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

Website Investigation of Pet Weight Management-Related Information and Services Offered by Ontario Veterinary Practices

Pet owners rely on information and advice from their veterinary practice to effectively manage their pet's weight. This study investigated weight management information and services displayed on practice websites in Ontario, Canada. Information collected from the websites of 50 randomly selected small and mixed-animal practices included practice and staff demographics and the type of weight management services, products, and information advertised or displayed. The most frequently advertised weight management service and product were nutritional counselling (34%) and therapeutic diets (25%), respectively. Current bodyweight measurement was advertised on just over half of the websites (54%), while physical therapy counselling was the least-advertised service (16%). Further statistical analyses were performed in an exploratory fashion to determine areas for future research. Binary logistic regression analyses were used to investigate the association between practice demographics and the type of weight management information advertised online. A maximum of two predictor variables were included in each regression model. Exploratory analyses indicated that when controlling for the number of veterinarians in each practice, having a higher number of veterinary technicians was associated with increased odds of a practice website advertising current bodyweight measurement by 80.1% (odds ratio (OR) = 1.80, p = 0.05). Additionally, when controlling the number of veterinary technicians, having a higher number of veterinarians was associated with increased odds of a practice website advertising sales of therapeutic diets by 119.0% (OR = 2.19, p = 0.04). When using corporate practices as reference, independently owned practices had decreased odds of advertising sales of treats and weight management accessories on their practice websites by 78.7% (OR = 0.21, p = 0.03). These preliminary results suggest that advertising weight management information is not prioritized on veterinary practice websites in Ontario, especially those with lower staff numbers. The findings of this study raise awareness on the current state of weight management promotion for pets on veterinary practice websites and highlight ways to improve upon a practice's online presence.

Effect of Different Fiber Sources as Additives to Wet Food for Beagle Dogs on Diet Acceptance, Digestibility, and Fecal Quality

In order to enhance the health and welfare of obese dogs and to facilitate the required loss of body weight, commercial diets are produced with fibrous ingredients. Cellulose is a common dietary fiber used mainly in powdered form. However, other processing forms and fibers are available as fibrous additives. This work aimed to test the effects of different fiber sources on apparent total tract digestibility and fecal quality in dogs. Four diets were fed to eight dogs (experimental design: 4 × 4 Latin square) for a 14-day period each. In addition to a basal diet (CO), three experimental diets varying in fiber sources were used: powdered cellulose (CE), granulated cellulose (GC), and lignocellulose (LC). Dogs fed the CO had lower crude fiber digestibility than those fed the other experimental diets (p < 0.0033). Dogs fed diets supplemented with fiber sources had lower gross energy digestibility (range: 76.2-77.3%) compared with those fed the CO (84.4%). In all groups, the fecal score (consistency and shape) ranged within the optimal values; solely wet fecal output was increased for the fiber groups compared with those on the CO. This study demonstrated that various sources of fiber such as GC and LC can be used as alternatives to CE without restrictions.

Assessing the Impact of a Pilot Nutrition Curriculum on Students' Confidence and Ability to Perform Nutritional Assessments on Overweight Dogs and Cats for Use in a Veterinary Outreach Program

Obesity is a growing concern for dogs and cats. Although veterinary input is critical to prevent and manage obesity, conversations addressing overweight pets are challenging and require training to perform effectively. This study assessed the impact of a nutrition curriculum developed for use in a veterinary outreach program on student confidence and ability to perform nutritional assessments, particularly on overweight pets. The curriculum was developed by students and a Board-Certified Veterinary Nutritionist focusing on (1) performing nutritional assessments and (2) discussing the findings with owners. Initial implementation and evaluation occurred with 32 students. Pre-study and post-study surveys were conducted asking students to rank their confidence in 14 aspects related to nutritional assessments, determine opportunities for change from a case summary, and describe their experience using the materials. Five students in the outreach program performed an additional nutritional assessment and developed a plan for a hypothetical case. Results were analyzed for significance via the likelihood ratios Chi-square and Wilcoxon signed-rank tests. Students showed significant increase in confidence for 11 of the 14 questions and significant improvements at determining opportunities for change (p < .05). Feedback was positive and supported the feasibility of using the materials with the outreach program. Overall, the findings support that the curriculum provides a positive learning experience and prepared veterinary students for performing nutritional assessments and creating management plans for obese pets. This article introduces the curriculum as a successful model for providing access to additional self-paced curricular units to veterinary students.

