body mass. The IDEXX SDMA test introduces a clinically relevant and reliable tool for the diagnosis and management of kidney disease. SDMA has been provisionally incorporated into the International Renal Interest Society guidelines for CKD to aid staging and targeted treatment of early and advanced disease.

Effect of question design on dietary information solicited during veterinarian-client interactions in companion animal practice in Ontario, Canada

OBJECTIVE

To establish the types of initial questions used by veterinarians in companion animal practice to solicit nutritional history information from owners of dogs and cats, the dietary information elicited, and the relationship between initial question-answer sequences and later nutrition-related questions.

DESIGN

Cross-sectional qualitative conversation analytic study.

SAMPLE

98 appointments featuring 15 veterinarians drawn from an observational study of 284 videotaped veterinarian-client-patient visits involving 17 veterinarians in companion animal practices in eastern Ontario, Canada.

PROCEDURES

Veterinarian and client talk related to patient nutrition was identified and transcribed; conversation analysis was then used to examine the orderly design and details of talk within and across turns. Nutrition-related discussions occurred in 172 visits, 98 of which contained veterinarian-initiated question-answer sequences about patient nutritional history (99 sequences in total, with 2 sequences in 1 visit).

RESULTS

The predominant question format used by veterinarians was a what-prefaced question asking about the current content of the patient's diet (75/99). Overall, 63 appointments involved a single what-prefaced question in the first turn of nutrition talk by the veterinarian (64 sequences in total). Dietary information in client responses was typically restricted to the brand name, the subtype (eg, kitten), or the brand name and subtype of a single food item. When additional diet questions were subsequently posed, they typically sought only clarification about the food item previously mentioned by the client.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that question design can influence the accuracy and completeness of a nutritional history. These findings can potentially provide important evidence-based guidance for communication training in nutritional assessment techniques.