Recording of body weight and body condition score of cats in electronic health records from UK veterinary practices

OBJECTIVES

The aim of this study was to determine how frequently body weight, body condition score (BCS) and terms pertaining to weight status are recorded in the electronic health records (EHRs) of veterinary practices in the UK, as well as to examine the variables affecting recording and associated with body weight, where recorded.

METHODS

Data recorded in EHRs were searched in two 3-month periods in 2019 and 2020. For each visit, variables including type and time of consultation, signalment, recording of body weight, recording of BCS, weight (kg), BCS value and whether an overweight or weight-loss term was used in free text were recorded. Linear mixed-effects models were created to examine associations between body weight and variables, while mixed-effects logistic regression was used to determine associations between the same variables and weight or BCS recording.

RESULTS

The statistical data set comprised 129,076 visits from 129,076 cats at 361 practices. Weight was recorded at most (95.2%) visits, BCS was recorded at only 22.5% of visits, and terms associated with weight loss and overweight status were recorded in 10.0% and 7.2% of free-text records, respectively. Where BCS was recorded, approximately one-third of cats had an overweight score (8.0% of total visits). Using either an overweight term (P <0.001) or weight-loss term (P <0.001) was associated with increased odds of body weight being recorded, while being an out-of-hours (P <0.001) or non-routine consultation (P <0.001) were associated with decreased odds. Increasing age (P <0.001), using a weight-loss term (P <0.001) and using an overweight term (P <0.001) were associated with increased odds of BCS being recorded, while being a non-routine consultation (P <0.001) was associated with decreased odds. Recording BCS was negatively associated with recording body weight and vice versa.

CONCLUSIONS AND RELEVANCE

Cats are regularly weighed in UK practice, but BCS is less frequently recorded, and both are less often recorded in non-routine consultations. To improve both the treatment and assessment of health and nutrition in cats, veterinary professionals should record body weight and BCS concurrently at every consultation.

Small animal general practitioners discuss nutrition infrequently despite assertion of indication, citing barriers

OBJECTIVE

To determine what perceived factors prevent small animal general practitioners from discussing pet nutrition with clients during healthy and sick pet appointments.

SAMPLE

403 veterinarians in small animal general practice.

PROCEDURES

An online survey was used to gather veterinarians' opinions on perceived barriers, knowledge levels, and confidence regarding pet nutrition discussions.

RESULTS

Reported barriers to discussing nutrition during healthy pet appointments included client resistance to changing brand (149/359), time constraints (146/359), misinformation online (138/359), and difficulty keeping up with products (132/359). Reported barriers to discussing nutrition during sick pet appointments included client cost concerns (101/349), pet not accepting new food (99/349), and time constraints (83/349). Veterinarians reported discussing nutrition less during healthy pet appointments, compared to sick pet appointments, and were significantly less confident with their knowledge regarding nontherapeutic food, compared to therapeutic food. Veterinarians also reported that they perceived conversations about therapeutic foods to be more positive than conversations about nontherapeutic foods, and veterinarians with more years in practice more commonly reported that there was nothing that would dissuade them from discussing nutrition. Veterinarians who reported barriers to discussing nutrition described a need for resources and reliable information for health-care teams and clients.

CLINICAL RELEVANCE

Results demonstrated a substantial gap between veterinarians' assertion that nutrition conversations are indicated and the frequency with which they discuss nutrition during appointments. Veterinarians reported that they felt their nutrition conversations were frequently positive; therefore, it is important to overcome barriers to engage with clients about pet nutrition.

Weight loss and high-protein, high-fiber diet consumption impact blood metabolite profiles, body composition, voluntary physical activity, fecal microbiota, and fecal metabolites of adult dogs

Canine obesity is associated with reduced lifespan and metabolic dysfunction, but can be managed by dietary intervention. This study aimed to determine the effects of restricted feeding of a high-protein, high-fiber (HPHF) diet and weight loss on body composition, physical activity, blood metabolites, and fecal microbiota and metabolites of overweight dogs. Twelve spayed female dogs (age: 5.5 ± 1.1 yr; body weight [BW]: 14.8 ± 2.0 kg, body condition score [BCS]: 7.9 ± 0.8) were fed a HPHF diet during a 4-wk baseline phase to maintain BW. After baseline (week 0), dogs were first fed 80% of baseline intake and then adjusted to target 1.5% weekly weight loss for 24 wk. Body composition using dual-energy x-ray absorptiometry and blood samples (weeks 0, 6, 12, 18, and 24), voluntary physical activity (weeks 0, 7, 15, and 23), and fresh fecal samples for microbiota and metabolite analysis (weeks 0, 4, 8, 12, 16, 20, and 24) were measured over time. Microbiota data were analyzed using QIIME 2. All data were analyzed statistically over time using SAS 9.4. After 24 wk, dogs lost 31.2% of initial BW and had 1.43 ± 0.73% weight loss per week. BCS decreased (P < 0.0001) by 2.7 units, fat mass decreased (P < 0.0001) by 3.1 kg, and fat percentage decreased (P < 0.0001) by 11.7% with weight loss. Many serum metabolites and hormones were altered, with triglycerides, leptin, insulin, C-reactive protein, and interleukin-6 decreasing (P < 0.05) with weight loss. Relative abundances of fecal Bifidobacterium, Coriobacteriaceae UCG-002, undefined Muribaculaceae, Allobaculum, Eubacterium, Lachnospira, Negativivibacillus, Ruminococcus gauvreauii group, uncultured Erysipelotrichaceae, and Parasutterella increased (P < 0.05), whereas Prevotellaceae Ga6A1 group, Catenibacterium, Erysipelatoclostridium, Fusobacterium, Holdemanella, Lachnoclostridium, Lactobacillus, Megamonas, Peptoclostridium, Ruminococcus gnavus group, and Streptococcus decreased (P < 0.01) with weight loss. Despite the number of significant changes, a state of dysbiosis was not observed in overweight dogs. Fecal ammonia and secondary bile acids decreased, whereas fecal valerate increased with weight loss. Several correlations between gut microbial taxa and biological parameters were observed. Our results suggest that restricted feeding of a HPHF diet and weight loss promotes fat mass loss, minimizes lean mass loss, reduces inflammatory marker and triglyceride concentrations, and modulates fecal microbiota phylogeny and activity in overweight dogs.

Nutritional consulting in regular veterinary practices in Belgium and the Netherlands

Background

Increased interest in nutrition by dog and cat owners stresses the importance of providing tailored nutritional guidance for each patient by veterinarians. The World Small Animal Veterinary Association (WSAVA) has provided guidelines to help veterinarians implement this in every‐day patient care, by screening patients for the presence of nutritional risk factors, establishing tailored nutritional plans and providing adequate patient follow‐up tools.

Objectives

This study aimed to assess the use of nutritional assessments in companion animal practices, and to investigate differences between Dutch and Belgian veterinarians.

Methods

A survey was conducted among Dutch and Belgian veterinarians. Of the 423 respondents, 53% were from Belgium, and 47% were from the Netherlands.

Results

Only 21% had prior knowledge of the WSAVA nutritional assessment guidelines. General trends in the usage of nutritional assessments were similar in the examined countries. Aside from weighing, diet evaluation by collecting dietary information and body condition or muscle condition scoring were used infrequently, mostly due to insufficient knowledge of the methods. Nutritional recommendations were often made as part of a treatment plan, and were mostly made by veterinarians, but in Dutch practices also by veterinary nurses.

Conclusion

Despite the fact that nutritional recommendations are a regular part of treatment plans, nutritional risk factors may be missed due to a lack of completely performed nutritional assessments. It remains important to promote the benefits of regular nutritional assessments to veterinarians, which will improve patients’ health.